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

  • Centre cites law to deny medical seats to Ukraine-returnees

    medical

    The Centre has told the Supreme Court that the law does not allow undergraduate medical students, who fled the “war-like situation” in Ukraine, to be accommodated in Indian medical colleges.

    Which laws is the govt talking about?

    • There are no provisions either under the Indian Medical Council Act, 1956, or the National Medical Commission Act, 2019 to accommodate or transfer medical students.
    • Till now, no permission has been given by the National Medical Commission to transfer or accommodate any foreign medical students in any Indian medical institute/university.

    Why foreign undergraduates are not permitted?

    • Absence of law: The extant regulations in India do not permit migration of students from foreign universities to India.
    • No backdoor entry: The public notice cannot be used as a back door entry into Indian colleges offering undergraduate courses.
    • Merit issue: The students had left for foreign universities for two reasons, poor marks in the National Eligibility cum Entrance Test (NEET) and affordability of medical education in foreign countries.
    • High cost: Besides, these students, if admitted in Indian colleges, would again face the problem of affordability.

    Why do Indians go abroad for medical studies?

    • According to estimates from Ukraine, reported in the media, around 18,000 Indian students are in Ukraine (before Operation Ganga).
    • Most of them are pursuing medicine.
    • This war has turned the spotlight on something that has been the trend for about three decades now.

    Preferred countries for a medical degree

    • For about three decades now, Indian students have been heading out to Russia, China, Ukraine, Kyrgyzstan, Kazakhstan, and Philippines to pursue a medical degree.

    Hype of becoming a Doctor

    • Prestige: The desire to study medicine still holds a lot of value in the Indian community (the other is becoming an IAS officer).
    • Shortages of Doctor: In many rural areas, people still look at doctors as god’s incarnate.
    • Rarity of opportunity: The lack of equal opportunities exacerbated by the caste factor in the Indian context, has a great deal of impact on the prestige still associated with being a doctor.
    • Social upliftment ladder: For years, certain communities were denied the opportunities, and finally they do have a chance at achieving significant educational status.

    Why do Indians prefer going abroad?

    • No language barrier: The medium of education for these students is English, a language they are comfortable with.
    • Affordability: The amount spent on living and the medical degree are far more affordable than paying for an MBBS seat in private medical colleges in India.
    • Aesthetics and foreign culture: People are willing to leave their home to study far away in much colder places and with completely alien cultures and food habits.
    • Practice and OPD exposure: It broadens students’ mind and thinking, expose them to a whole range of experiences, and their approach to issues and crises is likely to be far better.

    Doesn’t India have enough colleges?

    (a) More aspirants than seats

    • There are certainly far more MBBS aspirants than there are MBBS seats in India.
    • In NEET 2021, as per a National Testing Agency press release, 16.1 lakh students registered for the exam, 15.4 lakh students appeared for the test, and 8.7 lakh students qualified.
    • As per data from the National Medical Commission (NMC), in 2021-22, there were 596 medical colleges in the country with a total of 88,120 MBBS seats.
    • While the skew is in favour of Government colleges, it is not greatly so, with the number of private medical institutions nearly neck-to-neck with the state-run ones.

    (b) Fees structure

    • That means over 50% of the total seats are available at affordable fees in Government colleges.
    • Add the 50% seats in the private sector that the NMC has mandated must charge only the government college fees.
    • In fully private colleges, the full course fees range from several lakhs to crores.

    (c) Uneven distribution of colleges

    • These colleges are also not distributed evenly across the country, with States such as Maharashtra, Karnataka, Tamil Nadu and Kerala having many more colleges.

    What about costs?

    • The cost factor on both sides of an MBBS degree is significant.
    • The costs of an MBBS degree in a Government college tot up to a few lakhs of rupees for the full course, but in a private medical college, it can go up to â‚č1 crore for the five-year course.
    • In case it is a management seat, capitation fees can inflate the cost by several lakhs again.
    • Whereas, an MBBS course at any foreign medical university in the east and Eastern Europe costs far less (upto â‚č30lakh-â‚č40 lakh).

    Way forward

    • While PM Modi emphasised that more private medical colleges must be set up in the country to aid more people to take up MBBS, medical education experts have called for pause on the aspect.
    • If the aim is to make medicine more accessible to students of the country, the path ahead is not in the private sector, but in the public sector, with the Central and State governments’ involvement.
    • Starting private medical colleges by reducing the strict standards set for establishing institutes may not actually be the solution to this problem, if we think this is a concern.

