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[op-ed snap] Empowering primary care practitioners

Mains Paper 2 : Health & Education |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Nothing Much

Mains level : Strengthening primary health care to improve public health


Context

There is a need to empower primary health care providers to make crucial health decisions in India.

Problems with Indian healthcare

    • In India a hospital-oriented, technocentric model of health care took roots. 
    • Building urban hospitals through public investment enjoyed primacy over strengthening community-based, primary health care. 
    • A private sector with a rampant, unregulated dual-practice system flourished. 
    • This influential doctors’ community saw a lucrative future in super-specialty medicine and buttressed the technocentric approach. 
    • This had an enormous impact on the present-day Indian health care.

Focus on hospitalization

    • Preference for ‘high-tech’ medical care has trickled down to even the poor sections which cannot pay for such interventions. 
    • Health insurance schemes like Ayushman Bharat based on providing insurance to the poor for private hospitalisation are influenced by the popular demand for high-quality medical care.
    • Medical Council of India came to be dominated by specialists with no representation from primary care. 

NMC – community health care provision

    • The current opposition to training mid-level providers under the NMC Act 2019 is an example of how the present power structure is inimical to primary health care. 
    • Evidence proves that practitioners of modern medicine trained through short-term courses of a 2-3 year duration can greatly help in providing primary health care to the rural population. 
    • Such medical assistants and non-allopathic practitioners have been written-off as ‘half-baked quacks’ who would endanger the health of the rural masses. 
    • Nations like the U.K. and the U.S. are consistently training paramedics and nurses to become physician assistants or associates through two-year courses in modern medicine.

Way ahead

    • Countries such as the U.K. and Japan have incentivised general practitioners (GPs) and designed a system that strongly favors primary health care. 
    • It is imperative to reclaim health from the ivory towers called ‘hospitals’. 
    • We need to find a way to adequately empower PCPs and give them a prominent voice in our decision-making processes pertaining to health care.
    • No one should be allowed to bypass the primary doctor to directly reach the specialist unless situations such as emergencies so warrant. It is only because of such a system that general practitioners and primary health care have been thriving in the U.K.’s health system.
    • Bhore Committee report (1946) highlighted the need for a ‘social physician’ as a key player in India’s health system. 37 years after the report, PG in family medicine is a reality.

Best case – Japan

    • For the early part of Japan’s history, hospitals catered only to an affluent few. 
    • The government limited the funding of hospitals, restricted them to functions like training of medical students and isolation of infectious cases.
    • Reciprocal connections between doctors in private clinics and hospitals were forbidden.
    • The Japanese Social Health Insurance was implemented in 1927, and the Japanese Medical Association (JMA) as the main player in negotiating the fee schedule. It was headed by Primary Health Care providers.
    • Japan Managed to contain the clout of specialists in its health-care system and accorded a prominent voice to its primary care practitioners (PCP) in decision-making processes.
Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

[op-ed snap] The problem of skilling India

Mains Paper 3 : Indian Economy |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Nothing much

Mains level : Unemployment in India - the issue of skilling


CONTEXT

Prime Minister in his recent Independence Day speech, said, “We need to worry about population explosion”.

Issues

  • So far, India’s demographic dividend with the country’s population was seen as an asset. 
  • Demography brings a dividend only if the youth is trained properly. Without proper training, the country gets massive joblessness.
  • A minimum of 8 million new job seekers enters the job market every year. In 2017, only 5.5 million jobs had been created.
  • The unemployment rate is the highest in 45 years today.
    • The unemployment rate reaching 34% among the 20-24-year-olds in the first quarter of 2019.
    • It was 37.9% in urban areas according to the CMIE. 
  • According to the 2018 Periodic Labour Force Survey (PLFS), the unemployment rate among the urban 15-29-year-olds was 23.7%. 

Reasons

  • Poor training of the youth – only 7% of the people surveyed in the PLFS declared any formal or informal training.
  • According to a recent survey, 48% of Indian employers reported difficulties filling job vacancies due to talent shortage. 
  • In the IT sector, 1,40,000 skilled techies could not be recruited in 2018 despite the employers’ efforts – out of the 5,00,000 job offers that had been made that year. 
  • As per the CMIE reports, the more educated Indians are, the more likely they are to remain unemployed too. 
  • The last PLFS for 2018 revealed that 33% of the formally trained 15-29-year-olds were jobless.

