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Anusandhan National Research Foundation (NRF) Act, 2023

Context

The Anusandhan National Research Foundation Bill, 2023, has been presented in the Lok Sabha.

About Anusandhan National Research Foundation Bill-2023

• It aims to set up the Anusandhan National Research Foundation (NRF).
• It will be an apex body to provide high-level strategic direction of scientific research in the country as per recommendations of the National Education Policy (NEP).
• It seeks to set up a Rs 50,000-crore fund, with a sizeable contribution from the private sector, to "seed, grow and promote" research and development (R&D) and foster a culture of research and innovation throughout India's universities, colleges, research institutions, and R&D laboratories.
• It seeks to set up different funds:
  • Anusandhan National Research Foundation Fund: For the financing of activities under the Act.
  • Innovation Fund: For supporting outstanding creativity in the areas supported by the foundation
  • Science and Engineering Research Fund: For the continuation of the projects and programmes initiated under the Science and Engineering Research Board Act, 2008.
  • One or more special-purpose funds for any specific project or research.
• Functions of NRF:
  • NRF will forge collaborations among the industry, academia, and government departments and research institutions and create an interface mechanism for the participation and contribution of industries and state governments in addition to the scientific and line ministries.
  • It will focus on creating a policy framework and putting in place regulatory processes that can encourage collaboration and increased spending by the industry on R&D.
• Structure of NRF:
  • It will have a governing board consisting of 15 to 25 eminent researchers and professionals headed by the prime minister, who will be the ex-officio president.
  • The education minister and the science and technology Minister will be the vice presidents of the NRF.
  • The Department of Science and Technology (DST) will be the administrative department of NRF,
  • The proposed foundation will also have an executive council under the principal scientific adviser.

National Curriculum framework for school education (NCF SE)

Context

The Union Minister of Education recently released the National Curriculum Framework (NCF). The draft proposals for the NCF were made available for public feedback in April 2023. The final or revised version of the NCF includes the requirement of teaching three languages (including two Indian languages) in classes 9-10, and two languages (including one Indian language) in classes 11-12.

What are the National Curriculum Frameworks (NCFs)?

• The National Education Policy 2020 (NEP 2020) outlines the development of four National Curriculum Frameworks (NCFs), and a joint strategy by the Ministry of Education (MoE) and NCERT has been devised for their formulation. The National Steering Committee, led by K. Kasturirangan, was established by the MoE to work on these NCFs. The four NCFs are:
  • National Curriculum Framework for Early Childhood Care and Education (NCFECCE)
  • National Curriculum Framework for School Education (NCFSE)
  • National Curriculum Framework for Teacher Education (NCFTE)
  • National Curriculum Framework for Adult Education (NCFAE)
• These frameworks aim to bring about a transformative shift in education, focusing on holistic child development, skill-building, the crucial role of teachers, learning in the mother tongue, and cultural rootedness. It's important to note that while these frameworks are aligned with the NEP 2020, they are not mandatory for states to follow. The NCF has undergone revisions in the past (in 1975, 1988, 2000, and 2005), and the suggested modifications would constitute the fifth revision if implemented.

Pre-draft of the National Curriculum Framework for School Education (NCFSE)

