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Historical development of life expectancy, 1881 to 2019Development of child mortality rate in India since 1960
India's population in 2021 as per World Bank is 1.39 billion.[1] Being the world's most populous country and one of its fastest-growing economies, India experiences both challenges and opportunities in context of public health. India is a hub for pharmaceutical and biotechnology industries; world-class scientists, clinical trials and hospitals yet country faces daunting public health challenges like child undernutrition, high rates of neonatal and maternal mortality, growth in noncommunicable diseases, high rates of road traffic accidents and other health related issues.
The Human Rights Measurement Initiative[2] finds that India is fulfilling 80.5% of what it should be fulfilling for the right to health based on its level of income.[3] When looking at the right to health with respect to children, India achieves 92.1% of what is expected based on its current income.[3] In regards to the right to health amongst the adult population, the country achieves only 85.6% of what is expected based on the nation's level of income.[3] India falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 63.7% of what the nation is expected to achieve based on the resources (income) it has available.[3]
Major health indicators
The life expectancy at birth has increased from 49.7 years in 1970–1975 to 67.9 years in 2010–2014. For the same period, the life expectancy for females is 69.6 year and 66.4 years for males. In 2018, the life expectancy at birth is said to be 69.1 years.[4]
The infant mortality rate has declined from 74 per 1,000 live births in 1994 to 37 per 1,000 live births in 2015. However, the differentials of rural (41) and urban (25) as of 2015 are still high. In 2016, the infant mortality rate was estimated to be 34.6 per 1,000 live births.[4]
The under-five mortality rate for the country was 113 per 1,000 live births in 1994 whereas in 2018 it reduced to 41.1 per 1,000 live births.[4]
The maternal mortality ratio has declined from 212 per 100 000 live births in 2007–2009 to 167 per 100 000 live births in 2011–2013. However, the differentials for state Kerala (61) and Assam (300) as of 2011–2013 are still high. In 2013, the maternal mortality ratio was estimated to be 190 per 100 000 live births.[4]
The total fertility rate for the country was 2.3 in rural areas whereas it has been 1.8 in urban areas during 2015.
The most common cause of disability adjusted life years lost for Indian citizens as of 2016 for all ages and sexes was ischemic heart disease (accounting for 8.66% of total DALYs ), 2nd chronic obstructive pulmonary disease (accounting for 4.81% of total DALYs), 3rd diarrhea (accounting for 4.64% of total DALYs) and 4th lower respiratory infections (accounting for 4.35% of total DALYs).[5]
As per the figures about the child mortality rate which is quite a big hurdle for the government, the 2nd most common cause of DALYs lost for children under 5 years of age was diseases like diarrhea, lower respiratory tract infections and other communicable diseases (accounting for 22,598.71 DALYs per 100 000 population) as of 2016 which can be preventable.[5]
A demographic study found that, compared to 2019, life expectancy at birth was 2.6 years lower and mortality was 17% higher in 2020, implying 1.19 million excess deaths in 2020.[6] The study also found, in contrast to global patterns, females in India experienced a life expectancy decline that was 1 year larger than losses for males. In addition, the researchers found that in 2020, the life expectancy of an upper-caste Hindu dropped 1.3 years, compared to 2.7 years for those of a ‘scheduled caste’ and 5.4 years for Indian Muslims. The study results were contested by the Government of India.[7]
Health issues
Oral health in India
Oral health refers to optimum functioning of mouth (smile, swallow, chew, taste, etc.), proper dentition and ability to perform various movements of facial muscles, jaws and other orofacial structures without pain and discomfort.
Status of oral health both affects and gets affected by specific systemic health conditions. Many systemic diseases, such as; diabetes, can be suspected by examining oral signs and symptoms. Poor oral health is also a risk factor of cardio-vascular diseases, stroke, digestive issues, pre-term birth, low birth weight, preeclampsia etc. [8]
According to Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030 (WHO report), Globally, oral diseases affect 3.5 billion people and every three out of four people lives in middle-income countries. In India, there has been a steady increase in the burden of oral diseases since last two decades.[9] High prevalence of dental caries is notable among children and adults, due to high sugar consumption. It subsequently leads to high prevalence of periodontal diseases and edentulism.
