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‘Ayushman Bharat’ Program and Universal Health Coverage in India

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Abstract

India’s National Health Policy 2017 (NHP-2017) has its goal fully aligned with the concept of Universal health coverage. The Ayushman Bharat Program announced in the Union budget 2018–19 of the Government of India, aims to carry NHP-2017 proposals forward. The Ayushman Bharat Program has two initiatives/components – Health and Wellness Centers, and National Health Protection Scheme – aiming for increased accessibility, availability and affordability of primary-, secondary- and tertiary-care health services in India. Afterwards, the second component has been renamed as Pradhan Mantri Rashtriya Swasthya Suraksha Mission. The new program has received an unprecedented public, political and media attention; and is being attributed to have placed health higher on political agenda. This review article analyzes and provides critical reflections, suggestions and way forward for rapid and effective implementation of Ayushman Bharat Program. To be effective and impactful in achieving the desired health outcomes, there is a need for getting both design and implementation of Ayushman Bharat Program right, from the very beginning. If implemented fully and supplemented with additional interventions, the program can prove a potential platform to reform Indian healthcare system and to accelerate India’s journey towards universal health coverage.

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References

  1. Government of India. National Health Policy 2017. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, 2017. p. 1–32.

  2. World Health Organization. World Health Report 2010: Health Financing for Universal Coverage. Geneva: WHO, 2010.

  3. [No author listed]. Health in India, 2017. Lancet. 2017;389:127.

  4. Shiva Kumar AK, Chen LC, Choudhury M, Ganju S, Mahajan V, Sinha A, et al. Financing health care for all: challenges and opportunities. Lancet. 2011; 377:668–79.

    Article  Google Scholar 

  5. Government of India. Report of the Task force on Primary Health Care in India. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, 2017. p. 1–60.

  6. Gupta I. Out of Pocket Expenditure and Poverty: Estimates from 61 Rounds of NSS. Expert Group on Poverty. Planning Commission, New Delhi; 2009. Available from: https://doi.org/planningcommission.gov.in/reports/genrep/indrani.pdf . Accessed February 15, 2018.

    Google Scholar 

  7. World Health Organization and International Bank for Reconstruction and Development / The World Bank. Tracking Universal Health Coverage: 2017 Global Monitoring Report. Available from: https://doi.org/www.who.int/healthinfo/universal_health_coverage/report/2017_global_monitoring_report.pdf . Accessed February 15, 2018.

  8. Government of India. Rural Health Statistics 2017. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, 2017.

  9. Government of India. Rural Health Statistics 2016. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, 2016.

  10. Central Bureau of Health Intelligence. National Health Profile 2017. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, 2017. p. 1–270.

  11. National Health Systems Resource Centre. National Health Accounts 2014–15. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, 2017. p 1–74.

  12. World Health Organization. World Health Statistics 2017: Geneva: WHO. 2017. Available from: https://doi.org/www.who.int/gho/publications/world_health_statistics/2017/en/ . Accessed Febuary 04, 2018.

  13. National Sample Survey Organization. Report of 71st round of National Sample Survey 2014. Ministry of Planning, statistic and implementation, New Delhi, 2017. Available from: https://doi.org/mospiold.nic.in/national_data_bank/ndb-rpts-71.htm . Accessed February 10, 2018.

  14. Planning Commission, Government of India. Twelfth Five Year Plan of India: Health Chapter. New Delhi, 2017. p. 1–60.

  15. Das J, Holla A, Das V, Mohanan M, Tabak D, Chan B. In urban and rural India, a standardized patient study showed low levels of provider training and huge quality gaps. Health Aff (Millwood). 2012;31:2774–84.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Government of India. The Clinical Establishment (registration and regulation) Act, 2010. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi. 2010.

  17. Indian Council of Medical Research and Public Health Foundation of India. State of Health in India, Nov 2017. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, 2017, p:1–32.

