Extension of Food Fortification Scheme
To fight chronic anaemia and undernutrition, the government plans to distribute fortified rice through the Integrated Child Development Services and Mid Day Meal Schemes across the country from 2021, focusing on Aspirational districts.
- This was decided in a review meeting of an existing pilot scheme that aims to distribute fortified rice in 15 districts.
➤ Existing Scheme
- The centrally-sponsored pilot scheme was approved in February 2019, for three years from 2019-20 onwards. One district from the 15 predominantly rice-eating States was selected under it.
- However, out of 15 states, only 5 (Andhra Pradesh, Gujarat, Maharashtra, Tamil Nadu and Chhattisgarh) have started distributing fortified rice in their identified pilot districts.
- In other words, the scheme has only been implemented in five districts so far, although more than half the project duration is over.
➤ Renewed Push
- The Food Corporation of India (FSI) has now been mandated to scale up the annual supply of Fortified Rice Kernels (FRK) from the current 15,000 tonnes to at least 1.3 lakh tonnes.
- To cover Public Distribution System (PDS), angan- wadis and mid-day meals in the 112 aspirational districts, annual supply capacity would need to be increased to about 1.3 lakh tonnes.
- Further, existing rice mills will be equipped with Blending Machines for mixing FRK with regular rice.
➤ Other Related Initiatives
- Milk Fortification Project was launched by the National Dairy Development Board (NDDB) in collaboration with the World Bank and Tata Trusts as a pilot project in 2017. It is intended to address vitamin deficiency in consumers.
- Sept. 2020 was observed as Poshan Maah (Nutrition month). It includes month-long activities focussed on antenatal care, optimal breastfeeding, anaemia, girls education, diet, right age of marriage, hygiene and sanitation, eating healthy (food fortification), etc.
➤ Fortified Rice Kernels
- Fortifying rice involves grinding broken rice into powder, mixing it with nutrients, and then shaping it into rice-like kernels using an extrusion process.
- These fortified kernels are then mixed with regular rice in a ratio ranging from 1:50 to 1:200.
➤ Integrated Child Development Services
- It was launched on 2nd October 1975.
- It offers a package of six services (Supplementary Nutrition, Pre-school Non-formal Education, Nutrition and Health Education, Immunisation, Health Check-up and Referral Services) to children in the age group of 0-6 years, pregnant women and lactating mothers. Mid-day Meal Scheme
- It was launched in 1995 as a centrally sponsored scheme.
- It provides that every child within the age group of six to fourteen years studying in classes I to VIII who enrols and attends the school shall be provided with a hot cooked meal, free of charge every day except on school holidays.
- It comes under the Ministry of Education's Department of School Education and Literacy.
➤ Aspirational Districts Programme
- It was launched in January 2018.
- To expeditiously improve the socio-economic status of 117 districts through cooperative and competitive federalism.
- To rapidly transform communities showing relatively less progress in key social areas and have emerged as pockets of underdevelopment, thereby posing a challenge to balanced regional development.
➤ Food Fortification
- About: According to the World Health Organisation (WHO), food fortification is defined as the practice of deliberately increasing the content of essential micronutrients to improve the nutritional quality of the food supply and provide a public health benefit with minimal health risk.
- Mass fortification: For foods widely consumed by the general population.
- Targeted Fortification: To fortify foods designed for specific population subgroups, such as complementary foods for young children or rations for displaced populations.
- Market-driven Fortification: To allow food manufacturers to fortify foods available in the marketplace voluntarily.
- Procedure: The extent to which a national or regional food supply is fortified varies considerably. The concentration of just one micronutrient might be increased in a single foodstuff like the iodisation of salt or at the other end of the scale, there might be a whole range of food-micronutrient combinations.
- In October 2016, Food Safety and Standards Authority Of India (FSSAI) operationalised the Food Safety and Standards (Fortification of Foods) Regulations, 2016 for fortifying staples namely Wheat Flour and Rice (with Iron, Vitamin B12 and Folic Acid), Milk and Edible Oil (with Vitamins A and D) and Double Fortified Salt (with Iodine and Iron) to reduce the high burden of micronutrient malnutrition in India.
