Lok Sabha Question No. 2286 (UNSTARRED), answered on 2015-12-11
Subject: Universal Health Coverage
Ministry: HEALTH AND FAMILY WELFARE
Asked by: DODDAALAHALLI KEMPEGOWDA SURESH, RAMACHANDRAN MULLAPPALLY, POONAM  MAHAJAN

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2286 TO BE ANSWERED ON 11 TH DECEMBER, 2015

## UNIVERSAL HEALTH COV ERAGE

## 2286. SHRI D.K. SURESH: SHRI MULLAPPALLY RAMACHANDRAN: SHRIMATI POONAM MAHAJAN:

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

- (a)  whether  the  Government  proposes to  roll  out  Universal  Health  Coverage (UHC)  in  the country;
- (b) if' so, the details thereof along with thefunds sanctioned and released during each of the last three years and the current year, State/UT - wise;
- (c) whether the Government has taken cognizance of the recommendation of the Hig   Level Expert Group on UHC regarding the introduction of National Healt h Package that guarantees essential  health services  as  a  part  of  citizen  entitlement hrough  the  public  sector  as  well  as private facilities; and
- (d) if so, the details thereof?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

- (a): Public  Health  is  a  state  subject. M oving  towards  Universal  Health  Coverage  (UHC) wherein  people  are able  to  receive  quality  health  services  that  they  need  without  suffe financial  hardship  is  a  key  goal  of  the  Twelfth  Plan. The  National  Health  Mis s on  ( NHM) represents  the  prime  vehicle  for  achieving  UHC.  The  government  has  already  taken  st towards provision of free services for maternal health, child health, adolescent health, fa planning, universal immunisation programme, and for major dise ases such as TB, vector borne diseases such as Malaria, dengue and kalazar, HIV/AIDS, leprosy etc. Other major initiati which states are being supported include Janani Shishu Suraksha Karyakram (JSSK), Rashtr Bal Swasthya Karyakram (RBSK), Rashtr iya Kishor Swasthya Karyakram (RKSK), implementation of National Health Mission Free Drugs Service Initiative and National He Mission  Free  Diagnostics  Service  Initiative,  roll  out  of  Universal  Health  Coverage strengthening primary healthcare an d District Hospitals and implementation of National Quality Assurance Framework. The central  government is also implementing the Rashtriya Swasthya Bima  Yojana  (RSBY)  which  provides  health  cover  up to  Rs.30,000/ - for  secondary  care hospitalizations including maternity benefit on a family floater basis as per the approve rates to BPL population and 11 other  defined categories of unorganised workers.

(b): The State/UT - wise details of fund s sanctioned and released during the last three years and the current year under NHM are at Annexure -I.

(c) & (d): In line with commitment to UHC as per the Twelfth Plan document, the centra government  circulated  project  proposal  that  could  be  used  by States  to  provide  for  essential package of services to citizens. The same is attached as Annexure II.

