Master10
Public Health, Nutrition & Epidemics Module

Ayushman Bharat & National Health Policies

The Ayushman Bharat initiative, launched in 2018 pursuant to the National Health Policy 2017 recommendations, represents a structural shift from segmented healthcare delivery to an integrated continuum-of-care model. It rests on two fundamental pillars: Ayushman Arogya Mandirs (formerly Health and Wellness Centres) for comprehensive primary healthcare, and the Pradhan Mantri Jan Arogya Yojana (PM-JAY). PM-JAY is the world's largest government-funded health assurance scheme, offering secondary and tertiary hospitalization coverage of up to five lakh rupees per eligible beneficiary family annually. Complemented by the Ayushman Bharat Digital Mission, which implements Ayushman Bharat Health Account IDs, the architecture strengthens health records interoperability and equitable access across public and empanelled private hospitals.

Key Concepts & Examination Highlights

  • Ayushman Bharat PM-JAY provides health cover of ₹5 lakh per family per year for secondary and tertiary hospital care.
  • The National Health Policy (NHP) 2017 set the goal of increasing public health expenditure to 2.5% of GDP.
  • The Ayushman Bharat Health Account (ABHA) is a 14-digit unique health identifier under the Ayushman Bharat Digital Mission.
  • National Health Authority (NHA) is the apex statutory body responsible for implementing PM-JAY and ABDM.
  • Ayushman Bharat was launched in September 2018 based on the recommendations of the National Health Policy 2017 to achieve Universal Health Coverage (UHC).
  • The first pillar of Ayushman Bharat established 150,000 Ayushman Arogya Mandirs (formerly Health and Wellness Centres) to deliver Comprehensive Primary Health Care (CPHC) and free essential drugs and diagnostics.
  • PM-JAY beneficiary eligibility is determined by the deprivation and occupational criteria of the Socio-Economic Caste Census (SECC) 2011 for rural and urban areas.
  • PM-JAY is a completely cashless and paperless health assurance scheme, fully portable across all empaneled public and private hospitals across India.
  • The Ayushman Bharat Digital Mission (ABDM) enables longitudinal electronic health records through the Unified Health Interface (UHI) and Health Facility Registry (HFR).
  • The National Health Policy 2017 targeted reducing the Maternal Mortality Ratio (MMR) to below 100 per 100,000 live births and the Infant Mortality Rate (IMR) to 28 by 2019.
  • Under PM-JAY, there is no restriction on family size, age, or gender, and pre-existing medical conditions are covered from the very first day of enrollment.
  • In 2024, the Union Cabinet expanded the Ayushman Bharat PM-JAY scheme to provide free universal health insurance coverage of Rs 5 lakh per year to all senior citizens aged 70 years and above, irrespective of their income.
  • The Ayushman Bharat Health Account (ABHA) number is a 14-digit unique health identifier that enables citizens to store and share digital health records seamlessly across verified healthcare providers.
  • The Unified Health Interface (UHI), developed under the Ayushman Bharat Digital Mission (ABDM), creates an open network for digital health services, enabling interoperable teleconsultations and e-prescriptions.
  • The National Digital Health Blueprint (NDHB), prepared by the J. Satyanarayana Committee in 2019, laid the architectural foundation for India's federated digital health infrastructure.
  • The National Health Policy (NHP) 2017 aims to increase life expectancy at birth from 67.5 to 70 years by 2025 and reduce the Total Fertility Rate (TFR) to 2.1 at national and sub-national levels.
  • The National Health Policy 2017 established the target of reducing Under-Five Mortality Rate (U5MR) to 23 per 1,000 live births and Infant Mortality Rate (IMR) to 28 per 1,000 live births by 2025.
  • The eSanjeevani National Telemedicine Service of the Ministry of Health and Family Welfare (MoHFW) provides doctor-to-doctor (Ayushman Arogya Mandir) and patient-to-doctor teleconsultation platforms across India.
  • The Pradhan Mantri National Dialysis Programme (PMNDP) was rolled out in 2016 to provide free hemodialysis services to below-poverty-line patients at district hospitals under a public-private partnership (PPP) model.
  • Janani Shishu Suraksha Karyakram (JSSK), launched in June 2011, guarantees completely free and zero out-of-pocket expenses for institutional delivery, drugs, diagnostics, blood, and transport to pregnant women and sick neonates.
  • The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides free, assured, and quality antenatal checkups to pregnant women on the 9th day of every month across designated public health facilities.
  • The Clinical Establishments (Registration and Regulation) Act, 2010 provides a statutory framework for mandatory registration and regulation of all clinical establishments in India to prescribe minimum standards of facilities and services.
  • The National Medical Commission (NMC) Act, 2019 repealed and replaced the Medical Council of India (MCI) to establish the National Medical Commission as India's apex medical education regulatory body.
  • The Reproductive, Maternal, Newborn, Child, and Adolescent Health Plus Nutrition (RMNCAH+N) strategy provides an integrated continuum-of-care framework across all life stages under the National Health Mission.
  • Free Drugs and Free Diagnostics Service Initiatives under the NHM assist states in providing essential medicines and laboratory tests free of charge at all public health facilities.
  • The National Health Policy (NHP) 2017 advocates establishing primary health care as the foundational tier, allocating two-thirds or more of government health resources to primary healthcare.
  • Ayushman Arogya Mandirs provide 12 essential health service packages covering maternal-child health, non-communicable diseases, mental health, and palliative elderly care.
  • Under PM-JAY, secondary and tertiary healthcare services are defined under comprehensive Health Benefit Packages (HBP), with standard treatment guidelines for over 1,900 medical procedures.
  • The National Health Claims Exchange (NHCX), developed by the National Health Authority (NHA), is a standardized digital platform for seamless, interoperable health insurance claims processing.
  • PM-JAY operates a national Anti-Fraud Unit (NAFU) and State Anti-Fraud Units (SAFU) that deploy artificial intelligence and audit algorithms to detect fraudulent hospitalization claims.
  • The Ayushman Bharat Digital Mission (ABDM) sandbox allows health-tech companies and hospitals to test software integrations with ABHA, HFR, and HPR in a secure digital environment.
  • The Healthcare Professionals Registry (HPR) under ABDM is a verified national digital database of modern and traditional medical doctors across all systems of medicine in India.
  • The Health Facility Registry (HFR) is a comprehensive national directory of verified public and private health facilities including hospitals, clinics, diagnostic labs, and pharmacies.
  • The National Health Mission (NHM) encompasses two major sub-missions: the National Rural Health Mission (NRHM, launched in 2005) and the National Urban Health Mission (NUHM, launched in 2013).
  • Accredited Social Health Activists (ASHAs) are community health workers deployed under the NHM across rural villages and urban slums to connect communities with public health services.
  • Auxiliary Nurse Midwives (ANMs) are female village-level health workers based at Sub-Centres and Ayushman Arogya Mandirs, delivering maternal-child care, family planning, and immunization.
  • The Janani Suraksha Yojana (JSY), launched in 2005 under the NRHM, provides direct conditional cash transfers to pregnant women in low-performing states to promote institutional deliveries.
  • The Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), launched in 2021, is India's largest pan-India health infrastructure scheme to strengthen health systems against pandemics.
  • PM-ABHIM establishes integrated public health laboratories (IPHLs) in all 730 districts and 50-bed critical care hospital blocks in districts with high disease burdens.
  • The National Health Systems Resource Centre (NHSRC), established in 2006, serves as the apex technical support agency for the Ministry of Health and Family Welfare and NHM implementation.
  • The Indian Public Health Standards (IPHS) prescribe mandatory infrastructural, human resource, drug, and service delivery benchmarks for Sub-Centres, PHCs, CHCs, and District Hospitals.
  • Community Health Centres (CHCs) function as 30-bed referral units for four Primary Health Centres (PHCs), staffed by four medical specialists (surgeon, physician, gynecologist, and pediatrician).
  • Primary Health Centres (PHCs) cover a population of 30,000 in plain areas and 20,000 in hilly/tribal areas, functioning as the first contact point between the village community and medical officers.
  • Sub-Centres (now upgraded to Ayushman Arogya Mandirs) cater to a population of 5,000 in plain areas and 3,000 in hilly, tribal, and desert areas.
  • The National NCD Portal (CPHC NCD system) is deployed at Ayushman Arogya Mandirs to screen and monitor adults aged 30+ for hypertension, diabetes, and oral, breast, and cervical cancers.
  • Tele-MANAS (Tele Mental Health Assistance and Networking Across States), launched in October 2022, provides 24/7 free, confidential digital mental health counseling across all Indian states and UTs.
  • The National Health Accounts (NHA) estimates for India show that Out-of-Pocket Expenditure (OOPE) as a percentage of Total Health Expenditure declined significantly from 64.2% in 2013-14 to under 40% in 2021-22.
  • The Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), implemented by PMBI under the Department of Pharmaceuticals, provides quality generic medicines at 50% to 90% lower prices than branded equivalents.
  • Jan Aushadhi Sugam is a mobile application that helps citizens locate nearby Pradhan Mantri Bhartiya Janaushadhi Kendras and compare generic medicine prices with branded formulations.
  • The National Essential Diagnostics List (NEDL), released by ICMR, was the first national list globally to specify essential in-vitro diagnostic tests for each tier of healthcare delivery.
Curriculum & Reference Sources: Ministry of Health and Family Welfare (MoHFW), National Health Authority (NHA), NITI Aayog.

