Latest in the string of litigations filed after the enactment of the Right of Children to Free and Compulsory Education Act, 2009 (RTE Act), the Delhi High Court ruled that the Act shall not apply to nursery admissions in unaided private schools for the unreserved category of students. The decision, given on February 19, was in response to writ petitions filed by Social Jurist, a civil rights group and the Delhi Commission for the Protection of Child Rights. It contended that the guidelines of the Ministry of Human Resource Development related to schools’ selection procedure should also be applicable to pre-primary and pre-school classes. The right to education is applicable to children between the age of 6 and 14 years. The RTE Act states that schools have to reserve certain proportion of their seats for disadvantaged groups. It adds that where the school admits children at pre-primary level, the reservation for children of weaker sections shall apply. However, it does not mention whether other RTE norms are applicable to pre-schools. It only states that the appropriate government may make necessary arrangements for providing pre-school education to children between the age of 3 and 6 years. Guidelines of the Ministry with regard to selection procedure of students:
The two issues that the court considered were: (a) whether RTE applies to pre-schools including nursery schools and for education of children below six years of age; (b) whether RTE applies to the admission of children in pre-schools in respect of the unreserved seats (25% of seats are reserved for children belonging to disadvantaged groups). According to the verdict, the guidelines issued by the government do not apply to the unreserved category of students i.e. 75% of the admission made in pre-schools in private unaided schools. This implies that private unaided schools may formulate their own policies regarding admission in pre-schools for the unreserved category of students. However, they apply to the reserved category of students i.e. 25% of the admission s made in these schools for disadvantaged groups. The court has however stated that in its view this is the right time for the government to consider the applicability of RTE Act to the nursery classes too. In most schools, students are admitted from nursery and they continue in the same school thereafter. Therefore, the RTE Act’s prohibition of screening at the time of selection is rendered meaningless if it is not applicable at the nursery level.
Recently, the Standing Committee on Health and Family Welfare submitted its report to the Parliament on the National Commission for Human Resource for Health Bill, 2011. The objective of the Bill is to “ensure adequate availability of human resources in the health sector in all states”. It seeks to set up the National Commission for Human Resources for Health (NCHRH), National Board for Health Education (NBHE), and the National Evaluation and Assessment Council (NEAC) in order to determine and regulate standards of health education in the country. It separates regulation of the education sector from that of professions such as law, medicine and nursing, and establishes professional councils at the national and state levels to regulate the professions. See here for PRS Bill Summary. The Standing Committee recommended that this Bill be withdrawn and a revised Bill be introduced in Parliament after consulting stakeholders. It felt that concerns of the professional councils such as the Medical Council of India and the Dental Council of India were not adequately addressed. Also, it noted that the powers and functions of the NCHRH and the National Commission on Higher Education and Research (to be established under the Higher Education and Research Bill, 2011 to regulate the higher education sector in the country) were overlapping in many areas. Finally, it also expressed concern over the acute shortage of qualified health workers in the country as well as variations among states and rural and urban areas. As per the 2001 Census, the estimated density of all health workers (qualified and unqualified) is about 20% less than the World Health Organisation’s norm of 2.5 health workers per 1000 population. See here for PRS Standing Committee Summary. Shortfall of health workers in rural areas Public health care in rural areas is provided through a multi-tier network. At the lowest level, there are sub health-centres for every population of 5,000 in the plains and 3,000 in hilly areas. The next level consists of Primary Health Centres (PHCs) for every population of 30,000 in the plains and 20,000 in the hills. Generally, each PHC caters to a cluster of Gram Panchayats. PHCs are required to have one medical officer and 14 other staff, including one Auxiliary Nurse Midwife (ANM). There are Community Health Centres (CHCs) for every population of 1,20,000 in the plains and 80,000 in hilly areas. These sub health centres, PHCs and CHCs are linked to district hospitals. As on March 2011, there are 14,8124 sub health centres, 23,887 PHCs and 4809 CHCs in the country.