Ayushman Arogya Mandir

Indian Economy glossary

Also called: Health and Wellness Centre, HWC, Ayushman Bharat Health and Wellness Centres · Topic: Human Capital: Education, Health and Demographic Dividend · NCERT: Beyond NCERT

Meaning

Ayushman Arogya Mandirs (AAMs) are the primary-care pillar of Ayushman Bharat (2018). They are the old Health and Wellness Centres (HWCs) under a new name. They give preventive, promotive and basic curative care, such as screening for common diseases, free medicines and simple tests, at centres close to people's homes.

They matter because they are the first point of contact with the public health system. They try to catch disease early and cheaply, before it needs costly hospital care. That cuts the money families pay from their own pocket and protects the health part of India's human capital.

Explanation

Two pillars of Ayushman Bharat (2018)

  • Ayushman Bharat was launched in 2018 and has two pillars:
  • Ayushman Arogya Mandirs: primary care, delivered close to home.

  • PM-JAY: hospital insurance of ₹5 lakh per family per year for secondary and tertiary care (care in bigger hospitals, such as surgery and specialist treatment).

  • The two pillars are meant to work as a chain:

  • The AAM screens and treats common illness early.
  • It sends serious cases on to hospitals.

  • PM-JAY pays for the hospital stay.

  • AAMs are not new buildings. Existing Sub-Health Centres (in villages) and Primary Health Centres are upgraded to give a wider set of services.

What an AAM does

  • Comprehensive primary health care means care for the common needs of a whole community, not just one disease or one programme. It has four parts:
  • Preventive care: stopping disease before it starts, e.g. vaccination.
  • Promotive care: health literacy (helping people understand basic health), e.g. advice on diet, hygiene and tobacco. NCERT calls this social medicine.
  • Curative care at the basic level: treating common illness without admission to hospital. This is outpatient (OPD) care.

  • Screening for non-communicable diseases (NCDs), which are long-lasting diseases that do not spread from person to person, such as diabetes, high blood pressure and common cancers.

  • Free essential medicines and diagnostics (basic tests) are given at the centre.

  • Older programmes each targeted one disease or group (e.g. mother and child care). AAMs aim to cover all common health needs in one place.

Why it is a human capital input

  • Health is one of NCERT's five sources of human capital. Health spending directly increases the supply of healthy labour.
  • AAMs work on the cheap, early end of disease:
  • early screening → diabetes or blood pressure is found in time
  • → the person controls it with low-cost OPD medicines
  • → kidney failure or a heart attack is delayed or avoided

  • → fewer workdays are lost, and the family avoids a big hospital bill.

  • When primary care is weak, the chain runs the other way:

  • illness is found late → costly hospital care → high out-of-pocket expenditure (OOPE), meaning money patients pay from their own pocket

  • → families fall into poverty or skip care → human capital is lost.

  • Health has external benefits. A healthy person who keeps up hygiene stops infections from spreading. Markets under-supply care with such social benefits, so the state provides it free at AAMs.

In India

  • Ministry: Ministry of Health and Family Welfare (MoHFW) runs both pillars of Ayushman Bharat.
  • Policy anchor: NHP 2017 targets public health spending of 2.5% of GDP (by 2025). Strong primary care is central to that goal.
  • Spending gap (National Health Accounts 2021-22):
  • Government health spending is about 1.8% of GDP.
  • OOPE is about 39% of total health spending, down from about 64% in 2013-14.

  • OOPE rose back to 43.4% of total health expenditure in 2022-23, after 39.4% in 2021-22.

  • Why AAMs are the missing layer:

  • Outpatient care was about 38% of current health expenditure in 2021-22, and insurance schemes in India mostly do not pay for it.
  • PM-JAY, including its extension to people aged 70+ (Ayushman Vay Vandana), covers hospitalisation only.

  • So the doctor visits, tests and medicines that families still pay for themselves can only be covered by public primary care, which means AAMs.

  • Policy link: Parliament's Standing Committee on Health and Family Welfare recommended adding outpatient consultations, diagnostic tests and medicines to AB PM-JAY. This is the same gap AAMs are meant to fill.

  • Elderly care: WHO's ICOPE (Integrated Care for Older People) approach focuses on catching early loss of movement, vision, memory and mood in primary care. AAMs are the natural place in India to do this.

Don't confuse with

  • PM-JAY: the insurance pillar of Ayushman Bharat. It pays for hospital admission (secondary and tertiary care), up to ₹5 lakh per family per year. AAMs give primary and outpatient care directly, not insurance.
  • Ayushman Vay Vandana: an extension of PM-JAY to all citizens aged 70+. It is still hospital-only cover and is not a primary-care centre.
  • Primary Health Centre (PHC) / Sub-Health Centre: the older facilities. An AAM is a PHC or Sub-Health Centre that has been upgraded to give comprehensive primary care, including NCD screening and free medicines.
  • Curative vs preventive medicine: hospital treatment during illness is curative. AAMs focus mainly on preventive and promotive care, with only basic curative care.

Prelims Hooks

  • Ayushman Arogya Mandir is the new name of Health and Wellness Centres. They are the primary-care pillar of Ayushman Bharat (2018).
  • Ayushman Bharat has two pillars: AAMs (primary care) and PM-JAY (hospital cover of ₹5 lakh per family per year).
  • Trap: "AAMs provide hospitalisation cover of ₹5 lakh": FALSE. That is PM-JAY. AAMs provide outpatient care, screening and free medicines.
  • Trap: "Social medicine means free treatment in public hospitals": FALSE. It means spreading health literacy, which is part of the AAM's promotive role.
  • NHP 2017 target: public health spending of 2.5% of GDP. In 2021-22 government health spending was about 1.8% of GDP (National Health Accounts).
  • OOPE fell from about 64% (2013-14) to about 39% (2021-22) of total health spending.

Mains Points

  • Primary care as the base of human capital and UHC: Insurance-led schemes (PM-JAY, Vay Vandana) pay at the costly end-stage of disease. AAMs act earlier. For example, controlling diabetes and blood pressure can delay kidney failure, yet chronic haemodialysis is the second most common Vay Vandana claim by volume. A health system focused only on hospitals keeps OOPE high, because outpatient care is about 38% of current health expenditure (2021-22) and is mostly uninsured.
  • Fiscal trade-off (GS-III): India spends about 1.8% of GDP (2021-22) on public health against the 2.5% NHP 2017 target. Money put into AAMs is cheaper per life saved than hospital claims. But it competes with the fast-growing claims under PM-JAY. Primary care is also run by the States (health is a State subject), so its quality varies from State to State.
  • Ageing and the demographic window (GS-I/II): As India ages, AAMs can do doorstep enrolment for schemes, vision checks to catch cataract early, and ICOPE-style screening for older people. Done well, they would link screening at the centre to hospital care under PM-JAY. Without them, the elderly enter the system late and at high cost.

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