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Subject: Governance

Important aspects of Society

  • What are the concerns of digital health mission?

    The Ayushman Bharat Digital Mission (ABDM), was recently launched by the PM.

    About Ayushman Bharat Digital Mission

    • The pilot project of the National Digital Health Mission was announced by PM Modi during his Independence Day speech from the Red Fort on August 15, 2020.
    • The mission will enable access and exchange of longitudinal health records of citizens with their consent.
    • This will ensure ease of doing business for doctors and hospitals and healthcare service providers.

    The key components of the project include

    • Health ID for every citizen that will also work as their health account, to which personal health records can be linked and viewed with the help of a mobile application,
    • Healthcare Professionals Registry (HPR)
    • Healthcare Facilities Registries (HFR) that will act as a repository of all healthcare providers across both modern and traditional systems of medicine

    How will it work?

    • In order to be a part of the ABDM, citizens will have to create a unique health ID – a randomly generated 14-digit identification number.
    • The ID will give the user unique identification, authentication and will be a repository of all health records of a person.
    • The ID can also be made by self-registration on the portal, downloading the ABMD Health Records app on one’s mobile or at a participating health facility.
    • The beneficiary will also set up a Personal Health Records (PHR) address for the issue of consent, and for future sharing of health records.

    Major privacy issues involved

    • Informed Consent: The citizen’s consent is vital for all access. A beneficiary’s consent is vital to ensure that information is released.
    • Data leakages issue: Personalised data collected at multiple levels are a “sitting gold mine” for insurance companies, international researchers, and pharma companies.
    • Digital divide: Other experts add that lack of access to technology, poverty, and lack of understanding of the language in a vast and diverse country like India are problems that need to be looked into.
    • Data Migration: The data migration and inter-State transfer are still faced with multiple errors and shortcomings in addition to concerns of data security.

    Other challenges

    • Existing digitalization is yet incomplete: India has been unable to standardise the coverage and quality of the existing digital cards like One Nation One Ration card, PM-JAY card, Aadhaar card, etc., for accessibility of services and entitlements.
    • Lack of healthcare facilities: The defence of data security by expressed informed consent doesn’t work in a country that is plagued by the acute shortage of healthcare professionals to inform the client fully.
    • Lack of finance: With the minuscule spending of 1.3% of the GDP on the healthcare sector, India will be unable to ensure the quality and uniform access to healthcare that it hoped to bring about.

  • 2nd phase of SBM-U and AMRUT Mission

    The PM has launched the second phase of the Swachh Bharat Mission-Urban and Atal Mission for Rejuvenation and Urban Transformation.

    What are the missions?

    [A] Swachh Bharat Mission-Urban 2.0

    The Mission will focus on ensuring complete access to sanitation facilities to serve additional populations migrating from rural to urban areas in search of employment and better opportunities over the next 5 years.

    • Complete liquid waste management in cities in less than 1 lakh population to ensure that all wastewater is safely contained, collected, transported, and treated so that no wastewater pollutes our water bodies.
    • Source segregation- Under Sustainable Solid Waste Management, greater emphasis will be on source segregation.
    • Material Recovery Facilities and waste processing facilities will be set up, with a focus on phasing out single-use plastic.
    • Construction & demolition waste processing facilities will be set up.
    • Mechanical sweepers deployed in National Clean Air Programme cities and in cities with more than 5 lakh population.
    • Remediation of all legacy dumpsites will be another key component of the Mission.

    [B] AMRUT 2.0

    • Water management: It will build upon the progress of AMRUT to address water needs, rejuvenate water bodies, better manage aquifers, reuse treated wastewater, thereby promoting circular economy of water.
    • Water supply: It would provide100% coverage of water supply to all households in around 4,700 ULBs.
    • Sewerage: It will provide 100% coverage of sewerage and septage in 500 AMRUT cities.
    • Rejuvenation of water bodies and urban aquifer management: It will be undertaken to augment sustainable fresh water supply.
    • Recycle and reuse of treated wastewater: It is expected to cater to 20% of total water needs of the cities and 40% of industrial demand.
    • Pey Jal Survekshan: It will be conducted in cities to ascertain equitable distribution of water, reuse of wastewater and mapping of water bodies.

