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

  • Students suicides: A mismatch between rising aspirations, shrinking opportunities

    suicides

    Context

    • Three students committed suicide within 12 hours in Rajasthan’s Kota, which is regarded as the education and coaching hub of India. Known for producing IITians, doctors and engineers, Kota has been in the news for the last few years because of the students’ suicides and depression they suffer.

    What is Suicide?

    • Suicide is the act of intentionally causing one’s own death.
    • Mental and physical disorders, substance abuse, anxiety and depression are risk factors.
    • Some suicides are impulsive acts due to stress (such as from financial or academic difficulties), relationship problems (such as breakups or divorces), or harassment and bullying.
    • Despite being entirely preventable, India has been increasingly losing individuals to suicide.

    suicides

    The National Crime Records Bureau’s Accidental Deaths and Suicide in India report 2021.

    • The report released this year shows that the number of students’ deaths by suicide rose by 4.5 per cent in 2021.
    • Maharashtra bearing the highest toll with 1,834 deaths, followed by Madhya Pradesh with 1,308, and Tamil Nadu with 1,246.
    • According to the report, student suicides have been rising steadily for the last five years.
    • According to a 2012 Lancet report, suicide rates in India are highest in the 15-29 age group the youth population.
    • According to the National Crime Record Bureau (NCRB), in 2020, a student took their own life every 42 minutes; that is, every day, more than 34 students died by suicide.

    suicides

    What are the reasons behind these alarming stats of student’s suicide in India?

    • Education is for livelihood more than knowledge: Education in India has been viewed as a gateway to employment and livelihood rather than to knowledge.
    • Pressure to get into government jobs or highly paid private sector: Many students and their families dream of the coveted ‘sarkari naukri’ (government job) to escape the precarious social, caste and class predicaments they find themselves in.
    • Limited educational infrastructure: The failure of the Union government to improve the country’s educational infrastructure means that exam-oriented coaching had become the norm.
    • Coaching centres as prisons for many students: Cashing in on the ‘hope for a better future,’ coaching centres emerged as one of the predominant industries in the education sector. However, these centres are now being seen as prisons for the many youngsters who join them; where their bodies, souls and dreams are tamed.
    • Number of factors marginalising students who are already vulnerable: Students from marginalised sections are pushed further to the margins through a number of factors, such as the lack of English-medium education; private institutions charging high fees; poor quality education in government-run schools and institutes; ever-growing economic inequality; graduates not having the adequate skills to secure jobs; and caste discrimination.
    • Social ideology of success and failure: The rise of neoliberalism as an economic and social ideology has pushed the youth to blame themselves for their failure to secure their ‘dream job’ while the government continues to shirk its basic responsibility.
    • Flawed neoliberal agenda for failure and success: The neo-liberal agenda keeps propagating the belief that it is not that hard to find success if one works hard enough, normalising the notion that the youth should blame themselves for their ‘failures’.

    suicides

    What are various solutions have been proposed?

    • The myth of the Indian family being supportive also need to be called out: Family, being the primary social unit of the society, shapes the aspirations and dreams of the youth. Family should be supportive in true sense.
    • Deeper introspection is needed instead of make shift solutions: Deeper introspection on structural aspects of the education system is the need of the hour. Instead, we take pride in coming up with Jugaad (makeshift solutions) to manage affairs peripherally, without dealing with the root of problem.
    • Easing pressure in the students: Others have suggested like the guidelines issued by the Board of Intermediate Education in Andhra Pradesh in 2017 to ease the pressure on students, including yoga and physical exercise classes and maintaining a healthy student-teacher ratio.
    • Realising today’s realities and making changes: It is painfully evident that the failure to address the larger issue of a punishing education system that is simply not designed to support young minds or prepare them for today’s economic realities continues.
    • Collective responsibility: Not only family plays a significant role in students life, even the society has a huge influence. We as a society should realise true essence of life and not confine students into success and failure tags. Instead support them empathically in realising their true potential.

    Did you know this solution? What any sensitive person will think of this?

    • Some suggested bordering on the ludicrous, like the Indian Institute of Science’s reported move last year to replace ceiling fans in hostel rooms with those that are wall-mounted.

