Lok Sabha Question No. 2135 (UNSTARRED), answered on 2021-12-10
Subject: Aspirational Districts Programme
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Chandra Prakash Choudhary

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

## LOK SABHA UNSTARRED PARLIAMENT QUESTION NO. 2135 TO BE ANSWERED ON 10 th  DECEMBER 2021

## ASPIRATIONAL DISTRICT PROGRAM

## 2135: SHRI CHANDRA PRAKASH CHOUDHARY:

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

- (a) whether his  Ministry  has  been  implementing  Aspirational  Districts  Programme for improving healthcare facilities in the targeted districts;
- (b) if  so,  the  details  thereof  including  achievements  under  the  programme  so  far, district-wise especially in Jharkhand;
- (c) the details of the funds allocated for healthcare facilities under the Programme so far, district-wise in Jharkhand;
- (d) whether health and nutrition constitute major weightage in selection of Aspirational Districts in the country and if so, the details thereof;
- (e) whether these districts in Jharkhand are lagging behind from other parts of the country  in  terms  of  major  health  indicators  and  if  so,  the  reaction  of  the Government thereto; and
- (f) the remedial steps being taken/ proposed to be taken by the Government in this regard?

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

## ANSWER WELFARE (DR. BHARATI PRAVIN PAWAR)

(a)    NITI Aayog has been implementing the Aspirational District (AD) Programme since it was  launched  on  January  5,  2018  for  improving  socio-economic  indicators  in  the  selected backward  districts. Ministry  of  Health  and  Family  Welfare  (MoHFW)  is  supporting  all States/UTs  in implementation  of  various schemes/initiatives for improving  healthcare facilities under National Health Mission (NHM) based on the Annual Program Implementation Plan (APIP) submitted by States/ UTs.

- (b)      ADs  in  general  have  shown  improvement  with  respect  to  the  Health  and  Nutrition indicators. While most of the districts have improved, some of the districts have shown very rapid progress.

Districts  wise  details  of  achievements  in  Health  and  Nutrition  sector  for  the  State  of Jharkhand is attached at Annexure-1

(c)    As the main strategy of the Aspirational District program is based on convergence of existing  schemes  which  have  their  own  funding  arrangement.  However,  in  order  to  foster competitive  spirit  and  for  addressing  the  critical  gaps,  additional  allocation  via  challenge route  is  provided  by  NITI  Aayog.  Every  month,  districts  are  assessed  on  basis  of  monthly progress and the best performing Districts in overall terms and in each of the five sectors are identified. The first and second rankers in overall terms are awarded Rs. 10 crores and Rs. 5 crores respectively. The first ranker from each of the five sectors taken up in ADs including Health & Nutrition sector is awarded Rs. 3 crores each.

The details  of  fund  sanctioned  to  the  Aspirational  Districts  of  Jharkhand  for  the  Health  & Nutrition Sector is given at Annexure-II

(d)    Yes,  Health  and  Nutrition  has  been  assigned  major  weightage  of  30%  in  selection  of ADs. The details are given in Annexure-III

(e) & (f) Latest Health & Nutrition Sector Scores (Oct 2021) of 112 Aspirational Districts as per the Champions of Change Dashboard is given at Annexure-IV.

The progress of the Aspirational Districts on the Key Performance Indicators are regularly monitored and the districts are ranked on monthly basis in Champions of Change Dashboard by NITI Aayog. In order to provide focused attention for overall development of these ADs, NITI Aayog has nominated senior officers of the rank of Joint Secretary/Additional Secretary as Central Prabhari Officers for each of the 112 districts for guidance and monitoring of the Aspirational District Program.

MoHFW  has  developed  Operational  guidelines  and  Supportive  Supervision  checklists  to monitor and provide technical assistance for improving the Health interventions across the ADs.  Special  provisions  for  AD  program  include  extra  financial  resources  for  ADs, relaxation  of  norms  for  hiring  of  manpower,  flexibility  to  hire  specialists  with  top  up allowances  and  priority  sanctions  of  infrastructure  development  in  ADs  under  National Health Mission and other health system strengthening efforts.

