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Subject: Social Justice

  • Why is India rethinking its Anaemia Policy?

    Central Idea

    • Anaemia questions are excluded from National Family Health Survey (NFHS-6) due to concerns about accuracy, emphasizing the need for precise estimates to address India’s growing anaemia burden.
    • NFHS-5 data reveals a significant increase in anaemia prevalence in India, underscoring the urgency of accurate estimates to effectively tackle this public health challenge.

    National Family Health Survey (NFHS)

    • NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
    • Three rounds of the survey have been conducted since the first survey in 1992-93.
    • The International Institute for Population Sciences (IIPS) Mumbai, is the nodal agency, responsible for providing coordination and technical guidance for the survey.
    • IIPS collaborates with a number of Field Organizations (FO) for survey implementation.
    • The survey provides state and national information for India on fertility, infant and child mortality, the practice of family planning, maternal and child health, reproductive health etc.

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

    1.      To provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes, and

    2.      To provide information on important emerging health and family welfare issues.

     Anaemia: A bigger menace

    • Anaemia is characterized by low red blood cells or haemoglobin levels, leading to symptoms like fatigue and weakness.
    • Iron deficiency is the primary cause, but deficiencies in folate, vitamins B12, and A also contribute.
    • Addressing nutritional deficiencies is crucial for prevention and treatment.

    Shift to DABS-I for Anaemia Assessment

    • The Health Ministry shifted anaemia assessment to Diet and Biomarkers Survey in India (DABS-I) for more accurate prevalence estimates.
    • DABS-I is a comprehensive dietary survey collecting individual data to assess food and nutrient adequacy nationwide.

    Reasons for Methodology Change

    • Concerns of Over-Diagnosis: Using WHO cut-offs may not suit the Indian population due to various factors that influence anaemia.
    • Inadequacy of WHO Cut-Offs: Country-specific cut-offs are needed as the WHO’s haemoglobin cut-offs may not reflect the Indian anaemia situation accurately.
    • Differences in Blood Sampling Methods: Venous blood sampling is more accurate than the capillary blood sampling used in previous surveys.

    Role of DABS-I Dietary Survey

    • DABS-I collects detailed dietary intake data to understand nutritional patterns and deficiencies contributing to anaemia.
    • It provides information on nutrient composition in foods from different regions, aiding targeted interventions.

    Prevalence of Anaemia in India

    • High Burden: Anaemia is a significant public health concern in India, with a high prevalence across different population groups.
    • Anaemia among Women: Data from national surveys indicate that a considerable percentage of women in India, particularly those in the reproductive age group, are affected by anaemia.
    • Anaemia among Children: Anaemia is also prevalent among children in India, with a substantial proportion experiencing this condition at a young age.

    Causes and Risk Factors

    • Nutritional Deficiencies: Iron deficiency is the primary cause of anaemia in India. Inadequate intake and absorption of iron, along with deficiencies in other key nutrients, contribute to the problem.
    • Socioeconomic Factors: Factors such as poverty, limited access to nutritious food, and inadequate healthcare contribute to the high prevalence of anaemia in certain socioeconomically disadvantaged populations.
    • Infections and Diseases: Certain infections, such as malaria and helminthiasis, and chronic diseases like kidney disease and cancer, can increase the risk of developing anaemia.

    Impact on Health and Well-being

    • Physical Symptoms: Anaemia can cause a range of physical symptoms, including fatigue, weakness, shortness of breath, and impaired cognitive function.
    • Maternal and Child Health: Anaemia in pregnant women increases the risk of complications during pregnancy and childbirth. It can also lead to low birth weight and developmental issues in infants.
    • Impaired Growth and Development: Anaemia among children can hinder their growth, development, and overall well-being. It may affect cognitive function, school performance, and future productivity.

