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Date:16-12-17

Reducing child mortality must be a result of public-private parenthood

Nishant Pandey

India accounts for about 25% of the world’s newborn deaths, and 22% of under-5 deaths. Despite significant progress, it has missed the Millennium Development Goal (MDG) 4 on reducing under-5 mortality as well as infant mortality. The global Sustainable Development Goal (SDG) for child mortality represents a renewed commitment to the world’s children: to end preventable deaths of newbornsand under-5s by 2030, with all countries aiming to reduce neonatal mortality to at least 12 deaths per 1,000 live births and under-5 mortality to at least 25 deaths per 1,000 live births.According to the ministry of health and family welfare (MoHFW), about 26 million babies are born in India annually, of which 730,000 die within the first month of their lives. The first 28 days of life — the neonatal period — are the most vulnerable time for a child’s survival. What remains an urgent concern is that 80% of these newborn deaths are both preventable and treatable. So, what can be done to prevent these newborn deaths?

India’s public health system suffers from a variety of challenges, including an acute shortage of trained medical personnel, poor health infrastructure and service delivery (particularly in rural areas), and a lack of community ownership and partnerships in addressing abysmal health outcomes. To address some of these challenges, GoI appointed 8.9 lakh female community health workers, ‘Accredited Social Health Activists’ (ASHAs), in villages across the country under the National Rural Health Mission (NRHM).ASHAs are the cornerstone of maternal and newborn health, bridging the gap between the public healthcaredelivery system and the communities.Now, a five-year pilot project in Jharkhand has shown how ASHAs, when appropriately trained, supported and supervised, can effectively contribute to improving maternal health and reducing newborn and child mortality.

The Maternal and Newborn Survival Initiative (MANSI), a community-focused health intervention that addresses the problem of access to qualityand affordable healthcare for mothers and newborns close to their place of residence, was launched in 2009-10.Piloted through a public-private partnership (PPP) model in Seraikela, Jharkhand, Mansi is a simple, but effective, set of home- and community-based interventions relevant and practical in a low-resource setting.At its core lies the empowerment of local ASHAs so that they can save lives of newborns in remote rural areas, often tribal areas, where there are no doctors or Primary Health Centres for miles. ASHAs received training and mentoring in simple life-saving interventions for maternal and newborn health covering the antenatal period, the time around birth and the first month of life, as well as care for small, sick newborns and children.

Covering a rural, and predominantly tribal, population of 83,000 across 167 villages in the Seraikela Kharsawan district, the MANSI pilot achieved significant results. An external evaluation of independently conducted qualitative findings reflected quantitative findings, both of which confirmed across-the-board reductions of child mortality.Neonatal mortality reduced by 46%, infant mortality reduced by 39% and under-5 mortality reduced by 44%. Although MANSI did not measure a comparable control population, it compared the improvements both over time and with overall statistics for Jharkhand. The differences in health outcomes were five times the reductions achieved in rural Jharkhand during the same period.

MANSI provided quality training, refreshers and mentoring support to ASHAs of the block, along with hand-holding support to the district health team of the government for strengthening the supply chain and incentive systems. Along with building the capacity of ASHAs, significant behaviour change activities were conducted at the community level.With these encouraging results, MANSI aims to scale up to the rest of Jharkhand, as well as nationally.Each project partner brought in its unique strength and, together, achieved what was beyond them individually.It is a successful example of how the public sector, the corporate sector, civil society and a technical organisation can collaborate to address a key national health problem.Especially remarkable is how GoI’s own programme and workers benefited from both the non-profit private sector and the for-profit sector. These lessons can be of enormous value to state governments that want to reduce child mortality, as well as to corporates who wish to contribute socially.

Date:16-12-17

India needs to reach out to Nepal to counter Chinese influence

ET Editorials

Nepal’s Left alliance, comprising two Communist parties, the CPN-Unified Marxist Leninist (UML) and CPN-Maoist Centre, has won the country’s first legislative election under the new constitution. The election marks the Himalayan nation’s transition to democracy, bringing to an end the long period of volatility since the abolition of the monarchy and civil war. As ademocracy, New Delhi recognises the significance of the Nepal elections.

While Prachanda’s Maoist Centre is well-disposed towards India, it is the pro-China UML led by K P Oli that is in the driver’s seat. This is a concern for India, especially with China making it clear that it is focused on increasing its global influence, starting with South Asia, and having signed a Free Trade Agreement with Maldives. Concerns about a dominant India have marked the long and shared history of the two countries.

