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India ranked 145th among 195 countries in terms of Healthcare access and quality (HAQ) index in the year 2016, behind its neighbours like China, Bangladesh, Sri Lanka and Bhutan. The index was released as part of Global Burden of Disease study released by Lancet, one of the world’s oldest and best known peer-reviewed general medical journal. Healthcare access and quality (HAQ) Index

The study used index to measure quality and accessibility of healthcare, based on 32 causes of death which should be preventable with effective medical care. Each of 195 countries and territories assessed were given score between 0 (lowest)-100 (highest). For the first time, it also analysed healthcare access and quality between regions within seven countries: Brazil, China, India, England, Japan, Mexico, and US. Key Facts

The global average healthcare access and quality score in 2016 was 54.4, increasing from 42.4 points in 2000. The countries with lowest scores are Central African Republic (18.6), Somalia (19.0), Guinea-Bissau (23.4), Chad (25.4), and Afghanistan (25.9).

India’s Neighbours: India lags behind China (48th), Sri Lanka (71st), Bangladesh (133rd) and Bhutan (134th) in terms of levels of healthcare access and quality. But it is better than Nepal (149th), Pakistan (154th) and Afghanistan (191st). India related Facts

India has seen improvements in healthcare access and quality since 1990. In 2016, India’s healthcare access and quality scored at 41.2 (up from 24.7 in 1990). India performed poorly in tackling cases of rheumatic heart diseases, Ischaemic heart diseases, stroke, tuberculosis, testicular cancer, colon cancer and chronic kidney disease among others. Though, India’s improvements on HAQ index has hastened from 2000 to 2016, but gap between country’s highest and lowest scores widened (23·4-point difference in 1990, and 30·8-point difference in 2016). Goa and Kerala have highest HAQ index scores in 2016, each exceeding 60 points, whereas Assam and Uttar Pradesh have lowest, each below 40.

According recent research, worsening air quality in last two decades has emerged as one of major reasons for high numbers of premature deaths in India. The research was conducted by Indian Institute of Technology (IIT)-Delhi in collaboration with environmental NGO Centre for Environment and Energy Development (CEED). Background

The study was conducted 11 north Indian cities i.e. seven in Uttar Pradesh (Allahabad, Kanpur, Lucknow, Meerut, Varanasi and Gorakhpur), three in Bihar (Patna, Muzaffarpur and Gaya) and one in Jharkhand (Ranchi). It calculated annual mortality burden through averages of recorded deaths caused due to Chronic Obstructive Pulmonary Disease (COPD), Acute Lower Respiratory Infection (ALRI), coronary disease, stroke, and lung cancer in these 11 cities. It also used satellite-based high-resolution PM2.5 database to generate particulate matter statistics for past 17 years. Key Findings of Research

The annual mortality linked to air pollution was in range of 150-300 persons per 1 lakh population. Kanpur recorded highest number of premature deaths per year (4,173) due to chronic exposure to air pollution, followed by Lucknow (4,127), Agra (2,421), Meerut (2,044), Varanasi (1,581), Allahabad (1,443) and Gorakhpur (914).

COPD was largest cause of deaths (at 29.7%) and lung cancer the lowest (0.6%). The largest share in total burden was attributed to ALRI in Agra and Meerut and to COPD in Allahabad, Gaya, Gorakhpur, Kanpur, Lucknow, Patna, Muzaffarpur and Varanasi.

The estimates were not instant deaths, but represented premature (earlier than expected lifetime of Indian population) deaths due to chronic exposure from pollution. This premature mortality burden will be reduced by 14 to 28% annually if these cities achieve of Indian air quality standards.

The mean annual ambient fine particulate matter (PM) concentration was 75-120% higher than Indian annual air quality standard in 10 of 11 cities. The residential (cooking, heating and lighting) sources are largest contributors to annual ambient PM2.5 concentration (73.8%). Moreover, analysis of aerosol composition indicates higher percentage of sulphates, organic carbons and black carbon emitted primarily from anthropogenic sources.