## Rs. in crore

| Sl. No.                                     | States                                      | 2013-14    | 2013-14   | 2014-15    | 2014-15   | 2015-16    | 2015-16   |
|---------------------------------------------|---------------------------------------------|------------|-----------|------------|-----------|------------|-----------|
| Sl. No.                                     | States                                      | Allocation | Release   | Allocation | Release   | Allocation | Release   |
| 1                                           | Andaman & Nicobar Islands                   | 23.83      | 29.06     | 28.22      | 23.36     | 28.21      | 24.19     |
| 2                                           | Andhra Pradesh                              | 1184.24    | 878.73    | 707.15     | 519.73    | 616.13     | 439.35    |
| 3                                           | Arunachal Pradesh                           | 86.31      | 78.60     | 185.65     | 139.41    | 160.01     | 95.73     |
| 4                                           | Assam                                       | 1214.83    | 1077.81   | 1095.38    | 877.13    | 941.29     | 664.12    |
| 5                                           | Bihar                                       | 1487.65    | 1110.32   | 1292.13    | 1148.32   | 1108.61    | 914.17    |
| 6                                           | Chandigarh                                  | 18.53      | 11.46     | 19.40      | 12.15     | 14.24      | 7.55      |
| 7                                           | Chattisgarh                                 | 500.72     | 355.98    | 555.66     | 500.41    | 479.38     | 318.95    |
| 8                                           | Dadra & Nagar Haveli                        | 8.73       | 9.23      | 13.99      | 8.40      | 11.37      | 8.74      |
| 9                                           | Daman & Diu                                 | 6.48       | 6.50      | 9.69       | 6.91      | 9.11       | 7.41      |
| 10                                          | Delhi                                       | 211.46     | 129.78    | 192.59     | 154.04    | 142.81     | 102.87    |
| 11                                          | Goa                                         | 27.12      | 19.35     | 27.63      | 26.03     | 19.41      | 12.46     |
| 12                                          | Gujarat                                     | 833.94     | 833.72    | 858.47     | 832.86    | 677.65     | 449.75    |
| 13                                          | Haryana                                     | 313.57     | 315.94    | 317.42     | 273.60    | 249.33     | 212.16    |
| 14                                          | Himachal Pradesh                            | 225.95     | 205.29    | 232.00     | 185.84    | 197.92     | 157.90    |
| 15                                          | Jammu & Kashmir                             | 433.87     | 395.10    | 435.17     | 335.51    | 368.00     | 258.86    |
| 16                                          | Jharkhand                                   | 582.97     | 396.38    | 563.92     | 359.62    | 493.37     | 300.07    |
| 17                                          | Karnataka                                   | 814.17     | 611.11    | 834.09     | 697.24    | 706.09     | 474.78    |
| 18                                          | Kerala                                      | 424.15     | 360.98    | 373.58     | 521.99    | 305.87     | 224.51    |
| 19                                          | Lakshadweep                                 | 3.61       | 3.20      | 5.89       | 5.08      | 4.28       | 3.03      |
| 20                                          | Madhya Pradesh                              | 1141.03    | 865.94    | 1250.17    | 1162.50   | 1085.37    | 842.93    |
| 21                                          | Maharashtra                                 | 1520.71    | 1218.51   | 1536.58    | 1431.76   | 1282.31    | 773.10    |
| 22                                          | Manipur                                     | 127.75     | 88.93     | 144.97     | 128.81    | 118.53     | 77.18     |
| 23                                          | Meghalaya                                   | 139.24     | 125.51    | 160.21     | 104.13    | 131.00     | 59.78     |
| 24                                          | Mizoram                                     | 86.20      | 77.43     | 116.53     | 103.28    | 97.87      | 63.08     |
| 25                                          | Nagaland                                    | 114.42     | 99.73     | 131.26     | 114.92    | 108.75     | 68.03     |
| 26                                          | Orissa                                      | 678.99     | 604.20    | 730.09     | 667.16    | 624.71     | 434.93    |
| 27                                          | Puducherry                                  | 21.29      | 18.10     | 25.46      | 22.56     | 17.77      | 11.91     |
| 28                                          | Punjab                                      | 362.38     | 333.47    | 351.89     | 379.35    | 284.75     | 183.00    |
| 29                                          | Rajasthan                                   | 1091.20    | 922.93    | 1238.11    | 1115.96   | 1069.38    | 939.15    |
| 30                                          | Sikkim                                      | 42.32      | 45.91     | 51.42      | 51.60     | 45.86      | 15.99     |
| 31                                          | Tamil Nadu                                  | 1020.75    | 906.24    | 968.18     | 952.75    | 794.38     | 573.58    |
| 32                                          | Tripura                                     | 165.43     | 140.15    | 161.75     | 123.11    | 139.08     | 49.30     |
| 33                                          | Uttar Pradesh                               | 3584.98    | 3024.60   | 2650.25    | 2431.06   | 2299.49    | 1698.90   |
| 34                                          | Uttarakhand                                 | 310.55     | 245.25    | 308.10     | 270.55    | 256.60     | 163.33    |
| 35                                          | West Bengal                                 | 1179.64    | 948.51    | 1053.27    | 1058.62   | 883.49     | 559.74    |
| 36                                          | Telangana                                   | 0.00       | 0.00      | 506.45     | 378.72    | 440.58     | 252.17    |
| Sub Total Others including arrears under IM | Sub Total Others including arrears under IM |            |           |            |           |            |           |
|                                             |                                             | 132.77     | 89.77     | 1211.51    | 35.83     | 1121.00    | 0.00      |

## Note:

1. Allocation is as per Original B.E.
2. Releases are only Central Release and for the F.Y. 2015 - 16 releases updated upto 30.10.2015.
3. The above Releases relate to Central Govt. Grants & do not include state share contribution.
4. Allocation & Release does not contain head quarter figure, Kind Grants under immunization.

