GS 2 Governance Case studies for Mains Notes by UPSC Topper

State best Practices, Notes by UPSC Topper Ravisankar Sarma   Sector State Name of Project  Method Used Benefit Child Protection Odisha Sampark School student helpline 1. Brought accountability in the education system 2. Reduced teacher absenteeism 3. Platform to voice corporal punishment, and sexual abuse concerns Number of calls received have increased over years Education Gujarat Migration Card + monitoringsoftware The card contains education details of the child + makeshift schools (Tent Special Training Programme) in construction locations for inter-state migrant children helped increase retention under elementary education of children who migrate with parents looking for seasonal employment and reduce the drop-out rates of girls in primary education.   Chhattisgarh(LWE areas) Pota Cabins Building residential schools with impermanent materials like bamboo and plywood 1.  Schools cannot be used as LWE hideouts + students safer there. 2. The number of out-of-school children in the 6-14 years age group reduced and enrolment and retention have increased from 2011   Madhya Pradesh Prathibha Parv Regular assessment for students and facilities in government schools 1.Better quality of education 2.Better attendance rates 3. Better infrastructure due to continuous monitoring   Andhra Pradesh Saakshar Bharat Adult Education 1. Rise in enrolment from 2011 2. Reduction of gender disparity Environment Chennai Avadi Sewage Treatment Plant Sewage treatment plant + water used for kitchen garden 1. It treats 12 lakh litres of sewage every day with no negative discharge 2. produces manure 3. recharges groundwater 4. Provide water for kitchen garden 5. Removes the source of foul odour and waterborne diseases   Sikkim Dhara Vikas develop a cadre of para-hydro-geologists + develop spring sheds + rainwater harvesting + laying down trenches with MGNREGA workers in ideal recharge locations using information provided by these geologists 1.  Increased irrigation has encouraged farmers to cultivate new crops such as beans, radish, chilly+ perennial garden fruits etc (diversification, not just dry crops anymore). 2. 15% increase in crop yield obtained 3.  recharge lakes, spring 4.  Reforestation 5. Creation of a spring atlas with relevant hydro-geology information of the area   Andaman & Nicobar Environment ManagementInitiative 1.       Rainwater harvesting, 2.       effluent treatment plant, 3.       solid waste management, 4.       paper and jute recycling 1.   Nearly half of the institute campus’ water requirement is being met through rainwater harvesting. 2. The paper recycling plant produces 500 file folders every semester 3. Reduction of solid waste   Karnataka Forest ProduceTracking System Real time tracking of what is extracted, from where, by whom, what purpose through a web-portal. Also printed Transit Passes with QR codes and watermarks which are automatically verified at check posts- faster clearance 1.  Easier tracking 2. Improves transparency – reduces corrupt practices 3. Elimination of paper trail- increases efficiency   Meghalaya Integrated Basin Development and LivelihoodPromotionProgramme Identification, Training and capacity building, credit linkage and supply chain development for entrepreneurs in selected sectors 1. Inclusive growth 2.  Entrepreneurial promotion 3  Increased access to stakeholders   Mansagar(Rajasthan) Lake Restoration Passing water through a natural filter(bunds) + two chambers of vegetation + dredging to increase lake depth+ use of dredged mud to create embankments + sewage treatment plants PPP model Revived the lake and local ecosystem+ source of income generation   Kaikondrahalli(Karnataka) Lake Restoration Stopped encroachment, diverted sewage, de-weeded and de-silted the lake, thus increasing depth and thus storage capacity by 54%, created embankments, afforestation, creation of a separate pond for religious activities, construction of pathways and other recreational amenities Local community + BBMP Revived the lake and local ecosystem+ source of income generation   Kerala Mazhapolima Rooftop rainwater harvesting + open well recharge 1. Generation of public interest and awareness leading to self installation without government subsidy 2. Groundwater recharging   Delhi SAFAR- Systemof Air quality Forecasting And Research provide location-specific information on air quality in near real time and its forecast 1-3 days in advance in major metropolitan cities such as Delhi and Pune. 1. Awareness 2. Forecast of weather extremities 3.  Data for environmental and health studies 4.  Help improve crop yields through impact assessment   Himachal Pradesh Sustainable Plastic Waste Management Plan Ban on use of plastic + use it in road construction 1.  Cleaner environment 2.  Reuse of plastic 3. Community awareness Financial Inclusion Jharkhand Panchayat Banks e-government facilities centre + bank with basic financial services + government scheme payment(MGNREGA, scholarships ec), constructed and operated by local entrepreneurs 1.  Financial inclusion 2.  Creation of local entrepreneurs + source of livelihood 3.  Increase household savings 4.  Reduce systemic leakages and increase transparency Food Security and PDS Arunachal Pradesh Arun e-PDS Digitisation of PDS+ ration card + foodgrain requirement tracking through coupons issued for the year + tracking for intermediate supplychains(transfer from FCIs to FPS etc) 1.  Reduce pilferage of foodgrains 2. Detection of ghost ration cards 3.  Inclusion of more deserving people in the system   New Delhi Dilli Annashreeyojana Identify vulnerables(location, social or occupational) in the location and transfer amount of PDS benefit directly to beneficiary bank account(beneficiary = eldest woman of household) 1.  Gender sensitive 2. Food security to the vulnerable, who lack even documentation to avail other benefits like TPDS or AAY   Madhya Pradesh e-Uparjan Digitise procurement of foodgrains and track daily procurement amount depending on available storage 1. Create a decision support system to track how much to be procured in a day 2. transparency Health Kerala Arogyakeralam Palliative Care Project Free, home-based palliative care by trained nurses + special cases referred to hospitals + training to ASHAs and ANMs Palliative care, number of beneficiaries have increased over the years   Sikkim CATCH-ComprehensiveAnnual andTotal HealthCheck-up forHealthy Sikkim periodic health check-ups free of cost for all + follow ups for complex ailments + counselling for healthy lifestyle + individual health cards (barcoded smart cards containing detailed health profile) 1. Improving health and access to healthcare 2. Healthier lifestyle adoption and reduction in consumption of of harmful materials like tobacco, alcohol, sugar etc   Odisha Decentralisation of ICDS supplementary Nutrition Programme All procurement except rice and wheat are carried out locally at the village level + Pre-decided menu

