This article is about the critical findings observed under the National health profile 2019 published by CBHI (Central Bureau of Health Intelligence). This information is essential for the health system, policy development, governance, health research, human resource development, and health education and training. About Central Bureau of Health Intelligence
- Central Bureau of Health Intelligence (CBHI) is the National Nodal agency for Health Intelligence in the Directorate General of Health Services (Dte.GHS), Ministry of Health & Family Welfare, and Government of India.
- CBHI also functions as a Collaborating Centre for World Health Organization, Family of International Classification (WHO FIC) in India & South East Asia Region (SEAR) countries.
- CBHI is committed to building an integrated health informatics platform that can provide reliable, accurate, and relevant national health information and enable evidence-based policy formulation and decision making.
Central Bureau of Health Intelligence: Functions
- CBHI is committed to building an integrated Health Informatics Platform which can provide reliable, accurate and relevant national health information enabling evidence-based policy formulation and decision making.
- CBHI understands that effective health resources management and allocation requires timely and accurate information from various sources for monitoring of the health status of the population. Accurate and relevant information is not only important to identify the lacuna in the health service delivery, but also is vital for public health decision making, health sector reviews, planning, and resource allocation.
- At present, though CBHI extensively collects data from various States and UTs, Disease Control Programmes, and other organizations/agencies, still deficiencies such as non-reporting, under-reporting, and delays in transmission of public health data continue to exist.
- Further, the unavailability of private-sector health resources data including service and manpower availability, health infrastructure, equipment, and other important data points continues to be a challenge.
- As a result, public health resources planning and decision making miss an important dimension of leveraging private sector health infrastructure in service delivery.
About CBHI: National Health Resources Repository (NHRR)
- Understanding the need for timely and accurate health resources data from both the public and private sectors, CBHI conceptualized the framework of making a National Health Resources Repository (NHRR), where both public and private sector data resides.
- A national census was conceptualized in order to make a robust and comprehensive database of national health resources i.e., both public and private which inter-alia includes, hospitals, diagnostic labs, doctors and pharmacies, etc.
- The census data will comprise health infrastructure, human resource and the availability of medical facilities in each health establishment in the country.
About the National Health Profile:
- The National Health Profile covers demographic, socio-economic, health status and health finance indicators, along with comprehensive information on health infrastructure and human resources in health.
- CBHI has been publishing the National Health Profile every year since 2005.
- This is the 12th
- This information is essential for the health system, policy development, governance, health research, human resource development, and health education and training.
Findings of the National Health Profile (NHP 2019): State spending on health
- The cost of treatment has been on the rise in India and it has led to inequity in access to health care services.
- As per NHP 2019, Per capita, public expenditure on health in nominal terms has gone up from Rs 621 in 2009-10 to Rs 1,657 in 2017-18.
- Based on Health Survey (71st round) conducted by NSSO, average medical expenses incurred during hospital stay during January 2013-June 2014 was Rs 14,935 for rural and Rs 24,436 in urban India.
- In 2011, the High-Level Expert Group of the erstwhile Planning Commission recommended that central government and states combined should increase public expenditures on health from the current level of 2% of GDP to at least 2.5% by the end of the 12th plan and to at least 3% of GDP by 2022.
- However, India spends only 28% of its GDP (2017-18 BE) as public expenditure on health.
Relationship between Government Spending & Out of pocket expenditure on health Wide Disparities in the health spend of states
- The Empowered Action Group (EAG) states plus Assam had the lowest average per capita public expenditure on health in 2015-16
- EAG (the Empowered Action Group) states are the eight socio-economically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand, and Uttar Pradesh.
- Among the big states (erstwhile) Jammu and Kashmir lead with a 2.46% GSDP spend on healthcare – nearest to the ideal spend.
- Whereas the Northeastern states had the highest.
- Among the NE states, the leaders in health spend were Mizoram with 4.20% GSDP spend and Arunachal Pradesh with 3.29%.
