Health And Education

Question 1

What is WASH

Answer 1

Water sanitisation and hygiene

Question 2

Discuss the features of WASH strategy of WHO for 2018 to 2025

Answer 2

WHO has adopted WASH Strategy, 2018-25
o Vision: To substantially improve health through the safe management of water, sanitation and hygiene
services in all settings.
o Role of the WHO: Being a technical agency, the WHO does not directly implement WASH infrastructure
projects. In fact it focuses on its roles of
✓ Generating and disseminating standards and guidelines
✓ Strengthening health sector capacities in providing WASH support
✓ Public health oversight through surveillance and regulation,
✓ Promoting the generation of evidence

Question 3

Discuss the UNICEF strategy for water sanitation and hygiene 2016 to 2030

Answer 3

The purpose of this strategy is to guide UNICEF’s
organization-wide contribution to achieving SDG 6 by 2030. • It is designed to inform and support UNICEF’s core planning and strategy processes, and to guide the implementation of
its programmes.

Question 4

What is the UN sanitation and hygiene fund

Answer 4

SHF was launched in 2020 by the UN and is hosted by the UN Office for Project Services.
• Its purpose is to provide accelerated funding to countries with the heaviest burden of diseases stemming from lack of sanitation services and have the least ability to respond to them.
• It also aims to raise $2 billion over the next five years for these countries.

Question 5

Discuss the status of India for WASH

Answer 5

Inadequate WASH services in India’s
health facilities, contributes to the
high neonatal mortality rate.
In India’s schools, recent reports also
showed that 22% did not have
appropriate toilets for girls, 58% of preschools had no toilet at all and 56% of preschools had no water on the premises.

Question 6

What are the steps taken by India for WASH

Answer 6

Jal Jeevan Mission
• Launched in 2019 to provide every rural household with water supply by 2024.

2. Swachh Bharat Mission
   (SBM)
   • On October 2, 2019, all the villages in the 36 States and Union Territories of India were
   declared open defecation-free (ODF).
   • In 2020, the centre launched SBM 2.0 which aims at ODF plus by focusing on
   sustainability of the ODF.
3. 100-day campaign for 100% coverage
   • Launched by the Ministry of Jal Shakti on Gandhi Jayanti in 2020.
   • Aimed at providing potable piped water supply for drinking and cooking purposes and tap water for hand washing and in toilets in every school, anganwadi and
   ashramshala or residential tribal school in 100 days.
4. Namami Gange program
   • Holistic program on cleaning the Ganga.
   • It entails setting up biodiversity centers, crematoriums and toilets along the river
   banks to reduce pollution in the river.
5. Awareness campaign on benefits of hand washing
   • Upon the onset of COVID-19 pandemic government through various measures like call tunes, is promoting awareness about benefits of frequent hand washing.

Question 7

Discuss the correlation between WASH and sustainable development goals

Answer 7

WASH is an important component of the
Sustainable Development Goals (SDGs),
2030

o SDG3: Good health and well-being
✓ Combating water-borne diseases
✓ Reducing death and illness from unsafe water, unsafe sanitation, and lack of
hygiene

o SDG 6: Ensuring availability and sustainable
management of water sanitation for all.

According to the 2020 analysis by the World Resources Institute,

o Securing water for communities across the
world by 2030 could cost just over 1% of
global GDP.

o It would take India 3.2% of the GDP to
deliver sustainable water management by 2030 to deliver sustainable water management.

Question 8

What are the challenges in ensuring WASH

Answer 8

1. Access to clean water: In India over 120 million households lack access to clean water near their homes, the highest in the world (the UN-Water). Also, in rural India, close to 90% households do not have piped connections
2. Most of the Indian rivers are contaminated due to industrial pollutants. For example, each day,
   approximately 500 million litres of wastewater from industrial sources is dumped into the Ganga.
3. Even ground water is also contaminated in many parts of the country. For example the presence of
   arsenic in the eastern belt in the Ganga-Brahmaputra region.
4. Unsafe tap water: In 2019, the Bureau of Indian Standards (BIS) ranked various cities based on tap water quality. In 13 cities all tested samples failed to meet the BIS norms for piped drinking water.
5. Gap in Sanitation and Hygiene: The National Statistical Office (NSO), in November 2019, titled “Drinking water, sanitation, hygiene and housing conditions in India”, contradicts the Swachh Bharat data on open defecation free status. The report claimed that
6. about 28.7% of rural households across India still lacked access to any form of latrines. o 3.5% of those who have access to latrines, don’t use it (it reflects the behavioural issue).

Question 9

How can India’s friend and WASH

Answer 9

A. Water: Following steps would help enhancing the access to safe drinking water

1. Regulatory measure: It is mandatory for bottled water manufacturers to meet quality standards by the BIS standard.
   However, compliance with quality standards is voluntary for the public agencies which supply and distribute piped water. This shortcoming needs to be rectified.
2. Sensitisation, for judicious use of water and prevention of water bodies from pollution is the need of the hour.
3. Infrastructure for storage of water must be developed properly to ensure that people have access to safe water across the country.

B. Sanitation and hygiene:
1. Traditional approaches to behavioural change on hygiene have been limited to educational messages via awareness campaigns. Such an approach does not necessarily lead to sustained behaviour change.

2. Multiplefactors-emotions, habits, settings, infrastructure, poverty, attitude, and lack of will-prevent the conversion of hygiene-related knowledge into practice and practice into a habit.
3. Programmes on hygiene need to appreciate the interplay between these factors and design an integrated approach rather than addressing it in isolation.
4. Door-to-door campaigns, community meetings, emotional messaging, pledge, prayers, could be great platforms to promote the benefits of handwashing.

Question 10

What are noncommunicable diseases

Answer 10

NCDs, also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioral factors.
• Main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.

Question 11

What are the statistics regarding noncommunicable Diseases in India

Answer 11

As per WHO’s Global Health Observatory, India succeeded in reducing premature NCD-related mortalities from 503 to 490 per 1 lakh population between 2015 and 2019.

NCDs typically present in individuals aged 55 years or older in many developed countries, but their onset occurs in India a decade earlier (≥45 years of age).
• Cardiovascular diseases, respiratory diseases, and diabetes kill around 4 million Indians annually (as in 2016), and most of these deaths are premature, occurring among Indians aged 30–70 years.

Question 12

What are the benefits of inventing and controlling noncommunicable diseases

Answer 12

Economic
Boost GDP 
more money for health 
increased work force participation 
reduced healthcare expenditure

Social
Increased earning capacity
increased life expectancy
protect from financial risk

Question 13

What are the measures taken by India to control noncommunicable diseases

Answer 13

1. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010 with focus on strengthening infrastructure, human resource development, health promotion, early diagnosis, management and referral.
2. In response to WHO’s Globalaction plan for the prevention and control of NCDs 2013-2020, India is the first country to develop specific national targets to reduce number of global premature deaths from NCDs by 25% by 2025.
3. Food Safety and Standards Authority of India (FSSAI) proposed a tax and advertisement ban on unhealthy foods.
4. FSSAI has also launched ‘Eat Right India’ movement to improve public health and combat negative nutritional trends to fight lifestyle diseases and a mass media campaign ‘Heart Attack Rewind’ for the elimination of industrially produced trans-fat in the food supply.

Other efforts:

5. Ayushman Bharat Abhiyan aims to improve health and wellness through its preventive healthcare
   approach.
6. Schemes like Pradhan Mantri Ujjwala Yojana helps to reduce indoor air pollution thereby reducing risks
   of cancer and chronic lung diseases.
7. Promotion of an active life through activities like Yoga which can address the risk of cardiovascular
   diseases.

Question 14

What is the way forward to tackle noncommunicable diseases in India

Answer 14

• Cross-linking of screening services: Zambia’s effort to integrate national HIV services and cervical cancer prevention was helpful in screening more than 100,000 women for cervical cancer over the last 5 years.
• Using digital technology to combat NCDs: It can provide guidance and best practices for the planning, implementation and evaluation of various health programmes.
• Imposing sugar tax: Many countries, including Malaysia, South Africa etc. have used taxation to reduce the consumption of sugar-sweetened beverages and thereby tackling obesity and other NCDs.
• Integrating mental health and psychosocial support into primary care: It will enhance the psychological and social well-being of individuals and their communities by empowering community and individual resilience.

