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Subject: Governance

Important aspects of Society

  • Global digital governance

    digital governanceContext

    • In an interview earlier this month, Telecom Minister Ashwini Vaishnaw spoke about a comprehensive policy roadmap for India’s digital economy and digital governance.

    What is digital governance ?

    • Electronic governance or e-governance can be defined as the usage of Information and Communication Technology (ICT) by the government to provide and facilitate government services, exchange of information, communication transactions and integration of various standalone systems and services.

    What is “global digital governance”?

    • Global digital governance encompasses the norms, institutions, and standards that shape the regulation around the development and use of these technologies. Digital governance has long-term commercial and political implications.

    Why is it important?

    • The main objective of e-governance is to provide a friendly, affordable, and efficient interface between a government and its people. It is about ensuring greater transparency, accountability and objectivity, resulting in cost-effective and high-quality public service.

    What are the three domains of e-governance?

    • E-administration: improving government processes
    • E-services: connecting individual citizens with their government
    • E-society: building interactions with and within civil society.

    digital governanceIs there a historical parallel to governing key economic sectors globally?

    • Digital economy is not unprecedented: Sectors critical to the global economy are subject to international cooperation frameworks and pacts. Therefore, the idea of setting up a single multilateral organization with a mandate to govern the digital economy is not unprecedented.
    • The International Commission for Air Navigation (ICAN): Global aviation has been regulated since 1903 when the International Commission for Air Navigation (ICAN) first met, subsequently replaced by the International Civil Aviation Organization (ICAO) in 1947.
    • Bank for International Settlements (BIS): Similarly, the modern international banking system is governed by the Bank for International Settlements (BIS), an institution initially set up in the interwar period in 1930 to oversee Germany’s reparations to the Allies under the Treaty of Versailles. The BIS acquired a more global mandate beginning in the 1950s and is now partially responsible for global financial stability.

    Who are the key players in the global contest for digital governance?

    • China seeks to champion the concept of cyber sovereignty: An authoritarian vision drives the first model. Most notably, China is emerging as the standard-bearer for this model with its desire to “reinvent the internet.” China seeks to champion the concept of “cyber sovereignty,” allowing countries to control access to the internet, censor content, and institute data localization requirements, as a pretext to protecting individual national interests.
    • European Union’s General Data Protection Regulation (GDPR): Which provides a more democratic concept for digital governance. This model primarily seeks to protect the privacy and rights of internet users and online content consumers. Adopted with the overwhelming support of the European Parliament in 2014, the GDPR came into effect in May 2018, giving firms that rely on digital technologies the opportunity to modify their data usage and privacy policies. The adoption of the GDPR has been a turning point for global internet governance as consumers gained unprecedented control over their data in a manner that preserved freedom and openness online.

    digital governanceWhy global digital governance is important?

    • Minimum rights and protections for platform workers: Under the G20, the International Labour Organisation has already placed a proposal in the employment working group for digital labour platforms to develop an international governance system determining minimum rights and protections for platform workers.
    • Implementation of central bank digital currency projects: Similarly, on digital money, a reincarnated Bretton Woods is being advocated to address the distrust in private currencies and to coordinate the implementation of central bank digital currency projects.
    • Digital taxation: Finally, in the deeply contested area of digital taxation, the OECD facilitated Base Erosion and Profit Shifting (BEPS) negotiations and helped arrive at a global solution.
    • Digital sovereignty: The internet is splintering and digital sovereignty is now commonplace; yet, there is no better time for countries to come together and build a framework for global digital governance.

    digital governanceWhat are the big 5 tech companies called?

    • The Big Five tech giants—Apple, Amazon, Google (Alphabet), Meta, and Microsoft.

    Conclusion

    • The rapid digitalisation of the world along with a new focus on trust in the global supply chains for digital products and services presents tremendous opportunities for India and its youth.  It is now up to all of us to engage in a collective “sabka prayas” to realise New India’s economic potential.

    Mains question

    Q. The rapid digitalisation of the world along with a new focus on trust in the global supply chains for digital products and services presents tremendous opportunities for India. Comment.

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  • Eklavya Schools get short shrift in teacher recruitments

    The Ministry of Tribal Affairs has so far been unable to fix the teacher shortage faced across 378 of Eklavya model residential schools (EMRS) that are currently functional.

