Instead of asking 'how is India's PH?', I asked, 'how bad is it?'. The fact is that the current health statistics leave a lot to be desired from our system. But surely, we must have made some progress as a nation in the last few decades? While trying to understand this, I came across talks from the brilliant Hans Rosling who spent his life explaining world facts using simple data - they opened my eyes!
Here, I present (using Gapminder tools) certain facts about India's public health progress since independence. The first chart plots India's child mortality (0-5 year-olds dying per 1000 born) and population since 1947 to 2015. The bubble size depicts the number of child deaths under the age of five.
In 1947, when we had a population of 353 million, 272 children of every 1000 live births would die before their fifth birthday - this accounted to 4.11 million children deaths. Compare this to 2015: while our population almost quadrupled to 1.3 billion, the number of child deaths reduced to a quarter at 1.2 million at a rate of 45.2 per 1000 live births. The rate of decline has been much greater since 1991, when the Indian economy opened up (population = 888 million, child deaths = 3.26 million, child mortality = 122/ 1000 live births). The number of child deaths have reduced by two-thirds despite population increasing by 1.5 times in the last 24 years.
Child mortality is a great indicator of not just how public health, but how a nation has progressed. Reduction in child mortality over time subtly implies advancements on various fronts. It means more women have better nutrition and healthcare access during their pregnancies and more have their babies delivered in hospitals. It means more children have better nutrition, cleaner water and lesser infections, they have access to healthcare when they are sick, they are safer from accidents and epidemics. Society and parents have been able to provide children safer social and physical environments to grow in. This is aided by advancements in education and economic conditions.
The second chart below plots number of babies per woman and life expectancy since 1947. The bubble size depicts income per person*. Poorer sections of the society tend to have larger families for various reasons - they may see children as additional hands for earning their bread, they may have more babies as insurance against child mortality. As life expectancy and incomes grow, couples start having lesser number of babies.
In 1947, Indians had a life expectancy of 32.5 years and on average a woman would have 5.9 babies in her lifetime. By 2015, life expectancy has more than doubled to 68.2 years and on average a woman has 2.35 babies in her lifetime. The income per person* has multiplied six times from $920 to $5750. Again, the rates have accelerated since 1991 (Life expectancy = 59.4. babies per woman = 3.96, income per person* = $1740)