Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana
Ayushman Bharat, a flagship scheme of the Government of India, was launched as recommended by the National Health Policy-2017 to achieve the vision of universal health coverage. The initiative is designed to meet the Sustainable Development Goals and its underlined rivalry, which is "leaving no one behind".
The objective of the scheme is to provide guiding intervention salient to address the health care system in a holistic manner at primary, secondary and tertiary levels.
Ayushman Bharat - Vision
The vision of Pradhan Mantri Jan Arogya Yojana for the next five years is to achieve sustainable development target “SDG 3.8”. To ensure financial security against disastrous health expenditure and to ensure access to affordable and quality healthcare for all.
Ayushman Bharat - Mission
For the next five years, it is a mission to "create the best health programme in the world on a skilled and technologically strong ecosystem."
Brief Description:
The aim of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is to benefit 50 crore people in India. So far, 16.79 crore people have been made Ayushman Cards. In which 2.79 crore eligible beneficiaries have availed the benefit of treatment. A total of 24.24 thousand hospitals in India are listed under the scheme.
The scheme was inaugurated by Hons. Prime Minister Sri Naredra Modi on 23 Sept,.2018 in the name of Aushman Bharat PM Jan Arogya scheme. The target was to connect 10.74 crore families with the scheme. About 50 crore beneficiaries will be covered. BPL families were included on the basis of census 2011 database for selection of eligible families. 5 lakh per beneficiary per annum.
In Uttar Pradesh, under The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana, the target was to cover the 6.25 crore beneficiaries with this scheme. Golden cards were issued 95.25 lakh against the target till 23rd November, 2020. In a public interest initiative by the Government of Uttar Pradesh, golden cards were made by conducting a campaign to make golden cards in several phases and golden cards of 60.78 lakh beneficiaries. Golden Card has been issued to 1.56 crore beneficiaries against 6.25 crore beneficiaries till 3rd November, 2021.
In a meaningful initiative, the Uttar Pradesh government has covered 8.43 lakh families who were deprived of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana even though the families were eligible. Even after these efforts, most of the families holding antyodaya ration cards in Uttar Pradesh were deprived of this scheme and campaign. On which 40.78 lakh antyodaya ration card holders families of the State were covered under The Chief Minister's Jan Arogya Abhiyan vide order dated 23rd July, 2021 in a positive initiative by the State Government.
As on 3rd November, 2021, beneficiaries holding golden cards 8.29 lakh of the State availed the health benefits of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana.
Current Status-
Human Liberty Network (HLN), Uttar Pradesh conducted a survey of 14082 households of 375 Gram Panchayats in 23 development blocks during March-April -2021 in seven districts of Azamgarh, Prayagraj, Varanasi, Mirzapur, Jaunpur, Chandauli, Sant Ravidas Nagar. Informationon the issues of child protection, education, health, especially Ayushman Bharat Yojana, MGNREGA, etc. Based on the preliminary report, 80 percent of the households have taken loans locally for the treatment of their family members. These families do not have golden cards. Families of 93 percent of child labourers and working children were found deprived of golden cards. On this basis, we can say that now the poor families among the poor should focus on the level of implementation under this scheme.
Initiatives in Uttar Pradesh
On the meaningful initiative of the State Government, implementation initiatives have been taken at the district level in the respective 75 districts. Golden cards were made by camping in the village village. As a result, 60.78 lakh Golden Cards were made in the State during about 11 months. Even after the efforts of the State Government, the district administration, only 25 percent of the beneficiaries could be made golden cards. The 40.78 lakh beneficiary families of Antyodaya Ration Card which have been newly covered have a big goal of making golden cards. The work experience of the workers of Human Liberty Network (HLN), ROSA, Azamgarh, MSMVS, Varanasi and PGS Prayagraj, an affiliate of Uttar Pradesh, is showing the following obstacles:
Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana/Mukhyamantri Jan Arogya Abhiyan obstacles-
At community level
1. Under Ayushman Bharat/Mukhya Mantri Jan Arogya Abhiyan, SC/ST groups at village level are not covered under Jan Arogya Abhiyan. Eligible beneficiaries of SC/ST community are not able to reach golden card camps. Because there is a lack of information in those communities.
2. There is a lack of appropriate knowledge of Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan and awareness about making golden cards in the community due to which the beneficiary is inactive in making golden cards.
3. Ayushman Bharat/Mukhya Mantri Jan Arogya Abhiyan letter has not been received by many eligible beneficiaries. Due to which they are not aware of themselves being beneficiaries.
4. The community is not fully aware of the benefits of Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan due to which they are being deprived of health benefits.
5. The benefits of Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan are not even golden cards for many families migrating for employment. Due to which they are being deprived of health services.
6. Under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan, golden card holder beneficiaries are not mucjh aware of the locally listed hospitals and treatment procedures due to which they are not able to reach health benefits in case of illness.
7. Under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan, family members are not able to reach golden card camps at a time due to domestic conditions for the use of golden cards. So, all the family members are not getting golden cards.
8. The fee for making golden cards under Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan is not reaching the eligible beneficiary camp due to non-affordability of fees of all the family members at a time.
At the service provider level
1. Due to non-organizing of adequate Golden Card Camps at village level under Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan, some or the other members of eligible beneficiary are being deprived of Golden Card.
2. Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan During golden card camps held at village level, beneficiaries are becoming golden cards but due to non-getting print of Golden Card, eligible beneficiaries have to work hard or they are getting frustrated with the scheme.
3. Eligible beneficiaries are returning in anger over the demand for higher than standard fees at the local level for making golden cards of Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan.
4. Due to the distance of designated Sahaj Jan Seva Kendras of Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan, eligible familie sare not able to become part of the campaign due to expenses of golden card fees, travel expenses etc.
5. In case of non-matching of spelling in the name and other data of eligible beneficiary from the database of Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan, eligible beneficiaries are being deprived benefits of Golden Card due to non-availability of Golden Card.
6. Under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan, camps are not organized due to non-availability of internet in some villages. This is depriving the eligible beneficiaries.
7. Sahaj Jan Seva Kendras registered under Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan are not getting the desired target due to dis-interest in the scheme.
8. Due to non-adequate appointment of Ayushman Mitra under Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan, information and awareness work is not being carried out in the community.
At the impaneled hospital level
1. In some of the hospitals listed under Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan, the eligible family is forced to take health care at their personal level due to non-proper inputs and refusal of treatment to patients
2. Under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan, the listed hospital does not get adequate information to the patient due to non-installation of complete information at notice board of hospitals .
At policy/district level
1. Due to non-appointment and training of adequate Ayushman Mitra under Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan, the community is not getting access to health benefits.
2. The utility of Sahaj Jan Seva Kendra registered under Ayushman Bharat/Mukhyamandir Jan Arogya Abhiyan is shown to be inactive at the local level due to lack of coordination and better management at the district level.
Human Liberty Network (HLN) , UP in Public Interest, Recommendations -
Human Liberty Network, Uttar Pradesh provides the following recommendations to connect eligible most needy beneficiaries with Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan in the public interest in a short span of time:
At community level
1. Ayushman Mitra should be appointed and trained under Ayushman Bharat/Mukhyamantri Jan Arogya Abhiyan. Ayushman Mitra should be helped to reach out to the eligible beneficiary along with information as well as health benefits by focusing on dalit/mahadalit group/majra of Gram Panchayat.
2. ID should be provided to Ayushman Mitra selected under Ayushman Bharat/Mukhya Mantri Jan Arogya Abhiyan who is practically capable of making golden cards.
3. Under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan, gram pradhan of Gram Panchayat should be made a nodal at panchayat level. Who can play a role in fulfilling the objectives of Ayushman in coordination with Ayushman Mitra, ASHA worker, Sahaj Jan Seva Kendra, impaneled Hospital and Medical Officer-in-charge.
At the service provider level
1. Golden Card Camp should be organized at Gram Panchayat level at least one day every month under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan. The focus should be on dalit/mahadalit community during the camp.
2. Sahaj Jan Seva Kendra under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan ensure that the beneficiary registered for Golden Card gets print copy of Golden Card in the shortest possible time.
At impaneled hospital level
1. Under Ayushman Bharat/Mukhyamango Jan Arogya Abhiyan, impaneled hospitals should put up a board at their level to show the details of the type of treatment listed for.
2. Under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan, impaneled hospitals should organize health camps in their local area and diagnose and treat along with spread the message of Ayushman Bharat.
At policy/district level
1. A link should be provided for access to print copy of Golden Card after golden card registration under Ayushman Bharat/Mukhyamanthi Jan Arogya Abhiyan. The link to the golden card creation should be sent to the registered mobile of the registered beneficiary. So that the beneficiary can get an electronic copy or print copy.
2. Under Ayushman Bharat/Mukhya mantri Jan Arogya Abhiyan, self-help groups of National Livelihood Mission should be linked to publicity, help to eligible beneficiaries and the responsibility should be given to carry out public awareness at their village level.
3. Ayushman Bharat/Mukhyamandir Jan Arogya Abhiyan: List of district level listed hospitals and helpline number should be written in public places at Gram Panchayat level.
4. Under Ayushman Bharat/Mukhyamango Jan Arogya Abhiyan, information boards of Ayushman Bharat/Mukhyamango Jan Arogya Abhiyan should be installed at ration shops and kotedar should be given the responsibility to guide the Antyodaya beneficiary to make golden cards.