6.

SOCIAL ISSUES
6.1. UNIVERSAL HEALTH COVERAGE
Why in the news? Service Coverage Index (SCI)
Recently, the Tracking Universal Health Coverage: 2023 Global • SCI used to track SDG 3.8.1 (includes four indicator
categories
Monitoring report was jointly released by the World Health
o Reproductive, maternal and newborn and child
Organization and World Bank. health,
More in news o Infectious diseases,
o Non-communicable diseases and
• The report analyses progress towards Universal Health o Service capacity and access.
Coverage (UHC) using two Sustainable Development Goals • It is measured on a scale from 0 (worst) to 100 (best).
(SDGs) indicators i.e. • In 2021, India score decline to 63 from 64 in 2019.
o UHC Service Coverage Index (SCI) that covers essential
health services (SDG 3.8.1).
o Out-of-Pocket Health Expenditure (OOPE) measuring
catastrophic health spending (SDG 3.8.2).
• Key findings of the report
o The UHC service coverage index increased from 45 to 68
between 2000 and 2021.
o The world is off track to make significant progress towards
the UHC (SDG target 3.8) by 2030 as improvements to
health services coverage have stagnated since 2015.
o The proportion of the population not covered by essential
health services decreased by about 15% between 2000 and 2021, with minimal progress made after 2015.
✓ The COVID-19 pandemic disrupted essential services in 92% of countries at the height of the pandemic in
2021. In 2022, 84% of countries still reported disruptions.
o The proportion of the population that faced
catastrophic levels of OOP health spending
has increased.
o Financial hardship is more prevalent among
poorer households mostly due to higher rates
of impoverishing health spending rather than
catastrophic health spending.
Universal Health Coverage and its importance
• UHC means that all people have access to a full
range of quality health services without financial
hardship.
o It covers the full continuum of essential
health services, from health promotion to prevention, treatment, rehabilitation and palliative care.
• Importance of Universal Health Coverage
o Maximize human capital by making investments in health, which is crucial for both educational attainment in
children and workforce productivity in adults, which promotes economic growth.
o Well-functioning health system with equitably distributed healthcare infrastructure increases the demand for
skilled jobs.
o Helps in achieving Sustainable Development Goal 3 (Good Health and Well-being).
o Helps to reduce social barriers to care and, the distribution of health resources between different population
groups and empowers patients in decision-making.

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Challenges in achieving Universal Health Coverage Initiatives taken to achieve Universal Health Coverage
• Low Health care spending: As per, the Economic Survey • Ayushman Bharat Yojana: It aims to undertake
2022-23, central and state governments' budgeted interventions to holistically address health at primary,
secondary and tertiary level.
expenditure on healthcare increased marginally from
• Ayushman Bharat Digital Mission: It will improve
1.6% in FY21 to 2.1 % of GDP in FY23 and is among the
equitable access to quality healthcare by encouraging
lowest in the world. use of technologies such as telemedicine and enabling
• Lack of financial protection: As per NITI Aayog, at least national portability of health services.
30% of the population is devoid of any financial • National Health Policy 2017: It aims at achieving
protection for health due to existing gaps in coverage universal health coverage and delivering quality health
and overlap between schemes. care services to all at affordable cost.
• High out-of-pocket expenditure (OOPE): India’s OOPE as • Intensified Mission Indra Dhanush: It focusses on
a per cent of current health spending is 47.1% in 2019-20, reaching zero-dose children aged between 0 and 5
significantly above the global average of 18%. years and pregnant women who might have missed any
vaccine doses in the national immunisation schedule.
• Inequitable Access: Rural communities in India suffer
from significant access to healthcare such as a lack of
qualified medical professionals, physical limitations like distance, lack of established healthcare infrastructure and
inability to pay for necessary medical treatment.
o As per the Lancet publication (2023), the provision of core health services lacks uniformity across state-run
district hospitals. Only 16 per cent of the district hospitals in Tamil Nadu offered all key services. In states like
Assam, Punjab, Madhya Pradesh, Mizoram and UP, it was found to be just 1 per cent.
• Lack of medical manpower: India faces a shortage of healthcare professionals, including doctors, nurses, and
paramedical staff, which impacts the delivery of healthcare services.
Way forward
• Recommendations from report
o Adopting a primary healthcare approach can improve health systems and accelerate progress toward UHC.
o Expansion of essential services, especially for Non-Communicable Diseases.
o Removing financial barriers e.g., issues of indirect costs and co-payments in health care.
o Strong commitments to International Health Regulations in acute public health risk.
• Increase public spending: Government spending should be increased to around 5.2% i.e., the average health spending
of the Lower- and Middle-Income Countries (LMIC).
• Address Structural Issues: Structural weaknesses within the healthcare delivery system i.e., lack of medical supplies
and healthcare workers; irrational treatments etc. can be addressed by engaging the private sector, and civil society
and expanding medical seats etc.
• Centre-State Coordination: Central government should adopt a collaborative mechanism allowing for flexible policy-
making, and differential financing from the Centre to the state.
o This will also allow states to better meet the diverse requirements and develop health plans that are consistent
with the needs and requirements of populations.

