The ‘Ayushmann Bhav’ campaign was launched by the Indian president, Droupadi Murmu, on September 13, 2023. This programme intends to ensure saturation coverage of health schemes and an initiative to ensure optimum delivery. This scheme also aims to achieve 100 per cent health scheme coverage in every village/town.
India is facing a wide range of challenges that require immediate attention. Non-communicable diseases (NCDs) are increasingly becoming a concern in India. It is estimated that the deaths due to NCDs increased from 37.9 per cent in 1990 to 61.8 per cent in 2016, according to a study by the Indian Council of Medical Research (ICMR). According to the World Health Organization (WHO), NCDs contribute to about 605 of the total deaths in India. Tuberculosis (TB), malnutrition, and sickle cell anaemia are some of the other diseases which affect the population majorly.
To achieve universal health coverage (UHC) and the highest possible level of health for all, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), a flagship programme of the Government of India, was started in 2018. This scheme provides financial assistance of up to Rs 5 lakh per annum for secondary and tertiary health care.
Activities under Ayshuman Bhav
Ayushman Bhav is an initiative to complement the existing health-related schemes. It involves activities like ‘Ayushman Apke Dwar 3.0’, ‘Ayushman Sabhas’ and ‘Ayushman Melas-at Health and Wellness Centres, at community health centres (CHCs), and medical camps by medical colleges to ensure that every village and town will attain the status of ‘Ayushman Panchayat’ or ‘Ayushman Urban Ward’.
These activities can be summarised as follows:
- Ayushman-Apke Dwar 3.0 This campaign was first launched on March 01, 2021 across 33 states/UTs and is funded by the National Health Authority (NHA). The ‘Ayushman-Apke Dwar 2.0’ was launched on August 01, 2022. The third phase was launched on September 17, 2023. This campaign was launched to implement AB-PMJAY and to ensure that the Ayushman card is available to all eligible beneficiaries. The initiative aims to reach all eligible people and to reach saturation in the availability of the Ayushman card in all villages and urban areas. More than 10 crore Ayushman cards were created in 2022–23.
People in some areas, mainly in urban areas, were facing difficulties in having access to physical cards due to high rates of migration. Learning from the experiences of Apke Dwar 1.0 and 2.0, the government has enabled self-registration mode along with face recognition, OTP, fingerprint, and IRIS authentication so that the beneficiaries can register and access the card from anywhere through mobile applications instead of paper-based card.
- Ayushman Mela The purpose of this Health Mela is to provide early diagnosis of diseases through screening, comprehensive primary healthcare services, and diagnostics focusing mainly on marginalised sections of society.
These Melas also help in creating awareness and communication about health and healthy lifestyle. It also aims to spread awareness about various schemes available and services provided by the government. Each of these melas is to be held in accordance with the diseases prevalent in that area and the existing facilities. Melas are to be conducted at SHC-HWC (Sub Health Centre–Health and Wellness Centre), PHC-HWC (Primary Health Centre), UPHC-HWC (Urban Primary Health Centre), and UHWCs (Union of Health Work Committees).
The Melas also aim to do risk assessments for diseases like hypertension, diabetes, cancer, cataracts, TB, hepatitis B, etc. Health Melas are popular among the masses, so Health Melas must be conducted so that they encourage people to share their issues as well as learn to live a healthy lifestyle. Melas act as a platform to share issues, concerns, and interactively impart knowledge. They enable people-centric planning and implementation.
- Ayushman Sabha This Sabha is led by the Ward Committee and intends is to distribute Ayushman cards and raise awareness about NCDs, Tuberculosis (TB), and others through health talks. This Sabha also ensures the creation of unique IDs for ABHA (Ayushman Bharat Health Account). Various authorities have to take responsibility to implement and perform their respective roles at state, district, ward, and gram panchayat levels.
- Ayushman Gram Panchayat or Urban Ward This status shall be granted to a village or an urban area if they achieve 100 per cent coverage in the given parameters, such as Ayushman card distribution (above 5 years of age), ABHA ID generation (above 5 years of age), screening for NCDs (above 30 years of age), number of presumptive TB examinations–30 per 1000 population per year, initiation of TB treatment of identified cases and screening of sickle cell disease and card distribution. If any ward or village achieves 100 per cent coverage in the above parameters, the village or ward will be called ‘Ayushman Gram Panchayat’ or ‘Ayushman Urban Ward’.
Challenges
There are ground-level implementation problems in these schemes. Many hospitals under the PM-JAY do not have enough infrastructure to support patients. People who have PM-JAY are deprived of the benefits of RAN (Rashtriya Aarogya Nidhi) which provides a long-term medication provision (on an outpatient basis) which is especially helpful for patients who get treated in the long-term (like cancer patients). PM-JAY covers about 30 per cent of the hospital charges only. So, the rest of the burden falls again on the beneficiaries themselves.
Way Forward
The government should, therefore, introduce new schemes and initiatives considering the already existing problems faced at the ground level and improvising on the loopholes. The activities under the Ayushman Bhav initiative will catalyse the process of providing 100 per cent health scheme coverage to all villages and towns and provide a holistic approach to making the nation healthier.
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