Healthcare in India

SDG 3: Ensure healthy lives and promote well-being for all at all ages
By 2030, reduce the global maternal mortality ratio to
India’s SDG-Target-2030: Reduce mmr to less than 70, Under 5 mortality to 25, Annual tb reported
case to zero per 100,000 live births

Health statistics India

 As per National Family Health Survey 4(2015-2016)
 Average life expectancy 67.5 years
 Maternal Mortality Rate in India has dropped from 167 in 2011 to 130 per 1 lakh females as
per NFHS 2015
 under 5 child mortality rates (India 50 per 1000 live births, MDG – 42).
 Infant mortality (death under 1 year) 41 per 1000
 India’s neonatal mortality rate (2016) is 25.4/1000

UN's assessment of India between 2014-16 in the report The State of Food Security and
Nutrition in the World

 14.5% of the total population is undernourished

 21.5% Children under five suffer from wasting in 2016.
 38.5% children under five are stunted
 51.4% women of reproductive age are anaemic
As per the global hunger index (by IFPRI), India ranks 78th among 118 developing
countries with staggering 39% being stunted that is low height for age
According to National family health survey 2015-16 (NFHS-4), 38.4% of children under the
age of five are stunted and 21% are wasted  9.5% overweight and 3% obese
 53.1 % of All women age 15-49 years who are anaemic i.e. half the female population are
anaemic
 21% of Mothers who had full antenatal care
 Institutional births in hospitals was 78%. However, this is a massive improvement from the
previous health survey conducted a decade ago in 2005 which had 38%. This is mostly the
result of Janani Suraksha Yojana
 12% of the female population of the country suffers from repeated pregnancy (80% of their
productive life is spent in pregnancy) & lack of nutrition
 53.5% married women in age (15-49) use Family Planning Methods
 The number of contraceptives has increased, but is far from reaching the 100% mark

Non communicable diseases statistics

 Most of the premature death is due to four NCDs —cardiovascular diseases, cancers,
chronic respiratory diseases, and diabetes. Many other NCDs, such as neurological,
skin, genetic disorders, disabilities etc., are closely associated with these four major
NCDs
 Obesity has reached 13% and is increasing. India is the third most obese country in
the world. Obesity is plaguing children, who often become overweight due to factors
like lack of physical activity, unhealthy eating habits, increasing reliance on
convenience foods and hormonal issues
  By 2030, India is expected to be the diabetes capital of the world
 WHO report and Lancet study shows in India, cases increased from 11.9 million in
1980 to 64.5 million in 2014
 Non-communicable disease contributes to 60% of total deaths in 2017 rising from
45.4% of deaths in 2004-06
 Cardiovascular diseases are the biggest killers within NCDs. They account for 23.3%
of all deaths
 Mental disorders: The World Economic Forum estimated that India stands to lose
$4.58 trillion before 2030 due to NCDs and mental health conditions

Introduction
 Healthcare has become one of India’s largest sectors - both in terms of revenue and
employment
 India’s accounts for close to 10% of the global pharmaceutical industry in terms of
volume. This number goes to 20% for generic-drug exports by volume.
 It has been one of the highest sources of foreign exchange for India owing to its
relatively inexpensive healthcare systems, trained healthcare personnel,
indigenous healthcare systems like Yoga, Naturopathy
 The Indian healthcare market, which is worth US$ 100 billion meaning 5% of GDP,
will grow at a CAGR of 23 percent to US$ 280 billion by 2020
 It offers employment to 4% of the population
 India s total healthcare expenditure is 4.3% of its GDP out of which government
expenditure is 1.6%
 According to 71st National Sample Survey (NSS) total private hospitalization share in
rural and urban areas is 58% and 68% respectively
 Public healthcare system provided by government consists of primary healthcare
centres (PHCs) in rural areas, secondary and tertiary healthcare institutions in key
towns and cities.
 Private sector primarily caters to secondary, tertiary and quaternary care

Challenges in Healthcare Sector

 Rural-Urban disparity: Rural India accounts for 70% of the population but accounts
for only 30% of the healthcare services. This shows a huge demand-supply gap in the
rural areas. Private sector is highly concentrated in urban India
 Weak primary health care sector and Infrastructure: Substandard primary health
centres with issues in sanitation and Hygiene. There is also the issue of high regional
disparities in Primary health services. India compares unfavourably with China and
US in the number of hospital beds and nurses. There is one government hospital bed
for every 614 people in Goa compared with one every 8,789 people in Bihar
 Inadequate Healthcare Personnel: India has one of the lowest doctor to population
ratio (1:1700) which is far less than the recommended 1:1000 by WHO. In addition,
there is a clear rural-urban divide, regional divide, gender-divide
 Low government spending: Public expenditure on health accounts for only 1.2% of
the total health expenditure which is abysmally low when compared to WHO
recommendation of 5%. India’s per capita expenditure is only Rs 3 per day on each
citizen.
 Apart from this, the funding pattern is skewed i.e. in favour of curative and
communicable diseases despite the fact that non communicable diseases form 60%
of the health burden
 To fill this gap private sector has boomed which has come with its own set of
problems.
 Due to low government spending people are taking route towards private sector
which is costly and drives low income people to poverty
 High out of pocket expenditure: An overwhelming 60% of healthcare expenses in
India are met by out of pocket expenditure in-spite of India being the Global
Pharmacy of the World
 Insurance: 80% of Indians do not have health insurance. Government contribution
to insurance is just 32%. Low insurance penetration forces people to spend out of
pocket
 Weak Regulatory Framework, governance and accountability: India’s regulatory
framework for health remains in shambles. The nodal agency i.e. Medical Council of
India (MCI) has been marked by corruption, nepotism and favouritism
 Medical Education: While Indian-educated healthcare professionals are world
renowned, medical education in India has been dismal due to the same non
regulatory mechanism
 Weak regulatory mechanism has led to Malpractices in the sector: Selling
substandard and counterfeit medicines, unnecessary hospital admissions and
exploitation especially in private sector
 Fragmented health information systems: The systems of collecting healthcare and
patient data is not coherent and integrated. Non convergence between private and
public healthcare has led to incomplete information of number of births, deaths,
previous treatments etc.
 Irrational use of drugs: Taking medicines without prescription is a major concern as
it is leading to drug resistant bacteria and pathogens
 Status of Indigenous systems: While, there has been increasing emphasis on
indigenous system of Yoga, Ayurveda etc., their supporting system for
implementation remains weak
 Social Reasons:
 Healthcare can’t be seen in isolation but needs to be studied in a social context.
The poor state of healthcare in India is also because of wide poverty, lack of gainful
employment, ignorance, illiteracy, poor status of women, problem of open
defecation and poor sanitation facilities
 Discrimination on the basis of diseases is also a huge problem in Indian society esp in
case of TB, leprosy, HIV/AIDS, etc
  Increasing in Modern Diseases increase individualism, reproductive health facilities,
urban lifestyle, exam pressure, work pressure, corporate culture is giving way to new
challenges in healthcare discourse and rise of non-communicable diseases
 In India, lifestyle diseases like diabetes, anxiety disorder, depression etc. are
becoming major challenges especially in urban areas
 Also, India’s aged population has reached 100 million and is predicted to grow only
more. However, Indian healthcare continues to be abysmally underprepared for
geriatric health care

STEPS TAKEN

Constitutional Provisions

 Supreme Court in its various judgements has declared right to health within the
purview of Article 21 of Indian constitution.
 Apart from, this several article in Part Part-IV (Directive Principles) Article 39(e), 41,
42, 47 and 48 call upon State to strengthen healthcare system in India
Legislations, Schemes and Policies for healthcare

 National Health Policy 2017: It aims at providing healthcare in an “assured manner”

to all by addressing current and emerging challenges arising from the ever changing
socio-economic, epidemiological and technological scenarios
 Intensified Mission Indradhanush: It is aimed at reaching each and every child under
two years of age and all those pregnant women who have been left uncovered under
the routine immunisation programme
 Ayushman Bharat: It envisages a Rs 5 lakh annual insurance cover at no cost to 10
crore households, with the joint collaboration of both central and state governments
 Growing impetus on reviving indigenous healthcare system. Government has
launched National AYUSH Mission and Yoga day has been officially declared as a
global annual exercise
 Jan Aushadhi stores to provide low cost generic medicines
 Kayakalp scheme and Swacch Swasth Sarvatra for sanitisation and hygiene in
primary health centres
 National deworming initiative, National dialysis service program in all district
hospitals
 PM suraksha matritva abhiyan for legal and safe delivery in hospitals
 National program for control of cancer, diabetes, cardiovascular and non-
communicable diseases
 The Mental Healthcare Act, 2017 passed by the government takes a rights-based
approach to all aspects of mental healthcare
  National health stack, national health repository have been launched for better
health information system, electronic documentation and records of health care
system in the country
 National Rural Health Mission with Janani suraksha yojana etc for reducing mmr
and imr

Efforts of Civil Society Organisations

 Smile India foundation - It is aimed at bringing quality healthcare services to

doorsteps of the needy and to promote healthcare awareness.
 Rural Health Care Foundation - It is aimed at addressing the gap in the availability of
low-cost primary health care in rural areas.
 Seva Nilayam - It is working in partnership with the Government of Tamil Nadu an
objective to reduce the maternal mortality rate

Mohalla Clinics Model

Mohalla Clinics are primary health centres in the state of New Delhi that offer a basic
package of essential health services including medicines, diagnostics, and consultation free
of cost
These clinics serve as the first point of contact for the population, offer timely services, and
reduce the load of referrals to secondary and tertiary health facilities in the state

WAY FORWARD
conventional reforms

 expenditure, strengthening public health systems, strengthening health regulation

 Population stabilisation programs
 Even distribution of health personnel, health centres, better resource planning
 While the conventional reforms are indispensable, some areas of reforms which
haven’t been given adequate attention but are important and can be game-changer

Emerging Areas to initiate reform

Shift to Preventive healthcare: India’s health system continues to be guided by curative
healthcare. There is a need to shift to preventive healthcare which is more inclusive,
cheaper and offers a better life experience
Change in conception of Health

 There is a need to view health not as absence of illness but a state of well being.
There is a need to shift from hospital-centred model of health.
 Thus, the value system needs to be re-oriented to inculcate importance of sports,
right surroundings, right food, right sleep etc
Women as agency of health: One of the major ways of reforming healthcare has been
through agency of Women. Amartya Sen in his capability approach has highlighted how
Women empowerment has led to significant improvements in fertility rates, IMR and
MMR
Use of technology

 Information Technology can be a huge game changer in healthcare sector. New

technologies like Big Data for health information system, Artificial Intelligence and
Machine Learning can enable to strengthen and enhance the reach healthcare
delivery.
 States like Odisha, Chhattisgarh etc. are now using telemedicine for strengthening
healthcare delivery.
 India needs to put more emphasis in research and innovation especially in
biotechnology to build low cost affordable vaccines which can enable the
healthcare to be more affordable, available and accessible
Use of SHGs, PRI and Strengthening of ANMs, ASHAs

 There is a need to develop decentralized institutions like SHGs, PRIs for delivering
health since they are the first point of contact with the citizens
 Apart from that the ASHA, the Dai with traditional skills and modern hygiene, the re-
skilled ANM and the ICDS workers, should be trained together to form a multi-
skilled team at the village level

Rejuvenating our indigenous systems

 While there has been an increasing focus on Yoga and AYUSH, the supporting and
regulatory systems for the policy initiatives continue to remain weak.
 There is also need for further research into these systems to make them in-line
with needs of today.
 For e.g. Recent studies have shown the use of turmeric in fighting cancer and
depression
Learning from other successful models/examples
 Countries like Bangladesh, Thailand, Performance-based financing in Rwanda have
developed successful healthcare model.
 Even within India, states like Kerala, Karnataka, Andhra Pradesh etc. have developed
successful healthcare model.
 These models be replicated and moulded to suit India
Bridge Courses
 While there has been an attempt to introduce bridge courses for AYUSH doctors for
allopathy medicine.
 There is also a need for bridge course for allopathy doctors for AYUSH
Ethics
 There is also need to inculcate ethical values of selfless service, truthfulness,
confidentiality, autonomy, informed consent and justice in healthcare
professionals.
 Apart from that even the patient needs to be more sensitive about the position of
healthcare professionals
CONCLUSION

 Indian healthcare currently stands at a critical juncture.

