Lok Sabha Question No. 1071 (UNSTARRED), answered on 2019-02-08
Subject: Upgrading of Health Sub-Centres into Health and Wellness Centres
Ministry: HEALTH AND FAMILY WELFARE
Asked by: BALABHADRA MAJHI, J. JAYASINGH THIYAGARAJ NATTERJEE

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

## LOK SABHA UNSTARRED QUESTION NO. 1071 TO BE ANSWERED ON 08 TH FEBRUARY, 2019

## UPGRADING OF HEALTH SUB - CENTRES INTO HEALTH AND WELLNESS CENTRES

## 1071. SHRI BALABHADRA MAJHI: SHRI J.J.T. NATTERJEE:

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

- (a)  whether  the  Government  is  in  the process  of  upgrading  Health  Sub - Centres(HSC)  into Health and Wellness Centres (HWC), if so, the number of such HSCsupgraded in HWCs till date, State/UT - wise;
- (b)  the  human  resources  proposed  at each  HWC  along  with  the  number  of  human resources posted at such HWCs - State/UTwise;
- (c) whether there are any gaps in the human resources proposed at HWC and actual availability, if so, the details and reasons therefor along with the initiatives taken by the Government in this regard;
- (d) whether there is any specific outcome/output of converting HSC into HWC, if so, the details thereof, State/UT wise;and
- (e) the number of HWCs functional in tribal areas of Odisha, Andhra Pradesh, Madhya Pradesh and Uttarakhand?

## ANSWER

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

(SHRI ASHWINI KUMAR CHOUBEY)

- (a): As a part of Ayushman Bharat, Health Sub-Centres (HSC) and Primary Health Centres (PHCs) are to be transformed into Health and Wellness Centres (HWCs). The State/UT wis details of HSCs upgraded as HWCs as on 31 st January, 2019 are at Annexure -I.
- (b)& (c) : As per the Ayushman Bharat Operational Guidelines for Comprehensive Primary Health  Care  through  Health  and  Wellness  Centres - the  HWC  at  the  Sub  Health  Centre  level comprises of at least three service providers:
- a. One Mid-Level Health Provider (MLHP),
- b. Two, Multi - Purpose Worker s (two females or one male and one female)
- c. Team of ASHAs at the norm of one ASHA per 1000 population (in tribal, hilly and desert areas, norm relaxed to one ASHA per habitation).

'Public  Health  and  Hospitals'  being  a  State  subject,  the  primary  responsibility  of provision of human resource in public health facilities including HWC is that of respecti Government.The state/UT wise details of Human Resource posting/available a t HSC- HWCs on 31 st January, 2019 are at Annexure -II.

- (d): As  per  Ayushaman  Bharat  Operational  Guidelines  for  Comprehensive  Primary  Health Care through HWCs, the outcomes of converting SHC to HWC are as below:
- Improved  population  coverage: Active  empanelment  and  HWC  database  will improve the population coverage. The HWC database would enable HWC staff to monitor and identify the left out population and improve coverage of national h programmes.
- Reduced  out  of  pocket  expenditure  and  cat astrophic  health  expenditure : Improved access to expanded services closer to the community, assured availabil of medicines and diagnostic services and linkages for care coordination with Med Officers/specialists  across  levels  of  care  will  reduce financial  hardships  faced  by community.
- Risk factor mitigation : Health promotion efforts by primary health care team would support in addressing the risk factors for diseases.
- Decongestion  of  secondary  and  tertiary  health  facilities: A  strong  network  of HW Cs at the sub district level would facilitate resolving more cases at primar and reduce overcrowding at secondary and tertiary facilities for follow up cas well as serve a gate keeping function to higher - level facilities.

State/UT  wise  details of  screening  done  at  HSC  upgraded  to  HWCs  for  diabetes, hypertension, oral cancer & Breast cancer on 31 st January, 2019 are at Annexure -III.

(e): Andhra  Pradesh  and  Madhya  Pradesh  have  prioritized  operationalization  of  PHC  a HWCs for FY 2018- 19. Thus, S HCs as HWCs would be operationalized in FY 2019 - 20. Details of  HWCs  at  HSCs on  31 st January,  2019 in  districts  of  Odisha  and  Uttarakhand  along  with percentage of ST population in the district as per Census 2011is at Annexure -I V.

