Lok Sabha Question No. 2060 (UNSTARRED), answered on 2024-12-06
Subject: Public Health Facilities
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Smt. Bharti Pardhi

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

## LOK SABHA UNSTARRED QUESTION NO. 2060 TO BE ANSWERED ON 06.12.2024

## PUBLIC HEALTH FACILITIES

## 2060. SMT. BHARTI PARDHI:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) whether the Government is aware that most of the public health facilities including district hospitals/primary health centers are not upto the stipulated mark/norms;
- (b) if so, the details thereof along with the response of the Government thereon;
- (c) whether the Government has conducted any self evaluation recently in this regard;
- (d) if so, the outcome thereof along with the challenges brought into notice as a result thereof, State-wise particularly in Madhya Pradesh;
- (e) whether there is an urgent need to make health services better on national level for uniformity in providing better health services across the country; and
- (f) if so, the steps taken/proposed to be taken by the Government in this regard particularly in rural/remote areas along with the success achieved so far in this regard, area-wise?

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

(a) to (f): To improve health infrastructure and services in public health facilities, the government has laid down Indian Public Health Standards (IPHS) 2022. The IPHS are essential benchmarks that ensure the delivery of minimum essential services through public healthcare facilities, including District Hospitals, Sub-District Hospitals, Community Health Centers, Ayushman Arogya Mandir Primary Health Centers (AAM-PHCs), and Ayushman Arogya Mandir- Sub Centres (AAM SCs).

To facilitate the assessment of public health facilities, MoHFW has developed an Open Data Kit (ODK), an Android-based application. This application allows States and UTs to conduct a baseline assessment of their healthcare facilities, identify gaps, and implement timely corrective measures by achieving compliance to provide all essential services and work towards desirable standards.

National Health Mission (NHM) envisages universal access to equitable, affordable & quality health care services that are accountable and responsive to people's needs by supporting the States/UTs in providing financial and technical support for accessible, affordable and quality healthcare, especially to the poor and vulnerable sections in urban, rural, and tribal/hilly areas.

State/UT-wise details of facilities assessed and scored as per IPHS 2022 Assessment report as on 27.11.2024 is at Annexure-I.

In February 2018, the Government of India announced establishment of 1,50,000 Ayushman Arogya Mandirs (AAMs) erstwhile Ayushman Bharat Health and Wellness Centres (ABHWCs), across the country by December 2022. As updated by the States/UTs in AAM portal, a total of 1,74,966 Ayushman Arogya Mandirs have been established and operationalized till 31.10.2024, by transforming existing Sub-Health Centres (SHC) and Primary Health Centres (PHC) in rural and urban areas to deliver the expanded range of comprehensive primary healthcare services with complete 12 package of services that includes preventive, promotive, curative, palliative and rehabilitative services which are universal, free, and closer to the community. State/UT-wise No. of AAMs operationalized as on 31.10.2024 is attached at Annexure-II .

The teleconsultation services, available at operational AAMs, enables people to access the specialist services closer to their homes addressing concerns of physical accessibility, saving cost to care, shortage of service providers and to ensure continuum of care. Total teleconsultation conducted at Ayushman Arogya Mandir including Ayushman Melas are 29.66 cr as on 31.10.2024.

PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) was launched by Hon'ble Prime Minister of India for an amount of Rs.64,180 crore. The measures under the PMABHIM focus on developing capacities of health systems and institutions across the continuum of care at all levels, primary, secondary and tertiary, to prepare health systems in responding effectively to the current and future pandemics /disasters.

This Ministry supports 'Free Diagnostics Service Initiative' programme under NHM with the aim to provide accessible and affordable pathological and radiological diagnostics services closer to the community, which in turn reduces the Out-of-Pocket Expenditure (OOPE). Diagnostics services are provided free of cost at all levels of public health facilities (14 tests at Sub Centers, 63 at Primary Health Centers, 97 at Community Health Centres, 111 test at Sub District Hospitals and 134 tests at District Hospitals).

To ensure availability of essential drugs and reduce the OOPE of the patients visiting the public health facilities, Government has rolled out the Free Drugs Service Initiative under NHM. This includes financial support to States/UTs for 106 drugs at SHC level, 172 at PHC level, 300 at CHC level, 318 at SDH level and 381 drugs at district Hospitals.

