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Health Care for the Elderly, National Child Health Programme, National Nutrition Policy, Online Sale of Drugs, Organ Donation and Rashtriya Arogya Nidhi



Mr. Bill Gates Meets Health Minister Shri J P Nadda

Appreciates initiatives in Immunization, Family Planning and Health Systems Strengthening

Gates Foundation can help in enhancing investment in Health Sector: JP Nadda 
Mr. Bill Gates, Co-Chair & Trustee, Bill and Melinda Gates Foundation called on the Union Minister for Health & Family Welfare, Shri J P Nadda, here today and discussed various issues relating to the health sector in India. During the meeting, Mr. Gates expressed appreciation for the initiatives taken by the Ministry towards strengthening the health systems, particularly in the primary health care, in addition to the success of full immunization through Mission Indradhanush, the India launch of Inactivate Polio Vaccine (IPV) on 30th November and the resolve and commitment to launch new vaccines to protect the children and India’s population from various diseases. 


The Health Minister Shri J P Nadda said, “We are looking forward to develop synergies and to use expertise of the Bill and Melinda Gates Foundation (BMGF) in crucial health related issues. The Gates Foundation can play an important role in capacity building and enhancing the investment for the health sector in India.”

The Health Minister appreciated the efforts of Gates Foundation in complimenting the efforts of the Government in the Health Sector, which has enhanced the capacity of the health workers for more effective implementation of the projects.

The Health Minister elaborated on the new initiatives of the Government such as Mission Indradhanush aimed to cover all missed-out and left-out children with cover of full immunization and the successes within the nation-wide initiative, the launch of new vaccines including Pentavalent, Pneumococcal, Rota Virus and the adult JE vaccine.

During the meeting, it was agreed that BMGF will support the Ministry in strengthening health systems further in order to enhance the capacity within the sector and to reduce out-of-pocket expenditure.

Mr. Gates stated: ‘India has made significant progress in improving access to healthcare services, and I believe the country has the political will and creative thinking to come up with solutions of transformative healthcare models that work for all its people, especially women and children so that they survive, thrive and reach their full potential. We look forward to working with the government to strengthen primary healthcare, which is key to accelerating health outcomes for every woman and child in India.’

During the meeting with the Health Minister, Mr. Bill Gates expressed appreciation for the switch from DDT to Synthetic Pyrethroid (SP) in some districts for fighting Kala Azar in the affected districts, the expanded choice provided to women through the injectable contraceptives under the reproductive health sector, and India’s attention to the nutrition issues. 
****
Welfare of New Born Children and Mothers 

The Government of India under the National Health Mission (NHM) is implementing following interventions across all States and UTs of the country to improve the health of newborn babies and their mothers:-

1.      Promotion of institutional deliveries through JananiSurakshaYojana.
2.      Operationalization of sub-centres, Primary Health Centres, Community Health Centres and District Hospitals for providing 24x7 basic and comprehensive obstetric care services.
3.      New guidelines have been prepared and disseminated to the states: Screening for Diagnosis and management of Gestational Diabetes Mellitus, Hypothyroidism during pregnancy, Training of General Surgeons for performing Caesarean Section, Calcium supplementation during pregnancy and lactation, De-worming during pregnancy, Maternal Near Miss Review, Screening for Syphilis during pregnancy and Dakshata guidelines for strengthening intra-partum care.
4.      Name Based Web enabled tracking of Pregnant Women to ensure antenatal, intranatal and postnatal care.
5.      Mother and Child Protection Card in collaboration with the Ministry of Women and Child Development to monitor service delivery for mothers and children.
6.      Antenatal, intranatal and postnatal care including Iron and Folic Acid supplementation to pregnant and lactating women for prevention and treatment of anaemia.
7.      Engagement of more than 9 lakhs Accredited Social Health Activists (ASHAs) to generate demand and facilitate accessing of health care services by the community.
8.      Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services.
9.      The RashtriyaKishorSwasthyaKaryakram (RKSK) for adolescents to have better access to family planning, prevention of sexually transmitted Infections, Provision of counselling and peer education.
10.  Health and nutrition education to promote dietary diversification, inclusion of iron and folate rich food as well as food items that promote iron absorption.  
11.  JananiShishuSurakshaKaryakaram (JSSK) entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section.  The initiative stipulates free drugs, diagnostics, diet, blood transfusion besides free transport from home to institution, between facilities in case of a referral and drop back home.  Similar entitlements have been put in place for all sick infants, ate-natal and post-natal mothers accessing public health institutions for treatment.
12.  Strengthening Facility based newborn care: Newborn care corners (NBCC) are being set up at all health facilities where deliveries take place; Special New Born Care Units (SNCUs) and New Born Stabilization Units (NBSUs) are also being set up at appropriate facilities for the care of sick newborn including preterm babies.
13.  Home Based Newborn Care (HBNC):  Home based newborn care through ASHA has been initiated to improve new born practices at the community level and early detection and referral of sick new born babies
14.  India Newborn Action Plan (INAP) has been launched to reduce neonatal mortality and stillbirths.
15.  Newer interventions to reduce newborn mortality- Vitamin K injection at birth, Antenatal corticosteroids for preterm labour, kangaroo mother care and injection gentamicin for possible serious bacillary infection.
16.  Universal Immunization Programme (UIP): Vaccination protects children against many life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B and Measles. Infants are thus immunized against seven vaccine preventable diseases every year. The Government of India supports the vaccine programme by supply of vaccines and syringes, cold chain equipment and provision of operational costs.
17.  Capacity building of health care providers: Various trainings are being conducted under National Health Mission (NHM) to build and upgrade the skills of health care providers in basic and comprehensive obstetric care of mother during pregnancy, delivery and essential newborn care.
18.  To sharpen the focus on the low performing districts, 184 High Priority Districts (HPDs) have been prioritized for Reproductive, Maternal,Newborn, Child Health+Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes.
The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.
19.            
*****
Rashtriya Arogya Nidhi 
The RashtriyaArogyaNidhi (RAN) has been set up vide Resolution No. F-7-2/96-Fin-II dated 13/1/1997 and registered under the Society Registration Act, 1860, as a Society. The RAN was set up to provide financial assistance to patients, living below poverty line and who are suffering from major life threatening diseases, to receive medical treatment at any of the Government super speciality Hospitals/Institutes or other Government hospitals. The financial assistance to such patients is released in the form of ‘one-time grant’, which is released to the Medical Superintendent of the Hospital in which the treatment has been/is being received. An illustrative list of categories of treatment provided from the fund is given below. All Government hospitals/institutions are covered for treatment to poor patients under Rashtriya Arogya Nidhi.
An illustrative list of categories of treatment to be provided from this fund
(This list is reviewed by the Technical Committee from time to time )

