**Executive Summary**
This document is a response to Unstarred Question No. 2079 in Lok Sabha, regarding the screening of sickle cell anaemia in tribal areas, particularly in Odisha. It details the government's strategies, steps, and measures to address this issue and improve healthcare access in remote tribal regions. The response, provided by the Minister of State in the Ministry of Health and Family Welfare, Smt. Anupriya Patel, reports screenings as of 30.11.2025 and operationalised centres as of 07.12.2025.
**Key Points / Main Content**
* **Sickle Cell Anaemia Screening:**
* Under the National Sickle Cell Anaemia Elimination Mission (NSCAEM), screenings are conducted in the 0-40 age group at all health facilities in 17 tribal states, including 154 blocks of 13 tribal districts in Odisha.
* Over 6.57 crore screenings have been conducted nationally in tribal areas, including 56.46 lakh in Odisha, as of 30.11.2025.
* **Tribal Health and Wellness Centres:**
* Comprehensive primary healthcare (CPHC) is provided through Ayushman Arogya Mandirs (AAMs), strengthening Sub Health Centres (SHCs) and Primary Health Centers (PHCs) in tribal areas.
* Operational guidelines for AAMs provide for Community Health Officers (CHO), Auxiliary Nurse Midwives (ANM), Multipurpose workers, and ASHAs.
* **Food Security and Nutrition:**
* Operational Guidelines on Facility Based Management of Children with Severe Acute Malnutrition have been issued to States/UTs.
* Key nutrition interventions include Anemia Mukt Bharat, Nutrition Rehabilitation Centres, Mothers' Absolute Affection, Lactation Management Centres, and Vitamin A Supplementation programme.
* Mission Poshan 2.0 Abhiyaan aims to reduce anaemia among Pregnant Women and Lactating Mothers.
* **Village Health and Sanitation:**
* Village Health Sanitation and Nutrition Committees (VHSNCs) function as village-level platforms for health, sanitation, and nutrition.
* 5,20,292 VHSNCs have been constituted across the country, including the Sidhi Parliamentary Constituency of Odisha.
* **Healthcare Access in Remote Areas:**
* NHM norms have been relaxed for tribal/hilly/hard-to-reach areas to strengthen healthcare access.
* Population criteria for setting up SHCs, PHCs, and CHCs have been reduced.
* Increased allowance of ASHAs and Mobile Medical Units (MMUs) per district.
* Under PM-JANMAN, further relaxation in NHM norms has been provided with up to 10 MMUs per district with PVTGs.
* As per MMU portal, 751 MMUs under PM-JANMAN and 155 MMUs under Dharti Aaba Janjatiya Gram Utkarsh Abhiyan (DA-JGUA) are operational across the country as of 09.12.2025.
**Impact Analysis**
**Stakeholder: Tribal Populations in Affected States, particularly Odisha**
**Impact:** Enhanced access to sickle cell anaemia screening, improved primary healthcare services, and targeted nutrition interventions to address malnutrition and micronutrient deficiencies.
**Action Required:** Utilize the available screening and healthcare services, participate in VHSNC activities, and adopt recommended nutrition practices.
**Stakeholder: Healthcare Providers (CHOs, ANMs, Medical Officers, etc.)**
**Impact:** Increased responsibility for implementing NSCAEM, managing AAMs, and conducting outreach activities in tribal areas.
**Action Required:** Adhere to operational guidelines for AAMs, conduct screenings, provide comprehensive primary healthcare, and participate in training programs.
**Stakeholder: Government (Ministry of Health and Family Welfare, State Governments)**
**Impact:** Responsible for implementing and monitoring NSCAEM, establishing and maintaining AAMs, and ensuring adequate resources for healthcare services in tribal areas.
**Action Required:** Ensure proper implementation of NSCAEM, provide adequate funding for AAMs and other healthcare initiatives, monitor progress, and address any challenges in service delivery.
Key Entities Referenced
National Sickle Cell Anaemia Elimination Mission (NSCAEM): A program to conduct screenings for sickle cell anemia in the 0-40 age group, targeting tribal areas in affected states.
National Health Mission (NHM): A national program with relaxed norms for tribal/hilly/hard-to-reach areas to strengthen healthcare access.
Ayushman Arogya Mandirs (AAMs): Health & wellness centers providing comprehensive primary healthcare in tribal areas.
Odisha: A state where sickle cell anemia screening and tribal health initiatives are being implemented.
