Health & Family Welfare


 

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