1. Prologue
2. Constitutional provisions
3. FR
4. DPSP
5. Duties
6. 7^th Schedule
7. Bills/ Laws
   • Draft National Health Bill 2009.
   • Transplantation of Human Organs (Amendment) Bill, 2009
   • PCPNDT 2004
   • NCHRH Bill 2011
   • Draft Mental Healthcare bill, 2012
   • Draft DNA profiling Bill, 2012
8. Policies
   • National Population Policy 2000 (NPP)
   • National Blood Policy, 2002
   • National Policy on NDPS 2012
   • National Pharmaceutical Pricing Policy (NPPP) 2012
9. Committees related to drugs
10. Departments
11. Yearbook (schemes)
12. National rural health mission NRHM (2005)
13. National Health Mission
14. Family planning
15. Population state/UT
16. Government schemes for Family planning
17. Vasectomy vs Tubectomy
18. Contraceptives
    • RISYUG
    • Implanton
    • IUCD
    • KATNAL
19. Mother and Child
    • Definitions
    • TFR
    • MMR
    • IMR
    • Sex Ratio
    • Millennium Development goals (MDG): Health
    • Health Targets: Five Year plans
    • Janani Suraksha Yojana
    • Janani Shishu Suraksha Yojana
    • Indira Gandhi Matritva Sahyog Yojana (IGMSY)
    • Mother and Child Tracking system
    • Navjat Shishu Suraksha Karyakram (NSSK)
    • Challanges
20. School health program
21. SABLA
22. Weekly Iron Folic acid supplementation (WIFS)
23. ARSH
24. Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
25. Misc. programs/ initiatives
26. Health Insurance for BPL
27. Rashtriya Swasthya Bima Yojana
28. Annual Health Survey
29. AYUSH
30. Sowa Rigpa
31. Safety n Surveillance
32. Funds
33. Rashtriya Swasthya Bima Yojana (RSBY)
34. Swastha Bharat

Prologue

So far in the current affairs compilation

Persons in news, books, sports, Misc.GK	click me
Defense, missiles	click me
Sci-tech: Space tech, satellite launches	click me
Sci-tech: Healthcare/ public health related	In this article (3 parts)
Environment biodiversity	To be released
Economy	To be released

This series on Current affairs related to Public Health, contains three parts

1. Part 1: Polity, laws, policies, bills, yearbook (schemes)+ any current affairs related to that.
2. Part 2: Current affairs related to major diseases (AIDS, TB, Cancer, Heart), and other misc. science tech stuff from Hindu related to Healthcare. click me
3. Part 3: Mock questions based on part 1+2. click me

Constitutional provisions

FR	Article 21: life and liberty. It includes right to health, emergency medical aid, timely treatment in Government hospitals etc.
DPSP	Preserve health and strength of workers and children Opportunity for healthy Development of kids Public assistance for old age, sickness and disablement Maternity  relief Raise level of nutrition and improve public health Prohibit liquor and drugs consumption
Duties	Develop scientific temper (so one shouldn’t  go to Witchdoctor when his kid is ill nor he should prohibit a polio vaccine worker from giving “two-drops” to his kids.)

7^th Schedule

List	Matter
Union	Opium cultivation, mfg. and export Scientific/technical institutes of national importance.
State	Public health and sanitation Duties on opium, hemp and other narcotic drugs
Concurrent	Lunacy and mental deficiency Food adulteration Drugs and poisons Population control and family planning Medical education Legal, medical and other professions Infectious and contagious diseases

Bills/ Laws

Draft National Health Bill 2009.

• It aims to provide “right to health” as a legal right.
• Regulations related to good treatment, emergency care, etc.
• No individual should be denied emergency treatment because of he doesn’t have the fees / cannot get police clearance.
• Compulsory for the hospitals to address patient complaints.
• patient has the right to know name of doctor / nurse involved in his treatment, summary of the treatment. He can also complaint for over-charging of fees.
• A body to enforce the right to health.

