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Subject: Social Justice

  • Section 19 of the POCSO Act, 2012

    Why in the News?

    The Supreme Court has agreed to hear a petition regarding the mandatory reporting of sexual activity under Section 19 of the Protection of Children from Sexual Offences (POCSO) Act, 2012.

    About the POCSO Act, 2012:

    • The POCSO Act came into effect on November 14, 2012 (Children’s Day), following India’s ratification of the UN Convention on the Rights of the Child in 1992.
    • Its primary objective is to address offences related to the sexual exploitation and abuse of children, which were previously either not specifically defined or inadequately penalized.
    • According to the Act, a child is defined as any person below the age of 18 years.
    • In 2019, the Act underwent a review and amendment, introducing more stringent punishments (after Nirbhaya Case), including the death penalty, for those committing sexual crimes against children.

    Key Features of the POCSO Act:

    • Definition of a Child: A child is defined as anyone under 18 years of age.
    • Sexual Offences:
      • Penetrative Sexual Assault (Section 3)
      • Sexual Assault (Section 7)
      • Sexual Harassment (Section 11)
      • Using Children for Pornographic Purposes (Section 13)
      • Abetment and Attempt (Sections 16-18)
    • Special Courts & Procedures: Establishes Special Courts for speedy trials and mandates child-friendly procedures.
    • Protection of Identity: The identity of the child is protected throughout the process.
    • Rehabilitation & Compensation: Provides for the rehabilitation of child victims.
    • No Delay in Trials: Trials must be completed within one year of the offence.

    Recent Supreme Court Hearing:

    • Litigants have raised concerns that mandatory reporting under Section 19 might criminalize consensual sexual activity between juveniles, especially affecting adolescent girls’ right to health.
    • They emphasized counseling over criminalization, arguing that the law might discourage adolescents from seeking medical care.
    • The Supreme Court acknowledged these concerns and scheduled a detailed hearing on May 8 to address them.
    [UPSC 2017] Which of the following are envisaged by the Right against Exploitation in the Constitution of India?

    1. Prohibition of traffic in human beings and forced labour

    2. Abolition of untouchability

    3. Protection of the interests of minorities

    4. Prohibition of employment of children in factories and mines.

    Select the correct answer using the code given below:

    Options: (a) 1, 2 and 4 only (b) 2, 3 and 4 only (c) 1 and 4 only* (d) 1, 2, 3 and 4

     

  • Making primary health visible, offering accessible and affordable health care

    Why in the News?

    Public health has evolved with the growing economy and modern lifestyles. Key challenges include antimicrobial resistance, chronic diseases, zoonotic diseases, and mental health, with NCDs making up 60% of global deaths.

    What are the key modern public health challenges faced globally, and how do they impact India?

    • Rise of Non-Communicable Diseases (NCDs): NCDs like heart disease, diabetes, and cancer account for over 60% of global deaths and are projected to rise by 17% in the next decade. India faces a dual burden of NCDs and infectious diseases. Eg: As per National Family Health Survey (NFHS-5), over 20% of Indian adults suffer from high blood pressure.
    • Antimicrobial Resistance (AMR): Misuse of antibiotics in humans and livestock has led to drug-resistant infections, making common illnesses harder to treat. India is one of the largest consumers of antibiotics, and AMR increases mortality rates and healthcare costs. Eg: A 2019 ICMR report showed a rise in resistance to last-resort antibiotics like colistin in Indian hospitals.
    • Mental Health Crisis: Stress, urbanization, and socio-economic pressures are driving a rise in mental health illnesses, yet policymakers and health systems continue to under-address them. India has a high treatment gap — about 80% of people with mental illness do not receive treatment due to stigma and lack of resources. Eg: WHO estimates that India loses nearly $1 trillion in productivity annually due to mental health issues.

    How does the ‘Ayushman Bharat’ scheme aim to strengthen India’s public health system?

    • Financial Protection through PM-JAY: The Pradhan Mantri Jan Arogya Yojana (PM-JAY) offers ₹5 lakh health insurance coverage per family per year to poor and vulnerable populations. It reduces the financial burden of hospitalization and protects against catastrophic health expenditure. Eg: A BPL family needing heart surgery under PM-JAY can avail treatment in empanelled hospitals without paying out-of-pocket.
    • Strengthening Primary Healthcare via Ayushman Arogya Mandirs (AAMs): These upgraded Health and Wellness Centres (HWCs) provide comprehensive care, including preventive, promotive, curative, rehabilitative, and palliative services, close to communities. Eg: A rural health centre now screens for diabetes, mental health, and cancers under the AAM model, increasing early detection and timely treatment.
    • Infrastructure Development through PM-ABHIM: The Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) improves health system preparedness by investing in labs, critical care units, and public health surveillance systems. Eg: District hospitals are being upgraded with ICU beds and disease monitoring labs under PM-ABHIM, boosting emergency response and pandemic readiness.

    What are the reasons behind the lack of trust in India’s public health system?

