Ayushman Gram Panchayat/ Ayushman Urban Ward is a status awarded to a village / ward that has been able to achieve the following parameters in Table 1 up to March 2024. A 100% coverage is envisaged within the given time frame. The indicators will be assessed against the total population as per the household population enumeration by ASHA.

Indicators

The indicators being considered for achieving the Ayushman Gram Panchayat/ Ayushman Urban Ward status is as follows

Table 11: Indicator of Ayushman Panchayat

Parameter	Coverage
Ayushman card distribution (above 5 years of age)	100%
ABHA ID generation (above 5 years of age)	100%
Screening for non-communicable diseases (NCD) (diabetes & hypertension) - 30 years and above	100% for diabetes and hypertension
Number of Presumptive TB examination- 30 per 1000 population per year (TB related)	100%
Number of TB patients with treatment outcomes given as success (more than 85%)	100%
Screening for sickle cell disease (SCD) and Card Distribution (0-40 years) - as applicable	100%

Any village or ward which has been able to achieve the above-mentioned coverage shall be awarded the status of ‘Ayushman Gram Panchayat’ or ‘Ayushman Urban Ward’.

Key Interventions of Ayushman Gram Panchayat/Ayushman Urban Ward

The targets can be achieved by leveraging the services available at the facility level and outreach camps. Additionally, weekly Health Melas will be utilized to reach the targets. Role of PRIs, VHSNCs/MAS/ Ward Committee and JAS will be important in social mobilization and community participation to achieve these.

Ayushman card and ABHA ID generation

Every eligible individual above 5 years of age shall be encouraged for Ayushman card generation. An approach should be adopted to saturate Ayushman card generation for all eligible candidates. Every eligible individual visiting the facility, during Health Melas and outreach camps shall be motivated to get registered.

The responsibility of implementation of any component of Ayushman Bhav related to PMJAY will lie with respective CEO, SHA and that of ABDM will lie with SMD.

ABHA ID is a unique ID that consolidates the health records of an individual. A universal approach shall be adopted for 100% coverage of ABHA-ID generation of individuals 5 years and above. Every individual visiting the facility shall be motivated to get their ABHA-IDs generated. Additionally, AYUSHMAN AROGYA MANDIR team members while visiting the community during outreach camps shall motivate and encourage community members for the same.

Non-Communicable Disease (Hypertension & Diabetes) screening

NCD screening involves screening for Hypertension & Diabetes. On being screened, the patient is connected with the PHC-MO through teleconsultation for treatment initiation. If required, the patient is further referred to higher facilities. Drugs are dispensed according to the prescription made and the patient is followed up monthly.

CHOs with the assistance of ASHA should ensure that 100% of the population over 30 years undergo screening, diagnosis, treatment initiation and follow-up. Every individual 30 years and above should be screened for Hypertension and Diabetes once annually.

Sickle Cell Disease screening – where applicable

SCD screening will be conducted across 17 states with a high prevalence of SCD. Screening for SCD will have a universal approach for persons within the age group of 0 to 40 years. The screening of SCD cases could be done through a targeted group approach as follows:

• New-born screening – Every new-born should be screened for SCD at the facility after birth.
• 0-18 years screening – The Medical Mobile Units (MMUs) under the Rashtriya Bal Swastha Karyakram (RBSK) will be leveraged to screen individuals falling within the age group up to 18 years of age. Children between 6 months to 6 years can be screened at Anganwadi centres. Children and adolescents between the ages 6 to 18 can be screened at their respective schools, Eklavya Model Residential Schools (EMRS), and Ashramshalas. Additionally, the Adolescent Friendly Health Clinics (AFHCs) under the Rashtriya Kishore Swastha Karyakram (RKSK) shall be leveraged to screen adolescents especially school dropouts.
• Antenatal screening – Pregnant women will be screened during ANC check-ups. If a pregnant woman is diagnosed with SCD, her husband shall be screened subsequently for SCD and referred to higher facility for prenatal diagnosis and pregnancy continuation.
• Cascade screening – Screening of extended family members of carriers and sickle cell

Every individual who is screened shall be provided with a Sickle cell card and registered on the Sickle cell portal/ application. Sickle cell cards have the status of diagnosis (Normal, Diseased or Carrier). The cards shall be used extensively for the purpose of genetic counselling through premarital and pre-conceptional counselling.

Screening and treatment of Tuberculosis

With respect to the ‘Ayushman Gram Panchayat/Ayushman Urban Ward’, the village/ward to ensure that a minimum of 30 individuals per thousand population to be examined for presumptive TB in a year. Further, all the identified TB patients in the village/ward to be put on treatment

The information is available in Ni-Kshay portal. The PRIs shall be engaged in playing the key role of change makers to motivate people to adopt TB preventive behaviours and mobilize them to utilize screening and treatment services so that incidence of TB in their jurisdiction of panchayat/ward is prevented and panchayat moves towards TB free status.

Assessment and Certification

The process of the Ayushman Panchayat assessment and certification should be done in close coordination of the Gram/ Nagar panchayat, ASHA, CHO/ MO, Block Development Officer/ Assistant or Deputy Commissioner and District Administration. Once the Gram/ Ward Panchayat achieves 100% of the target, Gram / Nagar Panchayat shall submit the Ayushman Panchayat application for certification to the Block Development Officer/ Assistant or Deputy Commissioner. The following are the steps of certification:

• ASHAs shall submit Ayushman Sabha report to the CHO/ MO of its village/ town.
• CHO at SHC-AYUSHMAN AROGYA MANDIR level and MO at PHC-AYUSHMAN AROGYA MANDIR/ UPHC-AYUSHMAN AROGYA MANDIR/ URBAN AYUSHMAN AROGYA MANDIR level shall compile the data related to Ayushman Sabha, Health mela, facility level, outreach camps etc.
• AASHA shall nominate her village/ catchment area to the Gram / Ward with the supported documents and after verifying the documents from all the villages/ towns to the Gram/ Ward, Panchayats shall submit the Ayushman Gram Panchayat/Urban Ward application to the Block Development Officer/ Assistant or Deputy Commissioner on the achievement of the targets.
• The BDO/ Assistant or Deputy Commissioner shall verify and assess the data related to the indicators and finalize the Ayushman Gram Panchayat/Urban Ward for certification within 15 working days from the date of receiving the application.
• The BDO/ Assistant or Deputy Commissioner will nominate the list of final Ayushman Gram Panchayat/Urban Ward to the District Administration.
• The District Administration will review the applications received quarterly and shall certify the eligible Panchayats as ‘Ayushman Gram Panchayat or Ayushman Urban Ward’.
• The certified ‘Ayushman Gram Panchayat or Ayushman Urban Ward’ will be awarded during the Gram Sabha scheduled on 2nd October 2023. Every certified Ayushman Panchayat will be continuously monitored
• Further, the action plan and timeline for the remaining Panchayat/Wards yet to achieve the ‘Ayushman Gram Panchayat/Urban Ward’ status will be discussed during the gram sabha.
• A follow up Ayushman Sabha will also be conducted before 31st December 2023 to review the progress made by the villages/wards regarding the health indicators for Ayushman Gram/Ward Panchayat. The certified Ayushman Gram Panchayat/Urban Ward’ will be awarded during this gram sabha and timelines will be decided for the lagging panchayats.