Lok Sabha Question No. 3092 (UNSTARRED), answered on 2018-01-05
Subject: Public Health Programmes/Schemes
Ministry: HEALTH AND FAMILY WELFARE
Asked by: (SMT.) RATNA DE(NAG), RAJ KUMAR SAINI

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTI ON NO. 3092 TO BE ANSWERED ON   5 TH JANUARY, 2018

## PUBLIC HEALTH PROGRA MMES/SCHEMES

## 3092. DR. RATNA DE (NAG): SHRI RAJKUMAR SAINI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  the  major  programmes/schemes  being  implemented/proposed  to  be  implemented  by  the Government for improving the general public health across the country along w ith the target fixed in this regard for the next two years;
- (b)  the  fund  allocated  and  utilized  under  various  schemes/programmes  along  with achievement therefrom during the last three years and the current year; and
- (c) the various steps undertaken to ensure austerity in the Ministry during the said period?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

- (a ) & ( b): Health is a State subject.  However, the Ministry of Health and Family Welf supports and supplements the efforts of the States through various primary, secondary and care  activities  so  as  to  improve  the  general  public  health  across  the  country . Under  National Health Mission, support is provided to States/UTs for strengthening their health systems support  is  available  universally  to  the  population  availing  health  services  in  publ facilities.  The  budget  released  and  expenditure  duri ng  the  years  2014 - 15  to  2017 - 18  is Rs.67023.83 crores and Rs.88959.95 crores respectively.  The target fixed fo r next 2 years are at Annexure I.    The  achievements  in  the  last  three  years  and  current year  under  NHM  are  at Annexure II.

Under the Tertiary car e programmes, the Ministry is implementing the Rashtriya Varishth Jan  Swasthya  Yojana  (RVJSY),  the  National  Programme  for  Prevention  &  Management  of Trauma  and  Burn  Injuries  (NPPMTBI),  the  National  Mental  Health  Programme  (NMHP),  the National Programme for Control of Blindness and Visual Impairment (NPCBVI), the National Programme for Tobacco Control and Drug Addiction Treatment (NPTCDAT) and the National Program for Prevention and control of Cancer, Diabetes, CVDs and Stroke (NPPCDS).  The to budget all ocation and actual expenditure for these programmes during the years 2014 - 15 to 2016 -17 is Rs.1649.63 crores and Rs.1585.77 crores respectively. The details are at Annexure III.

Contd……..

The Government is also implementing the Integrated Disease Su rv illance Programme (IDSP),  the  National  Programme  on  Containment  of  Anti - Microbial  Resistance,  the  National Programme  on  Prevention  and  Control  of  Viral  Hepatitis,  the  National  Rabies  Cont Programme,  Programme  for  prevention  and  Control  of  Leptospiros is  and  Programme  for strengthening  of  Inter - sectoral  Coordination  for  Prevention  and  Control  of  Zoonotic  Diseases The total budget allocated/released and actual expenditure for these programmes during the 2014- 15 to 2017 - 18 is Rs.255.95 crores and Rs.250.99 crores respectively.   The target fixed for the next two years for these schemes is at Annexure IV.

(c) : Instructions and guidelines issued by the Government from time to time are followe ensure austerity in the Ministry.

