IASbaba YK Gist July 2017

Yojana and Kurukshetra- July 2017
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Preface
This is our 28th edition of Yojana Gist and 19th edition of Kurukshetra Gist, released for the
month of July, 2017. It is increasingly finding a place in the questions of both UPSC Prelims
and Mains and therefore, weve come up with this initiative to equip you with knowledge
thatll help you in your preparation for the CSE.
Every Issue deals with a single topic comprehensively sharing views from a wide spectrum
ranging from academicians to policy makers to scholars. The magazine is essential to build
an in-depth understanding of various socio-economic issues.
From the exam point of view, however, not all articles are important. Some go into scholarly
depths and others discuss agendas that are not relevant for your preparation. Added to this
is the difficulty of going through a large volume of information, facts and analysis to finally
extract their essence that may be useful for the exam.
We are not discouraging from reading the magazine itself. So, do not take this as a
document which you take read, remember and reproduce in the examination. Its only
purpose is to equip you with the right understanding. But, if you do not have enough time to
go through the magazines, you can rely on the content provided here for it sums up the
most essential points from all the articles.
You need not put hours and hours in reading and making its notes in pages. We believe, a
smart study, rather than hard study, can improve your preparation levels.
Think, learn, practice and keep improving! That is the key to success
Indias Health Sector policies- OVERVIEW
Indias rural health sector is usually known for its inadequate infrastructure and inefficient
service delivery. However, more and more efforts are being made to improve the health
scenario of Indians through various schemes and policies
Universal
Immunisation
Programme
Increase in Public National Health

Health Policy
Expenditure
National AYUSH Mental Health

Mission Policy
Swachh Bharat
Mission
Also recently, WHO and UNICEF acknowledged India for
Maternal and Neonatal Elimination (MNTE) Yaws- free
Maternal and neonatal tetanus (MNT) Yaws is a tropical

have been among the most common infection of the skin,
life threatening consequences of bones and joints caused
unclean deliveries and umbilical cord by bacteria.
care practices, and are indicators of Yaws is spread by direct
inequity in access to immunization contact with the fluid
and other maternal, newborn, and from a lesion of an
child health services. infected person and is
Aims to reduce MNT cases to such low usually of a non-sexual
levels that the disease is no longer a nature.
major public health problem. The disease is most
Unline polio and small pox, tetanus common among children,
cannot be eradicated but can be who spread it by playing
eliminated. together.
It is significant because India is the first country in the world to be declared Yaws-free in
2016 much ahead of WHO global target of 2020.
Similarly, India was validated for MNTE in Aril 2015, ahead of target of December 2015.
National Health Initiatives of India
In brief
Year Name Aim / Target

1943 Joseph Bhor committee One bed for every 550 people.
One doctor for every 4600 people in
every district.
1946 Government resolution One PHC for every 40000 people.
One CHC of 30 beds for every 5 PHCs.
One District Hospital with 200 beds in
every district.
1978 India adopts Alma Ata Providing comprehensive primary health
Declaration care to all its people.
1983 First National Health Emphasis on primary health care.
Policy Integrated vertical approach for disease
control programmes.
2002 National Health Policy Reiterated early policy recommendation.
Advocated increased public expenditure
to 2% of GDP.
2005 National Health Mission Designed on principles of
decentralisation and community
engagement.
Focus on revitalising primary care.
2017 National Health Policy Raise public health expenditure to 2.5% of
GDP.
Create patient centric institutions.
Prevention of diseases and promotion of
good health.
Emphasis on digital initiatives.
National Health Mission
NHM is Indias flagship health sector programme. It sought to revitalise rural and urban
health sectors by providing flexible finances to state governments. It comprises of 4
components:
National
Rural
Health
Mission
Human
Resources National
for Health NATIONA Urban
and L HEALTH Health
Medical MISSION Mission
Education
Tertiary
Care
Programm
es
Salient features of NHM
Reproductive and Child Health services were primary focus of NHM. The
introduction of JSY and ASHA programmes had significant impact on behavioural
changes in women and their families.
o ASHA workers acted as mobilisers for institutional deliveries.
o ASHA workers focused on integrated management of neonatal and
childhood illness.
o Ambulance services introduced for transportation of maternity cases to
public health institutions and for emergence care.
NHM represents Indias endeavour to expand focus of health services beyond
Reproductive and Child Health so as to address the double burden of
o Communicable diseases
o Non- Communicable diseases

It brought together at National Level the two departments of Health and Family
Welfare where the integration resulted in significant synergy in program
implementation and enhancement of health sector allocations.
It brought in considerable innovations in health sector such as
o Flexible financing
o Capacity building by induction of management specialists
o Simplified HR management practices
o Establishment of National Health Systems Resource Centre
Empowered people through Village Health and Sanitation Committees to formulate
village plans and exercise supervisory oversight of ASHA workers.
At PHC and CHC level, Rogi Kalyan Samitis are activated to establish systems of
oversight over public health facilities to create patient friendly institutions.
Some new government schemes
Mission Diphtheria
Indradhanush
Whooping cough
Tetanus
(Total=11)
Poliomyelitis
Tuberculosis
Measles
Hepatitis B
Rubella (Added in 2016)
Japanese Encephalitis (Added in 2016)
Injectable Polio Vaccine Bivalent (Added in 2016)
Rotavirus (Added in 2016)
Universal Tuberculosis
Immunisation Diphtheria
Programme
Pertussis (whooping cough)
Tetanus
(Total=12)
Poliomyelitis
Measles
Hepatitis B
Diarrhoea
Japanese Encephalitis
Rubella
Pneumonia( Heamophilus Influenza Type B)
Pneumococcal diseases (Pneumococcal Pneumonia and Meningitis) Added in 2017
India New Born Action Plan

Focus on reduction of neonatal mortality rate.
Successfully established Special New Born Care Units at District Level and New Born
Stabilization Units at CHC level.
Mothers Absolute Affection Programme

Launched in 2016 with focus on breastfeeding practices.
Rasthtriya Bal Suraksha Karyakram and Rashtriya Kishore Swasthya Karyakram

For early screenings and interventions in children and adolescent girls.
PM Surakshit Matritva Abhiyan

For assured antenatal care
Other programmes are

Swachh Swasthya Sarvatra
PM National Dialysis Programme
Kayakalp- inculcate practice of sanitation, health, hygiene, effective waste
management and infection control in public health facilities.
National Health Policy 2017
Primary aim is to strengthen and prioritise the role of government in shaping health
systems, make additional investments in health, healthcare services, prevention of diseases
and promotion of good health.
The key targets are:-

