Lok Sabha Question No. 293 (UNSTARRED), answered on 2023-02-03
Subject: Health Schemes for Rural Women
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kuldeep Rai Sharma

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

## LOK SABHA UNSTARRED QUESTION NO. 293

## TO BE ANSWERED ON THE 3 rd   FEBRUARY, 2023

## HEALTH SCHEMES FOR RURAL WOMEN

## 293:  SHRI KULDEEP RAI SHARMA:

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

- (a) whether the Government has taken note of rural women getting affected by various diseases due to ill health and if so, the details thereof along with the schemes being implemented for improving the health of rural women particularly in Andaman and Nicobar Islands;
- (b) whether the Government has also launched any healthcare scheme specially focussing on ST category women and their children in the country especially in Andaman and Nicobar Islands and if so, the details thereof; and
- (c) the  financial  support  extended  under  such  Scheme  in  the  last  three  years  particularly  in Andaman and Nicobar Islands?

## ANSWER

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

(a) to (c): The National Health Mission (NHM) is a Centrally Sponsored Scheme which envisages achievement of universal access to equitable, affordable & quality health care services that  are accountable and responsive to people's needs, including women, across the country. The main programmatic  components  include  Health  System  Strengthening  in  rural  and  urban  areas, Reproductive-MaternalNeonatal-Child and Adolescent Health (RMNCH+A), and Communicable and Non-Communicable Diseases.

The  primary  responsibility  for  ensuring  healthcare  services  lies  with  respective  State/UT Governments. Under National Health Mission, Ministry of Health & Family Welfare provides financial  and  technical  support  to  States/UTs,  including  Andaman  and  Nicobar  Islands,  to strengthen their healthcare systems, based on the requirements posed by them in their Programme Implementation Plans (PIPs) within their overall resource envelope.  Various works/initiatives carried out under NHM in the country are as below:

-  Ayushman  Bharat  -  Health  &  Wellness  Centres  (AB-HWCs) :  1,50,000  Sub-  Health Centres (SHC), Primary Health Centres (PHC) and Urban Primary Health Centres (UPHC) are  transformed  into  Ayushman  Bharat-  Health  and  Wellness  Centres  (AB-HWCs)  upto

December, 2022 to deliver twelve packages of Comprehensive Primary Health Care (CPHC) that includes preventive, promotive, curative, palliative and rehabilitative services which is universal, free and close to the community. These AB-HWCs will provide Comprehensive Primary Health Care (CPHC), by expanding and strengthening the existing Reproductive & Child Health (RCH) services and Communicable Diseases services and by including services related to Non- Communicable Diseases (NCD), to begin with the common NCDs such as, Hypertension, Diabetes and 3 common cancers of Oral, Breast and Cervix. It is also envisaged to incrementally add primary healthcare services for Mental health, ENT, Ophthalmology, Oral health, Geriatric and Palliative health care and Trauma care as well as Health promotion and wellness activities like Yoga. Against the target of 1,50,000, a total of 1,54,070 ABHWCs have been operationalized in the country by 31 st  December, 2022.

-  National Free Drugs Initiative : States/UTs are supported to provide essential drugs based on the level of public health facilities free of cost to all who access these facilities.
-  Free Diagnostics Initiatives. (FDI) : Under the initiative, support provided to States/UTs to provide a set of essential diagnostics in 33 States/UTs at various levels of care, free of cost.
-  National Ambulance Services (NAS) : Under the NHM, technical and financial support is provided  for  emergency  medical  services  in  States/UTs  through  a  functional  National Ambulance Service (NAS) network linked with a centralized toll-free number 108/102.
-  Mobile Medical Units (MMU) are supported to facilitate access to public health care at the doorstep particularly to people living in remote, difficult, under-served and unreached areas to provide primary care services.

