Health Scenario

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Aust. J. Rural Health (2002) 10, 129–135

Blackwell Science, Ltd

Original Article

Ashok Vikhe Patil,1 K. V. Somasundaram2 and R. C. Goyal2
Association of Agricultural Medicine and Rural Health and 2Department of Community Medicine, Rural Medical College of Pravara Medical Trust, Maharashtra, India 1International

ABSTRACT: India is the second most populous country of the world and has changing socio-politicaldemographic and morbidity patterns that have been drawing global attention in recent years. Despite several growthorientated policies adopted by the government, the widening economic, regional and gender disparities are posing challenges for the health sector. About 75% of health infrastructure, medical man power and other health resources are concentrated in urban areas where 27% of the population live. Contagious, infectious and waterborne diseases such as diarrhoea, amoebiasis, typhoid, infectious hepatitis, worm infestations, measles, malaria, tuberculosis, whooping cough, respiratory infections, pneumonia and reproductive tract infections dominate the morbidity pattern, especially in rural areas. However, non-communicable diseases such as cancer, blindness, mental illness, hypertension, diabetes, HIV/ AIDS, accidents and injuries are also on the rise. The health status of Indians, is still a cause for grave concern, especially that of the rural population. This is reflected in the life expectancy (63 years), infant mortality rate (80/1000 live births), maternal mortality rate (438/100 000 live births); however, over a period of time some progress has been made. To improve the prevailing situation, the problem of rural health is to be addressed both at macro (national and state) and micro (district and regional) levels. This is to be done in an holistic way, with a genuine effort to bring the poorest of the population to the centre of the fiscal policies. A paradigm shift from the current ‘biomedical model’ to a ‘sociocultural model’, which should bridge the gaps and improve quality of rural life, is the current need. A revised National Health Policy addressing the prevailing inequalities, and working towards promoting a long-term perspective plan, mainly for rural health, is imperative. KEY WORDS: commercialisation of health, communicable diseases, health infrastructure, health policy, health seeking behaviour, rural health.

India is drawing the world’s attention, not only because of its population explosion but also because of its prevailing as well as emerging health profile and profound political, economic and social transformations. After 54 years of independence, a number of urban and growth-orientated developmental programs having Correspondence: Dr Ashok Vikhe Patil, President: International Association of Agricultural Medicine and Rural Health, c/o Pravara Medical Trust, Loni 413 736, Ahmednagar District, Maharashtra, India. E-mails: or Accepted for publication January 2002.

been implemented, nearly 716 million rural people (72% of the total population), half of which are below the poverty line (BPL) continue to fight a hopeless and constantly losing battle for survival and health. The policies implemented so far, which concentrate only on growth of economy not on equity and equality, have widened the gap between ‘urban and rural’ and ‘haves and have-nots’. Nearly 70% of all deaths, and 92% of deaths from communicable diseases, occurred among the poorest 20% of the population. However, some progress has been made since independence in the health status of the population; this is reflected in the improvement in some health indicators. Under the cumulative impact of various measures and a host of national programs for livelihood, nutrition and



shelter, life expectancy rose from 33 years at Independence in 1947 to 62 years in 1998. Infant...
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