    Conclusion

    • Creating more medical colleges will be beneficial for the country, if access and availability can be ensured.
    • This will not be possible by resorting to private enterprise only.
    • The State and Central governments can start more medical colleges, as recommended by NITI Aayog, by utilising district headquarters hospitals, and expanding the infrastructure.
    • This way, students from the lower and middle socio-economic rung, who are otherwise not able to access medical seats, will also benefit.

     

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  • Fighting anaemia

    anaemiaContext

    • The recent National Family Health Survey (NFHS-5) data shows anaemia rates increased from 53 per cent to 57 per cent in women and 58 per cent to 67 per cent in children in 2019-21.

    Definition of anaemia

    • The WHO defines anaemia as a condition where the number of red blood cells or the haemoglobin concentration within them is lower than normal. This compromises immunity and impedes cognitive development.

    Why anaemia is a concern?

    • Adverse effects of anaemia affect all age groups lower physical and cognitive growth and alertness among children and adolescents, and lesser capacity to learn and play, directly impacting their future potential as productive citizens.
    • Anaemia among adolescent girls (59.1 per cent) advances to maternal anaemiaand is a major cause of maternal and infant mortality and general morbidity and ill health in a community.

    What causes anaemia?

    • Imbalanced diet: Cereal-centric diets, with relatively less consumption of iron-rich food groups like meat, fish, eggs, and dark green leafy vegetables (DGLF), can be associated with higher levels of anaemia.
    • Underlying factors: High levels of anaemia are also often associated with underlying factors like poor water quality and sanitation conditions that can adversely impact iron absorption in the body.
    • Iron deficiency is major cause: A diet that does not contain enough iron, folic acid, or vitamin B12 is a common cause of anaemia.
    • Some other conditions: That may lead to anaemia include pregnancy, heavy periods, blood disorders or cancer, inherited disorders, and infectious diseases.

    anaemiaWhy is anaemia so high in the country?

    • Low vitamin intake: Iron-deficiency and vitamin B12-deficiency anaemia are the two common types of anaemia in India.
    • High population and nutrition deprivation: Among women, iron deficiency prevalence is higher than men due to menstrual iron losses and the high iron demands of a growing foetus during pregnancies.
    • Overemphasis on cereals: Lack of millets in the diet due to overdependence on rice and wheat, insufficient consumption of green and leafy vegetables could be the reasons behind the high prevalence of anaemia in India.

    What is Iron fortification?

    • Iron fortification of food is a methodology utilized worldwide to address iron deficiency. Iron fortification programs usually involve mandatory, centralized mass fortification of staple foods, such as wheat flour.

    https://www.civilsdaily.com/news/mandatory-rice-fortification-policy-should-be-re-examined/Why need iron fortification?

    • Iron deficiency anaemia is due to insufficient iron.
    • Without enough iron, the body can’t produce enough of a substance in red blood cells that enables them to carry oxygen (haemoglobin).
    • Severe anaemia during pregnancy increases risk of premature birth, having a low birth weight baby and postpartum depression. Some studies also show an increased risk of infant death immediately before or after birth.

    anaemiaSuccess story / value addition

    • Nepal’s success story to improve maternal anaemia by national action plan .

    Anaemia Mukt Bharat

    • The scheme aims to reduce the prevalence of anaemia in India.
    • It provides bi weekly iron Folic acid supplementation to all under five children through Asha workers.
    • Also, it provides biannual Deworming for children and adolescents. The scheme also establishes institutional mechanisms for advanced research in anaemia.
    • It also focuses on non-nutritional causes of anaemia.

    We need to focus on the following interventions

    • Prophylactic Iron and Folic Acid supplementation.
    • Intensified year-round Behaviour Change Communication Campaign (Solid Body, Smart Mind).
    • Appropriate infant and young child feeding practices.
    • Increase in intake of iron-rich food through diet diversity/quantity/frequency and/or fortified foods with focus on harnessing locally available resources.
    • Testing and treatment of anaemia, using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents
    • Mandatory provision of Iron and Folic Acid fortified foods in government-funded public health programmes

    Way forward

    • India’s nutrition programmes must undergo a periodic review.
    • The Integrated Child Development Services (ICDS), which is perceived as the guardian of the nation’s nutritional well-being must reassess itself and address critical intervention gaps, both conceptually and programmatically, and produce rapid outcomes.
    • The nutritional deficit which ought to be considered an indicator of great concern is generally ignored by policymakers and experts. Unless this is addressed, rapid improvement in nutritional indicators cannot happen.

    Conclusion

    • When a person is anaemic, the capacity of his blood cells to carry oxygen decreases. This reduces the productivity of the person which in turn affects the economy of the country. Therefore, it is highly important to cover Anaemia under National Health Mission.