…………………

## Target & Dates of National Health Mission (NHM) for Next 2 Years

|   Sl. No | Target                                                                                                                                                                                                                                                                                                                                             | Date                     |
|----------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------|
|        1 | Reduction of MMR from 167/100000 to 100/100000                                                                                                                                                                                                                                                                                                     | 31.03.2020               |
|        2 | Reduce (i) U5MR from43/1000 to 32/1000; (ii) IMR from 37/1000 to 26/1000 (iii) NMR from 26/1000 to 20/1000                                                                                                                                                                                                                                         | 31.03.2020               |
|        3 | Reduce and sustaine TFR from 2.3 to 2.1 at National & sub - national level                                                                                                                                                                                                                                                                         | 31.03.2020               |
|        4 | Increase Modern Contraceptive Prevalence Rate by 1.5% annually from of 52.1 (Track 20 Estimate) and 47.1 -(DLHS 3)                                                                                                                                                                                                                                 | current level 31.03.2020 |
|        5 | Increase (i) ANC from present 85.2% to 90% . (ii) SBA from present 81.1% to 90%                                                                                                                                                                                                                                                                    | 31.03.2020               |
|        6 | Full immunization of all new - borns by one year of age from present 87.5% HMIS) to 90%                                                                                                                                                                                                                                                            | (as per 31.03.2020       |
|        7 | Achieve and maintain elimination status, in respect of: (i) Leprosy (presently - 118 endemic districts) (ii) Kala -Azar (Presently 54 endemic districts) (iii) Lymphatic Filariasis (presently 256 endemic districts) (iv) Malaria (Presently -ABER ≥10 &API <1 )                                                                                  | 31.03.2020               |
|        8 | Reduce/sustain case fatality rate for Dengue at <1% (by 2018 & 2019) sentinel site hospital (SSH) in each district. Accordingly, number of new SSH in 2018 and 2019 is 15 and10,respectively                                                                                                                                                       | and set up 31.03.2020    |
|        9 | Tuberculosis - Achieve and maintain a treatment success rate of 90% notified drug sensitive TB cases by 2020 (Presently treatment success notified drug sensitive TB cases is 75% as per Annual Report 2016)                                                                                                                                       | amongst rate 31.03.2020  |
|       10 | Blindness -Reduce the prevalence of blindness to 0.3% and the disease one fourth of 1.1%(2007)                                                                                                                                                                                                                                                     | burden by 31.03.2020     |
|       11 | To halt premature mortality from cardiovascular diseases, cancer, diabetes respiratory diseases by 2020. For baseline ICMR India State Level Disea se Burden Study regarding premature mortality from four common NCDs for the year 2015. (Available at URL http://icmr.nic.in/publications/India_Health_of_the_Nation's_States_Report_2017.pd f). | or 31.03.2020            |
|       12 | Reduce prevalence of current tobacco use by 15% vis - a- vis current level of as per the GATS -2016- 17                                                                                                                                                                                                                                            | 28.6% 31.03.2020         |
|       13 | Increase utilization of public health facilities by 22.5% from current (OPD) and 38% (IPD) as per NSSO 71 st Round.                                                                                                                                                                                                                                | levels 31.03.2020        |
|       14 | Reduce OOPE by 15% (base NSSO, 71 st Round) vis - a- vis the current OOPE health 64.2% (NHA 2014 - 15)                                                                                                                                                                                                                                             | on 31.03.2020            |

## Annexure - II (As on 31.03.2015)

|   S.N. | Parameters                 | Parameters                                                             | Parameters                                                   | Status    |
|--------|----------------------------|------------------------------------------------------------------------|--------------------------------------------------------------|-----------|
|      1 | ASHA                       | Total Number of ASHA in position as on -(31 0 - 2015)                  | High Focus states                                            | 578856    |
|      1 | ASHA                       | Total Number of ASHA in position as on -(31 0 - 2015)                  | Other Than High Focus states                                 | 329062    |
|      1 | ASHA                       | Total Number of ASHA selected and trained upto IV module               | High Focus states                                            | 558295    |
|      1 | ASHA                       | Total Number of ASHA selected and trained upto IV module               | Other Than High Focus states                                 | 289874    |
|      1 | ASHA                       | Number of VHSNCs                                                       | Constituted                                                  | 498079    |
|      2 | Upgradation of Sub Centres | Number of SCs                                                          | Available(RHS 2014)                                          | 152326    |
|      2 | Upgradation of Sub Centres | Sub Centres which are functional                                       | with two ANMs                                                | 53290     |
|      3 | Upgradation of PHCs        | Number of PHCs                                                         | Available(RHS 2014)                                          | 25020     |
|      3 | Upgradation of PHCs        | PHCs and equivalent where three staff nurses have positioned           | PHCs and equivalent where three staff nurses have positioned | been 6340 |
|      4 | Upgradation of CHCs        | Number of CHCs                                                         | Available(RHS 2014)                                          | 5363      |
|      4 | Upgradation of CHCs        | Number of CHCs/SDH & equivalent which have been upgraded to FRU status | as on date (31 - 03- 2015)                                   | 2028      |
|      5 | Upgradation of DHs         | Number of DH & equivalent which have been upgraded to FRU status       | as on date (31 - 03- 2015)                                   | 644       |

## Annexure - II

## (As on 31.03.2015 )

|   S.N | Parameters                 | Parameters                                                             | Parameters                                                        |   Status |
|-------|----------------------------|------------------------------------------------------------------------|-------------------------------------------------------------------|----------|
|     1 | ASHA                       | Total Number of ASHA in position as on 31-03-2016                      | High Focus states                                                 |   604606 |
|     1 | ASHA                       | Total Number of ASHA in position as on 31-03-2016                      | Other Than High Focus states                                      |   338180 |
|     1 | ASHA                       | Total Number of ASHA selected and trained upto IV module               | High Focus states                                                 |   492878 |
|     1 | ASHA                       | Total Number of ASHA selected and trained upto IV module               | Other Than High Focus states                                      |   293493 |
|     1 | ASHA                       | Number of VHSNCs                                                       | Constituted                                                       |   510416 |
|     2 | Upgradation of Sub Centres | Number of SCs                                                          | Available (RHS 2015)                                              |   153655 |
|     2 | Upgradation of Sub Centres | Sub Centres which are functional                                       | with two ANMs                                                     |    53786 |
|     3 | Upgradation of PHCs        | Number of PHCs                                                         | Available (RHS 2015)                                              |    25308 |
|     3 | Upgradation of PHCs        | PHCs and equivalent where three staff nurses have been positioned      | PHCs and equivalent where three staff nurses have been positioned |     6525 |
|     4 | Upgradation of CHCs        | Number of CHCs                                                         | Available (RHS 2015)                                              |     5396 |
|     4 | Upgradation of CHCs        | Number of CHCs/SDH & equivalent which have been upgraded to FRU status | as on date (31-03-2016)                                           |     2054 |
|     5 | Upgradation of DHs         | Number of DH & equivalent which have been upgraded to FRU status       | as on date (31-03-2016)                                           |      658 |

## Annexure - II

## (As on 31.03.2015 )

|   S.N | Parameters                 | Parameters                                                             | Parameters                                                        |   Status |
|-------|----------------------------|------------------------------------------------------------------------|-------------------------------------------------------------------|----------|
|     1 | ASHA                       | Total Number of ASHA in position as on 31-03-2017                      | High Focus states                                                 |   633006 |
|     1 | ASHA                       | Total Number of ASHA in position as on 31-03-2017                      | Other Than High Focus states                                      |   323107 |
|     1 | ASHA                       | Total Number of ASHA selected and trained upto IV module               | High Focus states                                                 |   493729 |
|     1 | ASHA                       | Total Number of ASHA selected and trained upto IV module               | Other Than High Focus states                                      |   293316 |
|     1 | ASHA                       | Number of VHSNCs                                                       | Constituted                                                       |   522290 |
|     2 | Upgradation of Sub Centres | Number of SCs                                                          | Available (RHS 2016)                                              |   155069 |
|     2 | Upgradation of Sub Centres | Sub Centres which are functional                                       | with two ANMs                                                     |    53113 |
|     3 | Upgradation of PHCs        | Number of PHCs                                                         | Available (RHS 2016)                                              |    25354 |
|     3 | Upgradation of PHCs        | PHCs and equivalent where three staff nurses have been positioned      | PHCs and equivalent where three staff nurses have been positioned |     6516 |
|     4 | Upgradation of CHCs        | Number of CHCs                                                         | Available (RHS 2016)                                              |     5510 |
|     4 | Upgradation of CHCs        | Number of CHCs/SDH & equivalent which have been upgraded to FRU status | as on date (31-03-2017)                                           |     2082 |
|     5 | Upgradation of DHs         | Number of DH & equivalent which have been upgraded to FRU status       | as on date (31-03-2017)                                           |      666 |

