9 Oct 2019

Ayushman Bharat –  Health and Wellness Centres

Source: Kurukshetra Magazine

Background

The National Health Policy, 2017 recommended strengthening the delivery of primary health care, through the establishment of “Health and Wellness Centres” as the platform to deliver comprehensive primary health care and called for a commitment of two-thirds of the health budget to primary health care. 

In order to expand access to Comprehensive Primary Health Care (CPHC), under Ayushman Bharat – Health and Wellness Centres (HWCs), Sub Health Centres (SHCs) and Primary Health Centres (PHCs) are being strengthened as Health and Wellness Centres (HWCs). 

Defining HWCs

To ensure delivery of Comprehensive Primary Health Care (CPHC) services, existing Sub Centres covering a population of 3000 -5000 would be converted to Health and Wellness Centres, with the principle being “time to care” to be no more than 30 minutes. Primary Health Centres in rural and urban areas would also be converted to HWC. Such care could also be provided/ complemented through outreach services, Mobile Medical Units, camps, home and community-based care, but the principle should be a seamless continuum of care that ensures the principles of equity, universality and no financial hardship.

Key features

  • The HWCs are to provide preventive, promotive, rehabilitative and curative care for an expanded range of services encompassing reproductive and child health services, communicable diseases, non-communicable diseases, palliative care and elderly care, oral health, ENT care, and basic emergency care. 
  • The services in HWCs will be provided through a Mid-level Health Care Provider (MLHP)/Community Health Officer (CHO) placed at an HWC-SHC and Medical Officer at PHC (Rural/Urban). The MLHP/CHO will undergo a Certificate in Community Health through IGNOU or public university.

 The expanded services

The HWC would deliver an expanded range of services. These services would be delivered at both SHCs and in the PHCs, which are transformed as HWCs. The level of complexity of care of services delivered at the PHC would be higher than at the sub-health center level and this would be indicated in the care pathways and standard treatment guidelines that will be issued periodically.

Expanded range of services

  1. Care in pregnancy and child-birth.
  2. Neonatal and infant health care services
  3. Childhood and adolescent health care services.
  4. Family planning, Contraceptive services and other Reproductive Health Care services
  5. Management of Communicable diseases including National Health Programmes
  6. Management of Common Communicable Diseases and Outpatient care for acute simple illnesses and minor ailments.
  7. Screening, Prevention, Control and Management of Non-Communicable diseases
  8. Care for Common Ophthalmic and ENT problems
  9. Basic Oral health care
  10. Elderly and Palliative health care services
  11. Emergency Medical Services
  12. Screening and Basic management of Mental health ailments

Key elements