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Health Status of
         India


Dr. Muhammedirfan H. Momin
Assistant Professor
Community Medicine Department
Government Medical College, Surat.
 5,000 year old ancient
civilization

 325 languages spoken

 18 official languages

>1 Billion population.

Worlds largest
democracy.
      DR IRFAN MOMIN
Largest English speaking
nation
  in the world.

 3rd largest standing army
force

 2nd largest pool of
scientists and engineers in
the World.
       DR IRFAN MOMIN
 India  is a
  union of
  28 states
  and
 7 union
  territories.



                 DR IRFAN MOMIN
DR IRFAN MOMIN
Urban and Rural Population in Gujarat in
2011




                         DR IRFAN MOMIN
The Measurement of Health Status
 Disease Frequency
 Cases
 Prevalence rate
 Incidence rate
 Deaths
  ◦ Case Fatality Rate
 Disability adjusted life years:
 Years of life lost to premature death
  and years lived with disability
  adjusted for the severity of the
  disability.           DR IRFAN MOMIN
The Measurement of Health Status
   Disease Distribution

   By time, place person
   Seasons, geographic area and age, sex,
    caste, religion, ethnicity etc.

   Determinants of Disease




                              DR IRFAN MOMIN
Human Development Index (HDI)
1.   Life expectancy at birth.
2.   Education index.
3.   GDP index.




                            DR IRFAN MOMIN
Human Development Index (HDI)
- 2011 Rankings
 Very High Human Development 01-47
 High Human Development      48-94
 Medium Human Development 95-141
 Low Human Development      142-169
1    = Norway
4    = United States
 101 = China
 134 = India
 187 = Congo
                     DR IRFAN MOMIN
Health Problems
Classification
1) Communicable diseases
2) Non Communicable
   diseases
3) Nutritional problems
4) Environmental Sanitation
5) Medical Care problem
6) Population Problems
                DR IRFAN MOMIN
Demographic issues or
population problems


 •   Population-1,21 ,01,93,422
 •   Density of population – 382 per
     sq.km.

 •   17.5% of world population is in
     India.
                         DR IRFAN MOMIN
DR IRFAN MOMIN
• Gujarat
• Population – 6,03,83,628
             (5% of India)

•   Density – 308 per sq. km.

•   Gujarat 10th on population

•   26 Districts

                       DR IRFAN MOMIN
India
                         Total         Rural      Urban
     Birth Rate1         22.5          24.1        18.3
    Death Rate1           7.3           7.8        5.8
Natural Growth Rate1     15.2          16.3        12.5
Infant Mortality Rate1    50              55       34
       Sex-ratio          940           947        926
   Population in 0-6     13.12         14.11      10.93
      age group
    Child sex-ratio       914           919         902
     Literacy rate       74.04         68.91      84.98%
(1=SRS 2011)                     DR IRFAN MOMIN
Gujarat
                          Total         Rural    Urban
       Birth Rate1        22.3           23.8    19.9
      Death Rate1          6.9            7.7     5.6
 Natural Growth Rate1     15.4           16.1    14.3
 Infant Mortality Rate1    48              55     33
        Sex-ratio          918           947      880
 Population in 0-6 age    12.41         13.49    10.96
          group
     Child sex-ratio       886           906      852
      Literacy rate       79.31           73     87.58
(1=SRS 2011)
                                DR IRFAN MOMIN
Statistics for Surat Municipal Corporation
*CENSUS 2011             Surat City
SEX RATIO                758 / 1000 Male*
CHILD SEX RATIO          813 / 1000 Boys*
CRUDE BIRTH RATE         18.25 / 1000 population
CRUDE DEATH RATE         4.37 / 1000 population
INFANT MORTALITY RATE 16.08 / 1000 live births
MATERNAL MORTALITY
                         0.41 / 1000 live births
RATE
LITERACY RATE            89.03 %*
MALE                     92.76 %*
FEMALE                   84.05 %*IRFAN MOMIN
                                DR
States literacy rate 2011




                   DR IRFAN MOMIN
Sex ratio




            DR IRFAN MOMIN
DR IRFAN MOMIN
- 940

    Sex-ratio (Adult)




DR IRFAN MOMIN
 Sex-ratio
    India - 940
    Gujarat – 918
    Surat Dist-788
    Surat city– 758
 Sex-ratioat 0-6 age group
   India – 914
   Gujarat – 886
   Surat city- 813


                       DR IRFAN MOMIN
- 914

  Sex-ratio (0-6 yrs)




  DR IRFAN MOMIN
Sex-ratio 2011




                 DR IRFAN MOMIN
Child (0-6years) Sex-ratio 2011




                   DR IRFAN MOMIN
Sex Ratio & Child Sex-Ratio




                DR IRFAN MOMIN
Rank                   Sex- ratio      Rank
            District
in 2011                2011       2001 in 2001


  01      The Dangs    1007         987        02
  02      Tapi         1004         996        01
  03      Dohad        986          985        04
  24      Kachchh      907          942        10


  25      Ahmadabad    903          892        25
  26      Surat        788          810
                              DR IRFAN MOMIN   26
The Measurement of Health Status
 Maternal   mortality rate
 ◦ The number of women who die
   as a result of childbirth and
   pregnancy related complications
   per 100,000 live births in a given
   year


                      DR IRFAN MOMIN
Maternal Mortality Ratio
•   India – 212 per 1,00,000 live births



•   Gujarat – 148 per 1,00,000 live births


Source – Special bulletin on MMR in India (SRS) June 2011




                                  DR IRFAN MOMIN
The Measurement of Health Status


 Infant   mortality rate
 ◦ The number of deaths in infants
   under 1 year per 1,000 live
   births for a given year




                       DR IRFAN MOMIN
Infant Mortality Rates
                     79
                65            64
57     57


