Lok Sabha Question No. 1878 (UNSTARRED), answered on 2024-12-06
Subject: Healthcare Infrastructure in Rural and Tribal Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Smt. D K Aruna, Shri Suresh Kumar Shetkar, Shri Eatala Rajender

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1878 TO BE ANSWERED ON 06 TH DECEMBER, 2024

## HEALTHCARE INFRASTRUCTURE IN RURALAND TRIBALAREAS

1878 :

SHRI EATALA RAJENDER SMT. D K ARUNA SHRI SURESH KUMAR SHETKAR

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state :

- (a). Whether strengthening the health-care infrastructure and capacity building of the existing workforce in rural/Tribal areas enhance the skilled workforce for the elderly and facilitate the utilisation of health care among senior citizens, if so the details thereof, area-wise.
- (b) Whether this all-inclusive package has a mental health service aspect as well as nutritionrelated services that will operationalise senior care through preventive, wellness and therapeutic interventions and holistic in nature, if so the details, thereof ; and
- (c) the steps taken/proposed to be taken by the Government in this regard alongwith the funds sanctioned/spent during the last twelve years therefore, State-wise ?

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

(a) to (c) Yes, Strengthening the healthcare infrastructure and capacity building of the existing workforce in rural/tribal areas enhance the skilled workforce for the elderly and facilitate the utilization of health care among senior citizens. The Ministry of Health & Family Welfare had launched the 'National Programme for Health Care of the Elderly' (NPHCE) during 2010-11 to address various health related problems of elderly people with comprehensive health care set up completely dedicated and tuned to the needs of elderly. Vision of NPHCE is to create new architecture for Ageing by enhancing capacity of the healthcare staff and equipping healthcare facilities with infrastructure to make the elderly healthcare services more accessible and affordable.

Under NPHCE training of healthcare staff including the staff in rural/tribal areas. ANM/Male health worker posted at Sub-Centre (SC) are trained at Primary Healthcare Center (PHC). Doctors/staff from PHCs are trained at Community Healthcare Centre (CHC) .Doctors and staff from CHCs are trained at District Hospital (DH). Procurement of Aids and Appliances at Sub Centres, Machinery and Equipment at PHCs, CHCs and DHs. Establishment of 10 bedded geriatric ward at District Hospital. The details of preventive, wellness and therapeutic services provided under NPHCE are as below:

At Sub Centre- ANM/Male Health Worker provides elderly /family/ community health care providers information on interventions such as Health Education for healthy ageing, environmental modifications, nutritional requirements, life styles and behavioral changes. Domiciliary visits for home bound/bedridden elderly. Provides Suitable callipers and supportive devices.

At PHC-Conduct health assessment of the elderly based on simple clinical examination relating to vision, joints, hearing, chest, BP ,blood sugar, etc. Advice on chronic ailments like Chronic Obstructive Lung Disease, Arthritis, Diabetes, Hypertension, etc. including dietary regulations.

At CHC-They are first medical referral unit for patients from PHCs and below. Dedicated and specialized Geriatric Clinics for the elderly twice a week. Physiotherapist/Rehabilitation worker provides physiotherapy and medical rehabilitation. Domiciliary visits for bed-ridden elderly and counselling of family.

At District Hospital-Geriatric Clinic with dedicated OPD services for Elderly along with existing specialities like General Medicine, Orthopaedics, Ophthalmology, ENT etc. 10bedded Geriatric Ward for in-patient care, laboratory investigations and provision of medicines. Referral services for severe cases to tertiary level hospitals/ Regional Geriatric Centre.

The funds sanctioned/spent from 2015-16 to 2022-23 attached as Annexure .