    Eklavya Model Residential Schools (EMRS)

    • EMRS started in the year 1997-98 to impart quality education to Scheduled Tribes (ST) children in remote areas in order.
    • It aims to enable them to avail of opportunities in high and professional educational courses and get employment in various sectors.
    • The schools focus not only on academic education but on the all-round development of the students.
    • Each school has a capacity of 480 students, catering to students from Class VI to XII.
    • Hitherto, grants were given for construction of schools and recurring expenses to the State Governments under Grants under Article 275 (1) of the Constitution.
    • Eklavya schools are on par with Navodaya Vidyalaya and have special facilities for preserving local art and culture besides providing training in sports and skill development.

    Features of Eklavya Schools

    • Admission to these schools will be through selection/competition with suitable provision for preference to children belonging to Primitive Tribal Groups, first-generation students, etc.
    • Sufficient land would be given by the State Government for the school, playgrounds, hostels, residential quarters, etc., free of cost.
    • The number of seats for boys and girls will be equal.
    • In these schools, education will be entirely free.

    Where are the Eklavya schools located?

    • It has been decided that by the year 2022, every block with more than 50% ST population and at least 20,000 tribal persons, will have an EMRS.
    • Wherever density of ST population is higher in identified Sub-Districts (90% or more), it is proposed to set up Eklavya Model Day Boarding School (EMDBS) on an experimental basis.
    • They aim for providing additional scope for ST Students seeking to avail school education without residential facility.

     

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  • Centre cites law to deny medical seats to Ukraine-returnees

    medical

    The Centre has told the Supreme Court that the law does not allow undergraduate medical students, who fled the “war-like situation” in Ukraine, to be accommodated in Indian medical colleges.

    Which laws is the govt talking about?

    • There are no provisions either under the Indian Medical Council Act, 1956, or the National Medical Commission Act, 2019 to accommodate or transfer medical students.
    • Till now, no permission has been given by the National Medical Commission to transfer or accommodate any foreign medical students in any Indian medical institute/university.

    Why foreign undergraduates are not permitted?

    • Absence of law: The extant regulations in India do not permit migration of students from foreign universities to India.
    • No backdoor entry: The public notice cannot be used as a back door entry into Indian colleges offering undergraduate courses.
    • Merit issue: The students had left for foreign universities for two reasons, poor marks in the National Eligibility cum Entrance Test (NEET) and affordability of medical education in foreign countries.
    • High cost: Besides, these students, if admitted in Indian colleges, would again face the problem of affordability.

    Why do Indians go abroad for medical studies?

    • According to estimates from Ukraine, reported in the media, around 18,000 Indian students are in Ukraine (before Operation Ganga).
    • Most of them are pursuing medicine.
    • This war has turned the spotlight on something that has been the trend for about three decades now.

    Preferred countries for a medical degree

    • For about three decades now, Indian students have been heading out to Russia, China, Ukraine, Kyrgyzstan, Kazakhstan, and Philippines to pursue a medical degree.

    Hype of becoming a Doctor

    • Prestige: The desire to study medicine still holds a lot of value in the Indian community (the other is becoming an IAS officer).
    • Shortages of Doctor: In many rural areas, people still look at doctors as god’s incarnate.
    • Rarity of opportunity: The lack of equal opportunities exacerbated by the caste factor in the Indian context, has a great deal of impact on the prestige still associated with being a doctor.
    • Social upliftment ladder: For years, certain communities were denied the opportunities, and finally they do have a chance at achieving significant educational status.

    Why do Indians prefer going abroad?

    • No language barrier: The medium of education for these students is English, a language they are comfortable with.
    • Affordability: The amount spent on living and the medical degree are far more affordable than paying for an MBBS seat in private medical colleges in India.
    • Aesthetics and foreign culture: People are willing to leave their home to study far away in much colder places and with completely alien cultures and food habits.
    • Practice and OPD exposure: It broadens students’ mind and thinking, expose them to a whole range of experiences, and their approach to issues and crises is likely to be far better.

    Doesn’t India have enough colleges?

