Lok Sabha Question No. 1132 (UNSTARRED), answered on 2019-06-28
Subject: Healthcare Schemes
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kinjarapu Ram Mohan Naidu, Ravindra Kushawaha, Nama Nageswara Rao, Ravi Kishan Shukla

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

LOK SABHA UNSTARRED QUESTION NO.1132 TO BE ANSWERED ON 28 TH JUNE, 2019

## HEALTHCARE SCHEMES

## 1132. SHRI RAM MOHAN NAIDU KINJARAPU:

SHRI RAVINDRA KUSHAWAHA:

SHRI NAMA NAGESWARA RAO:

SHRI RAVINDRA SHYAM NARAYAN SHUKLA ALIAS RAVI KISHAN:

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

the

- (a) the details of the schemes launched by the Government to provide medical as sistance to patients of all income groups;
- (b)  the  details  of  the  schemes  proposed  in  this  regard  through  which  free  treatment threatening diseases could be provided;
- (c) the number of patients who have been given free treatment under Ayushman Bharat Scheme, State/UT - wise including Uttar Pradesh;
- (d)  whether  the  Ayushman  Bharat  Scheme  is  availed  by  people  whose  income  is  less  th Rupees 10,000, if so, the details thereof; and
- (e) whether there is any scheme covering the remaining p eople who come under Economically Weaker Section; if so, the details thereof and if not the reasons therefor?

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

- (a)& (b) : Public Health is a State subject; hence, the responsibility of providing me assistance to patients of all income group is of respective State/ UT Governments. How National  Health  Mission  (NHM) -a  flagship  programme  of  the  Ministry  with  its  two SubMissions,  National  Rural  Health  Mission  (NRHM)  and  National  Urban  Health  Mission (NUHM), supports States /UTs to strengthen their health care systems so as to provide uni access to equitable, affordable and quality health care services.

The sc hemes launched under NHM are available free of cost to all income groups visiti in Public Health Facilities at sub district and district level (List is at Annexure -I).

Support under NHM to States/UTs includes provision of a host of free serv ices such as maternal health, child health, adolescent health, family planning, universal immuni programme, and for major diseases such as Tuberculosis, HIV/ AIDS, vector borne diseas like Malaria, Dengue and Kala Azar, Leprosy etc.

Other  major  initiatives  include  Janani  Shishu  Suraksha  Karyakram  (JSSK)  (under which  free  drugs,  free  diagnostics,  free  blood  and  diet,  free  transport  from  ho institution,  between  facilities  in  case  of  a  referral  and  drop  back  home  is  pro vided), Rashtriya  Bal  Swasthya  Karyakram  (RBSK)  (which  provides  newborn  and  child  health screening  and  early  interventions  services  free  of  cost  for  birth  defects,  di deficiencies and developmental delays to improve the quality of survival), impleme ntation of  Free  Drugs  and  Free  Diagnostics  Service  Initiatives  and  PM  National  Dialys Programme.

Mobile  Medical  Units  (MMUs)  &  Telemedicine  are  also  being  implemented  with NHM support to improve healthcare access particularly in rural areas.

- The  Ayushman  Bharat  Programme  launched  last  year  provides  for  holistic  and  integrat health care and is the principal vehicle for achieving Universal Health Coverage (UHC).
- It's  Health  and  Wellness  Centre  component  (AB - HWC)  provides  essential  primary  and community  health  services  such  as  maternal,  neonatal  and  child  health  services  incl immunization  and  nutrition,  thus  fostering  human  capital  development  during  children's critical  early  years.  These  centres  also  provide  services  to  prevent  and  manage common NCDs and major communicable diseases.
- The other component, AB - Pradhan Mantri Jan Arogya Yojana (AB - PMJAY) provides free and cashless care to about 500 million poor and deprived people for secondary and te hospitalization care.
- To  enhance  th e  facilities  for  tertiary  care  of  cancer,  Strengthening  of  Tertiary  Ca Cancer Scheme is being implemented to support setting up of State Cancer Institutes and Tertiary Care Cancer Centres (TCCC) in different parts of the country. Oncology i s various  aspects  has  focus  in  case  of  new  AIIMS  and  many  upgraded  institutions  und Pradhan Mantri Swasthya Suraksha Yojna (PMSSY).
- Financial assistance to patients living below poverty line for life threatening disea the schemes such as Rashtr iya Arogya Nidhi (RAN), Health Minister's Cancer Patient Fund (HMCPF) and Health Minister's Discretionary Grant (HMDG) is also provided.
- Affordable Medicines and Reliable Implants for Treatment (AMRIT) Deendayal outlets hav been  opened  with  an  objective  t o  make  available  drugs  and  implants  for  Cardiovascular Diseases (CVDs), Cancer and Diabetes at discounted prices to the patients.

