Challenges in Implementing the PM-ABHIM and HRHME Initiatives

Source: The post challenges in implementing the PM-ABHIM and HRHME initiatives has been created, based on the article “Gap between allocations for health, outcomes in States” published in “The Hindu” on 5th August 2024

UPSC Syllabus Topic: GS paper 2 – Governance-Issues relating to development and management of Social Sector/Services relating to Health

Context: The article discusses challenges in utilizing Union Budget allocations for health initiatives like PM-ABHIM and HRHME. Issues include low fund utilization, faculty shortages, and the need for states to manage recurring costs. Effective outcomes depend on addressing these fiscal and structural challenges.

For detailed information on India’s healthcare system on right track read this article here

What are the Central Health Initiatives?

1. Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): Focuses on building health and wellness centers (AB-HWCs), block-level public health units (BPHUs), integrated district public health laboratories (IDPHLs), and critical care hospital blocks (CCHBs) in each district. It aims to prepare India for future health emergencies.

For detailed information on PM ABHIM read this article here

2. Human Resources for Health and Medical Education (HRHME): Aims to expand medical personnel by establishing new medical, nursing, and paramedical colleges. It also seeks to increase seats in existing institutions and upgrade district hospitals by linking them with newly established medical colleges.

What are the Challenges in Implementing These Initiatives?

1. Low Fund Utilization: PM-ABHIM used only 29% of its budget in 2022-23, and the Revised Estimate for 2023-24 was around 50%. HRHME saw a similar low utilization, with only about a quarter of the allocated funds used in both 2022-23 and 2023-24.
2. Complex Funding Structures: PM-ABHIM relies on the 15th Finance Commission’s health grants for 60% of its resources, but only 45% of these grants were used from 2021-24 due to complex execution and hurdles in the States.
3. Integration of Health Labs: States struggled to integrate public health labs from different vertical programs, slowing down the implementation of the Integrated District Public Health Laboratories (IDPHLs) under PM-ABHIM.
4. Construction Delays: Rigid procedures and overlapping funding from different sources delayed construction projects like Block Public Health Units (BPHUs) and Critical Care Hospital Blocks (CCHBs).
5. Faculty Shortages: Over 40% of teaching faculty positions were vacant in newly created AIIMS, and in Uttar Pradesh, 30% of faculty positions were unfilled in government medical colleges.
6. State Recurring Costs: States will bear the recurring costs of maintaining health infrastructure beyond 2025, increasing their financial burden, as central support for human resources under PM-ABHIM ends in 2025-26.

Question for practice:

Examine the challenges in implementing the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) and Human Resources for Health and Medical Education (HRHME) as discussed in the article.