Lok Sabha Question No. 333 (STARRED), answered on 2022-03-25
Subject: Ayushman Bharat - Health and Wellness Centres
Ministry: HEALTH AND FAMILY WELFARE
Asked by: C.N. Annadurai, Gajanan Chandrakant Kirtikar

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

## LOK SABHA STARRED QUESTION NO.333 TO BE ANSWERED ON THE 25 TH  MARCH, 2022

## AYUSHMAN BHARAT - HEALTH AND WELLNESS CENTRES

## *333. SHRI C.N. ANNADURAI: SHRI GAJANAN KIRTIKAR:

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

- (a)  whether  the  Government  has  launched  Ayushman  Bharat  -  Health  and  Wellness Centres (AB-HWCs) initiative under the Ayushman Bharat Programme and if so, the details thereof along with achievements made since its launch;
- (b)  the  present  status  and  achievements  of  Community  Health  Centres  (CHCs)  and Primary Health Centres (PHCs), State/UT-wise particularly in Tamil Nadu;
- (c) whether the Government has set parameters for setting up of PHCs and CHCs and if so,  the  details  thereof  along  with  the  percentage  of  population  covered  by  PHCs  and CHCs during last three years;
- (d)  whether the Government has received proposals from States/UTs including Tamil Nadu for opening of new CHCs and PHCs and if so, the details thereof along with the funds  sanctioned  and  proposed  to  be  released  for  setting  up  of  CHCs/PHCs  in  the country, State/UTwise; and
- (e) whether the Government proposes to upgrade all the CHCs/PHCs as ISO certified wellness centres and improve quality of services and if so, the details thereof along with the number of ISO certified CHCs/PHCs functioning in the country, State/UT-wise?

## ANSWER

## THE MINISTER OF HEALTH AND FAMILY WELFARE (DR MANSUKH MANDAVIYA)

- (a) to (e) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 333* FOR 25 TH  MARCH, 2022

(a) to (e): Ayushman Bharat-Health and Wellness Centres (AB-HWCs) was launched in 2018 to progressively  achieve  Universal  Health  Coverage  through  delivery  of  Comprehensive  Primary Healthcare Services. It envisages to transform 1,50,000 Sub-Health Centres (SHCs) and Primary Health  Centres  (PHCs),  both  Rural  &  Urban,  into  Health  and  Wellness  Centres  (HWCs)  by December, 2022. As on 23rd March, 2022, a total 1,00,768 Ayushman Bharat-Health and Wellness Centres  (AB-HWCs)  are  functional  in  the  country  which  includes  73,668  SHC-HWC,  22,472 PHC-HWC and 4,628 UPHC-HWC, as reported by the States/UTs on AB-HWC portal. State/UT wise  Central  Release  under  Ayushman  Bharat-  Health  &  Wellness  Centres  (AB-HWC)  under NHM from the FY 2018-19 to 2021-22 is given at Annexure-I.

As  per  RHS  2019-20,  the  present  status  and  achievements  of  Community  Health  Centres (CHCs) and Primary Health Centres (PHCs), State/UT-wise, including Tamil Nadu, are  given at Annexure-II.

Government  of  India  has  laid  down  Indian  public  Health  Standards  (IPHS)  for  services, infrastructure,  human  resource,  diagnostics,  equipment,  medicines,  etc.  They  are  used  as  the reference point for planning and up-gradation of public health care infrastructure in the States and UTs.  These IPHS have given population norms for establishing the public health facilities. As per RHS,  2019-20,  average  rural  population  covered  by  the  health  facility  (based  on  the  mid-year population as on 1st July, 2020)  is given below

| Health Facility         | Norm as per IPHS   |   Average Rural Population covered (RHS-2019-20) |
|-------------------------|--------------------|--------------------------------------------------|
| Primary Health Centre   | 20,000-30,000      |                                            35730 |
| Community Health Centre | 80,000-1,20,000    |                                           171779 |

Besides this, States have the flexibility to propose for funding under the overall ambit of NHM for up-gradation of infrastructure, HR and services as per IPHS for public health facilities, after due gap analysis. States also have the flexibility to establish PHCs at 20,000 population and CHCs at 80,000 population in hilly/tribal/difficult areas.