                                                27

                                           11
            6




                          DR IRFAN MOMIN
Infant Mortality Rate
                   NFHS-1    NFHS-2       NFHS-3
                            85
                                                   79
                                 73
                                                        68
                                         62
 56                                                          57
       47
              42




      Urban                      Rural               Total
                                              DR IRFAN MOMIN
Marital Status
Percent of women age 20-24 married by
    54                                       53
             50 age 18
                      45


                                    28




 NFHS-1   NFHS-2   NFHS-3        Urban       Rural
                                    NFHS-3
                            DR IRFAN MOMIN
Desire for No More Children
among Women with 2 Children
                       83                    90       88
 72                         76
        66
                                                             61
                                  47
               37




      NFHS-1             NFHS-2                     NFHS-3

 2 sons         1 son and 1 daughter         2 daughters
                                   DR IRFAN MOMIN
Diseases




           DR IRFAN MOMIN
Leading contributor in global diseases
1990                     2020

1.Lower Rasp. Infec.     1.IHD
2.Diarrhoea              2.Major Depression
3.Prenatal condition     3.Road Traffic Injury
4.Unipolar major         4.Stroke
  depression             5.COPD
5.IHD                    6.Lower Resp. Inf.
6.Stroke                 7.TB
7.TB /HIV                8.Perinatal condition
8.Measles                9.Diarrhea Diseases
9.Road traffic Injury    10.HIV
10.Congenital
                           DR IRFAN MOMIN
Top ten risk factors leading to Disease,
                    Disability or Death
        Poorest countries              Developed countries


1.    Underweight                1.  Tobacco
2.    Unsafe sex                 2. High blood pressure
3.    Unsafe water & sanitatio   3. Alcohol
4.    Indoor smoke & solid       4. High cholesterol
      fuels                      5. High BMI
5.    Zinc Deficiency            6. Low Fruits and Veg Intake
6.    Iron Deficiency            7. Physical inactivity
7.    Vitamin A Deficiency       8. Illicit Drugs
8.    High blood pressure        9. Unsafe sex
9.    Tobacco use                10. Iron Deficiency
10.   High cholesterol                  DR IRFAN MOMIN
Trends in Global Deaths 2002-30




                Source: WorldIRFAN MOMIN
                          DR Health Statistics 2007
Major causes of death in children under 5 with
disease-specific contribution of undernutrition




                           DR IRFAN MOMIN
COMMUNICABLE DISEASES




             DR IRFAN MOMIN
Diseases Eradicated

 Small pox
 Guinea worm
 Polio




                DR IRFAN MOMIN
Small pox
 It was endemic in 33 countries in 1967
 The last indigenous case in India
  occurred on 17th may 1975 in Bihar.
 In April 1977 India was declared small
  pox free.
 The worlds last case occurred in Somalia
  (Africa) on 26 October 1977.
 The WHO declared on 8 May 1980 that
  small pox has been eradicated.

                        DR IRFAN MOMIN
Guinea worm or
    Dracunculosis
   Zero Incidence has been maintained
    since August 1996 in India

   In February 2000, India has been certified
    by WHO for the elimination of Guinea
    worm Disease and on 15th February 2001
    WHO declared India as “Guinea worm
    Disease free”.


                           DR IRFAN MOMIN
Wild poliovirus cases, India
 2000

                                         1 WPV case in 2011 compared to 42 in
 1750                                    2010

 1500


 1250


 1000


 750


 500


 250


   0
        1998   1999   2000   2001 2002   2003   2004 2005   2006   2007   2008 2009   2010 2011*

                                  P1 wild             P3 wild
* data as on 2 March 2012
WPV1 cases, India, 1998 - 2011
1750   1735

                                  1487
1500


1250


1000


750                                                          648

500           397

                            212          203
250
                     139                         127
                                                       62           83     75   80
                                                                                       18    1
  0
       1998   1999   2000   2001 2002    2003    2004 2005   2006   2007   2008 2009   2010 2011*
                                                Year
         * data as on 2 March 2012
Location of wild poliovirus cases by type,
India
                 WPVs                          2011*

         State   P1     P3   Total
 West Bengal     1            1
 Total           1            1
* data as on 2 March 2012



                                                       Onset of
                                                       paralysis -
                                                       13 January
                                                       Howrah,
                                                       West
                                                       Bengal
                                     DR IRFAN MOMIN
Polio
   Last case occurred in 13th January
    2011 in West Bengal.




                         DR IRFAN MOMIN
Disease does not occur in
India
 Yellow   Fever




                   DR IRFAN MOMIN
Communicable Diseases
 Malaria
 Tuberculosis
 Leprosy
 Diarrhea
 ARI
 HIV




                  DR IRFAN MOMIN
Malaria

Cases      1.52 million
           (0.12%)

Deaths     924


PF %       49.56

             DR IRFAN MOMIN
DR IRFAN MOMIN
Tuberculosis
Global Rank          1
Incidence ( all      170
cases)               /100,000/year
Incidence ( new      75 /100,000/year
sp)
Prevalence           185/ 100,000
( all cases)         (0.18 %)
TB mortality         24     /100,000/
                          DR IRFAN MOMIN
Diarrhea
            Pathogen                     % of Cases
Viruses     Rotavirus                15-25
Bacteria    Escherichia coli         10-20
            Shigella                 5-15
            Compylobactor jejuni 10-15
            Vibrio Cholerae 01       5-10
            Salmonella               1-5
Protozoan Cryptosporidium            5-15
s
                                 DR IRFAN MOMIN
Cholera

Cases           3482

Deaths          12

Case Fatality   0.34%
Rate

                     DR IRFAN MOMIN
Typhoid Fever
    Endemic in India


Cases                   1.03 million
                        ( 10 lac)

Deaths                  421

                          DR IRFAN MOMIN
Amoebiasis
   Prevalence 15%




                     DR IRFAN MOMIN
Hookwarm Infection
   Heavily infected areas are
   Assam,
   West Bengal,
   Bihar,
   Orissa,
   Andhra Pradesh,
   Tamilnadu,
    Kerala,
   Maharashtra.
   More than 200 million people are infected in
    India                     DR IRFAN MOMIN
Dengue Haemorrhagic Fever

CASES          15,509



DEATHS         89


                    DR IRFAN MOMIN
Japanese Encephalitis

Cases         4482




Deaths        774


                 DR IRFAN MOMIN
Leptospirosis
 Occurs in
 South Gujarat,
 Kerala,
 Maharashtra,
 Andaman Nicobar.




