Lok Sabha Question No. 4135 (UNSTARRED), answered on 2019-01-04
Subject: Achievement of Health Schemes
Ministry: HEALTH AND FAMILY WELFARE
Asked by: PARAYAMPARANBIL KUTTAPPAN BIJU

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

## LOK  SABHA UNSTARRED QUESTION NO. 4135 TO BE ANSWERED ON 04 TH JANUARY, 2019

## ACHIEVEMENT OF HEALT H SCHEMES

## 4135. DR. P.K. BIJU:

Will  the  Minister  of HEALTH  AND FAMILY  WELFARE be  pleased  to  state  the details  of  the  health schemes  launched  by  the  Government  since 2015  till  date  under  the Ministry, Year- wise  along  with  the  targets  set  and achievements  made  under  each  of  these schemes?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

The details of major health schemes launched by Government since 2015 till date w the targets set and achievements made under each of these schemes are at Annexure .

## 1. National Health Mission (NHM)

The details of health schemes are as under:

## A. Free Diagnostic Initiative (FDI)

The objective of the program is to ensure access to free diagnostic services to reduce Pocket  (OOP)  expenditure  on  healthcare. Under  the  National  Health  Mission  (NHM), Operational Guidelines for the NHM Free Diagnostics Services Initiative were dev eloped and disseminated among States/UTs on 2 nd July, 2015 with a mandate to provide free diagnostics to all the citizens of the country thereby reducing OOP expenses and providing access to m services. Diagnostic  services  are  to  be  provided  either  b y n  house  arrangement  in  PPP.  3 models of PPP suggested are -(i) Hub and spoke model for lab diagnostics (ii) Tele - rad ology and (iii) CT scan services in District Hospital.

Lab investigations has been rolled out in 31 States/UTs. CT scan services have been rolled out in 24 States/UTs and Tele - radiology has been rolled out in 10 States.

Ministry has pursued with all the States/UTs to provide essential diagnostics free of public health facilities and send proposals through Program Implementation Plan for fu ding under NHM.

Funds approved to States/UTs for 2016 - 17, 2017 - 18 and for 2018 - 19 as on 01.12.2018 are Rs. 649.30 crore, Rs. 761.18 crore and Rs. 1218.31 crore, respectively.

## B. Biomedical Equipment Management & Maintenance Program (BMMP)

Under BMMP, support is being provided to State Governments to outsource medical equipmen maintenance comprehensively for all its machinery across all the facilities. BMMP has been implemented in total 28 States (22 States in PPP and 6 States in in - house mode).

The implementation of BMMP has helped in providing assured quality diagnostics services public health facilities, thereby reducing cost of care and improving the quality of car patients. The programme is helping facilities in providing uninterrupted delivery of health care diagnostics, preventive, promotive, surgical and rehabilitation services .

## ANNEXURE

## C. Kayakalp

Kayakalp was launched in May, 2015 as a National Initiative to give Awards to those pu health facilities that demonstrate high levels of cleanliness, hygiene and infection focus  on  promoting  cleanliness  in  public  spaces.  The  objective  is  also  to  crea te nd  share sustainable practices related to improved cleanliness in public health facilities.

- Approval of Rs.36.66 crore for Kayakalp has been given in 2015 - 16, Rs. 107.99 crore in 2016- 17, Rs. 133.22 crore in 2017 - 18 and Rs. 225.66 crore in 2018 - 19.
- From  over  30,000  facilities  assessed  under  Kayakalp  Programme  in  2017 - 18,  2885 facilities had received Kayakalp awards including Commendation awards, which includ 271  District  Hospitals  (DHs),  748  Sub -Division  Hospitals  (SDHs)/Community  Health Centres (CHCs ), 1724 Primary Health Centres (PHCs) and 142 Urban Health facilities Out of which, 48 Districts Hospitals have been adjudged as winners & runners up, CHCs/SDHs and around 529 PHCs/UPHCs have been adjudged as winners.

