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

  • UNESCO endorses Banning Smartphones from Schools

    smartphone

    Central Idea

    • The UNESCO has released Global Education Monitoring (GEM) Report 2023.
    • The report warned against the negative impacts of excessive screen time on children’s well-being and academic performance.

    What is UNESCO?
    Full Name United Nations Educational, Scientific and Cultural Organization
    Established November 16, 1945
    Headquarters Paris, France
    Director-General Audrey Azoulay
    Purpose To promote peace and security through international cooperation in education, science, culture, and communication.
    Functions – Promoting education for all

    – Supporting scientific research

    – Safeguarding cultural heritage

    – Fostering freedom of expression

    – Promoting media development
    Membership Over 190 member states
    World Heritage Sites Over 1,100 designated sites worldwide
    Languages Official languages: Arabic, Chinese, English, French, Russian, Spanish

    Working languages: English, French

    About Global Education Monitoring Report 2023

    • Established in 2002, the GEM Report is an editorially independent report, hosted and published by UNESCO.
    • At the 2015 World Education Forum, it received a mandate from 160 governments to monitor and report on progress on education SDG 4.0.
    • The report provides in-depth analysis and assessment of key education issues and challenges worldwide.
    • It also offers evidence-based insights and policy recommendations to improve education systems and outcomes.

    Concerns raised in the report

    • Ills of digital learning: The report highlights that learning benefits diminish if technology is used excessively or without qualified teachers’ involvement.
    • Equitable Learning: The report reveals that inequities in learning emerge when instruction becomes exclusively remote, affecting vulnerable students, especially in rural areas.
    • Evidence-based Approach: The report urges for sound, impartial evidence on technology’s impact in education, as most available evidence originates from technology companies and may be biased.
    • Long-term Costs and Sustainability: Countries need to consider the long-term costs of digital learning and connectivity. The expansion of the Edtech market should not overshadow unmet basic education needs.
    • Threats posed by AI: The growth of generative AI and technology necessitates digital literacy and critical thinking skills.
    • Protecting Children’s Rights: During the pandemic, many online education initiatives risked infringing on children’s rights.

    Key endorsements: Banning smartphones in schools

    • The report endorses banning smartphones in schools if technology integration does not improve learning or negatively affects student well-being.
    • Research indicates that banning mobile phones from schools can lead to better academic performance, especially among low-performing students.

  • Tele-MANAS counsels 2 Lakh distressed people

    manas

    Central Idea: The government-run national tele-mental health programme, Tele MANAS, has achieved a significant milestone by receiving over 2,00,000 calls from individuals across India since its launch in October 2022.

    What is Tele-MANAS?

    • Tele Mental Health Assistance and Networking across States (Tele-MANAS) initiative has been launched by the Ministry of Health & Family Welfare in October 2022.
    • It aims to provide free tele-mental health services all over the country round the clock, particularly catering to people in remote or under-served areas.

    Implementation of the scheme

    • Counselling: The programme includes a network of 38 tele-mental health centres of excellence spread across 27 States and UTs working in over 20 languages.
    • Helpline: A toll-free, 24/7 helpline number (14416) has been set up across the country allowing callers to select the language of choice for availing services. Service is also accessible at 1-800-91-4416.

    Two-tier working

    • Tele-MANAS will be organised in a two-tier system; Tier 1 comprises state Tele-MANAS cells which include trained counsellors and mental health specialists.
    • Tier 2 will comprise specialists at District Mental Health Programme (DMHP)/Medical College resources for physical consultation and/or e-Sanjeevani for audio-visual consultation.

    Call Demographics and Concerns

    • Age Group: Two-thirds of the callers fall in the 18-45 years age group, while 12.5% belong to the 46-64 years age group, and 8% are below 18 years of age.
    • Gender Distribution: Of the two lakh calls, 59.6% were made by male callers, and 40% by female callers.
    • Top Concerns: The most common reasons for seeking help were general feelings of sadness (28.8%), sleep-related problems (27.6%), anxiety (20.4%), relationship issues (10%), aggression (9.2%), and low interest in activities (9.7%).

    Expansion of the scheme

    • The initial rollout providing basic support and counselling through a centralized Interactive Voice Response system (IVRS) is being customized for use across all States and UTs.
    • It is being linked with other services like National teleconsultation, e-Sanjeevani, Ayushman Bharat, mental health professionals, health centres, and emergency psychiatric facilities for specialized care.
    • This will not only help in providing immediate mental healthcare services but also facilitate a continuum of care.
    • Eventually, this will include the entire spectrum of mental wellness and illness, and integrate all systems that provide mental health care.

    Back2Basics: National Tele Mental Health Programme (NTMHP)

    • The Indian Government announced the National Tele Mental Health Programme (NTMHP) in the Union Budget 2022-23.
    • The National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru is the nodal centre for the programme.
    • The programme sought to establish a digital mental health network that can address the mental health crisis in the wake of the COVID-19 pandemic.
    • The pandemic has brought forth challenges to mental health, and the NTMHP aims to provide accessible and affordable mental health services to all.
    • The programme will involve the use of digital platforms such as teleconsultations, chatbots, and mobile applications to deliver mental health services.
    • The NTMHP will integrate with existing mental health services to provide a comprehensive and coordinated approach to mental healthcare.