    (a) More aspirants than seats

    • There are certainly far more MBBS aspirants than there are MBBS seats in India.
    • In NEET 2021, as per a National Testing Agency press release, 16.1 lakh students registered for the exam, 15.4 lakh students appeared for the test, and 8.7 lakh students qualified.
    • As per data from the National Medical Commission (NMC), in 2021-22, there were 596 medical colleges in the country with a total of 88,120 MBBS seats.
    • While the skew is in favour of Government colleges, it is not greatly so, with the number of private medical institutions nearly neck-to-neck with the state-run ones.

    (b) Fees structure

    • That means over 50% of the total seats are available at affordable fees in Government colleges.
    • Add the 50% seats in the private sector that the NMC has mandated must charge only the government college fees.
    • In fully private colleges, the full course fees range from several lakhs to crores.

    (c) Uneven distribution of colleges

    • These colleges are also not distributed evenly across the country, with States such as Maharashtra, Karnataka, Tamil Nadu and Kerala having many more colleges.

    What about costs?

    • The cost factor on both sides of an MBBS degree is significant.
    • The costs of an MBBS degree in a Government college tot up to a few lakhs of rupees for the full course, but in a private medical college, it can go up to ₹1 crore for the five-year course.
    • In case it is a management seat, capitation fees can inflate the cost by several lakhs again.
    • Whereas, an MBBS course at any foreign medical university in the east and Eastern Europe costs far less (upto ₹30lakh-₹40 lakh).

    Way forward

    • While PM Modi emphasised that more private medical colleges must be set up in the country to aid more people to take up MBBS, medical education experts have called for pause on the aspect.
    • If the aim is to make medicine more accessible to students of the country, the path ahead is not in the private sector, but in the public sector, with the Central and State governments’ involvement.
    • Starting private medical colleges by reducing the strict standards set for establishing institutes may not actually be the solution to this problem, if we think this is a concern.

    Conclusion

    • Creating more medical colleges will be beneficial for the country, if access and availability can be ensured.
    • This will not be possible by resorting to private enterprise only.
    • The State and Central governments can start more medical colleges, as recommended by NITI Aayog, by utilising district headquarters hospitals, and expanding the infrastructure.
    • This way, students from the lower and middle socio-economic rung, who are otherwise not able to access medical seats, will also benefit.

     

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  • Tamil Nadu’s new Breakfast Scheme in Schools

    breakfast

    Tamil Nadu CM has launched the Chief Minister’s Breakfast Scheme for students of Class I to V in government schools.

    CM’s Breakfast Scheme

    • The scheme covers around 1.14 lakh students in 1,545 schools which include 417 municipal corporation schools, 163 municipality schools and 728 taluk and village panchayat-level schools.
    • The inauguration of the scheme marks an important milestone in the State’s history of providing free meals to school students.

    How has the idea evolved?

    (a) Pre-independence

    • In November 1920, the Madras Corporation Council approved a proposal for providing tiffin to the students of a Corporation School at Thousand Lights at a cost not exceeding one anna per student per day.
    • Theagaraya Chetty, the then President of the Corporation and one of the stalwarts of the Justice Party, said the boys studying at the school were poor, which affected the strength of the institution ‘greatly’.
    • The scheme, which was extended to four more schools and facilitated higher enrollment of students.

    (b) Post-independence

    • The concept saw a Statewide application in 1956 when the then CM K. Kamaraj decided to provide free noon meal to poor children in all primary schools across the State.
    • The Budget for 1956-57 contained a provision for supplying mid-day meals to schoolchildren for 200 days a year, initially covering 65,000 students in 1,300 feeding centres.
    • In July 1982, it was left to the then CM MG Ramachandran to extend the programme to children in the 2-5 age group in Anganwadis and those in 5-9 age group in primary schools in rural areas.
    • Subsequently, the scheme now called Puratchi Thalaivar MGR Nutritious Meal Programme — was extended to urban areas as well.
    • Since September 1984, students of standards VI to X have been covered under the scheme.

    Beneficiaries of the programme

    • As of now, there are nearly 7 lakh beneficiaries spread over 43,190 nutritious meal centres.
    • This includes around 3,500 students of National Child Labour Project (NCLP) special schools.
    • Besides, as a consequence of the collaborative implementation of the Integrated Child Development Scheme (ICDS) and the nutritious meal programme, around 15.8 lakh children in the age group of 2+ to 5+ years receive nutritious meals.

