November 12, 2021
Implementation of a Population Health Program for Congenital Heart Disease
Updated February 5, 2026
Children’s HeartLink is excited to share our original research on the Implementation of a Population Health Program for Congenital Heart Disease (CHD) in Kerala, India [1] was published in October 2021.
The Children’s HeartLink initiative with the Kerala Government and Amrita Hospital Kochi began in the summer of 2017. As outlined in the New Initiative with Indian Government Will Help Us Reach More Children in 2017, the program aimed to improve early diagnosis, management and care of children with CHD. To our knowledge, this is the first such program for CHD services integration in primary care in a low- and middle-income country.
Amrita Hospital Kochi, the first Children’s HeartLink Center of Excellence, had one of the established pediatric heart surgery programs with the ability to perform infant and neonatal surgery in the state of Kerala. As a result, they were well positioned to be one of the key training collaborators in this project. Throughout the project, the Kerala Government made significant investments in the infrastructure and upskilling health care workers to assure patient referrals happened fast and on time.
In 2020, Our Partners Help to Reduce Infant Deaths in Kerala, India highlighted the positive impact the program was having on reducing the rate of infant deaths in the state.
[1] Nair SM, Zheleva B, Dobrzycka A, Hesslein P, Sadanandan R, Kumar RK. A Population Health Approach to Address the Burden of Congenital Heart Disease in Kerala, India. Global Heart. 2021; 16(1): 71. DOI: https://doi.org/10.5334/gh.1034
2025 Follow Up Study
In September 2025, a follow-up study A Population-Based Approach to Congenital Heart Disease in Kerala, India highlighted that early detection and intervention strategies led to decline in infant deaths by nearly 50% at Kerala’s largest hospital.
The study published in the American Academy of Pediatrics special supplement, Insights into Global Pediatric Health Equity Research and Health Care Delivery showed that:
- Of the roughly 23,000 children registered between 2017 and 2024, 33% required CHD surgery or intervention
- Newborn physical examination and pulse oximetry, or test to measure blood oxygen level, helped early detection of congenital heart disease
- Kerala’s infant mortality dropped from 12 per 1000 live births to 6 per 1000 live births
The paper demonstrates that governments, hospitals and non-governmental organizations can successfully collaborate to eliminate inequalities, reduce infant mortality rates and increase access to congenital heart disease care regardless of birthplace and economic means. Most importantly, it highlights that congenital heart disease can be effectively addressed through a population health approach.
