Global Health Observatory (GHO) : WHO

The 2012 edition of the World Health Statistics is now available:
For the first time, the World Health Statistics compares the state of child health from the years 2000 and 2010, showing how global public health advancements have helped save children’s lives in the past 10 years. In the year 2000, more than 477 000 children died from measles. In just 10 years, this vaccination has cut measles deaths by 74% to less than 114 000 child deaths worldwide. This achievement is entirely due to a strong campaign to increase global vaccination coverage. In 2010, 85% of children aged 12–23 months worldwide were immunized against measles.

Maternal mortality

800

women died each day in 2010 due to complications of pregnancy 

and child birth

Maternal mortality

Situation

Every day in 2010, about 800 women died due to complications of pregnancy and child birth, including severe bleeding after childbirth, infections, hypertensive disorders, and unsafe abortions. Out of the 800, 440 deaths occurred in sub-Saharan Africa and 230 in Southern Asia, compared to five in high-income countries. The risk of a woman in a developing country dying from a pregnancy-related cause during her lifetime is about 25 times higher compared to a woman living in a developed country. Maternal mortality is a health indicator that shows very wide gaps between rich and poor, both between countries and within them.

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Trends

The number of women dying due to complications during pregnancy and childbirth has decreased by 47% from an estimated 543 000 in 1990 to 287 000 in 2010. The progress is notable, but the annual rate of decline is less than half of what is needed to achieve the Millennium Development Goal (MDG) target of reducing the maternal mortality ratio by 75% between 1990 and 2015. This will require an annual decline of 5.5%. The 47% decline since 1990 translates into an average annual decline of just 3.1%.

Risk factors

1 in 10adults is obese

Overweight

Situation and trends

Worldwide, at least 2.8 million people die each year as a result of being overweight or obese, and an estimated 35.8 million (2.3%) of global DALYs are caused by overweight or obesity. Overweight and obesity lead to adverse metabolic effects on blood pressure, cholesterol, triglycerides and insulin resistance. Risks of coronary heart disease, ischemic stroke and type 2 diabetes mellitus increase steadily with increasing body mass index (BMI), a measure of weight relative to height. Raised body mass index also increases the risk of cancer of the breast, colon, prostate, endometrium, kidney and gall bladder. Mortality rates increase with increasing degrees of overweight, as measured by body mass index. To achieve optimum health, the median body mass index for an adult population should be in the range of 21 to 23 kg/m2, while the goal for individuals should be to maintain body mass index in the range 18.5 to 24.9 kg/m2. There is increased risk of co-morbidities for body mass index 25.0 to 29.9, and moderate to severe risk of co-morbidities for body mass index greater than 30.

In 2008, 35% of adults aged 20+ were overweight (BMI ≥ 25 kg/m2) (34% men and 35% of women). The worldwide prevalence of obesity has more than doubled between 1980 and 2008. In 2008, 10% of men and 14% of women in the world were obese (BMI ≥30 kg/m2), compared with 5% for men and 8% for women in 1980. An estimated 205 million men and 297 million women over the age of 20 were obese – a total of more than half a billion adults worldwide.

Child mortality

4.4 millionchildren under the age of 5 died from infectious diseases in 2010, nearly all of which were preventable

Causes of child mortality for the year 2010     

Situation

Globally, the four major killers of children under age five were pneumonia (18%), prematurity (16%: 14% during the neonatal period and 2% in the post-neonatal period), diarrhoeal diseases (11%), and birth asphyxia (10%: 9% during the neonatal period and 1% in the post-neonatal period). Malaria was still a major killer in Sub-Saharan Africa, causing about 15 percent of under-five deaths in the region.

Of the total 7.6 million children who died before 5 years of age, 4.4 million (58%) died of infectious diseases. Of all infections, pneumonia (1.4 million), diarrhoea (800 000) and malaria (563 000) were the leading causes of death, accounting together for 36% of all under-five deaths worldwide. The majority of these deaths can be prevented by known, simple, affordable and low cost interventions such as exclusive breastfeeding up to 6 months of age, immunization, appropriate use of antibiotics, oral rehydration therapy and zinc, insecticide treated bednets, and anti-malarials.