 To attain the SDG goals 2 and 3 India must attain nutrition security along with food security
 To borrow Amartya Sen analogy, India’s healthcare represents a islands of California
(achievements) in a sea of sub-Saharan Africa (Challenges).
 There is a need for overhaul of healthcare sector in India. This also includes a complete
different perception of healthcare, where it is seen as a process, as a part of life.
 In today’s world, where people are running after wealth, where wealth has
become the ultimate desire, it is important to go back to what, Mahatma Gandhi
said, “It is only health, that is the real wealth and not pieces of gold and silver”

NATIONAL HEALTH POLICY 2017

Targets under NHP 2017

 Increasing life expectancy to 70 years from 67.5 years by 2025

 reduce infant mortality rate to 28 by 2019
 reduce under five mortality to 23 by 2025
 reduce Total Fertility Rate to 2.1 at the national and sub-national levels by 2025
 Maternal Mortality Ratio from current levels to 100 by 2020
 Reduce neo-natal mortality to 16 and stillbirth rate to “single digit” by 2025.
 Reduce disease burden of India (from current 1/5th of the burden in world)

Provisions
 Strengthening role of public sector by increasing public health spending to 2.5% of
GDP by 2025 from current 1.15%. States should spend 8% of more of their budget
towards health by 2020
 Transition from communicable to non-communicable diseases: NHP recognizes
need for state intervention to control NCDs as they are reason for more than 60%
death in India. Thus, policy advocates pre-screening and sets the target to reduce
premature mortality via NCDs by 25% by 2025
 Collaborating & regulating the private sector which has grown tremendously since
2002, such that over 2/3rd services are provided by it. Policy seems to be patient-
centric, as it proposes National health care standards organization (NHCSO) to lay
down standards and protocol and Tribunals for redressal of grievances
 Shift from sick-care to wellness: NHP seeks to invest in preventive healthcare by:
early screening and diagnosis have been made a public responsibility
commitment to pre-emptive care to achieve optimum levels of child and adolescent
health through school health programmes and focus on health and hygiene in
curriculum
advocates 2/3rd or more allocation of health budget for Primary Health Care
assuring comprehensive primary health care through the Health and Wellness
Centers'
  Intersectoral approach involving various ministries such as MoEf, MoHWS, MoA,
MoUD, MoHRD, MoWCD etc.
 Urban Health Case: prioritizes addressing the primary health care needs of the
urban population with special focus on poor populations, convergence among the
wider determinants of health – air pollution, vector control, reduction of violence
and urban stress.
 Affordable quality healthcare for all by ensuring following
Universal access to drugs and diagnostics, emergency and essential health services
providing every family with a health card for PHC services
Establish public health management cadre in all states
 Mainstreaming AYUSH systems by three-dimensional integration encompassing
cross referrals, co-location and integrative practices across systems of medicines in
both rural and urban areas

NON-COMMUNICABLE DISEASES
Non communicable diseases statistics
 Most of the premature death is due to four NCDs —cardiovascular diseases, cancers,
chronic respiratory diseases, and diabetes. Many other NCDs, such as neurological,
skin, genetic disorders, disabilities etc., are closely associated with these four major
NCDs
 According to WHO report of 2015 Obesity has reached 13% in India and is increasing.
India is the third most obese country in the world. Obesity is plaguing children, who
often become overweight due to factors like lack of physical activity, unhealthy
eating habits, increasing reliance on convenience foods and hormonal issues
 Lancets National Nutrition Monitoring Bureau (NNMB) report raised concerns
about double burden of malnutrition, that is, underweight as well as obese
children in India. India has the second highest number with 14.4 million children
with excess weight
 By 2030, India is expected to be the diabetes capital of the world
 WHO report and Lancet study shows in India, cases increased from 11.9 million in
1980 to 64.5 million in 2014
 Non-communicable diseases contribute to 60% of total deaths in 2017 rising from
45.4% of deaths in 2004-06
 Cardiovascular diseases are the biggest killers within NCDs. They account for 23.3%
of all deaths
 Mental disorders: The World Economic Forum estimated that India stands to lose
$4.58 trillion before 2030 due to NCDs and mental health conditions
Reason for Rising Non communicable or lifestyle diseases
Four behavioural risk factors are responsible for significant proportions of these diseases
— tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol

 Although cereal consumption has reduced in compared to 3 decades ago but intake
of fat, sugar and oil have increased
  Oil standards - standard of 5% (by weight) for trans-fats in fat spreads, hydrogenated
vegetable oils etc. is high as compared to global best practices as countries are
moving towards near zero
 No proper regime of eating, sleeping & doing physical activity is followed
 Traditional foods are being replaced with packed & processed foods
 Sedentary urban lifestyle, over reliance on processed food, exam pressure, work
pressure, corporate culture is giving way to new challenges in healthcare discourse
and rise of non-communicable diseases
 Vicious cycle of poverty and NCDs: NCDs and their risk factors worsen poverty, while
poverty, isolation, marginalization, and discrimination contribute to rising rates of NCDs,
poses a threat to public health and socio-economic development
 No regulation on advertisements promoting junk food. Teenagers are most affected
 No basic labelling regulations - The current nutrition labelling does not declare
salt/sodium, added sugar and saturated fats on a mandatory basis. There is no
mandatory provision for nutrient declaration per serve. Rather, it is optional with per
100 gm of product
 Mental disorders are too often not included in basic UHC packages: It leads to an
exceptionally large gap in treatment
 Failure in converting their Commitments: into legislative and regulatory measures sustained
investments, or in financing for NCD programmes consistently. This will have enormous
health, economic, and societal consequences in all countries
 No policy guidelines to reduce obesogenic environments in schools and promoting
healthy foods and lifestyle even after 2015 Delhi High Court order to FSSAI to issue
guidelines for the same

Steps taken by government

 WHO has developed a comprehensive Global Monitoring Framework and Action

Plan for prevention and Control of NCDs (2013-2020)?
 The Framework includes a set of nine voluntary targets and 25 indicators which can
be applied across regional and country settings
 India is the first country globally to adopt the NCD Global Monitoring Framework and
Action Plan to its National Context
 The WHO Mental Health Atlas to provide a comprehensive, longitudinal, monitoring
of the mental health system performance
 In 2015, a specific NCD target within SDG target 3.4 was adopted which is a one-
third reduction of premature NCD mortality by 2030 through prevention and
treatment of NCDs and the promotion of mental health and well-being.
 25x25 strategy where Member States agreed to a 25% reduction in premature NCD
mortality by 2025
 WHO has released a step by step guide for the industry to eliminate trans fats from
the food by 2023. The guide, called REPLACE, has six actions which include Review
of dietary sources of trans fats, promoting replacement with healthier fats, Assessing
and monitoring trans fats content in food, setting up regulatory framework etc .
 The Government of India is implementing various NCD programmes as under
through the State Governments
  National Programme for Prevention and Control of Cancer, Diabetes,
Cardiovascular Diseases & Stroke (NPCDCS). National Programme of Health Care of
Elderly (NPHCE). National Iodine Deficiency Disorders Control Programme
(NIDDCP). National Programme for Control of Blindness (NPCB). National Mental
Health Programme (NMHP). National Programme for Prevention and Control of
Deafness (NPPCD).
 From 2013-14 onwards, the interventions up to the district level for prevention,
detection, diagnosis and treatment under NCDs programmes have been brought
under the umbrella of National Health Mission (NHM). A flexi pool of funds for Non-
Communicable Diseases (NCD) has been created
 The current permitted level of trans fat is 5 per cent (by weight) in India. FSSAI has further
proposed to limit the maximum amount of trans fat in vegetable oils, vegetable fat and
hydrogenated vegetable oil to 2 per cent to make India trans-fat free by 2022.
 Heart Attack Rewind: It's a mass media campaign by FSSAI, calling for the
elimination of industrially produced trans-fat in the food supply
The Food Safety and Standards Authority of India (FSSAI) recently organised the Swasth
Bharat Yatra, a key element of the ‘Eat Right India Movement
 It is multi-sectoral effort with primary focus on daily intake of salt, sugar, fat,
phasing-out trans-fats from diets and promoting healthier food options
 It brings together three ongoing initiatives of FSSAI that target citizens
 The Safe and Nutritious Food (SNF) Initiative, The Eat Healthy Campaign and Food
fortification

Way forward

 The focus of addressing NCDs should be behavioural change at the family and
community levels, promoting healthy dietary practices, physical activity,
prevention of smoking, alcohol and pollution, starting early in life. This will require
the engagement of sectors outside health
 The recently adopted Sustainable Development Goals offers an excellent opportunity
to bring focus on NCDs and multi-sectoral action. A tactical partnership between the
public and private sectors can help the government ameliorate the debilitating
conditions that communities are currently facing
 Awareness - Promotion of school-based cardiovascular health programs to dispel myths that
CVDs are problem of the aged only
 Regulation of marketing and advertisements of unhealthy foods, particularly those
targeted at children, that are high in salt, sugar and fat
 Labelling - the role of positive front of pack and standardised global nutrient
labelling on packaged foods may help in promotion of healthy foods and lifestyle
 Change in dietary pattern required with more fibre and protein and less of sugar
and starch.
 Increase taxes on sugary drinks for prevention of diseases such as diabetes
 Early detection and effective treatment must be routinely available in primary
healthcare centres
  Prioritizing interventions: within the overall NCD and mental health agenda, based on public
health needs. For e.g. comprehensive tobacco control, comprehensive cardiovascular
prevention and treatment programmes etc
 Re-orienting health systems: to ensure that the national UHC public benefit package includes
NCD and mental health services, strengthen primary health services to ensure suitable
coverage and synergise existing chronic-care platforms to jumpstart NCD and mental health
care
 Urban planning should support safe and pleasurable physical activity and activities
like green urban transport to create enough space for cycling and walking

ISSUES RELATED TO NUTRITION

UN's assessment of India 2014-16 in the report The State of Food Security and Nutrition
in the World

 14.5% of the total population is undernourished

 21.5% Children under five suffer from wasting.
 38.5% children under five are stunted
 51.4% women of reproductive age are anaemic
 This report puts India at 10th spot in underweight and 17th spot in stunted children
among 193 countries
As per the global hunger index (by IFPRI), India ranks 78th among 118 developing countries
with staggering 39% being stunted that is low height for age
According to National family health survey 2015-16 (NFHS-4),
38.4% of children under the age of five are stunted and 21% are wasted
9.5% overweight and 3% obese
Lancet study raised concerns about double burden of malnutrition, that is, underweight as well as
obese children in India
53.1 % of All women age 15-49 years who are anaemic i.e. half the female population are anaemic

Reasons for Hidden Hunger

Hunger especially hidden hunger−related poverty remains one of the major deprivations of India.
An even greater cause of concern is the status of malnutrition among children

