As per National Health Profile (NHP), India’s public health spend as a percentage of GDP has increased by 0.16 percentage points from 1.12% to 1.28% of GDP, between 2009-10 and 2018-19.
India’s target is 5% GDP on health spend.
The NHP is an annual stocktaking exercise on the health of the health sector.
The key findings of NHP 2019 are as below:
Increase in cost of treatmentleading to inequity in access to health care services.
Increase in per capita public expenditure on health in nominal terms from Rs 621 in 2009-10 to Rs 1,657 in 2017-18.
There has been an improvement in sex ratio and a decline in birth and death rates
Health expenditure as percentage of GDP
Spending by states showed deviation with the highest average per capita public expenditure on health by Northeastern states and the lowest by Empowered Action Group (EAG) states plus Assam.
EAG states are the eight socio-economically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh.
Among the NE states, highest GSDP spend was by Mizoram (4.20%) and Arunachal Pradesh (3.29%).
Tamil Nadu and Kerala though having better performers on health parameters, performed poorly on the health finance index with low GSDP spend (Tamil Nadu – 0.74% and Kerala – 0.93%).
Globally, India’s per capita health expenditure was only $16 in 2016. A comparison has provided against other countries that are on the UHC path.
Other Findings of NHP 2019
As per NHP 2019, there has been a change in disease profile of the country with a shift from communicable onestowards the non-communicable diseases (NCDs)such as cardiovascular disease, chronic obstructive pulmonary disease, cancer, mental health disorder and injuries.
This was also documented by the State Level Disease Burden Study 2017. It highlighted an increase in disease burden from NCDs from 30 to 55% between 1990 and 2016.
Several initiatives have been taken in this regard. These include:
National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) launched in 100 districts across 21 states with the aim to prevent and control thesediseases thorough awareness generation, behavior and lifestyle changes.
Free door-to-door screening programme for early detection of cancer, heart disorders and diabetes.
As per the NHP, sex ratio in the country has improved from 933 in 2001 to 943 in 2011.
The sex ratio in rural areas has increased from 946 to 949, and in urban areas from 900 to 929.
Kerala has recorded the highest sex ratio (1,084), and Chandigarh has recorded the lowest sex ratio (690).
Also, the estimated birth rate, death rate and natural growth rate are declining. During 2000 to 2016, the figures were as below:
The estimated birth rate reduced from 25.8 to 20.4.
The death rate declined from 8.5 to 6.4 per 1,000 population.
The natural growth rate declined from 17.3 to 14.
The total fertility rate in 12 States has fallen below 2 children per woman and nine States have reached replacement levels of 2.1 and above.
Delhi, Tamil Nadu and West Bengal have the lowest fertility rate among other States.
There has been growth in medical education infrastructure.
The country has 529 medical colleges, 313 Dental Colleges for BDS & 253 Dental Colleges for MDS.
About: National Health Profile (NHP)
The NHP covers demographic, socio-economic, health status and health finance indicators, human resources in the health sector and health infrastructure.
It is an important source of information on various communicable and non-communicable diseases that are not covered under any other major programmes.
This information is essential for health system policy development, governance, health research, human resource development, health education and training.
Universal Health Coverage
In 2011, the High Level Expert Group of the erstwhile Planning Commission submitted its report on the rollout of Universal Health Coverage (UHC) in India.
It recommended that the government (central government and states combined) should increase public expenditures on health from the current level of 1.2% of GDP to at least 2.5% by the end of the 12th plan and to at least 3% of GDP by 2022.
The benefit of increasing health expenditure would result in:
A five-fold increase in real per capita health expenditures by the government (from around Rs 650-700 in 2011-12 to Rs 3,400-3,500 by 2021- 22).
A corresponding decline in real private out-of-pocket expenditures(from around Rs 1,800-1,850 in 2011-12 to Rs 1,700-1,750 by 2021-22).
According to the WHO, Universal Health Coveragemeans “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
The three objectives of UHC are:
Equity in access to health services;
Quality of health services should be good enough to improve the health of those receiving them;
People should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm.
About: Central Bureau of Health Intelligence
Central Bureau of Health Intelligence (CBHI) was established in 1961 by the Act of Parliament on the recommendation of Mudaliar committee.
It is the Health Intelligence Wing under Directorate General of Health Services (Dte.GHS), Ministry of Health & Family Welfare (MoHFW).
Vision–To havea strong Health Management Information System (HMIS) in entire country.
Mission –To strengthen Health Information System (HIS) in each of the district in the country up to the facility level for evidence based decision-making in the Health Sector.
Sex Ratio – The number of females per 1,000 males
Total fertility rate – The average number of children that will be born to a woman during her lifetime
Disability-adjusted life years (DALYs) measures how much of a normal life span of an individual is taken away by a disease related morbidity of mortality.
