“Public Health and Hospitals” being a State subject, the primary responsibility of strengthening the public healthcare system including provision of essential medicines lies with the respective State Governments. However, under National Health Mission (NHM), technical and financial support is provided to the States/UTs to strengthen the public healthcare system including support for ensuring sufficient supply of life-saving medicines and other medical equipment at public healthcare facilities towards the objective of providing accessible, affordable and quality healthcare to all those who access public health facilities.
To ensure the availability of essential drugs and reduce the Out-of-Pocket Expenditure (OOPE) of the patients visiting the public health facilities, the Government has rolled out the Free Drugs Service Initiative (FDSI) under National Health Mission (NHM).
Under this, financial support is provided to States / UTs for the provision of free essential medicines in public health facilities based on the requirements posted by them in their Programme Implementation Plans (PIPs) within their overall resource envelope.
Support under the scheme is available for Procurement of drugs and strengthening /setting up robust systems of procurement, Quality Assurance, Supply chain management and warehousing, Prescription audit, grievance redressal, dissemination of Standard Treatment Guidelines, and Establishment of IT-enabled platform DVDMS (Drugs & Vaccine Distribution Management System) for monitoring the real status of procurement and availability of essential medicines.
Ministry has recommended facility wise Essential Medicines List (EML) to be made available at the public healthcare facilities:
- Sub Health Centre Health & wellness center (SHC-HWCs)– 105
- Primary Health Centre Health & wellness center (PHC-HWCs)- 172
- Community Health Centres (CHCs)- 455
- District Hospital (DHs)- 544
However, States have the flexibility to add more medicines and the Essential Drugs List (EDL) of States varies from State to State. Quality of drugs procured, under the Free Drugs Service Initiative, is ensured through the operational guidelines of the initiative that
- All drugs must be sourced from Good Manufacturing Practices (GMP) compliant manufacturers through a robust procurement mechanism.
- Post supply testing of every batch before distributing to the health facilities.
To address the healthcare challenges, particularly in rural areas, the National Rural Health Mission (NRHM) was launched in 2005 to supplement the efforts of the State/UT governments to provide accessible, affordable, and quality healthcare to all those who access public health facilities. Currently, NRHM is a sub-mission of the National Health Mission (NHM).
This support under NHM includes the provision of a host of free services related to maternal health, child health, adolescent health, family planning, universal immunization program, and for major diseases such as tuberculosis, HIV/ AIDS, vector-borne diseases like Malaria, Dengue, and Kala Azar, Leprosy, etc.
Other major initiatives include Janani Shishu Suraksha Karyakram (JSSK) (under which free drugs, free diagnostics, free blood and diet, free transport from home to institution, between facilities in case of a referral and drop back home is provided), Rashtriya Bal Swasthya Karyakram (RBSK) (which provides newborn and child health screening and early interventions services free of cost for birth defects, diseases, deficiencies, and developmental delays to improve the quality of survival), implementation of Free Drugs and Free Diagnostics Service Initiatives, PM National Dialysis Programme and implementation of National Quality Assurance Framework.
Mobile Medical Units (MMUs) & Telemedicine are also being implemented with NHM support to improve healthcare access, particularly in rural areas.
As part of Ayushman Bharat, the Government is supporting the States for strengthening sub-centers and Primary Health Centres as Health and Wellness Centres (AB-HWCs) for the provision of comprehensive primary health care that includes preventive healthcare and health promotion at the community level with a continuum of care approach.
Further, Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides health coverage up to Rs. 5.00 lakh per family per year to around 10.74 crore poor and vulnerable families as per Socio-Economic Caste Census (SECC). In so far as implementation of PMJAY is concerned, public hospitals are reimbursed for the healthcare services at par with the private hospitals under the scheme.
The Union Minister of State for Health and Family Welfare, Dr. Bharati Pravin Pawar stated this in a written reply in the Rajya Sabha here today.
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