Lok Sabha Question No. 123 (UNSTARRED), answered on 2019-06-21
Subject: Primary Health Centres
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kanakmal Katara

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

## LOK SABHA UNSTARRED QUESTION NO. 123 TO BE ANSWERED ON 21 ST JUNE,2019

## PRIMARY HEALTH CENTR ES

## 123. SHRI KANAKMAL KATARA:

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

- (a) whether the Government is aware that the functioning of Primary Health Centres (PHC) is not satisfactory due to lack of management and monitoring system;
- (b) if so, the details thereof;
- (c) the initiative taken by the Government to strengthen management and monitoring system so that  the  patients  can get  facilities  such  as  availability  of  doctors, basic  diagnostic  tests  and medicines; and
- (d) the type of assistance the Government provides to the State Governments for strengthening PHCs?

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

(a) & (b): Public Health and hospitals being a State subject, it is the responsibility of the S to  ensure satisfactory  functioning  of  Primary  Health  Centre  (PHC)  through  proper  management  and monitoring. The Government had constituted a Task Force on Comprehensive Primary Health Care i 2014. As per the Task Force report, poor functioning of primary health car e systems is reflected in the rapidly escalating demand for secondary and tertiary care services and increases in the cost of he

Primary health centre p ovides services that are limited to care in pregnancy, some aspects child health and some of the national disease programmes.

Therefore, while management and monitoring systems play a key role in ensuring functioning PHCs, other factors such as limited range of services also contribute in low service utilization.

- (c): (i)  Under  'Ayushman  Bharat',  1,50,000  PHCs  and  SHCs  are  to  be  converted  into  Health  and Wellness Centres (HWCs) in phased manner, to provide Comprehensive Primary Health Care (CPHC) close to the community.
- (ii) Ongoing initiatives to strengthen management and monitoring systems, are as follows: -
- In addition to the regular structures of the state governme nt, the National Health Mission has institutionalized Programme Management Units to review and assess gaps in service delive prepare annual action plans and enable efficient use of resources to address the gaps.
- Monthly  meetings  of  District  Health Society  are  held  to  review  functioning  of  health  care facilities.
- Mechanisms of reviews at State/regional/district level are in built in the programme des NHM.
- Free Diagnostics Initiative  has  been  launched to  ensure  availability  and  access  to  dia gnostic tests at public health facilities, free of cost.  As a part of free drugs initiative, Drug and Vaccine Delivery Management Systems(DVDMS) is being used for monitoring purposes.
- Health information sources such as; Health Management Information Systems, Human Resources Management Information Systems, Public Finance Monitoring Systems, Information systems for various national health  programmes (Reproductive & Child  Health Portal, NI KSHAY, Comprehensive  Primary  Health  Care  Non - Communicable  Disease  Application,  Integrated Disease Surveillance Program IDSP etc.), 'Mera Aspataal', are also utilized for this purpose.
- 104 Call Centre supports in tracking availability of inputs such as HR , medicines, diagnostics etc. as well as service utilization in public health facilities. These information sources ena monitoring  and  evaluation  at  the  block,  district  and  State  level  for  effective  pro management.
- (d): The assistance pr ovided for strengthening PHCs are as under: -
- (A) Financial  and  technical  assistance  is  provided  to  States/UTs  under  National  Health  Missi supplements their efforts in strengthening healthcare infrastructure including strengthening Funds are pro vided to States/UTs under NHM on the basis of the annual Project Implementation Plans (PIPs) through which they project activities and budget requirement for the financial y
- (B)Financial support provided under the NHM for PHCs is wide ranging and inclu des provisions for -Contractual HR - service delivery, Infrastructure Strengthening, Free Drugs Initiative, Diagnostics,  National  Health  Programmes,  Capacity  Building,  Community  bases  activities Community  Interventions  such  as  ASHA, Village  Health  Sanit ation  &  Nutrition  Committees (VHSNC) , Mahila Arogya Samiti ( MAS), for both rural and urban areas.
- (C)As a part of Ayushman Bharat, Health Sub - Centres(HSC) and Primary Health Centres (PHC) are being t ransformedinto Health and Wellness Centres, which will deli ver Comprehensive Primary Health Care (CPHC) close to the community.  This include preventive and health promotion at community  level  with  continuum  of  care  approach.    The  HWCs  are  envisioned  to  provide  an expanded  range  of  services  to  include  care  for non- communicable  diseases,  palliative  and rehabilitative care, Oral, Eye and ENT care, mental health and first level care for emergen trauma as well as health promotion and wellness activities like Yoga apart from services a being provided f or Maternal and Child Health including immunization and communicable diseases.