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Subject: Governance

Important aspects of Society

  • Ensuring a sustainable vaccination programme

    Context

    COVID-19, which disrupted supply chains across countries and in India too, marks an inflection point in the trajectory of immunisation programmes.

    UIP: Showcasing India’s strength in managing large scale vaccination

    • India’s Universal Immunisation Programme (UIP), launched in 1985 to deliver routine immunisation, showcased its strengths in managing large-scale vaccine delivery.
    • This programme targets close to 2.67 crore newborns and 2.9 crore pregnant women annually.
    • Full immunisation: To strengthen the programme’s outcomes, in 2014, Mission Indradhanush was introduced to achieve full immunisation coverage of all children and pregnant women at a rapid pace — a commendable initiative.
    • India’s UIP comprises upwards of 27,000 functional cold chain points of which 750 (3%) are located at the district level and above; the remaining 95% are located below the district level.
    • The COVID-19 vaccination efforts relied on the cold chain infrastructure established under the UIP to cover 87 crore people with two doses of the vaccine and over 100 crore with at least a single dose.

    Why strong service delivery network is essential?

    • While we have, over the years, set up a strong service delivery network, the pandemic showed us that there were weak links in the chain, especially in the cold chain.
    • Nearly half the vaccines distributed around the world go to waste, in large part due to a failure to properly control storage temperatures.
    • In India, close to 20% of temperature-sensitive healthcare products arrive damaged or degraded because of broken or insufficient cold chains, including a quarter of vaccines.
    • Wastage has cost implications and can delay the achievement of immunisation targets.

    Measures and initiatives in strengthening vaccine supply chains

    • The Health Ministry has been digitising the vaccine supply chain network in recent years through the use of cloud technology, such as with the Electronic Vaccine Intelligence Network (eVIN).
    • Developed with support from Gavi, the Vaccine Alliance, and implemented by the UN Development Programme through a smartphone-based app, the platform digitises information on vaccine stocks and temperatures across the country.
    • This supports healthcare workers in the last mile in supervising and maintaining the efficiency of the vaccine cold chain.

    Way forward

    • Electrification: There is a need to improve electrification, especially in the last mile, for which the potential of solar-driven technology must be explored to integrate sustainable development.
    • For instance, in Chhattisgarh, 72% of the functioning health centres have been solarised to tackle the issue of regular power outages.
    • This has significantly reduced disruption in service provision and increased the uptake of services.

    Conclusion

    India has pioneered many approaches to ensure access to public health services at a scale never seen before. Robust cold chain systems are an investment in India’s future pandemic preparedness; by taking steps towards actionable policies that improve the cold chain, we have an opportunity to lead the way in building back better and stronger.

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  • Public health engineering

    Context

    As we confront the public health challenges emerging out of environmental concerns, expanding the scope of public health/environmental engineering science becomes pivotal.

    Why does India need a specialised cadre of public health engineers

    • Achieving SDGs and growing demand for water consumption: For India to achieve its sustainable development goals of clean water and sanitation and to address the growing demands for water consumption and preservation of both surface water bodies and groundwater resources, it is essential to find and implement innovative ways of treating wastewater.
    •  It is in this context why the specialised cadre of public health engineers, also known as sanitation engineers or environmental engineers, is best suited to provide the growing urban and rural water supply and to manage solid waste and wastewater.
    • Limited capacity: The availability of systemic information and programmes focusing on teaching, training, and capacity building for this specialty cadre is currently limited.
    • Currently in India, civil engineering incorporates a course or two on environmental engineering for students to learn about wastewater management as a part of their pre-service and in-service training.
    • However, the nexus between wastewater and solid waste management and public health issues is not brought out clearly.
    • India aims to supply 55 litres of water per person per day by 2024 under its Jal Jeevan Mission to install functional household tap connections.
    • The goal of reaching every rural household with functional tap water can be achieved in a sustainable and resilient manner only if the cadre of public health engineers is expanded and strengthened.
    • Different from the international trend: In India, public health engineering is executed by the Public Works Department or by health officials. This differs from international trends.

