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Subject: Governance

Important aspects of Society

  • India Hypertension Control Initiative (IHCI)

    The IHCI project has demonstrated that blood pressure treatment and control are feasible in primary care settings in diverse health systems across various States in India.

    India Hypertension Control Initiative (IHCI)

    • It is a multi-partner initiative involving the Indian Council of Medical Research, WHO-India, Ministry of Health and Family Welfare, and State governments.
    • It aims to improve blood pressure control for people with hypertension.
    • The project initiated in 26 districts in 2018 has expanded to more than 100 districts by 2022.
    • More than two million patients were started on treatment and tracked to see whether they achieved BP control.

    The project was built on five scalable strategies:

    1. Simple treatment protocol with three drugs was selected in consultation with the experts and non-communicable disease programme managers.
    2. Supply chain was strengthened to ensure the availability of adequate antihypertensive drugs.
    3. Patient-centric approaches were followed, such as refills for at least 30 days and assigning the patients to the closest primary health centre or health wellness centre to make follow-up easier.
    4. The focus was on building capacity of all health staff and sharing tasks such as BP measurement, documentation, and follow-up.
    5. There was minimal documentation using either paper-based or digital tools to track follow-up and BP control.

    Prevalence of hypertension in India

    • Cardiovascular diseases (CVD) are the leading cause of death among adults in India.
    • One of the major drivers of heart attack and stroke is untreated high blood pressure or hypertension.
    • Hypertension is a silent killer as most patients do not have any symptoms.
    • India has more than 200 million people with hypertension, and only 14.5% of individuals with hypertension are on treatment.

    Success of IHCI

    • Blood pressure treatment and control were feasibly controlled in primary care settings in diverse health systems across various States in India.
    • Before IHCI, many patients travelled to higher-level facilities such as community health centres (block level) or district hospitals in the public sector for hypertension treatment.
    • Over three years, all levels of health staff at the primary health centres and health wellness centres were trained to provide treatment and follow-up services for hypertension.
    • Nearly half (47%) of the patients under care achieved blood pressure control.
    • The BP control among people enrolled in treatment was 48% at primary health centres and 55% at the health wellness centres.

    Contributing to its success: A data-driven approach

    • One of the unique contributions of the project was a data-driven approach to improving care and overall programme management.
    • The list of people who did not return for treatment was generated through a digital system or on paper by the nurse/health workers.
    • Patients were reminded either over the phone or by home visit (if feasible).
    • This strategy motivated a large number of patients to continue treatment.
    • In addition, programme managers reviewed aggregate data at the district and State levels to assess the performance of facilities in terms of follow-up and BP control.
    • Patients were provided generic antihypertensive drugs costing only ₹200 per year.
    • In addition, E-Sanjeevani, a telemedicine initiative, facilitated teleconsultations.

    Back2Basics: Hypertension

    • Hypertension also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
    • High blood pressure usually does not cause symptoms.
    • Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.
    • High blood pressure is classified as primary (essential) hypertension or secondary hypertension.
    • For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg.

     

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  • Structural interventions by state governments that can create higher-wage jobs

    Context

    The recent decision to deduct off-budget borrowings from state borrowing limits reminds chief ministers to be good policy ancestors.

    Financing welfare state

    • In A Brief History of Equality, economist Thomas Piketty suggests that “the world of the early 2020s, no matter how unjust it may seem, is more egalitarian than that of 1950 or 1900, which were… more egalitarian than those of 1850 or 1780”.
    • But how the welfare state is financed matters.
    • Changes in state borrowing limits: Adjusting state borrowing limits for their off-budget borrowings leads to transparency because they are routinely breached through vehicles for schemes whose bill comes due far in the future.
    • The confiscation of future spending — interest payments crowd out expenditure and revenue expenditure crowd out capex — matters because our prosperity problem is productivity, wages, not jobs.

    5 Structural interventions that can create high wage jobs

    1] Reduce regulatory hurdles

    • States control 80 per cent of India’s employers’ compliance ecosystem of 67,000+ compliances, 6,500+ filings and 26,000+ criminal provisions.
    • State governments that rationalise, decriminalise, and digitise their compliance ecosystem will reap lower corruption and higher formality.

    2] Fix government schools

    • The most powerful tool for social mobility and employability is free and quality school education.
    • State governments that undertake a significant overhaul of school performance management (the fear of falling and hope of rising for teachers) and governance (the allocation of decision rights around resources and hiring) will create an unfair advantage in human capital.

