Recently, Union Government has announced the Ayushman Bharat programme. National Health Protection scheme –code-named Ayushman Bharat — is aimed at making path breaking interventions to address health holistically, in primary, secondary and tertiary care systems, covering both prevention and health promotion.
The Ayushman Bharat programme is apparently driven by two main aims: 1) to strengthen primary health care which has been lacking in the country and 2) to offer financial protection from catastrophic expenditure, often encountered once a family member is sick and needs long-term health care.
The Union Minister for Finance while presenting the General Budget 2018-19 in Parliament announced two major initiatives in health sector as part of Ayushman Bharat programme.
The initiatives are as follows:-
(i) Health and Wellness Centre:-
The National Health Policy, 2017 has envisioned Health and Wellness Centres as the foundation of India’s health system. Under this 1.5 lakh centres will bring health care system closer to the homes of people. These centres will provide comprehensive health care, including for non-communicable diseases and maternal and child health services. These centres will also provide free essential drugs and diagnostic services. The Budget has allocated Rs.1200 crore for this flagship programme. Contribution of private sector through CSR and philanthropic institutions in adopting these centres is also envisaged.
(ii) National Health Protection Scheme:-
The second flagship programme under Ayushman Bharat is National Health Protection Scheme, which will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization. This will be the world’s largest government funded health care programme. Adequate funds will be provided for smooth implementation of this programme.
Lakhs of families borrow or sell assets to receive inpatient treatment and the government is concerned about the consequent “impoverishment of poor and vulnerable families”. India is presently in a state of health transition. Infectious diseases such as tuberculosis, malaria, dengue, H1N1 pandemic influenza and antimicrobial resistance remain a continued threat to health and economic security. At the same time, the country is having to confront the emerging problem of chronic non-communicable diseases such as cardiovascular diseases, diabetes, cancer which are now the leading cause of mortality.
This epidemiological transition is being fueled by social and economic determinants of health, as well as by demographic changes such as an ageing population, by environmental factors such as climate change, and by factors such as globalization, urbanization and changing lifestyles.
As a result, the health infrastructure is already under severe strain. Moreover, the high cost of health care and out of pocket expenditure force families to sell their assets, pushing nearly 60 million people every year into poverty.
These two health sector initiatives under Ayushman Bharat Programme will build a New India 2022 and ensure enhanced productivity, well being and avert wage loss and impoverishment. These Schemes will also generate lakhs of jobs, particularly for women.
In order to further enhance accessibility of quality medical education and health care, 24 new Government Medical Colleges and Hospitals will be set up, by up-grading existing district hospitals in the country. This would ensure that there is at least 1 Medical College for every 3 Parliamentary Constituencies and at least 1 Government Medical College in each State of the country.
The Ayushman Bharat scheme is apparently aimed at strengthening primary healthcare and offer financial protection from the huge expenditure often faced once a family member falls sick and needs long-term healthcare. Adequate funds will be provided for the scheme, set to be the world’s largest government-funded healthcare programme.
This new programme builds on the already existing Rashtriya Swasthya Bima Yojna or RSBY – a health insurance scheme for the below poverty line families, with entitlement of upto Rs 30,000 per annum for diseases requiring hospitalization.
The scheme is expected to cover 100 million households. The number of beneficiaries will be based on the Socio Economic Caste Census (SECC) data. The database of targeted beneficiaries is being created based on the SECC data, which has details of deprived households.
Manoj Jhalani, 1987 batch IAS officer has been designated as Mission Director of Ayushman Bharat. Another Kerala cadre IAS officer Dinesh Arora has been appointed as Director for Ayushman Bharat Scheme in the ministry of Health and Family Welfare.
India needs path-breaking interventions to address health holistically in primary, secondary and tertiary healthcare systems. This programme is innovative and path-breaking in the history of public health in India, which may have a transformative impact if implemented in an effective and coordinated manner. The programme would be a game changer by enhancing access to health care including early detection and treatment services by a large section of society who otherwise could not afford them.