Ayushman Bharat Health and Wellness Centres

Ayushman Bharat Health and Wellness Centres constitute the first of the two complementary pillars of the Ayushman Bharat programme, announced in the Union Budget of February 2018 by Finance Minister Arun Jaitley and operationalised from 14 April 2018, when Prime Minister Narendra Modi inaugurated the first centre at Jangla in Bijapur district, Chhattisgarh. The initiative draws its policy lineage from the National Health Policy 2017, which committed the state to strengthening primary care as the foundation of Universal Health Coverage, and from the recommendations of successive expert bodies advocating a shift from selective to comprehensive primary care. The programme is administered by the Ministry of Health and Family Welfare through the National Health Mission, with the National Health Authority overseeing the insurance pillar separately. The centres operationalise the constitutional Directive Principle under Article 47, which obliges the state to raise the level of public health, and they function within the federal framework wherein public health is a State subject under Entry 6 of the State List, requiring centre-state cost-sharing arrangements.

The operational mechanics rest on converting and upgrading existing infrastructure rather than building anew. Sub-Health Centres serving roughly 5,000 people and Primary Health Centres serving roughly 30,000 people are upgraded into Health and Wellness Centres delivering an expanded basket of services. The upgraded sub-centre is staffed by a Community Health Officer, a mid-level health provider—usually a nurse or Ayurveda practitioner who has completed a certificate course in community health—supported by Auxiliary Nurse Midwives and Accredited Social Health Activists (ASHAs). Each centre is mandated to deliver a defined package across an expanding number of service categories, including care in pregnancy and childbirth, neonatal and infant health, childhood and adolescent care, communicable disease management, management of non-communicable diseases such as hypertension and diabetes through population-based screening, basic oral, eye, ear, nose and throat care, mental health, geriatric and palliative care, and emergency stabilisation.

The model emphasises continuity of care, free essential medicines and diagnostics, and teleconsultation through the eSanjeevani platform, which links peripheral centres to specialists at higher facilities. Population-based screening for common cancers—oral, breast and cervical—forms a distinctive feature, with frontline workers conducting community enumeration and risk assessment. Financing flows through the National Health Mission's flexible pool, with the Centre and most states sharing costs in a 60:40 ratio, while the ratio is 90:10 for the north-eastern and Himalayan states and full central funding for Union Territories without legislatures. The programme was subsequently rebranded; in 2023 the centres were renamed Ayushman Arogya Mandir under a common Hindi nomenclature with a standardised logo and tagline.

By contemporary reckoning the government has reported operationalising more than 1.6 lakh such centres across states, with states including Tamil Nadu, Kerala, Gujarat and Andhra Pradesh among the more advanced implementers. The Health Ministry's dashboards track footfall, screening numbers and teleconsultations, and the network was repurposed during the COVID-19 pandemic for vaccination and surveillance. Integration with the Ayushman Bharat Digital Mission, launched in 2021, links the centres to the creation of Ayushman Bharat Health Accounts (ABHA identifiers) and longitudinal electronic health records.

The centres must be distinguished from the second pillar of the same programme, the Pradhan Mantri Jan Arogya Yojana (PM-JAY), which is a tax-financed health insurance scheme providing secondary and tertiary hospitalisation cover of five lakh rupees per family per year to roughly the poorest forty percent of the population. Where PM-JAY is a demand-side, claims-based purchasing mechanism administered by the National Health Authority, the Health and Wellness Centres are a supply-side investment in public infrastructure for primary care; the former pays empanelled hospitals for inpatient episodes, while the latter delivers preventive and ambulatory care directly. The centres are also distinct from the older Sub-Health Centre and Primary Health Centre designations they upgrade, and from the National Urban Health Mission's urban primary health facilities, though urban centres also fall within the programme.

Implementation has attracted scrutiny on several fronts. The availability of trained Community Health Officers, regular drug and diagnostic supply, functional referral linkages, and the disparity between physically certified centres and those delivering the full service package have been recurring concerns in CAG reports and parliamentary committee reviews. The 2023 rebranding to Ayushman Arogya Mandir generated political friction with non-aligned state governments over branding and cost-sharing conditionalities tied to central funds. Questions persist about whether the screening-heavy non-communicable disease component translates into sustained treatment and follow-up, and about the integration of AYUSH practitioners into allopathic primary care.

For the working practitioner, the Health and Wellness Centres represent India's most significant attempt to reorient a historically hospital-centric and curative health system toward comprehensive primary care and Universal Health Coverage. Civil services aspirants encounter the subject in General Studies Paper II under welfare schemes, governance and health, where the analytically valuable point is the deliberate two-pillar architecture pairing supply-side primary care with demand-side insurance. Policy analysts and desk officers tracking health diplomacy, federal fiscal transfers and digital health infrastructure should treat the centres as the operational backbone connecting frontline service delivery to the broader Ayushman Bharat and digital health ecosystem.