    Government Initiatives and interventions

    • National Nutrition Programs: The Government of India has implemented various programs, such as the National Iron+ Initiative and the Pradhan Mantri Matru Vandana Yojana, to address anaemia and improve maternal and child health.
    • Supplementation and Fortification: Iron and other micronutrient supplementation programs, along with food fortification initiatives, aim to enhance iron intake and combat anaemia.
    • Awareness and Education: Public awareness campaigns and educational programs focus on promoting nutrition, especially among vulnerable groups, and raising awareness about the importance of addressing anaemia.

    Challenges and Future Directions

    • Access to Healthcare and Nutritious Food: Improving access to quality healthcare services, affordable nutritious food, and clean drinking water is crucial in addressing anaemia in India.
    • Multisectoral Collaboration: Addressing anaemia requires collaboration across various sectors, including healthcare, nutrition, education, and social welfare, to develop comprehensive strategies and interventions.
    • Monitoring and Evaluation: Regular monitoring and evaluation of anaemia prevalence, intervention effectiveness, and progress towards targets are essential to track improvements and identify areas that require further attention.

  • Mandatory Anti-Tobacco Warnings on OTT Platforms

    tobacco

    Central Idea

    • Over-the-top (OTT) streaming platforms must display anti-tobacco warnings similar to those seen in movies screened in theatres and on TV.
    • The requirement is based on a Union Health Ministry notification that amends the rules under the Cigarettes and Other Tobacco Products Act (COTPA), 2004.

    What is COTPA, 2004?

    Description
    Purpose Regulate production, sale, distribution, and consumption of tobacco products
    Prohibition of Smoking in Public Places Smoking prohibited in public areas like offices, restaurants, parks, public transport, etc.
    Health Warnings on Tobacco Products Mandatory display of health warnings on cigarette packages and other tobacco products
    Ban on Advertisement and Promotion Prohibition on direct and indirect advertising of tobacco products
    Prohibition on Sale to Minors Selling tobacco products to individuals below 18 years of age is strictly prohibited
    Packaging and Labelling Requirements Health warnings and pictorial representations of harmful effects on cigarette packages
    Powers of Enforcement Authorities empowered to enforce the act, conduct inspections, and seize contraband products

    New requirements for Anti-Tobacco Warnings

    • Publishers of online curated content displaying tobacco products or their use must show anti-tobacco health spots at the beginning and middle of the program.
    • When tobacco products or their use are displayed during the program, an anti-tobacco health warning must be prominently displayed as a static message at the bottom of the screen.
    • The warning message should be legible and readable, with black font on a white background.
    • The specified warnings are ‘Tobacco causes cancer’ or ‘Tobacco kills.’
    • Health spots, warnings, and audio-visual disclaimers should be in the same language as used in the show.

    Negative health impacts of tobacco

    • Cancer: Tobacco use is the leading cause of preventable cancer. It can cause cancer of the lungs, mouth, throat, larynx, pancreas, bladder, kidney, and cervix.
    • Respiratory diseases: It may cause chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. It can also worsen asthma symptoms.
    • Cardiovascular diseases: Consumption increases the risk of heart attack, stroke, and other cardiovascular diseases. It damages blood vessels and increases the risk of blood clots.
    • Reproductive health: Tobacco use can lead to infertility, premature birth, and low birth weight in babies.

    Socio-economic impact

    (1) On an individual level:

    • Decreased productivity: Smoking-related illnesses can result in absenteeism from work, decreased work performance, and increased medical expenses.
    • Decreased life expectancy: Tobacco consumption can lead to decreased life expectancy, which reduces the overall productive years of an individual.

    (2) On a societal level:

    • Healthcare cost: Tobacco consumption can lead to decreased economic development due to the increased burden of healthcare costs and decreased productivity.
    • Increased social expenditure: According to a study conducted by the World Health Organization (WHO), tobacco-related illnesses cost India about $22.4 billion in healthcare costs and lost productivity annually

    Why tobacco isn’t completely banned?

