Ayushman Bharat: Ayushman Bharat comprises of two components:
Ayushman Arogya Mandir
The first component pertains to creation of 1,50,000 Health and Wellness Centres (AB-HWCs), now renamed as Ayushman Arogya Mandir, by upgrading the Sub Health Centres (SHCs) and rural and urban Primary Health Centres (PHCs), in both urban and rural areas, to bring health care closer to the community. These centres aim to provide Comprehensive Primary Health Care (CPHC), by expanding and strengthening the existing Reproductive  & Child Health (RCH) and Communicable Diseases services and by including services related to Non-Communicable Diseases (common NCDs such as, Hypertension, Diabetes and three common cancers of Oral, Breast and Cervix) and incrementally adding primary healthcare services for mental health, ENT, Ophthalmology, Oral health, Geriatric and Palliative care and Trauma care as well as health promotion and wellness activities like yoga. A few States/UTs have already started rolling out these additional packages in a phased manner.
Comprehensive Primary Health Care (CPHC) through Ayushman Arogya Mandir – Ayushman Bharat aims to holistically address health (covering preventive, promotive, curative, rehabilitative and palliative care), at primary, secondary and tertiary level by adopting a continuum of care approach. In the lifetime of an individual, the primary healthcare services cater to 80- 90% of the healthcare needs for improved healthcare outcomes and quality of life of the population.

The Primary Health Care team ensures that community outreach and population enumeration are done for individuals in their catchment area and screened for communicable diseases and non-communicable diseases for early detection and timely referral for accurate diagnosis. The team further ensures that treatment adherence and follow-up care are provided to the patients in the community. The essential health services along with the provisioning of essential medicines and diagnostics are provided closer to the community through these centres, as a step towards building stronger and resilient primary healthcare systems which cater to the healthcare needs of the population.
Ayushman Bharat PM-JAY:
•    Ayushman Bharat Pradhan Mantri - Jan Arogya Yojana (AB PM-JAY) is the largest publicly funded health assurance scheme in the world which provides health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization.
•    Currently, 55 Crore individuals corresponding to 12 Crore families are covered under the scheme. Many States/UTs implementing AB PM-JAY have further expanded the beneficiary base, at their own cost.
•    As of 20th December 2023, approximately 28.45 Crore Ayushman Cards have been created since the inception of the scheme, out of which, approximately 9.38 crore Ayushman Cards have been created during the current year 2023 (Jan -Dec 2023).
•    A total of 6.11 crore hospital admissions amounting to Rs. 78,188 crores have been authorized under the scheme, of which 1.7 crore hospitals admissions worth over Rs. 25,000 crores have been authorized during the year 2023 (Jan-Dec 2023).
•    A total of 26,901 hospitals including 11,813 private hospitals have been empanelled under AB PM-JAY to provide healthcare services to scheme beneficiaries.
•    AB PM-JAY has ensured gender equity in access to healthcare services.
•    Women account for approximately 49% of the total Ayushman cards created and approximately 48% of total authorized hospital admissions.
•    Ayushman Bhava initiative was launched by MoHFW for ensuring the saturation of various healthcare schemes at the village level, ultimately reaching the last mile beneficiaries. It was launched by Hon’ble President Smt. Droupadi Murmu on 13th September 2023.
•    This initiative encompasses a series of interventions, including ‘Aapke Dwar Ayushman 3.0’, ‘Ayushman Sabhas’, ‘Ayushman Melas’, and the ultimate goal of elevating villages to the status of ‘Ayushman Gram’.
•    NHA launched ‘Aapke Dwar Ayushman’ (ADA 3.0) campaign on 17th September 2023 as part of Ayushman Bhava campaign.
•    An Android based ‘Ayushman App’ has been launched by National Health Authority wherein self-verification feature for beneficiaries has been enabled. The app has been developed using latest technology and provided different modes of authentication i.e. face-auth, OTP, IRIS, and fingerprint for Ayushman Card creation.
