IASbaba's Daily Current Affairs Analysis

IASbaba’s Daily Current Affairs (Prelims + Mains Focus)- 28th February 2018

(PRELIMS+MAINS FOCUS)

Changes made to Contract farming Bill

Part of: Mains GS Paper III- Indian agriculture

Key pointers:

The Agriculture Ministry has broadened the scope of the proposed Contract Farming Bill by bringing marketing and services into its ambit.
The States’ role in regulating the sector has been reduced.
The State’s role will be limited to protecting the interests of farmers and others who enter into contract with sponsors.
Similarly, the modified Bill doesn’t call for notification of commodities for which farmers and contract sponsors can get into a contract as envisaged in the previous draft.

Major objectives of the Bill:

Giving price protection to farmers.
Setting up a Board to promote contract farming at the State level, and
Creating a mechanism at district and taluka levels to legally record all contracts.

Main focus:

The Act needs to be passed by State Assemblies to become law in those States.
The bill was drafted by a committee led by Ashok Dalwai, CEO of the National Rainfed Agricultural Authority.
The Act is trying to create a competitive market and level playing field for both the public and private sector.

Article link: Click here

FATF places Pakistan on its watch list

Part of: Mains GS Paper II- Internal Security

Key pointers:

The Financial Action Task Force (FATF) that monitors countries on action taken against terror-financing and money-laundering has decided to place Pakistan back on its watch list, or “greylist”, from June.
The decision is both appropriate and overdue, given Pakistan’s blatant violation of its obligations to crack down on groups banned by the Security Council 1267 sanctions committee.
Their leaders like Hafiz Saeed and Masood Azhar continue to hold public rallies and freely garner support and donations.
Under the 1267 sanctions ruling, banned entities can get no funds, yet Lakhvi received the bail amount, and the authorities have since lost track of him.

Cause of concern:

The initial support for Pakistan came from China, Saudi Arabia, Turkey and the Gulf Cooperation Council countries is cause for concern in New Delhi, given the recent diplomatic outreach by India.

Way ahead:

Pressure needs to be build up with financial strictures on Pakistan’s banks and businesses.
Targeted sanctions must be imposed against specific law enforcement and intelligence officials.

Such sanctions will persuade Pakistan to stop state support for these terror groups and become a responsible player on the global stage and a responsive neighbour.

Article link: Click here

(PRELIMS+MAINS FOCUS)

HEALTH

TOPIC: General Studies 2:

Issues relating to development and management of Social Sector/Services relating to Health

Development processes and the development industry the role of NGOs, SHGs, various groups and associations, donors, charities, institutional and other stakeholders

The “Healthy States, Progressive India” report

Introduction:

The “Healthy States, Progressive India” report has been released recently.
The focus has been on the performance and annual progress of states and Union territories on a myriad of health indicators.

About the report:

The comprehensive Health Index report titled, “Healthy States, Progressive India” was released by NITI Aayog.
The report ranks states and Union territories innovatively on their year-on-year incremental change in health outcomes, as well as, their overall performance with respect to each other.
It is the first attempt to establish an annual systematic tool to measure and understand the heterogeneity and complexity of the nation’s performance in Health.
The report has been developed by NITI Aayog, with technical assistance from the World Bank, and in consultation with the Ministry of Health and Family Welfare (MoHFW),

Best and worst performers:

Kerala is the leader among large states, closely followed by Punjab and Tamil Nadu. Uttar Pradesh, Rajasthan and Bihar are the least-performing states. Mizoram is the best-performing small state, followed by Manipur, while Nagaland and Tripura take the final two spots. Lakshadweep secured the top spot among Union territories, and Dadra and Nagar Haveli is at the end of the rankings.

Incremental performance:

The goal of the index is not just to rank the states based on their historical performance, but also on their incremental performance.
The attempt is to capture the change made during the course of the year.
Jharkhand, Jammu and Kashmir, and Uttar Pradesh are ranked first, second and third in their incremental performance ranking.

The “Performance on Health Outcomes” index:

The index is made up of 24 indicators in three different domains—
Health outcomes, Governance and information, and Key inputs and processes. The “health outcomes” account for 70% of the weight, and the other two domains weighs 12% and 18%, respectively.

The “health outcomes” domain has indicators such as total fertility rate (TFR), neonatal mortality rate (NMR), sex-ratio at birth (SRB), etc.
The governance and information domain measures the quality of data (data integrity indicator) and the average occupancy in important health-related posts such as principal secretary (health), chief medical officer, etc.
Key inputs and processes measure the current status of healthcare professional vacancies, infrastructure at district hospitals, and the speed of financial governance in the states.