    Mains question

    Q. “Every second adolescent girl has anaemia. Every second woman of reproductive age is anaemic”. In this context do you think Women’s empowerment will not have any meaning without tackling anaemia? Discuss.

     

     

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  • What is National List of Essential Medicines (NLEM)?

    The latest National List of Essential Medicines (NLEM) released September 13, 2022 by the Union health ministry added 34 new medicines and dropped 26 old ones from the previous list.

    What is NLEM?

    • As per the World Health Organisation (WHO), Essential Medicines are those that satisfy the priority health care needs of the population.
    • Ministry of Health and Family Welfare hence prepared and released the first National List of Essential Medicines of India in 1996 consisting of 279 medicines.
    • The list is made with consideration to disease prevalence, efficacy, safety and comparative cost-effectiveness of the medicines.
    • Such medicines are intended to be available in adequate amounts, in appropriate dosage forms and strengths with assured quality.
    • They should be available in such a way that an individual or community can afford.

    NLEM in India

    • Drugs listed under NLEM — also known as scheduled drugs — will be cheaper because the National Pharmaceutical Pricing Authority (NPPA) caps medicine prices and changes only based on wholesale price index-based inflation.
    • The list includes anti-infectives medicines to treat diabetes such as insulin — HIV, tuberculosis, cancer, contraceptives, hormonal medicines and anaesthetics.
    • They account for 17-18 per cent of the estimated Rs 1.6-trillion domestic pharmaceutical market.
    • Companies selling non-scheduled drugs can hike prices by up to 10 per cent every year.
    • Typically, once NLEM is released, the department of pharmaceuticals under the ministry of chemicals and fertilisers adds them in the Drug Price Control Order, after which NPPA fixes the price.

    Significance of EML

    • Drawing an essential medicines list (EML) is expected to result in better quality of medical care, better management of medicines and cost-effective use of health care resources.
    • This is especially important for a resource limited country like India.
    • The list of essential medicines is intended to have a positive impact on the availability and rational use of medicines.

    Also read

    What is the NPPA’s role in fixing drug prices?

     

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  • LGBTQ leap forward for positive future growth of human rights

    LGBTQContext

    • Four years after landmark LGBTQ verdict: The march to full citizenship.

    Why in news?

    • On September 6, 2018, exactly four years ago, in Navtej Singh Johar and Ors v Union of India, a five-judge constitution bench of the Supreme Court, in a beautifully elaborate decision, liberated LGBTQI Indians from the darkness of Section 377 of the Indian Penal Code, 1860.

    What is LGBTQ?

    • LGBTQ is an initialism that stands for lesbian, gay, bisexual, and transgender. In use since the 1990s, the initialism, as well as some of its common variants, functions as an umbrella term for sexuality and gender identity.

    What is Section 377 of the IPC?

    • It reads – Unnatural offences: Whoever voluntarily has carnal intercourse against the order of nature with any man, woman or animal shall be punished with imprisonment for life, or with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine.
    • The terms “carnal intercourse” and “against the order of nature” are not defined precisely anywhere in the code.

    LGBTQRole played by the judiciary hitherto

    • The Delhi High Court’s verdict in Naz Foundation vs Government of NCT of Delhi (2009) was a landmark in the law of sexuality and equality jurisprudence in India.
    • The court held that Section 377 offended the guarantee of equality enshrined in Article 14 of the Constitution, because it creates an unreasonable classification and targets homosexuals as a class.
    • In a retrograde step, the Supreme Court, in Suresh Kumar Koushal vs Naz Foundation (2013), reinstated Section 377 to the IPC.
    • However, the Supreme Court in Navtej Singh Johar & Ors. vs Union of India (2018) declared that the application of Section 377 IPC to consensual homosexual behaviour was “unconstitutional”.
    • This Supreme Court judgment has been a great victory to the Indian individual in his quest for identity and dignity.
    • It also underscored the doctrine of progressive realisation of rights.

    LGBTQWhat’s next?

    • Overarching legislation is needed to guarantee equality to all persons on the basis of sexual orientation, gender identity and expression, sex, caste, religion, age, disability, marital status, pregnancy, nationality, and other grounds.
    • The law should impose obligations of equality and non-discrimination on all persons, public and private, and in the areas of education, employment, healthcare, land and housing and access to public places.
    • It should provide for civil remedies to stop discriminatory behaviour, costs and damages, and positive action to make reparations.
    • We need an equality law to define what equality would encompass.
    • Supreme Court comes held in its privacy judgment in K.S. Puttuswamy v. Union of India (2017) that equality and liberty cannot be separated, and equality encompasses the inclusion of dignity and basic freedoms.

