Public Health

Public Health

KEY TRENDS 

 

• Based on available evidence, cardiovascular disease (24 percent), chronic respiratory disease (11 percent), cancer (6 percent) and diabetes (2 percent) are the leading cause of mortality in India $&

• The total number of dengue cases in India has grown from 28,292 in 2010 to 40,425 in 2014. The total number of dengue related deaths stood at 131 in 2014 $&


• The Proportion (per 1000) of Ailing Persons (PAP), measured as the number of living persons reporting ailments (per 1000 persons), was 89 persons in rural India and 118 persons in urban India *$

• Private doctors were the most important single source of non-hospitalized treatment in both the sectors (Rural & Urban). More than 70% (72 per cent in the rural areas and 79 per cent in the urban areas) spells of ailment were treated in the private sector (consisting of private doctors, nursing homes, private hospitals, charitable institutions, etc.) *$

• It is observed that in rural India, 42 percent hospitalised treatment was carried out in public hospital and rest 58 percent in private hospital. For the urban India, the corresponding figures were 32 percent and 68 percent. It may be noted in this context that households (or persons within households) were segregated in sector (rural/urban) by their place of domicile, and not by the place of treatment *$

• Average medical expenditure per hospitalisation case: Higher amount was spent for treatment per hospitalised case by people in the private hospitals (Rs. 25850) than in the public hospitals (Rs. 6120). The highest expenditure was recorded for treatment of Cancer (Rs. 56712) followed by that for Cardio-vascular diseases (Rs. 31647). Average medical expenditure per non-hospitalisation case was Rs. 509 in rural India and Rs. 639 in urban India *$

• As much as 86 percent of rural population and 82 percent of urban population were still not covered under any scheme of health expenditure support. Government, however, was able to bring about 12 percent urban and 13 percent rural population under health protection coverage through Rastriya Swasthya Bima Yojana (RSBY) or similar plan. Only 12 percent households of the 5th quintile class (Usual Monthly Per Capita Consumer Expenditure) of urban area had some arrangement of medical insurance from private provider *$
  

• The draft National Health Policy 2015 proposes a potentially achievable target of raising public health expenditure to 2.5% of the GDP. It also notes that 40% of this would need to come from Central expenditures. At current prices, a target of 2.5% of GDP translates to Rs. 3800 per capita, representing an almost four fold increase in five years $$
 
• Maternal mortality ratio (MMR)* in India stood at 560 maternal deaths (per 100000 live births) during 1990, 460 during 1995, 370 during 2000, 280 during 2005 and 190 during 2013. India could reduce MMR by 65 percent between 1990 and 2013**

At the country level, the two countries that accounted for one third of all global maternal deaths are India at 17 percent (50000) and Nigeria at 14 percent (40000)**

U5MR in India declined by 55 percent from 126 in 1990 to 56 in 2012. Infant Mortality Rate declined from 88 in 1990 to 44 in 2012. Neonatal mortality rate declined from 51 in 1990 to 31 in 2012. U5MR in India among boys declined from 121 in 1990 to 54 in 2012. U5MR in India among girls declined from 130 in 1990 to 59 in 2012. The share of neonatal deaths in under-five deaths stood at 55 percent in 2012 as compared to 41 percent in 1990 $ 

Pneumonia is the leading cause of child mortality in India, responsible for the deaths of nearly 400,000 children under five in 2010 π

The Indian Commission on Macroeconomics and Health notes that, in India, 13 household person-days per patient were lost per episode of malaria. Furthermore, the commission estimated that the overall monetary losses to families (income losses together with treatment expenses) could amount to between 200 and 400 Indian rupees (US$ 3.5 to 7)

Odisha is one of the most highly malaria-endemic states in India, accounting for 24% of reported cases in 2010 despite consisting of less of than 4% of the national population. Malaria is particularly common among tribal groups which represent 44% of the population of Orissa

Globally 12% of all deaths among adults aged 30 years and over were attributed to tobacco as compared with 16% in India, 17% in Pakistan and 31% in Bangladesh

A recent study illustrated the economic impact of Non-Communicable Diseases (NCDs) in India by estimating that if NCDs like: heart disease, cancer, diabetes, chronic respiratory conditions, and other NCDs were “eliminated”, the country’s 2004 GDP would have been 4 to 10 percent greater##

The share of out-of-pocket household health expenditures on NCDs in India increased from 32 percent to 47 percent between 1995–1996 and 2004. Moreover, 40 percent of these expenditures were financed by borrowing and sales of assets, increasing the household’s financial vulnerability##

In NFHS-III, 62% of women with two daughters and no sons say they want no more children, compared with 47% in NFHS-II*
 
 
$& National Health Profile 2015, Central Bureau of Health Intelligence, Ministry of Health and Family Welfare (please click here to access)
 
*$ 71st round NSS report: Key Indicators of Social Consumption in India-Health (published in June 2015), please click here to access the full report; please click here to read the summary of findings
 
$$ Draft National Health Policy 2015 (published in December 2014),Ministry of Health and Family Welfare (Please click here to download)
 
** United Nations' report (released in May, 2014) entitled Trends in maternal mortality estimates 1990 to 2013, (please click here to download)

$ Committing to Child Survival: A Promise Renewed Progress Report 2013, UNICEF

π Pneumonia Progress Report, 2012, released by IVAC and John Hopkins Bloomberg School of Public Health,

http://www.indiaenvironmentportal.org.in/files/file/IVAC-P
neumonia-Progress-Report-2012.pdf

 
∂ Defeating malaria in Asia, the Pacific, Americas, Middle East and Europe (2012), World Health Organization and PATH,

http://www.indiaenvironmentportal.org.in/files/file/Defeat
ing%20malaria.pdf

 

€ Children in India 2012-A Statistical Appraisal, Ministry of Statistics and Programme Implementation, GoI, http://www.im4change.org/docs/659Children_in_India_2012.pdf 

 

@ WHO Global Report: Mortality Attributable to Tobacco (2012), http://whqlibdoc.who.int/publications/2012/9789241564434_eng.pdf 

 

## The Growing Danger of Non-Communicable Diseases: Acting Now to Reverse Course, September, 2011, The World Bank,

http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPUL
ATION/Resources/Peer-Reviewed-Publications/WBDeepeningCris
is.pdf
 

 

* National Family Health Survey III (2005-06), http://www.nfhsindia.org/nfhs3.html  

 




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