UPSC CARE Mains Practice 19th September 2025
Topic – Sustainable Development Goals and Health
Q1. India has improved its SDG rankings, but progress on SDG 3 (Good Health and Well-being) remains uneven. Critically examine the challenges and suggest a holistic approach to bridge the gaps. (15 marks, 250 words)
Introduction
The Sustainable Development Goals (SDGs), adopted by the United Nations in 2015, set a global agenda for equitable and sustainable development by 2030. SDG 3 aims to ‘ensure healthy lives and promote well-being for all at all ages’. India’s rank improved from 109 (2024) to 99 (2025) in the SDG Index, showing progress in basic services and infrastructure. Yet, health indicators such as Maternal Mortality Ratio (MMR), under-five mortality, life expectancy, and out-of-pocket expenditure reveal that India is not on track to achieve SDG 3.
Body
- Current Gaps in Health Outcomes
- Structural and Systemic Challenges
- Strengthening Universal Health Coverage (UHC)
- Prevention-Oriented Health Education
- Multi-Stakeholder and Policy Actions
Conclusion
India’s improved SDG ranking reflects progress but masks the persistent gaps in health and nutrition. Achieving SDG 3 by 2030 requires a dual focus: strengthening healthcare infrastructure and embedding preventive health education at the school level. With concerted actions by the State, society, and individuals, India can not only meet the 2030 deadline but also lay the foundation for a Viksit Bharat 2047 that ensures healthier and longer lives for its citizens.
UPSC Syllabus
Sustainable Development Goals and Health
Why was this question asked?
‘Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyze. (2021)
Introduction
The Sustainable Development Goals (SDGs), adopted by the United Nations in 2015, set a global agenda for equitable and sustainable development by 2030. SDG 3 aims to ‘ensure healthy lives and promote well-being for all at all ages’. India’s rank improved from 109 (2024) to 99 (2025) in the SDG Index, showing progress in basic services and infrastructure. Yet, health indicators such as Maternal Mortality Ratio (MMR), under-five mortality, life expectancy, and out-of-pocket expenditure reveal that India is not on track to achieve SDG 3.
Body
Current Gaps in Health Outcomes
- Maternal Mortality Ratio (MMR): 97 per 100,000 live births, above the SDG 2030 target of 70.
- Under-five Mortality Rate (U5MR): 32 per 1,000 live births, against the target of 25.
- Life Expectancy: 70 years, short of the 2030 target of 73.63 years.
- Out-of-pocket Expenditure (OOPE): 13% of total consumption, nearly double the target of 7.83%.
- Immunisation Coverage: 93.23%—progressive, but below universal 100%.
Structural and Systemic Challenges
- Healthcare Infrastructure Deficit: Weak public health systems, especially in rural and tribal areas.
- Inequities in Access: Economic and regional disparities hinder universal coverage.
- Nutrition and Sanitation: Malnutrition, poor hygiene, and unsafe drinking water worsen health outcomes.
- Cultural Barriers: Stigma around reproductive and mental health restricts utilisation of services.
Strengthening Universal Health Coverage (UHC)
- Expansion of Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) for financial risk protection.
- Strengthening Primary Health Centres (PHCs) to ensure early detection and referral.
- Integration of care across primary, secondary, and tertiary levels for efficiency.
- Digital health tools (telemedicine, digital health records) to improve outreach in underserved areas.
Prevention-Oriented Health Education
- Introduce compulsory health education in schools focusing on:
- Nutrition and hygiene.
- Reproductive and sexual health.
- Road safety and first aid.
- Mental health and emotional well-being.
- Evidence from Finland (school-based reforms reducing cardiovascular mortality) and Japan (compulsory health education linked to higher life expectancy) shows long-term impact.
- In India, health education can create healthier adults, reduce MMR/U5MR, and enhance immunisation uptake.
Multi-Stakeholder and Policy Actions
- Policymakers: Embed structured health curricula; expand UHC and health financing.
- Parents & Communities: Support and reinforce school health lessons at home.
- Private Sector & NGOs: Collaborate on awareness campaigns and digital health innovations.
- Global Partnerships: Leverage WHO and World Bank models to strengthen primary care and insurance mechanisms.
Conclusion
India’s improved SDG ranking reflects progress but masks the persistent gaps in health and nutrition. Achieving SDG 3 by 2030 requires a dual focus: strengthening healthcare infrastructure and embedding preventive health education at the school level. With concerted actions by the State, society, and individuals, India can not only meet the 2030 deadline but also lay the foundation for a Viksit Bharat 2047 that ensures healthier and longer lives for its citizens.