    Way forward

    • Introducing public health engineering as a two-year structured master’s degree programme or through diploma programmes for professionals working in this field must be considered to meet the need of increased human resource in this field.
    • Interdisciplinary field: Furthermore, public health engineering should be developed as an interdisciplinary field.
    • Engineers can significantly contribute to public health in defining what is possible, identifying limitations, and shaping workable solutions with a problem-solving approach.
    • Public health engineering’s combination of engineering and public health skills can also enable contextualised decision-making regarding water management in India.

    Conclusion

    Diseases cannot be contained unless we provide good quality and adequate quantity of water. Most of the world’s diseases can be prevented by considering this. Training our young minds towards creating sustainable water management systems would be the first step.

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  • Report flags Risk of Fortified Rice

    A report has flagged issues due to threats posed to anaemic persons over iron over-nutrition created by rice fortification.

    Highlights of the report

    • No prior education: The activists discovered that neither field functionaries nor beneficiaries had been educated about the potential harms.
    • No warnings issued: There were no warning labels despite the food regulator’s rules on fortified foods.
    • No informed choice: The right to informed choices about one’s food is a basic right. In the case of rice fortification, it is seen that no prior informed consent was ever sought from the recipients.

    What are the risks highlighted?

    • Thalassemia, sickle cell anaemia and malaria are conditions where there is already excess iron in the body, whereas TB patients are unable to absorb iron.
    • Consumption of iron-fortified foods among patients of these diseases can reduce immunity and functionality of organs.

    Endemic zones identified

    • Jharkhand is an endemic zone of sickle cell disorder and thalassemia, with a prevalence of 8%-10%, which is twice the national average.
    • Jharkhand is also an endemic zone for malaria — in 2020, the State ranked third in the country in malaria deaths.

    What is Fortification?

    • The Food Safety and Standards Authority of India (FSSAI) has explicitly defined fortification.
    • It involves deliberate increasing of the content of essential micronutrients in a food so as to improve the nutritional quality of food and to provide public health benefit with minimal risk to health.

    Types of food fortification

    Food fortification can also be categorized according to the stage of addition:

    1. Commercial and industrial fortification (wheat flour, cornmeal, cooking oils)
    2. Biofortification (breeding crops to increase their nutritional value, which can include both conventional selective breeding, and genetic engineering)
    3. Home fortification (example: vitamin D drops)

    How is fortification done for rice?

    • Various technologies are available to add micronutrients to regular rice, such as coating, dusting, and ‘extrusion’.
    • The last mentioned involves the production of fortified rice kernels (FRKs) from a mixture using an ‘extruder’ machine.
    • It is considered to be the best technology for India.
    • The fortified rice kernels are blended with regular rice to produce fortified rice.

    How does the extrusion technology to produce FRK work?

    • Dry rice flour is mixed with a premix of micronutrients, and water is added to this mixture.
    • The mixture is passed through a twin-screw extruder with heating zones, which produces kernels similar in shape and size to rice.
    • These kernels are dried, cooled, and packaged for use. FRK has a shelf life of at least 12 months.
    • As per guidelines issued by the Ministry of Consumer Affairs, Food and Public Distribution, the shape and size of the fortified rice kernel should “resemble the normal milled rice as closely as possible”.
    • According to the guidelines, the length and breadth of the grain should be 5 mm and 2.2 mm respectively.

    But why does rice have to be fortified in the first place?

    • India has very high levels of malnutrition among women and children.
    • According to the Food Ministry, every second woman in the country is anaemic and every third child is stunted.
    • Fortification of food is considered to be one of the most suitable methods to combat malnutrition.
    • Rice is one of India’s staple foods, consumed by about two-thirds of the population. Per capita rice consumption in India is 6.8 kg per month.
    • Therefore, fortifying rice with micronutrients is an option to supplement the diet of the poor.

    What are the standards for fortification?

    • Under the Ministry’s guidelines, 10 g of FRK must be blended with 1 kg of regular rice.
    • According to FSSAI norms, 1 kg of fortified rice will contain the following: iron (28 mg-42.5 mg), folic acid (75-125 microgram), and vitamin B-12 (0.75-1.25 microgram).
    • Rice may also be fortified with zinc (10 mg-15 mg), vitamin A (500-750 microgram RE), vitamin B-1 (1 mg-1.5 mg), vitamin B-2 (1.25 mg-1.75 mg), vitamin B-3 (12.5 mg-20 mg) and vitamin B-6 (1.5 mg-2.5 mg) per kg.

