Content
- PHC doctors — a case where the caregivers need care
- The growing relevance of traditional medicine
- Basic structure
PHC doctors — a case where the caregivers need care
Context
- Primary Health Centres (PHCs): Backbone of India’s public health system; first point of contact in rural and semi-urban areas.
- Population coverage: ~30,000 per PHC; 20,000 in hilly/tribal regions; 50,000 in urban areas.
- Role of PHC doctors: Beyond clinical care—planners, coordinators, program implementers, health educators, and community leaders.
- PHC core functions: Preventive care, maternal and child health, immunization, disease surveillance, vector control, school health programs.
Relevance
- GS2 – Governance / Health Policy:
- Public health delivery, primary healthcare system, Universal Health Coverage (SDG 3.8).
- Role of PHC doctors in implementation of national programs (RBSK, immunization, disease surveillance).
- Workforce management, health administration, digital health systems (IHIP, HMIS).
- GS1 – Society / Social Issues:
- Access to healthcare in rural and tribal areas.
- Community-centered health delivery and participatory governance (gram sabhas, ASHA/ANM engagement).
Practice Questions :
- Critically examine the challenges faced by PHC doctors in India and suggest systemic reforms to strengthen primary health care delivery.(250 Words)
Expanded Responsibilities
- Clinical load: ~100 OPD patients/day; includes high-risk pregnant women, chronic illnesses, and emergencies.
- Multi-specialty expertise: Doctors must handle newborn care, geriatrics, infectious diseases, mental health, trauma, chronic diseases, and emergencies.
- Community engagement: Mentoring ASHAs/ANMs, visiting sub-centres/Anganwadis, organizing health education, participating in gram sabhas.
- Program execution: Key drivers of national health programs like RBSK, immunization campaigns, and outbreak response.
Administrative Burden
- Paperwork overload: 100+ physical registers for patient records, drugs, MCH, NCDs, sanitation, etc.
- Digital systems: IHIP, PHR, Ayushman Bharat, IDSP, HMIS, UWIN → often duplicate physical registers.
- Result: Long hours, administrative fatigue, reduced time for clinical care and research.
Burnout & Workforce Well-being
- PHC doctor stress: Clinical, administrative, and programmatic pressures → emotional exhaustion, detachment, and inefficiency.
- Global recognition: WHO ICD-11 recognizes physician burnout as occupational phenomenon; meta-analyses show 1/3 of primary care doctors in LMICs report exhaustion.
- India context: Even in progressive states like Tamil Nadu, systemic pressures remain despite NQAS certification.
Systemic Challenges
- Mismatch of expectations and support: High patient load, program targets, data reporting vs. inadequate staffing and recognition.
- Redundant processes: Manual + digital documentation; lack of meaningful automation.
- Limited capacity for innovation: PHC doctors have little time for reflection, research, or skill development.
Way Forward
- Administrative reform: Reduce redundant registers, meaningful digitization, delegate non-clinical tasks.
- Global best practices: Adopt initiatives like 25 by 5 to reduce documentation time by 75%.
- Supportive systems: Shift from compliance culture to facilitation; ensure physical, mental, and emotional well-being of doctors.
- Community-centered approach: Reinforce preventive care, local engagement, and holistic health delivery.
Strategic Importance
- PHCs & UHC: Gateway to Universal Health Coverage (SDG 3.8) → essential for access, quality, and financial protection.
- Investment priority: PHC doctors are the foundation of a resilient health system; their welfare directly impacts public health outcomes.
- Policy Implication: Strengthening primary care is not just infrastructure expansion but systemic redesign with empathy and efficiency.
The growing relevance of traditional medicine
Context
- Traditional Medicine (TM) globally: Practised in 88% of WHO member states (170/194 countries).
- Significance: Primary healthcare for billions in low- and middle-income countries due to accessibility, affordability, and cultural familiarity.
- Beyond healthcare: Supports biodiversity conservation, nutrition security, sustainable livelihoods.
Relevance
- GS1 – Society / Social Issues:
- Traditional knowledge systems, healthcare equity, wellness culture.
- Lifestyle diseases, preventive healthcare, community wellness.
- GS2 – Governance / Health Policy:
- Ministry of AYUSH initiatives, international cooperation, WHO partnerships, standards and recognition.
- Integration of traditional medicine in national/global health architecture.
Practice Questions :
- Evaluate the role of traditional medicine in India’s public health system and its potential contribution to global healthcare.(250 Words)
Global Market Overview
- Market growth: Global TM market projected to reach $583 billion by 2025 (10–20% annual growth).
- Key national sectors: China ($122.4B), Australia ($3.97B), India’s AYUSH ($43.4B).
- Trend: Shift from reactive treatment to preventive, wellness-oriented approaches addressing root causes.
India’s AYUSH Transformation
- Industry expansion: 92,000+ MSMEs; manufacturing revenue ↑ from ₹21,697 crore (2014–15) to ₹1.37 lakh crore; services revenue ₹1.67 lakh crore.
