India makes strides in some, but not all, health goals, finds WHOBMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h3125 (Published 08 June 2015) Cite this as: BMJ 2015;350:h3125
India has successfully met targets to reduce the spread of HIV and improve the availability of drinking water but has a long way to go in improving sanitation facilities and providing universal access to reproductive healthcare, the latest World Health Statistics report has found.
Findings showed that although the proportion of Indians using improved sources of drinking water rose from 70% in 1990 to 93% in 2012, the proportion of the population using improved sanitation facilities rose from 18% to only 36% over the same period.1
India made progress in controlling HIV and tuberculosis. Prevalence of HIV/AIDS fell from 222 per 100 000 in 2001 to 166 per 100 000 in 2013. However, only 36% of those eligible received antiretroviral therapy for HIV.
The prevalence of tuberculosis fell from 438 per 100 000 in 2000 to 211 per 100 000 in 2013. The proportion of new cases being treated successfully for the disease rose from 34% in 2000 to 88% in 2012, and mortality due to tuberculosis (in patients without HIV) fell by 50% between 1990 and 2013.
Life expectancy and mortality rates also improved. The life expectancy at birth rose from 58 in 1990 to 66 in 2013. Mortality rates improved in all age groups—neonatal mortality rate fell from 51.1 per 1000 live births to 29.2 per 1000 live births; the under 5 mortality rate fell from 125.9 per 1000 to 52.7 per 1000; and the adult mortality rate (aged 15-60) fell from 288 to 239 per 1000 men and from 242 to 158 per 1000 women.
Age standardized mortality rates in 2012 were 253 per 100 000 people for communicable diseases, 682 per 100 000 for non-communicable diseases and 116 per 100 000 for injuries. In 2013, 6008 cases of cholera were reported, 13 869 cases of leishmaniasis, 126 913 cases of leprosy, 881 730 cases of malaria, 13 822 cases of measles, 31 089 cases of pertussis, and 1 243 905 cases of tuberculosis.
In 2014, 9.7% of adult men and 9.2% of adult women had raised blood sugar (≥126 mg/dL) or were taking drugs for raised blood sugar, and 25.9% of men and 24.8% of women had high blood pressure (≥140/90). In 2012, 22.8% of men and 2.4% of women aged over 15 used some form of tobacco; in 2007-14 the prevalence was 19.0% and 8.3% among boys and girls, respectively, aged 13-15.
Universal access to reproductive healthcare has still not been achieved in the country. The prevalence of contraceptive use in 2007-13 was 55%, but about 21% of women of reproductive age, who were married or in a consensual union, were not using any contraceptive method despite wanting to prevent or delay pregnancy. In 2007-14 only 75% of pregnant women received antenatal coverage at least once during their pregnancy.
With regards to health systems, India had seven physicians and 17.1 nurses or midwives per 10 000 people between 2007 and 2013. India’s spending on healthcare fell from 4.3% of its gross domestic product in 2000 to 3.8% in 2012. But during this time the government’s contribution to health expenditure rose from 27.0% to 30.5%.
The World Health Statistics report is released annually by the World Health Organization to provide health related data and to track progress towards the millennium development goals in the 194 member states. Earlier this year the Indian government released an update on its progress towards the millennium development goals, which are based on the United Nations Development Group’s 2003 framework and encompass health and other development matters.2
Cite this as: BMJ 2015;350:h3125