Executive Summary:
The Ministry of Health and Family Welfare addresses concerns regarding the state of health services in the Bundelkhand region, which spans Uttar Pradesh and Madhya Pradesh. While healthcare is primarily a state subject, the central government provides support through the National Health Mission (NHM) and other initiatives. States can propose initiatives to strengthen their healthcare systems via Program Implementation Plans (PIPs). The central government reviews and approves these proposals based on available resources.
Key Points / Main Content:
• State Responsibility:
o Public health and hospitals are primarily the responsibility of state governments.
o States are responsible for planning, implementing, and maintaining healthcare facilities.
• Central Government Support:
o The central government provides financial and technical support to states/UTs under the National Health Mission (NHM).
o Support is based on proposals received from states/UTs in their Program Implementation Plans (PIPs).
o Proposals are approved in the form of Record of Proceedings (RoPs) based on norms and available resources.
• Bundelkhand Region:
o The Bundelkhand region spans Uttar Pradesh and Madhya Pradesh, encompassing 13 districts.
o Initiatives have been undertaken to strengthen primary and secondary care facilities, improve infrastructure, enhance human resources, and improve health outcomes in the region.
• Program Implementation Plans (PIPs):
o States/UTs have the flexibility to propose initiatives in their PIPs based on their needs and gaps in public health facilities.
o Initiatives may include support for infrastructure, human resources, diagnostics, equipment, and medicines.
o The Ministry of Health and Family Welfare (MoHFW) reviews and approves these proposals within the state's allocated resource envelope.
o Prioritization and operationalization of central programs are determined by individual state governments.
• Additional Support:
o The Government of India is making efforts to strengthen healthcare facilities across the country.
o The Government of India offers assistance to States by delivering health services that specifically address the needs of tribal populations and focus on improving healthcare in aspirational districts.
o State Government may propose the new initiatives as per norms and their need which may be sanctioned under NHM PIP, PMABHIM, 15th Finance Commission.
Impact Analysis:
• State Governments (Uttar Pradesh and Madhya Pradesh):
o Impact: Responsible for planning and implementing healthcare services in the Bundelkhand region and can receive support from the central government for strengthening healthcare infrastructure and services.
o Action Required: Assess the healthcare needs and gaps in their respective districts within the Bundelkhand region, develop and submit Program Implementation Plans (PIPs) to the central government, and prioritize the operationalization of approved programs.
• Ministry of Health and Family Welfare (MoHFW):
o Impact: Responsible for providing financial and technical support to states/UTs, reviewing and approving Program Implementation Plans (PIPs), and monitoring the implementation of healthcare programs.
o Action Required: Review and approve PIPs submitted by state governments, allocate resources based on norms and availability, and monitor the progress of healthcare initiatives in the Bundelkhand region.
• Citizens of Bundelkhand Region:
o Impact: Intended beneficiaries of improved healthcare services and infrastructure.
o Action Required: No direct action required; however, citizens can engage with their state governments to voice their healthcare needs and concerns.
Key Entities Referenced
Bundelkhand region: A region spanning across two States, Uttar Pradesh and Madhya Pradesh, encompassing 13 districts, where health services are reportedly in a pathetic condition.
Ministry of Health and Family Welfare: The Indian government ministry responsible for health and family welfare policies and programs.
National Health Mission (NHM): A centrally sponsored scheme for providing financial and technical support to States/UTs to strengthen the public healthcare system.
Uttar Pradesh: One of the states that Bundelkhand region spans across.
Madhya Pradesh: One of the states that Bundelkhand region spans across.
Community Health Centres: A rural health centre to which a group of primary health centres are attached.
Primary Health Centres: A primary healthcare facility in rural areas.
PM-ABHIM: A government scheme. (The policy text does not provide full name)
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENT OFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 1125
TOBE ANSWERED ON25THJULY,2025
HEALTH SERVICES IN BUNDELKHAND REGION
1125. SHRINARAYANDAS AHIRWAR:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) whether the Government is aware that healthservices of Bundelkhand regionare ina very pathetic
condition,if so, the details thereof;
(b) the steps taken by the Government so far in order to strengthen the hospitals, Community Health
CentresandPrimaryHealth Centresinthisarea;
(c) whether the Government proposes to bring any special health development package or scheme for
the Bundelkhand region in the near future to make available basic health services to the people of the
region; and
(d) if so, the detailsthereof?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILYWELFARE
(SHRIPRATAPRAO JADHAV)
(a) to (d): Public Health and hospital being a state subject, the primary responsibility for planning,
implementing,maintainingandtoset up adequatenumberof healthcarefacilitiesasperrequirement
of that State Government. Under the National Health Mission, financial and technical support is
provided toStates/UTs to strengthen the public healthcaresystem based on proposals received from
States/UTs in their Programme Implementation Plans (PIPs) within their resource envelop.
Government of India provides approval for the proposal in the form of Record of Proceedings
(RoPs) aspernormsandavailable resources.
Bundelkhand region, spans across two States viz. Uttar Pradesh and Madhya Pradesh and
encompasses 13 districts. Recognizing the critical importance of equitable access to quality
healthcare, several initiatives have been undertaken to strengthen primary and secondary care
facilities, improve healthcare infrastructure, human resource availability, and enhance health
outcomesinthe region.
Under National Health Mission (NHM), States/UTs are provided the flexibility to propose
initiatives in their Program Implementation Plans (PIPs) depending on their needs and gaps in
public health facilities and thus strengthen the health system. These initiatives mayinclude support
for infrastructure, human resources, diagnostics, equipment,andmedicines. The Ministry of Health
and Family Welfare (MoHFW) reviews and approves these proposals within the state's allocated
resource envelope. The number of approvals granted to each State is referenced in the Record ofProceedings(RoPs) available at the belowmentionedlink:
https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=1377&lid=744
The prioritization and operationalization of these central programs are determined by
individualstate governments based on localneeds, resource availability, andstrategic vision.
The Government of India is making concerted efforts to strengthen healthcare facilities
across the country, As health is a State subject, the planning and implementation of healthcare
schemes primarily fall under the jurisdiction of State Government. State Government may propose
the new initiatives as per norms and their need. The Govt. of India after examination may sanction
under NHM (PIP), PM-ABHIM, 15th Finance Commission as per norms as proposed by the
States/UTs.Also, the Government of India offers assistance to States by delivering health services
that specifically address the needs of tribal populations and focus on improving healthcare in
aspirational districts. The goal istoreduce disparities andimprove healthoutcomes.
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