Kerala Leads India's Journey
Towards Age-Friendly Healthcare
At a time when India is rapidly ageing and healthcare systems are unprepared, IMA Kerala has taken a historic step — creating the country's first statewide physician-led movement to make every hospital and clinic safer, more respectful and more responsive to older persons.
"Age-friendliness is not measured by luxury, bed strength or hospital size alone. It is measured by how safely, respectfully, efficiently and consistently an older person is cared for."
— IMA-AFHI Core Principle · Kerala State Network of Age-Friendly Hospitals and Healthcare InstitutionsKerala's Ageing Crisis — and Its Response
Kerala has one of the highest proportions of older persons in India. This is not merely a demographic fact — it is a healthcare emergency that demands urgent, systematic action.
Older persons in Kerala often live with multiple chronic conditions simultaneously — frailty, diabetes, hypertension, heart disease, arthritis and cognitive decline. They experience frequent falls, polypharmacy risks, functional dependence, caregiver burden and the constant need for coordinated, continuous care.
Yet most hospitals — including large ones — were never designed with older persons in mind. Reception counters are too high. Queues are too long. Signage is too small. Staff are untrained in respectful elder communication. Clinical pathways for delirium, falls and medication safety are absent or unused.
IMA Kerala recognised this gap and acted. Rather than waiting for policy change or government direction, the Kerala State Branch of the Indian Medical Association — through its Committee for Healthy Ageing — built the first physician-driven, hospital-network model for age-friendly healthcare in India.
Kerala's Ageing Reality
The numbers that make AFHI not just important — but urgent.
IMA Kerala — The Torchbearer
for Age-Friendly Healthcare in India
What IMA Kerala has built through AFHI is unprecedented in India. No other state medical association has created a structured, multi-hospital, domain-based, progressive quality-improvement network for age-friendly care at this scale. Kerala has shown what is possible when physicians lead.
First in India
The first state-level physician-led network dedicated exclusively to making hospitals age-friendly — built from within the medical community, not imposed from outside.
Original Framework
A 10-domain evaluation framework developed specifically for the Kerala healthcare context, aligned with WHO age-friendly principles and adapted for institutions of all sizes.
Beyond Accreditation
IMA-AFHI moved beyond one-time inspection to a continuous improvement model — where every hospital, from a small clinic to a 1,000-bed hospital, can participate and progress.
Physician-Driven
Led by doctors, for patients. IMA's credibility and reach through 14 district branches gives AFHI the trust, infrastructure and professional authority to create real change.
Scalable Model
The Kerala model is designed to be replicated. What works here — the domains, the levels, the training modules, the quarterly reporting cycle — can be scaled to any state in India.
Built-In Capacity
Role-specific training for doctors, nurses, administrators, front office staff, physiotherapists and quality managers — creating an entire ecosystem of age-friendly healthcare professionals.
What We Are Building
A Kerala-wide network of age-friendly healthcare institutions that uphold the dignity, rights, safety, autonomy and well-being of older persons — and a practical model that can be scaled across India.
Dignity and Justice
Every older person who walks into a member hospital is treated with respect, patience and courtesy — regardless of their condition, ability or social status.
Functional Age-Friendliness
Not cosmetic improvements — but real changes in how hospitals function for older persons. Priority queues that are actually used. Ramps that are actually accessible. Protocols that are actually followed.
Inclusion of All Institutions
From a 20-bed clinic in a small town to a 1,000-bed tertiary hospital in a city — every institution can and should be age-friendly. AFHI is not only for the large or the wealthy.
Continuous Improvement
Age-friendliness is a journey, not a destination. IMA-AFHI supports hospitals to keep improving through quarterly cycles, annual reviews and five progressive levels of recognition.
What We Measure
Scoring 100 points across 10 dimensions of age-friendly care — from governance to innovation.
A Movement, Not a Certificate
IMA-AFHI made a deliberate, bold shift from the conventional accreditation approach to a progressive network model. This is what makes it replicable — and honest.
| Conventional approach | The IMA-AFHI way |
|---|---|
| One-time inspection or accreditation | Continuous improvement journey with quarterly, annual and triennial review |
| Pass or fail — binary judgement | Five progressive levels — every institution starts where it is and improves |
| Infrastructure-heavy view | Functional age-friendliness — does it actually help an older person? |
| Only large hospitals can participate | Small clinics, cooperatives, government institutions — all can join |
| External inspectors drive the process | Hospital teams own the journey — evaluators are supportive, not punitive |
| Low scores penalised | Honest baseline reporting encouraged — improvement is the goal |
| Single institution focus | Statewide learning network — peer mentoring, shared practices |
The Five Levels of Age-Friendliness
Every hospital enters the network at Level 1 through commitment and self-evaluation. Progression to higher levels is earned through evidence, sustained improvement and active participation — not just inspection.
The model is designed to motivate improvement, not to punish institutions for starting small. Even a Level 1 hospital is making a public commitment to the dignity of older persons.
"A small clinic with respectful communication, priority access, fall-risk awareness and continuity support may score higher in age-friendliness than a large corporate hospital with advanced infrastructure but poor senior-sensitive systems."— IMA-AFHI Working Framework · Kerala State
Objectives and Expected Outcomes
How Your Hospital Can Become Part of History
Any hospital or healthcare institution in Kerala — regardless of size, ownership or specialty — can join the IMA-AFHI network. What is required is not infrastructure excellence. What is required is commitment to improving care for older persons.
Joining does not mean you are already age-friendly. It means you are committed to becoming more age-friendly — one step at a time, supported by IMA's district network, training calendar, peer mentoring and evaluation framework.
Join Kerala's Age-Friendly Healthcare Movement
Whether you are a hospital administrator, a doctor, a nurse or a patient — you have a role in this movement. Download the application pack, explore the network hospitals, or meet the committee that is making this happen.