đŸ’„Join UPSC 2027,2028 Mentorship (July Batch) + XFactor Notes & Microthemes PDF
Talk to Mentor

Civilsdaily

Login

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

  • Anti-microbial resistance needs urgent attention

    Context

    Ever since the pandemic struck, concerns have been raised about the improper use of antimicrobials amongst Covid-19 patients.

    Concern over anti-microbial resistance

    • The “Global burden of bacterial antimicrobial resistance in 204 countries and territories in 2019 (GRAM)” report, released last month, 4.95 million people died from drug-resistant bacterial infections in 2019, with 3,89,000 deaths in South Asia alone.
    • AMR directly caused at least 1.27 million of those deaths.
    • Lower respiratory infections accounted for more than 1.5 million deaths associated with resistance in 2019, making it the most burdensome infectious syndrome.
    • Amongst pathogens, E coli was responsible for the most deaths in 2019, followed by K pneumoniae, S aureus, A baumannii, S pneumoniae, and M tuberculosis.

    Concern for India

    • As per the yearly trends reported by the Indian Council of Medical Research since 2015, India reports a high level of resistance in all these pathogens, especially E coli and K pneumoniae.
    • Only a fraction of the Indian data, available through the WHO-GLASS portal, has been included in the GRAM report.
    • India has been reporting high levels of resistance to fluoroquinolones, cephalosporins and carbapenems across the Gram-negative pathogens that cause almost 70 per cent of infections in communities and hospitals.
    • Therefore, the Indian data on the AMR burden may not look very different from the estimates published in the report.
    • Now that we know that AMR’s burden surpasses that of TB and HIV, a sense of urgency in containing such resistance is called for.
    • With no new drugs in the pipeline for drug-resistant infections, time is running out for patients.

    Addressing AMR through a multipronged and multisectoral approach

    • Use existing antimicrobials judiciously: The urgency to develop new drugs should not discourage us from instituting measures to use the existing antimicrobials judiciously.
    • Improved infection control in communities and hospitals, availability and utilisation of quality diagnostics and laboratories and educating people about antimicrobials have proved effective in reducing antimicrobial pressure — a precursor to resistance.
    • The National Action Plan for AMR, approved in 2017, completes its official duration this year. The progress under the plan has been far from satisfactory.
    • There is enough evidence that interventions like infection control, improved diagnosis and antimicrobial stewardship are effective in the containment of AMR.

    Conclusion

    The GRAM report has underlined that postponing action could prove costly.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Who is a Chess Grandmaster?

    India’s teenage chess grandmaster Rameshbabu Praggnanandhaa has won praise for a stunning victory over world number one Magnus Carlsen in an online championship.

    Why are we reading this?

    • UPSC had asked three questions on sports in CSP 2021. They were based on Laureus World Sports Award, Summer Olympics, and ICC World Test Championship.
    • Try to ace uncertainties. No one can memorize such facts.

    Grandmaster: Behind the Title

    • Grandmaster is the highest title or ranking that a chess player can achieve.
    • The Grandmaster title — and other chess titles — is awarded by the International Chess Federation, FIDE (acronym for its French name FĂ©dĂ©ration Internationale des Échecs).
    • It is the Lausanne-Switzerland-based governing body of the international game.
    • The title is the badge of the game’s super elite, a recognition of the greatest chess talent on the planet, which has been tested and proven against a peer group of other similarly talented players.

    Other (lesser) titles

    Besides Grandmaster, the Qualification Commission of FIDE recognises and awards seven other titles:

    1. International Master (IM)
    2. FIDE Master (FM)
    3. Candidate Master (CM)
    4. Woman Grandmaster (WGM), Woman International Master (WIM), Woman FIDE Master (WFM), and Woman Candidate Master (WCM) and so on .

    Titles are for life

    • All the titles, including that of Grandmaster, are valid for life, unless a player is stripped of the title for a proven offence such as cheating.

    Qualifications for Grandmaster

    • The qualifications for Grandmaster were changed several times, including in 1957, 1965, and 1970.
    • Currently, FIDE awards chess’s highest honour to a player who is able to achieve a FIDE Classical or Standard rating of 2,500, plus three Grandmaster norms.
    • Grandmaster norms are defined by a set of complex and rigorous rules regarding tournaments, games, and players, that are set out in the FIDE Title Regulations.
    • The current regulations were approved by the FIDE Council on October 27, 2021, and came into effect on January 1, 2022.
    • Each norm is very difficult to attain.
    • Broadly, a player must have a performance rating of 2,600 or higher in a FIDE tournament that has nine rounds.