India and its Region, Notes by UPSC Topper Ravisankar Sarma

India-Africa Why Africa for India? Emerging Market: World Bank notes that the African continent houses 6 of the world’s fastest-growing economies. Africa hence offers India businesses a huge market for their goods and rich demographic dividend for production through foreign investments  Indian corporates are significantly involved in agri-businesses, engineering, construction, film distribution, pharmaceuticals and telecommunication. The Indian-African Business Council has enabled greater cooperation in the Track 2 diplomacy between economies Energy Security: Engagements with Africa for energy production and distribution can help diversify India’s dependence on West Asia for energy. Nuclear Energy: Several of the African countries have reserves of Uranium and Thorium that can enable India to produce atomic energy given India gains access to them. Soft Power Diplomacy: India’s capacity building and humanitarian efforts in Africa have earned it great goodwill across countries and multilateral platforms in contrast to China’s chequebook diplomacy and closed model of development Multilateral Diplomacy: African countries are pivotal to India securing its bid for UNSC and NSG. South Africa has been an important partner in BRICS given the increasing south-south cooperation and historical linkages between India and South Africa Historical Relations: India and Africa are bounded by South-South cooperation manifested in the Non-Aligned Movement. The Gandhian freedom movement in India and South Africa further cement historical linkages between India and Africa India’s initiatives Indo-Africa Summit: First held in 2008, the Indo-Africa summit has evolved to be the official platform for India-Africa relations signifying greater cooperation in economic and strategic domains. Doing away with the Banjul Formula, India now engages with all African countries through the summit. Pan-Africa e-network: India has focused on capacity building and institution development in Africa leveraging ICT measures. Through the Pan Africa e-network, it aims easy access to social services such as e-health, e-education and e-governance services to Africa. Team 9: The Team 9 initiative focuses on the development of 9 backward West African countries through an open inclusive model of development Indian Technical and Economic Cooperation: Through ITEC measures, India aims to inculcate skill development and skills transfer with a view to enhance the capacities of African economies in a win-win for all. Para-Diplomacy: A new trend in the relationship has been states directly engaging with Africa for economic engagements. Eg: Kerala is planning on importing cashew from Africa for its processing plants Cultural Diplomacy: Indian diaspora has positive relations with African people and the civilian governments. Historical linkages and Bollywood movies have served as key integrating factors for people in the region. Concerns Limited Diplomatic Engagements: Africa continues to be limited in presence in India’s foreign policy engagements. India is yet to establish embassies in several of the African countries Chinese Presence: China through its chequebook diplomacy has made great inroads into Africa. It has been able to deliver on its promise better than India. This has led many African countries to strategically embrace China at the expense of India. Eg: Chinese Port in Djibouti Lack of Economic Coordination: Indian businesses have little coordination with the state that compromises avenues of symbiotic Indo-African economic cooperation. Several Indian businesses have also been accused of unethical business practices in Africa Eg: Karuturi Global, an Indian company accused of land grabs in Ethiopia Instability in Africa: India’s investments and business engagements face the threat of extremist and insurgent elements in Africa. They pose a threat to India’s developmental and infrastructure projects like the Asia-Africa Growth Corridor Eg: Boko haram in Nigeria Enormous Diversity: India cannot proceed with a uniform foreign policy towards a continent as diverse as Africa in political, socio-cultural and economic spheres. It needs to step up its bilateral engagements with nations identifying complementary areas of cooperation Conclusion India needs to engage with Africa as a partner and elder brother in its resurgence harnessing its potential based on the Panchasheel ideals of equality, mutual respect for sovereignty, peaceful co-existence and mutual benefit. This would bonds the nations together on the Gandhian ideals that united them in the colonial era. Great Game In the new Great Game for Africa, there seems to be space for the Elephant and the Dragon in the hot deserts of Sahara and the Equatorial forests. India needs to focus on its capacity-building inclusive aid diplomacy driven model to counter china’s infrastructure building neo-imperialistic cheque book diplomacy for its own peaceful rise. Antarctica Antarctica has been treated as a Global Commons with no nation holding sovereign rights. The Antarctic Treaty proposes that all countries would use Antarctica solely for the purpose of scientific research despite the Antarctic holding rich reserves of energy and minerals. Antarctic Treaty Lays down that Antarctica shall remain peaceful without international discord Prohibits military activity, nuclear explosions and disposal of nuclear waste Promotes scientific research and exchange of data India has signed the treaty Concerns                 The geodynamics in the Arctic region and the sovereign rights of littoral nations there may offset a similar rush for resources violating the principle of Global Commons. India needs to use its status in the Arctic Council and the UN to maintain the spirit of the Antarctic Treaty. In the period of climate change, the last pristine frontiers on the planet cannot be depleted for greed. Conclusion                 As opposed to the Arctic, the Antarctic has signified a region of cooperation and harmony that is conducive to the world and environment. India as a responsible major power should strive to maintain the spirit of the treaty and ensure continued peace and research in the region expending its base stations of Maitri and Dakshin Gangotri Arctic Region Introduction The melting of the Arctic ice offers both challenges and opportunities to the international community. Despite India being a non-littoral state, the impacts of melting ice and the opportunities it offers in the form of resources and energy are of key interest to India. What Arctic Offers? Benefits of Shipping: As the ice melts, the ocean region offers new lanes of shipping that vastly reduce logistics cost and better linkages between North America, Europe, East Asia and Asia. This has the potential to reduce the relevance of current strategic choke points like the Bosphorous and the Suez canal Energy Potential: The arctic is said to hold 40% of the current HC and oil reserves whose extraction and use has become feasible due to climate change. This has the potential

