Lok Sabha Question No. 1909 (UNSTARRED), answered on 2021-07-30
Subject: Absence of Healthcare Facilities in Tribal, Backward and Slums
Ministry: HEALTH AND FAMILY WELFARE
Asked by: A. Ganeshamurthi, S. Ramalingam

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1909 TO BE ANSWERED ON THE 30 th JULY, 2021

## ' ABSENCE OF HEALTHCARE FACILITIES IN TRIBAL, BACKWARD AND SLUMS '

## 1909. SHRI A. GANESHAMURTHI: SHRI RAMALINGAM S.:

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

- a) whether the Government is aware of the fact that healthcare facilities in the tribal, slum  areas  are  unavailable/totally  neglected  and  the  people  living  in  these  are vulnerable to various diseases;
- b) if so, the details thereof;
- c) whether the Government proposes to launch any comprehensive plan to provide adequate healthcare facilities in all such areas;
- d) if so, the details thereof; and
- e) if not, the reasons therefor?

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

(a) to (e) 'Public  Health  and  Hospitals'  being  a  State  subject,  the  primary  responsibility  of strengthening  public  healthcare  system including  provision  of  healthcare  facilities  in the tribal, backward, slum areas and provision of comprehensive healthcare lies  with  the respective State / UT Governments.

To address the healthcare challenges, particularly in rural areas, the National Rural Mission  (NRHM)  was  launched  in  2005  to  supplement  the  efforts  of  the  State/UT Governments to provide accessible, affordable and quality healthcare to all those who ac public health facilities including tribal, backward, slum areas. Currently, NRHM is a -mission of National Health Mission (NHM).

Under the National Health Missi on (NHM), financial and technical support is provided to States/UTs to strengthen their health care systems including forsetting - up/upgrading public health facilities and augmenting health human resource on contractual basis for provisi equitable, af fordable healthcare to all its citizens including the people of tribal, backward and slum areas based on requirements posed by the States in their Programme Implementation Plans (PIPs).

Various  interventions  that  are  implemented  for  better  healthcare  in  tr ibal  areas  and beneficiaries are as follows;

- The population norms for setting up Health Facilities in tribal areas are relaxed. A the population norms of 5,000, 30,000, and 1,20,000 for setting up of Sub Centre, P and CHC respectively, in tribal an d desert areas its 3,000, 20,000 and 80,000.
- Relaxedpopulationorms for Mobile Medical Units (MMUs) & Ambulances
- SC/ST  households  are  covered  under  Ayushman  Bharat,  Pradhan  Mantri  Jan  Arogya Yojana (AB- PMJAY) for health coverage up to Rs 5 Lakh per famil y per year as per Socio Economic Caste Census (SECC).

Further, all tribal majority districts whose composite health index is below the State have  been  identified  as  High  Priority  Districts  (HPDs)  and  these  districts  receive resources per capita under the NHM as compared to the rest of the districts in the Sta These districts receive higher per capita funding, have enhanced monitoring and focus supportive supervision and are encouraged to adopt innovative approaches to address th peculiar health challenges.

Due to above interventions under NHM, there has been 73% increase in Health Facilitie available in Tribal areas as compared to 10% increase in all India

| Type of Facility   | All India   | All India   | All India   | Tribal Areas   | Tribal Areas   | Tribal Areas   |
|--------------------|-------------|-------------|-------------|----------------|----------------|----------------|
| Type of Facility   | RHS 2005    | RHS 2020    | % Increase  | RHS 2005       | RHS 2020       | % Increase     |
| SHCs               | 1,42,655    | 1,55,404    | 9%          | 16,748         | 29,745         | 78%            |
| PHCs               | 23,109      | 24,918      | 8%          | 2,809          | 4,203          | 50%            |
| CHCs               | 3,222       | 5,183       | 61%         | 643            | 1035           | 61%            |
| Total              | 1,68,986    | 1,85,505    | 10%         | 20,200         | 34,983         | 73%            |

NHM support is also provided for pr vision of  a host of  free services in  public  healthcare facilities in tribal, backward and slum areas, related to maternal health, child health, adolescent health, family planning, universal immunisation programme, and for major diseases such Tuberculosis, vector borne diseases like Malaria, Dengue and Kala Azar, Leprosy etc.

As part of Ayushman Bharat, the Government is supporting the States for transformation Sub Health Centres and Primary Health Centres into 1.5 lakh Health and Wellness Centr across the country by Decem ber, 2022 for provision of Comprehensive Primary HealthCare (CPHC) that includes preventive healthcare and health promotion at the community level w 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 . Further  Ayushman  Bharat,  Pradhan  Mantri  Jan  Arogya  Yojana  (AB -PMJAY) provides health coverage up to Rs 5 Lakh per family per year to around 10 . 74 crore poorand vulnerable families as per Socio Economic Caste Census (SECC).

Financial support is also provided to States for providing hard area allowance, perfor -based incentives, providing accommodation and transport facilities in rural and remote sponsoring  training  programmes,  etc  to  engaged  human  resources  to  addr ess  the  issue  of shortage of doctors and specialists n the public health facilities.