Lok Sabha Question No. 582 (UNSTARRED), answered on 2018-07-20
Subject: Single Source of Treatment
Ministry: HEALTH AND FAMILY WELFARE
Asked by: ARVIND GANPAT SAWANT, DARSHANA VIKRAM JARDOSH

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

## LOK SABHA UNSTARRED QUESTION NO. 582 TO BE ANSWERED ON 20 th JULY, 2018

## SINGLE SOURCE OF TRE ATMENT

## 582. SHRI ARVIND SAWANT: SHRIMATI DARSHANA VIKRAM JARDOSH:

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

(a)  whether  as  per  a  Health  Survey report private practitioners are the single most important source of treatment in both rural and urban areas;

(b) if so, the details thereof, State/ UT - wise;

(c) whether the Government is aware that a large part of population never avail any treatment for various diseases and if so, the details thereof; and

(d) the steps taken by the Government for improving healthcare facilities in the country?

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

(a)& (b): Yes.  According  to  NSS  Report  No.  574:  Health  in  India  based  on  National Sample Survey 71 st round (January 2014 -June 2014) conducted by National Sample Survey Office (NSSO), more than 70 percent (72 percent in the rural areas and 79 percent in th areas) spells of ailment were treated in the private sector (consisting of private docto nursing homes, private hospitals, charitable institutions).

State/UT  wise  percent  distribution  of  spells  of  ailment  treated  over  levels  of givenat Annexure -I.

(c ): Above NSS report also reveals that around 4.1 percent Male and 4.0 percent Fem ale in rural areas and 2.8 percent Male and 2.5 percent Female in urban people did not take/ any treatment for various ailments.

The details are given at Annexure -II.

(d): P ublic health and hospital are state subject, however, under National Hea lth Mission (NHM), support  is  provided  to  the  States/UTs  to  strengthen  their  health  care  system  based requirements  proposed  by  them  under  Programme  Implementation  Plans.  NHM  envisages achievement of universal access to equitable, affordable & qualit y healthcare services that are accountable  and  responsive  to  people's needs.  The  main  programmatic  components  include Health System Strengthening in rural and urban areas, Reproductive, Maternal, New - born, Child and  Adolescent  Health  (RMNCH+A)  intervention s  and  control  of  Communicable  and  Non -Communicable Diseases. The recent initiatives taken include the following:

- Launching of Pradhan Mantri National Dialysis Services Programme.
- Launching of Mother's Absolute Affection (MAA) Programme.
- Launching ofPradhan Mantri Surakshit Matritva Abhiyan.
- Introduction  of  Rubella  vaccine - it  has  been  introduced  in  Universal  Immunization Programme  as  Measles - Rubella  combination  vaccine  to  provide  protection  against congenital birth defects caused by Rubella infecti on.
- Free Drugs Service Initiative.
- Free Diagnostics Service Initiative.
- Launching of 'Mission Parivar Vikas' in high focus districts having higher total fertility rate (TFR) in the country.
- Launch of Kayakalp -an initiative for Award to Public Health Facilities.
- Expansion of basket of choices, to include new contraceptives like contraceptive, Centchroman and Progestogen Only Pills (POP).

Inject

- Launching  of  a  universal  population  based  screening  programm e  for  early  detection, management and control of common non - communicable diseases such as hypertension, diabetes, and cancers (breast, cervix and oral).
- Swachh  Swasth  Sarvatra  (SSS),  a  joint  initiative  of  the  Ministry  of  Health  &  Fa Welfare  (MoHFW)  and the  Ministry  of  Drinking  Water  and  Sanitation  (MoDWS)  to leverage the achievements of the two Ministries for convergence of the interventio maximise the health gains.

Further, In General Budget 2018 - 19, Government has announced two major initiatives n health sector, as part of Ayushman Bharat programme. These are Health and Wellness Centre provide comprehensive health care, including for non - communicable diseases and maternal and child health services and NationalHealth Protection Scheme to cov er over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage upto 5 lakh per family per year for secondary and tertiary care hospitalization.