## Annexure-I

## District wise percentage improvements and lifetime best rank in Health & Nutrition Sector for State of Jharkhand

|   S. No. | District            |   %Improvement since inception (Health &Nutrition) | Lifetime Best Rank (Health& Nutrition)   |
|----------|---------------------|----------------------------------------------------|------------------------------------------|
|        1 | Bokaro              |                                               6.42 | 1 in Sep- 2020                           |
|        2 | Chatra              |                                               6.32 | 1 in Aug-2021                            |
|        3 | Dumka               |                                               8.92 | 1 in Oct-2021                            |
|        4 | Garhwa              |                                              10.2  | 2 in Sep-2019                            |
|        5 | Giridih             |                                              20.76 | 5 in Jan-2019                            |
|        6 | Godda               |                                              16.85 | 6 in Feb-2021                            |
|        7 | Gumla               |                                              12.57 | 4 in Nov-2020                            |
|        8 | Hazaribagh          |                                               7.98 | 4 in Jan-2019                            |
|        9 | Khunti              |                                              14.95 | 3 in Feb-2021                            |
|       10 | Latehar             |                                              23.74 | 4 in Jan-2021                            |
|       11 | Lohardaga           |                                              16.9  | 9 in Aug-2021                            |
|       12 | Pakur               |                                               6.18 | 4 in Dec-2018                            |
|       13 | Palamu              |                                              16.79 | 1 in Aug-2019                            |
|       14 | Pashchimi Singhbhum |                                              12.25 | 3 in Aug-2021                            |
|       15 | Purbi Singhbhum     |                                               6.55 | 2 in Sep- 2020                           |
|       16 | Ramgarh             |                                               7.63 | 1 in Nov-2020                            |
|       17 | Ranchi              |                                              60.83 | 1 in Sep- 2021                           |
|       18 | Sahibganj           |                                              12.81 | 2 in Nov- 2020                           |
|       19 | Simdega             |                                              31.45 | 4 in Sep-2021                            |

1 Also available on the Champions of Change Dashboard (http://championsofchange.gov.in/site/coc-home/).

## Annexure-II

## District wise Details of funds sanctioned to the Aspirational Districts of Jharkhand for Health & Nutrition Sector since inception

|   S. No. | District        | Funds Sanctioned (₹)   | Projects under various stages of implementation in relation to Health &Nutrition   |
|----------|-----------------|------------------------|------------------------------------------------------------------------------------|
|        1 | Dumka           | 45,00,000              | Renovation of 3 Malnutrition Treatment Centres (MTCs)                              |
|        1 | Dumka           | 40,00,000              | Procuring 2 Mobile Medical Units (MMUs) to cater to 6 far- flung blocks            |
|        1 | Dumka           | 41,20,000              | Water Filters for all Anganwadi Centres in the district                            |
|        2 | Garhwa          | 20,00,000              | Upgradation of Anganwadi Centres                                                   |
|        2 | Garhwa          | 4,80,00,000            | District Hospital and CHCUpgrade                                                   |
|        3 | Khunti          | 3,00,00,000            | State of the Art Health Facility                                                   |
|        4 | Latehar         | 3,00,00,000            | Upgrading Anganwadis and Health Centres for Comprehensive Healthcare               |
|        5 | Pakur           | 1,38,11,000            | Community Based Management of Children With Severe Acute Malnutrition              |
|        6 | Purbi Singhbhum | 2,99,97,000            | Development of Model Anganwadi Centres                                             |
|        7 | Ranchi          | 1,41,91,800            | Upgradation of 20 PHCs                                                             |
|        7 | Ranchi          | 1,68,20,000            | Upgradation of Sonahatu CHC as model CHC                                           |
|        8 | Sahibganj       | 6,11,33,400            | Renovation of 300 Anganwadi Centres in hard to reach areas                         |
|        8 | Sahibganj       | 1,42,00,000            | Community based management of children with Severe Acute Malnutrition              |
|        8 | Sahibganj       | 2,39,40,000            | Recruitment of 11 Specialist doctors in the district                               |
|        9 | Simdega         | 2,75,00,000            | Mega Sports Complex at District Headquarter, Simdega                               |

## Annexure- III

## Weightage of Health & Nutrition Indicators in selection of Aspirational Districts

| DATABASES                                                                                    | SECTOR                  | WEIGHT   |
|----------------------------------------------------------------------------------------------|-------------------------|----------|
| Landless households dependent on Manual labour (Socio Economic Caste Census - Deprivation 7) | Deprivation (25%)       | 25%      |
| Ante natal care (National Health and Family Survey (NHFS) - 4)                               | Health& Nutrition (30%) | 7.5%     |
| Institutional delivery (NHFS-4)                                                              | Health& Nutrition (30%) | 7.5%     |
| Stunting of children below 5 years (NHFS-4)                                                  | Health& Nutrition (30%) | 7.5%     |
| Wasting in children below 5 years (NHFS-4)                                                   | Health& Nutrition (30%) | 7.5%     |
| Elementary dropout rate (Unified District Information System for Education (U-DISE) 2015-16) | Education (15%)         | 7.5%     |
| Adverse pupil teacher ratio (U-DISE 2015-16)                                                 | Education (15%)         | 7.5%     |
| Un-electrified households (Ministry of Power)                                                | Infra (30%)             | 7.5%     |
| Households without individual toilets (Ministry of Drinking Water and Sanitation)            | Infra (30%)             | 7.5%     |
| Un-connected PMGSYvillage (Ministry of Rural Development)                                    | Infra (30%)             | 7.5%     |
| Rural Household without access to water (Ministry of Drinking Water and Sanitation)          | Infra (30%)             | 7.5%     |
| Total                                                                                        | Infra (30%)             | 100%     |

