Lok Sabha Question No. 3359 (UNSTARRED), answered on 2022-08-05
Subject: National Programme for Prevention and Control of Fluorosis
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Poonamben Hematbhai Maadam

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

## LOK SABHA UNSTARRED QUESTION No. 3359 TO BE ANSWERED ON 05.08.2022

## NATIONAL PROGRAMME FOR PREVENTION AND CONTROL OF FLUOROSIS

## 3359.    SHRIMATI POONAMBEN MAADAM :

Will the MINISTER of HEALTH AND FAMILY WELFARE be please to state:

- (a) whether  the  Government  is  implementing  National  Programme  for  Prevention  and Control of Fluorosis (NPPCF);
- (b) if so, the details thereof, State/UT-wise including Gujarat;
- (c) the number of districts in the country identified for prevalence of Fluorosis, State/UTwise;
- (d) the  details  of  work  done  under  this  programme  in Jamnagar,  Gujarat  during  last  three years;
- (e) whether  the  Government  has  conducted  any  research  or  analysed  status  of  Fluorosis recently, if so, the details thereof; and
- (f) the other steps taken by the Government to curb the incidence of Fluorosis across the country ?

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

(a)  to  (c)    The  Government  implements  National  Programme  for  Prevention  and  Control  of Fluorosis (NPPCF) to address the problem of Fluorosis, including  - Dental Fluorosis, Skeletal Fluorosis and Non-skeletal Fluorosis. At present, the NPPCF is implemented in 163 districts of 19 States/UTs. The State-wise list of Districts under the Programme is at Annexure- I .

Under  NHM,  financial  assistance  is  provided  at  district  level  for  establishment  of  diagnostic facilities in the district, Training of manpower (Medical and Para-Medical), Manpower support, Health-Education, Management of Fluorosis cases including surgery, rehabilitation and nutritional supplementation.

In  the  state  of  Gujarat,  the  program  covers  4  districts,  namely  -  Jamnagar,  Sabarkantha, Vadodara and Banaskantha.

(d) The details of work done under this programme in Jamnagar, Gujarat during the last three years, is attached at Annexure-II .

(e)  As  per  available  information,  ICMR  conducted  studies  on  Fluorosis,  at  7  locations  in  the country  (covering  one  district  each  in  Odisha,  Madhya  Pradesh,  Telangana,  Punjab,  Bihar, Rajasthan and Assam).

ICMR-National Institute for Research in Tribal Health, Jabalpur has brought out a Policy brief 'Knocking Down Fluorosis', which is based on the results of a successful water and nutritional interventional strategy in several districts of Madhya Pradesh.

(f) The Ministry of Jal Shakti, in partnership with States implements Jal-Jeevan Mission - 'Har Ghar  Jal'  to  make  provision  of  potable  tap  water  supply  in  adequate  quantity,  of  prescribed quality to households.

States/UTs  have  been  advised  to  install  community  water  purification  plants  especially  in Fluoride and Arsenic affected habitations to provide potable water to households at the rate of 8-10 litre per capita per day for their drinking and cooking requirements.

## Annexure to Lok Sabha Unstarred  Question No. 3359 to be answered on 05.08.2022

## List of States / Districts under National Programme for Prevention and Control of Fluorosis  (NPPCF)

|   S.No. | State          |   No. of districts under NPPCF |
|---------|----------------|--------------------------------|
|       1 | Andhra Pradesh |                              9 |
|       2 | Assam          |                              7 |
|       3 | Bihar          |                             11 |
|       4 | Chhattisgarh   |                              7 |
|       5 | Gujarat        |                              4 |
|       6 | Haryana        |                              4 |
|       7 | Jammu &Kashmir |                              1 |
|       8 | Jharkhand      |                             13 |
|       9 | Karnataka      |                             19 |
|      10 | Kerala         |                              2 |
|      11 | Madhya Pradesh |                             15 |
|      12 | Maharashtra    |                              7 |
|      13 | Odisha         |                              3 |
|      14 | Punjab         |                              5 |
|      15 | Rajasthan      |                             30 |
|      16 | Tamil Nadu     |                              1 |
|      17 | Telangana      |                              9 |
|      18 | Uttar Pradesh  |                             10 |
|      19 | West Bengal    |                              6 |

