KURUKSHETRA JANUARY 2020

 The prevalence of underweight,

1. HEALTH AND NUTRITION stunted and wasted is higher in rural
OVERVIEW AND THE WAY FORWARD than urban populations.

What is the status of Nutrition in India?  The progress on other parameters of

the nutritional status such as level of
 India had poor health and nutritional
anemia in population groups and
indicators at the time of independence
birth-weight of newborns is also slow.
in 1947.
 Recognizing the challenge, India had a
 Around the 1950s, the life expectancy
series of initiatives and programmes
in India was 32 years (which has
increased to 68 years in 2017). since independence which focused on
improving nutritional status of the
 The infant mortality rate (IMR) was
population.
nearly 200 per 1,000 live births and
maternal mortality ratio (MMR) What are the Diseases Linked to Under -
Nutrition?
around 2,000 per 100,000 live births.

 The IMR in India in 2017 was  An undernourished individual,

33/1,000 live births and MMR was including those with micronutrient

130 per 100,000 LB during the period deficiency, are at higher risk of

of 2014-16. majority of infectious diseases

including tuberculosis, viral and all
 Over these years, through targeted
other infections.
interventions, the proportion of
population living below poverty line  An underweight and under-nourished

has declined and even the food child is at higher risk of diarrhea and

production and availability has pneumonia. The chances of recovery

drastically increased. in such children are slower.

 However, the nutritional status of  They are more likely to become under-

population has not witnessed the nourished after such a disease spell.

commensurate decline.  While the poor nutrition affects the

 India has had a high rate of under- health outcomes in all population

nourished population, with marginal sub-groups, it is the women in

improvement in the situation in the reproductive age and newborn and

last 25 years. children, who are most commonly and

adversely affected.

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  Public health science has generated  As part of this POSHAN Abhiyaan,
evidence that it is a vicious cycle of nutrition is proposed to be a Jan
under-nutrition which starts at the Aandolan or mass movement and the
time of pregnancy (in mother's womb) month of September has been
and continues to affect the newborn designated as POSHAN Mah.
for the rest of the life and for many  In addition, Pradhan Mantri Matru
generations. Vandan Yojana (also known as
 There are emerging evidence that Maternity Benefit Scheme) was
under-nourished and under-weight announced in late 2016 and launched
children are at higher risk of non- in 2017, aims to provide financial
communicable diseases such as assistance to pregnant women for the
cardio vascular strokes and diabetes first pregnancy and ensure good
in adult age. nutritional status.

What are the Initiatives launched by GOI  There is renewed attention on

to Improve Nutritional Status? reducing prevalence of anemia

 The efforts to tackle under-nutrition through Anemia Mukt Bharat.

in India have been partially successful  There are a number of complementary

so far and recent and new attempts initiatives under different ministries to
are being made to accelerate the focus on improved nutritional status
progress. though approaches such as Eat

 The Govt of India had launched Healthy and Fit India initiative.

National Nutrition Strategy in Aug  The Aspirational District programme

2017 and then National Nutrition also has nutritional status as a
Mission (NNM) in March 2018. performance indicator.

 NNM is now being implemented as What should be done?

POSHAN Abhiyaan, under Ministry of  The nutrition programme run under
Women and Child Development, ICDS and school mid-day meal
aiming for Kuposhan Mukt Bharat scheme of education department and
(Malnutrition free India) by year 2022. care of mothers and children under
 The programme aims at reducing health departments need to be
levels of underweight, stunted, low interlinked with better collaboration
birth weight and anemia in and coordination. It will be important
population.

