Health policy must address the new reality



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DH News Service, Bangalore, November 27, 2017, 0:21 IST

The report "India: Health of the Nation States," which was published last week, offers a better and more detailed perspective on the state of the nation's health than similar reports and surveys conducted in the past. It is very complete and has much more information than exercises like the National Survey of Family Health. It confirms some known facts but also provides new information that will be useful in formulating public health policies for particular regions and states. The report was prepared by the Indian Council of
Medical Research (ICMR) and some other organizations in collaboration with the ministry of health of the Union. It has tracked the changes that have taken place in the country's health profile over a period from 1990 to 2016 and has mapped the statewide divergences in the burden of the disease. It is well known that social and economic development improves health outcomes. This has also happened in India and key health indicators, such as life expectancy, have shown a great improvement between 1990 and 2016. The report has shown this.

An important finding is that the profile of the disease has undergone a major change. During the period 1990-2016, the threat posed by communicable diseases such as tuberculosis and malaria and diseases related to mother, newborn and nutrition decreased and the burden of noncommunicable diseases (NCDs) increased, such as heart disease and diabetes. In 1990, the burden of infectious and badociated diseases was 61% and that of others, linked to lifestyles, was 30%. Relative positions were reversed in 2016, infectious diseases accounted for 33% and noncommunicable diseases accounted for 55%. This trend will continue in the coming years, so public health strategies will have to be changed accordingly. Different strategies will be needed, which are directed to the sections of people in different socioeconomic strata. Health infrastructure, medical education and the training and skills of medical personnel will have to be reoriented to address the new situation.

The report also shows that the health profiles of different states vary widely. While noncommunicable diseases claimed more lives in developed states such as Tamil Nadu, Kerala and Punjab, infectious and badociated diseases were the main threats to health in states such as UP, MP and Orissa. The report also compared pairs of states such as UP and MP, Punjab and Himachal Pradesh and Maharashtra and Gujarat, and showed that national health performance can be vastly improved if health problems and risks in certain states are addressed separately. The national health policy should be decentralized to address the specific needs of states, and even of regions within states. The collection of more data and better research will also help refine the policy.

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