Eight factors behind Kerala’s successful Covid-19 response

Kerala model against covid-19 coronavirus infection
Kerala has more than 229,887 confirmed cases and more than 84,497 patients under treatment for Covid-19.

By John Samuel

Kerala state in southwest India received wide international attention for its successful Covid-19 response. The state reported its first case on January 30. Despite reporting a large number of coronavirus cases in February, Kerala responded in an effective manner to contain the spread of the pandemic. The state faced heavy odds in its fight against the outbreak – it is closely integrated with the world with almost 20% of its population residing outside. It will face a tough challenge when more Keralites return home, but the state government and the health department seem to be prepared for the big challenge.

As the Kerala experience in fighting the pandemic gains international acclaim, other Indian states are looking to learn from the state. Several commentators want other state governments to emulate the Kerala experience. However, other states may find Kerala a tough act to follow, because the state’s success in dealing with Covid-19 comes from several distinctive historic, social, economic and political factors. Here are eight factors that make Kerala distinct from the rest of India.

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1. History, geography, habitat

Due its long coastline, Kerala has witnessed more than 2,500 years of trade with countries in the east and the west. Trade ties with different parts of the world also brought different streams of religious and other faiths, helping Kerala evolve into a society of multiple faiths and disparate communities. Long history of trade with different cultural and linguistic communities has a great role in shaping Kerala’s multi-religious community that share the common habitat, culture and language. High density of population and relatively less economic and natural resources made the mixed habitat a competitive one.

In the last 100 years, a number of community and communitarian organisations competed with each other to open schools and health facilities. This led to high demand and better access to education open to all sections of the society. The collaborative competition still remains a character of the Kerala society.

The cosmopolitan character of society with different castes and creeds living together in mixed neighbourhoods across the state influenced political process as well. Kerala was neither a part of an empire nor did it ever come under a single ruler. Historically, political power was dispersed. There was intense caste-based discrimination in Kerala, but different streams of social reform movements against caste oppression gave the society an early tryst with modernity.

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The efforts by different governments, non-government and civil society organisations to promote education and healthcare resulted in Kerala achieving high human development milestones and capabilities. This, along with multiple streams of democratisation made society somewhat different historically.

Political parties as well as civil society organisations played an important role in the democratisation of the society. While the Indian National Congress and the freedom struggle facilitated social and political democratisation, the Communist movement since the 1940s played an important role in the empowerment of Dalits and other marginalized communities.

The mixed neighbourhood habitat of different castes and multiple streams of social reforms and political participation made the society and people more politically aware and active. Hence its geography, history, cosmopolitan ethos and competitive political culture gave Kerala a distinct governance trajectory.

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2. Higher human development

Kerala had achieved comparatively high human development milestones over the last several decades before and after independence. As per the latest Sustainable Development Goals Index of the Niti Aayog, Kerala is the top achiever in India. Higher public investment in education and healthcare resulted in a large number of professional, skilled and semi-skilled workforce with a capability to compete in the global market.

A significant increase in global migration of professional and skilled workers, particularly to the Gulf region, from the early 1980s onwards earned the state a steady flow of remittances in the last 30 years. The inflow of funds enabled Kerala achieve economic growth, poverty reduction and relatively better access to higher education and professional education. This also led to high levels of globalisation, giving a large number of people global experience and perspectives. All these factors helped Malayalis evolve into an aware, responsible society with high public participation and public action.

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3. Transparent and effective governance

Over the last several decades, Kerala has built an effective system of government. One of the major reasons for this is an educated public and government staff. Kerala may have the largest number of government staff with postgraduate degrees and professional qualifications. This has contributed to a relatively high systemic capacity to deliver.

Another reason for effective governance is that political executive always sought to innovate. For example, Kerala is one of the first states to adopt e-governance in an effective manner. This ability to adopt the latest technology and improve the ability of communication across departments also improved the system capacity and response quality. The political executive of the state has always been open to ideas from citizens and best practices from India and abroad.

4. Investment in public health system

Kerala has consistently allocated more budget for public health and for improving the quality of healthcare. Kerala is one of the few places in the world with a four-tier public healthcare system. The public health system evolved over the last 60 years. This system is active at the state, district, sub-district, panchayath, and even at the ward level. The effective public health system at the grass roots level enabled better public health monitoring and support system than other states.

