Role of National Health Mission (NHM) and Ayushman Bharat in Improving Healthcare Access

1. Overview of National Health Mission (NHM)

Objective and Scope

• Comprehensive Approach: Launched in 2013, NHM aims to provide accessible, affordable, and quality healthcare to the rural and underserved urban population. It focuses on strengthening primary healthcare through Health and Wellness Centres (HWCs) and improving maternal and child health.
• Recent Example: The 2024 expansion of HWCs to over 1.5 lakh centers across India reflects NHM’s commitment to enhancing primary healthcare services.

Key Achievements

• Improved Health Outcomes: NHM has contributed to significant improvements in health indicators, such as reducing maternal and infant mortality rates and increasing vaccination coverage.
• Recent Example: According to the 2023 National Family Health Survey (NFHS-5), the under-five mortality rate has decreased, partly due to NHM’s maternal and child health initiatives.

2. Overview of Ayushman Bharat Scheme

Objective and Scope

• Health Insurance Coverage: Launched in 2018, Ayushman Bharat consists of two components: Pradhan Mantri Jan Arogya Yojana (PMJAY), which provides health insurance coverage of up to ₹5 lakh per family per year, and Ayushman Bharat – Health and Wellness Centres (AB-HWCs), which focus on primary health services.
• Recent Example: The 2023 expansion of PMJAY to cover over 500 million beneficiaries highlights its role in providing financial protection against high medical costs.

Key Achievements

• Increased Access: PMJAY has facilitated access to quality healthcare services for economically vulnerable populations, reducing out-of-pocket expenditure and financial burden.
• Recent Example: The 2024 success story of a beneficiary receiving treatment for heart surgery under PMJAY demonstrates the scheme’s impact on improving access to essential health services.

3. Challenges and Limitations in Achieving Universal Health Coverage

Financial Constraints

• Funding Issues: Both NHM and Ayushman Bharat face challenges related to funding and financial sustainability. The increasing demand for healthcare services puts pressure on budget allocations.
• Recent Challenge: The 2024 budget constraints affecting NHM and PMJAY funding highlight ongoing financial challenges in maintaining and expanding healthcare services.

Infrastructure and Capacity Constraints

• Service Delivery Gaps: Despite significant investments, there are still gaps in healthcare infrastructure and service delivery, particularly in remote and rural areas. The quality of services can be inconsistent.
• Recent Challenge: The 2023 reports of infrastructure shortages in certain states, including limited availability of advanced diagnostic facilities and specialist care, underscore these constraints.

Awareness and Utilization

• Awareness Issues: Low awareness about the benefits and coverage of NHM and Ayushman Bharat among vulnerable populations can lead to underutilization of available services.
• Recent Challenge: The 2024 study on PMJAY utilization rates indicates that some eligible beneficiaries are unaware of their entitlements or face difficulties accessing services.

Fraud and Mismanagement

• Implementation Challenges: Issues related to fraud, mismanagement, and leakage of funds can undermine the effectiveness of both NHM and Ayushman Bharat.
• Recent Challenge: Reports of fraudulent claims and administrative inefficiencies in PMJAY highlight the need for better oversight and management.

4. Strategies to Address Challenges

Enhancing Financial Sustainability

• Increased Budget Allocation: Ensuring adequate and sustainable funding through increased budget allocations and innovative financing mechanisms, such as public-private partnerships.
• Recent Initiatives: The 2024 proposal for increased NHM funding aims to address financial challenges and support the expansion of healthcare services.

Strengthening Infrastructure and Capacity

• Infrastructure Investments: Investing in healthcare infrastructure, including building new facilities, upgrading existing ones, and ensuring the availability of essential medical equipment and supplies.
• Recent Initiatives: The 2024 infrastructure development plans under NHM include constructing new health centers and upgrading facilities in underserved regions.

Improving Awareness and Utilization

• Awareness Campaigns: Implementing comprehensive awareness campaigns to educate beneficiaries about their entitlements and how to access healthcare services under NHM and Ayushman Bharat.
• Recent Initiatives: The 2024 launch of the “Health for All” campaign aims to increase awareness about Ayushman Bharat and NHM services among rural populations.

Enhancing Monitoring and Accountability

• Strengthening Oversight: Implementing robust monitoring and accountability mechanisms to reduce fraud, ensure effective service delivery, and improve transparency.
• Recent Initiatives: The 2024 introduction of new digital monitoring systems for PMJAY aims to enhance oversight and reduce instances of fraud.

5. Conclusion

The National Health Mission (NHM) and Ayushman Bharat scheme have played crucial roles in improving access to healthcare and reducing out-of-pocket expenditures for India’s vulnerable populations. While significant progress has been made, challenges such as financial constraints, infrastructure limitations, awareness issues, and fraud persist. Addressing these challenges through increased funding, infrastructure investments, awareness campaigns, and enhanced monitoring will be essential for achieving universal health coverage and ensuring that healthcare services reach all segments of the population effectively.