 It results not just from a lack of food but from a diverse set of interlinked factors
linking healthcare, education, sanitation and hygiene, access to resources, women’s
empowerment and thus requires multidimensional interventions
 For poor, Insufficient intake of both macro and micro-nutrients cause
malnourishment. Since food security in India is primarily focused on providing rice
and wheat only, the diet lacks other essential nutrients and results into stunting etc.
 For urban, it is the sedentary lifestyle of poor diet, processed food with sugar and fat
etc.
 Only 17% children achieved a minimum level of diet diversity.
 Acute food insecurity in tribal and rural households is due to a loss of their
traditional dependence on forest livelihood and the State’s deepening agrarian crisis.
 Systemic issues and a weakness in public nutrition programmes which focus on food
security and not food nutrition
Hunger related Poverty due to Governmental deficits
 Poor fiscal capacity of the government due to tax evasion and avoidance versus
large population combined with corruption at all levels of administration and lack
of understanding the nature of poverty
 Despite a variety of approaches, programmes and schemes to alleviate poverty;
hunger, malnourishment, illiteracy and lack of basic amenities continue to be a
common feature in many parts of India. While Indian committees point at a figure of
22% BPL, the MPI index points at 30%
 Though the policy towards poverty alleviation has evolved in a progressive manner,
over the last five and a half decades, it has not undergone any radical transformation
 However, none schemes and programs have resulted in any radical change in the
ownership of land and assets, process of production and improvement of basic
amenities to the needy.
 Due to unequal distribution of land and other assets, the benefits from direct
poverty alleviation programmes have been appropriated by the non−poor
 Compared to the magnitude of poverty, the amount of resources allocated for
these programmes is not sufficient.
 Moreover, Rural Poverty alleviation programmes depend mainly on low level
government, bank officials, local shop dealers and retailer for their
implementation. Such officials have vested interests, are ill motivated,
inadequately trained, corruption prone and vulnerable to pressure from a variety
of local elites. Therefore, the resources are wasted and diverted to open markets.
There is also non−participation of local level institutions in programme
implementation
 Due to meagre allocation of resources and faulty policy designs, the overall impact of ICDS
over malnutrition has remained very limited.
 Since food is nutrition deficient in ICDS as well, children are facing the problem of hidden
hunger i.e. prevalence of Iodine, calcium, iron or Vitamin A deficiency
 FOCUS reports (Focus on Children Under Six Report by Right To Food Campaign NGO) show
that corruption is the main reason for failure of ICDS in removing malnutrition.
 It was found that ‘panjiri’ (ready-to-eat energy mix) meant for children is being used illegally
to feed the cattle of rich and influential in Uttar Pradesh. Rampant corruption, fudged
records and bland panjiri has become the reality of ICDS
 MDM is falling prey to private contractors. Also, political leaders and influential business
people have formed SHGs and mahila mandals to gain such contracts
 The cooks in government schools do not wear caps or gloves, and are not checked for
disease
 Most of the states, it was observed, did not follow the guidelines of Government of India
to deliver food grains at the school point by PDS dealer, thereby resulting in the leakage
of food grains
 Deficiencies in PDS due to corruption, leakages, divergence of food grains meant for
poor
 The nutrition expenditure as a percentage of the Budget has drastically declined in
many states
 Therefore, Undernutrition is also both a consequence as well as a cause of
perpetuating poverty. The already malnourished BPL mother has a high probability
 of conceiving a undernourished child. Further this child due to ineffective cognitive
and physical development will be a weak human capital and will be unable to exit
from his malnutrition. Thus, it is vicious circle of poverty and hunger through
irreversible and intergenerational effects.
 This intergenerational cycle of undernutrition, manifest as low birth weight, is
compounded by gender discrimination and social exclusion. Nutrition status of the
most vulnerable age group of children is also a sensitive proxy indicator of human
development and of the effectiveness of national socio-economic development
strategies

Government Reforms

 The ICDS, which caters to the needs of pregnant and nursing mothers and children
under the age of six;
 the mid-day meal scheme, which directly feeds approximately 120 million
schoolchildren every day; and
 the public distribution system, which makes available subsistence rations to above
and below poverty line families
However, these are mostly focused on food security rather than nutrition therefore
Government initiated National Nutrition Mission
National Nutrition Mission
Implementation and Target
 It would be executed with the Ministry of Women and Child Development (WCD)as
the nodal ministry along with Ministry of Drinking Water and Sanitation and Ministry
of Health and Family Welfare.
 This is to enable integration of nutrition-related interventions cutting across sectors
 The mission has a target to reduce stunting, under-nutrition, and low birth weight by
2 per cent per annum, and anaemia by 3 per cent annually.
 It aims to focus mainly on children up to the age of 6 years, pregnant and lactating
women, and adolescent girls.
 It would also strive to achieve reduction in stunting from 38.4% (NFHS-4) to 25% by
2022 (Mission 25 by 2022).
 It will be implemented in three phases: 2017-18, 2018-19 and 2019-20. 315 ‘high
burden’ are to be covered in the first phase, 235 in next and the remaining in last

National Nutrition Strategy Provisions

 NNM as an apex body will monitor, supervise, fix targets and guide the nutrition
related interventions.
 Decentralised Approach- With this the Strategy aims to strengthen the ownership of
PRIs and urban local bodies over nutrition initiatives
 Governance reforms envisaged in the Strategy include: (i) convergence of state and
district implementation plans for ICDS, NHM and Swachh Bharat, (ii) focus on the
 most vulnerable communities in districts with the highest levels of child
malnutrition, and (iii) service delivery models based on evidence of impact
 Mapping of various schemes contributing under malnutrition
 National Nutrition Surveillance System- Undernourished endemic zones of the
country will be mapped for identifying ‘high risk and vulnerable districts
 ICT (Information and Communication Technology) based real time monitoring
system
 Incentivising states/UTs for meeting targets
 Incentivising Anganwadi Workers (AWW) for using IT based tools and eliminating the
need for registers
 Measurement of height of children at Anganwadi Centres
 Nutrition Social Audits are to be undertaken to track the children and their health
progress
 Setting-up Nutrition Resource Centres
Food Fortification in India to achieve nutrition
 Food fortification is the deliberate addition of one or more micronutrients to food so as to
correct or prevent a deficiency (Hidden Hunger: Deficiency of Micronutrients)
 Food fortification is a “complementary strategy” and not a replacement of a balanced &
diversified diet to address malnutrition
 Fortification is being promoted through both open market and government schemes
like ICDS, MDMS, PDS,etc.
 In National Nutrition Strategy (Kuposhan Mukt Bharat), food fortification has been
given a major thrust.
 FSSAI has operationalised standards for fortification of:
wheat- flour-rice (with iron, Vitamin B12 and folic acid)
milk & edible oil (with Vitamins A and D)
double-fortified salt (with iodine and iron).
 It has also introduced the +F logo to identify fortified foods.
 It has also launched the Food Fortification Resource Centre (FFRC) to promote large-
scale fortification of food across India
 Indian Food Laboratory Network system (INFoLNET): It’s an initiative with bringing all
the stakeholders to a common platform for the establishment of a transparent food
testing network by FSSAI.
Food Safety and Standards (Fortification of Foods) Regulations, 2018
 It has prescribed standards for fortification of various food products such as All
fortified foods must not fall below the minimum level of micro nutrients
 Quality assurance:
 Every manufacturer and packer of fortified food shall give an undertaking on quality
assurance
 random testing of fortificants and fortified food
 Every package of fortified food shall carry name of the fortificant and the logo to
indicate.
 The Food Authority shall take steps to encourage the production, manufacture,
distribution, sale, and consumption of fortified food
Policy Recommendations to tackle hunger and malnutrition

 Prioritize resilience and adaptation among the most vulnerable groups and regions
 Empower families, children and young people to demand nutritious food: Stimulating
demand for nutritious foods means not only educating consumers on the benefits of
healthy diets, but also leveraging cultural and social aspirations
 Drive food suppliers to do the right thing for children: Demand alone is not enough;
healthy food must be available, affordable, safe and convenient. Governments must
create a level playing field for all producers and suppliers and help ensure that their
actions align with children’s best interests
 Transform food systems: Governments must promote sustainable production systems,
consumption of nutritious foods, and reduction of food loss and waste
 Build healthy food environments for all
 Mobilize supportive systems to scale up nutrition results: The health; water and
sanitation; education; and social protection systems must all deliver interventions in a
coordinated fashion
 A systems approach to children's nutrition can help ensure that children and families have
access to healthy diets and that children receive the nutrition services they need to
develop to their full potential
 Collect, analyse and use good-quality data and evidence regularly to guide action and track
progress
 Address inequalities: Measures to reduce poverty and existing inequalities are key to
building resilience to the effects of climate change among the most vulnerable people.
Therefore, governments must significantly increase investments in rural development,
social protection, health services, and education

MENTAL HEALTH
WHO defines mental health as a state of mental well-being in which people cope well with the many
stresses of life, can realize their own potential, can function productively and fruitfully, and are able to
contribute to their communities
Status of Mental Health issues in India
 Large number of cases: In 2017, there were 197·3 million people with mental disorders in
India, comprising 14·3% of the total population of the country. (One among every seven people
in India had a mental disorder, ranging from mild to severe.
 Contribution to total disease burden: Mental disorders contributed 4·7% of the total disability
adjusted life years (DALYs) in India in 2017, compared with 2·5% in 1990.
 Leading cause of Years Lived with Disability (YLD): Mental disorders were the leading
cause of YLDs in India, contributing 14·5% of the total YLDs
 Mental disorders that manifest predominantly during adulthood was generally higher in the
more developed southern states
 Among the mental disorders that manifest predominantly during adulthood, the highest
disease burden in India was caused by depressive and anxiety disorders, followed by
schizophrenia and bipolar disorder

Implications of depreciating Mental Health

Psycho-Social impacts
 Increase in substance abuse: To deal with the stressors, people may resort to different
negative ways of coping, including use of alcohol, drugs, tobacco
 Increased risks of discrimination and violence: related to gender, children and caste
  Rise in morbidity and suicides linked to mental health
Economic impacts: Short-term costs include hospital expenses while long-term costs include the low
productivity and consequently low efficiency and output of the individual

Analysis of the causes

 Modernisation and urbanisation: The higher prevalence of depressive and anxiety disorders
could be related to the higher levels of modernisation and urbanisation with youth losing the
connect and support of his family
 Gender discrimination: The observed higher prevalence of depressive and anxiety disorders
in females could be related to gender discrimination, violence, sexual abuse, antenatal and
postnatal stress, and adverse socio-cultural norms
 Influence of media: A significantly higher prevalence of eating disorders in females apart
from genetic and biological factors is also probably linked with sociocultural factors, social
media, and peer pressure to diet
 Old age issues: The high prevalence of depressive disorders in older adults could be due to
various factors, including chronic illness, social isolation and inadequate social support, and
elder abuse.

Challenges related to tackling mental health issues in India

 Poor implementation of mental health services in India with a high treatment gap for mental
disorders, poor evidence-based treatment, and gender- differentials in treatment
 Shortage of mental health personnel with two mental health workers and 0·3 psychiatrists per
100000 population, which is much lower than the global average
 Discriminatory attitude of health workers towards people with mental illness
 Demand-side barriers such as low perceived need for care, paucity of knowledge of mental
disorders, and stigma attached to mental disorders
 Paucity of research in India on risk factors for mental disorders
 Lack of population-level data on the prevalence of many mental disorders across the states of
India

What needs to be done to tackle mental health issues effectively?

 Integrated approach to detect, treat, and manage patient needs related to mental and
physical health is urgently needed in India because people with mental disorders die
prematurely and have excess disability
 Strengthening the role of communities and families in addressing mental health by reducing
stigma and discrimination, raising awareness, and promoting inclusion
 Building resilience amongst adolescents and young children: through School-based mental
health programmes
 Scaling up Digitally-mediated therapy and telepsychiatry to provide mental health services
in remote and inaccessible areas. For eg- NIMHANS runs a successful telepsychiatry
intervention in Karnataka
 Community-based interventions: such as Atmiyata’s community-based volunteers in
Maharashtra and Gujarat, SCARF’s mental health mobile vans in Tamil Nadu, and VISHRAM
in vidarbha, that used community health workers for the first line of treatment
 Promotion of physical activity, Yoga and mindfulness techniques to supplement mental
health

VIOLENCE AGAINST HEALTHCARE WORKERS AND CLINICAL

ESTABLISHMENTS
Reasons for violence and damage in clinical establishments
  Low patient satisfaction: due to factors such as
 Poor doctor-population ratio: The doctor-population ratio in India is 1:1456 against the WHO
recommendation of 1:1000. This leads to overcrowding, long waiting time to meet doctors,
multiple visits to get investigations done as well as consult doctors etc
 Rising cost of healthcare: The private sector often attracts ire for exorbitant costs and
exploitative practices
 Poor patient–doctor communication: due to factors such as use of jargon by doctors,
arrogant behaviour, condescending attitude etc
 Low health literacy: This often leads to unreal expectations from doctors, myths and false
accusations even in cases of death due to a previous illness
 Lack of security: Violence is easily orchestrated in Indian healthcare establishments partly
because security staff in both the government and private sectors is non-existent due to lack
of funds
 No stringent laws: Several States have enacted special laws to offer protection to doctors
and other medical personnel in the past. However, the penal provisions contained in these
laws are not stringent enough to deter mischief mongering

EDUCATION SECTOR IN INDIA

Intro
 Education is fundamental to all round development.
 It contributes to national cohesion, increases scientific temper, develops manpower
for different sectors of economy
 In sum, Investment in Education brings the best dividends
 Before 1976, education was the exclusive responsibility of the States. The
Constitutional Amendment of 1976 included education in the Concurrent List
SDG 4 Ensure inclusive and equitable quality education and promote lifelong learning
opportunities for all

SDG-4.1: By 2030, ensure that all boys and girls complete free, equitable and quality primary
and secondary education leading to relevant and effective learning outcomes

SDG 4.5: By 2030, eliminate gender disparities in education and ensure equal access to all
levels of Education and vocational training for the vulnerable, including persons with
disabilities, indigenous peoples and children in vulnerable situations

Pre-Schooling level

 Rapid urbanisation, rise in nuclear family and both working parents forcing many
parents to send their children to preschool
 Role of State - Early childhood Care and Education up to the age of 6 doesn’t form
part of the formal education under Central or State governments. In addition, this
vacuum has been partly filled by schools and pre-schools which have mushroomed in
the private sector without adequate regulation
  Pre-schooling has mostly tended to emphasize on a universal or one-size-fits-all
approach -approach to schooling without taking into consideration different
demands of children
 Also, pre-schooling has become a platform for admission into prestigious school
rather than a platform for learning

SCHOOL EDUCATION
The 75th round of National Sample Survey (NSS) conducted by National Statistical Office (NSO)
gathered the following data regarding Literacy Rates, Enrollment, attendance and drop outs for
persons of age 3 to 35 years in India
Literacy rate among persons of age 7 years and above was 77.7
The female literacy levels according to the Literacy Rate 2011 census are 65.46% where the male
literacy rate is over 80%.
 2011 census: literacy rate for STs is 59%
 The Gross Enrolment Ratio (GER) for grades I-V was over 100 AND for grades VI-VIII
was 94.7
 Teacher ratio at national level for elementary schools was 28:1 and for secondary
schools it was 27:16
 According to Pratham’s Annual Status of Education Report (ASER) data
 The proportion of children in grade III who can read at least a grade I level text
dropped from 50.6 in 2008 to 40.3 in 2014,
 high drop-out rate of around 20% at secondary level
 The proportion of children in grade III who can do at least subtraction fell from
39% in 2008 to 25.4% in 2014
 Poor learning outcomes are reflected in multiple other sources as well, including the
National Achievement Survey (NAS), which found worse results in Class V Cycle 4
(2015) compared to Cycle 3(2012).

