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
Way Ahead
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.
