NDHM, landmark initiative for quality healthcare
Author: Rajiv Roy
As a country of 135 crore people, India has all reasons to be proactive, innovative and focussed to ensure quality, affordable and ethical universal healthcare for all. Health facilities -- private or public – require to be responsive to people’s emergency and routine needs. The Centre and States are continuously working to make affordability in the health sector a reality. However, equally challenging is the task to ensure efficacy of existing health facilities, resources and their real time response during the need of the hour. Hence, the need for National Digital Health Mission (NDHM), which addresses a host of issues and constraints to strengthen India’s healthcare delivery systems. It has all potential to be a milestone on India’s road to achieve the goal of universal healthcare,
As India remains committed to make high quality healthcare accessible to all up to the last mile, digital health interventions have a huge role to play. In the words of J Satyanarayana, former chairman, UIDAI and chairman of the National Digital Health Blueprint (NDHB) Committee, digital health services will be the “biggest leap of the Government of India (GoI) towards achieving the goal of universal healthcare coverage (UHC) with an impetus on digital healthcare component.” For long, the need has been felt for a common platform for the integration of existing applications in health domain and data which has existed in silos either in public or private healthcare facilities in India, which is now being fulfilled in the form of NDHM.
To quote Union Health and Family Welfare Minister Dr Harsh Vardhan, “the need of the hour is to create an ecosystem which can integrate the existing disparate health information systems and show a clear path for upcoming programmes. There is a need to ensure convergence across these IT systems to monitor and provide health services in a robust and efficient manner.” Needless to say that real time critical intervention remains a major challenge so far as our health delivery system is concerned. Though over the years information technology (IT) has been adopted in the health sector immensely, a lot is still to be done, particularly in the field of making medical services accessible to all, a realisation which dawned upon us so explicitly during our fight against the coronavirus pandemic.
Under the NDHM, health identity (ID) will be given to every Indian, which will contain details of every test, disease, doctors visited, medicines taken and diagnosis. The information contained in the NDHM ID will not only be foolproof but also portable and easily accessible even if the patient shifts to a new place and visits a new doctor. It is a holistic, voluntary healthcare programme which integrates doctors, hospitals, pharmacies, insurance companies and makes a digital health infrastructure. Like eSanjeevani, Jan Oushadhi, the Pradhan Mantri Jan Arogya Yojana (PMJAY, perhaps the largest health assurance scheme in the world providing a health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalization, the digital health cards will help doctors treat patients accessing their past medical history.
To ensure that India’s leap towards digitization of health services is taken to its logical conclusion seamlessly and transparently, the National Health Authority (NHA), the apex agency responsible for the implementation of AB-PMJAY, has been tasked to design, build, roll-out and implement the NDHM in the country. Currently, the scheme has been rolled out as a pilot project in six Union Territories -- Chandigarh, Ladakh, Dadra and Nagar Haveli and Daman and Diu, Puducherry, Andaman and Nicobar Islands and Lakshadweep.
According to NHA, the NDHM aims to liberate citizens from the challenges of finding the right doctors, seeking appointment with them, payment of consultation fee, making several rounds of hospitals for prescription sheets and will empower all Indians with the correct information and sources enabling them to take an informed decision to avail the best possible healthcare. The new initiative consists of six key building blocks or digital systems - HealthID, DigiDoctor, Health Facility Registry, Personal Health Records, e-Pharmacy and Telemedicine. The core building blocks such as Health ID, DigiDoctor and Health Facility Registry (HFR) shall be owned, operated and maintained by the Central government. So far as private sector players are concerned, they will also have an equal opportunity to integrate with these building blocks and create their own products for the market. However, core activities and verifications, for example, generation of health ID or approval of a doctor or facility shall remain with the government.
It is worth stating here that NDHM is in tune with the spirit of the National Health Policy – 2017 (NHP—2017) , which focuses on addressing the current and emerging health challenges necessitated by the changing socio-economic, technological and epidemiological landscape. The NHP-2017 advocates extensive deployment of digital tools for improving the efficiency and outcome of the healthcare system and aims at an integrated health information system which serves the needs of all stake-holders and improves efficiency, transparency, and citizen experience. Advocating for progressively incremental assurance-based approach with focus on preventive and promotive healthcare, the NHP-2017 recommends linking the health card to primary care facility for a defined package of services anywhere in the country. NHP—2017 envisages providing a larger package of assured comprehensive primary healthcare and attaining the highest possible level of health and well-being for all at all ages through preventive and promotive healthcare and universal access to quality health services without anyone having to face financial hardship as a consequence.