Challenges in Primary and Secondary Education Level

 Out of School Children – Even though enrolment ratio is 94% but given India’s large
population, over 92 lakh children still remain out of schools
 Poor Learning Outcomes- Corroborated by Annual Status of Education Survey
 Gender disparities and social exclusions: Inadequate support for vulnerable
sections like women, tribals, physically disabled etc.
 According to U-DISE 2016-17 data, about 19.6% of students belong to Scheduled Castes at the
primary level, but this fraction falls to 17.3% at the higher secondary level. These enrolment drop-
offs are more severe for Scheduled Tribes students (10.6% to 6.8%), and differently abled children
(1.1% to 0.25%),
 Since many parents are illiterate, they have very little idea about their child’s
learning
 Rising cost of education because of mushrooming of private schools
 High dropout rates - Secondary education reflects a very high level of dropouts
especially for vulnerable groups because of financial poverty, social restrictions or
 lack of belief in usefulness of education. Also, since RTE is only till primary
education dropout rates increase post class 8
 Curriculum in India is route and book oriented. Also, it has negligible or no emphasis
on critical thinking, value based, practical, IT and vocational learning. Emphasis on
memorizing factual information instead of applied knowledge
 Political and Bureaucratic interference in school management
 Poor linkage with higher education - Students lack required educational competence,
knowledge and skills relevant to higher classes. Secondary level education has failed to
prepare students for higher education w.r.t skills or values. As a result, there is
skewed selection of courses for higher education
 Grade and marks pressure have led to mushrooming of coaching institutions which
cater to the elite and follow social exclusion principles.
 Infrastructure – Schools in small towns and cities lack facilities such as drinking
water, girl toilets, etc; overcrowded classrooms and improper construction of
classrooms/schools (inadequate ventilation and lighting); lack of open spaces,
greenery and playgrounds for students, no use of IT
 Flaws and ineffective implementation of RTE act. India has huge population of
children with special needs (Differently abled) who inspite of provisions in RTE for
statutory right to education continue to be denied this right.
 Fundamentals of teacher management, teacher training and education are lacking
 Low pupil teacher ratio, teachers being absent and providing private tuitions. 28:1
average pupil teacher ratio. The ratio can be as high as 100:1 in some schools
 According to the Economic Survey 2017- 18, India’s average expenditure on
education is 2.8% of GDP. Developing countries like South Africa and Brazil spend
about 5.8% whereas neighbouring Bhutan spends more than 7% of its GDP on
education
 Standard-setting and Accreditation for School Education:
 At present, all main functions of governance and regulation of the school education system are
handled by a single body, i.e., the Department of School Education or its arms
 This leads to conflict of interests and excessive centralized concentration of power, ineffective
management of the school system, inability to curb the commercialization and economic
exploitation of parents

Stakeholder in Education
Parents:
Urban Families

 Putting pressure on children for high grades

 Forced decisions on career-choices/selection of stream after 10th Boards, etc
 High income families resort to unfair practises to get their child admitted in elite
schools rather than emphasizing upon them the real value and essence of education
Rural Families

 Education is seen merely as a means to get the label of a degree

  High dropout rates because of unaffordable fees and lack of awareness about
welfare schemes, lack of faith in usefulness of education
 High social exclusion due to
 Transportation or commutation for girls a major hurdle to give them access to
education
 Medium of instruction also becomes a hurdle
 Caste based discrimination
 Huge gap between parent’s education and the environment they get in schools
 Child labour, migration, child marriage are others barriers to education
Students:
 Heightened expectations and pressure from family to become part of rat race -
competition, admission in colleges, good grades in board exams, etc
 Pressure for grades means no emphasis on critical thinking, value based, practical,
IT and vocational learning. Emphasis on memorizing factual information instead of
applied knowledge
 Influence of media - films, internet, and computer games, etc.
 Mental disorders - depression, attention deficit disorder, anxiety, addiction, etc.
 High stress leads to Crimes like cheating in exams, stealing, sexual assault,
intolerance towards teachers, and addiction to tobacco and alcohol at an early age
 Disconnect with family because of too much time spent on internet, with friends,
etc.
 India has huge population of children with special needs (Differently abled) who
inspite of provisions in RTE for statutory right to education continue to be denied
this right
 illiterates in this category of children continue to very high in proportion in
comparison with rest of the children

Teachers:

 Education is no longer seen as a service to transform students’ future but as a

profession. In many cases, entry into the teaching profession is out of compulsion
rather than choice
 Usage of mechanical/outmoded techniques and lack of innovative methods to teach.
 Overburdening and involvement of teachers in other non-teaching tasks.
 Low pay scale, especially in private institutions, compared to workload leading to
disinterestedness, leading to teacher absenteeism and conduction private tuitions
 No teachers’ accountability and system of feedback from the students
 Fundamentals of teacher management, teacher training and education are lacking
 Low pupil teacher ratio, teachers being absent and providing private tuitions
 28:1 average pupil teacher ratio. The ratio can be as high as 100:1 in some schools

Institutions/schools
Infrastructure, Access and Equity
  Lack of Infrastructure – lack of facilities such as drinking water, toilets, etc;
overcrowded classrooms and improper construction of classrooms/schools
(inadequate ventilation and lighting); lack of open spaces, greenery and playgrounds
for students
 Commercialisation of Education – Schools and Colleges have become money making
institutions rather than temples of learning. E.g. Capitation fees, excessive fee hikes,
additional costs for uniform, books, etc.
 Distortion of welfare schemes such as Mid-Day Meal by asking parents to pay for
meals.
 Issue of fake income and caste certificates leaves out the intended beneficiaries of
government initiatives
 Corruption, Lack of transparency and fairness in admission process and absence of
grievance redress mechanisms
 Private school violating the reservation 25% free seats for socially backward as
mandated by RTE act.

Curriculum and quality

 Education is book and route oriented, no emphasis on critical thinking, value based,
practical, IT and vocational learning. Rather Emphasis on memorizing factual
information instead of applied knowledge. Overburdening of students with
homework.
 Students lack required educational competence, knowledge and skills relevant to higher
classes. Secondary level education has failed to prepare students for higher
education w.r.t skills or values. As a result, there is skewed selection of courses for
higher education
 Lack of diversity in streams chosen - Only 10 Programmes out of approximately 180
cover 83% of the total students enrolled in higher education. (AISHE).
 Despite high enrolment, Poor learning outcomes are seen in the Annual Status of
Education Report – (ASER). For example, about 25% of 14-18 age group cannot read
basic text fluently in their own language
Student Assessment
The current nature of secondary school exams, including Board exams and entrance exams -
and the resulting coaching culture of today - are doing much harm
These exams also force students to learn a very narrow band of material in a single stream,
rather than allowing the flexibility and choice

SAMAGRA SHIKSHA ABHIYAN

 This integrated centrally sponsored scheme on School Education envisages the

‘school’ as a continuum from pre-school, primary, upper primary, secondary to
Senior Secondary levels.
 The SSA, RMSA, and TE have been merged in this scheme.
 The Centrally Sponsored Schemes of Sarva Shiksha Abhiyan (SSA), Rashtriya
Madhyamik Shiksha Abhiyan (RMSA) and Teacher Education (TE) are the three major
 school education development programmes of the Ministry of Human Resource
development (MHRD), implemented in partnership with State/UTs

Important Components of the Schemes

Key Provisions under NEP 2020

Pre-School Education: Early Childhood Care and Education (ECCE)
 Early childhood care is widely acknowledged as an essential input in providing school
readiness skills to pre-school children
 Universal Access for children of 3-6 years: bring the hitherto uncovered age group of 3-6 years (crucial
stage for development of mental faculties of a child) under school curriculum
 ECCE will be delivered through Anganwadis and pre-schools that will have teachers and Anganwadi
workers trained in the ECCE pedagogy and curriculum
 Pre-school sections covering at least one year of early childhood care and education will be added to
Kendriya Vidyalayas and other primary schools, particularly in disadvantaged areas.
 NCERT will develop a National Curricular and Pedagogical Framework for Early Childhood Care and
Education (NCPFECCE) for children up to the age of 8.
 Implementation to be jointly carried out by Ministries of HRD, Women and Child Development (WCD),
Health and Family Welfare (HFW), and Tribal Affairs

Curtailing Dropout Rates and Ensuring Universal Access to Education at All and improving
 Policy aims to achieve 100% GER in preschool to secondary level by 2030
 Composite/ Integrated School: All the levels of schooling from pre to Class XII should be
available at one place promoting vertical integration.
 Child tracking through SDMIS: The Scheme aims to achieve the goal of 100% retention
from preschool to senior secondary school through tracking of all children. The State/UT
may track these students through the Student Data Management Information System
(SDMIS) to ensure 100% retention
 Mapping of schools for Universal Access and to have a clear picture of current
availability of schools, identify the gaps i.e. areas or habitations which are unserved,
under served and plan to provide access to school to the identified unserved areas/
habitations according to possible solutions.
 Providing effective and sufficient infrastructure so that all students have access to safe and engaging
school education
 Policy aims to achieve 100% youth and adult literacy
 Use of schools/ school complexes beyond school hours and public library spaces for adult
education courses
Equitable and Inclusive Education- Provisions for Socio-Economically Disadvantaged/Girls
 Setting up of Gender Inclusion Fund for female and transgender students, Special Education Zones
(SEZs)- Large populations from SEDGs to be declared SEZs
 educational needs and predicament of the vulnerable and disadvantaged: (ST, SC),
minority, and especially girls to improve female literacy which is only 65%
 Inclusion of Children with special needs (CWSN) in education: Will cover all children
with special needs with one or more disabilities as mentioned in the schedule of
disabilities of the Right of the Persons with Disabilities (RPwD) Act, 2016 studying in
Government, Government-aided and local body schools
 Access will also mean to address the needs and requirement of other disadvantaged
categories of children such as children affected with migration, urban deprived
children, children whose families are involved in stigmatised professions, homeless
 children transgender and all other categories who would require additional support for
access to schooling
 Special mechanisms for children belonging to tribal groups to receive quality education
 Fee waivers and scholarships will be offered to meritorious students from all SEDGs
 Additional Schools- Setting-up of additional JNVs and KVs in aspirational districts/SEZs
 The scheme will focus on Beti Bachao Beti Padhao
 Girls from disadvantaged communities continue to form the bulk of out-of school
children. Therefore, both access and retention are considered to be an equity issue, as
SC, ST, Muslim girls are vulnerable, and most likely to dropout.
 In the Integrated Scheme, with regard to access and retention, the focus would be on
older girls, where the need is the greatest.
 Support measures would include transport, escorts, counselling, helping them
negotiate domestic work burdens, community support mechanisms and academic
support depending on the nature of the problem
 Monitoring of these institutions will be strengthened and PRIs will also be involved in
the monitoring process

Quality interventions: Attainment of Foundational Literacy and Numeracy

 National Mission on Foundational Literacy and Numeracy by MHRD: Under it, States/UTs will prepare
an implementation plan for attaining universal foundational literacy and numeracy in all primary
schools for all learners by grade 3 by 2025.
 National Book Promotion Policy is to be formulated to ensure the availability, accessibility, quality, and
readership of books across geographies, languages, levels, and genres
 National Repository of high-quality resources on foundational literacy and numeracy will be made
available on the Digital Infrastructure for Knowledge Sharing (DIKSHA).

