this topic is come in community health nursing for 4th year b.sc nursing course

1. Health Problems In India

2. INTRODUCTION
• “HEALTH” is the one of those terms
which most people find difficult to define.
The widely accepted definition of health is
given by world health organization (1948)
is as follows:
• “Health is a state of complete physical,
mental, social & spiritual wellbeing & not
merely an absence of disease or infirmity”

3. • The HEALTH PROBLEMS of India may be
conveniently grouped under the following
heads:
• Communicable disease problems
• Non-communicable disease problems
• Nutritional problems
• Environmental sanitation & Population
problems
• Medical care problems

4. Communicable disease problems
• Communicable diseases continue to be a major
problem in India. Diseases
Considered to be of great importance today are:
• Malaria
• Tuberculosis
• Diarrhoeal diseases
• ARI
• Leprosy
• Filaria
• AIDS
• Others

5. Malaria
• Malaria continues to be a major health
problem in India.
• Country's 95% population lives in malaria
risk areas.
• Malaria in India is unevenly distributed.
• The states of Andhra Pradesh, Chattisgarh,
Gujarat, Jharkhand, Madhya Pradesh,
Maharashtra, Rajasthan and Orissa together
contribute around 60-70% cases and deaths
due to malaria.

6. Malaria
• At present, malaria continues to be a public
health problem affecting around 20%
population that lives largely in remote,
inaccessible, forest and forest-fringe areas.
• Government of India launched the National
Malaria Control Programme (NMCP) in
1953.

7. Tuberculosis
• Tuberculosis is another leading public
health problem in India.
• Currently INDIA accounts for nearly one
third of global TB burden.
• About 30 per cent of the total population
are infected (tuberculin positive).
• 1.5 per cent have radio logically active
disease of the lungs of which 0.4 per cent
are sputum-positive cases.

8. • According to official estimates, India has
nearly 12.7 million cases of pulmonary
tuberculosis of which about 3.4 million are
sputum-positive. The number of deaths is
estimated to be nearly 500,000 every year
• There are 8.8 million new cases of
Tuberculosis (TB) and 1.75 million deaths
from TB, each year.
• A revised strategy for national TB control
programme was evolved.

9. Diarrhoeal diseases
• Diarrhoeal diseases constitute one of the
major causes of morbidity and mortality,
specially in children below 5 years of age.
• They are responsible for 7.1 lakh deaths
each year.
• Outbreaks of Diarrhoeal diseases
(including cholera) continue to occur in
India due to poor environmental
conditions.

10. ARI
• Acute respiratory diseases are one of the
major causes of mortality and morbidity in
children below 5 years of age.
• It is estimated that about 13.6 percent
hospital admissions and 13 percent
inpatient deaths in paediatric wards are
due to ARI.

11. Leprosy
• Leprosy is another major public health
problem in India. It is major health & socio-
economic problems which spreads mainly
by closed contact with the infected
patients.
• In short, India accounts for about 60% of
the leprosy cases in the world.
• The disease is present through out the
country but the distribution is uneven.

12. • Higher number of cases are in U.P., Bihar,
Jharkhand, Orissa, West Bengal,
Chhattisgarh & Madhya Pradesh.
• During the year 2003-2004, total of 2.20
lakh new cases were detected, out of which
child cases were 14.91% and deformity
grade II and above was 1.8%. 35.26 per
cent of these cases are estimated to be
multibacillary.
• The prevalence rate of leprosy is about 2.3
per 10,000 population. The proportion of
infectious cases varies between 6-8 percent

13. Filaria
• The problem is increasing in magnitude
every year, having risen at risk 420 million
presently.
• Of these 109 million are living in urban
areas and the rest in rural areas.
• There are estimated to be at least 6 million
attacks of acute filarial disease per year,
and at least 45 million persons currently
have one or more chronic filarial lesions,

14. AIDS
• According to 2007 figures compiled by the National
AIDS Control Organisation (NACO), and supported
by the UNAIDS and World Health Organisation,
there are an estimated 2.5 million people living with
HIV in India.
• Vulnerable groups include :
• injecting drug users,
• female sex workers, men who have sex with men,
• migrants and other mobile groups such as truck
drivers.
• The epidemic, however, is increasingly spreading
from vulnerable groups to the general population,
and from urban to rural areas.

