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GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 5733
TO BE ANSWERED ON27THMARCH, 2026
SHORTCOMINGS IN PUBLIC HEALTH INFRASTRUCTURE
†5733.SMT.DELKAR KALABEN MOHANBHAI:
will the MINISTER OFHEALTH AND FAMILYWELFARE be pleasedtostate:
(a) whether the Union Government has taken note of the shortcomings in public health
infrastructure particularlyin the rural and tribal districts of the Union Territory (UT) of Dadra
andNagar Haveli;
(b) if so, the steps being taken by the Government to address the shortage of doctors,
specialists and medical equipments in the Government hospitals and Primary Health Centres
(PHCs) inthe said UT;
(c) the details of the Central financial assistance provided to the said UT under scheme like
the Pradhan Mantri Ayushman Bharat Health infrastructure Mission (PM-ABHIM) and the
National HealthMission (NHM) during the last three years; and
(d) whether the Government proposes to open new medical colleges or upgrade the district
hospitals inunderserved areasof the said UT,if so, the detailsthereof?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY
WELFARE
(SHRIPRATAPRAO JADHAV)
(a) to (d) Under the National Health Mission (NHM), need-based financial and technical
support is provided to States/UTs including the UT of Dadra and Nagar Haveli to strengthen
the public health care system, based on the proposals received in the form of Program
Implementation Plans (PIPs). The Government of India provides approval for the proposal in
the form of Recordof Proceedings (RoPs) aspernormsandavailableresources.
To address shortages of medical personnel and equipment in Government Hospitals
and PHCs, the NHM under the UT conducts regular recruitment, bolstered by the 2019
establishment of the NAMO Medical Education and Research Institute to manage specialist
availability. Furthermore, the Ayushman Bharat Health Infrastructure Mission and NHM
support the strengthening of infrastructure and the procurement of essential diagnostic
equipment. The step undertaken to strengthen health infrastructure, medical services and
healthcare falls under the ambit of 4 pillar of Ayushman Bharat Yojana introduced under
NHM include-
AyushmanArogyaMandir(AAM) PradhanMantri-AyushmanBharatHealthInfrastructureMission(PM-ABHIM)
PradhanMantri-JanArogyaYojana(PM-JAY)
AyushmanBharatDigitalMission(ABDM)
Detailsmaybe found inAnnexure-1 andAnnexure-2.
The details of central financial assistance providedto the UTunder the NHM and PM
-ABHIM during the last three yearsisasunder:
Year NHM FundsReleased PM-ABHIM funds
(inCrore) released(inCrore)
2022-23 58.28 0.24
2023-24 39.92 0.28
2024-25 40.96 0.53
The details of healthcare infrastructure projects initiated or on-going during the last
three years, in the UT of Diu, Daman, Dadra & Nagar Haveli UT can be accessed year-wise
in the Ministry’s Website, viz.
https://nhm.gov.in/index4.php?lang=1&level=0&linkid=73&lid=86.
However, no proposals were submitted by UT of Dadra & Nagar Haveli for
construction of anynewhospitals/health facilitiesandupgradationof the existing hospitals.
******Annexure-1
Health Systems Strengthening
1. Ayushman Bharat – Ayushman Arogya Mandir (AB-AAM): Under AB-
AAM, existing Sub Health Centers (SHCs) and Primary Health Centers (PHCs)
are being upgraded to Ayushman Arogya Mandir (AAM) to deliver universal,
free comprehensive primary healthcare services, with a focus on wellness and
the delivery of an expanded range of services closer to the community. The
services span from promotive, preventive, curative, rehabilitative and palliative
care targeting holistic healthcare service delivery.
All AAM-PHC and AAM-Sub Centres are provided with sufficient space for
outpatient care, dispensing medicines, diagnostic services, adequate spaces to
display communication material of health messages, including audio-visual aids
and appropriate community spaces for wellness activities, including the practice
of Yoga and physical exercises.
Ayushman ArogyaShivirs are ‘one-stop’ platforms to address a comprehensive
range of health issues have proven to be an effective strategy to reach the
masses and augment the utilization of healthcare services. They are organised at
Sub Health Centre, Primary Health Centre and Community Health Centre.
AAM provide e-Sanjeevani teleconsultation services, connecting service
providers, including CHOs/ MOs, to specialists in secondary and tertiary centres.
This minimizes the need for physical travel, reducing costs and hardships for
patients along with enabling continuum of care.
The AAM team works closely with communities enabling empowerment of
individuals, families and communities with knowledge and skills to take
responsibility for their own health. The AAM also focus on improving health
literacy through interpersonal communication and media (including social
media) usage, for promotion of healthy lifestyles – balanced healthy diet, yoga,
exercise, tobacco cessation, and self-care for those with chronic disease
conditions.
The Accredited Social Health Activists (ASHA) program is a key component
of the community processes of National Health Mission (NHM). ASHAs are
women from the local community who serve the community’s healthcare needs.