    • Poor User Experience and Service Quality: Long wait times, overcrowding, and inadequate attention from healthcare staff often lead to patient dissatisfaction and erode trust in public facilities. Eg: Patients at many government hospitals report delays in receiving treatment due to staff shortages and administrative inefficiencies.
    • Inconsistent Infrastructure and Cleanliness: Lack of clean facilities, essential medicines, and functional equipment in some centers diminishes public confidence in receiving quality care. Eg: A 2022 Health Ministry survey found that several PHCs in remote areas lacked basic amenities like running water and power backup.
    • Stigma and Miscommunication in Care Delivery: Lack of sensitivity among staff, especially in mental health and maternal care, coupled with poor communication, creates a sense of neglect or discrimination. Eg: Many rural women avoid public health centers for childbirth due to past experiences of rude treatment or neglect by staff.

    How does the quality and accessibility of private healthcare in India compare to the public sector?

    • Better Infrastructure and Perceived Quality in Private Sector: Private hospitals often offer cleaner facilities, modern equipment, and shorter wait times, making them the preferred choice for many. Eg: Urban patients may choose a private multispecialty hospital over a government facility due to advanced diagnostic tools and faster service.
    • Higher Costs and Risk of Catastrophic Expenditure: While private healthcare ensures timely treatment, it comes at a high cost, which can push middle- and low-income families into debt. Eg: A cancer patient undergoing chemotherapy in a private hospital may face bills in lakhs, unlike subsidized or free treatment in public hospitals under schemes like PM-JAY.
    • Limited Accessibility for Rural and Poor Populations: Private hospitals are concentrated in urban areas and are often unaffordable for rural or economically weaker sections, widening the healthcare gap. Eg: A villager may have to travel over 50 km to access private healthcare, while a nearby government PHC is under-equipped or understaffed.

    What is the role of National Quality Assurance Standards (NQAS) in enhancing public health services in India?

    • Improves Service Delivery and Patient Care: NQAS ensures that healthcare facilities follow standardized procedures, improving the quality, safety, and effectiveness of care provided. Eg: A district hospital certified under NQAS follows set protocols for infection control and patient safety, reducing the chances of hospital-acquired infections.
    • Builds Accountability and Performance Monitoring: Facilities are regularly assessed on key quality indicators, encouraging a culture of accountability and continuous improvement. Eg: A Primary Health Centre (PHC) striving for NQAS certification upgrades its infrastructure and staff training to meet quality benchmarks.
    • Enhances Public Trust in Government Facilities: By aligning public health facilities with global standards like ISQua, NQAS boosts confidence among patients to seek care from government institutions. Eg: An NQAS-certified Community Health Centre (CHC) attracts more patients due to its improved cleanliness, better staff behaviour, and reliable service delivery.

    Way forward: 

    • Invest in Quality and Infrastructure: Strengthen public health facilities with adequate staff, modern equipment, and essential supplies to ensure reliable, high-quality care across rural and urban areas.
    • Promote Awareness and Trust: Launch community-based health education campaigns and feedback mechanisms to reduce stigma, improve service perception, and increase public trust in government healthcare systems.

    Mains PYQ:

    [UPSC 2021] “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse.

    Linkage: The importance of a strong primary health structure, which is fundamental to making healthcare accessible and achieving broader development goals.

  • Beware of child traffickers, Supreme Court cautions parents

    Why in the News?

    Recently, the Supreme Court said that hospitals will lose their licences if newborn babies go missing. It also directed High Courts to make sure all pending child trafficking case trials are finished within six months.

    What did the Supreme Court warn parents about regarding child trafficking?

    • Vigilance Against Child Trafficking: The Supreme Court warned parents to be “extremely vigilant” to protect their children from trafficking for purposes such as sexual exploitation, forced labour, and begging. A slight negligence or carelessness could lead to severe consequences.
    • Consequences of Negligence: The court highlighted that the pain parents experience when losing a child to trafficking is different and more agonising than the loss of a child due to death. The court emphasised that negligence could lead to the lifetime agony of not knowing the whereabouts or fate of the child.
    • Exploitation of Poor and Vulnerable Families: The court pointed out that traffickers often prey on families from poor sections of society, exploiting their helplessness. This issue is compounded by well-organized trafficking networks that use technology to track victims.

    Why does the court believe child trafficking for forced crime is on the rise?

    • Exploitation of Juvenile Justice Laws: Criminal gangs exploit the legal protection offered to minors under the Juvenile Justice (JJ) Act, using trafficked children for illegal activities like theft, drug peddling, and begging, knowing the penalties are lenient. Eg: According to NCRB 2022, over 5,000 children were apprehended for petty crimes, many suspected to be victims of trafficking and coercion by organized gangs who remain untouched by law.
    • Demand-Supply Gap in Adoption System: Long waiting periods and a complex legal framework for adoption in India create a black market for child adoption, encouraging trafficking. Eg: As per Central Adoption Resource Authority (CARA), while more than 29,000 parents were registered for adoption in 2023, only 3,596 adoptions took place—leading to illegal demand and fueling child trafficking networks.
    • Weak State Response and Enforcement: The court criticized state governments like Uttar Pradesh for lack of seriousness in tracking trafficking cases and failing to appeal against bail orders granted to traffickers. Eg: In the case heard, 13 accused granted bail by the Allahabad High Court absconded, and their whereabouts remained unknown for months, showing systemic gaps in enforcement.

    How did the Supreme Court respond to the bail granted by the Allahabad High Court in the child trafficking case?

