Question : Health Sub Centres

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether present Health Centres are sufficient to cater to the public health system in the country;

(b) if so, the details thereof along with the norms fixed and number of sub-centres functioning in the country at presents, State-wise, Union-Territory-wise;

(c) whether there is any job chart for health attendant (woman), ANM and ASHA workers of a sub-centre;

(d) if so, the details thereof;

(e) whether the Government proposes to increase the honorarium of ASHA workers so that they may be financially secured; and

(f) if so, the details thereof?

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(ASHWINI KUMAR CHOUBEY)
(a) & (b): The health care infrastructure in rural areas has been developed as a three tier system and is based on the following population norms :
Centre Population Norms
Plain Area Hilly/tribal/Difficult
Sub Centre 5000 3000
Primary Health Centre 30000 20000

Community Health Centre 120000 80000

As per Rural Health Statistics 2017, there is shortfalls in availability of different levels of health facilities such as sub centres, primary health centres and community health centres in the country. The States/UT wise details are given at Annexure-I.

(c) & (d): Roles and responsibilities/job charts have been prepared for service providers at the sub centre including ANM. The IPHS guidelines for sub centres (Revised 2012) lays down the roles and responsibilities of ANMs, which are available at http://www.nhm.gov.in/nhm/nrhm/guidelines/indian-public-health-standards.html. In addition, prototype job charts and weekly work plans have also been provided in the Ministry of Health and Family Welfare ‘Guidebook for enhancing performance of Multi-purpose worker (Female) 2014’ which is available at ‘http://nhsrcindia.org/category-detail/policy-and-guidelines/ODY=’
ASHA is a community level voluntary health worker, who is trained and supported to play a set of healthcare support roles in her community. The roles and responsibilities of ASHA as per the ASHA Guidelines released by the GIO are at Annexure-II.

(e) & (f): ASHAs are envisaged as Voluntary Health activists who receive only task/activity based incentives. The incentives to ASHAs finalized at the national level are regularly reviewed by the Government from time to time. In 2013, ASHA incentives were enhanced for many activities and new incentives for routine and recurring activities were introduced to ensure that ASHAs get at least Rs 1000/- per month. Thereafter, the Mission Steering Group of NHM approved incentives for ASHAs at the rate of Rs.100 for notification if the suspect referred is diagnosed to be TB patient by MO/Lab, in 2014. Rs 100/- per round during Indoor Residual Spray i.e. Rs 200 in total for two rounds Indoor Residual Spray, in 2015 and Rs. 150/case for escorting or facilitating beneficiary to the health facility for the Post Abortion IUCD insertion, in 2017. Under the Framework for Implementation of NHM, States have also been given the flexibility to design ASHA incentives.

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