Headline : Is seawater the ultimate answer?
Context of the topic:
- As per National Health Profile (NHP), India’s public health spend as a percentage of GDP has increased by 0.16 percentage points from 1.12% to 1.28% of GDP, between 2009-10 and 2018-19.
- India’s target is 5% GDP on health spend.
- The NHP is an annual stocktaking exercise on the health of the health sector.
The key findings of NHP 2019 are as below:
- Increase in cost of treatmentleading to inequity in access to health care services.
- Increase in per capita public expenditure on health in nominal terms from Rs 621 in 2009-10 to Rs 1,657 in 2017-18.
- There has been an improvement in sex ratio and a decline in birth and death rates
Health expenditure as percentage of GDP
- Spending by states showed deviation with the highest average per capita public expenditure on health by Northeastern states and the lowest by Empowered Action Group (EAG) states plus Assam.
- EAG states are the eight socio-economically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh.
- Among the NE states, highest GSDP spend was by Mizoram (4.20%) and Arunachal Pradesh (3.29%).
- Tamil Nadu and Kerala though having better performers on health parameters, performed poorly on the health finance index with low GSDP spend (Tamil Nadu – 0.74% and Kerala – 0.93%).
- Globally, India’s per capita health expenditure was only $16 in 2016. A comparison has provided against other countries that are on the UHC path.
Other Findings of NHP 2019
- As per NHP 2019, there has been a change in disease profile of the country with a shift from communicable onestowards the non-communicable diseases (NCDs)such as cardiovascular disease, chronic obstructive pulmonary disease, cancer, mental health disorder and injuries.
- This was also documented by the State Level Disease Burden Study 2017. It highlighted an increase in disease burden from NCDs from 30 to 55% between 1990 and 2016.
- Several initiatives have been taken in this regard. These include:
- National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) launched in 100 districts across 21 states with the aim to prevent and control thesediseases thorough awareness generation, behavior and lifestyle changes.
- Free door-to-door screening programme for early detection of cancer, heart disorders and diabetes.
- As per the NHP, sex ratio in the country has improved from 933 in 2001 to 943 in 2011.
- The sex ratio in rural areas has increased from 946 to 949, and in urban areas from 900 to 929.
- Kerala has recorded the highest sex ratio (1,084), and Chandigarh has recorded the lowest sex ratio (690).
- Also, the estimated birth rate, death rate and natural growth rate are declining. During 2000 to 2016, the figures were as below:
- The estimated birth rate reduced from 25.8 to 20.4.
- The death rate declined from 8.5 to 6.4 per 1,000 population.
- The natural growth rate declined from 17.3 to 14.
- The total fertility rate in 12 States has fallen below 2 children per woman and nine States have reached replacement levels of 2.1 and above.
- Delhi, Tamil Nadu and West Bengal have the lowest fertility rate among other States.
- There has been growth in medical education infrastructure.
- The country has 529 medical colleges, 313 Dental Colleges for BDS & 253 Dental Colleges for MDS.
About: National Health Profile (NHP)
- The NHP covers demographic, socio-economic, health status and health finance indicators, human resources in the health sector and health infrastructure.
- It is an important source of information on various communicable and non-communicable diseases that are not covered under any other major programmes.
- This information is essential for health system policy development, governance, health research, human resource development, health education and training.
Universal Health Coverage
- In 2011, the High Level Expert Group of the erstwhile Planning Commission submitted its report on the rollout of Universal Health Coverage (UHC) in India.
- It recommended that the government (central government and states combined) should increase public expenditures on health from the current level of 1.2% of GDP to at least 2.5% by the end of the 12th plan and to at least 3% of GDP by 2022.
- The benefit of increasing health expenditure would result in:
- A five-fold increase in real per capita health expenditures by the government (from around Rs 650-700 in 2011-12 to Rs 3,400-3,500 by 2021- 22).
- A corresponding decline in real private out-of-pocket expenditures(from around Rs 1,800-1,850 in 2011-12 to Rs 1,700-1,750 by 2021-22).
- According to the WHO, Universal Health Coveragemeans “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
- The three objectives of UHC are:
- Equity in access to health services;
- Quality of health services should be good enough to improve the health of those receiving them;
- People should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm.
About: Central Bureau of Health Intelligence
- Central Bureau of Health Intelligence (CBHI) was established in 1961 by the Act of Parliament on the recommendation of Mudaliar committee.
- It is the Health Intelligence Wing under Directorate General of Health Services (Dte.GHS), Ministry of Health & Family Welfare (MoHFW).
- Vision–To havea strong Health Management Information System (HMIS) in entire country.
- Mission –To strengthen Health Information System (HIS) in each of the district in the country up to the facility level for evidence based decision-making in the Health Sector.
- Sex Ratio – The number of females per 1,000 males
- Total fertility rate – The average number of children that will be born to a woman during her lifetime
- Disability-adjusted life years (DALYs) measures how much of a normal life span of an individual is taken away by a disease related morbidity of mortality.
- It is an international standard of disease burden.