Transplantation of Human Organs (Amendment) Bill, 2009

• Originally the Act was made in  1994: Transplantation of Human organ Act, 1994
• It’ll rename that act to “Transplantation of Human Organs and Tissues Act”.
• To regulate the removal, storage and transplantation of human organs and tissues.
• “near relative” can donate organ
• If the donor is not a “near relative” of the patient, then permission required from state Committee.
• Doctor has to inform and seek consent of donor
• Organ swapping allowed between a pair of donor-recipient. (e.g. family A has donor and willing recipient but their organs donot match medically then they can swap with another family B in similar situation IF donor from familyB’s organ is compatible with patient from family A and vice versa).
• Increased penalty for illegal organ removal and trade.

PCPNDT 2004

• Pre-conception and pre-natal diagnostic technique (PCPNDT)
• This act prohibits sex determination tests.
• Regulating the sale of ultrasound machines.
• Authorities can search, seizure and seal the machines and equipment of the clinics.

NCHRH Bill 2011

National Commission for Human Resources in Health (NCHRH) Bill

National Commission for Human Resources in Health (NCHRH)	This Commission will replace four existing (statutory) bodies for healthcare professionals viz. Medical Council of India, Dental Council of India, Pharmacists’ Council of India Nursing Council of India
National Board for Health Education (NBHE)	to facilitate academic studies and research. conduct a screening test doctors. An Indian citizen who wants to study medicine abroad has to obtain an eligibility certificate from NBHE.
National Evaluation and Assessment Council (NEAC)	Its recommendation necessary to open new educational institutions in medical and paramedical courses.

Bill also provides for

• Setting up a fund to finance above bodies.
• Penalties for educational institutes if they run courses without permission etc.

Parliamentary Standing Committee on Health and Family Welfare has rejected this bill in late 2012. WHY?

1. The new regulatory body doesn’t have provides any representation to state governments. (Even when Health is state subject)= federalism ignored.
2. Members will not be elected but nominated = democracy ignored.

Draft Mental Healthcare bill, 2012

• Provides the mental patients with right to treatment, information, Confidentiality. Legal aid etc.
• Provision for regulatory bodies at national and state level to enforce these rights.
• No punishment for Suicide Attempt
• Registration of mental healthcare establishments.

Draft DNA profiling Bill, 2012

• provides for a national database of DNA profiles. This database will be used for

1. crime detection
2. as an evidence in judicial proceedings

more details in old article click me

Policies

National Population Policy 2000 (NPP)

Short term	Provide contraception, health care infra, personnel, childcare
Medium term	Bring Total fertility rate to replacement level (=2.1) by 2010
Long term	Achieve stable population by 2045

To achieve above things, NPP policy formed National Socio-Demographic Goals for 2010.

1. Reduce IMR, MMR, school dropouts
2. Achieve universal immunization of children against all vaccine preventable diseases.
3. Promote delayed marriage for girls, not earlier than age 18 and preferably after 20 years of age.
4. Achieve 80 percent institutional deliveries and 100 percent deliveries by trained persons.
5. Provide contraceptives, counseling for family planning.
6. 100 per cent registration of births, deaths, marriage and pregnancy.
7. Reduce the spread of STD, HIV, communicable diseases.

National Blood Policy, 2002

1. National Blood Transfusion Council (NBTC) shall be the policy formulating apex body. NACO will give them money.
2. Similarly bodies @State/UT level
3. Drugs Controller General India will enforce the standards for blood products.
4. Trading in blood i.e. Sale & purchase of blood shall be prohibited.
5. All blood centres shall adhere to guidelines  given by Health ministry
6. Each blood centre shall create and update a blood donor’s directory which shall be kept confidential.
7. awareness, education, motivation to promote blood donation
8. strengthen manpower, encourage research –development, NGO involvement and other filler points.

Drugs & Cosmetics Act provides mandatory testing of blood for five major infections viz. HIV, Hepatitis B, Hepatitis C, Syphilis & Malaria. Every unit of blood is tested for all these infections.

National Policy on NDPS 2012

• NDPS= Narcotic Drugs and Psychotropic Substances
• drafted by the Ministry of Finance (and not health ministry)
• private sector may be allowed production of alkaloids (medical compounds) from opium.
• At present alkaloids from opium are produced only in Government Opium and Alkaloid Factories
• Policy also aims to reduce

Reduce	By
supply of narcotic drugs	use of satellite imageries to detect illicit cultivation of poppy and cannabis strategy to address drugs-peddlers at street level.
demand for narcotic drugs	periodic surveys of drug abuse recognition of de-addiction centers, provisions for treatment, rehabilitation and social re-integration of victims of drug abuse.

