Notes from National Health Profile (NHP) of 2019

India releases reports on our National Health Profile, the latest of which came out in the year 2019.

Some notes from that report:

  • 8.5% of our population is above the age group of 60:

    Age group-wise distribution of population of the country projected for 2015 and 2016 are given at Table No. 1.1.4(a) and Table No. 1.1.4(b) respectively. Accordingly to Table No. 1.1.4 (b), 27% of the total estimated population of 2016 were below the age of 14 years and majority (64.7%) of the population were in the age group of 15-59 years i.e. economically active population and 8.5% population were in the age group of 60 to 85+ years.

  • Here is the death rate by age group. The chart doesn’t mention this clearly, but this should be per ‘000 people.
  • I got to learn about the Integrated Disease Surveillance Project (page 128 and 129 on the National Health Profile report)
  • Public expenditure on health as a percentage of GDP was 1.02% in 2015-16. There is no significant change in expenditure since 2009-10. (Table 4.1.2)

  • The Centre-State share in total public expenditure on health was 31:69 in 2015-16. (Figure 4.1.1)

  • Around 48 crore individuals were covered under any health insurance in the year 2017-18. This amounts to 37.2% of the total population of India. 78% of them were covered by public insurance companies. (Table 4.3.5)

  • Overall, 80% of all persons covered with insurance fall under Government sponsored schemes. (Table 4.3.5)

  • Our spending on health as a % of GDP vis-a-vis other countries:
  • And a more specific comparison:
  • Number of Registered allopathic doctors possessing recognized medical qualifications (under MCI Act) and registered with state medical council for the years 2017 and 2018 were 43,581 and 41,371 respectively. At present average population served by Government Allopathic Doctor is 10,926 number of persons served per allopathic doctor. (Table 5.1 and 5.3)

  • There are 20,48,979 Registered Nurses and Registered Midwives (RN & RM) and 56,469 Lady Health Visitors serving in the country as on 31.12.2017

  • Medical education infrastructures in the country have shown rapid growth over the past few years. The country has 529 medical colleges, 313 Dental Colleges for BDS & 253 Dental Colleges for MDS. The total number of admissions for academic year 2018-19 in Medical Colleges is 58756.

  • There are 4035 hospitals and 27951 dispensaries to provide Medical care facilities under AYUSH by management as on 1.4.2018.

  • Health-care is the right of every individual. 60% of population lives in rural India. To cater the health needs of these rural populations there are 158417 Sub Centers, 25743 Primary Health Centers and 5624 Community Health Centers in India as on 31st March 2018

  • There are 43 government mental hospitals in this country. Table 6.2.7, on page 273 of the report

 

If there are other government reports that you know of that you think people should know about, please comment or email them in. I’ll share ’em here.

The Nobel Prize in Economics, 2019

Abhijit Banerjee, Esther Duflo and Michael Kremer have won the Nobel Prize in Economics for the year 2019.

Does Giving Aid Work?

When I teach classes in development economics, I often speak about the Easterly-Sachs spectrum*. Without getting into long, boring details, here is the point: William Easterly is of the opinion that giving aid does more harm than good. At the other end of the spectrum is Team Sachs: no way are countries ever going to develop without aid.

Now you, I and everybody else we know may have an opinion about this spectrum, and we could spend the rest of our lives arguing about our opinions. But if the issue is ever to have a chance of being settled, we need evidence, one way or the other.

Where to get that evidence from? How?

This year’s Nobel Prize has been awarded to the three people listed above for their attempt(s) at answering these questions.

The issue is impossibly difficult to deal with. Say you give aid to a country, and say the country does well next year. How much of the improvement was because of your aid? How much of the improvement would have taken place any way? Might it be the case that the improvement would have been (horror!) even more had you not given the aid? What if you gave aid to improve, say, primary healthcare for youngsters, and educational outcomes improved. Did kids learn better because of the aid given for healthcare? And on and on, making the issue all but impossible to resolve.

Nobel Prizes ought to be given for making all but impossible to resolve issues tractable, and from that viewpoint, this is an excellent choice.

The way the Nobel Prize winners sought to resolve this issue was by setting up experiments. Or, to use the jargon du jour, by setting up Randomized Control Trials. Or Impact Evaluations, if you will.

What are RCT’s?

Malaria is a frustrating disease to think about, because one the simplest ways to deal with it is to prevent it. And prevention is, for the most part, simply caused most effectively by using mosquito nets. And so an NGO called TAMTAM started distributing mosquito nets in Kenya.

Would people buy the nets if they weren’t subsidized? What if they were partially subsidized? What if they were free? This example is drawn from Poor Economics, but the idea is very simple (to describe, at any rate!): find out what works by experimenting.

Whichever method works best, well, deploy it.

Banerjee, Duflo and Kremer have all run a series of experiments on a variety of issues to figure out precisely this: which method is working best? Set up, as carefully as possible, an experiment to find out what works, and to what extent. Read Alex Tabarrok’s post over on Marginal Revolution to get a sense of some of the experiments that have been carried out.

There have been experiments carried out on gender, on mosquito nets, on savings behavior: the works. If you are curious about what kind of experiments have been carried out, this is a useful website.

So, awesome! Right? Well…

A long(ish) video, but here’s one of the dissenting voices.

 

But still…

All of the above being said, RCT’s have been fairly interesting in terms of helping us understand how a specific part of the world works for a specific period of time.

More than that is difficult to say, but that doesn’t mean at least that much shouldn’t be said!

Additional Links

  1. A book about randomized control trials.
  2. The latest book by Duflo and Banerjee (not out yet!)
  3. The Twitter thread announcing the news, from the official Nobel Prize Twitter handle.
  4. Via Niranjan Rajadhakshya’s Twitter feed, an old profile he had done of Banerjee and Duflo.
  5. Here is an old talk given by Michael Kremer on RCT’s.

Thursday’s links, needless to say, will be other posts written about this years prize winners.

The Bottom Line

Work done by Banerjee, Duflo and Kremer has helped us uncover some surprising truths, changed our guesses about what would happen to y if x was done, and we have come along much more in terms of the science of setting up credible, well designed, carefully constructed experiments. Whether or not you agree with their current popularity, they have aided our understanding of the world we live in, and that ought to be celebrated.

Congratulations!

 

 

 

 

 

 

*Duflo and Banerjee speak about this at the very start of their excellent book, Poor Economics, which is where I got the idea from, of course.