Lok Sabha Question No. 815 (UNSTARRED), answered on 2021-07-23
Subject: Strengthening of Primary Healthcare System
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Devendrappa Y

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

## LOK SABHA U NSTARRED QUESTION NO. 815 RD

## TO BE ANSWERED ON 23 JULY, 2021

## STRENGTHENING OF PRI MARY HEALTHCARE SYST EM

## 815. SHRI Y. DEVENDR APPA:

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

- (a)  whether  the  Government  has  any  proposal  to stengthen  primary  healthcare  system  by maximising the efficiency and effectiveness of Primary Healthcare Centres;
- (b) if so, the details thereof;
- (c) whether the Government has earmarked any fund for this purpose; and
- (d) 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 PRAVI N PAWAR )

(a)  to  (d):  'Public  Health  &  Hospitals'  being  a  State  subject,  the  primary  responsibility  for ensuring  healthcare  services  including  strengthening  of  Primary  Healthcare  system  lies respective State Governments.

To  address  the  healthcare challenges,  particularly  in  rural  areas,  the  National  Rur Health  Mission  (NRHM)  was  launched  in  2005  to  supplement  the  efforts  of  the  State/U governments  to  provide  accessible,  affordable  and  quality  healthcare  to  all  those  who public health faci lities. Currently, NRHM is a sub - mission of National Health Mission (NHM).

As per the budget announcement 2017 - 18,  1.5  lakh  Health  Sub  Centres  and  Primary Health Centres are to be transformed into Health and Wellness Centres (HWCs) by December, 2022. The roll out plan of Ayushman Bharat -HWCs is given as below:

- FY 2018- 19 = 15,000
- FY 2019- 20 = 25,000 (Cumulative 40,000)
- FY 2020- 21 = 30,000 (Cumulative 70,000)
- FY 2021- 2022 = 40,000 (Cumulative 1,10,000)
- Till 31 st December 2022 = 40,000 (Cumulative 1,50,000)

Under Ayushman Bharat (AB - HWCs) provision of comprehensive primary care includes preventive  healthcare  and  health  promotion  at  the  community  level  with  continuum  of approach for all. Services at AB - HWCs are free and un iversal to all individuals residing in the service area including mental health services.

Besides  expanding  and  strengthening  the  existing  Reproductive  and  Child  Healt (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) an incrementally adding other primary healthcare services for mental health, ENT, Ophthalmology, oral health, geriatric and palliative health care and trauma care etc.

So  far,  approvals  for  above  1,50,115  Ayushman  Bharat - Health  &  Wellness  Centres (HWCs) have been accorded. Out of those, as reported by the States/UTs on the HWC Portal, 77,406  Health  &  Wellness  Centres  have  been  operationalized  till  20 th July,  2021  (State  wise functional Health and Wellness Centres as on 20 th July 2021 is given at Annexure).

Central assistance released to the States/UTs under National Health Mission (NHM) since its inception during 2013 - 14 to 2020 - 21 is as follows:

- i. FY 2013- 14: Rs.17,407.39 crore
- ii. FY 2014- 15: Rs.18,288.50 crore
- iii. FY 2015- 16: Rs.18,065.50 crore
- iv. FY 2016- 17: Rs.18,424.43 crore
- v. FY 2017- 18: Rs.25,465.28 crore
- vi. FY 2018- 19: Rs.24,998.81 crore
- vii. FY 2019- 20: Rs.28,939.64 crore
- viii. FY 2020- 21: Rs.29,455.72 crore