National Pharmaceutical Pricing Policy (NPPP) 2012

1962	Government started drug price control after China war
2004	Drug policy
2012	New pharmaceutical pricing policy.

• At present, the government through the National Pharmaceutical Pricing authority (NPPA) controls prices of 74 bulk drugs and their formulations.
• With this new policy, 348 essential drugs will be put under price control.

Committees related to drugs

Mashelkar	Drugs Regulatory System, spurious drugs.
Pranab Sen	Drug pricing

Departments

Health ministry has only four departments

1. Health And Family Welfare
2. AYUSH
3. Health research
4. AIDS control

Department of Pharmaceuticals falls under Chemical and fertilizer ministry (and not under Health ministry).

Yearbook (schemes)

Note: in part 1, we’ll only see general schemes. Specific disease related schemes/current affairs given in part 2.

National rural health mission NRHM (2005)

• Decentralized health delivery system in rural areas via ASHA workers, PRI, NGO, AYUSH paramedics etc.
• Provide Better infrastructure, availability of manpower, drugs and equipment etc.
• It has many components: e.g. Janani Suraksha Yojana, Vector borne disease control, Leprosy eradication, revised TB control, Blindness and Iodine deficiency.

National Health Mission

• In his 15^th August speech, Mohan had said that National Rural Health Mission will be converted into a National Health Mission (NHM).
• National Health Mission would cover all villages and towns in the country.

ASHA worker

Every village/large habitat has a female Accredited Social Health Activist (ASHA) – chosen by and accountable to the Panchayat- to act as the interface between the community and the public health system.
She is given a Drug Kit containing generic AYUSH and allopathic drugsfor common ailments. She also works for family planning, TB control etc. (and earns Commission).

Family planning

• Started in 1952
• Aim: reduce birth-rate to stabilize population at a level that is consistent with the requirements of economy. (Besides family planning is also necessary to stop the ridiculously high level of competition in every exam e.g. 17 Lakh people applied in SBI PO 2013 – for just 1500 vacancies.)

India % land in the world	2.4%
India % population of the world	17.5%
Population as per 2011 census	1.21 billion

Population state/UT

Top 3		Bottom 3
States	UT	States	UT
UP Maha Bihar	Delhi Chandigarh Puducherry	Sikkim Mizoram Arunanchal	Lakshdweep Daman Diu Dadra and Nagar Haveli

above Data based on page 130, Ch.14, Economic Survey 2012-13

Sex Ratio: 2001 vs 2011

year	2001	2011
0-6	927	914 (decreased)
overall	933	940 (increased)

Sex Ratio: Highest Lowest (Census 2011)

Top 3 (Highest)		Bottom 3 (lowest)
States	UT	States	UT
Kerala TN Andhra	Puducherry Lakshadweep Andaman Nicobar	Haryana JK Sikkim	Diu Daman Dadra Nagar Chandigarh

Sex ratio (Census 2011): Some points

• Child sex ratio (0-6) is lowest since independence. Only 914 female/1000 males.
• From 2001 to 2011, sex ratio decreased for these states: JK, Guj, Bihar, Uttarakhand
• Punjab and Haryana : sex ratio has increased from 2001 to 2011. (can be used for MCQ, because many candidates would “guess” that sex ratio would have decreased for Haryana from 2001 to 2011.)

Government schemes for Family planning

In villages, ASHA worker gets commi$$ion for

1. Delivering contraceptives at doorstep
2. Promoting couples to have time gap between two kids.
3. Promoting institutional delivery for pregnant women.
4. Encouraging couples to opt for permanent family planning (vasectomy, tubectomy.)

Plus,

• National family planning insurance scheme: it provides money to if person dies during vasectomy / tubectomy or if the surgery fails or some complication arises.

