(Live Mint) Hidden hunger and the Indian health story-India needs to find better value for money in the health sector.
• According to the World Health Organization (WHO), there are three goals a country’s health system must aim for:
to improve health,
to be responsive to legitimate demands of the population and
to ensure no one is at risk of serious financial losses because of ill health.
• Despite the declining percentage of the number of women and children suffering from anaemia in the past few years, the high absolute numbers are worrying.
• Incidentally, anaemia accounts for 20% of the maternal deaths that take place in the country. According to the Rapid Survey on Children, 2013-14, around 40% of India’s children under the age of five are stunted (low height-for-age), nearly 15% are wasted (low weight-for-height) and 30% are underweight (low weight-for-age).
• Over the years, India has implemented numerous health-related schemes. The Integrated Child Development Scheme was started in 1975 to look into the health and well-being of mothers and children.
• The National Mid-Day Meal Scheme, the National Rural Health Mission and the Public Distribution System have had overlapping nutrition objectives.
• The National Nutritional Anaemia Prophylaxis Programme meant to maintain the adequate amount of iron and folate in expecting lactating mothers, children from aged 1-5 and anaemic adolescents was implemented as early as 1970.
• Taking its cue from NFHS-4 and the recently published India Health Report and Global Nutrition Report, the Indian health system needs to address its structural and operational deficiencies. In the latter instance, millets and fortified food should be incorporated in midday meals to tackle the problem of hidden hunger (micronutrient deficiency).
• Fortification enhances the nutrients present in salt, rice, wheat, milk and so forth, and millets have higher nutrient levels than cereals.
• An independent system for quality checks and outsourcing of activities like midday meals to private companies is also necessary here.
• Currently, laboratories designated to execute a quality check on samples from schools every month consistently fail to do so. And stocking food, monitoring cooking, serving and maintaining records compromise the productive time of the faculty.
• The per capita availability of inputs like the number of primary health centers, doctors, infrastructure like number of hospital beds and institutionalized deliveries are significant variables for enhancing efficiency.
• Hopefully, a joint initiative by the Indian Council of Medical Research and the health ministry, among others, to gather state-specific data with the first set of data estimates to be released this year will help in some measure.
• If India has to reap its demographic dividend in an ageing world, it should have its citizens hale and healthy. As the world’s first ever anatomist Herophilus once remarked, “When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.”