    • Revenue loss: The industry contributes a significant amount of tax revenue to the government. Banning tobacco would result in the loss of these tax revenues, which are used for various public welfare programs and initiatives.
    • Economic Impact: The tobacco industry provides employment to a large number of people, especially in the agricultural sector, where tobacco farming is prevalent.
    • Not a psychotropic substance: While the harmful effects of tobacco are well-documented, banning a legal product entirely requires careful consideration and legal processes.
    • Regulatory approach: Instead of a complete ban, the Indian government has adopted a regulatory approach to control tobacco use.

    Way forward

    • Strengthen tobacco control laws: Review and enhance existing laws to effectively reduce tobacco consumption.
    • Conduct public awareness campaigns: Educate the public about the health risks of tobacco use and the benefits of quitting.
    • Expand access to tobacco cessation programs: Increase availability of affordable and effective programs to support individuals who want to quit tobacco.
    • Implement sin taxes on tobacco products: Increase taxes to discourage consumption, especially among price-sensitive populations.
    • Enforce smoke-free environments: Strictly implement smoke-free laws in public places, workplaces, and public transport.
    • Support tobacco farmers: Provide alternative livelihood options and assistance for farmers transitioning away from tobacco farming.
    • Conduct research and surveillance: Invest in data collection and analysis to inform evidence-based policies and interventions.
    • Collaborate with international organizations: Partner with global entities like WHO to leverage expertise and resources in tobacco control.

     

     

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  • Iron Fortification: Health Risks of Excessive Iron Intake

    iron

    Central Idea

    • Iron is an essential mineral for bodily functions, but excessive intake can be harmful.
    • Fortification of food with iron is a suggested method for treating iron deficiency anemia.
    • Excess consumption of fortified foods or simultaneous consumption of multiple fortified foods can lead to excessive iron intake.

    What is Iron Fortification?

    • Iron fortification refers to the process of adding iron to food products to increase their iron content.
    • It is done using various forms of iron, such as iron salts or iron powders, which are added to the food during processing.
    • It is a public health strategy employed to address iron deficiency, particularly in populations where inadequate iron intake is prevalent.
    • The goal is to provide a significant portion of the recommended daily iron intake through fortified foods, contributing to the prevention and treatment of iron deficiency anaemia.

    Implications for Iron Overload

    • Comorbidities: Iron overload conditions, such as thalassemia, hemochromatosis, and chronic liver disease, have impaired iron excretion mechanisms.
    • Blooding events: Iron absorption is balanced by steady and minimal excretion, except during bleeding events.
    • Menstrual bleeding: Women can excrete iron through menstrual bleeding, while men are less capable of iron excretion.
    • Oxidative stress: Increased iron intake can lead to oxidative stress, cellular damage, and impaired mitochondrial function.
    • Heart ailments: High serum ferritin levels (a marker of iron storage) are associated with an increased risk of chronic diseases such as high fasting serum glucose, high total cholesterol, high triglycerides, and hypertension.
    • Liver damage: Very high amounts of iron can activate hepatic stellate cells and cause excessive deposition of extracellular matrix in the liver. Prolonged liver iron overload can lead to liver fibrosis and cirrhosis.

    Challenges and consequences

    • Minimal absorption: Only a small percentage of ingested iron from fortified foods is absorbed, with the rest passing through the intestine.
    • Digestive issues: Unabsorbed iron can cause inflammation in the gastrointestinal lining and disrupt the colonic microbiota, leading to abdominal discomfort and gastrointestinal issues.
    • Issues with nutrition absorption: Excessive iron in the gastrointestinal tract can impair the absorption of other essential minerals like zinc and copper and potentially result in other deficiencies.

    Way Forward

    • Implement individualized strategies for iron intake rather than mandatory fortification programs to avoid unsupervised high iron intake across diverse populations.
    • Ensure thorough monitoring and detection of adverse events related to iron intake.
    • Precision in public health approaches is necessary to prevent the risk of iron overload and potential long-term chronic illnesses associated with excess iron.
    • Evaluate the specific dietary iron needs of different population segments to avoid unnecessary excess iron consumption.

