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Subject: Social Justice

  • Agri Ministry questions Global Hunger reports’ methodology

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

    About GHI

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

    Various indicators used

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

    What is the concern?

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

    Actual scenario

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

  • Jharkhand’s SAAMAR campaign to fight malnutrition

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

    We can expect an MCQ like:

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

    () Bovine health

    () Mother and Child Health

    () Non-communicable diseases

    () None of these

    SAAMAR

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

    Features of the scheme

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

    Outlined strategy under the scheme

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

    Why need such a scheme?

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

  • ACT-Accelerator Coalition

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

    ACT-Accelerator

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

    Try this PYQ based on a global coalition:

    Q.Consider the following statements:

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

    Which of the above statements is/are correct?

    (a) 1 only

    (b) 2 only

    (c) Both 1 and 2

    (d) Neither 1 nor 2

  • What we must consider before digitising India’s healthcare

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

    Integrated digital health infrastructure

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

    Factors to be considered

    1) Carefully developing pathway to public good

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

    2) Balancing between public good and individual rights

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

    3) Managing the sector specific identities

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

    4) Working out the operational requirement of data infrastructure

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

    5) Issue of due process

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

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

    Conclusion

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

  • What changes after COVID-19 vaccination?

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

    What does being vaccinated mean?

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

    Is the COVID threat averted?

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

    What changes after you get a vaccine shot?

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

  • Women’s needs are key to Swachh Bharat success

    The article highlights the central role of women in the success of the Swacch Bharat Mission.

    Recognising the gender dimensions of sanitation in India

    • The Swachh Bharat Grameen Phase I guidelines (2017) state that requirements and sensitivities related to gender are to be taken into account at all stages of sanitation programmes.
    • Planning, procurement, infrastructure creation, and monitoring are the basic tenets of implementation in Swachh Bharat and the guidelines for the first phase of the mission called for strengthening the role of women.
    • The states were accordingly expected to ensure adequate representation of women in the village water and sanitation committees (VWSCs), leading to optimal gender outcomes.
    • The department of Drinking Water and Sanitation released the guidelines, recognising the gender dimensions of sanitation in India.
    • Swachh Bharat Mission 2 .0 speaks of sustained behavioural change while embarking on the newer agendas of sustainable solid waste management and safe disposal of wastewater and reuse.
    • Besides the government, the role of non-state actors like the Bill and Melinda Gates Foundation, Unicef and several NGOs, must be lauded as we pursue sustainable sanitation using a powerful gender lens.

    Challenges and solutions

    • There were inevitably cases where women were fronts for spouses.
    • This capturing has happened in panchayat seats as well but research has shown that over time, women do pick up the challenge, and if voted back are likely to assume charge.
    • The government has also very effectively used over 8 lakh swachhagrahis, mainly women, who for small honorariums work to push through behavioural change at the community level.
    • There are no quick solutions other than adopting concerted approaches to ensure the survival and protection of the girl child through good health from sanitation and nutrition.
    • Information, education, and communication, which aims at behaviour change of the masses, is key to the success of the swachhta mission 2.0.
    • Changes in SBM messaging reflects major transformations attempting to popularise and portray stories of women groups and successful women swachhta champions.

    Need for monitoring and evaluation system

    • A national monitoring and evaluation system to track and measure gender outcomes in SBM is necessary.
    • Several researchers in this space have commented that gender analysis frameworks have a long history in development practice.
    • We can learn from these frameworks to support design, implementation, and measurement.

    Conclusion

    There is no doubt that women can help to drive change and bring about lasting change as the jan andolan for swachhta, health and sanitation gains momentum.

  • Intensified Mission Indradhanush (IMI) 3.0

    States and UTs have started the implementation of the Intensified Mission Indradhanush 3.0, a campaign aimed to reach those children and pregnant women who have been missed out or been left out of the routine immunisation.

    Do not get confused with the Mission Indradhanush for Public Sector Banks launched in 2015. It aims at revamping the functioning of the Public Sector Banks to enable them to compete with the Private Sector Banks.

    Intensified Mission Indradhanush (IMI) 3.0

    • IMI 3.0 is aimed to accelerate the full immunization of children and pregnant women through a mission mode intervention.
    • The campaign is scheduled to have two rounds of immunisation lasting 15 days (excluding routine immunisation and holidays).
    • It is being conducted in pre-identified 250 districts/urban areas across 29 States/UTs in the country.
    • Beneficiaries from migration areas and hard to reach areas will be targeted as they may have missed their vaccine doses during the pandemic.

    About the Mission Indradhanush

    • Mission Indradhanush seeks to drive towards 90% full immunisation coverage of India and sustain the same by the year 2020. It was launched in December 2014.

    Aims and objectives

    • It aims to immunize all children under the age of 2 years, as well as all pregnant women, against eight vaccine-preventable diseases.
    • The diseases being targeted are diphtheria, whooping cough, tetanus, poliomyelitis, tuberculosis, measles, meningitis and Hepatitis B.
    • In 2016, four new additions have been made namely Rubella, Japanese Encephalitis, Injectable Polio Vaccine Bivalent and Rotavirus.
    • In 2017, Pneumonia was added to the Mission by incorporating the Pneumococcal conjugate vaccine under Universal Immunisation Programme

    Try this question from CSP 2016:

    Q.‘Mission Indradhanush’ launched by the Government of India pertains to:

    (a) Immunization of children and pregnant women

    (b) Construction of smart cities across the country

    (c) India’s own search for the Earth-like planets in outer space

    (d) New Educational Policy

  • What are Non-Alcoholic Fatty Liver Diseases (NAFLD)?

