Health Facilities
  Schemes/Activities of the Department
  Major Schemes Family Welfare
  Prevention of food adulteration
  Health Transport Organisation
  Insurance Medical Service
  National Aids Control Programme
  Blood Safety
  STD Control Programme
  Information,Education &Communication
  Medical Education
  R C C
  SCT Institute of Medical Sciences
  Health Status of Kerala
  Kerala Health Research & welfare Society
  Vital Statistics


For accelerating the Family Welfare Programme the need for information, Education and Communication is well recognised. The success of the Family Welfare Programme depends mainly on the voluntary and widespread acceptance of the concept of small family norm. The efforts undertaken so far through mass education and media activities have helped to create almost hundred percent awareness among the people of Family Welfare.
By the constant and continuous utilisation of educational methods and media, it has become possible to remove the deep-rooted attitudes, beliefs and misconceptions which were detrimental to the acceptance of health and family welfare programmes. Strategies of different types have been evolved and implemented with a view to achieving behavioural and attitudinal changes among the resistant groups. Efforts are continued to convert the existing widespread awareness into acceptance, and use of Family Planning methods by dissemination of information and education.

Community participation and involvement
The success of implementing every programme depends on the involvement and participation of the community. Propagation of small family norm among the eligible couples, removal of misconceptions and misunderstandings are effectively done through individual contact and group approach with the participation of Non-Governmental Organisations like Mahila Samajams, Youth Clubs and similar Socio-Cultural Organisations.

Mahila Swasthya Sangh
India is committed to the twin goal of “Health for All” and ‘Net Reproduction Rate of Unity” by the year 2000. These goals are recognised to be intimately intertwined and further their achievement contributing to the improvement of the condition of women and children. It was realised that a major component of Family Welfare Programme is related to health problems of women and children and these groups are vulnerable to health disorders and diseases. In order to mobilise community participation and to create a viable support structure within the community to sensitise rural women and to increase demand for integrated Health & Family Welfare Services available, the scheme of M.S.S was launched in 1990-91 in selected districts of Kerala.
To overcome various problems like low age at marriage, risk factors during pregnancy, unsafe and unplanned deliveries and high rate of child mortality, it was desired that women may be educated, motivated and persuaded to accept programmes to increase demand for services.
The scheme called Mahila Swasthya Sangh (MSS) was designed to include some of the village level functionaries already working with Social Welfare Department and Directorate of Health Services at state level. Besides the above 10 to 15 women members of the village called “Community leaders” were to be involved with the programme.

Initially the scheme was introduced in the state in 1990-91, constituting 888 MSSS. Subsequently based upon the feed back the scheme was extended to all districts. According to the design, it was planned to constitute MSS in villages having population more than 1000 to 2000 house holds. Those C.D. Blocks which were covered by the Social Welfare Department having adult education centre under ICDS projects were involved so that co-ordination with the female functionaries of these departments is obtained effectively. The members of MSS serve as a link between the community and local health functionaries.
The programme is still continuing. The total number of MSS functioning in the state till 1996-97 is 3440. It was decided that an evaluation should be carried out by an independent agency about the functioning of MSS and its utility during the previous years. Consequently the Institute of Management in Government has done an evaluation study and the result showed that the functioning of MSS satisfactory.
Training of Mahila Swasthya Sangh members and other grass root level functionaries at sub-centre level.
For developing communication skills, enriching the knowledge and to bring about coverage of related activities at the grass root level, training was imparted to MSS members on to topics viz. Child Survival & Safe Motherhood and spacing methods for family planning, saturation of weak areas with multimedia and local-specific interactive scheme.

IEC efforts need to be focussed and targeted for specific beneficiaries in demographically weak districts by utilising local specific folk media as interactive mode of communication. Specific and innovative cultural activities such as street plays, folk dances, dances, mimicry, puppetry, oppana were organised in identified weak districts having high CBR and IMR with the objective of creating awareness amongst all eligible couples regarding the various family welfare programme.
For saturation of weak districts, troops/registered folk parties etc. were identified to give song and drama performances, under local specific interactive scheme.

World Population day

The rapid increase in population is a cause of major concern to all developmental efforts. It is estimated that the present rate of growth of population of the country will be crossing one billion mark by the end of this century.
Keeping this in view, 11th of July every year is observed as World Population Day. The observance of the day is a grim reminder of the World Population increase which touched five billion mark on 11th July 1987. The objectives of observance of the day is to organise Mass Media Campaign and to take effective steps to bring the population growth rate to a sustainable level. All media and field organisations are to be harnessed to put the message that the only choice before humanity is to reduce the number.

Enhancement of the role of the NGOs in Family Welfare and Health sector
The Government of India policy statement on the National Family Welfare Programme spells out the need to promote Family Planning as a people’s movement. The association of voluntary organisations in the Governments’ programme ensures greater acceptability of the Family Welfare activities among the people. This is so because the voluntary organisations enjoy greater credibility and are closer to the community than the Government staff. The supplementary and complementary role played by the voluntary sector in the propagation of the small family norm is therefore vital for the success of the family welfare programme.
In order to involve voluntary organisations in the implementation of the Family Welfare Programme, and to make it a peoples’ movement, Government have evolved a policy for financial assistance to these organisations for their projects.

