Lok Sabha Question No. 1081 (UNSTARRED), answered on 2021-12-03
Subject: Lack of Medical and Testing Facilities in Uttar Pradesh
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Girish Chandra

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

## LOK SABHA UNSTARRED QUESTION NO. 1081

## TO BE ANSWERED ON THE 03 rd  DECEMBER, 2021

## LACK OF MEDICAL AND TESTING FACILITIES IN UTTAR PRADESH

## 1081. SHRI GIRISH CHANDRA:

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

- a) whether it is a fact that  several villages in  Uttar Pradesh are lacking  even in basic testing facilities and medical care;
- b) if so, the measures being taken to boost health facilities in rural areas of the country so that in addition to health, the economic condition of the country also improves; and
- c) the number of doctors (department-wise) that are working in all the District Hospitals and CHCs in Uttar Pradesh?

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

(a) and (b)

'Public Health and Hospitals' is a State subject, the primary responsibility of strengthening public healthcare system, including for provision of testing facilities and medical care, lies with  the  respective  State  Governments  including  Uttar  Pradesh.    However,  Ministry  of Health and Family Welfare, Governemt of India provides technical and financial support to the States/UTs to strengthen the public healthcare delivery at public healthcare facilities.

Support  is  provided  to  states/UTs  under  the  National  Health  Mission  for  strengthening  of accessible, affordable health care facilities through boosting of health facilities in rural areas as per norms and upgradation of existing facilities to bridge the infrastructure gaps based on the requirements posed by them in their Programme Implementation Plans (PIPs).

NHM assistance is provided to strengthen the free provision of various services for maternal health,  child  health,  family  planning,  the  universal  immunisation  program,  and  major diseases  such  as  tuberculosis,  vector-borne  diseases  such  as  malaria,  dengue,  and  kalazar, HIV/AIDS, leprosy, and so on. Other major initiatives for which states are supported include Janani  Shishu  Suraksha  Karyakram  (JSSK),  Rashtriya  Bal  Swasthya  Karyakram  (RBSK), RashtriyaKishorSwasthyaKaryakram (RKSK),strengthening primary healthcare and District Hospitals etc.

As part  of  Ayushman  Bharat,  the  States  are  supported  for  establishment  Ayushman  Bharat Health and Wellness Centres across the country for provision of comprehensive primary care that  includes  preventive  healthcare  and  health  promotion  at  the  community  level  with continuum of care approach. Besides expanding and strengthening the existing Reproductive and  Child  Health  (RMNCHA+N)  services  and  Communicable  Diseases  services,  the functional  AB-HWCs  provide  services  related  to  Non-Communicable  Diseases  (NCDs) (screening and management for NCDs such as Hypertension, Diabetes and 3 common cancers of  Oral,  Breast  and  Cervix)  and  incrementallyadding  other  primary  healthcare  services  for mental  health,  ENT,  Ophthalmology,  oral  health,  geriatric  and  palliative  health  care  and trauma care etc.Out of those, as reported by the States/UTs on the HWC Portal, 80466 Health & Wellness Centres have been operationalized till 28 th November, 2021.

Other initiative such as Mobile Medical Units (MMUs), PM National Dialysis Programme and  Tele-consultation  services  are  also  implemented  to  improve  access  to  healthcare particularly in rural areas.

Under Free Diagnostic Services, support is provided to States / UTs for provision of medical equipmentsto enables access and use of high-quality diagnostic services (134 tests at DHs, 111 tests at the SDHs, 97 at CHCs, 63 tests at PHC level AB-HWCs and 14 tests at SHC level AB-HWCs), including Hub and Spoke Model and Public Private Partnerships.

Similarly,  under  Free  Drugs  Service  Initiative,  provision  is  made  to  provide  free  essential medicines (544 medicines at DHs, 455 medicinesat CHCs, 172 medicinesat PHC and 105 medicinesat  SHC)  in  public  health  facilities  based  on  the  requirements  posted  by  them  in their  Programme  Implementation Plans (PIPs) within their overall resource  envelope. This support also includes for strengthening/setting up of robust systems of procurement, quality assurance mechanism, warehousing, and IT backed supply chain management systems like Drugs and Vaccines Distribution Management Systems (DVDMS).

Ayushman  Bharat-  Pradhan  Mantri  Jan  Arogya  Yojana  (AB-PMJAY),  provides  health coverage of up to Rs 5 lakh per family per year to around 10.74 crore poor and vulnerable families in the country as per Socio Economic Caste Census (SECC).

These interventions reduce the out of pocket expenditure (OOPE) of the citizens and improve the general wellbeing leading to increase in productivity and improved economic conditions.The OOPE has reduced from 64.2 percentin 2013-14 to 48.8 percent in 2017-18, of total health expenditure as per National Health Account of 2017-18.

