Kurukshetra Magazine is a vital source of study material for the UPSC IAS exam. It is a monthly magazine that gives information about important government schemes and programmes in various sectors. Kurukshetra is an authentic source of information for the UPSC Exam. Here, we provide the Gist of Kurukshetra, exclusively for the IAS Exam.
Chapter 1: Ayushman Bharat: Achieving Universal Health Coverage
Significance of good health:
- Attaining the highest possible standard of health is a fundamental right of every human being.
- Healthy individuals form the foundation of a strong nation. A healthy population can provide the vital human resource for the country.
- WHO (2017) has highlighted that “Investments in health systems could prevent 97 million premature deaths by 2030”.
- Good health can help realize important Sustainable Development Goals. Sustainable Development Goal-3 envisages good health and well-being for all. Notably, SDG-2, SDG-6 and SDG-5 also address health indirectly.
- Ayushman Bharat has two major components namely:
- Health and Wellness Centres (HWCs): 1,50,000 Health and Wellness Centres (HWCs) would be created under Ayushman Bharat to provide Comprehensive Primary Health Care (CPHC) closer to the residence/vicinity of the people. These centres will also provide free essential drugs and diagnostic services. Emphasis would be laid on health promotion along with prevention of diseases by engaging and empowering the individuals/communities for choosing healthy behaviours and making changes that reduce the risk of developing chronic diseases and other morbidities.
- Pradhan Mantri Jan Arogya Yojana – It is the largest government-funded health assurance scheme in the world which aims at providing a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalisation to over 10.74 crore poor and vulnerable families. PM-JAY provides cashless access to healthcare services for the beneficiary at the point of service i.e. the hospitals. A total of 50 crore beneficiaries from the bottom 40 percent of the Indian population will benefit from the scheme.
Significance of Ayushman Bharat:
- It will allow for comprehensive coverage for catastrophic illnesses, reduce catastrophic out of pocket expenditure, improve access to hospitalisation/health care, reduce unmet needs, and converge various health insurance schemes across the different states of India.
- It will support the objectives of prevention, treatment, management and overall well-being of the population with special emphasis on the vulnerable and resource-poor segments. By facilitating economical access to health services, the nation can help in breaking the vicious cycle of morbidity and poverty, especially among the vulnerable resource-poor population groups.
- Ayushman Bharat will help achieve the target of Universal Health Coverage. It will help provide a comprehensive need-based healthcare service delivery system to all.
Universal health coverage:
- The concept of universal health coverage implies individuals and communities should receive the health services they need without any economic stress.
- According to the World Health Organization (2021), Universal Health Coverage includes the full spectrum of essential quality health services from health promotion to prevention, treatment, rehabilitation, and palliative care across the life span reducing morbidity and mortality by facilitating easy, economical and secure access to good quality health services to the masses.
- The Astana Declaration (2018) emphasizes Universal Health Coverage.
Chapter 2: Fighting Against COVID-19
Innovation and entrepreneurship in India:
- The last decade has witnessed tremendous growth in the Indian start-up and innovation ecosystem.
- In recent times, India has prioritised fostering innovation and encouraging technology development by engaging research and development institutes, academia, industries, start-ups and even individual innovators.
- By 2030, India aims to become one of the largest economies, by focusing on the innovation ecosystem in the country.
Significance of innovation and entrepreneurship:
- The rise of entrepreneurs and young minds across the country is inspiring more people to create new disruptive and innovative products, services and solutions which can pave a path for a sustainable future.
- New start-ups can create new avenues for employment generation in India and also contribute to the economic growth and development of India.
- Notably, the start-ups were able to provide solutions that have helped people in their fight against the pandemic and are also continuing to do so.
- Thermaissance – This company working with the mission to reduce healthcare-associated and community-acquired infections developed nanotechnology-based textiles that could successfully inactivate various viruses, bacteria and fungi.
