Social Justice

The Marriage Penalty

Context: Recently, an investigation highlighted anomalies related to hiring of women employees in Apple iPhone maker Foxconn assembly plant in Tamilnadu. It was alleged that married women’s are being rejected on grounds of pregnancy, family commitment and greater number of leaves.

Though Foxconn came up with the clarification statement in which it highlighted that 25% of its new recruitment comprises women and around women constitute 70% of its total workforce.

However, this news article delves into several factors responsible for low Female LFPR in India.

Labour force Participation rate (LFPR)

The labour force participation rate is the measure to evaluate working-age population in an economy.
Labour force participation rate is defined as the percentage of working population in the age group of 15- 64 in the economy, currently employed or seeking employment.
As per OECD, it is calculated as the labour force divided by the total working-age population.

Status of Female Labour Force Participation Rate

As per the Periodic Labour Force Survey 2022-23
- LFPR for male in India increased from 75.8% in 2017-18 to 78.5% in 2022-23 and corresponding increase in LFPR for female was from 23.3% to 37.0%.

Now as per the findings of the report FLFPR is rising. However, It is still concerning when we focus on

Gender disparity – Male (78.5%) i.e. more than double of that of Women.
Rural Urban Gap – Higer in rural areas – reflects feminization of agriculture; lower in urban areas – Lack of formal employment opportunities
Comparison with developed economy – Europe and central Asia – 52%; North America – 56% ; East Asia and Pacific – 59%. FLFPR in India is below the global average of 47 percent for several years.

Reasons for low FLFPR in India

Unpaid care work: Women in India often have to bear the burden of unpaid care work, such as taking care of children, elderly family members, and household chores. It is often undervalued and not recognized as work.
Societal norms and cultural expectations: In India, traditional gender division of labour dictate that women should focus on household duties and raising children, while men are the primary breadwinners. Any deviation from such established norms attracts ostracization and marginalization which acts as a demotivation for women to take up formal jobs.
Lack of access to education: Girls are often denied access to education, or they drop out of school early due to poverty or familial responsibilities. This lack of education and skill development limits their employment opportunities and earning potential.
Limited job opportunities: Women often face discrimination in the job market, and there are fewer job opportunities available to them compared to men. For example, in the technology and finance sector.
Safety concerns: Women in India often face safety concerns and harassment at the workplace and also while commuting to and from work. It discourages them from seeking employment outside of the home.
Rising Household Incomes: Rising incomes allows women to escape harsh labour on farms and construction sites and focus on their families.
Lack of Rural connectivity: Lack of transport network to villages may prevent women from taking non-agricultural work in Neighbouring towns. Lack of transport services affects women more than men.
Nuclear families: The growing trend of nuclear families keeping childcare left to women with no support from family elders.
Lack of supportive policies: India lacks supportive policies, such as parental leave, and flexible work arrangements, which can enable women to balance work and family responsibilities.

Government initiatives to Improve Female Work Participation:

For Survival and Education of Females
- Beti Bachao Beti Padhao Scheme: For creating awareness among the people to educate all girl children in the country. The initiative intends to tackle the issue of the diminishing sex ratio in recent years, raise social awareness, and improve the effectiveness of welfare benefits for girls.
- National Education Policy (NEP), 2020: The policy prioritises gender equity and envisions ensuring equitable access to quality education to all students, with a special emphasis on Socially and Economically Disadvantaged Groups (SEDGs).

For Safe and Convenient Accommodation
- Working Women Hostel: One of the main difficulties faced by working women is lack of safe and conveniently located accommodation. The objective of the scheme is to promote availability of safe and conveniently located accommodation for working women, with day care facilities for their children, wherever possible, in urban, semi urban, or even rural areas where employment opportunities for women exist.

For Supporting Women affected by violence
- One Stop Centre (OSC) and Universalization of Women Helpline: To provide 24 hours immediate and emergency response to women affected by violence through referral (linking with appropriate authority such as police, One Stop Centre, hospital) and information about women related government schemes programs across the country through a single uniform number. Women Helpline (WHL) will be integrated with One Stop Centre Scheme (OSC) under which one OSC shall be established in every State/UT to provide integrated support and assistance to women affected by violence, both in private and public spaces under one roof.

Codification of the Labour Laws for harmonizing the needs of job seekers, workers and employers
- Labour Codes: The four Labour Codes namely, the Code on Wages, 2019, the Industrial Relations Code, 2020, the Code on Social Security, 2020 and the Occupational Safety, Health and Working Conditions Code, 2020. Codification of the Labour Laws provides a policy framework for harmonizing the needs of job seekers, workers and employers.
- The Labour Codes will, inter-alia, reduce multiplicity of definitions & authorities, facilitate implementation and use of technology in enforcement of labour laws and bring transparency and accountability in enforcement, promote setting up of more enterprises, catalyzing the creation of employment opportunities in the country.

Equal Opportunity and Congenial Work Environment
- Maternity Benefit (Amendment) Act, 2017: The Act increased the paid maternity leave from 12 weeks to 26 weeks, also made a provision for mandatory crèche facility in establishments having 50 or more employees, permitting women workers in the night shifts with adequate safety measures, etc.
- The Sexual Harassment of Women at Workplace Act, 2013: To provide protection against sexual harassment of women at workplace and for the prevention and redressal of complaints of sexual harassment and for matters connected therewith or incidental thereto.

