Public Health in India – Issues and Challenges

- By Chaitra Poojary

India is one of the fastest growing economies in the world. In the last 15 years its GDP has increased from 4% in 2002 to 5.7% at present. Over the years it is expected to reach 7.5%. But the same progress has not extended to the country’s public health system. Although there have been major improvements in public health since 1950’s, India is passing through demographic and environmental transition which is adding to the burden of diseases. The first half on the 20th century witnessed a large number of communicable disease epidemics. There is persisting inequality in health status due to varying economic, social and political causes.

Developing countries like India currently face a Triple Burden of disease from :

1. Unfinished agenda of Communicable diseases.

2. Emerging Non-communicable disease related to lifestyles.

3. Emerging Infectious diseases.

In the recent years there have been efforts towards strengthening public health in India under various initiatives like National Rural Health Mission (NRHM), up gradation of health care infrastructure as per Indian Public Health Standards (IPHS), initiation of more public health course in medical colleges, public health institutions and strengthening of public health functional capacity of states and districts under Integrated Disease Surveillance Programme (IDSP).

Current Health Status

India has the highest number of TB cases in the world. Out of 9.2 million cases of TB that occur in the world every year, nearly 1.9 million occur in India which accounts for nearly one-fifth of the global TB cases. Experts estimate that about 2.5 million persons have HIV infection in India. This is near 7.6% of the global burden of 33 million cases. More than 1.5 million persons are affected with malaria every year and almost half of them suffer from falciparum malaria. Nearly half of leprosy cases detected in the world in 2007 were contributed by India. It is also estimated that more than 35 million persons are carrier of viral Hepatitis B.

India has one of the lowest densities of health workforce; with density of physician (7 per 10,000 population) as against the global average of 14 according to the World Health Statistics, 2015. The issue is very serious, particularly in rural areas as most doctors and hospital beds are concentrated in urban areas catering to only 20% of India’s population.

Major problems of health services in India:

1. Lack of infrastructure – Lack of continuous water supply in many Public Health Care, some government building is being used as primary health center at some places.

2. Inefficient workforce – The lack of trained health professional is the major constraint to achieve proper health delivery.

3. Awareness – Primary Health problem can be solved if effective training and knowledge are given to the local population.

Mitigation measures:

It is important that the government and health professionals design and implement feasible health plans to tackle the health-related issues at a cost affordable to the masses. The implementation should be such that all the citizens are equally benefited. Some important measures are given below-

• Easy access to affordable and nutritious food to people belonging to all the sectors of the society.

• Sanitary facilities and cleanliness should be ensured by constructing enough toilets and educating people on the need to use them.

• Enough primary health centers should be constructed in rural areas and should be well equipped with resources to serve the purpose.

• Awareness campaign and education should be religiously carried out right from schools so as to instill in people hygienic practices.

• Stringent law to curb pollution have to be put in place for both companies and individual.

Target to be achieved –

India’s health target is to reduce its infant mortality rate from 41 deaths per 1000 live births in 2015-16 to 28 by 2019 and maternal mortality ratio from 167 deaths per 1000 births in 2013-14 to 100 by 2018-20 and eliminating tuberculosis by 2025.

The problem can be overcome by effective planning and allocating more funds. Accomplishing this will help to move India from developing to a developed nation.