Executive Summary:
The Ministry of Health and Family Welfare addressed concerns in Lok Sabha regarding increasing diabetes cases leading to kidney complications and dialysis needs. The Ministry assesses dialysis services regularly through the Pradhan Mantri National Dialysis Programme (PMNDP). Tamil Nadu has 142 operational haemodialysis centers, and the government supports states in expanding dialysis facilities and has allocated funds to Tamil Nadu. The government is integrating diabetic and nephrology care under the National Health Mission (NHM) to ensure early diagnosis and intervention.
Key Points / Main Content:
Diabetes and Kidney Complications:
* Diabetes prevalence in India is 10.1 crores (ICMR-INDIAB study, 2023).
* Diabetes can damage organs, potentially leading to dialysis due to kidney-related issues (especially in End-Stage Renal Disease (ESRD) patients).
Dialysis Services Assessment and Availability:
* The Ministry of Health & Family Welfare (MoHFW) regularly assesses the PMNDP via reviews, field visits, and consultations.
* The PMNDP portal integrates dialysis centers under the NHM, registers patients with ABHA IDs, and records dialysis sessions, improving portability and monitoring.
* Tamil Nadu has 142 government-sector haemodialysis centers: 41 in Government Medical College Hospitals, 33 in District Hospitals, and 59 in Sub-District Hospitals.
* An additional 9 haemodialysis units operate at Primary Health Centres (PHCs) under a Public-Private Partnership (PPP) model.
Expansion and Upgrade of Dialysis Facilities:
* The PMNDP aims to improve access to haemodialysis and peritoneal dialysis services.
* The MoHFW recommends establishing haemodialysis centers in district hospitals initially, scaling down to Community Health Centres (CHCs).
* The Government supports states financially to establish dialysis services as per their Programme Implementation Plan, based on dialysis burden and gap assessment.
Financial Allocations for Dialysis in Tamil Nadu:
* Funds sanctioned, released, and utilized in Tamil Nadu under PMNDP (in Lakh Rupees):
* 2020-21: Sanctioned 876.28, Released 876.28, Utilized 100
* 2021-22: Sanctioned 3644.85, Released 3644.85, Utilized 100
* 2022-23: Sanctioned 865.60, Released 865.60, Utilized 100
* 2023-24: Sanctioned 530.68, Released 530.68, Utilized 100
* 2024-25: Sanctioned 1670.99, Released 1670.99, Utilized 100
Integration of Diabetic and Nephrology Care:
* A population-based initiative screens for Non-Communicable Diseases (NCDs) like diabetes, hypertension, and common cancers under NHM.
* Individuals over 30 are targeted for NCD screening at Ayushman Arogya Mandirs.
* Tamil Nadu has initiated targeted NCD screening focusing on Retinopathy, Neuropathy and Nephropathy.
* Women Health Volunteers (WHVs) identify hypertensive and diabetic patients and refer them for screening; urine dipstick tests are conducted at HSCs and PHCs to screen high-risk patients for signs of nephropathy.
Impact Analysis:
Ministry of Health and Family Welfare (MoHFW):
* Impact: Responsible for ongoing assessment and support of the PMNDP and NCD screening initiatives.
* Action Required: Continue monitoring PMNDP, providing financial support to states, and refining NCD screening programs.
State Governments (Specifically Tamil Nadu):
* Impact: Responsible for implementing and utilizing funds for dialysis services and NCD screening programs.
* Action Required: Effectively utilize allocated funds, expand dialysis services based on need, and implement targeted NCD screening programs.
Healthcare Providers (Government Hospitals, PHCs, CHCs):
* Impact: Directly involved in providing dialysis services and conducting NCD screenings.
* Action Required: Ensure adequate staffing, equipment, and training for dialysis and screening programs, accurately record patient data, and refer patients for further care as needed.
Patients (Diabetic, Hypertensive, Kidney Disease):
* Impact: Benefit from increased access to dialysis services, early detection of kidney complications, and integrated care.
* Action Required: Participate in screening programs, follow medical advice, and utilize available dialysis services when necessary.
Women Health Volunteers (WHVs):
* Impact: Play a crucial role in identifying and referring patients for screening.
* Action Required: Conduct follow-up visits, identify patients with hypertension and diabetes, and refer them to HSCs or PHCs for further screening.
Key Entities Referenced
Tamil Nadu: A state in southern India, focus of the dialysis facilities assessment.
Pradhan Mantri National Dialysis Programme (PMNDP): A national program in India aimed at providing affordable dialysis services.
National Health Mission (NHM): A centrally sponsored scheme of the Government of India that addresses the health needs of under-served rural areas.
Indian Council of Medical Research India Diabetes (ICMR INDIAB): An Indian study on the prevalence of diabetes.
Ayushman Bharat Health Account (ABHA): A unique health account ID used to register dialysis patients on the PMNDP portal.
Non Communicable Diseases (NCDs): A group of diseases that are not infectious and may include diabetes, hypertension, and common cancers.
Chronic Kidney Disease (CKD): A condition characterized by gradual loss of kidney function.
