AYUSHMAN BHARAT-HEALTH and WELLNESS CENTRES

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Context: The Centre has announced that it will expand the range of services offered by the Ayushman Bharat Health and Wellness Centres (AB-HWCs) across the country by the end of August.

Details

• The AB-HWCs, which aim to provide comprehensive primary health care to the population, will now include screening, prevention, control and management of non-communicable diseases, such as diabetes, hypertension, cardiovascular diseases and cancer.
• The AB-HWCs will also provide care for common ophthalmic and ENT problems, such as cataracts, glaucoma, refractive errors, ear infections and hearing loss.
• The AB-HWCs will offer basic oral health care, such as dental check-ups, scaling, filling and extraction. Furthermore, it will cater to the needs of the elderly and palliative health care services, such as geriatric assessment, home-based care and pain management.
• The Centre hopes that by adding these services, the AB-HWCs will improve the access and quality of health care for the people, especially in rural and remote areas.

Ayushman Bharat Health and Wellness Centres (AB-HWCs)

• Ayushman Bharat-Health and Wellness Centres (AB-HWCs) is a flagship programme of the Government of India that was launched in 2018 as a part of the broader Ayushman Bharat initiative.
• The main objective of this programme is to strengthen the primary health care system in the country by transforming the existing sub-centres and primary health centres into comprehensive health and wellness centres.
• These centres offer a wide range of services, including prevention, promotion, treatment, rehabilitation, and palliation, to meet the diverse health needs of the people.
• They aim to improve the quality, accessibility, affordability, and equity of primary health care in India.

Features

• They deliver a comprehensive package of services that address the health needs of the population, ranging from maternal and child health, communicable and non-communicable diseases, oral health, eye care, mental health, geriatric care, emergency care, and basic diagnostics.
• They are manned by a team of competent and dedicated health workers, headed by a mid-level health provider (MLHP), who is either a nurse or an Ayurveda practitioner with additional training in public health.
• They are furnished with essential drugs, devices, and digital technology to ensure quality and continuity of care.
• They are connected to the secondary and tertiary levels of care through a referral system and a health insurance scheme (Pradhan Mantri Jan Arogya Yojana or PM-JAY).

Significances

• They enhance the accessibility and availability of primary health care services, especially for the rural and urban poor. They are located close to the communities and offer a range of services, such as screening, diagnosis, treatment, referral, counselling, and follow-up.
• They reduce the burden of disease and disability by focusing on prevention and early detection of common conditions. They cover priority areas, such as maternal and child health, non-communicable diseases, mental health, oral health, eye care, and geriatric care.
• They improve the efficiency and effectiveness of health service delivery by rationalizing the use of resources and reducing duplication and fragmentation. They are integrated with the existing public health system and leverage the potential of digital technology and telemedicine.
• They promote people's participation and empowerment by involving them in planning, monitoring, and feedback mechanisms. They have a Health and Wellness Team (HWT) comprising of a Community Health Officer (CHO) and two Auxiliary Nurse Midwives (ANMs), who work closely with the local health committees and community health workers.
• They foster inter-sectoral convergence and social determinants of health by collaborating with other departments and stakeholders. They address the social, economic, and environmental factors that affect health, such as nutrition, sanitation, education, livelihoods, and gender.

Challenges

• They require adequate financial, human, and infrastructural resources to ensure the quality and sustainability of services. This means that the government has to allocate sufficient funds, train and retain qualified staff, and equip the centres with essential drugs, diagnostics, and devices.
• They need strong governance and management structures to ensure accountability and responsiveness of service providers. This involves establishing clear roles and responsibilities, performance indicators, feedback mechanisms, and incentives for the staff and the community.
• They require effective coordination and integration with other components of the health system to ensure continuity and comprehensiveness of care. This requires developing referral linkages, information systems, supply chains, and quality standards across different levels of care.
• They entail a paradigm shift in the culture and behaviour of both the providers and the users of health services to adopt a holistic and patient-centred approach. This implies creating awareness, trust, and demand for the services among the population, as well as enhancing the skills, attitudes, and practices of the providers.

To enhance the performance and impact following measures are recommended:

• Allocate and spend at least 2.5% of GDP on primary health care by 2025 to ensure adequate resources for the AB-HWCs.
• Train and mentor health workers at all levels to improve their skills, knowledge, and motivation.
• Improve the infrastructure and equipment of the AB-HWCs to comply with the standards and norms set by the government.
• Use digital technology and innovation to collect, analyze, and use data for decision-making and quality improvement.
• Collaborate with the community and civil society organizations to raise awareness, generate demand, and foster ownership for the AB-HWCs.

Conclusion

• Ayushman Bharat Health and Wellness Centres (AB-HWCs) are an ambitious initiative by the Government of India to provide comprehensive primary health care to all citizens. The aim is to transform the existing sub-centres and primary health centres into AB-HWCs that offer a range of preventive, promotive, curative and rehabilitative services. They are expected to improve access, affordability and quality of health care, especially for the poor and vulnerable sections of society. They are also envisioned to strengthen the health system by creating a network of health facilities that are integrated, responsive and accountable.

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AYUSHMAN BHARAT - HEALTH AND WELLNESS CENTRES: https://www.iasgyan.in/daily-current-affairs/ayushman-bharat-health-and-wellness-centres

RURAL HEALTH STATISTICS REPORT: https://www.iasgyan.in/daily-current-affairs/rural-health-statistics-report

https://www.thehindu.com/sci-tech/health/biggest-ever-expansion-of-services-underway-for-ayushman-bharat-health-and-wellness-centres-programme/article67057379.ece