Lok Sabha Question No. 1445 (UNSTARRED), answered on 2023-02-10
Subject: Primary Health Centres
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Janardan Singh Sigriwal

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

## LOK SABHA UNSTARRED QUESTION NO. 1445 TO BE ANSWERED ON 10 TH  FEBRUARY, 2023

## PRIMARY HEALTH CENTRES

## †1445. SHRI JANARDAN SINGH SIGRIWAL:

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

- a) Whether the Government proposes to set up more Primary Health Centres (PHCs) in the country including Bihar and if so, the details thereof and if not, the reasons therefor;
- b) Whether the Government proposes to upgrade the functioning of the existing PHCs and if so, the details thereof, State/UT-wise and if not, the reasons therefor;
- c) Whether the Government proposes to interlink all PHCs in a State or district for better coordination in the country; and
- d) If so, the details thereof and if not, the reasons therefor?

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY

## ANSWER WELFARE (DR. BHARATI PRAVIN PAWAR)

- (a) The Ministry of Health and Family Welfare provides technical and financial support to the States/UTs to strengthen the public healthcare system, based on the proposals received in the form of Programme Implementation Plans (PIPs) under National Health Mission.  Government of India provides approval for the proposal in the form of Record of Proceedings (RoPs) as per norms & available resources.

As per established norms, a PHC in rural areas is to be established for a population of 20,000 (in hilly and tribal areas) and 30,000 (in plains)

As per RHS 2021-22, State/UT-wise details of PHCs is at Annexure-I.

(b) In February 2018, the Government of India announced 1,50,000 Ayushman Bharat- Health and Wellness Centres (AB-HWCs) to be established across the country by December 2022. The existing Sub- Health Centres (SHC), Primary Health Centres (PHC) and Urban Primary Health Centres (UPHC) are transformed into AB-HWCs to deliver Comprehensive Primary Health Care (CPHC) that includes preventive, promotive, curative, palliative and rehabilitative services which are universal, free, and closer to the community.

XV-Finance  Commission  Health  Grants  through  Local  Government  announced  as  part  of Union Budget 2021-22, for strengthening the healthcare system at primary healthcare level, has recommended grants aggregating to Rs. 70,051 crores over the period of five years (20212026).

As on 31.01.2023  a total  of  1,56,412  AB-HWCs  have  been  operationalized  across  the country. Further, as on 19.12.2022 details of the operationalized PHC-HWCs, State/UTs wise is at Annexure-II.

(c) & (d): For better coordination to ensure Comprehensive Primary Care in the country there is an existing referral mechanism starting from community level (Primary Health Care) to District level  (Tertiary  Health  Care).  The  AB-HWCs  provide  e-Sanjeevani  -  teleconsultation  services, whereby medical officer from PHC can access higher level consultation, including with specialists in secondary and tertiary care centres.

