One of the flagship programmes of the NDA government, Pradhan Mantri Jan Arogya Yojana (PM-JAY) Ayushman Bharat has committed to universal health coverage (UHC) for citizens of the country. The policy is certainly a game changer. To ensure that PM-JAY reaches out to the audience across the country, it is imperative for external stakeholders to take responsibility for creating awareness and educating people about the programme. Moreover, with health being primarily a state subject, external stakeholders who are politically agnostic can be of immense use to give UHC a reach impetus.
As per the PM-JAY website, there have been 15,623 hospitals empanelled, 29,16,040 beneficiaries admitted and 3,74,35,078 e-cards issued till June 18, 2019. Now, these figures can grow at a much faster pace and it needs to. Considering the fact that around 6 crore people falls below the poverty line every year due to health expenditure, the number of Indians estimated to benefit from PM-JAY is around 54 crore which is nearly 11 crore poor and vulnerable families. According to the National Health Accounts, WHO 2017, Indians spend 61 per cent out-of-pocket expenditure on total health expenditure every year. Keeping this in mind, we need to look at a fast growth trajectory for Ayushman Bharat and that is possible if there is a robust public-private partnership. It is not always feasible for the government to allocate human resources to spread awareness on a project of this magnitude. The coming of microfinance institutions in spreading awareness about PM-JAY is a welcome move.
For decades, the microfinance industry has been working towards poverty alleviation by serving the underserved. Today, the industry boasts of 96 per cent female clients on a base of over 400 lakh. This constitutes a substantial segment of the target population who desperately require access to affordable healthcare. In the last few years, the microfinance industry has been in the forefront to create innovative insurance products for the underserved, which complemented the government’s pension platform. The industry worked and is still working extensively to spread digital financial literacy through workshops and innovative interactive gaming solutions. So, if UHC is to become a reality, the microfinance sector will work towards spreading awareness and benefits of PM-JAY.
However, in this din we must not forget that the time is ripe for the microfinance industry to come up with innovative and affordable healthcare products. Along with health insurance, the microfinance industry should strive to develop products on health savings. A solution on this line will enable empowerment and provide financial independence to access healthcare. Little known to most is the seamless integration of integrated health and microfinance. The Sa-Dhan – COPHAM (Community of Practice of Health and Microfinance), has created a working situation where the two industries do not work in silos but work together to provide support to millions of microfinance clients across the country. The commitment of the sector towards awareness building, providing with healthcare solutions are well documented. Since 2012, the Bill & Melinda Gates Foundation has been supporting ‘health layering’ in Bihar and Uttar Pradesh through Self Help Groups. The ‘Integrated Health and Microfinance in India, Volume III: Banking on Health’ report showcases how participatory learning and behaviour change communication in five areas: Maternal Health, Newborn Health, Family Planning, Nutrition, and Sanitation, immensely impacted the lives of many. Empirical evidence in the report shows that awareness, communication and intervention helped improve breastfeeding, skin-to-skin-care, clean cord care, use of modern contraceptives and above all, it empowered women to make informed decisions, instill confidence and efficacy.
Finally, this brings me to the importance of last mile connectivity for the success of Ayushman Bharat. Instead of working in silos, if we all work together for the greater good, implementation of the policy will be smooth. The microfinance sector is already working towards developing health products and services for the underserved. PM-JAY will be the icing for them. However, a note of caution. While India is on the cusp of healthcare revolution, access to healthcare remains a challenge. And by access, it does not mean only affordability. Trained doctors and nurses along with medication in primary healthcare centres have to be beefed up. If hygienic and good government hospitals are not available in every district, the PM-JAY will not achieve its mission of universal healthcare in its true essence.
—The author is the executive director of Sa-Dhan, an association of community development finance institutions
The opinions expressed in this article are those of the author's and do not purport to reflect the opinions or views of THE WEEK