Promoting Entrepreneurship
- Female Entrepreneurship: To promote female entrepreneurship, the Government has initiated schemes like MUDRA, Stand Up India and Mahila e-Haat.
- Rashtriya Mahila Kosh: Provides micro-credit at concessional terms to poor women for various livelihood and income generating activities.
- Prime Minister’s Employment Generation Programme (PMEGP): Under the scheme, women entrepreneurs are provided 25 per cent and 35 per cent subsidies for the project set up in urban and rural areas respectively.

Measures to improve Female Work Participation:

Need of National Women’s Urban Employment Guarantee Act (WUEGA): Women should form at least 50% of the programme management staff, with a vision for decentralized management and local community involvement. Includes provisions for childcare at work sites, free public transportation for women, and work availability within a 5-km radius.
Ensure high participation of women in MGNREGS: Recommendations given by Parliamentary Standing Committee on Rural Development and Panchayati Raj: Government must take measures for better promotion of “women-centric works” through creation or linking of existing livelihood projects under the scheme. Ministry of Rural Development needs to bridge the wage disparity among states by notifying a uniform wage rate structure.
Identification of niche sectors: There is need for identification of niche sectors like countries like the United States initiative like Girls Who Code in the USA aim to close the gender gap in technology, Japan and Italy are focusing on the healthcare and social work sectors as areas of potential job growth for women.
Accounting for care work: There is a need to capture the value of care in the GDP calculation. Flexible Work Options as like Netherlands: Promote work models like part-time work, remote work, and parental leave policies, empowers women to manage work-life balance effectively.
Invest in a wide range of care infrastructure and services solutions: Covering not only childcare, but also elder care, domestic work, and long-term care for highly dependent adults to reduce dependency and access the silver economy. For instance, Japan has leveraged some private sector partnerships for investments in affordable senior living and care services. As the share of elderly persons in India’s population is expected to rise from 10 per cent currently to 20 per cent by 2050, India, too will need to prioritise elder care infrastructure and service investments.

Japan’s ‘womenomics’

Japan was grappling with falling fertility rates, a declining population, and stagnant growth, a series of reforms on “womenomics” were introduced as part of the “Abenomics” era.
Women’s labour force participation rate (WLFPR) in Japan has grown by ten percentage points, from 64.9 percent in 2013 to 75.2 per cent in 2023.
Majority of the “womenomics” reforms have been linked to investments in the care economy and rebalancing gender norms.

National Testing Agency

Context: The National Testing Agency (NTA) submitted to the Supreme Court that the score cards of 1,563 candidates who were given compensatory marks in the common undergraduate medical entrance examination, NEET-UG 2024, will be cancelled.

About National Testing Agency

Charges against NEET 2024 conducted by NTA:

There have been charges, including the slow distribution of question papers; providing the wrong question paper; wrong OMR sheets; and technical delays.
There have been complaints about the unusually high number of students (67) who hit the perfect score, 720/720.
Other cases pertaining to the question paper leak are still to be heard by the Supreme Court.

Experts and students pointed to how the very idea of starting NEET as a common entrance exam to regulate medical admissions in the country and ensure quality-control of the process would be defeated in the light of all the reported violations.

Need for National Testing Agency

Entrance exams play a key role in admission(s) criteria of various bodies.
Previously, all national entrance exams were conducted by different boards with different members and sometimes there were problems with question paper leakage etc., and therefore, the need was to have one body which organizes all the entrance exams.
To assess competence of candidates for admissions and recruitment has always been a challenge in terms of matching with research based international standards, efficiency, transparency and error free delivery.
The National Testing Agency is entrusted to address all such issues using best in every field, from test preparation, to test delivery and to test marking.
It was established to improve the equity and quality in education by administering research based valid, reliable, efficient, transparent, fair and international level assessments.
The best subject matter experts, psychometricians and IT delivery and security professionals will ensure that the current gaps in existing assessment systems are properly identified and bridged.
NTA is established to create a system which will promote teaching (by teachers), learning (by students) and assessment (by parents and institutions).
To practice these values, NTA will constantly engage with its stakeholders, viz. students, parents, teachers, experts and partner institutions.

National Testing Agency details

An autonomous agency under the Department of Higher Education of the Ministry of Education of India.
Established: 2017
It is a registered society under the Societies Registration Act, 1860.
It is responsible for conducting numerous national-level exams for admission and fellowship in higher educational institutions related to engineering, medicine, management and pharmacy.
Origin:
- The roots of the agency can be traced to the Programme of Action 1992, related to the National Policy of Education 1986, which mentioned conducting national-level common entrance tests to professional and non-professional programmes of study.
In 2017, an announcement about the NTA was made in the budget speech, and this was followed by Cabinet approval.
The agency is administered by a governing body which includes a chairperson, a secretary and eight or more officials representing different national level institutes.
- The Governing Body is chaired by the Secretary, Department of Higher Education, Ministry of Education.
- The Governing Body is responsible for the overall policy and direction of the NTA.
Some of the exams conducted by the NTA every year:
- NTA NEET (National Eligibility cum Entrance Test)
- CMAT (Common Management Admission Test)
- Graduate Pharmacy Aptitude Test (GPAT)
- IGNOU PHD OPENMAT (MBA) Exam

Objectives of National Testing Agency:

To conduct efficient, transparent and international standards tests in order to assess the competency of candidates for admission, and recruitment purposes.
To undertake research on educational, professional and testing systems to identify gaps in the knowledge systems and take steps for bridging them.
To identify experts and institutions in setting examination questions.
To produce and disseminate information and research on education and professional development standards.

