WASHINGTON, Oct. 23, 2025 - The World Bank's Board of Executive Directors today approved a new program to improve the life expectancy and quality of life for 11 million elderly and vulnerable people in the state of Kerala through wider access to health coverage and resilient health systems.
Kerala has made sustained health gains for more than two decades with improved neonatal (3.4 per 1,000 live births), infant (4.4 per 1,000 live births), under-five mortality (5.2 per 1,000 live births) rates, and maternal mortality (19 per 100,000 live births) rates. This stems from high literacy rates, public health awareness as well as decentralized governance. However, a rising burden of non-communicable diseases (hypertension, diabetes, cancer) and a rapidly aging population (with the elderly comprising over 20 percent of the total population) has strained the health system. Moreover, there are gaps in emergency and trauma care with over 4,000 deaths in road traffic reported annually.
The $280 million Kerala Health System Improvement Program will build a more comprehensive health system resistant to climate shocks. It will also strengthen Kerala's digital health systems through expanded eHealth services, integrated data platforms, and enhanced cybersecurity. The Program aims to treat and support over 90 percent of patients registered for hypertension and diabetes in the state through individual electronic tracking mechanisms. It will also establish a home-based care model for bedbound, home bound, and vulnerable elderly, to provide comprehensive health services.
"Good health empowers people, creates jobs and drives economic growth. Strong, resilient health systems also help economies prevent and better respond to health emergencies and pandemics," said Paul Procee, the World Bank's Acting Country Director for India. "In Kerala, women have one of the highest educational attainments in the country and can contribute more to the state's economic growth with optimum health. The Program will ensure a 40 percent increase in patients whose hypertension is controlled and 60 percent increase in cervical and breast cancer screening for women to accelerate efforts to end preventable deaths."
The Program will engage with local government bodies such as gram panchayats and municipal corporations adopt standard protocols and procedures for antibiotic use and address zoonotic disease outbreaks by fast-tracking reliable laboratory information for patients. Primary health facilities in districts of Wayanad, Kozhikode, Kasaragod, Palakkad, and Alappuzha will also adopt climate-led solutions to improve energy efficiency and manage extreme heat and floods.
"Kerala has adopted One Health approaches, and experiences from ongoing World Bank support have been tapped to establish a sound system of community surveillance," said Deepika Chaudhery and Hikuepi Katjiuongua, the Task Team Leaders of the program. "This Program will ensure elderly people in Kerala receive wider access to health coverage through innovative initiatives. The Program will also support a multilevel trauma and emergency care system to ensure that 8.5 million people receive timely and high-quality service."
The $280 million loan from the International Bank of Reconstruction and Development (IBRD) has a final maturity of 25 years with a grace period of five years.
