The Government of India is cognizant that primary Health Care is currently focusing largely on Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) and communicable diseases. This poses a challenge given the epidemiological transition, where non-communicable diseases accounts for nearly 62% of deaths among men and 52% among women – most of which are premature in nature. The situation is exacerbated by the fact that there is low utilization of public health system, especially at the level of Community Health Centre (except for child birth related services). There is lack of effective gate-keeping and referral, leading to fragmentation of health care services. Families are forced to incur high out of pocket expenditure thereby leading to impoverishment and poverty on account of medical and hospitalization expenses.
Health is an important cornerstone to the Government’s vision of development, ‘Swasth Bharat, Samriddha Bharat (Healthy India, Prosperous India). To fulfil the vision of Health for All and Universal Health Coverage, enshrined in the National Health Policy 2017, the Government conceived Áyushman Bharat’ (Healthy India), a pioneering initiative led by Hon’ble Prime Minister.
Ayushman Bharat (AB) is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. Ayushman Bharat aims to undertake path breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level. Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components.
The first component, pertains to creation of 1,50,000 Health and Wellness Centres which will bring health care closer to the homes of the people. These centres will provide Comprehensive Primary Health Care (CPHC), covering both maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services. The first Health and Wellness Centre was launched by the Hon’ble Prime Minister at Jangla, Bijapur, Chhatisgarh on 14 April 2018. The second component is the Pradhan Mantri Jan Arogya Yojana (PM-JAY) which provides health protection cover to poor and vulnerable families. The Health and Wellness Centres will play a critical role in creating awareness about PM-JAY, screening for non-communicable diseases, follow-up of hospitalisation cases among others.
These two far-reaching initiatives under Ayushman Bharat will build a New India 2022. This path-breaking initiative, which will be implemented at an unprecedented scale will bring a paradigm shift in India’s health sector. It will help India capitalize its demographic dividend, ensure enhanced productivity, well-being and avert wage loss and impoverishment.
The Government of India is committed to ensuring highest possible level of health and well-being for all, through a preventive and promotive health care orientation in developmental policies and universal access to good quality health care services without anyone having to face financial hardship.
To fulfil this vision, the Government of India conceptualized ‘Ayushman Bharat’ (Healthy India), a flagship initiative that attempts to move away from sectoral and segmented approach of service delivery to a comprehensive need-based health care service. Ayushman Bharat adopts a two-pronged approach. Firstly, the creation of health and wellness centres to bring health care closer to homes. Secondly, the formulation of a Pradhan Mantri Jan Arogya Yojana (PM-JAY) to protect poor and vulnerable families against financial risk arising out of catastrophic health episodes. The PM-JAY is one significant step towards achievement of Universal Health Coverage (UHC) and Sustainable Development Goal - 3 (SDG3).
National Health Agency (NHA), an autonomous entity, was constituted for focused approach and effective implementation of PM-JAY. Established as a Society on 11th May 2018, the National Health Agency was registered under the Society Registration Act, 1860. The State Governments are expected to similarly set up State Health Agencies (SHA) to implement PM-JAY. Consequent to the approval of the Cabinet on 7th January 2019, the status of NHA stands upgraded to National Health Authority as an attached office of the Ministry of Health and Family Welfare with full functional autonomy.
The National Health Authority (NHA) will provide overall vision and stewardship for design, roll-out, implementation and management of Pradhan Mantri Jan Arogya Yojana (PM-JAY) in alliance with state governments. Inter-alia, this will include, formulation of PM-JAY policies, development of operational guidelines, implementation mechanisms, co-ordination with state governments, monitoring and oversight of PM-JAY amongst other.
The National Health Authority will play a critical role in fostering linkages as well as convergence of PM-JAY with health and related programs of the Central and State Governments, including but not limited to Ayushman Bharat - Comprehensive Primary Health Care, the National Health Mission, RSBY to name a few.
The NHA will lead the development of strategic partnerships and collaborations with Central and State Governments, civil society, financial and insurance agencies, academia, think tanks, national and international organizations and other stakeholders to further the objectives of PM-JAY.
The National Health Authority will provide technical advice and operational inputs, as relevant, to states, districts and sub-districts for PM-JAY including formulating standards/ SOPs/guidelines/manuals to guide implementation, identification of capacity gaps and related trainings, development of health information and IT systems, facilitating cross-learnings, documentation of best practices, research and evaluation and undertake associated administrative and regulatory functions as a Society.