                     DR IRFAN MOMIN
Plague
 Epidemic in 1994 in Surat
 Epidemic in 2004 in Uttarakashi




                      DR IRFAN MOMIN
Tetanus
Cases      2051




Deaths     160



             DR IRFAN MOMIN
Neonatal Tetanus
Cases         889




Deaths        31



                    DR IRFAN MOMIN
Global Leprosy Situation

LEPROSY HAS BEEN
ELIMINATED    FROM THE
WORLD




               DR IRFAN MOMIN
Leprosy: 6 top countries

•6 top endemic countries: India,
 Brazil, Myanmar, Madgascar,
 Mozambique, Nepal contribute
 85% of global case load:
  (69% from India)
• 91% of global case new cases
  (81% from India)
                   DR IRFAN MOMIN
Leprosy
   India achieved leprosy elimination in
    December 2005

   By the end of march 2009, prevalence
    rate of Leprosy was 0.72 cases per
    10,000 population.




                          DR IRFAN MOMIN
Trend of Leprosy Prevalence & Annual New
                      Case Detection (ANCDR) Rates

                     30

                            25.9
                                                                                                    PR
Prevalence & ANCDR




                     25

                                   20.0                                                             ANCDR
                     20


                     15
                                            13.7
                                                   10.9
                                                                                  8.9
                     10
                                                          8.4                           7.0          5.9
                                                                5.9   5.8 5.5                 5.5
                                                                                                           4.4
                     5                                                                                           3.3
                                      6.4                             5.1   5.6                                        2.3   1.4
                          5.9   6.2           5.7    4.9    4.6                   5.3   5.3                                              1.17
                                                                                                     4.2                           1.2
                                                                                              3.7          3.2 2.4 1.3
                     0
                                                                                                                             0.84 0.72 0.74
                       91

                       92

                       93

                       94

                       95

                       96

                       97

                       98

                       99

                       00

                       01

                       02

                       03

                       04

                       05

                       06

                       07

                       08
                     19

                     19

                     19

                     19

                     19

                     19

                     19

                     19

                     19

                     20

                     20

                     20

                     20

                     20

                     20

                     20

                     20

                     20
                                                                        Year (March End) IRFAN MOMIN
                                                                                      DR
Five endemic states are as follows:
    1. Bihar
    2. Chattisgarh
    3. Jharkhand
    4. Chandigarh
    5. West Bengal

                     DR IRFAN MOMIN
State wise Contribution
New Leprosy Cases - year 2007-08
                                     Karnataka,
         Tamilnadu,                    3.28,        Delhi,
                          Orissa,                             Others,
             4,                         3%           0.97,
                           4.13,                               4.85,
            4%                                       1%
                            4%                                  5%
                                                                        Uttar Pradesh,
                                                                             22.54,
  Madhya Pradesh,                                                            23%
       4.4,
       4%

             Jharkhand,
               .94, 5%
                                                                                 Bihar,
  Gujarat,
                                                                                 13.83,
   5.25,
                                                                                  14%
    5%

    Chhattisgarh,                                              West Bengal,
       5.67,              Andhra Pradesh,    Maharashtra,         9.84,
        6%                      7.3,              9,              10%
                                7%               9%




   Contribution by six states 20.8% pop & 34.5% new cases

                                                             DR IRFAN MOMIN
Endemicity of Leprosy –
                  March.09
       P.R.- 0.87



                                                        PM            Dahod-2.25
                                                        2.22

                                                  Vadodara – 1.10
                                              Bharuch          Narmada- 1.26
P.R.                                           2.77
       >5                                               Surat-1. 39

       3-5                             Navsari                 Dang – 4.26
       2-3                              2. 04
                                                        Valsad –2. 18
       1 - 2 Gujaratachieved elimination as
       <1    on Oct-04
                                          DR IRFAN MOMIN
DR IRFAN MOMIN
Situation in Surat:
 Leprosy  not eliminated from Surat
 The prevalence rate 1.44
 The new case detection rate 2.57 in
  the year 2006.
 Male:female ratio as 58:42 (2006).
 Child cases among new cases of
  leprosy 12.8% (2006).
 Multibacillary cases among new
  cases 50.1%, 2006.
 Grade II disability 1.38% (2006).
                      DR IRFAN MOMIN
HIV
   Provisional estimates shows there are
    22.7 lakh people living with HIV /AIDS.



   Estimated adult HIV Prevalence rate
    is 0.28 %




                          DR IRFAN MOMIN
HIV Prevalence by Residence
         and Sex, India
                 Women           Men         Total
Sex               (%)            (%)          (%)
       HIV prevalence rate is 60% higher
Urban among males than females and 40% 0.35
                 0.29         0.41
        higher in urban areas than rural areas
Rural               0.18         0.32        0.25

India               0.22         0.36        0.28
                                DR IRFAN MOMIN
HIV
 High Prevalence states are
 Maharashtra,
 Tamilnadu,
 Karnataka,
 Andhra Pradesh,
 Manipur
 Nagaland.



                      DR IRFAN MOMIN
HIV
Groups     Prevalence
IDU        9.2
MSM        7.4
FSW        4.9
Migrants   3.6
Truckers   2.5
STD        2.5
ANC        0.5
             DR IRFAN MOMIN
AIDS Awareness
       Percent of women and men age 15-49 who have
                      heard of AIDS
                    Urban   Rural   Total

Women                                            81
                               46
                                     57

 Men                                                  94
                                            73
                                                 80


                            DR IRFAN MOMIN
Non Communicable Diseases
Ischemic heart   Prevalence
Disease          %

Urban            9.6


Rural            2.7

                   DR IRFAN MOMIN
Coronary Heart Disease
Indices   Urban   Rural             Total

Prevalen 6.4      2.5               3.7
ce
Death    0.8    0.4
rate
Per 1000
DALY per 2703.4 986.2
                   DR IRFAN MOMIN
Prevalence ( %) of Hypertension
among adults (> 25 years) , WHO
                   Male Female
India              23.1     22.6
China              29.8     25.6
Bangladesh         27.4     27.9
Sri Lanka          31.0     26.2
US                 17.0     14.2
UK                 27.7     19.1
Japan              26.4     16.7
                   DR IRFAN MOMIN
RULE OF HALVES


  Total
  Employees                        Employees on
    1493 (100%)                    regular
                                   Treatment 139
                                   (9.3%)
  Total
  Hypertensive
  455 (30.5%)
                                    Employees
                                    having
                                    controlled
Known
                                    Hypertension
Hypertensive
                                    71 (4.7%)
197 (13.2%)
                           DR IRFAN MOMIN
Rheumatic Heart Disease
 Prevalence 5-7/1000 in 5-15 years
 There are 1 million cases of RHD in
  India




                       DR IRFAN MOMIN
Accidents

World:
In developed countries -
 57% of male death and
 43% of female death in 10-24 yrs are
  due to accidents.




                         DR IRFAN MOMIN
Cancer
World
 Every year- 10 million diagnosed
                6 million die

Worldwide -   Lung Cancer (12.3 %)
              Breast Cancer(10.4%)
              Colorectal Cancer(9.4%)

Death from cancer -    Lung (17.8%)
                      Stomach (10.4%)
                      Liver (8.8 %)
                        DR IRFAN MOMIN
Male
 most common (by          most common (by
   occurrence)              mortality)[12]
prostate cancer (25%) lung cancer (31%)
lung cancer (15%)      prostate cancer (10%)
colorectal cancer
                       colorectal cancer (8%)
(10%)
bladder cancer (7%)    pancreatic cancer (6%)
non-Hodgkin            liver & intrahepatic bile
lymphoma (5%)          duct (4%)
                               DR IRFAN MOMIN
Female
     most common (by           most common (by
       occurrence)              mortality)[12]
breast cancer (26%)        lung cancer (26%)

lung cancer (14%)          breast cancer (15%)

colorectal cancer (10%)    colorectal cancer (9%)

endometrial cancer (7%)    pancreatic cancer (6%)
non-Hodgkin lymphoma
                           ovarian cancer (6%)
(4%)                            DR IRFAN MOMIN
India
 3.4 % of all deaths – cancer
 7 lakh new cases detected every year


   Males -  Mouth/oropharynx
            oesophagus
            stomach
            Lower respiratory tract
 Females -    Cervix
              Breast
              Mouth/oropharynx
              oesophagus DR IRFAN MOMIN
NUTRTIONAL PROBLEMS
 Under nutrition
 Obesity
 Anemia
 Vitamin A deficiency
 Vitamin B 12 deficiency
 Iodine Deficiency Disorders
 Zinc Deficiency



                       DR IRFAN MOMIN
Trends in Child Nutritional Status
         Percent of children age under 3 years
                    NFHS-3   NFHS-2

   51
        45                               43
                                              40


                             23
                      20




   Stunted             Wasted          Underweight
                                      (Low-weight-for-
(Low-height-for-   (Low-weight-for-        age)
     age)              height)    DR IRFAN MOMIN
DR IRFAN MOMIN
Anaemia among Children
Percent of children 6-35 months with anemia

  79                      81
              72                                 74




 Total       Urban       Rural                  NFHS-2
                               DR IRFAN MOMIN
Nutritional Status of Adults
   Percent of women and men age
               15-49
   Women    Men
                                                   55

     36
           34
                                                        24
                        13
                              9


 BMI below normal   Overweight/Obese               Anaemic
                                  DR IRFAN MOMIN
Malnutrition of Women by
         Residence and Education
         Percent of women age 15-49
60
50
                               7          7
     13                                                 13            14                            11
40                24                                                                21
30
20                         41             42
     36                                                 35            35                                36
                  25                                                                25
10
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                                   Underweight               Overweight MOMIN
                                                                   DR IRFAN
Malnutrition of Men by
Residence and Education
       Percent of men age 15-49
 50
 45
                               3                  6
 40                   5                  5
      8
 35
           14
 30                                                         14

 25
 20                  38        40        38       40
      34
 15                                                                     Overweight
           27                                               25
 10                                                                     Underweight
  5
  0
     an


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                                       8-

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                                                       DR IRFAN MOMIN
Vitamin B 12 Deficiency is in
 increasing trend in Gujarat



          ?
                   DR IRFAN MOMIN
Child Immunization Trends
     Percent of children age 12-23 months
                  vaccinated          62
       BCG                                              72
                                                             78
                                         54
     Polio3                                        63
                                                             78
                                       52
      DPT3                               55
                                         55
                                 42
    Measles                            51
                                              59
                           35
All Vaccines                     42
                                  44
               NFHS-1   NFHS-2    NFHS-3
                                 DR IRFAN MOMIN
Selected Household Characteristics
                      Percent of households
                                                                             93
       Electricity                                         56
                                                                   68

                                                      51
     Piped water             12
                                    25

                                                                        83
Any toilet facility                  26
                                                45

                                  Urban       Rural        Total
                                                      DR IRFAN MOMIN
India’s population to be the largest in
               the world

India is set to overtake China as the
   world's most populous nation by
                 2050.

 India’s population is expected to
    grow from 1.08bn to 1.63bn
 people, overtaking China, which is
   forecast to reach 1.44bn from
          1.3bn currently.

  India, will also have the highest
 working population in the World —
 700 million people out of 1.1 billion
    people are young; the young
  population will continue till 2050.
                    DR IRFAN MOMIN
Goldman Sachs Report of 1 October, 2003 –
     "Dreaming with BRICs: The path to 2050"

      India's GDP will reach $ 1 trillion by 2011,
                   $ 2 trillion by 2020,
                   $ 3 trillion by 2025,
                   $ 6 trillion by 2032,
               $ 10 trillion by 2038, and
                  $ 27 trillion by 2050,
 becoming the 3rd largest economy after USA and China.

In terms of GDP, India will overtake Italy by the year 2016,
              France by 2019, UK by 2022,
          Germany by 2023, and Japan by 2032.
                                      DR IRFAN MOMIN
Thank You




Mobile: 9426845307   E-mail: drmhmomin@yahoo.co.in
                                 DR IRFAN MOMIN

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Health status of india

  • 1. Health Status of India Dr. Muhammedirfan H. Momin Assistant Professor Community Medicine Department Government Medical College, Surat.
  • 2.  5,000 year old ancient civilization  325 languages spoken  18 official languages >1 Billion population. Worlds largest democracy. DR IRFAN MOMIN
  • 3. Largest English speaking nation in the world.  3rd largest standing army force  2nd largest pool of scientists and engineers in the World. DR IRFAN MOMIN
  • 4.  India is a union of 28 states and  7 union territories. DR IRFAN MOMIN
  • 6. Urban and Rural Population in Gujarat in 2011 DR IRFAN MOMIN
  • 7. The Measurement of Health Status  Disease Frequency  Cases  Prevalence rate  Incidence rate  Deaths ◦ Case Fatality Rate  Disability adjusted life years:  Years of life lost to premature death and years lived with disability adjusted for the severity of the disability. DR IRFAN MOMIN
  • 8. The Measurement of Health Status  Disease Distribution  By time, place person  Seasons, geographic area and age, sex, caste, religion, ethnicity etc.  Determinants of Disease DR IRFAN MOMIN
  • 9. Human Development Index (HDI) 1. Life expectancy at birth. 2. Education index. 3. GDP index. DR IRFAN MOMIN
  • 10. Human Development Index (HDI) - 2011 Rankings  Very High Human Development 01-47  High Human Development 48-94  Medium Human Development 95-141  Low Human Development 142-169 1 = Norway 4 = United States  101 = China  134 = India  187 = Congo DR IRFAN MOMIN
  • 11. Health Problems Classification 1) Communicable diseases 2) Non Communicable diseases 3) Nutritional problems 4) Environmental Sanitation 5) Medical Care problem 6) Population Problems DR IRFAN MOMIN
  • 12. Demographic issues or population problems • Population-1,21 ,01,93,422 • Density of population – 382 per sq.km. • 17.5% of world population is in India. DR IRFAN MOMIN
  • 14. • Gujarat • Population – 6,03,83,628 (5% of India) • Density – 308 per sq. km. • Gujarat 10th on population • 26 Districts DR IRFAN MOMIN
  • 15. India Total Rural Urban Birth Rate1 22.5 24.1 18.3 Death Rate1 7.3 7.8 5.8 Natural Growth Rate1 15.2 16.3 12.5 Infant Mortality Rate1 50 55 34 Sex-ratio 940 947 926 Population in 0-6 13.12 14.11 10.93 age group Child sex-ratio 914 919 902 Literacy rate 74.04 68.91 84.98% (1=SRS 2011) DR IRFAN MOMIN
  • 16. Gujarat Total Rural Urban Birth Rate1 22.3 23.8 19.9 Death Rate1 6.9 7.7 5.6 Natural Growth Rate1 15.4 16.1 14.3 Infant Mortality Rate1 48 55 33 Sex-ratio 918 947 880 Population in 0-6 age 12.41 13.49 10.96 group Child sex-ratio 886 906 852 Literacy rate 79.31 73 87.58 (1=SRS 2011) DR IRFAN MOMIN
  • 17. Statistics for Surat Municipal Corporation *CENSUS 2011 Surat City SEX RATIO 758 / 1000 Male* CHILD SEX RATIO 813 / 1000 Boys* CRUDE BIRTH RATE 18.25 / 1000 population CRUDE DEATH RATE 4.37 / 1000 population INFANT MORTALITY RATE 16.08 / 1000 live births MATERNAL MORTALITY 0.41 / 1000 live births RATE LITERACY RATE 89.03 %* MALE 92.76 %* FEMALE 84.05 %*IRFAN MOMIN DR
  • 18. States literacy rate 2011 DR IRFAN MOMIN
  • 19. Sex ratio DR IRFAN MOMIN
  • 21. - 940 Sex-ratio (Adult) DR IRFAN MOMIN
  • 22.  Sex-ratio India - 940 Gujarat – 918 Surat Dist-788 Surat city– 758  Sex-ratioat 0-6 age group India – 914 Gujarat – 886 Surat city- 813 DR IRFAN MOMIN
