Six Years of Ayushman Bharat: The Road Ahead

?? Shyamal Santra

Six Years of Ayushman Bharat: Transforming Lives, Building a Healthier India

Anjali Jha, 27, watched her two-month-old daughter with a newfound smile. Just a month and a half ago, anxiety clouded her face as her newborn faced serious health complications. The baby couldn't breastfeed, and with no paediatrician nearby, the family in Jharkhand's East Singhbhum district felt helpless. Fortunately, Sunita Jha, the baby's grandmother, heard about e-Sanjeevani, a telemedicine service offered at the Ayushman Arogya Mandir (AAM) in Sundarnagar, about 10 kilometres away. The baby was taken there and with the help of Navita Kumari, the Community Health Officer (CHO), the family connected with a doctor virtually who prescribed treatment. The baby has since recovered, and the family's relief is evident. Sunita expressed her immense gratitude for the telemedicine service. "The baby couldn't feed, but after visiting the wellness centre, all is well. I am thankful for this free online service that brought a smile back to my granddaughter's face," she said.

Anjali Devi's story is just one of many successes under Ayushman Bharat, the flagship scheme of the Government of India, in the tribal-dominated state of Jharkhand.

India @75: The Achievements and Challenges in Public Health:

Significant progress has been made in public health in India over the past few decades. Life expectancy has doubled, from 32 years in 1947 to an average of 67.9 years today. Child and maternal mortality rates have declined dramatically, and killer diseases like polio have been eradicated. Improvements in sanitation and immunization have been globally recognized. However, challenges remain.

India's demographics are changing. The population is aging, digitalization is rising, and climate change presents new challenges. These factors, along with the existing rural-urban divide in healthcare access, quality, and infrastructure, will significantly impact the future of Indian healthcare. As per niti.gov.in, approximately 14.9 crore individuals aged 60 and above constituted around 10.5% of India's population in 2022. This is estimated to increase to 15% (around 22.7 crores) by 2036 and 20.8% (approximately 34.7 crores) by 2050.

Ayushman Bharat: A Journey Towards Universal Health Coverage

Ayushman Bharat, a flagship scheme launched by the Government of India in 2018, has significantly impacted the country's healthcare landscape. This program aims to provide accessible and affordable healthcare services to all citizens, particularly those from vulnerable sections of society. Over the past six years, Ayushman Bharat has made remarkable progress in strengthening the primary healthcare system and paving the way for a healthier India.

One of the program's core focuses is on bolstering primary healthcare infrastructure. Recognizing its importance in improving health outcomes, Ayushman Bharat prioritizes establishing and upgrading existing Health Sub Centres and transforming them into Ayushman Arogya Mandirs (AAMs) across the country. As of April 24, 2024, over 1.72 lakh AAMs are functional, serving as the first point of contact for individuals seeking medical services. These centres provide comprehensive primary care, including preventive and promotive healthcare, encompassing a wider range of services than traditional healthcare facilities.

Ensuring Equitable Access to Health Services

The Ayushman Bharat scheme has made significant strides in ensuring equitable access to healthcare services. The program's insurance scheme, Pradhan Mantri Jan Arogya Yojana (PM-JAY), offers coverage for a vast array of medical facilities, including hospitalization services. This scheme has significantly reduced the financial burden on vulnerable populations, enabling them to access quality healthcare without facing financial constraints. PM-JAY, the world's largest health assurance scheme, provides a health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to over 10.74 crore poor and vulnerable families. That’s not all. The scheme leverages public-private partnerships (PPPs) to improve the quality and affordability of medical facilities. By impanelling over 12,800 private hospitals and 17,200 public health facilities, the program ensures a wider network of healthcare providers. Additionally, it enforces stringent quality standards to ensure patients receive safe and effective care.

Harnessing Technology for Transformation

Recognizing the growing importance of digital health, the scheme has embraced technology to bridge the gap in healthcare delivery. The introduction of e-Sanjeevani telemedicine services at AAMs has brought a ray of hope, particularly in remote areas. This telemedicine facility has demonstrably improved access to healthcare, with studies indicating an average travel distance saved of 21.59 km per patient visit in rural Jharkhand. Furthermore, the 'Ayushman Bharat Digital Health Mission' is transforming the digital infrastructure of India's healthcare system. The ABHA Number, a unique identifier, empowers individuals to manage their health records digitally, while the Health Facility Registry provides a comprehensive repository of health facilities.

The Road Ahead

In its six years of existence, Ayushman Bharat has transformed the fundamentals of India's public health ecosystem. Moving forward, the program should focus on empowering communities and fostering citizen participation, particularly women's collectives and local elected representatives. This will be instrumental in building trust in the public health system and ensuring health equity for all Indians. By collaborating with various stakeholders and addressing the social determinants of health, Ayushman Bharat can play a pivotal role in creating flourishing communities where everyone can live longer, healthier lives.