Prime Minister Narendra Modi’s neighbourhood first policy, and then India’s role as an effective first responder to Nepal’s devastating earthquake in 2015 sought to address these apprehensions. This changed when Oli became prime minister in October 2015, when he started diversifying the sourcing of essential items away from India, seeking closer ties with China. New Delhi’s call for improved representation of Madhesis, the plains people of south Nepal, in the political mainstream, and its alleged participation in the blockade of the Terai region provided an excuse for Oli to move closer to China.

New Delhi needs to reach out to Nepal, to ensure that the Himalayan state does not become a Chinese satellite. Shared history and India’s approach to partnership on Nepal’s vital development concerns should contribute to improving the relationship between the countries.

Date:16-12-17

राजनीति का अपराधीकरण रोकने वाला कारगर कदम 

संपादकीय

सुप्रीम कोर्टने राजनीति के अपराधीकरण पर अंकुश लगाने के उद्‌देश्य से सांसदों और विधायकों पर लगे फौजदारी के अभियोग की सुनवाई के लिए 12 विशेष अदालतें गठित करने को मंजूरी देकर एक ठोस कदम उठाया है। इससे इतनी उम्मीद जरूर बनती है कि फौजदारी मामलों को लंबित रखकर संसद और विधानसभा का सत्तासुख भोगने वालों पर सजा की तलवार जरूर लटकेगी। 2014 में चुनाव आयोग के समक्ष दायर हलफनामे के अनुसार ऐसे मामलों की संख्या 1581 है और संभव है इस बीच यह संख्या बढ़ी भी हो। यही कारण है कि केंद्र सरकार सुप्रीम कोर्ट को यह बताने की स्थिति में नहीं थी कि वास्तव में ऐसे कितने मामले हैं। याचिकाकर्ता और दिल्ली भाजपा के नेता और वकील अश्विनी कुमार उपाध्याय से लेकर सरकार और अदालत सभी का रुख यही था कि इन लंबित मुकदमों की तीव्र सुनवाई से मुख्यधारा की राजनीति से वैसे लोग बाहर होंगे, जिनका व्यवहार और चरित्र आपराधिक है। याचिकाकर्ता की यह भी मांग है कि सजायाफ्ता जन प्रतिनिधियों को छह साल की बजाय आजीवन चुनाव लड़ने से प्रतिबंधित कर दिया जाए। अगर विधायिका इस काम के लिए तैयार होती है तो लालू प्रसाद और शशिकला जैसे राजनेताओं को चुनाव लड़ने का अवसर ही नहीं मिलेगा। इस स्थिति की व्याख्या राजनीति को पवित्र बनाने के रूप में की जा सकती है लेकिन, क्या इतने कदम से ही राजनीति पवित्र हो जाएगी? पिछले कुछ वर्षों में धर्म, जाति और लिंग आधारित अपराध बढ़े हैं और वैसा करने वाले समाज में या तो गौरवान्वित हो रहे हैं या वे लगातार बच निकल रहे हैं। उन अपराधों की तरफ सरकारों का ध्यान नहीं है और हाल के कुछ मामलों में अदालतों के कड़े फैसलों के बावजूद वे बेरोकटोक घटित हो रहे हैं। अब ऐसा अपराध करने वाले चुनाव भले लड़ें लेकिन, वे चुनाव को प्रभावित कर रहे हैं और ऐसा माहौल बना रहे हैं, जिनसे उनको संरक्षण देने वाले उनके आका चुनाव जीतते रहें। केरल से राजस्थान तक विचारधारा प्रेरित अपराधों ने मौजूदा राजनीति को भयानक छवि प्रदान की है और समाज में क्रूरता को बढ़ाया है। उन्हें रोकने के लिए जहां न्यायिक प्रशासन को निष्पक्ष और स्वायत्त होना चाहिए वहीं सरकारों और उन्हें चलाने वाली पार्टियों में भी संवेदनशीलता होनी चाहिए। वैसी स्थिति लाने के लिए समाज में चौतरफा लोकतांत्रिक जागरुकता और सक्रियता की जरूरत है।

Date:15-12-17

Ill-prepared for future

There is a grave lack of engineering skills. This impacts industry, affects programmes such as Make in India

Editorials

The engineering profession in the country is riddled with paradoxes. India produces more engineers than China and the US combined. But in the past seven years, several reports have pointed out that India’s engineering institutes do not provide state-of-art skills. A NASSCOM survey of 2011, for example, pointed out that only 17 per cent of the engineering graduates in the country are employable. This signaled a mismatch between the demands of industry and the technical education system, which the then UPA government did little to address. But the NDA government has done no better. Last year, the National Employability Report revealed that more than 80 per cent of the students who passed out of engineering schools in 2015 did not have the competencies required by industry. An investigation by this paper, this week, has highlighted another paradox and shown that the rot runs deeper. In 2015-16, eight lakh BE/BTech engineering students graduated, a little over a quarter of those who finished the science stream that year. Yet, there are no takers for more than 50 per cent of seats in the country’s engineering colleges, the investigation has revealed.

The state of engineering colleges could have a bearing on the Make in India programme that aims to bolster the country’s manufacturing capacity and generate 100 million jobs by 2022. According the programme’s website, Make in India will “foster innovation, enhance skill-development and build best-in-class infrastructure”. This will require highly-skilled engineers who can design products to meet the requirements of international competition. The poor student intake in the country’s engineering institutes presages a shortage of human capital for the project.

Globally, higher education has expanded in two contrasting ways: Through strict regulation with rigorous insistence on quality, resulting in gradual growth of high-quality institutes or alternatively, low entry barriers, leading to a proliferation of colleges, but of lower quality. When it comes to engineering colleges, India has taken the second path. The All India Council of Technical Education’s (AICTE) criteria for setting up such colleges pertain to infrastructure, such as classrooms, laboratories, libraries and student-teacher ratio. The AICTE also has a model curriculum, revised every five years, that affiliated universities use as a base to prepare their own syllabus. But this newspaper’s investigation shows that most colleges follow decades-old programmes. With the challenge of automation looming large over manufacturing, the AICTE, and its affiliated institutes, will have to pull up their socks in order to ensure the competitiveness of Indian industry.

Date:15-12-17

Update error

EC’s conduct of Gujarat polls has invited questions it must address. It has a formidable reputation to protect

Editorials

The Congress has demonstrated before the Election Commission office in Delhi, protesting against what it sees as differential treatment of possible violations of the model code of conduct, after the EC took objection to an interview of Rahul Gandhi. But events in the final hours in the Gujarat poll process draw attention to a larger problem: The rules governing elections appear out of date. The Representation of the People Act of 1951, which offers the electorate a cooling-off period of 48 hours, insulated from political advocacy, has not kept up with communications technology. Section 126 of the Act prohibits election meets, the display of poll material by “cinematograph, television or other similar apparatus”, and the organisation of entertainment and events to aggregate voters in order to communicate with them. These would have covered all bases in the 20th century, providing enough silent time for voters to exercise autonomous choice. But India in the 21st century is a different country, where poll-related communications follow multiple channels.

The intention of Section 126 is to prevent contenders from collecting critical masses of the electorate in order to proselytise. The traditional mode is the poll meeting, which both reaches out to people and provides a visual metric of popular support, which is itself an inducement. In the 20th century, state-owned TV was misused by the party in office to inundate the viewer with poll communications, and cinema newsreels were compelling tools of propaganda before the advent of TV. But today, communications has surpassed the one-to-many model of broadcast media. Many-to-many communications is now the most powerful mode, as seen in social media. Facebook pages, online forums and WhatsApp groups are the new gathering places, performing the same function as a physical political meeting. But while broadcast media can be curbed — a single tap needs to be turned off for 48 hours — social media is immune to intervention. Since it would be unfair to curb traditional media while allowing new media free play, and the EC cannot be seen to be partial, perhaps it is time to rethink these curbs across the board. Another practical difficulty presents itself when the top leadership of government doubles as lead campaigners. Ministers have to attend public meets, announce schemes and field questions. But they must also be held to the model code, which specifies that official duties and election outreach cannot be clubbed.

From the time that TN Seshan swept the Augean stables, the Election Commission has developed a formidable reputation as the institution safeguarding Indian democracy. But from the controversy over election dates to the present charge of excessive zeal, its conduct of the Gujarat polls has invited accusations that threaten to diminish its sheen. After this election, it must work to stem the tide.

Date:15-12-17

Whither disaster management after Ockhi?