  • 23. - 914 Sex-ratio (0-6 yrs) DR IRFAN MOMIN
  • 24. Sex-ratio 2011 DR IRFAN MOMIN
  • 25. Child (0-6years) Sex-ratio 2011 DR IRFAN MOMIN
  • 26. Sex Ratio & Child Sex-Ratio DR IRFAN MOMIN
  • 27. Rank Sex- ratio Rank District in 2011 2011 2001 in 2001 01 The Dangs 1007 987 02 02 Tapi 1004 996 01 03 Dohad 986 985 04 24 Kachchh 907 942 10 25 Ahmadabad 903 892 25 26 Surat 788 810 DR IRFAN MOMIN 26
  • 28. The Measurement of Health Status  Maternal mortality rate ◦ The number of women who die as a result of childbirth and pregnancy related complications per 100,000 live births in a given year DR IRFAN MOMIN
  • 29. Maternal Mortality Ratio • India – 212 per 1,00,000 live births • Gujarat – 148 per 1,00,000 live births Source – Special bulletin on MMR in India (SRS) June 2011 DR IRFAN MOMIN
  • 30. The Measurement of Health Status  Infant mortality rate ◦ The number of deaths in infants under 1 year per 1,000 live births for a given year DR IRFAN MOMIN
  • 31. Infant Mortality Rates 79 65 64 57 57 27 11 6 DR IRFAN MOMIN
  • 32. Infant Mortality Rate NFHS-1 NFHS-2 NFHS-3 85 79 73 68 62 56 57 47 42 Urban Rural Total DR IRFAN MOMIN
  • 33. Marital Status Percent of women age 20-24 married by 54 53 50 age 18 45 28 NFHS-1 NFHS-2 NFHS-3 Urban Rural NFHS-3 DR IRFAN MOMIN
  • 34. Desire for No More Children among Women with 2 Children 83 90 88 72 76 66 61 47 37 NFHS-1 NFHS-2 NFHS-3 2 sons 1 son and 1 daughter 2 daughters DR IRFAN MOMIN
  • 35. Diseases DR IRFAN MOMIN
  • 36. Leading contributor in global diseases 1990 2020 1.Lower Rasp. Infec. 1.IHD 2.Diarrhoea 2.Major Depression 3.Prenatal condition 3.Road Traffic Injury 4.Unipolar major 4.Stroke depression 5.COPD 5.IHD 6.Lower Resp. Inf. 6.Stroke 7.TB 7.TB /HIV 8.Perinatal condition 8.Measles 9.Diarrhea Diseases 9.Road traffic Injury 10.HIV 10.Congenital DR IRFAN MOMIN
  • 37. Top ten risk factors leading to Disease, Disability or Death Poorest countries Developed countries 1. Underweight 1. Tobacco 2. Unsafe sex 2. High blood pressure 3. Unsafe water & sanitatio 3. Alcohol 4. Indoor smoke & solid 4. High cholesterol fuels 5. High BMI 5. Zinc Deficiency 6. Low Fruits and Veg Intake 6. Iron Deficiency 7. Physical inactivity 7. Vitamin A Deficiency 8. Illicit Drugs 8. High blood pressure 9. Unsafe sex 9. Tobacco use 10. Iron Deficiency 10. High cholesterol DR IRFAN MOMIN
  • 38. Trends in Global Deaths 2002-30 Source: WorldIRFAN MOMIN DR Health Statistics 2007
  • 39. Major causes of death in children under 5 with disease-specific contribution of undernutrition DR IRFAN MOMIN
  • 40. COMMUNICABLE DISEASES DR IRFAN MOMIN
  • 41. Diseases Eradicated  Small pox  Guinea worm  Polio DR IRFAN MOMIN
  • 42. Small pox  It was endemic in 33 countries in 1967  The last indigenous case in India occurred on 17th may 1975 in Bihar.  In April 1977 India was declared small pox free.  The worlds last case occurred in Somalia (Africa) on 26 October 1977.  The WHO declared on 8 May 1980 that small pox has been eradicated. DR IRFAN MOMIN
  • 43. Guinea worm or Dracunculosis  Zero Incidence has been maintained since August 1996 in India  In February 2000, India has been certified by WHO for the elimination of Guinea worm Disease and on 15th February 2001 WHO declared India as “Guinea worm Disease free”. DR IRFAN MOMIN
  • 44. Wild poliovirus cases, India 2000 1 WPV case in 2011 compared to 42 in 1750 2010 1500 1250 1000 750 500 250 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* P1 wild P3 wild * data as on 2 March 2012
  • 45. WPV1 cases, India, 1998 - 2011 1750 1735 1487 1500 1250 1000 750 648 500 397 212 203 250 139 127 62 83 75 80 18 1 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* Year * data as on 2 March 2012
  • 46. Location of wild poliovirus cases by type, India WPVs 2011* State P1 P3 Total West Bengal 1 1 Total 1 1 * data as on 2 March 2012 Onset of paralysis - 13 January Howrah, West Bengal DR IRFAN MOMIN
  • 47. Polio  Last case occurred in 13th January 2011 in West Bengal. DR IRFAN MOMIN
  • 48. Disease does not occur in India  Yellow Fever DR IRFAN MOMIN
  • 49. Communicable Diseases  Malaria  Tuberculosis  Leprosy  Diarrhea  ARI  HIV DR IRFAN MOMIN
  • 50. Malaria Cases 1.52 million (0.12%) Deaths 924 PF % 49.56 DR IRFAN MOMIN