Centre State Local Relations

Centre State Local Relations Devolution of Powers and Finances up to Local Levels and Challenges therein Financial Autonomy of ULBs/ RLBs                 The lower levels of government suffer from lack of devolution of funds and of self-generating revenue. Municipal bodies in urban areas face multiple challenges that necessitate capital: water supply, sanitation, power supply, solid waste management. Why a problem of Finance? Lack of devolution of funds: Devolution of adequate funds is the prerogative of the state government and is included among the voluntary provisions to be implemented by states in setting up local government institutions Lack of taxation powers: Most states have not provided avenues for municipalities to acquire revenue on their own through levying taxes and they continue to be dependent on state governments for grants Economic Survey: 4% of revenue of panchayats are raised from direct tax avenues Corruption and Mismanagement: Most municipalities are crippled by corruption and financial mismanagement that hinders productive spending on infrastructure and resources Taxation Powers not used: The Economic Survey points to a ‘low equilibrium trap’ wherein local bodies have been reluctant to use taxation powers vested in them to maintain the low level of accountability on local body institution. Inadequate delivery of serviceà Low Direct TaxesàWeak accountabilityàInadequate delivery Tied Funds—> No Functional Autonomy Way Forward Ensure Financial Accountability: Municipalities expenditure needs to be placed under professional scrutiny and debt management should be made a priority to plug leaking funds Sustainable Revenue Sources: Collection from property tax, sustained regular income from provision of services like water supply would usher in self-reliance when it comes to finances. GIS mapping and installation of ultra sound water meters can help in achieving both of these targets Municipal Bonds: They can be vital instruments to attract corporates and entrepreneurs to invest in urban planning and infrastructure development. It also reduces the burden on state governments and relieves ULBs of their financial dependence on state governments Local Self-Governments             Local self-governments were provided with constitutional status through the 73rd and 74th amendment with the objective of deepening democratic decentralization in the country. LSGs transform citizens being passive participants in election process to active decision makers at ground level thus heralding participative democracy. Why LSG? Citizen participation: LSGs enable citizens to be direct participants in decision making at the grass-root level. This inculcates political consciousness within citizens making them an active part of democracy Eg: The institution of Gram Sabha that is inclusive of all voters in a village is an embodiment of direct democracy where voices are directly heard and heeded to Decentralization: LSGs are the lowest rung in the governance ladder that enables decentralized demand-driven service delivery to citizens. The citizens at the grass-root level are more aware of the needs of the society as compared to higher ladder governance institutions  Eg: A village panchayat that needs healthcare service delivery will channelize its funds and functionaries in accordance with that priority in mind. Women Empowerment: By reservation of one-third of LSG seats, women are politically empowered being active decision-makers at the grass-root level. This can drive them towards better social status and economic empowerment. Similarly, SCs, STs and other backward classes are emancipated due to reservation of seats in panchayats Functions of a LSG Planning and Implementation: The LSGs are vested with the authority for planning and implementation for socio-economic development and welfare of its population. The state government and LSGs cooperate to achieve the laid out objectives. Beneficiary Identification: The LSGs are identifiers of deserving beneficiaries for state entitlements and assistance. They are better aware of grass root level demography and hence better placed to make decisions with regard to beneficiary identification Eg: LSGs decide the beneficiaries of MGNREGA Service Delivery: LSGs are responsible for service delivery of basic amenities to households- drinking water, electricity etc. In some states like Chhattisgarh, they are even managing the PDS to ensure fair and equal access to all beneficiaries. Safeguards for Tribal Population: The LSG institutions in Schedule V and VI areas are responsible for expending natural resources – minerals, land, forests, minor water bodies. The Gram Sabha has to be consulted in matters of land acquisition, rehabilitation of displaced population and mineral mining. Eg: Dongria Kond tribe of Niyamagiri hills rejected Vedanta’s request for Bauxite mining Infrastructure: LSGs play a pivotal role in infrastructural development in coordination with the state government on matters of road connectivity, telecom and electrification. Issues at the Local Body Level Lack of 3Fs: The state governments have not devolved enough funds, functions and functionaries hindering democratic decentralization to the third tier of the government. Many states have not included voluntary provisions of the amendment that included devolution of resources and functions. Lack of Financial Autonomy: Limited Taxation Powersà No self-reliance Limited use of existing taxation powersà Low revenue generation Low devolution of funds from state and centre-à Infrastructural backwardness Tied Fundsà Affects functional autonomy and priority based works of PRIs The Economic Survey of 2017-18 states that the direct tax collection of panchayats is at a meagre 4% of its revenue base illustrative of the heavy dependence on state and central devolution Recentralization: The decentralization of governance has been partly negated by para-statal authorities and recentralization schemes that abridge the authority and status devolved to lower levels of government MPLADS and GCDA Patriarchal Challenge: The provision for reservation of seats for women have been greatly compromised by the ‘Sarpanch pati’ system that puts husbands as active decision-makers in place of their passive spouse representative. Casteism: Panchayats have been formed along the lines of caste that have perpetuated caste divisions in villages and has assumed quasi-judicial functions that impose harsh punishments on lower caste sections on the basis of customary laws and practices. Khap Panchayats in parts of U.P and Bihar Corruption or Maladministration: Panchayats as political institutions have not been free of corruption and other antithetical activities that hinder development, progress and welfare for all Bureaucratic Culture: The introduction of the 3rd tier of governance has changed the role of a district collectorà The bureaucracy in practice is yet to be fully adapted to the change Ignorance of peri-Urban Areas: Regions at the periphery of cities that are transition zones for rural-urban areas suffer from lack of administrationà water and sanitation problems as per the 2nd ARC report Lack