All the States/UTs submit the proposals for opening of new CHCs and PHCs, through Program Implementation Plan (PIP) annually before the commencement of next financial  year. Year-wise Record of Proceedings (RoPs) and PIPs of all the States /UTs under NHM, including Tamil Nadu, are available at the link  https://nhm.gov.in/index4.php?lang=1&level=0&linkid=59&lid=72.

The State of Tamil Nadu has submitted a proposal to MoHFW, GOI during PIP 2022-24 for establishment of 25 New Primary Health Centre and 25 New Urban Primary Health Centre under NHM.

The ISO 9001:2008, now ISO 9001:2015 standards were initially framed for the manufacturing industry  and later adapted for service industry like healthcare industry. However, these standards are  generic  in  nature.  Therefore,  the  Ministry  of  Health  and  Family  Welfare  have  formulated National Quality Assurance Standards (NQAS) in November 2013 to improve the quality of care delivered  at  different  level  of  public  health  facilities.  The  Standards  are  accredited  by  apex international accrediting Agency ISQUA (International Society for Quality in Healthcare). Over the years, the programme has expanded its scope based on the emerging requirements and responses to newer initiatives taken up by the Ministry of Health and Family Welfare.

Quality Assurance Program has provision for national and state level quality certification of Health  facilities  on  meeting  the  predetermined  certification  criteria.  The  program  is  being implemented across all states and UTs. As on 16th March, 2022, 1463 public health facilities are quality certified at the national level and 3576 health facilities at the NQAS certified at the State level.

The National Quality Assurance Standards are broadly arranged under 8 "Areas of Concern"Service  Provision,  Patient  Rights,  Inputs,  Support  Services,  Clinical  Care,  Infection  Control, Quality Management and Outcome.

More details on the latest National Quality Assurance Standards are available at http://qi.nhsrcindia.org/sites/default/files/1596%20NQAS%20for%20PHF%202020\_16%20Dec%2 02021.pdf

## Annexure-I

State/UT  wise  Central  Release  under  Ayushman  Bharat  Yojana  -  Health  &  Wellness  Centres  (ABH&WCs) under NHM from the F.Y. 2018-19 to 2021-22

(Rs. in Crore)

|   Sl. No. | State/UT                 | 2018-19   | 2019-20   | 2020-21   | 2021-22   |
|-----------|--------------------------|-----------|-----------|-----------|-----------|
|         1 | Andaman &Nicobar Islands | 0.80      | 0.85      | 1.16      | 1.77      |
|         2 | Andhra Pradesh           | 43.51     | 52.44     | 59.38     | 11.60     |
|         3 | Arunachal Pradesh        | 8.15      | 8.59      | 14.80     | 8.19      |
|         4 | Assam                    | 68.67     | 97.60     | 89.69     | 100.18    |
|         5 | Bihar                    | 88.50     | 88.78     | 119.22    | 81.20     |
|         6 | Chandigarh               | 0.71      | 0.84      | 1.51      | 0.36      |
|         7 | Chhattisgarh             | 36.42     | 65.66     | 28.08     | 34.71     |
|         8 | Dadra &Nagar Haveli      | 0.70      | 0.96      |           |           |
|         9 | Daman &Diu               | 0.43      | 0.68      | 2.09      | 1.57      |
|        10 | Delhi                    | -         | -         | -         | -         |
|        11 | Goa                      | 0.79      | 1.26      | 0.88      | 0.30      |
|        12 | Gujarat                  | 44.64     | 49.98     | 69.75     | 16.84     |
|        13 | Haryana                  | 18.45     | 24.03     | 29.02     | 16.78     |
|        14 | Himachal Pradesh         | 16.08     | 27.21     | 25.87     | 4.70      |
|        15 | Jammu &Kashmir           | 32.66     | 38.88     | 39.27     | 19.10     |
|        16 | Jharkhand                | 26.02     | 75.81     | -         | 21.37     |
|        17 | Karnataka                | 47.98     | 54.70     | 75.51     | 59.10     |
|        18 | Kerala                   | 18.43     | 21.65     | 27.73     | 21.73     |
|        19 | Lakshadweep              | 0.18      | 0.26      | 0.24      | 0.44      |
|        20 | Madhya Pradesh           | 87.74     | 87.82     | 140.35    | 125.00    |
|        21 | Maharashtra              | 91.27     | 97.64     | 138.60    | 57.02     |
|        22 | Manipur                  | 5.44      | 9.22      | 8.06      | 4.98      |
|        23 | Meghalaya                | 8.64      | 12.46     | 9.17      | 6.48      |
|        24 | Mizoram                  | 4.03      | 5.19      | 5.25      | 3.90      |
|        25 | Nagaland                 | 5.01      | 5.34      | 6.22      | 3.04      |
|        26 | Odisha                   | 48.34     | 95.49     | 77.06     | 59.95     |
|        27 | Puducherry               | 14.46     | 0.22      | -         | 0.32      |
|        28 | Punjab                   | 19.69     | 20.39     | 22.17     | 11.73     |
|        29 | Rajasthan                | 83.70     | 68.64     | 62.63     | 68.91     |
|        30 | Sikkim                   | 2.16      | 1.62      | 2.71      | 1.12      |
|        31 | Tamil Nadu               | 56.41     | 89.12     | 82.65     | 52.70     |
|        32 | Tripura                  | 10.18     | 13.57     | 9.27      | 9.00      |
|        33 | Uttar Pradesh            | 176.10    | 330.85    | 279.52    | 136.78    |
|        34 | Uttarakhand              | 19.62     | 30.31     | 26.93     | 26.93     |
|        35 | West Bengal              | 59.47     | 61.55     | 99.44     | 66.03     |
|        36 | Telangana                | 46.14     | 33.70     | 35.94     | 22.26     |
|        37 | Ladakh                   | -         | -         | 7.36      | 3.84      |

