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GS Paper: GS2-13.Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

  • Silent Salt Consumption Epidemic

    Why in the News?

    The National Institute of Epidemiology (ICMR-NIE) has launched a community-driven initiative to promote awareness and encourage the adoption of low-sodium salt substitutes.

    About the Silent Salt Consumption Epidemic:

    • What is it: The epidemic refers to the widespread, unmonitored intake of excess salt leading to chronic diseases.
    • Silent Nature of the Problem: It remains “silent” as its health impacts like hypertension and heart ailments develop gradually over time.
    • Cultural and Behavioral Factors: Cultural dietary habits and low public awareness contribute to its persistence.
    • Public Health Recognition: ICMR-NIE has termed it a public health crisis, prompting intervention projects in selected states.

    Salt Consumption in India:

    • Urban-Rural Disparity: Urban Indians consume about 9.2 grams of salt per day, while rural populations consume around 5.6 grams—both above safe limits.
    • Gender-Based Consumption Data: A national survey (2023) revealed men consume 8.9 grams and women 7.1 grams daily.
    • Dietary Practices and Salt Intake: The excessive intake is tied to Indian cooking styles, snack consumption, and processed food habits.

    WHO Directives on Salt Consumption:

    • Recommended Salt Intake: WHO recommends a maximum daily salt intake of 5 grams per person.
    • Global Average Consumption: The global average salt consumption stands at 10.8 grams/day, highlighting a universal public health challenge.
    • Suggested Interventions: WHO encourages the use of low-sodium salt substitutes and public education campaigns to reduce consumption.

    Issues with High Salt Consumption:

    • Health Impact: Linked to kidney stones, osteoporosis, high blood pressure, cardiovascular diseases, and strokes.
    • Mortality Burden: Globally, excess salt intake is responsible for around 5 million deaths annually.
    • Limited Access to Low-Sodium Salt: Only 28% of retail outlets in Chennai had low-sodium salt; just 4% availability in small grocery shops.
    [UPSC 2005] Assertion (A): The person with diabetes insipidus feels thirsty. Reason (R): A person with diabetes insipidus suffers from excess secretion of vasopressin.

    Options: (a) A is true but R is false* (b) Both A and R are individually true and R is the correct explanation of A (c) A is false but R is true

    (d) A is false but R is false

     

  • [pib] 10 Years of Skill India Mission

    Why in the News?

    The Ministry of Skill Development and Entrepreneurship launched a week-long celebration to commemorate 10 years of the Skill India Mission.

    About Skill India Mission:

    • Launch: It was launched in 2015 by the Ministry of Skill Development and Entrepreneurship (MSDE) to empower India’s youth with employable skills.
    • Training Target: The mission aims to train 40 crore individuals by 2022 across various economic sectors and make them job-ready.
    • Progress Achieved: Over 2.27 crore people have been trained under the programme, including rural youth, women, and marginalized communities.
    • Standardization and Quality Assurance: All training and certifications are aligned with the National Skills Qualification Framework (NSQF), ensuring uniform standards and industry relevance.
    • Digital Integration: The courses are digitally integrated with DigiLocker and the National Credit Framework (NCrF) for secure storage and seamless academic and career progression.
    • Employment and Education Linkages: It promotes formal recognition of skills, enhances industry alignment, and ensures better linkages with employment and higher education.

    Components of Skill India Mission:

    [A] Pradhan Mantri Kaushal Vikas Yojana 4.0 (PMKVY 4.0)

    • Focus: It provides short-term training, reskilling, and upskilling opportunities for the youth.
    • Target Age Group: The scheme targets individuals aged 15 to 59 years.
    • Courses Offered: More than 400 new courses have been introduced in emerging technologies such as artificial intelligence (AI), 5G, cybersecurity, green hydrogen, and drones.
    • Recognition and Mobility: It emphasizes international mobility and recognition of prior learning (RPL) to certify existing skills.
    • Alignment with Flagship Missions: It is aligned with flagship government missions like PM Vishwakarma, Surya Ghar Muft Bijli Yojana, and the National Green Hydrogen Mission.

    [B] Pradhan Mantri National Apprenticeship Promotion Scheme (PM-NAPS)

    • Objective: PM-NAPS aims to promote apprenticeship training across industries by providing financial support.
    • Incentive Structure: It offers 25% of the stipend (up to ₹1,500 per month) through Direct Benefit Transfer (DBT) to apprentices.
    • Sectoral Expansion: The scheme has expanded apprenticeship opportunities in sectors like AI, robotics, blockchain, green energy, and Industry 4.0.
    • Special Focus Areas: It gives special attention to small establishments, MSMEs, Aspirational Districts, and the North-East region.
    • Target Age Group: The scheme targets individuals in the age group of 14 to 35 years.

