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Subject: Health

  • NCAHP Bill 2020

    The article highlights the key aspects of NCAHP Bill 2020 which recognises the allied healthcare professionals and seeks to regulate and set the standards of education.

    Regulating allied health professions

    • The National Commission for Allied and Healthcare Professions Bill, 2020 (NCAHP) was passed by Parliament in March.
    • Global evidence demonstrates the vital role of allied professionals in the delivery of healthcare services.
    • They are the first to recognise the problems of the patients and serve as safety nets.
    • Their awareness of patient care accountability adds tremendous value to the healthcare team in both the public and private sectors.
    • The passage of this Bill has the potential to overhaul the entire allied health workforce by establishing institutes of excellence and regulating the scope of practice by focusing on task shifting and task-re distribution.

    What the Bill provides for

    • This legislation provides for regulation and maintenance of standards of education and services by allied and healthcare professionals and the maintenance of a central register of such professionals.
    • It recognises over 50 professions such as physiotherapists, optometrists, nutritionists, medical laboratory professionals, radiotherapy technology professionals, which had hitherto lacked a comprehensive regulatory mechanism.
    • This Bill classifies allied professionals using the International System of Classification of Occupations (ISCO code).
    • This facilitates global mobility and enables better opportunities for such professionals.
    • The Act aims to establish a central statutory body as a National Commission for Allied and Healthcare Professions.
    • The Bill has the provision for state councils to execute major functions through autonomous boards.

    Shift in perception and policy in healthcare delivery

    • There has been a paradigm shift in perception, policy, and programmatic interventions in healthcare delivery in India since 2017.
    • In the past, curative healthcare received substantially greater attention than preventive and promotive aspects.
    • Ayushman Bharat as a programmatic intervention, with its two pillars of Health and Wellness Centres (HWCs) and Pradhan Mantri Jan Arogya Yojana (PMJAY), operationalised certain critical recommendations of the National Health Policy, 2017, emphasising wellness in healthcare.
    • With PMJAY, the neediest are protected from catastrophic expenditure and India took the first step towards delivering comprehensive primary healthcare with HWCs.

    Conclusion

    Caring for patients with mental conditions, the elderly, those in need of palliative services, and enabling professional services for lifestyle change related to physical activity and diets, all require a trained, allied health workforce. The NCAHP is not only timely but critical to this changing paradigm.

  • [pib]  ‘Anamaya’ Initiative

    Anamaya, the Tribal Health Collaborative was recently launched.

    Simply keep in mind, the name and purpose.

    ‘Anamaya’ Initiative

    • The Collaborative is a multi-stakeholder initiative of the Tribal Affairs Ministry supported by Piramal Foundation and Bill and Melinda Gates Foundation (BMGF).
    • It aims to build a sustainable, high-performing health eco-system to address the key health challenges faced by the tribal population of India.
    • It will converge efforts of various Government agencies and organisations to enhance the health and nutrition status of the tribal communities of India.
    • This collaborative is a unique initiative bringing together governments, philanthropists, national and international foundations, NGOs/CBOs to end all preventable deaths among the tribal communities of India.

    Terms of references

    • It will begin its operations with 50 tribal, Aspirational Districts (with more than 20% ST population) across 6 high tribal population states.
    • Over a 10-year period, the work of the THC will be extended to 177 tribal Districts as recognised by the Ministry of Tribal Affairs.

  • Integrated Health Information Platform (IHIP)

    The Union Minister of Health & Family Welfare has launched the Integrated Health Information Platform (IHIP).

    About IHIP

    • The new version of IHIP will house the data entry and management for India’s disease surveillance program.
    • In addition to tracking 33 diseases now as compared to the earlier 18 diseases, it shall ensure near-real-time data in digital mode, having done away with the paper mode of working.

    Various functions

    • IHIP will provide a health information system developed for real-time, case-based information, integrated analytics, advanced visualization capability.
    • It will provide analyzed reports on mobile or other electronic devices. In addition, outbreak investigation activities can be initiated and monitored electronically.
    • It can easily be integrated with another ongoing surveillance program while having the feature of the addition of special surveillance modules.

    Unique features

    • This is the world’s biggest online disease surveillance platform.
    • It is in sync with the National Digital Health Mission and fully compatible with the other digital information systems presently being used in India.
    • The refined IHIP with automated -data will help in a big way in real-time data collection, aggregation & further analysis of data that will aid and enable evidence-based policymaking.
    • With IHIP, the collection of authentic data will become easy as it comes directly from the village/block level; the last mile from the country.
    • With its implementation, we are fast marching towards AtmaNirbhar Bharat in healthcare through the use of technology.

    Also read:

    [Burning Issue] Rolling-out of National Digital Health Mission

  • What is Happiness Curriculum?

