Mains Paper 2 | Issues relating to development and management of Social Sector relating to Health
The following things are important from UPSC perspective:
Prelims level: EAG, DALY, Global Burden of Disease 2016 study
Mains level: This article highlights various finding of the recently released “Health of the Nation’’ state level disease burden study
The first-ever “Health of the nation” state-level disease burden study has turned on its head the perception that some states, placed higher on the development ladder, are better than others in terms of health
The report- ‘India: Health of the Nation’s States India State-level Disease Burden Initiative’
- The analysis aims to equip the government with evidence to identify specific state-level health challenges and priorities for intervention.
- The health study focused on key drivers of ill health, disability and premature death in all states and union territories, and included people from over 2,000 ethnic groups.
- It covered 333 diseases and injuries, and 84 risk factor trends, for each state between 1990 and 2016, as part of the Global Burden of Disease 2016 study
- The report is a part of All India State-level Disease Burden Initiative, which was launched by the Ministry of Health with the ICMR, PHFI, and the Institute for Health Metrics and Evaluation, in 2015
- This report has major policy implications for national and local governments
Key highlights from the study
- The study shows that UP, MP, Bihar, Rajasthan, Jharkhand, Chhattisgarh, Odisha and Uttarakhand, in the government’s Empowered Action Group (EAG), continue to battle child and maternal malnutrition.
- However, it also shows that states such as Tamil Nadu, Kerala, Punjab, and Goa have become hubs of non-communicable diseases (NCDs), including cancer and lifestyle-linked issues like heart ailments and diabetes.
- It also includes states like Tamil Nadu, Kerala and Punjab in the highest bracket for NCDs, for which prevention is a primary counter-strategy
- The states with better health systems, as seen in infant mortality and immunization rates, are failing on the prevention front
- That is, while states like Bihar and UP are still battling diarrhea deaths in children, those that have won that war, now have newer battles to fight
- According to it the individual states in India are in different phases of epidemiological transition, and this has resulted in wide inequalities in the magnitude and progress against various diseases and their causes
What are the reasons for NCD burden?
- According to the study, the NCD burden is high in the southern states and Punjab
- One prominent factor is the lifestyle
- Also,National Rural Health Mission, 2005 for years have focused on reproductive and child health because infant and maternal mortality rates were among the MDGs (Millennium Development Goals)
- So they have not been focussing on prevention or spreading awareness about dietary requirements
- Therefore, the National Health Policy talks about shifting towards tackling NCDs
What does Report says about Life expectancy at Birth?
- The report also found that life expectancy at birth had improved from 59.7 years in 1990 to 70.3 years in 2016 for females.
- For males, it has increased from 58.3 years to 66.9 years.
- There are continuing inequalities between states, with a range of varying life expectancy for males in UP and Kerala for females and it varies widely in Assam and Kerela for women.
The contribution of injuries to the disease burden
- Increased in most states since 1990, with young adults forming the highest proportion.
- Road injuries and self-harm, including suicides, were the leading contributors to the injury burden.
DALY (Disability Adjusted Life Years)
- It is an internationally recognized metric to rate a disease or health condition
- It is calculated as the sum of years of life lost due to premature mortality and the years lost due to disability in people living with a health condition or suffering its consequences
- A higher DALY metric indicates a severe disease burden
- The report assessed DALY for various diseases and its trend across states in India
Empowered Action Group (EAG)
- In India, the eight socioeconomically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh are referred to as the Empowered Action Group (EAG) states
- They lag behind in the demographic transition and have the highest infant mortality rates in the country
- They receive special attention from the central government