HEALTH:

• Healthcare sector in India comprises of hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance, and medical equipment.
• The government, or public healthcare system, concentrates on establishing primary healthcare centers (PHCs) in rural areas while maintaining a small number of secondary and tertiary care facilities in major cities.
• The bulk of secondary, tertiary, and quaternary care facilities are run by the private sector, with a focus on metropolises and tier-I and tier-II cities.

Challenges:

1. India suffers from a hospital deficit, especially in rural areas, and many of the country’s current healthcare institutions need basic supplies and equipment.
2. In India, the quality of healthcare varies greatly, with insufficient regulation leading to subpar care in some private healthcare facilities and rural areas with inadequate facilities and resources.
3. Over 60% of all deaths in India are caused by non-communicable diseases (NCDs), which also have high rates of chronic illnesses like diabetes, cancer, and heart disease.
4. India is one of the countries with the least mental health specialists per person.
5. The government spends very little money on mental health. Poor mental health outcomes and insufficient care for those with mental illnesses are the results of this.
6. The imbalance in the doctor-patient ratio is one of the most important issues. The Indian Journal of Public Health estimates that India will require 20 lakh doctors by 2030.

Government initiatives:

1. Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
2. National Health Mission
3. Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
4. Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) to strengthen India’s health infrastructure and improve the country’s primary, secondary and tertiary care services.
5. Ayushman Bharat Digital Mission to connect the digital health solutions of hospitals across the country. Under this, every citizen will now get a digital health ID and their health record will be digitally protected.
6. PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government.
7. Launched in February 2018, it offers a sum insured of Rs.5 lakh per family for secondary care

NITI Aayog has released the fourth edition of the State Health Index for 2019–20.

Larger States:

In terms of annual incremental performance, Uttar Pradesh, Assam and Telangana are the top three ranking states.

Smaller States:

Mizoram and Meghalaya registered the maximum annual incremental progress.

Union Territories:

Delhi, followed by Jammu and Kashmir, showed the best incremental performance.

The top-ranking states were Kerala and Tamil Nadu among the ‘Larger States’, Mizoram and Tripura among the ‘Smaller States’, and Dadra and Nagar Haveli and Daman and Diu (DH&DD) and Chandigarh among the UTs

The 5^th National Family Health Survey 2019-21 reports 35.5% of children under 5 are stunted, 19.3% are wasted, and 32.1% are underweight.

Meghalaya has the highest number of stunted children (46.5%), followed by Bihar (42.9%).

Maharashtra (25.6%) has the highest percentage of wasted children followed by Gujarat (25.1%).

Compared with NFHS-4, the prevalence of overweight or obesity has increased in most States/UTs in NFHS-5.

POSHAN Abhiyaan: The government of India has launched the National Nutrition Mission (NNM) or POSHAN Abhiyaan to ensure a “Malnutrition Free India” by 2022.

Eat Right India and Fit India Movement are some other initiatives to promote healthy eating and healthy lifestyle.

The National Food Security Act (NFSA), 2013: It aims to ensure food and nutrition security for the most vulnerables through its associated schemes and programmes, making access to food a legal right.

IMR in India

The IMR in India stands at 33 per 1000 live births. The IMR of India is poor as compared to China (8), Bangladesh (27), Sri Lanka (8) and Bhutan (26).

TAMILNADU – 13

KERALA-6

Highest

Madya pradesh – 43

Maternal Mortality Ratio (MMR) is defined as the number of maternal deaths during a given time per 1,00,000 live births during the same time..

Kerala, which has the lowest MMR, is followed by Maharashtra 33 and Telangana 43 Tamilnadu 54

Other states with high MMR include Madhya Pradesh (173), Uttar Pradesh (167), Chhattisgarh (137), Odisha (119), Bihar (118), Rajasthan (113), Haryana (110), Punjab (105) and West Bengal (105).

State Health Mission

To achieve the objectives of NRHM, the Tamilnadu State Health Mission was constituted and Tamilnadu State Health Society was registered under Tamilnadu Societies Registration Act 1975 with Registration No.47/2006. State Health Society is constituted merging the health societies for leprosy, tuberculosis, blindness control and integrated disease control programme except Tamilnadu State AIDS Control Society. All the National Health Programmes at the State and District level are brought under one umbrella and it will function through the individual sub committees. This will help to pool all resources available in implementation of the programme.

