Lok Sabha Question No. 2989 (UNSTARRED), answered on 2021-03-12
Subject: Healthcare Facilities in Rural/Tribal Areas in Andhra Region
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kinjarapu Ram Mohan Naidu

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

## LOK SABHA UNSTARRED QUESTION NO. 2989 TO BE ANSWERED ON 12 TH MARCH, 2021

## HEALTHCARE FACILITIE S IN RURAL/TRIBAL AR EAS IN ANDHRA REGION

## 2989. SHRI RAM MOHAN NAIDU KINJARAPU:

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

(a) whether the Government is aware that healthcare is a major concern in backward and tribal areas due to lack of proper healthcare facilities, if so, the details thereof;

(b) whether the Government proposes to launch any special initiatives towards development of health infrastructure in backward areas and if so, the details thereof; and

(c)  whether  there  is  any  proposal  to  build  a  super speciality  hospital  and  med ical  college  in Uttara Andhra Region, if so, the details thereof and time frame fixed for the same?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

(a)  &(b): Rural  Health  Statistics  (RHS)  is  an  annual  publication,  based  on  Health  c administrative  data  reported  by  States/UTs.  RHS  provides  information  on  rural  hea infrastructure  and  requirements  of  public  health  facilities  in  rural/tribal  areas  as  r by States. As per the RHS 2019, the state - wise details of shortfall of health facilities in rural a is at Annexure - 1 and the state - wise details of number of Sub Centres (SCs), Primary Health Centres (PHCs), Health and Wellness Centres Sub - Centres (HWCs- SCs), Health and Wellness Centres - PHCs (HWCs - PHCs) & Community Health Centres (CHCs) functioning in tribal areas is at Annex ure- 2 .

'Public  Health  and  Hospital'  being  a  State  subject,  the  primary  responsibility  of ensuring availability of healthcare facilities including development of health infrastr backward and tribal areas lies with respective State/UT Governments.

To  address  the  healthcare  challenges,  particularly  in  rural  areas,  the  National Health  Mission  (NRHM)  was  launched  in  2005  to  supplement  the  efforts  of  the  State/UT Governments to provide accessible, affordable and quality healthcare to all those who access public health facilities. Currently, NRHM is a sub - mission of National Health Mission (NHM).

National Health Mission (NHM) supplements the efforts of the State/UT governments t provide  accessible,  affordable  and  quality  healthcare  to  all  those  who access  public  health facilities including in backward and tribal areas. U nder the National Health Mission (NHM), financial and technical support is provided to States/UTs to strengthen their health care including setting - up/upgrading public health facilities and augmenting health human resource on  contractual  basis  for  provision  of  equitable,  affordable  healthcare  to  all  its particularly the poor and vulnerable population including tribal population requirements posed by the State s in their Programme Implementation Plans (PIPs).

based

Various  interventions  that  are  implemented  for  better  healthcare  in tribal areas  and beneficiaries are as follows;

- The population norms for setting up Health Facilities in tribal areas are relaxed. the population norms of 5,000, 30,000, and 1,20,000 for setting up of Sub Centre, and CHC respectively, in tribal and desert areas its 3,000, 20,000 and 80,000.
- Relaxed norms for Mobile Medical Units (MMUs)
- All tribal majority districts whose composite health index is below the State average have been identified as High Priority Districts (HPDs) and these districts receiv resources per capita under the National Health Mission (NHM) as compared to the r of the districts in a State.
- Implementati on of Free Drugs and Free Diagnostics Service Initiatives.
- SC/ST households are covered under Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB- PMJAY) for health coverage up to Rs 5 Lakh per family per year as per Socio Economic Caste Census (SECC).

