Safe environment and sanitation – Swachh Bharat, safe drinking water
Community participation – planning, implementation, awareness programs
Equity-oriented public policies – prioritize vulnerable groups (tribals, rural poor, children, elderly)
Marmot’s Key Principles: Give every child the best start, enable education and lifelong learning, ensure fair employment, provide healthy living conditions, create healthy communities, reduce income inequality. Health inequalities are socially created and preventable.
Q2. Child Mortality among Scheduled Tribes vs All Groups (NFHS-4)
Low literacy – poor awareness of nutrition, immunization, hygiene
Poor sanitation and unsafe water – diarrhea, infections, parasitic diseases
Inadequate healthcare infrastructure – shortage of doctors, health workers, medicines, transport
Social exclusion – discrimination, policy neglect, poor representation
The table demonstrates deep social inequality and failure of equitable healthcare delivery. Reducing tribal child mortality requires inclusive and equity-based public health policies.
Q3. Jangalkhas Incident and Social Determinants of Health
Social Determinants at Play
Poverty – no cultivable land, unstable income → food insecurity, poor nutrition
Low literacy – especially among women → poor health awareness, delayed treatment
Unemployment – only 8% main workers → economic insecurity, stress
The deaths cannot be explained only by disease. They reflect structural inequality, social deprivation, and neglect of tribal health. Disease occurs within social and economic contexts. Measures needed: improve nutrition, strengthen tribal healthcare, improve education, livelihood support, address alcohol abuse.
Q4. Government Health Insurance Scheme (2018) – Ayushman Bharat PM-JAY
Positive Impacts
Financial protection – reduces catastrophic health expenditure, borrowing, medical impoverishment
Increased healthcare access – timely treatment, hospitalization, service utilization
Reduction in health inequalities – marginalized populations gain better access
Early diagnosis and treatment – screening, diagnosis, management of chronic diseases
Improved maternal and child health – institutional delivery, neonatal care
Limitations & Challenges
Focus on hospitalization – curative care over prevention, primary healthcare, health promotion
Rural infrastructure gaps – lack of hospitals, specialists, diagnostic facilities
Awareness issues – poor populations lack information, face administrative barriers
Risk of private sector exploitation – unnecessary procedures, overbilling
Out-of-pocket expenses may continue – medicines, travel, diagnostics
Ayushman Bharat is an important step toward Universal Health Coverage and health equity. Long-term success depends on strengthening public health infrastructure, awareness, and preventive healthcare systems.
Q5. Menstrual Cycle, Rh Incompatibility, and Nervous System
(A) Physiological Basis of Menstrual Cycle
Phases
Menstrual Phase (Day 1–5): Shedding of endometrium due to decline in estrogen & progesterone