The modern public health system in India evolved due to a number of influences from the past 70 years, including British influence from the colonial period. The need for an efficient and effective public health system in India is large. 20% of all maternal deaths and 25% of all child deaths in the world occur in India. 69 out of 1000 children are dead by the time they reach the age of 5. 58% of Indians are immunized in urban areas compared to only 39% in rural areas. Communicable disease is the cause of death for 53% of all deaths in India.