More lives of fisherfolk would have been saved if disaster management action plans were implemented properly

M.G. Devasahayam is a retired bureaucrat

A disaster is an event causing extreme disruption in a society’s functioning. It results in widespread human, material, and environmental losses which are beyond the ability of the affected people to cope with on their own. Most disasters — floods, cyclones, earthquakes, landslides — are due to nature’s fury. When a disaster causes death and destruction, it becomes a calamity beyond human endurance. This is what happened when cyclone Ockhi struck Kanniyakumari district in Tamil Nadu and parts of Kerala on November 29th night and 30th morning.

As per the information given by fishermen associations in Tamil Nadu and Kerala, over 120 fishermen are dead and about 900 are still missing. Fishermen who ventured out into the sea to help in rescue operations reportedly saw bloated bodies floating. They were, however, unable to bring several of these bodies back to the shore. The Tamil Nadu government continues to be in denial mode as far as the number of deaths is concerned, although there is some consensus on the number of people missing.Cyclone Ockhi has left a massive trail of destruction in Kanniyakumari district. It is here that the government’s rapid response by way of disaster management should have stepped in.

Failure in damage control

There are three basic failings in the government’s response: the cyclone warning was delayed; the warning, when it came, was ineffective because it could not be conveyed to thousands of fisherfolk who were already out at sea; and once the cyclone struck, there was no war-like mobilisation and action, which are the hallmarks of good disaster management.Cyclone Ockhi’s devastation started within 12 hours of the first “rough seas” warning that was put out on November 29. Such conditions may have deterred fisherfolk in other parts of Tamil Nadu, but not those in Kanniyakumari, which has among the highest density of fisherfolk in India. Given the limited quantity of fish in nearshore waters, many fisherfolk have diversified into deep-sea and long-distance fishing. Considering that their fishing voyages sometimes last from ten days to more than a month, the Indian Meteorological Department’s timing of the cyclone forecast was futile.

The government’s own estimates suggest that 3,677 fishermen from Kanniyakumari and Kerala were lost in sea. On November 30 morning, action plans should have kicked in and the Indian Coast Guard, with its seaborne vessels and helicopters, should have launched emergency search and rescue operations. Coast Guard ships should have taken along a few fishermen from the villages as navigation assistants (because they knew where to look for missingpeople) and should have intensely combed the area. Had this been done, hundreds of fishing boats and fishermen would have been found and rescued within the shortest possible time.

Nothing of this sort happened, say fisherfolk in the worst-affected villages that I visited: Neerodi, Marthandamthurai, Vallavillai, Eraviputhenthurai , Chinnathurai, Thoothoor, Poothurai, Enayamputhanthurai. The Coast Guard, they said, turned a deaf ear to their pleas. Even when the Coast Guard reluctantly moved with some fishermen on board, all it did was to go up to about 60 nautical miles and then stop saying that it cannot go beyond its jurisdiction.

Even so, the Indian Navy with its vast array of ships, aircraft and state-of-the-art technology should have stepped in immediately. This too did not happen. The resultant outcry forced Defence Minister Nirmala Sitharaman to come to Kanniyakumari, conduct a review, and make some promises. A few days later, the government announced the rescue/recovery of several hundred mechanised/motorised fishing boats and over 3,000 fishermen who had landed on the coasts of Gujarat, Maharashtra, Karnataka and Kerala. While the Coast Guard and the Indian Navy staked claim to this “rescue” mission, the fishing community leaders say that all these boats and the fishermen drifted to the coast on their own.What has happened to the National Disaster Management Act (2005), the National Policy on Disaster Management (2009), the National Disaster Management Plan (2016) and the National Disaster Response Force and infrastructure created thereof? Did the disaster management control room in Delhi function at all? Villagers have printed the photos of the dead based on eye-witness accounts and the number is not less than 100. The government continues to dismiss this as being untrue.

The need for compensation

The cyclone has also resulted in massive losses to the livelihoods of people living in the coasts due to the destruction of crops, banana, rubber, coconut and forest trees. Relief and rehabilitation is going to be a monumental task and the State government alone cannot take the huge burden of providing a decent compensation to the victims of the cyclone.This calls for the combined efforts of the Central and State government (departments of agriculture, horticulture, animal husbandry and fisheries) and various departments (rubber board, coconut board, spices board, etc.) To get things moving, the Central Relief Commissioner should immediately visit the district, make realistic assessments, and award reasonable compensation immediately.