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1. CHILD DEATHS DUE TO MALNUTRITION
UNSTARRED QUESTION 5261
10/12/2010
(a) whether the number of malnutrition deaths has increased in the
country;
(b) if so, the details thereof indicating the number of deaths occurred
due to malnutrition during the last three years and the current year,
State-wise;
(c) whether Government proposes any immediate remedial programmes to
arrest this trend especially in tribal areas;
(d) if so, the details thereof;
(e) whether the Government has constituted any committee in this regard;
and
(f) if so, the details thereof?
ANSWER
http://164.100.47.132/LssNew/psearch/QResult15.aspx?qref=99626
(a) & (b): Data on deaths in children on account of malnutrition is not
available for the last three years. Malnutrition is not a major cause of
death in children though it can increase morbidity and mortality by
reducing resistance to infections. As per the data available from
Registrar General of India (RGI) for the period 2001-03, 2.8% of the
deaths in 0 to 4 years old were due to nutritional deficiencies.
(c) & (d): Government of India has taken various measures to improve the
health and nutrition status of vulnerable population of the country
including tribal area, details at Annexure-I.
(e) & (f): Prime Minister’s National council on India’s Nutrition
Challenges has been set up in 2008 with the members at Annexure-II.
http://164.100.47.132/Annexture/lsq15/6/au5261.htm
2. VECTOR BORNE DISEASES – INTERVENTION AND CONTROL:
STARRED QUESTION 250
26/11/2010
(a) the details of the strategies formulated and initiatives undertaken
by the Government for the prevention and control of vector borne
diseases in the country;
(b) the details of the financial assistance provided to the State
Governments and utilised by them for the purpose during each of the last
three years and the current year, State/UT-wise.
(c) the details of the foreign assistance received and utilised for the
control of these diseases during the said period, project-wise and
State/UT-wise;
(d) whether reports of lack of medical facilities and staff in the
Government hospitals to tackle the recent spurt in cases of vector borne
diseases and refusal to admit such patients have been received by the
Government; and
(e) if so, the details thereof alongwith the action taken/proposed to
expand and strengthen medical facilities in the Government hospitals to
deal with the situation?
ANSWER
http://164.100.47.132/LssNew/psearch/QResult15.aspx?qref=99397
(a)to(e): A statement is laid on the Table of the House.
STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO.250 FOR
26TH NOVEMBER, 2010
Government of India is implementing an integrated National Vector Borne
Disease Control Programme (NVBDCP) under the overarching umbrella of
National Rural Health Mission (NRHM), for prevention and control of
vector borne diseases. The main strategy for prevention and control of
vector-borne diseases focuses on early case detection and complete
treatment of cases, integrated vector control, and behavior change
communication. The programme is primarily being implemented through the
State/UT Governments.
The initiatives undertaken for prevention and control of vector-borne
diseases include use of Rapid Diagnostic Tests (RDTs) for detection of
Malaria and Kala-azar cases, use of Artemisnin based Combination Therapy
(ACT) for treatment of Plasmodium falciparum Malaria cases, use of
Miltefocine for treatment of Kala-azar cases, vaccination of eligible
population for Japanese Encephalitis prevention in endemic districts,
strengthening of sentinel surveillance hospitals for Dengue, Chikungunya
and Japanese Encephalitis and Mass Drug Administration in Filaria
endemic districts.
The State/UT-wise details of financial assistance released to the
States/ UTs under NVBDCP during last three years and current year and
utilized by them are given at Annexure-I.
The States covered under externally assisted projects are also provided
additional assistance in the form of grants-in-aid, both in cash and
kind, out of externally aided component of NVBDCP. The State-wise
details of cash grants released to the project States and its
utilization during last three years and current year under Global Fund
to Fight AIDS, TB and Malaria (GFATM) and the World Bank supported
projects are given at Annexure-II and Annexure-III respectively.
