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According to a letter, accessed by TOI, it reminds Kerala that PHMC creation is a national mandate under the National Health Policy, 2017, and that state health ministers themselves committed to completing the reform within defined timelines during the 13th, 14th, and 15th central council of health and family welfare meetings.
Kerala had been asked to shift towards a structured public health leadership workforce. The Centre emphasised that PHMC aims to build a structured public health leadership workforce, strengthen district and block-level leadership, and institutionalise preventive and promotive care. It also ensures a clear separation between clinical and public health roles.
A detailed guidance note enclosed with the letter highlighted how states such as Tamil Nadu and Odisha have advanced cadre restructuring, integrating trained public health professionals effectively.
The document cites pandemic lessons, stating that states with dedicated public health cadres "showed greater resilience" and avoided disruption of essential services during Covid-19. Kerala has been asked to constitute or strengthen its task force, map existing health staff, reorganise them into four cadres — public health, health management, specialist and teaching — and roll out a time-bound roadmap for training and career progression, reports TOI.
The ministry suggested a rapid 12-week action cycle, starting with task force activation and workforce mapping, culminating in an implementation plan submission to the state cabinet, followed by quarterly reviews.
The guidance also requires that new MBBS doctors joining Kerala’s health service acquire a public health qualification within 3-5 years, while leadership positions at district and block levels should prioritize public health-trained professionals, supported by robust data monitoring and reporting mechanisms
The ministry has indicated that a follow-up review meeting will be held soon to track progress and address state-specific challenges, signalling that the Centre will monitor not just compliance but the speed of implementation.
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For Kerala, the PHMC reform could reshape its traditionally clinician-driven primary care system, redefining leadership in district-level planning, surveillance, and public health management. With the deadline for national alignment approaching in the next financial cycle, Kerala is now under pressure to demonstrate evidence of cadre-based governance.
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