Alive to the contours of NHP-2017, the current dispensation at the Centre under the overall leadership of Prime Minister Narendra Modi has ensured that adequate funds are allocated to the health sector. In the Union Budget 2017-18, the Central government provisioned Rs 47352.51 crore to Ministry of Health and Family Welfare (MoHFW). This was a 27.7 per cent increase in allocation over the previous year. In 2018-19 as well, there was an increase of 11.5 per cent in the outlay of health over 2017-18 with allocation of Rs.52,800 crore. Also, Rs 24,908.62 crore was provided for the National Health Mission (NHM) in 2018-19, Rs. 2967.91 crore more than the last year’s allocation. Rs 62,659.12 crore outlay was earmarked for the health sector in the Union Budget for 2019-2020 fiscal, the highest in the last two financial years. The sincerity, with which the Central government is working to bring transparency and affordability in the health sector without compromising with its quality, will go a long way in laying the foundation of a strong India.
By
Rajeev Ranjan Roy
( The writer is a senior journalist and author. The views expressed are strictly personal.)
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NEP-2020 aspires for inclusive excellence in school education
Rajeev Ranjan Roy
The New Education Policy-2020 (NEP-2020), unveiled recently, aims at achieving excellence in school learning by imparting quality, affordable and inclusive education to all, with an extra emphasis on those children coming from socially and educationally disadvantaged groups of the society. It is a futuristic endeavour towards building Ek Bharat, Shrestha Bharat. The previous education policies largely focussed on the issues of access and equity in giving school education, while the NEP-2020 commits to laying the foundation of a vibrant Bharat where no one is devoid of a kind of school education, which helps every student become an asset for the nation in a true sense. The unfinished agenda of the National Policy on Education 1986, which was modified in 1992, has been effectively dealt with in the NEP-2020 along with the vision behind the Right to the Free and Compulsory Education Act, 2009, which “laid down legal underpinnings for achieving universal elementary education.”
Given the undisputed role of education in nation building, the NEP-2020 rightly lays the stress on standardization and accreditation of school infrastructure and teachers as well, since education with accountability, transparency and affordability is the need of the hour, and hence the need to “empower schools, teachers with trust, enabling them to strive for excellence and perform at their very best, while ensuring the integrity of the system through the enforcement of complete transparency and full public disclosure of all finances, procedures and outcomes.” Since private sector is significantly present in the field of school education, the idea to promote ‘not-for-profit’ entities is a unique feature of NEP-2020, which at the same time intends to promote private philanthropic efforts for quality education, thereby affirming the public-good nature of education, while protecting parents and communities from arbitrary increase in tuition fees.
An equally important area, which has got due attention in the NEP-2020 is the need for efficient resourcing and effective governance through school complexes and clusters, a significant initiative in view of the fact that nearly 28 per cent of India’s public primary schools and 14.8 per cent of upper primary schools have less than 30 students. The average number of students per grade in the elementary schooling system – Grades 1 to 8 – is about 14, with a notable proportion having below six students during 2016-17, the year which also had 1,08,017 single-teacher schools, and majority of them – 85,743 – being primary schools taking care of Grades 1-5 children. It was, therefore, a pressing need to evolve a mechanism for establishing a grouping structure, say, school complexes, consisting of one secondary school together with all other schools, which lead to greater resource efficiency and more effective functioning, coordination, leadership, governance, and management of schools in the cluster. This will not only ensure optimum utilisation of resources, but will also foster the sense of oneness and togetherness among the school children, who are the future of the nation.
What further makes the New Education Policy-2020 uniquely special is its pledge for equitable and inclusive education for all, one of the great dreams of our founding fathers. Education, as the NEP-2020 rightly envisions, is “the single greatest tool for achieving social justice and quality.” Inclusive and equitable education, indeed an essential goal in its own right, is also critical to achieving a social order where every citizen has “the opportunity to dream, thrive, and contribute to the nation.” Quality, affordable and ethical education to all is the first move to break multiple social and economic barriers, which sow the seeds of exclusion, discrimination and exploitation against our own people on different parochial considerations.
Needless to say efforts were made in the past as well to bridge the educational chasm between socially and educationally disadvantaged groups (SEDGs) and the children of top social strata, but the desired results remained elusive. SEDGs account for the country’s overwhelming population, but their children’s share in quality school educational institutions has been minimal over the years. Early childhood care and education (ECCE) needs to be handled more comprehensively. According to the Unified-District Information System for Education (U-DISE) 2016-17 data, about 19.6 per cent of students belonged to Scheduled Castes (SCs) at the primary level, but this fraction fell to 17.3 per cent at the higher secondary level. These enrollment drop-outs were more severe for ST students (10.6 per cent to 6.8 per cent), and differently-abled children (1.1 per cent to 0.25 per cent), with even greater declines for female students within each of these categories. Thus, there is no scope for any complacency on the part of the government. A series of interventions including better facilities, more and more hostels, scholarships and other enabling support have been provisioned in the NEP-2020 so that the idea of ‘learning for all’ is realised in a more comprehensive manner.
