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03 August, 2019

0 Min Read

Paper Topics Subject
GS-I Finding the data on missing girls.
GS-II Urban spaces need better designed homes and an egalitarian housing policy.
Health care is ailing.
Padding up for the next UNSC inning
What’s NEXT
GS-I :
Finding the data on missing girls.

GS-II: Finding the data on missing girls.

Context

The sex ratio at birth (SRB) has been dropping continuously since Census 2011, coming down from 909 girls per thousand boys in 2011-2013 to 896 girls in 2015-2017 as per the SRS Statistical Reports.

Facts

Female foeticide continues to increase at an alarming rate, as per the Sample Registration System (SRS) data released for the period 2015-2017.

In the 2014-2016 period, of the 21 large States, only two — Kerala and Chhattisgarh — had an SRB of above 950 girls per 1000 boys. Thus at present, about 5% of girls are ‘eliminated’ before they are born.

Data Problem

  • Niti Aayog acknowledged the seriousness of the problem in its latest report.
  • WCD Minister claimed in the Lok Sabha that SRB has improved from 923 to 931 girls. She was quoting data from the Health Management Information System (HMIS), a fundamentally flawed source that largely considers home deliveries and births in government institutions.
  • Data from the HMIS are incomplete and not representative of the country as a whole as births happening in private institutions are under-reported.

Different data sources

  • Private hospitals had a disproportionate excess of male children births, which the HMIS sample excludes.
  • Sources in the Niti Aayog confirmed that they did consider HMIS data but found after statistical examination that it was unreliable and therefore used sex ratio at birth (SRB).
  • Even when we only consider institutional deliveries in government hospitals, the SRB is falling.
  • The worst regional SRB for government sector was for Northern India (885 girls per thousand boys).
  • The picture was somewhat better for Central India (926) Southern India (940) while the performance of Eastern India (965) and Western India (959) was even better.
  • In the Northeast, where the government is the dominant health-care provider, the government sector SRB rivaled that of the private sector (both are 900).
  • Protecting the integrity of birth statistics will help the people, governments and health professionals to focus on ameliorating the gender gaps at birth.

Bias over firs-born child

  • NFHS-4 data also revealed a bias when it comes to the first-born child the SRB is among first-born children was 927, meaning that 2.5% of first-born girls are eliminated before birth.
  • Field visits in Uttar Pradesh and Bihar revealed a massive expansion of ultrasound clinics even in remote corners and in the absence of stringent implementation of the PCPNDT Act, practically anyone who wants to determine the sex of the foetus is able to get it done illegally.

Insights

  • Increased deterrence in States like Maharastra, Haryana and Rajasthan in recent years has been undermined by the laxity of the biggest States.
  • Central Supervisory Board established under the PCPNDT Act has not met for over one-and-a-half years. It should have ideally met at least thrice during this period.
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GS-II :
Urban spaces need better designed homes and an egalitarian housing policy.

GS-II: Urban spaces need better designed homes and an egalitarian housing policy.

Context

Homelessness is on the rise and has been for the past half a century. Eight years ago, after the 2011 Census, the demand for new housing was at 25 lakh units. With demand rising exponentially and increasing migration numbers the current requirement for shelter stands at 30 lakh units.

Challenges in providing housing

  1. Ineffective Programms
  • Pradhan Mantri Awas Yojana aims to provide cheaper houses quickly to low-income groups, with substantial interest subsidies on housing loans. The previous scheme, Awas Yojna, has been attempting the same since 1985 without much success. 
  • State housing boards have similar unachievable goals.

2.Idea of worship

  • In the early 1950s, new houses in most cities relied on the bungalow model. The home’s ownership, independence, and property rights were paramount.
  • 70 years later, despite a 100-fold increase in city population density and land values, little has changed from that ideal.
  • The unwillingness of a homeowner to rent out when the legal rights grossly favour tenants.

