Human resource development has three components — health, education and income or living standards. These are assessed in 187 countries and published annually by the United Nations Development Programme (UNDP). In its latest report Norway, Australia, Switzerland, Netherlands and USA figure in the top five countries while India, ranked at 135, figures among medium developed nations.
Health is the most crucial of the three parameters as a healthy population can be an asset and strengthen the overall human resource. India spends about one per cent of its GDP on public health care, compared to China’s 3 per cent , Brazil's 4.1 and the USA's 8.3. The allocation in the 2015-16 budget of Rs 33,152 crore is a marginal increase over the previous budget.
Health and Family Welfare is on the concurrent list of the Constitution with both Centre and State governments having responsibility to implement policies for improving the standard of community health. The national health policy for 2015 highlights the resource crunch as one significant factor for the failure to attain minimum levels of public health.
There are three stages in health care: primary, secondary and tertiary. Primary health care denotes the first level of contact between a citizen and the health care system. In rural areas primary health centres (PHC) and in urban areas health posts and family welfare centres provide medical service. The PHC is headed by a medical officer assisted by paramedical staff, and serves about 30,000 population. Each PHC supervises six subcentres that have an auxiliary nurse, a midwife and multi-purpose health workers to serve about 5,000 rural population.
Secondary health care consists of district hospitals and community health centres at the block level where patients are referred from PHCs for specialist treatment. Tertiary health care refers to the third level in the health care system in which specialised diagnostic and consultative care is provided on referral from primary and secondary medical care. Medical colleges and medical research institutions are part of tertiary health care .
The World Health Organisation has fixed one doctor for 1,000 population as the standard norm. In India the ratio is one for 1,800 population. Sixty years ago we had 47,524 medical officers with a ratio of one to 6,300 but now registered medical practitioners number 8.4 lakh, which has improved the doctor to population ratio threefold. The Medical Council of India under the Ministry of Health ensures quality medical education and has approved 412 medical colleges in India, which provide 52,225 medical seats to aspiring students.
Six lane highway link most of the major cities in the country. With increase in mobility road accidents have become a nightmare, with mangled victims and vehicles strewn on our highways. Annually in India about 1.4 lakh people, mostly youngsters, die in road mishaps. Trauma care and immediate accident relief is a priority and the government has strengthened the emergency relief in important hospitals. 108 (the emergency telephone number) is free for emergency services in India, currently operational in nineteen States. The 108 Emergency Response Service is a free emergency service providing integrated medical, police and fire emergency services. The service is a public-private partnership between State governments and private EMS providers. As of November 2014 this service had handled over 5.4 lakh emergency cases in India. For any emengency call the ambulance toll free 108 or 103 number.
Infant mortality is an important indictor of how we take care of our children. The 2015 Infant Mortality Rate (IMR), infants dying within a year of birth for every 1000 births, is 40 in India while the global figure is 32.
Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births. This is 190 in India.
Malnutrition among children is a huge problem and close to 45 per cent of children under five years of age are malnourished. Malnutrition leads to stunted growth and poor brain development. Due to poor brain development the cognitive skills are impaired, resulting in significant school drop out. Malnutrition is not just about stunted growth of children but the more serious issue of premature death due to malnutrition.
In 1975 the Central government launched the Integrated Child Development Scheme (ICDS) for concerted action to develop children. Its objectives are:
a)to improve the health status of children in the age-group 0-6 years;
b)to lay the foundation for proper psychological, physical and social development of the child;
c)to reduce the incidence of mortality, morbidity, malnutrition and school dropout;
d)to achieve effective co-ordination of policy and implementation amongst the various departments to promote child development; and
e)to enhance the capability of the mother to look after the normal health and nutritional needs of the child through proper nutrition and health education.
These objectives are sought to be achieved through a package of services like immunisation, health checks and referral services, delivered through the public health infrastructure under the Ministry of Health & Family Welfare.
Pre-school and non-formal education is implemented at the grass-root level through anganwadi centres (AWC) established in all villages. This is the backbone of the effort to impart health and hygiene education in the formative age of one to six years and to sensitise lactating mothers. There are over 1.5 million centres, covering almost every village in India.
Sanitation is another problem that results in malnutrition. Open defecation breeds harmful bacteria that affect the intestines, preventing nutrients from being absorbed. This cyclic effect gives rise to a multiplicity of diseases that damage the immune system. Annually nearly two lakh children die of diarrhoea. Swastha and swachh — health and cleanliness — have to go together to build a healthy India, which alone can give the much needed strength to our young working hands.