Lok Sabha Question No. 1252 (UNSTARRED), answered on 2024-02-09
Subject: Poor Public Health System
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Pritam Gopinath Munde

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH ANDFAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1252 TO BE ANSWERED ON 09 th FEBRUARY, 2024

## POOR PUBLIC HEALTH SYSTEM

## 1252. DR. PRITAM GOPINATHRAO MUNDE:

Will the Minister of HEALTH AND FAMILYWELFARE be pleased to state;

- (a) the details of the present coverage of the National Rural Health Mission (NRHM), State/UT-wise particularly in Maharashtra;
- (b) whether there is a need for improving access, enabling community ownership and demand for services, strengthening public health systems for efficient service delivery;
- (c) if so, the steps taken by the Union Government in this regard;
- (d) whether some States are facing challenges in strengthening poor public health systems;
- (e) if so, the names of these States and the assistance provided/proposed to be provided to these States for strengthening public health systems;
- (f) whether the Union Government had launched Ayushman Bhava for ensuring the saturation of various healthcare schemes at the village level ultimately reaching the last mile beneficiaries; and
- (g) if so, the details thereof?

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

(a) to (e): To address the healthcare challenges, particularly in rural areas, the National Rural Health Mission (NRHM) was launched in 2005 to supplement the efforts of the State/UT governments to provide accessible, affordable and quality healthcare to all those who access public health facilities. NHM support is provided to all States/ UTs including Maharashtra for setting up of new facilities as per norms and upgradation of existing facilities for bridging the infrastructure gaps based on the requirement posed by them.

The Government has launched four mission mode projects, namely PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), Ayushman Arogya Mandir erstwhile Ayushman Bharat Health & Wellness Centres (AB-HWCs), Pradhan Mantri Jan Arogya Yojana (PMJAY) and Ayushman Bharat Digital Mission (ABDM).

PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) was launched by Hon'ble Prime Minister of India with an outlay of Rs. 64,180 crore. The measures under the PMABHIM focus on developing capacities of health systems and institutions across the continuum of care at all levels, primary, secondary and tertiary, to prepare health systems in responding effectively to the current and future pandemics /disasters.

Through 1.64 lakh Ayushman Arogya Mandir, comprehensive primary healthcare is provided by strengthening Sub Health Centres (SHCs) and Primary Health Centres (PHCs). These Ayushman Arogya Mandir (AAM) provide preventive, promotive, rehabilitative and curative care for an expanded range of services encompassing reproductive and child healthcare services, Communicable diseases, Non-communicable diseases and other health issues.

Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides health coverage up to Rs. 5.00 lakh per family per year to poor and vulnerable families.

The Ayushman Bharat Digital Mission (ABDM) aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. It will bridge the existing gap amongst different stakeholders of Healthcare ecosystem through digital highways. As on 08.02.2024, 55 cr Ayushman Bharat Health Accounts (ABHA) have been created.

The Fifteenth Finance Commission (FC-XV) has recommended grants through local governments for specific components of the health sector to the tune of Rs 70,051 crores and the same have been accepted by the Union Government. These grants for health through Local Governments will be spread over the five-year period from FY 2021-22 to FY 2025-26 and will facilitate strengthening of health system at the grass-root level.

The Ministry of Health and Family Welfare provides technical and financial support to the States/UTs to strengthen the public healthcare system, based on the proposals received in the form of Programme Implementation Plans (PIPs) under National Health Mission. Government of India provides approval for the proposals in the form of Record of Proceedings (RoPs) as per norms & available resources.

The details of fund allocated and released under NHM for strengthening public health systems State/UT-wise is attached at Annexure.

(f) & (g): Ayushman Bhav Campaign was launched by Hon'ble President of India on 13th September, 2023. Ayushman Bhav Campaign is envisaged to saturate selected health care services in every village/ town in line with the commitment of Hon'ble Prime Minister to ensure reach to the last mile and enable access to health care services to everyone in the society. 'Ayushman Bhav' campaign involves a set of interventions that include following:

- (i) 'Ayushman - Apke Dwar 3.0'
- (ii) Ayushman Arogya Mandir Health Melas
- (iii) Weekly Health Melas at Community health centres (CHCs)

As on 31.01.2024, total Health Mela organized are 17.90 lakh, total footfall recorded is 1486.82 lakh, Wellness/Yoga/Meditation session are 11.94 lakh, no. of people who received free drugs are 837.99 lakh, no. of people who received free diagnostics services are 746.46 lakh and total 7 types of screening done are 2478.53 lakh.

Note:

1. Allocation is as per original outlay/B.E.
2. The above releases relate to Central Govt. Grants & do not include State share contribution.