International Relations

International Relations Soft Power Coined by American political scientist Joseph Nye, soft power is defined as the ability of an actor to change the behaviour of another actor to achieve a favourable end through attraction rather than coercion. According to Nye, a country’s soft power can come from 3 sources: Culture: Able to attract other countries Nepal, Bhutan and South-East Asia: Buddhism Spreading of the idea of Yoga Foreign policy India’s position on Palestine-Israel conflict Political Values: Lives up to it home and abroad India-South Africa relations: Gandhian values of non-violence and South-South cooperation Soft power cannot be a substitute for hard power. Bilateral Relations India-Korea Current Scenario: North Korea is enhancing its nuclear weapon capability and emerging as a threat to regional security that has heightened the arms race in the region involving U.S, South-Korea and Japan. India has firmly opposed North-Korea’s nuclear proliferation by: Imposing ban on trade: India aligned with the U.S policy to ban all trade to North Korea Stopping all capacity building initiatives for North Korean Citizens in India Launch of Korea Plus: An exclusive channel for inflow of South Korean investment India’s increased economic engagement with Seoul and lack of cooperation in economic and political spheres with Pyongyang arises from the need to contain North Korea which is beneficial for India’s regional security and economic interests as well as its approach to global nuclear non-proliferation regime as a responsible nuclear state. India- South Korea Korea Plus Civil Nuclear Deal: Although India is a non-NPT signatory, Seoul entered into a civil nuclear deal with India on account of its clean NPT record and is now a key supporter for India’s membership into the NSG Naval Cooperation: Joint Naval Exercises Indian Diaspora in Qatar Crisis As neighbouring countries have cut off its supply lines to Qatar, there is a shortage of supply of basic demands and commodities that leads to a steep increase in prices. The large number of working migrant population, including Indians has to now spend a high proportion of their wages on basic commodities. Migrant workers are also facing a blockade with Bahrain, Saudi and UAE not processing Qatari Visas. Hence many of them are unable to reach Qatar. India – UAE  Maritime Security: Recently, India and UAE announced joint naval exercise to preserve maritime security in the Indian Ocean and Gulf Region Counter-Terrorism: A joint document deploring double standards adopted by countries and affirming UAE’s support for India’s proposed convention on terrorism at the United Nations. Cybersecurity: Joint research and development centres of excellence to fight cyber threats will be expedited Investment: UAE is investing in India’s National Investment Infrastructure Fund (NIIF) through its sovereign wealth fund (Abu Dhabi Investment Authority) India-Uganda E-visa introduction India has included Uganda in its list of countries to which an electronic visa is sufficient to travel. India has good business and trade relations with the African nation. Enabled easier travel compared to the normal visa process and enables better people to people interaction and India’s significant Diaspora presence has encouraged the idea of an e-visa India and Uganda share cooperation in the energy, automobile, pharmacbtical, space research and peaceful use of atomic energy India- Mali 20% of cotton exports from Mali find their way to India Track 2 diplomacy with business enterprises engaged directly in cotton trade Mali is currently engaged in efforts to incentivize Indian entrepreneurial investment in the textile field China’s Influence in South Asia China has invested in several projects in South Asian countries as part of its chequebook diplomacy and peaceful rise doctrine – by which China alludes the fact that the growth of China as a powerful nation is in the best interests of all Asian countries In Male, Indian investment was turned down in favour of Chinese investments In Nepal, China is building railway and road linkages and also the airport of Pokhara China is also financing the Hambantota port in Srilanka and owns 80% of it. India aspires to develop the Mattala port in Hambantota and has launched the Economic and Technology Cooperation Agreement in pursuit of the same China is also the key defence supplier for Bangladesh and is investing heavily in its infrastructure and energy projects India’s Counter Restoring SAARC to improve relations with the neighbourhood and reduce China’s influence SAARC’s decline after the URI attacks have loosened the bonds, hence making it easier for China to make inroads into several South Asian countries Historically, countries in the neighbourhood see China as the one who delivers while India remains the promising country alone. Hence India must fast track its investment and projects in neighbouring countries to enhance credibility for its projects India should leverage the cultural homogeneity it shares with its neighbours which the China does not possess to ensure fruitful relations characterised by mutual respect and common interest BRICS Declares JeM and LeT as Terrorist Groups Denotes hyphenating of China’s relationship of India and Pakistan Can be seen as a decline in the China-Pakistan nexus and the special relationship Beijing had with Islamabad Displays commitment on counter-terrorism by all BRICS nations including China China reverted its stand on designating Masood Azhar of Jaish-e-Mohammed as an international terrorist putting a technical hold on UNSC’s bid to ban him. China had earlier expressed its willingness on the sidelines of the BRICS summit in Xiamen. INDIA-CANADA Areas of Cooperation Energy Security: Canada-India ministerial energy dialogue with particular focus on electricity, energy efficiency and renewable energy India and Canada are also cooperating in civil nuclear energy production Trade and Investment: The CEPA and Bilateral Foreign Investment Promotion and Protection Agreement (BFIPAPA) between the member countries aim to increase the flow of trade and investment between countries increasing market access and job opportunities for both nations Movement of People: Under the Global Skills Strategy, India and Canada have committed to liberal movement of highly skilled individuals from India to Canada. This attains greater importance in the context of stricter norms applied for the skilled individuals in U.S under the HI-B visa regime Strategic Cooperation: India and Canada’s avenues for strategic cooperation are limited by geography and lack of common interests. However, both countries have agreed to improve security cooperation by institutionalizing strategic dialogues at National Security Adviser (NSA) and

Social Justice in Health Sector

Social Justice- Health Sector Issues related to the provision of Social Sector Services Privatization of Health Sector NITI Aayog and Health Ministry has mooted the ideas of incorporating a PPP model into the provision of health services by allowing private hospitals to run select services within district hospitals by leasing out portions The select services included are treatments for cardiac disease, pulmonary disease and cancer care PPP model would improve accessibility to specialized health care PPP model would provide a mechanism for private sector to engage with the public utilising government facilities and infrastructure of district hospitals. A viability gap funding by the state government needs to be set up for this. Private parties would share ambulance services, mortuary services and blood banks with the district hospitals while public hospitals benefit from superior quality of human resources as well as increased capital of private players It would ensure timely diagnosis and detection of diseases reducing regional disparity in provision of such services Concerns Health being a state subject, NITI Aayog has limited advisory powers and hence a top-down approach may not be suitable for a subject in the state list Increased privatization may lead to further commercialization of the health sector- only BPL and insured patients would be provided access to free health care thus ignoring the majority of the population. Private parties would be able to cherry-pick districts with individuals who have high paying capacity thus widening the existing regional disparity in the provision of quality health services Handing over public healthcare services to private sector reflects the inefficiency of public health care services and abdication of governments duty from providing free healthcare to all citizens HIV AIDS UNAIDS REPORT India has a high percentage of HIV patients in the world and HIV cases have been reported in new areas of the country India is a vital supplier of generic antiretroviral drugs to world pharmacies and hence a coordinated approach on innovation, intellectual property rights and public health is required to tackle AIDS at the global level particular in low and middle-income countries UNAIDS focuses on achieving the 90-90-90 target: 90% diagnosed, out of them 90% provided ART and out of those provided treatment 90% are virally suppressed  HIV AIDS Response by the Govt through AIDS (Prevention and Control Bill) Prohibition of discrimination towards HIV patients in provision of education, health facilities, employment, housing and other such services. Any violation of this right due to unfair treatment vetted out to HIV patients will amount to punishment. All HIV patients under the state are guaranteed access to preventive, testing, medical and counselling care including ART which is the key feature of the bill aiming to attain 90-90-90 target. The state government is required to employ an ombudsman to address grievances relating to the violation of the act The status of HIV patients shall not be disclosed unless by a court order HIV and Hepatitis C Twins Similar to HIV, HCV can be transmitted through needles, inadequate sterilisation of needles and by sexual interaction Call for integrating HCV into National HIV Control Programme Health experts argue that twin testing facilities should be made available for HIV and Hepatitis C as cases of Hepatitis C have been commonly observed mainly in HIV patients Early detection of the disease can enable easier treatment with the availability of drugs A common infrastructure facility would be a win-win for both the government as well as the public in terms of cost and accessibility Built-up Drug resistance Overuse of antibiotics – Bacteria evolves to resist antibiotics – Government currently addressing the overuse by introducing red line medicines to discourage sale and consumption of antibiotics Unnecessary antibiotic usage among livestock Discharge of effluents from pharmaceutical industries Improper control on infection Lack of hygiene: A government report Scoping Report on Anti-microbial resistance in India have proved that mass bathing in the Ganga has caused anti-microbial resistance to build-up India faces a challenge of MDR TB and its resolution as a part of the Revised National TB Control Programme Currently concerns regarding resistance to antiviral drugs used for treatment of swine flu Similar to antibiotic resistance these drugs are antiviral in nature and their uncontrolled usage will build up resistance Government has decided to take off 2 drugs used or treatment of Swine flu from the restrictive Schedule X of the Drugs and Cosmetics Rules meaning that they are easily available rendering them vulnerable to misuse Antibiotic resistance is also cited as a roadblock in the treatment of the sexually transmitted disease Gonnorhea by WHO India’s fight against MDR TB According to WHO, India has 1.7 million new TB cases reported in 2016 and so a decline of 12% TB deaths from last year although there was a 5% increase in new cases (Improved diagnosis?) reported. India also has a 90-90-90 target in TB ( 90% reduction in disease incidence, mortality and catastrophic expenditure) India’s policy aimed at achieving this target is centred around improved diagnostics (using GenXpert devices), short term treatment courses (shifting to daily regime from thrice weekly),improved availability of bedaquiline and delamanid and comprehensive preventive strategies (improved nutrition, sanitation and hygiene) India follow the DOTS (Directly Observed Treatment Short Course) strategy recommended by WHO Prevention Mutual cause effect relationship between TB and malnutrition. People with malnutrition are predisposed to contracting TB and TB itself can result in under nourishment Need for provision of nutritional assistance for economically vulnerable TB patients through markets and other alternatives like CSOs facilitating access to low cost fortified foods National Strategic Plan (NSP) brought out by the government with an aim to eliminate TB by 2025 focuses on addressing nutritional insecurity of TB patients Under nutrition contribute to 55% of TB incidence in India Diagnosis Detection of the disease is key with regard to TB India lags behind in detection as most of the public and private sector still make use of smear microscopy which is an ineffective method as it can detect only 50% of TB cases. Xpert machines

