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Achieving a model health ecosystem

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Dr Mansukh Mandaviya
The National Health Policy (NHP) 2017 was formulated to reflect on and respond to shifting health priorities of the nation. While the earlier policies of 1983 and 2002 served well in guiding the approach for health sector in planning, NHP 2017 was designed with an aim to inform, clarify, strengthen and prioritise government’s role in overall shaping of the health systems, spanning investments, organisation of services and service delivery, cross sectoral actions, technology, human resources, and more.
Implementing the concept of “Healthy India”, Government of India under the dynamic and visionary leadership of the Prime Minister Narendra Modi has developed a defined mandate to design Indian healthcare system to maintain continuum of care across levels of care. Enunciating the vision of honourable Prime Minister, over the last eight years, there has been a continuous emphasis by the government to improve the public health facilities in the country, making them more accessible to all citizens.
India has witnessed a transition in public health governance, from being disease-centric to an integrated health and wellness approach. Over last eight years, important initiativeslike Free Drugs and Diagnostics Services, four pillars of Ayushman Bharat (AB) – Health and Wellness Centres (AB-HWC), Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), Digital Mission (ABDM), Health Infrastructure Mission (AB-HIM), Fifteenth Finance Commission (FC-XV) tied health grants to local bodies, etc., have provided us with experiences and learning to further strengthen public health governance with citizen centric approach to reduceOut of Pocket Expenditure (OOPE), provide world class quality of care at public health facilities and ensure adequate health care workforce.
Continuing the efforts in this direction through NHM – a flagship sector reform initiative of Government of India, the government in last eight years has not only provided support to strengthen state and UTs’ capacity to provide health care services to all but has also enabled the design and implementation of reforms related to governance, financing, procurement and information technology.
Following one of the NHP recommendations of strengthening the delivery of Primary Health Care, GoI took first step in the conversion of policy articulations to a budgetary commitment and in 2018 announced creation of 1.5 lakh AB-HWCs by Dec 2022. These AB-HWCswould act as a platform to deliver comprehensive primary health care closer to community and would be an affordable and effective path of India towards attainment of Universal Health Coverage.
AB-PMJAY provides health protection cover to poor and vulnerable families. The scheme compliments primary health care to ensure increased access to quality health and medication, timely treatments, improvements in health outcomes, patient satisfaction, improvement in productivity and efficiency and job creation thus leading to improvement in the quality of life for all.
Through 100% population enumeration at the empanelled HWCs and providing financial protection to vulnerable population subgroups, Ayushman Bharat programme aims to leave no one behind when it comes to quality healthcare. Improved access to healthcare services closer to communities with assured availability of drugs and diagnostic services would reduce out of pocket expenditure and catastrophic health expenditure.
The scheme has crossed the three-crore mark for hospital admissions and claim amount of Rs. 36,500 crores have been disbursed with more than 18 crore cards generated, since its implementation in 2018.
India has been moving towards a digital health ecosystem, and with an objective to bridge the existing gap amongst different stakeholders of health care ecosystem through digital interventions, Ayushman Bharat Digital Mission (ABDM) was launched in 2020.
With ongoing pandemic presenting the country with a set of complex challenges, the unfolding public health emergency reiterated the need of a concerted and “Whole of Government” and “Whole of Society” approach to build up a comprehensive, robust and prompt response system. With this concern, the GoI launched country’s largest pan India infrastructure scheme PM-ABHIMin 2021, which focuses to expedite capacities of health institutions across all levels of care, and to provide health infrastructure, surveillance and research.
The scheme will strengthen the districts, and enhance self-reliance through creation of infrastructure to ensure that districts have basic minimum capacities for surveillance and outbreak management, and are able to provide primary as well as critical care with equitable access to citizens, especially to women, children and those belonging to weaker sections.
With Prime Minister’s emphasis on adapting a holistic approach in health, Indian health systems are now providing an integrated platform to achieve convergence amongst four pillars of Ayushman Bharat i.e., AB-HWC, AB PM-JAY, AB-DM and PM-ABHIM aligned with NHM.
During Independence Day, honourable PM initiated a new approach with his slogan and said “To achieve our goals, we need ‘Sabka Saath, SabkaVikas, SabkaVishwas’, and also SabkaPrayas (everyone’s effort). This is important to accomplish it”. Reiterating PM’s vision, Ayushman Bharat complements country’s journey towards achieving goals and targets of the National Health Policy 2017 and the Sustainable Development Goals (SDGs).
Continuing efforts to invest and build a roadmap taking India back to high growth trajectory, this government has laid a foundation to now steer the economy over “AMRUT KAAL” of the next 25 years while the nation celebrates AZADI KA AMRUT MAHOTSAV. Setting out the vision for India @ 100, Honourable PM recited a poem “Yahisamayhai, sahisamayhai Bharat ka Anmol samayhai”, which is built upon his vision and reflects on his statementthat nation cannot wait so long to attain health goals and should continuously make efforts to build on the vision while deliberating to expedite developing capacities of health systems and institutions across levels of care.
While India is already on its path towards establishing the health care ecosystem as a global attraction, GoI under the leadership of Hon’ble PM has launched “Heal in India” and “Heal by India” initiatives which would make India a Global Medical Value hub, and contribute towards a healthy global society.
(The author is a Union Minister of Health and Family Welfare)

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