Functions of National Testing Agency:

To identify partner institutions with adequate infrastructure from the existing schools and higher education institutions which would facilitate conduct of online examinations without adversely impacting their academic routine.
To create a question bank for all subjects using the modern techniques
To establish a strong R&D culture as well as a pool of experts in different aspects of testing
To help individual colleges and universities in the field of testing and to provide training and advisory services to the institutions in India. To provide quality testing services to the academic institutions in India.
To develop a State of Art culture of testing in India by using domestic and international expertise.
To undertake any other examination that is entrusted to it by the Ministries/Departments of Government of India/State Governments.
To undertake the reforms and training of school boards as well as other bodies where the testing standards should be comparable with the entrance examinations.

Tobacco epidemic in India

Context: ‘World No Tobacco Day’ is observed annually on May 31. India ranks first globally in male cancer incidence and mortality rates. India tops the global list in tobacco-related lip and oral cancers, followed by lung cancer. Along with the health burden, tobacco use imposed an economic cost of ₹1.77 lakh crore (1.04% of India’s GDP) in FY18.
Tobacco prices remain low in India, thus tobacco affordability undermines WHO’s MPOWER framework and fuels the cancer epidemic in India.

Relevance of the Topic:Mains: Tobacco Epidemic in India: Government Initiatives.

About tobacco

It is the common name of several plants in the genus Nicotiana, and the general term for any product prepared from the cured leaves of these plants.
Dried tobacco leaves are mainly used for smoking in cigarettes and cigars, as well as pipes and hookahs. They can also be consumed as snuff, chewing tobacco and dipping tobacco.
It contains the highly addictive stimulant alkaloid nicotine as well as harmala alkaloids.
It is grown in warm climates with well-drained soil. Major tobacco-growing countries include China, India, Brazil, and the United States.
It causes a wide range of diseases , including heart disease, stroke, respiratory diseases, and various cancers (especially lung cancer) and affects those consuming it as well as those cultivating it.

Problems with tobacco cultivation:

It is a highly erosive crop that rapidly depletes soil nutrients. This requires more fertilizers to be used which further worsens soil quality.
The plant is also a major contributor to deforestation. Up to 5.4 kg of wood is required to process 1 kg of tobacco.
The production and consumption of tobacco generates nearly 1.7 lakh tonnes of waste every year in India.
A 2021 study estimated that the country incurred a loss exceeding ₹1.7 lakh crore as a result of tobacco’s effects on the health of its consumers in the fiscal year 2017-2018.

Status of tobacco use in India:

After China, India has the world’s highest number of tobacco consumers nearly 26 crore, according to an estimate in 2016-2017.
Also, the health of more than 60 lakh people employed in the tobacco industry is also placed at risk because of the absorption of tobacco through the skin, which can cause various diseases.
Tobacco use has gone down in the population and tobacco use in women, which went up by 2.1% between 2015-2016 (NFHS).
Tobacco use is also the cause for nearly 3,500 deaths in India every day, which impacts human capital and GDP growth in a negative way.

Government initiatives to curb tobacco epidemic in India:

WHO’s Framework Convention on Tobacco Control (FCTC), 2005: India is one of the 168 signatories, to reduce tobacco usage worldwide by helping countries develop demand and supply reduction strategies.
Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) Act (COTPA) 2003: Includes provisions for prohibiting smoking in public places, banning tobacco advertising, and mandating pictorial health warnings on tobacco products.
National Tobacco Control Program (NTCP) in 2007: To improve the implementation of COTPA and FCTC, improve awareness about the harms of tobacco use, and help people quit it.
Tobacco taxation: A globally accepted method to effectively control tobacco use is also applied in India. Tobacco, except for tobacco leaves, is placed in the highest tax slab of 28% under GST, and also subject to a heavy burden of cess, given that the commodity is seen as a sin good.
Promulgation of the Prohibition of Electronic Cigarettes Ordinance, 2019 : Prohibits Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement of e-Cigarettes.
National Tobacco Quitline Services (NTQLS): To provide telephone-based information, advice, support, and referrals for tobacco cessation.

Challenges in addressing the tobacco epidemic in India:

High prevalence of tobacco use: Due cultural acceptance and availability of wide variety of products including bidis, cigarettes, and smokeless tobacco, complicate efforts to regulate and control usage.
Issue with tobacco taxation: The GST system in India relies more on ad valorem taxes than the pre-GST system, which primarily used specific excise taxes. Many countries with a GST or value-added tax (VAT) also apply an excise tax on tobacco products.
- In India, the share of central excise duty in total tobacco taxes decreased substantially from pre-GST to post-GST for cigarettes (54% to 8%), bidis (17% to 1%), and smokeless tobacco (59% to 11%).
- A large part of the compensation cess as well as the National Calamity Contingent Duty, or NCCD currently applied on tobacco products is specific.
- Bidis and smokeless tobacco have low taxes, encouraging consumption.
- Smokeless tobacco products in India are taxed ineffectively due to their small retail pack size (often 1/2 gram or less) which keeps the price low.
- Cigarettes are taxed based on their length, and the presence of filters, creating multiple categories with varying tax implications creates opportunities for cigarette companies to avoid taxes legally.
Weak enforcement of tobacco control laws:
- Smokeless tobacco products (SLTs) such as gutka, khaini have predominantly been non-compliant with COTPA packaging guidelines.
- The fines for violating COTPA regulations have not been updated since 2003. For instance, a tobacco company is fined a maximum of only ₹5,000 for violating packaging restrictions for the first time.
- COTPA bans direct advertisements of tobacco but is unclear on indirect ads, allowing surrogate advertisements using proxy products like elaichi to promote tobacco brands.
  - During the ICC Men’s Cricket World Cup 2023, surrogate ads for at least two tobacco brands, endorsed by famous cricketers, were displayed. These ads indirectly promote tobacco use.
- NTCP is ineffectively implemented due to insufficient staffing, resource allocation, utilization, and lack of effective monitoring mechanisms.
Economic dependence on the tobacco industry: The industry provides employment and livelihoods to millions of people especially in rural areas, ana also it contributes significantly to government revenues through taxes, creating a conflict of interest in implementing stringent control measures.
Healthcare burden: The high prevalence of tobacco-related diseases puts a strain on the healthcare system, which is already burdened with other public health issues.
Access to cessation services: There is limited access to effective cessation programs and support services, particularly in rural and underserved areas.