Govt Initiatives – Skill India

  • The objective of the programme is “to train a minimum of 300 million skilled people by the year 2022”. 
  • In 2014, the government created a Ministry of Skill Development and Entrepreneurship to harmonise training processes, assessments, certification and outcomes. 
  • The Executive Committee monitoring the mission has representatives of nine ministries including agriculture, information technology, human resources development.
  • The governing council announced the setting up of 1,500 new ITIs and 50,000 Skill Development Centres.
  • Govt saw “Skill India” as a plan complementary to “Make in India”.
  • There was the creation of more courses and institutes of vocational training.
  • It integrated vocational training classes linked to the local economy with formal education from class nine onwards in at least 25% of the schools and higher education bodies. 
  • Its PPP character: Companies were requested to earmark 2% of their payroll bill for skill development initiatives. 
  • ITIs were supposed to tie up with the industry in the relevant trades to improve placement opportunities for candidates.
  • Under the Pradhan Mantri Kaushal Vikas Yojana, training fees were paid by the government. Its main tool was the “short-term training”, which could last between 150 and 300 hours, and included placement assistance by Training Partners upon successful completion of their assessment by the candidates.

Challenges faced by the scheme

  • The target of this scheme was to reach out to 300 million young people by 2022, but only a mere 25 million had been trained under this scheme by the end of 2018. 
  • Mismanagement of funds as they were either not spent sufficiently quickly because of a lack of candidates; or too little was spent. 
  • The money problem is evident from the PLF Survey mentioned above which showed that, in 2018, only 16% of the youth who had received formal training was funded by the government.
  • Those who have been trained don’t find jobs. The number of those who have benefited from the Skill India scheme has increased, from 3,50,000 in 2016-17 to 1.6 million in 2017-18, but the percentage of those who could find a job upon completion of their training has dropped from more than 50% to 30%. 
  • Under PMKVY, 4.13 million people had been trained, but only 15% of them got a job.
  • The training was not good enough – and this is why the employability rate remains very low. 
  • While the government expected that some of the PMKVY-trainees would create their own enterprise, only 24% of them started their business. Out of them, only 10,000 applied for MUDRA loans. 
  • India’s joblessness issue is not only a skills problem, it represents the lack of appetite of industrialists and SMEs for recruiting. 
  • The decline of the investment rate is a clear indication that the demand is weak.
  • Investment remains a challenge because of limited access to credit due to pile up of NPAs.

Conclusion

  • Skill India will not be enough to create jobs if the slowdown continues. 
  • Skill India will not be enough if government expenditures in education remain low. Allocation for school education has declined from 2.81% of the budget in 2013-14 to 2.05% in 2018-19.
Economic Indicators-GDP, FD,etc

[op-ed snap] Rates and risks

Mains Paper 3 : Indian Economy |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Monetary policy basics

Mains level : Monetary Policy transmission issues; Interest Rate and external benchmarks


CONTEXT

The Reserve Bank of India (RBI) has mandated banks to link all new floating rate loans extended to both retail consumers as well as micro and small enterprises to an external benchmark. 

Details

  • The external benchmark could be either the repo rate or the yield on the three- or six-month Treasury bill or any other benchmark interest rate published by the Financial Benchmarks India Private Limited (FBIL). 
  • This move comes after the MCLR regime has failed to improve the transmission of monetary policy.
  • Even though the policy rate was slashed by 75 basis points between February and June 2019, lending rates declined by only 29 basis points during the same period. 

Benefits

It might lead to faster transmission of monetary policy.

Challenges

  • Mandating external benchmarking of lending rates could lead to interest rate risks because it will cut the link between bank deposit and lending rates.
  • Bank interest margins will be stressed when interest rates are falling, as lending rates will fall faster than deposit rates. 
  • Banks may increase the spread allowed to charge over the benchmark rate to cut the risks. 
  • It may also lead to banks wanting to link their deposit rates to an external benchmark. This may hurt the depositors as they may prefer the option of having fixed rates. 
  • There is also the issue of small savings instruments. These rates are more static as compared to bank deposit rates and banks will face greater competition when interest rates are going down. It could lead to a flight of deposits. 
  • The issue of which benchmark to adopt. There may be a preference for the repo rate as yields on T-bills tend are more volatile in nature. But any sudden shock to the system could push up short-term yields sharply and have to be transmitted to borrowers.

