Lok Sabha Question No. 3741 (UNSTARRED), answered on 2022-03-25
Subject: PHCs in Scheduled Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Naba (Hira) Kumar Sarania

- (a) to (d) :

As per RHS 2019-20, the number of Primary Health Centres in the 177 Scheduled Tribe districts in the country (As defined by Ministry of Tribal Affairs) are given at Annexure-I. Death due to hunger and malnutrition in scheduled areas is not captured in HMIS and NFHS.

There  are  1080  Nutrition  Rehabilitation  Centres  (NRCs)  operational  across  the  country.  These NRCs  provide  medical  and  nutritional  care  of  the  admitted  sick  children  with  Severe  Acute Malnutrition (SAM), including the tribal sick SAM children. The State/UT-wise list of NRCs is placed at Annexure-II.

Government of India is taking some initiatives to reduce the mortalities due to malnutrition. Some of the key measures are as under:

- i. Nutritional  Rehabilitation  Centre: As  per  Operational  Guidelines  on  Facility  Based Management  of  Children  with  Severe  Acute  Malnutrition  released  in  2011,  Nutrition Rehabilitation Centre (NRC) is a unit in a health facility where children with Severe Acute Malnutrition (SAM) are admitted and managed. The unit should be a distinct area within the health facility and should be in proximity to the pediatric ward/inpatient facility.

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

## LOK SABHA UNSTARRED QUESTION NO. 3741 TO BE ANSWERED ON 25 th  MARCH, 2022

## PHCs IN SCHEDULED AREAS

## 3741.  SHRI NABA KUMAR SARANIA:

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

- (a) the number of Primary Health Centres existing in the Scheduled districts in the country;
- (b) the  number  of  deaths  reported  due  to  hunger  and  malnutrition  in  the  scheduled  areas, State/UT/ district-wise;
- (c) the number of nutritional centres set up and functioning at present in the Scheduled areas to address the problem of malnutrition among the Scheduled Tribes children, State/UT/district-wise; and
- (d) the other measures taken by the Government to prevent such deaths?

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

(DR. BHARATI PRAVIN PAWAR)

- ii. Integrated  Child  Development  Schemes  (ICDS): Launched  on  2nd  October,  1975,  the Integrated Child Development Services (ICDS) Scheme is one of the flagship programmes of the Government of India, implemented by Ministry of Women and Child Development. It is the  foremost  symbol  of  country's  commitment  to  its  children  and  nursing  mothers,  as  a response  to  the  challenge  of  providing  pre-school  non-formal  education  on  one  hand  and breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality on the other. The beneficiaries under the Scheme are children in the age group of 0-6 years, pregnant women and lactating mothers.

The ICDS Scheme offers a package of six services, viz. (a) Supplementary Nutrition (b) Preschool  non-formal  education (c)  Nutrition  &  health  education (d) Immunization (e) Health check-up and (f) Referral services. The last three services are majorly related to health and are financially and technically supported by Ministry/Department of Health and Family Welfare implemented through the State.

- iii. Poshan  Abhiyan is  a  multi-ministerial  convergence  mission  with  the  vision  to  ensure attainment of malnutrition free India by 2022. The objective of POSHAN Abhiyaan to reduce stunting  in  identified  Districts  of  India  with  the  highest  malnutrition  burden  by  improving utilization  of  key  Anganwadi  Services  and  improving  the  quality  of  Anganwadi  Services delivery.

The Ministry  of  Women  and  Child  Development  (MWCD) is  implementing  POSHAN Abhiyaan in phased manner. There are a number of schemes directly/indirectly affecting the nutritional status of children (0-6 year's age) and pregnant women and lactating mothers.

- iv. Infant  and  young  child  feeding  practices: GOI  has  released  a  guideline  on  Infant  and young child feeding practices  to  improve  the  cognitive  development,  enhance  weight  gain and  to  prevent  malnutrition  among  children . As  per  the  guidelines  for  enhancing  optimal infant  and  young  child  feeding  practices  2013  which  includes  practices  of  initiating  breast feeding  within  one  hour  of  birth,  exclusive  breast  feeding  for  the  first  6  months  of  life, initiation of appropriate complementary feeding from the age of 6 months, continued breast feeding for 2 years and beyond.

