Source: Plan Space

Both plan as well as non-plan expenditure on health have increased over these five years. Plan and non-plan investment in health and family welfare from 2012-13 to 2025-26 both in revenue and capital expenditure, percentage of health expenditure to total Government expenditure and percentage of health expenditure to GSDP are given in Table 6.2.10

Table 6.2.10 Investment in Health and Family Welfare (Rs in crore)

Source: Budget in Brief, DES
Note: ACC - Accounts, RE - Revised Estimate BE - Budget Estimate * Not estimated

Plan expenditure by other Departments included various departments viz. Excise, Industries, Science and Technology, Fisheries, Cultural Affairs, Sports and Youth Affairs, Social Justice, Women and Child Development, Scheduled Castes Development, Scheduled Tribes Development, Labor Department and LSGD.

Kerala Infrastructure Investment Fund Board (KIIFB)

KIIFB has undertaken 102 major health infrastructure projects with a total sanctioned cost of Rs 12,324.91 Cr, of which Rs 6,648.90 Cr has financial sanction and Rs2,609.41 Cr spent so far. This reflects a 21.2% utilisation of the total sanctioned amount and 39.2% utilisation against the financial sanction. The projects cover modernization of medical colleges, cancer centres, and upgradation of district/taluk hospitals, along with procurement of medical equipment and development of isolation wards. It reflects strong focus on both infrastructure and preparedness.

Major Health Problems in Kerala

Non-Communicable Diseases (NCD)

Common non-communicable diseases causing great threats to a healthy life are diabetes, hypertension, cardiovascular diseases, cancer and lung diseases. Unless interventions are made to prevent and control non-communicable diseases, their burden is likely to increase substantially in future because of an ageing population and lifestyle changes. Considering the high cost of medicines and longer duration of treatment, this constitutes a greater financial burden to low-income groups. Drastic lifestyle changes, heavy dependency on alcohol and tobacco, an affinity for white-collar jobs, unhealthy eating patterns, low priority for physical exercise, and high levels of stress in all strata of the population are some of the reasons contributing to the prevalence of non-communicable diseases in the State.

NCD control programme covers the entire State spreading across all districts and the services rendered through all district/general hospitals, sub-district level hospitals, Community Health Centres, Primary Health Centres and even the Sub centres which cater to a population of five thousand. Kerala is the only State where the entire health system is equipped with an NCD screening programme.

Amrutham Arogyam

Amrutham Arogyam is a State run Non Communicable Diseases Control programme. The objectives of the programme include 1. Reduction of risk factors in the population 2. Health education for the population on a healthy diet, exercise and ill effects of addiction 3. Screening for the population above 30 years of age for Non-Communicable Diseases irrespective of their disease conditions and free supply of medicines for all detected with NCDs and 4. Early management and treatment of complications. Amrutham Arogyam programme covers the entire State spreading across all districts and the services rendered through all district/general hospitals, sub-district level hospitals, Community Health Centre, Primary Health Centre and even the 5415 Sub centre which cater to a population of five thousand. Kerala is the only State where the entire health system is equipped with an NCD screening programme. The population above 30 years was subjected to screening at the Amrutham Arogyam clinics for NCDs.

Kerala COPD Prevention and Control Programme -SWAAS

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and morbidity worldwide. As per the Global Burden of Diseases (Institute for Health Metrics and Evaluation (IHME) at the University of Washington) estimates for India, COPD is the second leading cause of mortality in India. Recently the NCD programme has included COPD and Chronic Kidney Disease among the priority NCDs in India. SWAAS is a specific public health programme for COPD in Kerala which is implemented from the Family Health Centres (FHC) level as part of the Aardram Mission. SWAAS clinics were started in 685 Family Health Centres and 49 Sub Districts/District Hospitals. Based on the 2025-2026 (up to October 31) data, the SWAAS clinics screened 204,149 symptomatic patients, with 22,429 of those undergoing definitive Spirometry screening, ultimately leading to 16,440 diagnoses of COPD and 12,728 diagnoses of Asthma.

India Hypertension Management Initiative (IHMI)

The India Hypertension Management Initiative (IHMI) is a collaborative project of the Indian Council of Medical Research (ICMR), Ministry of Health and Family Welfare (MoHFW), Government of Kerala, World Health Organization (WHO) and Resolve to Save Lives initiative of Vital Strategies. Kerala State also fused diabetes control and monitoring along with IHMI. The initiative is implemented in all districts. The IHMI is focused on five essential components of scalable treatment of hypertension, based on the WHO HEARTS Package. Based on the programme data as on 31 October 2025, the hypertension control rate improved significantly from 13% to 41%, while the defaulter rate was nearly halved, dropping from 55% to 27.6%, with all diagnosed individuals being consistently tracked via patient cards, registers, and follow-up by field staff.

Nayanamritham- Diabetic Retinopathy Screening

Diabetic Retinopathy is a common complication of longstanding Diabetes Mellitus which can end up in total loss of vision. Complete effective treatment of diabetic retinopathy is available if the condition is detected in the early stages. With the technical support provided by E-health, the Health Services Department has implemented a care pathway in the public health system involving the primary centres, secondary centres and tertiary care centres. This programme is being implemented in all districts covering 172 FHCs of Kerala. ASHA workers and other field workers play an active role in identifying diabetic patients in the community and encouraging them to take part in the screening programme. 313 cases of Diabetic retinopathy / AMD and 118 persons with Glaucoma identified in Phase 2 with the help of AI system till August 31, 2025.

Population-Based Screening

In Kerala even though there is clinic-based data on the prevalence of Non-Communicable Diseases, there is no population-based registry of these diseases. The State has initiated population-based screening of non-communicable diseases in four districts with the support of ASHA volunteers who would visit the houses in their jurisdiction and collect information on the status of non-communicable diseases and their risk factors. Based on this data camp based and home-based screening will be conducted for those who are unaware of their NCD status, and the total data will be consolidated at the Health Centre level, District level and State level. An android application was developed by E-health for data collection `which is used by ASHA workers.

Shaili App

The Government of Kerala has launched an Android App Shaili, aimed at diagnosing and controlling lifestyle diseases among the people in the State of Kerala. The app has been set up as part of the population-based screening project launched by the Health Department under the Nava Kerala Action Plan. The Accredited Social Health Activist (ASHA) workers have been tasked with collecting information from persons over the age of 30 in their respective areas about any lifestyle diseases or risk factors they may have. The app was set up under the E-Health initiative. The app would primarily collect information about diseases like diabetes, high blood pressure, heart disease, and lung diseases as well as other lifestyle-related ailments and cancers. The health status of the individuals would be scored and those with a score of above four would be asked to visit the nearest health centre for a check-up for lifestyle diseases.

Apart from the diseases surveyed in the Shaili 1 survey, mental health, blindness, deafness and leprosy are also covered in the Shaili 2 survey. The details of screening done as part of population-based screening during Shaili 1 (up to 15th February 2024) and Shaili 2 (after 15th February 2024) are given in Table 6.2.11.

Table 6.2.11
The details of screening done on population-based screening

Source: shaili.ehealth.kerala.gov.in as on 12.10.2025

Stroke Management (SIRAS- Stroke Identification Rehabilitation Awareness and Stabilisation Programme)

Stroke is a complication of Hypertension, which occurs due to an occlusion of blood vessels due to a clot or haemorrhage of cerebral vessels. Stroke Management is time-bound and the recovery depends on the time frame within which the patient reaches the treatment centres which is usually 4 hours. Stroke Management is complicated as the management requires specialised skills, infrastructure and expensive medicines for stroke thrombolysis. The health department started the stroke management programme SIRAS by training the Physicians in stroke management at SCTIMST and setting up stroke ICUs in the district hospitals which have CT scans and Tele Radiology services. Twelve District Hospitals have started functioning stroke clinics and the rest of the districts are completing stroke ICUs. During 2025-26 (upto October), 406 thrombolysis procedures were conducted.

Diabetic Foot Clinics (Padasparsham)

Diabetic foot is a major complication of long-standing diabetes and may result in loss of limbs if not detected at an early stage. Medical Officers were given training on diabetic foot management by the Indian Institute of Diabetes. There are 84 Diabetic foot clinics functional in the State up to Taluk Hospitals.

