LitCovid-sentences  

PMC:7340764 / 8478-22587 JSONTXT 12 Projects

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Id Subject Object Predicate Lexical cue
T49 0-79 Sentence denotes Health & Wellness Centres (HWCs) and Comprehensive Primary Health Care in India
T50 80-223 Sentence denotes The first HWCs was launched in Jangla village in Bhairamgarh tehsil of Bijapur district of Chhattisgarh state in India on 14 April 2018 [1, 4].
T51 224-290 Sentence denotes The key events related to HWCs in India are summarized in Table 1.
T52 291-424 Sentence denotes As part of HWC components of ABP, the govt of India announced to make existing 150,000 GPHCFs in country functional by December 2022.
T53 425-617 Sentence denotes AB-HWCs are not new facilities and are being set up as an upgraded version of existing GPHCFs such as Health Sub-Centers (HSC); Primary Health Centers and Urban Primary Health Centers (UPHCs).
T54 618-828 Sentence denotes The proposed increase in provision of services (shift from erstwhile provision of 6 sub-group of services to 12 sub-group of services) and upgrade on other key design aspects are shown in Figs. 2 and 3 [1, 31].
T55 829-905 Sentence denotes Table 1 Evolution of Health & Wellness Centres (HWCs) in India [1, 3, 4, 30]
T56 906-936 Sentence denotes Timeline Specific developments
T57 937-1025 Sentence denotes July- Dec 2013 Initial discussion on Health and Wellness Centres (HWCs) in India started
T58 1026-1146 Sentence denotes 2015–16 Task Force on Primary Healthcare in India recommended formation of HWCs, with initial suggestions on the design.
T59 1147-1209 Sentence denotes 2017 India’s third National Health Policy (NHP 2017) released.
T60 1210-1264 Sentence denotes Union Budget announcement for setting up HWCs in India
T61 1265-1383 Sentence denotes 2018 HWC became one of the two pillars under Ayushman Bharat (AB) program announced in Union Budget on 1 February 2018
T62 1384-1474 Sentence denotes 14 April 2018 Inauguration of India’s first AB-HWC at Jangla, Bijapur, Chhattisgarh, India
T63 1475-1544 Sentence denotes 31 March 2019 A total of 17,149 AB-HWCs made functional across India.
T64 1545-1685 Sentence denotes This includes 8,801 Primary Health Centres; 6,795 Health Sub-centres (HSC) and 1,553 Urban Primary Health Centres (UPHCs) converted to HWCs.
T65 1686-1793 Sentence denotes 2019–20 25,000 additional AB-HWCs to be set up with all UPHC to be converted to HWCs in the financial year.
T66 1794-1845 Sentence denotes A total of 38,595 HWCs were set up by 31 March 2020
T67 1846-1926 Sentence denotes 31 December 2022 Indian states to have 150,000 functional AB-HWCs in the country
T68 1927-1986 Sentence denotes Fig. 2 Key components and design aspects of AB-HWCs [1, 31]
T69 1987-2035 Sentence denotes Fig. 3 Service provision through AB-HWCs [1, 31]
T70 2036-2152 Sentence denotes Against the target of 15,000 of HWC in year 1, a total of 17,149 AB-HWCs were made functional by 31 March 2019 [30].
T71 2153-2215 Sentence denotes Cumulative target of 40,000 HWCs was set up for 31 March 2020.
T72 2216-2353 Sentence denotes There was slow-down in setting up HWCs in March 2020 due to COVID-19 pandemic and total of 38,595 HWCs were operational by 31 March 2020.
T73 2354-2471 Sentence denotes The cumulative target is 70,000 HWCs by 31 March 2021, then 110,000 by 31 March 2022 and 150,000 by 31 December 2022.
T74 2472-2552 Sentence denotes Alongside, all UPHC across India were to be converted to HWCs by March 2020 [1].
T75 2553-2726 Sentence denotes Official data on utilization of services from HWCs was available till 22 Sept 2019, when nearly 21,000 AB-HWCs were operational which had reported a foot-fall of 17 million.
T76 2727-2993 Sentence denotes In these Centres 950,000 yoga sessions were conducted; 7 million people received treatment for hypertension and 3.1 million for diabetes mellitus, Sixteen million beneficiaries received essential medicines and 4.9 million received free essential diagnostics [1, 32].
T77 2994-3119 Sentence denotes The second component of AB-PMJAY was launched on 23 Sept 2018 and progress on this component is summarised in Box 2 [32, 33].
T78 3120-3231 Sentence denotes Box 2 Progress under Pradhan Mantri Jan Arogya Yojana (PMJAY) component of Ayushman Bharat in India [1, 32, 33]
T79 3232-3306 Sentence denotes Ayushman Bharat Program, from the time of announcement has two components.