The per capita health expenditure of Kerala is the highest in India. The state spends $125 per head per annum on healthcare, according to different reports. The health system is coordinated at every level. Kerala health department also gained some valuable experience while responding to the Nipah virus outbreak.

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Apart from the capacity of the system, effective leadership of health minister KK Shailaja made a big difference. In Kerala, the leadership of the health care system is managed by women. The Health Minister, a former high school teacher, proved to be a leader who consistently updated knowledge and managed with competence and empathy. Director of health department is also a professional woman leader with high competence.

5. Effective local government

The three-tier local government, envisaged in the 73rd constitutional amendment, is active in Kerala with a relatively high capacity to be responsive and responsible at the grassroots level. This is due to several factors. Peoples Planning process in the second half of 1990s strengthened the role of Panchayati Raj institutions.

Kerala allocated a relatively higher budget for local government institutions. They have direct responsibility for health, education, disaster response and several other welfare initiatives. This has increased the responsibility and legitimacy of Panchayati Raj institutions.

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In Kerala, political party workers at the grassroot level are social workers and social activists. Due to their direct interface with people and the civil society, there is a direct scrutiny by the people. Hence the responsiveness is among the highest in the country. There has been consistent investment in developing the capacity of panchayats through the efforts of Kerala Institute of Local Administration (KILA). Panchayati Raj institutions are at the front end of Covid-19 lockdown relief as well effective community monitoring.

6. Women’s education and leadership

Human development is higher in Kerala, compared with other parts of India. Women play a stellar leadership role in civil society as well as in public health. For example, nurses from Kerala are the brand ambassadors of the state in India and across the world. The Kudumbashree network of 4.2 million women played an important role in organizing community relief and response. Around 27,000 Asha health workers were at the forefront of Covid monitoring and support.

Despite the higher education and capability of women, political parties and various institutions still remain highly patriarchal. Hence there are very few women MLAs and MPs. However, at the level of local government, 50% of seats and leadership position are reserved for women. Women play a great role as members and leaders of local government institutions.

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7. Highly competitive democratic culture

One of the reasons why the Kerala government performed better against the coronavirus pandemic is the higher quotient of democratisation of civil society and political parties. Kerala has a highly competitive political culture. In the last 40 years, two alliances the Left Democratic Front (LDF) and the United Democratic Front (UDF) competed with each other in elections. The margin of wins between the victor and the vanquished has always been very thin which meant that the difference in vote share between the ruling political and opposition parties are not high. Hence no political alliance could rule Kerala for more than five consecutive years. This also meant no political party or leader can take the people for granted.

A very active opposition, civil society and media ensured scrutiny of the government and processes of governance. Such public scrutiny made the government more responsive. The collaborative competitive culture of Kerala didn’t give an opportunity, in the last 60 years, for a single party to rule Kerala. Hence the multi-party alliance culture has been prevalent in Kerala politics. So far, no alliance ruled Kerala for two consecutive terms. As a result, no party could subvert the government systems. The competitive political culture forced the alliances to perform better.

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8. Responsive political system and media

Chief Minister of Kerala Pinarayi Vijayan did a commendable crisis management by effective coordination and timely response. Regular public communication reassured people that the government is capable, responsible and responsive. In the times of pandemic emergencies, reassurance and constant communication ensure that information is correct, cohesive and coordinated. The chief minister is also the chair of Kerala Disaster Management Authority. This also helped better disaster management and responsive mitigation.

Media played a public information role as well as a public scrutiny role. This too made the government respond in a more transparent and calibrated manner. The opposition political parties and leaders kept the heat on the government by scrutinising the government on a daily basis. This made the government more transparent and responsive in terms of decision making and the public policy choices.

To sum up, there are a number of socioeconomic and political factors that are unique to Kerala. Its relatively more aware and responsible citizens, a highly competitive democratic culture, a responsive and capable government, a well-entrenched public health system, effective local government, and the crisis management quality of the political executive make Kerala different from other parts of the country. Kerala is an example of how democracy and development can enable and empower people and make government capable and responsive. This is also the reason why other Indian states may fail to emulate the Kerala experience in fighting the pandemic.

(John Samuel is a policy and governance expert, social entrepreneur and development economist.)

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