Structure of Health and Wellness Centres-AAM Under NHM and Impact of CHO

India’s public health system has undergone a revolutionary shift in the last decade, thanks largely to the National Health Mission (NHM). The NHM’s ambitious goal is to ensure affordable, accessible, and quality healthcare for all—especially those in the most remote corners of the country. To achieve this, Health and Wellness Centres (HWCs) were introduced under the Ayushman Bharat Programme in 2018. These centres symbolize a transition from a curative approach to a preventive and promotive one, reflecting the global call for Universal Health Coverage (UHC).

But how exactly are these HWCs structured? Who runs them? What services do they offer? And most importantly, how do they impact millions of Indians every day?

Let’s break it down.

What Are Health and Wellness Centres (HWCs)?

HWCs are revamped versions of existing Sub Health Centres (SHCs), Primary Health Centres (PHCs), and Urban PHCs. They deliver a wide spectrum of Comprehensive Primary Health Care (CPHC) services that include both preventive and curative care, with a strong emphasis on wellness, mental health, NCDs, and lifestyle diseases.

Envisioned as the first point of contact in India’s public health system, HWCs are designed to empower communities, reduce out-of-pocket expenses, and foster a sense of health responsibility at the grassroots.

Objectives of HWCs

HWCs aim to bridge the gap between healthcare infrastructure and community-level needs. Their main objectives include:

• Providing comprehensive, equitable, and universal healthcare to all sections of society.
• Shifting focus from episodic illness care to wellness and disease prevention.
• Reducing financial hardship caused by healthcare costs.
• Promoting healthy behaviors and lifestyle awareness.
• Improving access and quality of services in rural and underserved areas.

Evolution and Expansion of HWCs

Launched in 2018, the HWC initiative under Ayushman Bharat aimed to upgrade 1.5 lakh sub-centres and PHCs by the year 2022. As of early 2025:

• Over 1.65 lakh HWCs have been made operational.
• States like Tamil Nadu, Kerala, Gujarat, and Chhattisgarh have shown exemplary performance.
• HWCs are now accessible in tribal belts, hilly regions, border areas, and even urban slums.

Core Components of a Functional HWC

Infrastructure Standards

A model HWC must include:

• Consultation room for CHO and team
• Drug dispensing area and pharmacy
• Basic laboratory services
• Waiting area and health education space
• Clean water and functional toilets
• Solar power (in off-grid areas)
• Dustbins for biomedical waste

Human Resources in HWCs

The staffing pattern includes:

• 1 Community Health Officer (CHO) – Leads the HWC team
• 2 ANMs/MPWs – Provide reproductive and child health services
• 1 Pharmacist – Dispenses medicines and maintains stock
• 1 Lab Technician – Performs diagnostics
• ASHAs (Accredited Social Health Activists) – Community mobilizers

CHOs – The Pillars of Primary Healthcare

CHOs are the backbone of HWCs. Typically, they are BSc Nursing or AYUSH graduates who undergo a 6-month Bridge Program in Community Health. Their responsibilities include:

• Providing OPD services for minor ailments
• Managing NCD screening and follow-ups
• Supervising ANMs and ASHAs
• Conducting community outreach and awareness sessions
• Using tablets for real-time health data entry

Also Read: Top 10 Reasons Why NQAS is a Game-Changer for Healthcare Quality

Career Growth for Community Health Officers

CHO is not a dead-end job—it’s a stepping stone. Here’s how:

• After a probation period, many CHOs are regularized into government service.
• Opportunities for vertical promotions to Medical Officer (MO), Block Program Manager (BPM), or Training Coordinator roles.
• CHOs can specialize in public health, health administration, or pursue higher education like MPH or MBA (Health Management).
• Many states offer performance-based incentives and professional development workshops.

In short, it’s a rewarding career that balances clinical service, leadership, and community engagement.

Services Delivered at HWCs

HWCs provide 14 essential service packages, including:

• Maternal and Child Health: ANC, PNC, immunizations, growth monitoring
• Family Planning: Counseling, contraceptives, referrals
• Non-Communicable Diseases (NCDs): Hypertension, diabetes, cancer screening
• Mental Health: Counseling, depression screening, referrals
• Geriatric Care: Home visits, joint pain management, assistive aids
• Palliative and End-of-Life Care: Basic pain relief and family support
• Dental, ENT, and Ophthalmology: Initial diagnosis and referral
• Emergency First Aid: For minor injuries and burns
• Health Promotion: Yoga sessions, nutrition advice, physical activity

AYUSH Integration

India’s rich tradition of alternative medicine finds a home in HWCs. Through AYUSH integration, HWCs provide:

• Ayurvedic consultations
• Homeopathic remedies
• Yoga classes
• Lifestyle counseling based on ancient wellness sciences

This hybrid approach boosts trust among rural populations and adds cultural relevance to modern health delivery.

Role of Technology in HWCs

• eSanjeevani OPD: Enables video consultations with specialists
• HMIS and RCH Portal: Real-time data tracking
• Telemedicine Kits: Tablets, BP monitors, glucose meters, thermal printers
• Digital Health IDs: Enabling unified health records under ABDM (Ayushman Bharat Digital Mission)

Capacity Building and Training

• Bridge Course: Mandatory for CHO qualification
• Refresher Training: Conducted quarterly for all cadres
• Skill Labs: For hands-on practice
• Soft Skills: Counseling, communication, ethical practice

Financing and Support Mechanisms

• Joint funding from Central and State Governments
• Additional funds via NHM Flexipool
• Incentives for CHOs and ASHAs
• Support from CSR initiatives, NGOs, and UN agencies

Monitoring and Evaluation

• Daily and monthly reporting via HMIS
• District-level supervisory teams
• Annual performance audits
• Public feedback systems and grievance redress

Key Challenges in Implementation

• Lack of trained CHOs in some regions
• High attrition rates due to workload or delayed payments
• Inconsistent medicine supply chains
• Weak internet infrastructure in rural belts

These gaps need strategic investments in policy, HR, and infrastructure.

Impact of HWCs on Public Health

• Over 85 crore people served since inception
• OOPE (Out-of-Pocket Expenditure) reduced by ~20% in HWC-operational areas
• Early detection of lifestyle diseases like hypertension and diabetes
• Boost in community awareness about preventive health and hygiene

Success Stories and State Models

• Kerala: High health literacy and efficient HWC use
• Chhattisgarh: CHOs from tribal communities showing local leadership
• Uttar Pradesh: High patient footfall after infrastructure revamp

Also Read: Why Primary Health Care is the Backbone of India’s Healthcare System

Conclusion

The Health and Wellness Centre initiative under NHM is more than just a policy—it’s a movement toward a healthier, empowered India. From treating high blood pressure to guiding meditation sessions, HWCs are transforming villages, changing behaviors, and saving lives.

And the best part? Community Health Officers are at the heart of it all, driving change not just in others’ lives but shaping meaningful careers for themselves. With proper investment, support, and vision, HWCs can lead India into a new era of preventive and promotive healthcare.

FAQs

1. What’s the full form of HWC?
Health and Wellness Centre.

2. What’s the eligibility to become a CHO?
BSc Nursing or AYUSH graduate with completion of Bridge Program in Community Health.

3. Is AYUSH treatment compulsory in HWCs?
No, but many HWCs offer AYUSH services based on community needs and staff availability.

4. Do HWCs replace PHCs?
Not completely. They upgrade existing PHCs or SHCs into more comprehensive and integrated service centres.

5. What is the future of HWCs in India?
HWCs are expected to play a central role in achieving Universal Health Coverage and integrating digital health under ABDM.