India at 60 – A Public Health Perspective

Well, at least I don’t have to take part in endless parades and listen to speeches any more. But India turned 60 today, and the head of the Indian public health foundation takes stock, and it is sobering.

The Hindu : Persisting public health challenges

Recent health indicators in India are a cause for both celebration and concern. While life expectancy at birth has risen to 63 years, infant mortality rate (IMR) and maternal mortality rate (MMR) are still at unacceptably high levels (57 per 1000 and 301 per 100,000 live births respectively). There is widespread disparity among States with Kerala being the star performer. Within States, the rural areas are way behind the urban segments. Even as our economy has grown rapidly, the nutritional status of children has remained stunted, suggesting that wide income disparities are preventing the poor from becoming the beneficiaries of growth.

Yes, I be the killjoy.

More from Amartya Sen

There is reason enough to celebrate many things happening in India right now. But there are failures as well, which need urgent attention. For example, there is still widespread undernourishment in general and child undernutrition in particular–at a shocking level. The failures include, quite notably, the astonishing neglect of elementary education in India, with a quarter of the population–and indeed half the women–still illiterate.

The average life expectancy in India is still low (below 64) and infant mortality very high (58 per 1,000 live births). It is certainly true that India has narrowed the shortfall behind China in these areas–that is, in life expectancy and infant mortality–but there is still some distance to go for the country as a whole. The problems are gigantic in some of the more “backward” states like Bihar and Uttar Pradesh. And yet there are other states in which the Indian numbers are similar to China’s.

he goes on…

If India has to overcome these failures, it has to spend much more money on expanding the social infrastructure, particularly school education and basic health care. It also needs to spend much more in building up a larger physical infrastructure, including more roads, more power supplies and more water. In some of these, the private sector can help. But a lot more has to be spent on public services themselves, in addition to improving the system of delivery of these services, with more attention paid to incentives and disciplines, and better cooperation with the unions, consumer groups and other involved parties.

Ah, basic and boring infrastructure building!

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