Healthy India, Progressive India

Ensuring Affordable and Accessible Health Care For All

INTERVIEW

The Central Government has made gigantic strides in its commitment to ensure a health care system accessible by all. In the march towards achieving the Sustainable Development Goals for health, several schemes and strategies have been adopted including the National Health Mission, Ayushman Bharat Infrastructure Mission, Ayushman Bharat Health and Wellness Centers, Pradhan Mantri Jan Arogya Yojana, Ayushman Bharat Digital Mission, etc.

In an interview conducted by Bhupendra Singh for Employment News, Shri Vikas Sheel, Additional Secretary, Ministry of Health and Family Welfare, who is also the Mission Director, National Health Mission, spoke in detail about the various schemes adopted by the government to ensure preventive, affordable and quality healthcare for all.

Question: What are the key steps taken by the government to ensure health for all and bring about a qualitative change in the lives of Indian citizens?

Shri Vikas Sheel: The National Health Policy was released in the year 2017 under the leadership of Prime Minister Shri Narendra Modi. The mission targeted to ensure Universal Health Coverage in the country while eradicating communicable diseases and reduce the effects of noncommunicable diseases. In 2018, the Ayushman Bharat Yojana was launched to fulfill this vision. Under Ayushman Bharat, Health and Wellness Centres to deliver expanded range of health care services to the local populace was launched in 2018. The first such centre was inaugurated on 14th April 2018 by the Prime Minister at Jhangla in Chhattisgarh. Further, to protect the 10 crore families living below the poverty line from unaffordable health expenditure, the Pradhan Mantri Jan Arogya Yojana was launched. In 2021, the Ayushman Bharat Digital Mission and Ayushman Bharat Health Infrastructure Mission were launched to lend momentum to the health goals. Thus, through these four mission-mode programs, the government is working continuously to fulfill the goals of the National Health Policy and the SDG goals for health.

Question: Please shed some light on the kind of partnership between the Centre and the States in implementing the National Health Mission.

Shri Vikas Sheel: Since 2018, the National Health Mission (NHM) has lent a new direction to the country's health care sector. Health and Wellness Centers are being set up on mission-mode under the NHM and many other ambitious targets have been set. Key targets include eradicating Tuberculosis by the year 2025 and to make country Malariafree by 2030. Efforts are also being made on a war-footing to reduce the effects of noncommunicable diseases. For implementing all these targets, financial resources and technical assistance are provided to the States and I am happy to inform that in the last three-four years, many remarkable targets have been achieved under the NHM.

Question: Kindly elucidate the role of Ayushman Bharat Health and Wellness Centers in achieving the NHM targets.

Shri Vikas Sheel: At present, about one lakh seventeen thousand Health and Wellness Centers are functional in the country. A Community Health Officer or Mid Level Service Provider has also been arranged at these Health and Wellness Centers. These centers are equipped with the facility of screening of noncommunicable diseases as well as facilities for the treatment and care of pregnant women and new born babies. Additionally, an elaborate healthcare package including the treatment of ailments related to the eye, nose, ear, throat, mental health and palliative care, and basic emergency care, are available in these Health and Wellness Centers. These centers also provide teleconsultation and telemedicine. All these facilities have made it possible for people to get treatment facilities within a reasonable distance of their dwelling while also doing away with the menace of quacks and exorbitant fees charged by private health care providers.

Question: What are the specific efforts being made by the government to reduce the burden of noncommunicable diseases (NCDs) that account for more than 60% of deaths in the country?

Shri Vikas Sheel: Apart from providing affordable treatment, the focus is also on preventing NCDs among the population. The Health and Wellness Centers have been equipped and mandated to carry out extensive screening of NCDs so that patients are identified during the early onset of symptoms and treatment is started immediately. Early diagnosis and treatment is necessary to ensure that the disease does not progress further because all NCDs, especially hypertension and diabetes, as they progress, also lead to other diseases. On the preventive front, the Health and Wellness Centers have been directed to advise the public on ways and means to adopt healthy lifestyle by practising Pranayama or Yoga. Arrangements have been made at the Health and Wellness Centers to preach and practise Yoga. Consultations are also provided about balanced diet and immunity boosting activities, personal hygiene and community hygiene that play crucial role in warding off diseases.

Question: What is the progress on the front of Sustainable Development Goals for health?