Due  to  above  interventions,  t here  has  been  67.89 1%  increase  in  facilities  available  in Tribal areas compared to 16.24% increase for all, between 2005 and 2019:

|                  | All India   | All India   | All India   | Tribal Areas   | Tribal Areas   | Tribal Areas   |
|------------------|-------------|-------------|-------------|----------------|----------------|----------------|
| Type of Facility | RHS 2005    | RHS 2019    | % Increase  | RHS 2005       | RHS 2019       | % Increase     |
| CHCs             | 3222        | 5685        | 76.44       | 643            | 1022           | 58.94          |
| PHCs             | 23109       | 30045       | 30.01       | 2809           | 4211           | 49.91          |
| SCs              | 142655      | 160713      | 12.65       | 16748          | 28682          | 71.25          |
| Total            | 168986      | 196443      | 16.24       | 20200          | 33915          | 67.89          |

(c) : As per information received, the Government of Andhra Pradesh is establishing 5 mu -speciality hospitals in tribal areas and among them, two are in north Andhra region (Seet Parvathipuram) @ Rs 49.26 crores each. These hospitals shall be functiona l by October, 2022.

Government  of  Andhra  Pradesh  is  also  establishing  two  Medical  Colleges  at  Pader (Tribal  area)  and  Vizianagaram  (rural  area)  @  Rs.  500  crores  each).  For  Medical  Colle Paderu, Government of India has released Rs 195 crores (60% of central share on the estimated cost for medical college Rs 325 crores). Timelines of these MCs are as follows:

| Activity                                            | PaderuMC      | Vizianagaram MC   |
|-----------------------------------------------------|---------------|-------------------|
| Foundation Stone                                    | 10.09.2019    | 10.10.2019        |
| Grounding of Work                                   | 20.02.2020    | 20.03.2020        |
| Completion of Work                                  | 20.12.2022    | 20.01.2023        |
| Application for Govt. India/MCI admissions 2022 - 3 | of 01.07.2022 | 01.07.2022        |
| Admissions starts                                   | 01.08.2023    | 01.08.2023        |

