Kerala should improve the utilisation of public sector health care institutions and thus focus on reducing its high out-of-pocket expenditure on health, the Mission Director of National Rural Health Mission, P. K. Pradhan, has said.

“The challenge in Kerala would be to attract more people to the public health care institutions but this will happen only if you can provide good quality of care,” he added.

Mr. Pradhan, who is on a visit to the State, was talking to The Hindu after he was taken around the Vattiyoorkavu primary health centre in the district on Tuesday.

The PHC has implemented the first Cuban model of health care in the State, along with the novel concept of a polyclinic, offering specialist consultation on a weekly basis.

“In UP or Bihar, we have to provide delivery care services in primary health centres itself while in Kerala people only want to go to higher level institutions for delivery care. The polyclinic concept set up in Vattiyoorkavu is a better approach for Kerala because the PHCs would be better utilised. This is a model which could be scaled up and implemented across the State ,” Mr. Pradhan added.

He was briefed about the clinical registry which has been set up at the PHC, on the basis of the population-based survey held in the panchayat by ASHA workers. The survey data is being utilised for effectively implementing the non-communicable diseases surveillance programme.

Mr. Pradhan said that the States’ health care spending needed to go up, alongside increased Central allocations so that the NRHM’s target of bringing up public health spending to about 2-3 per cent of the gross domestic product (GDP).

“We need the States to be increasing its annual outlay for health by 10 per cent every year. In fact, from next year onwards, we will be very strict about the 15 per cent contribution that States are expected to put in . We are also going to the Planning Commission to persuade them to increase the allocations for States to spend on health system,” Mr. Pradhan said.

NRHM was also considering setting aside a budget to provide incentives to States which implement innovative reforms in the health sector, he added.

Mr. Pradhan pointed out that Kerala’s high burden of life style diseases and increasing rates of Caesarean section deliveries were a matter of concern and that the State would have to devise its own strategies for bringing this down.

He was very appreciative about the concept of adolescent health clinics which have been implemented in many public sector hospitals and said that it was one way in which interventions could start early to tackle lifestyle diseases.

Mr. Pradhan, who had visited the Women and Children hospital at Thycaud also, asked the State to explore the possibility of networking public sector hospitals and creating electronic medical records so that unique identity numbers and Smart Cards can be given to all patients visiting the hospitals.

“It is not possible for States like UP, but Kerala can do it,” he said.