Lok Sabha Question No. 4903 (UNSTARRED), answered on 2022-04-01
Subject: Health Facilities in Backward Districts
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Mohammad Jawed, Adoor Prakash, Behanan Benny

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

## LOK SABHA UNSTARRED QUESTION NO. 4903 TO BE ANSWERED ON 1 ST  APRIL, 2022

## HEALTH FACILITIES IN BACKWARD DISTRICTS

## 4903. DR. MOHAMMAD JAWED: ADV. ADOOR PRAKASH: SHRI BENNY BEHANAN:

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

- (a) the number of officially recognized backward districts in the country;
- (b) whether  each  officially  recognized  backward  district  has  a  functional  clinic  and/or hospital and if so, the details thereof and if not the reasons therefor;
- (c) whether  the  Government  conducts  regular  performance  evaluations  of  healthcare facilities in backward areas and if so, year-wise details of such evaluations conducted since 2014 to till date and if not, the reasons therefor;
- (d) whether  the  Government  has  taken  steps  to  address  backward  districts  that  have defunct clinics and hospitals with no doctors; and
- (e) if so, the details thereof and if not, the reasons therefor?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

- (a): Govt. of India has identified 112 Aspirational Districts based on their performance in 49  Key  Performance  Indicators  (KPIs)  across  five  themes  namely  Health  and  Nutrition, Education, Agriculture and Water Resources, Financial Inclusion and Skill Development and Basic Infrastructure.
- (b): 'Public Health and Hospital' is a State subject, hence, the primary responsibility of ensuring availability of healthcare facilities lies with the respective State/UT Governments.

As per RHS 2019-20, number of functional public health facilities such as DH, CHC, PHC, SCs in each State/ UTs is annexed at Annexure-I.

(c): The Government reviews functionality of the health centers as well as implementation of  various  health  programs  in  each  State  including  the  Aspirational  District  areas  through Central and State level monitoring mechanisms.  From Central level, Ministry of Health and Family  Welfare  undertakes  annual  Common  Review  Mission  (CRM)  and  Integrated Monitoring  Visits  (IMV)  to  review  the  progress  of  National  Health  Mission  (NHM)

implementation. In addition to this Health Management Information System (HMIS) data is updated  by  States  which  is  available  disaggregated  up-to-the  facility  level.  Similarly, aspirational district evaluation is also done by NITI Aayog based on the set indicators.

The reports of the CRM and performance evaluation of healthcare facilities, year-wise, from 2007 onwards can be accessed from the link https://nhsrcindia.org/php-crm-reports

Similarly, Aspirational district annual report can be accessed from the link https://www.niti.gov.in/annual-reports

(d) & (e):

The  proposals  from  State  /UT  Governments  are  received  in  the  form  of  Programme Implementation  Plans  (PIPS)  under  National  Health  Mission  (NHM)  and  Government  of India provides approval for the proposals in the form of Record of Proceedings (RoP) as per available resources.

Following are the main schemes which focus upon the bridging the gap in providing health services to the public at large:

-  PM  Ayushman  Bharat  Health  Infrastructure  Mission  (PM-ABHIM) with  an outlay  of  Rs.  64,180  Crores  aims  to  fill  critical  gaps  in  public  health  infrastructure.  It  is  a Centrally Sponsored Scheme with some Central Sector components. The Centrally Sponsored Scheme (CSS) Components includes support for infrastructure development for Sub-Health Centres, Urban Health and Wellness Centres, Block Public Health Units, Integrated District Public Health Laboratories and Critical Care Hospital Blocks.
-  Ayushman Bharat-Health & Wellness Centres (AB-HWCs): 1,50,000 Sub- Health Centres (SHCs), Primary Health Centres (PHCs) Rural and Urban are being transformed into Ayushman Bharat- Health and Wellness Centres (AB-HWCs) to deliver twelve packages of Comprehensive Primary Health Care (CPHC) that includes preventive, promotive, curative, palliative  and  rehabilitative  services  which  are  universal.  Another  essential  component  of AB-HWCs is the roll out of tele-consultation services through 'eSanjeevani'.
-  Human Resources :  Health  care  service  delivery  requires  intensive  human  resource inputs. NHM has attempted to fill the gaps in human resources by providing additional health human resources to the States on contractual basis which includes the following:
-  14,474 GDMOs,
-  3,502 Specialists,
-  74,783 Staff Nurses,
-  84,313 ANMs,
-  89,140 CHOs
-  48,585 Paramedics,
-  439 Public Health Managers
-  17,262 Programme Management staffs etc and
-  10.78 Lakhs ASHAs (10.08 lakhs in Rural + 0.77 lakhs in Urban)

Apart from providing support for health human resource, NHM has also focused on multi skilling  of  human  resources.NHM also focused on multi-skilling of doctors at strategically located  facilities  identified  by  the  States  e.g.  MBBS  doctors  are  trained  in  Emergency Obstetric Care (EmOC), Life Saving Anaesthesia Skills (LSAS) and Laparoscopic Surgery.