    3] Converge education and employability

    • States should set up skill universities that create qualification modularity (between certificates, diplomas, advanced diplomas, and degrees), delivery flexibility (equate online, apprenticeships, on-site and on-campus classrooms), and pray to the one god of employers.
    • Degree apprentices innovate at the intersection of employment, employability and education.
    • State governments that remove barriers in their path will see their population of employed learners exceed full-time learners.

    4] Devolution of money and power

    • Cities drive productive job creation — New York City’s GDP is higher than Russia’s.
    •  It took 70 years after 1947 for the budget of 28 states to cross the central government’s budget.
    • The combined budget of state governments now exceeds Rs 45 lakh crore, but 2.5 lakh municipalities and panchayats have a budget of only Rs 3.7 lakh crore.
    • Governments that devolve money and power from state capitals to their towns will avoid the curse of megacities and create the competition that drove China’s growth (they have 375 cities with more than a million people versus our 52).

    5] Civil service reforms

    • State governments must sell their 1,500+ loss-making public sector units, cut civil service compensation to less than 40 per cent of budget spending, and replace expenditure with capex.
    • Moving from outlays to outcomes needs a new human capital regime for civil servants via seven interventions; structure, staffing, training, performance management, compensation, culture, and HR capabilities.

    Shifting resources to protective and productive  version of states

    • Nobel Laureate James Buchanan said any state had three versions — the protective state (police, rule of law, defence, courts), the productive state (common goods like roads, power, health, education, etc.), and the redistributive state.
    • Too many state governments accept the status quo in the first two and “innovate” in the third version.
    • It’s time to shift resources to the first two.

    Conclusion

    Chief Ministers ought to create high wage jobs, and not borrow money future generations will have to repay.

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  • Bridging the health policy to execution chasm

    Context

    In April this year, the Union government released a guidance document on the setting up of a ‘public health and management cadre’ (PHMC) as well as revised editions of the Indian Public Health Standards (IPHS) — for ensuring quality health care in government facilities.

    Background

    • The need for a public health cadre and services in India rarely got any policy attention.
    • Limited understanding: The reason was that even among policymakers, there was limited understanding on the roles and the functions of public health specialists and the relevance of such cadres, especially at the district and sub-district levels.
    • However, the last decade and a half was eventful.
    • The initial threat of avian flu in 2005-06, the Swine flu pandemic of 2009-10; five more public health emergencies of international concern between years 2009-19; the increasing risks and regular emergence and re-emergence of of new viruses and diseases (Zika, Ebola, Crimean-Congo Hemorrhagic fever, Nipah viruses, etc.) in animals and humans, resulted in increased attention on public health.
    • National Public health Act: In 2017, India’s National Health Policy 2017 proposed the formation of a public health cadre and enacting a National Public Health Act.
    • The COVID-19 pandemic changed the status quo.
    • In the absence of trained public health professionals at the policy and decision making levels, India’s pandemic response ended up becoming bureaucrat steered and clinician led.

    Different cadres and its implications

    • Lack of career progression opportunities: At present, most Indian States (with exceptions such as Tamil Nadu and Odisha) have a teaching cadre (of medical college faculty members) and a specialist cadre of doctors involved in clinical services.
    • This structure does not provide similar career progression opportunities for professionals trained in public health.
    • Limited interest: It is one of the reasons for limited interest by health-care professionals to opt for public health as a career choice.
    • The outcome has been costly for society: a perennial shortage of trained public health workforce.

    Public health cadre

    • The proposed public health cadre and the health management cadre have the potential to address some of these challenges.
    • With the release of guidance documents, the States have been advised to formulate an action plan, identify the cadre strengths, and fill up the vacant posts in the next six months to a year.
    • A public health workforce has a role even beyond epidemics and pandemics.
    • A trained public health workforce ensures that people receive holistic health care, of preventive and promotive services (largely in the domain of public health) as well as curative and diagnostic services (as part of medical care).

    Revised version of IPHS and significance

    • This is the second revision in the IPHS, which were first released in 2007 and then revised in 2012.
    • The regular need for a revision in the IPHS is a recognition of the fact that to be meaningful, quality improvement has to be an ongoing process.
    • The development of the IPHS itself was a major step.
    • The revised IPHS is an important development but not an end itself.
    • In the 15 years since the first release of the IPHS, only a small proportion — around 15% to 20% — of government health-care facilities meets these standards. .
    • If the pace of achieving IPHS is any criteria, there is a need for more accelerated interventions.
    • Opportunities such as a revision of the IPHS should also be used for an independent assessment on how the IPHS has improved the quality of health services.

