INTRODUCTION: Assessment of health status and health problems is the first requisite for any planned effort to develop health care services. The data required for the analysis of health situation and health problems comprise of mortality, morbidity, demographic conditions, socioeconomic factors etc
HEALTH Acc to who health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
“Health problem is a state in which we are unable to function normally (state of ill health, unhealthiness)”
MAJOR HEALTH PROBLEMS : communicable disease problem nutritional problem environmental sanitation problem medical care problem population problem
COMMUNICABLE DISEASE PROBLEMS Communicable diseases are continue to be the major health problem in India. The diseases continue to be of greater importance are
MALARIA: Malaria is caused by a parasite that is Anopheles mosquitoes Symptoms: Anemia, Bloody stools,Chills, Coma, Convulsion, Fever, Headache, Jaundice, Muscle pain, Nausea, Sweating, Vomiting
CONT..: SIGNS AND TESTS: During a physical examination, the doctor may find an enlarged liver or enlarged spleen. A complete blood count (CBC) will identify anemia if it is present.
CONT..: Treatment: Chloroquine, for chloroquine-resistant infections(quinine plus doxycycline, tetracycline, or clindamycin)
TUBERCULOSIS: Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs, but may spread to other organs. Causes: Mycobacterium tuberculosis (M.tuberculosis)
CONT… Symptoms:- Cough (usually cough up mucus),- Coughing up blood,- Excessive sweating, especially at night,- Fatigue, Fever, Unintentional weight loss,- Breathing difficulty,- Chest pain,- Wheezing
CONT… Tests: Sputum examination and cultures, Biopsy of the affected tissue (rare), Bronchoscopy, Chest CT scan, Chest x-ray, Thoracentesis, Tuberculin skin test
DIARRHOEAL DISEASE: Diarrhoeal disease is the second leading cause of death in children under five years old. leading cause of malnutrition in children under five years old. Causes: Infection(bacterial, viral and parasitic organisms),
CONT… Prevention and treatment:- access to safe drinking-water- improved sanitation,- exclusive breastfeeding or the first six months of life,- good personal and food hygiene,- health education about how infections spread rotavirus vaccination.- Rehydration, Zinc supplements, Nutrient-rich foods, Consulting a health worker if there are signs of dehydration
ARI: Acute respiratory infections are causes of mortality and morbidity in children below 5yrs of age. It is estimated that about 13.6% hospital admissions and 13% inpatient deaths in paediatric ward are due to ARI. Acc. To 2009, Around two million deaths each year with the incidence of 0.29 and 0.05 episodes per child-year occurs. Causes: Streptococcus pneumonia, Haemophilus influenzae, Staphylococcus aureus and other bacterial species, measles virus, human parainfluenza viruses, influenza virus and varicella virus.
LEPROSY is another major public health problem in India. In 2002: 0.44 million cases were there. During the year 2003-2004: 2.20 lakh new cases were detected out of which child cases were 14.91%, all the states and union territories reported cases of leprosy. India accounts for the 60% of the leprosy cases in the world.
AIDS Since AIDS was first detected in year 1986, the cumulative number of cases has risen to 124995 by the end of Aug 2007. In 2009 : Total cases-2.4 million, 1.7 lakh HIV/AIDS related deaths were reported. 41% of new cases were reported from Orissa, Bihar, West bangal,U.P, Rajsthan, M.P, and Gujrat.
OTHERS: Kala-azar, Meningitis, viral hepatitis, Japanese encephalitis, entric fever, and helmenthic infestations are among the other important communicable disease problems in india
PROTEIN ENERGY MALNUTRITION:PEM refers to the deficiency of energy and protein in the body. 1-2% of preschool children in India suffer from PEM. In 1998, India is ranked 2nd in the world of the number of children suffering from malnutrition. In 1991,it has around 150 million children, constituting 17.5% of Indias population, who are below the age of 6 years. The 2011 Global Hunger Index (GHI) Report ranked India 15th, amongst leading countries with hunger situation
CONT…. CAUSES: Inadequate intake of food both in quantity and quality, Infections (Diarrhea, Respiratory infections, measles, intestinal worms) TYPES: MARASMUS, KWASHIORKER
NUTRITIONAL ANEMIA: India has probably the highest prevalence of nutritional anaemia in women and children. About one half of the non-pregnant women and children are estimated to suffer from anaemia. 60-80% of pregnant women are anaemic. 20-40% of maternal deaths are attributed to anaemia. Mostly the anaemia is of iron deficiency and less frequently is of folate and vitamin B12 deficiency
LOW BIRTH WEIGHT This is the major public health problem in developing countries. About 30% of the babies are born of low birth weight as compared to about 4% in some developed countries. Cause : Maternal malnutrition and anaemia. CAUSES: Inadequate nutritional intake during pregnancy.
XEROPHTHALMIA About 0.04% of total blindness in India are attributed to nutritional deficiency of Vit. A. Keramalacia has been the major cause of nutritional blindness in children usually between 1-3 years of age.
IODINE DEFICIENCY DISORDER Goitre The prevalence rate in some parts of Himachal Pradesh was 28.7%(Sirmor) and 34.5%(Mandi) ,45.8% in ropar;64.4% in bihar;27% in Arunachal Pradesh. According to 2011 census, 71 million people in India suffer from this, 1.3 crore people in UP, M.P-0.82 crore, Bihar-0.62 crore.
The two main problems1.) lack of safe water in many areas of the country2.) primitive methods of excreta disposal. Beside these, there has been a growing concern about the impact of new problems resulting from population explosion, urbanization and industrialization leading to hazards to human health in the air, in water, and in food chain.
MEDICAL CARE PROBLEMS
* Inadequate financial sources* health benefits to the urban population.* Uneven distribution* Migration to the urban areas, health problems have been* Aggravated like overcrowding in hospitals, inadequate staffing* Scarcity of certain drugs and medicines.Thus the major health care problem is inequitable distribution andinadequate services.