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

  • [ 24th March 2025] The Hindu Op-ed: The need for universal and equitable health coverage

    PYQ Relevance:

    Question: Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.’ Analyse (UPSC IAS 2021)

    Reason:  A strong primary health structure, as highlighted in this question, is fundamental for achieving equitable access to healthcare. It serves as the first point of contact and helps in early detection and management of health issues across all sections of society.

    Mentor’s Comment: UPSC usually focuses on the primary health structure in 2021 and Public healthcare system in 2024.

    India has made significant progress in TB care by expanding rapid molecular testing, introducing the shorter all-oral BPaLM regimen, increasing Ni-kshay Poshan Yojana support to ₹1,000 per month, and strengthening community involvement. These efforts led to a 17.7% drop in TB incidence and a 21.4% decline in TB deaths between 2015 and 2023.

    Today’s editorial highlights significant advancements in tuberculosis (TB) care and their impact. This information is valuable for GS Paper 2 and 3 in UPSC Mains answer writing.

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    Let’s learn!

    Why in the News?

    Integrating TB services into the public health system is essential for ensuring fair and universal healthcare for everyone in India.

    What are the key advancements India has made in tuberculosis (TB) care?

    • Expansion of Molecular Testing for Rapid Detection: India has significantly expanded molecular testing, enabling faster and more accurate diagnosis of TB and drug-resistant TB. Example: Introduction of CBNAAT (Cartridge-Based Nucleic Acid Amplification Test) and TrueNat machines in primary health centers for early detection.
    • Improved Drug Regimens & Shorter Treatment Duration: Newer drug combinations have reduced treatment duration for drug-resistant TB, increasing patient compliance. Example: The shorter BPaL regimen (Bedaquiline, Pretomanid, and Linezolid) has improved MDR-TB cure rates and reduced mortality.
    • Better Access to Free & Effective Treatment: Government programs like the National TB Elimination Programme (NTEP) provide free TB medicines, improving adherence and reducing deaths. Example: MDR-TB patients receiving Bedaquiline and Delamanid have better survival rates compared to traditional toxic injectable treatments.
    • Enhanced Nutritional and Financial Support: The Ni-kshay Poshan Yojana (NPY) doubled financial assistance from ₹500 to ₹1,000 per month for TB patients to ensure proper nutrition. Example: Over 40 lakh patients have benefited from direct benefit transfers under this scheme.
    • Integration of TB Services with Primary Healthcare: TB care is now incorporated into the Ayushman Bharat scheme, linking it with Health and Wellness Centres (Ayushman Arogya Mandirs). Example: These centers serve as sputum collection points and treatment hubs, improving accessibility for rural and urban populations.
    • Community Engagement and Preventive Strategies: Expansion of TB preventive therapy and involvement of TB survivors as “TB Champions” to promote awareness and early detection. Example: The “100 Days” campaign aims to improve case detection and ensure early intervention for high-risk populations.

    How have these advancements contributed to a decline in TB incidence and mortality rates?

    • Decline in TB Incidence: In 2015, TB incidence in India was 237 per lakh population. By 2022, it had dropped to below 200 per lakh, showing a 16% decline. Example: If 237 people per lakh had TB in 2015, now fewer than 200 per lakh are affected.
    • Reduction in TB Mortality: TB mortality declined from higher levels in 2015 to 23 per lakh population in 2022. This represents an 18% decline in TB-related deaths. Example: If 100,000 people were affected, 23 would die from TB in 2022 compared to a higher number in 2015.

    Who are the most vulnerable groups affected by TB?

    • People with Weakened Immune Systems: Individuals with HIV/AIDS, diabetes, malnutrition, or chronic illnesses are more susceptible due to weaker immunity. Example: TB is the leading cause of death among people with HIV, as their immune system cannot effectively fight the infection.
    • Low-Income & Undernourished Populations: Malnutrition and poverty increase TB risk by weakening immunity and limiting access to healthcare. Example: In India, undernourished populations, especially in tribal and slum areas, have higher TB incidence due to poor living conditions.
    • Migrants, Prisoners, and Urban Slum Dwellers: Overcrowded and poorly ventilated environments increase TB transmission. Example: Migrant workers living in congested dormitories or prison inmates are at a higher risk of infection due to close contact with infected individuals.

    Gender & Tuberculosis: Challenges, Data, and Solutions

    Category Challenges Data & Examples Solutions
    Women & TB Social Stigma and Fear of Isolation 60% of women diagnosed with TB in India face stigma (REACH, 2022). Community awareness campaigns like “TB Mukt Mahila” in Uttar Pradesh.
    Misdiagnosis & Underreporting Only 34% of TB cases in women are officially diagnosed (WHO, 2019). Gender-sensitive diagnostic protocols in PHCs. Routine TB screening during maternal health checkups (Rajasthan model).
    Limited Healthcare Access 50% of rural women delay TB treatment due to financial dependence (Global TB Report, 2023). Example: Bihar’s ASHA workers report women refusing solo hospital visits, delaying treatment. Mobile TB clinics and door-to-door screenings.
    Higher Risk of Malnutrition 45% of women with TB suffer from malnutrition (NFHS, 2023). Example: 80% of TB-infected women in Jharkhand lack protein-rich diets, increasing dropout rates. Ni-kshay Poshan Yojana benefits for women, with an extra ₹500 allowance in Madhya Pradesh.
    Children & TB Non-Specific Symptoms & Misdiagnosis 60% of childhood TB cases present with fever and weight loss, not cough (IAP, 2022). AI-based diagnostic tools like Bihar’s AI-assisted TB detection, which increased early diagnosis by 28%.
    Sputum Test Ineffectiveness 40-50% of children’s TB cases are undetectable using standard sputum tests (WHO, 2023). Example: Delhi’s AIIMS introduced stool-based PCR testing, increasing childhood TB detection by 25%. Nationwide adoption of stool-based PCR tests.
    Late Detection in Infants 30% of TB meningitis cases in infants are fatal due to delayed screening. Routine TB screening during childhood immunizations.
    Malnutrition & Weak Immunity Malnourished children are six times more likely to develop TB (WHO, 2023). Example: 90% of TB-infected children in Jharkhand were also undernourished. Integrate TB screening with anganwadi nutrition programs.
    Exposure to Household TB 50% of children living with TB-infected adults develop latent TB, but only 15% receive preventive therapy (Nikshay Portal, 2023). Example: Kerala’s preventive therapy program reduced childhood TB cases by 40%. Preventive therapy for all children in TB-affected households.
    Lack of Awareness Among Parents 70% of parents believe TB only affects adults (UP survey, 2023). Example: Schools in Gujarat introduced annual TB screening camps, improving early detection. Mandatory TB screening in schools and anganwadis. Maharashtra’s “TB-Free Schools” program detected 5,000 hidden cases in 2023.

    Why is the integration of TB services within the broader public health system crucial for achieving Universal Health Coverage (UHC) in India?