T80 3307-3406 Sentence denotes Other than Ayushman Bharat- Health and Wellness Centres (AB-HWC), AB-PMJAY is the second component.
T81 3407-3508 Sentence denotes It has built upon the erstwhile Rashtriya Swasthya Bima Yojana (RSBY), started in year 2008 in India.
T82 3509-3620 Sentence denotes Even since announcement of ABP, the scheme has witnessed a few evolutions in name before settling for AB-PMJAY.
T83 3621-3881 Sentence denotes It was announced as AB-National Health Protection scheme or AB-NHPS in February 2018, renamed as National Health Protection Mission (AB-NHPM) in early March 2018 and then Pradhan Mantri Rashtriya Swasthya Suraksha Mission (PM-RSSM) in third week of March 2018.
T84 3882-4050 Sentence denotes In mid August 2018, it was referred as Pradhan Mantri Jan Aarogya Abhiyan (PMJAA) (15 August 2018) before finally being renamed as AB-PMJAY towards the end of Aug 2018.
T85 4051-4132 Sentence denotes AB-PMJAY provides health cover of up to INR 500,000 (Exchange rate in April 2020:
T86 4133-4147 Sentence denotes 1 USD= approx.
T87 4148-4307 Sentence denotes 75 INR) per family per year on floater basis; covers 3-day pre-hospitalization and 15 d post hospitalization; expenses on medicines, follow up and diagnostics.
T88 4308-4421 Sentence denotes One thousand three hundred ninety three procedures in 24 specialties were part of the scheme, as on October 2019.
T89 4422-4537 Sentence denotes There is no cap on family size, age or gender, cashless and paperless treatment for beneficiaries at point of care.
T90 4538-4606 Sentence denotes Benefits are portable across the country in the empaneled hospitals.
T91 4607-4857 Sentence denotes The scheme was announced in Union Budget of India on 1 February 2018; Cabinet approval was received on 21 March 2018; National Health Agency got incorporated on 11 May 2018; AB-PMJAY was formally launched on 23 September 2018, from Ranchi, Jharkhand.
T92 4858-4954 Sentence denotes On completion of 100 d of launch on 2 January 2019; National Health Authority or NHA was formed.
T93 4955-5071 Sentence denotes At 1 y of completion of AB-PMJAY on 22 Sept 2019; a total of 32 states of 36 states/UT were implementing the scheme.
T94 5072-5122 Sentence denotes One hundred and three million e-cards were issued.
T95 5123-5338 Sentence denotes There were 18,236 hospitals empaneled [8,571 (47%) public and 9,665 (53%) private] and there were 4.65 million total hospital admissions with 2.18 million (47%) in govt. and 2.47 million (53%) in private facilities.
T96 5339-5525 Sentence denotes The total treatment equal to Indian Rupee (INR) 7,490 Cr (US$ 1.07 billion) was provided, which included INR 2,846 Cr (38%) in Public and INR 4,644 Cr (62%) in private sector facilities.
T97 5526-5728 Sentence denotes The HWCs aims to address the identified challenges in PHC systems in India, by focusing upon holistic PHC strengthening through various initiatives [Table 2 (structured as per health system functions)].
T98 5729-5799 Sentence denotes This is not first such initiative to strengthen PHC services in India.
T99 5800-5967 Sentence denotes Yet, why AB-HWCs appears more promising than all earlier initiatives to strengthen and deliver comprehensive PHC has been explained in Appendix 1 [1, 3, 27–29, 31–37].
T100 5968-6145 Sentence denotes This is relevant considering much of 14 y since the launch of National Rural Health Mission (NRHM) in the year 2005, had also focused on strengthening PHC system in the country.
