HEALTH STATUS OF INDIA

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Health situation in India

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Health Status of India Dr. Muhammedirfan H. Momin Assistant Professor Community Medicine Department Government Medical College, Surat.

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5,000 year old ancient civilization 325 languages spoken 18 official languages > 1 Billion population. Worlds largest democracy. DR IRFAN MOMIN

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Largest English speaking nation in the world . 3 rd largest standing army force 2 nd largest pool of scientists and engineers in the World. DR IRFAN MOMIN

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India is a union of 28 states and 7 union territories. DR IRFAN MOMIN

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DR IRFAN MOMIN

Urban and Rural Population in Gujarat in 2011:

Urban and Rural Population in Gujarat in 2011 DR IRFAN MOMIN

The Measurement of Health Status:

The Measurement of Health Status Disease Frequency Cases Prevalence rate Incidence rate Deaths Case Fatality Rate Disability adjusted life years: Years of life lost to premature death and years lived with disability adjusted for the severity of the disability. One DALY is one lost year of healthy life. DR IRFAN MOMIN

The Measurement of Health Status:

The Measurement of Health Status Disease Distribution By time, place person Seasons, geographic area and age, sex, caste, religion, ethnicity etc. Determinants of Disease DR IRFAN MOMIN

Human Development Index (HDI):

Human Development Index (HDI) Life expectancy at birth. Education index. GDP index. DR IRFAN MOMIN

Human Development Index (HDI) - 2011 Rankings:

Human Development Index (HDI) - 2011 Rankings Very High Human Development 01-47 High Human Development 48-94 Medium Human Development 95-141 Low Human Development 142-169 1 = Norway 4 = United States 101 = China 134 = India 187 = Congo DR IRFAN MOMIN

Health Problems Classification:

Health Problems Classification Communicable diseases Non Communicable diseases Nutritional problems Environmental Sanitation Medical Care problem Population Problems DR IRFAN MOMIN

Demographic issues or population problems:

Demographic issues or population problems Population-1,21 ,01,93,422 Density of population – 382 per sq.km. 17.5% of world population is in India. DR IRFAN MOMIN

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DR IRFAN MOMIN

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Gujarat Population – 6,03,83,628 (5% of India) Density – 308 per sq. km. Gujarat 10 th on population 26 Districts DR IRFAN MOMIN

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Total Rural Urban Birth Rate 1 22.5 24.1 18.3 Death Rate 1 7.3 7.8 5.8 Natural Growth Rate 1 15.2 16.3 12.5 Infant Mortality Rate 1 50 55 34 Sex-ratio 940 947 926 Population in 0-6 age group 13.12 14.11 10.93 Child sex-ratio 914 919 902 Literacy rate 74.04 68.91 84.98% India (1=SRS 2011) DR IRFAN MOMIN

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Total Rural Urban Birth Rate 1 22.3 23.8 19.9 Death Rate 1 6.9 7.7 5.6 Natural Growth Rate 1 15.4 16.1 14.3 Infant Mortality Rate 1 48 55 33 Sex-ratio 918 947 880 Population in 0-6 age group 12.41 13.49 10.96 Child sex-ratio 886 906 852 Literacy rate 79.31 73 87.58 Gujarat (1=SRS 2011) DR IRFAN MOMIN

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Statistics for Surat Municipal Corporation *CENSUS 2011 Surat City SEX RATIO 758 / 1000 Male* CHILD SEX RATIO 813 / 1000 Boys* CRUDE BIRTH RATE 18.25 / 1000 population CRUDE DEATH RATE 4.37 / 1000 population INFANT MORTALITY RATE 16.08 / 1000 live births MATERNAL MORTALITY RATE 0.41 / 1000 live births LITERACY RATE 89.03 %* MALE 92.76 %* FEMALE 84.05 %* DR IRFAN MOMIN

States literacy rate 2011:

States literacy rate 2011 DR IRFAN MOMIN

Sex ratio:

