Lok Sabha Question No. 914 (UNSTARRED), answered on 2021-07-23
Subject: Impact on Essential Health Services due to COVID-19
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kinjarapu Ram Mohan Naidu

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

## LOK SABHA U NSTARRED QUES TION NO. 914 TO BE ANSWERED ON 23 RD JULY, 2021

## IMPACT ON ESSENTIAL HEALTH SERVICES DUE TO COVID - 19

## 914. SHRI RAM MOHAN NAIDU KINJARAPU:

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

- (a)  whether  essential  health  services  relating  to maternal  health,  infant  &  child  health, immunisation, family  planning  or  hospital  treatment  for  major  diseases have  been  advers ely impacted since the first case of covid was reported in the country and if so, the details thereof;
- (b) the  details  of  the  provision  made  for such  essential  health  services  since  2018 - 19, State/UTwise;
- (c) whether the decline in such services is worse i n rural areas and if so, the details of percentage changeover previous year in extending such services since 2018- 19, State/UT - wise; and
- (d) whether any steps have been taken by the Government to ensure that amidst the crisis, access tosuch services rema ins uninterrupted and if so, the details thereof?

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

- (a)&  (d):    All  essential  health  services  relating  to  maternal  health,  infant  &  chil immunisation, family planning or hospital treatment for major diseases continued to be pr during  the  COVID  pandemic  period.  Public  health  and  hospitals  being  a  State  subject, primary responsibility to ensure provision of health services lies with the respective State/UT. However, MoHFW is continuously monitoring the implementation of essential health services provides required guidance and need - based technical and financial assistance to States/ UTs fro time to time.

The  Government  of  India  ha s  taken  the  following  steps  in  order  to  ensure  the uninterrupted access to such services:

- I. Issuing guidelines and advisories:
2. (i) Guidance Note on 'Enabling Delivery of Essential Health Services (including maternal,  newborn,  children,  nutrition,  immunization,  a bortion  care  and Adolescent  Health  and  hospital  treatment  for  major  diseases)  during  t COVID -19 Outbreak' was released on 14.04.20 to all States and UTs.
3. (ii) National  guidelines  to  safely  continue  immunisation  services  during  t COVID - 19 pandemic as releas ed on 21.05.20, wherein birth dose vaccination is to be continued at all health facilities with delivery points and immun services  are  to  be  provided  to  beneficiaries  who  reach  the  immunizati sessions  sites  in  containment  zones,  while  ensuring  adh erence to  COVID appropriate behaviour like physical distancing, use of mask, hand sanitizer
4. (iii) Guidance Note on Provision of RMNCAH+N Services with special focus on pregnant women and children during and post COVID - 19 Pandemic issued to states/UTs dated 24.05.2020.
5. (iv) An advisory dated 16.06.20 issued by MoHFW to all States/UTs stating that ensuring  access  to  safe  delivery  and  antenatal  and  postnatal  care  is  a -negotiable agenda and emphasized the directives at all levels in the stat prevent and pre -empt unfortunate adverse incidents.
6. (v) Appropriate communication material has been developed and shared with the States  and  UTs  for  addressing  vaccine  hesitancy  and  strengthening  routi immunization with due precautions, during COVID - 19 pandemic.
7. (vi) In  June  20 21,  MoHFW  issued  "Guideline  on  Operationalization  of  COVID care  services  for  children  and  adolescents"  with  focus  on  strengthen Paediatric  COVID  Care  services  in  the  country  and  also  on  continuing  a essential child and adolescent health services.
- II. Regular review with the States/UTs:
9. (i)  Regular  virtual  meetings by Hon'ble Union Minister for Health and Family Welfare with  the  State  Health  Ministers  to  impress  upon  them  on  the  importance  an continuation of the essential services includin g RMNCH+A services and with special focus on Pregnant women and children during COVID - 19 pandemic.
10. (ii)  Rounds  of  virtual  meetings  by  Secretary,  Health  and  Family  Welfare  with Principal  Health  Secretaries  and  Mission  Directors  of  Natio nal  Health  Mission including sharing of best practices.
11. (iii) In addition to these, various webinars/ meetings are organized by Ministry of and  Family  Welfare,  with  States/  UTs  to  review  and  guide  for  continuation  of essential se rvices during CoVID - 19 pandemic. Series of webinars were organised by AIIMS, New Delhi on treatment and management aspects of health service provision.
- III. Rolled out National Telemedicine Service -eSanjeevani
13. (i) On  13th  April  2020,  MoHFW  rolled  out  National  Tel emedicine  Service -eSanjeevani comprising of two variants of eSanjeevani namely -doctor to doctor (eSanjeevani AB -HWC) telemedicine platform and patient to doctor telemedicine platform (eSanjeevaniOPD) which provides outpatient services to the citizens the confines of their homes. Currently the eSanjeevani application is operat in 35 States/UTs and has rendered around 78 lakh consultations.
14. (ii) To  ensure  safe  and  secure  implementation  of  telemedicine  services  across  t country,  the  National  Medical  Co mmission  has  issued  Telemedicine  Practice Guidelines in March 2020.
15. (iii) eSanjeevani  application  has  also  been  integrated  with  country's  3.74  lakh Common Service Centers (CSC) to enable telemedicine services to the remotest area of the country.
- IV. In addition to above, Government of India has made provision of unique helpline 1921 in the Aarogya Setu App and 1075 as centralized Covid - 19 helpline. Moreover, for quick  transport  of  pregnant  women  and  infants  to  the  hospitals,  102,  108  and numbe rs are also operational.
- V. Supply  chain  of  vaccines  and  other  logistics  has  been  ensured  during  COVID - 19 pandemic.
- VI. Government of India also carried out Intensified Mission Indradhanush 3.0 (Intens Immunisation Drive) from February 2021 to March 2021.

( b): Provisions relating to maternal health, infant & child health, immunisation, family are included within the ambit of RMNCH+A services, which are deemed essential and contin to be essential during the Covid - 19 pandemic.

Furthermore,  during  th e  period  of  COVID - 19  pandemic,  a  series  of  guidelines  were developed  and  disseminated  for  carrying  out  these  services,  while  maintaining  COV appropriate behaviour

(c): As per data reported by states/UTs on the Health Management Information System (HMIS , the trend of key RMNCH+A services has remained stable in rural areas for 2018 - 19, 2019 -& 2020- 21. Details are placed at Annexure.

Annexure

| Health Management Information System   | Health Management Information System                        | Health Management Information System                                 | Health Management Information System                                           | Health Management Information System                          | Health Management Information System           |
|----------------------------------------|-------------------------------------------------------------|----------------------------------------------------------------------|--------------------------------------------------------------------------------|---------------------------------------------------------------|------------------------------------------------|
|                                        | %Institutional Deliveries against total reported deliveries | %Pregnant Woman received 4 ANC check- ups to Total ANC Registrations | %Newborns breast fed within 1 hour of birth against total reported live births | %Total reported live births against total reported deliveries | No. of children fully immunized in rural areas |
|                                        | Rural                                                       | Rural                                                                | Rural                                                                          | Rural                                                         | Rural                                          |
| 2018-19                                | 92%                                                         | 75%                                                                  | 92%                                                                            | 99%                                                           | 18614068                                       |
| 2019-20                                | 93%                                                         | 82%                                                                  | 93%                                                                            | 99%                                                           | 19763849                                       |
| 2020-21                                | 92%                                                         | 80%                                                                  | 93%                                                                            | 100%                                                          | 18401787                                       |

Source: HMIS data as on 20.7.21. HMIS data on no. of children fully immunized in rural areas is as on 21.7.21