HEALTH PROBLEMS IN INDIA OR BURDEN OF INDIA

COMMUNICABLE DISEASES
a. malaria
b. AIDS
c. leprosy
d. diarrheal
e. TB
f. Covid-19
g. ARI
h. filaria

non communicable diseases
nutritional problem
a. PEM
b. anemia
c. LBW
d. xeropthalmia
e. iodine deficiency disorder
medical service problems:
a. inequitable access and infrastructure gap
b. shortage of medical professional
c. high out of pocket expenditure
d. rising burden of NCD

population problem

1. HEALTH PROBLE MS IN INDIA Ms. Rajosi khanra

2. HEALTH PROBLEMS IN INDIA COMMUNICABLE DISEASES NON-COMMUNICABLE DISEASES ENVIRONMENTAL PROBLEMS MEDICAL CARE POPULATION PROBLEMS NUTRITIONAL PROBLEMS

3. COMMUNICABLE DISEASE MALARIA Malaria remains a significant health problem in India despite notable progress in recent years. India has achieved over a 78% reduction in malaria cases and deaths between 2015 and 2024, with more than 160 districts reporting zero malaria cases recently. However, malaria still affects many parts of the country, especially during and after the monsoon season when mosquito breeding increases. India is the highest malaria burden country in the WHO South-East Asia region and accounts for a significant share of malaria cases globally . Malaria is unevenly distributed, with about 80% of the disease burden concentrated among 20% of the population classified as high-risk states like Chhattisgarh, Uttar Pradesh, Gujarat, Jharkhand, and Mizoram report the highest incidence rates. Tribal areas, accounting for about 6.6% of India's population, contribute to about 32% of malaria cases and 42% of deaths.

4. Malaria is caused by parasites transmitted through infected mosquito bites and can be prevented by measures like using insecticide-treated nets, indoor spraying, early diagnosis, and complete treatment. Despite the success, cities like Mumbai still report spikes in malaria cases during monsoons, underscoring the need for continued vigilance and control efforts. Impact on Different Groups: Malaria cases are highest among the 25-40 age group due to higher exposure. Malaria related mortality is greatest among children aged 5-14, though deaths have significantly declined. Pregnant women and young children face serious health risks from malaria, including severe complications.

5. The government has launched multiple initiatives, including the National Strategic Plan for Malaria Elimination (2023-27), wide distribution of insecticide-treated nets, improved diagnostics, and community awareness programs. The country aims to eliminate malaria entirely by 2030, with a vision to achieve zero indigenous cases by 2027.

6. FILARIA Filaria, specifically lymphatic filariasis (LF), is indeed a major public health problem in India. India accounts for about 40% of the global burden of lymphatic filariasis, with an estimated 31 million people harboring microfilariae and around 23 million showing symptomatic disease. Approximately 473 million individuals in India are at risk of infection. National Filaria Control Programme launched in 1955 due to its significant socio-economic impact, including psychological suffering and disability. India carries out mass drug administration campaigns annually in endemic areas aiming at transmission control and eventual elimination of lymphatic filariasis as a public health issue, with efforts ongoing to eliminate it by 2027. High endemic states include Bihar, Kerala, Uttar Pradesh, Andhra Pradesh, and Tamil Nadu, among others.

7. ACUTE RESPIRATORY INFECTION Acute respiratory infections (ARI) are a major health problem in India, especially in children under 5 years. The prevalence of ARI in children under 5 is about 2.8%, based on recent National Family Health Survey data. Certain states like Delhi (5.6%), Ladakh, Puducherry, Meghalaya, and Jammu & Kashmir have higher ARI prevalence. These infections contribute significantly to child morbidity and mortality in India. Risk factors strongly associated with ARI include high levels of air pollution, overcrowding, use of unclean cooking fuel, poor sanitation, tobacco smoking, and malnutrition. The northern states such as Uttar Pradesh, Bihar, Delhi, Haryana, and Punjab show particularly high ARI hotspots, often overlapping with regions of high pollution and population density. Children under 1 year old and male children are reported to be at higher risk of ARI.

8. TUBERCULOSIS India accounts for approximately a quarter of the global TB burden, with more than 2.8 million new TB cases annually and around 26–28% of total global cases. The National Prevalence Survey in India (2019–2021) estimated that over 31% of people above 15 years of age have TB infection, while about 40% of the population carries TB bacteria in their bodies. TB is the leading cause of death from infectious diseases in India, resulting in about 393,000 deaths in 2021. India also has the world’s highest burden of drug-resistant TB, with an estimated 119,000 cases of drug-resistant TB reported out of 2.8 million total cases in 2021. Drug shortages, irregular access to care, and challenges in surveillance contribute to the growing prevalence of drug-resistant TB, particularly affecting poorer, rural, and marginalized communities.