Improve life expectance at birth from 67.5 to 70 years by 2025.
Reduce IMR to 28 by 2019.
Reduce under 5 mortality rate to 23 by 2025.
Reduce total fertility rate (TFR) to 2.1 by 2025.
Elimination of leprosy, kala-azar and filariasis by 2017-18
NHP lists infrastructure and human resource development in primary and secondary care
hospitals as key priority areas.
It also seeks to reform medical education. The unique status of AIIMSs has been reinforced
by significant infusion of financial resources for major expansion. 5000 post graduate seats
per annum have been created to ensure adequate availability of specialists.
Along with it, the Medical Council of India Amendment Act 2016 introduced a centralised
entrance exam. These all represent major steps to reform medical education in country.
NHP has also placed lot of emphasis on Digital Initiatives

Online registration system has been introduced in 71 hospitals in India as part of
Digital India initiative.
Digitisation of public hospitals has enabled a reduction of patient wait times and
freed clinician times.
A patient centric feedback system called Mera Aspataal has been introduced which
has flagged the important areas of patient dissatisfaction.
Conclusion
Thus, significant strides are envisaged to be made in health sector through the National
Health Policy interventions which will enable India to achieve the objectives of Affordable
health care for all.
Maternal and Child Healthcare in Rural India
The public health challenges are enormous in India where highest number of maternal and
infant deaths worldwide account for one-fifth of all global maternal mortalities.
Large inequalities exist in maternal and infant health status across Indian states, including
significant gaps between wealthy and deprived groups and rural urban differentials.
MMR= number of maternal deaths in a given period per 100000 live births.
Indias MMR for 2011-13= 167
IMR= number of infant deaths in a given period per 1000 live birth.
Indias IMR for 2013= 40
Those children who survive are often afflicted with multiple morbidities like diarrhoea,
pneumonia etc.
About 3 million young lives are lost due to malnutrition and additional 165 million children
remained stunted.
Similarly, large proportion of reproductive women are suffering from poor nutritional
status- anaemia and low BMI- that results in poor maternal and birth outcomes.
Maternal factors have a significant bearing on the child health beyond pregnancy. It is
therefore prudent to consider mother and child as a single unit rather than
compartmentalising them.
Determinants of maternal and child health care
Maternal and child health is a health issue affected by broader context of peoples lives
including their
economic circumstances
education
employment
living conditions
family environment
social and gender relationships
Traditional and legal structures within which they may live.
The biggest burden of maternal and infant mortality falls on marginalised communities, and
poor and rural populations. The health behaviour of population is governed by myriad
complex of biological, cultural and psychosocial factors. Therefore the attainment of
maternal and child health is not limited to interventions by health sector alone, rather
interventions of other sectors will also play an important role.
There are three domains of delivering health services

1. Facility based care- consists of clinically based services, delivered at the individual
level that includes treatment of diseases and also availability of skilled attendants at
delivery and emergency care.
2. Outreach- services that can be delivered on a periodic basis through visits within the
community, for eg. Immunisation process.
3. Home and community- consists of community and family oriented services that
support self-care and includes activities for health promotion and behavioural
changes such as breastfeeding.
Programmes and initiatives
Janani Surakhsha launched in April 2005 under NRHM

Give financial assistance to women who avail delivery services at public health facilities.
Yojana NFHS 4- instituional births increased to 78.9%. Reduction in perinatal and neonatal deaths
Janani Shishu A new approach towards 'Healthcare for All'- government will borne all expenses for delivery and no
user fee to be charged.
Suraksha A pregnant mother entitled to free transport from home to govt. facilities and between facilities
when referred.
The scheme also includes free drugs and consumables, free diagnostics, free blood and free diet
Karyakram during max 3 day's duration in hospital.
Launched in 2016. Gives a fixed day ANC service every month acros country.
PM Surakshit Envisaegd to improve quality and coverage of ANC, diagnostics and counselling services as part of
RMNCH+A services.
Matritva Abhiyan it also gives assistance in detection, referral, treatmetn and follow-up of high risk pregnancies and
women having complications.
Village Health and Organised every month at Anganwadi centre in the village.
Services provided under VHND include registration of pregnant women, provide antenatal care to
registered women, immunisation, identification and tracking of malnourished children, adminsiter
Nutrition Day vitamin A, give anti-TB drugs to TB patients, calcium tablets, condoms etc.
Conditional Cash Launched in Jan 2017- providing cash incentive of Rs. 6000 to preganant and lactating women.
It will be directly deposited to bank/post office account of beneficiaries.
Transfer Scheme
Challenges
The barriers of the programmes can be divided into three categories
1. Barriers to availability
Includes availability of critical components required to deliver the health services such as
infrastructure, human resources and financial resources to run the programme.
Health facilities should be established as per the population norms and should be well
equipped with trained health care providers and equipment as per IPHS standards.
2. Barriers to Accessibility
Accessibility means physical access of health services to the clients.
There are many financial and non-financial barriers which are responsible for delay or
prevent people in rural areas from seeking healthcare for mothers and their sick children.
Such barriers include financial barriers, geographical distance, language, socio-cultural,
ethnicity related barriers, lack of knowledge and awareness.
3. Barriers to utilisation
It is the use of multi-contact services, eg. First ante-natal contact or BCG immunisation.
Cost of care, distance from health facilities and poor quality of care, poor upkeep of
facilities, non-functional equipment are the major reasons why people do not seek care
from public health facilities.
Thus, the empowerment of women is an essential element of health. Educational

opportunities for girls and women powerfully affect their status and the control they have
over their own lives and their health and fertility.
Adolescent health care- in brief
Adolescence is characterised by transformation from being cared by someone to taking

care of someone. It is a transitional phase between child hood and adulthood.
There are a number of cognitive, emotional, physical, behavioural, intellectual and
attitudinal changes as well as changes in social roles, relationships and expectations.
Adolescents represent a huge opportunity that can transform the social and economic
fortunes of India. However, this demographic dividend is yet to be fully realised.
In order to enable adolescents to fulfil their potential, there is a need to make substantive
investments in their education, health, mental development and social environment.
This requires designing of programmes which recognise the special needs of adolescents
and address the specific problems related to their age in a supporting and non-judgemental
manner.
There is a need to achieve following objectives for the young generation

1. Increase availability and easing access to correct information about adolescent
health issues.
2. Increase accessibility and utilisation of quality health services including counselling
directed at adolescent health problems.
3. Forge multi-sectoral partnerships to create safe and supportive environments for
adolescents.
Content of adolescent health programmes should include
Tackling dual probelms of undernutrition and obesity

amongst adolescents.
Make youth aware of right nutrition choices to facilitate
physical growth, cognitive development, improved work
Nutrition performance and concentration.
Schemes such as SABLA, Iron Plus to increase nutritive
value in the adolescents
One of the most crucial information to be imparted to

Sexual and adolescents through discussions, attitude, behaviour and
practice building exercise.
Though menstrual cycle is physilogical every woman has
Reproductive to pass through, the stigma and cultural norms
associated to it have led to generations of women
Health suffering from ill health, discomfort, lack of hygiene and

even personal risk.
Increasing competition in school, sports and everyday

life to put mental pressure on adolescents which neither
Mental they are aware of neither prepared to handle.

