This document provides an introduction to Health and Wellness Centers (HWCs) under Ayushman Bharat, India's flagship public health initiative to achieve universal health coverage. It discusses the current health challenges in India, the need to strengthen primary healthcare services, and the two components of Ayushman Bharat - upgrading primary health centers to HWCs and the Pradhan Mantri Jan Arogya Yojana health insurance scheme. HWCs aim to deliver comprehensive primary care beyond maternal and child health services. The key elements of HWCs include an expanded service package, multidisciplinary teams, community outreach, and using digital tools and telehealth to ensure continuum of care.

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Presented by Shaziya Sheikh,
PM, Public Health (THC)
Introduction to
Health & Wellness
Centers

2. 2
05
Details about HR,
Infrastructure &
other Services
Part 01
04
Essential
Services at
HWCs
Part 01
03
Concept and Key
Principles of
HWCs, Key
Elements of HWCs
Part 01
02
Need for CPHC,
Contribution of
NHM, Ayushman
Bharat – A Holistic
Programme
Part 01
CONTENTS
01
Current
Scenario of
Health in India
Part -01

3. 3
OBJECTIVES
At the end of session the fellows will be able to:
Understand about the concepts and key components of Ayushman Bharat
Enumerate key elements of Health and Wellness Centers (HWCs) & Services
Understand about that, how a public healthcare system works in the community? How it
protecting and improving the health of individual and the communities.

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“Our nation has seen significant changes in the disease burden during the previous few decades”
Good Progress in Reducing Maternal & Child Mortality in last 15 yrs
IMR
30/1000 (SRS -
2019)
58/1000 (SRS
2002)
Maternal Mortality Ratio
103/ one lakh live births (SRS 2017-19)
234/ one lack live births (SRS – 2004-06)
Universal Immunization
Program
RCH under the
NHM
Nutritional
Programmes & schemes
U5MR
35/1000 (SRS – 2019)
74.3/1000 (SRS – 2005)
Several initiatives for
improving MH

5. 5
10–15 yrs ago communicable disease along with maternal & nutritional disorders contributed to the
major diseases burden…now we are seeing a change in this disease pattern?
DEA
TH
These all NCDs
accounts for
nearly 62% of all
mortality among
men and 52%
among women
01
NCD
CANCER
02
NCD
CVD – CARDIO
VASCULAR DISEASES
04
NCD
RESPIRATORY
DISEASES
03
NCD
DIABETES

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Mostly
demand
maximum
health
treatment at
the level of
district
hospitals

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The holistic
programme
Ayushman
Bharat
Selective Primary
Healthcare –
20%
Reduce OOPE
Improving the
utilization of
Government
health facilities –
RU 28%, 21% Ensuring
continuum of
care
Epidemiological
Transition (62%)
The first component involves upgrading of 1.5 lakh
Sub Health Centers (SHCs) and Primary Health Centers
(PHCs) into Ayushman Bharat - Health and Wellness
Centers for the delivery of CPHC.
• First Component
Comprises of Ayushman Bharat Pradhan Mantri
Jan Arogya Yojana (PMJAY)
• Second Component
AB - It comprises two inter-related components
As a result, “the nation will be able
to attain "Health for All" and
Universal Health Coverage”

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02
• HWCs go beyond
MCH care services
to include
comprehensive
health services to
the vulnerable
population, CP3R
01
• Healthcare for
pregnant women,
children
• Reproductive health
and communicable
diseases
03
• Health system
strengthening
efforts, Expansion of
health workforce &
strengthened
outreach services
04
• NHM developed the
cadre of 1 mn ASHAs to
expand outreach
• Systems for
registration, tracking &
follow-ups
Health and Wellness Centers Contribution of National Health Mission
05
• Follow-up of target
groups, MNCH, FP, HRP,
LBW, NRC
• Mechanisms for
referral & transport
services, capacity
building, free 3D,
procurement & logistics

9. 9
is an
initiative by Govt. of India to achieve UHC. It
ensure to deliver a comprehensive range of
services spanning preventive, promotive,
curative, rehabilitative and palliative care.
Under its 1st component, HWCs will be created
to deliver CPHC, that is universal and free to
users, with a focus on wellness & the delivery
of an expanded range of services to the
community.
The 2nd component, is the PM-JAY, which
provides health insurance cover of Rs. 5
lakh/yr to over 10 crore poor & vulnerable
families for seeking secondary & tertiary
care.
It has 2 components which are
complementary to each other.
launched by Prime Minister on 27th
September 2021. The ABDM aims to develop
the backbone necessary to support the
integrated digital health infrastructure of the
country.
A personal health record,
patient can maintain and manage their health
info.