## D. Health and Wellness Centres

- Health  &  Wellness  Centres  as  a  part  of  Ayushman  Bharat  seeks  to  undertake interventions to holistically address health (covering prevention, promotion ambulatory  care)  at  primary  level  for  comprehensive  Primary  health  Care  with continuum of care appr oach.
- In order to expand access to Comprehensive Primary Health Care (CPHC), Sub Health Centres (SHCs) and Primary Health Centres (PHCs) will be strengthened as Health an Wellness Centres (H&WCs).  The H&WCs  are expected to provide preventive, promotive,rehabilitative and curative care for an expanded range of servic encompassing  reproductive  and  child  health  services,  communicable  diseases,  no -communicable diseases, palliative care and elderly care, oral health, ENT care, and emergency care.
- Und er Ayushman Bharat -Health and Wellness Centres, 1,50,000 Health and Wellness Centres need to be operationalized by 2022. The Health and Wellness Centres would operationalized in phases as under:
- FY 2018- 19 = 15,000
- FY 2019- 20 = 25,000 (Cumulative 40,000)
- FY 2020- 21 = 30,000 (Cumulative 70,000)
- FY 2021- 2022 = 40,000 (Cumulative 1,10,000)
- Till 31st December 2022 = 40,000 (Cumulative 1,50,000)
- In the current year against target of 15000 Health and Wellness centres by March, 2 approval has been ac corded to States/UTs for over 21000 Health & Wellness Centres till date.  As  reported  by  the  States/  UTs, 4503  Health  &  Wellness  Centres  have  been operationalized till 15 th December, 2018.

## E. Swachh Swasth Sarvatra(SSS)

Swachh Swasth Sarvatra, a joint initiative of Ministry of Health and Family Welfare (MoHFW) and  Ministry  of  Drinking  Water  and  Sanitation  (MDWS),  was  launched  on  29 th December 2016. Under SSS: -

- One  CHC  in  each  of  the  Open  Defecation  Free  (ODF)  blocks  to  receive  additiona funding  of  Rs 10  lakhs  under  NHM  to  facilitate  the  CHC  to  achieve  Kayakalp certification  with  a  minimum  score  of  70  in  Kayakalp  assessment  and  improve  i Kayakalp score. Where there is no CHC in that block, the CHC catering to the popula of the ODF block may be ta ken up.
- MDWS  to  enable Gram  Panchayats  where  Kayakalp  awarded  PHCs  are  located  to become ODF. Further MDWS to build capacity through training in Water, Sanitation an Hygiene (WASH) to nominees from such CHCs and PHCs.
- A  list  of  498  Kayakalp  award  winning PHCs  for  FY  2017 - 2018  mapped  with  their respective  Gram  Panchayat,  Blocks  and  District  as  desired  by  MDWS  shared  with MDWS.
- Till date approvals of Rs 49.67 crore accorded to States under SSS for 853 CHCs i States, however further list of 773 CHCs as communicated by State based on approvals for FY 2018 - 19 is communicated to MDWS.

- [ ] Extension of SSS in collaboration with Ministry of Urban development (MoUD) is being rolled out to Urban areas. Guidelines bei ng issued shortly.

- List of 2074 ODF declared blocks shared by MDWS shared with States/UTs to enable them to map CHCs in or nearest to the ODF declared block and propose same in PIP 2018- 19.Based on the proposals submitted by States/UTs, RoPs for FY 201 8- 19 are being issued. List of CHCs mapped with these 2074 ODF blocks would be shared with MDWS.

