Kurukshetra Oct 2024 Magazine

KURUKSHETRA OCTOBER 2024- HEALTH & NUTRITION 1
ensure soil fertility, biodiversity, and a stable

TOPIC 1: THE ROLE OF supply of nutritious food.
TRADITIONAL AND INDIGENOUS • Example: In the tribal regions of Madhya
KNOWLEDGE IN COMBATING Pradesh and Chhattisgarh, mixed cropping
MALNUTRITION IN RURAL INDIA and agroforestry systems provide diverse
crops and protect against crop failure,
ensuring food availability throughout the
Introduction year.
• Malnutrition remains a critical public health b. Promotion of Indigenous Crops
issue in rural India, where many face food • Indigenous crops like millets and pulses
insecurity, limited healthcare access, and are drought-resistant and require fewer
inadequate nutrition. inputs, making them ideal for cultivation
• Despite modernization, traditional and in arid regions.
indigenous knowledge can be key in tackling
• Example: In Rajasthan, Bajra (pearl
malnutrition. This knowledge, passed through
millet) is a staple, thriving in dry climates.
generations, is deeply tied to local culture,
environment, and food practices that have
It is rich in iron and dietary fiber and
plays a crucial role in local diets, especially
supported rural communities for centuries.
during droughts.
Nutrient-Rich Diets Rooted in Tradition
Cultural Relevance and Acceptance
a. Balanced Nutritional Intake
• Traditional diets in rural India include locally a. Integration with Local Traditions
sourced foods like millets, pulses, vegetables, • Traditional food practices are deeply linked
fruits, and herbs, rich in essential nutrients. to local customs, festivals, and religious
• These diets ensure a balanced intake of rituals, ensuring their wide acceptance and
vitamins, minerals, proteins, and dietary easy integration into daily life, improving
fiber, addressing both macronutrient and nutrition.
micronutrient deficiencies. • Example: In Kerala, the use of turmeric and
• Example: In Karnataka and Maharashtra, the ginger in cooking is part of cultural heritage,
consumption of Ragi (finger millet) and Jowar known for their anti-inflammatory and
(sorghum) is common. These grains are rich immune-boosting properties.
in calcium, iron, and dietary fiber, vital for
b. Preservation of Traditional Knowledge
fighting malnutrition in children and women.
• Traditional diets help preserve indigenous
b. Health Benefits of Indigenous Foods knowledge, including food preparation
• Indigenous foods, such as leafy greens and and preservation methods that maximize
wild edibles, are often rich in micronutrients nutritional value.
like iron, vitamin A, and calcium. • Example: In the Northeastern states,
• Example: In Odisha, tribal communities fermenting bamboo shoots and fish
consume white leafy greens like amaranth improves their nutritional profile and
and drumstick leaves, which are high in promotes gut health.
iron and help reduce anemia, a widespread
problem in rural areas. Adaptability to Local Environments
a. Climate-Resilient Food Systems

Food Security through Sustainable Agricultural
Practices • Indigenous knowledge includes strategies like
drought-resistant crops, water conservation,
a. Resilient Farming Techniques and organic fertilizers to maintain food
• Traditional practices such as crop rotation, production despite climate change.
intercropping, and organic farming help Example: In Gujarat, traditional stepwells
NEW DELHI | AHMEDABAD | ANAND | BHUBANESWAR | CHANDIGARH | DEHRADUN | GANDHINAGAR | HYDERABAD | INDORE |
JAIPUR | KANPUR | KOLKATA | LUCKNOW | MUMBAI | PATNA | RAIPUR | RAJKOT | SURAT | THANE | VADODARA | VARANASI
2 KURUKSHETRA OCTOBER 2024- HEALTH & NUTRITION
and rainwater harvesting support agriculture Environmental and Gender Roles in Nutrition
in arid conditions.
b. Utilization of Wild Foods a. Women as Custodians of Traditional Knowledge
• Rural communities often rely on wild foods • In many rural communities, women are the
like fruits, nuts, and tubers, rich in nutrients primary keepers of traditional knowledge
and crucial during food shortages. related to food production, preparation, and
preservation.
• Example: In Jharkhand, tribal communities
gather wild mushrooms, berries, and tubers, • Example: In Rajasthan, women manage
providing essential nutrients during lean traditional kitchens, and kitchen garden
initiatives have improved family nutrition.
seasons.
b. Role in Maternal and Child Health
Sustainable Food Systems and Environmental • Traditional knowledge is vital in maternal
Stewardship and child health, addressing nutritional
needs during pregnancy, lactation, and early
a. Conservation of Biodiversity childhood.
• Traditional farming promotes biodiversity,
• Example: In Uttar Pradesh, postpartum diets
crucial for food security. By cultivating
include sesame seeds, jaggery, and ghee,
a variety of crops and using seed-saving
believed to aid recovery and lactation.
methods, rural communities conserve genetic
diversity. Community-Led Initiatives and Knowledge
• Example: In Tamil Nadu, saving and Sharing
exchanging indigenous rice strains helps
maintain agricultural biodiversity, with a. Revival of Traditional Foods through
varieties more nutritious and better adapted Community Efforts
to local conditions. • Community-led initiatives are reviving
traditional food practices, especially in areas
b. Low Environmental Impact
where they were neglected.
• Indigenous agricultural practices rely on • Example: In Odisha, efforts to revive millets
organic inputs, avoiding chemical fertilizers like kodo and kutki have improved child
and pesticides, and prioritize soil health, nutrition.
promoting sustainable food production.
b. Knowledge Sharing and Capacity Building
• Example: In the Sikkim Himalayas, shifting
• Traditional knowledge is shared through
cultivation (Jhum) is managed to allow land
community networks, festivals, and social
regeneration, maintaining soil fertility. gatherings, ensuring its transmission to
younger generations.
Health Benefits and Disease Prevention
• Example: Festivals like Bihu in Assam and
a. Medicinal Properties of Indigenous Foods Chapchar Kut in Mizoram serve as platforms
for sharing agricultural and food knowledge.
• Many traditional foods have medicinal
properties, helping manage chronic diseases.
Integration with Modern Nutritional
• Example: In Andhra Pradesh, tamarind is Interventions
used in cooking for its antioxidants, aiding
digestion and managing blood sugar levels. a.
Complementary Role in Government
b. Traditional Dietary Practices and Gut Health Programs
• Traditional knowledge complements modern
• Fermented foods in traditional diets support
nutritional programs by offering culturally
gut health, crucial for nutrient absorption
appropriate and locally sourced solutions to
and immunity.
malnutrition.
• Example: In Nagaland, fermented soybean • Example: In Karnataka, traditional foods
(axone) is rich in protein and probiotics, like millet are integrated into midday meal
enhancing gut health. programs, improving children’s nutrition.
b. Incorporation into Public Health Campaigns • Solution: Programs like PM POSHAN, which
• Public health campaigns that promote incorporates millets, should be expanded
traditional diets can address malnutrition nationwide.
while preserving cultural heritage. e.
Climate Change and Environmental
• Example: In Maharashtra, campaigns Degradation
promoting local foods like bhakri (millet • Climate change affects the cultivation of
flatbread) and varan (lentil stew) have increased traditional crops.
awareness of their nutritional benefits. • Solution: Promote climate-resilient
traditional crops through government
Government Measures
incentives and agricultural research.
• Various government schemes promote the
cultivation and consumption of traditional Conclusion
foods, integrating indigenous knowledge to
• Traditional and indigenous knowledge
fight malnutrition.
offers sustainable, culturally appropriate
• Strengthening these programs with solutions to malnutrition in rural India.
education, market access, and knowledge • Overcoming challenges such as modernization,
preservation can further enhance their market access, and stigma requires targeted
effectiveness. efforts in education, community initiatives,
and government support.
Challenges in Incorporating Traditional
• Integrating traditional practices with modern
Knowledge
interventions can enhance nutrition and food
a. Erosion of Traditional Knowledge security for future generations.
• Modernization, urban migration, and
Western diets are causing the loss of traditional
TOPIC 2: FUTURE REFORMS FOR
knowledge, especially among younger INDIA’S HEALTH SYSTEMS
generations.
• Solution: Revive traditional knowledge Introduction
through education and community programs.
• India has made significant strides in
b. Lack of Market Access for Indigenous Crops healthcare, with over 500 million citizens
• Farmers growing indigenous crops face benefiting from the Ayushman Bharat
market access challenges, making these Pradhan Mantri Jan Aarogya Yojana (AB-
crops less profitable. PMJAY).
• Solution: Improve market access by • The establishment of 1,73,000 Ayushman
incorporating indigenous crops into public Aarogya Mandirs (AAMs) has enhanced
distribution systems (PDS). primary healthcare.
c. Stigma Around Traditional Foods • Medical education has expanded, doubling
the availability of undergraduate and
• Traditional foods are often viewed as “poor
postgraduate seats over the last decade.
man’s food,” especially among younger
generations. • Out-of-pocket healthcare expenses have
reduced from 63% in 2014 to 39% in 2024.
• Solution: Use public campaigns and
initiatives like Poshan Abhiyan to promote • Despite progress, India still faces challenges
their health benefits. in achieving global health standards as it
works toward Viksit Bharat by 2047.
d. Lack of Integration with Modern Nutrition
Programs Health Indicators: A Global Comparison
• Many government programs focus on
fortified foods, ignoring traditional, locally a. Life Expectancy
available options. • India’s life expectancy: 71 years.
• Comparisons: Workforce Expansion and Development

