Lok Sabha Question No. 2070 (UNSTARRED), answered on 2024-12-06
Subject: Pradhan Mantri National Dialysis Programme (PMNDP)
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Basavaraj Bommai

## GOVERNMENTOFINDIA MINISTRY OFHEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2070 TO BE ANSWERED ON 6th DECEMBER, 2024

## PRADHANMANTRI NATIONALDIALYSIS PROGRAMME (PMNDP)

## 2070. SHRI BASAVARAJ BOMMAI:

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

- (a) the details of funds, equipment and resources that have been allocated to Karnataka ' s dialysis centres under the Pradhan Mantri National Dialysis Programme (PMNDP) in the last three years along with the current status of their utilization;
- (b) the details of functional dialysis machines currently provided under the PMNDP in Karnataka;
- (c) whether the Government has taken any steps or proposes to take steps to address issues relating to dysfunctional equipment and nephrologist shortages in the State, if so, the details thereof and if not, the reasons therefor;
- (d) whether the Government is considering conversion of dialysis centres to single-use dialysis units to reduce cross-infection risks; and
- (e) if so, the details thereof and if not, the reasons therefor?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV)

- (a) In Karnataka, funds approved and expenditure in last three financial years under the Pradhan Mantri National Dialysis Programme (PMNDP) is as follows:-

| Rs in Crores    | Rs in Crores   | Rs in Crores    | Rs in Crores   | Rs in Crores    | Rs in Crores   | Rs in Crores    | Rs in Crores                 |
|-----------------|----------------|-----------------|----------------|-----------------|----------------|-----------------|------------------------------|
| 2021-22         | 2021-22        | 2022-23         | 2022-23        | 2023-24         | 2023-24        | 2024-25         | 2024-25                      |
| Funds Approvals | Expenditure    | Funds Approvals | Expenditure    | Funds Approvals | Expenditure    | Funds Approvals | Expenditure as on 31.07.2024 |
| 45.54           | 29.71          | 77.35           | 34.13          | 66.04           | 43.15          | 79.95           | 24.11                        |

(b) There are 840 functional dialysis machines in Karnataka under PMNDP.

(c) PMNDPprogramme is functional in PPP mode in the State of Karnataka. The state has a mix of Haemodialysis (HD) machines both from service providers and procurement through Corporate Social Responsibility (CSR) funds. The issues related to dysfunctional HD machines are catered through original equipment manufacturer (OEM) service engineer by the service provider and by the district level equipment maintenance team for the machines supported under the CSR.

Ministry of Health and Family Welfare has prepared a revised model Request for Proposal (RFP) document based on the 'Quality and Cost-Based Selection (QCBS) methodology for selection of a suitable service provider in the PPP mode for guidance of the States/UTs. In the revised bid document, considering the shortage of nephrologists in the country, minimum 01 Nephrologist for 10 Dialysis Facility on consultancy basis in a state has been recommended.

States/UTs engage Nephrologists for review of dialysis patients as per need and availability. In Karnataka, the service provider (PPP) provides Nephrologists for review of patients at the dialysis facility, as per Memorandum of Understanding (MoU) between the state and the service provider.

(d) & (e): As per Request for Proposal (RFP) document for PMNDP, it has been approved that dialyzer re-use not more than 05 times or till the bundle volume is 80% and more of original capacity, whichever is earlier. In such cases dialyzer is reused only for the same patient after due sterilization using dialyzer reprocessing unit. Availability of Dialyzer reprocessing unit is mandatory for cleaning the dialyzer and assessment of bundle volume.

However, in the dialysis unit not having dialyzer re-processing machine, single use dialyzer has been recommended to prevent and reduce cross-infection risks.

The guidelines also recommend that the ' Dialyzer ' should not be reused for seropositive cases in any situation and the patient should be dialyzed on a separate isolated machine. In such cases, single use dialyzer is recommended.