ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a): Population norm is the criterion for setting up of health centres based on which the health care infrastructure in rural areas has been developed as a three tier system as given below: -
Centre Population Norms
Sub Centre
Primary Health Centre
Community Health Centre Plain Area
5000
30,000
1,20,000 Hilly/ Tribal/
Difficult Area
3000
20,000
80,000
However, as the population density in the country is not uniform, it shall also depend upon the case load of the facility and distance of the village/habitations which comprise the Sub-centre. A subdivision hospital caters to about 5-6 lakhs people. As regards district hospital, every district is expected to have one.
(b) to (d) The number of Sub-Centres, PHCs and CHCs needed State/UT-wise as well as those in position are as per Annexure. The information regarding district hospitals is not maintained centrally.
There is some shortfall in health centres vis-à-vis requirement, which is also reflected in Annexure-I. One of the reasons for deficient health infrastructure is historical underfunding in health sector.
Public health and hospitals being a State subject, the primary responsibility of providing quality medical facilities at an affordable cost lies with respective State/UT Governments. To address the healthcare challenges, particularly in rural areas, the National Rural Health Mission (NRHM) was launched in 2005 to supplement the efforts of the State/UT governments to provide accessible, affordable and quality healthcare to all those who access public health facilities. After National Urban Health Mission (NUHM) was introduced in 2013, the Mission was known as National Health Mission (NHM), merging both the components. Under NHM, technical and financial support is provided to States/UTs for strengthening their healthcare system in the form of Record of Proceeding(RoPs) based on the proposals submitted by the States in their Program Implementation Plans (PIPs).
This support under NHM includes provision of a host of free services such as 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.
Other major initiatives include Janani Shishu Suraksha Karyakram (JSSK) (under which free drugs, free diagnostics, free blood and diet, free transport from home to institution, between facilities in case of a referral and drop back home is provided), Rashtriya Bal Swasthya Karyakram (RBSK) (which provides newborn and child health screening and early interventions services free of cost for birth defects, diseases, deficiencies and developmental delays to improve the quality of survival), implementation of Free Drugs and Free Diagnostics Service Initiatives, PM National Dialysis Programme and implementation of National Quality Assurance Framework.
Mobile Medical Units (MMUs) & Telemedicine are also being implemented with NHM support to improve healthcare access particularly in rural areas.
As part of Ayushman Bharat, the Government is supporting the States for strengthening Sub Centres and Primary Health Centres as Health and Wellness Centres (AB-HWCs) for provision of comprehensive primary health care that includes preventive and health promotion at the community level with continuum of care approach. Further, Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides health coverage up to Rs. 5.00 lakh per family per year to around 10.74 crore poor and vulnerable families as per Socio Economic Caste Census (SECC).
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