About 40% of deaths in children younger than 5 years occurred before 28 days of life – the neonatal period. The most important cause of death was preterm birth complications. Birth asphyxia and sepsis were the second and third major causes of death in this early period of life, responsible together for 1.2 million deaths. The risk of dying from these conditions can be mitigated with quality care during pregnancy, safe and clean delivery by a skilled attendant, and immediate postnatal care, including neonatal resuscitation, extra care of low birth weight babies, attention to baby warmth, treatment of neonatal sepsis and early initiation of breastfeeding.

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Distribution

Patterns of the distribution of causes of child deaths vary widely between regions. The lowest proportion of neonatal deaths (30%) occurred in the African Region. On the other hand 96% of all under-five deaths due to malaria and 89% of all deaths due to HIV/AIDS worldwide happened in the African Region. In the remaining five WHO regions, high proportions of under-five child deaths occurred during the neonatal period, ranging from 42% in the Eastern Mediterranean Region to 54% in the Western Pacific Region. The proportion of deaths from pneumonia is lowest in the Americas and Europe. Deaths due to diarrhoeal diseases were responsible for only 4% of deaths in these same regions.

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Trends

The number of under-five deaths worldwide dropped from 12 million in 1990 to 9.6 million in the year 2000 to 7.6 in 2010. Nearly 60% of the 2 million lives saved in the past decade were due to reductions of deaths caused by pneumonia (455 000 fewer deaths), measles (363 000 fewer deaths), and diarrhoea (361 000 fewer deaths). India, Nigeria, Democratic Republic of the Congo, Pakistan, and China contributed to half the mortality attributable to infections and more than half due to neonatal causes worldwide.

Source: WHO

    

10 facts about water scarcity: WHO

Water is an essential resource for life and good health. A lack of water to meet daily needs is a reality today for one in three people around the world.

Globally, the problem is getting worse as cities and populations grow, and the needs for water increase in agriculture, industry and households. This fact file highlights the health consequences of water scarcity, its impact on daily life and how it could impede international development. It urges everyone to be part of efforts to conserve and protect the resource.

Fact 1: Water scarcity occurs even in areas where there is plenty of rainfall or freshwater. How water is conserved, used and distributed in communities, and the quality of the water available can determine if there is enough to meet the demands of households, farms, industry and the environment.

Fact 2: Water scarcity affects one in three people on every continent of the globe. The situation is getting worse as needs for water rise along with population growth, urbanization and increases in household and industrial uses.

Fact 3: Almost one fifth of the world's population (about 1.2 billion people) live in areas where the water is physically scarce. One quarter of the global population also live in developing countries that face water shortages due to a lack of infrastructure to fetch water from rivers and aquifers.


Fact 4: Water scarcity forces people to rely on unsafe sources of drinking water. It also means they cannot bathe or clean their clothes or homes properly.


Fact 5: Poor water quality can increase the risk of such diarrhoeal diseases as cholera, typhoid fever and dysentery, and other water-borne infections. Water scarcity can lead to diseases such as trachoma (an eye infection that can lead to blindness), plague and typhus.


Fact 6: Water scarcity encourages people to store water in their homes. This can increase the risk of household water contamination and provide breeding grounds for mosquitoes - which are carriers of dengue fever, malaria and other diseases.

Fact 7: Water scarcity underscores the need for better water management. Good water management also reduces breeding sites for such insects as mosquitoes that can transmit diseasees and prevents the spread of water-borne infections such as schistosomiasis, a severe illness.


Fact 8: A lack of water has driven up the use of wastewater for agricultural production in poor urban and rural communities. More than 10% of people worldwide consume foods irrigated by wastewater that can contain chemicals or disease-causing organisms.


Fact 9: Millennium Development Goal number 7, target 10 aims to halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. Water scarcity could threaten progress to reach this target.

Fact 10: Water is an essential resource to sustain life. As governments and community organizations make it a priority to deliver adequate supplies of quality water to people, individuals can help by learning how to conserve and protect the resource in their daily lives.

Source: WHO

How Big is the HUNGER Problem in India???

India is failing its rural poor with 230 million people being undernourished — the highest for any country in the world. Malnutrition accounts for nearly 50% of child deaths in India .According to the latest report on the state of food insecurity in rural India, more than 1.5 million children are at risk of becoming malnourished because of rising global food prices. The United Nations World Food Programme report points more than 27% of the world’s undernourished population lives in India while 43% of children (under 5 years) in the country are underweight. The figure is among the highest in the world. The proportion of stunted children (under-5) at 48% is again among the highest in the world. Every second child in the country is stunted, according to the health ministry’s figures.