•    This ensures that any mobile device can be used for Ayushman card creation. As a result, as of 20th December 2023, approximately 3.85 crore verification for Ayushman Card creation have been done during Ayushman Bhava campaign.
•    Viksit Bharat Sankalp Yatra (VBSY) has been launched by Hon’ble Prime Minister on 15th November 2023.
•    The purpose of the Yatra is to raise awareness about the government's development policies and schemes among the people, provide benefits of the scheme to eligible population and foster an atmosphere of trust and collaboration.
•    Ayushman Card creation and delivery have been selected for the on-spot services to be offered during the Yatra. As of 20th December 2023, a total of 96.03 lakh Ayushman Cards have been created during the campaign.
Achievement and Service Delivery at Ayushman Arogya Mandir:
•    As reported by the States/UTs on the Ayushman Arogya Mandir Portal, 1,63,402 Ayushman Arogya Mandir have been operationalized till 15th December, 2023.
•    As per the data update done by the States/UTs in Ayushman Arogya Mandir Portal, till date, 55.66 crore screenings have been done for hypertension and  48.44 crore screenings done for diabetes. Similarly, these functional Ayushman Arogya Mandir have done 32.80 crore screenings for oral cancer, 14.90 crore screenings for cervical cancer in women and more than 10.04 screenings for breast cancer in women.
•    Further, as on 15th December, 2023, a total of 2.80 crore Yoga/wellness Sessions have been conducted in operational Ayushman Arogya Mandir.
•    With the objective to provide quality health services to a patient residing in rural areas, Ayushman Arogya Mandir have facility of tele- consultation, achieving a total of more than 17 crore teleconsultations so far.
Viksit Bharat Sankalp Yatra
lndia is a country that is constantly progressing and growing with 1.4 billion population both in rural and urban areas. Since 2014, the Government of lndia has been committed to a model of development that ensures no one is left behind, "Sabka Sath Sabka Vikas, Sabka Vishwas, Sabka Prayaas”. To celebrate last 9 years’ achievements, in various fields across various schemes Government of lndia is conducting a nationwide awareness campaign named as "Viksit Bharat Sankalp Yatra". The campaign is designed to build on accomplishments of Government of lndia and usher in an era collective participation where rural and urban communities can actively engage in the nation's development. A 60-days long Yatra is being organised covering all districts, Gram Panchayat and urban locations across the country from 3rd week of November 2023 to January 2024.
The major objectives of Yatra include reaching the unreached especially the vulnerable population, dissemination of information about the schemes through Mobile vans travelling across the country, Enrolment of potential beneficiaries under various schemes and learning from citizens through interaction with beneficiaries of government schemes by  personal stories/experience sharing.
Ministry of Health and Family Welfare (MoHFW), has identified Schemes/programs to be showcased during the course of the Yatra such as  Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana as the Flagship Scheme of MoHFW and national TB Elimination Programme for the campaign with additional focus on Sickle Cell Anaemia Elimination Mission in Tribal Area. Further, Health Camps are also being organised at the places of halt of the mobile van where in Screening and Referral for Tuberculosis, Non-Communicable Diseases and Sickle Cell Disease, Nikshay Mitra Registration and Consent under Nikshay Mitra, Seeding of Bank Accounts for Nikshay Poshan Yojna, Ayushman Card creation and Physical Card distribution are conducted.
MoHFW has constituted a Central Co-ordination Committee along with senior officials being nominated as State Nodal Officers to oversee the activities of Viksit Bharat Sankalp Yatra.Also, 169 District Health Nodal Officers from DGHS, Regional Offices of Health and Family Welfare (RoHFW), National Centre for Disease Control (NCDC) have been given a checklist to ensure that requisite preparations have taken place and have also been requested to visit the district at least one day prior to the start of Yatra.Control Room has also been established to support States. Sequence of trainings and meetings have been conducted with the States to orient and monitor the progress on regular basis. Data Entry Microsite has been developed by MoHFW to capture the data real time.