    Way forward

    • Schools and colleges must effect changes in curricula for a better understanding of the community.
    • People of a different sexual orientation or gender identity often narrate harrowing tales of bullying, discrimination, stigma and ostracization.
    • Gender-neutral restrooms should be compulsory in educational institutes and other places.
    • Parents too need to be sensitised, because the first point of misunderstanding and abuse often begins at home, with teenagers being forced to opt for “conversion” therapies.

    Conclusion

    • Justice Chandrachud, speaking on the fourth anniversary of Johar and the journey ahead, while quoting the Beatles classic “All you need is love”, notes that “simply love is not enough”. Rights are necessary. Which will enhance dignity of the community.

    Mains question

    Q. “Silent segregation” on the grounds of gender, sexual orientation preferences are followed in several houses. Elucidate in context of LGBTQ issues. What Legal remedies are needed for its victims?

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  • Public health should be led by doctor alone

    public healthContext

    • Doctor shortages are creating hurdles in health emergency response

    What is the crux of the article in simple words?

    • Medical qualification and expertise is necessary to deliver quality health services by medical professionals unlike by general health care workers who lack competency.

    What is public health?

    • Public health has been defined as “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals”.

    Why there is need of qualification?

    • Lack of training: Health workers have no training in public health; they are grassroots-level service providers. Asking them to be part of public health cadre trivialises the profession of public health.
    • Separate profession: It is important to understand that public health is a separate profession with a specific set of competencies.

    public healthWhat are 4 pillars of public health?

    • Academics: Academics refers to a good understanding of evidence generation and synthesis by having a good grounding in epidemiology and biostatistics. These competencies are also critical for monitoring and evaluating programmes, conducting surveillance, and interpreting data and routine reporting.
    • Activism: Public health is inherently linked to ‘social change’ and an element of activism is core to public health. Public health requires social mobilisation at the grassroots level by understanding community needs, community organisation, etc. This requires grounding in social and behavioural sciences.
    • Administration: Administration refers to administering health systems at different levels from a primary health centre to the district, State, and national level. This includes implementing and managing health programmes, addressing human resource issues, supply and logistical issues, etc. It includes microplanning of programme delivery, team building, leadership as well as financial management to some extent.
    • Advocacy: In public health, there is little that one can do at an individual level; there must be communication with key stakeholders to change the status quo at different levels of government. This requires clear enunciation of the need, analysis of alternative set of actions and the cost of implementation or non-implementation. Good communication and negotiation skills are critical to perform this function. The related subjects are health policy, health economics, health advocacy and global health.

    public healthWhat are the hurdles in absorbing others as public health professionals?

    • Lack of skill: Many doctors and other health professionals work at the grassroots level and develop a good sense of public health due to their inclination. But they do not become public health professionals as they may not have the necessary skills. Nevertheless, they are valuable.
    • Lack of critical expertise: Clinicians with training in epidemiology and biostatistics would not qualify to be public health professionals as they lack not only other essential and critical expertise but also an appropriate perspective.
    • Compromise on quality:

    Current challenges faced by public healthcare in India

    • Deficiency: The doctor-patient ratio of 1:1655 in India as against WHO norm of 1:1000 clearly shows the deficit of MBBS. While the government is working towards a solution and targeting to reach the required ratio, there is a need to relook at the overall medical education.
    • Post pandemic scenario: The lag in formal medical education has come up evidently post-pandemic when the nation saw the medical fraternity struggling to fill the doctor deficit.
    • Limited government seats: The number of seats available for medical education in India is far less than the number of aspirants who leave school with the dream of becoming doctors.
    • Lack of skills: Though the institutes are managing to hire professors and lecturers, there is a lack of technical skills. Finding faculties in clinical and non-clinical disciplines is difficult and there are very few faculty development programs for upskilling the existing lot.
    • Lack of infrastructure: The gap in digital learning infrastructure is currently the biggest challenge the sector is facing. There is an urgent need to adopt technology and have resources available to facilitate e-learning.
    • Lack of research and innovation: The medical research and innovation needs an added push as there haven’t been many ground-breaking research here. The education system needs to focus more on increasing the quality of research. Additionally since industry academia partnership is not available, hence innovation also takes a back-seat.

    Conclusion

    • By establishing new medical colleges, the government can increase student intake as well as enhance equitable access to public health as separate profession. This will attract the best and the brightest people into this discipline, which is very important for the nation’s health. This is one lesson that we should learn from the pandemic.

    Mains question

    Q. What do you understand by public health? Do you think it is a separate profession requiring a specific set of competencies? Examine.

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  • TB mukt India

    TBContext

    • People’s participation in the ‘TB-Mukt India’ campaign can help eliminate the disease by 2025.