 Factors need to be evaluated in the search for a new model

  • Stringent urban land reforms would be the first step in that direction
  • Making housing part of city infrastructure projects, the government takes away land and construction from private builders and creates diverse pockets of housing in different parts of the city.
  • Ensuring citizens have easy access to subsidized rental housing without legal rights of ownership. Rental units would allow residents to live close to the office and employment, keeping the neighbourhood changing and dynamic.
  • It is imperative that a system of tax incentives and new rental regulations be used to achieve that goal
  • The imposition of a high un-occupancy tax on buildings that are vacant will help to inhabit almost a third of private housing that remains empty in most cities. 
  • Stricter construction restrictions are put in place; the government should see housing as a social service and not a business venture
  • Expanding the supply of low-income housing
  • Current densities of residential space need more efficient modifications – smaller multifunctional and compact unit makes more sense. Given the high land values, unless there is an increase in floor area ratio (FAR) and a decrease in a home’s occupancy footprint, economies of scale will never be achieved in city residential areas
  • Subsidies on efficient space planning, environmental considerations, and design that create shared community spaces should be encouraged and rewarded.

Conclusion

Housing in India is both inefficient, poorly constructed, thoughtlessly designed and conforms to outmoded ideas that still hark to the bungalow prototype. Unless more thoughtfully-designed homes with newer materials and technologies and a more egalitarian housing policy become part of future government programs, it is these citadels of waste and decay that will remain the public face of the city.

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GS-II :
Health care is ailing.

GS-II: Health care is ailing.

Context

The National Medical Commission Bill passed by Rajya Sabha addresses these concerns.

Why medical education needs these regulations?

  • To ensure that doctors are appropriately trained and skilled to address the prevailing disease burden
  • To ensure that medical graduates reflect a uniform standard of competence and skills
  • To ensure that only those with basic knowledge of science and aptitude for the profession get in
  • To ensure ethical practice in the interest of the patients
  • To create an environment that enables innovation and research
  • To check the corrosive impact of the process of commercialization on values and corrupt practices
  • The problem of inappropriately trained doctors of varying quality has been known for decades. The report of the Mudaliar Committee set up in 1959 pointed out how doctors had neither the skills nor the knowledge to handle primary care and infectious diseases that were a high priority concern then as now
  • Standards vary greatly with competence levels dependent upon the college of instruction.

Importance of the Bill

  • In setting curricula, teaching content, adding new courses and providing the much needed multi sectoral perspectives.
  • It has the potential to link the disease burden and the specialties being produced. In the UK, it is the government that lays down how many specialists of which discipline needs to be produced, which the British Medical Council then adheres to. In India the MCI has so far been operating independently.
  • It can encourage and incentivise innovation and promote research by laying down rules that make research a prerequisite in medical colleges.

Limitations

  1. Bill has proposed mandating the NEET and NEXT. NEET was mooted for three reasons: 
  • To reduce the pain of students taking almost 25 examinations to gain admission in a college.
  • Given the abysmal level of high school education, to ensure a minimum level of knowledge in science.
  • To reduce corruption by restricting student admission to those qualifying the NEET.
  • NEXT is an idea borrowed from the UK that has been struggling to introduce it. In all such countries, the licensing exams are stretched into modules, not a multiple choice questions type of exam. Bill has virtually given up inspections for assuring the quality of education.
  1. Relying only on the NEXT as the principal substitute is to abdicate governance. Undoubtedly, there are grey areas giving scope for corrupt practices and production of substandard doctors.
  2.  The reduced oversight allowing extensive discretionary powers to government makes it virtually an advisory body
  3. Permitting a registered medical practitioner to prescribe medicines.
  4. While there is a need to decentralize, to give to non-medical personnel some powers and authority it needs tight regulation and supervision.

Conclusion

Government has under this Bill, arrogated to itself an unprecedented power to appoint people in the various arms of the proposed structure. The quality and integrity of these people will then define the future of the health system in India.

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GS-II :
Padding up for the next UNSC inning

GS-II: Padding up for the next UNSC inning

Context

India was recently elected for its 8th term as a non-permanent member of the UN Security Council for the term 2021-22.India has served as a non-permanent member of the United Nations Security Council (UNSC) more often than any country other than Japan from the Asia-Pacific Group. India will need the vote of two-thirds of the 193 UN General Assembly members to win a non-permanent seat on the UNSC.