    • Ensures Comprehensive and Equitable Healthcare Access: Integrating TB services into primary healthcare allows early detection and treatment for all, especially marginalized populations. Example: Including TB screening in Ayushman Bharat-Health and Wellness Centres (HWCs) improves outreach in rural areas.
    • Reduces Financial Burden on Patients: Universal Health Coverage (UHC) aims to provide affordable treatment and minimize out-of-pocket expenses for TB care. Example: Linking TB care with PM-JAY (Ayushman Bharat) ensures free diagnostic and treatment services, reducing financial distress.
    • Improves Early Detection and Treatment Outcomes: Strengthening public health infrastructure with integrated screening programs improves early diagnosis and treatment adherence. Example: Nikshay Poshan Yojana provides nutritional support to TB patients, improving recovery and treatment success rates.
    • Addresses Co-Morbidities and Holistic Patient Care: TB patients often suffer from HIV, diabetes, or malnutrition; integration helps manage co-existing diseases efficiently. Example: Co-treatment of TB and HIV in ART (Antiretroviral Therapy) centers ensures better health outcomes.
    • Strengthens Disease Surveillance and Data Management: A unified health system enhances TB monitoring, tracking drug resistance, and controlling outbreaks. Example: The Nikshay portal helps track patient progress and ensures adherence to treatment regimens.

    How does the Ayushman Bharat scheme contribute to decentralizing TB care?

    • Expansion of Health and Wellness Centres (HWCs): Primary healthcare centres (PHCs) and HWCs under Ayushman Bharat provide TB screening, diagnosis, and treatment at the grassroots level, reducing dependency on tertiary hospitals. Example: A TB patient in a remote village can access free CBNAAT/Truenat testing at a nearby HWC, ensuring early detection.
    • Financial Protection through PM-JAY: The Pradhan Mantri Jan Arogya Yojana (PM-JAY) covers TB treatment costs, reducing the financial burden on poor and vulnerable groups. Example: A migrant laborer diagnosed with drug-resistant TB can avail free hospitalization and medication under PM-JAY without financial hardship.
    • Community-Based TB Care and Awareness: Health workers (ASHA, ANMs) are trained to provide TB awareness, medication adherence support, and nutritional aid at the community level. Example: An ASHA worker monitors a TB patient’s medicine intake and nutrition under the Nikshay Poshan Yojana, preventing treatment dropout.

    What are Ayushman Arogya Mandirs (AAMs)?

    • Ayushman Arogya Mandirs (AAMs) are upgraded Health and Wellness Centres (HWCs) under the Ayushman Bharat scheme, aimed at strengthening primary healthcare across India.
    • These centers provide comprehensive healthcare services at the community level, integrating preventive, promotive, curative, and diagnostic care.

    What role do Ayushman Arogya Mandirs (AAMs) play in this process?

    • Strengthening TB Screening and Early Detection: Ayushman Arogya Mandirs (AAMs) serve as first-contact healthcare facilities offering free TB screening and diagnostic services, improving early detection. Example: A person with persistent cough visiting an AAM in a rural area can get an immediate sputum test, preventing delayed diagnosis.
    • Ensuring Free and Continuous TB Treatment: AAMs provide directly observed treatment (DOTS) services, ensuring uninterrupted access to TB medicines and better adherence to treatment. Example: A TB patient enrolled at an AAM receives daily monitored medication, reducing the risk of drug resistance and treatment dropout.
    • Community Engagement and Nutritional Support: AAMs facilitate awareness programs, counseling, and nutritional support through schemes like Nikshay Poshan Yojana to enhance treatment outcomes. Example: A malnourished TB patient visiting an AAM is linked to a nutrition support program, improving overall recovery and immunity.

    Way forward: 

    • Strengthen Multi-Sectoral Collaboration: Enhancing partnerships between healthcare, nutrition, and social welfare sectors can ensure a holistic approach to TB care. Example: Expanding Nikshay Poshan Yojana with additional dietary interventions can improve patient recovery.
    • Leverage Technology for TB Surveillance & Treatment: Expanding AI-driven diagnostic tools and digital adherence tracking can improve early detection and treatment success. Example: Scaling up the use of AI-based X-ray screening in rural areas can enhance case detection rates.

  • TB treatment success rates are improving gradually in India

    Why in the News?

    Tuberculosis cases in India dropped from over 237 per lakh people in 2015 to below 200 per lakh in 2022, showing a 16% decrease.

    tb

    What has been the percentage decline in TB incidence and mortality in India since 2015?

    • Decline in TB Incidence: In 2015, TB incidence in India was 237 per lakh population. By 2022, it had dropped to below 200 per lakh, showing a 16% decline. Example: If 237 people per lakh had TB in 2015, now fewer than 200 per lakh are affected.
    • Reduction in TB Mortality: TB mortality declined from higher levels in 2015 to 23 per lakh population in 2022. This represents an 18% decline in TB-related deaths. Example: If 100,000 people were affected, 23 would die from TB in 2022 compared to a higher number in 2015.

    What factors led to a decline in TB incidence and mortality?

    • Improved Diagnosis and Treatment: The decline is attributed to better TB detection, newer diagnostic methods, and improved healthcare access. Example: The use of rapid molecular testing like CBNAAT and TrueNat has increased early detection rates.
    • Government Initiatives and Free Treatment Programs: Schemes like Nikshay Poshan Yojana, which provides nutritional support to TB patients, have played a role. Example: Free TB treatment under Revised National TB Control Programme (RNTCP) and National TB Elimination Programme (NTEP) has improved patient outcomes.
    • Targeted Approach for Drug-Resistant TB: Specialized treatment centers and newer drugs like Bedaquiline and Delamanid have improved survival rates for MDR-TB and XDR-TB patients.
      Example: The expansion of Drug-Resistant TB Centers (DR-TBCs) across India has ensured timely and quality treatment for resistant cases.
    • Active Case Finding and Surveillance: The government and NGOs have been proactively identifying TB cases, even among asymptomatic individuals, through door-to-door screening and community outreach programs. Example: The “Active Case Finding” (ACF) initiative.
      • The “Aashwasan” program is a large-scale ACF campaign successfully implemented across 174 tribal districts of India in 2022, focusing on TB among tribal communities.

    Note: Despite progress, drug-resistant TB (MDR-TB, XDR-TB) remains a major issue, with low treatment success rates. Example: While overall TB mortality is declining, severely drug-resistant TB still has a treatment success rate of only 45% in India (2021).

    Why is the treatment success rate for severely drug-resistant TB lower than other forms of TB?

    • Limited Effective Drugs & High Toxicity: Severely drug-resistant TB is resistant to isoniazid, rifampicin, fluoroquinolones, and at least one second-line injectable drug. This leaves fewer treatment options, and the available drugs often have severe side effects like organ damage. Example: Patients with Pre-XDR-TB (resistant to fluoroquinolones) have a success rate of only 68%, while MDR-TB (less resistant) has a success rate of 74%.
    • Longer & More Complex Treatment Regimens: Treatment can take 18-24 months with a combination of multiple drugs. Many patients fail to complete treatment due to the high cost, side effects, or lack of adherence. Example: A patient with XDR-TB (extensively drug-resistant TB) may require daily injections and strong antibiotics, leading to dropout and failure.
    • Weaker Immunity & Higher Mortality Risk: Severely drug-resistant TB is harder to treat in patients with weaker immune systems, such as those with HIV, diabetes, or malnutrition. Example: In India, a significant number of TB patients suffer from poor nutrition, making them more vulnerable to severe drug-resistant TB and treatment failure.

