Lok Sabha Question No. 1031 (UNSTARRED), answered on 2017-07-21
Subject: Development of Health Sector
Ministry: HEALTH AND FAMILY WELFARE
Asked by: ANSHUL VERMA

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

## LOK SABHA UNSTARRED QUESTION NO. 1031 TO BE ANSWERED ON 21 ST JULY, 2017

## DEVELOPMENT OF HEALT H SECTOR

## 1031. SHRI ANSHUL VERMA:

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

- (a)  whether  new  initiative  and  policies have  been  form ulated  by  the  Government  for  the comprehensive development of health sector;
- (b) if so, the details thereof;
- (c) the total expenditure incurred on various schemes/programmes during the last two years and the current year, Scheme wise/State - wise; and
- (d) whether the Government has formulated any comprehensive health scheme or new action plan by including Non - Governmental Organisations and non- profit making organizations in the implementation of health programmes and schemes particularly in the rural areas of the country?

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

- (a) & (b): The Government has for mulated the National Health Policy, 2017, which aims at attainment of the highest possible level of good health and well - being, through a preventive and promotive health care orientation in all developmental policies, and universal access t quality h ealth care services without anyone having to face financial hardship as a consequ The National Health Policy, 2017 is available http://mohfw.nic.in/sites/default/files/9147562941489753121.Pdf The Government has also devised various new initiatives on health sector which is provided in Annexure -I.

at

- (c): A statement showing major Schemewise releases for last two years and current year provided at Annexure -II to IV.
- (d): The National Health Policy 2017 advocates partnership with multi - stakeholders including partnership  with  not  for  profit  agencies  and  NGOs.  Policy  inter - alia  supports  enabling engagements with NGOs to serve as support and training institutions for ASHAs and to serv learnin g laboratories on future roles of community health workers. The Policy also envis active  involvement  of  local  self -gov rnment  in  areas  of  capacity  building,  and  provides  for community based monitoring of health outputs. The policy also envisages strate gic purchase of secondary  and  tertiary  care  services  as  a  short  term  measure  from  public  sector  ho followed by not - for profit private sector and then commercial private sector in underserved based  on  availability  of  services  of  acceptable  and defined  quality  criteria.  The  policy  also suggests exploring collaboration for primary care services with 'not - forprofit'  organizations having a track record of public services where critical gaps exist. The policy has advo building synergy wi th 'not for profit' organisations and private sector subject to availability of timely quality services as per predefined norms for critical gap filling.

## New Initiatives in Health Sector

The Government has devised various new initiatives on health sector which inter-alia includes:

1. Introduction of new vaccines
2. Mission Indradhanush
3. NHM Free Drug  and Diagnosis Initiatives
4. Setting up of New AIIMS Institutions
5. Upgradation of district hospitals to medical college hospitals.
6. Pradhan Mantri National Dialysis Services Programme
7. The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
8. Senior Citizen Health Insurance Scheme (SCHIS)
9. India Newborn Action Plan
10. Biomedical Equipment Management & Maintenance Program (BMMP)
11. MAA- Mother's Absolute Affection Programme
12. Kayakalp initiative
13. Affordable  Medicines  and  Reliable  Implants  for  Treatment (AMRIT) outlets
14. Health  and  wellness  centres  to  provide  comprehensive primary healthcare.
15. Universal Screening of Non-Communicable DiseasesGovernment  of  India  launched  Operational  Guidelines  on prevention, screening and control of common NonCommunicable Diseases: Hypertension, Diabetes and Common Cancer-Oral, Breast, Cervix.
16. Scheme for strengthening of Drug Regulatory system in the country
17. National Quality Assurance Programme,  under which, Quality Standards for District Hospitals, Community Health Centres, Primary Health Centres and Urban Primary Health Centres have been formulated.