Sample Solved Questions & Concept Explanations

8 Verified Concept Questions
Q1.EASY

What is the maximum annual health cover provided per eligible beneficiary family under Ayushman Bharat PM-JAY for secondary and tertiary hospitalizations?

Q2.MEDIUM

What target proportion of India's Gross Domestic Product (GDP) did the National Health Policy 2017 recommend government healthcare expenditure to reach in a phased manner?

Q3.MEDIUM

How many digits comprise the unique Ayushman Bharat Health Account (ABHA) number issued to citizens under the Ayushman Bharat Digital Mission (ABDM)?

Q4.HARD

Which apex autonomous agency under the Ministry of Health and Family Welfare is statutorily mandated to implement both PM-JAY and the Ayushman Bharat Digital Mission?

Q5.EASY

What is the new rebranded name of Ayushman Bharat Health and Wellness Centres (AB-HWCs) officially approved by the Government of India?

Q6.EASY

Under the Pradhan Mantri Jan Arogya Yojana (PM-JAY), what is the restriction regarding family size and age of beneficiary family members?

Q7.EASY

What does the acronym 'ASHA' stand for in India's National Health Mission (NHM)?

Q8.EASY

Which national telemedicine platform developed by CDAC Mohali enables doctor-to-doctor and patient-to-doctor teleconsultations across India under the Ayushman Bharat initiative?