Public health service can be divided into two kinds: diseases prevention services and disease –control services.

Good health comes from the available of the nutritious food, clean air and drinking water and good sanitation in the form of clean latrines. To achieve these, both people’s cooperation and governmental efforts are necessary.

Kerala has a low death rate among the people in general, but particularly among infants and pregnant women, only because of the availability of these facilities. Let us understand this in some detail.

About 24 lakh children below the age of five die in India every year. Madhya Pradesh has the highest infant mortality rate with 13.7 per thousand live births, while Kerala has the lowest with 18. In Andhra Pradesh, the infant mortality rate is 85 per thousand. The death rate among pregnant women is 707 against lakh live births in Uttar Pradesh, 670 in Rajasthan, 498 in Madhya Pradesh, 159 in Andhra Pradesh, and 79 in Tamil Nadu.

From an analysis of the above data, we can see that back ward states like Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh have a high death –rate because of lack of sanitation and contaminated water supply. In Tamil Nadu and Kerala, where sanitation is good, untimely deaths are fewer.

Diseases such as diarrhea, pneumonia, malaria, sepsis and tuberculosis cause most of the deaths. All these diseases are the result of unhygienic conditions. In Andhra Pradesh, public health is a major causality in the backward areas of Srikakulam, Vijayanagaram, Telangana, Adilabad and Mahabubnagar.

The most important challenge for the poor is housing. Our villages face a shortage of one crore 50 lakh houses. About one crore 15 Lakhs houses are beyond repair. About 50 lakh houses are very congested. According to the 2001 census, 19 crore families live in rural areas. Of these, 40% live in one –room and 30% in two-room houses. Only 26% of rural families live in three or more rooms. About 34 lakh families have no separate room as such. This is why as part of the Bharat Nirman program, a target of building 60 lakh houses in four years for the below poverty line people has been set, in our rural areas, only 81% of the families have drinking water facilities, 44% have electricity, 34% have drainage facility and 22% have sanitary latrines.

Initially, migration to large cities like Hyderabad, Visakhapatnam, Vijayawada, Kurnool, Warangal and Rajahmundry is either for education or employment. Soon, however, the people settle down in such places. This increases the challenge of urban housing.

Thousands of pilgrims come to temple –towns like Tirupati, Bhadrachalam and Simhachalam every day. They cause immense damage to the rivers and lakes around. Tourists and pilgrims consume water carelessly and damage the soil by littering carelessly. As a result, even basic environmental resources become scarce to the people residing in these areas.

In Sattupalli and Dammayipeta villages of Khammam district, people have stopped littering waste in the open every house and school has proper sanitary condition provide. About 708 schools in the district are implementing the program. The doctors, engineers and sarpanchas here went to each house and convinced the people about the need for hygiene. They made cement rings and installed them in each house as a dustbin.

Even in tribal areas, the construction of toilets has changed people’s lives. The educational committees cooperated in building toilets. In every school, with the help of the United Nations children’s fund [UNICEF] and with constant guidance from experts, the project was completed under the leadership. Though such initiatives and efforts, we can protect our lakes, rivers and environment. We can prevent diseases such as diarrhea and cholera. The examples of the two villages in Khammam should be an inspiration to us.

In 2003, there were 173 municipalities in the state. In 2006, there are 123, showing the rapid development of urban areas. In this rapid urbanization, our state stands seventh in India. In 1971, our urban population was 84 Lakhs. Now it is more than 2.5 crore.

While the urban population in Telangana is 44% the coastal areas have 41% Rayalaseema has only 15%. Hyderabad and Visakhapatnam are the two metropolises in Andhra Pradesh. Nearly 30% of our urban population is concentrated in these two cities.

In 1971, only four cities attracted the migrants. In 2001, twenty-eight cities did so. Hyderabad, Visakhapatnam, Guntur and Vijayawada are under severe pressure from migrants.

Any city can provide facilities for a limited number of people. But with growing populations and increasing migration, the problems increase many times over. There are shortfalls in sanitation, electricity and water supply. Slums, overcrowded buses, traffic jams and obscene of even basic facilities are a common sight. All this is due to growing urban population.



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