India has huge burden of Health problems .In India health problems are discussed under six major headings as commonly seen in the country. 1.Communicable Disease Problem 2. Non-Communicable disease problem 3.Nutritional problem 4.Environmental sanitation problem 5.Medical care problem 6.Population problem

1. ——
PREETI THAKUR
Assistant Professor
Community Health Department
SMVDCoN

2. Introduction
India is an incredibly diverse and
culturally rich country. Despite gigantic
and beautiful monuments, delicious food, a
booming business sector, and Bollywood,
it still has some major health issues that
many other countries have minimized far
more successfully. These health issues
affect absolutely everyone, from the
poorest people to the richest ones and from
those who live there to tourists who only
come for a short stay

3. Definition
:- Acc. to WHO health is a
state of complete physical, mental,
social and spiritual well-being and not
merely the absence of disease or
infirmity.
HEALTH PROBLEM :- it is a state in
which we are unable to function
n o r m a l l y ( s t a t e o f i l l h e a l t h ,
unhealthiness)

5. ——
PREETI THAKUR
Assistant Professor
Community Health Department
SMVDCoN

6. Definition
I n d i a h a s h u g e b u r d e n o f
H e a l t h p r o b l e m s . I n I n d i a
health problems are discussed
under six major headings as
c o m m o n a l y s e e n i n t h e
country.They are as follow:-

7. Communicable Disease Problem
Nutritional Problem
Environmental Sanitation
Problem
Medical Care Problem
Population Problem
Non-Communicable Problem

8. COMMUNICABLE
DISEASE
From Ancient days ,Communicable
disease served as the major cause of
morbidity and mortality profile of the
country.The Introduction of vaccine
against communicable disease brought
down the mortality rates largely. but
still, the disease couse public health
burden.

11. Malaria
A disease caused by a plasmodium parasite, transmitted
by the bite of infected mosquitoes.
The severity of malaria varies based on the species of
plasmodium.
Symptoms are chills, fever and sweating, usually
occurring a few weeks after being bitten.
People travelling to areas where malaria is common
typically take protective drugs before, during and after
their trip. Treatment includes antimalarial drugs.

12. Malaria
Malaria continues to be a health problem in India.
Although total malaria cases have declined compared
to previous years, the proportion of P. falciparum has
increased.
Malaria cases have increased in North-East states,
Madhya Pradesh, Chhattisgarh, Jharkhand, Orissa,
Andhra Pradesh, Maharashtra etc.
During 2013 there were 0.8 million cases of malaria
(which included 0.44 million cases of Pf malaria) and
379 deaths

14. Tuberculosis
A potentially serious infectious bacterial disease that
mainly affects the lungs.
The bacteria that cause TB are spread when an infected
person coughs or sneezes.
Most people infected with the bacteria that cause
tuberculosis don't have symptoms. When symptoms do
occur, they usually include a cough (sometimes blood-
tinged), weight loss, night sweats and fever.
Treatment isn't always required for those without
symptoms. Patients with active symptoms will require a
long course of treatment involving multiple antibiotics.

15. Tuberculosis
Tuberculosis remains a public health problem, with
India accounting for one-fifth of the world incidence.
Every year about 2.6 million persons develop
tuberculosis of which about 0.62 million are new smear
positive highly infectious cases and about 0.24 million
people die of TB every year.
The emergence of HIV-TB co-infection and multidrug
resistant TB has increased the severity and magnitude of
the disease. In March 2006 RNTCP has achieved
nation-wide coverage.

17. Diarrhoeal Diseases
Loose, watery stools that occur more frequently than
usual.
Diarrhoea is usually caused by a virus, or sometimes,
contaminated food. Less frequently, it can be a sign of
another disorder, such as inflammatory bowel disease
or irritable bowel syndrome.
Symptoms include frequent, loose, watery stools and
stomach pain.
Most cases clear on their own. Some infections may
need antibiotics. Severe cases can cause enough
dehydration to require intravenous fluids.

18. Diarrhoeal Diseases
Diarrhoeal diseases constitute one of the major
causes of morbidity and mortality, especially in
children below 5 years of age.
They are responsible for about 10.76 million cases
of diarrhoea each year.
Outbreaks of diarrhoeal diseases (including
cholera) continue to occur in India due to poor
environmental conditions.

