Universal health coverage for all Indian is a key long term objective of the Government of India. Significant progress has been made under the National Health Mission (NHM), as of September 2017, included decline in maternal mortality rate (MMR), infant mortality rate (IMR), under-five mortality rate (U5MR), and total fertility rate (TFR). IMR declined from 39 in 2014 to 37 in 2015, MMR from 178 during 2010-12 to 167 during 2011-13; U5MR dropped from 59 in 2010 to 43 in 2015. The number of endemic blocks with prevalence of more than one case of Kala Azar per 10,000 population was brought down from 230 in 2010 to 94 in 2016. Malaria API declined from 1.10 in 2011 to 0.84 in 2016. The Millennium Development Goal of halting and reversing the incidence of Malaria, TB, and HIV/AIDS was achieved.

Nevertheless, India’s geographical vastness and huge rural population present a unique set of challenges for healthcare. Health problems have a far greater impact on poor families as they also deplete their financial resources.

On February 1, 2018, the Government of India launched Ayushman Bharat programme, which is a major step towards ensuring healthcare access to 100 million families or around 500 million individuals (around 40% of India’s population).

The first initiative under Ayushman Bharat envisages the setting up of around 1.5 lakh health and wellness centres that will provide comprehensive healthcare, including non-communicable diseases, maternal and child health services as well as provision of free essential drugs and diagnostic services. While the Government has made an allocation of Rs 1,200 crore, it also envisages contribution of private sector via CSR as well as from philanthropic institutions.

The second flagship programme aims to provide health cover of up to Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to 100 million poor and vulnerable families, making it the world’s largest Government funded healthcare programme. The beneficiaries will be decided on the basis of socio-economic caste census, which uses criteria such as family structure, assets, and so on. The scheme has been launched in the spirit of cooperative federalism, as states have the option to choose the modalities for implementation and expansion.

Impact

1. The aim is to make major interventions in primary, secondary and tertiary care that will cover prevention as well as promotion.
2. Health protection to poor and vulnerable families will help enhance their productivity and well-being and also avert wage loss and impoverishment.
3. Ayushman Bharat is expected to generate lakhs of jobs in the healthcare sector. Women in particular will play a major role as physiotherapists, nurses, doctors, mid-level providers, etc.
4. The programme will lead to new capacities and new services. Private hospitals will also be roped in through an empanelment procedure.

Last updated: August, 2018