Sex ratio DR IRFAN MOMIN

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DR IRFAN MOMIN

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Sex-ratio (Adult) - 940 DR IRFAN MOMIN

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Sex-ratio India - 940 Gujarat – 918 Surat Dist-788 Surat city– 758 Sex-ratio at 0-6 age group India – 914 Gujarat – 886 Surat city- 813 DR IRFAN MOMIN

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Sex-ratio (0-6 yrs) - 914 DR IRFAN MOMIN

Sex-ratio 2011 :

Sex-ratio 2011 DR IRFAN MOMIN

Child (0-6years) Sex-ratio 2011:

Child (0-6years) Sex-ratio 2011 DR IRFAN MOMIN

Sex Ratio & Child Sex-Ratio:

Sex Ratio & Child Sex-Ratio DR IRFAN MOMIN

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Rank in 2011 District Sex- ratio Rank in 2001 2011 2001 01 The Dangs 1007 987 02 02 Tapi 1004 996 01 03 Dohad 986 985 04 24 Kachchh 907 942 10 25 Ahmadabad 903 892 25 26 Surat 788 810 26 DR IRFAN MOMIN

The Measurement of Health Status :

The Measurement of Health Status Maternal mortality rate The number of women who die as a result of childbirth and pregnancy related complications per 100,000 live births in a given year DR IRFAN MOMIN

Maternal Mortality Ratio:

Maternal Mortality Ratio India – 212 per 1,00,000 live births Gujarat – 148 per 1,00,000 live births Source – Special bulletin on MMR in India (SRS) June 2011 DR IRFAN MOMIN

The Measurement of Health Status:

The Measurement of Health Status Infant mortality rate The number of deaths in infants under 1 year per 1,000 live births for a given year DR IRFAN MOMIN

Infant Mortality Rates:

DR IRFAN MOMIN Infant Mortality Rates 6 11 27 64 79 65 57 57 India LDC MDC Bangladesh Pakistan Nepal Sri Lanka China

Infant Mortality Rate:

DR IRFAN MOMIN Infant Mortality Rate

Marital Status:

DR IRFAN MOMIN Marital Status Percent of women age 20-24 married by age 18 NFHS-3

Desire for No More Children among Women with 2 Children:

DR IRFAN MOMIN Desire for No More Children among Women with 2 Children

Diseases:

Diseases DR IRFAN MOMIN

Leading contributor in global diseases:

Leading contributor in global diseases 1990 1.Lower Rasp. Infec . 2.Diarrhoea 3.Prenatal condition 4.Unipolar major depression 5.IHD 6.Stroke 7.TB /HIV 8.Measles 9.Road traffic Injury 10.Congenital 2020 1.IHD 2.Major Depression 3.Road Traffic Injury 4.Stroke 5.COPD 6.Lower Resp. Inf. 7.TB 8.Perinatal condition 9.Diarrhea Diseases 10.HIV DR IRFAN MOMIN

Top ten risk factors leading to Disease, Disability or Death:

Top ten risk factors leading to Disease, Disability or Death Underweight Unsafe sex Unsafe water & sanitatio Indoor smoke & solid fuels Zinc Deficiency Iron Deficiency Vitamin A Deficiency High blood pressure Tobacco use High cholesterol Tobacco High blood pressure Alcohol High cholesterol High BMI Low Fruits and Veg Intake Physical inactivity Illicit Drugs Unsafe sex Iron Deficiency Poorest countries Developed countries DR IRFAN MOMIN

Trends in Global Deaths 2002-30:

Trends in Global Deaths 2002-30 Source: World Health Statistics 2007 DR IRFAN MOMIN

Major causes of death in children under 5 with disease-specific contribution of undernutrition:

Major causes of death in children under 5 with disease - specific contribution of undernutrition DR IRFAN MOMIN

COMMUNICABLE DISEASES:

COMMUNICABLE DISEASES DR IRFAN MOMIN

Diseases Eradicated:

Diseases Eradicated Small pox Guinea worm Polio DR IRFAN MOMIN

Small pox:

