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The changing pattern of healthcare and the rise of non- communicable diseases in India

The evolution of healthcare in India over the past 25 years has been described as “ a mixed bag”. While key health indicators such as the infant mortality rate (IMR) and maternal mortality ratio (MMR) have come down substantially, healthcare expenses and noncommunicable diseases (NCDs) have shot up. This article in LiveMint presents some interesting data :

  • the government’s allocation to health care as a percentage of the country’s GDP has fallen to 1.05% in 2015-16 from 1.47% in 1986-87
  • IMR has fallen to 41 per 1,000 live births in 2013 from 88 in 1990, according to a United Nations report ‘Levels and Trends in Child Mortality’ released in 2015. (For Nepal and Bangladesh, IMR per 1,000 live births was 33.6 and 33.1 in 2012)
  • according to a WHO report released in 2014, MMR in India has declined from 560 deaths per 100,000 live births in 1990 to 190 in 2013

The article highlights that while diarrhoea, respiratory infections and pre-term birth complications continue to affect India, NCDs such as heart diseases, stroke, pulmonary diseases and diabetes are now leading causes of premature death.NCDs account for nearly 60% of all deaths in India, according to the WHO. The economic burden of these lifestyle diseases accounts for about 40% of all hospital stays and roughly 35% of all recorded outpatient visits, according to a 2014 report by the World Economic Forum and Harvard School of Public Health

In an article by Dr. Anand Krishnan, India needs to focus on healthcare financing reforms to tackle NCDs threat. Dr. Krishnan is a Professor at the Centre for Community Medicine at All India Institute of Medical Sciences, New Delhi. According to him, one in four Indians are at the risk of dying from NCDs  such as stroke, cancer, diabetes or respiratory diseases before the age of  70. According to data mentioned in his article, NCDs account for 60 per cent of deaths and 53 per cent of the disease burden in India, today.  He goes on to add that “in the recent years, while India has witnessed a robust economic growth, healthcare spend is still over 1 percent of the GDP and health care spending is the lowest in the world. Mostly, the allocations are spent on reproductive, maternal and child health programs and on communicable diseases, leaving little room for NCDs.The failure of public investment in health is reflected in the worsening situation in terms of costs of care and impoverishment of individuals and families due to rising healthcare costs.”

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