Lok Sabha Question No. 1139 (UNSTARRED), answered on 2016-04-29
Subject: National Dialysis Service Programme
Ministry: HEALTH AND FAMILY WELFARE
Asked by: ADVOCATE NARENDRA KESHAV SAWAIKAR, C.R. CHAUDHARY, JITENDRA CHAUDHURY, SANKAR PRASAD DATTA

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

LOK SABHA UNSTARRED  QUESTION NO. 1139 TO BE ANSWERED ON 29 TH APRIL, 2016

## NATIONAL DIALYSIS SE RVICE PROGRAMME

## 1139. ADV. NARENDRA KESHAV SAWAIKAR:

SHRI C.R. CHAUDHARY:

SHRI JITENDRA CHAUDHURY:

SHRI SANKAR PRASAD DATTA:

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

- (a) whether the Government has taken cognizance of the World Health Organisation report that kidney ailment is one ofthe major causes of death in India and a sizeable number of population in India are dependent on life long dialysis or require kidney transplant, if so, the details thereof and the reasons therefor;
- (b) whether taking into consideration the above facts, t he Government has started/proposes to start National Dialysis Service Programme (NDSP) under National Health Mission (NHM);
- (c) if so, the details and allocation of funds thereof, State/UT - wise including Goa along with the other steps taken by the Governm ent to address the problems of chronic kidney patients;
- (d) the status of funds allocated by the Government and utilised by the States for strengthening of health  infrastructure, State/UT - wise  including  Rajasthan  during the  last  three  years  and  the current year; and
- (e)  whether  the  Government  has  made any  assessment  of  the  improvements  made in  health infrastructure of States/UTs based on the financial support provided to them from time to time, if so, the details thereof and the outcome thereon?

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

- (a): Nationwide scientific estimation of number of patients of Chronic Kidney Diseases ( has not been carried out. However, in some of the small population based studies, it was found to be in 0.79 % in North India and 0.16% in South India. State/UT - wise data is not available.
- (b) & (c): The Government has announced a new Programme, namely, the National Dialysis Program under the National Health Mission (NHM) in Public Private Partnership (PPP) mode in the Union Budget, 2016 - 7.  This is a Government of India initiative which is to be implemen by  State  /  UT  Governments  though  proposals  in  their  respective  Programme  Implementatio Plans  (PIPs).    The  Guidelines  of  National  Dia lysis  Programme  including  the  Request  for Proposal from the private providers were released on the World Health Day, i.e. 7 th April, 2016. As  per  the  guidelines  framed  for  the  programme,  the  private  partner  is  envisaged  to  p medical human resource, dialysis machine along with RO water plant infrastructure, dialyzer a consumables  while  the  space,  power  and  water  supply  within  the  District  Hospitals  is provided by the State Governments.
- (d): A  statement  showing  the  State/UT  wise  PIP  Approval vs  Utilization  against  Hospital Strengthening and New Constructions / Renovation and Setting up under entire NHM from th Financial Year 2012 - 3 to 2015 - 16 is at Annexure.
- (e): Under  NHM,  Common  Review  Mission  (CRMs) are undertaken  every  year  to  make asses sment  on  the  improvements made, inter - alia,  in  health infrastructure of States/UTs.  The State/UT - wise details of the observations made by the CRMs held so far, are available a URL http://nhm.gov.in/monitoring/common - review - mission.html .

The CRM report is disseminated at the National Level Dissemination Workshop which i attended by State health officials including the State Health Secretaries and Mission D Ministry als o sends State specific suggestions to the States every year based on the observ of CRM.

## Annexure

## Statement Showing the State/UTs wise SPIP Approval vs Utilization against Hospital Strengthening and New Constructions/ Renovation and Setting up under entire NHM from the F.Y. 2012-13 to 2015-16