    Conclusion

    • Scholars have long linked farmers’ suicides to India’s agrarian crisis; it is time that civil society starts looking at students’ suicides as an indicator of a grave crisis of the country’s educational structure, including the institutional structure, curriculum, and the like. The combination of a large population of young people with rising aspirations and an economy with shrinking opportunities has created a public health crisis that requires urgent attention.

    Mains Question

    Q. There has been a steady increase in student suicides in India over the past few years. What are the reasons and suggest what should be done?

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  • Day 10| Daily Answer Wars| CD WarZone

    Topics for Today’s question:

    GS-2          Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

    Question

     

    HOW TO ATTEMPT ANSWERS IN DAILY ANSWER WARS (DAW)?

    1. Daily 1 question either from General Studies 1, 2, 3 or 4 will be provided via live You Tube video session.
    2. You can write your answer on an A4 sheet and scan/click pictures of the same.
    3. The answer needs to be submitted by joining the telegram group given in the link below.

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  • Day 9| Daily Answer Wars| CD WarZone

    Topics for Today’s question:

    GS-3          Bilateral, regional and global groupings and agreements involving India and/or affecting  India’s interests.

    Question)

     

    HOW TO ATTEMPT ANSWERS IN DAILY ANSWER WARS (DAW)?

    1. Daily 1 question either from General Studies 1, 2, 3 or 4 will be provided via live You Tube video session.
    2. You can write your answer on an A4 sheet and scan/click pictures of the same.
    3. The answer needs to be submitted by joining the telegram group given in the link below.

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  • Curbing individualism in public health

    public

    Context

    • A failure to examine and interpret public health problems from a population perspective is leading to ineffective and unsustainable solutions as far as complex public health problems are concerned. There is a strong tendency in public health to prioritise individual-oriented interventions over societal oriented population-based approaches, also known as individualism in public health.

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    What are the problems in public health approach?

    • Micronutrient supplementation at Individualistic level instead sustainable approach at public level: Problems such as undernutrition, for which individualist solutions such as micronutrient supplementation and food fortification have been proposed as solutions in lieu of sustainable approaches such as a strengthening of the Public Distribution System, supplementary nutrition programmes, and the health services.
    • Diagnosis and treatment than the solutions that modify health behaviours: Similar is the case with chronic disease control, wherein early diagnosis and treatment is the most popular solution, with little scope for solutions that can modify health behaviours (through organised community action).

    Recent evidences that show individualism is preferred over population-based approach

    1. Pradhan Mantri Jan Arogya Yojana (PMJAY): A nationwide publicly-funded insurance scheme, the Pradhan Mantri Jan Arogya Yojana (PMJAY) falls under Ayushman Bharat. It is the largest health insurance scheme in the country covering hospitalisation expenses for a family for ₹5 lakh a year. The goal is to ensure ‘free’ curative care services for all kinds of hospitalisation services so that there is no financial burden to the beneficiary.
    • Approach needed: What is not talked about in the entire scheme is the need for hospitalisation services per year for any population.
    • Approach preferred: Instead, every individual is given an assurance that if there is a need for hospitalisation expenses, the scheme will cover the expenses, highlighting the risk/probability of every individual facing hospitalisation in a year.
    • Individualistic response: This is an individualistic response to the problem of hospitalisation expenditure faced by populations. This becomes obvious when one examines the data on annual hospitalisation across populations.
    1. vaccination for COVID-19 unlike other vaccinations: It was evident that a COVID-19 vaccine cannot prevent people from getting the disease but only reduce hospitalisation and deaths in the event of contracting COVID-19.
    • Approach needed: To effectively manage COVID-19, what was needed was to have primary, secondary, and tertiary health-care facilities to manage the above proportion of cases. This is what a population-based approach to epidemic would be focusing on.
    • Approach preferred: Instead, by focusing on a vaccination programme for the entire population, it is again an assurance and a promise to every individual that even if you get COVID-19, you will not need hospitalisation and not die. Even after the entire crisis, not much is talked about in terms of the grossly inadequate health-care infrastructure to ensure the necessary primary, secondary and tertiary care services for COVID-19 patients, in turn leading to many casualties.
    • Individualistic response: The entire focus has been on the success story that every individual is protected from hospitalisation and death achieved through vaccine coverage. Most of the deaths due to COVID-19 are a reflection of the failure to offer ventilator and ICU support services to the 1%-2% in desperate need of it. Curative care provisioning is never planned at an individual level as epidemiologically, every individual will not necessarily need curative care every time. The morbidity profile of a population across age groups is an important criterion used to plan the curative care needs of a population.