    What is TB?

    • A potentially serious infectious bacterial disease that mainly affects the lungs.

    How TB is caused?

    • Tuberculosis (TB) is caused by a type of bacterium called Mycobacterium tuberculosis. It’s spread when a person with active TB disease in their lungs coughs or sneezes and someone else inhales the expelled droplets, which contain TB bacteria.

    What does TB do to humans?

    • It mainly affects the lungs, but it can affect any part of the body, including the tummy (abdomen), glands, bones and nervous system.

    TBHow long has the TB infected us?

    • TB is as old as humanity itself, infecting us for at least 5,000 years. The infecting agent, a bacterium, was identified way back in 1882, by Robert Koch, signalling one of the landmark discoveries which laid the foundation of modern medicine

    Is TB painful?

    • If TB affects your joints, you may develop pain that feels like arthritis. If TB affects your bladder, it may hurt to go to the bathroom and there may be blood in your urine. TB of the spine can cause back pain and leg paralysis. TB of the brain can cause headaches and nausea.

    Can we get TB if vaccinated?

    • BCG is a vaccine for TB. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. The BCG vaccine is not very good at protecting adults against TB. We can still get TB infection or TB disease even if you were vaccinated with BCG.

    When do TB symptoms start?

    TB

     

    • TB disease usually develops slowly, and it may take several weeks before you notice you’re unwell. Your symptoms might not begin until months or even years after you were initially infected. Sometimes the infection does not cause any symptoms. This is known as latent TB.

    Is TB curable permanently?

    • TB can usually be completely cured by the person with TB taking a combination of TB drugs. The only time that TB may not be curable is when the person has drug resistant TB.

    What are drug-resistant tuberculosis?

    • Drug-resistant tuberculosis (DR-TB) is a form of antimicrobial resistance that is difficult and costly to treat. It is caused by TB bacteria that are resistant to at least one of the first-line existing TB medications, resulting in fewer treatment options and increasing mortality rates.

    Risk factors for TB include

    • Poverty
    • HIV infection.
    • Being in jail or prison (where close contact can spread infection)
    • Substance abuse.
    • Taking medication that weakens the immune system.
    • Kidney disease and diabetes.

    TB statistic for mains

    We are home to 1 in 4 of the world’s TB patients.

    Over 2.5 million Indians are infected.

    Government initiatives

    • Nikshay Poshan Yojana: in which TB patients receive Rs 500 every month while on treatment was launched. Nikshay Poshan Yojana ensure that the patients have economic support and nutrition during the required period.
    • TB Harega Desh Jeetega Campaign: was launched to accelerate the efforts to end TB by 2025. The campaign aims to initiate preventive and promotive health approaches.
    • Community-led approach: By applying “multi-sectoral and community-led” approach, the government is building a national movement to end TB by 2025.
    • Ni-kshay Mitra: Any individual or organisation can register as Ni-kshay Mitra on the Ni-kshay 2.0 portal to support people affected by the disease. The initiative intends to provide essential nutritional and social support to people with TB and root out stigma and discrimination against them.

    Some positive suggestions to eliminate TB

    • Sincere efforts need to be made to make our health systems more accessible and reliable.
    • It also required to ensure that those seeking care trust the healthcare system and get the appropriate care for completing treatment.
    • There is a need to create more labs, point of care tests, an assured drug pipeline, access to new drugs.
    • The government should also ensure counselling and support for those affected.
    • Every patient who is diagnosed late and does not receive timely treatment continues to infect others.
    • To break this cycle, government machinery at the field level should work with communities and provide free diagnosis and treatment to every affected individual.

    Conclusion

    • We have ignored TB for too long. It’s time we acknowledge the magnitude of the disease, and work harder at offering individuals equitable healthcare access and resources that the disease warrants.

    Mains question

    Q. Do you think we can eliminate TB by 2025? Discuss the roadmap and give some affirmative actions to be taken by government.

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  • Mother Tongue as a medium of instruction

    languageContext

    • English should be taught effectively not as the medium, but as a second language

    What is the debate?

    • Over the years, there has been a raging debate over the need for children to have their mother tongue as the medium of instruction in schools.
    • While educationists have emphasised the importance of learning in the mother tongue to enhance a child’s learning and overcome glaring inequities, there has been an equally steady demand for English-medium schools in several States.

    languageHistoric context to this debate

    • Orientalist: Orientalists were the group of people who wanted to give education to Indian people in the Indian language. The emphasis was on the knowledge of the East. They wanted Indians to learn about Indian philosophy, science, and literature. In the Initial stage, company officials favoured oriental learning.
    • Anglicist: Anglicists were those people who supported the teaching of modern western education to Indian people in the English language. People who favoured Anglicists were Thomas Babington, Macaulay, James’s mill, Charles wood, Charles Trevelyan, and Elphinstone. The Anglicists were supported by the most advanced Indians like Raja Ram Mohan Roy.

    languageWhy mother tongue is important?

