What role is the Ayushman Bharat scheme playing in achieving that objective?

Ayushman Bharat is the umbrella health reform to achieve UHC. Originally, it had two major approaches – financial protection for hospital-based care for about 100 million families falling under lower socio-economic strata under Pradhan Mantri Jan Arogya Yojana (PMJAY) coupled with free access to comprehensive primary healthcare through 150,000 health and wellness clinics. While PMJAY will improve the percentage of people with financial cover, there are estimated 500 million people without any financial cover. Informal labour and self-employed people account for bulk of these – so called ‘missing middle’. There are efforts to address the cover for the missing middle. Since the majority of health insurance schemes cover hospital-based care, OOPHE may not decrease significantly despite an increase in financial coverage. Ayushman Bharat Digital Mission (ABDM) and Ayushman Bharat Health Infrastructure Mission (ABHIM) have been announced during Covid-19 pandemic to enable the goal of UHC. These are the major steps in a long journey towards UHC. How well these get implemented will determine whether we are progressing towards the goal of UHC. Health ID is the most critical of building blocks being developed under ABDM. Standards-based, interoperable health data linked to health ID will build personal health records (PHRs) over lifetime of a person. Patients will have the right to share their personal health data through a consent mechanism. More than the health ID, it is the robust national digital health architecture that is vital the for the future success of ABDM in transforming India’s health system. In addition to Health ID, it consists of other core building blocks, namely national professional and facility registers, consent manager, health information exchanges, and personal health records. Data privacy bill will address privacy and security issues. Health being a State subject, the success of these national reforms will depend purely on States implementing these reforms. Almost all states have come on board to implement PMJAY and Health and Wellness Clinics. ABDM is being just rolled out across various states. Lack of fiscal space and institutional capacities may hamper the roll out plans. Since private health sector accounts for more than 50% of healthcare, governments should engage private sector in collaborative and constructive way to achieve the UHC target by all the States. The overarching purpose of ACCESS Health International is to support various efforts in making our health systems stronger and more resilient. It has adopted a systems approach to achieve this. It undertook policy research and analysis to articulate potential solutions to transform India’s health systems. It shared its ideas and open source designs towards building a robust digital health architecture. It engaged various health system stakeholders (providers, payers, health tech producers etc.) in dialogue related to the national digital health program. It is trying to address the critical role of human resource capacity in implementing the ABDM.  Lives and livelihoods are inseparable