    Impact on school education

    • Rise in enrolment: After the improved version of the mid-day meal scheme in 1982, the Gross Enrollment Ratio (GER) at primary level (standards I to V) went up by 10% during July-September, 1982 as compared to the corresponding period in 1981.
    • Girls’ enrolment: The rise in boys’ enrollment was 12% and in the case of girls, 7%, according to a publication brought out by the Tamil Nadu government on the occasion of the launch of the Scheme.
    • Increase in attendance: Likewise, attendance during July-September 1982 rose by 33% over the previous year’s figure.

    Focus areas programme

    • Anaemia is a major health problem in Tamil Nadu, especially among women and children, says the 2019-21 National Family Health Survey (NFHS)-5’s report.
    • From 50% during the period of the 2015-16 NFHS-4, the prevalence of anaemia in children now went up to 57%.
    • This and many other health issues can be addressed through the combined efforts of the departments of School Education, Public Health and Social Welfare and Women Empowerment.
    • Besides, a continuous and rigorous review of the progress of the scheme and nutritious meal programme should be carried out in a sustained manner.

     

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  • Delay in govt.’s flagship PMAY-G scheme to invite penalty

    Pulling up the States for the delay in completion of the government’s flagship rural household scheme — Pradhan Mantri Awas Yojana –Gramin (PMAY-G) — the Union Ministry of Rural Development has come up with a set of penalties that the State governments will have to bear for any further delay.

    About PMAY-G Scheme

    • In pursuance of the goal – Housing for all by 2022, the rural housing scheme Indira Awas Yojana was revamped to PMAY-G and approved during March 2016.
    • The main aim of the PMAY-G scheme is to provide pucca house with some of the basic amenities.
    • This scheme is meant for people who do not own a house and people who live in kutcha houses or houses which are severely damaged.
    • At present, the minimum size of the houses to be built under the PMAY-G scheme has been increased to 25 sq. mt. from 20 sq. mt.
    • Under PMAY, the cost of unit assistance is to be shared between Central and State Governments in the ratio 60:40 in plain areas and 90:10 for North Eastern and hilly states.

    Subsidies under PMAY – G scheme

    There are various subsidies offered under PMAY G. These include:

    • Loans up to Rs. 70,000 from financial institution
    • Interest subsidy of 3%
    • Subsidy for the maximum principal amount is Rs. 2 lakh

    Why in news?

    • Opposition-ruled states such as West Bengal, Chhattisgarh and Odisha are the leading four States who are far behind their targets.
    • The initial deadline for the scheme was March 2022, which owing to the COVID-19 pandemic was extended by another two years till March 2024.

    What are the penalty provisions?

    • If the sanction of the house is delayed for more than one month from the date of issue of the target, the State government will be penalised.
    • The penal fees are per week ₹10 per house for the first month of delay and ₹20 per house for each subsequent month of delay.
    • Similarly, if the first instalment due to the beneficiary is delayed for more than seven days from the date of sanction, then the State governments will have to pay ₹10 per house per week of delay.

     

    Also read:

    Govt. extends PMAY-Urban scheme

     

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  • Fighting anaemia

    anaemiaContext

    • The recent National Family Health Survey (NFHS-5) data shows anaemia rates increased from 53 per cent to 57 per cent in women and 58 per cent to 67 per cent in children in 2019-21.

    Definition of anaemia

    • The WHO defines anaemia as a condition where the number of red blood cells or the haemoglobin concentration within them is lower than normal. This compromises immunity and impedes cognitive development.

    Why anaemia is a concern?

    • Adverse effects of anaemia affect all age groups lower physical and cognitive growth and alertness among children and adolescents, and lesser capacity to learn and play, directly impacting their future potential as productive citizens.
    • Anaemia among adolescent girls (59.1 per cent) advances to maternal anaemiaand is a major cause of maternal and infant mortality and general morbidity and ill health in a community.

    What causes anaemia?

