Health Policy Issues and Health Programmes in ... - Amazon S3

Public Health Issues, Priorities, and the Role of the GovernmentTable 5. Health Status Indicators: Comparison Between the Poorest and Richest Quintiles ofthe Indian Population, 1992/93Scheduled Scheduled Other OtherCaste Tribes DisadvantagedClassIMR (per 1,000 births) 83.0 84.2 76.0 61.8Under-five mortality rate (U5MR)(per 1,000 births) 119.3 126. 103.1 82.6Total fertility rate (TFR) 3.15 3.06 2.83 2.66Children underweight(% below 2 standard deviations) 53.5 55.9 47.3 41.1Children with anaemia (%) 78.3 79.8 72.0 72.7Children with acute respiratoryinfection in past 2 weeks (%) 19.6 22.4 19.1 18.7Children with diarrhoea in past 2 weeks (%) 19.8 21.1 18.3 50.7Anaemia among women (%) 56.0 64.9 50.7 47.6Table 6. Effectiveness: Health Outcomes by Income Quintiles, Urban IndiaPoorest Second Middle Fourth RichestIMR 121.2 94.2 85.1 67.1 41.9U5MR 143.6 141.6 119.5 90.0 51.5Children underweight (% moderate) 74.3 61.5 56.3 52.5 34.5Children underweight (% severe) 30.9 32.4 21.9 18.9 11.3TFR (4.3) 3.5 3.2 2.9 2.1Table 7. Effectiveness: Health Outcomes by Income Quintiles, Rural IndiaPoorest Second Middle Fourth RichestIMR 108.9 107.2 90.3 64.9 51.3U5MR 155.0 153.8 119.5 85.4 63.9Children underweight (% moderate) 59.5 59.3 55.1 45.0 33.8Children underweight (% severe) 29.0 25.9 21.2 15.3 9.6TFR 4.1 3.6 3.2 2.8 2.2Calcutta Declaration of Public HealthThe Regional World Health Organization Conference in 2000 recognized that public health is thekey to human development and that health systems need to be strengthened and integratedwith other development sectors. Some of the key statements (given below) made in thedeclaration indicate a strong need for public health.l Promote public health as a discipline and as an essential requirement for healthdevelopment in the region. In addition to addressing the challenges posed by ill-health andpromoting positive health, public health should also address issues related to poverty,equity, ethics, quality, social justice, environment and community development andorganization.l Recognize the leadership role of public health in formulating and implementing evidencebasedhealthy public policies; creating supportive environments; enhancing social17