Health problems in india

HEALTH PROBLEMS IN INDIA
A.PRABHAKARAN, M.Sc.(N)
TUTOR, VMSON
Salem
Subject- Community Health Nursing
– II - Unit- V
Year – DGNM III Year

HEALTH PROBLEMS OF INDIA
The HEALTH PROBLEMS of India
may be conveniently grouped under the
following heads :
Communicable disease problems
Non-communicable disease problems
Nutritional problems
Environmental sanitation problems
Medical care problems
Population problems.

1. Communicable Disease Problems
Communicable diseases continue to be a
major problem in India. Diseases considered to
be of great importance today are:
(a)Malaria
(b)Tuberculosis
(c) Diarrhoeal diseases
(d)Acute respiratory diseases
(e)Leprosy
(f) Filaria
(g) AIDS
(h)Others

(a) Malaria:
Malaria continues to be a major health
problem in India. Although total malaria
cases has declined compared to previous
years, the proportion of P. falciparum has
increased.
Malaria cases have increased in North-
East states, Madhya Pradesh,
Chhattisgarh, Jharkhand, Orissa, Andhra
Pradesh, Maharashtra etc.
During 2013 there were 0.8 million cases
of malaria (which included 0.44 million
cases of Pf malaria) and 379 deaths.

(b) Tuberculosis:
 Tuberculosis remains a public health
problem, with India accounting for one-
fifth of the world incidence.
Every year about 2.6 million persons
develop tuberculosis, of which about
0.62 million are new smear positive
highly infectious cases and about 0.24
million people die of TB every year.
The emergence of HIV-TB co infection
and multidrug resistant TB has increased
the severity and magnitude of the
disease.

(c) Diarrhoeal diseases:
 Diarrhoeal diseases constitute one of the major
causes of morbidity and mortality, especially in
children below 5 years of age. They are responsible
for about 10.76 million cases of diarrhoea each
year.
 Outbreaks of diarrhoeal diseases (including cholera)
continue to occur in India due to poor environmental
conditions.
(d) ARI:
 Acute respiratory diseases are one of the major
causes of mortality and morbidity in children below
5 years of age. During 2013, 31.7 million episodes
of ARI were reported with 3,278 deaths.

(e) Leprosy:
Leprosy is another important public health
problem in India.
During the year 2013-2014, total of
1.27 lakh new cases were detected, out
of which child cases were 9.49% and
deformity grade II and above was 4.14%.
51.48 per cent of these cases are
estimated to be multi bacillary.
All the States and Union Territories
report cases of leprosy. With the
prevalence rate of about 0.68 per 10,000
populations, India has achieved the goal
of leprosy elimination at national level.

(f) Filaria:
The problem of filaria remains endemic
in about 250 districts in 20 States and
UTs. The population at risk is over 600
million.
To achieve elimination of LF, the Govt.
of India has launched nationwide Annual
Mass Drug Administration (MDA) with
annual single recommended dose of
diethylcar-bamazine citrate tablets in
addition to scaling up home based foot
care and hydrocele operations.

(g) AIDS:
 The problem of AIDS is stable. It is estimated
that by the end of year 2012 there were about
2.08 million HIV positive cases in the country.
(h) Others:
 Kala-azar, meningitis, viral hepatitis, Japanese
encephalitis, dengue fever, enteric fever and
helminthic infestations are among the other
important communicable disease problems in
India.
 In fact most of the developed countries of the
world have overcome many of these problems by
such measures as, manipulation of environment,
practice of preventive medicine and
improvement of standards of living.

2. Non- Communicable Diseases
(NCDs)

2. Non- Communicable Diseases (NCDs)
India is experiencing a rapid epidemiological
transition with a large and rising burden of
chronic diseases, which were estimated to
account for 53 per cent of all deaths and
44 per cent of Disability Adjusted Life
Years lost in 2005.
NCDs, especially diabetes mellitus, CVDs,
cancer, stroke, and chronic lung diseases
have emerged as major public health
problems due to an ageing population and
environmentally-driven changes in
behaviour.

 Cancer has become an important public health
problem in India with an estimated 7 to 9 lakh
cases occurring every year. About one million
tobacco related deaths occur each year, making
tobacco related health issues a major public
health concern.
 In India, more then 12 million people are blind.
Cataract (62.6 per cent) is the main cause of
blindness followed by Refractive Error (19.70
per cent). There has been a significant increase
in proportion of cataract surgeries with Intra
Ocular Lens (IOL) implantation
 Oral Health Care has not been given sufficient
importance in our country. Most of the district
hospitals have a post of dental surgeon but they
lack equipment, machinery, and material.