## Annexure-I

18. New Mental Health Policy 2014 envisions promoting mental health,  by  providing  accessible,  affordable  and  quality health and social care to all persons with mental illness.
19. Cartridge Based Nucleic Acid Amplification test (CB NAAT) specialized  machines  which  enables  accurate  diagnosis  of drug resistant TB within a few hours facilitating diagnosis and  treatment  of  Drug  Resistant  TB  have  been  set  up  in 628 districts.
20. Daily regimen for treatment of TB has been rolled out in five States. This will significantly improve treatment compliance.
21. E-governance  system  (SUGAM)  has  been  introduced  in CDSCO  for  online  processing  of  applications,  linking  of CDSCO  HQ  with other offices, laboratories, and for maintenance of database to promote ease of doing business.
22. New medical device Rules have been framed and published to provide separate legal framework  for regulation of medical  devices.  The  new  Rules  will  facilitate  expeditious approval of medical devices.
23. E-health initiatives such as Kilkari, Mobile Academy, ANM On  Line  (ANMOL),MeraAspataal,  e-hospital,  e-rakthkosh, etc have been rolled out.

\_\_\_\_\_\_\_\_\_\_

| Scheme wise Expenditure during 2015-16, 2016-17 & 2017-18 (Rs. in crore)   | Scheme wise Expenditure during 2015-16, 2016-17 & 2017-18 (Rs. in crore)   | Scheme wise Expenditure during 2015-16, 2016-17 & 2017-18 (Rs. in crore)   | Scheme wise Expenditure during 2015-16, 2016-17 & 2017-18 (Rs. in crore)   | Scheme wise Expenditure during 2015-16, 2016-17 & 2017-18 (Rs. in crore)   |
|----------------------------------------------------------------------------|----------------------------------------------------------------------------|----------------------------------------------------------------------------|----------------------------------------------------------------------------|----------------------------------------------------------------------------|
| S. No                                                                      | Name of Scheme                                                             | 2015-16                                                                    | 2016-17                                                                    | 2017-18* (12 th July2017)                                                  |
| 1                                                                          | National Health Mission (NHM)                                              | 18311.48                                                                   | 18951.43                                                                   | 9347.80                                                                    |
| 2                                                                          | Rashtriya Swasthya Suraksha Yojana(RSSY/RSBY)                              | 634.46                                                                     | 467.39                                                                     | 0.54**                                                                     |
| 3                                                                          | NACO                                                                       | 1605.72                                                                    | 1749.16                                                                    | 376.07                                                                     |
| 4                                                                          | Health Sector (other than NHM, RSBY &NACO)                                 | 12008.24                                                                   | 15314.85                                                                   | 5236.39                                                                    |
|                                                                            | TOTAL                                                                      | 32559.90                                                                   | 36482.83                                                                   | 14960.80                                                                   |

## ANNEXURE-III

## State-wise Expenditure under NHM & NACO during 2015-16, 2016-17 & 2017-18

[Rs. in crore]

