💥Join UPSC 2027,2028 Mentorship (August Batch) + XFactor Notes & Microthemes PDF
Talk to Mentor

Civilsdaily

Login

Subject: Governance

Important aspects of Society

  • Anganwadi centres

    The article highlights the role of Anganwadi’s in the effective implementation and service delivery under the ICDS.

    Gaps in the utilisation of services by ICDS

    • The economic fallout of COVID-19 makes the necessity of quality public welfare services more pressing than ever.
    • The Integrated Child Development Services (ICDS) programme is one such scheme.
    • ICDS caters to the nutrition, health and pre-education needs of children till six years of age as well as the health and nutrition of women and adolescent girls.  
    • However, recent reports have shown gaps in the utilisation of services.

    Recasting the Anganwadi centres

    • Anganwadi centres (AWCs) could become agents of improved delivery of ICDS’s services.
    • According to government data, the country has 13.77 lakh Anganwadi centres (AWCs).
    • These centres have expanded their reach, but they need to play a much larger role in anchoring community development.
    • Nearly a fourth of the operational AWCs lack drinking water facilities and 36 per cent do not have toilets.
    • In 2015, the NITI Aayog recommended better sanitation and drinking water facilities, improved power supply and basic medicines for the AWCs.
    • NITI Aayog also suggested that these centres be provided with the required number of workers, whose skills should be upgraded through regular training.
    •  It has acknowledged the need to improve anganwadi centres.
    • The Central government’s Saksham Anganwadi Scheme aims to upgrade 2.5 lakh such centres across the country. It is up to the state governments to take up the baton
    • Only a limited number of AWCs have facilities like creche, and good quality recreational and learning facilities for pre-school education.
    • An approach that combines an effective supplementary nutrition programme with pedagogic processes that make learning interesting is the need of the hour.

    Steps taken for effective implementation of ICDS

    • Effective implementation of the ICDS programme rests heavily on the combined efforts of the anganwadi workers (AWWs), ASHAs and ANMs.
    • The Centre’s POSHAN Abhiyaan has taken important steps towards building capacities of AWWs.
    • Technology can also be used for augmenting the programme’s quality.
    • AWWs have been provided with smartphones and their supervisors with tablets, under the government schemes.
    • Apps on these devices track the distribution of take-home rations and supplementary nutrition services.
    • The data generated should inform decisions to improve the programme.
    • In Andhra Pradesh and Telangana, anganwadi centres have been geotagged to improve service delivery.
    • Gujarat has digitised the supply chain of take-home rations and real-time data is being used to minimise stockouts at the anganwadi centres.

    Conclusion

    Government must act on the three imperatives. First, while infrastructure development and capacity building of the anganwadi remains the key to improving the programme, the standards of all its services need to be upscaled. Second, states have much to learn from each other’s experiences. Third, anganwadi centres must cater to the needs of the community and the programme’s workers.

  • Healthcare in India & Pandemic

    Pandemic has been ravaging the world in a way few could have imagined. It highlighted the flaws in our healthcare system. However, it also offers several important lessons for tackling future pandemics and healthcare emergencies.

    Where we stand after 1 year of pandemic

    • About a year after the first cases were reported, we are in a different position than at the start.
    • Doctors, public health specialists and policymakers have a better sense of the interventions that are required.
    • Many treatments initially proposed, based on expert experience, have been tested and removed from management strategies even as modified protocols have improved survival rates.
    • Vaccines have moved even faster than drugs with  nearly 40 of them undergoing clinical trials, a dozen of which are at the phase three stage, and at least one has been licensed post-phase three trials under conditional emergency use authorisation (EUA).
    • This highlights the importance of science, technology, multilateral partnerships such as the Coalition for Epidemic Preparedness Innovations and the WHO.
    • This highlights the importance of science, technology, multilateral partnerships such as the Coalition for Epidemic Preparedness Innovations and the WHO.

    Takeaways from our response to pandemic

    1) Increase investment on health services

    • The countries which handled the pandemic best (Thailand and Vietnam) have well-functioning health systems designed to deliver primary healthcare services.
    • These countries also have strong preventive and promotive health services as well as a dedicated public health workforce.
    • Their governments had made sustained investments in health over decades.
    • In contrast, countries which focused mainly on hospital centric medical systems struggled.

