Jharkhand public service commission – SCIENCE & TECHNOLOGY

📌 PART I: PRE-INDEPENDENCE FOUNDATION

1.1 Colonial Health Legacy

The modern public health institution in India was a byproduct of colonial rule . However, colonial health measures never assumed the real character of public health:

“Health measures adopted by the colonial administration typically centred around the interests of the European civilians and British army.”

1.2 The Bhore Committee (1946) – India’s Healthcare Foundation

Chairman: Sir Joseph Bhore

Significance: This was India’s first comprehensive health survey – the foundation document for independent India’s health policy .

Key Findings:

• Presented a bleak health landscape
• High mortality rates
• Low life expectancy
• Inadequate healthcare infrastructure

Key Recommendations:

“The Bhore Committee’s report presented a bleak health landscape in terms of mortality rates, life expectancy, and healthcare infrastructure.”

Static Link: The Bhore Committee report (1946) became the blueprint for India’s post-independence health policy .

📌 PART II: POST-INDEPENDENCE ERA (1947-1983)

2.1 Early Decades – Focus on Disease Eradication

After independence, the primary focus was on controlling and eradicating communicable diseases :

Static Link: Smallpox eradication in India (1977) – one of India’s greatest public health achievements.

2.2 The Alma-Ata Declaration (1978) – Global Influence

Signed: September 1978, Alma-Ata, USSR (now Kazakhstan)

Co-sponsored by: WHO and UNICEF

Goal: “Health for All by 2000 AD” – focusing on primary healthcare centres (PHC model) .

Key Principles:

• Healthcare as a fundamental human right
• Primary healthcare as the key to achieving “Health for All”
• Community participation
• Intersectoral coordination

Static Link: The Alma-Ata Declaration influenced India’s first National Health Policy (1983) .

📌 PART III: THE THREE NATIONAL HEALTH POLICIES

3.1 National Health Policy (NHP) 1983

Context: Shifted focus from disease control to improving healthcare facilities after the success of reducing communicable disease burden .

Key Features:

Static Link: PHC model – based on 1 PHC per 30,000 rural population (1 per 20,000 in hilly/tribal areas).

Critique: Despite progress, healthcare infrastructure remained inadequate and concentrated in urban areas .

3.2 National Health Policy (NHP) 2002

Context: Recognized the rural-urban divide and inadequate healthcare infrastructure.

Key Features:

Common Minimum Programme (2004):

• Proposed raising public health spending to 2-3% of GDP over next five years
• Focus on primary healthcare

Static Link: The UPA government’s Common Minimum Programme (2004) proposed 2-3% GDP spending on health.

Critique: Healthcare services remained largely skewed in favour of urban areas .

3.3 National Health Policy (NHP) 2017 – Paradigm Shift

Context: 15 years after the previous policy – healthcare scenario had changed significantly .

Key Features:

Key Targets (2025):

Preventive and Promotive Focus:
The NHP 2017 identified seven priority areas for improving the environment for health :

1. Swachh Bharat Abhiyan
2. Balanced, healthy diets and regular exercises
3. Tobacco, alcohol and substance abuse
4. Yatri Suraksha – road/rail accident prevention
5. Nirbhaya Nari – action against gender violence
6. Reduced workplace stress
7. Indoor and outdoor air pollution

Financing Reforms:

• Resource allocation to States linked with development indicators
• General taxation as predominant means
• Taxes on tobacco, alcohol, foods with negative health impact
• CSR funds leverage

Critiques of NHP 2017:

“The 2017 policy is high on hope and hype, and written in elegant prose, but opens itself to two kinds of critique: the agency-capability critique and the feasibility critique.”

📌 PART IV: THE NATIONAL HEALTH MISSION (NHM)

4.1 National Rural Health Mission (NRHM) – 2005

Launch Year: 2005

Objective: Improve healthcare accessibility, affordability, and quality in rural areas .

Key Features:

Key Targets (as per NHM extension 2021-26):

4.2 National Urban Health Mission (NUHM)

Launch Year: 2013 (as sub-mission of NHM)

Objective: Address healthcare needs of urban populations – especially slum dwellers and urban poor.

NRHM + NUHM = National Health Mission (NHM) – the umbrella mission .

NHM’s Major Objectives:

1. Reduction in child and maternal mortality
2. Prevention and control of communicable and non-communicable diseases
3. Access to integrated comprehensive primary health care
4. Population stabilisation, gender equality
5. Revitalize local health traditions & mainstream AYUSH
6. Universal access to public health services

📌 PART V: AYUSHMAN BHARAT – THE FLAGSHIP SCHEME

5.1 Introduction

Launch: September 23, 2018 – Ranchi, Jharkhand

Minister: Implemented by National Health Authority (NHA)

Significance: World’s largest government-funded health assurance program .

Goal: Achieve Universal Health Coverage (UHC)

Target Population: 12 crore vulnerable families (~55 crore beneficiaries) – poorest 40% population .