Key results that emerge from the health index:

Pic credit: http://www.livemint.com/r/LiveMint/Period2/2018/02/28/Photos/Processed/g_Oped_Table_web.jpg

There are large gaps between states.
The gap between the best-performing states and the least-performing states.(Refer Image)
Two-thirds of our citizens live in states with an overall score less than 60.
Incremental performance reveals that there has been a decline in performance on some states: While most states have registered an increase in their health index in 2015-16 relative to 2014-15, six states’ scores have declined—Kerala, Haryana, Gujarat, Karnataka, Himachal Pradesh, and Uttarakhand.
India has made significant strides in achieving the goals set out under the UN-SDG and our own National Health Policy.
Some of our states have already met or exceeded the goals a decade ahead of 2030.

Lessons from the health outcomes index:

An exercise of this kind requires data on health outcomes, which is periodic, reliable and comparable across different states and Union territories.
The effort showed us significant gaps in the availability of such data, especially for the smaller states.
We need robust programmatic data than can be used for continuous monitoring.
Incentives need to be linked to performance.
The two separate rankings, on absolute performance and year-on-year progress are designed to encourage states to work on their health sector and bring about meaningful transformation.
The linking of the health index with incentives under the National Health Mission will further push states to improve outcomes.
This index must motivate states towards improving their health sector outcomes in the spirit of cooperative and competitive federalism.

Conclusion:

Measures like upgrading and setting up of health and wellness centres under the Ayushman Bharat Scheme, the National Health Protection Scheme and annual publication of the Index and its availability on public domain on a dynamic basis will help us realize the goal of “good health and well-being” for all citizens(SDG3).

Connecting the dots:

What are the key results from the “Healthy States, Progressive India” report released recently. Also discuss key lessons.

HEALTH

TOPIC: General Studies 2:

Issues relating to development and management of Social Sector/Services relating to Health

Development processes and the development industry the role of NGOs, SHGs, various groups and associations, donors, charities, institutional and other stakeholders

National Health Protection Scheme: Challenges

Background:

The National Health Protection Scheme (NHPS), announced in the latest budget, is being hailed as the world’s largest public healthcare programme, which will cover about 40 per cent of India’s population. While any public effort at providing free healthcare to the poor is welcome, this is not the first public health insurance programme in the country.
Many states, including Maharashtra, Karnataka, Rajasthan, Andhra Pradesh, Goa and Tamil Nadu, have successfully implemented health insurance programmes, easily covering over 50 crore people.

Challenges:

NHPS will have to consider many critical aspects.

Total cost-
There is a token provision of Rs 2,000 crore in the budget. However, the total cost is likely to be nearer Rs 20,000 crore per year. A new 1 per cent cess will make about Rs 11,000 crore available to the government in a year.
Identification of the initial 10 crore families-
Any criteria, other than family income, will cause a huge discontent.
How will a village-level functionary select 40 per cent of the people and leave out the rest? Will these remaining families be covered later?
The government could alternately consider a universal roll-out for all the poor households, even at a lower level of maximum insurance cover, depending on the resource availability.
The list of medical procedures to be covered in the scheme-
Disease profile varies across the country.
Each state must be given the flexibility to curate its own list of medical procedures.
Selecting the insurance provider–
This is an extremely complex process.
Each step — such as the design of the tender documents, contracts and legal agreements, payment terms, penalties for non-compliance, prior experience — must be considered carefully. Otherwise, it could invite legal challenges.
The accreditation of participating hospitals–
If due care is not taken in selecting the right hospitals, it can derail the entire programme.
The Rashtriya Swasthya Bima Yojana (RSBY) is a glaring example- Many private hospitals registered under the RSBY were reported to have indulged in malpractices such as prescribing unnecessary diagnostic testing and hospitalisation.

Way forward:

Implementation of such a large health insurance scheme will require humongous preparation in the creation of infrastructure such as central data centre, software development, data entry, issuance of health cards, call centers for pre-authorisation, and claims settlement, hospital accreditation and online accounting.
Trained personnel (aarogya mitra) must be posted in each of the participating hospitals.

Conclusion:

Insurance-based intervention in the health sector can only be a partial solution. The government cannot, and must not, abdicate its responsibility of providing a high-quality and affordable public health infrastructure.

Connecting the dots:

The National Health Protection Scheme (NHPS), announced in the latest budget, is being hailed as the world’s largest public healthcare programme. Discuss the associated challenges and the way out.