The National Health Profile 2019 reveals several lacunae and loopholes in our healthcare system even as life expectancy increases marginally.
Indians of our generations are living longer now than our forefathers. No, this is not just an out of the hat comment, but actual numbers borne out by official statistics. Life expectancy of Indians has gone up from 49.7 years in 1970-75 to 68.7 years in 2012-16, as per National Health Profile 2019 released recently by the Central Bureau of Health Intelligence (CBHI).
For the same period, life expectancy for females is 70.2 years and 67.4 years for males. For comparison, in last year’s survey, the life expectancy had increased from 49.7 years in 1970-75 to 68.3 years in 2011-15.
While these numbers are indeed laudable and points towards an increasingly healthier India, the National Health Profile 2019 still throws up a number of disturbing statistics and highlights glaring areas of concern. To begin with, the population control measures are still not bearing the anticipated or desired results. The population continues to grow, as the decline in the birth rate is not as rapid as the decline in the death rate. As of 2017, India has registered birth rate of 20.2 per 1,000 population and death rate of 6.3 per 1,000 population while the natural growth rate was 13.9 per 1,000 population in India. While medical developments are ensuring higher life expectancy, population control measures need to be made more stringent to ensure the country maintains a level population. There is a significant urban rural divide here though. In fact, though the infant mortality rate has declined considerably (33 per 1,000 live births in 2016). However differentials of rural (37) & urban (23) are still high.
There are other critical areas of concerns too, especially on both the communicable and non communicable diseases front which takes away much off the sheen from the positive aspects of the National Health Profile 2019. In area of non-communicable diseases, the lifestyle related diseases are plaguing most Indians. The survey notes that out of 6.51 crore patients who attended NCD clinics, 4.75% people are diagnosed with diabetes, 6.19% are diagnosed with hypertension, 0.30% are diagnosed with cardiovascular diseases, 0.10% are diagnosed with stroke and 0.26% are diagnosed with common cancers.
On communicable diseases, in 2018, the maximum number of cases and deaths due to malaria have been reported in Chhattisgarh (77,140 cases and 26 deaths). The overall prevalence of the disease has diminished in 2012 and 2013 but there was a slight increase in 2014 and 2015 before it again started decreasing from 2016. Dengue and Chikungunya, transmitted by Aedes mosquitoes, are a cause of great concern to public health in India.
Another area of concern is the lack of proper medical treatment and practitioners. There is only one allopathic government doctor for every 10,926 people in India against the WHO’s recommended doctor-population ratio of 1:1000. The report, however, highlighted that there has been a marked improvement in the number of dentists. The number of dental surgeons registered with the central/state dental councils up to December 31, 2018, was 2,54,283. There has been a steady rise in the number of registered AYUSH doctors (Ayurveda treatment) in India from 7,73,668 in 2017 to 7,99,879 in 2018.
The report further states that the cost of treatment has been on the rise in India and it has led to inequity in access to health care services. An average medical expenditure incurred during stay at hospital from January 2013 to June 2014 was Rs 14,935 for rural and Rs 24,436 for urban in India. India spends only 1.28 per cent of its GDP (2017-18) on health. Per capita public expenditure on health in nominal terms has gone up from Rs 621 in 2009-10 to Rs 1,657 in 2017-18. The Centre-state share in total public expenditure on health was 37:63 in 2017-18. Both these numbers need to improve drastically to ensure that all Indians are in the pink of health.