9. COVID-19 COVID-19 has been a major health problem in India since its arrival in January 2020, causing large-scale infections, strain on healthcare infrastructure, and significant loss of lives. The pandemic hit India in waves, with a particularly devastating second wave in 2021 characterized by shortages of oxygen, vaccines, and hospital beds that severely affected healthcare delivery. India launched a massive COVID-19 vaccination drive in January 2021 using vaccines such as Covishield (AstraZeneca) and Covaxin, administering over 1.7 billion doses by early 2022. In 2021, India's official COVID-19 death toll was reported as approximately 330,000 (3.3 lakh) deaths. However, excess mortality data suggest a much higher death impact. India registered about 2 million (20 lakh) excess deaths in 2021 compared to expected deaths based on pre-COVID years, which is nearly six times the official COVID-19 death tally for that year.

10. DIARRHEAL DISEASES Diarrheal disease is a major health problem in India, especially among children under 5 years of age, where it remains a leading cause of morbidity and mortality. The prevalence of diarrhoea among children under 5 was about 7.3% nationally in 2021, showing a slight decline from 9.2% in 2016. However, the burden varies across districts, with some areas experiencing increases in diarrhoea prevalence over time. Diarrheal diseases contribute significantly to child mortality, with thousands of deaths daily in India attributed to diarrhoea and its complications like dehydration and malnutrition. High prevalence is observed particularly in poorer, overcrowded, and lower socioeconomic communities, often linked to inadequate water, sanitation, and hygiene ( WaSH ) practices. Oral Rehydration Salts (ORS) treatment for child diarrhea increased nationally from 57.5% coverage in 2016 to about 62.4% in 2021, but there is considerable inequality across districts, with some areas having low treatment coverage despite high diarrhea prevalence.

11. LEPROSY Leprosy is still a public health issue in India, but has seen remarkable progress in control and reduction over the decades. In 2025, India had a prevalence rate of 0.57 per 10,000 population with about 82,000 patients currently on treatment, marking a 99% reduction from a prevalence rate of 57.2 per 10,000 in 1981 when there were nearly 3.9 million patients under treatment. There has been a 37% decline in new case detection since reaching the elimination milestone in 2006, reflecting significant progress in case management and control. The percentage of child cases among new detections has dropped from 9.04% in 2014-15 to 4.68% in 2024-25, indicating improved early diagnosis and intervention.

12. AIDS India’s HIV epidemic is geographically concentrated in certain states, particularly in the industrialized southern and western regions, and the northeastern states, with Andhra Pradesh, Maharashtra, Karnataka, Tamil Nadu, Manipur, and Nagaland exhibiting higher prevalence rates. The infection is mainly transmitted through unprotected heterosexual intercourse, along with transmission through intravenous drug use in some regions. Women now constitute about 39% of the HIV-infected population, with increasing infections among pregnant women in many areas, highlighting gender-related vulnerabilities. The National AIDS Control Organisation (NACO) leads India’s HIV/AIDS response, focusing on prevention, treatment access, awareness campaigns, and support services.

13. NON-COMMUNICABLE DISEASES Non-communicable diseases (NCDs) are now the largest health burden in India, accounting for about 62% of the total disease burden measured in disability-adjusted life years (DALYs) as of recent estimates. This reflects a major epidemiological transition from communicable diseases to chronic diseases affecting the middle-aged and older population groups increasingly. Cardiovascular diseases (CVD) and injuries each contribute about 12% of total disease burden. Mental health disorders, cancers, respiratory diseases (like COPD and asthma), and diabetes are other major contributors, with diabetes expected to rise from 40.9 million cases to nearly 70 million by 2025. Risk factors driving this burden include tobacco smoking (high prevalence especially among males and youth), unhealthy diets, physical inactivity, obesity, air pollution, and social determinants such as urbanization and aging population

14. PEM Protein Energy Malnutrition (PEM) remains a major health problem in India, particularly affecting children under five years of age. The prevalence of PEM is quite high, with studies reporting rates ranging from about 43% to over 67%, with a higher burden in rural areas compared to urban settings. Factors such as inadequate dietary intake of proteins and calories, poor breastfeeding practices, and delayed complementary feeding are important determinants of PEM in India. Malnutrition contributes significantly to child morbidity and mortality, increasing susceptibility to infectious diseases and impairing physical and cognitive development. High rates of stunting (about 35%), underweight (about 32%), and wasting (around 19%) reflect the ongoing burden of malnutrition inclusive of PEM in children under five across India

15. ANEMIA Anemia is a major public health burden in India, affecting a large proportion of the population across all age groups, especially children and women of reproductive age. According to recent data from the National Family Health Survey-5 (2019-21), about 67% of children under five and around 57% of women aged 15–49 years are anemic. The prevalence is higher in rural areas compared to urban, and certain regions like the Eastern and Northern parts of India show higher rates. Men aged 15–49 have a lower but significant prevalence at about 25%.Elderly individuals show anemia prevalence ranging between 52% to 68% with regional variations.

