Increasing Access To Care In Uttar Pradesh

In continuation to the “Ayushman Samvad” initiative launched by ACCESS Health International in June 2020, a webinar was hosted on September 30, 2020, in partnership with the State Agency for Comprehensive Health Insurance and Integrated Services, (SACHIS), the State Health Agency for PM-JAY, in Uttar Pradesh. This webinar was to mark the celebration of two year anniversary of PM-JAY implementation in the state of Uttar Pradesh and to reflect upon the journey of undeterred provision of healthcare services under PM-JAY within COVID-19 pandemic. Over 500 district stakeholders and partners were live watching the event and around 165 participants joined the webinar platform. Participants were from various institutions and organizations across the state of Uttar Pradesh and a few other states. Attendees included public and private stakeholders, district officials, and partners, hospital representatives, administrators, medical coordinators, Arogya Mitras and district implementation units.

The webinar commenced with the launch of the Annual Report 2019-2020 – Increasing Access to Health for the people of Uttar Pradesh by Mr. Jai Pratap Singh, Honorable Minister of Medical Health & Family Welfare, Government of Uttar Pradesh.

Mrs. Sangeeta Singh, Chief Executive Officer, SACHIS, Government of Uttar Pradesh addressed the inaugural of the webinar. She gave a detailed overview of the journey and the milestones achieved in the past two of PM-JAY implementation in the state. With the objective to reduce catastrophic out-of-pocket health expenditure and improve access to hospital care to over 31 % of the population in the state, PM-JAY reached 12.6 million families in the past two years. It was empathized that the past year was a year of partnerships and collaborations. Over 800 new facilities were empaneled adding 26000 beds in the state and making a total of 2667 network hospitals in the state. A recap of all the important initiatives taken up by SACHIS was presented including but not limited to: data of villages with zero golden card shared with ASHAs for motivating beneficiaries to get their golden cards at Common Service Centre/ empaneled hospitals; initiated calls through state call centre and motivating them to utilize the scheme; and mapped data of migrant labors with SECC data and encouraging them to get golden card and utilize PM-JAY. SACHIS plans to focus on forging inter-departmental and institutional collaborations and will collaborate with community based enterprises to engage beneficiaries and empower them to change their health seeking behavior. SACHIS would want to emphasize on increasing operational efficiency of the Call Center/Arogya Mitras, ISA, reinitiate the patient feedback and satisfaction system in the coming year and introduce performance appreciation and incentives.

The inaugural session was chaired and addressed by various national and state level dignitaries. Mr. Jai Pratap Singh, Honorable Minister of Medical Health & Family Welfare, Government of Uttar Pradesh, appreciated SACHIS for their execution and implementation of the PM-JAY scheme in the state. Mr. Singh acknowledged the efforts made by SACHIS to ensure seamless provision of PM-JAY services to all its beneficiaries during this pandemic and during the lockdown period. He also referred to the attempts made by SACHIS to ensure targeted outreach to the migrant workers to provide healthcare services.

Mr. Alok Kumar, Principal Secretary, Medical Health and Family Welfare, acknowledged that the state of Uttar Pradesh has turned the COVID-19 crisis into an opportunity and SACHIS are driving large scale transformations and accelerated changes. The aftereffects of COVID-19 are now that people are delaying treatment which is resulting in chronic conditions. But, the efforts of SACHIS are commendable to regain utilization rates post lockdown period.

Mr. Amit Mohan Prasad, Additional Chief Secretary, Medical Health and Family Welfare, Government of Uttar Pradesh, referred to the one crore (Ten Million) golden cards issued in the state. This has a special significance for Uttar Pradesh as it has crossed the one crore COVID-19 tests done by the state.  He appreciated the Chief Executive Officer, Mrs. Sangeeta Singh for her diligence and constant efforts to control and contain COVID-19 by engaging and motivating both the public and private sector in this testing time.

Dr. Indu Bhushan, Chief Executive Officer, National Health Authority, said that despite Uttar Pradesh being one of the largest states in the country has done very well in terms of implementation of Ayushman Bharat. He appreciated the team in the state and the kind of innovations emerged in the state are quite heartening. He applauded the way SACHIS supported the states’ efforts in COVID-19 pandemic. Dr. Bhushan also cheered how Uttar Pradesh supported the private sector by empanelling maximum number.

Mr. Hari Menon, Country Director, Bill & Melinda Gates Foundation, said that the state has taken significant measures to contain and control the pandemic and it has emerged as an example for other states to learn from. The state has ramped up health infrastructure despite constraints in human resources, tried to ensure that adequate staff trained and made available to manage the mounting burden of COVID-19 and also created the most innovative digital backbone to track and respond to COVID-19.

A short film was screened to showcase the journey of PM-JAY implementation in the past two years, the operations, functioning, milestones achieved and also how the state seamlessly grappled and overcame resuming services post COVID-19 lockdown period.

A plenary session on “Resumption of Healthcare Services during COVID-19” was chaired and moderated by Dr. Krishna Reddy, Country Director ACCESS Health International. Dr. Rathan U Kelkar, IAS, Executive Director, Comprehensive Health Insurance Agency of Kerala (CHIAK), Government of Kerala and Mrs. Sangeeta Singh, Chief Executive Officer, SACHIS, Government of Uttar Pradesh paneled the session. The objective of the session was to understand state’s experience: strategies, lessons, innovations, and actions; in resuming delivery of healthcare services under PM-JAY and state health insurance schemes and to discuss how to identify policy determinants and key approaches required for overcoming disruption and ensuring continuity of health services.

Dr. Reddy mentioned that from the State Health Authority’s perspective, it is imperative that the ability to engage the beneficiaries, ability to guide them, to meet their healthcare needs and also to ensure that the beneficiaries are not denied of their benefits and cashless treatment when they reach the empaneled hospitals. Further to the opening of the panel, Dr. Reddy highlighted  three areas of policy changes and opened the discussion on: whether states were thinking to cover outpatient expenses, if there were any consideration for expanding the coverage to the missing middle, especially the migrant workers and if there would be integration of the scheme with the primary healthcare. The state of Kerala shared how it’s been successful in establishing good implementable governance structures in place. Kerala instituted various committees to manage the COVID-19. The state of Kerala has ensured maximum number of hospitals to be empaneled, especially by engaging the private sector. State has also explored integrated approach to healthcare delivery system. The state of Uttar Pradesh shared how they engaged private hospitals by motivating the inactive hospitals on a one on one basis through a series of webinars under the banner of “Ayushman Samvad” initiative. The state of Uttar Pradesh also shared that it in collaboration with the National Health Mission has trained the district officials and further trained the ASHAs for ensuring continuum of care. The state is also planning to covert the health and wellness centers into delivery centers and to ensure provision of a normal delivery package.

The webinar concluded with the thoughts that this platform not only was to share the PM-JAY implementation journey in Uttar Pradesh but also enabled cross learning between states, especially during the time of COVID-19 when it’s most essential to keep learning and moving forward.