360 degree Metabolic Centre of Excellence

As a part of the mission to control lifestyle diseases an exemplary centre named 360 Degree Metabolic Centre of Excellence started functioning at Ernakulam General Hospital, by the Government of Kerala with external support. The patient gets a unique ID once they register at the centre. They can then move towards the Pre-Clinical area where Basic information such as Patients height, weight, Blood Pressure, etc. are monitored and recorded. With the help of advanced point of care (POC) devices, a patient gets the test results within a short duration from the lab. After analysing the lab reports, if required, the doctor guides the patient for further tests and steps such as nutritional counselling, Physiotherapy, Pulmonary function test, Retinal Scanning, Diabetic foot assessment, etc. which are available under one roof. Treatment Summary including test results, diagnosis etc. are collected using database management systems, and the data is saved for future reference. A patient gets the complete treatment summary when they leave the centre. Using a tele-calling facility patient gets a reminder call before few days before the scheduled follow-up date. During 2025-26, this project is started in 11 more Distrct/ General/Taluk Head Quarters Hospitals.

Arogyam Anandam - Akattam Arbudham

Arogyam Anandam - Akattam Arbudham is Keralas largest-ever cancer screening campaign launched on World Cancer Day (Feb 4, 2025), with Phase 1 focusing on Breast and Cervical Cancer for women aged 30+, and Phase 2 targeting Oral and Colorectal Cancer in men. Details of cancer screening done on Arogyam Anandam as on 07/10/2025 is given in Table 6.2.12.

Hridayapoorvam (CPR Training)

Cardiovascular diseases (CVD) remain the leading cause of premature mortality, with one in five people dying early from CVD. Evidences show that up to 80 percent of heart disease and stroke cases are preventable through timely awareness and preventive action. Reports of sudden unexpected deaths following collapse have further underscored the urgent need for timely Cardiopulmonary Resuscitation (CPR), a simple but lifesaving intervention. As of now more than 26,864 people has been trained.

Hridyam

Hridyam is a web-based platform launched in August 2017 for the early identification, treatment, and continuous follow-up of congenital heart diseases in children up to 18 years of age. It ensures screening for heart disease for all babies born in government hospitals, enables web-based tracking from birth to 18 years, and facilitates surgeries through empanelled public and private hospitals, with 25,980 children registered and 8,516 surgeries or interventions completed so far.

Table 6.2.12
Cancer screening done on Arogyam Anandam

Source: Directorate of Health services as on 07/10/2025

Indian Institute of Diabetes

The Indian Institute of Diabetes (IID) at Thiruvananthapuram is an autonomous institution under the Government of Kerala. It is the only institution under the Government offering services exclusively for Diabetes Mellitus and its complications. IID, made operational in the year 2001, functions with the main centre at Pulayanarkotta near Akkulam in Thiruvananthapuram city. The major activities of this institute are to investigate the genetic basis of diabetes, provide adequate training for physicians and paramedical staff, provide research support to develop novel methods of treatment, endow academic chairs in diabetes and organise State-of-the-art conferences on various aspects of the disease. The total bed strength of the IID is 40. The average number of new cases detected every year is nearly 6000. Patients treated in 2024-25 were 74409, IP were 341 and new cases were 8664. In 2025-26 (up to August 31) IP, OP and new cases were 187 numbers, 33388 numbers and 3704 numbers respectively. Number of community medical camps conducted during 2024-25 was 22 and in 2025-26 (up to August 31) is 7.

Cancer

Cancer is a major non-communicable disease in Kerala. Apart from Medical Colleges, the Regional Cancer Centre, Malabar Cancer Centre and Cochin Cancer Research Centre are the major hospitals in the Government sector which offer treatment for cancer patients. Apart from these institutions, all the major Government hospitals provide cancer treatment. Delays in early detection, huge treatment costs, minimal treatment centres and lack of awareness contribute to high mortality of the disease.

Kerala has established a comprehensive Cancer Grid to seamlessly link health facilities and ensure range of care, with cancer screening available at all levels from Family Health Centres to Medical Colleges and dedicated cancer screening clinics in every facility. A digital Cancer Care Suite supports the entire pathway from screening to diagnosis, treatment, and follow-up, complemented by the Kerala Cancer Registry for systematic data management, and preparations are underway to introduce HPV vaccination soon as part of cervical cancer prevention efforts.

The State Health Department has launched a decentralized cancer treatment plan to conduct cancer screening and treatment. The district hospitals and selected taluk hospitals are equipped to diagnose cancer and provide treatment decisions including chemotherapy. This service has been made available in 28 hospitals in the State and steps are being taken to expand it to more hospitals. Apart from this, screening programme for the detection of cancers like breast cancer, lung cancer and uterine cancer have also been started in all primary health centres and family health centres. A massive survey was conducted by the health department through Asha workers to find out the cancer patients present in society. There are 28 units of daycare chemotherapy for giving follow-up chemotherapy treatment to patients diagnosed in major centres. District Cancer Control Programme report 2024-25 (up to October 31) is given in Table 6.2.13

Table 6.2.13
District Cancer Care Unit Report 2024-25 (up to October 31)

Source: Directorate of Health services

Malabar Cancer Centre

Malabar Cancer Centre, Kannur, an autonomous centre under the GoK, was established to provide oncology care to the people of north Kerala. The Centre has a bed strength of 353 and has many latest facilities for the treatment of cancer patients. In 2024-25, a total of 6406 inpatients and 120205 outpatients were treated in the Malabar Cancer Centre in new cases were 5633. During 2025-26 (up to 31.08.2025), the number of IP and OP are 2883 and 67166 respectively and new cases are 2459. The average number of new cases detected every year in the centre is 5253 (based on the last five years data). Total surgery done during 2024-25 was 3334 and during 2025-26 (up to August 2025) was 1614.

Unique Achievements of MCC

• Plaque brachytherapy was started for the first time in Kerala for eye cancers. Very few institutions in India perform this treatment. lt helps to preserve the eye in case of cancers of the eye.
• Robotic Surgical Systems: More than 200 complex robotic cancer surgeries were Performed.
• NABH Digital Health Standards- Silver level accreditation
• CAR-T Cell Therapy procedure: MCC is the second Government institution in the country to perform this latest cancer treatment
• New Treatment and Academic Block has been inaugurated
• Malabar Cancer Centre Innovation Incubation Nest (MIINT) for Start-Ups: This is the first government healthcare facility to start innovation and incubation centre in the state.
• Renovated Labs, Blood bank, Pharmacy and Operation Theaters
• Established Molecular Tumor Board and Personalized medicine facility in Cancer

Cancer Incidence

An estimated 9.7 million people died from cancer and 20 million new cases were reported globally in the year2022. In Kerala, cancer is becoming a public health concern due to socio demographic and epidemiological changes as well as the high prevalence of risk factors. With a population of 3.34 crore, Kerala is predicted to see over 66,000 new cases of cancer every year. Cumulative risk of developing cancer of any site in 0-74 years in Kerala is 1 in 7 in males and 1 in 9 in females. The five common cancers in males (n=20,829) were lung 4337 (20.8%), mouth 1524 (7.3%), stomach 1422 (6.8%), tongue 1076 (5.2%), and larynx 982 (4.7%), and in females (n=18,017), the common cancers were breast 5509 (30.6%), cervix 1395 (7.7%), ovary 1177 (6.5%), mouth 1009 (5.6%), and lung 714 (4%) as per the ten year trend based on HBCR in Northern Kerala (MCC-PGIOSR). A significant proportion of 19,786 (50.9%) of the patients were diagnosed at an advanced stage (Stage III and Stage IV) and only 10,182 (26.2%) of the patients were diagnosed at an early stage (Stage I and Stage II). The lung cancers in both males and females showed an increasing trend during the period from 2010 to 2020, as per Cancer registry in MCC (PGIOSR). (Source: Malabar Cancer Centre)

Cochin Cancer Research Centre (CCRC)

Growing concerns over the alarming increase in rates of cancer incidence together with the need for a dedicated tertiary cancer care and research centre. This necessitated the birth of the Cochin Cancer Research Centre. CCRC is a society registered under the Societies Act. The Centre has bed strength of 20 and an additional 100-bed facility will be ready during the financial year 2025-26. The average number of new cases detected every year is 1,200. Number of outpatients treated in 2024-25 was 10026, IP were 184 and new cases were 1153. In 2025-26 (up to August 31), the number of OP and new cases were 7395 and 883 respectively. The number of IPs during 2025-26 (up to August 31) was 120. The total number of surgeries conducted for the period was 173 and 107 respectively. The number of day care chemotherapy done during the period was 2558 and 1149 respectively.

