Table 1. Differences in institutional context.
| Kerala | West Bengal | |
|---|---|---|
| 1. Demographic indicators | ||
| a. Literacy * | 93.91% | 76.26%
- In Nadia - 74.97% |
| b. Life expectancy * | 73.2% Male
77.6% Female |
69.2% Male
72.1% Female |
| c. Infant mortality rate * | 12 | 32 |
| d. Maternal mortality ratio * | 81 | 145 |
|
e. State Government’s per capita
health expenditure ** (in Rupees, 2009–2010) |
499 | 330 |
|
f. % Population below poverty line
(2012) *** |
8% | 20% |
| 2. Legal infrastructure for palliative care | ||
|
a. Narcotics and Psychotropic
Substances Act |
Amended in 1999 to ease opioid access for
pain relief |
Amended in 2014 to ease opioid access
for pain relief - Access on the ground remains limited. Sanjeevani had no access to morphine. |
|
b. State Government palliative care
policy |
In 2008, Kerala state mandated provision of
palliative care at primary health center level |
No equivalent policy |
| 3. Voluntary organizations | High density of civil society organizations,
including community organizations, co- operatives |
Patron-client relations with political
parties; political mobilization of communities |