## Annexure-1

|       | State/ UT          |          |             |           |            | HWC - SCs PHCs and HWC   | HWC - SCs PHCs and HWC   | HWC - SCs PHCs and HWC   | HWC - SCs PHCs and HWC   |          |             |           |          |
|-------|--------------------|----------|-------------|-----------|------------|--------------------------|--------------------------|--------------------------|--------------------------|----------|-------------|-----------|----------|
| S.No. | State/ UT          | Required | In Position | Shortfall | % Shorfall | Required                 | In Position              | Shortfall                | % Shorfall               | Required | In Position | Shortfall | %        |
|       | State/ UT          | R        | P           | S         |            | R                        | P                        | S                        |                          | R        | P           | S         | Shorfall |
| 1     | Andhra Pradesh     | 7178     | 7437        | *         | *          | 1183                     | 1145                     | 38                       | 3                        | 295      | 140         | 155       | 53       |
| 2     | Arunachal Pradesh  | 338      | 385         | *         | *          | 51                       | 143                      | *                        | *                        | 12       | 63          | *         | *        |
| 3     | Assam              | 6374     | 4643        | 1731      | 27         | 1040                     | 946                      | 94                       | 9                        | 260      | 177         | 83        | 32       |
| 4     | Bihar              | 21337    | 9949        | 11388     | 53         | 3548                     | 1899                     | 1649                     | 46                       | 887      | 150         | 737       | 83       |
| 5     | Chhattisgarh       | 5323     | 5205        | 118       | 2          | 843                      | 792                      | 51                       | 6                        | 210      | 170         | 40        | 19       |
| 6     | Goa                | 96       | 219         | *         | *          | 15                       | 24                       | *                        | *                        | 3        | 5           | *         | *        |
| 7     | Gujarat            | 8055     | 9166        | *         | *          | 1308                     | 1476                     | *                        | *                        | 327      | 362         | *         | *        |
| 8     | Haryana            | 3460     | 2604        | 856       | 25         | 576                      | 379                      | 197                      | 34                       | 144      | 115         | 29        | 20       |
| 9     | Himachal Pradesh   | 1366     | 2089        | *         | *          | 225                      | 586                      | *                        | *                        | 56       | 87          | *         | *        |
| 10    | Jammu &            | 2102     | 3025        | *         | *          | 342                      | 622                      | *                        | *                        | 85       | 84          | 1         | 1        |
| 11    | Kashmir Jharkhand  | 6768     | 3848        | 2920      | 43         | 1079                     | 298                      | 781                      | 72                       | 269      | 171         | 98        | 36       |
| 12    | Karnataka          | 8028     | 9758        | *         | *          | 1318                     | 2127                     | *                        | *                        | 329      | 198         | 131       | 40       |
| 13    | Kerala             | 2340     | 5380        | *         | *          | 388                      | 848                      | *                        | *                        | 97       | 227         | *         | *        |
| 14    | Madhya Pradesh     | 13935    | 10226       | 3709      | 27         | 2233                     | 1199                     | 1034                     | 46                       | 558      | 309         | 249       | 45       |
| 15    | Maharashtra        | 14112    | 10668       | 3444      | 24         | 2299                     | 1828                     | 471                      | 20                       | 574      | 364         | 210       | 37       |
| 16    | Manipur            | 537      | 490         | 47        | 9          | 84                       | 90                       | *                        | *                        | 21       | 23          | *         | *        |
| 17    | Meghalaya          | 822      | 477         | 345       | 42         | 124                      | 118                      | 6                        | 5                        | 31       | 28          | 3         | 10       |
| 18    | Mizoram            | 179      | 370         | *         | *          | 27                       | 59                       | *                        | *                        | 6        | 9           | *         | *        |
| 19    | Nagaland           | 414      | 433         | *         | *          | 62                       | 126                      | *                        | *                        | 15       | 21          | *         | *        |
| 20    | Odisha             | 8382     | 6688        | 1694      | 20         | 1345                     | 1288                     | 57                       | 4                        | 336      | 377         | *         | *        |
| 21    | Punjab             | 3562     | 2950        | 612       | 17         | 593                      | 416                      | 177                      | 30                       | 148      | 89          | 59        | 40       |
| 22    | Rajasthan          | 12761    | 13512       | *         | *          | 2073                     | 2082                     | *                        | *                        | 518      | 571         | *         | *        |
| 23    | Sikkim             | 96       | 176         | *         | *          | 15                       | 29                       | *                        | *                        | 3        | 2           | 1         | 33       |
| 24    | Tamil Nadu         | 7355     | 8713        | *         | *          | 1222                     | 1422                     | *                        | *                        | 305      | 385         | *         | *        |
| 25    | Telangana          | 4479     | 4744        | *         | *          | 731                      | 636                      | 95                       | 13                       | 182      | 85          | 97        | 53       |
| 26    | Tripura            | 661      | 972         | *         | *          | 104                      | 108                      | *                        | *                        | 26       | 18          | 8         | 31       |
| 27    | Uttarakhand        | 1509     | 1847        | *         | *          | 250                      | 257                      | *                        | *                        | 62       | 67          | *         | *        |
| 28    | Uttar Pradesh      | 34726    | 20782       | 13944     | 40         | 5781                     | 2936                     | 2845                     | 49                       | 1445     | 679         | 766       | 53       |
| 29    | West Bengal        | 13226    | 10357       | 2869      | 22         | 2177                     | 908                      | 1269                     | 58                       | 544      | 348         | 196       | 36       |
| 30    | A & N              | 49       | 124         | *         | *          | 8                        | 22                       | *                        | *                        | 2        | 4           | *         |          |
| 31    | Islands Chandigarh | 1        | N App       | N App     | N App      | N App                    | N App                    | N App                    | N App                    | N App    | N App       | N App     | * N App  |
| 32    | Haveli             | 61       | 71          | *         | *          | 9                        | 9                        | 0                        | 0                        | 2        | 2           | 0         | 0        |
|       | D & N              |          |             |           |            |                          |                          |                          |                          |          |             |           |          |
| 33    | Daman & Diu        | 7        | 23          | *         | *          | 1                        | 4                        | *                        | *                        | 0        | 0           | N App     | N App    |
| 34 35 | Delhi              | 34       | 12          | 22        | 65         | 5                        | 5                        | 0                        | 0                        | 1        | 0           | 1         | 100      |
|       | Lakshadweep        | 1        | 14          | *         | *          | 0                        | 4                        | *                        | *                        | 0        | 3           | *         | *        |
| 36    | Puducherry         | 91       | 54          | 37        | 41         | 15                       | 24                       | *                        | *                        | 3        | 2           | 1         | 33       |
|       | All India/ Total   | 189765   | 157411      | 43736     | 23         | 31074                    | 24855                    | 8764                     | 28                       | 7756     | 5335        | 2865      | 37       |

