Lok Sabha Question No. 331 (STARRED), answered on 2022-03-25
Subject: Gender disparity in healthcare services
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sarmistha Sethi

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

## LOK SABHA STARRED QUESTION NO.331

## TO BE ANSWERED ON THE 25 TH  MARCH, 2022

## GENDER DISPARITY IN HEALTHCARE SERVICES

## *331. SHRIMATI SARMISTHA SETHI:

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

- (a) whether the Government is aware of the gender disparity in access to healthcare services in the country;
- (b) if so, the details thereof;
- (c) the necessary steps taken/proposed to be taken by the Government to imporve access to quality and affordable healthcare services to women in the country; and
- (d) if so, the details thereof?

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

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

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 331* FOR 25 TH  MARCH, 2022

- (a) to (d) : 'Public Health and Hospitals' is a State subject, hence, the primary responsibility  of  providing  healthcare  services  to  the  people  of  the  county, including women, lies with the State Governments. However, Ministry of Health and  Family  Welfare,  Government  of  India,  provides  technical  and  financial support to the States/UTs to strengthen the public healthcare facilities. Support is provided to States/UTs under the National Health Mission (NHM) for universal access to equitable, affordable & quality health care services to all citizens of the country including women based on the requirements posed by States/UTs in their Programme  Implementation  Plans  (PIPs)  and  within  their  overall  resource envelope.  Under  NHM,  States  are  supported  for  several  interventions  towards strengthening the primary healthcare services in the country. Under NHM, several steps  have  been  taken  for  making  treatment  affordable  to  the  people  of  the country,  including  women,  and  reducing  the  out-of-pocket  expenses  which  are given at Annexure .    Among them, some initiatives taken for making treatment affordable to the women of the country are as under:-
-  Pradhan Mantri Surakshit Matriva Abhiyan (PMSMA): States/ UTs are supported to ensure quality antenatal care to pregnant women in the country on the 9 th of every month.
-  Surakshit Matritva Aashwasan (SUMAN): States/  UTs are supported to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every women and new-born visiting the public health  facility  in  order  to  all  preventable  maternal  and  new-born  deaths  and morbidities and provide a positive birthing experience.
-  Janani  Suraksha  Yojana  (JSY): promotes  institutional  delivery  among pregnant  women  especially  with  weak  socio-economic  status  i.e  women  from Scheduled Castes, Scheduled Tribes and BPL households.
-  Further,  initiatives  such  as Mission  Parivar  Vikas,  Adolescent  Friendly Health Clinics (AFHCs), Weekly Iron Folic Acid Supplementation (WIFS), Menstrual  Hygiene  Scheme,  Facility  Based  Newborn  Care  (FBNC),  Home Based Newborn  Care Programme, Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS), Home Based Care for Young Child (HBYC), Rashtriya Bal Swasthya Karyakram (RBSK), Early Childhood Development (ECD), Comprehensive Abortion Care(CAC), Anemia Mukt Bharat (AMB) strategy, Nutrition Rehabilitation Centre(NRC)  program are  supported  to  increase  access  to  quality  healthcare services. Support  is also provided  to strengthen Universal  Immunization programme and introduction of new vaccines etc.

Several  steps  taken  for  making  treatment  affordable  to  the  people  of  the county, including women, and reducing the out-of-pocket expenses

