Daily News




Table of Content

  • GS-2 Social Justice
    • Healthcare in India has made great progress, but challenges remain
  • Fact File
  • New Reservation Policy by Karnataka Government
  • When lightning travels from ground to sky: How upward streamers work

Healthcare in India has made great progress, but challenges remain

GS-2: Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources.


The Indian healthcare system has successfully overcome seemingly insurmountable challenges over the years, which were once considered hopeless.


In 2007, national and international demographers predicted that India would achieve a total fertility rate of 2.1 (replacement level) only by 2041, but India achieved this by 2020. Similarly, maternal and infant mortality rates were expected to persist until as late as 2010.


Despite the evidence that showed the need for hospital deliveries, the traditional belief was that the traditional dais were the only option. However, the latest NFHS-5 findings reveal that even in the so-called BIMARU states, hospital deliveries have increased to 89 per cent.


Despite these achievements, India is facing certain major challenges such as Non-communicable diseases (NCDs), Infrastructure, Health insurance, Artificial Intelligence (AI) and digital technology. Since, India has the youngest population for more than three decades, and to fully redeem this advantage, tough health challenges must be confronted.


Challenges faced by the Indian Healthcare system

Non-communicable diseases (NCDs)

  • Cardiovascular diseases (CVDs), cancers, chronic respiratory diseases (CRDs) and diabetes are increasing in India, and they all share four behavioural risk factors — an unhealthy diet, lack of physical activity and use of tobacco and alcohol.
  • The proportion of deaths due to NCDs has increased from around 38 per cent in 1990 to 62 per cent in 2016.
  • Obesity has increased from 19 per cent to 23 per cent between NFHS-4 and NFHS-5, in both urban and rural areas.
  • Building awareness and promoting healthy lifestyles can prevent millions from illness and premature death.


  • The state of infrastructure matters, and since 2018, governments have been trying to bolster primary healthcare by establishing health and wellness centres.
  • However, there are huge variations between states, with some having better arrangements than others.
  • In urban areas, there is a gap in hospital services between large urban agglomerations and tier II and tier III cities.
  • People have to rely on the private sector, which owns two-thirds of the country’s hospital beds.
  • Large hospital chains account for just 4-5 per cent of the beds in the private sector, and standalone hospitals and nursing homes provide 95 per cent of private hospital beds.
  • Making the centrally-run hospitals and district hospitals fully functional is imperative.

Health insurance

  • Low health insurance penetration and high Out of Pocket expenditure on healthcare are problems in India.
  • However, more than four crore Indians have bought health insurance over the past three years, and the Ayushman Bharat insurance scheme for 10 crore poor families has been undertaken.
  • Nearly 74 per cent of Indians are either covered or eligible for health insurance coverage, which is a game-changer from the pre-2018 situation.
  • Out-patient doctor consultation costs, diagnostics, and drugs account for the biggest chunk of out-of-pocket personal expenditure.

Artificial Intelligence (AI) and digital technology

  • The use of AI and digital technology in healthcare is an emerging concern.
  • Surgery assisted by robots, the use of genetic codes, clinical judgements based on algorithms are examples of AI and digital technology in healthcare.
  • The challenge is to balance the benefits of technology with the ethical concerns.


Building awareness and promoting healthy lifestyles, improving infrastructure, increasing health insurance coverage, and balancing the benefits of technology with ethical concerns are essential to address these challenges.


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Fact File

New Reservation Policy by Karnataka Government

Context: Banjara, Bhovi, Koracha, and Korama communities are protesting against the new Reservation Policy.

New Reservation Policy

  • The policy aims to increase the Scheduled Castes and Tribes (SC/STs) quotas by 2% and 4%, respectively in education and jobs.
  • Currently, Karnataka provides 32% reservation for OBCs, 15% for SCs and 3% for STs that adds up to 50%.
  • The move will breach the ceiling of 50% reservation determined in the Indra Sawhney case, 1992.
  • The only way for Karnataka to hike the SC/ST quota is via the Schedule 9 which protects laws included in it from judicial scrutiny.
  • Earlier, Tamil Nadu did it under Schedule 9 to increase reservations to 69%.
  • According to the proposal, out of the 17 per cent reservation for SCs –
  • 6% has been awarded to the ‘SC Left’ group, which consists of the most backward of communities, including Madigas.
  • The less backward ‘SC Right’ category, which has around 25 communities such as Holeyas, got 5.5% of the quota.
  • Touchable’ communities such as Banjaras and Bhovis got 4.5%.
  • The other SC communities got the remaining 1%.
  • The government withdrew the 4% reservation available to Muslims in the backward classes category and distributed it to the dominant castes of Lingayats and Vokkaligas — taking their quota to 5% and 7%, respectively.
  • Under the new reservation policy, Muslims have been placed under the Economically Weaker Sections (EWS) reservation category, where they would compete with Brahmins, Jains, Vaishyas, and other non-backwards for a 10% quota.

When lightning travels from ground to sky: How upward streamers work

Upward Lightening

  • Upward lightning refers to positive electrical discharges that travel from lightning conductor rods towards negative discharge from lightning in the clouds.
  • This process requires storm electrification and a cloud charge region as contributing factors.
  • Tall objects with heightened vertical elevation amplify the electric field in the immediate area, creating favorable conditions for the initiation of an upward streak, also known as a leader.
  • The leader can also form in response to an electric field change triggered by a preceding lightning flash nearby.
  • This rapid flow of electrical charge creates a bright flash of light that we perceive as lightning, releasing a tremendous amount of energy in the form of heat, light, and sound.
  • Upward lightning is just one mechanism by which lightning can occur, with other processes including rocket-triggered lightning and ground lightning.

Process of lightening: Stepped Ladder Trigger

  • Stepped ladder trigger is triggered by the development of the stepped leader, a channel of negative charge that travels downward from a cloud.
  • As the stepped leader approaches the ground, the electrical charges between its tips and tall objects on the ground increase, ionizing the air above these objects.
  • This ionization creates a positively charged upward streamer that streaks upward towards the cloud.
  • The negatively charged stepped leader makes contact with the positively charged upward streamer, completing the lightning channel.
  • Charges can flow rapidly from the cloud to the ground, producing a bright flash of lightning in just a fraction of a second.


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