The Changing Dimensions of India's Foreign Relations During COVID-19

This chapter intends to critically analyze India's changing dimensions of foreign policy during COVID-19. India's strategy to counter China in association with Australia, the USA, Japan, and other democratic countries of the world has been highlighted in this chapter. India's policy of ‘self-reliant' and financial challenges has been sequentially discussed in this chapter. The chapter will further delineate the relations between the domestic factors and external factors in the formulation of the neworientation-based foreign policy of India.COVID-19, it has been discovered, has taught India a valuable lesson. Due to the pandemic, India's foreign policy focus and equations have been steadily altering. India has attempted to improve its acceptability in the post-COVID world with a variety of generous and humanitarian initiatives, as a step toward realizing its global ambitions. The focus is on realizing the idea of Vasudhaiva Kutumbakam. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022, corrected publication 2022.

The Ayushman Bharat Digital Mission (ABDM): making of India's Digital Health Story

Technology is being leveraged worldwide to deliver services to citizens in all domains, including healthcare. The COVID-19 pandemic has pushed everyone to embrace digital transformation and reconsider current healthcare trends. In response to the emerging need for digitization of healthcare in India, the Ayushman Bharat Digital Mission was launched in September 2021. It creates and uses Digital Public Goods in increasing the availability, accessibility, affordability and acceptability of health care through different building blocks. The purpose of this mission is to establish a national digital health ecosystem that is integrated, effective and inclusive. The interoperable frameworks, open protocols and consent artefact enable citizens, public and private healthcare providers, digital innovations and other stakeholders to come together and drive equitable digitization of healthcare across the country.

Side Effects Comparison of Coronavirus Vaccines Among Healthcare Workers in Shoushtar, Iran.

Objective: Vaccination is one of the effective ways to fight against COVID-19 disease. Various vaccines have been designed during the coronavirus pandemic. Each of the used vaccines has beneficial effects as well as side effects. Healthcare workers were among the first vaccinated persons against COVID-19 in different countries. The current study aims to compare the side effects of AstraZeneca, Sinopharm, Bharat, and Sputnik V on healthcare workers in Iran. Methods: This descriptive study was conducted from July 2021 to January 2022 on 1639 healthcare workers who received the COVID-19 vaccines. Data were collected using a checklist that contained questions related to systemic, local, and severe side effects of the vaccine. The collected data were analyzed using the Kruskal-Wallis, Chi-square, and trend chi-square. P < .05 was regarded as a significant statistical difference. Results: The most commonly injected vaccines were Sinopharm (41.80%), Sputnik V (36.65%), AstraZeneca (17.75%), and Bharat (3.80%), respectively. At least 37.5% of participants reported one complication. The most common side effects after 72 hours of the first and second doses were as follows: injection site pain, fatigue, fever, myalgia, headache, and chill. Overall complication rates were reported as follows: AstraZeneca (91.4%), Sputnik V (65.9%), Sinopharm (56.8%), and Bharat (98.4%). Bharat showed the highest overall side effects, while Sinopharm had the lowest overall side effects. Also, our results indicated that individuals with a previous history of positive COVID-19 infection had a higher rate of overall complications. Conclusions: The majority of participants did not show life-threatening side effects after the injection of 1 of the 4 studied vaccines. Since it was well accepted and tolerable by the participants, it can be used widely and safely against SARS-CoV-2.

Enlightenment: The Covid-19 Pandemic

All efforts are for body and soul. All scientific theories and technologies, government policies, infrastructures, and spiritual activities are meant to protect the soul, body, and hunger. If we can protect the lives of all living entities in any eventuality, the country is said to be a developed country. Every incident exposes the system and gives the experience to learn for better operation with minimum fatalities. The sudden outbreak of deadly microscopic Corona virus had opened the eyes of all walks of people in the world and put all the countries in danger of human losses as well as the financial crisis. The pandemic covid-19 has taught valuable lessons and exposed many grave areas—loss of family members, loss of jobs, the closing of industries, offices, and schools, tireless work of emergency service providers, and what could be the severity of spreading of Covid-19 and health care systems after post lockdown. Apart from this pandemic disease, other critical areas for Disastrous Management due to the regular occurring natural calamities are droughts, cyclones, and industrial explosions, etc. pose challenges and need for improvement in the areas such as emergency services, agriculture sectors, shelters, sanitation, cleanliness, public parks and playgrounds, beautification of cities, old premises, cremation grounds, market places, slaughterhouses, etc. These essential services need to be investigated with quality assurance for the welfare of the people in terms of health, environment, investments, revenue, and the creation of jobs. These experiential challenges are critically analyzed in detail and presented in this paper for the policymakers to take appropriate steps to avoid any future epidemic diseases and disastrous situations like Covid-19. © 2023 DMICS.

Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana And Its Crucial Impact On Human Health During The Time Of Covid-19 In India

Covid-19-a heinous event that had left an eternally unforgettable scar of troubles, setbacks and distress on the entire human population across the globe. No country could evade from the unfavorable consequences of it. All countries across the world found themselves engulfed in the hands of Covid-19. It had taken a serious toll on the healthcare system of every country across the world. In the context of India, which is a nation with a poor coverage of public healthcare facilities and annually 3.2% Indians falling below poverty line, made the country and its population the most vulnerable. During that time, the biggest question arose was the survival of the marginalized and disadvantaged section of the society. However, fortunately a tiny hope of survival for the population of India was ensured and extended by the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). Thus, the authors of this research paper have attempted to figure out and critically examine the role played by AB PM-JAY in not only managing but also mitigating the outbreak of the virus in India and how it helped Indians sail through the storm of Covid-19. Besides, this paper tries to put views forward through analysis for the policy makers and healthcare stakeholders to become well-prepared for any such troublesome crisis in future. Moreover, secondary data is used to collect necessary information and critical descriptive analysis has been used to interpret the results of the study.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

A study on the utilization of Ayushman Bharat arogya scheme among patients admitted to a tertiary care hospital during Covid pandemic

Introduction and Aim: In India, most of the households face financial hardships due to catastrophic health care expenses. In response to covid-19 pandemic, the government launched the Ayushman Bharat Arogya Karnataka program, which offered health insurance for the coverage of covid-19 treatment costs and prevent families from undergoing financial hardships and incurring healthcare costs. The purpose of this study was to investigate and compare the utilization of the Ayushman Bharat insurance scheme among covid-19 positive and non-covid patients admitted to a tertiary care hospital in the Karnataka district of Dakshina Kannada. Methodology: Data was collected from medical records of a tertiary care hospital in the Dakshina Kannada District of Karnataka for this cross-sectional study. The data collected was analyzed using the Microsoft Excel program, and the results subjected to statistical analysis using IBM SPSS software ver.20. Result(s): The study found that there was a significant association between utilization of ABArK among patients (Covid and non-Covid) admitted to the hospital. While the utilization of ABArK among covid patients was found to be 51.3%, the utilization among non-covid patients was only 14.1% (chi2= 1242.32, p value <0.001). Conclusion(s): To improve the utilization of this scheme, public awareness activities must be conducted. As a result, less out-of-pocket expenditure would be incurred and access to healthcare facilities made easier. Copyright © 2022, Indian Association of Biomedical Scientists. All rights reserved.

Health index scores and health insurance coverage across India: A state level spatiotemporal analysis

Introduction: Since the Government of India has decided to continue with the publicly funded health insurance (PFHI) strategy, it is now pertinent to attempt to determine the factors that drive health insurance coverage in India. The NITI (National Institute for Transforming India) Aayog (i.e. Commission) is the apex public policy think tank of the Government of India. The NITI Aayog assesses the health status of the states through its acclaimed health index consisting of 24 indicators for health outcomes, governance and infrastructure. All states and Union Territories (UTs) are ranked on the index. This study aims to assess associations between NITI Aayog health index scores and health insurance coverage across India through a state-level lens. Method(s): Health insurance coverage data has been extracted from the National Family Health Survey (NFHS) 4 and NFHS-5 data. NFHS-4 was conducted during 2015-16. NFHS-5 was interrupted by the COVID-19 pandemic and conducted in two phases from 2019 to 2021. This change in health insurance coverage is mapped to the NITI Aayog health index scores for the states and UTs. The NITI Aayog has classified states into two categories: Larger states and smaller states. Based on performance in health indices, NITI Aayog also classifies the states and UTs as Aspirants, Achievers and Front runners. Results and discussion: There is a positive linear relationship between the health index scores of front-runners (Pearson's r = 0.6037, p = 0.029) and the total insurance coverage. We observe poor linear relationship between the health index scores of achievers (Pearson's r = 0.2822, p = 0.498) and the total insurance coverage. There is no linear relationship between the NFHS-5 Total Insurance Coverage and the NITI Health Index Scores (Pearson's r = 0.2766, p = 0.125). Also, we observe a moderate positive linear relationship between the health index scores and the total insurance coverage among the Union Territories which is not statistically significant (Pearson's r = 0.4343, p = 0.465). A similar conclusion is made in the context of smaller states (Pearson's r = 0.3692, p = 0.368) and larger states (Pearson's r = 0.2103, p = 0.387). At the same time, we observe a decrease in insurance coverage across NFHS-4 and NFHS-5 in some states and UTs. Further research is needed to identify the determinants of these spatial changes across a span of five years, from a temporal lens. Copyright © 2022

PILLARS OF INDIAN ECONOMY IN COVID-19: COMPREHENSIVE STUDY OF FARMING & AGRO BASED INDUSTRY

The country was under lockdown from more than two months due to COVID-19. In this crisis, the farmers have not allowed food security to be endangered. Moreover, they have increased food production despite all the obstacles. Right now, farmers are facing many obvious and climatic problems. Prime Minister of India has said that we have to convert this crisis into opportunity. The solution to farmer's problems is necessary, to make the country Atmanirbhar Bharat and to take it rapid fast on the path of progress. The outbreak of this epidemic has come at a time when the harvesting of Rabi crops had already started. However, taking necessary steps, Ministry of Agriculture has worked with all agencies of selling and buying agricultural products, units notified by the state governments, farmers and agricultural labourers along with machines used in harvesting and sowing and agro-horticulture exempted from and out of state. In addition, the All India Transport Call Centre was launched to remove bottlenecks in the movement of seeds, pesticides, fertilizers and fruits, vegetables, milk, eggs, fish and other perishable agricultural products. © 2022 University of Stockholm. All rights reserved.

Aida Analysis of Swachh Bharat Abhiyan: Role of Behavioral Antecedents

The aim of advertising is to encourage consumers to buy or use what the company is offering. AIDA theory of advertising describes the effect of advertising media. According to AIDA model, a potential consumer goes through 4 phases when deciding whether to buy a product and these correlate to the 4 phases of the AIDA model. AIDA theory of advertising describes the effect of advertising media. The acronym AIDA stands for Attention/Awareness, Interest, Desire and action. The effectiveness of any advertising campaign can be easily judged through the four stages of AIDA theory. In the first phase, the attention of consumers is captured. Once the consumer is aware that the product or service exists, the business should work on increasing the potential’s customer’s interest level. In the third phase, an emotional connection is established moving consumer’s mindset from “I like it” to “I want it”. In the last stage, the focus is on achieving ultimate goal which is to drive the receiver of the marketing campaign to initiate action and purchase the product or service. India accounts for about 90% of the population in South Asia and 59% of the 1.3 billion people still defecate in open, making it the single largest contributor to open defecation in the world. India loses atleast 1000 children a day to diarrhoeal deaths due to open defecation and lack of proper sanitation facilities. Due to the increment of awareness of environmental issues, health issues and also economic issues, Swachh Bharat campaign has been established. On launching Swachh Bharat Abhiya, PM Narendra Modi had said “the pursuit of cleanliness can be an economic activity contributing to GDP growth, reduction in health care costs and a source of employment. Mahatma Gandhi wished to see a "Clean India" where people work hand in hand to make the country clean. To work seriously towards this vision of Gandhi Ji, Prime Minister Shri Narendra Modi launched the Swachh Bharat Abhiyaan on October 2, 2014 and asked people from all walks of life to help in successful implementation of this mission. He invited all the Indians to devote 100 hours to clean their surroundings. In order to bring out behaviour change, extensive awareness generation initiatives would need to be undertaken with regards to the negative healthcare issues related to open defecation. The campaign has been described as "beyond politics" and "inspired by patriotism". Post COVID the need for social distancing and personal hygiene is going to bring about several structural changes right from how people stand in a queue or get a haircut to flying or watching movies. The new institutional practices are likely to remain in place for a longer period of time, with some becoming a permanent feature of public life. The present paper seeks to study the Swachh Bharat Abhiyan (SBA) through the lens of AIDA model. The study investigates the perception of people towards SBA through behavioural antecedents viz. attitude towards SBA, role of social media & subjective norms. This study is carried out to explore consumers’ demographic variables and their significant influence on the 4 variables of AIDA theory. Research Methodology: This quantitative study employed the exploratory research design. Data was collected from 335 respondents from all over India which covered North region, South-East, South-West, East, West, North-East, North-West and central region with the help of a structured questionnaire and focus groups. Percentage analyses, one way ANOVA and multiple regression are the statistical tools adopted for testing the hypotheses using SPSS. Findings and Implications: The statistically significant results revealed that category influences interest, desire & action of individuals. Education also positively impacts desire & action of individuals. Service class people were found to show more interest in SBA. Females were found to show more desire and action towards SBA activities. Single respondents show more desire in SBA. Religion was also found to affect SBA activities. People from Eastern egion are more attentive to SBA activities while people from South West region were found to show interest in SBA activities. North West people have desire to actively participate in SBA while respondents from South East are the most action-oriented people as far as SBA activities are concerned.