Annexure - II

(As on 31.03.2015 )

|   Sl. No. | Parameters                 | Parameters                                                             | Parameters                                                        |   Status |
|-----------|----------------------------|------------------------------------------------------------------------|-------------------------------------------------------------------|----------|
|         1 | ASHA                       | Total Number of ASHA in position as on 30-09-2017                      | High Focus States                                                 |   641351 |
|         1 | ASHA                       | Total Number of ASHA in position as on 30-09-2017                      | Other Than High Focus States                                      |   323586 |
|         1 | ASHA                       | Total Number of ASHA selected and trained upto IV module               | High Focus States                                                 |   535033 |
|         1 | ASHA                       | Total Number of ASHA selected and trained upto IV module               | Other Than High Focus States                                      |   284316 |
|         1 | ASHA                       | Number of VHSNCs                                                       | Constituted                                                       |   533082 |
|         2 | Upgradation of Sub Centres | Number of SCs                                                          | Available (RHS 2017)                                              |   156231 |
|         2 | Upgradation of Sub Centres | Sub Centres which are functional                                       | With two ANMs                                                     |    52891 |
|         3 | Upgradation of PHCs        | Number of PHCs                                                         | Available (RHS 2017)                                              |    25650 |
|         3 | Upgradation of PHCs        | PHCs and equivalent where three staff nurses have been positioned      | PHCs and equivalent where three staff nurses have been positioned |     6416 |
|         4 | Upgradation of CHCs        | Number of CHCs                                                         | Available (RHS 2017)                                              |     5624 |
|         4 | Upgradation of CHCs        | Number of CHCs/SDH & equivalent which have been upgraded to FRU status | As on date (30-09-2017)                                           |     2245 |
|         5 | Upgradation of DHs         | Number of DH & equivalent which have been upgraded to FRU status       | As on date (30-09-2017)                                           |      704 |

1. The Rashtriya  Varishth  Jan  Swasthya  Yojana (RVJSY) is  proposed  to  be  continued  with  its existing activities of supporting establishment of 2 National Centres of Ageing, 20 Regional G Centres and continuation of Longitudinal Ageing Study in India at a cost of Rs. 330.00 crores o period 2017 - 2020.
2. The  proposal  for National  Programme  for  Prevention  &  Management  of  Trauma  and  Burn Injuries (NPPMTBI ) envisages  support  mainly  for  continuation  of  support  to  the  Institutes  suppo during the previous Plan periods for establishment of Trauma Car e F cilities (116 during 11 th FYP, 81 during 12 th FYP and 4 during the current financial year) along with establishment of new Trauma Ca Facilities in 30 Government Hospitals/ Medical Colleges & new Burn Units in 15 Medical Colleges a with establishm ent of Regional Apex Trauma Centres with a provision of heli - ambulance, incentivizing functional trauma care facilities, develop National Trauma Systems Plan, make provisions for inc to bystander first responders, research & training activities.
3. The proposal for National Mental Health Programme (NMHP )broadly aims at establishing 6 new Centres of Excellence, 16 new Post Graduate departments and 9 De - addiction centres in addition to the continuation of support to the Institutes supported in the pa st besides support to the Central and State Mental Health Authorities and IEC activities.
4. The  proposal  for  the National  Programme  for  Control  of  Blindness and  Visual  Impairment (NPCBVI) consists primarily of continued support for its existing component s of strengthening/ setting up of the 24 Regional Institutes of Ophthalmology (19 existing and 5 proposed) and 33 Government Medical  Colleges  in  a  phased  manner so  that  they  can  be  upgraded  as  Centres  of  Excellence  in  the regions. The proposal also envisag es intensification of IEC activities, capacity building of manpowe new Management Information System and surveys.
5. The proposal under National Programme for Tobacco Control and Drug Addiction Treatment (NPTCDAT) aims at continuation of existing activities for Tobacco Control including enforceme tobacco control laws and tobacco surveillance in addition to supporting the Global Knowledge Hu Smokeless  Tobacco,  enhancing  the  capacity  of  National  Tobacco  Test ing  Laboratories  etc.  It  is  also proposed to provide support to the three existing and three additional Central Government Insti run tertiary level drug dependence treatment centres. Support is also proposed for implementatio Scheme for pro viding Out - patient treatment for Drug De -addiction as the 'Drug Treatment Clinic (DTC) in 20 Government hospitals.
6. The present proposal under National Program for Prevention and control of Cancer, Diabetes, CVDs and Stroke (NPPCDS)aims at providing con tinued support to the 12 State Cancer Institute (SCIs) and 13 Tertiary Care Cancer Centres (TCCCs )supported in the previous plan periods across the country in  addition  to  providing  support  to  Institutions/Medical  Colleges  for  establishment  of  8  SCIs 7 TCCCs during the period 2017 - 2020.

