The correct answer is D. All of the above.
Kerala has achieved remarkable health outcomes, despite having a low per capita income. This is due to a number of factors, including high literacy rates, decentralized governance, and an emphasis on public health.
Kerala has one of the highest literacy rates in India, at 94%. This means that most people in Kerala are able to read and write, which gives them access to information and education about health. It also means that they are more likely to be able to understand and follow medical advice.
Kerala also has a decentralized system of governance, which means that decision-making power is devolved to local levels. This allows for more flexibility and responsiveness in the delivery of health services. It also means that people have a greater say in how health services are run.
Finally, Kerala has placed a strong emphasis on public health. This means that the government has invested in preventive measures, such as vaccination and sanitation, as well as in treatment and care. It also means that there is a strong focus on promoting healthy lifestyles.
All of these factors have contributed to Kerala’s success in improving health outcomes.