    • Criticized the High Court’s Decision as Callous: The Supreme Court strongly condemned the Allahabad High Court’s decision to grant bail, calling it “very callous” and insensitive given the gravity of the crime. Eg: The bail allowed 13 accused in an inter-State child trafficking racket to go free, most of whom later absconded, frustrating the investigation.
    • Cancelled the Bail of the Accused: The apex court revoked the bail orders and directed that the accused be taken into custody without delay. Eg: The accused included a nurse at a primary health centre in Chhattisgarh who played a key role in illegal infant sales under the guise of adoption.
    • Ordered Speedy Trial: The court directed that the trial be completed within six months to ensure justice is not delayed. Eg: This was aimed at avoiding procedural delays and ensuring accountability in crimes involving vulnerable children.

    What actions did the Supreme Court direct hospitals to take in cases of missing newborns?

    • Ensure Complete Protection of Newborns: Hospitals must take full responsibility to safeguard infants immediately after birth, ensuring no unauthorized person can access them. Eg: If a newborn goes missing from a maternity ward, the hospital administration will be held accountable for negligence.
    • Strict Monitoring and Accountability Measures: Hospitals were warned that if newborns are found trafficked, they could face suspension of license and legal action. Eg: A nurse involved in an infant trafficking racket from a Primary Health Centre in Chhattisgarh was among the accused in the case.
    • Implement Protocols for Birth and Discharge: The court emphasized the need for strict procedures during childbirth and discharge, including documentation and identity verification. Eg: Hospitals must verify the identity of guardians or parents before handing over the baby, to prevent impersonation or baby-swapping.

    Way forward: 

    • Strengthen Surveillance and Inter-agency Coordination: Establish a centralized digital monitoring system linking hospitals, child welfare committees, and law enforcement to track births, adoptions, and missing children in real time.
    • Community Awareness and Legal Safeguards: Launch nationwide awareness campaigns on child trafficking risks and ensure strict enforcement of child protection laws with fast-track courts for trafficking cases.

    Mains PYQ:

    [UPSC 2023] Development and welfare schemes for the vulnerable, by its nature, are discriminatory in approach.” Do you agree? Give reasons for your answer.

    Linkage: Child victims of trafficking are undoubtedly among the most vulnerable. This PYQ examines the nature of welfare schemes for vulnerable populations, which is relevant to the effectiveness of state interventions aimed at preventing child trafficking and rescuing victims.

  • Trends in Maternal Mortality (2000-2023), Report

    Why in the News?

    In 2023, India had the second-highest maternal deaths globally, with 19,000 deaths, tied with the Democratic Republic of Congo, and second only to Nigeria. This equated to 52 fatalities daily according to the UN Report.

    Trends in Maternal Mortality (2000-2023), Report

    About the UN Report

    • The report, titled ‘Trends in Maternal Mortality 2000-2023’, was prepared by the World Health Organisation (WHO), UNICEF, UN Population Fund, World Bank, and the UN Department of Economic and Social Affairs (population division).
    • It provides global data on maternal mortality and highlights the countries with the highest rates of maternal deaths.

    Note:

    • Maternal Mortality refers to the death of a woman during pregnancy, childbirth, or within 42 days after delivery, due to complications related to pregnancy or childbirth, as per WHO.
    • Maternal Mortality Ratio (MMR) refers to the number of maternal deaths per 100,000 live births in a given time period, usually over a year.

    Key Highlights of the Report:

    • Nigeria had the highest number of maternal deaths with 75,000 deaths, accounting for 28.7% of global deaths in 2023.
    • The top four countries (India, Nigeria, DRC, Pakistan) accounted for 47% of global maternal deaths.
    • Despite a population similar to India, China had only 1,400 maternal deaths in 2023.
    • Maternal mortality globally declined by 40% between 2000 and 2023, due to improved healthcare access.
    • COVID-19 caused an additional 40,000 maternal deaths in 2021 due to service disruptions.
    • The global MMR remained high, with 260,000 maternal deaths in 2023, one death every two minutes.

    India’s Progress in Reducing Maternal Mortality:

    • India’s MMR declined by 78% from 362 in 2000 to 80 in 2023 (NFHS 2019-21).
    • Institutional deliveries increased from 79% in 2015-16 to 89% in 2019-21, with Kerala achieving 100%.
    • Eight states (including Kerala, Maharashtra, Telangana, Tamil Nadu) reduced MMR to below the SDG target of 70 per 100,000 live births.

    Various Schemes for Maternal Health in India:

    Scheme  Launched Objective Notable Features Target Beneficiaries
    Janani Suraksha Yojana (JSY) 2005 To reduce maternal and neonatal mortality by promoting institutional deliveries. Cash incentives, Focus on rural areas, Increased access to institutional deliveries. Pregnant women from poor socio-economic backgrounds.
    Pradhan Mantri Matru Vandana Yojana (PMMVY) 2017 To provide maternity benefits and promote institutional deliveries. Cash benefit of ₹5,000 for the first child, Additional incentives for girl child under PMMVY 2.0. Women pregnant with their first child after 01.01.2017.
    Janani Shishu Suraksha Karyakaram (JSSK) 2011 To eliminate out-of-pocket expenses for pregnant women and sick infants. Free delivery services, Free transport, Free post-delivery services. Pregnant women and sick infants in public health institutions.
    Surakshit Matritva Aashwasan (SUMAN) 2019 To provide assured, dignified, and quality healthcare at no cost. Zero denial policy, Quality of care, Focus on respectful care. All pregnant women and newborns visiting public health institutions.
    LaQshya 2017 To improve the quality of care in labor rooms and maternity operation theatres. Focus on improving infrastructure, Monitoring and evaluation, Quality assurance. Pregnant women receiving care in labor rooms and maternity OT.