| Sl. No.   | States                    | National Health Mission   | National Health Mission   | National Health Mission   | National AIDS Control Programme   | National AIDS Control Programme   | National AIDS Control Programme   |
|-----------|---------------------------|---------------------------|---------------------------|---------------------------|-----------------------------------|-----------------------------------|-----------------------------------|
| Sl. No.   | States                    | 2015-16                   | 2016-17                   | 2017-18                   | 2015-16                           | 2016- 17                          | 2017-18                           |
| 1         | Andaman & Nicobar Islands | 11.47                     | 28.83                     | -                         | 0.96                              | 1.68                              | 0.07                              |
| 2         | Andhra Pradesh            | 1,090.17                  | 1,247.63                  | 157.56                    | 21.19                             | 40.96                             | 10.66                             |
| 3         | Arunachal Pradesh         | 146.27                    | 161.81                    | 3.35                      | 5.87                              | 10.92                             | 0.02                              |
| 4         | Assam                     | 1,186.01                  | 1,331.77                  | 67.31                     | 16.67                             | 17.53                             | 9.04                              |
| 5         | Bihar                     | 1,621.67                  | 1,536.72                  | -                         | 31.5                              | 22.08                             | 10.27                             |
| 6         | Chandigarh                | 20.98                     | 20.36                     | -                         | 6.29                              | 5.91                              | 0.71                              |
| 7         | Chhattisgarh              | 758.28                    | 987.4                     | 295.86                    | 17.68                             | 20.51                             | 2.66                              |
| 8         | Dadra & Nagar Haveli      | 15.54                     | 17.22                     | -                         | 0.82                              | 1.22                              | 0.16                              |
| 9         | Daman & Diu               | 15.69                     | 9.97                      | -                         | 1.89                              | 2.6                               | 0.42                              |
| 10        | Delhi                     | 137.29                    | 146.49                    | 21.44                     | 23.58                             | 42.71                             | 5.21                              |
| 11        | Goa                       | 24.92                     | 30.54                     | 11.23                     | 4.78                              | 4.91                              | 0.49                              |
| 12        | Gujarat                   | 1,272.42                  | 1,376.91                  | 517.81                    | 42.24                             | 55.39                             | 3.24                              |
| 13        | Haryana                   | 493.23                    | 510                       | 25.21                     | 16.1                              | 16.13                             | 4.92                              |
| 14        | Himachal Pradesh          | 281.26                    | 316.27                    | 201.52                    | 7.71                              | 9.7                               | 2.86                              |
| 15        | Jammu & Kashmir           | 420.94                    | 414.43                    | 308.73                    | 8.99                              | 6.74                              | 1.26                              |
| 16        | Jharkhand                 | 590.18                    | 570.6                     | 67.85                     | 13.29                             | 11.7                              | 11.28                             |
| 17        | Karnataka                 | 1,141.61                  | 1,128.61                  | 540.38                    | 61.64                             | 72.97                             | 7.24                              |
| 18        | Kerala                    | 632.88                    | 737.69                    | 213.72                    | 22.76                             | 26.79                             | 0.18                              |
| 19        | Lakshadweep               | 2.72                      | 4.32                      | -                         | 0.22                              | 0.17                              | 0.06                              |
| 20        | Madhya Pradesh            | 2,046.60                  | 1,956.84                  | 1,112.43                  | 33.52                             | 35.17                             | 13.2                              |
| 21        | Maharashtra               | 1,734.44                  | 1,773.47                  | 276.08                    | 98.02                             | 108.04                            | 10.71                             |
| 22        | Manipur                   | 105.51                    | 77.54                     | 10.48                     | 17.88                             | 31.94                             | 0.88                              |
| 23        | Meghalaya                 | 133.55                    | 145.68                    | -                         | 4.38                              | 5.75                              | 2.66                              |
| 24        | Mizoram                   | 172.38                    | 90.45                     | 7.20                      | 14.39                             | 14.93                             | 3.37                              |
| 25        | Nagaland                  | 81.05                     | 94.13                     | 5.97                      | 19.36                             | 18.87                             | 1.86                              |
| 26        | Orissa                    | 1,205.77                  | 1,255.88                  | 655.95                    | 27.14                             | 30.15                             | 2.02                              |
| 27        | Puducherry                | 21.77                     | 32.56                     | 3.10                      | 3.79                              | 3.71                              | 0.43                              |