Way ahead

  • Instead of mandating external benchmarking, a preferable option would have been to allow banks to gradually move towards this framework.
  • The State Bank of India has already linked its savings deposit and short-term loans to the repo rate. Such voluntary moves could have, over time, forced others to follow suit.

 


Back2Basics

Economics | Monetary Policy Explained with Examples

RBI Notifications

No Central Asian ancestry in Indus Valley Civilization

Mains Paper 1 : Arts & Culture |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Various sites of IVC

Mains level : Theory of Aryan Origin


hi


News

  • Throwing fresh light on the Indus Valley Civilization, a study of DNA from skeletal remains excavated from Rakhigarhi was recently conducted.
  • The study contends that the theory of the Harappans having Steppe pastoral or ancient Iranian farmer ancestry thus stands refuted.
  • Prior to the arrival of steppe pastoralists bringing their Indo-European languages about 4,000 years ago, we find no evidence of large-scale movements of people into South Asia.
  • It also concluded that the hunter-gatherers of South Asia, who then became a settled people, have an independent origin.

No Mass-migration of Aryans

  • The finding also negates the hypothesis about mass migration during Harappan times from outside South Asia.
  • Researchers successfully sequenced the first genome of an individual from Harappa and combining it with archaeological data.
  • It found that hunter-gatherers of South Asia had an independent origin, and authored the settled way of life in this part of the world.
  • They do not contain genome from either the Steppe region or ancient Iranian farmers.
  • The genetic continuity from hunter gatherer to modern times is visible in the DNA results.
  • The study finds that the same hunter-gatherer communities developed into agricultural communities and formed the Harappan civilization.

No migration from Central Asia

  • India had a heterogeneous population right from the beginning of settled life. There was a hint that settled life and domestication went from South Asia to West Asia.
  • The researchers also suggest that there was a movement of people from east to west as the Harappan people’s presence is evident at sites like Gonur in Turkmenistan and Sahr-i-Sokhta in Iran.
  • As the Harappans traded with Mesopotamia, Egypt, the Persian Gulf and almost all across South Asia, there was bound to be movement of people resulting in a mixed genetic history.

Origins of farming

  • The researchers concluded that farming in South Asia was not due to the movement of people from the farming cultures of the west and that local foragers adopted it.
  • In Europe, ancient-DNA studies have shown that agriculture tended to spread through an influx of people with ancestry in Anatolia, in modern day Turkey.
  • The new study shows a similar dynamic in Iran and Turan (southern Central Asia), where the researchers found that Anatolian-related ancestry and farming arrived around the same time.
  • In South Asia, however, the story appears quite different.
  • The researchers found an absence of Anatolian-related ancestry.
  • They saw that Iranian-related ancestry in South Asians comes from a lineage that separated from ancient Iranian farmers and hunter-gatherers before those groups split from each other, nearly 9,000 years ago.

Rakhigarhi- the epicenter

  • The discovery of two more mounds at the Harappan site of Rakhigarhi in Hisar district, Haryana, has led to archaeologists establishing it as the biggest Harappan civilisation site.
  • Until now, specialists in the Harappan civilisation had argued that Mohenjo-daro in Pakistan was the largest among the 2,000 Harappan sites known to exist in India, Pakistan and Afghanistan.
  • The archaeological remains at Mohenjo-daro extend around 300 hectares.
  • Mohenjo-daro, Harappa and Ganweriwala (all in Pakistan) and Rakhigarhi and Dholavira (both in India) are ranked as the first to the fifth biggest Harappan sites.

Back2Basics

Aryan Invasion Theory

  • In 1953 Mortimer Wheeler proposed that the invasion of an Indo-European tribe from Central Asia, the “Aryans”, caused the decline of the Indus Civilization.
  • As evidence, he cited a group of 37 skeletons found in various parts of Mohenjo-daro, and passages in the Vedas referring to battles and forts.
  • However, scholars soon started to reject Wheeler’s theory, since the skeletons belonged to a period after the city’s abandonment and none were found near the citadel.
Historical and Archaeological Findings in News

External Benchmark-based Lending

Mains Paper 3 : Indian Economy |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Various terms mentioned in the news

Mains level : Not Much


News

External Benchmark

  • The RBI has made it mandatory for all banks to link floating rate loans — to retail customers and loans to micro, small and medium enterprises (MSME) — to an external benchmark.
  • Some banks have already started to link home and auto loan rates to the repo rate, which is an external benchmark.
  • Banks can choose from one of the four external benchmarks — repo rate, three-month treasury bill yield, six-month treasury bill yield or any other benchmark interest rate.
  • The interest rate under external benchmark shall be reset at least once in three months.

