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

  • Kasturirangan panel for National Curriculum Framework

    The Centre has started the process to revise school textbooks by appointing former Indian Space Research Organisation (ISRO) chairman K. Kasturirangan as the head of a 12-member steering committee responsible for developing a new National Curriculum Framework (NCF).

    National Curriculum Framework (NCF)

    • The new NCF is in line with the National Education Policy (NEP) 2020.
    • The committee will be headed by K Kasturirangan, who had also led the NEP 2020 drafting committee.
    • The national curriculum framework serves as a guideline for syllabus, textbooks, teaching and learning practices in the country.
    • India is currently following its fourth national curriculum framework that was published by the NCERT in 2005.

    What was the last NCF?

    • The last such framework was developed in 2005.
    • It is meant to be a guiding document for the development of textbooks, syllabi and teaching practices in schools across the country.

    Why revamp NCF?

    • The subsequent revision of textbooks by the National Council of Educational Research and Training will draw from the new NCF.
    • In fact, the steering committee will develop four such frameworks, one each to guide the curriculum of school education, teacher education, early childhood education, and adult education.

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  • Front-of-pack labelling of Food Stuffs

    Seven years, four committees and two draft regulations later, India still does not have a clear labelling system to warn consumers about harmful levels of fat, salt and sugar in processed foods.

    Context

    • According to the Food Safety and Standards (Packaging and Labelling) Regulations, 2011, every pre-packed processed food product sold in the country must be labelled with nutritional information.
    • To ensure that consumers are able to easily see and interpret the nutritional information on food packets, an expert committee was established by the Food Safety and Standards Authority of India (FSSAI).
    • The committee, set up following an order of the Delhi High Court which was hearing a public interest petition seeking a ban on the sale of junk food in and around schools.

    Why label nutritional information?

    • This helps the consumer know everything about the food they buy and make an informed decision about what and how much to eat.
    • Such information is particularly crucial because the packaged food contain ultra-processed foods that are high in fat, salt or sugar and low in fibre and other essential micronutrients.
    • On the one hand, these foods cause malnutrition.
    • On the other hand they are linked strongly with obesity and diet-related non-communicable diseases, such as Type-2 diabetes, hypertension, heart ailments and certain cancers, like that of the colon.
    • All these increase the risk of premature death.

    Issues with labelling in India

    • Most products provide information in English understanding which can be daunting for a vast number of people in India.

    What is FoP labelling?

    • The front-of-pack (FoP) labelling system has long been listed as one of the global best practices to nudge consumers into healthy food choices.
    • It works just the way cigarette packets are labelled with images to discourage consumption.
    • Countries such as Chile, Brazil and Israel have laws to push the packaged food industry to adopt FoP labelling.
    • They have used FoP labelling as a measure to fight obesity and NCDs.

    FoP labelling in India

    • The system is yet to be implemented in India even seven years after it was first proposed by FSSAI.
    • The fact is, makers of packaged foods are also a powerful lot, with strong business acumen.
    • While companies in other countries have acceded to the FoP labelling laws, they are unwilling to do so in India — a country experiencing a dietary shift.

    Why must we have FoP labels?

    • Countries are working to find ways to nudge consumers into healthy food choices and to contain the growing crisis of obesity and diet-related non-communicable diseases (NCDs).
    • It is a crisis that increasingly impacts children and also exacerbates novel coronavirus disease (COVID-19) symptoms. Front-of-pack (FoP) labelling is definitely an effective tool in this effort.

    India definitely needs ‘warning labels’ on front-of-pack, but this must be a symbol-based label with no text and numbers. This is because:

    (1) Junk foods have high levels of unhealthy nutrients

    • There is strong evidence that sugar, salt and fat in junk foods are addictive, like nicotine in tobacco.
    • FoP ‘warning’ labels have helped reduce cigarette consumption. It is time we adopted the same for junk foods.

