Lok Sabha Question No. 3673 (UNSTARRED), answered on 2025-03-21
Subject: Changes in Public Health through National Health Mission
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Prof. Sougata Ray

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3673 TO BE ANSWERED ON 21.03.2025

## CHANGES IN PUBLIC HEALTH THROUGH NATIONAL HEALTH MISSION

## 3673. PROF. SOUGATA RAY:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

(a) whether a large number of public health concerns were addressed by National Health Mission (NHM) since its inception;

(b) if so, the details of drastic changes in lowering maternal mortality ratio and incidents of Tuberculosis (TB) and sickle cell anemia since NHM's formation, State-wise;

(c) the number of healthcare workers, including general duty medical officers AYUSH doctors involved in NHM;

(d) the expected time schedule of India to meet UN Sustainable Development Goals (SDG) targets for maternal, child and infant mortality;

(e) whether the NHM has fixed any time limit for the elimination and control of various diseases which are harmful to the public health of the citizen of the country; and (f) if so, the details thereof?

## ANSWER

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

(a) & (b): 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. Currently, NRHM is a sub-mission of National Health Mission (NHM). NUHM was also launched in 2013 as a sub-mission of NHM. NHM support is provided to States/ UTs 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 Ministry of Health and Family Welfare provides technical and financial support to the States/UTs to strengthen the public healthcare system including strengthening of health workforce 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.

As per the Special bulletin on Maternal Mortality Ratio (MMR), released by the Registrar General of India (RGI), the current MMR of the country is 97 per lakh live births. India has seen a significant decline of 157 points in MMR from 254 in 2004-06 to 97 in 2018-20. The State-wise MMR from 2004-06 to 2018-20, as per the Sample Registration System (SR) is given at Annexure-I(A) .

Under the aegis of the National Health Mission (NHM), the government implements the National TB Elimination Programme (NTEP). The incidence rate of TB in India has shown a 17.7% decline from 237 per 100,000 population in 2015 to 195 per 100,000 population in 2023, which is double the pace of global reduction. Further the State/UT-wise TB cases notified in 2024 (Jan - Dec) is placed as Annexure-I(B).

National Sickle Cell Anaemia Elimination Mission has been launched by Hon'ble Prime Minister from Madhya Pradesh on 1st July, 2023. The objectives of the Mission is provision of affordable and accessible care to all Sickle Cell Diseased patients, quality of care for SCD patients and reduction in the prevalence of Sickle Cell Disease through awareness creation, universal screening of 7 crore people in the age group of 0-40 years in affected 278 districts of tribal areas, and counselling through collaborative efforts of central ministries and state government. As of 18.03.2025, approximately 5.11 crore individuals have been screened, identified 1,91,103 sickle cell disease cases and 13,73,597 carriers.

(c): The number of healthcare workers deployed under NHM across the country, State/UTwise is attached at Annexure II . In addition, there are approx. 1.39 lakh community health officers deployed in Ayushman Arogya Mandirs (Sub-Health Centre).

(d) to (f): The details of UN Sustainable Development Goals (SDG) target for Maternal Mortality and Child Mortality and expected timeline is placed below;

| Indicators                                                                   | Current Status (India)                                                       | SDG Target& Timeline                                                         |
|------------------------------------------------------------------------------|------------------------------------------------------------------------------|------------------------------------------------------------------------------|
| Maternal Mortality Ratio (MMR)                                               | 97 per lakh Live Births                                                      | ≤70 by 2030                                                                  |
| Neonatal Mortality Rate (NMR)                                                | 20 per 1000 Live Births                                                      | ≤12 by 2030                                                                  |
| Under 5 Mortality Rate (U5MR)                                                | 32 per 1000 Live Births                                                      | ≤25 by 2030                                                                  |
| Source: Sample Registration System 2020 Report of Registrar General of India | Source: Sample Registration System 2020 Report of Registrar General of India | Source: Sample Registration System 2020 Report of Registrar General of India |

On 8th October, 2024, WHO declared, India has eliminated Trachoma. Target to eliminate Kala Azar has been achieved in 2023. Government of India is taking various steps to eliminate various diseases like Tuberculosis by 2025, Sickle Cell Anaemia by 2047 and Malaria by 2030.