Why such move?

  • At present, interest rates on loans are linked to a bank’s marginal cost of fund-based interest rate (MCLR).
  • It has been observed that due to various reasons, the transmission of policy rate changes to the lending rate of banks under the current MCLR framework has not been satisfactory.
  • The RBI, therefore, has issued a circular making it mandatory for banks to link all new floating rate personal or retail loans and floating rate loans to MSMEs to an external benchmark effective October 1, 2019.
  • The move is aimed at faster transmission of monetary policy rates.

Repo wasn’t useful

  • Even before RBI had made it mandatory, several banks had launched repo-linked lending rate products.
  • This was done in an effort to ensure faster transmission of policy rate cuts to borrowers.
  • The repo (or repurchase) rate is the rate at which the Reserve Bank of India (RBI) lends money to other banks.
  • Hence, cuts in the repo rate are meant to lead to cuts in home loan and other lending rates as banks get to borrow money cheaply from the RBI.
  • By pegging the rate to an external benchmark RBI is hoping for a faster transmission of rate cuts than has happened so far under the MCLR system.

About MCLR

  • MCLR (Marginal Cost of funds based Lending Rate) replaced the earlier base rate system to determine the lending rates for commercial banks.
  • RBI implemented MCLR on 1 April 2016 to determine rates of interests for loans.
  • It is the minimum interest rate that a bank can lend at.
  • MCLR is a tenor-linked internal benchmark, which means the rate is determined internally by the bank depending on the period left for the repayment of a loan.
  • MCLR is closely linked to the actual deposit rates and is calculated based on four components: the marginal cost of funds, negative carry on account of cash reserve ratio, operating costs and tenor premium.

Back2Basics

Base Rate

  • Base rate is the minimum rate set by the RBI below which banks are not allowed to lend to its customers.
  • It is decided in order to enhance transparency in the credit market and ensure that banks pass on the lower cost of fund to their customers.
  • Loan pricing will be done by adding base rate and a suitable spread depending on the credit risk premium.

Fixed Interest Rate

  • The fixed interest rate on loan means repayment of loans in fixed equal installments over the entire period of the loan.
  • In this case, the interest rate doesn’t change with market fluctuations.

Floating Interest Rate

  • Floating interest rate by name implies that the rate of interest varies with market conditions.
  • The drawback with floating interest rates is the uneven nature of monthly installments.
RBI Notifications

India declared free of Avian Influenza

Mains Paper 3 : Economics Of Animal-Rearing |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Avian flu

Mains level : Zoonotic diseases and their prevention


News

  • India has been declared free of Avian Influenza (H5N1).
  • The status will last only till another outbreak is reported. India was last declared free of the disease in 2017.

How H5N1 affects humans?

  • Avian Influenza was first reported from Hongkong in 1997. Since then, there have been many outbreaks across the world. India too has had multiple outbreaks since 2005.
  • The symptoms of an H5N1 infection in humans include mild upper respiratory tract infection (fever and cough), early sputum production and rapid progression to severe pneumonia.
  • It can lead to sepsis with shock, acute respiratory distress syndrome and even death.

Significance of the declaration

  • This declaration is important not just from the poultry industry standpoint, but also because humans can contact the disease from animals though the pathogen is not capable of sustained human-to-human transmission.
  • Humans can be infected with avian, swine and other zoonotic influenza viruses, such as avian influenza virus subtypes A(H5N1), A(H7N9), and A(H9N2) and swine influenza virus subtypes A(H1N1), A(H1N2) and A(H3N2),” says WHO.
Animal Husbandry, Dairy & Fisheries Sector – Pashudhan Sanjivani, E- Pashudhan Haat, etc

Chandrayaan-2 Mission

Mains Paper 3 : Awareness In The Fields Of It, Space, Computers, Robotics, Nano-Technology, Bio-Technology |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Chandrayan 2

Mains level : Significance of the Mission


News

  • The Vikram lander of the Chandrayaan-2 failed to make a smooth soft-landing, unable to bring down its speed to the required level.
  • The Vikram lander and Pragyan rover were supposed to land on the moon and carry out observations and experiments for 14 days.

