Lok Sabha Question No. 3922 (UNSTARRED), answered on 2023-03-24
Subject: Hospitals in Backward Districts
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Omprakash Bhupalsinh alias Pawan Rajenimbalkar, Sanghamitra Maurya, Sanjay Haribhau Jadhav

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

## LOK SABHA UNSTARRED QUESTION NO. 3922 TO BE ANSWERED ON 24 TH  MARCH, 2023

## HOSPITALS IN BACKWARD DISTRICTS

## †3922.   SHRI OMPRAKASH BHUPALSINH ALIAS PAWAN RAJENIMBALKAR: DR. SANGHMITRA MAURYA: SHRI SANJAY JADHAV:

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

- (a) the number of officially identified backward districts in the country, State-wise;
- (b) whether there is a functional hospital/health centre or is proposed to be set up in each of the recognized backward districts;
- (c) if so, the details thereof and if not, the reasons therefor;
- (d)whether the Government evaluates/assesses the performance of the health care facilities/services regularly in the backward regions;
- (e) if so, the details of such evaluations made from 2014 to till date, year-wise;
- (f) whether the Government has taken steps to sort out the problems of those backward districts where the hospitals are lying inactive and being run without doctors; and
- (g) if so, the details thereof and if not, the reasons therefor?

## ANSWER

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

(DR. BHARATI PRAVIN PAWAR)

- (a): Govt. of India has identified 112 Aspirational Districts based on their performance in 49  Key  Performance  Indicators  (KPIs)  across  five  themes  namely  Health  &  Nutrition, Education, Agriculture & Water Resources, Financial Inclusion & Skill Development and Basic Infrastructure. List of 112 Aspirational Districts is at Annexure.

(b) & (c) : As per established norms, in rural areas a Sub Health Centre for a population of 5,000 (in plain) and 3000 (in hilly and tribal area), a Primary Health Centre for a population of 30,000 (in plains) and 20,000 (in hilly and tribal areas) and Community Health Centre for a population of 1,20,000 (in plain) and 80,000 (in hilly and tribal area) is suggested. Further, First Referral Unit, Sub-District Hospital (SDH) and District Hospital (DH) provide secondary care services for rural & urban area including backward areas.

Rural  Health  Statistics  (RHS)  is  an  annual  publication,  based  on  Health  care administrative data reported by States/UTs. Details of State/UT-wise number of Sub-Centres,

PHCs, CHCs, Sub-Divisional Hospital, District Hospital & Medical Colleges functioning in rural areas including backward areas may be seen at the following link of RHS 2021-22:

## https://main.mohfw.gov.in/sites/default/files/RHS%202021%2022.pdf

(d) to (g): The Government reviews functionality of the health centers as well as implementation of  various  health  programs  in  each  State  including  the  Aspirational  District  areas  through Central and State level monitoring mechanisms. From Central level, Ministry of Health and Family  Welfare  undertakes  Common  Review  Mission  (CRM)  to  review  the  progress  of National  Health  Mission  (NHM)  implementation.  In  addition  to  this,  Health  Management Information System (HMIS) data is updated by States which is available disaggregated up-tothe facility level. Similarly, aspirational district evaluation is also done by NITI Aayog based on the set indicators.

The reports of the CRM and performance evaluation of healthcare facilities, year-wise, from 2014 onwards can be accessed from the link https://nhsrcindia.org/php-crm-reports.

Similarly, Aspirational district annual report can be accessed from the link https://www.niti.gov.in/annual-reports

National  Health  Mission  (NHM)  envisages  achievement  of  universal  access  to equitable,  affordable  &  quality  health  care  services  that  are  accountable  and  responsive  to people's needs. 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). Government of India provides approval  for  the  proposals  in  the  form  of  Record  of  Proceedings  (RoPs)  as  per  norms  & available resources.

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).

PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) with an outlay of Rs.  64,180  Crores  aims  to  fill  critical  gaps  in  public  health  infrastructure.  The  Centrally Sponsored  Scheme  (CSS)  Components  includes  support  for  infrastructure  development  for Sub-Health Centres, Urban Health and Wellness Centres, Block Public Health Units, Integrated District Public Health Laboratories and Critical Care Hospital Blocks.

