Lok Sabha Question No. 864 (UNSTARRED), answered on 2021-07-23
Subject: Setting up of Hospitals in Villages/Remote Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shiromani Ram

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

## LOK SABHA U NSTARRED QUESTION NO. 864 TO BE ANSWERED ON 23 RD JULY, 2021

## SETTING UP OF HOSPIT ALS IN VILLAGES/REMO TE AREAS

## 864. SHRI RAMSHIROMA NI VERMA:

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

- (a)  the  steps  being  taken  by  the  Government  to  set up  new  hospitals  or  make  the  existing hospitals resourceful to provide basic facilities accessible to villages and remote areas;
- (b)whether the ongoing efforts being made in this regard are sufficient to sustain the pressure on healthcare system  particularly  in  remote  and  rural  areas  in  wake  of the  likely  third  ware  of COVID - 19 pandemic;
- (c) if so, the details thereof; and
- (d) if not, the corrective steps proposed to be taken thereon?

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

- (a) to  (d) : 1.5 lakhs Health & Wellness Centers (HWCs)are being set up especially in villages and  remote  areas by  upgrading  Sub - Centers(SC 's)  & Primary  Health  Centers  ( PHC's)  for delivering comprehensive primary health care, cl oser to the homes of the people.
2. Health& Hospitals, being a State subject, primary responsibili ty of providing and strengthening   health services lies with the respective State Government s. However, the Central Government, under  NHM providesfortechnical  and  financial  support  to  the  States/UTs  for improving their health care systems, in rural and remote areas. Accordingly, 77,284 HWCs have become  functional with  this  support. The  basic  facility  available  through HWC's  are at

## Annexure - I

3. Government  of  India through  the Emergency  Response  and  Health  System  Preparedness package ( ECRP) has extendedsupport to the states/ UTs for managing the current and future imminent wave of COVID - 19.

## Details of ECRP I & II are at Annexure - II & III

4. In addition to the above , Prime Minister AtmanirbharSwasth Bharat Yojana ( PMASBY) Scheme has been announced in the budget FY 21-22,focusing on developing capacities of health systems  and  institutions  across  the  continuum  of  care  at  all  levels  viz.  primary,  s and  tertiary  and  on  preparing for  future pandemics/disasters. Details  of  PMASBY  are  at

## Annexure - IV

## Health Wellness Centres

HWC's are providing a package of following 12 services to make basic health facilities equitable, accessible, affordable to under - served people especially in rural and remote areas:

1. Care in Pregnancy and Child Birth.
2. Neonatal and Infant health care services.
3. Childhood and Adolescent health care services.
4. Family planning, contraceptive services and other reproductive health care services
5. Management of communicable diseases: National Health programmes
6. General out - patient care for acute simple illnesses and minor ailments
7. Screening,  prevention,  control  and  management  of  non - communicable  diseases  and chronic communicable disease s like tuberculosis and leprosy
8. Basic oral health care
9. Screening and basic management of mental Health ailments
10. 10.Care for common ophthalmic and ENT problem
11. 11.Elderly and palliative health care services
12. 12.Emergency medical services including burns and trauma.

In addition to the above there are a range of wellness activities which include the fo

- Regular Yoga sessions / Wellness sessions.
- Through Annual Health Calendar, 39 Health days have been identified to cond uct health promotion activities .
- Ayushman  Bharat - Health  and  Wellness  Ambassador  Ini tiative  has  been  launched wherein two teachers in every school will be Ambassadors to foster growth, developm and  educational  achievement  of  school  going  children  by  promoting  their  health wellbeing . This is joint initiative of MoHFW and MHRD under comprehensi ve School Health Program (SHP).
- Eat- Right toolkit and Food Safety kit (Magic Box) have been developed in collaborat with  FSSAI,  under  the  initiative  'SahiBhojanBehtarJeevan  ( सह भोजनबेहतरजीवन ) Eat Right India'

## Annexure - I

## Annexure - II

India COVID- 19 Emergency Response & Health System Preparedness Package

## (ECRP - I) Health Infrastructure for Co vi d- 19 Treatment

ECRP -I  for Rs.  15,000  Crore  (USD  2  billion) has  been  released  to  all  states/UTs  in April 2021 to prevent, detect and respond to the threat posed by COVID - 19. Under the package, so  far,  a  total  of Rs.13719.22  Cr of  committed  expenditure  has  been  reported  by  the implementation agencies. Rs.8147.29 Cr has been released to the States/UTs to prevent, detect, and respond to the threat posed by COVID - 19.

To equip existing health facilities and to set up additional facilities resources made  available.  Dedicated  hospitals  have  been  set  up  for  mee ting  the  COVID - 19  health emergency.

Table 1

|   S. No. | Category                                  |   As on March 2020 | As on 30 th June 2021   | No. of fold increase   |
|----------|-------------------------------------------|--------------------|-------------------------|------------------------|
|        1 | COVID dedicated hospitals                 |                163 | 4389                    | 27                     |
|        2 | Dedicated COV4.ID health centres          |                  0 | 8340                    | -                      |
|        3 | Dedicated COVID Care Centre               |                  0 | 10,015                  | -                      |
|        4 | Oxygen supported beds                     |              50583 | 4,16,947                | 8                      |
|        5 | Total isolation beds (excluding ICU beds) |              41000 | 1,811,850               | 44                     |
|        6 | Total ICU beds                            |               2500 | 121,671                 | 48                     |

## India COVID- 19 Emergency Response & Health System Preparedness Package (ECRP - II)

ECPP -II for Rs. 23,123 Crore has been approved by Cabinet on 8 th July 2021 and the amount is being released to the states, with an aim to strengthening district and sub district cap effective and rapid response to the pandemic.

Support is available for States/UTs to:

- Under India Covid - 19 Emergency Response and Health Systems Preparedness Package -Phase II' (ECRP - Phase - II)  during  2021 - 22, approved by  the  Cabinet  on  8.07.2021,  a n amount of Rs.23,123 crores, is earmarked for imple menting the scheme in 9 months from 1st July, 2021 to 31st March, 2022.  The Scheme is aimed to prevent, detect strengthen national health systems ,respond to the cont inuing threat posed by COVID - 19 in India.   The scheme is a Centrally Sponsored Sche me (CSS) with some Central Sector (CS) components.
- Create Paediatric units in all districts (42 or 32 bedded units including Oxygen Su beds  and  ICU  beds)and  also,  to  establish  Paediatric  Centre  of  Excellence  (Paedi CoE)  in  each  State/UT,  (eithe r  in  Medical  Colleges,  State  Govt.  Hospitals  or  Central Hospitals  such  as  AIIMS,  INIs,  etc)  for  providing  Tele -ICU  services,  mentoring  and technical hand - holding to the District Paediatric units
- Establishing 6 bedded units at Sub Health Centres and Primar y Health Centres and 20 bedded  units  at  Community  Health  Centres  for  meeting  the  requirement beds  in peri urban and tribal areas.
- Besides,  the  support  is  provided  to  provision  of  required  drugs  and  diagnostic COVID  management,  including  maintaining  a buffer  stock  for  essential  medicines required for effective COVID - 19 management.  Further, support is extended to establish Field Hospitals (100 bedded or 50 bedded units) wherever required.
- Augment ICU beds in public healthcare system out of which 20% wi ll be Pediatric ICU beds.
- Provide care closer to the community due to the ingress of COVID - 19 in rural, peri - urban and tribal areas, by creating pre -fabricated structures for adding additional beds at th existing CHCs, PHCs and SHCs (6 - 20 bedded units) an d support would also be provided to establish bigger field hospitals (50 - 100 bedded units) depending on the needs at tier -II or Tier -III cities and district HQs.
- Install  Liquid  Medical  Oxygen  Storage  Tanks  with  Medical  Gas  Pipeline  System (MGPS), with an a im to support at least one such unit per district.
- Augment the existing fleet of ambulances especially ALS ambulances to ensure at le one ALS ambulance is available in each block.
- Engage Final year MBBS students, Interns, Post Graduate Residents and fin al year BSc, & GNM nursing students for effective COVID management.
- As  'Test,  Isolate  and  Treat'  and  following  COVID  Appropriate  Behaviour  at  all  the times, is the national strategy for effective COVID - 19, support will be available to the States to maintai n at least 21.5 lakhs tests per day.
- Flexible support to the Districts for meeting the requirement of essential medici COVID - 19 management, including creation of buffer stock.

Guidance Note on 'India Covid - 19 Emergency Response and Health Systems Preparedness Package - Phase II'  (ECRP - Phase - II)  has been shared with the States/UTs on 14th July 2021, requesting the States to send the proposals for appraisal and approval.

15% of a mount of Central Share of CSS components of ECRP -II (Rs.1,827.8 Cr) has been released to 36 States/UTs on 22nd July 2021, as an advance to enable the States/UTs to implementation of critical activities.

## Annexure IV

Prime Minister AtmanirbharSwasth Bharat Yojana (PMASBY)

- Prime  Minister  AtmanirbharSwasth  Bharat  Yojana  ( PMASBY)  Scheme has an  outlay  of about Rs. 64,180 Cr over six years (to be implemented till 2025 - 26)

U nder PMASBY efforts to enhance public health capacities are b eing undertaken like the following:

- A paradigm shift in provision of Urban Primary Health Care services with establishmen 11,024 new urban Health and Wellness Centers across the country with a focus on slum and slum like areas
- Infrastructure support for 17,788 AB-Health and Wellness Centresin rural areas in seven High Focus States and three NE States.
- Setting up of 3,382 Block Public Health Units (BPHUs) in 11 High Focus States/UTs to strengthen P ublic H ealth functions such as surveillance, epidemiological investigations alo with enhanced capacities for clinical diagnostic services and
- Establishment / Strengthening of Integrated District Public Health Labs (IPHLs) in a districts.
- Establishment  of  50/ 100  bedded  Critical  Care  Hospital  Blocks in  602  Districts and  150 bedded Critical Care Hospital Blocks in 12 AIIMS and Central Institutions .
- Health  Emergency  Response - Two  state - of - the - art  Self - contained  container  based  mobile hospitals  and  15  Health  Emerg ency  Operation  Centres  (HEOCs)  towards strengthening Disaster and Epidemic Preparedness and response

The cabinet note for this scheme has been circulated and it is awaiting the approval of th cabinet.