    What the data on population hospitalization suggests?

    • Episode of hospitalization a year: Data from the National Sample Survey Organisation (75th round) show that on an average, only 3% of the total population in India had an episode of hospitalisation in a year (from 1% for Assam to 4% for Goa and 10% for Kerala the need also a function of availability). The proportion hovers around 3%-5% across most Indian States.
    • Population based healthcare planning is necessary: This is population-based health-care planning. Instead, giving an assurance to every individual without ensuring the necessary health-care services to the population is not really helping in a crisis.

    Determinants of individualistic approach

    • Misconception in philosophy of public health: The dominance of biomedical knowledge and philosophy in the field of public health with a misconception that what is done at an individual level, when done at a population level, becomes public health. This is despite the contrasting philosophy and approaches of clinical medicine and public health and the evidence that support the latter and must be based on population characteristics and economic resources.
    • Visibility impact and mistake of judging a population’s characteristics: Health effects are more visible and appear convincing at the individual level, wherein improvements at the population level will be clear only after population-level analysis; this needs a certain level of expertise and orientation about society an important skill required for public health practitioners.
    • Market’s role and the effect of consumerism in public health practice: The beneficiaries for a programme become the maximum when 100% of the population is targeted. Instead of making efforts to supply evidence of the actual prevalence of public health problems, market forces would prefer to cast a wide net and cover 100% of beneficiaries. Propagating individualism has always been a characteristic feature of a consumerist society as every individual can then be a potential ‘customer’ in the face of risk and susceptibility.

    public

    Conclusion

    • The need of the hour is population-level planning, which means, population as a single unit needs to be considered. All forms of individualistic approaches in public health need to be resisted to safeguard its original principles of practice, viz. population, prevention, and social justice.
  • Day 7| Daily Answer Wars| CD WarZone

    Topics for Today’s question:

    GS-3          Bilateral, regional and global groupings and agreements involving India and/or affecting  India’s interests.

    Question)

     

    HOW TO ATTEMPT ANSWERS IN DAILY ANSWER WARS (DAW)?

    1. Daily 1 question either from General Studies 1, 2, 3 or 4 will be provided via live You Tube video session.
    2. You can write your answer on an A4 sheet and scan/click pictures of the same.
    3. The answer needs to be submitted by joining the telegram group given in the link below.

      https://t.me/cdwarzone

    *In case your answer is not reviewed, reply to your answer saying *NOT CHECKED*. 

    1. For the philosophy of Daily Answer Wars and payment: 
  • Day 6 | Daily Answer Wars| CD WarZone

    Topics for Today’s question:

    GS-3          Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

    Question)

     

    HOW TO ATTEMPT ANSWERS IN DAILY ANSWER WARS (DAW)?

    1. Daily 1 question either from General Studies 1, 2, 3 or 4 will be provided via live You Tube video session.
    2. Announcement video: https://www.youtube.com/watch?v=kGzTviBKVpY; Day 5 winners: Deepali, Ritu, Mohi, Pooja, Manujanshu
    3. You can write your answer on an A4 sheet and scan/click pictures of the same.
    4. The answer needs to be submitted by joining the telegram group given in the link below.

      https://t.me/cdwarzone

    *In case your answer is not reviewed, reply to your answer saying *NOT CHECKED*. 

    1. For the philosophy of Daily Answer Wars and payment: 
  • Status of Maternal mortality in India

    Maternal mortality

    Context

    • India has improved its maternal mortality ratio (MMR) to 97 deaths per lakh in 2018-2020 from 103 deaths per lakh in 2017-2019. This is a considerable improvement from the 130 deaths per lakh in 2014-2016, the latest data released by the office of the Registrar General of India showed.

    What is maternal mortality?