¾ China: 77 years
a. Increasing Medical Education
¾ Japan: 84 years • Expanding the number of institutions and
¾ Brazil: 75 years increasing student intake to build a larger
b. Infant Mortality Rate (IMR) workforce.
b. Enhancing Working Conditions
• India’s IMR: 28 per 1,000 live births.
• Better salaries, job security, and working
• Comparisons: conditions for health professionals, especially
¾ China: 5 per 1,000 live births in rural areas.
¾ Japan: Less than 2 per 1,000 live births c. Deployment of Community Health Workers
c. Out-of-Pocket Health Expenditure • Trained community health workers can fill
gaps in underserved regions.
• India: 39%.
d. Attracting Healthcare Professionals Back to
• Comparison: India
¾ South Africa: 8% • Policies to encourage Indian healthcare
professionals abroad to return home and
Obstacles in Implementing Healthcare work.
Reforms e. Public-Private Sector Collaborations
• Private sector involvement in enhancing
a. Funding and Financial Constraints healthcare access and training.
• Inconsistent and insufficient funding for f. Telemedicine
healthcare programs due to competing • Leveraging telemedicine to improve efficiency
demands for limited resources. and access in healthcare services.
b. Infrastructure Deficiencies
Public Healthcare Expenditure
• Many rural and remote areas lack adequate
healthcare infrastructure, including hospitals, a. National Health Policy (NHP 2017) Targets
clinics, and diagnostic facilities, requiring • NHP 2017 recommends raising healthcare
substantial investment. spending to 2.5% of GDP by 2024-25.
c. Bureaucratic and Regulatory Barriers • States have varied in meeting the 8%
• Complex regulations and bureaucratic healthcare expenditure target.
processes delay timely reform implementation, b. Investment in Nutrition and Sanitation
necessitating streamlined procedures.
• Investments in nutrition, clean drinking
d. Public Awareness and Education water, and sanitation are critical for
• Low public awareness about new healthcare addressing childhood undernutrition and
initiatives leads to underutilization of anemia in women and children.
services.
Addressing Health of Children and
e. Technology Integration Challenges Adolescents
• Issues with interoperability and data security
arise as healthcare systems embrace technology. a. Early Childhood Development
• Focus on the first 1,000 days of life for
f. Healthcare Professional Shortage
nutrition and care (from pregnancy to the
• India has 10 doctors and 17 nurses/midwives child’s second birthday).
per 10,000 people compared to: • Strengthening 1.4 million Anganwadi
¾ China: 17 doctors, 40 nurses/midwives centers with better training for staff on child
¾ Brazil: 17 doctors, 40 nurses/midwives development.
¾ USA and Australia: 39 doctors, 120 b. School-Age Health
nurses/midwives • Health and nutrition initiatives for 255
million school children (aged 6-18) are vital b. Community Engagement

for leveraging the youth’s potential. • Involving local communities in nutrition
• A nationwide school health initiative programs to improve their relevance and
focusing on physical, mental health, nutrition, acceptance.
and wellness. c. Building Capacity of Frontline Workers
Strengthening Primary Healthcare • Training Anganwadi and ASHA workers to
deliver effective nutrition services.
a. Ayushman Arogya Mandirs (AAMs) d. Cross-Sector Collaboration
• The target is to completely transform all • Collaboration across health, education,
1,73,000 AAMs by 2027, focusing on: agriculture, and social welfare sectors to
¾ Community health officers address malnutrition.
¾ Infrastructure improvements
¾ Telemedicine services e. Public Awareness Campaigns
¾ Free medications and diagnostics • Nationwide campaigns to inform people
b. Operational Challenges about the importance of nutrition and
available services.
• Gaps remain in operationalization, coverage,
quality, and continuity.
Water and Sanitation Reforms
• Issues with inconsistent medication and
diagnostic supply. a. Systems Reforms
• Focus on improving treatment, follow-ups, • Enhancing performance through improved
cancer screening, and personnel training. management practices and transparent
reporting.
Challenges in Ayushman Bharat - PMJAY
b. Private Sector Engagement
a. Lack of Awareness • Private sector involvement to bring
• Low awareness in rural areas about AB- innovation, investment, and expertise to the
PMJAY, necessitating better communication WASH sector.
strategies. c. Integrated Planning
b. Funding and State Participation • Strategies for rainwater harvesting,
• Varying levels of participation among states, wastewater treatment, and reuse of treated
leading to uneven healthcare coverage. water for sustainability.
c. Healthcare Infrastructure Deficiencies d. Community Involvement

• Rural and remote areas lack the necessary • Local participation in water and sanitation
infrastructure to fully implement AB-PMJAY. projects for greater relevance and effectiveness.
d. Quality of Care e. Regulatory Strengthening

• Challenges with hospital accreditation and • Stronger enforcement of water quality
maintaining high standards of service. standards and sanitation norms.
e. Public-Private Coordination f. Climate Resilience