    Who holds maximum titles?

    • FIDE has so far recognized fewer than 2,000 Grandmasters out of the millions who play the game around the world.
    • A vast majority of Grandmasters have been male. Russia (and the erstwhile USSR) has produced the most Grandmasters in the world, followed by the United States and Germany.

    Grandmasters in India

    • India became a chess powerhouse in the 2000s, and now has more than 70 Grandmasters.
    • In 2016, Praggnanandhaa had become the world’s youngest IM at age 10 years, 10 months, and 19 days.

    Try this question from CSP 2021:

    Q. Consider the following statements in respect of the Laureus World Sports Award which was instituted in the year 2000:

    1. American golfer Tiger Woods was the first winner of this award.
    2. The award was received mostly by ‘Formula One’ players so far.
    3. Roger Federer received this award maximum number of times compared to others.

    Which of the above statements are correct?

    (a) 1 and 2 only

    (b) 2 and 3 only

    (c) 1 and 3 only

    (d) 1, 2 and 3

     

    [wpdiscuz-feedback id=”77m1w3if0o” question=”Please leave a feedback on this” opened=”1″]Post your answers here.[/wpdiscuz-feedback]

     

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Tapping technology for multilingual learning

    Context

    As the theme of International Mother Language Day 2022, it has much relevance in reshaping Indian higher education.

    India’s unique cultural and linguistic diversity

    • According to the Language Census in 2018, India is home to 19,500 languages or dialects, of which 121 languages are spoken by 10,000 or more people in our country.
    • For centuries, India has been home to hundreds of languages and thousands of dialects, making its linguistic and cultural diversity the most unique in the world. 
    • Our linguistic diversity is one of the cornerstones of our ancient civilisation.
    • Impact of globalisation: While languages are among the key bridges that ensure cultural and civilisational continuity, globalisation and Westernisation have impacted not just the growth but also the survival of many of our dialects in this rich cultural and linguistic tapestry.
    • Therefore, International Mother Language Day has special significance to the Indian context.

    Endangered languages

    • In November 1999, the UNESCO General Conference approved the declaration of February 21 as International Mother Language Day, in response to the declining state of many languages.
    • According to the UN agency, at least 43% of the estimated 6,000 languages spoken in the world are endangered.
    • UNESCO has been striving to protect the cultural and linguistic diversity of member-states through pro-active international measures.
    • It is our collective responsibility to revive and revitalise the 196 Indian languages which fall under the “endangered” category.

    Role of technology: This year’s theme

    • Globally, the role of technology came to the fore during the COVID-19 pandemic when school shutdowns forced educators and learners to adapt themselves to online education.
    • The theme of International Mother Language Day in 2022 — “Using Technology for Multilingual Learning: Challenges and Opportunities” — is one of special relevance to us.
    • The central idea is to leverage technology to support and enrich the teaching-learning experience on a multi-lingual level.
    •  It also aims at achieving a qualitative, equitable and inclusive educational experience.
    • Inevitably, the widespread use of technology would fast-track development.
    • Multilingual education predicated on the increasing use of one’s mother tongue is a key component of inclusion in education. 
    • Seen in its entirety, this is in line with Prime Minister Narendra Modi’s vision of “sabka saath, sabka vikas, sabka vishwas”.

    Direction of NEP

    • The National Education Policy (NEP) 2020 encourages the use of mother tongue as the medium of instruction till at least Class five but preferably till Class eight and beyond.
    • The use of mother tongue in teaching is bound to create a positive impact on learning outcomes, as also the development of the cognitive faculties of students.
    • There is a pressing need to create and improve scientific and technical terminology in Indian languages.
    • We have been able to create a large English-based education system which includes colleges that offer courses in medicine and multiple disciplines of engineering.
    • This impressive system paradoxically excludes a vast majority of learners in our country from accessing higher education.

    Way forward

    • The need to build an effective multilingual education system across diverse streams and disciplines becomes all the more imperative.
    • In this context, the collaboration between the AICTE and IIT Madras to translate some courses on the central government’s e-learning platform, Study Webs of Active Learning for Young Aspiring Minds (SWAYAM) into eight regional languages such as Tamil, Hindi, Telugu, Kannada, Bengali, Marathi, Malayalam and Gujarati, is commendable. Such tech-led initiatives will serve to democratise higher education.
    • At the same time, the decision of the AICTE to permit B. Tech programmes in 11 native languages, in tune with the NEP, is a historic move.
    • Our policy-planners, educators, parents and opinion leaders must bear in mind that when it comes to education in mother tongue and local languages, we can take the cue from European countries as well as Asian powers such as Japan, China and Korea, among others.