    • Imbalanced diet: Cereal-centric diets, with relatively less consumption of iron-rich food groups like meat, fish, eggs, and dark green leafy vegetables (DGLF), can be associated with higher levels of anaemia.
    • Underlying factors: High levels of anaemia are also often associated with underlying factors like poor water quality and sanitation conditions that can adversely impact iron absorption in the body.
    • Iron deficiency is major cause: A diet that does not contain enough iron, folic acid, or vitamin B12 is a common cause of anaemia.
    • Some other conditions: That may lead to anaemia include pregnancy, heavy periods, blood disorders or cancer, inherited disorders, and infectious diseases.

    anaemiaWhy is anaemia so high in the country?

    • Low vitamin intake: Iron-deficiency and vitamin B12-deficiency anaemia are the two common types of anaemia in India.
    • High population and nutrition deprivation: Among women, iron deficiency prevalence is higher than men due to menstrual iron losses and the high iron demands of a growing foetus during pregnancies.
    • Overemphasis on cereals: Lack of millets in the diet due to overdependence on rice and wheat, insufficient consumption of green and leafy vegetables could be the reasons behind the high prevalence of anaemia in India.

    What is Iron fortification?

    • Iron fortification of food is a methodology utilized worldwide to address iron deficiency. Iron fortification programs usually involve mandatory, centralized mass fortification of staple foods, such as wheat flour.

    https://www.civilsdaily.com/news/mandatory-rice-fortification-policy-should-be-re-examined/Why need iron fortification?

    • Iron deficiency anaemia is due to insufficient iron.
    • Without enough iron, the body can’t produce enough of a substance in red blood cells that enables them to carry oxygen (haemoglobin).
    • Severe anaemia during pregnancy increases risk of premature birth, having a low birth weight baby and postpartum depression. Some studies also show an increased risk of infant death immediately before or after birth.

    anaemiaSuccess story / value addition

    • Nepal’s success story to improve maternal anaemia by national action plan .

    Anaemia Mukt Bharat

    • The scheme aims to reduce the prevalence of anaemia in India.
    • It provides bi weekly iron Folic acid supplementation to all under five children through Asha workers.
    • Also, it provides biannual Deworming for children and adolescents. The scheme also establishes institutional mechanisms for advanced research in anaemia.
    • It also focuses on non-nutritional causes of anaemia.

    We need to focus on the following interventions

    • Prophylactic Iron and Folic Acid supplementation.
    • Intensified year-round Behaviour Change Communication Campaign (Solid Body, Smart Mind).
    • Appropriate infant and young child feeding practices.
    • Increase in intake of iron-rich food through diet diversity/quantity/frequency and/or fortified foods with focus on harnessing locally available resources.
    • Testing and treatment of anaemia, using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents
    • Mandatory provision of Iron and Folic Acid fortified foods in government-funded public health programmes

    Way forward

    • India’s nutrition programmes must undergo a periodic review.
    • The Integrated Child Development Services (ICDS), which is perceived as the guardian of the nation’s nutritional well-being must reassess itself and address critical intervention gaps, both conceptually and programmatically, and produce rapid outcomes.
    • The nutritional deficit which ought to be considered an indicator of great concern is generally ignored by policymakers and experts. Unless this is addressed, rapid improvement in nutritional indicators cannot happen.

    Conclusion

    • When a person is anaemic, the capacity of his blood cells to carry oxygen decreases. This reduces the productivity of the person which in turn affects the economy of the country. Therefore, it is highly important to cover Anaemia under National Health Mission.

    Mains question

    Q. “Every second adolescent girl has anaemia. Every second woman of reproductive age is anaemic”. In this context do you think Women’s empowerment will not have any meaning without tackling anaemia? Discuss.

     

     

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  • What is National List of Essential Medicines (NLEM)?

    The latest National List of Essential Medicines (NLEM) released September 13, 2022 by the Union health ministry added 34 new medicines and dropped 26 old ones from the previous list.

    What is NLEM?

    • As per the World Health Organisation (WHO), Essential Medicines are those that satisfy the priority health care needs of the population.
    • Ministry of Health and Family Welfare hence prepared and released the first National List of Essential Medicines of India in 1996 consisting of 279 medicines.
    • The list is made with consideration to disease prevalence, efficacy, safety and comparative cost-effectiveness of the medicines.
    • Such medicines are intended to be available in adequate amounts, in appropriate dosage forms and strengths with assured quality.
    • They should be available in such a way that an individual or community can afford.