    Back2Basics:

    All about the Swachh Bharat Abhiyan

     

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  • [pib] DigiSaksham Initiative

    The Ministry of Labour and Employment has launched DigiSaksham Initiative.

    DigiSaksham

    • It is joint initiative with Microsoft India is an extension of the Government’s ongoing programs to support the youth from rural and semi-urban areas.
    • Through DigiSaksham initiative, free of cost training in digital skills including basic skills as well as advance computing, will be provided to more than 3 lakh youths in the first year.
    • The Jobseekers can access the training through National Career Service (NCS) Portal.
    • DigiSaksham will be implemented in the field by Aga Khan Rural Support Programme India (AKRSP-I).

    Training offered

    • Under the initiative, there will be basically three types of training viz. Digital Skills – Self paced learning, VILT mode training (Virtual Instructor led) and ILT mode training (Instructor led).
    • The ILT training which is in person training would be conducted at the Model Career Centres (MCCs) and National Career Service Centres (NCSC) for SCs/STs across the country.
    • Students will be able to access training in areas like Java Script, Data Visualisation, Advance Excel, Power Bi, HTML, Programming languages, software development fundamentals, Introduction to coding etc.

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  • PM-CARES

    We all know that the Prime Minister’s Citizen Assistance and Relief in Emergency Situations (PM CARES) Fund doesn’t come under the ambit of Right to Information (RTI). This oped seeks to discuss certain aspects of this issue.

    Present context

    • In a recent affidavit, the Delhi High Court was informed that the PM CARES Fund is not a Government of India fund and that the amount collected by it does not go to the Consolidated Fund of India is strange.
    • This petition is seeking the PM-CARES fund to be declared as the “State” under Article 12 of the Constitution.

    Intriguing facts about PM-CARES fund

    • PM CARES has been created not by law, not by notification, but by the mere creation of a webpage, and set up last year in March to raise funds for those affected by the COVID-19 pandemic.
    • The page lists its structure, functions and duties in an arbitrary manner. The official appeals for funds are made under the national emblem.
    • The most significant lie of this sworn statement is that the Government has no control over the Fund.

    What is the case?

    • The PM-CARES Fund was not subject to CAG audit since the Supreme Court regarded it as a public charitable trust.
    • It is not under public scrutiny. Also contributions to it were 100% tax-free.
    • It is accused that there was statutory fund already in existence under the Disaster Management Act of 2005 to receive contributions to finance the fight against a calamity.

    What is RTI?

    • RTI is an act of the parliament which sets out the rules and procedures regarding citizens’ right to information.
    • It replaced the former Freedom of Information Act, 2002.
    • Under the provisions of RTI Act, any citizen of India may request information from a “public authority” (a body of Government or “instrumentality of State”) which is required to reply expeditiously or within 30.
    • In case of the matter involving a petitioner’s life and liberty, the information has to be provided within 48 hours.

    About PM CARES Fund

    • The PM CARES Fund was created on 28 March 2020 following the COVID-19 pandemic in India.
    • The fund will be used for combat, containment and relief efforts against the coronavirus outbreak and similar pandemic like situations in the future.
    • The PM is the chairman of the trust. Members will include the defence, home and finance ministers.
    • The fund will also enable micro-donations. The minimum donation accepted is â‚č10 (14Âą US).

    The other funds

    (1) National Disaster Response Fund (NDRF)

    • The statutorily constituted NDRF was established under the Disaster Management (DM) Act of 2005.
    • The NDRF is mandated to be accountable, and answerable under the RTI Act, being a public authority, and auditable by the Comptroller and Auditor General of India.

