NHA Records Reveal 48% Women Availed AB-PMJAY Hospitalisation Services

As per the NHA report, women beneficiaries have utilized the AB-PMJAY scheme more than men in 10 states/UTs.

Women constitute nearly 48% of authorized hospitalizations under the Ayushman Bharat-PM Jan Arogya Yojana (AB-PMJAY), revealed National Health Authority (NHA) records.

The AB-PMJAY is recognized as the world's largest publicly funded health assurance initiative designed to offer health coverage to the bottom 40% of the population. It aims to provide annual health coverage of INR 5 Lakh per family for secondary and tertiary care hospitalization to 12 Cr families.

Since its launch in 2018, the scheme has facilitated 6.5 Cr hospitalizations, with a cumulative treatment cost of INR 81,979 Cr. Notably, 3.2 Cr of these hospitalizations involved women, amounting to INR 39,349 Cr.

Women as Majority Users of AB-PMJAY Hospitalization Scheme

Top officials from the NHA reported that women beneficiaries have utilized the AB-PMJAY scheme more than men in 10 states/UTs.

The states and UTs include Meghalaya (68%), Arunachal Pradesh (57%), Chhattisgarh (56%), Mizoram (54%), Nagaland (53%), Jharkhand (51%), Tripura (51%), and Jammu and Kashmir (50%).

In a move to address specific health concerns, the scheme provides treatment corresponding to a total of 1,949 procedures under 27 different specialties, encompassing critical areas such as cancer, diabetes, and heart ailments.

Data from NHA documents reveal that certain medical specialties under PMJAY have been utilized more by women than men. These include cancer (56%), ophthalmology (54%), otorhinolaryngology (ENT-related) at 51%, and neonatal care packages with 57% utilization.

Participation of ASHA & Anganwadi Workers

Enrolment under the AB-PMJAY scheme is facilitated by thousands of Accredited Social Health Activists (ASHA) and Anganwadi workers across states and UTs.

Additionally, women play a significant role as healthcare providers at local units, particularly the AB-Health Wellness Centres. This increased involvement of women in healthcare provision has contributed to the higher utilization of the scheme among women, addressing historical gaps in health-seeking behavior.

Recently, Finance Minister Nirmala Sitharaman, while presenting the Union Budget 2024-25 in the Lok Sabha, announced the decision to expand health coverage under the Ayushman Bharat scheme to include ASHA workers and Anganwadi workers and helpers.

This expansion aims to ensure that these essential frontline workers in the healthcare system receive comprehensive health coverage, acknowledging their critical role in community health and awareness.

Individual Enrollment & Empowerment

A senior health ministry official highlighted a fundamental change brought about by the AB-PMJAY scheme that has contributed to increased women's involvement in healthcare.

Unlike the previous Rashtriya Swasthya Bima Yojana (RSBY), which issued a single card to each family, often held by men, AB-PMJAY issued individual Ayushman cards to each family member covered under the scheme. This shift enables women to seek treatment independently, eliminating the dependency on male family members.

The scheme's unique features include being completely cashless and paperless, with no concept of reimbursement. Beneficiaries can avail themselves of treatment under defined packages, and empaneled healthcare providers are reimbursed based on specified health benefits packages with standardized rates.

To date, the NHA reports that nearly 32 Cr beneficiaries have been enrolled under the AB-PMJAY scheme and issued Ayushman cards. The involvement of ASHAs in the last two years has significantly contributed to the increased card distribution.

Initially, in the first two years of the scheme, approximately 10 Cr intended beneficiaries received Ayushman cards. Over the past two years, an additional 20 Cr cards have been issued with the active engagement of ASHA workers.

The shift towards individual enrolment and the active involvement of community health workers have played pivotal roles in enhancing women's participation in the scheme.