    NLEM in India

    • Drugs listed under NLEM — also known as scheduled drugs — will be cheaper because the National Pharmaceutical Pricing Authority (NPPA) caps medicine prices and changes only based on wholesale price index-based inflation.
    • The list includes anti-infectives medicines to treat diabetes such as insulin — HIV, tuberculosis, cancer, contraceptives, hormonal medicines and anaesthetics.
    • They account for 17-18 per cent of the estimated Rs 1.6-trillion domestic pharmaceutical market.
    • Companies selling non-scheduled drugs can hike prices by up to 10 per cent every year.
    • Typically, once NLEM is released, the department of pharmaceuticals under the ministry of chemicals and fertilisers adds them in the Drug Price Control Order, after which NPPA fixes the price.

    Significance of EML

    • Drawing an essential medicines list (EML) is expected to result in better quality of medical care, better management of medicines and cost-effective use of health care resources.
    • This is especially important for a resource limited country like India.
    • The list of essential medicines is intended to have a positive impact on the availability and rational use of medicines.

    Also read

    What is the NPPA’s role in fixing drug prices?

     

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  • LGBTQ leap forward for positive future growth of human rights

    LGBTQContext

    • Four years after landmark LGBTQ verdict: The march to full citizenship.

    Why in news?

    • On September 6, 2018, exactly four years ago, in Navtej Singh Johar and Ors v Union of India, a five-judge constitution bench of the Supreme Court, in a beautifully elaborate decision, liberated LGBTQI Indians from the darkness of Section 377 of the Indian Penal Code, 1860.

    What is LGBTQ?

    • LGBTQ is an initialism that stands for lesbian, gay, bisexual, and transgender. In use since the 1990s, the initialism, as well as some of its common variants, functions as an umbrella term for sexuality and gender identity.

    What is Section 377 of the IPC?

    • It reads – Unnatural offences: Whoever voluntarily has carnal intercourse against the order of nature with any man, woman or animal shall be punished with imprisonment for life, or with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine.
    • The terms “carnal intercourse” and “against the order of nature” are not defined precisely anywhere in the code.

    LGBTQRole played by the judiciary hitherto

    • The Delhi High Court’s verdict in Naz Foundation vs Government of NCT of Delhi (2009) was a landmark in the law of sexuality and equality jurisprudence in India.
    • The court held that Section 377 offended the guarantee of equality enshrined in Article 14 of the Constitution, because it creates an unreasonable classification and targets homosexuals as a class.
    • In a retrograde step, the Supreme Court, in Suresh Kumar Koushal vs Naz Foundation (2013), reinstated Section 377 to the IPC.
    • However, the Supreme Court in Navtej Singh Johar & Ors. vs Union of India (2018) declared that the application of Section 377 IPC to consensual homosexual behaviour was “unconstitutional”.
    • This Supreme Court judgment has been a great victory to the Indian individual in his quest for identity and dignity.
    • It also underscored the doctrine of progressive realisation of rights.

    LGBTQWhat’s next?

    • Overarching legislation is needed to guarantee equality to all persons on the basis of sexual orientation, gender identity and expression, sex, caste, religion, age, disability, marital status, pregnancy, nationality, and other grounds.
    • The law should impose obligations of equality and non-discrimination on all persons, public and private, and in the areas of education, employment, healthcare, land and housing and access to public places.
    • It should provide for civil remedies to stop discriminatory behaviour, costs and damages, and positive action to make reparations.
    • We need an equality law to define what equality would encompass.
    • Supreme Court comes held in its privacy judgment in K.S. Puttuswamy v. Union of India (2017) that equality and liberty cannot be separated, and equality encompasses the inclusion of dignity and basic freedoms.

    Way forward

    • Schools and colleges must effect changes in curricula for a better understanding of the community.
    • People of a different sexual orientation or gender identity often narrate harrowing tales of bullying, discrimination, stigma and ostracization.
    • Gender-neutral restrooms should be compulsory in educational institutes and other places.
    • Parents too need to be sensitised, because the first point of misunderstanding and abuse often begins at home, with teenagers being forced to opt for “conversion” therapies.

