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Integrated tuberculosis-multimorbidity management in India: A SWOT analysis
Sucharita Panigrahi1, Debasini Parida1, Abhinav Sinha1
1Department of Microbiology & One Health, ICMR-National Institute of Health Research, Bhubaneswar, Odisha, India.
The Indian Journal of Medical Research
|July 3, 2026
Summary
Integrating India's National TB Elimination Programme (NTEP), NP-NCD, and NMHP within Ayushman Arogya Mandirs (AAMs) can improve care for tuberculosis multimorbidity. Strategic shifts towards person-centered, collaborative models are essential for Universal Health Coverage.
Area of Science:
- Public Health
- Health Systems Research
- Healthcare Management
Background:
- Tuberculosis (TB) multimorbidity presents a growing challenge in India.
- Existing national health programs (NTEP, NP-NCD, NMHP) operate in silos, causing fragmented care.
- Ayushman Arogya Mandirs (AAMs) offer a potential platform for integrated service delivery.
Purpose of the Study:
- To evaluate the integration potential of national health programs within AAMs.
- To identify strengths, weaknesses, opportunities, and threats (SWOT) for program integration.
- To inform strategies for managing multimorbidity and achieving Universal Health Coverage in India.
Main Methods:
- A SWOT analysis was conducted to assess the integration of the National TB Elimination Programme (NTEP), National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), and National Mental Health Programme (NMHP).
- The analysis focused on the potential for integration within the Ayushman Arogya Mandirs (AAMs) platform.
- Key factors including digital systems, workforce training, policy, and patient-related issues were examined.
Main Results:
- Strengths include NTEP's surveillance and NP-NCD's screening network.
- Weaknesses involve isolated digital platforms and lack of cross-programme training.
- Opportunities lie in linking digital systems (Ni-kshay, NP-NCD app) and composite care training; threats include policy fragmentation and stigma.
Conclusions:
- A strategic shift from vertical, disease-specific programs to a person-centered, integrated model is crucial.
- Integration requires policy collaboration, unified digital health records, and delegated primary care responsibilities.
- Effective management of multimorbidity and progress towards Universal Health Coverage necessitate integrated care models centered around AAMs.
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