1.Cardiology& Cardiac Surgery:
        
         1. Pacemakers
         2. CRT/Biventricular pacemaker
         3. Automatic Implantable Cardioverter defibrillator (AICD)
         4. Combo devices
         5. Diagnostic Cardiac Catheterization including Coronary Angiography
6.  Interventional procedure including Angioplasty, Balloon Valvuloplasty e.g.      PTMC, Aortic & Pulmonary BallonValvulotomy, FFR, IVUS etc.
         7. ASD, VSD and PDA device closure
8. Angioplasty including Peripheral Vascular Angioplasty, Aortic Angioplasty, Renal Angioplasty
         9. Coil Embolization and Vascular plugs
         10. Stents, Bare metal Stents as well as Drug Eluting Stents
         11. Electrophysiological Studies (EPS) and Radio Frequency (RF)
               Ablation
         12. Heart surgery for Congenital and Acquired conditions including
               C.A.B.G, Valve replacement etc.
         13. Vascular Surgery
         14. Cardiac Transplantation etc.

2. Cancer :

1.      Radiation treatment of all kinds including Radio Therapy and
Gama Knife Surgery.
2.      Anti-Cancer Chemotherapy supportive medication and antibiotic,
Growth factor,
3.      Bone Marrow Transplantation- Allogenic& Autologous
4.      Diagonostic Procedures- Flow cytometry/cytogenetics /IHC Tumour
Markers etc.
5.      Surgery for cancer patients

3.Urology/Nephrology/Gastroenterology :

1.      Dialysis and its consumable (Both haemodialysis as well as Peritoneal)
2.      Plasmalpheresis including all consumbales.
3.      Vascular access consumables (AV Grafts, catheters including perm catheters) for  Dialysis
4.      Renal transplant-cost of renal transplant varies, ceiling rate may be followed as per CGHS rates.
5.         Lithotripsy ( for Stones)
6.      Treatment of Acute Humoral/Cellular Rejaection in kidney transplant.
7.      Treatment of Rapidly progressive Glomerulonephritis, Nephritis and Vasculitis.
8.      Liver Transplantation and Surgery for portal hypertension.

4. Orthopedics:
1.                  Artificial prosthesis for limbs
2.                  Implants and total hip and knee replacement
3.                  External fixaters
4.                  AO implants, used in the treatment of bone diseases and
fractures
5.                  Spiral fixation Implant- Pedicle Screws (Traumatic,
                        Paraplegic, Quadriplegic)
6.                  Implant for Fracture fixation (locking plates & modular)
7.                  Replacement Hip –Bipolar /fixed
8.                  Bone Substitutes

5. Neurosurgery – Neurology :

1                 Brain Tumors
2                 Head injuries
3                 Intracranial aneurysm
4                 Vascular Malformations of brain & spinal cord.
5                 Spinal tumors
6                 Degenerative /Demyelinating diseases of brain/spinal cord
7                 Stroke
8              Epilepsy
9              Movement disorders
10          Neurological infections
11          Traumatic Spine Injury
12          Occlusive Vascular Disease of Brain

6.Endocrinology :
1.               Cases of complicated diabetes which require one time treatment
e.g. amputation or renal transplant
2.               Hypo pituitarism
3.               GH deficiency
4.               Cushings Syndrome
5.               Adrenal insufficiency
6.               Endocrine surgery
7.               Osteoporosis

7. Mental Illness :
1.               Organic Psychosis acute and chronic
2.               Functional psychosis including Schizophrenia, Bio-polar disorders, delusional disorders and other acute polymorphic psychosis
3.               Severe OCD, Somatoform disorders, eating disorders.
4.               Developmental disorders including autisms spectrum disorders and Severebehavioural disorders during childhood.
5.               Psycho diagnosis, neuropsychological assessments, IQ assessments, blood tests like serum lithium and drug level of carbamazepine, valporate, phenytoin and any other similar medications: CSF studies screening for substances or abuse/toxicology. 