    Where does India rank among lower-middle-income countries in terms of catastrophic health expenditure due to TB?

    • Third Highest Among Lower-Middle-Income Countries: Over 10% of India’s population faces catastrophic health expenditure due to TB. Catastrophic health spending is defined as exceeding 10% of a household’s income or consumption. Example: Among 14 lower-middle-income countries with a high TB burden, India ranks third in terms of the population facing financial strain due to TB treatment.
    • Despite High Health Coverage, Costs Remain High: Around 60% of India’s population has some form of health coverage, making it the third highest among these countries. However, out-of-pocket expenses remain high, leading to significant financial distress for many TB patients. Example: Even with government schemes like PM-JAY (Ayushman Bharat), many TB patients still bear steep medical and non-medical costs (e.g., travel, and nutrition).

    Who are the top-performing and bottom-performing states in India’s fight against TB according to the TB index?

    • Top-Performing States: Among major states, Himachal Pradesh, Odisha, and Gujarat rank highest in the TB index. Example: These states have shown better TB detection rates, improved treatment success rates, and stronger healthcare interventions to combat TB effectively.
    • Bottom-Performing States: Punjab, Bihar, and Karnataka rank lowest in the TB index among major states. Example: These states struggle with weaker TB surveillance, lower treatment adherence, and higher financial burden on patients, impacting overall TB control efforts.

    Way forward: 

    • Strengthen Drug-Resistant TB Management: Expand access to newer, effective TB drugs (e.g., Bedaquiline, Pretomanid) and ensure adherence through shorter, less toxic treatment regimens. Example: Scaling up all-oral MDR-TB regimens can improve treatment success rates.
    • Reduce Financial Burden on TB Patients: Enhance direct benefit transfers for nutrition and support under schemes like Nikshay Poshan Yojana and integrate TB care with Ayushman Bharat for full cost coverage. Example: Covering non-medical costs (e.g., travel, nutrition) can reduce catastrophic health expenditure.

    Mains PYQ:

    Question: “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” (2024)

    Reason: This question relates to strengthening the public health system, which is crucial for TB control and treatment success.

  • [17th March 2025] The Hindu Op-ed: The challenges of public health education in India

    PYQ Relevance:

    Q) “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.” (2024)

    Reason: This question requires an understanding of the challenges within the public healthcare system, including the availability and competence of public health professionals, which is linked to the quality and accessibility of public health education.

     

    Mentor’s Comment: UPSC Mains have focused on the ‘Public health system’ (in 2015) and  ‘role of Indian state in public healthcare system’ (2024).

    The U.S. decision to leave the World Health Organization (WHO) and cut funding for the United States Agency for International Development (USAID) has caused major disruptions in healthcare services in many developing countries. However, India has remained mostly unaffected because it relies very little on international aid, which makes up only 1% of its total health spending.

    Today’s editorial discusses the impact of the U.S. decision to withdraw from the World Health Organization (WHO) and reduce funding for the United States Agency for International Development (USAID). This analysis is relevant for GS Paper 2, covering International Relations (IR) and Governance in the health sector.

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    Let’s learn!

    Why in the News?

    Recently, the U.S. decided to leave the World Health Organization (WHO) and cut funding for the United States Agency for International Development (USAID).

    Why has the withdrawal of U.S. funding from WHO and USAID had a limited impact on India’s public health system?

    • Low Dependence on Foreign Aid – International aid accounts for only 1% of India’s total health expenditure, making the system largely self-reliant. For example, India’s Ayushman Bharat scheme is fully funded by the government, reducing dependence on external grants.
    • Strong Domestic Health Programs – India has large-scale, government-funded health programs like the National Health Mission (NHM) and the Universal Immunization Programme (UIP). For instance, India’s polio eradication drive was successful primarily due to government initiatives rather than foreign aid.
    • Growing Private Healthcare Sector – The private sector plays a dominant role in healthcare delivery, reducing reliance on foreign-funded public health initiatives. For example, large hospital networks like Apollo Hospitals and Narayana Health operate independently of international funding.
    • Diversified Funding Sources – India receives aid from multiple global organizations, including the Gavi Vaccine Alliance and the Global Fund, ensuring that a reduction in U.S. contributions does not severely impact the overall funding pool. For example, India’s HIV/AIDS control programs receive support from UNAIDS and the Global Fund, not just USAID.
    • Increased Government Health Spending – The Union Budget allocations for health have consistently increased, helping sustain key health initiatives. For instance, India’s health budget in 2023-24 was ₹89,155 crore, allowing for the continued expansion of primary health infrastructure and insurance schemes without heavy reliance on foreign aid.

    What are the key challenges faced by Master of Public Health (MPH) graduates in securing employment in India?

    • Limited Government Job Opportunities – Despite the increasing number of MPH graduates, government recruitment has stagnated. For example, the National Rural Health Mission (NRHM) initially opened roles for non-medical public health specialists, but hiring has since slowed.
    • Preference for Medical and Management Professionals – The private healthcare sector prioritizes hospital administrators and business managers over public health specialists. For instance, private hospitals often recruit MBA (Healthcare) graduates for leadership roles rather than MPH holders.
    • Declining International Funding for Public Health – Many research institutions and NGOs rely on foreign grants, which are shrinking due to the U.S. withdrawal from WHO and USAID cuts. For example, NGOs working on tuberculosis control have faced funding reductions, limiting hiring capacity.
    • Lack of Practical Training and Standardization – Many MPH programs lack field experience, making graduates less competitive. For example, graduates from institutions with strong internships (like PHFI) are often preferred over those from colleges with purely theoretical training.
    • Absence of a Public Health Cadre – Unlike developed nations where public health professionals have dedicated government roles, India lacks a structured Public Health Management Cadre. For example, states like Tamil Nadu and Maharashtra have proposed such a cadre, but implementation remains slow.

    How has the expansion of public health education in India led to concerns about the quality of MPH training?

    • Lack of Standardized Curriculum – Different universities follow varied curricula, leading to inconsistencies in training quality. For example, Tata Institute of Social Sciences (TISS) emphasizes social determinants of health and policy, while Manipal Academy of Higher Education (MAHE) focuses more on epidemiology and biostatistics. This lack of uniformity affects the competencies of graduates.
    • Insufficient Practical Training – Many MPH programs lack field-based learning, making graduates less prepared for real-world public health challenges. For instance, Public Health Foundation of India (PHFI) offers strong internship opportunities in collaboration with state governments, whereas some newer private universities, like Amity University, provide limited hands-on experience.
    • Shortage of Qualified Faculty – Several institutions face a shortage of experienced public health faculty, affecting the depth of education. For example, Banaras Hindu University (BHU) has an established public health faculty, whereas some recently launched programs in private universities struggle to recruit trained professionals, leading to a reliance on general medical or social science faculty.

    What are the steps taken by the Indian government? 