6.1.1. AYUSHMAN BHARAT DIGITAL MISSION

Why in the news?
Recently, National Health Authority (NHA) organized ‘Arogya Manthan’ 2023 to celebrate five years of Ayushman Bharat
Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) and two years of the Ayushman Bharat Digital Mission (ABDM).
*To read more about AB PM-JAY, kindly refer to Article 6.4. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
(ABPMJAY) of August 2023 Monthly Current Affairs Magazine.
More on the news
• At the event, States and Union Territories that excelled in various categories were awarded-
o Highest Ayushman Card Creation: Assam, Nagaland, and Jammu & Kashmir
o Highest Percentage of Utilization in Public Hospitals: Karnataka and Tripura
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 o Top State in Generation of ABHA Scan and Share Tokens: Uttar Pradesh
o Top State in Linking Health Records with ABHA: Andhra Pradesh
About ABDM
• Aim: To develop the backbone necessary
to support the integrated digital health
infrastructure of the country.
• Implementing Agency: NHA under the
Ministry of Health and Family Welfare.
• The digital infrastructure under the
scheme is being developed by adopting
India Enterprise Architecture
Framework (IndEA) released by the
Ministry of Electronics and Information Technology.
o IndEA is holistic a framework for streamlining, standardizing, and optimizing the e-Governance efforts across
the country for interoperability and integration.
Components of the mission
Ayushman Bharat • A randomly generated 14-digit number generated through self-registration.
Health Account • Purpose: Identifying individuals, authenticating them, and threading their health records (only with
(ABHA) Number the informed consent of the patient) across multiple systems and stakeholders.
ABHA app • A Personal Health Records {PHR) application available on Android and iOS platforms.
• Allows the self-uploading/scanning of existing physical health records such as diagnostic reports,
prescriptions, etc.
Health Facility • A comprehensive repository of all the health facilities of the country across different systems of
Registry medicine.
• Includes both public and private health facilities including hospitals, clinics, diagnostic laboratories
and imaging centers, pharmacies, etc.
Healthcare • A comprehensive repository of all healthcare professionals involved in the delivery of healthcare
Professionals Registry services across both modern and traditional systems of medicine.
Significance of the mission
• For patients: It will empower individuals with accurate
information to enable informed decision-making and increase
the accountability of healthcare providers.
o It will also ensure transparency in the pricing of services and
provide the option to access health services remotely
through teleconsultation and e-pharmacy.
• For healthcare professionals: They will have better access to
patient's medical history for prescribing more appropriate and
effective health interventions.
• Insurance Claim: It will help digitize the claims process and
enable faster reimbursement.
• For policymakers: Better quality of macro and micro-level data
will enable advanced analytics, better preventive
healthcare, and strengthen implementation and monitoring of health programmes and policies.
• For researchers: They will be able to study and evaluate the effectiveness of various programs and interventions.
Challenges in the implementation of ABDM
• Digital divide and illiteracy make it difficult for certain sections of the population to adopt ABDM.
• High cost of digitization of medical data.
• Poor interoperability between states, with data migration and inter-state transfer facing multiple errors and
shortcomings.
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• Capacity building and digital skilling of medical professionals needed to prepare them to use digital tools.
• Concerns about personal data security and privacy: For instance, the recent ransomware attack on the All-India
Institute of Medical Sciences (AIIMS), Delhi has brought questions of safety and privacy.
• Limited awareness among citizens about the app and its use.
• Health is a state subject: There are state schemes and initiatives that have the same vision and mission as ABDM
leading to a multiplicity of efforts. For instance, the eHealth initiative by Kerala.
Way forward
• Protecting details of patients through methods like anonymization and ensuring that the health records of the
patients remain entirely confidential and secure.
• Encourage Research and Development in digital health technologies, especially in areas such as artificial intelligence,
machine learning, and predictive analytics.
• Streamlining processes and standardizing medical data to ensure the smooth transfer of data between states.
• Increase Public Awareness to ensure that citizens understand how to access and utilize the digital healthcare services
available.
• Introducing the concepts of ABDM and digital health in the curriculum for medical professionals.
• Incentivizing private providers to participate in the process of digitization of medical health records. E.g., the Digital
Health Incentive scheme aims to incentivize stakeholders such as hospitals, labs etc. to adopt a digital health
ecosystem.

