New Delhi, Jun 19 (PTI) Health insurance in India is a growing segment, yet it hasn't taken off fully and several measures are needed to improve and expand insurance coverage, according to the National Health Profile 2018 released today.

Out of 4,37,457 persons covered under insurance, 79 per cent were covered by public insurance companies, with the remaining being covered by private insurance companies, it said.

The cost of treatment has been on the rise in India and it has led to inequity in access to health care services, according to the report.

Per capita public expenditure on health in nominal terms has gone up from Rs 621 in 2009-10 to Rs 1,112 in 2015-16, stated the report.

The report stated that the centre-state share in total public expenditure on health was 31:69 in 2015-16. The share of Centre in total public expenditure on health has been declining steadily over the years, except 2017-18.

National health programmes launched by the government have played a crucial role in tackling several serious health concerns, communicable and non-communicable diseases over the last two decades.

Malaria has been a problem in India for centuries and both the cases reported and deaths due to malaria have come down over the years.

The malarial death rate in India declined to 0.01 deaths per lakh population in 2016 from 0.10 deaths per lakh population in 2001.

To achieve malaria-free country by 2027 and elimination by 2030, National Startegic Plan (NSP) 2017-22 for Malaria Elimination has been developed by National Vector Borne Disease Control Programme.

Kala azar is the second largest parasitic killer in the world. In India Leishmania donovani is the only parasite that causes the disease. Bihar accounts for most of the cases by kala-azar. Out of the overall cases reported in 2017, 72 per cent of the cases have been reported in Bihar (table no 3.1.3)

Dengue and Chikunguniya transmitted by Aedes mosquitoes are a cause of great concern to public health in india. Every year, thousands of individuals are affected and contribute to the burden of health care.

Dengue outbreaks have continued since the 1950s but severity of disease has increased in the last two decades. There has been considerable decrease in the number of swine flu cases/deaths in the year 2014 as compared with 2012 and 2013, it said.

However, the number of cases and deaths has been drastically increased in the year 2015. In 2016, the cases have been decreased to 1786 and again increased to 38811 in 2017 (table no 3.1.28). Similarly, total to 63,679 cases of Chikungunya were reported in 2017 as compared to 64,057 cases in 2016, it said.

Estimated birth rate, death and natural growth rate are showing a declining trend. Estimated birth rate declined from 25.8 in 2000 to 20.4 in 2016 while the death rate declined from 8.5 to 6.4 per 1000 population over the same period, the report stated.

The SRS 2016 shows that total fertility rate -- the average number of children that will be born to a woman during her lifetime -- in 12 states has fallen below two children per women and nine states have reached replacements levels of 2.1 and above. Delhi, Tamil Nadu and West Bengal have lowest fertility among other countries. Fertility is declining rapidly, including among the poor and illiterate.

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