## Health & Nutrition Scores of 112 Aspirational Districts including State of Jharkhand on the basis of Health & Nutrition indicators

|   S.No | State Name        | District Name        |   Health &Nutrition Score (October 2021) |
|--------|-------------------|----------------------|------------------------------------------|
|      1 | Sikkim            | West District        |                                     87.9 |
|      2 | Andhra Pradesh    | Vizianagaram         |                                     86.2 |
|      3 | Madhya Pradesh    | Guna                 |                                     85.5 |
|      4 | Uttar Pradesh     | Chandauli            |                                     85   |
|      5 | Karnataka         | Yadgir               |                                     83.1 |
|      6 | Tamil Nadu        | Ramanathapuram       |                                     83   |
|      7 | Tamil Nadu        | Virudhunagar         |                                     82.9 |
|      8 | Rajasthan         | Karauli              |                                     82   |
|      9 | Maharashtra       | Osmanabad            |                                     81.9 |
|     10 | Maharashtra       | Washim               |                                     81.7 |
|     11 | Gujarat           | Dohad                |                                     81.5 |
|     12 | Karnataka         | Raichur              |                                     81.4 |
|     13 | Madhya Pradesh    | Damoh                |                                     81.2 |
|     14 | Jammu &Kashmir    | Kupwara              |                                     81   |
|     15 | Andhra Pradesh    | Y.S.R.               |                                     80.9 |
|     16 | Uttar Pradesh     | Chitrakoot           |                                     80.4 |
|     17 | Jharkhand         | Dumka                |                                     80.3 |
|     18 | Jharkhand         | Purbi Singhbhum      |                                     79.8 |
|     19 | Odisha            | Kalahandi            |                                     79   |
|     20 | Jammu &Kashmir    | Baramula             |                                     78.9 |
|     21 | Uttarakhand       | Udham Singh Nagar    |                                     78.7 |
|     22 | Jharkhand         | Simdega              |                                     78.7 |
|     23 | Odisha            | Nuapada              |                                     78.4 |
|     24 | Kerala            | Wayanad              |                                     78.3 |
|     25 | Chhattisgarh      | Mahasamund           |                                     77.6 |
|     26 | Odisha            | Dhenkanal            |                                     77.3 |
|     27 | Arunachal Pradesh | Namsai               |                                     77.2 |
|     28 | Punjab            | Moga                 |                                     77   |
|     29 | Chhattisgarh      | Sukma                |                                     76.4 |
|     30 | Odisha            | Rayagada             |                                     76.3 |
|     31 | Uttar Pradesh     | Fatehpur             |                                     76.2 |
|     32 | Rajasthan         | Sirohi               |                                     76.2 |
|     33 | Madhya Pradesh    | Khandwa (East Nimar) |                                     76.2 |
|     34 | Himachal Pradesh  | Chamba               |                                     76.1 |
|     35 | Odisha            | Kandhamal            |                                     76.1 |
|     36 | Uttar Pradesh     | Balrampur            |                                     76.1 |
|     37 | Jharkhand         | Pashchimi Singhbhum  |                                     75.7 |
|     38 | Odisha            | Malkangiri           |                                     75.5 |
|     39 | Jharkhand         | Godda                |                                     75.2 |
|     40 | Chhattisgarh      | Korba                |                                     75.1 |

## Annexure- IV

(Page-2…....)