     

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  • Highlights of the Joint Malnutrition Estimates (JME)

    Central Idea

    • According to the Joint Malnutrition Estimates (JME) by UNICEF, WHO, and the World Bank, India has shown a reduction in stunting among children under five.

    Such reports (including NFHS) are credible sources of information to substantiate your answers in Mains answer writing ….

    What is Stunting and Wasting?

      Stunting Wasting
    Definition Impaired growth and development due to chronic malnutrition. Rapid weight loss and muscle wasting in a short period.
    Measurement Height-for-age comparison against standardized growth reference. Weight-for-height comparison against standardized growth reference.
    Causes Insufficient intake of essential nutrients, frequent infections, poor maternal health. Inadequate caloric intake, poor feeding practices, infectious diseases.
    Effects Irreversible consequences, reduced cognitive development, increased disease vulnerability. Increased morbidity and mortality, severe malnutrition.
    Time Frame Long-term condition Short-term condition
    Overall Nutritional Status Reflects chronic malnutrition Represents acute malnutrition
    Focus Impacts growth and development Impacts weight and muscle mass

     

    Decline in Child Stunting in India

    • The prevalence of stunting in India dropped from 41.6% in 2012 to 31.7% in 2022, with 1.6 crore fewer stunted children recorded.
    • India’s share of the global burden of stunting declined from 30% to 25% in the past decade.

    Concerns over Wasting

    • Wasting remains a concern in India, with an overall prevalence of 18.7% in 2022.
    • India contributes 49% to the global burden of wasting, reflecting the severity of this malnutrition indicator.
    • Two-thirds of wasting cases in India may be attributed to maternal malnutrition, leading to low birth weight for height.

    Rise in Obesity

    • The prevalence of obesity in India increased marginally from 2.2% in 2012 to 2.8% in 2022.
    • India’s obesity classification remains low compared to the global prevalence of 5.6%.
    • Obesity contributes to 8.8% of the global burden, with 31.8 lakh obese children in India.

    Way Forward

    • The JME report highlights the need for accelerated efforts to achieve global nutrition targets.
    • India’s progress aligns with the National Family Health Survey (NFHS) data, indicating a reduction in stunting.
    • More research is needed to understand the complexities of wasting, particularly its links to maternal malnutrition.
    • Continued focus on addressing malnutrition, access to health services, and maternal nutrition is crucial for further improvement.
    • Learning more about wasting and its determinants will be essential for tailored interventions in India and Asia.

     

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  • Debate over Fortified Rice

    fortified rice

    Central Idea

    • The Union Food Ministry refuted the allegations made by the Opposition regarding the distribution of Fortified Rice through fair price shops.

    What is Fortified Rice?

    • Fortified rice refers to the process of enhancing regular rice with essential nutrients to address nutritional deficiencies in populations that heavily rely on rice as a staple food.
    • These added nutrients aim to improve the nutritional value of rice and combat specific deficiencies prevalent in certain regions or population groups.
    • The fortification process involves coating the rice grains with a nutrient-rich powder or premix.
    • The specific nutrients added to fortified rice can vary, but commonly include:
    1. Iron: Iron is often added to fortified rice to address iron deficiency anaemia, a widespread nutritional problem globally.
    2. Vitamins: Essential vitamins such as vitamin A, vitamin B-complex (including thiamine, riboflavin, niacin, and folic acid), and vitamin D may be included in fortified rice to address specific vitamin deficiencies prevalent in target populations.
    3. Minerals: Other minerals like zinc, calcium, and iodine may be incorporated into fortified rice, depending on the specific nutritional needs and deficiencies of the target population.

    Need for fortification

    • Data from the National Family Health Survey 2019-21 shows that 57 per cent of women in the reproductive age group (15-49) are deficient in iron.
    • Moreover, studies have shown that about a fifth of the children (0-5 years) who do not have access to a nutritious and diversified diet suffer from vitamin-A deficiency.
    • Vitamin D deficiency has been termed a silent epidemic.