Vasectomy vs Tubectomy

Vasectomy	Tubectomy
Males	Females
vasectomy will take only few minutes. It does not require hospitalization	Lengthy surgery
Any plain MBBS with simple three-day training can do it.	tubectomy is done with the help of a laproscope, which means that only an expert and experienced doctor can do the job.
None	Risk of infections and menstrual complications like excessive bleeding and pain in the abdomen.
Men can go back to work immediately.	One month’s rest necessary

Issue: in rural areas, men force their wives to undergo tubectomy, rather than going through vasectomy themselves.

Because of two myths, that after vasectomy

1. Man loses libido after vasectomy
2. Man will not be able to do strenuous work or lift heavy objects.

Contraceptives

RISYUG	Reversible Inhibition of Sperm Under Guidance Long term male contraceptive. (injection) Research still going on. (IIT Kharagpur)
Implanton	Female contraceptive (sub-dermal rod) A matchstick-sized rod is inserted in the arm. It releases progestin hormone to prevent pregnancy.
IUCD	intrauterine contraceptive device (IUCD) for females. Made up of copper / plastic.

KATNAL

• Today Males have only two reliable birth control methods: 1) Condoms 2) Vasectomy. (male birth control pills haven’t picked up popularity yet).
• Katnal is the gene responsible for sperm development.
• Now scientists are working to design a birth control pill for men, that can control this Katnal gene.

Mother and Child

First some stats:

Item	All India (approx.)	Highest	Lowest
Life Expectancy @Birth	66	Kerala, Maha, Punjab	Assam,MP,UP
Infant Mortality	44	MP, UP, Odisha	Manipur, Goa,Kerala
Birth Rate	22	MP,UP,Odisha	Kerala, TN, Punjab
Death Rate	7	MP,Odisha,Assam	West Bengal,Maharashtra, Haryana

Data based on Page 124 and 128, Ch.14, Economic Survey 2012-13

If you’re facing any interview soon, do look at mugup the numbers for you state.

Definitions

What?	Definition	Data for India*
TFR	Total Fertility Rate average number of children born to a woman during her entire reproductive period. Our target is to get 2.1, that is replacement level TFR.	2.5
MMR	Maternal mortality ratio No. of maternal deaths per 1 lakh live births. Death must be due to pregnancy or within 42 days of termination of pregnancy	212
IMR	Infant mortality rate No. of infants dying before the first birthday.	44
Sex Ratio	No of females per 1000 males	914 (0-6) and 940 (overall)(Census 2011)

*Data Based on Page 228, Ch.13 of Economic Survey 2012-13.

Millennium Development goals (MDG): Health

• These eight goals are setup by United Nations.
• Member countries adopted these goals during the U.N. Millennium Summit, 2000
• These goals are to be achieved by 2015.

Goal No.	What
1	Poverty and hunger
2	primary education
3	Women empowerment
4	Reduce Child Mortality (27/1000 for India)
5	Maternal health (109/1 lakh live births for India)
6	HIV, TB, Malaria etc.
7	environmental sustainability
8	global partnership for development

Health Targets: Five Year plans

Health Targets	11th FYP	Right now	12th FYP
IMR /1000	28	44	25
MMR/1 lakh	100	212	100
TFR	2.1	2.5	2.1
Reduce malnutrition in Children (0-3 age)	Yes	Not good	Yes
Reduce anaemia in females by 50%	Yes	Not good	same
Increase sex ratio (0-6 age)	935 by 2011 and 950 by 2016	914	950

12^th Five year plan also talks about

1. Universal Health Coverage (UHC)
2. Prevent and reduce Communicable and Non-Communicable diseases (including mental illnesses)
3. Reduction of poor households’ out-of-pocket expenditure. (meaning State should give out more free medical services to them).
4. A large expansion of medical schools, nursing colleges.
5. And many other things, I suggest you read third PDF, Chapter 20 (Health) of 12^th FYP after prelim/CSAT is over.

Janani Suraksha Yojana

• Under National rural health mission
• Promote institutional (hospital) delivery among poor pregnant women
• 100% centrally sponsored

Janani Shishu Suraksha Yojana

• Pregnant women get free hospital delivery, caesarean section, food, drugs, medical checkup and transport.