    [C] Jan Shikshan Sansthan (JSS) Scheme

    • About: It is a community-based vocational training initiative.
    • Target Beneficiaries: It focuses on empowering women, rural youth, and economically weaker sections through low-cost, flexible skilling programmes.
    • Target Age Group: The scheme is designed for individuals aged 15 to 45 years.
    • Integration with National Initiatives: The scheme is integrated with inclusive national initiatives like PM JANMAN and ULLAS (Understanding of Lifelong Learning for All in Society).
    [UPSC 2018] With reference to Pradhan Mantri Kaushal Vikas Yojana, consider the following statements:

    1. It is the flagship scheme of the Ministry of Labour and Employment.

    2. It, among other things, will also impart training in soft skills, entrepreneurship, financial and digital literacy.

    3. It aims to align the competencies of the unregulated workforce of the country to the National Skill Qualification Framework.

    Which of the statements given above is/are correct?

    Options: (a) 1 and 3 only (b) 2 only (c) 2 and 3 only* (d) 1, 2 and 3

     

  • PARAKH Survey reveals deficits in Student Learning

    Why in the News?

    The Ministry of Education recently released the PARAKH Rashtriya Sarvekshan (RS) Report, an extensive nationwide student performance assessment for Grades 3, 6, and 9.

    About PARAKH:

    • Full Form: PARAKH stands for Performance Assessment, Review, and Analysis of Knowledge for Holistic Development.
    • Establishment: It was established in 2023 as an autonomous institution under the National Council of Educational Research and Training (NCERT).
    • Vision and Role: PARAKH functions as India’s national assessment regulator, aiming to standardize school-level assessments across states and boards.
    • Policy Alignment: The initiative is aligned with the National Education Policy (NEP) 2020, which promotes competency-based, equitable, and inclusive learning.
    • Core Objective: Its main objective is to develop norms, standards, and guidelines for assessing learning outcomes at the national level.
    • Key Functions:
      • Standardization of Boards: PARAKH seeks to ensure equivalence in academic standards across various state and central school boards.
      • Assessment Focus: It designs and implements competency-based assessments, moving away from rote learning.
      • Progress Tracking: The unit is responsible for developing Holistic Progress Cards across the Foundational, Preparatory, Middle, and Secondary stages.
      • Survey Execution: It conducts Large-Scale Achievement Surveys, such as the PARAKH Rashtriya Sarvekshan (RS) (formerly known as the National Achievement Survey (NAS) launched in 2021) to track student learning outcomes at scale.

    Key Highlights of the PARAKH Rashtriya Sarvekshan (RS) Report – 2024:

    • Scale of the Survey: Assessed over 21.15 lakh students from Grades 3, 6, and 9, across 74,229 schools in 781 districts.
    • Top performers: Punjab, Kerala, Himachal Pradesh, Chandigarh, and Dadra & Nagar Haveli and Daman & Diu; low-performing districts were concentrated in Meghalaya, Jharkhand, and Arunachal Pradesh.
      • In Grade 3, around 60–70% of students demonstrated basic reading, vocabulary, and early math skills, though many struggled with geometry and spatial reasoning.
      • In Grade 6, fewer than 40% could solve real-life arithmetic problems or understand fractions, indicating gaps in conceptual understanding and application.
      • In Grade 9, only 28–31% applied percentages or understood number systems; less than half grasped core civic and scientific concepts such as the Constitution, biodiversity, or electricity.
    [UPSC 2017]  With reference to ‘National Skills Qualification Framework (NSQF)’, which of the statements given below is/are correct?

    1. Under NSQF, a learner can acquire the certification for competency only through formal learning. 2. An outcome expected from the implementation of NSQF is the mobility between vocational and general education.

    Select the correct answer using the code given below:

    Options: (a) 1 only (b) 2 only* (c) Both 1 and 2 (d) Neither 1 nor 2

     

  • [8th July 2025] The Hindu Op-ed: Fostering a commitment to stop maternal deaths

    PYQ Relevance:

    [UPSC 2020] In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss.