Having a strong footing in the community, they ensure the provision of a range
of services, door-to-door surveys, vaccination, providing information on
hygiene practices, nutrition and sanitation, reproductive and childcare services,
and communicable and non-communicable disease prevention and control.
2. Free Diagnostics Service Initiative (FDSI): Ministry of Health and Family
Welfare had launched the National Free Diagnostic Service Initiative (FDSI) in
2015 to achieve Universal Health Coverage (UHC) and reduce out of pocket
expenditure on healthcare by ensuring availability of essential diagnostics at thepublic health facilities, free of cost. As per the FDSI guidelines an expanded
range of diagnostics at all levels of public health facilities (14 tests at SHCs, 63
tests at PHCs, 97 tests at Community Health Centres (CHCs), 111 tests at Sub-
District Hospitals (SDHs) and 134 tests at District Hospitals (DHs) are
recommended.
3. Free Drugs Service Initiative (FDSI): Under Free Drugs Service Initiative,
Ministry of Health and Family Welfare 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).
MoHFW has recommended facility wise Essential Medicines List (EML) to be
made available at the public healthcare facilities - 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.
4. Community Participation: To bring the governance, convergence and action
for health from the local governments, community platforms like Village
Health Sanitation and Nutrition Committee (VHSNC) in rural areas and
Mahila Arogya Samiti (MAS) in urban areas have been introduced to address
the barriers and social determinants of health. Jan Arogya Samiti (JAS) are
being established at AAM (the SHC-AAM and PHC-AAMs level), as the
institutional platform for community participation in management of the facility,
and for supporting AAM team in its community level interventions.
5. Mobile Medical Units (MMUs): Mobile Medical Units (MMUs) to improve
access to public healthcare, especially for populations in remote, hard-to-reach,
and underserved areas. The primary goal of this initiative is to deliver healthcare
services directly to the doorsteps of rural, vulnerable, and marginalized
communities.
6. National Ambulance Services (NAS): NHM provides technical and financial
assistance to States & UTs to strengthen for emergency transportation of
patients for acute and critical illnesses including trauma through NAS.
7. Indian Public Health Standards (IPHS) 2022: The government has
established the IPHS 2022 standards to monitor and improve health
infrastructure and services in public health facilities. These standards include
population norms for the establishment of public healthcare facilities, such as
Sub-Centers (SC), Primary Health Centers (PHC), Community Health Centers
(CHC), and District Hospitals (DH). The standards cover services, infrastructure,human resources, diagnostics, equipment, and medicines, serving as the
reference for public health care infrastructure planning and upgrading in the
States and Union Territories. States have the flexibility to propose funding under
the National Health Mission (NHM) for upgrading infrastructure, human
resources, and services according to IPHS, following a gap analysis.
8. National Quality Assurance Standards (NQAS): The National Quality
Assurance Standards (NQAS) serves as a comprehensive framework to ensure
and enhance the quality of healthcare in public facilities by focusing on service
provision,patientrights,clinical care,infectioncontrol,and qualitymanagement.
Launched for District Hospitals in 2013 and subsequently extended to other
facility types, NQAS is internationally accredited and recognised by
organisations such as ISQua, IRDA, and NHA.
9. Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-
ABHIM): Launched in 2021, PM-ABHIM is a Centrally Sponsored Scheme
with certain Central Sector components, aimed at strengthening primary,
secondary, and tertiary healthcare facilities. The mission focuses on enhancing
grassroots public health institutions to ensure universal access to comprehensive
primary healthcare services, including diagnostics and critical care. This scheme
emphasizes on expansion of IT-enabled disease surveillance systems to
effectively detect, investigate, prevent, and manage public health emergencies
and disease outbreaks, making the healthcare system more responsive during
crises. Under PM-ABHIM, support is provided for the development of
infrastructure, including building-less sub-centres in rural and urban areas,
Block-level Public Health Units, Integrated Public Health Laboratories, and
Critical Care Hospital Blocks.
10. Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (AB PM-JAY) is
a flagship scheme of the Government which provides health cover of Rs. 5 lakh
per family per year for secondary and tertiary care hospitalization to 12 crore
families, constituting the economically vulnerable bottom 40% of India’s
population. On 29.10.2024, the scheme was further extended to cover 6 crore
senior citizens aged 70 years and above, representing 4.5 crore families, through
the Vay Vandana Card, irrespective of their socio-economic status.
11. Ayushman Bharat Digital Mission (ABDM) aims to create an online
platform enabling interoperability of health data within the health ecosystem.
