Social Issues: December 2021 Current Affairs - CLAT PDF Download

1. National Family Health Survey (NFHS)- 5

National Family Health Survey 5 is the recent round of the survey carried on by Ministry of Health and Family Welfare (MoH&FW) to bring out reliable data on emerging health and family welfare issues. International Institute for Population Sciences, Mumbai and Population Research Centres are the coordinating and implementing agencies that helped to bring out this NFHS round. ICF International, a global consulting and technology services company, provided technical assistance for the NFHS 5 while the United States Agency for International Development provided financial assistance.

Important Findings

• The NFHS provides estimates on key indicators related to population, family planning, child and maternal health, nutrition, adult health, and domestic violence, among others. 
• The biggest positive headline news from NFHS-5 is that the total fertility rate (TFR), which is the average number of children born to a woman during her lifetime, has been falling over time and is now just below the replacement rate of 2.1.

2. Low Life Expectancy Among Urban Poor

‘Health Care Equity in Urban India’- a report released by Azim Premji University explored health vulnerabilities and inequalities in cities in India. It also looked at the availability, accessibility and cost of healthcare facilities, and possibilities in future-proofing services in the next decade.

Findings

• Life expectancy among the poorest is lower by 9.1 years and 6.2 years among men and women, respectively, compared to the richest in urban areas. 
• Multiplicity of healthcare providers both within and outside the government who work without coordination leading to chaotic urban health governance. 
• Heavy financial burden on the poor, and less investment in healthcare by urban local bodies. 
• Urban healthcare has received relatively less research and policy attention.

Way Forward

• Strengthening governance community. 
• Building a comprehensive and dynamic database on the health and nutrition status, including comorbidities of the diverse, vulnerable populations. 
• Strengthening healthcare provisioning through the National Urban Health Mission, especially for primary healthcare services. 
• Putting in place policy measures to reduce the financial burden on the poor. 
• Better mechanism for coordinated public healthcare services and better governed private healthcare institutions.

Conclusion

A well-functioning, better coordinated and governed health care system is crucial at this point. The pandemic has brought to attention the need for a robust and resourced healthcare system. Addressing this now will benefit the most vulnerable and offer critical services to city dwellers across income groups.

3. Covid-19 & Adverse Impact of School Closure

According to UNESCO, school closures carry high social and economic costs for people across communities. Their impact, however, is particularly severe for the most vulnerable and marginalized children and their families. Educational disruption due to prolonged closure of schools across the globe will not only have alarming effects on learning loss but also poses threat to gender equality. The resulting disruptions exacerbate already existing disparities within the education system but also in other aspects of their lives.

These Include

• Interrupted learning: Schooling provides essential learning and when schools close, children and youth are deprived opportunities for growth and development. The disadvantages are disproportionate for under-privileged learners who tend to have fewer educational opportunities beyond school. 
• Poor nutrition: Many children and youth rely on free or discounted meals provided at schools for food and healthy nutrition. When schools close, nutrition is compromised. 
• Confusion and stress for teachers: When schools close, especially unexpectedly and for unknown durations, teachers are often unsure of their obligations and how to maintain connections with students to support learning. Transitions to distance learning platforms tend to be messy and frustrating, even in the best circumstances. In many contexts, school closures lead to separation from teachers. 
• Parents unprepared for distance and home schooling: When schools close, parents are often asked to facilitate the learning of children at home and can struggle to perform this task. This is especially true for parents with limited education and resources. 
• Challenges creating, maintaining, and improving distance learning: Demand for distance learning skyrockets when schools close and often overwhelms existing portals to remote education. Moving learning from classrooms to homes at scale and in a hurry presents enormous challenges, both human and technical. 
• Gaps in childcare: In the absence of alternative options, working parents often leave children alone when schools close and this can lead to risky behaviours, including increased influence of peer pressure and substance abuse. 
• High economic costs: Working parents are more likely to miss work when schools close to take care of their children. This results in wage loss and tend to negatively impact productivity. 
• Unintended strain on health-care systems: Healthcare workers with children cannot easily attend work because of childcare obligations that result from school closures. This means that many medical professionals are not at the facilities where they are most needed during a health crisis. 
• Rise in dropout rates: It is a challenge to ensure children and youth return and stay in school when schools reopen after closures. This is especially true of protracted closures and when economic shocks place pressure on children to work and generate income for financially distressed families.
• Increased exposure to violence and exploitation: When schools shut down, early marriages increase, more children are recruited into militias, sexual exploitation of girls and young women rises, teenage pregnancies become more common, and child labour grows. 
• Social isolation: Schools are hubs of social activity and human interaction. When schools close, many children and youth miss out on social contact that is essential to learning and development. 
• Challenges measuring and validating learning: Calendared assessments, examinations that notably determine high-stakes admission or advancement to new education levels and institutions, are thrown into disarray when schools close. Strategies to postpone, skip or administer examinations at a distance raise serious concerns about fairness, especially when access to learning becomes variable. Disruptions to assessments result in stress for students and their families and can trigger disengagement.

4. National Health Accounts

Union Ministry of Health and Family Welfare released findings of National Health Accounts (NHA) estimates for 2017-18. This is the 5th consecutive NHA report produced by National Health Systems Resource Centre (NHSRC). The NHA estimates are prepared by using an accounting framework based on internationally accepted System of Health Accounts, 2011, provided by WHO.

Findings of 2017-18 National Health Accounts

• Increasing public health expenditure: There has been an increase in the share of government health expenditure in the total GDP of the country. Public health expenditure has increased from 1.15% of GDP in 2013-14 to 1.35% in 2017-18.
• Share of government health expenditure in total health expenditure has also increased overtime. In 2017-18, the share of government expenditure was 40.8%, which is much higher than 28.6% in 2013-14. 
• Government's health expenditure as a share of total Government expenditure has increased from 3.78% to 5.12% between 2013-14 and 2017-18, clearly indicating Government's priority for the health sector. 
• In per capita terms, government health expenditure has increased from Rs 1042 to Rs 1753 between 201314 to 2017-18. More emphasis on primary healthcare: The share of primary healthcare in total government health expenditure has increased from 51.1% in 2013-14 to 54.7% in 2017-18. Expenditure on primary and secondary healthcare accounts for 80% of Government health expenditure. 
• In the private sector, the share of tertiary care has increased but primary and secondary care show a declining trend. Between 2016-17 and 2017-18 in government the share of primary and secondary care has increased from 75% to 86%. In private sector, the share of primary and secondary care has declined from 84% to 74%. 
• The share of social security expenditure on health, which includes social health insurance program, Government financed health insurance schemes, and medical reimbursements made to Government employees, has increased. As a percent of total health expenditure, the increase is from 6% in 2013-14 to around 9 % in 2017-18. 
• Declining out-of-pocket-expenditure (OOPE): Out-of-pocket-expenditure as a share of total health expenditure has come down to 48.8% in 2017-18 from 64.2% in 2013-14. 
• On the per-capita basis, OOPE has declined from Rs 2336 to Rs 2097 between 2013-14 and 2017-18. One of the factors attributing to this decline is the increased utilisation and reduction in cost of services in government health facilities. If we compare NHA 2014-15 and 2017-18 there has been a decline in OOPE for government hospitals in the tune of 50%.