(c ): Services at Ayushman Bharat -Health and Wellness Centres (AB - HWCs) are free and universal to all individuals residi ng in the service area.

Under  Ayushman  Bharat -Pradhan  Mantri  Jan  Arogya  Yojana  (AB - PMJAY),  the  State/  UT wise number of hospital admissions is at Annexure -II.

(d) &(e) : AB - PMJAY provides health coverage of up to Rs 5.00 lakh per family per year t 10.74  crore  poor,  deprived  families  as  per  Socio  Economic  Caste  Census  (SECC)  databas Details of the entitlement criteria are at Annexure -III.

## Annexure - I

The following programmes/ schemes are run by government under National Health Mission:

## Reproductive, Maternal, Neonatal, Child and Adolescent health

- Janani Shishu Suraksha Karyakaram (JSSK)
- Rashtriya Kishor Swasthya Karyakram(RKSK)
- Rashtriya Bal Swasthya Karyakram (RB SK)
- Universal Immunisation Programme
- Mission Indradhanush (MI)
- Janani Suraksha Yojana (JSY)
- Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
- Navjaat Shishu Suraksha Karyakram (NSSK)
- National Programme for Family planning
- LaQshya' programme (Labour Room Quality Improvement Initiative)

## National Nutritional Programmes

- National Iodine Deficiency Disorders Control Programme
- MAA (Mothers' Absolute Affection) Programme for Infant and Young Child Feeding
- National Prog ramme for Prevention and Control of Fluorosis (NPPCF)
- National Iron Plus Initiative for Anaemia Control

## Communicable diseases

- Integrated Disease Surveillance Programme (IDSP )
- Revised National Tuberculosis Control Programme (RNTCP)
- National Leprosy Eradication Programme (NLEP)
- National Vector Borne D isease Control Programme (NVBDCP)
- National AIDS Control Programme (NACP)
- Pulse Polio Programme
- National Viral Hepatitis Control Program (NVHCP)
- National Rabies Control Programme
- National Programme on Containment of Anti - Microbial Resistance (AMR)

## Non - communicable diseases

- National Tobacco Control Programme(NTCP)
- National  Programme  for  Prevention  and  Control  of  Cancer,  Diabetes,  Cardiovascula Diseases & Stroke (NPCDCS)
- National Programme for Control Treatment of Occupational Diseases
- National Programme for Prevention and Control of Deafness (NPPCD)
- National Mental Health Pro gramme
- National Programme for Control of Blindness & Visual Impairment (NPCB&VI)
- Pradhan Mantri National Dialysis Programme (PMNDP)
- National Programme for the Health Care for the Elderly (NPHCE)
- National Programme for Prevention & Management of Burn Injuries (NPPMBI)
- National Oral Health programme

Annexure-II

| Status as on 24.06.2019   | Status as on 24.06.2019     | Status as on 24.06.2019   |
|---------------------------|-----------------------------|---------------------------|
| Sl. No.                   | State                       | No of Hospital Admissions |
| 1                         | Andaman And Nicobar Islands | 22                        |
| 2                         | Andhra Pradesh              | 135,346                   |
| 3                         | Arunachal Pradesh           | 652                       |
| 4                         | Assam                       | 47,631                    |
| 5                         | Bihar                       | 48,711                    |
| 6                         | Chandigarh                  | 835                       |
| 7                         | Chhattisgarh                | 564,568                   |
| 8                         | Dadra And Nagar Haveli      | 12,081                    |
| 9                         | Daman and Diu               | 4,465                     |
| 10                        | Goa                         | 1,415                     |
| 11                        | Gujarat                     | 487,636                   |
| 12                        | Haryana                     | 27,811                    |
| 13                        | Himachal Pradesh            | 19,145                    |
| 14                        | Jammu And Kashmir           | 19,303                    |
| 15                        | Jharkhand                   | 184,760                   |
| 16                        | Karnataka                   | 197,799                   |
| 17                        | Kerala                      | 531,740                   |
| 18                        | Lakshadweep                 | -                         |
| 19                        | Madhya Pradesh              | 96,029                    |
| 20                        | Maharashtra                 | 139,906                   |
| 21                        | Manipur                     | 3,289                     |
| 22                        | Meghalaya                   | 15,404                    |
| 23                        | Mizoram                     | 13,422                    |
| 24                        | Nagaland                    | 945                       |
| 25                        | Sikkim                      | 122                       |
| 26                        | Tamil Nadu                  | 239,438                   |
| 27                        | Tripura                     | 17,505                    |
| 28                        | Uttar Pradesh               | 119,204                   |
| 29                        | Uttarakhand                 | 49,815                    |
| 30                        | West Bengal                 | 17,636                    |
| Grand Total               |                             | 2,996,635                 |