    (2) Disaster Response Fund

    • The DM Act also provided for a Disaster Response Fund — state and district level funds (besides the national level).
    • It also collects and uses the donations at the local level, with mandatory transparency and audit provisions.

    (3) Prime Minister’s National Relief Fund

    • There is the PMNRF operative since the days of Jawaharlal Nehru. It was established with public contributions to assist displaced persons from Pakistan.
    • The resources are now utilised primarily to render immediate relief to families of those killed in natural calamities and to the victims of the major accidents and riots.
    • However, it has the President of India and the Leader of Opposition also as trustees.

    Issues over PM-CARES Fund

    • No defined purpose: It is deliberately ignored while a new, controversial, unanswerable, and ‘non-accountable vehicle is created; its character is not spelt out till today.
    • Non-accountable: The government seems to consider statutory provisions for enquiry and information seeking to be embarrassing obstacles.
    • Centralization of donations: It centralises the collection of donations and its utility, which is not only against the federal character but also practically inconvenient. The issue is seeming, the trusteeship of the fund.

    Questions and gaps

    • Law/statute: The PM CARES Fund was neither created by the Constitution of India nor by any statute.
    • Authority: If that is the case, under what authority does it use the designation of the Prime Minister, designated symbols of the nation, the tricolour and the official (gov.in) website of the PMO, and grant tax concessions through an ordinance.
    • Collection and dispensation: The amount received by the Fund does not go to the Consolidated Fund of India. If it goes to the CFI, it could have been audited by the CAG.
    • Uncontrolled: The This Trust is neither intended to be or is in fact owned, controlled or substantially financed by any instrumentality of the any govt even being chaired by the PM.

    Issue over tax benefits

    • Income tax: An ordinance was promulgated to amend Income Tax Act, 1961 and declare that the donations to the PM CARES Fund “would qualify for 80G benefits for 100% exemption”.
    • CSR Funds: It will also qualify to be counted as Corporate Social Responsibility (CSR) expenditure under the Companies Act, 2013.
    • Foreign donations: It has also got exemption under the FCRA [Foreign Contribution Regulation Act] and a separate account for receiving foreign donations has been opened.

    What can be inferred from all these?

    • The Centre now considers it as another obstacle and has created a new trust with the Prime Minister and his Ministers only.
    • The manner in which the PM CARES Fund was set up — with its acronym created to publicise the point that the PM cares for people — shows a bypassing of the statutory obligations of a public authority.

    Query and response: Again ironical

    • After initial denials, the Government has conceded it to be a public charitable trust, but still maintains that it is not a ‘public authority’.
    • The point is that the PMO operates the Fund, but says it cannot supply any information about the PM CARES Fund because it is not a public authority.

    Severe interpretations: Is it an Office of Profit?

    • If the PM CARES Fund is unconnected with the Government, then the Fund could become an office of profit.
    • And that could disqualify him and the three Ministers from holding those constitutional offices.

    Conclusion

    • In order to uphold transparency, the PM CARES Fund should be declared as a Public Authority under the RTI Act, and all RTI queries answered truthfully.
    • The fund should be designated as a “public authority” under Section 2(h) of the RTI Act.

     

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  • PM Poshan Shakti Nirman Scheme

    The existing Mid-Day Meal scheme, which provides hot meals to students, has been renamed as the National Scheme for PM Poshan Shakti Nirman.