20. Acute respiratory infection is an infection
that may interfere with normal breathing. It
can affect just your upper respiratory system,
which starts at your sinuses and ends at your
vocal chords, or just your lower respiratory
system, which starts at your vocal chords and
ends at your lungs.

21. Acute respiratory diseases are one of
the major censes of mortality and
morbidity in children below 5 years of
age.
During 2013, 31.7 million episodes Of
ARI were reported with 3,278 deaths.

23. Filaria
Filariasis is a parasitic disease caused
by an infection with roundworms of the
Filarioidea type. These are spread by
blood-feeding insects such as black flies
and mosquitoes. They belong to the
group of diseases called helminthiases.

24. Filaria
The problem of filaria remains endemic in about
250 districts in 20 States and UTs. The population
at risk is over 600 million. To achieve elimination
of LF, the Govt. of India has launched nationwide
Annual Drug Administration (MDA) with annual
single recommended dose of diethylcarbamazine
citrate tablets in addition to scaling up home
based foot care and hydrocele operations.
In 2012, 250 endemic districts implemented MDA
targeting a population of about 554 million with a
coverage rate of 87 per cent.

26. Leprosy
A chronic, curable infectious disease mainly causing
skin lesions and nerve damage.
Leprosy is caused by infection with the bacterium
Mycobacterium leprae. It mainly affects the skin, eyes,
nose and peripheral nerves.
Symptoms include light-coloured or red skin patches
with reduced sensation, numbness and weakness in
hands and feet.
Leprosy can be cured with 6-12 months of multi-drug
therapy. Early treatment avoids disability.

27. Leprosy
Leprosy is another important public health problem in
India.
During the year 2013—2014, total of 1.27 lakh new cases
were detected, out of which child cases were 9.49% and
deformity grade II and above was 4.14% percent of cases
are estimated to be multibacillary. All the States and Union
Territories report cases of leprosy. However, there are
considerable variations not only between one State and
another, but also between one district and another.
With the prevalence rate of about 0.68 per 10,000
population, India has achieved the goal of leprosy
elimination at national level.

29. AIDS
HIV causes AIDS and interferes with the body's ability to fight
infections.
The virus can be transmitted through contact with infected
blood, semen or vaginal fluids.
Within a few weeks of HIV infection, flu-like symptoms such as
fever, sore throat and fatigue can occur. Then the disease is
usually asymptomatic until it progresses to AIDS. AIDS
symptoms include weight loss, fever or night sweats, fatigue
and recurrent infections.
No cure exists for AIDS, but strict adherence to antiretroviral
regimens (ARVs) can dramatically slow the disease's progress
as well as prevent secondary infections and complications.

30. AIDS
So far there is no treatment for curing HIV infections .India has
the third largest HIV epidemic in the world. In 2017, HIV
prevalence among adults (aged 15-49) was an estimated 0.2%.
This figure is small compared to most other middle-income
countries but because of India's huge population (1.3 billion
people) this equates to 2.1 million people living with HIV.1 2
Overall, India’s HIV epidemic is slowing down. Between 2010
and 2017 new infections declined by 27% and AIDS-related
deaths more than halved, falling by 56%.The problem of AIDS
is stable. It is estimated that by the end of year 2012 there were
about 2.08 million HIV positive cases in the country

32. 1. Kala-azar
2. Meningitis
3. Viral hepatitis
4. Japanese encephalitis
5. Dengue fever
6. Enteric fever
7. Helminthic infestations - are among the
other important communicable disease
problems in India

33. The tragedy is that most of these diseases
can be either easily prevented or treated
with minimum input of resources.
In fact, most of the developed countries of
the world have overcome many of these
p r o b l e m s b y s u c h m e a s u r e s a s
manipulation of environment, practice of
preventive medicine and, improvement of
standards of living.

37. India is experiencing a rapid epidemiological
transition with a large and rising burden of
chronic diseases, which were estimated to
account for 53 per cent of all deaths and 44
percent of disability adjusted life years lost in
2005.
NCD’s especially diabetes mellitus, CVDs,
cancer, stroke, and chronic lung diseases have
emerged as major public health problems due
to an ageing population and environmentally-
driven changes in behavior.