Role of NGOs & Other Organizations

Role of NGOs & Other Organizations Social Entrepreneurship It refers to a business venture where the entrepreneur’s main motive is to provide social services at low cost to the needy as opposed to making a profit. Eg: Grameen Bank of Mohammad Yunus in Bangladesh Potential of Social Entrepreneurship Provision of Social Services: A financially sustainable social enterprise model can be an invaluable asset in ensuring the provision of social services in untouched areas of the country through low-cost innovative solutions. Eg: Teach for India foundation’s work in providing education to children in remote regions of the country Correcting Gender Hierarchy: Social enterprises have time and again demonstrated their ability to emancipate women economically and in turn enhance their social position within and outside households. Eg: Kathkatha that helps empower women and children living in brothels by providing them with an alternate source of livelihoods Establishing Forward and Backward Linkages: Social enterprises act as bridges linking producers of traditional art and craft industries to global markets and supply chain. They also function as channels for raw materials for local product manufacture. Eg: Hastashilpi Gurukul Challenges to Social Entrepreneurship Access to Credit: Due to their narrow profit margins, social entrepreneurs have a hard time gaining access to formal credit. This compromises quality and coverage of service delivery Lack of Expertise: Social enterprises are formed by a few individuals who come together to give effect to an idea. They may not have the requisite expertise to effectuate the same efficiently. Weak Organization: The informal nature of organization given how loosely knit they are can be detrimental to the stability of social enterprises Way Forward Handholding Support: Social entrepreneurs can be provided handholding support in initial stages until they acquire proficiency in their area of entrepreneurship Incubators and PPP: Social enterprises that offer feasible ideas should be provided financial incentives in the form of taxes and a sustainable market financing model should be built up that is not merely dependent on charity alone.  Read Also NGO Enroll today with the best civils service academy and take your first step towards your Civils journey. Feel free to reach out to us for any inquiries, collaborations, or support. We’re here to help. Join Now

