Search

Poverty and healthcare issues are the most debatable topics today. Developing countries like India have as much as 45% of its population trapped in poverty because of various urgent healthcare needs. Universal health coverage (UHC) is a unique insurance system to provide financial protection to the marginalized groups of the country. It facilitates appropriate and immediate health needs, including required diagnostic, therapeutic and operational costs. However, UHC, a unique plan which focuses on the disadvantaged sections of the society, has some serious lacunae when it comes to its implementation in real life. This includes finances and human resources. Experts are reallocating adequate budgetary expenditure on healthcare issues, and in the meantime, a shortage of skilled health manpower is hunting down the UHC scheme in India. In recent times, different state governments are increasing budget allocation for the health sector. UHC is targeting low-income and poor families, forgetting the affordable and timely healthcare by way of improving services offered at the primary health centers and rapid expansion of the skilled health manpower across the country. UHC needs to focus on health paradigm systems, including improved healthcare-seeking behavior, nutrition, sanitation, potable water, reducing maternal and infant mortality, and dissemination of information of current technology to provide quality health services to the underserved and marginalized population of the country. These changes would symbolize a real way forward toward the immediate fulfillment of UHC goals for India.

Background: Right to health is one among the important components of basic human rights. The Government of India had announced “Ayushman Bharat for a new India-2022”, during 2018-19 parliament budget sessions with two components namely, Health and wellness centers for strengthening primary care and national health protection scheme now known as Pradhan Mantri Jan Arogya Yojana (PMJAY) for enabling access to secondary and tertiary health care by giving health (6). Current study was conducted to assess awareness and readiness of the health care workers in implementation of Pradhan Mantri Jan Arogya Yojana in tertiary care hospital, in Rishikesh. Material and Methods: A hospital based cross sectional study was conducted with estimated sample size calculated of 236, with treating consultants and residents as study participants. Participants filled a self-administered pretested semi structured questionnaire by which their awareness and readiness in implementing PMJAY was assessed. Data was entered and analyzed using EPI Info 7 software. Result: Total number of respondents was 181. Mean awareness score was 4.5±1.96 and mean readiness score was 16±5. Mean awareness and readiness score among medical and surgical branches was not statistically significant. There was significantly high awareness score among faculty compared to senior residents. Relation between awareness and readiness was found to be correlated with Pearson’s correlation of 0.206 and was statistically significant. Linear regression model demonstrated an increase of 0.531 units in readiness for every unit increase in awareness score. Conclusion: Mean awareness score of the doctors was just around half of maximum possible score. Awareness is more among the faculty members than residents. With increase in awareness there is an increase in readiness among the study population. There is a need to organize workshops on PMJAY for stakeholders.

A documentação concisa, o envolvimento indevido de intermediários e os freqüentes hacks de dados são alguns dos principais bloqueios que privam milhões de indivíduos de ter uma identidade oficial na Índia. Tendo examinado as questões de segurança relacionadas com um banco de dados centralizado, vários modelos de identidade digital foram apresentados à luz da proteção de dados, descentralização, imutabilidade, revogação, auditabilidade, velocidade e controle dos usuários sobre a informação pessoalmente identificável. Neste livro, foi feita uma visão abrangente das identidades físicas, bem como digitais. Tendo em conta os modelos centrais, federados e auto-soberanos de identidade digital, este último foi proposto para a gestão da identificação, alavancando a tecnologia de cadeias de bloqueio. Nos capítulos seguintes, a arquitetura da cadeia de bloqueio e suas características-chave foram discutidas em detalhes. Finalmente, o mecanismo de funcionamento da cadeia de bloqueio permitiu a gestão da identificação, os procedimentos transacionais, a irreversibilidade, a persistência, as aplicações e os desafios, que provavelmente virão no futuro, foram explicados.

