Abstract:
Background: Dalits and Adivasis together constitute 25.2 percent of India's population. Persistent structural and deep-rooted poverty and deprivation among Dalits and Adivasis manifest in all aspects of their lives. Health outcomes have remained grossly unequal, with India’s Dalits and Adivasis living shorter lives of poorer quality. A large chunk of Dalits and Adivasis do not use the formal healthcare system. Unregulated commercialization of provisioning, medical technology, and medical and paramedical education has a negative impact on the quality and cost of healthcare for the poor and marginalized communities. The high costs of healthcare were expected to be addressed by introducing a health insurance scheme. The Ayushman Bharat– Pradhan Mantri Jan Aarogya Yojana was launched in 2018 and became the government’s flagship scheme to make healthcare accessible to the poor and marginalized. However, its coverage in a tribal-concentrated population remains low. Both Dalits and Adivasis face discrimination in the private healthcare system. The majority of private providers lack interest in working in remote adivasi-dominated areas. Private hospitals tend to have an urban bias, with nearly 67 percent of private hospitals registered under PMJAY located in big cities. In contrast, it is rural areas with Adivasi and Dalit populations that suffer from severe infrastructure gaps.
Methods: The present paper purports to examine the public health status and healthcare challenges faced by tribal communities in Uttar Pradesh; to analyze the implementation and coverage of Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (PM-JAY) among tribal populations in Uttar Pradesh; and to assess the extent to which PM-JAY has improved access to quality secondary and tertiary healthcare services for tribal beneficiaries. The paper is based mainly on secondary data and a critical review of pertinent literature.
Results: The findings of the paper demonstrate that Pradhan Mantri Jan Arogya Yojana (PM-JAY) has improved access to healthcare and decreased out-of-pocket costs. To facilitate access to high-quality healthcare services and reduce financial strain during medical emergencies, the program offers Rs. 5 lakhs in health insurance coverage per family annually. Research shows that in tribal communities, PM-JAY has reduced catastrophic health spending and distress financing. By offering cashless care at empaneled hospitals, the program has reduced the financial strain on tribal families by lowering out-of-pocket costs for hospital stays. Tribal populations' health outcomes could be improved through PM-JAY by providing prompt, reasonably priced access to healthcare.
Conclusions: The program has helped reduce the need for distressed finance to pay for medical bills, such as taking out a loan or selling assets. By offering tribal people and families a healthcare safety net, Ayushman Bharat empowers them and fosters their social and economic well-being. For Tribals /Adivasi communities, catastrophic health expenditure is much higher during hospitalization in a private hospital than in a government hospital. Hence, government-run health and medical institutes have proven effective in delivering health care and medical services to tribals through health insurance coverage under PM-JAY.
Biography:
Dr. O. P. Singh is Professor in the Department of Community Medicine and Public Health at King George's Medical University (KGMU), Lucknow. He holds Master's degrees in Social Work and Sociology, LL.B., Postgraduate Diploma in Environmental Protection Law, Ph.D. in Social Work, and D.Litt. in Sociology from the University of Lucknow. A Gold Medal-winning social scientist, he has received several national honors for his contributions to public health and social welfare. Dr. Singh has guided numerous research scholars, published extensively, actively participates in academic forums, and is committed to improving healthcare access for disadvantaged communities through government welfare initiatives.
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