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Subject: Social Justice

  • [13th June 2026] The Hindu OpED: Equality of treatment for Persons with Disabilities 

    PYQ Relevance[UPSC 2022] The Rights of Persons with Disabilities Act, 2016 remains only a legal document without intense sensitisation of government functionaries and citizens regarding disability. Comment.Linkage: The PYQ examines the gap between statutory rights and actual social, administrative and economic inclusion of Persons with Disabilities. The proposed Minimum Universal Disability Pension Floor Rate (MUDPFR) represents the next step in translating legal rights into meaningful social protection and economic security for PwDs.

    Mentor’s Comment

    India’s welfare architecture has achieved remarkable success in digital inclusion and benefit delivery, yet disability pensions remain fragmented and dependent on State-level discretion. A Minimum Universal Disability Pension Floor Rate (MUDPFR) would establish a nationally guaranteed minimum social security entitlement for Persons with Disabilities, ensuring equality, dignity and portability of benefits while strengthening India’s transition towards a rights-based welfare state.

    Why does India’s disability pension system remain inadequate despite a rights-based legal framework?

    1. Large Beneficiary Base: Census 2011 recorded 2.68 crore PwDs; current estimates place the number at around 4.5-6 crore due to population growth and changing disease profiles.
    2. Constitutional Recognition: Supreme Court has recognized the right to live with dignity as a fundamental right.
    3. Legal Protection: Rights of Persons with Disabilities Act, 2016 provides statutory protection and mandates social security support.
    4. Fragmented Pension System: Disability benefits vary significantly across States.
    5. Low Pension Amounts: Most States provide pensions ranging between ₹300 and ₹500 per month.
    6. Limited Coverage: Indira Gandhi National Disability Pension Scheme covers only a small fraction of eligible beneficiaries.
    7. Domicile-Based Inequality: Pension support often depends on place of residence rather than disability status.

    How does India’s spending on disability welfare compare internationally?

    1. Low Public Spending: India spends only about 0.02% of GDP on disability welfare, including pensions.
    2. South Africa Comparison: Allocates approximately 0.12-0.15% of GDP.
    3. Brazil Comparison: Allocates around 0.45-0.50% of GDP.
    4. OECD Countries: Average spending around 2.2% of GDP.
    5. Australia Comparison: Allocates approximately 0.35-0.40% of GDP.
    6. Resource Gap: India’s spending remains multiple times lower than comparable welfare systems.

    What are the economic and social costs of inadequate disability support?

    1. GDP Loss: World Bank and UNDP estimates indicate low- and middle-income countries lose 3-7% of GDP from exclusion of PwDs.
    2. Educational Exclusion: Limited support reduces access to education.
    3. Employment Barriers: Inadequate social security weakens labour force participation.
    4. Household Vulnerability: Disability income support improves household stability.
    5. Consumption Multiplier: Studies indicate multipliers ranging between 1.4 and 1.6.
      1. Disability pensions have a consumption multiplier of 1.4-1.6, meaning every ₹100 transferred to beneficiaries can generate approximately ₹140-₹160 in economic activity through increased spending on food, healthcare, transport and local services.
    6. Economic Returns: Pro Bono Economics (2025) found socio-economic returns from disability pensions exceed costs by nearly 48%.
    7. Investment Perspective: Disability pensions function as economic investments rather than welfare expenditures alone.

    Why is a Minimum Universal Disability Pension Floor Rate (MUDPFR) being proposed?

    1. Constitutional Obligation: Supports Article 41 directing public assistance in cases of disability.
    2. Implementation of RPwD Act: Operationalises Section 24 guaranteeing social security measures.
    3. Universal Minimum Guarantee: Ensures a baseline pension irrespective of State of residence.
    4. Rights-Based Welfare: Shifts support from charity-based approaches to citizenship-based entitlements.
    5. Portability: Ensures continuity of benefits across States.
    6. Equity: Reduces interstate disparities in pension access and quantum.

    Proposed Design

    1. National Floor Rate: Central government guarantees a minimum pension.
    2. State Top-Ups: States remain free to provide higher benefits.
    3. Uniform Eligibility: Common eligibility standards across India.
    4. Portability: Benefits remain accessible across State boundaries.

    Is a universal disability pension financially feasible?

    1. ₹8,000 Monthly Pension Scenario: Cost estimated at approximately ₹38,400 crore annually.
    2. GDP Share: Around 0.08% of GDP.
    3. 10 Lakh Beneficiaries Scenario: Cost around ₹65 lakh crore? (Article indicates cost projections for larger coverage; emphasis remains below 0.2% GDP even under expanded coverage assumptions.)
    4. ₹15,000 Monthly Pension Scenario: Public expenditure would still remain below 0.2% of GDP.
    5. Comparative Fiscal Context:
      1. Food Subsidy: ₹2.05 lakh crore.
      2. Rural Development: ₹1.80 lakh crore.
      3. Tax Concessions and Revenue Foregone: ₹1.72 lakh crore.
      4. Infrastructure: ₹11.11 lakh crore.

    How can India move from fragmented welfare to integrated disability support?

    1. Institutional Fragmentation: Pension administration is divided between the Ministry of Rural Development and the Department of Empowerment of Persons with Disabilities.
    2. Administrative Delays: Multiple authorities create duplication and accountability gaps.
    3. International Practice: Several countries operate through unified disability-support institutions.

    Proposed Institutional Reforms

    1. National Disability Pension Authority: Oversees eligibility, portability and grievance redress.
    2. National Registry: Creates integrated beneficiary database.
    3. Digital Integration: Links welfare databases through interoperable platforms.
    4. Performance Monitoring: Enables State-wise accountability and benchmarking.
    5. Single Governance Framework: One standard, one system, one nation.

    What lessons can India learn from international experience?

    South Africa

    1. National Disability Grant: Uniform eligibility and nationwide coverage.
    2. Centralized Standards: Ensures portability and consistency.