## Annexure I

## Percentage dist ribution of spells of ailment treated on medical advice over levels of care in each State/UT

| State/UT          | Rural               | Rural            | Rural          | Rural             | U rban              | U rban           | U rban         | U rban            |
|-------------------|---------------------|------------------|----------------|-------------------|---------------------|------------------|----------------|-------------------|
| State/UT          | HSC/PHC and others* | Public hospitals | Private doctor | Private hospitals | HSC/PHC and others* | Public hospitals | Private doctor | Private hospitals |
| Andhra Pradesh    | 5.8                 | 9.8              | 29.1           | 55.4              | 2.6                 | 9.7              | 27.2           | 60.5              |
| Arunachal Pradesh | 71.4                | 28               | 0.5            | 0.1               | 6.6                 | 87.2             | 1.4            | 4.8               |
| Assam             | 53.8                | 30.4             | 15.1           | 0.6               | 19.8                | 24.5             | 44.3           | 11.5              |
| Bihar             | 6.2                 | 7.8              | 75.9           | 10.2              | 1.6                 | 10.7             | 80.7           | 7                 |
| Chhattisgarh      | 22.4                | 8.1              | 60.3           | 9.2               | 8.3                 | 7.4              | 66.6           | 17.7              |
| Delhi             | 0                   | 22.3             | 74             | 3.7               | 9.2                 | 10.9             | 71.6           | 8.3               |
| Goa               | 1.2                 | 19.5             | 62.4           | 17                | 4.3                 | 26.3             | 54             | 15.3              |
| Gujarat           | 13.2                | 10.5             | 48.1           | 28.2              | 4.4                 | 10.6             | 58.3           | 26.8              |
| Haryana           | 5                   | 5.6              | 59.6           | 29.8              | 0.3                 | 8.1              | 70.9           | 20.6              |
| Himachal Pradesh  | 5.3                 | 38               | 40             | 16.7              | 4.1                 | 75.3             | 13.9           | 6.8               |
| Jammu & Kashmir   | 4.8                 | 43.6             | 50.2           | 1.4               | 2.4                 | 38.6             | 58.1           | 1                 |
| Jharkhand         | 10.3                | 21.8             | 60.7           | 7.2               | 0.3                 | 14.4             | 64.5           | 20.9              |
| Karnataka         | 6.3                 | 19.7             | 47.8           | 26.2              | 3                   | 11.4             | 42.6           | 42.9              |
| Kerala            | 15.3                | 21               | 33.8           | 30                | 5.5                 | 25.6             | 37.5           | 31.4              |
| Madhya Pradesh    | 6.9                 | 22.5             | 58.9           | 11.7              | 4.9                 | 19               | 59.6           | 16.4              |
| Maharashtra       | 10.4                | 9.8              | 60.3           | 19.5              | 3.5                 | 11               | 64.8           | 20.7              |
| Manipur           | 17.5                | 32.6             | 32.7           | 17.3              | 0                   | 66               | 34             | 0                 |
| Meghalaya         | 78.3                | 5.5              | 15.9           | 0.3               | 0.8                 | 13               | 68.5           | 17.7              |
| Mizoram           | 83.5                | 3.2              | 12.1           | 1.2               | 19.4                | 24.2             | 49.7           | 6.7               |
| Nagaland          | 45.4                | 37.7             | 16             | 0.9               | 22                  | 33.3             | 29.4           | 15.4              |
| Odisha            | 49.7                | 25.8             | 23.6           | 1                 | 21.7                | 32.7             | 38.3           | 7.3               |
| Punjab            | 5.7                 | 11.1             | 55             | 28.2              | 2.8                 | 19.8             | 59.7           | 17.7              |
| Rajasthan         | 19.2                | 24.7             | 44.3           | 11.8              | 3.2                 | 25.8             | 50.3           | 20.6              |
| Sikkim            | 87.6                | 8.4              | 0.5            | 3.5               | 0                   | 45               | 38.2           | 16.8              |
| Tamil Nadu        | 11.4                | 30.9             | 18.8           | 38.9              | 3.6                 | 25               | 26.6           | 44.8              |

