Neglected Areas in Health—An Indian Scenario | UPSC Mains Essay Preparation PDF Download

Neglected areas in Health—An Indian Scenario

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(1) Opening    —    Communicable diseases are growing in both the developed and developing countries.

(2) Body    —    The ageing of the population brings to us the most costly non-communicable diseases.

    —    Misallocation of public money to more curative and low cost effective interventions required special attention.

    —    Sixty per cent of the health budget is utilised in urban areas.

    —    Need for effective and acceptable prophylactic vaccination against rabies.

    —    In health planning and budgeting mental disorders have received a very low priority.

    —    Developing countries should be self-sufficient in producing vaccines.

(3) Closing    —    Health for all - Investment

The developed world has even conquered almost all the communicable diseases though the developing countries are still fighting against them. However, the non-communicable diseases are growing in both the developing and the developed countries. One of the reasons for this is that without overall development, people in the developing world are adopting life styles and behavioural patterns of the developed world.

Rapid progress in reducing child mortality and fertility rates has already created new demands on the health care systems as the ageing of the population brings to us the more costly non-communicable diseases mainly of adults and the elderly. Tobacco-related deaths from heart diseases and cancers alone are likely to double by the first decade of the next century, to 2 million a year, and if present smoking patterns continue, they will grow to more than 12 million a year in developing countries in the second quarter of then next century.

In India provision of health is a state subject and the state is directly responsible for providing health care services to its people. Due to the threat of epidemic and endemic state communicable and non-communicable diseases, the state has to plan, implement and evaluate the best integrated and quality health care services. Most of the time, planning is influenced by scientific knowledge but sometimes politics, religion etc. also influence the eventual planning and its implementation. 

The role of public health services cannot be overemphasised. Public health measures brought about the eradication of small pox and have been central to the reduction in deaths caused by vaccine preventable childhoold diseases, but now there is increasing trends of problems originated from health system in India which, if not resolved, will frustrate efforts to respond to new health challenges and emerging diseases’ threat. Misallocation of public money to more curative and low cost effective interventions required special attention.

Around 60 per cent of the health budget is utilised in urban areas where only 25 per cent of the population is living. Health workers are badly deployed and supervised. Increasing numbers of general physicans and specialists, availability of new medical technologies and expanding health measure linked to fee-for-services payments together generate a rapidly growing demand for costly tests, procedures and treatments.

Rabies kills 20,000 persons annually. About 2 lakh people receive post-exposure treatment and many times more people are not receiving any antirabies treatment in India. Anti-rabies vaccination is given over a longer duration and causes a lot of pain. There is a great need for effective and acceptable prophylectic vaccination against rabies.

Around 5-10 per cent of the rural population is suffering from acute and chronic Suppurative otitis media-infective diseases of ear which significantly contribute to hearing impairment. Total ear mobidity would be many times more but no major step in relation to its prevention has been taken by the government.

Next to cigarette smoking Hepatitis B-Virus (HBr) is considered a second most important carcigenic agent of public health significance. Liver cancer, one of the common cancer has high risk of occurrence when the infection is acquired at an early age.

Dracunculosis (Guinea worm infestation), Hepatitis A&E, mosquitoborne diseases, worm infestation, poliomyelitis along with diarrheal diseases contribute significant morbidity and mortality in India. These are all originating in poor condition of the sanitation and supplies. We are nearing eradication of Dracunculosis as only 750 cases were reported in 1993. If safe water is provided to all rural areas of Rajasthan, Madhya Pradesh and Andhra Pradesh, dracunculosis could be eradicated from the country within the next one or two years.

Epidemics of multidrug resistance typhoid fever, tuberculosis, malaria and sexual-transmitted diseases pose a grave threat to mankind. If integrated approach to curb these problem is not taken seriously, they may cause significant disability.

Very large percentage (20-60 per cent) of adult population is using tobacco in one or other form. A study conducted by the Indian Council of Medical research (ICMR) has indicated that the prevalence rate of smoking among males above 15 years of age is 90 per cent in a rural community in Meerut district of Uttar Pradesh. tobacco is already responsible for 30 per cent of all cancer death and more than 6 per cent of total deaths.

Around 10-15 per cent of the Indian population is suffering from psycho-social problems at any point of time and 1-2 per cent are suffering from serious mental disorders. In health planning and budgeting mental disorders have received a very low priority.

One third of the patients in any large hospital are admitted due to iatrogenic illness. About 10 per cent of all such persons admitted have a life threatening disease. About 12 per cent of admissions in the intensive care units are due to iatrogenic diseases and these diseases are often fatal.

Other non-communicable diseases-dental carries pyarrhea, cardio vascular accidents, deafness, neurocerebral disorders, asthma and chronic obstructive pulmonary disorders are not rare public health problem and should receive attention of planners and managers at all levels of health services system.

Developing countries should be self-sufficient in producing vaccines because importing vaccines causes huge expenditure. We do not have vaccine for Malaria, leprosy, AIDS, diarheal and respiratory diseases. We should produce more effective vaccine for tuberculosis, hepatitis A-C-E, typhoid, influenza and cholera. More research and field trials are required for vaccine for fertility regulation in male and females.

Agricultural products and processes have both beneficial and harmful impact on health. Most of the sufferer are children, women and old aged from poor families of the developing countries. These families are employed mainly in agricultural sector where they work as private subsistence farmers. They are devoid of good health facilities, income, food and security from natural calamities. Healthier farmers and workers are more productive and careful. If health and nutrition are secure, farm families are better able to risk experiments with new methods of crops. Bad health and inadequate health care are among the reasons why bright people leave rural areas, depriving agricultural sector of the needed leaders and innovators.

Hazards of pesticides, fertilisers, new technology of agriculture are very obvious. Injuries 

due to accidents and snake bites are few other areas where special attention is required.

Health delivery system is a key element for improvement of health of the community. How efficiently manpower, material and money are utilised to deliver the services depends on management of the organisation.

Thrust areas for health system research are information education and communication, community participation programme implementation and management, health management information system, intra and inter sectoral co-ordination and collaboration population control, and socio-cultural aspect. Within each of these thrust areas, development of appropriate technology should be given high priority.

Space technology like remote sensing could conceivably be used in global surveillance of atmosphere pollution, drought, surface water and other environmental factors.

Biosensor advanced micro electronic device. The principle of this device is based on space technology used for health monitoring. Due to advanced computer and satellite technology medical science and public health will improve its diagnostic, monitoring, surveillance of diseases and magnificent capability.

Investment in health is seriously taken presently throughout the world because it is highly cost-effective. Millions of lives and billions of dollars could be saved if efforts are made to invest in public health. Mere investment will not help till an integrated approach to deal with all major public health problems with the participation of people is achieved. India is successful in establishing the biggest health delivery infrastructure in the world, but the quality of services provided is very poor.