‘Ayushman Bharat is a Boon for the Country’: Against the Motion

  • Surabhi Sethi Department of Community Medicine, NDMC Medical College & Hindu Rao Hospital, Delhi.
  • Priyanka Sharma Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
  • Ashok Kumar Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
  • Nidhi Singh Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
  • Jugal Kishore Director Professor & Head, Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
Keywords: Ayushman Bharat, Health and Wellness Center, PMJAY, National Health Protection Scheme

Abstract

Background: Ayushman Bharat, came into existence in 2018, was based on recommendations of National Health Policy 2017 with an aim to provide Universal Health Coverage to citizens of India. Under this, two inter-connected components were envisaged namely, Health and Wellness Centres and National health protection scheme. But since its inception, there has been concerns with its implementation throughout the country.

Objectives: This article primarily identifies the lacunaes in framework and implementation of Ayushman Bharat across the nation. The secondary objective was to study the potential consequences of this scheme on health care infrastructure of country.

Result: There is a shortfall of about 20% Sub centres and an equal number of Primary health centres in India and almost 90% of existing ones do not meet Indian Public health standards. This coupled with shortage of manpower is a crucial barrier in concept of HWCs. Inadequate and incomplete coverage of health services with exclusion of outpatient services, ambiguity in beneficiary definitions and concerns related to reports of frauds might affect NHPS implementation. Insufficient financial allocation is a key obstacle for successful implementation of AB. This scheme might lead to compromise in other health related programmes.

Conclusion: Without addressing existing deficiencies in health care system, mere introduction of a new comprehensive scheme might fail to achieve its objectives. There is a need to address these gaps first to get the expected results and improve health outcomes in country.

References

Central Bureau of Health Intelligence, Directorate General of Health Services, Ministry of Health & Family

Welfare, Government of India. National Health Profile, 2018. Available from: http://www.cbhidghs.nic.in/

WriteReadData/l892s/Before%20Chapter1.pdf.

Statistics Division, Ministry of Health & Family Welfare, Government of India. Rural Health Statistics 2017-

Available from: https://nrhm-mis.nic.in/Pages/RHS2018.aspx?RootFolder=% 2FRURAL%20HEALTH%20

STATISTICS%2F%28A%29%20RHS%20-%202018&FolderCTID=0x01200057278FD1EC909F429B03E86C7A7

C3F31&View=%7B09DDD7F4-80D0-42E3-8969-2307-C0D97DDB%7D.

WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights.

World Health Organization, Geneva. 2019. Available from: https://apps.who.int/iris/bitstream/hand

le/10665/325480/9789241550550-eng.pdf?ua=1.

Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India.

Indian Public Health Standards (IPHS) For Sub-Centres.Guidelines. 2006. Available from: http://www.iapsmgc.

org/userfiles/3IPHS_for_SUB-CENTRES.pdf.

Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India.

Indian Public Health Standards Revised Guidelines 2012. Available from: https://nhm.gov.in/index1.

php?lang=1&level=2&sublinkid=971&lid=154.

International Institute for Population Sciences (IIPS), 2010. District Level Household and Facility Survey

(DLHS-3), 2007-08: India. IIPS, Mumbai. Available from: http://rchiips.org/pdf/INDIA_REPORT_DLHS-3.pdf.

National Health Systems Resource Centre, Ministry of Health & Family Welfare, Government of India.

Ayushman Bharat. Comprehensive Primary Health Care through Health and Wellness Centres. Operational

Guidelines. 2018. Available from: http://nhsrcindia.org/sites/default/files/Operational%20Guidelines%20

For%20Comprehensive%20Primary%20Health%20Care%20through%20Health%20and%20Wellness%20

Centers.pdf.

Press Information Bureau, Ministry of Health and Family Welfare, Government of India. Health and Wellness

Centers under Ayushman Bharat. 2019. Available from: https://pib.gov.in/newsite/PrintRelease.

aspx?relid=188246.

Centre for Budget and Governance Accountability (CBGA) and Child Rights and You (CRY). Budgeting

for School Education: What Has Changed and What Has Not? Analysis of Six States in the 14th Finance

Commission Recommendation Period. 2018. Available from: https://www.indiaspend.com/wp-content/

uploads/2019/01/Budgeting-for-School-Education-What-Has-Changed-and-What-Has-Not.pdf.

International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family

Health Survey (NFHS-3), 2005-06: India: Volume I. IIPS, Mumbai. Available from: https://dhsprogram.

com/pubs/pdf/frind3/frind3-vol1andvol2.pdf.

Dalal K, Dawad S. Non-utilization of public healthcare facilities: examining the reasons through a national

study of women in India. Rural Remote Health 2009; 9(3): 1178. Available from: https://www.rrh.org.au/

journal/article/1178 [PubMed/ Google Scholar].

Press Information Bureau, Ministry of Health and Family Welfare, Government of India. Cabinet approves

Ayushman Bharat – National Health Protection Mission Benefit cover of Rs. 5 lakh per family per year More

than 10 crore families to be covered RSBY and SCHIS to be subsumed under Ayushman Bharat – NHPS.

Available from: https://pib.gov.in/newsite/PrintRelease.aspx?relid=177817.

Frank PG. The preamble of the constitution of the world health organization. Bull World Health Organ

; 80(12): 981-984. [PubMed/ Google Scholar]. 14. National Health Systems Resource Centre, Ministry

of Health and Family Welfare, Government of India. National Health Accounts Estimates for India (2014-

. 2017. Available from: https://mohfw.gov.in/sites/default/files/National%20Health%20Accounts%20

Estimates%20Report%202014-15.pdf.

National Health Systems Resource Centre, Ministry of Health and Family Welfare, Government of India.

Household Health Expenditures in India (2013-14). 2016. Available from: https://mohfw.gov.in/sites/

default/files/38300411751489562625.pdf.

National Health Agency. Beneficiary Identification Guidelines- Ayushman Bharat Pradhan Mantri

Jan Arogya Yojana. 2018. Available from: https://www.pmjay.gov.in/sites/default/files/2018-07/

GuidelinesonProcessofBeneficiaryIdentification_0.pdf.

National Health Agency. Hospital Empanelment Criteria. 2018. Available from: file:///C:/Users/dr%20surabh%20isethi/Documents/Adios%20SJH/Ayushman%20

Bharat%20Debate/references/Eligibility_Criteria.pdf.

National Health Agency. Health benefit packages & Empanelment criteria for AB-NHPM. Available from:

https://pmjay.gov.in/sites/default/files/2018-07/HBP.pdf.

CRISIL opinion. Ayushman Bharat- Improvement in quality of government infrastructure and leveraging

private sector at right price to be crucial tasks for the scheme. 2018. Available from: https://www.crisil.com/

content/dam/crisil/our-analysis/reports/Research/documents/2018/july/CRISIL-Opinion-Ayushman-

Bharat-Programme-12July2018.pdf.

The Times of India. 28 August 2019. How hospitals use bizarre ways to siphon off public funds. Available from: https://timesofindia.indiatimes.com/india/underayushman-bharat-how-hospitals-use-bizarre-waysto-

siphon-off-public-funds/articleshow/70654696.cms. 21. CNBC TV18. 20 June 2019. Doctors loot funds meant

for poor in Ayushman Bharat scheme with fake bills, bogus treatment; probe on. Available from: https://

www.cnbctv18.com/healthcare/doctors-loot-fundsmeant-for-poor-in-ayushman-bharat-scheme-withfake-

bills-bogus-treatment-probe-on-3754021.htm.

The New Indian Express. 26 February 2019. First fraud cases detected in Modi’s national health scheme.

Available from: http://www.newindianexpress.com/nation/2019/feb/26/first-fraud-cases-detected-inmodis-

health-scheme-1943866.html.

National Health Authority. 2019. Public Advisory. Available from: https://www.pmjay.gov.in/sites/

default/files/2019-07/Public%20Advisory%20v12.pdf.

Ministry of Finance, Government of India. Budget outlay on Major Schemes 2019-20. Available from:

https://www.indiabudget.gov.in/budgetglance.php.

Published
2019-12-19