    Advantages offered

    • Health: Fortified staple foods will contain natural or near-natural levels of micro-nutrients, which may not necessarily be the case with supplements.
    • Taste: It provides nutrition without any change in the characteristics of food or the course of our meals.
    • Nutrition: If consumed on a regular and frequent basis, fortified foods will maintain body stores of nutrients more efficiently and more effectively than will intermittently supplement.
    • Economy: The overall costs of fortification are extremely low; the price increase is approximately 1 to 2 percent of the total food value.
    • Society: It upholds everyone’s right to have access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger.

    Issues with fortified food

    • Against nature: Fortification and enrichment upset nature’s packaging. Our body does not absorb individual nutrients added to processed foods as efficiently compared to nutrients naturally occurring.
    • Bioavailability: Supplements added to foods are less bioavailable. Bioavailability refers to the proportion of a nutrient your body is able to absorb and use.
    • Immunity issues: They lack immune-boosting substances.
    • Over-nutrition: Fortified foods and supplements can pose specific risks for people who are taking prescription medications, including decreased absorption of other micro-nutrients, treatment failure, and increased mortality risk.

    Possible health hazard

    • Thalassemia, sickle cell anaemia and malaria are conditions where there is already excess iron in the body, whereas TB patients are unable to absorb iron.
    • Consumption of iron-fortified foods among patients of these diseases can reduce immunity and functionality of organs.

    Ministry’s justification of Fortified Rice

    • The Ministry cited various studies to support the assertion that consumption of fortified rice leads to a significant improvement in haemoglobin levels and a reduction in the prevalence of anaemia.
    • Rice fortification has been adopted by seven countries, including the U.S., since 1958, highlighting its effectiveness as a public health intervention.
    • Ongoing evaluation, conducted by NITI Aayog in collaboration with the Indian Council of Medical Research, is being carried out to assess the impact and effectiveness of fortified rice.
    • Evaluation studies focusing on pilot districts are currently underway to gather comprehensive data and insights.

    Way Forward

    • Collaborative efforts between the Ministry, NITI Aayog, and other relevant institutions should be prioritized to conduct a thorough and independent evaluation of the fortified rice program.
    • Transparent communication of evaluation results and findings is crucial to foster trust and address any potential shortcomings or areas of improvement.
    • Incorporating feedback and recommendations from stakeholders will be valuable in enhancing the implementation and impact of the fortified rice distribution program.
    • Continuous monitoring and assessment of the program’s effectiveness should be a priority, enabling necessary adjustments and improvements to be made in a timely manner.

     

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  • Arsenic Contamination in India

    arsenic

    Central Idea: A recent peer-reviewed study suggests that even low levels of arsenic consumption can affect cognitive function in children, adolescents, and young adults.

    Arsenic Contamination

    • Arsenic is a highly toxic element naturally present in the environment.
    • Contaminated water, particularly groundwater, is a major source of arsenic exposure.
    • Long-term arsenic exposure can lead to various health issues, including cancer, skin lesions, cardiovascular disease, and negative impacts on cognitive development.

    Menace in India

    • Arsenic contamination in groundwater is one of the most crippling issues in the drinking water scenario of India.
    • According to the latest report of the Central Ground Water Board (CGWB), 21 states across the country have pockets with arsenic levels higher than the BIS stipulated permissible limit of 0.01 milligram per litre (mg/l).
    • The states along the Ganga-Brahmaputra-Meghna (GBM) river basin — Uttar Pradesh, Bihar, Jharkhand, West Bengal and Assam — are the worst affected by this human-amplified geogenic occurrence.
    • In India, arsenic contamination was first officially confirmed in West Bengal in 1983.
    • Close to four decades after its detection, the scenario has worsened.
    • About 9.6 million people in West Bengal, 1.6 million in Assam, 1.2 million in Bihar, 0.5 million in Uttar Pradesh and 0.013 million in Jharkhand are at immediate risk from arsenic contamination in groundwater.

