AIR Discussions (October 4th Week)
26th October, 2021
AIR SPOTLIGHT: AYUSHMAN BHARAT HEALTH INFRASTRUCTURE MISSION
Context: Recently, the Prime Minister launched the Ayushman Bharat Health Infrastructure Mission.
About:
- Earlier known as Prime Minister Atmanirbhar Swasth Bharat Yojana (PMASBY), PMABHIM was announced as a long term health infrastructure development scheme in the Union Budget 2021-22 with an outlay of ₹4,810 crore over five years.
- The total outlay for the current year 2021-22 is ₹9155.97 crore while it is ₹10,465.09 crore for the next year. The scheme received Union Cabinet's approval in September 2021.
- The PMABHIM consists of mostly centrally sponsored schemes (CSS) and some central schemes.
- The key elements of the CSS components are:
- Ayushman Bharat - Health and Wellness Centres (AB-HWCs) in rural areas: Support for infrastructure development for 17788 Sub-Health Centres is proposed in seven High Focus States (Bihar, Jharkhand, Odisha, Punjab, Rajasthan, Uttar Pradesh and West Bengal) and three North Eastern States (Assam, Manipur and Meghalaya)
- Ayushman Bharat - Health and Wellness Centres (AB-HWCs) in Urban areas: Support for 11044 Urban Health & Wellness Centres across the country is proposed under this component.
- Block Public Health Units (BPHUs): Support for 3382 BPHUs in 11 High Focus States/ UTs (Assam, Bihar, Chhattisgarh, Himachal Pradesh, UT - Jammu and Kashmir, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand), is proposed under this component.
- Integrated District Public Health Laboratories in all districts.
- Critical Care Hospital Blocks in all districts with a population more than five lakhs, in state government medical colleges / District Hospitals.
Objectives:
- To ensure a robust public health infrastructure in both urban and rural areas, capable of responding to public health emergencies or disease outbreaks.
- To establish an IT-enabled disease surveillance system through a network of surveillance laboratories at block, district, regional and national levels.
- All the public health labs will be connected through the Integrated Health Information Portal, which will be expanded to all states and UTs.
- The mission rightfully addresses the health care sector with the aim of strengthening the critical healthcare infrastructure at various levels form the grassroots (village/block) to the national level over the next 5 years.
Pillars:
- Provide Effective Treatment:
- To enable effective and timely treatment, the government will support rural and urban health and wellness centres.
- Besides early detection of diseases these centres would also provide free medical consultation, free medicine and free tests. To provide care for the seriously ill, the mission will create 35,000 new critical care beds in 600 districts across the nation.
- Elaborate Testing Network:
- The mission will provide high class testing network so as to undertake effective diagnosis and monitoring of diseases.
- For the same, Integrated Public Health labs will be established in 730 districts of the country as also, Block Public Health Units would be set up in 3,000 blocks.
- Apart from this, 5 Regional Centres for Disease Control, 20 Metropolitan units and 15 Biosafety Level labs will also be established to add strength to the testing network.
- World Class Pandemic Research Institutes:
- Against the backdrop of the COVID-19 pandemic, this aspect bears special significance.
- As a part of this, existing 80 viral diagnostic and research labs will be strengthened while 15 new biosafety labs will be created.
- In addition, 4 National Institutes of Virology and one National Institute for One Health would also be established.
- In addition, the mission looks to boost the availability of health professionals, correct the existing regional imbalance in the distribution of medical colleges and make better use of district hospital infrastructure.
- For the same, around 157 new medical colleges have been sanctioned across the country spanning three phases of the project, with 63 of them being presently operational.
Challenges faced by Indian Healthcare system:
- In the Global Health Security Index, which measures pandemic preparedness for countries based on their ability to handle the crisis, India ranked 57.
- Lack of proper Infrastructure:
- dearth of well-equipped medical institutes, rate of construction of such medical teaching or training institutions remains low in comparison to the urgent requirement.
- India has 8.5 hospital beds per 10,000 citizens, one doctor for every 1,456 citizens (WHO’s prescribed norm is 1:1000) and 1.7 nurses per 1,000 people (WHO’s prescribed norm is 3:1000).
- Lack of adequate number of ventilators in hospitals needed for patients with severe COVID-19 infection.
- Availability of limited accredited diagnostic labs delays testing and consequent understanding of disease progression.
- Shortage of trained manpower: In India, the ratio of doctor to patient remains abysmally low (0.7) when compared to the guidelines set by the WHO, which sets 2.5 doctors per 1000 people. In India this ratio is a mere 0.7 doctors per 1,000 people.
- Increased patient load due to COVID-19: The task of managing the spread of a disease as contagious as the COVID-19 was a mammoth task in itself, let alone doing the same for a population as large as India’s which stands at 1.2 billion
- Skewed ratio of Health Care Infrastructure:
- Out of the 1.14 million registered modern medicine (allopathic) doctors in India, over 80 per cent operate in cities, which account for only 31 per cent of the country's population.
- Similarly, when it comes to physical infrastructure, such as Community Health Centres (CHCs), Primary Health Centres (PHCs), District Health Centres and hospitals there is a skewed geographical placement of resources in favour of the urban population.
- Accessing quality health care hence becomes difficult for the rural populace not only due to lack of requisite medical infrastructure, but also on account of high consultation fees and long travel distances.