• Effective coordination between public and • Building climate-resilient water and sanitation
private healthcare providers is crucial for infrastructure.
comprehensive coverage.
Conclusion
Social Determinants of Health
• Health and economic productivity are
a. Monitoring and Evaluation interconnected, making increased healthcare
funding essential.
• Enhanced systems for tracking progress and
identifying gaps through regular audits and • Improving healthcare quality with existing
feedback. resources is key.
• Political will and governance play a critical 1. Supporting vs. Creating new value
role in successful reform implementation. propositions.
• A collaborative effort between the government, 2. Differentiating between consumer and
private sector, and civil society is essential for patient roles.
building a resilient and inclusive healthcare system. 3. Building organizational capabilities to
leverage digital tools.
TOPIC 3: THE DIGITAL SHIFT Vision for Intelligent Healthcare Enterprises
IN HEALTHCARE: NAVIGATING
TECHNOLOGICAL TRANSFORMATION
Introduction to Industry 4.0 and Healthcare
• The healthcare industry is undergoing a
profound transformation due to Industry
4.0.
• Technologies such as Artificial Intelligence
(AI), Big Data, and advanced algorithms
are reshaping healthcare systems, driving
innovation in service delivery and
management.
• Healthcare’s importance:
¾ Integral to national development alongside
issues like poverty and climate change.
¾ Consumes significant national resources. a. Historical Evolution of IT in Healthcare
¾ Healthcare systems enhance population • Over the past 50 years, the IT industry has
health through prevention, diagnosis, and transformed healthcare:
treatment of physical and mental illnesses.
1. 1960s and 1970s: Mainframes and PCs
introduced industrial automation.
The Role of Technology in Healthcare
2. 1980s and 1990s: Internet and client-server
• Technology-driven transformation is architecture enabled business process
pushing healthcare organizations to explore automation.
new value propositions by lowering costs 3. 2000s: Cloud computing, mobile data,
and creating new service models. and social networks fueled digital
• COVID-19 pandemic: transformation.
¾ Highlighted the need for rapid b. Modern Intelligent Technologies
technological adaptation to maintain • Current technologies—AI, ML, advanced
service delivery. analytics, and IoT—are paving the way for
¾ Technology became a key enabler for intelligent enterprises.
remote care, minimizing disruption. • Despite slow progress, the volume of patient-
level data has increased exponentially, with
Barriers to Digital Transformation in new diagnostic information from connected
Healthcare devices, smartphones, and wearables.
• Despite the promise of technology, healthcare c. Challenges with Current Systems
faces several barriers: • Payment systems are primarily volume-
¾ Highly regulated environment. based, creating inefficiencies and hindering
¾ Prudence in a field where patient lives are value-based care.
at risk. • Lack of risk-sharing mechanisms leads to
¾ A need for a more structured approach to poor utilization of resources and negative
digital transformation, focusing on: patient outcomes.
Framework for Digital Transformation in Healthcare
a. Engagement 2. Dynamic Capabilities:

• Definition: Engagement is the motivation and Respond to environmental changes
involvement of individuals in the pursuit of their by aligning resources with consumer
goals, playing a vital role in patient-centered care. demands.
Enable structural changes in business
• For patients:
processes.
¾ Engagement ensures care is respectful of
individual preferences. Value Creation in Healthcare through
¾ It integrates emotional, cognitive, and Technology
behavioral aspects to improve the
a. Supporting Existing Value Propositions
healthcare experience.
• Focused on cost reduction and improving
b. Capabilities patient outcomes.
• Resource-Based View (RBV): Capabilities • Challenge: Measuring system-level costs
are organizational routines that combine when cost reduction is compartmentalized.
resources to gain a competitive advantage.
b. Creating New Value Propositions
• Key Capabilities:
• Patient-Centric View: Engages the end-user
1. Structured IT Capabilities: by improving care coordination and patient
IT Generation and Reconfiguration: activation through digital tools like EMR-
Adapt technology infrastructure to integrated systems and messaging.
external changes. • Consumer-Centric View: Reflects the
IT Integration: Coordinate data demand for quick and efficient services such
exchange within and outside the as process status updates, virtual care, and
organization. appointment scheduling.
The Role of Data and Intelligent Technologies ¾ Improve quality of life.

¾ Deliver value-based healthcare.
a. Rich Health Data Foundation ¾ Ensure a seamless patient experience.
• The integration of IoT, advanced analytics, a. Digital Maturity and Adoption
ML, and AI will drive improvements in:
• Although many healthcare organizations have
¾ Diagnostics.
initiated digital transformation projects, few
¾ Prevention. have achieved digital maturity.
¾ Patient therapy. • Future success depends on integrating
b. Real-Time Interaction intelligent technologies into core business
• Technologies enable live monitoring of processes for efficient, patient-centered care.
patients, allowing for immediate intervention
rather than periodic check-ins. Moving from Reactive to Proactive Healthcare
• Operational intelligence ensures healthcare • Reactive Health: Traditional model where
services are used efficiently, thereby diagnosis and treatment are responses to
optimizing costs. symptoms.
c. Regulatory and Security Challenges • Proactive Health:
• The healthcare industry is highly regulated, ¾ Based on early detection and continuous
and concerns over data privacy and security monitoring.
slow the adoption of technology. ¾ Leverages passive data capture, predictive
• Payment models like procedure-based models, and multiple connected data
sources for a personalized patient
payments also hinder the shift towards value-
based care. experience.
Vision for the Future: Value-Based Healthcare Government Initiatives: Towards Digital
Healthcare
• Intelligent healthcare providers aim to:
Conclusion and Way Forward ¾ Progress in reducing maternal and child

deaths has flatlined for the past 8 years.
a. Building Intelligent Enterprises ¾ Declining investment in maternal and
• Intelligent healthcare providers use advanced newborn health.
IT systems and data to:
¾ Respond to individual needs. India’s Progress
¾ Engage talents. • Significant improvement in pregnancy-
¾ Disrupt and innovate business models. related outcomes.
b. Digital Transformation for Competitive • India has made progress in reducing maternal
Advantage and neonatal mortality, supporting SDG 3.
• Agility and flexibility are key to improving • Unplanned pregnancies:
patient outcomes, reducing costs, and staying ¾ Globally, 1 in 4 pregnancies are unplanned.
competitive.
¾ In India, 1 in 7 pregnancies are unplanned.
• Successful digital transformation relies on:
• Unplanned pregnancies lead to:
1. Integration-ready applications.
¾ Pre-term birth
2. Extensible platforms that offer intuitive
user experiences. ¾ Low birth weight
¾ Congenital anomalies
c. Adapting to Future Technologies
• As technologies like ML, AI, IoT, and big data Shift in Focus:
become mainstream, healthcare organizations
must continue to experiment and adapt. • From reducing mortality to improving the
quality of maternal and child healthcare.
• Embedding intelligent technologies into
applications will be crucial for ongoing • Enhancing the quality of life and building
innovation and long-term success. healthier communities.
What is Pre-Pregnancy Care?