15. • Others : Kala-azar, meningitis, viral hepatitis,
Japanese encephalitis, enteric fever and
helminthic infestations are among the other
important communicable disease problems in
India.
• 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 problems by such measures as
manipulation of environment, practice of
preventive medicine and improvement of
standards of living.

16. NON COMMUNICABLE DISEASES
• Ischemic heart disease (IHD)
• Stroke
• Diabetes mellitus
• Cancer

17. Ischemic heart disease (IHD)
• Ischemic heart disease (IHD) is the leading cause
of death in economically developed countries and
is rapidly assuming serious dimensions in
developing countries. It is expected to be the single
most important cause of death in India by the year
2015 A.D.
• There is a steep increase in prevalence of IHD in
urban areas in India.
• The prevalence of IHD has increased considerably
during last decade, especially in urban areas.
Although there is increase in prevalence of the
disease in rural areas also, but it is not that steep
because life style changes have affected people in
urban areas more than in rural areas.

18. STROKE
• Although the prevalence of stroke appears to be
comparatively less in India than in developed
countries, it is likely to increase proportionally with
the increase in life expectancy.
• The proportion of strokes in the young is
significantly more in India than in developed
countries; some of the more important causes for
this are likely to be rheumatic heart disease,
ischemic strokes in per partum period and
arteriopathies as a squeal of CNS infections like
bacterial and tuberculosis, meningitis and
meningitis vascular syphilis.

19. DIABETES MELLITUS
• Diabetes mellitus has reached epidemic
proportions worldwide as we enter the new
millennium.
• The World Health Organization (WHO) has
commented there is ‘an apparent epidemic
of diabetes which is strongly related to
lifestyle and economic change’. Over the
next decade the projected number will
exceed 200 million.
• Most will have type-2 diabetes, and all are
at risk of the development of complications .

20. CANCER
• Aging population is the single most important
factor for cancer development. Recently there
has been remarkable growth of the elderly
population throughout the world.
• More than half of the world’s elderly people are
in the developing countries. In India 6.5% of the
total population is represented by older persons
(60 yrs and above).
• In India only 3.4% of the population is 65 yrs and
older but they still total 30 million.

21. • The increase in life expectancy will also lead to
increase in number of cancer cases.
• Tobacco use of has been considered controversial
for long although scientific evidence regarding its
health hazards started building since 1950s.
• The data from NSSO Survey has been used for
prevalence rates of tobacco use in present
investigation. The prevalence rates of tobacco use
among persons aged 25 + years .
• prevalence rates of tobacco use in urban areas as
43.
• In rural areas the prevalence rates for tobacco use
are 64.4
• India was one of the first countries to develop a
National Cancer Control Programme.

22. Cervical Cancer
• India means every case of cancer dies
within (approx) 2-4 years of diagnosis.
Brest cancer & cervical cancer both are
leading cause of death in our country .

23. Nutritional problems
• From the nutritional point of view, the
INDIAN society is a dual society,
consisting of a small group of well fed and
a very large group of undernourished. The
high income groups are showing diseases
of affluence which one finds in developed
countries.