• It covers the framework of curriculum for age groups 3 to 18 years.
• A key part of the document is inclusion of values and its “rootedness” in India.
  • This is in content and learning of languages, in the pedagogical approaches including tools and resources and in philosophical basis.
• It advocated the teaching of three languages (referred to as R1, R2 and R3) in classes 6, 7 and 8, and two languages in classes 9 and 10 (R1 and R2).
  • No guidelines were provided for language learning in classes 11 and 12.
  • R1 denoted the mother tongue or home language, R2 could be any other language (including English), and R3 was any language that wasn’t R1 or R2.
• The document leans towards making students acquainted with true sources of knowledge, which have been a philosophical preoccupation of ancient Indians.
  • These sources focus on six pramanas:
    • pratyaksa (perception through five senses),
    • anumana (using inferences to come to new conclusions),
    • upamana (knowing through analogy and comparison),
    • arthapatti (knowing through circumstantial implication),
    • anupalabdhi (perception of non-existence), and
    • sabda (something an individual can only directly know a fraction of all reality).
  • Moral development: Through panchakosha vikas or five-fold development. This concept is an ancient explanation of the importance of the body-mind link in human experience and understanding.
  • For Grade 10 certification: Students will have to take two essential courses from humanities, maths and computing, vocational education, physical education, arts education, social science, science and interdisciplinary areas.
• Grade 11 and 12:
  • Students will be offered choice-based courses in the same disciplines for more rigorous engagement.
  • Modular Board Exams will be offered as opposed to a single exam at the end of the year and final result will be based on cumulative result of each exam.
  • Immediate transition from annual to semester system in Class 12.

The Final Version of the NCFSE

• Holding the Class 12 board exam twice a year: To ensure students have enough time and opportunity to perform well.
  • Students can appear for a board exam in subjects they have completed and feel ready for.
  • They will also be allowed to retain the best score.
• Mandatory and optional subjects:
  • So far, the students from Classes 9 to 12 studied five mandatory subjects, with an option of adding one more subject.
  • Now, the number of mandatory subjects for Classes 9 and 10 is seven, and it’s six for Classes 11 and 12.
  • Optional subjects have been grouped in three parts in the NCF.
    • The first optional group includes art education (both visual and performing arts), physical education and vocational education.
    • The 2nd group includes Social Science, the Humanities, and interdisciplinary areas.
    • The 3rd group includes Science, Mathematics, and computational thinking.
• Emphasis on Indian languages: It mandates the compulsory instruction of 3 languages (referred to as R1, R2 and R3) up to Class 10. At least 2 of these 3 languages must be native to India.
  • In classes 11 and 12, students will have to study two languages and one of them has to be an Indian language.
  • The final NCF makes the study of Indian languages imperative across schools and boards, contrary to the optional nature of these subjects at present.
• Offers flexibility:
  • It offers students the freedom to pursue a mix of science and humanities to reduce the rigid boundaries separating arts, commerce and science in Classes 11 and 12 across school boards.
  • It also offers freedom to all boards to change to semester or term-based systems in Class 12in the long term.
• For Classes 6 to 8:
  • The NCF states that:
    • 20% content would be from the local level for the Social Science curriculum,
    • 30% content would be from the regional level,
    • 30% would be from the national level, and
    • 20% content would be global.

National Social Assistance Programme (NSAP)

Context

The Comptroller and Auditor General of India conducted a performance audit of the National Social Assistance Programme (NSAP) spanning the period from 2017-18 to 2020-21.

About National Social Assistance Programme

• It was launched on 15th August, 1995.
• Objective
  • It is a social security and welfare programme to provide support to aged persons, widows, disabled persons and bereaved families on death of primary breadwinner,belonging to below poverty line households.
• Eligibility
  • For getting benefits under NSAP the applicant must belong to a Below Poverty Line (BPL) family according to the criteria prescribed by the Govt. of India.
  • The other eligibility criteria and the scale of central assistance under the sub - schemes of NSAP are as follows
• Presently NSAP comprises of five schemes, namely –
  • Indira Gandhi National Old Age Pension Scheme (IGNOAPS): The eligible age for IGNOAPS is 60 years. The pension is Rs.200 p.m. for persons between 60 years and 79 years. For persons who are 80 years and above the pension is Rs.500/ - per month.
  • Indira Gandhi National Widow Pension Scheme (IGNWPS): Widow aged 40 years will get  pension is Rs.300 per month. After attaining the age of 80 years, the beneficiary will get Rs.500/ - per month.
  • Indira Gandhi National Disability Pension Scheme (IGNDPS): An individual aged 18 years and above and the disability level has to be 80% wil get Rs.300 per month and after attaining the age of 80 years, the beneficiary will get Rs 500/ - per month . 
  • National Family Benefit Scheme NFBS): In the event of death of the bread – winner Rs. 20000/ - will be given as a lumpsum assistance to the bereaved household. The breadwinner should have been between 18-60 years of age. 
  • Annapurna: The scheme aims at providing food security to meet the requirements of those eligible old aged persons who have remained uncovered under the IGNOAPS. Under this programme 10 kgs of food grains (wheat or rice) is given per month per beneficiary. 
• Nodal Ministry: Ministry of Rural Development

