Society & Social justice

All (4049)Current Affairs (4038)Mains Practice (126)Mains PYQs by Subjects (40)

Rising Non-Communicable Disease burden

Context: Non-Communicable Diseases (NCDs) are rapidly rising in India, particularly in the urban areas. Studies have shown increased risks of NCDs for women post-menopause, with a significant rise in diabetes, obesity, fatty liver, and hypertension.

Relevance of the topic: Mains- Role of Urbanisation in increasing the Burden of NCDs; Government Initiatives.

What are Non-Communicable Diseases?

NCDs: Group of chronic diseases that are not caused by infectious agents and typically have a long development period.
Diseases: They include a range of conditions such as cardiovascular diseases, cancer, diabetes, chronic respiratory diseases , and mental health disorders.
Risk factors for NCDs: Unhealthy diets, physical inactivity, tobacco use, harmful use of alcohol, pollution and environmental factors.
According to the World Health Organisation, NCDs account for 71% of all deaths globally, with cardiovascular diseases being the leading cause.
- As per the WHO’s latest report (2022), 66% of total deaths in India in 2019 were due to NCDs.
- Older adults (60 and above) have reported the highest infectious, NCDs, disability and injuries.

Non-Communicable Diseases - risk factors

Role of Urbanisation in Increasing the Burden of NCDs:

Economic Structure: Urban economies are primarily service-oriented, which reduces the need for manual labor compared to agrarian rural economies. This contributes to the sedentary lifestyle and associated risk of NCDs.
Changing Dietary Patterns: Urban areas often see increased consumption of processed foods, unhealthy fats, and sugars, leading to poor nutrition which are directly related to rising incidence of NCDs.
Environmental Factors: Pollution and the Urban Heat Island effect exacerbate health risks associated with NCDs.
Lifestyle Choices: Higher prevalence of alcohol consumption and smoking in urban settings increases the risk of developing NCDs.
Family Structure Changes: The shift towards nuclear families in urban areas can lead to mental health issues due to a lack of emotional support from extended family members.

Initiatives taken by the Government:

National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NP-CDCS): Implemented since 2010 intends to prevent and control major NCDs (Hypertension, Diabetes, Cardiovascular disease, Cancer, Stroke, Chronic kidney disease, COPD/ Asthma, Non-Alcoholic Fatty Liver Disease, etc).
National Action Plan: India has adopted the National Action Plan with specific national targets and indicators aimed at reducing the number of global premature deaths from NCDs by 25% by 2025.
- The plan was based on the WHO's Global Action Plan for the Prevention and Control of NCDs (2013-2020). UN SDG (Target 3.4) aims to reduce premature mortality from NCDs by one-third by 2030 in the world.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana includes coverage for treatment of NCDs, to over 10 crore families, including cancer.
Fit India Movement and promotion of Yoga to encourage people to remain healthy and fit by including physical activities and sports in their lifestyle.
National Mental Health Programme and National Tele Mental Health Programme to improve access to quality mental health counselling and care services in the country.

India’s Educational Transformation

Context: India’s education system in the past had been characterised by outdated policies, corruption, and a disconnect from India's civilisational ethos. The National Education Policy (NEP) 2020 marks a decisive shift towards accessibility, equity, and modernisation.

Relevance of the Topic:Mains: Education transformation in India: Key Initiatives.

National Education Policy (NEP) 2020

The NEP 2020 outlines the vision of the new education system of India. It replaces the previous National Policy on Education of 1986.
The NEP 2020 is based on five key pillars: Access, Equity, Quality, Affordability, and Accountability.

Read More: National Education Policy 2020

India’s Educational Landscape: Key Initiatives

In the recent decade, the government has undertaken significant reforms in the educational landscape. This has resulted in improved educational enrollment and reduction of structural inequities.

1. Promoting Inclusivity:

Since 2014-15, the enrolment of Scheduled Castes (SC) in higher education has increased by 50%, Scheduled Tribes (ST) by 75%, and Other Backward Classes (OBCs) by 54% since 2014-15.
Female enrolment across all categories has grown by an impressive 38.8%, crossing 2.18 crore in 2022-23. Among Muslim minority students, the female enrolment rose by 57.5%.

This is in line with NEP 2020 which aims to decentralise education and promote inclusivity.

2. Women’s Empowerment in Education:

In higher education, PhD enrolment among women has increased by 135%.
Women in the field of higher education STEMM (science, technology, engineering, mathematics, and medicine) constitute 43%.
Female teachers constitute 44% of the teaching workforce, up from 38% in 2014.

3. Increased Government Investment in Education:

Per-child government expenditure has risen by 130%, from ₹10,780 (2013-14) to ₹25,043 (2021-22).
Through NEP 2020, enhanced focus on early childhood education, foundational learning, and numeracy for holistic development.
Focus on modernisation of government schools with improved infrastructure and pedagogy. E.g.,
- Introduction of coding from middle school.
- Establishment of Atal Tinkering Labs (ATL): Over 10,000 ATLs are operational in 2024.

4. Higher Education Reforms and Global Recognition:

In higher education, sustainable revenue models have freed universities from resource dependency.
India now has 11 universities in the QS World Rankings top 500, a remarkable improvement from the past.
Research publications have increased by 88% since 2015, propelling India to 39 in the Global Innovation Index, up from 76 in 2014.
Anusandhan-National Research Foundation has been established to boost research and innovation in collaboration with industry and academia.

5. Restoring Indian Knowledge Traditions and Language Primacy:

NEP 2020 has restored primacy to all Indian languages and knowledge traditions, overcoming the decades of ‘English-first’ policies.
Through the Indian Knowledge Systems (IKS) initiative, over 8,000 higher education institutions have adopted the IKS curriculum.
Through the Bharatiya Bhasha Pustak Yojana, 15,000 original and translated textbooks in 22 Indian languages will be published.

The government envisions an educational renaissance aligning with India’s rich intellectual heritage. The educational initiatives along with NEP 2020 aim to propel India into the ranks of developed nations.

Abortion and Foetal Viability: Legal Framework in India

Context: Abortion rights remain a contentious issue globally, often caught between ethical concerns and legal frameworks. India has a progressive abortion law compared to some nations but still presents challenges beyond 24 weeks of pregnancy.

Relevance of the Topic: Mains: Abortion rights in India- Issues, Case Study, etc.

Abortion Laws in India

The law on abortion in India is primarily governed by Sections 312-316 of the Indian Penal Code and the provisions of the Medical Termination of Pregnancy Act, 1971.
The MTP (Amendment) Act, 2021 has expanded the access to safe and legal abortion services on therapeutic, eugenic, humanitarian and social grounds to ensure universal access to comprehensive care.

Major Provisions of the MTP (Amendment) Act, 2021:

Increase in Gestation Periods:
- The Amendment Act increases the maximum gestational limit for pregnancies that may be aborted on the advice of one 'registered medical practitioner' from 12 weeks to 20 weeks.
- For pregnancies that may be aborted on the advice of two medical practitioners, the limit has been raised to 24 weeks.
- Earlier, if the length of the pregnancy was over 20 weeks and a woman wished to undergo a termination, she would have to file a writ petition before the High Court concerned or the Supreme Court.
Recognition of Pregnancies outside of Traditional Marriages:
- The Amendment reflects the change in definition from "pregnant married woman" to "pregnant woman" and from "her husband" to "her partner".
Termination due to Failure of Contraceptive Method/Device:
- Another laudable amendment is the inclusion of unwanted pregnancies due to the failure of contraceptives, as a ground for abortion.
- Under the original MTP Act, abortions could take place only by proving that there was grave risk to the pregnant woman or grave risk of serious physical or mental abnormality.
Setting up of Medical Boards:
- All state and union territory governments will constitute a Medical Board. The Board will decide if a pregnancy may be terminated after 24 weeks due to substantial foetal abnormalities.
- Earlier, the medical boards were created by various High Courts and Supreme Court after entertaining writs filed by women, and were not in any way statutorily mandated.
Privacy: A registered medical practitioner may only reveal the details of a woman whose pregnancy has been terminated to a person authorised by law.

Also Read: Medical Termination of Pregnancy (Amendment) Act, 2021

Important Judgement(s) by the Supreme Court w.r.t. Abortion

2023 Supreme Court Judgment on Late-Term Abortions:
- The Supreme Court ruled that a woman's bodily autonomy must be respected, even in late-term pregnancies.
- However, it also emphasised the role of medical boards in determining whether abortion can be granted beyond 24 weeks.
- This judgment highlighted the conflict between individual reproductive rights and state-mandated medical scrutiny.
- This case has shown that women can be compelled to carry pregnancies, even if they vouch that the pregnancy is unwanted and dangerous to their well-being.
X v/s NCT of Delhi (2022):
- In this judgement, the Supreme Court held that termination of pregnancies between 20 and 24 weeks is available to all women who are undergoing any change in their material circumstances.
- The Court said that ‘it is the woman alone who has the right over her body’ and is the ‘ultimate decision-maker’ in deciding if she wants an abortion.

Key Considerations on ‘Abortion Rights’ in evolving Medico-legal landscape:

1. Rights of a Foetus Under Indian Law: The rights of a foetus under the Indian Constitution are unclear as there has been no upfront articulation of it. A 2016 Bombay High Court decision relied on international human rights law to hold that the foetus does not have rights till birth. Hence, there is an urgent need to articulate the rights of a foetus under the Indian Laws.