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 to share the data, have joint analysis of Nutrition (NIN), India has
and action plans. highlighted that the fruits and

 Diversification of supply of food under vegetables should share nearly 50 per

government programmes including cent of an individual‟s food plate.

more nutritious items such as millets,  Establishing more cold chain stores
eggs, milk, soybean and nutrient rich especially in rural India can
fresh foods. contribute to less wastage and

 Mass fortification of rice, wheat, salt, improved availability and thus

edible oils and salts, with essential improved nutrition for Indian

minerals and vitamins like iodine, population.

iron, zinc and vitamin A and D should  The production and consumption of
be optimally used. locally available all kinds of

 The inclusion of pulses and edible oil vegetables, fruits including seasonal

in Public Distribution System (PDS) as fruits in rural areas need to be

well as National Food Security Act promoted.

(NFSA) has been proposed by many  Educate people on health benefits of

experts. consumption of fruits and vegetables

 Similarly, there is a need to increase along with training in community or

protein and micronutrient content in kitchen gardening or terrace

mid-day meals and ICDS food. gardening.

 Ministry of Human Resource

Development has brought the concept 2. HEALTH SYSTEM: TOWARDS A
of school 'nutrition garden' NEW INDIA
encouraging eco-club of students to What are the achievements of India in
help them identify fruits and Health Sector?
vegetables best suited for topography,  India has made noteworthy strides on
soil and climate. health and nutrition over the last two
 These gardens are intended to give decades. Polio guinea worm disease,
students lifelong skills to identify yaws as well as maternal and
fruits and vegetables for their plates. neonatal tetanus have been

 With diet diversification in the eliminated.

spotlight, My Plate for the day'  The Total Fertility Rate has reduced
publication of The National Institute sharply from 2.7 in 2005-06 to 2.2 in

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 2015-16 and for the first time the  The health system is fragmented at
birth cohort has fallen below 25 multiple levels: payers and modes of
million. financing, providers of healthcare

 Contrary to expectations, we were able services and the digital backbone.

to achieve the Millennium  Currently the government (Union and

Development Goals in respect of the States combined) spends
Maternal Mortality Ratio (MMR level of approximately 1.13 per cent of GDP
130 against a target of 139) as well on health.
the Under-5 child mortality target (U5  As a consequence, households finance
MR level of 43 against a target of 42). 62 per cent of the healthcare spending
 Infant Mortality Rate has also reduced through out-of-pocket expenditure at
from 57 per 1000 live births in 2005- the point of care.
06 (National Family Health Survey-3)  Risk pooling is low, with less than 35
to 41 per 1000 live births in 2015- percent of the population participating
2016 (NFHS-4). in any risk pooling scheme and less
 Given the size, complexity and than 10 per cent being covered by a
diversity of our country, the functioning risk-pooling mechanism
importance of these improvements in which provides effective protection
the health and nutrition status of the against catastrophic health events.
population cannot be underestimated.  Delivery of health services is also
What are the challenges? fragmented into small sub-scale

 There are significant inter and intra- entities with 95 per cent of the care

state disparities in outcomes and being delivered by providers

socio-economically disadvantaged employing less than 10 workers each,

groups are especially vulnerable to adversely affecting the quality and

gaps in healthcare access. efficiency of service delivery.

 Additionally, while the burden of non-  The digital systems used in these

communicable diseases is rising, health care entities, if at all used, are

there is also a substantial unfinished also siloed in the absence of

agenda with respect to communicable mandatory adherence to any data

diseases as well as maternal and child standard.

health.  The result is that the patient health

records lie buried in manual systems
or disparate IT systems with little

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 standardization and almost no annual cover of Rs. 5 lakh per annum
possibility of interoperability. for hospitalization related expenses.

 This limits the availability of  By consolidating multiple health

information that could potentially insurance schemes under PM-JAY,
guide policy making. the government is taking a major step