| STATE/UT-WISE   | States/Union Territory             | OF HEALTH CENTRES IN INDIA (RURAL + URBAN)   | OF HEALTH CENTRES IN INDIA (RURAL + URBAN)   | OF HEALTH CENTRES IN INDIA (RURAL + URBAN)   | OF HEALTH CENTRES IN INDIA (RURAL + URBAN)   | OF HEALTH CENTRES IN INDIA (RURAL + URBAN)   |
|-----------------|------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|
| Sl. No.         | States/Union Territory             | Number of functional Sub Centres             | PHCs                                         | CHCs                                         | Sub Divisional Hospital                      | District Hospital                            |
| 1               | Andhra Pradesh                     | 7458                                         | 1385                                         | 198                                          | 28                                           | 13                                           |
| 2               | Arunachal Pradesh                  | 363                                          | 124                                          | 60                                           | 0                                            | 17                                           |
| 3               | Assam                              | 4680                                         | 1002                                         | 192                                          | 14                                           | 24                                           |
| 4               | Bihar                              | 10280                                        | 2027                                         | 64                                           | 35                                           | 36                                           |
| 5               | Chhattisgarh                       | 5569                                         | 837                                          | 174                                          | 20                                           | 26                                           |
| 6               | Goa                                | 218                                          | 59                                           | 6                                            | 2                                            | 2                                            |
| 7               | Gujarat                            | 9162                                         | 1795                                         | 362                                          | 37                                           | 22                                           |
| 8               | Haryana                            | 2617                                         | 485                                          | 131                                          | 21                                           | 22                                           |
| 9               | Himachal Pradesh                   | 2104                                         | 588                                          | 92                                           | 83                                           | 9                                            |
| 10              | Jharkhand                          | 3848                                         | 351                                          | 177                                          | 13                                           | 23                                           |
| 11              | Karnataka                          | 9435                                         | 2534                                         | 208                                          | 150                                          | 26                                           |
| 12              | Kerala                             | 5410                                         | 932                                          | 227                                          | 86                                           | 48                                           |
| 13              | Madhya Pradesh                     | 10226                                        | 1476                                         | 330                                          | 84                                           | 51                                           |
| 14              | Maharashtra                        | 10649                                        | 2675                                         | 418                                          | 100                                          | 49                                           |
| 15              | Manipur                            | 418                                          | 93                                           | 17                                           | 1                                            | 7                                            |
| 16              | Meghalaya                          | 443                                          | 143                                          | 28                                           | 0                                            | 11                                           |
| 17              | Mizoram                            | 370                                          | 65                                           | 9                                            | 2                                            | 9                                            |
| 18              | Nagaland                           | 415                                          | 137                                          | 21                                           | 0                                            | 11                                           |
| 19              | Odisha                             | 6688                                         | 1377                                         | 384                                          | 33                                           | 32                                           |
| 20              | Punjab                             | 3047                                         | 527                                          | 155                                          | 41                                           | 22                                           |
| 21              | Rajasthan                          | 13530                                        | 2477                                         | 614                                          | 20                                           | 27                                           |
| 22              | Sikkim                             | 153                                          | 25                                           | 2                                            | 1                                            | 4                                            |
| 23              | Tamil Nadu                         | 8713                                         | 1884                                         | 400                                          | 278                                          | 32                                           |
| 24              | Telangana                          | 4841                                         | 885                                          | 95                                           | 37                                           | 6                                            |
| 25              | Tripura                            | 1001                                         | 112                                          | 22                                           | 12                                           | 7                                            |
| 26              | Uttarakhand                        | 1847                                         | 295                                          | 68                                           | 19                                           | 13                                           |
| 27              | Uttar Pradesh                      | 20778                                        | 3473                                         | 723                                          | 0                                            | 168                                          |
| 28              | West Bengal                        | 10357                                        | 1369                                         | 348                                          | 60                                           | 18                                           |
| 29              | A&NIslands                         | 124                                          | 27                                           | 4                                            | 0                                            | 3                                            |
| 30              | Chandigarh                         | 0                                            | 48                                           | 2                                            | 1                                            | 2                                            |
| 31              | Dadra &Nagar Haveli and Daman &Diu | 97                                           | 13                                           | 4                                            | 1                                            | 3                                            |
| 32              | Delhi                              | 258                                          | 546                                          |                                              | 9                                            |                                              |
| 33              |                                    |                                              |                                              | 23                                           |                                              | 38                                           |
|                 | Jammu &Kashmir                     | 2492                                         | 972                                          | 77                                           | 0                                            | 21                                           |
| 34              | Ladakh                             | 238                                          | 32                                           | 7                                            | 0                                            | 2                                            |
| 35              | Lakshadweep                        | 11                                           | 4                                            | 3                                            | 2                                            | 1                                            |
| 36              | Puducherry                         | 81                                           | 39                                           | 4                                            | 3                                            | 5                                            |