    • As per World Health Organization, Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

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    Maternal mortality

    Maternal mortality ratio (MMR)

    • Main indicator: Maternal mortality ratio is a Kay indicator maternal mortality ratio.
    • Definition: The maternal mortality ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period.
    • Shows risk of maternal death: It depicts the risk of maternal death relative to the number of live births and essentially captures the risk of death in a single pregnancy or a single live birth.
    • SDG target: Target 3.1 of Sustainable Development Goals (SDG) set by the United Nations aims at reducing the global maternal mortality ratio to less than 70 per 100,000 live births.

    Maternal mortality

    Maternal mortality Ratio (MMR) in India: An overview of recent figures

    • North eastern states show improvement: In 2014-2016, the north-eastern state’s MMR was at a dangerously high 237 deaths per one lakh live births. This has improved significantly over the years to 229 in 2015-2017, 215 in 2016-2018 and 205 in 2017-2019, showed the data released November 28, 2022.
    • Southern states always better than national average: The southern state was always performing better than the national average and has almost consistently brought down even that figure from 46 in 2014-2016, 42 in 2015-2017, 43 in 2016-2018 and 30 in 2017-2019.
    • Kerala the best performer: Kerala continues to remain the best performer, with a low MMR of 19 per one lakh live births.
    • On regional level Assam improved but continues to have high MMR: On the regional level, Assam continues to have the highest MMR (195) but has improved its own performance over the years.
    • Better performing states: Among the better-performing states with an MMR lower than 100, barring Kerala, are Maharashtra (33), Telangana (43), Andhra Pradesh (45) and Gujarat (57).
    • Other states with high MMR: Madhya Pradesh (173), Uttar Pradesh (167), Chhattisgarh (137), Odisha (119), Bihar (118), Rajasthan (113), Haryana (110), Punjab (105) and West Bengal (105).
    • Sates with high MMR mostly belongs to socioeconomically poor regions: Most of these states belong to the Empowered Action Group (EAG) a classification of socioeconomically poor regions on whom the country’s development depends.

    The Statistics including Maternal Mortality Rate and lifetime risk

    • Maternal mortality rate: It is the maternal deaths of women in the ages 15-49 per lakh of women in that age group.
    • As defined by Registrar General of India: The Registrar General of India defines as “the probability that at least one woman of reproductive age (15-49 years) will die due to childbirth or puerperium (postpartum period), assuming that chance of death is uniformly distributed across the entire reproductive span.”

    Maternal Mortality Ratio (MMR) v/s Maternal Mortality Rate

    • Maternal Mortality Ratio (MMR): This is derived as the proportion of maternal deaths per 1,00,000 live births, reported under the Sample Registration System (SRS).
    • Maternal Mortality Rate: This is calculated as maternal deaths of women in the ages 15-49 per lakh of women in that age group, reported under SRS.

    Maternal mortality

    Maternal mortality rate in India

    • India’s maternal mortality rate is six.
    • poor-performing states include Madhya Pradesh (15.3), Uttar Pradesh (14.3), Assam (12.1), Bihar (11) and Chhattisgarh (9.9).
    • Kerala is the only state to achieve a maternal mortality rate of less than one, at 0.9.
    • Other states in the leading category include Maharashtra (1.8), Telangana (2.3), Andhra Pradesh (2.4) and Tamil Nadu (2.7).
    • The lifetime risk figures also show a similar trend, with Madhya Pradesh leading the way at 0.53 per cent, followed by Uttar Pradesh (0.50 per cent), Assam (0.42 per cent), Bihar (0.39 per cent) and Chhattisgarh (0.35 per cent).
    • At the national level, the lifetime risk of maternal mortality stands at 0.21 per cent.

    Conclusion

    • India’s performance on the maternal mortality front has been improving consistently as the country achieves its national target of reducing MMR to below 100.But it still lags behind the UN-mandated Sustainable Development Goals target of an MMR equivalent to 70 deaths per 100,000 live births. The country has eight years to meet this benchmark by 2030. Other indicators assessing maternal health indicate large room for improvement.

    Mains question

    Q. What is Maternal mortality. What is the difference between Maternal mortality ratio (MMR) and Maternal mortality rate. Evaluate India’s progress in reducing MMR.

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  • Education as a tool of innovation for the climate change generation.

    Education

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    Context

    • Instead of mirroring a broken development paradigm predicated on an extractive relationship with nature, India can lead with an approach that’s better for both people and the planet. A climate-resilient education system will be essential to realising this opportunity.

