Lok Sabha Question No. 2667 (UNSTARRED), answered on 2017-03-17
Subject: National Health Mission
Ministry: HEALTH AND FAMILY WELFARE
Asked by: KANWAR SINGH TANWAR, SHIVKUMAR CHANABASAPPA UDASI, INNOCENT

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

LOK SABHA UNSTARRED QUESTION NO. 2667 TO BE ANSWERED ON 1 7 th MARCH, 2017

## NATIONAL HEALTH MISS ION

## 2667. SHRI KANWAR SINGH TANWAR: SHRI SHIVKUMAR UDASI: SHRI INNOCENT:

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

- (a) the details along with salient features and objectives of the National Health Mission (NHM);
- (b) whether the Government has failed to achieve its objectives and targets under NHM and if so, the details thereof and the reasons therefor;
- (c) whether the Government has conducted evaluation of various programmes running under the NHM and if so, the details thereof, State/UT - wise; (d) whether the Government is aware that funds released under NHM are not being utilised by the States, if so, the details thereof; and
- (e) the details of funds allocated, released and expenditure incurred by the States during the last three years?

## ANSWER THE MINISTER OF STATE IN THE MINIS TRY OF HEALTH AND FAMILY WELFARE

(SHRI FAGGAN SINGH KULASTE)

- (a): The National Health Mission (NHM) aims for attainment of universal access to equita affordable and quality health care services, accountable and responsive to people's needs, with effe ctive inter - sectoral convergent action to address the wider social determinants of health.

Under NHM, support to States/UTs  is provided for five key programmatic  components:

- (i)Health Systems Strengthening including infrastructure, human resource, drugs & equipment, ambulances, MMUs, ASHAs etc under National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM).
- (ii) Reproductive, Maternal, Newborn, Child and Adolescent Health Services ( RMNCH + A)
- (iii) Communicable Disease Control Programmes
- (iv) Non - Communicable Diseases Control Programme interventions upto District Hospital level
- (v)Infrastructure Maintenance -to support salary of ANMs and LHVs etc .

The objectives of NHM are summarised as under:

- i. Reduction in child and maternal mortality
- ii. Preven tion and control of communicable and non - communicable diseases, including locally endemic diseases.
- iii. Access to integrated comprehensive primary health care.
- iv. Population stabilisation, gender and demographic balance.
- v. Revitalize local health traditions & ma i tream AYUSH.
- vi. Universal access to public services for food and nutrition, sanitation and hygie universal access to public health care services with emphasis on services addre women's and children's health and universal immunisation.
- vii. Promotio n of healthy life styles.

(b): The NHM has been successful in accelerating the decline of Maternal Mortality Rat (MMR), Under 5 Mortality Rate (U5MR), Infant Mortality Rate (IMR) and Total Fertility Ra (TFR). It has also achieved many of the disease control targets.

The key targets and achievements of NHM are given at Annexure -I.

(c) : V arious  programmes  running  under  the NHM has been regularly evaluated, inter -alia, through  external  surveys  such  as,  National  Family  Health  Survey  (NFHS), District  Lev el Household Survey (DLHS) and Sample Registration System (SRS). Further, Common Review Missions (CRMs) also undertake a review of NRHM/NHM annually.

The details on different evaluations are available in public domain as under:

NFHS - 4:

http://nrhm - mis.nic.in/SitePages/NFHS.aspx

DLHS 4:

https://nrhm - mis.nic.in/SitePages/DLHS - 4.aspx

SRS:

http://www.censusindia.gov.in/2011 - Common/Sample\_Registration\_System.html

CRM reports:

http://nhm.gov.in/monitoring/common - review - mission.html

(d) & (e): A statement showing State/UT - wise Central Release and Expenditure during the last three years is placed at Annexure -I I .

As evident from the annexed Statement, most of the States have been abl e to utilise most of the funds.

## Targets as per NHM Framework for Implementation

| S.no.                                                                      | Targets (2012-17)                                                                                                                                                                                                                                  |   Achievements |
|----------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------|
| Reduce IMR to 25/1000 live births                                          | IMR has reduced to 37 in 2015 (SRS).                                                                                                                                                                                                               |              1 |
| Reduce MMRto 100/1,00,000 live births                                      | MMRhas reduced to 167 in 2011-13 (SRS).                                                                                                                                                                                                            |              2 |
| Reduce TFR to 2.1                                                          | TFR has reduced to 2.3 in 2014 (SRS).                                                                                                                                                                                                              |              3 |
| Reduce annual prevalence and mortality from Tuberculosis by half           | Tuberculosis Prevalence and mortality reduced to half as compared to 1990 level. Incidence reduced from 300 / lakh in 1990 to 217/ lakh in 2015 Mortality reduced from 76/ lakh in 1990 to 32/ lakh in 2015 Data Source : WHOGlobal TB report 2016 |              4 |
| Reduce prevalence rate of Leprosy to <1/10000 population in all districts. | Prevalence rate of Leprosy reduced to Less than 1/10000 population in 551 Districts as on 31 st March 2016.                                                                                                                                        |              5 |
| Annual Malaria Incidence to be <1/1000                                     | Annual Malaria Incidence is 0.67 in 2016.(Prov)                                                                                                                                                                                                    |              6 |
| Less than 1 per cent microfilaria prevalence in all districts              | Out of 256 LF endemic districts, 222 districts have reported Mf rate less than 1% as per reports of 2016.                                                                                                                                          |              7 |
| Kala-Azar Elimination by 2015, <1 case per 10000 population in all blocks  | Out of 628 endemic blocks 492 (78%) have already achieved elimination till 2016.                                                                                                                                                                   |              8 |