Small pox It was endemic in 33 countries in 1967 The last indigenous case in India occurred on 17 th may 1975 in Bihar. In April 1977 India was declared small pox free. The worlds last case occurred in Somalia (Africa) on 26 October 1977. The WHO declared on 8 May 1980 that small pox has been eradicated. DR IRFAN MOMIN

Guinea worm or Dracunculosis :

Guinea worm or Dracunculosis Zero Incidence has been maintained since August 1996 in India In February 2000, India has been certified by WHO for the elimination of Guinea worm Disease and on 15 th February 2001 WHO declared India as “Guinea worm Disease free”. DR IRFAN MOMIN

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Wild poliovirus cases, India P1 wild P3 wild * data as on 2 March 2012 1 WPV case in 2011 compared to 42 in 2010

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WPV1 cases, India, 1998 - 2011 Year * data as on 2 March 2012

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Location of wild poliovirus cases by type, India Onset of paralysis - 13 January Howrah, West Bengal * data as on 2 March 2012 2011* DR IRFAN MOMIN

Polio:

Polio Last case occurred in 13 th January 2011 in West Bengal. DR IRFAN MOMIN

Disease does not occur in India:

Disease does not occur in India Yellow Fever DR IRFAN MOMIN

Communicable Diseases:

Communicable Diseases Malaria Tuberculosis Leprosy Diarrhea ARI HIV DR IRFAN MOMIN

Malaria:

Malaria Cases 1.52 million (0.12%) Deaths 924 PF % 49.56 DR IRFAN MOMIN

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DR IRFAN MOMIN

Tuberculosis :

Tuberculosis Global Rank 1 Incidence ( all cases) 170 /100,000/year Incidence ( new sp) 75 /100,000/year Prevalence ( all cases) / 100,000 (0.18 %) TB mortality 24 /100,000/ year % of New Cases MDR 2 DR IRFAN MOMIN

Diarrhea :

Diarrhea Pathogen % of Cases Viruses Rotavirus 15-25 Bacteria Escherichia coli 10-20 Shigella 5-15 Compylobactor jejuni 10-15 Vibrio Cholerae 01 5-10 Salmonella 1-5 Protozoans Cryptosporidium 5-15 No Pathogen found 20-30 DR IRFAN MOMIN

Cholera:

Cholera Cases 3482 Deaths 12 Case Fatality Rate 0.34% DR IRFAN MOMIN

Typhoid Fever:

Typhoid Fever Endemic in India Cases 1.03 million ( 10 lac ) Deaths 421 DR IRFAN MOMIN

Amoebiasis:

Amoebiasis Prevalence 15% DR IRFAN MOMIN

Hookwarm Infection:

Hookwarm Infection Heavily infected areas are Assam, West Bengal, Bihar, Orissa, Andhra Pradesh, Tamilnadu , Kerala, Maharashtra. More than 200 million people are infected in India DR IRFAN MOMIN

Dengue Haemorrhagic Fever:

Dengue Haemorrhagic Fever CASES 15,509 DEATHS 89 DR IRFAN MOMIN

Japanese Encephalitis:

Japanese Encephalitis Cases 4482 Deaths 774 DR IRFAN MOMIN

Leptospirosis:

Leptospirosis Occurs in South Gujarat, Kerala, Maharashtra, Andaman Nicobar. DR IRFAN MOMIN

Plague :

Plague Epidemic in 1994 in Surat Epidemic in 2004 in Uttarakashi DR IRFAN MOMIN

Tetanus:

Tetanus Cases 2051 Deaths 160 DR IRFAN MOMIN

Neonatal Tetanus:

Neonatal Tetanus Cases 889 Deaths 31 DR IRFAN MOMIN

Global Leprosy Situation:

Global Leprosy Situation LEPROSY HAS BEEN ELIMINATED FROM THE WORLD DR IRFAN MOMIN

Leprosy: 6 top countries:

Leprosy: 6 top countries 6 top endemic countries: India, Brazil, Myanmar, Madgascar , Mozambique, Nepal contribute 85% of global case load: (69% from India) • 91% of global case new cases (81% from India) DR IRFAN MOMIN

Leprosy:

Leprosy India achieved leprosy elimination in December 2005 By the end of march 2009, prevalence rate of Leprosy was 0.72 cases per 10,000 population. DR IRFAN MOMIN

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Trend of Leprosy Prevalence & Annual New Case Detection (ANCDR) Rates DR IRFAN MOMIN

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Five endemic states are as follows: 1. Bihar 2. Chattisgarh 3. Jharkhand 4. Chandigarh 5. West Bengal DR IRFAN MOMIN

State wise Contribution New Leprosy Cases - year 2007-08:

State wise Contribution New Leprosy Cases - year 2007-08 Contribution by six states 20.8% pop & 34.5% new cases DR IRFAN MOMIN

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Navsari Valsad – 2. 18 Dang – 4.26 Surat - 1. 39 Narmada - 1.26 Bharuch Vadodara – 1.10 PM 2.22 Dahod- 2.25 P.R.- 0.87 2.77 2. 04 Endemicity of Leprosy – March.09 > 5 2 - 3 1 - 2 < 1 P.R. 3 - 5 Gujarat achieved elimination as on Oct-04 DR IRFAN MOMIN

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DR IRFAN MOMIN

Situation in Surat::

Situation in Surat: Leprosy not eliminated from Surat The prevalence rate 1.44 The new case detection rate 2.57 in the year 2006. Male:female ratio as 58:42 (2006). Child cases among new cases of leprosy 12.8% (2006). Multibacillary cases among new cases 50.1%, 2006. Grade II disability 1.38% (2006). DR IRFAN MOMIN

HIV:

HIV Provisional estimates shows there are 22.7 lakh people living with HIV /AIDS. Estimated adult HIV Prevalence rate is 0.28 % DR IRFAN MOMIN

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DR IRFAN MOMIN Sex Women (%) Men (%) Total (%) Urban Rural 0.29 0.18 0.41 0.32 0.35 0.25 India 0.22 0.36 0.28 HIV Prevalence by Residence and Sex, India HIV prevalence rate is 60% higher among males than females and 40% higher in urban areas than rural areas

HIV:

HIV High Prevalence states are Maharashtra, Tamilnadu , Karnataka, Andhra Pradesh, Manipur Nagaland. DR IRFAN MOMIN

HIV:

HIV Groups Prevalence IDU 9.2 MSM 7.4 FSW 4.9 Migrants 3.6 Truckers 2.5 STD 2.5 ANC 0.5 DR IRFAN MOMIN

AIDS Awareness:

DR IRFAN MOMIN AIDS Awareness Percent of women and men age 15-49 who have heard of AIDS Women Men

Non Communicable Diseases:

Non Communicable Diseases Ischemic heart Disease Prevalence % Urban 9.6 Rural 2.7 DR IRFAN MOMIN

Coronary Heart Disease:

Coronary Heart Disease Indices Urban Rural Total Prevalence 6.4 2.5 3.7 Death rate Per 1000 0.8 0.4 DALY per 100,000 2703.4 986.2 DR IRFAN MOMIN

Prevalence ( %) of Hypertension among adults (> 25 years) , WHO:

Prevalence ( %) of Hypertension among adults (> 25 years) , WHO Male Female India 23.1 22.6 China 29.8 25.6 Bangladesh 27.4 27.9 Sri Lanka 31.0 26.2 US 17.0 14.2 UK 27.7 19.1 Japan 26.4 16.7 DR IRFAN MOMIN

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Total Employees 1493 (100%) Total Hypertensive 455 (30.5%) Known Hypertensive 197 (13.2%) RULE OF HALVES Employees on regular Treatment 139 (9.3%) Employees having controlled Hypertension 71 (4.7%) DR IRFAN MOMIN

Rheumatic Heart Disease:

Rheumatic Heart Disease Prevalence 5-7/1000 in 5-15 years There are 1 million cases of RHD in India DR IRFAN MOMIN

Accidents:

Accidents World: In developed countries - 57% of male death and 43% of female death in 10-24 yrs are due to accidents. DR IRFAN MOMIN

Cancer:

Cancer World Every year- 10 million diagnosed 6 million die Worldwide - Lung Cancer (12.3 %) Breast Cancer(10.4%) Colorectal Cancer(9.4%) Death from cancer - Lung (17.8%) Stomach (10.4%) Liver (8.8 %) DR IRFAN MOMIN

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Male most common (by occurrence) most common (by mortality) [12] prostate cancer (25%) lung cancer (31%) lung cancer (15%) prostate cancer (10%) colorectal cancer (10%) colorectal cancer (8%) bladder cancer (7%) pancreatic cancer (6%) non-Hodgkin lymphoma (5%) liver & intrahepatic bile duct (4%) DR IRFAN MOMIN

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Female most common (by occurrence) most common (by mortality) [12] breast cancer (26%) lung cancer (26%) lung cancer (14%) breast cancer (15%) colorectal cancer (10%) colorectal cancer (9%) endometrial cancer (7%) pancreatic cancer (6%) non-Hodgkin lymphoma (4%) ovarian cancer (6%) DR IRFAN MOMIN

India:

India 3.4 % of all deaths – cancer 7 lakh new cases detected every year Males - Mouth/ oropharynx oesophagus stomach Lower respiratory tract Females - Cervix Breast Mouth/ oropharynx oesophagus DR IRFAN MOMIN

NUTRTIONAL PROBLEMS:

NUTRTIONAL PROBLEMS Under nutrition Obesity Anemia Vitamin A deficiency Vitamin B 12 deficiency Iodine Deficiency Disorders Zinc Deficiency DR IRFAN MOMIN

Trends in Child Nutritional Status:

DR IRFAN MOMIN Trends in Child Nutritional Status Percent of children age under 3 years (Low-height-for-age) (Low-weight-for-height) (Low-weight-for- age)

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DR IRFAN MOMIN

Anaemia among Children:

DR IRFAN MOMIN Anaemia among Children Percent of children 6-35 months with anemia

Nutritional Status of Adults:

DR IRFAN MOMIN Nutritional Status of Adults Percent of women and men age 15-49

Malnutrition of Women by Residence and Education :

DR IRFAN MOMIN Malnutrition of Women by Residence and Education Percent of women age 15-49

Malnutrition of Men by Residence and Education :

DR IRFAN MOMIN Malnutrition of Men by Residence and Education Percent of men age 15-49

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? Vitamin B 12 Deficiency is in increasing trend in Gujarat DR IRFAN MOMIN

Child Immunization Trends:

DR IRFAN MOMIN Child Immunization Trends Percent of children age 12-23 months vaccinated

Selected Household Characteristics:

DR IRFAN MOMIN Selected Household Characteristics Percent of households

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India’s population to be the largest in the world India is set to overtake China as the world's most populous nation by 2050. India’s population is expected to grow from 1.08bn to 1.63bn people, overtaking China, which is forecast to reach 1.44bn from 1.3bn currently. India, will also have the highest working population in the World — 700 million people out of 1.1 billion people are young; the young population will continue till 2050. DR IRFAN MOMIN

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Goldman Sachs Report of 1 October, 2003 – "Dreaming with BRICs : The path to 2050" India's GDP will reach $ 1 trillion by 2011, $ 2 trillion by 2020, $ 3 trillion by 2025, $ 6 trillion by 2032, $ 10 trillion by 2038, and $ 27 trillion by 2050 , becoming the 3 rd largest economy after USA and China. In terms of GDP, India will overtake Italy by the year 2016, France by 2019, UK by 2022, Germany by 2023, and Japan by 2032. DR IRFAN MOMIN

Thank You:

Thank You Mobile: 9426845307 E-mail: drmhmomin@yahoo.co.in DR IRFAN MOMIN

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