What are the measures taken by GOI to towards 'One Nation One Scheme'

promote health and nutrition? which will ultimately ensure that all
citizens can access a common
 In 2017, the first-ever All India
package of secondary and tertiary
Institute of Ayurveda was launched
health services regardless of the State
along the lines of AIIMS, New Delhi,
in which they reside.
for creating synergies between the
traditional wisdom of Ayurveda and  Earlier this year, the government

modern technologies. enacted the landmark National

Medical Council Act 2019 for
 Cleanliness is crucial for preventing
overhauling medical education in
diseases. Following the
India.
implementation of the Swachh Bharat
Abhiyan, nearly 100 per cent of  Central and State government medical

households in rural India now have colleges are being upgraded to add

access to a toilet, compared to merely 10,000 undergraduate and 8,058

29.1per cent in 2005-06. postgraduate seats by 2020-21,

ensuring the presence of at least one
 To build a robust primary healthcare
medical college for every 3-5
system, the government has
Parliamentary Constituencies and at
announced the setting up of 150,000
least one in every State.
Health and Wellness Centres (HWCs)
between 2018 and 2022 under the  Similar efforts are also underway for

Ayushman Bharat initiative. producing the requisite number of

Currently, over 27,000 HWCs are skilled nursing professionals through

operational across the country. the setting up of 112 Auxiliary

Nursing and Midwifery schools and
 The second pillar of Ayushman Bharat
136 General Nursing Midwifery
is the Pradhan Mantri Jan Arogya
schools in underserved districts of the
Yojana (PM-JAY) which will provide 10
country.
crore of the poorest and most
vulnerable families in the country an  More than 5,500 Jan Aushadhi stores
have been opened for providing

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 quality drugs at affordable prices and  Operationalizing EHRs for every
the government plans to expand the citizen will be the key to optimizing
number of stores to 7,500 by 2020. It health information systems.
is estimated that these stores serve  A system-wide EHR will enable
between 10-15 lakh people across monitoring of diseases, expenditures
India on a daily basis. and performance to deliver financial
 India has made considerable progress and health outcomes.
in leveraging Information
Communication Technology (ICT) for
3. NUTRITION: A PUBLIC HEALTH
enhancing the coverage and quality of PRIORITY
maternal and child health services.
What is Nutrition and its related
 For example, the Auxiliary Nurse concepts?
Midwives Online or ANMOL
 The definition given by the British
application has been developed to
Nutrition Foundation is: „the study of
equip public health workers to
nutrients in food, how the body uses
register pregnant women, encourage
nutrients and the relationship
institutional birthing and monitor
between diet, health and disease.‟
immunisation programmes for
 The other more comprehensive
newborns.
definition is -„nutrition is the intake of
 In the area of digital health, the
food, considered in relation to the
National Health Stack proposed by
body‟s dietary needs.
NITI Aayog in 2018 is an important
 The important aspect to note here is
step.
the „intake of food in relation to the
 n 2019, the National Digital Health
body‟s dietary needs‟.
Blueprint was released by the
 This implies that as the body‟s needs
government. The key features of the
change, so should the diet i.e. a
blueprint include a Federated
lifecycle approach should ideally cater
Architecture, a set of architectural
to dietary needs of each stage.
principles, a 5-layered system of
 Good nutrition, an adequate, well
architectural building blocks, Unique
balanced diet combined with regular
Health ID (UHID), privacy and consent
physical activity, is considered to be a
management, national portability and
cornerstone of good health.
Electronic Health Records (EHRs)
among others.

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 Poor nutrition can lead to reduced  Wasting in children is a symptom of
immunity, increased susceptibility to acute under-nutrition, usually as a
disease, impaired physical and mental consequence of insufficient food
development, and reduced intake or a high incidence of
productivity. infectious diseases, especially

 This brings us to the next set of words diarrhoea.

which are results of improper  On the other hand, underweight is a

nutrition, and termed as malnutrition. condition where the weight is lower

 Malnutrition comprises both than the standard weight for the given

undernutrition and over-nutrition and age of the child.

they both lead to their own set of  Evidence has shown that children
disease conditions. who are even mildly underweight have

 In the realm of public health, we an increased risk of mortality and

consider three terms which are the severely underweight children are at a

standards to measure under-nutrition greater risk of the same.

