Context: The Union Cabinet has approved a budgetary allocation of Rs 6,000 crore for the newly launched initiative ‘One Nation One Subscription’ (ONOS).
Relevance of the topic: Prelims- Key facts about One Nation One Subscription initiative.
About One Nation One Subscription
ONOS is an initiative to facilitate better access to academic resources to India’s higher education institutions (HEIs).
Implementation: INFLIBNET Centre (Information and Library Network Centre) in Gandhinagar. It is an Inter-University Centre of the University Grants Commission under the Ministry of Education.
Scheme operation from: January 1, 2025.
Conceptualization: The initiative stems from the National Education Policy (NEP) 2020, which emphasised research as a critical pillar for achieving excellence in education and national development. ONOS aims to democratise access to knowledge and promote research in India.
Current Mechanism for Journal Access:
HEIs currently access journals through 10 different library consortia, under the administrative control of various ministries.
A library consortium is a group of two or more libraries that have agreed to share resources among its members.
E.g., INFLIBNET Centre oversees the UGC-Infonet Digital Library Consortium providing access to scholarly journals and databases.
HEIs also subscribe to several journals individually.
Key Features ofOne Nation One Subscription:
Centralised/ Single-Point Access: ONOS aims to centralise journal subscriptions for nearly 6,300 government-run institutions, offering access to 13,000 scholarly journals (published by 30 international publishers)under a single platform hosted by INFLIBNET.
Publishers include: Elsevier Science Direct (including Lancet), Springer Nature, Wiley Blackwell, IEEE, Sage Publishing, American Chemical Society, and American Mathematical Society etc.
Whether ONOS will also cover private HEIs is still undecided.
Equity in Access: HEIs from Tier 2 and Tier 3 cities will have the same access as premier institutions. Institutions need to register on the ONOS platform to use it.
Flexibility: HEIs can still individually subscribe to journals not covered under ONOS.
Benefits of One Nation One Subscription:
Enhanced Accessibility: Expand access to the best scholarly journals for 55 lakh to nearly 1.8 crore students, faculty, and researchers across roughly 6,300 government universities, colleges, research bodies, and Institutions of National Importance (INIs), including those in Tier 2 and Tier 3 cities.
Cost Efficiency: Avoid duplication of journal subscriptions across different library consortia and individual HEIs to reduce excess expenditure.
Data-driven Insights: Allows the government to analyse journal download and usage by HEIs, and accordingly improve resource allocation, and encourage under-utilising institutions to maximise benefits.
Context: The Union Cabinet has approved the continuation of Atal Innovation Mission (AIM) with an enhanced scope and a budget of Rs. 2750 crores until March 31, 2028.
Relevance of the topic: Prelims- Key provisions of Atal innovation Mission
About Atal Innovation Mission 2.0
AIM 2.0 is an upgrade over the original mission AIM 1.0 to expand, strengthen, and deepen India’s vibrant innovation and entrepreneurship ecosystem.
Implementation:Centrally Sponsored scheme by NITI Aayog.
Vision: To create a robust innovation and entrepreneurship ecosystem, boost India’s Global Innovation Index rank (currently 39) and enhance its startup ecosystem (third-largest in the world).
Objective: To create and promote an ecosystem of innovation and entrepreneurship across the country at school, university, research institutions, MSME and industry levels.
Launched: 2016.
Implementing Agency: NITI Aayog
Some of the components of AIM: Atal Tinkering Labs, Atal Incubation Centres, Atal New India Challenge, Mentor of Change Program, Atal Community Innovation Center and Atal Research & Innovation for Small Enterprises (ARISE).
All the initiatives of AIM are currently monitored and managed systematically using real-time MIS systems and dynamic dashboards.
Context: The RBI report has highlighted that Education loans have been growing at a notable pace in recent years and in this regard, a further boost is expected with the newly launched ‘Pradhan Mantri Vidyalaxmi Scheme’.
Relevance of the topic:Prelims- Key facts about the scheme and its provisions.
About PM Vidyalaxmi Scheme:
It is a Central Sector scheme under the Ministry of Education that seeks to provide financial support to meritorious students so that financial constraints do not prevent them from pursuing higher studies.
The initiative stems from the National Education Policy 2020, which had recommended that financial assistance should be made available to meritorious students through various measures in both public and private Higher Education Institutions (HEIs).
Key features:
Institutions Covered: Meritorious students of the top 860 Higher Education institutions, including-
Top 100 HEIs (both Government + Private) ranked in the National Institutional Ranking Framework (NIRF).
State Govt HEIs (ranked 101–200 in NIRF).
All Central Government Institutions: ~660 institutions.
Digitalisation: Students can apply through the Vidyalaxmi portal, which links major public and private banks. The portal provides a simplified digital application process and facilitates loan tracking.
Loan conditions:
Collateral free, guarantor free loan to cover the full amount of tuition fees and other expenses related to the course.
Loans up to ₹ 7.5 lakhs are backed by a 75% credit guarantee from the Government of India, encouraging banks to expand coverage.
For students with annual family income up to ₹ 8 lakhs, the scheme will provide 3% interest subvention on loans up to ₹ 10 lakh.
Students with up to Rs. 4.5 lakhs annual family income are eligible for full interest subvention.
Sync with other schemes: This will supplement the already existing Central Sector Interest Subsidy (CSIS) and Credit Guarantee Fund Scheme for Education Loans (CGFSEL), schemes under the Pradhan Mantri Uchchatar Shiksha Protsahan (PM-USP), being implemented by the Department of Higher Education.