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| SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER           | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   | SHORTFALL IN PRIMARY HEALTH CENTRES AS PER   |
|----------------------------------------------|----------------------------------------------|------------------------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|----------------------------------------------|
| S.N o.                                       | State/ UT                                    | Estimated mid-year population for Urban areas (as on | PHCs (URBAN)                                 | PHCs (URBAN)                                 | PHCs (URBAN)                                 | PHCs (URBAN)                                 | PHCs (RURAL )                                | PHCs (RURAL )                                | PHCs (RURAL )                                | PHCs (RURAL )                                |
| S.N o.                                       | State/ UT                                    | Estimated mid-year population for Urban areas (as on | Required                                     | In Position                                  | Shortf all                                   | %                                            | Required                                     | In Position                                  | Shortfa ll                                   | % Shorfall                                   |
| S.N o.                                       | State/ UT                                    | 1st July 2022)                                       | R                                            | P                                            | S                                            | Shorfall                                     | R                                            | P                                            | S                                            |                                              |
| 1                                            | Andhra Pradesh                               | 19129000                                             | 383                                          | 547                                          | *                                            | *                                            | 1167                                         | 1142                                         | 25                                           | 2                                            |
| 2                                            | Arunachal Pradesh                            | 395000                                               | 8                                            | 5                                            | 3                                            | 37                                           | 52                                           | 126                                          | *                                            | *                                            |
| 3                                            | Assam                                        | 5494000                                              | 110                                          | 90                                           | 20                                           | 18                                           | 1068                                         | 920                                          | 148                                          | 14                                           |
| 4                                            | Bihar                                        | 15348000                                             | 307                                          | 268                                          | 39                                           | 13                                           | 3698                                         | 1492                                         | 2206                                         | 60                                           |
| 5                                            | Chhattisgarh                                 | 8059000                                              | 161                                          | 52                                           | 109                                          | 68                                           | 864                                          | 770                                          | 94                                           | 11                                           |
| 6                                            | Goa                                          | 1179000                                              | 24                                           | 4                                            | 20                                           | 83                                           | 14                                           | 24                                           | *                                            | *                                            |
| 7                                            | Gujarat                                      | 34333000                                             | 687                                          | 330                                          | 357                                          | 52                                           | 1361                                         | 1474                                         | *                                            | *                                            |
| 8                                            | Haryana                                      | 12498000                                             | 250                                          | 103                                          | 147                                          | 59                                           | 582                                          | 394                                          | 188                                          | 32                                           |
| 9                                            | Himachal Pradesh                             | 766000                                               | 15                                           | 17                                           | *                                            | *                                            | 229                                          | 553                                          | *                                            | *                                            |
| 10                                           | Jharkhand                                    | 10199000                                             | 204                                          | 70                                           | 134                                          | 66                                           | 1115                                         | 291                                          | 824                                          | 74                                           |
| 11                                           | Karnataka                                    | 29720000                                             | 594                                          | 383                                          | 211                                          | 36                                           | 1313                                         | 2138                                         | *                                            | *                                            |
| 12                                           | Kerala                                       | 26368000                                             | 527                                          | 164                                          | 363                                          | 69                                           | 314                                          | 780                                          | *                                            | *                                            |
| 13                                           | Madhya Pradesh                               | 24840000                                             | 497                                          | 306                                          | 191                                          | 38                                           | 2311                                         | 1266                                         | 1045                                         | 45                                           |
| 14                                           | Maharashtra                                  | 60791000                                             | 1216                                         | 686                                          | 530                                          | 44                                           | 2323                                         | 1853                                         | 470                                          | 20                                           |
| 15                                           | Manipur                                      | 1033000                                              | 21                                           | 21                                           | 0                                            | 0                                            | 86                                           | 74                                           | 12                                           | 14                                           |
| 16                                           | Meghalaya                                    | 686000                                               | 14                                           | 25                                           | *                                            | *                                            | 127                                          | 122                                          | 5                                            | 4                                            |
| 17                                           | Mizoram                                      | 675000                                               | 14                                           | 9                                            | 5                                            | 33                                           | 27                                           | 57                                           | *                                            | *                                            |
| 18                                           | Nagaland                                     | 996000                                               | 20                                           | 7                                            | 13                                           | 65                                           | 59                                           | 129                                          | *                                            | *                                            |
| 19                                           | Odisha                                       | 8622000                                              | 172                                          | 105                                          | 67                                           | 39                                           | 1409                                         | 1288                                         | 121                                          | 9                                            |
| 20                                           | Punjab                                       | 12724000                                             | 254                                          | 100                                          | 154                                          | 61                                           | 595                                          | 422                                          | 173                                          | 29                                           |
| 21                                           | Rajasthan                                    | 21333000                                             | 427                                          | 276                                          | 151                                          | 35                                           | 2136                                         | 2133                                         | 3                                            | 0                                            |
| 22                                           | Sikkim                                       | 327000                                               | 7                                            | 2                                            | 5                                            | 69                                           | 14                                           | 24                                           | *                                            | *                                            |
| 23                                           | Tamil Nadu                                   | 40950000                                             | 819                                          | 464                                          | 355                                          | 43                                           | 1202                                         | 1422                                         | *                                            | *                                            |
| 24                                           | Telangana                                    | 17877000                                             | 358                                          | 256                                          | 102                                          | 28                                           | 714                                          | 578                                          | 136                                          | 19                                           |
| 25                                           | Tripura                                      | 1585000                                              | 32                                           | 9                                            | 23                                           | 72                                           | 101                                          | 108                                          | *                                            | *                                            |
| 26                                           | Uttarakhand                                  | 4112000                                              | 82                                           | 76                                           | 6                                            | 8                                            | 252                                          | 531                                          | *                                            | *                                            |
| 27                                           | Uttar Pradesh                                | 56021000                                             | 1120                                         | 594                                          | 526                                          | 47                                           | 5955                                         | 2919                                         | 3036                                         | 51                                           |