     

    [UPSC 2023] Consider the following statements in relation to Janani Suraksha Yojna:

    1. It is safe motherhood intervention of the State Health Departments.

    2. Its objective is to reduce maternal and neonatal mortality among poor pregnant women.

    3. It aims to promote institutional delivery among poor pregnant women.

    Select the correct answer using the code given below:

    (a) 1 and 2 only (b) 2, 3 and 4 only (c) 1, 3 and 4 only (d) 1, 2, 3 and 4

     

  • Central Sector Scheme for Promotion of International Cooperation for AYUSH 

    Why in the News?

    The Ministry of Ayush is implementing the Central Sector Scheme for Promotion of International Cooperation for AYUSH to enhance global recognition and development of AYUSH systems, including Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy.

    About the Scheme

    • The scheme focuses on promoting AYUSH systems internationally, contributing to their global growth.
    • The scheme is announced on the AYUSH website, and applications are invited through open advertisements.
    • Proposals are screened by a committee and approved for financial assistance based on needs and activity limits.
    • Key Components of the Scheme:
      1. International Exchange of Experts & Officers: Facilitates deputation of AYUSH experts for international conferences and training.
      2. Incentives for Drug Manufacturers: Provides financial support for international propagation and product registration.
      3. Market Development Support: Supports exhibitions, conferences, and market surveys for international market development.
      4. Promotion through Young Postgraduates: Deploys young postgraduates to promote AYUSH abroad through NGOs.
      5. Translation and Publication: Funds the translation and publication of AYUSH literature in foreign languages.
      6. AYUSH Information Cells/Health Centres: Establishes AYUSH cells and health centers in foreign countries through Indian missions.
      7. International Fellowship Programme: Offers fellowships to foreign nationals to study AYUSH courses in India.

    Significance of Yoga and AYUSH in India’s International Outreach

    • The International Day of Yoga (IDY) was declared by the United Nations in 2014, with ₹161 crore spent on its promotion. IDY celebrations spread Yoga’s global message.
    • Yoga is now part of the National Curriculum Framework (NCF), making it compulsory for students from Class I to Class X.
    • The Yoga Certification Board (YCB) under the Ministry of Ayush certifies yoga professionals and accredits institutions, ensuring quality and standards in Yoga practice.
    • The Ministry of Ayush has signed 24 Country-to-Country MoUs and 51 Institute-to-Institute MoUs to promote Indian traditional medicine systems globally.

  • Health Expenditure at 1.84% of GDP

    Why in the News?

    The Union government has steadily increased its spending on healthcare, with the expenditure rising to 1.84% of GDP in 2021-22, up from 1.15% in 2013-14.

    Overview of India’s Health Expenditure

    • India has shown a consistent increase in government spending on healthcare, reflecting a growing commitment to improving the public healthcare system.
    • As of 2021-22, government health expenditure (GHE) rose to 1.84% of GDP, up from 1.15% in 2013-14, and is on track to meet the National Health Policy 2017 target of 2.5% of GDP by 2025.
    • The rise in health expenditure has been particularly significant post–COVID-19, with a 37% increase in government spending from 2020-21 to 2021-22.
    • This has led to better healthcare accessibility, reduced financial burden on individuals, and greater focus on strengthening healthcare infrastructure.

    What is Total Health Expenditure?

    • Total Health Expenditure (THE) refers to the sum of all current and capital expenditures incurred by the government, private sector, and external sources for healthcare purposes in a given period.
    • This includes:
      • Current Health Expenditure (CHE): Ongoing spending on healthcare services, such as hospitals, doctor visits, and medical supplies.
      • Capital Expenditure: Investments in healthcare infrastructure, such as building hospitals or purchasing medical equipment.
    • In 2020-21, India’s THE was estimated at ₹7,39,327 crores, constituting 3.73% of GDP, with a per capita expenditure of ₹5,436.
    • In 2021-22, this figure increased to ₹9,04,461 crores, representing 3.83% of GDP, reflecting a proactive government response to healthcare challenges and pandemic management.

    Reasons for Reduced Out-of-Pocket Expenditure (OOPE)

    The reduction in OOPE can be attributed to:

    • Increased government health spending, making healthcare more affordable.
    • Expansion of public health services, including vaccination and preventive care.
    • Growth in government-funded health insurance and social security programs, reducing reliance on personal funds.
    • Health initiatives like Ayushman Bharat have eased the financial burden.
    • Improved public healthcare access and financial protection have reduced hardship for low- and middle-income families.

    PYQ:

    [2021] “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse.

     

  • [12th March 2025] The Hindu Op-ed: Building compassion into the health-care structure 

    PYQ Relevance:

    Q)  Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. (UPSC CSE 2021)

     

    Mentor’s Comment: UPSC mains have always focused on the moral imperative of a Welfare State, primary health structure (2021) and Appropriate local community-level healthcare intervention (2018).

