MAINS Current Affairs includes India’s Emerging Drought Stress: Monsoon Variability and Agricultural Risks & Ayushman Bharat 8th Anniversary

Geography /Environment/ Disaster Management

1. India’s Emerging Drought Stress: Monsoon Variability and Agricultural Risks

Context: As the southwest monsoon enters its withdrawal phase, drought-like conditions have expanded across more than half of India’s geographical area.

• Persistent soil-moisture stress is raising concerns regarding:
  • Kharif crop yields;
  • Rabi sowing; and
  • Overall water security.

About Drought in India

• Drought refers to a prolonged period of abnormally low rainfall resulting in water scarcity, with its effects varying across meteorological, agricultural and hydrological systems.
• Drought assessment in India is increasingly based on multiple indicators rather than rainfall alone, including:
  • Rainfall;
  • Soil moisture;
  • Vegetation health;
  • Reservoir storage; and
  • Groundwater conditions.
• India’s vulnerability is particularly high because around 55–60% of its net sown area is rainfed.
• The National Disaster Management Authority (NDMA) and the Ministry of Agriculture focus on:
  • Drought monitoring;
  • Early-warning systems;
  • Contingency crop planning; and
  • Efficient water

India’s Emerging Drought Stress

1. Monsoon Variability

• The principal concern is not simply a deficit in total seasonal rainfall but its uneven distribution across time and space.
• Frequent alternation between intense wet spells and prolonged dry periods can result in persistent soil-moisture depletion.
• Consequently, isolated episodes of rainfall may not necessarily restore drought conditions when pre-existing soil-moisture deficits remain significant.

2. Extent and Spread of Drought

• According to the IIT Gandhinagar India Drought Monitor, approximately 5% of India’s area was under dry or drought conditions by September 16, 2026, compared with 38.9% around a month earlier.
• Regional levels of stress were particularly significant:

3. Rainfall Deficit and Spatial Variability

• Between June 1 and September 22, 2026, India received approximately 9 mm of rainfall, compared with the normal 832.4 mm, representing a 15% deficit.
• Around 41% of the country experienced deficient seasonal rainfall.
• Significant regional rainfall deficits included:
  • Rayalaseema — 43%;
  • Coastal Andhra Pradesh — 37%;
  • Marathwada — 36%;
  • Interior Karnataka — 32%; and
  • Kerala — 28%.

4. El Niño and Monsoon Uncertainty

• A strengthening El Niño introduces additional uncertainty into rainfall and temperature patterns.
• Its interaction with other ocean–atmosphere processes can influence the timing, intensity and spatial distribution of monsoon rainfall.
• Recent research also highlights the role of ENSO variability in modifying drought characteristics and agricultural productivity.

Implications for Agriculture & Overall Economy

1. Impact on Kharif Sowing

• Drought stress is already reflected in kharif sowing patterns.
• By September 11, total kharif acreage stood at approximately 1,096.49 lakh hectares, compared with 1,112.54 lakh hectares during the corresponding period a year earlier.
• Paddy acreage declined by nearly 17 lakh hectares.

2. Crop Yields and Farm Incomes

• Persistent soil-moisture deficits can negatively affect:
  • Crop yields;
  • Livestock productivity; and
  • Farm incomes.
• At the same time, farmers may face greater dependence on irrigation and government support mechanisms.

3. Impact on Rabi Agriculture and Food Security

• Reduced reservoir storage and groundwater recharge could constrain the availability of irrigation water for rabi sowing.
• This could have wider implications for:
  • Food prices;
  • Rural employment; and
  • Agricultural GDP.

4. Vulnerable Districts

• The vulnerability is particularly significant because the Agriculture Ministry and ICAR had identified 315 districts as potentially vulnerable to El Niño-related agricultural distress.
• Of these, 111 districts were identified as high-priority districts with irrigation coverage below 25%.

Way Forward

• Strengthen district-level drought early-warning systems: Integrate rainfall, soil moisture, groundwater and satellite-based observations for timely assessment.
• Promote climate-resilient agriculture: Encourage millets, pulses and drought-tolerant crop varieties suited to water-stressed conditions.
• Expand water-conservation measures: Scale up micro-irrigation, watershed development and rainwater harvesting.
• Adopt dynamic contingency crop planning: Modify crop choices and agricultural practices according to real-time monsoon conditions.
• Improve water availability for rabi: Strengthen reservoir management and groundwater recharge to improve post-monsoon agricultural resilience.
• Strengthen farmer support: Improve crop insurance, weather-based advisories and targeted livelihood assistance in drought-vulnerable districts.
• Move towards impact-based drought monitoring: Assessment should go beyond rainfall deficits and incorporate the actual effects on soil moisture, crops, water resources and livelihoods.

