Public Health in India: An overview

At the time of independence India’s health status was one of the worst in the world. the life expectancy at birth was estimated at 36.7 years in 1951. the infant mortality rate was high at 146 per 1000 in 1951. Poor socio-economic development opportunities coupled with deadly disease gift mortality rates very high. However the improve access of Healthcare service along with improved living conditions such as food supply, housing facilities, sanitation and hygiene, led to a gradual decline in deaths from infectious disease such as smallpox, malaria, pneumonia, tuberculosis, diarrhoea, poliomyelitis, typhoid, cholera and plague in the post independent India. Over a period of time both the life expectancy and other later indicator showed significant improvement.

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Health

Accord­ing to the lat­est report the life expectan­cy has crossed 267 years.Though infant mor­tal­i­ty rate (33 per 1000) and mater­nal mor­tal­i­ty ratio (122 per 100000 live birth) have come down sig­nif­i­cant­ly since Inde­pen­dence it is still unac­cept­ably high. Many dis­eases polio, Guinea worm dis­ease, yaws and tetanus have been erad­i­cat­ed. If we look at the recent his­to­ry there have been sig­nif­i­cant improve­ments in the over­all health sta­tus spe­cial­ly in the last 20 years.The recent improve­ments in health care ser­vice can par­tial­ly be attrib­uted to the Nation­al Health Mission.

Present­ly, India is under­go­ing a health tran­si­tion, Demo­graph­i­cal­ly as well as epi­demi­o­log­i­cal­ly. Demo­graph­ic tran­si­tion is char­ac­ter­ized by mor­tal­i­ty decline, nat­ur­al increase in pop­u­la­tion size, fer­til­i­ty decline, urban­iza­tion and pop­u­la­tion ageing.Whereas epi­demi­o­log­i­cal tran­si­tion can be char­ac­ter­ized by Low mor­tal­i­ty, high mor­bid­i­ty and by the dou­ble bur­den of com­mu­ni­ca­ble dis­ease and non com­mu­ni­ca­ble dis­ease (NCDs.). Though India still has heavy bur­den of com­mu­ni­ca­ble dis­ease such as TB and malar­ia, and NCDs such as heart dis­ease, can­cer, dia­betes chron­ic pul­monary dis­ease and now the lead­ing cause of death India Con­tribut­ing to near­ly 60% of death. Experts have argued that present­ly India suf­fers from the triple bur­den of dis­ease com­mu­ni­ca­ble dis­eases. Non com­mu­ni­ca­ble dis­ease and mal­nu­tri­tion. the recent report shows that more than one third of the world small mal­nu­tri­tion chil­dren live in India. in spite of gov­ern­men­t’s effort to address the mal­nu­tri­tion issue through mas­sive new Nation­al lev­el pro­grams such as POSHAN Abhiyan, mal­nu­tri­tion still remains as one of the biggest devel­op­ment chal­lenges in India.

Inad­e­quate water, San­i­ta­tion and and hygiene (WASH) ser­vices have a rip­ple effect on almost every­one’s life.According to UNICEF just a few years ago in 2015 near­ly half of Indi­a’s pop­u­la­tion of around 568 mil­lion peo­ple suf­fered the indig­ni­ty of defe­cat­ing in fileds, For­est, bod­ies of water or oth­er pub­lic spaces due to lack of access to toilets.India alone account­ed for 90% of the peo­ple in South Asia and half of the 1.2 bil­lion peo­ple in the world that defe­cat­ed in the open.2019 accord­ing to the lat­est esti­mate the num­ber of peo­ple with­out access to toi­let has reduced sig­nif­i­cant­ly by an esti­mat­ed 450 mil­lion peo­ple. Tremen­dous achieve­ment only pos­si­ble because of the swachh Bharat mission(SBM) (clean India Cam­paign), Though the SBM is seen as big sucess by Inter­na­tion­al Organ­i­sa­tion sug­gest UNICEF its real impact on infant and child health is yet to be ful­ly understood.