5.2 Three Components of Ayushman Bharat

Component 1: Health and Wellness Centres (HWCs)

Component 2: Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Component 3: Ayushman Bharat Digital Mission (ABDM)

5.3 Eligibility under PM-JAY

Based on SECC 2011 Data:

5.4 PM-JAY Key Statistics (as of 2024)**

5.5 PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)**

Launch: FY 2021-22 Budget

Allocation: ₹64,180 crore over 6 years (up to FY 2025-26)

Key Features:

5.6 Challenges of PM-JAY**

📌 PART VI: CURRENT SCENARIO (2026) – THE TRANSFORMATION

6.1 Budget 2026-27 – Health Allocation**

Key Budget Announcements:

• 100% customs duty exemption on 17 new cancer drugs
• Training target: 1 lakh allied health professionals + 1.5 lakh caregivers over 5 years
• Three new AIIMS (Ayurveda) – to meet growing global demand

6.2 Health Indicators – Transformational Progress**

Maternal Mortality Ratio (MMR):

Under-Five Mortality Rate (U5MR):

• Since 1990: 79% decline (vs global 61% decline)

Neonatal Mortality Rate (NNMR):

• Since 1990: 70% decline (vs global 54% decline)

Other Indicators:

Mission Indradhanush:

• 5.46 crore children vaccinated who had missed routine immunisation
• 1.32 crore pregnant women vaccinated

HPV Vaccination Drive (Feb 2026):

• 50+ lakh adolescent girls vaccinated

6.3 National Ambulance Services (NAS) Operational Guidelines, 2026

Launched: 16th CCHFW Conference (June 2026)

Purpose: Uniform national standards for emergency medical transport services .

Key Features:

• Standardizing ambulance infrastructure, staffing, equipment
• Response protocols
• Digital integration
• Quality assurance mechanisms

6.4 SUMAN Roadmap 2030

Full Name: Surakshit Matritva Aashwasan (SUMAN)

Purpose: Strengthen maternal and newborn healthcare services .

Targets:

• Improve service quality
• Ensure respectful maternity care
• Reduce preventable maternal and neonatal deaths
• Accelerate progress toward SDGs related to maternal and child health

6.5 Anaemia Mukt Bharat Abhiyaan (Next Phase)**

Launched: 16th CCHFW Conference (June 2026)

Key Features:

• Saturation-based screening
• Digital beneficiary tracking
• Case-based management
• Nutrition interventions
• Dietary diversification
• Behaviour change communication

📌 PART VII: CENTRAL COUNCIL OF HEALTH AND FAMILY WELFARE (CCHFW) – 16TH CONFERENCE (JUNE 2026)

7.1 Key Outcomes

7.2 Key Observations by Health Minister

“The last twelve years have witnessed transformational changes in India’s healthcare sector. The National Health Policy, 2017 marked a paradigm shift… from predominantly curative care to a holistic, inclusive and comprehensive healthcare system encompassing preventive, promotive, curative, palliative and rehabilitative care.”

Infrastructure Achievements:

📌 PART VIII: CURRENT AFFAIRS CONNECTIONS

8.1 Private Healthcare Cost Debate – August 2026

The 176th Report of the Parliamentary Standing Committee: Private hospitalisation costs are 7.6x higher than government hospitals (₹50,508 vs ₹6,631) .

Role of Information Asymmetry:

• Patient rarely independently decides necessity of tests/procedures
• Provider’s financial incentives distort care intensity (“medicalisation”)
• Over-testing, unnecessary admissions, aggressive interventions

Policy Implications:

• Needs nuanced distinction between greenfield investments (encourage) vs acquisitions (scrutinise)
• Price-capping room tariffs to 3-star hotel rates is simplistic
• Diagnosis-Related Groups (DRGs) as better instrument – bundled, pre-determined payment per diagnosis

“India cannot ‘regulate its way out of weak public healthcare.'” (August 2026 Hindu analysis)

8.2 Disaster Fund Architecture – Heatwaves Added (August 2026)

Notification: August 4, 2026 – MHA added heatwaves + lightning to notified natural calamities (now 14 total)

FC-XVI Recommendation: ₹2.04 lakh crore for State Disaster Funds (2026-31)

• SDRF: ₹1.6 lakh crore (immediate relief/response)
• SDMF: Rest (long-term risk reduction)
• NDRF: ₹79,406 crore (disasters exceeding State capacity)

Implementation Gaps:

• Only 300 of ~4,800 ULBs/districts have Heat Action Plans
• 79% of HAPs rely on unfunded “self-allocation”

8.3 UPI 10th Anniversary (August 25, 2016)

Transaction Growth:

8.4 Delimitation – August 2026 Developments

TN Assembly Resolution: Called for freeze at 543 Lok Sabha seats (Maintain 2.2:1 LS:RS ratio)

DMK’s Opposition: Accused government of “U-turn” on delimitation

📌 PART IX: STATIC REVISION – KEY ARTICLES & ACTS

📌 PART X: QUICK REVISION – KEY DATES