    (2) Warning labels are easy to notice and understand

    • They do not confuse consumers with mixed messages.
    • Their distinct shape, colour and size make them noticeable in the otherwise cluttered and colourful packaging.
    • With one label for one nutrient, it becomes easier to know if a product is high in more than one nutrient.

    (3) Warning labels are the global best practice now

    • At least seven countries have adopted warning labels in the past five years. These include Chile, Peru, Mexico, Israel and Uruguay.
    • Low- and middle-income mothers have shown profound changes in attitudes towards food purchases as they now understand the nutritional content of packaged foods.
    • Even children can read the labels and take an informed decision. This has also forced food companies to reduce the amount of sugar and sodium in foods and beverages.

    (4) They are best suited for India

    • Warning labels are best suited for India as they do not include numbers unlike many other FoP labels.
    • In fact, warning labels that are symbol-based, like that of Israel, can transcend the barriers of literacy and language in India.

    (5) FSSAI has experience of successfully implementing symbol-based FoP labels

    • Its “green filled circle in green outlined square” logo to depict vegetarian food has been hugely successful in informing consumers.
    • In recent years, FSSAI also has made similar laws to depict fortification (+F logo) and organic food (a green-coloured tick for Jaivik Bharat logo).

    Way forward

    • FoP labels must include information on nutrients that make food injurious to health.
    • This should be distinct from the details on the back-of-pack. FoP labels should aim to inform the consumer, while the back-of-pack label serves the purpose of scientific compliance and enforcement.
    • FoP labels should have information on ‘total sugar’ and not ‘added sugar’. There is no analytical laboratory method to differentiate ‘added sugar’ from total sugar and quantify it.

     

  • Empathy through education

    Context

    While the National Education Policy (2020) notes numeracy and literacy as its central aims, Social and Emotional Learning should be an equally important goal as it supports skills such as communication, collaboration, critical thinking and creativity.

    What is social and emotional learning (SEL)?

    • SEL is the process of learning to recognise and manage emotions and navigate social situations effectively.
    • SEL is foundational for human development, building healthy relationships, having self and social awareness, solving problems, making responsible decisions, and academic learning.
    • Neurobiologically, various brain regions such as the prefrontal and frontal cortices, amygdala, and superior temporal sulcus are involved in the cognitive mechanisms of SEL.
    • Brain systems that are responsible for basic human behaviour, such as getting hungry, may be reused for complex mechanisms involved in SEL.
    • Despite its importance to life, SEL is often added as a chapter in a larger curriculum rather than being integrated in it.
    • The pandemic has brought unprecedented challenges for SEL as school closures reduced opportunities for students to deepen social relationships and learn collaboratively in shared physical spaces.
    • Even with parental involvement, the challenge of an inadequate support system for SEL remains.

    Way forward

    • Perhaps we can contextually adapt best practices from existing models.
    • A starting point would be to consider insights from the Indian SEL framework:
    • One, the application of SEL practices should be based on students’ socioeconomic backgrounds.
    • Two, SEL strategies of caretakers and educators must align with one another.
    • Three, long-term success requires SEL to be based on scientific evidence.

    Conclusion

    As a sustainable development goal outlines, policymakers now have to ensure that future changes prioritise “inclusive and equitable quality education and promote lifelong learning opportunities for all.” Importantly, the onus lies on all of us to make individual contributions that will drive systemic change.

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  • NEET

    The Tamil Nadu Assembly has passed a bill exempting the State from the National Eligibility-cum-Entrance Test (NEET) for admission to undergraduate (UG) medical courses.

    About NEET

    The NEET has replaced the formerly All India Pre-Medical Test (AIPMT).

    It is an all-India pre-medical entrance test for students who wish to pursue undergraduate medical (MBBS), dental (BDS) and AYUSH (BAMS, BUMS, BHMS, etc.) courses.

    The exam is conducted by National Testing Agency (NTA).

    TN law: Permanent Exemption for NEET

    • The Bill exempts medical aspirants in Tamil Nadu from taking NEET examination for admission to UG degree courses in Indian medicine, dentistry and homeopathy.
    • Instead, it seeks to provide admission to such courses on the basis of marks obtained in the qualifying examination, through “Normalization methods”.
    • The aim of the Bill is to ensure “social justice, uphold equality and equal opportunity, protect all vulnerable student communities from being discriminated”.
    • It seeks to bring vulnerable student communities to the “mainstream of medical and dental education and in turn ensure a robust public health care across the state, particularly the rural areas”.

    Why TN is against NEET?

    • Non-representative: TN opposes because NEET undermined the diverse societal representation in MBBS and higher medical studies.
    • Disfavors the poor: It has favored mainly the affordable and affluent sections of the society and thwarting the dreams of underprivileged social groups.
    • Exams for the elite: It considers NEET not a fair or equitable method of admission since it favored the rich and elite sections of society.
    • Healthcare concerns: If continued, the rural and urban poor may not be able to pursue medical courses.

    Can any state legislate against NEET?

    • Admissions to medical courses are traceable to entry 25 of List III (Concurrent List), Schedule VII of the Constitution.
    • Therefore, the State can also enact a law regarding admission and amend any Central law on admission procedures.

    Views of the stakeholders appointed by TN

    • A majority of stakeholders were not in favor of the NEET requirement.
    • NEET only worked against underprivileged government school students, and had profited coaching centres and affluent students.
    • NEET had not provided any special mechanism for testing the knowledge and aptitude of the students.
    • The higher secondary examination of the State board itself was an ample basis for the selection of students for MBBS seats.

    A move inspired by a SC Judgement

    • This thinking of the State may be due to the observation made by the Supreme Court in the selection process of postgraduate (PG) courses in medicine.
    • The Medical Council of India (MCI) had prescribed certain regulations providing reservations for in-service candidates.
    • The Supreme Court struck down regulation 9(c) made by the MCI on the ground of the exercise of power beyond its statute.

    Not a similar case

    • It must be remembered that the Supreme Court was only dealing with a regulation framed by the MCI.
    • The requirement of NEET being a basic requirement for PG and UG medical courses has now been statutorily incorporated under Section 10D of the Indian Medical Council (IMC) Act.
    • When the Tamil Nadu government issued an order in 2017 providing for the reservation of 85% of the seats for students passed out from the State board it was struck down by the Madras High Court.
    • The introduction of internal reservation for government school students is under challenge before the Madras High Court. Similarly, NEET as a requirement is also pending in the Supreme Court.
    • Unless these two issues are decided, NEET cannot be removed by a State amendment.

    The bill cannot be passed

    • The present move to pass a fresh Bill on the same lines is most likely to meet the same fate.
    • The President refused to give his assent to this bill.
    • It is significant that no other State in India has sought an exemption from NEET and, therefore, exempting Tamil Nadu alone may not be possible.
    • Even among the seats allotted to the State, there is no bar for students from other States from competing or selecting colleges in Tamil Nadu.

    The bigger question

    • The question is not whether the State government can amend a law falling under the Concurrent List.
    • The question is whether the State government can exempt Section 10D of the IMC Act, which is a parliamentary law that falls under the Central List (Entry 66).
    • Moreover, the Supreme Court has also upheld NEET as a requirement.
    • Mere statistics highlighting that a majority of the stakeholders do not want NEET in Tamil Nadu is not an answer for exempting the examination.

    Again, it is State and Centre are at crossroads

    • Normally, a Bill requires assent from the Governor to become a law. Stalin’s contention is that this Bill deals with education, which is a Concurrent List subject.
    • Admissions to medical courses fall under Entry 25 of List III, Schedule VII of the Constitution, and therefore the state is competent to regulate the same.
    • Yet, as far as matters relating to the determination of standards for higher education are concerned, the central government has the power to amend a clause or repeal an Act.
    • So, just the passing of the Bill doesn’t enable the students to get exempted from writing NEET.
    • Already, Union Higher Education Secretary Amit Khare has held that if any State wants to opt out of the exam, it has to seek permission from the Supreme Court.

