Parliament Question: Public Health Infrastructure in Rural and Remote Areas

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 2271 TO BE ANSWERED ON01.08.2025 PUBLIC HEALTH INFRASTRUCTURE IN RURALANDREMOTE AREAS 2271. SMT.GENIBEN NAGAJI THAKOR: Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate: (a) whether the Government has taken steps to strengthen public health infrastructure, especially inrural andremote areas; (b) if so, the details of funds allocated and utilized under the National Health Mission (NHM) during the last three years; (c) whether there is a shortage of doctors, nurses and medical staff in Government hospitals and primaryhealthcentres, if so, the detailsthereof; and (d) the measures being taken by the Government to improve access to affordable healthcare and essential medicinesfor poor and vulnerable populationsinthe country? ANSWER THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILYWELFARE (SHRIPRATAPRAO JADHAV) (a): The Ministry of Health and Family Welfare provides technical and financial support to the States/UTs to strengthen the public healthcare system, based on the proposals received in the form of Programme Implementation Plans (PIPs) under National Health Mission (NHM). Government of India provides approval for the proposal in the form of Record of Proceedings (RoPs) aspernorms& available resources. In February 2018, the Government of India announced establishment of 1,50,000 Ayushman Arogya Mandirs (AAMs) erstwhile Ayushman Bharat HealthandWellness Centres(AB-HWCs), across the country by December 2022. As updated by the States/UTs in AAM portal, a total of 1,77,906AyushmanArogyaMandirs havebeenestablished andoperationalizedason30.06.2025, by transforming existing Sub-Health Centres (SHC) and Primary Health Centres (PHC) in rural and urban areas to deliver the expanded range of comprehensive primary healthcare services with complete 12 package of services that includes preventive, promotive, curative, palliative andrehabilitative services which are universal, free,andcloser tothe community. The details of funds approved for development of building infrastructure under NHM in the countryfor the FYfrom 2023-24 to2025-26 isasunder: (In Crores) FinancialYear Fundsapproved 2023-24 4688.49 2024-25 4222.232025-26 4249.15 In addition to the National Health Mission (NHM), Government of India has allocated the following funds for developingpublic healthcare infrastructure andservices: • Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) is a Centrally Sponsored Scheme (CSS) with some Central Sector Components (CS) which has an outlayof Rs. 64,180 Crores for the scheme period (2021-22 to2025-26). The measures underthe PM-ABHIM focus on developing capacities of health systems and institutions across the continuum of care at all levels, primary, secondary and tertiary, to prepare health systems in responding effectively tothe current andfuture pandemics/disasters. Administrative approvals have been accorded to States/UTs for FY 2021-22, FY 2022-23, FY 2023-24, FY 2024-25 & FY 2025-26 for an amount of Rs 33081.82 Crore for construction/strengthening of 10609 Building less-AAMs, 5456 Urban-AAMs, 2151 Block Public Health Units (BPHUs), 744 Integrated Public Health Labs (IPHLs) at District level and 621Critical Care Blocks(CCBs). • The Fifteenth Finance Commission (FC-XV) has recommended grants through local governments for specific components of the health sector and spread over the five-year period from FY 2021-22 to FY 2025-26 to facilitate strengthening of health system at the grass-root levelfor anamountof Rs. 70,000crores. These grantsare for strengthening primarycare through specified components such as Building-less Sub-Health Centres (SHCs), Primary Health Centres (PHCs), Community Health Centres (CHCs), Conversion of rural PHCs and Sub-Centres to Ayushman Arogya Mandir (AAM), Support for diagnostic infrastructure to the primary healthcarefacilities, BlockLevelPublicHealthUnits, Urban - AAM. • Under Centrally Sponsored Scheme (CSS), ‘Establishment of new medical colleges attached with existing district/referral hospitals’, under which 157 new medical colleges have beenapproved. (b): The details of Central Release under National Health Mission from FY2022-23 to FY2024- 25isasunder: (Rs. incrores) Sl.No. FinancialYear CentralRelease 1. 2022-23 31,278.84 2. 2023-24 33,042.62 3. 2024-25 36,529.14 (c): The details of doctors, nurses and medical staff in Government Hospitals and Primary Health Centre the country are available at website of Ministry of Health and Family Welfare at the Uniform Resources Locator(URL) asunder: https://mohfw.gov.in/sites/default/files/Health%20Dynamics%20of%20India%20%28Infrastruct ure%20%26%20Human%20Resources%29%202022-23_RE%20%281%29.pdf (d): Further, to improve access to quality healthcare services in remote and rural areas support for Mobile Medical Unit(MMU) is provided to States/UTs, based on the requirements posed by them in their Programme Implementation Plans (PIPs), subject to availability of resources. Deployment of MMUs is based on a normal population norm with 1 MMU per 10 lakhs population. Also, Ministry of Health and Family Welfare has developed eSanjeevani, a telemedicine application, which provides doctor to doctor (HWC module) and patient to doctorconsultation services (OPD module). This application works on a hub and spoke model. At hub level,a specialist doctorprovidesservices toHealthandWellnessCenters(HWCs) inrural areas. Under FreeDrugs Service Initiative (FDSI), Government of India supports procurement of drugs and strengthening robust systems of procurement, Quality Assurance, Supply chain management and warehousing, Prescription audit, grievance redressal, dissemination of Standard Treatment Guidelines and Establishment of IT enabled platform DVDMS (Drugs & Vaccine Distribution Management System) for monitoring the real status of procurement and availability of essential medicines. Ministry of Health and Welfare (MoHFW) has recommended facility wise Essential Medicines List (EML) to be made available at the public healthcare facilities which includes provision of a variety of free services related to maternal health, child health, adolescent health, family planning, universal immunisation programme, and for major diseases such as Tuberculosis, HIV/ AIDS, vector borne diseases like Malaria, Dengue and Kala Azar, Leprosy etc. The facility wise number of medicines in the EML includes 106 drugs at Sub Health Centre level, 172 at Primary Health Centre level, 300 at Community Health Centre level, 318 at Sub- district Hospital level and 381 drugs at district Hospital level. However, States have the flexibilitytoaddmore medicines. ***