## State/UT wise SPIP Approvals and Expenditure towards National Programme for Health Care for the Elderly (NPHCE) under NHM from FY 2015-16 till FY 2023-24

| S                  | 2015-16       | 2015-16      | 2016-17          | 2016-17     | 2017-18          | 2017-18       | 2018-19          | 2018-19   | 2019-20          | 2019-20     | 2020-21       | 2020-21      | 2021-22        | 2021-22      | 2022-23        | 2022-23      | 2023-24        | 2023-24      |
|--------------------|---------------|--------------|------------------|-------------|------------------|---------------|------------------|-----------|------------------|-------------|---------------|--------------|----------------|--------------|----------------|--------------|----------------|--------------|
| No . States/UT     | SPIP Approval | Expenditur e | SPIP Approval re | Expenditu   | SPIP Approval re | Expenditu     | SPIP Approval re | Expenditu | SPIP Approval re | Expenditu   | SPIP Approval | Expenditu re | SPIP Approval  | Expenditu re | SPIP Approval  | Expenditur e | SPIP Approval  | Expenditu    |
| 1 Andaman & Nico   | 42.00         | 0.00         | 82.00            | 0.00        | 0.00             | 0.00          | 118.00           | 0.00      | 37.72            | 1.70        | 1.50          | 0.00         | 30.40          | 0.00         | 17.98          | 0.02         | 9.00           | 0.00         |
| 2 Andhra Pradesh   | 2,096.18      | 0.00         | 105.70           | 0.44        | 89.40            | 128.97        | 39.00            | 0.00      | 78.20            | 0.00        | 789.90        | 789.90       | 455.06         | 114.58       | 316.50         | 18.57        | 269.00         | 207.65       |
| 3 Arunachal Prade  | 0.00          | 0.00         | 0.00             | 68.62       | 331.20           | 2.53          | 122.40           | 131.13    | 150.00           | 24.64       | 165.40        | 125.27       | 40.00          | 255.44       | 146.60 97.50   |              | 151.60         | 23.80        |
| 4 Assam            | 1,393.22      | 118.16       | 1,263.77         | 301.59      | 567.60           | 126.84        | 411.60           | 180.67    | 406.59           | 119.87      | 310.30        | 169.41       | 65.46          | 23.62        | 490.15         | 107.14       | 92.25          | 221.43       |
| 5 Bihar            | 1,650.46      | 17.71        | 315.48           | 27.56       | 1,005.20         | 164.71        | 1,491.40         | 115.38    | 383.49           | 37.16       | 165.77        | 40.56        | 5.67           | 20.83        | 74.72          | 5.59         | 78.46          | 6.30         |
| 6 Chandigarh       | 0.00          | 0.00         | 0.00             | 0.00        | 0.00             | 0.00          | 0.00             | 0.00      | 0.00             | 0.00        | 0.00          | 0.00         | 0.00           | 0.00         | 0.00           | 0.00         | 0.00           | 0.00         |
| 7 Chhattisgarh     | 0.00          | 25.51        | 154.97           | 159.35      | 515.80           | 844.59        | 115.08           | 927.01    | 365.65           | 96.08       | 95.36         | 63.09        | 512.11         | 254.31       | 387.50         | 312.22       | 487.60         | 268.06       |
| Dadra & Nagar H    | 28.00         | 14.77        | 23.11            | 34.99       | 2.00             | 0.00          | 0.00             | 0.00      | 0.00             | 0.00        |               | 0.00         |                |              |                |              |                | 0.00         |
| 8 Daman & Diu      | 0.00          | 0.00         | 3.30             | 0.00        | 0.40             | 0.00          | 5.94             | 0.39      | 0.40             | 0.06        | 0.35          |              | 0.00           | 0.00         | 27.87          | 0.25         | 2.35           |              |
| 9 Delhi            | 333.43        | 0.00         | 259.34           | 0.00        | 41.80            | 0.00          | 8.80             | 0.15      | 14.80            | 0.00        | 9.80          | 0.00         | 24.90          | 7.42         | 331.00         | 0.05         | 313.00         | 8.12         |
