Topic 1 : How water insecurity affects women
Context
The time burden of collecting water inevitably falls on the women and girls of the household
Access to water
- While India has made remarkable progress in expanding household access to water, the National Sample Survey 78th round multiple indicator survey (2020-21) suggests that over 41% of rural households lack access to safely managed drinking water within their households, and geographical disparities in household access to safe water, though declining, continue to persist.
- The distance to the principal source of drinking water for these households falls in the range of 0.2 to 1.5 km or more.
- India makes up 18% of the world’s population, with a share of water resources of less than 5%.
The Consequences
- Evidence suggests that lack of access to water can cause considerable stress among households.
- In water-scarce areas or among households whose principal water source lies outside their household premises, water collection is typically perceived as a gendered activity, with the time burden of collecting water inevitably falling on women and girls of the household.
- Water insecurity affects women’s everyday lives, household dynamics, and social relationships.
- It also affects the school attendance and academic performance of girls.
- Women also face gender-based violence during the commute for water collection, which has an adverse impact on their mental health.
- Lack of access to adequate water leads to the practice of open defecation. This, in turn, has a multitude of effects on women.
- Apart from the health impacts like diarrhoea, typhoid and cholera, and impacts on menstrual health, women who practise open defecation also face psychosocial stress as well as a greater risk of non-partner sexual violence.
Government policies
- The Jal Jeevan Mission (JJM) and the National Water Mission present an important shift in the policy for water management.
- The JJM enables access to drinking water through household tap connections.
- The programme seeks to measure this through increased participation of women in community engagement, including in gram panchayat and self-help group activities.
- To this end, the programme is designed to empower women by encouraging their involvement in Pani Samitis constituted for the purpose of planning, implementation, operations and maintenance, and monitoring of the programme at the village level.
- JJM guidelines also recommend that at least five women from every village are trained in periodic water quality monitoring.
- This serves the dual objective of empowering these women as well as ensuring the delivery of quality water to all rural households under this programme.
Way forward
Beyond reporting on progress in terms of water access or quality, it is also imperative that we measure progress against intended gender goals – be it in terms of reduction in the drop-out rates among school-going girls or reduction in drudgery among rural women and the extent to which this translates to improved socio-economic outcomes for these women.
Topic 2 : Focus on prevention to preserve and protect your kidney function
Context
In 2019, chronic kidney disease (CKD) was responsible for over 3.1 million deaths, ranking it as the 7th leading cause of death worldwide. World Kidney Day signals to us the importance of awareness and diligence in treatment of kidney disease.
Kidney disease
- As India faces innumerable challenges in providing healthcare to its 1.44 billion people, kidney disease is emerging as an illness to reckon with.
- The diversity of India especially with regard to socio economic status, literacy, food habits, cultural beliefs, and access to healthcare are all important and complex issues facing the State and central governments.
- A total of 2,200 kidney specialists, skewed in distribution with a majority in the four (advanced) southern States and metropolitan cities leaves a critical gap in providing timely care to kidney disease patients.
- The global mortality attributed to all kidney diseases is estimated to range between 5 and 11 million annually, particularly impacting low and middle-income countries (LMICs).
Compliance with treatment
- The burning issues are that people with high blood pressure, diabetes and heart disease do not comply with treatment and follow up after the diagnosis is made, which more often than not, lead to complications.
- Therefore it is important at this juncture to spread the message of prevention; besides addressing and evaluating the disease state periodically for the success of management strategies.
- Chronic Kidney Disease of unknown origin (CKDu) predominantly affecting the farming and fishing community in different geographic locations and salt pan workers calls for more research.
- The genetic predisposition to kidney disease is not apparent in the majority of people in India as it is different from Caucasian, Africans, Chinese and Japanese ethnic groups.
Strategies
- Management strategies for Non Communicable Diseases such as diabetes, and hypertension include counselling, nutrition, medical therapy and drugs.
- The newer drugs for slowing down the progression of diabetic kidney disease are available in India and marketed by many pharmaceutical companies.
- These drugs are called as SGLT2 inhibitors such as dapagliflozin, canagliflozin, enpagliflozin which also protect the heart.
- The RAAS blockade is an effective treatment modality with telmisartan, losartan and olmesartan.
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The renin-angiotensin-aldosterone system (RAAS) is the system of hormones, proteins, enzymes and reactions that regulate your blood pressure and blood volume on a long-term basis. It regulates your blood pressure by increasing sodium (salt) reabsorption, water reabsorption (retention) and vascular tone.
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- The introduction of a new drug, Finerenone, which is a mineralocorticoid receptors antagonist is useful in slowing the progression of kidney and heart diseases.
- Effective blood pressure control with different group of medications to <130/80MMHg is a very useful measure to slow down kidney disease progression and heart failure and stroke.
- Also exercise and appropriate food intake to reduce weight.
- The use of alternate medications and continuous consumption of Non Steroid Anti Inflammatory drugs as painkillers and proton pump inhibitors such as pantoprazole should be discouraged.
- Individuals who are working under direct heat in the open should reduce exposure to the sun in summer and consume salt and fluids to prevent dehydration and hence, kidney injury.
The World Kidney Day
- The World Kidney Day slogan in 2024 is ‘Advancing Equitable Access to Care and Optimal Medication Practice’.
- In this mission, the kidney community world-wide including physicians, scientist, nurses, patients, other health care providers, administrators, health policy experts, Government officials, local, regional and national kidney organisations and foundations should be in the forefront to spread the message.
- The message of World Kidney Day is, kidney disease is common, harmful and treatable.
- The platform by the Ministry of Health in Tamil Nadu — Makkalai Thedi Maruthuvam — is a great initiative for detection of both non-communicable (NCD) and communicable disease such as Tuberculosis and other chronic infections which can have an impact on kidney functions.
Conclusion
- With all these initiatives the future looks bright for kidney disease patients in India. The WKD will definitely accelerate the knowledge base every year and will help platform common people.