Primary Health Centres (PHCs): Government-run health facilities that provide basic medical care in rural areas.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH ANDFAMILYWELFARE
DEPARTMENTOFHEALTHAND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 3310
TOBE ANSWERED ON08TH AUGUST,2025
DIALYSIS FACILITIES IN TAMILNADU
3310. SHRINAVASKANI K
SHRISELVAM G:
SHRIC N ANNADURAI:
Will the Minister of HEALTH ANDFAMILYWELFAREbe pleased tostate:
(a) whether the Government is aware that the number of diabetic patients inthe country is increasing
rapidly andmany of them eventuallyneed dialysis because of kidney-related complications,if so, the
detailsthereof;
(b) whether the Government has assessed the current availability of dialysis centres and nephrology
services in Government hospitals across the country, including Tamil Nadu and if so, the details
thereof;
(c) the number of dialysis centres operational in Tamil Nadu along with the number of patients
availingthe services annually during the last three years, year-wise;
(d) whether the Government proposes to expand or upgrade dialysis facilities in rural and
underserved areasof Tamil Nadu andif so, the detailsthereof;
(e) the amount of funds allocated/released and utilized under Pradhan Mantri National Dialysis
Programme/anyother scheme inTamilNadu during the last five years, year-wise;and
(f) whether the Government proposes to integrate diabetic and nephrology care under a common
NCD framework toensure earlydiagnosis andtimely interventionandif so, the detailsthereof?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND
FAMILYWELFARE
(SHRIPRATAPRAO JADHAV)
(a): As per Indian Council of Medical Research – India Diabetes (ICMR -INDIAB) study published in
2023, the prevalence of diabetes is 10.1 crores. The detailed report is available at the following link-
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(23)00119-5/fulltext.
Over the time, diabetes can damage the heart, blood vessels, eyes, kidneys and nerves and many of
them eventually may need dialysis due to kidney related complications, particularly patients with
‘EndStageRenal Disease’ (ESRD).
(b) & (c): Ministry of Health & Family Welfare (MoHFW) conducts regular assessment of the
Pradhan Mantri National Dialysis Programme (PMNDP), through Common Review Mission, field
visits and tele-consultations with the States and Union Territories from time to time. PMNDP Portal
hasbeendevelopedwith integratingall the dialysiscentresundertheNational HealthMission(NHM).
The PMNDP portal has the facility to register dialysis patients with the unique Ayushman BharatHealth Account (ABHA) ID and record all dialysis sessions. The portal has resulted in providing
portabilitytothe dialysis patientsandinimprovingfollow-up andmonitoring.
As informed by the Government of Tamil Nadu, there are 142 Haemodialysis Centres operational
across the State under the Government sector through the in-house model. This includes 41 Units in
Government Medical College Hospitals and their allied institutions, 33 Units in District Hospitals,
and 59 Units in Sub-District Hospitals. In addition,9 Haemodialysis Units are operational at Primary
HealthCentres(PHCs) underthe Public-Private Partnership(PPP) mode.
(d) : The objective of the PMNDP program is to improve access to dialysis services (both
Hemodialysis & Peritoneal Dialysis). MoHFW has recommendedsetting up of haemodialysis centres
in all the district hospitals initially and on saturation scale down till the Community Health Centres
(CHCs) at the taluka level.
Health is a state subject. However, States and Union Territories are financially supported for
establishing dialysis services (haemodialysis or peritoneal dialysis) for improving access to dialysis
services as per the their Programme Implementation Plan, based on the dialysis burden and gap
assessment undertakenbyStates andUnion Territories.
(e): As per the Government of Tamil Nadu, year-wise details of funds sanctioned, released, and
utilizedare asfollows:
FinancialYear Sanctioned(Rs.in Released(Rs.in %Utilization
lakh) lakh)
2020-21 876.28 876.28 100%
2021-22 3644.85 3644.85 100%
2022-23 865.60 865.60 100%
2023-24 530.68 530.68 100%
2024-25 1670.99 1670.99 100%
(f): A population-based initiative for prevention, control and screening for common Non-
Communicable Diseases (NCDs) i.e.,diabetes, hypertension andcommoncancershasbeenrolledout
in the country under NHM and also as a part of Comprehensive Primary Health Care. Under the
initiative, persons more than 30 years of age are targeted for their screening for common NCDs.
Screening of these common NCDs isan integralpart of service delivery at AyushmanArogyaMandir
which generatesawareness on risk factorsof NCDs.
Government of Tamil Nadu has initiated targeted Non Communicable Diseases (NCDs) screening
complications under National Health Mission (NHM) focusing on Retinopathy Screening for early
detection of diabetic eye complications, Neuropathy Screening for identifying diabetic foot risk, and
Nephropathy Screening, recognizing that uncontrolled hypertension and diabetes are major
contributorstoChronic Kidney Disease (CKD) andrenal failure.
To address nephropathy specifically, a structured CKD screening process has been implemented
across various levels of the public healthcare system. In this initiative, Women Health Volunteers
(WHVs) at community level identify confirmed hypertensive and diabetic patients during follow-up
visits and refer them to nearby Health Sub-Centres (HSCs) or Primary Health Centres (PHCs) for
further screening. At the facility level,urine dipstick tests are conductedat HSCsandPHCs toscreen
high-risk patientsfor signs of nephropathy.
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