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GS Paper: GS2

  • Law and disorder

    Several inadequacies in the justice delivery system lie hidden as disproportionate attention is given to the Supreme Court.

    Public expects the judiciary to be ideal

    • The citizens of the country expect the Supreme Court and its constituents to be ideal, and the challenge of the Supreme Court is to come to terms with that reality.
    • However, it is not the Supreme Court alone that matters in the justice delivery system. There are other inadequacies of the system that don’t get as much public attention.

    Practice Question: Explain the various inadequacies in the justice delivery system in India which lie hidden. What steps need to be taken to address them?

    Spending on judiciary

    • The issue of spending on judiciary, most often, is equated with increasing the salaries of judges and providing better court infrastructure. Such perceptions are unfortunate.
    • India has one of the most comprehensive legal aid programmes in the world, the Legal Services Authority Act of 1987.
    • Under this law, all women, irrespective of their financial status, are entitled to free legal aid. Scheduled Castes and Scheduled Tribes and children too are entitled to free legal aid.
    • In reality, this law is a dead letter. There has been little effort on the part of successive governments to provide a task force of carefully selected, well-trained and reasonably paid advocates to provide these services.
    • In comparison, the system of legal aid in the U.K. identifies and funds several independent solicitor offices to provide such services. India is yet to put in place anything similar to this.

    Poor judge-population ratio

    • The judge-population ratio provides one of the most important yardsticks to measure the health of the legal system. The U.S. has about 100 judges per million population. Canada has about 75 and the U.K. has about 50.
    • India, on the other hand, has only 19 judges per million population. Of these, at any given point, at least one-fourth is always vacant.
    • Lower courts where the common man first comes into contact (or at least should) with the justice delivery system is also unnoticed and hardly any attention is focused on their gaping inadequacy.
    • These inadequacies are far more important to the common man than the issues relating to the apex court that are frequently highlighted in the public space.
    • In All India Judges Association v. Union of India (2001), the Supreme Court had directed the Government of India to increase the judge-population ratio to at least 50 per million population within five years from the date of the judgment. This has not been implemented.

    Access to justice

    • Though ‘access to justice’ has not been specifically spelt out as a fundamental right in the Constitution, it has always been treated as such by Indian courts.
    • In Anita Kushwaha v. Pushpa Sadan (2016), the Supreme Court held unambiguously that if “life” implies not only live in the physical sense but a bundle of rights that make life worth living, there is no justice or other basis for holding that denial of “access to justice” will not affect the quality of human life.
    • It was for the first time that the Supreme Court had attempted a near-exhaustive definition of what “access to justice” actually means.
    • Further, the court pointed out four important components of access to justice.
    1. The need for adjudicatory mechanisms.
    2. The mechanism must be conveniently accessible in terms of distance.
    3. The process of adjudication must be speedy.
    4. The process of adjudication must be affordable to the disputants.
    • It is of course a paradox that this judgment, which emphasizes the concept of speedy justice, was passed in 2016 in a batch of transfer petitions that were filed between 2008 and 2014.

    Way forward

    • The state in all its glorious manifestations — the executive, judiciary and the legislature — there is a need to draw out a national policy and road map for clearing backlogs and making these concepts real.
    • A disproportionate amount of attention that is given to the functioning of the Supreme Court, it is equally important to have a clear focus on these and similar issues.

  • US imposes CAATSA sanctions on Turkey

    The US has imposed sanctions on NATO-ally Turkey for its purchase of Russia’s S-400 missile defence system.

    Q.What is CAATSA law? Discuss how it will impact India’s ties with Russia.

    Turkey defies the US

    • Turkey decided to move ahead with the procurement and testing of the S-400, despite the availability of alternative, NATO-interoperable systems to meet its defence requirements.
    • This decision resulted in Turkey’s suspension and pending removal from the global F-35 Joint Strike Fighter partnership.

    What is CAATSA?

    • CAATSA stands for Countering America’s Adversaries through Sanctions Act (CAATSA).
    • It is a US federal law that imposed sanctions on Iran, North Korea, and Russia.
    • The bill provides sanctions for activities concerning:

    (1) cybersecurity, (2) crude oil projects, (3) financial institutions, (4) corruption, (5) human rights abuses, (6) evasion of sanctions, (7) transactions with Russian defence or intelligence sectors, (8) export pipelines, (9) privatization of state-owned assets by government officials, and (10) arms transfers to Syria.

    Why is India concerned?

    • This sanction is of particular interest to New Delhi, which is also in the process of buying the S-400 from Moscow.
    • This action has sent a clear signal that the US will fully implement CAATSA sanctions and will not tolerate significant transactions with Russia’s defence and intelligence sectors.

    What does the sanction mean?

    These sanctions comprise:

    1. a ban on granting specific US export licences and authorizations for any goods or technology,
    2. a ban on loans or credits by US financial institutions totalling more than $10 million in any 12-month period
    3. a ban on US Export-Import Bank assistance for exports
    • Additionally, sanctions will include full blocking sanctions and visa restrictions as well.
    • Last year, the US had removed Turkey from its F-35 jet programme over concerns that sensitive information could be accessed by Russia if Turkey used Russian systems along with US jets.