Government of India has not received any report of lack of medical
facilities and staff in the Government hospitals to tackle the cases of
vector borne diseases and refusal to admit such patients.
http://164.100.47.132/Annexture/lsq15/6/as250.htm
3. SOCIAL SAFETY NET SCHEMES:
UNSTARRED QUESTION 2958
26/11/2010
(a) the number of Primary Health Centres (PHCs) under the Social Safety
Net Schemes, State-wise;
(b) the funds sanctioned and utilisation thereof by the States during
the last three years;
(c) whether the Planning Commission has conducted an evaluation study of
health projects under NRHM;
(d) if so, the details alongwith the outcome thereof; and
(e) the steps taken by the Government to streamline the functioning of
the PHCs?
ANSWER
http://164.100.47.132/LssNew/psearch/QResult15.aspx?qref=99553
(a): National Rural Health Mission[NRHM] was launched in year 2005 with
the objective to provide accessible, accountable and affordable health
care services in the rural areas across the country. As per Bulletin on
Rural Health Statistics in India 2009, 23391 Primary Health Centres (PHCs)
are functioning across the country as on arch 2009 A list of State-wise
PHCs is annexed at Annexure A.
(b): Statement showing the funds released and utilized under (NRHM)
during the financial year 2007-08,2008-09,2009-10 and 2010-11 to all
States/UTs Government including for upgradation/establishment of PHCs is
annexed at Annexure B.
(c) to (d): A study of NRHM has been done by Kavery Gill for the
Planning Commission.
# The study was based on the sample study of few institutions in Andhra
Pradesh, Uttar Pradesh, Rajasthan and Bihar.
# The study indicates uneven progress in the States, different States
perform differently on different parameters – which suggest something is
happening, NRHM institutional arrangements are in place, confidence to
spend is taking time in some places, not much evidence of corruption,
and NRHM has created hope for rural infrastructure in health.
(e): The streamlining/upgradation of PHCs is a continuous process. NRHM
stipulates a Patient Welfare Committee or Rogi Kalyan Samiti consisting
of eminent persons like local MP/MLA, eminent citizens to be nominated
by the District Collector, and leading donors etc. for supervising the
management of healthcare facilities including the PHCs. PHCs are also
provided annual maintenance grant and untied funds in order to make them
functionally better.
http://164.100.47.132/Annexture/lsq15/6/au2958.htm
4. CAG Audit on NRHM
UNSTARRED QUESTION 4768
23/4/2010
(a) whether the Comptroller and Auditor General (CAG) in its latest
audit report has found several loopholes relating to funds management
and health facilities under the National Rural Health Mission (NRHM) and
has recommended to establish essential infrastructure, equipment and
manpower in Community Health Centres and Primary Health Centres to
ensure improvement in equality of healthcare in rural areas at an
affordable cost;
(b) if so, the details thereof and the action taken thereon;
(c) whether the Government has conducted any review of the
implementation of the NRHM in various States/UTs;
(d) if so, the details of the findings thereof, State-wise; and
(e) the corrective measures taken or proposed to be taken by the
Government to plug these loopholes and to check doctors/pharmaceutical
companies nexus to make the health services more effective under the
NRHM?
ANSWER
THE MINISTER OF HEALTH & FAMILY WELFARE (SHRI GHULAM NABI AZAD)
(a) & (b) The Comptroller and Auditor General (CAG) in their report on
the Performance Audit of National Rural Health Mission (NRHM) has made
some recommendations to rationalize fund flow arrangements for speedy
transfer of funds from Government of India to States, States to
Districts and below, to minimize unspent balances, streamlining
accounting procedures and proper maintenance of accounts. Further, it
has also recommended establishment of new infrastructure i.e. health
centres and strengthening and capacity building of existing ones. NRHM
gives special focus to 18 States including eight NE States, which have
weak public health indicators and/or weak infrastructure. Besides, 140
backward districts based on ranking on 13 DLHS III indicators, districts
having considerable population of SC/ST and 33 highly left wing affected
districts as prepared by Ministry of Home Affairs were selected for high
focus planning. The State/UT Governments were asked to take up
activities for such districts on priority and incorporate the same in
their annual Programme Implementation Plans [PIPs] for the financial
year 2010-11. Funds are released to all States/UTs with the approval of
the National Programme Coordination Committee [NPCC].
