This article is based on the Dr. K. N. Rao Memorial Oration delivered by professor D.C.S.Reddy at the 50th All India Annual Conference of IPHA at Tirupati.

This article is based on the Dr. A.L. Saha Memorial Oration, delivered by Professor C.S. Pandav at the 50th All India Annual Conference of IPHA at Tirupati

Five blocks of Nasik district in Maharashtra were surveyed in 1999-2000 for distribution and academic degrees of doctors of all kinds. The five blocks have 84 % villages without any health care provider (read doctor) no matter qualified or quack. All the 555 doctors including Govt. doctors are concentrated in 16 % of villages, mainly in small townships and market centers. Physical access to any doctor is thus tedious. Often it requires travelling and hidden costs like loss of wages for the accompanying person. It also involves a hidden cost of deferred treatment. To ensure access to rational medical care at affordable cost a major overhaul of the existing health services is necessary.

Maternal mortality is a major health and development concern. The available information on maternal mortality in rural India is inadequate and scanty. This study presented maternal mortality data from the demographically and developmentally (including for health) poor performing state of Uttar Pradesh. A descriptive, cross-sectional survey was conducted utilizing a stratified cluster sampling design between 1989-90 in eight districts of Uttar Pradesh. Four good performing districts namely, Agra, Farrukhabad, Ghaziabad and Badaun from the western region and four poor performing districts from the eastern region namely, Gorakhpur, Basti, Varanasi and Pratapgarh were chosen. A door-to-door household interview survey was carried out in the selected villages covering a population of 11.67 lakhs in 889 villages. Maternal mortality rates during 1989 ranged between 533745 per 100,000 live births except in Ghaziabad district where the rate was as low as 101 per 100,000 live births. The rate in Eastern U.P. was higher (573 per 100,000 live births) as compared to that in Western U.P. (472 per 100,000 live births). A total of 286 maternal deaths were reported during the study period. The direct obstetric causes accounted for 55.7% of maternal deaths with haemorrhage (26.4%) being the most prevalent. Anaemia and jaundice (17.4%) were the most prevalent indirect causes of maternal deaths. Most of the maternal deaths could have been prevented if timely medical care was available.

Fat and fatty acid intakes of 25 healthy adult urban males from Ghaziabad, U.P.; Goa and Kolkata, W.Bengal, respectively were studied. Fat intakes were estimated using dietary records, food frequency questionnaires and chemical analysis of the diets consumed. Fatty acid intakes were estimated by gas chromatography. Total fat intakes ranged from 26.9 g/day to 163.2g/day. Percent subjects having intakes above the desirable level were 72% in Kolkata, 36% in Ghaziabad, U.P. and only 10% in Goa. Visible fat constituted more than 60 percent of total fat. In all 3 areas, SFA intakes were higher and MUFA lower than desirable levels. Palmitic acid constituted at least 50% of SFA intakes. In Goa, lauric acid, in Ghaziabad and Kolkata, stearic acid and myristic acid were major dietary SFAs, In Kolkata, erucic acid was 17.3΁8.3%. Overall 60% of subjects had n-6:n-3 intakes close to the desirable ratio. Linoleic acid constituted almost the entire n-6 intake. Alpha linolenic acid constituted most of the n-3 intakes in Ghaziabad, U.P. and Kolkata. The ratios of SFA:MUFA--PUFA vaned widely and percent subjects with intakes close to the desirable ratios were 12% in Goa, 23% in Ghaziabad and 40% in Kolkata. The data highlights the need for limiting fat intakes and modifying diets to provide fatty acids in desirable ratios.

Campylobacteriosis is a leading cause of zoonotic diarrhoea in the developed as well as developing countries. Domestic animals particularly the poultry act as a source of human infections. Domestic animal rearing is a very common practice in India particularly in rural areas. The present study of KAP of Zoonosis showed 68.2 % of 500 families interviewed did not have knowledge about zoonotic diseases in rural Bengal and not a single family had any idea of Campylobacter infections.