2. Challenges in Accessing Late-Term Abortions (Medico-legal Barriers): Medical boards follow strict guidelines, allowing abortion only in extreme cases. Even severe congenital conditions may not guarantee approval for termination. Women seeking abortions post-24 weeks face lengthy legal battles, delaying decisions. E.g., A woman with postpartum depression was denied abortion at 26 weeks despite medical complications.

3. Implications of Advancements in Neonatal Medicine: With medical advancements, premature babies as early as 24-26 weeks can survive with intensive care. This raises concerns that should abortion rights be reduced as neonatal care improves? However, there is a risk of legal precedence restricting abortion rights based on medical developments rather than reproductive autonomy.

4. Privacy Concerns (Case study: Haryana’s Pregnancy registration mandate): Haryana state government aims at curbing female foeticide by ensuring early pregnancy registration. It mandates ultrasound centers to register pregnant women. Critics argue it violates privacy rights and deters women from seeking legal abortions. Could push women towards unsafe abortions outside formal healthcare systems. The mandate is in conflict with the MTP Act, which ensures confidentiality in abortion cases.

India’s Social Security Coverage Doubles

Context: According to the International Labour Organisation’s (ILO) World Social Protection Report 2024-26, India’s social protection coverage has doubled to 48.8% in 2024.

Relevance of the topic: Prelims: World Social Protection Report; Key Government Initiatives.

Major Highlights:

India’s social protection coverage has doubled from 24.4% in 2021 to 48.8% in 2024 as per ILO’s World Social Protection Report (WSPR) 2024-26.
A comprehensive data pooling exercise by the Union Ministry of Labour in collaboration with ILO shows:
- Nearly 92 crore people, or 65% of India’s population is covered by at least one form of social protection, whether in cash or in-kind, through central government schemes.
More than 200 crore records were processed to identify unique beneficiaries by utilising encrypted Aadhaar across 34 major Central schemes such as the MGNREGA, Employees Provident Fund and Employees State Insurance.

Criticism

ILO’s assessment of 48.8% is considered an underestimation as it does not include:
- In-kind benefits like food security (E.g., PM Garib Kalyan Anna Yojana), housing, and health benefits.
- State-administered social welfare schemes.

World Social Protection Report

Comprehensive assessment published periodically by the International Labour Organisation (ILO). ILO is a specialised agency of the United Nations dedicated to labour rights and social justice.
The report evaluates social protection systems globally, examining their coverage, effectiveness, and progress in ensuring social security for diverse populations.
Utility: key resource for governments and policymakers to work towards stronger and more inclusive welfare systems.

Expanding Social Security: Key Government Initiatives

Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana: As of March 2025, over 39 crore Ayushman Cards have been issued, offering free health coverage of up to ₹5 lakh per family. The scheme is accessible at 24,810 empanelled hospitals nationwide.
Pradhan Mantri Garib Kalyan Anna Yojana: Provides free food grains to vulnerable populations. As of December 2024, over 80.6 crore people are receiving free food grains, close to the intended coverage of 81.35 crore beneficiaries.
eShram Portal (2021): To create a National Database of Unorganised Workers. A Universal Account Number (UAN) is given to workers for enhanced social security. As of March, 2025, over 30 crore unorganised workers have registered (53% of them being women).
Atal Pension Yojana (2015): Provides universal social security to underprivileged and unorganised sector workers. Along with Pradhan Mantri Jeevan Jyoti Bima Yojana and Pradhan Mantri Suraksha Bima Yojana, it strengthens the social security system.

Over the past decade, India’s social security measures have helped lift 24.8 crore people out of multidimensional poverty.

Guidelines to tackle MGNREGS Job Card Deletions

Context: The Ministry of Rural Development has issued guidelines to tackle the challenge of high rate of deletions of job cards issued to workers under the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS).

Relevance of the Topic: Prelims: Key Facts about MGNREGA.

Mahatma Gandhi National Rural Employment Guarantee Scheme

Launched: under the Mahatma Gandhi National Rural Employment Guarantee Act 2005.
Objective: Provides at least 100 days of guaranteed wage employment per financial year to rural households whose adult members volunteer for unskilled manual work.
Implementing Authority: Ministry of Rural Development (MoRD)
Type of Work Covered: Water conservation, rural connectivity, irrigation, land development, etc.

