Lok Sabha Question No. 107 (STARRED), answered on 2021-12-06
Subject: Health Sector Grants
Ministry: FINANCE
Asked by: Bhartruhari Mahtab

## GOVERNMENT OF INDIA MINISTRY OF FINANCE DEPARTMENT OF EXPENDITURE

## LOK SABHA STARRED QUESTION NO. 107

## Answered on Monday the 6 th December, 2021/ AGRAHAYANA 15, 1943 (SAKA)

## Health Sector Grants

## *107.  SHRI  BHARTRUHARI  MAHTAB:

Will the Minister of FINANCE be pleased to state:

- (a) whether  as  per  the  recommendations  of  the  Fifteenth  Finance  Commission,  the Government  has  released  funds  as  health  sector  grants  for  rural  and  urban  local bodies of nineteen States;
- (b) if so,  the details thereof along with the amount of such grants recommended to be released for rural and urban local bodies in the current financial year, State/UT-wise including Odisha;
- (c) the present status of proposals from remaining nine States received in this regard along with the funds proposed to be released to the respective States/UTs;
- (d) whether the government has also identified interventions that will directly lead to strengthening the primary health infrastructure and facilities in both rural and urban areas and has earmarked grants for each intervention; and
- (e) whether the Government has set targets to strengthen the health systems and plug critical gaps in healthcare systems at primary healthcare level and if so, the details thereof, State/UT-wise?

## ANSWER

## MINISTER OF FINANCE

## (SMT. NIRMALA SITHARAMAN)

- (a) to (e): A statement is laid on the table of the House.

## STATEMENT  REFERRED  IN  PART  (A)  TO  (E)  OF  THE  REPLY  TO  THE  LOK SABHA  STARRED  QUESTION  NO.  *107  BY  SHRI    BHARTRUHARI    MAHTAB REGARDING  'HEALTH  SECTOR  GRANTS'  DUE  FOR  ANSWER  ON  MONDAY DECEMBER 06, 2021.

- (a) Yes Sir.  As per the recommendations  of the Fifteenth Finance Commission and based on the examination of proposals of States and consequent  recommendations by the Ministry of Health & Family Welfare, the Department of Expenditure has released funds as Health Grants for rural and urban local bodies of  all the States.
- (b) State-wise and component-wise Health Grants released to all the States including the State of Odisha during the current financial year is given in Annexure-I.  Statewise  details  of  Health  Sector  Grants  for  local  bodies  recommended  by  the  15 th Finance Commission for the current year is given in Annexure-II.
- (c) Health  Grants  to  all  the  remaining  nine  States  (i.e.  Gujarat,  Haryana,  Kerala, Meghalaya,  Nagaland,  Telangana,  Goa,  Tripura  and  Uttar  Pradesh)  were  also released on 30-11-2021. Annexure-I includes details of these nine States as well.
- (d) Yes Sir.
- (e) Yes  Sir.  The  Fifteenth  Finance  Commission  (FC-XV)  in  its  Final  Report  in Chapter  7  entitled  'Empowering  Local  Governments'  has  recommended  a  total grant amounting to Rs. 70,051 crore to strengthen and plug the critical gaps in the health care system at the primary health care level.  In pursuance of the acceptance of  the  recommendations  of  FC-XV,  a  National  Level  Committee  has  been constituted under the Chairmanship of the Secretary, Ministry of Health & Family Welfare and States have been requested to constitute State Level Committees and District Level Committees with members from all Nodal Ministries/Departments for monitoring and approval of the health sector grants.  Further, the Ministry of Health and Family Welfare has developed Technical and Operational Guidelines for implementation of all the components of FC-XV, as per the mandate given by the FC-XV  which  inter-alia  includes description of  each of the specific components,  objectives  of  the  component,  the  unit  cost applicable for the component, factors to be considered for planning etc.  The components identified for  upgradation  of  primary  health  care  infrastructure  in  Rural  and  Urban  areas along  with  the  summary  of  the  amount  earmarked  year-wise  are  given  in Annexure-III.

