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Prevention of Chronic Diseases: Reorienting Primary Health Systems in India

dc.contributor.authorAli Mehdi
dc.contributor.authorDivya Chaudhry
dc.contributor.authorPriyanka Tomar
dc.contributor.authorPallavi Joshi
dc.description.abstractIndividuals should be entitled to a ‘fair innings’, and the primary role of health systems should be the prevention of premature mortality. In India, 66 percent of all deaths are premature. The burden of premature mortality has shifted from child (0-5 years) to adult (30-69 years) level over the years – there are three times more deaths happening at the latter vis-ŕ-vis the former level. Nevertheless, primary health systems continue to focus almost exclusively on child mortality. They need to make a health system transition and get engaged in the prevention of risk factors, morbidity and mortality related to chronic diseases – the biggest determinant of adult mortality – together with their original focus on child mortality. This paper analyzes some of the major challenges in terms of governance, manpower and financing that such a transition will be faced with, and offers a number of actionable policy recommendations. It does so based on desk and field research in four Indian states – Uttar Pradesh, Rajasthan, Kerala and Tamil Nadu (two health-backward and two health-advanced) – and four countries – Japan, Canada, United States and Sri Lanka (with varying probability of premature mortality due to non-communicable diseases) – involving semi-structured interviews with close to 200 stakeholders from policy, industry, international organizations, civil society and the academia. A reorientation of national and state health policies, systems and resources (financial, human and infrastructural) is urgently required to begin addressing the massive burden of premature mortality due to chronic diseases in India – the highest in the world – and prevent human and economic costs associated with them. State governments will have to embrace their legal responsibility of being the primary agents for the survival and health of their population. Their role is also the most critical because prevention of chronic diseases requires a sustained, long-term engagement, which neither the Centre nor international organizations could commit to. There will, however, be macro roles – visionary, regulatory, financial, technical, etc. – that the Centre will have to play towards this end.
dc.publisherIndian Council for Research on International Economic Relations
dc.titlePrevention of Chronic Diseases: Reorienting Primary Health Systems in India
dc.typeWorking Papers
dc.subject.expertGood Governance
dc.subject.expertGovernance Approach
dc.subject.expertGovernance Models
dc.subject.expertWorld Health Organization
dc.subject.expertQuality of Health Care
dc.subject.expertPublic Health Finance
dc.subject.expertPrivate Health Care
dc.subject.expertHealthier Families
dc.subject.expertNutrition and Health Care
dc.subject.expertHealth Statistics
dc.subject.expertHealth Objectives
dc.subject.expertHealth Issues
dc.subject.expertHealth Care Cost Control
dc.subject.adbPolitical Leadership
dc.subject.adbPublic Administration
dc.subject.adbTraditional Medicine
dc.subject.adbMedical Statistics
dc.subject.adbMedical Services
dc.subject.adbMedical Costs
dc.subject.adbHealth Costs
dc.subject.adbMedical Aspects
dc.subject.adbChild Nutrition
dc.subject.naturalCivil government
dc.subject.naturalCommon good
dc.subject.naturalFederal government
dc.subject.naturalDelivery of government services
dc.subject.naturalGovernment missions
dc.subject.naturalPublic health records
dc.subject.naturalCost of medical care
dc.subject.naturalNutrition policy
dc.subject.naturalHealth status indicators
dc.title.seriesICRIER Working Papers
dc.contributor.imprintIndian Council for Research on International Economic Relations
oar.themeLabor Migration
oar.adminregionSouth Asia Region
oar.authorMehdi, Ali
oar.authorChaudhry, Divya
oar.authorTomar, Priyanka
oar.authorJoshi, Pallavi

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