**5. Conclusions and limitations**

India's population is increasing at a tremendous rate. With increase in population, the prevalence of morbidity is also increasing. In spite of the vigorous efforts to reduce mortality and morbidity in India, India is still struggling with its unfinished agenda of restricting communicable disease. On the other side, the prevalence of non-communicable is rising rapidly. This leads to heavy double burden of disease in India. The prevalence of communicable diseases in the younger ages has become a threat for the newly born child, whereas the prevalence of non-communicable diseases in middle-aged adult and the older ages is concerning the adults and elderly population. Thus, both the working and dependent populations are in the clutch of morbidity and putting a question on the health system. Females are the real victims of disease sufferers and disability. The increasing significance of non-communicable disease burden also suggests the need for serious intervention strategies to prevent non-communicable disease burden not only for the elderly but also for the adult age group. The basic challenge would be to implement appropriate prevention strategies to halt the growing trend in non-communicable diseases against a background of infectious diseases, which remain out of control. The increasing burden of diseases among working adults and elderly in a country will impose high financial hardship on its government and households.

Though this study examines the burden of communicable and non-communicable disease in India, the result presented in the paper should be interpreted keeping the following limitation in mind: First, all the diseases estimated in this research paper are based on self-reporting rather than medical investigation. Self-reported morbidity is the only variable that gives us information about morbidity in the absence of information from medical fields. One of the major doubts that arise is about the validity of self-morbidity. In the absence of proper knowledge about the ailment, cultural and societal factors, lack of media exposure and socio-economic condition may lead to under- or overreporting and biasness towards self-reported morbidity. The states which are socio-economically well-off report higher morbidity in comparison to the other underprivileged states. A study states that Kerala which is the most developed state in country reports higher morbidity than Bihar which has lower life expectancy and lower educational level. The adequate measurement of morbidity is one of the important factors that do could give us a precise depiction of the prevalence of morbidity [24]. Second, information used (cause of death) in calculation of DALY is based on sample survey rather than complete enumeration. Third, age- and cause-specific proportion of death was not available at state level; therefore, we used the national-level estimate. Fourth, information on proportion of disability was given at 10 years of interval, which is bifurcated in 5 years of interval.