## Annexure-I

## Details of facilities assessed and scored as per IPHS 2022 Assessment report (27.11.2024)

| State/UTs                              |   Number of Facilities (as per HDI 2022-23) |   No. of facilities assessed |   No. of facilities which scored more than 50% |
|----------------------------------------|---------------------------------------------|------------------------------|------------------------------------------------|
| Andaman &Nicobar Islands               |                                         157 |                          140 |                                             63 |
| Andhra Pradesh                         |                                       13045 |                        11788 |                                          11603 |
| Arunachal Pradesh                      |                                         611 |                          599 |                                            234 |
| Assam                                  |                                        5979 |                         5731 |                                           2753 |
| Bihar                                  |                                       12869 |                        11389 |                                           1968 |
| Chandigarh                             |                                          55 |                           52 |                                             31 |
| Chhattisgarh                           |                                        6543 |                         4941 |                                           3220 |
| Daman and Diu & Dadar and Nagar Haveli |                                         118 |                          117 |                                             86 |
| Goa                                    |                                         258 |                          275 |                                            147 |
| Gujarat                                |                                       11431 |                        10295 |                                           7738 |
| Haryana                                |                                        3362 |                         2586 |                                           1213 |
| Himachal Pradesh                       |                                        2888 |                         2235 |                                            424 |
| Jammu &Kashmir                         |                                        3533 |                         3026 |                                           1362 |
| Jharkhand                              |                                        4477 |                         3946 |                                           1000 |
| Karnataka                              |                                       12177 |                        10958 |                                           5858 |
| Kerala                                 |                                        6721 |                         6029 |                                           3789 |
| Ladakh                                 |                                         330 |                          276 |                                            221 |
| Madhya Pradesh                         |                                       12575 |                        10641 |                                           5275 |
| Maharashtra                            |                                       14150 |                        13398 |                                           7411 |
| Manipur                                |                                         537 |                          496 |                                            202 |
| Meghalaya                              |                                         651 |                          501 |                                            321 |
| Mizoram                                |                                         458 |                          464 |                                            254 |
| Nagaland                               |                                         636 |                          569 |                                            270 |
| Odisha                                 |                                        8540 |                         7693 |                                           5364 |
| Puducherry                             |                                         137 |                          102 |                                             43 |
| Punjab                                 |                                        3698 |                         3771 |                                           1858 |
| Rajasthan                              |                                       17351 |                        14451 |                                           5756 |
| Sikkim                                 |                                         186 |                          162 |                                            149 |
| Tamil Nadu                             |                                       11300 |                         9425 |                                           8174 |
| Telangana                              |                                        5943 |                         6072 |                                           5803 |
| Tripura                                |                                        1163 |                         1166 |                                            890 |
| Uttar Pradesh                          |                                       30451 |                        25316 |                                           9231 |
| Uttarakhand                            |                                        2577 |                         2102 |                                            310 |
| West Bengal                            |                                       14369 |                         3958 |                                           2134 |
| Delhi                                  |                                         615 |                          393 |                                            122 |
| Lakshadweep                            |                                          19 |                            7 |                                              7 |
| India Total (Rural+Urban)              |                                      209910 |                       175070 |                                          95284 |

State/UT-wise AAMs operationalized as on 31.10.2024

| Sl. No.   | State Name               | Total operationalized AAMs as on 31.10.2024   |
|-----------|--------------------------|-----------------------------------------------|
| 1         | Andaman &Nicobar Islands | 129                                           |
| 2         | Andhra Pradesh           | 11,862                                        |
| 3         | Arunachal Pradesh        | 485                                           |
| 4         | Assam                    | 4,749                                         |
| 5         | Bihar                    | 10,330                                        |
| 6         | Chandigarh               | 58                                            |
| 7         | Chhattisgarh             | 5,848                                         |
| 8         | DNH&DD                   | 95                                            |
| 9         | Goa                      | 300                                           |
| 10        | Gujarat                  | 10,580                                        |
| 11        | Haryana                  | 3,229                                         |
| 12        | Himachal Pradesh         | 2,480                                         |
| 13        | Jammu &Kashmir           | 3,091                                         |
| 14        | Jharkhand                | 3,921                                         |
| 15        | Karnataka                | 9,949                                         |
| 16        | Kerala                   | 7,002                                         |
| 17        | Ladakh                   | 321                                           |
| 18        | Lakshadweep              | 13                                            |
| 19        | Madhya Pradesh           | 11,867                                        |
| 20        | Maharashtra              | 11,962                                        |
| 21        | Manipur                  | 418                                           |
| 22        | Meghalaya                | 611                                           |
| 23        | Mizoram                  | 403                                           |
| 24        | Nagaland                 | 469                                           |
| 25        | Odisha                   | 7,358                                         |
| 26        | Puducherry               | 127                                           |
| 27        | Punjab                   | 3,144                                         |
| 28        | Rajasthan                | 11,293                                        |
| 29        | Sikkim                   | 184                                           |
| 30        | Tamil Nadu               | 8,246                                         |
| 31        | Telangana                | 5,038                                         |
| 32        | Tripura                  | 1,130                                         |
| 33        | Uttar Pradesh            | 22,682                                        |
| 34        | Uttarakhand              | 2,199                                         |
| 35        | West Bengal              | 13,393                                        |
|           | TOTAL                    | 1,74,966                                      |