La documentaci��n engorrosa, la participaci��n indebida de los intermediarios y los frecuentes hackeos de datos son algunos de los principales obst��culos que privan a millones de personas de tener una identidad oficial en la India. Una vez examinados los problemas de seguridad relacionados con una base de datos centralizada, se han presentado varios modelos de identidad digital a la luz de la protecci��n de datos, la descentralizaci��n, la inmutabilidad, la revocaci��n, la auditabilidad, la rapidez y el control de los usuarios sobre la informaci��n personal identificable. En este libro, se ha hecho un repaso exhaustivo de las identidades tanto f��sicas como digitales. Teniendo en cuenta los modelos central, federado y auto-soberano de la identidad digital, se ha propuesto este ��ltimo para la gesti��n de la identificaci��n aprovechando la tecnolog��a blockchain. En los cap��tulos siguientes, se ha discutido en detalle la arquitectura de la cadena de bloques y sus caracter��sticas clave. Por ��ltimo, se ha explicado el mecanismo de funcionamiento de la gesti��n de la identidad habilitada por blockchain, los procedimientos transaccionales, la irreversibilidad, la persistencia, las aplicaciones y los retos que probablemente se presenten en el futuro., {"references":["Garg, Rishabh. Identidades de Soberania Própria. Edições Nosso Conhecimento, Potuguese, 2021: 01-104.","Garg, Rishabh. Identidades auto-soberanas. Ediciones Nuestro Conocimiento, Spain, 2021: 01-104.","Garg, Rishabh. Identità auto sovrane. Edizioni Sapienza, Italy, 2021: 01-104.","Garg, Rishabh. Identités auto-souveraines. Editions Notre Savoir, France, 2021: 01-104.","Garg, Rishabh. Souveräne Identitäten. Verlag Unser Wissen, Germany, 2021: 01-104.","Garg, Rishabh. Self Sovereign Identities. Lambert Academic Publishing, Germany, 2021: 01-78.","Garg, Rishabh. Digital Identity Leveraging Blockchain. Barnes & Noble, Basking Ridge, New Jersey, US, 2021: 01-124.","Garg, Rishabh. Global Identity through Blockchain. International Webinar on Blockchain. Scholars Park, India 2021: 01-60.","Garg, Rishabh. Blockchain based Decentralized Applications for Multiple Administrative Domain Networking. BITS - Pilani, KK Birla Goa Campus, India, 2021: 01-69.","Garg, Rishabh. Digital Identity and Access Management through Distributed Ledger Technology. Research Project, Department of Higher Education, Government of MP, 2021.","Garg, Rishabh. Blockchain Ecosystem for Education and Employment Verification. 13th International Conference on Network & Communication Security, Toronto, Canada 2021.","Garg, Rishabh. Interplanetary File System for Document Storage and e-Verification. 2nd International Conference on Software Engineering, Security & Blockchain, Sydney, Australia. 2021.","Garg, Rishabh. Decentralized Transaction Mechanism based on Smart Contracts. 3rd International Conference on Blockchain and IoT, 2021.","Garg, Rishabh. Hi-Tech ID with Digital Tracking System, National Conference on Application of ICT for Built Environment, 2017.","Garg, Rishabh. Multipurpose ID: One Nation - One Identity, Indian Society for Technical Education (ISTE) Annual Convention - National Conference on Recent Advances in Energy, Science & Technology, 2019 (39).","Garg, Rishabh. Multipurpose ID: A Digital Identity to 1.34 Billion Indians. Ideate for India - Creative Solutions using Technology. National e-Governance Division, Ministry of Electronics & Information Technology, Government of India, 2018.","Garg, Rishabh. Digital ID with Electronic Surveillance System. Innovation registered with National Innovation Foundation, Autonomous Body of Department of Science & Technology, Government of India, 2018."]}

Background & objective: Given that Ayushman Bharat Yojna was launched in 2018 in India, analysis of Rashtriya Swasthya Bima Yojna (RSBY) become relevant. The objective of this study was to examine the scheme design and the incentive structure under RSBY. Methods: The study was conducted in the districts of Patiala and Yamunanagar in the States of Punjab and Haryana, respectively (2011-2013). The mixed method study involved review of key documents; 20 in-depth interviews of key stakeholders; 399 exit interviews of RSBY and non-RSBY beneficiaries in Patiala and 353 in Yamunanagar from 12 selected RSBY empanelled hospitals; and analysis of secondary databases from State nodal agencies and district medical officers. Results: Insurance companies had considerable implementation responsibilities which led to conflict of interest in enrolment and empanelment. Enrolment was 15 per cent in Patiala and 42 per cent in Yamunanagar. Empanelment of health facilities was 17 (15%) in Patiala and 37 (30%) in Yamunanagar. Private-empanelled facilities were geographically clustered in the urban parts of the sub-districts. Monitoring was weak and led to breach of contracts. RSBY beneficiaries incurred out-of-pocket (OOP) expenditures (₹5748); however, it was lower than that for non-RSBY (₹10667). The scheme had in-built incentives for Centre, State, insurance companies and health providers (both public and private). There were no incentives for health staff for additional RSBY activities. Interpretation & conclusions: RSBY has in-built incentives for all stakeholders. Some of the gaps identified in the scheme design pertained to poor enrolment practices, distribution of roles and responsibilities, fixed package rates, weak monitoring and supervision, and incurring OOP expenditure.

India has recently announced the “Ayushman Bharat–National Health Protection Scheme (AB-NHPS),” one of the largest government health insurance schemes in the world. The scheme aims to provide quality health care to the poor and vulnerable families, a step forward toward the government's commitment on universal health care. The beneficiary households under the AB-NHPS will be based on the deprivation and occupation status of the family, drawn from the Socioeconomic and Caste Census database. The scheme will take care of all the secondary health care and most of the tertiary health care procedures. The road map envisaged for the implementation of the scheme consists of number of challenges such as funding, acceptance by the states, exclusion of primary health care, and outpatient expenditure from the scheme. We conclude that successful implementation of the said scheme will require robust planning, stringent regulations, simplified processes, and continuous monitoring using advanced technological E-health platforms.