| 10 Goa             | 0.00          | 0.00         | 42.34            | 0.10        | 49.40            | 3.45          | 34.60            | 14.59     | 29.80            | 12.00       | 13.34         | 10.79        | 27.30          | 22.61        | 29.30          | 23.42        | 29.30          | 22.38        |
| 11 Gujarat         | 397.68        | 190.51       | 348.04           | 183.29      | 313.98           | 51.42         | 36.15            | 35.94     | 20.10            | 66.62       | 20.20         | 9.19         | 78.05          | 29.84        | 179.35         | 57.10        | 159.35         | 178.22       |
| 12 Haryana         | 339.70        | 68.26        | 175.38           | 100.50      | 14.91            | 9.22          | 48.08            | 3.67      | 61.82            | 29.31       | 70.29         | 33.02        | 91.11          | 72.46        | 131.62         | 84.52        | 101.82         | 73.04        |
| 13 Himachal Prades | 509.40        | 47.22        | 44.40            | 35.31       | 115.20           | 40.38         | 40.00            | 25.12     | 27.09            | 22.96       | 1.50          | 24.01        | 15.94          | 35.91        | 83.00          | 13.31        | 78.00          | 25.75        |
| 14 Jammu and Kash  | 368.36        | 90.92        | 538.73           | 72.39       | 362.95           | 41.15         | 105.20           | 7.13      | 164.95           | 21.18       | 144.50        | 1.00         | 166.50         | 80.75        | 136.50         | 18.74        | 101.50         | 8.39         |
| 15 Jharkhand       | 1,187.50      | 0.00         | 677.95           | 51.94       | 117.20           | 10.88         | 328.70           | 15.22     | 181.11           | 40.39       | 13.23         | 33.98        | 268.83         | 168.14       | 481.58         | 180.76       | 301.98         | 217.57       |
| 16 Karnataka       | 831.68        | 92.23        | 1,271.84         | 237.52      | 39.00            | 67.17         | 36.30            | 141.45    | 340.08           | 356.72      | 1,310.80      | 331.73       | 129.60         | 79.15        | 793.72         | 193.77       | 159.00         | 165.84       |
| 17 Kerala          | 180.97        | 76.16        | 223.54           | 128.57      | 84.00            | 436.99        | 196.00           | 93.87     | 421.00           | 35.62       | 128.50        | 139.19       | 363.50         | 188.09       |                | 72.95        | 343.30         | 88.01        |
| 18 Ladakh          | 0.00          | 0.00         | 0.00             | 0.00        | 0.00             | 0.00          | 0.00             | 0.00      | 0.00             | 0.00        | 0.00          | 0.40         | 53.70          | 74.74        | 487.80 24.90   | 52.06        | 17.90          | 52.73        |
| 19 Lakshadweep     | 0.00          | 25.42        | 14.27            | 2.38        | 4.40             | 24.49         | 4.00             | 0.00      | 1.00             | 9.51        | 12.35         | 2.00         | 11.40          | 0.43         | 8.80           | 2.49         | 8.88           | 0.40         |
| 20 Madhya Pradesh  | 386.26        | 104.50       | 140.93           | 81.01       | 40.50            | 19.98         | 595.58           | 20.64     | 67.44            | 30.13       | 139.00        | 118.05       | 1,518.63       | 172.71       | 210.50         | 432.75       | 135.50         | 399.52       |
| 21 Maharashtra     | 486.85        | 185.90       | 286.43           | 79.10       | 72.79            | 22.53         | 104.50           | 81.87     | 213.00           | 11.11       | 151.60        | 30.98        | 131.49         | 75.29        | 307.30         | 71.93        | 331.30         | 219.20       |
| 22 Manipur         | 146.00        | 60.00        | 48.20            | 0.00        | 325.60           | 0.00          | 16.60            | 132.10    | 299.10           | 0.00        | 114.30        | 31.43        | 135.97         | 0.00         | 67.50          | 47.55        | 67.50          | 2.97         |
| 23 Meghalaya       | 0.00          | 0.00         | 0.00             | 0.00        | 68.70            | 0.00          | 124.15           | 0.00      | 14.50            | 6.14        | 86.97         | 79.28        | 200.98         | 79.61        | 198.21         | 113.48       | 89.75          | 28.17        |