Pradhan Mantri Janjati Adivasi Nyaya Maha Abhiyan (PM-JANMAN): A program launched by the Ministry of Tribal Affairs to further relax NHM norms in tribal areas.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2079
TOBE ANSWERED ON12TH DECEMBER, 2025
SCREENING OFSICKLE CELLANAEMIAIN TRIBALAREAS
2079.SHRIJASHUBHAI BHILUBHAI RATHVA:
SHRIRAHULSINGH LODHI:
DR. RAJESH MISHRA:
SMT.SMITAUDAYWAGH:
SHRIBALABHADRAMAJHI:
SHRIPRADEEPKUMAR SINGH:
SMT.HIMADRI SINGH:
SHRIMAHESHKASHYAP:
SHRIBIBHU PRASAD TARAI:
Will the Ministerof HEALTHANDFAMILYWELFAREbe pleasedtostate:
(a) the strategy of the Government to ensure universal screening of sickle cell anaemia in all
tribal-majority development blocks and the manner in which the screening results being
integratedwith the ABDM platform, particularlyinOdisha;
(b) the steps taken to establish specialized Tribal Health and Wellness Centres with trained
staff in remote PVTG areas of Odisha for addressing malaria, malnutrition and other major
healthchallengesin the country;
(c) whether any guidelines have been issued for food security with aims to reduce chronic
malnutrition and micronutrient deficiencies among children and pregnant women in Odisha’s
tribal regions, if so, the details thereof;
(d) whether the Goverment is extending formal support to traditional healers while ensuring
access to modern healthcare services in remote tribal areas of Odisha including the Sidhi
Parliamentary Constituency andif so, the detailisthereof; and
(e) the measures proposed to be taken by the Government to improve last-mile service
deliveryinhard-to-reach tribal settlements?
ANSWER
THE MINISTER OFSTATE INTHE MINISTRYOFHEALTH ANDFAMILY
WELFARE
(SMT.ANUPRIYAPATEL)
(a): Under National Sickle Cell Anaemia Elimination Mission (NSCAEM), screenings in the
targeted age group of 0-40 years are conducted at all health facilities from District Hospitals
(DH) upto Ayushman Arogya Mandir (AAM) level in affected 17 tribal states including the
154 blocks of 13 tribal district of Odisha for diagnosis of Sickle Cell Disease. As per Sickle
1Cell Disease (SCD) portal, more than 6.57 cr screenings have been conducted in tribal
dominatedareasof the country including56.46 lakhscreenings inOdisha, ason30.11.2025.
(b) & (c) Through Ayushman Arogya Mandirs (AAMs) (erstwhile Ayushman Bharat-Health
& wellness centres), comprehensive primary healthcare (CPHC) is provided by strengthening
Sub Health Centres (SHCs) and Primary Health Centers (PHCs) across the country including
tribal areas for an expanded range of services encompassing Communicable diseases, Non-
communicable diseases, reproductive and child healthcare services, emergency medical
services andotherhealthissues. For SHC-AAM,operational guidelinesfor AAMs provide for
Community Health Officer (CHO), Auxiliary Nurse Midwife (ANM) and Multipurpose
worker -Male along with ASHAs in the catchment area. For PHC-AAM, the norms provide
for Medical Officer, staff nurses, pharmacist,HealthAssistants andLabtechnician.
As per AAM portal, a total of 7,373 AAMs, including 3,343 AAMs in tribal districts and
1,991AAMs inaspirational districts, have been operationalisedinOdisha, ason07.12.2025.
Under National Vector Borne Disease Control Programme, various interventions are provided
for preventionandcontrol of Malaria inthe tribal areasincludingPVTGareas.
Operational Guidelines on Facility Based Management of Children with Severe Acute
Malnutrition have beenissued toStates/UTs byGovt. of India for food security with anaim to
reduce chronic malnutrition and micronutrient deficiencies. The Government of India is also
implementing several key nutrition interventions i.e. Anemia Mukt Bharat, Nutrition
Rehabilitation Centres, Mothers’ Absolute Affection, Lactation Management Centres and
Vitamin A Supplementation programme under the RMNCAH+N strategy of the National
Health Mission (NHM) to address maternal and child malnutrition, across the country
including tribal areas of the State of Odisha. Further, Government has also set up Mission
Poshan 2.0 Abhiyaan, which has one of the aim to prevent and reduce prevalence of anaemia
amongPregnantWomenandLactatingMothers.
(d) Village Health Sanitation and Nutrition Committees (VHSNCs) function as village-level
platforms for health, sanitation, nutrition awareness, planning and action. These committees
play a key role in conducting Village Health & Nutrition Days (VHNDs), supporting early
detection, and community-based prevention of malnutrition and communicable diseases and
awareness of traditional systems of medicine. As on 31st March 2025, a total of 5,20,292
VHSNCs have been constituted across the country including Sidhi Parliamentary
Constituency of Odisha.
(e) Under NHM, norms have been relaxed for tribal/hilly/hard-to-reach areas to strengthen
healthcare access. Population criteria for setting up of SHCs, PHCs and CHCs have been
reducedto 3,000,20,000and80,000 respectively. One ASHAisallowedperhabitationinstead
of per 1,000 population, and up to 4 Mobile Medical Units (MMUs) per district are permitted
intribal andhard-to-reach areas, comparedto2inplaindistricts.
Under the PradhanMantri Janjati Adivasi Nyaya Maha Abhiyan (PM-JANMAN), launchedon
15th November, 2023byMinistry of Tribal Affairs (MoTA), further relaxation inNHM norms
2has been provided up to 10 MMUs per district with Particularly Vulnerable Tribal Groups
(PVTG) areas. Norms have been relaxed for one additional ANM for each Multi Purpose
Centre (MPC) constructed by MoTA.
As per MMU portal, 751 MMUs under PM-JANMAN and 155 MMUs under Dharti Aaba
Janjatiya Gram Utkarsh Abhiyan (DA-JGUA) are operational across the country for providing
basic healthservices intribal areastill 09.12.2025.
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