    How can a beneficiary distinguish between fortified rice and regular rice?

    • Fortified rice will be packed in jute bags with the logo (‘+F’) and the line “Fortified with Iron, Folic Acid, and Vitamin B12”.

    Advantages offered

    • Health: Fortified staple foods will contain natural or near-natural levels of micro-nutrients, which may not necessarily be the case with supplements.
    • Taste: It provides nutrition without any change in the characteristics of food or the course of our meals.
    • Nutrition: If consumed on a regular and frequent basis, fortified foods will maintain body stores of nutrients more efficiently and more effectively than will intermittently supplement.
    • Economy: The overall costs of fortification are extremely low; the price increase is approximately 1 to 2 percent of the total food value.
    • Society: It upholds everyone’s right to have access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger

    Issues with fortified food

    • Against nature: Fortification and enrichment upset nature’s packaging. Our body does not absorb individual nutrients added to processed foods as efficiently compared to nutrients naturally occurring.
    • Bioavailability: Supplements added to foods are less bioavailable. Bioavailability refers to the proportion of a nutrient your body is able to absorb and use.
    • Immunity issues: They lack immune-boosting substances.
    • Over-nutrition: Fortified foods and supplements can pose specific risks for people who are taking prescription medications, including decreased absorption of other micro-nutrients, treatment failure, and increased mortality risk.

     

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  • Actions that corrode the steel frame of India

    Context

    A letter war between two sets of retired public officials (civil servants, judges and army officers), concerning the prevailing political and social situation in the country, has been widely reported in the media.

    Role of civil service

    • It is the police and magistracy, judicial courts and other regulatory agencies — not politicians — which have been authorised and empowered by law to take preventive action against potential troublemakers, enforce the laws relating to criminal, economic and other offences, and maintain public order.
    • In mature democracies, self-respecting public officials normally discharge their constitutional and legal responsibilities with honesty, integrity and their own conscience, firmly resisting the dictates of the vested interests.

    Deterioration in the standard of civil service

    • The deterioration in standards was very visible during the National Emergency declared in 1975.
    • The civil services, like other institutions including the judiciary, just caved in; the trend might have accelerated over the years.
    • Now, no one even talks of civil service neutrality.
    • Earlier, during communal or caste riots, the Administration focused on quelling the disturbances and restoring peace in the affected locality, without ever favouring one group over the other.
    • Now, there are allegations of local officers taking sides in a conflict.
    • A civil servant’s pliant and submissive behaviour means an end to civil service neutrality and the norms and values that this trait demands, does not seem to bother either the political or bureaucratic leadership.
    • Despite the protection and safeguards in Article 311 of the Constitution, politicians could have a civil servant placed in an inconvenient position or even punish him.

    Norms and values associated with a civil servant

    • Norms: The norms that define neutrality are: independence of thought and action; honest and objective advice; candour and ,‘speaking truth to power’.
    • Values: Associated with these norms are the personal values that a civil servant cherishes or ought to cherish, namely, self-respect, integrity, professional pride and dignity.
    • All these together contribute to the enhancement of the quality of administration that benefits society and the people.

    Conclusion

    Constitutional morality is not a natural sentiment,” wrote B.R. Ambedkar, the architect of the Constitution and added, “It has to be cultivated. We must realise that our people have yet to learn it. Democracy in India is only a top dressing on an Indian soil which is essentially undemocratic.”

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  • [pib] NITI Aayog launches National Data & Analytics Platform (NDAP)

    NITI Aayog has launched the NDAP for open public use.

    Note: This portal has much useful data. We can use these to substantiate our answers in mains exam.

    What is NDAP?

    • The platform aims to democratize access to public government data by making data accessible, interoperable, interactive, and available on a user-friendly platform.
    • It hosts foundational datasets from various government agencies, presents them coherently, and provides tools for analytics and visualization.
    • NDAP follows a use-case-based approach to ensure that the datasets hosted on the platform are tailored to the needs of data users from government, academia, journalism, civil society, and the private sector.
    • All datasets are standardized to a common schema, which makes it easy to merge datasets and do cross-sectoral analysis.