Question 15

What is the Pradhan Mantri Swasthya Suraksha Nidhi

Answer 15

single non-lapsable reserve fund for Health expenditure.
• It is fund for Health in the Public Account, from the proceeds of Health and Education cess levied under Finance Act, 2007.
o In the budget speech
2018, existing 3% Education cess is replaced by 4% Health and Education Cess.

Question 16

Discuss the significance of the Pradhan Mantri Swasthya Suraksha Nidhi

Answer 16

1. enhance access to universal & affordable healthcare through availability of earmarked resources.
2. Amount does not lapse at the end of financial year but carried forward to use in next financial year.
3. Better health improves productivity ,impact scholastic achievements and income.
4. With improved health conditions one extra year of population life expectancy raises GDP per capita by 4%.
5. Investment in health creates millions of jobs, largely for women, through a much-needed expansion of the health workforce.

Question 17

Who raises the rural health statistics report

Answer 17

Ministry of health and family welfare

Question 18

What are the barriers for promotion of health in the rural areas

Answer 18

1. Inaccessibility of PHCs and CHCs: In some cases, for e.g. in tribal areas these centres are quite far from the villages because of which people often turn to unregistered local private healthcare practitioners that are rarely open or equipped to address even basic illnesses.
2. Lack of basic facilities: Poor sanitation facilities, shortage of electricity and water discourages medical graduates to serve in rural centers.
   Cultural and social norms surrounding health behaviors such as not taking care of menstrual hygiene, consulting local healers with limited medical knowledge for treating diseases like smallpox.
3. Lack of Awareness: The rural population is not adequately educated on basic issues like the importance of sanitation, health, nutrition, hygiene and on healthcare policies, importance of medical services, their rights, financial support options, and the need for proper waste disposal facilities.
4. Poor connectivity: Limited affordable, reliable, or public transportation options reduces the motivation to seek health consultation.
5. Lower population densities: Economy of scale cannot be achieved by healthcare industry in rural and tribal areas. It discourages the investment in rural health infrastructure.
6. Nutritional deficiency: The culture of fast food has also penetrated the rural arena, displacing the traditional healthy diet patterns.

Question 19

What are the steps taken in India for promotion of rural health

Answer 19

1. National Rural Health Mission (NRHM): It is a component under National Health Mission, to provide accessible, affordable and quality health care to the rural population, especially the vulnerable groups.
2. The thrust of the mission is on establishing a fully functional, community owned, decentralized health
   delivery system with inter-sectoral convergence at all levels, to ensure simultaneous action on a wide
   range of determinants of health such as water, sanitation, education, nutrition, social and gender equality.
3. Achieving universal health coverage through Ayushman Bharat scheme. Under the scheme:
4. 1,50,000 Health and Wellness Centres (HWCs) to deliver Comprehensive Primary Health Care (CPHC), will be established by transforming the existing Sub Centres and Primary Health Centres.
5. Pradhan Mantri Jan Arogya Yojna provides a health cover of Rs.5 lakhs per family per year for secondary and tertiary care hospitalization to over 10.74 crores poor and vulnerable families
6. Improving nutritional level through schemes like Integrated Child Development Service, National Food Security Act, Poshan Abhiyan etc.
7. Improving sanitation facilities through schemes such as Swachha Bharat Mission and Jal Jeevan Mission.
8. Kaya kalp award is given to Community Health Centres, Primary Health Centres and Health & Wellness Centres who have achieved high level of cleanliness, hygiene and infection control.
9. Increasing accessibility through telemedicine: eSanjeevani platform has enabled two types of telemedicine services viz. Doctor-to-Doctor (eSanjeevani) and Patient-to-Doctor (eSanjeevani OPD) Tele-consultations.
10. Increasing affordability: Making quality medicines available at affordable prices for all, particularly the poor and disadvantaged, through exclusive outlets “Jan Aushadhi Medical Store” to reduce out of pocket expenses in healthcare.
11. Promoting traditional medicines under the National AYUSH Mission.

Question 20

What are the suggestions regarding improvement of rural health in India

Answer 20

If basic healthcare does not reach the rural areas, no matter how much progress is achieved in the urban and semi- urban areas, the overall growth as a nation will be retarded.
Primary health care in India needs to be re-evaluated and concrete steps to be taken, to bring about a balance between growth and human resource development.