    Options for Tamil Nadu

    • Data is necessary only when there is power to legislate on the subject concerned.
    • Since the Bill, which will become an Act only after the President’s nod, will come into effect only from the next academic year, the battle for and against the NEET requirement will continue in courts.
    • Hopefully, the courts will determine the legality and have a definite solution to the question of medical admissions within the next year.
    • Till such time, students who wrote NEET will fill the seats under the State quota.

    Way forward: Preventing Commercialization of Medical Education

    • The time may also have come to examine whether NEET has met its purposes of improving standards and curbing commercialization and profiteering.
    • Under current norms, one quite low on the merit rank can still buy a medical seat in a private college, while those ranked higher but only good enough to get a government quota seat in a private institution can be priced out of the system.
    • The Centre should do something other than considering an exemption to Tamil Nadu.
    • It has to conceive a better system that will allow a fair admission process while preserving inter se merit and preventing rampant commercialization.

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  • Outpatient Opioid Assisted Treatment Centres

    The state government in Punjab is banking on Outpatient Opioid Assisted Treatment Centres (OOAT) to curb the drug menace in the state.

    What are the OOAT Centres?

    • The move to set up OOAT centres in Punjab began in October 2017.
    • The centres administer de-addiction medicine, a combination of buprenorphine and naloxone, to the opioid-dependent people registering there.
    • Administered in the form of a pill, the treatment is primarily for addicts of opioid drugs, including heroin, poppy husk and opium.
    • There are such private and state-run centres in Punjab.

    Why is the Punjab government planning?

    • Punjab is planning to open OOAT linked extension centres and clinics in rural areas to broaden the outreach of this treatment.
    • The idea is that patients get medicine nearer their place of residence.
    • It will also reduce pressure on existing OOAT centres which cater to patients from far-off places.

    Administering medicine at OOAT Centres

    The patients are broadly put into three categories or phases.

    • In the induction phase, the newly-registered patients are administered medicine at the OOAT centres for a week or two to manage withdrawal symptoms in the presence of the doctor and counselor.
    • In the second, stabilization, phase, which extends between two to four months.
    • The patient is put on watch for taking any opioid-based “super-imposed” illicit drug and accordingly maximum tolerated dose is administered to nullify the kick of the “super-imposed” drug.
    • In the third, maintenance, phase, the patient is given take-home medicine and it continues for a year and a half before an assessment is done to see whether the medicine can be tapered off.

    Why is Punjab banking so much on OOAT therapy?

    There are two major approaches to wean away opioid-dependent persons.

    • One is the abstinence approach and another alternate medication approach.
    • There are more chances of relapse in an abstinence-based approach as compared to alternate medication for de-addiction.
    • In the abstinence approach, it would have taken years to rehabilitate patients by admitting them to facilities and there would have been increased chances of relapse.
    • On the other hand, the alternate medication approach has been acknowledged as better in various scientific studies worldwide.

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  • The nutrition-hygiene link

    Context

    A recent UNICEF report stated that nearly 12 lakh children could die in low-income countries in the next six months due to a decrease in routine health services and an increase in wasting. Nearly three lakh such children would be from India.

