THE SOCIAL ISSUES, SOCIAL JUSTICE AND HEALTH

1. KERALA TOPS IN MATERNAL, CHILD HEALTH

THE CONTEXT: Kerala has yet again emerged on top when it comes to maternal and child health, with the State recording the lowest Maternal Mortality Ratio (MMR) of 30 (per one lakh live births) in the country. This puts Kerala way ahead of the national MMR of 103.

THE EXPLANATION:

According to the latest Sample Registration System (SRS) special bulletin on maternal mortality in India (2017-19), brought out by the office of the Registrar General of India, Kerala’s MMR has dropped by 12 points. The last SRS bulletin (2015-17) had put the State’s MMR at 42 (later adjusting it to 43).

• The report highlighted that,India’s maternal mortality ratio (MMR) improved to 103 per 100,000 live births for the period 2017-19.
• However, the MMR worsened in states like West Bengal, Haryana, Uttarakhand, and Chhattisgarh. Populous states such as Uttar Pradesh, Rajasthan, Bihar and Madhya Pradesh showed major improvement with decrease in their MMR by 30, 23, 19 and 10 points, respectively. These states continue to have high level MMRs despite the improvement.
• The top state with the lowest MMR is Kerala, which dramatically improved from 43 to 30. Kerala is followed by Andhra Pradesh, Telangana, Tamil Nadu, and Maharashtra.
• Despite the dip in MMR, Madhya Pradesh, India’s second largest state by area, continues to be the third worst-performing state in this regard, following Assam (205) and Uttar Pradesh (167). Besides, more than 80% of births in MP took place in institutional facilities, according to National Family Health Survery (NFHS)-5.

Value Addition:

• Maternal death is the MMR is a key health indicator that shows the number of maternal deaths per 100,000 live births for a given period. According to the World Health Organization, “Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.”
• One of the targets under the Sustainable Development Goals (SDG) set by the United Nations aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births. India now seems close to achieving that goal much before the target year of 2030.

Interventions for improving Maternal Mortality Rate (MMR):

• Janani Suraksha Yojana (JSY), a demand promotion and conditional cash transfer scheme was launched in April 2005 with the objective of reducing Maternal and Infant Mortality by promoting institutional delivery among pregnant women.
• Janani Shishu Suraksha Karyakram (JSSK) aims to eliminate out-of-pocket expenses for pregnant women and sick infants by entitling them to free delivery including caesarean section, free transport, diagnostics, medicines, other consumables, diet and bloodin public health institutions.
• Surakshit Matratva Ashwasan (SUMAN) aims to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting the public health facility to end all preventable maternal and newborn deaths.
• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women fixed day, free of cost assured and quality Antenatal Careon the 9thday of every month.
• Comprehensive Abortion Care services are strengthened through trainings of health care providers, supply of drugs, equipment, Information Education and Communication (IEC) etc.
• Midwifery programme is launched to create a cadre for Nurse Practitioners in Midwifery who are skilled in accordance to International Confederation of Midwives (ICM) competencies and capable of providing compassionate women-centred, reproductive, maternal and new-born health care services.

Interventions for improving Infant Mortality Rate (IMR):

• Anaemia Mukt Bharat (AMB) strategy as a part of POSHAN Bhiyan aims to strengthen the existing mechanisms and foster newer strategies to tackle anaemia which include testing & treatment of anaemia in school going adolescents & pregnant women, addressing non nutritional causes of anaemia and a comprehensive communication strategy.
• Rashtriya Bal Swasthya Karyakaram (RBSK): Children from 0 to 18 years of age are screened for 30 health conditions (i.e. Diseases, Deficiencies, Defects and Developmental delay) under Rashtriya Bal SwasthyaKaryakaram (RBSK) to improve child survival. District Early Intervention Centres (DEICs) at district health facility level are established for confirmation and management of children screened under RBSK.
• Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative implemented since 2019 for reduction of Childhood morbidity and mortality due to Pneumonia.
• Universal Immunization Programme (UIP) is implemented to provide vaccination to children against life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningitis caused by Haemophilus Influenzae B. The Rotavirus vaccination has also been rolled out in the country for prevention of Rota-viral diarrhoea. Pneumococcal Conjugate Vaccine (PCV) has been introduced in all the States and UTs.

THE ENVIRONMENT AND ECOLOGY

2. THE LARGEST WINTERING GROUND OF THE INDIAN SUBCONTINENT

THE CONTEXT: Chilika Lake, the largest brackish water lake and wintering ground of the birds in the Indian subcontinent saw a million birds, including uncommon Mongolian gull, visiting the waterbody.

