Subject: Health

Menstrual Leave and its Global Standing
Recently, the Supreme Court refused to entertain a PIL about menstrual leave for workers and students across the country, calling it a policy matter.

Menstrual Leave: Explained
- Menstrual leave refers to a policy that allows women to take paid or unpaid leave from work when experiencing painful menstrual symptoms.
- This means that female employees who are experiencing discomfort, pain, or other symptoms related to their menstrual cycle can take time off from work without having to worry about losing pay or facing disciplinary action.
- It is a relatively new concept and is not yet widely available, but it has gained attention in recent years as more countries and companies consider its implementation.
Recent debate
- The concept of menstrual leave for workers and students has swirled around for a couple of centuries.
- Such policies are uneven and subject to much debate, even among feminist circles.
How prominent is the idea?
- Menstruating women were given leave from paid labour in Soviet Russia in the 1920s.
- A historian even claims that a school in Kerala granted period leave as early as 1912.
- In light of this, we explore the global framework for menstrual leave and which countries currently have them.
Need for menstrual leave
- Pain and discomfort: Menstrual leave is needed because menstruation can cause a range of symptoms that can be painful and debilitating, making it difficult for women to perform their jobs.
- Ensure job security: Such leave allows women to take time off when they need it, without having to worry about losing pay or facing disciplinary action.
- Ensure productivity: This helps ensure that women are able to fully participate in the workforce and can perform to the best of their abilities.
- Detaches stigma and discrimination: Additionally, menstrual leave can help reduce the stigma surrounding menstruation and promote a culture of openness and support for women.
Issues if policy measures are enforced

Not everyone— not even all those who menstruate— are in favour of menstrual leave.
- Create employer discrimination: Some believe either that it is not required or that it will backfire and lead to employer discrimination against women.
- Obligation may backfire: If govt policy compels employers to grant menstrual pain leave, it may operate as a de facto disincentive for employers to engage women in their establishments.
Arguments against menstrual leaves
- Potential for discrimination against women: If women are given additional leave days, they may be viewed as less capable or less committed to their jobs compared to their male counterparts.
- Concerns about decreased productivity: Opponents of menstrual leave policies argue that allowing women to take time off work during their menstrual cycle could result in decreased productivity, and ultimately harm businesses.
- Challenges in implementation: Enforcement of such policies could be challenging for businesses, particularly small and medium-sized enterprises. These businesses may struggle to manage their workforce effectively if employees are taking additional leave days throughout the year.
What kind of menstrual leave policies are in place globally?
- Spain: Recently, Spain became the first European country to grant paid menstrual leave to workers, among a host of other sexual health rights. Workers now have the right to three days of menstrual leave— expandable to five days— a month.
- Japan: It introduced menstrual leave as part of labour law in 1947, after the idea became popular with labor unions in the 1920s. At present, under Article 68, employers cannot ask women who experience difficult periods to work during that time.
- Indonesia: It introduced a policy in 1948, amended in 2003, saying that workers experiencing menstrual pain are not obliged to work on the first two days of their cycle.
- Philippines: In the Philippines, workers are permitted two days of menstrual leave a month.
- Taiwan: It has an Act of Gender Equality in Employment in place. Employees have the right to request a day off as period leave every month, at half their regular wage. Three such leaves are permitted per year— extra leaves are counted as sick leave.
- Zambia: Among the African nations, Zambia introduced one day of leave a month without needing a reason or a medical certificate, calling it Mother’s Day.
- Others: The petition also mentioned that the United Kingdom, China and Wales have menstrual leave provisions.
Thus we can say that almost every alternate country has provisions for menstrual leave.

What attempts are being made in India?
- In India, too, certain companies have brought in menstrual leave policies— the most famous example being Zomato in 2020, which announced a 10-day paid period leave per year.
- Time reported that 621 employees have taken more than 2,000 days of leave after the policy was introduced.
- Other such as Swiggy and Byjus have also followed suit.
- Among State governments, Bihar and Kerala are the only ones to introduce menstrual leave to women, as noted in the petition before the Supreme Court.
Parliamentary measures

Parliament has seen certain measures in this direction, with no success.
- In 2017, MP Ninong Ering from Arunachal Pradesh introduced ‘The Menstruation Benefits Bill, 2017’ in Parliament.
- It was represented in 2022 on the first day of the Budget Session in the Lok Sabha, but was disregarded as an “unclean topic,” the petition says.
- Shashi Tharoor also introduced the Women’s Sexual, Reproductive and Menstrual Rights Bill in 2018, which proposed that sanitary pads should be made freely available for women by public authorities in their premises.
Way forward
- Education and Awareness: Education and awareness campaigns can be conducted to educate employers, employees, and policymakers about the importance of menstrual health and the need for menstrual leave policies.
- Flexible Work Arrangements: In lieu of specific menstrual leave policies, companies can offer flexible work arrangements, such as remote work or flexible scheduling, to accommodate employees who are experiencing menstrual discomfort.
- Consultation with Experts: Policymakers can consult with health experts, labor organizations, and other stakeholders to develop comprehensive menstrual leave policies that meet the needs of both employees and businesses.
- Pilot Programs: Pilot programs can be implemented to test the effectiveness of menstrual leave policies and evaluate their impact on businesses and employees.
- Workplace Culture: Companies can work to create a workplace culture that supports menstrual health and normalizes conversations around menstruation. This can help to reduce the stigma associated with menstruation and promote gender equity in the workplace.
Attempt UPSC 2024 Smash Scholarship Test | FLAT* 100% OFF on UPSC Foundation & Mentorship programs

Get your Rs 10,000 worth of UPSC Strategic Package for FREE | PDFs, Zoom session, Tests, & Mentorship
February 27, 2023
What is ‘e-Sanjeevani App’?
The eSanjeevani app was featured in Prime Minister’s “Mann Ki Baat” address as part of the government’s efforts to promote digital healthcare in the country.

What is the e-Sanjeevani app?
- E-Sanjeevani is a browser-based platform-independent application that allows for both ‘doctor-to-doctor’ and ‘patient-to-doctor’ teleconsultations.
- During the Covid pandemic, the union health ministry launched the e-Sanjeevani telemedicine services to ensure that health consultations reach people even in remote villages.
- At the time of its launch, the union health ministry stated that it was a doctor-to-doctor telemedicine service that would provide general and specialised health care in rural areas.
How does e-Sanjeevani work?
- The e-Sanjeevani service establishes a virtual link between the beneficiary and doctor or specialist at the hub, which will be a tertiary healthcare facility.
- This network’s spoke would be a paramedic or generalist at a health and wellness centre.
- It allows for real-time virtual consultations between doctors and specialists at the hub and the beneficiary (via paramedics) at the spoke.
- The e-prescription generated at the conclusion of the session is used to obtain medications.
What is the reach of e-Sanjeevani?
- Sanjeevani HWC is currently operational in approximately 50,000 health and wellness centres across the country.
- As PM Modi stated in ‘Mann Ki Baat’, the number of tele-consultants using the e-Sanjeevani app has now surpassed 10 crore.
- Health minister has stated that 100.11 million patients were served at 115,234 Health and Wellness Centres (as spokes) via 15,731 hubs and 1,152 online OPDs staffed by 2,29,057 telemedicine-trained medical specialists and super-specialists.
- More than 57% of e-Sanjeevani beneficiaries are women, with only about 12% being senior citizens, according to union health ministry.
Attempt UPSC 2024 Smash Scholarship Test | FLAT* 100% OFF on UPSC Foundation & Mentorship programs

Get your Rs 10,000 worth of UPSC Strategic Package for FREE | PDFs, Zoom session, Tests, & Mentorship
February 27, 2023

Amendments to Organ Transplant Rules

In a major tweak to the organ donation policy, the Union Ministry of Health and Family Welfare said that the clause that people beyond 65 years could not receive cadaver organ transplants had been removed.

What are the changes introduced?

(1) No Age Bar

Now an individual of any age can register for organ transplant.
People beyond 65 years in need of an organ donation will also be eligible to get one.
The government has decided to do away with a clause in the National Organ and Tissue Transplant Organisation (NOTTO) guidelines as the clause violates the Right to Life.

(2) Doing away with domicile compulsion

Earlier an organ recipient could register for a prospective transplant in domicile State.
States like Gujarat had made it mandatory for registered patients to furnish a domicile certificate to be eligible for a transplant.
In November last year, the Gujarat High Court quashed the discriminatory policy of the State government.

Organ transplant in India: Key statistics

According to data accessed from the Health Ministry, the number of organ transplants have increased by over three times from 4,990 in 2013 to 15,561 in 2022.
Of the 15,561 transplants, a majority — 12,791 (82%) — are from live donors and 2,765 (18%) are from cadavers (the dead).
Up to 11,423 of the 15,561 organ transplants are for the kidney, followed by liver (766), heart (250), lung (138), pancreas (24) and small bowel transplants (3).
Most of these transplants occur in private hospitals, the numbers in government hospitals are relatively lower.

Challenges to Organ Donation in India

Lack of awareness: There is a lack of awareness among the general public about the importance of organ donation, the legal framework governing it, and the procedures involved. This can limit the number of potential donors.
Cultural beliefs and superstitions: In India, there are several cultural beliefs and superstitions that discourage organ donation. Some people believe that organ donation is against religious beliefs, or that it can impact the soul or afterlife.
Lack of infrastructure: India faces a shortage of hospitals and medical facilities that are equipped to handle organ transplantation. This can limit the availability of organs for transplantation.
Regulatory bottlenecks: While the legal framework exists, there is a lack of implementation and enforcement of the law. This can lead to issues such as organ trafficking and black market activities.

Way ahead

To address these challenges, the government and other stakeholders are working to raise awareness, improve infrastructure, and strengthen the legal framework governing organ donation.
Campaigns and initiatives are being undertaken to educate the public and healthcare professionals about the importance of organ donation, and to dispel myths and misconceptions.
Efforts are also being made to improve the infrastructure and facilities for organ transplantation, and to enhance the regulatory framework to prevent illegal activities.
These steps are aimed at promoting organ donation and increasing the availability of organs for transplantation, which can save lives and improve the quality of life for many people in India.

About National Organ Transplant Programme (NOTP)

In 2019, the GoI implemented the NOTP for promoting deceased organ donation.
Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994.

Types of Organ Donations

The law allows both deceased and living donors to donate their organs.
It also identifies brain death as a form of death.
Living donors must be over 18 years of age and are limited to donating only to their immediate blood relatives or, in some special cases, out of affection and attachment towards the recipient.

(1) Deceased donors:

They may donate six life-saving organs: kidneys, liver, heart, lungs, pancreas, and intestine.
Uterus transplant is also performed, but it is not regarded as a life-saving organ.
Organs and tissues from a person declared legally dead can be donated after consent from the family has been obtained.
Brainstem death is also recognized as a form of death in India, as in many other countries.
After a natural cardiac death, organs that can be donated are cornea, bone, skin, and blood vessels, whereas after brainstem death about 37 different organs and tissues can be donated, including the above six life-saving organs

(2) Living donors:

They are permitted to donate the following:

one of their kidneys
portion of pancreas
part of the liver

Features of the NOTP

Under the NOTP a National Level Tissue Bank (Biomaterial Centre) for storing tissues has been established at National Organ and Tissue Transplant Organization (NOTTO), New Delhi.
Further, under the NOTP, a provision has also been made for providing financial support to the States for setting up of Bio- material centre.
As of now a Regional Bio-material centre has been established at Regional Organ and Tissue Transplant Organization (ROTTO), Chennai, Tamil Nadu.

Back2Basics: National Organ and Tissue Transplant Organization (NOTTO)

NOTTO is a national-level organization set up under the Directorate General of Health Services, Ministry of Health and Family Welfare.

1. National Human Organ and Tissue Removal and Storage Network

2. National Biomaterial Centre (National Tissue Bank)

[I] National Human Organ and Tissue Removal and Storage Network

This has been mandated as per the Transplantation of Human Organs (Amendment) Act 2011.
The network will be established initially for Delhi and gradually expanded to include other States and Regions of the country.
Thus, this division of the NOTTO is the nodal networking agency for Delhi and shall network for the Procurement Allocation and Distribution of Organs and Tissues in Delhi.
It functions as apex centre for All India activities of coordination and networking for procurement and distribution of Organs and Tissues and registry of Organs and Tissues Donation and Transplantation in the country.

[II] National Biomaterial Centre (National Tissue Bank)

The Transplantation of Human Organs (Amendment) Act 2011 has included the component of tissue donation and registration of tissue Banks.
It becomes imperative under the changed circumstances to establish National level Tissue Bank to fulfil the demands of tissue transplantation including activities for procurement, storage and fulfil distribution of biomaterials.
The main thrust & objective of establishing the centre is to fill up the gap between ‘Demand’ and ‘Supply’ as well as ‘Quality Assurance’ in the availability of various tissues.

The centre will take care of the following Tissue allografts:

1. Bone and bone products

2. Skin graft

3. Cornea

4. Heart valves and vessels

Crack Prelims 2023! Talk to our Rankers

(Click) FREE 1-to-1 on-call Mentorship by IAS-IPS officers | Discuss doubts, strategy, sources, and more

February 17, 2023

Understanding India’s Mental Healthcare Act, 2017
Central idea: The article discusses the challenges faced in implementing India’s Mental Healthcare Act, 2017 and the need for better mental healthcare services in the country.

Mental Healthcare Act, 2017

The Mental Healthcare Act, 2017 is a comprehensive legislation that provides for the protection and promotion of the rights of people with mental illness. Some of the key features of the Act are:
- Decriminalization of suicide: The Act decriminalizes suicide and prohibits the use of inhuman and degrading treatment towards those who attempt suicide.
- Advance directives: The Act allows individuals to make advance directives, specifying the type of treatment they would like to receive in the event of a mental health issue.
- Informed consent: The Act mandates that patients have the right to give or refuse consent to treatment, and to be informed about the benefits, side effects, and alternatives of the treatment.
- Mental health review boards: The Act establishes Mental Health Review Boards at the national and state levels to oversee the implementation of the Act and protect the rights of people with mental illness.
- Prohibition of inhuman treatment: The Act prohibits the use of inhuman treatment methods, including chaining, electroconvulsive therapy (ECT) without anaesthesia, and solitary confinement.
- Right to access mental healthcare: The Act guarantees the right to access mental healthcare services, and mandates the establishment of mental health services in every district.
- Protection of rights and dignity: The Act aims to protect the rights and dignity of people with mental illness, and prohibits discrimination and stigmatization on the basis of mental illness.
- Establishment of a Central Mental Health Authority: The Act establishes a Central Mental Health Authority to regulate mental health services in the country.
NHRC flags alert
- Pity over healthcare institution: The National Human Rights Commission (NHRC) in a report flagged the “inhuman and deplorable” condition of all 46 government-run mental healthcare institutions across the country.
- Prolonged hospitalization: The report notes that the facilities are “illegally” keeping patients long after their recovery, in what is an “infringement of the human rights of mentally ill patients”.
- Need for Assessment: These observations were made after visits to all operational government facilities, to assess the implementation of the Mental Healthcare Act, 2017 (MHA).
Major issue: Lack of implementation
- Despite the act’s provisions, mental health institutions in India have been plagued by a lack of adequate infrastructure, staff, and training.
- Patients have reported human rights violations, including abuse, neglect, and violence.
Need for effective implementation
- The Mental Healthcare Act needs effective implementation and oversight to ensure that patients receive the care and treatment they need with dignity and respect.
- This requires increased investment in mental health infrastructure, including facilities, staff, and training.
Way forward
- Ensuring proper implementation of the Act: There is a need for proper implementation of this act across the country, with a focus on ensuring the rights and dignity of patients in mental healthcare institutions.
- Increasing awareness: Awareness needs to be raised about the Act, and the rights of mental healthcare patients among the general public, healthcare professionals, and law enforcement agencies.
- Providing training and capacity building: Healthcare professionals, including doctors, nurses, and caregivers, need to be trained and equipped with the skills and knowledge to provide quality care and support to mental healthcare patients.
- Strengthening mental healthcare infrastructure: There is a need to strengthen the infrastructure and facilities in mental healthcare institutions, including better staffing, improved physical facilities, and access to quality medication.
- Encouraging community-based care: Community-based care for mental health patients can help reduce the burden on mental healthcare institutions and provide a more supportive environment for patients.
- Promoting human rights: There is a need for greater emphasis on the human rights of mental healthcare patients, including the right to dignity, privacy, and freedom from discrimination and abuse.
Crack Prelims 2023! Talk to our Rankers

(Click) FREE 1-to-1 on-call Mentorship by IAS-IPS officers | Discuss doubts, strategy, sources, and more
February 16, 2023
Norovirus Cases detected in Kerala
The Kerala Health Department confirmed two cases of the gastrointestinal infection norovirus in class 1 students in Ernakulam district.

What is Norovirus?
- Norovirus is an important cause of acute non-bacterial gastroenteritis in children as well as adults worldwide.
- It leads to diarrhoea, vomiting, nausea, and abdominal pain. Being a diarrhoeal disease, it can lead to dehydration, so drinking plenty of fluids is recommended.
- The virus was first discovered in connection with an outbreak of acute diarrhoeal disease in Norwalk, Ohio, in 1968 and was called the Norwalk Virus.
- Later, several stomach flu viruses closely linked to the Norwalk virus were found and together, these are now called Noroviruses.
- Many stomach flu outbreaks typically in cruise ships have been traced to NoV.
How deadly is this?
- Norovirus is not new; it has been circulating among humans for over 50 years and is thought to be one of the primary causes of gastroenteritis.
- The virus is estimated to kill 200,000 persons globally every year, with most deaths occurring among those below the age of five years and those over the age of 65 years.
- The virus is capable of surviving low temperatures, and outbreaks tend to be more common during the winter and in colder countries — that is why it is sometimes referred to as “winter vomiting disease”.
What is the incidence of infection in India?
- Cases of norovirus are not as common in India as in many other places — at the same time.
- The infection has been reported in previous years as well, mainly from Southern India, and especially from Kerala.
- A 2021 study from Hyderabad reported that norovirus was detected in 10.3% samples of children who came in with acute gastroenteritis.
Can norovirus infection cause a large-scale outbreak?
- Even though more cases of norovirus are being detected, experts say that this is unlikely to lead to a large-scale outbreak.
- There is no epidemiological study to co-relate of these cases.
Crack Prelims 2023! Talk to our Rankers

(Click) FREE 1-to-1 on-call Mentorship by IAS-IPS officers | Discuss doubts, strategy, sources, and more
January 25, 2023
Indian biotech investigated following deaths of Uzbek children
The Central Drugs Standards Control Organisation (CDSCO) are investigating Noida-based firm after the deaths of 18 children in Uzbekistan by drinking health syrup contaminated with Diethylene Glycol (DEG).

India’s response to these deaths
- It is certainly the responsibility of the importing country to test medicines before releasing them in their market.
- After being informed about the incident, India’s apex regulatory body, Central Drugs Standard Control Organisation (CDSCO) opened investigations and lifted control samples.
Issue: India’s credibility at stake
- India is one of the leading exporters of medicines.
- PM Modi recently stressed that Indian drugs had earned the world’s trust and that India could be called the ‘pharmacy to the world’.
- However, such negative reports on the quality and safety of our medicines will be a massive blow to the country’s image as a source of cheap generic drugs to the world.
Issues highlighted by the incident
- Smuggling of cheap drugs: Inquiry reveals that these were imported from an Indian manufacturer, not under public tender but privately.
- Ignorance by authorities: The drug which is banned for domestic consumption has got exported and led to fatalities. This is a huge blissful mistake by Indian Authorities.
- Lack of inspection: There are not enough drug inspectors in the country to conduct as many inspections as is ideally required in such as vast set-up.
- Inadequacies in quality-check: Despite huge production units, there are not an adequate number of laboratories to test the samples in time if all the samples that should be lifted for testing are picked up.
- Blot on credibility: The matter, if not properly handled, can damage the perception that Indian medicines are trustworthy for many countries and the global South.
Possible factors behind this tragedy
- There are rackets of counterfeit Indian medicines turning up in many countries.
- Some of these were coming from unregistered producers in India, who would produce medicine depending on what cost was paid to them without concern for quality.
- In some cases, competitors from other countries were known to make counterfeit medicines with Indian markings and dump them in markets where Indian pharmaceuticals were well regarded.
Way forward
- The pharmaceutical trade is vital and must be protected from predatory practices and violations of regulatory norms.
- Regulatory mechanism on both sides should be strengthened.
- Importers should be given lists of recognised Indian manufacturers.
- Training should be provided to drug controllers to curtail the menace of counterfeit and poor-quality medicine entering from India.
Back2Basics: Diethylene Glycol (DEG)
- A/c to WHO, Diethylene Glycol (DEG) or ethylene glycol is toxic to humans when consumed and can prove fatal.
- It can cause kidney and neurological toxicity and has been associated with several cases of mass poisoning when consumed via drugs.
- The chemical tastes sweet and is water-insoluble.
- The toxic effects of the chemical include abdominal pain, vomiting, diarrhea, inability to pass urine, headache, altered mental state, and acute kidney injury.
Click and get your FREE Copy of CURRENT AFFAIRS Micro Notes

(Click) FREE 1-to-1 on-call Mentorship by IAS-IPS officers | Discuss doubts, strategy, sources, and more
December 30, 2022
Union Health Ministry rolls out India’s 1st Suicide Prevention Policy
The Ministry of Health and Family Welfare announced a National Suicide Prevention Strategy, the first of its kind in the country.

What is Suicide?
- Suicide is the act of intentionally causing one’s own death.
- Mental and physical disorders, substance abuse, anxiety and depression are risk factors.
- Some suicides are impulsive acts due to stress (such as from financial or academic difficulties), relationship problems (such as breakups or divorces), or harassment and bullying.
- Despite being entirely preventable, India has been increasingly losing individuals to suicide.
Why need such strategy?

Ans. Suicides in India
- The burden of deaths by suicide has increased in India — by 7.2 per cent from 2020 — with a total of 1,64,033 people dying by suicide in 2021.
- In India, more than one lakh lives are lost every year to suicide, and it is the top killer in the 15-29 years category.
- In the past three years, the suicide rate has increased from 10.2 to 11.3 per 1,00,000 population, the document records.
- The most common reasons for suicide include family problems and illnesses, which account for 34% and 18% of all suicide-related deaths.
- The report follows a 2021 Lancet study that noted “India reports the highest number of suicide deaths in the world”.
About the National Suicide Prevention Strategy

The NSPS puts a time-bound action plan and multi-sectoral collaborations to achieve reduction in suicide mortality by 10% by 2030. The strategy broadly seeks to establish-
1. Effective surveillance mechanisms for suicide within the next three years,
2. Establish psychiatric outpatient departments that will provide suicide prevention services through the District Mental Health Programme in all districts within the next five years, and
3. Integrate a mental well-being curriculum in all educational institutions within the next eight years.
The strategy also envisages:
1. Developing guidelines for responsible media reporting of suicides and
2. Restricting access to means of suicide
Significance of the strategy
- The most important thing is that the government has acknowledged that suicide is a problem.
- We now have a well-conceived plan involving multi-sectoral collaborations, because the only way a strategy would work would be to involve various sectors.
- The strategy should now be passed on to the States for them to develop locally relevant action plans; and then cascade to the district, primary health and community levels.
Why suicide is such a big issue?
- More youth committing: For the youth of the country (15-29 years), among whom 1/3rd of all suicides take place.
- Performance pressure: Data suggests that one student dies by suicide every 55 minutes, and 1,129 suicides among children below 18 years of age in 2020 were due to failure in examinations.
- Farm distress: This is followed by farmer’s suicide and the gendered variance observed these days.
- Gendered variances: More women are committing suicides these days.
Way forward
- Holistic approach: Promoting national and sectoral research into the reasons for suicide mortality and its rise, and making culturally and economically appropriate suggestions to help mitigate the problem is critical.
- Counselling by mass-media: During times of distress, media must promote health-seeking behaviour, correct information and counter the possible myths related to suicide.
- Evidence-based interventions: Keep in mind the needs of the most vulnerable and marginalized populations, like women and young individuals, providing the required support systems can reduce the number of lives lost and build a healthier response system.
Click and get your FREE Copy of CURRENT AFFAIRS Micro Notes

(Click) FREE1-to-1 on-call Mentorship by IAS-IPS officers | Discuss doubts, strategy, sources, and more
November 22, 2022
Is India a Diabetes capital of the world?
Context
- India is often referred to as the ‘Diabetes Capital of the World as it accounts for 17%percent of the total number of diabetes patients in the world. There are currently close to 80 million people with diabetes in India and this number is expected to increase to 135 million by 2045. World Diabetes day is observed on 14 November.
What is Diabetes?
- Diabetes is a chronic (long-lasting) health condition that affects how our body turns food into energy.
- Diabetes is a metabolic disorder in which the body has high sugar levels for prolonged periods of time.
- The lack of insulin causes a form of diabetes.
- Type-I Diabetes: It is a medical condition that is caused due to insufficient production and secretion of insulin from the pancreas. Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake). This reaction stops your body from making insulin. Approximately 5-10% of the people who have diabetes have type 1
- Type-2 diabetes: With type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. About 90-95% of people with diabetes have type 2.
Type-2 diabetes in brief
- Long term Condition: It is long-term (chronic) condition which results in too much sugar circulating in the bloodstreams and poor response of insulin. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems. Type 2 diabetes is an impairment in the way the body regulates and uses sugar (glucose) as a fuel. It is a defective response of Insulin
- More common in adults: Type 2 is more common in older adults, but the increase in the number of children with obesity has led to more cases of type 2 diabetes in younger people.
- Slow signs and symptoms: Signs and symptoms of type 2 diabetes often develop slowly. Symptoms include, Increased thirst, Frequent urination, Increased hunger, Unintended weight loss, Fatigue, Blurred vision, Slow-healing sores, Frequent infections etc. It develops over many years and is usually diagnosed in adults (but more and more in children, teens, and young adults).
- Cure for Type-2: There’s no cure for type 2 diabetes, but losing weight, eating well and exercising can help you manage the disease. If diet and exercise aren’t enough to manage your blood sugar, you may also need diabetes medications or insulin therapy.
What is insulin?
- Insulin is a hormone produced by the pancreas.
- Insulin regulates the movement of sugar into your cells.
- Blood glucose levels tightly controlled by insulin.
- When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level
The prevalence of diabetes in India
- People living with Diabetes in India: There are an estimated 77 million people with diabetes in India. Which means one in every 10 adults in India has diabetes. Half of those who have high blood sugar levels are unaware. Even among those who have been diagnosed with diabetes, only half of them have their blood sugar level under control.
- Rapid increase in younger population: According ICMR report, the prevalence of diabetes in India has increased by 64 percent over the quarter-century. prevalence among the younger population has also increased above 10%.
- Children impacting more: Worryingly, in India, a large number of children are also impacted by diabetes. Children are developing obesity and metabolic syndrome early because of the change in diets to more processed and fast foods.
- Projected Estimation: About 98 million Indians could have diabetes by 2030, these projections come from the International Diabetes Federation and the Global Burden of Disease project.
- Children impacting more: Worryingly, in India, a large number of children are also impacted by diabetes. Children are developing obesity and metabolic syndrome early because of the change in diets to more processed and fast foods.
Why Indians are more prone to diabetes?
- Lifestyle changes: The current exponential rise of diabetes in India is mainly attributed to lifestyle changes. The rapid change in dietary patterns, physical inactivity, and increased body weight, especially the accumulation of abdominal fat, are some of the primary reasons for increased prevalence.
- Ethnically more prone: Ethnically, Indians seem to be more prone to diabetes as compared to the Caucasians, although the precise mechanisms are not well known. we Indians have a greater degree of insulin resistance which means our cells do not respond to the hormone insulin. And when compared to Europeans, our blood insulin levels also tend to rise higher and more persistently when we eat carbohydrates.
- Greater genetic predisposition: The epidemic increase in diabetes in India along with various studies on migrant and native Indians clearly indicate that Indians have an increased predilection to diabetes which could well be due to a greater genetic predisposition to diabetes in Indians.
- Decrease in traditional diets: At the same time, the increased ‘westernization’, especially in the metros and the larger cities, has led to a drastic change in our dietary pattens. Indian diets have always been carbohydrate-heavy and now the reliance on refined sugars, processed food in the form of quick bites and fuss-free cooking and trans fatty acids are creating havoc.
- Mechanization of day-to-day work: With the increasing availability of machines to do our work, there’s also a substantial drop in day-to-day activities.
- Consumption of high calorie food and lack of physical activities: Obesity, especially central obesity and increased visceral fat due to physical inactivity, and consumption of a high-calorie/high-fat and high sugar diets, thus become major contributing factors.
- Rapid urbanization: Currently, India is undergoing a rapid epidemiological transition with increased urbanization. The current urbanization rate is 35% compared to 15% in the 1950’s and this could have major implications on the present and future disease patterns in India with particular reference to diabetes and coronary artery disease.
- Rural-urban migration: The rural migration to urban areas and associated stress plays a significant role in lifestyle change.
Ways to manage Increasing Diabetes in India
- Aggressive Screening procedures: Indians need an upstream approach or prioritizing protection of the population as a whole, beginning with women and children. This can be done with aggressive screening procedures. “Anybody above 18, with a clear-cut risk like family history, weight issues and young women with polycystic ovarian syndrome (PCOS) should be tested. All Indians above 30 should be screened.
- Timely diagnosis and right management: Medical experts feel that timely detection and right management can go a long way in helping patients lead a normal life.
- Diet discipline for children: For children, Doctors recommends a serious diet discipline. “Only healthy meals are the option that remains. Tutor the tastebuds of the young and stop their access to fast foods. There can be supportive policy measures making healthy fruits and vegetables accessible in a cost-effective manner to all instead of plain carbs. The mid-day meal or tiffin needs to be looked at thoughtfully and to make it healthy.
- Promoting physical activities: “The overall decline in physical activity has had devastating impacts on our metabolism,” while agreeing with the 30-minute a day exercise and activity schedule, sounds a note of caution. The recent scientific evidence suggests even five minutes of walk after any meal provides some protection.
- Adopting healthy Lifestyle: Though a chronic medical condition, Diabetes can be curbed at the initial level by introducing lifestyle changes. Experts suggests, reduce stress; sleep on time and for minimum of seven hours, maintaining ideal body weight, regular physical activity stop smoking, stopping/ minimum alcohol intake and get early treatment for any pre-existing or co-morbid health condition such as hypertension.
- Regular check-ups: Regular visits to the doctor are important to assess sugar control and assessment/ prevention of complications related to the disease.
Conclusion
- With the country having the highest number of diabetic patients in the world, the sugar disease is posing an enormous health problem to our country today. According to a World Health Organization (WHO) fact sheet on diabetes, an estimated 3.4 million deaths are caused due to high blood sugar in the world.
Mains Question

Q. Diabetes is increasing alarmingly across all age groups in India. Discuss the reasons and suggest measures to manage epidemic of diabetes if it is not curable?

(Click) FREE1-to-1 on-call Mentorship by IAS-IPS officers | Discuss doubts, strategy, sources, and more
November 18, 2022
Role of Private Sector in Ayushman Bharat Digital Mission
Context
- On 27 September, 2021, Prime Minister Narendra Modi announced the rollout of the Ayushman Bharat Digital Mission with the aim of integrating the different and disparate digital health systems that exist into a National Digital Health Ecosystem.
What is Ayushman Bharat Digital Mission (ABDM)?
- The ABDM currently has five main components:
- Ayushman Bharat Health Account (ABHA) number: A unique health identification number,
- Healthcare Professionals Registry (HPR): A repository of healthcare professionals across both modern and traditional systems of medicine,
- Health Facility Registry (HFR): A repository of both public and private health facilities, including hospitals, clinics, diagnostic laboratories, and pharmacies,
- Unified Health Interface (UHI): An open protocol for digital health services linking patients with healthcare providers,
- ABHA Mobile App: An app allowing an individual to carry electronic health records.
Analyzing the future of India’s health care system
- Digitization push of Government: To achieve the Sustainable Development Goals and targets of universal health coverage, the Indian government has expended significant efforts to promote the digitization of the healthcare sector to make health accessible, affordable, and equitably distributed.
- Citizens and doctors can access the health registry: The two registries would ostensibly create a database of India’s healthcare institutions and professionals that citizens would be able to access.
- Digital health card: The ABHA number and the application allow citizens to securely identify themselves and carry their health records to any healthcare facility.
- Targeted health care services: And lastly, the UHI would facilitate greater access to and delivery of healthcare services.
- Huge data for research: All of this activity has and will generate a tremendous quantity of data, which will be crucial for research, innovation, and policymaking.
Importance of private sector in health sector
- Mixed health care system: India has a mixed healthcare system, which means that it has both public and private healthcare providers. Without significant participation from the private healthcare providers, the ABDM’s ability to achieve its objectives will be limited.
- 81% doctors are private: This is because private healthcare infrastructure accounts for nearly 62 per cent of all of India’s health infrastructure and the private sector also provides 81 per cent of the doctors in India.
- Preference to private healthcare: Both rural and urban population in India seem to prefer seeking treatment from the private sector. Only 33 per cent of the rural and 26 per cent of the urban population depend on the public sector for healthcare.
Why Private health care are opting out of ABDM?
- Voluntary participation in ABDM: The voluntary nature of participation in the ABDM has led to a significant portion of private healthcare providers opting to not participate in the universal programme nor integrate into the UHI.
- High cost for digital records: Small healthcare providers like charitable hospitals, clinics, diagnostic labs, pharmacies, or nursing homes are less inclined to participate because of the significant costs involved.
- Requirement of manpower for digitization: The cost to these healthcare providers, who are most likely in various stages of digitisation, is the number of man hours required to digitise their health records and other data.
- Financial cost of digitization: The actual financial cost of upgrading or altering their digital health systems to meet basic required standards to participate in the ABDM and the UHI.
Impact of non-participation by private players
- A lack of participation from the private sector will negatively impact the objectives of the ABDM in major way:
- Limited success for UHI: Considering the concentration of private healthcare providers in urban areas, a lack of their participation and integration would limit the UHI’s ability to bring previously inaccessible services to the rural population who would otherwise have to travel to access them.
- Incomplete data and ineffective policy: The data generated by the ABDM and use of the UHI would be incomplete, which in turn would significantly limit the effectiveness of policy planning and programme delivery.
Conclusion
- It is unclear whether the government intends to achieve private sector participation through incentives or mandates. Without either approach, it seems that the ABDM will see little participation from smaller private healthcare providers, though how this will play out remains to be seen.
Mains Question

Q. What is the significance of Private Players in health care system of India? Explain the crucial role of Private health care in Ayushman Bharat digital Mission.

(Click) FREE1-to-1 on-call Mentorship by IAS-IPS officers | Discuss doubts, strategy, sources, and more
November 17, 2022
Centre opposes petition in HC against provisions of Surrogacy Law
The Centre has opposed before the Delhi HC a petition challenging certain provisions of the surrogacy laws, including the Assisted Reproductive Technology (Regulation) Act, 2021, and the Surrogacy (Regulation) Act, 2021.

What is the case?
- The provisions challenged includes the exclusion of a single man and a married woman having a child from the benefit of surrogacy as a reproductive choice.
- It challenged the ban on commercial surrogacy.
- In their plea, the petitioners have stated that commercial surrogacy is the only option available to them.
Invoking Article 21
- The personal decision of a single person about the birth of a baby through surrogacy, that is, the right of reproductive autonomy is a facet of the right to privacy guaranteed under Article 21 of the Constitution.
- Thus, the right affecting a decision to bear or beget a child through surrogacy cannot be taken away, the petition said.
What rules say?
- Under the Surrogacy (Regulation) Act, 2021, a married couple can opt for surrogacy only on medical grounds.
- The law defines a couple as a married Indian “man and woman” and also prescribes an age-criteria with the woman being in the age of 23 years to 50 years and the man between 26 years to 55 years.
- The couple should not have a child of their own.
- Though the law allows single women to resort to surrogacy, she has to be a widow or a divorcee between the age of 35 and 45 years.
- The law does not allow single men to go for surrogacy.
Distinct features of the Surrogacy (Regulation) Act, 2021
- Definition of surrogacy: It defines surrogacy as a practice where a woman gives birth to a child for an intending couple with the intention to hand over the child after the birth to the intending couple.
- Regulation of surrogacy: It prohibits commercial surrogacy, but allows altruistic surrogacy which involves no monetary compensation to the surrogate mother other than the medical expenses and insurance.
- Purposes for which surrogacy is permitted: Surrogacy is permitted when it is: (i) for intending couples who suffer from proven infertility; (ii) altruistic; (iii) not for commercial purposes; (iv) not for producing children for sale, prostitution or other forms of exploitation; and (v) for any condition or disease specified through regulations.
- Eligibility criteria: The intending couple should have a ‘certificate of essentiality’ and a ‘certificate of eligibility’ issued by the appropriate authority ex. District Medical Board.
Eligibility criteria for surrogate mother:
- To obtain a certificate of eligibility from the appropriate authority, the surrogate mother has to be:
1. A close relative of the intending couple;
2. A married woman having a child of her own;
3. 25 to 35 years old;
4. A surrogate only once in her lifetime; and
5. Possess a certificate of medical and psychological fitness for surrogacy.
- Further, the surrogate mother cannot provide her own gametes for surrogacy.
Click and get your FREE Copy of CURRENT AFFAIRS Micro Notes
November 8, 2022