Executive Summary:
The Ministry of Health and Family Welfare addresses questions regarding the Free Drugs Service Initiative and Free Diagnostics Service Initiative under the National Health Mission (NHM). The initiative provides financial support to states/UTs, including Tamil Nadu, for free essential medicines and diagnostics in public health facilities. The ministry monitors the availability of drugs and diagnostics and encourages the use of digital platforms for tracking.
Key Points / Main Content:
* **Financial Support under NHM:**
* Financial support is provided to all States/UTs, including Tamil Nadu, for free essential medicines and diagnostics based on their Programme Implementation Plans (PIPs).
* **Essential Drugs List (EDL):**
* The Ministry recommends a facility-wise EDL to ensure widespread access to essential medicines in public healthcare facilities, including those in Tamil Nadu.
* **Free Diagnostics Service Initiative (FDSI):**
* The FDSI aims to provide accessible and affordable pathological and radiological diagnostic services to reduce out-of-pocket expenditure (OOPE).
* **Medicine and Diagnostics Services:**
* The number of recommended essential medicines and diagnostics services varies by facility type:
* District Hospitals (DHs): 381 medicines, 134 diagnostics
* Sub-District Hospitals (SDHs): 318 medicines, 111 diagnostics
* Community Health Centres (CHCs): 300 medicines, 97 diagnostics
* Ayushman Arogya Mandir (AAM) Primary Health Centres (PHCs): 172 medicines, 63 diagnostics
* AAM Sub Health Centre (SHCs): 106 medicines, 14 diagnostics
* States have the flexibility to add more medicines and diagnostics.
* Tamil Nadu provides 482 essential drugs at PHC, CHC, SDH, and DHQ levels and 484 specialty drugs at DH and Tertiary levels.
* Tamil Nadu provides 134 tests at DH, 111 at SDH, 97 at CHC, 63 at PHC, and 14 tests at Sub-Health Centres.
* **Monitoring Mechanism:**
* A multi-layered monitoring approach is adopted to identify and address gaps in procurement, supply chain, and stock management.
* Digital platforms like Drugs and Vaccine Distribution Management System (DVDMS) are used to track procurement, consumption, and replenishment of drugs.
* The Open Data Kit (ODK) tool is used to assess health facilities, including the availability of essential drugs and diagnostics.
* Field visits by senior officials from both Union and State Governments monitor the availability and utilization of services.
Impact Analysis:
* **State Governments/Union Territories (including Tamil Nadu):**
* *Impact:* Receive financial support for providing free essential medicines and diagnostics in public health facilities.
* *Action Required:* Develop and implement Programme Implementation Plans (PIPs), ensure the availability of essential medicines and diagnostics, and utilize digital platforms for tracking and monitoring.
* **Public Health Facilities (DHs, SDHs, CHCs, PHCs, SHCs):**
* *Impact:* Required to provide free essential medicines and diagnostics as per the recommended lists.
* *Action Required:* Ensure the availability of essential medicines and diagnostics, maintain accurate records, and participate in monitoring activities.
* **Patients:**
* *Impact:* Benefit from reduced out-of-pocket expenditure due to the availability of free essential medicines and diagnostics.
* *Action Required:* Utilize the available services at public health facilities.
* **Ministry of Health and Family Welfare:**
* *Impact:* Responsible for providing financial support, recommending EDLs, and monitoring the implementation of the initiatives.
* *Action Required:* Continue to provide financial support, update EDLs, and monitor the implementation of the initiatives through various mechanisms.
Key Entities Referenced
National Health Mission: A centrally sponsored scheme of the Government of India to address the health needs of under-served rural areas.
Tamil Nadu: A state in southern India, specifically mentioned for the implementation and monitoring of health initiatives.
Free Drugs Service Initiative: An initiative under the National Health Mission to provide essential medicines free of cost at public health facilities.
Free Diagnostics Service Initiative: An initiative under the National Health Mission to provide free diagnostic services at public health facilities.
Essential Drugs List: A list of essential medicines that should be available at public healthcare facilities as recommended by the Ministry of Health and Family Welfare.
Primary Health Centres: Government-owned health centers at the first point of contact between the village community and the medical officer.
Community Health Centres: Government-owned health centers that provides referral as well as specialist health care services to rural people.
Out of Pocket Expenditure: Direct payments made by individuals to health care providers at the time of service use.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH ANDFAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2099
TOBE ANSWERED ON1st AUGUST,2025
FREE DRUGS AND DIAGNOSTICS SERVICE INITIATIVE UNDER NHM
2099. SHRI SELVAM G:
SHRI C N ANNADURAI:
SHRI NAVASKANI K
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) whether the Government is implementing the Free Drugs Service Initiative and
Free Diagnostics Service Initiative under the National Health Mission (NHM) across
the country, if so, the detailsthereof,State-wise including TamilNadu;
(b) the number of essential drugs and diagnostic tests mandated to be providedfree of
cost at different levelsof public healthfacilities underthese initiatives;
(c) the extent to which the State of Tamil Nadu has implemented these initiatives at
SubHealth Centres (SHCs), Primary Health Centres (PHCs), Community Health
Centres(CHCs), Sub-District Hospitals (SDHs) andDistrict Hospitals;
(d) whether the Union Government has any monitoring mechanism in place to ensure
uninterrupted availability of essential drugs and timely delivery of diagnostic services
inpublic healthfacilities inTamilNadu andif so,the detailsthereof; and
(e) the steps being taken by the Union Government to further reduce the Out-Of-
Pocket Expenditure of patients in Tamil Nadu through enhanced coverage of free
drugs anddiagnostics?
ANSWER
THE MINISTER OFSTATE INTHE MINISTRYOFHEALTH& FAMILY
WELFARE
(SHRIPRATAPRAOJADHAV)
(a) to (e): Under NHM, financial support is provided to all States / UTs including
Tamil Nadu for provision of free essential medicines & free essential diagnostics in
public health facilities based on the requirements posed by States/UTs in their
Programme Implementation Plans (PIPs) within their overall resource envelope.
Under Free Drugs Service Initiative, Ministry has recommended facility wise
Essential Drugs List (EDL) to be made available at the public healthcare facilities in
the countryincludingTamil Nadu toensure widespread accesstoessential medicines.
The Ministry of Health and Family Welfare, Government of India supports ‘Free
Diagnostics Service Initiative’ (FDSI) programme under National Health Mission.
The programme was launched with the aim to provide accessible and affordable
pathological and radiological diagnostics services closer to the community which inturn reduces the Out-of-Pocket Expenditure (OOPE). The number of medicine and
Diagnostics services recommended at these health facilities in the country including
Tamil Nadu are givenasbelow. However,Stateshave the flexibilitytoaddmore.
Sr. Name of Facilities No. of No. of
No. essential Diagnostics
Medicine
1 District Hospitals 381 134
(DHs)
2 Sub-District 318 111
Hospitals(SDHs)
3 Community Health 300 97
Centres(CHCs)
4 Ayushman Arogya 172 63
Mandir (AAM) -
Primary Health
Centres(PHCs)
5 AAM-Sub Health 106 14
Centre (SHCs)
As informed by the State Govt. of Tamil Nadu, total 482 essential drugs are provided
at PHC, CHC, SDH and DHQ level and 484 specialty drugs at DH and Tertiary level.
Total 134 test at DH, 111 at SDH, 97 at CHC, 63 at PHC and 14 test at Sub-Health
Centresare providedinTamil Nadu.
The Ministry has adopted a multi-layered monitoring approachto identifyand address
gaps in procurement, supply chain,and stock management. Many States have adopted
digital platforms like Drugs and Vaccine Distribution Management System (DVDMS)
to track procurement, consumption, and replenishment of the drugs. Through Open
Data Kit (ODK) tool the various parameters of health facilities are assessed by States
which include availability of essential drugs as well as diagnostics. Field visits by
senior officials of Union Government as well as State Government also monitor the
availabilityandutilisation of these services.
*****