Context: Today, apart from solar energy being the major factor in the climate patterns, it is also a transformative, democratising force in electricity generation. Distinct from traditional sources of energy which require extensive infrastructure and intermediary transmission lines, solar energy can now be harnessed directly at its point of use in homes. It is now a home product.
Solar energy is empowering women
Environmental sustainability and societal structures: Decentralized solar energy enables individuals and communities to generate power locally, significantly benefiting environmental sustainability and societal structures.
It economically empowers marginalized groups, especially women, who often face limited access to energy.
Examples include women salt farmers in Gujarat who shifted from diesel to solar pumps, increasing income and reducing emissions.
Financial inclusion and job creation: Solar energy contributes to financial inclusion and community development by integrating women across the solar value chain.
In 2022, solar employed around 4.9 million people globally, 40% of whom were women. India’s renewable goals aim to create an additional three million jobs by 2030, enhancing opportunities for women and supporting societal progress.
Health and safety: Traditional biomass for cooking exposes women to harmful indoor air pollution. Solar-powered cookers and clean energy solutions reduce health hazards.
High education attainment: With reliable lighting, children, especially girls often tasked with daytime chores, can study in the evenings, boosting their educational attainment.
Social entrepreneurship: Solar initiatives encourage women to become solar entrepreneurs and ambassadors within their communities. Organizations like Solar Sister train women to sell solar products, providing income and fostering leadership.
Reduced labour: Access to solar-powered water pumps, mills, and other machinery reduces time spent on manual labour, enables women to dedicate more time to education, self-improvement, and income-generating activities.
Despite its benefits, the solar industry faces challenges, including geographical imbalances (with investments concentrated in developed nations), sectoral imbalances (large-scale farms over small applications), and manufacturing concentration.
To ensure sustainability, the solar industry must prioritize recycling and waste management for solar materials. Establishing clear producer guidelines, fostering government collaboration, and exploring mobile recycling plants can enhance environmental health in the sector.
The need for a just energy transition necessitates gender-sensitive policies that integrate energy access with sectors like agriculture and rural development. Such inclusivity helps dismantle barriers disproportionately affecting women, promoting a sustainable and equitable energy economy.
Initiatives such as the Barefoot College (India), the Grameen Shakti (Bangladesh), and Solar Sister (Africa) empower women to become solar engineers, benefiting millions and improving community health and safety. For example, We Care Solar’s suitcases reduced perinatal deaths by 72% in Uganda’s health centres.
Context: As of January 31, 2022, 46,000 refugees and asylum-seekers were registered with UNHCR India. 46% of this population is comprised of women and girls, a disproportionately burdened and vulnerable group. The United Nations Population Fund has acknowledged that “the face of displacement is female”.
About displacement:
Photo by Ahmed akacha
Itrefers to the forced movement of people from their homes or communities, which various factors, including conflict, natural disasters,development projects and persecution can cause.
According to the United Nations High Commissioner for Refugees (UNHCR), by the end of 2023, 11.73 crore people, worldwide had been forcibly displaced due to persecution, conflict, violence, human rights violations or events seriously disturbing public order. Among them, 3.76 crore were refugees.
With the Israel-Hamas war having escalated since then, the Ukraine-Russia war continuing, and Rohingyas facing fresh threats in Myanmar, the number of refugees worldwide is only expected to multiply significantly.
Since independence, India has hosted over 200,000 diverse refugee groups. As of January 31, 2022, UNHCR India had 46,000 registered refugees and asylum-seekers, 46% of whom are women and girls.
Negative impact of displacement on people
Loss of life and livelihood: Many displaced individuals lose family members, homes, land, and sources of income leaving them economically vulnerable.
Psychological trauma: Exposure to violence, witnessing deaths, sexual abuse, or being forcibly separated from loved ones leads to post-traumatic stress disorder (PTSD), depression, and anxiety.
Health crises: Refugee camps or temporary settlements can become breeding grounds for diseases due to overcrowding, inadequate sanitation, and lack of healthcare.
Loss of common property resources: When people lose access to shared resources that are essential for their survival, this affects not only the economic aspect of their lives but also their social and communal relationships.
Marginalisation: Exacerbates inequalities and reinforces the vulnerability of already disadvantaged groups, including women, children, and ethnic minorities.
Food insecurity: Malnutrition and hunger become critical issues, particularly for children, pregnant women, and the elderly in displaced communities.
Social disarticulation: The disarticulation of communities also erodes social cohesion, cultural practices, and traditions, leading to psychological distress and a loss of identity.
Challenges to female refugee
Gendered responsibilities: Burdened with caregiving for children, the elderly, and family survival, often being the last to flee conflict zones.
Physical and mental health: Refugee women are affected by a multitude of stressors spanning deaths of partners and children, hardships of camp life, complex alterations in family dynamics, limited access to community networks, and reduced safety.
Gender-based abuse: Prolonged conflict, shifting gender roles, broken social support systems, and socio-economic challenges expose refugee women to higher risks of gender-based abuse, including transactional sex.
Psychological and psychosocial conditions: They are twice as likely to develop PTSD and four times more likely to suffer from depression than men.
A study in Darfur, Sudan found 72% of displaced women experienced PTSD and distress due to trauma and camp conditions, showing their higher risk of mental health issues compared to male refugees.
Social and gender inequalities: Especially when refugee populations belong to patriarchal societies, lead to the experiences and testimonies of displaced women being dismissed.
Legal framework available to displaced women
Global level:
The UN Convention on the Rights of Persons with Disabilities (UNCRPD) Recognises ‘long-term mental or intellectual impairments which, in interaction with various barriers, may hinder full and effective participation in society’ as ‘psychosocial disability’ and guarantees a plethora of rights to the affected persons.