T101 6146-6263 Sentence denotes Table 2 Challenges in PHC system, provisions through AB-HWCs and complementarity with NHM in India [1, 3, 27, 28, 31]
T102 6264-6433 Sentence denotes Health System Function Challenges in PHC system (Indicative) AB-HWC and related initiatives Ongoing and other proposed initiatives (including NHM & other state specific)
T103 6434-6563 Sentence denotes Service provision and delivery ▪ Narrow range of six services (mostly focused on Maternal & child health and infectious diseases)
T104 6564-6592 Sentence denotes ▪ Curative care predominance
T105 6593-6764 Sentence denotes ▪ ‘Continuum of care’ mostly for maternal and child health services ▪ Stronger focus on service delivery with an enhanced package of 12 services (from existing 6 services)
T106 6765-6901 Sentence denotes ▪ Attention on preventive and promotive health services; focus on wellness and lifestyle modification, specifically for chronic diseases
T107 6902-7051 Sentence denotes ▪ Integration with Indian systems of medicine, AYUSH, including the promotion of Yoga as form of lifestyle change to tackle non-communicable diseases
T108 7052-7126 Sentence denotes ▪ Population based screening for common conditions including three cancers
T109 7127-7241 Sentence denotes ▪ Attention on quality and patient safety; Develop standard treatment flows (STF) for peripheral health facilities
T110 7242-7302 Sentence denotes ▪ Extending prescription rights to CHO through legal process
T111 7303-7474 Sentence denotes ▪ Adopt ‘Resolve more & refer less’ approach at peripheral health facilities; strengthening of referral system to ensure continuity of care; Telemedicine and consultations
T112 7475-7657 Sentence denotes ▪ Enhanced provision of point of care diagnostics at both levels HWC- HSC and HWC-PHC ▪ Community based network of ASHA and VHNSC to support preventive and promotive health services.
T113 7658-7728 Sentence denotes ▪ State specific models of service delivery to provide cross learnings
T114 7729-7807 Sentence denotes ▪ Build on systems for emergency referral and transport; established under NHM
T115 7808-7910 Sentence denotes ▪ Utilise strengthening of secondary care services & District hospitals for effective referral linkage
T116 7911-7995 Sentence denotes ▪ Build upon quality standards and mechanism for ensuring use of treatment protocols
T117 7996-8128 Sentence denotes ▪ Community Health Officers (CHO) proposed in the National Medical Commission (NMC) Act to strengthen public health service delivery
T118 8129-8212 Sentence denotes Human resources and infrastructure ▪ Shortage of infrastructure and human resources
T119 8213-8239 Sentence denotes ▪ Inequitable distribution
T120 8240-8358 Sentence denotes ▪ Health Sub-centres (HSCs) led by one or two Auxiliary nurse midwife (ANM) who has focus on Mother and child services
T121 8359-8549 Sentence denotes ▪ Narrow range of skills and services at lower level PHC facilities ▪ Provision of Mid-level healthcare provider (MLHP), trained in 6-month course at AB-HWCs to address common health problem
T122 8550-8619 Sentence denotes ▪ Institutional strengthening for increased annual production of MLHP
T123 8620-8710 Sentence denotes ▪ Task shifting to different cadre of healthcare providers and team-based service delivery
T124 8711-8793 Sentence denotes ▪ Proposal to change the roles of ANMs as multi-purpose workers (female) or MPW- F
T125 8794-8974 Sentence denotes ▪ Services at the HWC-HSC, to be delivered through a team, led by a new cadre of non-physician health worker, a MLHP or CHO, supported by one or two multipurpose workers, and ASHAs
T126 8975-9106 Sentence denotes ▪ Shift from doctor centric facilities to a team-based service delivery where provision of providers is dependent upon service need
T127 9107-9211 Sentence denotes ▪ AYUSH providers to be mainstreamed in PHC systems ▪ Recruitment of contractual providers in the system
T128 9212-9285 Sentence denotes ▪ Flexibility to states in salary for HR, under NHM to ensure recruitment
T129 9286-9340 Sentence denotes ▪ Institutionalize the mechanisms for training of MLHP
T130 9341-9469 Sentence denotes ▪ Consider an All India cadre of specialist doctors to tackle shortage of specialist doctors & that of public health specialists
T131 9470-9544 Sentence denotes ▪ Innovation in human resources including incentives to recruit and retain
T132 9545-9600 Sentence denotes Health financing ▪ Limited government funding on health
T133 9601-9660 Sentence denotes ▪ High OOPE to the range of 60% of total health expenditure
T134 9661-9705 Sentence denotes ▪ Budget mostly line item-based funding only
T135 9706-9752 Sentence denotes ▪ Limited use of strategic purchasing services
T136 9753-9916 Sentence denotes ▪ People get poor because of health expenditures ▪ Reforms on provider payment mechanisms including the introduction of performance-linked incentives in PHC system
T137 9917-10036 Sentence denotes ▪ Mechanisms to reduce cost of health seeking through assured provision of more medicines and point of care diagnostics
T138 10037-10117 Sentence denotes ▪ Performance-linked payments to the MLHP and to the team of front-line workers.
