NRHM challenges and success

• Purpose: universal access to affordable, equitable and quality healthcare
• successes
• increased health finance
• revived the helaht delivery systems
• traine dhelath care staff
• established institutionals tandards
• facilitated inc entralised procurement of drugs
• village health and hospital committees
• challenges
• health is a state subject
• while center funds NRHM, state implements it

to ensure uniform quality and standard of health care dleivery across country, center needs to play rôle in implementation

SOLUTIOn: bring it under concurrent list

• improve governance
• study of NRHM process inidcators like
• utilisation of funds
• improvement in healthcare delivery
• community participation

it is observed that there is wide variation across states and regions

good performance states have improved while regions which had poor indices continue to remain so despite more funding for poor regions

there is need for overall improvement of governance in poor performance states

• increase funding
• current funding 1% of GDP
• developed nations: 5-10% of GDP
• need to increase to 2-3%
• prevent diversion of funds
• expand focus
• current focus on maternal and child health
• need to expand focus onto general health problems
• urban health
• National urban health mission should be given equal priority as NRHM
• urban health care has glaring deficiencies
• Evaluation criteria
• current assessment based on process indicators
• finance
• infra
• personnel
• shift to indicators of efficient functioning and assess health outcomes
• differential payments for staff serving in remote and difficult terrains
• health information monitoring
• community monitoring and social audits
• empower local communities
• approach
• coordinate with various other schemes
• aim for poverty reduction, social exclusion and gender discrimination
• funding priorities
• why increase fundings?
• better health of people leads to more economic growth
• NRHM should be made integral part of FYPs
• NUHM should get equal funding and work in coordination with NRHM
• improve governance
• develop system to monitor and audit performance

appointment of secretaries and higher officials in government

• CVC post has been made a mere post for accommodating superannuated  civil servants
• Pre hawala days CBI director was changed frequently
• With 1997 Supreme Court direction , CBI director tenure has been fixed at 2 years
• HOW SECRETARIES ARE SELECTED?
• The officers for above the joint secretary level are selected by a panel which is supposed to choose officers with ability and integrity
• The panel  comprises of secretaries and cabinet secretary
• The panel list out 3 names for every post which is forwarded to Appointments committee of cabinet
• ACC includes PM and ministers concerned
• The list is arranged merit wise but ACC is not ibliged to go by merit list
• Most cases the names are leaked. This elads to lobbying and mudslinging
• When finally an officer is chosen he is made to feel obliged for the favour done to him by the executive
• This undermines the morale of civil servants

EVOLUTION OF LOKPAL

Critical path analysis-MIND MAP!!

Turkey's reset

·         in its history, it has seen 4 militairy coups and civilian rule dominated by militairy

·         now things are changing

·         under PM Erdogan(serving 3^rd term as PM), turkey has achieved high economic growth

·         He has curtailed the power of militairy

·         Turkey has formulated a foreign policy that seeks to

o   Remain independent of its western allies

o   Join EU

o   Engage with its west asian neighbours

·         Turkeys democratic credentials are held ina we in arab world where it enjoys friendly ties

ISSUES

·         Erdogan’s party justice and development party(AKP) has its roots in political islam

·         There is fear that erdogan may take coutnry away from kremalist secularism as define in its 1982 constitution

·         This issue ahs polarised its society

·         Government now plans to frame a new consitution

o   It needs to ensure that in this process it heals the divisions in society and delivers an inclusive, democratic and liberal constitution

India iran summits

• Importance of iran to india
• core energy partner
• geostrategic importance vis à vis afghan
• access to chabar port
• transcontinental transit
• Importance of India to iran
• India on UNSC can help its cause
• Huge market in India for iran petroleum products
• Strain in relation
• india shifitng to saudi oil
• saudi foe of iran
• solution
• establish parallel relations with saudi and iran

Noise by numbers

• Problem
• noise levels exceed healthy level
• legal perissible levels is upto 10 dB
• Causes
• lax law(noise pollution rules 2000) implementation
• lack of reliable data
• lack of proper redressal
• Effect
• hearing impairment
• hypertension
• heart rate disorder
• psychological problems

• solution
• scale up monitoring system
• data gathered made public on interned
• awareness campaign
• impart legal literacy
• inculcate driving culture