Curriculum and Pedagogy

 Restructuring school curriculum and pedagogy in a new 5+3+3+4 design
 5 years of the Foundational Stage (covering ages 3-8): 3 years of Anganwadi/pre-school + 2 years in
primary school in Grades 1-2
 3 years of the Preparatory Stage (covering ages 8-11): Grades 3, 4, 5
 3 years of the Middle Stage (covering ages 11-14): Grades 6, 7, 8)
 4 years of the High Stage (covering ages 14-18): Grades 9, 10, 11, 12
 National Curricular Framework for School Education will be developed by the NCERT
 Policy focuses on learners’ cognitive development as the major explicit objective and
on education’s role in promoting values and attitudes of responsible citizenship and in
nurturing creative and emotional development.
 Focus on critical thinking, value based, practical, IT and vocational learning.
Emphasis on applied knowledge rather than memorizing information
 Reduced curriculum content to its core essentials to enhance essential learning and critical thinking
Experiential learning will be adopted in all stages, including hands-on learning, arts integrated and
sports-integrated education
 Every state/district will be encouraged to establish “Bal Bhavans” as a special daytime boarding
school, to participate in art-related, career-related, and play-related activities
 Free school infrastructure can be used as Samajik Chetna Kendras to promote social,
intellectual, and voluntary activities
 Freedom of choosing a variety of subject combination: no rigid separation among ‘curricular’,
‘extracurricular’, or ‘co-curricular’, among ‘arts’, ‘humanities’, and ‘sciences’, or between ‘vocational’ or
‘academic’ streams
 Introduction of contemporary subjects such as Artificial Intelligence, Design Thinking, Holistic Health,
Organic Living, Environmental Education, Global Citizenship Education
  Bridge course for out of school children may also be envisaged as transitory measures to
provide schooling till regular facilities are available
Technology in Education
Use of ICT tools in school education (ICT) has become one of the basic building blocks of modern
society. Therefore, the new approach in school education includes Universal equitable, open and free
access to a state of art ICT and IT enabled learning environment, tools and digital resources, labs,
projectors, digital attendance available to students, teachers and teacher educators
An autonomous body, National Educational Technology Forum (NETF), will be created to provide a platform
for the free exchange of ideas on the use of technology to enhance learning, assessment, planning,
administration.
Appropriate integration of technology into all levels of education will be done to improve classroom processes,
support teacher professional development, and enhance educational access for disadvantaged groups.
Quality technology-based options for adult learning such as online courses, satellite-based TV channels and ICT-
equipped libraries and Adult Education Centres, etc. will be developed
Online Education and Digital Education: A comprehensive set of recommendations for promoting online
education in order to ensure preparedness with alternative modes of quality education whenever and wherever
traditional and in-person modes of education are not possible

Vocationalisation of Education

 inclusion of those practical subjects or courses, which shall generate among the
students some basic knowledge, skills and disposition that prepare them to think of
becoming skilled workers or entrepreneurs. The scheme will emphasise Kaushal Vikas
in schools
 It may be seen as an instrument for providing diversification of educational
opportunities, enhancing individual’s employability and enabling individual to pursue
higher education
 The Vocationalisation of School Education shall make funding arrangements for the
introduction of vocational courses along with general education subjects from Classes IX
to XII
 The vocational subjects are to be introduced as an additional or compulsory subject at
the Secondary level and as compulsory (elective) at the Senior Secondary level
 Exposure to Vocational Education would also be provided in Classes VI to VIII with an
aim to provide opportunities to the students to orient themselves with the skills
required for the various occupations in a sector and to equip them to make informed
choices while selecting their subjects in higher classes
 Vocational education through 10-day bagless period sometime during Grades 6-
8 where students will intern with local vocational experts such as carpenters,
gardeners, potters, artists, etc
 vocationalisation of Education may reduce the high drop-out rate of around 18% at
secondary level
 It will also help in reducing the gap between academic and applied learning (industry
required skills).

Student Assessment
 School examinations in Grades 3, 5, and 8 which will be conducted by the appropriate authority
 Board exams for Grades 10 and 12 will be continued but redesigned
 National Assessment Centre, PARAKH (Performance Assessment, Review, and Analysis of
Knowledge for Holistic Development), will be set up as a standard-setting body under MHRD
  Holistic Progress Card with 360-degree, multidimensional report that reflects the progress as well as
the uniqueness of each learner in the cognitive, affective, and psychomotor domains. It will also
include self-assessment, peer assessment, and teacher assessment
 National Testing Agency (NTA) to serve as a autonomous testing organization to conduct entrance
examinations for undergraduate and graduate admissions and fellowships in higher education
institutions

Multilingualism and the power of language

 Medium of instruction up till grade 5, and preferably till Grade 8 and beyond, will be home language/
mother-tongue/ local language
 ‘The Languages of India’ a fun project/ activity on to be taken by every student under the ‘Ek Bharat
Shrestha Bharat’ initiative
 Three languages formula with greater flexibility
 All classical languages (Sanskrit,Tamil, Telugu, Kannada, Malayalam, Odia) will be widely available in
schools as options.
 Indian Sign Language (ISL) will be standardized across the country

Teacher education, Recruitment and Teacher Training

 Several committees such as Kothari Commission (1964-66) and Chatopadhyaya

Committee (1983-85), and National Policy on Education 1986, as well as the New
Education Policy (Kasturi Ranjan Committee) have highlighted upon the importance of
Teacher education.
 New and comprehensive National Curriculum Framework for Teacher Education (by 2021)
 By 2030, the minimum degree qualification for teaching will be a 4-year integrated B.Ed. degree
 NTA testing for admission to B.Ed
 Setting-up of National Mission for Mentoring with a large pool of outstanding senior/retired faculty
 Teacher Eligibility Tests (TETs) for all teachers across Foundational, Preparatory, Middle and
Secondary stage in both public and private schools
 More autonomy to teachers in choosing aspects of pedagogy in classroom teaching
 National Professional Standards for Teachers (NPST) will be developed by the National Council for
Teacher Education
 ensure pre-service or in-service training of teachers up to higher secondary level
 Restructuring of NCTE- National Council for Teacher Education (NCTE) to be restructured as a
Professional Standard Setting Body (PSSB) under General Education Council
NITI Aayog’s Action Agenda for School Education
Orient the system towards outcomes

 Track and support state level improvement through a School Education Quality Index
(SEQI).
 Modify RTE requirements on inputs and shift it towards outcome, so that RTE turns
into Right to Learning, instead of just being a Right to education
Provide tools to teachers and students for effective learning
 Introduce evidence-based Information and Communication Technology tools.
 Focus on foundational learning. A time-bound national program with focus on
ensuring that all children have such basic literacy and numeracy skills should be
launched.
 Pilot a system of technology aided adaptive “Concept of exams on demand” which
test students on absolute competencies instead of relative ‘marks’ and allow
students to take and re-take exams when they are ready
Improve existing governance mechanisms
  Enrolment in public schools is much lesser than that in private schools. The reason is
high rate of teacher absenteeism, limited time spent on teaching when the teacher is
in class and generally poor quality of education.
 Quality improvement through improved governance is one way of slowing or
reversing this process.
 A set of basic governance processes and structural reforms that have the maximum
impact have been identified and included in the School Education Quality Index

New governance mechanisms

 Separation of the functions of policy making from regulation since policies require
expertise, Currently, all these functions are carried out under the State Ministry of
Education
 Giving more autonomy to the directorate of education and making it accountable
through clear, measurable goals; quality of top managers selected; independence
and authority for the management to take necessary steps to reach the goals; and
oversight and accountability based on credible measurement of outcomes
Key Provisions under NEP 2020

 Schools can be organized into complexes or clusters which will be the basic unit of governance and
ensure availability of all resources including a strong professional teacher community
 Schools will develop School Development Plans (SDPs). These plans will then become the basis for the
creation of School Complex/Cluster Development Plans (SCDPs)
 The twinning/pairing of one public school with one private school will be adopted across the country,
so that such paired schools may learn from each other, and also share resources

Standard-setting and Accreditation for School Education

 Clear, separate systems for policy making, regulation, operations and academic matters
 Independent State School Standards Authority (SSSA) to be set up by States/UTs
 School Quality Assessment and Accreditation Framework (SQAAF) to be developed by SCERT.
 Public and private schools (except the schools that are managed/aided/controlled by the Central
government) will be assessed and accredited on the same criteria
 For a periodic ‘health check-up’ of the overall system, a sample-based National Achievement Survey
(NAS) of student learning levels will be carried out by the proposed new National Assessment Centre,
PARAKH

Explore the role for states and private players: Public-Private Partnership (PPP) models
could also be explored where the private sector adopts government schools while being
publicly funded on a per child basis
OTHER MAJOR PROVISIONS of NEP
The Centre and the States will work together to increase the public investment in Education sector to reach 6%
of GDP
Policy calls for promotion and support for private philanthropic activity in education sector
Some suggestions

 There is a need to introduce a new education component in Anganwadi practices, to ensure

that the pre-school children are exposed to elementary education.
 NCERT and SCERTs should formulate curricular framework for pre-primary education apart
from conducting intensive training programs for teachers to orient them with handling of
pre-school children
  There is a need to gradually extend provision of RTE to cover secondary education to reduce
dropout rates
 There is a need to scale up the existing National Skills Qualification Framework to include
more students.
 There is also a need to in-line choice of vocational courses in accordance with local
opportunities and resources

T.S.R. Subramanian Committee 2016

 Increase public spending on education from 3% to 6% of GDP
 Expand Mid-Day Meal scheme to secondary schools.
 There should be minimum eligibility condition with 50% marks at graduate level for
entry to existing B.Ed courses. Teacher Entrance Tests (TET) should be made
compulsory for recruitment of all teachers. The Centre and states should jointly lay
down norms and standards for TET
 Compulsory licensing or certification for teachers in government and private schools
should be made mandatory, with provision for renewal every 10 years based on
independent external testing
 Discontinue no detention policy after class V
 Extend 25% EWS quota in private schools to minority institutions
 Allow top foreign universities to open campuses in India
 An All-India service Indian Education Service (IES) should be established
 Reduction of UGC role to disbursal of scholarships and fellowships & separate law for
management of higher education.
 Consolidation or merging of small, non-viable schools {But it violates RTE act having
access to school at walking distance of max 1 Km below Std 5th}.
 Compulsory quality audit of all higher education institutions, both private and public,
in three years
 The panel has proposed that colleges and universities should consider derecognizing
student political groups which are based on caste and religion

Way Forward

 Need for multidisciplinary – There is need for a shift from traditional single subject
focused education towards combining multiple disciplines to address real world
problems and solve complex societal and business challenges.
 Restructuring of examination system to end bookish and factual exams- Bringing an
end to similar assignments and exams each term which leads to plagiarism/cheating
specially in this age of free access to information.
 Students need to taught ethics and academic integrity as well.
  Transparency changes in India’s academic culture are required to ensure that
meritocracy operates at all levels

Right to Education Act

 This act is an embodiment of Article 21-A, which says that every child has a right to full
time elementary education of satisfactory and equitable quality in a formal school which
satisfies certain essential norms and standards.
 The 86th Constitution Amendment Act, 2002 requires the State to provide free and
compulsory elementary education to all children. The Right of Children to Free and
Compulsory Education (RTE) Act, 2009 seeks to give effect to this Amendment under which
all children between the ages of 6 and 14 years have the right to elementary education (class
1-8) in a neighbourhood school
Salient features
 Free and compulsory primary education to all children of India in the 6 to 14 age group.
 It clarifies that ‘Free’ means that no child shall be liable to pay any kind of fee or
charges or expenses ‘and compulsory education’ means obligation of the appropriate
government to provide free elementary education and ensure compulsory admission,
attendance and completion of elementary education to every child in the six to
fourteen age group.
 No detention policy: No child shall be held back, expelled or required to pass a board
examination until the completion of elementary education that is till class 8
 This has been implemented as part of the Continuous and Comprehensive Evaluation (CCE)
under the RTE Act to ensure all-round development of students
 It lays down the norms and standards relating inter alia to Pupil Teacher Ratios (PTRs),
buildings and infrastructure, school-working days, teacher-working hours.
 The Sarva Shiksha Abhiyan (SSA) is the main vehicle for implementation of the RTE Act.
It is one of the largest programmes of its kind in the world. It is primarily funded from
central budget and it covers the whole country
 The RTE Act stipulates to have a school within 1 km of radius of every habitat to ensure
every child gets the opportunity of having a school within his habitation
 The National Commission for the Protection of Child Rights shall review the safeguards
for rights provided under this Act, investigate complaints and have the powers of a civil
court in trying cases
 RTE Section 12(1)(c) mandates private unaided schools (except minority and residential
schools) to keep 25 percent of the seats (at entry level) reserved for children belonging
to economically weaker sections
 The Supreme Court upheld the constitutional validity of Right of Children to Free and
Compulsory Education Act, 2009, on April 12, 2012 and directed every school, including
 privately-run ones, to give immediately free education to students from socially and
economically backward classes from class-I till they reach the age of 14 years

THE RTE AMENDMENT ACT 2019

 The RTE Act states that a child cannot be detained in any class till the completion of
elementary education
 This has been implemented as part of the Continuous and Comprehensive Evaluation
(CCE) under the RTE Act to ensure all-round development of students
 As per the amended Act, regular examination will be held in Classes 5 and 8 and if a
child fails there is a provision to give his/her additional opportunity to take a re-
examination within two months
 If s/he fails again in the re-examination, the relevant Central or State Government may
decide to allow schools to detain the child.
 But no child shall be expelled from a school till the completion of elementary education .

