World Bank approved a USD 400 million (≈ ₹3,400 crore) loan to support the Kerala Health System Improvement Programme (KHSIP) under the state’s Health Department. The programme aims to strengthen Kerala’s public health infrastructure, improve elderly care, and enhance digital and climate-resilient health systems.
Key Details of Project
| Parameter | Detail |
| Total Funding | USD 400 million (~₹3,400 crore) |
| World Bank Share | 70% (USD 280 million / ₹2,400 crore) |
| State Government Share | 30% (USD 120 million / ₹1,000 crore) |
| Funding Agency | International Bank for Reconstruction and Development (IBRD) – a World Bank arm |
| Loan Tenure | 25 years, with a 5-year grace period |
| Project Mode | Programme-for-Results (PforR) model |
| Implementing Agency | Kerala State Health Department |
| Year of Approval | 2025 |
| Preliminary Approval | 2023 (submitted to Centre for clearance) |
Kerala Health System Improvement Programme (KHSIP)
Objective:
- To improve life expectancy, healthcare quality, and resilience for over 11 million elderly and vulnerable people in Kerala.
Key Focus Areas
Non-Communicable Disease (NCD) Care
- Target: Treatment & tracking of 90% of patients registered for hypertension and diabetes using electronic health records.
- Use of individual electronic-tracking systems for continuity of care.
Elderly & Home-Based Care
- Development of a home-care model for bedridden, housebound, and vulnerable elderly populations.
- Integration with local self-government institutions like gram panchayats and municipal corporations.
Digital Health & e-Governance
- Expansion of eHealth services and data integration platforms.
- Strengthened cybersecurity and digital health records under Kerala’s eHealth Mission.
Climate-Resilient Health Infrastructure
- Primary health facilities in Wayanad, Kozhikode, Kasaragod, Palakkad, and Alappuzha to adopt climate-adaptive solutions for energy efficiency and flood management.
- The project will make Kerala’s health system resilient to climate shocks.
Emergency and Trauma Care
- Establishment of an efficient 24×7 trauma and emergency response network.
- Development of ambulance systems, trauma registries, and integrated disaster response units.
Zoonotic & Infectious Disease Preparedness
- Improved laboratory infrastructure for early detection and response.
- Focus on zoonotic diseases and antibiotic resistance management.
Public Health Spending & Capacity Building
- Increased public investment in healthcare, workforce training, and improved resource capacity.
- Local bodies to implement standard protocols for disease surveillance and preventive care.
Programme-for-Results (PforR) Model
- The PforR model is a World Bank financing instrument that links fund disbursement directly to achieved results rather than to inputs or expenditures.
- Under KHSIP, funds will be released based on measurable health outcomes like:
- Reduction in NCD burden
- Improved elderly care coverage
- Expansion of eHealth and trauma networks
- Climate resilience performance of health centres
Significance of Project
- Will modernize Kerala’s healthcare delivery model
- Builds a resilient, inclusive, and tech-enabled health system.
- Enhances Kerala’s preparedness for pandemics, disasters, and ageing population.
- Supports the state’s Universal Health Coverage (UHC) and Sustainable Development Goals (SDG 3) — “Good Health and Well-being.”
- KHSIP will serve as a model for other Indian states to build digitally integrated and climate-resilient healthcare systems.
- It supports Decentralized Health Governance, engaging local self-government institutions.
- Reinforces Kerala’s position as a global leader in human development and health innovation.
Kerala’s Healthcare
| Indicator | Kerala’s Position |
| Life Expectancy | ~75 years (highest among Indian states) |
| Infant Mortality Rate (IMR) | 4 per 1,000 live births (among the lowest in India) |
| Maternal Mortality Ratio (MMR) | 30 per 1,00,000 live births |
| Health Index Rank (NITI Aayog 2024) | 1st among all Indian states |
| Health Spending | ~5% of total state budget |
| Disease Burden | Rising prevalence of NCDs like hypertension, diabetes, and cardiovascular diseases |
| SDG Achievement | Kerala has already surpassed several SDG 3 targets for 2030 (maternal & child health) |
Despite these achievements, Kerala faces challenges such as:
- Ageing population (over 13% above 60 years).
- Climate-induced health risks (heat, floods, vector-borne diseases).
- Limited fiscal space for expanding health infrastructure.
The KHSIP addresses these new realities by focusing on preventive care, climate adaptation, and digital health integration.
World Bank’s Role
The World Bank continues to support India’s health system transformation through state-level projects.
- E.g., Assam State Health System Strengthening Project (2024),
- Ayushman Bharat Digital Mission (ABDM) support,
- Tamil Nadu Health Reform Program (2021).
The Kerala project aligns with the World Bank’s Country Partnership Framework (CPF) for India, which emphasizes:
- Human Capital Development,
- Climate Resilience, and
- Digital Transformation.
Key Facts
| Topic | Fact |
| World Bank Headquarters | Washington D.C., USA |
| President (2025) | Ajay Banga (India-origin banker) |
| Founded | 1944 (Bretton Woods Conference) |
| Member Countries | 189 |
| Major Institutions | IBRD and IDA |
| Kerala Capital | Thiruvananthapuram |
| Kerala Health Minister (2025) | Veena George |
| World Bank Arm Funding KHSIP | IBRD (International Bank for Reconstruction and Development) |
| Loan Maturity Period | 25 years |
| Grace Period | 5 years |
| PforR Financing Model | Programme-for-Results |
| Kerala’s 2024–29 Focus Areas | Health resilience, NCD management, climate adaptation, and elderly care |