Regional Cancer Centre (RCC)

RCC, Thiruvananthapuram is the premier comprehensive dedicated centre for diagnosis, treatment and control of cancer in Kerala. RCC is rated amongst the top 28 RCCs in the country and maintains a working relationship with international bodies. Daily average patient visits in RCC in 2024-25 are 863. Over the past thirty-nine years, RCC has been able to contribute significantly to the increasing needs of cancer care to the people of Kerala and adjoining areas of Tamil Nadu and Karnataka at the lowest possible cost. In 2024-25, 14770 new cases, 247684 review cases and 12652 in-patient admissions were done in RCC. Daily average patient visits are 879. Bed strength of RCC is 298. Further details on RCC are covered in section 5.2 of this review.

Mental Health

As per the Census of India 2011, 0.20 per cent of the population of Kerala suffers from mental illness and 0.20 per cent suffers from intellectual disability compared to a national average of 0.06 per cent and 0.12 per cent respectively. Since Kerala reports higher levels of mental illness more attention has not been given to the field of mental health in Kerala. A mental health policy was approved by the State Government in May 2013. The policy suggests that the treatment for mental illness should be started from the PHCs making the mental hospitals and the Department of psychiatric medicines as referral centres by upgrading them. As part of the Aardram Mission, Aswasam depression management in primary care was started in 471 Family Health Centres across the State. A total of 2.66 lakh persons were screened for depression in Kerala, with 30,775 individuals diagnosed and provided with psychosocial support and pharmacotherapy.

Sampoorna Manasikarogyam

Sampoorna Manasikarogyam is a comprehensive model of sensitization, mental health training, case detection campaigns and camps, enabling the detection of the unidentified case burden in the community. Their integration into primary care clinics enables follow-ups, overcomes treatment gaps and improves access to mental health care. Up to 31st August 2025, it was implemented in 642 Grama Panchayats. A total of 19,161 ASHA workers have been trained, 37,847 people have been newly identified and linked to care, and 60,205 individuals are currently on treatment, reflecting strong community-level outreach and continuity of care.

In Kerala, three mental health centres are functioning with bed strength of 1,366. District mental health programme are functioning in all the districts with a total of around 10,000 outpatients per month. Rehabilitation facilities are offered through these Centres. Lack of awareness, attitude of the general public, neglect of family members and lack of proper follow-up are the major problems noticed in this regard. The State Government has started 31 daycare homes through which 502 cured mentally ill patients are being given daycare.

Amma Manass programme is a maternal mental health initiative that screens and treats psychological issues in pregnant and postpartum women, contributing significantly to reducing suicides from 18 in 2019-20 to just 4 in 2024-25.

District Mental Health Programme (DMHP)

DMHP is functioning in all the 14 Districts of the State. Mental health clinics are being conducted in all PHCs and CHCs in the District by trained doctors of the institutions and medicines are made available to patients from their nearest PHCs. More than 50,000 patients are receiving treatment every month from DMHPs in the State. Other activities include information, education and communication (IEC) for the public to create awareness and reduce stigma, training for doctors, nurses, pharmacists and health workers for integration of mental health into primary care and targeted interventions such as substance abuse prevention, suicide prevention, geriatric mental health and stress management. Daycare centres were started for the mentally ill in remission under the Comprehensive Mental Health Scheme. Now 31 day care centres are functioning in the State under the scheme. School mental health programme is implemented in the State in association with the National Health Mission (NHM).

Institute of Mental Health and Neurosciences (IMHANS)

The Institute of Mental Health and Neurosciences (IMHANS), Kozhikode is an autonomous institution established by the Government of Kerala in 1982. The institute is functioning in the Government Medical College campus, Kozhikode. The institute now runs M.Phil. courses in psychiatric social work (8 seats), clinical psychology (8 seats), post-basic diploma in psychiatric nursing (10 seats) and has also 3 seats for PhD. In clinical services, the institute currently focuses on community psychiatry, child psychiatry and rehabilitation services. IMHANS has no inpatient facility at present. During 2024-25 number of OP cases was 24818 with which new OP cases were 8915 and it was 10011 cases and 3875 cases respectively during 2025-26 (up to August 31).

Institute for Communicative and Cognitive Neurosciences (ICCONS)

The Society for Rehabilitation of Cognitive and Communicative Disorders (SRCCD) is a Charitable society registered under the Travancore Cochin Literary, Scientific and Charitable Societies Act 1955. SRCCD has established the ICCONS at Thiruvananthapuram and Shoranur to promote scientific research, clinical services and advanced education and training in the field of communicative and cognitive neuroscience and disabilities. Institute for Communicative and Cognitive Neurosciences (1CCONS) is a pioneer institution under Govt. of Kerala for the comprehensive management, rehabilitation, education, research and development in the field of developmental and acquired disabilities from infancy to elderly such as Autism, Learning Disability, Mental retardation, Cerebral palsy, single and multiple congenital abnormalities, epilepsy, post-stroke and post-traumatic syndrome and various degenerative disorders affecting the nervous system. The centre gives specific emphasis to conditions that interfere with cognitive, language and motor functions. A multidisciplinary team consisting of Neurologists, Pediatricians, ENT specialists, Audiologists, Speech Language Pathologists, Clinical Psychologists, Physiotherapists and Special Educators are involved in the rehabilitative services provided by the institution. The institute provides inpatient and outpatient services and rehabilitation programme such as speech therapy, behavioural training, physiotherapy and linguistics training to the above-mentioned group of patients regularly. The ICCONS Shoranur has a 60-bed inpatient ward with Neuro-ICU for emergency services and an advanced fully automated Neuro-endocrine and metabolic lab & electro-physiology lab ready for patient service. The centre is giving treatment to children, adults and the elderly with various acquired and developmental disabilities such as autism, mental retardation, cerebral palsy, single and multiple congenital anomalies post-stroke and post-mental traumatic syndrome, adult aphasia, dementia etc. ICCONS is conducting a four-year course in graduate Audiology and Speech-Language Pathology (BASLP) at ICCONS Shoranur. It is affiliated with KUHS and has the recognition of the Rehabilitation Council of India. The annual intake of students is 20. Number of patients treated during 2024-25 in Thiruvananthapuram centre was 20820 and in Shoranur centre was 25601. New registration in two centers during 2024-25 is 1167 and during 2025-26, it is 504 (up to August 31).

Prevalence of Anaemia

The findings of the NFHS-5 (2019 - 2021) reveal that there has been an increase in the prevalence of anaemia among women and children compared to NFHS-4, 2015-16. Kerala is the only State to have recorded a prevalence of less than 40 per cent in all targeted age groups. The Anaemia Mukt Bharat (AMB) strategy was launched in 2018 to reduce Anaemia prevalence among children, adolescents and women in the reproductive age group. Anaemia Free Kerala aims to strengthen the existing mechanisms imparted as part of Anemia Mukth Bharth and foster state-specific newer strategies for tackling anaemia. Details of Anaemia prevalence in Kerala as per NFHS 5 compared to NFHS 4 are given in Table 6.2.14.

Table 6.2.14
Anaemia prevalence in Kerala as per NFHS 5 compared to NFHS 4

Source: NFHS 5, NFHS 4

Even though various State as well as GoI schemes are being undertaken to mitigate Anaemia, it still exists. Hence GoK decided to conduct a statewide campaign and it is progressing.

VIVA Project

VIVA (The abbreviation of Vilarchayil Ninnum Valarchayilekku in Malayalam) is an anaemia prevention project which is launched on 18-02-2023. This project is jointly organized by the departments of Health and Family Welfare, LSGD and Women & Child Development of the Government of Kerala. The campaign aims at anaemia screening, treatment and awareness among girls and women aged 15 to 59 years. According to the World Health Organization, 42 per cent of children under the age of five and 40 per cent of pregnant women in the world are anaemic. According to the National Family Health Survey-5 in India 2022, the prevalence of anaemia among children under 5 years of age, pregnant women and lactating mothers in India is 40 per cent, 32 per cent and 40 per cent respectively. According to the National Family Health Survey, Kerala has the lowest rate of anaemia in India. However, the aim is to make Kerala anaemia-free among women through effective interventions. 54,79,889 women have been tested during the first phase of the campaign.