Reasons for scrapping No detention policy

 Children become complacent, lazy, inattentive to studies and irregular in attendance and at
the same time parents also don’t bother as their children cannot be held back in the
class
 Many government school teachers and principals opined that it has become a
challenge to ensure minimum learning levels among the children
 Poor Learning outcomes were observed in According to Pratham’s Annual Status of
Education Report (ASER) data
 The proportion of children in grade III who can read at least a grade I level text
dropped from 50.6 in 2008 to 40.3 in 2014,
 The proportion of children in grade III who can do at least subtraction fell from 39% in
2008 to 25.4% in 2014
 Poor learning outcomes are reflected in multiple other sources as well, including the
National Achievement Survey (NAS), which found worse results in Class V Cycle 4
(2015) compared to Cycle 3(2012)

 Students lack required educational competence, knowledge and skills relevant to higher
classes. It was also found that the lack of education attainment meant that students in
the age group of 14 to 18 struggled with foundational skills such as reading a text in their
own language or solving a simple arithmetic division.
 This poor understanding among students, in turn, led to a sharp spike in dropout rates in
classes IX and X
 Continuous and Comprehensive Evaluations though envisaged very well has failed
because teacher are not skilled to follow CCE. It needs resources, training, manuals
including number of teachers, seamless processes and a supportive ecosystem
 In recent years, three expert committees-Geeta Bhukkal (2014) and TSR Subramanian
(2016)- and NITI aayog reviewed the no-detention provision in the RTE Act and
recommended it be removed or be discontinued in a phased manner

Positives of “No Detention Policy

  India has made the largest progress (in absolute terms) by any country in the world reducing
out-of- school (children) numbers from 20 million in 2000 to 2.3 million in 2006, and
(around) 1.7 million in 2017
 The Gross Enrolment Ratio (GER) in 2015-16 for grades I-V was 99.2% AND for grades VI-
VIII was 92.8%. which is a massive improvement from the last decade
 Detaining children at the elementary level damages their self-esteem and give them a
permanent inferiority complex:
 The social stigma associated with “failing”, has deeply damaging effects on the psyche of
the child
 Once declared fail students drop out rather than repeating especially rural and tribals
 Bring back the old pass fail without correction in other areas will bring back the same
problem of illiteracy and drop outs
Way forward for No-detention policy
 instead of detaining and repeating the same whole material again for another nine
months, weaker areas of the child can be selectively targeted to cover the gaps in two or
three months
 Detention should be resorted to only after giving the child remedial coaching and at
least two extra chances to prove his capability
 As recommended by TSR Subramanian committee if a child again fails to clear the
examination, she should also be given other opportunities of pursuing her education
through a vocational stream so that she can demonstrate her abilities and
competencies elsewhere.
 Advances in technology must provide an additional ‘augmentation’ avenue to help the
slow-learner child makeup for the lost ground

Other issues in RTE

ISSUES RAISED BY CAG REPORT

 Ineffective child tracking under RTE - Regular household surveys have not been
conducted by local authorities in 21 states/ UTs to maintain/update record of children
from their birth till they attain age of 14 years
 Children with special needs – transport, aid and appliances were not provided as
envisaged in the act to all the eligible children with special needs
 Ineffective National advisory council – Council largely remained and not in existence
since November 2014. It has responsibility of advising on the implementation of the Act
 Disbursal of less funds by central government - funds demanded by state governments
were consistently curtailed by the Centre’s Project Approval Board (PAB) hampering
implementation
 Retention of huge balances by state governments and non -adherence to expenditure
norms by them
 Gaps in financial management - mismatch is found in the unspent balances at the end
of the year with opening balances of succeeding years showing mismanagement of
account books.
General Issues
  Many schools set up under the stipulation of 1 km radius did not have the required number
of students to have separate rooms for each class. In some cases, four classes were
operational with only two teachers in two classrooms
 Parents prefer to send their sons to private schools where as the girl child is sent to
government schools
 The ASER report says there has not been much progress in compliance with various RTE-
related norms. Despite the increase in SSA infrastructure budget, the proportion of schools
with shortfall in the number teachers, classrooms, drinking water facilities, kitchen/shed,
playground, complete boundary wall, a separate room for the headmaster has not
increased much or remained more or less unchanged

The report ‘State of the Nation: RTE Section 12 (1) (c)’ by RTE resource centre at IIM Ahmedabad
highlights the status of implementation of the Section 12 (1)(c) of RTE Act

RTE Section 12(1)(c) mandates private unaided schools (except minority and residential schools) to
keep 25 percent of the seats (at entry level) reserved for children belonging to economically weaker
sections

Findings of the Report

 Even after six years of implementation of the right to education (RTE) Act, children from
economically weaker section are still struggling to find their seats in schools.
 Low State Fill Rate - According to data from District Information System for Education
(DISE), the state fill rate – share of available seats filled by the mandate – is a low 15.12
percent in 2014-15 Inter-State Variation - The report shows that states amongst
themselves have large variation in their seat fill rate, from zero percent in Andhra
Pradesh to 44.61 percent in Delhi.
 No Implementation in majority of the states - Out of 34 states and UTs, 18 show zero
schools implementing the provision. These include states like Andhra Pradesh, Haryana,
Kerala, West Bengal and Punjab
Reasons of Poor Implementation

 Slow reimbursement of fees from state governments to the private schools, which takes
up to two years
 Lack of awareness about the rule among the citizens especially in the rural area
 Unwillingness on the part of private schools and even the states to incur additional
expenses
 Most states have either unclear rules or guidelines or are not implementing this
provision.
 Provision of child support and child tracking is almost non-existent after admission in
school.

HIGHER AND TECHNICAL EDUCATION IN INDIA

 India's higher education system is the world's third largest in terms of students, next to
China and the United States
  India's Higher Education sector has witnessed a tremendous increase in the number of
Universities/University level Institutions & Colleges since independence

Challenges plaguing the Sector

Enrolment
As per All India Survey of Higher Education (AISHE) for the year 2018

The Gross Enrolment Ratio (GER) of India in higher education is only 26.3%which is quite low as
compared to the developed countries like US with 89.1% as well as, other developing countries
like China with 30% and Russia 76%

Regional disparities and Inequalities

 Social Backwardness: SC & ST student enrolment is 14.89% & 5.53% respectively. Among
minorities, 5.23% students belong to Muslim category and 2.32% to other minority
communities
 There is no equity in GER among different sects of the society. GER for males (26.3%),
females (25.4%), SC (21.8%) and ST (15.9%).
 There are regional variations. The college density (number of colleges per lakh eligible
population) varies from 7 in Bihar to 59 in Telangana as compared to All India average
of 28.
 2/3rd of GER is in private institution which are costly and add the pressure of education
loan
 Also, most of premier universities and colleges are centred in metropolitan and urban
city, thereby leading to the regional disparity in access to higher education. However, to
fill this gap government has launched Technical Education Quality Improvement
Programme (TEQIP) for rural areas
 Social structure biases and prejudices towards downtrodden and women is still rampant
even in higher education

Quality, Research and Innovation

 Expansion in Quantity has been at expense of Quality
 Education system is fixated on route learning and degree attraction rather than critical
thinking, value education, employability, skill development and industry level
research. An assessment of 150,000 engineering graduates in 2016 found that only 18%
of engineers were employable in the software services sector in a functional role
 Low R&D, low fund availability for research, low patents either due to low research or
unawareness of IPR laws
 Lack of interdisciplinary focus while the industry is moving towards convergence of
different technologies and fields
 Low enrolment in PHD and post-doctoral research

Brain Drain: Higher perception of a foreign degree, better research and job facilities, ease of
affiliation with institutions and corporates has resulted in large scale emigration from India.

Infrastructure and Faculty

  Deficiencies in library books, labs, computers, Internet, lecture theatres. There are
large numbers of colleges which are functioning on second or third floor of the building
 Faculty shortages and the inability of the state educational system to attract and
retain well qualified teachers have been posing challenges to quality education for
many years. Shortage of faculty leads to Ad-hoc expansion even in premier institution
 The Pupil to teacher ratio though has been stable in the country (30:1), however it
needs to improve such as compared to USA (12.5:1), China (19.5:1) and Brazil (19:1).
 Large numbers of NET / PhD candidates are unemployed even when there are lot of
vacancies in higher education.

Structural and Administrative Problems

 University Grants Commission Act was enacted in 1956. However, it is unsuitable for
regulation today and needs to be changed in-line with the growing complexity and
increased number of higher educational institutions
 Issue of fake universities, fake degrees, over centralisation, bureaucratic and Political
interference of UGC, lack of transparency in fund disbursal
 Other Regulators - Regulators like MCI, AICTE, ICAI continue to be marked by
inadequate financial and human resources, nepotism, corruption and favouritism

Accreditation

 As per the data provided by the National Assessment and Accreditation Council
(NAAC), not even 25% of the total higher education institutions in the country were
accredited. And among those accredited, only 30% of the universities and 45% of the
colleges were found to be of quality to be ranked at 'A' level

All the above issues have diluted the core focus on academics and research
As a result, India continues to perform abysmally in global ranking of higher educational
institutions

Way Forward to Improve Higher Education

When we look to successful higher education systems across the world, we find that less
regulation and more focus on autonomous governance, transparency and outcomes are critical
components of a vibrant and successful higher education sector.
National Education Policy
Institutional Restructuring & Consolidation
 All higher education institutions to be consolidated into three types of institutions
 Research Universities - equal focus on research and teaching
 Teaching Universities for employment mainly - primary focus on teaching with significant focus on
research
 Autonomous degree-granting colleges - almost exclusive focus on teaching
 Affiliation of colleges is to be phased out in 15 years and a stage-wise mechanism is to be established for
granting graded autonomy to colleges
 By 2040, all higher education institutions (HEIs) shall aim to become multidisciplinary institutions
 There shall, by 2030, be at least one large multidisciplinary HEI in or near every district
 The aim will be to increase the Gross Enrolment Ratio in higher education including vocational
education from 26.3% (2018) to 50% by 2035
Holistic Multidisciplinary Education
 The policy envisages undergraduate education with flexible curricula, creative combinations of
subjects, integration of vocational education and multiple entry and exit points with appropriate
certification
 Focus more in particular on those skills that are expected to be in high demand from the
public sector in the coming years. Examples include public health workers, foundational
skills teaching, green skills, nursing and paramedics
 Multidisciplinary Education and Research Universities (MERUs), at par with IITs, IIMs, to be set up as
models of best multidisciplinary education of global standards
 The National Research Foundation will be created as an apex body for fostering a strong research
culture and building research capacity across higher education
Regulation
 Higher Education Commission of India (HECI) will be set up as a single overarching umbrella body
for entire higher education, excluding medical and legal education
 HECI to have independent verticals such as National Higher Education Regulatory Council, Higher
Education Grants Council, National Accreditation Council, General Education Council
 Public and private higher education institutions will be governed by the same set of norms for
regulation, accreditation and academic standards
Equity and Inclusion
 Earmark suitable Government funds for the education of SEDGs
 Set clear targets for higher GER for SEDGs
 Enhance access by establishing more high-quality HEIs in aspirational districts and Special Education
Zones containing larger numbers of SEDGs
 Mitigate opportunity costs and fees for pursuing higher education
 Provide more financial assistance and scholarships to SEDGs
 Make curriculum more inclusive
 Ensure sensitization of faculty, counsellor, and students on gender-identity issue