****

## Annexure-I(A)

| MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   | MATERNALMORTALITYRATIO (per 1,00,000 live births)   |
|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|
| India/State s                                       | 2004-0 6                                            | 2007-0 9                                            | 2010-1 2                                            | 2011-1 3                                            | 2014-1 6                                            | 2015-1 7                                            | 2016-1 8                                            | 2017-1 9                                            | 2018-2 0                                            |
| India                                               | 254                                                 | 212                                                 | 178                                                 | 167                                                 | 130                                                 | 122                                                 | 113                                                 | 103                                                 | 97                                                  |
| Andhra Pradesh                                      | 154                                                 | 134                                                 | 110                                                 | 92                                                  | 74                                                  | 74                                                  | 65                                                  | 58                                                  | 45                                                  |
| Assam                                               | 480                                                 | 390                                                 | 328                                                 | 300                                                 | 237                                                 | 229                                                 | 215                                                 | 205                                                 | 195                                                 |
| Bihar                                               | 312                                                 | 261                                                 | 219                                                 | 208                                                 | 165                                                 | 165                                                 | 149                                                 | 130                                                 | 118                                                 |
| Jharkhand                                           | 312                                                 | 261                                                 | 219                                                 | 208                                                 | 165                                                 | 76                                                  | 71                                                  | 61                                                  | 56                                                  |
| Gujarat                                             | 160                                                 | 148                                                 | 122                                                 | 112                                                 | 91                                                  | 87                                                  | 75                                                  | 70                                                  | 57                                                  |
| Haryana                                             | 186                                                 | 153                                                 | 146                                                 | 127                                                 | 101                                                 | 98                                                  | 91                                                  | 96                                                  | 110                                                 |
| Karnataka                                           | 213                                                 | 178                                                 | 144                                                 | 133                                                 | 108                                                 | 97                                                  | 92                                                  | 83                                                  | 69                                                  |
| Kerala                                              | 95                                                  | 81                                                  | 66                                                  | 61                                                  | 46                                                  | 42                                                  | 43                                                  | 30                                                  | 19                                                  |
| Madhya Pradesh                                      | 335                                                 | 269                                                 | 230                                                 | 221                                                 | 173                                                 | 188                                                 | 173                                                 | 163                                                 | 173                                                 |
| Chhattisgar h                                       | 335                                                 | 269                                                 | 230                                                 | 221                                                 | 173                                                 | 141                                                 | 159                                                 | 160                                                 | 137                                                 |
| Maharashtra                                         | 130                                                 | 104                                                 | 87                                                  | 68                                                  | 61                                                  | 55                                                  | 46                                                  | 38                                                  | 33                                                  |
| Odisha                                              | 303                                                 | 258                                                 | 235                                                 | 222                                                 | 180                                                 | 168                                                 | 150                                                 | 136                                                 | 119                                                 |
| Punjab                                              | 192                                                 | 172                                                 | 155                                                 | 141                                                 | 122                                                 | 122                                                 | 129                                                 | 114                                                 | 105                                                 |
| Rajasthan                                           | 388                                                 | 318                                                 | 255                                                 | 244                                                 | 199                                                 | 186                                                 | 164                                                 | 141                                                 | 113                                                 |
| Tamil Nadu                                          | 111                                                 | 97                                                  | 90                                                  | 79                                                  | 66                                                  | 63                                                  | 60                                                  | 58                                                  | 54                                                  |
| Telangana                                           | 111                                                 | 97                                                  | 90                                                  | 79                                                  | 81                                                  | 76                                                  | 63                                                  | 56                                                  | 43                                                  |
| Uttar Pradesh                                       | 440                                                 | 359                                                 | 292                                                 | 285                                                 | 201                                                 | 216                                                 | 197                                                 | 167                                                 | 167                                                 |
| Uttarakhand                                         |                                                     |                                                     |                                                     |                                                     |                                                     | 89                                                  | 99                                                  | 101                                                 | 103                                                 |
| West Bengal                                         | 141                                                 | 145                                                 | 117                                                 | 113                                                 | 101                                                 | 94                                                  | 98                                                  | 109                                                 | 103                                                 |
| Other States                                        |                                                     |                                                     |                                                     |                                                     | 97                                                  | 96                                                  | 85                                                  | 77                                                  | 77                                                  |

