1. Steps taken by the Government of India for COVID-19 containment and management

The WHO declared COVID-19 a pandemic on 11th March and asked all countries to take urgent and aggressive action against this public health crisis.  As on 21stDecember, 2020, 222 countries/territories worldwide are affected.

With India’s endeavor to manage COVID-19 through a whole of government & whole of society approach, India has been able to limit its cases and deaths.As on 29thDecember, 2020, a total of 10,224,303confirmed cases (with 2,68,581 active cases comprising 2.62% of the total cases) have been reported in India. 98,07,569(95.%92) cases have recovered while the cases fatality is 1.45%, one of the lowest globally.

The increasing magnitude of this outbreak in India called for a pre-emptive, pro-active, graded, whole-of-government, whole-of-society approach, built around a comprehensive strategy to prevent infections, save lives and minimize impact.

Government of India initiated a series of actions to prevent entry of the disease and to contain it. Hon’ble Prime Minister himself interacted with the Chief Ministers of all States and UT administrations and all stakeholders to regularly understand issues and collaborate with the States for effective COVID management. Group of Ministers under the Chairmanship of Health and Family Welfare Minister Dr. Harsh Vardhan, consisting of Minister of External Affairs, Minister of Civil Aviation and Minister of State for Home Affairs, Minister of State for Shipping and Minister of State for Health & Family Welfare met 22 times since its inception on 3rdFebruary, 2020. Committee of Secretaries under Cabinet Secretary took regular reviews with all related Ministries of Health, Defence, Ministry of External Affairs, Civil Aviation, Home, Textiles, Pharma, Commerce and other officials including with State Chief Secretaries.

Govt. of India has constituted 11 Empowered Groups on 29th March 2020 on different aspects of COVID-19 management in the country to take informed decisions on issues ranging from (i) medical emergency planning, (ii) availability of hospitals, isolation and quarantine facility, disease surveillance and testing, (iii) ensuring availability of essential medical equipment, (iv) augmenting human resource and capacity building, (v) supply chain and logistics management, (vi) coordination with private sector, (vii) economic and welfare measures, (viii) information, communications and public awareness, (ix) technology and data management, (x) public grievance and (xi) strategic issues related to lockdown. These groups have been restructured on 10th September based on the need and evolving scenario.

The Health Ministry held video conferences with States regularly. The Joint Monitoring Group (JMG) under the Chairmanship of DGHS which advises MoHFW on technical matters has met several times till now to assess the risk, review the preparedness & response mechanisms and finalize technical guidelines.

Government of India, based on its experience of successfully managing pandemics and epidemics in the past, provided the requisite strategy, plans and procedures to the State Governments and UT administrations. This included containment plans and guidelines on a wide range of subjects related to travel, behavioural & psycho-social health, surveillance, laboratory support, hospital infrastructure, clinical management, rational use of Personal Protective Equipment (PPE) etc., including inspirational guidance for healthcare personnel.

Government of India also undertook several other measures to contain/suppress the transmission of COVID. The first Travel Advisory was issued on 17thJanuary, 2020 and as situation evolved, the travel advisories were revised in a graded manner. Universal screening of passengers from all countries was introduced and up to 23rd March, 2020 (till suspension of all commercial flights), a total of 14,154 flights with 15,24,266 passengers were screened at the airports. In addition to airports, about 16.31 lakh persons were screened at land border crossings and about 86,379persons were screened at 12 major, 65 minor sea ports.

Government of India has advised no scheduled international commercial passenger aircraft be allowed to take off from any foreign airport for any airport in India, from March 22, 2020 except under Vande Bharat Mission on May 7th 2020, which aimed to bring home stranded Indians in many countries due to COVID-19 pandemic. A ‘Guidelines for International arrivals’ was also been issued by the Ministry on 24thMay, 2020, which were revised on 2nd August, 2020.

A dedicated call center / helpline (1075) was started in the initial days to guide community at large which is being used by the citizens very effectively and on a regular basis. Community surveillance was initiated initially for travel related cases and subsequently for cases being reported from community by Integrated Disease Surveillance Programme (IDSP).

Ministry of Health & Family Welfare released containment plans to contain cluster and large outbreaks on 2nd March and 4^th April, 2020 respectively and these plans were updated from time to time. The containment plans envisage a strategy of breaking the chain of transmission by (i) defining containment and buffer zones, (ii) applying strict perimeter control, (iii) intensive active house to house search for cases and contacts, (iv) isolation and testing of suspect cases and high risk contacts, (v) quarantine of high risk contacts, (vi) intensive risk communication to raise community awareness on simple preventive measures and need for prompt treatment seeking and (vii) strengthening of passive Influenza Like Illness (ILI)/ Severe Acute Respiratory Illness (SARI) surveillance in containment and buffer zones.

The laboratory network is continuously being strengthened. From a situation of a single laboratoryequipped to undertake testing for COVID in January, by the end of December, 2288 laboratories (as on 30th December 2020) are conducting COVID-19 Testing. Laboratories have been established in difficult terrains like Ladakh, Sikkim, Arunachal Pradesh, Nagaland as well as other North Eastern states, Lakshadweep and Andaman & Nicobar island.Currently the testing has crossed 1.5 million tests a day, much higher than that stipulated by WHO which is 140 tests per million population per day. A total of 17,09,22,030 samples have been tested so far as on 30th December 2020.While there were no indigenous manufacturers of laboratory diagnostics or testing machines for COVID, today India has an indigenous production capacity of more than 10 lakh kits/day.

