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From the wiki:

Kerala's unusual socioeconomic and demographic situation was summarized by author and environmentalist Bill McKibben:[26]

Kerala, a state in India, is a bizarre anomaly among developing nations, a place that offers real hope for the future of the Third World. Though not much larger than Maryland, Kerala has a population as big as California's and a per capita annual income of less than $300. But its infant mortality rate is very low, its literacy rate among the highest on Earth, and its birthrate below America's and falling faster. Kerala's residents live nearly as long as Americans or Europeans. Though mostly a land of paddy-covered plains, statistically Kerala stands out as the Mount Everest of social development; there's truly no place like it.[26]