## The Esse nt ial Package of Se rvi ces:

The essent i al l is t spans 20 services that ai m for a cont i nui ty of care fr om pr i m ary t hr ough ter t i ar y.  P r event i ve and Pro m ot i ve carei s an i nte gralpar t of ser vi ces ateach le vel and i nclu des appr opr i ate i nter vent i ons f or behavi or change com m uni cat i on thro ugh an appr opr i ate m i x of i nt erp er s onal,and m ass m edi a,and counsel in g ateach level.

| Primary Care                                                                                                                                                                                                                                                                                                     | C onti nuit y of Ca re t o secondary/ t ert ia ry                                                                                                                                                                                                                                                                                |
|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| l evels 1.SafePregnancy ( Ma te rnaland Reproduct i ve H eal t h Services )                                                                                                                                                                                                                                      | l evels 1.SafePregnancy ( Ma te rnaland Reproduct i ve H eal t h Services )                                                                                                                                                                                                                                                      |
| Carefornor m al p r egnancy and m anagem entof com pl i cat i ons not req ui r in g sur ger y,blo od or speci al is t i nter vent i ons-An t e- natal, del i ver y,and Postnatal, care, and sc r eeni ng form edi calcondi t i ons of pr egnancysuch as hyperte nsi on, an aem i a,and gestatio nal d i abet es. | Mana gem entof c om pl i cat i onsof pr egnancy anddel i veryre qui r i ng sur gery orblo od tra nsf usi on, and second tri m ester abort i on Ser vi ces, a nd m anagem ent sc reeningform edi calcondi t i onsof pr egnancysuch as hy perte nsi on, an aem i a, and gestatio nal d i abet es. G ynaecol ogi calsur geryforpost |
| D i sorde rsofm enstrua t i on and Syndrom i c m anagem ent ofcom m on Reproduct i ve T r actInf ect i ons/ Sexual ly Tra nsm i tted In f ect i ons                                                                                                                                                              | part um i ncont i nence, ute r i ne pro l apse, f i br oi d, hyster ect om y,asappropr i ate. D i agnost i c and speci al i stconsulta t i on asrequ i r ed for                                                                                                                                                                  |
| RTI/ STI 2.N ew born,Infantand ChildH eal t h Services                                                                                                                                                                                                                                                           | RTI/ STI 2.N ew born,Infantand ChildH eal t h Services                                                                                                                                                                                                                                                                           |
| Essent i alnew born car e,care for com m on i lln esses ofnewborn a nd ofchi ld r en,withski l l st o i dent i fy com pl i cat i ons,                                                                                                                                                                            | Si ck N ewbornCare                                                                                                                                                                                                                                                                                                               |
| Prevent i on and comm uni t y ma nagem entof d i arrh ea, fever and A RI                                                                                                                                                                                                                                         | Inst i t ut i onalcar e for t he sic k chi l d - pneum oni a,di ar r hea w i thdehydrat i on and                                                                                                                                                                                                                                 |
| fevers Prevent i on and early det ect i on of c hi ldhood di sabi l i t i es                                                                                                                                                                                                                                     | fevers Prevent i on and early det ect i on of c hi ldhood di sabi l i t i es                                                                                                                                                                                                                                                     |
| 3.Immu niz at ion                                                                                                                                                                                                                                                                                                | 3.Immu niz at ion                                                                                                                                                                                                                                                                                                                |
| Package of BCG+ 3 D PT+ m easl es+ H epat i t i s                                                                                                                                                                                                                                                                | Package of BCG+ 3 D PT+ m easl es+ H epat i t i s                                                                                                                                                                                                                                                                                |
| 4.N utri t ion Rel at ed                                                                                                                                                                                                                                                                                         | 4.N utri t ion Rel at ed                                                                                                                                                                                                                                                                                                         |
| A ll a spectsof p r event i on,counsel i ng on I nfant and Y oung Chi l d Feedi ng (IYC F)and ma nagem entof m alnut r i t i on, e xcepti ng t hose t hatreq ui re in st i tu t i onal                                                                                                                           | A ll a spectsof p r event i on,counsel i ng on I nfant and Y oung Chi l d Feedi ng (IYC F)and ma nagem entof m alnut r i t i on, e xcepti ng t hose t hatreq ui re in st i tu t i onal                                                                                                                                           |
| care. U ni ver saluse of io di zed salt.                                                                                                                                                                                                                                                                         | care. U ni ver saluse of io di zed salt.                                                                                                                                                                                                                                                                                         |
| Identi f i cat i on and ma nagem entof a nem i a,                                                                                                                                                                                                                                                                | Identi f i cat i on and ma nagem entof a nem i a,                                                                                                                                                                                                                                                                                |
| Followup forN RC chi ld r en and com m unity care f orSA M                                                                                                                                                                                                                                                       | N ut r i t i onalR ehabi l i t at i on Cent er s( N RC) f or                                                                                                                                                                                                                                                                     |
| 5.C ontracept iveServic es                                                                                                                                                                                                                                                                                       | 5.C ontracept iveServic es                                                                                                                                                                                                                                                                                                       |
| SevereA cute Malnutri t i on (SA M) C ounsel i ng /BCC t o delayage at m ar r i age,dela yi ng                                                                                                                                                                                                                   | SevereA cute Malnutri t i on (SA M) C ounsel i ng /BCC t o delayage at m ar r i age,dela yi ng                                                                                                                                                                                                                                   |
| f i r stchi ld bi r t h andspaci ng Provi si on ofl i m i t i ng m et hods:O ral Contr acept i ves, C ondom s, I U C D ,                                                                                                                                                                                         | PPI U CD, Fem ale and Ma l e ster i l i zat i on ser vi ces,                                                                                                                                                                                                                                                                     |