6.2. NEWS IN SHORTS

6.2.1. THE GENDER SNAPSHOT 2023 o SDG 13 (Climate Action): 158 million women
and girls globally may be pushed into poverty as
• “Progress on the Sustainable Development Goals a direct result of climate change.
(SDGs): The gender snapshot 2023” report released
by UN Women and UN Department of Economic
and Social Affairs (DESA).
• Key findings
o SDG 1 (No Poverty): Over 340 million women
and girls will still live in extreme poverty by 2030.
✓ Progress will need to be 26times faster to
reach SDG 1 by 2030.
o SDG 2 (Zero Hunger): Close to 1 in 4 women and
girls will experience moderate or severe food 6.2.2. WOMEN’S BASIC INCOME
insecurity by 2030.
✓ Addressing gender gaps in agrifood systems • Tamil Nadu launched the Kalaignar Magalir Urimai
can reduce food insecurity and boost global Thogai (Women’s Basic Income) scheme.
GDP by nearly $1 trillion. • This scheme will provide a monthly stipend of Rs
o SDG 4 (Quality Education): Only 60% of girls 1,000 for eligible women.
have completed schooling at upper secondary o Women who hold less than specified land and
level compared to 57% of boys. annual family income aged above 21 years old
o SDG 5 (Gender Equality): Next generation of are eligible.
women will spend an average of 2.3 more hours o Other states like Karnataka, Madhya Pradesh,
per day on unpaid care and domestic work than and Punjab have similar schemes for women.
men. • As per Economic Survey 2016-17, a Universal Basic
o SDG 10 (Reduced inequalities): Women are Income (UBI) for women has large multiplier effects
twice as likely as men to report instances of on the household.
discrimination based on sex and almost twice as o UBI has three components: universality,
likely as men to experience discrimination on unconditionality, and agency (by providing
basis of marital status. support in the form of cash transfers to respect,
not dictate, recipients’ choices).
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 Argument in favor of UBI Argument against UBI

• Treats beneficiaries as • Might make people

agents and entrusts lazy and opt out of
citizens with the the labor market.
responsibility of using • Gender disparity as
welfare spending. men are likely to
• As all individuals are exercise control over
targeted, the exclusion spending of the UBI.
error (poor being left out) • A cash transfer’s
is zero. purchasing power
• Provides a safety net may severely be
against health, income, curtailed by market
and other shocks. fluctuations
• Encourage greater usage of • Huge burden on the
bank accounts, leading to government budget
improvement in financial
inclusion.

6.2.3. MALAVIYA MISSION - TEACHERS

TRAINING PROGRAMME (MM-TTP) 6.2.5. DEEMED TO BE UNIVERSITY
• University Grants Commission’s MM-TTP was STATUS
launched. • NCERT has been granted the status of deemed to be
• About MM-TTP university. Deemed university status will now allow
o It is proposed by restructuring of existing NCERT to
schemes of capacity building of teachers under o offer its own graduate, post-graduate and
Department of Higher Education. doctoral degrees and
o It envisages capacity-building training for the o have autonomy in terms of introduction of
faculty and staff across higher educational programmes, course structure, conducting
institutions (HEIs), in the light of National examinations and management, among others.
Education Policy (NEP) 2020 within two years • An institution of higher education, other than a
through multiple training centres. university, doing the work of high standard in a
o Human Resource Development Centres specific area, can be declared as an institution
(HRDCs) will also be renamed as Madan Mohan deemed to be university.
Malaviya Teachers’ Training Centre. • Declared by Central Government under section 3 of
6.2.4. DIGITAL INFRASTRUCTURE FOR University Grants Commission (UGC) Act, 1956.
KNOWLEDGE SHARING (DIKSHA) 6.2.6. NMC GETS WFME RECOGNITION
PLATFORM FOR 10 YEARS
• National eGovernance Division (NeGD) under MeitY • National Medical Commission (NMC) is India's
is set to integrate Personalised Adaptive Learning regulatory body overseeing medical education and
(PAL) into its existing DIKSHA platform. practice.
o PAL is a software-based approach that allows o It is a statutory body, constituted by NMC Act,
each student to have an individualized learning 2019.
experience. • World Federation for Medical Education (WFME)
• DIKSHA is an initiative of National Council for grants recognition Status to individual accrediting
Education Research and Training (NCERT), Ministry agencies that meet WFME recognition criteria.
of Education. • Benefits
o It will enable Indian medical graduates to
pursue postgraduate training in other countries

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 that require WFME recognition, e.g., the United 6.2.7. AYUSHMAN BHAV CAMPAIGN
States, Canada, etc.
o All the 706 existing medical colleges in India will • It is a collaborative effort spearheaded by Gram
become WFME accredited. Panchayats to extend comprehensive healthcare
o New medical colleges that will be set up in the coverage to every village and town.
next 10 years will automatically get accredited. • It has 3 components:
o It will enhance the quality and standards of o Ayushman Apke Dwar 3.0: to provide Ayushman
medical education in India. cards to remaining eligible beneficiaries enrolled
o Aligning medical education with global best under the PM-JAY scheme.
practices and benchmarks. o Ayushman Melas: To facilitate the creation of
o Make India an attractive destination for Health IDs and issuance of Ayushman Bharat
international students. Cards.
o Ayushman Sabhas: To raise awareness about
vital health schemes and disease conditions.

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