Lok Sabha Question No. 1841 (UNSTARRED), answered on 2021-07-30
Subject: Strengthening of Rural Healthcare Infrastructure during COVID-19 Pandemic
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dayanidhi Maran

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

## LOK SABHA UNSTARRED QUESTION NO. 1841 TO BE ANSWERED ON THE 30 th JULY, 2021

## 'STRENGTHENING OF RURAL HEALTHCARE INFRASTRUCTURE DURING COVID -19 PANDEMIC'

## 1841. SHRI DAYANIDHI MARAN:

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

- a) the  details  of  necessary  steps  taken  by  the  Government  to  strengthen  rural  heal infrastructure during the COVID - 19 pandemic;
- b) whether  his  Ministry  has  he ld  consultations  with  other  Ministries  regarding  spread  of COVID - 19 in rural areas and to strengthen infrastructure to handle increased patie on rural healthcare facilities and if so, the details thereof; and
- c) the  itemized  list  of  infrastructural  upg rad tion  work  carried  out  during  COVID - 19 pandemic,  district - wise  during  the  period  between  March  2020  and  July  2021  in  the country?

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

(a) to (c)

'Public  Health  and  Hospitals'  being  a  State  subject,  the  primary  responsibility  of strengthening  public  healthcare  system,  including  for  the  efforts  to  strengthen  rural healthcare infrastructure, lies with the respective State Governments.  However, under

National  Health  Mission  (NHM),  technical  and  financial  support  is  provided  to  the States/UTs to strengthen the public healthcare delivery at public healthcare facilities. NHM support is provided to States/ UTs for setting up of new facilities as per norms and upgradation of existing facilities for bridging the infrastructure gaps, including in rural areas, based on the requirement posed by them.

As part of Ayushman Bharat, the Government is supporting the States for transformation of Sub  Health  Centres  and  Primary  Health  Centres into  1.5  lakh  Health  and  Wellness Centres across the country by December, 2022 for provision of Comprehensive Primary Health  Care  (CPHC)  that  includes  preventive  healthcare  and  health  promotion  at  the community  level  with  continuum  of  care  approach.  Under this  programme,  CPHC services of an expanded range of services, that are universal and free to users, with a focus on wellness, are provided, closer to the community.

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

Support has also been provided to States/UTs under the 'India COVID-19 Emergency Response & Health System Preparedness Package' for the containment and management  of pandemic, including for augmentation of infrastructure,  oxygen supported beds, isolation beds, ICUs & Human Resources, supply of drugs, etc. During the  financial  year  2020-21,  Rs.8147.28  Crs.  has  been  released  to  States  under  this package. In addition, Rs.110.60 Crs has been made available for insurance of Health Care workers. Thus, a total amount of Rs.8257.88 Crs has been provisioned for the States/ UTs.    MOHFW has also provided in-kind support to the States/UTs, by procuring and distributing oxygen cylinders, Trunat COVID Test Cartridges, X-pert COVID cartridges, N 95 masks, PPE kits, Remdesivir and ventilators, including for rural healthcare facilities. Ministry  of  Health  and  Family  Welfare holds  consultations  with  all  the  concerned Ministries  on  regular  basis,  including for effective  management  in  view  of  spread  of COVID-19 in rural areas.  An SOP on COVID-19 Containment and  Management in Peri- urban, Rural & Tribal areas during May 2021 to ensure that  community-based  services  and  primary  level  health  infrastructure  in rural,  periurban and tribal areas are equipped and oriented to manage COVID-19 cases has been shared with all the States/UTs. This document also outlines the containment and clinical management  practices  to  be  put  in  place  in  these areas  with  respect  to  COVID-19 management. The Union Cabinet  has  also  approved 'India  Covid-19  Emergency Response  and Health Systems Preparedness Package - Phase-II' (ECRP-Phase-II) on 8.07.2021 for an amount of Rs.23,123 crores. The scheme is a Centrally Sponsored Scheme (CSS) with some  Central  Sector  (CS)  components. The  Scheme  is  aimed  to  prevent,  detect and respond  to  the  continuing  threat  posed  by  COVID-19  and  strengthen  national  health systems for preparedness in India. Under  CSS  components  of  ECRP-II,  support  is  being  provided  to  the  States/UTs  for provision  for  establishing  District  Paediatric  Units  (42  or  32  bedded  units  including Oxygen  Supported  beds  and  ICU  beds)  in  all  the  Districts  of  the  Country.  Besides, support is also provided to increase the availability of ICU beds in Government health facilities  and  to  create  pre -fabricated  structures  for  augmenting  beds  at      Sub  Health Centres, Primary Health Centres & Community Health Centres in rural, peri-urban and tribal  areas .  Maintaining,  buffer  stock  for  essential  medicines  required  for  effective COVID management, in addition to provision for required drugs and diagnostics, is also being supported.   Support is also available for establishing field hospitals, (100 bedded or 50 bedded units) wherever required. In  order to  ensure  implementation  of  critical  activities  at  the  State/District  levels  to prepare  the  public  healthcare  system  in  response  to  the  evolving  pandemic, 15%  of Central Share of Resource Envelope of the State/UT, has been released in-advance to the States/UTs . For making oxygen available in Health Care Facilities, Government has sanctioned 1573 Pressure Swing Adsorption Oxygen generation plants, including in rural areas.   Out of these, as on 20th July, 2021, 316 plants have been commissioned.

1,14,000 Oxygen Concentrators are also being supplied to the States/UTs for deployment in rural, peri urban & tribal areas. Under the Loan Guarantee Scheme for COVID Affected Sectors, it is aimed at up scaling medical infrastructure targeting underserved areas. This Guarantee cover for expansion and  new  projects  related  to  health/medical  infrastructure  in  cities  other  than  8 metropolitan cities and the Guarantee coverage is 50% for expansion & 75% for new projects. For Aspirational Districts, the guarantee cover is of 75% for both new projects and expansion. The maximum loan under the scheme is Rs. 100 crore. The duration of the Guarantee is up to 3 years, with the interest rate capped at 7.95%. and the Guarantee is by National Credit Guarantee Trustee Company Limited.