Healthcare system in India 2[1].pptx by K.park

Healthcare system in india community medicine by K.park
PowerPoint by Dr.Pratibha Ahirwal
Pg 1st year
Community medicine

1. Healthcare System in India Presented by :- Dr.Pratibha Ahirwal PG 1 st year Department of Community Medicine SSMC,Rewa

2. Overview Introduction Historical Background Committees & Policies Structure of Health System Health Human Resources. Public Health Programs Current Schemes & Missions Healthcare Challenges Role of International Agencies Innovations & Digital Health Future Roadmap & Recommendations Conclusion & References

3. Introduction India's healthcare system is a blend of public and private sectors, each playing a pivotal role in delivering medical services. The  public sector , managed by central and state governments, offers healthcare at three levels: Primary Health Care : Delivered through sub- centers , Primary Health Centers (PHCs), and Community Health Centers (CHCs), focusing on preventive, promotive , and basic curative services. Secondary Health Care : Provided by district hospitals offering specialized medical services.

4. Introduction Tertiary Health Care : Offered by specialized hospitals and medical colleges providing advanced diagnostic and therapeutic services. The  private sector  complements the public system, especially in urban areas, by providing specialized and advanced medical services, often at a higher cost.   Traditional medicine systems , including Ayurveda, Yoga, Unani, Siddha, and Homeopathy (collectively known as AYUSH), are integrated into the healthcare framework to offer holistic and culturally relevant care options .

5. Objective Improvement in the health status of the population – To reduce morbidity and mortality rates and improve overall health indicators like life expectancy. Prevention and control of communicable and non-communicable diseases – By implementing preventive, promotive , and curative measures. Provision of comprehensive health care – Including promotive , preventive, curative, and rehabilitative services. Accessibility and affordability – Ensuring that healthcare services are available, accessible, and affordable for all, especially vulnerable and underserved populations.

6. Objective Equity in health services – Reducing disparities in health status and healthcare services among different socio-economic and regional groups. Health education and promotion – Encouraging healthy lifestyles and awareness through information, education, and communication. Community participation – Involving people in planning and implementation of health services to ensure relevance and responsiveness. Intersectoral coordination – Collaborating with other sectors like education, agriculture, sanitation, etc., to address the broader determinants of health.

7. Health Systems The health system is the organized structure that manages and delivers health services. It includes both management and organizational aspects .

8. Key Themes in Health Service Delivery Universal Coverage :Health services should address the needs of the whole population, not just select groups, and provide preventive, curative, and rehabilitative care. Primary Health Care Focus :The most effective way to reach underserved rural and urban poor populations is through strong primary health care, supported by a referral system. Global health policy emphasizes building systems based on primary health care to achieve "Health for All."

9. Community Participation : Involving the community is now considered essential for all aspects of healthcare-treatment, promotion, and prevention There is a shift from focusing only on medical care and urban areas to providing comprehensive health care, especially for rural populations,

10. Definition Health :- Health is a State of complete Physical, mental and Social well – being and not merely an absence of disease or infirmity

11. Historical Background India's Rural Health Scheme (1977) established a three-tier system based on the Shrivastav Committee's recommendations. Following the 1978 Alma-Ata Declaration, India adopted the Primary Health Care approach, leading to the National Health Policy in 1983. This policy aimed to achieve "Health for All by 2000" through affordable, universal care. Later developments included the National Population Policy 2000, National Health Policy 2002, and the National Rural Health Mission with Indian Public Health Standards.

12. 1.Public Health Sector a. Primary Health Care • Primary Health Centre • Sub- Centres b. Ho spitals / Health Centres • Community Health Centres • Rural Hospitals • District Hospitals/ Health Centre • Specialist Hospitals• • Teaching Hospitals STRUCTURE OF HEALTH SYSTEM

13. c. Health Insurance Schemes • Employees State Insurance(ESI) • Central Government Health Scheme(CGHS) • Ayushmann Bharath - NPHS • Other Agencies • Defence Services • Railways

14. 2. Private Sector . a. Private hospitals, polyclinics, nursing homes, dispensaries. b. General practitioners and clinics. 3. Indigenous Systems Of India a. Ayurveda And Siddha b. Unani And Tibbi c. Homoeopathy d. Unregistered Practitioners 4. Voluntary Health Agencies 5 .National Health Programmes

15. Primary Healthcare in India In 1977, the Government of India launched a Rural Health Scheme the principle of "placing people's health in people's hands“ It is three-tier system of health care delivery in rural areas based onthe Shrivastav Committee in 1975.

