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UK report places India 67th in Quality of Death Index, says despite economic growth it ranks low in health care

By Our Representative
A new report by the Economist Intelligence Unit (EIU), United Kingdom, has ranked India on 67th position in the Quality of Death Index (QDI) of 80 countries it has selected. The index is meant to measure how well do governments across the world work to improve life for their citizens so that they “die well”, insisting, economic growth alone cannot improve health facilities for the aged.
A measure of quality of palliative care available to adults, QDI seeks to analyse the approaches taken to “improve the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual”.
While India can console itself that China is placed worse, 71st, in QDI ranking, and Bangladesh on the 79th, the countries that do much better than India include Mongolia (28th), Argentina (32nd), South Africa (34th), Brazil (42nd), Mexico (43rd), Venezuela (45th), Russia (48th), Indonesia (53rd), Vietnam (58th), Kenya (63rd), and Sri Lanka (65th).
As expected, the developed countries better do best with United Kingdom topping, followed by Australia, New Zealand, Ireland, Belgium, Taiwan, Germany, Netherlands and the United States.
The report states, “While the European, Asia-Pacific and North American countries in the top of the index benefit from relatively high levels of government support, several less wealthy countries with less well developed healthcare systems stand out. These include Chile, Mongolia, Costa Rica and Lithuania, which appear in the top 30, at positions 27, 28, 29 and 30 respectively.”
Providing different categories which make up QDI, the report ranks India 51st in palliative and healthcare environment, saying, “India, which was at the bottom of the list in the 2010 Index, is at a slightly higher position in 2015—at 51—reflecting a stronger indication of government commitment.”
Then, India ranks 67th in the human resources category, 74th – one of the worst – in affordability of care category, 59th in the quality of care category, and 45th in community arrangement.
The report praises Mongolia in following words: “Mongolia is an impressive case. The driving force behind the increase in palliative care in the country is Odontuya Davaasuren, a doctor who is helping to build a national palliative care programme, pushing to change prescription regulations to make generic opioids available, training palliative care specialists, and working to include education on palliative care in the curricula for doctors, nurses and social workers.”
“By contrast”, the report states, “Some countries that might be expected to perform more strongly, given their rapid recent economic growth, rank at low positions in the index. India and China perform poorly overall, at positions 67 and 71 in the index. In the light of the size of their populations, this is worrying.”
The report adds, “While the budget allocation for India’s 2012 National Program for Palliative Care was withdrawn, elements of the strategy remains in place and, as a result, some teaching programmes are emerging across the country. Moreover, recent legislative changes have made it easier for doctors to prescribe morphine in India.”
Further, the report places India in the 60th position in the capacity to deliver palliative care, saying, “India has a shortage of specialised care professionals and accreditation for palliative care is not yet the norm.”
The report comments, “In India, the passing in 2014 of the Narcotic Drugs and Psychotropic Substances (Amendment) Act by parliament brings legal clarity for physicians wanting to prescribe opioids to their patients.”
It adds, “While work remains to be done to train doctors and nurses, the passing of the bill represents a major step forward for India, which was criticised in a 2009 Human Rights Watch report for failing to facilitate provision of opioid painkillers to its citizens (an issue also highlighted in the report accompanying the 2010 EIU QDI).”

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