World Health Survey, 2003, India- National Dissemination Seminar 26 September, 2006 : India Habitat Centre, New Delhi

World Health Survey
The World Health Survey (WHS) is a global multi-country survey programme implemented in 70 countries by the World Health Organization to collect high quality baseline data on three major areas of health, namely: levels of health of the population and risks to health, the responsiveness of the health system to peoples’ expectations and the expenditure that people incur on health. The objectives of the WHS were to develop evidence base for informed policy making and develop capacity to monitor trends over time to see if interventions are having the desired effect.

The World Health Organization and the Ministry of Health and Family Welfare, Government of India designated the International Institute for Population Sciences, Mumbai as the nodal agency to undertake the survey in India.

The WHS was conducted in six states of India namely Assam, Karnataka, Maharashtra, Rajasthan, Uttar Pradesh and West Bengal .The states selected are from across the six regions of the country. The survey covered a combined random sample of 10, 279 households and 9,994 adults in ages 18+ with nearly equal proportion of male and female respondents. The survey provides state level estimates of population health indicators for the six states and a pooled estimate for the country.

The six states combined country report and state reports on health system performance were formally released on 26 September, 2006 by Smt. Jaleja, Additional Secretary, NRHM, Ministry of Health and Family Welfare at Casurina Hall, India Habitant Centre, Delhi. Dr. S. J. Habayeb, WHO country representative for India received copies of the reports.

Smt. Jalaja, Addl. Secretary, MOHFW, in her inaugural address observed:
The survey provides valuable baseline evidence base on the burden of disease, health services reach, health state disabilities and health system responsiveness. The data on risk factors can be used for preventive and promotive health care in India. It provides important evidence on inpatient and outpatient health care and the cost of health care services in the context of public health perspective. The evidence also points to the fact that country is moving on the expected direction and suggests areas in which health interventions have to be focussed.

Since NRHM also focuses on interlinkages of the related sectors, the findings reaffirm and the validity of the need to have inter-sectoral link in policy interventions. The evidence base reminds us that the twenty first century is century of health care in the country. The findings are valuable baseline evidence for interventions of the national rural health mission (NRHM).

She also pointed out the importance of periodic survey on health systems to monitor health systems and its various programmes. She posed a challenge to WHO to take a step forward and provide similar evidence base for other states and also at the district level. .

Dr. Habayeb, WHO country representative for India in his special address observed:
The World Health Survey significantly adds to the existing health information data base. Responding to the demand for district level health data base, Dr. Habayeb said that WHO is now funding a follow-up survey of WHS households in six states, known as Study of Global Ageing and Adult Health (SAGE). The proposal of collecting similar evidence base for other states is also being considered.

Panelists: Prof. C. A. K. Yesudian, Prof. Lalit Dandona, Prof. P. N. Mari Bhat and Mr. Sunil Nandraj.
The panellists agreed on the richness of the data. The prevalence of chronic diseases are increasing, physical inactivity in urban areas are significant and are increasing. The data on road accidents and others injuries is completely new which are not available from any other sources. The data on health states valuation is the first time evidence base in India which bride the gap in health information for policy. All these data have direct policy implications. The data on risk factors, morbidity, health state and health services coverage need to be correlated to develop appropriate health system interventions.

The data on morbidity, health state and coverage by income quintiles is a new base of evidence which confirm the expected pattern of evidence. Dispelling the myth, the poor have also reported higher levels of morbidity but in the absence of capacity the health spending among the poor is much lower. In contrast, the respondents of richer household income quintile spent more on their health care. The costing of health care data was one aspect of data on which concern was raised for caution because of smaller sample.

In a nutshell, there was agreement that this survey is new and a foundation for health intervention policies for which there are no existing data base. All the reports and original data sets are to be put on the public domain (WHO, IIPS websites) for the use of researchers and policy makers. In addition, there was a suggestion that wider dissemination should be undertaken to encourage students and researchers to undertake further in-depth analyses of these data and publish their work to engage all stakeholders in the policy debate.

The seminar was organized by Dr. P. Arokiasamy, Dr. H. Lhungdim and Dr. M. Guruswamy. For further information please contact Tel No. 022 – 2557 5206, email parokiasamy@iips.net .

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