  • India achieves record DPT3 vaccination coverage in 2022: WHO

    dpt3

    Central Idea

    • The coverage rate for DPT3 vaccines (diphtheria, pertussis, and tetanus) in India reached an all-time high of 93% in 2022, surpassing the pre-pandemic record of 91% in 2019.
    • This significant increase from the 85% coverage in 2021 was reported by the World Health Organization (WHO).

    What is DPT3?

    • DPT3 vaccines refer to a combination vaccine that provides protection against three infectious diseases: diphtheria, pertussis (whooping cough), and tetanus.
    • The “DPT” in DPT3 stands for the initials of these three diseases:
    1. Diphtheria: It is a bacterial infection that primarily affects the respiratory system. It can cause severe throat and nose congestion, difficulty breathing, and in severe cases, it can lead to heart and nerve damage.
    2. Pertussis (Whooping Cough): It is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. It is characterized by severe coughing fits, often accompanied by a “whooping” sound when gasping for breath. Pertussis can be particularly dangerous for infants and young children.
    3. Tetanus: Also known as lockjaw, is a bacterial infection caused by the bacterium Clostridium tetani. It enters the body through wounds or cuts and produces a toxin that affects the nervous system, leading to muscle stiffness and spasms, particularly in the jaw and neck muscles.

    WHO records on immunization

    • DPT3 Coverage Recovery: The WHO South-East Asia Region saw the DPT3 coverage recover to pre-pandemic levels of 91% in 2022, a significant increase from 82% in 2021.
    • Measles Vaccine Coverage: The region also witnessed a six percent improvement in measles vaccine coverage, rising to 92% in 2022 from 86% in 2021.
    • Zero-Dose Children: The number of zero-dose children (those who have not received even the first dose of the DPT vaccine) halved from 4.6 million in 2021 to 2.3 million in 2022.
    • Partially Vaccinated Children: The number of partially vaccinated children (those who received at least one dose but not the complete three-dose series) decreased from 1.3 million in 2021 to 650,000 in 2022.

  • Poverty’s Impact on Brain Development

    poverty brain

    Introduction

    • In 1844, Frederich Engels observed that poor living conditions had physical effects on the poor, manifesting in various health issues.
    • Neuroscientists in the 1960s discovered that growing up in poverty could hinder brain development in rats.
    • Recent studies have shown a correlation between low-income families and lower cortical volume, poor academic performance, and smaller hippocampus in human children.

    The Link between Poverty and Brain Development

    • Poverty’s Effect on the Brain: Poverty has been found to affect brain development in children and young adults.
    • Cortex and Academic Performance: Studies in 2015 revealed that children from low-income families had lower cortical volume and performed poorly in academic tests.
    • Importance of the Hippocampus: Another study in 2015 highlighted the correlation between family socioeconomic status and the volume of the hippocampus, a key region for learning and memory.

    New Study on Anti-Poverty Policies and Hippocampus Size

    • The Study: Researchers from Harvard University and Washington University conducted a study published in May 2023 in the journal Nature Communication.
    • Data: The study analyzed brain scans of over 10,000 children aged 9-11 from 17 U.S. states with varying costs of living and anti-poverty programs.
    • Findings: Children from low-income families had a smaller hippocampus, but generous anti-poverty policies significantly reduced this risk.
    • State-Level Public Policies: The study highlights the potential of state-level public policies to address the correlation between brain development and low income.

    Implications for Children’s Health and Well-being

    • Psychological Impact: Impaired hippocampal development is associated with a higher risk of mental health issues such as major depressive disorder and post-traumatic stress disorder.
    • Internalizing and Externalizing Psychopathologies: The study found a negative association between family income and the incidence of internalizing and externalizing psychopathologies in children.
    • Impact of Anti-Poverty Policies: Generous cash benefits were associated with larger hippocampal volumes and reduced internalizing problems in low-income households.

    Considerations and Limitations

    • Systemic Discrimination: Poverty is often a result of systematic discrimination, such as racial disparities.
    • Alternative Explanations: The study aimed to rule out alternative explanations, including racial and ethnic factors, but acknowledges the need for further investigation.
    • Applicability to Other Contexts: The study’s findings may not directly apply to other countries like India, given different macroeconomic conditions.

    Role of Welfare and Policy

    • Financial Resources and Stressors: Access to more financial resources can help shield families from chronic stressors associated with low income, potentially influencing hippocampal development.
    • Generous Anti-Poverty Policies: Such policies not only increase family income but also enable families to make decisions that reduce stress, such as working fewer hours.
    • Investing in Social Safety Net Programs: Investments in social safety net programs can mitigate socioeconomic disparities in neurodevelopment, addressing mental health, education, and economic challenges.

    Conclusion

    • Longitudinal Study: The researchers will continue studying the mental health and brain development trajectories of the study’s participants to examine the influence of policy changes.
    • Importance of Social Safety Net Programs: The study underscores the significance of investing in social safety net programs to address the consequences of socioeconomic disparities in brain development.

