Cost effective solutions to address priority diseases, reduce poverty and increase economic growth
The full report can be seen here: Karnataka’s Roadmap to Improved Health
New data on the most common causes of death in Karnataka for men and women at various age groups are presented in a report titled Karnataka’s Roadmap to Improved Health. The report indicates that several hundred thousand people in Karnataka are dying prematurely from easily preventable causes. Using verbal autopsy methodology to rigorously follow up on and establish cause of death for deaths reported through the Sample Registration System, the main causes of death for people below the age of 70 in Karnataka from 2001-03 have been estimated as follows:
• About 48,000 children under the age of 5 in Karnataka died in 2012. Of these, approximately 11,600 newborns died of prematurity & intra-uterine growth retardation, 4,860 died of neonatal infections, and 5,700 died of birth asphyxia & birth trauma before one month old. Approximately 3,750 children died of pneumonia and 3,628 died of diarrhoeal diseases.
• In 2010, about 8,000 children between the ages 5-14 died of avrtable causes. For both boys and girls, about a quarter of the deaths were due to communicable diseases: primarily diarrheal disease and meningitis/encephalitis for boys, and primarily diarrheal disease and measles for girls. This suggests that routine immunization, which is usually reserved for children below five years of age, might also benefit older children. Other significant causes of deaths among 5-14 year old boys are drowning (14%), venomous snakes and animal attacks (9%) and falls (6%); and for girls, drowning (9%) and transport accidents (9%).
• An estimated 35,000 young adults aged 15-29 years died prematurely in 2010. The leading killer by far for both men and women was suicide: 20% of all deaths for men and 21% for women. Other leading causes among young men involved high risk behaviours, such as transport accidents, HIV/AIDS, and alcohol related diseases.
• Pregnant women most often died for reasons that can be addressed by ensuring institutional delivery in good quality institutions, as well as emergency obstetric care: haemorrhage, sepsis, eclampsia and complications from abortion or miscarriage.
• The five leading causes of death in Karnataka among both adult men and women (30-69 years) are heart disease, stroke, chronic lung disease, cancer, and tuberculosis. These five diseases accounted for 57% of all deaths among men and 55% among women.
Based on this analysis of the leading causes of death, the report suggests an Entitlement Package of cost-effective interventions that can prevent over 130,000 premature deaths at the cost of about Rs. 650 per person per year: less than the cost of a monthly bus pass in Bengaluru. Currently the bulk of health expenditures are paid for from personal funds, causing a heavy financial burden on individuals and households, especially the poor. In order to reduce spending by individuals from their personal savings, total government investment in health must increase substantially. This is very much in line with the recommendation of the High Level Expert Group on Universal Health Coverage, which advocates that the government should implement a health entitlement card which assures every citizen access to a national health package of essential in-patient and out-patient health care (Sen, 2012).
The Government of Karnataka can take several steps to achieve good health at reasonable cost: (i) they should increase health budgets sufficiently so that people can access health services without having to pay from their own pocket, especially for essential health care; (ii) they should use the currently available budget to provide comprehensive coverage for the Entitlement Package; and (iii) they should put in place a universal health program with a combination of government and private sector service. The government can directly provide quality services through the existing network of public health facilities at the primary, secondary and tertiary levels. They can also contract well-regulated private providers for selected essential services, paid for by either the government or through social insurance.
Shreelata Rao Seshadri
Professor
Azim Premji University
The full report can be seen here: Karnataka’s Roadmap to Improved Health