Some major initiatives  under  NHM  focusing  on  women  and  children,  including  ST  category women and children, throughout the country, are as follows:

-  Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) , provides health coverage of up to Rs 5 lakh per family per year to around 10.74 crore poor and vulnerable families in the country as per Socio Economic Caste Census (SECC).
-  Surakshit  Matritva  Aashwasan  (SUMAN) provides  assured,  dignified,  respectful  and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting public health facilities to end all preventable maternal and newborn deaths.
-  Janani Suraksha Yojana (JSY) , a demand promotion and conditional cash transfer scheme for promoting institutional delivery.
-  Under Janani Shishu Suraksha Karyakram (JSSK), every pregnant woman is entitled to free  delivery,  including  caesarean  section,  in  public  health  institutions  along  with  the provision of free transport, diagnostics, medicines, other consumables & diet
-  Pradhan  Mantri  Surakshit  Matritva  Abhiyan  (PMSMA) provides  pregnant  women  a fixed day, free of cost assured and quality antenatal check up by a Specialist/Medical Officer on the 9th day of every month.
-  LaQshya i mproves the quality of care in labour room and maternity operation theatres to ensure that pregnant women receive respectful and quality care during delivery and immediate post-partum.
-  Monthly Village Health, Sanitation and Nutrition Day (VHSND) is an outreach activity at  Anganwadi  centers  for  provision  of  maternal  and  child  care  including  nutrition  in convergence with the ICDS.
-  Reproductive and child health (RCH) portal is a name-based web-enabled tracking system

for pregnant women and new born so as to ensure seamless provision of regular and complete services to them including antenatal care, institutional delivery and post-natal care.

-  MCP  Card  and  Safe  Motherhood  Booklet are  distributed  to  the  pregnant  women  for educating them on diet, rest, danger signs of pregnancy, benefit schemes and institutional deliveries.
-  Delivery Points - Over 25,000 'Delivery Points' across the country have been strengthened in terms of infrastructure,  equipment, and trained manpower for provision of comprehensive RMNCAH+N services
-  Setting  up  of  Maternal  and  Child  Health  (MCH)  Wings at  high  caseload  facilities  to improve the quality of care provided to mothers and children.
-  Functionalization  of  First  Referral  Units  (FRUs) by  ensuring  manpower,  blood  storage units, referral linkages to improve the access to quality of care for pregnant women.
-  Further,  initiatives  such  as Mission  Parivar  Vikas,  Adolescent  Friendly  Health  Clinics (AFHCs), Weekly Iron Folic Acid Supplementation (WIFS), Menstrual Hygiene Scheme, Facility  Based  Newborn  Care  (FBNC),  Home  Based  Newborn  Care  Program,  Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS), Home Based Care  for  Young  Child  (HBYC),  Rashtriya  Bal  Swasthya  Karyakram  (RBSK),  Early Childhood Development (ECD), Comprehensive Abortion Care (CAC), Anemia Mukt Bharat (AMB) strategy, Nutrition Rehabilitation Centre (NRC) program are supported to increase access to quality healthcare services. Support is also provided to strengthen Universal Immunization programme, introduction of new vaccines.

## Relaxed norms for tribal areas under NHM

- o Differential population norms for tribal areas have been relaxed under NHM.
- o In  tribal,  hilly  and  desert  areas,  the  norm  can  be  relaxed  to  one  ASHA  per  habitation, depending on the workload, geographic dispersion, and difficult terrain.
- o Relaxed norms for Mobile Medical Units (No capping of 5 MMUs per district) as per needs.
- o Negotiable salaries to attract Specialists.
- o To attract quality Human Resources special provisions like ''You quote, we pay' / Hard area allowances.
- o Mobility support.

| Health Centre                 | Population Norms   | Population Norms             |
|-------------------------------|--------------------|------------------------------|
|                               | Plain Areas        | Hilly/Tribal/Difficult Areas |
| Sub Health Centre (SHC)       | 5,000              | 3,000                        |
| Primary Health Centre         | 30,000             | 20,000                       |
| Community Health Centre (CHC) | 1,20,000           | 80,000                       |

As reported by UT of Andaman and Nicobar Islands , the UT Health Mission has provided the scheme benefits to all the women, including the ST category women and their children, under various healthcare schemes of NHM.