- Perkant Tech Private Limited – The innovative Med-Tech solutions provider company has developed and designed a revolutionary patented medical product “Abhay Parimiti” that can detect many diseases with just a 20-second finger placement including Hypertension, Diabetes, COVID-19, COPD and many other respiratory and cardiac diseases. This loT enabled technology can bring healthcare accessibility to the fingertips of all and introduce affordability for mass adoption.
- For many reasons that go beyond the COVID-19 crisis, the ecosystem of start-ups is essential to the future of the nation.
Governmental measures being taken to promote innovation and entrepreneurship:
- With a vision to establish India as a global hub for start-ups on the world map, Atal Innovation Mission since its inception is working to become a powerhouse of innovation and entrepreneurship.
- Atal Innovation Mission has established a total of 68 Atal Incubation Centres. Spread across the length and breadth of the country, these business incubators are supporting start-ups by providing technological facilities and advice, initial growth funds, network and linkages, co-working spaces, lab facilities, mentoring, and advisory support. These incubators are fostering the next generation of innovators and entrepreneurs who will be influencers of tomorrow.
Chapter 3: Yoga for Good Health
Increasing popularity of yoga:
- The community of Yoga practitioners has grown manifold not just in India but around the world.
- Many countries have included Yoga in preventive and promotive health strategies.
Significance of Yoga:
- Yoga improves both physical and mental well-being. It constitutes a holistic approach to health and well-being.
- Yoga is a powerful way for people of all ages and incomes, whatever their gender or ethnicity, to prevent and control NCDs (non-communicable diseases), increase overall physical and mental health, and reduce individual and public health expenditure.
- Yoga has been also found to have a curative value. There are many documented examples of effective healing by Yoga. Yoga and relaxation have been successfully used to check high blood pressure and coronary artery disease. A study conducted by doctors of AIIMS in 2020 found that Yoga can reduce not just migraine but even lower the treatment costs of the disease.
- The relevance of Yoga has increased even more during the pandemic as it is known to boost immunity.
- Given that Yoga originated in ancient India, it has come to be recognised as India’s most effective soft power.
Initiatives taken to popularize Yoga:
- June 21 is being celebrated as International Yoga Day. International Yoga Day aims to raise awareness worldwide on the many benefits of practising Yoga.
- In 2021, the theme of International Yoga Day was “Yoga for Wellness”.
- AYUSH Ministry has been propagating Yoga as a comprehensive health intervention. The AYUSH Ministry has been coming up with innovative ways to propagate Yoga. The Union Minister of AYUSH, launched the ‘Yoga break’ App, a mobile app to enable professionals de-stress at the workplace.
Chapter 4: National Family Health Survey – 5
National Family Health Survey:
- The National Family Health Survey-5 (NFHS-5) provides data on a range of indicators pertaining to health and nutrition, among others, from over 6 lakh sample households.
- NFHS-5 fieldwork conducted over two phases was completed in January 2020 (Phase-1) and April 2021 (Phase-2). NFHS-5 findings were released in November 2021.
- The data is disaggregated to the level of districts to enable identification of areas where progress has been made as well as provide direction for future policy action.
- The Total Fertility Rate (TFR) has declined from 2.2 to 2.0 at the national level
- Across most states in the country, the Total Fertility Rate (TFR) has declined since NFHS-4. Replacement fertility levels have been achieved in 19 out of 22 States and UTs, with only Manipur (2.2), Meghalaya (2.9) and Bihar (3.0) having a TFR above replacement levels.
- Institutional births have increased substantially from 79 percent to 89 percent at all-India levels.
- The prevalence rate of contraceptives has also increased considerably in the majority of states/UTs.
- The full immunisation coverage among children between 12-23 months has improved substantially from 62 percent to 76 percent at the all-India level.
- NFHS-5 findings released in November 2021 highlight the improvement in the use of clean cooking fuel by Indian households attributable to the success of the Pradhan Mantri Ujjwala Yojana (PMUY) which provides LPG connections to the entire nation. This has had a noticeable impact on indoor pollution-induced illness and deaths.
- Globally, 3.8 million deaths every year can be attributed to household air pollution. Data from the Global Burden of Disease Study, 2019 published in the Lancet, suggests that 37 percent of 1.67 million deaths in India in 2019 due to air pollution were attributable to household air pollution.
- With respect to child nutrition indicators, the progress is mixed.
- Child nutrition indicators show a slight improvement at an all-India level as Stunting has declined from 38 percent to 36 per cent, wasting from 21 percent to 19 percent and underweight from 36 per cent to 32 percent at the all-India level.
- Anaemia among children and women continues to be a cause of concern. More than half of the children and women (including pregnant women) are anaemic.
- The NFHS-5 results have also highlighted some important public health concerns, including high blood glucose levels, hypertension, obesity and tobacco use. It is estimated that nearly a fourth of all men and women are overweight or obese (BMI > 25.0 kg/m2).
Chapter 5: Rural Healthcare Infrastructure
- The state of healthcare infrastructure differs between urban areas and rural areas.
- With more than 70 percent of India’s population living in rural areas, the importance of rural healthcare facilities cannot be emphasized enough.
Governmental efforts to strengthen rural health infrastructure:
- Healthcare facilities in rural areas under the National Rural Health Mission (as part of the National Health Mission) have been developed as a three-tier system —Sub-Centres, Primary Health Centres (PHC) and Community Health Centres (CHC).
- As part of Ayushman Bharat, the government is supporting the States for the transformation of Sub Health Centres and Primary Health Centres into 1.5 lakh Health and Wellness Centres across the country by December 2022 for the provision of Comprehensive Primary Health Care (CPHC) that includes preventive healthcare and health promotion at the community level with a continuum of care approach.
- Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) envisages increased investments in public health and other health reforms to provide better access to health in rural areas by:
- Strengthening of Health and Wellness Centres.
- Addition of new critical care-related beds at district-level hospitals.
- Integrating district public health laboratories in all districts.
- Mobile Medical Units (MMUs) and Tele-consultation services to improve access to healthcare, particularly in rural areas.
- Despite the continuing shortfall of medical staff in rural areas, the number of healthcare workers posted in rural areas has witnessed some improvement in recent years. Financial support is provided to States for providing hard area allowance, performance-based incentives, providing accommodation and transport facilities in rural and remote areas including tribal areas.
- One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist — ASHA (Accredited Social Health Activist). The ASHA worker acts as the interface between the community and the public health system in rural India and is empowered with knowledge and a drug kit to deliver first-contact healthcare. The total number of ASHAs under the National Health Mission (NHM) stands at 10.7 lakh.
Chapter 6: Maternal and Child Health
Significance of maternal nutrition and health:
- Maternal malnutrition has been linked to an increased risk of maternal morbidity, premature birth, and newborns that are too small for their gestational age.
- Poor maternal nutrition during and throughout pregnancy is a major public health concern and has negative repercussions for both women and their children.
Status of maternal health in India:
- 24 percent of mothers in South Asia have a low BMI.
- Anaemia affects 30 percent of reproductive-age women and 37 percent of pregnant women.
- In 10 Indian states only approximately half of the pregnant women are getting enough protein and calories. As per available data, most pregnant women’s iron, vitamin A and C, and folic acid consumption were less than half of what was advised.
Causes of poor maternal nutrition:
Schemes for maternal health:
- POSHAN Abhiyaan — India’s flagship National Nutrition Mission — aims to enhance maternal nutrition by employing technology, behaviour change communication, community engagement, and cross-sectoral convergence, take-home rations and hot cooked meals for pregnant and lactating women, micronutrient supplements, food fortification, and delivery of subsidized staples through the Public Distribution System, cash transfers, nutrition-sensitive agriculture, diet education and counseling.
- Ministry of Women and Child Development’s Integrated Child Development Services (ICDS) programme envisages providing micronutrient-fortified supplementary food and/or energy-dense take-home meals for pregnant women and mothers who are breast-feeding. It also provides micronutrient supplements, deworming tablets, weight gain, monitoring, and nutrition advice to pregnant women as part of antenatal care.
