(GIST OF KURUKSHETRA) Ayushman Bharat: achieving Universal Health Coverage

[February-2022]

Ayushman Bharat: achieving Universal Health Coverage

Context:

As per the World Health Organisation (WHO), attaining the highest possible standard of health
is a fundamental right of every human being. For achieving the targets of Universal Health Coverage, the Government of India has implemented a flagship public health scheme – ‘Ayushman Bharat’.

About:

The main objective of providing comprehensive need-based healthcare service delivery system under the Ministry of Health and Family Welfare, it has a budget of nearly Rs. 8,000 crore for the financial year 2021-2022.
It aims to holistically address the healthcare system-covering prevention, promotion and ambulatory care at all levels - primary, secondary and tertiary.
To enhance the quality, efficiency and efficacy of healthcare delivery, it draws expert services and facilities from various sectors/departments.

Ayushman Bharat has two major components namely:

Health and Wellness Centres (HWCs), and
Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Universal Health Coverage – The Framework of Action

To meet the SDGs targets, nations across the globe are trying to achieve UHC with a focus on its three major pillars:

Service Delivery
Health Financing
Governance

Since different nations have their own unique health concerns, resource pool and challenges, they need to develop their need specific framework of action keeping in mind the following aspects:

1. Finance

Expand financial pool by promoting public-private partnerships and corporate social responsibility.
Increase domestic resource mobilisation and budget reallocation at frequent intervals.
Enhance affordability of health services, infrastructure, medicines and related items.
Provide financial protection to each citizen of the country.
Facilitate efficient and judicious time bound utilisation of financial resources.

2. Health Services

Establish people-centric health services.
Ensure equity and bias-free health service.
Prioritise health services which are of most significance to reducing mortality and morbidity.
Promote partnerships between the civil society (community) with public/private sector so as to enhance access to key preventive, rehabilitative and curative health services.
Invest in pre-service medical and paramedical education.
Engage in multi-sectoral partnerships to address determinants of health.

3. Equity

Target vulnerable populations so to develop and implement health/nutrition programs tailored to their needs.
Expand service delivery for marginalised and vulnerable groups (age, gender, demography, etc.)
Scale-up safety net approaches including vouchers and conditional cash-transfers which directly or indirectly support good health and well-being.
Ensure fulfilment of basic rights especially of women, children and elderly.

4. Preparedness

Prepare and regularly improve National preparedness plans especially for natural disasters.
Promote adherence to the International Health Regulations.
Refer to international framework for monitoring and evaluation of policies and program which are directly or indirectly related to the health sector.
Enhance State level and international collaborations to prepare for and respond to public health emergencies such as epidemics/pandemics.

5. Governance

Establish platforms and processes which facilitate dialogue between various stakeholders (service providers and receivers).
Ensure workable effective mechanisms for inter-sectoral dialogue and work.
Establish transparent monitoring and reporting on progress towards UHC and make it available on public domains.
Strengthen national institutions and organisations through capacity building.
Ensure that all citizens have access to data and information on UHC.

Salient components covered under PM-JAY – the health assurance scheme:

Medical examination, treatment and consultation
Pre-hospitalisation
Medicine and medical consumables
Non-intensive and intensive care services
Diagnostic and laboratory investigations
Medical implantation services (where necessary)
Accommodation benefits and Food services
Complications arising during treatment
Post-hospitalisation follow-up care up to 15 days

Conclusion:

Since its inception, Ayushman Bharat has been trying to successfully meet its objectives of ensuring comprehensive coverage for catastrophic illnesses, reduce catastrophic out-of-pocket expenditure, improved access to hospitalisation/health-care, reduce unmet needs, and converging various health insurance schemes across the different states of India.