Teachers are not only an integral part of an education system, but the most important stakeholder in the entire gamut of things. Their quality and ability to teach school students, when they are in their formative age, become something of paramount importance. From their recruitment to training, every precaution needs to be taken to ensure that school education is not rendered to a mere formality, but becomes a game changer. The New Education Policy-2020 comes with a basket full of tools and parameters to ensure holistic training and upgradation of teachers and their teaching skills in a sustainable manner. From continuous professional development (CPD) to career management and progression (CMP), the NEP-2020 vouches for a set of common guidelines – National Professional Standards for Teachers (NPST), which will be put in place by the National Council for Teacher Education (NCTE) in its restructured new form as the Professional Standard Setting Body (PSSB) under the General Education Council. This exercise will be carried out in consultation with National Council Educational Research and Training (NCERT), SCERTs, teachers from across levels and regions.
The teacher education will also undergo a sea-change. By 2030, the minimum degree qualification for teaching will be a 4-year integrated B.Ed. that teaches a range of knowledge content. Today B.Ed. teaching is most poorly regulated in our country ever since the standalone B.Ed. colleges were allowed to be opened up in the private sector. It is high time to take B.Ed. teaching more than seriously. The NEP-2020 stipulates that by 2021, a new and comprehensive National Curriculum Framework for Teacher Education (NCFTE-2021) will be formulated by the NCTE. NCFTE, which will also factor in the requirements of teacher education curricula for vocational education, will be revised once every 5-10 years.
In conclusion, the NEP-2020 visualizes to impart a school education which lays the foundation of a self-reliant India and also to help our country emerge as a knowledge hub. From the foundation of learning to foundational literacy and numeracy to checking drop outs and ensuring universal access to education for all and at all levels to the restructuring of school curriculum, India is in for a metamorphosis in the field of school education, recognizing, identifying and fostering the unique capabilities of each student. Tools such as multi disciplinarity, emphasis on conceptual understanding, creativity and critical thinking, ethics and human and constitutional values, full equity and inclusion, and light but tight regulatory framework are bound to do wonders. Education is a public service, a rare pursuit in nation building, which should be holistic and inclusive and must make one take pride in India and its rich, diverse, ancient and modern culture and knowledge systems and tradition. The NEP-2020 aspires so, indeed!
( The writer is a senior journalist and author. The views expressed are strictly personal.)
NEP-2020 aspires for inclusive excellence in school education
Rajeev Ranjan Roy
The New Education Policy-2020 (NEP-2020), unveiled recently, aims at achieving excellence in school learning by imparting quality, affordable and inclusive education to all, with an extra emphasis on those children coming from socially and educationally disadvantaged groups of the society. It is a futuristic endeavour towards building Ek Bharat, Shrestha Bharat. The previous education policies largely focussed on the issues of access and equity in giving school education, while the NEP-2020 commits to laying the foundation of a vibrant Bharat where no one is devoid of a kind of school education, which helps every student become an asset for the nation in a true sense. The unfinished agenda of the National Policy on Education 1986, which was modified in 1992, has been effectively dealt with in the NEP-2020 along with the vision behind the Right to the Free and Compulsory Education Act, 2009, which “laid down legal underpinnings for achieving universal elementary education.”
Given the undisputed role of education in nation building, the NEP-2020 rightly lays the stress on standardization and accreditation of school infrastructure and teachers as well, since education with accountability, transparency and affordability is the need of the hour, and hence the need to “empower schools, teachers with trust, enabling them to strive for excellence and perform at their very best, while ensuring the integrity of the system through the enforcement of complete transparency and full public disclosure of all finances, procedures and outcomes.” Since private sector is significantly present in the field of school education, the idea to promote ‘not-for-profit’ entities is a unique feature of NEP-2020, which at the same time intends to promote private philanthropic efforts for quality education, thereby affirming the public-good nature of education, while protecting parents and communities from arbitrary increase in tuition fees.
