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The Total Sanitation Campaign (TSC), a ‘flagship’ programme of the Government of India, has completed a decade of implementation. The TSC over the period has been able to improve human health and sanitation coverage in the country. The initial success could be attributed to ‘Nirmal Gram Puraskar’. The total sanitation campaign has effectively made use of the village social structures in Kerala to solve the first generation sanitation issues. Disparities could also be seen. As the TSC is on the verge of a positive transformation to a new and broader perspective, and as the state look forward for a new dimension in sanitation concepts over the next five-year plan, it asks for a review on the coverage patterns. This would support the policy-makers to invest in edifying ideals as the nation progress from the TSC to ‘Nirmal Bharat Abhiyan’. The broad objective of the study thus is to assess the impact of sanitation and hygiene coverage in the state. For measuring the outcomes and relative performance in terms of total sanitation provision, seven selected Gram Panchayats of Kozhikode district are considered. To arrive at a robust scenario, a synthesis of a narrative and statistical model was used. An innovative measurement framework known as ‘Total Sanitation Index’ was developed. The index was formulated for comprehending the relative positions of each Panchayat in terms of total sanitation and the results were presented.

Mahatma Gandhi National Rural Employment Guarantee Scheme (NREGS) and Kudumbashree Poverty Alleviation Mission take a different approach to poverty alleviation. When viewed through the lens of capability approach the difference becomes more evident. Both the programmes, through their procedures and outputs, enable the beneficiaries themselves to be the agent of change. People themselves could utilize the opportunities generated by the procedural, output aspect of the programmes to remove their unfreedoms and deprivations to attain their desired functioning for well being. Community development also takes place along with individual development. The convergence of Mahatma Gandhi NREGS and Kudumbashree under the umbrella of the Local Self Government complement each other’s effort in poverty alleviation.

Intervention projects aimed at preventing STD and HIV generally tend to target women sex workers and through them their clients. This approach sees women sex workers as agents of change, with the attendant burden, but has failed to recognise gender issues surrounding sexual health, particularly power relations existing in society. While gender justice is a recognised legitimate concern, the discourse has excluded sex workers from its purview making them the moral 'other'. Sexual health projects implemented currently in different parts of Kerala are not sensitive to gender issues because they mistakenly assume that sex workers are autonomous subjects. In the sexual health project for female sex workers implemented in the Kottayam municipal area some gender issues were tackled with modest success. This paper makes a strong plea for more gender sensitivity in sexual health projects and for men to take their fair share of responsibility for HIV transmission.