Publication: Ayushman Bharat Digital Mission’s Integrated Digital Health Ecosystem is the Foundation of Universal Citizen-Centered Health Care in India: Case Study
Loading...
Date
2025-01-21
ISSN
Published
2025-01-21
Author(s)
Editor(s)
Abstract
The COVID-19 pandemic ushered in the need for accelerated digitization of health care across the globe. The Government of India amply demonstrated their digital prowess in their response to the pandemic by building Digital Public Goods (DPGs) that leverage several standalone initiatives to develop an integrated national digital health ecosystem. The aim of this ecosystem is to support Universal Health Coverage through the provision of real-time data, information and infrastructure using open-source, interoperable, standards-based digital systems. In the last decade, digital public infrastructure within India has expanded exponentially. Several initiatives like the digital identity system known as Aadhaar (for unique identification), and the Unified Payments Interface have become central to India’s public service delivery architecture. The Unified Payments Interface has transformed heterogeneous payment modalities by aggregating them under one easy to use, highly secure mobile-based system for money transfer. Mobile and internet connections have expanded at a fast pace and penetrated ever deeper into rural areas. Currently over 572,000 villages out of 597,000 have mobile or network connectivity. There are nearly 1.2 billion mobile subscribers, 800 million internet users, and 510 million smartphone users. This expansion can be attributed to the cost of mobile and internet connections dropping substantially, allowing for increased digital access across the country. Within the public digital infrastructure, there are 1.24 billion unique Aadhar digital IDs in place, and it is estimated that nearly 10 billion plus eKYC (Know Your Client) transactions and 2.64 billion Unified Payments Interface transactions take place monthly. This infrastructure forms the basis of the Ayushman Bharat Digital Mission (ABDM).
Link to Data Set
Citation
“World Bank. 2025. Ayushman Bharat Digital Mission’s Integrated Digital Health Ecosystem is the Foundation of Universal Citizen-Centered Health Care in India: Case Study. © World Bank. http://hdl.handle.net/10986/42710 License: CC BY-NC 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication The Health Effects of Universal Health Care : Evidence from Thailand(World Bank, Washington, DC, 2012-07)This paper exploits the staggered rollout of Thailand s universal health coverage scheme to estimate its impacts on whether individuals report themselves as being too ill to work. The statistical power comes from the fact that there is an average of 62,000 respondents in the labor force survey at each survey date and no less than 68 survey dates, most of which are just one month apart. The analysis finds that universal coverage reduced the likelihood of people reporting themselves to be too sick to work: the authors estimate the effect to be -0.004 one year after universal coverage and -0.007 three years after. The estimated effects are much larger among those age 65 and over. Universal coverage had a much larger effect on health (about four times larger) than the Village Fund scheme, which provided free credit to rural households through a subsidized microcredit scheme and which was rolled out around the same time as universal coverage.Publication India - Swachh Bharat Mission Support Operation(Washington, DC, 2015-11-05)A fiduciary systems assessment (FSA) was carried out to evaluate the arrangements relevant to the operation and to determine whether they provide reasonable assurance that the operation funds will be used for their intended purpose. Taking into account the improvements required and the agreement on the actions required to strengthen the systems (which are reflected in the program action plan (PAP), the overall fiduciary framework is considered adequate to support the operation management and to achieve the desired results. Assessments have been carried out in five states through two consulting firms. PricewaterhouseCoopers Private Limited (PwC) was engaged to carry out assessments in West Bengal and Odisha, while Ernst and Young Limited (E and Y) were engaged for assessments in Chattisgarh, Madhya Pradesh, and Rajasthan. The overall objective of the operation is to accelerate efforts under swachh Bharat mission gramin (SBM-G) to achieve universal sanitation coverage, enhance cleanliness, and eliminate open defecation in rural areas by leveraging Bank funds to incentivize performance of the states and, to increase ministry of drinking water and sanitation (MDWS) capacity to facilitate states in program implementation. The proposed operation will support the national program over a five year period (2015-2020); coinciding with the timeframe of the national program. To strengthen the program’s procurement implementation capacity, several crucial measures should be adopted including additional staffing, intensive training, and hiring of qualified procurement and contract management support consultants, and robust procurement audit. The Bank will also provide assistance and support to the program implementation and will closely monitor the program procurement performance.Publication Improving Universal Primary Health Care by Kenya : A Case Study of the Health Sector Services Fund(World Bank, Washington DC, 2013-01)This case study describes the Government of Kenya's initiative to expand the supply of health care and strengthen primary health care through implementation of the Health Sector Services Fund (HSSF), which provides direct cash transfers to primary health facilities. This initiative, launched in 2010, is a direct response to challenges identified by the Public Expenditure Tracking Surveys in making funds for operation and maintenance available to the health facilities, and builds on lessons from initiatives supported by the Danish International Development Agency (DANIDA) in the Coastal Region.Publication Peru’s Comprehensive Health Insurance and New Challenges for Universal Coverage(World Bank, Washington DC, 2013-01)This case study analyzes the progress of Peru's Comprehensive Health Insurance (SIS) and evaluates the challenges that remain to achieving universal health care coverage. Peru is an upper-middle-income country with a gross domestic product (GDP) per capita of just over US$10,000 (purchasing power parity). The country has grown rapidly in the last decade; the average growth rate was 6.5 percent. However, 28 percent of the population lives in poverty (2011), which is estimated with regionally differentiated poverty lines between US$1 and US$2 per capita per day. In addition, only one in four individuals has employment with social security coverage. The SIS aims to reduce economic barriers through the elimination of user fees for a package of services. Although its budget has been low, the SIS has played an important role in the reduction of maternal and child mortality. However, the improvements expected to the overall health system have not materialized. Meanwhile, when the decentralization process transferred funds and authority to the regions, it did so in a context of weak management capabilities, and it failed to clearly define the relationship between the national and regional governments. A major effort to strengthen the technical capacity of the Ministry of Health (MOH) should accompany the strategies outlined above. This effort should emphasize a review of health priorities, the design of effective interventions within a fiscally sustainable benefits package, and the introduction of incentives and new payment mechanisms at hospitals and other health facilities.Publication For Better Quality and More Integrated Primary Health Care Services through Harnessing the Private Sector in Sindh Province(World Bank, Washington, DC, 2019-06-01)Achieving universal health coverage (UHC) in Pakistan, as in most countries, will require strengthened collaboration between the public and private sectors, as the public sector often does not have the flexibility nor the fiscal space to grow service delivery capacity at sufficient pace and quality. However, successful partnering with the private sector through various forms of contracting and service agreements including public-private partnerships (PPPs), requires the appropriate analysis and identification of the gaps in service provision. To that end, this study aims to assist the government of Sindh (GoS) in identifying opportunities to engage the private health sector more effectively, to help provide affordable, quality primary health care (PHC) services to the urban poor whilst also creating evidence for the better integration of the private health sector in health service delivery. As part of the initial phase of this advisory work, and operating within a limited time-frame and funding environment, this policy note presents the initial set of observations and recommendations, based on the information collected via questionnaires and informant interviews, as well as secondary data or existing studies.
