AN INSTRUMENTAL ROLE PLAYED BY AYUSHMAN BHARAT PRADHAN MANTRI-JAN AROGYA YOJANA AMIDST THE OUTBREAK OF COVID -19
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International Journal of Management (IJM)
Volume 12, Issue 1, January 2021, pp. 1604-1609 Article ID: IJM_12_01_142
Available online at http://www.iaeme.com/ijm/issues.asp?JType=IJM&VType=12&IType=1
Journal Impact Factor (2020): 10.1471 (Calculated by GISI) www.jifactor.com
ISSN Print: 0976-6502 and ISSN Online: 0976-6510
DOI: 10.34218/IJM.12.1.2021.142
© IAEME Publication Scopus Indexed
AN INSTRUMENTAL ROLE PLAYED BY
AYUSHMAN BHARAT PRADHAN MANTRI-JAN
AROGYA YOJANA AMIDST THE OUTBREAK
OF COVID -19
Pallavi Omkar Sawant
P.h.D. Research Scholar, D.T.S.S. College of Commerce, Malad, Mumbai,
University of Mumbai, India
Dr. Ashok S. Luhar
In-Charge Principal, HOD (Commerce),
Anandibai Damodar Kale Degree College of Arts & Commerce, Borivali (West),
University of Mumbai, Mumbai, India
ABSTRACT
Covid-19 has taken a serious toll on the human race across the globe. Even the
developed countries found themselves engulfed in the hands of Covid-19. For a country
like India, where the public health system lacks proper coverage of healthcare facilities,
the question of survival always hovered around the marginalized section of the
population. In this panic situation, a ray of hope was been certainly extended by
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) as it helped to
survive and face the disappointment especially experienced by the vulnerable section of
the population during this pandemic period. Thus, the authors of this paper have
attempted to bring out the instrumental role played by AB PM-JAY in helping its
beneficiaries to survive amidst the outbreak of Covid-19 and why its relevance was felt,
understood, and commended during this period.
Key words: Covid-19, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
Cite this Article: Pallavi Omkar Sawant and Dr. Ashok S. Luhar, An Instrumental Role
Played by Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana Amidst the Outbreak of
Covid-19, International Journal of Management, 12(1), 2021, pp. 1604-1609.
http://www.iaeme.com/IJM/issues.asp?JType=IJM&VType=12&IType=1
1. INTRODUCTION
Coronaviruses (CoV) are a large family of viruses that causes illness right from cold to more
severe diseases like Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute
Respiratory Syndrome (SARS-CoV). Novel Coronavirus or Covid-19 has become a huge
challenge to human health [9]. It was first detected in Wuhan, China in December 2019 and
http://www.iaeme.com/IJM/index.asp 1604 editor@iaeme.comAn Instrumental Role Played by Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana Amidst the
Outbreak of Covid-19
then was spread throughout the world and therefore, was been declared as a ‘pandemic’ by
World Health Organization on 11th March 2020. This disease is highly transmissible and has
affected the world out of proportion. Covid-19 (pandemic) has ruined societies’ future just like
a specter [8]. That is the reason many countries went ahead and declared lockdown across the
boundaries. In India, the first case was reported on January 30, 2020, and on 24th March 2020,
the government of India declared ‘lockdown’ in the whole country to curb the spread of Covid-
19. But this couldn’t have been the ultimate resort to solve the problem. In a country like India,
where healthcare is ruled largely by the private sectors, the pandemic situation raised a question
of survival for many in the nation, and on top of this when the maximum expenditure incurred
on health in India is shelled out of pocket, dealing with Covid-19 at such a junction was a matter
of concern. To this, AB PM-JAY worked the way it should have been. Right from an early
stage, AB PM-JAY strived hard to provide maximum support to its beneficiaries by covering
testing and treatment of Covid-19 under the scheme. Many press releases and office
memorandum were issued to make the State Health Agencies and the Union Territories
associated with the scheme work on rendering testing and treatment services related to Covid-
19 under the scheme. The nodal agency of AB PM-JAY shares that about 80% of the
beneficiaries of the scheme reside in rural areas of the country and those 105,000 beneficiaries
approximately belonged to the red zone and approximately 250,000 beneficiaries belonged to
the orange zone [14]. With such a high vulnerability towards the pandemic, the beneficiaries
who belong to the sheer marginalized section of the population got a sigh of relief. Right from
the beginning of the lockdown, AB PM-JAY came up with many such initiatives where it
offered testing and treatments for Covid-19 under its scheme to the beneficiaries. Also when
the migration of people from the hotspots of Covid-19 was seen and observed, initiating the
idea of national portability proved to be the best in its place. This paper, therefore, attempts to
study the role played by AB PM-JAY amidst Covid-19 that seems to be a straw for the drowning
beneficiaries to clutch upon.