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY)

Context

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) authorized around 20.32 lakh Covid-19 tests and 7.08 lakh treatments between April 2020 and July 2021.

Key Points

• About:
  • It offers a sum insured of Rs.5 lakh per family for secondary care (which doesn’t involve a super specialist) as well as tertiary care (which involves a super specialist).
  • Under PMJAY, cashless and paperless access to services are provided to the beneficiaries at the point of service.
  • Health Benefit Packages covers surgery, medical and day care treatments, cost of medicines and diagnostics.
    • Packaged rates (Rates that include everything so that each product or service is not charged for separately).
    • They are flexible, but they can’t charge the beneficiary once fixed by the hospitals.
    • The scheme also has prescribed a daily limit for medical management.
• Beneficiaries: It is an entitlement-based scheme that targets the beneficiaries as identified by latest Socio-Economic Caste Census (SECC) data.
  • Once identified by the database, the beneficiary is considered insured and can walk into any empanelled hospital.
• Funding:
  • The funding for the scheme is shared – 60:40 for all states and UTs with their own legislature, 90:10 in Northeast states and Jammu and Kashmir, Himachal and Uttarakhand and 100% Central funding for UTs without legislature.
• Nodal Agency:
  • The National Health Authority (NHA) has been constituted as an autonomous entity under the Society Registration Act, 1860 for effective implementation of PM-JAY in alliance with state governments.
  • The State Health Agency (SHA) is the apex body of the State Government responsible for the implementation of AB PM-JAY in the State.
• Challenges:
  • Cooperation of States: Since health is a State subject and States are expected to contribute 40% funding for the scheme, it will be critical to streamline and harmonise the existing State health insurance schemes to PMJAY.
    • West Bengal, Telangana, Odisha and Delhi have not implemented PMJAY.
• Burden of Costs:
  • Costs are a contested area between the care-providers and the Centre, and many for-profit hospitals see the government’s proposals as unviable.
• Inadequate Health Capacities:
  • The ill-equipped public sector health capacities calls for necessary partnerships and coalitions with private sector providers.
  • In such circumstances, the provision of services can be ensured only if the providers are held accountable for their services.
• Unnecessary Treatment:
  • The National Health Policy 2017 proposed “strategic purchasing” of services from secondary and tertiary hospitals for a fee.
  • The contracts with the healthcare providers who will receive the financial compensation package should clearly spell out the strict following of notified guidelines and standard treatment protocols in order to keep a check on potential for unnecessary treatment.
• Achievements:
  • Beneficial for Poor: In around the first 200 days of implementation, PM-JAY has benefitted more than 20.8 lakh poor and deprived people who received free treatment worth more than Rs. 5,000 crores.
  • During Covid-19: A key design feature of PM-JAY from the beginning of the scheme is portability, which helps to ensure that a PM-JAY-eligible migrant worker can access the scheme’s services in any empanelled hospital across the country, irrespective of their state of residence.
• Related Scheme: India Covid-19 Emergency Response & Health System Preparedness Package: Phase-II (ECRP-II package):
  • This scheme is a Centrally Sponsored Scheme with some Central Sector components.
  • Launched recently, it aims to accelerate health system preparedness for immediate responsiveness for early prevention, detection and management, with a focus on health infrastructure development including for Paediatric Care and with measurable outcomes.