|   S.No | State Name     | District Name            |   Health &Nutrition Score (October 2021) |
|--------|----------------|--------------------------|------------------------------------------|
|     41 | Uttarakhand    | Hardwar                  |                                     74.9 |
|     42 | Manipur        | Chandel                  |                                     74.7 |
|     43 | Uttar Pradesh  | Sonbhadra                |                                     74.7 |
|     44 | Assam          | Hailakandi               |                                     74.5 |
|     45 | Assam          | Darrang                  |                                     74.4 |
|     46 | Jharkhand      | Garhwa                   |                                     74.4 |
|     47 | Chhattisgarh   | Uttar Bastar Kanker      |                                     74.2 |
|     48 | Odisha         | Koraput                  |                                     74.2 |
|     49 | Rajasthan      | Dhaulpur                 |                                     74   |
|     50 | Jharkhand      | Latehar                  |                                     74   |
|     51 | Odisha         | Gajapati                 |                                     74   |
|     52 | Maharashtra    | Gadchiroli               |                                     74   |
|     53 | Chhattisgarh   | Bijapur                  |                                     73.7 |
|     54 | Chhattisgarh   | Rajnandgaon              |                                     73.4 |
|     55 | Mizoram        | Mamit                    |                                     73.3 |
|     56 | Assam          | Goalpara                 |                                     73.2 |
|     57 | Chhattisgarh   | Bastar                   |                                     73.2 |
|     58 | Odisha         | Nabarangapur             |                                     72.7 |
|     59 | Andhra Pradesh | Visakhapatnam            |                                     72.4 |
|     60 | Uttar Pradesh  | Shrawasti                |                                     72.1 |
|     61 | Jharkhand      | Hazaribagh               |                                     72   |
|     62 | Madhya Pradesh | Chhatarpur               |                                     71.9 |
|     63 | Chhattisgarh   | Dakshin Bastar Dantewada |                                     71.8 |
|     64 | Bihar          | Sheikhpura               |                                     71.7 |
|     65 | Maharashtra    | Nandurbar                |                                     71.7 |
|     66 | Madhya Pradesh | Rajgarh                  |                                     71.2 |
|     67 | Telangana      | Bhoopalapalli            |                                     71.1 |
|     68 | Uttar Pradesh  | Bahraich                 |                                     71   |
|     69 | Jharkhand      | Ramgarh                  |                                     71   |
|     70 | Jharkhand      | Ranchi                   |                                     70.7 |
|     71 | Uttar Pradesh  | Siddharthnagar           |                                     70.7 |
|     72 | Jharkhand      | Lohardaga                |                                     70.5 |
|     73 | Odisha         | Balangir                 |                                     70.3 |
|     74 | Jharkhand      | Bokaro                   |                                     70.3 |
|     75 | Chhattisgarh   | Kondagaon                |                                     69.6 |
|     76 | Chhattisgarh   | Baksa                    |                                     69.6 |
|     77 | Jharkhand      | Gumla                    |                                     69.2 |
|     78 | Punjab         | Firozpur                 |                                     69   |
|     79 | Gujarat        | Narmada                  |                                     68.8 |

Annexure- IV (Page-3……)

|   S.No | State Name     | District Name        |   Health &Nutrition Score (October 2021) |
|--------|----------------|----------------------|------------------------------------------|
|     80 | Telangana      | Bhadradri-Kothagudem |                                     68.7 |
|     81 | Jharkhand      | Pakur                |                                     68.4 |
|     82 | Rajasthan      | Jaisalmer            |                                     68.2 |
|     83 | Madhya Pradesh | Vidisha              |                                     68.2 |
|     84 | Jharkhand      | Giridih              |                                     68   |
|     85 | Jharkhand      | Chatra               |                                     67.9 |
|     86 | Jharkhand      | Khunti               |                                     67.8 |
|     87 | Rajasthan      | Baran                |                                     67.7 |
|     88 | Tripura        | Dhalai               |                                     66.9 |
|     89 | Bihar          | Nawada               |                                     66.5 |
|     90 | Jharkhand      | Palamu               |                                     66.4 |
|     91 | Chhattisgarh   | Narayanpur           |                                     66.2 |
|     92 | Assam          | Barpeta              |                                     66.1 |
|     93 | Bihar          | Sitamarhi            |                                     64.6 |
|     94 | Telangana      | Asifabad (Adilabad)  |                                     63.9 |
|     95 | Assam          | Dhubri               |                                     63.5 |
|     96 | Bihar          | Aurangabad           |                                     63.2 |
|     97 | Bihar          | Begusarai            |                                     63.1 |
|     98 | Nagaland       | Kiphire              |                                     62.7 |
|     99 | Bihar          | Muzaffarpur          |                                     62.6 |
|    100 | Bihar          | Katihar              |                                     62.1 |
|    101 | Jharkhand      | Sahibganj            |                                     61.7 |
|    102 | Madhya Pradesh | Singrauli            |                                     61.5 |
|    103 | Meghalaya      | Ribhoi               |                                     61.5 |
|    104 | Madhya Pradesh | Barwani              |                                     57.9 |
|    105 | Bihar          | Banka                |                                     56.1 |
|    106 | Haryana        | Mewat                |                                     55.4 |
|    107 | Assam          | Udalguri             |                                     55.2 |
|    108 | Bihar          | Purnia               |                                     54.6 |
|    109 | Bihar          | Araria               |                                     52.8 |
|    110 | Bihar          | Jamui                |                                     47.8 |
|    111 | Bihar          | Gaya                 |                                     46.6 |
|    112 | Bihar          | Khagaria             |                                     44.7 |