SCOVA (Standing Committee on Voluntary Action)

To consider applications received from voluntary organisations working at the grass-root level in the rural areas and urban slums for setting up family welfare projects relating to MCH, Family Planning, at state level, a Committee (SCOVA) consisting of State Government Officials, representatives of established Voluntary Organisations in the state and the Regional Director of Health and Family Welfare was constituted in the State.
The Committee is to recommended projects in FW from the voluntary sector for funding from the centre. The Standing Committee on Voluntary Action (SCOVA) have sanctioned model schemes for promotion of small family norm and population control by encouraging spacing methods and sterilization.

Swathya Mela
In remote and difficult areas, provision of health services particularly to the vulnerable groups have been very difficult. To ill the gaps in delivery of health services created by inadequate infrastructure, and to increase accessibility of health services to the community relating to prevention of diseases and their cure, as well as for promotion of a healthy way of life, a Mela approach has been introduced.
Wide publicity is required for ensuring a large turnout for seeking health services during these Swathya Melas. Counseling is another area taken up n the melas. Couselling has a district advantage in leading to informed choice in contraception, assisting individuals in acting upon health information received by them, increasing access to give points of service delivery, promoting good relation between service providers and clients.

Special School Health Check-up Programme
A special school health checkup of students in primary schools was carried out in 1996 using the health workers, AWWs and Volunteers. An effective IEC campaign was organised by the State, giving emphasis to create awareness among the parents to send their wards to schools on the checkup day and to provide wide publicity regarding referral cards and referral services.

Pulse Polio Immunisation Campaign
Pulse Polio Immunisation campaign are carried in December and January. Intensive social mobilisation campaign and media announcements is a unique feature in all Pulse Polio Immunisation campaigns. Awareness is created through IEC efforts on the benefits of PPI and why fully immunized children also should receive OPV during this campaign.

Target Free Approach in Family Welfare
Communication programmes aim at generating demand and better utilisation of health and family welfare services in the community and empower people to take care of their health. Now it is being realised that the IEC programmes have to be area specific and addressed to the problems of the area. This warrants decentralised planning approach in designing IEC programme. Another important dimension of the IEC programme is based on needs of the area. The proposed IEC strategies are:

1. identify the communication needs to plan IEC activities.
2. Involve community and NGOs through unified messages.
3. Effective use of mass media for back up.
4. Strengthening inter-personnel communication.

Moving from Family Welfare to Reproductive Health
New direction in the Family Welfare Programme towards a client – oriented reproductive health approach has major implications for IEC. As is evident from the services identifying as components of an essential reproductive health packages, the range of activities which IEC must now take-up are considerably broader in scope than before. In addition to prevention of unwanted pregnancies and the promotion of childhood immunization, IEC strategies are concerned with safe abortion (Medical Termination of Pregnancy) safe motherhood, prevention and management of RTIs/STIs, sexuality and gender information education and counselling.

The goals require a strategic approach to IEC identifying meaningful segments of the target audience, promoting a number of new behaviours that are closely linked but complex, identifying messages, and using a mix of communication channels to effectively reach these various audience segments.
Thrust areas have been identified for Family Welfare Programme, for which audience-specific message and use of suitable media were to be discussed and finalised from individual, group and mass approach point of view. The situation analysis reveals the following thrust area for designing IEC Programmes

· Reproductive Health of Adolescent girls
· Counselling of adolescents entering the reproductive age group for Family Life education
· Women’s education
· Higher age at marriage
· Early Ante-natal registration and care
· Nutrition during pregnancy and lactation
· Institutional delivery
· Vaccine preventable diseases
· Protected water supply
· Diarrhoea and ARI management
· Low birth weight
· Birth interval, birth spacing
· Medical Termination of Pregnancy
· Childhood disability
· Breast feeding.

Health Education
Health Education is a wide as Community Health and it is a process which effects changes in the health practices of the people and in the knowledge and attitude related to such changes. It includes imparting knowledge about health, removing superstitious beliefs, building favourable health habits and attitudes and effecting the necessary changes in the health practices. As health education is an essential tool of the community health it becomes the responsibility of the Government to assist and guide the health education of the general public. Hence in 1956 in the Central Ministry of Health, a Health Education Bureau was established with the assistance of the Technical co-operation mission of the United States of America. Subsequently in 1958 a School Health Education Division was established following which in 1959 a scheme for State Health Education Bureau with central assistance was formulated. In Kerala reorganising the existing health education facilities, the State Health Education Bureau, on modern line was set up in 1960. In 1971, District Health Education Bureau were established by winding up the Regional Health Education unit in all the districts. Besides the central and state District Education Bureau there are official agencies such as the Directorate of Advertising and Visual Publicity, the Press Information Bureau and the AIR and TV etc. which are engaged in health education work. Health Education is a complex activity in which different organisations play a part.