8. Miscellaneous:                              

Other major illness/treatment/intervention considered appropriate  for financial assistance by Medical Superintendent/Committee ofDoctors could be considered for grant.
Revolving funds have been set up in 12 designated Central Government Hospitals/Institutions and funds upto Rs. 50,00,000/- (fifty lakhs) are placed at their disposal for providing treatment to the BPL patients suffering from life threatening diseases.
Financial powers delegated to 12 designated Central Government Hospitals/Institutions have been enhanced from Rs. 2lakh to Rs. 5lakh for providing financial assistance in cases where emergency surgery is required.
The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.
1.            
*****
Organ Donation 

As per Transplantation of Human Organs and Tissue Act, 1994 (as amended), the Central Government has been given the mandate tomaintain National registry of donors and recipients of human organs and tissues. National Organ and Tissue Transplant Organization (NOTTO) has been set up to maintain this registry based on the information received from the transplant/retrieval hospitals and other related organizations. The National registry has been launched on 27-11-2015.
There is a shortage of donated organs in the country as compared to the number of patients of organ failure who require transplants. Total number of persons who have pledged their organs for donations under the National Registry till 30-11-2015 is 568.
The Government of India has taken proactive steps to spur organ donation in the country. These include:

       I.            The importance of organ donation has been highlighted by the Hon’ble Prime Minister in Mann Ki BaatProgramme broadcast in October and November 2015;

    II.            Website of NOTTO namely www.notto.nic.in has been made  functional for providing updated information to general public.

 III.            A 24x7 call centre with toll free helpline number (1800114770) has been established for providing information and facilitating networking of hospitals. The number has been widely publicized through print, SMS, electronic and social media.

 IV.            Indian Organ Donation Day is being observed annually since 2010. This year it was observed on 27th November 2015.

    V.            National Organ and Tissue Donation and Transplant Registry has been launched.

 VI.            Members of Donor families from different parts of the country and winners of national competition of slogan on organ donation were felicitated.

VII.            Award has been given to the best performing State (Tamil Nadu) in the area of Organ Donation.

VIII.            Organ Donation Publicity through print media, Display Boards, Frequently Asked   Questions, Mobile SMSes, talks by experts, etc. is being undertaken. 

 IX.            The networking of the transplant and/or retrieval hospitals has been commenced to ensure that any organ which is donated is not wasted.

    X.            Systems have now been put in place to register organ donation pledges. Those who want to pledge for organ donation can do so through both offline and online mode.

 XI.            Financial assistance has been provided for establishing four regional level organizations called Regional Organ and Tissue Transplant Organization (ROTTO) in the States of Tamil Nadu, Maharashtra, Assam and UT of Chandigarh and carrying out awareness and training of transplant coordinators.

XII.            Training of Transplant Coordinators of Delhi and NCR has been conducted by NOTTO.

XIII.            Transplant Hospitals in Delhi and National Capital Region have been instructed for placing Display Boards outside the Intensive Care Units and at strategic locations in the hospital, mentioning that Law requires the doctor on duty/transplant coordinator/counsellor to make inquiry and request for organ donation from the family members of brain stem dead persons.

XIV.            As per the need, financial assistance is also provided under the National Organ Transplant Programme for hiring of transplant coordinators in Government Hospitals and Trauma Centres..

The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.
1.            
*****
Online Sale of Drugs 
The sale and distribution of drugs in the country is regulated under the provisions of Drugs & Cosmetics Act, 1940 and Rules made thereunder. As per Drugs & Cosmetics Rules, 1945, Drugs specified in Schedule H, H1 or Schedule X cannot be sold except on and in accordance with the prescription of a Registered Medical Practitioner. The supply of prescription drugs can be effected only by or under the personal supervision of a registered pharmacist from a licensed premises.

A number of representations have been received from chemists and druggist associations against the online sale of prescription drugs. Similarly, a number of representations have also been received to permit such sales.

The representations received were discussed in detail in the 48th meeting of the Drugs Consultative Committee (DCC), held on 24th July, 2015. The DCC has constituted a Seven Member Sub-Committee to examine the issue of sale of drugs on the internet, while taking care of the risks and concerns related to such sales. All measures considered necessary for safeguarding the interests of Consumers are taken by the Government.

The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today. 
*****
National Nutrition Policy 
National Nutrition Policy (NNP) has been adopted by the Government in 1993. The National Nutrition Policy (NNP) identified key action in various areas having impact on nutrition such as agriculture, food production, food supply, education, information, health care, social justice, tribal welfare, urban development, rural development, labour, women and child development, people with special needs and monitoring and surveillance.

The core strategy envisaged under NNP is to tackle the problem of nutrition through direct nutrition interventions for vulnerable groups as well as through various development policy instruments which will improve access and create conditions for improved nutrition.

The direct short-term nutrition intervention suggested by NNP include: (i) Nutrition interventions for specially vulnerable group such as children below 6 yrs, adolescent girls and pregnant and lactating women, expanding the safety nets, facilitating behaviour change among mothers, reaching the adolescent girls and ensuring better coverage of expectant women; (ii) Fortification of essential food items with appropriate nutrients; (iii) Popularization of low cost nutritious foods prepared from indigenous and locally available raw materials; (iv) Control of micronutrient deficiencies among vulnerable groups.

The indirect long term nutrition interventions leading to institutional and structural changes including: (i) Food security for improved availability of food grains; (ii) Improvement of dietary patterns through production and demonstration; (iii) Policies for effecting income transfers so as to improve the entitlement package of the rural and urban poor – improving the purchasing power and strengthening public distribution system; (iv) Land reforms measures for reducing vulnerabilities of landless and landed poor; (v) Strengthen health & family welfare programme; (vi) Imparting basis health and nutrition knowledge; (vii) Prevention of food adulteration; (viii) Improvement in nutrition surveillance; (ix) Monitoring of nutrition programmes; (x) Research into various aspects of nutrition; (xi) Equal remuneration for women; (xii) Communication through established media (xiii) Minimum wage administration to ensure its strict enforcement and timely revision and linking it with price rise through a suitable nutrition formula –a special legislation for providing agricultural women labourers the minimum support, and at least 60 days leave by the ‘employer in the last trimester of her pregnancy; (xiv) Community participation for generating awareness on NNP – active participation of community members in management nutrition programmes & related interventions through beneficiaries committees, participation of women in food production & processing, promoting kitchen gardens, food preservation, preparation of weaning food, generating demand of nutrition services; (xv) Education and literacy; (xvi) Improvement in status of women.

