MUMBAI: Global experts have identified a new killer: poor quality healthcare. Around five million people die every year — almost a third of them in India (1.6 million) — due to inadequate healthcare , said a new analysis published in The Lancet There is an “epidemic of poor quality care”, said the study compiled by 30 public health experts from across the world and supported by the Gates Foundation and Harvard T H Chan School of Public Health. As countries work towards the WHO’s diktat of providing free healthcare access to all, the Lancet Global Health report aimed to point out that “improved access to care is not sufficient to improve health”.The past 20 years have been called a golden age for global health, said the report while noting the major increase in domestic health spending and donor funding in low and middle income countries. The number of deaths due to heart attacks, stroke, diabetes, neonatal mortality, and injuries have either increased or stagnated.It is becoming clear that access to health care is not enough, and that good quality of care is needed to improve outcomes. “India learned this with Janani Suraksha Yojana, a cash incentive programme for facility births, which massively increased facility delivery but did not measurably reduce maternal or newborn mortality,” said the analysis that included India’s Public Health Foundation of India. At present, 130 women die during childbirth for every 1,00,000 live births in India.Gynecologist-turned-health activist Dr Arun Gadre said that as a doctor in a rural setting he had seen the poor quality of healthcare.The Lancet study noted that only 40% of the items on WHO’s safe childbirth checklist are followed in UP. Diagnostic accuracy for childhood pneumonia in primary healthcare settings in India hovers between 8 and 20% and mammogram coverage is 1% in India. “Healthcare has grown in the last few decades, but it has not translated into better healthcare,” said liver surgeon Dr S Nagral said. One explanation could be that the growth has occurred mainly in private sector that most of the population cannot access.“Quality care should not be a privilege for a lucky few, in a few facilities, in a few countries. Health systems must effectively protect, treat and respect all people, especially the vulnerable,” noted the study.