Issues Impacting Health and Development
Poverty and malnutrition are the leading causes of high maternal and child mortality rates in developing countries. Together, they seriously impair the resistance of the body to infections. In children, malnutrition impacts their learning ability besides leading to high dropouts from schools. This reduces the returns to investment in education. The average real rate of social return on primary schooling in low income countries was estimated at 24 per cent (World Bank, 1981). If improved health status can be ensured through proper nutritional and health care, the rate of return on education can be improved. Better health implies that less resources are required to be devoted for curative health care. Resources thus spared can be spent for other productive purposes. Realising the severity of the problem, the millennium development goals (MDGs) of the UN included three goals to be targeted for achievement by 2015 in the health sector. These are
(i) reduction of under five child mortality by two-thirds;
(ii) improvement in maternal health by achieving reduction in maternal mortality rate by three-quarters;
(iii) combat diseases like malaria, HIV/AIDS and other diseases by reducing their incidence by one-half reversing the spread of such major diseases.
To achieve the above goals, massive funding and policy initiatives are required. Such initiatives, besides focusing on improvement in consumption/nutritional levels, can be centred around the major diseases. Tuberculosis and Malaria are identified to be among the major diseases contributing to adult mortality. Acute respiratory infections is identified to be a major child killer. These diseases are known to hurt rural people more than city dwellers suggesting that the focus of policy initiatives should centre more on the rural population. Some simple measures/provisions identified to prevent the mortality arising from these diseases are: bed-nets, affordable antibiotics, trained birth attendants and spreading awareness on basic hygiene.
However, due to the large magnitude of the problem, the resources required to implement even such simple measures are huge. Along with the issue of limited resources, two other issues confronting the task of effective health delivery are
inequity and inefficiency. While the former refers to the problem of the rural health systems not having enough staff and resources dedicated to women and children, the latter refers to the anomaly on account of non-integration of vertical
programmes for specific diseases with the general health systems. All these concerns have received wide attention everywhere and specific suggestions have been made to tackle these problems.