    Problem of nutrition in India and factors responsible for it

    • The National Family Health Survey (NFHS 5) indicates that since the onset of the pandemic, acute undernourishment in children below the age of five has worsened.
    • According to the latest data, 37.9 per cent of children under five are stunted, and 20.8 per cent are wasted — a form of malnutrition in which children are too thin for their height.
    • Comparison with other countries: This is much higher than in other developing countries where, on average, 25 per cent of children suffer from stunting and 8.9 per cent are wasted.
    • Factors: Inadequate dietary intake is the most direct cause of undernutrition.
    • Several other factors also affect nutritional outcomes, such as contaminated drinking water, poor sanitation, and unhygienic living conditions.
    • According to the World Health Organisation, 50 per cent of all mal- and under-nutrition can be traced to diarrhoea and intestinal worm infections.
    • Nutrition and water, sanitation, and hygiene (WASH) are intricately linked, and changes in one tend, directly or indirectly, to affect the other.
    • Poor hygiene and sanitation in developing countries lead to a sub-clinical condition called “environmental enteropathy” in children.
    • Environmental enteropathy is a disorder of the intestine which prevents the proper absorption of nutrients, rendering them effectively useless.
    • Childhood diarrhoea is a major public health problem in low- and middle-income countries, leading to high mortality in children under five.
    • According to NFHS 4, approximately 9 percent of children under five years of age in India experience diarrhoeal disease.

    Way forward

    • Investment in WASH: The link between WASH and nutrition suggests that greater attention to, and investments in, WASH are a sure-shot way of bolstering the country’s nutritional status.
    • Addressing nutrition sanitation problems together: Both WASH and nutrition must be addressed together through a lens of holistic, sustainable community engagement to enable long-term impact.
    • One of the first instances of the link between WASH and nutrition appeared in the Convention on the Rights of the Child in 1989, which urges states to ensure “adequate nutritious foods and clean drinking water” to combat disease and malnutrition.
    • Safe drinking water, proper sanitation, and hygiene can significantly reduce diarrhoeal and nutritional deaths.
    • Multistructural approach: What we require is a coordinated, multisectoral approach among the health, water, sanitation, and hygiene bodies, not to mention strong community engagement.
    • WHO has estimated that access to proper water, hygiene, and sanitation can prevent the deaths of at least 8,60,000 children a year caused by undernutrition.

    Conclusion

    At the end of the day, all sides are working towards a common goal: A safe and healthy population and the hope that the 75th year of Independence becomes a watershed moment in India’s journey.

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  • What is the School Bubble Concept?

    The Karnataka government has proposed the ‘school bubble’ concept to mitigate the spread of the disease among children (aged below 18) attending offline classes at schools and pre-university colleges across the state.

    It takes a village to raise a child.

    -Anonymous

    What are school bubbles?

    • School bubbles are physical classifications made between groups comprising a small number of students.
    • As per the concept, each such bubble will include students who tend to remain as a group during school hours throughout the term or an academic year.
    • The concept would help managements easily isolate a fewer number of students in case anyone gets infected.
    • For instance, a school bubble can include 30 students. If one among them gets infected, the others can self-isolate but the school need not be closed completely.
    • This would allow uninterrupted learning to others as well.

    Why are school bubbles significant?

    • The concept of school bubbles, experts feel, will be more relevant to students studying in primary school or below.
    • These students will have more chances of peer-to-peer interactions on a daily basis.
    • With school bubbles in place, the risk assessment process to identify close contacts of a Covid-positive student will also get easier.

    Is this concept completely new?

    • This has been successfully implemented at schools in the United Kingdom.
    • The government there has further relaxed social-distancing measures for students within a particular school bubble.
    • However, all members of the bubble are mandatorily subjected to RT-PCR tests if a student is infected.

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  • Why India needs an NHS-like healthcare model

    Context

    Even after the pandemic, the Indian government continues to budget less than 1 per cent of GDP for healthcare, one of the lowest in the world.

    About NHS

    • Every year, Britain’s legendary health network National Health Service (NHS) cures 15 million patients with chronic ailments, at a fraction of the cost spent by the US.
    • The NHS funded by direct taxes is also the fifth largest employer in the world, after McDonalds and Walmart.
    • One of every 20 British workers is employed as a doctor, nurse, catering and technical personnel.

