GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

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1 GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE LOK SABHA UNSTARRED QUESTION NO TO BE ANSWERED ON 29 TH JULY, 2016 PHCS AND CHCS SHRI PRAHLAD SINGH PATEL: DR. SWAMI SAKSHIJI MAHARAJ: SHRI DUSHYANT CHAUTALA: SHRI J.J.T. NATTERJEE: SHRIMATI NEELAM SONKER: SHRI RAJESHBHAI CHUDASAMA: SHRI ASHWANI KUMAR CHOUBEY: Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state: (a) the details of funds allocated/utilised under National Health Mission (NHM), State/UT-wise including UP; (b) whether the Government has established various rural health centres, sub centres including Public Health Centres (PHCs) and Community Health Centre (CHCs) under NHM, if so, the details thereof and the number of such centres established under NHM during the last three years and current year, State/UT-wise; (c) whether the Government is aware of shortages of medical personnel and equipments in these health centres and sub centres, if so, the details thereof along with the number of vacant posts of medical personnel in the above centres during the said period, State/UT-wise including Haryana; (d) the steps taken by the Government to fill up the posts and improve the doctor patient ratio; and (e) whether Government is preparing any annual integrated action plan under NHM and has also reviewed its implementation across the country, if so, the details thereof and the outcome thereon? ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE) (a): A statement showing funds allocated, released and utilised in , State/UT-wise under National Health Mission is enclosed as Annexure-I. (b): A statement indicating number of Sub-Centres, Public Health Centres (PHCs) and Community Health Centres (CHCs) supported under NHM during the last three years, State/UTwise is enclosed as Annexure-II.

2 (c) & (d): There is some shortage of medical personnel and equipments in these health centres. Details of the number of vacant post of medical personnel in the above centres during the last three years States/UT wise including Haryana is annexed as Annexure-III. Under the NHM, technical and financial support is provided to States/UTs to strengthen their healthcare systems, including support for engagement of medical personnel on contractual basis and equipment based on the requirements posed by the States/UTs in the Programme Implementation Plans (PIPs), within the resource envelope availabl e for particular State/UT. To facilitate engagement of doctors and specialists, attractive remuneration including hard reaching area allowance and performance based incentives are approved so that doctors and specialists find it attractive to join public health facilities. In order to encourage doctors to work in remote and difficult areas, the Medical Council of India, with the previous approval of Central Government, has amended the Post Graduate Medical Education Regulations, 2000 to provide: I. 50% reservation in Post Graduate Diploma Courses for Medical Officers in the Government service, who have served for at least three years in remote and difficult areas; and II. Incentive at the rate of 10% the marks obtained for each year in service in remote or difficult areas as upto the maximum of 30% of the marks obtained in the entrance test for admissions in Post Graduate Medical Courses. The Government has taken the following steps to further augment the supply of doctors in the country: I. The ratio of teachers to students has been revised from 1:1 to 1:2 for all MD/MS disciplines and 1:1 to 1:3 in subjects of Anaesthesiology, Forensic Medicine, Radiotherapy, Medical Oncology, Surgical Oncology and Psychiatry. II. DNB qualification has been recognized for appointment as faculty to take care of shortage of faculty. III. Enhancement of maximum intake capacity at MBBS level from 150 to 250. IV. Enhancement of age limit for appointment/extension/re-employment against posts of teachers/dean/principal/ director in medical colleges from years. V. Relaxation in the norms for setting up of a medical college in terms of requirement for land, faculty, staff, bed/ bed strength and other infrastructure. VI. VII. VIII. Strengthening/upgradation of State Government Medical Colleges for starting new PG courses/increase of PG seats. Establishment of New Medical Colleges by upgrading district/referral hospitals preferably in underserved districts of the country. Strengthening/ upgradation of existing State Government/Central Government Medical Colleges to increase MBBS seats. (e): Public Health is a State subject. Thus, it is the State Governments that prepare the annual Programme Implementation Plan (PIPs) under NHM. Besides, evaluation s done through National Family Health Survey (NFHS), District Level Household and Facility Survey (DLHS), Sample Registration System (SRS) etc., annual Common Review Mission (CRM) is organized to assess the progress and implementation of NHM. The CRM includes Government Officials of health and related departments, officials of NITI Aayog, public health experts, representatives of the Development Partners and Civil Society Organisations.

3 Statement Showing State wise Allocation, Release and Utilisation under NHM for the F.Y Annexure-I Rs. in crore Sl. No. States Allocation Release Utilisation 1 Andaman & Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chattisgarh Dadra & Nagar Haveli Daman & Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Telangana Sub Total Note: 1. Allocation is as per original B.E/Outlay 2. The above Releases relate to Central Govt. Grants & do not include state share contribution. 3. Utilisation includes utilisation against central Release, state release & unspent balances at the beginning of the year. Utilisation is as per FMR reported by State/UTs.

4 ANNEXURE-II NUMBER OF SUB-CENTRES, PHCs & CHCs FUNCTIONING (As on 31st March 2013) S. No. State/UT Sub centre PHCs CHCs 1 Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Punjab Rajasthan Sikkim Tamil Nadu Tripura Uttarakhand Uttar Pradesh West Bengal Andaman & Nicobar Islands Chandigarh Dadra & Nagar Haveli Daman & Diu Delhi Lakshadweep Puducherry All India Note State informed that PHCs include 79 other hospitals which are equivalent to PHCs

5 Note: 1 NUMBER OF SUB-CENTRES, PHCs & CHCs FUNCTIONING (As on 31st March 2014) S. No. State/UT Sub centre PHCs CHCs 1 Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Punjab Rajasthan Sikkim Tamil Nadu Tripura Uttarakhand Uttar Pradesh West Bengal Andaman & Nicobar Islands Chandigarh Dadra & Nagar Haveli Daman & Diu Delhi Lakshadweep Puducherry All India State informed that PHCs include 79 other hospitals which are equivalent to PHCs

6 NUMBER OF SUB-CENTRES, PHCs & CHCs FUNCTIONING (As on 31st March 2015) S. No. State/UT Sub centre PHCs CHCs 1 Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur* Meghalaya Mizoram Nagaland Odisha Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttarakhand Uttar Pradesh West Bengal Andaman & Nicobar Islands Chandigarh Dadra & Nagar Haveli Daman & Diu Delhi Lakshadweep Puducherry All India Note: * Data for repeated 1 State informed that PHCs include 79 other hospitals which are equivalent to PHCs

7 Doctors at Primary Health Centres ANNEXURE-III (As on 31 st March 2013) S. No State/UT Required Sanctioned In Position Vacant Shortfall Note- (R ) (S ) (P) (S-P) (R-P) 1 Andhra pradesh * 2 Aunachal Pradesh 97 NA 92 NA 5 3 Assam 978 NA 1495 NA * 4 Bihar * * 5 Chhattisgarh Goa * * 7 Gujrat Haryana Himachal Pradesh * 10 Jammu & Kashmir * * 11 Jharkhand * * 12 Karnatka Kerala * * 14 Madhya Pradesh Maharastra * 16 Manipur * 17 Meghalaya * 18 Mizoram Nagaland * * 20 Odisha Punjab * 22 Rajasthan * 23 Sikkim 24 NA 28 NA * 24 Tamilnadu * 25 Tripura 83 NA 89 NA * 26 Uttarakhand Uttar Pradesh West Bengal * 29 A & N Island * 30 Chandigarh D & N Haveli Daman & diu * * 33 Delhi * 34 Lakshaweep * 35 Puducherry * All India ### Sanctioned data for 2011 used Data for 2012 repeated Data for 2011 repeated # # Sanction data for 2011 used 1 One per Primary Health Centre 2 For Calculating the overall percentage of vacancy,the States/Uts for which manpower position is not available, may be excluded 3 Allopathic Doctors * Surplus. All India figures for Vacancy & Shortfall are the totals of State-wise vacancy & Shortfall ignoring surpluss in some States/Uts. NA - Not Available The PHC data included Area Hospitals & Other Hospitals