Way forward:

Implement the proposed amendments to COTPA in 2015 and 2020:
- Regulations on surrogate advertisements, inclusion of films and video games in the definition of ‘advertisement’, and increasing the fines for violation of advertisement norms by a factor of 10.
- Made licensing necessary for the production, supply, and distribution of tobacco products.
Inflation adjustment: Mandatory inflation indexing should be applied to specific tax rates on tobacco products to maintain their value and effectiveness in controlling consumption.
Uniform tax: All products that are exclusively used for tobacco making are brought under the uniform 28% GST slab, will generate the right public health message that all tobacco products are bad and their consumption needs to be discouraged.
- To standardise and increase the retail price, mandatory standardised packing should be implemented for smokeless tobacco pouches (at least 50 g-100 g). This will also make it easier to implement graphic health warnings on the packaging.
- The tiered system should be eliminated or reduced to two tiers, which can then be phased out over time to have a single tier.
Implement COTPA, PECA, and NTCP more stringently.
Support for tobacco farmers to switch to alternate crops, avoiding loss of livelihood.
There is also a need for up-to-date data to understand trends in tobacco use to tackle the tobacco industry, which modifies its sales strategies based on readily available sales trends.

Uniform Code for Pharmaceutical Marketing Practices – 2024

Context: Ministry of Chemicals and Fertilizers has notified the Uniform Code for Pharmaceutical Marketing Practices, 2024 to curb unethical marketing of drugs and ban medical representatives from using inducements to access healthcare professionals. Before this, pharmaceutical industry was following UCPMP 2015 which was voluntary in nature. However, the new UCPMP 2024 is quasi-judicial in nature.

SALIENT FEATURES OF UNIFORM CODE FOR PHARMACEUTICAL MARKETING PRACTICES 2024

According to 'Ethical Criteria for Medicinal Drug Promotion, 1988' of WHO, 'Promotion' refers to all informational and persuasive activities by manufacturers and distributors, the effect of which is to induce the prescription, supply, purchase and/or use of drugs.
Promotion of a drug must be consistent with the terms of its marketing approval and a drug must not be promoted prior

Medical Representatives

Medical Representatives are sales representatives and other company representatives who call on healthcare professionals, pharmacies, hospitals or healthcare facilities in connection with promotion of drugs.
Medical representatives must not employ any inducement or subterfuge to gain an interview. They must not pay, under any guise, for access to a healthcare professional.
Companies are responsible for the activities of their employees, including the medical representatives, for ensuring compliance of this Code.

Brand Reminders

Brand Reminders are permitted in two categories

Informational and education items including books, calendars, diaries, journals (including digital), dummy device models and clinical treatment guidelines for professionals used in healthcare settings value of which does not exceed Rs 1000 (One thousand) per item. Such items should not have an independent commercial value for healthcare professionals
Free samples provided by the companies to medical professionals:
- Free samples of drugs shall not be supplied or directly handled to a who is not qualified to prescribe such a product.
- Such samples should be provided only for creating awareness about treatment options and for acquiring experience in dealing with the product.
- Such samples should be limited to prescribed dosage for not more than three patients for the required course of treatment.
- Each sample should be marked 'free medical sample not for sale' or bear another legend of analogous meaning.
- Each sample should not be larger than the smallest pack present in the market.
- Sample of a drug which is hypnotic, sedative or a tranquilizer should not be given.
- Each company should maintain details such as product name, doctor name, quantity of samples, date of supply of free samples to healthcare professionals etc.
- Monetary value of samples distributed should not exceed 2% of domestic sales of the company per year.

Continuing Medical Education

Engagement of pharmaceutical industry with healthcare professionals for Continuing Medical Education (CME), Continuing Professional Development (CPD) or otherwise for conference, seminar, workshop etc. should only be allowed through a well-defined, transparent and verifiable set of guidelines.
Conduct of such activities in foreign locations is prohibited.
All pharmaceutical companies should share details of such activities on their website and may be subject to independent, random or risk-based audit.

Support for Research

Pharmaceutical companies can provide rational support and encouragement to research and innovation through industry-academia linkage subject to following conditions:

The research study should have requisite approval from competent authority (ICMR, DCGI, Ethics Committee, Institutional Authority, NMC etc.) and is conducted at a recognised site or location.
Engagement of healthcare professionals in consultant-advisory capacity shall be for bonfide research services, under a consultancy agreement involving a consultancy fee or an honorarium-based payment.
Expenditure on research by pharmaceutical companies is an allowable expenditure subject to provisions of Income Tax Act, 1961.

Relationship with Healthcare Professionals

No gifts should be offered or provided or promised for personal benefit of any healthcare professional or family members by any pharmaceutical company or its agents.
No travel facilities inside or outside the country should be extended to healthcare professionals or their family members by pharma companies or their representatives except the person is a speaker for a CME or a CPD program.
No hospitality like hotel-stay, expensive cuisine, resort accommodation etc. should be extended to healthcare professionals or their family members by pharma companies and their representatives except when the person is a speaker for a CME or a CPD program.
No cash or monetary grant should be extended to any healthcare professional or their family members under any pretext.

Compliance of UCPMP 2024 by Pharmaceutical Associations

All complaints related to an activity of breach of the Code should be made within six months of the alleged of the breach of the Code, with an additional delay of 6 months. Complainant should identify himself, the pharma company and details of breach of the Code.
A non-refundable amount of Rs 1,000 is to be deposited by the complainant along with complaint.
All Indian Pharmaceutical Associations will form a committee for handling complaints as 'Ethics Committee for Pharma Marketing Practices (ECPMP), in each Association to be chaired by its Chief Executive Officer. The Committee will have 3-5 members and its composition will be approved by the Board of Association.
ECPMP will conduct enquiry and decisions of the committee should be taken by majority
Penalties: Once it is established that a breach of UCPMP 2024 has taken place by an entity, the ECPMP can propose one of the following against the erring entity:
- Suspend or expel the entity from the Association
- Reprimand the entity and publish full details of such reprimand.
- Require the entity to issue a corrective statement in the same or other suitable media.
- Ask the entity to recover money or items, given in violation of Code from the concerned person/s.
- In cases where disciplinary, penal or remedial action lies within the domain of any agency or authority of Government in accordance with statute, the ECPMP may send its recommendations to such agency or authority through the Department of Pharmaceuticals.
- Appeal against UCPMP 2024
  - If a party to the complaint is dissatisfied with the decision of ECPMP, it may file an appeal before the Apex Committee for Pharma Marketing Practices (ACPMP) to be headed by Secretary, Department of Pharmaceuticals, having a Joint Secretary and a Finance Officer as its members.
  - Appeals against the order of ECPMP must be ordinarily filed within 15 days with an additional 15 days of reasonable time delay permitted for reasons to be recorded in writing

Menstrual Hygiene Day

Context: Menstrual Hygiene Day, observed on May 28th, highlights the critical importance of proper menstrual hygiene management. The health, happiness, and empowerment of women and girls all suffer as a result of improper management of menstrual hygiene.

Insufficient knowledge and poor hygiene during menstruation can result in various health issues. On this day, it is crucial to shed light on the consequences of improper menstrual hygiene management and its impact on women's health.

What is Mensuration?

Menstruation is the process in which the uterus sheds blood and tissue through the vagina. This is a natural and healthy process for girls and women of reproductive age. In Western communities, this is often called “the period.” It typically lasts 2 to 5 days, but this varies by individual.
Menstruation is a natural and normal process experienced by females, yet societal taboos, cultural beliefs, and limited access to resources often lead to inadequate practices.

According to 5^th NHFS (2019-2021):

Women aged 15-24 years who use a hygienic method of protection during their menstrual cycle is 78%. Among these women, 64% use sanitary napkins, 50% use cloth, and 15% use locally prepared napkins.
Only 73% of rural women while 90% of urban women use a hygienic method of menstrual protection respectively.
However, a few States continue to have lower than average access to use of a hygienic method of menstrual protection by women and girls.

Important consequences of improper menstrual hygiene management:

Health Implications: Poor menstrual hygiene can lead to various infections, such as urinary tract infections (UTIs), bacterial vaginosis, and yeast infections.
- Further, there is a correlation between poor menstrual hygiene and an increased risk of cervical cancer. A study by the World Health Organization (WHO) highlights that inadequate menstrual hygiene management can contribute to the development of human papillomavirus (HPV), a leading cause of cervical cancer.
Psychological Impact: Lack of access to proper menstrual hygiene products and facilities can cause significant stress, anxiety, and embarrassment among women and girls. A report by UNICEF reveals that the stigma and shame associated with menstruation can negatively affect mental health, leading to feelings of low self-esteem and social isolation.
Social Consequences
- Educational Disruption: Girls who lack access to menstrual hygiene products often miss school during their periods. UNESCO estimates that one in ten girls in Sub-Saharan Africa misses school during their menstrual cycle, which can accumulate to 20% of the school year. This absenteeism can hinder their academic performance and limit their future opportunities.
- Poor menstrual health can significantly impact the sexual and reproductive health. It can lead to being pushed into child marriage, and facing a higher risk of domestic violence, malnourishment etc.
- Workplace Challenges: Inadequate menstrual hygiene can also impact women's participation in the workforce. It is found that women in low-income settings often miss work during their periods due to a lack of access to proper sanitation facilities. This can affect their income and career advancement opportunities.
Environmental Impact: Improper disposal of menstrual hygiene products, such as throwing them in open areas or water bodies, can lead to environmental pollution, affecting both human health and ecosystems.
Economic Consequences: The health complications arising from poor menstrual hygiene can lead to increased healthcare costs for individuals and communities. Treating infections and diseases caused by inadequate hygiene can strain both personal finances and public health resources.
- Loss of Productivity: The absenteeism from school and work due to menstrual hygiene issues results in a loss of productivity. According to a study by the International Labor Organization (ILO), this loss of productivity has broader economic implications, affecting the overall economic growth and development of a country.
Human Rights Issues: Poor menstrual hygiene management is a significant barrier to achieving gender equality. Women and girls who lack access to menstrual hygiene products and facilities are often unable to participate fully in social, educational, and economic activities. The United Nations Population Fund (UNFPA) emphasizes that menstrual hygiene is a critical aspect of women's rights and gender equality. Further, the stigma and discrimination associated with menstruation can lead to social exclusion and discrimination against women and girls. This can prevent them from accessing essential services and participating in community activities, further entrenching gender disparities.

