General Studies 2024 GS Paper II 15 marks 250 words Compulsory Suggest

Q17

In a crucial domain like the public healthcare system the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level. (Answer in 250 words) 15

हिंदी में प्रश्न पढ़ें

लोक स्वास्थ्य देखभाल प्रणाली जैसे महत्त्वपूर्ण क्षेत्र में भारतीय राज्य को उस व्यवस्था के बाजारीकरण के दुष्प्रभावों को रोकने के लिए व्यापक भूमिका निभानी चाहिए। कुछ ऐसे उपाय सुझाइए जिनके माध्यम से राज्य, लोक स्वास्थ्य देखभाल प्रणाली की पहुँच का विस्तार तृणमूल स्तर तक कर सके। (उत्तर 250 शब्दों में लिखिए)

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Directive word: Suggest

This question asks you to suggest. The directive word signals the depth of analysis expected, the structure of your answer, and the weight of evidence you must bring.

See our UPSC directive words guide for a full breakdown of how to respond to each command word.

How this answer will be evaluated

Approach

The directive 'suggest' requires proposing concrete, implementable measures rather than mere description. Structure should begin with a brief context on marketisation challenges (catastrophic health expenditure, Ayushman Bharat limitations), followed by 4-5 specific state-led interventions for grassroots reach, and conclude with integrated governance approach linking centre-state-local bodies.

Key points expected

Recognition of marketisation harms: rising out-of-pocket expenditure (60%+ of health spending), corporatisation of tertiary care, and urban-rural asymmetry in access
Strengthening sub-centres and PHCs through HR reforms: NHM contractual staff regularisation, incentives for rural posting, task-shifting to ASHA/ANM workers
Decentralised drug procurement and generic medicine availability: Tamil Nadu Medical Services Corporation (TNMSC) model, Jan Aushadhi expansion at village level
Technology-enabled last-mile connectivity: telemedicine hubs under e-Sanjeevani, drone delivery of vaccines/medicines (ICMR pilot in Manipur, Arunachal)
Convergence with nutrition and sanitation: integration of POSHAN Abhiyaan, Swachh Bharat with health outreach; Mohalla Clinics (Delhi) or Arogya Mandir (Rajasthan) as integrated models
Community participation and accountability: Rogi Kalyan Samitis, social audits under NRHM, grievance redressal mechanisms

Evaluation rubric

Dimension	Weight	Max marks	Excellent	Average	Poor
Demand-directive understanding	20%	3	Clearly distinguishes 'suggest' from 'analyse'—offers actionable, specific policy prescriptions rather than generic discussion; explicitly addresses 'grassroots level' and 'marketisation containment' as twin objectives	Provides some measures but mixes description with suggestion; partially addresses grassroots focus or treats marketisation only in passing	Misreads directive as 'discuss' or 'explain'; offers no concrete suggestions or ignores grassroots/last-mile dimension entirely
Content depth & accuracy	20%	3	Covers multi-level governance (centre-state-panchayat), HR, infrastructure, technology, and financing with accurate scheme names and constitutional provisions (11th/12th Schedule health functions)	Covers 2-3 dimensions adequately but misses critical aspects like HR crisis or inter-governmental coordination; minor factual errors in scheme names	Superficial listing without depth; major factual errors (confusing NHM with NHA); ignores structural constraints like 15th Finance Commission health grants
Structure & flow	20%	3	Logical progression: problem identification → systemic measures (preventive-primary-tertiary) → implementation mechanism → conclusion; smooth transitions between paragraphs	Basic intro-body-conclusion structure but measures appear as disjointed list; weak thematic grouping or abrupt shifts between ideas	No discernible structure; random jumping between points; missing introduction or conclusion; exceeds word limit significantly
Examples / case-law / data	20%	3	Deploys 3+ specific Indian examples: TNMSC/ Kerala's decentralised health planning/ Delhi Mohalla Clinics/ e-Sanjeevani; uses data (OOP 62%, doctor-population ratio 1:834) or cites High Court directives on right to health (Parmanand Katara, Paschim Banga)	1-2 generic examples (Ayushman Bharat mentioned without specificity); data used without context or outdated figures; no case law	No Indian examples; uses foreign models without adaptation; invented data or schemes; irrelevant case law citation
Conclusion & analytical edge	20%	3	Synthesises measures into coherent vision (e.g., 'Ayushman Bharat 2.0 with strengthened public provisioning'); acknowledges fiscal/political constraints; ends with forward-looking note on health as public good vs commodity	Summary restatement of points without synthesis; generic closing statement on 'healthy India'; no critical reflection on implementation challenges	Abrupt ending or no conclusion; contradictory final statement; purely aspirational without analytical grounding

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