16. International conference at Alma-Ata in 1978, along with WHO set the goal "Health for All" by the year 2000, through primary healthcare approach. Government of India evolved National Health Policy National Health Policy has a plan of action for reorienting and shaping the existing rural health infrastructure.

17. The Alma-Ata international conference g ave primary health care a wider meaning. The Alma-Ata Conference defined primary health care as follows :- "Primary health care is essential health care madeuniversally accessible to individuals and acceptable tothem , through their full participation and at a cost thecommunity and country can afford"

18. Elements of primary health care Th e Alma-Ata Declaration has outlined 8 essential components of primary health care 1. education concerning prevailing health problem sand the methods of preventing and controlling them 2. promotion of food supply and proper nutrition 3. an adequate supply of safe water and basic sanitation

19. 4. maternal and child health care, including family Planning 5. immunization against major infectious diseases 6. prevention and control of locally endemic diseases 7. appropriate treatment of common diseases and injuries 8. provision of essential drugs.

20. Primary Health Care Principles Equitable Distribution : Health services should be accessible to all, regardless of income or location. Currently, services are concentrated in cities, leaving rural and vulnerable groups underserved. Primary health care aims to correct this by bringing services closer to where people live. Community Participation : Involving individuals and communities in planning, implementing, and maintaining health services is crucial. Local health workers like village health guides and trained birth attendants are effective because they understand and are accepted by the community.

21. Intersectoral Coordination : Health care must involve collaboration with other sectors such as agriculture, education, housing, and public works. This coordination requires political will, resource reallocation, and effective planning to ensure holistic health development. Appropriate Technology : Health technologies should be scientifically sound, affordable, and suited to local needs. Avoiding costly, unnecessary technologies helps ensure sustainability and accessibility.

22. 1. Village level One of the basic tenets of primary health care is universal coverage an d equitable distribution of health resources . To implement this policy at the village level, the following schemes are in operation: • ASHA scheme • ICDS Scheme (Integrated Child Development Services • Training of local Dais

23. ASHA is a trained female health worker selected from the local community, preferably aged 25–45, with at least 8th-grade education. She represents disadvantaged groups and serves one per 1000 population (relaxed in difficult areas). ASHA is a part-time worker paid a modest incentive, playing a vital role in promoting health awareness and facilitating access to healthcare services. A. Accredited Social Health Activist (ASHA) scheme

24. • Her responsibilities include : Educating on safe childbirth, breastfeeding, immunization, contraception, and hygiene. Assisting women with antenatal/postnatal care and escorting them to health facilities. Providing basic medical care for minor illnesses and supporting national programs like DOTS for TB. Maintaining a supply of essential medicines and reporting births, deaths, and disease outbreaks.

25. Supporting sanitation campaigns and helping formulate village health plans. Overall, ASHA acts as a crucial link between the healthcare system and the rural population, promoting preventive and basic curative care.

26. An Anganwadi worker is a part-time female worker selected from the local community under the Integrated Child Development Services (ICDS) Scheme. One worker serves a population of 400–800, and each ICDS project includes around 100 workers. She receives 4 months of training in health, nutrition, and child development and is paid an honorarium of ₹1500 per month. Anganwadi Workers

27. • Key Services Provided: Health check-ups and growth monitoring Immunization support Supplementary nutrition Health and nutrition education Non-formal preschool education Referral services for medical attention

28. • Primary Beneficiaries: Pregnant and nursing mothers Women aged 15–45 Children under 6 years Adolescent girls Anganwadi workers are a vital link between the community and health services, especially for young children and women.

29. Sub- centres are the first point of contact in the rural health delivery system, set up for every 5,000 people (3,000 in difficult areas). As of March 2017, 25,650 PHCs functioned with six sub- centres each. They offer basic health services at the grassroots and are supervised by one LHV and a male health assistant . Under Indian Public Health Standards (IPHS), revised in 2012, sub- centres aim to deliver promotive , preventive, and limited curative care. Services are categorized as Essential or Desirable . Sub- centres are classified into two types : Subcentres

30. Type A :- Sub- Centres do not have facilities for deliveries but provide all other essential health services. These are usually located in remote or underserved areas with poor infrastructure. ANMs here are trained in skilled birth attendance (SBA) for emergencies. Upgradation to Type B is considered if the delivery demand increases

31. Type B (MCH) :- Sub- Centres are better equipped with proper buildings, labour rooms, and higher delivery case loads. They are centrally located with good connectivity and no nearby higher-level delivery facilities. These serve as delivery points and also support surrounding Type A sub- centres .