  • 52. Tuberculosis Global Rank 1 Incidence ( all 170 cases) /100,000/year Incidence ( new 75 /100,000/year sp) Prevalence 185/ 100,000 ( all cases) (0.18 %) TB mortality 24 /100,000/ DR IRFAN MOMIN
  • 53. Diarrhea Pathogen % of Cases Viruses Rotavirus 15-25 Bacteria Escherichia coli 10-20 Shigella 5-15 Compylobactor jejuni 10-15 Vibrio Cholerae 01 5-10 Salmonella 1-5 Protozoan Cryptosporidium 5-15 s DR IRFAN MOMIN
  • 54. Cholera Cases 3482 Deaths 12 Case Fatality 0.34% Rate DR IRFAN MOMIN
  • 55. Typhoid Fever  Endemic in India Cases 1.03 million ( 10 lac) Deaths 421 DR IRFAN MOMIN
  • 56. Amoebiasis  Prevalence 15% DR IRFAN MOMIN
  • 57. Hookwarm Infection  Heavily infected areas are  Assam,  West Bengal,  Bihar,  Orissa,  Andhra Pradesh,  Tamilnadu,  Kerala,  Maharashtra.  More than 200 million people are infected in India DR IRFAN MOMIN
  • 58. Dengue Haemorrhagic Fever CASES 15,509 DEATHS 89 DR IRFAN MOMIN
  • 59. Japanese Encephalitis Cases 4482 Deaths 774 DR IRFAN MOMIN
  • 60. Leptospirosis  Occurs in  South Gujarat,  Kerala,  Maharashtra,  Andaman Nicobar. DR IRFAN MOMIN
  • 61. Plague  Epidemic in 1994 in Surat  Epidemic in 2004 in Uttarakashi DR IRFAN MOMIN
  • 62. Tetanus Cases 2051 Deaths 160 DR IRFAN MOMIN
  • 63. Neonatal Tetanus Cases 889 Deaths 31 DR IRFAN MOMIN
  • 64. Global Leprosy Situation LEPROSY HAS BEEN ELIMINATED FROM THE WORLD DR IRFAN MOMIN
  • 65. Leprosy: 6 top countries •6 top endemic countries: India, Brazil, Myanmar, Madgascar, Mozambique, Nepal contribute 85% of global case load: (69% from India) • 91% of global case new cases (81% from India) DR IRFAN MOMIN
  • 66. Leprosy  India achieved leprosy elimination in December 2005  By the end of march 2009, prevalence rate of Leprosy was 0.72 cases per 10,000 population. DR IRFAN MOMIN
  • 67. Trend of Leprosy Prevalence & Annual New Case Detection (ANCDR) Rates 30 25.9 PR Prevalence & ANCDR 25 20.0 ANCDR 20 15 13.7 10.9 8.9 10 8.4 7.0 5.9 5.9 5.8 5.5 5.5 4.4 5 3.3 6.4 5.1 5.6 2.3 1.4 5.9 6.2 5.7 4.9 4.6 5.3 5.3 1.17 4.2 1.2 3.7 3.2 2.4 1.3 0 0.84 0.72 0.74 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 19 19 19 19 19 19 19 19 19 20 20 20 20 20 20 20 20 20 Year (March End) IRFAN MOMIN DR
  • 68. Five endemic states are as follows: 1. Bihar 2. Chattisgarh 3. Jharkhand 4. Chandigarh 5. West Bengal DR IRFAN MOMIN
  • 69. State wise Contribution New Leprosy Cases - year 2007-08 Karnataka, Tamilnadu, 3.28, Delhi, Orissa, Others, 4, 3% 0.97, 4.13, 4.85, 4% 1% 4% 5% Uttar Pradesh, 22.54, Madhya Pradesh, 23% 4.4, 4% Jharkhand, .94, 5% Bihar, Gujarat, 13.83, 5.25, 14% 5% Chhattisgarh, West Bengal, 5.67, Andhra Pradesh, Maharashtra, 9.84, 6% 7.3, 9, 10% 7% 9% Contribution by six states 20.8% pop & 34.5% new cases DR IRFAN MOMIN
  • 70. Endemicity of Leprosy – March.09 P.R.- 0.87 PM Dahod-2.25 2.22 Vadodara – 1.10 Bharuch Narmada- 1.26 P.R. 2.77 >5 Surat-1. 39 3-5 Navsari Dang – 4.26 2-3 2. 04 Valsad –2. 18 1 - 2 Gujaratachieved elimination as <1 on Oct-04 DR IRFAN MOMIN
  • 72. Situation in Surat:  Leprosy not eliminated from Surat  The prevalence rate 1.44  The new case detection rate 2.57 in the year 2006.  Male:female ratio as 58:42 (2006).  Child cases among new cases of leprosy 12.8% (2006).  Multibacillary cases among new cases 50.1%, 2006.  Grade II disability 1.38% (2006). DR IRFAN MOMIN
  • 73. HIV  Provisional estimates shows there are 22.7 lakh people living with HIV /AIDS.  Estimated adult HIV Prevalence rate is 0.28 % DR IRFAN MOMIN
  • 74. HIV Prevalence by Residence and Sex, India Women Men Total Sex (%) (%) (%) HIV prevalence rate is 60% higher Urban among males than females and 40% 0.35 0.29 0.41 higher in urban areas than rural areas Rural 0.18 0.32 0.25 India 0.22 0.36 0.28 DR IRFAN MOMIN
  • 75. HIV  High Prevalence states are  Maharashtra,  Tamilnadu,  Karnataka,  Andhra Pradesh,  Manipur  Nagaland. DR IRFAN MOMIN
  • 76. HIV Groups Prevalence IDU 9.2 MSM 7.4 FSW 4.9 Migrants 3.6 Truckers 2.5 STD 2.5 ANC 0.5 DR IRFAN MOMIN
  • 77. AIDS Awareness Percent of women and men age 15-49 who have heard of AIDS Urban Rural Total Women 81 46 57 Men 94 73 80 DR IRFAN MOMIN
  • 78. Non Communicable Diseases Ischemic heart Prevalence Disease % Urban 9.6 Rural 2.7 DR IRFAN MOMIN
  • 79. Coronary Heart Disease Indices Urban Rural Total Prevalen 6.4 2.5 3.7 ce Death 0.8 0.4 rate Per 1000 DALY per 2703.4 986.2 DR IRFAN MOMIN