| 6.School& Ad ol esce ntH eal t h Services 1.Biannualsc r eeni ng ofchi ld r en i n A WW cent er sand annualyearsc r eeni ng ofchi ldren for de velo pm ent aldela ys, di seases, d i sabi l i t i esand def i ci enci es, lo cal he alth care pro vi si on, p r ovi si on ofgla ss es, all t hreele velsof   | Package of r eferr al c ar e -withlin kst o ter t i arycaref or c ongeni tal a nd r heum at i c heart d i sease                                                                    |
|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 2.A dol escentHealth ser vi ces:peercounsel l ing , l i feskills educat i on, a nd adol escentcl i nic s.                                                                                                                                                                                                    |                                                                                                                                                                                    |
| 7.Emergency Responseand Pati                                                                                                                                                                                                                                                                                 |                                                                                                                                                                                    |
| entTransportServices                                                                                                                                                                                                                                                                                         | entTransportServices                                                                                                                                                               |
| Patie nttra nsport s yst em st hatcan br i ng and dropback patien t sby pr i or i t i zat i on-e.g. forsafe de l i ver y,new bor ns for f i rst28 da ys,sic k i nf ant s,for d i sabi l i t y, a nd speci al pro ble m s of a ccessdue t o l ack of tr ansport,                                              | Em er gency R esponseser vic esforl i fe saving e m er genci esw i thEm er gency Med i cal te chni ci an on board                                                                  |
| 8.Emergency Ca re                                                                                                                                                                                                                                                                                            | 8.Emergency Ca re                                                                                                                                                                  |
| Fi r stA i d Sta bi l i zat i on car e for poi soni ng                                                                                                                                                                                                                                                       | Prevent i on and appro pr i ate m anagem entin poi sonin gs,                                                                                                                       |
| Bites and st i ngs:Fir stA i d                                                                                                                                                                                                                                                                               | m anagem entofBi tesand st i ngs ( snakebi t es and scorp i on st i ngs, a nd animalbi te s)                                                                                       |
| C om plete f i r stai d f ort ra um a i nclu di ng ma nagem ent ofminori nj ur i es,and f or fr actur es                                                                                                                                                                                                     | Mana gem entofFra ct ures                                                                                                                                                          |
| Prevent i on and f i r stai d:Burns and corr osi ons                                                                                                                                                                                                                                                         | Mana gem entofBurns                                                                                                                                                                |
| 9.A cut e Com mu nica bl e Disea se: Fevers                                                                                                                                                                                                                                                                  | 9.A cut e Com mu nica bl e Disea se: Fevers                                                                                                                                        |
| A ll m easur es,f orpre venti on ofvectorbor ne d i seases, early and pro m pttr eat m ent , a nd referral ofcom pl i cated cases.i ncl udi ng poi ntof ca r e di agnost i csf or malar i a, kala - azar, Japanese Encephal i t i s                                                                          | D i agnost i csi n am bulato r y care ; Ho spi tal i zat i on when needed for m ala r i a, kala -azar, e ncephal i t i s, (for any fe ver w i th                                   |
| Pri m arycaref or ot her in f ect i ousdi seases, p r esentin g as fever s-especi ally acut e r espira t ory inf ect i ons.                                                                                                                                                                                  | lo ssofconsci ousness-al t eredsensor i um ), f or de ngue r equi r i ng plate l et s D i agnost i csi n am bulato r y car e-and w here i nst i t ut i onalcarei srequi r ed as in |
| pneum oni a, 10.A cut e Comm unica bl e Dis ease-G ast ro- i ntes t i nal                                                                                                                                                                                                                                    | pneum oni a, 10.A cut e Comm unica bl e Dis ease-G ast ro- i ntes t i nal                                                                                                          |
| Prevent i ve act i on and pr i m arycare for wa t er bor ne dis ease, e speci ally di ar r hoeas( cholera, to herent er i t i s)and dysent er y, t yphoi d,hepat i t i s(A and E)                                                                                                                            | Typhoi d, lep t ospi r osi srequi r i ng adm is si on, h epati t i sacute ( chro ni c hepat i t i snoti ncl uded)especi al lyhepat i t i s inpre gnancy                            |
| C ontrol of he l mint hi asis .                                                                                                                                                                                                                                                                              |                                                                                                                                                                                    |
| Reduct i on of i nf ect i oushepatit i sand i dent i f i cat i on and referra l .                                                                                                                                                                                                                            | Hepati t i sB-anti -vi ra l snoti nclu ded.                                                                                                                                        |
| 11. Ch ronicC omm unic able Disea se-TB and Leprosy                                                                                                                                                                                                                                                          | 11. Ch ronicC omm unic able Disea se-TB and Leprosy                                                                                                                                |
| Screeningfor lep r osy,r ef erral on suspi ci on, and f ol low up on casesw i thconf i r m ed dia gnosi sand pr esc r i bed t r eat m ent .                                                                                                                                                                  | Start of tr eat m ent . Rehabi l i ta t i ve sur ger y-                                                                                                                            |
| Referral ofsuspecttube r cul osis ,f am i lyle velsc r eeni ng of k nown pat i ent s, a nd fo l l ow up w i th D O TS f or                                                                                                                                                                                   | Start of tr eat m ent,MDR TB,                                                                                                                                                      |

