New Delhi: India, the second largest country in the world by population, has been working towards overall health and well-being through various programmes and it is evident with improvement under various health indices. As per the Sample Registration System (SRS) report published by the Office of the Registrar General and Census Commissioner, Government of India, the average life expectancy at birth has increased from 49.7 during 1970-75 to 69.7 during the year 2015-19 registering an increase of 20 years during this period. India’s success in eradicating polio is not hidden from anyone. Similarly, India declared itself free of smallpox in 1979.
The World Health Organisation Constitution states, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” For India, it is not just about eradicating diseases by undertaking health-specific interventions but also, looking at other parameters like nutrition that affect health. Let us take a look at some of the biggest game changers in health in the past 75 years of India’s independence.
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Universal Immunisation Programme
The Ministry of Health and Family Welfare, Government of India introduced Immunisation Programme in India in 1978 as the ‘Expanded Programme of Immunisation’ (EPI). In 1985, the programme was modified as the ‘Universal Immunisation Programme’ (UIP), as its reach was expanded beyond urban areas. UIP is one of the largest public health programmes targeting close of 2.67 crore newborns and 2.9 crore pregnant women annually. It is one of the most cost-effective public health interventions and is largely responsible for the reduction of vaccine preventable under-5 mortality rate. Under UIP, immunisation is provided free of cost against 12 vaccine preventable diseases:
- Nationally against 9 diseases – Diphtheria, Pertussis, Tetanus, Polio, Measles, Rubella, a severe form of Childhood Tuberculosis, Hepatitis B and Meningitis and Pneumonia caused by Hemophilus Influenza type B
- Sub-nationally against 3 diseases – Rotavirus diarrhoea, Pneumococcal Pneumonia and Japanese Encephalitis; of which Rotavirus vaccine and Pneumococcal Conjugate vaccine are in process of expansion while JE vaccine is provided only in endemic districts
The two major milestones of UIP have been the elimination of polio in 2014 and maternal and neonatal tetanus elimination in 2015.
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Pulse Polio Immunisation Programme
In 1995, India committed to a resolution passed by World Health Assembly for the Global Polio Eradication (1988) and launched Pulse Polio Immunization Program. Within two decades, India received ‘Polio-free certification’ from World Health Organization on March 27, 2014, with the last polio case being reported in Howrah in West Bengal on January 13, 2011. The WHO states,
Ensuring equitable access to vaccines to everyone, including the most marginalised and vulnerable groups living in the remotest parts of the country, made eradication possible. A high commitment at every level led to policymakers, health workers, frontline workers, partners and community volunteers, working in tandem to deliver life-saving polio drops to every child wherever they were, be it at home, in school, or in transit.
The efforts to keep the country polio free continue. India conducts one National Immunization Day and two Sub-National Immunization Day (SNIDs) for polio every year to maintain population immunity against wild poliovirus and to sustain its polio free status.
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National Programme For Mid-Day Meal In Schools Or PM POSHAN Scheme
Popularly known as the Mid-Day Meal Scheme, the programme was initiated by the Ministry of Education in 1995. The scheme was launched in 2,408 blocks across the country for providing one meal per day to students in primary school (Class I to V). It was later made universal by extending the coverage to all government and government-aided schools in 2001, following the Supreme Court order dated November 28 of the same year. The scope of the scheme was further extended to cover the students of Upper Primary (Class VI to VIII) in 2007.
The programme received support from the Right of Children to Free and Compulsory Education Act, 2009 which mandated the provision of a kitchen in every school, where the midday meal would be cooked. Later, it was further strengthened by the National Food Security Act, 2013 which laid down the legal entitlement of every school child up to the age of fourteen years to a free, cooked, hot midday meal in all schools that are either run or aided by the government or local bodies.
In September 2021, the scheme was renamed as PM POSHAN (POshan SHAkti Nirman) Scheme for providing one hot cooked meal in Government and Government-aided schools from 2021-22 to 2025-26. The scheme covers about 11.80 crore children studying in 11.20 lakh schools across the country. During 2020-21, the Government of India invested more than Rs.24,400 crore in the scheme, including the cost of about Rs.11,500 crore on food grains.
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National Family Programme
India was the first country in the world to have launched a National Programme for Family Planning in 1952. Over the decades, the programme has undergone transformation in terms of policy and actual programme implementation and is currently being repositioned to not only achieve population stabilisation goals but also promote reproductive health and reduce maternal, infant and child mortality and morbidity. Some of the initiatives under the Family Planning Programme are:
- Mission Parivar Vikas for substantially increasing the access to contraceptives and family planning services in the high fertility districts of seven high focus states – Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, Chhattisgarh, Jharkhand and Assam
- New Contraceptive Choices
- Redesigned Contraceptive Packaging to influence the demand for these commodities
- Emphasis on spacing methods like Intra-Uterine Contraceptive Device (IUCD)
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While chairing the National Family Planning Summit in July 2022, Dr. Bharati Pravin Pawar, Union Minister of State for Health and Family Welfare shared the impact of the National Family Planning Programme and said,
India has achieved replacement level fertility with as many as 31 states/UTs having achieved a Total Fertility Rate of 2.1 or less and modern contraceptive usage has increased substantially to 56.5 per cent (NFHS 5). NFHS-5 data shows an overall positive shift towards spacing methods which would be instrumental in impacting positively the maternal and infant mortality and morbidity.
Oral Rehydration Therapy
Diarrhoea is a leading killer of children, accounting for approximately 9 per cent of all deaths among children under age 5 worldwide in 2019, shows WHO and the Maternal and Child Epidemiology Estimation Group (MCEE) estimates, 2020. This translates to over 1,300 young children dying each day, or about 4,84,000 children a year, despite the availability of a simple treatment solution. And that solution is Oral Rehydration Therapy (ORT). It is a treatment consisting of a salt-and-sugar-based solution taken orally to treat dehydration from diarrhoea. Glucose-electrolyte solution called Oral Rehydration Salts (ORS) solution helps balance our bodies’ fluids and manage hydration.
World ORS Day is marked annually on July 29 to highlight the importance of Oral Rehydration Salts (ORS) as a cost-effective method of health intervention.
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Universal Salt Iodisation
Since 1994, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have recommended universal salt iodization as a safe, cost-effective and sustainable strategy to ensure sufficient intake of iodine by all individuals. Iodisation of salt means adding iodine to salt.
As per UNICEF, without the right iodine intake in the diets of children and pregnant women, children’s growth and intellectual development can be impaired. Iodine deficiency in pregnant women may cause damage to fetal brain development, miscarriages, and low birth weight.
Iodine deficiency is the most common cause of Goitre. In order to prevent and control the problem of Goitre in the country, the Government of India launched National Goitre Control Programme (NGCP) in 1962. Subsequently, the Programme was renamed as National Iodine Deficiency Disorders Control Programme (NIDDCP) in 1992 so as to cover all Iodine Deficiency Disorders and is being implemented in all states/UTs.
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Aravind Model: A Mission To Eliminate Needless Blindness
G. Venkataswamy popularly known as ‘Dr V.’ was the founder and former chairman of Aravind Eye Hospitals. During his lifetime, Dr V introduced a number of innovative programmes to deal with the problem of blindness in India like outreach camps in eye care (1960) and a rehabilitation centre for the blind (1966). In recognition of his work in the fight against blindness, Dr, V received the Padmashree award in 1973 by the Government of India.
Upon his retirement from government service, Dr. V founded Aravind Eye Hospital as an 11-bed facility in 1976. Aravind, with its mission to ‘eliminate needless blindness’, provides large volume, high quality and affordable care. 50 per cent of its patients receive services either free of cost or at a steeply subsidised rate, yet the organisation remains financially self-sustainable. With ‘equity’ at its heart, the organisation ensures that all patients are accorded the same high quality care and service, regardless of their economic status.
Over 4.5 lakh eye surgeries or procedures are performed a year at Aravind, making it the largest eye care provider in the world. Since its inception, Aravind has handled more than 6 crore (65 Million) outpatient visits and performed more than 78 lakh (7.8 million) surgeries. The Aravind Eye Care System now serves as a model for India, and the rest of the world.
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India, The Pharmacy Of The World
Prime Minister Narendra Modi has described India as the pharmacy of the world as it sent much-needed medicines to scores of countries during the COVID-19 pandemic. While speaking at the First Global Innovation Summit of the Pharmaceuticals sector in 2021, PM Modi said,
Whether it is lifestyle, or medicines, or medical technology, or vaccines, every aspect of healthcare has received global attention over the last two years. In this context, the Indian pharmaceutical industry has also risen to the challenge. The global trust earned by the Indian healthcare sector has led to India being called the ‘pharmacy of the world’ in recent times.
He added, “Our definition of wellness is not limited by physical boundaries. We believe in the well-being of the entire humankind. And, we have shown this spirit to the whole world during the COVID-19 global pandemic.”
According to the annual report (2020-21) of the Department of Pharmaceuticals, Ministry of Chemicals and Fertilisers, the Indian pharmaceutical industry is the world’s third largest by volume and 14th largest in terms of value.
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Medicines And Treatment Made Affordable And Accessible
Not just this, India also offers quality generic medicines at affordable prices under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) launched by the Department of Pharmaceuticals. 1,616 drugs and 250 surgical items are available at a cheap rate across 8,012 Janaushadhi Kendras in India.
A medicine under PMBJP is priced on the principle of a maximum of 50 per cent of the average price of the top three branded medicines. Therefore, the price of Jan Aushadhi Medicines is cheaper at least by 50 per cent and in some cases, by 80 per cent to 90 per cent of the market price of branded medicines.
Padma Bhushan Dr Devi Shetty offers heart surgeries for as low as Rs 65,000. In 2001, Dr Shetty founded Narayana Hrudayalaya, the world’s largest heart hospital with over 1,000 beds, in Bommasandra, Bengaluru.
India has indeed achieved success in various health domains, but the right to health is still not a fundamental right. We have a long way to go and a lot more needs to be done to become a healthier nation.
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NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.