  18. 2015 Healthcare Access and Quality Collaborators. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: A novel analysis from the Global Burden of Disease Study 2015. Lancet. 2017;390:231–66.

  19. Government of India. Millennium development Goals, India Country Report 2015. Minsitry of Statistics, Planning and Implementation. Govt of India, New Delhi. 2016. Available from: https://doi.org/mospi.nic.in/sites/default/files/publication_reports/mdg_2july15_1.pdf . Accessed March 03, 2018.

  20. Deshmukh V, Lahariya C, Krishnamurthy S, Das MK, Pandey RM, Arora NK. Taken to health care provider or not, under-five children die of preventable causes: findings from cross-sectional survey and social autopsy in rural India. Indian J Community Med. 2016;41:108–19.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lahariya C, Dhawan J, Pandey RM, Chaturvedi S, Deshmukh V, Dasgupta R, et al.; for INCLEN Program Evaluation Network. Inter district variations in child health status and health services delivery: lessons for health sector priority setting and planning from a cross-sectional survey in rural India. Natl Med J India. 2012;25:137–41.

    PubMed  CAS  Google Scholar 

  22. Government of India. India Budget 2018–19 and Budget Speech. Ministry of Finance, New Delhi. Available from: https://doi.org/www.indiabudget.gov.in/ . Accessed Febuary 12, 2018. 23.

  23. Government of India. Union Budget website for previous years. Ministry of Finance, New Delhi. Available from: https://doi.org/www.indiabudget.gov.in/ . Accessed February 12, 2018.

  24. Lahariya C. Budget India 2008: What is new for health sector. Indian Pediatr. 2008; 45:399–400.

    PubMed  Google Scholar 

  25. BBC News. India unveils ‘world’s largest’ public healthcare scheme. 1 February 2018. Available from: https://doi.org/www.bbc.com/news/world-asia-india-42899402 . Accessed February 15, 2018.

  26. Government of India. National Consultation on Ayushman Bharat: Operationalizing Health and Wellness Centres to deliver Comprehensive Primary Health Care. 1–2 May 2018; New Delhi.

  27. Press Information Bureau. Cabinet approves Ayushman Bharat–National Health Protection Mission. 21 March 2018; New Delhi. Available from: https://doi.org/pib.nic.in/newsite/PrintRelease.aspx?relid=177816 . Accessed February 15, 2018

  28. Government of India. Rashtiya Swasthya Bima Yojana. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi. 2014.

  29. Highlights of union budget 2016–17. The Hindu, New Delhi; 29 March 2016.

  30. NITI Aayog comes to the Rescue as Health Ministry Clueless on ‘World’s Largest Healthcare Programme. The Wire, 2018, Feb 03. New Delhi. Available from: https://doi.org/thewire.in/220634/health-budget-2018-niti-aayog/ . Accessed February 15, 2018.

  31. Through the looking glasses: The Readers’ Editor writes: Scroll.in should take the lead in advocating primary healthcare overhaul. Scroll; New Delhi;2018, Feb 26. Available from: https://doi.org/scroll.in/article/869658/thereaders-editor-writes-scroll-in-should-take-lead-inadvocating-a-primary-healthcare-overhaul . Accessed February 27, 2018.

  32. Government of India. Socioeconomic and Caste Census (SECC). Registrar General of Census Operations, New Delhi. 2012.

  33. World Bank. Investing in Health: World Development Report 1993. New York: Oxford University Press,1993.

  34. Save the children. Primary Healthcare first. London: Save The children Fund 2017; p. 1–4. Available from: https://doi.org/www.savethechildren.org.uk/what-we-do/policy-andpractice/our-featured-reports/primary-health-care-first Accessed February 12, 2018.

  35. Press Information Bureau. Evaluation of Accredited Social Health Activist (ASHA). Government of India, 2015. Available from: https://doi.org/pib.nic.in/newsite/PrintRelease.aspx?relid=116029 . Accessed February 12, 2018.