    Linkage: The article on maternal mortality highlights various deficiencies in healthcare delivery and infrastructure (e.g., lack of specialists, blood banks, operation theatres, and trained personnel) that contribute to maternal deaths, indicating the critical need for sound policies. This question is most directly relevant as it specifically names “maternal health care” as a crucial area for sound and adequate healthcare policies to enhance social development.

     

    Mentor’s Comment:  Despite progress, India still loses 93 mothers for every 1,00,000 births due to problems that could be prevented during childbirth. Although the number has come down from 103 (2017–19) to 93 (2019–21), there are still huge differences between states. For example, Kerala has brought the number down to 20, but in states like Madhya Pradesh (175) and Assam (167), the numbers are very high.

    Today’s editorial analyses the issues related to India’s Maternal Mortality Ratio. This topic is important for GS Paper I (Women-related Issues) and GS Paper II (Social Justice and Health) in the UPSC mains exam.

    _

    Let’s learn!

    Why in the News?

    India’s Maternal Mortality Ratio is going down, but some states still need to work on solving basic problems and improving their healthcare systems.

    What do MMR trends reveal about regional disparities in India?

    • Declining National MMR: India’s MMR dropped from 103 (2017–19) to 93 (2019–21), showing slow but consistent improvement.
    • Kerala leads with an MMR of 20, indicating robust institutional care and maternal health awareness.
    • Southern States (like Tamil Nadu and Andhra Pradesh) show better performance (MMR under 50–60), while EAG States such as Madhya Pradesh (175) and Assam (167) remain critical zones.
    • “Other” States: Maharashtra (38) and Gujarat (53) have made notable progress, while Punjab (98) and Haryana (106) still struggle.

     

    Why is India’s Maternal Mortality Ratio still high despite better healthcare access?

    • Regional Disparities in Healthcare Infrastructure: MMR is significantly higher in Empowered Action Group (EAG) states like Assam (167) and Madhya Pradesh (175), compared to Kerala (20). Eg: States like Bihar and UP face shortages in skilled staff and poor facility access, despite national programmes.
    • Inadequate Functioning of FRUs (First Referral Units): Many FRUs lack specialists, blood banks, and operating theatres. Over 66% of specialist posts remain vacant. Eg: In 2,856 designated FRUs, many lack anaesthetists or functional surgical units, risking lives in emergencies.
    • Three Delays in Maternal Care: Delays in seeking care, reaching hospitals, and receiving treatment result in avoidable deaths.  

    How are the three key delays contributing to maternal deaths?

    • Delay in Decision-Making at Home: Families often fail to recognise danger signs during pregnancy or childbirth and delay seeking medical help. Eg: A pregnant woman showing signs of excessive bleeding may not be taken to a hospital promptly due to family neglect, financial constraints, or the belief that delivery is natural.
    • Delay in Reaching a Healthcare Facility: Lack of timely transportation from remote or rural areas hinders access to skilled birth attendants or emergency care. Eg: A woman in a tribal village may take hours to reach a hospital due to poor roads or lack of ambulances, resulting in delivery en route.
    • Delay in Receiving Adequate Care at the Facility: Even after reaching a hospital, care may be delayed due to absence of doctors, operation theatres, or blood supply. Eg: A woman experiencing uterine rupture may not get immediate surgery because the anaesthetist is unavailable or the OT isn’t ready.
    What are First Referral Units (FRUs)?

    First Referral Units (FRUs) are designated health facilities equipped to provide comprehensive emergency obstetric and newborn care (CEmONC). These units serve as the first-level referral centres for maternal and child health emergencies, especially in rural and underserved areas.

     

    How can FRUs be made more effective in reducing maternal deaths?

    • Ensure Availability of Specialist Medical Staff: FRUs must be equipped with qualified obstetricians, anaesthetists, and paediatricians to handle maternal emergencies. Eg: In many districts, over 60% vacancies in specialist posts mean pregnant women cannot access timely surgeries like C-sections, leading to avoidable deaths.
    • Establish Fully Functional Emergency Infrastructure: FRUs must have operational operation theatres, blood banks, and 24×7 emergency care to address complications like postpartum haemorrhage. Eg: A woman suffering massive bleeding after childbirth can be saved if a blood transfusion and surgery are available within two hours.
    • Strengthen Referral and Transport Systems: Ensure robust ambulance networks and clear referral protocols to reduce delays in reaching FRUs from rural or remote areas. Eg: The 108 ambulance service, when linked efficiently with FRUs, can reduce deaths caused by obstructed labour during long-distance travel.

    What lessons does the Kerala model offer for reducing MMR nationwide?

    • Confidential Review of Maternal Deaths: Kerala uses a systematic review process to study every maternal death to identify medical and systemic gaps. Eg: Led by Dr. V.P. Paily, Kerala’s Confidential Review Committee analyses causes like hemorrhage, embolism, or surgical delay, enabling precise interventions.
    • High-Quality Emergency Obstetric Care: Kerala emphasizes emergency preparedness, with trained obstetricians, well-equipped operation theatres, and availability of blood banks.  
    • Holistic Maternal Health Approach: Kerala addresses not only physical but also mental health aspects of pregnancy, like antenatal depression and postpartum psychosis.  

    Way forward: 

    • Strengthen FRUs and Emergency Care Infrastructure: Ensure that all First Referral Units (FRUs) are fully staffed with specialists, equipped with blood banks, operation theatres, and essential medicines to manage obstetric emergencies swiftly.
    • Scale Up Kerala’s Model Nationwide: Implement confidential maternal death reviews, train healthcare personnel in advanced obstetric practices, and integrate mental health support into maternal care programs across all States.

  • National Sports Policy, 2025

    Why in the News?

    The Union Cabinet recently approved the National Sports Policy, 2025.

    About the National Sports Policy, 2025:

    • It is a comprehensive policy approved by the Union Cabinet to transform India into a leading sporting nation.
    • It replaces the earlier 2001 policy and aligns with the vision of Viksit Bharat @2047 and the National Education Policy (NEP) 2020.
    • The policy envisions India as a global sporting powerhouse and strengthens its bid to host international events, including the 2036 Olympic Games.
    • It was developed through extensive consultations involving central ministries, NITI Aayog, state governments, national sports federations, athletes, and experts.
    • The Khelo Bharat Niti 2025 serves as the operational framework for NSP 2025.

    Key Features of the National Sports Policy, 2025:

    1. Excellence on the Global Stage
      • Talent identification and athlete development from grassroots to elite level.
      • Expansion of leagues, rural-urban infrastructure, and high-performance training.
      • Adoption of sports science, medicine, and technology.
      • Reforms in governance and functioning of National Sports Federations.
    1. Sports for Economic Development
      • Promotion of sports tourism and hosting of global events.
      • Support for indigenous manufacturing, startups, and PPP investments.
      • Encouragement of CSR in sports development.
    1. Sports for Social Development
      • Inclusive participation of women, tribals, PwDs, and marginalised groups.
      • Revitalisation of traditional and indigenous games.
      • Dual-career pathways and diaspora engagement.
    1. Sports as a People’s Movement
      • Nationwide campaigns for fitness and community participation.
      • Launch of fitness indices and public access to sports infrastructure.
    1. Integration with Education (NEP 2020)
      • Sports embedded in school curricula.
      • Training for educators and promotion of sports education.

  • Biomarkers of Healthy Aging, Resilience, Adversity, and Transitions (BHARAT)

    Why in the News?

    IISc Bengaluru has launched BHARAT (Biomarkers of Healthy Aging, Resilience, Adversity, and Transitions), a pioneering study exploring the biology, lifestyle, and environment behind Aging.

    About the BHARAT Project:

    • Scientific Launch: It is a nationwide research initiative by the Indian Institute of Science (IISc), Bengaluru.
    • Primary Goal: It aims to build India’s first scientific baseline on how Indians age—biologically, environmentally, and socially.
    • Project Leadership: The project is led by Professor DK Saini from IISc’s Department of Development Biology and Genetics.
    • Addressing Global Gaps: It fills a major research void by offering Indian-specific data, unlike most global ageing studies based on Western populations.
    • Redefining Normal: It will challenge international health standards (e.g., for cholesterol, vitamin D) that may misclassify Indian health parameters.
    • Biological Age Focus: Instead of using chronological age, the project will study biomarkers of biological ageing for early disease risk detection.

    Key Features of the Project:

    • India-Centric Baseline: The database will offer reference biomarker cut-offs tailored to Indian genetics, diet, and lifestyle.
    • Wide Biomarker Range: It will include genomic, metabolic, and environmental indicators to detect organ ageing and resilience early.
    • AI-Driven Analysis: Machine learning tools will be used to find ageing patterns, simulate health interventions, and forecast risks.
    • Holistic Ageing Model: The study will include nutrition, pollution, infections, and social factors that influence how Indians age.
    • Equity for Global South: It corrects global biases that misdiagnose Indians as deficient by using locally validated health data.
    • Healthspan Focus: The emphasis is on quality of life—living healthier for longer—rather than just extending life years.
    [UPSC 2024] Consider the following countries: 1. Italy 2. Japan 3. Nigeria 4. South Korea 5. South Africa

    Which of the above countries are frequently mentioned in the media for their low birth rates, or ageing population or declining population?

    Options: (a) 1,2 and 4 * (b) 1,3 and 5 (c) 2 and 4 only (d) 3 and 5 only

     

  • [1st July 2025] The Hindu Op-ed: How do unsafe cancer drugs reach patients?

    PYQ Relevance:

    [UPSC 2014] While doctor’s prescription is a must to get drugs, many people buy them over the counter without prescription. Discuss the contributors to the emergence of drug-resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved.

    Linkage: The wider discussion about checking drug quality and the difficulties in doing so is very important to stop unsafe drugs, like cancer medicines, from reaching patients. This question is relevant because it looks into how drugs are monitored and the problems faced in keeping them safe.

     

    Mentor’s Comment:  A major global investigation by the Bureau of Investigative Journalism, reported by The Hindu, has revealed that poor-quality and unsafe cancer drugs, many of them from India, have been sent to over 100 countries. These faulty medicines have caused serious health problems, including the deaths of children in Yemen, Colombia, and Saudi Arabia. The report highlights serious regulatory weaknesses in low- and middle-income countries, and shows that the WHO’s warning system only acts after harm is done. This is especially worrying because it affects cancer patients, one of the most vulnerable groups.

    Today’s editorial talks about the poor-quality and unsafe cancer drugs. This topic is important for GS Paper II (Health & Governance) in the UPSC mains exam.

    _

    Let’s learn!

    Why in the News?

    Recently, a major global investigation by the Bureau of Investigative Journalism, reported by The Hindu, found that low-quality and unsafe cancer drugs.

    The Bureau of Investigative Journalism (TBIJ) is an independent, non-profit news organization based in the United Kingdom. It was founded in 2010 with the aim of producing in-depth, public interest journalism that holds power to account.

    What are the major quality risks in cancer drug manufacturing and distribution?

    • Contamination during manufacturing: Risk of bacterial contamination from improper disinfection, untrained staff, or poor cleanroom discipline. Even small errors like air movement or touching non-sterile items can spread bacteria.
    • Poor quality control: Failure to test raw ingredients, clean equipment, or filter water properly can make life-saving drugs toxic or lethal.
    • Distribution chain vulnerabilities: Changes in temperature, humidity, or poor handling during transport can degrade drug quality. The complex journey from raw materials to patient requires strict monitoring at each stage.

    Why are poorer countries more exposed to unsafe cancer drugs?

    • Weak Regulatory Frameworks: Many low-income countries lack strong drug regulatory authorities and legal frameworks to ensure medicine quality. Eg: In Nepal, there is no effective testing or monitoring of imported drugs due to limited institutional capacity.
    • Lack of Testing Infrastructure and Experts: These countries often do not have certified laboratories or trained personnel to check for contamination, dosage accuracy, or manufacturing faults. Eg: Nepal and similar nations lack verified experts or facilities to evaluate drug safety before market entry.
    • Inability to Track Drugs Through Supply Chains: Poor digital and logistical infrastructure leads to ineffective drug tracking, making it easier for substandard or counterfeit drugs to infiltrate the system. Eg: In countries with porous borders and no tracking systems, drugs can be repackaged or sold without oversight.
    • Corruption and Weak Enforcement: Corruption in customs, licensing, and procurement processes allows unverified drugs to enter public hospitals and pharmacies unchecked. Eg: In some regions, low-cost cancer drugs without proper quality assurance enter due to bribery and lack of regulatory follow-up.
    • Dependence on Low-Cost Imports Without Verification: Due to budget constraints, poorer nations rely heavily on cheap generic imports without adequate checks for Good Manufacturing Practices (GMP) or source validation. Eg: In Yemen (2022), at least 10 children died after receiving contaminated methotrexate, highlighting the consequences of poor import verification.

    How does WHO ensure drug safety?

    • Rapid Alert System for Dangerous Drugs: WHO operates a global Rapid Alert System to identify and inform member countries about harmful or substandard medicines. Eg: If contaminated cancer drugs are reported in one country, WHO sends out a global alert so others can take preventive action.
    • Global Benchmarking and Certification Tools: WHO uses tools like the Global Benchmarking Tool to assess national regulatory systems and ranks them from Level 1 (weakest) to Level 4 (strongest). Eg: In 2023, 70% of member countries were rated at Level 1 or 2, showing limited capacity to regulate drug safety.
    • Prequalification, GMP, and CoPP Systems: WHO runs prequalification programs to approve safe drugs, ingredients, and labs; enforces Good Manufacturing Practices (GMP); and issues the Certificate of Pharmaceutical Product (CoPP) to confirm quality of exported drugs. Eg: A CoPP acts like a passport for medicines, verifying they are approved and safely made in the exporting country.

    What are the steps taken by the Indian Government?

    • Strengthening Drug Regulatory Framework: The government has empowered the Central Drugs Standard Control Organization (CDSCO) to regulate drug approval, quality checks, and enforcement across India. CDSCO conducts inspections and sampling under the Drugs and Cosmetics Act, 1940 to detect substandard medicines.
    • Track and Trace Mechanism: India has introduced a barcode-based Track and Trace system for export of pharmaceutical products to improve transparency and traceability. Eg: The system helps monitor supply chain integrity and detect counterfeit drugs, especially in exports.
    • The Production Linked Incentive (PLI) Scheme for pharmaceuticals promotes domestic manufacturing of quality drugs and APIs while reducing import dependence. Eg: Incentives are given to firms that meet Good Manufacturing Practices (GMP) and global export standards.

    Way forward: 

    • Establish a National Drug Quality Monitoring Authority: Create a centralised, independent regulatory body to oversee real-time quality audits, enforce uniform GMP standards, and ensure accountability across manufacturing units.
    • Invest in Testing Infrastructure and Skilled Workforce: Strengthen drug testing laboratories, equip them with modern technology, and train qualified professionals to carry out rigorous inspections and batch verifications at every stage.

  • Vaccinating India: On Zero-Dose Children

    Why in the News?

    India has made significant progress in expanding vaccine coverage, with a dramatic drop in the percentage of zero-dose children from 33.4% in 1992 to 6.2% in 2023. But even though India is not affected by war or extreme poverty like some other countries, it still has the second-highest number of children without any vaccination in the world.

    What is the trend in global and Indian vaccine coverage?

    • Global Progress: Since 1980, coverage for six major diseases—including measles, polio, and tuberculosis—has doubled worldwide, and the proportion of zero-dose children has fallen to around 75% fewer globally.
    • India’s Improvement with Persistent Gaps: India has dramatically reduced zero-dose children from 33.4% in 1992 to 6.2% in 2023, yet still ranks second globally in absolute numbers, indicating significant strides amid ongoing challenges.

    What are zero-dose children?

    • Zero-dose children are those who have not received the first dose of the diphtheria, tetanus, and pertussis (DTP) vaccine.
    • They are a crucial performance marker of a country’s immunisation system and indicate inequities in vaccine coverage.

    Why are they important for assessing vaccination?

    • Reflects health system coverage and equity: A high number of zero-dose children shows that vaccination programmes are not reaching all segments of the population. NFHS-5 (2019–21) Data also showed that full immunisation coverage among children aged 12–23 months was significantly lower in rural and tribal regions compared to urban areas (e.g., Nagaland: 57.8%, compared to Tamil Nadu: 89.8%).
    • Indicates social and economic exclusion: The presence of zero-dose children highlights barriers like poverty, low maternal education, and marginalisation. Eg: Urban slums with high migrant populations tend to have more zero-dose children due to lack of awareness and access.
    • Warns of vulnerability to disease outbreaks: Areas with many zero-dose children are more likely to face outbreaks of vaccine-preventable diseases. Eg: Measles outbreaks are more common in districts with poor immunisation coverage.

    Why does India still have a high number of zero-dose children despite adequate resources?

    • High birth rate increases absolute numbers: India has the highest number of annual births globally. In 2023, India had around 23 million births, making even a small percentage of zero-dose children translate into a large number.
    • Geographical and logistical challenges: Remote tribal areas, urban slums, and migrant populations are harder to reach due to terrain, mobility, and poor infrastructure. E.g., children in parts of Meghalaya or urban Delhi, slums often miss vaccinations due to lack of access and follow-up.
    • Socio-cultural barriers and vaccine hesitancy: Low maternal education, religious beliefs, and misinformation lead to vaccine hesitancy in certain communities. Eg: In some Muslim households or among Scheduled Tribes, distrust or misinformation about vaccines limits uptake.