    2) Important role played by health workers

    • The role of community health workers in recognising, referring and motivating individuals for therapy was remarkable.
    • Healthcare workers, particularly those at the frontline, such as the accredited social health activists (ASHA) who visited hundreds of households repeatedly during the pandemic.
    •  If we are to build back better, we need to give them better recognition, salaries and career progression.

    3) Increase community participation

    • Third, community trust and participation is essential for implementation of non-pharmacological interventions.
    • Dharavi in Mumbai is an example of the difference community participation can make.

    4) Importance of data

    • Outside of the immediate response, the need for timely and quality data in a health information system was recognised again during the pandemic.
    • Without real time data on testing, disease surveillance and other outcomes, tailored responses are near impossible.
    • The solutions that have brought us hope have come from long-term private or public investments in scientific research and developments.

    Conclusion

    Future readiness needs to start now, and we have the resources and knowledge to do this — all we need is commitment and that is outlined in the recent National Health Policy 2017 and reiterated in the report of the Fifteenth Finance Commission, which for the first time has a dedicated chapter on health.

  • [pib] Digital platform ‘CO-WIN’

    A New Digital platform ‘CO-WIN’ is being used for COVID-19 Vaccine Delivery.

    Q.India’s first mass adult vaccination drive against COVID-19 is a difficult task. Explain.

    CO-WIN

    • This user friendly mobile app for recording vaccine data is working as a beneficiary management platform having various modules.
    • The platform will be used for recording vaccine data and will form a database of healthcare workers too.
    • The app will have separate modules for administrator, registration, vaccination, beneficiary acknowledgement and reports.
    • Once people start to register for the app, the platform will upload bulk data on co-morbidity provided by local authorities.
    • In the process of forming database of Healthcare Workers, which is in an advanced stage across all States/UTs, data is presently being uploaded on the Co-WIN platform.

    Prioritized group

    Prioritized Population Groups include:

    1. Healthcare Workers in both Government and Private Healthcare facilities
    2. Frontline Workers including personnel from state and central police department, armed forces, home guard, civil defence organizations, disaster management volunteers and municipal workers and
    3. Prioritized Age Group, which includes those aged above 50 years & those with co-morbidities

    (Note: This is not the sequence, but categorization.)

  • Who are the Tharu Tribals?

    The Uttar Pradesh government has recently embarked upon a scheme to take the unique culture of its ethnic Tharu tribe across the world.

    The Terai or Tarai is a lowland region in northern India and southern Nepal that lies south of the outer foothills of the Himalayas, the Sivalik Hills, and north of the Indo-Gangetic Plain. This lowland belt is characterized by tall grasslands, scrub savannah, sal forests and clay rich swamps.

    Tharu Tribals

    • The community belongs to the Terai lowlands, amid the Shivaliks of lower Himalayas. Most of them are forest dwellers and some practised agriculture.
    • The word Tharu is believed to be derived from their, meaning followers of Theravada Buddhism.
    • The Tharus live in both India and Nepal. In the Indian Terai, they live mostly in Uttarakhand, Uttar Pradesh, and Bihar.
    • According to the 2011 census, the Scheduled Tribe population in Uttar Pradesh was more than 11 lakh; this number is estimated to have crossed 20 lakh now.
    • The biggest chunk of this tribal population is made up of Tharus.
    • Members of the tribe survive on wheat, corn and vegetables are grown close to their homes. A majority still lives off the forest.

    Tharu language, food, and culture

    • They speak various dialects of Tharu, a language of the Indo-Aryan subgroup, and variants of Hindi, Urdu, and Awadhi.
    • In central Nepal, they speak a variant of Bhojpuri, while in eastern Nepal, they speak a variant of Maithili.
    • Tharus worship Lord Shiva as Mahadev and call their supreme being “Narayan”, who they believe is the provider of sunshine, rain, and harvests.
    • Tharu women have stronger property rights than is allowed to women in mainstream North Indian Hindu custom.
    • Standard items on the Tharu plate are bagiya or dhikri – which is a steamed dish of rice flour that is eaten with chutney or curry – and ghonghi, an edible snail that is cooked in a curry made of coriander, chili, garlic, and onion.

    What is this scheme about?

    • The UP government is working to connect Tharu villages in the districts of Balrampur, Bahraich, Lakhimpur and Pilibhit bordering Nepal, with the homestay scheme of the UP Forest Department.
    • The idea is to offer tourists an experience of living in the natural Tharu habitat, in traditional huts made of grass collected mainly from the forests.
    • Tharu homeowners will be able to charge tourists directly for the accommodation and home-cooked meals.
    • The government expects both domestic and international tourists to avail of the opportunity to obtain a taste of the special Tharu culture by staying with them, observing their lifestyle, food habits, and attire.

  • Surgery as part of Ayurveda

    Last month, a government notification listed out specific surgical procedures that a postgraduate medical student of Ayurveda must be “practically trained to acquaint with, as well as to independently perform”.

    Q.Allowing modern surgeries to Ayurveda professionals is a mixopathy and an encroachment into the jurisdiction and competencies of modern medicine. Critically analyse.

    What is the notification?

    • The notification mentions 58 surgical procedures that postgraduate students must train themselves in and acquires skills to perform independently.
    • These include procedures in general surgery, urology, surgical gastroenterology, and ophthalmology.

    The issue

    • The notification has invited sharp criticism from the Indian Medical Association, which questioned the competence of Ayurveda practitioners to carry out these procedures.
    • They have called the notification as an attempt at “mixopathy”.
    • The IMA has planned nationwide protests against this notification and has threatened to withdraw all non-essential and non-Covid services.

    Surgery as a part of Ayurveda

    • It is not that Ayurveda practitioners are not trained in surgeries, or do not perform them.
    • In fact, they take pride in the fact that their methods and practices trace their origins to Sushruta, an ancient Indian sage and physician.
    • The comprehensive medical treatise Sushruta Samhita has, apart from descriptions of illnesses and cures, detailed accounts of surgical procedures and instruments.
    • There are two branches of surgery in Ayurveda — Shalya Tantra, which refers to general surgery, and Shalakya Tantra which pertains to surgeries related to the eyes, ears, nose, throat and teeth.
    • All postgraduate students of Ayurveda have to study these courses, and some go on to specialize in these and become Ayurveda surgeons.

    Distinctions in surgical procedures

    • For several surgeries Ayurvedic procedures almost exactly match those of modern medicine about how or where to make a cut or incision, and how to perform the operation.
    • There are significant divergences in post-operative care, however.
    • The only thing that Ayurveda does not do is super-speciality surgeries, like neurosurgery or open-heart surgeries.
    • For most other needs, there are surgical procedures in Ayurveda. It is not very different from allopathic medicine.

    Ayurvedic surgeries before the notification

    • PG education in Ayurveda is guided by the Indian Medical Central Council (Post Graduate Education) Regulations framed from time to time.
    • Currently, the regulations formulated in 2016 are in force. The latest notification of last month is an amendment to the 2016 regulations.
    • The 2016 regulations allow postgraduate students to specialise in Shalya Tantra, Shalakya Tantra, and Prasuti evam Stree Roga (Obstetrics and Gynecology), the three disciplines involving major surgical interventions.
    • Students of these three disciplines are granted MS (Master in Surgery in Ayurveda) degrees.

    Arguments in favour

    • Ayurveda practitioners point out that students enrolling in Ayurveda courses have to pass the same NEET (National Eligibility-cum-Entrance Test).
    • Ayurveda institutions prescribe textbooks from modern medicine, or that they carry out surgeries with the help of practitioners of modern medicine.
    • Their course, internship and practice also run parallel to the MBBS courses.
    • Postgraduate courses require another three years of study. They also have to undergo clinical postings in the outpatient and In-patient departments at hospitals apart from getting hands-on training.
    • Medico-legal issues, surgical ethics and informed consent is also part of the course apart from teaching Sushruta’s surgical principles and practices.

    So, what is new?

    • Ayurveda practitioners say the latest notification just brings clarity to the skills that an Ayurveda practitioner possesses.
    • The surgeries that have been mentioned in the notification are all that are already part of the Ayurveda course. But there is little awareness about these.
    • A patient is usually not clear whether an Ayurvedic practitioner has the necessary skill to perform one of these operations.
    • Now, they know exactly what an Ayurveda doctor is capable of. The skill sets have been defined. This will remove question marks on the ability of an Ayurveda practitioner.

    What are the IMA’s objections?

    • IMA doctors insist that they are not opposed to the practitioners of the ancient system of medicine.
    • But they say the new notification somehow gives the impression that the skills or training of the Ayurveda doctor in performing modern surgeries are the same as those practising modern medicine.
    • This, they say, is misleading, and an “encroachment into the jurisdiction and competencies of modern medicine”.
    • The IMA has condemned the move calling it predatory poaching on modern medicine and its surgical disciplines.
    • The IMA has demanded that the notification, as well as the NITI Aayog, move towards ‘One Nation One System’ (of AYUSH) be withdrawn.

  • Caste Census and associated issues

    The Tamil Nadu government has decided to appoint a commission to formulate a methodology to collect caste-wise particulars of its population and use that to come up with a report.

    Q.India’s caste system is perhaps the world’s longest surviving social hierarchy. Critically analyse.

    The issue

    • The Centre conducted a ‘Socio-Economic Caste Census’ (SECC) in 2011 throughout the country, but it did not make public the caste component of the findings.
    • In Karnataka, the outcome of a similar exercise has not been disclosed to the public.

    Caste details as a part of the census

    • Caste was among the details collected by enumerators during the decennial Census of India until 1931.
    • It was given up in 1941, a year in which the census operation was partially affected by World War II.
    • In his report on the 1941 exercise, then Census Commissioner of India, M.W.M. Yeatts, indicated that tabulation of caste details separately involved additional costs.
    • However, at the time of sorting the details, some provinces or States that wanted a caste record for administrative reasons were given some data on payment.

    Issues with caste in the census

    • H. Hutton, the Census Commissioner in 1931, notes that on the occasion of each successive census since 1901, some criticism had been raised about taking any note of the fact of caste.
    • It has been alleged that the mere act of labelling persons as belonging to a caste tends to perpetuate the system.
    • Some argue that there is nothing wrong in recording a fact and ignoring its existence.

    View after Independence

    • The 1951 census did not concern itself with questions regarding castes, races and tribes, except insofar as the necessary statistical material related to ‘special groups’.
    • It created certain other material relating to backward classes collected and made over to the Backward Classes Commission.
    • ‘Special Groups’ has been explained as referring to Scheduled Castes, Scheduled Tribes, Anglo-Indians and certain castes treated provisionally as ‘backward’ for the purposes of the census.
    • This implies that BC data were collected, but not compiled or published.

    How have caste details been collected so far?

    • While SC/ST details are collected as part of the census, details of other castes are not collected by the enumerators.
    • The main method is by self-declaration to the enumerator.
    • So far, backward classes commissions in various States have been conducting their own counts to ascertain the population of backward castes.
    • The methodology may vary from State to State.

    What about SECC 2011?

    • The Socio-Economic Caste Census of 2011 was a major exercise to obtain data about the socio-economic status of various communities.
    • It had two components: a survey of the rural and urban households and ranking of these households based on pre-set parameters, and a caste census.
    • However, only the details of the economic conditions of the people in rural and urban households were released. The caste data have not been released till now.
    • While a precise reason is yet to be disclosed, it is surmised that the data were considered too politically sensitive.
    • Fear of antagonizing dominant and powerful castes that may find that their projected strength in the population is not as high as claimed may be an important reason.

    Legal imperative for a caste count

    • The Supreme Court has been raising questions about the basis for reservation levels being high in various States.
    • In particular, it has laid down that there should be quantifiable data to justify the presence of a caste in the backward class list, as well as evidence of its under-representation in services.
    • It has also called for periodical review of community-wise lists so that the benefits do not perpetually go in favour of a few castes.

    Caste data for reservations

    • Legislators argue that knowing the precise number of the population of each caste would help tailor the reservation policy to ensure equitable representation of all of them.
    • While obtaining relevant and accurate data may be the major gain from a caste census, the possibility that it will lead to heartburn among some sections and spawn demands for larger or separate quotas.

  • What are Municipal Bonds?

    Bonds issued by the Lucknow Municipal Corporation (LMC) got listed on the Bombay Stock Exchange. It’s the ninth city in the country to raise capital through municipal bonds.

    Find out the rest eight cities issuing Municipal Bonds in India. Do let us know in the comment box.

    What are Municipal Bonds?

    • A municipal bond or muni bond is a debt instrument issued by municipal corporations or associated bodies.
    • These local governmental bodies utilise the funds raised through these bonds to finance projects for socio-economic development through building bridges, schools, hospitals, providing proper amenities to households, et al.
    • Such bonds come with a maturity period of three years, whereby municipal corporations provide returns on these bonds either from property and professional tax collected or from revenues generated from specific projects or both.
    • The Securities and Exchange Board of India (SEBI) revised the guidelines related to the issuance of municipal bonds in 2015 in an attempt to enable ULBs or local government bodies to raise finances from such sources.
    • Following this measure, different cities have capitalized on the new guidelines to fund initiatives such as Atal Mission for Rejuvenation and Urbanisation Transformation (AMRUT) and Smart Cities Mission.

    Their types

    There are primarily two types of municipal bonds in India, categorised as per their usage. These are –

    (1) General Obligation Bonds

    • These are issued to raise finances for general projects such as improving the infrastructure of a region.
    • Repayment of the bond, along with interest, is processed through revenue generated from different projects and taxes.

    (2) Revenue Bonds

    • These are issued to raise finance for specific projects, such as the construction of a particular building.
    • Repayment of such bonds (principal and accrued interest) shall be paid through revenues explicitly generated from the declared projects.

    Advantages of such Bonds

    There are multiple advantages of investing in municipal bonds which include –

    (1)Transparency

    Municipal bonds that are issued to the public are rated by renowned agencies such as CRISIL, which allows investors transparency regarding the credibility of the investment option.

    (2)Tax benefits

    In India, municipal bonds are exempted from taxation if the investor conforms to certain stipulated rules. In addition to such conformation, interest rates generated on such investment tools are also exempt from taxation policy.

    (3) Minimal risk

    Municipal bonds are issued by municipal authorities, implying involvement of minimal risk with these securities.

    Their limitations

    The disadvantages of municipal bonds are enumerated below –

    (1) Long maturity period

    • Municipal bonds come with a lock-in period of three years, imposing a burden on the liquidity requirements of investors.

    (2) Low-interest rates

    • Even though interest rates on municipal bonds, in some cases, are higher than other debt instruments, these rates are considerably low when compared to returns from market-linked financial instruments such as equity shares.

  • India’s Population with Disabilities

    December 3 is marked by the UN as International Day of Persons with Disabilities in a bid to promote a more inclusive and accessible world for the differently-abled and to raise awareness for their rights.

    Try this question from our AWE initiative:

    What are the legal provisions and policy initiatives in India for the welfare of persons with disabilities? What are the challenges faced by persons with disabilities in India? 10 marks

    Disability in India

    • About 2.2% of India’s population lives with some kind of physical or mental disability, as per the National Statistics Office report on disability released last year.

    How are the disabled identified?

    • Until the 2011 census, there were questions on seven kinds of disabilities in the questionnaire.
    • This list of disabilities was expanded to 21 when the Rights of People with Disabilities was introduced in 2016.
    • Accordingly, the 2019 report included questions to identify people with temporary loss of ability as well as neurological and blood disorders in addition.
    • The earlier definition included mental retardation and permanent inability to move, speak, hear and see.
    • Significantly, the revised definition recognizes deformities and injuries of acid attack victims as disabilities, entitling them to various relief measures.

    Who are disabled and in what way?

    • Rural men had the highest prevalence of disability in India, according to the NSO report.
    • A higher proportion of men were disabled in India compared with women, and disability was more prevalent in rural areas than in urban areas.
    • Inability to move without assistance was the most common disability. More men experienced locomotor disability than women.
    • These numbers were self-reported. In other words, the respondents were asked if they experienced any difficulty in performing tasks like moving, talking, etc.

    Are these measures in line with those from other surveys?

    • The 2011 census estimated that the number of people with disabilities in India is close to 2.68 crore (or 2.2% of the population) — that is more than the entire population of Australia.
    • This number was based on the older definition of disability, yet the proportion of disabled people in the population is not different from the 2019 NSO report, which used the expanded definition of disability.
    • Other metrics for evaluating disability have provided different estimates.
    • A group of doctors from AIIMS found that alternate questionnaires like the Rapid Assessment of Disability have resulted in a prevalence ranging from 1.6%-43.3%.

    How can the range be so wide?

    • The proportion of population facing disability becomes bigger as one move from a narrow definition to a broader one.
    • For instance, if one defines disability as the difficulty in accessing public services for all kinds of reasons, even social or economic, then the proportion goes up.

    Why is it important to map disabled people?

    • Like other disadvantaged groups, the disabled in India are entitled to some benefits, ranging from reservation in educational institutes to concessions on railway tickets.
    • To claim these benefits, they have to furnish certificates as proof of disability.
    • At the macro level, data on the prevalence and type of disability is useful while making allocations for welfare schemes.

  • Issues related to disability

    Legal provisions not turning into reality through their implementation adds to the difficulties faced by persons with disabilities. The article deals with the idea of enabling persons with disability to contribute to society.

    Context

    • December 3 is the annual International Day of Persons with Disabilities, it is also a stark reminder of how far we in India need to go in meeting the needs of the disabled.

    Lack of implementation of provisions

    • The World Bank estimates that there may be well over 40 million Indians living with disabilities.
    • The Rights of Persons with Disabilities Act was passed in 2016 but our country is still largely devoid of ramps on its footpaths or government buildings.
    • The law promises them equality of opportunity and accessibility. Our practices deny them what the law promises.

    Challenges faced by persons with disabilities

    • Indians with disabilities are far more likely to suffer from poor social and economic development.
    •  45 per cent of this population is illiterate, making it difficult for them to build better, more fulfilled lives.
    • This is compounded by the community’s lack of political representation:
    • In our seven decades of independence, we have had just four parliamentarians and six state assembly members who suffer from visible disabilities.
    • This lack of representation, and these general attitudes, translate directly into policy that undermines the well-being of people with disabilities.
    •  Last year, for example, the government inexplicably decided to depart from convention and render people suffering from cerebral palsy ineligible for the Indian Foreign Service.

    Initiatives and steps taken by the government

    • The government has had some admirable initiatives to improve the lot of Indians with disabilities, such as the ADIP scheme for improving access to disability aids.
    • The Sugamya Bharat Abhiyan, or Accessible India Campaign, has aimed to make public transport, buildings and websites more accessible.
    • In 2017, the Mental Healthcare Act recognised and respected the agency of persons with mental-health conditions, expanding the presence of mental-health establishments across the country, restricted the harmful use of electroshock therapy, clarified the mental-health responsibilities of state agencies such as the police, and effectively decriminalised attempted suicide.
    •  In 2007, the UN passed the Convention on the Rights of Persons with Disabilities.
    • India is a state party to the convention.

    Conclusion

    It is critical that the government work with civil society and individuals with disabilities to craft an India where everyone feels welcome and treated with respect, regardless of their disabilities. Only then can we welcome the next International Day of Persons with Disabilities without a sense of shame.

  • [pib] E-Sanjeevani Telemedicine Service

    In a landmark achievement, eSanjeevani, Health Ministry’s national telemedicine initiative today completed 9 lakh consultations.

    Although telemedicine brings with it many benefits, there are some downsides to it as well. Discuss.

    What is E-Sanjeevani?

    • Ministry of Health & Family Welfare has launched two variants of eSanjeevani namely – doctor to doctor (eSanjeevani AB-HWC) in the hub and spoke model and patient to doctor (eSanjeevaniOPD).
    • E-Sanjeevani OPD (out-patient department) is a telemedicine variant for the public to seek health services remotely; it was rolled out on 13th of April 2020 during the first lockdown in the country.
    • It enables virtual meetings between the patients and doctors & specialists from geographically dispersed locations, through video conferencing that occurs in real-time.
    • At the end of these remote consultations, eSanjeevani generates electronic prescriptions which can be used for sourcing medicines.
    • Andhra Pradesh was the first state to roll out eSanjeevani AB-HWC services in November 2019.

    Benefits of telemedicine

    Telemedicine benefits patients in the following ways:

    • Transportation: Patients can avoid spending gas money or wasting time in traffic with video consultations.
    • No missing work: Today, individuals can schedule a consultation during a work break or even after work hours.
    • Childcare/Eldercare Challenges: Those who struggle to find care options can use telemedicine solutions.