Indian consumer's receptivity to Chinese products in 'aatma nirbhar Bharath' era

With the global supply chain being disrupted due to the covid-19 pandemic and India embroiled in border tension with China, the Prime Minister of India gave an emergency appeal for 'Aatma Nirbhar Bharat' (self-reliant India). Given these circumstances, it is purposeful to comprehend how the consumers of India differentiate between the Chinese products and the domestic alternatives in this post-pandemic era of Aatma Nirbhar Bharat, where there are many product categories for which there is no or very few domestic alternatives available. The current study inspects the relationship among consumer ethnocentrism, animosity, quality-evaluation of Chinese goods and perceived inadequacy of domestic alternatives, and their impact on Indian consumers' purchase intention regarding Chinese goods. Structural equation modeling was adapted to experiment with the suggested sample. The research outputs indicate that the sentiments of animosity and the degree of ethnocentrism in consumers have a remarkable influence on the buying intention regarding Chinese goods even when no or very few domestic alternatives are available. It is also found from the results that the perceived inadequacy of domestic alternatives has no significant impact on the buying intention regarding Chinese goods. [ FROM AUTHOR] Copyright of Cardiometry is the property of Cardiometry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Distress return migration amid COVID-19: Kerala's response.

Emigrants from Kerala, India, were among the international migrants affected by the displacing consequences of COVID-19 - job losses, decreasing wages, inadequate social protection systems, xenophobia and overall uncertainty - which led to large-scale return migration to India. Returning home due to exogenous shocks calls into question the voluntary nature of return, the ability of returnees to reintegrate and the sustainability of re-embedding in the home country. The role of return migrants in the development of their societies of origin is also unclear. In this commentary, we explore the circumstances of return migration since the beginning of the COVID-19 pandemic by focusing on a case study of Kerala and provide insights on the future of emigration from this corridor along with policy suggestions. The role of return migrants in the development of their societies of origin requires further research and policy interventions.

Changing roles of frontline workers (FLWs) at health and wellness centres of south-west Bihar: A qualitative study

Background: Ayushman Bharat Program was announced by Government of India in February 2018 with a vision, which is supposed to deliver comprehensive primary health care services to the entire population. Objectives: To obtain views of FLWs about their changing role at health & wellness centre and the challenges being faced by them in service delivery. Methods: A qualitative study done in 10 Health and wellness centres selected nearby Narayan Medical College & Hospital of Rohtas District of Bihar. The frontline workers posted in the selected HWCs were the study participants. Total duration of the study was 10 months. IDI of FLWs were done and the analysis of the verbatims was done using ATLAS-Ti (Free trial version) software. Results: After analysis of the verbatims two broad themes were made and there were several domains & codes under which the result was stated. It was observed that the frontline workers posted at the selected health & wellness centres were aware of the expanded range of services like yoga, school health, geriatric & palliative care being provided but they were also facing some challenges like manpower, equipment, working hour in service delivery. Conclusion: It was concluded from the study that frontline workers posted at the selected health & wellness centres were aware of the expanded range of services provided but they were also facing some challenges in service delivery. © 2022.

