Health and wellness component of Ayushman Bharat aims to address the requirements of preventive and promotive health services through Health & Wellness Centres. The government realized that the contribution of NCDs to the overall disease burden in the country has increased over the years. In the past many district hospitals in the country have focused mainly on communicable diseases and reproductive and child health. As a result of which the capacity for handling NCD cases has not been adequately developed.
NITI Aayog, government’s policy think tank also recently chalked out a PPP mode plan to be adopted under AB-PMAJY. NITI Aayog held that the patients in mofussil towns and rural areas are largely underserviced. In this context, PPP for NCDs in district hospitals will play a pivotal role in ensuring the availability of the services at least at the district headquarters.
The government chose to expand a program that was already running in Andhra Pradesh and Telangana under AB-PMJAY. In July 2016, Tata Trusts and Dell started a programme in Andhra Pradesh – the Master Mahila Check Up Program -- to screen women, over the age of 30, for seven NCDs -- Diabetes, Hypertension, Hormonal imbalances, Ophthalmic problems, and three cancers (Oral, Cervical, and Breast cancer). The Government of Telangana too adopted the programme in April 2017. Under these state-specific programmes, 21 lakh individuals were screened in Andhra Pradesh, and 24.9 lakh in Telangana.
“The programmes attracted the attention of the central government, as they were in alignment with the Union Government’s on-going NCDs screening programme since 2010. An MoU was signed in June 2018 for this Tata Trusts-Dell programme to be scaled up in the entire country, under the umbrella of the Ayushman Bharat scheme," said Sita Rama Budaraju, Senior Consultant – Health, Tata Trusts.
While Dell has developed the Ayushman Bharat - NCD application, Tata Trusts is the implementation partner on ground, training ASHA volunteers, Auxiliary Nurse Midwives (ANMs), and Medical Officers (MO), on the software, and assisting states in the roll-out and monitoring of this programme.
“As a result of this MoU, the Trusts and Dell have thus far enrolled 52.19 lakh individuals out of whom 27.4 lakh have already been screened, in the past one year in about 400 districts of 19 states. At present, there are about 10,000 ANMs doing the screenings. Since 2010, government’s NCD screening programme, now aided by the Tata Trusts-Dell programme, has enrolled about 4.85 crore citizens, and screened 53 lakh citizens," said Budaraju.
Presently, in India patients have to travel long distances for availing medical services for NCDs due to urban bias in the availability of private health care, especially secondary and tertiary care which is disproportionately skewed towards Tier-1 cities. “The work by Dell and Tata Trust in critical for ensuring continuum of care and linking the health and wellness centres with PMJAY. Now we will need to work on expanding the supply of tertiary care services in tier 2 and tier 3 cities so that our beneficiaries don’t have to travel far to seek services.
Most of tertiary care services are currently located in large cities. This constrains their use by the poor. NCDs are exponentially increasing in the country which is also more expensive to treat as compared to communicable diseases," said Indu Bhushan, Chief Executive Officer (CEO), AB-PMJAY.
Ayushman Bharat, also popular as Modicare and described as the biggest government-funded health scheme, aims to cover over 10 crore poor and vulnerable families i.e. around 50 crore beneficiaries with health insurance up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. The scheme also aims to set up 150,000 health and wellness centres across India by 2022 for providing primary health care.