    Key propositions in the PM POSHAN Scheme

    • Supplementary nutrition: The new scheme has a provision for supplementary nutrition for children in aspirational districts and those with high prevalence of anaemia.
    • States to decide diet: It essentially does away with the restriction on the part of the Centre to provide funds only for wheat, rice, pulses and vegetables. Currently, if a state decides to add any component like milk or eggs to the menu, the Centre does not bear the additional cost. Now that restriction has been lifted.
    • Nutri-gardens: They will be developed in schools to give children “firsthand experience with nature and gardening”.
    • Women and FPOs: To promote vocal for local, women self-help groups and farmer producer organisations will be encouraged to provide a fillip to locally grown traditional food items.
    • Social Audit: The scheme also plans “inspection” by students of colleges and universities for ground-level execution.
    • Tithi-Bhojan: Communities would also be encouraged to provide the children food at festivals etc, while cooking festivals to encourage local cuisines are also envisaged.
    • DBTs to school: In other procedural changes meant to promote transparency and reduce leakages, States will be asked to do direct benefit cash transfers of cooking costs to individual school accounts, and honorarium amounts to the bank accounts of cooks and helpers.
    • Holistic nutrition: The rebranded scheme aims to focus on “holistic nutrition” goals. Use of locally grown traditional foods will be encouraged, along with school nutrition gardens.

    About the Mid-Day Meal Scheme

    • The Midday Meal Scheme is a school meal program designed to better the nutritional standing of school-age children nationwide.
    • It was launched in the year 1995.
    • It supplies free lunches on working days for children in primary and upper primary classes in:
    1. Government, government aided, local body schools
    2. Education Guarantee Scheme, and alternate innovative education centres,
    3. Madarsa and Maqtabs supported under Sarva Shiksha Abhiyan, and
    4. National Child Labour Project schools run by the ministry of labour
    • The Scheme has a legal backing under the National Food Security Act, 2013.

    Objective:

    To enhance the enrolment, retention and attendance and simultaneously improve nutritional levels among school going children studying in Classes I to VIII

    History of the scheme

    • In 1925, a Mid Day Meal Programme was introduced for disadvantaged children in Madras Municipal Corporation.
    • By the mid-1980s three States viz. Gujarat, Kerala and Tamil Nadu and the UT of Pondicherry had universalized a same scheme with their own resources for children studying at the primary stage.
    • In 2001, the Supreme Court asked all state governments to begin this programme in their schools within 6 months.

    Calorie approach

    • Primary (1-5) and upper primary (6-8) schoolchildren are currently entitled to 100 grams and 150 grams of food grains per working day each.
    • The calorific value of a mid-day meal at various stages has been fixed at a minimum:
    Calories Intake Primary Upper Primary
    Energy 450 calories 700 calories
    Protein 12 grams 20 grams

     

    Impact created by the Scheme

    • The MDM Scheme has many potential benefits: attracting children from disadvantaged sections (especially girls, Dalits and Adivasis) to school, improving regularity, nutritional benefits, socialisation benefits and benefits to women are some that have been highlighted.
    • Apart from nutrition, this scheme has been miraculous. Mothers who first used to interrupt their work to feed their children at home, now no longer need to do so.

    Issues with the Scheme

    • Discrimination: Caste-based discrimination continues to occur in the serving of food, though the government seems unwilling to acknowledge this.
    • Leakages: The scheme has been subjected to leakages similar to the Public Distribution System.
    • Unhealthy and unhygienic: There have been cases of eating pesticide-contaminated mid-day meals leading to food poisoning.

     

    Try this PYQ:

    Which of the following can be said to be essentially the parts of Inclusive Governance?

    1. Permitting the Non-Banking Financial Companies to do banking
    2. Establishing effective District Planning Committees in all the districts
    3. Increasing government spending on public health
    4. Strengthening the Mid-day Meal Scheme

    Select the correct answer using the codes given below:

    (a) 1 and 2 only

    (b) 3 and 4 only

    (c) 2, 3 and 4 only

    (d) 1, 2, 3 and 4

     

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  • Antimalarial drug resistance in India

    In recent years there is increasing evidence for the failure of artemisinin-based combination therapy for falciparum malaria either alone or with partner drugs.

    What is Malaria?

