GS PAPER – I

NORMS FOR SEX SELECTIVE SURGERIES ON INTERSEX INFANTS

Why in news?

• The Kerala High Court has directed the State government to issue within three months an order regulating sex selective surgeries on intersex infants and children. It said that nod for conducting such a surgery would impinge the rights guaranteed under the Constitution.

Court’s decision

• The Kerala High Court has ordered that until the regulation was put in place, sex selective surgery shall be permitted only based on the opinion of a State-level multidisciplinary committee that the surgery was essential to save the life of such child/infant.
• The court passed the directives recently while disposing of a writ petition filed by the parents of a child born with ambiguous genitalia seeking permission of the court to conduct a genital reconstructive surgery on the child.
• The court directed the government to constitute a State-level multidisciplinary committee consisting of a paediatrician/ paediatric endocrinologist, paediatric surgeon and child psychiatrist/child psychologist to decide whether the child was facing any life-threatening situation by reason of the ambiguous genitalia. If so, permission could be granted for carrying out the surgery.

Ethical dimension of the issue

• Granting of permission for conducting genital reconstructive surgery would impinge the rights guaranteed under the Constitution and conduct of the surgery without consent would violate the child’s dignity and privacy.
• Granting such permission may also result in severe emotional and psychological issues if, on attaining adolescence, the child developed orientation towards the gender, other than the one to which the child was converted through surgical intervention.
• It pointed out that the definition of transgender in Section 2(k) of the Transgender Persons (Protection of Rights) Act took in persons with intersex variations also, thereby making the protections under the Act available to such persons. Section 4(2) of the Act guaranteed the right to have a self-perceived gender identity.
• Thus, it was beyond cavil that the right to choose gender was vested with the individual concerned and no one else, not even the court.

Transgender Persons (Protection of Rights) Act, 2019

• According to the Act transgender means a person whose gender does not match with the gender assigned to that person at birth.
• It includes trans-person with intersex variations, gender-queer and person having such socio-cultural identities as kinnar, hijra, aaravani and jogta.
• India’s 2011 Census was the first census in its history to incorporate the number of ‘trans’ population of the country. The report estimated that 4.8 million Indians identified as transgender.

Issues faced by Transgender persons

• Lack of Legal Protection: They are subjected to custodial violence, dereliction of duty by state and overall apathy to their issues such as educational, residential, medical and employment.
• Poverty: Lack of legal protection translates into unemployment for transgender people. They’re denied services and experience high rates of unemployment, housing insecurity and marginalisation.
• Harassment and Stigma: They are met with ridicule from the society and are considered mentally ill, socially deviant and sexually predatory.
• Anti-Transgender Violence: They are forced for gender conformism, aversion based pseudo-psychotherapies, forced marriages, stripping, physical and verbal abuse and are pushed into prostitution by their own families.
• Barriers to Healthcare: Their exposure to basic health care is minimal as they are subject to apathy from medical fraternity with professionals lacking transgender health care competency.

GS PAPER – I

MORE STUDENTS USING SMARTPHONES FOR ENTERTAINMENT THAN STUDY: SURVEY

Why in news?

• A pan-India survey of 6,229 parents of schoolchildren aged six to 16 in rural communities across 21 States revealed that more children used smartphones for entertainment rather than for studies.

About the Report

• The State of Elementary Education in Rural India report, released by Union Education Minister Dharmendra Pradhan, is based on a survey conducted by the Development Intelligence Unit (DIU), a collaboration between Transform Rural India and Sambodhi Research and Communications.

Findings of the Report

• The survey revealed that 49.3% of students in rural India have access to smartphones. However, among parents whose children have access to gadgets, 76.7% said the latter primarily used mobile phones to play video games.
• Of the students with access to gadgets, 56.6% used the devices for downloading and watching movies, while 47.3% used them to download and listen to music.
• Only 34% use the gadgets for downloading study material, and 18% accessed online learning through tutorials.
• Of the 6,229 parents surveyed, 6,135 had school-going children, 56 had children who dropped out of school, and 38 had children who had never enrolled in school.
• At least 78% of the parents of girls and 82% of the parents of boys wanted to educate their children to the level of graduation or above.
• Students in Class 8 and above had more access to smartphones (58.32%), while students in Classes 1 to 3 also had access (42.1%).
• Questions on the learning environment at home revealed that 40% of the parents said that age-appropriate reading materials, other than textbooks, are available at home.