    The Delhi Deputy CM has said that during the pandemic, the Happiness Curriculum immensely helped them to apply life skills to deal with stressful situations.

    Try this question:

    Q.What is Happiness Curriculum? Discuss the scope of introducing happiness curriculum supplementary to the regular curriculum across the country.

    What is Delhi’s ‘happiness curriculum’?

    • The curriculum calls for schools in India to promote development in cognition, language, literacy, numeracy and the arts along with addressing the well-being and happiness of students.
    • It further says that future citizens need to be “mindful, aware, awakened, empathetic, firmly rooted in their identity…” based on the premise that education has a larger purpose, which cannot be in isolation from the “dire needs” of today’s society.
    • For the evaluation, no examinations are conducted, neither will marks be awarded.
    • The assessment under this curriculum is qualitative, focusing on the “process rather than the outcome” and noting that each student’s journey is unique and different.

    Objectives of the curriculum

    The objectives of this curriculum include:

    • developing self-awareness and mindfulness,
    • inculcating skills of critical thinking and inquiry,
    • enabling learners to communicate effectively and
    • helping learners to apply life skills to deal with stressful and conflicting situations around them

    Learning outcomes of this curriculum

    The learning outcomes of this curriculum are spread across four categories:

    • becoming mindful and attentive (developing increased levels of self-awareness, developing active listening, remaining in the present);
    • developing critical thinking and reflection (developing strong abilities to reflect on one’s own thoughts and behaviours, thinking beyond stereotypes and assumptions);
    • developing social-emotional skills (demonstrating empathy, coping with anxiety and stress, developing better communication skills) and
    • developing a confident and pleasant personality (developing a balanced outlook on daily life reflecting self-confidence, becoming responsible and reflecting awareness towards cleanliness, health and hygiene).

    How is the curriculum implemented?

    • The curriculum is designed for students of classes nursery through the eighth standard.
    • Group 1 consists of students in nursery and KG, who have bi-weekly classes (45 minutes each for one session, which is supervised by a teacher) involving mindfulness activities and exercise.
    • Children between classes 1-2 attend classes on weekdays, which involves mindfulness activities and exercises along with taking up reflective questions.
    • The second group comprises students from classes 3-5 and the third group is comprised of students from classes 6-8 who apart from the aforementioned activities, take part in self-expression and reflect on their behavioural changes.

  • N K Singh bats for moving Health Sector to Concurrent List

    Health should be shifted to the Concurrent list under the Constitution, and a developmental finance institution (DFI) dedicated to healthcare investments set up, Fifteenth Finance Commission Chairman N.K. Singh has said.

    Other key recommendations

    • Bringing health into the Concurrent list would give the Centre greater flexibility to enact regulatory changes and reinforce the obligation of all stakeholders towards providing better healthcare.
    • He has urged the government spending to enhance expenditure on health to 2.5% of GDP by 2025.
    • He said primary healthcare should be a fundamental commitment of all States in particular and should be allocated at least two-thirds of such spending.

    The Concurrent List or List-III (of Seventh Schedule) is a list of 52 items (though the last subjects are numbered 47) given in the Seventh Schedule to the Constitution of India.

    What is the Seventh Schedule?

    • This Schedule of the Indian Constitution deals with the division of powers between the Union government and State governments.
    • It defines and specifies the allocation of powers and functions between Union & States. It contains three lists; i.e. 1) Union List, 2) State List and 3) Concurrent List.

    The Union List

    • It is a list of 98 (Originally 97) numbered items as provided in the Seventh Schedule.
    • The Union Government or Parliament of India has exclusive power to legislate on matters relating to these items.

    The State List

    • It is a list of 59 (Originally 66) items.
    • The respective state governments have exclusive power to legislate on matters relating to these items.

    The Concurrent List

    • There are 52 (Originally 47) items currently in the list.
    • This includes items which are under the joint domain of the Union as well as the respective States.

    Must read

    [Burning Issue] India’s Ailing Health Sector and Coronavirus

    Healthcare in India

    • The Indian Constitution has incorporated the responsibility of the state in ensuring basic nutrition, basic standard of living, public health, protection of workers, special provisions for disabled persons, and other health standards, which were described under Articles 39, 41, 42, and 47 in the DPSP.
    • Article 21 of the Constitution of India provides for the right to life and personal liberty and is a fundamental right.
    • Public Health comes under the state list.
    • India’s expenditure on healthcare has shot up substantially in the past few years; it is still very low in comparison to the peer nations (at approx. 1.28% of GDP).

  • Agri Ministry questions Global Hunger reports’ methodology

    Union Minister of State for Agriculture has questioned the methodology and data accuracy of the Global Hunger Index (GHI) report, which has placed India at 94th (out of 107 countries) rank in 2020.

    About GHI

    • GHI is a peer-reviewed annual report, jointly published by Concern Worldwide, an Ireland-based humanitarian group, and Welthungerhilfe, a Germany-based NGO.
    • It is designed to comprehensively measure and track hunger at the global, regional, and country levels.
    • It says the aim of publishing the report is to trigger action to reduce hunger around the world.
    • According to the GHI website, the data for the indicators come from the United Nations and other multilateral agencies, including the World Health Organisation and the World Bank.

    Various indicators used

    1. UNDERNOURISHMENT: the share of the population that is undernourished (that is, whose caloric intake is insufficient);
    2. CHILD WASTING: the share of children under the age of five who are wasted (that is, who have low weight for their height, reflecting acute undernutrition);
    3. CHILD STUNTING: the share of children under the age of five who are stunted (that is, who have low height for their age, reflecting chronic undernutrition); and
    4. CHILD MORTALITY: the mortality rate of children under the age of five (in part, a reflection of the fatal mix of inadequate nutrition and unhealthy environments).

    What is the concern?

    • India was ranked below countries such as Nepal, Bangladesh and Myanmar when it was among the top 10 food-producing countries in the world.

    Actual scenario

    • The Comprehensive National Nutrition Survey (CNNS) compiled in 2017-18 showed an improvement of 4%, 3.7% and 2.3% in wasted, stunted and malnourished children respectively.
    • The first-ever CNNS was commissioned by the government in 2016 and was conducted from 2016-18, led by the Union Health Ministry, in collaboration with the UNICEF.
    • The findings were published in 2019. CNNS includes only nutrition data, whereas NFHS encompasses overall health indicators.

  • Jharkhand’s SAAMAR campaign to fight malnutrition

    The Jharkhand government has announced the launch of the SAAMAR campaign to tackle malnutrition in the state.

    We can expect an MCQ like:

    Q.SAAMAR campaign sometimes seen in news is related to:

    () Bovine health

    () Mother and Child Health

    () Non-communicable diseases

    () None of these

    SAAMAR

    • SAAMAR is an acronym for Strategic Action for Alleviation of Malnutrition and Anemia Reduction.
    • The campaign aims to identify anaemic women and malnourished children and converge various departments to effectively deal with the problem in a state where malnutrition has been a major problem.
    • Every second child in the state is stunted and underweight and every third child is affected by stunting and every 10th child is affected by severe wasting and around 70% of children are anaemic NFHS-4 data.

    Features of the scheme

    • Although existing schemes are there, seeing the current situation, the intervention was required with a ‘different approach to reduce malnutrition.
    • SAAMAR has been launched with a 1000 days target, under which annual surveys will be conducted to track the progress.
    • It talks of convergence of various departments such as the Rural Development Department and Food and Civil Supplies and engagement with school management committees, gram sabhas among others and making them aware of nutritional behaviour.
    • Most importantly, the campaign, as per the note, also tries to target Primarily Vulnerable Tribal Groups.

    Outlined strategy under the scheme

    • To tackle severe acute malnutrition children, every Anganwadi Centres will be engaged to identify these children and subsequently will be treated at the Malnutrition Treatment Centres.
    • In the same process, the anaemic women will also be listed and will be referred to health centres in serious cases.
    • All of these will be done by measuring Mid-Upper Arm Circumference (MUAC) of women and children through MUAC tapes and Edema levels.
    • Angawadi’s Sahayia and Sevika will take them to the nearest Health Centre where they will be checked again and then registered on the portal of State Nutrition Mission.

    Why need such a scheme?

    • The state government runs various schemes under Child Development Schemes, National Nutrition Mission among others to deal with the situation, but it is not enough.
    • Dealing with malnutrition in the state monitoring has been an important concern due to the lack of doctors or health care workers.

  • ACT-Accelerator Coalition

    ACT-Accelerator, a global coalition formed in April 2020 to fight the novel coronavirus disease (COVID-19) is facing a severe fund crunch to meet its goals for 2020-21.

    ACT-Accelerator

    • The Access to COVID-19 Tools Accelerator (ACT Accelerator) is a G20 initiative announced on 24 April 2020.
    • A call to action was published simultaneously by the World Health Organization (WHO).
    • The ACT Accelerator is a cross-discipline support structure to enable partners to share resources and knowledge.
    • It comprises four pillars, each managed by two to three collaborating partners:
    1. Vaccines (also called “COVAX”)
    2. Diagnostics
    3. Therapeutics
    4. Health Systems Connector
    • India is an active donor in this alliance.

    Try this PYQ based on a global coalition:

    Q.Consider the following statements:

    1. Climate and Clean Air Coalition (CCAC) to Reduce Short Lived Climate Pollutants is a unique initiative of G20 group of countries.
    2. The CCAC focuses on methane, black carbon and Hydrofluorocarbons.

    Which of the above statements is/are correct?

    (a) 1 only

    (b) 2 only

    (c) Both 1 and 2

    (d) Neither 1 nor 2

  • What we must consider before digitising India’s healthcare

    As India seeks to create digital health infrastructure, it must consider several issues.

    Integrated digital health infrastructure

    • The National Digital Health Mission aims to develop the backbone needed for the integrated digital health infrastructure of India.
    • This can help not only with diagnostics and management of health episodes, but also with broader public health monitoring, socio-economic studies, epidemiology, research, prioritising resource allocation and policy interventions. 
    • However, before we start designing databases and APIs and drafting laws, we must be mindful of certain considerations for design choices and policies to achieve the desired social objectives.

    Factors to be considered

    1) Carefully developing pathway to public good

    • There must be a careful examination of how exactly digitisation may facilitate better diagnosis and management, and an understanding of the data structures required for effective epidemiology.
    • We must articulate how we may use digitisation and data to understand and alleviate health problems such as malnutrition and child stunting.
    • We need the precise data we require to better understand crucial maternal- and childcare-related problems.

    2) Balancing between public good and individual rights

    • The potential tensions between public good and individual rights must be examined, as must the suitable ways to navigate them.
    • Moreover, for the balancing to be sound and for determining the level of due diligence required, it is imperative to clearly define the operational standards for privacy management.
    • Conflating privacy with security, as is typical in careless approaches, will invariably lead to problematic solutions.
    • In fact, most attempts at building health data infrastructures worldwide — including in the UK, Sweden, Australia, the US and several other countries — have led to serious privacy-related controversies and have not yet been completely successful.

    3) Managing the sector specific identities

    • Even if we define and use a sector-specific identity, the question of when and how to link it with that of other sectors remains.
    • For example, with banking or insurance for financial transactions, or with welfare and education for transactions and analytics.
    • Indiscriminate linking may break silos and create a digital panopticon, whereas not linking at all will result in not realising the full powers of data analytics and inference.

    4) Working out the operational requirement of data infrastructure

    • We need to work out the operational requirements of the data infrastructure in ways that are informed by, and consonant with, the previous points.
    • In other words, the design of the operationalisation elements must follow the deliberations on above points, and not run ahead of them.
    • This requires identifying the diverse data sources and their complexity — which may include immunisation records, birth and death records, informal health care workers, dispensaries etc.
    • It also requires an understanding of their frequency of generation, error models, access rights, interoperability, sharing and other operational requirements.
    • There also are the complex issues of research and non-profit uses of data, and of data economics for private sector medical research.

    5) Issue of due process

    • Finally, “due process” has always been a weak point in India, particularly for technological interventions.
    • Building an effective system that can engender people’s trust not only requires managing the floor of the Parliament and passing a just and proportional law, but also building a transparent process of design and refinement through openness and public consultations.
    • In particular, technologists and technocrats should take care to not define “public good” as what they can conveniently deliver, and instead understand what is actually required.
    • While we can understand the urge to move forward quickly, given the urgent need to improve health outcomes in the country, deliberate care is needed.

    Consider the question “While seeking to develop digital health infrastructure through the National Digital Health Mission, we should be mindful of certain considerations for design choices and policies to achieve the desired social objectives. Comment.”

    Conclusion

    Developing a comprehensive understanding of the considerations related to health data infrastructure may also inform the general concerns of e-governance and administrative digitisation in India, which have not been all smooth sailing.

  • What changes after COVID-19 vaccination?

    As the vaccination drive gains momentum, questions have emerged about appropriate behaviour after being vaccinated.

    What does being vaccinated mean?

    • Being fully vaccinated means a period of two weeks or more following the receipt of the second dose in a two-dose series, or two weeks or more following the receipt of a single-dose vaccine.
    • In India, currently, both vaccines being used — Covishield and Covaxin — follow a two-dose regimen.
    • Typically, the immune response takes a while to build up after a vaccine shot.
    • After the first jab of a two-dose vaccine, a good immune response kicks in within about two weeks. It is the second dose that boosts the immune response.

    Is the COVID threat averted?

    • It is still unclear how long immunity lasts from the vaccines at hand now.
    • Whether or not the immune response is durable, how it performs with the passage of time, and how long it lasts can be found out only by monitoring people who have already been vaccinated over a period.
    • If the vaccinated individual is still carrying the virus, the vaccine may provide immunity from severe disease for him or her, but the individual could still transmit the virus.

    What changes after you get a vaccine shot?

    • After vaccination, one risk of severe disease from COVID-19 goes down dramatically.
    • There is not enough evidence yet of vaccine response for some age groups, and vaccines are in short supply in the community.