India's health report card before Covid-19 pandemic: explained in 6 charts

Food poisoning and diarrhea were the main disease outbreaks in India before the Covid-19 pandemic hit. A look at India's health profile in 2019 through six charts

The poorest fifth of India's rural population spent 12 times the poverty line of Rs 972 a month on hospitalisation, out of their pocket in 2019, on average, show data from the recently released National Health Profile. The poorest in urban areas spent, on average, nine times the urban poverty line of Rs 1,407 a month, data show

The National Health Profile is an annual dataset released by the health ministry's Central Bureau of Health Intelligence. In six charts, we look at its highlights:

India had over 480,000 cases of malaria and dengue in 2019

Pneumonia had the highest death rate of any communicable disease, with nearly 6 men for every 1,000 cases, and 5 women for every 1,000 cases, dying with the disease in 2019.

Malaria and dengue were the most common vector-borne diseases--illnesses transmitted by vectors, such as mosquitos. Over 330,000 cases of malaria and over 150,000 cases of dengue were reported in 2019, making up 83% of all vector-borne diseases.

The most deaths from vector-borne diseases were because of Acute Encephalitis Syndrome (AES), a term used to refer to a number of diseases, which include an acute onset of fever and a change in mental status, including confusion, disorientation, delirium and coma.

Japanese encephalitis, of which 220 died in 2019 is, after the eradication of polio, the leading cause of childhood viral neurological infection and disability in Asia, we reported in August 2016.

Hypertension is the most common non-communicable disease in India

The disease pattern in India is changing; non-communicable diseases (NCDs) today make up for a greater share of deaths than do communicable diseases, data show. As a result India's health system faces a dual challenge--it has to grapple with diseases such as diarrhoea, lower respiratory infections, tuberculosis and neonatal disorders, while at the same time caring for those with non-communicable conditions, including heart disease, stroke and diabetes, we had reported in November 2017.

In 2019, over 68 million Indians were screened for NCDs under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke. Of these, 4.3 million were diagnosed with hypertension, followed by 3.3 million with diabetes and 1.3 million with both hypertension and diabetes.

In 2019, India had 187 chickenpox outbreaks, 181 of dengue

India's Integrated Disease Surveillance Programme was launched in 2004 to detect and respond to outbreaks of epidemics, and captures data on 30 diseases prone to outbreaks. In 2019, the country had 1,677 disease outbreaks--most of food poisoning (345), followed by acute diarrheal diseases (341), chickenpox (187), dengue (181) and chikungunya (72).

Health spending out of pocket

Despite the Ayushman Bharat programme, under which 'poor deprived families' receive an annual family health insurance cover of up to Rs 5 lakh for the treatment of diseases that cannot be cured at a primary healthcare center, those in the poorest fifth of the population spent Rs 11,994 out of their pockets on hospitalisation, on average. In urban areas, those in the poorest fifth of the population spent Rs 13,578, on average.

Nearly 40% of the rural population and over 26% of the urban population lives below the poverty line in India, based on 2011-12 data.

To fund hospital expenses, people mostly dip into their savings, while some borrow and some take funds from friends and family.