  • Women’s reproductive autonomy as the new catchword

    reproductive

    Why is this news?

    • India’s progress in family planning initiatives and achievements in areas such as life expectancy, maternal health, and gender empowerment. Instead of ensuring reproductive autonomy for each woman, society has obsessed with total fertility rates and the ideal population size of a family.

    Central Idea

    • The theme of this year’s World Population Day, Unleashing the power of gender equality: Uplifting the voices of women and girls to unlock our world’s infinite possibilities, holds significant relevance for India. In order to foster women-led development across various sectors in India, it is imperative to prioritize reproductive autonomy as a core component.

    What is mean by reproductive autonomy?

    • Reproductive autonomy refers to an individual’s right and ability to make informed decisions regarding their reproductive health and choices without interference, coercion, or discrimination.
    • It encompasses the freedom to decide whether or when to have children, the number of children to have, and the spacing between pregnancies.
    • Reproductive autonomy includes access to comprehensive reproductive healthcare services, including family planning methods, contraceptives, sexual education, prenatal care, safe abortion services, and support for reproductive health decisions.

    India’s progress in family planning

    • Family planning initiatives: India has been commended for its family planning initiatives, aiming to provide comprehensive reproductive health services to every potential beneficiary.
    • Reproductive health services: Efforts have been made to expand the contraceptive basket and provide a range of modern short and long-acting reversible contraceptives, permanent methods, information, counseling, and services, including emergency contraception.
    • Maternal health improvements: India has made impressive strides in maternal health, as reflected in the significant reduction in maternal mortality rates. The current rate stands at 97 per 100,000 live births, down from 254 in 2004.
    • Gender empowerment: India has achieved progress in empowering women and girls. The number of child marriages has been cut in half since the early 2000s, and teen pregnancies have significantly decreased.
    • Access to vital services: India has witnessed improved access to crucial services, including health, education, and nutrition.
    • Longer life expectancy: Life expectancy at birth has significantly increased in India over the years, with Indians now living a decade longer compared to the 1990s.

    What are the Challenges?

    • Lack of physical autonomy: Despite the progress made, many women in India continue to lack physical autonomy.
    • Limited decision-making power: According to the National Family Health Survey, only 10% of women in India are independently able to make decisions about their own health.
    • Acceptance of marital violence: The survey also reveals that 11% of women believe that marital violence is acceptable if a woman refuses to have sex with her husband.
    • Unplanned pregnancies: Nearly half of all pregnancies in India are unplanned, highlighting a challenge in ensuring effective family planning services and education.
    • Ongoing gender disparities: While progress has been made, there are persistent gender disparities and inequalities that need to be addressed to achieve true gender equality.
    • Societal attitudes: Attitudes and societal norms that perpetuate gender-based discrimination and violence continue to pose challenges to women’s empowerment.

    Opportunities for India

    • Advancing gender equality: India has a significant opportunity to advance gender equality, which can have far-reaching positive effects on various aspects of society, including economic growth, social progress, and inclusive development.
    • Economic growth potential: By increasing women’s labor force participation by 10 percentage points, India could unlock significant economic growth potential. It is estimated that this could contribute to more than 70% of the potential GDP growth, amounting to an additional $770 billion by 2025.
    • Human capital development: Empowering women through education and family planning can lead to the accumulation of human capital, which is crucial for sustainable development and economic progress.
    • Harnessing women’s potential: By enabling women to participate fully in various sectors, including science, technology, agriculture, education, and healthcare, India can tap into the immense talent, ideas, and innovation that women bring to the table.
    • Rights-based legislation and policies: India has the opportunity to formulate and implement legislation and policies that empower women, girls, and marginalized individuals, enabling them to assert their rights and make life-changing personal decisions.
    • Inclusive economic development: Promoting gender equality and empowering women can contribute to inclusive economic development by ensuring equal opportunities and participation for all segments of society.
    • Shifting population dynamics: By focusing on reproductive choices and ensuring reproductive autonomy for individuals, India can shape its population dynamics in a way that respects individual rights and choices, while also addressing demographic challenges.

    Way forward

    • Investments in women’s lives: Ensuring gender equality and empowering women requires making investments in every stage of a woman’s life, from childbirth to adolescence to maturity. This includes providing access to quality education, healthcare, and support systems that enable women to make informed choices and assert their rights.
    • Legislation and policies: Formulating and implementing rights-based legislation and policies that empower women, girls, and marginalized individuals is crucial. This involves engaging with these groups, understanding their needs, and creating an enabling environment that supports their rights and decision-making.
    • Comprehensive reproductive health services: Continued efforts should be made to provide comprehensive reproductive health services that are accessible, affordable, and of high quality. This includes expanding the contraceptive basket, ensuring access to family planning methods, information, counseling, and emergency contraception.
    • Gender-just approaches: Adopting gender-just approaches and solutions is essential for building a prosperous and inclusive India. This involves challenging societal norms and attitudes that perpetuate gender discrimination and violence, and promoting gender equality as a fundamental value.
    • Population and development discourse: Reaffirming the commitment to placing individual rights, particularly women’s rights and well-being, at the center of the population and development discourse is crucial. Shifting the focus from population stabilization to respecting reproductive choices and promoting reproductive autonomy is essential.