conf i r m ed

| 12.Ch ronicC omm unic able Disea se:H IV                                                                                                                                                                                                                                                                                                                                     | 12.Ch ronicC omm unic able Disea se:H IV                                                                                                                                                                                                                                                 |
|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| HIV t est i ng, ap pro pr i at e referral a nd f ollowup on speci al i st -i ni t i atedt rea t m ent .                                                                                                                                                                                                                                                                      | Drug trea t m entfor H I V ,                                                                                                                                                                                                                                                             |
| Prevent i on ofm ot hertochi ldt ra nsmissi on 13.In Ch ronicNo n-C om mu ni cable Disea se:(Package of5),H ypert ensi on,Diabet es, E pilepsy, Ch ronic                                                                                                                                                                                                                     | Prevent i on ofm ot hertochi ldt ra nsmissi on 13.In Ch ronicNo n-C om mu ni cable Disea se:(Package of5),H ypert ensi on,Diabet es, E pilepsy, Ch ronic                                                                                                                                 |
| O bstru ct i ve Pulmonary disea se ( CO PD ) ,A sthm a, Ma ssScree ni ng for d i abet esand hy per t ensi on- al l popula t i on above 3 0. Detect i on of epi l epsy,C O PD and ast hm a-by sel f -reportin g/op portun i st i c scree ni ng. Ensur i ng followup on doctor ini t i ated d r ugsi n di abete s, hy perte nsi on, e pi le psy,CO PD, a st hm a-and secondary | Speci al is tconsulta t i on-i ni t i al lyfor pre scr i pt i on and di agnost i cs, a nd then adm i ssi on and ma nagem entfor com pl i cat i ons-(i nclu di ng stroke, heart atta ck( MI )-butnot i nclu di ng r enal fa i l ure, re spi ratory fai lu r e beyond a DH ' s capaci t y) |
| pre vent i on - so that no com pl i cat i onsdevelop. 14.E ndem ic/ O ccupat i onalprobl ems (S t at e Specific: e.g. Sic kle cell ,f l uorosi s,silic osis et c)as                                                                                                                                                                                                          | pre vent i on - so that no com pl i cat i onsdevelop. 14.E ndem ic/ O ccupat i onalprobl ems (S t at e Specific: e.g. Sic kle cell ,f l uorosi s,silic osis et c)as                                                                                                                      |
| appropriate. Op portun i st i c scr eeningf or a ra nge of d i seases - such as si cklecell d i sease asal so part of R BSK , fol l ow up f or tho se d i agnosed wi t h sic klecell di sease . No screening f orsi cklecell tr ai t.                                                                                                                                        | Mana gem entofsic kl i ng cr i si s                                                                                                                                                                                                                                                      |
| W ork - pla ce scree ni ng and cl i nic sforsi l i cosi s, occupat i onal d i sease.                                                                                                                                                                                                                                                                                         | Referral f or s peci al is t s consulta t i ons, d i agnost i cs                                                                                                                                                                                                                         |
| 15.N C D -Me ntalH ealt h                                                                                                                                                                                                                                                                                                                                                    | 15.N C D -Me ntalH ealt h                                                                                                                                                                                                                                                                |
| Screeningform ent aldi sorders and counsel i ng, a nd fo l low up to speci al i sti ni t i at ed care.                                                                                                                                                                                                                                                                       | Speci al is tconsulta t i on and drug pre scr i pt i on                                                                                                                                                                                                                                  |
| C ounsel i ng and supportt o vic t i m sofvi ole nce.                                                                                                                                                                                                                                                                                                                        | Speci alcounsel i ng,m edic o- le galassi st                                                                                                                                                                                                                                             |
| Prevent i ve m easur esagain stall ha r m f ul adic t i ve subst ances-t obacco i n t he mai n,but al so al cohol and addi ct i ve d r ugs.                                                                                                                                                                                                                                  | De-addi ct i on cent ersinD H                                                                                                                                                                                                                                                            |