Squamous cell carcinoma is the most common form of oral cancer in India and primarily affects middle age population (31–50 years). Epidemiologically, Kerala has the lowest and West Bengal has the highest incidence of oral cancer. For India, self-examination is the most effective method for early diagnosis of oral cancer.[10]
Risk factors for all kind of dental diseases include; high dietary sugar, areca nut, alcohol and tobacco (gutkha, khaini, mawa, etc.) consumption, smoking, etc.[9]
Dental caries with partial edentulismLower Lip Cancer
According to the WHO 'oral health country profile' below is the prevalence of main oral health issues:[11]
Oral Disease Burden in India (2019)
Oral Health Issue
Prevalence (%)
Untreated caries of deciduous teeth in children (1–9 years)
43.3
Untreated caries of permanent teeth in people (5+ years)
28.8
Severe periodontal disease in people (15+ years)
21.8
Edentulism in people (20+ years)
4
Oral and lip cancer (2020)
Header text
Male
Female
Total
Number of new cases
104,661
31,268
135,929
Incidence rate (%)
14.8
4.6
9.8
Prevalence of Risk Factors (WHO, 2019)
Risk Factor
Male
Female
Total
Per capita availability of sugar (g/day)
....
....
53.8
Prevalence of current tobacco use, 15+ years (%)
42.4
13.7
28.1
Per capita alcohol consumption, 15+ years (litres of pure alcohol/year)
9.1
1.9
5.6
Root Issues
However, the number of dentists in 2011 was 117,825 and approximate number for 2020 is 309,700, but still, majority people are devoid of proper dental treatment. Reasons for this gap, 1) unequal distribution of dentists in urban (70%) and rural (30%) areas, 2) 90% services provided by private practitioners and only 10% through the government settings, and 3) Negligeable% of insurance coverage for dental treatments. As a result, oral diseases cause high economic burden.[12]
Malnutrition refers to deficiencies, excesses or imbalances in a person's intake of energy and/or nutrients. The term malnutrition covers 2 broad groups of conditions. One is undernutrition – which includes stunting (low height for age), wasting (low weight for height), underweight (low weight for age) and micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals). The other is overweight – overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and cancer).[13]
According to a 2005 report, 60% of India's children below the age of three were malnourished, which was greater than the statistics of sub-Saharan African of 28%.[14] World Bank data indicates that India has one of the world's highest demographics of children suffering from malnutrition – said to be double that of sub-Saharan Africa with dire consequences. India's Global Hunger Index India ranking of 67, the 80 nations with the worst hunger situation places it even below North Korea or Sudan. 44% of children under the age of 5 are underweight, while 72% of infants have anemia.[15] It is considered that one in three malnourished children live in India.
Uttar Pradesh: Most children here, in India's densest state by population, under the age of 5 are stunted due to malnutrition.
Tamil Nadu: The state, despite high education, has a prominent child malnutrition problem. A National Family Health Survey reveals that 23% of children here are underweight, while 25% of Chennai children show moderately stunted growth.
Madhya Pradesh: 2015 data reveals that Madhya Pradesh has India's highest number of malnourished children – 74.1% of them under 6 suffer from anemia, and 60% have to deal with malnutrition.
Jharkhand and Bihar: At 56.5%, Jharkhand has India's second highest number of malnourished children. This is followed by Bihar, at 55.9%.
A well-nourished child is one whose weight and height measurements compare very well within the standard normal distribution of heights and weights of healthy children of same age and sex.[18] A child without sufficient nutrients in its daily intake is not only exposed to physical and motor growth delays, but also to heightened risk of mortality, reduced immune defenses and decreased cognitive and learning capacities. Malnutrition limits the productivity of all those who are its victims, and thus serves to perpetuate poverty. As with serious malnutrition, growth delays also hinder a child's intellectual development. Sick children with chronic malnutrition, especially when accompanied by anemia, often have a lower learning capacity during the crucial first years of attending school.[16]
Iodine deficiency – Still births (includes neo-natal deaths)
90,000
Obesity related chronic diseases (BMI >25)
%
36.0
7.8
2.4
40.0
10.9
3.2
Hypertension
%
35.0
25.0
25.0
35.0
24.0
23.0
Diabetes mellitus (year 2006)
%
16.0
5.0
16
5.0
Coronary heart disease
%
7–9
3–5
7–9
3–5
Cancer incidence rate
per million
113
123
*: <Median -2SD of WHO Child Growth Standards
#: NNMB Rural Survey – 2005–06
^: NNMB Tribal Survey – 2008–09
Due to their lower social status, girls are far more at risk of malnutrition than boys of their age. Partly as a result of this cultural bias, up to one third of all adult women in India are underweight. Inadequate care of these women already underdeveloped, especially during pregnancy, leads them in turn to deliver underweight babies who are vulnerable to further malnutrition and disease.[19]
Obesity
Obesity in India has grown to epidemic levels in India in the 21st century, with morbid obesity affecting 5% of the population.