Mother and Child Tracking system

• Under national E-governance plan (NeGP)
• Government  keeps maintains data of the mothers with their addresses, telephone numbers, etc.
• This contact database is used for ante-natal (before birth) and post-natal (immediately after birth) check-up of mothers and vaccination for their babies.
• Another similar project is Health Management Information System (HMIS): software for online data capture at district level, regarding reproductive and child health (RCH).

Navjat Shishu Suraksha Karyakram (NSSK)

• To train heathcare personnel for taking care of infants: hypothermia, infection, premature birth, pneumonia, diarrhea, measles, resuscitation etc.
• Setup new-born care units at district level hospitals.
• Started in 2005 to to reduce Infant Mortality Rate (IMR) from to 30 by the year 2012.

Indira Gandhi Matritva Sahyog Yojana (IGMSY)

• Launched by Women and Child Development Ministry (and NOT by Health Ministry)
• To compensate mothers for wage-loss during childbirth and childcare.
• Available to all women for first two children.
• Not available to women who get paid maternity leave.
• Conditional cash transfer.
• Condition: she should get pre-natal checkups, get vaccination for infant, attend counseling session etc.
• The scheme is now covered under the Direct Benefit Transfer (DBT) programme

Challanges

• Bogus Beneficiaries: A woman usually gives birth to a baby after nine months of pregnancy, but in Bihar almost 300 women claim to have delivered two to five children in a span of 60 days- as per the Government records!= bogus beneficiaries, local official chowing down the Government money.
• NRHM scam: worth thousands of crores rupees in Uttar Pradesh. Two chief medical officers died (or murdered) to keep a lid on the scam.
• Crib deaths: many infants died in the Government hospitals of West Bengal in 2012. Reason: they were already under-weight and got infection due to unhygienic condition in the Government hospitals. + manpower shortage
• Encephalitis: Hundreds of children died in Uttar Pradesh due to Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES). National Commission for Protection of Child Rights (NCPCR) concluded that Government’s casual approach was responsible for widespread deaths.

Rajiv Gandhi Crèche

• Scheme for the Children of Working/Ailing Mothers:
• Basically NGOs given money to setup crèche for working women
• Condition: family’s monthly income < 12k, and kid is within 0-6 age group

School health program

• Medical checkup
• Nutrition, iron supplements.

SABLA

• Man, this SABLA is getting too clichéd for MCQs.
• Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG)-Sabla:
• all-round development of adolescent girls in the age group 11-18 years.
• The scheme has two major components, 1) nutrition and 2) non-nutrition.

#1: Nutrition	Girls are given ‘take home rations’ or ‘hot cooked meals’ to out-of –school.
#2: Non-Nutrition	provided iron-folic acid supplementation, health check-up, health and skill education, vocational training etc.

Weekly Iron Folic acid supplementation (WIFS)

• To reduce Anemia in adolescents (age group 15 to 19)
• In both rural and urban areas.
• Pills for iron and folic acid given to boys (only school going)
• Girls (both school going girls + not school going girls)

ARSH

• Adolescent reproductive and sexual health
• Adolescent are more vulnerable to sex-abuse, STD, HIV, pregnancy.
• Government launched toll free helpline, tele-counciling for them
• +life skill education programs.

Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)

It has two objectives

#1: set up 8 new AIIMS-like institutions

1. Bihar (Patna),
2. Chattisgarh (Raipur),
3. Rajasthan (Jodhpur)
4. Madhya Pradesh (Bhopal),
5. Orissa (Bhubaneswar),
6. Uttaranchal (Rishikesh)
7. West Bengal
8. Uttar Pradesh

• Some books/ magazines / sites/ coaching material would say : PMSSY = 6 new AIIMs like institutions.
• But that information is outdated. Originally there were six, later Government added WB and UP.

#2: upgrade existing Medical colleges in several states.

Now steering committee on health for 12th Five Year Plan has recommended the Union government to create four new AIIMS like institutions

Misc. programs/ initiatives

1. Truma centers on national highways
2. National programs for fluorosis, deafness, elderly , tobacco, mental health etc.