The UNCRPD also recognises that ‘women and girls with disabilities are subject to multiple discrimination’ and mandates measures to ensure ‘full and equal enjoyment by them of all human rights and fundamental freedoms’ (Article 6).
These guarantees are required to be secured to all without any discrimination (Article 5).
India
India ratified the UNCRPD and enacted the Rights of Persons with Disabilities Act, 2016 (RPWDA).RPWDA does not explicitly use the term ‘psychosocial disability,’ it recognizes “mental illness” under the RPWDA.
The RPWDA guarantees rights to persons with disabilities, including healthcare (Section 25) and equal rights for women with disabilities (Section 4).
The Supreme Court of India has upheld the right to life under Article 21,includes theright to health, for refugees.
Measures to strengthen the protection of displaced women
Effective policy-making also depends on the collection of disaggregated data on their health conditions, necessitating swift and systematic identification and registration processes.
India may consider signing the 1951 Refugee Convention and its 1967 Protocol to protect and define refugees' rights.
Specific domestic legislation addressing refugees specifically addresses the needs of displaced women, including protection from gender-based violence (GBV), access to healthcare, and economic opportunities.
Establish safe spaces and services for women and girls in displacement settings to prevent and respond to GBV, including shelters, counselling, and support services.
To secure the implementation of the aforesaid guarantees, it is crucial to integrate refugees with disabilities into relevant policies and programmes in an accessible manner.
Context: The Food Safety and Standards Authority of India (FSSAI) has issued a show-cause notice to a Tamil Nadu-based firm, which supplied ghee to the Tirupati temple in Andhra Pradesh, for allegedly providing substandard product to the temple.
About Food adulteration
It is the intentional or unintentional addition of substances to food that can make it harmful to consume. These substances, known as adulterants, can be added to increase the quantity, reduce the cost, or improve the appearance of food.
Common types of adulterants :
Milk is often adulterated with water, detergent, fat, and even urea.
Preservatives such as nitrites (used in cured meats)and benzoates (used in soft drinks and pickles), lead to digestive issues and long-term health problems.
Tea leaves are commonly mixed with similarly colored leaves, some of which are inedible.
Cornstarch, sawdust, and flour are used as fillers in spices.
Antibiotics and hormones such as estrogen and testosterone in meat and poultry to promote growth, but excessive consumption can lead to antibiotic resistance and hormone imbalances.
Khoya is adulterated with paper, refined oil, and skimmed milk powder.
Pesticides (like DDT and organophosphates) in fruits and vegetables, heavy metals like lead and mercury in seafood, and industrial pollutants in food packaging.
Foreign substances such as insects, dirt, or other foreign substances can accidentally contaminate food during processing or storage.
Arhar dal is usually adulterated with metanil yellow.
Reason behind ghee adulteration:
High price of milk fat: Milk-derived fats from cow and buffalo milk cost around Rs 460-470 per kg, with ghee production and packaging raising the price to Rs 485-495 per kg. This high cost incentivizes adulteration to cut production expenses.
Price differential between milk and vegetable fats: Vegetable fats, such as refined palm, soybean, sunflower, and rapeseed oils, are significantly cheaper, ranging from Rs 120-150 per kg. The vast price difference between milk fats and vegetable fats encourages manufacturers to mix the latter into ghee to increase profits.
Scarcity of milk fat: Milk fat is relatively scarce, as dairies prioritize selling liquid milk and producing other products like curd and lassi . Only limited availability of milk is available for the manufacture for production of ghee, further increases its value and drives adulteration.
Profit motive of dairies: Large dairy cooperatives and private players prefer selling ghee in retail consumer packs rather than in bulk, as it fetches higher profits. Some dairies also use milk fat for ice cream production, which offers better returns. This reluctance to sell ghee in bulk pushes organizations to seek cheaper, often adulterated, alternatives.
Lower demand and competition: Sales of ghee from companies like Patanjali have decreased significantly in recent years, putting additional pressure on manufacturers to cut costs, potentially through adulteration.
Laws deal with food adulteration:
Under Indian Constitution, the adulteration of foodstuffs and other items falls in the Concurrent List.
Food Safety and Standards Act, 2006: It is a comprehensive legislation dealing with various aspects with respect to the regulation of food safety.
Food Safety and Standard Authority of India (FSSAI) is established under Section 4 of the Act to supervises and regulates food safety and standards.
It prohibits any person to operate any food business without a license.
The law prohibits producing, selling, and distributing contaminated or counterfeited foods.
The Act also imposes a penalty for the possession of adulterant.
The Bharatiya Nyaya Sanhita (BNS): Impose penalties, including imprisonment and fines, for food adulteration, with stricter punishments for hazardous food practices.
Context: A seven-judge constitution bench of the Supreme Court in the State of Punjab vs Davinder Singh judgement has held that sub-classification of SC and ST categories is permissible. Also, States have power to create these sub-classifications. Earlier, the Supreme Court in E. V. Chinnaiah vs State of Andhra Pradesh (2004) had ruled that sub-classification was not permissible in the SC category. The Davinder Singh Judgement has overturned the E. V. Chinnaiah judgement.
Present Status - reserved categories
Currently, the entire Scheduled Castes and Scheduled Tribes are treated as one large class. There is no sub-categorisation among these communities.
However, even among the SCs and STs there are communities which are relatively more backward. Thus, there has been an ongoing demand for allowing sub-categorisation in these communities enabling the relatively backward in these communities to apportion greater benefits.
