Pradhan Mantri Swasthya Suraksha Nidhi

The Union Cabinet approves the Pradhan Mantri Swasthya Suraksha Nidhi (PMSSN).

About Pradhan Mantri Swasthya Suraksha Nidhi(PMSSN):

• This program will ensure access to universal & affordable health care through a fund that does not lapse at the end of the financial year.

Features:

• It has been set up as a single non-lapsable reserve fund for a share of Health.
• It will be made from the share of health in the proceeds of Health and Education Cess.
• The fund will be administered and maintained by the Ministry of Health & Family Welfare
• Finance Minister announced the 4% Health and Education Cess during the Budget 2018-19.
• It replaced the existing 3% Education Cess.

How will the fund be utilised?

• The fund will be utilized for the following flagship schemes of the Ministry of Health & Family Welfare:
  • Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
  • Ayushman Bharat – Health and Wellness Centres (AB-HWCs)
  • National Health Mission
  • Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
  • Emergency & disaster preparedness and responses during health emergencies
  • Any future programme/scheme that targets to achieve progress towards SDGs and the targets set out in the National Health Policy (NHP) 2017.

Ayushman Bharat–PM Jan Arogya Yojana

• Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a Centrally Sponsored Scheme having a central sector component under the Ayushman Bharat Mission anchored in the Ministry of Health and Family Welfare (MoHFW).
• It is an umbrella of two major health initiatives, namely Health and wellness Centres and National Health Protection Scheme.

National Health Protection Mission (AB-PMJAY)

• AB-PMJAY provides a defined benefit cover of Rs. 5 lakh per family per year.
• This cover will take care of almost all secondary care and most of the tertiary care procedures.
• To ensure that nobody is left out (especially women, children and the elderly) there will be no cap on family size and age in the scheme.
• The benefit cover will also include pre and post-hospitalisation expenses.
• All pre-existing conditions will be covered from day one of the policy.
• A defined transport allowance per hospitalization will also be paid to the beneficiary.
• Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public/private empanelled hospitals across the country.
• All public hospitals in the States implementing AB-PMJAY, will be deemed empanelled for the Scheme.
• As for private hospitals, they will be empanelled online based on defined criteria.
• States/ UTs will have the flexibility to modify these rates within a limited bandwidth.

Key components of AB-HWC:

• A new cadre of health care professionals- referred to as the Mid-Level Health Provider- who is a nurse or an Ayurvedic Practitioner trained and accredited for a set of competencies related to primary health care and public health.
• Mid-Level Health Provider will lead the team of MPWs and ASHAs at SHC level
• Multiskilling/ Training of existing service providers - upgrading skills to provide an expanded package of services
• Efficient logistics system to ensure availability of a wide range of drugs and point-of-care diagnostics.
• Robust IT system to create unique health id and longitudinal health record of all individuals and provision of teleconsultation services
• Provision of services related to the indigenous health system and yoga etc for promotion of wellness
• Linkages with schools to train Health and Wellness Ambassadors to enable creating healthy habits in schools

The package of services envisaged at AB-HWC are:

• 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 including National Health Programmes
• Outpatient care for acute simple illness and minor ailments.
• Screening, Prevention, Control and Management of non-communicable diseases.
• Care for Common Ophthalmic and ENT problems
• Basic Oral health care
• Elderly and palliative health care services
• Emergency Medical Services
• Screening and Basic management of Mental health ailments

Pradhan Mantri Swasthya Suraksha Yojana

• The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) aims at correcting the imbalances in the availability of affordable healthcare facilities in the different parts of the country.
• The first phase in the PMSSY has two components - the setting up of six institutions in the line of AIIMS.

National Health Mission

• National Health Mission (NHM) was launched by the government of India in 2013 subsuming the National Rural Health Mission and the National Urban Health Mission.
• The main programmatic components include Health System Strengthening in rural and urban areas.
  • (RMNCH+A), and Communicable and Non-Communicable Diseases.
• The National Health Mission seeks to ensure the achievement of the following indicators:
  • Reduce MMR to 1/1000 live births
  • Reduce IMR to 25/1000 live births
  • Reduce TFR to 2.1
  • Prevention and reduction of anaemia in women aged 15–49 years
  • Prevent and reduce mortality & morbidity from communicable, non-communicable; injuries and emerging diseases
  • Reduce household out-of-pocket expenditure on total health care expenditure
  • Reduce annual incidence and mortality from Tuberculosis by half
  • Reduce the prevalence of Leprosy to <1/10000 population and incidence to zero in all districts
  • Annual Malaria Incidence to be <1/1000
  • Less than 1 per cent microfilaria prevalence in all districts
  • Kala-azar Elimination by 2015, <1 case per 10000 population in all blocks

National Health Policy -2017

Objectives

• Improve health status through concerted policy action in all sectors and expand preventive, promotive, curative, palliative and rehabilitative services provided through the public health sector with a focus on quality.
• Increase Life Expectancy at birth from 67.5 to 70 by 2025.
• Disability Adjusted Life Years (DALY) Index as a measure of the burden of disease and its trends by major categories by 2022.
• Reduction of TFR to 2.1 at the national and sub-national level by 2025.
• Reduce Under Five Mortality to 23 by 2025 and MMR from current levels to 100 by 2020.
• Reduce infant mortality rate to 28 by 2019.
• Reduce neonatal mortality to 16 and the stillbirth rate to “single-digit” by 2025.
• Achieve the global target of 2020 which is also termed as the target of 90:90:90, for HIV/AIDS i. e,- 90% of all people living with HIV know their HIV status, – 90% of all people diagnosed with HIV infection receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression.
• To achieve and maintain a cure rate of >85% in new sputum-positive patients for TB and reduce the incidence of new cases, to reach elimination status by 2025.
• To reduce the prevalence of blindness to 0.25/ 1000 by 2025 and disease burden by 1/3 from current levels.
• To reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.
• Increase utilization of public health facilities by 50% from current levels by 2025.
• Antenatal care coverage to be sustained above 90% and skilled attendance at birth above 90% by 2025.
• More than 90% of newborn are fully immunized by one year of age by 2025.
• Meet the need for family planning above 90% at the national and sub-national levels by 2025.
• The relative reduction in the prevalence of current tobacco use by 15% by 2020 and 30% by 2025.
• Reduction of 40% in the prevalence of stunting of under-five children by 2025.
• Reduction of occupational injury by half from current levels of 334 per lakh agricultural workers by 2020.
• Increase health expenditure by Government as a percentage of GDP from the existing 1.15% to 2.5 % by 2025.
• Increase state sector health spending to > 8% of their budget by 2020.
• Ensure availability of paramedics and doctors as per the Indian Public Health Standard (IPHS) norm in high-priority districts by 2020.
• Increase community health volunteers to population ratio as per IPHS norm, in high priority districts by 2025.
• Establish primary and secondary care facilities as per norms in high-priority districts (population as well as time to reach norms) by 2025.
• Ensure the district-level electronic database of information on health system components by 2020.
• Establish federated integrated health information architecture, Health Information Exchanges and National Health Information Network by 2025.