While rural India is facing the challenge of malnutrition, urban India is getting obese!

Author: Pramila Tripathi;  Date: 28 June 2018

The saying that ‘Heath is Wealth’ is age-old and as we all know, old is gold. No matter what heights the human race reaches with its scientific expeditions, maintaining proper health should always remain the major concern for everyone. It is important to note here that by the word ‘a healthy being’ the wellness of both mental and physical health is referred. We often neglect our mental health and think that being physically well makes us an utterly healthy being. However, it is high time that we give both our psychological and physical health equal attention.

Worth of the Indian Health Industry
India, with a vast 135.37 crores population is the second most populated country in the world. However, all the achievements that have come in this country’s way, unfortunately, do not include a radical and much-needed improvement in the health sector. As according to a report published by The Firstpost, the Indian Health Industry is worth almost $81.3 billion. This health industry is the result of the simultaneous rise of diseases and health consciousness among the growing Indian population. The net worth of this industry is expected to rise almost by 17 percent by the year 2020.

However, despite this colossal net worth of the healthcare industry of this country, the health of the population does not look very promising. India is the country that has the lowest public spend and government spending as a proportion of the GDP (Gross Domestic Product) as well as the lowest per capita health spending. Countries like China, UK or the US are far in a far advanced position than India in this respect. Indians are compelled to make almost 62 percent of their health care expenditure from their own pockets where the citizens of US, UK, and China have to spend 13.4 percent, 10 percent, and 54 percent respectively.

Lack of Proper Sanitation
Another major problem that constitutes ill health of the Indian population, especially among women and girls is the lack of enough number of toilets. According to a report by The Times of India, our country has topped the list based on the number of people who do not have access to a proper and healthy toilet. A shocking 56 percent of the Indian population does not have access to well-built toilets, while the percentage of China and Bangladesh stands at 25 and 53 respectively. The lack of proper sanitary systems not only contributes to an overall unhealthy population of the country but also makes the females susceptible to sexual harassment and illiteracy. Even though the government has been trying to improve the sanitary condition of the nation by introducing various programs like the Swachh Bharat campaign, India continues to rank low in the sanitary index.

However, on the brighter side, as according to a data published by the government the October 2014 launched Swachh Bharat mission has helped the sanitation coverage of the country to increase to 65% from a mere 39% by 2017 November. In this four years of the campaign, almost 52 million toilets were built in rural India. The WaterAid report, titled Out of Order: The State of the World’s Toilets 2017 mentioned that the cleanliness drive by the government has successfully lessened the percentage of people defecating in the open by almost 40 percent, which meant that a considerable number of more than 100 million people of rural India started using toilets after the campaign. However, the WaterAid report also mentioned that in India a shocking 60,700 children are killed by diarrhoeal diseases. This number not only gives a grim picture of the health of Indian children but also shows that despite the positive results brought out by Swachh Bharat India is still running quite low regarding offering cleanliness and robust hygiene to its citizens.

Besides ill health lack of proper sanitation makes a significant impact on the female population of the country. Given the fact that lack of hygiene is a problem that mainly hovers in the rural areas of India, women, and girls belonging to these areas can be said to be living the nightmare every day. Lack of toilet facilities can be the reason behind the high rate of dropouts and non-enrolment in rural India. On June 19, 2017, IndiaSpend reported that 23 percent of the rural girls had stated menstruation to be their primary reason for dropping out of school. Raman V.R, Head of Policy at WaterAid India opined that “Sanitation policies should cover the needs of those who are vulnerable. Adolescent girls and women want facilities in which they can manage their periods safely and hygienically. Pregnant women need easily accessible and usable toilets, and the elderly or people with disability require toilets with design features that help overcome the physical constraints they typically face.”

The Problem of Obesity and Malnutrition
Another alarming situation that India is facing is that the country tops the list of underweight population and features among the top five nations attacked by obesity as well. According to a new study by The Lancet Journal India and China, both have secured places in the lists of countries containing the highest number of underweight newborns and overweight adults. The study shows that India houses almost 40 percent of the entire world’s underweight population with 101 million underweight women and 102 million underweight men. Though China holds the second position, its percentages are not as scary as India. It has 8 percent of underweight men and 12 percent of the underweight female. However, despite housing 40 percent of world’s underweight population, India has incredibly and ironically surged housing obese people as well. In 1975, only 1.3 percent of the global obese population inhibited India, in 2014 the percentage made a crazy rise to 3.7 with almost 9.8 million Indian men being fat. As with the women population, India now holds the third rank with 5.3 percent of the global obese female population inhibiting India.

Now, these problems of a significant percentage of the population being underweight as well as obese constitutes in giving rise to the rate of various heart diseases and cardiac failure. It is a well-known fact that weight-related issues play a significant role in the well being or illness of the heart as well as work as substantial causes of diabetes and other fatal diseases. Thus obesity, as well as malnutrition, works as lessening the entire health condition of India. One should note that these weight-related issues are not the rural India problems. The urban population is a significant constituent of these percentages, and it is mainly the urban population who fall victim to obesity because of the lifestyle and food habits.

The Rise in Life Expectancy:
Another report presented by the Firstpost reveals that though India is observing an increase in life expectancy, the quality of the healthcare services provided by the country continues to remain inadequate. From 1990 to 2013 the average age of death of the Indian population rose from 58 years to 66 years. Ties Boerma, Director of the Department of Health Statistics and Information at the WHO, stated that “India must have had a lot of progress because it is such a driver of global progress (in pushing up life expectancy) because it is so big (in size).”

