Health Policy

Improvement in the health status of a population is recognised as instrumental for increasing productivity and economic growth, as well as end in itself. Health conditions in India have improved considerably in recent decades. Generally, the improvements have accompanied socio-economic progress. Life expectancy at birth is the most reliable measure of the health status of a country. It provides an index to the range and intensity of health problems.

Life expectancy at birth in India has increased from 32 years ( in 1951) to 62 years. Likewise, the death rate in the country has also recorded a steep fall. The death rate in India was 27.4 in 1951; it came down to 22.8 in 1961 and further to 9.0 presently. The rise in life expectancy and fall in death rate indicates that the health conditions in India have considerably improved. But the life expectancy at birth, even after a very sharp rise in recent years, is miserably low as compared to the life expectancy found in other countries. In Japan it is 78 years, in the USA it is 75 years, in Sweden it is 77 years, and even in Mexico, it is 69 years. It shows that the average standard of health in India is poor.

Causes of Poor Health

The important causes of poor health are as follows:

High Birth Rate and Fast Growth of Population:

A number of health risks derive from high fertility rates in India. When a large number of people live in poor households located in crowded, unsanitary surroundings, communicable diseases spread easily. High mortality results therefrom especially among the children. High mortality rates, in turn, induce families to have many children so that they can assure themselves of a few surviving children. This circular pattern adversely affects health standards.

Population Growth

Similarly, population growth makes it more difficult to provide a safe or sufficient water supply, garbage disposal and sanitation for the community. It increases the cost of providing adequately trained healthy manpower and medical facilities.

Malnutrition:

Widespread malnutrition contributes to the incidence and severity of health problems. It poses a major threat to the children and, in extreme cases, threatens their lives.

In addition, malnutrition creates serious health problems by contributing to premature births and abnormally low weight at birth. Malnutrition is also a major contributing factor to infectious diseases. Malnutrition weakens normal body response to diseases, thereby reducing acquired immunity, The problem of inadequate nutrition is compounded by rapid population growth, Large family size and close spacing of births frequently preclude sufficient food and care for children. Unsanitary Conditions and Housing: The contamination of food, water or soil with human waste is a cause of some diseases. If water is not safe for drinking or is insufficient for personal hygiene and sewage disposal, diseases will spread more easily. This reduces the health status of the country,

In addition to poor sanitation and water supply, and water supply, a very sizeable proportion of the total population of cities live in sub-standard dwellings lacking in space, ventilation and sunlight. Such conditions tend to increase the incidence of diseases.

Health Care System

Over the last six decades, India has built up a vast health care system. The health care system consists of the following:

Primary, secondary and tertiary care institutions, manned by medical and paramedical personnel. The primary health care institutions provide the first level of contact between the population and health care providers. These consist of primary health centres, community health centres sub-divisional hospitals, dispensaries run by various government departments, the medical infrastructure of PSUs and large industries.

The secondary health care institutions consist of district hospitals and urban hospitals. They take care of (i) patients referred to them by the primary health care institutions and (ii) primary health care needs of the population in the city in which they are located The tertiary health care hospitals are attached to medical colleges, both in the public and the private sector.

Medical colleges and paraprofessional training institutions to train the needed manpower and give the required academic input. Programme managers managing ongoing programmes at central, state and district levels; and Health management information system consisting of a two-way system of data collection, collation, analysis and response.

Deficiencies in Health Care System

Despite the phenomenal expansion of the health care systems at all levels, primary, secondary and tertiary, it suffers from some deficiencies.

One, communicable diseases have become more difficult to combat because of the development of insecticide-resistant strains of vectors, antibiotic-resistant strains of bacteria and the emergence of HIV infection for which there is no therapy.
Two, longevity and changing lifestyle have resulted in the increasing prevalence of non-communicable diseases.
Three, under-nutrition, micronutrient deficiencies and associated health problems coexist with obesity and non-communicable diseases.
Four, the existing health system suffers from inequitable distribution of institutions and manpower.
Five, even though the country produces every year about 20,000 doctors in the modern system of medicine and a similar number of practitioners and para profession in the Indian system of medicine, there are huge gaps in critical manpower in institutions providing primary health care, especially in the remote rural and tribal areas, where the health care needs are the greatest.

Issues In Health Care

It is becoming clear that India is in the midst of a health care transition. This transition has four dimensions as follows: 1.

Demographic Transition:

With declining mortality and fertility, the age composition of a population is fast-changing older population, many may be widows, without family support. The demographic shift has implications for how health care is delivered and accessed.

Epidemiological Transition:

We are encountering a “double burden of disease”. A high proportion of the population continues to die from preventable infections like diarrhoea, pneumonia, under-nutrition, childbirth-related complications, TB, malaria, and HIV-AIDS. Simultaneously, the growing incidence of non-communicable, chronic conditions of ill health like cardiovascular diseases, diabetes and cancer attributed to changing lifestyles is stretching the capacity of the health care system.

Social Transition:

There is, on the one hand, rising demand for high-quality health care, including a preference for multi-speciality hospitals even if these entail higher costs. On the other hand, there is an unwillingness to discard myths and misconceptions, for example, those contributing to adverse sex selection…

Managerial Transition:

We need to develop health financing systems that will address the shift in disease burden, the increase in health costs, and inefficiencies across health care management.

Responding to these issues and ‘existing deficiencies to these issues and existing deficiencies in the health care system, a comprehensive national health policy has been formulated and is being implemented.

Here are the notes for Transport Policy And Functions.