Lok Sabha Question No. 4851 (UNSTARRED), answered on 2022-04-01
Subject: Tribal Health Indicators
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Suresh Kumar Kashyap

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

## LOK SABHA UNSTARRED QUESTION NO. 4851 TO BE ANSWERED ON 01.04.2022

## TRIBAL HEALTH INDICATORS

## 4851: SHRI SURESH KUMAR KASHYAP:

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

(a) the details of Tribal Health Indicators featured in National Family Health Surveys, State/UTwise including Himachal Pradesh;

- (b)  whether  there  have  been  any  significant  improvement  observed  in  the  Tribal  Health Indicators;
- (c)  if  so,  the  details  thereof  specific  to  individual  indicators  of  healthcare  wherein  the Government has observed significant improvement;
- (d)  the  details  of  any  targeted  intervention  initiated  and  implemented  by  the  Government  for improving Tribal Health Indicators since 2014, State/UT-wise including Himachal Pradesh; and
- (e) the number of Mobile Medical Units in Himachal Pradesh, district-wise and the amount of funds sanctioned for the same?

## ANSWER

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

(a)  to  (c): The  Ministry  of  Health  &  Family  Welfare  (MoH&FW)  conducts  one  integrated survey namely National Family Health Survey (NFHS) at an interval of about 3 years to provide high quality data on population and health indicators as well as data on emerging issues in health and  family  welfare  and  to  provide  essential  information  that  may  assist  policymakers  and programme  managers  in  setting  benchmarks.  Five  rounds  of  the  NFHS  have  been  completed during the period 1992-93, 1998-99, 2005-06, 2015-16 and 2019-21.

The  NFHS  survey  provides  State/UT  wise  and  also  by  background  characteristics  including Schedule Tribes, information on Fertility, Family Planning, Infant and Child Mortality, Maternal Health, Child Health, Nutrition and Anemia, etc.

It  is  evident  from  the  recent  round  of  NFHS that  there  are  significant  improvements in the key health,  family  welfare  and  associated  indicators  for  the  tribal  population  across  State/UTs including Himachal  Pradesh, as compared  to the previous rounds. The  States/UTs wise performance of the key Health Indicators in respect of Scheduled Tribes are given at Annexure-1 .

(d)  and  (e): Public  Health  and  Hospitals  being  a  State  Subject,  all  the  administrative  and personnel  matters,  including  support  for  outsourcing/engagement  of  doctors  and  other  health human resources lies with  the  respective  State  Governments/UT  Administration.  Further,  under National Health Mission (NHM), Government of India provides financial and technical support to States/UTs to strengthen their healthcare systems. Details of some of the specific initiatives taken by the Government of India for better healthcare in tribal areas includes:

- i. The  tribal  majority  districts  whose  Composite  Health  Index  is  below  the  State average,  have  been  identified  as  High  Priority  Districts  (HPDs)  for  receiving  more resources/funds.
- ii. Hard area allowances and special packages are provided to attract health professionals, to remote and difficult areas.
- iii. The  population  norms  for  setting  up  Health  Facilities  in  tribal  areas  have  been relaxed.
- iv. States/UTs have been given flexibility to deploy Mobile Medical Units (MMUs) to provide a range of health care services for the population particularly living in remote areas.
- v. National Free Drugs and Diagnostic Service Initiative has been rolled out to minimize the Out of Pocket Expenditure incurred on health services.
- vi. Support has been provided for implementation of National Ambulances Services for free transportation of sick patients to the health facilities.

Under NHM, in the Final Year 2021-22, an amount of Rs. 189.70 lakhs was sanctioned by the MoH&FW to the State of Himachal Pradesh for 12 Mobile Medical Units.

