Lok Sabha Question No. 3327 (UNSTARRED), answered on 2016-08-05
Subject: Community Health Centres
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RAMA DEVI, LAXMI NARAYAN YADAV

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

## LOK SABHA UNSTARRED  QUESTION NO. 3327 TO BE ANSWERED ON 5 TH AUGUST, 2016

## COMMUNITY HEALTH CEN TRES

## 3327. SHRIMATI RAMA DEVI:

## SHRI LAXMI NARAYAN YADAV:

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

- (a)  whether  the  Government  has  put  in place  any  system  for  grading  of Community  Health Centres (CHCs) functioning in the country;
- (b) if so, the details thereof along with the reasons therefor; and
- (c) the funds allocated as incentive to States on the basis of said grading during the last three years, State/UT - wise and the extent to which the said grading system has improved the quality of CHCs?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

(a) &(b): The Ministry of Health and Family Welfare has initiated star rating of Communi Health Centers (CHCs) in April, 2015. Further, it has been renamed as 'Grading of CHCs' in June  2016.  The  main  reason  for  grading  of  CHCs  is  to  bring  focus  on  key  initiatives under National  Rural  Health  Mission  /  National  Health  Mission  and  to  encourage  strengthening health  facilities.  Grading  of  CHCs  is  based  on  monthly  performance  data  and  ann infrastructure data as uploaded on Health Management Information System (HMIS ) portal. It is generated on quarterly basis.

The criteria to grade the CHCs are annexed.

- (c) :  Though under National Health Mission, there is a provision of 5% incentive or based on the grading, yet the total amount of money provided as inc entive to States/UTs depends on aggregated performance of nine parameters including grading. None of the States/UTs received any incentive under this parameter .

From the data uploaded by the States/UTs on the HMIS portal it is observed that eligi ble /not applicable CHCs for grading due to non - availability of data have declined from about 77% in 2014 - 15  to  about 43% in 2015 - 16  while CHCs having 3 or higher grades have increased from about 15 % in 2014 - 15 to about 53% in 2015 - 16. This shows improve ment in infrastructure, services and/or data reporting.

## The crit eria followed to grade the CHCs are given below:

## 1. Infrastructure data:

| Category                        | Indicators/ Criteria                                                                            | Grade                                                                                         |
|---------------------------------|-------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------|
| Human Resource & infrastructure | Number of Doctors including specialists ≥ 2                                                     | If CHC satisfies all the under the category, it eligible for g ading & will get grade. public |
| Human Resource & infrastructure | Number of Nurse and Auxiliary Nurse Midwife (ANM) ≥ 6                                           | If CHC satisfies all the under the category, it eligible for g ading & will get grade. public |
| Human Resource & infrastructure | Number ofl aboratory t echnician ≥ 1                                                            | If CHC satisfies all the under the category, it eligible for g ading & will get grade. public |
| Human Resource & infrastructure | Availability of separate utilities for males and females                                        | If CHC satisfies all the under the category, it eligible for g ading & will get grade. public |
| Human Resource & infrastructure | Availability of operation t heatre                                                              | If CHC satisfies all the under the category, it eligible for g ading & will get grade. public |
| Human Resource & infrastructure | Availability of s tandby power facility (generator)                                             | If CHC satisfies all the under the category, it eligible for g ading & will get grade. public |
| Drugs and supplies              | Availability of 2 month s supply of essential drugs                                             | CHC will get 1 grade for all the criteria of this category.                                   |
| Drugs and supplies              | Availability of 2 month s supply of essential vaccines                                          | CHC will get 1 grade for all the criteria of this category.                                   |
| Drugs and supplies              | Availability of 2 month s supply of essential contraceptives                                    | CHC will get 1 grade for all the criteria of this category.                                   |
| Service availability            | Availability of 24 - hour delivery services including normal and assisted deliveries            | CHC willget 1 grade for all the criteria of this category.                                    |
| Service availability            | Availability of emergency care of sick children                                                 | CHC willget 1 grade for all the criteria of this category.                                    |
| Service availability            | Availability of essential l aboratory services                                                  | CHC willget 1 grade for all the criteria of this category.                                    |
| Client orientation              | Availabilit y of p ublicly displayed mechanism, whereby a complaint/grievance can be registered | CHC will get 1 grade for all the criteria of this category.                                   |
| Client orientation              | Availabilit y of publicly displayed Citizen's charter                                           | CHC will get 1 grade for all the criteria of this category.                                   |
| Client orientation              | Provision of m onitoring yb Panchayati Raj Institutions /Zila Parishad / Rogi Kalyan Samiti     | CHC will get 1 grade for all the criteria of this category.                                   |

## 2. Performance / Service Utilization data :

| Category            | Indicators                                                            | Criteria (Non Hilly districts & States/UTs)   | Criteria (Hilly * districts & N orth E astern States; after incorporating 30% relaxation)   | Grade                                                           |
|---------------------|-----------------------------------------------------------------------|-----------------------------------------------|---------------------------------------------------------------------------------------------|-----------------------------------------------------------------|
| Service Utilization | Number of d eliveries conducted at the (Including Caesarean Sections) | facility 100 per month                        | 70 per month                                                                                | CHC will get 1 grade for fulfilling criteria 4 out 5 indicators |
| Service Utilization | Number of new IUCD Insertions at facility                             | 3 per month                                   | 2 per month                                                                                 | CHC will get 1 grade for fulfilling criteria 4 out 5 indicators |
| Service Utilization | Number of infants (0 - 11 months old) who immunized with BCG vaccine  | are 80 per month                              | 56 per month                                                                                | CHC will get 1 grade for fulfilling criteria 4 out 5 indicators |
| Service Utilization | Number of i npatients in CHC (IPD)                                    | the 500 per month                             | 350 per month                                                                               | CHC will get 1 grade for fulfilling criteria 4 out 5 indicators |
| Service Utilization | O ut patients attendance (All)                                        | 750 per month                                 | 525 per month                                                                               | CHC will get 1 grade for fulfilling criteria 4 out 5 indicators |

for

*Hilly States : -Himachal Pradesh ,Jammu & Kashmir (except Srinagar), Uttarakhand (except Dehradun, Haridwar & Udham Singh Nagar).

Final grading of CHC is done after adding grades from all the above mentioned categories. The facility will not be considered for grading if data under the Infrastructure is not the facility.

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