*********

Annexure-I

| S. No.   | NAMEOF STATE                   | Support for diagnostic infrastructure to the   | Support for diagnostic infrastructure to the   | Support for diagnostic infrastructure to the   | (Rs. in crore) Block Level PHUs   | UHWCs                         | Building - less SCs, PHCs& CHCs     | Conversion of Rural PHCs and SCs into HWC   | TOTAL                               |
|----------|--------------------------------|------------------------------------------------|------------------------------------------------|------------------------------------------------|-----------------------------------|-------------------------------|-------------------------------------|---------------------------------------------|-------------------------------------|
| S. No.   | NAMEOF STATE                   | SHCs                                           | facilities PHCs                                | UPHCs                                          | (Rs. in crore) Block Level PHUs   | UHWCs                         | Building - less SCs, PHCs& CHCs     | Conversion of Rural PHCs and SCs into HWC   | TOTAL                               |
| 1        | Andhra Pradesh                 | 54.7600                                        | 57.2500                                        | 14.2900                                        | 134.3936                          | 102.8726                      | 0.0000                              | 124.5865                                    | 488.1527                            |
| 2        | Arunachal Pradesh              | 2.8200                                         | 6.9600                                         | 1.2980                                         | 22.9376                           | 5.2400                        | 1.0400                              | 6.6484                                      | 46.9440                             |
| 3        | Assam                          | 46.8600                                        | 50.6350                                        | 10.9725                                        | 5.3100                            | 65.5500                       | 13.3180                             | 79.6054                                     | 272.2509                            |
| 4        | Bihar                          | 157.1038                                       | 172.7900                                       | 27.4116                                        | 49.4700                           | 185.4300                      | 329.2900                            | 194.8100                                    | 1116.305                            |
| 5        | Chhattisgarh                   | 39.1900                                        | 41.0600                                        | 10.2270                                        | 13.5600                           | 133.8800                      | 10.7500                             | 90.1274                                     | 338.7944                            |
| 6        | Goa                            | 1.6100                                         | 1.1700                                         | 0.2400                                         | 2.4100                            | 20.4800                       | 1.5400                              | 3.9996                                      | 31.4496                             |
| 7        | Gujarat                        | 67.4900                                        | 71.8800                                        | 17.6300                                        | 50.3100                           | 260.7300                      | 1.1700                              | 160.0100                                    | 629.2200                            |
| 8        | Haryana                        | 24.1638                                        | 27.8709                                        | 6.9833                                         | 28.3360                           | 138.0000                      | 29.4150                             | 46.6100                                     | 301.3790                            |
| 9        | Himachal Pradesh               | 15.3663                                        | 28.4460                                        | 4.1376                                         | 1.8500                            | 1.4000                        | 2.6800                              | 44.1300                                     | 98.0099                             |
| 10       | Jharkhand                      | 49.4896                                        | 51.4006                                        | 13.1000                                        | 24.3610                           | 118.8000                      | 118.5400                            | 68.7071                                     | 444.3983                            |
| 11       | Karnataka                      | 71.8500                                        | 103.5800                                       | 16.0200                                        | 38.2300                           | 122.9300                      | 10.0600                             | 188.8600                                    | 551.5300                            |
| 12       | Kerala                         | 39.6100                                        | 48.3600                                        | 10.9400                                        | 30.5900                           | 191.7000                      | 0.5000                              | 105.4300                                    | 427.1300                            |
| 13       | Madhya Pradesh                 | 102.6100                                       | 108.7500                                       | 27.1700                                        | 28.9900                           | 427.5000                      | 30.0300                             | 197.7492                                    | 922.7992                            |
| 14       | Maharashtra                    | 103.4280                                       | 109.6800                                       | 27.6675                                        | 61.2916                           | 238.0800                      | 50.0700                             | 187.7898                                    | 778.0069                            |
| 15       | Manipur                        | 3.9491                                         | 4.3800                                         | 1.0344                                         | 12.9536                           | 9.8000                        | 2.0300                              | 8.7300                                      | 42.8771                             |
| 16       | Meghalaya                      | 6.0500                                         | 6.0400                                         | 1.5100                                         | 9.2500                            | 23.3000                       | 3.2100                              | 9.2884                                      | 58.6484                             |
| 17       | Mizoram                        | 2.7200                                         | 2.8700                                         | 0.4400                                         | 5.2300                            | 12.0100                       | 0.5600                              | 7.3600                                      | 31.1900                             |
| 18       | Nagaland                       | 3.1900                                         | 6.1400                                         | 1.0200                                         | 14.8900                           | 22.5500                       | 1.0300                              | 8.1900                                      | 57.0100                             |
| 19       | Odisha                         | 61.7200                                        | 65.4673                                        | 18.3600                                        | 29.0800                           | 89.1900                       | 72.8300                             | 125.1200                                    | 461.7673                            |
| 20       | Punjab                         | 26.1050                                        | 28.8800                                        | 7.2100                                         | 28.7808                           | 241.7500                      | 20.2300                             | 46.7000                                     | 399.6558                            |
| 21       | Rajasthan                      | 43.1310                                        | 21.3300                                        | 3.2400                                         | 27.4000                           | 106.4900                      | 191.3900                            | 263.1900                                    | 656.1710                            |
| 22       | Sikkim                         | 1.3000                                         | 1.4100                                         | 0.1480                                         | 6.4400                            | 8.1900                        | 0.5300                              | 2.9600                                      | 20.9780                             |
| 23       | Tamil Nadu                     | 64.1600                                        | 69.2500                                        | 18.7500                                        | 77.4700                           | 356.4800                      | 71.2100                             | 148.6080                                    | 805.9280                            |
| 24       | Telangana                      | 34.9300                                        | 35.2500                                        | 8.8600                                         | 118.2016                          | 133.0992                      | 2.8098                              | 85.0509                                     | 418.2015                            |
| 25       | Tripura                        | 7.1600                                         | 5.2600                                         | 1.2700                                         | 11.1020                           | 41.6800                       | 0.2500                              | 17.3600                                     | 84.0820                             |
| 26       | Uttar Pradesh                  | 217.4400                                       | 281.5300                                       | 70.3133                                        | 76.1024                           | 424.5008                      | 333.5472                            | 387.3375                                    | 1790.771                            |
| 27       | Uttarakhand                    |                                                |                                                | 3.2600                                         | 69.2197                           |                               | 49.0400                             | 192.9578                                    |                                     |
| 28       | West Bengal                    | 13.6000                                        | 12.5200                                        |                                                | 2.2200                            | 81.5700                       | 1.4300                              | 35.4965                                     | 150.0965                            |
|          |                                | 97.3881                                        | 105.9866                                       | 26.3772                                        |                                   | 287.1000                      |                                     |                                             | 828.0694                            |
| x        | TOTAL                          | 1359.1947                                      | 1526.1464                                      | 349.8804                                       | 980.380                           | 3850.305                      | 1348.5000                           | 2837.4125                                   | 12251.816                           |
|          | (i)PHC:-Primary Health Centers | (i)PHC:-Primary Health Centers                 | (ii) CHC:- Community Health Centers            | (ii) CHC:- Community Health Centers            | (iii) SC:-Sub-Health Centers.     | (iii) SC:-Sub-Health Centers. | (iv) HWC:-Health &Wellness Centers. | (iv) HWC:-Health &Wellness Centers.         | (iv) HWC:-Health &Wellness Centers. |