UNSC

  • UNSC is one of the principal organisation of United Nation with an aim for the international peace and security. As of now there are 15 members of UNSC.
  • Five of those US, UK, France, Russia and China are permanent members. India has been elected as a non-member of the UNSC for 7 terms.
  • Prime function of the UNSC should be to maintain international peace and security. It should also focus on shared goals, especially international social and economic cooperation.
  • India was seemingly offered the UNSC membership twice but in both cases the offer could not have materialised since multiple forces were at play.
  • India is at the forefront of efforts at the UN to push for the long-pending reform of the Security Council, emphasising that it rightly deserves a place at the UN high table as a permanent member.

Objectives for Indian foreign policy in UNSC

  • India should aim to have its decisions in UNSC based on legal merit. This would be well respected by international community. Enhance its credentials as a constructive and responsible member of international society, which can be used in future to push for a permanent UNSC seat.
  • India should emphasize and strengthening multilateralism in international politics to counter existing trends towards unilateralism, ethno-centrism, protectionism and racial intolerance.
  • India should attempt to make progress on the non-discriminatory elimination of weapons of mass destruction, protection of the environment against global warming &amp and safeguarding outer space from weaponization.
  • India should seek to protect the World Trade Organisation from American attempts to undermine it, since the WTO’s dispute mechanism is a resource for developing countries.
  • India could use its presence on the UNSC’s sanctions subcommittee to proscribe Pakistan-based militant groups and individuals.

Conclusion

 Diplomatic win for India and a testament to its growing global stature, India’s candidature for a non-permanent seat at the United Nations Security Council for a two-year term was unanimously endorsed by the Asia-Pacific group of the world body, including Pakistan and China.  India should aim to end its eighth term on the Council with its merit- and legality-based judgments intact and widely respected.

 

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GS-II :
What’s NEXT

GS-II: What’s NEXT?

Context

In its second iteration, the National Medical Commission (NMC) Bill seems to have gained from its time in the bottle, like ageing wine. The new version has some sharp divergences from the original.

Background

  • Presented in Parliament in 2017, it proposed to replace the Medical Council Act, 1956, but it lapsed with the dissolution of the Lok Sabha.
  • The NMC will have authority over medical education approvals for colleges, admissions, tests and fee-fixation.
  • The provisions of interest are in the core area of medical education. The Bill proposes to unify testing for exit from the MBBS course, and entry into postgraduate medical courses.
  • A single National Exit Test (NEXT) will be conducted across the country replacing the final year MBBS exam, and the scores used to allot PG seats as well.
  • It will allow medical graduates to start medical practice, seek admission to PG courses, and screen foreign medical graduates who want to practise in India.

Changes in National Exit Test (NEXT)

  • It offers a definite benefit for students who invest much time and energy in five years of training in classrooms, labs and the bedside, by reducing the number of tests they would have to take in case they aim to study further.
  • There are detractors, many of them from Tamil Nadu — which is still politically opposing the National Eligibility-cum-Entrance Test (NEET) — who believe that NEXT will undermine the federal system, and ask whether a test at the MBBS level would suffice as an entry criterion for PG courses.
  • The Bill has also removed the exemption hitherto given to Central institutions, the AIIMS and JIPMER, from NEET for admission to MBBS and allied courses.

Benefits

  • In doing so, the government has moved in the right direction, as there was resentment and a charge of elitism at the exclusion of some institutions from an exam that aimed at standardising testing for entry into MBBS.
  • The government also decided to scrap a proposal in the original Bill to conduct an additional licentiate exam that all medical graduates would have to take in order to practise, in the face of virulent opposition.
  • It also removed, rightly, a proposal in the older Bill for a bridge course for AYUSH practitioners to make a lateral entry into allopathy.

Way Forward

  • It is crucial now for the Centre to work amicably with States, and the Indian Medical Association, which is opposed to the Bill, taking them along to ease the process of implementation.
  • At any cost, it must avoid the creation of inflexible roadblocks as happened with NEET in some States.
  • The clearance of these hurdles, then, as recalled from experience, become fraught with legal and political battles, leaving behind much bitterness.
  • NEXT will have to be a lot neater.
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