2. OBJECTIVE OF THE STUDY
• To comprehend the relevance of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana amidst
the outbreak of Covid-19.
• To discuss the role played by Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana amidst the
outbreak of Covid-19.
3. REVIEW OF LITERATURE
• ANGELL, B.J., PRINJA,S., GUPT,A., JHA.V., JAN,S.(2019) have addressed some challenges
that AB-PMJAY needs to overcome to reform the system. The authors have insisted on proper
implementation, delivery, and monitoring of the program which will only help to meet its aim
of having universal health coverage in India and achieve its goal of having sustainable
development across pan India. The paper also points out a need to have a reformed relation
between the public and private sector which from the two pillars of the scheme to provide better
and accessible health care anywhere in India.
• LAHARIYA, C. (2018) have analyzed and provided critical reflections, suggestions, and a road
ahead for proper implementation of AB-PMJAY. The author highlights that in India the cost of
medicines and diagnostics are the major contributors to the Out of Pocket Expenditure. Further,
the paper also discusses that in 2014-15, the OOP in India was Rs 302,425 crores (Approx) and
the annual budget of AB-PMJAY is certainly insufficient in overcoming the above figure with
a mere annual budget of Rs 1,200 crores only.
• Sharma, A., & Aggarwal, A.K. (2020) have elaborated the contribution put in by AB PM-JAY
during this period of the pandemic. The authors are also of the opinion that the efforts taken by
the scheme could only fetch results when the stakeholders would carry the responsibilities put
on their shoulders genuinely.
http://www.iaeme.com/IJM/index.asp 1605 editor@iaeme.comPallavi Omkar Sawant and Ashok S. Luhar
• Gopichandran, V., & Subramaniam, S. (2020) strongly talks about the need to have a robust
public health system in India. They criticize the AB PM-JAY scheme for having an
inappropriate budget allocation for both its components. The paper highlights the need of having
an emphasis on preventive curative measures over actual hospital-based curative treatments as
the former holds a capacity to cater to such infectious diseases at an early stage.
• Lodha,R., & Kabra, S.K. (2020) talks about the road ahead that should be considered for
overcoming the crisis in India. The paper highlights improving on the public health system. The
authors opine to have disaster management be introduced in medical colleges that will train the
medical population on how to deal with such healthcare disasters and also to train the human
resource in general to handle such health crises.
4. DATA COLLECTION
The data collected for this study is mainly from secondary sources. Different journals and
articles were referred to collect data. Also, major national newspapers were considered for
retrieving the data as they were linked in the official website of the scheme.
5. DISCUSSIONS AND FINDINGS
Ayushman Bharat –Pradhan Mantri Jan Arogya Yojana was been launched by the Ministry of
Health and Family Welfare (MoFHW), Government of India (GoI) in September 2018. The
scheme was thought of to achieve ‘Universal Health Coverage’ which is strongly promoted by
the World Health Organization (WHO)[17]. The target audience that gets covered under this
scheme is the poor and vulnerable households that come to nearly 10.74 crores of poor families
forming the bottom 40% of the Indian population. The eligibility of the beneficiaries is based
on the deprivation criteria as specified in the Socio-Economic Caste Census (SECC 2011) [1].