| No.                      | State                    | 2013-14   | 2013-14   | 2014-15   | 2014-15   | 2015-16   | 2015-16   |
|--------------------------|--------------------------|-----------|-----------|-----------|-----------|-----------|-----------|
|                          |                          | SPIP      | Exp       | SPIP      | Exp       | SPIP      | Exp       |
| A. High Focus States     | A. High Focus States     |           |           |           |           |           |           |
| 1                        | Bihar                    | 37.53     | 15.03     | 80.73     | 39.87     | 10.06     | 8.10      |
| 2                        | Chattisgarh              | 107.29    | 65.80     | 48.79     | 104.63    | 29.48     | 71.79     |
| 3                        | Himachal Pradesh         | 20.70     | 26.45     | 6.55      | 8.72      | 37.22     | 9.94      |
| 4                        | Jammu & Kashmir          | 77.53     | 101.53    | 118.77    | 123.77    | 49.97     | 9.55      |
| 5                        | Jharkhand                | 64.85     | 87.87     | 36.58     | 29.03     | 24.21     | 2.71      |
| 6                        | Madhya Pradesh           | 123.49    | 32.46     | 58.83     | 72.94     | 107.92    | 106.08    |
| 7                        | Orissa                   | 149.40    | 109.30    | 150.88    | 191.65    | 120.63    | 120.01    |
| 8                        | Rajasthan                | 243.04    | 192.98    | 298.31    | 236.11    | 290.14    | 194.61    |
| 9                        | Uttar Pradesh            | 458.71    | 69.20     | 50.17     | 353.94    | 533.95    | 327.31    |
| 10                       | Uttarakhand              | 4.98      | 10.03     | 14.57     | 15.49     | 2.94      | 1.42      |
| Sub Total                | Sub Total                | 1287.52   | 710.66    | 864.19    | 1176.17   | 1206.52   | 851.52    |
| B. NE States             | B. NE States             |           |           |           |           |           |           |
| 11                       | Arunachal Pradesh        | 10.39     | 20.71     | 20.24     | 8.45      | 25.42     | 55.55     |
| 12                       | Assam                    | 191.74    | 48.81     | 158.99    | 81.01     | 199.31    | 138.24    |
| 13                       | Manipur                  | 8.14      | 0.31      | 9.50      | 19.12     | 7.64      | 2.09      |
| 14                       | Meghalaya                | 18.32     | 5.30      | 15.42     | 15.84     | 25.29     | 15.28     |
| 15                       | Mizoram                  | 1.12      | 5.06      | 1.44      | 0.00      | 2.12      | 0.00      |
| 16                       | Nagaland                 | 18.77     | 10.35     | 6.82      | 1.90      | 7.65      | 0.14      |
| 17                       | Sikkim                   | 0.88      | 4.33      | 3.45      | 3.38      | 4.20      | 1.29      |
| 18                       | Tripura                  | 36.00     | 24.61     | 21.62     | 30.06     | 4.59      | 5.48      |
|                          | Sub Total                | 285.36    | 119.48    | 237.46    | 159.74    | 276.23    | 218.07    |
| C. Non-High Focus States | C. Non-High Focus States |           |           |           |           |           |           |
| 19                       | Andhra Pradesh           | 158.62    | 60.20     | 106.32    | 120.70    | 2.92      | 30.90     |
| 20                       | Goa                      | 2.55      | 2.43      | 1.66      | 0.08      | 0.19      | 0.02      |
| 21                       | Gujarat                  | 75.78     | 101.88    | 103.78    | 53.91     | 76.23     | 28.86     |
| 22                       | Haryana                  | 24.13     | 1.56      | 9.05      | 5.18      | 8.81      | 0.48      |
| 23                       | Karnataka                | 143.78    | 83.52     | 105.33    | 91.07     | 78.09     | 52.57     |
| 24                       | Kerala                   | 83.05     | 32.75     | 51.56     | 32.69     | 46.32     | 26.43     |
| 25                       | Maharashtra              | 169.16    | 163.20    | 139.30    | 64.30     | 117.81    | 26.98     |

(Rs. In crore)

| 26                  | Punjab                    | 66.76   | 29.71   | 8.43    | 27.50   | 38.19   | 28.48   |
|---------------------|---------------------------|---------|---------|---------|---------|---------|---------|
| 27                  | Tamil Nadu                | 270.75  | 290.03  | 216.82  | 474.92  | 60.72   | 67.60   |
| 28                  | Telangana                 | 0.00    | 0.00    | 90.97   | 60.67   | 5.00    | 3.02    |
| 29                  | West Bengal               | 128.67  | 179.68  | 81.73   | 84.04   | 21.78   | 33.87   |
|                     | Sub Total                 | 1123.25 | 944.96  | 914.96  | 1015.05 | 456.05  | 299.21  |
| D. Small States/UTs | D. Small States/UTs       |         |         |         |         |         |         |
| 30                  | Andaman & Nicobar Islands | 0.00    | 1.50    | 0.25    | 0.92    | 0.45    | 0.00    |
| 31                  | Chandigarh                | 0.00    | 0.00    | 0.00    | 0.00    | 0.00    | 0.00    |
| 32                  | Dadra & Nagar Haveli      | 0.00    | 0.00    | 0.00    | 0.00    | 0.13    | 0.00    |
| 33                  | Daman & Diu               | 0.03    | 0.01    | 0.03    | 0.01    | 0.05    | 0.01    |
| 34                  | Delhi                     | 41.52   | 8.53    | 60.77   | 64.51   | 3.00    | 4.79    |
| 35                  | Lakshadweep               | 0.00    | 0.00    | 0.00    | 0.00    | 0.00    | 0.00    |
| 36                  | Puducherry                | 0.07    | 0.16    | 0.09    | 0.05    | 0.05    | 0.05    |
|                     | Sub Total                 | 41.62   | 10.20   | 61.14   | 65.49   | 3.68    | 4.84    |
|                     | Grand Total               | 2737.75 | 1785.29 | 2077.75 | 2416.46 | 1942.47 | 1373.64 |

## Note:

1. SPIP- State Programme Implementation Plan.
3. The above data comprises of Hospital Strengtheining - Up- Gradation of CHCs, PHCs, Dist. Hospitals, Strengthening of Districts, Sub Divisional Hospitals, CHCs, PHCs  and  Sub Centre Rent and Contingencies  and New  Constructions/ Renovation  and  Setting  up -CHCs,  PHCs,  SHCs/Sub  Centres,  Setting  up Infrastructure  wing  for  Civil  works,  Govt.  Dispensaries/  others  renovations  and Construction  of  BHO,  Facility  improvement,  civil  work,  BemOC  and  CemOC centres,  Major  civil  works  for  operationalization  of  FRUS,  Major  civil  works  for operationalization  of  24  hour  services  at  PHCs,  Civil  Works  for  Operationalising Infection  Management  &  Environment  Plan  at  health  facilities,  Infrastructure  of Training Institutions, SDH, DH and Civil work of DEIC (RBSK).
2. Above mentioned Utilization figures are as reported by States/UTs and includes expenditure against Central Release, State share & unspent balances, updated up to 31-12-2015.