## Annexure on Functional Health and Wellness Centres as on 20 th July 2021

| SN                   | STATE                                       | Functional HWCsas on 20 th July 2021   | Functional HWCsas on 20 th July 2021   | Functional HWCsas on 20 th July 2021   | Functional HWCsas on 20 th July 2021   |
|----------------------|---------------------------------------------|----------------------------------------|----------------------------------------|----------------------------------------|----------------------------------------|
| SN                   | STATE                                       | SHC-HWC*                               | PHC-HWC** 17                           | UPHC-HWC***                            | TOTAL                                  |
| 1                    | &Nicobar Islands                            |                                        |                                        |                                        |                                        |
|                      | Andaman                                     | 58 2,904 136                           | 1,145 63                               | 5 243 4                                | 80 4,292                               |
| 2 3 4                | Andhra Pradesh Arunachal Pradesh Assam      |                                        |                                        |                                        | 203                                    |
| 5                    | Bihar                                       | 1,539 1,057                            |                                        |                                        | 2,209 2,174                            |
|                      |                                             | 0                                      | 617 1,019                              | 53 98                                  |                                        |
|                      |                                             |                                        | 28                                     | 45                                     |                                        |
| 6                    | Chandigarh                                  | 2,457 52                               | 634                                    |                                        | 28 3,136                               |
| 7 8                  | Chhattisgarh Dadra &Nagar Haveli Daman &Diu | 26                                     | 8 4                                    |                                        | 60 30                                  |
|                      | Goa                                         |                                        |                                        |                                        |                                        |
| 9                    |                                             |                                        |                                        |                                        | 112                                    |
| 10 11                |                                             | 53 4,468 430                           | 54 1,469 360                           | 5 316 100                              | 6,253 890                              |
| 12                   | Gujarat                                     |                                        | 497                                    | 14                                     |                                        |
|                      | Haryana                                     | 554                                    | 378                                    | 16                                     | 1,065 1,309                            |
|                      | Himachal Pradesh Jammu &Kashmir Jharkhand   |                                        |                                        |                                        |                                        |
| 13 14 15             | Karnataka                                   | 915                                    |                                        | 54                                     |                                        |
| 16                   | Kerala                                      | 1,378 3,298 1,520                      | 177 2,166 859                          | 365 93                                 | 1,609                                  |
| 17                   |                                             |                                        |                                        |                                        | 5,829 2,472                            |
|                      |                                             | 69                                     | 20                                     |                                        | 89                                     |
|                      | Ladakh                                      |                                        |                                        |                                        |                                        |
| 18 19 20             | Lakshadweep Madhya Pradesh Maharashtra      | 0                                      | 3                                      |                                        | 3 6,367 8,657                          |
| 21                   | Manipur                                     | 5,098 6,376 154                        | 1,124 1,824                            | 145 457                                | 211                                    |
|                      | Meghalaya                                   |                                        | 55 78 53                               | 2 19 8                                 | 279 181                                |
| 22                   |                                             | 182 120 168                            | 48                                     |                                        |                                        |
| 23 24 25             | Mizoram Nagaland                            | 316                                    |                                        |                                        |                                        |
|                      |                                             |                                        | 1,229 39                               | 7 90 2                                 | 223 1,635                              |
| 26 27                | Odisha Puducherry                           |                                        |                                        |                                        | 121                                    |
| 28                   |                                             | 80 2,270 160                           |                                        |                                        | 2,691 2,397                            |
| 29                   | Punjab Rajasthan Sikkim                     | 74                                     | 328 1,957 16                           | 93 280 1                               | 91                                     |
|                      | Tamil                                       |                                        |                                        |                                        |                                        |
| 30 31                | Nadu Telangana                              |                                        | 1,381                                  |                                        |                                        |
|                      |                                             | 3,027 1,875                            | 634                                    | 460 223 5                              | 4,868 2,732                            |
| 32 33                | Tripura Uttar Pradesh Uttarakhand           | 241 6,644 536                          | 33 1,656 359                           | 435 38                                 | 279 8,735 933                          |
| 34                   |                                             |                                        |                                        |                                        |                                        |
| 35 West Bengal Total | 35 West Bengal Total                        | 4,041 52,276                           | 783 21,115                             | 339 4,015                              | 5,163 77,406                           |

Delhi do not implement HWC Programme

**- Primary Health Centre Health and Wellness Centre

***- Primary Health Centre Health and Wellness Centre