32.  As on 31st March 2019, 5335 community health centers were established by upgrading the primary health centers, each community health centre covering a population of to 1.20 lakh (one in each community development block) with 3o beds and specialists in different departments. For strengthening preventive and promotive aspects, a new non-medical post called community health officer has been created. The community health officer is selected from amongst the supervisory category of staff at the PHC and district level with minimum of 7 years experience in rural health programmers. The specialists at the community health center may refer a patient directly to the State level hospital or the nearest/ appropriate Medical College Hospital, as necessary, without the patient having to go first to the sub-divisional or District Hospital. There are 25 staff for CHC Community Health Centres

33. Caters to a population of 20000 to 30000 Provides curative care, preventive and promotive care, rehabilitative and palliative care to its beneficiaries Hub for coordination of all public health activities in an LSG area Renewing of "Family Doctor" concept Supervision & support of spokes (Sub centres ) Continuity of care established through e- health mechanism Other services includes: (Kerala) Pregnancy & childcare Management of NCDS: India Hypertension Management Initiative, Nayanamritam : screening for diabetic retinopathy FAMILY HEALTH CENTERS/ HEALTH AND WELLNESS CENTERS

34. Mental health: Sampoorna Manasikarogyam , Aswaas Clinics Amma Manass , School Mental Health Program Community based management of communicable diseases: Arogya Jagratha Campaign, Water Source Chlorination Wellness: Yoga training, play areas at workplaces Demand generation with Panchayati Raj Institutions (PRI) involvement

35. • Introduction :- Tertiary health care represents the highest level of specialized medical care, typically provided in advanced hospitals or medical centers . It involves complex procedures and treatments administered by specialists in state-of-the-art facilities. This level of care is usually accessed through referrals from primary or secondary health care providers Tertiary Level Health Care System

36. Highly specialized medical staff. Use of advanced diagnostics and treatment techniques. Focus on complex and critical health conditions. Emphasis on research and training. Key Features

37. Public Sector: AIIMS, PGIMER, JIPMER, etc. Private Sector: Corporate hospitals with multi-specialty services. Referral-based access from secondary/primary care. Structure of Tertiary Care

38. Organ transplants Cancer treatment (chemotherapy, radiotherapy) Advanced cardiac surgeries Neurosurgery and trauma care Neonatal intensive care units (NICUs) Examples of Services

39. Overcrowding and long waiting times. High costs in private sector. Urban-rural disparity in access. Shortage of specialists in remote areas. Inadequate referral coordination. Challenges Faced

40. Definition & Classification: Health manpower includes both: Professional personnel: Doctors, nurses, specialists. Auxiliary personnel: Workers with partial training (e.g., multipurpose workers, technicians). WHO defines an auxiliary as a "technical worker in a specific field with less than full professional training.“ HEALTH HUMAN RESOURCES

41. 2. Planning and Needs: Health manpower planning is an integral part of community health planning Requirements are based on:Population health needs and demands. Target health outcomes. Health indicators like doctor-population, nurse-population, and bed-population ratios.

42. • Manpower Production in India (Annual Averages): ☆ Allopathic (MBBS): 1,04,163 graduates.MD /MS: 42,100 specialists ☆ Ayurvedic : 34,119 graduates ☆ Unani: 3,606 graduates ☆ Siddha: 916 graduates. ☆ Homeopathy: 21,077 graduates.

43. 3. Challenges :- Urban concentration: Around 73.6% of doctors work in urban areas, which house only 6% of the population Rural shortages due to Lack of infrastructure Evolving Manpower Needs New programmes have led to diversification of health roles, including: Multipurpose workers Technicians and paramedics. Driven by goals like Health for All, and national programs on TB, leprosy, and blindness  control.and amenities.Limited career growth and professional support.Cultural and lifestyle differences between urban and rural areas.