## 7. The outlay proposed for the major activities in the present note is as under:

(Rs. in crore)

| Component                                                                       | 2017-18    |   2018-19 |   2019-20 |   Total |
|---------------------------------------------------------------------------------|------------|-----------|-----------|---------|
| Rashtriya Varishth Jan Swasthya Yojana                                          | 86.56      |    108.2  |    135.24 |     330 |
| National Programme for Prevention & Management Trauma and Burn Injuries         | of 183.61  |    229.51 |    286.88 |     700 |
| National Mental Health Programme                                                | 70.81      |     88.51 |    110.68 |     270 |
| National Programme for Control of Blindness Visual Impairment                   | and 68     |     86    |    106    |     260 |
| National Programme for Tobacco Control and Addiction Treatment                  | Drug 65.57 |     81.97 |    102.46 |     250 |
| National Programme for Prevention and control Cancer, Diabetes, CVDs and Stroke | of 472.13  |    590.16 |    737.71 |    1800 |

## Annexure IV

| Deliverables for IDSP                                                                            | Deliverables for IDSP                                                                                        |
|--------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------|
| 2018- 19                                                                                         | 2019- 20                                                                                                     |
| ≥ 77% completeness of 'Syndromic (S)' form in all States and at National Level.                  | ≥ 80% completeness of 'Syndromic (S)' form in all States and at National Level.                              |
| ≥87% completeness of 'Presumptive (P)' form in all States and at National Level.                 | ≥90% completeness of 'Presumptive (P)' form in all States and at National Level.                             |
| Number of District Public Health Labs strengthened for diagnosis/testing of prone diseases - 235 | (DPHLs) epidemic Number of District Public Health Labs strength ened for diagnosis/testing of diseases - 300 |

## Deliverables for Programme  Anti - Microbial Resistance Containment 2018 - 19 & 2019 - 20

The target fixed in this regard for the next two years are:

1. AMR Surveillance: Include additional 5 labs each year in the network over next 2 years.
2. Strengthening Quality assurance in  AMR surveillance labs
3. Finalize  the  detailed  Hospital  infection  prevention  and  control  guidelines  and  coor implementat ion of these guidelines.
4. Coordinate antibiotic usage studies and implement antimicrobial stewardship  activities in care facilities in the country

Operationalize the strategic national action plan on AMR containment which has already been developed

## Deliverables for National Programme for Viral Hepatitis 2018 - 19 & 2019 - 20

The target fixed in this regard for the next two years are:

1. Number of regional labs doing enhanced case reporting for hepatitis to be increased to
2. Number of districts rep orting on acute  hepatitis surveillance to be increased to 40
3. Population based survey to be undertaken for surveillance of chronic hepatitis.
4. Number of tertiary care hospitals undertaking sequel surveillance for chronic hepatiti increased to 6.

## Deliverables for National Rabies Control Programme 2018 - 19 & 2019 - 20

The Human Health and Animal Health components of the programme will be implemented.

## Deliverables for Strengthening of Inter sectoral Coordination for Prevention and Control of Zoonotic Diseases  2018 - 19 & 2019 - 20

## Deliverable's 2018 - 19:

- 1 . Three Joint orientation workshop ( State level ) for medical and veterinary professional
2. Preparation of IEC material and IEC campaign's for 2 priority zoonotic diseases.
- 3.Lab. Strengthening for diagnosis for zoonotic diseases( 2 labs )

## Deliverable's 2019 -20:

1. Three Joint orientation workshop ( State level ) for medical and veterinary   professional
2. Preparation of  IEC material and IEC campaign's  for 2 priority zoonotic diseases
3. Lab. Strengthening for diagnosis for zoonotic diseases( 2 labs )