    Background

    • India’s LiFE mass movement: At COP27, India released its Long-Term Low Emissions and Development Strategies (LT-LEDS). This outlines priorities for carbon-intensive sectors like electricity and industry and transport, and emphasizes the role of a Lifestyle for Environment (LiFE) as a mass movement towards sustainable consumption and production.
    • Education is vital: From behavioral shifts of individuals to the re-shaping of markets, education has a vital role in the LiFE movement.
    • Potential of demand side actions: According to the Intergovernmental Panel on Climate Change (IPCC), this could make a significant dent in reducing planet-warming gases, demand-side actions have the potential to cut greenhouse gas emissions by 40-70 per cent in 2050.

    Education

    What are the challenges facing the education sector and children at present?

    • School closures during the Covid pandemic affect productivity: school closures during the pandemic have led to a learning deficit that’s getting reflected in reduced test scores. This will likely impact productivity and per capita income levels in the long term. One year of school closures could reduce GDP levels by anywhere from 1.1 to 4.7 per cent by mid-century, according to a paper by the Organisation for Economic Co-operation and Development.
    • Hinderance to the economic mobility: The lasting impacts of Covid-19 could hinder economic mobility for a generation of Indians and alter the arithmetic for public finance.
    • Climate change impacts children more: Climate impacts are already disrupting children’s learning and well-being globally. For instance, extreme heat reduces students’ learning levels and causes physiological harm. Schools are temporarily shut down and children’s health is affected due to persistently poor air quality in cities like Delhi.
    • Disasters and displacing families affecting children: Debilitating deluges are permanently displacing families, often leading to children (and disproportionately girls) dropping out of schools and being trafficked or subject to child labour due to distressed household incomes. As these disasters grow more frequent and intense, we must prepare the infrastructure, content, and delivery of the public education system to protect the most vulnerable citizens, many of whom will be climate refugees.
    • Anxiety about the future: The lived experiences of climate-induced disasters and anxiety about the future are causing despair and dread among young people. This is compounded by digital platforms and news cycles that don’t linger long enough to make sense of challenges or build a widespread understanding of breakthroughs like the significant reductions in the costs of renewable energy.

    Education

    How can the climate education system be used to both prevent crisis and create opportunity?

    • Creating a strong and inclusive climate-resilient education system at national level: At a national level, a strong enabling framework for a climate-resilient education system shall cover matters from curricula to nutrition to school building codes in a climate-changed world. With its scale and reach, the public school system is not only a source of learning but also shelter, clothing, food, and community for millions.
    • Programs in states shall be implemented according to the local demands: Design and implementation in states and districts should be shaped by existing local needs and anticipated climate risks. This could involve infrastructure investments so school buildings can double up as emergency shelters in cyclone-prone areas and capacity additions so government schools in mega-cities that are destinations for climate migrants can integrate and empower children
    • Emphasize should be on social and emotional learning: Students’ mental health needs should be served through an empathic expansion and an emphasis on social and emotional learning. Across the board, children should be able to access clean water and nutritious food.
    • Technical curriculum with indigenous knowledge shall be applied: Curricula can be infused with scientific and technical know-how alongside indigenous and local knowledge. In pockets, there are already innovative initiatives under-way where non-government organisations are adding tremendous value through contextualisation and close work with communities.
    • Integrating biodiversity conservation learning process: Students should be taught about the potential of integrating biodiversity conservation with regenerative agriculture. Youth must be empowered and encourages to take civic and climate actions from waste management to recycle, to lake restorations and to make their city more liveable.
    • Fostering critical thinking: The cross-cutting imperative should be to foster critical thinking instead of rote learning so that the next generation can embrace complexity and make informed choices.

    Education

    Way ahead

    • There is a need for climate education across society rather than simply at the primary and secondary levels.
    • There is need to retrain workers in industries that have a future in a green economy.
    • So is the need to priorities technical training in colleges and universities so we can rapidly accelerate our decarbonization pathway.

    Conclusion

    • We can’t afford to be narrowly focusing on technical training for the innovation, research, and development of climate technologies. Rather, we should develop strong analytical capabilities and holistic thinking about societal transformations and how new technologies will be embedded in communities. As Elizabeth Kolbert, the Pulitzer Prize-winning journalist put it, “the ‘invisible hand’ always grasps for more”.