    On February 7, 2025, the WHO released the “Compassion and Primary Health Care” report, emphasizing compassion as a transformative force in health care. Based on my interactions with medical pioneers and global advocacy efforts, including the 74th World Health Assembly, I am encouraged to see growing recognition of compassion’s vital role in improving health care worldwide.

    Today’s editorial highlights the importance of compassionate health care, offering valuable insights for GS Papers, particularly in policy-making and ethics discussions.

    _

    Let’s learn!

    Why in the News?

    Compassionate health care should guide the actions of industry leaders, hospitals, and health-care organizations.

    What is the key message of the WHO report “Compassion and Primary Health Care”?

    • Compassion as a Transformative Force: The report highlights compassion as a core value in improving primary health care outcomes. Example: A cancer patient’s recovery improves significantly when doctors spend an extra 40 seconds expressing support, as found in a Johns Hopkins study.
    • Improved Patient Outcomes through Compassion: Compassionate care leads to faster recovery, shorter hospital stays, and reduced patient anxiety.Example: Stanford University’s CCARE research found that patients treated with compassion experience quicker healing and fewer complications.
    • Benefits for Health-Care Providers: Compassion reduces stress, prevents burnout, and increases job satisfaction for medical professionals. Example: Nurses who engage in compassionate care report stronger patient relationships and improved emotional well-being.
    • Distinguishing Compassion from Empathy and Sympathy: Compassion involves mindful problem-solving while maintaining emotional stability, unlike empathy, which may cause emotional fatigue. Example: A compassionate doctor can acknowledge a patient’s suffering while staying emotionally balanced to provide sustained care.
    • Global Call for Compassionate Health Systems: The report urges policymakers to integrate compassion into health systems and decision-making processes. Example: The WHO calls for training programs to equip health workers with compassionate communication skills across nations.

    Why is compassion considered beneficial for both patients and health-care providers?

    • Faster Recovery and Better Patient Outcomes: Compassionate care leads to quicker recovery, reduced pain, and shorter hospital stays for patients. Example: A Johns Hopkins study found that when doctors express solidarity (e.g., saying, “We are in this together”), patient anxiety decreases, improving their healing process.
    • Enhanced Patient Trust and Satisfaction: Patients feel heard, valued, and safe when treated with compassion, which strengthens their trust in the healthcare system. Example: Cancer patients who receive compassionate communication are more compliant with treatment and express higher satisfaction with care.
    • Reduced Stress and Burnout for Health-Care Providers: Compassion reduces emotional exhaustion and prevents burnout by fostering emotional resilience. Example: Nurses trained in compassionate care report lower stress levels and improved emotional well-being.
    • Stronger Patient-Provider Relationships: Compassion fosters deeper connections, improving communication and shared decision-making between patients and healthcare providers. Example: Physicians who practice compassionate care build long-term patient trust, leading to better health outcomes and loyalty.
    • Increased Job Satisfaction and Professional Fulfillment: Compassion enhances job satisfaction by giving healthcare providers a sense of purpose and fulfillment. Example: Doctors who engage in compassionate interactions report feeling more connected to their profession and experience greater personal reward.

    How does compassion differ from sympathy, empathy, and kindness in the context of health care?

    • Compassion: Compassion is the ability to recognize a patient’s suffering and actively take steps to alleviate it. It involves an emotional connection combined with a willingness to help. Example: A nurse notices that a terminally ill patient is in pain despite receiving standard treatment. She advocates for a change in medication to improve the patient’s comfort while offering emotional support to the family.
    • Sympathy: Sympathy is feeling sorrow or concern for someone’s suffering but without deeply sharing their emotional experience. Example: A doctor expresses condolences to a patient’s family after delivering bad news but does not necessarily feel the pain personally.
    • Empathy: Empathy is the ability to understand and share the feelings of another person by mentally putting oneself in their position. Example: A physician listens to a patient with chronic pain, acknowledges the emotional toll, and adjusts treatment plans accordingly while providing reassurance.

    What are the steps taken by the government? 

    • Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY): Provides free health coverage to economically vulnerable families. Example: Over 50 crore beneficiaries are eligible for ₹5 lakh annual health coverage per family for secondary and tertiary care, reducing financial burdens and ensuring accessible healthcare.
    • National Health Mission (NHM): Strengthens rural and urban healthcare infrastructure and ensures equitable healthcare access. Example: Under NHM, initiatives like Janani Shishu Suraksha Karyakram (JSSK) provide free maternal care during pregnancy, delivery, and postnatal services, ensuring compassionate care for mothers and newborns.
    • Tele-MANAS (Tele Mental Health Assistance and Networking Across States): Provides free tele-mental health services to address rising mental health concerns. Example: Launched in 2022, this initiative provides 24/7 mental health support, helping patients access timely counseling and care, especially in rural areas.
    • Pradhan Mantri National Dialysis Program (PMNDP): Provides free dialysis services to patients with chronic kidney disease. Example: More than 12 lakh dialysis sessions are provided annually across 800+ districts, reducing the financial and emotional stress on patients and their families.
    • Health and Wellness Centers (HWCs): Deliver comprehensive primary healthcare closer to communities. Example: Over 1.6 lakh HWCs have been established nationwide, offering preventive care, maternal health services, and non-communicable disease screenings, fostering compassionate and inclusive healthcare.