Outpatient services are also provided, outpatient services of public health facilities comprising of:

-  Antenatal clinic
-  IYFC counselling centre
-  Sick child consultation in outpatient department
- v. Kangaroo Mother Care (KMC) and optimal feeding of low-birth-weight infants: Public health facilities encourage for Kangaroo Mother care and optimal feeding of low-birthweight infantsAs per Operational guidelines on Kangaroo Mother care and optimal feeding of low-birth-weight infants 2014, KMC is associated with reduced incidence of severe illness including pneumonia during infancy. In most of the studies KMC has been found to be more effective than incubator care for stable newborns in providing adequate thermal care, reducing nosocomial  infections,  improving  exclusive  breastfeeding  and  weight  gain,  and  fostering greater maternal and family involvement in care.

|   Sl. No. | States/Union Territory   | Name of the District   | Number of functional PHCs   |
|-----------|--------------------------|------------------------|-----------------------------|
|         1 | Andhra Pradesh           | Vishakapatnam          | 113                         |
|         2 | Arunachal Pradesh        | Anjaw                  | 6                           |
|         2 | Arunachal Pradesh        | Changlang              | 5                           |
|         2 | Arunachal Pradesh        | Dibang Valley          | 1                           |
|         2 | Arunachal Pradesh        | East Kameng            | 11                          |
|         2 | Arunachal Pradesh        | East Siang             | 11                          |
|         2 | Arunachal Pradesh        | Kurung Kumey           | 4                           |
|         2 | Arunachal Pradesh        | Lohit                  | 4                           |
|         2 | Arunachal Pradesh        | Lower Dibang Valley    | 3                           |
|         2 | Arunachal Pradesh        | Lower Subansiri        | 7                           |
|         2 | Arunachal Pradesh        | Papum Pare             | 16                          |
|         2 | Arunachal Pradesh        | Tawang                 | 6                           |
|         2 | Arunachal Pradesh        | Tirap                  | 7                           |
|         2 | Arunachal Pradesh        | Upper Siang            | 2                           |
|         2 | Arunachal Pradesh        | Upper Subansiri        | 8                           |
|         2 | Arunachal Pradesh        | West Kameng            | 5                           |
|         2 | Arunachal Pradesh        | West Siang             | 12                          |
|         3 | Assam                    | Baksa                  | 35                          |
|         3 | Assam                    | Chirang                | 24                          |
|         3 | Assam                    | Dhemaji                | 24                          |
|         3 | Assam                    | Dima Hasao             | 12                          |
|         3 | Assam                    | Karbi Anglong          | 42                          |
|         3 | Assam                    | Kokrajhar              | 46                          |
|         3 | Assam                    | Udalguri               | 24                          |
|         4 | Bihar                    | Aurangabad             | 72                          |
|         4 | Bihar                    | Banka                  | 42                          |
|         4 | Bihar                    | Gaya                   | 91                          |
|         4 | Bihar                    | Jamui                  | 39                          |
|         4 | Bihar                    | Muzaffarpur            | 103                         |
|         5 | Chhattisgarh             | Nawada Balod           | 52 30                       |
|         5 | Chhattisgarh             | Balrampur              | 28                          |
|         5 | Chhattisgarh             | Bastar                 | 41                          |
|         5 | Chhattisgarh             | Bijapur Dantewada      | 11 13                       |
|         5 | Chhattisgarh             | Dhamtari               | 27                          |
|         5 | Chhattisgarh             | Gariyaband             | 18                          |
|         5 | Chhattisgarh             | Jashpur                | 35                          |
|         5 | Chhattisgarh             | Kanker                 | 35                          |
|         5 | Chhattisgarh             | Kondagaon              | 21                          |
|         5 | Chhattisgarh             | Korba                  | 40                          |
|         5 | Chhattisgarh             | Koriya                 | 29                          |
|         5 | Chhattisgarh             | Mahasamund             | 31                          |
|         5 | Chhattisgarh             |                        |                             |

