Public Health helps achieve the discovery, test and dissemination of health threat and problems. India is a nation that comprises many languages, religions, life styles and food habits which accounts one sixth of the world’s population occupying less than 3% of the world’s area

1. THE ROLE OF PUBLIC HEALTH SYSTEM IN IMPROVING THE
HEALTH OF INDIANS
Shalvi
Definition:
According to Winslow, 1920 : “Public Health is the science and art of preventing disease,prolonging
life and promoting physical health and efficiency through organized community efforts for the
sanitation of the environment, the control of communicable infections, the education of the individual
in personal hygiene, the organization of medical and nursing services for the early diagnosis and
preventive treatment of disease,and the development of the social machinery which will ensure every
individual in the community a standard of living adequate for the maintenance of health; so
organizing these benefits in such a fashion as to enable every citizen to realize his birthright of health
and longevity”.(1)
Introduction:
Public Health helps achieve the discovery, test and dissemination of health threat and problems. India
is a nation that comprises many languages, religions, life styles and food habits which accounts one
sixth of the world’s population occupying less than 3% of the world’s area.(2)
The diversity of the nation, the different political agendas at times may work as a hindrance but can
be very useful either. As for the public health sector the government has done a considerable work
delivering medicines and medical care to the hoi polloi of India either free or in an affordable rate
although we can see serious lapses of public health care in severalrural areas of the country mainly
due to contrary political views, lack of maintenance or other issues.
Day to day face off with the severalminor and major health hacks in this vertiginous environment of
this diligent world has now become a trend and so people do not really bother at these regular guests
until the same grows severe. The role of the public health system in improving the health of the nation
has not been a word among the people of India. They seem to be entirely incognizant of the various
roles and practices of the public health system.
The Widespread, practices, roles, challenges,outcomes:
The public health system in India has a set of health care facilities funded and controlled by the
government of India. Some of them are centralthat are controlled by Ministry of Health and Family
welfare,and some State wise. (3)
The practice of public health has been dynamic in India, and has witnessed many hurdles in its
attempt to affect the lives of the people of this nation. Since Independence major public health
problems like malaria, tuberculosis, leprosy, high maternal and child mortality and lately, human
immunodeficiency virus (HIV) have been addressed through a concerted action of the government.
The practice of medicine to eviscerate these diseases and more depends on various aspects like
resources allocation, choice of technology, human resources policy and degree to which health
services are to be made available to the population. Despite of several failures in public health sector

2. we can proudly point out along with the world in India too health care has led to a decrease in the
mortality rates and birth rates. (4)
(5)
Our top priorities in public health comprise epidemiological transition (rising burden of chronic non-
communicable diseases),demographic transition (increasing elderly population) and environmental
changes. We should also not forget child and maternal mortality, HIV aids pandemic and other
communicable diseases act on out health system. (4)
Reports from WHO depicts that India has 14% of its population suffering from arthritis(approx 140
million), 10% suffering from Hypertension(approx 100 million).According to international diabetes
federation, approximately 5% of Indian population suffers from diabetes(50 million) and elderly
people in India accounts about 150 million. (2)
Apart from the other diseases there are some silent killers that are acting like venom and can’t be
tackled only with medicine because of the pleasure of addiction they create. The tobacco-attributable
deaths range from 800,000 to 900,000/year, leading to huge social and economic losses. Mental and
neurological disorders create sufferings and even can decimate lives. Beneath all these sparkling
figures lie human sufferings. On one hand health systems are at sixes and sevens fighting the existing
diseases and on top of that there is an ever growing threat of emerging and re-emerging diseases like
(drug-resistant TB, malaria, SARS, avian flu and the current H1N1 pandemic. Inadequate financial
resources as well as improper distribution of finance create a huge pandemonium in the health system.
(4)
Not only the distribution of finance we are quite urban centric when it comes to the distribution of
resources. According to a survey by Indian Medical Society, 75% of the qualified consultant doctors
practice in urban areas, 23% in semi urban areas and only 2% in rural areas where 65% of the total
population live. (2)
Inadequate nutrient intake, poverty, caste discrimination, gender inequality and lack of access to
social determinants of health contribute to a host of public health problems. In most of the rural and
even in some urban areas we often find a strange problem of people not taking health issues seriously
and not adopting a preventive health care,this can be due to the cost factor. With age the income of a