|                             | Rural               | Rural            | Rural          | Rural             | U rban              | U rban           | U rban         | U rban            |
|-----------------------------|---------------------|------------------|----------------|-------------------|---------------------|------------------|----------------|-------------------|
| State/UT                    | HSC/PHC and others* | Public hospitals | Private doctor | Private hospitals | HSC/PHC and others* | Public hospitals | Private doctor | Private hospitals |
| Telangana                   | 8                   | 10.6             | 41.9           | 39.5              | 1.2                 | 7.5              | 29.2           | 62.1              |
| Tripura                     | 31.7                | 31.8             | 34.1           | 2.5               | 13.5                | 27.7             | 50.4           | 8.3               |
| Uttar Pradesh               | 5                   | 9.5              | 75.5           | 10.1              | 3.9                 | 12.2             | 71.4           | 12.6              |
| Uttarakhand                 | 12.9                | 44.5             | 22.1           | 20.5              | 0.4                 | 25.3             | 62.1           | 12.3              |
| West Bengal                 | 7.1                 | 15.5             | 74.6           | 2.9               | 2.9                 | 11.9             | 82             | 3.2               |
| A ndaman & N icobar Islands | 64.6                | 10.5             | 24.5           | 0.5               | 21.2                | 49.7             | 14.5           | 14.6              |
| Chandigarh                  | 7.6                 | 27.2             | 63.9           | 1.2               | 9.2                 | 31.5             | 58.3           | 1                 |
| Dadra & NagarHaveli         | 33.5                | 9.8              | 10.6           | 46.2              | 13.9                | 46.7             | 14.5           | 24.9              |
| Daman & Diu                 | 23.4                | 2.4              | 10             | 64.2              | 1.6                 | 1.3              | 40.6           | 56.4              |
| Lakshadweep                 | 47.7                | 36.3             | 0              | 16                | 1.2                 | 70.1             | 3.8            | 24.9              |
| Puducherry                  | 0.2                 | 18.1             | 65.6           | 16.2              | 0.3                 | 48.6             | 4.6            | 46.5              |
| all                         | 11.5                | 16.8             | 50.7           | 21                | 3.9                 | 17.3             | 50             | 28.8              |

## Annexure I I

## Percentage of spells of ailment for which no treatment was received

| State/UT                    | R ural   | R ural   | U rban   | U rban   |
|-----------------------------|----------|----------|----------|----------|
|                             | M ale    | Female   | M ale    | Female   |
| Andhra Pradesh              | 1.1      | 4        | 0.1      | 1.3      |
| Arunachal Pradesh           | 4.8      | 3.8      | 0        | 35.1     |
| Assam                       | 0.6      | 1.4      | 0        | 0        |
| Bihar                       | 2.3      | 3.5      | 0.3      | 0.6      |
| Chhattisgarh                | 0.1      | 7        | 0.1      | 0.1      |
| Delhi                       | 0        | 0        | 0        | 0.2      |
| Goa                         | 0        | 1.9      | 6.2      | 0        |
| Gujarat                     | 19.7     | 21.5     | 11.1     | 11.3     |
| Haryana                     | 2.9      | 0.3      | 0.7      | 3.4      |
| Himachal Pradesh            | 0.6      | 4.3      | 0.8      | 0.7      |
| Jammu & Kashmir             | 0        | 0        | 0        | 0        |
| Jharkhand                   | 2.4      | 17.5     | 5.8      | 1.4      |
| Karnataka                   | 1.9      | 0.3      | 4.2      | 2        |
| Kerala                      | 4        | 2.1      | 6.6      | 2.9      |
| Madhya Pradesh              | 3.9      | 5.7      | 0.3      | 1.6      |
| Maharashtra                 | 5.4      | 5        | 0.6      | 1.3      |
| Manipur                     | 0        | 0        | 0        | 0        |
| Meghalaya                   | 1.2      | 12.2     | 0        | 0.2      |
| Mizoram                     | 0        | 0        | 0        | 0        |
| Nagaland                    | 0        | 0.8      | 0        | 0        |
| Odisha                      | 1.3      | 2.6      | 2.2      | 0.4      |
| Punjab                      | 0        | 0        | 0        | 0        |
| Rajasthan                   | 1.7      | 1.7      | 7.6      | 0.5      |
| Sikkim                      | 0        | 0        | 0        | 0        |
| Tamil Nadu                  | 5.1      | 2.3      | 1.5      | 2.3      |
| Telangana                   | 0.7      | 0        | 0        | 0        |
| Tripura                     | 0        | 0.5      | 0        | 0        |
| Uttar Pradesh               | 5.2      | 1.7      | 1.1      | 1.6      |
| Uttarakhand                 | 1.8      | 1.8      | 0        | 0        |
| West Bengal                 | 5.1      | 6.5      | 1.7      | 4.2      |
| A ndaman & N icobar Islands | 4.7      | 5.8      | 14.8     | 1.7      |
| Chandigarh                  | 0.5      | 0.3      | 0        | 0        |
| Dadra & NagarHaveli         | 10.3     | 17.3     | 0        | 0.3      |
| Daman & Diu                 | 0        | 0        | 0        | 0        |
| Lakshadweep                 | 0        | 0        | 6.6      | 16.4     |
| Puducherry                  | 0        | 0        | 0        | 0        |
| all                         | 4.1      | 4        | 2.8      | 2.5      |