| Narayanpur          | 8     |
|---------------------|-------|
| Raigarh             | 53    |
| Rajnandgaon         | 50    |
| Sukma               | 12    |
| Surajpur            | 35    |
| Surguja             | 27    |
| Bharuch             | 46    |
| Chhota Udepur       | 51    |
| Dahod               | 99    |
| Dang                | 10    |
| Mahisagar           | 36    |
| Narmada             | 28    |
| Navsari             | 50    |
| Panchmahal          | 54    |
| Tapi                | 39    |
| Valsad              | 58    |
| Chamba              | 45    |
| Kinnaur             | 24    |
| Lahul Spiti         | 17    |
| Bokaro              | 20    |
| Chatra              | 9     |
| Dumka               | 35    |
| Garhwa              | 11    |
| Giridih             | 17    |
| Gumla               | 2     |
| Hazaribagh          | 16    |
| Jamtara             | 13    |
| Khunti              | 5     |
| Latehar             | 7     |
| Lohardaga           | 7     |
| Pakur               | 10    |
| Palamu              | 24    |
| Pashchimi Singhbhum | 16    |
| Purbi Singhbhum     | 25    |
| Ramgarh             | 8     |
| Ranchi              | 34    |
| Sahibganj           | 12    |
| Saraikela           | 13    |
| Simdega             | 8     |
| Alirajpur           | 16    |
| Anuppur             | 18    |
| Barwani             | 30    |
| Betul               | 36    |
| Burhanpur           | 15    |
| Chhindwada Dhar     | 69 52 |
| Dindori             | 22    |
| Harda               | 7     |
| Jhabua              | 21    |
| Khandwa             |       |
|                     | 31    |
| Khargone            | 63    |

| Mandla                   | 34    |
|--------------------------|-------|
| Ratlam                   | 30    |
| Seoni                    | 32    |
| Shahdol                  | 30    |
| Sidhi                    | 28    |
| Singroli                 | 15    |
| Umaria Dhule             | 13 49 |
| Gadchiroli               | 48    |
| Nandurbar                | 61    |
| Nashik                   | 156   |
| Palghar                  | 70    |
| Chandel                  | 5     |
| Churachandpur            | 11    |
| Senapati                 | 14    |
| Tamenglong               | 6     |
| Ukhrul                   | 8     |
| East Garo Hills          | 8     |
| East Jaintia Hills       | 6     |
| East Khasi Hills         | 44    |
| Ri Bhoi South Garo Hills | 10 7  |
| West Garo Hills          | 15    |
| West Khasi Hills         | 16    |
| Aizawl East              | 9     |
| Champhai                 | 11    |
| Kolasib                  | 5     |
| Lawngtlai                | 5     |
| Lunglei                  | 11    |
|                          | 6     |
| Mamit                    |       |
| Saiha Serchhip           | 4 5   |
| Mon                      | 15    |
| Dimapur                  | 12    |
| Kiphire Kohima           | 4     |
|                          | 15    |
| Longleng                 | 3     |
| Mokokchung Peren         | 17    |
|                          | 8     |
| Phek Tuensang            | 23 14 |
| Wokha                    | 13    |
| Zunheboto                | 13    |
|                          | 8     |
| Deogarh Gajapati         | 22    |
| Jharsuguda               | 20    |
| Kalahandi                | 46    |
| Kandhamal                | 40    |
|                          | 67    |
| Keonjhar Koraput         | 51    |

