Lok Sabha Question No. 4686 (UNSTARRED), answered on 2025-03-28
Subject: National Ambulance Services under National Health Mission
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Santosh Pandey, Dr. Byreddy Shabari, Shri Tangella Uday Srinivas

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

## LOK SABHA UNSTARRED QUESTION NO. 4686 TO BE ANSWERED ON 28.03.2025

## NATIONALAMBULANCESERVICESUNDERNATIONALHEALTHMISSION

## 4686. SHRI TANGELLAUDAYSRINIVAS: DR. BYREDDYSHABARI: SHRI SANTOSH PANDEY:

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

- (a) Whether the Government is planning to implement the National Ambulance Service (NAS) to support Basic Life Support (BLS), Advanced Life Support (ALS) and Patient Transport Vehicles (PTVs) across the States, if so, the details thereof;
- (b) the number of ALS and BLS ambulances allocated to each State in the country under NAS based on prescribed population norms, State-wise;
- (c) the criteria and process followed by the States in proposing the required number of ambulances based on specific needs and current service gaps, State-wise;
- (d) whether the Government has conducted any assessment of the adequacy of ambulance services under NAS, particularly in rural and underserved areas in the country along with the measures taken to improve the coverage in these regions, if so, the details thereof;
- (e) the total number of functional and non-functional Active Advance Life Support (AALS) and BLS ambulances under NAS across the country as of the current year, State/district-wise including Andhra Pradesh;
- (f) the total number of people assisted by these ambulances during the last five years, State -wise;
- (g) whether the said life support ambulances available in sufficient numbers in the State of Chhattisgarh, if so, the details thereof;
- (h) the amount provided for the maintenance the said ambulances during the last three years; and
- (i) whether any audit of the ambulance and the equipment kept in them carried out?

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

(a) to (f): The Ministry of Health and Family Welfare (MoHFW) introduced the National Ambulance Services (NAS) in the year 2012 under the National Health Mission (NHM) which has become an integral part of the Indian health care system. NAS has been operating in 36 states/UTs in the country. NHM provides technical and financial assistance to States & UTs to strengthen their healthcare systems, including emergency transportation of patients through NAS. The model for implementation of NAS is selected by respective State/UT Government depending upon their requirement and suitability. NHM provides support towards operational cost and capital expenditure for Basic Life Support (BLS) ambulance, Advance Life Support (ALS) ambulance, Patient transport vehicle (PTV) and innovative solutions like bike, boat ambulances for remote and difficult-to-access areas.

Health being a State subject, the primary responsibility to ensure availability and service adequacy of ambulances lies with the State/UT Governments. However, the Ministry of Health and Family Welfare (MOHFW) provides financial and technical support to the States/UTs each year for improving their emergency ecosystem through State Programme Implementation Plan (SPIP) duly appraised by National Programme Coordination Committee (NPCC). States have been given this flexibility to propose for a particular type of ambulance and the required number of ambulances including the operational costs/full operational costs based on the requirement and the gap analysis in their respective State/UT. State/UT also has the flexibility to deploy the ambulances based on need/service requirements, taking into account the needs of the citizens, including those living in rural or remote areas.

The distribution of ALS and BLS ambulances follows a strategic approach based on population norms outlined under NHM. According to these norms, one ALS ambulance is recommended per 500,000 people, while one BLS ambulance is recommended per 100,000 people. This allocation is designed to ensure a balanced and efficient response to healthcare needs across the country including rural and underserved areas.

Every year under NHM, a Common Review Mission (CRM) is conducted which evaluates performances of various health system and programme components, including ambulances. The findings of the report (latest is 16 th round, 2024) is available at https://nhsrcindia.org/sites/default/files/2025-03/16th%20CRM%20Report%20%282024%29 \_0.pdf

As per NHM-MIS, September 2024, the total number of functional active ALS and BLS ambulances under NAS across the country, state-wise including Andhra Pradesh is given at Annexure . The ambulance services are implemented by the States/UTs and the data relating to people assisted by these ambulances is managed by respective State/UT.