Communicable Diseases

Kerala is witnessing an increasing burden of communicable and non-communicable diseases. Although the State has been successful in controlling several communicable diseases earlier, the prevalence of nipha, dengue, leptospirosis, malaria, hepatitis, H1N1, scrub typhus, and COVID-19 in recent years has led to considerable morbidity and mortality. Instances of vector-borne diseases such as dengue, malaria and scrub typhus incidents have been seen in many Districts. Waterborne infections such as different kinds of diarrhoeal diseases, typhoid and hepatitis are also reported in many districts.

Prevalence of Major Communicable Diseases

A comparative analysis of the prevalence of major communicable diseases over the last five years is given in Table 6.2.15.

Table 6.2.15
Prevalence of communicable diseases in Kerala

Source: Directorate of Health Services

Dengue

Dengue fever, which surfaced in Kerala as early as 1998, has now become the single largest vector-borne disease in the State. Till 2015, this disease was more prevalent in districts such as Thiruvananthapuram, Kollam, Kottayam, Pathanamthitta, Kozhikode and Malappuram. But in 2017, all the districts reported dengue and that too in large numbers. Districts located at higher altitudes had low prevalence, but all others showed a high incidence of the disease. These mosquitoes, which in the earlier days were seen more in rural settings, now spread to urban areas also. District-wise number of patients treated, and deaths reported affecting dengue fever from 2021 to 2025 (up to September 15, 2025) are given in Table 6.2.15.

Leptospirosis

Leptospirosis is another public health challenge faced by the State. It was considered a rare disease in early 1980, but later it spread to all districts. The disease was seen initially as a rodent-borne infection, spread through the urine of the infected rodents and the consequent contamination of the environment. Over the years, the disease has been reported in many domestic animals such as cows, dogs and pigs and thus has become an occupational risk for those engaged in agriculture works. People, who have been involved in cleaning stagnant canals and drains, were reported to have contracted the disease. More recently the mortality due to leptospirosis is also on the rise and joint efforts of veterinary and animal husbandry departments are essential for effective control of this disease. District-wise number of patients treated, and deaths reported affecting Leptospirosis in 2024 and 2025 (up to August 31, 2025) are given in Appendix 6.2.1 and the number of cases and deaths reported from 2021 to 2025 (up to September 15, 2025) are given in Table 6.2.15.

Chikungunya

This disease is believed to have originated in the remote islands in the Arabian Sea in 2005-06 and spread rapidly over the whole of Kerala within the next two years, affecting more than 80 per cent of our population. This has resulted in lifelong immunity for the affected population. In 2022, 66 cases were reported in Kerala. Here again, the vector responsible for disease transmission is the Aedes mosquitoes. Since both dengue and chikungunya are transmitted by the same mosquito and as the same mosquitoes are responsible for the transmission of the potential threat of Zika virus disease and Yellow fever, the health system is vigilant. In 2024, 29 cases were reported of which 15 cases were from Thiruvananthapuram District. In 2025 (up to August 31), 35 cases were reported, of which 29 were from Thiruvananthapuram only. The details of district-wise patients treated for chikungunya and deaths reported in 2024 and 2025 (up to August 31) are given in Appendix 6.2.2 and the number of cases and deaths reported from 2021 to 2025 (up to September 15, 2025) are given in Table 6.2.15.

A total of 2879108 viral fever cases were reported in Kerala in 2024. In 2025 (up to August 31), the number of reported cases was 18,56,136. The details of district-wise patients treated for viral fever in 2024 and 2025 (up to August 31) are given in Appendix 6.2.2 and the number of cases and deaths reported from 2021 to 2025 (up to September 15, 2025) are given in Table 6.2.15.

Malaria

Malaria, a vector-borne disease transmitted by Anopheles mosquitoes, has been a major public health challenge for our country for the past many decades. Various national programme targeting its elimination have met with limited success. Though Kerala had controlled the disease in the early 1970s, Malaria incidents still exist as a public health challenge. The problem has recently aggravated because of the presence of large-scale population movement from malaria endemic States. The proportion of falciparum malaria, the more severe form of the disease also exists in Kerala. Though the elimination of the Indigenous form of Malaria has been included in the SDG targets by the State, the issues in its fulfilment are many. Rapid urbanisation, extensive infrastructure development in many districts, uncontrolled construction works in urban areas and climate-related changes in the life cycle of mosquitoes are big hurdles in the attainment of the SDG goals. Annual cases of malaria in Kerala are less than 500 and the number of deaths reported is also very low. Kasaragod District has persistently had a high number of malaria cases, over many years, because of its proximity to the highly endemic districts of Karnataka. The movement of fishermen along the western coast of our State is a potential threat to the spread of malaria along the coastal districts. In 2024 number of cases reported was 952 and death reported was 6. In 2025, up to August, 788 cases and 2 deaths were reported. The number of malaria cases and deaths has been increasing over the years in Kerala. Number of cases and death from 2021 to 2025 (up to September 15, 2025) are given in Table 6.2.15.

Japanese Encephalitis (JE)

This is a form of encephalitis, an inflammatory disease of the brain and its coverings, and is also a mosquito-borne infection. Kerala is more prone to this disease because of the presence of large paddy fields as the virus responsible for the disease is spread by Culex mosquitos, which breeds abundantly in water-logged areas of paddy fields. The peculiar nature of the Culex mosquito to breed in contaminated water increases the potential threat in other areas as well. The role of migratory birds in the transmission of JE is an extra risk for Kerala because our State has many sanctuaries for migratory birds. But since there is an effective vaccine against JE, we can be optimistic in its control programme, by strengthening the JE vaccination. In 2024, ten cases and four deaths were reported. No cases and deaths have been reported in 2025 (up to August 31). Details of cases and deaths from 2021 to 2025 (up to September 15, 2025) are given in Table 6.2.15.

Waterborne diseases

The waterborne disease is mainly attributed to the unavailability of safe drinking water in many parts of the State especially in tribal and coastal areas. Unhygienic drinking water sources such as wells, pump houses, water supplied through tanker lorry, leaks in public water supply pipes and the consequent mixing of foul water with drinking water, dumping of wastes including sewage in water sources, use of commercial ice in preparation of cool drinks and using unsafe water in preparation of welcome drinks are some reasons for the spread of water-borne diseases. The Health Department has implemented a programme called "Jagratha" since November 2017 for the prevention and control of communicable diseases. There has been a considerable increase in incidents of typhoid, Hepatitis -A, Cholera and ADD (diarrhoea) in Kerala since 2021. Details of cases and deaths due to waterborne diseases of Acute Diarrhoeal Diseases (ADD), typhoid and Hepatitis from 2021 to 2025 (up to September 15, 2025) are given in Table 6.2.16.

Table 6.2.16 Prevalence of waterborne diseases in Kerala

Source: Directorate of Health Services

HIV/AIDS

Kerala State Aids Control Society is the pioneer organisation in the State working to control the spread of HIV as well as strengthen the States capacity to respond to HIV/AIDS. The society was formed to implement the National Aids Control Programme in the State. The current phase of the AIDS Control Programme (NACP-V) is from 2021 to 2026. The critical targets for achieving the 2030 SDG goals are for 95 per cent of people living with HIV to know their HIV status, 95 per cent of people who know their HIV status to receive treatment and to reduce HIV transmission by 95 per cent of people on treatment by 2025. The prevalence rate in the State has declined from 0.21 per cent in 2008-09 to 0.13 in 2010-11 and 0.06 per cent in 2021. The prevalence rate in India in 2021 is 0.21 per cent. In Kerala, the prevalence of HIV/AIDS is 0.41 per cent (4.95 per cent in 2011) among injecting drug users (IDU) which is 6.26 per cent at the national level. It is 0.23 per cent (0.36 per cent in 2011) among men having sex with men (MSM) which is 2.69 per cent at the national level and 0.10 per cent (0.73 per cent in 2011) among Female Sex Workers (FSW) which is 1.56 per cent in India in 2017. Among transgender, the HIV prevalence rate in Kerala is 0.16 per cent which is 3.14 per cent at the national level. HIV prevalence among migrants in India is 0.51 per cent (Source: Kerala State Aids Control Society). HIV estimates in India and Kerala based on India HIV Estimates 2023 are given in Appendix 6.2.3.

