ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH & FAMILY WELFARE
(DR. BHARATI PRAVIN PAWAR)
(a) to (c)
“Public Health and Hospitals” being a State subject, the primary responsibility of strengthening public healthcare system, including for the efforts to strengthen rural healthcare infrastructure, lies with the respective State Governments. However, under National Health Mission (NHM), technical and financial support is provided to the States/UTs to strengthen the public healthcare delivery at public healthcare facilities.
NHM support is provided to States/ UTs for setting up of new facilities as per norms and upgradation of existing facilities for bridging the infrastructure gaps, including in rural areas, based on the requirement posed by them.
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 transformation of Sub Health Centres and Primary Health Centres into 1.5 lakh Health and Wellness Centres across the country by December, 2022 for provision of Comprehensive Primary Health Care (CPHC) that includes preventive healthcare and health promotion at the community level with continuum of care approach. Under this programme, CPHC services of an expanded range of services, that are universal and free to users, with a focus on wellness, are provided, closer to the community.
Support has also been provided to States/UTs under the “India COVID-19 Emergency Response & Health System Preparedness Package” for the containment and management of pandemic, including for augmentation of infrastructure, oxygen supported beds, isolation beds, ICUs & Human Resources, supply of drugs, etc. During the financial year 2020-21, Rs.8147.28 Crs. has been released to States under this package. In addition, Rs.110.60 Crs has been made available for insurance of Health Care workers. Thus, a total amount of Rs.8257.88 Crs has been provisioned for the States/ UTs. MOHFW has also provided in-kind support to the States/UTs, by procuring and distributing oxygen cylinders, Trunat COVID Test Cartridges, X-pert COVID cartridges, N 95 masks, PPE kits, Remdesivir and ventilators, including for rural healthcare facilities.
Ministry of Health and Family Welfare holds consultations with all the concerned Ministries on regular basis, including for effective management in view of spread of COVID-19 in rural areas. An SOP on COVID-19 Containment and Management in Peri-urban, Rural & Tribal areas during May 2021 to ensure
that community-based services and primary level health infrastructure in rural, peri-urban and tribal areas are equipped and oriented to manage COVID-19 cases has been shared with all the States/UTs. This document also outlines the containment and clinical management practices to be put in place in these areas with respect to COVID-19 management.
The Union Cabinet has also approved “India Covid-19 Emergency Response and Health Systems Preparedness Package - Phase-II” (ECRP-Phase-II) on 8.07.2021 for an amount of Rs.23,123 crores. The scheme is a Centrally Sponsored Scheme (CSS) with some Central Sector (CS) components. The Scheme is aimed to prevent, detect and respond to the continuing threat posed by COVID-19 and strengthen national health systems for preparedness in India.
Under CSS components of ECRP-II, support is being provided to the States/UTs for provision for establishing District Paediatric Units (42 or 32 bedded units including Oxygen Supported beds and ICU beds) in all the Districts of the Country. Besides, support is also provided to increase the availability of ICU beds in Government health facilities and to create pre -fabricated structures for augmenting beds at Sub Health Centres, Primary Health Centres & Community Health Centres in rural, peri-urban and tribal areas. Maintaining, buffer stock for essential medicines required for effective COVID management, in addition to provision for required drugs and diagnostics, is also being supported. Support is also available for establishing field hospitals, (100 bedded or 50 bedded units) wherever required.
In order to ensure implementation of critical activities at the State/District levels to prepare the public healthcare system in response to the evolving pandemic, 15% of Central Share of Resource Envelope of the State/UT, has been released in-advance to the States/UTs .
For making oxygen available in Health Care Facilities, Government has sanctioned 1573 Pressure Swing Adsorption Oxygen generation plants, including in rural areas. Out of these, as on 20th July, 2021, 316 plants have been commissioned.
1,14,000 Oxygen Concentrators are also being supplied to the States/UTs for deployment in rural, peri urban & tribal areas.
Under the Loan Guarantee Scheme for COVID Affected Sectors, it is aimed at up scaling medical infrastructure targeting underserved areas. This Guarantee cover for expansion and new projects related to health/medical infrastructure in cities other than 8 metropolitan cities and the Guarantee coverage is 50% for expansion & 75% for new projects. For Aspirational Districts, the guarantee cover is of 75% for both new projects and expansion. The maximum loan under the scheme is Rs. 100 crore. The duration of the Guarantee is up to 3 years, with the interest rate capped at 7.95%. and the Guarantee is by National Credit Guarantee Trustee Company Limited.
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