Content

1. PHC doctors — a case where the caregivers need care
2. The growing relevance of traditional medicine
3. 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.