## 2. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)

- Pradhan  Mantri  Surakshit  Matritva  Abhiyan  (PMSMA)  has  been  launched  in  2016  to provide fixed - day  assured,  comprehensive  and  quality  antenatal  care  univ ersally to  all pregnant women on the 9 th of every month.
- While antenatal care is routinely provided to pregnant women, special Ante Natal (ANC)  services  are  provided  by  Obstetrics  and  Gynecology  (OBGY)  Specialists/ Radiologist/ Physicians at government health facilities under PMSMA.
- As part of the campaign, a minimum package of antenatal care services are provide pregnant women in their 2 nd /3 rd trimesters of at Government health facilities (PHCs/CHCs, DHs/urban health facilities etc.) in bo th urban and rural areas.
- Using the principles of a single window system, a minimum package of investigatio and medicines such as Iron & Folic Acid (IFA) and Calcium supplements etc. are bei provided to all pregnant women attending the PMSMA clinics.
- O ne of the critical components of the Abhiyan is identification and follow - up of high risk pregnancies and red stickers are added on to the Mother and Child Protection card women with high risk pregnancies.

Year wise and achievement under the scheme -

|   No. | Indicator                                        |   2016- 17 |   2017- 18 |   2018- 19(Till Nov) |
|-------|--------------------------------------------------|------------|------------|----------------------|
|     1 | ANC checkups                                     |    4743954 |    7157098 |              4630172 |
|     2 | Total Number of high risk pregnancies identified |     276676 |     342394 |               207336 |
|     3 | Total Number of Volunteer Registered             |       3555 |       1343 |                  421 |

## 3. Senior Citizens Health Insurance Scheme (SCHIS) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY)

Since 2015 till date, two health schemes have been launched:

## A. Senior Citizens Health Insurance Scheme (SCHIS)

SCHIS  as  top  up  over  existing Rashtriya  Swasthya  Bima  Yojana  (RSBY)  scheme  has  been implemented from 01.04.2016 for senior citizens aged 60  years and above. SCHIS provid enhanced coverage of Rs. 30,000 per senior citizen in the family enrolled under RSBY. S covers all the senior citizens of families enrolled under RSBY.

Around 18 lakh families having senior citizen(s) were covered under SCHIS till 23.09.201

## B. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY)

The Government has launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) on  23.09.2018.  This  scheme  provides  coverage  upto  Rs.  5  lakh  per  family  per  year  f secondary  and  tertiary  care  hospitalisation  to  over  10  crore  poor  and  vulnerable  f (approx. 50 crore families) under PMJAY. This scheme cove rs 10.74 crore poor and vulnerable families based on deprivation and occupational criteria as per Socio Economic Caste C (SECC) data.

After the launch of PMJAY, RSBY and SCHIS got subsumed in it. State - wise chievements in respect of PMJAY are as under:

Status of PMJAY

| Status as on 04.12.2018   | Status as on 04.12.2018                  | Status as on 04.12.2018           | Status as on 04.12.2018   | Status as on 04.12.2018            | Status as on 04.12.2018          |
|---------------------------|------------------------------------------|-----------------------------------|---------------------------|------------------------------------|----------------------------------|
| State                     | Beneficiary families covered (in lakhs)* | Hospitals Empanelled + In Process | E - Cards Issued          | Beneficiaries Admitted in Hospital | Amount Authorized for Admissions |
| Andaman And Nicobar       | 0.78                                     | 6                                 | 1,271                     | 1                                  | 2,987                            |
| Arunachal Pradesh         | 2.80                                     | 0                                 | 29                        | 0                                  | 0                                |
| Assam                     | 27.02                                    | 200                               | 3                         | 2,501                              | 4,80,09,957                      |
| Bihar                     | 108.95                                   | 1,043                             | 39,931                    | 2,232                              | 1,91,94,357                      |
| Chandigarh                | 0.71                                     | 17                                | 5,491                     | 50                                 | 7,78,929                         |
| Chhattisgarh              | 41.46                                    | 1,574                             | 1,28,375                  | 72,498                             | 46,45,90,417                     |
| Dadra And Nagar Haveli    | 3.40                                     | 5                                 | 76,199                    | 537                                | 15,14,013                        |
| Daman And Diu             | 2.40                                     | 5                                 | 19,060                    | 92                                 | 3,97,827                         |
| Goa                       | 0.37                                     | 4                                 | 585                       | 2,817                              | 9,48,46,523                      |
| Gujarat                   | 44.85                                    | 2,341                             | 1,01,874                  | 93,338                             | 1,26,33,85,905                   |
| Haryana                   | 15.51                                    | 536                               | 1,73,927                  | 1,732                              | 2,44,13,587                      |
| Himachal Pradesh          | 4.80                                     | 210                               | 25,266                    | 1,464                              | 1,45,81,117                      |
| Jammu And Kashmir         | 6.13                                     | 159                               | 2,31,968                  | 0                                  | 0                                |
| Jharkhand                 | 57.00                                    | 747                               | 1,75,743                  | 12,642                             | 13,17,71,071                     |
| Karnataka                 | 103.00                                   | 958                               | 0                         | 46,135                             | 77,12,20,302                     |
| Kerala                    | 34.84                                    | 10                                | 0                         | 75,721                             | 42,86,57,692                     |
| Lakshadweep               | 0.01                                     | 1                                 | 8                         | 0                                  | 0                                |
| Madhya Pradesh            | 118.00                                   | 261                               | 2,17,740                  | 8,706                              | 8,08,57,003                      |
| Maharashtra               | 83.63                                    | 1,131                             | 11,254                    | 33,253                             | 78,69,18,229                     |
| Manipur                   | 2.77                                     | 16                                | 8,859                     | 391                                | 58,32,392                        |
| Meghalaya                 | 8.37                                     | 163                               | 0                         | 0                                  | 0                                |
| Mizoram                   | 1.95                                     | 110                               | 20,902                    | 1,460                              | 1,01,73,115                      |
| Nagaland                  | 2.50                                     | 65                                | 5,038                     | 64                                 | 5,72,110                         |
| NHA empanelled hospitals  | NHA empanelled hospitals                 | 26                                | 0                         | 271                                | 94,98,496                        |
| Puducherry                | Puducherry                               | 8                                 | 6                         | 0                                  | 0                                |
| Punjab                    | 1.04 42.00                               | 210                               | 0                         | 0                                  | 0                                |
| Sikkim                    | 0.40                                     | 7                                 | 438                       | 6                                  | 1,00,751                         |
| Tamil Nadu                | 157.00                                   | 1,837                             | 0                         | 63,911                             | 1,50,98,42,014                   |

| Tripura       | 4.90   | 67     | 28,741    | 542      | 29,58,515      |
|---------------|--------|--------|-----------|----------|----------------|
| Uttar Pradesh | 118.04 | 1,887  | 1,46,795  | 7,007    | 7,09,86,394    |
| Uttarakhand   | 19.68  | 185    | 11,465    | 370      | 36,89,328      |
| West Bengal   | 112.00 | 1,348  | 0         | 12,037   | 10,92,08,203   |
| Overall       | 1,126  | 15,137 | 14,30,968 | 4,39,778 | 5,85,40,01,234 |

## 4. Strengthening of Food Testing System in the Country including provision of Mobile Food TestingLabs (SoFTeL)

To upgrade Food Testing Laboratories in India, a Central Sector Scheme 'Strengthening of Food  Testing  System  in  the  Country  including  provision  of  Mobile  Food  Testing  Labs (SoFTeL)' with a total outlay of Rs. 481.95 Crore is being implemente d during 2016 - 17  to 2018- 19. The scheme focuses on all aspects of food testing system including strengtheni State  food  labs  and  referral  labs,  capacity  building  of  food  analysts  and  other personnel  engaged  in  the  analysis  of  food  and  creatio n  of  mobile  food  labs  across  all States/UTs.