Internationalization of HEIs
 Internationally relevant curricula
 An International Students Office at each HEI hosting foreign students will be set up to coordinate all
matters relating to welcoming and supporting students
 High performing Indian universities will be encouraged to set up campuses in other countries, and
similarly, selected universities e.g., those from among the top 100 universities in the world will be
facilitated to operate in India.
 A legislative framework facilitating such entry will be put in place, and such universities will be given
special dispensation regarding regulatory, governance, and content norms
 Research collaboration and student exchanges between Indian institutions and global institutions will
be promoted
 Credits acquired in foreign universities will be permitted, where appropriate as per the requirements
of each HEI

In this context, NITI Aayog has provided a Higher Education Action Agenda which includes
following key areas

1. Reform of the regulatory system

 Introduce a system of regulation that focuses only on information disclosure and
governance rather than micro management of universities.
 This requires an overhaul of the UGC as a regulatory system and a rationalization of the
role of professional councils. Recently, The Ministry of Human Resource and
Development (MHRD) has prepared a HECI (Repeal of University Grants Commission Act)
Bill 2018 and has placed it in public domain for comments and suggestions

2. A tiered system of universities

  Within the existing legal framework, a tiered system can be introduced whereby
First tier
 Exclusive research-focused universities, which promise to compete globally, are given
full autonomy and promised additional resources based on significant improvements
over time.
 These universities may be subject to high standards of transparency with full freedom
granted in operational matters such as courses, curriculum, teaching hours and
pedagogy.
 Quality should be enforced through periodic third-party assessments

A second tier of universities

 Exclusively Focus on providing jobs for the labour force

 Sufficient Freedom given to them to adjust admission policies, curriculum and courses
to respond to shifts in job composition in the marketplace.
 They will also be evaluated according to their success in job placements of their
students
The last tier of the universities

 Primarily to provide higher education to all and increase gross enrolment ratio
 should be the most regulated one.
 This tier will consist of the universities that are currently performing poorly and not
likely to perform well on either research or employment dimension.
 While this tier can receive greater scrutiny from the UGC, there is a need for loosening
control here as well with priority given to transparency

Besides these actions, reform at the state level is also required and should be carried out
through incentivization by the Rashtriya Uchchatar Shiksha Abhiyan (RUSA). These reforms
should also encourage autonomy and good governance practices in universities in the state level
regulation of higher education

3. Designation of World Class Universities and autonomy for top colleges

 Identify 20 universities (10 Private 10 Public) to be free from regulatory regime. (Not in
any of the above 3 tiered)
 Transform them to world class through focused funding based on outcomes like world
rankings.
 Further established and reputed colleges should be taken out of the centralized
control of their university to promote excellence in teaching and research the option
to convert into unitary universities (example various colleges under Delhi University
are burdened under DU regulations despite being established and well reputed)
 This will allow the colleges to develop their brand name and compete more effectively

4. Establish a system of project- and scholar-specific research grants

 A system of public funding for research in specific areas of public utility
 Model of ‘prize’ system with funding going to research/innovation groups that deliver
solutions to clearly specified problems. Such a system can be used in the future to
drive innovation and research, solve pressing problems
  The most promising candidates should receive the most funds and be accountable for
outcomes, while receiving the same flexibility in governance as any university
worldwide.

Increased focus on vocational and profession led education

 Include vocational subjects at school itself and then in universities to increase their
societal acceptance for non-academic students
 inclusion of those practical subjects or courses, which shall generate among the
students some basic knowledge, skills and disposition that prepare them to think of
becoming skilled workers or entrepreneurs. The scheme will emphasise Kaushal Vikas
in schools and colleges
 It may be seen as an instrument for providing diversification of educational
opportunities, enhancing individual’s employability and enabling individual to pursue
higher education
 Establish and promote norms/standards/courses based for institutions that focus on skill
development and trades for vocational employment
 Focus more in particular on those skills that are expected to be in high demand from the
public sector in the coming years. Examples include public health workers, foundational
skills teaching, green skills, nursing and paramedics
Other recommendations

 There is a need for regulatory overhaul in apart from streamlining the financing of
higher education Sector. UGC should be relieved of fund disbursal. Currently UGC is
responsible for Grants. Although HEFA has been established recently
 In the US, there is the concept of a super regulator that regulates autonomous
regulators, particularly of professional sectors which need specialised knowledge.
Similar democratic structures exist in many European democracies. India needs to learn
from their experiences
 Also, there is a need to reform the process of recruitment, opportunities etc. for
teachers. Addressing the concerns of faculty shortage, etc.
 There is a need to introduce performance-based incentives on a objective criteria to rate
and promote teachers
 Need to improve the awareness of IPR laws in colleges and universities. Encouraging
collaboration with the industrial sector for commercialising innovations.
 Simplifying, digitising and easing of patent laws thereby reducing operational time.
 A Central Educational Statistics Agency (CESA) should be established as the central
data collection, compilation and consolidation agency with high quality statistical
expertise and management information system should be used for predictive analysis,
manpower planning and future course corrections.
 An expert committee should be constituted to study the systems of accreditation in
place internationally. Need to learn from the US, the UK and Canada where none of the
institutions is exempted from accreditation. In India, institutions like IITs are free from
accreditation
 Aim of higher education should be to ensure that poor and meritorious students can
afford to be educated in subjects of their choice
Steps By government
 RUSA is a Centrally Sponsored Scheme to increase enrolment in higher education by 30% by
2020.
 It also seeks to increase the spending on higher education by the State Governments by
providing strategic funding to eligible State higher educational institutions
 Prime Minister’s Research Fellows (PMRF) Scheme of Rs 70,000 monthly fellowship and
Revitalising Infrastructure and Systems in Education (RISE) announced in the Union
Budget 2018-19 by 2022 with a total investment of 1,00,000-crore in the next four years
are good steps to promote research.
 Atal Innovation Mission – Atal Tinkering Labs and Atal Incubators for supporting an
innovative ecosystem in schools, universities, small and medium industries, corporate,
NGOs and research institutions.
 The government in 2015 has launched the National Institutional Ranking Framework to
 ranks institutions within five broad generic parameters - Teaching; Learning and
resources; Research and professional practice; Graduation outcomes; Outreach and
inclusivity; Perception
 HRD Ministry has signed a deal with Canara Bank to set up a Higher Education Financing
Agency (HEFA) that would eventually take over UGC’s financial powers
 It would be formed as a SPV within a PSU Bank/ Government-owned-NBFC (Promoter). It
would leverage the equity to raise up to Rs. 1 lakh crore for funding projects for
infrastructure and development of world class Labs in IITs/IIMs/NITs and such other
institutions including school infrastructure
 India has taken a firm step towards building 20 world-class educational institutions,
which will be termed Institutions of Eminence
 Each public Institution selected as ‘Institution of Eminence’ will get financial assistance
up to Rs. 1000 Crore over the period of five years under this scheme
 These Institutions shall be provided with greater autonomy to admit foreign students up
to 30% of admitted students; to recruit foreign faculty upto 25% of faculty strength; to
offer online courses upto 20% of its programmes; to enter into academic collaboration
with top 500 in the world ranking Institutions without permission of UGC
 It is expected that the above selected Institutions will come up in top 500 of the world
ranking in 10 years and in top 100 of the world ranking eventually overtime
 Unnat Bharat Abhiyan to connect and higher education institutions and rural society to
enable use of technology in modern problems
 Swayam portal for online learning for middle- and lower-income people
 GIAN to attract foreign academicians for lectures and courses
 National Testing agency to conduct exams for admissions in higher education institutions
to promote transparency and relieve other agencies of dual tasks

Conclusion
 India has one of the youngest populations in an aging world. By 2020, the median age in
India will be just 28, compared to 37 in China and the US, 45 in Western Europe, and 49
in Japan.
 Education with a holistic perspective is concerned with the development of every
person's intellectual, emotional, social, physical, artistic, creative and spiritual potentials.
 
To leverage the advantage of demographic dividend India needs to invest into its
abundant human capital resources through quality education, reforming the curriculum
and pedagogical processes, improving delivering by utilizing public-private partnerships,
evolving an efficient audit and accountability mechanism and resolving the existing
lacunae in the current institutional system which will help unleash the true potential of
Indian citizens and lead to economic and social prosperity.
ANALYSIS OF NEW EDUCATION POLICY-2020
Significance of the Policy

More focus on vocational studies and skill education even in school level
Allocation of 6% of the GDP in Education sector
Restructuring of School education, examination reforms
The three language formula for school education:
Transformation of regulatory system of the higher education in India: With the establishment of a
single regulatory body called HECI

Implementation Challenges & Issues with the NEP 2020

Funding: NEP talks about spending 6% of GDP on education. However, such an increase in funding has
been proposed earlier but not achieved. This policy also does not elaborate how to raise this fund
Multilingualism and also ignoring the importance of English: NEP recommending mother
tongue/regional language the medium of instruction till Grade 5—even beyond if this can be done—
ignores several realities like:
 Sure, early comprehension of concepts is better in the home language and is critical for future
progress, but it is also true that a core goal of education is social and economic mobility, and
the language of mobility in India is English
 Students of the private schools will be introduced with English at a much earlier age than
the students of the Government schools. The academic syllabus will be taught in the
respective regional languages of the Government school students. This is one of the major
new education policy drawbacks as this will increase the number of students uncomfortable
in communicating in English thus widening the gap between sections of the societies
 With inter-state migration for employment, and India’s large diversity of languages, regional
language will hobble some students’ learning
 It is particularly problematic in light of the right of the people to move from one state to
another since the inter-state movement shall result in the change of the local language and
the mode of education
 There is a problematic teacher to student ratio in India, thus introducing mother languages
for each subject in academic institutes is a problem. Sometimes, finding a competent teacher
becomes a problem and now another challenge comes with the introduction of the NEP 2020,
that is bringing study material in mother languages

Vocational Education: Stress on vocational training from the preparatory stage, many fear, would
lead to students from marginalised backgrounds dropping out early to take up jobs. This may also
impede a more holistic learning
Legal complexities: The policy has also been criticised due to the legal complexities surrounding the
applicability of two operative policies namely The Right to Education Act, 2009 and the New
Education Policy, 2020. Certain provisions such as the age of starting schooling will need to be
deliberated upon, in order to resolve any conundrum between the statute and the recently
introduced policy
Federal Setup: In a federal system like India, where education is a concurrent subject, any
educational reform can be implemented only with support from the States, and the Centre has the
giant task of building a consensus on the many ambitious plans. As an example, the proposed national
assessment body or PARAKH and its realization requires active cooperation of as many as 60
education boards across the country
Fear of Commercialization and privatization of education
Many experts argue that NEP, in the name of philanthropic schools and PPP, is laying the roadmap for
entry of private players in education, which will further commercialise education and the existing
inequalities will be exacerbated
The NEP suggests that admission to all higher education programmes should be based on
standardised test scores conducted by the National Testing Authority. This encourages coaching
classes and rote memorisation, further eroding the value of examinations and assessments conducted
by the schools, colleges, and universities
Lack of detailed thinking may affect the NEP’s vision. For instance, it has proposed a four-year
undergraduate programme. A similar experiment in Delhi University failed a few years ago. The then
HRD minister had to withdraw the four- year course, which was implemented without proper
thinking, leading to much confusion among students and teachers
Students willing to complete their graduation have to study for four years while one can easily
complete his/ her diploma degree in two years. This might encourage the pupil to leave the course
midway
Ground realities: Experiential learning, for instance, through project work requires significant
financial resources for procuring project materials and setting up tinkering labs.
A pedagogy that ingrains critical thinking requires the assessment of answers to long-form questions.
Such activities simply need more teachers, while the reality on the ground is that school systems face
chronic and persistent teacher shortages.
The bulk of schools pay salaries which are unlikely to attract too many good applicants, and most will
certainly worry about the cost of acquiring the 4-year B.Ed. degree for a job that may not be
remunerative enough
One of the most important neglected points is the policy of no exams till the 7th or 8th standard.
This policy has been heavily criticized for impacting learning outcomes in the absence of exams at the
school level
As discussed earlier, there is a mismatch in the skill imparted in educational institutions and jobs
available. This important issue has been largely ignored in the policy. Especially, there is insufficient
discussion on new-age technologies like Artificial Intelligence, cyber security, etc when these fields are
set to dominate world knowledge and job space