    • Expansion of Public Health Institutes – The government has established institutions to strengthen public health education. Example: The All India Institute of Hygiene and Public Health (AIIHPH) and National Institute of Public Health Training & Research (NIPHTR) provide specialized training in public health.
    • Inclusion of Public Health in Government Initiatives – Various health programs now incorporate public health professionals. Example: The National Health Mission (NHM) and Ayushman Bharat programs employ MPH graduates in areas like health policy, epidemiology, and disease surveillance.
    • Strengthening Public Health Cadre – Several states are working on creating a structured public health cadre for MPH graduates. Example: Tamil Nadu and Maharashtra have proposed dedicated Public Health Management Cadres (PHMCs) to integrate MPH professionals into government health services.
    • Skill Development and Capacity Building – Initiatives to enhance practical training and research skills. Example: The Indian Council of Medical Research (ICMR) and National Centre for Disease Control (NCDC) offer training in epidemiology, biostatistics, and field research.
    • Accreditation and Regulation Efforts – Steps are being taken to ensure uniform standards in MPH education. Example: The University Grants Commission (UGC) has proposed guidelines for public health courses, and discussions are ongoing for a central regulatory body to oversee MPH programs.

    Way forward: 

    • Establishment of a Public Health Cadre – The government should create a dedicated Public Health Management Cadre (PHMC) at the state and central levels to ensure structured employment for MPH graduates. For example, states like Tamil Nadu and Maharashtra have proposed such cadres, but national-level implementation is required.
    • Standardization of MPH Curriculum – A central body like the National Medical Commission (NMC) or the University Grants Commission (UGC) should regulate MPH programs, ensuring a uniform curriculum with a balance of theoretical knowledge and practical skills. For instance, defining core competencies such as epidemiology, health policy, and program management would enhance graduate employability.

  • A voluntary mandate: On the APAAR student ID

    Why in the News?

    The Ministry of Education introduced the Automated Permanent Academic Account Registry (APAAR) ID to digitally store each student’s academic records, providing a single, reliable source of their educational history throughout their life in India.

    Should the APAAR ID be imposed without a legal framework in place?

    • Violation of Right to Privacy: Without a legal framework, imposing APAAR violates the right to privacy upheld by the Supreme Court in the Puttaswamy judgment (2017). Example: The Court ruled that Aadhaar cannot be mandatory for basic services like school admissions. APAAR, linked to Aadhaar, may similarly infringe on privacy rights.
    • Lack of Informed Consent: Mandatory implementation without clear legal guidelines undermines voluntary participation and informed consent. Example: Parents in Uttar Pradesh and Karnataka face pressure to enroll their children despite official claims that APAAR is voluntary.
    • Data Security Risks: Collecting sensitive student data without legal safeguards increases vulnerability to data breaches and misuse. Example: The Aadhaar leak incidents exposed millions of personal records, highlighting risks in handling large-scale digital databases without strict protection laws.
    • Discrimination and Exclusion: Errors in digital records (e.g., name mismatches) can exclude students from educational benefits if no legal recourse is available. Example: In DigiLocker, discrepancies in Aadhaar details have led to failed registrations and denial of services. Similar risks exist with APAAR.
    • Need for Legislative Oversight: A legal framework ensures transparency, accountability, and public trust in the system’s operation. Example: Countries like Germany regulate educational data under the General Data Protection Regulation (GDPR) to protect citizens’ privacy. India lacks similar comprehensive safeguards for APAAR.

    What is the purpose of the APAAR ID introduced by the Ministry of Education?

    • Digitisation of Academic Records: APAAR (Automated Permanent Academic Account Registry) aims to create a digital repository for every student’s academic transcripts, ensuring a lifetime record of their educational journey.
      • It seeks to provide a unified and verified database for academic credentials, reducing discrepancies and ensuring authenticity across institutions.
    • Improved Accessibility and Portability: Enables students to access, share, and transfer their academic records seamlessly across educational institutions and employment platforms.
    • Integration with Digital Public Infrastructure (DPI): APAAR is part of the broader Digital Public Infrastructure strategy, aligning with initiatives like UDISE+ and the Student Database Management System to enhance educational governance.
    • Facilitating Future Opportunities: It aims to streamline processes like scholarship applications, higher education admissions, and employment verification, making these services more efficient and transparent.

    How are schools and state education authorities in Uttar Pradesh and Karnataka enforcing APAAR enrolment?

    • Imposing 100% Enrolment Targets: Schools have been directed to achieve “saturation”, meaning complete APAAR enrolment for all students, putting pressure on administrators and parents. Example: In Uttar Pradesh, education authorities have set strict deadlines for schools to register every student under the APAAR system.
    • Threatening Consequences for Non-Enrolment: Schools are warning parents of potential penalties or loss of educational services if they refuse to enroll their children. Example: In Karnataka, some schools have informed parents that students may face issues in accessing government benefits and future educational opportunities without APAAR registration.
    • Targeting Minority Institutions and Administrators: Religious minority schools and district education officials face increased scrutiny for discrepancies between APAAR and existing student records. Example: In Uttar Pradesh, authorities have questioned minority institutions over mismatched enrollment data, raising concerns about discrimination and administrative overreach.

    Way forward: 

    • Enact a Clear Legal Framework: Introduce legislation to regulate APAAR, ensuring data protection, informed consent, and compliance with the right to privacy as upheld by the Supreme Court.
    • Ensure Voluntary Participation and Transparency: Maintain APAAR enrolment as optional, provide clear communication to parents and institutions, and establish grievance redressal mechanisms to address errors and concerns.

    Mains PYQ:

    Q Examine the scope of Fundamental Rights in the light of the latest judgement of the Supreme Court on the Right to Privacy. (UPSC IAS/2017)

    Reason- UPSC’s focus on privacy concerns related to government actions.

  • [12th March 2025] The Hindu Op-ed: Building compassion into the health-care structure 

    PYQ Relevance:

    Q)  Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. (UPSC CSE 2021)

     

    Mentor’s Comment: UPSC mains have always focused on the moral imperative of a Welfare State, primary health structure (2021) and Appropriate local community-level healthcare intervention (2018).

    On February 7, 2025, the WHO released the “Compassion and Primary Health Care” report, emphasizing compassion as a transformative force in health care. Based on my interactions with medical pioneers and global advocacy efforts, including the 74th World Health Assembly, I am encouraged to see growing recognition of compassion’s vital role in improving health care worldwide.

    Today’s editorial highlights the importance of compassionate health care, offering valuable insights for GS Papers, particularly in policy-making and ethics discussions.

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    Let’s learn!

    Why in the News?

    Compassionate health care should guide the actions of industry leaders, hospitals, and health-care organizations.

    What is the key message of the WHO report “Compassion and Primary Health Care”?

    • Compassion as a Transformative Force: The report highlights compassion as a core value in improving primary health care outcomes. Example: A cancer patient’s recovery improves significantly when doctors spend an extra 40 seconds expressing support, as found in a Johns Hopkins study.
    • Improved Patient Outcomes through Compassion: Compassionate care leads to faster recovery, shorter hospital stays, and reduced patient anxiety.Example: Stanford University’s CCARE research found that patients treated with compassion experience quicker healing and fewer complications.
    • Benefits for Health-Care Providers: Compassion reduces stress, prevents burnout, and increases job satisfaction for medical professionals. Example: Nurses who engage in compassionate care report stronger patient relationships and improved emotional well-being.
    • Distinguishing Compassion from Empathy and Sympathy: Compassion involves mindful problem-solving while maintaining emotional stability, unlike empathy, which may cause emotional fatigue. Example: A compassionate doctor can acknowledge a patient’s suffering while staying emotionally balanced to provide sustained care.
    • Global Call for Compassionate Health Systems: The report urges policymakers to integrate compassion into health systems and decision-making processes. Example: The WHO calls for training programs to equip health workers with compassionate communication skills across nations.