Efficient Municipal Solid Waste Management: A Case Study of Dehradun City

Sanitization having a Lion Share of Attention on a Global dais in all the three-time zone Pre-COVID, COVOID, and Post-COVID is a matter of concern, especially for countries, which in the pre-era were striving hard to achieve it. Indian Government knitting the Spheris of Central and State Government has in the recent past shown bend towards the burning issue of Municipal Solid Waste Management. The Government had launched the schemes Swatch Bharat Mission, and it has been successful but is still on the backstage of its optimal potential as the basic motor of planning, i.e., “Master Plan” is missing in tier II and III cities when it comes to execution of such schemes. An attempt has been made in this paper to prepare a comprehensive plan for Dehradun city of Uttarakhand named “Solid waste Management Master Plan for Dehradun City 2041”. The following study will provide a complete spectrum approach towards the management of each component of Municipal Solid Waste Management of the city, including Waste Generation, Collection, Transportation, Treatment, and Disposal. Also, a service Level Benchmarking of both the Existing and Proposed System has been done to quantify the Output of the proposals and recommendations in the Existing System. Software such as GIS, GPS, and Remote Sensing is used in the study and has given an extra edge of Real-time and locational management for the Waste Management system of Dehradun until 2041. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

A systematic review on mucocutaneous presentations after COVID-19 vaccination and expert recommendations about vaccination of important immune-mediated dermatologic disorders.

With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID-19 vaccine administration were retrieved using the following keywords: COVID-19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life-threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non-significant, self-limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare-ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra-indications.

Under Pressure: Integrating Policy Interventions to Save Distressed Indian SMEs of COVID-19 Aftershocks

The Micro, Small, Medium Enterprises (MSME) sector has one of India’s highest employment Indexes and is the launchpad for all genres and innovators. This sector is inclusive in integrating grass root level workers into tech innovators. There are about 63 million MSMEs in India, employing 110 million individuals. According to 2019 MSME reports, the sector contributed 29% to the overall GDP catalyzing socio-economic development. The Covid-19 pandemics have left world economies and business entities to redefine and rethink policy regulations and business models. The pandemic has created socio-economic displacement across business sectors, and no country is free from the socio-economic exclusions that has triggered. The Indian economy has been badly affected by a projection of over a seven percent decline in quarterly GDP in 2021.The coronavirus pandemic has impacted MSME earnings by 20–50 percent, with micro and small organizations being the worst hit due to liquidity crunch. According to the survey conducted by Endurance International Group, many MSMEs have temporarily shut their operations or laid off their staff due to the inability to pay salaries. Further, due to slip in demand and halted production, many had to vacate the rented premises where they were functioning. MSMEs seek government support to tide over the situation with policy interventions on tax discounts or exemptions and loans distributed at cheaper rates or zero interest rates. With the economic slowdown and global restrictions on business outsourcing, and border tensions with China, India revived its Swadeshi (ethnic) dream of Mahatma Gandhi. The Government launched Atmanirbhar Bharat Mission to boost MSMEs and thrust indigenous industries and processes to reduce our foreign nations’ resilience. Indian government policies are favourable because they have committed $50 billion to help small businesses survive and provide low-income workers with a $266 billion stimulus package of around two percent of India’s annual economic output. Aatmanirbharta’ which means self-reliance, has been chosen by Oxford Languages as its Hindi word of the year 2020 as it authenticated the everyday achievements of the countless Indians who survived the perils of a pandemic,” as stated in one of the popular daily newspaper. The paper focuses on the issues and challenges faced by MSMEs in India due to the pandemic. Further, an analysis of changes in MSME definition presented in the Union Budget 2021 and various policy interventions by the Government and their impact on reviving in the MSME sector is presented. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Hospital selection under Insured Public Health Schemes in the multi-criteria group decision-making environment

A thriving healthcare system perfectly reflects economic development and contentment amongst the people of any region. With increasing anxiety concering health and growing medical needs, hospitals worldwide face substantial challenge to provide patients with adequate medical facilities under one roof. With a fragile state of the health industry in a developing country like India, there is a need for the hospitals to opt for international standards and comply with other premier health centers of the country. This paper aims to select the hospitals based on incongruous and conflicting criteria involving group decision-making using the Intuitionistic Fuzzy (IF) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. The criteria used are concomitant to an insured public health scheme named Ayushman Bharat-National Health Protection Scheme (AB-NHPS) of the Government of India. For each alternative Euclidean distance has been used to calculate the positive and negative separation measure from the ideal solution. The relative closeness to the ideal solution has been used to rank the hospitals. The result is a list of hospitals ranked from best to worst based on the laid criteria. It can aid governing bodies in decision-making under an uncertain environment with multiple complex criteria to analyze.

