Lok Sabha Question No. 3020 (UNSTARRED), answered on 2019-12-06
Subject: Deaths Caused by Pneumonia
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Mohanbhai Sanjibhai Delkar, Sanjay Haribhau Jadhav, Ranjeetsingh Naik Nimbalkar, Ashok Mahadeorao Nete

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

## LOK SABHA UNSTARRED QUESTION NO. 3020 TO BE ANSWERED ON 6 TH DECEMBER, 2019

## DEATHS CAUSED BY PNE UMONIA

## 3020. SHRI MOHAN S. DELKAR: SHRI SANJAY JADHAV: SHRI RANJEETSINGH HINDURAO NAIK NIMBALKAR: SHRI ASHOK MAHADEORAO NETE:

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

(a)  whether  India  stands  second  in  the  world  with  regard  to  deaths  of  children  caus pneumonia, if so, the reaction of the Government thereto;

(b) whether the Union Government has compiled the data of such deaths during the last years,  State/UT - wise  including  Dadar  and  Nagar  Haveli  and  Maharashtra,  if  so,  the  detai thereof, State/UT - wise;

(c) whether seven lakh infants die every year in the rural areas of the country due to di are preventable or treatable particularly pneumonia, if so, the reasons therefor;

- (d)  whether  any  assessment  has  been  made  regarding  the  shortage  of  spec ialist  doctors  and hospitals for the treatment of such diseases, State/UT - wise and if so, the details thereof;

(e) the corrective measures being taken by the Government along with the time by which appointment of new specialist doctors are proposed t o be issued; and

(f) the other concrete measures being taken by the Government to control the increasing n of pneumonia cases?

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

(SHRI ASHWINI KUMAR CHOUBEY)

(a):     As per the UNICEF analysis 2019, India stands second in the world in regard to d children caused by Pneumonia. As per this analysis, in 2018 there were 127,000 child pneum deaths in the country.

In November 2019, Ministry of Health a nd Family Welfare has launched SAANS (Social Awareness and Actions to Neutralize Pneumonia Successfully) Initiative to accelerate act reduce deaths due to Childhood Pneumonia under Reproductive, Maternal, and Newborn, Child Adolescent health and Nut rition (RMNCHA+N) program of National Health Mission.

- (b) : The  death  in  under  5  children  due  to  Pneumonia  reported  by  States/UTs  in  Heal Management Information System (HMIS) for last three years is at Annexure 1.
- (c) : As per the Sample Regi stration System 2017, Infant Mortality Rate (IMR) is 33 per 1000 live birth which translate into 8 lakh infant deaths in a year and out of this estimated 1 deaths are due to pneumonia which are mostly preventable or treatable.

(d)  &  (e) : Public  Health  and  Hospitals  being  a  State  subject,  all  the  administrative personnel  matters,  including  recruitment  of  specialists  doctors  at  Public  Health  Facil with the State Governments. Also, shortage of doctors in Public Health Facilities var ies from State  to  State  depending  upon  their  policies  and  context.  However,  as  per  Bulletin  on Health Statistics in India 2019, States/UTs wise shortage of specialist doctors is at Anne

Under National Health Mission (NHM), financial and technical support is provided States/UTs  to  strengthen  their  healthcare  systems  with  support  for  recruitment  of  d including specialist on contractual basis, based on the requirements posed by Stat es/UTs in their Programme Implementation Plans (PIPs) within their overall resource envelope

Under NHM, States/UTs are encouraged to adopt flexible norms for engaging doctors f Public  Health  Facilities.  Financial  support  is  also  provided  to  S tates/UTs  for  providing performance - based  incentives,  hard  area  allowance,  providing  accommodation  and  transpor facilities in rural and remote areas etc for engaging doctors in Public Health Facilities.

(f) : Under National Health Mission, there is spe cial provision to hire specialist doctors on contract  basis.  Beside  this  the  Government  of  India  is  implementing  following  interve under National Health Mission to address Childhood Pneumonia:

- SAANS (Social Awareness and Actions to Neutralize Pneumon ia Successfully) Initiative to accelerate action to reduce deaths due to Childhood Pneumonia. The SAANS initiative encompasses a three tiered strategy: i) National Childhood Pneumonia Management Guideline on treatment and management of Childhood Pneumonia; ii) Skill building and training of service providers for identification and standardized mana of  Pneumonia;  and  iii)  a  360 0 communication  SAANS  Campaign  to  ensure  greater awareness  on  childhood  Pneumonia  among  families  and  parents  in  order to  trigge r behaviour change and improve care seeking.
- Universal Immunization Programme (UIP) focuses on Measles, Haemophilus Influenzae (B) and Pneumococcal Vaccine for prevention of pneumonia.
- Early initiation and exclusive breastfeeding for first six months and appropriate Infant and  Young  Child  Feeding  (IYCF)  practices  are  promoted  under  Mothers'  Absolute Affection (MAA) initiative.
- Facility  based -Integrated  Management  of  Neonatal  and  Childhood  Illness  (F -IMNCI) training to build capacity of Medical Officer a nd Nurses in Primary Health Centres, First Referral Unit, Community  Health Centres, and  District Hospital on Acute Respirat Infection (ARI) Management.

