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Ncmh Background Papers—Burden Of Disease In India

4970 words - 20 pages

NCMH Background Papers—Burden of Disease in India
Disease burden in India: Estimations and causal analysis
Disease burden in India
Estimations and causal analysis*
Disease burden estimations based on sound epidemiological
research provide the foundation for public policy. Which
diseases and what interventions does public policy need to
focus upon are normally derived from such evidence. Well
researched, longitudinal data can enable judicious targeting
and help decide what needs to be done where, for whom,
and when. Conversely, the absence of such good quality
empirical data can affect programme designing and consequently
outcomes. India has ample evidence of such
impacts, ...view middle of the document...

Analysis of data from the 1995–
96 survey round of the National Sample Survey (NSS)
undertaken by the National Commission on Macroeconomics
and Health (NCMH) suggests that the out-of-pocket expenditure
by individuals hospitalized on account of heart disease
was roughly Rs 11,000 per person, or 120% of the average
annual per capita expenditure of the households they
belonged to. Likewise, roughly Rs 32,000 is the annual cost
of treatment for acute cases of COPD that involve hospitalization.
Therefore, it is clear that the onset of disease needs
to be averted and when it occurs it should be treated quickly.
For policies to ensure this, it is necessary that we have an
evidence-based understanding of the extent of disease
burden, the population groups that are the most vulnerable,
and what interventions are needed to avert premature death
or needless suffering.
With the above objectives in mind, the NCMH undertook
an exercise to (i) identify major health conditions in terms
of their contribution to India’s disease burden; (ii) estimate
the incidence and prevalence levels of the diseases/conditions
at present and in 2015; (iii) list the causal factors underlying
the spread of the diseases/conditions; (iv) suggest, based on
the available evidence, the most cost-effective and lowcost
solutions/strategies, both preventive and curative, for
reducing the disease burden, particularly among the poor;
and (v) indicate what interventions should be provided
where and by whom. For assisting us in this onerous task,
the help of leading experts was taken.
The experts identified 17 priority health conditions (Table 1)
which they felt to be significant public health problems,
affecting all segments of the population. Identification of
these conditions was based on three criteria: first, the
likelihood of the burden of a specific health condition falling
on the poor, such as infectious and vector-borne conditions,
TB and many maternal and child health conditions; second,
in the absence of interventions, the probability of a listed
health condition continuing to impose a serious health
burden on the Indian population in the future, say by 2015,
such as cancers, cardiovascular conditions and diabetes, or
new infections such as HIV/AIDS; and third, the possibility
of a health condition driving a sufficiently large number of
people into financial hardship, including their falling below
the poverty line.
*This overview is based on a paper entitled ‘Choosing Investments in Health’ prepared by Dr Ajay Mahal, Assistant Professor, Harvard School of
Public Health, USA, for the National Commission on Macroeconomics and Health.

NCMH Background Papers—Burden of Disease in India
Disease burden in India: Estimations and causal analysis
Baseline estimates and projections of priority
health conditions
Exhaustive review of the available literature brought forth
two factors of critical importance to public policy: (a) for

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