    Types of datasets available

    1. Internal & External Affairs
    2. Agriculture, Fisheries and Animal Husbandry
    3. Socio-Economic development
    4. Power & Natural Resources
    5. Industries
    6. Finance
    7. Health
    8. Human Resources Development
    9. Science and Technology
    10. Consumer Affairs
    11. Transport
    12. Housing
    13. Culture and Tourism
    14. Communications

    Why need such data?

    • The rise of data and digital technologies are rapidly transforming economies and societies, with enormous implications for governments’ daily operations.
    • NDAP is a critical milestone – which aims to aid India’s progress by promoting data-driven disclosure, decision making and ensuring the availability of data connecting till the last mile.

     

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  • India Hypertension Control Initiative (IHCI)

    A project called the India Hypertension Control Initiative (IHCI) finds that nearly 23% out of 2.1 million Indians have uncontrolled blood pressure.

    What is the IHCI?

    • Recognizing that hypertension is a serious, and growing, health issue in India, the Health Ministry, the ICMR, State Governments, and WHO-India began a five-year initiative to monitor and treat hypertension.
    • The programme was launched in November 2017.
    • In the first year, IHCI covered 26 districts across five States — Punjab, Kerala, Madhya Pradesh, Telangana, and Maharashtra.
    • By December 2020, IHCI was expanded to 52 districts across ten States — Andhra Pradesh (1), Chhattisgarh (2), Karnataka (2), Kerala (4), Madhya Pradesh (6), Maharashtra (13), Punjab (5), Tamil Nadu (1), Telangana (13) and West Bengal (5).

    What is Hypertension?

    • Hypertension is defined as having systolic blood pressure level greater than or equal to 140 mmHg or diastolic blood pressure level greater than or equal to 90 mmHg.
    • The definition also assumes taking anti-hypertensive medication to lower his/her blood pressure.

    Why need IHCI?

    • India has committed to a “25 by 25” goal, which aims to reduce premature mortality due to non-communicable diseases (NCDs) by 25% by 2025.
    • To achieve India’s target of a 25%, approximately 4.5 crore additional people with hypertension need to get their BP under control by 2025.

    What has the IHCI found so far?

    • Its most important discovery so far is that nearly one-fourth of (23%) patients under the programme had uncontrolled blood pressure, and 27% did not return for a follow-up in the first quarter of 2021.
    • There were an estimated 20 crore adults with hypertension in the country.
    • There weren’t enough validated high-quality digital blood pressure monitors in several health facilities, which affected accuracy of hypertension diagnosis.

    How prevalent is the problem of hypertension?

    • About one-fourth of women and men aged 40 to 49 years have hypertension.
    • Southern States have a higher prevalence of hypertension than the national average, according to the latest edition of the National Family Health Survey.
    • While 21.3% of women and 24% of men aged above 15 have hypertension in the country, the prevalence is the highest in Kerala where 32.8% men and 30.9% women have been diagnosed with hypertension.
    • Kerala is followed by Telangana where the prevalence is 31.4% in men and 26.1% in women.

     

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  • MTP Act 2021

    Context

    The issue of abortion is in the news again, internationally.

    Criminal law provisions related to termination of pregnancy

    • Under the general criminal law of the country, i.e. the Indian Penal Code, voluntarily causing a woman with child to miscarry is an offence attracting a jail term of up to three years or fine or both, unless it was done in good faith where the purpose was to save the life of the pregnant woman.
    • A pregnant woman causing herself to miscarry is also an offender under this provision apart from the person causing the miscarriage, which in most cases would be a medical practitioner.

    Background of the MTP Act

    • In 1971, after a lot of deliberation, the Medical Termination of Pregnancy (MTP) Act was enacted.
    • This law is an exception to the IPC provisions above.
    • Who, when, where, why and by whom? The law sets out the rules — of when, who, where, why and by whom — for accessing an MTP.
    •  This law has been amended twice since, the most recent set of amendments being in the year 2021 which has, to some extent, expanded the scope of the law.
    • The law does not recognise and/or acknowledge the right of a pregnant person to decide on the discontinuation of a pregnancy.
    • The law provides for a set of reasons based on which an MTP can be accessed.