    India may get an exemption

    • Most of India’s weapons, naval arsenal, missiles, aircraft and aircraft carriers are of Soviet/Russian origin.
    • As per the Stockholm International Peace Research Institute (SIPRI) Arms Transfer Database, during the period 2010-17, Russia was the top arms supplier to India.
    • The Russian share in India’s arms imports during the same period has declined to 68 per cent, from an all-time high of 74 per cent during the 2000s.
    • The combined share of the US and Israel has increased from nine to 19 per cent.
    • Accounting for about 15 per cent, the US is the second-biggest supplier of arms to India during the five year period ending 2017.
    • Hence, US officials have earlier requested for “some relief from CAATSA” for countries like India.

    China factor

    • China being more assertive and Russia finding new partners, this waiver or “carve-out” would mean India has been able to secure its interests.
    • Hence, the US has designated India as a Major Defence Partner, and both countries coming together on Indo-Pacific strategy, the newly formed Quad, are on a stable footing.

    Why is CAATSA bad?

    • CAATSA impacts Indo-US ties and dents the image of the US as a reliable partner.
    • It also makes a point on principles that, as a sovereign country, India cannot be dictated about its strategic interests by a third country.
    • It also shows the need for India to be nimble-footed in its diplomacy when it comes to its key major power relationships – and one cannot be sacrificed at the cost of another.

    Back2Basics: India-US Defence Partnership

    • India is a major market for the US defence industry.
    • In the last decade, it has grown from near zero to USD 15 billion worth of arms deals.
    • Since 2008, major deals include the C-17 Globemaster, C-130J transport planes, P-8 (I) maritime reconnaissance aircraft, M777 light-weight howitzer, Harpoon missiles, and Apache and Chinook helicopters.
    • In percentage terms, the US share of Indian arms imports total 23 per cent in terms of the number of contracts and 54 per cent by value.
    • This value is all set to increase further with the US likely accepting an Indian request for Sea Guardian drones.

     

  • Issues related to Judicial appointment

    The SC Collegium has recommended the transfer of judges of several HC, including the transfer of a Justice of the Andhra Pradesh High Court.

    Must read:

    [Burning Issue] Uproar over AP CM’s letter to CJI

    What is Collegium?

    • Collegium system of the Supreme Court (SC) and the High Courts (HCs) of India is based on the precedence established by the “Three Judges Cases (1982, 1993, 1998) “.
    • It is a legally valid system of appointment and transfer of judges in the SC and all HCs.
    • It is a system of checks and balance, which ensures the independence of the senior judiciary in India.

    The Collegium System: A detailed backgrounder

    • The Collegium of judges is the Indian SC’s invention.
    • It does not figure in the Constitution, which says judges of the SC and HC are appointed by the President and speaks of a process of consultation.
    • In effect, it is a system under which judges are appointed by an institution comprising judges.
    • After some judges were superseded in the appointment of the CJI in the 1970s and attempts made subsequently to effect a mass transfer of High Court judges across the country.
    • Hence there was a perception that the independence of the judiciary was under threat. This resulted in a series of cases over the years.

    The Judges Cases

    • The First Judges Case (1981) ruled that the “consultation” with the CJI in the matter of appointments must be full and effective.
    • However, it rejected the idea that the CJI’s opinion, albeit carrying great weight, should have primacy.
    • The Second Judges Case (1993) introduced the Collegium system, holding that “consultation” really meant “concurrence”.
    • It added that it was not the CJI’s individual opinion, but an institutional opinion formed in consultation with the two senior-most judges in the SC.
    • On a Presidential Reference in its opinion, the SC, in the Third Judges Case (1998) expanded the Collegium to a five-member body, comprising the CJI and four of his senior-most colleagues.

    The procedure followed by the Collegium:

    Appointment of CJI

    • The President of India appoints the CJI and the other SC judges.
    • As far as the CJI is concerned, the outgoing CJI recommends his successor.
    • In practice, it has been strictly by seniority ever since the supersession controversy of the 1970s.
    • The Union Law Minister forwards the recommendation to the PM who, in turn, advises the President.

    Other SC Judges

    • For other judges of the top court, the proposal is initiated by the CJI.
    • The CJI consults the rest of the Collegium members, as well as the senior-most judge of the court hailing from the High Court to which the recommended person belongs.
    • The consultees must record their opinions in writing and it should form part of the file.
    • The Collegium sends the recommendation to the Law Minister, who forwards it to the Prime Minister to advise the President.

    For HC

    • The CJs of HC is appointed as per the policy of having Chief Justices from outside the respective States. The Collegium takes the call on the elevation.
    • High Court judges are recommended by a Collegium comprising the CJI and two senior-most judges.
    • The proposal, however, is initiated by the Chief Justice of the High Court concerned in consultation with two senior-most colleagues.
    • The recommendation is sent to the Chief Minister, who advises the Governor to send the proposal to the Union Law Minister.

    Does the Collegium recommend transfers too?

