KHISP is a comprehensive state-sector initiative aimed at enhancing the quality of healthcare services and improving the efficiency of healthcare delivery systems across Kerala.
Published May 27, 2025 | 12:00 PM ⚊ Updated May 27, 2025 | 12:00 PM
File photo of the Kozhikode Medical College. (Supplied)
Synopsis: In partnership with the World Bank, Kerala is implementing KHSIP to future-proof its healthcare system and safeguard its hard-earned health gains. It aims to enhance high-quality health services, particularly for the BPL population, while strengthening the state’s capacity to respond to emerging public health and climate-related threats.
Kerala’s celebrated healthcare model, often regarded as a blueprint for the nation, is poised for its next significant transformation.
Confronted by the twin pressures of a rising non-communicable disease (NCD) burden and an ageing population, alongside the growing threats of climate change and recurring outbreaks, the state is charting a bold new course.
In partnership with the World Bank, the state government is implementing the Kerala Health Systems Improvement Programme (KHSIP) — an ambitious initiative designed to future-proof its healthcare system and safeguard its hard-earned health gains.
According to the health department, KHISP is a comprehensive state-sector initiative aimed at enhancing the quality of healthcare services and improving the efficiency of healthcare delivery systems across Kerala.
Supported by the World Bank through its lending arm, the International Bank for Reconstruction and Development (IBRD), the ₹3,000 crore project — with ₹2,100 crore as external assistance and ₹900 crore from the state government — will be implemented over five years in all 14 districts of the state.
The primary objective of KHSIP is to build a resilient, value-based health system that effectively addresses Kerala’s advanced demographic and epidemiological transitions.
It aims to enhance high-quality health services, particularly for the Below Poverty Line (BPL) population, while strengthening the state’s capacity to respond to emerging public health and climate-related threats.
The programme envisions a comprehensive ecosystem for the prevention and management of NCDs, improved emergency and trauma care services, and holistic strategies targeting reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH+N), alongside elderly care services.
Key focus areas include strengthening human resources, scaling up digital health applications, augmenting public financing for health, and fostering intersectoral collaboration to ensure longer, healthier lives for the people of the state.
Expected to be unveiled in July 2025 and run till August 2030, the new programme will focus on nine critical sectors — NCD, One Health, trauma care, fiduciary matters, procurement, environmental matters, social and gender sector, and elderly care.
The programme’s overall institutional framework has been modelled on the modalities of the Rebuild Kerala Initiative (RKI) and consists of an Advisory Council, Program Steering Committee, Apex Committee, Program Executive Committee, a Technical Support Unit (TSU), Program Implementation Units, and Implementation Agencies.
At the apex level, an Advisory Council chaired by the chief minister will provide overarching guidance for implementation, with members including the ministers for health, women and child welfare, finance, local self government, forests and wildlife protection, and animal husbandry and dairy development, along with the secretaries of the respective departments.
The Programme Steering Committee, chaired by the Chief Secretary, will oversee the programme’s strategic direction, facilitate cross-sector collaboration, and approve annual work plans and budgets.
Meanwhile, the Apex Committee and Programme Executive Committee will support governance, and the TSU will extend technical expertise, with implementation responsibilities resting on the Programme Implementation Units and Implementation Agencies.
The independent verification agency (IVA), as mandated by the World Bank, will be IIM-Kozhikode.
“Kerala has always been at the forefront of public healthcare in India, but the challenges we face today demand a new and future-ready approach. The KHISP will be a watershed moment for the state’s health sector — transforming not just how we deliver care, but how we anticipate, prepare for and respond to the evolving health needs of our people. This is about safeguarding the health gains we’ve achieved over decades and building a resilient and equitable system that can withstand the uncertainties of tomorrow,” a senior official in the state health department told South First.
According to the project proposal, KHISP is a comprehensive initiative aimed at enhancing the quality of healthcare services and improving the efficiency of healthcare delivery systems in the state.
The overarching goal, it states, is to support the people of Kerala in attaining long and high-quality lives, free from preventable diseases, injuries and premature deaths.
The programme seeks to build resilient, value-based health systems capable of responding to the state’s advanced demographic and epidemiological transition, while also addressing emerging public health threats, including those posed by climate change.
Informed by global and national best practices, the programme will draw implementation lessons from countries like Israel, Poland, and China that have undergone similar health system transformations, while integrating One Health approaches and antimicrobial resistance strategies.
It will also leverage digital health innovations from Estonia and South Korea, alongside lessons from Tamil Nadu’s trauma care system.
Central to the program is the development of a state policy on One Health and climate change, backed by comprehensive district and local-level vulnerability assessments.
This will support climate-resilient healthcare facilities and communities through mitigation and adaptation strategies — including green buildings, energy audits, air quality monitoring, and solar infrastructure. Advanced data analytics and big data tools will be deployed for zoonotic, climate-sensitive disease surveillance and air quality management.
Aligned with the Kerala State Planning Board’s Fourteenth Five-Year Plan for Medical and Public Health (2022–2027), KHSIP envisions moving “towards planetary health” through equity, efficiency, quality and cultural competency, prioritising universal health coverage, empowering local governance, addressing social determinants of health and reducing out-of-pocket expenditure by strengthening public health infrastructure and human resources.
(Edited by Muhammed Fazil.)
