The most important basic human needs are roti (food), kapda (clothes) aur makan (housing). However, the ills of modernization have widened the necessities for every civilized society to include education, health care, nutrition and sanitation the list of essentials.
With the health care delivery system failing to justify its accessibility across this vast nation, the Central Government had launched National Rural Health Mission in 2013 to boost health services in rural areas, which was extended in March 2018 till March 2020. Moreover, 52 hospitals with more than 5,000 beds across India were run by the cooperatives to augment the services.
As fund always pose a problem, Ayushman Sahakar was introduced in 2017 to revolutionize healthcare delivery in rural areas with funding from National Cooperative Development Corporation (NCDC) in tune with National Health Policy.
The NCDC, set up under an Act of Parliament in 1963 for promotion and development of cooperatives, has extended around Rs 1.60 lakh crore as loans to cooperatives so far. Any cooperative society with suitable provision in its byelaws to undertake healthcare related activities will be able to access the fund. The assistance will flow either through state governments/UT administrations or directly to the eligible cooperatives.
The NCDC's scheme aligns itself while covering health systems in all dimensions that include investments in health, organisation of healthcare services, access to technologies, development of human resources, encouragement of medical pluralism and affordable healthcare to farmers. The scheme would specifically cover establishment, modernisation, expansion, repairs, renovation of hospitals and healthcare and education infrastructure encompassing all hospitals and Ayush facilities. It shall also cover yoga wellness centre, ayurveda, allopathy, unani, siddha, homoeopathy and other traditional medicine healthcare centres by dovetailing the NCDC subsidy/grant with other sources.
Moreover, 52 hospitals with more than 5,000 beds across India were run by the cooperatives to augment the services.After the virtual launch of Ayushman Sahakar on October 19, union minister of state for agriculture Parshottam Rupala had said: "The ongoing pandemic has brought into focus the requirement of creation of more facilities and the NCDC scheme will be a step towards strengthening farmers' welfare activities by the Central Government."
"The NCDC would extend term loans of Rs 10,000 crore to prospective beneficiaries under the scheme, which would revolutionize the way healthcare delivery takes place in rural areas", Rupala had said, adding the scheme also provides working capital and margin money to meet operational requirements. The scheme provides interest subvention of 1% to women majority cooperatives announced and exhorted all existing cooperatives to avail the benefit, he added.
The North Eastern region with vast geographical area, difficult terrain, hilly region, large forest areas, high rainfall, inadequate communication facilities and large number of ethnic groups poses difficulties in offering 24x7 health care services to all inhabitants easily. Thus, Assam Healthcare Cooperative Society Ltd (AHCSL), the first of its kind in the country, was established in 2016 without government patronage to address these problems on the strength of the collective power of the membership and cooperative spirit and functioning now with Dr Sudip Bardhan as its CEO.
The AHCSL has signed a MoU (Service Level Agreement) with Ayursundra Group to provide diagnostic services to the members at a discounted price up to 40% on production of the membership ID card.Other centres (Primus, Panacea, Pathcare) are also extending discount to card holders. The members also avail discount for inpatient treatment in Ayursundra, Down Town and Northeast Cancer Hospital in Guwahati and Indrprastha Apollo, Delhi. It has set up its first model multi-specialty clinic 'Ayurkalpa' at 222 Abani Complex, MC Road, Guwahati.
The AHCSL services include chronic diseases preventative health checkup, chronic diseases management (non-acute) clinic, health shop/pharmacy, optician's services (eye test and spectacles), telemedicine, impartial counseling for advanced treatment options, medicolegal advice and medical insurance advice.However, as the services were still not up to mark, the Centre in its 2015-16 annual report had identified the following problems in health sector in NE states: Shortage of trained manpower; discrepancies in providing access to sparsely populated, remote, far flung areas and suboptimal governance in health sector were the cardinal ones. The need for improving quality of health services rendered; making full utilization of existing facilities effectively and effective and timely utilization of financial resources available were other problems. Moreover, morbidity and mortality due to malaria; high level of tobacco consumption and the associated high risk to cancer and high incidence of HIV/AIDS in Nagaland, Manipur while incidence rising in Mizoram and Meghalaya were other major problems identified.
Though large scale development in health care services and medical education has taken place during the last few decades, a lot still needs to be done by the central and state governments to boost health care services for all. Moreover, the North Eastern Council has been funding state specific schemes to overcome the deficits.