    • Suitability to child: There is an almost-complete consensus among educationists, linguistic experts and psychologists that the mother tongue, or the language of the region where the child lives, is the only appropriate language of learning for the child.
    • Incomprehension: A child can be taught any number of languages, particularly later in life, but the medium of learning should be the mother tongue. As a number of classrooms today are stalked by the curse of incomprehension.
    • Pressure of English language: There are a growing number of schools, mostly private, that teach in English. Government schools too in States like Tamil Nadu, unable to bear the pressure from parents and to stop students from migrating to private schools, are switching to English medium.
    • Development in every way: The mother tongue, home language or the first language educationally means the language which the child is using to connect to the world, to people, to nature, to the environment, and to make sense of everything that’s going on. This is the language which helps the child to build, grow and develop in every way.
    • Inability to learn: English medium education is a profound tragedy in Indian education today. Millions are languishing because of their inability to learn in English not English as a language but as a medium through which they acquire any knowledge of any subject.

    Why English Should Be the Medium of Instruction in Schools, Colleges?

    • Connectivity with The Rest of the World: To communicate and be on par with the world, the first language that stands common is English. With English, a student can remain on par with what is happening across the globe. Lack of English knowledge or alone mother tongue does not allow children to progress with the rest of the world.
    • Technologies Can Be Used Only With English Instruction: Most of the modern technologies are invented, reinvented and modernized in foreign shores. The inventors keep the English language for the instruction manual of the technological gadget so that the gadget can be used worldwide.
    • Higher Education Emphasizes on The English language: The main focus of teaching medium in higher secondary as well as in graduation and post-graduation colleges in India. There is no doubt that lecturers also teach in Hindi or other regional languages. However, question design comes in both English and regional language. But most of the classes are taught in English.

    How multilingual approach helps

    • Firstly, multilingualism gives equal status to all languages and there’s enough work, history and research on this.
    • Second, children come from different backgrounds, and in some cases, they are first-generation learners with not much support at home.
    • The multilingual approach thus, is much more flexible, closer to the child, and inclusive. It is democratic, and it accepts that the teacher is not coming from a place of authority and is only correcting spellings and pronunciations.

    Conclusion

    • This myth must be broken that our education system is class and caste neutral. A powerful political movement will have to take place to make the language of learning a choice that is made democratically.

    Mains question

    Q. Should the mother tongue or English be the medium of instruction? Critically explain.

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  • What is the PM SHRI Scheme?

    Prime Minister has announced that under the PM SHRI Scheme, as many as 14,500 schools will be “upgraded” across India to showcase the components of the National Education Policy, 2020.

    What is the PM SHRI scheme?

    • According to the Ministry of Education, the centrally sponsored scheme will be called PM SHRI Schools (PM Schools for Rising India).
    • Under it, as many as 14,500 schools across states and Union Territories will be redeveloped to reflect the key features of the NEP, 2020.
    • The plan was first discussed with the education ministers of states and UTs during a conference organised by the Ministry of Education in June at Gandhinagar in Gujarat.
    • While there are exemplary schools like Navodaya Vidyalayas, Kendriya Vidyalayas, the PM SHRI will act as “NEP labs”.

    What are the key features of NEP in school education?

    • The NEP envisages a curricular structure and teaching style divided into various stages – foundational, preparatory, middle and secondary.
    • The foundational years (pre-school and grades I, II) will involve play-based learning.
    • At the preparatory level (III-V), light textbooks are to be introduced along with some formal classroom teaching. Subject teachers are to be introduced at the middle level (VI-VIII).
    • The secondary stage (IX-XII) will be multidisciplinary in nature with no hard separation between arts and sciences or other disciplines.

    What is a centrally sponsored scheme?

    • A centrally sponsored scheme is one where the cost of implementation is likely to split in the 60:40 ratio among the Union government and the states/Union Territories.
    • For instance, the mid-day meal scheme (PM Poshan) or the PM Awas Yojana are examples of centrally sponsored schemes.
    • In the case of the Northeastern states, Himachal Pradesh, Uttarakhand, Jammu and Kashmir and UTs without legislatures, the Centre’s contribution can go up to 90 per cent.

    How will PM SHRI schools be different from Kendriya Vidyalayas or Jawahar Navodaya Vidyalayas?