-  Ayushman  Bharat  -  Health  &  Wellness  Centres  (AB-HWCs): 1,50,000 Sub-  Health  Centres  (SHCs),  Primary  Health  Centres  (PHCs)  and  Urban Primary  Health  Centres  (UPHCs)  are  being  transformed  into  Ayushman Bharat- Health and Wellness Centres (AB-HWCs) to deliver twelve packages of  Comprehensive  Primary  Health  Care  (CPHC)  that  includes  preventive, promotive, curative, palliative and rehabilitative services which are universal. Another essential component of AB-HWCs is the roll out of tele-consultation services through 'eSanjeevani'.
-  National Free Drugs Initiative: provides essential drugs based on the level of public health facilities free of cost to all who access these facilities. States are assisted to set up robust IT backed procurement, quality assurance, warehouses, and supply chain systems that are benchmarked for key management processes with the best practices in this field.
-  Free Diagnostics Initiative (FDI): provides support to States/UTs to provide a set of essential diagnostics at various levels of care, free of cost (14 tests at Sub Centre/ Health and Wellness Centre level, 63 tests at PHC/ PHC-HWC level, 97 tests at CHC level, 111 tests at SDH level and 134 tests at DH level).
-  National Ambulance Services (NAS): supports  emergency  medical services in  States/UTs  through  a  functional  National  Ambulance  Service  (NAS) network linked with a centralised toll-free number 108/102.
-  National Mobile Medical Units (NMMU): facilitates access to public health care  at  the  doorstep  particularly  to  people  living  in  remote,  difficult,  underserved and unreached areas to provide primary care services.
-  Pradhan  Mantri  Surakshit  Matriva  Abhiyan  (PMSMA): States/  UTs  are supported to ensure quality antenatal care to pregnant women in the country on the 9 th of every month.
-  Surakshit  Matritva  Aashwasan  (SUMAN): States/  UTs  are  supported  to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance  for  denial  of  services  for  every  women  and  new-born  visiting  the public health facility in order to all preventable maternal and new-born deaths and morbidities and provide a positive birthing experience.
-  Janani  Suraksha  Yojana  (JSY): promotes  institutional  delivery  among pregnant women especially with weak socio-economic status i.e women from Scheduled Castes, Scheduled Tribes and BPL households.

The other important health programmes/schemes with the focus to strengthen the health care systems to improve access are:

-  Ayushman  Bharat  -  PradhanMantri  Jan  ArogyaYojana(AB-PMJAY) which  provides  health  coverage  up  to  Rs.  5.00  lakh  per  family  per  year  to around identified 10.74 crore poor and vulnerable families identified based on Socio Economic Caste Census (SECC) data.
-  Fifteen Finance Commission: Health sector grants through local government has recommended grants aggregating to Rs. 70,051 Crores over the period of five  years  (2021-2026) through local government to strengthen the healthcare system in states.
-  Pradhan  Mantri  Ayushman  Bharat  Health  Infrastructure  Mission  (PMABHIM ) with an outlay of Rs. 64,180 Crores aims to fill critical gaps in public health  infrastructure.  It  is  a  Centrally  Sponsored  Scheme  with  some  Central Sector  components.  The  Centrally  Sponsored  Scheme  (CSS)  Components includes support for infrastructure development for Sub-Health Centres, Urban Health  and  Wellness  Centres,  Support  for  3382  BPHUs,  Integrated  District Public Health Laboratories and Critical Care Hospital Blocks.
-  A Centrally Sponsored Scheme for 'Establishment of new Medical Colleges attached  with  existing  district/referral  hospitals' ,  under  the  Ministry  has approved  establishment  of  157  new  medical  colleges  in  three  phases.  Out  of these, 70 medical colleges have become functional till date. This Scheme aims to  increase  the  availability  of  health  professionals,  reduce  disparities  in  the existing geographical distribution of medical colleges in the country, promote affordable  medical  education  in  the  country  and  improve  tertiary  care  in  the Government  sector  which  will  benefit  all  citizens  of  the  country,  including women.
-  "Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)' under the Ministry aims  to  correct  regional  imbalances  in  the  availability  of  affordable/reliable tertiary  healthcare  services  and  also  to  augment  facilities  for  quality  medical education  in  the  country  benefitting  all  citizens  of  the  country  including women. PMSSY, a Central Sector Scheme, has two components - (i) setting up of AIIMS-like institutions; and (ii) up-gradation of existing State Government Medical  College/Institutions.  As  on  date,  establishment  of  22  AIIMS  and 75  upgradation  projects of GMCs/Institutes  have  been  sanctioned under PMSSY.