    How has India’s zero-dose child rate changed over time, especially post-COVID?

    • Steady decline before the pandemic: Between 1992 and 2016, India reduced the percentage of zero-dose children from 33.4% to 10.1%, showing consistent improvement in immunisation outreach.
    • Sharp rise during the COVID-19 pandemic: Disruptions in health services led to a surge in zero-dose children, increasing from 1.4 million in 2019 to 2.7 million in 2021, reversing years of progress.
    • Partial recovery after the pandemic: The number dropped to 1.1 million in 2022 but rose again to 1.44 million in 2023, indicating ongoing challenges in sustaining immunisation coverage.

    Where are zero-dose children mainly located in India?

    • High-burden states in northern and central India: Large numbers of zero-dose children are concentrated in Uttar Pradesh, Bihar, Maharashtra, Rajasthan, Madhya Pradesh, and Gujarat, which have large populations and gaps in last-mile immunisation delivery.
    • Northeastern and underserved regions: A relatively high proportion is also found in Meghalaya, Nagaland, Mizoram, and Arunachal Pradesh, where geographic inaccessibility, scattered populations, and weaker health infrastructure pose challenges.

    What actions are needed for India to meet the WHO’s 2030 immunisation target?

    • Expand and intensify targeted immunisation drives: Strengthen last-mile delivery through regular and focused vaccination campaigns in underserved regions. Eg: Mission Indradhanush and its intensified versions could increase immunisation coverage in low-performing districts.
    • Strengthen community-level engagement and awareness: Promote behavioural change and reduce vaccine hesitancy through culturally tailored IEC (Information, Education, and Communication) activities. Eg: Janani Suraksha Yojana (JSY) encourages institutional deliveries and postnatal care, which can be used to ensure timely vaccination of newborns.
    • Integrate immunisation with digital health monitoring systems: Use technology for real-time tracking of vaccine coverage and follow-up in high-birth and high-risk areas. Eg: eVIN (Electronic Vaccine Intelligence Network) monitors vaccine stocks and cold chain availability, improving efficiency and reducing wastage.

    Conclusion: India’s immunisation journey shows a mixed reality, while the country is a global leader in vaccine development, it still struggles to ensure all its children receive basic immunisation. Closing this gap is important not just for public health but also for social fairness and overall development. The need is even more urgent because India has the highest number of newborns in the world. The Immunisation Agenda 2030 should be treated as a national priority.

    Mains PYQ:

    [UPSC 2022] How do vaccines work? What approaches were adopted by the Indian vaccine manufacturers to produce COVID-19 vaccines?

    Linkage: It explicitly deals with “vaccines” and “Indian vaccine manufacturers”. While it focuses on COVID-19 vaccines, the discussion around vaccine functionality and production capacity is fundamentally linked to the broader challenge of “Vaccinating India” and reaching “zero-dose children” for various preventable diseases.

  • State- and sex-wise liver disease data hint at underlying factors

    Why in the News?

    In 2022, liver disease rose to become the eighth leading cause of death in India, marking a serious public health issue that had not occurred in the previous five years.

    What do sex- and age-wise trends reveal about liver disease deaths in India?

    • Sex-wise trend: Male deaths due to digestive diseases (especially liver-related) were 3.5 times higher than female deaths in 2022.
    • Liver diseases accounted for 70–75% of digestive disease deaths in men, while in women it ranged between 52–57%.
    • Age-wise trend:
      – For women, liver-related deaths increased with age, especially in the 65+ age group.
      – For men, the highest death rates occurred in the 35–54 age group, pointing to middle-age vulnerability.

    Why are liver disease deaths significantly higher among men than women?

    • Higher Alcohol Consumption: A major reason is the wide gender gap in alcohol use—around 19% of men consume alcohol compared to just 1% of women. This significantly increases the risk of liver disease among men. In 2022, 75% of male deaths due to digestive diseases were liver-related, compared to 57.5% in women.
    • Middle-Age Vulnerability: Most male deaths from liver disease occur in the 35–54 age group, indicating that lifestyle-related liver damage starts early. In contrast, among women, liver disease deaths are more common in the 65+ age group, often linked to age-related complications rather than lifestyle.
    • Biological and Behavioural Differences: Men may be more prone to risk-prone behaviours, including excessive alcohol and meat consumption, both of which are linked to liver damage. Data also shows men consistently have 3 to 3.5 times higher death rates from digestive diseases than women over the last decade.