|    |                        | Malkangiri             |   27 |
|----|------------------------|------------------------|------|
|    |                        | Mayurbhanj             |   88 |
|    |                        | Nabarangapur           |   41 |
|    |                        | Nuapada                |   17 |
|    |                        | Rayagada               |   39 |
|    |                        | Sambalpur              |   36 |
| 16 |                        | Banswara               |   59 |
| 16 |                        | Dausa                  |   47 |
| 16 |                        | Dungarpur              |   59 |
| 16 | Rajasthan              | Pratapgarh             |   32 |
| 16 |                        | Sirohi                 |   34 |
| 16 |                        | Udaipur                |  115 |
|    |                        | East                   |    7 |
|    |                        | North                  |    5 |
| 17 | Sikkim                 | South                  |    6 |
|    |                        | West                   |    7 |
| 18 | Telangana              | Khammam                |   30 |
|    |                        | Dhalai                 |   16 |
|    |                        | Gomati                 |   11 |
| 19 | Tripura                | Khowai                 |    9 |
|    |                        | North Tripura          |   14 |
|    |                        | South Tripura          |   18 |
| 20 |                        | Alipurduar             |   14 |
| 20 | West Bengal            | Darjeeling             |   28 |
| 21 | A&NIslands             | Nicobar                |    4 |
| 22 | Dadra and Nagar Haveli | Dadra and Nagar Haveli |    9 |
| 23 |                        | Poonch                 |   44 |
| 23 | Jammu&                 | Rajouri                |   55 |
| 23 | Kashmir                | Reasi                  |   33 |
| 24 |                        | Kargil                 |   16 |
|    | Ladakh                 | Leh Ladakh             |   16 |
| 25 | Lakshadweep            | Lakshadweep            |    4 |

| State/UT-wise list of Nutrition Rehabilitation Centres (till Q2 of FY 2O21-22)   | State/UT-wise list of Nutrition Rehabilitation Centres (till Q2 of FY 2O21-22)   | State/UT-wise list of Nutrition Rehabilitation Centres (till Q2 of FY 2O21-22)   |
|----------------------------------------------------------------------------------|----------------------------------------------------------------------------------|----------------------------------------------------------------------------------|
| Sl. No.                                                                          | State/ UT                                                                        | Total No. of functional NRCs                                                     |
|                                                                                  | INDIA                                                                            | 1080                                                                             |
| 1.                                                                               | Arunachal Pradesh                                                                | 1                                                                                |
| 2.                                                                               | Andhra Pradesh                                                                   | 21                                                                               |
| 3.                                                                               | Assam                                                                            | 25                                                                               |
| 4.                                                                               | Bihar                                                                            | 41                                                                               |
| 5.                                                                               | Chandigarh                                                                       | 1                                                                                |
| 6.                                                                               | Chhattisgarh                                                                     | 81                                                                               |
| 7.                                                                               | Dadra &NH                                                                        | 1                                                                                |
| 8.                                                                               | Delhi                                                                            | 2                                                                                |
| 9.                                                                               | Gujarat                                                                          | 135                                                                              |
| 10.                                                                              | Haryana                                                                          | 11                                                                               |
| 11.                                                                              | Himachal Pradesh                                                                 | 4                                                                                |
| 12.                                                                              | Jammu &Kashmir                                                                   | 6                                                                                |
| 13.                                                                              | Ladakh                                                                           | 2                                                                                |
| 14.                                                                              | Jharkhand                                                                        | 95                                                                               |
| 15.                                                                              | Karnataka                                                                        | 30                                                                               |
| 16.                                                                              | Kerala                                                                           | 4                                                                                |
| 17.                                                                              | Madhya Pradesh                                                                   | 318                                                                              |
| 18.                                                                              | Maharashtra                                                                      | 38                                                                               |
| 19.                                                                              | Manipur                                                                          | 1                                                                                |
| 20.                                                                              | Meghalaya                                                                        | 7                                                                                |
| 21.                                                                              | Nagaland                                                                         | 1                                                                                |
| 22.                                                                              | Odisha                                                                           | 66                                                                               |
| 23.                                                                              | Rajasthan                                                                        | 40                                                                               |
| 24.                                                                              | Tamil nadu                                                                       | 6                                                                                |
| 25.                                                                              | Telangana                                                                        | 12                                                                               |
| 26.                                                                              | Tripura                                                                          | 1                                                                                |
| 27.                                                                              | Uttar Pradesh                                                                    | 77                                                                               |
| 28.                                                                              | Uttarakhand                                                                      | 2                                                                                |
| 29.                                                                              | West Bengal                                                                      | 51                                                                               |