(GIST OF YOJANA) Build upon ongoing initiatives and supplementary steps to transform health in India [SEPTEMBER-2019]

(GIST OF YOJANA) Build upon ongoing initiatives and supplementary steps to transform health in India

Develop a road-map for a possible health insurance/assurance programme, for secondary and tertiary level hospitalization with no financial cap covering up to 80% Indian population, under Pradhan Mantri Jan Arogya Yojana(PM-JAY). Though, non-poor may be asked for mandatory contribution.
Link existing secondary and tertiary level insurance schemes with financial cover for non-hospitalisation (out-patient consultation) services.
In other words, effective hospitalisation and out-patient coverage linkage. The services should be designed to be free at the point of delivery.
Revise the norm for Urban Primary Health Centre (UPIIC) from one for every 50,000 population to one for every 25,000 population by 2022 and for every 10.000 population by 2028.
Establish additional 50,000 IIWCs by 2022 to fill the shortage of Government primary healthcare infrastructure in India. More such facilities need to come up in urban areas and with innovative approaches.

All Indian states to set up public health cadre to strengthen preventive and preventive health services.
Consider an All India cadre of specialist doctors (on line of erstwhile Indian Medical Services) to address the shortage of specialist doctors at public health facilities. This approach can help, along with designing of sub-district-based health system, to address shortage of specialist doctors which is in the range of 60-80% in most of the states.
Establish independent and autonomous institutional mechanisms for operational/ implementation research and for technical support to provide evidence and guidance for health systems strengthening. The health sector is a specialised field and dedicated and evidence-based technical advice by full time staff is desirable for effective and large-scale health initiatives in India.
Plan health services so as to see both primary healthcare and hospital in continuum of care with effective functioning at all levels. Evidence suggests that a strengthened PHC system performs better when supported by an equally well-functioning hospital services/system, with two-way referral. In this context, there is a need to consider establishing stronger linkage under Ayushman Bharat Programme between HWC and PMJAY.