Barriers to Menstrual Hygiene

Socio-Cultural Barriers: Cultural taboos and societal stigma around menstruation can prevent open discussions and proper education on menstrual hygiene. Menstruating women and girls may face social exclusion and discriminatory practices, limiting their participation in daily activities.
Educational Barriers: Inadequate education on menstrual health and hygiene leads to misconceptions and misinformation. Many girls miss school during their periods due to lack of proper facilities or support, affecting their education and future opportunities.
Economic Barriers: High cost of sanitary products can be prohibitive, especially for low-income families. Further, Limited availability of affordable menstrual hygiene products in many regions.
Infrastructure Barriers: Lack of clean and private toilets in schools and public places makes it difficult for women and girls to manage their periods. Also, Insufficient access to clean water for washing and maintaining hygiene.
Health System Barriers: Poor access to healthcare services for menstrual-related issues and reproductive health. Shortage of healthcare providers trained in menstrual health education and management.
Policy and Legal Barriers: Insufficient government policies and regulations to support menstrual health and hygiene. As was evident in the recent debate over proposals of menstrual leave, which clearly highlighted lack of consensus.

By addressing these barriers, we can improve menstrual hygiene management and support the overall well-being of women and girls.

Constitutional Provisions:

Article 42, Constitution of India: The State shall make provision for securing just and humane conditions of work and for maternity relief.

Draft Menstrual Hygiene Policy-2023·

Ministry of Health and Family Welfare (MoHFW) is the Nodal Ministry for the Menstrual hygiene policy.
The policy recognizes menstruation as a natural bodily process for all who menstruate including girls and women of reproductive age and addresses the long-standing challenges associated with menstruation in our country.
The policy will serve as a catalyst to raise awareness, challenge societal norms and foster a society that embraces menstrual hygiene as a natural and normal part of life.

Policy strategy·

Ensure access to affordable and safe menstrual hygiene products: To ensure affordable and accessible menstrual products such as disposable or reusable sanitary pads, menstrual cups, tampons or reusable cloth pads, etc are available to all who menstruate, especially those in low-income communities and marginalized groups.
Promote quality standards and regulatory framework: Develop and implement comprehensive quality standards for different types of menstrual hygiene products available in the market to ensure their safety, efficacy and reliability.
Availability of clean and dignified menstrual hygiene facilities: Promote the development and improvement of menstrual-friendly infrastructure in homes, educational institutions, workplaces and public spaces to include safe, clean and private toilets, proper waste disposal systems and handwashing facilities with soap and clean water.
Promotion of education and awareness on menstrual hygiene: Awareness campaigns targeting menstruators to provide accurate information including options of products available, debunk myths and misconceptions and address social and gender-related challenges associated with menstruation.
Collaboration with Non-government sector/engagement with private sector: Support research and development initiatives that explore new technologies, materials and product designs which improve menstrual hygiene management, while considering accessibility, ease of use, affordability and environmental sustainability.
Foster research and innovation in menstrual hygiene management: Encourage research institutes and academia to contribute to evidence-based policymaking, promote innovation and improve the overall understanding and implementation of menstrual hygiene practices.

Pre-eclampsia

Context: May 22 is commemorated as Pre-eclampsia Day to prioritize proactive measures for safe motherhood and childbirth, as preeclampsia significantly raises the risk of heart failure, coronary heart disease, stroke, and cardiovascular mortality for mothers.

About pre-eclampsia:

It is a serious pregnancy complication that typically develops after 20 weeks of pregnancy in women with previously normal blood pressure. It can also develop shortly after childbirth.
It is characterized by high blood pressure and signs of damage to other organ systems, most often the kidneys.

Symptoms:

High blood pressure, protein in the urine (proteinuria), severe headache, nausea or vomiting, vision problems (including light sensitivity, blurred vision, or seeing spots), upper right abdominal pain and rapid weight gain,.

Causes:

The exact cause is unknown.

Risk factors:

History of high blood pressure, a family history of pre-eclampsia, multiple pregnancies (twins, triplets, etc.), diabetes, obesity, autoimmune diseases and in vitro fertilization (IVF).

Complications:

If left untreated, it can lead to serious complications for both mother and baby. For the mother, complications can include eclampsia (seizures), stroke, bleeding problems, kidney failure, and heart attack. For the baby, complications can include premature birth, low birth weight, and growth problems.

Prevention

The prevention is the use of low-dose aspirin.

Addressing India's Nutrition Challenges: Comprehensive Guidelines for a Healthier Future

Introduction to Nutritional Concerns in India

India faces a dual burden of undernutrition and overnutrition, contributing to a significant rise in noncommunicable diseases (NCDs) such as cardiovascular diseases, cancers, and diabetes, affecting not just adults but also adolescents and children.
In response, the National Institute of Nutrition (NIN) under the Indian Council of Medical Research has issued robust dietary guidelines targeting vulnerable groups including pregnant and lactating women, children, and the elderly.