    Conclusion

    Co-existing over centuries, borrowing from and nurturing each other, our languages are interwoven with our individual, local and national identity.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • UGC’s ‘Academic Bank of Credits’ scheme

    Context

    The National Education Policy (NEP) 2020 has recommended a revamp of the higher education scene in India. A new initiative stemming from this desire is an ‘Academic Bank of Credits’ (ABC) in higher education idea, which was notified recently by the University Grants Commission (UGC).

    About the Academic Bank of Credits’ (ABC)

    • Any undergraduate or postgraduate student can create an account in the ABC portal and store information of his/her completed courses (i.e., subjects/papers in old terminology) and grades obtained.
    • These grades are stored for a period of five years. 
    • As multiple institutes are connected to the ABC portal, one can be formally enrolled in university ‘A’ but can choose to do some courses from university ‘B’, some more from university ‘C’ and so on and all of these would count towards the student’s degree.
    • Flexible and multidisciplinary: One can enrol in an equivalent course from another college in the same city or join online courses offered by other universities; or can enrol in SWAYAM (a programme initiated by the  Government of India) or the National Programme on Technology Enhanced Learning (NPTEL) and add these credits.
    • Thus, education will truly become flexible and interdisciplinary, without forcing any single institute to float an unmanageable number of courses.
    • This flexibility will offer students a chance to enrol in a course and learn from teachers from some of the best institutes such as the Indian Institutes of Technology (IIT) or the Indian Institutes of Science Education and Research.

    Issues with ABC

    • Limited seats: ABC regulations say that the institute should allow up to 20% supernumerary seats for students enrolling through the ABC scheme.
    • There is no clarity on how the selection of students would be made if there are more than 20% seats.
    • Massive Open Online Courses (MOOC) platforms such as SWAYAM and NPTEL are ‘supposedly designed’ for large enrolments.
    • So far we have not found any evidence in the public domain that these MOOC platforms can provide a reliable assessment of learning achievement if there is massive enrolment for a course.
    • Filtering criterion: The ABC portal will accept courses from a large inumber of higher education institutes.
    • The filtering criterion in the original regulation was that higher education institutes should have obtained an ‘A’ grade or higher in the latest round of National Assessment and Accreditation Council (NAAC) accreditation.
    • This filtering criterion is not satisfactory.
    • Impact on small colleges: The ABC scheme specifies that students can avail up to 70% of courses from other institutes while being enrolled in a particular college.
    • If students avail these credits outside the parent college, they need not enrol for the corresponding in-house courses.
    • As the number of teaching posts in any higher education institute are calculated on the basis of student enrolment numbers, what happens when a large fraction of students do not enrol for the courses offered by you? 

    Conclusion

    In India, where the quality of education varies drastically from one institute to the next, this can lead to unmanageable academic and administrative issues in higher education institutes with brand names, and lead to a contraction in the number of teaching posts in smaller higher education institutes.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • What are Eat Right Campuses?

    Four police stations of New Delhi district have been certified as ‘Eat Right Campus’ by the Food Safety and Standards Authority of India (FSSAI).

    Eat Right Campus

    • Eat Right India is a flagship mission of FSSAI, which aims at ensuring that the citizens of the country get safe and nutritious food.
    • The ‘Eat Right Campus’ initiative led by FSSAI aims to promote safe, healthy and sustainable food in campuses such as schools, universities, colleges, workplaces, hospitals, tea estates etc. across the country.
    • The objective is to improve the health of people and the planet and promote social and economic development of the nation.
    • The initiative is not mandatory to adopt.

    Evaluation Criteria

    • Benchmarks have been created on four different parameters based on which campuses are evaluated and certified as ‘Eat Right Campus’.
    • These parameters include
    1. Food safety measures, steps to ensure the provision of healthy, Environmentally sustainable food, and Building awareness to make the right food choices.
    2. These practices include mandatory steps such as licensing and registration of food service providers in the campus and compliance to food safety and hygiene standards as per Schedule 4 of the Food Safety and Standards (FSS) Act, 2006.