16. Anaemia in India is predominantly caused by iron deficiency linked to poor dietary intake, low bioavailability of iron in diets, and deficiencies in vitamin B12 and folic acid. Socioeconomic factors including poverty, low literacy, poor sanitation, and lack of healthcare access, exacerbate the problem. India has launched the Anemia Mukt Bharat campaign focusing on iron supplementation, dietary diversification, deworming, and awareness programs.

17. LOW BIRTH WEIGHT Low birth weight (LBW) is a significant health burden in India, with recent data from the National Family Health Survey (2019-21) indicating that about 18% of newborns in India are born with low birth weight (less than 2500 grams). This translates to approximately 4.2 million LBW babies annually in India, with nearly half of these births concentrated in four states: Uttar Pradesh, Bihar, Maharashtra, and West Bengal. The prevalence of LBW in India has declined from around 26% in 1993 to 18% in 2021, showing progress but still remaining high compared to global targets. States like Punjab and Delhi have the highest prevalence rates around 22%, while northeastern states like Mizoram, Nagaland, and Manipur report much lower prevalence (4%-7%). Around 50% of low birth weight babies are born to women with little or no formal education and from the poorest households, indicating strong socioeconomic determinants.

18. XEROPTHALMIA Xerophthalmia, a condition caused by Vitamin A deficiency, continues to be a notable public health burden in India, particularly among young children aged 2-6 years. The prevalence of xerophthalmia in this age group in North India was found to be about 4.43%, with higher rates observed among girls and children from low socioeconomic backgrounds. Night blindness, an early sign of Vitamin A deficiency, had a prevalence of approximately 2.93% in the same population, indicating a moderate public health problem according to WHO criteria. states where rice is a staple food—like Bihar, Tamil Nadu, West Bengal, Andhra Pradesh, and Odisha—tend to have a higher burden of Vitamin A deficiency and xerophthalmia due to the low carotene content in rice.

19. IODINE DEFICIENCY DISORDER Iodine deficiency disorder (IDD) remains a significant public health issue in India, despite impressive progress in its control. Over 200 million people are still at risk of IDD, and about 70 million suffer from goiter and other iodine deficiency-related disorders. The entire population is vulnerable due to iodine-deficient soil, affecting both plant and animal food sources. India’s National Iodine Deficiency Disorders Control Programme (NIDDCP), started in 1962, is considered a public health success story with over 90% of households now consuming iodized salt.The government has made iodization of edible salt mandatory and expanded efforts to ensure universal salt iodization (USI) reaching 78% of households with adequately iodized salt, reducing IDD substantially.

20. MEDICAL SERVICE PROBLEMS A. Inequitable Access and Infrastructure Gaps: There is a stark disparity in healthcare access between urban and rural areas, with around 70% of the population living in rural zones but only 35-40% of infrastructure located there. Rural healthcare facilities remain insufficient, often poorly equipped, and lack adequate medical professionals, especially nurses and doctors. The concentration of healthcare resources in urban centers leaves rural residents with limited options, necessitating long travel for care. B. Shortage of Medical Professionals: There is a significant shortage of healthcare workers, especially in rural areas, resulting in long waiting times and treatment delays.

21. C. High Out-of-Pocket Expenditure: A large proportion of healthcare costs in India are paid out-of-pocket by patients, pushing approximately 55 million people into poverty annually. Despite government schemes like Ayushman Bharat aiming to reduce financial burden, high expenses in private healthcare and gaps in insurance coverage persist. D. Rising Burden of Non-Communicable Diseases (NCDs): Rapidly increasing NCDs like diabetes, cardiovascular diseases, and cancer are straining the health system. Lifestyle risks such as sedentary behaviour , poor diet, and tobacco use are major contributors

22. E. Other Challenges: Lack of awareness about available healthcare services and preventive care. Corruption and mismanagement issues affect fund utilization and service delivery. Environmental health risks like air and water pollution worsen public health. Limited health insurance coverage and systemic barriers hinder universal health coverage goal.

23. POPULATION PROBLEMS Population growth in India poses a significant health burden, affecting healthcare access, quality, and outcomes. India’s large and growing population, currently over 1.4 billion, stresses the health infrastructure, with rural areas where nearly two-thirds of people live having access to only 30% of hospital beds and low nurse and doctor densities compared to WHO recommendations. Overcrowding and inadequate healthcare infrastructure in densely populated regions exacerbate management of both communicable and non-communicable diseases (NCDs), increasing disease burden. Maternal and child health services are challenged by high population density in certain areas, impacting timely antenatal care, immunization, and nutrition programs essential to reducing mortality and morbidity.

24. Population growth fuels exposure to risks like air pollution and undernutrition, which are leading causes of disability-adjusted life years (DALYs) lost in India. High population density contributes to poor sanitation, water quality, and housing conditions, which are crucial determinants of health for diseases such as diarrheal illnesses and respiratory infections.