44. Patient Care Attends to outdoor patients in the morning. Supervises fieldwork in the afternoon. Field Supervision Conducts regular tours covering all basic health services, including family planning. Universal Immunization Programme (UIP) Plans and ensures effective implementation. Maintains vaccine supply, cold chain equipment, and other materials. Job Description of a Medical Officer at a Primary Health Centre (PHC):

45. Ensures proper delivery of Integrated Management of Neonatal and Childhood Illnesses as per guidelines. Conducts school visits for health check-ups and immunization at regular intervals.Family Planning Services: Organizes tubectomy and vasectomy camps. Trains community health workers like ASHA, Anganwadi workers, and Dais. Oversees and ensures their effective implementation in the PHC area. Visits each subcentre regularly, offering guidance and leadership.

46. Staff Meetings: Holds monthly staff meetings to review progress and solve problems. Team Leadership: Acts as a planner, promoter, director, supervisor, coordinator, and evaluator. PHC success heavily depends on the MO’s leadership.

47. Health Worker Female (ANM – Auxiliary Nurse Midwife) Coverage: Serves 350–500 families (within 3,000–5,000 population, depending on area type). 1. Maternal & Child Health (MCH): Registers and monitors pregnant women, ensures 4 ANC visits, urine/sugar tests, and hemoglobin estimation. Job responsibilities of Health Workers (Female and Male) under the Multipurpose Worker Scheme:

48. Conducts/supervises deliveries, manages JSY disbursements, and tracks postnatal care (PNC). Initiates breastfeeding, tracks low birth weight babies, and ensures timely referrals. Monitors growth of infants/under-5 year , treats common illnesses like diarrhea/ARI, and educates on MCH and hygiene.

49. 2. Family Planning: Maintains eligible couple register and distributes contraceptives. Refers for sterilization, monitors side effects, and provides follow-ups. Works with Dais, ASHAs, and women leaders to promote family welfare. 3. Medical Termination of Pregnancy (MTP): Refers eligible women and educates on safe abortion vs. septic abortion risks.

50. 4. Nutrition: Identifies malnourished children, distributes Iron & Folic Acid, and gives Vitamin A as per guidelines. 5. Immunization (UIP): Administers vaccines to pregnant women and children. Ensures cold chain, injection safety, and manages AEFI reporting. Plans and mobilizes beneficiaries with help from AWW/ASHA, maintains immunization records, and tracks dropouts.

51. 6. Dai Training & Collaboration: Assists in training traditional birth attendants (Dais) and uses them to promote health and family welfare. 7. Communicable Diseases: Identifies and refers cases of fever, diarrhea, malaria, leprosy, TB, HIV/AIDS. Administers ORS, collects blood smears, and collaborates with the male health worker on follow-up and reporting.

52. 8. Non-Communicable Diseases (NCDs): Provides health education for NCD prevention and early detection. 9. Vital Events Registration: Maintains and reports births and deaths, especially of mothers and infants. 10. Record-Keeping: Maintains detailed MCH, FP, immunization, and disease surveillance records.

53. Submits weekly/monthly reports and tracks malaria cases and treatments. 11. Minor Ailments & First-Aid: Treats minor illnesses/injuries, provides first-aid, and refers complex cases to higher centers. 12. Team & Community Work: Participates in staff meetings, coordinates with male health workers, ASHAs, Dais, and PRI bodies. Maintains sub- centres cleanliness, ensures waste disposal, and supports health camps and campaigns

54. Financial resources are crucial for delivering effective health care. Developed countries spend about 18% of their GNP on health, while most developing nations, including India, spend less than 3%. Underfunding leads to poor access and unequal distribution of services, often benefiting only a small segment of the population. Health Financing

55. In resource-limited settings, funds must be used efficiently to maximize health outcomes. Investment should focus on preventing common, preventable diseases (e.g., measles, TB, diarrhoea , malaria). Cost-effectiveness and cost-benefit analysis help in optimal resource allocation for community health interventions

56. Health Insurance in India : Rashtriya Swasthya Bima Yojana (RSBY): Launched in 2008 to provide health insurance of Rs. 30,000 per year per family (up to 5 members) on a family floater basis. Targeted BPL families and 11 categories of unorganized workers (e.g., MGNREGA, street vendors, sanitation workers). Covered 1516 treatment packages through more than 8,000 empanelled hospitals. Subsumed under Ayushman Bharat - PM-JAY in 2018.

