Lok Sabha Question No. 3425 (UNSTARRED), answered on 2021-12-17
Subject: Transforming SHCs, PHCs into Ayushman Bharat - health and wellness centres
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kalyan Banerjee

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

## LOK SABHA UNSTARRED QUESTION NO. 3425 TO BE ANSWERED ON THE 17 th  DECEMBER, 2021

## TRANSFORMING SHCS, PHCS INTO AYUSHMAN BHARAT - HEALTH AND WELLNESS CENTRES

## 3425. SHRI KALYAN BANERJEE:

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

- (a) whether the Government proposes to transform sub-health centres and primary health centres  into  Ayushman  Bharat  Health  and  Wellness  Centres  (AB-HWCs)  for providing comprehensive primary health care with a view to promote minimum care approach;
- (b) if  so,  the  details  thereof  and  the  financial  and  other  assistance/support  provided  to states for the purpose, State-wise;
- (c) whether the AB-HWCs have been able to deliver the expanded range of services to address  the  basic  primary  healthcare  needs  of  the  entire  population  at  community level and if so, the details thereof; and if not the reasons therefor; and
- (d) the  necessary  steps  taken/proposed  to  be  taken  by  the  Government  to  deliver  the provision of Comprehensive Primary Health Care?

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

(a) to (d):

As  per  the  budget  announcement  2017-18,  1.5  lakh  Sub-Health  Centres  (SHCs)  and  Primary Health  Centres  (PHCs)  are  to  be  transformed  into  Health  and  Wellness  Centres  (HWCs)  by December, 2022.

'Public Health & Hospitals' is a State subject, hence, the primary responsibility of providing comprehensive primary health care to all the citizens of the country lies with respective State Government. However, the States and UTs are supported for transformation and operationalization of Health & wellness Centres with an aim to provide Comprehensive Primary

Health Care (CPHC) that includes effective, affordable, quality and accessible healthcare at the community  level  with  continuum  of  care  approach  primarily  under  National  Health  Mission (NHM) and also under recently launched PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM).  The  details  of  State-wise  financial  support  provided  under  NHM  and  PMABHIM is attached at Annexure-I.

AB-HWCs  provide  Comprehensive  Primary  Health  Care  (CPHC)  through  the  range  of  12 expanded health services package, closer to community. These primarily include Reproductive and  Child  Health  (RMNCHA+N)  services,  Communicable  Diseases,  Non-Communicable Diseases (NCDs) (screening and management for NCDs such as Hypertension, Diabetes and 3 common cancers of Oral, Breast and Cervix) and incrementally adding other services for mental health, ENT, Ophthalmology, oral health, geriatric and palliative health care and trauma care etc. AB-HWCs  also  conduct  various  wellness  related  activities  like  Yoga,  Zumba,  Shirodhara  , Meditation etc. which will enable improved physical and mental health. As on 15 th December, 2021, more than 80,764 AB-HWCs are operational.  In these AB-HWCs:

- Footfalls of more than 74.91 crore. Out of this, 53.7% are women
- Screening of 15.35 crore individuals for hypertension and 12.68 crore for diabetes
- Screening  for  three  common  cancers  which  include  oral  cancer  (8.20  crore  screenings), breast cancer (4.08 crore screenings in women) and cervical cancer (2.77 crore screenings in women) done across the country
- More than 91.51 lakh Yoga / Wellness sessions have been conducted so far.

