Reconnect public health with people’s needs, Pg12

Key Highlights:

• Public health policies in India are criticized for failing to address core issues of access and quality, despite aiming for Universal Health Coverage.
• Recent government initiatives, specifically Ayushman Bharat Health and Wellness Centres and Ayushman Bharat Digital Health Mission, are highlighted for their inadequacies.
• The article points to a problematic shift in focus from population health outcomes to individual well-being, which is subjective and difficult to measure.
• Concerns are raised about the lack of concrete measures to strengthen public healthcare institutions and address immediate needs like curative care.

Detailed Insights:

• Ayushman Bharat Health and Wellness Centres, introduced in 2018, primarily rebranded existing grassroots institutions like Health Sub-Centres (SCs), Primary Health Centres (PHCs), and Community Health Centres (CHCs).
• This rebranding created ambiguity among health professionals regarding the actual mandate and roles of these institutions.
• The shift towards 'wellness' places primary responsibility on individuals, potentially underestimating the structural and social determinants that shape health outcomes.
• Ayushman Bharat Digital Health Mission (ABDHM) aims to create a digital health repository for individuals through a unique health ID, the ABHA card.
• The article argues that mere data generation through ABDHM does not address the fundamental challenges of inadequate healthcare infrastructure and affordability.
• Effective public health policies must recognize people's immediate needs, such as access to curative care, before focusing on preventive and promotive interventions.
• Current policy initiatives are seen as missing concrete measures to strengthen public healthcare institutions, which are crucial for India's three-tier healthcare system.

Key Concepts Involved:

• Universal Health Coverage (UHC): A concept ensuring all individuals have access to needed health services without suffering financial hardship.
• Demographic Dividend: The economic growth potential that can result from shifts in a population’s age structure, particularly when the working-age population share is larger.
• Health Promotion: A population-based approach recognizing how social, economic, and environmental conditions influence people’s ability to adopt healthy behaviors.
• Wellness: A holistic concept of health extending beyond the absence of disease to include mental, spiritual, social, and environmental dimensions.