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

  • Central Sector Scheme for Promotion of International Cooperation for AYUSH 

    Why in the News?

    The Ministry of Ayush is implementing the Central Sector Scheme for Promotion of International Cooperation for AYUSH to enhance global recognition and development of AYUSH systems, including Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy.

    About the Scheme

    • The scheme focuses on promoting AYUSH systems internationally, contributing to their global growth.
    • The scheme is announced on the AYUSH website, and applications are invited through open advertisements.
    • Proposals are screened by a committee and approved for financial assistance based on needs and activity limits.
    • Key Components of the Scheme:
      1. International Exchange of Experts & Officers: Facilitates deputation of AYUSH experts for international conferences and training.
      2. Incentives for Drug Manufacturers: Provides financial support for international propagation and product registration.
      3. Market Development Support: Supports exhibitions, conferences, and market surveys for international market development.
      4. Promotion through Young Postgraduates: Deploys young postgraduates to promote AYUSH abroad through NGOs.
      5. Translation and Publication: Funds the translation and publication of AYUSH literature in foreign languages.
      6. AYUSH Information Cells/Health Centres: Establishes AYUSH cells and health centers in foreign countries through Indian missions.
      7. International Fellowship Programme: Offers fellowships to foreign nationals to study AYUSH courses in India.

    Significance of Yoga and AYUSH in India’s International Outreach

    • The International Day of Yoga (IDY) was declared by the United Nations in 2014, with ₹161 crore spent on its promotion. IDY celebrations spread Yoga’s global message.
    • Yoga is now part of the National Curriculum Framework (NCF), making it compulsory for students from Class I to Class X.
    • The Yoga Certification Board (YCB) under the Ministry of Ayush certifies yoga professionals and accredits institutions, ensuring quality and standards in Yoga practice.
    • The Ministry of Ayush has signed 24 Country-to-Country MoUs and 51 Institute-to-Institute MoUs to promote Indian traditional medicine systems globally.

  • India’s educational transformation — the true picture 

    Why in the News?

    India’s education system was neglected for decades, with no major policy update since 1986. While the world evolved, India remained stuck in outdated methods, resisting technological and global advancements.

    What were the key flaws in India’s education system before NEP 2020?

    • Outdated and Rigid Curriculum: The last major policy revision was in 1986 (with minor changes in 1992), making the education system disconnected from modern technological and economic advancements. Example: While global education systems embraced digital learning and skill-based curricula.
    • Lack of Access and Equity: The system failed to provide inclusive education, with marginalized communities, women, and rural students facing significant barriers. Example: Inadequate scholarships, lack of infrastructure in rural schools, and gender disparity led to lower enrollments among Scheduled Castes (SC), Scheduled Tribes (ST), and women.
    • Political Interference and Corruption: Governance bodies like UGC and AICTE became instruments of political control rather than enablers of academic excellence. Example: The 2009 Deemed University scandal, where 44 private institutions were granted university status without proper evaluation, exposing financial irregularities.
    • Underfunded Public Education & Rise of Unregulated Private Institutions: Public universities were systematically starved of funds, leading to poor infrastructure and faculty shortages. Meanwhile, private institutions emerged as degree mills with little regulation. Example: Many engineering and medical colleges prioritized profit over education quality, leading to subpar graduates with minimal employable skills.
    • Eurocentric and Ideologically Driven Curriculum: The education system failed to incorporate India’s rich intellectual and cultural heritage, with history often being selectively framed to suit political narratives. Example: Contributions of revolutionaries like Bhagat Singh, Chandra Shekhar Azad, and Veer Savarkar were downplayed.

    How has the NEP 2020 contributed to improving access, equity, and quality in education in India?

    • Increased Access to Education for Marginalized Groups: NEP 2020 introduced policies to improve enrollment among SCs, STs, OBCs, and minorities. Example: Enrollment in higher education increased by 50% for SCs, 75% for STs, and 54% for OBCs since 2014-15. Women’s enrollment also grew by 38.8% in 2022-23.
    • Expansion of Early Childhood Education & Foundational Learning: NEP 2020 introduced the 5+3+3+4 system, focusing on foundational literacy and numeracy. Example: The NIPUN Bharat Mission aims to ensure that every child attains foundational literacy and numeracy by Grade 3.
    • Multilingual Education & Inclusion of Indian Knowledge Systems (IKS): Promotes regional languages in schools and integrates traditional knowledge into the curriculum. Example: The Bharatiya Bhasha Pustak Yojana aims to publish 15,000 textbooks in 22 Indian languages to make higher education accessible in local languages.
    • Improved Infrastructure & Teacher-Student Ratio: NEP 2020 mandates modern infrastructure, teacher training, and support systems to improve learning outcomes. Example: Per-child government expenditure increased by 130% (from ₹10,780 in 2013-14 to ₹25,043 in 2021-22), leading to improved pupil-teacher ratios and reduced dropout rates.
    • Quality Enhancement Through Skill-Based & Digital Learning: NEP 2020 emphasizes coding, AI, and multidisciplinary learning to prepare students for the future. Example: Over 10,000 Atal Tinkering Labs (ATLs) have been set up to promote STEM education, and plans are underway to establish 50,000 more with broadband access.