    • Kendriya Vidyalayas or Jawahar Navodaya Vidyalayas come entirely under the Centre’s Ministry of Education. They are fully funded by the Union government under Central Sector Schemes.
    • While KVs largely cater to children of Union government employees posted in states and UTs, JNVs were set up to nurture talented students in rural parts of the country.
    • In contrast, PM SHRI schools will be an upgrade of existing schools run by the Centre, states, UTs and local bodies.
    • This essentially means that PM SHRI schools can either be KVs, JNVs, state government schools or even those run by municipal corporations.

    Where will the PM SHRI schools come up?

    • The Centre has not yet released the list of schools that have been chosen for this purpose.
    • It has however announced that the PM SHRI schools will also “offer mentorship” to other schools in their vicinity.
    • These schools will be equipped with modern infrastructure including labs, smart classrooms, libraries, sports equipment, art room etc.
    • It shall also be developed as green schools with water conservation, waste recycling, energy-efficient infrastructure and integration of organic lifestyle in curriculum.

     

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  • Mental Health in india

    mental wellnessContext

    • How to deal with mental wellness challenges in the uniformed forces

    What is stress?

    • Stress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stress is your body’s reaction to a challenge or demand.

    What is mental wellness?

    • Mental wellness encompasses emotional, psychological, and social well-being. It influences cognition, perception, and behaviour. It also determines how an individual handles stress, interpersonal relationships, and decision-making.

    Why is Mental Health Important?

    • Mental health is more important now than ever before; it impacts every area of our lives. The importance of good mental health ripples into everything we do, think, or say.

    mental wellnessReasons for Persistence of Mental Illness

    • Stigma to seek help: The staggering figures are void of millions of others directly, or indirectly impacted by the challenge and those who face deep-rooted stigma, many times rendering them unable to seek help.
    • Lack of awareness: This growing challenge in dealing with mental health issues is further compounded by a lack of information and awareness, self-diagnosis, and stigma.
    • Psycho-social factors: Institutions like gender, race and ethnicity, are also responsible for mental health conditions.
    • Post-Treatment gap: There is a need for proper rehabilitation of the mentally ill persons post/her treatment which is currently not present.
    • Rise in Severity: Mental health problems tend to increase during economic downturns, therefore special attention is needed during times of economic distress.

    mental wellnessOngoing challenges in mental wellness regime

    • There is a need to expand understanding of the full scope of what uniformed Services and other mental health experts can achieve.
    • Stigma regarding mental health both domestically and around the world remains strong.
    • There is a lack of trained personnel and healthcare and public health systems in many areas of the world.
    • Training needs are broad and reach beyond direct patient care, especially regarding cultural competence, crisis communication, and consultation.
    • There is a need for expanded support for the value of multi-professional and multi-organizational integration and collaboration.

    Government Policy initiatives

    • National Mental Health Program (NMHP): To address the huge burden of mental disorders and shortage of qualified professionals in the field of mental health, the government has been implementing the NMHP since 1982.
    • Mental HealthCare Act 2017: It guarantees every affected person access to mental healthcare and treatment from services run or funded by the government.
    • Rights of Persons with Disabilities Act, 2017: The Act acknowledges mental illness as a disability and seeks to enhance the Rights and Entitlements of the Disabled and provide an effective mechanism for ensuring their empowerment and inclusion in the society
    • Manodarpan Initiative: An initiative under Atmanirbhar Bharat Abhiyan aims to provide psycho-social support to students for their mental health and well-being.

    What needs to be done?

    • Open dialogue: The practice of open dialogue, a therapeutic practice that originated in Finland, runs through many programmes in the Guidance. This approach trains the therapist in de-escalation of distress and breaks power differentials that allow for free expression.
    • Increase investment: With emphasis on social care components such as work force participation, pensions and housing, increased investments in health and social care seem imperative.
    • Network of services: For those homeless and who opt not to enter mental health establishments, we can provide a network of services ranging from soup kitchens at vantage points to mobile mental health and social care clinics.

    Conclusion

    • Persons with mental health conditions need a responsive care system that inspires hope and participation without which their lives are empty. We should endeavour to provide them with such a responsive care system.

    Mains question

    Q. Mental disorders are now among the top leading causes of health burden worldwide, with no evidence of global reduction since 1990. Examine.

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  • Ban on Conversion Therapy for the LGBTQIA+ Community

    The National Medical Commission (NMC), the apex regulatory body of medical professionals in India, has written to all State Medical Councils, banning sexual conversion therapy and calling it a “professional misconduct”.

    What is the news?