    Conclusion

    • On this World Population Day, let us reiterate our commitment to placing individual rights, particularly women’s rights and well-being, at the forefront of population and development discourse. Embracing gender-just approaches and solutions is essential for building a prosperous India and a better world for all.

    Also read:

    (more…)

  • Performance Grading Index (PGI) released for 2021-22

    grading

    Central Idea

    • The annual Performance Grading Index (PGI) released by the Union government ranks the performance of States and Union Territories in school education for the year 2021-22.
    • While Chandigarh and Punjab emerged as the top performers, none of the states or UTs achieved the highest grade, Daksh, indicating room for improvement across the board.

    Performance Grading Index (PGI)

    • The Performance Grading Index (PGI) is a tool to provide insights on the status of school education in States and UTs including key levers that drive their performance and critical areas for improvement.
    • The Department of School Education and Literacy (DoSEL) has designed the PGI to catalyse transformational change in the field of school education.

    Key Parameters of the PGI

    • Learning Outcomes: Assessing students’ performance in subjects such as language, math, science, and social science.
    • Access to Education: Evaluating net enrolment ratio, retention rates, transitions between educational levels, and mainstreaming of out-of-school children.
    • Infrastructure: Examining availability of science labs, computer labs, book banks, vocational education subjects, mid-day meal supply, functional drinking water facilities, and provision of uniforms and free textbooks.
    • Equity: Considering the performance gap between marginalized communities and the general category, as well as the presence of inclusive infrastructure like ramps and disabled-friendly toilets.
    • Educational Governance and Management: Assessing digital attendance records, the presence of single-teacher primary schools, vacancies in educational posts, inspections, and teacher evaluations.

    PGI Grades and Rankings

    • Daksh: The highest grade in the PGI, scoring above 940 out of 1,000 points.
    • Akanshi-3: The lowest grade, with scores up to 460 points.
    • Top Performers: Chandigarh and Punjab secured the sixth-highest grade, Prachesta-2, followed closely by Gujarat, Kerala, Maharashtra, Delhi, Puducherry, and Tamil Nadu at Prachesta-3.
    • Improvement Needed: Thirteen states, including Andhra Pradesh, Chhattisgarh, Haryana, West Bengal, and Madhya Pradesh, were categorized as Akanshi-1 states, indicating substantial room for improvement.

    Action for Improvement

    • Domain-Wise Action: The report highlights that states can take specific actions in each domain to improve their overall score in the PGI.

     

  • Connection between Anaemia and Maternal Health

    anaemia

    Introduction

    • Recent discussions in India have brought anaemia to the forefront, with debates surrounding the measurement and management of haemoglobin levels.
    • The WOMAN-2 trial collaborators published a study in The Lancet, emphasizing the importance of anaemia in postpartum haemorrhage and calling for informed policy decisions in India.
    • Anaemia affects a significant number of women worldwide and is associated with high mortality rates in postpartum haemorrhage cases.

    What is Anaemia?

    • Anaemia is a medical condition characterized by a decrease in the number of red blood cells or a deficiency in haemoglobin, the protein responsible for carrying oxygen throughout the body.
    • This condition can lead to a reduced capacity of the blood to deliver oxygen to tissues and organs.
    • The symptoms of anaemia can vary depending on the underlying cause and the severity of the condition.

    However, some common symptoms of anaemia include:

    1. Fatigue and weakness: Feeling tired and having a lack of energy is a common symptom of Anaemia. This occurs because the body’s tissues and organs do not receive enough oxygen.
    2. Shortness of breath: Due to the reduced oxygen-carrying capacity of the blood, individuals with Anaemia may experience difficulty breathing, especially during physical activity or exertion.
    3. Rapid or irregular heartbeat: In an attempt to compensate for the lack of oxygen, the heart may beat faster or irregularly. This symptom is particularly noticeable during physical activity or when the individual is at rest.
    4. Dizziness and light-headedness: Anaemia can cause a decrease in blood flow to the brain, leading to feelings of dizziness and lightheadedness.
    5. Cold hands and feet: Reduced blood flow can result in a sensation of coldness in the extremities, such as the hands and feet.
    6. Headaches: Some individuals with anaemia may experience frequent headaches, which can be a result of the decreased oxygen supply to the brain.

    How Anaemia is linked to maternal risks?

    • Increased risk of complications: Anaemia during pregnancy raises the risk of preterm birth, low birth weight, and maternal mortality.
    • Fatigue and weakness: Anaemia can cause exhaustion, making it harder for pregnant women to handle physical demands.
    • Preeclampsia: Anaemia is linked to a higher likelihood of developing preeclampsia, a dangerous condition.
    • Postpartum haemorrhage: Anaemia increases the risk of excessive bleeding after childbirth.
    • Impaired immune function: Anaemia weakens the immune system, making pregnant women more susceptible to infections.
    • Iron deficiency Anaemia: Common during pregnancy, it can negatively impact maternal and fetal health.