Sometimes children adopt harmful measures to cope up
with pressure.
Health Thus, friendly advice should be available throguh schools

and nearby health centres.
Substance Adolescence marks experimenting of surroundings,

habits and choices.
Young people want to make more friends and be socially
Misuse acceptable which at times leads to wrong choices in

making friends and developing habits thereby like eating
tobacco, cigarattes, alcohol.
prevention
Lifestyle or There is a need for positive behavioural intervention to

mitigate emergence of risk factors that lead to non-
communicable diseases.
Non- The root cause of such is adoption of faulty lifestyle like
consumption of alcohol, tobacco, poor dietary habits,
Communicable sedentry lifestyle and stress.
diseases
Provision of correct knowledge is key for health

promotion among all age groups.
It is not about questions and answer session but
interactive sessions to understand the problems.
Counselling Counselling is important for adolescents to develop a
better understanding of change happening around them
and make positive changes in their lives wrt these
changes.
Special adolescent friendly clinics should be oriented and

better equipped to meet their health needs.
Govt has established ARSH- Adolescent Reproductive
Clinics and Sexual Health clinics for addressing the reproductive

health.
These clinics should be linked to community for
generating demand and mobilising adolescents to avail
services.
They should be the center of any adolescent health care

programme.
Schools can serve as platform to educate and counsel
Schools adolescents on behaviour risk modification.

Participatory, process-oriented teaching-learning
approaches should be utilised to engage adolescents.
Water, Sanitation and Hygiene (WASH):

Interlinkages in Rural India
WASH is one of the primary drivers of public health and if we can secure access to clean
water and to adequate sanitation facilities for all people, a huge battle against all kinds of
diseases will be won.
Access to clean water, sanitation and hygiene are essential elements in achieving a basic
standard of health.
Interventions in form of improved water supply, sanitation and hygiene can significantly
improve the health outcomes like reductions in severity and prevalence of diarrhoea and
other infectious diseases.
Improvement in WASH services has a long way to go across the globe, improper WASH
services lead to second leading cause of death that is diarrhoeal disease in children under 5
year old (WHO 2017).
India has a mortality rate of 27.4 per lakh associated with WASH services. It also requires a
significant improvement to better the WASH services as it is in the top 25% of the countries
with maximum mortality rate due to unsafe WASH services.
Water- pollution and wastefulness

Only 18% of the rural households (restricted to few states only) receive treated water
supply. There is huge inter-state variation in services such. For example, in Bihar, Assam,
Jharkhand, WB and Odisha, the % of rural households getting treated tap water within the
premises are 2%, 4%, 5%, 6% and 6% respectively. These are all eastern states where the
rural population is largely dependent on ground water for drinking purposes.
In a typical rural region in India, irrigation water requirement is the major demand followed
by drinking water requirements. The irrigation efficiency is low- 50-60%, leading to wasteful
use of water and in addition due to excess fertiliser use, which gets drained into run-off,
there is large scale pollution of water resources.
Also, a rural community may not be necessarily completely isolated from the urban regions,
as rural regions receive untreated wastewater flows from nearby cities, thereby further
polluting the water sources.
Due to unavailability of sewage treatment in rural setup and large scale open defecation,
several freshwater ponds have turned into sewage ponds.
Sanitation- Open defecation

Open defecation is a major cause of fatal diarrhoea. Everyday about 2000 children aged less
than five succumb to diarrhoea and every 40 seconds a life is lost.
UNICEF- India accounts for 90% of the people in South Asia and 59% of 1.1 billion people in
the world who practice open defecation.
WHO + UNICEF- around 400 million people in India practice open defecation despite having
latrines available.
Hygiene- Behavioural change is the key

To change behaviour, mapping the village defecation area, toilets, water & food
sources and finding the target areas and audience.
Behaviour can be changed by doing focussed group discussions, showing audio-
visuals, community meetings etc.
Associating shame and disgust with open defecation and pride with clean toilets.
Mechanisms such as awarding/recognising households with toilets.
Other measures
Every schools can be mandated to build separate toilets for girls.
By utilising public spaces, construction of atleast one community toilet complex per
village is suggested.
Regular cleaning of individual and community toilets is necessary for maintaining
hygiene status.
Training of district level expert team and community led total sanitation (CLTS)
facilitators can be done.
Monitoring and evaluation by such teams can prepare report of the type of toilets
present and functioning at individual and community level.
Some flagship missions to improve WASH and health services in rural India are
National Rural Drinking

National Rural Drinking National Rural Health
Water Quality Monitoring
Water Programme- 2009 Mission-
Surveillance Prog- 2005
To provide every rural To set up fully functional To ensure good quality of
person with adequate community owned, public water supply to
safe drinking water, decentralsied health care rural people through
cooking and other delivery system with decentralised water
domestic basic needs on focus on determinants of quality monitoring
sustainable basis. health-water, education, systems.
sanitation, nutrition.
Swachh Bharat National Rurban

Jalmani- 2008
Mission- 2014 Mission-2015
To supplement To improve geenral To provide basic
NRDWP to ensure quality of life in the amenities like piped
good quality safe rural areas, by water supply, solid
drinking water by promoting and liquid waste
installing stand cleanliness, management and
alone purification hygeiene and drains in rurban
systems, esp. in eliminating open clusters.
schools. defecation.
UN SDGs recognise WASH and health as important areas to be targeted.

Goal 6- Ensure availability and sustainable management of water and sanitation for all
It talks about achieving universal and equitable access to safe and affordable drinking water
for all, reduced pollution, increasing water use efficiency, source protection and
participation of local communities in improving water and sanitation management.
Conclusion
At national level linking programmes such as NBA, SSA, MGNREGA, DWSS, NRHM etc. which
are working in isolation but for similar cause is important.
Telemedicine
It is the remote diagnosis and treatment of patients by means of telecommunications

technology.
Background
In 1925, Dr. Hugo Gernsback had the first idea of a spindly robot fingers and radio
technology to examine the patient from a far and showing a video feed of the
patient to doctor.
It was called teledactly and over next few decades, the world formalised the name
telemedicine.
NASA played an important part in kicking off the first commercial wave of
telemedicine.
Today, telemedicine is not only about getting a video feed of remote patient but also about
apps which are installed on smart phones, tablets, desktops, kiosks and offer multi-
dimensional support in terms of organising a remote connectivity between doctor and
patient using a video feed.
Whereas the entire primitive telemedicine infrastructure used to be simple technology

protocols such as Bluetooth and Wi-Fi, but for the future, in terms of scale and accessibility,
IOT is the key.
Internet of Things-
is the inter-networking of physical devices, vehicles (connected devices), buildings, and
other items embedded with electronics, software, sensors, actuators and network
connectivity which enable these objects to collect and exchange data.
Today, there are many companies which offer different forms of telemedicine platforms
Remote consulting which enables you to connect to a doctor through smart phone
or webpage.
Remote monitoring which enables doctors to keep a regular check on the body of
remote patient using connected devices and get real time access to his medical data.
Health kiosks/PHCs where there is a small set up with or without the physical
presence of doctor which could be run by para-medics and perform basic tasks like
knowing basic health parameters of a person like blood pressure, blood glucose etc.,
and facilitate video consultation with doctor on demand.
Strengthening the rural health care

