In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.
| India is undergoing an epidemiological transition to non-communicable diseases (NCDs), with NCDs contributing to nearly 60 percent of all deaths in India. NCDs are challenging to manage given their silent onset, low health awareness, significant informational asymmetry, and low health-seeking behavior among the rural population and the poor in India. The Ministry of Health and Family Welfare (MoHFW), Government of India, launched Ayushman Bharat to move from a sectoral and segmented approach of health service delivery to a more comprehensive one. As part of this effort, a program was launched for population-based screening (PBS) and management of five common NCDs-hypertension, diabetes, oral, breast, and cervical cancers. The success of the program, among other things, will be determined largely by the early detection, timely treatment, and diligent follow-ups to manage the five NCDs. In line with WHO's Global action plan for the prevention and con-
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