8 Total Specialists At Community Health Centres (As on 31 st March 2013) Toal Specilists(Surgeons,OB&Gy, Physicians & Paediatricians) S. No State/UT Required Sanctioned In Position Vacant Shortfall Note- (R ) (S ) (P) (S-P) (R-P) 1 Andhra pradesh Aunachal Pradesh 216 NA 1 NA Assam 440 NA 119 NA Bihar 280 NA 98 NA Chhattisgarh Goa Gujrat 1272 NA 74 NA Haryana Himachal Pradesh 312 NA 8 NA Jammu & Kashmir Jharkhand Karnatka Kerala * Madhya Pradesh Maharastra Manipur Meghalaya Mizoram Nagaland * Odisha Punjab Rajasthan Sikkim 8 NA 0 NA 8 24 Tamilnadu Tripura 72 NA 0 NA Uttarakhand Uttar Pradesh West Bengal A & N Island Chandigarh * * 31 D & N Haveli Daman & diu Delhi Lakshaweep Puducherry * 13 All India # Data for 2012 repeated NA: Not AVAILAble Four Specialist per Community Health Centre 1 2 For Calculating the overall percentage of vacancy,the States/Uts for which manpower position is not available, may be excluded 3 For 2013, Specialists attending CHCs on hiring basis * Surplus. All India figures for Vacancy & Shortfall are the totals of State-wise vacancy & Shortfall ignoring surpluss in some States/Uts. Specilists are attending CHCs on hiring basis

9 Doctors at Primary Health Centres 2014 Doctors at PHC's S. No State/UT Required Sanctioned In Position Vacant Shortfall Note- (R ) (S ) (P) (S-P) (R-P) 1 Andhra pradesh * 2 Aunachal Pradesh 117 NA 92 NA 25 3 Assam 1014 NA 1355 NA * 4 Bihar * * 5 Chhattisgarh Goa * * 7 Gujrat Haryana Himachal Pradesh * 10 Jammu & Kashmir * * 11 Jharkhand * * 12 Karnatka Kerala * * 14 Madhya Pradesh Maharastra * 16 Manipur * 17 Meghalaya * 18 Mizoram Nagaland * 0 20 Odisha Punjab * 22 Rajasthan * 23 Sikkim 24 NA 38 NA * 24 Tamilnadu * 25 Tripura 84 NA 160 NA * 26 Uttarakhand Uttar Pradesh West Bengal A & N Island * 30 Chandigarh D & N Haveli * 0 32 Daman & diu * * 33 Delhi * 34 Lakshaweep * 35 Puducherry * All India ### Sanctioned data for 2011 used Data for 2013 repeated # # Sanction data for 2011 used One per Primary Health Centre 1 2 For Calculating the overall percentage of vacancy,the States/Uts for which manpower position is not available, may be excluded 3 Allopathic Doctors * Surplus. All India figures for Vacancy & Shortfall are the totals of State-wise vacancy & Shortfall ignoring surpluss in some States/Uts.

10 Total Specialists At Community Health Centres As on 31 st March 2014 Toal Specilists(Surgeons,OB&Gy, Physicians & Paediatricians) S. No State/UT Required Sanctioned In Position Vacant Shortfall (R ) (S ) (P) (S-P) (R-P) Note- 1 Andhra pradesh Aunachal Pradesh 208 NA 1 NA Assam 604 NA 121 NA Bihar 280 NA 69 NA Chhattisgarh Goa Gujrat 1200 NA 74 NA Haryana Himachal Pradesh * Jammu & Kashmir Jharkhand * Karnatka Kerala * Madhya Pradesh Maharastra Manipur Meghalaya Mizoram Nagaland * Odisha Punjab Rajasthan Sikkim 8 NA 0 NA 8 24 Tamilnadu Tripura 72 NA 0 NA Uttarakhand Uttar Pradesh West Bengal A & N Island Chandigarh * * 31 D & N Haveli Daman & diu Delhi Lakshaweep Puducherry * 9 All India # Data for 2013 repeated NA: Not Applicable Four Specialist per Community Health Centre 1 2 For Calculating the overall percentage of vacancy,the States/Uts for which manpower position is not available, may be excluded 3 For 2013, Specialists attending CHCs on hiring basis * Surplus. All India figures for Vacancy & Shortfall are the totals of State-wise vacancy & Shortfall ignoring surpluss in some States/Uts.