Way Forward

• The expansive goals of the AB-PMJAY program provide an opportunity to address the systemic reforms needed to achieve India's Universal Health Coverage (UHC) objectives. This necessitates increased investment in a historically underfunded healthcare system, coupled with a focus on governance, quality control, and stewardship for sustainable progress toward UHC.
• Public spending on healthcare in India remains one of the lowest globally. To bridge this gap, leveraging technology and innovation becomes crucial. AI-powered mobile applications, offering high-quality, cost-effective, patient-centric, and intelligent wellness solutions, can contribute to reducing overall healthcare costs. The Ayushman Bharat's scalable and interoperable IT platform represents a positive step in this direction.

Tribal Health

Context

A significant health disparity exists between India's tribal population and non-tribal population. Compounding this issue is the lack of comprehensive data and information on the health and nutrition status of various tribal communities. This absence of data poses a significant challenge for decision-makers as they formulate policies and interventions to bridge these health gaps.

Tribal Health in India

• In India, tribal communities constitute 8.9% of the total population, yet they face significant underservice and neglect in terms of healthcare access.
• A study by the Ministry of Tribal Affairs indicates that newborn mortality in tribal communities is 63% higher than the national average, with a 44% higher death rate, emphasizing the urgent need for equitable healthcare access.
• Complex challenges faced by tribal communities include financial constraints, insufficient medical personnel, inadequate infrastructure, lack of connectivity, high costs, and various other issues.
• The "Particularly Vulnerable Tribal Groups" (PVTGs), often known as "Primitive Tribes," form around 2.5% of the total Scheduled Tribes population, and they are the most marginalized within this category.
• PVTGs are dispersed across several states, with higher prevalence in Madhya Pradesh, Maharashtra, Odisha, Chhattisgarh, Rajasthan, North Eastern Region (NER) states, and the Andaman & Nicobar Islands.
• Tribal groups in India confront numerous challenges related to poverty, illiteracy, malnutrition, health, employment, infrastructure, and human rights, leading to disparities in human development indicators compared to the national average.
• Non-tribal individuals and institutions often subject them to violence, exploitation, relocation, and prejudice, further limiting their opportunities and resources for empowerment.
• The United Nations Declaration on the Rights of Indigenous Peoples emphasizes the right to health for tribal populations, with specific attention to the needs of elders, women, youth, children, and persons with disabilities.
• The declaration asserts the right of indigenous peoples to actively participate in developing their health programs, access traditional medicines, maintain their health practices, and enjoy the highest attainable standard of physical and mental health on an equal basis.

Challenges for Tribal Health care

• Tribal people do not consume enough or the proper kind of food to maintain their health. They struggle with malnutrition, anemia, stunting, wasting, and hunger.
• Due to several conditions, including inadequate sanitation and hygiene, and limited access to healthcare, tribal people are more susceptible to contracting communicable diseases such as malaria, Tuberculosis, leprosy, HIV/AIDS, diarrhea, respiratory infections, and diseases carried by insects or animals.
• People from tribal groups are also susceptible to developing chronic illnesses including cancer, cardiovascular disease, diabetes, hypertension, and mental problems.
• Genetic diseases like sickle cell anemia are also prevalent among the tribal population.
• Compared to 56% and 30% of non-tribal males, more than 72% of tribal men aged 15 to 54 use cigarettes, and more than 50% drink alcohol.
• Most tribals don’t know their age or date of birth which hinders the census of life expectancy for healthcare planning.
• Early marriage, early childbirth, low BMI, and high incidence of anemia are critical reasons for high maternal mortality.
• Child health indicators for the scheduled tribes are poor and worse than the general population.
• Micronutrient deficiency among the tribal population is rampant according to the National Nutrition Monitoring Bureau (NNMB).

Rapid deforestation and forest laws that limit access to forest produce have robbed many tribal communities of food, fodder, shelter, and livelihoods.

• Migration and displacement of the tribal population due to loss of livelihoods, floods, famines, and large-scale infrastructure and mining projects have a serious impact on the security, safety, and mental and physical health of the tribal people.
• It limits their access to facilities like the ICDS and schools. Such tribal migrants are doubly vulnerable as they do not have access to the special schemes and programs being run for STS in the scheduled areas.

