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.
Ayushman Bharat Health & Wellness Centres
- Ayushman Bharat Health & Wellness Centres (HWCs) is the one of the two components of Ayushman Bharat
- Ayushman Bharat is an attempt to move from a selective approach to health care to deliver comprehensive range of services spanning preventive, promotive, curative, rehabilitative and palliative care. It has two components which are complementary to each other.
- Under its first component, 1,50,000 Health & Wellness Centres (HWCs) will be created to deliver Comprehensive Primary Health Care, that is universal and free to users, with a focus on wellness and the delivery of an expanded range of services closer to the community.
- The second component is the Pradhan Mantri Jan Arogya Yojana (PM-JAY) which provides health insurance cover of Rs. 5 lakhs per year to over 10 crore poor and vulnerable families for seeking secondary and tertiary care.
- HWC are envisaged to deliver expanded range services that go beyond Maternal and child health care services 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 , including free essential drugs and diagnostic services
Expanded range of services
The expansion of services has been planned in incremental manner. As a first step, Screening, Prevention, Control and Management of Non-communicable Diseases and Chronic Communicable diseases like Tuberculosis and Leprosy has been introduced at HWCs.
- Care in pregnancy and childbirth.
- Neonatal and infant health care services
- Childhood and adolescent health care services.
- Family planning, Contraceptive services and Other Reproductive Health Care services
- Management of Communicable diseases: National Health Programs
- Management of Common Communicable Diseases and General Out-patient care for acute simple illnesses and minor ailments
- Screening, Prevention, Control and Management of Non-Communicable diseases and chronic communicable disease like TB and Leprosy
- Basic Oral health care
- Care for Common Ophthalmic and ENT problems
- Elderly and Palliative health care services
- Emergency Medical Services
- Screening and Basic management of Mental health ailment
Other services in HWCs
These centres will provide Comprehensive Primary Health Care (CPHC), by expanding and strengthening the existing Reproductive & Child Health (RCH) and Communicable Diseases services and by including services related to Non-Communicable Diseases (common NCDs such as, Hypertension, Diabetes and 3 common cancers of Oral, Breast and Cervix) and incrementally adding primary healthcare services for Mental health, ENT, Ophthalmology, Oral health, Geriatric and Palliative care and Trauma care as well as health promotion and wellness activities like yoga.
A few States/UTs have already started rolling out these additional packages in a phased manner.
Key Milestones
The first HWC was launched in Bijapur, Chhattisgarh on April 18th, 2018. In the first year, over 17,000 HWCs were operationalized, more than the target of 15,000 set for FY 2018-19.
Roll-out plan
Given the magnitude of inputs required to strengthen the primary health care facilities, the operationalization of HWC has been planned in a phased manner till the year 2022.
