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Background:In contrast to India's poor performance in palliative and end-of-life care, the state of Kerala has gained considerable attention for its palliative care (PC) policy. This study tried to understand the structure, organization, and delivery of the program currently offered to the rural population, and its conformity to the state's PC policy and guidelines for Local Self-government Institutions (LSGIs).Materials and Methods:A descriptive research design involving a review of Kerala palliative policy and guidelines for LSGIs was followed by direct field observation and interviews of stakeholders. Two LSGIs in rural Kerala served also by a nongovernmental organization (NGO), were selected. Data were collected from health workers (doctors, nurses, and PC nurses), government stakeholders (LSGI members and representatives of the National Health Mission), and the health workers and officials of NGO.Results:The program in two LSGIs varies considerably in terms of composition of the palliative team, infrastructure and human resource, cost, and type of service provided to the community. A comparative assessment with a nongovernmental service provider shows that the services offered by the LSGIs seemed to be restricted in scope to meet the needs of the resource-stricken community. Compliance with policy guidelines seems to be poor for both the LSGIs.Conclusions:Despite a robust policy, the palliative program lacks a public health approach to end-of-life care. A structural reconfiguration of the delivery system is needed, involving greater state responsibility and political will in integrating PC within a broader social organization of care.

Context:Change in stunting as the children grow older is rarely found in published literature.Aims:The present paper compares the change in the prevalence of stunting among children as they grow from 0–4 years to 7–11 years.Settings and Design:The present paper is a secondary analysis of India Human Development Survey-I (IHDS-I) (2005) and IHDS-II (2012) data for Kerala.Methods and Materials:In total, 411 children of age 0–4 years and 390 children of age 7–11 years with anthropometric measurements were included in the present study, respectively, from IHDS-I and IHDS-II.Statistical Analysis Used:The statistical analyses were done using SPSS 21.0. The prevalence of stunting was estimated. Bivariate and multivariate analyses were performed using the Pearson Chi-square test.Results:The prevalence of stunting among children has been drastically reduced (50.4% to 20.3%) while growing older from 0–4 years to 7–11 years.Conclusions:More than half of the stunted children below 5 years regained normal growth, as they grow older.

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