## Annexure to Lok Sabha Unstarred  Question No. 3359 to be answered on 05.08.2022

## DETAILS OF WORK DONE IN JAMNAGAR, GUJARAT DURING LAST THREE YEARS UNDER NPPCF PROGRAMME

| DISTRICT                                                                                                  | JAMNAGAR-GUJARAT                                                               | JAMNAGAR-GUJARAT                                                                | JAMNAGAR-GUJARAT                                                                |
|-----------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------|---------------------------------------------------------------------------------|---------------------------------------------------------------------------------|
| REPORTING YEAR                                                                                            | 2019-20                                                                        | 2020-21                                                                         | 2021-22                                                                         |
| 1. Excess Fluoride in Drinking Water                                                                      |                                                                                |                                                                                 |                                                                                 |
| Total Villages No.                                                                                        | 432                                                                            | 432                                                                             | 432                                                                             |
| Total Habitations No.                                                                                     | 380                                                                            | 380                                                                             | 380                                                                             |
| Fluoride Affected Villages No.                                                                            | 240                                                                            | 240                                                                             | 240                                                                             |
| Fluoride Affected Habitations No.                                                                         | 110                                                                            | 110                                                                             | 110                                                                             |
| 2.Manpower, Training and Infrastructure in State/District                                                 |                                                                                |                                                                                 |                                                                                 |
| Year of initiating the programme                                                                          | 2015                                                                           | 2015                                                                            | 2015                                                                            |
| Engagement of contractual staff                                                                           |                                                                                |                                                                                 |                                                                                 |
| District Consultant (Y/N)                                                                                 | Y                                                                              | Y                                                                               | Y                                                                               |
| Lab. Technician (Y/N)                                                                                     | Y                                                                              | Y                                                                               | Y                                                                               |
| Establishment of Lab. (Y/N)                                                                               | Y                                                                              | Y                                                                               | Y                                                                               |
| Training of NPPCF Staff (Give as Y/N)                                                                     |                                                                                |                                                                                 |                                                                                 |
| State Nodal Officer (SNO)                                                                                 | Y                                                                              | Y                                                                               | Y                                                                               |
| District Nodal Officer (DNO)                                                                              | Y                                                                              | Y                                                                               | Y                                                                               |
| District Consultant (DC)                                                                                  | Y                                                                              | Y                                                                               | Y                                                                               |
| Lab. Technician (LT)                                                                                      | Y                                                                              | Y                                                                               | Y                                                                               |
| 3. Programme Components                                                                                   |                                                                                |                                                                                 |                                                                                 |
| Survey-Community Survey                                                                                   |                                                                                |                                                                                 |                                                                                 |
| No. of villages surveyed                                                                                  | 110                                                                            | 80                                                                              | 121                                                                             |
| No. of persons examined                                                                                   | 3580                                                                           | 2613                                                                            | 3938                                                                            |
| No. with suspected dental fluorosis                                                                       | 2084                                                                           | 1521                                                                            | 2292                                                                            |
| No. with suspected skeletal fluorosis                                                                     | 1080                                                                           | 788                                                                             | 1188                                                                            |
| School Survey                                                                                             |                                                                                |                                                                                 |                                                                                 |
| No. of Schools surveyed                                                                                   | 39                                                                             | 28                                                                              | 43                                                                              |
| No. of children examined (aged 6-11 yrs)                                                                  | 4785                                                                           | 3493                                                                            | 5264                                                                            |
| No. with suspected dental fluorosis                                                                       | 3605                                                                           | 2632                                                                            | 3966                                                                            |
| Water Analysis                                                                                            |                                                                                |                                                                                 |                                                                                 |
| Total No. of samples analysed                                                                             | 42                                                                             | 31                                                                              | 46                                                                              |
| No. above the limit (1.5 ppm)                                                                             | 22                                                                             | 16                                                                              | 24                                                                              |
| Urinary Analysis                                                                                          |                                                                                |                                                                                 |                                                                                 |
| Total No. of samples analysed                                                                             | 4340                                                                           | 3168                                                                            | 4774                                                                            |
| No. above the limit (1.0 ppm)                                                                             | 2454                                                                           | 1791                                                                            | 2699                                                                            |
| IEC activities (ISP)                                                                                      | Press Note- 2 Seminar- 44 Wall painting- 24 Poster Fixing- 32 Pamphlets- 59000 | Press Note- 01 Seminar- 15 Wall painting- 06 Poster Fixing- 10 Pamphlets- 10000 | Press Note- 02 Seminar- 44 Wall painting- 24 Poster Fixing- 32 Pamphlets- 59000 |
| Trainings conducted at district level No. of trainings held No. of MOs trained No. of Paramedical trained | No. of training - 07 MO-17                                                     | No. of training - 10 MO-20 Para Med. - 40                                       | No. of training - 07 MO-17 Para Med. - 35                                       |
| Others trained                                                                                            | Para Med. - 35 18                                                              | 22                                                                              | 14                                                                              |
| Medical Management                                                                                        |                                                                                |                                                                                 |                                                                                 |
| Supplementation provided (No. of persons)                                                                 | 8270                                                                           | 9924                                                                            | 6616                                                                            |
| Rehabilitation aids provided (No. of persons)                                                             | 4                                                                              | 5                                                                               | 3                                                                               |
| Other provisions for medical management                                                                   | Transfer patient to District civil hospital for further surgical               | Transfer patient to District civil hospital for further surgical                | Transfer patient to District civil hospital for further surgical                |