    Link between Anaemia and Postpartum Haemorrhage

    • Global anaemia burden: Over half a billion women of reproductive age suffer from anaemia worldwide.
    • Postpartum haemorrhage risk: Anaemia increases the risk of postpartum haemorrhage, a leading cause of maternal deaths, particularly in low- and middle-income countries.
    • WOMAN-2 trial: The trial examined the association between prebirth haemoglobin levels and postpartum haemorrhage risk in women from Pakistan, Nigeria, Tanzania, and Zambia.

    Findings from the WOMAN-2 Trial

    • Continuous relationship: Lower haemoglobin levels were directly associated with increased blood loss and clinical postpartum haemorrhage.
    • Impact on maternal function: Women with anaemia experience reduced oxygen-carrying capacity, leading to shock after smaller blood loss volumes.
    • Severity of anaemia: Severe anaemia was associated with higher odds of death or near-miss events compared to moderate anaemia.

    Recommendations and Prevention Strategies

    • Preventive treatment: Attention should be given to preventing and treating anaemia in women of reproductive age.
    • Existing initiatives: The Indian government provides iron and folic acid supplements to address anaemia, especially among adolescent girls.
    • Challenges and mission-mode approach: Rising levels of anaemia in India require an intensified public health approach to combat the issue effectively.
    • Cultural and social considerations: Public health programs should consider cultural attitudes and preferences regarding blood draws for accurate haemoglobin measurement.
    • Outreach program considerations: A comprehensive understanding of cultural and social realities is crucial to ensure the success of anaemia prevention initiatives.

    Conclusion

    • The WOMAN-2 trial highlights the significance of anaemia in postpartum haemorrhage, urging policymakers in India to use evidence-based guidelines for anaemia management.
    • The Indian public health program should focus on prevention, treatment, and community engagement to combat rising anaemia levels effectively.
    • Cultural and social factors must be considered when designing outreach programs, ensuring their relevance and acceptance by the target population.

     

  • Cabinet approves Bill for National Research Foundation (NRF)

    research

    Central Idea

    • The Union Cabinet’s approval of the National Research Foundation (NRF) Bill, 2023 marks a significant milestone in the field of scientific research in India.
    • With an estimated budget of ₹50,000 crore from 2023-28, the NRF will reshape the research landscape in the country.

    What is NRF?

    • Apex Body: The NRF will be established as the highest governing body for scientific research, in accordance with the recommendations of the National Education Policy (NEP).
    • Department of Science and Technology’s Role: The DST will serve as the administrative department of the NRF, with a Governing Board consisting of eminent researchers and professionals from various disciplines.
    • Leadership Structure: PM will be the ex-officio President of the Board, while the Union Minister of Science & Technology and the Union Minister of Education will be the ex-officio Vice-Presidents.
    • Functioning: The Principal Scientific Adviser will chair the Executive Council responsible for NRF’s functioning.

    Consolidation and Funding

    • Integration of Science and Engineering Research Board: The proposed Bill repeals the Science and Engineering Research Board (SERB) established in 2008 and subsumes it into the NRF.
    • Equitable Funding: The NRF aims to ensure equitable distribution of research funding, addressing the current disparity between eminent institutions like IITs and IISc and state universities. It seeks to allocate research funds more fairly, with an expected private sector investment of ₹36,000 crore.
    • Government Contribution: The government will contribute ₹10,000 crore over five years, while the DST will continue to receive its annual budget for funding autonomous research bodies, scholarships, and capacity-building programs.

    Collaboration and Policy Framework

    • Industry-Academia-Government Collaboration: The NRF will foster collaborations among industries, academia, government departments, and research institutions. It will establish an interface mechanism to facilitate participation and contributions from industries, state governments, scientific ministries, and line ministries.
    • Policy Framework and Regulatory Processes: NRF’s focus will include creating a policy framework and regulatory processes that encourage collaboration and increased industry spending on research and development (R&D).
    • Research in Social Sciences and Humanities: The NRF aims to promote research not only in natural sciences but also in humanities, social sciences, and arts. It recognizes the importance of integrating these disciplines in decision-making processes.

    Addressing National Priorities

    • Priority Areas: The NRF intends to identify priority areas aligned with national objectives, such as clean energy, climate change, sustainable infrastructure, improved transportation, and accessible healthcare.
    • Multidisciplinary Projects and Centers of Excellence: To address national priorities, the NRF will support large-scale, long-term, multidisciplinary, and multi-institutional projects. It also plans to establish Centers of Excellence focusing on crucial research areas for the country.
    • International Collaborations: The NRF will coordinate and support research in mega international projects, including LIGO and ITER, in which India is actively involved.

    Funding and Impact

    • Increased Funding: The NRF aims to significantly increase the funding available for scientific research in India from both government and private sources. Currently, India’s spending on research and development remains below 0.7% of its GDP.
    • Potential Impact: The NRF’s establishment has the potential to address the pressing issues in Indian science and enhance the country’s research output. Experts view it as a major landmark for science in India, with the allocated ₹50,000 crore as a starting point for future growth and impact.