3. person decreases however the costs regarding health issues increase. We need to look for much
affordable health care solutions.
All these above mentioned problems pave an effortful and responsible way to the public health
system, which means the system has to bring up a solution for each one of these. And we come across
various interventions rather really successfulinterventions in order to treat, prevent and eradicate the
different health severities.
Different “ public health intervention strategies” can be categorized even. Here are a few:
Biological strategies include Immunizations, Prophylaxis, improved nutrition, mother and child health
programs, microbicides, improved sanitation, improved water quality including oceans,etc.
Behavioural strategies include promotion of good health habits as for example habit of exercising, and
good diet that refers to healthy and balanced diet. School health programs. Promotion of
immunization programs by the use of TV, radio, media public health messages. Also promotion of
safe sexualbehaviour.
Political strategies include lobby legislators, promotion of healthy safe communities, promotion and
enforcement of appropriate health laws and regulations. Political strategies have tried to promote
universal access to health care,especially preventive care,it emphasize on the improved standard of
living example housing, and reduce poverty.
Structural strategies could be listed as below:
 Monitoring and surveillance of diseases and health hazards
 Safe drinking water
 Safe waste disposal
 Regulations to protect workers
 Regulate driving (e.g.,speed limits, auto and road safety)
 Legislation and regulations for safety; e.g.,occupational, vehicular, roads, etc.
 Laws to ban smoking, require helmets, etc.
 Regulate air and water quality (ocean, lakes, waterway)
 Enforcement of health and safety laws
 Establish safe communities and parks
 Establish universal medical access
 Taxation on cigarettes, alcohol
 Regulation of drugs and food (FDA)
There has been an use of public health tool like Anxiety which on sufficient generation gives
appropriate action whereas too little of it has no consequence and too much be fataland no action.
Other programs include Isolation and quarantine :
Isolation of cases such as SARS,Ebola. Quarantine of exposed individuals e.g. yellow fever, SARS,
H1N1. Culling (murder) of diseased flocks, herds e.g. H5N1.

4. Eradication of smallpox, Polio, Measles,Dracunculus. (6)
This is because of the public health system that has been keeping control of the nation’s health that
now everybody knows this vividly that India has earned a sharp decrease in the maternal mortality
ratio.
(7)
Another intervention namely Community Intervention focuses on getting the community to recognize
the problem, to accept responsibility and implement changes,also it helps changing community norms
like smoking, condoms.
The interventions are also needed to be evaluated in order to extract the most benefit and prevent
negative impacts. (6)
Social determinant of health is illustrated by Kerala which is often quoted as an example in
international forums for achieving a good status of public health by addressing the fundamental
determinants of health : Investments in basic education, public health and primary care.(4)
Nowadays,the entire spectrum of public health is enormously complex and public health activities are
oriented to many challenges related to health. Public health addresses the health of the population as a
whole rather than medical health care,which focuses on the treatment of the individual disease. It
deals with collective problems in society and seeks collective solutions.
Facts and reports :
Taking about the hindrance in health services in modern world nothing can be achieved without
proper financial support, with an allocation of about Rs 33,000 crores in 2016, it reflects a token
increase in health allocation of 13% over 2015. (8). Only 0.5 hospital-beds exist per 1000 population,
as compared to 9.1 for Russia and 3 for China. Only 0.21% (Rs 938 Crore) of the total infrastructure
investments in India is in the health sector, according to an analysis of government data by
IndiaSpend. (9)
The Government had manifested in its last year budget that around 3000 government run pharmacies
will help people to avail of cheaper drugs, which sound proper but the figures tell us a different story.
In India there are about 850,000 pharmacies that sell branded drugs at a very high rate making it
difficult for people to get hands on cheaper drugs. Now, the proposed 3000 government pharmacies