1. Investments in primary healthcare: The policy commitment to invest 2.5% of GDP on healthcare and 70% of this expenditure on primary healthcare should be tracked periodically.
2. States that provide lower allocations on health care should be encouraged and supported to provide higher allocations.
3. Medical colleges need to encourage students to visit rural areas and understand the healthcare requirements of poor and downtrodden.
4. Educating people on preventing lifestyle diseases which are slowly penetrating even the rural areas.
5. Primary care team should be adequately supported through regular skilling, incentives, and supervision. Appropriate technological solutions should be provided to help them deliver quality healthcare.
6. Revise undergraduate medical and nursing curriculum to align with rural priorities: The training of MBBS should be aligned toward producing rural family physicians, and of nursing graduates, to produce rural primary care nurses
7. Currently, the graduate training of nurses and doctors has a heavy urban and tertiary healthcare bias
8. Optimal utilisation of skills possessed by allied and healthcare professionals to deal with the problem of shortage of doctors:

Question 21

Discuss the status of tobacco use in India

Answer 21

Tobacco is the foremost preventable cause of death and disease in the world today, killing half of the people who use it.
• As per Global Adult Tobacco Survey-India (GATS2) India is home to over 27 crore tobacco users and globally it is the second largest producer and consumer of tobacco products.
o However, prevalence of tobacco use has reduced from 34.6% to 28.6% during the period from 2009-10
to 2016-17
• The prevalence of current tobacco use among men is 42.4% as compared with 14.2% among women.
• Among both men and women, the prevalence of tobacco use is higher in rural as compared to urban areas.

Question 22

What are the consequences of tobacco use

Answer 22

Approximately 3500 deaths every day in India
economic and social cost owing to the mortality and negative externalities associated with the consumption of tobacco products

ecological and environmental cost tobacco cultivation causes deforestation and displaces the indigenous flora and fauna

increase irrigation and mismanaged fertiliser application causes excessive leaching

noncommunicable disease like cancer chronic lung disease and diabetes et cetera

infectious diseases like tuberculosis and lower respiratory infection

Question 23

What steps have been taken in India to curb the use of tobacco

Answer 23

1. India became a Party to the WHO Framework Convention on Tobacco Control (FCTC) in 2005. o FCTC, the first international treaty negotiated under the auspices of WHO, was developed in response to the globalization of the tobacco epidemic.
2. WHO FCTC importance of both demand reduction strategies as well as supply issues to address addictive substances issues.
3. Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade, Commerce, Production, Supply and Distribution) Act (COTPA), 2003 which aims to provide smoke free public places and also places restrictions on tobacco advertisement and promotion.
4. National Tobacco Control Programme (NTCP) was launched in 2007-08 with objective of ensuring effective implementation of the provisions under COTPA, 2003 to create awareness about the harmful effects of tobacco consumption etc.
5. Juvenile Justice Act, 2015 provides for strict punishment against giving tobacco products to children.
6. National Health Policy 2017 has set an ambitious target of reducing tobacco use by 30% by 2025.
7. National level tobacco cessation quit-line to provide tobacco cessation counseling services to the community through a toll-free number.
8. Pictorial Health Warnings to cover 85% of the front and back panels of the tobacco product package
9. Prohibition of Electronic Cigarettes Act, 2019 which prohibits Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement of e-Cigarettes.

Question 24

Discuss the ways of curbing tobacco use in India

Answer 24

1. Targeted approach: Tobacco control policies in India should adopt a targeted, population- based approach to control and reduce tobacco consumption in the country.
2. Price and tax measures: Tax increases on all tobacco products need to be enforced immediately and the taxes collected should be used to support health promotion and tobacco control programmes.
3. Public health awareness: Raising a mass movement against tobacco, sensitizing and educating all health care professionals for tobacco control.
4. Tobacco farming and livelihood: More synergy between Ministry of Health and Ministry of Agriculture is needed to enhance research on alternative crops for tobacco growers.
5. Prohibit brand stretching (the process of using an existing brand name for new products or services that may not seem related) or brand sharing of tobacco products.
6. No additives, scents, sweeteners or flavourings should be used as an ingredient in tobacco or nicotine products.