The core components of the Mission include Ayushman Bharat Health Account
(ABHA) for citizens, Health Professional Registry (HPR), Health Facility
Registry (HFR), and ABHA Application. The digital health ecosystem created
by ABDM supports continuity of care across primary, secondary, and tertiary
healthcare in a seamless manner.12. XV-Finance Commission Health Grants channelized through local
government - The XV Finance Commission recommended grants through local
governments, allocating ₹70,051 crores over five years from FY 2021-22 to FY
2025-26 to strengthen primary healthcare. This funding supports various rural
healthcare components, including the development of building-less sub-centres,
primary health centres (PHCs), and community health centres (CHCs). It also
facilitates the conversion of rural PHCs and sub-health centres (SHCs) into
Ayushman Arogya Mandir, enhances diagnostic infrastructure in primary
healthcare facilities, and establishes Block-Level Public Health Units, with a
special focus on tribal areas and aspirational districts.
13. To enhance availability of specialists, NHM offers flexible provisions, which
include the following:
The GoI support States in recruiting and retaining specialists in public health
facilities through the innovative “You Quote, We Pay” scheme under NHM,
which allows specialists to negotiate lucrative and flexible salaries. There are
also provisions for engaging specialists ona per-case basis if required.
To address shortages in difficult and underserved areas, provision for
differential salaries based on the place of posting are available under NHM.
Many States have categorized all their blocks and facilities based on the
difficulty level for providing services there. The staff posted in these areas are
given an additional amount as a difficult/ hard area allowance till the time they
are posted there.
In-sourcing of speciality services wherever required to ensure service
availability.
State may also make provision of performance-based/ team-based incentives
to staff after achieving over and above defined threshold of performance
GoI also recommends fixed-tenure postings in difficult areas and ensuring
proper working conditions in terms of availability of team, equipment and
supplies, and living quarters/ transit hostels
Honorarium to Gynecologists/ Emergency Obstetric Care (EmoC) trained,
Pediatricians & Anesthetist/ Life Saving Anaesthesia Skills (LSAS) trained
doctors are also provided to increase availability of specialists for conducting
Cesarean Sections in rural and remote areas.
Measures such as multi-skilling including short-term in-service training
programs like EmOC and LSAS for medical officers, and continuous capacity
buildingthrough in-service training are also supported.
These provisions can be utilized by all the states/ UTs including UT of Dadra
and Nagar Haveli and propose budgetary support in their Programme
Implementation Plans (PIPs) based ontheir specific needs and available resource
envelope.
******Annexure-2
Programs and Schemes under NHM
Health Systems Strengthening
1. Health care Infrastructure
a. AyushmanArogyaMandir(AB-AAM)
b. PradhanMantri-AyushmanBharat Health InfrastructureMission(PM
-ABHIM)
c. 15th FCHealthgrantstoLocalbodies
2. Free Diagnostics Service Initiative (FDSI)
3. Free Drugs Service Initiative (FDSI)
4. Mobile Medical Units (MMUs)
5. National Ambulance Services (NAS)
6. Indian Public Health Standards (IPHS) 2022
7. National Quality Assurance Standards (NQAS)
Reproductive, Maternal, Neonatal, Child and Adolescent health
8. Janani Shishu Suraksha Karyakaram (JSSK)
9. Rashtriya Kishor Swasthya Karyakram(RKSK)
10. Rashtriya Bal Swasthya Karyakram (RBSK)
11. Universal Immunisation Programme
12. Mission Indradhanush (MI)
13. Janani Suraksha Yojana (JSY)
14. Pradhan Mantri Surakshit MatritvaAbhiyan (PMSMA)
15. Navjaat Shishu Suraksha Karyakram (NSSK)
16. National Programme for Family planning
17. LaQshya’ programme (Labour Room Quality Improvement Initiative
National Nutritional Programmes
18. National Iodine Deficiency Disorders Control Programme
19. MAA (Mothers’ Absolute Affection) Programme for Infant and Young
Child Feeding
20. National Programme for Prevention and Control of Fluorosis (NPPCF)
21. National Iron Plus Initiative for Anaemia Control
22. Mid-day Meal Scheme
Communicable diseases
23. Integrated Disease Surveillance Programme (IDSP)
24. Revised National Tuberculosis Control Programme (RNTCP)
25. National Leprosy Eradication Programme (NLEP)
26. National Vector Borne Disease Control Programme (NVBDCP)
27. National AIDS Control Programme (NACP)
28. Pulse Polio Programme
29. National Viral Hepatitis Control Program (NVHCP)
30. National Rabies Control Programme
31. National Programme on Containment of Anti-Microbial Resistance(AMR)
Non-communicable diseases
32. National Tobacco Control Programme(NTCP)
33. National Programme for Non-Communicable Diseases (NP-NCD)
34. National Programme for Control Treatment of Occupational Diseases
35. National Programme for Prevention and Control of Deafness (NPPCD)
36. National Mental Health Programme
37. National Programme for Control of Blindness & Visual Impairment
(NPCB&VI)
38. Pradhan Mantri National Dialysis Programme (PMNDP)
39. National Programme for the Health Care for the Elderly (NPHCE)
40. National Programme for Prevention & Management of Burn Injuries
(NPPMBI)
41. National Oral Health programme
42. National Sickle CellAnemia Elimination Mission
*******