THE EXPLANATION:

• Chilika lake hosts birds migrating from thousands of miles away from the Caspian Sea, Lake Baikal, Aral Sea, remote parts of Russia, Kirghiz steppes of Mongolia, Central and South-East Asia, Ladakh and the Himalayas. The winged guests find the vast mud-field and abundant fish stock here suitable to congregate.
• As per the waterbird status survey-2022 conducted in the Chilika, a total of 10,74,173 birds of the 107 waterbird species and 37,953 individuals of 76 wetland-dependent species were counted at the entire lagoon. In the year 2021, the count in Chilika was over 12 lakh. Bird census members reported rare sightings of the uncommon Mongolian gull.
• The census was undertaken jointly by the Odisha State Wildlife Organisation, the Chilika Development Authority (CDA) and the Bombay Natural History Society. The Chilika Lagoon was divided strategically into 21 segments for the census.
• A total of 3,58,889 birds (97 species) were counted in the Nalabana Bird Sanctuary inside Chilika – a decrease of 65,899 from the year 2021. The decrease is attributed to high water levels and the presence of water in cultivated fields in adjoining areas.
• “Among the three pintail species of ducks, the northern pintail (1,72,285), gadwall (1,53,985), Eurasian wigeon (1,50,843) accounted for over one lakh in this year’s count,” says the report. However, the population of gadwall and Eurasian wigeon was less than that of the year 2021.
• There was a marginal decrease in the number of species such as the northern shoveler, tufted duck and red-crested pochard. An increase in the population of northern pintail, common coot and common pochard was noticed.
• “The increase in numbers for the greater flamingo at Nalabana mudflat indicates that the restoration at Nalabana is effective. This year’s greater flamingo count was the highest in the last decade. It is largely due to appropriate management of mudflats”. Overall, the local resident species such as purple swamp-hen, purple heron, Indian moorhen, and jacanas were found in higher numbers.

Value Addition:

Significance of Chilika Lake:

• After the New Caledonian barrier reef, it is Asia’s largest and world’s second-largest brackish water lagoon.
• A lagoon is a shallow body of water that is isolated from a larger body of water by a narrow landform like reefs, barrier islands, barrier peninsulas, or isthmuses.
• It has been designated as a Ramsar Site and a possible UNESCO World Heritage Site.
• Chilika Lake was declared as the first Ramsar Convention wetland of international importance in India in 1981.
• Satapada Island, Irrawaddy dolphins are frequently seen.
• In 1987, Nalabana Island (Forest of Reeds), a 16-square-kilometre island in the lagoon, was designated as a bird sanctuary.
• It covers an area of nearly 1,100 km2 and is located at the mouth of the Daya River, which flows into the Bay of Bengal.

THE SCIENCE AND TECHNOLOGY

3. THE SARAS 3 RADIO TELESCOPE

THE CONTEXT: Indian researchers have conclusively refuted a recent claim of the discovery of a radio wave signal from cosmic dawn, the time in the infancy of our Universe when the first stars and galaxies came into existence.

THE EXPLANATION:

• In 2018 a team of researchers from Arizona State University (ASU) and MIT in the US detected a signal from stars emerging in the early universe using data from the EDGES radio telescope. The study published in the journal Nature created much excitement in the astronomy community around the world.
• ASU/MIT team had claimed the discovery of a radio wave signalling the birth of the First Stars, which was also hailed by Harvard astrophysicist Avi Loeb as worthy of two Nobel prizes.
• Utilising the indigenously invented and built SARAS 3 radio telescope, researchers from Raman Research Institute, an autonomous institute of the Department of Science & Technology, Govt. of India refuted this claim.

Findings:

• The finding implies that the detection reported by EDGES was likely contamination of their measurement and not a signal from the depths of space and time. SARAS 3 was indeed the first experiment to reach the required sensitivity and cross-verify the claim of the signal detection.
• However, astronomers still do not know what the actual signal looks like. Having rejected the ASU/MIT claim, the SARAS experiment is geared towards discovering the true nature of Cosmic Dawn. The SARAS 3 team at RRI is planning more observations on remote lakes in India. Such expeditions will allow the team to detect the 21-cm signal from the Cosmic Dawn and unravel this last remaining gap in the history of our Universe.

Why is it difficult to detect radio wave signals early period of the Universe?

