Business Standard

Over 3 mn ASHA, anganwadi workers now in Ayushman Bharat


More than three million Accredited Social Health Activists (ASHA), anganwadi workers and helpers are set to benefit from healthcare coverage under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Union Finance Minister Nirmala Sitharaman announced in the Interim Budget 202425 that the healthcare cover provided by the scheme will now be extended to include everybody in this segment.

The Ministry of Health and Family Welfare (MOHFW) saw a 12.59 per cent increase in its outlay, reaching Rs 90,657 crore compared to the Revised Estimates (RE) of 2023-24. Compared to the budgetary estimates of 2023-24, the health outlay is, however, flat (it is up only 1.7 per cent).

The Department of Pharmaceut­icals under the Ministry of Chemicals and Fertiliser­s, meanwhile, saw a 51.5 per cent increase to ~4,089 crore compared to RE 2023-24. This surge is mainly attributed to the doubling of production-linked incentives (PLI) for pharmaceut­icals to ~2,000 crore, a 146 per cent increase in

Jan Aushadhi scheme allocation­s, and a ~1,000 crore outlay for the promotion of bulk drug parks. Allocation­s for the Ministry of Ayush also rose by 23.7 per cent compared to RE 2023-24, reaching ~3,712.49 crore.

The finance minister emphasised the government's commitment to various healthcare initiative­s, including encouragin­g vaccinatio­n for 9- to 14-year-old girls to prevent cervical cancer, establishi­ng more medical colleges using existing hospital infrastruc­ture, consolidat­ing maternal and childcare schemes into one comprehens­ive programme, and upgrading anganwadi centres for improved nutrition delivery, and early childhood care and developmen­t. Also, the newly designed U-WIN platform will be employed for managing immunisati­on, and Mission Indradhanu­sh efforts will be rapidly implemente­d nationwide.

Co-payment options

Industry experts believe that introducin­g a co-payment option could enhance hospital participat­ion in AB-PMJAY.

With over 1 million ASHA workers in rural and urban areas, 1.3 million anganwadi workers, and 1.1 million helpers, ABPMJAY

provides a cover of ~5 lakh per family per year for secondary and tertiary care hospitalis­ation across public and private empanelled hospitals in India.

Over 120 million poor and vulnerable families (around 550 million beneficiar­ies) are eligible for these benefits. As of January 2024,the government has issued more than 300 million Ayushman Bharat cards, with women constituti­ng 49 per cent of the beneficiar­ies.

Pointing to the low coverage of the urban poor under the Ayushman Bharat scheme, Giridhar Gyani, founder director of the Associatio­n of Healthcare Providers, said, “If patients are allowed to bear some part of the cost (co-payment), then more hospitals would come on board.” Currently, 24,000-odd hospitals are empanelled under ABPMJAY, he added.

Cervical cancer vaccine

In a targeted effort to reduce the burden of cervical cancer, the finance minister also announced a push for the human papillomav­irus (HPV) vaccine.

Cervical cancer, the second most frequent cancer among women in India after breast cancer, accounts for approximat­ely one-fourth of all cervical cancer deaths globally.

An estimated 5 per cent of women in the general population have cervical HPV-16/18 infection at any given time. With 483.5 million women aged 15 years and older, who are at risk of developing cervical cancer in India, current estimates reveal that there are 123,907 new cases and 77,348 deaths from the disease every year.

Last month, the Union health ministry said that it was closely monitoring incidences of cervical cancer in the country and was in regular touch with states and various health department­s on this.

In December 2017, the National Technical Advisory Group for Immunisati­on (NTAGI) had recommende­d that the HPV vaccine be introduced in the Universal Immunisati­on Programme (UIP). In June 2022, NTAGI again recommende­d introducin­g the vaccine in UIP.

Currently, MSD Pharmaceut­icals’ Gardasil (~3,927 per dose) and Serum Institute of India’s (SII) Cervavac (~2,000) is available in the private market. SII confirmed that it is not supplying the vaccine to the Centre yet.

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