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Article 47's directive to raise nutrition levels and improve public health informs health system reforms: Ayushman Bharat provides health insurance, Health and Wellness Centres strengthen primary care, reflecting that health justice requires not just facilities but ______ access to quality, affordable care for all.
- economic
- equitable
- administrative
- military
Answer: equitable
Article 47 nutrition and public health systems: (a) Article 47 text: State shall regard raising level of nutrition, standard of living of people, improvement of public health as among its primary duties; endeavor to bring about prohibition of intoxicating drinks, drugs injurious to health, (b) Equitable access rationale: (i) Health as right: Access to quality healthcare essential for human dignity, capability development; not privilege of affluent, (ii) Social determinants: Health outcomes shaped by social, economic factors; equitable access requires addressing poverty, discrimination, exclusion, (iii) Systemic approach: Equitable access requires not just facilities but affordable, acceptable, accessible services; addresses financial, geographic, cultural barriers, (c) Health system operationalization: (i) Ayushman Bharat - PM-JAY: Provides health insurance coverage up to ₹5 lakh per family per year for economically vulnerable families; reduces catastrophic health expenditure, (ii) Health and Wellness Centres: Transforming sub-centers, primary health centers into comprehensive primary care facilities; enhances access, quality at grassroots, (iii) Public health programs: Immunization, maternal health, disease control programs address population-level health needs, prevent inequities, (d) Applications: (i) Financial protection: PM-JAY reduces out-of-pocket expenditure, enables access to secondary, tertiary care for poor families, (ii) Primary care strengthening: HWCs provide preventive, promotive, curative services; reduce burden on hospitals, improve health outcomes, (iii) Digital health: Ayushman Bharat Digital Mission enables portability, continuity of care through digital health records, telemedicine, (e) Challenges: (i) Quality assurance: Ensuring quality of care in public, private sectors requires standards, accreditation, monitoring, (ii) Human resources: Shortage of doctors, nurses, especially in rural areas; require training, incentives, task-shifting, (iii) Convergence: Coordination among health, nutrition, sanitation, education departments essential for holistic health outcomes, (f) Illustrates transformative health policy: Article 47 operationalized through health system reforms; balance between infrastructure, human resources, financial protection essential for realizing constitutional vision of equitable, quality healthcare for all.