orissa health problem_dr nihar

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MAJOR HEALTH PROBLEMS OF ORISSA

By Dr Nihar Ranjan Ray

Orissa is a high focus state for its culture, heritage, rich with minerals and diseases as well. It has ratedas one of the measurable state so far the health care is concerned. Badly affected by the poverty,illiteracy, natural disasters Orissa registered very poor health indicators as per the WHO reports. Its statewith a population of 3.68 crores, comprising of 85% rural habitants, with 22% Scheduled Tribe and 16.5%Scheduled Caste population. From a lot of health issues I need to focus the following topics with birdvision felling their importance and seriousness.

Infant mortality

Infant Mortality Rate (IMR) is only 53 per 1,000 live births in urban areas as compared to 76 in ruralareas, only 26.4 per cent of tribal children are immunized when compared to 43.7 per cent among thegeneral population in the State and anemia is very high of 61.2 per cent among women.

The State needed to arrest the malnutrition trend as early as possible. "The level of malnutrition in the

State is quite high. Over 30 per cent of children are severely malnourished. As per the latest survey, 40.7per cent under age of 3 are underweight, 45 per cent are stunted and 19.5 per cent are wasted. About 65per cent of children aged between 6 and 35 months are anemic.

Maternal mortality rate

One woman dies every seven minutes from complications related to pregnancy and child birth in Indiaand in Orissa nine women die everyday for the same reasons.

The MMR in the state has come down from 367 per one lac (100,000) child births in 1993 to 358 deathsper one lac births in 2003 which is a very negligible drop. In fact there has not been any significantreduction in the rate of maternal deaths in the last few years and this is a worrying factor, said participantsat the "Know Your Entitlements" organized here to coincide with the National Safe Motherhood Day.

The White Ribbon Alliance-Orissa in collaboration with Department of Health and Family Welfare,

government of Orissa, Unicef and UNFPA organized the workshop.

With a view to curb this problem by minimizing maternal death rate, the White Ribbon Alliance for SafeMotherhood unites individuals, organizations and communities who are committed towards increasingpublic awareness on this issue and promote Safe Motherhood.

This year, the Central government declared, "Know your Entitlement" as the theme of the National SafeMotherhood Day. The objective was to generate awareness amongst women and family members ontheir entitlements under various schemes and policies taken up by the government.

Several NGO's working in the health sector across the state including the Nehru Yuva Kendra which hastrained 12,000 youths for the purpose participated in the workshop here today.

Flood ravaged Orissa

Floods cause health problems in Orissa: Oxfam India has warned that 8.5 million people affected byJuly's floods are facing serious health threats. 78 870 cases of diarrhoea have occurred, resulting in 41deaths; 124 cases of jaundice were reported, with two deaths. 300 people have been bitten by snakes,leading to 22 deaths.

Malaria

Malaria is the foremost public health problem of Orissa contributing 23% of malaria cases, 40% of Plasmodium falciparum cases and 50% of malaria deaths in the country. The tribal population are badlyaffected by the Malaria. More than 60% of tribal population of Orissa live in highrisk areas for malaria.Though the tribal communities constitute nearly 8% of the total population of the country, they contribute


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25% of the total malaria cases and 15% of total P.falciparum cases. Various epidemiological studies andmalariometric surveys carried out in tribal population including primitive tribes reveal a high transmissionof P.falciparum in the forest regions of India, because malaria control in such settlements has alwaysbeen unattainable due to technical and operational problems. In a specific

study conducted in undivided Koraput district, it was observed that the district is endemic for malaria andis hyperendemic in top hills where Bondo primitive tribes are residing.

Diarrhoeal Disorders

Water-borne communicable diseases like gastrointestinal disorders including acute diarrhoea areresponsible for a higher morbidity and mortality due to

poor sanitation, unhygienic conditions and lack of safe drinking water in the tribal areas of the country. Ina cross sectional study conducted by RMRC, Bhubaneswar in 4 primitive tribes of Orissa, the diarrhoealdiseases including cholera was found to occur throughout the year attaining its peak during the rainyseason .Generally the infants ,preschool children and adolescent groups are mostly affected.