    Mains question

    Q. Climate change is rapidly altering the environment and economy, especially affecting children. In this light, Climate resilient education systems can be used to prevent crises and create opportunities. Discuss.

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  • Measles outbreak: Need to accelerate Children Immunization program

    Measles

    Context

    • A measles outbreak in Mumbai has raised concerns amongst the country’s public health authorities. The city has reported more than 200 cases in the past two months and at least 13 children have lost their lives.

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    Measles: A memory shot

    • Measles is a highly contagious viral disease.
    • Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air.
    • The virus infects the respiratory tract, then spreads throughout the body.
    • Measles is a human disease and is not known to occur in animals.

    outbreak

    All you need to know about Measles

    • Signs and symptoms include:
    • The first sign of measles is usually a high fever, runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage.
    • The most serious complications include blindness, encephalitis, severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia.
    • Who is at risk?
    • Unvaccinated young children are at highest risk of measles and its complications, including death.
    • Unvaccinated pregnant women are also at risk.
    • Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.
    • Transmission:
    • Measles is one of the world’s most contagious diseases.
    • It is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.
    • Treatment:
    • No specific antiviral treatment exists for measles virus.
    • Severe complications from measles can be reduced through supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution.
    • All children diagnosed with measles should receive two doses of vitamin A supplements.
    • Prevention:
    • Routine measles vaccination for children, combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce global measles deaths.
    • The measles vaccine is often incorporated with rubella and/or mumps vaccines.

    Reasons sought behind the sudden outbreak of Measles in India

    • A backslide in the universal immunisation programme during the pandemic:
    • By all accounts, the outbreak seems to have been precipitated by a backslide in the universal immunisation programme during the pandemic.
    • According to the state government data, only 41 per cent of the eligible children have been inoculated against measles in Mumbai.
    • Vaccine hesitancy:
    • Parents, reportedly, are showing a disinclination to continue the inoculation regime for their children after they developed fever on being administered the first jab.
    • Overworked public health professionals, including ASHA workers, have also had to combat vaccine hesitancy.

    outbreak

    Government efforts and the status of Immunization programs

    • Mission Indradhanush: In recent years, the Centre’s Mission Indradhanush project has improved vaccine coverage and reduced delays between shots.
    • Low coverage in last two years: WHO and UNICEF studies have shown that immunisation programmes especially those focusing on DPT (diphtheria, pertussis and tetanus) and measles have taken a hit in low- and mid-income countries, including India, in the past two years.
    • Missed shots during Pandemic restrictions: Early in the pandemic, the National Health Mission’s information system reported that at least 100,000 children missed their shots because of the restrictions on movement.
    • India speeding up the immunization after the pandemic: Anecdotal reports do indicate that India’s universal inoculation programme picked up during the latter part of the pandemic. But measles is a highly contagious disease. Experts had cautioned that even a 5 per cent fall in the vaccination rate can disrupt herd immunity and precipitate an outbreak. The surge of the disease in Mumbai indicates that their fears are coming true.

    Countries with lower per capita incomes are more at risk

    • Measles is still common in many developing countries particularly in parts of Africa and Asia. The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures.
    • Measles outbreaks can be particularly deadly in countries experiencing or recovering from a natural disaster or conflict. Damage to health infrastructure and health services interrupts routine immunization, and overcrowding in residential camps greatly increases the risk of infection.
    • Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children. In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection.

    outbreak

    Conclusion

    • Studies have shown that child vaccination had suffered during the pandemic as attention shifted towards adult vaccination. Now that the pandemic has waned, governments must carefully evaluate at the grassroots how many children fell out of the vaccine net during this period and take countermeasures.

    Mains question

    Q. Measles is a highly contagious disease with a high mortality rate in unvaccinated children. Discuss the reasons behind the recent outbreak of measles in India.

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  • A reality check on Nutrition programs

    Nutrition

    Context

    • The Global Hunger Index (GHI) 2022 has brought more unwelcome news for India, as far as its global ranking on a vital indicator of human development is concerned. India ranked 107 out of 121 countries. Malnutrition still haunts India

    Global hunger Index (GHI)

    • The GHI is an important indicator of nutrition, particularly among children, as it looks at stunting, wasting and mortality among children, and at calorific deficiency across the population.