Constitutional Status of Scheduled Castes
Article 366 (24): Scheduled Castes are defined to mean such castes, tribes or parts or groups within such castes, races or tribes as deemed under Article 341 of the Constitution.
Article 341(1): President has given the power to notify castes, races or tribes which shall be deemed to be Scheduled Castes for a State or UT. The President will notify the SCs for a State or UT in consultation with the Governor of the State.
Article 341(2): Parliament may by law include or exclude any caste, race, or tribe from the list of Scheduled Castes specified in the Presidential notification issued under Article 341(1).
Articles 342 and Article 342-A relate to notification of STs and SEBCs respectively and contain provisions similar to Article 341.
Judgement in EV Chinnaiah Case
Scheduled Castes form a class by themselves.
Sub-classification amounts to tinkering with the Presidential order issued under Article 341. States have no power to deal with State Legislature.
Scheduled Castes constitute a class and further classification is not permissible among the SCs. Indira Sawhney judgement permitted the sub-classification of the Other Backward Classes, but this is not applicable to SCs. Sub-classification amounts to giving preference to a 'miniscule proportion' of the SCs, over other members of the SCs which would impermissible under Article 14.
SALIENT FEATURES OF DAVINDER SINGH JUDGEMENT
Article 14 of the Constitution:
Article 14 is an amalgamation of two expressions - equality before law and equal protection of laws.
Equality before law means absence of special privileges for any individual. However, it does not mean that the same law should apply to everyone, but that the same law should apply to those who are similarly situated.
Equal protection of laws means that laws must be administered equally among equals. This also enjoins the State the with power to reasonably classify those who are differently placed.
Thus, equality under Article 14 is not 'sameness' but that there must be a parity of treatment under parity of conditions. The substantive equality under the Article calls for equality of opportunities over equality of treatment.
Thus, sub-classification is a facet of equality and law can further classify a class that is already created by law for a limited purpose. The classification should be based on intelligible differentia and rational nexus.
Intelligible Differentia means a discernible and understandable distinction. Thus, the distinction should be based on clear criterion or standard.
Rational nexus: There should be a clear and rational link between classification criterion and intended outcome or goal of the classification.
The test to determine whether sub-classification within a class is justified under Article 14, is whether the class is homogenous or not.
Homogeneity of SCs
There are historical and empirical evidence to show that SCs are homogenous.
Some studies such as by AM Shah have highlighted that SCs are not a homogenous class.
Hardships and backwardness which SCs have suffered historically would differ from category to category.
Some communities are included in the Presidential list while the same community has not been included in SCs in other states highlighting the none homogenous nature of SCs.
The word 'deemed' in Article 341 was not indicative of creation of legal fiction. The intention of this legal fiction created under Article 341 was for limited purpose of identifying the SCs and differentiating them from other groups. It was not indicator of homogeneity.
Sub-classification and States interference with SC list
In the EV Chinnaiah judgement, the court opined that sub-classification amounts to states tinkering with Presidential List under Article 341. However, in the Davinder Singh Case, the SC held that sub-classification did not led to including or excluding any caste through legislation. Thus, did not amount to tinkering with the list.
Also, States had the legislative power to create sub-classification as it did not amount to tampering with the Presidential List. This power stemmed from Article 15 and Article 16 of the Constitution.
Criteria for Sub-classification
Article 15(4) provides that the beneficiary class for the purpose of the provision must be socially and educational backward. The social and educational backwardness should not be seen as mutually exclusive but together.
The purpose of this Article is to ensure substantive equality by ameliorating social backwardness. Thus, the states need to prove varying degrees of backwardness and inadequate representation within the group based on empirical evidence.
Although sub-classification with the SC category was permitted, however, it did not meant that that seats should be allocated for each caste group. Classes exhibiting similar level of backwardness, should be categorised together.
Creamy Layer among SCs
State must evolve a policy for identifying creamy layer exception even from SCs/STs (Indira Sawhney judgement mandated creamy layers only for OBCs).
Within the SCs, certain caste groups were reaping the benefits of reservation more than others. Thus, these caste groups should that they should walk away from special provisions making way for the needy.
Context: Kerala, Tamil Nadu, and Jammu & Kashmir were ranked as the top three performers on the State Food Safety Index 2024.
Key findings of State Food Safety Index 2024:
Kerala has, for the second time in a row, topped the sixth State Food Safety Index (SFSI) 2024 and has achieved more than 100 per cent of its inspections target in FY24, improved its food-testing infrastructure and organised special drives to increase the number of license-holders and registrations, among other achievements.
Tamil Nadu has got a “significant number of full-time designated food safety officers.
Jammu and Kashmir got third position in the Index while Gujarat secured fourth position in the Index.
Nagaland was given special acknowledgement among the northeastern states as the index said that the hilly state showed overall progress in improving the food safety ecosystem compared to the previous year.
Eat Right campaign, the Pradhan Mantri Garib Kalyan Yojana, and the promotion of millets as important initiatives the centre took to ensure safe and good food.
About State Food Safety Index (SFSI):
Released by: Food Safety and Standards Authority of India (FSSAI).
Released on: June 7 on the occasion of World Food Safety Day.
1st report: Since 2019.
Parameters: Human resources and institutional data , compliance, food testing infrastructure, training and capacity building, and consumer empowerment. In the 2023 index, a new parameter ‘Improvement in SFSI Rank’ was added
Objective: To foster healthy competition and catalyse positive change in the food safety ecosystem throughout the country, ultimately ensuring the provision of safe and wholesome food to all residents.