    Why is the empowerment of women a key focus of the education reforms under NEP 2020?

    • Bridging Gender Gaps in Education: NEP 2020 emphasizes increasing female enrollment across all levels of education. Example: Female enrollment in higher education grew by 38.8%, crossing 2.18 crore in 2022-23. Among Muslim minority students, female enrollment rose by 57.5%.
    • Encouraging Women in STEMM Fields: The policy promotes gender inclusion in science, technology, engineering, mathematics, and medicine (STEMM). Example: Women now make up 43% of students in STEMM fields, breaking traditional gender barriers in male-dominated domains.
    • Improving Female Representation in Academia: NEP 2020 ensures equal opportunities in teaching and research positions. Example: The proportion of female teachers increased from 38.6% in 2014 to 44.23%, transforming academic leadership landscapes.
    • Financial and Social Support for Girls’ Education: NEP 2020 promotes scholarships, financial aid, and safety measures to encourage girls’ education. Example: The introduction of Gender Inclusion Fund supports school infrastructure, sanitary facilities, and incentives for female students.
    • Skill Development & Economic Independence: NEP 2020 integrates vocational training, entrepreneurship, and digital literacy to empower women economically. Example: The policy supports multidisciplinary learning and skilling programs that prepare women for careers in emerging fields like AI and data science.

    Which NEP 2020 initiatives promote innovation and research in education?

    • Establishment of the National Research Foundation (NRF): The NRF aims to fund, mentor, and support research across disciplines by integrating industry and academia. Example: India’s research publications have increased by 88% since 2015, and India’s ranking in the Global Innovation Index improved from 76 (2014) to 39 (2023).
    • Introduction of Atal Tinkering Labs (ATLs) for Grassroots Innovation: Over 10,000 ATLs have been set up in schools to nurture a culture of experimentation, problem-solving, and innovation among students. Example: The government plans to expand ATLs to 50,000 schools with broadband connectivity in the next five years.
    • Multidisciplinary and Flexible Learning Approach: NEP 2020 promotes multidisciplinary research by breaking rigid subject barriers and introducing coding, artificial intelligence (AI), and data science at the school level. Example: Indian Knowledge Systems (IKS) are being integrated into over 8,000 higher education institutions, encouraging innovation rooted in traditional knowledge.

    Way forward: 

    • Enhanced Public-Private Collaboration in Research & Innovation: Strengthen industry-academia partnerships to bridge the skill gap, improve employability, and boost indigenous research in emerging technologies like AI, quantum computing, and biotechnology.
    • Robust Monitoring & Implementation Framework: Establish independent regulatory bodies to track progress, ensure equitable access, and prevent commercialization of education, ensuring that NEP 2020 achieves its intended objectives effectively.

    Mains PYQ:

    Question: National Education Policy 2020 is in conformity with the Sustainable Development Goal-4 (2030). It intends to restructure and reorient education system in India. Critically examine the statement. [UPSC 2020]

    Linkage: Critical examination of the policy’s intent to restructure and reorient the education system.

  • [31st March 2025] The Hindu Op-ed: The ‘3Cs’ that haunt Indian education today

    PYQ Relevance:

    Question: National Education Policy 2020 is in conformity with the Sustainable Development Goal-4 (2030). It intends to restructure and reorient education system in India. Critically examine the statement. [UPSC 2020]

    Linkage: Critical analysis of a major education policy, where aspects of centralisation, commercialisation, and the underlying ideological orientation (potentially related to communalisation, although not directly stated) could be part of the critique.

     

    Mentor’s Comment:  The National Education Policy (NEP) 2020 may seem important, but it hides the government’s lack of real effort to improve education for children and youth in India. Over the past ten years, the government has mainly focused on three things—taking more control over education, encouraging private schools and colleges while reducing public funding, and changing textbooks and courses to fit its own ideas.

    Today’s editorial discusses education policy and its impact, providing useful insights for GS Paper 2 in the UPSC Mains exam.

    _

    Let’s learn!

    Why in the News?

    The government’s three-point agenda is causing serious harm to the education system, affecting accessibility, quality, and fairness in learning opportunities.

    What is the three-point agenda of the government?

