Polity & Governance Prelims cum Mains

Ayushman Bharat to be rolled out in alliance with state health plans

The News

  • The first meeting of Ayushman Bharat-National Health Protection Mission Council (AB-NHPMC) that will give policy directions and foster coordination between Centre and States will happen in Delhi on June 14.

 

About Ayushman Bharat- National health protection Mission

  • Announced in the Budget this year, NHPM (since referred to as Ayushman Bharat-NHPM) aims to provide an annual health cover of Rs 5 lakh to 10.74 crore families or 50 Cr. population.
  • Under the preventive health component of Ayushman Bharat, 1,53,000 health and wellness centres will be set up across the country.
  • Beneficiaries for AB-NHPM will be identified on the basis of deprivation and occupational criteria as per Socio Economic and Caste Census 2011 data.
  • The scheme is for secondary and tertiary healthcare, mainly for hospital care.
  • The government will require Rs 12000 crore for its implementation, with cost shared on a 60:40 basis between central and state governments.

 

State’s role in implementation of the Ayushman Bharat

  • Ayushman Bharat is an umbrella programme including NHPM and a preventive healthcare component and it will be rolled out as an “alliance” with the state health programmes.
  • The memorandum of understanding has been signed with 15 states.
  • All the state health schemes will continue to run. This means that in states where the existing list of beneficiaries is larger than the beneficiary list as per SECC data, the states would be free to pay the premium for the population other than beneficiaries listed as per SECC data from their own resources.
  • States would need to have their own State Health Agency to implement the scheme.
  • They have the option to use an existing Trust / Society / Not for Profit Company/ State Nodal Agency or set up a new one.

 

Need of the scheme

  • 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 has 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.
  • To address these challenges, on February 1 the world’s largest government-funded health programme called National Health Protection Scheme (NHPS) was unveiled.

 

Significance of the scheme

  • This flagship scheme is likely to benefit more than 37% of the population, meaning that nearly all the poor and vulnerable families will be covered.
  • The “health & wellness” centres will offer a set of services including maternal and child health services, mental health services, vaccinations against selected communicable diseases, and screening for hypertension, diabetes, and some cancers.
  • 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 scheme, if implemented properly could 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.
  • Ultimately, NHPS could help country move towards universal health coverage and equitable access to healthcare which is one of the UN Sustainable Development Goals or SDGs.

 

 

 

Challenges

  • It is clear that the NHPS scheme, which primarily offers support for clinical services such as hospitalization, is unlikely to help fix the broken public health system in the country.
  • The most critical issue remains the limited and uneven distribution of human resources at various levels of health services, with up to 40 per cent of health worker posts lying vacant in some states.
  • Without addressing the human resource situation, public sector health care will remain of poor quality and largely unacceptable, forcing patients to go to the private sector, which is detrimental for the poor for whom the scheme is intended.
  • Effective implementation of the schemes might be a biggest challenge.

 

Way ahead

  • Clarity is also needed on what services will be provided by government health facilities and for which conditions patients will have to use private parties and what mechanisms are being thought of.
  • There is a need for uniformly pricing systems for various health interventions, including diagnostics and medicines, and making them transparent by displaying them in hospital premises.
  • Moreover, a continuum of care system also needs to be established by linking institutions or hospitals, with health centres and the community to ensure that the health and wellness centres and the primary health centres are responsive to the needs of the community.
  • For the successful implementation of the programme, an independent body or unit may be set up within the ministry of health & family welfare to plan, coordinate, and provide technical backstopping to states, including in capacity building and development of standards and guidelines for the programme.
  • The identification of beneficiaries can be done by linking with Aadhar and similarly following up for services received and health outcomes achieved, thereby helping to monitor and evaluate the impact of the programme.

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