    Brazil

    1. BPC Programme: Guarantees a national minimum income for persons with disabilities.

    Australia

    1. Nationwide Disability Pension: Central administration with State coordination.
    2. Employment Incentives: Combines social security with labour participation.

    New Zealand

    1. Universal Framework: Nationwide disability support system.

    Other Developing Countries

    1. Kenya, Rwanda, Thailand and Indonesia: National disability income support mechanisms demonstrate feasibility even in developing economies.

    Why should disability pensions be linked with employment and economic participation?

    1. Inclusive Growth: Moves beneficiaries from survival support to productive participation.
    2. MUDPFR Advantage: Creates financial security necessary for skill development and employment.
    3. Employer Incentives: Encourages hiring of persons with disabilities.
      1. Singapore: Integrates disability support with skills training and workforce participation programmes.
      2. South Korea: Combines income support with vocational rehabilitation and employment assistance.
      3. South Africa: Provides a nationwide Disability Grant ensuring minimum income security for PwDs.
      4. Brazil: Guarantees income support through the Benefício de Prestação Continuada (BPC) programme.
      5. Nigeria: Offers tax incentives to employers hiring persons with disabilities, encouraging workplace inclusion.
      6. United Kingdom (Access to Work): Provides financial assistance for workplace accommodations and support services.
      7. Australia (Wage Subsidies): Offers wage subsidies to employers to improve employment opportunities for persons with disabilities.
    4. Existing Indian Base: PM-DAKSH, NAPS and State-level incentives provide foundations for expansion.

    How does a universal disability pension strengthen constitutional morality?

    1. Equality: Reduces domicile-based discrimination.
    2. Dignity: Recognises persons with disabilities as rights-bearing citizens.
    3. Citizenship: Moves welfare from discretionary charity to guaranteed entitlement.
    4. Article 14: Advances equality before law.
    5. Article 21: Supports dignified living.
    6. Social Justice: Aligns welfare architecture with constitutional commitments.
    7. Federal Balance: Preserves State flexibility while guaranteeing minimum national standards.

    Conclusion

    A Minimum Universal Disability Pension Floor Rate (MUDPFR) would mark a shift from fragmented welfare to rights-based social protection by ensuring that disability support is determined by citizenship and need rather than geography. As India aspires to become a developed nation, guaranteeing a minimum income floor for Persons with Disabilities is not merely a welfare measure but a constitutional imperative that advances equality, dignity, inclusion and human capital development.

  • Antyodaya in Action

    Why in the news?

    The Government highlighted the progress of welfare initiatives implemented under the Antyodaya approach aimed at ensuring inclusive development of deprived communities.

    Antyodaya

    • Means “rise of the last person”.
    • Inspired by the philosophy of Mahatma Gandhi.
    • Focuses on bringing the poorest and most marginalised sections to the forefront of development.

    Key Schemes and Initiatives

    PM JANMAN (Pradhan Mantri Janjati Adivasi Nyaya Maha Abhiyan)

    • Launched: November 2023
    • Targets 75 Particularly Vulnerable Tribal Groups (PVTGs) across 18 States and 1 UT.
    • Budget Outlay: ₹24,104 crore.
    • Implemented through 11 interventions by 9 Ministries.
    • Interventions include: Housing, Road connectivity, Piped water supply, Mobile medical units, Anganwadi centres, Hostels, Electrification, Mobile towers, Multipurpose centres, Van Dhan Vikas Kendras, and Vocational skilling

    Van Dhan Vikas Kendras (VDVKs)

    • Promote value addition and marketing of forest produce.
    • Implemented with support from TRIFED.
    • 491 VDVKs operationalised out of 500 targeted.
    • 38,391 PVTG members trained.

    PM-JUGA (Dharti Aaba Janjatiya Gram Utkarsh Abhiyan)

    • Launched in October 2024.
    • Convergence of 17 Ministries.
    • Focuses on tribal-majority villages and PVTG habitations.

    Eklavya Model Residential Schools (EMRS)

    • Residential schools for Scheduled Tribe students from Classes VI-XII.
    • Established in tribal-dominated areas.
    • 499 schools operational.
    • 323 schools under construction.
    • Over 1.56 lakh students enrolled.

    Tribal Research Institutes (TRIs)

    • Function in 29 States/UTs.
    • Document and preserve tribal languages, traditions, and indigenous knowledge.
    • Supported under the TRI-ECE Scheme.

    Tribal Freedom Fighter Museums

    • 11 museums sanctioned across 10 States.
    • 4 inaugurated and 7 under construction.
    • Honour tribal leaders who fought colonial rule.

    Janjatiya Gaurav Divas

    • Observed on 15 November. Marks the birth anniversary of Birsa Munda.

    Scheduled Caste Initiatives

    PM-AJAY (Pradhan Mantri Anusuchit Jaati Abhyuday Yojana)

    • Launched in 2021.
    • Develops SC-majority villages.
    • Covers: 47,334 villages, 597 districts, and 26 States Over 4 crore beneficiaries.

    DAPSC (Development Action Plan for Scheduled Castes)

    • Framework for SC-targeted expenditure.
    • Covers: 38 Ministries/Departments and 239 schemes.

    SHREYAS (Scholarships for Higher Education for Young Achievers Scheme)

    • Launched in 2019.
    • Benefits SC, OBC and EBC students.
    • Includes: Top Class Education, Free Coaching, National Overseas Scholarship, and Fellowships.

    SHRESHTA (Scheme for Residential Education for Students in High Schools in Targeted Areas)

    • Launched in 2022.
    • Residential education support for SC students (Classes IX-XII).
    • Admission through NETS.

    OBC, DNT (De-notified, Nomadic, and Semi-Nomadic Tribes) and EBC (Economically Backward Classes) Schemes

    PM-YASASVI (PM Young Achievers Scholarship Award Scheme for Vibrant India)

    • Launched in 2021-22.
    • Covers OBC, EBC and DNT students.
    • Includes scholarships and hostel facilities.
    • At least 30% seats reserved for girls.