➤ India's National Nutritional Strategy 2017
- It has listed food fortification as one of the interventions to address anaemia, vitamin A and iodine deficiencies apart from supplementation and dietary diversification.
National Cancer Awareness Day
National Cancer Awareness Day is observed on 7th November each year to spread awareness about early cancer detection to timely fight the deadly disease.
- It is a large group of diseases that can start in almost any organ or tissue of the body when abnormal cells grow uncontrollably, go beyond their usual boundaries to invade adjoining parts of the body and spread to other organs. The latter process is called metastasizing and is a significant cause of death from cancer.
- A neoplasm and malignant tumour are other common names for cancer.
- Lung, prostate, colorectal, stomach and liver cancer are the most common types of cancer in men, while breast, colorectal, lung, cervical and thyroid cancer are the most common among women.
➤ Cancer Burden
- Cancer remains one of the leading causes of adult illness and death due to chronic and Non-Communicable Diseases (NCD) worldwide, including in India.
- According to the World Health Organisation (WHO), cancer is the second leading cause of death globally and in 2018, there were approximately 18 million cases globally, of which 1.5 million were in India alone.
- There were around 0.8 million cancer deaths in India in 2018 against 9.5 million globally. The numbers of new cases are estimated to double in India by 2040.
➤ Deaths due to Cancer can be Prevented
- Between 30% and 50% of cancer deaths could be prevented by modifying or avoiding the key risk factors. Key risk factors include tobacco use, alcohol use, diet, exposure to ultraviolet radiation, pollution, chronic infections, etc.
- Options include surgery, cancer medicines and radiotherapy, administered alone or in combination.
- Palliative care, which focuses on improving patients and their families' quality of life, is an essential component of cancer care.
➤ Global Initiative
- The International Agency for Research on Cancer (IARC) was created in 1965 by a resolution of the World Health Assembly, as the specialized cancer agency of the World Health Organization.
- World Cancer Day is observed on 4th February every year.
➤ Indian Initiatives
- National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) is being implemented under the National Health Mission (NHM) for up-to-the- district-level activities.
- Under the ambit of Ayushman Bharat, Pradhan Mantri Jan ArogyaYojana (PM-JAY) is being implemented to reduce the financial burden for poor and vulnerable groups arising out of catastrophic hospital episodes and to provide access to quality health services.
- National Cancer Grid (NCG) is a network of major cancer centres, research institutes, patient groups and charitable institutions across India with the mandate of establishing uniform standards of patient care for prevention, diagnosis, and treatment of cancer, providing specialized training and education in oncology (the study of cancer) and facilitating collaborative basic, translational and clinical research in cancer. It was formed in August 2012.
- National Pharmaceutical Pricing Authority (NPPA) had launched a Pilot on Trade Margin Rationalisation for 42 anti-cancer drugs in February 2020 as a step towards making healthcare more affordable for the suffering patients. This led to a reduction in the prices of drugs.
Online Education Woes
A recent study by the Azim Premji University on the efficacy and accessibility of e-learning has highlighted various challenges involved in online education in the country.
➤ Student Specific Findings
- Reason for student's lack of accessibility to online classes
(i) Non-availability or an inadequate number of smartphones for dedicated use or sharing.
(ii) Difficulty in using apps for online learning.
(iii) Children with disabilities found it more difficult to participate in online sessions.
➤ Parents Specific Findings
- 90% of parents of government school students surveyed were willing to send their children back to school if their children's health was taken care of.
- 70% of the parents surveyed thought that online classes were not effective and did not help in their child's learnings. Teacher Specific Findings:
- Teachers' main problem found during the online classes was one-way communication, which made it difficult for them to assess whether students understood what was being taught.
- More than 80% of teachers surveyed said they could not maintain emotional connect with students during online classes. In comparison, 90% of teachers felt that no meaningful assessment of children's learning was possible.