Government Schemes

2. Ayushman Bharat 8th Anniversary

Context: On the 8th anniversary of Ayushman Bharat, the Prime Minister highlighted the programme’s achievements and its contribution towards India’s goal of Universal Health Coverage (UHC).

• Launched in 2018, Ayushman Bharat represents a shift from fragmented, sector-specific healthcare interventions towards an integrated and need-based continuum of healthcare.

About Ayushman Bharat

What is it?

• Ayushman Bharat was launched on September 23, 2018 as India’s flagship national health initiative.
• It seeks to provide a comprehensive healthcare continuum covering financial protection, primary healthcare, digital health infrastructure and health-system preparedness.

Four Integrated Pillars of Ayushman Bharat

1. AB-PMJAY (Pradhan Mantri Jan Arogya Yojana):

• Provides financial protection and cashless access to secondary and tertiary inpatient hospital care.

2. Ayushman Arogya Mandirs (AAMs):

• Provide comprehensive primary healthcare at the grassroots level.
• Emphasise preventive healthcare, screening and wellness.

3. Ayushman Bharat Digital Mission (ABDM):

• Develops an interoperable digital public health infrastructure.
• Facilitates digital health identities, health records and connections between healthcare stakeholders.

4. PM-ABHIM (PM-Ayushman Bharat Health Infrastructure Mission):

• Strengthens health infrastructure, disease surveillance, critical-care capacity and diagnostic laboratory networks.

Key Achievements & Performance Data

1. Financial Cover & Outreach

• Approximately 33% of India’s population, representing more than 51 crore individuals, has verified Ayushman cards.
• Eligible families receive cashless hospitalisation cover of up to ₹5 lakh per year.

2. Hospitalisation and Financial Savings

• The scheme has supported more than 25 crore hospital admissions.
• These admissions were valued at approximately ₹2.03 lakh crore.
• The programme has helped reduce out-of-pocket medical expenditure and protect vulnerable households from medical debt.

3. Empanelled Hospital Network

• More than 38,000 public and private hospitals are empanelled under the programme.
• The network covers around 1,961 procedures across 27 medical specialties.

4. Primary Healthcare Footprint — Ayushman Arogya Mandirs

• Ayushman Arogya Mandirs have recorded more than 4 billion cumulative visits.
• They have also facilitated more than 50 crore teleconsultations through the e-Sanjeevani telemedicine platform.

5. Digital Public Infrastructure — ABDM

• More than 61 crore ABHA IDs have been generated.
  • Women:74%;
  • Men:26%; and
  • Other genders:01%.
• More than 95 crore digital health records have been linked.
• More than 78 lakh healthcare facilities and around 11 lakh healthcare professionals have been registered on the relevant national registries.

Beneficiary Identification & Special Expansions

1. SECC 2011 Baseline

Rural Households

Beneficiaries were initially identified using deprivation criteria under the Socio-Economic and Caste Census (SECC) 2011, including:

• D1: Household living in a single room with kuchcha walls and roof;
• D2: No adult member between 16–59 years;
• D3: Female-headed household with no adult male member;
• D4: Household with a disabled member and no able-bodied adult;
• D5: SC/ST households; and
• D7: Landless households dependent primarily on manual labour.

Urban Workers

• Coverage also extends to 11 identified informal occupational groups, including:
  • Ragpickers;
  • Domestic workers;
  • Street vendors;
  • Construction workers;
  • Sanitation workers;
  • Transport workers; and
  • Employees in small shops, among others.

2. Targeted Inclusion of Frontline Workers

• In March 2024, coverage was expanded to approximately 37 lakh families of:
  • ASHA workers;
  • Anganwadi Workers (AWWs); and
  • Anganwadi Helpers (AWHs).
• More than 81 lakh Ayushman cards had been issued to this group.

3. Universal Senior Citizen Coverage

• In September 2024, coverage was expanded to all senior citizens aged 70 years and above, irrespective of socio-economic status.
• The expansion covers approximately 6 crore senior citizens.
• More than 36 crore Ayushman Vaya Vandana cards have been issued.

