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Subject: Health

  • Identify the Millennium Development Goals (MDGs) that are related to health. Discuss the success of the actions taken by the Government for achieving the same.

  • Public health system has limitations in providing universal health coverage. Do you think that the private sector could help in bridging the gap? What other viable alternatives would you suggest?

  • ‘To ensure effective implementation of policies addressing water, sanitation and hygiene needs, the identification of beneficiary segments is to be synchronized with the anticipated outcomes’ Examine the statement in the context of the WASH scheme.

  • Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All ‘ in India. Explain.

    The goal of ‘Health for All’, as envisioned in the Alma-Ata Declaration (1978) and reinforced through National Health Policy 2017, emphasizes universal, equitable, and accessible healthcare.

    Importance of Local Community-Level Healthcare Interventions

    Accessibility and Inclusivity – Brings primary healthcare closer to grassroot and reduces dependency on overburdened tertiary hospitals. Eg- Ayushman Bharat – Health and Wellness Centres (HWCs)

    Preventive and Promotive Health – Community health workers (e.g., ASHA, Anganwadi, ANM) enable early detection, immunization, maternal and child care.

    Local interventions are more trust-based, improving adoption of health services. Eg- ASHA workers act as a bridge between local communities and formal healthcare systems

    Cost-Effectiveness – Community-based preventive healthcare reduces out-of-pocket expenditure (OOPE). (Presently at 40%)

    Empowering Local Governance – Panchayati Raj Institutions (PRIs) and Village Health Sanitation and Nutrition Committees (VHSNCs) ensure decentralized planning and monitoring.

    Integration of Traditional and Modern Systems – Incorporates AYUSH practices alongside allopathy to widen reach and enhance preventive health.

    Empowering Women and Local Workforce – ASHAs and Anganwadi workers-over 10 lakh women-act as frontline caregivers.

    Community health networks enable rapid disease surveillance and emergency response. Eg- ASHAs and PRIs played a critical role in contact tracing during COVID-19

    Continuous community engagement increases awareness of disease prevention, hygiene, family planning, and nutrition.

    Key Challenges

    Shortage of trained manpower and high attrition among ASHA and ANM workers.

    Inadequate infrastructure at Sub-Centres and PHCs.

    Weak inter-sectoral convergence (between health, sanitation, and nutrition departments).

    Limited community participation due to lack of awareness and ownership.

    Way Forward

    Strengthen Primary Health Infrastructure: Upgrade all 1.5 lakh HWCs with telemedicine and diagnostics.

    Capacity Building: Continuous training and performance-based incentives for ASHA and ANM workers.

    Community Ownership: Empower Panchayats and SHGs in planning and monitoring local health outcomes.

    Technology Integration: Use eSanjeevani, digital health IDs, and mobile-based health tracking.

    Social Determinants Approach: Integrate health with nutrition, sanitation (Swachh Bharat), and clean energy (Ujjwala Yojana).

    Achieving Universal Health Coverage (UHC) by strengthening local healthcare will help realize the vision of “Swasth Bharat – Samriddh Bharat.”

  • In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss.

    ​​Social development rests on improving human well-being, equity, and inclusivity. Health care is a key determinant of human capital formation and social progress.

    Importance of Geriatric Care

    India’s elderly (60+ years) population is projected to reach 19.5% by 2050 (UNFPA).

    A larger elderly population implies growing dependency ratios and burden on families and social welfare

    Healthy and active elderly contribute to knowledge transfer, social cohesion, and community engagement.

    Reduces healthcare expenditure through preventive and primary care, enhancing productivity of caregivers.

    Healthy ageing aligns with the SDG 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities).

    Key Interventions

    National Programme for Health Care of the Elderly (NPHCE) – dedicated geriatric units in district hospitals.

    Atal Vayo Abhyuday Yojana (AVYAY) – integrated senior citizen welfare.

    Ayushman Bharat – provides insurance for elderly with chronic diseases.

    Importance of Maternal Healthcare

    Foundation of Human Development – Maternal health directly influences infant mortality, child nutrition, and family welfare.

    Promotes inter-generational well-being, preventing malnutrition and anaemia cycles.

    Economic Impact – Reduces healthcare costs, improves labour participation of women,

    Healthier mothers mean healthier children and better learning outcomes, strengthening the human capital base.

    Key Interventions

    Janani Suraksha Yojana (JSY) and Pradhan Mantri Matru Vandana Yojana (PMMVY) – incentives for institutional deliveries and nutrition.

    POSHAN 2.0 – integration of health and nutrition for pregnant and lactating women.

    LaQshya and SUMAN – focus on quality maternal and newborn care.

    Challenges in Maternal and Geriatric Healthcare

    Shortage of geriatric specialists, gynaecologists, and ASHA workers in rural areas.

    Regional Disparities – Maternal mortality in Assam (195) vs. Kerala (19).

    Out-of-pocket expenditure (OOPE) remains 40%, pushing poor households into poverty.

    Focus remains on curative rather than preventive health.

    Social and Cultural Barriers

    Patriarchal norms restrict women’s access to healthcare and nutrition.

    Elderly often face neglect, isolation, and financial insecurity.

    Way Forward

    Increase Public Health Expenditure to 2.5% of GDP as per National Health Policy 2017.

    Strengthen Home-Based Care Models and palliative services for the elderly.

    Decentralize Planning and Monitoring via Panchayati Raj Institutions. (Kerala Model)

    Strengthen ASHAs, ANMs, and geriatric caregivers at village level.

    Use of telemedicine (eSanjeevani) and digital records for continuum of care.

    A life-cycle approach to health is essential to achieve equitable and sustainable development and achieve Viksit Bharat @2047.

  • “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse.(150 words)

    The Directive Principles of State Policy (Articles 38, 39, 42, and 47) mandate the State to ensure the health and well-being of all citizens.

    Moral Imperative of the Welfare State

    Right to Health forms part of Article 21 (Right to Life)

    Ensuring accessible, affordable, and equitable healthcare upholds social justice and human dignity.

    Primary healthcare represents state accountability towards vulnerable groups, fulfilling the ethos of “Sabka Saath, Sabka Vikas.”

    Reduces out of pocket expenditure and vicious cycle of poverty

    Primary Health as a Precondition for Sustainable Development

    SDG-3 emphasizes ensuring healthy lives and well-being for all.

    Social Development – Reduces disease burden, enhances productivity, and improves quality of life. Eg- Reduction in IMR (24) and MMR (97)

    Economic Development – World Bank (2023):

    Strong primary healthcare ensures better productivity, improved livelihoods, and universal healthcare access.

    Institutional Sustainability – Strengthens local governance and community participation in health planning. Eg- ASHA workers

    Supported by the Astana Declaration and National Health Policy 2017, which envisions comprehensive and affordable healthcare.

    Key Challenges

    India spends only 1.9% of GDP on healthcare (Economic Survey 2024), far below the WHO’s recommendation of 2.5%.

    Overemphasis on tertiary care- only 15% of public funds go to primary care

    Human resource shortage: Shortfall of 76% doctors at PHCs (RHS 2023).

    Urban-Rural Disparities (Spatial Inequity) – only 33% of doctors and 25% of hospital beds in rural areas.

    Way Forward

    Increase Public Health Expenditure to 2.5% of GDP as per National Health Policy 2017.

    Decentralize Planning and Monitoring via Panchayati Raj Institutions. (Kerala Model)

    Strengthen ASHAs, ANMs, and geriatric caregivers at village level.

    Use of telemedicine (eSanjeevani) and digital records for continuum of care.

    Strong primary and preventive healthcare is essential to achieve equitable and sustainable development and achieve Viksit Bharat @2047.

  • In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.

    The Directive Principles of State Policy (Articles 38, 39, 42, and 47) mandate the State to ensure the health and well-being of all citizens. However, increasing marketisation of healthcare has led to inequality and exclusion, necessitating proactive state intervention.

    Adverse Impacts of Marketisation

    High OOPE: Nearly 47% of health expenditure in India is borne out-of-pocket (NHA 2023).

    Around 75% of private hospitals are located in urban areas, creating rural-urban disparities

    Profit Orientation: Commercial motives undermine equity and quality.

    Violation of Right to Health under Article 21 (Olga Tellis Case)

    Neglect of Preventive and Primary Care – Private sector prioritises curative and high-profit specialities

    Erosion of Equity and Ethics: Healthcare becomes a commodity

    Weak Regulation and Accountability leads to price inflation, quackery, and malpractice.

    Brain Drain from Public Sector due to better pay and infrastructure in private sector

    Role of the State

    As per Article 38 and 47, the State must promote public health and ensure equitable access.

    Ensuring Universal Health Coverage (UHC): State intervention is key to fulfilling SDG-3 (Good Health and Well-being) and ensuring healthcare equity.

    Correcting Market Failures: Government must act as a regulator and service provider, ensuring affordability, quality, and inclusivity.

    Measures to Enhance Reach of Public Healthcare at the Grassroots Level

    Upgrade Sub-Centres, PHCs, and CHCs under the Ayushman Bharat. Ensure diagnostic labs, maternity wards, and telemedicine facilities at PHC level.

    Raise public health spending to 2.5% of GDP (National Health Policy 2017). Prioritise spending on rural and preventive healthcare.

    Recruit and train ASHA, ANM, and community health officers with proper incentives and infrastructure.

    Implement transparent PPPs for tertiary healthcare in district hospitals (NITI Aayog)

    Expand Pradhan Mantri Jan Aushadhi Kendras for affordable drugs. Mandate prescription of generic medicines.

    Decentralised Health Governance – Empower Panchayati Raj Institutions and urban local bodies for health planning, awareness, and monitoring. (Kerala Model)

    Preventive Health – Strengthen immunisation, sanitation, and nutrition programmes (e.g., POSHAN Abhiyaan, Swachh Bharat).

    Promote health literacy through ASHA-led campaigns.

    Expand telemedicine (eSanjeevani) to connect rural PHCs with urban specialists.

    Integrate AYUSH systems with allopathic care at PHC level for holistic wellness.

    By strengthening primary care, the State can transform healthcare into a rights-based, inclusive, and sustainable system, achieving the goal of “Swastha Bharat, Samriddh Bharat.”

    Issues Related to Poverty and Hunger

  • [22nd June 2026] The Hindu OpED: End the free rein of junk food advertising in India

    Mentor’s Comment

    India committed in 2017 to restrict the advertising of ultra-processed foods (UPFs) and foods high in fat, sugar and sodium (HFSS) foods under the National Multisectoral Action Plan, but that commitment remains unimplemented. In February 2026, the Supreme Court of India weighed in on the issue through a PIL on front-of-pack warning labels, and the Economic Survey 2025-26 called for stronger regulation of UPF advertising, bringing the policy gap into sharp focus.

    What has made UPF and HFSS advertising a public health concern?

    1. Rising exposure: Children and adolescents encounter UPF advertisements across television, social media, sports broadcasts and influencers.
    2. Misleading health claims: Advertisements highlight selective attributes such as “baked”, “multigrain” or “12-grain” and conceal high sugar, salt and fat content.
    3. Targeted marketing: Celebrity endorsements and child actors increase product appeal among vulnerable consumers.
    4. Demand creation: Advertising does not merely reflect demand. It actively shapes consumer preferences and consumption patterns.
    5. Scale of advertising expenditure: In 2024, three major transnational corporations spent USD 13.2 billion on UPF advertising globally. In India alone, more than two lakh junk food advertisements appeared in a single month, backed by an advertising expenditure of approximately ₹170 crore.

    Why are UPFs increasingly linked to adverse health outcomes?

    1. Industrial formulation: UPFs contain additives, flavour enhancers, emulsifiers and refined ingredients designed for high palatability.
    2. Overconsumption effect: Their design encourages repeated consumption and reduces satiety.
    3. Diet displacement: UPFs replace traditional and minimally processed foods.
    4. Disease burden: Scientific evidence links high UPF consumption to obesity, hypertension, diabetes and cardiovascular diseases.
    5. Rising NCD challenge: Growing UPF consumption coincides with increasing obesity rates globally and in India.

    Why are existing regulatory safeguards proving inadequate?

    1. Policy implementation gap: The National Multisectoral Action Plan (2017-2022) envisaged restrictions on HFSS advertising, but implementation remains incomplete.
    2. Weak disclosure norms: Advertisements can omit critical nutritional information and still remain legally compliant.
    3. Limited consumer protection: Existing rules focus more on product safety than marketing practices.
    4. Judicial concern: The Supreme Court has highlighted the need for stronger consumer information measures such as front-of-pack labelling.
    5. Reliance on self-regulation: Industry-led safeguards have not substantially reduced child-targeted advertising.

    What Is the Constitutional and Legal Basis for Restricting UPF and HFSS Advertising?

    1. State duty to protect vulnerable groups: Children are especially vulnerable to food marketing, requiring state intervention to safeguard public health.
    2. Existing policy commitment: The NMAP (2017-22) envisaged restrictions on HFSS food advertising, but implementation remains pending.
    3. Advertising law as the key instrument: The proposed solution is amendment of advertising laws, a measure already contemplated by the government.
    4. Supporting legal measures: The Supreme Court (2026) endorsed front-of-pack labelling, while MPs have advocated warning labels and taxation of UPFs.
    5. Right to health framework: Regulation of unhealthy food advertising flows from the constitutional right to health and is supported by the Economic Survey 2025-26.

    Does nutrition education alone solve the problem?

    1. Information asymmetry: Consumers receive nutrition advice but are simultaneously exposed to aggressive food marketing.
    2. Behavioural influence: Marketing exploits emotional triggers that often outweigh rational dietary choices.
    3. Children’s vulnerability: Children lack the capacity to critically assess persuasive advertising.
    4. Environmental constraint: Food choices are shaped by the surrounding commercial environment, not only by awareness levels.
    5. Public health limitation: Education programmes cannot fully offset continuous exposure to unhealthy food promotion.

    What do international experiences demonstrate about food advertising regulation?

    1. City of San Francisco lawsuit against UPF manufacturers: In 2024, San Francisco filed a lawsuit against 10 major UPF manufacturers alleging child-targeted marketing, highly compelling product formulations, and inadequate health risk disclosure. The suit sought prevention of deceptive marketing and corrective measures for past false advertising.
    2. Chile: Strong statutory restrictions on unhealthy food advertising reduced reliance on voluntary industry commitments.
    3. Mexico: Regulatory interventions demonstrated greater effectiveness than self-regulation mechanisms.
    4. Global evidence: International experience shows enforceable legal measures outperform voluntary compliance frameworks.
    5. Lancet Series evidence (November 2025): Three papers published in The Lancet in November 2025 presented scientific evidence linking UPF consumption to poorer diet quality, displacement of real foods, hypertension, cardiovascular disease, type 2 diabetes, obesity, and other non-communicable diseases. The series argued that policymaking should not wait for further evidence.

    Why is this ultimately a state responsibility rather than a market choice?

    1. Right to Health: The state has a constitutional duty to protect public health when harms are foreseeable.
    2. Child protection principle: Children constitute a vulnerable group requiring enhanced regulatory safeguards.
    3. Market failure: Consumers often lack complete information about nutritional risks.
    4. Externalities: Rising obesity and NCDs impose social and healthcare costs beyond individual consumers.
    5. Public interest regulation: Restrictions on harmful advertising are comparable to other public health interventions.

    What policy changes are required?

    1. Advertising restrictions: Prohibit or significantly restrict child-targeted advertising of UPFs and HFSS foods.
    2. Front-of-pack labelling: Introduce clear warning labels to improve informed choice.
    3. Digital platform regulation: Extend restrictions to social media, influencers and online advertising.
    4. Stronger enforcement: Replace voluntary compliance with statutory obligations and penalties.
    5. Healthy food promotion: Incentivise marketing of minimally processed and nutritious foods.

    Conclusion

    The central issue is not consumer ignorance but the commercial environment that shapes food choices. Nutrition education cannot succeed when aggressive marketing continuously promotes unhealthy foods. India’s public health response must move beyond awareness campaigns and regulate the advertising ecosystem that drives UPF consumption, especially among children.

  • International Sickle Cell Day 2026

    Why in the news?

    The President of India, Droupadi Murmu, commemorated International Sickle Cell Day at Omkareshwar and highlighted the achievements of the National Sickle Cell Anaemia Elimination Mission (NSCAEM).

    National Sickle Cell Anaemia Elimination Mission (2023)

    • Launched to eliminate Sickle Cell Disease (SCD) as a public health problem by 2047.
    • Targets screening of 7 crore people (0-40 years age group) in affected tribal and high-prevalence areas.
    • One of the world’s largest genetic disease screening programmes.
    • So far: Around 2.5 lakh patients identified. Over 20 lakh carriers detected.

    Sickle Cell Disease (SCD)

    • A hereditary genetic blood disorder caused by mutation in the haemoglobin gene.
    • Red blood cells become sickle-shaped, reducing oxygen supply.
    • Leads to anaemia, pain episodes, infections, organ damage, and reduced life expectancy.
    • Inherited in an autosomal recessive pattern.

    High-Risk Areas in India

    • Predominantly affects tribal populations across Madhya Pradesh, Maharashtra, Chhattisgarh, Odisha, Gujarat, Jharkhand, and Rajasthan

    Madhya Pradesh Initiatives

    • Sickle Mitra Initiative: Trains volunteers, NCC cadets, and civil society members for awareness and patient support.
    • Swasth Nari, Sashakt Parivar Abhiyan (2025): Screened over 4 lakh women for SCD.

    [2023] Consider the following statements in the context of interventions being undertaken under Anaemia Mukt Bharat Strategy:
    1. It provides prophylactic calcium supplementation for pre-school children, adolescents and pregnant women.
    2. It runs a campaign for delayed cord clamping at the time of child- birth.
    3. It provides for periodic deworming to children and adolescents.
    4. It addresses non-nutritional causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis.
    How many of the statements given above are correct?

    [A] Only one

    [B] Only two

    [C] Only three

    [D] All four

  • [19th June 2026] The Hindu OpED: NFHS-6 reveals progress amid nutrition challenge

    PYQ Relevance[UPSC 2018] Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain.
    Linkage: The NFHS-6 findings highlight that achieving better nutrition outcomes requires community-level interventions through ASHAs, AWWs, crèches, behaviour-change communication, local governance participation and preventive counselling, rather than relying solely on institutional healthcare services.

    Mentor’s Comment

    NFHS-6 indicates that India has achieved substantial progress in public health delivery. The central challenge has shifted from expanding access to services toward improving caregiving, feeding behaviour, maternal support, and diet quality.

    What change does NFHS-6 reveal in India’s nutrition landscape?

    1. Decline in Stunting: Stunting among children under five declined from 35.5% to 29.3%.
    2. Better Maternal Care: Around 95% of mothers received antenatal care.
    3. Rise in Institutional Deliveries: Institutional births reached about 90%.
    4. Higher Immunisation Coverage: About 87% of children aged 12–23 months are fully vaccinated.
    5. Improved Public Health Access: Better housing, sanitation, education, and health services have strengthened child health outcomes.

    Why has nutrition progress lagged behind improvements in health indicators?

    1. Poor Breastfeeding Practices: Only about half of newborns are breastfed within the first hour of birth.
    2. Delayed Complementary Feeding: Many children do not receive timely solid and semi-solid foods after six months. In many households, complementary feeding begins only after annaprasana. Delays during this period contribute to growth faltering.
    3. Inadequate Diet Diversity: Only around 15% of children aged 6-23 months receive an adequate diet.
    4. Persistent Wasting: Severe wasting indicators show limited improvement.
    5. Weak Feeding Awareness: Families often lack information regarding age-appropriate nutrition.

    Why is maternal time poverty emerging as a major nutrition challenge?

    1. Double Burden of Work: Women perform paid and unpaid work simultaneously.
    2. Informal Labour Participation: Large numbers of women work in agriculture and informal sectors.
    3. Childcare Deficit: Lack of crèches forces many mothers to leave infants with relatives or older siblings.
    4. Crèches as Nutrition Infrastructure: Community childcare centres improve feeding continuity, support breastfeeding and reduce women’s unpaid care burden.
    5. Disrupted Feeding Practices: Work responsibilities reduce breastfeeding and complementary feeding frequency.
    6. Limited Childcare Infrastructure: Rural areas lack adequate crèches and support systems.

    Why does greater food expenditure not guarantee better nutrition?

    1. Consumer Expenditure Shift: Recent Consumer Expenditure Survey findings show declining spending on cereals and rising expenditure on dairy, processed foods and beverages.
    2. Nutrition-Diversity Gap: Dietary diversity does not necessarily ensure nutritional adequacy.
    3. Affordability Constraints: Pulses, fruits, vegetables, nuts, and animal-source foods remain expensive.
    4. Convenience Advantage: Processed foods are easily available and ready to consume.
    5. Departure from NIN Guidelines: Many household diets diverge from recommended nutritional patterns.

    Why must India’s nutrition strategy move beyond treatment to prevention?

    1. Critical First 1,000 Days: Nutrition from pregnancy to age two determines lifelong outcomes.
    2. Early Growth Faltering: Stunting and growth failure begin well before severe malnutrition becomes visible. Growth faltering often begins before severe malnutrition becomes visible and peaks during the second year of life.
    3. Need for Early Detection: Regular anthropometric monitoring can identify risks sooner.
    4. Preventive Counselling: Timely guidance to mothers can prevent nutrition deficits.
    5. Focus on At-Risk Children: Current interventions remain heavily oriented toward severe cases.
    6. 0-2 Years Data Gap: Lack of disaggregated data for children aged 0-2 years limits targeted interventions during the most critical growth period.
    7. POSHAN Focus Gap: Current identification systems focus on severely malnourished children rather than children beginning to show growth decline

    What implementation gaps weaken frontline nutrition delivery?

    1. Data Quality Challenges: Large volumes of nutrition data remain underutilised.
    2. Limited Analytical Capacity: Local-level analysis and feedback mechanisms remain weak.
    3. Training Deficits: AWWs, ASHAs, and ANMs need stronger nutrition counselling skills.
    4. Human Resource Gaps: District-level nutritionists and data analysts are inadequate.
    5. Limited Digital Support: Technology tools remain underused for counselling and monitoring.

    Why is child malnutrition not merely a health-sector problem?

    1. Water and Sanitation Linkages: Safe drinking water and sanitation directly influence nutrition outcomes.
    2. Local Governance Role: Gram Sabhas and Panchayats can prioritise nutrition interventions.
    3. Need for Convergence: Health, ICDS, education, and local governments must coordinate.
    4. Gender Dimension: Women’s economic participation requires childcare support systems.
    5. Role of Men in Caregiving: Shared domestic responsibilities improve child feeding practices.

    What is the central tension in India’s nutrition transition?

    1. Access vs Outcomes: Health-care access has improved substantially, but nutrition outcomes lag behind.
    2. Health Care vs Nutrition Outcomes: India has largely solved access-related deficits in maternal and child health, but feeding practices, caregiving constraints and diet quality now drive malnutrition.
    3. Treatment vs Prevention: Policy focus remains stronger on rehabilitation than early prevention.
    4. Food Availability vs Nutrition Quality: More food spending does not ensure better diets.
    5. Women’s Work vs Childcare Needs: Economic participation often competes with caregiving responsibilities.
    6. Data Generation vs Data Utilisation: India collects extensive nutrition data but uses it inadequately for corrective action.

    Conclusion

    NFHS-6 shows that India has largely succeeded in expanding health-care access and public service delivery. The next phase of nutrition improvement depends on correcting feeding practices, reducing maternal time poverty, improving diet quality, strengthening frontline counselling, and using nutrition data for preventive action. Better health care alone cannot overcome India’s nutrition challenge.