i.e. stunting, wasting and under-  A child is considered to be over-weight

weight; while over nutrition is when the weight is higher than the
measured by incidence of overweight, standard weight for the given age of
obesity, and diet-related Non- the child.
Communicable Diseases (NCDs)  Childhood obesity is associated with a
comprising of heart disease, stroke, higher probability of obesity in
diabetes and cancer. adulthood, which can lead to a variety
 A stunted child is one whose height is of disabilities and diseases, such as
lower than the standard height for the diabetes and cardiovascular diseases.
given age of child. What is the nutritional status in India?
 Stunting is the result of long-term  Globally, 15.08 crore children under
nutritional deprivation and often five years are stunted and 5.05 crore
results in delayed mental are wasted, as stated by the Global
development, poor school performance Nutrition Report 2018. In India, 4.66
and reduced intellectual capacity. crore children are stunted, and 2.55
 Wasting is defined as a condition crore are wasted.
where the weight of the child is lower
than the standard weight for the given
height.

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  Also, India figures among the set of  Mothers Absolute Affection (MAA), the
countries that have more than 10 exclusive breastfeeding initiative, is
lakh overweight children. focused on increasing rates of

 Overall, of the 141 countries analysed exclusive breast feeding to reduce

in the report, 88 per cent (124 infection amongst children up to the

countries) experience more than one age of 6 months.

form of malnutrition.  For children, adolescents and

 The developmental, economic, social pregnant women, to manage nutrition

and medical impacts of the global issues, MoHFW also implements the

burden of malnutrition are serious Intensified Diarrhoea Control

and lasting, for individuals, their Fortnight (ICDF) programme, National

families, communities and for the Deworming Day (NDD) programme

countries that suffer from loss of and the Pradhan Mantri Surakshit

productivity and therefore lower Matritva Abhiyaan (PMSMA).

growth.  In September 2017, the cost norms

What are the initiatives by GOI to solve for providing supplementary nutrition

nutrition issues? through anganwadis to pregnant

women and lactating mothers,
 The Swachh Bharat Mission focuses
children and adolescent girls were
on creating Open Defecation Free
revised and linked with the food price
(ODF) communities; this has
index.
significantly contributed to reduced
incidences of diarrhea and gut  Government is implementing POSHAN

infections amongst children. Abhiyaan, earlier known as National

Nutrition Mission, since 18th
 The Pradhan Mantri Matru Vandana
December 2017 to address the
Yojana provides support to the
problem of malnutrition in the
pregnant women and lactating
country and it aims to reduce
mothers and also encourages health
malnutrition in the country in a
seeking behaviour and immunisation.
phased manner, through a life cycle
 Mission Indradhanush, which targets
approach, by adopting a synergised
the left out and missed out children
and result oriented approach.
and pregnant women for
immunisation, is aimed on increasing
the rates of complete immunisation of
women and children.

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What is 6X6X6 AMB Strategy?  Severe Acute Malnutrition (SAM)

 Provision of supervised biweekly iron refers to very low weight for height (<

folic acid (IFA) supplementation by the 3z scores of the median), visible severe

ASHAfor all under five children; wasting, or the presence of nutritional

oedema.
 Weekly IFA supplementation for 5-10
years old children;  Moderate Acute Malnutrition (MAM) is
defined as a weight-for-age between -3
 Annual/biannual deworming (children
and -2 z-scores below the median.
and adolescents);
 It can be due to a low weight for
 Point of care testing (POCT) and
height (wasting) or a low height-for-
treatment for in-school adolescents
age (stunting) or to a combination of
and pregnant women using newer
both.
technologies;

 Establishing institutional mechanisms What are the Causes of Malnutrition?

for advanced research in anemia;  Malnutrition is a complex

 Addressing non-nutritional causes of multidimensional issue.