  • Assisted Reproductive Technology Regulations (ART), 2023

    Central Ideas

    • The Health Ministry of India introduced the Assisted Reproductive Technology Regulations (ART), 2023 earlier this year, aiming to improve medical care and security for donors and patients.
    • However, industry insiders report that the new provisions have led to increased medical costs and pose challenges for doctors and couples seeking ART due to limited availability of donors.

    Assisted Reproductive Technology (ART) in India

    • ART refers to a range of techniques used to achieve pregnancy by handling sperm or egg cells outside the human body and transferring embryos into the woman’s reproductive tract.
    • It is regulated by Assisted Reproductive Technology (Regulation) Act 2021 in India.
    • ART in India is regulated by the Indian Council of Medical Research (ICMR).
    • National Guidelines for Accreditation, Supervision, and Regulation of ART Clinics were established in 2005.

    Definition and Techniques of ART

    • ART encompasses various procedures, including sperm donation, in-vitro fertilization (IVF), and gestational surrogacy.
    • It involves handling sperm and egg cells in a laboratory setting to facilitate fertilization and embryo development.

    Types of ART Procedures permitted:

    1. In Vitro Fertilization (IVF): Eggs and sperm are fertilized in a laboratory dish, and resulting embryos are transferred to the uterus.
    2. Intracytoplasmic Sperm Injection (ICSI): A single sperm is directly injected into an egg.
    3. Intrauterine Insemination (IUI): Sperm is placed directly into the uterus during ovulation.
    4. Surrogacy: A surrogate mother carries and delivers a baby for another individual or couple.

    Salient Provisions of the ART (Regulation) Act 2021:

    [A] Regulation of ART Clinics and Banks:

    • Registration Requirement: ART clinics and banks must be registered under the National Registry of Banks and Clinics of India, maintaining a central database of these institutions.
    • Validity and Renewal: Registration is valid for five years and can be renewed for an additional five years.
    • Compliance and Penalties: Violation of the Act’s provisions may result in cancellation or suspension of the institution’s registration.

    [B] Conditions for Sperm Donation and ART Services:

    • Eligibility Criteria: Registered ART banks can screen, collect, and store semen from men aged between 21 and 55 years, as well as store eggs from women aged between 23 and 35 years.
    • Female Donor Requirements: Female donors must be married with at least one child of their own, aged at least three years.
    • Parental Rights: A child born through ART procedures is legally considered the couple’s biological child, and the donor does not retain any parental rights over the child.

    [C] Consent and Insurance Coverage:

    • Informed Consent: ART procedures require written informed consent from both the couple seeking the procedure and the donor.
    • Insurance Coverage: The couple must provide insurance coverage for the female donor, protecting against loss, damage, or death.

    [D] Regulation of ART Processes:

    • National and State Boards: The Surrogacy Act 2021 establishes National and State Boards responsible for regulating ART services.
    • Advisory Role: These boards advise the government on policy matters, review and monitor law implementation, and formulate a code of conduct for ART clinics and banks.

    [E] Offences and Penalties:

    • Offences defined: Child abandonment or exploitation, sale or trade of embryos, exploitation of couples or donors, and transfer of embryos into males or animals.
    • Penalties: Offenders may face imprisonment ranging from 8 to 12 years and fines up to Rs 10 to 20 lakhs.
    • Sex-Selective ART Prohibition: Clinics and banks are prohibited from advertising or offering sex-selective ART, with penalties of imprisonment ranging from 5 to 10 years and fines up to Rs 10 to 25 lakhs.

    New Provisions of the ART Regulations, 2023

    • Donation Frequency Restrictions: The regulations limit the number of times a donor (male or female) can donate sperm or oocytes in their lifetime.
    • Age Limits for Donors: The provisions specify age criteria for oocyte donors, requiring prior marriage and having at least one living child of their own.
    • Limitations on Gamete Distribution: ART banks are prohibited from supplying reproductive cells from a single donor to more than one commissioning couple.
    • Insurance Coverage Requirement: Parties seeking ART services must provide insurance coverage for oocyte donors against any loss, damage, or death.
    • Prohibition on Pre-Determined Sex Selection: Clinics are prohibited from offering to provide a child of pre-determined sex.
    • Genetic Disease Screening: Checking for genetic diseases before embryo implantation is mandated.

    Issues with these regulations

    [A] Impact on Availability of Suitable Donors

    • Restricted Opportunities: The new provisions significantly limit the opportunities for ART couples to find suitable donors, affecting their chances of successful treatment.
    • Increased Costs: The restrictions on donation attempts have the potential to increase costs for couples relying on assisted reproductive techniques.
    • Challenges for Couples: The limitations pose challenges for couples in need of ART services, as finding compatible donors becomes more difficult.

    [B] Implications for Fertility Rates:

    • Declining Fertility Rates: Like other parts of the world, India is experiencing a decline in fertility rates.
    • Increased Challenges: Further limiting the pool of available donors through the new regulations is likely to exacerbate the challenges faced by couples seeking ART.