3. Nutritional Problems
From the nutritional point of view, the
Indian society is a dual society, consisting of a
small group of well fed and a very large group
of undernourished.
(a) Protein-Energy Malnutrition
(b) Nutritional Anaemia
(c) Low Birth Weight
(d) Xerophthalmia
(e) Iodine Deficiency Disorders
(f) Others

(a) Protein-Energy Malnutrition:
 Insufficiency of food - the so-called "food
gap"- appears to be the chief cause of PEM,
which is a major health problem particularly
in the first years of life.
 The great majority of cases of PEM, nearly
80 per cent are mild and moderate cases.
The incidence of severe cases is 1 to 2 per
cent in preschool age children.
 The problem exists in all the States and the
nutritional marasmus is more frequent than
kwashiorkor.

(b) Nutritional Anaemia:
 India has probably the highest prevalence of
nutritional anaemia in women and children.
About one-half of non-pregnant women and
young children are estimated to suffer from
anaemia. 60 to 80 per cent of pregnant
women are anaemic.
 The survey also shows that the incidence of
anaemia in children aged 6-35 months is 79.2
per cent with 72.7 per cent in urban areas
and 81.2 per cent in rural areas.
 By far the most frequent cause of anaemia is
iron deficiency, and less frequently folate and
vitamin B12 deficiency.

(c) Low Birth Weight
 This is a major public health problem in many
developing countries. About 28 per cent of
babies born are of low birth weight (less than
2.5 kg), Maternal malnutrition and anaemia are
mainly responsible for this condition.
(d) Xerophthalmia
 About 0.04 per cent of total blindness in India
is attributed to nutritional deficiency of vitamin
A. Keratomalacia has been the major cause of
nutritional blindness in children usually between
1-3 years of age.
 Subclinical deficiency of vitamin A is also
widespread and is associated with increased
morbidity and mortality from respiratory and
gastro-intestinal infections.

(e) Iodine Deficiency Disorders:
 Goitre and other iodine deficiency disorders (IDD)
have been known to be highly endemic in sub-
Himalayan regions.
 Reassessment of the magnitude of the problem by
the Indian Council of Medical Research showed
that the problem is not restricted to the "goitre
belt" where the prevalence of IDD is more than
10 per cent. It is also estimated that more than
71 million people are suffering from goitre and
other IDD.
(f) Others: Other nutritional problems of importance
are lathyrism and endemic fluorosis in certain
parts of the country. To these must be added the
widespread adulteration of foodstuffs.

4. Environmental Sanitation
 The most difficult problem to
tackle in this country is
perhaps the environmental
sanitation problem, which is
multifaceted and
multifactorial.
 The great sanitary awakening
which took place in England in
1840's is yet to be born.
The twin problems of
environmental sanitation are
lack of safe water in many
areas of the country and
primitive methods of excreta
disposal.

 Besides these, there has been a growing
concern about the impact of "new" problems
resulting from population explosion,
urbanization and industrialization leading to
hazards to human health in the air, in water
and in the food chain.
 As of year 2012 safe water is available to 96
per cent of the urban and 87 per cent of the
rural population; and adequate facilities for
waste disposal to 54 per cent of the urban and
21 per cent of the rural population. The
problem is gigantic.

5. Medical Care Problems
 India has a national health policy. It does
not have a national health service. The
financial resources are considered inadequate
to furnish the costs of running such a
service.
 The existing hospital-based, disease-
oriented health care model has provided
health benefits mainly to the urban elite.
 Approximately 80 per cent of health
facilities are concentrated in urban areas.
Even in urban areas, there is an uneven
distribution of doctors.

 With large migrations
occurring from rural to
urban areas, urban health
problems have been
aggravated and include
overcrowding in hospitals,
inadequate staffing and
scarcity of certain essential
drugs and medicines.
 The rural areas where
nearly 72 per cent of the
populations live, do not enjoy
the benefits of the modern
curative and preventive
health services. Many
villages rely on indigenous
systems of medicine.

Thus the major medical care problem in
India is in equable distribution of
available health resources between urban
and rural areas, and lack of penetration
of health services to the social
periphery.
The HFN2000 movement and the
primary health care approach which lays
stress on equity, intersectoral
coordination and community participation
seek to redress these imbalances.

6.Population problem
 The population problem is
one of the biggest problems
facing the country, with its
inevitable consequences on
all aspects of development,
especially employment,
education, housing, health
care, sanitation and
environment.
 The country's population
has already reached one
billion mark by the turn of
the century.

 The Government has set a
goal of 1 per cent
population growth rate by
the year 2000 (which was
not attained}; currently,
the country's growth rate is
1.8 per cent. This calls for
the "two child family norm".
 The population size and
structure represent the
most important single factor
in health and manpower
planning in India today
where the law of diminishing
returns, among other
factors, plays an important
role in the economic
development of the country.

Health problems in india

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