    • Malaria is caused by the bite of the female Anopheles mosquito if the mosquito itself is infected with a malarial parasite.
    • There are five kinds of malarial parasites — Plasmodium falciparum, Plasmodium vivax (the commonest ones), Plasmodium malariae, Plasmodium ovale and Plasmodium knowlesi.
    • Therefore, to say that someone has contracted the Plasmodium ovale type of malaria means that the person has been infected by that particular parasite.

    Burden of Malaria in India

    • In 2018, the National Vector-borne Disease Control Programme (NVBDCP) estimated that approximately 5 lakh people suffered from malaria.
    • 63% of the cases were of Plasmodium falciparum.
    • The recent World Malaria Report 2020 said cases in India dropped from about 20 million in 2000 to about 5.6 million in 2019.

    Treatment of Malaria

    • Malaria is treated with prescription drugs to kill the parasite. Chloroquine is the preferred treatment for any parasite that is sensitive to the drug.
    • In most malaria-endemic countries including India, Artemisinin-based antimalarial drugs are the first-line choice for malaria treatment.
    • This is especially against Plasmodium falciparum parasite which is responsible for almost all malaria-related deaths in the world.

    Why in news now?

    • There are reports of artemisinin resistance in East Africa and is a matter of great concern as this is the only drug that has saved several lives across the globe.
    • In India, after the failure of chloroquine to treat P. falciparum malaria successfully, artemisinin-based combination therapy was initially introduced in 2008.
    • Currently, several combinations of artemisinin derivatives are registered in India.

    Artemisinin-based combination therapy failure in India

    • In 2019, a report from Eastern India indicated the presence of two mutations in P. falciparum cases treated with artemisinin that linked to its presence of resistance.
    • Again in 2021, artemisinin-based combination therapy failure was reported from Central India where the partner drug SP showed triple mutations with artemisinin wild type.
    • This means the failure of artemisinin-based combination therapy may not be solely linked to artemisinin. Here it is needed to change the partner drug as has been done in NE states in 2013.

    History of drug resistance

    • In the 1950s chloroquine resistance came to light.
    • Both chloroquine and pyrimethamine resistance originated from Southeast Asia following their migration to India and then on to Africa with disastrous consequences.
    • Similarly, artemisinin resistance developed from the six Southeast Asian countries and migrated to other continents, as is reported in India and Africa.
    • It would not be out of context that artemisinin is following the same path as has been seen with chloroquine.
    • Now, the time has come to carry out Molecular Malaria Surveillance to find out the drug-resistant variants so that corrective measures can be undertaken in time to avert any consequences.
    • Some experts even advocate using triple artemisinin-based combination therapies where the partner drug is less effective.

    Try this PYQ:

    Widespread resistance of malarial parasite to drugs like chloroquine has prompted attempts to develop a malarial vaccine to combat malaria.

    Why is it difficult to develop an effective malaria vaccine?

    (a) Malaria is caused by several species of Plasmodium

    (b) Man does not develop immunity to malaria during natural infection

    (c) Vaccines can be developed only against bacteria

    (d) Man is only an intermediate host and not the definitive host

     

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  • Explained: Digital Health ID

    The PM has recently launched the flagship Ayushman Bharat Digital Mission (ABDM) which involves the creation not just a unique digital health ID for every citizen.

    Ayushman Bharat Digital Mission

    What is the unique health ID?

    • If a person wants to be part of the ABDM, she must create a health ID, which is a randomly generated 14-digit number.
    • The ID will be broadly used for three purposes: unique identification, authentication, and threading of the beneficiary’s health records, only with their informed consent, across multiple systems and stakeholders.

    Why is this initiative significant?

    • The initiative has the potential to “increase the ease of living” along with “simplifying the procedures in hospitals”.
    • At present, the use of digital health ID in hospitals is currently limited to only one hospital or to a single group, and mostly concentrated in large private chains.
    • The new initiative will bring the entire ecosystem on a single platform.
    • The system also makes it easier to find doctors and specialists nearest to you.
    • Currently, many patients rely on recommendations from family and friends for medical consultation, but now the new platform will tell the patient who to reach out to, and who is the nearest.
    • Also, labs and drug stores will be easily identified for better tests using the new platform.

    How can one get it?

    • One can get a health ID by self-registration on the portal or by downloading the ABMD Health Records app on one’s mobile.
    • Additionally, one can also request the creation of a health ID at a participating health facility.
    • Health facilities may include government or private hospitals, community health centres, and wellness centres of the government across India.
    • The beneficiary will also have to set up a Personal Health Records (PHR) address for consent management, and for future sharing of health records.

    What is a PHR address?

    • It is a simple self-declared username, which the beneficiary is required to sign into a Health Information Exchange and Consent Manager (HIE-CM).
    • Each health ID will require linkage to a consent manager to enable sharing of health records data.
    • An HIE-CM is an application that enables sharing and linking of personal health records for a user.
    • At present, one can use the health ID to sign up on the HIE-CM; the National Health Authority (NHA), however, says multiple consent managers are likely to be available for patients to choose from in the near future.

    What does one need to register for a health ID?

    • Currently, ABDM supports health ID creation via mobile or Aadhaar.
    • The official website states that ABDM will soon roll out features that will support health ID creation with a PAN card or a driving licence.
    • For health ID creation through mobile or Aadhaar, the beneficiary will be asked to share details on name, year of birth, gender, address, mobile number/Aadhaar.

    Is Aadhaar mandatory?

    Ans. No, it is voluntary.

    • One can use one’s mobile number for registration, without Aadhaar.
    • If the beneficiary chooses the option of using her Aadhaar number, an OTP will be sent to the mobile number linked to the Aadhaar.
    • However, if she has not linked it to her mobile, the beneficiary has to visit the nearest facility and opt for biometric authentication using Aadhaar number.
    • After successful authentication, she will get her health ID at the participating facility.

    Are personal health records secure?

    • The NHA says ABDM does not store any of the beneficiary health records.
    • The records are stored with healthcare information providers as per their “retention policies”.
    • They are “shared” over the ABDM network “with encryption mechanisms” only after the beneficiary express consent.

    Can one delete my health ID and exit the platform?

    Ans. Yes, the NHA says ABDM, supports such a feature.  Two options are available: a user can permanently delete or temporarily deactivate her health ID.

    • On deletion, the unique health ID will be permanently deleted, along with all demographic details.
    • The beneficiary will not be able to retrieve any information tagged to that health ID in the future, and will never be able to access ABDM applications or any health records over the ABDM network with the deleted ID.
    • On deactivation, the beneficiary will lose access to all ABDM applications only for the period of deactivation.
    • Until she reactivates her health ID, she will not be able to share the ID at any health facility or share health records over the ABDM network.

    What facilities are available to beneficiaries?

    • Users can access personal digital health records right from admission through treatment and discharge.
    • One can access and link his/her personal health records with your health ID to create a longitudinal health history.

    What other features will be rolled out?

    • Upcoming new features will enable access to verified doctors across the country.
    • The beneficiary can create a health ID for her child, and digital health records right from birth.
    • Third, she can add a nominee to access her health ID and view or help manage the personal health records.
    • Also, there will be much inclusive access, with the health ID available to people who don’t have phones, using assisted methods.

    How do private players get associated with a government digital ID?

    • The NHA has launched the NDHM Sandbox: a digital architecture that allows helps private players to be part of the National Digital Health Ecosystem as health information providers or health information users.
    • The private player sends a request to NHA to test its system with the Sandbox environment.
    • The NHA then gives the private player a key to access the Sandbox environment and the health ID application programming interface (API).
    • The private player then has to create a Sandbox health ID, integrate its software with the API; and register the software to test link records and process health data consent requests.
    • Once the system is tested, the system will ask for a demo to the NHA to move forward. After a successful demo, the NHA certifies and empanels the private hospital.

    Now try this PYQ:

    Consider the following statements:

    1. Aadhaar metadata cannot be stored for more than three months.
    2. State cannot enter into any contract with private corporations for sharing of Aadhaar data.
    3. Aadhaar is mandatory for obtaining insurance products.
    4. Aadhaar is mandatory for getting benefits funded out of the Consolidated Fund of India.

    Which of the statements given above is/are correct?

    (a) 1 and 4 only

    (b) 2 and 4 only

    (c) 3 only

    (d) 1, 2 and 3 only

     

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  • Ayushman Bharat Digital Mission

    The PM has launched the Ayushman Bharat Digital Mission to provide a digital Health ID to people which will contain their health records.

    Ayushman Bharat Digital Mission

    • The pilot project of the National Digital Health Mission was announced by PM Modi during his Independence Day speech from the Red Fort on August 15, 2020.
    • The mission will enable access and exchange of longitudinal health records of citizens with their consent.
    • This will ensure ease of doing business for doctors and hospitals and healthcare service providers.

    The key components of the project include

    • Health ID for every citizen that will also work as their health account, to which personal health records can be linked and viewed with the help of a mobile application,
    • Healthcare Professionals Registry (HPR)
    • Healthcare Facilities Registries (HFR) that will act as a repository of all healthcare providers across both modern and traditional systems of medicine

    What makes this special?

    • The mission will create integration within the digital health ecosystem, similar to the role played by the Unified Payments Interface (UPI) in revolutionising payments.
    • Citizens will only be a click-away from accessing healthcare facilities.

     

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  • [pib] SAUBHAGYA Scheme completes 4 years

    The Pradhan Mantri Sahaj Bijli Har Ghar Yojana – SAUBHAGYA Scheme has successfully completed four years of its implementation.

    Progress till date

    • 82 crore households have been electrified since the launch of SAUBHAGYA till 31st March, 2021.

    About SAUBHAGYA Scheme

    • The Saubhagya is a scheme to ensure electrification of all willing households in the country in rural as well as urban areas.
    • It was launched in September 2017.
    • The Rural Electrification Corporation Limited (REC) is the nodal agency for the operationalization of the scheme throughout the country.

    Objective

    • To provide energy access to all by last mile connectivity and electricity connections to all remaining un-electrified households in rural as well as urban areas
    • To achieve universal household electrification in the country

    Beneficiaries of the project

    • The beneficiaries for free electricity connections would be identified using Socio-Economic and Caste Census (SECC) 2011 data.
    • However, un-electrified households not covered under the SECC data would also be provided electricity connections under the scheme on payment of Rs. 500 which shall be recovered by DISCOMs in 10 installments through electricity bill.
    • The solar power packs of 200 to 300 Wp with battery bank for un-electrified households located in remote and inaccessible areas, comprises Five LED lights, One DC fan, One DC power plug.
    • It also includes Repair and Maintenance (R&M) for 5 years.

    Implementation process

    • For the easy and accelerated implementation of the Scheme, modern technology shall be used for household surveys by using Mobile App.
    • Beneficiaries shall be identified and their application for electricity connection along with applicant photograph and identity proof shall be registered on spot.
    • The Gram Panchayat/Public institutions in the rural areas may be authorised to collect application forms along with complete documentation, distribute bills and collect revenue in consultation with the Panchayat Raj Institutions and Urban Local Bodies.

    Expected outcomes of the scheme

    The expected outcome of the Scheme is as follows:

    • Environmental upgradation by substitution of Kerosene for lighting purposes
    • Improvement education services
    • Better health services
    • Enhanced connectivity through radio, television, mobiles, etc.
    • Increased economic activities and jobs
    • Improved quality of life especially for women

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  • Disease surveillance system

    Context

    A well-functioning system can reduce the impact of diseases and outbreaks.