TOPIC 4: PRE-PREGNANCY CARE:
WHAT EXISTS AND THE WAY • Pre-pregnancy care involves a range of
FORWARD interventions provided to women and
couples before pregnancy, including:
Global Progress and Challenges ¾ Health education
¾ Medical management
• Significant strides have been made in
maternal and child health through evidence- ¾ Lifestyle modifications
based interventions focusing on: • Goals:
¾ Promoting health ¾ Ensure women enter pregnancy in optimal
¾ Strengthening human resources health.
¾ Improving financial structures and ¾ Improve pregnancy outcomes and enhance
infrastructure the health of future generations.
• Sustainable Development Goals (SDGs)
Targets: Key Criteria for Pre-Pregnancy Care:
¾ Maternal mortality: Reduce to 70 per
• Risk Prevention: Address health risks before
100,000 live births.
pregnancy.
¾ Under-5 mortality (U5M): Reduce to 25
per 1,000 live births. • Health Promotion: Improve health outcomes
for mothers and children.
¾ Neonatal mortality: Reduce to 12 per 1,000
live births.
Benefits of Pre-Pregnancy Care
• Current Challenges:
¾ 95% of deaths occur in low- and lower- • Positive Impacts:
middle-income countries. ¾ Improved health knowledge.
¾ Reduced substance use (alcohol and • Emphasizes pre-pregnancy care as part of

tobacco). a continuum of care from pre-pregnancy
¾ Improved dietary habits, physical activity, through childbirth and the postnatal period.
and folate intake.
Strategic Interventions for Pre-Pregnancy Care
• Health Outcomes:
• Indian Academy of Pediatrics (IAP)
¾ Reduction in pre-eclampsia and low birth
weight. Guidelines
• Long-term Impact: • Cover 10 key domains for pre-pregnancy
care:
¾ Healthy development of future children.
1. Eumetabolic Health
Evidence from Key Studies 2. Nutrition
• WINGS Trial (Delhi): 3. Healthy Lifestyle
¾ Focus: Health, nutrition, psychological 4. Substance Abuse Avoidance
care, and WASH interventions before and 5. Genetic Screening
during pregnancy. 6. Reproductive Health
¾ Outcome: 24% reduction in low birth 7. Humanization
weight (less than 2,500 gm), with over 8. Body Image Cosmetics
half of the reduction due to pre-pregnancy
interventions. 9. Dental Health
10. Relationship Management and Mental
• PRIYA Trial (Pune):
Well-Being Support Systems
¾ Focus: Vitamin B12 supplementation
before pregnancy.
Conclusion and Way Forward
¾ Outcome: Improved cognitive and
language development in children of Integration of Pre-Conception Care into Health
mothers who took vitamin B12. Services
The Women First Trial: Multi-country • Collaboration among stakeholders is key:
randomized controlled trial showing:
¾ State governments, development partners,
• Positive impact of maternal nutrition research institutions, and scientific
supplementation before pregnancy. communities need to engage in policy
• Improved fetal growth and reduction in development.
stunting, underweight, wasting, and small- • Empower individuals and families with
for-gestational-age (SGA) births. informed choices about pre-pregnancy care.
The Importance of Pre-Pregnancy Care Cultural Shift Towards Proactive Pregnancy
Planning
• Reducing Neonatal and Birth Disorders:
• Successful pre-conception care requires
¾ Address modifiable risk factors before a cultural shift to prioritize proactive
pregnancy. pregnancy planning.
¾ Targeted interventions lead to healthier
• Positive Health Outcomes:
pregnancies and better long-term outcomes.
¾ Improved child and maternal health.
• Early Risk Assessment:
¾ Most fetal organ development begins shortly ¾ Intergenerational benefits across
after conception, making early care critical. healthcare, communities, and households.
Need for Behavioral Change
Policy Recommendations for Pre-Pregnancy
Care • Targeted interventions are needed for
individual and family-level behavioral
Indian Newborn Action Plan (INAP) change.
• A comprehensive initiative aimed at reducing • Providing information on:
newborn mortality and improving maternal ¾ Healthy lifestyle choices
health. ¾ Balanced diet
¾ Regular physical activity • Consume plenty of vegetables, fruits, and

¾ Stress management legumes, with a special emphasis on green
¾ Avoidance of harmful substances (tobacco, leafy vegetables (GLVs).
alcohol, drugs). • Obtain high-quality proteins and
Community Awareness and Action essential amino acids (EAAs) through food
• Generate community awareness through combinations; avoid protein supplements.
Jan Andolan and social behavior change • Consume oils and fats in moderation.
communication. Include a variety of nuts, seeds, millets, and
• Prioritize Pre-Pregnancy Care: legumes to meet essential fatty acid (EFA)
needs.
¾ Improve nutrition and health status before
and during pregnancy to enhance fetal • Restrict salt intake and minimize sugar
growth and obstetric outcomes. consumption.
¾ Ensure long-term health for both mothers • Minimize consumption of high-fat, sugar,
and children. salt (HFSS), and ultra-processed foods
Vision of “Viksit Bharat” (UPFs).
• A developed and thriving India can be • Drink adequate amounts of water and other
achieved by aligning pre-pregnancy care with healthy beverages.
the vision of a “Viksit Bharat”. • Ensure food safety by consuming clean and
safe food and water.
TOPIC 5: DIETARY GUIDELINES • Use appropriate cooking methods to
FOR INDIANS 2024: APPROPRIATE minimize nutrient loss.
NUTRITION AND HEALTH • Provide extra nutrition and healthcare
PROMOTION during pregnancy and lactation.
• Promote exclusive breastfeeding for the first
six months and continued breastfeeding until
Current Health Challenges in India two years or beyond.
• India faces a triple burden of disease: • Introduce homemade, semi-solid
¾ Chronic energy deficiency and complementary foods to infants after six
undernutrition months.
¾ Diet and lifestyle-related chronic diseases • Provide adequate nutrition for children and
(e.g., coronary heart disease, diabetes) adolescents during both health and sickness.
¾ Infectious diseases • Ensure nutrient-rich diets for the elderly to
• Unhealthy diets contribute to 56.4% of the promote well-being.
total disease burden. • Stay physically active to maintain overall
• Balanced diets can: health.
¾ Prevent nutritional deficiencies and • Adopt a healthy lifestyle to prevent obesity,
excesses diabetes, and heart disease.
¾ Support optimal growth and development • Read food labels carefully to make informed
¾ Reduce the risk of non-communicable choices.
diseases (NCDs) like heart disease,
The Role of Nutrition Across Life Stages
hypertension, and up to 80% of type 2
diabetes cases • Nutrition is critical from conception to old
¾ Prevent premature deaths through the age.
adoption of healthy lifestyles. • A balanced diet ensures optimal growth,
development, and long-term health.
Key Dietary Guidelines for 2024
• It also helps minimize the risk of diet-related
• Eat a variety of foods to ensure a balanced non-communicable diseases (DR-NCDs) in
diet. later life.
4. Evolution of Dietary Guidelines in India 8. Meat/fish/poultry Eggs, meat, fish,