Parent participation

• The survey showed that only 40% of parents have conversations with their children around learning in school every day, while 32% have such conversations with their children a few days a week.
• The survey also sought to know the reasons for children dropping out of school from a subset of 56 respondents. As much as 36.8% of the parents of girls who had dropped out said it was because they were needed to help out with the family’s earnings.
• Additionally, 31.6% of parents mentioned their child’s lack of interest in studies, while 21.1% believed that their daughters had to take care of household chores and siblings.
• For boys, as per the survey, the key reason for dropping out from school was the child’s lack of interest in studies. As much as 71.8% of respondents cited this reason, while another 48.7% said the boys were required to help out in the earnings for the family.
• On parent participation, the survey revealed that 84% of parents stated that they regularly attend parent-teacher meetings at school. The top two reasons for parents not attending meetings were short notice and a lack of willingness.

GS PAPER – I & III

DISAGGREGATED DATA ON THE HEALTH CONDITIONS OF TRIBAL POPULATIONS

Why in news?

• A parliamentary committee on the empowerment of women tabled a report, which pulled up the Union government for not having disaggregated data on the health conditions of tribal populations in the country and called for extensive data collection in this regard.

Panel’s finding and demand

• The panel wants the Tribal Affairs Ministry to be empowered so that it can deploy resources for health and education. The panel also called for a review in the Allocation of Business Rules so that the Tribal Affairs Ministry can be empowered to appropriately plan resources for tribal welfare in sectors such as health, education, nutrition, skill development and livelihood.
• The committee, painted a grim picture of the health conditions of tribal women in the country with whatever data was made available to it by the government from various sources.
• In the report on health facilities for tribal women, the committee noted how several diseases such as sickle cell anaemia and leprosy continued to be more prevalent in tribal populations.

Poor health

• The Health Ministry stated that genetic conditions such as sickle cell disease and G-6 PD deficiency were rising in tribal areas and that hypertension prevalence was also high in these areas, in addition to a higher prevalence of communicable diseases such as leprosy, tuberculosis and cholera, compared with other social groups.
• More than half of all tribal women in the reproductive age group are anaemic, the panel noted. It added that sickle cell disease testing of around 1.5 crore tribal people in targeted districts had shown 10.5 lakh people to be carriers, with around 50,000 diagnosed with the ailment.

GS PAPER –I & III

TRIAL DONE IN INDIA SHOWS NUTRITION SUPPORT PREVENTS TB

Why in news?

• A large trial undertaken in India has underscored the role of nutritional supplementation in sharply cutting down tuberculosis (TB) disease rate in the household contacts of an index patient, and mortality reduction in people diagnosed with active pulmonary TB.

About the Trial

• The trial was conducted in four districts in Jharkhand between August 2019 and August 2022. The results of the study were published in The Lancet and The Lancet Global Health.
• The trial was conducted on 2,800 people with pulmonary TB (1,979 men and 821 women). Over 80% of the participants had a BMI less than 18 and nearly 49% had a BMI less than 16 (severely underweight).

Findings of the trail

• In the randomised controlled trial involving household contacts of patients with pulmonary TB, nutritional support led to 39-48% reduction in TB disease in the intervention group compared with the control arm. \
• In the study that lasted for six months, 122 people in the control group developed TB whereas the intervention arm had only 96 TB cases.
• The 39% reduction in TB disease included all forms of TB (pulmonary and extra-pulmonary), while the 48% reduction was in microbiologically confirmed pulmonary TB. The intervention arm had 5,621 household contacts, and the control group had 4,724 family members.

Nutritional support given under the trial

• Each adult family member in the intervention arm received monthly nutritional support for six months — 5 kg of rice, 1.5 kg of split pigeon peas (tur dal), and a micronutrient pill;
• Each child below 10 years received 50% of the adult nutrition support. Those in the control arm did not get any nutritional supplementation and were on a usual diet.
• The trial also provided nutritional supplementation to all 2,800 people with active pulmonary TB undergoing treatment. Treatment was successful in nearly 94% (2,623) of TB patients. There were only about 4% (108) deaths during the six-month follow-up.
• Early weight gain in the first two months was associated with 60% lower risk of TB mortality. For ethical reasons, all 2,800 TB patients were provided with nutritional support.

Risk Factors

• The study documented high levels of severe and extremely severe undernutrition in patients at diagnosis. Severe undernutrition is one of the contributory causes of deaths in TB patients. Nutrition support provides protection against TB disease akin to a vaccine.
• Among the risk factors for TB, undernutrition accounts for over 40% of new TB cases every year. While other risk factors like diabetes, HIV infection, smoking and alcohol also need attention, the one risk factor that stands out is undernutrition.