Recent Central Govt. guidelines on Job Card Deletions:

Gram Sabha Approval: Job cards or workers' deletions should take place only after due verification in the gram sabha, or in the social audit gram sabha, or in a special gram sabha called for the purpose.
Permitted reasons for Job Card Deletion:
- Permanent migration of the household to urban areas or another Panchayat.
- Gram Panchayat declared as an urban settlement.
- Duplicate job card or forged registration.
- Death of the worker.
- Household/workers formally requesting deletion in writing.
Publication of Deleted Names: Names of deleted workers/job cards must be in the public domain for 30 days to allow objections. The cause of deletion of each job card has to be revealed. Each cause of deletion must be confirmed by the gram sabha.
Right to Appeal: Households can appeal against job card cancellations. Gram Sabhas to discuss flagged deletions twice a year.
Payment of Dues: No deletion to be carried out before clearing pending wages of workers.

Reason for Issuance of Guidelines

High rate of deletions of job cards issued under MGNREGS. Over 10.43 crore workers were deleted in the last four years. The deletions have increased after the Aadhaar-Based Payment System (ABPS) became mandatory in January 2023.

Mass deletions of job cards without proper scrutiny can undermine MGNREGS’s purpose. A balance must be maintained between policy enforcement and ensuring social security for the rural workforce.

Unified Pension Scheme

Context: The Finance Ministry has introduced a one-time, one-way switch facility from the Unified Pension Scheme (UPS) to the National Pension System (NPS).

From 1 April 2025, the government introduced the UPS as an option under the NPS for Central government employees. UPS will provide assured payouts to the employees.

Relevance of the Topic: Prelims: Key facts about the Unified Pension Scheme (UPS).

Key Features of the Unified Pension Scheme

Assured pension: 50% of the employee’s average basic pay drawn over the last 12 months before superannuation for a minimum qualifying service of 25 years.
Assured minimum pension: In the case of superannuation after a minimum 10 years of service, the UPS provides for an assured minimum pension of Rs 10,000 per month.
Assured family pension: Upon a retiree’s death, their immediate family would be eligible for 60% of the pension last drawn by the retiree.
Inflation Indexation: Pension amounts are adjusted for inflation using the All India Consumer Price Index for Industrial Workers (Dearness Relief).
Lumpsum payment at superannuation: Subscribers receive a lump sum payment upon retirement, supplementing their regular pension.
Contributory Scheme: Similar to the National Pension System (NPS), the scheme is funded by contributions from:
- Employees: 10% of their basic pay plus Dearness Allowance (DA).
- Government: 18.5%.

Eligibility Criteria:

The UPS is applicable to the following categories of Central Government employees:

Existing employees: Those in service as of April 1, 2025, and currently covered under NPS.
New recruits: Individuals joining Central Government services on or after April 1, 2025.
Retired employees: Employees who were under NPS and have superannuated, voluntarily retired, or retired under Fundamental Rules 56(j) on or before March 31, 2025.
In cases where the subscriber has passed away prior to opting for UPS, the legally wedded spouse is eligible.

Implementation Timeline:

The regulations for the operationalisation of UPS come into effect from April 1, 2025.

National Pension Scheme:

NPS was a market-linked contribution scheme introduced by the Central Government. NPS replaced the Old Pension Scheme on 1st January, 2004.
The Pension Fund Regulatory and Development Authority (PFRDA) regulates and administers NPS under the PFRDA Act, 2013.

Need for NPS:

OPS had a fundamental problem, i.e. it was unfunded, there was no corpus specifically for pension.
Over time, this led to the government’s pension liability to balloon to fiscally unhealthy levels. The pension liabilities of the Centre jumped from Rs 3,272 in 1990-91 to Rs 1,90,886 crore in 2020-21.

Working of NPS:

The NPS was different from OPS in two fundamental ways.
- It did away with an assured pension.
- It would be funded by the employee himself/ herself, along with a matching contribution by the government.
The defined contribution comprised 10% of the basic pay and dearness allowance by the employee, and the government’s contribution of 14%.
Individuals under NPS can choose from a range of schemes and pension fund managers as well as private companies to invest their money contributed to NPS.

Opposition to NPS:

Under the NPS, government employees received lower guaranteed returns and had to contribute to their pension, unlike the OPS where there were no employee contributions and higher guaranteed returns.
Amid ongoing calls for a return to the OPS, the union government established a committee in 2023 led by T V Somanathan. The recommendations of the committee have led to the introduction of the new Unified Pension Scheme (UPS).