A telemedicine platform offers the rural people a very easy alternative for medical diagnosis
instead of traveling several kilometres to get access to even nearest primary healthcare
services.
Although referrals/advance diagnosis requires more than this, but this is the most efficient
way to build an effective first response system.
Challenges
The most critical challenge is to provide the service on time.
Only government initiatives will not be sufficient and private sector involvement is
necessary to reach the wide scale and build sufficient infrastructure.
Way forward
The official Telecom Subscription Data by TRAI shows that rural India has close to 500
million wireless telephone subscribers and is growing at 1.05% per month.
Most of the international mobility forums have reported that India possesses one of the
worlds largest smartphone internet user bases. This proves that cell/data network has
reached to the farthest corner of the nation. Thus, increasing penetration of smartphone
network would simplify the access and use of telemedicine.
Parallel to it, constant innovation should happen in iOT ecosystem where the devices are
being developed to consume low power and higher efficiency of connectivity to provide
network directly. This would help ensure seamless connectivity of PHCs to nodal centres
offering smoother functioning.
Social Security Freedom from Want
Objective of Social Security: To provide sustenance to those who cannot work and earn
their living due to temporary or chronic reasons
Article 22 of the Universal Declaration of Human Rights: Right to Social Security

Everyone, as a member of society, has the right to social security and is entitled to
realization, through national effort and international co-operation and in accordance
with the organization and resources of each State, of the economic, social and
cultural rights indispensable for his dignity and the free development of his
personality.
Article 23 of the Universal Declaration of Human Rights: Right to Work

Everyone has the right to work, to free choice of employment, to just and favourable
conditions of work and to protection against unemployment.
Everyone, without any discrimination, has the right to equal pay for equal work.
Everyone who works has the right to just and favourable remuneration ensuring for
himself and his family an existence worthy of human dignity, and supplemented, if
necessary, by other means of social protection.
Everyone has the right to form and to join trade unions for the protection of his
interests.
Indian Constitution says
DPSP:
Within the limits of its economic capacity and development, make effective provision
for securing the right to work, to education and to public assistance in cases of
unemployment, old age, sickness and disablement, and in other cases of undeserved
want
Provisions for just and humane conditions of work and maternity relief
Note: Non justiciable in court
VIIth Schedule/Concurrent List

Social security and insurance
Welfare of labour
Provident funds
Employers liability
Workmens compensation
Old age pension
Maternity benefits
Employment and unemployment
Note: Both union and state Government can make laws
How effective are social security and welfare in India?
India does not yet explicitly recognise a national minimum social security cover. In
recent years, including with an intervention by the Supreme Court in the Right to
Food case, the government has moved forward to providing nutrition and
employment support with a legal guarantee through the MGNREGA.
Economists Amartya Sen and Jean Dreze distinguish two aspects of social security
protection and promotion. While the former denotes protection against a fall in
living standards and living conditions through ill health, accidents, the latter focuses
on enhanced living conditions, helping everyone overcome persistent capabilities
deprivation.
In 2011, in an affidavit to the Supreme Court on the official poverty line, the Planning
Commission estimated that based on the Tendulkar Committee report 30 pe rcent of
the population live below the official poverty line. Several debates followed on how
the poverty line ought to be defined. But what has remained absent from both
public discourse and laws is a more crucial question: how do these 35 crore people
survive on Rs. 32 per person per day in urban areas and Rs. 26 per person per day in
rural areas? What do they do in contingencies of illness, old age, and death, and how
do they protect themselves from slipping into further poverty?
Seven ways Forward for India to increase breadth and depth of social security measures
A. Develop and agree on a roadmap for universalization: Government should

Work on a roadmap and should release it officially to bring public accountability
Establish supporting institutional mechanisms and integrate schemes to bring
efficiency
B. Establish an autonomous national social security organisation: To bring efficiency and

implementation effectiveness of the number of schemes currently running
C. Develop a social sector investment plan with innovative financing mechanisms:

A social security investment plan for next 15 or 20 years needs to be developed with
clear understanding of the resource requirement, giving due consideration to
changing demographics
List/propose innovative and assured mechanisms for financial allocation to these
schemes to ensure sustainability
D. Focus on solidarity as well as public awareness and engagement:

A key principle in social security system, where people commit to help those who are
underprivileged and less fortunate
It can be brought through involvement of community through awareness generation
efforts
E. Consider universal health coverage (UHC) as part of social security measures:

Lack of universal health coverage and health related expenditure is undoing all social
security efforts including efforts targeted for poverty reduction
It is time that Rashtriya Swasthya Bima Yojana (RSBY) and National Health protection
Scheme (NHPS) are financed sufficiently with a vision for incremental government
investment on health to advance towards Universal Health Coverage.
F. Proactive Leadership by State Government:

In a federal country, States have to play a major role in social security measures.
It will provide flexibility and window for innovations to make social security
initiatives a success.
G. Consider legislative and legal reforms:

The social security schemes need to have legislative and legal support for
sustainability, if need be should also be supported by constitutional amendments
Also, tax based financing has to be replaced with mandatory contributions from
those who can afford to pay
H. Corporate Social Responsibility the Harbinger for Empowerment

Required for scale, speed and creating best practices for others to emulate
The CSR ecosystem is getting a boost as the 17 Sustainable Development Goals
(SDGs) adopted by the UN in 2015 are becoming pivotal areas for the corporate
sector to act upon through CSR activities.
Corporate Social Innovation should go hand in hand with Corporate Social
Responsibility - Creating shared value through innovative models will have deep
rooted societal impacts that will mainstream the marginalized.
Solve:
Question 1
Question 2
Hand-holding the Elderly
Definition of Ageing/Old Age

Elderly or old age consists of ages nearing or surpassing the average life span of
human beings (generally agreed cut off is 65+ years)
Note: At the moment, there is no United Nations standard numerical criterion
In Indian context, the National Policy on Older Persons, 1999 defines senior citizen
or elderly as a person who is of age 60 years and above
In brief, ageing means deteriorative biological and psychological changes that occur
in genetically matured organism
What happens in the Less Developed Countries (LDCs)?