    Key findings of the recent study

    (1) Arsenic impact on behaviour

    • The study found that individuals exposed to arsenic had reduced grey matter and weaker connections within key regions of the brain associated with cognitive functions.
    • Chronic exposure to arsenic could have significant consequences at a population level, leading to increased school failures, diminished economic productivity, and higher risks of criminal and antisocial behavior.

    (2) Arsenic Exposure and Socioeconomic Factors

    • As previous studies have shown, arsenic exposure is particularly harmful to the poor.
    • The recent study reaffirms that economically and nutritionally disadvantaged individuals experience greater cognitive impairment from arsenic exposure.
    • The impact of arsenic on impairing cognition is more pronounced at a collective level rather than at an individual level.

    Government Initiatives to address Arsenic Contamination

    • Governments in Bihar and West Bengal have taken steps to address arsenic contamination since the 1990s.
    • Strategies include promoting piped water access, installing arsenic removal plants, and encouraging groundwater extraction from deeper aquifers with lower arsenic levels.
    • The goal is to minimize arsenic exposure and mitigate its health impacts in affected regions.

    Possible solutions

    Some of the management options include

    • Uses of surface water sources
    • Exploring and harnessing alternate arsenic-free aquifer
    • Removal of arsenic from groundwater using arsenic treatment plants/filters
    • Adopting rainwater harvesting/ watershed management practices.

     

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  • Trend of unnecessary Hysterectomies

    hyster

    Central Idea: The Health Ministry in India is concerned about the high incidence of unnecessary hysterectomies, particularly among poor, less-educated women in rural areas.

    Why in news?

    • The Supreme Court has directed States and Union Territories to implement health guidelines formulated by the Centre to monitor and prevent unnecessary hysterectomies.

    What is Hysterectomy?

    • Hysterectomy is a surgical procedure to remove the uterus, and sometimes surrounding organs and tissues.
    • It can be classified as a partial hysterectomy (removal of the uterus), total hysterectomy (removal of the uterus and cervix), or radical hysterectomy (removal of the uterus, cervix, part of the vagina, and surrounding tissues).
    • The procedure can be performed through the vagina or through an incision in the abdomen.

    Issues with such surgery

    • Overuse and unnecessary procedures: Hysterectomy can be performed without exploring alternative treatments.
    • Psychological and emotional impact: The procedure may lead to feelings of loss and changes in body image.
    • Surgical risks and complications: Hysterectomy carries risks such as infection and damage to surrounding organs.
    • Long-term health effects: Removal of the uterus may have impacts on hormones and bone health.
    • Patient autonomy and informed consent: Patients should be fully informed about the procedure and involved in decision-making.
    • Access and equity: Disparities in access to healthcare may contribute to overuse, particularly among marginalized communities.

    Concerns and Petition

    A public interest litigation (PIL) highlighted the occurrence of unnecessary hysterectomies in the states of Bihar, Chhattisgarh, and Rajasthan under government healthcare schemes.

    • Marginalized women were targeted: Women from marginalized communities, such as Scheduled Castes, Scheduled Tribes, and Other Backward Communities, were disproportionately affected.
    • Misuse and Insurance Fraud: Healthcare institutions were found to be misusing hysterectomies to claim high insurance fees from the government under various health insurance schemes.

    Key issue: Violation of Fundamental Rights

    • The recent judgement acknowledges that rising hysterectomy rates among young women in India deviate from trends observed in developed countries.
    • It recognizes the violation of fundamental rights, stating that unnecessary hysterectomies infringe upon the right to health and the right to life under Article 21 of the Constitution.

    Government action and guidelines

    • The Health Ministry has closely monitored the issue of hysterectomies and requested States to share data on hysterectomy cases before and after the implementation of guidelines.
    • Compulsory audits for all hysterectomies are advised, similar to those conducted for maternal mortality, in both public and private healthcare institutions.
    • In 2022, the Health Ministry issued guidelines to prevent unnecessary hysterectomies and urged States to comply with them.