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A cover of INR 5 lakh per family per year
Over 10 crore poor and vulnerable families eligible
States given flexibility to decide on mode of
implementation
Benefits will be portable across the country
Entitlement based scheme
1. Family ID no. (MP)
2. Identity card (any one - Adhar),
mobile number, e-mail id)
3. Ayushman Mitr, CCC,
4. Pmjay.gov.in
7 days pre and 10 days post
hospitalization – free drugs,
diagnostics and screening
Important Documents for
AB Card -
Ayushman Bharat Helpline
No - 14555

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CP3R
Govt. & Private (under AB-PMJAY)
SDH, DH, M&CH, other specialty
hospitals (both in public & private)
Follow-up
CPHC through
AB-HWCs

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Health & Wellness Centers are envisaged to deliver expanded range of services that go beyond Maternal and
Child health care services to include comprehensive health services to the vulnerable population.
The first Health and Wellness Center was launched by Hon’ble Prime Minister at Jaangla (HWC), Bijapur,
CG on 14, April 2018.
Definition HWCs -
To ensure delivery of CPHC services, existing Sub
Centers covering a population of 3000-5000 would
be converted to Health & Wellness Centers, with the
principle being “time to care” to be no more than
30 minutes.

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Existing Building
SHCs + PHCs + UPHCs = CPHC through AB-HWCs

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People Centered Expanded Package
of Services
Health Promotion & Wellness
Ensuring Continuum of Care
Reaching the Last Mile
Term & Team Based Approach
‘Time to Care’ – to be more than 30 minutes
High Quality, Standard
TT&PC
CP3R

15. 15

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New cadre of
non-physician HW
Critical role in
provision of
expanded range
of essential
package
Lead – Primary
health care
team (SHC)
Provide clinical
management &
ambulatory care
Important
coordination link
Objectives of CHO
Improve access to Healthcare in rural/remote
area
Reduce OOPE
Increase utilization of PH services at PC level
Reduce fragmentation of care
Reduce work load of secondary & tertiary care

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STEP
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Expanding HR – MLHP & Multi skilling
Expanding Diagnostics Point of Care & New
Technologies
Expanded Service Delivery at HWC
Health Promotion
Continuum of Care – Tele health / Referral
Infrastructure

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Robust IT System
Essential Drugs & Supplies
Financing / Provider Payment Reforms

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https://youtu.be/JvWQzt8bUtQ

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1. Care in Pregnancy & Child-birth
2. Neonatal & Infant Health Care Services
3. Childhood & Adolescent Health Care Services
4. Family Planning, CC Services &
Reproductive HCS
5. Management of Communicable
Diseases: NHP
6. General OP Care for Acute
Simple Illness & Minor Ailments
7. Screening, Prevention, Control &
mgmt of NCDs
8. Care for Common Ophthalmic &
ENT Problems
9. Basic Oral Health Care
10. Elderly & Palliative Care Services
11. Emergency Medical Services
12. Screening & Basic Mgmt. of Mental Health Ailments

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FPCC
Let’s Do Some Exercise -
OOOM
EENN

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Managerial
functions –
effective
functioning of
HWC
Public health
functions –
health
promotion
disease
prevention/surv
eillance
Clinical
functions –
provide out-
patient care &
management
1. Early detection & screening
2. Referral
3. Follow-up care
4. Counselling support, 5. Teleconsultation
1. Ensure collection of population-based data –
planning services
2. CA for health promotion
3. Disease surveillance
1. Recording, reporting & monitoring
2. Administration
3. Supportive Supervision – HWC team

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Branding –
As per facility branding instructions of GOI
Citizen Charter
A HWC should have space for –
Examination room with adequate privacy & Telehealth
Diagnostics
Medicine dispensation
Storage of documents, health cards and registers
Wellness: Yoga, Physiotherapy, Group meetings
Waiting area
IEC display
Labor room at delivery points