Users also downloaded
Showing related downloaded files
Publication Supporting Youth at Risk(World Bank, Washington, DC, 2008)The World Bank has produced this policy Toolkit in response to a growing demand from our government clients and partners for advice on how to create and implement effective policies for at-risk youth. The author has highlighted 22 policies (six core policies, nine promising policies, and seven general policies) that have been effective in addressing the following five key risk areas for young people around the world: (i) youth unemployment, underemployment, and lack of formal sector employment; (ii) early school leaving; (iii) risky sexual behavior leading to early childbearing and HIV/AIDS; (iv) crime and violence; and (v) substance abuse. The objective of this Toolkit is to serve as a practical guide for policy makers in middle-income countries as well as professionals working within the area of youth development on how to develop and implement an effective policy portfolio to foster healthy and positive youth development.Publication Digital Public Infrastructure and Development(Washington, DC: World Bank, 2025-03-11)DPI is an approach to digitalization focused on creating “foundational, digital building blocks designed for the public benefit.” By providing essential digital functions at society scale that can be reused across sectors, DPIs enable public and private service providers to build on these systems, innovate, and roll out new services more quickly and efficiently. Common systems built as DPIs include digital identity and electronic signatures, digital payments, and data sharing. However, to provide DPI functionality, these systems must embed principles such as inclusion, openness, modularity, inclusivity, user-centricity, privacy-by-design, and strong governance. This paper provides a common framework and primer on DPI for policymakers, practitioners, WBG staff, and the broader development community, including: • DPI Concepts and Theory of Change: This includes a working definition of DPI and its core characteristics, including the role of the private sector, how DPI differs from past approaches to digitalization, and the relationship between core DPI systems, sector-specific systems, other digital technologies, and broader ecosystem enablers and safeguards. The paper also articulates the potential benefits of DPI across a range of public and private sector services, as well as risks and challenges for implementation and adoption. • Considerations for Implementation: Drawing on the experiences of a diverse set of countries across different regions, income levels, and DPI approaches, the paper identifies common trends for building, scaling, and using DPIs that are safe and inclusive. This includes identifying what we know (and do not yet know) around different DPI design choices and models, implementation strategies, procurement, issues around use case integration and sequencing of DPI, and more. • Principles and Practical Lessons: Finally, it summarizes key lessons from countries’ experiences with DPI to date, highlighting critical success factors and risk mitigation strategies for policymakers, practitioners, and development partners. A separate volume provides examples of DPI from countries around the globe. By leveraging the opportunities presented by DPI, countries can accelerate their digital transformation journeys and achieve more inclusive and sustainable development. The World Bank Group is committed to supporting this crucial endeavor. The WBG’s new Global DPI Program will address key knowledge gaps and support countries in building safe, inclusive, and transformative DPI.Publication State and Trends of Carbon Pricing 2024(Washington, DC: World Bank, 2024-05-21)This report provides an up-to-date overview of existing and emerging carbon pricing instruments around the world, including international, national, and subnational initiatives. It also investigates trends surrounding the development and implementation of carbon pricing instruments and some of the drivers seen over the past year. Specifically, this report covers carbon taxes, emissions trading systems (ETSs), and crediting mechanisms. Key topics covered in the 2024 report include uptake of ETSs and carbon taxes in low- and middle- income economies, sectoral coverage of ETSs and carbon taxes, and the use of crediting mechanisms as part of the policy mix.Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.Publication World Bank Annual Report 2024(Washington, DC: World Bank, 2024-10-25)This annual report, which covers the period from July 1, 2023, to June 30, 2024, has been prepared by the Executive Directors of both the International Bank for Reconstruction and Development (IBRD) and the International Development Association (IDA)—collectively known as the World Bank—in accordance with the respective bylaws of the two institutions. Ajay Banga, President of the World Bank Group and Chairman of the Board of Executive Directors, has submitted this report, together with the accompanying administrative budgets and audited financial statements, to the Board of Governors.