Lok Sabha Question No. 4014 (UNSTARRED), answered on 2023-03-24
Subject: Appointment of Pharmacists as MLSP
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Vellalath Kochukrishnan Nair. Sreekandan

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

LOK SABHA UNSTARRED QUESTION NO. 4014 TO BE ANSWERED ON 24 th  MARCH, 2023

## APPOINTMENT OF PHARMACISTS AS MLSP

## 4014. SHRI V.K. SREEKANDAN:

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

- (a) whether it is a fact that the Government provides medicines to patients through districtlevel  mental  health  and  non-communicable  disease  control  schemes  and  if  so,  the  details thereof;
- (b)  whether  it  is  also  true  that  the  National  Health  Policy  of  2017  provides  for  the appointment of nurses,  pharmacists  and  ayurvedic  doctors  as  Mid-Level  Service  Providers (MLSP) and if so, the details thereof;
- (c) whether it is also true that the appointment of pharmacists as MLSP has been barred and if so, the details thereof;
- (d) whether the Government is reconsidering to appoint them as MLSP and if so, the details thereof; and
- (e)  whether  the  Government  is  considering  setting  up  commissions  for  pharmacists  and nurses in line with the national medical commission and if so, the details thereof?

## ANSWER

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

- (a)  Under NHM financial support is provided to States / UTs for provision of free essential medicines in public health facilities based on the requirements posed by States/UTs in their Programme Implementation Plans (PIPs) within their overall resource envelope. Ministry has recommended facility  wise Essential  Drugs  List  (EDL)  to  be  made  available  at  the  public healthcare facilities to ensure widespread access to essential medicines which include mental health and non-communicable disease. No of medicines recommended at various facilities are given below. However States have the flexibility to add more.

|   Sr. No. | Name of Facility   |   No. of essential Medicine |
|-----------|--------------------|-----------------------------|
|         1 | DH                 |                         377 |
|         2 | SDH                |                         313 |
|         3 | CHC                |                         299 |
|         4 | HWC-PHC            |                         171 |
|         5 | HWC-Sub Centre     |                         105 |

(b) to (e) National health Policy, Para 11.4 -Mid-Level Service Providers : For expansion of primary care from selective care to comprehensive care, complementary human resource strategy is the development of a cadre of mid-level care providers. This can be done through appropriate  courses  like  a  B.Sc.  in  community  health  and/or  through  competency-based bridge  courses  and  short  courses.  These  bridge  courses  admit  graduates  from  different clinical  and  paramedical  backgrounds  like  AYUSH  doctors,  B.Sc.  Nurses,  Pharmacists, GNMs,  etc  and  equip  them  with  skills  to  provide  services  at  the  sub-centre  and  other peripheral levels. Locale based selection, a special curriculum of training close to the place where they live  and  work,  conditional  licensing,  enabling  legal  framework  and  a  positive practice  environment  ensure  that  this  new  cadre  is  preferentially  available  where  they  are needed most, i.e. in the under-served areas.

The functions of Community Health Officer (CHO) include provision of primary health care inclusive  of  clinical,  public  health  and  managerial  functions.  Their  role  includes  early diagnosis,  management,  care  coordination,  prevention,  control  and  surveillance  of  disease conditions.  This  has  to  be  achieved  by  providing  appropriate  and  timely  treatment  and necessary social support.

Nurses  and  Ayurveda  practitioners  are  serving  as  CHOs.  They  not  only  have  an  in-depth knowledge of the human body through rigorous clinical experience and training, but also a holistic understanding of public health, which is essential for them to deliver Comprehensive Primary Health Care.

A review of the outline of Bachelor of Pharmacy (B. PHARM) curriculum indicates that a significant  component  of  Pharmacist  training  is  related  to  Pharmacokinetics,  pharmacy, biochemistry, pharmaceutics, bio-technology, drug manufacturing, pharmacology labs, drug interactions etc. Except anatomy and pathophysiology, emphasis on other clinical disciplines such  as-  General  Medicine,  General  Surgery,  Obstetrics/Gynaecology,  Paediatrics,  Mental Health and Preventive and Social Medicine/Community Health are not covered in the course design.  These  skills  are  critical  for  performing  the  role  of  Community  Health  Officer. Operational  guidelines  of  Comprehensive  Primary  Healthcare  through  Ayushman  Bharat Health  &  Wellness  Centres  approved  Nurses  and  Ayurveda  practitioners  for  the  post  of Community Health Officer.

The Pharmacy Council of India and the Indian Nursing Council govern the professions of pharmacy and nursing respectively.

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