Health in India: the view from 30,000 feet
Since the 1980’s, India has become one of the fastest growing nations of the world. Between 1980 and 2010, India achieved a growth of 6.2 per cent, while the world as a whole showed a growth rate of 3.3 per cent. It is now recognised as a global power in key economic sectors. Currently, the private sector is booming as India has been constantly expanding its information technology (IT) sector and liberalising its foreign investment laws.
Despite these economic advances, issues such as poverty and poor health still plague the country. Here, growth and increase in income have not automatically translated to a higher standard of living for a majority of the Indian population. While there have been positive trends in healthcare such as the eradication of the new wild type polio infections, the provision of quality health care services is insufficient at best. India spends about 4% of its GDP on health (the government currently spends 1.4% on health). The government aims to increase its investment in healthcare to 2.5 percent by the end of 12th five-year plans. (Source: Planning Commision)
There is a large gap in the healthcare system between urban and rural areas. This inequity is due to a lack of healthcare resources and infrastructure in the rural region. Complicating the issue, 68 percent of the population resides in the rural areas, which implies that only a quarter of the Indian population has access to quality healthcare. Those who have access are not necessarily able to afford it. This is because poor government services calls for the private sector to fill the gap. This leads to provision of services at a higher cost, which creates an even wider gap between the rich and the poor. Much needed public private partnerships that can provide solutions have not really come into play.
This inequity has shaped the current market environment and created serious concerns for India which are highlighted by following facts:
1) According to UNICEF, around 46 per cent of all children below the age of three are too small for their age and 47 per cent are underweight. About one-third of all adult women are underweight. Inadequate care of women and girls, especially during pregnancy, results in low birth weight babies. Nearly 30 per cent of all newborns have a low birth weight, making them vulnerable to further malnutrition and disease.
2) Sanitation and hygiene are still a major concern, especially in the rural areas. According to UNICEF India (2008), only 31 per cent of India’s population use improved sanitation . According to the Public Health Association, only 53 per cent of the population wash hands with soap after defecation, 38 per cent wash hands with soap before eating and only 30 per cent wash hands with soap before preparing food. WASH Interventions significantly reduce diarrhoeal morbidity as it is well known that poor WASH causes diarrhoea, which is the second biggest cause of death in children under five years.
3) Infectious diseases such as dengue, tuberculosis, diarrhoea, hepatitis, and malaria continue to plague the country. According to a recent article, in the Hindustan Times, India is at the top of any table for the most vaccine-preventable deaths yet ironically over half of all vaccines produced in the world are made in India. In 2012, pneumonia and diarrhea claimed the lives of over 500,000 children in India.
4) Lifestyle diseases such as heart disease and diabetes are on the rise in India. According to the International Diabetes Federation (IDF), India is presently home to 62 million people living with diabetes and by 2030, India’s diabetes numbers may cross the 100 million mark. Diabetes includes Type 1 diabetes – insulin-dependent, usually first diagnosed in children or young adults; Type 2 diabetes-adult onset diabetes or noninsulin-dependent diabetes which results from being overweight and inactive and Gestational diabetes – affecting women during the later stages of pregnancy. Diabetes affects not only the urban population in India but also the rural population as they have a poor diet consistent of low quality meat, inadequate protein and lack of fibre.Recent studies have also shown that South Asians in general are at higher risk for Type 2 diabetes, up to four times higher than other ethnic groups probably due to a combination of genetics and environment and diets high in refined carbohydrates .
5) According to a recent article in the Economic Times, India’s medical tourism sector is expected to experience an annual growth rate of 30%, making it a $2 billion industry by 2015. People from the US, UK, and the Middle East are coming to India for their treatment. Today, the private Indian hospitals are well equipped with the latest technology and have highly qualified staff who can provide quality medical treatment to patients. Sadly, a huge percentage of India’s population has little or no access to these facilities.
6) Many experts feel that India will not be able to meet its MDG goals 4, 5 and 6. Even though the government has implemented many programmes, policies and schemes to address these challenges, it needs further support, partnerships, and outreach strategies to give momentum to the progress toward achievement of the MDG goals.
India’s healthcare sector certainly presents a dichotomy with its numerous health challenges. In the aspects of growth and innovation, India remains a beacon for other developing countries but it is still far behind in providing high-quality healthcare for its people.
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