The quality of life in a country can be best gauged by its education and health indicators. In fact, they are a measure of the country’s progress. Since Independence, India has done reasonably well on the education front, though we could have done better.
On health indices, there have been some successes but we still face innumerable, complex challenges. Over the years, we have successfully eradicated diseases such as polio and tetanus, done reasonably well in the fight against malaria and in halting the spread of HIV. Today, the country is grappling with the twin problems of communicable and non-communicable diseases (NCDs) due to a variety of causes. With India ranked at an unflattering 154th in a Lancet study on “Healthcare Access and Quality Index” published last year, we need to gird up our loins to make India “Swasth Bharat” in the coming years. Both the public and private sector have a gargantuan task on hand as a whole range of issues have to be tackled — from the problem of malnutrition to providing an inclusive and affordable healthcare to every citizen.
No doubt, we have made rapid strides in expanding medical facilities but the growth is lop-sided with the rural areas lagging far behind cities, where state-of-the-art hospitals, both in the public and private sector, are catering to the people. The functioning of government-run medical facilities in rural areas has to be improved. Although the number of medical colleges in the country has increased to 470, India has less than one doctor for every 1,000 people, which is below the WHO norm. The doctor-population ratio is estimated to be 0.62:1,000 as per the current population, while the number of hospital beds is estimated to be 0.5 per 1,000 people.
Today being the World Health Day, we need to introspect on our shortcomings and chalk out a time-bound roadmap to meet various goals to make India a healthy nation. The first and foremost priority has to be to increase the public expenditure on the health sector.
With the economy projected to improve further in the coming years, public expenditure on the health sector has to be enhanced significantly. Among the communicable diseases, tuberculosis needs to be tackled on a war-footing as MDR-TB is posing a major health concern. Seasonal outbreak of vector-borne diseases like dengue and growing antibiotic resistance is the other major concern.
With modern lifestyles — lack of physical activity, unhealthy food habits, tobacco and alcohol use and work-related stress — playing havoc with the lives of people, the non-communicable diseases (NCDs) — diabetes, heart disease and stroke, cancer and chronic respiratory disease — have now become the leading cause of death in India. It is estimated that they are responsible for about 61 per cent of deaths. A similar trend is being witnessed in rural areas too.
Ensuring proper healthcare to the elderly is another major area of concern for the governments and all other stakeholders involved in the health sector. The problems associated with geriatrics such as dementia, Alzheimer’s and Parkinson’s diseases are on the rise, while depression in both the young and old is becoming a major health issue. Perhaps, it might be a good idea to set up special geriatric clinics in different localities in cities under public-private partnership.
Although successive governments, both at the national level and in various states, have been constantly upgrading and creating new infrastructure to improve health outcomes, we still have to ensure that IMR and MMR decline further. Undoubtedly, economic status plays a major role in determining the health outcomes. Lack of proper nutrition, sanitation and poverty are associated with worse health outcomes. With unhygienic conditions causing various infectious diseases, the Swachh Bharat programme will definitely help in tackling this issue in a significant way.
In view of the low penetration of health insurance in India, I am sure the recently announced Ayushman Bharat scheme to provide health cover to 10 crore families and the proposal to set up 1.5 lakh health and wellness centres will go a long way in providing the much-needed affordable healthcare to millions across the country.
As regards lifestyle diseases, it is time to launch a national movement to reverse their growing incidence. Instead of eating food preserved in the fridge, we need to return to our roots — traditional, time-tested food habits, besides taking up regular physical activity. People also prefer organic foods in view of their health benefits. In old times, food habits were dictated by the seasons. For instance, people in Telugu-speaking states used to eat “Saddi Annam” (fermented rice cooked overnight) in the morning. It is believed to have many health benefits. Similarly, we have been using turmeric in India for thousands of years while the Western world has discovered its medicinal traits such as anti-cancer and anti-inflammatory properties only in recent times. It should be remembered that a healthy nation can become a wealthy nation, but not vice versa.
The fact that we have moved away from nature in modern times is also a reason for various illnesses. Living in harmony with nature and having enough fresh air, sunlight, fresh water and greenery are equally important for a healthy living. Health experts warn that children who do not spend enough time outdoors are at risk of developing myopia. We need to promote and practice yoga to lead a healthy life. It should become a part of the daily routine from schools to workplaces.
In the end, I would like to conclude by stressing the need for every individual to make lifestyle changes and for the government to ensure that healthcare is affordable and accessible to the common man so that a healthy and happy India becomes a reality in the coming years. The private sector must follow ethical practices and supplement the efforts of the government.
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