The official launch of the Ayushman Bharat Digital Mission (ABDM) started an initiative that will give every citizen a unique digital health ID, linked to a personal health record (PHR). The ID will also be linked to the Aadhaar.
The process of assigning these health IDs started months ago when individuals using the Aadhaar to sign up for vaccinations on the CoWin app were assigned Digital Health IDs by default.
It is hoped the ABDM will significantly improve the efficiency, effectiveness, and transparency of health service delivery.
Someone with a health ID and PHR will be able to store personal medical history digitally (including prescriptions, diagnostic reports, discharge summaries, etc), access it, and share it as required. This can, for example, be of benefit to a patient with a medical issue while travelling.
Similarly, it will allow for the seamless transfer of patients across health care facilities. Health insurance providers will also find it useful for more efficient service delivery.
For health ID creation through the mobile or the Aadhaar, the beneficiary will be asked to share details of the name, year of birth, gender, address, and mobile number/Aadhaar. However, there are serious concerns about such digital systems in key areas of privacy and consent, particularly because India does not have a personal data protection law.
Reports indicate over 125 million people — anybody who used the Aadhaar to sign up for the CoWin app — has been assigned a health ID by default. Their consent was not explicitly sought, though it might have been hidden in the fine print of permission for CoWin.
This is not an auspicious beginning in terms of consent and privacy. The security features of the PHR servers where the data will be recorded are also quite hazy.
By definition, millions of individuals and multiple different agencies, institutions, and stakeholders will seek access to this data and leakages can prove damaging. It should be possible for users to opt out of the health ID and ADBM and still receive health care.
Also, user-consent for every granular access of the PHR and of the demographic data should ideally be built in. The official website says users will be allowed to permanently delete, or deactivate their PHR and health ID, if they desire.
This would mean all demographic details would be erased. The devil will be in the detail of this inbuilt feature, but it will surely take care of some consent issues.
The health ID will collate data and create a repository. This can, in theory, lead to better health care services and also aid in the creation of better health policies if that data is analysed for trends.
But Aarogya Setu and the CoWin app, and their efficacy in practice, raise questions about some basic issues. For instance, those without smartphones found it difficult to get onboard and exclusivity could be a problem here as well.
More worrying, despite the obsession with gathering data, the pandemic was not efficiently tackled. Many died due to lack of oxygen, and the vaccination programme moved by stops and starts due to the late procurement of vaccines.
Data collection is necessary to deliver more efficient services, but that in itself is not sufficient to assure such services if attention is not paid to the basics.
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[wptelegram-join-channel link=”https://t.me/s/upsctree” text=”Join @upsctree on Telegram”]2021 WEF Global Gender Gap report, which confirmed its 2016 finding of a decline in worldwide progress towards gender parity.
Over 2.8 billion women are legally restricted from having the same choice of jobs as men. As many as 104 countries still have laws preventing women from working in specific jobs, 59 countries have no laws on sexual harassment in the workplace, and it is astonishing that a handful of countries still allow husbands to legally stop their wives from working.
Globally, women’s participation in the labour force is estimated at 63% (as against 94% of men who participate), but India’s is at a dismal 25% or so currently. Most women are in informal and vulnerable employment—domestic help, agriculture, etc—and are always paid less than men.
Recent reports from Assam suggest that women workers in plantations are paid much less than men and never promoted to supervisory roles. The gender wage gap is about 24% globally, and women have lost far more jobs than men during lockdowns.
The problem of gender disparity is compounded by hurdles put up by governments, society and businesses: unequal access to social security schemes, banking services, education, digital services and so on, even as a glass ceiling has kept leadership roles out of women’s reach.
Yes, many governments and businesses had been working on parity before the pandemic struck. But the global gender gap, defined by differences reflected in the social, political, intellectual, cultural and economic attainments or attitudes of men and women, will not narrow in the near future without all major stakeholders working together on a clear agenda—that of economic growth by inclusion.
The WEF report estimates 135 years to close the gap at our current rate of progress based on four pillars: educational attainment, health, economic participation and political empowerment.
India has slipped from rank 112 to 140 in a single year, confirming how hard women were hit by the pandemic. Pakistan and Afghanistan are the only two Asian countries that fared worse.
Here are a few things we must do:
One, frame policies for equal-opportunity employment. Use technology and artificial intelligence to eliminate biases of gender, caste, etc, and select candidates at all levels on merit. Numerous surveys indicate that women in general have a better chance of landing jobs if their gender is not known to recruiters.
Two, foster a culture of gender sensitivity. Take a review of current policies and move from gender-neutral to gender-sensitive. Encourage and insist on diversity and inclusion at all levels, and promote more women internally to leadership roles. Demolish silos to let women grab potential opportunities in hitherto male-dominant roles. Work-from-home has taught us how efficiently women can manage flex-timings and productivity.
Three, deploy corporate social responsibility (CSR) funds for the education and skilling of women and girls at the bottom of the pyramid. CSR allocations to toilet building, the PM-Cares fund and firms’ own trusts could be re-channelled for this.
Four, get more women into research and development (R&D) roles. A study of over 4,000 companies found that more women in R&D jobs resulted in radical innovation. It appears women score far higher than men in championing change. If you seek growth from affordable products and services for low-income groups, women often have the best ideas.
Five, break barriers to allow progress. Cultural and structural issues must be fixed. Unconscious biases and discrimination are rampant even in highly-esteemed organizations. Establish fair and transparent human resource policies.
Six, get involved in local communities to engage them. As Michael Porter said, it is not possible for businesses to sustain long-term shareholder value without ensuring the welfare of the communities they exist in. It is in the best interest of enterprises to engage with local communities to understand and work towards lowering cultural and other barriers in society. It will also help connect with potential customers, employees and special interest groups driving the gender-equity agenda and achieve better diversity.