24. The specific nutritional problems in the
country are :
• Protein-energy malnutrition
• Nutritional anemia
• Low birth weight
• Xerophthalmia (nutritional blindness)
• Iodine deficiency disorders
• Others

25. 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,

26. 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 anaemia.
• 60 to 80 per cent of pregnant women are anaemic.
• 20 to 40 per cent of maternal deaths are attributed
to anemia.
• By far the most frequent cause of anemia is iron
deficiency, and less frequently folic and vitamin B
deficiency

27. Low birth weight
• This is a major public health problem in many
developing countries.
• About 30 per cent of babies born are of low birth
weight (less than 2.5 kg), as compared to about 4
per cent in some developed countries.
• Maternal malnutrition and anemia are mainly
responsible for this condition .
• The current probability of a child dying before his
or her 5th birthday is 8.7%.
• It is estimated that at least half of these deaths
are related to malnutrition, often associated with
infectious diseases

28. 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.
• Sub clinical deficiency of vitamin A is also
widespread and is associated with
increased morbidity and mortality from
respiratory and gastro-intestinal infections.

29. 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 is not restricted to the "goiter belt"
as was thought earlier, but is extremely prevalent in
other parts of India as well.
• In India the number who are iron deficient is
estimated to be nearly 70%.
• Increase the risk of death during childbirth, and in
India this is widespread as less than 50% of all
households use iodized salt.

30. • Others : Other nutritional problems of
importance are lathyrism and endemic
Flurosis in certain parts of the country. To
these must be added the widespread
adulteration of foodstuffs.

31. Environmental sanitation &
Population Problem
• The most difficult problem to tackle in this
country is perhaps the environmental
sanitation problem, which is
• multifaceted and
• multifactorial.

32. Major environmental issues are:
• lack of safe water in many areas of the country
and
• primitive methods of excreta disposal.
• population explosion,
• urbanization and industrialization
• hazards to : air, in water and in the food chain.
• Forest and Agricultural land degradation,
• Resource depletion (water, mineral, forest, sand,
rocks etc.)
• Environmental degradation, Public Health,
• Livelihood Security for the Poor

33. • various natural hazards, particularly
cyclones and annual monsoon floods,
population growth, increasing individual
consumption, industrialization,
infrastructural development, poor
agricultural practices, and resource mal
distribution have led to substantial human
transformation of India’s natural
environment.
• An estimated 60% of cultivated land
suffers from soil erosion, water logging,
and salinity.

34. Water pollution
• Out of India's 3,119 towns and cities, just
209 have partial treatment facilities, and
only 8 have full wastewater treatment
facilities (WHO 1992).
• 114 cities dump untreated sewage and
partially cremated bodies directly into the
Ganges River. Open defecation is
widespread even in urban areas of India.

35. Air pollution
• Indian cities are polluted by vehicles and
industry emissions. Road dust due to
vehicles also contributing up to 33% of air
pollution .
• In cities like Bangalore, around 50% of
children suffer from asthma.

36. • Electric rickshaws are being designed and
will be sub sidised by the government but
the supposed ban on the cycle rickshaws in
Delhi will require a huge increase on the
reliance of other methods of transport,
mainly those with engines.
• In India 78% of the population consign the
dead bodies to fire for cremation as a ritual
in open air
• It also appeared that the excessive pollution
was having an adverse effect on the Taj
Mahal.

37. Noise pollution
• The Supreme Court of India gave a
significant verdict on noise pollution in 2005.
• Unnecessary honking of vehicles makes for
a high decibel level of noise in cities.
• The use of loudspeakers for political
purposes and by temples and mosques
make for noise pollution in residential areas.
• Recently Government of India has set up
norms of permissible noise levels in urban
and rural areas. How they will be monitored
and implemented is still not sure.

38. Land pollution:
• Land pollution in India is due to pesticides
and fertilizers as well as corrosion

39. POPULATION PROBLEM:
• employment,
• education,
• housing,
• health care,
• sanitation and environment,
• Road traffic accidents.
WORLD HEALTH DAY 2011(APRIL 7)
THEME: URBANISATION & HEALTH

40. Medical care problems
• India has a national health policy. It does
not have a national health service.
• The financial resources :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.
• uneven distribution of doctors
:Approximately 80 per cent of health
facilities are concentrated in urban areas

41. Urban health problems have been
aggravated and include :
• overcrowding in hospitals,
• inadequate staffing and scarcity of certain
essential drugs and medicines.
• The rural areas where nearly 74 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: