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Subject: Health

  • What the NFHS data reveals about inequality in India

    Context

    The release of the NFHS data (and the Niti Aayog’s study on developing a multi-dimensional index of poverty — MPI) has led to a considerable amount of discussion, and justifiably so.

    Understanding the progress and development: MPI

    • The MPI is an Oxford-based initiative that develops an exclusive broadly non-monetary living standard index of poverty.
    • MPI indices are the third in the series of global studies on poverty.
    • Global studies on poverty: Global studies started with the World Bank’s income/consumption-based measure of absolute poverty.
    • The UN expanded the monetary index adding health and education indicators via the Human Development Index (HDI).

    Evolution of poverty over time

    • Like with the other poverty indices (World Bank and HDI), most information and useful policy analysis comes via a study of the inter-temporal evolution of poverty. 
    • Regional inequality: Ajit Ranade acknowledges that regional inequality has existed for some time, but he argues that poverty incidence across Indian states even as per the MPI is astoundingly unequal.
    • T N Ninan talks about the simultaneous existence of Africa’s Sahel region and the Philippines in India.
    • He finds that the two Indias are not getting any closer.
    • Indeed, India’s development trajectory has not been uniform, but the regional imbalance of development cannot be viewed at a fixed point in time.

    Analysing the NHFS data

    • A detailed examination of the summary statistics reported in the NFHS data (large and small states of India for the two years 2015-16 and 2019-21), reveals the opposite result.
    • Convergence: The analysis reveals remarkable convergence in living standards, a convergence possibly unparalleled in Indian history and in the space of just five years.
    • NFHS reports the averages for all states, and for 131 variables, for two years 2015-16 and 2020-21.
    • Seventeen of these 131 welfare indicators are used to construct indices under four classifications.
    • Improvement in lives of girls/women: The first classification concerns itself with the improvement in the lives of girls/women (five indicators, for example, sex ratio, fertility, female education).
    • Housing conditions: The second bucket consists of housing conditions (three indicators, for example, improved sanitation, clean fuel).
    • Children’s welfare: The third list consists of children’s welfare (four indicators such as adequate diet, stunting)
    • Women’s welfare: The fourth classification includes women’s empowerment (five indicators, for example, owning a house, less spousal violence).
    • Given that Niti Aayog’s report primarily relies on the NFHS-4, these findings can be used as the baseline scenario to evaluate the delta — that is, the per cent change in indicators between NFHS-4 and NFHS-5.
    • The table reports the results for several states.

    • Seventeen indicators imply a maximum possible score of 1,700.
    • Kerala performs the best with an aggregate index of 1,300 in NFHS-5 — a very small 1.5 per cent increase from its 2015-16 value.
    • In contrast, Bihar increases its index by 56 per cent.
    • Punjab does better than Tamil Nadu and today has a higher index – 1,240 versus 1,178 in 2020-21.
    • UP (along with Rajasthan and MP) performs the best — a 60 plus per cent increase in the welfare index, more than five times the increase in the rich states.

    Major findings from the NHFS data

    • Convergence: Higher improvement by less developed states is evidence in support of catch-up, which suggests that regional imbalances are reducing, and in some indicators, rapidly so.
    • States such as UP, Bihar and Jharkhand are fast approaching similar standards for select indicators as some of the “developed” states.
    • Result of targeted intervention: This acceleration in catch up is no coincidence, but rather an outcome of an approach that involves targeted interventions to improve developmental outcomes.
    • The approach was not just limited to sanitation, proper fuel or electricity — interventions that are targeted to an individual household — but also to the holistic development of an entire region.

    Consider the question “What does NHFS-5 data reveal about the inequality in India?”

    Conclusion

    India has been, and was, not one but several Indias. What is remarkable about its recent history is the rapid process of uneven change — where progress is considerably higher for the poorer states — the convergent, and inclusive pattern of development. That is the real story behind the NFHS-4 and NFHS-5 numbers.

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  • What the latest NFHS data says about the New Welfarism

    Context

    The second and final phase of NFHS-5 was released which covered 11 states (including Uttar Pradesh (UP), Tamil Nadu, Punjab, Rajasthan, Madhya Pradesh (MP), Jharkhand, Haryana, and Chhattisgarh) and about 49 per cent of the population.

    Major findings

    [1] Success of New Welfarism

    • Figure one plots household access to improved sanitation, cooking gas and bank accounts used by women.
    • The improvements are as striking as they were based on the performance of the phase 1 states.
    • In all cases, access has increased significantly, although claims of India being 100 per cent open defecation-free still remain excessive.

    [2] Child-related outcomes

    • India-wide, stunting has declined although the pace of improvement has slowed down post-2015 compared with the previous decade.
    • For example, stunting improved by 0.7 percentage points per year between 2005 and 2015 compared to 0.3 percentage points between 2015 and 2021.
    • On diarrhoea too, adding the new data reverses the earlier finding.
    • However, on anaemia and acute respiratory illness, there seems to have been deterioration.
    • The new child stunting results are significant but also surprising because of the sharply divergent outcomes between the phase 1 and phase 2 states.
    •  The interesting pattern is that nearly all the phase 2 states show large improvements, whereas most of the phase 1 states exhibited a deterioration in performance.

    [3] Catch up by the laggard states

    • If the new child stunting numbers are right, a different picture of India emerges.
    • Apparently, Madhya Pradesh now has fewer stunted children than Gujarat; Uttar Pradesh and Jharkhand are almost at par with Gujarat; Chhattisgarh fares better than Gujarat, Karnataka, and Maharashtra; and Rajasthan and Odisha fare better than Gujarat, Karnataka, Maharashtra, West Bengal, Telangana and Himachal Pradesh!
    • On child stunting, the old BIMARU states (excepting Bihar) are no longer the laggards; the laggards are Gujarat, Maharashtra, and Karnataka, and to a lesser extent, West Bengal, Andhra Pradesh and Telangana.
    • Indeed, the decline in stunting achieved by the poorer states such as UP, MP, Chhattisgarh and Rajasthan would be all the more remarkable given the overall weakness in the economy between 2015 and 2021.

    Conclusion

    When commentators speak of two Indias, it is now important to ask: Which ones and on what metrics.

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  • Assisted Reproductive Technology (Regulation) Act, 2021

    The Lok Sabha has passed the Assisted Reproductive Technology- ART (Regulation) Bill,, 2020 that proposes the establishment of a national registry and registration authority for all clinics and medical professionals serving in the field.

    Key highlights of the Bill:

    Definition of ART

    • The Bill defines ART to include all techniques that seek to obtain a pregnancy by handling the sperm or the oocyte (immature egg cell) outside the human body and transferring the gamete or the embryo into the reproductive system of a woman.
    • Examples of ART services include gamete (sperm or oocyte) donation, in-vitro-fertilisation (fertilising an egg in the lab), and gestational surrogacy (the child is not biologically related to surrogate mother).
    • ART services will be provided through: (i) ART clinics, which offer ART related treatments and procedures, and (ii) ART banks, which store and supply gametes.

    Regulation of ART clinics and banks

    • The bill provides that every ART clinic and bank must be registered under the National Registry of Banks and Clinics of India.
    • It will act as a central database with details of all ART clinics and banks in the country.
    • State governments will appoint registration authorities for facilitating the registration process.
    • Clinics and banks will be registered only if they adhere to certain standards (specialised manpower, physical infrastructure, and diagnostic facilities).
    • The registration will be valid for five years and can be renewed for a further five years.

    Conditions for gamete donation and supply

    • Screening of gamete donors, collection and storage of semen, and provision of oocyte donor can only be done by a registered ART bank.
    • A bank can obtain semen from males between 21 and 55 years of age, and oocytes from females between 23 and 35 years of age.
    • An oocyte donor should be an ever-married woman having at least one alive child of her own (minimum three years of age).
    • The woman can donate oocyte only once in her life and not more than seven oocytes can be retrieved from her.
    • A bank cannot supply gamete of a single donor to more than one commissioning couple (couple seeking services).

    Conditions for offering ART services:

    • ART procedures can only be carried out with the written informed consent of both the party seeking ART services as well as the donor.
    • The party seeking ART services will be required to provide insurance coverage in the favour of the oocyte donor (for any loss, damage, or death of the donor).
    • The Bill also requires checking for genetic diseases before the embryo implantation.

    Rights of a child born through ART

    • A child born through ART will be deemed to be a biological child of the commissioning couple and will be entitled to the rights and privileges available to a natural child of the commissioning couple.
    • A donor will not have any parental rights over the child.

    National and State Boards:

    • The Bill provides that the National and State Boards for Surrogacy constituted and will for the regulation of ART services.
    • Key powers and functions of the National Board include:
    1. Advising the central government on ART related policy matters
    2. Reviewing and monitoring the implementation of the Bill
    3. Formulating code of conduct and standards for ART clinics and banks
    4. Overseeing various bodies to be constituted under the Bill
    5. State Boards will coordinate enforcement of the policies and guidelines for ART as per the recommendations, policies, and regulations of the National Board

    Offences and penalties

    Offences under the Bill include:

    1. Abandoning, or exploiting children born through ART,
    2. Selling, purchasing, trading, or importing human embryos or gametes,
    3. Using intermediates to obtain donors,
    4. Exploiting commissioning couple, woman, or the gamete donor in any form, and
    5. Transferring the human embryo into a male or an animal
    • These offences will be punishable with a fine between 5 and 10 lakh rupees for the first contravention.
    • For subsequent contraventions, these offences will be punishable with imprisonment for a term between eight and 12 years, and a fine between 10 and 20 lakh rupees.
    • Any clinic or bank advertising or offering sex-selective ART will be punishable with imprisonment between five and ten years, or fine between Rs 10 lakh and Rs 25 lakh, or both.
    • No court will take cognisance of offences under the Bill, except on a complaint made by the National or State Board or any officer authorised by the Boards.

     

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  • National Health Accounts Estimates: 2017-18

    Out-of-pocket expenditure (OOPE) as a share of total health expenditure and foreign aid for health has both come down as per the findings of the National Health Accounts (NHA) estimates for India for 2017-18.

    What is National Health Accounts (NHA)?

    • The NHA estimates are prepared by using an accounting framework based on internationally accepted System of Health Accounts 2011, provided by the World Health Organization (WHO).
    • It is released by Ministry of Health & Family Welfare.
    • It describes health expenditures and flow of funds in the country’s health system over a financial year of India.
    • It answers important policy questions such as what are the sources of healthcare expenditures, who manages these, who provides health care services, and which services are utilized.
    • It is a practice to describe the health expenditure estimates according to a global standard framework, System of Health Accounts 2011 (SHA 2011), to facilitate comparison of estimates across countries.

    Objective of the NHA

    • To describe the Current Health Expenditures (CHE).

    The details of CHE are presented according to

    • Revenues of healthcare financing schemes: – entities that provide resources to spend for health goods and services in the health system;
    • Healthcare financing schemes: entities receiving and managing funds from financing sources to pay for or to purchase health goods and services;
    • Healthcare providers: entities receiving finances to produce/ provide health goods and services;
    • Healthcare functions: It describes the use of funds across various health care services.

    About NHA (2017-2018)

    • The 2017-18 NHA estimates shows government expenditure on health exhibiting an increasing trend and growing trust in public health care system.
    • With the present estimate of NHA 2017-18, India has a continuous Time Series on NHA estimates for both government and private sources for five years since 2013-14.
    • These estimates are not only comparable internationally, but also enable the policy makers to monitor progress towards universal health coverage as envisaged in the National Health Policy, 2017.

    Key Highlights

    Increase in GDP share: The NHA estimates for 2017-18 clearly show that there has been an increase in the share of government health expenditure in the total GDP from 1.15% in 2013-14 to 1.35% in 2017-18.

    Increase in govt share in expenditures: In 2017-18, the share of government expenditure was 40.8%, which is much higher than 28.6% in 2013-14.

    Per-Capita increase in expenditure: In per capita terms, the government health expenditure has increased from Rs 1042 to Rs.1753 between 2013-14 to 2017-18.

    Focus on total healthcare: The primary and secondary care accounts for more than 80% of the current Government health expenditure.

    Social security expenditure: The share of social security expenditure on health, which includes the social health insurance program, Government financed health insurance schemes, and medical reimbursements made to Government employees, has increased.

    Decline in foreign aid: The findings also depict that the foreign aid for health has come down to 0.5%, showcasing India’s economic self-reliance.

    Decline in OOPE: The government’s efforts to improve public health care are evident with out-of-pocket expenditure (OOPE) as a share of total health expenditure coming down to 48.8% in 2017-18 from 64.2% in 2013-14.

    Way forward

    • After 18 months of Covid-19, financial year 2017-18 appears to be from another era.
    • However, learnings from that year’s NHA help us to plan for health system strengthening in the post-Covid years.
    • The special financing packages for Covid emergency response, announced by the central government in 2020 and 2021, represent an extraordinary situation.
    • The resolve to increase public financing for health must remain strong even after Covid.

     

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  • Key Demographic Transitions captured by 5th round of NFHS

    The Union health ministry released the summary findings of the fifth round of the National Family and Health Survey (NFHS-5), conducted in two phases between 2019 and 2021.

    About NFHS

    • The NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
    • The previous four rounds of the NFHS were conducted in 1992-93, 1998-99, 2005-06 and 2015-16.
    • The survey provides state and national information for India on:

    Fertility, infant and child mortality, the practice of family planning, maternal and child health, reproductive health, nutrition, anaemia, utilization and quality of health and family planning services etc.

    Objectives of the survey

    Each successive round of the NFHS has had two specific goals:

    • To provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes
    • To provide information on important emerging health and family welfare issues.

    Key highlights of the NFHS-5

    [1] Women outnumbering men

    • NFHS-5 data shows that there were 1,020 women for 1000 men in the country in 2019-2021.
    • This is the highest sex ratio for any NFHS survey as well as since the first modern synchronous census conducted in 1881.
    • To be sure, in the 2005-06 NFHS, the sex ratio was 1,000 or women and men were equal in number.

    [2] Fertility has decreased

    • The Total Fertility Rate (TFR) has also come down below the threshold at which the population is expected to replace itself from one generation to next.
    • TFR was 2 in 2019-2021, just below the replacement fertility rate of 2.1. To be sure, in rural areas, the TFR is still 2.1.
    • In urban areas, TFR had gone below the replacement fertility rate in the 2015-16 NFHS itself.

    [3] Population is ageing

    • A decline in TFR, which implies that lower number of children are being born, also entails that India’s population would become older.
    • Sure enough, the survey shows that the share of under-15 population in the country has therefore further declined from 28.6% in 2015-16 to 26.5% in 2019-21.

    [4] Children’s nutrition has improved

    • The share of stunted (low height for age), wasted (low weight for height), and underweight (low weight for age) children have all come down since the last NFHS conducted in 2015-16.
    • However, the share of severely wasted children has not, nor has the share of overweight (high weight for height) or anaemic children.
    • The share of overweight children has increased from 2.1% to 3.4%.

    [5] Nutrition problem for adults

    • For children and their mothers, there are at least government schemes such as Integrated Child Development Services (ICDS) that seek to address the nutritional needs at the time of childbirth and infancy.
    • However, there is a need to address the nutritional needs of adults too.
    • The survey has shown that though India might have achieved food security, 60% of Indians cannot afford nutritious diets.
    • While the share of women and men with below-normal Body Mass Index (BMI) has decreased, the share of overweight and obese (those with above-normal BMI) and the share of anaemic has increased.

    [6] Basic sanitation challenges

    • Availability of basic amenities such as improved sanitation facilities clean fuel for cooking, or menstrual hygiene products can improve health outcomes.
    • There has been an improvement on indicators for all three since the last NFHS. However, the degree of improvement might be less than claimed by the government.
    • For example, only 70% population had access to an improved sanitation facility.
    • While not exactly an indicator of open defecation, it means that the remaining 30% of the population has a flush or pour-flush toilet not connected to a sewer, septic tank or pit latrine.

    [7] Use of clean fuel

    • The share of households that use clean cooking fuel is also just 59%.

    [8] Financial inclusion

    • The share of women having a bank account that they themselves use has increased from 53% to 79%.
    • Households’ coverage by health insurance or financing scheme also has increased 1.4 times to 41%, a clear indication of the impact of the government’s health insurance scheme.

     

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  • HomoSEP: Robot for cleaning Septic Tanks

    IIT Madras has developed a robot that can, if deployed extensively, put an end to this practice of sending people into septic tanks.

    HomoSEP

    • HomoSEP stands for “homogenizer of septic tanks”.
    • It has a shaft attached to blades that can open like an inverted umbrella when introduced into a septic tank.
    • This is helpful as the openings of the septic tanks are small and the tank interiors are bigger.
    • The sludge inside a septic tank contains faecal matter that has thickened like hard clay and settled at the bottom.
    • This needs to be shredded and homogenized so that it can be sucked out and the septic tank cleaned. The whirring blades of the robot achieve precisely this.

    Manual scavenging deaths in India

    • A statement by the Social Justice and Empowerment Ministry conveyed that in the five years till December 31, 2020, there have been 340 deaths due to manual scavenging.
    • Uttar Pradesh (52), Tamil Nadu (43) and Delhi (36) leads in the list. Maharashtra had 34 and Gujarat and Haryana had 31 each.
    • This is despite bans and prohibitory orders.

    Various policy initiatives

    • Prohibition of Employment as Manual Scavengers and their Rehabilitation (Amendment) Bill, 2020: It proposes to completely mechanise sewer cleaning, introduce ways for ‘on-site’ protection and provide compensation to manual scavengers in case of sewer deaths.
    • Prohibition of Employment as Manual Scavengers and their Rehabilitation Act, 2013: Superseding the 1993 Act, the 2013 Act goes beyond prohibitions on dry latrines, and outlaws all manual excrement cleaning of insanitary latrines, open drains, or pits.
    • Rashtriya Garima Abhiyan: It started national wide march “Maila Mukti Yatra” for total eradication of manual scavenging from 30th November 2012 from Bhopal.
    • Prevention of Atrocities Act: In 1989, the Prevention of Atrocities Act became an integrated guard for sanitation workers since majority of the manual scavengers belonged to the Scheduled Caste.
    • Judicial intervention: In 2014, a Supreme Court order made it mandatory for the government to identify all those who died in sewage work since 1993 and provide Rs. 10 lakh each as compensation to their families.

     

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  • Health Care Equity in Urban India

    The report on ‘Health Care Equity in Urban India’ exploring health vulnerabilities and inequalities in cities in India was recently released.

    About the report

    • The report is released recently by Azim Premji University in collaboration with 17 regional NGOs across India.
    • It notes that a third of India’s people now live in urban areas, with this segment seeing rapid growth from about 18% (1960) to 28.53% (2001) to 34% (in 2019).
    • The study draws insights from data collected through detailed interactions with civil society organizations in major cities and towns.
    • This also included an analysis of the National Family and Health Surveys (NHFS), the Census of India, and inputs from State-level health officials on the provision of health care.
    • It also looks at the availability, accessibility, and cost of healthcare facilities, and possibilities in future-proofing services in the next decade.

    Key highlights of the report

    • Urban poverty on rise: Close to 30% of people living in urban areas are poor.
    • Declining life expectancy: Life expectancy among the poorest is lower by 9.1 years and 6.2 years among men and women, respectively, compared to the richest in urban areas.
    • Chaotic health governance: The report, besides finding disproportionate disease burden on the poor, also pointed to a chaotic urban health governance.
    • Multiplicity and non-coordination: The multiplicity of healthcare providers both within and outside the government without coordination challenges to urban health governance.
    • Lack of political attention: Urban healthcare has received relatively less research and policy attention.

    Major recommendations

    The report calls for:

    • Strengthening community participation and governance
    • Building a comprehensive and dynamic database on the health and nutrition status, including co-morbidities of the diverse, vulnerable populations
    • Strengthening healthcare provisioning through the National Urban Health Mission, especially for primary healthcare services
    • Putting in place policy measures to reduce the financial burden of the poor
    • A better mechanism for coordinated public healthcare services and better governed private healthcare institutions

    Conclusion

    • As urbanization is happening rapidly, the number of the urban poor is only expected to increase.
    • A well-functioning, better coordinated, and governed health care system is crucial at this point.
    • The pandemic has brought to attention the need for a robust and resourced healthcare system.
    • Addressing this will benefit the most vulnerable and offer critical services to city dwellers across income groups.

     

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  • More a private sector primer than health-care pathway

    Context

    NITI Aayog recently published a road map document entitled “Health Insurance for India’s Missing Middle”.

    About missing middle and provision in the NITI Aayog report

    • The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), aims to extend hospitalisation cover of up to â‚č5 lakh per family per annum to a poor and vulnerable population of nearly 50 crore people.
    • Left out segment: Covering the left out segment of the population, commonly termed the ‘missing middle’ sandwiched between the poor and the affluent, has been discussed by the Government recently.
    • Towards this, NITI Aayog recently published a road map document entitled “Health Insurance for India’s Missing Middle”.
    • Primary role for private commercial health insurer: The report proposes voluntary, contributory health insurance dispensed mainly by private commercial health insurers as the prime instrument for extending health insurance to the ‘missing middle’.

    Issues with the provision in the NITI Aayog report

    • Narrow coverage: Government subsidies, if any at all, will be reserved for the very poor within the ‘missing middle’ and only at a later stage of development of voluntary contributory insurance.
    • This is a major swerve from the vision espoused by the high-level expert group on UHC a decade ago, which was sceptical about such a health insurance model.
    • No country has ever achieved UHC by relying predominantly on private sources of financing health care.
    • Contributory insurance not best way: Evidence shows that in developing countries such as India, with a gargantuan informal sector, contributory health insurance is not the best way forward and can be replete with problems.
    • Issues with low premium model: For hospitalisation insurance, the report proposes a model similar to the Arogya Sanjeevani scheme, albeit with lower projected premiums of around â‚č4,000-â‚č6,000 per family per annum.
    • This model is a little different from commercial private insurance, except for somewhat lower premiums.
    • Low premiums are achieved by reducing administrative costs of insurers through an array of measures, including private use of government infrastructure.
    • This model is vulnerable to nearly every vice that characterises conventional private insurance.
    • Insufficient measures to deal with adverse selection: The report suggests enrolment in groups as a means to counter adverse selection.
    • The prevailing per capita expenditure on hospital care is used to reflect affordability of hospital insurance, and thereby, a possible willingness to pay for insurance.
    • Both these notions are likely to be far-fetched in practice, and the model is likely to be characterised by widespread adverse selection notwithstanding.
    • OPD insurance on a subscription basis: The report proposes an OPD insurance with an insured sum of â‚č5,000 per family per annum, and again uses average per capita OPD spending to justify the ability to pay.
    • However, the OPD insurance is envisaged on a subscription basis, which means that insured families would need to pay nearly the entire insured sum in advance to obtain the benefits.
    • Clearly, this route is unlikely to result in any significant reduction of out-of-pocket expenditure on OPD care.
    • Role of government:The NITI report defies the universally accepted logic that UHC invariably entails a strong and overarching role for the Government in health care, particularly in developing countries.

    Consider the question “What are the challenges in achieving universal health coverage? What are the issues with private sources  financing health care to achieve UHC?”

    Conclusion

    The National Health Policy 2017 envisaged increasing public health spending to 2.5% of GDP by 2025. Let us not contradict ourselves so early and at this crucial juncture of an unprecedented pandemic.

  • Project Sampoorna: A successful measure against malnutrition

    Project Sampoorna’s success in reducing child malnutrition is a model that can be easily implemented anywhere.

    What is Project Sampoorna?

    • Project Sampoorna has been implemented in the Bongaigaon district of Assam.
    • It aims to target Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM).
    • It was launched to target the mothers of SAM/ MAM children with the tagline being ‘Empowered Mothers, Healthy Children’.
    • It was based on the success of the community-based COVID-19 management model (Project Mili Juli).

    Key features of the project

    • Under this project, the mother of a healthy child of an Anganwadi Centre was paired with the target mother and they would be Buddy Mothers.
    • They were usually neighbours and shared similar socioeconomic backgrounds.
    • They were given diet charts to indicate the daily food intake of their children and would have discussions on all Tuesdays at the Anganwadi centres.
    • 100 millilitres of milk and an egg on alternate days for the children for the first 3 months were provided so that their mothers could stabilise themselves in the newly found jobs.
    • Children who had not improved were checked and treated by doctors under the Rashtriya Bal Swasthya Karyakram (RBSK).

    Success of the project

    • This project has prevented at least 1,200 children from becoming malnourished over the last year.
    • National Nutrition Mission and the State government recognised this project in the ‘Innovation Category’.
    • The mothers were enrolled in Self Help Groups (SHGs) under the National Rural Livelihoods Mission (NRLM) and were thus working.

     

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  • Global Drug Policy Index inaugurated

    The first-ever Global Drug Policy Index was recently inaugurated.

    Global Drug Policy Index

    • It is released by the Harm Reduction Consortium, ranks Norway, New Zealand, Portugal, the UK and Australia as the five leading countries on humane and health-driven drug policies.
    • It is a data-driven global analysis of drug policies and their implementation.
    • It is composed of 75 indicators running across five broad dimensions of drug policy:
    1. Criminal justice
    2. Extreme responses
    3. Health and harm reduction
    4. Access to internationally controlled medicines and
    5. Development

    Highlights of the 2021 ranking

    • The five lowest-ranking countries are Brazil, Uganda, Indonesia, Kenya, and Mexico.
    • Norway, despite topping the Index, only managed a score of 74/100.
    • And the median score across all 30 countries and dimensions is just 48/100.

    India’s performance

    • India’s rank is 18 out of 30 countries
    • It has an overall score of 46/100.

     

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