The BJP may not be a big fan of Kerala's welfare initiatives, but Prime Minister Modi's Economic Advisory Council begs to differ. A recent working paper by the Economic Advisory Council to the Prime Minister (EAC-PM) identifies Kerala as one of the country’s leading examples in addressing the growing care crisis, despite the Centre’s frequent criticism of the state’s welfare-oriented approach. 

India’s elderly population, which accounted for 10.1% of the population in 2021, is projected to rise to 15% by 2036, with more than half the states entering the ageing category by then. Kerala, the first Indian state to become an ageing society with 16.5% of its population above 60 years, is expected to see that figure rise further to 22.8% by 2036. Driven largely by demographic necessity, the state has gradually reshaped its care economy through a series of policy interventions over the past decade. 

Among Kerala’s eldercare initiatives, the working paper specifically highlights the Vayomithram scheme and the Kudumbashree Elder Care Model. Launched in 2010-11, Vayomithram caters to senior citizens aged 65 years and above, with plans to lower the eligibility age to 60 years. The programme offers free mobile clinics, medicines, palliative care, help desks, special medical camps including eye camps, and social engagement activities. Implemented by the Kerala Social Security Mission under the Department of Social Justice, the scheme currently functions through 95 units across six corporations and 85 municipalities. 

“Kerala is leading the transition much ahead of other states because birth rates are lower and life expectancy is higher here. During the 14th Five-Year Plan, the second LDF government identified the care economy as a major policy intervention and an important focus area,” said Prof Jiju P Alex, former member of the Kerala State Planning Board. 

The Kudumbashree Elder Care Model, active during 2023-24, provides daycare services, nutrition kits, first-aid support and palliative care assistance through the Kudumbashree self-help group network. Around 90 women have been trained in each district under the programme, which has reached nearly 2.9 lakh senior citizens through 168 centres and 95 mobile units. 

“Kerala did not interpret the care economy merely as geriatric care. Over time, the state attempted to create an integrated caregiving system and a broader caregiving landscape that also included palliative care,” Alex said. 

 Ravi Raman, member of the Kerala State Planning Board, said Kerala’s strength lies in embedding the care economy within its overall development process rather than treating it as a separate welfare activity. “The state follows an all-inclusive development model in which social care is integrated into the broader development structure,” he said. 

According to Raman, existing institutional frameworks played a crucial role in making this possible. “Institutions such as Kudumbashree have existed in Kerala for many years, eliminating the need to create entirely new structures for care delivery. Economic functions and care-related responsibilities were instead grafted onto existing social institutions,” he said. 

Kudumbashree, for instance, was given specialised caregiver training programmes in which groups of women were trained in basic caregiving assistance and later organised into community-based caregiving units across the state. Raman also pointed to Kerala’s long-standing rights-based welfare culture, where people actively demand social entitlements, as another factor behind the success of such initiatives. 

The report further cites Kerala’s Sayamprabha Homes and Vathilpadi Sevanam as examples of hybrid care models combining public funding with community-level delivery through networks such as ASHA workers and Kudumbashree. While Sayamprabha Homes provides daycare facilities for the elderly, Vathilpadi Sevanam delivers government services to senior citizens at their doorstep through ASHA workers and volunteers. Embedded within existing health system and supported by local bodies, these programmes seek to move eldercare beyond fragmented welfare measures toward a more coherent and rights-oriented long-term support framework. 

According to the working paper, India’s care economy continues to suffer from major supply, regulatory and financing gaps because caregiving is still largely treated as a private, women-led household responsibility rather than as essential social infrastructure. Public eldercare programmes such as the Atal Vayo Abhyuday Yojana (AVYAY) have limited reach, while workforce development remains fragmented due to the absence of standardised certification systems and stable employment pathways. 

Against this backdrop, Kerala has managed to integrate the care economy into its broader socio-economic framework. The paper identifies Kudumbashree as a scalable community-based care cooperative model that trains and deploys local women as caregivers for home-based eldercare and daily assistance, helping address rising care demands while simultaneously generating livelihoods and increasing women’s workforce participation. 

“However, these interventions alone are not sufficient to address Kerala’s future ageing challenge,” Alex warns. “They need to be scaled up substantially. Future governments will have to continue and expand them. The private and voluntary sectors also have an important role to play”. 

The paper also highlights Kerala’s K4 Care project as a proactive initiative linking care training with employment opportunities. Implemented by Kudumbashree in partnership with the National Institute for Physical Medicine and Rehabilitation (NIPMER), the programme offers a one-month certified course in elderly care, bedridden patient support and post-natal care. In its first phase, 605 trainees secured paid employment, reflecting strong livelihood linkages within Kerala’s community network structure. 

Beyond eldercare, the EAC-PM paper also highlights Kerala’s childcare interventions, particularly for vulnerable groups. Under the Kerala Maternity Benefits Amendment Rules introduced in 2022, workplace crèches were established for children below three years and preschool children up to six years by restructuring Anganwadi centres into crèches and creating safe after-school spaces for adolescent girls. Kerala also launched mobile crèches and daycare centres for children of migrant labourers during 2022-23 by integrating them with existing Anganwadi infrastructure. 

Overall, the working paper positions Kerala’s care economy initiatives as more than welfare schemes, describing them instead as integrated systems linking healthcare, social inclusion, women’s employment and community participation. By combining state support with community networks, the Kerala model demonstrates how care infrastructure can simultaneously address demographic change, generate employment and reduce the unpaid care burden traditionally imposed on households. 

The last budget presented by the LDF government also placed special emphasis on the care economy, with the Elderly Budget for 2026-27 earmarking a consolidated outlay of ₹46,236.52 crore, accounting for 19.07% of the total state budget, for the welfare of senior citizens.