    PM-DAKSH (Pradhan Mantri Dakshata Aur Kushalta Sampann Hitgrahi Yojana)

    • Launched in 2020-21.
    • Provides free skill training.
    • Covers SCs, OBCs, EBCs, DNTs, sanitation workers and waste pickers.
    • Over 2.08 lakh beneficiaries trained.

    VISVAS(Vanchit Ikai Samooh aur Vargon ko Aarthik Sahaita)Yojana

    • Provides interest subsidy up to 5% on loans.
    • Promotes entrepreneurship and self-employment.

    SEED (Scheme for Economic Empowerment of DNTs)

    • Launched in February 2022.
    • Components: Free coaching, Health insurance, Livelihood assistance, and Housing support.

    Minority Welfare

    PM VIKAS (Pradhan Mantri Virasat Ka Samvardhan)

    • Launched in 2025.
    • Integrates five previous minority welfare schemes.
    • Focuses on skill development and entrepreneurship.

    Sanitation Workers

    NAMASTE (National Action for Mechanised Sanitation Ecosystem) Scheme

    • Launched in FY 2023-24.
    • Replaces hazardous manual cleaning with mechanised sanitation.
    • Since June 2024, also covers waste pickers.

    Regional Development

    Aspirational Districts Programme

    • Launched in 2018.
    • Covers 112 districts.
    • Focuses on: Health and Nutrition, Education, Agriculture, Financial Inclusion, and Basic Infrastructure

    Aspirational Blocks Programme

    • Launched in 2023.
    • Covers 500 blocks across 329 districts.

    [2019] Consider the following statements about Particularly Vulnerable Tribal Groups (PVTGs) in India:
    1. PVTGs reside in 18 States and one Union Territory.
    2. A stagnant or declining population is one of the criteria for determining PVTG status.
    3. There are 95 PVTGs officially notified in the country so far.
    4. Irular and Konda Reddi tribes are included in the list of PVTGs.
    Which of the statements given above are correct?

    [A] 1, 2 and 3

    [B] 2, 3 and 4

    [C] 1, 2 and 4

    [D] 1, 3 and 4

  • Supreme Court Recognises Homemakers as “Nation Builders”

    Why in News?

    The Supreme Court held that unpaid domestic work performed by homemakers must be assigned a minimum notional value of ₹30,000 per month while calculating compensation in motor accident death cases. The Court described homemakers as “nation builders.”

    Background

    • The case arose from the death of Reshma in a road accident in Punjab (November 2001).
    • Her husband and three children sought compensation before the Motor Accident Claims Tribunal (MACT).
    • 2003: MACT awarded compensation.
    • The High Court enhanced it to ₹8.43 lakh with 7.5% interest.
    • The matter later reached the Supreme Court.

    Key Observations

    • Homemakers make significant contributions to families, society, and nation-building.
    • The Court recommended replacing the term “housewife” with “homemaker” to recognise the dignity and value of unpaid care work.

    Major Directions

    • Minimum valuation: Unpaid domestic work to be valued at ₹30,000 per month under the head “Loss of Domestic Care.”
    • Periodic revision: The amount shall increase by 10% every three years.
    • Homemakers with paid employment: ₹30,000 per month for domestic care shall be added to their actual income while computing compensation.
    • MACT timelines: Motor Accident Claims Tribunal cases should ordinarily be disposed of within one year.

    Loss of Domestic Care

    • Recognises the economic value of unpaid services such as: Childcare, Cooking and cleaning. Elderly care, Household management, Emotional and social support

    Motor Accident Claims Tribunal (MACT)

    • A specialised tribunal established under the Motor Vehicles Act, 1988.
    • It adjudicates compensation claims arising from motor vehicle accidents and determines liability and compensation payable to victims or their dependents.

    [2021] ‘Right to Privacy’ is protected under which Article of the Constitution of India?

    [A] Article 15

    [B] Article 19

    [C] Article 21

    [D] Article 29

  • Marketing of Divyangjan Vishwakarma Products through One Station One Product (OSOP)

    Why in the news?

    The Ministry of MSME is promoting the products of Divyangjan Vishwakarma artisans through the One Station One Product (OSOP) initiative under the PM Vishwakarma (PMV) Scheme, providing dedicated retail spaces at railway stations to improve market access and livelihoods.

    PM Vishwakarma (PMV) Scheme

    • A flagship scheme of the Government of India.
    • Launched to support traditional artisans and craftspeople.

    Objectives

    • Recognition of artisans and craftspeople.
    • Issuance of PM Vishwakarma certificates and ID cards.
    • Skill upgradation and training.
    • Access to modern tools and technology.
    • Market linkages. Financial assistance. Improved livelihood opportunities.

    One Station One Product (OSOP)

    • A marketing initiative under PM Vishwakarma.
    • Dedicated retail outlets are established at selected high-footfall railway stations.
    • Designed specifically to promote products made by Divyangjan Vishwakarma artisans.

    Objectives

    • Expand market reach.
    • Increase product visibility.
    • Enhance sales opportunities.
    • Promote sustainable livelihoods.
    • Foster economic inclusion and financial independence.

    Achievements under OSOP

    • Total Beneficiaries: 28 Divyangjan artisans facilitated.
    • States Covered: 12 States/UTs
    • Total Stalls: 28 stalls

    [2023] Consider the following statements with reference to India:
    1. According to the Micro, Small and Medium Enterprises Development (MSMED) Act, 2006, the ‘medium enterprises are those with and machinery between is crore and 25 crore.
    2. All bank loans to the Micro, Small and Medium Enterprises qualify under the priority sector.
    Which of the statements given above is/are correct?

    [A] 1 only

    [B] 2 only

    [C] Both 1 and 2

    [D] Neither 1 nor 2

  • What is lost and gained in NFHS-6 

    Why in the News?

    The preliminary fact sheets of NFHS-6 (2023-24) have been released by the Ministry of Health and Family Welfare, covering nearly 6.8 lakh households across all States and Union Territories except Manipur. For the first time, several critical health and demographic indicators have been omitted from the preliminary release.

    What is the National Family Health Survey (NFHS)?

    It is a large-scale, multi-round household survey conducted across India to collect comprehensive data on population dynamics, health, nutrition, and family welfare. Launched in 1992-93, it acts as a critical health “dashboard” that helps the Ministry of Health and Family Welfare (MoHFW) and other agencies evaluate existing government schemes, set development benchmarks, and design new public health policies.

    Key Features & Objectives

    1. Nodal Agency: The International Institute for Population Sciences (IIPS), Mumbai, coordinates and provides technical guidance for the survey. 
    2. Policy Support: It supplies high-quality, reliable, and comparable data to track progress toward the global Sustainable Development Goals (SDGs). 
    3. Granular Scope: The survey covers national and state levels, and since NFHS-4, it provides highly localized estimates down to the district level.

    How has NFHS evolved as India’s principal health and demographic database?

    1. Coverage: NFHS-6 collected information from nearly 6.8 lakh households across India, excluding Manipur.
    2. Policy Significance: Provides nationally representative data for health, nutrition, fertility, gender and social indicators.
    3. Survey Expansion: NFHS has progressively expanded its scope while retaining previous questions for comparability.
    4. Digital Transformation: NFHS-4 introduced district-level estimates and tablet-based data collection.
    5. Expanded Domains: NFHS-5 added education, disability, access to toilets, health insurance, bank accounts, bathing practices during menstruation, abortion-related indicators and age coverage up to 49 years for women and 54 years for men.
    6. Broader Adult Coverage: NFHS-6 expanded adult measurements to all individuals aged 15 years and above.

    Why has the reduction in indicators in NFHS-6 generated concern?

    1. Indicator Reduction: NFHS-6 preliminary fact sheet contains 101 indicators compared to 131 in NFHS-5, representing a reduction of nearly 23% in reported indicators.
    2. Net Change: 43 indicators were dropped and 13 were added, producing a net reduction of 30 indicators.
    3. Data Continuity Issue: Several long-running indicators are unavailable in the preliminary release.
    4. Policy Monitoring Gap: Removal affects trend analysis across survey rounds.
    5. Comparability Challenge: Limits direct comparison of progress in key health and demographic outcomes.

    Which important indicators have been removed from the preliminary fact sheets?

    Health Indicators

    1. Anaemia: Removed from preliminary fact sheets despite being a major public health concern.
    2. Mortality Indicators: Infant mortality, neonatal mortality and under-five mortality are absent.
    3. Sex Ratio at Birth: No current survey-based estimate available.
    4. Cancer Screening: Indicators covering cervical, breast and oral cancer screening removed.
    5. Comprehensive HIV Knowledge: Certain HIV-related indicators no longer available in the fact sheet.

    Living Conditions Indicators

    1. Sanitation Coverage: Household sanitation data absent.
    2. Clean Cooking Fuel Usage: Indicator removed from preliminary release.
    3. Internet Access: Household-level population living in households with internet access not reported.

    Why was anaemia removed and what does the evidence show?

    1. Worsening Trend: Anaemia has consistently shown deterioration in previous survey rounds.
    2. Children’s Anaemia: Increased from 58.6% (NFHS-4, 2015-16) to 67.1% (NFHS-5, 2019-21).
    3. Women’s Anaemia: Increased from 53.1% to 57% among women aged 15–49 years.
    4. Pregnant Women: Rose from 50.4% to 52.2%.
    5. Geographic Spread: Anaemia increased in 28 States and Union Territories.
    6. Severe Burden States: Assam recorded 35.7% to 68.4%; Mizoram recorded 19.3% to 46.4%.
    7. Policy Importance: Anaemia was a major target of the Anaemia Mukt Bharat campaign launched in 2018.
    8. Measurement Method: Earlier surveys measured haemoglobin using finger-prick blood samples.
    9. Methodological Concerns: Researchers questioned the reliability of portable analysers used for anaemia estimation.
    10. Future Tracking: Anaemia will now be monitored separately through the Diet and Biomarkers Survey under the National Institute of Nutrition.
    11. Alternative Data Collection: NFHS-6 collected venous blood and urine biomarkers instead of finger-prick methods.
    12. Additional Biomarkers: Survey collected information on nutritional deficiencies and obesity.
    13. Pending Release: Detailed biomarker dataset has not yet been released.

    What new themes and indicators have been introduced in NFHS-6?

    Digital Inclusion

    1. Digital Literacy: Introduced new questions assessing digital capabilities.
    2. Internet Use: Expanded assessment of digital access and usage patterns.
    3. Financial Fraud Awareness: Added questions on awareness of digital and financial fraud.

    Social and Economic Inclusion

    1. Direct Benefit Transfers (DBT): Added questions on DBT access and receipt.
    2. Self-Help Group Membership: Introduced indicators on SHG participation.

    Public Health

    1. Hepatitis-B Testing: Included testing among men and women.
    2. Hepatitis-B Child Testing: Included dried blood spot collection among children aged 4-5 years.
    3. Expanded Biomarkers: Added broader nutritional and obesity-related measurements.

    What methodological and definitional changes have occurred in NFHS-6?

    1. HIV Module Revision: HIV testing component removed from survey implementation.
    2. Knowledge Questions Retained: HIV/AIDS knowledge, attitudes and behaviour questions retained.
    3. Ownership Redefinition: Women’s ownership of house or land shifted to a household-level measure.
    4. Hepatitis-B Classification: Moved from individual measure to birth-dose measure.
    5. Education Indicator Revision: Pre-school attendance reclassified into younger age bands.
    6. Demographic Revisions: Several indicators modified through definitional changes rather than removal.