- Pradhan Mantri Matru Vandana Yojana (PMMVY): As a part of the National Food Security Act of 2013, the Maternity Benefit Program envisages providing eligible beneficiaries conditional cash incentives.
- Janani Suraksha Yojana (JSY): The National Rural Health Mission’s Janani Suraksha Yojana (JSY) is a safe motherhood intervention, lowering maternal and infant mortality by encouraging pregnant women to give birth in a hospital.
- Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) has the goal of eliminating out-of-pocket payments for pregnant women and unwell newborns seeking treatment at a public health facility. While prenatal care is commonly provided to pregnant women, PMSMA requires specialists, radiologists, and physicians to provide particular antenatal services at government health institutions.
Child health in India:
- India has one of the highest numbers of malnourished children in the world.
- As per NFHS-5 findings, only 11 percent of children aged 6 to 23 months had an adequate dietary intake.
- Overall, 67 percent of children in the age group of 6 to 59 months and 57 percent of adolescents (15-19 years) were anaemic (NFHS, 2021). The increase in the percentage of children suffering from anaemia – from 59 percent in NFHS-4 to 67 percent in NFHS-5 – is even more concerning.
- The percentage of stunted, wasted, underweight, and anaemic children in India is 36 percent, 19 percent, 32 percent, and 67 percent, respectively.
- India can consider the following measures to improve the nutrition and wellbeing of mothers and children.
- ‘Jan Andolan’ for nutritional and health awareness.
- Home-based newborn care program, ideas to promote exclusive breastfeeding for 6 months, maximize deworming and immunization, reduce consumption of unhealthy ultra-processed foods high in fats, sugars and salt.
- Using financial levers for maximum impact: Enable access to healthy and sustainably-produced foods to all sections of society through the alignment of subsidies, taxes, incentives and reviewing policies targeting food environments, food procurement, and public.
- Push for agricultural policies emphasizing quality, nutritious and sustainable food production practices rather than concentrating only on producing greater quantities of food.
- Improve Education, Research and their Dissemination.
- Establish an evidence base of systemic drivers and actions, including indigenous and traditional approaches to health and wellbeing.
Chapter 7: Progressing Nation through Make in India
- India’s economy needs a strong manufacturing push as the nation’s dominant services sector is combating the aftershocks of pandemic waves. Notably, growth in manufacturing has not been to expected levels despite the availability of cheap labour and other resources.
Major government initiatives:
Make in India initiative:
- The Make in India initiative is designed to facilitate investment and foster innovation while boosting skill development that would finally help build one of the world’s best manufacturing infrastructure in India.
- The focus of the Make in India programme encompasses 25 sectors including automobiles, automobile components, aviation, biotechnology, chemicals, construction, defence manufacturing, electrical machinery, electronic systems, food processing, IT & BPM, leather, media and entertainment, mining, oil and gas, pharmaceuticals, ports and shipping, railways, renewable energy, roads and highways, space, textile and garments, thermal power, tourism and hospitality and wellness.
Production Linked incentive scheme:
- A keystone of Make in India is the Production Linked Incentive (PLI) scheme. In the Union Budget 2021-22, an outlay of Rs 1.97 lakh crore for the PLI Schemes for 13 key sectors was announced, to create national manufacturing champions and generate employment opportunities for the country’s youth aim to improve India’s rank on the Ease of Doing Business index by eliminating unnecessary laws and regulations, making bureaucratic processes easier, and making the government more transparent, responsive and accountable.
Significance of the initiatives:
Potential of India:
- India has a massive domestic market with an increasing purchasing power, the largest pool of workers across diverse skill categories, and its industrial ecosystem is maturing which makes it a viable option for investment and growth, and make India a manufacturing hub.
- India is now 4th amongst the world’s most attractive investment destinations.
- India has emerged as the fastest growing economy globally.
- India is forecast to grow at 10.1 percent in 2022, becoming the fastest-growing major economy in the world.