An equally important area, which has got due attention in the NEP-2020 is the need for efficient resourcing and effective governance through school complexes and clusters, a significant initiative in view of the fact that nearly 28 per cent of India’s public primary schools and 14.8 per cent of upper primary schools have less than 30 students. The average number of students per grade in the elementary schooling system – Grades 1 to 8 – is about 14, with a notable proportion having below six students during 2016-17, the year which also had 1,08,017 single-teacher schools, and majority of them – 85,743 – being primary schools taking care of Grades 1-5 children. It was, therefore, a pressing need to evolve a mechanism for establishing a grouping structure, say, school complexes, consisting of one secondary school together with all other schools, which lead to greater resource efficiency and more effective functioning, coordination, leadership, governance, and management of schools in the cluster. This will not only ensure optimum utilisation of resources, but will also foster the sense of oneness and togetherness among the school children, who are the future of the nation.
What further makes the New Education Policy-2020 uniquely special is its pledge for equitable and inclusive education for all, one of the great dreams of our founding fathers. Education, as the NEP-2020 rightly envisions, is “the single greatest tool for achieving social justice and quality.” Inclusive and equitable education, indeed an essential goal in its own right, is also critical to achieving a social order where every citizen has “the opportunity to dream, thrive, and contribute to the nation.” Quality, affordable and ethical education to all is the first move to break multiple social and economic barriers, which sow the seeds of exclusion, discrimination and exploitation against our own people on different parochial considerations.
Needless to say efforts were made in the past as well to bridge the educational chasm between socially and educationally disadvantaged groups (SEDGs) and the children of top social strata, but the desired results remained elusive. SEDGs account for the country’s overwhelming population, but their children’s share in quality school educational institutions has been minimal over the years. Early childhood care and education (ECCE) needs to be handled more comprehensively. According to the Unified-District Information System for Education (U-DISE) 2016-17 data, about 19.6 per cent of students belonged to Scheduled Castes (SCs) at the primary level, but this fraction fell to 17.3 per cent at the higher secondary level. These enrollment drop-outs were more severe for ST students (10.6 per cent to 6.8 per cent), and differently-abled children (1.1 per cent to 0.25 per cent), with even greater declines for female students within each of these categories. Thus, there is no scope for any complacency on the part of the government. A series of interventions including better facilities, more and more hostels, scholarships and other enabling support have been provisioned in the NEP-2020 so that the idea of ‘learning for all’ is realised in a more comprehensive manner.
Teachers are not only an integral part of an education system, but the most important stakeholder in the entire gamut of things. Their quality and ability to teach school students, when they are in their formative age, become something of paramount importance. From their recruitment to training, every precaution needs to be taken to ensure that school education is not rendered to a mere formality, but becomes a game changer. The New Education Policy-2020 comes with a basket full of tools and parameters to ensure holistic training and upgradation of teachers and their teaching skills in a sustainable manner. From continuous professional development (CPD) to career management and progression (CMP), the NEP-2020 vouches for a set of common guidelines – National Professional Standards for Teachers (NPST), which will be put in place by the National Council for Teacher Education (NCTE) in its restructured new form as the Professional Standard Setting Body (PSSB) under the General Education Council. This exercise will be carried out in consultation with National Council Educational Research and Training (NCERT), SCERTs, teachers from across levels and regions.
The teacher education will also undergo a sea-change. By 2030, the minimum degree qualification for teaching will be a 4-year integrated B.Ed. that teaches a range of knowledge content. Today B.Ed. teaching is most poorly regulated in our country ever since the standalone B.Ed. colleges were allowed to be opened up in the private sector. It is high time to take B.Ed. teaching more than seriously. The NEP-2020 stipulates that by 2021, a new and comprehensive National Curriculum Framework for Teacher Education (NCFTE-2021) will be formulated by the NCTE. NCFTE, which will also factor in the requirements of teacher education curricula for vocational education, will be revised once every 5-10 years.
In conclusion, the NEP-2020 visualizes to impart a school education which lays the foundation of a self-reliant India and also to help our country emerge as a knowledge hub. From the foundation of learning to foundational literacy and numeracy to checking drop outs and ensuring universal access to education for all and at all levels to the restructuring of school curriculum, India is in for a metamorphosis in the field of school education, recognizing, identifying and fostering the unique capabilities of each student. Tools such as multi disciplinarity, emphasis on conceptual understanding, creativity and critical thinking, ethics and human and constitutional values, full equity and inclusion, and light but tight regulatory framework are bound to do wonders. Education is a public service, a rare pursuit in nation building, which should be holistic and inclusive and must make one take pride in India and its rich, diverse, ancient and modern culture and knowledge systems and tradition. The NEP-2020 aspires so, indeed!
( The writer is a senior journalist and author. The views expressed are strictly personal.)
