Under the sponsorship of the remarkable World Health Organization (WHO) and other related organizations, World Heath Day is a worldwide health awareness day celebrated every year on 7 April. The theme for this year’s World Health Day is ‘building a fairer, (and) healthier world’ for everyone to live in. Our world has been unequal since the beginning of time. COVID-19 and the coronavirus-induced lockdown worldwide have highlighted this global disparity among the different groups of people. Because of the social conditions in which some of us are born, grow, live, work, and age, we can live a healthier life and access better health services.
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While the other groups of people are struggling every day to make ends meet with daily income, some do not even have that. The poorer section has more impoverished housing conditions, less education and employment opportunities, face gender inequality, and have significantly less or no access to a safe and healthy environment. They also don’t get clean water, food security, or ant health provisions. These conditions cause unnecessary suffering, premature deaths, and avoidable illness that equally harm our economies and societies.
Significant Health Challenges
2020 stood as the most devastating year for global health and economies. Coronavirus, the previously unknown virus, rapidly spread across all the world’s major continents and shocked the world population. It emerged as one of the top killers this century have seen and broadcasted the limitations and inadequacies of health systems globally.
In 2021, countries worldwide will need to battle the coronavirus and the other prevalent Heath care problems. Let us look into four global health issues (and a comparison with India) that need to be addressed urgently.
Communicable diseases or transmissible diseases or infectious diseases are illnesses resulting from the infection, presence, and the growth of pathogenic biologic agents present in an individual human being or other animal hosts. Infections from infectious diseases may range in severity from asymptomatic to severe and fatal.
According to WHO reports, Malaria, tuberculosis, HIV-AIDS, neglected tropical diseases, and viral hepatitis affects billions of people worldwide and causes more than 4 million deaths each year.
Malaria cases have fluctuated between 1.3 and 1.6 million per year for the past five years globally. In India alone, there were over 1.31 million reported cases of malaria in the year 2011. About 95% population in India resides in malaria-endemic areas. 80% of malaria cases reported in the country are confined to 20% of the population residing in tribal, hilly, rugged, and inaccessible areas.
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Tuberculosis (TB) stands as one among the deadliest infectious diseases as this influenza infects up to 5 million people per year. 94% of malaria fatalities occur in sub-Saharan Africa. Some over 1.2 million new cases are on record annually and over 0.64 million cases new of which at least 0.32 million cases die each year. As per WHO, the prevalence of tuberculosis in 2012 is 230 per 100,000 populations in India. Health Day pledges to recover TB from the face of the world!
Diarrheal diseases are the second most common cause of death among the Indian population. It is responsible for at least one in every ten child deaths during the first five years of life worldwide.
Amongst the new cases of leprosy, India ranks first every year. According to WHO, India accounted for over 134,752 new cases in 2012 of 232,857 worldwide. Statistics have shown that more than 12 million people in India were living with leprosy between 1991 and 2007. With more than 1,000 new leprosy cases, India also ranks as one of the 16 countries ranked “worst” in 2012. The other countries in the list of leprosy morbidity include Brazil, Indonesia, Nigeria, Ethiopia, Bangladesh, Congo, Nepal, Myanmar, Tanzania, Sri Lanka, Philippines, South Sudan, Madagascar, China, and Ivory Coast.
The countries that account for more than 90% of the people living with HIV in the Asia- Pacific region are China, Myanmar, India, Myanmar, Vietnam, and Thailand. With over 2.1 million infected cases, India has the third-highest number of people living with HIV globally. It amounts to about four out of every ten people in the Asia-Pacific region infected with the deadly virus. The treatment coverage of HIV is only 36% in India.
Non-communicable diseases (NCDs) are diseases that are not transmissible from one person to another directly. Some of the significant examples of NCDs on World Health Day inception include Parkinson’s disease, autoimmune diseases, strokes, heart diseases, most cancers, diabetes, chronic kidney disease, osteoarthritis, osteoporosis, Alzheimer’s disease, cataracts, and many more. Forty-one million people die of non-communicable diseases (NCDs) each year, equivalent to 71% of all deaths globally.
As per WHO, cardiovascular diseases, which severely affect the heart and also the blood vessels leading to instant heart attacks or strokes in extreme cases, account for the majority of NCD deaths or 17.9 million people annually. It is followed by respiratory diseases, which stand at 3.9 million. Cardiovascular diseases account for 26% of deaths in India, or 2.5 million. India has several heart failure cases due to the coronary heart disease, severe hypertension, obesity, high diabetes, and rheumatic heart disease that ranges from anywhere between 1.3- 4.6 million population count. There is an average annual incidence of the population at 491,600-1.8 million, with over 2.4 million Indians who die of heart disease. Coronary Heart Diseases (CHDs) prevalence is higher in the urban areas between 7-13% and 2-7% in the rural areas.
According to WHO, 1.6 million people die from diabetes every year. India has the highest number of recorded diabetic cases globally, and over 77 million people in India have pre-diabetes.
