The health policy of India aims at an integrated approach, which is to provide accessible, affordable and equitable quality health care to the marginalised and vulnerable sections. For a heavily populated country such as India, this is an uphill task.
However, the aim of good health and well-being for all is envisaged in the sustainable development goal (SDG) 3. To quote, it envisages to “ensure healthy lives and promote well-being for all at all ages”, which provides an impetus to the policies of India to synchronise all our health targets.
The top 4 improving health indices are:
1. Doubling of life expectancy and reducing crude death rate
India is seeing Life expectancy that has doubled coupled with infant mortality and crude death rates that have reduced sharply.
Life expectancy is understood to be a statistical measure of the average time one is expected to live, based on the year of their birth, their current age and other demographic factors including sex.
The crude death rate of mortality rate, on the other hand, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. The mortality rate is typically expressed in units of deaths per 1,000 individuals per year; thus, a mortality rate of 9.5 (out of 1,000) in a population of 1,000 would mean 9.5 deaths per year in that entire population or 0.95 percent out of the total.
As per the WHO’s World Statistics Report 2016, life expectancy at birth for the year 2015 was 68.3 years in India which breaks down to 66.9 years for men and 69.9 years for women.
On the other hand, as per the ministry of health and family welfare, Government of India, the crude death rate for India worked out to be 7.31 in 2015. India has seen its decadal crude death rate decline to 8.5 in 2001-2011 from 42.6 in 1901-1911. Though the death rates have come down, the rural-urban divide still remains – the death rate was 6 in urban areas and it was 8.2 in rural areas in 2001-2011.
2. Declining total fertility rate
India’s total fertility rate (TFR) has been steadily declining and was 2.3 (rural 2.5 and urban 1.8) during 2014. Total fertility rate can be understood as the number of children who would be born per woman (or per 1,000 women) if she/they were to pass through the childbearing years bearing children according to a current schedule of age-specific fertility rates.
3. Declining infant mortality rate
Infant mortality rate (IMR) has declined to 37 per 1000 live births in 2015 from 44 in 2011. The challenge lies in addressing the huge gap between IMR in rural (41 per 1000 live births) and urban (25 per 1000 live births) areas.
Infant mortality refers to deaths of young children, typically those less than one year of age. It is measured by the infant mortality rate (IMR), which is the number of deaths of children under one year of age per 1000 live births.
4. Declining maternal mortality ratio
The maternal mortality ratio (MMR) declined from 301 maternal deaths per 100,000 live births during 2001-03 to 167 maternal deaths per 100,000 live births during 2011-13. The maternal mortality rate (MMR) may be understood to be the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes).
There are wide regional disparities in MMR, with States like Assam, Uttar Pradesh, Rajasthan, Odisha, Madhya Pradesh and Bihar recording MMR well above all India MMR of 167. Therefore, in addition to reducing all India MMR in line with SDG 3 targets, by improving health policy and nutritional status of women, there is need to focus on States with MMR higher than the national average.
Although the basic health parameters are showing an upward rise, there is a huge gap in access to quality health care in India and hence health policy may require some tweaking. There are chronic diseases that plague the population. Primary amongst these seem to be the prevalence of high levels of anaemia among women in the age group 15-49 leading to high levels of maternal mortality.
In Haryana and West Bengal more than 60 percent of women suffers from anaemia. Under the National Health Mission, Government of India has programmes to address the issue of anaemia through health policy and nutrition education to promote dietary diversification, the inclusion of iron foliate rich food as well as food items that promote iron absorption.