## Note:

## Statement Showing State/UT-wise Central Release and Expenditure under NHM from the F.Y. 2013-14 to 2015-16

| Sl. No.   | States                   | 2013-14         | 2013-14     | 2014-15         | 2014-15     | 2015-16         | 2015-16     |
|-----------|--------------------------|-----------------|-------------|-----------------|-------------|-----------------|-------------|
| Sl. No.   | States                   | Central Release | Expenditure | Central Release | Expenditure | Central Release | Expenditure |
| 1         | Andaman &Nicobar Islands | 29.06           | 29.12       | 23.36           | 24.33       | 37.30           | 11.47       |
| 2         | Andhra Pradesh           | 878.73          | 1,044.81    | 519.73          | 902.91      | 643.52          | 1,090.17    |
| 3         | Arunachal Pradesh        | 78.60           | 92.03       | 139.41          | 69.50       | 162.65          | 146.27      |
| 4         | Assam                    | 1,077.81        | 956.89      | 877.13          | 915.88      | 971.35          | 1,186.01    |
| 5         | Bihar                    | 1,110.32        | 1,480.68    | 1,148.32        | 1,427.40    | 1,159.49        | 1,621.67    |
| 6         | Chandigarh               | 11.46           | 14.42       | 12.15           | 15.26       | 23.89           | 20.98       |
| 7         | Chattisgarh              | 355.98          | 805.50      | 500.41          | 716.04      | 412.26          | 758.28      |
| 8         | Dadra &Nagar Haveli      | 9.23            | 9.83        | 8.40            | 8.56        | 14.37           | 15.54       |
| 9         | Daman &Diu               | 6.50            | 8.40        | 6.91            | 7.67        | 10.53           | 15.69       |
| 10        | Delhi                    | 129.78          | 132.59      | 154.04          | 222.64      | 163.80          | 137.29      |
| 11        | Goa                      | 19.35           | 30.58       | 26.03           | 29.50       | 16.77           | 24.92       |
| 12        | Gujarat                  | 833.72          | 977.48      | 832.86          | 873.66      | 693.78          | 1,272.42    |
| 13        | Haryana                  | 315.94          | 423.79      | 273.60          | 438.18      | 291.96          | 493.23      |
| 14        | Himachal Pradesh         | 205.29          | 158.60      | 185.84          | 306.92      | 246.49          | 281.26      |
| 15        | Jammu &Kashmir           | 395.10          | 391.10      | 335.51          | 393.29      | 367.90          | 420.94      |
| 16        | Jharkhand                | 396.38          | 521.49      | 359.62          | 372.01      | 411.50          | 590.18      |
| 17        | Karnataka                | 611.11          | 812.56      | 697.24          | 858.18      | 740.45          | 1,141.61    |
| 18        | Kerala                   | 360.98          | 673.07      | 521.99          | 509.83      | 304.14          | 632.88      |
| 19        | Lakshadweep              | 3.20            | 2.28        | 5.08            | 1.36        | 5.69            | 2.72        |
| 20        | Madhya Pradesh           | 865.94          | 1,583.60    | 1,162.50        | 1,738.02    | 1,132.19        | 2,046.60    |
| 21        | Maharashtra              | 1,218.51        | 1,806.86    | 1,431.76        | 1,834.40    | 1,085.92        | 1,734.44    |
| 22        | Manipur                  | 88.93           | 74.57       | 128.81          | 86.91       | 112.16          | 105.51      |
| 23        | Meghalaya                | 125.51          | 71.53       | 104.13          | 70.72       | 102.22          | 133.55      |
| 24        | Mizoram                  | 77.43           | 91.89       | 103.28          | 93.29       | 94.68           | 172.38      |
| 25        | Nagaland                 | 99.73           | 90.40       | 114.92          | 63.04       | 104.85          | 81.05       |
| 26        | Orissa                   | 604.20          | 901.65      | 667.16          | 944.10      | 652.62          | 1,205.77    |
| 27        | Puducherry               | 18.10           | 25.43       | 22.56           | 23.35       | 18.61           | 21.77       |
| 28        | Punjab                   | 333.47          | 437.57      | 379.35          | 460.59      | 295.23          | 649.49      |
| 29        | Rajasthan                | 922.93          | 1,457.06    | 1,115.96        | 1,722.69    | 1,287.84        | 1,799.11    |
| 30        | Sikkim                   | 45.91           | 44.82       | 51.60           | 41.36       | 41.01           | 50.71       |
| 31        | Tamil Nadu               | 906.24          | 1,430.28    | 952.75          | 2,248.06    | 1,093.22        | 1,633.37    |
| 32        | Tripura                  | 140.15          | 101.93      | 123.11          | 130.15      | 136.29          | 118.77      |
| 33        | Uttar Pradesh            | 3,024.60        | 2,924.38    | 2,431.06        | 3,671.26    | 2,862.83        | 4,451.78    |
| 34        | Uttarakhand              | 245.25          | 255.28      | 270.55          | 324.42      | 276.41          | 335.95      |
| 35        | West Bengal              | 948.51          | 1,271.71    | 1,058.62        | 1,196.78    | 959.51          | 1,487.62    |
| 36        | Telangana                | -               | -           | 378.72          | 334.68      | 436.63          | 505.55      |
|           | Total                    | 16,493.93       | 21,134.19   | 17,124.48       | 23,076.94   | 17,370.07       | 26,396.94   |

1. The above Releases relate to Central Govt. Grants & do not include State share contribution.
3. Expenditure (As per FMR submitted by States/UTs) includes Expenditure against Central Release, State release & Unspent balances at the beginning of  the year.
2. The above releases are as per revised allocation

Rs. in crore