Rs. in Cr.

| Sl. No.   | States                            | 2020-21    | 2020-21   | 2021-22     | 2021-22   | 2022-23    | 2022-23   |
|-----------|-----------------------------------|------------|-----------|-------------|-----------|------------|-----------|
| Sl. No.   | States                            | Allocation | Release   | Allocatio n | Release   | Allocation | Release   |
| 1         | Andaman & Nicobar Islands         | 39.02      | 36.91     | 41.62       | 43.68     | 45.95      | 45.26     |
| 2         | Andhra Pradesh                    | 1079.09    | 1097.81   | 1237.95     | 1199.37   | 1,182.93   | 1,489.45  |
| 3         | Arunachal Pradesh                 | 236.60     | 243.04    | 294.27      | 188.53    | 272.48     | 233.82    |
| 4         | Assam                             | 1483.91    | 1807.48   | 1732.64     | 1955.93   | 1,615.70   | 1,981.83  |
| 5         | Bihar                             | 1849.38    | 1814.63   | 2026.69     | 1748.76   | 1,853.57   | 1,586.57  |
| 6         | Chandigarh                        | 24.75      | 22.21     | 26.30       | 17.47     | 31.73      | 38.09     |
| 7         | Chhattisgarh                      | 958.45     | 979.41    | 985.85      | 969.61    | 949.94     | 1,195.08  |
| 8         | Dadra & Nagar Haveli & Daman &Diu | 39.89      | 36.39     | 46.15       | 38.59     | 51.18      | 58.28     |
| 9         | Delhi                             | 165.69     | 125.73    | 179.64      | 127.37    | 164.98     | 35.15     |
| 10        | Goa                               | 36.23      | 34.81     | 40.57       | 26.01     | 38.13      | 55.42     |
| 11        | Gujarat                           | 946.75     | 1005.66   | 1147.40     | 1094.48   | 1,059.03   | 1,120.06  |
| 12        | Haryana                           | 519.03     | 531.50    | 566.85      | 577.07    | 501.71     | 681.21    |
| 13        | Himachal Pradesh                  | 421.35     | 441.94    | 507.47      | 555.09    | 472.62     | 494.65    |
| 14        | Jammu and Kashmir                 | 616.26     | 667.46    | 716.25      | 459.10    | 659.02     | 651.52    |
| 15        | Jharkhand                         | 691.72     | 602.80    | 933.20      | 640.18    | 853.19     | 810.30    |
| 16        | Karnataka                         | 1125.91    | 1232.19   | 1305.23     | 1274.71   | 1,129.18   | 1,246.67  |
| 17        | Kerala                            | 753.30     | 788.22    | 784.68      | 771.47    | 746.63     | 1,036.76  |
| 18        | Lakshadweep                       | 7.23       | 7.11      | 9.53        | 8.41      | 10.55      | 9.97      |
| 19        | Madhya Pradesh                    | 2247.97    | 2377.14   | 2220.09     | 2295.66   | 2,056.81   | 2,582.10  |
| 20        | Maharashtra                       | 1790.69    | 1833.59   | 1938.87     | 1769.67   | 2,006.38   | 2,187.13  |
| 21        | Manipur                           | 174.98     | 189.49    | 207.19      | 95.59     | 192.47     | 61.40     |
| 22        | Meghalaya                         | 154.53     | 202.63    | 211.03      | 282.46    | 196.26     | 261.56    |
| 23        | Mizoram                           | 117.39     | 143.73    | 140.94      | 93.82     | 132.58     | 111.82    |
| 24        | Nagaland                          | 156.19     | 188.21    | 175.46      | 126.66    | 164.27     | 91.38     |
| 25        | Odisha                            | 1465.69    | 1617.63   | 1238.50     | 1263.07   | 1,163.82   | 1,284.69  |
| 26        | Puducherry                        | 30.72      | 25.55     | 36.58       | 21.33     | 36.49      | 20.73     |
| 27        | Punjab                            | 555.46     | 568.14    | 488.28      | 349.21    | 448.58     | 448.89    |
| 28        | Rajasthan                         | 2018.67    | 2000.58   | 2024.38     | 1924.95   | 1,867.04   | 1,460.80  |
| 29        | Sikkim                            | 62.09      | 70.13     | 71.50       | 51.86     | 67.47      | 73.30     |
| 30        | Tamil Nadu                        | 1433.71    | 1522.71   | 1533.20     | 1631.91   | 1,373.29   | 1,652.24  |
| 31        | Tripura                           | 186.91     | 225.91    | 238.22      | 217.95    | 222.50     | 231.90    |
| 32        | Uttar Pradesh                     | 3591.98    | 3772.95   | 4419.86     | 3235.46   | 4,130.21   | 5,133.59  |
| 33        | Uttarakhand                       | 563.05     | 583.25    | 629.00      | 553.47    | 491.17     | 505.01    |
| 34        | West Bengal                       | 1809.71    | 1895.01   | 1643.35     | 1654.26   | 1,439.37   | 1,252.32  |
| 35        | Telangana                         | 627.62     | 671.88    | 825.48      | 725.67    | 767.82     | 683.77    |
| 36        | Ladakh                            | 89.28      | 91.89     | 112.15      | 44.79     | 124.65     | 94.94     |