1. Needed, a public health data architecture for India
UPSC Syllabus: Mains – GS Paper II – Social Issues
Sub Theme: NFHS Data| Ayushman Bharat Digital Health Mission | UPSC
Context- In a country perennially thirsty for reliable health data, the National Family Health Survey (NFHS) is like an oasis. It has a large volume of data that is openly accessible. It would be better off with few comprehensive national surveys than being over-dependent on the omnibus NFHS
For the uninitiated, the NFHS is a large survey conducted in a representative sample of households throughout India which started in 1992-93 and is repeated at an interval of about four to five years. It is the Indian version of the Demographic and Health Surveys (DHS), as it is known in other countries. Currently, the survey provides district-level information on fertility, child mortality, contraceptive practices, reproductive and child health (RCH), nutrition, and utilisation and quality of selected health services. The respondents are largely women in the reproductive age group (15-49 years) with husbands included.
Over the years its scope has been expanded to include HIV, non-communicable diseases, or NCDs (tobacco and alcohol use, hypertension, blood sugar, etc.), Vitamin D3.
Issues related to Indian Surveys:
- A very long survey- In NFHS-4, the household questionnaire had 74 questions, the women’s questionnaire was 93 pages long with 1,139 questions and the men’s questionnaire was 38 pages long with 843 questions. The NFHS-5 questionnaire was even longer. The size of the survey has obvious implications for data quality.
- Fragmented data- Healthcare data in India is fairly fragmented and scattered, given the interaction of citizens ranges across multiple diagnostic centres, hospitals, medical practitioners and pharmacies. There are also several distinct parts in delivery chain, whether its insurance agents, third-party administrators (TPAs) or intermediaries such as ASHA workers. The issues of fragmentation are acknowledged by the Health Ministry, in its electronic health record (EHR) standards document of 2016 that look at this digitisation of workflows in healthcare systems.
- Quality of agency and its workers- There is an entrenched set of agencies which survive on this survey. Issues have been raised on the quality of these agencies and their workers.
- Outsourcing- The NFHS is coordinated by the International Institute for Population Sciences (IIPS Mumbai) and the actual survey is outsourced.
- Quality: India has conducted the National NCD Monitoring Survey (NNMS), the National Mental Health Survey (NMHS), the Global Adult Tobacco Survey (GATS), the alcohol survey, the Comprehensive National. Nutrition Survey (CNNS) and many others. Many of these have been implemented by premier academic institutions at costs below ₹25 crore, though none of these generated district-level estimates.
- Overlapping questions: For example, for tobacco we have another vertical survey. Then why do we have questions on these in the NFHS?
- Lack of technical capacity with Department of Planning, Statistics and Programme Monitoring.
- Irregularity- NFHS is the only major survey that India has a record of doing regularly. One does not know if and when the other surveys will be repeated. For example, we do not have any surety that the second round of the NNMS will be conducted, though it is due.
What to do?
- Promoting computer assisted surveys to reduce time and cost.
- We have to identify a set of national-level indicators and surveys that will be done using national government funds. Just three national surveys — an abridged NFHS focusing on Reproductive and Child Health (RCH) issues, a Behavioral Surveillance Survey (focusing on HIV, NCD, water sanitation and hygiene (WASH)-related and other behaviours) and one nutrition-biological survey (entails collection of data on blood pressure, anthropometry, blood sugar, serology, etc.) done every three to five years in a staggered manner.
- We should take a national-level sample for such surveys and ask States to invest in conducting focused State-level surveys.
- Other important public health questions can be answered by specific studies (which may or may not need a national-level study), conducted by academic institutions on a research mode based on availability of funding.
- It is also very important to ensure that the data arising from these surveys are in the public domain. This enables different analyses and viewpoints to be presented on the same set of data enriching the discussion and unlocks the full potential of the survey.
Ayushman Bharat Digital Health Mission:
- Ayushman Bharat–Digital Mission will connect digital health solutions of hospitals across the country with each other.
- Also known as Pradhan Mantri Digital Health Mission or the National Digital Health Mission
- A health ID for every citizen that will also work as their health account, to which personal health records can be linked and viewed with the help of a mobile application,
- A Healthcare Professionals Registry (HPR): A repository of all healthcare professionals.
- Healthcare Facilities Registries (HFR) that will act as a repository of all healthcare facilities across both modern and traditional systems of medicine. This will ensure ease of doing business for doctors and hospitals and healthcare service providers.
- NDHM Sandbox: A digital architecture that allows helps private players to be part of the National Digital Health Ecosystem as health information providers or health information users.
2. About Olive Ridley Turtles
UPSC Syllabus: Prelims: Environment | Mains – GS Paper III – Environment & Biodiversity
Sub Theme: Olive Ridley Turtle| Mass Nesting | UPSC
The olive ridley sea turtle also known commonly as the Pacific ridley sea turtle.
|Olive Ridley Turtle|
- It is found in warm and tropical waters, primarily in the Pacific and Indian Oceans, but also in the warm waters of the Atlantic Ocean.