Ayushman Bharat comprises of two inter-related components, namely; Health and Wellness
Centres (HWCs) and Pradhan Mantri Jan Arogya Yojana(PM-JAY). Where HWCs
prominently works to provide primary healthcare services, PM-JAY is focused on providing
secondary and tertiary healthcare services. The beneficiary households of this scheme get a
health cover of Rs 5 lakhs with no cap on the family size. It covers around 1,393 medical
treatments/procedures at present. In this journey of establishing universal health care, AB PM-
JAY has achieved many milestones, right from February 2018, when Union Budget announced
the concept of having AB PM-JAY till very recent August 2020, where to date 1.09 crore
hospitalization is observed and 12.55 crores of E-cards are been issued to the beneficiaries to
avail the facilities under this scheme [12].
5.1. The Relevance of AB PM-JAY Amidst the Outbreak of COVID-19
It is said that in India, the government’s expenditure on health as a percentage of Gross
Domestic Product (GDP) still hovers around 1.5%, this stands to be one of the lowest across
the globe. Further, the statistics say that 52% of households in urban areas and 44% of
households in rural areas largely depend upon private health care facilitators as their main
source of health care [3]. The main reason for this inclination could be that around one-fourth
of health facilities that are provided by the public sectors cover three-fourths of the demand
rose for healthcare services for this sector. This causes the people to seek private health care
facilities to suffice their needs. Indeed, this leads to a severe spike in the health expenditures
that the people have to face. It is estimated that nearly 3.6% and 2.9% of both rural and urban
poverty is generated all because of this catastrophic healthcare-expenditure that the people are
compelled to incur on their health. Further, it is estimated that on average, nearly 60 to 80
million people in India are pushed below the poverty line [6]. And with Covid-19 being the
new reason to push such people deeper into poverty, it is so essential that such people should
http://www.iaeme.com/IJM/index.asp 1606 editor@iaeme.comAn Instrumental Role Played by Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana Amidst the
Outbreak of Covid-19
have a savior for the matter of surviving, and yes, Ayushman Bharat has extensively worked
for such people by extending its helping hand at such a crucial time.
5.2. An Instrumental Role Played by AB-PMJAY Amidst COVID-19
To deal with the rising pandemic, AB PM-JAY undertook several measures to face the
challenges put forward by Covid-19. A press release of the Ministry of Health & Family
Welfare National Health Authority, Government of India issued on 4th of April 2020 proclaims
free testing and treatment of Covid-19 available under AB PM-JAY. In the same, Dr, Harsh
Vardhan, Union Minister of Health and Welfare has conveyed that, “In this unprecedented crisis
we have to very actively involve the private sector as a key partner and stakeholder in the fight
against COVID-19. Making testing and treatment available under Ayushman Bharat PM-JAY
will significantly expand our capacities by including private sector hospitals and labs and
mitigate the adverse impact of this catastrophic illness on the poor.” This decision indeed was
taken to increase the supply of testing and providing treatment facilities by mushrooming in the
private sector and thereby increasing its accessibility through this scheme [11]. On a similar
page, several office memorandums (OMs) were issued by the Government of India, National
Health Authority (NHA) to different states and union territories to cover the testing and
treatment of Covid-19 under AB PM-JAY. In one of the OMs dated 1st of December 2020,
different states and union territories were instructed to negotiate and calculate a decent cost of
Covid-19 testing keeping in view within the upper limits mentioned by the Indian Council of
Medical Research (ICMR). It subsequently happened that, many states and union territories
reduced the cost of testing Covid-19 by seeking ICMR’s approval [16]. Another OM issued by
NHA, on 4th of May 2020, suggested the State Health Agencies (SHAs) support the empanelled
hospitals in linking with private labs and collect data of such labs that shall provide services to
such empanelled hospitals in the state. On the other hand, SHAs were also instructed to identify
such labs, within the states or outside that can be tied up with AB PM-JAY for providing Covid-
19 testing. SHAs were then asked to hunt which private hospitals can provide Covid-19
treatment or also for that matter, hospitals that provide treatments for Severe Acute Respiratory
Infection (SARI). The OM not only suggested the SHAs to carry out the above-said activities
but also directed the SHAs to follow utter protocols for ensuring Covid-19 testing. This defined
the role of SHAs like to be ensured about all ICMR protocols to be followed by the empanelled
hospitals and labs. The Third Party Administrators(TPAs) or Insurance Companies shall be
instructed to process claims of only such cases where test reports are uploaded by Education,
Health and Care Plan( EHCPs) [15]. Apart from this, the official website of AB PM-JAY
highlights some news that defines the role played by the schemes amidst Covid-19. One of the
leading newspapers of India talks about the contribution of AB PM-JAY during this pandemic.