[i] Sub-Health Centres and Primary Health Centres
Table 1: State-wise comparison of vacancy in PHCs
|
Doctors at PHCs |
ANM at PHCs and Sub-Centres |
|||||
| State | Sanctioned post | Vacancy | % of vacancy | Sanctioned post | Vacancy | % of vacancy |
| Chhattisgarh | 1482 | 1058 | 71 | 6394 | 964 | 15 |
| West Bengal | 1807 | 801 | 44 | 10,356 | NA | 0 |
| Maharashtra | 3618 | 1326 | 37 | 21,122 | 0 | 0 |
| Uttar Pradesh | 4509 | 1648 | 36 | 25,190 | 2726 | 11 |
| Mizoram | 57 | 20 | 35 | 388 | 0 | 0 |
| Madhya Pradesh | 1238 | 424 | 34 | 11,904 | 0 | 0 |
| Gujarat | 1123 | 345 | 31 | 7248 | 817 | 11 |
| Andaman & Nicobar Isld | 40 | 12 | 30 | 214 | 0 | 0 |
| Odisha | 725 | 200 | 28 | 7442 | 0 | 0 |
| Tamil Nadu | 2326 | 622 | 27 | 9910 | 136 | 1 |
| Himachal Pradesh | 582 | 131 | 22 | 2213 | 528 | 24 |
| Uttarakhand | 299 | 65 | 22 | 2077 | 0 | 0 |
| Manipur | 240 | 48 | 20 | 984 | 323 | 33 |
| Haryana | 651 | 121 | 19 | 5420 | 386 | 7 |
| Sikkim | 48 | 9 | 19 | 219 | 0 | 0 |
| Meghalaya | 127 | 23 | 18 | 667 | 0 | 0 |
| Delhi | 22 | 3 | 14 | 43 | 0 | 0 |
| Goa | 46 | 5 | 11 | 260 | 20 | 8 |
| Karnataka | 2310 | 221 | 10 | 11,180 | 0 | 0 |
| Kerala | 1204 | 82 | 7 | 4232 | 59 | 1 |
| Andhra Pradesh | 2424 | 76 | 3 | 24,523 | 2876 | 12 |
| Rajasthan | 1478 | 6 | 0.4 | 14,348 | 0 | 0 |
| Arunachal Pradesh | NA | NA | NA | NA | NA | 0 |
| Assam | NA | NA | NA | NA | NA | 0 |
| Bihar | 2078 | 0 | NA | NA | NA | 0 |
| Chandigarh | 0 | 0 | NA | 17 | 0 | 0 |
| Dadra & Nagar Haveli | 6 | 0 | NA | 40 | 0 | 0 |
| Daman & Diu | 3 | 0 | NA | 26 | 0 | 0 |
| Jammu & Kashmir | 750 | 0 | NA | 2282 | 0 | 0 |
| Jharkhand | 330 | 0 | NA | 4288 | 0 | 0 |
| Lakshadweep | 4 | 0 | NA | NA | NA | 0 |
| Nagaland | NA | NA | NA | NA | NA | 0 |
| Puducherry | 37 | 0 | NA | 72 | 0 | 0 |
| Punjab | 487 | 0 | NA | 4044 | 0 | 0 |
| Tripura | NA | NA | NA | NA | NA | 0 |
| India | 30,051 | 7,246 | 24 | 1,77,103 | 8,835 | 5 |
| Sources: National Rural Health Mission (available here), PRS.Note: The data for all states is as of March 2011 except for some states where data is as of 2010. For doctors, these states are Bihar, UP, Mizoram and Delhi. For ANMs, these states are Odisha and Uttar Pradesh. | ||||||
Community Health Centres
Table 2: Vacancies in CHCs of medical specialists
| Surgeons | Gynaecologists | Physicians | Paediatricians | |
| State |
% of vacancy |
|||
| Andaman & NicobarIsland | 100 | 100 | 100 | 100 |
| Andhra Pradesh | 74 | 0 | 45 | 3 |
| Arunachal Pradesh | NA | NA | NA | NA |
| Assam | NA | NA | NA | NA |
| Bihar | 41 | 44 | 60 | 38 |
| Chandigarh | 50 | 40 | 50 | 100 |
| Chhattisgarh | 85 | 85 | 90 | 84 |
| Dadra & Nagar Haveli | 0 | 0 | 0 | 0 |
| Daman & Diu | 0 | 100 | 0 | 100 |
| Delhi | 0 | 0 | 0 | 0 |
| Goa | 20 | 20 | 67 | 66 |
| Gujarat | 77 | 73 | 0 | 91 |
| Haryana | 71 | 80 | 94 | 85 |
| Himachal Pradesh | NA | NA | NA | NA |
| Jammu & Kashmir | 34 | 34 | 53 | 63 |
| Jharkhand | 45 | 0 | 81 | 61 |
| Karnataka | 33 | NA | NA | NA |
| Kerala | NA | NA | NA | NA |
| Lakshadweep | 0 | 0 | 100 | 0 |
| Madhya Pradesh | 78 | 69 | 76 | 58 |
| Maharashtra | 21 | 0 | 34 | 0 |
| Manipur | 100 | 94 | 94 | 87 |
| Meghalaya | 50 | NA | 100 | 50 |
| Mizoram | NA | NA | NA | NA |
| Nagaland | NA | NA | NA | NA |
| Odisha | 44 | 45 | 62 | 41 |
| Puducherry | 0 | 0 | 100 | NA |
| Punjab | 16 | 36 | 40 | 48 |
| Rajasthan | 57% | 46 | 49 | 24 |
| Sikkim | NA | NA | NA | NA |
| Tamil Nadu | 0 | 0 | 0 | 0 |
| Tripura | NA | NA | NA | NA |
| Uttar Pradesh | NA | NA | NA | NA |
| Uttarakhand | 69 | 63 | 74 | 40 |
| West Bengal | 0 | 57 | 0 | 78 |
| India | 56 | 47 | 59 | 49 |
| Sources: National Rural Health Mission (available here), PRS. | ||||
[i]. “Rural Healthcare System in India”, National Rural Health Mission (available here).