- Even states seen as better performers on health parameters, such as Tamil Nadu and Kerala, fare poorly on the health finance index. Tamil Nadu spent 0.74% of its GSDP and Kerala 0.93% of its GSDP on healthcare.
India and world: Comparison of Health Spending
- In 2016, India’s Domestic general government health expenditure stood at $16 per capita. This is lower than in Norway, Canada, and Japan.
- Among the 23 countries including India that the Central Bureau of Health Intelligence chose for that comparison, the highest per capita spender is the United States at $8078.
Key Findings on Change in disease profile of the country
- The NHP also notes the change in the disease profile of the country with a shift towards the non-communicable disease from communicable ones.
- It has been observed that the non-communicable diseases dominate over communicable in the total disease burden of the country.
- In a recent report of India Council of Medical Research, titled India: Health of the Nation’s States: The India State-Level Disease Burden Initiative (2017), it is observed that
- The epidemiological transition, however, varies widely among Indian states:
- 48% to 75% for non-communicable diseases,
- 14% to 43% for infectious and associated diseases, and
- 9% to 14% for injuries.
“DALYs is an international standard of disease burden that measures how much of a normal life span of an individual is taken away by disease-related morbidity of mortality”. Key Findings on Vector-borne diseases Dengue and Chikungunya, transmitted by Aedes mosquitoes, are a cause for great concern to public health in India
- The survey pointed out that in 2018, the maximum number of cases and deaths due to malaria were reported in Chhattisgarh (77,140 cases and 26 deaths).
- The overall prevalence of the disease has diminished in 2012 and 2013, but there was a slight increase in 2014 and 2015 before it again started decreasing from 2016.
- However, the reported cases of Chikungunya in the country has shown a slight decrease from 67,769 to 57,813 in 2018 as compared to 2017.
Key Findings on Medical education & infrastructure
- Medical education infrastructure has shown rapid growth over the past few years.
No.of colleges Admissions for the academic year 2018-19 529 medical colleges Medical Colleges is 58756 313 Dental Colleges for BDS Dental Colleges 26960 253 Dental Colleges for MDS MDS 6288
Key Findings on the birth rate, death rate, and natural growth rate The birth rate is the number of live births per 1,000 population and death rate is the number of deaths per 1,000 population per year There has been a consistent decrease in the birth rate, death rate and natural growth rate in India from 1991 to 2017.
- In 2017, India had a birth rate of 20.2 and a death rate of 6.3, while the natural growth rate was 13.9 per 1,000 population. The birth rate in rural areas was higher than in urban. Similarly, the death rate and natural growth rate were also higher in rural areas as compared to urban.
Key Findings on Life expectancy
- According to the National Health Profile (NHP), 2019 average life expectancy in India rose marginally to 68.7 years in the 2012-16 period.
Key Findings on sex ratio
- As per the NHP, sex ratio (number of females per 1,000 males) in the country has improved from 933 in 2001 to 943 in 2011.
- In rural areas, the sex ratio has increased from 946 to 949.
- Kerala has recorded the highest sex ratio in respect of the total population (1,084), rural population (1,078) and urban (1,091).
- The lowest sex ratio in rural areas has been recorded in Chandigarh (690).
Total fertility rate:
- As per the report, the total fertility rate (average number of children that will be born to a woman during her lifetime) in 12 States has fallen below two children per woman and nine States have reached replacement levels of 2.1 and above.
- Delhi, Tamil Nadu, and West Bengal have the lowest fertility rate among other States.
Key Findings on Health manpower availability
Registered allopathic doctors up to 2018 11,54,686 Dental surgeons registered with Central/State Dental Councils of India 2,54,283 Registered AYUSH Doctors in India 7,99,879
Universal Health Coverage, according to the World Health Organization, means that “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.” The three objectives are: equity in access to health services; quality of health services should be good enough to improve the health of those receiving them; people should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm. Accordingly, the National Health profile by CBHI throws a stark reality on different parameters that need to be addressed to make Universal Health Coverage a reality in India. Also read: Ayushman Bharat Yojana: National Health Protection Scheme (AB-NHPS) National Digital Health Blueprint Report