    Importance of disease surveillance system

    • Successful tackling of cholera in 1854 in London by use of the health statistics and death registration data from the General Registrar Office (GRO) started the beginning of a new era in epidemiology.
    • Importance of data: The application of principles of epidemiology is possible through systematic collection and timely analysis, and dissemination of data on the diseases.
    • This is to initiate action to either prevent or stop further spread, a process termed as disease surveillance.
    • Subsequently, the high-income countries invested in disease surveillance systems but low- and middle-income countries used limited resources for medical care.
    • Then, in the second half of the Twentieth century, as part of the global efforts for smallpox eradication and then to tackle many emerging and re-emerging diseases, many countries recognised the importance and started to invest in and strengthen the diseases surveillance system.
    • These efforts received a further boost with the emergence of Avian flu in 1997 and the Severe Acute Respiratory Syndrome (SARS) outbreak in 2002-04.

    Surveillance in India

    • The Government of India launched the National Surveillance Programme for Communicable Diseases in 1997.
    • However, this initiative remained rudimentary.
    • In wake of the SARS outbreak, in 2004, India launched the Integrated Disease Surveillance Project (IDSP).
    • The focus under the IDSP was to increase government funding for disease surveillance, strengthen laboratory capacity, train the health workforce and have at least one trained epidemiologist in every district of India.

    Issues with surveillance: Interstate variation

    • Variation among states: The disease surveillance system and health data recording and reporting systems are key tools in epidemiology.
    • In the fourth round of serosurvey, Kerala and Maharashtra States could identify one in every six and 12 infections, respectively; while in States such as Madhya Pradesh, Uttar Pradesh and Bihar, only one in every 100 COVID-19 infections could be detected.
    • This points towards a weak disease surveillance system.
    • In a well-functioning disease surveillance system, an increase in cases of any illness would be identified very quickly.
    • While Kerala is picking the maximum COVID-19 cases; it could pick the first case of the Nipah virus in early September 2021. 
    • On the contrary, cases of dengue, malaria, leptospirosis and scrub typhus received attention only when more than three dozen deaths were reported and health facilities in multiple districts of Uttar Pradesh, began to be overwhelmed.

    Way forward

    • A review of the IDSP in 2015, conducted jointly by the Ministry of Health and Family Welfare, the Government of India and World Health Organization India had made a few concrete recommendations to strengthen disease surveillance systems.
    • These included increasing financial resource allocation, ensuring an adequate number of trained human resources, strengthening laboratories, and zoonosis, influenza and vaccine-preventable diseases surveillance.
    • Increase allocation: The government resources allocated to preventive and promotive health services and disease surveillance need to be increased by the Union and State governments.
    • Trained workforce: The workforce in the primary healthcare system in both rural and urban areas needs to be retrained in disease surveillance and public health actions.
    • The vacancies of surveillance staff at all levels need to be urgently filled in.
    • Capacity increase: The laboratory capacity for COVID-19 needs to be planned and repurposed to increase the ability to conduct testing for other public health challenges and infections.
    • The interconnectedness of human and animal health: The emerging outbreaks of zoonotic diseases, be it the Nipah virus in Kerala or avian flu in other States as well as scrub typhus in Uttar Pradesh, are a reminder of the interconnectedness of human and animal health.
    • The ‘One Health’ approach has to be promoted beyond policy discourses and made functional on the ground.
    • Strengthening registration system: There has to be a dedicated focus on strengthening the civil registration and vital statistics (CRVS) systems and medical certification of cause of death (MCCD).
    • Coordination: It is also time to ensure coordinated actions between the State government and municipal corporation to develop joint action plans and assume responsibility for public health and disease surveillance.
    • The allocation made by the 15th Finance Commission to corporations for health should be used to activate this process.

    Consider the question “Examine the measure for disease surveillance in India? How it can help reduce the impact of the diseases?”

    Conclusion

    We cannot prevent every single outbreak but with a well-functioning disease surveillance system and with the application of principles of epidemiology, we can reduce their impact.

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