    Findings according to the National family health survey findings (NFHS-5)

    • India’s National Family Health Survey (NFHS-5) from 2019-21 reported that in children below the age of five years, 35.5% were stunted, 19.3% showed wasting, and 32.1% were underweight.

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    Nutrition

    Status of budgetary allocation for Government Schemes

    • Gaps in the funding: Experts have suggested several approaches to address the problem of chronic malnutrition, many of which feature in the centrally-sponsored schemes that already exist. However, gaps remain in how they are funded and implemented, in what one might call the plumbing of these schemes.
    • Saksham Anganwadi:
    • The Government of India implements the Saksham Anganwadi and Prime Minister’s Overarching Scheme for Holistic Nutrition (POSHAN) 2.0 scheme (which now includes the Integrated Child Development Services (ICDS) scheme),
    • It seeks to work with adolescent girls, pregnant women, nursing mothers and children below three.
    • However, the budget for this scheme for FY2022-23 was ₹20,263 crore, which is less than 1% more than the actual spent in FY2020-21 an increase of less than 1% over two years.
    • PM POSHAN:
    • PM POSHAN, or Pradhan Mantri Poshan Shakti Nirman, known previously as the Mid-Day Meal scheme (National Programme of Mid-Day Meal in Schools).
    • The budget for FY2022-23 at ₹10,233.75 crore was 21% lower than the expenditure in FY2020-21.
    • It is clear that the budgets being allocated are nowhere near the scale of the funds that are required to improve nutrition in the country.

    Nutrition

    What are the hurdles for effective Implementation of such large-scale schemes.

    • Underfunded Nutrition Programme: An Accountability Initiative budget brief reports that per capita costs of the Supplementary Nutrition Programme (one of the largest components of this scheme) has not increased since 2017 and remains grossly underfunded, catering to only 41% of the funds required.
    • Vacant posts of Projects officers and insufficient manpower: The budget brief also mentions that over 50% Child Development Project Officer (CDPO) posts were vacant in Jharkhand, Assam, Uttar Pradesh, and Rajasthan, pointing to severe manpower constraints in successfully implementing the scheme of such importance.
    • Regular controversies over the food served under MDM: While PM POSHAN (or MDM) is widely recognized as a revolutionary scheme that improved access to education for children nationwide, it is often embroiled in controversies around what should be included in the mid-day meals that are provided at schools.
    • Irregular social audits: Social audits that are meant to allow community oversight of the quality of services provided in schools are not carried out routinely.
    • Volatile food prices effects: The effect of cash transfers is also limited in a context where food prices are volatile and inflation depletes the value of cash.
    • Social factors: Equally, there are social factors such as ‘son preference’, which sadly continues to be prevalent in India and can influence household-level decisions when responding to the nutrition needs of sons and daughters.

    Nutrition

    Suggestions for the effective delivery of the government schemes

    • Tracing the reasons behind existing malnutrition: It is clear that malnutrition persists due to depressed economic conditions in large parts of the country, the poor state of agriculture in India, persistent levels of unsafe sanitation practices, etc. Political battles over malnutrition are not going to help; nor is continuing to think in silos.
    • Cash transfers where purchasing poverty is less: Cash transfers have a role to play here, especially in regions experiencing acute distress, where household purchasing power is very depressed. Cash transfers can also be used to incentivize behavioural change in terms of seeking greater institutional support.
    • Targeted supplementation: Food rations through PDS and special supplements for the target group of pregnant and lactating mothers, and infants and young children, are essential.
    • Community participation: Getting these schemes right requires greater involvement of local government and local community groups in the design and delivery of tailored nutrition interventions.
    • Comprehensive social education programs for girls: A comprehensive programme targeting adolescent girls is required if the inter-generational nature of malnutrition is to be tackled. There is a need of comprehensive social education programme.

    Conclusion

    • Malnutrition has been India’s scourge for several years now. A month-long POSHAN Utsav may be good optics, but is no substitute for painstaking everyday work. The need of the hour is to make addressing child malnutrition the top priority of the government machinery, and all year around.

    Mains Question

    Q. Despite large government nutrition programs, malnutrition still haunts India. Discuss the problems and suggest solutions.

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