- GS-2: Issues relating to development and management of Social Sector/Services relating to Health,
- GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
Ayushman Bharat Health Infrastructure Mission
Context: COVID-19 exposed several weaknesses in India’s underfunded health system.
What are the major issues with India’ s Health System?
- Rural primary care is underfunded and has shortages of staff, equipment, drugs and infrastructure in many parts of the country.
- Urban primary healthcare has still not emerged as an active programme in many States.
- District and medical college hospitals suffer shortages of specialist doctors and support staff.
- The private sector ranges from advanced tertiary care hospitals in big cities to informal and often unqualified care providers in villages.
- During the pandemic, Private sector could not effectively provide affordable care or deliver vaccines in large parts of India.
- There is a disconnect between the various levels of care within the public system, and the private system operated in a separate universe.
- Most government-funded healthcare insurance programmes did not cover outpatient care.
Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (ABHIM)
- It will support infrastructure development of 17,788 rural health and wellness centres (HWCs) in seven high-focus States and three north-eastern States.
- In addition, 11,044 urban HWCs will be established in close collaboration with Urban Local Bodies.
- To provide a continuum of care at different levels, HWCs will be linked with the Pradhan Mantri Jan Arogya Yojana, for all entitled beneficiaries. The hub-and-spoke model of block, district, regional and national public health laboratories will enable effective microbial surveillance.
- Simultaneously, the network of centres will build a trained public health workforce that can perform routine public health functions while responding to a public health emergency.
- Support for 3,382 block public health units (BPHUs) in 11 high-focus States
- It will provide for establishment of integrated district public health laboratories in all 730 districts that will strengthen capacity for information technology-enabled disease surveillance.
- To enhance the capabilities for microbial surveillance, a National Platform for One Health will be established.
- Four Regional National Institutes of Virology will be established. Laboratory capacity under the National Centre for Disease Control, ICMR and national research institutions will be strengthened.
- Critical care hospital blocks, with 50-100 beds, will be established in 602 districts, to enable care for those with serious infectious diseases without disrupting other services.
- For enhancing the level of disaster response readiness, 15 health emergency operation centres and two container-based mobile hospitals will be created.
- Private sector participation in service delivery may be invited by States, as per need and availability.
- The government will spend Rs 64,180 crore on the scheme from the financial year 2021-22 to 2025-26.
- It can enable data-driven decentralised decision-making and people-partnered primary care at the block level while strengthening national connectivity for delivering universal healthcare.
Therefore, the scheme aims at establishing
- comprehensive surveillance of infectious diseases.
- comprehensive diagnostics and treatment facilities.
- comprehensive pandemic research
- There is a need to train and deploy a larger and better skilled health workforce. Upgraded district hospitals offer the best opportunity for creating new training centres.
- Public health expertise will be needed for programme design, delivery, implementation and monitoring in many sectors that impact health.
- Many independently functioning programmes will have to work with a common purpose and this requires a need for a change of bureaucratic mindsets and a cultural shift in Centre-State relations.
Connecting the dots: