Lok Sabha Question No. 197 (STARRED), answered on 2016-05-06
Subject: Fund Allocation for Health Projects
Ministry: HEALTH AND FAMILY WELFARE
Asked by: C.S. PUTTARAJU, SANKAR PRASAD DATTA

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

## LOK SABHA STARRED QUESTION NO. 197 TO BE ANSWERED ON THE 06 TH MAY, 2016 FUND ALLOCATION FOR HEALTH PROJECTS

## *197. SHRI C. S. PUTTA RAJU: SHRI SANKAR PRASAD DATTA:

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

- (a)  the  details  of  Centrally  aided  health  projects  functioning  alon schemewise  allocation  and  utilisation  of  funds,  State/UT - wise  including Karnataka;
- (b) whether  the  Government  has  conducted  any  survey  on  the  prevailing healthcare facilities and infrastructure in rural areas of the country, details thereof and the outcome thereon;
- (c) whether the Government is aware of shortage of doctors in ru ral areas, if so, the details thereof and the reasons therefor; and
- (d)  the  steps  taken  by  the  Government  to  provide  healthcare  facili infrastructure and adequate number of doctors in rural areas in order to f objectives of the Sulabh Chikitsa and Swasthya Bharat programme?

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

- (a) to ( d):  A statement is laid on the Table of the House

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA TH

## STARRED QUESTION NO. 19 7* FOR 06 MAY, 2016

(a) Ministry  of  Health  and  Family  Welfare  is  implementing  following Centrally aided health schemes :

## (i) National Health Mission (NHM)

(ii)

- Establishment  of  new  Medical  Colleges  attached  with  existing district/referral hospitals,
- Upgradationof  existing  State  Government/Central  Government medical colleges to increase MBBS seats in the country,
- Strengthening and upgradation of State Government Medical colleges for starting new PG disciplines and increasing PG seats
- (iii) National AIDS Control Programme
- (iv) Tertiary Care Cancer Centre

Details  of  these  schemes  along  with  allocation  and  utilisation  of State/UT - wise is at Annexure - I to IV

(b) Three rounds of District Level Household and Facility Surveys (DLHS were undertaken in the past (Round-I in 1998 - 99, Round - II in 2002 - 04, and Round - III in 2007 - 08) with the main objective to provide reproductive an child health database at district level in India.

The Ministry of Health and Family Welfare, Government of India carried o the fourth round of District Level Household and Facility Survey (DLHS - 4) of public health facilities with the objective of estimating reliable of population, maternal & child health and family planning at District and higher levels.  The DLHS - 4 was conducted during 2012 - 13. The Survey was funded by the Ministry of Health and Family Welfare, Government of Ind and the International Institute for Population Sciences (IIPS) was the Agency  for  conducting  District  Level  Household  and  Facility  S urvey - 4 (DLHS - 4).

This survey reveals that in most of the States, improvements were foun percentage of Sub - Health Centres located in government building, availability of additional ANMs in Sub - Health Centres, percentage of PHCs that are functional 24 X 7 hours, percentage of PHCs that have AYUSH doctors, percentage of PHCs having residential quarter for Medical Off and percentage of CHCs having 24 X 7 hours normal delivery services etc. Details are at Annexure - V.

(c) As per Rural Health Statistics (RHS) 2015, the State/UT - wise information  of  Sanctioned  and  In  Position  of  Doctors  at  Primary  Hea Centres (PHCs) and Community Health Centres (CHCs) and Specialists at CHCs are at Annexure - VI.

Various reasons attributed for shortage of doctors in rural areas include non -availability of requisite number of doctors, feeling of professional i among  doctors  and  unwillingness  on  the  part  of  doctors  to  work  in  r areas.

(d) Public health is a State subject. Therefore, the primary responsibi ens ure availability of doctors in rural areas lies with the State Gover However, under the National Health Mission (NHM), financial and technic support  is  provided  to  States/UTs  to  strengthen  their  healthcare  sy including  support  for  healthcare facilities,  infrastructure  and  engaging  of doctors  on  contractual  basis,  based  on  the  requirements  posed  by States/UTs in their PIPs.

Support under NHM is also provided for multi - ski l ng of doctors, for giving hard area allowance to medical professi onals for serving in rural and remote areas and for their residential quarters so that they find it attracti in public health facilities in such areas. Also, States are advised place  transparent  policies  of  posting  and  transfer,  and  en sure  rational deployment  of  medical  professionals.  As  the  posts  required  for  he facilities  are  filled  up  by  respective  State/UT  Governments,  they impressed upon from time to time to fill up the vacant posts.

Further, in order to encourage doctors t o work in remote and difficult areas, the  Medical  Council  of  India,  with  the  previous  approval  of  Cent Government, has amended the Post Graduate Medical Education Regulations, 2000 to provide:

(i) 50%  reservation  in  Post  Graduate  Diploma  Courses  f or  Medical Officers in the Government service, who have served for at least t years in remote and difficult areas; and

(ii) Incentive at the rate of 10% the marks obtained for each year service in remote or difficult areas as upto the maximum of 30% of the marks  obtained  in  the  entrance  test  for  admissions  in  Post  Gradu Medical Courses.

The  Government  has  taken  the  following  steps  to  further  augment  t availability of doctors in the country:

subjects

Medical

- I. The ratio of teachers to students has been rev ised from 1:1 to 1:2 for all MD/MS disciplines and 1:1 to 1:3 in Anaesthesiology, Forensic Medicine, Radiotherapy, Oncology, Surgical Oncology and Psychiatry.

o

- II. DNB qualification has been recognized for appointment as facult to take care of shortage of faculty.
- III. Enhancement  of  maximum  intake  capacity  at  MBBS  level  from 150 to 250.
- IV. Enhancement of age limit for appointment/extension/re -employment  against  posts  of  teachers/dean/principal/  director medical colleges from 65 - 70 years.
- V. Relaxation in the norms for setting up of a medical college in t of requirement for land, faculty, staff, bed/ bed strength and infrastructure.
- VI. Strengthening/upgradation of State Government Medical Colleges for starting new PG courses/Increase of PG seats with fund sharing between the Central and State Government.
- VII. Establishment of New Medical Colleges by upgrading district/referral hospitals preferably in underserved districts country  with  fund  sharing  between  the  Central  Govern ment  and States.
- VIII. Strengthening/ upgradation of existing State Government/Centra Government Medical Colleges to increase MBBS seats with fund sharing between the Central Government and States.

## National Health Mission (NHM)

The National Health Mission (NHM)  envisages achievement of universal access to equitable, affordable  &  quality  health  care  services  that  are  accountable  and  responsive  to  people's  needs. NHM encompasses  its  two  Sub-Missions,  the  National  Rural  Health  Mission (NRHM)  and  the National Urban Health Mission (NUHM). The main programmatic components include Health System Strengthening  in  rural  and  urban  areas,  Reproductive-MaternalNeonatal-Child  and  Adolescent Health (RMNCH+A), and Communicable and Non-Communicable Diseases.

Under the NHM, technical and financial support is provided to State / UTs for strengthening of  their  healthcare  systems  based  on  the  proposals submitted  by  them  in  their  Programme Implementation Plans (PIPs).

The allocation and utilization of funds, State/UT wise including Karnataka is at Annexure-I(a)

## Annexure-I

## Annexure-I(a)

## Statement Showing State wise Allocation and Utilization under NHM for the    F.Y. 2015-16

Rs. in crore

| Sl. No.   |                          | 2015-16            | 2015-16      |
|-----------|--------------------------|--------------------|--------------|
| Sl. No.   | States                   | Central Allocation | Utilization* |
| 1         | Andaman& Nicobar Islands | 28.21              | 7.46         |
| 2         | Andhra Pradesh           | 616.13             | 538.39       |
| 3         | Arunachal Pradesh        | 160.01             | 110.70       |
| 4         | Assam                    | 941.29             | 857.52       |
| 5         | Bihar                    | 1108.61            | 812.81       |
| 6         | Chandigarh               | 14.24              | 13.84        |
| 7         | Chattisgarh              | 479.38             | 440.70       |
| 8         | Dadra& Nagar Haveli      | 11.37              | 8.37         |
| 9         | Daman &Diu               | 9.11               | 8.31         |
| 10        | Delhi                    | 142.81             | 82.29        |
| 11        | Goa                      | 19.41              | 21.29        |
| 12        | Gujarat                  | 677.65             | 713.18       |
| 13        | Haryana                  | 249.33             | 310.90       |
| 14        | Himachal Pradesh         | 197.92             | 171.15       |
| 15        | Jammu &Kashmir           | 368.00             | 230.12       |
| 16        | Jharkhand                | 493.37             | 379.60       |
| 17        | Karnataka                | 706.09             | 740.74       |
| 18        | Kerala                   | 305.87             | 406.92       |
| 19        | Lakshadweep              | 4.28               | 1.79         |
| 20        | Madhya Pradesh           | 1085.37            | 1285.82      |
| 21        | Maharashtra              | 1282.31            | 1088.92      |
| 22        | Manipur                  | 118.53             | 66.13        |
| 23        | Meghalaya                | 131.00             | 66.29        |

| 24        | Mizoram       |    97.87 |    69.47 |
|-----------|---------------|----------|----------|
| 25        | Nagaland      |   108.75 |    48.87 |
| 26        | Orissa        |   624.71 |   715.86 |
| 27        | Puducherry    |    17.77 |    17.36 |
| 28        | Punjab        |   284.75 |   434.85 |
| 29        | Rajasthan     |  1069.38 |  1242.42 |
| 30        | Sikkim        |    45.86 |    33.89 |
| 31        | Tamil Nadu    |   794.38 |  1003.43 |
| 32        | Tripura       |   139.08 |    77.8  |
| 33        | Uttar Pradesh |  2299.49 |  2279.56 |
| 34        | Uttarakhand   |   256.6  |   213.79 |
| 35        | West Bengal   |   883.49 |   955.4  |
| 36        | Telangana     |   440.58 |   229.32 |
| Sub Total | Sub Total     | 16213    | 15685.3  |
| Others    | Others        |  1100    |     0    |
| Total     | Total         | 17313    | 15685.3  |

Note:

1. Allocation is per Original outlay/B.E.
2. *Utilization includes Utilization against Central Release, State release & Unspent balances at the beginning of  the year.
3. Utilization for the F.Y. 2015-16 is only upto 31.12.2015 (as per FMR) and is provisional.

## Statement showing Scheme wise Central Allocation and Utilization under NHM for the F.Y. 201516

## [Rs. In crore]

|                            | Sl.                        | 2015-16            | 2015-16      |
|----------------------------|----------------------------|--------------------|--------------|
| No .                       | Programme                  | Central Allocation | Utilization* |
| A. NRHM- RCH Flexible Pool | A. NRHM- RCH Flexible Pool | 9818.56            | 9943.28      |
| 1                          | RCH Flexible Pool          | 4348.32            | 4899.06      |

| 2                                                            | Mission Flexible Pool                                        |   4926.09 |   4647.21 |
|--------------------------------------------------------------|--------------------------------------------------------------|-----------|-----------|
| 3                                                            | Routine Immunization                                         |    200    |    278.83 |
| 4                                                            | Pulse Polio Immunisation                                     |    328    |    115.11 |
| 5                                                            | National I.D.D. Control Prog.                                |     16.15 |      3.07 |
| B. Infrastructure Maintenance                                | B. Infrastructure Maintenance                                |   4420.4  |   4559.29 |
| C. Flexible Pool for Communicable Disease Control Programmes | C. Flexible Pool for Communicable Disease Control Programmes |   1160.68 |    525.82 |
| a                                                            | National Vector Borne Diseases Control Programme             |    463.13 |    135.84 |
| b                                                            | Revised National Tuberculosis Control Prog.                  |    603.2  |    319.82 |
| c                                                            | National Leprosy Eradication Prog.                           |     35.5  |     27.41 |
| d                                                            | Integrated Disease Surveillance Project                      |     58.85 |     42.75 |
| D. Flexible Pool for Non Communicable Disease Programmes     | D. Flexible Pool for Non Communicable Disease Programmes     |    527.36 |    187.54 |
| E. National Urban Health Mission- Flexible Pool              | E. National Urban Health Mission- Flexible Pool              |   1386    |    469.34 |
| Grand Total                                                  | Grand Total                                                  |  17313    |  15685.3  |

## Note:

1. Allocation is per Original outlay/B.E.
2. *Utilization includes utilization against central Release, state release & unspent balances at the beginning of  the year.
3. Utilization for the F.Y. 2015-16 is only upto 31.12.2015 (as per FMR) and is provisional.

## Annexure-II

Establishment of new Medical Colleges attached with existing district/referral hospitals :- To meet the shortfall of human resource in health, the government is implementing a Centrally Sponsored Scheme for  'establishment  of  new  medical  colleges  by  upgrading  district/referral  hospitals'  with fund  sharing  between  the  Central  Government  and  States  in  the  ratio  of  90:10  for  NE/special category states and 60:40 for other states. The total cost of establishment of one Medical College under  the  scheme  is  Rs.189  crore.  This  Scheme  was  approved  in  January,  2014. Criteria  for identification of Districts under the Scheme:

i District Hospitals/referral hospital with bed strength of 200 or more. ii District/Referral hospitals of the districts where there is no medical college. iii Preference to underserved areas.

58  districts  in  20  States/UTs  have  been  identified under  this  Scheme  to  establish new  Medical Colleges attached with existing district/referral hospitals. Out of these, 47 have been approved till date. Funds  to  the  tune  of  Rs.659.73  core  have  been  released  to  the  State  Governments  for  the approved districts under the Scheme. Detail at Annexure-II(a) .

Upgradation of existing State Government/Central Government medical colleges to increase MBBS seats in the country:This Scheme was approved in January, 2014. The funding pattern is 90:10 by Central and State Governments respectively for North Eastern States and Special category States and 60:40  for  other  States  with  the  upper  ceiling  cost  pegged  at  Rs.1.20  crore  per  seat.  22 Medical Colleges have been approved under the scheme to increase UG seats. Funds to the tune of Rs.50 crore have been released to the State Governments till date under this Scheme. Detail at AnnexureII(b).

Strengthening  and  upgradation  of  State  Government  Medical  colleges  for  starting  new  PG disciplines  and  increasing  PG  seats :-The  scheme  was  launched  in  the  XI  Plan  period  with  the objective to strengthen and upgrade State/Central Government Medical Colleges to create new PG seats.  The  funding  pattern  between  Centre  and  States  is  in  the  ratio  of 60:40.  A  total  of  72 Government Medical colleges are covered under the scheme for increasing PG seats. Funds to the tune of Rs.726.94 crore have been released under the scheme till 2014-15. Detail may be seen as per Annexure-II(c)

Funds released under the Centrally Sponsored Scheme for Establishment of New Medical Colleges attached with existing District/Referral hospitals during last three years

(Rs. in crore)

| S. No.   | States/UT                   |   Amount Released |
|----------|-----------------------------|-------------------|
| 1.       | Andaman and Nicobar Islands |             28    |
| 2.       | Arunachal Pradesh           |             42.5  |
| 3.       | Assam                       |             30    |
| 4.       | Bihar                       |              8    |
| 5.       | Chhattisgarh                |             53.02 |
| 6.       | Himachal Pradesh            |             80.51 |
| 7.       | Madhya Pradesh              |             38    |
| 8.       | Maharashtra                 |             13    |
| 9.       | Mizoram                     |             30    |
| 10.      | Nagaland                    |             36.5  |
| 11.      | Odisha                      |            120    |
| 12.      | Rajasthan                   |            130.2  |
| 13.      | West Bengal                 |             20    |
| 14.      | Uttar Pradesh               |             16    |
| 15.      | Uttarakhand                 |             14    |
|          | TOTAL                       |            659.73 |

Funds  released  under  the Centrally  Sponsored  Scheme  for  'Up-gradation  of  existing  State Government/Central Government medical colleges to increase MBBS seats in the Country'

(Rs. in crore)

| S. No.   | States/UT      |   Amount released to State |
|----------|----------------|----------------------------|
| 1.       | Andhra Pradesh |                        6   |
| 2.       | Goa            |                        4.5 |
| 3.       | Madhya Pradesh |                       12   |
| 4.       | Odisha         |                        5   |
| 5.       | Punjab         |                        4   |
| 6.       | Rajasthan      |                        7   |
| 7.       | Tamil Nadu     |                        9.5 |
| 8.       | Uttarakhand    |                        2   |
|          | TOTAL          |                       50   |

Status  of  Funds  Released  under  the  scheme  for  'Strengthening  and  up-gradation  of State Government Medical Colleges for starting new PG disciplines and increasing PG seats'

| S. No.   | State/UT         |   Amount Released to State (Rs. in crore) |
|----------|------------------|-------------------------------------------|
| 1        | ASSAM            |                                    17.71  |
| 2        | ANDHRA PRADESH   |                                    46.075 |
| 3        | BIHAR            |                                    29.06  |
| 4        | CHANDIGARH       |                                    17.09  |
| 5        | CHHATTISGARH     |                                    12.275 |
| 6        | GOA              |                                    16.07  |
| 7        | GUJARAT          |                                    22.22  |
| 8        | HIMACHAL PRADESH |                                    10.05  |
| 9        | JAMMU &KASHMIR   |                                    14.08  |
| 10       | JHARKHAND        |                                    16.49  |
| 11       | KERALA           |                                    21.455 |
| 12       | MADHYA PRADESH   |                                    31.91  |
| 13       | MAHARASHTRA      |                                   129.57  |
| 14       | ORISSA           |                                     5.54  |
| 15       | PUNJAB           |                                    44     |
| 16       | RAJASTHAN        |                                   103.54  |
| 17       | TELANGANA        |                                    23.565 |
| 18       | TRIPURA          |                                     7.29  |
| 19       | UTTARAKHAND      |                                     7.65  |
| 20       | UTTAR PRADESH    |                                    38.53  |
| 21       | WEST BENGAL      |                                   112.77  |
|          | TOTAL            |                                   726.94  |

## National AIDS Control Programme

The National AIDS Control Programme (NACP) has been implemented by Government of India as 100% centrally sector scheme through State AIDS Control Societies in the States for prevention and control of HIV/AIDS in the country. Currently, the NACP IV (2012-2017) is in the last year of its implementation. As per India HIV Estimation 2015 report, National adult (15-49 years)  HIV  prevalence in  India  is  estimated  at  0.26%  in  2015.  The  State/UT-wise adult HIV prevalence including Karnataka is provided at Annexure-III(a)

The total of Rs. 1615.00 crore was allotted to the National AIDS Control Programme during 2015-16. The State/UTs wise release and expenditure in 2015-16 is provided at AnnexureIII (b)

Adult (15-49 years) HIV prevalence (%) State/UT-wise, 2015

| State/UTs         |   HIV Estimate (%) |
|-------------------|--------------------|
| Andhra Pradesh    |               0.66 |
| Arunachal Pradesh |               0.07 |
| Assam             |               0.06 |
| Bihar             |               0.25 |
| Chhattisgarh      |               0.19 |
| Delhi             |               0.23 |
| Goa               |               0.4  |
| Gujarat           |               0.42 |
| Himachal Pradesh  |               0.12 |
| Haryana           |               0.13 |
| Jharkhand         |               0.17 |
| Jammu & Kashmir   |               0.03 |
| Karnataka         |               0.45 |
| Kerala            |               0.11 |
| Meghalaya         |               0.06 |
| Maharashtra       |               0.37 |
| Manipur           |               1.15 |
| Madhya Pradesh    |               0.09 |
| Mizoram           |               0.8  |
| Nagaland          |               0.78 |
| Odisha            |               0.25 |
| Punjab            |               0.19 |
| Rajasthan         |               0.23 |
| Sikkim            |               0.23 |
| Tamil Nadu        |               0.28 |

| Tripura                   |   0.31 |
|---------------------------|--------|
| Uttarakhand               |   0.11 |
| Uttar Pradesh             |   0.12 |
| West Bengal               |   0.21 |
| Andaman & Nicobar Islands |   0.07 |
| Chandigarh                |   0.35 |
| Dadra & Nagar Haveli      |   0.18 |
| Daman & Diu               |   0.14 |
| Puducherry                |   0.15 |
| India                     |   0.26 |

State/UT-wise release and expenditure 2015-16(as on 05.05.16)

| Sl. No.   | State                         | Release   | Expenditure as on 05.05.16   |
|-----------|-------------------------------|-----------|------------------------------|
| 1         | Andhra Pradesh                | 3904.86   | 1384.60                      |
| 2         | Bihar                         | 2017.81   | 2854.04                      |
| 3         | Chhattisgarh                  | 1130.76   | 1767.90                      |
| 4         | Delhi                         | 3558.12   | 2358.16                      |
| 5         | Goa                           | 452.29    | 478.11                       |
| 6         | Gujarat (Inculded Ahmadabad)  | 4150      | 4224.42                      |
| 7         | Haryana                       | 1269.27   | 1342.16                      |
| 8         | Himachal Pradesh              | 1034.02   | 763.48                       |
| 9         | Jammu & Kashmir               | 748.18    | 643.34                       |
| 10        | Jharkhand                     | 1242.65   | 1328.91                      |
| 11        | Karnataka                     | 6077.38   | 4274.60                      |
| 12        | Kerala                        | 2138.35   | 2275.83                      |
| 13        | Madhya Pradesh                | 3247.78   | 3352.07                      |
| 14        | Maharashtra                   | 7000.1    | 7825.14                      |
| 15        | Mumbai District               | 1596.25   | 1937.79                      |
| 16        | Odisha                        | 2160.04   | 2714.12                      |
| 17        | Puducherry                    | 382.54    | 378.99                       |
| 18        | Punjab                        | 2604.63   | 2808.70                      |
| 19        | Rajasthan                     | 2779.82   | 3142.72                      |
| 20        | Tamil Nadu (inculded Chennai) | 5613.08   | 5827.10                      |
| 21        | Telangana                     | 2784.77   | 3443.79                      |
| 22        | Uttar Pradesh                 | 5709.4    | 5237.47                      |
| 23        | Uttarakhand                   | 969.49    | 1285.16                      |
| 24        | West Bengal                   | 3183.98   | 3880.13                      |
|           | Sub total                     | 65755.57  | 65528.73                     |
| NE States | NE States                     | NE States | NE States                    |

| 25                      | Arunachal Pradesh       | 855.49                  | 586.65                  |
|-------------------------|-------------------------|-------------------------|-------------------------|
| 26                      | Assam                   | 2003.05                 | 1667.26                 |
| 27                      | Manipur                 | 2401.13                 | 1787.95                 |
| 28                      | Meghalaya               | 591.21                  | 438.31                  |
| 29                      | Mizoram                 | 1478.23                 | 1438.23                 |
| 30                      | Nagaland                | 1930.2                  | 1935.89                 |
| 31                      | Sikkim                  | 441.37                  | 474.71                  |
| 32                      | Tripura                 | 592.71                  | 744.70                  |
|                         | Sub total               | 10293.39                | 9073.699                |
|                         | Grand Total             | 76048.96                | 74602.43                |
| UNION TERRORITIES (UTs) | UNION TERRORITIES (UTs) | UNION TERRORITIES (UTs) | UNION TERRORITIES (UTs) |
| 33                      | Chandigarh              | 549.33                  | 629.48                  |
| 34                      | A & N                   | 109.21                  | 95.91                   |
| 35                      | D & D                   | 216.28                  | 189.29                  |
| 36                      | DNH                     | 66.56                   | 82.20                   |
| 37                      | Lakshadweep             | 20.28                   | 6.96                    |
|                         | Sub Total               | 961.66                  | 1003.844                |
|                         | Grand Total             | 77010.62                | 75606.27                |

Tertiary  Care  for  Cancer  a  scheme  (TCCC)  under  the  National  Programme for  Prevention  and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS).

To  strengthen  of  Tertiary  Care  for  Cancer  a  scheme  (TCCC)  under  the  National  Programme  for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS). Under the scheme the State Cancer Institutes (SCI) /Tertiary Care Cancer  Centre will provide comprehensive cancer diagnosis, treatment and care services. SCI will be the apex institution in the State for Cancer related activities. SCI will provide outreach services, diagnosis and referral treatments, develop treatment protocols, undertake  research  and  enhance  the  capacity  of  personnel  in  the  State  in  this  field.  TCCC  will undertake similar activities, though at a lower scale.

## Expected Role of SCI and TCCC

- The SCI /TCCC will provide comprehensive cancer diagnosis, treatment and care services.
- SCI will be a role model and leader in this field. It will serve as the nod apex Institution to mentor other Government Institutes (including TCCC and RCC). Similarly the TCCC shou ld mentor cancer related activities including at the district level and below in their respective footprint area (the areas where patients are accessing the TCCC).
- SCI/TCCC will promote prevention of cancer; participate in outreach and other activiti es under NPCDCS and other related public health programmes.
- SCI/TCCC will help in training of doctors/health personnel for cancer.
- SCI/TCCC will participate in the cancer registry programme.
- SCI/TCCC will promote research activities for cancer.
- Patients screened for cancer under NPCDCS and other Government programmes will get Tertiary care diagnosis and treatment in TCCC and SCI.

Under  the  scheme,  there  is  the  provision  of  providing  one  time  grant  up  to  Rs.  120 crore for SCI and up to Rs. 45 crore for TCCC including State share. This grant would be used for procurement of equipment and building construction. From 2015-16 the fund sharing ratio between Centre and State has been revised to 60:40 except for NE and Hilly States where the ratio remains unchanged at 90:10.

## Financial assistance released under TCCC scheme of NPCDCS during the year 2015-16

|   S No. | State            | Name of the Institute                                             | Project approved for   |
|---------|------------------|-------------------------------------------------------------------|------------------------|
|       1 | Himachal Pradesh | Indira Gandhi Medical College, Shimla,                            | TCCC                   |
|       2 | Uttar Pradesh    | Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow | TCCC                   |
|       3 | Mizoram          | Civil Hospital, Aizawl                                            | TCCC                   |
|       4 | Bihar            | Indira Gandhi Institute of Medical Sciences, Patna                | SCI                    |

Rs.  126.5  crore were released  to  these  institutions  during  2015-16.  The  details  are  placed  at Annexure-IV(a)

.

## Financial assistance released under TCCC scheme of NPCDCS during the year 2015-16 (Rs in crore)

| S No .   | State            | Name of the Institute                                             | SCI/   | Amount Approved by Standing Committee   | GoI share   |   Amount released | 75% of GOI share (First eligible installment)   |   Balance wrt total GOI share |   Balance wrt first eligible installment |
|----------|------------------|-------------------------------------------------------------------|--------|-----------------------------------------|-------------|-------------------|-------------------------------------------------|-------------------------------|------------------------------------------|
| 1        | Himachal Pradesh | Indira Gandhi Medical College, Shimla,                            | TCCC   | 45                                      | 40.5        |            14.87  | 30.375                                          |                        25.63  |                                  15.505  |
| 2        | Uttar Pradesh    | Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow | TCCC   | 41.5                                    | 31.13       |            11.43  | 23.3475                                         |                        19.7   |                                  11.9175 |
| 3        | Mizoram          | Civil Hospital, Aizawl                                            | TCCC   | 44.27                                   | 39.84       |            14.64  | 29.88                                           |                        25.2   |                                  15.24   |
| 4        | Bihar            | Indira Gandhi Institute of Medical Sciences, Patna                | SCI    | 120                                     | 90          |            33.06  | 67.5                                            |                        56.94  |                                  34.44   |
| 5        | Rajasthan        | SP medical college bikaner                                        | TCCC   | 38.05                                   | 22.83       |            17.123 | 17.1225                                         |                         5.707 |                                  -0.0005 |
| 6        | Telangana        | MNJ Institute                                                     | SCI    | 112.7                                   | 67.62       |            18.12  | 50.715                                          |                        49.5   |                                  32.595  |
| 7        | Karnataka        | Mandya Institute                                                  | TCCC   | 38.35                                   | 23.01       |            17.257 | 17.2575                                         |                         5.753 |                                   0.0005 |
|          |                  |                                                                   |        |                                         |             |           126.5   |                                                 |                       188.43  |                                 109.698  |

## Annexure- IV (a)

## Details about DLHS-4

The selection  of  households  were carried  out  in  two  stages;  in  the  first  stage  mapping  and  listing  of households in  a  selected  Primary  Sampling  Unit  (A  village  in  the  case  of  Rural  areas  and  a  Urban  Frame Survey block in the case of Urban areas) followed by administering the questionnaires in randomly selected households out of households listed in the Primary Sampling Unit.

As part of DLHS-4, Facility Survey was also carried in to capture information on the availability and utilization of  health  care  services  at  District  Hospital  (DH), Sub-divisional Hospital  (SDH),  Community  Health  Centre (CHC), Primary Health Centre (PHC) and Sub Health Centre (SHC). The methodology followed to identify the health facilities covered is as follows:

-  During course of mapping and listing the teams collected the names of Sub-Health Center (SHC), Primary Health Center (PHC) and Community Health Center (CHC) which were serving the selected rural PSU.  From each district about 40-70 PSUs were selected based on PPS (Probability Proportional to Size) systematic sampling method. The Health Sub-Centre which was serving  the selected PSU has been  selected  for the  facility  survey.  Subsequently  the PHC that caters to the Sub Health Centre was covered for the survey. In addition, all CHCs, SDHs and DHs within the district were also covered in the facility survey.
-  In  the 8  Empowered Action Group States (Bihar,  Jharkhand,  Uttar  Pradesh,  Uttarakhand, Madhya Pradesh, Chhattisgarh,  Odisha  and  Rajasthan)  and  Assam covered  in  the  Annual Health Survey (AHS) only facility survey was carried out in DLHS 4. The PSU list was provided by the office of the Registrar General and Census commissioner, India, which has been used in  the  Annual  Health  Survey  (AHS)  for  conducting  household  survey. Using  this  list  as  a frame facilities in these States were selected for the survey.

As part of the facility survey the following information was collected from SHC, PHC, CHC and DH / SDH:

-  SHC: Availability  of  human  resources,  physical  infrastructure,  equipment  and  essential drugs and MCH service provided in one month preceding the survey.
-  PHC: Status  of  availability  of  24x7  facility  and  services  for  delivery  and  new  born  care, availability of Lady Medical Officer, functional Labour Room, Operation Theater, number of beds, drug storage facilities, waiting room for OPD, availability of RCH related equipment, essential drugs and essential laboratory testing facilities etc.

## Annexure-V

-  CHC: Availability  of 24X7  services  for  delivery  and  new  born  care,  status  of  in-position clinical, supporting and  paramedical staff, availability of specialists trained for NSV (NonScalpel  Vasectomy),  emergency  obstetric,  MTP,  new  born  care,  treatment  of  RTI  /  STI, IMNCI, ECG etc. Physical infrastructure of CHC  such as water supply, electricity, communication, waste disposal facilities,  OT,  Labour  Room  and  availability  of  residential quarters for medical doctors etc. .
-  DH  /  SDH :      Availability  of  essential  laboratory  and  ambulance  services,  emergency obstetric care service, availability of specialists, nurses, paramedics and technicians either on regular or contractual basis, infrastructure, provision for bio-medical and waste disposal and availability of residential quarters for doctors, nurses and staff etc.

Indicators of the facility survey are available for all States / UTs except for Gujarat, Jammu & Kashmir, Dadra & Nagar Haveli, Daman & Diu, and Lakshadweep where the survey was not carried out and for Delhi where the results were not of acceptable quality.

## Key indictors from the facility survey of DLHS-3 and DLHS-4 are given in Statements I-III

Statement-1

| .N o.   | State/UTs      | Sr Sub-Health Centre - Human   | Sr Sub-Health Centre - Human   | Sr Sub-Health Centre - Human                     | Sr Sub-Health Centre - Human                     | Sr Sub-Health Centre - Human   | Sr Sub-Health Centre - Human   | Sr Sub-Health Centre - Human                                      | Sr Sub-Health Centre - Human                                      | Sr Sub-Health Centre - Human                                    | Sr Sub-Health Centre - Human   | Sr Sub-Health Centre - Human   | Facilities in sub-centre (%)   | Facilities in sub-centre (%)   | Facilities in sub-centre (%)   | Facilities in sub-centre (%)   | Facilities in sub-centre (%)   | Community sub-centre(%)      | Community sub-centre(%)   | Community sub-centre(%)   |
|---------|----------------|--------------------------------|--------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------|--------------------------------|-------------------------------------------------------------------|-------------------------------------------------------------------|-----------------------------------------------------------------|--------------------------------|--------------------------------|--------------------------------|--------------------------------|--------------------------------|--------------------------------|--------------------------------|------------------------------|---------------------------|---------------------------|
| .N o.   | State/UTs      | No. of Sub- Centres covered    | No. of Sub- Centres covered    | Sub-Health Centre located in government building | Sub-Health Centre located in government building | Sub-Health Centre with ANM     | Sub-Health Centre with ANM     | Sub-Health Centre with male health worker Centre quarter facility | Sub-Health Centre with male health worker Centre quarter facility | Sub-Health with ANM residing in Sub- Health Centre where Centre | is                             | Sub-Health with additional ANM | Regular electricity            | Water                          | Toilet                         | Labor Room                     | Labor Room in curren t use     | Citizen's Charter displaye d | VHSC Facilitate d*        | Untied Fund receive d     |
| .N o.   | State/UTs      | DLHS- 4                        | DLHS- 3                        | DLHS-4                                           | DLH S-3                                          | DLH S-4                        | DLH S-3                        | DLH S-4                                                           | DLH S-3                                                           | DLH S-4                                                         | DLH S-3                        | DLH S-4                        | DLH S-3 DLHS- 4                | DLH S-4                        | S-4                            | DLH                            | DLH S-4 DLH S-4                | DLHS- 4                      | DLHS-4                    | DLHS -4                   |
| 1       | 2              | 13                             | 14                             | 15 16                                            |                                                  | 17                             | 18                             | 19                                                                | 20                                                                | 21                                                              | 22                             | 23                             | 24                             | 25                             | 26                             | 27                             | 28 29                          | 30                           | 31                        | 32                        |
|         | INDIA          | 18367                          | 18068                          | na                                               | 55.7 na                                          |                                | 90.7                           | na                                                                | 39.3                                                              | na                                                              | 57.9                           | na                             | 20.0                           | na                             | na                             | na                             | na na                          | na                           | na                        | na                        |
| 1       | Andhra Pradesh | 468                            | 885                            | 22.8                                             | 21.9                                             | 90.4                           | 84.4                           | 38.3                                                              | 40.6                                                              | 67.6                                                            | 63.3                           | 73.2                           | 28.0                           | 29.0                           | 46.7                           | 28.0                           | 2.8 33.3                       | 78.9                         | 97.5                      | 93.4                      |
| 2       | Assam          | 857                            | 714                            | 74.9                                             | 52.8                                             | 94.1                           | 96.1                           | 63.2                                                              | 6.1                                                               | 36.5                                                            | 50.6                           | 69.6                           | 60.1                           | 23.1                           | 79.2                           | 91.6                           | 13.9 78.2                      | 43.4                         | 96.3                      | 87.2                      |
| 3       | Bihar          | 1,828                          | 1,165                          | 46.2                                             | 35.3                                             | 71.4                           | 91.2                           | 3.1                                                               | 13.3                                                              | 21.6                                                            | 26.6                           | 47.2                           | 27.6                           | 4.6                            | 47.9                           | 37.8                           | 15.9 32.8                      | 37.5                         | 95.7                      | 71.8                      |
| 4       | Chattisgarh    | 826                            | 574                            | 70.5                                             | 45.3                                             | 89.7                           | 76.5                           | 64.2                                                              | 51.6                                                              | 73.8                                                            | 80.1                           | 8.3                            | 5.9                            | 52.2                           | 61.7                           | 76.9 83.0                      | 78.8                           | 34.3                         | 97.2                      | 93.0                      |
| 5       | Gujarat        | na                             | 714                            | na                                               | 65.7                                             | na                             | 94.7                           | na                                                                | 55.5                                                              | na                                                              | 37.8                           | na                             | 8.0                            | na                             | na                             | na                             | na na                          | na                           | na                        | na                        |
| 6       | Haryana        | 673                            | 625                            | 57.7                                             | 54.9                                             | 90.6                           | 92.3                           | 58.2                                                              | 51.8                                                              | 35.6                                                            | 31.4                           | 83.5                           | 74.2                           | 24.2                           | 92.3                           | 92.3                           | 40.0 82.5                      | 85.1                         | 89.2                      | 88.5                      |
| 7       | Jharkhand      | 694                            | 783                            | 66.7                                             | 57.5                                             | 55.9                           | 91.3                           | 23.2                                                              | 18.7                                                              | 32.2                                                            | 42.5                           | 63.5                           | 44.1                           | 11.8                           | 52.8                           | 46.2 81.8                      | 88.4                           | 42.4                         | 96.2                      | 85.7                      |
| 8       | Karnataka      | 1024                           | 880                            | 61.5                                             | 57.6                                             | 87.9                           | 92.7                           | 43.8                                                              | 40.5                                                              | 61.5                                                            | 67.4                           | 6.4                            | 1.8                            | 11.6                           | 76.7                           | 80.8                           | 37.9 33.1                      | 20.9                         | 98.6                      | 91.0                      |
| 9       | Kerala         | 151                            | 532                            | 57.6                                             | 76.9                                             | 93.4                           | 97.6                           | 76.2                                                              | 80.3                                                              | 56.4                                                            | 53.3                           | 21.3                           | 0.4                            | 79.3                           | 92.0                           | 89.7                           | 6.9 100.0                      | 88.1                         | 94.7                      | 77.5                      |
| 10      | Madhya Pradesh | 1,485                          | 1,362                          | 74.7                                             | 55.6                                             | 94.8                           | 90.2                           | 40.5                                                              | 58.5                                                              | 52.2                                                            | 63.9                           | 20.7                           | 8.2                            | 23.3                           | 64.1                           | 76.3                           | 18.5 42.9                      | 47.3                         | 94.5                      | 84.1                      |
| 11      | Maharashtra    | 1019                           | 1058                           | 83.6                                             | 70.0                                             | 94.8                           | 93.0                           | 70.9                                                              | 76.6                                                              | 90.7                                                            | 71.5                           | 49.8                           | 30.7                           | 82.9                           | 89.9                           | 93.9                           | 79.1 95.1                      | 95.6                         | 98.5                      | 93.1                      |
| 12      | Odisha         | 1,493                          | 1,053                          | 51.4                                             | 60.0                                             | 94.8                           | 78.1                           | 58.7                                                              | 59.8                                                              | 69.1                                                            | 40.6                           | 7.4                            | 51.5                           | 22.1                           | 72.5                           | 57.7                           | 20.2 28.4                      | 16.2                         | 93.9                      | 78.2                      |
| 13      | Punjab         | 643                            | 595                            | 60.7                                             | 56.1                                             | 73.7                           | 79.7                           | 45.7                                                              | 56.5                                                              | 12.9                                                            | 17.8                           | 61.7                           | 5.6                            | 65.9                           | 92.3                           | 87.7                           | 13.1 20.0                      | 77.3                         | 99.4                      | 89.3                      |
|         | Rajasthan      | 989                            | 1035                           | 80.9                                             | 75.9                                             | 90.7                           | 86.5                           |                                                                   | 9.7                                                               | 52.9                                                            | 50.4                           | 26.8                           | 22.4                           | 16.0                           | 70.3                           | 75.3                           | 47.3                           | 28.5                         | 97.2                      |                           |
| 14      |                |                                |                                |                                                  |                                                  |                                |                                | 10.6                                                              |                                                                   |                                                                 |                                |                                |                                |                                |                                |                                | 75.7                           |                              |                           | 83.9                      |

| 15   | Tamil Nadu           | 921   | 861        | 75.5      | 72.2   | 33.9 99.8   | 4.7       | 71.6   | 62.2      | 59.9     | 3.0      | 2.8     | 72.7     | 76.8      | 88.6      | 68.0      | 19.0 61.6   | 96.1   | 88.9   |
|------|----------------------|-------|------------|-----------|--------|-------------|-----------|--------|-----------|----------|----------|---------|----------|-----------|-----------|-----------|-------------|--------|--------|
| 16   | Telangana            | 260   | na 32.4    | na        | 97.3   | na          | 25.4 na   | 46.2   |           | na 73.8  | na       | 17.9    | 40.5     | 47.6      | 15.5      | 30.8      | 84.2        | 93.9   | 89.6   |
| 17   | Uttar Pradesh        | 2,595 | 2,403 80.6 | 42.2      | 95.2   | 99.5        | 1.8       | 6.2    | 30.5      | 57.3 9.2 |          | 3.3     | 5.2      | 81.2      | 74.8      | 82.4 30.2 | 33.0        | 95.1   | 68.4   |
| 18   | West Bengal          | 510   | 688 86.7   | 45.8      | 99.4   | 89.6        | 22.4      | 40.7   | 6.3       | 14.7     | 66.3     | 1.2     | 62.8     | 77.5      | 84.9 11.4 | 21.6      | 72.7        | 91.3   | 94.3   |
| 19   | A&N Islands          | 56    | 25 98.2    | 96.0      | 76.4   | 96.0        | 23.2      | 12.0   | 59.2      | 68.2     | 42.9     | 56.0 na | na       |           | na na     | na        | na          | na     | na     |
| 20   | Arunachal Pradesh    | 111   | 112 92.0   | 96.4      | 69.4   | 93.8        | 46.8      | 63.4   | 53.3      | 31.3     | 45.4     | 9.8     | 14.7     | 68.6      | 73.5 28.4 | 63.0      | 12.6        | 74.7   | 54.1   |
| 21   | Delhi                | na    | 38 na      | 44.7      | na     | 100.0       | na        | 0.0    | na        | 100.0    | na       | 84.2    | na       | na        | na        | na na     | na          | na     | na     |
| 22   | Goa                  | 47    | 39 31.9    | 20.5      | 85.1   | 97.4        | 66.0      | 74.4   | 22.2      | 33.3     | 10.6     | 2.6     | 86.7     | 100.0     | 100.0     | 100.0 --  | 19.2        | 100.0  | 74.5   |
| 23   | Himachal Pradesh     | 280   | 409 75.4   | 79.7      | 92.8   | 83.1        | 51.8      | 51.1   | 43.5      | 60.5     | 1.6      | 1.2     | 88.0     | 83.7 86.1 | 3.9       | 33.3      | 71.0        | 96.5   | 94.6   |
| 24   | Jammu & Kashmir      | na    | 368 na     | 38.0      | na     | 68.8        | na        | 19.8   | na        | 64.1     | na       | 16.6    | na       | na        | na na     | na        | na          | na     | na     |
| 25   | Manipur              | 148   | 118 79.1   | 70.3      | 97.3   | 93.1        | 39.2      | 50.0   | 33.3      | 0.0      | 70.3     | 53.4    | 5.2 44.7 |           | 62.9 10.3 | 16.7      | 27.9        | 90.7   | 91.8   |
| 26   | Meghalaya            | 195   | 115 84.6   | 94.8      | 99.5   | 100.0       | 6.2       | 29.6   | 58.1      | 46.4     | 88.6 9.6 | 53.9    | 93.9     | 98.2      | 24.2      | 70.3      | 6.2         | 49.2   | 73.3   |
| 27   | Mizoram              | 140   | 172 98.6   | 97.1      | 89.2   | 95.4        | 64.3      | 93.0   | 76.6      | 79.1     | 13.8     | 38.4    | 62.8     | 87.0      | 87.7 39.1 | 82.4      | 67.1        | 96.4   | 95.0   |
| 28   | Nagaland             | 150   | na         | 89.3 na   | 98.6   | na          | 24.0      | na     | 42.1      | na       | 77.0 na  |         | 42.5     | 65.7      | 85.1      | 23.9 54.8 | 82.7        | 93.4   | 94.0   |
| 29   | Sikkim               | 76    | 84 96.0    | 89.3      | 88.2   | 86.9        | 85.5      | 84.5   | 26.9      | 33.3     | 23.9     | 23.8    | 78.1     | 91.8      | 97.3      | 98.6 95.8 | 73.7        | 97.4   | 97.4   |
| 30   | Tripura              | 105   | 163        | 77.1 54.0 | 59.1   | 78.5        | 55.7      | 66.3   | 54.6      | 7.7      | 8.6      | 4.3     | 49.4     | 70.4      | 53.1 11.1 | 22.2      | 42.9        | 91.1   | 81.9   |
| 31   | Uttarakhand          | 555   | 412        | 69.4 58.0 | 98.4   | 99.5        | 5.4       | 5.1    | 46.3 63.5 |          | 11.0     | na      | 39.7     | 69.4      | 84.2      | 48.3 45.9 | 64.0        | 78.0   | 80.2   |
| 32   | Chandigarh           | 23    | 5 60.9     | 60.0      | 52.2   | 80.0        | 47.8 40.0 |        | 0.0 0.0   | 75.0     |          | 60.0    | na       | na        | na        | na na     | na          | na     | na     |
| 33   | Dadra & Nagar Haveli | na    | 29 na      | 93.1      | na     | 82.8        | na        | 6.9    | na        | 47.8     | na       | 51.7    | na       | na        | na        | na        | na na       | na     | na     |
| 34   | Daman & Diu          | na    | 22 na      | 77.3      | na     | 95.5        | na        | 68.2   | na        | 0.0      | na       | 22.7    | na       | na        | na        | na na     | na          | na     | na     |
| 35   | Lakshadweep          | na    | na         | 60.0      | na     | 100.0       | na        | 80.0   | na        | 0.0      | na       |         |          | na        | na        | na        | na          | na     |        |
|      |                      |       | 5          |           |        |             |           |        |           |          |          | 0.0     | na       |           | na        |           | na          |        | na     |
| 36   | Puducherry           | 45    | 26         | 71.1 65.4 | 51.1   | 100.0       | 0.0       | 80.8   | 48.0      | 26.7     | 60.8     | 84.6    | na       | na        |           | na        | na na       | na     | na     |

Statement-2

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Statement-3

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| Sr. No   | State/UTs      | Sub-Divisional Hospitals (SDH) (%)       | Sub-Divisional Hospitals (SDH) (%)   | Sub-Divisional Hospitals (SDH) (%)   | Sub-Divisional Hospitals (SDH) (%)   | Sub-Divisional Hospitals (SDH) (%)   | Sub-Divisional Hospitals (SDH) (%)   | Sub-Divisional Hospitals (SDH) (%)   | Sub-Divisional Hospitals (SDH) (%)         | District Hospitals (DH) (%)         | District Hospitals (DH) (%)   | District Hospitals (DH) (%)      | District Hospitals (DH) (%)   | District Hospitals (DH) (%)     | District Hospitals (DH) (%)        | District Hospitals (DH) (%)   | District Hospitals (DH) (%)               |
|----------|----------------|------------------------------------------|--------------------------------------|--------------------------------------|--------------------------------------|--------------------------------------|--------------------------------------|--------------------------------------|--------------------------------------------|-------------------------------------|-------------------------------|----------------------------------|-------------------------------|---------------------------------|------------------------------------|-------------------------------|-------------------------------------------|
| .        | State/UTs      | No. of Sub- Divisional Hospitals covered | SDHs having Paediatric ian           | SDHs having regular radiograp her    | SDHs having 2D Echo facility         | SDHs having Ultrasou nd facility     | SDHs having three phase connecti on  | SDHs having critical care area       | SDHs having suggesti on and complai nt box | No. of District Hospit als covere d | DHs having Paediatric ian     | DHs having regular radiograp her | DHs having 2D Echo facility   | DHs having Ultras ound facility | DHs having three phase connecti on | DHs having critical care area | DHs having sugge stion and compl aint box |
| .        | State/UTs      | DLHS-4                                   | DLHS- 4                              | DLHS- 4                              | DLHS -4                              | DLHS -4                              | DLHS -4                              | DLHS -4                              | DLHS -4                                    | DLHS -4                             | DLHS -4                       | DLHS -4                          | DLHS -4                       | DLHS -4                         | DLHS -4                            | DLHS -4                       | DLHS -4                                   |
|          | INDIA          | 890                                      | na                                   | na                                   | na                                   | na                                   | na                                   | na                                   | na                                         | 650                                 | na                            | na                               | na                            | na                              | na                                 | na                            | na                                        |
| 1        | Andhra Pradesh | 38                                       | 60.5                                 | 13.2                                 | 5.3                                  | 71.1                                 | 100.0                                | 78.9                                 | 73.7                                       | 17                                  | 82.3                          | 52.9                             | 23.5                          | 100.0                           | 100.0                              | 88.2                          | 52.9                                      |
| 2        | Assam          | 11                                       | 27.3                                 | 0.0                                  | 9.1                                  | 45.5                                 | 81.8                                 | 54.5                                 | 81.8                                       | 25                                  | 76.0                          | 24.0                             | 12.0                          | 76.0                            | 100.0                              | 64.0                          | 92.0                                      |
| 3        | Bihar          | 30                                       | 50.0                                 | 13.3                                 | 0.0                                  | 26.7                                 | 76.7                                 | 60.0                                 | 76.7                                       | 38                                  | 76.3                          | 44.7                             | 13.2                          | 63.2                            | 94.7                               | 81.6                          | 94.7                                      |
| 4        | Chattisgarh    | 4                                        | 2.0                                  | 0.0                                  | 1.0                                  | 0.0                                  | 4.0                                  | 3.0                                  | 3.0                                        | 16                                  | 14.0                          | 10.0                             | 2.0                           | 10.0                            | 16.0                               | 10.0                          | 16.0                                      |
| 5        | Gujarat        | na                                       | na                                   | na                                   | na                                   | na                                   | na                                   | na                                   | na                                         | na                                  | na                            | na                               | na                            | na                              | na                                 | na                            | na                                        |
| 6        | Haryana        | 21                                       | 28.6                                 | 9.5                                  | 4.7                                  | 14.3                                 | 90.5                                 | 42.8                                 | 100.0                                      | 21                                  | 95.2                          | 38.1                             | 38.1                          | 90.5                            | 100.0                              | 76.2                          | 100.0                                     |
| 7        | Jharkhand      | 10                                       | 30.0                                 | na                                   | 10.0                                 | 10.0                                 | 60.0                                 | 20.0                                 | 40.0                                       | 21                                  | 85.7                          | 19.5                             | 9.5                           | 47.6                            | 100.0                              | 42.9                          | 85.7                                      |
| 8        | Karnataka      | 148                                      | 51.4                                 | 16.2                                 | 4.1                                  | 37.8                                 | 98.0                                 | 46.0                                 | 75.0                                       | 29                                  | 86.2                          | 62.1                             | 34.5                          | 89.7                            | 96.6                               | 75.9                          | 82.8                                      |
| 9        | Kerala         | 55                                       | 96.4                                 | 45.5                                 | 45.4                                 | 52.7                                 | 100.0                                | 90.9                                 | 100.0                                      | 15                                  | 93.3                          | 86.6                             | 73.3                          | 93.3                            | 100.0                              | 100.0                         | 100.0                                     |
| 10       | Madhya Pradesh | 54                                       | 55.6                                 | 11.1                                 | 5.6                                  | 29.6                                 | 92.6                                 | 31.5                                 | 75.9                                       | 49                                  | 97.9                          | 63.2                             | 16.3                          | 89.8                            | 100.0                              | 73.5                          | 93.8                                      |
| 11       | Maharashtra    | 80                                       | 13.8                                 | 13.8                                 | 7.5                                  | 45.0                                 | 100.0                                | 90.0                                 | 97.5                                       | 39                                  | 97.4                          | 79.5                             | 38.5                          | 92.3                            | 100.0                              | 89.7                          | 97.4                                      |
| 12       | Odisha         | 26                                       | 80.8                                 | 3.9                                  | 7.7                                  | 3.9                                  | 88.5                                 | 26.9                                 | 84.6                                       | 29                                  | 93.1                          | 31.0                             | 3.5                           | 69.0                            | 96.6                               | 51.7                          | 89.7                                      |
| 13       | Punjab         | 38                                       | 63.1                                 | 26.3                                 | 7.8                                  | 63.1                                 | 100.0                                | 55.2                                 | 94.7                                       | 20                                  | 90.0                          | 50.0                             | 15.0                          | 90.0                            | 100.0                              | 51.7                          | 95.0                                      |
| 14       | Rajasthan      | 17                                       | 64.7                                 | 41.1                                 | 23.5                                 | 100.0                                | 100.0                                | 76.4                                 | 70.5                                       | 36                                  | 91.6                          | 61.1                             | 25.0                          | 100.0                           | 100.0                              | 86.1                          | 91.6                                      |

<!-- image -->

|   15 | Tamil Nadu           | 248   | 65.3      | 40.3   | 11.7   | 81.1   | 96.7       | 42.3   | 66.9   | 30   | 90.0    | 50.0   | 73.3        | 93.3      | 100.0   | 46.6   | 76.7   |
|------|----------------------|-------|-----------|--------|--------|--------|------------|--------|--------|------|---------|--------|-------------|-----------|---------|--------|--------|
|   16 | Telangana            | 33    | 72.7 9.1  | 0.0    |        | 72.7   | 100.0 75.7 | 69.7   | 9      | 77.8 | 55.5    | 22.2   | 100.0       | 100.0     |         | 88.8   | 55.5   |
|   17 | Uttar Pradesh        | 10    | 50.0 10.0 |        | 0.0    | 0.0    | 90.0 60.0  | 60.0   | 132    | 84.1 | 62.8    |        | 9.1         | 69.7      | 96.9    | 58.3   | 87.8   |
|   18 | West Bengal          | 43    | 97.6 83.7 | 7.0    | 79.1   | 97.6   | 48.8       | 83.7   | 19     | 95.0 | 100.0   | 47.4   | 100.0       | 100.0     |         | 63.2   | 94.7   |
|   19 | A&N Islands          | na    | na        | na     | na     | na na  |            | na na  |        | 3    | 1.0 0.0 | 1.0    |             | 2.0 3.0   |         | 2.0    | 3.0    |
|   20 | Arunachal Pradesh    | na    | na        | na     | na     | na na  |            | na     | na 14  | 5.0  | 2.0     | 2.0    |             | 7.0       | 7.0     | 4.0    | 10.0   |
|   21 | Delhi                | na    | na        | na     | na     | na     | na         | na     | na     | na   | na      | na     | na          | na        | na      | na     | na     |
|   22 | Goa                  | 1     | 100.0     | 100.0  | 100.0  | 100.0  | 100.0      | 100.0  | 100.0  | 2    | 100.0   | 100.0  | 100.0 100.0 |           | 100.0   | 50.0   | 100.0  |
|   23 | Himachal Pradesh     | na    | na        | na     | na     | na     | na         | na     | na     | 12   | 91.7    | 75.0   | 25.0        | 83.3      | 100.0   | 50.0   | 100.0  |
|   24 | Jammu & Kashmir      | na    | na        | na     | na     | na     | na         | na     | na     | na   | na      | na     | na          | na        | na      | na     | na     |
|   25 | Manipur              | 1     | 0.0       | 0.0    | 0.0    | 0.0    | 100.0      | 0.0    | O      | 7    | 42.9    | 14.3   | 0.0         | 42.9      | 42.9    | 28.6   | 71.4   |
|   26 | Meghalaya            | na    | na        | na     | na     | na     | na         | na na  |        | 5    | 100.0   | 40.0   | 20.0        | 80.0 60.0 |         | 20.0   | 100.0  |
|   27 | Mizoram              | 2     | 50.0      | 0.0    | 0.0    | 0.0    | 0.0        | 0.0    | 100.0  | 8    | 50.0    | 12.5   | 25.0 100.0  | 62.5      |         | 35.5   | 87.5   |
|   28 | Nagaland             | na    | na        | na     | na     | na     | na         | na     | na     | 11   | 45.4    | 18.2   | 18.2        | 72.7      | 54.5    | 18.2   | 81.8   |
|   29 | Sikkim               | na    | na        | na     | na     | na     | #REF!      | na     | na     | 4    | 3.0     | 2.0    | 0.0         | 4.0       | 4.0     | 3.0    | 3.0    |
|   30 | Tripura              | 11    | 36.4      | 0.0    | 0.0    | 63.6   | 90.9       | 27.3   | 54.6   | 5    | 60.0    | 40.0   | 20.0        | 60.0 80.0 |         | 40.0   | 100.0  |
|   31 | Uttarakhand          | 9     | 8.0       | 5.0    | 0.0    | 7.0    | 9.0        | 4.0    | 8.0    | 30   | 22.0    | 14.0   | 4.0         | 20.0      | 29.0    | 14.0   | 29.0   |
|   32 | Chandigarh           | na    | na        | na     | na     | na     | na         | na     | na     | 1.0  | 100.0   | 100.0  | 100.0       | 100.0     | 100.0   | 100.0  | 100.0  |
|   33 | Dadra & Nagar Haveli | na    | na        | na     | na     | na     | na         | na     | na     | na   | na      | na     | na          | na        | na      | na     | na     |
|   34 | Daman & Diu          | na    | na        | na     | na     | na     | na         | na     | na     | na   | na      | na     | na          | na        | na      | na     | na     |
|   35 | Lakshadweep          | na    | na        | na     | na     | na     | na         | na     | na     | na   | na      | na     | na          | na        | na      | na     | na     |
|   36 | Puducherry           | na    | na        | na     | na     | na     | na         | na     | na     | 3    | 66.6    | 66.6   | 66.6        | 100.0     | 100.0   | 100.0  | 100.0  |

## Annexure-VI

| DOCTORS + AT PRIMARY HEALTH CENTRES   | DOCTORS + AT PRIMARY HEALTH CENTRES   | DOCTORS + AT PRIMARY HEALTH CENTRES   | DOCTORS + AT PRIMARY HEALTH CENTRES   | DOCTORS + AT PRIMARY HEALTH CENTRES   | DOCTORS + AT PRIMARY HEALTH CENTRES   | DOCTORS + AT PRIMARY HEALTH CENTRES   |
|---------------------------------------|---------------------------------------|---------------------------------------|---------------------------------------|---------------------------------------|---------------------------------------|---------------------------------------|
| S. No.                                |                                       | (As on 31st March, 2015)              | (As on 31st March, 2015)              | (As on 31st March, 2015)              | (As on 31st March, 2015)              | (As on 31st March, 2015)              |
|                                       | State/UT                              | Required 1                            | Sanctioned                            | In Position                           | Vacant                                | Shortfall                             |
|                                       |                                       | [R]                                   | [S]                                   | [P]                                   | [S-P]                                 | [R-P]                                 |
| 1                                     | Andhra Pradesh                        | 1069                                  | 2270                                  | 1412                                  | 858                                   | *                                     |
| 2                                     | Arunachal Pradesh                     | 117                                   | NA                                    | 102                                   | NA                                    | 15                                    |
| 3                                     | Assam                                 | 1014                                  | NA                                    | 1355                                  | NA                                    | *                                     |
| 4                                     | Bihar###                              | 1883                                  | 2078                                  | 2521                                  | *                                     | *                                     |
| 5                                     | Chhattisgarh                          | 792                                   | 752                                   | 368                                   | 384                                   | 424                                   |
| 6                                     | Goa                                   | 21                                    | 48                                    | 56                                    | *                                     | *                                     |
| 7                                     | Gujarat#                              | 1247                                  | 1504                                  | 889                                   | 615                                   | 358                                   |
| 8                                     | Haryana                               | 461                                   | 635                                   | 489                                   | 146                                   | *                                     |
| 9                                     | Himachal Pradesh                      | 500                                   | 636                                   | 571                                   | 65                                    | *                                     |
| 10                                    | Jammu & Kashmir                       | 637                                   | 1352                                  | 834                                   | 518                                   | *                                     |
| 11                                    | Jharkhand                             | 327                                   | 327                                   | 372                                   | *                                     | *                                     |
| 12                                    | Karnataka                             | 2353                                  | 2353                                  | 2196                                  | 157                                   | 157                                   |
| 13                                    | Kerala                                | 827                                   | 1120                                  | 1169                                  | *                                     | *                                     |
| 14                                    | Madhya Pradesh                        | 1171                                  | 1658                                  | 999                                   | 659                                   | 172                                   |
| 15                                    | Maharashtra                           | 1811                                  | 3009                                  | 2937                                  | 72                                    | *                                     |
| 16                                    | Manipur^                              | 85                                    | 238                                   | 199                                   | 39                                    | *                                     |
| 17                                    | Meghalaya                             | 110                                   | 128                                   | 114                                   | 14                                    | *                                     |
| 18                                    | Mizoram##                             | 57                                    | 152                                   | 49                                    | 103                                   | 8                                     |
| 19                                    | Nagaland                              | 128                                   | 108                                   | 133                                   | *                                     | *                                     |
| 20                                    | Odisha 3                              | 1305                                  | 1312                                  | 1008                                  | 304                                   | 297                                   |
| 21                                    | Punjab                                | 427                                   | 490                                   | 441                                   | 49                                    | *                                     |
| 22                                    | Rajasthan                             | 2083                                  | 2807                                  | 2412                                  | 395                                   | *                                     |
| 23                                    | Sikkim                                | 24                                    | NA                                    | 29                                    | NA                                    | *                                     |

| 24   | Tamil Nadu    |   1372 |   2744 |   2375 | 369   | *    |
|------|---------------|--------|--------|--------|-------|------|
| 25   | Telangana     |    668 |   1318 |   1024 | 294   | *    |
| 26   | Tripura       |     91 |    158 |    158 | 0     | *    |
| 27   | Uttarakhand** |    257 |    325 |    160 | 165   | 97   |
| 28   | Uttar Pradesh |   3497 |   4509 |   2209 | 2300  | 1288 |
| 29   | West Bengal   |    909 |   2600 |    723 | 1877  | 186  |
| 30   | A& N Islands  |     22 |     42 |     36 | 6     | *    |
| 31   | Chandigarh    |      0 |      0 |      0 | 0     | 0    |
| 32   | D & N Haveli  |      7 |      6 |      8 | *     | *    |
| 33   | Daman & Diu   |      3 |      3 |      5 | *     | *    |
| 34   | Delhi         |      5 |     21 |     21 | 0     | *    |
| 35   | Lakshadweep   |      4 |      9 |      9 | 0     | *    |
| 36   | Puducherry    |     24 |     38 |     38 | 0     | *    |
|      | All India 2   |  25308 |  34750 |  27421 | 9389  | 3002 |

## Sanctioned data for 2013-14 used

# Data  for 2013 repeated

**Inposition data for 2013-14 used

###Inposition data for 2013-14 & Sanctioned data for 2011 used

^Data for 2013-14 repeated

NA: Not Available.