Further to this a National Plan of Action on Nutrition (NPAN) 1995 was laid down focusing on reducing under nutrition which entails a Multi-sectoral approach for accelerated action on determinants of malnutrition.

The NITI Aayog has been mandated to examine the emerging data on under-nutrition and prepare, in consultation with ministries of Women and Child Development and Health and Family Welfare, a specific strategy for poor performing states/districts.

The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today. 
*****
National Child Health Programme 

Under the National Health Mission (NHM), the Government of India is implementing RashtriyaBalSwasthyaKaryakram (RBSK) since 2013, for screening of all the children from 0-18 years of age including school children for 4 Ds i.e. Defects at birth, Deficiencies, Diseases and Development delays including disability.

The State/UT wise number of children examined is given below:-

Number of children screened by RBSK mobile health teams
underRBSK programme in States/UTs in last three years

Sl.
No
States/UTs

2013-14, as on March 2014
2014-15, as on March, 2015
2015-16, as on June, 2015
A.    Non-NE High Focus States
1
Bihar

62,612
0
2
Chhattisgarh

63,399
4,357
3
Himachal Pradesh

8,99,502
0
4
Jammu & Kashmir
88,568
15,27,980
4,14,537
5
Jharkhand

8,833
32,800
6
Madhya Pradesh
7,93,205
90,82,774
35,68,066
7
Odisha
9,17,209
48,97,389
14,49,296
8
Rajasthan
59,96,254
21,04,888
0
9
Uttar Pradesh
1,22,29,486
1,82,06,135
41,00,181
10
Uttarakhand
15,50,876
13,82,535
2,34,353
B. NE States
11
Arunachal Pradesh
2,15,617
2,25,484
41,537
12
Assam
17,95,346
29,44,064
10,90,748
13
Manipur
1,807
83,167
36,140
14
Meghalaya
3,10,869
43,398
41,076
15
Mizoram
92,111
2,52,012
83,409
16
Nagaland
16,474
38,352
49,365
17
Sikkim
77,288
87,083
27,000
18
Tripura
56,258
1,41,422
13,176
C. Non High Focus States
19
Andhra Pradesh
26,34,427
3,79,066
73,136
20
Telangana
NA
0
0
21
Goa
2,24,875
2,17,848
28,533
22
Gujarat
1,49,83,485
1,23,38,318
43,47,072
23
Haryana
9,85,635
28,38,024
4,43,689
24
Karnataka
31,86,441
92,02,678
19,42,652
25
Kerala,
16,66,397
36,46,432
5,27,936
26
Maharashtra
1,46,62,378
1,93,35,990
17,85,849
27
Punjab
44,75,536
29,14,456
5,52,167
28
Tamil Nadu
68,08,232
65,57,027
8,19,830
29
West Bengal
52,44,968
66,17,918
29,98,246
D. Union Territories
30
Andaman and Nicobar

21,383
2,547
31
Chandigarh
96,114
2,22,249
67,008
32
Dadra and Nagar Haveli
69,317
85,364
11,614
33
Daman
31,022
38,329
1,570
34
Delhi
6,30,809
0
0
35
Lakshadweep

0
0
36
Puducherry
97,432
1,34,137
21,107
India
 7.99 crore
 10.66 Crores
2.48 crores

The state-wise/ UT wise financial allocation, utilization as reported by State/UT is given below:-

Financial allocation and utilization under RBSK programme for last three years
Sl. No
States/UTs
2013-14, as on March 2014
2014-15, as on March, 2015
2015-16, as on June, 2015
Approvals (Rs in Lakhs)
Utilisation (Rs in Lakhs)
Approvals (Rs in Lakhs)
Utilisation (Rs in Lakhs)
Approvals (Rs in Lakhs)
Utilisation (Rs in Lakhs)
Till 2nd Qtr.
A. Non-NE High Focus States 
1
Bihar
4626.01
153.98
5850.13
9.92
8739.89
196.69
2
Chhattisgarh
3564.40
4.46
3507.36
1641.46
3880.90
960.59
3
Himachal Pradesh
1245.76
352.62
927.20
543.86
1688.38
104.52
4
Jammu & Kashmir
1753.04
114.33
4459.11
1411.83
4656.04
1658.24
5
Jharkhand
3580.08
116.73
3500.73
0.00
2792.19
32.10
6
Madhya Pradesh
5135.98
588.62
8518.67
3925.12
13354.13
3084.63
7
Odisha
5991.35
986.90
7248.75
3957.82
8307.39
2732.89
8
Rajasthan
3026.24
1.24
2427.77
9.60
6871.45
127.99
9
Uttar Pradesh
15850.78
1909.02
19793.59
14881.12
24709.61
6237.13
10
Uttarakhand
2869.97
516.31
3523.09
2088.81
3390.78
966.15
B. NE States 
11
Arunachal Pradesh
655.64
215.70
709.50
112.94
750.75
97.77
12
Assam
4854.93
501.58
7764.47
1507.69
6944.39
1198.77
13
Manipur
210.29
6.32
854.99
78.57
1745.97
9.06
14
Meghalaya
539.89
29.87
1092.03
87.53
1110.11
256.78
15
Mizoram
329.84
69.78
621.97
271.02
924.34
0.00
16
Nagaland
698.53
22.04
458.82
115.34
439.73
0.00
17
Sikkim
233.83
10.88
151.54
65.15
268.70
47.56
18
Tripura
401.57
8.86
324.77
55.73
604.66
109.30
C. Non High Focus States 
19
Andhra Pradesh
8090.69
381.49
5197.92
423.90
3789.36
204.46
20
Telangana


