On Tuesday, June 18, the Marriage Equality Billwas approved by the Thai Senate, the upper house of Thailand’s National Assembly, with overwhelming support.
What does the Bill entail?
Gender-Neutral Language: The bill replaces gender-specific terms such as “husbands” and “wives” in Thai marriage laws with gender-neutral terms like “spouse” and “person”. This change allows any two individuals, regardless of their gender, to marry each other.
Equal Rights: Same-sex couples will have the same rights as heterosexual couples in various legal and practical aspects, including:
Adoption rights: Same-sex couples can adopt children.
Inheritance rights: They are entitled to inherit property from their spouses.
Tax benefits: They will receive similar tax benefits as heterosexual married couples.
Legal decision-making: They can make legal decisions on behalf of their spouses, such as consenting to medical treatment.
Recognition and Protection: The bill ensures that same-sex marriages are legally recognised and protected, providing stability and legal security to LGBTQ+ couples in Thailand.
Public Support: The bill’s passage reflects growing societal acceptance and support for LGBTQ+ rights in Thailand. Public opinion has been largely positive, with significant cross-party support in the Thai Senate and lower house of the National Assembly.
What about other Asian countries?
Criminalization: Many Asian countries, beyond those mentioned (Thailand, Taiwan, Nepal), still criminalize same-sex sexual activity. This includes countries like Malaysia, Myanmar, Pakistan, and Sri Lanka, where laws derived from colonial-era penal codes often penalize homosexuality with imprisonment or fines.
Lack of Legal Recognition: Most Asian nations do not legally recognizesame-sex marriages or partnerships.
Even in countries where same-sex relations are not explicitly criminalized, there is often no legal framework for marriage or civil unions for LGBTQ+ individuals.
Legal Battles: In countries like India, legal battles continue as activists seek to overturn discriminatory laws and secure legal recognition for same-sex relationships, including marriage.
International Pressure: International human rights organizations and diplomatic efforts sometimes exert pressure on Asian governments to improve LGBTQ+ rights. However, progress is often slow and faces strong domestic resistance.
Note: Currently, same-sex marriage is legal in 36 countries (not including Thailand) globally, according to LGBTQ+ rights advocacy Human Rights Campaign.
Way forward:
Legal Challenges and Reform: Support ongoing legal challenges in courts across Asia to overturn discriminatory laws and promote legal recognition of same-sex relationships. This includes advocating for legislative reforms that protect LGBTQ+ rights, including the recognition of same-sex marriages or civil unions.
International Pressure and Diplomacy: Encourage international human rights bodies, governments, and diplomatic missions to engage with Asian countries diplomatically, urging them to uphold international human rights standards, including LGBTQ+ rights.
The phenomenon of ageing stands out as one of the most significant developments of this century, characterized by notable advancements in human longevity alongside historically low reproduction rates.
About the Magnitude and Multiplication of the aged population
The magnitude of Aging Population: The 21st century is witnessing a significant demographic shift marked by a notable increase in human longevity.
Improved healthcare and living conditions have contributed to a rise in life expectancy, leading to a larger elderly population. By mid-century, India is projected to have around 319 million elderly people, growing at a rate of approximately 3% annually.
Multiplication of Aging Phenomenon: Despite longevity gains, there is a simultaneous decline in fertility rates, leading to an ageing population with a lower proportion of younger generations.
This demographic shift poses challenges related to healthcare, social security, and economic sustainability. The elderly population is becoming increasingly feminized, with a higher prevalence of elderly women due to longer life expectancy and higher widowhood rates.
Aged Population as per the 2011 Census:
According to the 2011 Census of India, the population of people aged 60 and older in India was 104 million, which is 8.6% of the total population. This is an increase from 5.6% in 1961.
The census also found that 53 million of the elderly population were female and 51 million were male, with a sex ratio of 1033. 71% of the elderly population lived in rural areas and 29% lived in urban areas. Additionally, 5.18% of the elderly population, or 53,76,619 people, had some disability
Issues and Challenges
Vulnerabilities of the Elderly: Many elderly individuals in India face significant vulnerabilities, including limitations in activities of daily living (ADL), multi-morbidity, poverty, and lack of financial security.
A substantial proportion of the elderly report poor health conditions, with a high prevalence of chronic diseases such as diabetes and cancer.
Mental health issues, particularly depression, are also prevalent among the elderly population.
Social and Economic Insecurities: Food insecurity affects a notable percentage of the elderly, with reports of reduced portions or skipped meals due to economic constraints.
Lack of legal protection: Awareness and access to welfare measures and legal protections for the elderly are low, with limited knowledge about schemes like IGNOAPS, IGNWPS, and Annapurna.
Abuse and Neglect: Elder abuse is a significant concern, especially for elderly women in rural areas who often experience neglect and mistreatment within their families and communities.
Social exclusion and limited opportunities for productive engagement exacerbate feelings of insecurity and marginalization among the elderly.
Way Forward:
Enhancing Social Support and Welfare Measures: Strengthening awareness and accessibility of welfare schemes and legal protections for the elderly. Implementing social security measures to ensure financial stability and improve quality of life for ageing populations.
Healthcare and Mental Well-being: Prioritizing healthcare interventions tailored to the needs of the elderly, including preventive measures against chronic diseases and mental health support. Promoting healthy ageing through lifestyle interventions and healthcare policies that address the unique challenges of an ageing population.
Empowerment and Social Inclusion: Fostering social inclusion through community engagement and initiatives that empower the elderly to contribute actively to society. Developing innovative institutional frameworks that value the elderly as assets and promote their participation in societal development.
Mains PYQ:
Q. Critically examine the effects of globalization on the aged population in India. (UPSC IAS/2013)
Q Discuss the possible factors that inhibit India from enacting for its citizen a uniform civil code as provided for in the Directive Principles of State Policy. (UPSC IAS/2015)
Q Customs and traditions suppress reason leading to obscurantism. Do you agree? (UPSC IAS/2020)
Mentor comment: Interfaith marriages in India face legal and societal challenges despite protections under the Special Marriage Act, 1954. Recent judicial interventions have raised concerns about misinterpretations, impacting couples’ rights to choose partners freely. Such marriages often encounter opposition from families and communities, leading to social tensions. Efforts to protect couples through legal frameworks are crucial amid ongoing debates on religious and cultural sensitivities.
Let’s learn!
Why in the News?
A recent order from the Madhya Pradesh High Court has raised concerns about the interpretation of the law regarding inter-faith marriages and the scope of the Special Marriage Act, 1954.
About Special Marriage Act, 1954:
•The SMA was passed by the Parliament on October 9, 1954. •It governs a civil marriage where the state sanctions the marriage rather than the religion. •The minimum age to get married under the SMA is 21 years for males and 18 years for females. Need for SMA: •Issues of personal law such as marriage, divorce, and adoption are governed by religious laws that are codified. •These laws, such as the Muslim Marriage Act,1954, and the Hindu Marriage Act, 1955, require either spouse to convert to the religion of the other before marriage. •However, the SMA enables marriage between inter-faith or inter-caste couples without them giving up their religious identity or resorting to conversion.
Erroneous Considerations
Typical Assessment Under Article 226: When a petition for police protection is filed under Article 226 of the Constitution, the High Court usually assesses the violation of the petitioners’ rights and the threat they face.
Extended Protection Examples:
The Madras High Court granted protection to a lesbian couple, recognizing the dangers they faced.
The Punjab and Haryana High Court provided protection to a live-in couple, emphasizing the protection of their fundamental rights under Article 21 of the Constitution.
Contrasting Focus of Madhya Pradesh HC: Instead of focusing on the threats faced by the couple, the HC focused on the validity of the couple’s impending marriage, disregarding their right to life and liberty.
What is Article 226 of the Constitution?: Article 226 grants the High Courts of Indian states the power to issue writs. These writs are primarily meant for the enforcement of fundamental rights guaranteed under Part III of the Constitution or for any other legal purpose. The High Courts have the authority to issue writs such as habeas corpus, mandamus, prohibition, quo warranto, and certiorari.
Dilution of the Special Marriage Act
Contradictory Order: The Madhya Pradesh High Court’s order contradicts the core principles of the Special Marriage Act.
Irrelevant Supreme Court Precedent: The court erroneously relied on a Supreme Court precedent related to property succession under Mohammedan Laws, which is irrelevant to the validity of inter-faith marriages under the Special Marriage Act.
Misinterpretation of Section 4: The court misinterpreted Section 4 of the Act, which excludes marriages between close relatives, not inter-faith marriages.
Act’s Purpose: The Act is designed to facilitate marriage between any two Indian nationals, regardless of their faith.
Present status of Special Marriages:
Significance of the Order: The Madhya Pradesh High Court order is significant given the current social and political climate, where inter-faith and inter-caste marriages face vigilantism and right-wing propaganda.
Ongoing Petitions: There are ongoing petitions challenging unconstitutional provisions within the Special Marriage Act, such as the prior notice requirement, pending before the Supreme Court.
Supreme Court’s Ruling in Shafin Jahan Case:
Emphasized the protection of personal liberty and the right to choose a life partner, regardless of faith or caste.
Justice D.Y. Chandrachud’s judgment highlighted that intimate personal decisions do not require social approval and are protected by the Constitution.
Way forward
Disregard of Shafin Jahan Judgment: The Madhya Pradesh High Court’s order disregards the spirit of the Shafin Jahan judgment, which prioritizes individual autonomy, privacy, and liberty.
Courts’ Responsibility: Constitutional courts must remember that jurisprudence favours autonomy and personal liberty.
While global gender parity has improved to 68.5% in 2024 from 68.4% in 2023, progress remains slow. The World Economic Forum’s report indicates it will take 134 years to achieve full parity at this rate.
The Global Gender Gap Report 2024
It is released by the World Economic Forum (WEF), and highlights significant disparities in gender parity across various sectors.
Present Scenario:
Global Gender Gap Report 2024:
The global gender gap stands at 68.5% closed, indicating slow progress towards gender parity.
Iceland leads with over 90% closure, while India has slipped to 129th position out of 146 countries, with 64.1% closure.
India’s slight regression is attributed to declines in education and political empowerment indices.
Challenges in India:
Despite improvements in economic participation, India needs to bridge gaps in education and political representation.
The labour force participation rate for women is 45.9%, indicating significant untapped potential.
Gender disparity in literacy rates persists, with women lagging 17.2 percentage points behind men, impacting India’s global ranking.
Significance of Low Gender Gap in the Education Sector:
Bridging the gender gap in education is crucial for enhancing women’s economic opportunities.
Measures such as preventing dropout rates among girls, imparting job skills, and ensuring workplace safety are essential.
Improving literacy rates and educational attainment levels for women can lead to higher economic productivity and empowerment.
Significance of Low Gender Gap in Political Representation:
India shows low representation of women in political bodies despite some progress. Women constitute only 13.6% of the Lok Sabha members, reflecting inadequate political empowerment.
Implementation of the Women’s Reservation Bill, aimed at reserving one-third of seats in legislative bodies, remains crucial for enhancing women’s political participation and influence.
Way forward:
Enhancing Education Access and Quality: Implement targeted policies to reduce the gender gap in education, focusing on increasing girls’ enrollment and retention rates.
Promoting Women’s Political Empowerment: Implement initiatives to encourage women’s active participation in politics, such as leadership training programs, awareness campaigns, and support networks.
Mains PYQ:
Q Can the vicious cycle of gender inequality, poverty and malnutrition be broken through microfinancing of women SHGs? Explain with examples. (UPSC IAS/2021)
FOGSI launched a detailed immunization plan for women in Mumbai, featuring essential vaccines and recommended dosages, presented by women’s health advocate Kajal Aggarwal.
About the Federation of Obstetric and Gynaecological Societies of India (FOGSI)
The Federation of Obstetric and Gynaecological Societies of India (FOGSI) is a prominent professional organization dedicated to advancing the field of obstetrics and gynaecology in India.
Foundation and Scope: FOGSI was established in 1950 and currently represents over 34,000 obstetricians and gynaecologists across India. It serves as a unified platform for healthcare professionals specializing in women’s health.
Objectives: The primary objective of FOGSI is to promote the study and practice of obstetrics and gynaecology through education, research, and advocacy. It aims to improve the standards of healthcare delivery for women in India.
Significance of Preventive Health Care
Early Detection and Intervention: Preventive healthcare emphasizes regular screenings, vaccinations, and health checks to detect potential health issues early. This proactive approach allows healthcare providers to intervene early, often before symptoms appear, which can lead to better treatment outcomes and lower healthcare costs.
Promotion of Health and Well-being: By focusing on preventive measures such as healthy lifestyle choices, vaccination against preventable diseases, and routine health screenings, individuals can maintain optimal health and well-being. Preventive healthcare encourages behaviours that reduce the risk of chronic illnesses and promote longevity.
Reduction of Healthcare Burden: Investing in preventive healthcare can alleviate the burden on healthcare systems by reducing the prevalence and severity of diseases. By preventing illnesses before they occur or progress, fewer resources are needed for acute care, hospitalizations, and long-term management of chronic conditions.
Accessing ‘Vulnerable Period’
Postpartum Period: The postpartum period, typically defined as the first six weeks after childbirth, is a critical vulnerable period for women. During this time, the body undergoes significant physiological changes, including hormonal fluctuations and potential immune system alterations. These changes can increase susceptibility to infections and other health complications, necessitating close monitoring and appropriate medical interventions.
Menopausal Transition: Menopause marks a significant transition in a woman’s life when reproductive hormone levels decline, leading to various physical and psychological changes. This period can be accompanied by symptoms such as hot flashes, mood swings, and changes in bone density. Due to these changes, women may be more vulnerable to conditions like osteoporosis and cardiovascular disease.
Chronic Illness Management: Women with chronic conditions such as diabetes, hypertension, or autoimmune disorders may experience periods of vulnerability related to their specific health challenges. Fluctuations in hormone levels, stress, and lifestyle factors can exacerbate these conditions or increase the risk of complications. Healthcare strategies during these vulnerable periods often include personalized treatment plans, regular monitoring, and patient education to optimize disease management and promote overall well-being.
Conclusion: FOGSI’s launch of a women’s immunization schedule underscores their commitment to advancing women’s health through proactive care, addressing vulnerable periods like postpartum and menopause, and promoting disease prevention and management strategies.
Mains PYQ:
Q In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss. (UPSC IAS/2020).
This year’s theme for International Fatty Liver Day, an awareness initiative observed annually in June, is ‘Act Now, Screen Today’. This theme holds more urgency now than ever before.
Liver Diseases in recent times
Liver diseases have long been primarily linked to excessive alcohol consumption, which continues to be a major cause of advanced chronic liver disease.
However, in recent years, a new and quietly escalating threat to liver health has emerged: non-alcoholic fatty liver disease.
India’s Growing Burden of Fatty Liver Disease
Note: MASLD, or Metabolic dysfunction-associated steatotic liver disease, is a reclassification of what was previously known as non-alcoholic fatty liver disease (NAFLD).
High Prevalence Rates: The global prevalence of Metabolic dysfunction-associated steatotic liver disease (MASLD) is estimated at 25-30%. In India, a 2022 meta-analysis revealed that the pooled prevalence of fatty liver among adults was 38.6%. Among obese children in India, the prevalence was around 36%.
Progression of Disease: The continuous damage caused by fatty liver leads to more severe conditions such as steatohepatitis and cirrhosis, often requiring liver transplants.
Causes of Growing Burden of Fatty Liver Disease
Lack of Early Detection: Fatty liver disease often goes undetected in early stages due to lack of symptoms. Diagnosis usually occurs at an advanced stage, when significant liver damage has already taken place.
Diet and Insulin Resistance: Excessive consumption of carbohydrates, especially refined carbs and sugars, leads to metabolic problems. High carbohydrate intake results in persistently high insulin levels and insulin resistance, promoting the conversion of excess glucose into fatty acids, which are then stored in the liver.
Initiatives Taken by the Government
Integration with NPCDCS: The Ministry of Health & Family Welfare launched operational guidelines for integrating NAFLD with the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in February 2021.
Health Promotion and Prevention: The Ayushman Bharat- Health and Wellness Centres (AB-HWCs) are being used to promote healthy living and screen for hypertension, diabetes, and other common NCDs.
Personalization is the Key
Tailored Screening Tests: The selection of screening tests and their frequency should be based on individual risk factors, including family history, lifestyle, and pre-existing health conditions.
Avoiding Generic Assumptions: Clinicians should not rely solely on age or physical markers; instead, they should consider a comprehensive risk profile. Non-communicable diseases are increasingly affecting diverse populations, including children.
Integrated Health Strategies: Combining dietary modifications, regular physical activity, and effective weight management to mitigate liver disease risks.
Frequent Screenings: Regular monitoring of liver health through non-invasive tools like vibration-controlled transient elastography. Continuous assessment of liver stiffness to detect early stages of liver fibrosis and monitor treatment responses.
Active Health Management: Emphasis on the importance of individuals taking control of their health by being aware of their diet and lifestyle choices.Encouragement of frequent health screenings to detect and manage liver disease early.
Way Forward:
Awareness Campaigns: Government initiatives focus on raising awareness about the importance of liver health and the risks associated with MASLD.
Health Screenings: Programs promoting comprehensive health screenings that include physical examinations, blood tests, and abdomen ultrasounds to detect liver diseases early.
Mains PYQ
Q The public health system has limitations in providing universal health coverage. Do you think that the private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)
India’s new cabinet has only 2 women ministers, down from 10 previously. The Global Gender Gap Report 2024 (by the World Economic Forum) ranks India third-lowest in South Asia, highlighting significant gender disparity in leadership and representation.
Comparison of Indian Ranking with Other Countries:
Global Gender Gap Report 2024: India ranked 129th out of 146 economies in the overall gender gap index. Ranked third-lowest among South Asian economies, behind Bangladesh, Nepal, Sri Lanka, and Bhutan.
Key points as Gender Gap Report 2024:
Economic Participation and Opportunity: 142nd, Health and Survival: 142nd, Educational Attainment: 112th, and Political Empowerment: Best rank (65th), but overall political representation remains low.
Political Empowerment: India performs relatively better on the head-of-state indicator (40.7%). However, women’s representation in ministerial positions (6.9%) and parliament (17.2%) is significantly lower. The region of South Asia shows high political disparity, with Nepal leading in ministerial representation (23.5%).
Educational Attainment: Despite high enrollment rates in primary, secondary, and tertiary education for women, the gap in literacy rate between men and women is significant (17.2 percentage points). India ranks 112th globally in this indicator.
Economic Participation: India has seen improvement in economic participation and opportunity, although it still ranks low (142nd). Challenges remain in bridging gender gaps in earned income, leadership roles, labour force participation, and technical professions.
Major observations around the causes of the Gender Gap
Patriarchal Structures: Patriarchy influences decision-making processes and power dynamics, often marginalising women’s voices and restricting their participation in political, economic, and social spheres.
Gender Bias: Gender bias manifests in various forms, affecting women’s access to resources, healthcare, education, and career advancement opportunities compared to men.
Gender Pay Gap: Women in India typically earn less than men for similar work, reflecting systemic inequalities in pay and compensation.
Occupational Segregation: Women are often concentrated in lower-paying sectors and informal employment, facing barriers to accessing high-paying and leadership roles.
Political Underrepresentation: Low representation of women in decision-making bodies such as parliament and state assemblies hinders legislative reforms and policies that could promote gender equity and address systemic barriers.
Way forward:
Gender Quotas: Implement and enforce quotas for women’s representation in parliament, state assemblies, and ministerial positions. This can be modelled after successful practices in other countries where gender quotas have significantly increased women’s political participation.
Equal Pay Initiatives: Enforce equal pay for equal work through rigorous monitoring and enforcement mechanisms. Encourage transparency in salary structures and promote awareness among employers and employees.
Mains PYQ:
Q Can the vicious cycle of gender inequality, poverty and malnutrition be broken through microfinancing of women SHGs? Explain with examples.(UPSC IAS/2021)
Persistent exclusion results in some disciplines becoming a last resort for many students with social sciences increasingly becoming a significant reservoir of the excluded in India.
Causes of Exclusion in Higher Education:
Excessive Competition: Premier institutions have stringent filtering mechanisms due to high demand, which results in significant exclusion of students.
Financial Factors: Private institutions often have high fees not regulated by statutory norms, and public institutions, facing reduced government funding, also increase fees, making education inaccessible for many.
Subject and Course Availability: There is a regional disparity in the availability of courses. Certain regions offer generic courses with outdated syllabi, limiting students’ choices and leading to exclusion.
Surge of Empirical Orientation:
Employability Perception: Courses with empirical and practical applications, like economics, are perceived to offer better employment opportunities compared to more theoretical courses like anthropology or sociology.
Policy Intervention Skills: There is a growing expectation for social science students to develop problem-solving skills similar to those of engineering students, which narrows the focus within social sciences.
Private Universities: The emergence of private universities catering to the affluent has led to a demand for courses that are less popular in public institutions, creating a dichotomy in course preference and quality.
Improving Quality of Higher Education:
Expand Quantity and Improve Quality: Increase the number of seats to accommodate excluded students and ensure concerted efforts towards enhancing the quality of education like entry based on competitive exams.
Enhance Teaching Quality: Prioritize the improvement of teaching methods and the content of courses to make education more relevant and effective for example reviewing and taking feedback on learning experiences from students.
Address Financial Exclusion: Implement measures to reduce financial barriers and prevent the widening of educational inequalities, ensuring that quality education is accessible to a broader demographic. For example, the Government can provide loans or scholarships.
Update Course Content: Regularly revise and update the syllabi to keep pace with societal changes and technological advancements, such as generative artificial intelligence.
Focus on Inclusivity: Ensure that policies and interventions in higher education focus on inclusivity, addressing the needs of diverse student populations and reducing regional disparities in course offerings.
Steps taken by Government
All India Council for Technical Education (AICTE) Initiatives: The AICTE has undertaken various initiatives to enhance the quality of technical education, such as the establishment of Deen Dayal Upadhyay KAUSHAL Kendras and the introduction of B.Voc degree programs.
University Grants Commission (UGC) Regulations: The UGC has notified regulations to improve the quality of higher education, including those related to recognition, accreditation, minimum qualifications for teachers, curbing ragging, and grievance redressal.
Scholarship and Fellowship Schemes: The UGC has launched various scholarship and fellowship schemes, such as the PG Doctoral Fellowship for SC/ST students, to promote inclusion and equity in higher education.
Conclusion: Efforts to enhance higher education, including expanding access, improving quality, and addressing financial barriers, are crucial for fostering inclusivity and equipping students for India’s future.
Mains PYQ:
Q The quality of higher education in India requires major improvement to make it internationally competitive. Do you think that the entry of foreign educational institutions would help improve the quality of technical and higher education in the country Discuss. (UPSC IAS/2015)
The king and queen of the “Onge tribe” welcomed a baby boy in the Andaman Islands, marking a significant moment for the tribe. With the arrival of the newborn, the tribe’s total population now stands at 136, as confirmed by an official source.
About Onge Tribe
The Onge are PVTGs (Particularly Vulnerable Tribal Groups) native to the Andaman Islands.
They have traditionally been hunter-gatherers and fishers, while also practising cultivation.
Their population significantly decreased after colonization, from 672 in 1901 to around 100.
They practice a form of animism, with ancestor worship being significant.
They traditionally make decisions through group consensus.
Today, the surviving members are confined to two reserve camps on Little Andaman: Dugong Creek in the northeast, and South Bay.
Genetically, the Onge are distantly related to East Asian populations and show affinities with Southeast Asian Negrito ethnic groups.
Other Indigenous People of Andaman and Nicobar
1. Great Andamanese Tribe
One of the largest tribes, the Great Andamanese tribe is currently settled on the Strait Island under the Andaman & Nicobar Administration. Despite their historic bravery, diseases and other challenges have reduced their population to 43 individuals as of the 2001 census.
Government initiatives: The administration provides housing, coconut plantations, and rationing to support their livelihoods and well-being.
2. Jarwas Tribe
Jarwas inhabit the Western coast of the Middle and South Andaman Islands. They are known to be hostile but have shown receptivity to friendly contact expeditions since 1974. Their present numbers are estimated at between 250–400 individuals.
Jarwas are nomadic hunters and gatherers, using traditional methods like bows and arrows for hunting and fishing.
3. Sentinelese Tribe
Sentinelese reside on the small North Sentinel Island, maintaining a wary stance towards outsiders.
Despite initial scepticism, contact expeditions have made progress since 1991, albeit with caution.
Who are the Particularly Vulnerable Tribal Groups (PVTGs)?
These groups are among the most vulnerable sections of our society as they are few in number, and have not attained any significant level of social and economic development.
They generally inhabit remote localities having poor infrastructure and administrative support.
75 such groups have been identified and categorized as Particularly Vulnerable Tribal Groups (PVTGs).
Origin of the concept
The Dhebar Commission (1960-1961) stated that within Scheduled Tribes there existed an inequality in the rate of development.
During the fourth Five Year Plan (1969-74) a sub-category was created within Scheduled Tribes to identify groups that were considered to be at a lower level of development.
This sub-category was named “Primitive tribal group”.
In 2006 the government of India proposed to renamePVTGs.
Features of PVTGs
The features of such a group include a:
Pre-agricultural system of existence
The practice of hunting and gathering
Zero or negative population growth
Extremely low level of literacy in comparison with other tribal groups
Groups that satisfied any one of the criteria were considered PTG.
PYQ:
[2019] Consider the following statements about Particularly Vulnerable Tribal Groups (PVTGs) in India:
PVTGs reside in 18 States and one Union Territory.
A stagnant or declining population is one of the criteria for determining PVTG status.
There are 95 PVTGs officially notified in the country so far.
Irular and Konda Reddi tribes are included in the list of PVTGs.
Q The public health system has limitations in providing universal health coverage. Do you think that the private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)
Q In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss. (UPSC IAS/2020)
Mentors comment: In the last week of May, a tragic fire at a private neonatal care nursing home in New Delhi shocked everyone. Political parties started blaming each other, and the media exaggerated by incorrectly claiming that many nursing homes in Delhi operate without a license. Despite the intense media coverage, the incident has been largely forgotten, leaving the grieving parents behind. Instead of focusing on who to blame, it’s important to recognize that such tragedies are usually the result of systemic failures—in this case, the failure of health-care regulations.
Let’s learn–
Why in the news?
Health regulations are crucial, but their implementation in India needs to be thoughtful and carefully balanced.
Regulation and standards in the Indian health care system
Excessive and Complex Regulations: Some states have over 50 approvals required under multiple regulations for each healthcare facility, creating a bureaucratic burden. Despite the complexity, there is a perception among officials that the private health sector is under-regulated.
Unrealistic Standards: Many healthcare quality standards set by the government, such as those in the Clinical Establishments (Registration and Regulation) Act, 2010, and the Indian Public Health Standards (IPHS), are considered unrealistic and difficult to implement. Only a small percentage of government primary healthcare facilities meet these standards despite their aspirational goals.
Mixed health-care system in India
Diverse Healthcare Providers: India’s healthcare system includes both government and private sector providers, ranging from single-doctor clinics and small nursing homes to large corporate hospitals, each serving different population segments.
Dominance of Private Sector: The private sector delivers approximately 70% of outpatient services and 50% of inpatient services, indicating a significant reliance on private facilities for health care by the Indian population.
Regulatory and Quality Challenges: There are disparities in regulation enforcement and quality standards between the private and government sectors, with issues such as approval delays, cost of compliance, and ensuring consistent quality care across diverse facilities.
Challenges related to mixed health-care system
Regulatory Disparities: Uneven enforcement of regulations between private and government health facilities. Overzealous regulation of private facilities while government facilities face fewer consequences for similar infractions.
Approval Delays: Sluggish approval processes for private facilities, causing operational delays and financial strain. Long waiting periods for renewal applications, even when submitted well in advance.
Cost and Accessibility: High cost of services in large corporate hospitals compared to smaller clinics and nursing homes. Limited accessibility of government facilities for certain populations, despite being free or low-cost.
Differential Standards: Impractical to hold small clinics and nursing homes to the same standards as large hospitals. Need for a tiered approach to regulation, with essential and desirable standards based on facility type.
Financial Burden: High cost of compliance with regulations for smaller facilities, potentially making health services unaffordable for patients. The a need for government subsidies or funding to help smaller providers meet regulatory standards without increasing costs for patients.
Stakeholder Involvement: Insufficient involvement of health-care providers, facility owners, and community members in the formulation of regulations. Lack of representation from various types of facilities in regulatory processes.
Public Perception and Trust: Political rhetoric and sensational media coverage undermining trust in health-care providers. Potential for increased violence against health-care providers due to public mistrust.
Infrastructure and Safety: Inconsistent emphasis on essential safety measures like fire safety across facilities. Need for equitable implementation of safety standards in all healthcare buildings.
Affordable care is one need
Role of Small Providers: Single doctor clinics and small nursing homes are crucial for providing initial access and health services, particularly for middle-income and low-income populations. These smaller providers deliver a significant portion of health services at a lower cost compared to large corporate hospitals.
Supportive Regulations: There is a need for regulations that support small providers to keep healthcare costs low and affordable. Guidelines should be practical and implementable, harmonizing multiple regulations and simplifying the application process with timely approval.
Differential Approach: Regulations should recognize the different capabilities of various health facilities. Smaller clinics and nursing homes should not be held to the same standards as large hospitals to avoid escalating costs that could be transferred to patients. Essential and desirable regulatory points should be established, with regular self-assessments and inspections to ensure compliance.
Government subsidies and funding should be considered to help smaller facilities adhere to necessary regulations without increasing costs for patients.
Why do we need to Focus on the primary caregivers?
Accessibility and Affordability: Single-doctor clinics and small nursing homes provide essential health services at a lower cost, making health care more accessible and affordable for middle-income and low-income populations.
Primary Care Foundation: Promoting primary care helps manage health issues early, reducing the burden on secondary and tertiary care facilities and supporting the goals of the National Health Policy, 2017, for people-centric, accessible, and affordable health services.
Sustainable Support: Simplified, fair, and collaborative regulatory processes, along with government subsidies, can help primary-care providers operate effectively, ensuring quality and safety without escalating costs for patients.
Conclusion: Primary health care is crucial for achieving the SDG goal of universal health coverage by providing accessible, affordable, and quality health services, thus reducing the burden on higher-level care facilities and promoting overall health equity.
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