- +: Allopathic Doctors
- *: Surplus. All India figures for Vacancy and Shortfall are the totals of State-wise Vacancy and Shortfall ignoring surplus in some States / UTs
- 1 One per Primary Health Centre
- 2 For calculating the overall percentages of vacancy, the States/UTs for which manpower position is not available, may be excluded
- 3 The PHC data included Area Hospitals & Other Hospitals

| General Duty Medical Officers (GDMOs) - Allopathic at CHCs   | General Duty Medical Officers (GDMOs) - Allopathic at CHCs   | General Duty Medical Officers (GDMOs) - Allopathic at CHCs   | General Duty Medical Officers (GDMOs) - Allopathic at CHCs   |
|--------------------------------------------------------------|--------------------------------------------------------------|--------------------------------------------------------------|--------------------------------------------------------------|
| S. No.                                                       | State/UT                                                     | (As on 31st March, 2015)                                     | (As on 31st March, 2015)                                     |
|                                                              |                                                              | Sanctioned                                                   | In Position                                                  |
|                                                              |                                                              | [S]                                                          | [P]                                                          |

Notes:

|   1 | Andhra Pradesh    | 312   |   272 |
|-----|-------------------|-------|-------|
|   2 | Arunachal Pradesh | NA    |   114 |
|   3 | Assam             | NA    |   456 |
|   4 | Bihar^            | NA    |   285 |
|   5 | Chhattisgarh      | 628   |   334 |
|   6 | Goa               | 12    |    10 |
|   7 | Gujarat#          | 1060  |   747 |
|   8 | Haryana           | 410   |   265 |
|   9 | Himachal Pradesh  | 234   |   208 |
|  10 | Jammu & Kashmir   | 772   |   533 |
|  11 | Jharkhand         | 564   |   757 |
|  12 | Karnataka         | 255   |   224 |
|  13 | Kerala            | 781   |  1019 |
|  14 | Madhya Pradesh    | 1109  |   864 |
|  15 | Maharashtra       | 512   |   486 |
|  16 | Manipur^          | 97    |    94 |
|  17 | Meghalaya         | 91    |    74 |
|  18 | Mizoram           | NA    |    11 |
|  19 | Nagaland          | 42    |    53 |
|  20 | Odisha            | 449   |   463 |
|  21 | Punjab            | 174   |   372 |
|  22 | Rajasthan         | 1442  |  1071 |
|  23 | Sikkim            | NA    |     4 |
|  24 | Tamil Nadu        | 1919  |  1740 |
|  25 | Telangana         | 226   |   197 |
|  26 | Tripura           | 64    |    64 |
|  27 | Uttarakhand       | 61    |    54 |
|  28 | Uttar Pradesh     | 0     |     0 |

| 29   | West Bengal   |   1800 |   980 |
|------|---------------|--------|-------|
| 30   | A& N Islands  |     13 |    13 |
| 31   | Chandigarh##  |      6 |    19 |
| 32   | D & N Haveli  |      0 |     6 |
| 33   | Daman & Diu   |      4 |     4 |
| 34   | Delhi         |      0 |     0 |
| 35   | Lakshadweep   |     11 |    11 |
| 36   | Puducherry    |     18 |    18 |
|      | Total 2       |  13066 | 11822 |

Notes: # Data  for 2013 repeated ^Data for 2013-14 repeated ##Sanctioned data for 2013-14 used NA: Not Available 2 For calculating the overall percentages of vacancy,  the States/UTs for which manpower position is not available, may be excluded

| TOTAL SPECIALISTS AT CHCs                                 | TOTAL SPECIALISTS AT CHCs                                 | TOTAL SPECIALISTS AT CHCs                                 | TOTAL SPECIALISTS AT CHCs                                 | TOTAL SPECIALISTS AT CHCs                                 | TOTAL SPECIALISTS AT CHCs                                 | TOTAL SPECIALISTS AT CHCs                                 |
|-----------------------------------------------------------|-----------------------------------------------------------|-----------------------------------------------------------|-----------------------------------------------------------|-----------------------------------------------------------|-----------------------------------------------------------|-----------------------------------------------------------|
| Specialists [Surgeons, OB&GY, Physicians &Paediatricians] | Specialists [Surgeons, OB&GY, Physicians &Paediatricians] | Specialists [Surgeons, OB&GY, Physicians &Paediatricians] | Specialists [Surgeons, OB&GY, Physicians &Paediatricians] | Specialists [Surgeons, OB&GY, Physicians &Paediatricians] | Specialists [Surgeons, OB&GY, Physicians &Paediatricians] | Specialists [Surgeons, OB&GY, Physicians &Paediatricians] |
| S. No.                                                    |                                                           | (As on 31st March, 2015)                                  | (As on 31st March, 2015)                                  | (As on 31st March, 2015)                                  | (As on 31st March, 2015)                                  | (As on 31st March, 2015)                                  |
|                                                           | State/UT                                                  | Required 1                                                | Sanctioned                                                | In Position                                               | Vacant                                                    | Shortfall                                                 |
|                                                           | State/UT                                                  | [R]                                                       | [S]                                                       | [P]                                                       | [S-P]                                                     | [R-P]                                                     |
| 1                                                         | Andhra Pradesh                                            | 716                                                       | 384                                                       | 159                                                       | 225                                                       | 557                                                       |
| 2                                                         | Arunachal Pradesh                                         | 208                                                       | NA                                                        | 1                                                         | NA                                                        | 207                                                       |
| 3                                                         | Assam                                                     | 604                                                       | NA                                                        | 121                                                       | NA                                                        | 483                                                       |
| 4                                                         | Bihar                                                     | 280                                                       | NA                                                        | 63                                                        | NA                                                        | 217                                                       |
| 5                                                         | Chhattisgarh                                              | 620                                                       | 628                                                       | 78                                                        | 550                                                       | 542                                                       |
| 6                                                         | Goa                                                       | 16                                                        | 5                                                         | 4                                                         | 1                                                         | 12                                                        |
| 7                                                         | Gujarat#                                                  | 1280                                                      | NA                                                        | 74                                                        | NA                                                        | 1206                                                      |
| 8                                                         | Haryana                                                   | 436                                                       | 153                                                       | 30                                                        | 123                                                       | 406                                                       |
| 9                                                         | Himachal Pradesh                                          | 312                                                       | 0                                                         | 7                                                         | *                                                         | 305                                                       |
| 10                                                        | Jammu & Kashmir                                           | 336                                                       | 343                                                       | 167                                                       | 176                                                       | 169                                                       |
| 11                                                        | Jharkhand                                                 | 752                                                       | 131                                                       | 128                                                       | 3                                                         | 624                                                       |
| 12                                                        | Karnataka                                                 | 824                                                       | 824                                                       | 502                                                       | 322                                                       | 322                                                       |
| 13                                                        | Kerala                                                    | 888                                                       | 30                                                        | 39                                                        | *                                                         | 849                                                       |
| 14                                                        | Madhya Pradesh                                            | 1336                                                      | 897                                                       | 263                                                       | 634                                                       | 1073                                                      |
| 15                                                        | Maharashtra                                               | 1440                                                      | 823                                                       | 578                                                       | 245                                                       | 862                                                       |
| 16                                                        | Manipur^                                                  | 68                                                        | 4                                                         | 3                                                         | 1                                                         | 65                                                        |
| 17                                                        | Meghalaya                                                 | 108                                                       | 3                                                         | 3                                                         | 0                                                         | 105                                                       |
| 18                                                        | Mizoram                                                   | 36                                                        | 0                                                         | 0                                                         | 0                                                         | 36                                                        |
| 19                                                        | Nagaland                                                  | 84                                                        | 0                                                         | 4                                                         | *                                                         | 80                                                        |
| 20                                                        | Odisha                                                    | 1508                                                      | 908                                                       | 356                                                       | 552                                                       | 1152                                                      |
| 21                                                        | Punjab                                                    | 600                                                       | 563                                                       | 173                                                       | 390                                                       | 427                                                       |
| 22                                                        | Rajasthan                                                 | 2272                                                      | 1566                                                      | 526                                                       | 1040                                                      | 1746                                                      |

| 23   | Sikkim        |     8 |    NA |    0 | NA   | 8     |
|------|---------------|-------|-------|------|------|-------|
| 24   | Tamil Nadu 3  |  1540 |     0 |    0 | 0    | 1540  |
| 25   | Telangana     |   456 |   284 |  116 | 168  | 340   |
| 26   | Tripura       |    80 |     3 |    3 | 0    | 77    |
| 27   | Uttarakhand   |   236 |   197 |   49 | 148  | 187   |
| 28   | Uttar Pradesh |  3092 |  2099 |  484 | 1615 | 2608  |
| 29   | West Bengal   |  1388 |  1792 |  114 | 1678 | 1274  |
| 30   | A& N Islands  |    16 |     9 |    0 | 9    | 16    |
| 31   | Chandigarh##  |     8 |    11 |   27 | *    | *     |
| 32   | D & N Haveli  |     4 |     0 |    2 | *    | 2     |
| 33   | Daman & Diu   |     8 |     2 |    1 | 1    | 7     |
| 34   | Delhi         |     0 |     0 |    0 | 0    | 0     |
| 35   | Lakshadweep   |    12 |     0 |    0 | 0    | 12    |
| 36   | Puducherry    |    12 |     2 |    3 | *    | 9     |
|      | All India 2   | 21584 | 11661 | 4078 | 7881 | 17525 |

Notes:

# Data  for 2013 repeated

^Data for 2013-14 repeated

##Sanctioned data for 2013-14 used

NA: Not Available.

- 1 Four per Community Health Centre
- *: Surplus. All India figures for Vacancy and Shortfall are the totals of State-wise Vacancy and Shortfall ignoring surplus in some States / UTs

2

For calculating the overall percentages of vacancy and shortfall, the States/UTs for which manpower position is not available, may be excluded

- 3 Specialists are attending CHCs on hiring basis