Context: It has been nearly three years since the School Health and Wellness Programme was launched under the Ayushman Bharat scheme, and so far only 15 of India’s States – less than half – have started weekly 40-minute classroom sessions with students, official sources from the Union Health Ministry said.
What is School Health and Wellness Programme?
- Schools play a critical role in helping students establish lifelong healthy behaviours. Recognizing the importance of this, school-based health promotion activities have been incorporated as a part of the Health and Wellness component of the Ayushman Bharat Programme.
- School Health & Wellness Programme (launched in Feb 2020) is being implemented in government and government aided schools in districts (including aspirational districts).
- Two teachers, preferably one male and one female, in every school, designated as “Health and Wellness Ambassadors” shall be trained to transact with school children, health promotion and disease prevention information on 11 thematic areas in the form of interesting joyful interactive activities for one hour every week.
About Ayushman Bharat Programme
- Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC).
- This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to “leave no one behind.”
- Ayushman Bharat is an attempt to move from a sectoral and segmented approach of health service delivery to a comprehensive need-based health care service.
- This scheme aims to undertake path-breaking interventions to holistically address the healthcare system (covering prevention, promotion and ambulatory care) at the primary, secondary and tertiary level.
- Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components, which are –
- Health and Wellness Centres (HWCs)
- Pradhan Mantri Jan Arogya Yojana (PM-JAY)
Health and Wellness Centers (HWCs)
- In February 2018, the Government of India announced the creation of 1,50,000 Health and Wellness Centres (HWCs) by transforming the existing Sub Centres and Primary Health Centres.
- These centres are to deliver Comprehensive Primary Health Care (CPHC) bringing healthcare closer to the homes of people. They cover both, maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services.
- Health and Wellness Centers are envisaged to deliver an expanded range of services to address the primary health care needs of the entire population in their area, expanding access, universality and equity close to the community.
- The emphasis of health promotion and prevention is designed to bring focus on keeping people healthy by engaging and empowering individuals and communities to choose healthy behaviours and make changes that reduce the risk of developing chronic diseases and morbidities.
Pradhan Mantri Jan Arogya Yojana (PM-JAY)
- The second component under Ayushman Bharat is the Pradhan Mantri Jan Arogya Yojna or PM-JAY as it is popularly known. This scheme was launched on 23rd September 2018 in Ranchi, Jharkhand by the Hon’ble Prime Minister of India, Shri Narendra Modi.
- Ayushman Bharat PM-JAY is the largest health assurance scheme in the world which aims at providing a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 10.74 crores poor and vulnerable families (approximately 50 crore beneficiaries) that form the bottom 40% of the Indian population.
- The households included are based on the deprivation and occupational criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas respectively.
- PM-JAY was earlier known as the National Health Protection Scheme (NHPS) before being rechristened.
- It subsumed the then existing Rashtriya Swasthya Bima Yojana (RSBY) which had been launched in 2008. The coverage mentioned under PM-JAY, therefore, also includes families that were covered in RSBY but are not present in the SECC 2011 database. PM-JAY is fully funded by the Government and cost of implementation is shared between the Central and State Governments.
Key Features of PM-JAY
- PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government.
- It provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India.
- Over 10.74 crore poor and vulnerable entitled families (approximately 50 crore beneficiaries) are eligible for these benefits.
- PM-JAY provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital.
- PM-JAY envisions to help mitigate catastrophic expenditure on medical treatment which pushes nearly 6 crore Indians into poverty each year.
- It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines.
- There is no restriction on the family size, age or gender.
- All pre–existing conditions are covered from day one.
- Benefits of the scheme are portable across the country i.e. a beneficiary can visit any empanelled public or private hospital in India to avail cashless treatment.
- Services include approximately 1,393 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician’s fees, room charges, surgeon charges, OT and ICU charges etc.
- Public hospitals are reimbursed for the healthcare services at par with the private hospitals
Key Findings of the Report
- Until December 2022, only 71 of 766 districts have achieved 100% HWA training targets, according to Ministry data. Only four States and UTs – Andhra Pradesh, Sikkim, Chandigarh, Dadra and Nagar Haveli – have achieved 100% coverage. Some States are on the road to achieving targets, like Rajasthan (99%), Uttarakhand (97%), and Haryana (92%).
- In 2022-23, over 300 districts have been targeted to be covered across 36 States and UTs,” a senior health ministry official said.
- In States like Chhattisgarh and West Bengal, the number of HWAs trained is at 8% and 9% respectively. States like Uttar Pradesh (29%), Karnataka (31%), Andaman and Nicobar Islands (32%) and Madhya Pradesh (34%) have also not met training targets.
- The Health Ministry is facing various challenges in implementing the programme.
- One major hindrance is that teachers at government schools are overworked. In Delhi for instance, the Health and Wellness Programme syllabus is in addition to the Happiness Curriculum, Desh Bhakti Curriculum, and Entrepreneurship Mindset Curriculum that schools are already implementing.
- Not all States have set aside the weekly time slot in the classroom schedule to conduct these programmes.
- There is currently no formal reporting structure or accountability to ensure that the syllabus is implemented
- The challenge is conducting adequate teacher training programmes while maintaining quality.
- The syllabus, designed by the National Council of Educational Research and Training (NCERT) in conjunction with the Ministry of Health and the Ministry of Human Resource Development (HRD) covers 11 core themes including managing emotional and mental health, navigating interpersonal relationships, and promoting the safe use of internet and social media.