SRS does not release Maternal Mortality Ratio (MMR) of the following states and UTs.Andaman & Nicobar Islands, Arunachal Pradesh, Chandigarh, Delhi, Goa, Himachal Pradesh, Jammu and Kashmir, Ladakh, Lakshadweep, Manipur, Meghalaya, Mizoram, Nagaland, Puducherry, Sikkim, The Dadra and Nagar Haveli and Daman and Diu, Tripura

## Annexure I(B)

State/UTs wise TB cases notified in the country during 2024 (Jan Dec)

| State/UT wise TB deaths of Notified TB cases in the Country   | State/UT wise TB deaths of Notified TB cases in the Country   |
|---------------------------------------------------------------|---------------------------------------------------------------|
| State/UT                                                      | 2024 (Jan-Dec)                                                |
| Andaman &Nicobar                                              | 18                                                            |
| Andhra Pradesh                                                | 1686                                                          |
| Arunachal Pradesh                                             | 73                                                            |
| Assam                                                         | 2062                                                          |
| Bihar                                                         | 4978                                                          |
| Chandigarh                                                    | 197                                                           |
| Chhattisgarh                                                  | 1940                                                          |
| Dadra and Nagar Haveli and Daman and Diu                      | 6                                                             |
| Delhi                                                         | 2482                                                          |
| Goa                                                           | 167                                                           |
| Gujarat                                                       | 5904                                                          |
| Haryana                                                       | 3534                                                          |
| Himachal Pradesh                                              | 931                                                           |
| Jammu &Kashmir                                                | 408                                                           |
| Jharkhand                                                     | 1623                                                          |
| Karnataka                                                     | 5159                                                          |
| Kerala                                                        | 2020                                                          |
| Ladakh                                                        | 9                                                             |
| Lakshadweep                                                   | 1                                                             |
| Madhya Pradesh                                                | 7007                                                          |
| Maharashtra                                                   | 8556                                                          |
| Manipur                                                       | 115                                                           |
| Meghalaya                                                     | 249                                                           |
| Mizoram                                                       | 127                                                           |
| Nagaland                                                      | 102                                                           |
| Orissa                                                        | 2619                                                          |
| Pondicherry                                                   | 155                                                           |
| Punjab                                                        | 2726                                                          |
| Rajasthan                                                     | 4970                                                          |
| Sikkim                                                        | 43                                                            |
| Tamil Nadu                                                    | 5292                                                          |
| Telangana                                                     | 1419                                                          |
| Tripura                                                       | 210                                                           |
| Uttar Pradesh                                                 | 19533                                                         |
| Uttarakhand                                                   | 992                                                           |
| West Bengal                                                   | 5503                                                          |

Data Source: Ni-kshay

*****

## Annexure II

| Sl. No.   | HR underNHMas on 30.09.2024                                                    |   In Number |
|-----------|--------------------------------------------------------------------------------|-------------|
| 1         | General Duty Medical Officers (GDMOs)                                          |       17881 |
| 2         | Allied &Health Care workers                                                    |       98334 |
| 3         | Specialists                                                                    |        4778 |
| 4         | Staff Nurses                                                                   |       77537 |
| 5         | Auxiliary Nurse Midwife (ANMs)                                                 |       93348 |
| 6         | AYUSH Doctors                                                                  |       24874 |
| 7         | AYUSH Pharmacist                                                               |        3637 |
| 8         | AYUSH Paramedics                                                               |        2434 |
| 9         | State Programme Management Units (SPMUs), District PMUs &Block PMUs under NRHM |       52537 |
| 10        | Programme Management Staffs underNUHM                                          |        1733 |
| 11        | Lady Health Visitor (LHV)                                                      |        3066 |
| 12        | Public Health Managers                                                         |         527 |
| TOTAL     | TOTAL                                                                          |      380686 |

Source: NHM MIS as on September 2024