KURUKSHETRA SUM MARY NOVE M BER-2018 PRESENTED BY DR. SWASTI SINHA unacademy
AYUS H MAN BHARAT: INDIA'S ROAD TO UNIVERSAL HEALTH CARE COVERAGE
ABOUT AYUSHMAN BHARAT: The Ayushman Bharat scheme marks an unprecedented high-level political commitment to universal Health coverage (UHC) It comprises two pillars the first is provision of universal and comprehensive Primary Health Care (CPHC) delivered in formulation of Health and Wellness Centres (HWCs); which are the transformed first two tiers of the public health system i.e. the Sub Health Centres (SHC) and the primary Health centres (PHC) The second component is the Pradhan Mantri Jan Arogya Abhiyaan (PMJAY) for provision of health coverage of up to Rs.5, 00,000/ family for nearly 10.34 crore Households to obtain secondary and tertiary in -patient care The implementation of Ayushman Bharat rests on the health systems strengthening achieved through the National Health Mission (NHM).
HEALTH STATISTICS e As per the latest report of the Registrar General of India, Sample Registration System (RGISRS) MMR of India has shown a decline from 167per 100,000 live births in the period 2011-13 to 130 Per 100,000 live births in the period 2014-16 India has thus, achieved the Millennium Development Goal (MDG) for Maternal Mortality Ratio (MMR) Infant Mortality Rate (IMR) is 34/1000 live births with rate of decline increasing from 2.5% in 2013 -14 to 8.1% in 2015-16 The under- five Mortality Rate (U5MR) in India is 39/1000 live births with rate of decline increasing from 8.2% in 2013-14 to 9.3% in 2015-16 e At the current rate of decline, India will achieve the Sustainable Development Goal (SDG) target of U5MR and MMR by 2023 itself. The country also achieved the MDG 6, which was to reverse the incidence of Malaria, TB and HIV/ AIDS Despite these positive outcomes, some challenges persist. These are the unfinished MDG Agenda, elimination of TB, eradication of Malaria, Kala Azar, relative lack of services for chronic diseases, inequity in access to services and fragmented and poor quality care that have forced care seeking in the private sector leading to high Out of Pocket Expenses (OOPE)
PILLAR I: HWCS The World Bank estimates that just 10% of medical conditions require more complex treatment in hospitals or specialist care. The delivery of CPHC through HWCs therefore becomes a necessity.
. The H&WCs are proposed to provide Comprehensive Primary Health Care (CPHC), covering both Mother and Child Health services, Communicable as well as Non- Communicable Diseases (NCD), including free essential drugs and diagnostic services. In addition, they will also be responsible for providing a range of preventive and life style related services such as vaccination screening for early detection of diseases as well as yoga. However, the transformation of HWC requires action on many fronts and coordination of multiple work streams, as demonstrated in the following diagram:
Continuum of Care Partnership For Knowledge & Implementation Telehealth,/ Ref erral Expanded Service Delivery Expanding HR-MLHP Robust IT CPHC Through HWC System Multitasking Financing/Provi der Payment Reforms Medicines & Expanding Diagnostics- Point of care & new technology Community Mobilisation and Health Promotion. Infrastructure
PILLAR II: PMJAY e Launched in September 2018, it has subsumed the Rashtriya Swasthya Bima yojana (RSBY) and Senior citizen Health insurance Scheme (SCHIS) e Poised to be the largest public funded health insurance scheme in the world, PMJAY will ensure the continuum of care from AB-HWCs and substantial reduction in OOPE on catastrophic healthcare * AB-PMJAY leverages on CPHC through HWCs for preventive, Promotive and curative care and will ensure seamless continuum of care