- 50% of the teachers reported that children were unable to complete assignments shared during the online classes, which had led to severe gaps in learning.
- The survey also revealed that around 75% of the teachers spent, on average, less than an hour a day on online classes for any grade.
- Teachers also reported that they were ill-prepared for online learning platforms.
- More than half the teachers surveyed shared that their knowledge and user-experience on online platforms and modes of teaching were inadequate.
Report on National Nutrition Mission: NITI Aayog
Recently, the NITI Aayog has released "Accelerating Progress On Nutrition In India: What Will It Take", the third progress report on the National Nutrition Mission or the Poshan Abhiyaan.
➤ National Nutrition Mission
- Launched in 2018, it is the Government of India's flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers.
- It is backed by a National Nutrition Strategy prepared by the NITI Aayog to attain "Kuposhan Mukt Bharat" or malnutrition-free India by 2022.
- To reduce stunting, undernutrition, anaemia (among young children, women and adolescent girls) and low birth weight by 2%, 2%, 3% and 2% per annum, respectively.
- To address the problem of malnutrition in a mission-mode. o 50% of the total budget comes from the World Bank or other multilateral development banks, and the rest of the 50% is through the Centre's budgetary support.
- The Centre's fiscal support is further divided into 60:40 between the Centre and the States, 90:10 for the north-eastern region and the Himalayan States and 100% for the Union Territories (UTs) without legislature.
- Prevalence: More than a third of children under five suffer from stunting and wasting, and 40% of children between one and four are anaemic. Over 50% of pregnant and non-pregnant women were found to be anaemic, according to the National Family Health Survey-4 released in 2016.
➤ About the Report
- The third progress report (October 2019-April 2020) takes stock of the roll-out status on the ground and implementation challenges encountered at various levels through large scale datasets.
- These datasets are the NFHS-4 and Comprehensive National Nutrition Survey (CNNS).
- The initial Reports I and II, focused majorly on the Mission's preparedness and implementation by States and UTs, respectively.
- The review report was drafted in March 2020 and does not factor in worsening poverty and hunger levels since then, which are expected to have gone down further due to the Covid-19.
➤ Concerns Highlighted
- On stunting, India's targets are conservative as compared to the global target defined by the World Health Assembly (WHA), which is a prevalence rate of 5% of stunting as opposed to India's goal of reducing stunting levels to 13.3% by 2022.
- The target of reducing prevalence levels of anaemia among pregnant women from 50.3% in 2016 to 34.4% in 2022 and among adolescent girls from 52.9% in 2016 to 39.66%, is also considered conservative compared to the WHA's target of halving prevalence levels.
- In the wake of the pandemic, experts warn that deepening poverty and hunger may delay achieving the goals defined under the Mission.
➤ On Stunting
- To improve complementary feeding using both behaviour change interventions and complimentary food supplements in the Integrated Child Development Services (ICDS).
- To work towards investments in girls and women (education during childhood, reducing early marriage and early pregnancy, improving care during and after pregnancy), and other social determinants.
- To improve water, sanitation, handwashing with soap and hygienic disposal of children's stools with other effective interventions.
➤ On Wasting
- To include interventions that go beyond the treatment of severe acute malnutrition (SAM) and also address moderate wasting, which have the potential to achieve larger declines in wasting.
- To scale-up to reach facility-based treatment of SAM to all those needing in-patient care.
- To urgently release a full strategy for preventing and integrating waste nationally.
➤ On Anaemia
- To scale-up scenario that focuses only on health sector interventions which will achieve modest improvements in anaemia among women of reproductive age.
Initiatives for Transgender Persons
Recently, the Ministry of Social Justice and Empowerment has launched the National Portal for Transgender Persons and has inaugurated Garima Greh, a shelter home for transgender persons.
➤ National Portal for Transgender Persons
- It has been launched following the Transgender Persons (Protection of Rights) Rules, 2020.
- It would help transgender people digitally apply for a certificate and identity card from anywhere in the country, thus preventing any physical interaction with officials.