State/UT wise Health Sub Centre s upgraded as Health and Wellness C entre s as on 31 st January, 2019

| Sl. No.   | State Name                | SHC - HWC   |
|-----------|---------------------------|-------------|
| 1         | Andaman & Nicobar Islands | 28          |
| 2         | Andhra Pradesh            | 0           |
| 3         | Arunachal Pradesh         | 3           |
| 4         | Assam                     | 232         |
| 5         | Bihar                     | 3           |
| 6         | Chandigarh                | 5           |
| 7         | Chhattisgarh              | 160         |
| 8         | Dadra & Nagar Haveli      | 24          |
| 9         | Daman & Diu               | 20          |
| 10        | Delhi                     | 0           |
| 11        | Goa                       | 13*         |
| 12        | Gujarat                   | 26          |
| 13        | Haryana                   | 68          |
| 14        | Himachal Pradesh          | 0           |
| 15        | Jammu & Kashmir           | 25          |
| 16        | Jharkhand                 | 178         |
| 17        | Karnataka                 | 528         |
| 18        | Kerala                    | 0           |
| 19        | Lakshadweep               | 0           |
| 20        | Madhya Pradesh            | 0           |
| 21        | Maharashtra               | 0           |
| 22        | Manipur                   | 25          |
| 23        | Meghalaya                 | 0           |
| 24        | Mizoram                   | 0           |
| 25        | Nagaland                  | 0           |
| 26        | Odisha                    | 14          |
| 27        | Puducherry                | 0           |
| 28        | Punjab                    | 156         |
| 29        | Rajasthan                 | 137         |
| 30        | Sikkim                    | 0           |
| 31        | Tamil Nadu                | 147         |
| 32        | Telangana                 | 220         |
| 33        | Tripura                   | 40          |
| 34        | Uttar Pradesh             | 365         |
| 35        | Uttarakhand               | 41          |
| 36        | West Bengal               | 0           |
| Total     |                           | 2458        |

Source: HWC Portal www.ab - hwc.nhp.gov.in

Note: Delhi  and  Lakshadweep  has  not  started implementing *  Goa- SCs  are  being  upgraded, by posting of MOs at HSC - HWC

State/UT wise details of Human Resource posting/available at HSC - HWCs and proposed MLHPs on 31st January, 2019 .

| Sl. No.   | State/UT Name             |   HSC - HWC operational |   Total MLHP s In Position |   Total MPW (F) In Position |   Total MPW (M) In Position |   Total ASHAs In Positio n |
|-----------|---------------------------|-------------------------|----------------------------|-----------------------------|-----------------------------|----------------------------|
| 1         | Andaman & Nicobar Islands |                      28 |                         28 |                          26 |                           0 |                         28 |
| 2         | Arunachal Pradesh         |                       3 |                          3 |                           3 |                           2 |                         17 |
| 3         | Assam                     |                     232 |                        232 |                         400 |                         172 |                       1416 |
| 4         | Bihar                     |                       3 |                          3 |                           4 |                           0 |                         17 |
| 5         | Chandigarh                |                       5 |                          5 |                          10 |                           0 |                          7 |
| 6         | Chhattisgarh              |                     160 |                        160 |                         204 |                         137 |                       2029 |
| 7         | Dadra & Nagar Haveli      |                      24 |                         24 |                          37 |                          23 |                         74 |
| 8         | Daman & Diu               |                      20 |                         20 |                          36 |                          13 |                         68 |
| 9         | Goa*                      |                       0 |                          0 |                          17 |                          18 |                         14 |
| 10        | Gujarat                   |                      26 |                         26 |                          27 |                          27 |                        131 |
| 11        | Haryana                   |                      68 |                         68 |                         126 |                          12 |                        589 |
| 12        | Jammu & Kashmir           |                      25 |                         25 |                          44 |                           5 |                        101 |
| 13        | Jharkhand                 |                     178 |                        178 |                         291 |                          98 |                       1632 |
| 14        | Karnataka                 |                     528 |                        528 |                         497 |                         307 |                       2835 |
| 15        | Manipur                   |                      25 |                         25 |                          20 |                          22 |                        162 |
| 16        | Odisha                    |                      14 |                         14 |                          15 |                           7 |                        103 |
| 17        | Punjab                    |                     156 |                        156 |                         213 |                         132 |                        935 |
| 18        | Rajasthan                 |                     137 |                        137 |                         150 |                           3 |                        418 |
| 19        | Tamil Nadu                |                     147 |                        147 |                         148 |                           8 |                         60 |
| 20        | Telangana                 |                     220 |                        220 |                         368 |                           9 |                        691 |
| 21        | Tripura                   |                      40 |                         40 |                          41 |                          18 |                        206 |
| 22        | Uttar Pradesh             |                     365 |                        365 |                         411 |                          15 |                       2621 |
| 23        | Uttarakhand               |                      41 |                         41 |                          26 |                           0 |                        251 |
|           | Total                     |                    2445 |                       2445 |                        3114 |                        1028 |                      14405 |

Source: HWC Portal www.ab - hwc.nhp.gov.in as on 31 Jan 2019 IST: 7:01:48 PM - Report Generated only for HWC - SHCs Note: Delhi and Lakshadweep has not started implementing * Goa-13 HSCs are being upgraded, by posting of MOs at SHC -HWC

