Under the National Health Mission, the Ministry of Health and Family Welfare provides technical and financial support to the States/UTs to strengthen the public healthcare system including to take measures to improve healthcare infrastructure in rural areas to support and retain medical professionals based on the proposals received in the form of Programme Implementation Plans (PIPs) under National Health Mission. Government of India provides financial approval for the proposal in the form of Record of Proceedings (RoPs) as per norms & available resources. The details are available in public domain at: https://nhm.gov.in/index1.php

Under NHM, following types of incentives and honorarium are provided for encouraging healthcare professionals including females to practice in rural and remote areas of the country:

• Hard area allowance to specialist doctors for serving in rural and remote areas and for their residential quarters so that they find it attractive to serve in public health facilities in such areas.
• Honorarium to Gynecologists/ Emergency Obstetric Care (EmoC) trained, Pediatricians & Anesthetist/ Life Saving Anaesthesia Skills (LSAS) trained doctors is also provided to increase availability of specialists for conducting Cesarean Sections in rural & remote area.
• Incentives like special incentives for doctors, incentive for Auxiliary Nurse and Midwife (ANM) for ensuring timely Antenatal Checkup (ANC) checkup and recording, incentives for conducting Adolescent Reproductive and Sexual Health activities.
• States are also allowed to offer negotiable salary to attract specialist including flexibility in strategies such as “You Quote We Pay”.
• Non-Monetary incentives such as preferential admission in post graduate courses for staff serving in difficult areas and improving accommodation arrangement in rural areas have also been introduced under NHM.
• Multi-skilling of doctors is supported under NHM to overcome the shortage of specialists. Skill upgradation of existing HR is another major strategy under NRHM for achieving improvement in health outcomes.

In addition to the National Health Mission, Government of India has implemented the following to improve healthcare infrastructure in rural and urban areas of the country:

• Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) envisages increased investments in public health and other health reforms to provide better access to health in rural areas by i) Strengthening of Health and Wellness Centres in villages and cities for early detection of diseases; ii) Addition of new critical care-related beds at district level hospitals; iii) Support for Block Public Health Units (BPHU) in 11 high focus States; and iv) Integrated district public health laboratories in all districts.

• The Fifteenth Finance Commission (FC-XV) has recommended grants through local governments for specific components of the health sector and spread over the five-year period from FY 2021-22 to FY 2025-26 to facilitate strengthening of health system at the grass-root level.

Further, as per the ‘Guidelines for Human Resources for Health, National Health Mission (NHM)’, States/ UTs should make sure that living quarters/lodging facilities are provided to the HRH, especially in rural and difficult areas, close to the health facilities. The State may also explore the option of providing crèche facilities for women working with the NHM in the Block/District/ State offices.

The Union Minister of State for Health and Family Welfare, Shri Prataprao Jadhav stated this in a written reply in the Rajya Sabha today.

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HFW/ Steps taken to expand healthcare professionals in rural areas/25 March 2025/4