    Reasons allowed for MTP

    • Reasons: The continuation of the pregnancy would involve a risk to the life of the pregnant woman or result in grave injury to her physical or mental health.
    • The law explains that if the pregnancy is as a result of rape or failure of contraceptive used by the pregnant woman or her partner to limit the number of children or to prevent a pregnancy, the anguish caused by the continuation of such a pregnancy would be considered to be a grave injury to the mental health of the pregnant woman.
    • The other reason for seeking an MTP is the substantial risk that if the child was born, it would suffer from any serious physical or mental abnormality.
    •  A pregnant person cannot ask for a termination of pregnancy without fitting in one of the reasons set out in the law.
    • Gestational age of pregnancy: The other set of limitations that the law provides is the gestational age of the pregnancy.
    • The pregnancy can be terminated for any of the above reasons, on the opinion of a single registered medical practitioner up to 20 weeks of the gestational age.
    • From 20 weeks up to 24 weeks, the opinion of two registered medical practitioners is required.
    • Any decision for termination of pregnancy beyond 24 weeks gestational age, only on the ground of foetal abnormalities can be taken by a Medical Board as set up in each State, as per the law.
    • The law, as an exception to all that is stated above, also provides that where it is immediately necessary to save the life of the pregnant woman, the pregnancy can be terminated at any time by a single registered medical practitioner.

    Issues with the MTP Act provisions

    • While India legalised access to abortion in certain circumstances much before most of the world did the same, unfortunately, even in 2020 we decided to remain in the logic of 1971.
    • Right to health and right to life: By the time the amendments to the MTP Act were tabled before the Lok Sabha in 2020, a number of cases came before the courts.
    • In these cases, the courts had articulated the right of a pregnant woman to decide on the continuation of her pregnancy as a part of her right to health and right to life, and therefore non-negotiable.
    • Violation of right to privacy: In right to privacy judgment of the Supreme Court of India it was held that the decision making by a pregnant person on whether to continue a pregnancy or not is part of such a person’s right to privacy as well and, therefore, the right to life.
    • The standards set out in this judgment were also not incorporated in the amendments being drafted.
    • Not in sync with central laws: The new law is not in sync with other central laws such as the laws on persons with disabilities, on mental health and on transgender persons, to name a few.
    • In conflict with other laws: The amendments also did not make any attempts to iron out the conflations between the MTP Act and the Protection of Children from Sexual Offences (POCSO) Act or the Drugs and Cosmetics Act, to name a few.

    Conclusion

    While access to abortion has been available under the legal regime in the country, there is a long road ahead before it is recognised as a right of a person having the capacity to become pregnant to decide, unconditionally, whether a pregnancy is to be continued or not.

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  • Union Finance Ministry revises MPLADS Rules

    At a time when MPs have been asking for an increase in the MP Local Area Development Scheme (MPLADS) fund, the Union Finance Ministry has ordered revised rules, under which the interest that the fund accrues will be deposited in the Consolidated Fund of India.

    What is the MPLAD scheme?

    • The Members of Parliament Local Area Development Scheme (MPLADS) is a program first launched during the Narasimha Rao Government in 1993.
    • It was aimed towards providing funds for developmental works recommended by individual MPs.

    Funds available

    • The MPs then were entitled to recommend works to the tune of Rs 1 crore annually between 1994-95 and 1997-98, after which the annual entitlement was enhanced to Rs 2 crore.
    • The UPA government in 2011-12 raised the annual entitlement to Rs 5 crore per MP.

    Implementation

    • To implement their plans in an area, MPs have to recommend them to the District Authority of the respective Nodal District.
    • The District Authorities then identify Implementing Agencies that execute the projects.
    • The respective District Authority is supposed to oversee the implementation and has to submit monthly reports, audit reports, and work completion reports to the Nodal District Authority.
    • The MPLADS funds can be merged with other schemes such as MGNREGA and Khelo India.

    Guidelines for MPLADS implementation

    • The document ‘Guidelines on MPLADS’ was published by the Ministry of Statistics and Programme Implementation in June 2016 in this regard.
    • It stated the objective of the scheme to enable MPs to recommend works of developmental nature with emphasis on the creation of durable community assets based on the locally felt needs in their Constituencies.
    • Right from the inception of the Scheme, durable assets of national priorities viz. drinking water, primary education, public health, sanitation, and roads, etc. should be created.
    • It recommended MPs to works costing at least 15 percent of their entitlement for the year for areas inhabited by Scheduled Caste population and 7.5 percent for areas inhabited by ST population.
    • It lays down a number of development works including construction of railway halt stations, providing financial assistance to recognized bodies, cooperative societies, installing CCTV cameras etc.