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## Annexure-I

## Performance of Key Health Indicators for Scheduled Tribe (ST) by States/UTs in NFHS-5(2019-21) and NFHS-4 (2015-16)

| States/UTs        | Current use of Any contraception Methods by currently married women aged 15-49   | Current use of Any contraception Methods by currently married women aged 15-49   | Total Unmet need for family planning   | Total Unmet need for family planning   | Mothers who had four or more ANC visits   | Mothers who had four or more ANC visits   | Percentage of births delivered in a health facility   | Percentage of births delivered in a health facility   | All women age 15-49 years who are anaemic 2 (<12.0 g/dl)   | All women age 15-49 years who are anaemic 2 (<12.0 g/dl)   |
|-------------------|----------------------------------------------------------------------------------|----------------------------------------------------------------------------------|----------------------------------------|----------------------------------------|-------------------------------------------|-------------------------------------------|-------------------------------------------------------|-------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|
| States/UTs        | NFHS-5                                                                           | NFHS-4                                                                           | NFHS- 5                                | NFHS- 4                                | NFHS- 5                                   | NFHS- 4                                   | NFHS- 5                                               | NFHS- 4                                               | NFHS- 5                                                    | NFHS- 4                                                    |
| Andhra Pradesh    | 56.7                                                                             | 56.8                                                                             | 6.5                                    | 7.6                                    | 59.8                                      | 58.8                                      | 89.3                                                  | 77.8                                                  | 62.6                                                       | 71.8                                                       |
| Arunachal Pradesh | 57.2                                                                             | 27.5                                                                             | 13.4                                   | 22.4                                   | 35.9                                      | 24.1                                      | 80.3                                                  | 51.3                                                  | 36.3                                                       | 35.8                                                       |
| Assam             | 63.2                                                                             | 53.8                                                                             | 10.2                                   | 13.8                                   | 59.9                                      | 46.5                                      | 89.8                                                  | 78.2                                                  | 69.2                                                       | 48.5                                                       |
| Bihar             | 52.1                                                                             | 12                                                                               | 15.9                                   | 23.5                                   | 17.5                                      | 11.2                                      | 78.7                                                  | 54.7                                                  | 64.7                                                       | 64.4                                                       |
| Chhattisgarh      | 58.7                                                                             | 47.1                                                                             | 10.4                                   | 12.6                                   | 55.9                                      | 51.3                                      | 77.4                                                  | 62.2                                                  | 70.9                                                       | 55.9                                                       |
| Goa               | 58.7                                                                             | 28.8                                                                             | 7.8                                    | 13.8                                   | (87.8)                                    | (83.8)                                    | (100)                                                 | (94.8)                                                | 42.5                                                       | 33.6                                                       |
| Gujarat           | 71.6                                                                             | 48.1                                                                             | 7.3                                    | 15.3                                   | 77.6                                      | 55.8                                      | 60.2                                                  | 76.6                                                  | 78.3                                                       | 59                                                         |
| Haryana           | 66                                                                               | 26.6                                                                             | 7.5                                    | 32.9                                   | (36.3)                                    | (36.7)                                    | 95.4                                                  | 62                                                    | 64.2                                                       | 64.8                                                       |
| Himachal Pradesh  | 68.2                                                                             | 58.1                                                                             | 10.9                                   | 14.7                                   | 71.5                                      | 56.1                                      | 82.1                                                  | 63.7                                                  | 53.8                                                       | 58.9                                                       |
| Jammu and Kashmir | 55.8                                                                             | NA                                                                               | 8.5                                    | NA                                     | 66.8                                      | NA                                        | 77.5                                                  | NA                                                    | 68.6                                                       | NA                                                         |
| Jharkhand         | 55.9                                                                             | 27.3                                                                             | 12.6                                   | 22.1                                   | 32.7                                      | 22.3                                      | 66.4                                                  | 49.2                                                  | 72                                                         | 75                                                         |
| Karnataka         | 65                                                                               | 54.4                                                                             | 7.4                                    | 7.6                                    | 70.6                                      | 71.1                                      | 95.7                                                  | 91.2                                                  | 46.2                                                       | 46.8                                                       |
| Kerala            | 59.7                                                                             | 55.6                                                                             | 7.5                                    | 10.8                                   | 86                                        | 83.3                                      | 100                                                   | 99.6                                                  | 52.9                                                       | 48                                                         |
| Madhya Pradesh    | 72.1                                                                             | 49.3                                                                             | 6.5                                    | 10.7                                   | 55.5                                      | 24.6                                      | 82                                                    | 60.3                                                  | 64.2                                                       | 64                                                         |