Coronavirus Disease (COVID-19)

The first case of Covid-19 in India was reported in Kerala on January 30, 2020. Kerala adopted a multi-pronged strategy in dealing with the pandemic even before the first Covid-19 confirmed case was reported. Keralas response to COVID-19 started much earlier than March 11, 2020, when the Director General of the World Health Organisation (WHO) characterised COVID-19 as a pandemic. The containment strategies were well in place when the first case was reported. From the beginning of COVID-19 control activities, the private hospital engagement team was working in close liaison with the district private hospital engagement nodal officers, private hospital managements and the Indian Medical Association. Kerala Medical Services Corporation Limited has played the most critical role in the ambulance services by managing the Kaniv-108 ambulances to mobilise the COVID-19 suspects/patients from their houses/exit points to the isolation facilities. During the coronavirus outbreak in Kerala, it was decided to provide psychosocial support Ottakkalla Oppamundu to the persons in quarantine/isolation and their family members. State-level trainings were conducted exhaustively and elaborately covering all staff working in the health sector. Ward-level teams were active in all Panchayats and were ensuring daily calls and visits to the homes of the elderly. A series of mass media campaigns were being conducted for COVID-19 awareness from the beginning of 2020. Health Department launched e-Sanjeevani telemedicine services in Kerala on June 10, 2020. They were providing services in a centralised manner and DISHA is the States hub managing the telemedicine activities for the State.

Public Health Laboratories

At present, there are 9 Public Health (PH) Labs in the State. There is State Public Health Lab at Thiruvananthapuram, Regional Public Health Labs at Ernakulam, Kozhikode, Pathanamthitta, Kannur, and Public Health Labs at Alappuzha, Malappuram, Wayanad and Kollam. Technical Guidance and material supply to all the PH labs are provided by the Director, of the State Public Health and Clinical Lab. An average of 150-200 patients attends the laboratories every day for various lab investigations. An average of 1300 lab tests are performed every day. State PH lab is the WHO referral laboratory for Vaccine Preventable Diseases (VPD). Two-year Diploma MLT course is conducted regularly for 15 students/ batch.

Newborn Screening (NBS) Programme (2013-23)

The Newborn Screening (NBS) Programme started in March 2013 and was extended to all the Government hospitals in September 2017. The blood samples of newborns are tested through the State Public Health and Clinical Laboratory, Thiruvananthapuram and three Regional Laboratories at Ernakulam, Kozhikode and Kannur. The screening test is done for four selected disorders namely Congenital Hypothyroidism, Congenital Adrenal Hyperplasia, Phenyl Ketonuria and G6PD deficiency. The director of the State PH Lab is the State Nodal officer for the newborn screening programme of Kerala. The cumulative total number of samples received for NBS in four PH Labs from April 2013 to March 2025 comes to a total of 1242347 of which positive Congenital Hypothyroidism (684 cases), Congenital Adrenal Hyperplasia (181 cases), G6PD deficiency (465 cases) and Galactosemia (31 cases) were detected.

Kerala Centre for Disease Control and Prevention (K-CDC)

Kerala continues to face a dual burden of emerging and re-emerging infectious diseases along with an increasing prevalence of non-communicable diseases. In recent years, the state has encountered health challenges such as Nipah virus, Zika, amoebic meningoencephalitis, and the COVID-19 pandemic. The high mobility of Keralas population, combined with frequent climate-related disasters like floods and zoonotic outbreaks, has further increased its vulnerability to epidemics and public health crises. To address these challenges, the Government of Kerala established the Kerala Centre for Disease Control and Prevention (K-CDC). The centre is envisioned as a scientific institution capable of providing evidence-based and context-specific responses to public health threats. It will work collaboratively with existing departments by synthesizing data from multiple sources and developing strategies to predict, prevent, and manage outbreaks, epidemics, and pandemics. The primary goal of K-CDC is to strengthen Keralas health system through integration, data-driven decision-making, and proactive public health management, ensuring the state remains resilient against current and future health challenges. The K-CDC will operate through three main components: 1. Leveraging the One Health concept for comprehensive disease prevention and control 2. Establishing a Public Health Emergency Operations Centre to coordinate rapid responses 3. Organizing activities under fourteen specialized divisions to ensure focused and effective functioning.

Family Welfare Programme

Family Welfare Programme was a 100 per cent CSS during several plan periods and the funding pattern and the financing components of CSS have been changed w.e.f 2016-17 financial year. Central assistance has been limited to the salary of the regular staff engaged in the implementation of the Family Welfare Programme in the State. Now the programme is being implemented as a part of the National Health Mission (NHM) and DHS.

Delivery and Maternal Mortality Ratio

Based on the last 10 years data DHS, the deliveries in Government hospitals were seen at around 30 per cent. Maternal Mortality Ratio in Kerala is 30, it is 88 in India (Source: Special Bulletin on MMR 2021-23). The details of deliveries in public and private hospitals since 2012-13 are given in Table 6.2.17.

Table 6.2.17
The details of deliveries in public and private hospitals since 2012-13 in Kerala

Source: DHS

Immunisation Coverage

Immunisation is one of the most successful and cost-effective health interventions and prevents debilitating illness, disability and death from vaccine-preventable diseases such as diphtheria, hepatitis A and B, measles, mumps, pneumococcal disease, polio, rotavirus diarrhoea, tetanus etc. The coverage of immunisation programme in Kerala for five years from 2020-21 is given in Appendix 6.2.4.

Health Care Institutions

In Kerala modern medical services are offered by the Directorate of Health Services (DHS) and the medical education is dealt with by the Directorate of Medical Education (DME).

Health Care Institutions under DHS

At present there are 1,289 health institutions with 38525 beds, 6582 doctors, 14528 nursing staff and 7590 paramedical staff under Health Services Department consisting of 849 PHC/FHCs, 226 CHCs/Block FHCs, 88 taluk headquarters hospitals, 18 District hospitals, 18 general hospitals, 3 mental health hospitals, 10 women and children hospitals, 3 leprosy hospitals, 14 TB hospitals, 2 other speciality hospitals and 58 other hospitals. PHCs/ FHCs are institutions providing comprehensive primary care services including preventive care and curative care. CHCs/ Block FHCs and taluk level institutions form the basic secondary care institutions. District hospitals, general hospitals and maternity hospitals provide speciality services and some super speciality services. Category-wise major medical institutions and beds in Kerala, details of IP and OP cases, major and minor surgeries conducted DHS during 2024-25 and 2025-26 and medical and paramedical personnel under DHS are given in Appendices 6.2.5 , 6.2.6, 6.2.7 .

District-wise distribution of hospital beds in Kerala

District-wise distribution of hospital beds in Kerala is given in Figure 6.2.1 Thiruvananthapuram and Ernakulam districts have a higher number of beds as compared to other districts while Kasaragod, Idukki and Wayanad districts have a lesser number of beds. The bed population ratio in Kerala is 1:594 and it is 1:656 for modern medicine alone. The average doctor bed ratio in Kerala is 1:4 and it is 1:5 for modern medicine alone. The doctor-population ratio in Kerala is 1:2585. The population here is estimated for the year 2021. These figures reflect the status of the Government sector only and the figures will be much better if the private sector is also considered.

Figure 6.2.1 District-wise distribution of hospital beds in Kerala

Source: Various Health Departments / Institutions

Health Assurance

State Health Agency (SHA)

The State Health Agency is the nodal agency for implementing the health insurance scheme in the state.

Karunya Arogya Suraksha Padhathi (KASP)
Karunya Arogya Suraksha Padhathi (KASP) is the comprehensive health insurance programme of the Government of Kerala implemented through the State Health agency which includes Pradhan Mantri Jan Arogya Yojana (PM-JAY). GoK implemented PM-JAY as KASP. KASP converge all the Government-sponsored health insurance schemes namely, Rashtriya Swasthya Bima Yojana (RSBY), Comprehensive Health Insurance Scheme (CHIS) and Senior Citizen Health Insurance Scheme (SCHIS).