    • The NMC has empowered the State bodies to take disciplinary action against medical professionals who breach the guideline.
    • The NMC was following a Madras High Court directive to issue an official notification listing conversion therapy as a wrong, under the Indian Medical Council (Professional Conduct, Etiquettes and Ethics) Regulations, 2002.

    What is Sexual Conversion Therapy?

    • Conversion or reparative therapy is an intervention aimed at changing the sexual orientation or gender identity of an individual.
    • It uses either psychiatric treatment, drugs, exorcism and even violence, with the aim being to make the individual a heterosexual.
    • The conversion therapy umbrella also includes efforts to change the core identity of youth whose gender identity is incongruent with their sex anatomy.
    • Often, the therapy is offered by quacks with little expertise in dealing with the issue.
    • As late as 2018, medical books listed homosexuality and lesbianism as a “perversion”.

    What are the risks?

    • The interventions under conversion therapy are provided under the false premise that homosexuality and diverse gender identities are pathological.
    • They are not; the absence of pathology means there is no need for conversion or any other like intervention.
    • Conversion therapy poses the risk of causing or exacerbating mental health conditions, like anxiety, stress and drug use which sometimes even lead to suicide.

    What is the role of the Madras High Court in the ban?

    On June 7, 2021, Justice N. Anand Venkatesh of the Madras High Court gave a landmark ruling on a case he was hearing about the ordeal of a same-sex couple who sought police protection from their parents.

    • Pending adequate legislation more protective of the community, Justice Venkatesh issued a slew of interim guidelines.
    • It aimed for the police, activists, Union and State Social Welfare Ministries, and the National Medical Commission to ensure their safety and security to lead a life chosen by them.
    • The ruling prohibited any attempt to medically “cure” or change the sexual orientation of LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual or of any other orientation) people.
    • It urged the authorities to take action against professionals involving themselves in any form or method of conversion therapy,” which could include the withdrawal of licence to practice medicine.
    • On July 8, 2022, the court gave an order to the NMC directing it to issue necessary official notification by enlisting ‘Conversion Therapy’ as a professional misconduct.

    What were some of the other guidelines issued by the court?

    • The court asked the Ministry of Social Justice & Empowerment to draw up a list of NGOs and other groups which could handle the issues faced by the community, and gave it a time of 8 weeks from the date of the order.
    • The court said the community should be provided with legal assistance by the District Legal Services Authority in coordination with law enforcement agencies.
    • It asked agencies to follow the Transgender Persons (Protection of Rights) Rules, 2020, and the Transgender Persons (Protection of Rights) Act, 2019, in letter and spirit.
    • The court said it was imperative to hold sensitisation programmes for an all-out effort to understand the community and its needs.

    Way forward

    • Schools and colleges must effect changes in curricula for a better understanding of the community.
    • People of a different sexual orientation or gender identity often narrate harrowing tales of bullying, discrimination, stigma and ostracization.
    • Gender-neutral restrooms should be compulsory in educational institutes and other places.
    • Parents too need to be sensitised, because the first point of misunderstanding and abuse often begins at home, with teenagers being forced to opt for “conversion” therapies.
    • Health professionals point out that even adults opting for sex reassignment surgeries need to get proper guidance like therapy pre and post operation.

    Back2Basics: Transgender Persons (Protection of Rights) Act, 2019: Key Features

    Defining Transperson

    • The act defines a transgender person as one whose gender does not match the gender assigned at birth.
    • It includes trans-men and trans-women, persons with intersex variations, gender-queers, and persons with socio-cultural identities, such as kinnar and hijra.

    Prohibition against discrimination

    • It prohibits the discrimination against a transgender person, including denial of service or unfair treatment in relation to education, employment, healthcare, access to, or enjoyment of goods, facilities, opportunities available to the public.
    • Every transgender person shall have a right to reside and be included in his household.
    • No government or private entity can discriminate against a transgender person in employment matters, including recruitment, and promotion.

    HRD measures

    • A transgender person may make an application to the District Magistrate for a certificate of identity, indicating the gender as ‘transgender’.
    • Educational institutions funded or recognised by the relevant government shall provide inclusive facilities for transgender persons, without discrimination.
    • The government must provide health facilities to transgender persons including separate HIV surveillance centres, and sex reassignment surgeries.

    Grievances redressal

    • The National Council for Transgender persons (NCT) chaired by Union Minister for Social Justice, will advise the central government as well as monitor the impact of policies with respect to transgender persons.
    • It will also redress the grievances of transgender persons.

    Legal Protection

    • The Bill imposes penalties for the offences against transgender persons like bonded labour, denial of use of public places, removal from household & village and physical, sexual, verbal, emotional or economic abuse.

     

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