| Maharashtra       | 63.7                                                                             | 62.9                                                                             | 9.9                                    | 9.3                                    | 65.5                                      | 60.9                                      | 84.8                                                  | 74.3                                                  | 59.7                                                       | 53.9                                                       |
| Manipur           | 61.3                                                                             | 18                                                                               | 10.5                                   | 29                                     | 59.5                                      | 44.3                                      | 59.2                                                  | 27.2                                                  | 26.8                                                       | 20                                                         |
| Meghalaya         | 28                                                                               | 22                                                                               | 27.3                                   | 21.8                                   | 52.5                                      | 50.5                                      | 57.6                                                  | 52.5                                                  | 53.3                                                       | 50.8                                                       |
| Mizoram           | 30.9                                                                             | 34.9                                                                             | 19.3                                   | 19.8                                   | 59.5                                      | 61.8                                      | 87.4                                                  | 80.3                                                  | 34.3                                                       | 24.4                                                       |
| Nagaland          | 57.3                                                                             | 26                                                                               | 9.2                                    | 21.9                                   | 17.8                                      | 14.8                                      | 43.5                                                  | NA                                                    | 27.7                                                       | 23                                                         |
| NCT Of Delhi      | 75.7                                                                             | NA                                                                               | 7.4                                    | NA                                     | (83.6)                                    | NA                                        | (92.6)                                                | NA                                                    | 51.5                                                       | NA                                                         |
| Odisha            | 71.4                                                                             | 52.6                                                                             | 6.2                                    | 13.2                                   | 69.8                                      | 59.9                                      | 82.8                                                  | 72.5                                                  | 71.7                                                       | 63.3                                                       |
| Punjab            | 61.1                                                                             | NA                                                                               | 19.4                                   | NA                                     | NA                                        | NA                                        | (86.2)                                                | NA                                                    | 54.4                                                       | (69.2)                                                     |
| Rajasthan         | 71                                                                               | 55.7                                                                             | 7.1                                    | 12                                     | 55.9                                      | 30.9                                      | 94                                                    | 78.3                                                  | 61.6                                                       | 63                                                         |
| Sikkim            | 68.5                                                                             | 49.9                                                                             | 15.5                                   | 22.4                                   | 55.7                                      | 77.4                                      | 97.1                                                  | 94.5                                                  | 42.6                                                       | 34.6                                                       |
| Tamil Nadu        | 67.3                                                                             | 50                                                                               | 4.7                                    | 10.3                                   | 85.3                                      | 77                                        | 100                                                   | 91.8                                                  | 59                                                         | 54.9                                                       |
| Telangana         | 65.2                                                                             | 56.6                                                                             | 7.1                                    | 3.5                                    | 67.3                                      | 68.6                                      | 94                                                    | 79.7                                                  | 64                                                         | 66.2                                                       |
| Tripura           | 71                                                                               | 62.6                                                                             | 9.2                                    | 10.5                                   | 42.7                                      | 53.3                                      | 85.9                                                  | 68.6                                                  | 66.8                                                       | 55.3                                                       |
| Uttar Pradesh     | 57.1                                                                             | 32.4                                                                             | 14.7                                   | 25.5                                   | 28.7                                      | 14.6                                      | 74.7                                                  | 50.2                                                  | 51                                                         | 57.6                                                       |
| Uttarakhand       | 77.9                                                                             | 43.7                                                                             | 6.6                                    | 17.7                                   | 67.1                                      | 25.1                                      | 84.8                                                  | 68.9                                                  | 56                                                         | 55.6                                                       |
| West Bengal       | 65.4                                                                             | 67.8                                                                             | 9                                      | 7.2                                    | 70.9                                      | 79.9                                      | 90.8                                                  | 78.3                                                  | 82.3                                                       | 75.5                                                       |

Source: NFHS-5 and NFHS-4 States/UTs reports available on website: http://rchiips.org/NFHS/index.shtml

Note:

NA: Not Available

( ) Based on 25-49 unweighted cases

* Percentage not shown; based on fewer than 25 unweighted cases

1 BCG,  MCV/Measles/MMR/MR, and three doses each of DPT/Penta and polio vaccine (excluding polio  vaccine  given  at birth)

2 For pregnant women the value is <11.0 g/dl

3 Locally prepared napkins, sanitary napkins, tampons, and menstrual cup are considered to be hygienic methods of protection