Dual Disease Burden

During the 1990s the mortality rate in the province reached a plateau and now the state has entered into a new era of dual disease burden. On one hand, it has become more difficult to combat communicable diseases because of development of insecticides resistant strains of vectors, antibiotics resistant strains of virus and bacteria and emergence of HIV infection for which there is no therapy. On the other hand longevity and changing lifestyles have resulted in increasing prevalence of non-communicable diseases. Under nutrition, micro-nutrient deficiencies and associated health problems coexist with obesity and non-communicable diseases.

Indian Council of Medical Research has identified the following communicable diseases that to a large extent contribute to morbidity and mortality in the province:

• Tuberculosis
• Tetanus
• Diarrhoea
• Acute respiratory infections
• Measles
• Malaria
• Polio
• Leprosy
• Filariasis

HIV/AIDS is now emerging as a new challenge to be tackled.

Undernutrition is another major problem affecting the health status in the province. Undoubtedly Green Revolution ensured that increase in food production stayed ahead of increase in population. The public distribution system was revamped to improve access to food. Some schemes like food supplementation for pre-school children, primary school children, pregnant and lactating women also have been initiated along with national programmes for tackling anaemia, iodine deficiency disorders and vitamin A deficiency. As a result of these interventions there has been some reduction in severe grades of under nutrition among children. However, several challenges still remain. Appropriate steps have to be taken to minimise potential adeverse consequences of globalisation on domestic production and employment. In spite of huge buffer stock many do not get two meals a day and there are pockets where severe undernutrition takes its toll even today. Every third child is underweight. Low birth weight is associated with higher infant morgality rate and long term health consequences including increased risk to non-communicable diseases. Micronutrient deficiencies are widespread. More than half of women and children are anaemic.

Indicators reflecting health status in Uttar Pradesh

Source: SRS 1998 and RCH-RHS 1997-98