* India beset by high rates of child, maternal deaths
* Faces growing problem of chronic diseases
* Experts urge universal healthcare by 2020
By Tan Ee Lyn
HONG KONG, Jan 11 Despite rapid economic
growth, India's healthcare system remains blighted by high
rates of infant mortality and deaths in childbirth, malaria,
tuberculosis and a growing problem with chronic diseases,
In a series of seven papers published in The Lancet on
Tuesday, they said India's healthcare system was unable to
cater to the needs of its population and out-of-pocket health
bills were pushing 39 million residents into poverty each year.
Among the proposals produced in the reports was a call for
universal healthcare by 2020.
They warned that chronic diseases like heart and
respiratory ailments, mental disorders, diabetes and cancer
will account for nearly 75 percent of all deaths in India by
2030, and urged the government to produce a comprehensive plan
to meet the healthcare needs of its 1.16 billion-strong
"The number of years of life lost because of coronary
heart disease deaths before the age of 60 years will increase
from 7.1 million in 2004 to 17.9 million in 2030," researchers
led by Vikram Patel at the London School of Hygiene and
Tropical Medicine wrote in their paper, the third in the series.
"(This) means that by 2030, more life years will be lost
as a result of this disease in India than is projected for
China, Russia and the United States combined."
One article, produced by a team led by Srinath Reddy at
the Public Health Foundation of India, concluded that only the
creation of a national health service could tackle the issue.
"We propose the following targets to be achieved by 2020
through the creation of the Integrated National Health System
with three overarching goals: ensure the reach and quality of
health services to all in India; reduce the financial burden
of healthcare on individuals; and empower people to take care
of their health and hold the healthcare system accountable,"
the team wrote in the seventh article in the series.
In comparison, China, also a fast-growing major economy,
implemented healthcare reforms in 2003 and gave it an
additional boost in 2009 by injecting $124 billion.
It said 92 percent of China's population was now covered
by basic healthcare insurance (See FACTBOX on how India
compares with other countries: TOE70A077).
Infectious diseases such as tuberculosis and malaria
account for 30 percent of India's disease burden, according to
a team led by Jacob John, a retired professor at the Christian
Their paper highlighted the gaps in health information as
autopsies are rarely performed and scarce attention is paid to
infectious diseases by the medical profession.
Even though India met the World Health Organisation's
target of eliminating leprosy by 2005, new cases have been
creeping up at a rate of 1.17 per 10,000 population a year and
they warned that the disease may surge anew in the future.
India also carries the world's largest burden of maternal,
newborn and child deaths, according to a paper authored by
Vinod Kumar Paul at the All India Institute of Medical Sciences.
In 2008, 1.8 million children below age five, including
one million neonates (four weeks old and under), and 68,000
mothers died. India also has the greatest number of
undernourished children, and about 52 million of them are
Paul and colleagues also pointed out a tendency to neglect
female babies in a country where boys are preferred.
"Financial incentives for care seeking need to be
considered, particularly for female infants and children,"
To tackle the rise of chronic illnesses, the experts
called for population-wide programmes to promote lifestyle
changes, such as reducing salt intake and tobacco and alcohol
consumption. Better management of diabetes, exercise and
dietary changes should also be encouraged.
To strengthen the public health system, incentives can be
used to encourage healthcare workers to work in poorly served
rural and remote areas, they wrote.
Another paper, led by Y Balarajan at the Harvard School of
Public Health, said more than three-quarters of health
spending was paid privately and that such high out-of-pocket
expenditures pushed 39 million Indians into poverty every year.
(Editing by Ron Popeski)
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