Integration of Ayush Services into Ayushman Arogya Mandir

The integration of Ayush services into Ayushman Arogya Mandir (AAM) represents a transformative shift in India's public healthcare architecture, moving beyond the conventional biomedical model toward a pluralistic, holistic wellness paradigm. This initiative, operationalised under the Centrally Sponsored Scheme National Ayush Mission (NAM), has successfully upgraded 12,500 existing Ayush Dispensaries and Sub Health Centres across 36 States and Union Territories into functional AAM (Ayush) units — a 100% operationalisation rate that underscores strong Centre-State coordination. The scheme's genesis lies in the National Health Policy 2017, which explicitly advocated mainstreaming Ayush systems within the public health system to achieve universal health coverage, and the subsequent establishment of the Ministry of Ayush in 2014 (elevated from a Department in 2003) provided the institutional backbone for such integration. Constitutionally, this aligns with Article 47 (Directive Principles of State Policy) which mandates the State to raise the level of nutrition and standard of living and improve public health, and Article 21 (Right to Life) as interpreted by the Supreme Court to include the right to health. The involvement of ASHAs (Accredited Social Health Activists) — a cadre created under the National Rural Health Mission (2005) — as field-level connectors ensures last-mile delivery and community ownership, reflecting the decentralised governance ethos of the 73rd and 74th Constitutional Amendments. The financial architecture — Rs.16.22 lakh per Ayush Dispensary and Rs.15.744 lakh per Sub-Centre — follows the standard Centrally Sponsored Scheme funding pattern (typically 60:40 Centre:State for most states, 90:10 for NE and Himalayan states), ensuring fiscal federalism. The significance extends beyond healthcare delivery. By offering Prakriti Parikshan (constitutional assessment), Yoga therapy, and medicinal plant awareness, AAM (Ayush) addresses the rising burden of non-communicable diseases (NCDs) — responsible for 63% of all deaths in India (WHO 2022) — through preventive and promotive care. This reduces out-of-pocket expenditure (OOPE), which still constitutes ~48% of total health expenditure (NHA 2019-20), by providing free or low-cost alternatives. The NABH accreditation and third-party reviews introduce quality assurance mechanisms often lacking in public facilities. Moreover, the data from Annexure-II — 3,648 hospitals and 40,269 dispensaries offering Ayush OPD as of April 1, 2024 — reveals a massive existing infrastructure base, with Karnataka (274 hospitals, 7,641 dispensaries) and Uttar Pradesh (1,982 hospitals, 3,761 dispensaries) leading, indicating deep-rooted institutional presence. Stakeholders include the Ministry of Ayush (policy), State Health Departments (implementation), NABH (quality), ASHAs/ANMs (last-mile), and citizens (beneficiaries). The Rajya Sabha written reply by MoS (I/C) Shri Prataprao Jadhav highlights parliamentary accountability. Future implications include potential integration with Ayushman Bharat Digital Mission (ABDM) for longitudinal health records, expansion of tele-Ayush services post-COVID, and leveraging India's traditional medicine diplomacy (e.g., WHO Global Centre for Traditional Medicine in Jamnagar) for medical tourism and global health leadership. However, challenges remain: standardising treatment protocols across diverse Ayush systems, ensuring adequate trained human resources (currently ~7.9 lakh registered Ayush practitioners), and strengthening referral linkages to secondary/tertiary allopathic facilities for complications. This initiative, if sustained, could position India as a global model for integrative medicine — a unique blend of tradition and modernity rooted in constitutional mandate and federal cooperation.