It is an international standard of disease burden.
Headline : Vet institute, ambulances mooted in lion conservation plan
In a bid to step up conservation and protection efforts of critically endangered ‘Asiatic Lions, the Centre and the Gujarat government have announced a 3-year dedicated ‘Asiatic Lion Conservation Project’.
About Asiatic Lions
Asiatic Lions are critically endangered species, listed in the Schedule 1 of Wildlife (Protection) Act 1972, Appendix I of CITES and endangered on IUCN Red List.
Asiatic lions were once distributed in dry deciduous forests and scrublands from West Bengal in east to Rewa, MP in the west.
Currently, the last surviving population of the Asiatic lions is confined to Gir National Park and Wildlife Sanctuary, which is the only habitat of the Asiatic lion.
According to 2015 census, there are currently 523 Asiatic lion in India compared to about 50 in 1980s.
Need for the conservation project
In the recent years, there is a rise in number of deaths of Asian Lions due to various unnatural causes.
According to estimates, the numbers of deaths of Asiatic Lions are 104 and 80 in 2016 and 2017 respectively.
The main reason for death of Asiatic lions:
Construction of open wells in their habitat
A viral disease known as Canine Distemper Disease. (a majority of deaths in 2018 are reported to be due to CDD)
Further, Asiatic Lions are long-neglected with low allocation in conservation plans; Rs. 95000/ lion as compared to 15 Lakh/ individual in case of tigers.
About Asiatic Lion Conservation Project
Asiatic Lion Conservation Project will be a 3-year centrally sponsored scheme funded from CSS-Development of Wildlife Habitat (CSS-DWH) with centre-state contribution ratio of 60:40.
It focuses both on protection and conservation of the lion species.
It is mainly based on ‘species conservation over a large landscape” approach. Accordingly, Zone Plans and Theme Plans are developed.
Zone Plans include expansion of habitat and developing a Greater Gir region including Girnar, Pania and Mitiyala.
The Greater Gir region is then divided into Core Zone, the Sanctuary Zone, the buffer Zone for different levels of conservation.
Theme Plans include habitat improvement, protection, wildlife health service, addressing to man-wild animal conflict issues, research and monitoring, awareness generation, and ecotourism.
Main features of the project
Bringing together multi-sectoral agencies for disease control.
Stepping up veterinary care by construction of veterinary hospitals
back-up stocks of vaccines that may be required
Increasing the number of lion ambulances.
ICT-driven monitoring and surveillance systems including
GPS Based Tracking
Automated Sensor Grid with magnetic sensors, movement sensors, infra-red heat sensors
Headline : What impact will the thundershowers, hailstorm have on rabi crop?
Recently, there was heavy rainfall and hailstorms in the many areas of northern India.
This articles assesses the impact of heavy rainfall and hailstorms on rabi crops.
In early February, the National Capital Region, Punjab, Haryana, parts of Uttar Pradesh and northern Madhya Pradesh witnessed heavy rainfall and hailstorms.
According to the Meteorological department, the source of the thundershowers was a fresh Western Disturbance. Further fresh Western Disturbance are also expected.
This will affect the Rabi crops in these regions.
About Rabi crops
”Rabi” is an Arabic word for “spring”.
Harvesting of the winter crops happens in the springtime, thus these crops are called as Rabi crops.
The Rabi season usually starts in November and lasts up to March or April.
Rabi crops are mainly cultivated using irrigation as monsoon rains are already over by November.
Moreover, the unseasonal showers in winter seasons can ruin the crops.
Wheat, barley, mustard and green peas are some of the major Rabi crops of India and different crops require different climatic conditions. For example:
It requires cool temperatures during its growing season in the range of about 14°c to 18°c.
Rainfall of about 50 cms to 90 cms is most ideal.
However, during harvesting season in the spring, wheat requires bright sunshine and slightly warmer temperatures.
It requires a subtropical climate to grow which is a dry and cool climate.
The temperature range to grow mustard is between 10°c to 25°c.
Therefore, the heavy rainfall and hailstorms differently impact various Rabi crops based on various stages of crop production.
Assessment of impact of rainfall and hailstorms on different Rabi crops this season
Heavy rains during this period have negative impact on the mustard, chana (chickpea) and potato crops that are about to mature or in early-harvesting stage.
This crop that is usually planted during the first half of October, and in early February would be in the pod-filling stage (the beginning of the last stage ripening), where the flowers and seeds have already taken shape and size.
The kernels would have been accumulating starch, fat and protein matter.
Hence, rains during this time can impact the yields negatively.
Moreover, if the rain continues, the environment will become helpful for fungal diseases such as sclerotinia stem rot and alternaria blight.