    Way forward: 

    • Integrate Compassion Training in Medical Education: Include structured programs to develop compassionate communication and patient-centered care skills for all healthcare professionals, ensuring empathy and emotional resilience.
    • Strengthen Policy Frameworks for Compassionate Care: Implement guidelines that prioritize compassion in healthcare delivery, with regular assessments and incentives to encourage patient-centered, humane practices across public health systems.

  • [8th March 2025] The Hindu Op-ed: What ails Pre-Clinical PG Courses?

    PYQ Relevance:

    Q) Appropriate local community level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain. (UPSC CSE 2018)

     

    Mentor’s Comment: UPSC mains have always focused on the ‘Health for All’ (2018) and primary health structure is a necessary precondition (2021).

    No students enrolled in postgraduate (PG) medical pre-clinical courses like anatomy, biochemistry, physiology, forensic medicine, microbiology, and pharmacology at Vydehi Institute of Medical Sciences and Research Centre (VIMS), Bengaluru, until the second round of PG-NEET counselling.

    Today’s editorial discusses the issues related to postgraduate medical seats. This content would help in GS Paper 2 and 3 in the mains paper.

    _

    Let’s learn!

    Why in the News?

    Many postgraduate medical seats are vacant this year because students are choosing pre-clinical courses.

    Why are postgraduate medical students reluctant to choose pre-clinical courses in Karnataka?

    • Lack of Job Opportunities: Pre-clinical graduates cannot practice as doctors and are limited to working in laboratories, diagnostic centers, or as faculty. Example: Despite reducing tuition fees and offering job guarantees, private institutions like the Vydehi Institute of Medical Sciences struggle to fill pre-clinical seats due to limited employment avenues.
    • Lower Salary Compared to Clinical Courses: Pre-clinical roles offer significantly lower remuneration than clinical practice, making them financially unattractive. Example: A clinical doctor can earn a higher salary working in hospitals or private practice, while pre-clinical graduates face salary stagnation in academic or lab-based roles.
    • Limited Career Progression and Mobility: Clinical course graduates have the flexibility to work globally and in various healthcare sectors, while pre-clinical graduates are restricted to teaching or research roles. Example: An MD in General Medicine can practice as a physician anywhere, whereas an MD in Anatomy primarily qualifies for academic positions.
    • High Capital Requirement for Self-Employment: Establishing independent diagnostic centers requires significant investment, which deters pre-clinical graduates from entrepreneurial ventures. Example: Diagnostic centers with advanced technology demand substantial startup costs, making it challenging for pre-clinical graduates to become self-employed.
    • Persistent Seat Vacancies Reflect Low Demand: Consistent under-enrollment over the years signals a long-term disinterest in these courses. Example: In 2024-25, only 6 out of 104 MD Anatomy seats were filled in Karnataka, despite five rounds of counselling and reduced cut-off percentages.

    What is the trend of student enrollment in PG medical courses at the all-India level?

    • Substantial Increase in PG Medical Seats: The number of PG medical seats has risen from 31,185 before 2014 to 70,645 by the 2023-24 academic year, marking a 127% increase.
    • Growth in Medical Colleges: The total number of medical colleges has expanded by 82%, from 387 before 2014 to 704 in 2023. This expansion has contributed to the increased availability of both undergraduate (UG) and PG medical seats.
    • Rising Demand for Medical Education: The number of candidates aspiring to study MBBS grew from 16 lakh in 2019 to 24 lakh in 2024, reflecting a heightened interest in medical education.
    • Improved UG to PG Seat Ratio: The ratio of UG to PG medical seats improved from 2.1:1 in 2018-19 to 1.9:1 in 2022-23, indicating better alignment between the number of medical graduates and available PG training opportunities.
    • Emerging Challenges: Despite the increase in seats, challenges such as geographic disparities in seat distribution and concerns about the quality of education persist.
      • For example,  Karnataka has the highest number of PG medical seats, totaling 5,984, with a significant contribution from private institutions, but States like Arunachal Pradesh, Dadra and Nagar Haveli, Mizoram, and Nagaland currently do not offer PG medical seats.

    What is the significance of pre-clinical courses? 

    • Foundation for Advanced Medical Practice: Pre-clinical courses (Anatomy, Physiology, Biochemistry) provide the scientific basis for understanding human biology and disease mechanisms. Example: The COVID-19 pandemic highlighted the importance of biochemistry in vaccine development and understanding viral behavior.
    • Essential for Medical Education and Training: These courses are crucial for training future doctors, ensuring they understand the human body before clinical practice. Example: Medical schools worldwide adopted virtual anatomy labs during the pandemic, enhancing remote learning and maintaining education continuity.
    • Innovation in Diagnostic and Therapeutic Techniques: Pre-clinical research drives advancements in diagnostic tools and medical treatments. Example: Advances in physiology have contributed to wearable health devices like continuous glucose monitors for diabetic patients.

    How has the National Medical Commission (NMC) addressed the issue of unfilled PG medical seats in Karnataka?