(c) & (d) Yes. Health is a state subject and the Government of India
supplements the efforts of the State Governments. The Third Common
Review Mission of NRHM (November, 2009), which covered 14 States and 3
Union Territories, looked at various aspects including the position with
regard to diagnostics and logistics and supply chain management. The
Report of the Common Review Mission was shared with all the States/UTs
in a dissemination workshop. The follow up to the comments made are
being monitored through the process of preparation of the Programme
Implementation Plans. Promotion of rational drug use, finalization of
essential drug lists in States, uninterrupted and adequate supply of
drugs through a good logistics and supply chain management and improved
diagnostics are all priorities of the NRHM.
(e) As regards the recommendations on financial management, this
Ministry has put in place a monthly concurrent audit in addition to
annual statutory audit, periodic financial reviews and reviews are also
undertaken by Common Review Missions and Joint Review Missions.Regarding
doctors/pharmaceutical companies nexus, the Indian Medical
Council[Professional conduct, Etiquette and Ethics] Regulations,2002
were amended by Medical Council of India with the prior approval of
Government of India providing that a medical practitioner shall not
endorse any drug or product of the industry publically.
http://164.100.47.132/LssNew/psearch/QResult15.aspx?qref=85311
5. CASES OF MALARIA
UNSTARRED QUESTION 1547
5/3/2010
(a) the total number of the cases of Malaria reported in the country and
the number of patients died of the said disease during the last three
years and the current year, State/UT-wise;
(b) the corrective measures taken and the financial assistance provided
to the State Governments including Uttar Pradesh to curb the incidence
of Malaria during the said period and the achievements made as a result
thereof;
(c) whether the Government proposes to take new measures to stop the
large number of deaths due to various kinds of Malaria including Brain
Malaria in the country; and
(d) if so, the details thereof?
ANSWER
http://164.100.47.132/LssNew/psearch/QResult15.aspx?qref=82382
THE MINISTER OF STATE FOR HEALTH & FAMILY WELFARE(SHRI DINESH TRIVEDI)
(a) Cases of Malaria in the country are reported calendar year-wise i.e.
January to December of the year.Accordingly, the number of cases and
deaths reported due to Malaria during 2006 to 2009,State/UT-wise, are
given in Annexure-I.
(b) Government of India through its National Vector Borne Disease
Control Programme (NVBDCP) has developed a strategy for prevention and
control of vector-borne diseases including Malaria, which advocates for
integrated vector control, early case detection and complete
treatment,and behaviour change communication.Government of India
provides technical support and also supplements the States by providing
funds and commodities as per their annual requirements approved under
National Rural Health Mission for carrying out the above stated
activities. However, the programme is primarily being implemented
through the State Governments.
The details of financial assistance in the form of grants- in-aid (cash
& kind) provided to the States/UTs including Uttar Pradesh for
prevention and control of vector-borne diseases during the years 2006-07
to 2009-10 are given in Annexure-II.
As a result of above measures the number of reported malaria cases has
declined from 17,85,129 in 2006 to 15,33,169 in 2009. Deaths reported
due to malaria have also declined from 1707 in 2006 to 1068 in 2009.
(c) & (d) For effective control of malaria, including P. falciparum
malaria, and to reduce malaria mortality, Government has already taken
the following initiatives:
# Intensification of surveillance by involving the community volunteers
like ASHAs for diagnosis of Brain Malaria (P.falciparum cases) by using
rapid diagnosis tests (RDTs) and treating positive cases with the ACT (Artesunate
sulpha -pyrimethamine combination treatment).
# Distribution of Long lasting insecticide treated nets (LLINs) in high
malaria endemic areas for protection of family members from the bites of
vector mosquitoes.