5. will constitute less than 1% of the total pharmacies which will have a negligible impact on the normal
people trying to access cheaper drugs. (8)
Where public health care services should be more affordable and accessible in India around 39 million
people are pushed to poverty each year surging medical expenses. Not only that if we talk about
accessibility of health care centers in India , 682 out of every 100,000 people die from non-
communicable diseases,as against the global of 539, according to the WHO.
Richard Horton, the editor of globally acclaimed medical journal Lancet had thrashed Indian Public
health care system for their lapses, in his journal he wrote, “Since Modi has come in, health has
completely vanished. India is on the edge. If PM Modi does not tackle health, India's economy
combined with rising population is not sustainable. For India, health is an issue of national security.
The government cannot protect the sovereignty of its nation, cannot ensure sustainability unless it has
a healthy population. At present Modi has done nothing much to tackle the challenge”.
Talking about the medical staffs,PHCs in India are short of more than 3000 doctors, with the shortage
being an alarming 200% over the last 10 years according to an analysis by IndiaSpend. On top of that
there is an 83% shortage, of specialist medical professionals (Gynaecologists, surgeons, physicians,
etc) across CHCs in India. Not only this, most states in India haven’t got any specialists at all. (9)
After all these we should not forget that India is the largest producer of doctors that go to the foreign
countries for practices and research. As aren’t many and effective public healthcare in rural India they
are forced to opt for private health care burdening their pockets.
To prevent all these public health system plays quite a vital role. If we go through the aspects of their
various improving deeds we can discover how over time the public health system has helped our
medical approach towards the common people.
Government has risen the health spending to 30% of country’s total health expenditure from about
20% in 2005 and out-of-pocket payments are decreased to 58% from 69% a decade ago. Registry of
Hospitals in Network of Insurance,also known as ROHINI,is the first ever database for hospitals in
India which now includes 32,000 hospitals. ROHINI comprises the unique identification numbers and
geographical locations of all the hospitals. (10)
Financial assistance strengthens public health care services like hospital infrastructure, human
resource and programme management, patient transport system including helpline numbers like 108
and 102,mobile medical units and community participation like ASHAs. Severalprogrammes to
control communicable diseases are launched like National Leprosy Eradication Programme, Revised
National Tuberculosis Control Programme, National Vector Borne Disease control Programme and
Integrated Disease Surveillance Project. (11)
Conclusion :
The new agenda for public health in India includes the epidemiological transition, demographical
transition, environmental changes and social determinants of health. The role of the government in
influencing population health is not limited within the health sector but also by various sectors outside
the health systems. Health system strengthening, human resource development and capacity building
and regulation in public health are important areas within the health sector. (4)
The purpose of a department of public health is to put into effect for the benefit of all the people in
the community the practical lessons of preventive medicines. Every health department ought to

6. provide for a program and services which will prevent so far as possible the preventable diseases and
the preventable hazards to health.
Population stabilization, gender mainstreaming and empowerment, reducing the impact of climate
change and disasters on health, improving community participation and governance issues are other
important areas for action. Making public health a shared value across the various sectors is a
politically challenging strategy, but such collective action is crucial. (4)
The milestones in the history of public health that have had a telling effect on millions of lives –
launch of Expanded Program of Immunisation in 1974, Primary health care enunciated at Alma Ata in
1978, eradication of Smallpox in 1979, launch of polio eradication in 1988, and many more. The
ultimate goal of great nation would be one where the rural and urban divide has reduced to a thin line,
with adequate access to clean energy and safe water,where the best of health care is available to all,
where the governance is responsive, transparent and corruption free, where poverty and illiteracy have
been eradicated and crimes against women and children are removed – a healthy nation that is one of
the best places to live in. (4)
References:
1. Winslow CEA. The untitled field of public health. Modern medicine 1920;2(3):183-191
2. Health care system in India health and social care essay [online] [cited 2017 July 18].
Available from : URL : https://www.uniassignment.com/essay-samples/health-social-
care/health-care-system-in-india-health-and-social-care-essay.php
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https://en.m.wikipedia.org/wiki/Public_health_system_in_India
4. Lakshminarayanan.S . Role of government in public health: Current scenario in India and
future scope. Journal of family and community medicine. 2011 Jan-Apr;18(1):26-30
5. [Online] [cited 2017 July 20]. Available from : URL : http://cdn.yourarticlelibrary.com/wp-
content/uploads/2014/05/clip_image0064.jpg
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qCh20mAWCEAAYASAAEgKZefD_BwE
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years.png
8. [Online] [cited 2017 July 20]. Available from : URL : https://thewire.in/24924/health-budget-
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9. [Online] [cited 2017 July 20]. Available from : URL :
http://www.thenewsminute.com/article/why-health-sector-allocation-budget-2016-simply-
not-enough-39697
10. [Online] [cited 2017 July 20]. Available from: URL :
https://www.weforum.org/agenda/2015/12/how-is-india-improving-its-healthcare-system/
11. [Online] [cited 2017 July 20]. Available from : URL :
http://www.bestcurrentaffairs.com/steps-taken-improve-primary-healthcare-system/