    • Yes, the Collegium also recommends the transfer of Chief Justices and other judges.
    • Article 222 of the Constitution provides for the transfer of a judge from one High Court to another.
    • When a CJ is transferred, a replacement must also be simultaneously found for the High Court concerned. There can be an acting CJ in a High Court for not more than a month.
    • In matters of transfers, the opinion of the CJI “is determinative”, and the consent of the judge concerned is not required.
    • However, the CJI should take into account the views of the CJ of the High Court concerned and the views of one or more SC judges who are in a position to do so.
    • All transfers must be made in the public interest, that is, “for the betterment of the administration of justice”.

    Loopholes in the Collegium system

    • Many have faulted the system, not only for its being seen as something unforeseen by the Constitution makers but also for the way it functions.
    • Opaqueness and a lack of transparency, and the scope for nepotism are cited often.
    • The attempt made to replace it by a ‘National Judicial Appointments Commission’ was struck down by the court in 2015 on the ground that it posed a threat to the independence of the judiciary.
    • Some do not believe in full disclosure of reasons for transfers, as it may make lawyers in the destination court chary of the transferred judge.
    • Embroilment in public controversies and having relatives practising in the same High Court could be common reasons for transfers.

    Scope for transparency

    • In respect of appointments, there has been an acknowledgement that the “zone of consideration” must be expanded to avoid criticism that many appointees hail from families of retired judges.
    • The status of a proposed new memorandum of procedure, to infuse greater accountability, is also unclear.
    • Even the majority opinions admitted the need for transparency, now the Collegium’s resolutions are now posted online, but reasons are not given.

  • [pib] Vision 2035: Public Health Surveillance in India

    NITI Aayog today released a white paper: Vision 2035: Public Health Surveillance (PHS) in India.

    Q.Discuss the role of Public Health Surveillance in the success of Ayushman Bharat Abhiyan.

    Vision 2035 for PHS

    • It is a continuation of the work on health systems strengthening.
    • It contributes by suggesting mainstreaming of surveillance by making individual electronic health records the basis for surveillance.
    • Public health surveillance (PHS) is an important function that cuts across primary, secondary, and tertiary levels of care. Surveillance is ‘Information for Action’.

    Let’s have a look at the executive summary of the vision document:

    PHS in India

    • Surveillance is an important Public Health function.
    • It is an essential action for disease detection, prevention, and control. Surveillance is ‘Information for Action’.

    Why need PHS?

    • Multiple disease outbreaks have prompted India to proactively respond with prevention and control measures. These actions are based on information from public health surveillance.
    • India was able to achieve many successes in the past. Smallpox was eradicated and polio was eliminated.
    • India has been able to reduce HIV incidence and deaths and advance and accelerate TB elimination efforts.
    • These successes are a result of effective community-based, facility-based, and health system-based surveillance.
    • The COVID19 pandemic has further challenged the country. India rapidly ramped up its diagnostic capabilities and aligned its digital technology expertise.
    • This ensured that there was a comprehensive tracking of the pandemic.

    Highlights of the vision document

    • It builds on initiatives such as the Integrated Health Information Platform of the Integrated Disease Surveillance Program.
    • It aligns with the citizen-centricity highlighted in the National Health Policy 2017 and the National Digital Health Blueprint.
    • It encourages the use of mobile and digital platforms and point of care devices and diagnostics for amalgamation of data capture and analyses.
    • It highlights the importance of capitalizing on initiatives such as the Clinical Establishments Act to enhance private sector involvement in surveillance.
    • It points out the importance of a cohesive and coordinated effort of apex institutions including the National Centre for Disease Control, the ICMR, and others.

    Gap areas in India’s PHS that could be addressed

    • India can create a skilled and strong health workforce dedicated to surveillance activities.
    • Non-communicable disease, reproductive and child health, occupational and environmental health and injury could be integrated into public health surveillance.
    • Morbidity data from health information systems could be merged with mortality data from vital statistics registration.
    • An amalgamation of plant, animal, and environmental surveillance in a One-Health approach.
    • PHS could be integrated within India’s three-tiered health system.
    • Citizen-centric and community-based surveillance, and use of point of care devices and self-care diagnostics could be enhanced.
    • To establish linkages across the three-tiered health system, referral networks could be expanded for diagnoses and care.

    Moving ahead

    • Establish a governance framework that is inclusive of political, policy, technical, and managerial leadership at the national and state level.
    • Identify broad disease categories that will be included under PHS.
    • Enhance surveillance of non-communicable diseases and conditions in a step-wise manner.
    • Prioritize diseases that can be targeted for elimination as a public health problem, regularly.
    • Improve core support functions, core functions, and system attributes for surveillance at all levels; national, state, district, and block.
    • Establish mechanisms to streamline data sharing, capture, analysis, and dissemination for action.
    • Encourage innovations at every step-in surveillance activity.

  • Standards must not be lowered to certify Ayurveda postgraduates surgeons

    This conundrum of different standards for surgical training must be solved because patient safety is far more important than the career progression of Ayurvedic postgraduates.