- It will help them track the status of application, rejection, grievance redressal, etc., which will ensure transparency in the process.
- The issuing authorities are also under strict timelines to process the applications and issue certificates and I-cards without any necessary delays.
➤ Garima Greh
- It has been opened in Vadodara, Gujarat and will be run in association with the Lakshya Trust, a community-based organisation entirely run by the transgenders.
- The Scheme of 'Shelter Home for Transgender Persons' includes shelter facility, food, clothing, recreational facilities, skill development opportunities, yoga, physical fitness, library facilities, legal support, technical advice for gender transition and surgeries, capacity building of trans-friendly organizations, employment, etc.
- The scheme will rehabilitate a minimum of 25 transgender persons in each home identified by the Ministry.
- 10 cities have been identified to set up the 13 Shelter Homes. Transgender Persons (Protection of Rights) Rules, 2020
- The Central Government made the rules under the powers conferred by the Transgender Persons (Protection of Rights) Act, 2019.
- The Act came into effect on 10th January 2020, which is the first concrete step towards ensuring the welfare of transgender persons.
- The rules seek to recognise the identity of transgenders and prohibit discrimination in the fields of education, employment, healthcare, holding or disposing of property, holding public or private office and access to and use of public services and benefits.
- In 2014, the Supreme Court of India, in the case of the National Legal Services Authority versus Union of India, established the foundation for the rights of transgender persons in India by recognising 'transgender' as a 'third gender' and laying down several measures for the prohibition of discrimination against transgender persons and protection of their rights.
- The judgment recommended reservations for transgenders in jobs and educational institutions and their right to declare the self-perceived gender identity without undergoing sex reassignment surgery.
Key Features of the Law Relating to Transgender Persons
- Definitions of 'person with intersex variation andtransgender person' have been provided to include trans men and trans women (whether or not such person has undergone sex reassignment surgery, hormone or other therapy).
- It prohibits the discrimination of transgender persons at educational establishments, in employment or occupational opportunities, healthcare services and access to public facilities and benefits.
- It further reinforces transgender persons' right to movement, right to reside, rent, or otherwise occupy the property.
➤ Certificate of Identity
- It provides for a right to self-perceived gender identity and casts an obligation on the district magistrate to issue a 'certificate of identity as a transgender person, without the requirement of any medical or physical examination.
- If the transgender person undergoes medical intervention to change sex either as a male or female and requires a revised identity certificate, they would need to apply to the district magistrate and a certificate issued by the medical superintendent or chief medical officer of the concerned hospital.
➤ Equal Opportunity Policy
- Every establishment has been mandated to formulate an equal opportunity policy for transgender persons with certain specific information as prescribed under the law.
- This will help create inclusive establishments like inclusive education, etc.
- The process of inclusion also requires the creation of infrastructure facilities like separate wards in hospitals and washrooms (unisex toilets).
➤ Complaint Officer
- Every establishment has been mandated to designate a person as a complaint officer to handle complaints from transgender persons.
➤ Transgender Protection Cell
- Every state government will also have to set up a Transgender Protection Cell under District Magistrate and Director General of Police to monitor offence against transgender persons.
➤ Welfare schemes
- The government has been mandated to formulate welfare schemes and programs that are transgender sensitive, non-stigmatising and non-discriminatory.
➤ Medical Care Facilities
- The government has been mandated to set up separate Human Immunodeficiency Virus (HIV) sero-surveillance centres to conduct sero-surveillance for transgender persons; provide for medical care facilities including sex reassignment surgery and hormonal therapy, and provide for coverage of medical expenses by a comprehensive insurance scheme for surgeries and other therapies.
➤ National Council for Transgender Persons
- Constitution of the NCT to advise the government for the formulation and monitoring of policies and redress the grievances of transgender persons.
➤ Offences and Penalties
- Offences, like indulging transgender persons in forced or bonded labour or denial of access to public places or physical, emotional or sexual abuse.