Initially, the scheme was implemented in the State from April 1, 2019, to June 2020 under insurance mode for the entire Rs 5 lakh coverage per family. From July 1, 2020 onwards, the same scheme is being implemented under assurance mode with the same Rs 5 lakh coverage per family. A total of 42.09 lakh families are covered under the KASP scheme, out of which, 23.98 lakh families are covered under PMJAY and SECC categories. Central assistance is limited to the families covered under PMJAY and SECC. The Central Government has a fixed premium ceiling of Rs 900 for each family and 60 per cent of that will be given to the State as a Central share. The Central Government, therefore, provides Rs 631.2 for each enrolled AB-PMJAY (RSBY) family and hence the expected Central assistance will be Rs.151 Crore (23,97,610 families * 631.2). A total of 597 hospitals have so far been empanelled, which include 394 private hospitals and 203 Public hospitals including 5 GoI hospitals. Karunya Benevolent Fund (KBF) scheme is also included as a separate component under the same Mission.

The details of the progress of AB PM-JAY/KASP are given in Table 6.2.18 and utilisation of AB PM-JAY/KASP by sector is given in Appendix 6.2.8.

Table 6.2.18
Progress of AB PM-JAY / KASP during 2020-21 to 2025-26 (up to August 31, 2025)

Source: State Health Agency Kerala

Karunya Benevolent Fund (KBF)
The Karunya Benevolent Fund (KBF) scheme was started in February 2012 by the Government of Kerala to give financial assistance to members of families from financially backward sections for the treatment of certain chronic diseases. Every family whose annual income is below Rs 3 lakhs as per the Ration Card irrespective of their APL Status can avail of financial assistance under this scheme. However, this income limit is not imposed on the treatment of haemophilia. Every family can avail financial assistance of up to Rs 3 lakhs for the treatment of kidney diseases and up to Rs 2 lakhs for other prescribed diseases. One or more people can benefit from the same ration card subject to the limit prescribed above. The scheme was implemented through the Department of State Lotteries. From September 1, 2020, onwards, it is being implemented by the State Health Agency. Total amount claimed as of October 31, 2025 (2020 July to 2025 October) is Rs 580.56 Cr.

Arogyakiranam

Arogyakiranam is one of the flagship health programme of the GoK. The programme provides free treatment and related medical services to all patients from birth to 18 years, as an entitlement. Expenses covered by this entitlement include costs incurred for OP registration, investigations, drugs/implants/materials used in treatment and procedures. The fund for coverage of treatment expenditure was allotted to districts, to be maintained as a corpus fund, from which all expenses were debited. The scheme is being implemented by the State Health Agency from the financial year 2022-23 onwards. Total amount claimed as of October 31, 2025 is Rs. 60.27 Cr.

Sruthitharangam

Shruthitharangam is for cochlear implantation surgery among children and its follow-up. Children between 0-5 years of age are eligible for this scheme. However, children above the age group of 5 years will also be considered in cases where profound hearing loss occurred because of post-meningitis injury since it improves the quality of life of children above 5 years. The cost of the procedure is Rs 5.2 Lakh and an average of 200 applications are settled every year and 300 upgradation are also settled. The details of assistance provided so far (Upto October 31, 2025) are given in Table 6.2.19.

Table 6.2.19
Details of assistance provided under the scheme Shruthitharangam (Upto October 31, 2025)

Source: State Health Agency Kerala

Thalolam

The Thalolam scheme aims to provide free treatment to the children below age of 18, who are suffering from Kidney diseases, Cardiovascular diseases, Cerebral Palsy, Brittle Bone Disease, Hemophilia, Thalassemia, Sickle Cell Anemia, Orthopedic deformities and other Neuro-Developmental Disabilities, Congenital anomalies (Endosulfan victims) and accident cases which need surgery.

Cancer Suraksha for Children

Recognising the urgent need to extend financial support to cancer victim children, who are too poor to afford treatment, the State launched the Cancer Suraksha Scheme on 1st November 2008 for children below the age of 18 who suffer from cancer.

National Health Mission (NHM)

National Health Mission is a Centrally Sponsored Scheme which includes two submissions NUHM and NRHM. NHM has five financing components to the States, viz. (i) NRHM/RCH Flexi-pool, (ii) NUHM Flexi-pool (iii) Flexible pool for communicable diseases, (iv) Flexible pool for non-communicable diseases including injury and trauma and (v) Infrastructure Maintenance. Under the infrastructure maintenance component, support has been given over several Plan periods, to States to meet salary requirements of schemes namely, Direction and Administration (Family Welfare Bureaus at State and District level), Sub Centres, Urban Family Welfare Centres, Urban Revamping Scheme (Health Posts), ANM/LHV Training Schools, Health and Family Welfare Training Centres and Training of Multi-Purpose Workers (Male).

NHM is implemented in the State for the development of health care delivery with Central Government funding. Forty per cent of the total fund is given to the NHM by the State Government as a State share. NHM supports the Health Services Department, Directorate of Medical Education and AYUSH Departments. National Rural Health Mission aims to provide accessible, affordable and accountable quality health services to the poorest households in the remote rural regions. Under NRHM, the focus is on a functional health system at all levels, from the Village to the District. There are 102 Urban PHCs under NHM. The total GoI release to the State from 2019-20 to 2025-26 (up to October 31) is given in Table 6.2.20. The total staff strength of NHM is 17221 (up to August 2025) under medical, paramedical and other categories.

Table 6.2.20
Release of central assistance for NHM from 2019-20 to 2025-26 (up to August 31) Rs. in crores

Source: NHM Kerala

State Institute of Medical Education and Technology (SI-MET)

SI-MET was established in the State in 2008 to promote medical education and research. Eleven nursing colleges are functioning under SI-MET with an annual intake of 60 students. A total of 1920 students are studying in the Nursing Colleges of SI-MET as of October 2025. A total of 141 teaching staff and 155 non-teaching staff are working under Si-met.

Child Development Centre (CDC)

Child Development Centre (CDC) established by the GoK is an autonomous Centre of excellence in early childcare and education, adolescent care and education, pre-marital counselling, womens welfare and other related fields to reduce childhood disability through novel scientific initiatives. The number of patients treated in 2024-25 was 25429. Only out-patient services are available and there is no facility for admitting patients. The number of student intakes is two (PG).

Insurance Medical Services Department

Employees State Insurance Scheme of India is the countrys first integrated multi-dimensional social security scheme for workers in the organized sector. Medical care under this scheme is implemented in the State of Kerala through the Insurance Medical Services Department. This Department is under the administrative control of the Labour Department, before which the scheme was implemented through the State Health Services Department. ESI Scheme is assigned with the significant and socially useful task of providing comprehensive medical care services to the worker population and their dependents and protecting against certain eventualities that result in loss of wages or earning capacity. The scheme also takes care of physically disabled workers and their dependents with monetary support, where death or disablement has occurred due to employment injury or occupational disease. Administration of medical care is the statutory responsibility of the State Government, and it is implemented through the Insurance Medical Services Department. Medical facilities are provided through 9 Hospitals and 147 Dispensaries. Total number of doctors in the Department is 515. Treatment under Allopathic, Ayurvedic and Homoeopathic systems is provided to ESI beneficiaries. The ESIC is the collector and custodian of funds and reimburses the expenditure to the Government of Kerala in the agreed ratio of 7:1 based on audit certification from the Accountant General on the final account payment system. District-wise wise number of ESI dispensaries, hospitals and bed strength is given in Table 6.2.21.

Table 6.2.21
District-wise number of ESI dispensaries, hospitals and bed strength during 2024-2025

Source: Insurance Medical Services Department

Drugs Control Department

The responsibility of the Drugs Control Department is to ensure the availability of quality drugs to the public and see that the market is free from counterfeit, spurious and substandard drugs and no drugs are sold at a price higher than the retail price marked on the container. The department has 6 Regional Offices, 11 District Offices, 4 Ayurveda wing offices and 4 drug testing laboratories (Thiruvananthapuram, Ernakulam, Pathanamthitta and Thrissur). NABL-accredited drug testing laboratories are functioning at Thiruvananthapuram and Ernakulam with an analytical capacity of 11,500 samples per annum. The establishment of one more laboratory at Kannur is in progress. There are around 25,000 licensed medical shops/dealers and pharmacies, in the State. Rule 51 of the Drugs & Cosmetics Rules, 1945, stipulates that the Drugs Inspector shall inspect not less than once a year, all establishments licensed for the sale of drugs within the area assigned to them. At present, there are 47 posts of drug inspectors in the State. Major achievements of the Department in 2024-25 are given in
Table 6.2.22.