## Annexure-I

| State/UT wise Central Release under Ayushman Bharat Yojana - Health &Wellness Centres (AB- H&WCs) under NHMfrom the F.Y. 2018-19 to 2021-22   | State/UT wise Central Release under Ayushman Bharat Yojana - Health &Wellness Centres (AB- H&WCs) under NHMfrom the F.Y. 2018-19 to 2021-22   | State/UT wise Central Release under Ayushman Bharat Yojana - Health &Wellness Centres (AB- H&WCs) under NHMfrom the F.Y. 2018-19 to 2021-22   | State/UT wise Central Release under Ayushman Bharat Yojana - Health &Wellness Centres (AB- H&WCs) under NHMfrom the F.Y. 2018-19 to 2021-22   | State/UT wise Central Release under Ayushman Bharat Yojana - Health &Wellness Centres (AB- H&WCs) under NHMfrom the F.Y. 2018-19 to 2021-22   | State/UT wise Central Release under Ayushman Bharat Yojana - Health &Wellness Centres (AB- H&WCs) under NHMfrom the F.Y. 2018-19 to 2021-22   |
|-----------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------|
| S.No.                                                                                                                                         | State/UT                                                                                                                                      | 2018-19                                                                                                                                       | 2019-20                                                                                                                                       | 2020-21                                                                                                                                       | Rs. In Crore 2021-22                                                                                                                          |
| 1                                                                                                                                             | Andaman &Nicobar Islands                                                                                                                      | 0.80                                                                                                                                          | 0.85                                                                                                                                          | 1.16                                                                                                                                          | 1.19                                                                                                                                          |
| 2                                                                                                                                             | Andhra Pradesh                                                                                                                                | 43.51                                                                                                                                         | 52.44                                                                                                                                         | 59.38                                                                                                                                         | -                                                                                                                                             |
| 3                                                                                                                                             | Arunachal Pradesh                                                                                                                             | 8.15                                                                                                                                          | 8.59                                                                                                                                          | 14.80                                                                                                                                         | -                                                                                                                                             |
| 4                                                                                                                                             | Assam                                                                                                                                         | 68.67                                                                                                                                         | 97.60                                                                                                                                         | 89.69                                                                                                                                         | 59.41                                                                                                                                         |
| 5                                                                                                                                             | Bihar                                                                                                                                         | 88.50                                                                                                                                         | 88.78                                                                                                                                         | 119.22                                                                                                                                        | 58.93                                                                                                                                         |
| 6                                                                                                                                             | Chandigarh                                                                                                                                    | 0.71                                                                                                                                          | 0.84                                                                                                                                          | 1.51                                                                                                                                          | 0.08                                                                                                                                          |
| 7                                                                                                                                             | Chhattisgarh                                                                                                                                  | 36.42                                                                                                                                         | 65.66                                                                                                                                         | 28.08                                                                                                                                         | 23.83                                                                                                                                         |
| 8                                                                                                                                             | Dadra &Nagar Haveli                                                                                                                           | 0.70                                                                                                                                          | 0.96                                                                                                                                          |                                                                                                                                               |                                                                                                                                               |
| 9                                                                                                                                             | Daman &Diu                                                                                                                                    | 0.43                                                                                                                                          | 0.68                                                                                                                                          | 2.09                                                                                                                                          | 1.57                                                                                                                                          |
| 10                                                                                                                                            | Delhi                                                                                                                                         | -                                                                                                                                             | -                                                                                                                                             | -                                                                                                                                             | -                                                                                                                                             |
| 11                                                                                                                                            | Goa                                                                                                                                           | 0.79                                                                                                                                          | 1.26                                                                                                                                          | 0.88                                                                                                                                          | -                                                                                                                                             |
| 12                                                                                                                                            | Gujarat                                                                                                                                       | 44.64                                                                                                                                         | 49.98                                                                                                                                         | 69.75                                                                                                                                         | 4.75                                                                                                                                          |
| 13                                                                                                                                            | Haryana                                                                                                                                       | 18.45                                                                                                                                         | 24.03                                                                                                                                         | 29.02                                                                                                                                         | 11.76                                                                                                                                         |
| 14                                                                                                                                            | Himachal Pradesh                                                                                                                              | 16.08                                                                                                                                         | 27.21                                                                                                                                         | 25.87                                                                                                                                         | 0.14                                                                                                                                          |
| 15                                                                                                                                            | Jammu &Kashmir                                                                                                                                | 32.66                                                                                                                                         | 38.88                                                                                                                                         | 39.27                                                                                                                                         | 8.52                                                                                                                                          |
| 16                                                                                                                                            | Jharkhand                                                                                                                                     | 26.02                                                                                                                                         | 75.81                                                                                                                                         | -                                                                                                                                             | 11.38                                                                                                                                         |
| 17                                                                                                                                            | Karnataka                                                                                                                                     | 47.98                                                                                                                                         | 54.70                                                                                                                                         | 75.51                                                                                                                                         | 45.97                                                                                                                                         |
| 18                                                                                                                                            | Kerala                                                                                                                                        | 18.43                                                                                                                                         | 21.65                                                                                                                                         | 27.73                                                                                                                                         | 16.86                                                                                                                                         |