  36. Government of India. National Health Mission. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi. 2005.

  37. Karan A, Yip W, Mahal A. Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on out of pocket spending for healthcare. Soc Sci Med. 2017;181:83–92.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ghosh S, Gupta ND. Targeting and Effects of Rashtriya Swasthya Bima Yojana on Access to Care and Financial Protection. Econ Pol Weekly. 2017;52:32–40.

    Google Scholar 

  39. Sood N, Bendavid E, Mukherji A, Wagner Z, Nagpal S, Mullen P. Government health insurance for people below poverty line in India: Quasi-experimental evaluation of insurance and health outcomes. BMJ. 2014;349:g5114.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Is National Health Protection scheme good public policy? Mint (newspaper); New Delhi; March 12, 2018; p.12.

  41. Morton M, Nagpal S, Sadanandan R, Bauhoff S. India’s largest hospital insurance program faces challenges in using claims data to measure quality. Health Aff (Millwood). 2016;35:1792–9.

    Article  PubMed  Google Scholar 

  42. Salve P, Yadavar S. Why India’s National Health Insurance Scheme Has Failed Its Poor. India Spend, Mumbai; 17 October 2017. Available from: https://doi.org/www.indiaspend.com/cover-story/why-indias-nationalhealth-insurance-scheme-has-failed-its-poor-49124 . Accessed February 15, 2018.

  43. International Institute of Population Sciences. National Family Health Survey - 4. National report. IIPS, Mumbai and ORC Macro, 2017.

  44. National Health Protection Scheme will not help its intended beneficiaries. Mint; 2018, Feb 15; New Delhi. Available from: https://doi.org/www.livemint.com/Opinion/k80NvWWKvFGwHptVIDIqNJ/National-Health-Protection-Scheme-will-not-help-its-intended.html . Accessed February 15, 2018.

  45. Karnataka to roll out Aadhaar-linked universal health coverage on November 1. The New Indian Express; Bengaluru; 28 August 2017.

  46. Press Information Bureau. Cabinet approves rationalization of Autonomous Bodies under Department of Health & Family Welfare. Government of India; New Delhi; 7 February 2018. Available from: https://doi.org/pib.nic.in/PressReleaseIframePage.aspx?PRID=1519860 . Accessed February 12, 2018.

  47. Kurian OC. Financing public healthcare in India: towards a common goal. Oxfam India: New Delhi, 2015. P. 1–18.

    Google Scholar 

  48. Reddy KS, Patel V, Jha P, Paul VK, Kumar AK, Dandona L; Lancet India Group for Universal Healthcare. Towards achievement of universal health care in India by 2020: A call to action. Lancet. 2011;377:760–8.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Kaur H. Why Modi Must Seek Legal Backing for His Ambitious Healthcare Project. Swarajya magazine; 27 April 2018. Available from: Available from: https://doi.org/swarajyamag.com/ideas/what-are-the-arguments-forhaving-a-modicare-law . Accessed February 12, 2018.

  50. Government of India. Employee State Health Insurances Act, 1948.

  51. Government of India. Central Government health Insurance scheme, 1954

  52. Webster C. The National Health Services: a political history. Second edition. Oxford University Press. Oxford; 2002.

    Google Scholar 

  53. Hughes D, Leethongdee S. Universal coverage in the land of smiles: Lessons from Thailand’s 30 Baht health reforms. Health Aff (Millwood). 2007;26:999–1008.

    Article  PubMed  Google Scholar 

  54. Rasanathan K, Posayanonda T, Birmingham M, Tangcharoensathien V. Innovation and participation for healthy public policy: the first National Health Assembly in Thailand. Health Expectations. 2012;15:87–96.

    Article  PubMed  Google Scholar 

  55. Kickbusch I, Franz C, Holzscheiter A, Hunger I, Jahn A, Köhler C, et al. Germany’s expanding role in global health. Lancet. 2017;390:898–912.

