Lok Sabha Question No. 1129 (UNSTARRED), answered on 2020-09-18
Subject: Shortage of Doctors in Primary Health Centres (PHCs)
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Nihal Chand Chauhan

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

## LOK SABHA UNSTARRED QUESTION NO. 1129 TO BE ANSWERED ON 18 TH SEPTEMBER, 2020

## SHORTAGE OF DOCTORS IN PRIMARY HEALTH CE NTRES (PHCS)

## 1129. SHRI NIHAL CHA ND:

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

- (a) the State - wise details of the operational Primary Health Centres across the country including Rajasthan;
- (b) whether there is shortage of doctors, trained staff and equipments in Primary Health Centres;
- (c) if so, the steps taken to meet this shortage;
- (d) whether the Government has received any proposal from the States to open new Primary HealthCentres; and
- (e) if so, the details of funds allocated therefo r?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- a) As per the Rural Health Statistics - 2019, as on 31.03.2019 ,a total of 30,045Primary Health Centres( PHCs )  have  been  functional in  the  country.  State - wise  details  are  given  in Annexure- 1.
- b) & c):Public health being a State subject, the primary responsibility to ensure avai of doctors, trained staff and medical equipment in public health facilities lies with the State  Gov ernments.  However,  under  the  National  Health  Mission  (NHM), Central Government provides financial and technical support toStates /UTs to strengthen their healthcare systems including forprocurement of equi pment and insourcing /engagement of doctors and health workers on contractual basis, based on the requirements posed by the States /UTs in their Programme Implementation Plans (PIPs).

As  per  Rural  Health  Statistics - 2019,  there  is  around  6%  of  shortfall  of  doctors  in  th PHC s in the Country, besides some shortfall of trained health workers. The deta shortfall of doctors and health assistants in PHCs is given in Annexure -II.

Central  Government  also  provides  support to  States / UTs  for  hard - area  allowance  to doctors for serving in rural and remote areas and for their residential quarters so t health  professionals find  it  attractive  to  serve  in  public  health  facilities  in  such Some  states  have  int roduced  mandatory  rural  posting for  medical  graduates  from government institut ionsto improve the availability of doctors.

Further, in order to encourage doctors to work in remote and difficult areas, the Council  of  India,  with  the  approval  of  Central  Government,  has  amended  the  Po Graduate Medical Educati on Regulations, 2000 to provide:

- (i)  50%  reservation  in  Post  Graduate  Diploma  Courses  for  Medical  Officers  in Government  service,  who  have  served  for  at  least  three  years  in  remote  and  diff areas; and
- (ii) Incentive at the rate of 10% the mark s obtained for each year in service in remote or difficult areas as upto the maximum of 30% of the marks obtained in the entrance te admissions in Post Graduate Medical Courses.
- d) & (e):Under NHM, funds are allocated to the States/ UTs pool - wi e and not individual activity - wise.State - wise details of State Programme Implementation Plans approvals for PHCs covered under NHM for the year 2020 - 21 aregiveninAnnexure-III.

## NUMBER OF PRIMARY HEALTH CENTRES (PHCs) FUNCTIONING IN RURAL AND URBAN AREAS (As on 31.03.2019)

| Sr. No.           | State / UT                | PRIMARY HEALTH CENTRES (PHCs)   | PRIMARY HEALTH CENTRES (PHCs)   | PRIMARY HEALTH CENTRES (PHCs)   |
|-------------------|---------------------------|---------------------------------|---------------------------------|---------------------------------|
| Sr. No.           | State / UT                | Rural                           | Urban                           | Total                           |
| 1                 | Andhra Pradesh            | 1,145                           | 364                             | 1,509                           |
| 2                 | Arunachal Pradesh         | 143                             | 4                               | 147                             |
| 3                 | Assam                     | 946                             | 55                              | 1,001                           |
| 4                 | Bihar                     | 1,899                           | 95                              | 1,994                           |
| 5                 | Chhattisgarh              | 792                             | 45                              | 837                             |
| 6                 | Goa                       | 24                              | 0                               | 24                              |
| 7                 | Gujarat                   | 1,476                           | 318                             | 1,794                           |
| 8                 | Haryana                   | 379                             | 97                              | 476                             |
| 9                 | Himachal Pradesh          | 586                             | 20                              | 606                             |
| 10                | Jammu & Kashmir           | 622                             | 49                              | 671                             |
| 11                | Jharkhand                 | 298                             | 57                              | 355                             |
| 12                | Karnataka                 | 2,127                           | 435                             | 2,562                           |
| 13                | Kerala                    | 848                             | 83                              | 931                             |
| 14                | Madhya Pradesh            | 1,199                           | 136                             | 1,335                           |
| 15                | Maharashtra               | 1,828                           | 538                             | 2,366                           |
| 16                | Manipur                   | 90                              | 9                               | 99                              |
| 17                | Meghalaya                 | 118                             | 0                               | 118                             |
| 18                | Mizoram                   | 59                              | 10                              | 69                              |
| 19                | Nagaland                  | 126                             | 5                               | 131                             |
| 20                | Odisha                    | 1,288                           | 87                              | 1,375                           |
| 21                | Punjab                    | 416                             | 16                              | 432                             |
| 22                | Rajasthan                 | 2,082                           | 377                             | 2,459                           |
| 23                | Sikkim                    | 29                              | 1                               | 30                              |
| 24                | Tamil Nadu                | 1,422                           | 463                             | 1,885                           |
| 25                | Telangana                 | 636                             | 249                             | 885                             |
| 26                | Tripura                   | 108                             | 5                               | 113                             |
| 27                | Uttarakhand               | 257                             | 0                               | 257                             |
| 28                | Uttar Pradesh             | 2,936                           | 624                             | 3,560                           |
| 29                | West Bengal               | 908                             | 448                             | 1,356                           |
| 30                | Andaman & Nicobar Islands | 22                              | 2                               | 24                              |
| 31                | Chandigarh                | 0                               | 46                              | 46                              |
| 32                | Dadra & Nagar Haveli      | 9                               | 2                               | 11                              |
| 33                | Daman & Diu               | 4                               | 0                               | 4                               |
| 34                | Delhi                     | 5                               | 535                             | 540                             |
| 35                | Lakshadweep               | 4                               | 0                               | 4                               |
| 36                | Puducherry                | 24                              | 15                              | 39                              |
| TOTAL - ALL INDIA | TOTAL - ALL INDIA         | 24,855                          | 5,190                           | 30,045                          |