    What do NFHS-6 findings reveal about maternal and child health outcomes?

    Maternal Healthcare

    1. Antenatal Care: Mothers receiving at least four antenatal check-ups increased by about seven percentage points compared with NFHS-5.
    2. Institutional Deliveries
      1. Institutional Births: Continued improvement in institutional delivery coverage.
    3. Child Nutrition
      1. Stunting Reduction: Number of children under five who are stunted declined.
      2. Exclusive Breastfeeding: Declined among infants under six months.
    4. Contraception
      1. Modern Contraceptive Use: Declined from 56.4% to 52.7%.

    How have gender and social indicators changed between NFHS-5 and NFHS-6?

    1. Women’s Empowerment
      1. Internet Usage: Significant increase in women’s internet use.
      2. Spousal Violence: Women reporting spousal violence declined from 29.3% to 22.3%.
    2. Health Insurance
      1. Coverage Expansion: Increased from 33.7% to 88.2% of households in West Bengal.
      2. Largest State-Level Improvement: Andhra Pradesh increased from 21% to 63.6%.
    3. Nutrition Transition
      1. Overweight and Obesity: Share of women classified as overweight or obese increased in every State.

    What policy gaps emerge from the omission of key indicators?

    1. Mortality Monitoring Gap: Absence of infant and child mortality data weakens health assessment.
    2. Gender Monitoring Gap: Missing sex ratio at birth limits monitoring of gender discrimination.
    3. Nutrition Monitoring Gap: Lack of anaemia data affects evaluation of Anaemia Mukt Bharat.
    4. Environmental Health Gap: Missing sanitation and cooking fuel indicators weaken tracking of Swachh Bharat and clean energy transitions.
    5. Cancer Surveillance Gap: Absence of screening indicators limits preventive healthcare assessment.
    6. Evidence Gap: No alternative survey currently provides many of these indicators at NFHS scale.

    Conclusion

    NFHS-6 presents a mixed picture of India’s health transition. Improvements in maternal healthcare, institutional deliveries, health insurance coverage and digital inclusion indicate progress in human development outcomes. However, the omission of critical indicators such as anaemia, mortality and sex ratio at birth creates significant gaps in public health monitoring and long-term trend analysis. The challenge before policymakers is to balance methodological improvements with a continuity of data. This will ensure that India’s most important health survey remains both scientifically robust and policy relevant.

    PYQ Relevance

    [UPSC 2022] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.

    Linkage: Public healthcare delivery depends on robust health data for identifying gaps, targeting interventions and evaluating outcomes. NFHS-6 is a key instrument for evidence-based public health policymaking; therefore, the omission of indicators such as anaemia, mortality and sex ratio at birth may weaken assessment of healthcare outcomes and grassroots service delivery.

  • Pradhan Mantri Surakshit Matritva Abhiyaan (PMSMA)

    Why in the news?

    The Pradhan Mantri Surakshit Matritva Abhiyaan (PMSMA) completed 10 years on 9 June 2026. Since its launch in 2016, over 7.5 crore pregnant women have received antenatal care services under the scheme.

    About PMSMA

    • Launched: 9 June 2016
    • Ministry: Ministry of Health and Family Welfare
    • Objective:
      • Ensure safe pregnancy and childbirth.
      • Provide free and quality antenatal care (ANC).
      • Identify and manage high-risk pregnancies (HRPs).

    Beneficiaries

    • Pregnant women in Second trimester (13-27 weeks) and Third trimester (28 weeks till delivery)
    • Special focus on High-risk pregnancies and Women missing routine ANC services

    Key Features

    Monthly ANC Services

    • Conducted on the 9th of every month.
    • Available at designated government health facilities.

    Service Package

    • Clinical examination, Blood and urine tests, Ultrasonography, Free medicines, Nutrition counselling, Birth preparedness counselling, and Safe pregnancy awareness

    High-Risk Pregnancy (HRP) Identification

    What is a high-risk pregnancy?

    • Pregnancies with conditions that increase the risk of complications for the mother or baby.

    PMSMA Screens for 25 HRP Conditions

    • Important conditions include: Severe anaemia, HIV/AIDS, Syphilis, Gestational diabetes, Pregnancy-induced hypertension, Hypothyroidism, Tuberculosis, Malaria, Hepatitis B, Twin/multiple pregnancy, Previous Caesarean section, History of stillbirth, Teenage pregnancy, Advanced-age pregnancy, Negative blood group

    Follow-up Mechanism

    • HRPs linked to nearest: First Referral Unit (FRU)
    • Individual tracking till safe delivery.

    Extended PMSMA (2022)

    • Launched in January 2022.
    • Purpose: Strengthen follow-up care for high-risk pregnancies.

    Features

    • Additional ANC visits.
    • Continuous monitoring.
    • SMS reminders to: Beneficiary and ASHA worker
    • Financial incentives for pregnant women and Accredited Social Health Activist (ASHA)

    [2024] With reference to the ‘Pradhan Manti Surakshit Matritva Abhiyan’, consider the following statements:
    1. This scheme guarantees a minimum package of antenatal care services to women in their second and third trimesters of pregnancy and six months post-delivery health care service in any government health facility.
    2. Under this scheme, private sector health care providers of certain specialties can volunteer to provide service at nearby government health facilities.
    Which of the statements given above is/are correct ?

    [A] 1 only

    [B] 2 only

    [C] Both 1 and 2

    [D] Neither 1 nor 2

  • India’s Health Transformation

    Why in the news?

    India highlighted major achievements in healthcare over the past 12 years, focusing on universal health coverage, affordable healthcare, digital health, disease control, and healthcare infrastructure expansion.

    Key Highlights

    • Over 44 crore families are insured under Ayushman Bharat.
    • More than 1.86 lakh Ayushman Arogya Mandirs are operational.
    • Over: 47 crore telemedicine consultations delivered.
    • 12 new AIIMS have been operational since 2014.
    • Generic medicines available: 50–90% cheaper through Jan Aushadhi Kendras.
    • Maternal and child mortality have significantly reduced.
    • TB incidence and malaria deaths declined sharply.