• The National Institute of Nutrition (NIN) (Flesh foods) poultry, etc.
released the first dietary guidelines in 1998, 9. Nuts, oil seeds, Nuts (peanuts,
with a second edition in 2011, and the revised oils, and fats walnuts, almonds,
edition in 2024. etc.), oil seeds (sesame,
sunflower seeds, etc.),
• The guidelines help individuals make better
vegetable oils, ghee,
food choices and ensure dietary diversity for butter, cream, etc.
optimal nutrition.
10. Spices, Spices, condiments &
Importance of Dietary Diversity condiments & herbs like turmeric,
herbs dry ginger, mustard,
• A varied diet ensures that essential nutrients pepper, cumin,
are consumed in adequate amounts. coriander, etc.
• Including different types of foods helps to
balance nutrient intake and improve health 1. Cereals/Millets: Wheat, rice, maize, jowar,
outcomes. bajra, barley, foxtail millets, oats
Food Groups and Nutritional Variety 2. Pulses/Legumes: Bengal gram, green gram,
lentils, rajma, soybeans
To ensure dietary diversity, include a variety of
foods from the following groups: 3. Green Leafy Vegetables (GLVs): Spinach,
methi, coriander, mustard leaves
Table-1: Examples 4. Starchy Roots and Tubers: Potato, sweet
Classification potato, yam
of different 5. Other Vegetables: Carrot, peas, brinjal,
foods into cucumber, pumpkin
various Food 6. Fruits: Apple, banana, guava, mango,
Groups watermelon
1. Cereals & Cereals, millets, 7. Nuts and Oil Seeds: Almonds, groundnuts,
millets and their products sesame, sunflower seeds
like bread, suji, 8. Milk and Milk Products: Cow’s milk, curd,
vermicelli, noodles, cheese, butter
pasta, etc.
9. Non-Vegetarian Foods: Meat, poultry, fish
2. Pulses & Pulses and legumes
10. Fats and Oils: Butter, ghee, various edible
legumes (whole/split/
dehusked) and their oils
products
My Plate For TheDay Approach
3. Starchy Roots & Potato, sweet potato,
tubers arbi, yam, tapioca, • This concept, recommended by ICMR-NIN,
etc. suggests sourcing macro and micronutrients
4. Green leafy Seasonal & regional from 8 food groups.
vegetables green leafy • A daily diet should include foods from at
(GLVs) vegetables (GLVs) least 5–7 groups.
5. Other Seasonal vegetables • Half the plate should consist of vegetables
Vegetables other than GLVs and (GLVs, roots, tubers) and fruits, while the
Roots & tubers other half includes cereals, millets, pulses,
6. Fruits Seasonal fruits/fruit nuts, and dairy.
products
Focus on Health-Promoting Nutrients
7. Dairy products Milk, curd, buttermilk,
paneer, processed • Nutrients like dietary fiber, antioxidants,
cheese, etc. and phytochemicals are essential for health
and disease prevention. Dissemination and Public Awareness

• A balanced diet rich in these components
• These guidelines need to be widely
supports long-term well-being.
disseminated to improve public knowledge,
attitudes, and practices.
Additional Dietary Recommendations
• The goal is to enhance public health and
• Limit salt and sugar intake to reduce the risk prevent diet-related diseases, especially non-
of cardiovascular diseases and diabetes. communicable diseases (NCDs).
• Avoid ultra-processed foods (UPFs) and
those high in fat, sugar, and salt (HFSS). TOPIC 6 : THE ROLE OF
• Drink adequate fluids to stay hydrated and AGRICULTURE IN PROMOTING
promote food safety. HEALTH AND NUTRITION:
Maternal and Child Nutrition
Agriculture and its Role in Health and
• Adequate nutrition during pregnancy and
Nutrition
lactation is crucial for:
¾ Better pregnancy outcomes • Foundation of human survival: Agriculture
¾ Optimal growth and development of the provides essential food and nutrients.
baby • More than food production: Agriculture
• The first 1,000 days (from conception to contributes to:
two years) are critical for the child’s health, ¾ Food safety
reducing the risk of metabolic syndromes, ¾ Prevention of non-communicable diseases
diabetes, and cardiovascular diseases later in (NCDs)
life. ¾ Dietary diversity
¾ Sustainable farming practices
Breastfeeding and Child Feeding Practices
• Agriculture is critical in addressing health
• Exclusive breastfeeding is recommended for challenges such as malnutrition, obesity,
the first six months, followed by continued and food scarcity, especially in degraded
breastfeeding alongside complementary environments.
feeding.
Agriculture as a Source of Nutrient-Dense
Elderly Nutrition Foods
• The elderly should consume nutrient-rich
Types of Nutrient-Dense Foods from
foods to ensure better health and well-being
Agriculture
in old age.
• Fruits and vegetables:
Promoting Physical Activity and Healthy ¾ Rich in vitamins A, C, K, antioxidants,
Lifestyles and dietary fiber.
¾ Benefits:
• Regular exercise and an active lifestyle can
Promotes cardiovascular health.
help prevent overweight, obesity, and NCDs
such as diabetes and heart disease. Reduces the risk of certain cancers.
Supports healthy digestion.
Shift from Traditional to Modern Diets
• Whole grains:
• Traditional diets were more nutritious, whereas ¾ Major sources of complex carbohydrates,
modern diets, influenced by industrialization, B vitamins, and other micronutrients.
have led to increased health risks. ¾ Provides energy for basic body functions.
• A return to health-promoting diets and • Animal products:
mindful eating is necessary to combat these ¾ Rich in proteins, good fats, vitamins, and
risks. minerals essential for overall health.
Role of Bio-Fortified Crops items throughout the year, improving both

• Bio-fortification: Process of genetically nutrition and resilience to economic/
environmental shocks.
enhancing crops with higher levels of essential
nutrients (e.g., iron, zinc, vitamin A). Nutrition-Sensitive Agricultural Policies
• Helps combat hidden hunger and • Policies such as the Mission for Integrated
micronutrient deficiencies, especially where Development of Horticulture (MIDH) have
access to diverse diets is limited. enhanced the links between agriculture and
• Example: nutrition.
¾ Harvest Plus initiative: Produced bio- • India is a leading producer of fruits and
fortified strains of rice, maize, and sweet vegetables, creating great potential to
potatoes to address nutrient deficiencies, improve nutrition by increasing access to a
particularly in developing countries. wider range of foods.
Links Between Agricultural Practices and Agricultural Policies and Public Health: A
Dietary Diversity Crucial Intersection
Importance of Dietary Diversity Impact of Agricultural Policies on Public Health