3189.78
0.00
4184.78
71.73
21
Goa
213.97
11.37
293.76
116.12
312.69
76.58
22
Gujarat
10686.45
1074.71
7790.62
2863.75
9072.04
1808.86
23
Haryana
2081.10
353.07
3801.79
2028.18
3203.92
1170.17
24
Karnataka
4746.99
842.85
6460.84
3308.20
5991.94
1209.15
25
Kerala,
4851.69
418.98
4195.54
751.79
4097.35
1501.66
26
Maharashtra
12002.14
3284.54
15145.68
7157.76
12799.26
3163.11
27
Punjab
2455.56
545.03
3782.49
591.04
3749.24
1615.66
28
Tamil Nadu
4123.49
1277.13
4715.59
0.00
4389.05
52.00
29
West Bengal
12048.78
1026.32
11346.21
4682.81
11799.49
3992.82
D. Union Territories
30
Andaman & Nicobar
94.46
6.25
154.05

208.29
20.04
31
Chandigarh
24.87
0.00
171.11
121.31
207.63
0.00
32
Dadra & Nagar Haveli
103.05
28.53
205.84
0.00
201.55
32.20
33
Daman
80.31
4.64
102.26
91.30
114.09
20.11
34
Delhi
427.61
0.00
19.92
0.00

0.51
35
Lakshadweep
0.00
0.00
18.80
0.45
25.40
0.07
36
Puducherry
38.14
5.88
81.58

86.18
27.01
India
1176.37 Crores
148.70 Crores
1384.08 Crores
529 Crores
1554.12 crores
327.86 crores

Under the initiative, the children identified with any health condition are referred to an appropriate health facility for further management and linking with tertiary level institutions.
The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.
1.            
*****
Implementation of National Mental Health Programme (NMHP) 

In 2005, the National Commission on Macroeconomics and Health reported that 10-20 million (1-2% of population) suffered from severe mental disorders such as schizophrenia and bipolar disorder and nearly 50 million (5% of population) from common mental disorders such as depression and anxiety, yielding an overall estimate of 6.5 per cent of the population. The data regarding casualties related to mental illness is not maintained centrally.
The Government of India is implementing the District Mental Health Programme (DMHP) under the National Mental Health Programme (NMHP) with the objectives to:
                   I.            Provide mental health services including prevention, promotion and long term continuing care at different levels of district healthcare delivery system.

                II.            Augment institutional capacity in terms of infrastructure, equipment and human resource for mental healthcare.

             III.            Promote community awareness and participation in the delivery of mental health services.

             IV.            Broad-base mental health into other related programs.
To address the acute shortage of qualified mental health professionals in the country, the Government, under the National Mental Health Programme (NMHP), is implementing manpower development schemes for establishment of Centres of Excellence and strengthening/ establishing Post Graduate (PG) Departments in mental health specialties. Till date, support has been provided for establishment of 11 Centres of Excellence and strengthening/ establishing 27 PG Departments (in 11 Institutes) in mental health specialties in the country. The Government has approved a proposal for establishment of additional 10 Centres of Excellence and support to strengthen/establish 93 PG Departments during the 12th Five Year Plan Period.
The list of Institutes supported under the Manpower Development Schemes is given below:-
Institutes supported under Manpower Development Schemes
Scheme – A : Centres of Excellence

1.      Institute of Mental Health & Hospital, Agra, Uttar Pradesh
2.      Hospital for Mental Health, Ahmadabad, Gujarat 
3.      State Mental Health Institute, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana
4.      Institute of Psychiatry- Kolkata, West Bengal
5.      Institute of Mental Health, Hyderabad, Andhra Pradesh
6.      Psychiatric Diseases Hospital, Government Medical College, Srinagar, Jammu & Kashmir
7.      Department of Psychiatry, Govt. Medical College, Chandigarh
8.      Mental Health Institute, Cuttack
9.      Institute of Mental Health And Neuro Sciences, Kozhikode
10.  Institute of Human Behaviour and Allied Sciences, Shahdra, Delhi
11.  Maharashtra Institute of Mental Health, Pune
Scheme – B : Strengthening PG Departments

S.No.
Mental Hospital/ Institute
PG Course
1
PDU Medical College, Rajkot, Gujarat
Psychiatric Nursing
2
Government Medical College, Surat, Gujarat
Clinical Psychology
3
CSM Medical University, Lucknow, Uttar Pradesh
Psychiatry
4
Clinical Psychology
5
Psychiatric Social Work
6
Psychiatric Nursing
7
Ranchi Institute of Mental Health and
Neuro Sciences, Ranchi,
Psychiatry
8
Clinical Psychology
9
Psychiatric Social Work
10
Psychiatric Nursing
11
Dr. RML Hospital, Delhi
Psychiatry
12
Clinical Psychology
13
Psychiatric Nursing
14
S.P Medical College, Bikaner, Rajasthan
Psychiatry
15
R. N. T. College, Udaipur, Rajasthan
Psychiatry
16
Institute of Mental Health, Chennai
Psychiatry
17
Psychiatric Nursing
18
LGB Regional Institute of Mental Health, Tezpur, Assam
Psychiatry
19
Clinical Psychology
20
Psychiatric Social Work
21
Psychiatric Nursing
22
Government Medical College, Trivandrum
Psychiatry
23
Clinical Psychology
24
Psychiatric Social Work
25
Psychiatric Nursing
26
NIMHANS, Bangalore
Clinical Psychology
27
Psychiatric Social Work

The details of funds released for the implementation of the DMHP and Manpower Development Schemes under the NMHP during the last three years and the current year are given below:-
Details of funds allocated and released under DMHP and NMHP

(In Rs.crore)
S. No.
Year
Allocation
Releases
1
2012-13
100
50.34
2
2013-14
130
74.34
3
2014-15
268.28
61.56
4
2015-16
*


* District level activities under the National Mental Health Programme along with the National Programme for Control of Blindness, National Tobacco Control Programme and National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke are a part of the NCD Flexible Pool under the National Health Mission for which total allocation at BE stage for 2015-16 is Rs. 554.50 crores. Separately, budget provision of Rs. 35 crore has been made for implementation of tertiary level activities under the National Mental Health Programme.

During the previous plan periods, funds have also been provided for up-gradation of 88 Psychiatric Wings of Govt. Medical Colleges/ General Hospitals and modernization of 29 State run mental hospitals in the country.
The National Trust, under the Ministry of Social Justice and Empowerment, runs several schemes like Samarth (Residential centre), Niramaya (Health Insurance Scheme), Aspiration (Day Care Center), Gyan Prabha (Scholarship Scheme), Uddyam Prabha (Interest Subsidy Scheme), Sahyogi (Caregivers Training Scheme), GHARAUNDA etc. all over the country for the welfare of four disabilities i.e. Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities. The funds under the above schemes are provided by the Ministry of Social Justice and Empowerment.
No proposal for a centrally sponsored insurance scheme to cover mental illness is under consideration in this Ministry presently.
The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today.
1.            
*****
Health Sector of the Country 
The focus of the Government is to provide accessible, affordable and accountable healthcare facilities to all sections of the country. Accordingly, Government of India also provides financial assistance to State/UT Governments for supplementing their efforts in this direction as the health is a State subject. The public expenditure on healthcare provisioning has increased from Rs.88,054crore in 2009-10 to Rs. 1,54,567 crore in 2014-15 (BE) as per Economic Survey 2014-15.

The Government of India has formulated the draft of National Health Policy 2015 in the light of the changes that have taken place in the country’s health sector scenario since the formulation of the National Health Policy 2002.

The public expenditure on health as percentage of GDP stands at 1.2 percent for 2014-15 (BE) as per Economic Survey 2014-15. The Twelfth Five Year Plan envisages increasing total public health funding on core health to 1.87 percent of GDP by the end of the Plan period.

The primary responsibility to regulate the private health care sector rests with the State/UT Governments. The Central Government has enacted the Clinical Establishment (Registration and Regulation) Act, 2010, to provide a legislative framework for the registration and regulation of clinical establishments in the country and also seeks to improve the quality of health services through the National Council for Standards by prescribing minimum standards of facilities and services which may be provided. The Clinical Establishments Act has, however, been adopted only by the States of Sikkim, Mizoram, Arunachal Pradesh, Himachal Pradesh, Uttar Pradesh, Bihar, Jharkhand, Rajasthan, Uttarakhand and all Union Territories except Delhi.

Further, the Medical Council of India (MCI) grants recognition of medical qualifications, gives accreditation to medical colleges, grants registration to medical practitioners, and monitors medical practice in India, through the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. Complaints against medical practitioners with regard to professional misconduct fall within the ambit of the Medical Council of India or the concerned State Medical Council, as the case may be.

In order to meet the country’s needs in health sector, the Government has taken several steps which inter-alia includes:-

• Initiatives under the National Health Mission (NHM) for providing free of cost health care in the public health facilities through a nationwide network of Community Health Centres (CHCs), Primary Health Centres (PHCs) and Sub Centres (SCs) in both rural and urban areas. Various programs such as National AYUSH Mission, RashtriyaKishorSwasthyaKaryakram, RashtriyaBalSwasthyaKaryakram, National Deworming day, Weekly Iron Folic Acid supplementation program, Menstrual Hygiene Program, Mission Indradhanush, KayakalpAbhiyan, Free Drugs and Diagnostic Initiative, Free care for family welfare services, JananiShishuSurakshaKaryakaram (JSSK), free medicines under the various national health programmes like Anti-Malaria and Anti-TB Programmesseek to strengthen various health components.

• Making available tertiaryhealth care services in the public sector through strengthening of hospitals, establishment of AIIMS institutions in the States and up-gradation of existing Government medical colleges across the country.

• Making available quality generic medicines at affordable prices to all, under ‘Jan Aushadhi Scheme’, in collaboration with the State Governments.

• RashtriyaSwasthyaBimaYojana (RSBY) which provides for smart card based cashless health insurance including maternity benefit on family floater basis

The Government has also taken several steps in the direction of preventive health care, which inter-alia include Universal Immunization of children against seven diseases; Pulse Polio Immunization; Family Planning services; Maternal and Reproductive Health Services; Child Health services that include both home based and facility based New born Care; Adolescent Reproductive and Sexual Health (ARSH) services; Investigation/ screening and treatment for Malaria; Kala-azar, Filaria, Dengue; Japanese Encephalitis and Chikungunya; Detection and treatment for Tuberculosis including MDR-TB; Detection and treatment for Leprosy; Detection, treatment and counseling for HIV/AIDs; Cataract surgery for Blindness control.