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WHO estimated that over 9.0 million cases of cancer deaths are on record every year. India alone reports about one million new cases each year. Of the eight million cancer-related deaths recorded in 2012, nearly 700,000 were in India, accounting for about 8% of the world’s cancer patients. 71% of deaths between 30-69 years in India are cancer-related. The estimated cancer mortality cases have risen from 478,185 in 2013 to 491,597 in 2014 in India alone. Statistically speaking, cancer is the second most common disease in India, responsible for maximum mortality, with about 0.3 million deaths per year. An estimated 600,000-700,000 deaths across India occurred due to cancer in 2012.
Of the 37 million blind people globally, about 15 million of them are in India. A cataract is a severe common cause of preventable blindness globally and in India as well. The annual demand is over 150,000, although about 35,000 corneas are collected annually nationwide.
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Environmental quality and sanitization problem
Even though nobody is immune to pollution and its adverse effects, government studies relay that low-income, impoverished, racial, and ethnic minorities will predominantly reside in areas where they often face environmental risks. Compared to the general Indian population, a higher proportion of the elderly live just over the poverty threshold and is a significant environmental risk.
The cases are far worse in India as we see on World Health Day, where about 400 million people defecate in the open, and 44% of mothers dispose of their children’s feces out in the open. India accounts for over 60% of global and 50% of its population open defecation.
- Children in India suffering from some degree of malnutrition numbered 48%.
- The female school dropout rate has increased in the adolescent age due to lack of toilet facilities.
- Only 25% of schools have availability of drinking water on their premises. Most Indian households do not treat drinking water, though although it may be chemically and bacterially contaminated.
Access to treatments and healthcare
About one-third of the people worldwide lack access to essential health products such as diagnostic tools, medicines, and vaccines. According to WHO, limited access to these products fuel drug resistance and threaten people’s lives and health.
India does not have a health service but instead has a health policy. The need-based health services primarily cater to the urban population’s needs, which houses about 32% of the national population. WHO prescribed 1:1,000 as the doctor population ratio. India’s ratio stands at 1: 1,700, which is relatively less than the standard ratio. Medical practitioners are almost four times more in urban than in rural areas per 10000 population.
The Indian government has implemented several initiatives and undertaken different measures over the past few decades to boost healthcare opportunities to have access in rural areas and urban slums. International researchers and organizations have cited the need to implement more long-term solutions to improve slum health permanently. They also argued that government-funded programs like the National Rural Health Mission (NRHM) or the National Urban Health Mission (NUHM) have a short-lived impact.
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Maternal and Child Health
Maternal health means the overall health of women during pregnancy, childbirth, and the postnatal period. Each stage is exceptionally crucial that determines the health of the woman and the child. Each stage should be a positive experience, and it should ensure that both the women and their babies reach their full potential for well-being and overall health.
Significant progress is visible in the last two decades, but still, the number is unacceptably high since over 295,000 women have died during and following pregnancy and childbirth in 2017. Excessive blood loss during delivery, infection, high blood pressure, unsafe abortion, and obstructed labor, in addition to other indirect factors like anemia, malaria, and heart disease, are few causes of maternal injury and even death. Timely management and treatment by a skilled health professional who works in a supportive environment can prevent the majority of maternal deaths.
Causes of Maternal Mortality
The primary causes of maternal deaths across India remain hemorrhage, anemia, abortion, toxemia, and puerperal sepsis. Although child health in India has improved tremendously in recent decades, it is still a significant concern. In India, only about 411 first referral units in community health centers are functioning correctly. The prenatal care of mothers includes the administration of tetanus toxoid and iron-folic acid tablets. Despite the ignorance, the prenatal coverage reached about 50% of mothers all over India. The state statistics are somewhat disappointing. The coverage was only 21.4% in Bihar, 23.8% in Nagaland, 29.3% in Rajasthan, and 29.6% in Uttar Pradesh. In these constituencies, the administrative inefficiency is widespread with the non-availability of essential drugs for malaria, infections, sepsis, dysentery, and colds.
Organizational Support Maternal Care
WHO urges all nations that ending preventable maternal death must remain at the top of the global agenda. But simply surviving pregnancy and childbirth can neither be the marker of successful maternal health care. Therefore it is incredibly crucial to pledge on World Health Day to expanding efforts at reducing maternal injury and disability to promote their health and well-being.
Every woman, their pregnancy, and their childbirth is unique. It is fundamental to ensure that all women have access to respectful and high-quality maternity care by addressing inequalities that affect their health outcomes, especially reproductive and sexual health and rights, and gender.
Tackling the issue of health problem is a global problem that needs to be intervened by every nation’s leaders to ensure that everyone has living and working conditions conducive to good health. Further, every country and its leaders need to monitor health inequities and ensure that all people can access quality health services whenever and wherever they need them.
The COVID-19 has hit all countries hard, but its impact has been harshest on those already vulnerable communities. These groups of people were already more exposed to the disease and less likely to access quality health care services. As a result of the COVID-19 pandemic, these groups of people are also more likely to experience adverse consequences due to measures implemented to contain the pandemic.
Therefore, it is of utmost urgency for everyone to ensure that they have access to better health quality and services this World Health Day. Let us pledge to make this world a better place for everyone to live in.