Lok Sabha Question No. 3203 (UNSTARRED), answered on 2024-12-13
Subject: Free Diagnostic Service
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Smt. Bharti Pardhi, Shri Arvind Ganpat Sawant, Shri Shrirang Appa Chandu Barne, Shri Dharmendra Yadav

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

## LOK SABHA UNSTARRED QUESTION NO. 3203 TO BE ANSWERED ON 13.12.2024

## FREE DIAGNOSTIC SERVICE

## 3203. SMT BHARTI PARDHI:

SHRI ARVIND GANPAT SAWANT:

SHRI SHRIRANG APPACHANDU BARNE:

SHRI DHARMENDRAYADAV:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) whether the Government has rolled out the Free Diagnostic Service initiative under National Health Mission (NHM);
- (b) if so, whether laboratory service have been implemented in the country, particularly in the State of Madhya Pradesh and Uttar Pradesh and if so, the details thereof, State/UT-wise;
- (c) the details of the test facilities available at Sub-centre, Primary Health Centres (PHCs), Community Health Centres (CHCs), Sub-District Hospital (SDH) and District Hospital (DH) in this regard;
- (d) whether the patients have not availed the laboratory services due to non-functional equipment across public health facilities; and
- (e) if so, the details thereof along with the steps taken by the Government to address the issue of non-funcional equipment in the country?

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

(a): The Ministry of Health & Family Welfare had launched Free Diagnostics Services Initiative (FDSI) in 2015 under NHM. The FDSI guidelines have recommended a minimum set of laboratory tests tailored to healthcare facility level in alignment with the National Essential Diagnostic List (NEDL). Subsequently, in 2019, the MoHFW launched a guidance document for implementing laboratory services to provide an expanded range of diagnostics free of cost at all levels of public health facilities (14 tests at Ayushman Arogya Mandir (AAM)-Sub Centres, 63 at AAM Primary Health Centres/UPHC, 97 at Community Health Centres, 111 test at Sub District Hospitals and 134 tests at District Hospitals) thereby reducing high out of pocket expenditure incurred by patients for diagnostics.

(b): FDSI providing laboratory services has been implemented in all 36 States/UTs, out of which 12 States/UTs are implementing in mixed mode i.e. (PPP as well as In-house mode) of service delivery and in 24 States/UTs through In-house mode only. In Madhya Pradesh, the state has implemented through both in-house & PPP mode. State has adopted selective tests outsourcing with wet lease rental reagent model for 06 high-end auto analysers (Haematology, biochemistry, urine, hormone, coagulation and HPLC) at 50 DHs and 35 Civil Hospitals for conducting around 134 tests. Sample transportation for CHC and below facilities is undertaken in PPP mode through runners arranged by the service provider. In Uttar Pradesh, the state has implemented FDSI through In-House mode. The service delivery is undertaken in 'Hub and spoke model'. The state has strengthened the in-house capacity and has established diagnostic hubs at selected CHCs (around 125-150 CHC hub labs in whole State) which are equipped as per IPHS 2022 guidelines. State/UTs wise details of mode of service delivery under FDSI is at ANNEXURE .

(c): The details of the test facilites available at Sub-centre, Primary Health Centres (PHCs), Community Health Centres (CHCs), Sub-District Hospital (SDH) and District Hospital (DH) is available at website at :

https://nhm.gov.in/New\_Updates\_2018/NHM\_Components/Health\_System\_Stregthe ning/Comprehensive\_primary\_health\_care/letter/Guidance\_document\_for\_Free\_Lab oratory\_Services.pdf

(d) & (e) : MoHFW, Government of India has launched the Biomedical Equipment Management and Maintenance Program (BMMP) in 2015 under NHM to address the issue of Non-functional equipment at the public health facilities. The laboratory equipment is covered under BMMP (post warranty) and is operational either through in-house, PPP and mixed model of service delivery. State Government monitors the non-functionality of equipment through this BMMP portal ensuring upkeep time of 95% at District Hospital level, 90% at Community health Centre level and 80% at Primary Health Centre level.

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Annexure referred to in reply to part (b) of Lok Sabha Unstarred Question No. 3203 for 13.12.2024 asked by Smt Bharti Pardhi, Shri Arvind Ganpat Sawant, Shri Shrirang Appa Chandu Barne and Shri Dharmendra Yadav, Hon'ble MPs regarding 'Free Diagnostic Service'

## State/UTs wise details of mode of service delivery under FDSI

| State/UT                                                                                                                                                                                                                                                                                                  | Mode of service delivery                         |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------|
| Arunachal Pradesh, Assam, Delhi, Himachal Pradesh, Jharkhand, Madhya Pradesh, Maharashtra, Manipur, Odisha, Punjab, Tripura, and Uttarakhand (12 States)                                                                                                                                                  | PPP as well as In-house mode of service delivery |
| Andhra Pradesh, A&N Island, Bihar, Chandigarh, Chhattisgarh, D&N Haveli- Daman & Diu, Goa, Gujarat, Haryana, Jammu & Kashmir, Karnataka, Kerala, Ladakh, Lakshadweep, Meghalaya, Mizoram, Nagaland, Puducherry, Rajasthan, Sikkim, Tamil Nadu, Telangana, Uttar Pradesh, and West Bengal. (24 States/UTs) | Only In-house mode of service delivery           |