One factor that may impact the rise of obesity in India is the growing establishment of fast-food and mithai shops within India. Fast-food is among one of India's largest growing markets, especially amid the COVID-19 pandemic where it saw tremendous growth due to the speed of service and no-contact model. Moreover, the rise of food-delivery apps such as Zomato and Swiggy in India has allowed access to fast-foods on an unparalleled level in India. By increasing the ease of access to such unhealthy foods, Indians are more likely than ever before to choose such options rather than cooking at home. In 2021, the most ordered-foods on Swiggy were biryani and paneer butter masala, both of which are highly fattening when ordered from restaurants.[20] Such delivery apps also use what some may consider predatory business tactics to hook customers on to their services. First time customers are offered a month's worth of free delivery and discounts to build their reliance on delivery apps, so even after the trial ends the customers continue paying and ordering food. Even prior to COVID and online food ordering services, fast food has been readily available around the streets of Indian cities, just minutes away from most residential areas. Ever since McDonalds entered India in 1996, numerous fast food chains have followed suit including Dominos, Pizza Hut, Burger King, and KFC.[citation needed]
Communicable diseases
Diseases such as dengue fever, hepatitis, tuberculosis, malaria and pneumonia continue to plague India due to increased resistance to drugs.[21]
This diagram shows the percentage distribution of morbidity reported in communicable diseases in 2016 in India according to the National Health Profile 2017This diagram shows the percentage distribution of mortality reported in communicable diseases in 2016 in India according to the National Health Profile 2017
In 2011, India reported a 'totally drug-resistant' form of tuberculosis .[22] India is the highest TB burden country in the world in terms of absolute number of incident cases that occur each year.[23] TB primarily affects people in their most productive years of life. While two-thirds of the cases are male, TB takes disproportionately larger toll among young females, with more than 60 per cent of female cases occurring by the age of 34 years. In 2018, the TrueNat test, an indigenously developed technology under the "Make in India" initiative, was deployed in about 350 PHCs. This led to marked increase in access to highly sensitive molecular tests with augmented capacity for resistance testing at the peripheral level.[24]
HIV/AIDS in India is ranked third highest among countries with HIV-infected patients. National AIDS Control Organisation, a government apex body is making efforts for managing the HIV/AIDS epidemic in India.[25]Diarrheal diseases are the primary causes of early childhood mortality.[26] These diseases can be attributed to poor sanitation and inadequate safe drinking water.[27] India has the world's highest incidence of rabies. Malaria has been a seasonal health problem in India from a very long time. The maximum number of malaria cases and deaths have been reported mostly form the rural parts of Orissa. The overall prevalence of the disease has diminished in 2012 and 2013 however there is a slight increase in 2014 and again started decreasing from 2015. WHO (World Health Organization) adopted a strategy in May-2015, that provides a technical guidance to countries emphasizing the importance of scaling up malaria responses and moving towards elimination of malaria. This is known as The Global Technical Strategy for Malaria (2016-2030) [28]. A major scale-up of malaria responses will not only help countries reach the health-related targets for 2030, but will contribute to poverty reduction and other development goals.
Kala-azar is the second largest parasitic killer in the world. Most of the cases (76%) were found in Bihar in 2016. Dengue and chikungunya transmitted by Aedes mosquitoes, is another problem of concern in India. Dengue outbreaks have continued since the 1950s but severity of disease has increased in the last two decades. In 2016, India reported a total of 58,264 cases of chikungunya. Chicken pox is a highly contagious and a viral infection which breaks out in many parts of India.[29] Cases were reported to be 61,118 & deaths to be 60 in 2016.
In 2012, India was polio-free for the first time in its history.[30] This was achieved because of the Pulse Polio programme started in 1995–96 by the government.[31]
NCD incidence rates from 1990 to 2019 in India according to IHME (Institute of Health Metrics and Evaluation)
Non-communicable diseases
India has witnessed huge progress in the health status of its population since independence. The transition has been seen in economic development, nutritional status, fertility and mortality rates and consequently, the disease profile has changed considerably. Although great efforts have been done to control the communicable diseases, but they still contribute significantly to disease burden of the country. Decline in disability and death from communicable diseases has been accompanied by a gradual shift to, and accelerated rise in the prevalence of chronic non-communicable diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancers, mental health disorders and injuries. Indians are at particularly high risk for atherosclerosis and coronary artery disease. This may be attributed to a genetic predisposition to metabolic syndrome and adverse changes in coronary artery vasodilation.