    Why is compassion considered beneficial for both patients and health-care providers?

    • Faster Recovery and Better Patient Outcomes: Compassionate care leads to quicker recovery, reduced pain, and shorter hospital stays for patients. Example: A Johns Hopkins study found that when doctors express solidarity (e.g., saying, “We are in this together”), patient anxiety decreases, improving their healing process.
    • Enhanced Patient Trust and Satisfaction: Patients feel heard, valued, and safe when treated with compassion, which strengthens their trust in the healthcare system. Example: Cancer patients who receive compassionate communication are more compliant with treatment and express higher satisfaction with care.
    • Reduced Stress and Burnout for Health-Care Providers: Compassion reduces emotional exhaustion and prevents burnout by fostering emotional resilience. Example: Nurses trained in compassionate care report lower stress levels and improved emotional well-being.
    • Stronger Patient-Provider Relationships: Compassion fosters deeper connections, improving communication and shared decision-making between patients and healthcare providers. Example: Physicians who practice compassionate care build long-term patient trust, leading to better health outcomes and loyalty.
    • Increased Job Satisfaction and Professional Fulfillment: Compassion enhances job satisfaction by giving healthcare providers a sense of purpose and fulfillment. Example: Doctors who engage in compassionate interactions report feeling more connected to their profession and experience greater personal reward.

    How does compassion differ from sympathy, empathy, and kindness in the context of health care?

    • Compassion: Compassion is the ability to recognize a patient’s suffering and actively take steps to alleviate it. It involves an emotional connection combined with a willingness to help. Example: A nurse notices that a terminally ill patient is in pain despite receiving standard treatment. She advocates for a change in medication to improve the patient’s comfort while offering emotional support to the family.
    • Sympathy: Sympathy is feeling sorrow or concern for someone’s suffering but without deeply sharing their emotional experience. Example: A doctor expresses condolences to a patient’s family after delivering bad news but does not necessarily feel the pain personally.
    • Empathy: Empathy is the ability to understand and share the feelings of another person by mentally putting oneself in their position. Example: A physician listens to a patient with chronic pain, acknowledges the emotional toll, and adjusts treatment plans accordingly while providing reassurance.

    What are the steps taken by the government? 

    • Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY): Provides free health coverage to economically vulnerable families. Example: Over 50 crore beneficiaries are eligible for ₹5 lakh annual health coverage per family for secondary and tertiary care, reducing financial burdens and ensuring accessible healthcare.
    • National Health Mission (NHM): Strengthens rural and urban healthcare infrastructure and ensures equitable healthcare access. Example: Under NHM, initiatives like Janani Shishu Suraksha Karyakram (JSSK) provide free maternal care during pregnancy, delivery, and postnatal services, ensuring compassionate care for mothers and newborns.
    • Tele-MANAS (Tele Mental Health Assistance and Networking Across States): Provides free tele-mental health services to address rising mental health concerns. Example: Launched in 2022, this initiative provides 24/7 mental health support, helping patients access timely counseling and care, especially in rural areas.
    • Pradhan Mantri National Dialysis Program (PMNDP): Provides free dialysis services to patients with chronic kidney disease. Example: More than 12 lakh dialysis sessions are provided annually across 800+ districts, reducing the financial and emotional stress on patients and their families.
    • Health and Wellness Centers (HWCs): Deliver comprehensive primary healthcare closer to communities. Example: Over 1.6 lakh HWCs have been established nationwide, offering preventive care, maternal health services, and non-communicable disease screenings, fostering compassionate and inclusive healthcare.

    Way forward: 

    • Integrate Compassion Training in Medical Education: Include structured programs to develop compassionate communication and patient-centered care skills for all healthcare professionals, ensuring empathy and emotional resilience.
    • Strengthen Policy Frameworks for Compassionate Care: Implement guidelines that prioritize compassion in healthcare delivery, with regular assessments and incentives to encourage patient-centered, humane practices across public health systems.

  • Women in South India, Delhi, Punjab have higher levels of obesity 

    Why in the News?

    About 25% of men and women in India were overweight or obese in 2019-21, a 4% increase from 2015-16. Obesity is more common among women in South Indian states, Delhi, and Punjab, but it is rising faster among men.

    What is the definition of “overweight” and “obese” based on BMI measurements in the National Family Health Survey?

    • Overweight: BMI between 25.0 and 29.9. Example: A person who is 1.65 m (5’5″) tall and weighs 70 kg would have a BMI of 25.7, categorizing them as overweight.
    • Obese: BMI of 30.0 or above. Example: A person who is 1.70 m (5’7″) tall and weighs 90 kg would have a BMI of 31.1, classifying them as obese.
    • Calculation Formula: BMI = Weight (kg) ÷ (Height in meters)². Example: If a person is 1.60 m tall and weighs 60 kg, their BMI would be: BMI=601.6×1.6=23.4\text{BMI} = \frac{60}{1.6 \times 1.6} = 23.4BMI=1.6×1.660​=23.4 (Healthy range).

    When did the share of overweight and obese individuals in India significantly increase? 

    • Period of Increase (2015-16 to 2019-21): The National Family Health Survey (NFHS-5) recorded a significant rise in the share of overweight and obese individuals between 2015-16 (NFHS-4) and 2019-21 (NFHS-5).
    • Increase in Overweight Individuals: Women: Increased from 15.5% in 2015-16 to 17.6% in 2019-21 (a rise of 2.1 percentage points). Men: Increased from 15.9% in 2015-16 to 18.9% in 2019-21 (a rise of 3 percentage points).
      • Example: In Delhi, the proportion of overweight men and women was among the highest in the country during 2019-21.
    • Increase in Obese Individuals: Women: Increased from 5.1% in 2015-16 to 6.4% in 2019-21. Men: Increased from 3% in 2015-16 to 4% in 2019-21. Example: Punjab recorded one of the sharpest increases in obesity among women during this period.

    Which Indian states reported the highest increase in obesity levels?

    • Northern States with Sharp Increases: Delhi and Punjab recorded the highest increase in obesity levels for both men and women between 2015-16 and 2019-21. Example: Delhi had the largest proportion of obese and overweight men in the country by 2019-21.
    • Southern States with Persistent High Obesity Rates: Tamil Nadu, Kerala, Andhra Pradesh, Telangana, and Karnataka consistently reported high obesity levels, with a notable rise over the survey period. Example: In Kerala, a significant portion of the population—both men and women—crossed the obesity threshold by 2019-21.
    • States with Accelerated Growth in Obesity: States in the South and North-West witnessed faster increases in obesity, reflecting a shift toward unhealthy dietary habits like increased consumption of fried foods and aerated drinks. Example: Punjab experienced a sharp increase in the share of obese women, making it one of the top states for rising obesity.

