Lok Sabha Question No. 3453 (UNSTARRED), answered on 2025-03-21
Subject: Health Services in Rural Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Balya Mama Suresh Gopinath Mhatre

## GOVERNMENTOFINDIA MINISTRY OFHEALTH AND FAMILY WELFARE DEPARTMENT OFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3453 TO BE ANSWERED ON 21 st MARCH, 2025

## HEALTH SERVICES IN RURALAREAS

## +3453. SHRI BALYAMAMASURESH GOPINATH MHATRE:

## Will be MINISTER OFHEALTH AND FAMILY WELFARE be pleased to state:

(a) the details of the Health Scheme implemented by the Government to improve the infrastructure condition of health services in rural areas of the country during the last three years; and

(b) the details of the health schemes implemented during the said period, State-wise, particularly in Maharashtra?

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

(a) & (b) National Health Mission (NHM): With the objective of attainment of universal access to equitable, affordable and quality health care services, the Ministry of Health & Family Welfare is implementing various programs and provides technical and financial support to the States/UTs for improvement in infrastructure condition of health services.

The healthcare system of the country involves a three-tier system with Sub Health Centre (Rural), Primary Health Centre (Urban and Rural) and Community Health Centre (Urban and Rural) as the three pillars of Primary Health Care System in India.

As per established norms, in rural areas, a Sub Health Centre for a population of 5,000 (in plain) and 3000 (in hilly and tribal area), a Primary Health Centre for a population of 30,000 (in plains) and 20,000 (in hilly and tribal areas) and Community Health Centre for a population of 1,20,000 (in plain) and 80,000 (in hilly and tribal area) is suggested. Further, District Hospital (DH), SubDistrict Hospital (SDH) and First Referral Unit provide secondary care services for rural & urban area. The existing Sub Centres and Primary Health Centres in both rural and urban areas are transformed into Ayushman Arogya Mandir (AAM) to deliver Comprehensive Primary Health Care that includes preventive, promotive, curative, palliative and rehabilitative services, which are universal, free and closer to the community, this will improve the access to quality care in the rural areas.

The Ministry of Health and Family Welfare provides technical and financial support to the States/UTs to strengthen the public healthcare system, 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. The project-wise and year wise budgets approved under RoPs for all states/UTs including Maharashtra can be accessed at link mentioned below:

https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=1377&lid=744

Health Dynamics of India 2022-23 report, which is published based on the data reported by States/Union Territories (UTs), the details of health facilities functioning in the country, available resources, as on 31.03.2023 can be assessed at the following link of HDI 2022-23:

https://mohfw.gov.in/sites/default/files/Health%20Dynamics%20of%20India%20%28Infrastructu re%20%26%20Human%20Resources%29%202022-23\_RE%20%281%29.pdf

PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): PM-ABHIM is one of the largest Pan-India scheme with an outlay of Rs.64180/- Crores for strengthening health care infrastructure to effectively manage and respond to any future pandemics and outbreaks across the country. The scheme period is for 5 years ie. FY 2021-22 to FY 2025-26. Under the CSS components of the scheme, following are the five activities where support is provisioned to the State/UTs during the scheme period (2021-2026):

- Construction of 17,788 Buildingless Sub-Centres as Ayushman Bharat- Health & Wellness centres, now known as Ayushman Arogya Mandir (AAM)
- Establishment of 11,024 Health & wellness Centres, now AAM in Urban areas with a focus on slum and slum like areas,
- Establishment of 3382 Block Public Health Units (BPHUs) at the block level,
- Establishment of 730 District Integrated Public Health Labs (IPHL) in the country, wherein each district will have one such lab.
- Establishing 602 Critical Care Hospital Blocks (CCBs) in all districts with population more than 5 lakhs.

The details of sanctioned and expenditure amount for last three years States/UTs wise under PMABHIM is attached as Annexure-1 .

India COVID-19 Emergency Response and Health Systems Preparedness Package-II ' (ECRP-II): The Cabinet has also approved the ECRP-II scheme on 08 th July 2021 for an amount of Rs.23,123 crore for the F.Y. 2021-22. The scheme aims to accelerate health system preparedness for immediate responsiveness for early prevention, detection and management of COVID-19, with the focus on health infrastructure development including for Pediatric Care and with measurable outcomes. The details of sanctioned amount States/UTs wise under ECRP-II is attached as Annexure-2 .

15 th Finance Commission (FC-XV): The Fifteenth Finance Commission (FC-XV) has recommended grants through local governments for specific components of the heath sector to the tune of Rs.70,051 crore and the same have been accepted by the Union Government. These grants for health through Local Governments will be spread over the five-year period from FY 20212022 to FY 2025-26 and will facilitate strengthening of health system at the grass-root level.