    Public healthcare in India

    • Even after the pandemic, the Indian government continues to budget less than 1 per cent of GDP for healthcare, one of the lowest in the world.
    • In contrast, China invests around 3 per cent, Britain 7 per cent and the United States 17 per cent of GDP.
    • So, 62 per cent of health expenses in India are paid for by patients themselves
    • This is one of the main reasons for families falling into poverty especially during the pandemic.
    • In India, hospitals are beleaguered with absentee staff.
    • As per a Niti Aayog database, in the worst state of Bihar in 2017-18, positions for 60 per cent of midwives, 50 per cent of staff nurses, 34 per cent of medical officers and 60 per cent of specialist doctors were vacant.
    • Those on the job, despite being handsomely paid, are chronically overworked.

    Conclusion

    In the 21st century, not much has improved in India’s public hospitals. Still, in India doctors are often equated with gods. What India needs in NHS like healthcare model.

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  • Issues related to people with disabilities

    Context

    Twenty years ago on August 6 in Erwadi in Tamil Nadu’s Ramanathapuram, a fire broke out in a thatched shelter, engulfing 43 chained people who had psychosocial disabilities.

    Legal provision for the persons with disabilities

    • India ratified the Convention on the Rights of Persons with Disabilities (CRPD) in 2007.
    • The Rights of Persons with Disabilities Act  was enacted in 2016.
    • The Mental Healthcare Act (MHCA) was enacted in 2017.

    Failure of the states

    • Sates have failed to uphold the human rights of people with disabilities in general and those with psychosocial and intellectual disabilities in particular.
    • Only eight states/UTs — Karnataka, Andhra Pradesh, Uttar Pradesh, Jammu & Kashmir, Maharashtra, Odisha, Kerala, and West Bengal — have framed rules for implementation of MHCA.
    • Unless we implement the law in letter and spirit, the Global Mental Health Movement will remain a mere buzzword and the CRPD-reliant MHCA will remain a law only on paper.

    Violations of rights in private asylums

    • Private asylums survive because of their close proximity to faith-based healing centres.
    • Because mental health conditions carry a high stigma, caregivers flock to these faith-based facilities in the hopes of finding a cure.
    • Private players take advantage of their vulnerabilities, forcing such persons with psychosocial issues to be grouped together and chained in these shelters.
    • Chaining in any way or form is outlawed under Section 95 of the MHCA.

    Way forward

    • Human right approach: We must work to ensure that the human rights approach to disability is integrated into mental health systems, education, law, and bureaucracy.
    • We move away from pathologisation, segregation, and a charity-based approach.

    Conclusion

    Implementation of rights of the persons with disability needs implementation in letter and spirit and human rights based approach.

  • [pib] PM-DAKSH Scheme

    Union Minister for Social Justice and Empowerment has launched the ‘PM-DAKSH’ Portal and ‘PM-DAKSH’ Mobile App.

    About PM-DAKSH Scheme

    • The PM-DAKSH stands for Pradhan Mantri Dakshta Aur Kushalta Sampann Hitgrahi (PM-DAKSH) Yojana.
    • It is being implemented by the Ministry of Social Justice and Empowerment from the year 2020-21.
    • Under this scheme, eligible target group are being provided skill development training programmes on (i) Up-skilling/Re-skilling (ii) Short Term Training Programme (iii) Long Term Training Programme and (iv) Entrepreneurship Development Program (EDP).
    • These training programs are being implemented through Government Training Institutes, Sector Skill Councils constituted by the Ministry of Skill Development and Entrepreneurship and other credible institutions.

    PM-DAKSH Portal/App

    • Any person can get all the information related to skill development training at one place by visiting the ‘PM-DAKSH’ Portal.
    • Also, with just one click, one can get information about skill development trainings happening near him/her and he/she can easily register himself/herself for skill training.

    Some of the features of this portal are as follows:

    • Availability of all information related to skill development at one place for Scheduled Castes, Backward Classes and Safai Karamcharis.
    • Facility to register for the training institute and program of their interest.
    • Facility to upload desired documents related to personal information.
    • Facility to register the attendance of the trainees through face and eye scanning during the training period.
    • Monitoring facility through photo and video clip during training etc.