Further, under RashtriyaBalSwasthyaKaryakram (RBSK) support is being provided to States/UTs for child health screening and early intervention services through early detection and early management of common health conditions classified into 4 Ds i.e. Defects at birth, Diseases, Deficiencies, Development delays including disability. A comprehensive National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) for activities including health promotion, early detection and treatment of Cancer, Diabetes, Cardiovascular diseases and Stroke, has also been initiated.

The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today. 
*****
Health Care for the Elderly 

Keeping in view the recommendations made in the “National Policy on Older Persons” as well as the State’s obligation under the “Maintenance & Welfare of Parents & Senior Citizens Act 2007”, the Ministry of Health & Family Welfare had launched the “National Programme for the Health Care of Elderly” (NPHCE) during 2010-11 to address various health related problems of the elderly people.

The major objectives of the NPHCE are establishment of Department of Geriatric in identified Medical Institutions as Regional Geriatric Centres for different regions of the country and to provide dedicated health facilities in District Hospitals, Community Health Centres (CHCs), Primary Health Centres (PHCs) and Sub-Centres (SCs) levels through State Health Society.

The following facilities are being provided under the programme:-

                               I.            Geriatric OPD, 30 Bedded ward for in-patient care etc. at Regional Geriatric Centres.
                            II.            Geriatric OPD and 10 bedded Geriatric Ward at District Hospitals.
                         III.            Bi-weekly Geriatric Clinic at Community Health Centres (CHCs).
                         IV.            Weekly Geriatric Clinic at Primary Health Centres (PHCs)
                            V.            Provision of Aids and Appliances at Sub-centres.

As on date, a total of 104 districts of 24 States/UTs and 08 Regional Geriatric Centres have been covered under the programme. Details of activities undertaken at different levels under the NPHCE as per information available are enclosed below:-

Activities initiated at different levels under the NPHCE

Institution
Institutions covered under NPHCE
OPD
Indoor wards
Physiotherapy
Equipments
District Hospital
104
68
58
48
43
CHCs
832
403
NA
171
334
PHCs
4032
1018
NA
NA
646
SCs
27173
NA
NA
NA
4541

NA=Not applicable

Details of funds released to the States/Union Territories during 2012-13 to 2014-15 and the current year are given below:-

NATIONAL PROGRAMME FOR HEALTH CARE OF THE ELDLERY (NPHCE)
Statement  Showing Allocation/Release of fund and Expenditure (As on 31.05.2015)
Sl. No
Name of the States

Rs. In Lakhs


2012-13

2013-14

2014-15

2015-16*



GIA Released by GOI
Expenditure  Reported By the State
GIA Released by GOI
Expenditure  Reported By the State
GIA Released by GOI
Expenditure Report By the States
GIA Released by GOI
Expenditure Report By the States
s1
Andhra Pradesh
871.52
0
0
1.37
0
0
0.00
0.00
2
Assam
0
23.44
0
128.61
142.27
53.55
3333.00
32.72
3
Bihar
446.72
13.28
0
83.02
150
134.91
597.00
0.00
4
Chhattisgarh
229.2
23.39
50.94
121.24
99
49.2
526.00
0.00
5
Gujarat
225.44
85.28
0
99.5
215.66
230.87
1551.00
71.54
6
Haryana
0
65.73
0
133.86
77.62
48.81
331.00
32.83
7
Himachal Pradesh
0
0
0
19.15
11.85
68.04
263.00
3.03
8
Jammu and Kashmir
0
218.29
0
126.76
0
84.94
629.00
0.00
9
Jharkhand
0
1.28
0
20.42
111
37.77
790.00
22.37
10
Karnataka
0
151.78
0
158.3
170.95
16.33
1187.00
13.65
11
Kerala
470.72
88.88
0
122.81
150
749.74
467.00
0.00
12
Madya Pradesh
391.84
150.26
0
237.09
209.45
81.54
2681.00
35.55
13
Maharashtra
426.96
412.22
0
145.36
203.64
239.44
2375.00
37.95
14
Odisha
374.56
109.35
33.89
354.15
116
140.71
1065.00
32.95
15
Punjab
196.24
31.51
0
171.31
111.36
48.14
312.00
0.10
16
Rajasthan
711.2
147.65
0
61.94
87.05
23.15
2704.00
476.53
17
Sikkim
0
77.46
31.08
43.27
44
0
66.00
53.10
18
Tamil Nadu
344.16
0
0
0
0.42
0
1300.00
0.00
19
Uttarakhand
81.04
56.77
0
94.14
0
11.24
624.00
1.11
20
Uttar Pradesh
1855.04
0
0
188.77
0
0
3626.00
40.66
21
West Bengal
231.2
0.95
0
88.9
150
18.58
0.00
12.98
22
Daman and Diu
0
0
0
0
24.34
0
35.00
0.00
23
Lakshadweep
0
0
0
0
95.66
0
0.00
0.00
24
Mizoram
0
0
0
0
119.06
0
137.00
0.00

Total
6855.84
1657.52
115.91
2399.97
2289.33
2036.96
24599.00
867.07
* No separate allocation of funds has been made for National Programme for Health Care of the Elderly (NPHCE), during 2015-16. NPHCE is the part of NCD flexible pool under the National Health Mission for which total allocation at BE stage for 2015-16 is Rs. 527.36 crores.

At present, Government had launched following programmes/schemes i.e. under which, inter alia health care facilities are being provided to elderly people also in the country.
       I.            National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)- The programme is being implemented under National Health Mission (NHM) for intervention upto the district level includes awareness generation for Cancer prevention, screenining, early detection and referral to an appropriate level institution for treatment.

