Lok Sabha Question No. 1621 (UNSTARRED), answered on 2016-11-25
Subject: Self-Harm Deaths
Ministry: HEALTH AND FAMILY WELFARE
Asked by: BHEEMRAO BASWANTHRAO PATIL

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

## LOK SABHA UNSTARRED QUESTION NO. 1621 TO BE ANSWERED ON 25 TH NOVEMBER, 2016

## SELF - HARM DEATHS

## 1621. SHRI BHEEMRAO B. PATIL:

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

- (a) whether the latest report of Global Burden of Disease (2015) shows that despite ec growth, health indicators in our country have not shower any improvement improved;
- (b) if so, the details and reasons thereof;
- (c) whether self - harm deaths have increased over the years, if so, the details thereof alon the measures taken in this regard; and
- (d)  the  details  of  centrally  sponsored  schemes  and  status  along  with  State/UTwise budget allocation and utilization during the last three years?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

- (a)& (b): No.  Global  Burden  Disease  report  (2015)  has  compared  results  in  curre stud y  with  2005  observations  and  India  has  shown  improvement  across  multiple indicators. For instance, the life expectancy has improved (for males as well as and  mortality  for  under  5  age  group  has  reduced  too.  Additionally,  mortality  d various d iseases has reduced. For instance, the mortality (between the years 2005 2015)  is  reduced  for  lower  respiratory  infections  (by  22.6%),  diarrhoeal  diseas 31.7%), tuberculosis (by 30.7%), Neonatal preterm birth (by 39.5%), neona encephalopathy ( by 31%) and road injuries (by 2.7%).
- (c): As per the Global Burden of Disease report for India, the deaths due to self - harm for the period 2005 to 2015 have declined by 3.9%.
- (d): The  Centrally  Sponsored  Scheme  (CSS)  National  Health  Mission  (NHM), has two  sub - missions,  viz.  the  National  Rural  Health  Mission  (NRHM)  and  the  National Urban Health Mission (NUHM). While NRHM was launched in April 2005, launch of NUHM was approved by the Cabinet on 1 st May 2013. NHM envisages achievement of universal  acc ess  to  equitable,  affordable  &  quality  healthcare  services  that

accountable  and  responsive  to  people's  needs.  The  main  programmatic  components inclu de  Health System s trengthening in rural and urban areas, Reproductive -Maternal Neonatal - Child  and  Adoles cent  Health (RMNCH+A)  interventions  and  control  of Communicable and Non - Communicable Diseases. Under NHM, support is provided to the States/UTs to strengthen their health care system based on the requirements po them under Programme Implementation Pl ans.Funds allocated, released and expenditure incurred State/UT wise are given at Annexure 1.

To meet  the  shortfall  of  human  resource  in  health, the  government implementing  a  Centrally  Sponsored  Scheme  for  'establishment  of  new  medical colleges by upg rading district/referral hospitals' with fund sharing between the Central Government and States in the ratio of 90:10 for North Eastern /special category and  60:40  for  other  states. This  s cheme  was  approved  in  January,  2014.  Criteria  for identificat ion  of  Districts  under  the scheme are i)  District  Hospitals/referral  hospital w ith bed strength of 200 or more ii) District/Referral hospitals of the districts wh ere there is no medical college i ii) Preference to underserved areas. Funds released to th St ate Governments for th e approved districts under the s chem are given at Annexure- 2.

Upgradation of existing State Government/Central Government medical colleges to increase MBBS seats in the country: - This s cheme was approved in January, 2014. The fundi ng pattern is 90:10 by Central and State Governments respectively for No Eastern  States  and  Special  category  States  and  60:40  for  other  States  with  the ceiling cost pegged at Rs.1.20 crore per seat. 22 Medical Colleges have been appr under  the scheme  to  increase  UG  seats.  Funds  released under  this  s cheme  are  at Annexure- 3.

Strengthening and upgradation of State Government Medical colleges for starti new PG disciplines and increasing PG seats : - The scheme was launched in the XI Plan period with the objective to strengthen and upgrade State/Central Government Medi Colleges to create new PG seats. The funding pattern between Centre and States is ratio of 60:40. A total of 72 Government M edical colleges are covered under the scheme for increasing PG seats. Funds released under the scheme are at Annexure- 4.

Rashtriya  Swasthya  Bima  Yojana  (RSBY),  a Centrally  S ponsored Health I nsurance scheme is being implemented by this Ministry which cove rs BPLfamilies (a unit  of  five)  and other  categories  namely  Building  &  Other  Construction  Workers, licensed Railway porters, Street Vendors, MGNREGA workers (who have worked for more  than  fifteen  days  during  preceding  financial  year),  Beedi  workers,  Domes tic workers,  Sanitation  Workers,  Mine  Workers,  Rickshaw  pullers,  Rag  pickers  and Auto/Taxi drivers, who are enrolled under RSBY. They are entitled for health insur coverage  of  Rs.30,000/ - cashless    per  annum  per  family.  Under  RSBY  there  is  no state/UT - wise allocation of funds. Central Government releases its share of premium State Governments on the receipt of their proposals. The State/UT - wise details of the funds released to State Governments during last three years are at A nnexure - 5.