    Practice Question: There is a need to rethink on the recent notification of AYUSH Ministry allowing Ayurveda postgraduates to conduct surgeries keeping the safety of the patient at the centre. Discuss.

    The current clash

    • The clash between the allopathic and AYUSH fraternities is about the AYUSH practitioners’ “right” to conduct surgeries.
    • The Ayurvedic fraternity maintains postgraduates in Shalya and Shalakya (two surgical streams among 14 post-graduate courses) are taught procedures listed in the curriculum.
    • The oldest-known surgical specialist was, in fact, an Ayurvedic surgeon/sage Sushrut (600 BC) who wrote the Sushrut Samhita — a profound exposition on conducting human surgery which continues to receive worldwide acclaim.
    • Surgery was practised by Ayurvedic surgeons long before the advent of western medicine.
    • Allopaths question the logic of Sushrut’s millennia-old pre-eminence bestowing the right to practise modern surgery. Ayurvedic surgeons may not know the hidden risks of every surgical procedure and how to surmount sudden mishaps.
    • The Ministry of AYUSH justifies its notification on the ground that not all vaidyas but only postgraduates qualifying from two surgical streams have been authorized to perform selected surgeries.

    The contentious issue

    • The moot point is about who decides whether Ayurvedic surgeons possess sufficient proficiency to conduct these surgeries safely and by what standard their skills are judged.
    • Surgical proficiency cannot be judged by different standards in one country — particularly when less-educated patients would rather save money than question a surgeon’s qualifications.
    • The statutory regulatory body for AYUSH education is the Central Council of Indian Medicine (CCIM). CCIM has only promoted what private college managements demand, propelled, in turn, by students’ need to earn a stable income as medical professionals.
    • In this misplaced zeal to give better earnings to the Ayurvedic vaidyas, CCIM has sidelined many skills that Ayurveda could have included, which are relevant even today.
    • This has subjugated the curriculum to nurture more and more replicas of doctors of modern medicine.
    • This has killed the knowledge, purity and goodness of classical Ayurveda, which ironically is the Ayurveda in high demand in Europe, Russia and America.

    Nothing can replace practise and training to perform surgery

    • When it comes to surgery, it is not knowledge but rigorous training and continuous practice which makes for perfection. Both require clinical material and most Ayurvedic hospitals do not have a fraction of the surgical patients found in allopathic general hospitals.
    • Allopathic students of surgery learn first by watching and then performing scores of surgeries under supervision.
    • Surgical skills are by no means impossible to learn but they become difficult to master without continuous training and supervision.
    • Due to the paucity of patients, limited scope for training and access to gaining hands-on practice, it is hazardous to allow all Shalya and Shalakya postgraduates to undertake surgical procedures.
    • In the last three decades, specialization has excluded general surgeons from performing what was once considered routine. For example, only an ENT surgeon can perform a tonsillectomy.
    • Therefore, to notify that Ayurvedic postgraduates in surgery can perform omnibus operations runs counter to the norm in India and in other countries.

    Way forward

    • In performing surgery, the only benchmark should be the duration of hands-on training received — counted by surgeries under supervision, and being judged through external evaluation.
    • Every surgeon’s skills and competence must be tested by applying exactly the same standards before she/he can operate.
    • This conundrum of different standards for surgical training must be solved because patient safety is far more important than the career progression of Ayurvedic postgraduates.

  • India needs to rethink its nutrition agenda

    Poor nutritional outcomes in NFHS-5 show that a piecemeal approach does not work.

    Nutrition-related data released by NFHS-5

    • The Ministry of Health and Family Welfare has released data fact sheets for 22 States and Union Territories (UTs) based on the findings of Phase I of the National Family Health Survey-5 (NFHS-5).
    • The 22 States/ UTs don’t include some major States such as Tamil Nadu, Rajasthan, Punjab, Uttar Pradesh, Jharkhand, Odisha and Madhya Pradesh.

    Practice Question: The latest findings from the National Family Health Survey data shows a sign of worry. Suggest the policy measures required to tackle the health and nutrition-related issues in India.

    Worrying findings

    • There is an increase in the prevalence of severe acute malnutrition in 16 States/UTs (compared to NFHS-4 conducted in 2015-16). Kerala and Karnataka are the only two big states where there is some decline.
    • The percentage of children under five who are underweight has also increased in 16 out of the 22 States/UTs.
    • Anaemia levels among children as well as adult women have increased in most of the States with a decline in anaemia among children being seen only in four States/UTs.
    • There is also an increase in the prevalence of other indicators such as adult malnutrition in many States/ UTs.
    • Most States/UTs also see an increase in overweight/obesity prevalence among children and adults shows the inadequacy of diets in India both in terms of quality and quantity.
    • The data report an increase in childhood stunting (an indicator of chronic under-nutrition and considered a sensitive indicator of overall well-being) in 13 of the 22 States/UTs.
    • Poshan Abhiyaan, one of the flagship programmes of the PM, launched in 2017, aimed at achieving a 2% reduction in childhood stunting per year.

