Kerala Rising: From Exporting People to Exporting Ideas · Page 177 of 353

KERALA RISING · FROM EXPORTING PEOPLE TO EXPORTING IDEAS

KERALA RISING · FROM EXPORTING PEOPLE TO EXPORTING IDEAS
reforms), and what is missing is a loop that lets the
healthy action be seen, acknowledged, and turned
into something neighbours encourage in each other.
The program supplies that loop and for attendance
and completion, and for nothing else.
The restraint is not timidity; it is what makes the
program safe to run at scale. A recognition engine
pointed at clinical numbers; weight, blood sugar,
blood pressure and would be both dangerous and
counter-productive: it would shame the people most
in need of care, deter the anxious from screening at
all, and create incentives to falsify or avoid the very
measurements that matter. Pointed only at showing
up; the walk, the camp visit, the donation, the same
engine raises the behaviours that precede good
clinical outcomes without ever touching, displaying,
or rewarding a clinical fact. The boundary is the
design, and the chapters that follow hold to it
without exception.
~1 in 4
~15%
30+
adults with diabetes
of those, condition
age for opportunistic
controlled
screening
Exhibit 10 – The burden the loop addresses. Sources: ICMR-INDIAB; Kerala
NCD studies (see References 10–11). Figures are estimates; see the
assumptions register.
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