• India’s agricultural sector supports dietary • Agricultural policies in India influence:
diversity, contributing to the population’s ¾ Food production methods
nutrition and well-being. ¾ Crop types produced
• The country produces a wide variety of crops ¾ Food availability, access, and equity
(e.g., cereals, pulses, fruits, vegetables, ¾ Nutrition and health status of millions
spices, and livestock products) due to its • National Food Security Act:
varied agro-climatic zones. ¾ Provides subsidized grains to over 800
Impact on Food Security and Nutrition million people.
• Diversified agriculture (e.g., mixed farming, ¾ Has significantly reduced hunger and
crop-livestock integration) improves food undernutrition but primarily focuses on
security and dietary diversity. calorie-rich, nutrient-poor foods (lacking
proteins, vitamins, and minerals).
• Farmers with diverse crops: Tend to have
more nutritionally diverse diets by growing • POSHAN Abhiyaan (National Nutrition
cereals, pulses, fruits, and vegetables or Mission):
rearing livestock. ¾ Integrates agriculture with nutrition to
address malnutrition, especially among
Success Stories in India children and pregnant women.
• NFHS-5 report: Mixed farming practices ¾ Emphasizes the production and
in rural areas have led to improved dietary consumption of pulses, fruits, and
diversity and nutritional status, especially vegetables to improve dietary diversity
for women and children. and fight malnutrition.
• Pulse cultivation: Sustainable Agriculture and Food Safety
¾ Pulses (e.g., lentils, chickpeas) are rich in Policies
plant-based protein, iron, and folic acid. • Eat Right India campaign (FSSAI):
¾ Promotion through the National ¾ Promotes organic farming, sustainable
Food Security Mission has improved agricultural practices, and consumption
sustainable agriculture and nutritional of locally-produced foods to reduce
outcomes in India. exposure to contaminants and enhance
• Agro-forestry practices: nutrition.
¾ In states like Kerala and Karnataka, • Paramparagat Krishi Vikas Yojana (PKVY):
farmers grow spices, fruits, and vegetables ¾ Focuses on organic farming to reduce
alongside cereals. chemical inputs and produce healthier,
¾ Ensures a steady supply of varied food toxin-free foods.
¾ 2021 study: Found that organic foods Agriculture’s Role in Combating Non-
in India have lower pesticide residues, Communicable Diseases (NCDs)
reducing long-term health risks.
Agriculture’s Contribution to Addressing NCDs
Sustainable Agriculture and Food Security • NCDs such as diabetes, cardiovascular
diseases, cancers, and chronic respiratory
Need for Sustainable Agriculture
diseases account for 71% of global deaths
• Global food demand is projected to rise by (WHO).
60% by 2050. • Healthy, nutrient-dense foods produced through
• Developing sustainable agricultural agriculture can reduce the risk of NCDs.
practices is crucial to meet future food needs ¾ Example: Diets rich in fruits, vegetables,
and ensure food security. whole grains, and legumes help reduce
the risk of heart disease, stroke, and certain
Key Sustainable Agriculture Initiatives in India
cancers.
• Zero-Budget Natural Farming (ZBNF):
India’s Agricultural Initiatives for NCDs
¾ Implemented in Andhra Pradesh and
• Bio-fortified crops (e.g., iron-rich pearl millet,
Karnataka.
zinc-enriched rice) under the National Food
¾ Minimizes chemical inputs and promotes Security Mission help combat micronutrient
organic fertilizers, improving soil health deficiencies linked to diseases like anemia
and reducing production costs.
and stunted growth.
• National Action Plan on Climate Change: • Mission for Integrated Development of
¾ Includes measures like drip irrigation Horticulture promotes fruits and vegetables
and the use of drought-resistant crops vital for heart-healthy diets.
to conserve water and boost resilience to
• Reduction of chemical inputs:
climate change.
¾ Overuse of chemical fertilizers and
¾ FAO estimates: Climate-resilient practices pesticides is linked to long-term health
can increase productivity by up to 50% in issues like cancer and respiratory
rain-fed areas. illnesses.
Agro-Ecology and Soil Health ¾ Programs like Paramparagat Krishi Vikas
Yojana (PKVY) support reduced use of
• Agro-ecological practices (e.g., crop synthetic inputs, ensuring toxin-free,
rotation, agro-forestry) enhance biodiversity, healthier foods.
reduce soil erosion, and improve long-term
productivity. Revival of Millets
¾ Millets (nutri-cereals) are being
• India’s arable land: Over 30% is degraded;
reintroduced as part of national dietary
sustainable practices are critical to reviving strategies due to their low glycemic
soil fertility and ensuring food security. index and high fiber content, helping
Nutrition-Sensitive Farming control diabetes and reduce the risk of
cardiovascular diseases.
• Sustainable agriculture prioritizes not only
the volume of food production but also its Challenges and Opportunities in Agriculture
nutritional quality. for Health and Nutrition
• National Food Security Mission (NFSM)
emphasizes cultivating pulses and millets, Key Challenges Facing Agriculture
which are rich in nutrients and require • Natural resource degradation: Soil erosion,
minimal water. water scarcity, and loss of biodiversity
• Millets are being reintroduced in mainstream threaten farmland productivity.
agriculture due to their drought-resistant ¾ FAO data: 33% of the world’s soils are
nature, addressing both malnutrition and already degraded, impacting the ability to
climate resilience. grow nutrient-dense crops.
• Climate change: Rising temperatures, erratic • Despite government efforts (e.g., Ayushman
rainfall, and extreme weather events disrupt Bharat), there are still gaps in timely access
crop cycles and reduce yields. to healthcare, especially for remote villages.
¾ Agricultural productivity may decline
by 10-25% by 2030 in some areas due to Role of Health Tech Startups in Rural
climate change. Healthcare
Opportunities for Innovation Emergence of Health Tech Startups
• Technological advancements: Precision
• Health tech startups are revolutionizing
farming, biotechnology, and digital tools offer
rural healthcare by integrating technology
ways to improve agricultural sustainability
into patient care, diagnosis, and treatment.
and efficiency.
• These startups leverage technologies
• Bio-fortification: Enriching crops with
like artificial intelligence (AI), machine
essential nutrients (e.g., vitamin A, iron,
learning, telemedicine, and data analytics to
zinc) to combat malnutrition and improve
provide affordable, accessible, and efficient
overall health.
healthcare services to rural populations.
¾ Harvest Plus bio-fortified crops have
• Startups bridge the gap between urban
improved nutrition for over 40 million
people worldwide. healthcare facilities and rural patients,
eliminating geographical barriers.
• Reviving traditional crops: Promoting
climate-resilient crops like millets and pulses The Growing Health Tech Ecosystem
helps address both malnutrition and climate • CAGR of 127% from 2016 to 2023: The
change challenges. healthcare startup sector has expanded
rapidly.
Conclusion
• 10,000+ startups recognized by the
• Agriculture is pivotal in promoting health Department for Promotion of Industry and
and nutrition, especially as the world faces Internal Trade (DPIIT) as of 2023, with 47%
rising challenges like malnutrition, non- coming from Tier 2 and Tier 3 cities.
communicable diseases, and climate change. • Growing interest from investors due to:
• Sustainable farming practices, nutrition- ¾ The expansion of the Indian healthcare
sensitive agricultural policies, and the market.
promotion of bio-fortified crops are ¾ Government support through healthcare
essential for improving public health, schemes.
ensuring food security, and fostering ¾ The large untapped rural market for
long-term resilience in food systems. innovative healthcare solutions.
Telemedicine: A Key Technology for Rural