    Economic growth vs health indicators

    • There is an increase in the prevalence of childhood stunting in the country during the period 2015-16 to 2019-20.
    • This calls for serious introspection on not just the direct programmes in place to address the problem of child malnutrition but also the overall model of economic growth that the country has embarked upon.
    • The World Health Organization calls stunting “a marker of inequalities in human development”.
    • Over the last three decades, India has experienced high rates of economic growth. But this period has also seen increasing inequality, greater informalisation of the labour force, and reducing employment elasticities of growth.
    • Currently, India is witnessing a slowdown in economic growth, stagnant rural wages and highest levels of unemployment. This is reflected in the rising number of reported starvation deaths from different parts of the country.
    • The situation has become even worse due to the pandemic and lockdown-induced economic distress.
    • Field surveys such as the recent ‘Hunger Watch’ are already showing massive levels of food insecurity and decline in food consumption, especially among the poor and vulnerable households.
    • All of this calls for urgent action with commitment towards addressing the issue of malnutrition.

    Social protection schemes and their impact on nutrition indicators

    • Social protection schemes and public programmes such as the Mahatma Gandhi National Rural Employment Guarantee Scheme, the Public Distribution System, the Integrated Child Development Scheme (ICDS), and school meals have contributed to a reduction in absolute poverty as well as previous improvements in nutrition indicators.
    • However, there are continuous attempts to weaken these mechanisms through underfunding and general neglect.
    • Only about 32.5% of the funds released for Poshan Abhiyaan from 2017-18 onwards had been utilized.
    • There are some improvements seen in determinants of malnutrition such as access to sanitation, clean cooking fuels and women’s status – a reduction in spousal violence and greater access of women to bank accounts.

    A piecemeal approach

    • The overall poor nutritional outcomes show that a piecemeal approach addressing some aspects does not work.
    • Direct interventions such as supplementary nutrition (of good quality including eggs, fruits, etc.), growth monitoring, and behaviour change communication through the ICDS and school meals must be strengthened and given more resources.
    • Universal maternity entitlements and child care services to enable exclusive breastfeeding, appropriate infant and young child feeding as well as towards recognizing women’s unpaid work burdens have been on the agenda for long, but not much progress has been made on these.
    • The linkages between agriculture and nutrition both through what foods are produced and available as well as what kinds of livelihoods are generated in farming are also important.

    Conclusion

    • The basic determinants of malnutrition – household food security, access to basic health services and equitable gender relations – cannot be ignored any longer.
    • An employment-centred growth strategy which includes the universal provision of basic services for education, health, food and social security is imperative.
    • There have been many indications in our country that business as usual is not sustainable anymore.
    • It is hoped that the experience of the pandemic, as well as the results of NFHS-5, serve as a wake-up call for a serious rethinking of issues related to nutrition and accord these issues priority.

  • Delimitation should be based on 2031 Census

    A paper released by the Pranab Mukherjee Foundation (PMF) has suggested that the next delimitation exercise should be a two-step process:

    1. First a Delimitation Commission should be set up to redraw boundaries of constituencies on the basis of the 2031 Census
    2. And then a State Reorganization Act be passed to split States into smaller ones

    Q.With the new Parliament House, the role of the Presiding officers of the Houses is going to be more challenging. Discuss, how.

    Back in news

    • PM recently inaugurated a brand new Parliament Annexe building that will afford our lawmakers more space and enable better functioning.
    • In a few years from now, we might actually need a new building for Parliament altogether due to the likely increase in a number of seats in both Houses after the lifting of the freeze imposed by the 42nd Constitutional Amendment Act, 1976, which is due in 2026.

    What is Delimitation? Why is it needed?

    • Delimitation is the act of redrawing boundaries of Lok Sabha and state Assembly seats to represent changes in population.
    • In this process, the number of seats allocated to different states in Lok Sabha and the total number seats in a Legislative Assembly may also change.
    • The main objective of delimitation is to provide equal representation to equal segments of a population.
    • It also aims at a fair division of geographical areas so that one political party doesn’t have an advantage over others in an election.

    Why such debate?

    • The 84th Amendment to the Constitution in 2002 had put a freeze on the delimitation of Lok Sabha and State Assembly constituencies till the first Census after 2026.
    • While the current boundaries were drawn on the basis of the 2001 Census, the number of Lok Sabha seats and State Assembly seats remained frozen on the basis of the 1971 Census.
    • The population according to the last census preceding the freeze was 50 crore, which in 50 years has grown to 130 crores.
    • This has caused a massive asymmetry in the political representation in the country.

    Why there are fewer delimitations?

    • The Constitution mandates that the number of Lok Sabha seats allotted to a state would be such that the ratio between that number and the population of the state is, as far as practicable, the same for all states.
    • Although unintended, this provision implied that states that took little interest in population control could end up with a greater number of seats in Parliament.
    • The southern states that promoted family planning faced the possibility of having their seats reduced.
    • To allay these fears, the Constitution was amended during Indira Gandhi’s Emergency rule in 1976 to suspend delimitation until 2001.
    • Despite the embargo, there were a few occasions that called for readjustment in the number of Parliament and Assembly seats allocated to a state.