57. 2. Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY): Launched in 2018 as a flagship scheme to provide Rs . 5 lakh health cover per family per year. Covers over 10.74 crore families (approx. 50 crore individuals). Offers cashless treatment, portability, and no cap on age, gender, or family size. All pre-existing conditions covered. Over 21,800 hospitals empanelled , saving families over Rs . 22,500 crore in out-of-pocket costs.

58. 3. Employees State Insurance Scheme (ESI): Established in 1948 by legislation. Covers employees earning up to Rs . 21,000/month. Offers medical care, maternity, sickness, injury benefits, and dependents’ pension.

59. 4. Central Government Health Scheme (CGHS): Started in 1954 to serve Central Government employees. Provides comprehensive medical care, including outpatient care, hospitalization, specialist services, and family welfare. Now covers 72 cities and nearly 50 lakh beneficiaries, including retired employees, widows, MPs, and more

60. The Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) Strategy is an integrated approach to ensure a continuum of care across various stages of life. It aims to reduce maternal and child mortality through improved health services, infrastructure, and community participation. RMNCH+A HEALTH PROGRAMMES IN INDIA

61. This program focuses on improving the health of women and children by offering services such as antenatal and postnatal care, skilled birth attendance, family planning, and immunization. It also addresses nutrition, adolescent health, and prevention of reproductive tract infections. Reproductive and Child Health Program

62. A key initiative that provides free vaccines to infants, children, and pregnant women to protect them from life-threatening diseases like polio, measles, diphtheria, and hepatitis B. It plays a critical role in reducing child mortality and improving overall public health. National Immunization Program

63. The Integrated Child Development Services (ICDS) scheme provides a package of services including supplementary nutrition, immunization, health check-ups, and preschool education. It primarily targets children under 6 years, pregnant women, and lactating mothers through Anganwadi centers. ICDS – Structure & Services

64. This program aims to prevent and control the spread of HIV/AIDS through awareness campaigns, condom promotion, blood safety measures, and free Antiretroviral Therapy (ART) services. It focuses on high-risk groups and encourages voluntary testing and counseling. National AIDS Control Program

65. Previously known as the Revised National Tuberculosis Control Program (RNTCP), this initiative seeks to eliminate TB by 2025 through early diagnosis, standardized treatment, and public awareness. It includes the use of Directly Observed Treatment, Short-course (DOTS) strategy. National TB Elimination Program

66. This program is committed to eliminating leprosy as a public health problem by providing early diagnosis and complete treatment using Multi-Drug Therapy (MDT). It also aims to reduce stigma and promote community-based rehabilitation. National Leprosy Eradication Program

67. The National Vector Borne Disease Control Programme tackles diseases like malaria, dengue, chikungunya, filariasis, Japanese encephalitis, and kala-azar. It focuses on surveillance, prevention, integrated vector management, and early case detection. NVBDCP (Vector Borne Disease)

68. Aim of the Non-Communicable Disease (NCD) programme is to reduce the burden of chronic diseases such as cardiovascular diseases, diabetes, cancer, and chronic respiratory conditions. The programme emphasizes prevention, early detection, and effective management through a comprehensive public health approach. Non-Communicable Diseases Program

69. Aims to provide community-based mental healthcare services, raise awareness about mental health issues, and integrate mental health into the general healthcare system. It seeks to reduce the stigma and ensure accessible and affordable mental health support. National Mental Health Program

70. Ayushman Bharat is a flagship health scheme launched in 2018 to achieve Universal Health Coverage. It comprises two key components: 1. Health and Wellness Centers (HWCs): Provide comprehensive primary health care services including maternal and child health, non-communicable diseases, and free essential drugs and diagnostic services. Ayushman Bharat: Components CURRENT SCHEMES AND MISSIONS

71. 2. Pradhan Mantri Jan Arogya Yojana (PM-JAY): Offers health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary hospitalization to over 10 crore poor and vulnerable families.