    • Centralisation of Power: The Union Government has taken control over education policy and decision-making, sidelining State governments.
    • Commercialisation & Outsourcing to the Private Sector: Government policies have led to the closure of public schools and increased dependence on expensive private education.
    • Communalisation of Curriculum & Institutions:  The Opposition has accused the government of modifying textbooks and appointing ideologically aligned individuals in academic institutions to promote a biased narrative.

    What are the key concerns regarding the centralization of education under NEP 2020?

    • Lack of State Consultation & Decision-Making: Despite education being in the Concurrent List, the Union Government has not consulted State governments on policy implementation. Example: The Central Advisory Board of Education (CABE), which includes State Education Ministers, has not been convened since 2019.
    • Financial Coercion to Implement Central Schemes: The Union Government uses financial control to push State governments into adopting centrally designed schemes. Example: Funds under Samagra Shiksha Abhiyan (SSA), meant for RTE implementation, were withheld to pressure States into adopting PM-SHRI model schools.
    • Undermining State Control Over Higher Education: The Union Government is reducing the role of State governments in governing their own universities. Example: The 2025 UGC guidelines remove State governments from the process of appointing Vice-Chancellors, giving power to Governors (as Chancellors) instead.
    • Shift from Neighborhood Schools to Centralized School Complexes: NEP 2020 promotes school complexes, which leads to the closure of small public schools, reducing accessibility for marginalized students. Example: Since 2014, 89,441 government schools have been shut down, while 42,944 private schools have been opened.
    • Increased Control Over Curriculum & Textbooks: The Union Government has made unilateral changes to the NCERT curriculum, promoting a selective historical and ideological narrative. Example: Mahatma Gandhi’s assassination details, Mughal history, and the Preamble to the Indian Constitution were removed from textbooks, later reinstated due to public backlash.

    How has the commercialisation of education impacted public schools and higher education institutions in India?

    • Closure of Public Schools & Growth of Private Schools: The shift towards school complexes under NEP 2020 has led to the closure of public schools, forcing students into expensive private education. Example: Since 2014, 89,441 public schools have been closed, while 42,944 private schools have opened, increasing educational inequality.
    • Higher Education Funding Shift to Loans Instead of Grants: The introduction of the Higher Education Financing Agency (HEFA) forces universities to take loans at market interest rates, instead of receiving government grants. Example: Universities now recover loan repayments from student fees, leading to fee hikes, making higher education less affordable.
    • Rise in Corruption & Lack of Accountability: Increased privatisation and outsourcing have led to corruption in regulatory bodies and lower academic standards. Example: The NAAC bribery scandal and failures of the National Testing Agency (NTA) have exposed financial misconduct and inefficiency in public education governance.

    What is the criticism of the Higher Education Financing Agency (HEFA)?

    • Shift from Grants to Loans Increases Financial Burden: HEFA replaces UGC’s block grants with market-rate loans, forcing universities to generate their own funds. Example: Universities struggle to repay loans, leading to higher student fees, making education less accessible to the economically weaker sections.
    • Universities Rely on Student Fees for Loan Repayments: Most universities lack revenue sources, so they increase student fees to repay loans. Example: The Parliamentary Standing Committee on Education found that between 78% to 100% of HEFA loans were repaid using student fees, worsening affordability.
    • Neglect of Public Education & Research: HEFA discourages public investment in higher education, prioritizing financial viability over quality education and research. Example: Many state universities, lacking resources, avoid infrastructure development or research expansion due to loan repayment concerns.

    Which specific changes in NCERT textbooks have been linked to the alleged communalisation of education?

    • Removal of Mughal History & Selective Erasure of Historical Facts: Chapters on Mughal India and references to their contributions in architecture, administration, and culture have been removed or reduced.Example: Class 12 history textbooks no longer include sections on Mughal rule, diminishing a key period of Indian history.
    • Omission of Mahatma Gandhi’s Assassination and Hindutva Ideology’s Role: References to Nathuram Godse and the RSS’s role in Gandhi’s assassination were removed, altering historical narratives. Example: Class 12 Political Science textbooks no longer mention how Hindu nationalist ideologies influenced Godse’s actions.
    • Exclusion of Constitutional Principles & Secularism: The Preamble of the Indian Constitution was initially removed, and sections on secularism and democracy have been diluted. Example: Class 10 political science textbooks saw removal of content discussing secularism as a foundational principle, sparking public backlash.

    Way forward: 

    • Strengthen Federalism in Education Governance: Restore State consultation mechanisms like the Central Advisory Board of Education (CABE) to ensure inclusive decision-making.
    • Ensure Transparency & Academic Integrity in Curriculum Revisions: Establish an independent curriculum review committee with experts from diverse backgrounds to prevent ideological biases in textbooks.