1. Reduction of infant mortality and maternal mortality.
2. Universal access to public health services / women’s health, child health, drinking water, sanitation and hygiene, nutrition and universal immunization.
3. Prevention and control of communicable and non-communicable diseases.
4. Population stabilization-Gender and demographic factors.
5. Access to integrated comprehensive primary health care.
6. Revitalizing local health traditions and mainstreaming ISM.
7. Promotion of healthy life styles.

Tamil Nadu Health Systems Project

1. Increased access of health services for poor, disadvantaged, and tribal groups
2. Developing effective interventions to address key health challenges
3. Improving health outcomes and quality of service by strengthening management of the public sector health systems and by involving the non governmental sector
4. Increasing the effectiveness and efficiency of the public sector hospital services at the district and sub-district levels

Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS)

The Government of India has initiated several healthcare schemes to provide best-in-class healthcare facilities to a number of low-income families in the country. One such health scheme implemented for the betterment of the people in the Indian state of Tamil Nadu is the Chief Minister’s Comprehensive Health Insurance Scheme.

Almost 65% of low-income families in Tamil Nadu get access to world-class healthcare facilities with cashless assistance under the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS), also known as Amma Health Insurance. Due to this, the people of Tamil Nadu do not have to undergo any financial struggle when seeking assistance during a medical emergency.

Makkalai thedi maruthuvam thittam

To provide healthcare facilities at the doorstep of the poor residents of Tamil Nadu, the respected chief minister MK Stalin launched a new scheme on 5^th August 2021 known as Makkalai Thedi Maruthuvam Scheme. Under the Tamil Nadu Doorstep Healthcare Scheme, various facilities like physiotherapy-related therapies, testing, and providing medicine for non-communicable diseases will be provided to poor people.

INNUYIR KAPPOM THITTAM

Under Accident Victim Treatment Scheme, govt. Will provide free care to road accident victims in 609 government and private hospitals.

Tamilnadu government will offer free 81 life-saving procedures worth Rs. 1 lakh to accident victims in the first 48 hours of their hospitalisation

EDUCATION:

• Literacy rate in India as per Census 2011: 74%.
• Literacy rate: Male: 82.1%; Female: 65.5%
• Kerala tops the rankings, followed by Delhi, Maharashtra and Tamil Nadu.
• Bihar is the lowest among states, followed by Arunachal Pradesh, Rajasthan, Jharkhand etc., however, they are improving their position.
• Bihar has a literacy rate of 63.8%, and that of women is 53.3%.
• Pre-primary level: 5-6 years of age.

Primary (elementary) level: 6-14 years of age. Elementary-level education is guaranteed by our constitution under Article 21 A. For this level, the government has introduced Sarva Shiksha Abhiyan (SSA) under the Right to Education (RTE) Act.

Secondary level: Age group between 14-18. For this level, the government has extended SSA to secondary education in the form of the Rashtriya Madhyamik Shiksha Abhiyan.

Higher education: generally of three levels: UG→ PG→ MPhil/PhD. To cater to the requirements of higher education, the government has introduced Rashtriya Uchhattar Shiksha Abhiyan (RUSA).

Provisions in the Indian Constitution:

Under Article 45 in DPSP, it was mentioned that the government should provide free and compulsory education for all children up to the age of 14 years within 10 years from the commencement of the Constitution. As this was not achieved, Article 21A was introduced by the 86^th Constitutional Amendment Act of 2002, making elementary education a fundamental right rather than a directive principle. And Article 45 was amended to provide for early childhood care and education to children below the age of six years.

To implement Article 21A, the government legislated the RTE Act. Under this act, SSA – Sarva Shiksha Abhiyan – got a further impetus. SSA aims to provide Universalization of Elementary Education (UEE) in a time-bound manner.

Right to free and compulsory education act

86^th Amendment Act 2002 introduced Article 21-A, which provides for free and compulsory education of all children in the age group of six to fourteen years as a Fundamental Right.

The Right of Children to Free and Compulsory Education (RTE) Act was enacted to implement this fundamental right.

British period:

WOOD’S DESPATCH OF 1854

It is also known as the ‘Magna Carta of English education in India’ was the first comprehensive plan to envisage mass education in India.

HUNTER COMMISSION ON INDIAN EDUCATION 1882

Transfer of control of primary education to the new district and municipal boards.

RALEIGH COMMISSION 1902

Viceroy Curzon believed that universities were the factories producing students with revolutionary ideologies; hence he constituted the commission to review the entire university education system in India. The recommendation of the commission led to the universities act of 1904.

INDIAN UNIVERSITIES ACT 1904

More attention to study and research in universities rather than revolutionary activities. The numbers of fellows were reduced and were to be nominated by the government. The government acquired veto power against university senate decisions. Stricter affiliation rules

WARDHA SCHEME OF BASIC EDUCATION BY THE INDIAN NATIONAL CONGRESS (INC)

1. Basic handicrafts should be included in the syllabus
2. First 7 years of school to be free and compulsory
3. Hindi as medium till class 7 and English from class 8 onwards

Independent India:

Radhakrishnan committee:

In 1948-49, the University Education Commission was constituted under Radhakrishnan. It moulded the education system based on the needs of an independent India.

Kothari commission:

1. Standardization of educational system on 10+2+3 pattern.
2. Establishment of Indian Education Service
3. To raise expenditure on education from 2.9% of the GDP to 6% by 1985.

National Educational Policy 1968:

1. Equalization of educational opportunities to achieve national integration and greater cultural and economic development.
2. Increase public expenditure of education to 6% of GDP.
3. Provide for better training and qualification of teachers.
4. Three-language formula

National Educational Policy 1985:

1. Launching of “Operation Blackboard” to improve primary schools nationwide.
2. IGNOU, the Open University, was formed.
3. The literacy rate of Tamil Nadu was 80.09%, of which the male literacy is 86.77% and female literacy is 73.14%.

T.S.R Commitee 2015:

1. Early Childhood Care and Education (ECCE) – children from four to five years of age – to be declared as a fundamental right.
2. All India Education Service.

Kasturirangan Report On School Education (Draft National Education Policy) 2019

Natioanl education policy 2020:

Curriculum framework:

1. The current structure of school education to be restructured based on the development needs of students.
2. 10+2+3 structure to be replaced by 5-3-3-4 design comprising: (i) five years of foundational stage (three years of pre-primary school and classes one and two), (ii) three years of preparatory stage (classes three to five), (iii) three years of middle stage (classes six to eight), and (iv) four years of secondary stage (classes nine to 12).
3. Public spending at 6% of GDP

The Right to Education Act, 2009 (RTE Act):

Expanding the ambit of the Act to all children between the ages of three to 18 years, thus including early childhood education and secondary school education.

Higher Education:

1. National Higher Education Regulatory Authority (NHERA)
2. The policy aims to increase GER to 50% by 2035
3. Allowing Foreign Universities: The document states universities from among the top 100 in the world will be able to set up campuses in India.

Education in Tamil Nadu:

1. The literacy rate of Tamil Nadu was 80.09%, of which the male literacy is 86.77% and female literacy is 73.14%. The sex ratio of Tamil Nadu was 996 females per 1000 males, which is much above the national average of 940.
2. Tamil Nadu has 37 universities, 500 engineering colleges, 482 degree colleges, 75 medical colleges, 5 ayurveda colleges, 80 catering and hotel management colleges, 12 dental colleges, 10 homeopathy colleges, 125 management colleges, 42 nursing colleges, 7 colleges of occupational therapy, 37 pharmacy colleges, 49 physiotherapy colleges, 203 polytechnics and 1 unani medical college

Illam Thedi Kalvi Scheme:

1. The very first purpose of the scheme is to provide the doorstep learning in order to compensate for the losses during the pandemic.
2. It aims for the enrollment of one lakh students from the state with the government schools.
3. The government will appoint volunteers. These volunteers will get selected from the school management committees.
4. The volunteers will reach the doorsteps in order to teach the students.
5. Students from 1 to 8 students are eligible

Ennum Ezhuthum Scheme:

1. This scheme was launched to bridge the learning gap among students aged under 8, caused as a result of COVID-19 pandemic.
2. It aims to ensure foundational numeracy and literacy by 2025.
3. Under the Ennum Ezhuthum Scheme, education department will distribute workbooks to students from Classes 1 to 3, in order to assess and bridge the learning gap.