India still lags behind on many critical health indicators, notwithstanding its impressive turnaround in the last decade
. The easiest way to assess a country’s overall healthcare status is its infant and maternal mortality indicators. The proportion of underweight children in India has gone down from 53.5% in 1990s to 40% in 2015, but yet it is well below the global goal of 26%. Similarly, India’s progress on the goal of achieving maternal mortality rate (MMR) of 109 per 100,000 live births by 2015 will be missed by 31 points
. Of course, these figures vary from one state or region to other.
For instance, the difference in infant mortality rate between the best performing state in India (Goa) and the worst performing states (Madhya Pradesh/Assam) is nearly six fold. If this is taken to the level of social groups, one can observe sharp variations across key health indicators. For instance, the marginalised social groups, particularly the Dalits and Adivasis, are over-represented among India’s undernourished children
This implies that more than two decades of high growth has not yielded comparable positive health outcomes in the country. Ironically, India’s poorer neighbours have shown better performance on many key health indicators. The comparative figures for Bangladesh and Nepal for infant mortality rate are much lower at 33 and 32 per 1000 live births respectively (see Table 1).
The reasons for such poor showing on key health indicators include among other flawed policies, lack of capacity, weak execution, and corruption and above all lack of accountability and coordination among differ
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