T139 10118-10432 Sentence denotes ▪ MLHP to get salary on blended formula –a fixed component and incentives linked to key outcomes, measured through IT platform-based monitoring system with key performance indicators ▪ Increased government allocation for primary health care, through formula-based approach and sharing between union and state level
T140 10433-10482 Sentence denotes ▪ Capacity building of states in health financing
T141 10483-10618 Sentence denotes Medicines and vaccines ▪ Many states started free medicines and diagnostics scheme, yet govt spending as share on cost of medicines low
T142 10619-10715 Sentence denotes ▪ Medicines and access to diagnostics mostly at higher level facilities and no assured provision
T143 10716-10753 Sentence denotes ▪ Medicines major cost paid by people
T144 10754-10851 Sentence denotes ▪ Irrational use of medicines ▪ Revision and expansion of essential medicines & diagnostics lists
T145 10852-10961 Sentence denotes ▪ Assured provision of larger basket of medicines with inclusion of additional medicines for chronic diseases
T146 10962-11031 Sentence denotes ▪ Assured dispensing of medicines for longer duration of 4 wk or more
T147 11032-11101 Sentence denotes ▪ Attention on expanded range of diagnostic services of Point of Care
T148 11102-11203 Sentence denotes ▪ Proposal for rapid expansion of Pradhan Mantri Jan Aushadhi stores for low cost & generic medicines
T149 11204-11277 Sentence denotes ▪ Proposal for setting up state level procurement and supply corporations
T150 11278-11501 Sentence denotes ▪ Provision of dispensing medicines from HWCs, for patients who need long term treatment and initially attended care at higher level of facilities ▪ Provision of free medicines and diagnostics (as well as schemes) under NHM
T151 11502-11616 Sentence denotes ▪ Strengthening of Mission Indradhanush for increasing coverage with vaccines under Universal Immunization Program
T152 11617-11722 Sentence denotes ▪ Launch of state specific free medicines and free diagnostics schemes with enhanced budgetary allocation
T153 11723-11782 Sentence denotes Health information systems ▪ Weak health information system
T154 11783-11813 Sentence denotes ▪ Limited use of ICT platforms
T155 11814-11978 Sentence denotes ▪ Delay in recording and reporting of health data ▪ Attention to build a robust ICT system for population enumeration, enrolment, tracking and follow-up of patients
T156 11979-12050 Sentence denotes ▪ Attention on registration of beneficiaries at associated HWC facility
T157 12051-12115 Sentence denotes ▪ Increased use of mobile based technology and hand-held devices
T158 12116-12177 Sentence denotes ▪ Provision of tele-health and tele-medicine at each facility
T159 12178-12518 Sentence denotes ▪ Use of Digital technology and ICT platforms (proposed for) to ensure continuity of care through universal population empanelment and registration to a HWC, facilitating performance payments and ensuring continuity of care and also for improved recording & reporting system ▪ Telemedicine and tele-radiology services as per the local needs
T160 12519-12576 Sentence denotes ▪ Health Management Information System (HMIS) established
T161 12577-12620 Sentence denotes Governance and leadership ▪ Weak regulation
T162 12621-12671 Sentence denotes ▪ Limited transition of policy into implementation
T163 12672-12716 Sentence denotes ▪ Health state subject and variable priority
T164 12717-12893 Sentence denotes ▪ The job -descriptions of various health staff are not aligned with the activities they do ▪ High level political and administrative priority assigned to AB-HWCs at all levels
T165 12894-12979 Sentence denotes ▪ System and coordination mechanism being proposed to link PHC services with AB-PMJAY
T166 12980-13051 Sentence denotes ▪ National Knowledge Platform for implementation & operational research
T167 13052-13089 Sentence denotes ▪ Revisions of operational guidelines
T168 13090-13140 Sentence denotes ▪ Enhanced community-based monitoring for AB-HWCs.
T169 13141-13186 Sentence denotes ▪ Regular reviews on progress and performance
T170 13187-13453 Sentence denotes ▪ Revision in responsibilities of auxiliary nurse midwife to make them multi-purpose workers ▪ A number of governance and leadership mechanisms were established under NHM level including mission steering groups at top level to community based VHSNC at village level.
T171 13454-13520 Sentence denotes ▪ The Clinical Establishment Registration and Regulation Act, 2010
T172 13521-13592 Sentence denotes ▪ Stronger community and civil society participation in health services
T173 13593-14109 Sentence denotes AB-HWCs Ayushman Bharat- Health & Wellness Centres; AB-PMJAY Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana; ASHA Accredited Social Health Activist; HR Human resources; HWC-HSC Health & Wellness Centres- Health Sub-Centers; HWC-PHC Health & Wellness Centres- Primary Health Care; ICT Information and communication technology; NHM National Health Mission; NMC Act The National Medical Commission Act; OOPE Out of pocket expenditure; PHC Primary Health care; VHNSC Village health, nutrition and sanitation committee