Social Justice for Vulnerable Sections

Social Justice- Vulnerable Sections Poverty             Absolute poverty in India has reduced from 50 percent in 1993-94 to below 5 percent in present day according to the Tendulkar poverty line of 1.91$ purchasing power parity. Poverty lines in India and all over the world by WEF and WB have been monetized on the basis of cost of basic amenities which have been increasingly diversified to include calories, nutrients, proteins, health, education, electricity, transportation, drinking water and sanitation. Poverty Detection Increasing Diversification of Requirements: The Tendulkar and Rangarjan committees have widened the amenities for requirement. The purchasing power required for this aggregate consumption basket has been fixed as poverty line. Unit of Analysis: The Tendulkar and Rangarajan lines follow different units as the basis for poverty identification- individual and households respectively Automatic Exclusion and Inclusion: The Socio-Economic caste census has brought in parameters that automatically exclude (tax payer) and include (manual scavenger) citizens into beneficiary list Rural- Urban Divide: Indian poverty line indicators are reflective of the rural urban divide in terms of varying consumption patterns and the skewed access to amenities like drinking water, electricity and sanitation where rural areas appear highly disadvantaged. The falling agricultural incomes have further eroded their financial capability. Reasons for Poverty Overpopulation: Being the 2nd most populous country in the world, India has great strain on natural resources of land and water which deprives a select few on the basis of financial capability Loss of Agriculture Income: Fragmentation of lands, climate changes and declining fertility of soil has led to declining incomes of farmers causing a downward spiral in rural economy Lack of livelihood opportunities: India has a huge demographic potential that may become a liability unless sufficient opportunities are created for them with regard to employment and entrepreneurship Coverage of secondary and higher education (Accessibility and Affordability issues) Highest out of pocket expenditure in Health: A lack of a comprehensive health insurance policy and poor public sector healthcare has caused a highly vulnerable urban and rural population deprived of sanitation and hygiene to spend big on the treatment of diseases Solutions Needed Targeted Welfare Approach: The government can focus on targeted areas of backward regions in states of U.P, Bihar and Madhya Pradesh. Greater impetus can be given to skill development initiatives and entrepreneurship opportunities to leverage demographic asset of theses regions Participative Development: The government can curb direct financial assistance and instead seek to create livelihood opportunities for the deprived to make them self-reliant. SHG platforms and MGNREGA can serve the same purpose Universal Provision of Social Services: Public expenditure must be drastically increased and public partnerships sought to plug infrastructural gaps in rural and remote regions of the country in health and education sector. A universal health insurance under the U.K model should be ushered in to reduce the out of pocket expenditure for healthcare Diversification of welfare provisions: The government’s welfare provisions may be diversified in accordance with widening purview of poverty. The nutrition basket of PDS and mid-day meal schemes can be diversified to accommodate proteins and micro-nutrients for the population Plugging leakges: The Aadhaar based DBT can be used to directly transfer subsidies to the deserving t increase transparency and plug leakage of funds in welfare endeavours of the government Eg: Wages of MGNREGA             In the future, the government may explore the provision for provision of UBI through this platform.   CSR Programmes Issues Diversion of funds Green Washing Emancipating own employees Regional and Sectoral Imbalance Way Forward             The government has launched the National CSR data portal which contains all filed information with respect to expenditure across states, districts and developmental sectors. This can help in evaluating effectiveness of CSR projects and consolidating CSR activities.             Increased transparency in financial and non-financial information also keeps a check on fund diversion thereby increasing accountability on companies to spend productively. MAHARASHTRA’S SOCIAL BOYCOTT BAN LAW Targeted at informal caste panchayats (or village councils) and denial of service to citizens due to virtue of caste, morality, social acceptance, political inclination or sexuality – ostracism by dominant sections of society A clear example of a renewed political will of the Maharashtra Government to place individual liberties over social acceptance or cultural tolerance in a marked departure from previous governments who have often favoured the cause of the group over the individual What it includes? Specifies practices which come under social boycott- ‘preventing performance of religious or caste customs and traditions’, ‘denial of right to perform funeral or marriages’, ‘denial of public facilities to communities – halls, medical, education services’ Criminal Offence with imprisonment of upto 3 years Ensures trials are completed within 6 months of filing of report Concern People of the religion may advocate that their fundamental right of freedom to manage religious affairs may be violated and challenge the legislation in court with regard to its constitutionality New legislation does not address inter community social ostracism like denial of housing to minorities, attacks due to virtue of diet or dress Way Forward Legislation is a basic foundation for implementation of democratic principles which in this case is equality. The government should politically take steps to ensure that a climate of prejudice and intolerance is gradually replaced with one of social harmony. Domestic Workers’ Rights- Domestic Workers Regulation of work and Social Security Bill, 2016 Currently unrecognized as an economic activity, Indian state has not implemented ILO’s Convention 189 on Decent Work for domestic workers to bring domestic work under state regulation Largely constituted by citizens belonging to vulnerable communities – women, tribal community, SC/ST Prejudiced to be a security risk are subjected to police verification affects dignity enshrined in constitution Face risk of domestic violence, abuse, sexual harassment Intense work, persistent surveillance and quasi-magisterial authority of employer implode the dignity of domestic workers Lack of adequate redressal mechanisms Provided protection under Sexual Harassment of Women at Workplace ( Prohibition, Prevention and Redressal) Unorganised Sector – No minimum wages, poor conditions of work, no security Read Also National Register of Citizens Prospective Solution Domestic Workers Regulation of work and Social Security Bill,2016 aims to monitor domestic workers by making mandatory registration of employer and

Social Justice in education sector

Social Justice- Education Sector Education: Private vs Public Sector                 Recent data trends from the MHRD suggests a growing privatization in the education sector. Between 2010 and 2015 student enrolment in government schools have fell by 13 million while on the private side it has increased by 17.5 million. Issues in the Private sector Quality: Recently, the World Development Report brought out by the World Bank elucidated that private schools perform better only because they accommodate children from affluent background Affordability: Charge exorbitant fees from parents of children and hence are out of reach for a large section of the population. The NSSO recently stated a 175% increase in average annual private expenditure on education. Obsolete Curriculum: Lacks excellence and imagination and is non-committed to meeting global standards. As a result, students fare badly in global exams for measuring learning outcomes Programme for International Student Assessment Test (PISA) Safety and Security: Have been cases where children have suffered from sexual and physical abuse even causing death. Private institutions have not been able to take adequate precautionary measures in preventing the same Ryan murder case Lack of Transparency and Accountability in its functioning: Private schools are hard to monitor and require large quantum of financial and human resources. The WB’s report opines that it would be more straightforward and expeditious for the government itself to provide quality education Public Sector Institutions Although greater in number, they fail to meet the demands of aspirational families and students of the country Accessibility: The proportion of public institutions providing education to private sector institutions is still low compared to other countries Segregation: Generally seen as institutions for poor and marginalized sections of society Quality: Greatly compromised in terms of infrastructure and teaching expertise leading to low learning outcomes among students. The ASER report by Pratham sites inability to read, write and do arithmetic among students Way Forward Private education should be given more space in lieu of lack of quality public education and the lack of finances available for spending on the same Monitoring Framework: Strict regulation and monitoring from responsible authorities to ensure that the current limitations of private education is addressed and it remains accountable to provide affordable quality education in a safe and secure environment for children Stepping up spending on Education: India currently spends 4% of its GDP on education and should ideally aim to raise it to 6% that is globally accepted and recommended. New Education Policy: India’s NEP that is due in December shall focus on providing Universal, free, safe and quality public education to all its young citizens Read Also Agricultural credit in India Establishment of National Testing Agency                 The Centre has approved the creation of a National Testing Agency which would be an autonomous body registered under Indian Societies Act,1860 with the responsibility of conducting tests for entrance to higher educational institutions.                 NTA thus relieves the pressure on CBSE and AITCE from conducting entrance tests and also ensures there is an independent agency that measures merit level of students. Primary Education Introduction                  The Economic Survey 2017 points out that in a techno-intensive world, India’s primary education output breeds Human Capital Regression that subverts India’s demographic dividend, threatening to be a demographic disaster. Issues Poor learning outcomes: ASER (Annual Status of Education Report) 2018 brought out by Pratam illustrates that there is a learning deficit and poverty of basic reading and arithmetic skills among children Gender Disparity: Despite consistent improvement, UNESCO’s Gender Parity report flags concerns that in the backward regions of the country, girls have 42% less chance of receiving primary education Teacher Quality and Quantity: The low pupil-teacher ratios and the poor quality of teaching has adverse effect on learning outcomes. Obsolete Curriculum: Curriculum in several public schools are not relevant to current ground realities. Hence there is a need to reform the curriculum for holistic development of children with focus on extra-curricular activities as well. Infrastructural Gaps: Class rooms, benches, desks, toilet facilities, books Employability: The poor learning outcomes offshoot the disability that school education has little utility in job creation. Such an aspect is relevant even at primary education Reasons for Poor Performance Lack of Funding: Public expenditure on education as a percentage of GDP is insufficient to plug existing infrastructural gaps in educational institutions. There is a lack of coordination for need-based infrastructural development and diversion of funds allotted for the same. The T.S.R report has called on the government to increase its public expenditure on education to 6% of GDP Quality of Teachers: There is a serious lack in the quantity and quality of teachers particularly in schools in rural areas that have detrimentally affected reading and arithmetic ability of students. The T.S.R committee report has mentioned in its report to set a cut off of 50% marks for graduate examination for teachers and to conduct a period-wise examination for teachers to sustain and monitor their quality Lack of Regulation: Primary level schools have largely laid ignored by monitoring and regulatory authorities that has led to such a sever depreciation in quality of imparting education Obsolete Curriculum: The education curriculum and methods of teaching fail to focus on learning aspects, logical reasoning and innovation among students Way Forward Plug Infrastructural Gaps: The government can increase its public expenditure to 6% of the GDP on education as stated in the TSR Subramanian Committee Report. It can look into collaborations with private organizations and CSOs to plug infrastructural deficiencies Ensuring Teacher Quality: As cited in the TSR Subramanian committee’s report, minimum cut off of 50% marks for graduate examination for teachers and to conduct a period-wise examination for teachers to sustain and monitor their quality can enhance teacher quality levels Revamping Curriculum: The curriculum can be revamped to provide holistic education to children to focus on learning outcomes and aim to induce their critical thinking and logical reasoning capacity rather than seeking conformity to syllabus Atal Innovation Mission seeks to induce innovation in children through play spaces equipped with state of art technologies Pre-School Education: Ensuring the right to quality pre-school education can help lay foundations for effective impartation of primary education Outcome-based monitoring: Levels of education may be assessed based on learning outcomes of children rather than infrastructural and human resource inputs alone. The National Achievement Survey performed by the NCERT aims to do the same. Enhancing Employability of Education: Skill courses currently imparted between classes 9 and 12 may be advanced to class 6

