Community action for health in India: evolution, lessons learnt and ways forward to achieve universal health coverage

Lahariya, Chandrakant; Roy, Bijit; Shukla, Abhay; Chatterjee, Mary; Graeve, Hilde De; Jhalani, Manoj; Bekedam, Henk

doi:10.4103/2224-3151.283002

Cited by 48 publications

(26 citation statements)

References 4 publications

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“…The most important being that AB-HWCs start on an advantage of already strengthened and existing PHC system through NHM between 2005 and 2018. The other factors being the ongoing attention on advancing UHC; states showing increasing and more than ever interest in improving PHC services through their own mechanism and increasing civil society participation and engagement in health [45].…”

Section: Discussionmentioning

confidence: 99%

“…This can be achieved with increased and active community involvement; accountability and involving local body representatives and civil society organizations in the process, from the very early stage. In backdrop of recent policy dialogues and approaches adopted for Swachh Bharat Mission (clean Indian mission) and the approach to behavioral economics of nudge need to be examined for suitable adoption in health sector [43][44][45].…”

Section: Making Health and Wellness Centres Of India Workmentioning

confidence: 99%

“…A few more suggestions on how to make AB-HWCs more effective and better functional are provided in articles published earlier [1,30,45,46].…”

Section: Making Health and Wellness Centres Of India Workmentioning

confidence: 99%

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Health & Wellness Centers to Strengthen Primary Health Care in India: Concept, Progress and Ways Forward

Lahariya

2020

Indian J Pediatr

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141

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In February 2018, the Indian Government announced Ayushman Bharat Program (ABP) with two components of (a) Health and Wellness Centres (HWCs), to deliver comprehensive primary health care (PHC) services to the entire population and (b) Pradhan Mantri Jan Arogya Yojana (PMJAY) for improving access to hospitalization services at secondary and tertiary level health facilities for bottom 40% of total population. The HWC component of ABP aims to upgrade and make 150,000 existing Government Primary health care facilities functional by December 2022. The first HWC was launched on 14 April 2018 and by 31 March 2020, a total 38,595 AB-HWCs were operational across India. This article documents and analyses the key design aspects of HWCs, against core components of PHC & the health system functions. The article reviews the progress and analyses the potential of HWCs to strengthen PHC services and therefore, advance Universal Health Coverage in India. Challenges emerged from COVID-19 pandemic & learnings thus far has also been analyzed to guide the scale up of HWCs in India. It has been argued that effectiveness and success of HWCs will be dependent upon a rapid transition from policy to accelerated implementation stage; focus on both supply and demand side interventions, dedicated and increased funding by both union and state governments; appropriate use of information and communication technology; engagement of community and civil society and other stakeholders, focus on effective and functional referral linkages; attention on public health services & population health interventions; sustained political will & monitoring and evaluation for the mid-term corrections, amongst other. Experience from India may have lessons and learnings for other low and middle-income countries to strengthen primary healthcare in journey towards universal health coverage.

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Section: Discussionmentioning

confidence: 99%

Section: Making Health and Wellness Centres Of India Workmentioning

confidence: 99%

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Health & Wellness Centers to Strengthen Primary Health Care in India: Concept, Progress and Ways Forward

Lahariya

2020

Indian J Pediatr

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141

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“…The ‘communitisation’ of the health system through the NRHM has shown that involving civil society is important because they are closer to the community and are more responsive to needs of the community and vulnerable populations. In over 20 states of India, Community Action for Health (CAH) has shown positive impacts in improving health care services at primary care levels (Lahariya et al, 2020). CAH has a strong civil society component.…”

Section: Planning and Managing Health Problems: The Need To Improve Health Governance And Financing At District Level Through A Whole-of-mentioning

confidence: 99%

Managing Health at District Level: A Framework for Enhancing Programme Implementation in India

Dawa¹,

Narayan

Narain

2021

Journal of Health Management

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COVID-19 pandemic has brought to the fore the need for a strong health system for the social protection of people and to improve health programme implementation in the coming years. India has made great progress in health over the past 50 years; however, despite the progress made, it is faced with several challenges. While infectious diseases remain an unfinished agenda, chronic non-communicable diseases (NCDs) are rising and are now the leading cause of mortality in the country. This is further compounded by the prevailing inequalities in access to quality health care among population groups including those living in remote rural areas. To achieve Universal Health Coverage and Sustainable Development Goals by 2030, India in 2017 revised its National Health Policy and committed itself to attain the highest possible level of good health and well-being, through preventive and promotive health interventions. While policies are enunciated and plans are formulated, the implementation at ground level is at best tardy and lack lustre As an administrative unit for programme implementation, a district has a key role to play in implementing national programmes and in delivery of basic health services to the people. They are strategically placed to plan, organise and lead efforts meant to deliver primary health care services through better management of existing resources and by fully engaging all relevant stakeholders in contributing towards achievement of national health goals and in responding to a public health emergency such as Covid-19. Planning and managing health problems need an improved and responsive health governance. Strategic planning, monitoring and evaluation require integration and coordination of various health programmes including dealing with health crises, fostering inter-sectoral involvement and engagement of the community as a key actor. Efforts are needed to ensure that services reach the most vulnerable and marginalised sections of the society. Adequate governance support at district level through a whole-of-society approach is essential to bridge the health inequities and ensure equitable access to health services.

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“…[ 17 18 ] In addition, the mechanisms for social accountability and community participation can help improving health system responsiveness and approaches need to be institutionalized. [ 19 ] There is also a felt need for public health teaching and training institutions in India to develop and conduct short training programs on health system responsiveness as part of overall health system strengthening initiatives.…”

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confidence: 99%

Send a ‘good camel’ to the tent

Lahariya

2020

Journal of Postgraduate Medicine

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Community action for health in India: evolution, lessons learnt and ways forward to achieve universal health coverage

Cited by 48 publications

References 4 publications

Health & Wellness Centers to Strengthen Primary Health Care in India: Concept, Progress and Ways Forward

Health & Wellness Centers to Strengthen Primary Health Care in India: Concept, Progress and Ways Forward

Managing Health at District Level: A Framework for Enhancing Programme Implementation in India

Send a ‘good camel’ to the tent

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