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HWCs TEAM
MLHP/Community Health Officer (one)
ANM/MPW (two female) or ANM/MPW – female)
& MPW – male
ASHA (one for 1000 population)
Other requirements -
Assured water & electricity supply
Proper system for drainage
Deep burial / sharp pit for bio-medical
waste management
Internet connectivity
Display boards
Contact details of the team
Details of referral centers
Jurisdiction of gram Panchayat / Urban local body

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HWCs - SHC
One Community Health Officer
2 Multi purpose workers – male/ female
5 ASHAs for outreach
HWCs – PHC / UPHC
PHC team as per IPHS norms - (at least – 1 MBBS doctor, 1 staff
nurse, 1 pharmacist, 1 LT and LHV) + MPW+ASHAs
At PHCs, where cervical cancer screening is being planned an
additional staff nurse can be posted5 ASHAs for outreach
HWCs - FLWs
ASHAs – 5 day in NCD training package in 1st phase +
Refresher and newer package annually (15 days)
MPWs – 4 days for NCD package & new package for
additional services
Reporting and recording information using digital
Application, need base joint training of MPWs with ASHAs
HWCs – MO & Staff Nurses
3 days for NCD screening & management
14 days for screening for cancer – VIA for Ca Cervix
Online training through Massive Open Online Courses (MOOC) &
ECHO
Certificate courses in NCD mngt./MCH care/Elderly care/Mental
health
Partnership with AIIMS/regional Cancer centers/ Knowledge
networks to act as training resource centres

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Drugs & Supply -
Essential drug lists (with expanded drugs for NCDs)
MLPs to dispense medicines for chronic diseases on prescription of MO
Uninterrupted availability of medicines to ensure adherence and continuation of care
DVDMS expansion to level of HWCs - PHCs, UPHCs, SHCs
Point to care diagnostics –
7 investigations at SHC (Hb blood sugar, Nischay kit, RDT for Malaria & Dengue, Sputum for AFB, Urine
Protein & Urine Sugar) & 19 at PHC HWC
Blood collection point for Hub & Spoke model at different levels

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Program Manager -
Dashboards
Provide monitoring reports
to assess performance for
payments
Patient Centric –
Unique individual ID &
individual health record
Family health folder
Facilitates continuum of
care through alerts
Service Provider –
Tablet for MPW & MLHP
with ANMOL app/ RCH
portal and NCD module of
CPHC IT system uploaded
Facilitates use of platform
like ECHO
Internet connectivity
Integration of existing IT System – RCH portal / NCD app / NIKSHAY (TB)/ IDSP/HMIS

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Phased introduction to teleconsultation – as a mechanism for improved referral and ensuring
continuum of care
HWC staff to be equipped for tablets / smart phones / laptops for teleconsultation
Capture and transmit images, prescriptions & diagnostic reports
Use of teleconsultation for :
 Emergency consultation – at appropriate levels
 Dedicated time for specialist consultation
 Capacity building
 Standing orders for prescription

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Close coordination with Ministry of AYUSH / Department of AYUSH at the state and district level
Training & certification of local yoga teachers to be steered by Department of AYUSH
Pool of local yoga sessions for community yoga training at HWCs
Provision for additional remuneration to in house yoga teacher or in sourced yoga instructor
Population enumeration & family folder - entire population of the village
Filling up of the CBAC (community based assessment check list) from – 30 yrs & above
Raising public awareness of HWC & CPHC by ASHA
Fixed day screening in HWC & community for common NCD
Yearly screening for HTN & DM
5 yearly screening for CA oral cavity, CA cervix & CA breast
Referral & follow up – Maintaining continuum of care

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National CPHC guideline
Booklet on CPHC, and Health and Wellness Centers by NHSRC, NIHFW, New Delhi

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During your field visit, visit the Health and Wellness Centers and keep an eye on the
work being done by the Health and Wellness Centers, and collect information by interacting with the staff
there. Take a few home visits and inquire about the programs and services offered by the health and
wellness center and include the answer in your project report.
Write your project report in these points –
1. Introduction, 2. Background, 3. Objectives, 4. Survey, 5. Analysis (Data / Interpretation), 6. Discussion,
7. Problems & Challenges, 8. Conclusion, 9. Suggestion & Recommendation (include 3-4 photographs
only)
Report should be in 1500 words (maximum 3 pages, & 1 page extra for photographs)
Total duration & Last date to submit assignment – 15 days (15th July 2022)

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https://www.menti.com/m8xwz2j4kj

37. • ICDS, National Nutrition Mission & Convergence
THANK YOU