Why in news?

In June 2023, the NITI Aayog had prepared a report to study the performance of the Ayushman Bharat Scheme.

The report has not been made public yet. However, it is learnt that its findings have been shared with the Ministry of Health and Family Welfare.

What’s in Today’s Article?

• Ayushman Bharat Scheme (Objective, Components)
• Ayushman Bharat HWCs (Purpose, Features, etc.)
• Key Findings of the Report

About Ayushman Bharat Scheme:

• Ayushman Bharat, a flagship scheme of Government of India, was launched in 2018 as recommended by the National Health Policy (2017).
• Objective: To achieve the vision of Universal Health Coverage.
• This initiative has been designed to meet Sustainable Development Goal number 3 and its underlining commitment, which is to "leave no one behind."
• Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components, which are:
• Pradhan Mantri Jan Arogya Yojana (PM-JAY)
  • It provides health insurance cover of Rs. 5 lakhs per year to over 10 crore poor and vulnerable families for seeking secondary and tertiary care.

• Health and Wellness Centres (HWCs)

Ayushman Bharat Health and Wellness Centres (HWCs):

• In February 2018, the Government of India announced the creation of 1,50,000 Health and Wellness Centres (HWCs) by transforming the existing Sub Centres and Primary Health Centres.
• The goal is to ensure access to quality healthcare closer to the community, thereby improving health outcomes and reducing out-of-pocket healthcare expenditures for individuals and families.
• These centres provide free essential medicines and diagnostic services, teleconsultation, and health promotion including wellness activities like Yoga.
• The HWCs also offer annual screening for those 30 years or older for Non Communicable Diseases such as:
• Hypertension, Diabetes, and three of the most common Cancers in India — oral, breast and cervical.

Cancer Menace in India:

• In 2022, India had more than 14.1 lakh new cancer cases and over 9.1 lakh deaths due to the disease.
• Breast cancer was the most common, according to the latest estimates of the disease's global burden by the World Health Organization (WHO).
• Most common Cancers among Men:
  • Cancers of lip/oral cavity and lung were the most common ones in men, accounting for 15.6 and 8.5 per cent of the new cases, respectively.
• Most common Cancers among Women:
  • Cancers of breast and cervix were the most frequent ones in women, making up close to 27 and 18 per cent of the new cases.
• Globally, the WHO estimated 2 crore new cancer cases and 97 lakh deaths in the year 2022.

Key Findings of the Report:

• Six years since the launch, the Ayushman Bharat insurance scheme has been availed of by more than 5.47 crore users across the country.
• However, when it comes to cancer screening at the HWCs, there is a huge gap.
• Negative Takeaways:
  • Currently, there are three distinct methods of screening for the three cancers:
    • Oral visual examination for oral cancer;
    • Visual inspection with acetic acid for cervical cancer (under this, the cervix is examined after the application of 3-5% acetic acid); and
    • Clinical breast examination (CBE) for breast cancer for the people in the age-group 30-65 years.
  • Nurses and Midwives at the HWCs were meant to be trained in these three screening methods.
  • The training is required to sharpen the screening skills for cancer. However, this hasn’t been achieved to the extent that was expected.
  • For example, provision for screening of cervical cancer is yet to be operationalized.
  • The report also flagged that although NCD screening was underway at most facilities, yearly screening was still largely absent.
  • The NITI Aayog teams also found that the HWC staff had limited or no knowledge of the fact that the screening for hypertension and diabetes needed to be done on an annual basis.
• Positive Takeaways:
  • The report said that the infrastructure in HWCs was in accordance with standards as envisaged in the operational guidelines.
  • All basic devices such as stethoscope, BP apparatus (digital), weighing scale (adult and infant), clinical thermometer (oral and digital) were available and functional.
  • The NITI Aayog teams found that medicines and diagnostic tests were available free-of-cost in all the visited facilities.