    Implementation challenges

    • The effective part of implementation is interplay: policy formulation, financial allocation, and the availability of a trained workforce.
    • In this case, policy has been formulated.
    • Financial allocations: Then, though the Government’s spending on health in India is low and has increased only marginally in the last two decades; however, in the last two years, there have been a few additional — small but assured — sources of funding for public health services have become available.
    • The Fifteenth Finance Commission grant for the five-year period of 2021- 26 and the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) allocations are available for strengthening public health services and could be used  as States embark upon implementing the PHMC and a revised IPHS.
    • Availability of trained workforce: The third aspect of effective implementation, the availability of trained workforce, is the most critical.
    • As States develop plans for setting up the PHMC, all potential challenges in securing a trained workforce should be identified and actions initiated.

    Conclusion

    The public health and management cadres and the revised IPHS can help India to make progress towards the NHP goal. To ensure that, State governments need to act urgently and immediately.

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    Back2Basics: Indian Public Health Standards (IPHS)

    • IPHS are a set of uniform standards envisaged to improve the quality of health care delivery in the country.
    • The IPHS documents have been revised keeping in view the changing protocols of the existing programmes and introduction of new programmes especially for Non-Communicable Diseases.
    • Flexibility is allowed to suit the diverse needs of the States and regions.
    • These IPHS guidelines will act as the main driver for continuous improvement in quality and serve as the bench mark for assessing the functional status of health facilities.

  • On marital rape, regressive notions undermine autonomy of women

    Context

    On 11 May, two judges of the Delhi High Court handed down separate judgments in RIT Foundation v Union of India.

    Background

    • Section 375 of the IPC defines “rape” as when a man has sex with a woman without her consent.
    • Exception to Section 375 of IPC:  An exception to Section 375 provides that it is not rape for a husband to have sex with his wife, regardless of consent.

    The two judgements

    1] Violation of rights:

    • In his judgment, Justice Rajiv Shakdher concluded that the marital rape exception violated the rights to life, equality, non-discrimination, and freedom of speech and expression under the Constitution.
    • There is no reasonable basis to distinguish between married and unmarried women.
    • Marriage is a relationship of equals, and women do not forfeit their agency and sexual autonomy upon marriage.

    2] Issues with Constitutional validity of exception

    • Justice C Hari Shankar took a different view, concluding that the marital rape exception is constitutionally valid.
    • First, the judge held that it is the wrong starting point to assume that a husband who has sex with his wife without her consent “commits rape”.
    • 1] Exclusion from definition argument: The judge noted that the effect of the exception to Section 375 of the IPC is that any sex between a husband and wife, whether or not consensual, is excluded from the definition of rape.
    • That analysis does not bear scrutiny.
    • It makes little difference whether the starting point is that non-consensual sex within marriage should be characterised as rape or, for example, sexual assault.
    • The critical question is whether it is unconstitutional to exclude non-consensual sex from the definition of rape.
    • 2] Preservation of marital institution argument: The judge held that the marital rape exception was “aimed at preservation of the marital institution, on which the entire bedrock of society rests”.
    • The difficulty with that proposition is obvious — is it the policy of the law that marriage is to be preserved at all costs?
    • If so, does that withstand constitutional scrutiny?
    • 3] Impact argument: the judge rejected the challenge to the martial rape exception based on the right to equality on the spurious assumption that the impact on a woman who is raped by her husband cannot “be equated with the impact of a woman who is raped by a stranger”.
    •  No evidence is cited in support of those claims.
    • They also defy logic. Being raped by someone in whom you have reposed trust is likely to have an indelible emotional impact.
    • 4] Reluctance to file complaint: The judge concluded that, as a practical matter, a “majority of Indian women” would be reluctant to file a complaint of rape against their husbands in any event.
    • Even if that were true, it is no reason to disempower, by the operation of the law, women who do have the resolve to make a rape complaint against their husbands from doing so.
    • 5] Creation of new offence: Justice Shankar held that it is not within the court’s power to create a new offence, and striking down the marital rape exception would have that effect.
    • There is no question of creating a new offence — the court would simply be striking down an exception carved out of an existing offence.
    • The only principled basis for the judge’s objection is that it may be unfair to punish someone for rape for conduct that was excluded from the definition of rape when it was undertaken.
    • But that is not a reason to avoid striking down the marital rape exception.
    • The easy solution is for the court to declare that its judgment will apply only to conduct after the date of the judgment.

    Conclusion

    Whether the marital rape exception violates fundamental rights under the Constitution is a question that falls within the Court’s core competency. There is only one reasonable answer to that question.

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  • 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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