Under  NHM,  following  types  of  incentives  and  honorarium  are  provided  for encouraging Health Specialists to practice in different regions of the country including rural and remote areas of the country:

-  Hard area allowance to specialist doctors for serving in rural and remote areas and for their residential quarters.
-  Honorarium to Gynecologists/ Emergency Obstetric Care (EmoC) trained, Pediatricians & Anesthetist/ Life Saving Anaesthesia Skills (LSAS) trained doctors.
-  Incentives like special incentives for doctors, incentive for ANM for ensuring timely ANC checkup and recording, incentives for conducting Adolescent Reproductive and Sexual Health activities.
-  States  are  also  allowed  to  offer  negotiable  salary  to  attract  specialist  including flexibility in strategies such as 'You Quote We Pay'.
-  Non-Monetary incentives such as preferential admission in post graduate courses for staff  serving  in  difficult  areas  and  improving  accommodation  arrangement  in  rural areas have also been introduced under NHM.
-  Multi-skilling  of  doctors  is  supported  under  NHM  to  overcome  the  shortage  of specialists.

## Annexure

| List of 112 Aspirational Districts   | List of 112 Aspirational Districts   | List of 112 Aspirational Districts                                                                                                                                                    |
|--------------------------------------|--------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Sr. No.                              | State                                | District                                                                                                                                                                              |
| 1                                    | Andhra Pradesh                       | Vizianagaram,Visakhapatnam, Y.S.R. Kadapa                                                                                                                                             |
| 2                                    | Arunachal Pradesh                    | Namsai                                                                                                                                                                                |
| 3                                    | Assam                                | Goalpara, Barpeta, Hailakandi, Baksa, Darrang, Udalguri, Dhubri                                                                                                                       |
| 4                                    | Bihar                                | Sitamarhi, Araria, Purnia, Katihar, Muzaffarpur, Begusarai, Khagaria, Banka, Sheikhpura, Aurangabad, Gaya, Nawada, Jamui                                                              |
| 5                                    | Chhattisgarh                         | Korba, Rajnandgaon, Mahasamund, Kanker, Narayanpur, Dantewada, Bijapur, Bastar, Kondagaon, Sukma                                                                                      |
| 6                                    | Gujarat                              | Dahod, Narmada                                                                                                                                                                        |
| 7                                    | Haryana                              | Mewat                                                                                                                                                                                 |
| 8                                    | Himachal Pradesh                     | Chamba                                                                                                                                                                                |
| 9                                    | Jammu &Kashmir                       | Kupwara, Baramulla                                                                                                                                                                    |
| 10                                   | Jharkhand                            | Garhwa, Chatra,Giridih, Godda, Sahibganj, Pakur, Bokaro, Lohardaga, Purbi Singhbhum, Palamu, Latehar, Hazaribagh, Ramgarh, Dumka, Ranchi, Khunti, Gumla, Simdega, Pashchimi Singhbhum |
| 11                                   | Karnataka                            | Raichur, Yadgir                                                                                                                                                                       |
| 12                                   | Kerala                               | Wayanad, Chhatarpur, Damoh, Barwani, Rajgarh, Vidisha, Guna, Singrauli, Khandwa                                                                                                       |
| 13                                   | Maharashtra                          | Nandurbar, Washim, Gadchiroli, Osmanabad                                                                                                                                              |
| 14                                   | Manipur                              | Chandel                                                                                                                                                                               |
| 15                                   | Meghalaya                            | Ribhoi                                                                                                                                                                                |
| 16                                   | Mizoram                              | Mamit                                                                                                                                                                                 |
| 17                                   | Nagaland                             | Kiphire                                                                                                                                                                               |
| 18                                   | Odisha                               | Dhenkanal, Gajapati, Kandhamal, Balangir, Kalahandi, Rayagada, Koraput, Malkangiri, Nabarangpur, Nuapada                                                                              |
| 19                                   | Punjab                               | Moga, Firozpur                                                                                                                                                                        |
| 20                                   | Rajasthan                            | Dholpur, Karauli, Jaisalmer, Sirohi, Baran                                                                                                                                            |
| 21                                   | Sikkim                               | West Sikkim                                                                                                                                                                           |
| 22                                   | Tamil Nadu                           | Virudhunagar, Ramanathapuram                                                                                                                                                          |
| 23                                   | Telangana                            | Asifabad, Bhoopalapally, Bhadradri-Kothagudem                                                                                                                                         |
| 24                                   | Tripura                              | Dhalai                                                                                                                                                                                |
| 25                                   | Uttar Pradesh                        | Chitrakoot, Fatehpur, Bahraich, Shrawasti, Balrampur, Siddharthnagar, Chandauli, Sonbhadra,                                                                                           |
| 26                                   | Uttarakhand                          | Udham Singh Nagar, Haridwar                                                                                                                                                           |