| 19                                                                                                                                            | Lakshadweep                                                                                                                                   | 0.18                                                                                                                                          | 0.26                                                                                                                                          | 0.24                                                                                                                                          | 0.26                                                                                                                                          |
| 20                                                                                                                                            | Madhya Pradesh                                                                                                                                | 87.74                                                                                                                                         | 87.82                                                                                                                                         | 140.35                                                                                                                                        | 75.20                                                                                                                                         |
| 21                                                                                                                                            | Maharashtra                                                                                                                                   | 91.27                                                                                                                                         | 97.64                                                                                                                                         | 138.60                                                                                                                                        | -                                                                                                                                             |
| 22                                                                                                                                            | Manipur                                                                                                                                       | 5.44                                                                                                                                          | 9.22                                                                                                                                          | 8.06                                                                                                                                          | -                                                                                                                                             |
| 23                                                                                                                                            | Meghalaya                                                                                                                                     | 8.64                                                                                                                                          | 12.46                                                                                                                                         | 9.17                                                                                                                                          | 2.43                                                                                                                                          |
| 24                                                                                                                                            | Mizoram                                                                                                                                       | 4.03                                                                                                                                          | 5.19                                                                                                                                          | 5.25                                                                                                                                          | -                                                                                                                                             |
| 25                                                                                                                                            | Nagaland                                                                                                                                      | 5.01                                                                                                                                          | 5.34                                                                                                                                          | 6.22                                                                                                                                          | 1.75                                                                                                                                          |
| 26                                                                                                                                            | Odisha                                                                                                                                        | 48.34                                                                                                                                         | 95.49                                                                                                                                         | 77.06                                                                                                                                         | 46.20                                                                                                                                         |
| 27                                                                                                                                            | Puducherry                                                                                                                                    | 14.46                                                                                                                                         | 0.22                                                                                                                                          | -                                                                                                                                             | -                                                                                                                                             |
| 28                                                                                                                                            | Punjab                                                                                                                                        | 19.69                                                                                                                                         | 20.39                                                                                                                                         | 22.17                                                                                                                                         | 6.32                                                                                                                                          |
| 29                                                                                                                                            | Rajasthan                                                                                                                                     | 83.70                                                                                                                                         | 68.64                                                                                                                                         | 62.63                                                                                                                                         | -                                                                                                                                             |
| 30                                                                                                                                            | Sikkim                                                                                                                                        | 2.16                                                                                                                                          | 1.62                                                                                                                                          | 2.71                                                                                                                                          | 0.46                                                                                                                                          |
| 31                                                                                                                                            | Tamil Nadu                                                                                                                                    | 56.41                                                                                                                                         | 89.12                                                                                                                                         | 82.65                                                                                                                                         | 38.15                                                                                                                                         |
| 32                                                                                                                                            | Tripura                                                                                                                                       | 10.18                                                                                                                                         | 13.57                                                                                                                                         | 9.27                                                                                                                                          | 6.80                                                                                                                                          |
| 33                                                                                                                                            | Uttar Pradesh                                                                                                                                 | 176.10                                                                                                                                        | 330.85                                                                                                                                        | 279.52                                                                                                                                        | 51.69                                                                                                                                         |
| 34                                                                                                                                            | Uttarakhand                                                                                                                                   | 19.62                                                                                                                                         | 30.31                                                                                                                                         | 26.93                                                                                                                                         | 21.40                                                                                                                                         |
| 35                                                                                                                                            | West Bengal                                                                                                                                   | 59.47                                                                                                                                         | 61.55                                                                                                                                         | 99.44                                                                                                                                         | 19.67                                                                                                                                         |
| 36                                                                                                                                            | Telangana                                                                                                                                     | 46.14                                                                                                                                         | 33.70                                                                                                                                         | 35.94                                                                                                                                         | -                                                                                                                                             |
| 37                                                                                                                                            | Ladakh                                                                                                                                        | -                                                                                                                                             | -                                                                                                                                             | 7.36                                                                                                                                          | 1.96                                                                                                                                          |
| Note:                                                                                                                                         |                                                                                                                                               |                                                                                                                                               |                                                                                                                                               |                                                                                                                                               |                                                                                                                                               |