    II.            National Programme for Control of Blindness (NPCB)This programme was launched in the year 1976 as a 100% centrally sponsored scheme with the goal of reducing the prevalence of blindness to 0.3% by 2020.  Rapid Survey on Avoidable Blindness conducted under NPCB during 2006-07 showed reductionin the prevalence of blindness from 1.1% (2001-02) to 1% (2006-07.  Under this programme there are provision for distribution of free spectacles to old persons suffering from presbyopia and free treatment for cataract surgery.


 III.            National Oral Health Programme: Taking into account the oral health situation in the country, Government of India has initiated a National Oral Health Programme to provide integrated, comprehensive oral health care in the existing health care facilities with a view to improve the determinants of oral health, reduce morbidity from oral diseases, integrate oral health promotion and provide preventive services.

 IV.            National Programme for Prevention and Control of Deafness (NPPCD): This Ministry has launched this programme on the pilot phase basis in the year 2006-07(January 2007).  Under this programme, hearing-aid is provided as per synergy between Assistance to Disabled Persons (ADIP) Scheme of Ministry of Social Justice & Empowerment (MSJE) and National Programme for Prevention and Control of Deafness (NPPCD) of Ministry of Health & Family Welfare. At present, the Programme is being implemented in 281 districts of 27 States and 6 Union Territories. 
The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.
1.            
*****
AIIMS Like Institutions in the Country 


The AIIMS like Institutions at Bhopal, Bhubaneswar, Jodhpur, Patna, Raipur and Rishikesh, in the first phase of PradhanMantriSwasthyaSurakshaYojana(PMSSY), are functional. AIIMS at Rae Bareli, under the Phase-II of PMSSY, is under construction.
Proposals have been received from 13 states for setting up of new AIIMS like institutions and colleges. Land/site details furnished by the State Governments are given below:-
Land/site details furnished by the State Government
S.No.
State’s Name
Location as per requirement

(i)
Andhra Pradesh
Govt. of Andhra Pradesh identified single location at MangalgiriMandal in Guntur District for setting of up AIIMS in Andhra Pradesh.
(ii)
Arunachal Pradesh
Suggested only single location without proper details.
204 acres Located around 30 km (approx.) from Itanagar via NH 52 A (Hollongi-Itanagar road) under Tubung Village of Balijan Circle, Papum Pare District, Arunachal Pradesh.
(iii)
Assam
Suggested three locations-
(a) DimoriaMouza in Kamrup (Metro) district.
 (b) Kamalpur revenue circle in Kamrup district.
 (c) ShahariMouza of Raha in Nagaon district
  Further, State Govt has identified another site at North Guwahati.
(iv)
Goa

State Government has identified only single location which is situated in Dhargar village of PernemTaluka
(v)
Gujarat
State Government has identified four suitable sites in two district of the State namely Rajkot and Vadodara:

(a)Village-Chokari and Village Pavda, TalukaPadra, District, Vadodara;
(b)Village- Khirasara (Ranmalji),  Tehsil- Lodhika,       District- Rajkot
(c)Village-Khandheri, Tehsil- Padadhari, District Rajkot ;
  (d) Village-Para Pipaliya, Tehsil-Rajkot, District Rajkot
(vi)
Himachal Pradesh
Kothipura in BilaspurDistt
(vii)
Jharkhand
State Govt. has identified location for new AIIMS at Devipur in Deoghar
(viii)
Karnataka
State Government has identified three locations in the state –
(a)Harohalli in Ramanagar District near Bangalore.
(b)Itagatti in Dharwad District.
(c)District Hospital Campus, Bijapur (Canter Distt. Head Quarters)
(ix)
Kerala
State Government has identified following four locations:
(a)    Thiruvananthapuram District-KattakadaTaluk, Kallikadu Village, Block 31, Resurvey 66
      (b) Kottayam District-Arpookkara, Athirampuzha and        Peraicakadu villages
      (c) Ernakulam District- Block No.5, 717/5,  Block No.6,  321/1
     (d) Kozhikode District- Kinalur and Kanthalad villages in PanangadGramaPanchayath, ThamarasseryTaluk.
(x)
Maharashtra
Govt. of Maharashtra identified location at Nagpur in Nagpur District for setting of up AIIMS in Maharashtra.
(xi)
Tamil Nadu
State has identified locations at:
 (a) Chengalpattu in Kancheepuram District   
(b) Pudukkottaitowm in  Pudukkottai  District
(c) Sengipatti in Thanjavur District                
(d) Perundurai in Erode District              
(e) Thoppur in Madurai District
(xii)
Telangana
State Govt. has identified location for new AIIMS at Bibinagar in Telenagana
(xiii)
West Bengal
Govt. of West Bengal identified location at Kalyani in Nadia District for setting of up AIIMS in West Bengal.

Also, the Finance Minister in his Budget Speech for the year 2014-15, announced for setting up four AIIMS, one each in Andhra Pradesh, Vidarbha Region (Maharshtra), West Bengal and Purvanchal in Uttar Pradesh. In the Budget Speech for the year 2015-16, the FM has proposed to set up AllMS in Jammu and Kashmir, Punjab, Tamil Nadu, Himachal Pradesh and Assam. Of these, the Cabinet on October 7th, 2015 has approved the setting up of AIIMS-like institute in Andhra Pradesh, West Bengal and Maharashtra. The Ministry has also finalized the site for the setting up of AIIMS-like institute in Punjab at Bathinda.The timeline for setting up of such tertiary level health care facilities would depend upon the receipt of due approvals.
The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.


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