11 Doctors at Primary Health Centres Doctors at PHC's S. No State/UT Required Sanctioned In Position Vacant Shortfall (R ) (S ) (P) (S-P) (R-P) 1 Andhra pradesh * 2 Aunachal Pradesh 117 NA 102 NA 15 3 Assam 1014 NA 1355 NA * 4 Bihar * * 5 Chhattisgarh Goa * * 7 Gujrat Haryana * 9 Himachal Pradesh * 10 Jammu & Kashmir * 11 Jharkhand * * 12 Karnatka Kerala * * 14 Madhya Pradesh Maharastra * 16 Manipur * 17 Meghalaya * 18 Mizoram Nagaland * * 20 Odisha Punjab * 22 Rajasthan * 23 Sikkim 24 NA 29 NA * 24 Tamilnadu * 25 Telangana * 26 Tripura * 27 Uttarakhand Uttar Pradesh West Bengal A & N Island * 31 Chandigarh D & N Haveli * * 33 Daman & diu * * 34 Delhi * 35 Lakshaweep * 36 Puducherry * 2015 All India Note- # Data for 2013 repeated NA: Not Applicable ### Inposition data for & Sanctioned data for 2011 used Data for repeated ** Inposition data for used # # Sanction data for 2011 used 1 One per Primary Health Centre 2 Total Given in the table are not strictly comparable as figures for some of the States were not available in For calcilationg the overall percentage of vacancy & shortfall, the States/Uts for which manpower position is not available, may be excluded 3 Allopathic Doctors * Surplus. All India figures for Vacancy & Shortfall are the totals of State-wise vacancy & Shortfall ignoring surpluss in some States/Uts.

12 Total Specialists At Community Health Centres Surgeons,OB&Gy, Physicians & Paediatricians S. No State/UT Required Sanctioned In Position Vacant Shortfall (R ) (S ) (P) (S-P) (R-P) 1 Andhra pradesh Aunachal Pradesh 208 NA 1 NA Assam 604 NA 121 NA Bihar 280 NA 63 NA Chhattisgarh Goa Gujrat 1280 NA 74 NA Haryana Himachal Pradesh * Jammu & Kashmir Jharkhand Karnatka Kerala * Madhya Pradesh Maharastra Manipur Meghalaya Mizoram Nagaland * Odisha Punjab Rajasthan Sikkim 8 NA 0 NA 8 24 Tamilnadu Telangana Tripura Uttarakhand Uttar Pradesh West Bengal A & N Island Chandigarh * * 32 D & N Haveli * 2 33 Daman & diu Delhi Lakshaweep Puducherry * 9 All India Note- # Data for 2013 repeated NA: Not Applicable ### Inposition data for & Sanctioned data for 2011 used Data for repeated ** Inposition data for used # # Sanction data for 2011 used Four Specialist per Community Health Centre 2 Total Given in the table are not strictly comparable as figures for some of the States were not available in For calcilationg the overall percentage of vacancy & shortfall, the States/Uts for which manpower position is not available, may be excluded 3 For 2013, Specialists attending CHCs on hiring basis * Surplus. All India figures for Vacancy & Shortfall are the totals of State-wise vacancy & Shortfall ignoring surpluss in some States/Uts. OB&GY- Obstetrician & Gynaecologist

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