Current Conditions:
However, India’s inability to provide quality health care to its citizens has been made more apparent by the list prepared by Global Burden of Disease Study in which India ranks 145 among 195 countries regarding accessibility and quality of healthcare provided to the citizens. Despite this disheartening rank, the study also revealed that India’s healthcare accessibility had grown upwards since the 1990s. India’s healthcare quality and access scored 41.2 in 2016, which is quite an achievement in comparison to the 24.7 of the year 1990. The study stated that “Although India’s improvements on the (health care access and quality) HAQ index hastened from 2000 to 2016, the gap between the country’s highest and lowest scores has widened (23•4-point difference in 1990, and 30•8-point difference in 2016).” The highest scoring states of 2016 were Goa and Kerala (each had secured 60 points) whereas the lowest scoring states of that year were Assam and Uttar Pradesh (each scoring below 40). Regarding health care quality and accessibility, India is ahead of Nepal, Afghanistan, and Pakistan but lags behind China, Bangladesh, Sri Lanka and Bhutan. The study also revealed the diseases that India had been handling poorly, and they are tuberculosis, Ischemic heart diseases, rheumatic heart diseases, testicular cancer, stroke, and chronic kidney disease to name a few.

This study along with several other studies conducted on the condition of the health of Indian people reveals that India needs immediate attention towards its healthcare accessibility and quality. The focus of care should be towards the rural areas as there exists a significant discrepancy between the health of the urban population and the rural ones. The facilities that both of these populations can avail also vary widely, resulting in the overall deterioration of the health of the country.

Role of the Government:
However, on the brighter side, the government is trying to make the situation better by using different means. The National Health Policy was brought out in the year 2017 with the aim of raising the level of public expenditure in the health sector from the present 1.5 percent to 2.5 percent over a given time of three years. The primary goal of the policy is to provide free treatment, medicines, and necessary drugs to all the existing public hospitals so that the underprivileged people can avail proper check-ups and diagnosis free of cost. To make this successful, budgetary allocation needs to increase as additional hospitals and medical facilities would become necessary to establish. Another problem that demands attention is the shortage of doctors and nurses. There is not enough number of trained medical staffs who can help to make the situation better. As according to a study between the years 2017 and 2022 the required number of health care professionals is going to rise from 4.7 million to 7.3 million. It is essential to increase the number of seats in the existing medical colleges as well as build new colleges to fulfill the necessary quota of doctors and nurses. Identification of land for developing new medical colleges should immediately commence as the situation needs immediate attention. The government might have to tie up with various private sectors as well to complete the undertaken projects on time.

Role of the Individuals:
Lastly, one should not forget that taking care of one’s health is a necessary duty of an individual as well. The individual citizens of the country must make sure that they are taking proper care of their health. This can be achieved by maintaining a healthy lifestyle and having adequate food. Healthcare awareness must begin. It is not possible for the government alone to change the health scenario of this country radically. To transform it for better we all need to unite and start taking care of ourselves. The change is bound to come.

Works Cited:
India’s healthcare sector: A look at the challenges and opportunities faced by $81.3 billion industry. 12 Jan. 2018, https://www.firstpost.com/india/indias-healthcare-sector-a-look-at-the-challenges-and-opportunities-faced-by-81-3-billion-industry-3544745.html
At 732 Million, India Tops List on Number of People Without Access to Toilets: Report. 16 Nov. 2017, https://thewire.in/health/732-million-india-tops-list-number-people-without-access-toilets-report
No. 1 in underweight population, India among top 5 in obesity. 2 Apr. 2016, https://timesofindia.indiatimes.com/india/No-1-in-underweight-population-India-among-top-5-in-obesity/articleshow/51656193.cms
Life expectancy in India on the rise, but quality health care services inadequate. 20 May. 2016, https://www.firstpost.com/india/life-expectancy-in-india-on-the-rise-but-quality-health-care-services-inadequate-2790442.html
India 145th among 195 countries in healthcare access, quality: Lancet. 23 May. 2018, https://timesofindia.indiatimes.com/india/india-145th-among-195-countries-in-healthcare-access-quality-lancet/articleshow/64283179.cms
Healthcare costs land 5 crore Indians in poverty. 15 Dec. 2017, https://timesofindia.indiatimes.com/india/healthcare-costs-land-5cr-indians-in-poverty/articleshow/62076906.cms
Ensuring health care for all citizens. 27 Jan. 2018, https://www.thehindu.com/business/budget/ensuring-healthcare-for-all-citizens/article22536933.ece
Prince, Martin J., et al. “The burden of disease in older people and implications for health policy and practice.” The Lancet385.9967 (2015): 549-562.
Nandi, Arindam, et al. “Reduced burden of childhood diarrheal diseases through increased access to water and sanitation in India: A modeling analysis.” Social Science & Medicine 180 (2017): 181-192.
Hirve, Siddhivinayak, et al. “Psychosocial stress associated with sanitation practices: experiences of women in a rural community in India.” Journal of Water Sanitation and Hygiene for Development 5.1 (2015): 115-126.

About the Author:
Pramila Tripathi
has completed her MA in English Language and Literature from Calcutta University and is currently working as an Online English Language Expert as well as a freelance. She was born in Delhi but was brought up in Kolkata. She has a flair for writing that has helped her to bag various acclamations. She works as the Book Review Editor of Ethos Literary Journal. She believes that her skills would help her to achieve her goal of becoming an Editor and Writer.

What’s India of her dreams like?
A country that is free of hypocrisy. A country where the meaning of the word ‘consent’ is well understood and where toxic masculinity does not hinder the growth of the females. A nation where there would be religious tolerance in the true sense of the term and most importantly a state free of poverty, child marriages and killing of girl children. A nation free of sexism and full of equality. And of course, a country where no one is scared to speak his/her mind and can live freely without a tinge of fear in their hearts.

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