Comparing various Pension Schemes

Feature	Unified Pension Scheme (UPS)	New Pension Scheme (NPS)	Old Pension Scheme (OPS)
Type of Scheme	Hybrid (Assured pension + contribution-based)	Contribution-based	Defined benefit (assured pension)
Applicability	Central govt. employees; State government has option to adopt	Central and state government employees (except armed forces)	Central and state government employees before April 1, 2004.
Pension Guarantee	Minimum pension guaranteed	No assured pension; depends on market returns	50% of last drawn salary as pension guaranteed
Employee Contribution	10% of salary; govt. contributes 18.5%.	10% of salary; 14% by the government for central employees.	No contribution from employees (fully funded by govt)
Inflation Adjustment	Yes (dearness relief linked to inflation index)	No guaranteed inflation adjustment	Yes (DA revisions based on inflation)
Withdrawal Options	Lumpsum + monthly pension	60% lumpsum, 40% annuity	No lumpsum withdrawal, only pension
Family Pension	60% of pension amount to dependents	Not guaranteed but depends on chosen annuity plan	50% of pension amount given as family pension

Is APAAR ID for Students Mandatory?

Context: APAAR is part of the National Education Policy 2020’s record-keeping reforms. While the registration is voluntary; activists and parents are worried about the rapid push by schools to generate an APAAR ID.

Relevance of the topic:

Prelims: About APAAR ID.

Mains: Government policies and interventions for development in various sectors, Important aspects of governance, transparency, and accountability

What is an APAAR ID ?

APAAR (Automated Permanent Academic Account Registry) system introduces a 12-digit unique ID for every student in India, as part of India’s One Nation, One Student ID initiative.
Aim: To store and consolidate students academic records and accomplishments, facilitating seamless transitions between educational institutions.
APAAR ID is linked to Aadhaar and is stored in the DigiLocker. The registry provides students with standardised data on their marksheets and institutional affiliation.
APAAR is generated through the Unified District Information System For Education Plus (UDISE+) portal, which contains regional academic statistics and data on schools, teachers and students.

Benefits of APAAR ID ?

Unified academic identity: A single platform to consolidate and showcase academic records.
Streamlining student records: Simplifying record-keeping for students, parents, and educators.
Digital repository: Securely storing academic data and achievements.
Seamless academic mobility: Facilitating smooth transitions between educational levels. Educational institutes can rapidly process and verify any given student’s academic transcripts.

How is an APAAR ID generated?

Schools verify a student’s demographic details, i.e., their name and date of birth.
Parents are required to fill a consent form, and after authentication by the school, the APAAR ID is generated.

Is APAAR mandatory ?

APAAR is voluntary. Parents have the option of writing to schools and opting out of generating the APAAR ID for their children.
The Union government re-confirmed the optional nature of APAAR in response to a Parliament query in December 2022.

However, there are reports of state governments, particularly in Uttar Pradesh and Karnataka, exerting pressure on schools to achieve full enrollment.

Criticism and Concerns:

Privacy and data security: APAAR is linked to Aadhaar, raising concerns regarding potential risk of data leaks and misuse.
No strong legal framework and policy documents for the APAAR ID system governing data collection, use, storage, and disclosure, particularly of children's (minors) data.
No transparency over data handling practices, such as how data is collected, used, stored, and shared, and who accesses it. E.g., Internet Freedom Foundation (IFF) filed an RTI but the request was transferred more than 30 times, without a reply.
Discrepancies between Aadhaar and school documents, including typos, may lead to processing delay and administrative burden.

India witnesses growing Education-Employment Mismatch

Context: India’s labour market is facing a critical imbalance between education levels and employment opportunities. While thousands of graduates and postgraduates enter the workforce each year, a significant portion remains stuck in semi-skilled or even elementary jobs.

Relevance of the Topic:Mains: Key Trends reflecting Education-Employment Gap in Indian Labour Market.

Present Employment Trends and Challenges

Low Education levels of Workforce: PLFS 2023-24 data reveal that 90% of the workforce has an education level equivalent to or below secondary education. This results in 88% of the workforce being engaged in low-competency occupations, primarily in elementary and semiskilled roles.
Income disparity based on Education: Only 4.2% of the workforce (those with advanced education and specialised skills) earn between ₹4 lakh and ₹8 lakh annually. Nearly 46% earn less than ₹1 lakh, predominantly comprising low- to semi-skilled workers such as agricultural labourers, clerical staff, factory workers, and small-scale service providers.
Lack of Jobs as per Expertise: Highly educated individuals are not finding employment matching their qualifications. This highlights misalignment between industry demands and the availability of required competencies in the workforce. E.g.,
- Graduate-degree holders are heavily employed in specialised roles (38%) but also occupy semiskilled (50%) and even elementary jobs (3%).
- Post-graduate degree holders are employed in specialised roles (63%) but also occupy semi-skilled jobs (28%).

Lack of Vocational Education: According to PLFS 2023-24, 65% of the workforce has received no vocational training (specialised, industry-specific skills), highlighting a significant gap in skill development and industry readiness. Prevalence of low-skilled workers is linked to poor educational outcomes.