Notes: The requirement is calculated using the prescribed norms on the basis of rural population estimation for mid year for the year 2019.  All India shortfall is deriv adding state - wise figures of shortfall ignoring the existing surplus in some of the states.(Mid year Tribal population for the year 2019 c alculated based on the percentages of Tribal population in the Rural areas in Census 2011)

R: Required; P: In Position; S: Shortfall;     *: Surplus

N App-Not Applicable

## Annexure-2

| NUMBER OF SUB -CENTRES,                                | NUMBER OF SUB -CENTRES,                                | HWCs -SCs, HWCs - PHCs & CHCs FUNCTIONING in Tribal Areas   | HWCs -SCs, HWCs - PHCs & CHCs FUNCTIONING in Tribal Areas   | HWCs -SCs, HWCs - PHCs & CHCs FUNCTIONING in Tribal Areas   | HWCs -SCs, HWCs - PHCs & CHCs FUNCTIONING in Tribal Areas   | HWCs -SCs, HWCs - PHCs & CHCs FUNCTIONING in Tribal Areas   |
|--------------------------------------------------------|--------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|
| S. No.                                                 | State/UT                                               | Sub centre                                                  | (As PHCs                                                    | on 31st March 2019) HWC -SC                                 | HWC -PHC                                                    | CHCs                                                        |
| 1                                                      | Andhra Pradesh                                         | 762                                                         | 0                                                           | 40                                                          | 153                                                         | 21                                                          |
| 2                                                      | Arunachal Pradesh                                      | 307                                                         | 101                                                         | 78                                                          | 42                                                          | 63                                                          |
| 3                                                      | Assam                                                  | 664                                                         | 131                                                         | 114                                                         | 50                                                          | 27                                                          |
| 4                                                      | Bihar                                                  | NA                                                          | NA                                                          | NA                                                          | NA                                                          | NA                                                          |
| 5                                                      | Chhattisgarh                                           | 2440                                                        | 288                                                         | 372                                                         | 107                                                         | 81                                                          |
| 6                                                      | Goa                                                    | 66                                                          | 0                                                           | 0                                                           | 8                                                           | 1                                                           |
| 7                                                      | Gujarat                                                | 2519                                                        | 203                                                         | 259                                                         | 218                                                         | 92                                                          |
| 8                                                      | Haryana *                                              | N App                                                       | N App                                                       | N App                                                       | N App                                                       | N App                                                       |
| 9                                                      | Himachal Pradesh                                       | 104                                                         | 47                                                          | 0                                                           | 0                                                           | 8                                                           |
| 10                                                     | Jammu & Kashmir                                        | 304                                                         | 42                                                          | 3                                                           | 6                                                           | 11                                                          |
| 11                                                     | Jharkhand                                              | 2522                                                        | 103                                                         | 143                                                         | 89                                                          | 98                                                          |
| 12                                                     | Karnataka                                              | 321                                                         | 64                                                          | 0                                                           | 0                                                           | 7                                                           |
| 13                                                     | Kerala                                                 | 831                                                         | 137                                                         | 0                                                           | 0                                                           | 12                                                          |
| 14                                                     | Madhya Pradesh                                         | 3274                                                        | 306                                                         | 0                                                           | 32                                                          | 99                                                          |
| 15                                                     | Maharashtra                                            | 2162                                                        | 341                                                         | 420                                                         | 126                                                         | 67                                                          |
| 16                                                     | Manipur                                                | 234                                                         | 53                                                          | 18                                                          | 2                                                           | 7                                                           |
| 17                                                     | Meghalaya #                                            | 445                                                         | 110                                                         | 32                                                          | 8                                                           | 28                                                          |
| 18                                                     | Mizoram #                                              | 370                                                         | 65                                                          | 0                                                           | 4                                                           | 9                                                           |
| 19                                                     | Nagaland #                                             | 397                                                         | 126                                                         | 56                                                          | 5                                                           | 21                                                          |