(g) to (i) : As per NHM-MIS, September 2024, there are 30 Advanced Life Support (ALS) ambulances and 296 Basic Life Support (BLS) ambulances functioning in the State of Chhattisgarh. This support is provided based on the Programme Implementation Plan (PIPs) submitted by the State.

Under National Health Mission (NHM), funds for the maintenance of the ambulances are in-built in the Opex cost and is being provided to the States/UTs based on the proposals made by them in their respective Programme Implementation Plan proposals within their overall resource envelope. However, the funds allocated to the State Government of Chhattisgarh for ambulances under NHM since year 2022 are detailed below:

(Rs. in Lakhs)

| State        | 2022-2023   | 2023-2024   | 2024-2025   |
|--------------|-------------|-------------|-------------|
| Chhattisgarh | 8,935.00    | 11,340.77   | 8,576.12    |

The operational cost for ambulances includes maintenance expenses.

The Ministry of Health & Family Welfare provides technical and financial support to States/UTs for strengthening the National Ambulance Services across the nation. 'Public Health and Hospitals' is State subject, the primary responsibility of strengthening public healthcare system, including efforts to have required number of ambulances ensuring their functionality and operationality lies with the respective State/UT Governments.The implementation progress and performance of ambulances are regularly monitored through regular review meetings and field visits conducted through NHM.

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## ANNEXURE

ANNEXURE REFERRED TO IN REPLY TO PARTS (A) TO (F) OF LOK SABHA UNSTARRED QUESTION NO. 4686 FOR 28.03.2025 ASKED BY SHRI TANGELLA UDAY SRINIVAS, DR. BYREDDY SHABARI AND SHRI SANTOSH PANDEY, HON'BLE MPS REGARDING 'NATIONAL AMBULANCE SERVICES UNDER NATIONALHEALTH MISSION' .

## State/UT wise number of functional ALS and BLS ambulances

| State/UT                           |   Advanced Life Support (ALS) |   Basic Life Support (BLS) |
|------------------------------------|-------------------------------|----------------------------|
| Andhra Pradesh                     |                           105 |                        523 |
| Arunachal Pradesh                  |                             0 |                        112 |
| Assam                              |                            14 |                        779 |
| Bihar                              |                           576 |                       1082 |
| Chhattisgarh                       |                            30 |                        296 |
| Goa                                |                            27 |                          0 |
| Gujarat                            |                           175 |                        425 |
| Haryana                            |                            55 |                        264 |
| Himachal Pradesh                   |                            25 |                        173 |
| Jharkhand                          |                           124 |                        418 |
| Karnataka                          |                           231 |                        484 |
| Kerala                             |                             0 |                        315 |
| Madhya Pradesh                     |                           167 |                        835 |
| Maharashtra                        |                           233 |                        704 |
| Manipur                            |                             0 |                          0 |
| Meghalaya                          |                            12 |                         38 |
| Mizoram                            |                             0 |                          0 |
| Nagaland                           |                             0 |                         27 |
| Odisha                             |                           411 |                        449 |
| Punjab                             |                            25 |                        300 |
| Rajasthan                          |                           147 |                        797 |
| Sikkim                             |                             0 |                          8 |
| Tamil Nadu                         |                           205 |                       1148 |
| Telangana                          |                            31 |                        426 |
| Tripura                            |                             0 |                         50 |
| Uttarakhand                        |                            54 |                        217 |
| Uttar Pradesh                      |                           250 |                       4470 |
| West Bengal                        |                             0 |                       1000 |
| Andaman &Nicobar Islands           |                             0 |                         26 |
| Chandigarh                         |                             0 |                          6 |
| Dadra &Nagar Haveli and Daman &Diu |                             0 |                          0 |
| Delhi                              |                             0 |                         29 |
| Jammu &Kashmir                     |                           139 |                         64 |
| Ladakh                             |                            22 |                          0 |
| Lakshadweep                        |                             0 |                          0 |
| Puducherry                         |                             0 |                         10 |
| Total                              |                          3058 |                      15475 |

Source: NHM-MIS, September,2024