Why it was difficult?

  • The polar regions of the moon are a very different, and difficult, terrain.
  • Many parts lie in a completely dark region where sunlight never reaches, and temperatures can go below 230 degree Celsius.
  • Lack of sunlight and extreme low temperatures create difficulty in operation of instruments.
  • In addition, there are large craters all over the place, ranging from a few cm in size to those extending to several thousands of kilometres.

About the Chandrayaan Mission

Chandrayaan-2 Mission

ISRO Missions and Discoveries

[pib] National Animal Disease Control Programme

Mains Paper 3 : Economics Of Animal-Rearing |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : FMD

Mains level : About the initiative


News

  • Prime Minister will be launching National Animal Disease Control Programme for Foot and Mouth Disease and Brucellosis today.

National Animal Disease Control Programme

  • The programme for Foot and Mouth Disease and Brucellosis is a 100% centrally funded programme, with a total outlay of Rs.12,652 crore from 2019 to 2024.
  • It aims to control Foot and Mouth Disease and Brucellosis by 2025 with vaccination and eventual eradication by 2030.

 About FMDs

  • Foot and mouth disease (FMD) is a severe, highly contagious viral disease of livestock that has a significant economic impact.
  • The disease affects cattle, swine, sheep, goats and other cloven-hoofed ruminants.
  • Intensively reared animals are more susceptible to the disease than traditional breeds.
  • The disease is rarely fatal in adult animals, but there is often high mortality in young animals due to myocarditis or, when the dam is infected by the disease, lack of milk.
  • FMD is characterised by fever and blister-like sores on the tongue and lips, in the mouth, on the teats and between the hooves.
  • The disease causes severe production losses, and while the majority of affected animals recover, the disease often leaves them weakened and debilitated.
  • FMD is found in all excretions and secretions from infected animals. Notably, these animals breathe out a large amount of aerosolised virus, which can infect other animals via the respiratory or oral routes.
  • The virus may be present in milk and semen for up to 4 days before the animal shows clinical signs of disease.
Animal Husbandry, Dairy & Fisheries Sector – Pashudhan Sanjivani, E- Pashudhan Haat, etc

[pib] 28th Indo–Thai CORPAT

Mains Paper 3 : Various Security Forces, Agencies & Their Mandates |

Note4Students

From UPSC perspective, the following things are important :

Prelims level : About the Exercise

Mains level : UNCLOS


News

  • 28th edition of India-Thailand Coordinated Patrol (Indo-Thai CORPAT) between the Indian Navy (IN) and the Royal Thai Navy (RTN) is being conducted from 05 – 15 September 2019.

About the exercise

  • Indian Navy has been participating in the biannual Coordinated Patrol (CORPAT) with the Royal Thai Navy (RTN) since 2003.
  • The Objectives of the Indo-Thai CORPAT are to ensure effective implementation of United Nations Conventions on Laws of the Sea (UNCLOS).
  • UNCLOS specify regulations regarding protection and conservation of natural resources, conservation of marine environment, prevention and suppression of illegal, unregulated fishing activity/ drug trafficking/ piracy, exchange of information in prevention of smuggling, illegal immigration and conduct of Search and Rescue operations at sea.

Back2Basics

UNCLOS

  • The convention is also sometimes referred to as the Law of the Sea Convention or the Law of the Sea treaty.
  • It defines the rights and responsibilities of nations with respect to their use of the world’s oceans, establishing guidelines for businesses, the environment, and the management of marine natural resources.
  • It came into operation and became effective from 16th November 1982.
  • Before the nautical law of UNCLOS came into force, there existed a school of thought known as freedom-of-the-seas.
  • This doctrine had first come into operation during the 17th As per this law, there were no limits or boundaries set to the aspect of marine business and commercial activities.
  • Over-exploitation of the sea’s resources was immensely felt towards the middle of the 20th century and many nations started feeling the need to ensure protection of their marine resources.
  • Features defined by the UNCLOS are as follows:

Indian Ocean Power Competition