Executive Summary:
The Ministry of Health and Family Welfare addresses healthcare funding disparities across states through the National Health Mission (NHM) and other centrally sponsored schemes. These initiatives aim to improve healthcare infrastructure and access, especially in underserved regions. The ministry provides technical and financial support to states based on proposals and existing norms, with relaxed norms for tribal areas. Government Health Expenditure has increased to 1.84% of GDP in 2021-22.
Key Points / Main Content:
* **National Health Mission (NHM):**
* Provides technical and financial support to states/UTs for improved health infrastructure and human resources.
* Approvals based on State/UT Programme Implementation Plans (PIP) and resource availability.
* Relaxed population norms for establishing Sub-Health Centres (SHC), Primary Health Centres (PHC), and Community Health Centres (CHC) in tribal areas.
* Increased ASHA workers per habitation and Mobile Medical Units (MMU) per district in tribal/hilly areas.
* **Pradhan Mantri Janjati Adivasi Nyaya Maha AbhiyaN (PM-JANMAN):**
* Further relaxation in NHM norms for Particularly Vulnerable Tribal Groups (PVTG) areas, including increased MMUs, ANMs, and Multi-Purpose Centres.
* **Healthcare Infrastructure Schemes:**
* NHM supports a three-tier primary healthcare system (SHC, PHC, CHC).
* Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): Aims to strengthen healthcare infrastructure with an outlay of Rs. 64180 Crores (FY2021-22 to FY2025-26) to manage pandemics and outbreaks.
* Pradhan Mantri Swasthya Suraksha Yojana (PMSSY): Supports setting up AIIMS and upgrading existing Government Medical Colleges.
* Establishment of new medical colleges attached with existing district/referral hospitals in underserved areas and aspirational districts.
* **15th Finance Commission (FCXV):**
* Recommended grants of Rs. 70,051 cr through local governments for specific health sector components.
* **Healthcare Spending:**
* Government Health Expenditure (GHE) as percentage of GDP increased to 1.84% in 2021-22.
* Centrally sponsored schemes encourage states to earmark funds for healthcare in their budgets.
Impact Analysis:
* **States/Union Territories:**
* Impact: Receive financial and technical support for healthcare improvements, especially in underserved regions. Expected to align proposals with NHM guidelines and resource envelopes.
* Action Required: Develop and submit Programme Implementation Plans (PIPs) and earmark funds for healthcare in their budgets.
* **Tribal and Hilly Areas/PVTGs:**
* Impact: Benefit from relaxed norms for healthcare infrastructure and human resources, leading to improved access to services.
* Action Required: Utilize the relaxed norms and increased resources to improve healthcare delivery in these regions.
* **General Population:**
* Impact: Aims for attainment of universal access to equitable, affordable and quality healthcare services
* Action Required: None
Key Entities Referenced
National Health Mission NHM: A centrally sponsored scheme implemented by the Ministry of Health and Family Welfare (MoHFW) to attain universal access to equitable, affordable, and quality healthcare services.
Pradhan Mantri Janjati Adivasi Nyaya Maha AbhiyaN PM JANMAN: A scheme launched on 15th November 2023, providing further relaxation in NHM norms for Particularly Vulnerable Tribal Groups (PVTG) areas.
Pradhan Mantri Ayushman Bharat Health Infrastructure Mission PMABHIM: A Pan-India scheme with an outlay of Rs. 64180 Crores for strengthening healthcare infrastructure to manage future pandemics and outbreaks, spanning from FY2021-22 to FY2025-26.
Pradhan Mantri Swasthya Suraksha Yojana PMSSY: A scheme providing support for setting up All India Institute of Medical Sciences (AIIMS) and upgrading existing Government Medical College Institutions.
All India Institute of Medical Sciences AIIMS: A network of autonomous public medical institutes of higher education and research.
15th Finance Commission FCXV: The Finance Commission that recommended grants through local governments for specific components of the health sector.
Ministry of Health and Family Welfare MoHFW: The Indian government ministry responsible for health policy in India.
