Country profile: India

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Overview

India is a very large country that lies in Southern Asia, with the Himalayas sweeping along it in the north where it borders Pakistan, China, Nepal, Bhutan and Bangladesh, in the south it is surrounded by the Indian Ocean. It is the second most populous country in the world after China. India is emerging as a major power on the world political stage and has a fast growing economy. It has a huge variety of cultures, languages and architecture that make it an amazing place to visit. Due to some significant regional climatic differences, the country is best described in regions.

The Himalaya region in the north contains some of the world’s highest peaks including Kanchenjunga and Nanga Parbat, and is becoming increasingly popular with trekkers and mountaineers despite the remoteness and extreme coldness at high altitude. The foothills are attractive for their pleasant temperature and scenery.

South of this region are the huge alluvial plains of the rivers Ganges, Indus and Brahmaputra which have been settled by waves of immigrants who have been assimilated into the population but still retain many of their own cultural characteristics. Within this area lies the capital city of New Delhi. The area has a tropical monsoon climate.

Further south is the Deccan Plateau, which comprises most of the peninsular part of India, but rises on either side to mountainous ranges, up to 900 metres high (the East and West Ghats) where the altitude moderates the tropical climate. Some areas are densely wooded with valuable timber and are still home to some of India’s wild animals such as elephants and rare snakes.

Although successive governments have attempted to make the country cohesive and profitable, most of the people are poor and the caste system still causes unjustifiable discrimination. The hot climate and dense population add to the spread of innumerable infectious diseases, as does poor waste disposal. Malnutrition is common and the general standard of health in the cities and country alike is very poor while the birth rate is high.

History, art, architecture and religion have always been closely bound together in India. Education has always been deemed very important, producing rich returns over many centuries. Good universities and libraries are available in the major cities of Delhi, Calcutta, Mumbai (Bombay), Chenmai (Madras), Ahmadabad and Banbalore. Hinduism is the main religion, but Muslims, Sikhs and Buddhists and many other religions are present.

Health system

Providing good healthcare for such a large population is a near impossibility, but India does try. India is a Democratic Republic consisting of 28 States and seven Union Territories (directly administered by the Central Government). According to the Constitution of India, state governments have jurisdiction over public health, sanitation and hospitals while the Central Government is responsible for medical education.

In terms of its organization, the health sector primarily comprises of the public and private sectors. Government health care services are organised at different levels, generally corresponding to the organisational structure of the administrative machinery. The Primary Health Centre (PHC) is the core of the rural health services infrastructure in India. It has both outpatient and outreach services. These outreach services are provided by sub-centres and staffed by multipurpose health workers. District hospitals and medical college teaching hospitals along with specialized institutions provide referral care. India has a large and unregulated private sector, in both formal and informal sectors. In the formal sector, the private sector accounts for 68% of the hospitals and 64% of the beds. There are large numbers of informal healthcare providers, most of them being less than fully qualified service providers. The private non-profit sector includes health services provided by voluntary organizations, charitable institutions, missions, and charitable trusts among others. According to a rough estimate, more than 7,000 voluntary organizations in the country work in the area of healthcare.

India is home to many indigenous systems of medicine, including Ayurveda and Siddha. Homeopathy, Unani, Naturopathy and various other systems are also widely practiced. The Government of India and many state governments have taken steps to formalize and initiate standardization of these systems. These include evolving pharmacopoeia standards for drugs, upgrading educational standards in indigenous medicine and in homeopathy colleges in the country and encouraging research on applicability of these systems to specific diseases.

Communicable diseases, perinatal and maternal conditions and malnutrition are the leading causes of mortality, followed by cardiovascular diseases. In India, the communicable disease burden remains significant. Every year, there are over 1.8 million new cases of tuberculosis and about 370,000 deaths resulting from the disease. Over one and a half million people contract malaria each year. It is estimated that over 550 million people live in areas endemic to filariasis are exposed to the risk. As many as 90,000 persons are undergoing treatment for leprosy. More than five million people were living with HIV in India in 2005 with a mixed distribution in the country and with higher prevalence in most southern states and the north-eastern region. The total all India prevalence remains under 1%. Polio is localized now to two geographical areas in Uttar Pradesh and Bihar. Dengue outbreaks have been reported from all over the country. Pregnancies and deliveries are safer in India today than they were in the years immediately following independence. Yet the number of avoidable deaths of mothers and infants is still high.