Work on health and wellness centres makes little headway

The country’s progress in building health and wellness centres (HWCs) is slow and the targets remain distant, going by the latest figures.

These centres are envisioned to provide preventive healthcare and replace the health sub-centres which are the first point of contact for a person seeking healthcare in their vicinity.

Only 2% built

Of 1.5 lakh planned HWCs, close to 3,000 (2 per cent) have been built till date, Union Health Secretary Preeti Sudan told BusinessLine. Of these, 2,800 are in aspirational (economically backward) districts.

Union Health Minister JP Nadda had announced that 1.5 lakh HWCs would be built by 2022 and that ₹1,200 crore has been allocated for the purpose. This entails building at least 50,000 HWCs every year in the coming three years. Critics have dubbed this an unrealistic target.

Up to 21,411 HWCs have been approved for building till date. “But, according to available resources, we can build only 15,000 HWCs this year,” Sudan said.

India’s health system is a tale of fragmentation, said NITI Aayog’s health advisor Alok Kumar. He said in 95 per cent of government-run health set-ups (such as block-level hospitals or primary health centres), there is not more than one doctor, and in barely 5 per cent of the set-ups there are five doctors or more.

While the idea looks great on paper, manning the HWCs with adequate human resources will be a challenge.

Unfilled vacancies

For example, according to the Rural Health Statistics 2017, of the 1,56,231 female health workers currently required in sub-centres, 26,172 positions are lying vacant. Also, up to 33,448 positions for male health workers are lying vacant.

The HWCs are expected to provide mother and child healthcare, eye and ENT (ear-nose-throat), oral healthcare, geriatric care, mental health, emergency services and yoga sessions. Also, free screening for non-communicable diseases such as diabetes, high blood pressure and so on has to be made available, it was stated.

Insurance scheme

Winnie Yip, public health economist at the Harvard TH Chan School of Public Health, said integration of HWCs with the government-run cashless health insurance scheme Ayushman Bharat hasnot yet been done.

“Also, if the primary health care systems are strong, tertiary hospitals attached to Ayushman Bharat will lose patients. Every patient who goes to the sub-centre is lost to insurance in the hospital,” said Yip.