    • Reduction of NEET-PG Cut-off Scores: In an unprecedented move, the NEET-PG 2023 cut-off was reduced to zero, making all candidates who appeared for the exam eligible for PG medical programs. This decision aimed to expand the pool of eligible candidates and fill vacant seats across various specialties.
    • Guidelines for Interstate Posting Under District Residency Programme: The NMC issued directives emphasizing strict adherence to the Post-Graduate Medical Education Regulations, 2023.
      • These guidelines facilitate the interstate posting of PG medical students under the District Residency Programme, ensuring a more even distribution of medical professionals and addressing regional disparities in seat occupancy.
    • Monitoring and Rectifying Seat Allocation Discrepancies: The NMC has been proactive in addressing discrepancies between its records and those of state authorities. For instance, admissions to 23 PG medical seats in Bengaluru were put on hold due to mismatches between NMC and Directorate of Medical Education (DME) lists. Such actions ensure that seat allocations are transparent and accurate.
    • Annual Increase of PG Seats: The NMC has facilitated the process for medical institutions to apply for an increase in PG seats for the academic year 2025-26. By inviting applications and setting clear guidelines, the commission aims to enhance the availability of PG medical seats, thereby reducing the likelihood of vacancies.

    Way forward: 

    • Enhance Pre-Clinical Career Prospects: Introduce incentives like research grants, industry collaborations, and fellowship programs to improve career progression and salary prospects for pre-clinical graduates.
    • Targeted Seat Distribution and Quality Monitoring: Implement region-specific seat allocation policies and strengthen regulatory oversight to ensure quality education and equitable access across underserved states.

  • Women in South India, Delhi, Punjab have higher levels of obesity 

    Why in the News?

    About 25% of men and women in India were overweight or obese in 2019-21, a 4% increase from 2015-16. Obesity is more common among women in South Indian states, Delhi, and Punjab, but it is rising faster among men.

    What is the definition of “overweight” and “obese” based on BMI measurements in the National Family Health Survey?

    • Overweight: BMI between 25.0 and 29.9. Example: A person who is 1.65 m (5’5″) tall and weighs 70 kg would have a BMI of 25.7, categorizing them as overweight.
    • Obese: BMI of 30.0 or above. Example: A person who is 1.70 m (5’7″) tall and weighs 90 kg would have a BMI of 31.1, classifying them as obese.
    • Calculation Formula: BMI = Weight (kg) ÷ (Height in meters)². Example: If a person is 1.60 m tall and weighs 60 kg, their BMI would be: BMI=601.6×1.6=23.4\text{BMI} = \frac{60}{1.6 \times 1.6} = 23.4BMI=1.6×1.660​=23.4 (Healthy range).

    When did the share of overweight and obese individuals in India significantly increase? 

    • Period of Increase (2015-16 to 2019-21): The National Family Health Survey (NFHS-5) recorded a significant rise in the share of overweight and obese individuals between 2015-16 (NFHS-4) and 2019-21 (NFHS-5).
    • Increase in Overweight Individuals: Women: Increased from 15.5% in 2015-16 to 17.6% in 2019-21 (a rise of 2.1 percentage points). Men: Increased from 15.9% in 2015-16 to 18.9% in 2019-21 (a rise of 3 percentage points).
      • Example: In Delhi, the proportion of overweight men and women was among the highest in the country during 2019-21.
    • Increase in Obese Individuals: Women: Increased from 5.1% in 2015-16 to 6.4% in 2019-21. Men: Increased from 3% in 2015-16 to 4% in 2019-21. Example: Punjab recorded one of the sharpest increases in obesity among women during this period.

    Which Indian states reported the highest increase in obesity levels?

    • Northern States with Sharp Increases: Delhi and Punjab recorded the highest increase in obesity levels for both men and women between 2015-16 and 2019-21. Example: Delhi had the largest proportion of obese and overweight men in the country by 2019-21.
    • Southern States with Persistent High Obesity Rates: Tamil Nadu, Kerala, Andhra Pradesh, Telangana, and Karnataka consistently reported high obesity levels, with a notable rise over the survey period. Example: In Kerala, a significant portion of the population—both men and women—crossed the obesity threshold by 2019-21.
    • States with Accelerated Growth in Obesity: States in the South and North-West witnessed faster increases in obesity, reflecting a shift toward unhealthy dietary habits like increased consumption of fried foods and aerated drinks. Example: Punjab experienced a sharp increase in the share of obese women, making it one of the top states for rising obesity.

    What are the steps taken by the Indian government? 

    • Public Awareness Campaigns: The government promotes healthy lifestyle choices through initiatives like “Eat Right India” and “Fit India Movement” to encourage balanced diets and physical activity. Example: In Mann Ki Baat, Prime Minister advised reducing oil consumption by 10% monthly to combat obesity.
    • School-Based Interventions: Implement nutrition guidelines in midday meal programs and ban junk food in and around school premises to promote healthy eating habits among children. Example: The Food Safety and Standards Authority of India (FSSAI) issued regulations to restrict high-fat, salt, and sugar (HFSS) food sales in schools.
    • Policy and Regulation of Processed Foods: Introducing front-of-pack labeling for processed and packaged foods to inform consumers about high sugar, salt, and fat content. Example: FSSAI’s Eat Right Logo helps consumers identify healthier food options.
    • Lifestyle Disease Control Programs: The National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) targets obesity, diabetes, and hypertension through screening and lifestyle modification programs. Example: Community health workers under Ayushman Bharat conduct health screenings for BMI and other risk factors.
    • Promotion of Traditional Wellness Practices: Encouraging the adoption of Yoga and Ayurveda through programs like International Yoga Day to promote holistic health and weight management. Example: The AYUSH Ministry organizes free Yoga sessions to spread awareness about natural ways to maintain healthy BMI levels.