Government Initiatives for tribal health

“Public Health and Hospital” is a state subject, the primary responsibility of ensuring the availability of healthcare facilities including access to healthcare facilities in tribal-dominated areas lies with the respective State Governments including Madhya Pradesh. However, the Ministry of Health and Family Welfare, Government of India provides technical and financial support to the States/UTs to strengthen the public healthcare facilities through National Health Mission.

Swasthya

• Swasthya is a one-stop solution presenting the health and nutrition status of the tribal population of India.
• It provides information and data as well as curates innovative practices, research briefs, case studies, and best practices collected from different parts of India to facilitate the exchange of evidence, expertise, and experiences.
• It is envisaged that information available on Swasthya will provide insights to all stakeholders working with the tribal population of India, in the areas of health and nutrition.
• Swasthya is maintained by the Centre of Excellence for Knowledge Management for Health and Nutrition, established by the Ministry of Tribal Affairs.

Report on Tribal Health in India

In 2018, an expert committee, constituted jointly by the Ministry of Health and Family Welfare and the Ministry of Tribal Affairs released the first comprehensive report on Tribal Health in India.
Recommendations of the report were:

• Implement Universal Health Assurance under the National Health Policy (2017) in tribal areas.
• Utilize Aarogya Mitra, trained local tribal youth, and ASHA workers for primary care in tribal communities with support from the gram sabha.
• Provide financial protection through government medical insurance schemes for secondary and tertiary care.
• Introduce ST Health Cards for tribal people living outside scheduled areas to facilitate access to benefits at any healthcare institution.
• Implement a Tribal Malaria Action Plan in tribal-dominated districts under the National Health Mission.
• Strengthen Home-Based Newborn and Child Care (HBNCC) programs to reduce infant and child mortality.
• Enhance food security and strengthen Integrated Child Development Services (ICDS) to address malnutrition.
• Publish a state of tribal health report every three years and establish a Tribal Health Index (THI) to monitor tribal health.
• Establish a National Tribal Health Council as an apex body, along with Tribal Health Directorate and Tribal Health Research Cell, at both central and state levels.

Other health schemes in tribal areas

• National Health Mission (NHM): The NHM focuses on Health System Strengthening in both rural and urban areas, Reproductive-Maternal- Neonatal-Child and Adolescent Health (RMNCH+A), and the management of Communicable and Non-Communicable Diseases.
• Ayushman Bharat– Health and Wellness Centres (HWCs): HWCs are established by transforming Sub-Health Centres (SHCs) and Primary Health Centres (PHCs) under Ayushman Bharat to enhance healthcare accessibility.
• Mobile Medical Units (MMUs): NHM allows states/UTs to deploy MMUs, offering various healthcare services in remote and underserved areas to address the specific needs identified by the respective regions.
• National Free Drugs Service Initiative and National Free Diagnostic Service Initiative: These initiatives aim to reduce Out-of-Pocket Expenditure on health services by providing essential medicines and diagnostic services free of charge.
• ASHA Program: ASHA recruitment guidelines accommodate habitation-level recruitment, especially in hilly, tribal, and challenging areas.
• High Priority Districts (HPDs): Tribal majority districts with a composite health index below the state average are designated as High Priority Districts. These districts receive additional resources per capita under NHM compared to other districts in the state.

Way forward

There is still a long way to go to improve and bring tribal health in India to par with the general population.
Some aspects that can be carefully looked into are:

• addressing the discrepancy in indigenous groups’ health-seeking patterns and access to healthcare.
• recognizing and appreciating the services that tribal communities’ traditional healers give.
• empowering tribal groups to make wise decisions regarding their health through health literacy programs.
• putting into practice targeted recruiting and retention tactics to draw medical professionals to tribal areas. And improving connections by making investments in the construction of road networks, transportation infrastructure, and communication networks.