Till 30th November,2023 information pertaining to 12,774 Gram Panchayats have been received with the total footfall of more than 18,24,582 people. 18,05,069 Ayushman Cards have been created and 3,20,872 Ayushman cards have been physically distributed. 5,91,491 people have been screened for Tuberculosis, out of which more than 47,189 were referred to higher Public Health Facilities. 88,041 people have been screened for Sickle Cell Disease, out of which 3,995 were found to be positive and referred to higher Public Health Facilities. Around 6,99,308 people were screened for Hypertension and 6,52,101 people screened for Diabetes. More than 70,281 people were suspected to be positive for Hypertension and more than 52,149 were suspected to be positive for Diabetes and more than 1,13,706 people were referred to higher Public Health Facilities.
 National COVID-19 Vaccination Programme
On 16th January 2021, India launched the National COVID-19 Vaccination Programme. COVID  vaccination in the country commenced with vaccination to all Health Care Workers followed by Front line Workers, population aged ≥60 years and has subsequently expanded to cover the population aged 12 years and above. The Vaccination Programme is being guided by immaculate planning based on a regular review of scientific and global test practices by National Expert Group on Vaccine Administration for COVID-19 (NEGVAC). Since the start of the COVID Vaccination drive, it has focused on taking decisions guided by science. Prioritizing our health workers, frontline workers and other vulnerable populations in a phased manner has been an excellent way to scale up the vaccination program. Vaccines are provided free of cost at all Government vaccination centres.
Under the National COVID-19 Vaccination Programme, three vaccines namely Covaxin manufactured by M/s Bharat Biotech International Limited, Covishield manufactured by M/s Serum Institute of India and CorBEvax manufactured by M/s Biological E. have been made available at the Government COVID-19 Vaccination Centres (CVCs). Additionally, Sputnik V vaccine developed by Gamaleya Research Institute, Russia (imported by Dr Reddy’s Lab), DNA–based ZyCov-D by M/s Cadila Healthcare Ltd., Covovax made by M/s Serum Institute of India, Gemcovac-19 and Gemcovac-OM by M/s Gennova Biopharmaceutical Limited and India’s first intranasal vaccine i.e iNCOVACC produced by M/s Bharat Biotech International Limited are available at private CVCs.
India was pioneer in developing and utilizing a digital platform – CoWIN (Winning over Covid) which acted as a backbone for implementation of the entire vaccination programme. The CoWIN not only proved to be a seamless digital delivery mechanism supporting the programme managers in vaccination session planning at vaccination centre level, inventory management, tracking of every unique vaccination event, line listing of due beneficiaries and coverage analysis etc., but also provided the beneficiaries with easy prior registration, advance booking of vaccination appointments as per each person’s preferences for the choice of vaccination centre, vaccination time slots and vaccine type, grievance redressal mechanism, availability of QR based individual digital certificates. With the administration of 200 crore Covid vaccine doses across the country on 17th July 2022, India achieved a significant milestone of administering over 100 crore doses of COVID vaccines to its eligible adult population in just 9 months and another set of 100 crores vaccine doses have been administered in the next 9 months, depicting sustainability. As on 21st December 2023, with 220.67 crore vaccine doses administered across the country, over 97% citizens have received the 1st dose of COVID-19 vaccine while over 90% eligible citizens have received 2nd dose of the vaccine. Additionally, 22.88 crore precaution doses have also been administered across the country among the eligible adult population.
Immunization
 
•  Introduction of third dose of fractional Inactivated Polio Virus (fIPV3): As recommended by the National Technical Advisory Group on Immunization (NTAGI), the third dose of fIPV has been included in the National Immunization schedule, effective from 1st January 2023. fIPV3 has to be administered intradermally, along with the MR containing vaccine during 9-12 months of age.  It enhances the protective effects of the Polio vaccine.
