Health Care services to reach last mile

On: 09 FEB 2024 – 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. NHM support is provided to all States/ UTs including Maharashtra for setting up of new facilities as per norms and upgradation of existing facilities for bridging the infrastructure gaps based on the requirement posed by them.

The Government has launched four mission mode projects, namely PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), Ayushman Arogya Mandir erstwhile Ayushman Bharat Health & Wellness Centres (AB-HWCs), Pradhan Mantri Jan Arogya Yojana (PMJAY) and Ayushman Bharat Digital Mission (ABDM).

PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) was launched by Hon’ble Prime Minister of India with an outlay of Rs. 64,180 crores. The measures under the PM-ABHIM focus on developing capacities of health systems and institutions across the continuum of care at all levels, primary, secondary and tertiary, to prepare health systems in responding effectively to the current and future pandemics /disasters.

Through 1.64 lakh Ayushman Arogya Mandir, comprehensive primary healthcare is provided by strengthening Sub Health Centres (SHCs) and Primary Health Centres (PHCs). These Ayushman Arogya Mandir (AAM) provide preventive, promotive, rehabilitative and curative care for an expanded range of services encompassing reproductive and child healthcare services, Communicable diseases, Non-communicable diseases and other health issues.

Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides health coverage up to Rs. 5.00 lakh per family per year to poor and vulnerable families.

The Ayushman Bharat Digital Mission (ABDM) aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. It will bridge the existing gap amongst different stakeholders of Healthcare ecosystem through digital highways. As on 08.02.2024, 55 cr Ayushman Bharat Health Accounts (ABHA) have been created.

The Fifteenth Finance Commission (FC-XV) has recommended grants through local governments for specific components of the health sector to the tune of Rs 70,051 crores and the same have been accepted by the Union Government. These grants for health through Local Governments will be spread over the five-year period from FY 2021-22 to FY 2025-26 and will facilitate strengthening of health system at the grass-root level.

Union Health Ministry provides technical and financial support to the States/UTs to strengthen the public healthcare system, based on the proposals received in the form of Programme Implementation Plans (PIPs) under National Health Mission. Government of India provides approval for the proposals in the form of Record of Proceedings (RoPs) as per norms & available resources.

The details of fund allocated and released under NHM for strengthening public health systems State/UT-wise are as under:

Details of funds allocated and released under NHM for the FY 2020-21 to FY 2022-23, State/UT wise

Rs. in Cr.

Note:

1. Allocation is as per original outlay/B.E.

2. The above releases relate to Central Govt. Grants & do not include State share contribution.

Ayushman Bhav Campaign was launched by Hon’ble President of India on 13th September, 2023. Ayushman Bhav Campaign is envisaged to saturate selected health care services in every village/ town in line with the commitment of Hon’ble Prime Minister to ensure reach to the last mile and enable access to health care services to everyone in the society. ‘Ayushman Bhav’ campaign involves a set of interventions that include following:

(i) ‘Ayushman – Apke Dwar 3.0’

(ii) Ayushman Arogya Mandir Health Melas

(iii) Weekly Health Melas at Community health centres (CHCs)

As on 31.01.2024, total number Health Melas organized are 17.90 lakh, out of which total footfall recorded is 1486.82 lakh; 11.94 lakh Wellness/Yoga/Meditation session have been conducted; 837.99 lakh people received free drugs, 746.46 lakh people received free diagnostic services and 2478.53 lakh screenings of 7 types of diseases have been done.

The Union Minister of State for Health and Family Welfare, Dr Bharati Pravin Pawar stated this in a written reply in the Lok Sabha.