# Strengthening of the programme through additional manpower.
# Strengthening of referral centres by equipping them with essential
anti-malarials and other supportive drugs and equipment to deal with
severe malaria cases.
http://164.100.47.132/LssNew/psearch/QResult15.aspx?qref=82382
6. PROGRAMME UNDER NATIONAL RURAL HEALTH MISSION
UNSTARRED QUESTION NUMBER 446
20/11/2009
http://164.100.47.132/LssNew/psearch/QResult15.aspx?qref=81179
, like Qnssa, Chhattisgarh, Jharlchand and West Bengal which lack
minimum health
(c)if so, the details thereofand the steps taken in this, regard;
(d)the achievement made so far under the scheme, State/UT-wise;
(e) whether there is separate provision for people living below poverty
line under, the scheme;
(f) if so, the details thereof; and
(g) the steps taken by peCjovernment to streamline implementation o^ the
spfje^me and to meet the shortage of doctors and nurses in the rural
areas?
ANSWER
MINISTER OF THE STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI
GHULAM NABIAZAD)
(a): Funds are allocated to the States/UTs on the basis of a transparent
formula by using population as the basis. The High. Focus. S$atjesfare-given
a weightage factor of 1.3, States`WChhattisgarh, Himachal Pradesh Jammu
& Himachal, Jharkhand and Uttarakhand are given a weightage factor of
1.5, North-Eastern States are given a weightage factor of 3.2 and the
remaiftmg Statf s are given a weightage factor of 1.
(b) and (c); Funds are released annually to the States/UTs under the
National Rural Health Mission to provide /accessible, affordable and`
cpaalityf health care to the rural population especially the vulnerable
sections of the country. Additional funds are also provided to the
States/UTs depending upon ; their utilization status and availability of
funds
(d): A statement showing the progress -u-ndenNBHM is enclosed as annexu#e.
(e) and (f): Although there is no separate provision for people living
below poverty line unddr the Scheme but efforts are made to covenrqral
population especially the vulnerable sections.
(g): Under the National, Rurall Health Mission pRHM],, Government of
India receives Annual Programme Implementation Plans [PIPs] from the
States/UTs and the same are examined in the Ministry and approved by the
National Programme Coordination Committee , of the Ministry. The funds
are released after due appraisal and approval. Further , a detailed
framework for trie monitoring of the Programme has been operationalised.
Periodic review missions are also undertaken to the States to monitor
progress of the Programme. The Review Mission teams comprise Government
of India Officers, Public Health experts of NIHFW, NHSRC, Development
Partners and State Health & Family` Welfare representatives. The
progress of NRHM is also reviewed and monitored by high level bodies
like the Mission Steering Group [MSG], Empowered Programme Committee [EPC],
Advisory Group on Community Action (AGCA) and ASHA Mentoring Group (AMG)
set up under the Ministry of Health & Family Welfare. In addition,
independent external evaluations are also conducted by Government and
Non-Governmental agencies on thematic and geographical basis to document
the progress of the NRHM. Community level validation of key programme
components is also carried out under NRJHM through the process of
Physical and Financial Monitoring Reports, regular MIS, survey reports
and user responses.
An integrated web based Health Management Information System (HMIS),
which compils progress of NRHM on key parameters at various,levels has
been operationalised.
A task `group was constituted under the NRHM under the Chairmanship of
DGHS and has recommended various measures to enspre the services of
Doctors in rural areas. These recommendations haye already been shared
with the State Government. The main recqmmeliddtions are - increase in
the age of retirement of Doctors to 65 years preferably with posting
near hometown, decentralization of recruitment at District .level,
walk-in-interview .and contractual appointment of Doctors, enhancing tte
salary for positing in rural: areas by one-third-increasimg the
admission capacity in medical college for Anaesthesia, reviving the;
Diploma course in Anaesthesia, to start one year certificate course in
Anaesthesia , for Medical Officers working in the system at ;present to
be given by national Board of Examination, recognition of five hundred
bedded hospitals to provide the .facility for conducting the above
course and hiring of private practitioners on case-to-case basis. Under
NRHM, 6660 Ayush Doctors, 24,494 Staff Nurses and 44,561 Auxiliary Nurse
Midwife have been hired by the States on contract basis.
http://164.100.47.132/Annexture/lsq15/3/au446.htm
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