    Background

    • According to Article 81 of the Constitution — as it stood before the 42nd CAA 1976 — the Lok Sabha was to comprise of not more than 550 members.
    • Clause (2) of Article 81 provided that there shall be allotted to each State a number of MPs in such manner that the ratio between that number and the population of the State is the same for all States.
    • Further, clause (3) defined the expression “population” for the purposes of Article 81 to mean the population as ascertained at the last preceding census of which the relevant figures have been published.

    Dilemma over delimitation

    • States which took a lead in population control faced the prospect of their number of seats getting reduced and States which had higher population figures stood to gain by increase in the number of seats in Lok Sabha.
    • As a result of the freezing of the allocation of seats, the allocation done on the basis of the 1971 Census continues to hold good for the present population figures.
    • According to the 2011 Census, the population of our country stands at 121 crores with a registered electorate of 83.41 crores.
    • Basing the 1971 Census figure of 54.81 crores to represent today’s population presents a distorted version of our democratic polity and is contrary to what is mandated under Article 81 of the Constitution.
    • So when the first Census figure will be available after 2026 — that is, in 2031 — a fresh delimitation will have to do which will dramatically alter the present arrangement of seat allocation to the States in Parliament.

    Acquainting more MPs: A big challenge

    • One question that has to be addressed is how the Presiding Officers of the Houses/Legislatures will deal with such a large number of members to capture the attention of the Speaker to raise issues in the House.
    • Even with the current strength of 543 members, the Speaker finds it extremely difficult to conduct the proceedings of the House.
    • Members do not show much heed to the appeals of the Speaker, thereby making smooth conduct of House proceedings a difficult affair.
    • The Speaker’s directions and rulings are not shown proper respect, and disruptions of proceedings aggravate the problem.
    • The sudden increase in numbers will render the task of the Speaker more difficult and onerous.

    Conclusion

    • While 2026 is still a few years away. But we need to be clear on how to deal with the problems that are likely to arise, we will be forced to postpone the lifting of the freeze to a future date as was done in 2001.
    • This will only postpone the problem for which we must find a solution sooner or later.
    • Even the various proposals for electoral reforms which have been recommended by various Commissions over the past decade do not address these issues.
    • These are challenges which our political leaders have to address in the immediate future.

  • National Family Health Survey- 5 Part: I

    • Current times require integrated and coordinated efforts from all health institutions, academia and other partners directly or indirectly associated with the health care services to make these services accessible, affordable and acceptable to all.
    • The data in NFHS-5 gives requisite input for strengthening existing programmes and evolving new strategies for policy intervention, therefore government and authorities should take steps to further improve the condition of women in India.

    The first phase of the fifth National Family Health Survey (NFHS-5) has been released.

    Do you think that India is still the sick man of Asia?

    What is the National Family Health Survey?

    • The NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
    • Three rounds of the survey have been conducted since the first survey in 1992-93.
    • The survey provides state and national information for India on fertility, infant and child mortality, the practice of family planning, maternal and child health, reproductive health, nutrition, etc.
    • The Ministry of Health has designated the International Institute for Population Sciences (IIPS) Mumbai, as the nodal agency, responsible for providing coordination and technical guidance for the survey.

    Part I of the Survey

    • The latest data pertains to 17 states — including Maharashtra, Bihar, and West Bengal — and five UTs (including J&K) and, crucially, captures the state of health in these states before the Covid pandemic.
    • Phase 2 of the survey, which will cover other states such as Uttar Pradesh, Punjab and Madhya Pradesh, was delayed due to the pandemic and its results are expected to be made available in May 2021.

    Highlights of the NHFS-5

    • The NFHS-5 contains detailed information on population, health, and nutrition for India and its States and Union Territories.
    • This is a globally important data source as it is comparable to Demographic Health Surveys (DHS) Programme of 90 other countries on several key indicators.
    • It can be used for cross country comparisons and development indices.

    Good news

    • Several of the 22 states and UTs, for which findings have been released, showed an increase in childhood immunisation.
    • There has been a drop in neonatal mortality in 15 states, a decline in infant mortality rates in 18 states and an increase in the female population (per 1,000 males) in 17 states.
    • Fertility rate decline and increase in contraceptive use were registered in almost all the states surveyed showing trends of population stabilization.

    Some bad news

    • There has been an increase in stunting and wasting among children in several states, a rise in obesity in women and children, and an increase in spousal violence.
    • In several other development indicators, the needle has hardly moved since the last NFHS-4.

    (1) Hunger Alarm

    • The proportion of stunted children has risen in several of the 17 states and five UTs surveyed, putting India at risk of reversing previous gains in child nutrition made over previous decades.
    • Worryingly, that includes richer states like Kerala, Gujarat, Maharashtra, Goa and Himachal Pradesh.
    • The share of underweight and wasted children has also gone up in the majority of the states.

    (2) Fertility Rate

    The total fertility rate (TFR) is defined as the average number of children that would be born to a woman by the time she ends childbearing.