About FSSAI:
Body: Statutory body has been established under Food Safety and Standards , 2006. It works as an independent authority and attained a special status. The FSS Act took 7 older acts into one umbrella.
Nodal ministry: Ministry of Health & Family Welfare, is the Administrative Ministry for the implementation.
Headed by: Non-executive chairperson, appointed by the Central Government, either holding or has held the position of not below the rank of Secretary.
Objective: To establish a single reference point for all matters relating to food safety and standards, by moving from multi- level, multi- departmental control to a single line of command.
Function:
Framing of regulations to lay down food safety standards
Laying down guidelines for accreditation of laboratories for food testing
Providing scientific advice and technical support to the Central Government
Contributing to the development of international technical standards in food
Collecting and collating data regarding food consumption, contamination, emerging risks, etc.
Disseminating information and promoting awareness about food safety and nutrition in India.
Health Coverage Expansion: As per the Union Cabinet announcement in September 2024, the government extended health coverage under AB PM-JAY to all senior citizens aged 70 and above, benefitting around 6 crore senior citizens and 4.5 crore families.
Insurance Coverage: Each senior citizen will receive health insurance cover worth ₹5 lakh annually under this new provision.
Distinct Health Cards: Eligible citizens will receive separate AB PM-JAY health cards for easy identification and service delivery.
Top-Up for Existing Beneficiaries:
Senior citizens already covered under AB PM-JAY will receive an additional top-up of ₹5 lakh, providing exclusive health coverage for themselves.
Choice of Scheme: Senior citizens already benefiting from other schemes like Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), and Ayushman CAPF will have the flexibility to choose between these schemes or AB PM-JAY.
About Ayushman Bharat : It is a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind."
Ayushman Bharat adopts a continuum of care approach, comprising two inter-related components, which are –
Health and Wellness Centers (HWCs): In February 2018, the Government of India announced the creation of 1,50,000 Health and Wellness Centres (HWCs) by transforming the existing Sub Centres and Primary Health Centres. These centres are to deliver Comprehensive Primary Health Care (CPHC) bringing healthcare closer to the homes of people. They cover both, maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services.
Pradhan Mantri Jan Arogya Yojana (PM-JAY): The second component under Ayushman Bharat is PM-JAY, the largest health assurance scheme in the world, which aims at providing a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India.
(ii) Health care is an essential factor, along with other variants like income, hygiene, and nutrition.
(iii) According to the World Health Organization, every country must invest at least 4% of the Gross Domestic Product (GDP) on their health.
(iv) The out-of-pocket expenditure on healthcare is 40% in India.
(v) The Government Scheme not only covers for expensive treatments but also provides quality services to all the people eligible under the plan.
Provisions of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY):
1. Largest Public Health Assurance Scheme: The scheme is the world’s largest publicly funded health assurance program.
Launched in 2018, the Ayushman Bharat scheme covers 55 crore individuals or 12.34 crore families, offering health insurance worth ₹5 lakh per year for secondary and tertiary care hospitalisation.
2. Coverage of Pre and Post-Hospitalization Costs: Costs of diagnostics and medicines are covered for:
Up to 3 days before hospitalization (pre-hospitalization).
15 days after hospitalization (post-hospitalization).
All pre-existing medical conditions are also covered.
3. Ayushman Card: The Ayushman Card acts like a pre-paid card worth ₹5 lakh.
Can be used to avail free treatment at more than 27,000 empanelled hospitals across India.
Every hospital must have Pradhan Mantri Arogya Mitras (PMAMs) to assist the beneficiaries.
4. Interstate Portability: The scheme offers interstate portability, allowing beneficiaries to access treatment at empanelled hospitals across different states.
5. Aadhaar-Based Authentication: Aadhaar-based authentication is required for:
Card creation.
Registration for treatment under the scheme.
6. Administration by the National Health Authority (NHA): The scheme is administered by the National Health Authority (NHA) under the Ministry of Health and Family Welfare.
NHA has a governing board with representatives from the central government, domain experts, and state authorities.
Post-Discharge Follow-up:
NHA’s call center contacts beneficiaries 48 hours post-discharge to assess treatment quality.
A second follow-up call is made 15 days post-discharge to check the patient’s prognosis.
7. Inclusivity: PM-JAY is an inclusive scheme, covering transgender individuals among its beneficiaries.
50 special packages were designed for transgender healthcare needs, including Sex Reassignment Surgery (SRS).
8. Anti-Fraud Mechanism: The National Anti-Fraud Unit (NAFU) designs, implements, and oversees anti-fraud initiatives within the scheme.
Anti-Fraud Units also operate at the state level to prevent misuse and fraud in the healthcare system.
Achievements of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY):
1. Nudging of State Governments: The scheme has encouraged states and Union Territories, responsible for public health under India's federal structure, to expand healthcare coverage to more beneficiaries.
National Sample Survey Organization (NSSO) 71st round: It was found that 85.9% of rural and 82% of urban households lacked healthcare insurance. PM-JAY specifically targets deprived and poor families, addressing this critical gap.
2. Effective fiscal management: AB-PMJAY has reduced Out-of-Pocket Expenditure (OOPE), which has been a significant financial burden for Indian households.
Over 17% of Indians previously spent more than 10% of their household budget on healthcare, leading many into debt. The scheme mitigates these financial risks by providing coverage for secondary and tertiary care.
3. Bridge the gap: PM-JAY has effectively connected healthcare providers with service users by uniting them through government channels, thereby addressing the shortfall in access to healthcare services for marginalized populations.
