(a) whether the Government have conducted/propose to conduct any survey
regarding the health care needs of the people especially the poor people and the
people living in rural areas of the country;
(b) if so, the details thereof;
(c) whether doctors required for this purpose and the annual requirement
inquantitative terms of the medicines for free cost supply; and
(d) if so, the steps proposed to be taken by the Government to meet the
shortage of doctors and medicines in rural areas?
MINISTER OF HEALTH AND FAMILY WELFARE (DR. C.P. THAKUR)
(a) to (d): A statement is laid on the Table of the Lok Sabha.
STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 439 FOR 22.8.2001
(a) & (b) Separate survey for poor people has not been carried out. The results
of important characteristics from the National Family Health Survey
(1998-99) pertaining to health care in rural and urban areas are enclosed at
Annexure- I.
(c)&(d) Health being a state subject, the primary responsibility for appointment
of doctors for providing Health Care and for supplying drugs in rural areas
rests with the states. The availability and shortfall of doctors in Primary
Health Centres in the states are enclosed at Annexure-II (a) & II (b).
As per the Facility Survey (1998-99) conducted by Government of India in
selected Districts/Sub Divisions/Blocks, the statement showing the number of
PHCs/CHCs with adequate supplies of selected medicines is enclosed at Annexure-
IlI (a) &III (b).
The Central Government provides assistance to states in cash and kind for
implementing the National Health Programmes. Under the Reproductive and Child
Health Programme, funds for hiring doctors to visit PHCs and anesthetics for
helping in emergency obstetric care are provided to the states. Some drugs
are supplied to all sub-centres in the country. Selected PHCs and FRUs in the
districts have provision of essential and emergency obstetric care. Drugs are
also supplied to states under Malaria Control programme, TB Control programme,
Blindness Control programme and other National programmes.
ANNEXURE-I
Family Planning and MCH activities as per National Family Health Survey-II (1998-99)
Indicators By Residence By Standard of Living Index Urban Rural Total Low Medium High
MCH % Mothers received by 85.6 59.3 65.1 54.1 66.3 87.0 ANC % Institutional 65.1 24.6 33.6 18.5 34.9 64.6 delivery % Safe delivery 73.3 33.5 42.3 25.4 44.3 75.7 Tetenus. Toxide.(for Pregnant Women (2 or more) 60.5 36.6 42.0 30.4 43.2 64.7 % Children Fully Immunised % Children given BCG 86.8 67.1 71.6 59.3 74.1 91.2 % Children given 78.2 58.3 62.8 51.9 64.8 81.2 Polio % Children given DPT 73.4 49.8 55.1 42.7 56.9 78.0 % Children given 69.2 45.3 50.7 37.6 51.6 77.2 Measels Vcc. % Children given ORS 32.7 25.0 26.8 24.2 27.3 32.6 Morbidity among Children (less than 3 years age) 16.2 20.3 19.3 21.0 19.4 15.7 % suffering from ARI % suffering from 28.8 29.7 29.5 29.8 30.1 26.7 fever 9 % suffering from 19.6 19.0 19.2 19.9 19.7 16.1 Diarrhoea Family Planning Currently using any 58.2 44.7 48.2 39.5 48.4 61.2 method Sterilisation 37.8 35.4 36.1 33.0 37.7 37.2 Spacing method 13.4 4.5 6.8 2.5 5.6 15.9 Unmet need 13.4 16.7 15.8 17.9 15.6 12.8 TFR 2.3 3.1 2.9 3.4 2.9 2.1
ANNEXURE-II(a) HEALTH MANPOWER IN RURAL AREAS - DOCTORS AT PRIMARY HEALTH CENTRES (PHCs)
S. State/UT Doctors at Primary Health Centres No. Required+ Sanctio In Vacant Shortfall ned Position (S-P) (R) (S) (R-P) (P)
1. Andhra Pr. 1636 1895 1495 400 141
2. Arunachal 45 31 31 - 14 Pr.
3. Assam 619 584 584 - 35
4. Bihar 2209 2121 2121 - 88
5. Goa 17 106 101 5 ++ 6. Gujarat 967 990 966 24 1
7 Haryana 401 674 514 160 ++
8. Himachal 312 354 326 28 ++ Pr.
9. J & K 337 158 158 - 179 10. Karnataka 1676 2237 1944 293 ++ 11. Kerala 962 1317 1121 196 ++ 12. Madhya Pr. 1690 1760 1469 291 221 13. Maharashtra 1699 3068 2993 75 ++ 14. Manipur 69 95 95 - ++ 15. Meghalaya 85 96 86 10 ++ 16. Mizoram 55 38 41 ++ 14 17. Nagaland 33 29 29 - 4 18. Orissa 1352 2636 2351 285 ++ 19. Punjab 484 484 424 60 60 20. Rajasthan 1662 2200 1949 251 ++ 21. Sikkim 24 48 41 7 ++ 22. Tamil Nadu 1436 2899 2648 251 ++ 23. Tripura 58 161 120 41 ++ 24. Uttar Pr. 3808 3787 2263 1524 1545 25. West Bengal 1262 1841 1547 294 ++ 26. A&N Islands 17 29 25 4 ++ 27. Chandigarh - - - - - 28. D&N Haveli 6 6 6 - - 29. Daman & Diu 3 1 1 - 2 30. Delhi 8 6 6 - 2 31. Lakshadweep 4 6 6 - ++ 32. Pondicherry 39 45 45 - ++
All India 22975 29702 25506 4199 2306
(Figures are provisional) NA : Not Available Nil ++ : Surplus + : One per Primary health Centre
Source: GULLETINON RURAL HEALTH STATISTICS IN INDIA JUNE, 2000
ANNEXURE-II(b)
HEALTH MANPOWER IN RURAL AREAS - DOCTORS AT PRIMARY HEALTH CENTRES (PHCs)
S. State/UT Total Number of PHCs functioning No. Number of PHCs functio ning With 4+ With 3 With 2 With With Witho With With Doctors Doctors Doctors one out ut out Lady docto Doct Lab Phar Docto r or tech. ma. r
1. Andhra Pr. 1636 48 15 391 826 55 214 185 65
2. Arunachal 45 2 34 36 2 NA Pr.
3. Assam 619 26 16 146 17 176 130 NA
4. Bihar 2209 NA NA NA NA NA NA NA NA
5. Goa 17 10 7 12 6. Gujarat 967 24 144 87 108 32 102 51 73
7 Haryana 401 24 144 87 10-8 32 102 51 73
8. Himachal 312 1 24 82 86 39 37 13 NA Pr.
9. J & K 337 NA NA NA NA NA NA NA NA 10. Karnataka 1676 24 56 296 1118 282 884 512 257 11. Kerala 962 40 58 72 688 98 391 111 192 12. Madhya Pr. 1690 404 896 390 416 541 13. Maharashtra 1699 1368 331 964 NA NA 14. Manipur 69 3 20 42 4 42 9 16 15. Meghalaya 85 5 76 6 36 54 16. Mizoram 55 5 42 9 44 9 15 17. Nagaland 33 1 29 5 NA 18. Orissa 1352 186 1166 1166 NA 19. Punjab 484 130 354 16 NA 20. Rajasthan 1662 92 59 217 1118 160 375 340 21. Sikkim 24 2 13 9 24 20 22. Tamil Nadu 1436 26 15 1263 110 1046` 23. Tripura 58 11 10 15 16 10 NA 24. Uttar Pr. 3808 51 133 256 289 NA 25. West Bengal 1262 104 NA 26. A&N Islands 17 8 9 8 27. Chandigarh - NA 28. D&N Haveli 6 2 4 2 29. Daman & Diu 3 2 1 2 30. Delhi 8 NA NA` NA NA NA NA 2 31. Lakshadweep 4 2 2 NA 32. Pondicherry 39 6 18 6 6 NA All India 22975 353 947 4585 8350 1463 5068 1852 2176
(Figures are provisional)
NA : Not Available Nil
Note: In many States, the total of the break up of number of PHCs with 4 + 3 or no doctor do not tally with the total number of PHCs in that State
Source: GULLETINON RURAL HEALTH STATISTICS IN INDIA JUNE, 2000
ANNEXURE- III (a)
PERCENT OF PHCs HAVING ADEQUATE SUPPLIES OF SELECTED MEDICINES
S. State/UT No. of Percent having No. PHCs Kit G Kit 1 EMOC Mount Oral Measl IFA ORS medicin medicin drug ed pill es Tab packe es es kit Lamp s vacci (Lar ts 200 W ne ge
1. AP 622 32 45 6 9 62 84 25 58
2. ASSAM 333 27 37 21 1 79 60 41 68
3. BIHAR 339 4 8 1 1 12 12 4 19
4. GUJARAT 614 17 17 6 1 60 95 11 85
5. HARYANA 73 99 97 93 0 96 81 99 97 6. KARNATAKA 854 73 52 26 13 80 68 34 70
7 KERALA 790 18 11 1 1 77 74 64 92
8. MP 386 35 29 4 3 51 26 50 59
9. MAH. 645 98 98 77 1 75 97 43 80 10. ORISSA 505 5 10 1 0.4 16 18 12 71 11. PUNJAB 26 92 88 58 8 81 88 58 58 12. RAJASTHAN 484 81 71 14 6 86 54 41 74 13. TN 672 87 85 60 3 65 90 28 78 14. UP 486 8 14 4 4 16 16 10 17 15. Wb 825 68 62 6 1 49 35 23 33
NOTE: For Haryana and Punjab only 6 districts each are considered.
ANNEXURE III (b)
S. State/UT No. of Percent having No. CHCs
1. AP 63 5 30 10 3 16 38
2. ASSAM 24 0 38 25 8 29 50
3. BIHAR 2 0 50 0 0 50 50
4. GUJARAT 97 6 13 3 2 4 13
5. HARYANA 10 0 90 80 40 90 100 6. KARNATAKA 69 13 45 22 6 28 64
7 KERALA 108 2 10 1 0 4 16
8. MP 46 11 22 2 0 7 46
9. MAH 71 0 13 17 17 11 17 10. ORISSA 69 0 12 10 1 10 38 11. PUNJAB 107 7 76 36 0 36 91 12. RAJASTHAN 55 13 25 7 11 20 91 13. TN 41 0 27 34 2 12 76 14. UP 24 25 13 8 0 0 33 15. WB 65 6 17 6 2 5 68
NOTE: For Haryana only 6 districts are considered
1. All six sets of standard surgical kits 2. Emergency obstetric care drug kit 3. New born care equipment kit.