    Conclusion

    • While the new ART regulations in India aim to enhance safety measures and transparency, they have inadvertently led to challenges in the availability of suitable donors.
    • With declining fertility rates, the restrictions imposed by the regulations pose additional difficulties.
    • Balancing the need for regulation and patient access to effective ART treatments will be crucial to ensure the well-being of couples and the continued progress of assisted reproductive technology in India.

  • Mental Health in India

    Mental Health

    Central Idea

    • India is grappling with a significant mental health crisis, with an estimated 6%-7% of the population affected by mental disorders. The COVID-19 pandemic further exacerbated the situation, leading to increased stress levels across social segments. Unfortunately, most cases of mental illness remain untreated due to ignorance and social stigma, leaving patients and their families to suffer in silence.

    The Prevalence of Mental Health Issues in India

    • National Mental Health Survey (2016): According to this survey conducted by the National Institute of Mental Health and Neurosciences (NIMHANS), approximately 13.7% of India’s population (around 150 million individuals) was estimated to be in need of active mental health interventions. This survey covered a wide range of mental health disorders, including depression, anxiety disorders, substance use disorders, and psychosis.
    • World Health Organization (WHO) Report (2017): The WHO reported that India has one of the highest rates of major depression in the world, with over 5% of the population affected by this disorder. The report also highlighted that the prevalence of anxiety disorders in India was around 3.8%.
    • Global Burden of Disease Study (2017): This study estimated that mental health disorders accounted for 9.9% of the total disease burden in India. It encompassed a broad range of mental disorders, including depression, anxiety, bipolar disorder, schizophrenia, and substance use disorders.
    • National Health Mission (NHM) Estimates: NHM estimates suggest that 6%-7% of India’s population suffers from mental disorders. This aligns with the prevalence rates reported in other studies.

    Causes for Caregiver Stress

    • Physical and Emotional Caregiving: Caregivers are responsible for providing physical and emotional support to individuals with mental health disorders. The demanding nature of caregiving tasks, such as managing medications, attending to personal care needs, and addressing emotional distress, can contribute to caregiver stress.
    • Social Isolation: Caregivers often experience social isolation as they may have limited time for social interactions and leisure activities. The focus on caregiving can lead to a decreased social support network and feelings of loneliness.
    • Financial Difficulties: Mental health disorders can place a financial burden on families. The cost of treatment, medications, therapy sessions, and other related expenses can be significant. Caregivers may face financial strain, which adds to their stress levels.
    • Troublesome Behavior of the Patient: Behavioral issues associated with mental health disorders, such as aggression, mood swings, and self-harm, can be challenging for caregivers to manage. Dealing with these behaviors on a daily basis can contribute to high levels of stress.
    • Non-Adherence to Treatment: Many individuals with mental health disorders may struggle with adhering to treatment plans, such as taking medication regularly or attending therapy sessions. Non-adherence to treatment can be frustrating for caregivers, as it hampers the progress and well-being of the patient, leading to increased caregiver stress.
    • Primary Caregiver Burden: In larger families, the responsibility of caregiving may be shared among family members. However, with reducing family sizes and changing social dynamics, the primary caregiver burden often falls on one individual, such as the spouse. This increased responsibility and lack of support can contribute to caregiver stress.
    • Balancing Multiple Roles: Women caregivers, in particular, may face challenges in balancing caregiving responsibilities with other roles such as careers, child-rearing, and household chores. The juggling of multiple roles without sufficient support can lead to increased stress levels.

    The Need for Structured Interventions

    • Education and Awareness: Structured interventions can provide caregivers with comprehensive education and awareness about mental health disorders. This includes understanding the nature of the illness, its symptoms, treatment options, and available resources. Education empowers caregivers with the knowledge needed to better support their loved ones and navigate the challenges associated with mental health disorders.
    • Role Clarity and Responsibilities: Structured interventions help caregivers clarify their roles and responsibilities in providing care for individuals with mental health disorders. This clarity reduces confusion and uncertainty, allowing caregivers to have a better sense of control and confidence in their caregiving abilities.
    • Coping Skills and Stress Management: Caregiving can be emotionally and physically demanding, leading to high levels of stress. Structured interventions can equip caregivers with coping skills and stress management techniques to better handle the challenges they face. This may include strategies for self-care, relaxation techniques, problem-solving skills, and setting boundaries to prevent burnout.
    • Peer Support and Networking: Structured interventions often incorporate peer support and networking opportunities. Caregivers can connect with others who are going through similar experiences, fostering a sense of belonging and reducing feelings of isolation. Sharing experiences, exchanging advice, and receiving support from peers can be invaluable in coping with caregiver stress.
    • Access to Counseling and Helplines: Structured interventions can provide caregivers with access to professional counseling services and helplines. These services offer a safe and confidential space for caregivers to express their concerns, seek guidance, and receive emotional support. Counseling can help caregivers process their emotions, manage caregiver stress, and develop effective coping strategies.
    • Psychoeducation and Skill Building: Structured interventions often include psychoeducational sessions and skill-building workshops for caregivers. These sessions cover various topics such as understanding the condition, recognizing early warning signs of relapse, learning about available therapies and their effectiveness, managing treatment-related expenses, and identifying and implementing effective coping mechanisms.
    • Family Counselling and Involvement: Involving the entire family in structured interventions can foster a supportive environment for the individual with a mental health disorder. Family counselling sessions can enhance communication, understanding, and cooperation within the family, leading to better overall outcomes for the individual’s mental health.