    Article  PubMed  Google Scholar 

  56. Press Information Bureau. Universal Health Insurance Scheme (2003). PIB, Government of India. New Delhi. 2011. Available from: https://doi.org/pib.nic.in/newsite/PrintRelease.aspx?relid=78863 . Accessed February 12, 2018.

  57. National Institute of Public Finance and Policy. Report on Utilisation, Fund Flows and Public Financial Management under the National Health Mission: A Study of Selected States, NIPFP; 2017.

  58. Kapur A. Baisnab P. Budget brief: National health Mission; Government of India, 2018–19. Accountability Initiative; Center for Policy research, New Delhi. p. 1–8. Available from: https://doi.org/accountabilityindia.in/budget/briefs/download/1814 .

  59. Lahariya C, Bhagwat S, Saksena P, Samuel R. Strengthening urban health for advancing universal health coverage in India. J Health Management. 2016;18:361–6.

    Article  Google Scholar 

  60. Press Information Bureau. A new health protection scheme to provide health cover up to Rs.1 lakh per family announced. PIB, Government of India. New Delhi. Press release on 29 Feb 2016. Available from: https://doi.org/pib.nic.in/newsite/PrintRelease.aspx?relid=136989 . Accessed February 15, 2018.

  61. Press Information Bureau. Cabinet approves pan-india implementation of maternity benefit program. PIB, New Delhi, 17 March 2017. Available from: https://doi.org/pib.nic.in/newsite/PrintRelease.aspx?relid=161857 . Accessed February 15, 2018.

  62. Press Trust of India. Maternity benefit scheme unlikely to get boost in Budget 2018. Times of India; New Delhi; 30 Jan 2018. Available from: https://doi.org/timesofindia.indiatimes.com/business/india-business/maternitybenefit-scheme-unlikely-to-get-boost-in-budget-2018/articleshow/62712742.cms Accessed February 15, 2018.

  63. Lahariya C. Strengthening primary healthcare: From promises to reality. Ideas for India; 27 March 2018. Available from: https://doi.org/www.ideasforindia.in/topics/human-development/strengthening-primary-healthcarefrom-promises-to-reality.html . Accessed February 12, 2018.

  64. World Health Organization. World Health Day 2018: Universal health coverage: everyone, everywhere. Geneva: WHO; 2018. Available from: https://doi.org/www.who.int/campaigns/world-health-day/en/ . Accessed February 18, 2018.

  65. Government of India. National Urban Health Mission (NUHM): Framework for Implementation. Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi. 2013.

  66. Lahariya C. Mohalla Clinics of Delhi, India: Could these become platform to strengthen primary healthcare? J Family Med Prim Care. 2017;6:1–10.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Lahariya C. Decongest hospitals with Mohalla clinics. Deccan Herald; Bengaluru; 27 May 2017; Available from: https://doi.org/www.deccanherald.com/content/613762/decongest-hospitals-mohalla-clinics.html . Accessed February 12, 2018.

  68. Press Information Bureau. Transforming 115 backward districts across the country. Government of India. 23 Nov 2017; New Delhi. Available from: https://doi.org/pib.nic.in/newsite/PrintRelease.aspx?relid=173788 . Accessed February 12, 2018.

  69. Press Information Bureau. Gram Swaraj Abhiyan on Ambedkar Jayanti. Government of India. 6 April 2018; New Delhi. Available from: https://doi.org/pib.nic.in/newsite/PrintRelease.aspx?relid=178495 . Accessed February 12, 2018.

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Authors and Affiliations

  1. National Professional Officer – Universal Health Coverage, World Health Organization, New Delhi, India

    Chandrakant Lahariya

  2. B-7/24/2, First Floor, Safdarjung Enclave Main, New Delhi, 110 029, India

    Chandrakant Lahariya

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Lahariya, C. ‘Ayushman Bharat’ Program and Universal Health Coverage in India. Indian Pediatr 55, 495–506 (2018). https://doi.org/10.1007/s13312-018-1341-1

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