- Other offences committed under the provisions of the Transgender Persons Act, are punishable with imprisonment for a term of at least six months, extending up to two years along with a fine.
Covid-19 and Children: UNICEF
Recently, the United Nations Children's Fund (UNICEF) has released the report "Averting a lost Covid generation, " highlighting significant and growing consequences of Covid-19 on children.
- The report came ahead of World Children's Day (20th November).
➤ About the Report
- It is the first UNICEF report to comprehensively outline the dire and growing consequences for children as the pandemic goes on.
- It shows that while symptoms among infected children remain mild, infections are rising and the longer-term impact on the education, nutrition and well-being of an entire generation of children and young people can be life-altering.
➤ Data Analysis
- Children and adolescents account for 1 in 9 reported Covid-19 infections. o As of the beginning of November 2020, children and adolescents accounted for 11% of the 25.7 million infections reported across 87 countries.
- It estimated that a third of the countries analysed witnessed a drop of at least 10% in coverage of health services and a 40% decline in the coverage of nutrition services for women and children across 135 countries.
- As of October 2020, 265 million children were still missing out on school meals globally.
- 65 countries reported a decrease in-home visits by social workers in September 2020, compared to 2019.
- These numbers bust the myth that children are barely affected by the disease, which has been prevalent throughout the pandemic.
- Disruptions to key services and soaring poverty rates pose the biggest threat to children and the longer the crisis persists, the deeper its impact on children's education, health, nutrition and well-being.
- Vulnerabilities of women and children have increased, as health services continue to be disrupted and schools shut, denying children free mid-day meals offered at schools for underprivileged children.
- While children could transmit the virus to each other and to older age groups, there was strong evidence that, with basic safety measures in place, the net benefits of keeping schools open outweighed the costs of closing them.
- Schools are not the main driver of community transmission, and children are more likely to get the virus outside of school settings.
India Specific Highlights
➤ Infections in Under 20
- As per data from the Indian Council of Medical Research (ICMR) on the National Centre for Disease Control dashboard, 11.89% of Covid-19 cases in India are under 20.
- 1.5 million school closures have impacted 247 million children enrolled in elementary and secondary education and 28 million children attending pre-school education in Anganwadi Centres.
- An estimated 20 million children under 5 years of age suffer from wasting (low weight for height), over 40 million children are chronically malnourished and more than half of the Indian women aged 15-49 years are anaemic.
- The pandemic has further exposed the fragility of children, less by the virus itself but much more by the indirect and long-term fallout.
➤ Newborn Mortality
- Covid-19 poses a grave threat to India's gains in the Neonatal Mortality Rate (NMR) and Infant Mortality Rate (IMR), which saw improvements in recent years.
- NMR is defined as the number of deaths during the first 28 completed days of life per live births in a given year or period'.
- IMR is defined as the number of deaths of children under the age of 1 year per 1000 live births for a given year.'
- The socio-economic stress and migration resulting due to the Covid-19 put access to toilets and the practice of using them at risk.
- The schools which offered improved access to and quality of water, sanitation and hygiene facilities are closed and the facilities are not accessed.
- Ensure all children learn, including by closing the digital divide.
- Guarantee access to Nutrition and health services and make vaccines affordable and available to every child.
- Support and protect children and young people's mental health and bring an end to abuse, gender-based violence, and neglect in childhood.
- Increase access to safe drinking water, sanitation and hygiene and address environmental degradation and climate change.
- Reverse the rise in child poverty and ensure an inclusive recovery for all.
- Redouble efforts to protect and support children and their families living through conflict, disaster and displacement. World Children's Day
- It is celebrated on 20th Nov each year to promote international togetherness and awareness among children worldwide and improve children's welfare.
- The date of 20th November is important because, on this date, the United Nations General Assembly adopted the Declaration of the Rights of the Child in 1959 and the Convention on the Rights of the Child in 1989.
- Convention on the Rights of the Child recognises every human being under 18 years old as a child and is the world's most widely ratified human rights treaty.
- India approved it in 1992.