| 20                                                     | Odisha                                                 | 2674                                                        | 116                                                         | 27                                                          | 311                                                         | 133                                                         |
| 21                                                     | Punjab *                                               | N App                                                       | N App                                                       | N App                                                       | N App                                                       | N App                                                       |
| 22                                                     | Rajasthan                                              | 1564                                                        | 211                                                         | 10                                                          | 22                                                          | 67                                                          |
| 23                                                     | Sikkim                                                 | 48                                                          | 12                                                          | 9                                                           | 1                                                           | 0                                                           |
| 24                                                     | Tamil Nadu                                             | 332                                                         | 66                                                          | 100                                                         | 39                                                          | 25                                                          |
| 25                                                     | Telangana                                              | 698                                                         | 0                                                           | 0                                                           | 93                                                          | 23                                                          |
| 26                                                     | Tripura                                                | 484                                                         | 45                                                          | 0                                                           | 3                                                           | 9                                                           |
| 27                                                     | Uttarakhand                                            | 155                                                         | 10                                                          | 0                                                           | 0                                                           | 5                                                           |
| 28                                                     | Uttar Pradesh                                          | NA                                                          | NA                                                          | NA                                                          | NA                                                          | NA                                                          |
| 29                                                     | West Bengal                                            | 3206                                                        | 300                                                         | 0                                                           | 0                                                           | 104                                                         |
| 30                                                     | A&N Island                                             | 33                                                          | 4                                                           | 8                                                           | 0                                                           | 1                                                           |
| 31                                                     | Chandigarh *                                           | N App                                                       | N App                                                       | N App                                                       | N App                                                       | N App                                                       |
| 32                                                     | D&N Haveli #                                           | 34                                                          | 4                                                           | 24                                                          | 3                                                           | 0                                                           |
| 33                                                     | Daman & Diu                                            | 0                                                           | 0                                                           | 5                                                           | 0                                                           | 0                                                           |
| 34                                                     | Delhi *                                                | N App                                                       | N App                                                       | N App                                                       | N App                                                       | N App                                                       |
| 35                                                     | Lakshadweep#                                           | 14                                                          | 4                                                           | 0                                                           | 0                                                           | 3                                                           |
| 36                                                     | Puducherry *                                           | N App                                                       | N App                                                       | N App                                                       | N App                                                       | N App                                                       |
|                                                        | All India                                              | 26964                                                       | 2889                                                        | 1718                                                        | 1322                                                        | 1022                                                        |
| Note:                                                  |                                                        |                                                             |                                                             |                                                             |                                                             |                                                             |
| #:States are predominently tribal areas                | #:States are predominently tribal areas                | #:States are predominently tribal areas                     |                                                             |                                                             |                                                             |                                                             |
| *: State / UT has no separate Tribal Area / Population | *: State / UT has no separate Tribal Area / Population | *: State / UT has no separate Tribal Area / Population      |                                                             |                                                             |                                                             |                                                             |
| N App -Not applicable N A -Data not available          | N App -Not applicable N A -Data not available          | N App -Not applicable N A -Data not available               |                                                             |                                                             |                                                             |                                                             |