4. Spirit of Inclusiveness: The scheme promotes inclusivity, with 48% of treatments being availed by women, and also covers transgender individuals.
Beneficiaries can access services even if they do not possess an Ayushman card at the time of treatment, ensuring no one is left out.
5.Regularisation of process: In order to engage private healthcare providers effectively, Health Benefit Packages (HBPs), covering in-patient treatment, have been revised five times in the last five years to stay relevant and comprehensive.
6. Early Claim settlement: To ensure smooth and timely financial management, efforts are being made to settle claims within a 15-day standard. States like Uttarakhand have managed to reduce the settlement time to under seven days, setting an example for others.
7. Reward to Hospitals: To encourage trustworthy and efficient hospital service, hospitals with a good record receive 50% of the claim amount as an upfront payment immediately after submitting their claims, without the need for adjudication.
8. Interoperability: The scheme is particularly beneficial for migrants, providing interoperability across states and ensuring that the poor and marginalized can access healthcare services even when they move across borders. This has proven vital in emergencies.
9. Effective Monitoring: The end-to-end digital service delivery system eliminates bias, ensuring transparency. The National Health Authority (NHA) monitors the scheme's implementation through internal checks and a public dashboard, enabling real-time tracking.
10. Fraud management: The establishment of institutions like the National Anti-Fraud Unit (NAFU) has significantly reduced fraud in the registration, verification, and insurance claims processes, ensuring accountability and integrity within the system.
11. Use of technology: Leveraging Artificial Intelligence (AI) and Machine Learning (ML), the NHA uses advanced technology to detect suspicious transactions and potential fraud, ensuring efficient monitoring and reducing misuse of the scheme.
Issues
1. Exclusion Error: One of the most significant challenges is the Socio-Economic Caste Census (SECC) data, which has been criticized for non-transparent methods of data collection and outdated population figures.
These errors can lead to eligible beneficiaries being left out, and hence, there is a need to update and improve the estimates for better targeting.
2. Asymmetric Federalism: Several states have increased the coverage of the scheme via state schemes. This entails increased expenditure by states which choose to expand coverage, such as Kerala. However, this may be particularly hard for cash-strapped states like Bihar which depend on Union government funding more than their own resources.
3. Ghost Beneficiaries: Unrelated ineligible beneficiaries are admitted based on forging a relationship with the head of the beneficiary family. The challenge that lies ahead for National Health Authority is to strengthen artificial intelligence to pick up all such instances of fraud.
4. Future Fiscal Burden: As insurance coverage grows, there is a possibility of a rise in hospitalization rates, leading to increased claim ratios and higher premiums, which may strain government finances.
Insurers, needing to run a profitable business, may demand higher premiums, creating fiscal stress on the program.
5. Infrastructural and man-power issues: Public health infrastructure faces severe deficiencies:
56% of sub-centers (SCs) lack staff washrooms, 73% lack separate washrooms, and 36% of PHCs do not have gender-segregated facilities.
These infrastructural gaps undermine the scheme's effectiveness.
6. Compliance Burden: In rural India, beneficiaries face a significant compliance burden due to long distances to hospitals, which makes access to care difficult. This often results in a lower than expected usage of health services.
7. Double Charging: Publicly Funded Health Insurance Schemes (PFHIS) are prone to double charging, where the hospital makes the patient pay for some or all services/medicines/diagnostics which are covered under the PFHI and also claim the reimbursement from the PFHI.
8. Information Asymmetry: There is a lack of awareness among beneficiaries about their entitlements under the scheme.
The hierarchical structure of the healthcare system and the complexity of the scheme exacerbate this issue, leading to low utilization of the available benefits.
9. Outpatient Care: AB-PMJAY does not cover outpatient care, which constitutes between 40% and 80% of Out-of-Pocket Health Expenditure (OOPHE). This is a significant gap, as outpatient care is a major contributor to rising health expenses.
10. Upcoding: Upcoding is the practice of fraudulent medical billing in which the bill for a medical service is more expensive than it should have been based on the service that was performed.
11. Cost: The rates provided by PM-JAY serve as guidelines and have not been strictly followed by states, which has either kept big hospitals at bay or resulted in disparities in service costs across states.
12. Empanelment: Empaneling hospitals in remote areas, such as in the northeast and Leh, has been difficult, creating significant gaps in healthcare access for people living in these regions.
13. Inequity in access: There is inequity in access to healthcare, especially for the poor. Many patients suffering from serious illnesses find that their conditions are not listed among the medical packages covered under AB-PMJAY, leaving them without adequate support.
14. Implementation: The scheme faces several implementation issues:
Improper procedures for empanelment and cost fixation mechanisms.
Inordinate delays in reimbursement to hospitals.
Lack of standardization in services across hospitals, with the National Accreditation Board for Hospitals (NABH) certification covering only some hospitals.
Budgetary constraints are also a major issue, as the AB budget, while substantial, may not be sufficient to cover the growing costs of the scheme. This has resulted in payment backlogs to hospitals, which has led some hospitals to limit the number of patients they accept under the scheme.
Beneficiaries often prefer private hospitals over public ones due to perceived better quality care and fewer capacity constraints in private institutions.
15. Low Monitoring and Grievance Redressal: Monitoring of the scheme is suboptimal, with several states yet to form State Health Authorities (SHAs) or establish Anti-Fraud Cells and Claim Review Committees.
For example, a CAG report revealed the fraudulent registration of 7.5 lakh beneficiaries under a single phone number.
Additionally, the Public Financial Management System (PFMS) guidelines for tracking expenditure flows have not been fully complied with.