Health Sector in India – Holistic Study Part 1

Preventive Health Care Poverty, Malnutrition, Hunger, Substance Abuses, Sanitation, Clean Drinking Water, Food Safety, Immunization. Curative Health Care Communicable and Non-communicable Diseases Issues in India’s Health Sector Accessibility : Regional disparity in the provision of healthcare services – Lack of PHCs and CHCs in certain rural areas of the country. Hence rural population are denied access to primary healthcare which aggravates their health problems and eventually become a burden on tertiary health sector which is not equipped to deal with the high inflow of patients. Inadequate doctor to patient ratio: According to the National Health Profile, India has a million doctors to treat its 1.3 billion Doctors largely render services in urban areas and hence rural population are left vulnerable Affordability: Lack of Public Expenditure: India is currently spending only 1.2% of its GDP on the health sector. This reflects the low level of political commitment for ensuring health care and how it has never been an electoral issue Prices of Drugs: Even when medical services and expertise is available and affordable, an average citizen in India spends a large amount of money on drugs prescribed. The nexus between doctors and pharmaceutical companies has often exploited the patients to earn large profits No Health Insurance Policy and Minimal Coverage: The citizens spent highest on medical services from out of their pocket Quality Infrastructure: Government hospitals are often ill-equipped to provide specialized care and devices and medical infrastructure are old and need of maintenance and repair. There is also an issue of lack of adequate beds in public hospitals Technical Expertise: The NITI Aayog in its Action Agenda points out that India faces a huge challenge in the number, distribution, skill and quality of health care expertise. Inefficiency in Regulation and Monitoring Mechanism: Medical Council of India consumed with Nepotism and Corruption means healthcare institutions are neither adequately monitored nor regulated in their management or administration giving them a free hand at providing lacklustre services to citizens Read Also Social Justice in Education Sector Triple Burden of Diseases Fight with Communicable Diseases: NITI Aayog reports India lost 33% of its DALYs owing to the communicable diseases Non-Communicable Diseases (Lifestyle): According to India: The Health of Nation’s States Report brought out by ICMR, 61% of India’s disease burden consisted of CMNNDs till 1990 but fell to 33% in 2016. NCD has replaced this vacuum surging from 31% to 55%. Threats of Rising NCDs Diverse requirements from the health sector that needs to cater to both CMNNDs as well as NCDs The burden of Expenditure: NCD treatment is more expensive as compared to CMNND disease thus putting further pressure on the government’s economic resources NITI Aayog reports a rising morbidity and mortality cost attributed to NCDs Threat of New diseases Prospective Solutions Universal healthcare: Correct regional disparity in provision of health care Services : Set up PHCs and CHCs in unserved and underserved areas. Recruit greater number of ASHA workers and ensure the smooth functioning so that they can act as bridge between villagers and access to healthcare services. Incentivize Service in rural areas: Doctors and nurses should be financially incentivized to serve in rural and remote areas to ensure that people in these areas are not left behind for access to quality medical care Correcting Affordability Rapidly Increase Public Spending: As per NHP, public health expenditure needs to be doubled to 2.4% of GDP from current 1.2%. Even such an increase would pale in comparison to what other countries are spending on their healthcare sector Gen Oushadi Shops: To sell affordable medicines in the form of generic drugs to citizens Introduce a health insurance policy: The government through the NHPS is aiming to provide such an insurance coverage to 10 crore beneficiaries. Enhancing Quality Strategic Engagement and System Strengthening with Private sector Partnership: Enhance technical, infrastructure and specialized healthcare service quality by forming partnerships with private sector entities Raising public spending Overhaul Monitoring and Regulation Mechanism : Introduce exit eligibility test for doctors, incentivize working in rural areas and replacing MCI with National Medical Commission Holistic development of public health addressing all social determinants including nutrition, sanitation and drinking water. The focus on entirety shall be a far cry from the sole focus on provisioning of health care Preventive> Cure: The public health system through the promotion of healthy life styles, prevention of injuries and detection and control of infectious diseases can achieve preventive cure. The state must then reprioritize its goals to transition from curative to preventive Role of the Government: The NITI Aayog advices the government to play a stewardship role in setting and enforcing rules to guide the health system. A data driven decentralized model can help in bettering health outcomes National Health Policy, 2017 First National Health policy in 15 years seeks to ensure universal access to affordable quality healthcare services to all citizens in the country. Universal Accessible Affordable Primary Healthcare Comprehensive Healthcare package including palliative, rehabilitative and geriatric healthcare Providing digital health card for access to health services from all over India Gen Oushadi Shops to enhance access to affordable generic drugs Preventive and Promotive Focus with Pluralistic Choice Integration of traditional medicines into mainstream health care services Co-location of AYUSH with western medical facilities in public hospitals Make in India for a Healthy India Production of Active Pharmaceutical ingredients Enables to reduce import of drugs and creation of customized indigenous drugs Eases affordability for drugs in market Fostering Patient Focus and Quality – Assurance Based Approach Establishment of National Healthcare Standards Organization Maintain Quality of healthcare Digital intervention Electronic Database for access to patient records for all doctors from anywhere in India Tele-medicine yielding dual benefits of employment generation and better and equitable access to medical services in far flung regions Establishment of National Digital Health Authority System Strengthening and Strategic Engagement Entering into sustainable models of partnerships with private sector entities, both for-profit and not-for profit to improve quality of healthcare services rendered in terms of infrastructure and technical expertise Objective to improve access to quality screening, diagnosis, treatment services for cardiovascular, pulmonary diseases and cancer in district hospital through PPP Increase Public expenditure to 2.5% of GDP Primary healthcare Issues Coverage: There exists a regional