    Benefits of Eat Right Campus

    • It can provide immense benefits to the campus and the individuals on the campus not only in terms of health but also economics.
    • Safe, healthy, and sustainable food on the campus would reduce the incidence of food-borne illnesses, deficiency diseases, and non-communicable diseases among the people on the campus.
    • This means less absenteeism and loss of working hours and greater wellbeing, motivation, and productivity of people.
    • This would also reduce the burden of healthcare costs for the workplace, institution, hospital, jail, or tea estate.

    Back2Basics: Food Safety and Standards Authority of India (FSSAI)

    • The FSSAI is an autonomous body established under the Ministry of Health & Family Welfare, Government of India.
    • It has been established under the Food Safety and Standards Act, 2006 which is a consolidating statute related to food safety and regulation in India.
    • It is responsible for protecting and promoting public health through the regulation and supervision of food safety.
    • It is headed by a non-executive Chairperson, appointed by the Central Government, either holding or has held the position of not below the rank of Secretary to the Government of India.

     

     

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Intensified Mission Indradhanush (IMI) 4.0 launched

    The Union Health Minister has launched the Intensified Mission Indradhanush (IMI) 4.0.

    About IMI 4.0

    • The IMI 4.0 will have three rounds and will be conducted in 416 districts (including 75 districts identified for Azadi ka Amrit Mahotsav) across 33 States and UTs, a Health Ministry statement said.
    • It will immensely contribute in filling the gaps and make lasting gains towards universal immunisation.
    • It will ensure that Routine Immunisation (RI) services reach the unvaccinated and partially vaccinated children and pregnant women” he said.

    What is Mission Indradhanush ?

    • With the aim to increase the full immunisation coverage, the PM launched Mission Indradhanush in December 2014.
    • It aimed to cover the partially and unvaccinated pregnant women and children in pockets of low immunisation coverage, high-risk and hard-to-reach areas and protect them from vaccine preventable diseases.
    • The first two phases of the Mission resulted in 6.7% increase in full immunisation coverage in a year.

    Aims and objectives

    • It aims to immunize all children under the age of 2 years, as well as all pregnant women, against eight vaccine-preventable diseases.
    • The diseases being targeted are diphtheria, whooping cough, tetanus, poliomyelitis, tuberculosis, measles, meningitis and Hepatitis B.
    • In 2016, four new additions have been made namely Rubella, Japanese Encephalitis, Injectable Polio Vaccine Bivalent and Rotavirus.
    • In 2017, Pneumonia was added to the Mission by incorporating the Pneumococcal conjugate vaccine under Universal Immunisation Programme

     

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Paray Shikshalaya Initiative

    The West Bengal government has launched ‘Paray Shikshalaya’ Initiative.

    Paray Shikshalaya

    • It is an open-air classroom in the neighborhood programme – for students from class 1 to 7.
    • The aim of this initiative is to encourage students who dropped out of schools during the Covid-19 pandemic to continue their education.

    Why was this initiative launched?

    • In view of the rising demand for physical classes, the state government reopened schools.
    • Classroom teaching could not be called on due to fear of spikes in covid cases.
    • Hence, students are being called in batches.

    Where were these classes held?

    • Schools which do not have open-air spaces conducted the classes in neighbourhood parks and grounds.
    • Local councilors and MLAs helped set up infrastructure in such parks like putting up makeshift shades and chairs, besides making mid-day meal arrangements for the students.
    • Schools which have open-air spaces held the classes there.
    • Benches were set up for students and blackboards were placed to provide a real classroom experience.

     

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Weighing in on a health data retention plan

    Context

    The National Health Authority (NHA) — the body responsible for administering the Ayushman Bharat Digital Mission (ABDM) — has initiated a consultation process on the retention of health data by healthcare providers in India. The consultation paper asks for feedback on what data is to be retained, and for how long.

    Issues with the policy for healthcare data retention

    • Risk of over-collection: A simple classification system, as suggested in the consultation paper, exposes individuals to harms arising from over-collection and retention of unnecessary data.
    • At the same time, this kind of one-size-fits-all system can also lead to the under-retention of data that is genuinely required for research or public policy needs.
    • Instead, we should seek to classify data based on its use. 

    Do we need a policy for the mandatory retention of health data?

    • Currently, service providers can compete on how they handle the data of individuals or health records, in theory, each of us can choose a provider whose data policies we are comfortable with.
    • Whether the state should mandate a retention period at all is an open question.
    • Given the landscape of healthcare access in India, including through informal providers, many patients may not think about this factor in practice.
    • Nonetheless, the decision to take the choice out of the individual’s hands should not be taken lightly.