16. Parallel Systems and Beneficiary Overlap: Some states operate parallel transaction management systems, leading to the overlap of beneficiaries between Ayushman Bharat and state-specific health schemes. This creates confusion and may result in inefficiencies in service delivery.
Suggestions for improvement
Improve the public health sector by dealing with limited resources and creating systems that encourage healthcare providers and patients to support universal health coverage.
There is a need to consolidate government healthcare spending and clear payment backlogs owed to hospitals by the government.
To realise the scheme’s full potential, the National Health Authority (NHA) along with its counterparts in the states should aim to provide every possible beneficiary with an Ayushman Card.
State governments which have not formed the SHAs, Fraud cells etc. should consult and through dialogue the bodies should be constituted to improve the interoperability of the scheme.
The issue of upcoding, dead patients availing benefits, double charging should be addressed by reducing information asymmetries and increasing the awareness of the people.
Parallel transactions management system creates ambiguities in management and ensuring accountability, states and Centre should come up with a unified and transparent system.
Recommendations by Indian Medical Association (IMA):
i. Government hospitals, which already provide services free of charge, should be excluded from the scope of the scheme. Instead, public hospitals should receive direct funding from the government.
ii. India should move away from utilizing insurance-based healthcare delivery due to high administrative costs and problematic ties with insurance companies, which often prioritize profits over quality care.
The goal of 'Swasth Bharat' should be to embrace a holistic approach to health, which will naturally progress towards a 'Sampann Bharat' or a prosperous India. To realize this vision, there is a need for effective implementation of this scheme.
Context: Sexual harassment remains a pervasive issue across various professions, including academia, media, and corporate sectors. Despite the existence of laws such as the Prevention of Sexual Harassment (PoSH) Act, 2013, women still hesitate to report such incidents. A recent case involving a research scholar from a reputed university in Delhi highlights the challenges women face in bringing forth their complaints. This article delves into the reasons behind the reluctance to report sexual misconduct and the systemic issues that exacerbate the problem.
Key Challenges Faced by Women Reporting Sexual Misconduct
Delayed Action by Internal Committees
Many institutions delay the process of addressing sexual harassment complaints, as seen in the case of the 29-year-old PhD scholar. Despite filing her complaint in May, the Internal Complaints Committee (ICC) took action only in July, by which time the victim had already left the university.
Victims often face insensitivity and delays, discouraging them from pursuing their complaints further.
Fear of Repercussions and Career Impact
Victims of sexual harassment often worry that reporting their experience will negatively affect their careers. The PhD scholar mentioned that had the ICC acted promptly, she would not have felt the need to quit her PhD.
Women fear that filing a complaint could "complicate things," leading to retaliation or career setbacks.
Character Assassination
Many women face personal attacks and character defamation after they come forward. In one case from Jamia Millia Islamia, a student alleged sexual harassment by her professor, only to face character assassination during the ICC proceedings.
These experiences often cause victims to feel more vulnerable, leading them to avoid reporting in the first place.
Lack of Trust in Internal Complaints Committees (ICCs)
Although the PoSH Act mandates the establishment of ICCs in workplaces with 10 or more women employees, many women do not trust these committees to act impartially or effectively.
Some women, like the Jamia student, approach the police rather than the ICC because they fear the committee will not take their complaint seriously.
Institutional Evasion of Responsibility
Many organizations or institutions treat complaints with varying degrees of seriousness. A human resources professional in Delhi noted that some companies dismiss less severe complaints, like inappropriate comments, and only act when incidents are deemed more serious.
Organizations may also make the process of filing complaints intimidating by suggesting reconciliation rather than taking formal action, which discourages victims from pursuing justice.
Insufficient Penalties and Oversight
Although the PoSH Act prescribes penalties for non-compliance, such as fines or revocation of licenses, enforcement is weak. Instances of organizations losing their licenses due to non-compliance are rare.
Most district authorities do not rigorously enforce adherence to the guidelines, with only basic checks conducted. For example, Gurgaon district offices have introduced more thorough questionnaires, but such practices are not uniformly followed across the country.
Recommendations for Better Implementation of PoSH
Stricter Monitoring and Accountability: There should be government-mandated platforms that allow external ICC members to report inconsistencies and violations across organizations.
Improved Sensitivity and Timeliness of Responses: Internal committees must be trained to respond to complaints sensitively and promptly to avoid driving victims away.
Ensuring Victim Protection and Transparency: To encourage women to come forward, organizations need to ensure that victims are protected from retaliation and character assassination during the investigation process.
By addressing these systemic issues and fostering a culture of support and accountability, organizations and institutions can create safer environments where women feel empowered to report sexual misconduct without fear.
Context: In a bold statement on September 9, 2024, Tamil Nadu Chief Minister M.K. Stalin accused the central government of withholding funds from high-performing states like Tamil Nadu. He argued that the denial of funds stems from states' refusal to implement the controversial National Education Policy (NEP) rather than their performance in education outcomes.
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Impact on Education in Tamil Nadu: Tamil Nadu has consistently been a top-performing state in terms of education, with high literacy rates and well-implemented school programs. However, the state's refusal to adopt the NEP has put it at odds with the Centre. By withholding Samagra Shiksha funds, which are integral for educational improvement in public schools, the Centre may inadvertently be punishing the very states that are already demonstrating success.
This clash between the state and central governments showcases the larger debate in India regarding federalism and the balance of power in policymaking, especially in sectors as crucial as education.
About the Samagra Shiksha Scheme
What is Samagra Shiksha?