  • 80. Prevalence ( %) of Hypertension among adults (> 25 years) , WHO Male Female India 23.1 22.6 China 29.8 25.6 Bangladesh 27.4 27.9 Sri Lanka 31.0 26.2 US 17.0 14.2 UK 27.7 19.1 Japan 26.4 16.7 DR IRFAN MOMIN
  • 81. RULE OF HALVES Total Employees Employees on 1493 (100%) regular Treatment 139 (9.3%) Total Hypertensive 455 (30.5%) Employees having controlled Known Hypertension Hypertensive 71 (4.7%) 197 (13.2%) DR IRFAN MOMIN
  • 82. Rheumatic Heart Disease  Prevalence 5-7/1000 in 5-15 years  There are 1 million cases of RHD in India DR IRFAN MOMIN
  • 83. Accidents World: In developed countries -  57% of male death and  43% of female death in 10-24 yrs are due to accidents. DR IRFAN MOMIN
  • 84. Cancer World  Every year- 10 million diagnosed 6 million die Worldwide - Lung Cancer (12.3 %) Breast Cancer(10.4%) Colorectal Cancer(9.4%) Death from cancer - Lung (17.8%) Stomach (10.4%) Liver (8.8 %) DR IRFAN MOMIN
  • 85. Male most common (by most common (by occurrence) mortality)[12] prostate cancer (25%) lung cancer (31%) lung cancer (15%) prostate cancer (10%) colorectal cancer colorectal cancer (8%) (10%) bladder cancer (7%) pancreatic cancer (6%) non-Hodgkin liver & intrahepatic bile lymphoma (5%) duct (4%) DR IRFAN MOMIN
  • 86. Female most common (by most common (by occurrence) mortality)[12] breast cancer (26%) lung cancer (26%) lung cancer (14%) breast cancer (15%) colorectal cancer (10%) colorectal cancer (9%) endometrial cancer (7%) pancreatic cancer (6%) non-Hodgkin lymphoma ovarian cancer (6%) (4%) DR IRFAN MOMIN
  • 87. India  3.4 % of all deaths – cancer  7 lakh new cases detected every year  Males - Mouth/oropharynx oesophagus stomach Lower respiratory tract  Females - Cervix Breast Mouth/oropharynx oesophagus DR IRFAN MOMIN
  • 88. NUTRTIONAL PROBLEMS  Under nutrition  Obesity  Anemia  Vitamin A deficiency  Vitamin B 12 deficiency  Iodine Deficiency Disorders  Zinc Deficiency DR IRFAN MOMIN
  • 89. Trends in Child Nutritional Status Percent of children age under 3 years NFHS-3 NFHS-2 51 45 43 40 23 20 Stunted Wasted Underweight (Low-weight-for- (Low-height-for- (Low-weight-for- age) age) height) DR IRFAN MOMIN
  • 91. Anaemia among Children Percent of children 6-35 months with anemia 79 81 72 74 Total Urban Rural NFHS-2 DR IRFAN MOMIN
  • 92. Nutritional Status of Adults Percent of women and men age 15-49 Women Men 55 36 34 24 13 9 BMI below normal Overweight/Obese Anaemic DR IRFAN MOMIN
  • 93. Malnutrition of Women by Residence and Education Percent of women age 15-49 60 50 7 7 13 13 14 11 40 24 21 30 20 41 42 36 35 35 36 25 25 10 0 al n an s l l s s ta ta ar io ar ar ur rb To to at ye ye ye R U uc 2 + 9 <8 S- 10 8- ed FH o N N Underweight Overweight MOMIN DR IRFAN
  • 94. Malnutrition of Men by Residence and Education Percent of men age 15-49 50 45 3 6 40 5 5 8 35 14 30 14 25 20 38 40 38 40 34 15 Overweight 27 25 10 Underweight 5 0 an al l s rs n s ta ar ar io ur a rb To ye ye at ye R U uc <8 + 9 8- 10 ed o N DR IRFAN MOMIN
  • 95. Vitamin B 12 Deficiency is in increasing trend in Gujarat ? DR IRFAN MOMIN
  • 96. Child Immunization Trends Percent of children age 12-23 months vaccinated 62 BCG 72 78 54 Polio3 63 78 52 DPT3 55 55 42 Measles 51 59 35 All Vaccines 42 44 NFHS-1 NFHS-2 NFHS-3 DR IRFAN MOMIN
  • 97. Selected Household Characteristics Percent of households 93 Electricity 56 68 51 Piped water 12 25 83 Any toilet facility 26 45 Urban Rural Total DR IRFAN MOMIN
  • 98. India’s population to be the largest in the world India is set to overtake China as the world's most populous nation by 2050. India’s population is expected to grow from 1.08bn to 1.63bn people, overtaking China, which is forecast to reach 1.44bn from 1.3bn currently. India, will also have the highest working population in the World — 700 million people out of 1.1 billion people are young; the young population will continue till 2050. DR IRFAN MOMIN
  • 99. Goldman Sachs Report of 1 October, 2003 – "Dreaming with BRICs: The path to 2050" India's GDP will reach $ 1 trillion by 2011, $ 2 trillion by 2020, $ 3 trillion by 2025, $ 6 trillion by 2032, $ 10 trillion by 2038, and $ 27 trillion by 2050, becoming the 3rd largest economy after USA and China. In terms of GDP, India will overtake Italy by the year 2016, France by 2019, UK by 2022, Germany by 2023, and Japan by 2032. DR IRFAN MOMIN
  • 100. Thank You Mobile: 9426845307 E-mail: drmhmomin@yahoo.co.in DR IRFAN MOMIN