Health Insurance for BPL

What?	Falls under this ministry
Health Insurance Scheme for BPL	Health
Rashtriya Swasthya Bima Yohana	Labour

Rashtriya Swasthya Bima Yojana (Rsby)

• RSBY provides for ‘cash-less’, smart card based health insurance cover
• Upto Rs.30000k per annum
• For family upto 5 members.
• The beneficiary family pays only 30 per annum as registration/renewal fee.
• The scheme covers hospitalisation expenses (Out-patient expenses are not covered),
• includes maternity benefit, and pre-existing diseases.
• Even in private clinics.
• Funding: centre –state=75:25 and 90:10 for Jammu Kashmir and North-East.
• RSBY was originally limited to Below Poverty Line (BPL) families but was later extended to building and other construction workers, MGNREGA beneficiaries, street vendors, beedi workers, and domestic workers.
• In Budget 2013, Chindu extended this scheme to rickshaw, auto-rickshaw and taxi drivers, sanitation workers, rag pickers and mine workers.

Annual Health Survey

• To prepare district health profile including IMR, TFR etc.
• Done by Registrar General of India for Health Ministry.

AYUSH

• A=Ayurveda
• Y=Yoga and Naturopathy
• U=Unani
• S=Siddha
• H=Homeopathy

Sowa Rigpa

• Latest addition in AYUSH system.
• ancient Tibetan medicinal system
• believed to have been taught by Buddha himself – Sowa Rigpa
• commonly known as Amchi system
• popular in the Himalayan region of India. Also in Tibet, Magnolia, Bhutan, some parts of China, Nepal.
• it is similar to Ayurveda, and also include few principles of Traditional Chinese Medicine.

AYUSH Regulation

• Ayurveda, Unani, Siddha and Homeopathy drugs are regulated under Drug and cosmetics Act 1940.
• Most of these drugs are manufactured from medicinal plant material, hence AYUSH department setup National medicinal plants board to regulate it.

Safety n Surveillance

FSSAI	Food safety standard authority of India Regulates food safety (both domestic and imported) It is a statutory body
CDSCO	Central Drug standard control organization Regulates quality of drugs and cosmetics (both domestic and imported)
Pharmacoviligance program	Monitors the adverse drug reactions
Whistleblower for spurious drugs	Govt. gives reward to any informer that solid  info spurious (fake/bogus) drugs to regulators.
Airport/ Port Health organizations	They monitor travellers at ports, prevent spread of epidemic diseases from one nation to another. They function under DG Health services.
Integrated disease surveillance project (IDSP)	World bank launching this program To detect and respond to drug outbreaks quickly. It collect data on epidemic diseases on weekly basis.

Funds

RAN	Rastriya Arogya Nidhi Setup under Health Ministry, 2007 Gives money to BPL patients suffering from life threatening disease.
Health Minister’s Cancer patient fund	Setup under RAN, 2009
Health Minister’s discretionary grant	Max Rs.50k For poor patient for life threatening diseases.

Rashtriya Swasthya Bima Yojana (RSBY)

• RSBY provides for ‘cash-less’, smart card based health insurance cover
• Upto Rs.30000k per annum
• For family upto 5 members.
• The beneficiary family pays only 30 per annum as registration/renewal fee.
• The scheme covers hospitalisation expenses (Out-patient expenses are not covered),
• includes maternity benefit, and pre-existing diseases.
• Funding: centre –state=75:25 and 90:10 for Jammu Kashmir and North-East.
• RSBY was originally limited to Below Poverty Line (BPL) families but was later extended to building and other construction workers, MGNREGA beneficiaries, street vendors, beedi workers, and domestic workers.
• In Budget 2013, Chindu extended this scheme to rickshaw, auto-rickshaw and taxi drivers, sanitation workers, rag pickers and mine workers.

Swastha Bharat

• Health program on doordarshan and all India radio.
• World’s Biggest Public Health Media Initiative
• Shown 5 days — a week in 19 Indian languages and 17 Dialects
• Supported by Union Ministry of Health & Family Welfare

This concludes first part. Here are the links to next parts

• Part 2 of 3: drugs, invention, NACO, Glivec etc.
• Part 3 of 3: mock questions based on part 1+2

In the third and last part, we’ll see the mock questions from part 1 and 2.

For more science-tech, public health, space tech and defense related current affairs, visit Mrunal.org/snt