Shocking isn’t it? But where does the cause lie?

The failure does not lie in any operational inability to produce more food, but a far reaching failure to make the poor of the country able to afford enough food. Firstly let’s talk about the food policy, and in particular food prices policy. Why is it the case that the large expenditure on food subsidy in India does not achieve more in reducing undernourishment? Part of the answer lies in the fact that the subsidy is mainly geared to keep food prices high for the sellers of food – farmers in general – rather than to make food prices low for the buyers of food. Secondly, the ambitious Targeted Public Distribution System (TPDS) is failing. Apart from failing to serve the intended goal of reduction of food subsidies, the TPDS also is leading to greater food insecurity for large sections of the poor and the near-poor. These targeting errors arise due to imperfect information, inexact measurement of household characteristics, corruption and inefficiency. Another problem, I feel, of the TPDS is the issue of quantity of grain that a household is entitled to. The TPDS initially restricted the allotments to BPL households to 10 kg per month. For a family of five, this amounted to 2 kg per capita. Using the ICMR recommended norm of 330 grams per day, the requirement per person per month would be 11 kg and that for a family of five would be 55 kg. Thirdly and most importantly the governments apathy. It is shameful that in a country where so many people go hungry it is left to the media and other agencies to highlight the pathetic state of affairs.

What, then, should we do, indeed what can we do? People have to go hungry if they do not have the means to buy enough food. Hunger is primarily a problem of general poverty, and thus overall economic growth and its distributional pattern cannot but be important in solving the hunger problem. It is particularly critical to pay attention to employment opportunities, other ways of acquiring economic means, and also food prices, which influence people’s ability to buy food, and thus affect the food entitlement they effectively enjoy. The public distribution system must be strengthened and it must be ensured that the food the government sets aside for BPL families is distributed to them through effective agencies. We must increase allocation through PDS, give food grain through the NREGA, offload the excess stock in the market, but not feed it to the rats.

Given our democratic system, nothing is as important as clear-headed public discussions of the causes of deprivation and the possibility of successful public intervention. Public action includes not only what is done for the public by the state, but also what is done by the public for itself. It includes what people can do by demanding remedial action and through making governments accountable. The lives and well-being of hundreds of millions of people will depend on the extent to which our public discussion can be broadened and be made more informed. I hope we manage to have some impact.


Underlying causes of hunger in India
· Falling per capita food production (especially in the last ten years).
· Increasing share of surplus states and large farmers in food production, resulting in export of artificial surplus reducing availability of food grains.
· Increasing inequality, with marginal increase in the per capita expenditure of the population’s economically poor. From their meager income, the poor are forced to spend more on medicines, education, transport, fuel, etc., which reduces the share of their expenditure on food.
· Poor access of the lower income population to expensive foods such as pulses, vegetables, oils, fruits, and meat products, which provide essential proteins, fats and micro nutrients.
· Low status of women in Indian society, their early marriage, low weight at pregnancy and illiteracy leading to low weight of new born babies.
· Poor children practices, such as not immediately cultivating the habit of regular breastfeeding after.

Some common features of poverty in India:
· Poverty is concentrated in the poorer states such as Uttar Pradesh, Bihar and Jharkhand, which account for 27 per cent of the country’s population but 30 per cent of India’s poor lived there in 1973-74, which increased to 41 per cent by 2005.
· Three quarters of the poor live in rural areas and depend on agriculture.


There has been hardly any decline in poverty for the scheduled tribe households: almost half of them continue to be below the poverty line Although poverty amongst Scheduled Castes has declined from 46 to 37 per cent during 1993-2004 (Planning Commission 2008), the caste systems confines those from lower castes to a limited number of poorly paid, often socially stigmatized occupational niches from which there is no escape.
· Many states, in the northern and western parts of the country, are characterized by long standing and deeply entrenched social inequalities associated with gender.


Poverty is connected with vulnerability and shocks, compounded by general uncertainty with respect to livelihood and life. At the macro level, food grain availability in India is calculated as 87.5 per cent of the gross production (the rest is estimated as requirement for seeds, farm animal feed and waste) plus net imports, minus changes in government stocks. Assuming no net change in private stocks, this can be taken as a good proxy for overall food grain consumption in the country. During the last fifty years before independence, Food grain availability declined from 545 grams to 407 grams per head per day.


Hunger in India: 'The real cause is lack of political will'