    Ayushman Bharat Programme

    Ayushman Bharat is India’s flagship universal health coverage programme launched in 2018.

    Four Pillars

    1. AB-PMJAY
    2. Ayushman Arogya Mandirs
    3. PM-ABHIM
    4. Ayushman Bharat Digital Mission (ABDM)

    AB-PMJAY

    • Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
    • World’s largest publicly funded health insurance scheme.
    • Provides: ₹5 lakh annual insurance per family.
    • Covers: About 12 crore vulnerable families.
    • 44.14 crore Ayushman cards issued.
    • 12.03 crore hospitalisations covered.
    • Treatment worth: ₹1.80 lakh crore provided.
    • 36,218 hospitals empanelled.
    • Extends insurance coverage to: All citizens above 70 years.

    Ayushman Arogya Mandirs (AAMs)

    • Purpose: Community-level comprehensive primary healthcare centres.
    • Preventive healthcare, Diagnostics, Mental healthcare, Teleconsultation, Free medicines, and Emergency care.
    • 1.86 lakh+ centres operational.
    • Over 540 crore cumulative footfall.

    PM-ABHIM

    • Pradhan Mantri Ayushman Bharat Health Infrastructure Mission
    • Objective: Strengthen healthcare infrastructure and pandemic preparedness.
    • Integrated public health labs.
    • Critical care hospital blocks.
    • Urban and rural wellness centres.
    • Disease surveillance systems.
    • Outlay: ₹64,180 crore.

    Ayushman Bharat Digital Mission (ABDM)

    • Objective: Develop citizen-centric digital healthcare ecosystem.
    • ABHA: Ayushman Bharat Health Account.
    • 14-digit digital health ID.
    • Portable digital health records.
    • Paperless healthcare access.
    • Better health data integration.
    • 20.49 crore app registrations.
    • 27,328 healthcare facilities connected.

    National Health Mission (NHM)

    • National Rural Health Mission
    • National Urban Health Mission.
    • Pradhan Mantri Surakshit Matritva Abhiyan: Free antenatal care for pregnant women.
    • Janani Suraksha Yojana: Promotes institutional deliveries.
    • Janani Shishu Suraksha Karyakram: Free delivery and treatment for mothers and newborns.
    • Mission Indradhanush: Vaccinate partially immunised and unvaccinated children and pregnant women.
      • 5.46 crore children vaccinated.
      • 1.32 crore pregnant women covered.
      • WHO Recognition: India declared free from maternal and neonatal tetanus in 2015.

    U-WIN Platform

    • Purpose: Digital immunisation tracking platform.
    • 11.87 crore children registered.
    • 3.96 crore pregnant women registered.

    Tuberculosis Elimination

    • Programme: National Tuberculosis Elimination Programme
    • Pradhan Mantri TB Mukt Bharat Abhiyaan: Community participation for TB elimination.
    • Support System: Nikshay Mitras provide nutritional and social support.

    Malaria Elimination

    • National Framework for Malaria Elimination launched in 2016.
    • Goal: Eliminate malaria by 2027.
    • Other Disease Control Achievements Improvements in: HIV/AIDS, Kala-azar, Dengue, Japanese Encephalitis, Leprosy, and Lymphatic Filariasis.

    COVID-19 Response

    • 220 crore vaccine doses administered.
    • Testing labs expanded: From 14 to 3,400.
    • Oxygen-supported beds increased significantly.
    • Vaccine Maitri: Vaccines supplied to nearly 100 countries.

    Non-Communicable Diseases (NCDs)

    • Screenings Conducted Over: 60 crore cancer screenings.
    • Diseases Covered: Oral cancer, Breast cancer, Cervical cancer, Diabetes, Hypertension.

    Affordable Healthcare

    • Jan Aushadhi Kendras: Pradhan Mantri Bhartiya Janaushadhi Pariyojana
    • Benefits: Generic medicines available at 50–80% lower prices.

    AMRIT Pharmacies

    • Objective: Provide discounted life-saving medicines and implants.
    • Impact: ₹8,400 crore patient savings.

    Emergency Healthcare

    Ambulance Services

    • Dial 108: Medical emergencies.
    • Dial 102: Pregnant women and child transport.

    Digital Healthcare

    • eSanjeevani
    • 47 crore+ teleconsultations.
    • 2.34 lakh healthcare providers onboarded.

    Tele-MANAS

    • Purpose: Mental health tele-counselling service.
    • Coverage: Available in 20 languages across all States and UTs.
    • i-DRONE: Drone-based delivery of: Medicines, Vaccines, and Blood samples.
    • AI-enabled Clinical Decision Support Systems (CDSS).
    • “Cough Against TB” tool for TB screening.
    • MadhuNetrAI for diabetic retinopathy detection.

    Medical Education Expansion

    • Medical colleges more than doubled since 2014.
    • 157 new nursing colleges approved.
    • AYUSH Integration: Ministry of AYUSH established in 2014.
      • AYUSH facilities integrated with public health centres.
      • AYUSH Visa introduced in 2023.

    [2022] With reference to Ayushman Bharat Digital Mission, consider the following statements:
    1. Private and public hospitals must adopt it.
    2. As it aims to achieve universal health coverage, every citizen of India should be part of it ultimately.
    3. It has seamless portability across the country.
    .Which of the statements given above is/are correct?

    [A] 1 and 2 only

    [B] 3 only

    [C] 1 and 3 only

    [D] 1, 2 and 3

  • [6th June 2026] The Hindu OpED: India needs innovative stratergies to eliminate TB

    PYQ Relevance[UPSC 2022] What is the basic principle behind vaccine development? How do vaccines work? What approaches were adopted by the Indian vaccine manufacturers to produce COVID-19 vaccines?Linkage: The PYQ tests understanding of vaccine science, indigenous vaccine development, and the role of biotechnology in addressing public health challenges. The PreVenTB Trial evaluates indigenous vaccines (VPM1002 and Immuvac) for TB prevention, highlighting India’s growing capabilities in vaccine research and the use of biotechnology to combat infectious diseases.