Universal Screening of NCDs at HSC upgraded to HWCs on 31 st January, 2019

| Sl. No.   | State/UT Name             |   Individuals screened for Diabetes |   Individuals Screened for Hypertension |   Individuals Screened for Oral Cancer | Individuals Screened for Breast Cancer   |
|-----------|---------------------------|-------------------------------------|-----------------------------------------|----------------------------------------|------------------------------------------|
| 1         | Andaman & Nicobar Islands |                                4346 |                                    4346 |                                   4346 | 2476                                     |
| 2         | Arunachal Pradesh         |                                 167 |                                     169 |                                     61 | 29                                       |
| 3         | Assam                     |                               30740 |                                   30884 |                                  26933 | 14384                                    |
| 4         | Bihar                     |                                   0 |                                       0 |                                      0 | 0                                        |
| 5         | Chandigarh                |                                3879 |                                    4672 |                                   3851 | 877                                      |
| 6         | Chhattisgarh              |                               19454 |                                   21874 |                                   8229 | 4469                                     |
| 7         | Dadra & Nagar Haveli      |                                6272 |                                    6272 |                                   6270 |                                          |
| 8         | Daman & Diu               |                               53223 |                                   53223 |                                  52262 | 24101                                    |
| 9         | Goa                       |                                4014 |                                    4010 |                                   4005 | 1012                                     |
| 10        | Gujarat                   |                                6974 |                                    7146 |                                   5221 | 2674                                     |
| 11        | Haryana                   |                                6502 |                                    6833 |                                   5555 | 3233                                     |
| 12        | Jammu & Kashmir           |                               17987 |                                   18747 |                                  12163 | 7421                                     |
| 13        | Jharkhand                 |                                1627 |                                    1869 |                                   1040 | 1008                                     |
| 14        | Karnataka                 |                               80314 |                                   93253 |                                   8955 | 3758                                     |
| 15        | Manipur                   |                                4824 |                                    4863 |                                   3668 | 1815                                     |
| 16        | Odisha                    |                                 706 |                                    1844 |                                    390 | 569                                      |
| 17        | Punjab                    |                                 815 |                                     951 |                                    182 | 130                                      |
| 18        | Rajasthan                 |                               14331 |                                   15341 |                                  13271 | 5311                                     |
| 19        | Tamil Nadu                |                               58432 |                                   60068 |                                  62046 | 2441                                     |
| 20        | Telengana                 |                              215659 |                                  176524 |                                  63860 | 37652                                    |
| 21        | Tripura                   |                                 388 |                                     791 |                                      0 | 0                                        |
| 22        | Uttar Pradesh             |                               15488 |                                   26272 |                                   8536 | 4516                                     |
| 23        | Uttarakhand               |                                 188 |                                     381 |                                      0 | 0                                        |
|           | Total                     |                              546330 |                                  540333 |                                 290844 | 117876                                   |

Source: HWC Portal www.ab - hwc.nhp.gov.in as on 31 Jan 2019 IST: 7:01:48 PM Report Generated only for HWC - SHCs

District wise number of HSC upgraded to HWCs Operational in Odisha on 31 st January, 2019

| Sl. No.   | Name of Districts with Operational HWCs   | % of ST Population as per Census 2011   |   No. of SHC HWC Operational |
|-----------|-------------------------------------------|-----------------------------------------|------------------------------|
| 1         | Baudh                                     | 12.55                                   |                           01 |
| 2         | Deogarh                                   | 35.33                                   |                           02 |
| 3         | Ganjam                                    | 3.37                                    |                           06 |
| 4         | Jagatsinghapur                            | 0.69                                    |                           01 |
| 5         | Jajapur                                   | 8.29                                    |                           01 |
| 6         | Kandhamal                                 | 53.58                                   |                           02 |
| 7         | Kendrapara                                | 0.66                                    |                           01 |
|           | Total                                     |                                         |                           14 |

Source: HWC Portal www.ab - hwc.nhp.gov.in as on 31 Jan 2019 IST: 7:01:48 PM Report Generated only for HWC- SHCs

## District wise number of SHC HWCs Operational in Uttarakhandon 31 st January, 2019

| Sl. No   | Name of Districts with Operational HWCs   | % of ST Population as per Census 2011   |   No. of SHC HWC Operational |
|----------|-------------------------------------------|-----------------------------------------|------------------------------|
| 1        | Dehradun                                  | 6.58                                    |                           15 |
| 2        | Garhwal                                   | 0.14                                    |                            5 |
| 3        | Haridwar                                  | 0.33                                    |                            2 |
| 4        | Nainital                                  | 0.79                                    |                           16 |
| 5        | Udham Singh Nagar                         | 7.46                                    |                            3 |
|          | Total                                     |                                         |                           41 |

Source: HWC Portal www.ab - hwc.nhp.gov.in as on 31 Jan 2019 IST: 7:01:48 PM Report Generated only for HWC - SHCs