Table 6.2.22
Major achievements of the Drugs Control Department in 2024-25

Source: Drugs Control Department

Commissionerate of Food Safety Kerala

Food Safety and Standards Authority of India was established under the provisions of the Food Safety and Standards Act, 2006 as a statutory body for laying down scientific-based standards for articles of food and to regulate the manufacture, storage, distribution, sale and import of food to ensure availability of safe and wholesome food for human consumption. The department aims to ensure safe and healthy food and water for the citizens of Kerala and to develop healthy food habits. The Government Analysts Laboratory at Thiruvananthapuram, two Regional Analytical laboratories at Ernakulam and Kozhikode and the State Food Testing Laboratory at Pathanamthitta are under the Commissionerate of Food Safety. Testing of water, milk, common adulterants like colour, artificial sweeteners, extraneous matter, and fungal growth are carried out in these laboratories. Three analytical laboratories viz., Government Analysts Laboratory, Thiruvananthapuram, Regional Analytical Laboratories at Ernakulam and Kozhikode have got NABL accreditation. Major achievements of the Department in 2024-25 and 2025-26 are given in Table 6.2.23.

Table 6.2.23
Major achievements of the Commissionerate of Food Safety in 2024-25 and 2025-26

Source: Commissionerate of Food and Safety

Chemical Examiners Laboratory Department

The chemical examiners laboratory is functioning under the administrative control of the Home Department. It caters to the needs of Judiciary, Excise, Police and medico-legal experts directly and indirectly and thus assists in the prosecution of criminal cases. It renders independent scientific service to the criminal justice administrative system. The Chemical Examiners Laboratory Department consists of a Central Laboratory in Thiruvananthapuram and Regional Laboratories in Ernakulam and Kozhikode. The Chemical Examiners Laboratory Department analyzes the material objects related to cases of murder, sexual offenses, human poisoning, liquor samples under the Abkari Act, and narcotic and psychotropic substances under the NDPS Act. Detailed chemical analysis reports are provided to the relevant authorities and law enforcement agencies. The department focuses on enhancing laboratory facilities, improving analytical methods, and ensuring the highest standards of accuracy and precision in chemical analysis certification. All three laboratories are accredited by NABL. The details of cases received, analyzed, and pending are given in the Table 6.2.24.

Table 6.2.24
The details of cases received, analyzed, and pending at chemical examiners laboratory from 2022-23 to 2024-25

Source: Insurance Medical Services Department

Medical Education

In Kerala, medical education is imparted through 14 medical colleges in 14 districts. Nursing education is imparted through 14 Nursing Colleges in 14 districts. Six Dental Colleges are functioning in Thiruvananthapuram, Kozhikode, Alappuzha, Thrissur, Kannur and Kottayam districts. Besides, four colleges of Pharmacy and one Paramedical Institute are also functioning under the Department. Kerala has become the first state in the country to have government medical colleges with MBBS admissions in all districts. Between 2016 and 2025, undergraduate MBBS seats increased from 1,200 to 1,855, postgraduate seats from 692 to 898, and super speciality seats from 100 to 161, reflecting substantial expansion in medical education capacity.

Government Medical College, Thiruvananthapuram, has placed 42nd among the top 50 medical education institutions ranked by the National Institutional Ranking Framework (NIRF) under the Ministry of Education. In the dental college category, Government Dental College Thiruvananthapuram has taken the 21st position in the NIRF ranking. Among Government medical colleges in the country, the Thiruvananthapuram GMC is ranked sixth and Government Dental College, Thiruvananthapuram, figures in fifth place among Government dental colleges in the country.

Total number of faculties under DME as of August 31, 2025, is 3712. Medical and Paramedical courses conducted in Government medical colleges with an annual intake of students, and details of clinical and non-clinical personnel in Medical Colleges under DME, in 2025-26 are given in Appendix 6.2.9 and Appendix 6.2.10 . A comparative analysis of the status of medical college hospitals and attached institutions in 2024-25 and 2025-26 is given in Appendix 6.2.11. The bed strength has increased by 873 in 2025-26 in Medical College institutions as compared to the previous years figure of 15237.

Kerala University of Health and Allied Sciences (KUHS)

Kerala University of Health Sciences was established as per the Kerala University of Health Science Act, 2010 to ensure proper and systematic instructions, teaching, training and research in modern medicine, homoeopathy and the Indian system of medicine and allied health sciences in Kerala. Academic activities of the University commenced in the academic year 2010-11. The number of institutions affiliated to the University (up to October 2025) is 384 with 55 Government colleges, 5 Government-aided colleges 11 self-financing co-operative colleges and 313 self-financing colleges. The colleges fall under all systems of medicine such as Modern medicine, Ayurveda, Homeopathy, Sidha, Unani, Yoga, Naturopathy, Nursing, Pharmaceutical science and Paramedical courses. Details of the government-aided and unaided colleges affiliated under various streams are given in Table 6.2.25.

Table 6.2.25
Details of the Government aided, and unaided colleges affiliated under various streams, number as of October 2025

Source: Kerala University of Health and Allied Sciences

A graphical representation of the Government and unaided colleges affiliated with the Kerala University of Health and Allied Sciences (KUHS) as of October 2025 is given in Figure 6.2.2. Government and Government colleges constitute only 15 per cent of the total number of colleges affiliated with KUHS

AYUSH (Ayurveda, Yoga and Naturopathy, Siddha, Unani and Homoeopathy)

The total intake of students during 2024-25 is 29540 (5684 males and 23856 females) under various health sciences streams. Details of the annual intake of students in each discipline and the male/female count of students in each discipline are given in Table 6.2.26.

Table 6.2.26
Details of the Annual intake of students as of March 2025

Source: Kerala University of Health and Allied Sciences

Indian System of Medicine (ISM)

The department of the Indian System of Medicine renders medical aid to the people through the network of Ayurveda, Sidha, Unani, Visha, Netra and Naturopathy institutions. Speciality hospitals such as Mental Hospital (1), Panchakarma (1), Nature Cure (1), Siddha (1), Visha (3), Sports Ayurveda (1) and Marma (1) are also functioning under this Department. At present, there are 130 hospitals and 818 dispensaries under the Department which include Ayurveda (806), Visha (4), Siddha (6), Nature Cure (1) and Unani (1). The total bed strength of these hospitals is 3,154. The State Medicinal Plants Board coordinates matters relating to the cultivation, conservation, research development and promotion of medicinal plants in the State. District-wise distribution of institutions, beds, IP, OP and doctors under the ISM department in 2023-24 and 2024-25 are given in Appendix 6.2.12.

Special projects were implemented by the ISM department in 2024-25 and 2025-26 in addition to the normal medical treatment. They are Drishti, Jeevani, Punarnava, Snehadhara, Geriatric Care, Yoga, Sports Medicine, Panchakarma, Ksharasutra, Manasikam, Koumarabhrithyam, Prosoothithantra, Sickle cell, Nirvisha, siddha and Child and adolescent care. Details of special projects, districts implemented, and number of beneficiaries are given in Appendix 6.2.13

AYUSH (Ayurveda, Yoga and Naturopathy, Siddha, Unani and Homoeopathy)

GoI has set up two regulatory bodies to set standards for medical education. The Central Council of Indian Medicine (CCIM) under the Indian Medicine Central Council (IMCC) Act, 1970 regulates educational institutions and practitioners in respect of Ayurveda, Unani and Sidha systems of medicine. The Central Council of Homeopathy (CCH) under the Homeopathy Central Council Act, 1973 regulates educational institutions and practitioners concerning the Homeopathy system of medicines. At present Yoga and Naturopathy, being drugless systems, are not regulated.

National AYUSH Mission

Department of AYUSH, Ministry of Health and Family Welfare, GoI has launched the National AYUSH Mission (NAM). The basic objective of NAM is to promote AYUSH medical systems through cost-effective AYUSH services, strengthening of educational systems, and facilitating the enforcement of quality control of Ayurveda, Sidha, Unani and homoeopathy drugs and medicinal plants. The funding pattern is 60:40 by Centre and State. GoK started the Ayush Department in the State on August 8, 2015. GoI fund release for the last five years is given in Table 6.2.27.