## Annexure-III

- Ayushman Bharat -PMJAY is an entitlement-based scheme with entitlement  to  be  decided  on  the  basis  of  deprivation  and  occupational criteria in the SECC database.
- The different categories in rural area include:

Automatically included households (based on fulfilling any of the 5 parameters of inclusion):

- a. Households without shelter.
- b. Destitute, living on alms.
- c. Manual scavenger families.
- d. Primitive tribal groups.
- e. legally released bonded labour Total of (a) to (e) = 15.95 lakh

| Standard Deprivation Parameter                                                                                                    | Households   |
|-----------------------------------------------------------------------------------------------------------------------------------|--------------|
| Only one room with kucha walls and kucha roof (D1)                                                                                | 2.38 crore   |
| No adult member between age 16 to 59 (D2)                                                                                         | 65.33 lakh   |
| Female headed households with no adult male member between age 16 to 59 (D3)                                                      | 69.43 lakh   |
| Disabled member and no able bodied adult member (D4)                                                                              | 7.20 lakh    |
| SC/ST households (D5)                                                                                                             | 3.87 crore   |
| No literate adult above 25 years (D6)                                                                                             | 4.22 crore   |
| Landless households deriving major part of their income from manual casual labour (D7)                                            | 5.40 crore   |
| Total deprived Households targeted for PM-JAY who belong to one of the six deprivation criteria amongst D1, D2, D3, D4, D5 and D7 | 8.03 crore   |

For  urban  areas ,  11  defined  occupational  categories  are  entitled  under  the scheme. Targeted Urban Household categories proposed to be included in PMJAY : 2.33 crore

| Sr. No.                         | Worker Category                                                                                                | Households   |
|---------------------------------|----------------------------------------------------------------------------------------------------------------|--------------|
| 1                               | Rag picker                                                                                                     | 23,825       |
| 2                               | Beggar                                                                                                         | 47,371       |
| 3                               | Domestic worker                                                                                                | 6,85,352     |
| 4                               | Street vendor/ Cobbler/hawker / Other service provider working on streets                                      | 8,64,659     |
| 5                               | Construction worker/ Plumber/ Mason/ Labor/ Painter/ Welder/ Security guard/ Coolie and other head-load worker | 1,02,35,435  |
| 6                               | Sweeper/ Sanitation worker / Mali                                                                              | 6,06,446     |
| 7                               | Home-based worker/ Artisan/ Handicrafts worker / Tailor                                                        | 27,58,194    |
| 8                               | Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller            | 27,73,310    |
| 9                               | Shop worker/ Assistant/ Peon in small establishment/ Helper/ Delivery assistant / Attendant/ Waiter            | 36,93,042    |
| 10                              | Electrician/ Mechanic/ Assembler/ Repair worker                                                                | 11,99,262    |
| 11                              | Washer-man/ Chowkidar                                                                                          | 4,60,433     |
| Total Targeted Urban Households | Total Targeted Urban Households                                                                                | 2.33 crore   |

Total families covered under PMJAY

| Sr. No.   | Categories                                                                                   |   Households (number in crore) |
|-----------|----------------------------------------------------------------------------------------------|--------------------------------|
| 1         | i) Rural (based on deprivation criteria)                                                     |                           8.03 |
|           | ii) Rural (automatically included)                                                           |                           0.16 |
| 2         | Urban                                                                                        |                           2.33 |
| 3         | Such number of families that are currently enrolled under RSBY but not in targeted SECC data |                           0.22 |
| Total     | Total                                                                                        |                          10.74 |