Way Forward

Education reforms: Emphasise practical, job-oriented training over theoretical knowledge. Promote lifelong learning and skill upgradation programs.
Vocational Education: Integrate technical and vocational education into mainstream academics. Expand skill development programs aligned with industry needs.
Enhance Industry-Academia collaboration: Establish partnerships between educational institutions and industries to design relevant curriculum.

A well-aligned labour market will enhance workforce efficiency, boost economic growth, and improve job satisfaction for individuals.

Barriers faced by Construction Workers

Context: Recently, the Chairman & Managing Director of Larsen & Toubro highlighted growing labour shortages in the Construction sector. He quoted that some workers are reluctant to relocate for work due to the availability of welfare schemes, which offer them financial security. However, this narrative oversimplifies the structural issues faced by the construction labourers.

Relevance of the Topic: Mains: Construction Sector: Current Status, Challenges & Way Forward

Construction Sector in India

The Construction Sector is one of the fastest-growing industries in India contributing approximately 9% to the national GDP. The sector is projected to reach $1.4 trillion by 2025.
By 2030, it is estimated that around 3 crore workers will be employed in this sector.
The sector faces significant labour shortages, exacerbated by structural barriers to worker welfare and employment continuity.

Challenges faced by Construction Workers:

Fragmented employment landscape: Construction workers, especially migrant labourers, endure a fragmented employment landscape characterised by frequent relocations, high job insecurity, inconsistent access to welfare benefits, and precarious working conditions.
Seasonal employment disruption: Construction workers affected by seasonal employment disruptions (such as heat waves, ban on construction due to air pollution) struggle to access direct benefit transfers despite legal provisions. The lack of digital public infrastructure to facilitate rapid disbursement exacerbates their vulnerability.
Lack of proper documentation required for welfare registration: Due to the transient nature of their work, many labourers lack permanent addresses, making it difficult for them to secure documents such as birth certificates, residence proofs, and rental agreements required to access welfare benefits.
Poor Implementation of welfare provisions:
- State governments collect a 1-2% construction cess under the Building and Other Construction Workers (BOCW) Act, 1996 to fund worker welfare. According to a 2023 Parliamentary Standing Committee report approximately 75% of it remains unutilised.
- Employment Certificates proving 90 days of work per year are difficult to obtain, as contractors are often unwilling or unable to provide it, leaving workers unable to prove their eligibility for welfare benefits.
Lack of Interoperable systems: Migrant workers often move across multiple States searching for employment, but the absence of interoperable systems means that benefits registered in one State cannot be accessed in another. This disrupts continuity in welfare delivery and discourages workers from registering altogether.

Way Forward

Implement Unified National Labour Identification System similar to One Nation One Ration Card to facilitate inter-State portability of welfare benefits
Link BOCW registrations with UAN (Universal Account Number) on e-Shram to facilitate seamless access to entitlements for construction regardless of their location.
Digital Public Infrastructure for welfare access: State governments should adopt open-source digital platforms to improve the accessibility and efficiency of welfare schemes. Implement a centralised portal with standardised workflows to reduce administrative delays and enhance transparency.
Simplified documentation by accepting alternative proofs, and relaxing the verification protocols to ease the process. State governments can facilitate bulk registration through on-site welfare camps to ensure that large construction projects maintain accurate worker records.
Investing in skill development programmes for construction to address long-term labour shortages. A robust skilling ecosystem tailored to meet the evolving demands of the industry can enhance worker productivity and retention.
Ensure a safe and dignified work environment to maintain workers’ health and efficiency.

Construction firms can play a key role by committing to both medium-term skilling initiatives and improved workplace standards, to create a more stable, skilled, and resilient workforce.

Also Read: The Problem Associated with the Indian Informal Sector

Healthcare in India

Context: The neglect of Primary Health care (PHC) systems under AB-PMJAY and focus on targeted interventions instead of a comprehensive agenda to tackle malnutrition call for an urgent overhaul of the healthcare sector in India.

Relevance of the Topic: Mains: Healthcare in India- Nutrition, Insurance- challenges, way forward

Health for All

India is committed to the principle of 'Health for All' under WHO’s Universal Health Coverage (UHC) framework. This framework prioritises Primary Health Care (PHC) and aims to reduce out-of-pocket expenditure (OOPE).
Initiatives like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aim to provide financial protection and reduce OOPE. However, there are growing concerns regarding neglect of primary healthcare (PHCs) and increasing reliance on market-driven private healthcare.