    Conclusion

    • Justice Chandrachud, speaking on the fourth anniversary of Johar and the journey ahead, while quoting the Beatles classic “All you need is love”, notes that “simply love is not enough”. Rights are necessary. Which will enhance dignity of the community.

    Mains question

    Q. “Silent segregation” on the grounds of gender, sexual orientation preferences are followed in several houses. Elucidate in context of LGBTQ issues. What Legal remedies are needed for its victims?

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  • Public health should be led by doctor alone

    public healthContext

    • Doctor shortages are creating hurdles in health emergency response

    What is the crux of the article in simple words?

    • Medical qualification and expertise is necessary to deliver quality health services by medical professionals unlike by general health care workers who lack competency.

    What is public health?

    • Public health has been defined as “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals”.

    Why there is need of qualification?

    • Lack of training: Health workers have no training in public health; they are grassroots-level service providers. Asking them to be part of public health cadre trivialises the profession of public health.
    • Separate profession: It is important to understand that public health is a separate profession with a specific set of competencies.

    public healthWhat are 4 pillars of public health?

    • Academics: Academics refers to a good understanding of evidence generation and synthesis by having a good grounding in epidemiology and biostatistics. These competencies are also critical for monitoring and evaluating programmes, conducting surveillance, and interpreting data and routine reporting.
    • Activism: Public health is inherently linked to ‘social change’ and an element of activism is core to public health. Public health requires social mobilisation at the grassroots level by understanding community needs, community organisation, etc. This requires grounding in social and behavioural sciences.
    • Administration: Administration refers to administering health systems at different levels from a primary health centre to the district, State, and national level. This includes implementing and managing health programmes, addressing human resource issues, supply and logistical issues, etc. It includes microplanning of programme delivery, team building, leadership as well as financial management to some extent.
    • Advocacy: In public health, there is little that one can do at an individual level; there must be communication with key stakeholders to change the status quo at different levels of government. This requires clear enunciation of the need, analysis of alternative set of actions and the cost of implementation or non-implementation. Good communication and negotiation skills are critical to perform this function. The related subjects are health policy, health economics, health advocacy and global health.

    public healthWhat are the hurdles in absorbing others as public health professionals?

    • Lack of skill: Many doctors and other health professionals work at the grassroots level and develop a good sense of public health due to their inclination. But they do not become public health professionals as they may not have the necessary skills. Nevertheless, they are valuable.
    • Lack of critical expertise: Clinicians with training in epidemiology and biostatistics would not qualify to be public health professionals as they lack not only other essential and critical expertise but also an appropriate perspective.
    • Compromise on quality:

    Current challenges faced by public healthcare in India

    • Deficiency: The doctor-patient ratio of 1:1655 in India as against WHO norm of 1:1000 clearly shows the deficit of MBBS. While the government is working towards a solution and targeting to reach the required ratio, there is a need to relook at the overall medical education.
    • Post pandemic scenario: The lag in formal medical education has come up evidently post-pandemic when the nation saw the medical fraternity struggling to fill the doctor deficit.
    • Limited government seats: The number of seats available for medical education in India is far less than the number of aspirants who leave school with the dream of becoming doctors.
    • Lack of skills: Though the institutes are managing to hire professors and lecturers, there is a lack of technical skills. Finding faculties in clinical and non-clinical disciplines is difficult and there are very few faculty development programs for upskilling the existing lot.
    • Lack of infrastructure: The gap in digital learning infrastructure is currently the biggest challenge the sector is facing. There is an urgent need to adopt technology and have resources available to facilitate e-learning.
    • Lack of research and innovation: The medical research and innovation needs an added push as there haven’t been many ground-breaking research here. The education system needs to focus more on increasing the quality of research. Additionally since industry academia partnership is not available, hence innovation also takes a back-seat.

    Conclusion

    • By establishing new medical colleges, the government can increase student intake as well as enhance equitable access to public health as separate profession. This will attract the best and the brightest people into this discipline, which is very important for the nation’s health. This is one lesson that we should learn from the pandemic.

    Mains question

    Q. What do you understand by public health? Do you think it is a separate profession requiring a specific set of competencies? Examine.

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  • Adoption in India

    adoption

    There is confusion over the implementation of new adoption rules that require the transfer of adoption petitions from courts to District Magistrates (DMs).