It claims 32,000 Covid-19 patients getting treated under Ayushman Bharat across India and
335,000 cashless tests been performed [10]. On a similar note, a written reply given by the
Ministry of State (Health and Family Welfare) stated that, since inception, under ABPM-JAY
over 1.26 crore hospital admission have been authorized and out of these, 5.13 lakhs hospital
admission have been authorized for testing and providing treatment of Covid-19 [4]. The
government officials of AB PM-JAY are also striving hard to trace potential Covid-19 patients
by running up call centers exclusively for the beneficiaries, enquiring them about the Covid19
symptoms. Around 754,000 calls were been made to 384,000 beneficiaries that seemed to be
vulnerable to Covid-19. With the help of this facility, around 1,303 beneficiaries were been
asked to consult a doctor after hearing and analyzing their symptoms. Amazingly, with the help
of call centers, the NHA could also trace some 257 cases as non-Covid-19 health emergencies
[13].
http://www.iaeme.com/IJM/index.asp 1607 editor@iaeme.comPallavi Omkar Sawant and Ashok S. Luhar
6. LIMITATION OF THE STUDY
This paper is largely restricted on the instrumental contributions undertaken by AB PM-JAY
amidst the outbreak of Covid-19. The paper relies on the secondary data retrieved from press
releases, office memorandums, research articles, research papers, and from major national
newspapers those which were linked under the scheme’s website.
7. CONCLUSION & SUGGESTIONS
The role played by AB PM-JAY before the pandemic has given the nation a fair chance to face
the crisis. The beneficiaries of this scheme that belong to the underprivileged section of the
population were thereby attempted to save from the heat of the catastrophic expenditure that
otherwise would have further dragged them deep in the poverty. The pandemic situation has
also certainly given a chance to reframe and reshape some features of this scheme by also
focusing on infection, prevention, and control of co-morbid conditions [2]. The promotion of
transport facility for the Covid-19 workforce in parts of the nation has supported in managing
the situation to a good extent. On top of all, the additional feature of national portability has
been designed to curb the farsighted problems that may be raised because of migration [13].
The success of the scheme to handle the pandemic situation can be only achieved if the
stakeholders including the private hospitals would work with the same level of commitment as
the public health system would. Moreover, the hold of any health system completely depends
upon what components it is made up of [5]. Regarding this scheme, AB PM-JAY should imbibe
a proper governance framework and a core financing mechanism that will help to be more
responsive and prepared for any such crises in the future. Thus, the paper intends to suggest the
policymakers, to give preference to the primary and preventive treatments by allocating
sufficient budget to them and not just majorly emphasize on secondary and tertiary curative
treatments as the scheme is currently doing. This is because infectious disease preventive
measures are so within the ambit of the public health systems that a wise decision could make
things work better, and will certainly help the public health systems to be more buoyant and
remain afloat during such crises.
REFERENCES
[1] Angell, B. P. (2019). The Ayushman Bharat Pradhan Mantri Jan and the path to universal health
coverage in India: Overcoming the challenges of stewardship and governance. PLoS Medicine , 16
(03), e1002759. https://doi.org/10.1371/journal.