• Detecting a faint signal from such an early period of the Universe is extremely difficult. The celestial signal is exceptionally faint – buried in sky radio waves that come to us from the gas in our own Galaxy, the Milky Way, which are a million times brighter.
• Besides, this cosmic signal is in a radio wavelength band used by numerous terrestrial communications equipment and TV and FM radio stations, which makes detecting the extra-terrestrial signal extremely difficult.

 Value Addition:

SARAS 3 radio telescope

SARAS is a niche high-risk high-gain experimental effort of RRI initiated by RRI, it is an to design, build and deploy in India a precision radio telescope to detect extremely faint radio wave signals from the depths of time, from our “Cosmic Dawn” when the first stars and galaxies formed in the early Universe.

What is Cosmic Dawn?

One of the most important gaps in our understanding of our Universe’s history is the “Cosmic Dawn.” The period from about 50 million years to one billion years after the Big Bang when the first stars, black holes, and galaxies in the Universe formed.

Significance:

The requirements for these telescopes will push both technology boundaries and our knowledge of environmental effects at target destinations for human exploration. Such issues as trafficability in antenna deployment, space plasma effects, thermal shocking of electronics and mechanical systems, as well as power, survivability, and operation during lunar nights have direct applicability to exploration. The design of these observatories to conduct decadal-level research will provide some technology solutions for exploration.

4. THE NEW GENOMICC RESEARCH PROJECT

THE CONTEXT: Scientists in the United Kingdom as part of a research project, GenOMICC (Genetics of Mortality in Critical Care), have identified 16 new genetic variants that make a person more susceptible to a severe COVID-19 infection.

THE EXPLANATION:

Scientists have developed a powerful, inclusive new tool for genomic research that boosts efforts to develop more precise treatments for many diseases by leveraging a better representation of the genetic diversity of people around the world.

What is the GenOMICC study?

• It is a research study that brings together clinicians and scientists from around the world to find the genetic factors that lead to determine the outcome in critical illnesses.
• While millions suffer from infectious diseases every year, even though most cases are mild, some people become extremely unwell and need critical care. This may be because of their genes and the GenOMICC project is about identifying them.

Methodology

The scientists involved compare the DNA of critically ill patients with members of the general population. However, ferreting out such differences requires a large number of people and comparing their genetic structures at multiple levels of resolution. Since 2015, the GenOMICC has been studying emerging infections such as SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), flu, sepsis, and other forms of critical illness.

How was the GenOMICC study for COVID-19 done?

The scientist sequenced the genomes of 7,491 patients from 224 intensive care units in the United Kingdom. Their DNA was compared with 48,400 other people who had not suffered from COVID-19, and that of a further 1,630 people who had experienced mild symptoms. Determining the whole genome sequence for all participants in the study allowed the team to create a precise map and identify genetic variation linked to severity of COVID-19.

What are the key findings?

• The team found key differences in 16 genes in ICU patients compared to the DNA of the other groups. It also confirmed the involvement of seven other genetic variations already associated with severe COVID-19 discovered in earlier studies by the same team.
• The 16 new genetic variants included some that had a role in blood clotting, immune response and the intensity of inflammation. A single gene variant, the team found, disrupted a key messenger molecule in immune system signalling — called interferon alpha-10 — that increased a patient’s risk of severe disease.
• There were variations in genes that control the levels of a central component of blood clotting — known as Factor 8 — that were linked with critical illness in COVID-19. This highlights the gene’s key role in the immune system and suggests that treating patients with interferon, which are proteins released by immune cells to defend against viruses, may help manage disease in the early stages.

How useful are these findings?

• The overarching aim of genome association studies is to not only correlate genes but also design treatments. For instance, the knowledge that interferons play a role in mediating a severe infection is already being used in drug therapies in the management of severe COVID.
• Genomics studies reveal an association with certain conditions but don’t necessarily explain how the genes direct the chain of chemical reactions that bring about an adverse outcome. But the knowledge of the gene helps to design targeted drugs.
• New technologies, such as CRISPR, allow genes to be tweaked or silenced and therefore this approach could be used to make new medicines. The GenOMICC study isn’t the only one of its kind. Several consortia globally are working on identifying genes that may explain different disease outcomes.

THE GOVERNMENT SCHEMES/INITIATIVES IN NEWS

5. LAQSHYA PROGRAM

Ministry of Health & Family Welfare, Government of India launched an ambitious program LaQshyaon in 2017 with following objectives:

• Reduce maternal and newborn morbidity and mortality
• Improve quality of care during delivery and immediate post-partum period
• Enhance satisfaction of beneficiaries, positive birthing experience and provide Respectful Maternity Care (RMC) to all pregnant women attending public health facilities.