    Mentor’s Comment

    India’s fight against tuberculosis (TB) has received a major boost with the publication of the ICMR-led PreVenTB Trial. The trial found that the indigenous vaccine candidates VPM1002 and Immuvac provide protection against both pulmonary TB and the difficult-to-diagnose extrapulmonary TB (EPTB). The findings are significant as they offer new evidence from a large real-world Indian population at a time when India continues to bear one of the world’s highest TB burdens. They also strengthen hopes for achieving TB elimination, even as TB remains the leading infectious disease killer globally. 

    Why has a “one-size-fits-all” vaccine approach failed in TB control?

    1. Diverse Disease Pathways: TB infection can remain latent for years, progress to subclinical disease, or develop into active pulmonary or extrapulmonary TB.
    2. Biological Complexity: Individuals differ in infection status, age, comorbidities, and immune responses.
    3. Vaccine Limitations: Previous TB vaccine development largely focused on preventing pulmonary TB.
    4. Unrealistic Expectations: Search for a single vaccine capable of preventing all forms of TB has repeatedly disappointed global TB control efforts.

    How severe is the TB burden and why does it demand urgent action?

    1. Global Mortality: TB continues to kill more people annually than any other infectious disease.
    2. Burden in LMICs: Incidence in many low- and middle-income countries remains between 200-300 cases per 100,000 population.
    3. Elimination Threshold: TB incidence must decline to 10-20 cases per 100,000 population to approach elimination.
    4. Indian Context: India carries one of the world’s highest TB burdens, requiring sustained public health investments.
    5. Long-Term Challenge: Elimination demands decades of coordinated interventions rather than a single technological solution.

    What are the key pillars of a layered TB elimination strategy?

    1. Better Detection
      1. Advanced Diagnostics: Enables identification of subclinical TB before progression to active disease.
      2. Risk-Based Screening: Supports early detection among vulnerable populations.
      3. Public Health Impact: Reduces transmission and disease progression.
    2. Preventive Therapy
      1. Latent TB Treatment: Prevents inactive infection from progressing to active disease.
      2. Targeted Intervention: Particularly relevant for household contacts and high-risk populations.
    3. Vaccination
      1. Critical Tool: Complements diagnostics and preventive therapy.
      2. Population Protection: Reduces progression from infection to disease.
      3. Integrated Strategy: Most effective when combined with nutrition and case management.

    What are the major findings of the PreVenTB Trial?

    1. Institution: Conducted by the Indian Council of Medical Research (ICMR).
    2. Scale: Conducted at multiple sites across India.
    3. Participants: More than 12,700 household contacts of TB patients.
    4. Target Group: Individuals aged six years and above, including those with comorbidities and varying infection status.
    5. Vaccines Evaluated: VPM1002 and Immuvac.
      1. Efficacy of VPM1002
        1. Extrapulmonary TB Protection: 50.4% efficacy against EPTB.
        2. Pulmonary TB Protection: 21.4% efficacy against pulmonary TB overall.
      2. Efficacy of Immuvac
        1. Overall Protection: 64.6% efficacy against all forms of TB.
        2. Children Protection: More than 60% efficacy among children aged 6–10 years.
        3. Progression Prevention: More than 60% efficacy against progression to disease among individuals with latent infection.

    Significance

    1. First-of-Its-Kind Evidence: Demonstrates efficacy against both pulmonary and extrapulmonary TB.
    2. Real-World Conditions: Large Phase III trial conducted in an Indian population.
    3. Broad Coverage: Includes multiple age groups and disease forms.

    Why is extrapulmonary TB an important policy concern?

    Extrapulmonary tuberculosis (TB) is an active Mycobacterium tuberculosis infection occurring in organs other than the lungs. It accounts for 15% to 40% of all TB cases and primarily affects lymph nodes, pleura, the spine, and the central nervous system.

    1. Hidden Burden: Harder to diagnose than pulmonary TB.
    2. Missed Cases: Frequently underreported and undetected.
    3. Higher Morbidity: Associated with severe complications and mortality.
    4. Clinical Impact: A reduction of over 50% in EPTB cases would significantly lower patient suffering and healthcare costs.
    5. Novel Evidence: Current findings provide rare vaccine efficacy data against EPTB.

    What opportunities do the findings create for children and adolescents?

    1. Strong Signal: Vaccine efficacy exceeded 60% among school-age children and adolescents.
    2. Policy Gap: India currently lacks a structured TB vaccination strategy beyond infancy.
    3. Booster Potential: Findings may support future booster-dose vaccination programmes.
    4. Disease Prevention: Offers protection before transition to adulthood, when disease burden increases.

    Why is nutrition emerging as a critical component of TB control?

    1. Low BMI Impact: Reduced vaccine efficacy observed among individuals with low Body Mass Index.
    2. Immune Function: Nutritional status influences vaccine effectiveness and disease resistance.
    3. Integrated Approach: Vaccination must be aligned with nutritional interventions.
    4. Policy Relevance: Supports strengthening nutrition-TB convergence programmes.

    What operational advantages does VPM1002 offer?

    1. Single-Dose Vaccine: Simplifies deployment.
    2. Modified BCG Platform: Uses an established vaccine platform.
    3. Manufacturing Ease: Can be produced at scale.
    4. Cost Effectiveness: Suitable for large population programmes.
    5. LMIC Relevance: Practical for resource-constrained settings.

    What lessons can India draw from previous vaccine decisions?