The chronic unemployment, extreme deprivation, underemployment and the existence of a
large informal sector leads one to a state of vulnerability that is beyond the risks that are
covered even in the More Developed Countries (MDCs). In fact, increase in the percentage
of the aged from 7% of the total population to 14%, which took nearly 100 to 120 years for
some European countries could happen to India, China, etc. in just about 40 years (due to
faster mortality decline in LDCs).
Arent MDCs grappling with the same issues?

Yes, they are owing to their long history of fertility decline leading to increase in the
percentage of beneficiaries i.e., elderly and decline in the percentage of contributors i.e.,
the working age group.
India and the nature of the problem at hand

1950-55: Life expectancy at birth in India was 36.6 years, whereas the average in the world
was 46.8 years
2010-15: Life expectancy in India had almost caught up with the global average: 67.5 years
in India, compared with 70.5 years globally
Result of
Reduction in poverty
Improvement in healthcare and general social conditions
India: Home to 1/5th of the worlds population, which includes a third of the worlds poor
and 1/8th of the worlds elderly
2/5th of the elderly have no personal income and half of them are financially
dependent on others
Elderly women are the most vulnerable
India will have 330 million elderly people (19.4% of the population) by 2050
Problem of ageing population
This profound shift in the share of older Indianstaking place in the context of changing
family relationships and severely limited old-age income supportbrings with it a variety of
social, economic, and health care policy challenges.
While Indias celebrated demographic dividend has for decades underpinned its rapid
economic progress, an equally counter force may offset some of the gains from having a
relatively young population:
Rapid ageing at the top end of the scale - This is a cause of deep concern for
policymakers as India already has the worlds second largest population of the
elderly, defined as those above 60 years of age.
As this 104-million-strong cohort continues to expand at an accelerating pace, it will
generate enormous socio-economic pressures as the demand for healthcare services
and tailored accommodation spikes to historically unprecedented levels. It is
projected that approximately 20% of Indians will be elderly by 2050, marking a
dramatic jump from the current 6%.
However, thus far, efforts to develop a regime of health and social care that is
attuned to the shifting needs of the population have been insufficient.
While more mature economies have created multiple models for elder care, such as

o Universal or widely accessible health insurance,
o Networks of nursing homes
o Palliative care specializations.
it is hard to find such systemic developments in India.
Issues
Modernization:
Becomes an obligation

Rural:

Worst case: Aged women
Work Status:
Agriculture + industries: Adversely affected the participation rate of the elderly + less
scope of financial assistance
Organized sector- Mandatory retirement
Women: Immense contribution but with no counted economic value
Gender Ageing
Early marriage + Prohibition on remarriage- Widowhood prevails (Double jeopardy)
Health & Disability
Low: Literacy level + present healthcare conditions
Transition from communicable to non-communicable diseases
Increased disability in female
Rise in suicide cases: Depression + destitution + Socio-economic factors
ActionHelp Age India: Comprehensive Plan + Program + Action
Kinship bonds
Social Security: Weakened + Declining
Decline in Joint Family
Decrease in interaction & expression of emotions Alienation
Building a Knowledge base on Population Ageing in India (BKPAI) Survey brings into focus:
Government initiatives
The Ministry of Social Justice and Empowerment (MoSJE) is the nodal ministry for
policy and programme initiatives for Elderly Welfare. The MOSJE should focus on
effective policies and programmes for the senior citizens in close collaboration with
state governments, NGOs and civil societies.
Article 47 also provides that the state shall regard the raising of the level of nutrition
and the standard of living of its people and the improvement of public health among
its primary duties.
Towards this end, the Government of India enacted some policies such as the
Maintenance and Welfare of Parents and Senior Citizens Act in 2007 and Integrated
Programme for Older Persons (IPOP)
Concerns with governments policies and programmes:
Case I: Maintenance and Welfare of Parents and Senior Citizens Act

The Maintenance and Welfare of Parents and Senior Citizens Act make it obligatory
for children or relatives to provide maintenance to senior citizens and parents. It also
provides for the setting up of old age homes by State governments.
(But these provisions are poorly implemented and not strictly followed in India)
Many children and relatives have failed to provide maintenance to senior citizens
and parents. Most elderly people in India would rather suffer than have the family
name sullied by taking their own children to court for not providing maintenance for
them.
Lack of knowledge of rights, the inherent inability of the elderly to approach a
tribunal for recourse under the law, and poor implementation of the Act by various
State governments is other concerns.
Case II: Integrated Programme for Older Persons (IPOP)

The main objective of the Scheme is to improve the quality of life of the Older
Persons by providing basic amenities like shelter, food, medical care and
entertainment opportunities and by encouraging productive and active ageing
through providing support for capacity building of Government/ Non-Governmental
Organizations/Panchayati Raj Institutions/ local bodies and the Community at large.
(But these provisions are also poorly implemented and not strictly followed in India)
The number of old age homes the Centre supports under the Integrated Programme
for Older Persons (IPOP) has seen a decline from 269 homes in 2012-13 to a dismal
137 in 2014-15
The Centre has asked State governments to ensure that there are old-age homes
whose functioning can be supported under IPOP, but since it is optional for the State
governments to do so, the total number of old-age homes remains abysmally low.
Awareness and utilisation

Hardly 13% have availed of IGNOAPS pension and only 20% widows have availed of IGNWPS
pension
Difficulties faced by illiterate poor elderly in providing documentary proof of their
eligibility conditions
Problems regarding accuracy of the BPL list leading to frauds and fake cases
Long waiting period for getting pension
Inadequate pension amount
Underutilisation of funds allotted to states due to failure in identifying eligible
beneficiaries
Note: 6 million elderly in India receive old age pension and about 3 million receive widow
pension.
Recent initiatives by the government:
Atal Pension Yojana (APY)

Primarily targeted at the unorganised sector and informal workers
Under the scheme, a subscriber would receive a minimum guaranteed
pension of Rs.1000 to Rs. 5000 per month, depending upon his contribution,
from the age of 60 years. The same pension would be paid to the spouse of
the subscriber and on the demise of both the subscriber and the spouse, the
accumulated pension wealth is returned to the nominee.
PMJDY - To provide 'universal access to banking facilities' starting with "Basic Saving
Bank Account" with an overdraft upto Rs.5000 subject to satisfactory operation in
the account for six months and RuPay Debit card with inbuilt accident insurance
cover of Rs. 1 lakh
Jan Suraksha Bima Yojana Provides accident insurance; linked to PMJDY