Such diseases could result in the premature ripening of the crop or the pods producing dry, shrinking or discoloured seeds.
The rains are more likely to damage early-sown crops, sown in the last week of September, which would have been ready for harvesting.
Many other Rabi crops are harvested during February-March like Chana, Masur (lentil), Potato, Jeera (cumin-seed) and Dhania (coriander).
These might already be in its final stages of grain-filling or ripening stages.
The risk of rainfall and hailstorm is more for such crops.
In the worst scenario, experts are predicting the repeat of conditions as was in March 2015, when the winter rainfall and hailstorm affected the total area of 182 lakh hectares in North, West and central India.
The positive impact of winter rainfall can be predicted for Wheat, as this crop is sown by mid-November and currently would be in the late-tillering stage, when it produces multiple side stems.
Only the wheat crops sown early in the end of October may get negatively affected.
In fact, rains will have following benefits for the timely or late-sown wheat crops-
It will provide additional round of irrigation to the crops.
It will reduce the temperatures and prolong the winter, which is good for yields.
The Supreme Court has cleared the Chardham highway project, by modifying an NGT order.
It has also ordered to constitute a fresh committee to look into environmental concerns related to the project.
It ordered the Ministry of Environment and Forests to form the high-powered committee (HPC).
After the project got approval, petitions were filed at the National Green Tribunal (NGT), seeking a stay on the Char Dham project. They said the project violated the Environmental Impact Assessment (EIA) notification 2006.
In September, 2018, the NGT gave its conditional approval to the project in view of larger public interest.
Some non-profit group had filed a petition against the NGT order in the Supreme Court saying the project would cause an irreversible damage to regional ecology.
Supreme Court’s decision
Supreme Court has only modified the September NGT order by constituting a fresh high-powered committee (HPC).
In addition to this, the court added representatives from Physical Research Laboratory under the government’s Department of Space, Dehradun-based Wildlife Institute of India, MoEF (from Dehradun regional office) and Defence Ministry to the HPC.
The top court asked the committee to submit its recommendations within four months.
The HPC shall hold quarterly meetings thereafter to ensure compliance and may suggest any further measures after each review meeting.
The committee shall consider the cumulative and independent impact of the Chardham project on the entire Himalayan valleys.
It will give directions to conduct Environmental Impact Assessment by the Ministry of Road Transport and Highways (MoRTH).
The committee will consider whether revision of the full Chardham project should take place with a view to minimize the adverse impact on the environment and social life.
It will identify the sites where quarrying has started and recommend measures required to stabilise the area and for safe disposal of muck.
It will also assess the environmental degradation – loss of forest lands, trees, green cover, water resources etc. – on the wildlife and will direct mitigation measures.
The HPC will also suggest the areas in which afforestation should be taken and the kind of saplings to be planted.
About: Char Dham Highway Project
The Chardham Mahamarg Vikas Pariyojna, or the Chardham highway project, is an initiative to improve connectivity to the Char Dham pilgrimage centres (Gangotri, Yamunotri, Kedarnath and Badrinath) in the Himalayas.
The Prime Minister had launched the construction of the Char Dham Mahamarg in December, 2016, as a tribute to those who died in the 2013 Kedarnath disaster.
The project will develop around 900 km of national highways in Uttarakhand at an approximate cost of Rs 12,000 crore.
It involves widening the existing, geometrically deficient highway that connects the four abodes.
Apart from widening, it plans to improve the stretches to two-lane carriageway with paved shoulders, protect landslide hazard zones, construct bypasses, long bridges, tunnels and elevated corridors to ensure safety for the users.
The project will make travel to Char Dham safer and more convenient. Connectivity & tourism will get a strong boost through the project.
Proper slope stabilisation will ensure protection against landslides.
The project is also important from a strategic point of view as it is close to the China border.
In the eventuality of any aggression, improved roads will facilitate movement of heavy weapons, equipments and artillery guns.
It is an extremely fragile region. The area forms the Main Central Thrust of the Lesser Himalayan region. This is where the Indian tectonic plate goes under the Eurasian Tectonic Plate.
The phenomenon makes the region susceptible to earthquakes and landslides.
The Geological Survey of India corroborates this in its report prepared after the Kedarnath disaster.
It states that road construction in mountains reactivates landslides as it disturbs the toe of the natural slope of the hill.
About: Char Dham
Char Dham refers to the 4 pilgrimage centres – Gangotri, Yamunotri, Kedarnath and Badrinath – in the Himalayas, in the state of Uttarakhand.
Badrinath or Badrinarayan Temple is a Hindu temple dedicated to Lord Vishnu, and situated in the town of Badrinath in Uttarakhand.
