3,4 To review and track the progress under NHM, various monitoring mechanisms are put in place. NHM has been instrumental in supporting the states in building an integrated network of primary, secondary and a substantial part of tertiary care to provide care-continuum. In India, the NHM (erstwhile National Rural Health Mission), launched in 2005 3 is the prime vehicle for UHC, considering its role in shaping the public healthcare system. 2 This reiterates the need for accessible, affordable and acceptable diagnostic services to achieve desired population health outcomes through universal health coverage (UHC) and care-continuum pathways. While the availability of diagnostic services has been one of the key components under National Health Mission (NHM), several constraints in access have been identified as barriers to patient assessment and management 1 leading to empirical treatment, patients switching between providers or even opting out of care. States need to leverage the existing mechanisms, assess their implementation, and arrive at feasible and sustainable solutions to strengthen access to diagnostic services.Īccess to affordable and quality diagnostic services is crucial for population health, given their guiding role towards measures to improve health outcomes. The nation has strategized accessible, affordable and acceptable diagnostic services to achieve universal health coverage and care-continuum pathways. In a complex adaptive system, access to diagnostic services depends on the concurrent strengthening of various health system components across the levels of care. The major themes that emerged include (i) the approach to health systems strengthening, (ii) efficiency of procurement and distribution systems, (iii) infrastructure, (iv) modes of service delivery, (v) implementation of Free Diagnostic Service Initiative, Comprehensive Primary Health Care and Biomedical Equipment Management and Maintenance Program, and (vi) quality of care, and (vii) diagnostic service outcomes. Each theme was analysed further to deduce context-specific enablers and barriers influencing access to diagnostic service delivery. Analysis of the data was done iteratively to identify the themes emerging from the reports over the years. The data were segregated for each Indian state and categorized under the pre-determined themes: state-specific practices, key findings, and challenges. Data relevant to diagnostic services were retrieved using defined search terms. ![]() MethodsĬommon Review Mission (CRM) reports between 20 were selected for the study. ![]() The objective of the study was to understand key health system factors augmenting or limiting access to diagnostic services and outcomes. To continually enhance citizens’ ability to seek and avail quality and affordable services, it is imperative to take stock of various components of the diagnostic ecosystem that may be common or unique to states and understand their influence on equipping the health system. ![]() This effort has improved access to, and utilization of, diagnostic services at public healthcare facilities. In India, the National Health Mission (NHM) has been supporting the states in building an integrated public healthcare network across the levels of care.
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