anemia; and  It is caused due to a number of

 Setting a comprehensive generic factors such as poverty,

communication strategy including inadequate food consumption (due to

mass/mid media/social media poor availability/access), inequitable

communication material (radio and TV food distribution, poor maternal

spots, posters, job-aids, inter-personal nutrition, sub-optimal infant feeding

communication (IPC) material, etc). and child care practices,

inequity/gender imbalances, poor
sanitary and environmental
4. ROLE OF ANGANWADI WORKERS
conditions, and restricted access to
AND ASHAS IN CURBING
quality health care, education and
MALNUTRITION
social safety-net services/facilities.
What is meant by Malnutrition?
 Further, various economic,
 It is lack of proper nutrition, caused
environmental, geographical,
by not having enough to eat, not
agricultural, cultural, health and
eating enough of the right things, or
governance issues complement the
being unable to use the food that one
general factors in causing under-
does eat.
nutrition in children.

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What are the Roles and Responsibilities registering their child's birth and
of Anganwadi Workers? reporting the same to the village level
 To elicit community support and functionary notified as Registrar of
participation in running the Births.
programme.  To conduct home visits for educating
 To weigh each child every month and the parents, especially the mothers,
plotting it on the growth card; for enabling them to play an effective
maintain the child cards (for children role in their child's growth and
below 6 years) to be examined by the development with particular emphasis
visiting medical/para-medical on that of the newborn child.
personnel; and using the referral  To assist the PHC staff in effective
cards for referring mothers/children implementation of the programme's
to the sub-centre/PHC etc. health component viz. immunization,
 To carry out, annually, a quick survey health checkups and ante-
of all the families in their respective natal/postnatal check-ups etc.
area of work with particular attention  To assist the ANMs in the
to the mothers and children. administration of IFA tablets (for
 To organise non-formal pre-school anaemia control) and vitamin A doses
activities for children aged 3-6 years (for preventing VAD) to the
and to help in designing/making toys beneficiaries.
out of indigenous resources.  To share the health-related
 To organise supplementary nutrition information with the ANM.
feeding for infants/children (below 6  To support in organizing Pulse Polio
years) as well as pregnant women and Immunization (PPI) drives.
nursing mothers via planning of menu  To inform the ANM regarding any
based on locally available food/local emergency cases like diarrhoea,
recipes. cholera etc.
 To provide health/nutrition education  To guide ASHAs (Accredited Social
along with counselling on Health Activists under NRHM) in the
breastfeeding as well as infant/young delivery of healthcare services and
child feeding practices to the mothers. maintaining the records.
 To help and coordinate the health  Anganwadi Workers can act as depot
centre visits of pregnant holders for RCH Kit/contraceptives
women/nursing mothers for

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 and disposable delivery kits, though minimum package of appropriate and
the actual responsibility lies with the feasible curative care or arrange for
ANMs or ASHAs except that for over- timely referrals.
the counter drugs.  They generate community awareness
 To assist in implementing Scheme for concerning the various determinants
Adolescent Girls (SAG) and of health such as nutrition, basic
motivate/educate the adolescent girls, sanitation & hygienic practices and
their parents and community as a healthy living/working conditions, as
whole by organizing social awareness well as regarding the existing
programmes/campaigns etc. Also, to healthcare services and the
assist in implementing the Nutrition importance of timely utilisation of
Programme for Adolescent Girls health & family welfare services.
(NPAG) and maintaining the records.  They counsel women on birth
 During home visits, to identify preparedness, importance of safe
disability among children and delivery, breastfeeding &
referring them immediately to the complementary feeding, appropriate
nearest PHC or District Disability care of the young child, immunization,
Rehabilitation Centre. contraception and prevention of

 To inform the Supervisors/CDPO common infections including

regarding any village level reproductive tract infections/sexually

developments requiring their attention transmitted infections (RTIs/STIs).

and intervention, particularly for the  They mobilise the community and
coordinating arrangements with facilitate their accessing
different departments. health/health related services such as

 To maintain liaison with other immunisation, antenatal/postnatal

institutions (eg. Mahila Mandals) and check-ups(ANC/PNC), supplementary

to involve school teachers (women nutrition, sanitation and other

only) and primary/middle school girl governmental services available at the

students of the village, where anganwadi/sub-centre/primary

necessary. health centres.