ASHA: Accredited Social Health Activist - a community health worker.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 1083
TOBE ANSWERED ON 25TH JULY,2025
DISPARITYINHEALTHCAREFUNDING
1083. SHRIK GOPINATH:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleased tostate:
(a) the measures being taken to address the significant disparity in healthcare funding across States,
particularlyinunderserved regions;
(b) whether the Government plans to increase healthcare spending to meet the global average,
giventhatIndia’shealthcarespending remainsat just 1.8percentof GDP;
(c) if so, the detailsthereof;
(d) the manner in which the Government intends to improve healthcare infrastructure and access,
considering the current inadequacies highlightedbyexperts; and
(e) the accountability mechanisms in place to ensure that the States prioritise healthcare in their
budgets?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY
WELFARE
(SHRIPRATAPRAOJADHAV)
(a) to (e): With the objective of attainment of universal access to equitable, affordable and quality health
care services, the Ministry of Health & Family Welfare (MoHFW) is implementing National Health
Mission (NHM). Government provides technical and financial support to the States/UTs for improvement
in health infrastructure, availability of adequate human resources to health facilities, to improve
availabilityand accessibility toqualityhealthcare especially for the underserved andmarginalized groups.
Based onthe proposals receivedfrom the StatesintheirProgrammeImplementation Plan(PIP),approvals
are providedkeepinginviewthe resource envelope of the States/UTs aswell asexisting norms.Under NHM, norms have been relaxed for tribal area to address need-based intervention in terms of
healthcareinfrastructure andhumanresources:
The population norms for setting up health facilities in tribal areas have been relaxed from
5,000, 30,000 and 1,20,000 to 3000, 20,000 and 80,000 for setting up of Sub-Health Centre
(SHC), Primary Health Centre (PHC) and Community Health Centre (CHC) in tribal and hilly
areasrespectively;
Against norm of one ASHA per 1000 population in normal areas, one ASHA per habitation in
Tribal/hilly anddifficult areas; and
Against the norm of 2 Mobile Medical Units (MMU) per district in plains, 4 MMUs per district
intribal/hilly/ inaccessible/ remote andhardtoreachareas.
Under the Pradhan Mantri Janjati Adivasi Nyaya Maha AbhiyaN (PM JANMAN) launched on 15th
November, 2023,further relaxationinNHMnormshasbeenprovidedtothe ParticularlyVulnerable Tribal
Groups (PVTG) areas such as 10 MMU per district, additional ANM and Multi Purpose Centres, and
beneficiarysaturationinPVTGareas.
Further,detailsof afewmajorschemespromotinghealth infrastructure areasunder:
NHM is a centrally sponsored scheme, which involves a three-tier system with SHC (Rural),
PHC (Urban and Rural) and CHC (Urban and Rural) as the three pillars of Primary Health Care
SysteminIndia.
Pradhan Mantri- Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): PM-
ABHIM is one of the largest Pan-India Scheme with an outlay of Rs.64180/- Crores for
strengthening health care infrastructure to effectively manage and respond to any future
pandemicsandoutbreaksacross thecountry. Thescheme periodisfor 5yearsi.e.FY2021- 22to
FY2025-26.Thishasbothcentrallysponsored aswell ascentralsectorcomponents.
Pradhan Mantri Swasthya Suraksha Yojana (PMSSY): The scheme provides support for (i)
Setting up of All India Institute of Medical Sciences (AIIMS); and (ii) Up-gradation of existing
Government Medical College/ Institutions
Establishment of new medical colleges attached with existing district/referral hospitals:
This centrally sponsored scheme aims at Establishment of Medical Colleges in underserved
areasandaspirational districts. 15th Finance Commission (FC-XV): The FC-XV has recommended grants through local
governmentsfor specific components of the healthsector tothe tune of Rs.70,051 cr.
As perNational HealthAccountsEstimatesfor India2021-22, the Government HealthExpenditure(GHE)
as percentage of Gross Domestic Product (GDP) has increased from 1.13% in 2014-15 to 1.84% in 2021-
22.Centrallysponsored schemes(CSS) encourage Statestoearmarkfunds for healthcare intheirbudget.
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