Statement showing States/UTs wise Allocation, Release and Expenditure during 2013 - 14 to 2015

## Annexure - I

National Health Mission - 16 (Rs in crore)

| Sl.   |                           | 2013- 14   | 2013- 14   | 2013- 14     | 2014- 15    | 2014- 15   | 2014- 15     | 2015- 16    | 2015- 16   | 2015- 16    |
|-------|---------------------------|------------|------------|--------------|-------------|------------|--------------|-------------|------------|-------------|
| No.   | States                    | Allocation | Release    | Expendi ture | Allocati on | Release    | Expendi ture | Allocati on | Release    | Expenditure |
| 1     | Andaman & Nicobar Islands | 23.83      | 29.06      | 29.12        | 28.22       | 23.36      | 24.33        | 28.21       | 37.30      | 11.47       |
| 2     | Andhra Pradesh            | 1184.24    | 878.73     | 1044.81      | 707.15      | 519.73     | 902.91       | 616.23      | 643.52     | 1090.17     |
| 3     | Arunachal Pradesh         | 86.31      | 78.60      | 92.03        | 185.65      | 139.41     | 69.50        | 160.01      | 162.65     | 146.27      |
| 4     | Assam                     | 1214.83    | 1077.81    | 956.89       | 1095.38     | 877.13     | 915.88       | 941.29      | 971.35     | 1186.01     |
| 5     | Bihar                     | 1487.65    | 1110.32    | 1480.68      | 1292.13     | 1148.32    | 1427.40      | 1108.61     | 1159.49    | 1621.67     |
| 6     | Chandigarh                | 18.53      | 11.46      | 14.42        | 19.40       | 12.15      | 15.26        | 14.24       | 23.89      | 20.98       |
| 7     | Chattisgarh               | 500.72     | 355.98     | 805.50       | 555.66      | 500.41     | 716.04       | 479.38      | 412.26     | 758.28      |
| 8     | Dadra & Nagar Haveli      | 8.73       | 9.23       | 9.83         | 13.99       | 8.40       | 8.56         | 11.37       | 14.37      | 15.54       |
| 9     | Daman & Diu               | 6.48       | 6.50       | 8.40         | 9.69        | 6.91       | 7.67         | 9.11        | 10.53      | 15.69       |
| 10    | Delhi                     | 211.46     | 129.78     | 132.59       | 192.59      | 154.04     | 222.64       | 142.81      | 163.80     | 137.29      |
| 11    | Goa                       | 27.12      | 19.35      | 30.58        | 27.63       | 26.03      | 29.50        | 19.41       | 16.77      | 24.92       |
| 12    | Gujarat                   | 833.94     | 833.72     | 977.48       | 858.47      | 832.86     | 873.66       | 677.65      | 693.78     | 1272.42     |
| 13    | Haryana                   | 313.57     | 315.94     | 423.79       | 317.42      | 273.60     | 438.18       | 249.33      | 291.96     | 493.23      |
| 14    | Himachal Pradesh          | 225.95     | 205.29     | 158.60       | 232.00      | 185.84     | 306.92       | 197.92      | 246.49     | 281.26      |
| 15    | Jammu & Kashmir           | 433.87     | 395.10     | 391.10       | 435.17      | 335.51     | 393.29       | 368.00      | 367.90     | 420.94      |
| 16    | Jharkhand                 | 582.97     | 396.38     | 521.49       | 563.92      | 359.62     | 372.01       | 493.37      | 411.50     | 590.18      |
| 17    | Karnataka                 | 814.17     | 611.11     | 812.56       | 834.09      | 697.24     | 858.18       | 706.09      | 740.45     | 1141.61     |
| 18    | Kerala                    | 424.15     | 360.98     | 673.07       | 373.58      | 521.99     | 509.83       | 305.87      | 304.14     | 632.88      |
| 19    | Lakshadweep               | 3.61       | 3.20       | 2.28         | 5.89        | 5.08       | 1.36         | 4.28        | 5.69       | 2.72        |
| 20    | Madhya Pradesh            | 1141.03    | 865.94     | 1583.60      | 1250.17     | 1162.50    | 1738.02      | 1085.37     | 1132.19    | 2046.60     |
| 21    | Maharashtra               | 1520.71    | 1218.51    | 1806.86      | 1536.58     | 1431.76    | 1834.40      | 1282.31     | 1085.92    | 1734.44     |
| 22    | Manipur                   | 127.75     | 88.93      | 74.57        | 144.97      | 128.81     | 86.91        | 118.53      | 112.16     | 105.51      |
| 23    | Meghalaya                 | 139.24     | 125.51     | 71.53        | 160.21      | 104.13     | 70.72        | 131.00      | 102.22     | 133.55      |
| 24    | Mizoram                   | 86.20      | 77.43      | 91.89        | 116.53      | 103.28     | 93.29        | 97.87       | 94.68      | 172.38      |
| 25    | Nagaland                  | 114.42     | 99.73      | 90.40        | 131.26      | 114.92     | 63.04        | 108.75      | 104.85     | 81.05       |
| 26    | Odisha                    | 678.99     | 604.20     | 901.65       | 730.09      | 667.16     | 944.10       | 624.71      | 652.62     | 1205.77     |
| 27    | Puducherry                | 21.29      | 18.10      | 25.43        | 25.46       | 22.56      | 23.35        | 17.77       | 18.61      | 21.77       |
| 28    | Punjab                    | 362.38     | 333.47     | 437.57       | 351.89      | 379.35     | 460.59       | 284.75      | 295.23     | 649.49      |
| 29    | Rajasthan                 | 1091.20    | 922.93     | 1457.06      | 1238.11     | 1115.96    | 1722.69      | 1069.38     | 1287.84    | 1799.11     |
| 30    | Sikkim                    | 42.32      | 45.91      | 44.82        | 51.42       | 51.60      | 41.36        | 45.86       | 41.01      | 50.71       |
| 31    | Tamil Nadu                | 1020.75    | 906.24     | 1430.28      | 968.18      | 952.75     | 2248.06      | 794.38      | 1093.22    | 1633.37     |
| 32    | Tripura                   | 165.43     | 140.15     | 101.93       | 161.75      | 123.11     | 130.15       | 139.08      | 136.29     | 118.77      |
| 33    | Uttar Pradesh             | 3584.98    | 3024.60    | 2924.38      | 2650.25     | 2431.06    | 3671.26      | 2299.49     | 2862.83    | 4451.78     |
| 34    | Uttarakhand               | 310.55     | 245.25     | 255.28       | 308.10      | 270.55     | 324.42       | 256.60      | 276.41     | 335.95      |
| 35    | West Bengal               | 1179.64    | 948.51     | 1271.71      | 1053.27     | 1058.62    | 1196.78      | 883.49      | 959.51     | 1487.62     |
| 36    | Telangana                 | 0.00       | 0.00       | 0.00         | 506.45      | 378.72     | 334.68       | 440.58      | 436.63     | 505.55      |