(c)

Rural Health Statistics (RHS) is an annual publication, based on Health care administrative data  reported  by  States/UTs.  RHS  provides  information  on  rural  health  infrastructure  and requirements of public health facilities in rural/tribal areas as reported by States. As per the RHS 2019-20, the number of doctors (department-wise) that are working in all the District Hospitals/Sub  Divisional/ Sub  Divisional Hospital and  CHCs  in  Uttar  Pradesh  is at Annexure-I and II respectively.

One per Community Health Centre as per IPHS norms

## Annexure-I

| NUMBER OF DOCTORS AT DISTRICT HOSPITAL AND SUB DISTRICT/ SUB DIVISIONAL HOSPITAL IN UTTAR PRADESH   | NUMBER OF DOCTORS AT DISTRICT HOSPITAL AND SUB DISTRICT/ SUB DIVISIONAL HOSPITAL IN UTTAR PRADESH   | NUMBER OF DOCTORS AT DISTRICT HOSPITAL AND SUB DISTRICT/ SUB DIVISIONAL HOSPITAL IN UTTAR PRADESH   | NUMBER OF DOCTORS AT DISTRICT HOSPITAL AND SUB DISTRICT/ SUB DIVISIONAL HOSPITAL IN UTTAR PRADESH   |
|-----------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------|
|                                                                                                     | (As on 31st March, 2020)                                                                            | (As on 31st March, 2020)                                                                            | (As on 31st March, 2020)                                                                            |
| S. No.                                                                                              | State/UT                                                                                            | DISTRICT HOSPITAL                                                                                   |                                                                                                     |
|                                                                                                     |                                                                                                     | Sanctioned                                                                                          | In Position                                                                                         |
| 1                                                                                                   | DOCTORS AT DISTRICT HOSPITAL AND SUB DISTRICT/ SUB DIVISIONAL HOSPITAL                              | 3486                                                                                                | 2849                                                                                                |

## Annexure-II

| Doctors in Community Health Centres in Rural Areas in Uttar Pradesh   | Doctors in Community Health Centres in Rural Areas in Uttar Pradesh     | Doctors in Community Health Centres in Rural Areas in Uttar Pradesh   | Doctors in Community Health Centres in Rural Areas in Uttar Pradesh   | Doctors in Community Health Centres in Rural Areas in Uttar Pradesh   | Doctors in Community Health Centres in Rural Areas in Uttar Pradesh   | Doctors in Community Health Centres in Rural Areas in Uttar Pradesh   |
|-----------------------------------------------------------------------|-------------------------------------------------------------------------|-----------------------------------------------------------------------|-----------------------------------------------------------------------|-----------------------------------------------------------------------|-----------------------------------------------------------------------|-----------------------------------------------------------------------|
| S. No.                                                                | Human Resource                                                          | (As on 31st March 2020)                                               | (As on 31st March 2020)                                               | (As on 31st March 2020)                                               | (As on 31st March 2020)                                               | (As on 31st March 2020)                                               |
| S. No.                                                                | Human Resource                                                          | Required 1                                                            | Sanctioned                                                            | In Position                                                           | Vacant                                                                | Shortfall                                                             |
| S. No.                                                                | Human Resource                                                          | [R]                                                                   | [S]                                                                   | [P]                                                                   | [S-P]                                                                 | [R-P]                                                                 |
| 1                                                                     | AYUSH specialists at CHCs in Rural Areas                                | 711                                                                   | 374                                                                   | 202                                                                   | 172                                                                   | 509                                                                   |
| 2                                                                     | General Duty Medical Officers (GDMOs)- AYUSH at CHC in Rural Areas      | 711                                                                   | 580                                                                   | 510                                                                   | 70                                                                    | -                                                                     |
| 3.                                                                    | General Duty Medical Officers (GDMOs)- Allopathic at CHC in Rural Areas | 1422                                                                  | 1793                                                                  | 1793                                                                  | 0                                                                     | -                                                                     |
| 4                                                                     | SURGEONS at CHCs in Rural Areas                                         | 711                                                                   | 527                                                                   | 166                                                                   | 361                                                                   | 545                                                                   |
| 5                                                                     | OBSTETRICIANS& GYNAECOLOGISTS at CHCs in Rural Areas                    | 711                                                                   | 513                                                                   | 161                                                                   | 352                                                                   | 550                                                                   |
| 6                                                                     | PHYSICIANS at CHCs in Rural Areas                                       | 711                                                                   | 639                                                                   | 309                                                                   | 330                                                                   | 402                                                                   |
| 7                                                                     | PAEDIATRICIANS at CHCs in Rural Areas                                   | 711                                                                   | 492                                                                   | 180                                                                   | 312                                                                   | 531                                                                   |

Note:

1