Establishment of Ayushman Bharat Health and Wellness Centers in India: A Systematic Review Using the Antecedents, Decisions and Outcomes (ADO) Framework

Abstract

Access to quality healthcare is a fundamental human right and a cornerstone of Sustainable Development Goal (SDG) 3- Good Health and Well-being. As the global focus on Universal Health Coverage (UHC) Intensifies, India faces significant challenges in ensuring equitable health access. In response, India launched Ayushman Bharat Health and Wellness Centres (AB-HWCs) to strengthen primary healthcare, expand coverage and accelerate the progress towards UHC. However, while considerable research has examined AB-HWCs, a comprehensive synthesis of their implementation challenges, service delivery outcomes, and system readiness is still needed. This study systematically reviews existing research on AB-HWCs to assess their impact on healthcare accessibility, disease prevention, barriers, and the development of these centres. Using a structured literature search across Scopus and Google Scholar, 37 relevant studies were analysed through the Antecedents, Decisions, and Outcomes (ADO) framework, following the PRISMA guidelines. Findings reveal gaps in healthcare infrastructure, lack of trained healthcare workforce and disparities in delivery. The study highlights the need for policy refinements, enhanced resource allocation, micro level impact assessments and better integration of technology.