HEALTH AN INTEGRAL COMPONENT OF SOCIAL WELFARE, LEITMOTIF FOR THE GOVERNMENT

COMPREHENSIVE AND ‘LEAVE NO ONE BEHIND’ APPROACH GUIDING PRINCIPLES OF HEALTHCARE

ENSURING THE PROVISION OF QUALITY HEALTH FACILITIES TO CITIZENS -AN IMPORTANT PRIORITY FOR THE GOVERNMENT

INFANT MORTALITY RATE (IMR), UNDER FIVE MORTALITY RATE (U5MR) AND NEONATAL MORTALITY RATE (NMR) FOLLOW A STEADY DOWNWARD TREND

Health is an integral component of social welfare, leitmotif for the Government. Comprehensive and ‘leave no one behind’ approach form the guiding principles of healthcare, as per the Economic Survey 2022-23 tabled today in Parliament by Smt Nirmala Sitharaman, Union Minister for Finance and Corporate Affairs.  

Major initiatives from 2014 to 2022 for better overall health

The pre-budget Survey notes that ensuring the provision of quality health facilities to citizens is an important priority for the Government. Towards this objective, multidimensional initiatives have been launched and carried forward for better overall health of the citizens, as encapsulated below. Under the National Health Mission, the Government has made concerted efforts to engage with all relevant sectors and stakeholders to move in the direction of achieving universal health coverage and delivering quality healthcare services to all at affordable cost.

Improvement in health-related Indicators

The Economic Survey highlights that the Indian healthcare network is among the largest in the world. The results of an effective health approach are visible in the improvement in some of the important health-related indicators, as seen below.

	NFHS-4  (2015-16)	NFHS-5 (2019-21)
Households with any usual member covered under a health insurance/ financing scheme (per cent)	28.7	41.0
Total fertility rate (children per woman)	2.2	2.0
Current Use of Family Planning Method- Any Method (per cent)	53.5	66.7
Mothers who had at least 4 antenatal care visits (per cent)	51.2	58.1
Institutional births (per cent)	78.9	88.6
Neonatal mortality rate (per 1000 live births)	29.5	24.9
Infant mortality rate (per 1000 live births)	40.7	35.2
Under-five mortality rate (per 1000 live births)	49.7	41.9
Children age 12-23 months fully vaccinated based on information from either vaccination card or mother’s recall (per cent)	62.0	76.4
Children under age 6 months exclusively breastfed (per cent)	54.9	63.7
Children under 5 years who are stunted (height-for-age) (per cent)	38.4	35.5
Children under 5 years who are wasted (weight-for-height) (per cent)	21.0	19.3
Children under 5 years who are underweight (weight-for-age) (per cent)	35.8	32.1
Children under 5 years who are overweight (weight-for-height) (per cent)	2.1	3.4
Women who are overweight or obese (BMI≥25.0 kg/m2) (per cent)	20.6	24.0
Men who are overweight or obese (BMI≥25.0 kg/m2) (per cent)	18.9	22.9
Women age 15-24 years who use hygienic methods of protection during their menstrual period (per cent)	57.6	77.3

Source: National Family Health Surveys (NFHS) 2015-16 and 2019-21, MoHFW

With concerted efforts made under the Reproductive, Maternal, New-born, Child, Adolescent Health Plus Nutrition (RMNCAH+N) strategy, India has made considerable progress in improving the health status of both mothers and children. As per the Sample Registration System (SRS) data, India has successfully achieved the major milestone to bring the Maternal Mortality Ratio (MMR) to below 100 per lakh live births by 2020 (laid down in National Health Policy 2017) by bringing it down to 97 per lakh live births in 2018-20 from 130 per lakh live births in 2014-16. Eight states have already achieved the SDG target to reduce MMR to less than 70 per lakh live births by 2030. These include Kerala (19), Maharashtra (33), Telangana (43) Andhra Pradesh (45), Tamil Nadu (54), Jharkhand (56), Gujarat (57), and Karnataka (69).

Following a steady downward trend, Infant Mortality Rate (IMR), Under Five Mortality Rate (U5MR) and Neonatal Mortality Rate (NMR) have further declined as a result of countrywide efforts towards increasing health service coverage through strengthening of service delivery; quality assurance; RMNCAH+N; human resources, community processes; information and knowledge; drugs and diagnostics, and supply chain management, etc.

Trends in Mortality indicators

	2014	2016	2018	2020
Maternal Mortality Ratio (per lakh live births)	167 (2011-13)	130 (2014-16)	113 (2016-18)	97 (2018-20)
Infant Mortality Rate (per 1000 live births)	39	34	32	28
Neonatal Mortality Rate (per 1000 live births)	26	24	23	20
Under 5 Mortality Rate (per 1000 live births)	45	39	36	32
Early Neonatal Mortality Rate – 0- 7 days (per 1000 live births)	20	18	18	15

Source: Sample Registration System

Health as an integral social welfare priority: strengthening universal coverage and programme delivery to reduce mortality and expand access. Health is an integral component of social welfare and a central government priority pursued through a comprehensive, 'leave no one behind' approach. The Government advances this objective via the National Health Mission and related programmes, strengthening service delivery, quality assurance, human resources, supply chains and information systems to expand outreach and affordability. Concentrated efforts under the RMNCAH+N strategy, together with improved antenatal care, institutional births, immunisation and nutrition interventions, are presented as the mechanisms driving reductions in maternal, neonatal, infant and under-five mortality and gains in health coverage indicators.