1. Allocation is as per Original outlay/Budget Estimates
2. Expenditure includes  expenditure against central Release, state release & unspent balances at the beginning of  the year and it updated as per FMR submitted by the States/UTs.

## Annexure-2

Funds  released  under the  Centrally  Sponsored  Scheme  for  Establishment  of  New  Medical Colleges attached with existing District/Referral hospitals during last three years (Rs. in crore)

|   S. No. | States/UT                   |   2014- 15 |   2015- 16 |   2016- 17 till date |
|----------|-----------------------------|------------|------------|----------------------|
|        1 | Andaman and Nicobar Islands |       0    |      28    |                   20 |
|        2 | Arunachal Pradesh           |       0    |      42.5  |                   10 |
|        3 | Assam                       |       0    |      30    |                   19 |
|        4 | Bihar                       |       0    |       8    |                   34 |
|        5 | Chhattisgarh                |      14    |      39.02 |                   83 |
|        6 | Himachal Pradesh            |      12.53 |      67.98 |                  114 |
|        7 | Jharkhand                   |       0    |       0    |                   48 |
|        8 | Jammu & Kashmir             |       0    |       0    |                   48 |
|        9 | Madhya Pradesh              |      14    |      24    |                   81 |
|       10 | Maharashtra                 |       6    |       7    |                   55 |
|       11 | Mizoram                     |       0    |      30    |                   10 |
|       12 | Nagaland                    |       0    |      36.5  |                   10 |
|       13 | Odisha                      |      35    |      85    |                   50 |
|       14 | Rajasthan                   |      41    |      89.2  |                   88 |
|       15 | Uttar Pradesh               |       0    |      16    |                   78 |
|       16 | Uttarakhand                 |       6    |       8    |                   18 |
|       17 | West Bengal                 |       0    |      20    |                   79 |

## Annexure - 3

Funds  released  under  the  Centrally  Sponsored  Scheme  for  ' Up - gradation  of  existing  State Government/Central Government  medical  colleges  to  increase  MBBS  seats  in  the  Country ' during the last three years