Target Beneficiaries:

LaQshya program will benefit every pregnant woman and new-born delivering in public health institutions. Program will improve quality of care for pregnant women in labour room, maternity Operation Theatre and Obstetrics Intensive Care Units (ICUs) & High Dependency Units (HDUs).

Following facilities are being taken under LaQshya initiative on priority:

• All Government Medical College hospitals.
• All District Hospitals & equivalent healthy facilities.
• All designated FRUs and high case load CHCs with over 100 deliveries/60 (per month) in hills and desert areas.

Significance:

• The percentage of institutional births in India has doubled from 38.7% to 78.9% in the decade 2015-16, according to the National Family Health Survey (NFHS-4). However, this increase in coverage has not translated in commensurate reduction of maternal and newborn mortality and stillbirths.
• One of the major factors being inadequacies in the quality of care provided in health facilities. The current figures of maternal mortality ratio of 130and neonatal mortality rate of 24 suggest that though there has been tremendous improvement in maternal newborn healthcare indicators, there still exists a vast scope to achieve the targets set for our country.
• It is estimated that approximately 46% maternal deaths,over 40% stillbirths and 25% of under-5 deaths take place on the day of the delivery. Half of the maternal death each year can be prevented if we provide higher quality health care. Quality of care is increasingly recognized as a critical aspect of the unfinished maternal and newborn health agenda, mainly with respect to care around labour and delivery and in the immediate postnatal period.
• In this respect, Ministry of Health and Family Welfare has launched program ‘LaQshya’- quality improvement initiative in labour room & maternity OT, aimed at improving quality of care for mothers and newborn during intrapartum and immediate post-partum period.

6. VIBRANT VILLAGE PROGRAMME

THE CONTEXT: The Union government plans to open the villages along the Chinese border for tourists under the Vibrant Village programme announced in the Union Budget 2022-23.

THE EXPLANATION:

• Recently the Ministry of Home Affairs (MHA) held a meeting with public representatives of such villages from the States of Himachal Pradesh, Uttarakhand, Sikkim, Arunachal Pradesh and the Union Territory of Ladakh.
• A Parliamentary Committee on Home Affairs in its December 2021 report had recommended that all villages in Ladakh, particularly those located in Zero-Border like Chumar and Demchok, should be electrified “in order to stop migration of people from these areas.”
• According to the report, of 236 habitable villages in Ladakh, only 172 have telecom infrastructure and “only 24 and 78 villages have 3G and 4G Internet connectivity” respectively.

About the Vibrant Villages Programme

• The Vibrant Villages programme is launched to improve infrastructure in villages along India’s border with China. Infrastructure will be improved in states like Uttarakhand, Himachal Pradesh, and Arunachal Pradesh.
• Under the programme, residential and tourist centres will be constructed.
• It will also provide for improvement in road connectivity and development of decentralized renewable energy sources.
• Direct access of Doordarshan and education related channels will be provided. Support will be provided for livelihood.

SIGNIFICANCE:

• China has established several new villages along the LAC in the past few years particularly across the Arunachal Pradesh border.
• The Vibrant Village programme was a counter to China’s model villages but the nomenclature has been carefully chosen so as to not cause any consternation in the neighbouring country. China and India have been engaged in a standoff at multiple locations in Eastern Ladakh fo the past two years and in one of the violent clashes with the China’s Peoples Liberation Army (PLA), as many as 20 Indian soldiers were killed.

THE PRELIMS PRACTICE QUESTIONS

QUESTIONS OF THE DAY 14^TH MARCH  2022

Q. Which of the following space agencies have cooperated for building the International Space Station?

1. NASA of the U.S.
2. China National Space Administration
3. Roscosmos of Russia
4. JAXA of Japan
5. Indian Space Research Organisation
6. Canadian Space Agency
7. European Space Agency

Select the correct answer using the codes given below:

a) 1, 2, 3, 4 and 6 only

b) 1, 2, 3, 5, 6 and 7 only

c) 1, 3, 4, 6 and 7 only

d) 1, 2, 3, 4, 5, 6 and 7

ANSWER FOR 12^TH MARCH 2022

ANSWER: A

EXPLANATION:

• The Biological Weapons Convention (BWC) effectively prohibits the development, production, acquisition, transfer, stockpiling and use of biological and toxin weapons. It was the first multilateral disarmament treaty banning an entire category of weapons of mass destruction (WMD).The Convention has reached almost universal membership with 183 States Parties and four Signatory States.
• India ratified this treaty in 2015. India is not the founding member of BWC.

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