Table 6.2.27
Year-wise Resource Allocations of National AYUSH Mission Kerala (Rs. in lakhs)

Source: National Ayush Mission Kerala

Central release for the National Ayush Mission to Kerala has seen an increase over different financial years.

AYUSH Yoga Clubs

AYUSH Yoga Clubs offer regular yoga sessions, health awareness, events focusing NCD prevention & Social health. A total of 10,132 AYUSH Yoga Clubs have been established across Kerala, comprising 7,581 general yoga clubs and 2,551 womens yoga clubs. These clubs together benefit 2,01,179 individuals, including 1,51,191 general participants and 49,988 women participants.

Ayurveda Medicine Manufacturing - OUSHADHI

OUSHADHI is the largest manufacturer of Ayurvedic medicines functioning in India in the public sector. It is one of the few profit-making public sector undertakings. Oushadhi is the exclusive supplier of Ayurvedic medicines to Government Hospitals and dispensaries of the Ayurveda Department. In Kerala, Oushadhi supplies medicines to the State ISM department at 30 per cent less than the market price and the ISM Department supplies this medicine to the poor patients in the State free of cost. The company also caters to the demands of the public through a network of 865 exclusive agencies spread in and outside the State. The profit of the firm before tax in 2024-25 was Rs 63.27 crores which is an increase from Rs 62.27 crores in 2023-24. During 2024-25, Oushadhi has achieved a record turnover which amounts to Rs 197 crores and also Oushadhi Panchakarma Hospital & Research Institute achieved its highest turnover.

Ayurveda Medical Education - Ayurveda Colleges

There are 3 Government Ayurveda colleges situated at Thiruvananthapuram, Thrippunithura and Kannur having bed strength of 1,385. The total number of inpatients treated in 2024-25 was 9244 and outpatients treated were 427992. It is 4390 and 180764 respectively in 2025-26 (up to August 31). Panchakarma Hospital and Women and Children Hospital are also functioning under the Government Ayurveda College Thiruvananthapuram. There are two aided Ayurveda colleges, 12 self-financing Ayurveda colleges, one self-financing Siddha college, one self-financing Unani College and 6 paramedical self-financing colleges for imparting medical education in the State. The annual intake of students for UG Degree in Government is 226, PG Degree 162 and PG Diploma 30. College-wise distribution of beds and patients treated under Ayurveda Medical Education in Kerala during 2024-25 and 2025-26 (up to August 31) is given in Appendix 6.2.14. Details of annual intake of ISM students in government, aided and private colleges in Kerala are given in Table 6.2.28.

Table 6.2.28
Annual intake of ISM students in government, aided and private colleges in Kerala

Source: Directorate of Ayurveda Medical Education

International Research Institute of Ayurveda (IRIA)

Government initiated a project to establish an International level Research in Ayurveda in Kannur District which is first of its kind in the country. Department identified a total of 311.76 acres of land in kalliad, Kannur. The 1st phase DPR has been approved by the KIIFB with outlay of 69.05 Crores. 115.21 Acres of land from the total identified land for the project is also transferred to Department of Ayurveda Medical Education. The 1st phase construction work includes the following; IRIA 100 bedded Hospital, IRIA Medicinal Plant Nursery and IRIA Manuscript Centre. The 1st phase of construction is going on and 75 percent is completed, the rest is expected to complete during 2025-26.

Government Ayurveda College Idukki Udumbanchola

The Govt. has transferred 20.82 Acres of land to Ayurveda Medical Education Department for the establishment of Udumbanchola Govt. Ayurveda College. Construction activities are already started. Meanwhile the department initiates to commence the Hospital in a Temporary Building. Rs. 10 crore is kept in the Idukki development Package for construction activities.

HOMOEOPATHY

There are 709 homoeopathic dispensaries, 14 District hospitals, 17 taluk hospitals, 2 ten-bedded hospitals and one hospital with total bed strength of 1000 are functioning under the Homeopathy Department in the State. In addition, Kerala State Homoeopathic Co-operative Pharmacy (HOMCO) Alappuzha, a medicine manufacturing unit is also functioning under the Homeopathy Department. HOMCO has been running in profit for the last 30 years. In 2024-25, net profit of Homoeo amounts to Rs 13.19 crore. District-wise distribution of institutions, beds and patients treated under the homoeopathic department in 2024 and 2025 are given in Appendix 6.2.15.

The Department has undertaken several innovative projects including Seethalayam (womens health), Sadgamaya (adolescent care), JANANI (infertility care), Ayushman Bhava (lifestyle diseases), Palliative Care, Reach (epidemic control) and other specialty clinics. Digital initiatives such as the Ayush Homoeopathy Information Management System (AHiMS) and NABH accreditation have modernized healthcare delivery. During 2024-25, 575 transgender OP and 37 follow-up cases were treated in homoeopathy hospitals.

Homoeo Medical Education

Homoeo medical education is imparted through two Government homoeopathic medical colleges at Thiruvananthapuram and Kozhikode. In addition to this 3 aided colleges and one unaided paramedical institute are functioning under this Department. The total bed strength of the Government homoeopathic medical college at Thiruvananthapuram is 116 and Kozhikode 100. Patients treated in these two Medical Colleges in 2023-24 in IP and OP was 27925 and 154976 respectively. In 2024-25 the respective figures were 10750 and 110692 (up to August 31). Details of Specialty Projects in Homoeopathy Department are given in Table 6.2.29.

Table 6.2.29
Specialty Projects in Homoeopathy Department

Source: Directorate of Homoeopathy

AHiMS (Ayush Homoeopathy Information Management System) is a web-based/ mobile app-based software solution designed to enhance the management and delivery of services in the field of homeopathy in 2019, by the Department of Homeopathy. The important modules in AHiMS 2.0 include employee module, OP module, Real time stock management, Medicine Procurement, Asset module, Laboratory Information System, Fever & prophylactic module, Account module, etc. The annual intake of students and courses in the six Homoeo Medical Colleges and one paramedical institute / college-wise distribution of beds and patients treated are given in Appendix 6.2.16.

The Way Ahead

The Vision 2031 document outlines a comprehensive roadmap to transform Keralas healthcare system into a decentralized, technology-driven, and patient-centric model by the year 2031. Core of this vision is the decentralization of specialized services, such as cancer care, by establishing comprehensive treatment facilities (surgery, chemotherapy, and radiation) at the district level to reduce the burden on apex institutions. The state aims to implement a robust Cancer Policy and fulfill the objectives of the Palliative Care action plan 2023, ensuring high-quality home-based care through trained personnel and digital monitoring tools.

A significant strategic shift is proposed for lifestyle diseases, moving from high-risk individual strategies to population-based prevention. Key initiatives include; School-based health introducing a "Healthy Policy for Schools" and a Kerala-model syllabus to instill healthy eating and exercise habits early in life. Stroke Care by expanding the "Sirassu Project" to ensure primary stroke units in every district, enabling life-saving treatments like thrombolysis within the "golden hour". Public Awareness like "Know Your Number" campaigns to encourage citizens to monitor their own health metrics like blood pressure and blood sugar.

Furthermore, the document emphasizes Medical Research and Innovation by proposing the establishment of a National Healthcare Research Framework (NHRF) and Centers of Excellence in medical colleges. This includes the integration of Artificial Intelligence in diagnostics and the development of Kerala-specific risk assessment tools. By fostering public-private partnerships and strengthening "One Health" protocols for infectious disease management, Vision 2031 seeks to create a resilient health ecosystem where individual responsibility and government infrastructure work in tandem to improve the states overall longevity and quality of life.

Keralas robust public healthcare system remains central to its human development and economic progress. As the state advances through the 14th Five-Year Plan, strengthening this system is vital to ensure equitable and sustainable health outcomes. Priority areas include improving general, rural, tribal, and urban health services; addressing the needs of women, children, and guest laborers; and expanding health insurance coverage to reduce financial burdens. Continuous investment in infrastructure, technology, and skilled manpower, along with enhanced partnerships across sectors, will be key. By promoting preventive care, community participation, and inclusive policies, Kerala can continue to lead in public health and model comprehensive human development for the rest of the country.