    How do regional differences affect liver and digestive disease mortality?

    • Higher Burden in North-Eastern States: Five North-Eastern states recorded over 10% of certified deaths due to digestive diseases in 2022, with Sikkim leading at nearly 20%. This indicates a regional concentration of liver and digestive health issues.
    • Lifestyle Factors in the Region: The North-East has the highest combined prevalence of alcohol and meat consumption in India. This overlap may be a key factor contributing to the elevated liver disease burden in the region.
    • State-Wise Variation Highlights Public Health Gaps: No other state outside the North-East showed a double-digit share of digestive disease deaths, pointing to geographic health disparities.

    What are the steps taken by the Indian Government?

    • National Programme for Prevention and Control of NCDs (NP-NCD): The government launched NP-NCD to tackle non-communicable diseases, including liver disorders, by promoting early diagnosis, screening, and health awareness at the primary healthcare level.
    • National Action Plan and Monitoring Framework (NAP-NCD): Aims to reduce harmful alcohol use, improve dietary habits, and promote healthy lifestyles through public campaigns and community outreach, aligning with WHO targets.
    • Ayushman Bharat – Health and Wellness Centres (AB-HWCs): These centres provide comprehensive primary healthcare, including counselling on nutrition, lifestyle modification, and screening for liver and digestive diseases, especially in rural and underserved areas.

    What measures can strengthen research on lifestyle-related liver diseases? (Way forward)

    • Enhance Data Collection and Surveillance: Develop region-specific health databases that track alcohol and meat consumption, age, and liver disease trends. States like Sikkim and others in the North-East could benefit from focused public health monitoring to identify at-risk populations.
    • Promote Longitudinal and Causal Research: Support long-term studies that move beyond correlation to establish causal links between lifestyle choices and liver disease.
    • Encourage Community-Based Health Studies: Launch grassroots-level research programs involving local communities to understand dietary habits, alcohol use, and health-seeking behaviour.

    Mains PYQ:

    [UPSC 2024] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.

    Linkage: The increasing deaths due to liver diseases in India, which accounted for a substantial share of digestive system diseases and became the eighth leading cause of death in 2022, highlight a significant public health challenge. This question directly addresses the role of the public healthcare system in containing adverse health impacts and enhancing its reach at the grassroots level.

  • [pib] ‘NAVYA’ Initiative for Skilling Adolescent Girls

    Why in the News?

    The Ministry of Women and Child Development (MWCD) has launched the NAVYA initiative.

    About the ‘NAVYA’ Initiative:

    • Overview: NAVYA stands for Nurturing Aspirations through Vocational Training for Young Adolescent Girls.
    • Nodal Agencies: It is a joint pilot initiative by the Ministry of Women and Child Development (MWCD) and the Ministry of Skill Development and Entrepreneurship (MSDE).
    • Target Beneficiaries: It targets adolescent girls aged 16–18 years who have completed at least Class 10, particularly from under-served regions.
    • Implementation: The pilot phase will be implemented in 27 districts across 19 states, including Aspirational Districts and those from North-Eastern regions.
    • Objective: To build skills, confidence, and employability among young girls in sectors beyond traditional roles.

    Key Features:

    • Focus on Non-Traditional Skills: Girls will receive training in emerging fields like electronics repair, drone technology, solar energy, and more.
    • Certification Support: Beneficiaries will receive skill certificates under schemes like Pradhan Mantri Kaushal Vikas Yojana (PMKVY) and PM Vishwakarma.
    • Post-Training Pathways: Designed to ensure employment, entrepreneurship, or further education opportunities for girls.
    • Inclusive Development Goal: Empowers girls to be agents of socio-economic change, aligning with India’s growth trajectory toward Viksit Bharat by 2047.
    [UPSC 2017] Which of the following are the objectives of ‘National Nutrition Mission’?

    1. To create awareness relating to malnutrition among pregnant women and lactating mothers.

    2. To reduce the incidence of anaemia among young children, adolescent girls and women.

    3. To promote the consumption of millets, coarse cereals and unpolished rice.

    4. To promote the consumption of poultry eggs.

    Select the correct answer using the code given below:

    (a) 1 and 2 only* (b) 1, 2 and 3 only (c) 1, 2 and 4 only (d) 3 and 4 only