Topic – Air pollution
Q 2. “Stubble burning in North India continues to worsen air quality despite several institutional interventions. Discuss the need for a holistic and multi-pronged approach to tackle the issue.” (15 marks, 250 words)
Introduction
Stubble burning in Punjab, Haryana, Uttar Pradesh, and parts of Rajasthan has emerged as a recurring environmental and health crisis. Each year, post-harvest agricultural residue is burnt to prepare fields for rabi sowing, releasing toxic pollutants and contributing to severe air pollution episodes in North India, particularly in the National Capital Region (NCR). Despite the establishment of the Commission for Air Quality Management (CAQM – Commission for Air Quality Management in NCR and Adjoining Areas) and judicial oversight, the persistence of farm fires highlights gaps in policy, enforcement, and farmer support systems. A holistic, multi-pronged approach is therefore necessary.
Body
- Structural Causes of Stubble Burning
- Institutional and Policy Gaps
- Environmental and Health Consequences
- Towards a Holistic Strategy
- Governance, Enforcement, and Awareness
Conclusion
Stubble burning is not merely a law-and-order problem but a manifestation of deeper structural and economic issues in Indian agriculture. Criminalizing farmers without addressing systemic constraints would only aggravate rural distress. A holistic approach combining policy reform, technological innovation, economic support, institutional strengthening (CAQM), and cooperative federalism is essential to sustainably resolve the crisis while ensuring both environmental protection and farmer welfare.
UPSC Syllabus
Air pollution
Why was this question asked?
Q. Describe the key points of the revised Global Air Quality Guidelines (AQGs) recently released by the World Health Organisation (WHO). How are these different from its last update in 2005? What changes in India’s National Clean Air Programme are required to achieve these revised standards? [2021]
Introduction
Stubble burning in Punjab, Haryana, Uttar Pradesh, and parts of Rajasthan has emerged as a recurring environmental and health crisis. Each year, post-harvest agricultural residue is burnt to prepare fields for rabi sowing, releasing toxic pollutants and contributing to severe air pollution episodes in North India, particularly in the National Capital Region (NCR). Despite the establishment of the Commission for Air Quality Management (CAQM – Commission for Air Quality Management in NCR and Adjoining Areas) and judicial oversight, the persistence of farm fires highlights gaps in policy, enforcement, and farmer support systems. A holistic, multi-pronged approach is therefore necessary.
Body
Structural Causes of Stubble Burning
- Narrow sowing windows due to the paddy–wheat crop cycle compel farmers to adopt burning as a quick, low-cost method.
- High cost of residue management equipment (Happy Seeder, Super Straw Management System) limits adoption among debt-ridden small and marginal farmers.
- Weak procurement diversification policies continue to incentivize paddy cultivation, despite its ecological costs such as groundwater depletion and residue surplus.
Institutional and Policy Gaps
- The CAQM, created under the 2021 Act as a statutory body with powers to coordinate across states, has failed to exercise its mandate independently of political pressures.
- Half-hearted enforcement: penalties and restrictions are inconsistently applied across states.
- Lack of transparency in monitoring: for instance, reports of underreporting of farm fires by state governments reduce accountability and credibility.
Environmental and Health Consequences
- Contribution to winter smog: particulate matter (PM2.5 and PM10) levels surge in Delhi-NCR during October–November.
- Public health impact: increases in respiratory diseases such as asthma, COPD, and cardiovascular ailments.
- Climate dimension: releases greenhouse gases like carbon dioxide, methane, and nitrous oxide, worsening climate change.
Towards a Holistic Strategy
- Economic incentives: Subsidies and direct cash transfers for adopting residue management machines.
- Crop diversification: Encourage maize, pulses, and oilseeds through assured procurement and MSP (Minimum Support Price) support.
- Technological innovations: Use of bio-decomposer solutions, ethanol production from stubble, and decentralized biomass power plants.
- Community-led models: Farmer cooperatives to share machinery and reduce costs at the village level.
Governance, Enforcement, and Awareness
- Strengthen CAQM with independent decision-making powers and greater financial autonomy.
- Transparent, real-time satellite monitoring of stubble fires with publicly available data to build public trust.
- Awareness campaigns highlighting long-term health hazards for farming communities themselves.
- Promote cooperative federalism – coordinated action between Centre, States, judiciary, and local panchayats.
Conclusion
Stubble burning is not merely a law-and-order problem but a manifestation of deeper structural and economic issues in Indian agriculture. Criminalizing farmers without addressing systemic constraints would only aggravate rural distress. A holistic approach combining policy reform, technological innovation, economic support, institutional strengthening (CAQM), and cooperative federalism is essential to sustainably resolve the crisis while ensuring both environmental protection and farmer welfare.
