Palliative care activities in Kerala began in 1993 through voluntary initiatives. In 2008, Kerala became the first state in India to announce a palliative care policy. In accordance with this policy, palliative care programs were implemented under the leadership of healthcare institutions and local self-government bodies. Based on the experiences gained over a decade of implementation, the revised policy was published in 2019. In 2002, palliative care high power committee working group was constituted. Following discussions held at various administrative levels, an action plan for implementing the updated palliative care policy was formulated, and in July 2023, the government approved the action plan.

According to the ‘Shaili Survey’ conducted as part of the Annual Health Screening, it is estimated that 0.6% of Kerala's population is bedridden due to various health conditions. Additionally, another 2% of the population, though not confined to bed, suffers from Serious Health Sufferings (SHS) due to long-term illnesses.

In the public sector, Kerala has a total of 1,141 primary palliative care units encompassing all Gram Panchayats, Municipalities, and Corporations. Under the Department of Health, there are 113 secondary-level units functioning in major hospitals and 231 units operating at Community Health Centres. Palliative care units are functional in eight medical colleges, the Regional Cancer Centre and the Malabar Cancer Centre. In addition,44 secondary palliative care units have been established under the Indian Systems of Medicine (ISM) Department, and 18 secondary units under the Department of Homeopathy. In the NGO/CBO sectors, over 500 units provide home-based medical care and nursing services. Additionally, there are more than 1,000 charitable and social organizations across Kerala offering psychological and financial support to palliative care patients.

The Universal Palliative Care Programme focuses on the coordination of palliative care services available at various levels.

●    Each bedridden patient is connected with trained palliative care volunteers from their neighbourhood.
●    In each ward, a Neighbourhood Network for Palliative Care (NNPC) team is being formed under the leadership of ASHA workers to support patients in need.
●    Each JAK registers patients with long-term illnesses who are not bedridden but are experiencing SHS, and ensures they receive appropriate follow-up care. For this purpose, training is being provided to the MLSP nurses appointed at the JAK.
●    In all panchayats and municipalities, a palliative home care team operates to provide home care to bedridden patients. The team is led by community nurses. As part of the initiative, the home care team ensures that every bedridden patient is visited at least once a month and receives the necessary support.
●    The Directors of the Department of Health, the Department of Indian Systems of Medicine, and the Department of Homoeopathy will ensure that all Community Health Centres and major hospitals have secondary specialized palliative care programs, staffed with trained nurses and doctors. As part of the program, doctors will visit patients at their homes once a week.
●    Specialized palliative care units in medical colleges and cancer centers will be strengthened. Palliative care units will also be established in all medical colleges, including private institutions, to ensure that medical students receive palliative care training during their academic period.
●    Palliative care will be integrated into the curriculum of all medical and nursing schools/colleges.
●    To ensure the involvement, state-level registration has been implemented for volunteers,NGOs/CBOs that provide medical and nursing care through home visits. Units that offer psychological and social support to palliative care patients are also being registered under the respective local self-government institutions. To facilitate smooth collaboration at all levels, common platforms have been established, and training programs are being conducted.
●    Training centres providing palliative care training for healthcare workers are operational in all 14 districts under the government sector. In the voluntary sector, six training centres are also functioning. Various structured training programs are being conducted, including: Six-week training for doctors (BCCPM), Six-week training for nurses (BCCPN), Four-month training for community nurses (CCCPN), Ten-day training for both doctors and nurses, Three-day training for health workers, and Three-day training for volunteers. A unified syllabus for these courses has been issued by the Health Department.
●    To enhance the quality of palliative care units, programme is being implemented following the Kayakalp model.
●    A programme has been launched in collaboration with Kudumbashree in Ernakulam and Malappuram districts to provide vocational rehabilitation for patients with paraplegia.
●    In collaboration with the Department of Education and under the leadership of SCOLE Kerala, a six-month course titled ‘Diploma in Domiciliary Nursing Care’ has been launched with the objective of developing scientifically trained home nurses.
●    The government aims to strengthen and expand the achievements made in the field of palliative care and transform Kerala into a ‘complete palliative-friendly state’. The goal is to establish a universal palliative care system that ensures high-quality care at home for all individuals in need, irrespective of their financial status. All voluntary organizations, volunteers, and government institutions working in this sector will be coordinated at various levels including grama panchayat, municipality, and corporation levels ensuring comprehensive care reaches everyone in need.
●    To coordinate the above-mentioned activities, the Palliative Care Grid named 'Kerala Care', was launched by the Hon’ble Chief Minister on March 3, 2025. So far, 1,362 government institutions and 1,085 voluntary organizations involved in palliative care have been registered on the Grid. Information on 158,100 bedridden patients is currently available through the Grid. Follow-up care for these patients is being coordinated via the Grid, in collaboration with voluntary organizations. To support this initiative, the government continues to provide ongoing training to doctors, nurses, other healthcare professionals, and volunteers engaged in palliative care.
●    The government has provided an opportunity through the Sannadha Sena portal for anyone willing to volunteer at least an hour of their time for a patient in their locality to register as a volunteer. Nearly ten thousand new volunteers have registered in the past month. A three-day training program on coordinating patient care through the Palliative Care Grid has been provided to them, and activities to integrate them into the Grid have already begun. It is estimated that currently over one lakh volunteers are actively serving in the field of palliative care. The government intends for all of them to undergo training and become part of the Grid.
●    Palliative care initiatives in Kerala have been commended by the World Health Organization and several other agencies. The Palliative Care Grid is expected to become a model of excellence that showcases Kerala’s remarkable contribution to this field.