| 24 Mizoram         | 357.20        | 7.03         | 67.80            | 64.27       | 103.35           | 20.15         | 21.70            | 27.07     | 21.85            | 4.62        | 19.86         | 14.89        | 27.24          | 11.46        | 28.15          | 5.65         | 34.45          | 14.71        |
| 25 Nagaland        | 0.00          | 0.00         | 214.96           | 0.00        | 482.90           | 0.95          | 11.06            | 3.03      | 2.26             | 1.34        | 7.99          | 0.49         | 20.40          | 24.25        | 5.03           | 0.20         | 4.13           | 0.35         |
| 26 Odisha          | 326.63        | 80.84        | 414.09           | 69.71       | 694.10           | 96.32         | 321.60           | 453.19    | 231.16           | 379.52      | 173.10        | 204.31       | 137.55         | 224.01       | 678.30         | 420.60       | 169.10         | 263.35       |
| 27 Puducherry      | 67.90         | 0.00         | 63.35            | 18.17       | 45.25            | 42.32         | 36.50            | 0.00      | 30.85            | 9.90        | 31.30         | 0.47         | 32.40          | 10.35        | 40.07          | 30.78        | 43.89          | 13.61        |
| 28 Punjab          | 364.00        | 81.61        | 217.45           | 68.57       | 673.00           | 0.00          | 98.90            | 4.40      | 11.00            | 110.01      | 17.60         | 24.61        | 40.40          | 58.67        | 199.50         | 4.85         | 211.50         | 211.50       |
| 29 Rajasthan       | 866.80        | 825.53       | 923.54           | 637.50      | 0.00             | 57.01         | 25.00            | 10.00     | 30.00            | 0.00        | 30.00         | 0.00         | 310.10         | 161.23       | 31.40          | 16.81        | 31.40          | 20.31        |
| 30 Sikkim          | 110.46        | 51.05        |                  | 31.19       | 6.92             | 0.00          |                  | 1.31      |                  |             | 17.80         | 0.21         | 19.15          | 9.73         |                |              | 13.93          | 12.22        |
| 31 Tamil Nadu      | 350.56        | 0.00         | 77.51 236.00     | 126.00      | 554.70           | 159.00        | 6.29 593.90      | 835.70    | 4.72 246.50      | 0.00 282.50 | 54.25         | 58.76        | 212.86         | 166.55       | 13.90 202.01   | 13.83        | 325.50         | 108.50       |
| 32 Telangana       | 365.00        | 0.00         | 120.50           | 0.00        |                  | 0.00          |                  | 0.00      | 60.00            | 73.31       |               |              | 75.00          | 22.40        | 19.25          |              | 122.90 0.00    | 4.95         |
| 33 Tripura         | 0.00          | 0.00         |                  |             | 246.00           |               | 0.00             | 0.00      | 11.22            |             | 142.00        | 0.00         |                |              | 55.55          | 27.04 117.55 | 7.00 65.60     | 34.97 177.84 |
| 34 Uttar Pradesh   | 0.00          | 627.84       | 10.80 2,090.57   | 0.00        | 40.00 405.00     | 0.00          | 40.00            | 31.50     | 5.25             | 7.54 572.37 | 0.00 731.25   | 1.97         | 93.17          | 6.39         | 1,047.50 62.43 | 23.16        | 1,977.98 52.32 | 42.91        |
| 35 Uttarakhand     | 1,911.30      | 0.00         | 240.90           | 914.79 0.00 | 88.30            | 666.77 215.07 | 2,240.00         | 1,538.08  | 1,166.80         | 5.25        | 44.94         | 194.31 23.54 | 1,154.73 65.01 | 64.16        | 50.67          |              | 229.05         | 145.67       |
| 36 West Bengal     | 605.84        | 24.37        | 446.69           | 51.34       | 287.40           | 46.32         | 21.50 92.00      | 153.79    | 59.00            | 36.61       | 103.43        | 105.17       | 60.70          | 121.13       | 274.36         | 147.57       |                |              |

## Note:

1. The above data is as per the available Financial Management Reports (FMRs) reported by the States/UTs and is provisional.
2. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year. Expenditure is as per FMRs submitted by States/UTs and is provisional.

3. NCD Pool was implemented from FY 2015-16 onwards.

4. 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.

## Annexure (Rs. in Lakh)