COVID vaccination in patients under treatment with rituximab: A presentation of two cases from Iran and a review of the current knowledge with a specific focus on pemphigus.

SARS-COV2 vaccines were approved without long-term monitoring due to emergent situations. This has raised some issues about the timing and protocol of receiving vaccines in specific situations such as patients receiving immunomodulatory agents including rituximab, which is widely used for various disorders such as multiple sclerosis, pemphigus, and many rheumatologic disorders. We described two cases of pemphigus vulgaris (a new case and one with flare-up) following vaccination with Astrazeneca in Iran and reviewed the existing data in this regard through searching on PubMed, Google Scholar, and Scopus. All of the relevant papers published until June 28, 2021, which we could access their full-texts were included. We found some recommendations made by rheumatologists, neurologists, and dermatologists in regard to vaccination timing in this group of patients and tried to summarize them to provide a practical guide for clinicians. Clinicians should perform a careful, individualized risk-benefit assessment for their patients and consider a delay in rituximab administration after completion of COVID vaccination if there is not any considerable risk of disease relapse or organ failure. Moreover, choosing vaccines with potential of providing protection after single dose, especially in countries with limited access to vaccines may be a reasonable approach.

Awareness and readiness of health care workers in implementing Pradhan Mantri Jan Arogya Yojana in a tertiary care hospital at Rishikesh.

BACKGROUND: Right to health is one among the important components of basic human rights. The Government of India had announced "Ayushman Bharat for a new India-2022", during 2018-19 parliament budget sessions with two components namely, Health and wellness centers for strengthening primary care and national health protection scheme now known as "Pradhan Mantri Jan Arogya Yojana (PMJAY)" for enabling access to secondary and tertiary healthcare services. Current study was conducted to assess awareness and readiness of the health care workers in implementation of Pradhan Mantri Jan Arogya Yojana. MATERIALS AND METHODS: A hospital based cross sectional study was conducted with estimated sample size calculated of 236, with treating consultants and residents as study participants. Participants filled a self-administered pretested semi-structured questionnaire to assess the level of awareness and readiness in implementing PMJAY. Data was entered and analyzed using EPI Info 7 software. RESULTS: Total number of participants were 181. Mean awareness score was 4.5±1.96 and mean readiness score was 16±5. Mean awareness and readiness score among medical and surgical branches was not statistically significant. There was significantly high awareness score among faculty as compared to senior residents. Relationship between awareness and readiness was found to be correlated with Pearson's correlation of 0.206 and was statistically significant. Linear regression model demonstrated an increase of 0.531 units in readiness for every unit increase in awareness score. CONCLUSION: Mean awareness score of doctors was just around half of maximum possible score. Awareness is more among faculty members than residents. With increase in awareness there is an increase in readiness among the study population. There is a need to organize workshops on PMJAY for stakeholders.

Health & Wellness Centers to Strengthen Primary Health Care in India: Concept, Progress and Ways Forward.

In February 2018, the Indian Government announced Ayushman Bharat Program (ABP) with two components of (a) Health and Wellness Centres (HWCs), to deliver comprehensive primary health care (PHC) services to the entire population and (b) Pradhan Mantri Jan Arogya Yojana (PMJAY) for improving access to hospitalization services at secondary and tertiary level health facilities for bottom 40% of total population. The HWC component of ABP aims to upgrade and make 150,000 existing Government Primary health care facilities functional by December 2022. The first HWC was launched on 14 April 2018 and by 31 March 2020, a total 38,595 AB-HWCs were operational across India. This article documents and analyses the key design aspects of HWCs, against core components of PHC & the health system functions. The article reviews the progress and analyses the potential of HWCs to strengthen PHC services and therefore, advance Universal Health Coverage in India. Challenges emerged from COVID-19 pandemic & learnings thus far has also been analyzed to guide the scale up of HWCs in India. It has been argued that effectiveness and success of HWCs will be dependent upon a rapid transition from policy to accelerated implementation stage; focus on both supply and demand side interventions, dedicated and increased funding by both union and state governments; appropriate use of information and communication technology; engagement of community and civil society and other stakeholders, focus on effective and functional referral linkages; attention on public health services & population health interventions; sustained political will & monitoring and evaluation for the mid-term corrections, amongst other. Experience from India may have lessons and learnings for other low and middle-income countries to strengthen primary healthcare in journey towards universal health coverage.