NCD mortality numbers from 1990 to 2019 in India
The burden of the Non-Communicable Diseases (NCD) in India with a population of the over 1.3 billion is huge. NCDs in India contributed to 6.8 million deaths in 2019, which is about 67.6% percent of overall deaths. In the same year Ischemic heart disease accounted for highest mortality followed by COPD, Stroke and Diabetes among all NCD related deaths.[32]
Starting in early 1990s, there have been wide disparities in terms of NCD burden on Indian diaspora. While life expectancy has increased it is the number of years lost due to ill-health, disability or early death (DALY) rate that is almost doubled. It was 29.17% in 1990 and reached 57.92% in 2019 according to IHME. Also NCDs are accounting for more than 90% of total prevalent cases in India at any given point of time. Between ages 15–49 NCDs mortality share was 35.56% in 1990 while the share is increased to 48.95% in 2019[33]
Through Arbitrage Research Institute (TARI) a private not for profit market research firm has developed a report for ASSOCHAM regarding NCD status in India. This study highlighted the burden of NCDs among Indians and has highlighted that the prevalence of having any NCDs among the Indian population is 116 per 1000 population.
Key findings
High blood pressure, intestinal disorders related to digestion, diabetes, respiratory disorders, neurological disorders, cardiovascular diseases, renal disorders, and cancers are top NCDs among Indians
Major risk factors for NCDs include air pollution (76%), low physical activity (67%), imbalanced diet (55%), stress (44%) and obesity (24%)
Among states Odisha has the highest prevalence of NCDs, with every 272 per 1,000 population with any NCD and Gujarat has the lowest prevalence — 60 per 1,000.
More than two-thirds of people with non-communicable disease (NCDs) in India are in the 26-59 age group
Prevalence of NCD has shown to be increasing after 18 years and makes a quantum leap when an individual crosses the age of 35
Diabetes and hypertension showed higher prevalence in those who are 50 years and above while brain/neurological disorders showed higher prevalence in the age group 35 years and below
In 2018 chronic obstructive pulmonary disease was the leading cause of death after heart disease. The 10 most polluted cities in the world are all in northern India with more than 140 million people breathing air 10 times or more over the WHO safe limit. In 2017, pollution levels forced schools to close for several days and air pollution killed 1.24 million Indians.[35]
A statewide STEPS survey done in Madhya Pradesh estimated 22.3 percent had hypertension and 6.8 percent had diabetes.[36]
High infant mortality rate
Despite health improvements over the last thirty years, lives continue to be lost to early childhood diseases, inadequate newborn care and childbirth-related causes. More than two million children die every year from preventable infections.[37]
Approximately 1.72 million children die each year before turning one.[38] The under five mortality and infant mortality rates have been declining, from 202 and 190 deaths per thousand live births respectively in 1970 to 64 and 50 deaths per thousand live births respectively in 2009 and to 41.1 (in 2018) and 34.6 (in 2016) deaths per thousand live births respectively.[38][39][4] However, this decline is slowing. Reduced funding for immunization leaves only 43.5% of the young fully immunized.[40] A study conducted by the Future Health Systems Consortium in Murshidabad, West Bengal indicates that barriers to immunization coverage are adverse geographic location, absent or inadequately trained health workers and low perceived need for immunization.[41] Infrastructure like hospitals, roads, water and sanitation are lacking in rural areas.[42] Shortages of healthcare providers, poor intrapartum and newborn care, diarrheal diseases and acute respiratory infections also contribute to the high infant mortality rate.[38]
In 2008 there were more than 122 million households that had no toilets, and 33% lacked access to toilets, over 50% of the population (638 million) defecated in the open.[43] This was relatively higher than Bangladesh and Brazil (7%) and China (4%).[43] 211 million people gained access to improved sanitation from 1990 to 2008.[43] A huge portion of Indian Population lacked access to toilets prior to the 2014, and open defecation on roads and railway tracks were very common.[43] However, due to the success of "Swacch Bharat Mission" initiative of the government of India, launched in 2014, India constructed 110 million toilets in the country on the cost of $28 billion. As of 2018 about 95.76% of Indian households have toilet access and in 2019 the Government of India declared the country "Open Defecation Free" (ODF).[44]
Several million more have multiple episodes of diarrhea and still others fall ill on account of Hepatitis A, enteric fever, intestinal worms and eye and skin infections caused by poor hygiene and unsafe drinking water.[45]