## PM-ABHIM Financial outlay - State wise total allocation under CSS component for HWCs in rural and urban areas

Rs. In Crore

| S. No.   |                             | 2021-22 to 2025-26         | 2021-22 to 2025-26     |
|----------|-----------------------------|----------------------------|------------------------|
| S. No.   | State                       | AB-HWCs in rural areas SHC | Ab-HWCs in urban areas |
| 1        | Andaman and Nicobar Islands | 0.00                       | 7.50                   |
| 2        | Andhra Pradesh              | 0.00                       | 1400.85                |
| 3        | Arunachal Pradesh           | 0.00                       | 15.75                  |
| 4        | Assam                       | 470.32                     | 212.25                 |
| 5        | Bihar                       | 3161.32                    | 366.00                 |
| 6        | Chandigarh                  | 0.00                       | 171.75                 |
| 7        | Chhattisgarh                | 0.00                       | 174.00                 |
| 8        | D &NHaveli                  | 0.00                       | 7.50                   |
| 9        | Daman &Diu                  | 0.00                       | 0.00                   |
| 10       | Delhi                       | 0.00                       | 2058.75                |
| 11       | Goa                         | 0.00                       | 0.00                   |
| 12       | Gujarat                     | 0.00                       | 1223.25                |
| 13       | Haryana                     | 0.00                       | 363.75                 |
| 14       | Himachal Pradesh            | 0.00                       | 75.20                  |
| 15       | Jammu &Kashmir              | 0.00                       | 189.00                 |
| 16       | Jharkhand                   | 1124.97                    | 219.00                 |
| 17       | Karnataka                   | 0.00                       | 1673.99                |
| 18       | Kerala                      | 0.00                       | 320.25                 |
| 19       | Ladakh                      | 0.00                       | 0.00                   |
| 20       | Lakshadweep                 | 0.00                       | 0.00                   |
| 21       | Madhya Pradesh              | 0.00                       | 522.75                 |
| 22       | Maharashtra                 | 0.00                       | 2069.25                |
| 23       | Manipur                     | 46.29                      | 34.50                  |
| 24       | Meghalaya                   | 100.86                     | 0.00                   |
| 25       | Mizoram                     | 0.00                       | 37.50                  |
| 26       | Nagaland                    | 0.00                       | 19.50                  |
| 27       | Odisha                      | 665.28                     | 334.50                 |
| 28       | Puducherry                  | 0.00                       | 58.50                  |
| 29       | Punjab                      | 6.11                       | 60.75                  |
| 30       | Rajasthan                   | 1471.80                    | 1450.44                |
| 31       | Sikkim                      | 0.00                       | 3.75                   |
| 32       | Tamil Nadu                  | 0.00                       | 1782.00                |
| 33       | Telangana                   | 0.00                       | 958.47                 |
| 34       | Tripura                     | 0.00                       | 19.50                  |
| 35       | Uttar Pradesh               | 2698.46                    | 2401.50                |
| 36       | Uttarakhand                 | 0.00                       | 0.00                   |
| 37       | West Bengal                 | 127.30                     | 1723.50                |
|          | Total                       | 9872.30                    | 19955.25               |