TOPIC 7: HEALTH TECH STARTUPS IN
Health
INDIA
What is Telemedicine?
Overview of Health Management in Rural • Telemedicine: The use of telecommunication
India technology to provide remote diagnosis,
consultations, and treatment.
• Rural population: Nearly 65% of India’s
• It covers a range of services like regular check-
population resides in rural areas, where
ups, prescription renewals, and follow-up
healthcare access remains a challenge.
consultations.
• Healthcare infrastructure: Rural India faces
• Impact on rural health:
a shortage of:
¾ Eliminates the need for patients to travel
¾ Healthcare centers
to distant cities.
¾ Medical professionals
¾ Provides instant medical advice via
¾ Diagnostic tools and services smartphones or digital platforms.
¾ Ensures continuity of care for chronic ¾ Eliminates the challenge of accessing

illnesses or post-operative follow-ups. medicines in remote locations.
Telemedicine in Action ¾ Projected industry growth: Expected to
grow at a 44% CAGR by 2025.
• Startups like Practo, 1mg, and CallHealth
• Benefits:
are building platforms that allow patients to
consult specialists from their homes. ¾ Reduces the need for physical visits to
pharmacies.
• Ayushman Bharat Yojana: Integrates
¾ Ensures the timely delivery of prescription
telemedicine services at government medications.
healthcare centers.
Digital Health Records and Health ID
• Projected growth: The telemedicine industry
in India is expected to grow at 31% CAGR by • Electronic Health Records (EHRs): Startups
2025. are digitizing patient records, allowing secure
access to health information from anywhere.
Digital Health Monitoring and AI-Based ¾ Improves efficiency in patient care.
Diagnostics ¾ Reduces duplication of medical tests and
ensures continuity of care.
Digital Health Monitoring Tools • Health ID: Part of the National Digital Health
• Health monitoring platforms collect, track, Mission (NDHM), it enables patients to store
and analyze real-time health data. their health information digitally and share it
¾ Uses wearable devices, sensors, and apps securely with doctors.
to track health metrics like blood pressure,
glucose levels, and heart rates. Government Initiatives and Policies Supporting
¾ Empowers patients to actively manage Health Tech
their health.
Ayushman Bharat and Telemedicine Expansion
¾ Startups like HealthifyMe offer
• Ayushman Bharat Yojana (2018):
personalized health recommendations
based on collected data. ¾ Provides access to telemedicine,
e-pharmacy, and diagnostic services at
AI-Based Diagnostics more than 2.5 lakh healthcare centers
• Artificial Intelligence (AI) is used to: across India.
¾ Analyze medical data and diagnostic ¾ World’s largest government-backed
images (e.g., X-rays, CT scans). healthcare scheme.
¾ Detect patterns and make accurate • National Digital Health Mission:
diagnoses. ¾ Aims to create a digital healthcare ecosystem
● Benefits in rural healthcare: with initiatives like Health ID, DigiDoctor,
and electronic medical records.
¾ AI-based tools help rural doctors diagnose
illnesses faster. ¾ Promotes secure data management and
improves health outcomes through digital
¾ AI-driven apps allow healthcare workers
tools.
to triage patients effectively, reducing the
load on hospitals. Deep Tech Startup Ecosystem
• India has a large pool of talent working on
ePharmacies and Improved Access to deep tech solutions for healthcare.
Medicines
• Deep Tech Startup Policy (drafted by the
ePharmacy Platforms Principal Scientific Advisor of India) supports
• ePharmacies like NetMeds and PharmEasy the development of innovative health tech
provide access to medications through online solutions.
platforms. • Government incubators and accelerators are
¾ Patients can order medicines and health supporting health tech startups in scaling
supplies through mobile apps. their operations and reaching rural areas.
Benefits of Health Tech Startups for Rural Future Growth Prospects

Healthcare Expanding Telemedicine and ePharmacy
Improved Accessibility and Affordability • Telemedicine is expected to play a more
• Health tech startups reduce the cost of significant role in rural healthcare with
healthcare by minimizing travel and increased smartphone penetration and
providing remote services. internet access.
• E-consultations and telemedicine platforms • ePharmacy platforms will likely grow,
make expert advice affordable and accessible providing affordable medicines to even more
even in the most remote areas. remote locations.
Enhanced Efficiency Focus on Preventive Healthcare
• Data analytics and AI streamline administrative • Startups are also focusing on preventive
tasks, reducing the burden on healthcare healthcare by using wearable devices, mobile
professionals. apps, and health monitoring platforms to
• Electronic Medical Records (EMRs) allow encourage healthier living and reduce the
seamless sharing of patient data between burden on hospitals.
different healthcare providers, ensuring better Funding and Investments
care coordination. • With increasing interest from investors, the
Evidence-Based Healthcare Indian health tech sector is set to witness
• Data-driven insights from health tech major expansion.
tools enable healthcare providers to make • Potential market size: The healthcare market
informed decisions based on real-time data. is expected to reach $50 billion by 2033,
• AI-based diagnostics improve accuracy, growing at a 26% annual growth rate.
reducing the chances of misdiagnosis and
enhancing patient outcomes. Conclusion
Bridging the Urban-Rural Divide • Health tech startups are revolutionizing
• Startups are making quality healthcare rural healthcare in India by using technology
accessible to rural populations, providing to address longstanding challenges of
city-like services through telemedicine and accessibility, affordability, and quality.
e-pharmacy platforms. • Government initiatives, coupled with
• Innovations like AI-based diagnostic tools innovations in telemedicine, AI, and digital
and digital health monitoring improve the health platforms, are fostering a robust
quality of care in underserved areas. healthcare ecosystem in rural areas.
Challenges Faced by Health Tech Startups • With continued support from investors and
regulatory frameworks, health tech startups
Connectivity Issues are set to play an even larger role in ensuring
• Internet access is still limited in some comprehensive healthcare access for India’s
remote areas, which hinders the growth of vast rural population.
telemedicine and digital health services.
• Infrastructure development is needed to TOPIC 8 : A DECADE OF SWACHH
improve broadband and mobile network
penetration in rural regions.
BHARAT: HEALTH OUTCOMES
THROUGH WASTE MANAGEMENT
Regulatory Challenges
REFORMS
• Health tech startups need to navigate
complex regulations surrounding data
privacy, medical licensing, and the sale of Introduction to Swachh Bharat Mission (SBM)
pharmaceuticals online. • SBM was launched to improve sanitation
• Ensuring compliance with government and waste management, addressing India’s
policies while scaling operations is a growing waste crisis due to urbanization and
significant challenge. industrialization.
• Key Data: India produces 55 million tons • Rural areas: 11.66 crore household toilets
of municipal solid waste (MSW) annually, built, aiding 5,54,099 villages to achieve
projected to rise to 165 million tons by 2030 ODF+ status.
and 436 million tons by 2050. b) Community and Public Toilets
• The increase in MSW is expected to contribute
• Over 6,36,826 community and public toilets
41.09 million tons of GHG emissions
were built, especially in densely populated
annually by 2030.
cities like Mumbai, Kolkata, and Delhi.
Waste Management Focus of SBM c) Aspirational Toilets
• Segregation at Source: The mission • SBM introduced 1,000 aspirational toilets in
emphasized mandatory waste segregation high-traffic public spaces (e.g., bus stations,
into wet and dry categories. hospitals, schools) designed for inclusivity
• Recycling and Composting: SBM promoted and better hygiene.
environmentally friendly disposal methods
to reduce landfill waste. Waste-to-Energy Initiatives
• Health Impact: Better waste management a) Biogas Plants
practices directly contributed to reducing public • Achievement: By 2023, 4,500 biogas plants
health issues such as respiratory diseases, were set up, primarily in rural areas.
waterborne illnesses (like diarrhea), and vector-
• Impact: Over 2 million rural households
borne diseases (like malaria and dengue).
benefited from biogas as a cleaner cooking
Key Certifications and Their Impact on Public fuel, reducing reliance on firewood and
Health improving indoor air quality.
b) Waste-to-Electricity Plants
a) ODF – Open Defecation Free
• Achievement: By October 2019, 6 lakh • Achievement: Over 20 waste-to-electricity
villages were declared ODF. plants process 1,500 tons of waste daily,
generating clean energy in urban centers.
• Health Impact: Reduced contamination of
water sources, contributing to a decrease in c) Compressed Biogas (CBG) Plants
waterborne diseases like diarrhea and cholera. • Achievement: By 2023, 40 CBG plants
b) ODF+ and ODF++ converted 5,000 metric tons of biodegradable
• ODF+: Focus on sustaining ODF status and waste daily into biogas for fuel and electricity.
maintaining public toilets.
Plastic Waste Management
• ODF++: Focus on safe management of fecal
sludge and sewage. a) Plastic Recycling
• Status: By 2023, 3,913 cities achieved ODF+ • Achievement: By 2023, 50,000 tons of plastic
certification, and 1,423 cities achieved ODF++ waste were collected and processed annually,
certification. with 12,000 Plastic Waste Management Units
established across India.
c) Water+ Certification
• Objective: Ensures no untreated wastewater b) Plastic-to-Fuel Plants
is discharged into water bodies, managing • Achievement: Over 20 plastic-to-fuel plants
liquid waste efficiently. processed 1,000 tons of plastic waste daily,
• Status: By 2022, 700 cities achieved Water+ converting waste into alternative fuels such
certification, crucial for protecting water as diesel and gasoline.
resources and reducing waterborne diseases.
Case Studies of Waste-to-Energy Plants
Expanding Sanitation Coverage
a) Varanasi, Uttar Pradesh – Waste to Charcoal
a) Individual Household Latrines (IHHLs) • Capacity: Processes 800 tons of waste daily,
• Urban areas: 63.63 lakh IHHLs constructed converting it into Biochar for use as a soil
by 2024. enhancer in agriculture.
• Impact: Sequesters carbon and reduces b) Decline in Respiratory Issues