## Data of number of under 5 deaths due to Pneumonia as per HMIS

| S.No   | States               | 2016-17   |   2017-18 |   2018-19 |
|--------|----------------------|-----------|-----------|-----------|
| 1      | A & N Islands        | 4         |        10 |         0 |
| 2      | Andhra Pradesh       | 163       |       576 |       437 |
| 3      | Arunachal Pradesh    | 6         |        10 |        12 |
| 4      | Assam                | 448       |      1050 |       793 |
| 5      | Bihar                | 470       |       836 |       544 |
| 6      | Chandigarh           | 11        |        45 |        51 |
| 7      | Chhattisgarh         | 565       |       669 |       646 |
| 8      | Dadra & Nagar Haveli | 11        |        26 |        17 |
| 9      | Daman & Diu          |           |         0 |         2 |
| 10     | Delhi                | 296       |       817 |       792 |
| 11     | Goa                  | 6         |        11 |         7 |
| 12     | Gujarat              | 520       |      1337 |      1166 |
| 13     | Haryana              | 184       |       138 |       456 |
| 14     | Himachal Pradesh     | 56        |        52 |        68 |
| 15     | Jammu & Kashmir      | 38        |        45 |       114 |
| 16     | Jharkhand            | 100       |       225 |       236 |
| 17     | Karnataka            | 372       |       691 |       625 |
| 18     | Kerala               | 5         |       157 |       111 |
| 19     | Lakshadweep          | 1         |         0 |         2 |
| 20     | Madhya Pradesh       | 1497      |      1907 |      1977 |
| 21     | Maharashtra          | 781       |       980 |      1015 |
| 22     | Manipur              | 12        |        13 |         9 |
| 23     | Meghalaya            | 632       |       429 |       409 |
| 24     | Mizoram              | 75        |        85 |        67 |
| 25     | Nagaland             | 24        |        31 |        29 |
| 26     | Odisha               | 1012      |      1125 |      1262 |
| 27     | Puducherry           | 4         |        52 |        42 |
| 28     | Punjab               | 130       |       205 |       153 |
| 29     | Rajasthan            | 1482      |      1676 |      1198 |
| 30     | Sikkim               | 3         |         6 |        11 |
| 31     | Tamil Nadu           | 89        |       396 |       267 |
| 32     | Telangana            | 65        |       189 |       182 |
| 33     | Tripura              | 98        |        81 |        57 |
| 34     | Uttar Pradesh        | 118       |       990 |       568 |
| 35     | Uttarakhand          | 14        |        32 |        49 |
| 36     | West Bengal          | 723       |      1390 |      1575 |
|        | All India            | 10015     |     16282 |     14949 |

