THE FUTURE OF PUBLIC HEALTH IN INDIA Mala Rao Director, Indian Institute of Public Health Hyderabad 23 September, 2008
More a continent than a single country 35 states and union territories significantly larger than European countries 1600 dialects Rich blend of cultures, traditions, religions Remains a vibrant democracy with a highly sophisticated and visionary government. Ambitious, “Can Do” attitude reflected in Eleventh Five Year Plan 2007-2012. INDIA TODAY
Very Rich Levels of rising “overnutrition” World class academies and institutes. World class health care facilities and booming health tourism Women with education, power and influence A third of the world’s poor, nearly 400million living on less than $1/day 46% of children malnourished Highest number of illiterate people in the world Maternal mortality rate of 301/100,000 live births and the infant mortality rate of 57/1000 live births. Sex ratio of 933 females/1000 males ALSO A LAND OF IMMENSE CONTRASTS Source: 1) Sample Registration System 2003- Annual Report, Office of the Registrar General, India 2) census of India 2001 3) Department of International Development (DFID) Department for international develpoment.
INDIA IS ON THE MOVE…… Strategies which will improve public health include: • Community empowerment • Panchayat Raj Institutions as delivery mechanisms. • Indian Legislative Support for women. • Self-Help groups. • Directly Targeted Poverty Reduction Programmes include: • National Rural Employment Guarantee Act. • Rural Housing Programme. • Safe Water and Sanitation. • Electricity, Telephone, and Broadband Connectivity. • All weather road connections.
EDUCATION Targeted schemes include: • Midday Meal Scheme vastly extended as a means to increase enrollment and reduce dropout. • Increasing Girls Only Schools especially in rural areas. • Improving adult literacy. • Improving the school infrastructure and quality of teachers.
HEALTH • National Rural Health Mission launched 2005. • Integrated Child Development Services Scheme - cares for mothers, children and adolescent girls. • National Health Programs - National TB Control Program, National Blindness Control Program etc.. • Reproductive and Child Health (RCH) • Rajiv Aarogyasri Community Health Insurance Scheme.
INDIA WINS A GOLD MEDAL AT THE OLYMPICS!! AbhinavBindra
Mortality in India Death and DALY Estimates by Cause, 2002 http://www.who.int/whosis/mort/profiles/mort_searo_ind_india.pdf
URBANISATION & GLOBALISATION Increasing challenges of: • Urban slums, poor access to water and sanitation • Urban housing • Transport • New stress of working in Call Centres and IT • Fast Food
IT Helping India leapfrog into 21st century Health and Social care • EMRI (Emergency Management and Research Institute) • HMRI (Health Management and Research Institute) • Social Audit (NREGA) • Rajiv Aarogyasri Community Health Insurance Scheme
CLIMATE CHANGE Puts everything at risk…. www.careclimatechnage.org/files/maps_all_hazards_popdenisty_world.jpg
A comparison of India’s per capita GHG emissions with some other countries.(2004) SOURCE: National Action Plan On Climate Change., Government Of India, 2008.
HOW THE RSPH MIGHT HELP • Sanitation, water, engineering skills and capacity building. • Food Safety. • Experience of Accreditation. • Building global awareness • to address climate change.