Pradhan Mantri Swasthya Suraksha Yojana (PMSSY): Under the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), there is a provision for upgradation of existing Government Medical Colleges/Institutions (GMCIs) by way of setting up of Super Specialty Blocks (SSB)/Trauma Centres. So far, 75 such projects have been approved under the Scheme. Further, establishment of 22 new All India Institute of Medical Sciences (AIIMS) has been approved under the Scheme. Under Centrally Sponsored Scheme for ' Establishment of new Medical Colleges attached with existing district/referral hospitals ' , a total of 157 Medical Colleges have been approved in the country.

## State/UT-wise Central Release and Expenditure under Pradhan Mantri Ayushman Bharat Health Infrastructure Mission since inception to FY 2023-24

| Rs. In Crore   | Rs. In Crore                       | Rs. In Crore      | Rs. In Crore   | Rs. In Crore      | Rs. In Crore   | Rs. In Crore      | Rs. In Crore   |
|----------------|------------------------------------|-------------------|----------------|-------------------|----------------|-------------------|----------------|
| S. N o.        | Name of the State/UT               | 2021-22           | 2021-22        | 2022-23           | 2022-23        | 2023-24           | 2023-24        |
|                |                                    | Centr al Releas e | Expenditu re   | Centr al Releas e | Expenditu re   | Centra l Releas e | Expenditu re   |
| 1              | Andaman and Nicobar Islands        | -                 | -              | 1.11              | -              | -                 | -              |
| 2              | Andhra Pradesh                     | 3.75              | -              | 15.76             | 6.25           | 35.78             | 28.85          |
| 3              | Arunachal Pradesh                  | 0.56              | -              | 0.10              | -              | 8.83              | 2.25           |
| 4              | Assam                              | 57.90             | -              | 2.26              | 1.16           | 91.45             | 68.45          |
| 5              | Bihar                              | 125.86            | -              | 7.17              | -              | -                 | 50.69          |
| 6              | Chandigarh                         | -                 | -              | 4.79              | 1.73           | 10.38             | 5.83           |
| 7              | Chattisgarh                        | 11.25             | -              | 1.34              | 11.01          | 32.23             | 19.64          |
| 8              | Dadra &Nagar Haveli and Daman &Diu | -                 | -              | 0.24              | -              | 0.28              | 0.21           |
| 9              | Delhi                              | -                 | -              | -                 | -              | -                 | -              |
| 10             | Goa                                | -                 | -              | 0.06              | -              | 3.75              | 0.00           |
| 11             | Gujarat                            | -                 | -              | 29.54             | 32.24          | 46.04             | 56.13          |
| 12             | Haryana                            | 11.06             | -              | 1.31              | -              | 17.67             | 16.63          |
| 13             | Himachal Pradesh                   | -                 | -              | 28.05             | 9.98           | 15.69             | 15.27          |
| 14             | Jammu &Kashmir                     | 16.11             | -              | 1.00              | -              | 44.01             | 36.67          |
| 15             | Jharkhand                          | 44.70             | -              | 183.04            | 240.87         | 102.27            | 454.05         |
| 16             | Karnataka                          | 11.25             | -              | 37.10             | 18.75          | 100.57            | 104.47         |
| 17             | Kerala                             | 3.75              | -              | 24.89             | 4.72           | -                 | 36.66          |
| 18             | Ladakh                             | -                 | -              | 0.00              | -              | 0.62              | 0.31           |
| 19             | Lakshadweep                        | -                 | -              | 0.63              | -              | -                 | 0.07           |
| 20             | Madhya Pradesh                     | 22.85             | -              | 98.70             | 99.43          | 228.52            | 300.93         |
| 21             | Maharashtra                        | 17.45             | -              | 4.07              | -              | 31.76             | 34.47          |
| 22             | Manipur                            | 4.56              | -              | 10.92             | 4.56           | 13.78             | 16.89          |
| 23             | Meghalaya                          | 9.65              | -              | 43.28             | 8.80           | 4.42              | 28.02          |
| 24             | Mizoram                            | 0.28              | -              | 1.52              | 0.27           | 4.52              | 1.32           |

| 25    | Nagaland      | 0.28   | -     | 0.08   | -      | 4.42   | 0.60   |
|-------|---------------|--------|-------|--------|--------|--------|--------|
| 26    | Odisha        | 32.15  | -     | 211.46 | 258.55 | 171.58 | 423.43 |
| 27    | Puducherry    | 0.42   | -     | 0.19   | 0.62   | 2.67   | 2.88   |
| 28    | Punjab        | -      | -     | 24.16  | -      | -      | 2.07   |
| 29    | Rajasthan     | 45.37  | -     | 83.59  | 108.50 | 173.06 | 280.43 |
| 30    | Sikkim        | -      | -     | 0.75   | 0.26   | 3.88   | 2.05   |
| 31    | Tamil Nadu    | 17.45  | 29.08 | 150.42 | 183.35 | 279.36 | 389.37 |
| 32    | Telangana     | 11.25  | -     | 53.88  | 83.75  | 95.21  | 141.73 |
| 33    | Tripura       | -      | -     | 0.90   | 0.38   | 2.48   | 1.43   |
| 34    | Uttar Pradesh | 124.63 | -     | 173.71 | 254.04 | 247.96 | 252.69 |
| 35    | Uttarakhand   | 1.56   | -     | 32.31  | 1.60   | -      | 16.35  |
| 36    | West Bengal   | 9.95   | -     | -      | 9.75   | 30.91  | 49.78  |
| Note: | Note:         |        |       |        |        |        |        |

1. 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.

2. The above releases relate to Central Govt. Grants & do not include State share contribution.

## State/UT wise details of Central Release of Grants in aid under ECRP-II for the F.Y. 2021-22

| S. No.                                                                              | State/UT                                                                            | (Rs. in crore)                                                                      |
|-------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|
| 1                                                                                   | Andaman &Nicobar Islands                                                            | 14.22                                                                               |
| 2                                                                                   | Andhra Pradesh                                                                      | 417.91                                                                              |
| 3                                                                                   | Arunachal Pradesh                                                                   | 149.13                                                                              |
| 4                                                                                   | Assam                                                                               | 731.22                                                                              |
| 5                                                                                   | Bihar                                                                               | 1032.87                                                                             |
| 6                                                                                   | Chandigarh                                                                          | 9.47                                                                                |
| 7                                                                                   | Chhattisgarh                                                                        | 376.07                                                                              |
| 8                                                                                   | Dadra &Nagar Haveli                                                                 | 4.76                                                                                |
| 9                                                                                   | Daman and Diu                                                                       |                                                                                     |
| 10                                                                                  | Delhi                                                                               | 30.21                                                                               |
| 11                                                                                  | Goa                                                                                 | 11.78                                                                               |
| 12                                                                                  | Gujarat                                                                             | 479.22                                                                              |
| 13                                                                                  | Haryana                                                                             | 182.42                                                                              |
| 14                                                                                  | Himachal Pradesh                                                                    | 344.79                                                                              |
| 15                                                                                  | Jammu &Kashmir                                                                      | 407.30                                                                              |
| 16                                                                                  | Jharkhand                                                                           | 383.34                                                                              |
| 17                                                                                  | Karnataka                                                                           | 504.04                                                                              |
| 18                                                                                  | Kerala                                                                              | 173.89                                                                              |
| 19                                                                                  | Ladakh                                                                              | 62.51                                                                               |
| 20                                                                                  | Lakshadweep                                                                         | 1.49                                                                                |
| 21                                                                                  | Madhya Pradesh                                                                      | 874.35                                                                              |
| 22                                                                                  | Maharashtra                                                                         | 820.77                                                                              |
| 23                                                                                  | Manipur                                                                             | 98.73                                                                               |
| 24                                                                                  | Meghalaya                                                                           | 104.12                                                                              |
| 25                                                                                  | Mizoram                                                                             | 61.25                                                                               |
| 26                                                                                  | Nagaland                                                                            | 77.60                                                                               |
| 27                                                                                  | Odisha                                                                              | 517.18                                                                              |
| 28                                                                                  | Puducherry                                                                          | 5.42                                                                                |
| 29                                                                                  | Punjab                                                                              | 198.89                                                                              |
| 30                                                                                  | Rajasthan                                                                           | 883.37                                                                              |
| 31                                                                                  | Sikkim                                                                              | 41.05                                                                               |
| 32                                                                                  | Tamil Nadu                                                                          | 479.59                                                                              |
| 33                                                                                  | Telangana                                                                           | 298.68                                                                              |
| 34                                                                                  | Tripura                                                                             | 83.72                                                                               |
| 35                                                                                  | Uttar Pradesh                                                                       | 1879.88                                                                             |
| 36                                                                                  | Uttarakhand                                                                         | 394.22                                                                              |
| 37                                                                                  | West Bengal                                                                         | 604.76                                                                              |
| Note:                                                                               | Note:                                                                               | Note:                                                                               |
| 1. ECRP refers to India COVID-19 Emergency Response and Health Systems Preparedness | 1. ECRP refers to India COVID-19 Emergency Response and Health Systems Preparedness | 1. ECRP refers to India COVID-19 Emergency Response and Health Systems Preparedness |
| Package. 2. Release under ECRP-Phase II and is as per funding pattern under         | Package. 2. Release under ECRP-Phase II and is as per funding pattern under         | Package. 2. Release under ECRP-Phase II and is as per funding pattern under         |