Government of India has launched Ayushman Bharat Scheme to address critical issue of access to health care. Comprehensive Primary Health Care (CPHC) is essential to avert disease and promote well-being, ensure continuity of care and enable gate-keeping so as to reduce the burden on secondary and tertiary level facilities, thus saving costs to system and the individual.

Idea of Ayushman Arogya Mandir:
India has adopted a three tiered system of health care delivery and Sub Centre is the peripheral outpost that caters to a population of 5000 in plane areas and 3000 populations in tribal, hilly and desert areas. Currently, the package of services that a sub-centre provides largely relates to outreach RCH care. Owing to the changes in disease profile, with non-communicable diseases and communicable diseases contributing a major part of the disease burden there is a conscious shift in focus from select primary care to comprehensive primary care beyond RCH services & select communicable diseases and inclusive of Preventive and Promotive care. For provision of comprehensive primary health care, the strategy is to re-define the role of the sub-centre and its staffing pattern and strengthen the Sub Centres into Health and Wellness Centres (HWC).

Type of AAM:

• 1.  Primary Health Centres - AAM
• 2.  Sub Centres - AAM
• 3.  Urban Primary Health Centres - AAM
• 4.  Urban – Ayushman Arogya Mandir (UHWCs)

The HWCs provide preventive, promotive, rehabilitative and curative care for a package of 13 services as below-

• 1.  Care in Pregnancy and Child-birth.
• 2.  Neonatal and Infant Health Care Services
• 3.  Childhood and Adolescent Health Care Services.
• 4.  Family Planning, Contraceptive Services and other Reproductive Health Care Services
• 5.  Management of Communicable Diseases: National Health Programmes
• 6.  General Out-patient Care for Acute Simple Illnesses and Minor Ailments
• 7.  Screening, Prevention, Control and Management of Chronic & Non-communicable,Communicable Diseases including-TB & Leprosy
• 8.  Care for Common Ophthalmic and ENT Problems
• 9.  Basic Oral Health Care
• 10.  Elderly and Palliative Health Care Services
• 11.  Emergency Medical Services including Burns and Trauma
• 12.  Screening and Basic Management of Mental Health Ailments
• 13.  Yoga & Ayush

HWC deliver, these set of comprehensive services through team based approach. A primary health care team trained and equipped in a set of skills and redesigned work processes to ensure a continuum of care that places emphasis on preventive and promotive health.

HWCs not only to expand the service package, but also to create a perception in the community, that the facility close to them, offers a platform for preventive and promotive action. Apart from service provision, key interventions envisaged under HWC include Population Enumeration, Creation of Family folders and use of IT platform and to assure continuity of care, through diagnostic services, regular refills of drugs for chronic diseases, and access to Tele- Consultation

The HWCs are to be headed by a Community Health Officer with a primary health care team including ANMs, MPW (M) and ASHAs of the sub center area. Under AB-HWC programme , BAMS ,BUMS & Nursing graduates are being appointed as Community Health Officer.

To provide CPHC near to the community, State is moving forward with strengthening of all the SCs, PHCs & UPHCs as HWCs along with additional provision of health promotion & wellness activities viz. Yoga. State has already started implementation of population based screening, control and management of Hypertension, Diabetes and Cancers (Oral, Breast & Cervical).

State is committed to transform all 10,673 SCs, 1839 PHCs & 651 UPHCs in to Health and Wellness Centers in phase wise manner by 2022.

At SC –HWC 14 types of diagnostic tests are being provided and at PHC-HWC 63 types of diagnostic tests are being provided free of cost to the patients through HLL. As per Government of India guidelines, 105 types of medicines at SC - HWC and 172 types of medicines at PHC- HWC should be available. Medicines for SC-HWC are being procured at State as per demand taken from district through Haffkine Bio-pharma Ltd. Also Medicines for HWCs are procured from the DPDC Fund and approved NHM Fund for HWC.

As per Government of India guideline, HWC Tele-consultation services have been started as Hub and Spoke Model in the State. Community Health Officer & Medical Officer at spoke provide medical advice to patients through consultation with MBBS/Specialist Doctors at Hub via video conference using e-Sanjeevani application.