    What is the news?

    • From September 1, DMs have been empowered to give adoption orders instead of courts.
    • All cases pending before courts have to be now transferred.
    • Hundreds of adoptive parents in the country are now concerned that the transfer process will further delay what is already a long and tedious process.
    • There are questions whether an order passed by the executive will pass muster when an adopted child’s entitlements on succession and inheritance are contested before a court.

    Adoption in India: A backgrounder

    • In 2015, the then Minister for Women and Child Development centralised the entire adoption system by empowering Central Adoption Resource Authority (CARA).
    • It was empowered to maintain in various specialised adoption agencies, a registry of children, prospective adoptive parents as well as match them before adoption.
    • This was aimed at checking rampant corruption and trafficking as child care institutions and NGOs could directly give children for adoption after obtaining a no-objection certificate from CARA.

    DMs to issue Adoption Orders

    • The Parliament passed the Juvenile Justice (Care and Protection of Children) Amendment Bill, 2021 in order to amend the Juvenile Justice Act (JJ Act), 2015.
    • The key changes include authorising District Magistrates and Additional District Magistrates to issue adoption orders under Section 61 of the JJ Act by striking out the word “court”.
    • This was done “in order to ensure speedy disposal of cases and enhance accountability,” according to a government statement.
    • The DMs have also been empowered under the Act to inspect child care institutions as well as evaluate the functioning of district child protection units, child welfare committees, juvenile justice boards, specialised juvenile police units, child care institutions etc.

    Why is there concern over the revised rules?

    • Parents, activists, lawyers and adoption agencies will have to be transferred and the process will have to start afresh.
    • A delay in such an order can often mean that a child can’t get admission into a school because parents don’t yet have a birth certificate.
    • Parents and lawyers also state that neither judges, nor DMs are aware about the change in the JJ Act leading to confusion in the system and delays.
    • DMs don’t handle civil matters that bestow inheritance and succession rights on a child.
    • If these rights are contested when a child turns 18, a judicial order is far more tenable to ensure the child is not deprived of his or her entitlements.

    Is it such a big issue?

    • The Central Adoption Resource Authority (CARA) says there are nearly 1,000 adoption cases pending before various courts in the country.
    • This is not such a huge burden.

    What is the adoption procedure in India?  

    • Adoptions in India are governed by two laws:
    1. Hindu Adoption and Maintenance Act, 1956 (HAMA): It is a parent-centric law that provides son to the son-less for reasons of succession, inheritance, continuance of family name and for funeral rights and later adoption of daughters was incorporated because kanyadaan is considered an important part of dharma in Hindu tradition.
    2. Juvenile Justice Act, 2015: It handles issues of children in conflict with law as well as those who are in need of care and protection and only has a small chapter on adoptions.
    • Both laws have their separate eligibility criteria for adoptive parents.
    • Those applying under the JJ Act have to register on CARA’s portal after which a specialised adoption agency carries out a home study report.
    • After it finds the candidate eligible for adoption, a child declared legally free for adoption is referred to the applicant.
    • Under HAMA, a “dattaka hom” ceremony or an adoption deed or a court order is sufficient to obtain irrevocable adoption rights.

    Issues with child adoption in India

    • Parent-centrism: The current adoption approach is very parent-centred, but parents must make it child-centred.
    • Age of child: Most Indian parents also want a child between the ages of zero and two, believing that this is when the parent-child bond is formed.
    • Institutional issues: Because the ratio of abandoned children to children in institutionalised care is lopsided, there are not enough children available for adoption.
    • Lineage discrimination: Most Indians have a distorted view of adoption because they want their genes, blood, and lineage to be passed down to their children.
    • Red-tapism: Child adoption is also not so easy task after the Juvenile Justice Rules of 2016 and the Adoption Regulations of 2017 were launched.

    Practical issues in adoption

    • There are no rules for monitoring adoptions and verifying sourcing of children and determining whether parents are fit to adopt.
    • There are many problems with the adoption system under CARA but at the heart of it is the fact that there are very few children in its registry.
    • According to the latest figures there are only 2,188 children in the adoption pool, while there are more than 31,000 parents waiting to adopt a child.

     

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