- Exports: $1.54 billion to 150+ countries; Ayurveda gaining formal recognition internationally.
- Public awareness: NSSO 2022–23 → 95% rural, 96% urban aware; over 50% used AYUSH in preceding year.
- Usage pattern: Ayurveda preferred for rejuvenation and preventive care.
Scientific Validation & Research
- Institutions: All India Institute of Ayurveda, Institute of Teaching & Research in Ayurveda, National Institute of Ayurveda, CCRAS.
- Focus areas: Clinical validation, drug standardization, integrative care models combining traditional and modern medicine.
- Technological integration: AI, digital health, big-data analytics to strengthen clinical validation and predictive care.
Global Outreach
- International partnerships: 25 bilateral agreements, 52 institutional collaborations.
- Global presence: 43 AYUSH Information Cells in 39 countries; 15 academic chairs in foreign universities.
- WHO Global Traditional Medicine Centre: Located in India; aims to integrate traditional medicine with modern science and technology.
Philosophy & Contemporary Relevance
- Core principles: Balance of body–mind, humans–nature, consumption–conservation.
- Holistic approach: Encompasses human, veterinary, and plant health → aligns with “One Health” concept.
- Relevance 2025: Ayurveda Day theme “Ayurveda for People & Planet” emphasizes sustainable, preventive, and inclusive healthcare.
Policy & Strategic Implications
- Economic: AYUSH sector as billion-dollar industry and global export driver.
- Soft power: Promotes India’s cultural heritage and traditional knowledge internationally.
- Public health: Supports preventive care, lifestyle disease mitigation, affordable access.
- Sustainability: Integrates health with environmental conservation, biodiversity, and climate resilience.
Conclusion
- India’s AYUSH sector is a convergence of traditional knowledge, modern science, and technology, serving preventive, inclusive, and sustainable healthcare.
- Global positioning: Enhances India’s soft power, economic footprint, and leadership in integrating traditional medicine with global health strategies.
- Future outlook: Traditional medicine systems like Ayurveda can provide solutions for lifestyle disorders, climate-related health challenges, and holistic wellness, making them integral to planetary and human health.
Basic structure
Context
- Event: Mysuru Dasara festival, state-sponsored cultural celebration at Chamundeshwari Temple, Karnataka.
- Incident: Banu Mushtaq, a Muslim Booker Prize-winning writer, invited to inaugurate the festival.
- Petition: Claimed her participation violated Articles 25 & 26 (freedom of religion).
Relevance
- GS1 – Society / Social Issues:
- Secularism, religious pluralism, cultural integration.
- Role of festivals in social cohesion.
- GS2 – Governance / Constitution:
- Articles 25, 26, and the Preamble; basic structure doctrine.
- Judicial review as a check against communalisation of public events.
Practice Question :
- “Secularism is the cornerstone of India’s constitutional identity.” Discuss in light of recent Supreme Court rulings on public events.(250 Words)
Supreme Court Intervention
- Bench: Justices Vikram Nath and Sandeep Mehta.
- Ruling: Petition dismissed; clarified Dasara is a public/state cultural event, not a private religious ceremony.
- Principle reaffirmed: Secularism is part of the basic structure of the Constitution.
- Key observation: The State cannot discriminate based on religion in public events; participation in cultural events cannot be restricted by religious identity.
Constitutional & Legal Dimensions
- Articles cited:
- Article 25: Freedom of conscience and free profession, practice, and propagation of religion.
- Article 26: Freedom to manage religious affairs.
- Interpretation reinforced:
- Right to practise one’s religion does not confer the right to restrict others from participating.
- Public events organised by the State must respect pluralism and secularism.
- High Court support: Karnataka High Court previously upheld participation as constitutional.
Social & Cultural Significance
- Festivals historically transcend social and religious barriers, promoting unity.
- Shared participation in cultural events strengthens social cohesion and pluralism.
- Editorial warns against political opportunists exploiting communal sensitivities to create rifts in society.
Ethical & Governance Implications
- Ethical stance: Excluding participants based on religion is indefensible in a diverse society.
- Governance message: State events must reflect constitutional values — secularism, equality, and inclusivity.
- Accountability: Individuals or groups attempting to communalise public spaces must be held responsible legally and socially.
Broader Lessons
- Secularism is not just a legal principle; it is cultural and political praxis in India.
- Public celebrations can serve as platforms to reinforce national unity and pluralistic ethos.
- Courts play a crucial role in upholding constitutional values against opportunistic communal interventions.
Conclusion
- The Supreme Court reaffirmed that public events cannot discriminate on religious grounds, strengthening secularism as a core constitutional value.
- Key takeaway: In a pluralistic society, cultural celebrations must embrace diversity and reinforce the ethos of coexistence, resisting communal exploitation.