Under the JSY programme, Aadaman & Nicobar Islands provides cash assistance amounting to Rs. 700/- to all the pregnant women for their delivery at Health Facilities and Rs. 500/- for  home deliveries.  The details of last  three year are as under:

| Financial Year   |   Institutional Deliveries |   Home Deliveries |
|------------------|----------------------------|-------------------|
| 2019-20          |                        322 |                06 |
| 2020-21          |                        141 |                01 |
| 2021-22          |                        114 |                 0 |

The  financial  support  extended  to  States/  UTs  under  NHM,  including  Andaman  and Nicobar Islands, in the last three years is given at Annexure .

****

## State/UT wise Central Release under National Health Mission (NHM) from F.Y. 2019-20 to 2021-22

(Rs. In Crore)

|   Sl. No. | State/UT                 | 2019-20   | 2020-21   | 2021-22   |
|-----------|--------------------------|-----------|-----------|-----------|
|         1 | Andaman &Nicobar Islands | 34.92     | 36.91     | 43.68     |
|         2 | Andhra Pradesh           | 1111.07   | 1097.81   | 1199.37   |
|         3 | Arunachal Pradesh        | 185.95    | 243.04    | 188.53    |
|         4 | Assam                    | 1749.24   | 1807.48   | 1955.93   |
|         5 | Bihar                    | 1510.68   | 1814.63   | 1748.76   |
|         6 | Chandigarh               | 22.77     | 22.21     | 17.47     |
|         7 | Chhattisgarh             | 816.07    | 979.41    | 969.61    |
|         8 | Dadra &Nagar Haveli      | 25.33     |           |           |
|         9 | Daman &Diu               | 16.79     | 36.39     | 38.59     |
|        10 | Delhi                    | 138.74    | 125.73    | 127.37    |
|        11 | Goa                      | 35.47     | 34.81     | 26.01     |
|        12 | Gujarat                  | 1110.8    | 1005.66   | 1094.48   |
|        13 | Haryana                  | 567.71    | 531.5     | 577.07    |
|        14 | Himachal Pradesh         | 504.84    | 441.94    | 555.09    |
|        15 | Jammu &Kashmir           | 702.2     | 667.46    | 459.1     |
|        16 | Jharkhand                | 830.63    | 602.8     | 640.18    |
|        17 | Karnataka                | 1173.77   | 1232.19   | 1274.71   |
|        18 | Kerala                   | 836.14    | 788.22    | 771.47    |
|        19 | Lakshadweep              | 6.16      | 7.11      | 8.41      |
|        20 | Madhya Pradesh           | 1728.73   | 2377.14   | 2295.66   |
|        21 | Maharashtra              | 1724.99   | 1833.59   | 1769.67   |
|        22 | Manipur                  | 185.65    | 189.49    | 95.59     |
|        23 | Meghalaya                | 141.17    | 202.63    | 282.46    |
|        24 | Mizoram                  | 127.24    | 143.73    | 93.82     |
|        25 | Nagaland                 | 123.23    | 188.21    | 126.66    |
|        26 | Odisha                   | 1475.14   | 1617.63   | 1263.07   |
|        27 | Puducherry               | 31.56     | 25.55     | 21.33     |
|        28 | Punjab                   | 712.02    | 568.14    | 349.21    |
|        29 | Rajasthan                | 1781.83   | 2000.58   | 1924.95   |
|        30 | Sikkim                   | 53.55     | 70.13     | 51.86     |
|        31 | Tamil Nadu               | 1424.22   | 1522.71   | 1631.91   |
|        32 | Tripura                  | 239.47    | 225.91    | 217.95    |
|        33 | Uttar Pradesh            | 4749.05   | 3772.95   | 3235.46   |
|        34 | Uttarakhand              | 348.83    | 583.25    | 553.47    |
|        35 | West Bengal              | 1749.32   | 1895.01   | 1654.26   |
|        36 | Telangana                | 964.34    | 671.88    | 725.67    |
|        37 | Ladakh                   | -         | 91.89     | 44.79     |

## Note:

1. The above releases relate to Central Govt. Grants & do not include State share contribution.
2. After the Reorganisation of the State of Jammu and Kashmir (J&K) into the Union Territory of J&K and Union Territory of Ladakh, NHM funds to the UT of Ladakh were disbursed for the first time during 2020-21.