| Sl. No.   | States        | National Health Mission   | National Health Mission   | National Health Mission   | National AIDS Control Programme   | National AIDS Control Programme   | National AIDS Control Programme   |
|-----------|---------------|---------------------------|---------------------------|---------------------------|-----------------------------------|-----------------------------------|-----------------------------------|
|           |               | 2015-16                   | 2016-17                   | 2017-18                   | 2015-16                           | 2016- 17                          | 2017-18                           |
| 28        | Punjab        | 649.49                    | 687.75                    | 131.28                    | 28.09                             | 31.16                             | 9.57                              |
| 29        | Rajasthan     | 1,799.11                  | 1,704.99                  | 266.18                    | 31.43                             | 32.56                             | 4.33                              |
| 30        | Sikkim        | 50.71                     | 50.57                     | -                         | 4.75                              | 3.81                              | 0.74                              |
| 31        | Tamil Nadu    | 1,633.37                  | 1,816.97                  | 404.81                    | 58.27                             | 72.39                             | 0.61                              |
| 32        | Telangana     | 505.55                    | 687.15                    | 446.99                    | 34.44                             | 31.95                             | 4.55                              |
| 33        | Tripura       | 118.77                    | 141.27                    | 8.94                      | 7.45                              | 6.95                              | 2.3                               |
| 34        | Uttar Pradesh | 4,451.78                  | 4,901.10                  | 1,676.90                  | 52.37                             | 60.75                             | 6.8                               |
| 35        | Uttarakhand   | 335.95                    | 346.01                    | 66.91                     | 12.86                             | 10.35                             | 3                                 |
| 36        | West Bengal   | 1,487.62                  | 1,743.92                  | 364.28                    | 38.8                              | 37.81                             | 0.36                              |
|           | Total         | 26,396.95                 | 28,083.85                 | 7,869.46                  | 791.12                            | 906.91                            | 138.14                            |

## Note:

## NHM:

- (ii) Release for the financial year 2017-18 is updated upto 30-6-2017 and is provisional.
- (i)  Expenditure includes Central release, State release and unspent balances at the beginning of the year.  Expenditure for the financial year 2016-17 is provisional.

## NACO:

As reported by the respective States AIDS Control Societies. Figures are prov. for 2016-17 &2017-18.

## ANNEXURE -IV

## State-wise Release under RashtriyaSwasthyaBimaYojanaduring 2015-16, 2016-17 & 2017-18

[Rs. in crore]

| Sl. No   | States/UT                   |   2015-16 |   2016-17 |   2017-18 |
|----------|-----------------------------|-----------|-----------|-----------|
| 1        | Andaman and Nicobar Islands |      0    |      0    |         0 |
| 2        | Andhra Pradesh              |      0    |      0    |         0 |
| 3        | Arunachal Pradesh           |      0    |      0    |         0 |
| 4        | Assam                       |     23.24 |     54.72 |         0 |
| 5        | Bihar                       |      0    |      0    |         0 |
| 6        | Chhattisgarh                |     88.77 |    114.09 |         0 |
| 7        | Gujarat                     |     74.24 |     22.34 |         0 |
| 8        | Haryana                     |      4.67 |      0.6  |         0 |
| 9        | Himachal Pradesh            |     13.9  |     12.3  |         0 |
| 10       | Jammu & Kashmir             |      0    |      0    |         0 |
| 11       | Jharkhand                   |      0    |      0    |         0 |
| 12       | Karnataka                   |     94.99 |     45.89 |         0 |
| 13       | Kerala                      |    112.37 |     73.29 |         0 |
| 14       | Madhya Pradesh              |      1    |      0    |         0 |
| 15       | Maharashtra                 |      0    |      0    |         0 |
| 16       | Manipur                     |      1.17 |      2.2  |         0 |
| 17       | Meghalaya                   |      4.1  |      4.1  |         0 |
| 18       | Mizoram                     |      9.43 |     14.13 |         0 |
| 19       | Nagaland                    |      0    |      0    |         0 |
| 20       | Odisha                      |     59.55 |     31.7  |         0 |
| 21       | Puducherry                  |      0.17 |      0    |         0 |
| 22       | Punjab                      |      2.8  |      0    |         0 |
| 23       | Rajasthan                   |     53.57 |      0    |         0 |
| 24       | Tripura                     |     15.64 |     10.83 |         0 |
| 25       | Telangana                   |      0    |      0    |         0 |
| 26       | Tamil Nadu                  |      0    |      0    |         0 |
| 27       | Uttar Pradesh               |     11.91 |      0    |         0 |
| 28       | Uttarakhand                 |     10.2  |      0    |         0 |
| 29       | West Bengal                 |     93.38 |     50.47 |         0 |
|          | TOTAL                       |    675.1  |    436.66 |         0 |