India
India is the second largest country in the world with over 1 billion people with diverse social and cultural backgrounds. The Federal and State spend about 1.3% of the GDP on Health. Three quarters of the total health spending is out of pocket. Health as a total percentage of Federal budget has been about 2-3% over the last 50 years with a gradual increase in emphasis on family welfare programs of population stabilizations and mother and child health. Some 60% of the Federal budget for health is spent on the five national disease control programs: leprosy, malaria, tuberculosis, HIV/AIDS and blindness. The remainder is spent on public health institutions, hospitals and research.India accounts for 16% of the world’s population and 21% of the world’s global burden of disease. Over 30% of the population is classified as poor. In the last fifty years substantial gains in health included increased life expectancy, reduced infant mortality rate, reduced fertility rate, eradication of small pox and guinea worm, reduction of poliomyelitis and leprosy.
Life expectancy at birth increased from 32.1 from 1951 to 61 years in 2006. Infant mortality rate declined from 146 per thousand in 1951 to 81 per 1000 in 2006. It is estimated that over 30% of newborns are low birth weight (less than 2500 grams at birth), over 50% of children under five are malnourished, and over 80% of pregnant women are anemic. However in a country as vast as India , health indicator averages masks the wide disparities that exist between urban and rural populations, between states, between districts within states, and within communities within districts. High priority focus on health issues include eliminating leprosy as a public health problem, reducing malaria, lymphatic filariases and visceral leishmaniases, ensuring availability and rational use of quality essential drugs, reducing of maternal mortality within the framework of comprehensive reproductive health program and advocating for health care reform, and health as a basic human right. This would improve preventive and curative services and accountability while increasing the effectiveness and strengthening public health.
