 "Interim Budget: Over 3 mn ASHA, anganwadi workers now in Ayushman Bharat")
More than three million Accredited Social Health Activists (ASHA), anganwadi workers and helpers are set to benefit from healthcare coverage under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Union Finance Minister Nirmala Sitharaman announced in the Interim Budget 2024-25 that the healthcare cover provided by the scheme will now be extended to include everybody in this segment.
The Ministry of Health and Family Welfare (MoHFW) saw a 12.59 per cent increase in its outlay, reaching Rs 90,657 crore compared to the Revised Estimates (RE) of 2023-24. Compared to the budgetary estimates of 2023-24, the health outlay is, however, flat (it is up only 1.7 per cent).
The Department of Pharmaceuticals under the Ministry of Chemicals and Fertilisers, meanwhile, saw a 51.5 per cent increase to Rs 4,089 crore compared to RE 2023-24. This surge is mainly attributed to the doubling of production-linked incentives (PLI) for pharmaceuticals to Rs 2,000 crore, a 146 per cent increase in Jan Aushadhi scheme allocations, and a Rs 1,000 crore outlay for the promotion of bulk drug parks. Allocations for the Ministry of Ayush also rose by 23.7 per cent compared to RE 2023-24, reaching Rs 3,712.49 crore.
The finance minister emphasised the government's commitment to various healthcare initiatives, including encouraging vaccination for 9- to 14-year-old girls to prevent cervical cancer, establishing more medical colleges using existing hospital infrastructure, consolidating maternal and childcare schemes into one comprehensive programme, and upgrading anganwadi centres for improved nutrition delivery, and early childhood care and development. Also, the newly designed U-WIN platform will be employed for managing immunisation, and Mission Indradhanush efforts will be rapidly implemented nationwide.
Co-payment options
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Industry experts believe that introducing a co-payment option could enhance hospital participation in AB-PMJAY.
With over 1 million ASHA workers in rural and urban areas, 1.3 million anganwadi workers, and 1.1 million helpers, AB-PMJAY provides a cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation across public and private empanelled hospitals in India.
Over 120 million poor and vulnerable families (around 550 million beneficiaries) are eligible for these benefits. As of January 2024,the government has issued more than 300 million Ayushman Bharat cards, with women constituting 49 per cent of the beneficiaries.
Pointing to the low coverage of the urban poor under the Ayushman Bharat scheme, Giridhar Gyani, founder director of the Association of Healthcare Providers, said, “If patients are allowed to bear some part of the cost (co-payment), then more hospitals would come on board.” Currently, 24,000-odd hospitals are empanelled under AB-PMJAY, he added.
Cervical cancer vaccine
In a targeted effort to reduce the burden of cervical cancer, the finance minister also announced a push for the human papillomavirus (HPV) vaccine.
Cervical cancer, the second most frequent cancer among women in India after breast cancer, accounts for approximately one-fourth of all cervical cancer deaths globally.
An estimated 5 per cent of women in the general population have cervical HPV‐16/18 infection at any given time. With 483.5 million women aged 15 years and older, who are at risk of developing cervical cancer in India, current estimates reveal that there are 123,907 new cases and 77,348 deaths from the disease every year.
Last month, the Union health ministry said that it was closely monitoring incidences of cervical cancer in the country and was in regular touch with states and various health departments on this.
In December 2017, the National Technical Advisory Group for Immunisation (NTAGI) had recommended that the HPV vaccine be introduced in the Universal Immunisation Programme (UIP). In June 2022, NTAGI again recommended introducing the vaccine in UIP.
Currently, MSD Pharmaceuticals’ Gardasil (Rs 3,927 per dose) and Serum Institute of India’s (SII) Cervavac (Rs 2,000) is available in the private market. SII confirmed that it is not supplying the vaccine to the Centre yet.
Reacting to the Interim Budget, SII CEO Adar Poonawalla tweeted: “I applaud the Indian government's announcement to vaccinate girls aged 9-14 against cervical cancer. Let's pledge to prevent HPV and ensure easy access to vaccination.”
Sangita Reddy, joint managing director, Apollo Hospitals Group, said they planned to raise awareness about cervical cancer vaccination through various campaigns and programmes to ensure women’s well-being.