| 28   | West Bengal               | 36057000   |   721 |   456 | 265   | 37   | 2171   | 915   | 1256   | 58    |
|------|---------------------------|------------|-------|-------|-------|------|--------|-------|--------|-------|
| 29   | A&NIslands                | 176000     |     4 |     5 | *     | *    | 7      | 22    | *      | *     |
| 30   | Chandigarh                | 1222000    |    24 |    43 | *     | *    | N App  | N App | N App  | N App |
| 31   | D &NHaveli and Daman& Diu | 966000     |    19 |     2 | 17    | 90   | 10     | 12    | *      | *     |
| 32   | Delhi                     | 20991000   |   420 |   545 | *     | *    | 3      | 5     | *      | *     |
| 33   | Jammu & Kashmir           | 4111000    |    82 |    82 | 0     | 0    | 335    | 891   | *      | *     |
| 34   | Ladakh                    | 91000      |     2 |     1 | 1     | 45   | 10     | 32    | *      | *     |
| 35   | Lakshadweep               | 67000      |     1 |     0 | 1     | 100  | 0      | 4     | *      | *     |
| 36   | Puducherry                | 1136000    |    23 |    15 | 8     | 34   | 16     | 24    | *      | *     |
|      | All India                 | 48088000 0 |  9618 |  6118 | 3822  | 39.7 | 31640  | 24935 | 9742   | 31    |

Notes: The requirement is calculated using the prescribed norms on the basis of urban population from midyear population (as on 1st July 2022).  All India shortfall is derived by adding state-wise figures of shortfall ignoring the existing surplus in some of the states.

The required no. of PHCs is based on the population norms of 50000 and is rounded off to nearest integer.

R: Required; P: In Position; S: Shortfall;     *: Surplus

## Annexure-II

## Cumulative no. of PHCs (Rural & Urban) operationalized as AB-HWCs

(Source: AB-HWC portal as on 19.12.2022)

|   S.N. | State/UT                       | Rural PHC   |   Urban PHC |
|--------|--------------------------------|-------------|-------------|
|      1 | Andaman &Nicobar Islands       | 22          |           5 |
|      2 | Andhra Pradesh                 | 1,144       |         386 |
|      3 | Arunachal Pradesh              | 91          |           4 |
|      4 | Assam                          | 914         |          53 |
|      5 | Bihar                          | 1,140       |         106 |
|      6 | Chandigarh                     | 0           |          29 |
|      7 | Chhattisgarh                   | 748         |          59 |
|      8 | Dadra Nagar Haveli &Daman &Diu | 12          |           0 |
|      9 | Goa                            | 57          |           4 |
|     10 | Gujarat                        | 1,470       |         323 |
|     11 | Haryana                        | 386         |         106 |
|     12 | Himachal Pradesh               | 465         |          19 |
|     13 | Jammu &Kashmir                 | 588         |          45 |
|     14 | Jharkhand                      | 192         |          57 |
|     15 | Karnataka                      | 2,166       |         361 |
|     16 | Kerala                         | 850         |          98 |
|     17 | Ladakh                         | 32          |           1 |
|     18 | Lakshadweep                    | 6           |           0 |
|     19 | Madhya Pradesh                 | 1,118       |         138 |
|     20 | Maharashtra                    | 1,859       |         582 |
|     21 | Manipur                        | 87          |           9 |
|     22 | Meghalaya                      | 112         |          18 |
|     23 | Mizoram                        | 55          |           8 |
|     24 | Nagaland                       | 75          |           7 |
|     25 | Odisha                         | 1,260       |         106 |
|     26 | Puducherry                     | 24          |          21 |
|     27 | Punjab                         | 381         |          98 |
|     28 | Rajasthan                      | 2,034       |         292 |
|     29 | Sikkim                         | 22          |           2 |
|     30 | Tamil Nadu                     | 1,381       |         460 |
|     31 | Telangana                      | 633         |         226 |
|     32 | Tripura                        | 105         |           9 |
|     33 | Uttar Pradesh                  | 2,376       |         535 |
|     34 | Uttarakhand                    | 400         |          38 |
|     35 | West Bengal                    | 915         |         459 |