Challenges with e-learning in India

 Digital Divide: less than 15% of rural Indian households have Internet connection (as
opposed to 42% urban Indian households).
 Further, classes at times get disturbed due to connectivity issues
 As per NSSO data, only 4.4% of rural households and 23.4% of urban households have
computer/laptop.
 Thus 75% of students are using smartphones to watch online classes. Teachers are
apprehensive about students using smartphones because of distracting apps
 Difficult for parents to adjust: Parents complain of increased screen time for children, aren’t
comfortable with technology themselves and increased pressure from the added household
work
 Gender divide: Increased domestic responsibilities especially for girls is impairing the
atmosphere of learning. According to a recent UN report, only 29% of all internet users are
female, which indicates that transitions to digital learning may compound the gender gap in
education
 Lack of vernacular content: Most of the content and existing lectures on internet are in
English. In India, the Ministry of HRD data shows that there are only 17% English medium
schools
 Creating new inequality: Only a handful of private schools, universities and IITs could adopt
online teaching methods. Their low-income private and government counterparts do not
have access to e-learning solutions
 Without adequate training, many teachers are not comfortable with using technology
  Also, with reduced interaction, it is difficult for teachers to develop a rapport with the
children for effective teaching
 Teachers are also under tremendous pressure due to interference by overenthusiastic
parents
 Student Feedback is weak as compared to face-to-face feedback in traditional classrooms
 Social Isolation due to the absence of human communication in physical classrooms
 Requires strong self-motivation
 Lack of communicational skill development due to the lack of face-to-face communication
between peers, students and teachers in an online setting
 Cheating prevention during online assessments is complicated
 Lack of institutions’ autonomy: Existing rules have constrained Indian education institutions
to take advantage. Till now, the UGC has licensed only seven universities to offer online
courses
 Conducting large-scale, high-stakes examinations will be more complicated. Most board and
entrance examinations have been either postponed or suspended, causing disruptions in the
academic calendar
Advantages of e-learning
 Flexibility to plan schedule
Ease of Access
 More Affordable as online programs are cheaper when compared to the ones held in a
traditional campus
 Solves teacher scarcity
 Environmentally friendly as it consumes less energy and emits fewer CO2 emissions than
traditional university courses. In addition, as E-Learning is a paperless learning method

Way Forward
Policies often fall short of getting implemented due to several pitfalls
Policies often fail due to conflicting goals and a complete disconnect with previous policies. The new
NEP is a major departure from the previous education policies and addresses their most critical
limitations and fault lines. But there is visible continuity in terms of realising universal access to quality
education
Setting the right priorities is another important step
There are two key players in the implementation of NEP – the Ministry of Education at the Centre
and the stakeholders, which includes state governments, schools and academic institutions
Both the players have to set the priorities right and these priorities should be based on both the
short-term and long-term needs of educational institutes, funding requirements and realistic
deadlines
The Ministry of Education and HECI need to work in tandem withthe states and the educational
institutes
Attitudinal changes: Many of the changes that NEP sets out to achieve require attitudinal changes by
adopting effective teaching-learning processes, academic and administrative procedures
Distinctly outlining the chain of command for implementation to avoid duplication and overlap of
efforts
Define the key performance indicators
Strengthen the existing network of anganwadi centres
Revisit state and national norms for age of entry to school: ASER shows clearly that performance is
closely related to children's age. Permitting underage children into primary grades puts them at a
learning disadvantage which is difficult to overcome
Breadth of skills is important, and focusing too early on formal subject learning is counter-
productive: ASER 2019 data shows a focus on activities that strengthen cognitive skills rather than
subject learning in the early years may generate substantial benefits in terms of children’s future
learning
Need to streamline the curriculum at the pre-school stage so that all pre-schools focus on activities
that build cognitive and early literacy and numeracy skills
Reducing the Gender Divide by leveraging the digital solutions to enrol out of school girls
Courses on Indian traditional knowledge systems in the fields of yoga, Indian medicines, architecture,
agriculture etc. should be integrated with the mainstream university education topromote scientific
innovations, values
Open-source digital learning solutions and Learning Management Software should be adopted so
teachers can conduct teaching online. The DIKSHA platform, with reach across all states in India, can
be further strengthened to ensure accessibility of learning
Deployment of ed-tech applications which takes into account the low internet bandwidth and patchy
connections
Improve content in regional language. The existing EdTech solutions can prioritize the translation of
key modules into regional dialects and deliver educational content with the help of grassroots
Leveraging community owned tablets and smart devices for education can also aid learners. Also, the
services of Bharatnet and Wi-Fi Choupal (wifi hotspots) can be used to access the educational
modules by the students in remote villages
Establishing quality assurance mechanisms and quality benchmark for online learning as well as
eLearning platforms. Many e-learning players offer multiple courses on the same subjects with
different levels of certifications, methodology and assessment parameters. So, the quality of courses
may differ across different e-learning platforms

Recently, The Ministry of Human Resource and Development (MHRD) has prepared a HECI
(Repeal of University Grants Commission Act) Bill 2018 and has placed it in public domain for
comments and suggestions

Evaluation of UGC

 University Grants Commission Act was enacted in 1956. However, it is unsuitable for
regulation today and needs to be changed in-line with the growing complexity and
increased number of higher educational institutions
 Issue of fake universities, fake degrees, over centralisation, bureaucratic and Political
interference of UGC, lack of transparency in fund disbursal
 Therefore, Administration of UGC continues to be marked by inadequate financial and
human resources, nepotism, corruption and favouritism
 Since the UGC is preoccupied with disbursing funds it is unable to concentrate on
mentoring the institutes, focusing on research to be undertaken etc.
 UGC has no power to ensure compliance. All it can do it is recommend penal provision
to the ministry of HRD
 Red tape and lethargy: Several committees like Yash Pal committee, National Knowledge
Commission and the Hari Gautam committee have recommended a single education
regulator to rid higher education of red tape and lethargy.
 Earlier, TSR Subramanian committee recommended to replace UGC by new national
higher education act. Accordingly, govt has now planned to set up “Higher education
commission of India” (HECI).
 NITI Aayog’s Higher Education Action Agenda also suggested overhaul of archaic UGC
Act 1956
Key features of the Higher Education Commission of India (Repeal of
University Grant Commission Act) Bill , 2018:

1. This Act provides for establishing the Higher Education Commission of India
repealing the University Grants Commission Act, 1956.
2. This Act is applicable for all higher educational institutions established, under
any Act of the Parliament excluding Institutions of National Importance so
notified by the Government, Act of State Legislature and to all Institutions
Deemed to be Universities so notified by the Government.
3. Term of office of Chairperson, Vice Chairperson and 12 Members

 A person appointed as Chairperson, Vice Chairperson and other Members

shall hold office for a term of five years from the date on which he enters upon
his office or upto 70 years of age
 Chairperson, Vice Chairperson and Members shall be eligible for one more
term subject to age limit of seventy years
 Government can remove chairman for various reasons (No such power to
government in UGC act)

4. Separation of academic and funding aspects (In UGC it was combined)

 HECI will be in charge of ensuring academic quality in universities and

colleges
 Ministry of Human Resource Development (MHRD) will be responsible for
funding universities and colleges.

5. Maintenance of academic standards in the Higher Education system

 Specify learning outcomes for courses of study in higher education;

 Lay down standards of teaching / assessment / research or any aspect
that has bearing on outcomes of learning in higher educational institutions
including curriculum development, training of teachers and skill development;
 Evaluate the yearly academic performance of higher educational
institutions, by monitoring the performance on criteria laid down;
 Promote research in HEIs and coordinate with Government for provision of
adequate funding for research;
 Put in place a robust accreditation system for evaluation of academic
outcomes by various HEIs;
 Provide for mentoring of institutions found to be failing in maintaining the
required academic standards;
 Order closure of institutions which fail to adhere to minimum standards
without affecting the student’s interest or fail to get accreditation within the
specified period; (UGC had no such power)
 Specify norms for award of degrees by the institutions laying down
minimum credits to be earned in the given period;

6. Advise the Central Government or any State Government on any question

which may be referred to the Commission by the Central Government or the
State Government, as the case may be;
 7. Specify minimum eligibility conditions for appointment of Vice Chancellor,
ProVice Chancellor, Directors / Principals, Deans, Heads of Department,
teaching and non-teaching staff of any Higher Educational Institutions;
8. Specify norms and processes for fixing of fee chargeable by Higher
Educational Institutions
9. Perform such other functions as may be prescribed or as may be deemed
necessary by the Commission for advancing the cause of higher education in
India or as may be incidental or conducive to the discharge of the above
functions.
10. Monitor, through a national database, all matters concerning the
development of emerging fields of knowledge, balanced growth of higher
educational institutions in all spheres and academic quality in higher
education and research;
11. Submit an annual report to the Parliament on the roles, responsibilities and
powers and functions discharged.

The HECI draft Bill is critised on the following grounds:

 Political interference: The structure of the new body is such that it will give
political parties more say in decision making regarding education.
 Transferring all financial powers from the UGC to the MHRD would amount to imposing direct
state control over higher education institutions
 The bill talks about promoting autonomy. Several institutions have opposed autonomy as it is
a route towards commercialisation and increased marginalisation or complete exclusion of
students from socially oppressed and economically weaker sections
 The powers to authorise, monitor, shut down, lay down norms for graded autonomy or
standards for performance-based incentivisation been made unilateral and absolute
 There is no plan to merge all higher education regulators, as was
proposed through a planned agency called Higher Education Empowerment
Regulation Agency (HEERA), which was supposed to be put in place as a
super regulator.
 Loopholes in UGC should have been addressed: The loopholes in the
functioning of the UGC should have been addressed by the academicians in
the higher education sector and not the government.
 Government control: The nature of the structure of the commission and its
advisory council shows that they are bound to have more “government” in
decision making processes rather than academics.
 The proposed draft has drastically reduced the presence of teachers in the body. UGC has 4
teacher members out of total 10 members, while the HECI has only 2 teacher members out of
total 12 members
 Foreign degree granting institutions: The Bill seems to implicitly open the
door to foreign degree-granting institutions as long as they meet the specified
norms, it will be best to make it explicit. This will eliminate the threat of legal
challenges should a foreign institution wish to enter India.
 More authoritative: Sweeping powers render the HECI more authoritative
than the collective strength of campus authorities.
 Over regulate and micromanage universities: With its mandate of
improving academic standards with a specific focus on learning outcomes,
evaluation of academic performance by institutions, training of teachers, the
HECI is likely to overregulate and micromanage universities.
  Impact on autonomy: The proposal to empower the centre to remove the
HECI’s chairperson and vice-chairperson for reasons including “moral
turpitude” will again curtail the regulators autonomy, which in turn will impact
the autonomy of universities.
 Institutions of National Importance: The Institutions of National Importance
(INIs) have been kept out of purview of the proposed HECI Act

Way ahead:

 While HECI can uplift Indian higher education, but requires some correctives
before enactment
 The government should also address the concerns of various academician
before initiating any reform
 restoring the value of education in social sciences and the humanities,
 ensuring that poor and meritorious students can afford to be educated in
subjects of their choice,
 improving the quality of instruction to enhance the employability of the
students,
 Addressing the concerns of faculty shortage, etc.
 Ensure separation of funding decisions from political considerations
 Need to learn from the US, the UK and Canada where none of the institutions
is exempted from accreditation. In India, institutions like IITs are free from
accreditation.
 The future role of multiple regulatory bodies that currently exist for
engineering, medicine and law must be addressed.
 In the US, there is the concept of a super regulator that regulates autonomous
regulators, particularly of professional sectors which need specialised
knowledge. Similar democratic structures exist in many European
democracies. India needs to learn from their experiences.
 Set academic benchmarks for each stream, with sufficient autonomy to
innovate on courses and encourage studies across disciplines.