The Burden of Unhealthy Diets

According to the NIN, an unhealthy diet is responsible for approximately 56.4% of India’s total disease burden.
Emphasizing that a healthy diet combined with physical activity could prevent up to 80% of Type 2 diabetes cases and significantly reduce the incidences of heart disease and high blood pressure, these guidelines are timely and critical.

Need to Focus on Mothers and Children

Optimal nutrition from conception to the age of 2 years is crucial for proper growth and development, preventing undernutrition, micronutrient deficiencies, and obesity.
The 2019 Comprehensive National Nutrition Survey highlighted the concerning prevalence of lifestyle diseases among children and adolescents, with findings such as:
About 5% of children aged 5-9 and 6% of adolescents are overweight or obese.
Prevalence of diabetes and pre-diabetes in young populations.
High levels of bad cholesterol (LDL and triglycerides) in 37.3% of children ages 5-9, and 19.9% of pre-teens and teens ages 10-19. Levels of good cholesterol were low in a fourth of all children and adolescents.

Challenges of Micronutrient Deficiency

Micronutrient deficiencies (including zinc, iron, vitamins) affect between 13% to 30% of children aged 1 to 19.
Although severe undernutrition cases like marasmus and kwashiorkor have declined, anaemia remains prevalent, affecting significant percentages of children across different age groups.

General Dietary Principles for the Indian Population

The NIN guidelines recommend diversifying diets to include at least eight food groups including vegetables, leafy vegetables, roots and tubers, dairy, nuts, and oils and reducing the staple consumption of cereals from 50-70% of total energy to 45%.
Increased intake of proteins (pulses, meat, poultry, fish), which should constitute 14% of daily energy intake, is advised.
The guidelines also focus on the importance of polyunsaturated fatty acids (PUFA) and B12, recommending sources like flax seeds, chia seeds, and walnuts for vegetarians.
Salt consumption should be restricted to 5g a day, and strongly recommends against consuming highly processed foods that are typically high in fats, salt, sugar.

Specific Guidelines for Different Groups

Pregnant Women: The guidelines suggest small, frequent meals, especially for those experiencing nausea, and emphasize foods high in iron and folate.
Infants and Children: Exclusive breastfeeding is recommended for the first six months, followed by the introduction of complementary foods.
Elderly: A diet rich in proteins, calcium, micronutrients, and fiber is advised. Elderly individuals should focus on whole grains, low-fat dairy products, nuts, oilseeds, and ample fruits and vegetables, complemented by regular exercise to maintain bone density and muscle mass.

Conclusion

India's strategic approach to combating the growing epidemic of NCDs and nutritional deficiencies through these comprehensive guidelines offers a blueprint for healthier generations. By addressing both overnutrition and undernutrition, these guidelines pave the way for a healthier future, emphasizing preventive healthcare through proper diet and lifestyle changes.

Kotia: A tribal gram panchayat

Context: Kotia, a predominantly tribal gram panchayat that Odisha and Andhra both claim, seeks to vote differently with two votes to a person, one in each State, in the ongoing Lok Sabha elections.

About Kotia, a tribal gram panchayat:

It is a group of tribal villages on the AP-Odisha border. Both states claim territorial rights over them.
These villages are inhabited by Kondh tribals.
The area is abundant in mineral reserves such as gold, platinum, manganese, bauxite, graphite, and limestone.
Before 1936, villages within the Kotia panchayat were part of the Jeypore Estate. Since 1936, this gram panchayat has been in Odisha. In 1953, Andhra Pradesh claimed it as part of the state.
In the 1980s, Odisha filed a case in the Supreme Court seeking control and jurisdiction over 21 villages. However, in 2006, the court decided that disputes regarding state boundaries fall outside its jurisdiction, stating that only Parliament could resolve such issues.

About Kondh tribe:

It is the largest tribal group in the state of Odisha. They are a also designated Scheduled Tribe in the states of Andhra Pradesh, Bihar, Chhattisgarh, Madhya Pradesh, Maharashtra, Odisha, Jharkhand and West Bengal.
They speak Kui and Kuvi as their native languages. They are most closely related to the Gondi language. Both are Dravidian languages and are written with the Odia script.
Traditionally their religious beliefs were syncretic combining totemism, animism, ancestor worship, shamanism and nature worship.
The tribe has a number of sub-tribes, such as, the Dongria, Kovi, Kuttia, Languli, Penga, and Jharnia.
While many Khond have transitioned to rice cultivation, some groups, like the Kuttia Khond, continue to engage in slash-and-burn agriculture (kondhs call it dongar chaas or podu chaas)
The Niyamgiri hills in Odisha are home to the Dongria Khond, recognized as a Particularly Vulnerable Tribal Group.

Pradhan Mantri Jan Arogya Yojana (PMJAY)

Context: Since the inception of the Pradhan Mantri Jan Arogya Yojana (PMJAY), 34.27 crore cards have been issued, and 6.5 crore beneficiaries have received treatment across 30,000 empanelled hospitals. Despite its extensive reach, the program has encountered significant challenges, including substantial payment backlogs owed to hospitals by the government.

This financial strain has led some hospitals to either refuse or limit the number of PMJAY patients they accept, raising concerns about whether the scheme needs a design overhaul to address these challenges.