| 16.N C D -Cancers                                                                                                                                                                                                                                                                                                                                                            | 16.N C D -Cancers                                                                                                                                                                                                                                                                        |
| Screeningforbre astand cer vi calcancersi n all w om en over the a ge of 4 0,counsel i ng and supportw hi l e on t re at m ent                                                                                                                                                                                                                                               | C hem ot herap y,sur ger y,r adi ot herapy asi ndi cated - onlyf ort hese t w o cancer s.                                                                                                                                                                                                |
| Screeningforor alcancer s: C ounsel i ng and supportf ort rea t m ent .                                                                                                                                                                                                                                                                                                      | Sam e as above                                                                                                                                                                                                                                                                           |
| 17.E ye Ca re                                                                                                                                                                                                                                                                                                                                                                | 17.E ye Ca re                                                                                                                                                                                                                                                                            |
| Screeningforvi suali m pai r m ent s:                                                                                                                                                                                                                                                                                                                                        | Catar actand G la ucom a ( we could al so add d i abet i c r et i nopat hy)                                                                                                                                                                                                              |
| C orr ect i on of ref r act i ve e r rors - especi ally the p ost 40s, Ba si c Eye I nf ect i ons-conj unct i vi t i s, tra chom a 18.DentalCa re                                                                                                                                                                                                                            |                                                                                                                                                                                                                                                                                          |
| Dentalhygi ene,scree ni ng,m edi calcar e of car i es,ging i vi t i s,                                                                                                                                                                                                                                                                                                       | cor nealt r ansplant Toot h e xtra ct i ons, Den t ur es, Root canal s and f i l l i ngs; e xclu di ng ort hodont i c sur gery                                                                                                                                                           |
| 19.B asicSurgical Ca re                                                                                                                                                                                                                                                                                                                                                      | 19.B asicSurgical Ca re                                                                                                                                                                                                                                                                  |
| M i nor in j ur i es,cut s,dra i ni ng of a bscesses                                                                                                                                                                                                                                                                                                                         | Li d, ad nexa m i norsur ger i es- exclu di ng squi nt. Surgeryforacut e a bdom en, hem orr hoi ds, hydro coele and her ni as,                                                                                                                                                           |

| 20 G eneralO PD                                                                                                                                                                                    | 20 G eneralO PD                                                                                 |
|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|
| Regular am bulat oryout -pat i entcare a nd counsel i ng- forminori lln essnotcoming underabove cate gor i es- body a ches,headaches,gast r i t i s,                                               |                                                                                                 |
| Prevent i ve a nd pr om ot i ve me asurest o ad dre ssm uscul o- skelet al d i sor ders -m ai nlyosteo por osi s, ar t hr i t i sof di ff ere ntsor t sand refe r ral or f oll ow up asin di cated | Speci al is tconsulta t i on and d i agnost i cs f or arthr i t i s-especi al lyr heum at oi d. |
| Healthcheck- up                                                                                                                                                                                    |                                                                                                 |