    Way forward: 

    • Strengthen Multi-Sectoral Collaboration: Enhance coordination between health, education, and food regulatory bodies to implement comprehensive obesity prevention programs. Example: Integrate nutrition education in school curricula and expand community-based health screenings.
    • Promote Sustainable Food Systems: Encourage the availability of affordable, nutritious foods and regulate ultra-processed foods through taxation and clear labeling. Example: Introduce subsidies for healthy food options and enforce strict advertising regulations for unhealthy products.

    Mains PYQ:

    Q The increase in life expectancy in the country has led to newer health challenges in the community. What are those challenges and what steps need to be taken to meet them? (UPSC IAS/2022)

  • A green signal for India to assert its health leadership

    Why in the News?

    Recently, the Budget has acknowledged health care as a cornerstone of national growth and development.

    What are India’s steps towards healthcare transformation in Budget 2025-26?

    • Increased Healthcare Spending: The budget includes a substantial allocation of ₹99,859 crore to the healthcare sector, marking a 9.8% increase from the previous fiscal year.
    • Expansion of Medical Education: The budget allocates resources to add 10,000 new seats in medical colleges across India in FY26, with plans to add 75,000 seats over the next five years. This expansion aims to address the rising demand for skilled healthcare professionals.
    • Strengthening Healthcare Infrastructure: There is an increase of ₹1,000 crore allocation under the PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), which aims to strengthen health infrastructure at all levels.
    • Digital Health Focus: The budget emphasizes the expansion of digital health portfolios, including telemedicine and AI-driven diagnostic solutions, to bridge care gaps and offer efficient healthcare solutions to underserved regions.
    • Promoting Medical Tourism: With the launch of the ‘Heal in India’ initiative, the budget aims to position India as a top medical tourism destination by introducing on-arrival visas for international patients and streamlining visa norms.
    • Healthcare Coverage for Gig Workers: The budget extends Ayushman Bharat coverage to one crore gig workers, recognizing their contribution to the new-age services economy.
    • Support for AI in Healthcare: The budget announces the establishment of India’s Centre of Excellence for AI, and the expansion of the Atal Tinkering Labs (ATL) initiative, will further propel research within the Indian healthcare sector.

    What would be the implications of Customs duty exemptions?

    • Cost Reduction: The budget includes a full exemption of customs duty on 36 life-saving drugs used to treat cancer, rare diseases, and other severe chronic conditions. This measure will significantly reduce the cost of these essential medications, making them more accessible to patients, especially those from economically disadvantaged backgrounds.
    • Improved Access to Medications: The exemption extends to specific drugs under Patient Assistance Programs run by pharmaceutical companies, along with adding 37 new medicines and 13 new patient assistance programs by next year. This will improve access to critical medications for patients, particularly those with chronic conditions.

    What are the objectives of synergy – ‘Heal in India’?

    • Promote Medical Tourism: The ‘Heal in India’ initiative aims to promote medical tourism by simplifying visa procedures for international patients.
    • Establish India as a Global Healthcare Destination: By enhancing hospital infrastructure and streamlining visa processes, India is poised to become the preferred medical destination for international patients.

    What are the challenges in India? 

    • Inadequate Infrastructure: India faces a shortage of healthcare infrastructure, particularly in rural areas, leading to unequal access to services.
      • For example, India has only 0.9 beds per 1000 population, with only 30% of these beds located in rural areas. This is significantly lower than the WHO’s suggested norm of 3.5 beds per 1000 population.
      • The underdeveloped state of roads and railways, along with erratic power supply, further complicates the establishment of rural health facilities.
    • Financial Barriers: A significant portion of the population faces affordability issues, with many households bearing healthcare expenses out-of-pocket.
      • For instance, a large proportion of the Indian population lacks health insurance coverage, exacerbating the financial burden and limiting access to necessary healthcare services.
      • High costs of intensive care units (ICUs), averaging ₹60,000-90,000 per day, are beyond the reach of most Indians.
    • Shortage of Healthcare Professionals: There is a shortage of trained healthcare professionals, including doctors, nurses, and specialists.
      • For example, shortages of surgeons, obstetricians and gynaecologists, general physicians, and paediatricians range from 74.2% to 81.6% of the required strength in Community Health Centers (CHCs). The doctor-patient ratio is significantly low, especially in rural areas.

    Way forward: 

    • Strengthen Rural Healthcare Infrastructure – Increase investments in rural hospitals, improve transport and power infrastructure, and incentivize private sector participation to bridge accessibility gaps.
    • Expand Medical Workforce & Insurance Coverage – Enhance training programs for doctors and nurses, increase medical seats, and extend affordable health insurance schemes to reduce out-of-pocket expenses for low-income groups.

    Mains PYQ:

    Q Public health system has limitation in providing universal health coverage. Do you think that private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)