    What are the steps taken by the Indian government? 

    • Public Awareness Campaigns: The government promotes healthy lifestyle choices through initiatives like “Eat Right India” and “Fit India Movement” to encourage balanced diets and physical activity. Example: In Mann Ki Baat, Prime Minister advised reducing oil consumption by 10% monthly to combat obesity.
    • School-Based Interventions: Implement nutrition guidelines in midday meal programs and ban junk food in and around school premises to promote healthy eating habits among children. Example: The Food Safety and Standards Authority of India (FSSAI) issued regulations to restrict high-fat, salt, and sugar (HFSS) food sales in schools.
    • Policy and Regulation of Processed Foods: Introducing front-of-pack labeling for processed and packaged foods to inform consumers about high sugar, salt, and fat content. Example: FSSAI’s Eat Right Logo helps consumers identify healthier food options.
    • Lifestyle Disease Control Programs: The National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) targets obesity, diabetes, and hypertension through screening and lifestyle modification programs. Example: Community health workers under Ayushman Bharat conduct health screenings for BMI and other risk factors.
    • Promotion of Traditional Wellness Practices: Encouraging the adoption of Yoga and Ayurveda through programs like International Yoga Day to promote holistic health and weight management. Example: The AYUSH Ministry organizes free Yoga sessions to spread awareness about natural ways to maintain healthy BMI levels.

    Way forward: 

    • Strengthen Multi-Sectoral Collaboration: Enhance coordination between health, education, and food regulatory bodies to implement comprehensive obesity prevention programs. Example: Integrate nutrition education in school curricula and expand community-based health screenings.
    • Promote Sustainable Food Systems: Encourage the availability of affordable, nutritious foods and regulate ultra-processed foods through taxation and clear labeling. Example: Introduce subsidies for healthy food options and enforce strict advertising regulations for unhealthy products.

    Mains PYQ:

    Q The increase in life expectancy in the country has led to newer health challenges in the community. What are those challenges and what steps need to be taken to meet them? (UPSC IAS/2022)

  • [14th February 2025] The Hindu Op-ed: The problematic globalisation of medical education

    PYQ Relevance:

    Q) Public health system has limitation in providing universal health coverage. Do you think that private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC CSE 2015)

     

    Mentor’s Comment: UPSC mains have always focused on the Public health system (2015), and the Health for All’ in India (2018).

    Medical education is changing in unusual ways. There is a shortage of doctors, yet governments and medical professionals limit access to medical studies. As a result, more students from different countries travel abroad to study medicine. In the past, medical education was international, but now each country controls it while it still becomes more global. This trend is important because of healthcare needs. The exact number of students studying medicine abroad is unknown, but it is estimated to be over 200,000, often in low-quality institutions. Before the Russian invasion, Ukraine had 24,000 foreign medical students, mostly from India.

    Today’s editorial talks about issues in the  Medical sector. This content would help in GS Papers 1, 2 and 3 to substantiate your answer.

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    Let’s learn!

    Why in the News?

    Studying medicine abroad is common, but it is largely unnoticed and lacks proper regulation.

    How does the globalization of medical education impact the quality and accessibility of healthcare?

    • Increased Access to Medical Education but Quality Concerns Persist: India has only 1 medical seat for every 22 applicants, with 2.3 million students appearing for NEET annually.
      • As a result, over 20,000 Indian students go abroad for medical studies each year. While foreign education provides an alternative, some countries have lax regulatory frameworks, leading to concerns over clinical training standards.
    • Low Licensing Exam Pass Rates for Foreign Medical Graduates: India’s Foreign Medical Graduate Examination (FMGE) pass rate has historically been below 20%.
      • In 2022, only 10,500 out of 41,349 candidates (25.4%) cleared the exam. Many foreign-trained doctors struggle to meet national standards, delaying their entry into the healthcare system.
    • Disproportionate Dependence on Foreign-trained Doctors in Some Countries: In the US, 25% of physicians are international medical graduates (IMGs), while in the UK, 37% of doctors in the NHS come from abroad.
      • While globalization helps address doctor shortages in developed countries, it exacerbates the “brain drain” in source countries like India, Nigeria, and Pakistan.
    • Growth of For-profit Medical Schools with Limited Oversight: The Caribbean region alone has over 50 private medical schools, many catering exclusively to international students from the US and Canada.
      • These institutions charge high tuition fees but often lack sufficient clinical training infrastructure, raising concerns about graduate competence.
    • Shortage of Trained Doctors in Source Countries: The WHO estimates a global shortfall of 10 million healthcare workers by 2030, with Africa facing a deficit of 6 million doctors and nurses.
      • Many doctors trained abroad do not return home, worsening healthcare shortages in low-income countries while benefiting high-income nations.

    What are the consequences of medical degrees that are obtained abroad, especially from countries with lower academic standards?

    • High Failure Rates in Licensing Exams: Foreign-trained doctors often struggle to meet national medical standards, leading to low pass rates in licensing exams.
      • Example: In India, the Foreign Medical Graduate Examination (FMGE) pass rate has historically been below 20%. In 2022, only 10,500 out of 41,349 candidates (25.4%) cleared the exam, delaying their entry into the healthcare system.
    • Limited Clinical Exposure and Skill Gaps: Some foreign medical colleges lack proper clinical training, affecting students’ hands-on experience in diagnosing and treating patients.
      • Example: Several Caribbean medical schools, catering to US and Canadian students, have faced criticism for their limited hospital affiliations, forcing students to complete clinical rotations in different countries.
    • Difficulty in Securing Residency and Employment: Graduates from lesser-known foreign institutions often struggle to secure postgraduate training and jobs in competitive healthcare markets.
      • Example: In the United States, international medical graduates (IMGs) face higher rejection rates for medical residencies, with only about 60% of non-US IMGs matching into residency programs in 2023, compared to 93% of US medical graduates.

    Is the global mobility of medical education sustainable, and how does it affect local health systems?

    • Brain Drain Weakens Healthcare in Source Countries: Many doctors trained abroad do not return, leading to a shortage of medical professionals in their home countries.
      • Example: Nigeria loses over 2,000 doctors annually to migration, worsening its doctor-to-patient ratio, which stands at 1:5,000, far below the WHO-recommended 1:1,000.
    • Unequal Distribution of Healthcare Professionals: High-income countries attract foreign-trained doctors, leaving rural and underserved regions in low- and middle-income nations critically short-staffed.
      • Example: In India, only 20% of doctors serve in rural areas, even though 65% of the population resides there, leading to severe healthcare disparities.
    • Reliance on Foreign-trained Doctors in Host Countries: Developed nations depend on foreign medical graduates to fill workforce gaps, making their healthcare systems vulnerable to changing immigration policies.
      • Example: The UK’s NHS workforce includes 37% foreign-trained doctors, with a significant number from India and Pakistan.