    Challenges and Gaps in Support Systems

    • Lack of Trained Specialists: One of the major challenges is the shortage of trained mental health specialists, such as psychiatrists and clinical psychologists. India has a low ratio of psychiatrists and psychologists per population, making it difficult to provide adequate support and interventions for caregivers.
    • Cost-Effective Intervention Implementation: Implementing cost-effective intervention models for caregiver support is hindered by the lack of trained specialists. The shortage of mental health professionals makes it challenging to scale up and deliver structured interventions that are accessible and affordable for caregivers.
    • Insufficient Budget Allocation: The are concerns about insufficient budget allocation for mental health patients. Inadequate funding for mental health services further exacerbates the challenges in developing and implementing interventions specifically designed to support caregivers.
    • Limited Insurance Coverage: Mental illnesses are often excluded from the list of ailments covered by leading medical insurers in India. While government schemes like Ayushman Bharat provide coverage for mental disorders, coverage by private insurers remains limited. This lack of comprehensive insurance coverage creates a gap in financial support for caregivers seeking mental health services.
    • Expensive Private Mental Health Institutions: Private mental health institutions may provide services, but their costs can be prohibitively expensive for many individuals and families. This restricts access to quality mental health care and support for caregivers who may not be able to afford the high costs associated with private institutions.
    • Inadequate Support for Caregivers: The current counselling services provided to caregivers upon request are not sufficient. Many caregivers may not be aware of their own emotional strain or may not proactively seek support due to various reasons, such as lack of awareness, stigma, or personal barriers.

    Mental Health

    Gaps in Insurance Coverage for Mental Health Disorders

    • Exclusion from Leading Medical Insurers: The mental illnesses are excluded from the list of ailments covered by leading medical insurers in India. This means that individuals seeking treatment for mental health conditions may not receive adequate insurance coverage or reimbursement for their expenses.
    • Mental Healthcare Act 2017: The Mental Healthcare Act 2017 aimed to rectify this issue by mandating that mental disorders should be treated on par with physical disorders for insurance coverage. However, it suggests that private insurers still have limited coverage for mental health disorders, indicating a gap between the mandate and its implementation.
    • Government Schemes and Public Sector Insurance: While government schemes like Ayushman Bharat provide coverage for mental disorders, the article mentions that coverage by private insurers remains limited. This implies that individuals relying on private insurance may face challenges in obtaining comprehensive coverage for mental health conditions.
    • Affordability and Accessibility: The private mental health institutions may provide services but at a higher cost, making them financially burdensome for many individuals and families. The lack of comprehensive insurance coverage further restricts access to affordable mental health care, exacerbating the affordability and accessibility challenges

    Way Forward

    • Structured Intervention Programs: Introducing structured intervention programs specifically aimed at educating and supporting caregivers are essential. These programs should provide information about mental health disorders, caregiver roles and responsibilities, coping mechanisms, and resources for assistance.
    • Comprehensive Treatment Approach: There is need of a comprehensive treatment approach that involves healthcare professionals, informal caregivers, and psychosocial interventions. This collaborative approach recognizes the crucial role of caregivers and their involvement in the treatment process.
    • Early Support for Caregivers: Studies in developed countries have shown that providing support to family caregivers at the onset of the psychiatric illness of their loved ones is crucial. Early intervention and support can enhance caregiver well-being and improve patient treatment participation.
    • Intervention Models: Successful intervention models include cognitive-behavioral therapy, psychoeducational skill building, family counseling, and peer support. These models focus on providing caregivers with practical skills, knowledge, and emotional support to effectively manage caregiver responsibilities and cope with the challenges they face.
    • Addressing Systemic Gaps: There are evident gaps in the healthcare system, including the shortage of trained specialists and insufficient budget allocation for mental health patients. Addressing these systemic gaps is crucial for developing and implementing effective caregiver support programs.
    • Insurance Coverage: Expanding insurance coverage for mental disorders, as mandated by the Mental Healthcare Act 2017, is essential. Private insurers should also be encouraged to provide comprehensive coverage for mental health conditions to ensure financial support for caregivers seeking mental health services.
    • Non-Governmental Organizations (NGOs) and Community Movements: There is need to acknowledge the work of NGOs and community movements engaged in community support for mental illness and caregivers. Scaling up their efforts and ensuring collaboration with healthcare professionals can help bridge the existing gaps in caregiver support

    Conclusion

    • Recognizing and addressing the caregiver burden is imperative in India’s mental health landscape. Structured interventions that educate and support caregivers are crucial for improving their well-being and promoting patient treatment participation. Moreover, bridging the gaps in healthcare infrastructure, sufficient trained specialists, and expanding insurance coverage for mental disorders are essential steps toward providing comprehensive care for psychiatric patients and their caregivers.

    Also read:

    Its high time to focus on Mental Health