Health Sector in India – Holistic Study Part 2

Privatisation Of Health Sector Introduction                 The increased role of the private sector in the Health sector has raised a concern whether India is moving from the UK based patient-centric model to the American insurance-driven health delivery system. A careful analysis of the privatization of healthcare is needed to elucidate its ramifications.                 The recent NHP, 2017 lays emphasis on systemic strengthening and strategic engagement with the private sector to comprehensively improve health service delivery in the country. Why necessity? Lack of public investment in the health sector means there is a huge demand-supply mismatch with regard to the provision of healthcare services. Partnerships with private sector entities enable quality screening, diagnosis, treatment services accessibility to patients with better infrastructure and technical expertise NITI Aayog Guidelines Co-habitation of private sector entities engaged in the provision of such services within public hospitals to provide specialized healthcare and treatment for cardiovascular, pulmonary diseases and cancer Conditions for entering into PPP – State government Must accommodate a minimum number of state referred patients who are eligible to avail NCD services for cashless treatment of their ailments (To avoid commercialisation) In selecting public hospitals, a criteria of minimum patient strength and bed strength needs to be followed so that hospitals with largest inflow of patients gain most from partnerships Minimum services to be offered – IPD, OPD, Emergency services, critical care State governments need to leverage national and state initiatives and schemes for maximizing potential of privatisation – RSBY and NHPS Benefits of Privatization Access to Specialized Healthcare: PPP model would improve accessibility to specialized health care in terms of human expertise, technology and equipment Enhance Infrastructural Quality: PPP model would provide a mechanism for private sector to engage with the public utilising government facilities and infrastructure of district hospitals. A viability gap funding by the state government needs to be set up for this. Economies of Scale: Private parties would share ambulance services, mortuary services and blood banks with the district hospitals while public hospitals benefit from superior quality of human resources as well as increased capital of private players Better Diagnosis: It would ensure timely diagnosis and detection of diseases given the expedition of advanced medical devices reducing regional disparity in provision of such services GeneXpert devices to diagnose TB Holistic Medical Growth: Expansion of Private-sector servicesà Greater investment in research and developmentà Greater procurement of medical infrastructureà Job creation and growth in the medical field Way forward and Concerns Commercialisation: Privatized healthcare model works on pure economics of demand and supply. If there is no effective regulation, the citizens may fall prey to the exploitation of the private health sector machinery India has the highest Out of Pocket expenditure of 86% according to WHO Unethical Practices: An unregulated private sector can breed unethical practices like false diagnosis and testing of medicines. Such practices may have adverse effects on the health of patients. Health being a state subject, NITI Aayog has limited advisory powers and hence a top down approach may not be suitable for a subject in the state list. Hence different states may adopt different guidelines which can lead to coverage disparity between them Neglected Diseases: The demand supply chain invariably works on the purchasing power of citizens. Diseases which affects the poor and vulnerable may continue to lie ignored in the face of privatization of health care India continues to fight against WHO classified neglected tropical diseases like Lymphatic Filariasis Regional Disparity: Danger of private sector institutions cherry picking districts with individuals who have high paying capacity thus widening the existing regional disparity in provision of quality health services Inefficiency of Public Healthcare System: Handing over public healthcare services to private sector reflects inefficiency of public health care services and abdication of governments duty from providing affordable quality healthcare to all citizens Conclusion The primary responsibility for providing affordable universal healthcare services rests on the state. A well regulated private sector based on the pillars of trust, accountability and efficiency can be a boon to India’s citizens. Parameters for Assessing Health Sector Total Fertility Rate Ideally should be around 2.1 – Currently around 2.3 Huge regional disparity with backward regions having higher TFR close to 37 (Bihar) and other regions having lower fertility rate (as low as 1.24  in Sikkim) – National Family Health Survey Hence targeted differential policy is required In areas of High TFR – Solutions Empower women by providing with skilling and livelihood opportunities – As women are empowered and gain voice within households gradually the population decreases. A high correlation currently exists between women’s illiteracy levels and TFR rates as witnessed in the EAG states. Poverty Alleviation: The lower economic rung in the society always looks upon children as economic assets rather than liabilities. Hence alleviating them out of poverty can have a contraction effect on population Family Planning and Use of Contraceptives: Precisely what Mission Parivar Vikas under MHFW seeks to implement targeting the UP, Bihar belt Discouraging early marriages: Sukanya Samriddhi Yojana and Beti Bachao Beti Padao Provide opportunities and scholarships for higher education of women: The West Bengal government’s Kanyashree Prakalpa is an astute initiative in this direction. Infant Mortality Rate Number of deaths per 1000 live births in 1 year India – 41 per 1000 live births Neo-Natal Mortality: 29 per 1000 live births Causes of Child Mortality Maternal Health Issues: Poor nutritional status of the mother can affect the survival of the child. NFHS notes 20% children born with low birth weight in the country having high risk of mortality The government has launched the National Nutrition mission with convergence across departments. This can address the nutrition requirements of the mother and child through the Anganwadis Poor Institutional delivery: The lack of expertise in delivery, poor antenatal and neo natal health services can cause infant mortality. The lack of infrastructure like warm towels can increase risks of infant mortality The PM Matritva Suraksha Abhiyan and the PM Janani Suraksha Yojana emphasizes on providing vital ante-natal and neo-natal care to reduce IMR Vulnerability to Diseases: The lack of hygiene and sanitation facilities render the children vulnerable to pneumonia and diarrhoea. Diarrhoeaà Low capacity of nutritionà Stunting, Wasting and Child mortality The Swachchh Bharat Abhiyan and the NRDWP aim to provide households with clean drinking water Under Nutrition: The NFHS notes that 33% of under 5 deaths in India are due to malnutrition