Access to protected sources of drinking water improved from 68% of the population in 1990 to 88% in 2008.[43] However, only 26% of the slum population has access to safe drinking water,[44] and 25% of the total population has drinking water on their premises.[43] This problem is exacerbated by falling levels of groundwater caused mainly by increasing extraction for irrigation.[43] Insufficient maintenance of the environment around water sources, groundwater pollution, excessive arsenic and fluoride in drinking water pose a major threat to India's health.[43]
A major issue for women in India is that few have access to skilled birth attendants and fewer still to quality emergency obstetric care. In addition, only 15 per cent of mothers receive complete antenatal care and only 58 per cent receive iron or folate tablets or syrup.[37] Women's health in India involves numerous issues. Some of them include the following:
Malnutrition: The main cause of female malnutrition in India is the tradition requiring women to eat last, even during pregnancy and when they are lactating.[46]
Breast cancer: One of the most severe and increasing problems among women in India, resulting in higher mortality rates.
Maternal mortality: Indian maternal mortality rates in rural areas are one of the highest in the world.[46]
Rural health
Rural India contains over 68% of India's total population,[47] and half of all residents of rural areas live below the poverty line, struggling for better and easy access to health care and services.[48] Health issues confronted by rural people are many and diverse – from severe malaria to uncontrolled diabetes, from a badly infected wound to cancer.[49] Postpartum maternal illness is a serious problem in resource-poor settings and contributes to maternal mortality, particularly in rural India.[50] A study conducted in 2009 found that 43.9% of mothers reported they experienced postpartum illnesses six weeks after delivery.[51] Furthermore, because of limited government resources, much of the health care provided comes from non profits such as The MINDS Foundation.[52]
India's urban population has increased from 285 million in 2001 to 377 million (31%) in 2011. It is expected to increase to 535 million (38%) by 2026 (4). The United Nations estimates that 875 million people will live in Indian cities and towns by 2050. If urban India were a separate country, it would be the world's fourth largest country after China, India and the United States of America. According to data from Census 2011, close to 50% of urban dwellers in India live in towns and cities with a population of less than 0.5 million. The four largest urban agglomerations Greater Mumbai, Kolkata, Delhi and Chennai are home to 15% of India's urban population.[53]
A woman and her baby boy are healthy and safe post delivery, after receiving access to healthcare services through an assistance program in Orissa, India.
Child health and survival disparities in urban India
Analysis of National Family Health Survey Data for 2005–06 (the most recent available dataset for analysis) shows that within India's urban population – the under-five mortality rate for the poorest quartile eight states, the highest under-five mortality rate in the poorest quartile occurred in UttarPradesh (110 per 1,000 live births), India's most populous state, which had 44.4 million urban dwellers in the 2011 census[54] followed by Rajasthan (102), Madhya Pradesh (98), Jharkhand (90) and Bihar (85), Delhi (74), and Maharashtra (50). The sample for West Bengal was too small for analysis of under-five mortality rate. In Uttar Pradesh was four times that of the rest of the urban populations in Maharashtra and Madhya Pradesh. In Madhya Pradesh, the under-five mortality rate among its poorest quartile was more than three times that of the rest of its urban population.[55]
Maternal healthcare disparities in urban India
Among India's urban population there is a much lower proportion of mothers receiving maternity care among the poorest quartile; only 54 per cent of pregnant women had at least three ante-natal care visits compared to 83 per cent for the rest of the urban population. Less than a quarter of mothers within the poorest quartile received adequate maternity care in Bihar (12 percent), and Uttar Pradesh (20 percent),and less than half in Madhya Pradesh (38 percent), Delhi (41 percent), Rajasthan (42 percent), and Jharkhand (48 percent). Availing three or more ante-natal check-ups during pregnancy among the poorest quartile was better in West Bengal (71 percent), Maharashtra (73 percent).[55]
High levels of undernutrition among the urban poor
For India's urban population in 2005–06, 54 percent of children were stunted, and 47 percent underweight in the poorest urban quartile, compared to 33 percent and 26 percent, respectively, for the rest of the urban population. Stunted growth in children under five years of age was particularly high among the poorest quartile of the urban populations in Uttar Pradesh (64 percent), Maharashtra (63 percent), Bihar (58 percent), Delhi(58 percent), Madhya Pradesh (55 percent), Rajasthan (53 percent), and slightly better in Jharkhand (49 percent). Even in the better-performing states close to half of the children under-five were stunted among the poorest quartile, being 48 percent in West Bengal respectively.[55]
