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Thursday, April 07, 2005

World Health Day.

April 07 is the World Health Day. The theme for 2005 is 'Make every mother and child count'.

Apart from this aspect, the world is plagued by innumerable health-related issues. Same goes for India, too, where the nation is striving to get itself rid of ailments which hampers the economic growth of any developing nation.

The following data, for India, is taken from The World Health Report 2004 published by the World Health Organization (WHO).

Total expenditure on health as % of GDP

1997 5.3%
1998 5.0%
1999 5.2%
2000 5.1%
2001 5.1%

General government expenditure on health as % of total expenditure on health

1997 15.7%
1998 18.4%
1999 17.9%
2000 17.6%
2001 17.9%

Private expenditure on health as % of total expenditure on health

1997 84.3%
1998 81.6%
1999 82.1%
2000 82.4%
2001 82.1%

General government expenditure on health as % of total government expenditure

1997 3.2%
1998 3.5%
1999 3.3%
2000 3.1%
2001 3.1%

Children under five years of age underweight for age: 46.7(%) in year 1998-99
Under-five mortality rate (per 1000 live births): 96
Infant mortality rate (per 1000 live births): 77
One-year-olds immunized against measles (5%) (2001): 56
Maternal mortality ratio (per 100,000 live births): 540
Births attended by skilled health personnel (%): 42.3

HIV prevalence among 15-49-year-olds (%): 0.8
Malaria mortality rate (per 100,000): 3
Tuberculosis prevalence (per 100,000): 431
Tuberculosis mortality rate (per 100,000): 41
Tuberculosis cases detected under DOTS (2001): 23
Tuberculosis cases cured under DOTS: 84

Population using solid fuels (%): 81
Population with sustainable access to an improved water source (%) (urban): 95
Population with sustainable access to an improved water source (%) (rural): 79
Population with access to improved sanitation (%) (urban): 61
Population with access to improved sanitation (%) (rural): 15

However, to derive a meaningful analysis from the above numbers would involve comparison with data for other countries.

A few things can be said, though. India's total health expenditure was 5.2% of GDP in 2001. Of this, the Government of India spends less than 1% of its gross national product on its health care budget. Private health spending, mostly in the form of out-of-pocket expenditures by families and individuals, accounts for 82.2% of the total health expenditures. The 2002 Indian national health policy suggests increasing health expenditures from 5.2% of GDP in 2001 to 6% of GDP by 2010, and government health spending from 0.9% of GDP in 2002 to 2% of GDP in 2010.

The Centre for Monitoring Indian Economy (CMIE) reports the following data on expenditure of central and state governments in health.

Years % to GDP
1993-94 1.25
1994-95 1.22
1995-96 1.02
1996-97 0.95
1997-98 1.00
1998-99 1.11
1999-2000 0.90

The government expenditure on health as percentage of total government expenditure (2001) for a few countries stood as follows.

China 10%
Ghana 9%
India 3%
Indonesia 3%
Mexico 17%
Sri Lanka 6%

Though the key health indicators are looking much better than they were when India got independence, there is still much left to be done. Life expectancy has gone up markedly, the infant mortality rate has been halved, 42 per cent of children receive the essential immunizations. We have a huge private healthcare infrastructure. And yet, critical health issues remain: infectious diseases continue to claim a large number of lives, babies continue to die needless deaths from diarrhoea and respiratory infections, and millions still do not have access to the most basic healthcare.

In India, just like the disparity in wealth, there is a vast disparity in healthcare infrastructure, too. If some of the cities in India are the hottest destination for medical tourism, then healthcare infrastructure in most of the rural India is in abysmal conditions. The root causes of these afflictions in the rural healthcare infrastructure seems to encompasses various aspects, such as the governmental healthcare policy, accessibility to healthcare infrastructure, private vs. public healthcare debates, etc. This reflects in the quality of the healthcare accessible to the denizens of a particular part of the country. Globalization adds another angle to the healthcare issue.

But, all is not bad, at least so it seems. Various individuals and non-governmental organization are taking up this issue, and handling them as per their own resources. They provide medical services, as well as, documentation on the state of healthcare and possible ways to remedy the situation. People's movements have also helped to bring this issue to the forefront. However, as expected, it is a very slow process, and all it requires is dedication and persistence.


Anonymous Blue Cross of California said...

It's great to hear India is one of the hottest place for medical tourism. Health insurance is a great importance and I hope they are working on improving coverage.

10:42 PM  

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