    • The TFR across most Indian states declined in the past half-a-decade, more so among urban women, according to the latest NFHS-5.
    • Sikkim recorded the lowest TFR, with one woman bearing 1.1 children on average; Bihar recorded the highest TFR of three children per woman.
    • In 19 of the 22 surveyed states, TFRs were found to be ‘below-replacement’ — a woman bore less than two children on average through her reproductive life.
    • India’s population is stabilizing, as the total fertility rate (TFR) has decreased across majority of the states.

    (3) Under-5 and infant mortality rate (IMR)

    • The Under 5 and infant mortality rate (IMR) has come down but in parallel recorded an increase in underweight and severely wasted under 5 children among 22 states that were surveyed.
    • These states are Goa, Gujarat, Himachal Pradesh, Kerala, Maharashtra, Meghalaya, Mizoram, Nagaland, Telangana, Tripura, West Bengal, Lakshadweep and Dadra & Nagar Haveli and Daman and Diu.

    For the first time: Gaps in internet use

    • In 2019, for the first time, the NFHS-5, which collects data on key indicators on population health, family planning and nutrition, sought details on two specific indicators: Percentage of women and men who have ever used the Internet.
    • On average, less than 3 out of 10 women in rural India and 4 out of 10 women in urban India ever used the Internet, according to the survey.
    1. First, only an average of 42.6 per cent of women ever used the Internet as against an average of 62.16 per cent among the men.
    2. Second, in urban India, average 56.81 per cent women ever used the Internet compared to an average of 73.76 per cent among the men.
    3. Third, dismal 33.94 per cent women in rural India ever used the Internet as against 55.6 per cent among men.
    • In urban India, 10 states and three union territories reported more than 50 per cent women who had ever used the Internet: Goa (78.1%), Himachal Pradesh (78.9%), Kerala (64.9%), and Maharashtra (54.3%).
    • The five states reporting the lowest percentage of women, whoever used the Internet in urban India were Andhra Pradesh (33.9%), Bihar (38.4%), Tripura (36.6%), Telangana (43.9%) and Gujarat (48.9%).

  • Hazardous ideas for the Himalayas

    By planning hydropower projects, India and China are placing the region at great risk.

    China’s new hydropower project

    • Recently China announced that it is planning to build a major hydropower project as a part of its 14th Five-Year Plan (2021-25), on the YarlungZanbo River, in Mêdog County in Tibet.
    • The hydropower generation station is expected to provide 300 billion kWh of electricity annually.
    • The Chinese authorities say the project will help the country realize its goal of reaching a carbon emission peak before 2030 and carbon neutrality before 2060.

    Misadventures

    • Such ‘super’ dams projects are very unviable as they are being planned in an area that is geologically unstable.
    • There are two hydropower projects being built in Arunachal Pradesh on the tributaries of the Brahmaputra: the 600 MW Kameng project on the Bichom and Tenga Rivers and the 2,000 MW Subansiri Lower Hydroelectricity Project.
    • China has already completed 11 out of 55 projects that are planned for the Tibetan region. In this race, the two countries overestimate their economic potential and grossly underestimate the earthquake vulnerability of the region.
    • High seismic zones coincide with areas of high population concentration in the Himalayan region where landslides and glacial lake outburst floods are common.

    Practice Question:‘’Carbon neutrality should not be at the expense of the environment.” Elaborate with proper examples.

    Havocs created due to these earthquakes

    • About 15% of the great earthquakes of the 20th century (with a magnitude of more than 8) occurred in the Himalayan region.
    • The northeast Himalayan band has experienced several large earthquakes of magnitude 7 and above in the last 100 years, more than the share from other parts of the Himalayas.
    • The 1950 earthquake just south of the McMahon Line was of 6 magnitudes. It was the largest continental event ever recorded and devastated Tibet and Assam.
    • The earthquake killed thousands, and caused extensive landslides, widespread land level changes and gaping fissures. It resulted in water and mud oozing in the Himalayan ranges and the upper Assam valley.
    • The earthquake was felt over an extensive area comprising parts of India, Tibet, erstwhile East Pakistan and Myanmar.
    • The2015 Gorkha earthquake of magnitude 7.8 in central Nepal resulted in huge losses in the hydropower sector. Nepal lost about 20% of its hydropower capacity consequent to the earthquake.
    • About 30 projects with a capacity of 270 MW, mostly located along the steep river valleys, were damaged.

    What are the issues of high concern?

    • The main mechanisms that contributed to the vulnerability of hydropower projects were found to be landslides, which depend on the intensity of seismic ground shaking and slope gradients.
    • Heavy siltation from giant landslides expected in the project sites and headwater region from future earthquakes will severely reduce the water-holding capacity and life expectancy of such dams.
    • Even without earthquakes, the steep slopes made of soft rocks are bound to slide due to deforestation and road-building. These activities will get intensified as part of the dam-building initiatives.
    • Desilting of dams is not an economically viable proposition and is technologically challenging.

    A transnational asset under threat

    • The Himalayan range is a transnational mountain chain and is the chief driver of the Asian climate.
    • It is a source for numerous Asian river systems and glaciers which are now under the threat of degradation and retreat due to global warming; these river systems provide water for billions of people.
    • The ongoing low-level military confrontations between these two countries have led to demands for further infrastructural development on both sides, including all-weather roads, much to the peril of regional biodiversity and the livelihoods of the indigenous population.
    • The Himalayas have seen the highest rate of deforestation and land-use changes.

