KARNATAKA - of Planning Commission

CHAPTER 6Demography, Health and NutritionIntroductionGood health is an invaluable asset for bettereconomic productivity, both at the individual andnational level, but above all, it is valued by thosewho own it as a prerequisite for a better quality oflife and better standards of living. Sub-populationswho are at the highest risk from poor health andits effects on longevity and morbidity are the poor,women, the Scheduled Castes and Scheduled Tribes.The main reasons for the high level of vulnerabilityof these sub-groups are, fi rst, the inaccessibility ofhealthcare, and second, their inability to spend onhealthcare interventions. Public healthcare systemsmust, therefore, provide that critical barrier betweenill-health and the ones who are most vulnerable,but here too, factors such as fi nancing and effi ciencygreatly infl uence the quality and coverage of publichealthcare services.The health scenario in Karnataka today is acombination of achievements and challenges.Signifi cant advances have taken place in healthand healthcare services over the past decade. Abrief review of the key demographic indicators thatoffer a reliable overview of the status of health inKarnataka suggest that the state’s performance ismuch better than the all-India average. The state’spopulation increased from 4.49 crore in 1991 to5.27 crore in 2001. A comparison of the decadalgrowth of population shows a signifi cant declinefrom 21 per cent between 1981-91 to 17.5per cent in 1991-2001. Life expectancy at birthhas increased to about 66 years in 2001. Infantand maternal mortality are among the mostreliable indicators for assessing health status, andKarnataka’s performance here, as in reducingneonatal mortality, child mortality and maternalmortality rates – all of which show a downwardtrend – is better than the aggregated fi gures forthe whole of India (Table 6.1). In fact, Karnatakais well on its way to achieving the Tenth Planobjective of reducing MMR to 2 per 1000 birthsby 2007. Institutional deliveries now account for51 per cent of total deliveries, compared with 34per cent for all-India. Small pox has beeneradicated; the state is free from plague andguinea worm and the incidence of polio has beenconsiderably reduced. A widespread infrastructureof health and medical institutions comprisingprimary health centres offering basic services tostate-of-the-art super-speciality hospitals witha national, and even international reputation, isnow in place.There are, however, some challenges which the statewill have to confront with aggressive strategies.Rural-urban disparities, far from diminishing, haveonly intensifi ed: for example, the infant mortalityrate (IMR) is 64 in rural areas as compared with24 in urban areas (2004). There are noticeableregional disparities in spite of overall improvementsin the various health indicators. The fi ve districts ofnortheast Karnataka – Gulbarga, Bidar, Koppal,Raichur and Bellary – and two districts of northwestKarnataka – Bagalkot and Bijapur – have worsehealth indicators than the rest of the state. Thehealth status of the Scheduled Castes and Tribes iscause for serious refl ection because it is so distancedfrom the health status of the total population.Under-nutrition among pregnant women andinfants continues to take its toll. The incidenceof communicable diseases such as tuberculosis,malaria and intestinal infections is still relativelyhigh. Now the state must confront HIV/AIDS andthe very human issues it brings to the fore. Lifestylerelatedailments like diabetes, heart disease, andcancer are also registering an unwelcome increase.Certain preventable health problems continue toState/CountryTABLE 6.1Some demographic indicatorsDecennial population growth(1991-2001)Good health is aninvaluable asset forbetter economicproductivity, both at theindividual and nationallevel, but above all, it isvalued by those who ownit as a prerequisite for abetter quality of life andbetter standards of living.IMR NNM CMR MMR LEBKarnataka 17.5 52 37.1 19.3 195/lakh 65.8All-India 21 60 43.4 29.3 407/lakh 64.8Sources:1. Registrar General of India, Census 2001.2. National Family and Health Survey-2, IIPS, Mumbai, 1998-99.3. Registrar General of India, Sample Registration System, SRS bulletin, volume 39 (1), April 2005.129