Pradhan Mantri Jeevan Jyoti Beema Provides a life insurancr policy which gives a
sum of Rs. 2 lakhs to the family fot he policy holder after his/her death.
Rashtriya Vayoshri Yojana To provide physical aids and assisted living devices to
the elderly
National Programme for the Health Care of Elderly (NPHCE) Establishment of
Department of Geriatrics in identified Medical Institutions as Regional Geriatric
Centres (RGCs) for different regions of the country and to provide dedicated health
facilities at District Hospitals, Community Health Centres (CHCs), Primary Health
Centres (PHCs) and Sub-Centres (SCs) levels through State Health Society.
The Way ahead:

There is a need for a pragmatic approach, with focus on the three key aspects of health,
housing, and dignity.
Strengthen the health-care system

Good quality health care should be made available and also should be accessible to
the elderly in an age-sensitive manner.
It is crucial to encourage research in geriatric diseases, and push for building capacity
in the geriatric departments across the primary and tertiary health-care systems.
Rehabilitation, community or home based disability support and end-of-life care
should also be provided where needed in a holistic manner, to address the issue of
falling health among the elderly.
Strengthen the Housing

There needs to be a network of old age homes, both in the private and public sector.
There also seems to be a growing informal industry of home care providers, which
urgently needs regulation and mandated guidelines.
While the private sector has taken the lead in setting up some state-of-the-art
facilities, most of these are priced well out of the reach of ordinary citizens. State
governments must be mandated to set up quality, affordable homes.
Ensure life and dignity

As traditionally supportive social structures are changing and the elderly are
increasingly losing their status as the family patriarchs, it is also time that we did
our bit to help address the indignities and loneliness that this change is bringing.
Businesses could look at harnessing the talent of elders by retaining or hiring older
workers and offering flexible working hours for those who want to continue working
after retirement.
Industry will benefit by retaining their knowledge and experience and the elderly will
continue to be financially independent and retain their sense of self-worth.
At the community level we also need to increase the avenues for older people to
participate in local issues, in resident associations, set up and manage spaces for
community interaction, to leverage their experience as a resource, give them an

opportunity to share their concerns, and help them feel that they contribute socially
and have a purpose in life.
Empowering the Differently Abled
UNCRPD: Defines persons with disabilities in Article 1 as being those who have long-term
physical, mental, intellectual or sensory impairments which in interaction with various
barriers may hinder their full and effective participation in society on an equal basis with
others.
UN proclamation in 1981:
Subsequent declaration of Decade for Disabled and the Biwako Millenium Framework of
Actions, to which India is a signatory, is binding on the member countries to protect the
rights, provide equal opportunities and empower persons with disability.
Section 33 of the PWDA:

Makes it mandatory for the government to provide 3 per cent reservation to the
disabled in public employment

Calls upon Central and State governments to establish special employment
exchanges to facilitate easy and hassle-free placement for eligible disabled
candidates.
But the implementation has been weak owing to the majority of state governments, such as
Bihar, Maharashtra, Madhya Pradesh, Rajasthan and Uttar Pradesh, which accounts for the
largest proportion of the disabled, being biased against employing educated disabled
candidates.
Statistics Speak:
Disabled have: 3% quota in govt. job
Reality: Add up to only 0.12%
Out of over 24 lakh employees belonging to group A, B and C, the total number of persons
employed from disabled category was merely 5,014
140 disabled category people were employed in group A, where total number of
such employees is around 77,000
Out of around 1.90 lakh employees of group B category, only 712 were from disabled
category
Representation of disabled people in around 22.60 lakh employees of group C

category was merely 4,162
Percentage of disabled employees:
o Group A: 18 per cent
o Group B: 37per cent
o Group C:18 per cent
Disability Law
The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full
Participation) Act, 1995, (PWDA) and Rights of Persons with Disabilities Act, 2016 has
provisions of preventive social security measures
Pre-natal and post-natal care for the mother and child
Unemployment allowance and insurance
Right of disabled people to lead independent lives
Protection from all kinds of violence
But the success of any law depends upon the effectiveness with which it brings about the
desired changes and uplifts that section of the society. But the majority of disabled people
are undergoing issues like:
Delay in availing the entitlements envisaged
Inaccessible public places,
Non-accommodative educational institutions
Lack of employment opportunities for the disabled
Hurdles in Mainstreaming
No research is undertaken to ascertain the woes of the disabled and no review of the
workings of the PWDA is taken to check the tardy implementation in place
Lack of effective implementation of the employment provision

Absence of penal provision for violation of the PWDA
Lack of awareness on the part of major stakeholders: Public, Disabled and
Bureaucracy
Marginalisation of women, SCs and STs in rural areas

Lack of coordination between different government services
Additional Costs act as a deterrence- Transport, support and other costs associated
with work
Inflexible working environment-
o Difficulties with physical access to the workplace,
o Getting to and from work,
o Inadequate adjustments
o Adaptations to workplace equipment,
o Inflexible working hours
Limited opportunities:
o Under-representation in the vocational, education and training systems,
o Limited scope and variety of jobs offered
o Lower possibilities for promotion
o Lower paying jobs
o Lower retention rates
Guardianship system: Disabled people who have a guardian will have no standing
before the law as their rights will be taken over by the guardian and will be left with
no decision-making abilities.
The United Nations Convention on the Rights of Persons with Disabilities, to which India is a
signatory, promotes full legal capacity. Choice of autonomy should be respected and
guardianship does not allow for this.
Instead, the govt. should:

Create support systems at every level
Sensitise people to rights of the disabled

Make information available
Issues with the Bill:
o Failed to address the need for a rights-based statute which is focused on
eliminating barriers and discrimination, and recognizing equality for persons
with disabilities
o Fails to appreciate the articulations of the UNCRPD and instead, responded in

a manner that trivialized the draft law in question
o Change of the name of the Bill from Rights of Persons with Disabilities Bill
to Rights of Persons with Different Abilities or Special Abilities Bill, brought
discomfort to the community.
Inclusive India Initiative Will cater to persons with intellectual and developmental
disabilities; with an objective to include these people in the mainstream and in all important
aspects of social life, namely education, employment and community Inclusive India in
about changing the attitudes.
'Anuyatra' or walking together campaign - for the persons with special needs the cause of
integration of children with special needs in the mainstream; will have over 20 strategic
interventions having objectives ranging from prevention of disability to sustainable self-
reliant rehabilitation and economic empowerment
Deendayal Disabled Rehabilitation Scheme (DDRS) - Opportunities for the differently abled
persons in the field of education and employment are provided by way of providing financial
assistance in the form of Grant-in-Aid to NGOs. The major components of the scheme are:-
Vocational Training Centres,
Sheltered Workshop
Special Schools
Project for Pre-School and Early Intervention and Training
Under Swadesh Darshan or PRASAD (National Mission on Pilgrimage Rejuvenation and