The organisational divisions under these are as follows

1. Administrative Division
2. Media and Publicity Division
3. Editorial Wing
4. Training Unit
5. District Health Education Unit

The State Health Education Council with the Hon’ble Minister for Health as the Chairman, reviews and guides the activities of the State Health Education Bureau in general.
The State Health Education Bureau is functioning at the Directorate of Health Services with the Assistant Director of Health Services or Deputy Director of Health Services in charge as the programme officer, assisted by a Technical Officer, School Health Education Officer, Social Scientist and Sub Editor with supporting staff. The Central Health Education Bureau is giving guidance and leadership for the activities besides providing education materials. A library is functioning under the bureau at the Directorate of Health Services.
The Media and Publicity Division of the Bureau is concerned with the planning of the activities of the Bureau and purchase and distribution of materials, whereas the District Health Education Unit guides and assists the regular public health personnel in organising health education, film shows, exhibitions etc. The Editorial wing of the Bureau brings out the quarterly health journal ‘Susthithi” besides of posters and folders. The field study demonstration and training unit under the bureau takes up demonstration and study projects and organises periodically in service training programmes in health education and allied subjects for health workers. This unit at Neyyattinkara functions as the field laboratory to the State Health Education Bureau. The training unit provides job orientation training in health education for paramedical staff.
The Audio Visual unit attached to the Bureau conducts regularly film shows and exhibitions and renders service in conference and seminars. The art section with the assistance of the statistical unit prepares materials like drawings, title heads, charts, posters, display boarders etc for various programmes.
In short, no health programme, however useful it might be, could be implemented successfully without the cooperation of the public for which the only tool is Health Education.

School Health Programme
The Programme was introduced in Kerala in 1980-81. This programme was formulated for providing comprehensive physical examination and medical care to the entire school going children of the state. The main objectives of the

school health programme are:
1. To reduce the morbidity among school children through school health services.
2. To prepare children for adopting healthy life styles (health practices) through health education
As part of achieving the goal of “Health for All by 2000 AD” School Health Education is given prime importance. It is easy and useful to instill the desired health behaviour through the syllabus, class lessons, group discussions, education, competition etc regarding different aspects of health education in the formative age group of 5-15 years.

During the 8th Five Year Plan, one day orientation training was conducted for school teachers at district level. First aid kits, weighing machines and measuring tapes are supplied to selected schools.
During 1996-97 the special school check up programme formulated on a national level by the Government of India, was successfully conducted in Kerala as per the guidelines issued by the Government of India. It was a 6 days continuous programme from July 22nd to the 27th and was a great success. Referral camps were also organised at several places for giving further medical care for the children having various health problems.

Nutrition Programme
It is well known that maintenance of health is greatly dependent on adequate nutrition. Although the target of a number of indicators of ‘Health for All by 2000 AD” have already been achieved, malnutrition continues to be one of the major public health problems in the state. Extensive diet and nutrition surveys carried out in different parts of the state have indicated wide prevalence of malnutrition among pre school children, pregnant mother and lactating women especially in poor socio economic strata of society. To control and prevent malnutrition a number of nutrition programmes are being implemented through different departments by the Government.
The nutrition division under the Directorate of Health Services consists of three wings viz. State Nutrition Division, National Nutrition Monitoring Bureau and Applied Nutrition Programme. The state nutrition division is mainly engaged in conducting diet survey and nutrition survey, besides conducting anaemia survey, nutrition camps, cooking demonstration, nutrition demonstration and training programmes and also preparing of nutrition education materials.
Recently a diet and anaemia survey was conducted among school children of Thiruvananthapuram. The National Nutrition Monitoring Bureau has carried out diet and nutrition survey in various districts during 96-97 to assess the dietary intake and nutritional status of various segments of the population.
Ignorance of the people regarding various aspects of nutrition and health is one of the major contributing factor to malnutrition. One day nutrition education training camps were conducted in all districts for SC/ST mothers of pre school children as a means of imparting nutrition and health education to the weaker sections of the population. Cooking demonstration cum nutrition education programme is being carried out in various districts by the mobile kitchen unit. The nutrition camps and the demonstration programme are conducted with a view to making the people more aware of the importance of adequate nutrition in maintaining their health and also to encourage them to improve the dietary intake of nutrients by using available cheap and nutritious food materials.
Nutrition education and medical checkup camps are conducted in hostels for scheduled castes and scheduled tribes through out the state to ensure better health of the inmates and also to teach them basic principles of health and nutrition. These camps helped to improve the nutritional awareness and personal hygiene of the children and also environmental sanitation of the hostels.

Per capita net availability per day: Cereals and pulses in India


























Designed & Maintained by: C-DIT, Thiruvananthapuram,
for Public Relations Department, Govt. of Kerala.