What are the Roles and Responsibilities  They act as depot holders for essential

of ASHA Workers? provisions like Oral Rehydration

Solution (ORS), Iron Folic Acid tablets
 They are promoters of good health
(IFA), chloroquine, Disposable
practices. In addition, they provide a

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 Delivery Kits (DDK), oral contraceptive again create isolated medical records
pills & condoms, etc. which increase the burden on citizen

 Since ASHAs cannot function without significantly.

adequate institutional support at the  India has just around one doctor for
village level, women's committees 11,000 people – a ratio far below from
(self-help groups/women's health WHO‟s standard which recommends
committees), village health & one doctor per 1000 patients.
sanitation committee (Gram  Most of the rural Indians lack access
Panchayat), peripheral health workers to basic health care facilities.
especially ANMs and Anganwadi
 Lack of infrastructure makes it
workers, and the ASHA trainers (for
extremely difficult to retain doctors in
periodic in-service training) provide
villages, as they fear becoming
them the needed support.
professionally isolated and outdated.
 Recently, Home-Based-Care for Young
 In addition, Poor villagers in order to
Children (HBYC) has been initiated to
get treatment have to travel to
extend the community-based-care by
specialty hospitals in the city.
ASHA workers with particular focus
 A study by Indian Institute of Public
on nutrition counselling, improved
Opinion found that 89 percent of rural
child rearing practices and
Indians have to travel about 8 kms to
breastfeeding promotion etc.
access basic medical treatment.

 With Government hospitals already

5. DIGITAL TRANSFORMATION IN
flooded with local patients, these
HEALTH CARE
villagers have to wait for their turn
What is the need for moving from which ultimately inflates their overall
Physical to Digital Health?
expanses.
 While the efforts of deploying
 Cost of setting and maintaining health
technology for rural healthcare have
care infrastructure is quite huge in
been consistent and widespread, the
rural setting.
benefits to the rural masses are
 In such a situation, introducing
concentrated only in small pockets of
“Digital” instead of “Physical” Health
the country.
Centres could pave the way for quality
 In the absence of any centralized
healthcare at a lower cost.
system, the service providers have
undertaken fresh diagnostic tests that

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  The report of Mckinsey Global Welfare (MoHFW) include the following
Institute has estimated that the programmes – Reproductive Child
implementation of telemedicine Health Crae (RCH), Integrated Disease
technology could save $ 4-5 billion Surveillance Programme, e-Hospital,
every year and replace half of in- e-Shusrut, Electronic Vaccine
person outpatient consultations in Intelligence Network (eVIN), National
India. Health Portal, National Identification

What is meant by CSC enabled Number (NIN), Online Registration

Healthcare system? System, Mera Aspatal (Patient

Feedback System) and National
 Telemedicine is the form of primary
Medical College Network.
care, where the patient walking in at a
Common Service Centre (CSC) seeks  Since health is a state subject, states

the doctor‟s advice about non- are supported under National Health

emergency medical problems which do Mission for services like telemedicine,

not require immediate doctor‟s teleradiology, teleoncology,

location visit. teleophthalmology and Hospital

Information System.
 Villages in less developed states are
using telemedicine to get medical  The state of Gujarat has implemented

consultation from the doctors of big e-Aushidhi project which is primarily

cities through video conferencing. a supply chain management

application.
 With the mandate of the Ministry of
Electronics and IT, CSC-SPV is also  The main objective is to ascertain the

implementing the Digi Gaon initiative needs of various district warehouses

in rural and remote villages the in such a way that all the required

country, where citizens can avail materials/drugs are constantly

various online services such as tele- available.

education, telemedicine, financial  Rajasthan has initiated Pregnancy,

services, internet connectivity and Child Tracking & Health Services
others. Management System which is an
online software used as an effective
What are the various central and state
level projects? planning and management tool.