Spiritual Augmentation Drive) Schemes
State Government/Union Territory Administration has to submit an undertaking in
the specified format stating that barrier free environment for differently abled
tourists has been incorporated in the design of the built up areas of the project.
Award of Excellence for Most Barrier- Free Monument/Tourist Attraction in the
country has been instituted to encourage the agencies responsible for maintaining
monuments/tourist attractions to create barrier- free environment for the
promotion of accessible tourism.
The condition of making the hotels accessible for people with different abilities by
providing facilities like dedicated room with attached bathroom, designated parking,
ramps, free accessibility in public areas and at least one restaurant, designated toilet
(unisex) at the lobby level, etc. have been included in the guidelines
GST exemption for products used by differently abled people - Specified assistive devices,
rehabilitation aids and other goods for differently abled people will attract the lowest (non-
Nil) GST rate of 5%.
The way ahead:

All the provisions under the Bill should be made applicable to the private sector to
enable the provision of education and reservation of jobs for persons with
disabilities
Though the Bill has ushered in a new wave of advocacy and activism, governments at
the Centre and in states need to focus on how to reach out to persons with
disabilities in rural India. Sufficient financial allocation and strict monitoring of the
PWDAs implementation can empower the disabled in far-flung areas as well
Limiting the disabilities to a list shouldnt be the way ahead and thus, a rights-based
model needs to be worked out and their effective participation should be ensured in
the society
There is also an urgent need to work upon:
o Establishing a proper surveillance systems for national level registration and
identification system
o Need of systematic and organized community based rehabilitation facilities
to identify and take care of persons with disability
o Develop the evidence based guidelines to provide services for the effective
diagnosis, care, understanding the cause, management, treatment and
prevention of various types of disabilities; along with the need to evaluate
these health systems at the both primary and secondary levels
o Evaluation of the regulation of international and national policies and
guidelines for persons with disability to ensure their correct, effective and
fruitful functioning
Solve: Question
Social Security in Education

Academic and anecdotal literature is replete with instances of the failure of benefits
reaching the intended. Many attempts have been undertaken to fix the system and one
such among them is making biometrics mandatory for a child to receive a mid-day meal in
school.
Issue of midday meals in schools as a form of social security in education and implication
of biometric reform in improving the functioning of the programme -
To access education, children of vulnerable backgrounds, require some forms of social

security, but education itself is also a form of social security against future vulnerabilities.
However, teaching on hungry stomachs is unlikely to lead to learning. Therefore, mid-day
meals in schools address the twin objectives of improving nutrition, as well as enabling
children to come to school and remain there throughout the day. The other benefits
include-
Reduces hunger
Increases enrolment and attendance
Improve learning outcomes
Infuses the habit of students eating together irrespective of their social backgrounds
Increases involvement of the local community in monitoring the meals
Increases parental engagement
Provides employment to many, especially SC/ST/OBC women in India
Using Biometrics
Official basis for mandating UID: The use of Aadhaar as identity document for delivery of
services or benefits or subsidies simplifies the Governments delivery processes, brings in
transparency and efficiency
It might limit the number of children that can access MDMs, rather than improving
their access owing to the several gaps in allocation of the UID
It does not affect the irregularities in supply, poor hygiene and infrastructure or
inadequate nutritional content of meals
It is not yet clear as to what will happen if the technology fails
Social Security for the Unorganised Sector in India
In India
About 84% of workers are in the unorganised or informal sector
More than 90% are involved in informal employment
97% - Self-employed
78% - Casual labourers
However, a large majority of workforce (most of the poor) in this sector is devoid of any
formal social security protection. Lack of social protection reduces productivity, and is an
important cause of households incurring debt due to out-of-pocket expenses in times of
illness.
Challenges of the current Social Security Administration in the country

Multiplicity of policies, schemes and agencies
Poor coverage and outreach
Inadequate benefits
Fragmentation
Poor quality of implementation (and selection)
High costs
Exclusion of large sections particularly unorganised sectr workers
Code on Social Security and Welfare

Proposes a three tier Social Security Administration Structure with tripartite representation-
a) National Social Security Council headed by the PM
b) Central Board of Social Security at Union level
c) State Board(s) of Social Security at State/UT level for implementation of the
framework
Mindmap: Draft Labour Code on Social Security Analysis
Safeguarding Domestic workers
Domestic Workers in India:

NSSO Data: Around 3.9 million domestic workers in India, belonging to vulnerable
communities Adivasis, Dalits or landless OBCs
Women constitute over two-thirds of the workforce in this unorganised sector
Domestic workers can be hired and fired at will as the employer has no legally
binding obligations.
Neither the Maternity Benefits Act nor the Minimum Wages Act or any of the scores
of other labour laws apply to domestic work
Background of legislations associated with Domestic Workers:
Domestic Workers Welfare and Social Security Act - In 2010, the National Commission for
Women had drafted the Domestic Workers Welfare and Social Security Act to help address
complaints about unpaid wages, starvation, inhumane work hours and verbal, physical and
sexual abuse. The proposed law was meant for domestic workers above 18 years of age and
clearly stated that no child shall be employed as a domestic worker. (But the draft remained
a proposal.)
International Labour Organization (ILOs) Convention 189

In 2011, the International Labour Organization adopted Convention 189 which
offers specific protection to domestic workers. It lays down the basic rights and
principles, and requires States to take a series of measures with a view to making
decent work a reality for domestic workers. (India voted in favour of the
convention, but is yet to ratify it.)
Ratifying an international convention amounts to a formal commitment to
implement all the obligations, including passing of comprehensive legislation for
domestic workers.
Rashtriya Swasthya Bima Yojana (RSBY)

The same year (in 2011), the government made a half-hearted effort by including
domestic workers in the Rashtriya Swasthya Bima Yojana (RSBY) a smart card
based cashless health insurance scheme. But, there was a catch. Only registered
domestic workers could avail the cover of up to Rs 30,000 cover.
To register, a domestic worker would have to get certificates from two of four listed
institutions the employer, the police, the resident welfare association, or
recognised trade unions.
Unorganized Workers Social Security Act, 2008 and Sexual Harassment of Women at
Workplace
India has only two laws that, in a roundabout way, construe domestic helps as
workers.
The Unorganized Workers Social Security Act, 2008 (UWSSA) and the Sexual
Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act,
2013 include domestic workers, but does not address their specific vulnerabilities.
While the former is a social welfare scheme, the latter is aims to protect working
women in general. Neither of these recognises domestic helps as rights-bearing
workers.
The way ahead:

There is a necessary pre-condition for a National Policy for Domestic Workers and enacting a
Domestic Workers (Regulation of Work and Social Security) Act which
Calls for promoting awareness of domestic work as a legitimate labour market
activity
Recommends amending existing labour laws to ensure that domestic workers enjoy
all the labour rights that other workers do
Calls for the compulsory registration of the employer and the employee with the
District Board for regulation of domestic workers
Mandates the collection of cess from the employer for the maintenance of a social
security fund for domestic workers
Moreover, the most important thing is to change the mind-set of the society which is the
root cause of such discriminatory and abusive attitude towards the domestic workers.
Providing safety-net: Pension for all
According to a recent report by the World Economic Forum, the retirement savings gap in
India is estimated to escalate to $85 trillion by 2050. And as most people in India do not
have any kind of insurance and, as the population ages, it will also be pension less. The
retirement savings gap will not only affect the quality of life of retirees, but can also pose
macroeconomic challenges. As the proportion of retirees rises in the population, a shortfall
in retirement income will affect consumption and growth. It will also affect fiscal
sustainability as governments will have to spend more on retirees even in countries that do
not have a state-funded retirement system.
What is NPS?
NPS (National Pension System) is a defined contribution based Pension Scheme launched by
Government of India with the following objectives-
To provide old age income
Reasonable market based returns over long run
Extending old age security coverage to all citizens
It is based on a unique Permanent Retirement Account Number (PRAN) which is allotted to
each Subscriber upon joining NPS.
What is required?
In order to improve financial security the policymakers should focus on three key areas
Providing a safety- net pension for all.
Improving access to retirement plans
Encouraging initiatives to increase the rate of contribution.
Providing safety-net pension for all:

It should be the responsibility of the government to provide a pension income for all citizens
that acts as a safety net and prevents those who miss out on other forms of pension
provision from dropping below the poverty line.
Challenges:
Fiscal constraints. The biggest problem for India is that about 90% of the workforce is
in the unorganized sector and lacks proper access to retirement-saving instruments.
The pension challenge in India will be fairly acute. According to the UN Population
Division, the share of population aged 60 or above will rise to 19% by 2050,
compared with 8% in 2010.
Even those who are investing may not be aware how much money they will need
after retirement and what it takes to attain that goal. People generally lack the
ability to make complex calculations and give more importance to their near-term
needs than a longer-term requirement like retirement saving.
Steps taken by government:

A pension regulator was established in 2003.
New government employees (except in the armed forces) have been moved to a
defined contribution-based National Pension System (NPS) from 2004.
The NPS was opened to all citizens on a voluntary basis in 2009 and the government
offers tax benefits to contributors.
Budget 2014-15 had announced such a scheme, post which Life Insurance
Corporation of India (LIC) had launched its single premium Varishtha Pension Bima
Yojana. That scheme collected over R7,000 crore and offered lifelong pension at
9.3% per annum, providing monthly pension of R500-5,000.
Union finance minister Arun Jaitley, in his 2015 budget speech, announced steps for
creating a social security system. This included insurance and pension schemes,
mostly for the underprivileged segments of society.
Recent developments:
A new Rs 5,000-crore pension formula is in process. It is expected to benefit more
than five million central government employees. The new formula will calculate
pension based on the latest drawn salary for a particular post.
The new method was fixed by an empowered committee of secretaries (Ecos)
headed by secretary (pensions).
The seventh pay commission recommended that pension could be calculated by two
methods:
o Pension would be 50% of the last salary and multiplied by 2.57.
o An incremental method where pension was fixed at the last salary drawn
with adjustments of increments drawn in that particular pay band.
However, the incremental method was found to have lacunae as 20% of records were found
to be missing in various government departments, and officials felt this could lead to
litigation in future. To avoid legal hurdles, the Ecos came up with the pay fixation method.
What more needs to be done?

Creating awareness: Both the government and the makers of retirement products
must place adequate emphasis on spreading awareness.
The pension products must be simple and easily available.
Technology can play a big role in making products available to savers.
In India, generating more employment in the formal sector will help address the
problem to some extent.
As the government lack fiscal space, we will need to work on increasing retirement
savings. Mobilizing savings for retirement could be a big opportunity as it would
provide long-term solution.
Must Read:
Minimum Wage and labour issues
Challenges and Scope of Unorganised Manufacturing Sector
Regards
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Yojana and Kurukshetra- July 2017

thatll help you in your preparation for the CSE.

an in-depth understanding of various socio-economic issues.

extract their essence that may be useful for the exam.

most essential points from all the articles.

Indias Health Sector policies- OVERVIEW

Increase in Public National Health

National AYUSH Mental Health

Also recently, WHO and UNICEF acknowledged India for

Maternal and Neonatal Elimination (MNTE) Yaws- free

Maternal and neonatal tetanus (MNT) Yaws is a tropical

National Health Initiatives of India

Year Name Aim / Target

National Health Mission

Salient features of NHM

o Non- Communicable diseases

Some new government schemes

Pneumonia( Heamophilus Influenza Type B)

Pneumococcal diseases (Pneumococcal Pneumonia and Meningitis) Added in 2017

India New Born Action Plan

Mothers Absolute Affection Programme

Rasthtriya Bal Suraksha Karyakram and Rashtriya Kishore Swasthya Karyakram

PM Surakshit Matritva Abhiyan

Other programmes are

National Health Policy 2017

The key targets are:-

NHP has also placed lot of emphasis on Digital Initiatives

Maternal and Child Healthcare in Rural India

Determinants of maternal and child health care

There are three domains of delivering health services

Programmes and initiatives

Janani Surakhsha launched in April 2005 under NRHM

Thus, the empowerment of women is an essential element of health. Educational

Adolescent health care- in brief

Adolescence is characterised by transformation from being cared by someone to taking

There is a need to achieve following objectives for the young generation

Content of adolescent health programmes should include

Tackling dual probelms of undernutrition and obesity

One of the most crucial information to be imparted to

Health suffering from ill health, discomfort, lack of hygiene and

Increasing competition in school, sports and everyday

Mental they are aware of neither prepared to handle.

Health Thus, friendly advice should be available throguh schools

Substance Adolescence marks experimenting of surroundings,

Misuse acceptable which at times leads to wrong choices in

Lifestyle or There is a need for positive behavioural intervention to

Provision of correct knowledge is key for health

Special adolescent friendly clinics should be oriented and

Clinics and Sexual Health clinics for addressing the reproductive

They should be the center of any adolescent health care

Schools adolescents on behaviour risk modification.

Water, Sanitation and Hygiene (WASH):

Water- pollution and wastefulness

Sanitation- Open defecation

Hygiene- Behavioural change is the key

National Rural Drinking

Swachh Bharat National Rurban

UN SDGs recognise WASH and health as important areas to be targeted.

It is the remote diagnosis and treatment of patients by means of telecommunications

Whereas the entire primitive telemedicine infrastructure used to be simple technology

Strengthening the rural health care

Social Security Freedom from Want

Article 22 of the Universal Declaration of Human Rights: Right to Social Security

Article 23 of the Universal Declaration of Human Rights: Right to Work