[2] AyushmanNHA/status. (2020, June 09). Retrieved Jnauary 30, 2021, from www.twitter.com:
https://twitter.com/AyushmanNHA/status/1270264006830362624?s=19
[3] Chetterje, P. (2020). Gaps in India's preparedness for COVID-19 control. The Lancet Infectious
Diseases , 20 (05), 544; DOI:https://doi.org/10.1016/S1473-3099(20)30300-5.
[4] Choubey, S. A. (2020, September 23). PressReleaseIframePage. Retrieved Jnauary 26, 2021, from
www.pib.gov.in: https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1658281
[5] Gopichandran, V. &. (2020). Response to Covid-19: An ethical imperative to build a resilient health
system in India. Indian Journal of Medical Ethics , 05 (02), 89-92; DOI:10.20529/IJME.2020.026.
[6] LAHARIYA, C. (2018). ‘Ayushman Bharat’ Program and Universal Health Coverage in India.
Indian Pediatrics , 55, 495-506, DOI: 10.1007/s13312-018-1341-1.
[7] Lodha, R. K. (2020). COVID-19 Pandemic: The Way Forward. The Indian Journal of Pediatrics ,
87 (09), 6676-679; https://doi.org/10.1007/s12098-020-03356-2.
[8] emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-
disease-covid-19. (2020, October 12). Retrieved Janauary 30, 2021, from www.who.int:
http://www.iaeme.com/IJM/index.asp 1608 editor@iaeme.comAn Instrumental Role Played by Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana Amidst the
Outbreak of Covid-19
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-
a-detail/coronavirus-disease-covid-19
[9] Important Notice On COVID-19. (2020, March 23). Retrieved Janauary 30, 2021, from
www.pmjay.gov.in: https://pmjay.gov.in/sites/default/files/2020-04/IMPORTANT-NOTICE-ON-
COVID-19-%28V_3%29-Revised-23-03-2020.pdf
[10] India-news/32-000-covid-patients-treated-under-ayushman-bharat-centre/. (2020, September 24).
Retrieved January 26, 2021, from www.hindustantimes.com:
https://www.hindustantimes.com/india-news/32-000-covid-patients-treated-under-ayushman-
bharat-centre/story-7kjhtzTPi06kmi7r2xb1dJ.html
[11] Ministry of Health & Family Welfare National Health Authority Government of India. (2020, April
04). Testing and treatment of COVID -19 now available for free under Ayushman Bharat Pradhan
Mantri Jan Arogya Yojana .pmjay.gov.in. (2018). Retrieved January 21, 2021, from pmjay.gov.in:
https://pmjay.gov.in/about/pmjay
[12] Sharma, A. &. (2020). The Role of Pradhan Mantri Jan Arogya Yojana in Managing COVID-19 in
India. International Journal of Health Systems and Implementation Research , 4 (2), 17-23.
[13] Sharma, N. C. (2020, June 04). science/health/govt-to-use-ayushman-bharat-to-trace-potential-
covid-19-patients. Retrieved Jnauary 30, 2021, from www.livemint.com:
https://www.livemint.com/science/health/govt-to-use-ayushman-bharat-to-trace-potential-covid-
19-patients-11591276970748.html
[14] sites/default/files/2020-05/5th-OM-COVID-19. (2020, May 04). Retrieved January 23, 2021, from
www.pmjay.gov.in: https://pmjay.gov.in/sites/default/files/2020-05/5th-OM-COVID-19.pdf
[15] sites/default/files/2020-12/COVID-19. (2020, December 01). Retrieved January 23, 2021, from
www.pmjay.gov.in: https://pmjay.gov.in/sites/default/files/2020-12/COVID-19.pdf
[16] Universal Health Coverage. (2019, January 24). Retrieved Janauary 23, 2021, from www.who.int:
https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)
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