| TOTAL SPECIALISTS AT CHCs (Total Specialists [Surgeons,OB&GY,   | TOTAL SPECIALISTS AT CHCs (Total Specialists [Surgeons,OB&GY,   | TOTAL SPECIALISTS AT CHCs (Total Specialists [Surgeons,OB&GY,   | TOTAL SPECIALISTS AT CHCs (Total Specialists [Surgeons,OB&GY,   | TOTAL SPECIALISTS AT CHCs (Total Specialists [Surgeons,OB&GY,   | TOTAL SPECIALISTS AT CHCs (Total Specialists [Surgeons,OB&GY,   |
|-----------------------------------------------------------------|-----------------------------------------------------------------|-----------------------------------------------------------------|-----------------------------------------------------------------|-----------------------------------------------------------------|-----------------------------------------------------------------|
| S. No.                                                          | State/UT                                                        | Required 1                                                      | Sanctioned In                                                   | Position Vacant                                                 | Shortfall                                                       |
|                                                                 |                                                                 | [R]                                                             | [S] [P]                                                         | [S-P]                                                           | [R-P]                                                           |
| 1                                                               | Andhra Pradesh                                                  | 772                                                             | 533 384                                                         | 149                                                             | 388                                                             |
| 2                                                               | Arunachal Pradesh                                               | 252                                                             | NA 4                                                            | NA                                                              | 248                                                             |
| 3                                                               | Assam                                                           | 688                                                             | NA 158                                                          | NA                                                              | 530                                                             |
| 4                                                               | Bihar                                                           | 600                                                             | NA 82                                                           | NA                                                              | 518                                                             |
| 5                                                               | Chhattisgarh                                                    | 676                                                             | 652 57                                                          | 595                                                             | 619                                                             |
| 6                                                               | Goa                                                             | 16                                                              | 5 10                                                            | *                                                               | 6                                                               |
| 7                                                               | Gujarat                                                         | 1452                                                            | 1177 118                                                        | 1059                                                            | 1334                                                            |
| 8                                                               | Haryana                                                         | 452                                                             | 59 17                                                           | 42                                                              | 435                                                             |
| 9                                                               | Himachal Pradesh                                                | 364                                                             | NA 4                                                            | NA                                                              | 360                                                             |
| 10                                                              | Jammu & Kashmir                                                 | 336                                                             | 344 256                                                         | 88                                                              | 80                                                              |
| 11                                                              | Jharkhand                                                       | 684                                                             | 684 92                                                          | 592                                                             | 592                                                             |
| 12                                                              | Karnataka                                                       | 824                                                             | 824 498                                                         | 326                                                             | 326                                                             |
| 13                                                              | Kerala                                                          | 908                                                             | 30 40                                                           | *                                                               | 868                                                             |
| 14                                                              | Madhya Pradesh                                                  | 1236                                                            | 1236 248                                                        | 988                                                             | 988                                                             |
| 15                                                              | Maharashtra                                                     | 1444                                                            | 823 485                                                         | 338                                                             | 959                                                             |
| 16                                                              | Manipur                                                         | 92                                                              | 4 3                                                             | 1                                                               | 89                                                              |
| 17                                                              | Meghalaya                                                       | 112                                                             | 3 9                                                             | *                                                               | 103                                                             |
| 18                                                              | Mizoram                                                         | 36                                                              | 33 0                                                            | 33                                                              | 36                                                              |
| 19                                                              | Nagaland                                                        | 84 NA                                                           | 8                                                               | NA                                                              | 76                                                              |
| 20                                                              | Odisha                                                          | 1508                                                            | 1529 253                                                        | 1276                                                            | 1255                                                            |
| 21                                                              | Punjab                                                          | 604                                                             | 593 105                                                         | 488                                                             | 499                                                             |
| 22                                                              | Rajasthan                                                       | 2352                                                            | 1731 565                                                        | 1166                                                            | 1787                                                            |
| 23                                                              | Sikkim                                                          | 8                                                               | NA 0                                                            | NA                                                              | 8                                                               |
| 24                                                              | Tamil Nadu                                                      | 1540                                                            | NA 210                                                          | NA                                                              | 1330                                                            |
| 25                                                              | Telangana                                                       | 364                                                             | 320 112                                                         | 208                                                             | 252                                                             |
| 26                                                              | Tripura                                                         | 88                                                              | 0 2                                                             | *                                                               | 86                                                              |
| 27                                                              | Uttarakhand                                                     | 268                                                             | 268 29                                                          | 239                                                             | 239                                                             |
| 28                                                              | Uttar Pradesh                                                   | 3288                                                            | 2099 192                                                        | 1907                                                            | 3096                                                            |
| 29                                                              | West Bengal                                                     | 1392                                                            | 669 125                                                         | 544                                                             | 1267                                                            |
| 30                                                              | A& N Islands                                                    | 16                                                              | 9 0                                                             | 9                                                               | 16                                                              |
| 31                                                              | Chandigarh                                                      | 0                                                               | 0 0                                                             | 0                                                               | 0                                                               |
| 32                                                              | D & N Haveli                                                    | 8                                                               | 0 0                                                             | 0                                                               | 8                                                               |
| 33                                                              | Daman & Diu                                                     | 8                                                               | 6 3                                                             | 3                                                               | 5                                                               |
| 34                                                              | Delhi                                                           | 0                                                               | 0 0                                                             | 0                                                               | 0                                                               |
| 35                                                              | Lakshadweep                                                     | 12                                                              | 0 0                                                             | 0                                                               | 12                                                              |
| 36                                                              | Puducherry                                                      | 12                                                              | 4 5                                                             | *                                                               | 7                                                               |
|                                                                 | All India 2 / Total                                             | 22496                                                           | 13635 4074                                                      | 10051                                                           | 18422                                                           |

Notes:

NA: Not Available. All India figures for Vacancy and Shortfall are the totals of State -wise Vacancy and Shortfall ignoring surplus in some States / UTs

1 Four per Community Health Centre as per IPHS norms* Surplus

2 For calculating the overall percentages of vacancy and shortfall, the States/UTs for which manpower position is not available, are excluded