Present Healthcare Landscape in India

Malnutrition: India has one of the highest rates of malnourished children and anaemic women. According to National Family Health Survey-5:
- 36% of children under five are stunted.
- Only 11% of children aged 6-23 months are breastfed and receive an adequate diet.
- 57% of women in the 15-49 age group are anaemic.
Non-communicable diseases (NCDs) such as diabetes, hypertension, and lifestyle-induced diseases are on the rise, highlighting another dimension of under-nutrition.
- 24% of women and 23% of men are overweight or obese.
- 14% of the population uses medication for diabetes.
Skewed Health Budget: Budget 2025 places much emphasis on medical digital infrastructure and expanding medical education over strengthening primary healthcare.
Privatisation in Insurance: The government has increased Foreign Direct Investment (FDI) cap in the insurance sector aims to boost insurance penetration. While it attracts more private players, it further intensifies privatisation of healthcare services.

Challenges in Healthcare

1. Problems with current nutrition schemes (Narrow Focus):

Poshan 2.0 fails to recognise the broader national nutrition challenge confining efforts to certain geographic regions and population segments.
Current policies predominantly focus on malnutrition among women and children, leaving out other vulnerable groups such as men, senior citizens, and individuals suffering from non-communicable diseases (NCDs) related to diet.
The policies do not address the broader aspects of under-nutrition, such as insufficient access to nutritionally rich food or lifestyle-induced diseases like obesity and diabetes.

2. Inadequate Infrastructure:

Rural areas may have a higher concentration of Health and Wellness Centres (HWCs), but urban areas face a lack of sufficient coverage.
Current services at HWCs (including nutrition advice for pregnant women, lactating women, children, adolescents and the elderly) are not systematically implemented and not consistently available.

3. Cultural and Socio-economic barriers: Dietary habits are influenced by culture and caste dynamics which complicate the design and implementation of nutrition interventions leading to fragmented approaches. E.g., Resistance to eggs in mid day meal schemes.

4. Overpriced drugs: Private firms have invested heavily in R&D for new drugs, especially for secondary and tertiary care; hence, the price of patented drugs is passed on to consumers.

5. Healthcare policies-related challenges:

Concerns with Ayushman Bharat: PMJAY excludes outpatient care. As people requiring only outpatient care outnumber those requiring hospitalisation, the majority have to rely on costly private facilities for outpatient care.
Low Health Budget: Despite the significant increase in government expenditure on Health, it is still below the target of National Health Policy (2017)- 2.5% of GDP. The National Health Mission, essential for grassroots healthcare, receives a declining share in the Health budget.
Insurance illiteracy: Migrant workers and the non-literate sections of the population face challenges in accessing insurance services.
Health security for Informal workers: Informal workforce remains without adequate health security due to the lack of universal coverage.
Outdated data from the 2011 Census and the 2020-21 Periodic Labour Force Survey hinders effective resource allocation and limits the efficiency of social protection schemes.

As a result, a significant portion of healthcare expenditure in India is from out-of-pocket expenditure (47.1% in 2019-20).

Way Forward

Comprehensive National Nutrition Strategy beyond maternal and child malnutrition. Identifying the nutritional needs of men, senior citizens, and people suffering from lifestyle diseases and a wider range of deficiencies.
Locally available nutrient-dense, and low-cost food options can ensure access to nutritious food.
Strengthen Health and Wellness Centres. HWCs must be more widely distributed, particularly in urban areas, equipped with a comprehensive set of nutrition services for all age groups with dedicated nutrition staff.
Public health education campaigns focusing on dietary habits and lifestyle changes to combat the rising incidence of NCDs.
Strengthen Primary Health Care to expand access to affordable and preventive healthcare at the grassroots level. Allocate more funds to National Health Mission (NHM).
Address Informal workers’ health security to achieve universal health coverage. E.g., PMJAY is expanded to gig workers.
Regular surveys and Census updates to track the health needs of the population and for better allocation of resources.

To move India towards UHC, the government, civil society, health-care providers, and communities need to work together.

Health Ministry refuses to make Cancer a Notifiable Disease

Context: There have been calls to designate Cancer as a notifiable disease in India, in order to enhance Cancer surveillance and treatment. However, the Union Ministry of Health has resisted the move, citing that the practice is to notify only infectious diseases.

Relevance of the Topic:Prelims: Key facts about Notifiable diseases; India’s National Cancer Registry Programme (NCRP).

Major Highlights:

Cancer in India is not a notifiable disease. The Indian Ministry of Health and Family Welfare refuses to declare it as a notified disease despite recommendations from the Indian Council of Medical Research.
Reasons given by the Ministry:
- Cancer is not a communicable disease and does not have community spread.
- Cancer requires long-term management rather than emergency interventions.

Which are Notifiable Diseases?

