Over 3 lakh ASHAs apply for Centre’s health cover

  • February 12, 2024
  • Posted by: OptimizeIAS Team
  • Category: DPN Topics
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Over 3 lakh ASHAs apply for Centre’s health cover

Subject: Schemes

Section: Health

Context:

  • The Indian government has decided to extend the Ayushman Bharat free public health cover scheme to include Accredited Social Health Activists (ASHAs), as well as Anganwadi workers and helpers.
  • The Health Ministry has already collected Aadhaar details for 23 lakh Anganwadi personnel and over three lakh ASHA workers from different states.

Key component:

  • The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) extends health coverage up to ₹5 lakh annually to poor and vulnerable families, recently expanded to include healthcare workers as announced by Finance Minister during the interim Union Budget 2024-25.
  • The ASHA program, pivotal in community health, has significantly contributed to healthcare access and played a crucial role during the COVID-19 pandemic.
  • As of December 31, 2023, India had over 13 lakh Anganwadi workers, over 10 lakh helpers, and 9.83 lakh ASHAs, making it the largest community volunteer program globally.
  • Currently, 55 crore individuals across 12 crore families benefit from AB-PMJAY, with states/UTs expanding this at their expense.
  • Up to December 20, 2023, about 28.45 crore Ayushman cards have been issued, leading to 6.11 crore hospital admissions valued at ₹78,188 crore, including 1.7 crore admissions in 2023 worth over ₹25,000 crore.
  • The scheme has also achieved gender equity in healthcare access, with women making up about 49% of Ayushman cardholders and 48% of hospital admissions, across 26,901 empanelled hospitals, including 11,813 private ones.

Accredited Social Health Activists (ASHA):

  • The ASHA program was launched in 2005-06 as part of the National Rural Health Mission, initially in rural areas.
  • It was later extended to urban settings with the introduction of the National Urban Health Mission in 2013.
  • The ASHA programme was introduced as a key component of the community process intervention and now it has emerged as the largest community health worker programme in the world and is considered a critical contribution to enabling people’s participation in health.
  • As of June 2022, there are over 10.52 Lakh ASHAs in all states/UTs (except Goa).
  • Role of ASHA:
    • ASHA is a community-level worker whose role is to function as a health care facilitator, and a service provider and to generate awareness on health issues.
    • Besides delivering key services to maternal child health and family planning, they also render important services under the National Disease Control Programme.
    • ASHA workers, all women, serve populations of approximately 1,000 in rural areas and 2,000 in urban settings, with room for local adjustments.
    • Generally, there is “1 ASHA per 1000 population”. However, this norm can be relaxed in tribal, hilly and desert areas to “1 ASHA per habitation” depending upon the workload.
  • Selection of ASHA:
    • ASHA must primarily be a woman resident of the village married/ widowed/ divorced, preferably in the age group of 25 to 45 years.
    • She should be a literate woman with due preference in selection to those who are qualified up to 10 standard wherever they are interested and available in good numbers. This may be relaxed only if no suitable person with this qualification is available.
    • ASHA workers are not recognized as the government’s “workers”, but are instead classified as holding an “honorary/volunteer” position.
  • Ayushman Bharat adopts a two-pronged approach:
    • Firstly, the creation of health and wellness centres to bring health care closer to homes.
    • Secondly, the formulation of a Pradhan Mantri Jan Arogya Yojana (PMJAY)to protect poor and vulnerable families against financial risk arising out of catastrophic health episodes.
  • PMJAY offers a sum insured of Rs.5 lakh per family for secondary care (which doesn’t involve a super specialist) as well as tertiary care (which does). For the beneficiaries, this is a free scheme.
  • It is an entitlement-based scheme that targets the beneficiaries as identified by latest Socio-Economic Caste Census (SECC) data.
  • Individuals can walk into any empanelled hospital that can process cashless payments.
  • Once identified by the database, the beneficiary is considered insured.
  • The insurance cost is shared by the centre and the state mostly in the ratio of 60:40.
  • Empanelled hospitals agree to the packaged rates under PMJAY—there are about 1,400 packaged rates for various medical procedures under the scheme.
    • These packaged rates also mention the number of average days of hospitalization for a medical procedure and supporting documents that are needed.
    • These rates are flexible, but once fixed hospitals can’t change it and under no circumstances can they charge the beneficiary. The scheme also has prescribed a daily limit for medical management.
  • National Health Agency has been constituted as an autonomous entity under the Society Registration Act, 1860 for effective implementation of PMJAY in alliance with state governments.

Source: TH

Over 3 lakh ASHAs apply for Centre’s health cover Schemes