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Resilient and high-performing health systems that can respond to the global polycrisis hinge upon the effectiveness of their primary healthcare (PHC) system. This requires adequate and sustainable financing for PHC, which should be predominantly government financed. The recent Ayushman Bharat health reforms in India aim to ensure comprehensive PHC services and enhance financial risk protection through increased government financing. The government has augmented investments to fortify the PHC system by establishing Health and Wellness Centers (HWCs), equipped with an expanded benefit package for PHC services & human resource capacity. Aligned with the National Health Mission's targeted and flexible financial mechanisms, this offers States the opportunity to contextualize solutions and offer incentives to healthcare workers. However, aligning public financing arrangements to service delivery complexities and health outcomes pose intricate challenges in shaping the required reforms. The economic growth and room for increased taxation on health products provide an avenue for increased funding. Smart and efficient payment mechanism with improved accountability should complement increased investment. [ABSTRACT FROM AUTHOR]

Ayushman Bharat is a flagship programme of Government of India and has been much publicised; however, the extent of its translation to the ground level has not been documented. A study was conducted to assess the implementation and satisfaction of the AB-PMJAY scheme in the inpatient department of AIIMS, New Delhi. Data were collected from January 2019 to June 2019. The sample size was a universal sample, and therefore, all the beneficiaries who availed the services at AIIMS, New Delhi were enrolled. A total of 120 patients were enrolled in the study. The mean age of the participant was 36.37 years, about 45.83% of the participants were illiterate and 69.17% resided in the rural area. A total of 88% of patients did not face any problem in availing the scheme, while 18% of the patients were asked to purchase medications from outside. Patients were highly satisfied with the ease and benefits of availing the scheme. The government should examine the reasons why some medications are being purchased from outside, and a contingency fund may be given to the hospital to prevent people from purchasing the medications from outside. [ABSTRACT FROM AUTHOR]

The Ayushman Bharat, the universal healthcare scheme in India, faced service adoption challenges after its launch in 2018. It was an enigma for the top management in Ayushman Bharat regarding slower service adoption of a free mass healthcare coverage scheme by the target population. The case focuses on the service adoption challenges from patient and physician perspectives while implementing a universal healthcare system. It provides insights to policymakers, physicians, service operations managers, and healthcare administrators regarding managing the universal healthcare system's implementation challenges in a developing country context. Research questions/Objective: This study aims to understand service adoption challenges in a universal healthcare system setting. The study explores the following research questions: How is service adoption theory applied in a universal health coverage program? What should be the integrated marketing communication plan to improve the awareness about a universal healthcare program? Links to theory: The study uses service adoption theory. It analyzes service adoption challenges for the universal healthcare system in India called Ayushman Bharat. It also uses literature on the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Phenomenon studied: The case study uses pan India patient and physician data to explore service adoption issues in Ayushman Bharat - a universal healthcare scheme in India. Case context: The primary data collected through the field (hospital) visits and interaction with patients and physicians of Ayushman Bharat form the basis of this case study. Findings: The study emphasizes on performance expectancy, ease in availing of the service, positive social influence, and facilitating conditions for service delivery of Ayushman Bharat. The Ayushman Bharat scheme's performance expectancy means how being a healthy individual would contribute to better performance at the workplace. The effort expectancy is the level of ease an eligible Ayushman Bharat scheme can avail the service at the empanelled hospital. The social acceptance of the Ayushman Bharat scheme by friends, peers, and people in the vicinity would create a positive social influence. The facilitating conditions in the Ayushman Bharat scheme are the government's capacity to provide organizational and technological infrastructure to support this universal healthcare program. Discussions: The use of service adoption theory and the UTAUT model to enhance the adoption of the universal healthcare system in India have been discussed in the case study. [ABSTRACT FROM AUTHOR]

Compared to its peers, India has always spent far less on health. This is slowly changing as are the drivers that are forcing some of these changes. Demographical and epidemiological changes have moved the disease burden away from communicable and maternal and childhood diseases to non-communicable diseases. More people are city dwellers and achieving UHC is one of Sustainable Development Goals. To tackle these commitments and shifting demands, in 2017, there was a committed move towards improving primary health care by introducing comprehensive PHC through health and wellness centres. These centres are close to the community and by improving the quality of care given and increasing the range of services that they provide, there should be an increase in access to health. However, much needs to be done to ensure that these centres will provide high quality care to the local populations. Training the healthcare workers needed to staff these HWCs will take time. Keeping the required funding to expand the programme will be challenging in the current fiscal space. There is a need to integrate care and flow of funds between primary and secondary care and empowering local populations to engage in governance of the HWCs will take time. [ABSTRACT FROM AUTHOR]