Anybody following India’s digital health plans in recent years would agree that we can’t fault it for a lack of ambition or vision. Every year, a new piece of the jigsaw puzzle is announced, and some budgetary allocation happens. But just as ‘culture eats strategy for breakfast', execution in the government eats vision for lunch. And if it’s healthcare, it hurts even more. We at Mumbai Multimedia Studio, investigate at the ~$200 million Ayushman Bharat Digital Mission (ABDM). On the face of it, the ABDM is a mere digitisation programme; in reality, it is the connective tissue meant to link the central, state, and private healthcare services of every citizen in the country—the “central verifier of all truths in healthcare”. It has learnt that tenders floated in many states toward this scheme are struggling, including in Jammu and Kashmir, Uttarakhand, Bihar, and Delhi. For instance, in Bihar, our writers have learnt, the Rs 191-crore ($24 million) tender was surprisingly awarded, in part, to a consultancy firm that primarily handles construction and road projects. Since the announcement, a rival bidder has filed a complaint asking for an inquiry into the matter, even as Bihar officials delay the project further by not signing a memorandum of understanding with the tender winners. There is a public sector alternative for states that are sick of dealing with private vendors. But the adoption rates there are nothing to write home about, except for pockets in Karnataka. It’s fair to argue that whoever wrote the blueprint of the ABDM perhaps forgot that any software requires hardware to run.
Any digitisation effort requires accompanying equipment like scanners and printers. In all this, the agency meant to implement the ABDM, the National Health Authority, has become more of a stepping stone for bureaucrats to pursue a public health course in premier US universities than a focused implementer. Its current chief executive’s term will end in about six months. I won’t hazard a guess as to whether he will get an extension or if that will solve the problem. But I will urge you to read this free story and share it widely