     

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  • India nears milestone with first indigenous Dengue Vaccine

    dengue

    Central Idea: Serum Institute of India and Panacea Biotec have applied to the ICMR’s call for Expression of Interest for collaborative Phase-III clinical trials for an indigenous dengue vaccine.

    What is Dengue?

    Details
    Transmission Primarily transmitted through the bite of infected Aedes mosquitoes
    Virus and Serotypes Dengue virus belonging to the Flaviviridae family

    Four distinct serotypes: DENV-1, DENV-2, DENV-3, and DENV-4
    Symptoms High fever, severe headache, joint and muscle pain, rash, pain behind the eyes, mild bleeding
    Severe Dengue Progression to severe dengue can cause plasma leakage, bleeding, organ impairment
    Geographic Distribution Endemic in more than 100 countries, particularly in tropical and subtropical regions
    Incidence and Global Impact 100-400 million dengue infections occur annually globally, affecting healthcare systems and economies
    Vector and Breeding Sites Aedes aegypti mosquito breeds in stagnant water containers found near human dwellings
    Treatment No specific antiviral treatment available; supportive care, rest, fluid intake, symptom management
    Prevention and Control Reduce mosquito breeding sites, proper water storage, cleaning of water containers, use of insecticides

     

    Dengue Virus Disease and Global Impact

    • Dengue virus disease causes significant morbidity and mortality worldwide, with 2 to 2.5 lakh (200,000 to 250,000) cases reported annually in India.
    • The global incidence of dengue has increased dramatically, with over half of the world’s population at risk.
    • The World Health Organization (WHO) has identified dengue as one of the top ten global health threats in 2019.
    • Currently, there is no specific treatment for dengue, highlighting the urgent need for effective vaccines.

    Desirable Characteristics of a Dengue Vaccine

    The ICMR highlights the desirable characteristics of a dengue vaccine, including a-

    • Favorable safety profile
    • Protection against all four serotypes of dengue
    • Reduced risk of severe disease and death
    • Induction of a sustained immune response and
    • Effectiveness regardless of previous sero-status and age

     

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  • Early Childhood Care and Education through Anganwadis

    Central Idea: The Centre is planning to promote ‘Early Childhood Care and Education’ through anganwadi centres as part of the ‘Poshan Bhi, Padhai Bhi’ slogan announced by the Women and Child Development Minister.

    What is Anganwadi scheme?

    • The scheme was started in 1975 and aims at the holistic development of children and empowerment of mother.
    • It is a Centrally-Sponsored scheme. The scheme primarily runs through the Anganwadi centre.
    • The scheme is under the Ministry of Women and Child Development.

    Moto: Poshan Bhi, Padhai Bhi

    • The focus will be on both nutrition and early learning for children under 6 years, with a particular emphasis on those under 3 years.
    • Early learning has been neglected in the Integrated Child Development Scheme (ICDS) and seen as secondary to nutrition.
    • Anganwadi centres will be repositioned as pre-schools to provide early learning access to socially and educationally backward communities.

    Why such move?

    • Two emerging trends are noted: young children shifting to private pre-schools and under-age children being admitted to Class 1 in some states.
    • The quality of services provided at Anganwadi centres is perceived as inferior, leading to the shift to private nursery schools.

    Task Force and Recommendations

    • Rebranding anganwadis: The task force recommends a “mission-mode approach” to rebranding anganwadis, including infrastructure upgrades, materials, play equipment, etc.
    • Focus on volunteer support: It suggests involving panchayat raj institutions, women’s self-help groups, local NGOs, and college volunteers to enhance the learning environment.
    • Boost to Anganwadi sisters: The task force proposes re-designating anganwadi workers as anganwadi teachers and helpers as childcare workers.
    • Nutrition boost: Infrastructure improvements, additional nutrition supplements (such as eggs and milk), extended timings, creches, and day care services are recommended.
    • MGNREGS liasion: The task force suggests leveraging funds from the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS).