| Annexure-II                                                                    | Annexure-II                                                                    | Annexure-II                                                                    | Annexure-II                                                                    | Annexure-II                                                                    |
|--------------------------------------------------------------------------------|--------------------------------------------------------------------------------|--------------------------------------------------------------------------------|--------------------------------------------------------------------------------|--------------------------------------------------------------------------------|
| 15th Finance Commission recommended Health Sector Grants for the year 2021-22. | 15th Finance Commission recommended Health Sector Grants for the year 2021-22. | 15th Finance Commission recommended Health Sector Grants for the year 2021-22. | 15th Finance Commission recommended Health Sector Grants for the year 2021-22. | 15th Finance Commission recommended Health Sector Grants for the year 2021-22. |
| S. No.                                                                         | NAME OF STATE                                                                  | Total Rural Components for the year 2021-22 (Rs. in crore)                     | Total Urban Components for the year 2021-22 (Rs. in crore)                     | Total Health Sector Grant for the year 2021-22 (Rs. in crore)                  |
| 1                                                                              | Andhra Pradesh                                                                 | 372.63                                                                         | 117.17                                                                         | 489.80                                                                         |
| 2                                                                              | Arunachal Pradesh                                                              | 40.47                                                                          | 8.31                                                                           | 48.78                                                                          |
| 3                                                                              | Assam                                                                          | 196.91                                                                         | 82.59                                                                          | 279.50                                                                         |
| 4                                                                              | Bihar                                                                          | 904.47                                                                         | 228.63                                                                         | 1133.10                                                                        |
| 5                                                                              | Chhattisgarh                                                                   | 194.69                                                                         | 144.11                                                                         | 338.80                                                                         |
| 6                                                                              | Goa                                                                            | 10.73                                                                          | 20.72                                                                          | 31.45                                                                          |
| 7                                                                              | Gujarat                                                                        | 350.86                                                                         | 278.36                                                                         | 629.22                                                                         |
| 8                                                                              | Haryana                                                                        | 158.23                                                                         | 146.34                                                                         | 304.57                                                                         |
| 9                                                                              | Himachal Pradesh                                                               | 92.58                                                                          | 5.65                                                                           | 98.23                                                                          |
| 10                                                                             | Jharkhand                                                                      | 314.07                                                                         | 132.31                                                                         | 446.38                                                                         |
| 11                                                                             | Karnataka                                                                      | 412.58                                                                         | 138.95                                                                         | 551.53                                                                         |
| 12                                                                             | Kerala                                                                         | 225.71                                                                         | 333.27                                                                         | 558.98                                                                         |
| 13                                                                             | Madhya Pradesh                                                                 | 468.14                                                                         | 455                                                                            | 923.14                                                                         |
| 14                                                                             | Maharashtra                                                                    | 528.72                                                                         | 802.09                                                                         | 1330.81                                                                        |
| 15                                                                             | Manipur                                                                        | 33.18                                                                          | 10.95                                                                          | 44.13                                                                          |
| 16                                                                             | Meghalaya                                                                      | 33.84                                                                          | 24.81                                                                          | 58.65                                                                          |
| 17                                                                             | Mizoram                                                                        | 18.74                                                                          | 12.45                                                                          | 31.19                                                                          |
| 18                                                                             | Nagaland                                                                       | 33.44                                                                          | 23.63                                                                          | 57.07                                                                          |
| 19                                                                             | Odisha                                                                         | 354.46                                                                         | 107.55                                                                         | 462.01                                                                         |
| 20                                                                             | Punjab                                                                         | 152.25                                                                         | 248.96                                                                         | 401.21                                                                         |
| 21                                                                             | Rajasthan                                                                      | 698.68                                                                         | 134.3                                                                          | 832.98                                                                         |
| 22                                                                             | Sikkim                                                                         | 12.64                                                                          | 8.34                                                                           | 20.98                                                                          |
| 23                                                                             | Tamil Nadu                                                                     | 430.7                                                                          | 375.23                                                                         | 805.93                                                                         |
| 24                                                                             | Telangana                                                                      | 276.95                                                                         | 142.46                                                                         | 419.41                                                                         |
| 25                                                                             | Tripura                                                                        | 42.23                                                                          | 42.95                                                                          | 85.18                                                                          |
| 26                                                                             | Uttar Pradesh                                                                  | 1334.79                                                                        | 494.92                                                                         | 1829.71                                                                        |
| 27                                                                             | Uttarakhand                                                                    | 65.29                                                                          | 84.83                                                                          | 150.12                                                                         |
| 28                                                                             | West Bengal                                                                    | 514.65                                                                         | 314.41                                                                         | 829.06                                                                         |
| x                                                                              | TOTAL                                                                          | 8272.63                                                                        | 4919.29                                                                        | 13191.92                                                                       |