    1. TrueNat Example: Indigenous molecular test adopted by the National TB Elimination Programme before WHO qualification.
    2. COVID-19 Response: Covaxin received approval under a “clinical trial mode” during the pandemic to accelerate access while evidence accumulated.
    3. Rotavirus Vaccine: Indigenous vaccines were introduced despite early uncertainty and later demonstrated significant reductions in severe disease and child mortality.
    4. Policy Lesson: Timely deployment based on credible evidence can yield substantial public health gains.

    What should India’s future TB strategy look like?

    1. Targeted Vaccination: Deployment of VPM1002 and Immuvac among household contacts and high-risk groups.
    2. School-Based Vaccination: Focus on adolescents and school-going children.
    3. Preventive Therapy: Integration with latent TB treatment programmes.
    4. Nutritional Support: Strengthening nutrition interventions for vulnerable populations.
    5. Case-Based Management: Improved diagnosis and treatment adherence.
    6. Public Health Investment: Sustained funding and surveillance systems.
    7. Combination Approach: Multiple interventions rather than reliance on a single vaccine breakthrough.

    Conclusion

    The PreVenTB Trial offers a promising pathway for strengthening India’s TB elimination efforts through indigenous vaccines and targeted interventions. Achieving the goal of a TB-Mukt Bharat by 2025 and contributing to SDG 3’s target of ending the TB epidemic by 2030 will require a combination of vaccination, nutrition, early detection, and sustained public health action.

    Value Addition

    Tuberculosis (TB): Key Facts

    1. Causative Agent: Mycobacterium tuberculosis
    2. Transmission: Airborne droplets
    3. Types: Pulmonary TB and Extrapulmonary TB
    4. Latent TB: Infection without symptoms; can later progress to active disease
    5. SDG Target: End TB epidemic by 2030

    National TB Elimination Programme (NTEP)

    1. Formerly Revised National TB Control Programme (RNTCP)
    2. Based on National Strategic Plan for TB Elimination
    3. Uses molecular diagnostics and universal drug susceptibility testing
    4. Provides free diagnosis and treatment

    Major Government Initiatives

    1. Ni-kshay Portal: Facilitates digital tracking of TB patients.
    2. Ni-kshay Poshan Yojana: Provides nutritional support to TB patients.
    3. TB Mukt Bharat Abhiyan: Supports community participation in TB elimination.
    4. PM TB Mukt Bharat Abhiyan: Encourages adoption of TB patients through Ni-kshay Mitras.

  • Key Indicators Removed from NFHS-6 Factsheet

    Why in the news?

    Several indicators that were part of the National Family Health Survey-5 (NFHS-5) have been omitted from the newly released NFHS-6 factsheet. The government stated that the move was aimed at “data harmonisation”.

    What is NFHS?

    The National Family Health Survey (NFHS) is:

    • A large scale nationwide household survey.
    • Conducted to collect data on:
      • Health
      • Nutrition
      • Family welfare
      • Population trends.
    • Conducted by: International Institute for Population Sciences
    • Under: Ministry of Health and Family Welfare

    NFHS Timeline

    • First NFHS conducted in 1992-93.
    • NFHS-5 Conducted during 2019-21.
    • NFHS-6 Conducted during 2023-24.

    Major Changes in NFHS-6

    • NFHS-5 factsheet contained 131 key indicators.
    • NFHS-6 factsheet contains: 101 indicators.

    Indicators Removed

    Population Indicators

    • Sex ratio
    • Sex ratio at birth
    • Mortality rates
    • Birth and death registration data

    Women’s Health Indicators

    • Adolescent fertility rate
    • Contraceptive methods used
    • Family planning counselling
    • Information on contraceptive side effects
    • Out of pocket expenditure during delivery

    Child and Public Health Indicators

    • ORS and zinc treatment for diarrhoea
    • HIV awareness indicators
    • Waist to hip ratio data

    Cancer Screening Indicators

    Data related to screening for:

    • Cervical cancer
    • Breast cancer
    • Oral cancer
      was removed.

    Anaemia Data Excluded

    • Anaemia prevalence data was also excluded from NFHS-6.
    • Reason: Experts argued finger prick blood tests may overestimate anaemia prevalence.
    • Future anaemia estimates may come from: “Diet and Biomarker” survey by the National Institute of Nutrition.

    Government’s Explanation

    The Health Ministry stated that:

    • Several indicators are already covered under other surveys and schemes, such as:
      • Sample Registration System (SRS)
      • Swachh Bharat Mission reports
      • Ujjwala Yojana reports
      • ICMR cancer data systems.

    This was done to improve:

    • Data harmonisation
    • Avoid duplication across surveys.

    [2024] The total fertility rate in an economy is defined as:

    [A] the number of children born per 1000 people in the population in a year.

    [B] the number of children born to a couple in their lifetime in a given population.

    [C] the birth rate minus death rate.

    [D] the average number of live births a woman would have by the end of her child-bearing age.

  • Missing Data on Clean Cooking Fuel in NFHS-6

    Why in the news?

    The NFHS-6 factsheet released in 2026 omitted data on “households using clean cooking fuel”, an important indicator previously included in NFHS-5.

    Key Highlights

    • NFHS-6 showed: Households with electricity increased to: 98.3%.
    • However, data on: Access to clean cooking fuel was removed from the factsheet.

    About NFHS

    The National Family Health Survey (NFHS):

    • Is India’s largest household health survey.
    • Conducted by: International Institute for Population Sciences
    • Under: Ministry of Health and Family Welfare

    Clean Cooking Fuel in NFHS-5

    NFHS-5 (2019-21) reported:

    • Only 58.6% households had access to clean cooking fuel.
    • About 40.6% households still depended on Firewood, Dung cakes, and Biomass fuels.

    [2019] Consider the following:
    1. Carbon monoxide
    2. Methane
    3. Ozone
    4. Sulphur dioxide
    Which of the above are released into the atmosphere due to the burning of crop/biomass residue?

    [A] 1 and 2 only

    [B] 2, 3 and 4 only

    [C] 1 and 4 only

    [D] 1, 2, 3 and 4