The temple is located in Garhwal hill tracks in Chamoli district along the banks of Alaknanda River.
The temple and town form one of the four Char Dham sites.
The temple is also one of the 108 Divya Desams, the holy shrines for Vaishnavites, dedicated to Vishnu (who is worshipped as Badrinath).
It is open for six months every year (between the end of April and the beginning of November), because of extreme weather conditions in the Himalayan region.
Kedarnath Temple is a Hindu temple (shrine) dedicated to Lord Shiva. It is one of the twelve Jyotirlingas, the holiest Hindu shrines of Shiva.
It is located in the Garhwal Himalayan range near the Mandakini river, in Uttarakhand.
Kedarnath is seen as a homogenous form of Lord Shiva, the ‘Lord of Kedar Khand’, the historical name of the region.
Due to extreme weather conditions, the temple is open to the general public only between the months of April (Akshaya Tritriya) and November (Kartik Purnima, the autumn full moon).
Gangotri is a town and a Nagar Panchayat (municipality) in Uttarkashi district in the state of Uttarakhand.
It is a Hindu pilgrim town on the banks of the river Bhagirathi and origin of River Ganges. It is on the Greater Himalayan Range, at a height of 3,100 metres.
According to popular Hindu legend, it was here that Goddess Ganga descended when Lord Shiva released the mighty river from the locks of his hair.
The river is called Bhagirathi at the source and acquires the name Ganga (the Ganges) from Devprayag onwards where it meets the Alaknanda.
The origin of the holy river is at Gaumukh, set in the Gangotri Glacier, and is 19 kms from Gangotri. The temple is closed from Diwali every year and is reopened in May.
Yamunotri Temple is situated in the western region of Garhwal Himalayas at an altitude of 3,291 metres in Uttarkashi district, Uttarakhand.
River Yamuna originates at Yamunotri.
The temple is dedicated to Goddess Yamuna and has a black marble idol of the goddess.
Headline : What is the economics behind e-vehicle batteries?
In May 2019 NITI Aayog had proposed to ban the sale of all internal combustion engine (ICE) powered 3-wheelers from 2023 and 2-wheelers below 150cc from March 2025, and called for them to be converted to electric vehicles (eVs).
To boost eVs, the Union Budget presented in July had also announced tax incentives for early adopters of eVs.
However, the automobile industry had objected to the some of the eV related proposals, especially the ban on ICE vehicles to push eVs, saying eVs are still not financially viable.
In conventional Internal Combustion Engines, petrol or diesel is used as a fuel in the engine.
However, in EVs, batteries are not the fuel, instead electrons supplied by the battery fuel the vehicle.
The battery is a device that stores electrons/energy which is sourced from electricity.
Cost Structure of EVs:
Low cost of the drivetrain:
The cost of the drivetrain of EVs (the system in a motor vehicle which connects the transmission to the drive axles) in comparison to the cost of the entire vehicle is four percent lower when compared to ICE vehicles.
This low cost of the drivetrain is primarily due to less parts in the electric drivetrain.
High cost of batteries:
However, the battery pack takes up nearly half the cost of an electric vehicle. For any meaningful reduction in the cost of EVs, the cost of battery packs needs to reduce significantly.
Batteries prices falling:
The price of Li-ion battery packs has been falling consistently over the past few years.
This decrease is in part due to technological improvements, economies of scale and increased demand for lithium-ion batteries.
Strong competition between major manufacturers has also been instrumental in bringing down prices.
Given that raw materials account for 60% of the cost of the battery pack, the room for further cost reduction is limited.
Two wheelers to lead the way:
According to NITI Aayog, 79% of vehicles on Indian roads are two-wheelers. Further, three-wheelers and cars that cost less than Rs 10 lakh account for 4% and 12% of the vehicle population, respectively.
In India, EV adoption will be driven by two-wheelers rather than cars because India’s mobility market is driven more by two wheelers.
Two-wheelers will also need smaller batteries when compared to cars and hence the overall affordable cost.
Battery manufacturing units expected to grow:
At present, cells are imported and assembled into batteries, as setting up a battery manufacturing unit requires high capital expenditure,
However, battery manufacturing in India is expected to grow as electric vehicles grow.
Environment friendliness of EVs also needs work
Presently, most of India’s electricity is generated using conventional sources.
In 2018-19, over 90% of India’s electricity was generated from conventional sources, including coal, and around 10% was produced from renewable sources such as solar, wind and biomass.
This means that even the Li-ion batteries are predominantly using the conventional polluting sources to power the technology.
While the rate of electricity generated from renewable sources has increased over the years, more needs to be done for their adoption.
This is because the EV-charging infrastructure needs to be powered through renewable sources to make it truly sustainable.