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Establishment of a government funded cochlear implant program in Kerala - guidelines for efficient
Puthiyaparambil M.M. , Ashraf T.P.
MESIARC, Otology- Otoneurology, Calicut, India, 2Government Social Security Mission, Ministry of Social Welfare, Thiruvananthapuram,
The main disadvantage of a cochlear implant program in developing countries is the prohibitive cost entailed in
the process of getting a cochlear implant. Because the main focus in developing countries is the paediatric
cochlear implant program, there is a lot of emotion attached to it as well. The dynamics of the need to bring
hearing to the deaf and the cost involved in a large scale, expensive program has to be balanced so that it is
considered truly cost effective. The only answer to this solution is to have a robust Government funded program
that will not only reach out to the needy but also provide a cost efficient solution to the exchequer.
The state of Kerala in India is a small state with a population of about 33,387,677and has one of the highest
literacy rates, the lowest infant mortality rate and the lowest population growth in India. The Government of
Kerala has formulated and designed a cochlear implant program with the help of professionals in the industry to
be as close to ideal as possible. Funding for the program is generated from the state lottery and donations to the
social security mission which is a government organization under a separate ministry. The evaluation process for
the centres that are chosen for executing the implant program is based on facilities, professional experience and
the willingness to perform to the strict criteria made by the government. The program is also designed to follow
up patents, evaluate outcomes and ensure that the ideals are met.
We evaluated 350 cases done in 18 months in Kerala and did an analysis of the patient profile, the economic
status, age of diagnosis, age of implantation, cause of deafness and the outcomes and complications in eight
centers across the state. We have come to the conclusion that a robust, well founded government cochlear
implant program is the need of the hour in a country like India. Only this can convince the economists about the
cost effectiveness and the value of the program to people even if the numbers are statistically small.