Anemia Mukt Bharat programme & Update on RMNCAH+N

The Government of India implements Reproductive Maternal Newborn Child Adolescent Health Plus Nutrition (RMNCAH+N) strategy under National Health Mission, which includes various activities to address the problem of anemia and malnutrition among women and children across the county. Interventions are as below:

1. Mothers’ Absolute Affection (MAA) is implemented to improve breastfeeding coverage which includes early initiation of breastfeeding and exclusive breastfeeding for first six months followed by age-appropriate complementary feeding practices through capacity building of frontline health workers and comprehensive IEC campaigns.
2. Nutrition Rehabilitation Centres (NRCs) are set up at public health facilities to provide in-patient medical and nutritional care to children under 5 years of age suffering from Severe Acute Malnutrition (SAM) with medical complications. In addition to curative care, special focus is given on timely, adequate and appropriate feeding for children, correction of micronutrient deficiencies, improving the skills for mother and caregivers on complete age-appropriate caring and feeding practices. and counselling support is provided to mothers for identifying nutrition and health problems in child.
3. Anemia Mukt Bharat (AMB) programme is implemented to reduce anemia among six beneficiaries age group – children (6-59 months), children (5-9 years), adolescents (10-19 years), pregnant and lactating women and in women of reproductive age group (15-49 years) in life cycle approach through implementation of six interventions via robust institutional mechanism. The steps taken to address the problem of anemia are:

1. Prophylactic Iron and Folic Acid Supplementation in all six target age groups
2. Intensified year-round Behaviour Change Communication (BCC) Campaign for: (a) improving compliance to Iron Folic Acid supplementation and deworming, (b) enhancing appropriate infant and young child feeding practices, (c) encouraging increase in intake of iron-rich food through diet diversity with focus on harnessing locally available resources, and (d) ensuring delayed cord clamping after delivery in health facilities
3. Testing using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents
4. Addressing non-nutritional causes of anemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis
5. Providing incentives to the ANM for identification and follow-up of pregnant women with severe anemia in high priority districts (HPDs)
6. Management of severe anemia in pregnant women by administration of IV Iron Sucrose/ Blood transfusion
7. Awareness by ASHAs through community mobilization and IEC/BCC activities
8. Convergence and coordination with other line departments and ministries for strengthening implementation

4. Under National Deworming Day (NDD) albendazole tablets are administered in a single fixed day approach via schools and anganwadi centres in two rounds (February and August) to reduce the soil transmitted helminth (STH) infestation among all children and adolescents (1-19 years).
5. Monthly Village Health, Sanitation and Nutrition Day (VHSND) is an outreach activity at Anganwadi centers for provision of maternal and child care including nutrition in convergence with the ICDS.
6. MCP Card and Safe Motherhood Booklet are distributed to the pregnant women for educating them on diet, rest, danger signs of pregnancy, benefit schemes and institutional deliveries.

As informed by Ministry of Consumer Affairs, Food and Public Distribution, the Government implements various schemes to improve the access to nutritious food, such as National Food Security Act (NFSA) 2013, which provides highly subsidized food grains under Targeted Public Distribution System (TPDS) for coverage up to 75% of the rural population and up to 50% of the urban population and under Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY), free food grains are provided to 81.35 crore beneficiaries of Antyodaya Anna Yojana households and Priority Households, for a period of five years with effect from 1^st January 2024.

As informed by Indian Council of Agricultural Research, Ministry of Agriculture and Farmers Welfare, under Krishi Vigyan Kendra Scheme, 16681 nutri-gardens are established across 30310 farm families and awareness activities are conducted on health and nutrition literacy.

As informed by Ministry of Women and Child Development, under Mission Poshan 2.0, Supplementary Nutrition Program provides nutritional support to children less than 6 years age, adolescent girls (14-18 years), pregnant women and lactating mothers as per nutrition norms under Schedule II of NFSA Act 2013.  

Also, the Pradhan Mantri Poshan Shakti Nirman (PM POSHAN) under Ministry of Education provides one hot cooked meal in Government and Government-aided schools as per nutrition norms under Schedule II of NFSA Act, 2013 to school going children from Balvatikas (pre-school) to Class VIII.

The Government of India takes various measures to augment domestic availability and stabilize the prices of essential food commodities.

The Union Minister of State for Health and Family Welfare, Dr. Bharati Pravin Pawar’s written reply in the Lok Sabha.

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