    Way forward: 

    • Strengthening Domestic Medical Education Infrastructure: Increase the number of medical seats and improve the quality of training in home countries to reduce dependence on foreign institutions. Example: India has added over 100 new medical colleges since 2019 to expand access to medical education.
    • Stricter Accreditation and Recognition of Foreign Medical Degrees: Establish global accreditation standards and bilateral agreements to ensure only high-quality foreign medical degrees are recognized. Example: The National Exit Test (NExT) in India will standardize assessment for both domestic and foreign medical graduates.

  • [8th February 2025] The Hindu Op-ed: Technology and the challenge of equitable education

    PYQ Relevance:

    Q) How have digital initiatives in India contributed to the functioning of the education system in the country? Elaborate your answer (UPSC CSE 2020)

    Q) Despite the consistent experience of high growth, India still goes with the lowest indicators of human development. Examine the issues that make balanced and inclusive development elusive.  (UPSC CSE 2019)

     

    Mentor’s Comment: UPSC mains have always focused on National Education Policy (2020), and Significance of Primary Education (2016 and 2022).

    Did you know that, the Budget Allocation for the FY 2024-25 of ₹ 73,498 cr is the highest ever for the Department of School Education & Literacy. On the other hand, while science and technology have integrated countries, education can generate the need for profit and can widespread use of innovations.

    Today’s editorial discusses the major observations from the ASER 2024 Report. This content can be used in Mains answer to present the Digital divide in Rural and Urban Area. Further this content also tells you the Potential of Digital infrastructure and Implementation that India needs to build. 

    _

    Let’s learn!

    Why in the News?

    According to the recent ACER Survey 2024, India lacks a road map in the field of education that allows the promise of technology to be harnessed for those who need it the most.

    What are the Key Highlights given by ASER 2024?

    The Annual Status of Education Report (ASER) is a citizen-led survey that provides estimates of schooling and learning levels in rural India. Published by the NGO Pratham, ASER has been conducted since 2005. After 2016, the survey transitioned to an alternate-year model, with the “basic” ASER conducted in all rural districts every other year. In the intervening years, a smaller survey focuses on specific age groups and domains. The “basic” ASER tracks enrollment for children aged 3-16 and assesses the reading and arithmetic skills of children aged 5-16 through household surveys.
    • Academic Observations and Reporting: Since 2006, private school enrollment in rural India has been increasing, plateauing at 30.8% in 2014 and remaining there in 2018.
      • Basic arithmetic abilities in Class 3 have risen to 33.7% in 2024, exceeding both 2022 and 2018 rates. Class 5 reading levels are also up, nearly matching 2018 figures, although private schools have not yet reached their pre-pandemic reading levels.
      • Attendance for both teachers and students in government elementary schools has improved. Several states have pre-primary enrollment rates above 90%.
    • Focus on Foundational Literacy and Numeracy: The big push for foundational literacy and numeracy (FLN) under NEP 2020 and the NIPUN Bharat Mission has helped to improve foundational learning through better resources, learning materials, and teacher training which appears to be a major contributor to the improvements noted in the ASER 2024 report.
    • Emphasis on Early Childhood Education: NEP 2020’s emphasis on early childhood education is expected to further improve access, as ASER 2024 reported increased enrollment in early childhood education, with almost 80% of children aged 3 to 6 years enrolled in some form of pre-primary education.
    • Improved Accessibility and Potential: In 2018, approximately 90% of rural households possessed basic mobile phones, while 36% owned smartphones. By 2022, smartphone ownership in these households increased to over 74%, and further to 84% in 2024, but educational use is limited to 57%.
      • Among children aged 14-16, smartphone ownership rose from 19% to about 31% within a year.
      • Smartphones were mainly used to send texts, worksheets, and videos during the pandemic as a substitute for textbooks. Digital skills from the pandemic remained relevant, and artificial intelligence (AI) generated new interest.
    • Reversing Pandemic Losses: The ASER 2024 report suggests a rebound from the learning losses during the COVID-19 pandemic, especially in government schools, where reading and arithmetic skills have reached or exceeded pre-pandemic levels.
      • The improvement in standard III implies that some of its credit can go to the NIPUN Bharat Mission.

    What are the present challenges of digital divide in India according to ASER Report 2024?

    • Gender Disparity: Boys outpace girls in access, ownership, and smartphone usage, which puts girls at a disadvantage and exacerbates existing inequalities. Even when smartphones are available, girls face systemic barriers that limit their access, such as social norms, parental control, and prioritization of boys’ education.
    • Access vs. Usage: While nearly all children between 14 and 16 have access to cell phones, only 57% use smart devices for education-related activities, while about 76% use them for social media.
    • Variations Across States: ASER 2024 indicates wide variations in digital literacy across states.
    • Digital Literacy Skills: While smartphone access is widespread, structured digital education programs can enhance meaningful use of technology for learning.
      • There is a gender gap in digital skills, with 85.5% of boys and 79.4% of girls reporting that they know how to use a smartphone.
    • Smartphone Ownership: There is a gender gap in smartphone ownership, with only 36.2% of boys and 26.9% of girls reporting owning a smartphone.
      • This lack of personal ownership limits access and curtails opportunities for girls to explore and learn independently.

    How can technology be leveraged to bridge the digital divide and ensure equitable access to educational resources?

    • Targeted distribution of school-owned devices: Schools can monitor device-to-student ratios to decide how each device can best support specific learning activities within the curriculum.
      • Distribution can be based on the individual needs of the student, ensuring that each device is allocated where it can have the most significant impact on learning.
    • Embrace pedagogically-led technology integration: Prioritizing integrating technology in a way that enhances the learning experience as a whole can ensure that every student benefits from the transformative potential of digital tools.
      • This includes how educators are trained in technology as a means to achieve equitable learning outcomes.
    • Assess Needs and Resources: Survey families to understand current technology access at home and take inventory of existing school technology equipment and infrastructure. Identify areas that need upgrades to support 1:1 device programs.
    • Provide Multiple Access Options: Offer devices that students can use at school and take home and create a community technology center with free WiFi, computers, and printers. Partner with community organizations to provide access outside of school

  • A green signal for India to assert its health leadership

    Why in the News?

    Recently, the Budget has acknowledged health care as a cornerstone of national growth and development.

    What are India’s steps towards healthcare transformation in Budget 2025-26?

    • Increased Healthcare Spending: The budget includes a substantial allocation of ₹99,859 crore to the healthcare sector, marking a 9.8% increase from the previous fiscal year.
    • Expansion of Medical Education: The budget allocates resources to add 10,000 new seats in medical colleges across India in FY26, with plans to add 75,000 seats over the next five years. This expansion aims to address the rising demand for skilled healthcare professionals.
    • Strengthening Healthcare Infrastructure: There is an increase of ₹1,000 crore allocation under the PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), which aims to strengthen health infrastructure at all levels.
    • Digital Health Focus: The budget emphasizes the expansion of digital health portfolios, including telemedicine and AI-driven diagnostic solutions, to bridge care gaps and offer efficient healthcare solutions to underserved regions.
    • Promoting Medical Tourism: With the launch of the ‘Heal in India’ initiative, the budget aims to position India as a top medical tourism destination by introducing on-arrival visas for international patients and streamlining visa norms.
    • Healthcare Coverage for Gig Workers: The budget extends Ayushman Bharat coverage to one crore gig workers, recognizing their contribution to the new-age services economy.
    • Support for AI in Healthcare: The budget announces the establishment of India’s Centre of Excellence for AI, and the expansion of the Atal Tinkering Labs (ATL) initiative, will further propel research within the Indian healthcare sector.