High levels of stunted growth and underweight issues among the urban poor in India points to repeated infections, depleting the child's nutritional reserves, owing to sub-optimal physical environment. It is also indicative of high levels of food insecurity among this segment of the population. A study carried out in the slums of Delhi showed that 51% of slum families were food insecure.[56]
Initiatives
Health education programs
The Indian government has implemented several initiatives over the past few decades to boost healthcare opportunities and access in both rural areas and urban slums. International researchers and organizations have cited the need to implement more long-term solutions to permanently improve slum health; they argue that government-funded programs like the National Rural Health Mission (NRHM) or the National Urban Health Mission (NUHM) have a short-lived impact.[57] The National Immunization Programme, a notable example, prioritized providing vaccinations to slum-dwellers to reduce spread of infectious disease, but research suggests that the efficacy of this program was limited because slum residents remain unaware of the significance of being immunized.[58] This finding demonstrated the need to implement health education programs to work towards long-term solutions to the slum health crisis.[59] Non-profit organizations have approached this problem in a multitude of different ways.
While some organizations continue to provide service through opening medical facilities in inner city areas or advocating for infrastructural change (e.g. improving water sanitation), other newer organizations are increasingly focusing on educating the population on health care resources through community-based health education programs.[60] Factors like fear of consequence, gender, individual agency, and overall socioeconomic environment have an effect on the ability and willingness of patients to seek healthcare resources.[61] Implementing health awareness programs and focusing on improving the population's knowledge of healthcare resources has a significant effect on their ability to access affordable care, prevent illness, and prevent job loss.[62] For example, in parts of India, public facilities offer free treatment for tuberculosis, yet many slum residents choose to visit expensive private healthcare facilities due to lack of awareness of this program. After an initiative involving conversations between health experts and slum households, a significant number of residents turned to public facilities rather than private hospitals to receive effective treatment at no cost.[63]
Organizations have implemented a similar method of health education within urban schools to combat nutritional deficiency and malnutrition among children.[64] Through use of informational videos and posters and curriculum changes, all implemented within a school setting, adolescents had an increased awareness of their nutritional needs and the resources they could utilize.[65] Overall, health education programs have proven to be an effective strategy in addressing the root causes of health disparities and promoting long-term change in underserved communities.
According to Huffington Post, doctors spoke about the problems with "corporate hospitals" and senior surgeons being told to sell surgeries to their patients even if they weren't needed. In one instance, a doctor was told he would be sacked if he didn't have enough patients to operate on.[67] The majority of India's private, for-profit hospitals charge exorbitant costs for medical services and supplies, which has put a strain on the country's public finances.[67][68][69][70]
According to the recently conducted national survey in 2024, Uganda's population stands at 45.9 million. Health status is measured by some of the key indicators such as life expectancy at birth, child mortality rate, neonatal mortality rate and infant mortality rate, maternal mortality ratio, nutrition status and the global burden of disease. The life expectancy of Uganda has increased from 39.3 in 1950 to 62.7years in 2021. This is lower below the world average which is at 71.0 years. The fertility rate of Ugandan women slightly increased from an average of 6.89 babies per woman in the 1950s to about 7.12 in the 1970s before declining to an estimate 4.3 babies in 2019. This figure is higher than the world average of 2 and most world regions including South East Asia, Middle East and North Africa, Europe and Central Asia and America. The under-5-mortality-rate for Uganda has decreased from 191 deaths per 1000 live births in 1970 to 41 deaths per 1000 live births in 2022.
In demography and medical geography, epidemiological transition is a theory which "describes changing population patterns in terms of fertility, life expectancy, mortality, and leading causes of death." For example, a phase of development marked by a sudden increase in population growth rates brought by improved food security and innovations in public health and medicine, can be followed by a re-leveling of population growth due to subsequent declines in fertility rates. Such a transition can account for the replacement of infectious diseases by chronic diseases over time due to increased life span as a result of improved health care and disease prevention. This theory was originally posited by Abdel Omran in 1971.