Health and nutri­tion­al sta­tis­tics in India and else­where reflect social and eco­nom­ic inequities.Therefore it is impor­tant to bear in mind that the health and nutri­tion­al inequities in India for the exac­er­bat­ed by the social inequities aris­ing out of class, caste ‚reli­gion and reli­gion dis­par­i­ties. Many researchers has point­ed out the evi­dence Asso­ci­a­tion of Appalling­ly Low health sta­tus with poor, female gen­der, rur­al place of Res­i­dence, trib­al eth­nic­i­ty, sched­uled caste (SC) and spe­cif­ic minor­i­ty groups.

Types of Mission launched by Indian Government.

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NHM

National Health Mission (NHM)

The Nation­al Health Mis­sion (NHM) encom­pass­es is to sub­mis­sion the Nation­al Rur­al Health Mission(NRHM) and the nation­al Urban Health Mission(NUHM) . the main pro­gram­mat­ic Com­po­nents include health sys­tem strength­en­ing ‚repro­duc­tive — mater­nal — neona­tal child and Ado­les­cent Health (RMNCH + A) and Com­mu­ni­ca­ble and non com­mu­ni­ca­ble Dis­ease. The NHM envis­ages achive­ment of uni­ver­sal access to equi­table , afford­able and qual­i­ty health cre ser­vices that are accountable 

National Rural Health Mission

The Nation­al Rur­al Health Mis­sion (NRHM) was launched by the Hon’ble prime min­is­ter on 12th April 2005, to pro­vide acces­si­ble ‚afford­able and qual­i­ty health care to the rur­al pop­u­la­tion, espe­cial­ly the vul­ner­a­ble groups . The union Cab­i­net vide its deci­sion dat­ed 1st May 2013,has approved the launch of Nation­al Urban Health Mis­sion (NUHM) as a sub mis­sion of an over arch­ing Nation­al Health Mis­sion (NHM), with Nation­al Rur­al health Mis­sion (NRHM) being the oth­er sub mis­sion. Of Nation­al Health Mission.

NRHM seeks to pro­vide equi­table ‚afford­able and qual­i­ty health care to the rur­al pop­u­la­tion, espe­cial­ly the vul­ner­a­ble groups. Under the NRHM , the Empow­ered Action Group (EAG) States as well as North East­ern states , Jam­mu and kash­mir and Himachal Pradesh have been giv­en spe­cial focus . the thrust of the mis­sion is on estab­lish­ing a ful­ly func­tion­al , com­mu­ni­ty owned ‚decen­tralised health deliv­ery sys­tem with inter — sec­toral con­ver­gence at all lev­els to ensure simul­ta­ne­ous action on a wide range of deter­mi­nants of health such as water, san­i­ta­tion, edu­ca­tion , nutri­tion, social and gen­der equal­i­ty . Insti­tu­tion­al inte­gra­tion with­in the frag­ment­ed health sec­tor was expect­ed to pro­vide a focus on out­comes ‚mea­sured against Indi­an pub­lic Health Stan­dard for all health facilities.

National Urban health Mission

The National urban Health Mission (NUHM) as a sub mission of National Health mission (NHM) has been approved by the cabinet on 1st May 2013.

NUHM Envis­ages to meet Health­care needs of the Urban pop­u­la­tion with the focus on urban poor by mak­ing avail­able to them essen­tial Pri­ma­ry Health Care ser­vices and reduc­ing their out of pock­et expens­es for treat­ment. This will be achieved by strength­en­ing the exist­ing Health Care Ser­vice Deliv­ery Sys­tem tar­get­ing the peo­ple liv­ing in slums and con­verg­ing with var­i­ous schemes relat­ed to why the deter­mi­nant of health like drink­ing water, san­i­ta­tion, school edu­ca­tion etc. Imple­ment­ed by Min­istry of Urban Devel­op­ment, Hous­ing and urban pover­ty alle­vi­a­tion, human resource devel­op­ment and women child development.

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