The primary aim of Ayushman Bharat program is to achieve universal health coverage. National Health Policy 2017 envisage establishment of Health and Wellness Centre (HWC) to provide comprehensive primary health care that is universal, free and closer to the community.
To fulfill the aim, Health and Wellness Centre Program was launched in 2018 and the first AB-HWC was inaugurated by the Honorable Prime Minister at Jaangla, Bijapur Chhattisgarh on 14th April 2018.
Under the program, existing Sub- Health Centres (SHCs) & Primary Health Centres (PHCs) are being transformed as Ayushman Bharat - Health & Wellness Centres (AB-HWCs) and 1, 50,000 AB-HWCs will be operationalized by December 2022.
Click to view the real time update on number of AB-HWCs across the country.
Key components of AB-HWCs
The delivery of comprehensive primary health care through AB-HWCs is complex task as it requires a paradigm shift at all levels of health system. The operationalization of AB-HWCs requires several inputs.
- Expanded Service delivery: AB-HWCs enable the expansion of the package of services that go beyond maternal and child health to include care for non -communicable diseases, palliative and rehabilitative care, Oral, Eye and ENT care, mental health and first level care for emergencies and trauma.
- Continuum of Care- Tele-health and referral:The delivery of comprehensive primary health care through AB- HWCs envisages a gatekeeping function, and a two-way referral system- that links to secondary and tertiary care and also follow up care. At all levels, teleconsultation are being done to improve referral advice, seek clarifications, and undertake virtual training including case management support by specialists.
- Expanding HR – CHO and multiskilling: A new cadre of worker Community Health Officer, trained in competencies of public health and primary health care has been posted at SHC-HWC. The Community Health Officer is expected to improve clinical management, continuum of care, dispensation of drugs and close follow up for those with chronic illness/patients discharged from health facilities . CHO leads the team of Multipurpose Workers, and ASHAs. All the service providers at AB-HWCs are being trained appropriately to deliver the expanded package of services to the community.
- Medicines and Expanding diagnostics: – Adequate availability of essential medicines and diagnostics enable medicine dispensation and necessary tests close to community. A total of 105 free and essential medicines at HWC-SHC and 172 medicines at HWC-PHC; and 14 diagnostic tests at HWC-SHC and 63 at HWC-PHCs are available for the community.
- Community Mobilization and Health Promotion – Health promotion at AB-HWCs is facilitated through engagement of community level collectives such as – VHSNCs, MAS and SHGs. Community mobilization, for action on social and environmental determinants, build on the accountability initiatives under NHM ensure that there is no denial of health care and universality and equity are respected
- Robust IT System- HWC team are equipped with IT equipment- Tablets at SCs and Laptop/ Desktop at PHC level to create electronic health record of the population covered by HWCs. Developing a robust IT system will support AB-HWC team to track patients for treatment adherence and follow up.
- Infrastructure – AB-HWCs are being upgraded and branded to provide sufficient space for expanded service delivery, for medicine dispensation, diagnostics organized, space for wellness related activities including the practice of yoga etc. with adequate spaces for display of communication material of health messages, including audio visual aids.
- Partnerships for knowledge and implementation- Partnerships with development partners and technical support agencies is being done to integrate AB-HWC in their domain. These partnerships provide implementation support to the states, research and advocacy of AB-HWC Program.
- Financing- provider payment reforms- Performance linked payment linked to the performance of AB-HWC team have been introduced at AB-HWCs to foster team spirit. It is a mechanism to promote demand of health care in the community and deliver optimum and timely care close to the community.