Malaysia is classified by The World Bank as upper middle-income country and is attempting to achieve high-income status by 2020 and to move further up the value-added production chain by attracting investments in high technology, knowledge-based industries and services. Malaysia's HDI value for 2015 was recorded at 0.789 and HDI rank no 59 out of 188 countries and territories on the United Nations Development Programme's Human Development Index. In 2016, the population of Malaysia is 31 million; Total expenditure on health per capita is 1040; Total expenditure on health as % of GDP (2014) was 4.2. Gross national income (GNI) per capita was recorded at 24,620.
Health in Ethiopia has improved markedly since the early 2000s, with government leadership playing a key role in mobilizing resources and ensuring that they are used effectively. A central feature of the sector is the priority given to the Health Extension Programme, which delivers cost-effective basic services that enhance equity and provide care to millions of women, men and children. The development and delivery of the Health Extension Program, and its lasting success, is an example of how a low-income country can still improve access to health services with creativity and dedication.
Health care services in Nepal are provided by both public and private sectors and are generally regarded as failing to meet international standards.
Sudan is still one of the largest countries in Africa, even after the split of the Northern and Southern parts. It is one of the most densely populated countries in the region and is home to over 37.9 million people.
The Tajikistan health system is influenced by the former Soviet legacy. It is ranked as the poorest country within the WHO European region, including the lowest total health expenditure per capita. Tajikistan is ranked 129th as Human Development Index of 188 countries, with an Index of 0.627 in 2016. In 2016, the SDG Index value was 56. In Tajikistan health indicators such as infant and maternal mortality rates are among the highest of the former Soviet republics. In the post-Soviet era, life expectancy has decreased because of poor nutrition, polluted water supplies, and increased incidence of cholera, malaria, tuberculosis, and typhoid. Because the health care system has deteriorated badly and receives insufficient funding and because sanitation and water supply systems are in declining condition, Tajikistan has a high risk of epidemic disease.
The quality of health in Cambodia is rising along with its growing economy. The public health care system has a high priority from the Cambodian government and with international help and assistance, Cambodia has seen some major and continuous improvements in the health profile of its population since the 1980s, with a steadily rising life expectancy.
Bangladesh is one of the most populous countries in the world, as well as having one of the fastest growing economies in the world. Consequently, Bangladesh faces challenges and opportunities in regards to public health. A remarkable metamorphosis has unfolded in Bangladesh, encompassing the demographic, health, and nutritional dimensions of its populace.
Despite India's 50% increase in GDP since 2013, more than one third of the world's malnourished children live in India. Among these, half of the children under three years old are underweight.
A landlocked sub-Saharan country, Burkina Faso is among the poorest countries in the world—44 percent of its population lives below the international poverty line of US$1.90 per day —and it ranks 185th out of 188 countries on UNDP's 2016 Human Development Index. Rapid population growth, gender inequality, and low levels of educational attainment contribute to food insecurity and poverty in Burkina Faso. The total population is just over 20 million with the estimated population growth rate is 3.1 percent per year and seven out of 10 Burkinabe are younger than 30. Total health care expenditures were an estimated 5% of GDP. Total expenditure on health per capita is 82 in 2014.
Ecuador has a comprehensive publicly funded health system and national health insurance. Free medical care is available to all residents regardless of income, and without buying any type of medical insurance. An extensive and proactive program for public health includes actions such as teams of nurses going door-to-door offering influenza vaccines to residents. Isolated rural areas are also served by this system, as physicians, dentists, and nurses are obliged to perform one year of "rural service" in these communities. This service is mandatory for professional licensing in Ecuador.
The 2010 maternal mortality rate per 100,000 births for Tanzania was 790. This is compared with 449 in 2008 and 610.2 in 1990. The UN Child Mortality Report 2011 reports a decrease in under-five mortality from 155 per 1,000 live births in 1990 to 76 per 1,000 live births in 2010, and in neonatal mortality from 40 per 1,000 live births to 26 per 1,000 live births. The aim of the report The State of the World's Midwifery is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child
Malawi ranks 170th out of 174 in the World Health Organization lifespan tables; 88% of the population live on less than £2.40 per day; and 50% are below the poverty line.
The National Health Mission (NHM) was launched by the government of India in 2013 subsuming the National Rural Health Mission and National Urban Health Mission. It was further extended in March 2018, to continue until March 2020. It is headed by Mission Director and monitored by National Level Monitors appointed by the Government of India.Rural Health Mission (NRHM) and the recently launched National Urban Health Mission (NUHM). Main program components include Health System Strengthening (RMNCH+A) in rural and urban areas- Reproductive-Maternal- Neonatal-Child and Adolescent Health, and Communicable and Non-Communicable Diseases. NHM envisages achievement of universal access to equitable, affordable and quality health care services that are accountable and responsive to the needs of the people.
Lesotho's Human development index value for 2018 was 0.518—which put the country in the low human development category—positioning it at 164 out of 189 countries and territories. Health care services in Lesotho are delivered primarily by the government and the Christian Health Association of Lesotho. Access to health services is difficult for many people, especially in rural areas. The country's health system is challenged by the relentless increase of the burden of disease brought about by AIDS, and a lack of expertise and human resources. Serious emergencies are often referred to neighbouring South Africa. The largest contribution to mortality in Lesotho are communicable diseases, maternal, perinatal and nutritional conditions.
Zambia is a landlocked country in Sub Saharan Africa which experiences a burden of both communicable and non-communicable diseases. In line with WHO agenda for equity in health, it has adopted the Universal Health Coverage agenda to mitigate the challenges faced within the health sector. The Ministry of Health (MOH) provides information pertaining to Zambian health. The main focus of the Ministry of Health has been provision of uninterrupted care with emphasis on health systems strengthening and services via the primary health care approach.
Even though Panama has one of the fastest growing economies in the western hemisphere, an estimated 500,000 people are in extreme poverty. Panama has major socioeconomic and health inequalities between the country’s urban and rural populations. The indigenous population lives in more disadvantaged conditions and experiences greater vulnerability in health. In general, the population living in more marginalized areas has less service coverage and less access to health care.
Women's health in India can be examined in terms of multiple indicators, which vary by geography, socioeconomic standing and culture. To adequately improve the health of women in India multiple dimensions of wellbeing must be analysed in relation to global health averages and also in comparison to men in India. Health is an important factor that contributes to human wellbeing and economic growth.
Montenegro is a country with an area of 13,812 square kilometres and a population of 620,029, according to the 2011 census. The country is bordered by Croatia, the Adriatic Sea, Bosnia, Herzegovina, Serbia, Kosovo and Albania. The most common health issues faced are non-communicable diseases accounting for 95% of all deaths. This is followed by 4% of mortality due to injury, and 1% due to communicable, maternal, perinatal and nutritional conditions. Other health areas of interest are alcohol consumption, which is the most prevalent disease of addiction within Montenegro and smoking. Montenegro has one of the highest tobacco usage rates across Europe. Life expectancy for men is 74 years, and life expectancy for women is 79.
1 2 Ramanarayanan, V., Janakiram, C., Joseph, J., & Krishnakumar, K. (2020). Oral health care system analysis: A case study from India. Journal of family medicine and primary care, 9(4), 1950–1957. https://doi.org/10.4103/jfmpc.jfmpc_1191_19Archived 6 July 2024 at the Wayback Machine
↑ "Archived copy"(PDF). Archived(PDF) from the original on 27 December 2023. Retrieved 18 September 2023.{{cite web}}: CS1 maint: archived copy as title (link)
↑ Vundavalli S. (2014). Dental manpower planning in India: current scenario and future projections for the year 2020. International dental journal, 64(2), 62–67. https://doi.org/10.1111/idj.12063Archived 6 July 2024 at the Wayback Machine
↑ Rieff, David (11 October 2009). "India's Malnutrition Dilemma". Source: The New York Times 2009. Archived from the original on 29 August 2019. Retrieved 20 September 2011.
↑ Singh, Sanjeev; Sahu, Damodar; Agrawal, Ashish; Vashi, Meeta Dhaval (July 2018). "Ensuring childhood vaccination among slums dwellers under the National Immunization Program in India – Challenges and opportunities". Preventive Medicine. 112: 54–60. doi:10.1016/j.ypmed.2018.04.002. PMID29626558. S2CID4879865.
↑ Yang, Li; Zhao, Qiuli; Zhu, Xuemei; Shen, Xiaoying; Zhu, Yulan; Yang, Liu; Gao, Wei; Li, Minghui (August 2017). "Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers". Quality of Life Research. 26 (8): 2153–2160. doi:10.1007/s11136-017-1550-4. ISSN0962-9343. PMID28401417. S2CID4587634.
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