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Indian healthcare needs urgent reforms: The Lancet

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London: Indian healthcare system needs urgent reforms across several key challenges if the country is to achieve the government’s vision of assuring health for all, says a paper in The Lancet.

The paper, authored by professor Vikram Patel from London School of Hygiene & Tropical Medicine and colleagues, has documented India’s progress on major health indicators in the past decade but also its many deficiencies.

Key health indicators for Indian states

“The health time-bomb ticks on due to the rising burden of non-communicable diseases. There are widespread inequities in health outcomes that are apparent in the large morbidity and mortality differentials across socio-economic status, caste, class, sex, and geographic location,” Patel said.

The most disturbing indicator of the deficiencies of the Indian healthcare system is the observation that health care costs are driving millions into poverty.

The authors argue not only for more resources but for an integrated national healthcare system, built around a strong public primary care system with a clearly defined supportive role for the private and indigenous sectors.

The system should address acute as well as chronic health care needs and should be cashless at the point of service delivery, the authors said.

According to the paper, India continues to lag behind regional neighbours especially on health indicators like mortality rates for children aged under five years, with India recording 27 percent of all neonatal deaths and 21 percent of all child deaths in the world.

The paper calls for strengthening the country’s weak primary health system.

“Second is the challenge of skilled human resources, where an overall shortage was further compounded by inequitable distribution of skilled workers,” the paper said.

“Also, India needs to better harness and regulate its large private sector” in 2014, more than 70 percent of outpatient care and 60 percent of inpatient care was provided in the private sector.

“However, lack of regulation has led to corruption across the sector, with consequent poor quality of care and impoverishment of patients,” it added.

According to the authors, dismally low public spending on health has crippled the public sector and created large barriers in quality and access.

Gaps in the availability of health professionals in India

The total expenditure on health in India fell from 4.5 percent of gross domestic product (GDP) in 2004-05 to 4.0 percent of GDP in 2013-14.

Real expenditure and government expenditure on health per head from 2004 to 2014

With India spending as little 0.1 percent of its GDP on publicly funded drugs, close to two-thirds of the total out-of-pocket expenditure on health was incurred on drugs, often used irrationally.

Out-of-pocket expenditures on health per episode of inpatient and outpatient care in India

“Only a radical restructuring of India’s healthcare system will assure healthcare for all Indians,” Patel said.(IANS)

(Picture courtesy: www.thelancet.com)

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Infant Mortality Rate declined in 2016, shows Health Ministry data

The Sample Registration System showed a significant 8% decline in country's IMR, despite the death of infants being more in rural areas

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Infant Mortality Rate in India
Infant Mortality Rate declines in India. Pixabay
  • The Infant Mortality Rate in India has declined from 37 per 1000 live births in 2015 to 34 per 1000 live births in 2016
  • The Sample Registration System showed a significant 8% decline in country’s IMR
  • According to the SRS Bulletin there has been a steady decline in the gender gap in India for child survival

New Delhi, October 2, 2017: The Infant Mortality Rate, IMR in India has declined by three points, from 37 per 1000 live births in 2015 to 34 per 1000 live births in 2016, according to the latest Ministry of Health and Family welfare’s data released on Friday.

This is indeed a progress looking at the two points decline last year. The 2019 target of IMR 28 per 1000 births, however, is still a long way to go.

The Sample Registration System showed a significant 8% decline in country’s IMR, despite the death of infants being more in rural areas. India has also recorded a remarkable drop in birth cohort, which has come down to below 25 million for the first time, according to the system.

I90000 fewer infant deaths were registered by India in 2016 as compared to 2015. The total estimated drop in the number of infant deaths have come down from 930000 (9.3 Lakhs) in 2015 to 840000 (8.4 lakhs) in 2016, mentions the Hans India report.

According to the SRS Bulletin there has been a steady decline in the gender gap in India for child survival. There has been reduction in the gender difference between female and male IMR.

“We are meeting our targets faster than the global targets, which means our efforts are showing results,” Union health minister JP Nadda had said during a post Cabinet briefing recently, according to the Hindustan Times report.

Also readSafe Rest Practices for Infants made Readily Available to New Parents through Emails and Texts!

“The results signify that the strategic approach of the ministry has started yielding dividends and the efforts of focusing on low performing states is paying off,” stated a health ministry statement.

“The countrywide efforts to increase the health service coverage through various initiatives, including strengthening of service delivery and drugs and diagnostics have worked well,” it further said.

All the states except Uttarakhand, among the Empowered Action Group (EAG) States and Assam have reported decline in IMR in comparison to 2015.

The report suggests this decline as of 4 points in Bihar, 3 in Assam, Jharkhand, Uttar Pradesh, Madhya Pradesh, and decline of two points in Chhattisgarh, Rajasthan and Odisha.

-prepared by Samiksha Goel of NewsGram. Twitter @goel_samiksha