The targets of the said scheme:

- to establish at least one of the Food testing Laboratories in each State/UT and t in larger States. A total of 45 State labs are proposed to be strengthened.
- to provide  the  financial  support  to  the  States  food  testing  labs  for  procureme major equipment facilities and other related head.
- to establish of 62 Food Safety on Wheels (the mobile lab -one in every 20 districts, with at least one Mobile lab in each State/UT).
- to ensure that all the State Food testing laboratories attain the NABL accreditat bring them at par with best of the laboratories in the country
- to cover 500 schools/colleges across the country for establishing basic facilitie grant of Rs. 3.00 lakh each and another 1000 schools/colleges to establish facili food testing with a grant of Rs.1.00 lakh each over a period of three years.

## Achievements as on 21.12.2018 under this scheme are: - :

- So far, a total of 31 State Food Safety Laboratories of 25 States/UTs have been taken up  for  upgradation  including  setting  up  11  microbiology  laboratories  in States/UTs have been taken for upgradation and a grant of Rs.128.45 Crore has bee sanctioned/released.
- A Grant of Rs. 13.715 Crore has been released for strengthening of 7 Referral Fo Testing Laboratories (for procurement of one/two high end equipment).
- 40 Food Safety Wheels (FSWs) have been sanctioned to 29 States/UTs out of which 33 FSWs has been delivered to 27 States/UTs.
- A  number  of  capacity  building  programmes  have  been  conducted  in  which  state officials were also invited. Details of participation of state officials are giv -
- a) 4  National  Accreditation  Board  for  Testing  and  Calibration  Laboratorie (NABL) Awareness Programmes -142 participants
- b) 16  Good Food Laboratory Practices (GFLP) -265 participants
- c) 12 specialized programmes -28 participants

172 Food Testing Laboratories (NABL accredited) have been recognised and notified und section 43(1) of FSS Act, 2006.

## 5. Drugs Regulation

The  Cabinet  Committee  on  Economic  Affairs  (CCEA)  had  approved  the  proposal  for strengthening the drug regulatory syst em in the country, both under the Central and the State Governments. The share of the Centre and the States in case of State component will be the ratio of 60:40 for all States except Jammu and Kashmir, Himachal Pradesh, Uttarakhan Sikkim and Seven No rth - Eastern States for which the ratio will be 90:10. The Scheme was to be  implemented  during  the  three  financial  years  viz.  2015 - 16,  2016 - 17  and  2017 - 18; however, the competent authority has approved its continuation for further two years, 2018- 19 an d 2019 - 20.

Accordingly,  proposals  were  asked  for  from  the  States.  Out  of  the  36  States/UTs, following  24  States/UTs  have  submitted  proposals  for  release  of  funds  along  with  t Memorandum of Understanding (MoU) duly signed by the respective States/UTs . These are: (i) Karnataka (ii) Delhi, (iii) Goa, (iv) Jharkhand, (v) Odisha, (vi) Gujarat, (vii) Ker Andhra  Pradesh,  (ix)  Telangana,  (x)  Punjab,  (xi)  Jammu  &  Kashmir,  (xii)  Bihar,  (xii Madhya Pradesh, (xiv) Uttarakhand, (xv) Tripura,  (xvi) M izoram,  (xvii)  Sikkim, (xvii) Arunachal  Pradesh,  (xix) Himachal Pradesh,(xx) Meghalaya (xxi) Maharashtra, (xxii) Tami Nadu (xxiii) Haryana (xxiv) Nagaland.

Rs.29.01 crore, Rs.52.35 crore and Rs.206 crore have been allocated during the years 20 -17;2017-18 and 2018 - 19 respectively for the Scheme. Year -wise details of funds released under the scheme are:

(Rs. in crore)

| Sl. No   | Name of States/UT   | Year 2016- 17             | Year 2017- 18             | Year 2018- 19             |
|----------|---------------------|---------------------------|---------------------------|---------------------------|
|          |                     | Fund sanctioned/ released | Fund sanctioned/ released | Fund sanctioned/ released |
| 1        | Andhra Pradesh      | 7.01                      | ---                       | 18.77                     |
| 2        | Sikkim              | 02.00                     | ---                       | ---                       |
| 3        | Meghalaya           | 02.00                     | ---                       | ---                       |
| 4        | Mizoram             | 06.00                     | ---                       | ---                       |
| 5        | Tripura             | 06.00                     | ---                       | ---                       |
| 6        | Arunachal Pradesh   | 06.00                     | ---                       | ---                       |

| 7     | Himachal Pradesh   | ---   | 15.00   | ---      |
|-------|--------------------|-------|---------|----------|
| 8     | Jammu and Kashmir  | ---   | 13.00   | ---      |
| 9     | Gujarat            | ---   | 06.00   | 13.55    |
| 10    | Odisha             | ---   | 05.00   | 1.9695   |
| 11    | Punjab             | ---   | 03.00   | ---      |
| 12    | Delhi              |       | 04.00   | ---      |
| 13    | Karnataka          | ---   | 03.35   | ---      |
| 14    | Jharkhand          | ---   | 03.00   | ---      |
| 15    | Bihar              | ---   | ---     | 20.00    |
| 16    | Madhya Pradesh     | ---   | ---     | 15.00    |
| 17    | Haryana            | ---   | ---     | 10.00    |
| 18    | Maharashtra        | ---   | ---     | 25.00    |
| 19    | Goa                |       | ---     | 2.43     |
| 20    | Uttarakhand        | ---   | ---     | 5.00     |
| 21    | Tamil Nadu         | ---   | ---     | 12.00    |
| 22    | Telangana          | ---   | ---     | 8.00     |
| 23    | Kerala             | ---   | ---     | 9.00     |
| 24    | Nagaland           | ---   | ---     | 2.6256   |
| TOTAL | TOTAL              | 29.01 | 52.35   | 143.3451 |

## 6. Family Planning Schemes

- Mission  ParivarVikas  (MPV) was  launched  in  2016  for  increasing  access  to contraceptives and family planning services in 146 high fertility districts of se focus States with Total Fertility Rate (TFR) of 3 and above.
- Three  new  Contraceptives viz,  Injectable  contra ceptive  (under  Antara  Program), Centchroman  and  Progesterone  Only  Pills  (POP)  were  added  to  the  existing  basket choices in 2016.
- A  Family  Planning  Logistic  Management  Information  Systems  (FP - LMIS) was launched in 2017 to strengthen family planning suppl y chain management system.
- The  packaging  for  Condoms,  Oral  Contraceptive  Pills  (OCPs)  and  Emergency Contraceptive Pills (ECPs) were revamped in 2016 so as to increase the demand for these commodities.
- A dedicated 360 degree media campaign on Family plannin g was developed in 2016 and 2017 for improving demand generation and awareness.
- The COT (Clinical Outreach Team) Scheme was designed in 2017 to meet the Family Planning needs in the far flung and underserved areas.

Achievements under Family Planning

|                                                         | 2015- 16   | 2016- 17   | 2017- 18   | 2018- 19(up to December, 2018)   |
|---------------------------------------------------------|------------|------------|------------|----------------------------------|
| Intra Uterine Contraceptive Device (IUCD)               | 5,540,743  | 5,971,293  | 5,874,525  | 3,593,923                        |
| Post Partum Intra Uterine Contraceptive Device (PPIUCD) | 1,065,433  | 1,690,155  | 2,090,250  | 1,408,374                        |
| Total Sterilization                                     | 4,069,670  | 3,930,459  | 3,568,409  | 1,600,936                        |
| Injectable contraceptive                                | MPA -      | -          | 145,812    | 489,634                          |
| Centchroman (Chhaya)                                    | -          | 484,498    | 959,433    | 848,643                          |

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