• Polio Sub-National Immunization Day (SNID):   India was declared Polio free Country in 2014 and to mitigate the risk of Polio myelitis from being transmitted from neighboring countries, regular Polio SNIDs are held in India. In the year 2023, 2 SNIDs have been conducted on 28th May 2023 and 10th Dec 2023 in high-risk areas in 13 States/UTs and over 200 identified districts throughout the country.
• Intensified Mission Indradhanush 5.0: The Intensified Mission Indradhanush (IMI) 5.0 is a catch-up vaccination campaign rolled out for children upto 5 years of age and pregnant women, who were left out or dropped out of routine immunization. Three rounds of IMI 5.0 were held  in the month of August, September and October 2023, across all districts of the country with a special focus on Measles Rubella Elimination goal.
•    Since 2014, 12 phases of Mission Indradhanush/IMI have been held across the country and so far 5.46 crore children and 1.32 crore pregnant women have been vaccinated.
• U-Win digital platform pilot
•    Following the success of Co-WIN digital platform, an online case-based tracking and reporting system for the Universal Immunization Program, for both children and pregnant women was introduced in the month of January 2023, in a pilot mode across 65 districts nationwide, for registration of every vaccination event.
•  Measles Rubella Elimination                               
•    India is committed to Measles Rubella Elimination by December 2023.  Robust MR surveillance across the country is being carried out with an all-time high NMNR (Non-Measles Non-Rubella discard rate) of 5.5/1 lakh population. Outbreak Investigations and MR supplementary vaccination campaigns is being carried out in various States/Districts where outbreaks have been reported to close the immunity gaps.
National TB Elimination Programme (NTEP) Performance
With the goal of achieving Sustainable Development Goals related to TB by 2025, five years ahead of the global targets of 2030, the Ministry implements the National TB Elimination Programme with the following objectives:
•    Early diagnosis of TB patients, prompt treatment with quality-assured drugs and treatment regimens.
•    Engaging with the patients seeking care in the private sector.
•    Prevention strategies include contact tracing in high-risk/vulnerable populations.
•    Airborne infection control.
•    Multi-sectoral response for addressing social determinants.
Achievements in Key Programme Indicators over the last 9 years are as under:
 
India pioneered a mathematical model for TB Burden Estimation, a first among nations, which shows that India is progressing against the SDG goals at a far greater pace than the global average, with a decline in TB incidence by 16% (as compared to the global decline of 10%) and a decline of 18% in TB deaths (as compared to the global decline of 10%).
•    Pradhan Mantri TB Mukt Bharat Abhiyaan: Pradhan Mantri TB Mukt Bharat Abhiyaan was launched by the Honorable President of India on September 9, 2022, with the objectives to provide additional support to TB patients in order to improve treatment outcomes, augment community involvement and leverage Corporate Social Responsibility (CSR) activities. As per the clarion call of the Hon’ble Prime Minister of India, Shri Narendra Modi at Delhi End TB Summit in March 2018 to eliminate TB by 2025, five years ahead of Sustainable Development Goal, PMTBMBA initiative was launched to bring together people from all backgrounds into a ‘Jan Andolan’ and escalate the progress toward TB elimination.
 
Achievements under Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA) (13.12.2023):
•    Ni-kshay Mitra registered: 111,749.
•    TB patients on treatment: 14.41 lakhs.
•    TB patients consented to receive community support: 10.15 lakhs.
•    Commitment by Ni-kshay Mitra for TB patients: 10.14 lakhs.
•    Among the renowned Ni-kshay Mitras, Hon’ble Governors/Lt. Governors of 26 State/UTs, Hon’ble Union Ministers, Ministers of State, Chief Ministers, State Health Ministers of many State/UTs have come forward to adopt TB patients. Many MLAs & local parishads have also become Ni-kshay Mitras. Around 17 Cabinet Secretariat officials and 23 MoHFW/CTD officials have also adopted TB patients.
1.    TB Notifications: The overall notification of TB cases has improved by 64% over the last 9 years, from 2014 to 2023. India notified 24.2 lakh TB cases in 2022 which was higher than the pre-COVID level of 2019. In 2023, a total of 22.31 lakh TB patients have been notified till Nov 2023 (as on 01-12-2023). From 2015 onwards, the efforts to find all cases have resulted in over ~58% increase in TB case notifications.
2.    Private Sector Notification: With a focused and targeted engagement with the private sector through interventions like Patient Provider Support Agency (PPSA), gazette notification for mandatory notification of TB cases, incentives for notification of cases and collaborations with professional bodies like IMA, IAP, FOGSI, etc., there has been an increase in private sector notification by more than 7 times over the past 8 years. In 2022, the country was able to notify 7.33 lakh TB cases (highest ever) respectively accounting for 30% of total notifications. In 2023, till Nov, 7.3 lakh patients were notified from the private sector (as on 01-12-2023) which contributed to 32% of total notifications. The programmatic collaborative efforts resulted in a 7 times increase in cases reported from the private sector. The innovative private sector models have been global best practices.
3.    Introduction of newer anti-TB drugs – Bedaquiline, Delamanid: Shorter, safer oral Bedaquiline-containing DR-TB regimens have been rolled out pan-India across all states and UTs. These drugs are given to multi-drug-resistant TB patients with or without resistance to fluoroquinolones. In 2022, a total of 30,864 patients were initiated on the longer all-oral M/XDR-TB regimen and 27,431 patients were initiated on the shorter MDR/RR-TB regimen (Oral/Injection based). In 2023 till July, 39,186 patients have been diagnosed with MDR/RR and out of them 35,302 have been initiated on treatment (as on 17-08-2023). Amongst these, 17,836 patients were initiated on shorter oral MDR/RR-TB regimen (9-11 months) and 17,466 patients were initiated on longer M/XDR-TB regimen (18-20 months).
4.    TB Treatment Success Rate: Over the last 9 years, despite one-third of notifications coming from the private sector, the programme was able to sustain a treatment success rate of above 80%. In 2021, the success rate had reached 84% and in 2022, it marginally increased to 85.5%. In 2023 (till Nov), the success rate increased to 86.3%.
5.    Nikshay Poshan Yojana: Undernutrition is an important risk factor for TB, the Government introduced a scheme of Nikshay Poshan Yojana (NPY) in April 2018 for providing Rs 500/month as DBT to support the nutrition of TB patients for the entire duration of treatment. Cumulatively, till November-2023, NTEP has disbursed Rs 2617.44 Cr to 993 lakh TB patients.
6.    Active Case Finding: For reaching out to missing TB patients, the Government has begun systematic active TB case finding in high-risk groups. The programme has proactively conducted house-to-house searches of TB cases among these vulnerable populations. This includes people living with HIV, diabetics, undernourished, residential institutes like prisons, asylums, old age homes, orphanages, tribal areas, and marginalized populations.  This activity has resulted in the diagnosis of an additional ~3 lakh TB cases since its inception.
7.    Infrastructure Scale-Up: There has been a huge infrastructure scale-up of TB laboratory services. Designated Microscopy Centers (DMCs) have increased by 80% (13583 in 2014 to 24449 in Nov 2023) over the past 9 years and 6196 new molecular diagnostic laboratories have been established till now. The number of drug-resistant TB treatment centers has increased from 127 in 2014 to 792 in 2022.
8.    Sub National disease-free certification: To monitor the trends of the TB Epidemic at the State/UTs/District level, the ministry has introduced a novel initiative of estimating disease burden through a methodology of community-level survey (Inverse sampling methodology) and tracking drug sales data in the private sector and measuring the level of under-reporting to the programme. Through this methodology, State/UTs/District level estimates of TB disease are derived and measured against the baseline of 2015.