Micronutrient Deficiency

Orissa is very much infamous for starvation death cases. Micronutrient deficiency is closely linked withnutritional disorders and diarrhoea. Deficiency of essential dietary components leads to malnutrition,protein calorie deficiency and micronutrient deficiencies (like vit A, iron and iodine deficiency). Vitamin Adeficiency in the form of Bitot's spot, conjunctival xerosis and night blindness was observed

Skin Infection

Skin problems like scabies is a major health problem amongst the rural population of orissa and theproblem is much worse in the primitive tribes because of overcrowding and unhygienic living conditions asalso close contacts and lack of health awareness. In a study conducted by the RMRC, Bhubaneswar.

Intestnal Paracitism

Intestinal protozoan and helminthic infestations are the major public health problems and were observedin Most of these infections are due to indiscriminate defecation in the open field, bare foot walking andlack of health awareness and hygiene. The problem enhances in the rainy season. These are preventablewith repeated administration of anti-helminthic and protozoal treatment at 4 months interval which can beused effectively in national parasitic infection control program.

HEALTH INDICATORS OF ORISSA

The Total Fertility Rate of the State is 2.6. The Infant Mortality Rate is 73 and Maternal MortalityRatio is 358 (SRS 2001 - 03) which are higher than the National average. The Sex Ratio in the State is972 (as compared to 933 for the country). Comparative figures of major health and demographic

indicators are as follows:Table I: Demographic, Socio-economic and Health profile of Orissa State as compared to Indiafigures

S. No.

Item

Orissa

India


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1

Total population (Census 2001) (in million)

36.80

1028.61

2

Decadal Growth (Census 2001) (%)

16.25

21.54

3

Crude Birth Rate (SRS 2007)

21.9

23.5

4

Crude Death Rate (SRS 2007)

9.37.5

5

Total Fertility Rate (SRS 2006)

2.6

2.9

6

Infant Mortality Rate (SRS 2007)

73

57

7

Maternal Mortality Ratio (SRS 2001 - 2003)

358

301

8

Sex Ratio (Census 2001)

972

933

9

Population below Poverty line (%)47.15

26.10

10

Schedule Caste population (in million)

6.08

166.64


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Schedule Tribe population (in million)

8.15

84.33

12

Female Literacy Rate (Census 2001) (%)

50.5

53.7

Table II: Health Infrastructure of Orissa

Particulars

Required

In position

shortfallSub-centre

7283

5927

1356

Primary Health Centre

1171

1279

-

Community Health Centre

292

231

61

Multipurpose worker (Female)/ANM at Sub Centres & PHCs

7206

6768

438

Health Worker (Male) MPW(M) at Sub Centres

5927

33922535

Health Assistant (Female)/LHV at PHCs

1279

726

553

Health Assistant (Male) at PHCs


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1279

168

1111

Doctor at PHCs

1279

1353

-

Obstetricians & Gynaecologists at CHCs

231

NA

NA

Physicians at CHCs

231

NA

NAPaediatricians at CHCs

231

NA

NA

Total specialists at CHCs

924

NA

NA

Radiographers

231

8

223

Pharmacist

1510

1984

-

Laboratory Technicians

1510

3111199

Nurse/Midwife

2896

637

2259

(Source: RHS Bulletin, March 2007, M/O Health & F.W., GOI)


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Health Institution

Medical College-6

District Hospitals-32

Referral Hospitals

City Family Welfare Centre

Rural Dispensaries

Ayurvedic Hospitals-8

Ayurvedic Dispensaries-624

Unani Hospitals

Unani Dispensaries-9

Homeopathic Hospitals

Homeopathic Dispensary-603

Conclusion

Despite the above said problems we have to make our stands strong to fight against the disease,poverty, illiteracy and natural as well as the man made disasters(Naxlite problem).Now under the ableleadership of Mr Naveen Pattnaik Orissa has registered record foreign investment as well as anappreciable economical growth. Now it is time to flex our muscles and brain to expedite our developmentin health care system. Orissa is doing well in the influence of NRHM .Orissa has many a miles to go toimprove its health indicators that needs a lot of patience, composure and brain storming.

Dr.Nihar Ranjan Ray

Dt.29th july 2008

orissa health problem_dr nihar

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