(Rs. in crore)

|   S. No. | States/UT      |   2014- 15 |   2015- 16 |   2016- 17 till |
|----------|----------------|------------|------------|-----------------|
|        1 | Andhra Pradesh |          0 |        6   |           10.2  |
|        2 | Gujarat        |          0 |        4.5 |           11.56 |
|        3 | Madhya Pradesh |          0 |       12   |           27.48 |
|        4 | Odisha         |          0 |        5   |           12    |
|        5 | Punjab         |          0 |        4   |            6.8  |
|        6 | Rajasthan      |          0 |        7   |           15.4  |
|        7 | Tamil Nadu     |          0 |        9.5 |           23.16 |
|        8 | Uttarakhand    |          0 |        2   |            3.4  |

## Annexure - 4

Funds Released under the scheme for 'Strengthening and up -gradation of State Government Medical Colleges for starting new PG disciplines and increasing PG seats' during the last three years ( Rs in crore)

|   S. No. | State/UT         |   2013- 14 |   2014- 15 | 2016- 17 Till   |
|----------|------------------|------------|------------|-----------------|
|        1 | Assam            |       0    |          0 | 3               |
|        2 | Andhra Pradesh   |       0    |          0 |                 |
|        3 | Bihar            |       0    |          0 |                 |
|        4 | Chandigarh       |       0    |          0 |                 |
|        5 | Chhattisgarh     |       0    |          0 |                 |
|        6 | Goa              |       0    |          0 |                 |
|        7 | Gujarat          |       0    |          0 |                 |
|        8 | Himachal Pradesh |       0    |          0 |                 |
|        9 | Jammu & Kashmir  |       0    |          0 |                 |
|       10 | Jharkhand        |       0    |          0 |                 |
|       11 | Kerala           |       0    |          0 |                 |
|       12 | Madhya Pradesh   |       0    |          5 | 1.94            |
|       13 | Maharashtra      |       0    |          0 |                 |
|       14 | Odisha           |       0    |          0 | 3.06            |
|       11 | Punjab           |      30.92 |          0 |                 |
|       16 | Rajasthan        |       0    |          0 |                 |
|       17 | Telangana        |       0    |          0 | 2               |
|       18 | Tripura          |       0    |          0 |                 |
|       19 | Uttarakhand      |       0    |          5 |                 |
|       20 | Uttar Pradesh    |       0    |          0 |                 |
|       21 | West Bengal      |       0    |          0 |                 |

Note: There was no release in 2015 - 16

## Annexure - 5

Central share of Premium released to State Governments under RSBY  during last three ye ( Amount in Crore)

|   Sr. No. | Name of State /UT   | 2013- 14   | 2014- 15   | 2015- 16   |
|-----------|---------------------|------------|------------|------------|
|         1 | Arunachal Pradesh   | -          | -          | -          |
|         2 | Assam               | 35.68      | 1.06       | 23.24      |
|         3 | Bihar               | 152.71     | 34.07      | -          |
|         4 | Chandigarh          | 0.00       | -          | -          |
|         5 | Chhattisgarh        | 48.34      | 58.81      | 88.77      |
|         6 | Delhi               | -          | -          | -          |
|         7 | Goa                 | -          | -          | -          |
|         8 | Gujarat             | 60.59      | 18.47      | 74.24      |
|         9 | Haryana             | 13.01      | 5.38       | 4.67       |
|        10 | Himachal Pradesh    | 9.03       | 3.75       | 13.90      |
|        11 | Jammu & Kashmir     | 0.53       | -          | -          |
|        12 | Jharkhand           | 51.25      | 5.51       | -          |
|        13 | Karnataka           | 31.59      | -          | 94.99      |
|        14 | Kerala              | 115.49     | 110.43     | 112.37     |
|        15 | Madhya Pradesh      | 2.82       | 8.21       | 1.00       |
|        16 | Maharashtra         | 13.88      | -          | -          |
|        17 | Manipur             | 2.52       | 1.73       | 1.17       |
|        18 | Meghalaya           | 1.79       | 1.25       | 4.10       |
|        19 | Mizoram             | 4.31       | 10.35      | 9.43       |
|        20 | Nagaland            | 2.07       | 4.66       | -          |
|        21 | Odisha              | 70.51      | 93.64      | 59.55      |
|        22 | Puducherry          | -          | -          | 0.17       |
|        23 | Punjab              | 5.58       | 2.59       | 2.80       |
|        24 | Rajasthan           | 10.72      | 32.10      | 53.57      |
|        25 | Tamil Nadu          | -          | -          | -          |
|        26 | Tripura             | 18.70      | 14.29      | 15.64      |
|        27 | Uttar Pradesh       | 72.56      | 36.47      | 11.91      |
|        28 | Uttarakhand         | 1.78       | -          | 10.20      |
|        29 | West Bengal         | 160.45     | 101.65     | 93.38      |