    What would be the implications of Customs duty exemptions?

    • Cost Reduction: The budget includes a full exemption of customs duty on 36 life-saving drugs used to treat cancer, rare diseases, and other severe chronic conditions. This measure will significantly reduce the cost of these essential medications, making them more accessible to patients, especially those from economically disadvantaged backgrounds.
    • Improved Access to Medications: The exemption extends to specific drugs under Patient Assistance Programs run by pharmaceutical companies, along with adding 37 new medicines and 13 new patient assistance programs by next year. This will improve access to critical medications for patients, particularly those with chronic conditions.

    What are the objectives of synergy – ‘Heal in India’?

    • Promote Medical Tourism: The ‘Heal in India’ initiative aims to promote medical tourism by simplifying visa procedures for international patients.
    • Establish India as a Global Healthcare Destination: By enhancing hospital infrastructure and streamlining visa processes, India is poised to become the preferred medical destination for international patients.

    What are the challenges in India? 

    • Inadequate Infrastructure: India faces a shortage of healthcare infrastructure, particularly in rural areas, leading to unequal access to services.
      • For example, India has only 0.9 beds per 1000 population, with only 30% of these beds located in rural areas. This is significantly lower than the WHO’s suggested norm of 3.5 beds per 1000 population.
      • The underdeveloped state of roads and railways, along with erratic power supply, further complicates the establishment of rural health facilities.
    • Financial Barriers: A significant portion of the population faces affordability issues, with many households bearing healthcare expenses out-of-pocket.
      • For instance, a large proportion of the Indian population lacks health insurance coverage, exacerbating the financial burden and limiting access to necessary healthcare services.
      • High costs of intensive care units (ICUs), averaging ₹60,000-90,000 per day, are beyond the reach of most Indians.
    • Shortage of Healthcare Professionals: There is a shortage of trained healthcare professionals, including doctors, nurses, and specialists.
      • For example, shortages of surgeons, obstetricians and gynaecologists, general physicians, and paediatricians range from 74.2% to 81.6% of the required strength in Community Health Centers (CHCs). The doctor-patient ratio is significantly low, especially in rural areas.

    Way forward: 

    • Strengthen Rural Healthcare Infrastructure – Increase investments in rural hospitals, improve transport and power infrastructure, and incentivize private sector participation to bridge accessibility gaps.
    • Expand Medical Workforce & Insurance Coverage – Enhance training programs for doctors and nurses, increase medical seats, and extend affordable health insurance schemes to reduce out-of-pocket expenses for low-income groups.

    Mains PYQ:

    Q Public health system has limitation in providing universal health coverage. Do you think that private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)

  • How has India revised obesity parameters?

    Why in the News?

    A report by the Lancet Diabetes and Endocrinology Commission emphasized body fat distribution, beyond Body Mass Index (BMI), as a vital health and disease risk indicator. In this response, India has revised its obesity guidelines after 15 years.

    What is the present status of Obesity?

    • Rising Obesity Rates: The obesity rate in India has significantly increased, with approximately 9.8% of women and 5.4% of men classified as obese as of 2022, compared to just 1.2% for women and 0.5% for men in 1990. This translates to around eight crore individuals being classified as obese, including one crore children aged 5 to 19 years.
    • Economic Impact and Healthcare Costs: It is projected that India will spend about $13 million annually on treating obesity-related illnesses by 2025 as per the World Obesity Federation. The rising prevalence of obesity is associated with various non-communicable diseases, including diabetes and cardiovascular issues.
    • Changing Demographics: The prevalence of obesity is expected to continue rising, with forecasts suggesting that by 2040, around 30.5% of men and 27.4% of women will be either overweight or obese.

    What are the initiatives taken by the government? 

    • National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS): This program aims to screen individuals for obesity-related risk factors and ensure early intervention to prevent complications associated with obesity. It is part of the broader National Health Mission.
    • Eat Right India Movement: Launched by the Food Safety and Standards Authority of India (FSSAI), this initiative focuses on transforming the food system to promote safe, healthy, and sustainable food for all citizens. It includes awareness campaigns about nutrition and healthy eating habits.
    • Ayushman Bharat Health Wellness Centres: These centres strengthen preventive healthcare by promoting wellness activities and targeted communication at the community level, addressing non-communicable diseases (NCDs) including obesity.
    • Regulatory Measures: The FSSAI has set guidelines to limit trans fats in food products to no more than 2% by weight and has introduced labelling regulations that require nutritional information on food packaging, helping consumers make informed dietary choices.

    What are the new guidelines?  

    • Terminology Update: The term “overweight” has been removed, categorizing obesity into Grade I (BMI >23 kg/m² without health issues) and Grade II (BMI >23 kg/m² with associated health limitations) to emphasize nuanced stages of obesity.
    • Focus on Abdominal Obesity: Waist circumference (>90 cm for men, >80 cm for women) and waist-to-height ratio are prioritized as critical measures for assessing health risks in Asian Indians

    Why has it been revised after 15 years?

    • Rising Prevalence of Obesity: The prevalence of obesity in India has doubled over the past two decades, with significant increases observed in both adults and children. This alarming trend necessitated a reevaluation of existing guidelines to address the growing public health crisis effectively.
    • Limitations of Previous Guidelines: The previous guidelines, established in 2009, relied solely on Body Mass Index (BMI) for diagnosing obesity.
      • This approach was found inadequate as it did not consider critical factors such as abdominal fat distribution and the unique metabolic responses of Asian Indians, who tend to develop obesity-related health issues at lower BMI thresholds compared to Western populations.
    • Global Framework Alignment: The revised guidelines align with global recommendations from the Lancet Diabetes & Endocrinology Commission, which advocates for a broader understanding of obesity as a chronic disease rather than merely excess weight.

    What are the health issues that can develop due to obesity?

    • Cardiovascular Diseases: Obesity significantly increases the risk of developing heart disease and stroke. It contributes to high blood pressure and unhealthy cholesterol levels, which are critical risk factors for cardiovascular conditions.
    • Type 2 Diabetes: Excess body weight can disrupt the body’s ability to use insulin effectively, leading to insulin resistance and a higher likelihood of developing type 2 diabetes. This chronic condition is closely linked to obesity and can result in severe health complications if not managed properly.
    • Certain Cancers: Obesity is associated with an elevated risk of various cancers, including breast, colon, endometrial, and liver cancers. The increased body fat may influence hormone levels and inflammation, contributing to cancer development.

    Way forward: 

    • Comprehensive Public Health Strategies: Strengthen preventive measures through awareness campaigns, promote healthy lifestyles, regulate unhealthy food products, and expand screening programs under initiatives like NPCDCS and Ayushman Bharat.
    • Collaborative Policy Reforms: Enhance inter-sectoral collaboration to address urbanization, sedentary lifestyles, and dietary patterns while aligning with global obesity management frameworks for effective, long-term solutions.

    Mains PYQ:

    Q  Public health system has limitations in providing universal health coverage. Do you think that private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)