Notifiable disease is a disease that is legally required to be reported to the government by both private and public hospitals.
The primary purpose of disease notification is to ensure that contagious diseases are kept under check. Notifiability triggers rapid containment measures. Usually, diseases are declared notifiable if they:
- Have the potential to cause an outbreak
- Leads to significant mortality
- Require rapid investigation and public health action.
State governments are responsible to declare a disease as a notifiable disease, and the list of notifiable diseases differs from state to state.
- Registered medical practitioners must notify such diseases, typically in a standard form within three days, or notify verbally via phone within 24 hours if urgent.
- Every government hospital, private hospital, laboratory, and clinic will have to report cases of the disease to the local government authorities.
- Any failure to report a notifiable disease is a criminal offence and the state government can take necessary actions against defaulters.

Notifiable Diseases in India

Cholera, diphtheria, encephalitis, leprosy, meningitis, pertussis (whooping cough), plague, tuberculosis, AIDS, hepatitis, measles, yellow fever, malaria, dengue.

India’s National Cancer Registry Programme (NCRP):

NCRP functions as a data collection mechanism. It compiles crucial information on:
- demographics of cancer patients
- cancer identification including type, stage, and morphology
- timing of diagnosis and staging at the time of detection
- treatment details such as chemotherapy, radiation, and surgery, and follow-up and survival outcomes.
The NCRP includes hospital-based registries, which collect data from cancer-treating hospitals, and population-based registries, which capture cancer incidence in a defined geographic area.

Also Read: Immunotherapy for Cancer Treatment

Rather than legally mandating notification, strengthening existing cancer registries is a more thorough and effective alternative for comprehensive nationwide cancer surveillance.

Implementation gaps in Pradhan Mantri Awas Yojana-Gramin

Context: Parliamentary Standing Committee on Rural Development has accused the government of failing to identify “genuine beneficiaries” for its flagship rural housing scheme, Pradhan Mantri Awas Yojana-Gramin (PMAY-G).

Relevance of the Topic: Prelims: Key facts about Pradhan Mantri Awas Yojana-Gramin (PMAY-G).

Pradhan Mantri Awas Yojana-Gramin (PMAY-G)

Launched on April 1, 2016, by restructuring the Indira Awaas Yojana (IAY).
Aim: Provide "Housing for All" in rural areas by March 2029.
Implemented by: Ministry of Rural Development
Financial assistance is provided for constructing pucca houses with basic amenities for the rural poor.
Key Objectives:
- Provide permanent housing to eligible rural households.
- Address housing deprivation identified through the Socio-Economic Caste Census (SECC) 2011.
- Ensure basic facilities such as electricity, sanitation, and clean drinking water.
- Promote women empowerment by mandating joint ownership in house allotment.
Funding:
- 60:40 ratio between the Centre and States: for Plains.
- 90:10 ratio for Northeast, Himalayan States, Jammu & Kashmir, and Ladakh.
- 100% centrally funded for Union Territories.
Financial Assistance to Beneficiaries:
- ₹1.2 lakh per unit in plains.
- ₹1.3 lakh per unit in hilly and difficult areas.
Beneficiary selection based on SECC 2011 data, verified through Gram Sabha. It Includes:
- SCs/STs and freed bonded labourers.
- Non-SC/ST BPL families.
- Widows and next-of-kin of defence personnel killed in action.
- Ex-servicemen, paramilitary forces, disabled persons, and minorities.
Progress and Targets:
- Target (2016-2029): 4.95 crore houses.
- As of February 2, 2025:
  - Target allotted: 3.79 crore houses.
  - Houses sanctioned: 3.34 crore.
  - Houses completed: 2.69 crore.
- Additional 2 crore houses approved for construction during 2024-29.

Monitoring and Transparency Measures:

AwaasSoft platform: Tracks progress through geo-tagged, time-stamped photographs.
Regular inspections: Conducted at block, district, and national levels.
Social audits: Annual audits at Gram Panchayat level.
Direct Benefit Transfer (DBT): Ensures funds go directly to beneficiary bank accounts.
Performance Index Dashboard: Monitors implementation and progress.
Grievance redressal mechanisms: Complaints can be lodged via CPGRAMS, IGRS, and CM helplines.

Challenges highlighted by Standing Committee on Rural Development:

Outdated beneficiary data: PMAY-G still relies on SECC 2011, leading to exclusion of genuine beneficiaries and inclusion of ineligible categories.
Financial assistance has not increased despite rising construction costs.
Issue of backlogs: Scheme extension mainly covers previous backlog rather than new allocations.

Way Forward

Recommendations by Standing Committee on Rural Development

Update beneficiary data: Conduct a comprehensive review to include newly emerging needy households.
Expand eligibility: Include semi-permanent structure owners.
Increase per-unit assistance to ₹4 lakh, considering rising construction costs and inflation.
Addressing backlog and fresh allocations: Increase total houses planned under extended PMAY-G to 3.46 crore (1.46 crore backlog + 2 crore fresh allocations).