  • The CBSE’s ‘two-exam scheme’ overcomplicates things

    Why in the News?

    Recently, CBSE plans to let Class 10 students take their board exams twice a year (in February/March and May) from 2026. This change is meant to help students and follows the National Education Policy (NEP) 2020.

    What are the key objectives of the CBSE’s proposed two-examination policy for Class 10 students starting from 2026?

    • Provide a Second Chance: Students can take board exams twice in an academic year (February/March & May) to improve their scores. Example: A student who performs poorly in the first attempt due to illness can appear again without waiting a full year.
    • Promote Competency-Based Learning: Shift from rote memorization to testing conceptual understanding and problem-solving skills. Example: Instead of asking students to memorize historical dates, the exam may include analytical questions on historical events’ impact.
    • Align with National Education Policy (NEP) 2020: Encourage a flexible, student-friendly assessment model focused on continuous learning. Example: Like international systems (e.g., SAT in the U.S.), students get multiple opportunities to improve scores without excessive pressure.

    Why does the policy raise concerns about increased student stress instead of reducing examination pressure?

    • Short Remediation Window: The gap between the first (Feb/March) and second (May) exams is too short for meaningful improvement in weak areas. Example: A student struggling with math concepts in February may not get enough time to improve before the second attempt in May.
    • Double the Exam Preparation Pressure: Instead of easing stress, students may feel pressured to prepare for two board exams in a short span. Example: Students may end up studying rigorously for both exams, fearing they might need a second attempt.
    • Coaching-Centric Approach: The risk of coaching institutes exploiting the two-exam format may increase, leading to more emphasis on exam-focused learning rather than conceptual understanding. Example: Coaching centers may start specialized crash courses for the second attempt, pushing students into additional preparation cycles.

    How could the proposed policy impact students from economically weaker sections?

    • Higher Examination Fees: Students must pay a non-refundable fee covering both attempts, even if they only take one exam. Example: A student from a low-income family who performs well in the first attempt still pays for the second, increasing financial burden.
    • Increased Dependence on Coaching: Private coaching centers may exploit the two-exam system, making it harder for students without financial resources to compete. Example: Wealthier students might afford special coaching for the second attempt, while economically weaker students struggle with self-study.
    • Limited Access to Remedial Support: Schools may not provide structured support between the two exams, leaving underprivileged students without proper guidance. Example: A government school student scoring low in February may not have access to extra tutoring before the May exam.
    • Delayed Class 11 Admissions: If second-attempt results are declared late, students from poor backgrounds may struggle with securing admissions or scholarships in time. Example: A student awaiting May results might miss out on early admissions in better schools with financial aid opportunities.
    • Increased Psychological Pressure: Financial struggles combined with the pressure of performing well in two exams may cause additional stress and anxiety. Example: A student from a single-income household may feel forced to clear the first attempt to avoid extra financial strain on their family.

    What changes are needed to make sure the policy follows the NEP 2020 and supports skill-based learning? (Way forward)

    • Shift from Rote Learning to Competency-Based Assessment: Redesign question papers to focus on conceptual understanding, application, and problem-solving rather than memorization. Example: Instead of asking students to recall historical dates, exams should test their ability to analyze historical events and their impact.
    • Structured Remedial Support Between Exams: Schools should provide focused remedial classes for students who perform poorly in the first attempt, helping them improve their conceptual understanding. Example: If a student struggles with algebra in February, they should receive targeted math coaching before the May exam.
    • Flexible Examination Fee Structure: Allow students to pay for only one attempt if they do not wish to appear for both, ensuring financial equity. Example: A student confident in their preparation should not be forced to pay for a second exam they do not intend to take.
    • Staggered Implementation with Pilot Studies: Conduct phased trials in diverse school settings to identify logistical and pedagogical challenges before nationwide implementation. Example: A pilot program in rural and urban schools can reveal differences in access to resources and necessary adjustments.
    • Integration of Continuous and Holistic Assessment: Move towards year-round assessments that evaluate practical skills, creativity, and critical thinking, reducing reliance on a single high-stakes test. Example: Schools can introduce project-based assessments in science subjects, testing real-world application rather than just theoretical knowledge.

    Mains PYQ:

    Question: “National Education Policy 2020 is in conformity with the Sustainable Development Goal-4 (2030). It intends to restructure and reorient education system in India. Critically examine the statement.” (UPSC 2020) 

    Reason: This question is directly linked with NEP 2020, the same policy framework that the CBSE’s ‘two-exam scheme’ claims to align with.

  • [ 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.

    _

    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.

    _

    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.

    _

    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)