Major Sectoral Success Stories:
- The manufacturing sector is expected to reach USD 1 trillion by 2025 and contribute about 25 percent to India’s GDP. As per the World Bank, manufacturing contributed about 16 percent to the country’s GDP in 2016.
- Global car majors have been ramping up investments in India to cater to growing domestic demand. These manufacturers plan to leverage India’s competitive advantage to set up export-oriented production hubs. The Indian automotive industry is the fifth largest in the world and is slated to be the third largest by 2030.
- Indian retail industry has emerged as one of the most dynamic and fast-paced industries due to the entry of several new players. It accounts for over 10 percent of the country’s gross domestic product (GDP) and around eight percent of the employment.
- India is the largest provider of generic drugs globally. Indian pharmaceutical sector supplies over 50 percent of global demand for various vaccines, 40 percent of generic demand in the US and 25 percent of all medicine in the UK.
- Globally, India ranks 3rd in terms of pharmaceutical production by volume and 14th by value. The domestic pharmaceutical industry includes a network of 3,000 drug companies and 10,500 manufacturing units.
- In the global pharmaceuticals sector, India is a significant and rising player.
Chapter 8: e-Health Services and Technology Interventions
- E-Health can be described as the delivery of healthcare services using electronic information and communication technologies.
- It consists of different electronic health data exchange such as:
- Some major trends in digital health in the post COVID-19 world are:
- Smartphones are being used to effectively operate digital technology to support healthcare facilities, address the growing health concerns and support the use of m-health services.
- Big data is providing a lower rate of medication errors.
- Virtual Reality: Virtual Reality has already started making its mark in the digital health world by providing support in treating anxiety and post-traumatic stress among others.
- Wearables: Wearables like fitness bands, sugar monitors, etc, are playing an important role in making patients aware of the likelihood of a health emergency by providing up to date monitoring of high-risk patients.
- Artificial Intelligence: The power of artificial intelligence can be seen in areas such as precision medicine, medical imaging, drug discovery and genomics.
- Block chain: Block chain technology has already been deployed to create digital versions of medical charts.
Significance of e-health:
- Efficiency: It will help save time and accurately diagnose and treat diseases.
- Reduction in cost: More efficient treatments lead to reduction in cost.
- Empowerment: e-Health services enable both the consumers and healthcare providers to feel more empowered by making available the knowledge base of medical data and health records over the Internet.
- Equity: e-Health is a great concept for reducing the gap between the haves and the have nots. It enables equitable healthcare access irrespective of age, race, gender, ethnicity, geography, etc. Digital health also enables access to better healthcare facilities to remote locations.
- Education: e-Health services are beneficial for educating healthcare professionals of any medical advancements. It would also be beneficial for consumers to educate themselves about personalized preventive healthcare.
- Faster decision making: With the advent of decision-making software and increased automation, decision making in medical situations have become much faster and more efficient.
- Ministry of Health and Family Welfare has undertaken several measures to promote e-healthcare.
- Establishing the National eHealth Authority (NeHA) to serve as a promotional, regulatory and standards-setting organization in the health sector. NeHA has a goal to ensure development and promotion of eHealth ecosystem in India and enable the organization, management and provision of effective people-centred health services to all in an efficient, cost-effective and transparent manner.
- National Health Policy, 2017 aims to deploy digital tools to improve the efficiency and outcome of the healthcare system in India.
- A Hospital Information System is being implemented for computerized registration and capturing of patients.
- The Health Ministry has implemented a framework for the National Health Stack (NHS) that has recommended a National Digital Health Blueprint.
- To facilitate greater adoption of telemedicine, the government has undertaken the implementation of the National Telemedicine Network (NTN) that provides telemedicine services to the country’s most remote areas by upgrading existing government healthcare facilities in all states. eSanjeevani portal, a doctor-to-patient telemedicine system under Ayushman Bharat Scheme has been launched.
- The National Health Portal (NHP) is perhaps the most popular such undertaking that aims to improve health literacy, improve access to health services, decrease burden of diseases through awareness and serve as a single point of access for consolidated healthcare-related information for Indian citizens.