    The Union Govt has integrated the Non-alcoholic fatty liver disease (NAFLD) in the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke.

    Try this MCQ:

    Q.A Company marketing food products advertises that its items do not contain trans-fats. What does this campaign signify to the customers?

    1. The food products are not made out of hydrogenated oils.
    2. The food products are not made out of animal fats/oils.
    3. The oils used are not likely to damage the cardiovascular health of the consumers.

    Which of the statements given above is/are correct?

    (a) Only 1

    (b) 2 and 3 only

    (c) 1 and 3 only

    (d) 1, 2 and 3

    NAFLD

    • NAFLD is the abnormal accumulation of fat in the liver in the absence of secondary causes of fatty liver, such as harmful alcohol use, viral hepatitis, or medications.
    • According to doctors, it is a serious health concern as it encompasses a spectrum of liver abnormalities.
    • It can cause non-alcoholic fatty liver (NAFL, simple fatty liver disease) to more advanced ones like non-alcoholic steatohepatitis (NASH), cirrhosis and even liver cancer.

    Why such a move?

    • NAFLD is emerging as an important cause of liver disease in India.
    • Epidemiological studies suggest the prevalence of NAFLD is around 9% to 32% of the general population in India with a higher prevalence in those with overweight or obesity and those with diabetes or prediabetes.
    • Researchers have found NAFLD in 40% to 80 % of people who have type 2 diabetes and in 30% to 90% of people who are obese.
    • Studies also suggest that people with NAFLD have a greater chance of developing cardiovascular disease.
    • Cardiovascular disease is the most common cause of death in NAFLD.

  • vaccine hesitancy

    Reluctance to take the vaccine has several implications. The misinformation around the vaccines needs to be fought through several measures. 

    Understanding vaccine hesitancy

    • According to the World Health Organization, vaccine hesitancy is defined as a reluctance or refusal to vaccinate despite the availability of vaccine services.
    • To date, two vaccines have been approved for inoculation in India: Pune-based Serum Institute’s Covishield and Hyderabad-based Bharat Biotech’s Covaxin.
    • An adequate supply of vaccines is in place at least for the first phase, but the trickier part is to persuade the population for vaccination.
    • Like Western nations, vaccine hesitancy has been a cause of concern in the past in India as well.
    • Social media has seen a rising number of self-proclaimed experts who have been making unsubstantiated claims.
    • The debates around hesitancy for COVID-19 vaccines include concerns over safety, efficacy, and side effects due to the record-breaking timelines of the vaccines, competition among several companies, misinformation, and religious taboos.

    Need to adopt libertarian paternalism

    • It is suggested that we adopt the idea of libertarian paternalism, which says it is possible and legitimate to steer people’s behaviour towards vaccination while still respecting their freedom of choice.
    • Vaccine hesitancy has a different manifestation in India, unlike in the West.
    • According to the World Economic Forum/Ipsos global survey, COVID-19 vaccination intent in India, at 87%, exceeds the global 15-country average of 73%.

    Way forward

    • Instead of anti-vaxxers, the target audience must be the swing population i.e., people who are sceptical but can be persuaded through scientific facts and proper communication.
    • The second measure is to pause before you share any ‘news’ from social media.
    • It becomes crucial to inculcate the habit of inquisitive temper to fact-check any news related to COVID-19 vaccines.
    • The third measure is to use the celebrity effect — the ability of prominent personalities to influence others to take vaccines.
    • Celebrities can add glamour and an element of credibility to mass vaccinations both on the ground and on social media.

    Consider the question “What is vaccine hesitancy? Suggest the measures to deal with it”

    Conclusion

    The infodemic around vaccines can be tackled only by actively debunking myths, misinformation and fake news on COVID-19 vaccines.

  • [pib] National Creche Scheme

    The Union Minister of Women and Child Development have given information about the National Creche Scheme to the Lok Sabha.

    Try this PYQ:

    Q.Which of the following statements is/are correct regarding the Maternity Benefit (Amendment) Act, 2017?

    1. Pregnant women are entitled to three months pre-delivery and three months post-delivery paid leave.
    2. Enterprises with creches must allow the mother a minimum of six crèche visits daily.
    3. Women with two children get reduced entitlements.

    Select the correct answer using the code given below.

    (a) 1 and 2 only

    (b) 2 only

    (c) 3 only

    (d) 1, 2 and 3

    National Creche Scheme

    • The Ministry of WCD implements the NCS for the children of working mothers as a Centrally Sponsored Scheme through States/ UTs with effect from 01.01.2017.
    • It aims to provide daycare facilities to children (age group of 6 months to 6 years) of working mothers.

    The Scheme provides an integrated package of the following services:

    • Daycare facilities including sleeping facilities.
    • Early stimulation for children below 3 years and pre-school education for 3 to 6 years old children
    • Supplementary nutrition (to be locally sourced)
    • Growth monitoring
    • Health check-up and immunization