Shri Vikas Sheel: I am happy to share that the decline in maternal mortality rate and infant mortality rate is much greater in India as compared to other countries of the world. Some states have already achieved the SDG target while the others are steadily progressing towards the goals. As far as the eradication of communicable diseases is concerned, the work is being executed in a very well planned manner. As far as TB is concerned, Lakshadweep is now certified TB-free. One district of Kashmir, Budgam, became TB-free last year and there are many other districts and states which are moving extremely fast in this direction. If we talk about Malaria, India is the only country in the world which has registered more than 85% reduction in cases in the last 4 years despite the healthcare system being burdened by the COVID pandemic. Mortality due to malaria decreased by about 85% and we are moving steadily towards achieving the SDG of eradicating Malaria. Apart from this, sustained efforts are underway to eradicate Elephantiasis and Kala Azar (Black Fever). A separate campaign is also being run to clear the backlog of cataract surgery.

Question: What has been the public response to e Sanjeevani?

Shri Vikas Sheel: The COVID pandemic taught us that technology can take facilities to the doorstep of each and every citizen in a hassle-free manner. You must remember that COWIN platform was used for COVID vaccination. Similarly, e Sanjeevani platform was launched to provide medical advice to the people sitting at home during the pandemic. The response was immense and now the scope of e-Sanjeevani has been expanded with all Health and Wellness Centers providing facility for consultation through the application. Anyone having access to the internet and smart phone can avail the facility of e-Sanjeevani on their own while those not possessing a smartphone can avail the facility at their nearest Health and Wellness Center. For this, adequate funds have been made available to the states in the Emergency COVID Response Package and under the National Health Mission. Further arrangements are being made to set up Teleconsultation or Tele-medicine hubs in each district.

Question: According to the report of NITI Aayog, atleast 40 crore Indians do not have the financial capacity or insurance coverage for expensive medical treatments. How has the Pradhan Mantri Jan Arogya Yojana solved this problem?

Shri Vikas Sheel: You will be surprised to know that a very significant part of the country's population slip below the poverty line due to emergency health expenditure. To protect all such families, under the Pradhan Mantri Jan Arogya Yojana, a protective cover of up to five lakh rupees is provided. More than 30 million people have been benefited so far and more beneficiaries are being added rapidly. Earlier, the poor had to depend only on government hospitals, now because private hospitals are also empanelled under the Jan Arogya Yojana, those who otherwise could not afford treatment in private hospitals can now avail treatment in empanelled private hospitals.

Question: What steps have been taken by the government to further strengthen the medical infrastructure and to increase the number of doctors and health workers across the country?

Shri Vikas Sheel: In order to address the lack of adequate health care professionals, many concrete steps have been taken. For example, the establishment of the National Medical Commission. Most recently, the government enacted the National Commission for Allied and Healthcare Professions Act, 2021 which provides for a strengthening the pool of paramedics. Sustained efforts are also underway to expand the scope of nursing services and to provide better training facilities for nurses. The centre is also collaborating with states to ensure that not only there are facilities for treatment but those facilities are also adequate in terms of human resources for ensuring public health. Meanwhile, ensuring adequate human resources is not enough. We are also working towards augmenting the capacity of the available human resources including doctors, nurses and paramedics. For this, various types of training modules have been devised under the National Health Mission. Online training and upskilling of healthcare professionals are also being arranged on a large scale. Many Centers of Excellence have been set up across the country for the capacity enhancement of healthcare workers in a sustained manner.

Question: Please tell us briefly about the Ministry of Health and Family Welfare's future course of action.

Shri Vikas Sheel: Our foremost priority is to finish setting up 1.5 lakh Health and Wellness Centers by the end of 2022 as promised by Prime Minister Shri Narendra Modi. Not only will we be making the centres functional, but we also intend to expand the range of health care services available at such centers. We are also working towards ensuring that each centre has the facility of tele-consultation. We also aim to ensure that each family eligible for Golden Cards under the Pradhan Mantri Jan Arogya Yojana, get such cards and start availing the benefits of the scheme. Under the new Health and Infrastructure Mission, certain targets have been set for the next five years and we will be working to achieve those targets. The Ayushman Bharat Digital Mission launched last year will also be pursued further making treatment facilities more accessible by the public.

(The interviewer is Correspondent, All India Radio. He can be reached at airnews. bhupendra@gmail.com)