Ayushman Bharat-Health & Wellness Centres (AB-HWC)
Delivery of comprehensive primary health care services through Health &Wellness Centres is a critical component of the newly announced Ayushman Bharat scheme. It places people and communities at the center of the health care delivery system, making health services responsive, accessible and equitable.
Nearly 1.5 lakh Sub-Centres and Primary Health Centres would be transformed as Health & Wellness Centres by 2022 to provide comprehensive and quality primary care close to the community while ensuring the principles of equity, affordability and universality.
Till date, 4503 HWCs have been operationalized in various states.
Key components of AB-HWC:
Additional Human Resource - New cadre of health care professional- referred to as the Mid-Level Health Provider- who is a nurse or an Ayurvedic Practitioner trained and accredited for a set of competencies related to primary health care and public health. Mid-Level Health Provider will lead the team of MPWs and ASHAs at SHC level
Multiskilling/ Training of existing service providers - upgrading skills to provide expanded package of services
Efficient logistics system to ensure availability of wide range of drugs and point of care diagnostics
Robust IT system – to create unique health id and longitudinal health record of all individuals and provision of tele-consultation services
Provision of services related to indigenous health system and yoga etc for promotion of wellness
Linkages with schools to train Health and Wellness Ambassadors to enable creating healthy habits in schools
The package of services envisaged at AB-HWC are:
Care in pregnancy and child-birth.
Neonatal and infant health care services
Childhood and adolescent health care services
Family planning, Contraceptive services and other Reproductive Health Care services
Management of Communicable diseases including National Health Programmes
Management of common communicable diseases and outpatient care for acute simple illness and minor ailments.
Screening, Prevention, Control and Management of non-communicable diseases.
Care for Common Ophthalmic and ENT problems
Basic Oral health care
Elderly and palliative health care services
Emergency Medical Services
Screening and Basic management of Mental health ailments
Key benefits for community under AB-HWC:
Expanded package of primary care services –ranging from maternal and child health, communicable diseases to non-communicable diseases (universal screening, prevention, control and management of five common communicable diseases: hypertension, diabetes and three common cancers – those of the oral cavity, breast and cervix, primary health care for diseases for the eye, oral health, ENT, mental health, provision of palliative care and care for the elderly, and medical emergencies)
Wide range of free drugs
Point of care diagnostics at the centres.
Tele-consultation services with Medical Officers for complications
Continuum of care ensured through referral linkages and protocols
Unique health id – longitudinal health record for each individual
Services related to indigenous health system and yoga for promotion of wellness.
FREE DRUGS & DIAGNOSTICS SERVICES INITIATIVE
MOHFW has provided an indicative list of drugs & diagnostics investigations to be provided at each level of health care facility. However, the state may provision for additional number of drugs & diagnostic services.
In PHCs, 285 medicines and 19 types of test available.
In CHCs, 455 medicines and 39 types of test available.
In District Hospitals, 544 medicines and 56 types of test available.
Since 2015, more than Rs. 16631 crore has been accorded to the States/UTs.
BIOMEDICAL EQUIPMENT MANAGEMENT & MAINTENANCE PROGRAM
MoHFW organized consultations with officials from states to devise appropriate mechanisms to ensure that medical equipment already purchased are used and properly maintained. An extensive exercise was undertaken to map the inventory of all Bio-medical equipment including their functionality status.
The mapping has been completed in 29 States. 7,60,849 number of equipment in 29,115 health facilities costing approximately Rs 4646.37 Crore were identified. Equipment in range of 13% to 34% was found dysfunctional across states.
BMMP has been implemented in total 26 States
20 States in PPP mode in the state of Andhra Pradesh, Arunachal Pradesh, Assam, Chhattisgarh, Jharkhand, Kerala, Madhaya Pradesh, Maharashtra, Meghalaya, Mizoram, Nagaland, Puducherry, Punjab, Sikkim, Telangana, Tripura, Rajasthan, Uttar Pradesh,West Bengal, Jammu & Kashmir.
In house mode of 6 States - Gujarat, D&N Haveli, Daman & Diu, Delhi, Lakshadweep, Tamil Nadu.
The tender to outsourcing is in progress in 6 States- Goa, Haryana, Karnataka, Uttarakhand, Odisha and Manipur.