India’s Health Profile and Key Indicators: How is the World’s Second Most Populated Country doing in terms of Health?
Snapshot of India’s GDP, population, and healthcare expenditure
India is amongst the top 4 fastest growing economies in the world, with a growth rate of 7.1% in 2017, and an expected 7.8% in 2018. It is the 6th largest economy worldwide, and the 3rd largest by purchasing power parity (PPP).
With 1.343 bn inhabitants, India has the second largest population worldwide, which is around 70,000 residents less than China. 75-80% of the working population is employed in the informal, or unorganized sector, excluding them from social welfare and healthcare benefits issued through Central Government programs.
India’s healthcare (HC) expenditures were €110.4 bn in 2017, or 5% of the GDP. As a percentage of GDP this expenditure is forecasted to increase slightly in 2018, amounting to over €123 bn spent on healthcare. With €82/capita spent on healthcare, it spends averagely for its region, but dramatically less than central European nations, e.g. Belgium spends €4,107/capita.
About 33.5% of all healthcare funding is provided by Central and State Governments; the rest comes from private sources and Out-of-Pocket patient payments.
India spends around 20.4% of its total healthcare expenditure on pharmaceuticals, medical consumables, devices and capital equipment.
Mortality and life expectancy
Infant mortality in India is close to 35 deaths per 1000 live births, an alarmingly high rate. The infant mortality rate can vary greatly between the different states, for example, infant mortality in Kerala is as low as 12/1000, in comparison to 56/1000 in Assam.
India’s total life expectancy is around 69 years old. India has achieved great improvements in terms of life expectancy in the last 5 decades. However, its life expectancy is low in correlation to the economic progress that it has made in the same period.
It has a birthrate of 18.8/1000 population. India has one of the highest counts of maternal deaths amongst developing economies worldwide (only several African countries record higher maternal deaths annually).
Interesting to note, disability-adjusted life years (DALYs) lost due to injuries, have increased over the last 20 years by 3%. In most developing economies this cause of morbidity or mortality generally decreases with time, rather than increase.
High children death- and stunted growth rates
Due to overall structural shortcomings in the Indian healthcare system, poor and unhygienic home conditions, high infectious disease prevalence, and poverty-driven undernourishment– there are a plethora of serious HC threats to the youngest and weakest of India’s population.
India ranks amongst the worst performing nations internationally for under-5 mortality rates.
India ranks first for having the largest population of children with stunted growth, which is directly attributed to chronic malnutrition. The deficiencies in primary and tertiary care (as well as the insufficiencies in social welfare schemes) are unable to provide adequate care for these children. There are studies correlating stunted growth to losses in economic productivity; children with stunted growth are less likely to succeed in the labour market, which drives the negative spiral of needing social support, being exposed to health risks, needing but unable to obtain affordable HC, etc.
According to a World Bank study, stunted adults earn 20% less, and there is a total average loss in economic productivity of 1.4%.
Top causes of death
From 1990 up to 2016, deaths attributed to non-communicable diseases increased by 24%, and now account for close to 62% of all deaths.
Diarrhoeal diseases are the second most common cause of death in India; unquestionably due to the large shares of the population living in rural areas with extremely poor to no sanitation networks and lack of food-hygiene awareness.
A significant share of the disease burden in India is attributed to its lack of clean drinking water, inadequate sanitation and generally poor public health services, which facilitate the breeding and spreading of infectious diseases.
Blood transfusions, lack of disease awareness, and poor living conditions, particularly for the youngest of the population and those living in rural areas, are also significant causes of the spread of diseases, morbidity and mortality.
Nonetheless, the general trend is positive, and from 1990 to 2016, communicable diseases decreased by 26%.
Communicable disease numbers:
- Tuberculosis –In 2016, 0.92/100,000 suffered a TB related death (including HIV cases), with an incidence rate of 6.6/100,000. Total notified cases in 2016 were 1,936,00, of which 1,764,000 were new or relapsed, and 84% were pulmonary. TB treatment coverage is 63%.
- HIV – Around 2,100,000 adults and children are living with HIV in India and in 2016, there were 80,000 new infections. In the last 7 years, HIV infection has decreased by 46% and AIDS-related deaths decreased by 23%. Antiretroviral treatment coverage is 49%
In order of prevalence, the most common communicable diseases in India are:
- Malaria (95% of the Indian population lives in a malaria-risk area)
- Typhoid (prevalence varies throughout India from 100 to 2,220/100,000 population)
- Diarrhoeal diseases
- Hookworm infection
Life-style related indicators
- Tobacco – In 2016, 20.4% of males in India smoke, and 1.9% of females. These rates, when compared to similarly developed economies, are slightly lower than average. Amongst males, tobacco-related deaths represent 13% of mortalities, and 5.3% of deaths amongst females.
- Alcohol – Total alcohol consumption per capita (ages 15 and over) is 4.5 l (pure alcohol). This is relatively low on an international scale. On average, males consume 16 times more than females. Alcohol disorders including dependency is estimated at 2.2%, this is slightly higher than the South-East Asia regional average.
- Obesity – Around 5% of the population is considered obese. Women are twice as likely to suffer from obesity. 21% of the population is clinically overweight.
- Diabetes – Prevalence in 2016 was recorded at 7.8%; one of the lower rates in Asia.
- Child malnutrition – A WHO report dating 2015, states that 37% of India’s children are undernourished and 40% are too short for their age due to malnutrition. Around 20% of under 5-year-olds weigh too little for their height. India has highest rate of stunted children worldwide and this is a substantial burden upon the life quality of the individual, their health, and the potential of the population accordingly. There is a 10% difference in child malnutrition prevalence between urban and rural populations.
- Underweight adults – Poverty and malnutrition has also taken its toll on adult populations, and currently around 20% of adult males are categorized as undernourished; the majority share of this underweight population lives in rural settings.
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About Laura Weynants
Performs primary and secondary market research to create country reports at TforG. Interviews KOLs and medical sector professionals to build on TforG’s healthcare market expertise and competence networks. Complementing five years of sustainability policy and CSR communication, she now focuses on grasping key medical market trends, structures and opportunities in medical sectors worldwide. Coming from an international background of living in Germany, Spain, USA, UK and Belgium, she has gained a keen insight in international organizations and language skills to perform first hand investigations. She graduated from Sussex University Brighton, UK with a BA English Literature and Sociology and achieved a Master Degree in Sustainability and Corporate Social Responsibility in EOI Business School in Madrid, Spain.