    Major target: Improve Child Nutrition

    • The task force highlights that over 35% of young children in India are stunted, according to the latest NFHS data.
    • Although there has been a reduction, India still has the largest population of stunted children globally.
    • Child stunting affects developmental outcomes and the ability to learn at school.
    • NFHS-5 reveals that only 11.3% of children below 2 years receive an adequate diet.
    • The task force recommends introducing eggs as an effective intervention for nutrition.

     

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  • Govt. program for Non-Communicable Diseases renamed

    disease

    Central Idea: The article discusses the decision by the Indian Ministry of Health and Family Welfare to rename and expand its program for the control and prevention of non-communicable diseases (NCDs).

    What are Non-Communicable Diseases (NCDs)?

    • NCDs are also known as chronic diseases, which are not caused by infectious agents and are not transmissible from person to person.
    • NCDs are long-lasting and progress slowly, typically taking years to manifest symptoms.
    • Examples of NCDs include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.
    • These diseases are often caused by modifiable risk factors such as unhealthy diet, lack of physical activity, tobacco and alcohol use, and environmental factors.
    • NCDs are a major cause of morbidity and mortality worldwide, accounting for around 70% of all deaths globally.

    Why in news?

    • The addition of many new diseases and health initiatives have prompted the Indian government to expand and rename its NCD program.

    Renaming of the NCD Program and Portal

    • The Ministry has renamed the NPCDCS as the “National Programme for Prevention & Control of Non-Communicable Diseases [NP-NCD].”
    • The application or software named Comprehensive Primary Healthcare Non-Communicable Disease (CPHC NCD IT) will now be renamed “National NCD Portal.”
    • The Ministry communicated this decision to the States on May 3, 2023, through a one-page letter and asked them to adhere to the changes.

    Implementation and future action

    • The NPCDCS is implemented under the National Health Mission across India.
    • The letter addressed to Principal Secretaries and Health Secretaries of all States and Union Territories advised the government to use the new names for the scheme and portal in all their future references and correspondences with the Indian government.
    • Under NPCDCS, 677 NCD district-level clinics, 187 District Cardiac Care Units, 266 District Day Care Centres and 5,392 NCD Community Health Centre-level clinics have been set up.

    Burden of NCDs in India

    • The study ‘India: Health of the Nation’s States – The India State-Level Disease Burden Initiative in 2017’ by the ICMR estimated that the proportion of deaths due to NCDs in India has increased from 37.9% in 1990 to 61.8% in 2016.
    • The four major NCDs are:
    1. Cardiovascular diseases (CVDs)
    2. Cancers
    3. Chronic respiratory diseases (CRDs) and
    4. Diabetes
    • The study shared four behavioural risk factors – unhealthy diet, lack of physical activity, and the use of tobacco and alcohol.

    Solutions to mitigate NCD burden

    • Promote healthy lifestyle: Encourage people to adopt healthy lifestyle habits such as regular physical activity, balanced and nutritious diet, avoiding tobacco and alcohol, and getting enough sleep.
    • Increase awareness and education: Increase awareness among the public about the risk factors of NCDs and educate them about ways to prevent these diseases.
    • Improve healthcare infrastructure: Increase access to healthcare facilities, especially in rural and remote areas, to ensure early detection, treatment, and management of NCDs.
    • Implement policies and regulations: Implement policies and regulations that promote healthy living, such as increasing taxes on tobacco and alcohol products, and regulating the marketing of unhealthy food products.
    • Foster public-private partnerships: Foster partnerships between the government, private sector, and civil society organizations to work collaboratively towards preventing and managing NCDs.
    • Increase research and innovation: Increase research and innovation in the prevention, early detection, and treatment of NCDs to develop new and effective interventions.

     

     

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