    Balancing the policy for public health data retention with the right to privacy

    • Four-part test for privacy: The Supreme Court of India has clarified that privacy is a fundamental right, and any interference into the right must pass a four-part test: legality; legitimate aim; proportionality, and appropriate safeguards.
    • Health data and privacy: The mandatory retention of health data is one such form of interference with the right to privacy.
    • 1] Legality: In this context, the question of legality becomes a question about the legal standing and authority of the NHA.
    • Since the NHA is not a sector-wide regulator, it has no legal basis for formulating guidelines for healthcare providers in general.
    • 2]Legitimate aim: The aim of data retention is described in terms of benefits to the individual and the public at large.
    • Benefits to the individuals: Individuals benefit through greater convenience and choice, created through portability of health records.
    • The broader public benefits through research and innovation, driven by the availability of more and better data to analyse.
    • Risk involved: Globally, legal systems consider health data particularly sensitive, and recognise that improper disclosure of this data can expose a person to a range of significant harms. 
    • Benefits must be clearly defined: As per Indian law, if an individual’s rights are to be curtailed due to anticipated benefits, such benefits cannot be potential or speculatory: they must be clearly defined and identifiable.
    • 3] Proportionality: This is the difference between saying that data on patients with heart conditions will help us better understand cardiac health — a vague explanation — and being able to identify a specific study that will include data from that patient.
    • It would further mean demonstrating that the study requires personally identifiable information, rather than just an anonymous record — the latter flowing from the principle of proportionality, which requires choosing the least intrusive option available.
    • 4] Safeguard: Standards for anonymisation are still developing.
    • We are not yet able to rule out the possibility of anonymised data still being linked back to specific individuals.
    • In other words, even anonymisation may not be the least intrusive solution to safeguarding patients’ rights in all scenarios.

    Way forward

    • Clear and specific case for retention: The test for retaining data should be that a clear and specific case has been identified for such retention, following a rigorous process run by suitable authorities.
    • Anonymise data: A second safeguard would be to anonymise data that is being retained for research purposes — again, unless a specific case is made for keeping personally identifiable information.
    • If neither of these is true, the data should be deleted.
    • Express and informed consent: An alternate basis for retaining data can be the express and informed consent of the individual in question.
    • User-based classification process: Health-care service providers — and everyone else — will have to comply with the data protection law, once it is adopted by Parliament.
    • The current Bill already requires purpose limitation for collecting, processing, sharing, or retaining data; a use-based classification process would thus bring the ABDM ecosystem actors in compliance with this law as well.

    Consider the question “What are the advantages and concerns with the retention of public health data? Suggest the ways to ensure the privacy-centric public health data retention policy.”

    Conclusion

    A privacy-centric process is needed to determine what data to retain and for how long.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • Missed opportunity to opportunity of employment-centred and inclusive growth

    Context

    India continues to rank poorly in various global indices that reflect the quality of life, human capital or human development in the country. In this context, it was expected that the current Budget would see an expansion in government spending on the social sector.

    Need for greater spending on social sector

    • In Human Development Index, India ranks 131 out of 189 countries and on the Global Hunger Index, it ranks 101 out of 116 countries.
    • The pandemic over the last two years has had a severe impact on the health, education and food security of the poor and informal sector workers.
    • The country has been experiencing increasing inequality over the last couple of decades.

    Marginal increase in allocation for school education

    • In the budget, the government announced that it will expand its ‘one class, oneTVchannel’ scheme instead of announcing enhanced allocations for schools  the government announced that it will expand its ‘one class, oneTVchannel’ scheme instead of announcing enhanced allocations for schools so that they can reopen with vigour.
    •  The budget for school education at â‚č63,449 crore is a slight improvement over last year’s â‚č54,873 crore (2021-22 budget estimates, BE) and a mere increase of 6% in nominal terms compared to 2020-21 BE of â‚č59,845 crore.
    • After rechristening the school mid-day meal scheme as Pradhan Mantri Poshan Shakti Nirman, simply called PM Poshan, the allocation for the scheme has reduced from â‚č11,500 crore last year to â‚č10,233 crore this year.

    Low allocation for health

    • Despite repeated statements about strengthening the public health system, the overall budget for the Department of Health and Family Welfare at â‚č83,000 crore has gone up by only 16% over the BE for 2021-22 and by less than â‚č1,000 crore compared to the RE for 2021-22, which is â‚č82,921 crore.
    • However, by including water and sanitation in the budget for health, there is an increase being shown in health spending as a proportion of GDP.
    • Also, even though the budget for the Jal Jeevan Mission has increased from â‚č50,000 crore to â‚č60,000 crore, only 44% of the allocated funds to the Department of Water and Sanitation for 2021-22 has been spent as on end December 2021.