The Samagra Shiksha Scheme is a comprehensive initiative launched by the Government of India to improve school education. It aims to provide equitable and inclusive quality education from pre-primary to Class XII, ensuring holistic development in schools across the country.
Key Features of Samagra Shiksha Scheme
Objective: provision of quality education and enhancing learning outcomes of students; Bridging Social and Gender Gaps in School Education; Ensuring equity and inclusion at all levels of school education; Ensuring minimum standards in schooling provisions; Promoting Vocationalisation of education; Support States in implementation of Right of Children to Free and Compulsory Education (RTE) Act, 2009; and Strengthening and up-gradation of SCERTs/State Institutes of Education and DIET as a nodal agencies for teacher training.
Integration: The scheme combines three prior schemes—Sarva Shiksha Abhiyan (SSA), Rashtriya Madhyamik Shiksha Abhiyan (RMSA), and Teacher Education (TE).
Key Components:
Infrastructure Support: provides funds for developing school infrastructure, including building new classrooms, upgrading facilities, and providing essential learning materials.
Teacher Education: The scheme focuses on improving the quality of teachers through professional development programs.
Learning Outcomes: It places a strong emphasis on improving student learning outcomes and bridging gaps in access to education for marginalized groups.
Funding Mechanism: The fund sharing pattern for the scheme between Centre and States is at present in the ratio of 90:10 for the 8 North-Eastern States viz. Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura and 3 Himalayan States viz. Jammu & Kashmir, Himachal Pradesh and Uttarakhand and 60:40 for all other States and Union Territories with Legislature. It is 100% centrally sponsored for Union Territories without Legislature.
The scheme also supports states in improving educational outcomes but now appears to be intertwined with the acceptance of other central initiatives like PM-SHRI.
Samagra Shiksha Fund:
This fund is the financial backbone of the Samagra Shiksha scheme, aimed at providing comprehensive support to state governments for implementing educational initiatives.
Funds are shared between the Centre and states and are crucial for the smooth functioning of schools, teacher training programs, and infrastructural improvements in education.
Despite its importance, the fund's disbursal has been delayed, and some states have faced obstacles in accessing it due to conditions tied to the acceptance of additional central government schemes such as PM-SHRI.
Context: The effectiveness of Union Budget allocations for India’s health sector largely depends on State-level factors. Since many health initiatives are implemented as Centrally Sponsored Schemes (CSS), State governments play a vital role in their success by sharing costs and ensuring smooth execution. Two major CSS programs,the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) and Human Resources for Health and Medical Education (HRHME), aim to bolster India's healthcare infrastructure and workforce, but their success faces multiple hurdles.
Key Initiatives in Health Sector
PM-ABHIM
Aims to strengthen health infrastructure, build health and wellness centres (HWCs), block-level public health units (BPHUs), district public health labs (IDPHLs), and critical care hospital blocks (CCHBs).
Focuses on improving India’s emergency preparedness, especially for pandemics.
HRHME
Focuses on increasing the capacity of medical education by establishing new medical, nursing, and paramedical colleges.
Plans to strengthen district hospitals and convert them into medical colleges.
Aims to address shortages of medical personnel through increased seats and better training infrastructure.
Key Highlights of the article
1. Low Fund Utilisation in Key Health Schemes: Despite ambitious goals, fund utilisation in both PM-ABHIM and HRHME has been low, reflecting inefficiencies in budget absorption.
PM-ABHIM: In 2022-23, only 29% of the budget estimate was spent. In 2023-24, although the revised estimate increased to 50%, the actual expenditure is expected to be lower.
HRHME: Utilisation of funds was around a quarter of the budget estimates in both 2022-23 and 2023-24.
Key Challenges in Fund Utilisation
Dependence on 15th Finance Commission Health Grants
Around 60% of PM-ABHIM’s funding is sourced from health grants recommended by the 15th Finance Commission. Only about 45% of these grants were utilised from 2021-22 to 2023-24, partly due to complex execution procedures at the State level.
States are required to merge public health labs from various vertical programs under IDPHLs, necessitating significant planning and reorganisation. This integration has delayed implementation.
Delayed Fund Absorption in Construction Projects
Components like BPHUs and CCHBs involve construction, where fund absorption is slowed by rigid procedural requirements and overlapping funding from multiple sources.
2. Shortage of Faculty and Specialists: A major challenge for HRHME is the shortage of teaching faculty and specialists, which affects both new and existing medical institutions. According to a study by the Centre for Social and Economic Progress (CSEP),
Faculty Shortage in AIIMS: There is a 40% shortage in teaching positions across 11 newly created AIIMS.
State Medical Colleges: In Uttar Pradesh, 30% of teaching faculty positions in newly established government medical colleges were vacant in 2022.
Specialist Shortages in Hospitals: More than a third of sanctioned specialist positions in urban CHCs and two-thirds in rural CHCs were vacant as of March 2022.
3. Fiscal Space Constraints for States: The financial burden of maintaining new health infrastructure will fall on State governments once the central support ends in 2025-26. States will need to plan for additional recurring costs, which may strain their fiscal space.
State governments need to create fiscal capacity not only to sustain PM-ABHIM and HRHME infrastructure but also to support other health schemes and initiatives.
Conclusion: For the Union Budget’s health allocations to translate into meaningful health outcomes, the following factors are crucial:
Strengthening the fiscal capacity of States to support recurring expenses.
Addressing human resource shortages, especially in teaching faculty and specialists.
Streamlining public financial management processes to improve fund absorption and scheme execution.
Addressing these challenges will be essential to ensure that capital expenditures in India’s health sector lead to improved infrastructure and better healthcare delivery.