- The olive ridley turtle has a circumtropical distribution, living in tropical and warm waters of the Pacific and Indian Oceans from India, Arabia, Japan, and Micronesia south to southern Africa, Australia, and New Zealand.
Mass Nesting Phenomenon
|Mass Nesting of Olive Radley at Gahirmatha Beach|
- Olive ridley turtles are best known for their behaviour of synchronized nesting in mass numbers, termed arribadas.
- Females return to the same beach from where they hatched, to lay their eggs.
- They lay their eggs in conical nests about one and a half feet deep, which they laboriously dig with their hind flippers.
|Distribution of Olive Ridley around the globe|
- In the Indian Ocean, the majority of olive ridleys nest in two or three large groups near Gahirmatha in Odisha.
- The coast of Odisha in India is one the largest mass nesting site for the olive ridley, along with the coasts of Mexico and Costa Rica.
- IUCN: The olive ridley is classified as vulnerable according to the International Union for Conservation of Nature and Natural Resources (IUCN),
- CITES: It is listed in Appendix I of CITES.
- Convention on Migratory Species :
- India: It is also enlisted in schedule 1 of Wildlife protection Act, 1972 which giver this species highest level of protection in India.
- Predators of eggs: Known predators of olive ridley eggs include raccoons, coyotes, feral dogs and pigs, opossums, coatimundi, caimans, ghost crabs, and the sunbeam snake.
- Predators of Hatchlings: Known predators are preyed upon as they travel across the beach to the water by vultures, frigate birds, crabs, raccoons, coyotes, iguanas, and snakes.
- Anthropogenic: Other major threats include mortality associated with boat collisions, and incidental takes in fisheries. Trawling, gill nets, ghost nests, longline fishing, and pot fishing have significantly affected olive ridley populations, as well as other species of marine turtles
|· The olive ridley turtles turn up in millions for mass nesting along the Odisha coast every year namely at three river mouths: Dhamara, Devi and Rushikulya.
· Gahirmatha beach off Bay of Bengal coast in Kendrapara district is acclaimed as the world’s largest nesting ground of these turtles.
· It extends from Dhamra River mouth in the north to Brahmani river mouth in the south.
· The wetland is represented by 3 Protected Areas, the Bhitarkanika National Park, the Bhitarkanika Wildlife Sanctuary and the Gahirmatha Marine Sanctuary.
3. This clean cooking fuel plan needs more firing up
UPSC Syllabus: Prelims: Polity & Governance | Mains: GS Paper-II – Polity & Governance
Sub Theme: Pradhan Mantri Ujjwala Yojana | UPSC
Context: This article has analysed the scope of Pradhan Mantri Ujjwala Yojana in providing the access to clean energy sources to rural women.
Objectives of Pradhan Mantri Ujjwala Yojana
The Pradhan Mantri Ujjwala Yojana was launched for providing clean fuel to women below the poverty line. The use of unclean cooking fuel is harmful to human health. The aims of the Pradhan Mantri Ujjwala Yojana are given below:
- To empower women and protect their health.
- To minimize health issues arising from the use of unclean fossil fuel and other fuel while cooking.
- To control indoor pollution from the use of fossil fuel which causes respiratory issues.
- To prevent degradation of the purity of the environment that is compromised by widespread usage of unclean cooking fuel.
Some of the major benefits provided by Pradhan Mantri Ujjwala Yojana are:
- It provides five crore LPG connections to families below the poverty line.
- Financial support of Rs 1600 is provided by the scheme for each LPG connection for BPL households. The administrative cost of this support is borne by the Government. This subsidy is meant for the security fee for the cylinder, pressure regulator, booklet, safety hose, and other fitting charges.
- Under the scheme, oil marketing companies also provide interest-free loans for refilling and purchasing stoves.
- The Pradhan Mantri Ujjwala Yojana covers all the BPL families that come under all forms of distributorship and distributes various sizes of cylinders (14.2 kg, 5 kg, etc.) as per the field situation.
- The benefits of this scheme are also available for the people of all Hilly States including the NE States (who are treated as ‘Priority States’).
- The scheme effectively addresses several difficulties faced by the people in the States of Jammu and Kashmir, Himachal Pradesh, Uttarakhand, Sikkim, Assam, Nagaland, Manipur, Mizoram, Arunachal Pradesh, Meghalaya, and Tripura in accessing LPG for cooking purposes.
Limitations of this scheme:
- According to the recently released National Family Health Survey (NFHS)-5, there was a higher prevalence of TB in households that were using solid fuels when compared to those using clean cooking fuels in most States.
- Rural households could not meet their energy demand through this schemes for uses like bath water, cooking large quantities of parboiled rice or cattle feed.
- Average per capita consumption among Ujjwala customers has hovered around only three cylinders per year which is low.
- Extreme poor families’ participation still remains low.
- Despite reaching the 80 million subscriber target, still the universal delivery is a distant dream.
- Shifting focus towards the refill of existing cylinders at more subsidised rates.
- Enhance various capacities such as of the ports for handling imports, of tanks for storage of LPG, of pipelines and trucks for transportation of gas, and of bottling plants for filling in more cylinders.
- Regular availability of customer review and outreach programme.