39. A disease in which abnormal cells divide
uncontrollably and destroy body tissue.
MOST COMMON TYPES
q Breast cancer
A cancer that forms in the cells of the breasts.
o Prostate cancer
A cancer in a man's prostate, a small walnut-sized
gland that produces seminal fluid.
o Basal cell cancer
A type of skin cancer that begins in the basal cells.
Skin cancer (melanoma) .The most serious type of
skin cancer.

40. o Colon cancer
A cancer of the colon or rectum, located at the
digestive tract's lower end.
o Lung cancer
A cancer that begins in the lungs and most often
occurs in people who smoke.
o Leukemia
A cancer of blood-forming tissues, hindering the
body's ability to fight infection.
o Lymphoma
A cancer of the lymphatic system.

41. Cancer has become an important public health
problem in India with an estimated 7 to 9 lakh cases
occurring every year. At any point of time, it is
estimated that there are nearly 25 lakh cases in the
country.
In India, tobacco related cancers account for about
half the total cancers among men and 20% among
women. About one million tobacco related deaths
occur each year, making tobacco related health
issues a major public health concern.

43. Clouding of the normally clear lens of the
eye.
Most cataracts develop slowly over the
course of years.
The main symptom is blurry vision. Having
cataracts can be like looking through a
cloudy window.
When a cataract interferes with someone's
usual activities, the cloudy lens can be
replaced with a clear, artificial lens. This is
generally a safe, outpatient procedure.

44. In India, more than 12 million people are
blind. Cataract (62.6 per cent) is the main
cause of blindness followed by Refractive
Error (19.70 per cent).
There has been a significant increase in
proportion of cataract surgeries with Intra
Ocular Lens (IOL) implantation from <5 per
cent in 1994 to 95 per cent in 2011—12.

46. Oral hygiene is the practice of keeping one's mouth
clean and free of disease and other problems by
regular brushing of the teeth and cleaning between
the teeth. It is important that oral hygiene be
carried out on a regular basis to enable prevention
of dental disease and bad breath

47. Oral Health Care has not been given sufficient
importance in our country.
Most of the district hospitals have a post of dental
surgeon but they lack equipment, machinery, and
material.
Even where the equipment exists, the maintenance
is poor, hence service delivery is affected.

53. Nutritional Problems

54. From the nutritional point of view,
the Indian society is a dual society,
consisting of a small group of well fed
a n d a v e r y l a r g e g r o u p o f
undernourished. The high-income
groups are showing diseases of
a ff l u e n c e w h i c h o n e f i n d s i n
developed countries.

55. Nutritional disease, any of the nutrient-
related diseases and conditions that cause
illness in humans. They may include
deficiencies or excesses in the diet, obesity
and eating disorders, and chronic diseases
s u c h a s c a r d i o v a s c u l a r d i s e a s e ,
hypertension, cancer, and diabetes mellitus.

57. Protein-energy Malnutrition
Insufficiency of food — the so-called "food gap"—
appears to be the chief cause of PEM, which is a major
health problem particularly in the first years of life.
The great majority of cases of PEM, nearly 80 per cent
are mild and moderate cases.
The incidence of severe cases is 1 to 2 per cent in
preschool age children.
The problem exists in all the States and the nutritional
marasmus is more frequent than kwashiorkor

61. Nutritional Anemia
India has probably the highest prevalence of nutritional anemia
in women and children.
About one-half of non-pregnant women and young children are
estimated to suffer from anemia i.e., 60 to 80 per cent of
pregnant women are anemic, 19 per cent of maternal deaths are
attributed to anemia.
According to NFHS-3, about 57.9 per cent women are anemic
of which 54.6 per cent are in urban areas and 59 per cent in
rural areas.
The survey also shows that the incidence of anemia in children
aged 6-35 months is 79.2 per cent with 72.7 per cent in urban
areas and 81.2 per cent in rural areas. By far the most frequent
cause of anemia is iron deficiency, and less frequently folate
and vitamin B12 deficiency

63. Low birth weight
A term used to describe an infant born
weighing 5.5 pounds (2500 grams) or less. A
low birth weight may occur when an infant is
born too early (premature). These infants may
have an increased risk of serious health
problems.

