Lok Sabha Question No. 3089 (UNSTARRED), answered on 2024-12-13
Subject: National Health Mission in Odisha
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Ananta Nayak

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3089 TO BE ANSWERED ON 13.12.2024

## NATIONALHEALTH MISSION IN ODISHA

## 3089. SHRI ANANTANAYAK:

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

- (a) whether the National Health Mission (NHM) programme has been able to achieve its objective in the State of Odisha and particularly in Keonjhar district, if so, the details thereof;
- (b) whether the Government is aware that many health care facilities under NHM in the State particularly in the rural/remote areas including Keonjhar district have inadequate infrastructure and also lack basic amenities;
- (c) if so, the details thereof along with the steps taken by the Government to overcome the said situation;
- (d) whether it is true that there is a shortage of qualified health care professionals including doctors, nurses and specialists in many hospitals/health centres in the State of Odisha particularly in Keonjhar district; and
- (e) if so, the details thereof along with the steps taken/being taken by the Government to recruit the same and provide training to the existing professionals?

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

(a) : The National Health Mission (NHM) aims for attainment of universal access to equitable, affordable and quality health care services, accountable and responsive to people's needs, with effective intersectoral convergent action to address the wider social determinants of health. It is implemented in all the States/UTs in the country including Odisha. The key achievements in status of health indicators of Odisha are as under:

-  Odisha reported highest point decline in the country, in IMR with 39 points decline from 75 in 2005 to 36 in 2020.(Source: SRS)
-  State has achieved SDG Goal in population stabilization measures by reducing the Total Fertility Rate (TFR) to 1.8 (India 2.0). (Source: NFHS)
-  Odisha has reported 2nd highest point decline in the country in Maternal Mortality Ratio with a 49 points decline from 168 in 2015-17 to 119 in 2018-20. (Source: SRS)
-  State has secured 1st rank among all States in Full immunization coverage with 90.5 % coverage. (Source: NFHS)
-  There is a consistent improvement in the ranking of State as per TB Score at the national level with 60.5% score in 2018 (14th Rank) to 2nd rank in the Country in 2023 for its efforts towards elimination of TB.

(b) to (e): The details of infrastructure and basic amenities in State of Odisha including Keonjhar district and health care professionals including doctors, nurses and specialists in the State of Odisha are available in public domain at the following URL:

https://mohfw.gov.in/sites/default/files/Health%20Dynamics%20of%20India%20%28Infra structure%20%26%20Human%20Resources%29%202022-23\_RE%20%281%29.pdf

As informed by the State of Odisha, the details of vacancy position of major health care staff including doctors in the district Keonjhar is at Annexure.

The Ministry of Health and Family Welfare provides technical and financial support to the States/UTs to strengthen the public healthcare system including setting up of health facilities, providing basic amenities and recruitment of health care professionals based on the proposals received in the form of Programme Implementation Plans (PIPs) under National Health Mission. Government of India provides approval for the proposal in the form of Record of Proceedings (RoPs) as per norms & available resources. The details are available in public domain at: https://nhm.gov.in/index4.php?lang=1&level=0&linkid=45&lid=58

In addition to the National Health Mission, Government of India has allocated the following funds for developing public healthcare infrastructure and services to Odisha:

-  PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) envisages increased investments in public health and other health reforms to provide better access to health in rural areas. Administrative approvals have been accorded to the State of Odisha, for four years (i.e. FY 2021-22, 2022-23, 2023-24 & 2024-25) for an amount of Rs. 1049.38 Cr. for establishment and strengthening of 604 Building less-AAM (Sub-Centers Health & wellness Centers), 140 Urban- AAM (U-HWC), 119 Block Public Health Units (BPHUs), 21 Integrated Public Health Laboratories (IPHLs) and 21 Critical Care Blocks (CCBs) at District Hospitals and Medical College level, as per proposal of the State.
-  Under Fifteenth Finance Commission (FC-XV) for the State of Odisha, an approval of Rs. 1988.92 Cr. has been given over the five year period from FY 2021-22 to FY 2025-26 for establishment and strengthening of 1280 Building-less Sub Health Centres/ Primary Health Centres (884 SHCs and 396 PHCs) and 90 Block Public Health Units (BPHUs) as per proposal of the State.
-  The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) aims at correcting regional imbalances in the availability of affordable tertiary healthcare services and to augment facilities for quality medical education in the country. Under the Scheme approvals has been accorded for Establishment of One new All India Institute of Medical Sciences (AIIMS) at Bhuvaneshwar and upgradation of three Government Medical Colleges/ Institutions (GMCIs) at Behrampur, Burla and Cuttack for the State of Odisha.
-  Under Centrally Sponsored Scheme (CSS) for ' Establishment of new medical colleges attached with existing district/referral hospitals' with preference to underserved areas and aspirational districts, where there is no existing Government or private medical college. 07 medical colleges were approved in Odisha State at Districts Balasore, Baripada, Bolangir, Koraput, Puri, Jajpur and Kalahandi.

Under NHM, following types of guidelines for encouraging doctors to practice in rural and remote areas of the country to minimize the gap between supply and demand for doctors:

-  Hard area allowance to specialist doctors for serving in rural and remote areas and for their residential quarters so that they find it attractive to serve in public health facilities in such areas.
-  Honorarium to Gynecologists/ Emergency Obstetric Care (EmoC) trained, Pediatricians & Anesthetist/ Life Saving Anaesthesia Skills (LSAS) trained doctors is also provided to increase availability of specialists for conducting Cesarean Sections in rural & remote area.
-  Incentives like special incentives for doctors, incentive for Auxiliary Nurse and Midwife (ANM) for ensuring timely Antenatal Checkup (ANC) checkup and recording, incentives for conducting Adolescent Reproductive and Sexual Health activities.
-  States are also allowed to offer negotiable salary to attract specialist including flexibility in strategies such as 'You Quote We Pay'.
-  Non-Monetary incentives such as preferential admission in post graduate courses for staff serving in difficult areas and improving accommodation arrangement in rural areas have also been introduced under NHM.
-  Multi-skilling of doctors is supported under NHM to overcome the shortage of specialists. Skill upgradation of existing HR is another major strategy under NRHM for achieving improvement in health outcomes.

****

Annexure Annexure referred to in reply to parts (b) to (e) of the Lok Sabha Unstarred Question No. 3089 for 13.12.2024 asked by Shri Ananta Nayak, Hon ' ble MP regarding ' National Health

Mission in Odisha ' .

## VACANCYPOSITION OFMAJOR HEALTHCARE STAFFOF KEONJHAR DISTRICT

|   Sl. No | Category of Staff              |   Sanction |   In-position |   Vacancy |
|----------|--------------------------------|------------|---------------|-----------|
|        1 | Doctors                        |        672 |           313 |       359 |
|        2 | Pharmacist                     |        136 |           100 |        36 |
|        3 | Nursing Staff                  |        592 |           234 |       358 |
|        4 | Community Health Officer (CHO) |        285 |           260 |        25 |
|        5 | Lab Technician                 |         84 |            40 |        44 |
|        6 | Radiographer                   |         26 |            11 |        15 |
|        7 | MPHW(Female)                   |        562 |           461 |       101 |
|        8 | MPHW(Male)                     |        245 |           230 |        15 |