landfill waste, contributing to climate change • 10-12% reduction in particulate matter
mitigation. levels in ODF++ cities due to proper waste
b) Pimpri, Chinchwad, Maharashtra – Waste to segregation, reduced open burning, and the
Electricity use of scientific landfills.
• Capacity: Processes 700 tons of waste daily,
c) Decline in Vector-Borne Diseases
generating 11.5 MW of electricity.
• Impact: Reduces air pollution, minimizes landfill • Cities achieving ODF++ and Water+ status
use, and serves as a model for other cities. experienced a 20-25% decline in diseases like
malaria and dengue due to efficient waste
Legacy Waste Remediation management.
• Achievement: 89.1 million metric tons of d) Public Health Awareness
legacy waste treated through bio-mining and • By 2023, 90% of households in urban areas
bio-remediation. practiced waste segregation at the source,
• Impact: Reclaimed 4,543 acres of land and fostering healthier living environments.
reduced methane emissions from decaying
waste piles. Integration of Informal Sector (Ragpickers)
Health Outcomes from Waste Management • Achievement: Integrated 1.5 million
Reforms ragpickers into formal waste management
a) Reduction in Waterborne Diseases systems, promoting economic empowerment
• A 40% decline in waterborne diseases like and enhancing the mission’s effectiveness.
diarrhea was recorded in rural areas (2015–
Challenges in Waste Management: Urban vs
2020), attributed to improved sanitation and
Rural
water safety.
Category Urban Challenges Rural Challenges
Population Density High population density leads Lower population density, but
to large volumes of waste, geographic dispersion makes
straining existing systems. waste collection difficult.
Infrastructure Inadequate infrastructure for Limited resources and
waste collection, segregation, infrastructure for comprehensive
and processing. waste management systems.
Waste Segregation Poor segregation of waste Limited awareness of waste
at source due to lack of segregation; informal practices
awareness and systems. dominate.
Informal Sector Significant involvement of Less formal integration of the
rag pickers, but often without informal sector, with scattered
proper recognition or safety. and unregulated waste collection
practices.
Financial Resources Cities may have higher Limited financial resources
budgets, but infrastructure for building necessary waste
is still underfunded or management facilities.
mismanaged.
Public Engagement Mixed levels of engagement; Low awareness and education
some urban areas show low about waste management
community participation in practices, limiting community-
waste management. driven initiatives.
Waste Volume Larger volumes of waste Smaller volumes but spread

due to high density and over large areas, complicating
commercial activity. centralized management.
Sustainability Pressure to maintain ODF++, Difficulty in sustaining ODF and
Water+ certifications in ODF+ status without consistent
expanding cities. monitoring.
Conclusion ¾ Expanding scientific waste disposal systems.

¾ Scaling waste-to-energy initiatives.
• The Swachh Bharat Mission has achieved ¾ Empowering local governments with
significant public health improvements through modern tools for capacity building.
waste management reforms. However, future ¾ Investing in infrastructure to sustain
focus should be on: ODF++ and Water+ statuses.

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KURUKSHETRA OCTOBER 2024- HEALTH & NUTRITION 1

ensure soil fertility, biodiversity, and a stable

a. Climate-Resilient Food Systems

• Comparisons: Workforce Expansion and Development

million school children (aged 6-18) are vital b. Community Engagement

c. Healthcare Infrastructure Deficiencies d. Community Involvement

d. Quality of Care e. Regulatory Strengthening

e. Public-Private Coordination f. Climate Resilience

Framework for Digital Transformation in Healthcare

a. Engagement 2. Dynamic Capabilities:

The Role of Data and Intelligent Technologies ¾ Improve quality of life.

Conclusion and Way Forward ¾ Progress in reducing maternal and child

What is Pre-Pregnancy Care?

¾ Reduced substance use (alcohol and • Emphasizes pre-pregnancy care as part of

¾ Regular physical activity • Consume plenty of vegetables, fruits, and

4. Evolution of Dietary Guidelines in India 8. Meat/fish/poultry Eggs, meat, fish,

and disease prevention. Dissemination and Public Awareness

Role of Bio-Fortified Crops items throughout the year, improving both

Importance of Dietary Diversity Impact of Agricultural Policies on Public Health

Telemedicine: A Key Technology for Rural

¾ Ensures continuity of care for chronic ¾ Eliminates the challenge of accessing

Benefits of Health Tech Startups for Rural Future Growth Prospects

• Impact: Sequesters carbon and reduces b) Decline in Respiratory Issues

Category Urban Challenges Rural Challenges

Waste Volume Larger volumes of waste Smaller volumes but spread

Conclusion ¾ Expanding scientific waste disposal systems.

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4. Evolution of Dietary Guidelines in India 8. Meat/fish/poultry Eggs, meat, fish,