64. Low birth weight
A term used to describe an infant born
weighing 5.5 pounds (2500 grams) or less. A
low birth weight may occur when an infant is
born too early (premature). These infants may
have an increased risk of serious health
problems.
This is a major public health problem in many
developing countries.
About 28 percent of babies born are of low
birth weight (less than 2.5 kg), as compared
to about 4 percent in some developed

67. Nutritional Blindness
Nutritional blindness is loss of useful
vision resulting from vitamin deficiency.
A malnutrition Xerophthalmia means all
the ocular manifestations of inadequate
metabolism of vitamin A, nutritional
blindness being the end result of the
most severe cases.

68. Xerophthalmia
(Nutritional blindness)
About 0.04 per cent of total blindness in India
is attributed to nutritional deficiency of
vitamin A.
Keratomalacia has been the major cause of
nutritional blindness in children usually
between 1—3 years of age.
Subclinical deficiency of vitamin A is also
widespread and is associated with increased
morbidity and mortality from respiratory and
gastro-intestinal infections

70. Iodine Deficiency Disorders
Population effects of severe iodine deficiency,
termed iodine deficiency disorders (IDDs),
include endemic goiter, hypothyroidism,
cretinism, decreased fertility rate, increased
infant mortality, and mental retardation

71. Iodine Deficiency Disorders
Goiter and other iodine deficiency disorders(IDD) have
been known to be highly endemic in sub-Himalayan regions.
Reassessment of the magnitude of the problem by the
Indian Council of Medical Research showed that the
problem I not restricted to the “goiter belt” as was thought
earlier but is extremely prevalent in other parts of India as
well.
It has been found that out of 324 districts surveyed in 29
states and all Uts, 263 districts are endemic i.e. where the
prevalence of IDD is more than 10 per cent.
It is also estimated that more than 71 million people are
suffering from goiter and other IDD.

73. OTHERS
Other nutritional problems of
importance are lathyrism and endemic
fluorosis in certain parts of the country.
To these must be added the widespread
adulteration of foodstuffs.

75. The population problem is one of the biggest
problems the country with its inevitable
consequences on all aspects of development
especially
Ø Employment,
Ø Education,
Ø Housing,
Ø Health care,
Ø Sanitation and Environment.

76. Besides 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 the
food chain.
As of year, 2012 safe water is available to 96 per cent
of the urban and 87 per cent of the rural population; and
adequate facilities for waste disposal to 64 percent of
the urban and 21 percent of the rural population. The
problem is gigantic.

77. The population problem is one of the biggest problems facing
the country, with its inevitable consequences on all aspects of
development, especially employment, education, housing,
health care, sanitation and environment.
The country's population has already reached one billion
marks by the turn of the century.
The Government has set a goal of 1 per cent population growth
rate by the year 2000 (which was not attained); currently, the
country-s growth rate is 1.8 per cent. This calls for the "two
child family norm".
The population size and structure represent the most important
single factor in health and manpower planning in India today
where the law of diminishing returns, among other factors,
plays an important role in the economic development of the
country

80. The financial resources are considered
inadequate to furnish the costs of running
such a service.
The existing hospital-based, disease-
oriented health care model has provided
health benefits mainly to the urban elite.

82. Ø Inadequate financial sources.
Ø Health benefits to the urban
population.
Ø Uneven distribution
Ø Migration to the urban, health
problem have been.
Ø Aggravated like overcrowding in
hospital, inadequate staffing.
Ø Scarcity of certain drugs and
medicine.

84. Approximately 80 per cent of health facilities
are concentrated in urban areas.
Even in urban areas, there is an uneven
distribution of doctors.
With large migrations occurring from rural to
urban areas, urban health problems have been
aggravated and include overcrowding in
hospitals, inadequate staffing and scarcity of
certain essential drugs and medicines.

85. The rural areas where nearly 72 per cent of the
population live, do not enjoy the benefits of the
modern curative and preventive health services.
Many villages rely on indigenous systems of
medicine. Thus, the major medical care problem in
India is in equable distribution of available health
resources between urban and rural areas, and lack of
penetration of health services to the social periphery.
The HFA/2000 movement and the primary health
care approach which lays stress on equity,
intersectoral coordination and community
participation seek to redress these imbalances.

86. Assessment of health status and health
problems is the first require for any planned
effort develop to health care services.
• The data required for the analysis of health
situation and health problems comprise of
mortality , morbidity , demographic condition,
socioeconomic factors etc

87. PREETI THAKUR
Assistant Professor
Community Health Department
SMVDCoN