Public health in Kerala runs on three authorities, from the Director of Health Services down to a local medical officer

Background

Public health in Kerala works through a system built on three tiers, one at the state, one in each district and one in each local body. Public health authorities are not new posts but officials already in place, so the Director of Health Services is the State Public Health Authority, the district medical officer (health) is the District Public Health Authority, and at the bottom sits the medical officer of that local self-government institution. Medical practitioners have to report an incident or outbreak of a notifiable communicable disease to the Local Authority, which passes the details to the District and State Surveillance Officers of the department. Local Authority work covers an annual action plan for the area, directing a person or authority to stop or begin an activity for public health, levying fines, compounding an offence, and entering and inspecting places for vector control. In a public health emergency the State Authority can set up an ad hoc advisory committee of departmental nominees and outside experts. It is the State Authority that specifies the conditions for declaring a public health emergency, and it can advise the state government to declare one. All the diseases covered are listed, with dengue among the communicable diseases and nipah among the notifiable ones, and more can be notified later.