About Pradhan Mantri Jan Arogya Yojana (PMJAY):

Launched in: 2018

Type of scheme: Centrally sponsored scheme
Subsumed scheme: Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
Key features: It is an entitlement-based scheme that targets the beneficiaries as identified by latest Socio-Economic Caste Census (SECC) data.
- It offers a sum insured of Rs.5 lakh per family for secondary care and tertiary care hospitalisation to the bottom 40 per cent of the population of India.
- It covers the cost of hospitalization, pre-hospitalization, medication, and post-hospitalization during the treatment of tertiary and secondary care procedures.
- The Ayushman Card is like a pre-paid card worth Rs 5 lakh, which can be used to avail free treatment at more than 27,000 empanelled hospitals.
- Every hospital must provide Pradhan Mantri Arogya Mitras (PMAMs) to assist beneficiaries.
- The National Health Authority (NHA) has been constituted as an autonomous entity under the Society Registration Act, 1860 for effective implementation of PM-JAY in alliance with state governments.
- The State Health Agency (SHA) is the apex body of the State Government responsible for the implementation of AB PM-JAY in the State.

Food Safety and Standards Authority of India (FSSAI) to probe allegations against Fast Moving Consumer Goods (FMCG) companies

Context: The Union Consumer Affairs Ministry has asked the Food Safety and Standards Authority of India (FSSAI) to investigate the allegations against the leading Fast Moving Consumer Goods (FMCG) companies. This follows recent claims that Nestle’s baby food products in India, as well as those in Africa and Latin America, contain excessive sugar levels.

About Fast Moving Consumer Goods (FMCG)

FMCGs are products that sell quickly at relatively low cost. These goods are also called consumer packaged goods.
They have a short shelf life because of high consumer demand such as soft drinks and confections or because they are perishable (e.g., meat, dairy products, and baked goods).
There are several types of FMCGs such as:
- Processed foods such as cheese products, cereals, and boxed pasta
- Beverages such as bottled water, energy drinks, and juices
- Fresh foods, frozen foods, and dry goods
- Medicines such as aspirin, pain relievers, and other medication that can be purchased without a prescription
- Cleaning products such as baking soda, oven cleaner, and window and glass cleaner
- Cosmetics and toiletries such as hair care products, concealers, toothpaste, and soap
- Office supplies such as pens, pencils, and markers
The FMCG sector, as India's fourth-largest industry, employs about 3 million people, making up 5% of the country's total factory employment.

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.
- Prevention of Food Adulteration Act, 1954.
- Fruit Products Order, 1955
- Meat Food Products Order, 1973
- Vegetable Oil Products (Control) Order, 1947
- Edible Oils Packaging (Regulation) Order 1998
- Solvent Extracted Oil, De- Oiled Meal and Edible Flour (Control) Order, 1967
- Milk and Milk Products Order, 1992
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.

Dongria Kondh Tribe

Context: Generations of Dongria Kondh tribals in Odisha’s Rayagada district have not been to school because of the challenges of living in a hilly area in the forest.

About Kondh tribe

While many Khond have transitioned to rice cultivation, some groups, like the Kuttia Khond, continue to engage in slash-and-burn agriculture (kondhs call it dongar chaas or podu chaas)

It is the largest tribal group in the state of Odisha. They are an also designated Scheduled Tribe in the states of Andhra Pradesh, Bihar, Chhattisgarh, Madhya Pradesh, Maharashtra, Odisha, Jharkhand and West Bengal.
They speak Kui and Kuvi as their native languages. They are most closely related to the Gondi language. Both are Dravidian languages and are written with the Odia script.
Traditionally their religious beliefs were syncretic combining totemism, animism, ancestor worship, shamanism and nature worship.
The tribe has a number of sub-tribes, such as, the Dongria, Kovi, Kuttia, Languli, Penga, and Jharnia.

About Dongria Kondh

They are a Particularly Vulnerable Tribal Group (PVTG).
They are located in the Niyamgiri hills in the state of Odisha in India.
- They sustain themselves from the resources of the Niyamgiri forests, practising horticulture and shifting cultivation.
- Niyamgiri is a hill range, which falls under the Rayagada and Kalahandi District in south-west Odisha, India. Its highest point is the mountain known as Niyamgiri or Niyam Dongar.
Language: Kui language. The Kui language does not have a script, but it is spoken among the people of the Kondh community.

state wise list of Particularly vulnerable tribal groups PVTGs

About Particularly Vulnerable Tribal Group (PVTG):

A particularly vulnerable tribal group or PVTG, is a sub-classification of Scheduled Tribe or section of a Scheduled Tribe, that is considered more vulnerable than a regular Scheduled Tribe.
The PVTG list was created by the Indian Government with the purpose of better improving the living standards of endangered tribal groups based on priority.
The Dhebar Commission (1960-1961) found that within the Scheduled Tribe classification an inequality existed in the rate of development of certain tribes over others.
- As a result in the fourth Five Year Plan (1973), the sub-category "Primitive tribal group" was created within the grouping of Scheduled Tribe to identify groups considered to be especially lacking in modern development.
In 2006, the Government of India renamed the PTGs as Particularly Vulnerable Tribal Groups (PVTGs).
The identification of such groups was based on one or more of the following characteristics:
- Preservation of pre-agricultural practices.
- Hunting and gathering practices.
- Decreasing or stagnant population growth.
- Relatively low levels of literacy in contrast to other tribal groups.
75 PTVGs have been identified across the country, spread over 18 states and 1 Union Territory (Andaman & Nicobar).
Among the 75 listed PVTGs, the highest number are found in Odisha (13), followed by Andhra Pradesh.