    No indication of plan to extend the PMGKAY

    • 60% of the population are covered by ration cards currently under the National Food Security Act.
    • Those who were eligible benefited from the additional free foodgrains that they have been given under the Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY).
    • However, the food subsidy (BE) for 2022-23 at â‚č2.06 lakh crore is only enough to cover the regular NFSA entitlements.
    • The indication is that there is no plan to extend the PMGKAY.
    • The food subsidy RE for 2021-22 is â‚č2.86 lakh crore.

    Other schemes

    • Budgets for important schemes such as Saksham Anganwadi, maternity entitlements and social security pensions are around the same as the allocations for last year.
    • The allocation for MGNREGA at â‚č73,000 crore also does not reflect the increased demand for work or thethe pending wages of â‚č21,000 crore.

    Continued negligence

    • The resources allocated for crucial government schemes in the fields of health, education, nutrition, and social protection have remained stagnant or show negligent increase.
    • In fact, the budgets for these schemes have been declining in real terms since 2015.
    • The World Social Protection Report 2020-22, brought out by the International Labour Organization, shows that the spending on social protection (excluding health) in India is 1.4% of the GDP, while the average for low-middle income countries is 2.5%.

    Conclusion

    This continued negligence does not bode well for inclusive development in India.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

  • How the Budget can push India’s health system transformation

    Context

    After decades of low government expenditure on health, the Covid pandemic created a societal consensus on the need to strengthen our health system.

    Steps to strengthen our health system

    • The Fifteenth Finance Commission recommended greater investment in rural and urban primary care, a nationwide disease surveillance system extending from the block-level to national institutes, a larger health workforce and the augmentation of critical care capacity of hospitals.
    • The Union budget of 2021 reflected these priorities in a proposed Pradhan Mantri Aatmanirbhar Swasth Bharat Yojana (PMASBY) to be made operational over six years, with a budget of Rs 64,180 crore.
    • Broader vision of health: The Finance Minister also projected a broader vision of health beyond healthcare by merging allocations to water, sanitation, nutrition and air pollution control with the health budget.
    • Under the Ayushman Bharat umbrella the Digital Health Mission was launched in September 2021.
    • The Health Infrastructure Mission, launched in October 2021, was a renamed and augmented version of the PMASBY.
    • These missions join the two other components of Ayushman Bharat launched in 2018.
    • The Comprehensive Primary Health Care (CPHC) component is nested in the National Health Mission (NHM) while the Pradhan Mantri Jan Arogya Yojana (PMJAY) is steered by the National Health Authority (NHA).

    Way forward

    • While much of the following needs to be done by the states, the Centre should incentivise and support such efforts by the states.
    • Link synergically: Primary healthcare services under the CPHC and linkage with water, sanitation, nutrition and pollution control programmes will strengthen the capacity of the health system for health promotion and disease prevention.
    • The budget of 2022 must not only fund these missions adequately but indicate how they will link synergically while functioning under different administrative agencies.
    • Allocate more funds: The NHM received only a 9.6 per cent increase in the 2021 budget.
    • PMJAY did not see an increase in allocation last year, because its utilisation for non-Covid care declined sharply in the previous year.
    •  More importantly, limiting cost coverage to hospitalised care reduces the PMJAY’s capacity to significantly lower out-of-pocket expenditure (OOPE) on health, which is driven mostly by outpatient care and expenditure on medicines.
    • Focus on Digital Heath Mission: The Digital Health Mission can enhance efficiency of the health systems in a variety of ways.
    • These include better data collection and analysis, improved medical and health records, efficient supply chain management, tele-health services, support for health workforce training, implementation of health insurance programmes, real time monitoring and sharper evaluation of health programme performance along with effective multi-sectoral coordination.
    • Improve the skill and number of healthcare workers:  We need to increase the numbers and improve the skills of all categories of healthcare providers.
    • While training specialist doctors could take time, the training of frontline workers like Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) can be done in a shorter time.
    • Upgrade district hospitals: District hospitals need to be upgraded, with greater investment in infrastructure, equipment and staffing.
    • In underserved regions, such district hospitals should be upgraded to become training centres for students of medical, nursing and allied health professional courses.

    Conclusion

    The expanded ambit of health, as defined in last year’s budget, must continue for aligning other sectors to public health objectives. The Union budget of 2022 can add further momentum to our health system transformation.

    UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)