    Way Forward

    • There is a need for India and China to sit together to deliberate on the consequences of such misadventures in an area where massive earthquakes are bound to take place.
    • The upper Himalayas should be converted into a nature reserve by an international agreement.
    • The possibility of a Himalayan River Commission involving all the headwater and downstream countries needs to be explored.
    • There is a need to understand that – ‘’Carbon neutrality should not be at the expense of the environment’’.

  • Issues related to Nursing Sector in India

    The year 2020 has been designated as “International Year of the Nurse and the Midwife”.

    But the nursing education in India displays a grim situation. It suffers poor quality of training, inequitable distribution, and non-standardized practices.

    Nursing sector in India

    • Nurses and midwives will be central to achieving universal health coverage in India.
    • India’s nursing workforce is about two-thirds of its health workforce. Its ratio of 7 nurses per 1,000 population is 43% less than the World Health Organization norm; it needs 2.4 million nurses to meet the norm.
    • The sector is dogged by structural challenges that lead to poor quality of training, inequitable distribution, and non-standardized practices.

    Uneven regulation

    Nursing education in India has a wide array of certificate, diploma, and degree programmes for clinical and non-clinical nursing roles.

    • The Indian Nursing Council regulates nursing education through prescription, inspection, examination, and certification. 91% of the nursing education institutions are private and weakly regulated. The quality of training of nurses is diminished by the uneven and weak regulation.
    • The current nursing education is outdated and fails to cater to the practice needs. The education, including re-training, is not linked to the roles and their career progression in the nursing practice.
    • There are insufficient postgraduate courses to develop skills in specialities and address critical faculty shortages both in terms of quality and quantity.
    • These factors have led to gaps in skills and competencies, with no clear career trajectory for nurses.
    • Multiple entries point to the nursing courses and lack of integration of the diploma and degree courses diminish the quality of training.
    • A common entrance exam, a national licence exit exam for entry into practice, and periodic renewal of licence linked with continuing nursing education would significantly streamline and strengthen nursing education.
    • Transparent accreditation, benchmarking, and ranking of nursing institutions too would improve the quality.
    • The number of nursing education institutions has been increasing steadily but there are vast inequities in their distribution. Around 62% of them are situated in southern India.
    • There is little demand for postgraduate courses. Recognizing the need for speciality courses in clinical nursing 12 PG diploma courses were rolled out but the higher education qualification is not recognized by the recruiters.
    • The faculty positions vacant in nursing college and schools are around 86% and 80%, respectively.

    Gaps in education, services

    • There is a lack of job differentiation between diploma, graduate, and postgraduate nurses regarding their pay, parity, and promotion.
    • The higher qualifications are underutilized, leading to low demand for postgraduate courses.
    • Those with advanced degrees seek employment in educational institutions or migrate abroad which has led to an acute dearth of qualified nurses in the country.
    • Small private institutions with less than 50 beds recruit candidates without formal nursing education. They are offered courses of three to six months for non-clinical ancillary nursing roles and are paid very little.
    • The Indian Nursing Act primarily revolves around nursing education and does not provide any policy guidance about the roles and responsibilities of nurses in various cadres.
    • Nurses in India have no guidelines on the scope of their practice and have no prescribed standards of care and is a major reason for the low legitimacy of the nursing practice and the profession. This may endanger patient safety.
    • The Consumer Protection Act holds only the doctor and the hospital liable for medico-legal issues; nurses are out of the purview of the Act. This is contrary to the practices in developed countries where nurses are legally liable for errors in their work.

    Institutional reforms required

    1. The governance of nursing education and practice must be clarified and made current.
    2. The Indian Nursing Council Act of 1947must be amended to explicitly state clear norms for service and patient care, fix the nurse to patient ratio, staffing norms and salaries.
    3. The jurisdictions of the Indian Nursing Council and the State nursing councils must be explained and coordinated so that they are synergistic.
    4. Incentives to pursue advanced degrees to match their qualification, clear career paths, the opportunity for leadership roles, and improvements in the status of nursing as a profession should be done.
    5. A live registry of nurses, positions, and opportunities should be a top priority to tackle the demand-supply gap in this sector.
    6. The public-private partnership between private nursing schools/colleges and public health facilities is another strategy to enhance nursing education. NITI Aayog has recently formulated a framework to develop a model agreement for nursing education.
    7. The Government has also announced supporting such projects through a Viability Gap Funding.

    Practice Question:

    Q. Discuss the various issues related to nursing sector in India and measures to be taken to address them.

    A Bill that could spell hope

    • The disabling environment prevalent in the system has led to the low status of nurses in the hierarchy of health-care professionals. In fact, nursing has lost the appeal as a career option.
    • The National Nursing and Midwifery Commission Bill currently under consideration should hopefully address some of the issues highlighted.
    • These disruptions are more relevant than ever in the face of the COVID-19 pandemic.