    Answer this PYQ in the comment box:

    With reference to the funds under the Members of Parliament Local Area Development Scheme (MPLADS), which of the following statements are correct? (CSP 2020)

    1. MPLADS funds must be used to create durable assets like physical infrastructure for health, education, etc.
    2. A specified portion of each MP’s fund must benefit SC/ST populations.
    3. MPLADS funds are sanctioned on a yearly basis and the unused funds cannot be carried forward to the next year.
    4. The district authority must inspect at least 10% of all works under implementation every year.

    Select the correct answer using the code given below:

    (a) 1 and 2 only

    (b) 3 and 4 only

    (c) 1, 2 and 3 only

    (d) 1, 2 and 4 only

     

    [wpdiscuz-feedback id=”8vgi4pxuwk” question=”Please leave a feedback on this” opened=”1″]Post your answers here.[/wpdiscuz-feedback]

     

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  • Extreme Poverty down in India

    Context

    A recent World Bank Report has shown that extreme poverty in India more than halved between 2011 and 2019 – from 22.5 per cent to 10.2 per cent.  The reduction was higher in rural areas, from 26.3 per cent to 11.6 per cent.

    What explains the reduction in poverty?

    • Poverty has reduced significantly because of the government’s thrust on improving the ease of living of ordinary Indians through schemes.
    • These schemes include the Ujjwala Yojana, PM Awas Yojana, Swachh Bharat Mission, Jan Dhan and Mission Indradhanush in addition to the Deendayal Antyodaya Yojana-National Rural Livelihood Mission and improved coverage under the National Food Security Act.
    • It is important to understand how poverty in rural areas was reduced at a faster pace.
    • Much of the success can be credited to all government departments, especially their janbhagidari-based thrust on pro-poor public welfare.

    Contributing factors

    1] Identification of beneficiaries through SECC 2011

    • The identification of deprived households on the basis of the Socioeconomic and Caste Census (SECC) 2011 across welfare programmes helped in creating a constituency for the well-being of the poor, irrespective of caste, creed or religion.
    • Deprivation criterion: Since deprivation was the key criterion in identifying beneficiaries, SC and ST communities got higher coverage and the erstwhile backward regions in Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh, Jharkhand, Odisha, Chhattisgarh, Assam, Rajasthan and rural Maharashtra got a larger share of the benefits.
    • Gram Sabha Validation: Social groups that often used to be left out of government programmes were included and gram sabha validation was taken to ensure that the project reached these groups.

    2] Widened coverage of women

    • The coverage of women under the Deendayal Antyodaya Yojana and Self Help Groups (SHG) increased from 2.5 crore in 2014 to over 8 crore in 2018 as a result of more than 75 lakh SHGs working closely with over 31 lakh elected panchayati raj representatives, 40 per cent of whom are women.
    • This provided a robust framework to connect with communities and created a social capital that helped every programme.
    • The PRI-SHG partnership catalysed changes that increased the pace of poverty reduction and the use of Aadhaar cleaned up corruption at several levels and ensured that the funds reached those whom it was meant for.

    3] Creation of basic infrastructure

    • Finance Commission transfers were made directly to gram panchayats leading to the creation of basic infrastructure like pucca village roads and drains at a much faster pace in rural areas.
    • The high speed of road construction under the Pradhan Mantri Gram Sadhak Yojana created greater opportunities for employment in nearby larger villages/census towns/kasbas by improving connectivity and enhancing mobility.

    4] Availability of credit through SHGs

    • The social capital of SHGs ensured the availability of credit through banks, micro-finance institutions and MUDRA loans.
    • Livelihood diversification: The NRLM prioritised livelihood diversification and implemented detailed plans for credit disbursement.

    5]  Implementation of social sector schemes

    • In the two phases of the Gram Swaraj Abhiyan in 2018, benefits such as gas and electricity connections, LED bulbs, accident insurance, life insurance, bank accounts and immunisation were provided to 63974 villages that were selected because of their high SC and ST populations.
    • The performance of line departments went up manifold due to community-led action.
    • The gains are reflected in the findings of the National Family Health Survey V, 2019-2021.

    6] Universal coverage schemes

    • The thrust on universal coverage for individual household latrines, LPG connections and pucca houses for those who lived in kuccha houses ensured that no one was left behind. This created the Labarthi Varg.

    7] Increase in fund transfer to rural area

    • Seventh, this was also a period in which a high amount of public funds were transferred to rural areas, including from the share of states and, in some programmes, through extra-budgetary resources.

    8] Community participation

    • The thrust on a people’s plan campaign, “Sabki Yojana Sabka Vikas” for preparing the Gram Panchayat Development Plans and for ranking villages and panchayats on human development, economic activity and infrastructure, from 2017-18 onwards, laid the foundation for robust community participation involving panchayats and SHGs, especially in ensuring accountability.

    9] Social and concurrent audit

    • Through processes like social and concurrent audits, efforts were made to ensure that resources were fully utilised.
    • Several changes were brought about in programmes like the MGNREGS to create durable and productive assets.

    10] Focus of states on improving livelihood diversification

    • The competition among states to improve performance on rural development helped.
    • Irrespective of the party in power, nearly all states and UTs focussed on improving livelihood diversification in rural areas and on improving infrastructure significantly.

    Conclusion

    All these factors contributed to improved ease of living of deprived households and improving their asset base. A lot has been achieved, much remains to be done.

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  • Highlights of the National Family Health Survey (NFHS) 5 Part: II

    The Total Fertility Rate (TFR), the average number of children per woman, has further declined from 2.2 to 2.0 at the national level between National Family Health Survey (NFHS) 4 and 5.

    What is NFHS?

    • The NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
    • The IIPS is the nodal agency, responsible for providing coordination and technical guidance for the NFHS.
    • NFHS was funded by the United States Agency for International Development (USAID) with supplementary support from United Nations Children’s Fund (UNICEF).
    • The First National Family Health Survey (NFHS-1) was conducted in 1992-93.

    Objectives of the NFHS

    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
    • Anaemia
    • Utilization and quality of health and family planning services

    Modifications in NFHS 5

    NFHS-5 includes new focal areas that will give requisite input for strengthening existing programmes and evolving new strategies for policy intervention. The areas are:

    • Expanded domains of child immunization
    • Components of micro-nutrients to children
    • Menstrual hygiene
    • Frequency of alcohol and tobacco use
    • Additional components of non-communicable diseases (NCDs)
    • Expanded age ranges for measuring hypertension and diabetes among all aged 15 years and above.

    Highlights of the NFHS 5 Part-II

    (a) Fertility Rate

    • There are only five States — Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26) Manipur (2.17) —which are above replacement level of fertility of 2.1.

    (b) Institutional Births

    • The institutional births increased from 79% to 89% across India and in rural areas around 87% births being delivered in institutions and the same is 94% in urban areas.
    • As per results of the NFHS-5, more than three-fourths (77%) children aged between 12 and 23 months were fully immunised, compared with 62% in NFHS-4.
    • The level of stunting among children under five years has marginally declined from 38% to 36% in the country since the last four years.
    • Stunting is higher among children in rural areas (37%) than urban areas (30%) in 2019-21.

    (c) Decision making

    • The extent to which married women usually participate in three household decisions (about health care for herself; making major household purchases; visit to her family or relatives) indicates that their participation in decision-making is high, ranging from 80% in Ladakh to 99% in Nagaland and Mizoram.
    • Rural (77%) and urban (81%) differences are found to be marginal.
    • The prevalence of women having a bank or savings account has increased from 53% to 79% in the last four years.

    (d) Rise in obesity

    • Compared with NFHS-4, the prevalence of overweight or obesity has increased in most States/UTs in NFHS-5.
    • At the national level, it increased from 21% to 24% among women and 19% to 23% among men.
    • More than a third of women in Kerala, Andaman and Nicobar Islands, AP, Goa, Sikkim, Manipur, Delhi, Tamil Nadu, Puducherry, Punjab, Chandigarh and Lakshadweep (34-46 %) are overweight or obese.

     

    Also read

    National Family Health Survey- 5 Part: I

     

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