 A few of the ongoing initiatives in  Andhra Pradesh initiated Rashtriya

digital health being implemented by Bal Swasthya Karyakram (RBSK)

the Ministry of Health and Family which was aimed at screening over 27

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 crore children from 0 to 18 years for  Childhood diarrhoea is closely
the 4Ds – Defects at Birth, Diseases, associated with insufficient water
Deficiencies, and Development Delays supply, inadequate sanitation, water
including Disabilities. contaminated with communicable

 Chhattisgarh Govt. launched Chirayu disease agents, and poor hygiene

Programme. Its aim is to screen practices.

children for birth defects and various  Diarrhoea is estimated to cause 1.5
types of nutritional deficiencies, so million child deaths per year, mostly
that any permanent disability can be among children under five years of
cured at an early stage. age living in developing countries.

 The prevalence of stunting in India

6. WATER AND SANITATION FOR (38.4 per cent) is among the highest in
HEALTHY INDIA the world, and diarrhoea is a major

What is the relation between Water, killer of children younger than 5

Sanitation and Hygiene? years.

 Contaminated water and a lack of  The links between lack of water and

basic sanitation are undermining sanitation access and the

efforts to end extreme poverty and development goals are clear, and the

disease in the world's poorest solutions to the problem are known

countries. and cost-effective.

 In 2017, 2 billion people worldwide  A 2012 WHO study shows that every

did not have access to basic US $1 invested in improved sanitation

sanitation facilities such as toilets or translates into an average global

latrines and 673 million people still economic return of US $5.5.

practised open defecation.  Those benefits are experienced

 According to the WHO/ UNICEF Joint specifically by poor children and in

Monitoring programme for Water the disadvantaged communities that

Supply and Sanitation, at Ieast 1.2 need them most.

billion people worldwide are estimated
to drink water that is not protected
against contamination from faeces.
 Unclean water and poor sanitation are
a leading cause of child mortality.
What are the initiatives by GOI in this
regard?
 The Government of India is being
proactive about water management
and has created the new Ministry of

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 Jalshakti, in which the erstwhile Sustainable Development Goals
ministries of Water Resources and (SDGs) and the States of Himachal
Drinking Water and Sanitation will be Pradesh, Kerala and Tamil Nadu and
merged, to consolidate interrelated the Union Territories of Chandigarh
functions pertaining to water and Pondicherry, were among the
management. front-runners.

 The newly formed Jal Shakti Ministry  Himachal Pradesh has surged to the
has launched the Jal Shakti Abhiyan - top backed by its success in providing

a campaign for water conservation clean water and sanitation, in

reducing inequalities and in
and water security in 1,592 water
preserving the mountain ecosystem.
stressed blocks in 256 districts, to
 Sanitation is also one of the important
ensure five important water
components of the quality parameters
conservation interventions. in the composite human index.
 Interventions will be in the form of  The Swachh Bharat Mission (SBM),
water conservation and rainwater India's flagship and the world's largest
harvesting, renovation of traditional sanitation programme, aims to

and other water bodies/ tanks, reuse, accelerate universal access to

sanitation in rural and urban India.
bore well recharge structures,
 Since its launch in 2014, SBM reports
watershed development and intensive
building close to 100 million toilets by
afforestation.
way of providing financial incentives
 The Jal Shakti Abhiyan is a time- to needy families, involving local
bound, mission mode water governments and communities in
conservation campaign. construction and in monitoring
progress, and by conducting mass
 Other initiatives include the Water
awareness campaigns.
Framework Law of India 2016,
 Today, India is at an important
National Rural Drinking Water
juncture, with SBM data showing
Program (NRDWP), Accelerated Urban
more than 98 per cent sanitation
Water Supply Programme (AUWSP),
coverage and sample studies reporting
Namami-Gange (National Mission for
good progress but lower coverage in
Clean Ganga), and National Water
terms of latrine ownership (71 per
Policy.
cent) and sanitation coverage (93.1
 NITI Aayog in 2018 came out with a
per cent) in rural India.
baseline index of Indian States'
performance on various UN

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