The  components  identified  by  the  Fifteenth  Finance  Commission  for  upgradation  and strengthening of primary health care infrastructure in Rural and Urban areas along with the summary of the amount earmarked year-wise for each component is given below;

## For Rural Areas

| (Rs. in crore)   | (Rs. in crore)                                                             | (Rs. in crore)   | (Rs. in crore)   | (Rs. in crore)   | (Rs. in crore)   | (Rs. in crore)   | (Rs. in crore)   |
|------------------|----------------------------------------------------------------------------|------------------|------------------|------------------|------------------|------------------|------------------|
| S. No.           | Total Health Grants                                                        | 2021-22          | 2022-23          | 2023-24          | 2024-25          | 2025-26          | Total            |
| 1                | Support for diagnostic infrastructure to the primary healthcare facilities | 3084             | 3084             | 3238             | 3400             | 3571             | 16377            |
|                  | (i)Sub centers                                                             | 1457             | 1457             | 1530             | 1607             | 1687             | 7738             |
|                  | (ii)PHCs                                                                   | 1627             | 1627             | 1708             | 1793             | 1884             | 8639             |
| 2                | Block level public health units                                            | 994              | 994              | 1044             | 1096             | 1151             | 5279             |
| 3                | Building-less SCs, PHCs, CHCs                                              | 1350             | 1350             | 1417             | 1488             | 1562             | 7167             |
| 4                | Conversion of rural PHCs and sub centers into health and wellness centre   | 2845             | 2845             | 2986             | 3136             | 3293             | 15105            |
| x                | Total Health Grants                                                        | 8273             | 8273             | 8685             | 9120             | 9577             | 43928            |

## For Urban Areas :-

| S. No.   | Total Health Grants                                                       |   2021-22 |   2022-23 |   2023-24 |   2024-25 |   2025-26 |   Total |
|----------|---------------------------------------------------------------------------|-----------|-----------|-----------|-----------|-----------|---------|
| 1        | Support for diagnostic infrastructure to the PHC facilities in Urban PHCs |       394 |       394 |       415 |       435 |       457 |    2095 |
| 2        | Urban health and wellness centres (HWCs)                                  |      4525 |      4525 |      4751 |      4989 |      5238 |   24028 |
| x        | Total Health Grants                                                       |      4919 |      4919 |      5166 |      5424 |      5695 |   26123 |

| i. (SC):-Sub-Health Centers         | iii.   | (PHC):-Primary Health Centers    |
|-------------------------------------|--------|----------------------------------|
| ii. (CHC):-Community Health Centers | iv.    | (HWC) :-Health &Wellness Centers |