- Denial of healthcare: Private hospitals are reportedly denying treatments to the poor along with the cases of overcharging patients. This has been seen in Bihar, which has witnessed an almost complete withdrawal of the private health sector which has nearly twice the bed capacity of public sector.
- Lack of focus on preventive healthcare: Of all healthcare spending, only 7% was spent on preventive healthcare, while more than 80% was spent on treatment and cure as of FY17
Way Forward:
- There is an immediate need to increase the public health spending to 2.5% of GDP, despite that being lower than global average of 5.4%.
- The process to bridge doctor to patient gap would require a sustained effort through capacity building of current medical institutes in addition to building new ones.
- Due to COVID-19, streamlining of operational and clinical processes became the foremost priority to efficiently manage patient inflow. In this scenario the focus on building efficient and quality health care centres becomes even more crucial.
- Accessing quality health care needs to be eased for the rural populace with requisite medical infrastructure, lower consultation fees, reduced travel distances.
- The achievement of a distress-free and comprehensive wellness system for all hinges on the performance of health and wellness centres as they will be instrumental in reducing the greater burden of out-of-pocket expenditure on health.
- A National Health Regulatory and Development Framework needs to be made for improving the quality, performance, equity, efficacy and accountability of healthcare delivery across the country.
- Increase the Public-Private Partnerships to increase the last-mile reach of healthcare.
- National Innovation Council should encourage a culture of innovation in India and help develop policy on innovations that will focus on an Indian model for inclusive growth.
- India should take cue from other developing countries like Thailand to work towards providing Universal Health Coverage.
- Leveraging the benefits of Information Technology to improve quality of healthcare service delivery.
https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1766604
NEWS IN BRIEF: PRELIMS SPECIAL
Climate Finance Delivery Plan
- UK which holds the Presidency of the COP26 summit published a Climate Finance Delivery Plan to provide clarity on when and how developed countries will meet the 100 billion Dollar climate finance goal.
- The new outlook states that the goal will be met from 2023.
- This is three years later than what was committed to by the Developed Countries at the Paris Summit in 2015.
- Developed countries committed to a goal of mobilising jointly 100 billion Dollars a year by 2020 to address the needs of developing countries, in the context of meaningful mitigation actions and transparency on implementation.
- The Climate Finance Delivery Plan calls upon those developed countries who have not yet made a pledge should come forward with an ambitious climate finance commitment as soon as possible.
G-20 Leaders Summit-2021
- Summit-2021 will begin in Rome (Italy).
- The G-20 is the international forum that brings together the world’s major economies, extending participation to guest countries and international organizations.
- Its leadership rotates on an annual basis among its members.
- Italy assumed the 2021 Presidency on the 1st December 2020.
- The forum has met every year since 1999 and includes, since 2010, a yearly Summit, with the participation of the respective Heads of State and Government.
- It will focus on three broad, interconnected pillars of action: People, Planet and Prosperity.
- The G-20 is made up of 19 countries and the European Union.
- The 19 countries are Argentina, Australia, Brazil, Canada, China, Germany, France, India, Indonesia, Italy, Japan, Mexico, the Russian Federation, Saudi Arabia, South Africa, South Korea, Turkey, the UK, and the US.
Mahatma Gandhi National Fellowship
- Ministry for Skill Development and Entrepreneurship launched phase-II of MGNF.
- It aims to create opportunities for young and dynamic individuals to contribute to enhancing skill development at the grassroots.
- The two-year fellowship seeks to combine classroom sessions by academic partner Indian Institute of Management to create credible plans and identify barriers in raising employment, economic output and promoting livelihoods in rural areas.
- The two-year blended program combines classroom sessions at host IIMs with mentorship of Fellows while in district.
- It provides an opportunity to engage with schemes and institutions at the district level to strengthen institutions and improve skill development, link markets and create growth.
- Candidates selected from the 2021-23 admissions cycle will be fully funded by MSDE.
- On joining the program, the candidate will receive a stipend of Rs. 50,000 per month during Year 1 of the program. On completing the requirements of Year 1, the candidate will receive a stipend of Rs. 60,000 per month during Year 2 of the program.
18th ASEAN-India Summit and 16th East Asia Summit
- PM Modi will attend these events virtually.
- The 18th ASEAN-India Summit will review the status of the ASEAN-India Strategic Partnership and take stock of progress made in key areas including Covid-19 and Health, Trade and Commerce, Connectivity and Education and Culture.
- ASEAN-India Summits are held annually and provide an opportunity for India and ASEAN to engage at the highest level.
- The year 2022 will mark 30 years of ASEAN-India relations
- East Asia Summit is the premier Leaders-led forum in the Indo-Pacific.
- Since its inception in 2005, it has played a significant role in the strategic and geopolitical evolution of East Asia.
- Apart from the 10 ASEAN Member states, East Asia Summit includes India, China, Japan, South Korea, Australia, New Zealand, the United States and Russia.
- India, being a founding member of the East Asia Summit, is committed to strengthening the East Asia Summit and making it more effective for dealing with contemporary challenges.
'Konkan Shakti 2021'
- The sea phase of the maiden Tri-Service exercise 'Konkan Shakti-2021' between the India and the United Kingdom (UK) was held off the Konkan coast in the Arabian Sea.
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