72. HWCs are aimed at strengthening the delivery of comprehensive primary health care services. They provide: - Free essential drugs and diagnostics - Services for maternal and child health, non-communicable diseases - Mental health services and emergency care - Health promotion and wellness activities They serve as the foundation of preventive and promotive healthcare in the community. Health and Wellness Centers

73. The National Urban Health Mission (NUHM) focuses on the healthcare needs of urban poor populations. It: - Strengthens the primary health care infrastructure in urban areas - Establishes Urban Primary Health Centers and Urban Health & Wellness Centers - Engages community health volunteers (ASHA) in urban slums - Aims to provide equitable access to quality healthcare services for urban populations. National Urban Health Mission

74. eSanjeevani is a telemedicine platform launched by the Government of India to enable remote consultations. It supports: Doctor-to-Doctor consultations ( eSanjeevani AB-HWC) Doctor-to-Patient consultations ( eSanjeevani OPD) Reduces the need for patients to travel long distances for health consultations Facilitates access to specialists and improves healthcare access in remote areas. Telemedicine & eSanjeevani

75. Launched in 2020, the National Digital Health Mission (NDHM) aims to digitize the healthcare system in India. Key features include: Health ID for every citizen Digital health records DigiDoctor registry and Health Facility Registry Ensures accessibility, portability, and transparency in healthcare services through digital infrastructure. National Digital Health Mission

76. 1. WHO & UNICEF • WHO (World Health Organization): Sets global health standards Supports disease surveillance, eradication (e.g., polio) Technical assistance in policy and emergencies • UNICEF: Focuses on child health, nutrition, immunization Supports maternal and newborn care programs Role of International Agencies

77. 2. World Bank & UNDP • World Bank: Funds health infrastructure and reforms Supports public health programs and system strengthening • UNDP (United Nations Development Programme ): Addresses social determinants of health Supports sustainable development and health equity

78. 3. Bilateral Health Collaborations • Collaboration between two countries for health development • Examples: Indo-US Vaccine Action Program Indo-German Health Program • Focus on training, research, and technical support

79. 1. Sustainable Financing Mechanisms • Need: Sustainable health financing is crucial for maintaining health gains and achieving UHC without financial stress on citizens. Funding Sources: • Government allocation from general taxation. • Social health insurance (e.g., ESIC, CGHS). • Community-based and private health insurance. • Development partner assistance. Future Roadmap & recommendations

80. Strategic Approaches: Increase in health expenditure to at least 2.5% of GDP. Strategic purchasing of services based on health outcomes. Strengthening fund flow systems using PFMS. Financial Risk Protection: Expansion of risk pooling mechanisms (PM-JAY). Reduction of catastrophic out-of-pocket health expenditures. Financial inclusion through digital payment models and DBT.

81. 2.Strengthening PHC and Human Resources Importance: Primary Health Care (PHC) serves as the foundation of a robust health system ensuring early detection, prevention, and continuity of care. Strategic Measures: • Infrastructure: Upgrade PHCs and Sub- Centres into HWCs. • Technology: Introduce eHealth and telemedicine platforms. • Community Participation: Train ASHAs, ANMs, and CHOs for outreach and health education.

82. Human Resources: Bridging workforce gaps through task shifting and multi-skilling. Incentive structures and retention policies in rural/remote areas. Establishment of training institutions and in-service training programs. Monitoring: Real-time HRH dashboards. National Health Resource Repository (NHRR).

83. 3. Public-Private Partnerships (PPP) Concept : Public-Private Partnerships involve collaboration between government and private entities to bridge resource and service delivery gaps in healthcare. Objectives: Enhance infrastructure and technology. Ensure last-mile delivery of services. Leverage private sector efficiency.

84. Successful Models: Chiranjeevi Yojana (Gujarat): Safe delivery services in rural areas. EMRI 108 Services: Emergency ambulance service. Dialysis services under PPP in district hospitals. Best Practices: Clear contract management. Regulatory and quality assurance frameworks. Transparent financing and outcomes monitoring.

85. Primary Level: Sub- Centres and PHCs for basic services. Secondary Level : CHCs and district hospitals for specialist care. Tertiary Level: Advanced care in medical colleges and specialty hospitals. Sectors Involved: Public sector: Government-funded services. Private sector: Major provider of outpatient and inpatient care Voluntary sector & AYUSH: Support services and traditional medicine. Healthcare System in India – Brief Summary Three-tier structure :

86. Key Programs: National Health Mission (NHM) Ayushman Bharat (PM-JAY) Programs for TB, NCDs, RMNCH+A, etc. Challenges : Low public spending (~1.3% of GDP) Workforce shortages Urban-rural healthcare gap Double disease burden (communicable & non-communicable)

87. THANK YOU