Press Release

Dialogues on Kerala Development #1 “Challenges of Health and Demographic Transition”

Published on 14-01-2023

The first conference in the triennial conference series titled “Dialogues on Kerala Development“, launched by the Centre for Socio-economic & Environmental Studies (CSES) to commemorate the Centre’s 25th anniversary in the field of social science research, concluded at Thiruvananthapuram. The conference series, to be held once every three years, envisages to discuss and deliberate upon issues and challenges that the state is facing in a particular area. The first conference, which was held on the 12th and 13th of January at Kerala State Institute of Health and Family Welfare (KSIHFW) deliberated upon the challenges of Health and Demographic Transition faced by Kerala. The conference, inaugurated by Prof V K Ramachandran, Vice Chairperson, Kerala State Planning Board, focused majorly on four themes; Demographic and Epidemiological Transition, Health Disparities, Health System Governance, and Ageing and Health.

In his inaugural address Prof. VK Ramachandran, remarked that though Kerala is much ahead of other states in health and demographic indicators, there is scope for further improvement. The health sector has witnessed significant improvement in the recent years. However, the demographic transition has also brought its own challenges. The care and health of the elderly is the major area on which the state needs to focus on now. Dr. N. Ajith Kumar, Director, CSES delivered the introductory remarks in the inaugural session.

The inaugural session was followed by address by three key note speakers who spoke on various dimensions of the conference theme. Dr. KS James, Director, International Institute for Population Sciences, Mumbai who spoke on Challenges of Demographic Transition in Kerala with special reference to family change made observations on how there has been a drastic change in the recent years in the demographic indicators in Kerala and emphasised on the difference between households and families and its implications on survey data.

Dr. Biju Soman, Professor & Head at the Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology who spoke on challenges of health and healthcare in Kerala in the context of epidemiological transition, emphasised on the need to focus on improving overall health, which includes physical, mental, social and spiritual health and on the need to shift towards One Health, an integrated, unifying approach to balance and optimise the health of people, animals, and environment.  It is also important to strive towards digitisation in delivery of healthcare.

Renowned public health expert and social activist, Dr. KP Aravindan spoke on “Beyond Demographic and Health Transition in Kerala: The Task Ahead”. Dr. Aravindan stressed on the fact that the greatest health challenge that Kerala was facing was the increasing and high out of pocket expenditure. He suggested a two pronged approach towards curtailing this private expenditure, one, reducing the prevalence of lifestyle diseases and its complications at individual level which has significant implications on cost and two, increasing public health expenditure. Increasing public health expenditure would be required to expand the scale of services in the public sector, especially to address shortage of personnel.

Four technical sessions were held, two on 12th afternoon and two on 13th morning. The first session,  on Demographic and Epidemiological Transition was chaired by Dr. TV Sekher, Professor, IIPS, Mumbai. The second session, on Health Disparities was chaired by Dr. Rakhal Gaitonde, Professor, AMCHSS, SCTIMST. The third session,  “Health System Governance”, was chaired by Dr. CK Jagadeeshan, Former Dy DHS, Planning and the final session, on “Ageing and Health”, was chaired by Dr. D Radhadevi, Former Professor at IIPS, Mumbai. 24 papers by policymakers, academicians, researchers and practitioners were presented in the sessions, which included presentations by Dr. Bipin Gopal, Dy DHS NVBDCP and Dr. Jithesh, Executive Director, SHSRC-K,  Dr. Jaideep Menon, Consultant Cardiologist, AIIMS and Dr. Praveen Pai, Chairperson, MAGICS.

The concluding plenary held in the afternoon of the second day of the two-day conference was presided by Dr Irudaya Rajan (Former Professor, Centre for Development Studies and Founder Chair IIMAD). The plenary brought together senior researchers in the field of health and demography in Kerala. Dr Mala Ramanathan (Professor, AMCHSS, SCTIMST) discussed gender and health. Dr T.V. Sekher (Professor, IIPS) spoke on ageing in Kerala, and Dr A.K. Jayashree (Professor, Pariyaram Medical College) talked about the Health of vulnerable groups and Dr Mathew George (Professor, Central University of Kerala) spoke on challenges confronting Kerala’s health system.

Dr. Irudaya Rajan remarked on the decreasing working population and the decreasing number of births in the state, which will have serious implications on development in the future. Dr. Mala Ramanathan observed that though the state is far ahead of other states in health indicators as reported in the National Family Health Survey (NFHS), there are some areas where women are seen to lag behind men. Though morbidity is higher among women, given their reproductive role, among other factors, the per capita expenditure on health by women is less than men, by around Rs.100, which is a serious concern. Women also tend to be more physically inactive than men, as in Kerala they do not have time nor safe physical spaces. There is also a need for increasing public expenditure in infertility treatment and the role of men in contraception. Dr. TV Sekher emphasised upon the health and care needs of the elderly in Kerala, based on the Longitudinal Ageing Survey of India (LASI) data. Lifestyle diseases are common among the elderly in Kerala and more studies are required in this area. Dr. AK Jayasree said that though we have attained much success in health, there are still some sections of the society who are backward, which include Adivasis, fisherfolk, persons with disabilities, migrant workers, transgender persons and sex workers. To understand the nuances of the issues faced by such minority communities, in-depth qualitative data is required. To help overcome these vulnerabilities, it is also important to think beyond health and adopt and intersectoral approach. Dr. Mathew George, in his address, emphasised on the need to strengthen the public health infrastructure in the state further, especially at the secondary care level. He also pointed out the need for a dedicated public health cadre in the state. The field level public health workers need to integrated with a middle level public health management system at the Block level. There should also be an opportunity for the public health workers to upgrade their managerial skills and to move up the ladder.

CSES Associate Fellow Dr Parvathy Sunaina presented the key points and learning derived from the discussions held at the two-day conference. The Convenor of the Conference Organising Committee Dr Rakkee Thimothy delivered the valedictory address.  

CSES is an independent research institute conducting in-depth studies related to the Kerala development issues for the last 25 years. Various studies conducted by the centre has initiated serious academic debated related to Kerala development paradigm. The triennial conference series was launched with the goal of promoting quality research, bridging the gap between public and policy makers and facilitating evidence-based policy. The platform is envisaged to facilitate in-depth academic and policy-level discussions on issues related to Kerala’s development by bringing togethersocial scientists, policymakers, young researchers, and students, thereby contributing towards a transformative policy-making process. Each conference in the triennial series will focus on a specific developmental issue confronting Kerala.

More details on the Conference are available at