Note:

1. The above information comprises of Ayushman Bharat- Health & Wellness Centres under NRHM and NUHM.
2. The above releases relates to Central govt. Grants & do not include State share contribution Release For the F.Y. 2021-22 is updated upto 04.03.2022.

## Annexure-II

Present  Status  and  achievements  of  Community  Health  Centres  (CHCs)  and  Primary  Health

## Centres (PHCs)

| Sl. No.         | STATE/UT                    |   PHCs |   CHCs |
|-----------------|-----------------------------|--------|--------|
| 1               | AndhraPradesh               |   1142 |    141 |
| 2               | ArunachalPradesh            |    119 |     60 |
| 3               | Assam                       |    946 |    190 |
| 4               | Bihar                       |   1702 |     57 |
| 5               | Chhattisgarh                |    792 |    170 |
| 6               | Goa                         |     55 |      6 |
| 7               | Gujarat                     |   1477 |    348 |
| 8               | Haryana                     |    385 |    118 |
| 9               | HimachalPradesh             |    564 |     85 |
| 10              | Jharkhand                   |    291 |    171 |
| 11              | Karnataka                   |   2176 |    189 |
| 12              | Kerala                      |    784 |    211 |
| 13              | MadhyaPradesh               |   1199 |    309 |
| 14              | Maharashtra                 |   1829 |    278 |
| 15              | Manipur                     |     85 |     17 |
| 16              | Meghalaya                   |    119 |     28 |
| 17              | Mizoram                     |     57 |      9 |
| 18              | Nagaland                    |    130 |     21 |
| 19              | Odisha                      |   1288 |    377 |
| 20              | Punjab                      |    427 |    143 |
| 21              | Rajasthan                   |   2094 |    548 |
| 22              | Sikkim                      |     24 |      2 |
| 23              | Tamil Nadu                  |   1420 |    385 |
| 24              | Telangana                   |    636 |     85 |
| 25              | Tripura                     |    107 |     22 |
| 26              | Uttarakhand                 |    257 |     56 |
| 27              | UttarPradesh                |   2880 |    711 |
| 28              | WestBengal                  |    913 |    348 |
| 29              | A&NIslands                  |     22 |      4 |
| 30              | Chandigarh                  |      0 |      0 |
| 31 32           | Dadra&NagarHaveli Daman&Diu |     10 |      4 |
| 33              | Delhi                       |      5 |      0 |
| 34              | Jammu&Kashmir               |    923 |     77 |
| 35              | Ladakh                      |     32 |      7 |
| 36              | Lakshadweep                 |      4 |      3 |
| 37              | Puducherry                  |     24 |      3 |
| All India/Total | All India/Total             |  24918 |   5183 |

Source: RHS 201920