Institutional Architecture Across the Four Pillars

Pillar 1: AB-PMJAY — Centrally Sponsored Scheme

• Funding Pattern:
  • 60:40 between the Centre and States;
  • 90:10 for North-Eastern States, Himachal Pradesh, Uttarakhand and Jammu & Kashmir;
  • 100% central funding for Union Territories without legislatures.
• Union Budget 2026–27: An allocation of ₹9,500 crore was provided in the Budget Estimates.

Pillar 2: Ayushman Arogya Mandirs — Primary Care Transformation

• Sub-Health Centres and Primary Health Centres are upgraded into Ayushman Arogya Mandirs.
• They provide 12 essential service packages, covering areas such as:
  • Screening for non-communicable diseases;
  • Mental healthcare;
  • ENT and eye care;
  • Palliative care; and
  • AYUSH-related services.
• The objective is to shift healthcare towards prevention, early detection and comprehensive primary care.

Pillar 3: Ayushman Bharat Digital Mission — Digital Health Ecosystem

• ABDM creates a national digital health ecosystem comprising:
  • Ayushman Bharat Health Account (ABHA);
  • Health Facility Registry (HFR);
  • Healthcare Professionals Registry (HPR); and
  • Unified Health Interface (UHI) based on open protocols.
• These components are intended to enable interoperable digital prescriptions, health records and claims.

Pillar 4: PM-ABHIM — Infrastructure & Epidemic Preparedness

• PM-ABHIM has an outlay of ₹64,180 crore for 2021–2026.
• It seeks to establish:
  • 631 Critical Care Hospital Blocks in districts with populations exceeding 5 lakh;
  • 744 Integrated Public Health Laboratories (IPHLs), with provision for every district; and
  • 3,389 Block Public Health Units across priority States.
• The mission strengthens India’s ability to respond to public-health emergencies and disease outbreaks.

Implementation Challenges

1. Inter-State Health Inequities & Hospital Participation

• Private hospitals in Tier-2 and Tier-3 cities may remain reluctant to participate because of:
  • Delays in claim settlement; and
  • Disputes regarding relatively static package reimbursement rates.
• This can affect the availability of specialised healthcare in underserved areas.

2. Out-of-Pocket Outpatient Expenses

• AB-PMJAY primarily covers secondary and tertiary inpatient hospitalisation.
• Expenses related to outpatient consultations, diagnostic imaging and medicines can continue to impose a financial burden on lower- and middle-income households.

3. Digital Divide in ABHA Integration

• Slow adoption of digital hospital-management systems in remote rural health facilities can make end-to-end integration of digital health records
• Limited digital infrastructure and literacy can further constrain effective utilisation.

4. Shortage of Specialists

• Rural Ayushman Arogya Mandirs and sub-district hospitals continue to face shortages of specialist medical personnel.
• Patients may therefore need referrals to already burdened tertiary government medical colleges.

Way Ahead

1. Dynamic Revision of Health Benefit Packages

• Periodically revise reimbursement rates under Health Benefit Packages (HBP) using actual actuarial costing.
• This can improve participation of accredited multi-specialty hospitals, particularly in underserved districts.

2. Expand Outpatient Care Integration

• Gradually consider incorporating high-cost outpatient maintenance therapies within the cashless healthcare framework.

3. Institutionalise Fraud Detection and Anti-Abuse Systems

• The National Health Authority (NHA) can use AI and machine-learning based analytics to identify:
  • Phantom admissions;
  • Inflated billing; and
  • Unnecessary surgical procedures.

4. Strengthen Public Healthcare Infrastructure

• Accelerate implementation of PM-ABHIM so that district hospitals and critical-care facilities develop sufficient capacity for complex procedures and emergencies.

5. Promote Digital Literacy for ABHA

• Simplify consent mechanisms and strengthen safeguards under the Digital Personal Data Protection Act (DPDPA)
• Improve citizen awareness and trust so that individuals can conveniently access and manage their personal health records through digital platforms.

Conclusion

• Over eight years, Ayushman Bharat has reshaped India’s healthcare architecture and strengthened the country’s movement towards Universal Health Coverage.
• Its four-pillar structure integrates:
  • Cashless hospitalisation and financial protection;
  • Comprehensive primary healthcare;
  • Digital health infrastructure; and
  • Critical-care and public-health preparedness.
• Going forward, addressing outpatient expenditure, specialist shortages, digital gaps and hospital participation will be essential for ensuring that quality and affordable healthcare becomes accessible across regions and population groups.

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