STATUS OF DOCTORS AND TRAINED STAFF IN PRIMARY HEALTH CENTRES

| Source: RHS 2019       |   Required |   In-place |   Shortfall | Shortfall (%)   |
|------------------------|------------|------------|-------------|-----------------|
| Doctors (PHC)          |      24855 |      29799 |        1484 | 6%              |
| Staff Nurse (PHC)      |      24855 |      30071 |        5800 | 23%             |
| Pharmacist (PHC)       |      24855 |      18975 |        7220 | 29%             |
| Lab Technician (PHC)   |      24855 |      12462 |       12638 | 51%             |
| ANM/ MPW(Female) (PHC) |      24855 |      28992 |        6492 | 26%             |

## ANNEXURE 2

## Details of SPIP Approvals for the PHCs (Hospital Strengthening and New Constructions) under NHM for the FY 2020-21

## Rs. In Lakhs

| S.No.                    | Name of the State / UT    | 2020-21             |
|--------------------------|---------------------------|---------------------|
| A. High Focus States     |                           |                     |
| 1                        | Bihar                     | 3,225.00            |
| 2                        | Chattisgarh               | 1,260.38            |
| 3                        | Himachal Pradesh          | -                   |
| 4                        | Jammu & Kashmir           | -                   |
| 5                        | Jharkhand                 | 1,381.96            |
| 6                        | Madhya Pradesh            | 8,509.59            |
| 7                        | Orissa                    | 5,160.69            |
| 8                        | Rajasthan                 | -                   |
| 9                        | Uttar Pradesh             | 120.00              |
| 10 Total                 | Uttarakhand Sub           | 19,657.62 39,315.24 |
| B. NE States 11          | Arunachal Pradesh         | 1,464.54            |
| 12                       | Assam                     | 540.00              |
| 13                       | Manipur                   | -                   |
| 14                       | Meghalaya                 | -                   |
| 15                       | Mizoram                   | 286.44              |
| 16                       | Nagaland                  | -                   |
| 17                       | Sikkim                    | 1,840.00            |
| 18 Total                 | Tripura Sub               | 4,235.98 8,366.96   |
| C. Non-High Focus States | C. Non-High Focus States  |                     |
| 19                       | Andhra Pradesh            | 21.00               |
| 20                       | Goa                       | -                   |
| 21                       | Gujarat                   | -                   |
| 22                       | Haryana                   | 200.00              |
| 23                       | Karnataka                 | 1,202.49            |
| 24                       | Kerala                    | 17,243.82           |
| 25                       | Maharashtra               | -                   |
| 26                       | Punjab                    | 3,005.00            |
| 27                       | Tamil Nadu                | -                   |
| 28                       | Telangana                 | -                   |
| 29                       | West Bengal               | 22,392.31           |
| Sub Total States/UTs     | Sub Total States/UTs      | 44,064.62           |
| D. Small 30              | Andaman & Nicobar Islands | -                   |
| 31                       | Chandigarh                | -                   |
| 32                       | Dadra & Nagar Haveli      | -                   |
| 33                       | Daman & Diu               | -                   |
| 34                       | Delhi                     | -                   |
| 35                       | Lakshadweep               | 1,399.11            |
| 36                       | Puducherry                | -                   |
| Sub Total                | Grand Total               | 1,399.11            |
|                          |                           | 93,145.93           |

## Note:

1. SPIP stands for State Program Implementation Plan.
2. The above figures are as per reported by the State/UTs.
3. The above figures are inclusive of activity Additional Building/ Major Upgradation of existing Structure, Up gradation, Spill over of Ongoing Works, New Constructions, Staff Quarters, Carry forward of new construction initiated last year, or the year before and Major civil works for operationalization of 24 hour services at PHCs.