A three-tier arrangement of health facilities was created for appropriate management of COVID-19 cases, [(i) COVID Care Center with isolation beds for mild or pre-symptomatic cases; (ii) Dedicated COVID Health Centre (DCHC) with oxygen supported isolation beds for moderate cases and (iii) Dedicated COVID Hospital (DCH) with ICU beds for severe cases] has been implemented. Tertiary care hospitals under ESIC, Defence, Railways, paramilitary forces, Steel Ministry etc. have been leveraged for case management.

As on 29th December 2020, a total of 15,378 COVID treatment facilities with 12,67,127 dedicated isolation bed without O2 have been created. Also, a total of 2,70,710 oxygen supported isolation beds and 81,113 ICU beds (including 40,627 ventilator beds) have been created. Constant monitoring of the disease trend, analysis of available infrastructure and planning in advance for the future has averted a major crisis as was faced by many developed countries. In addition, a total of 12,669 quarantine centres with 5,91,496 beds have been created.

Guidelines on Clinical management of COVID-19 were issued and regularly updated and widely circulated. These included case definition, prevention of infection control, laboratory diagnosis, early supporting therapy, management of severe cases and complications. In addition, provisions for investigational therapies were also made for using Remdesivir, Convalescent plasma and Tocilizumab for managing severe cases under close medical supervision.

With the intent to ensure dissemination of these standard treatment protocols and reduce mortality to maximum extent, a number of initiatives were launched. An AIIMS Corona helpline 9971876591 was started to guide the doctors on medical management. AIIMS Delhi hosts the COVID-19 National Tele-consultation Centre (CoNTeC) which can be reached by calling +91-9115444155. It caters to doctors, from anywhere in the country, who want to consult AIIMS faculty for the management of COVID-19 patients, as well as to the public in general. Telemedicine guidelines have been issued to provide tele-consultation to patients for mitigation of their illness and prevention of crowding in clinics. It may also help in triage, treatment and counseling for care of ill patients by healthcare providers in areas with limited access.

A clinical Center of Excellence (CoE) initiative was also launched by the Ministry with AIIMS, Delhi as apex nodal institution and State level CoEs to provide guidance on clinical management protocols. Weekly webinars are being organized by AIIMS to guide these State level CoEs on crucial clinical issues that doctors may require guidance on managing COVID cases. These State level CoEs are expected to further disseminate these in their districts.

To ensure accessibility of quality treatment for both COVID and non-COVID health issues, to far flung areas, use of telemedicine has been promoted in a big way. 'eSanjeevani', a web-based comprehensive telemedicine solution is being utilized (in23states) to extend the reach of specialized healthcare services to masses in both rural areas and isolated communities. As on 29thDecember 2020, more than 11 lakh tele-consultations have been held on this digital platform.

ICMR is establishing a National Clinical Registry on COVID that will provide insights into clinical course of COVID-19 disease, its spectrum and outcome of patients.

To coordinate procurement and distribution of COVID vaccine, Government of India has constituted a National Expert Group on Vaccine Administration for COVID-19 on 7thAugust, 2020, under the Chairmanship of Member (Health), NITI Aayog.

Government of India has constituted the INSACOG (Indian SARS-CoV-2 Genomics Consortium) comprising 10 labs (NIBMG Kolkata, ILS Bhubaneswar, NIV Pune, CCS Pune, CCMB Hyderabad, CDFD Hyderabad, InSTEM Bengaluru, NIMHANS Bengaluru, IGIB Delhi, NCDC Delhi) for genome sequencing.

2. Ayushman Bharat

 

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• Comprehensive Primary Health Care (CPHC) through Ayushman Bharat Health and Wellness Centres (AB-HWCs) – Ayushman Bharat aims to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level by adopting a continuum of care approach. In the lifetime of an individual, the primary healthcare services cater to 80-90% of the healthcare needs. The preventive and promotive healthcare needs for the improved healthcare outcomes and quality of life of the population.
• The Primary Health Care team will ensure that community outreach and population enumeration are done for individuals in their catchment area and screened for communicable diseases and non-communicable diseases for early detection and timely referral for accurate diagnosis. The team will further ensure that treatment adherence and follow-up care are provided to the patients in the community. These centres are aimed at delivering primary healthcare services closer to the people and be the first point of contact for healthcare provisioning and referral for secondary and tertiary care. Thus, the essential health services along with the provisioning of essential medicines and diagnostics are provided closer to the community through these centres, as a step towards building stronger and resilient primary healthcare systems which cater to the healthcare needs of the population.

0. • Ayushman Bharat comprises of two components:
1. The first component pertains to creation of 1,50,000 Health and Wellness Centres (AB-HWCs) by upgrading the Sub Health Centres (SHCs) and rural and urban Primary Health Centres (PHCs), in both urban and rural areas, which will bring health care closer to the community. These centres will provide Comprehensive Primary Health Care (CPHC), by expanding and strengthening the existing Reproductive & Child Health (RCH) and Communicable Diseases services and by including services related to Non-Communicable Diseases (common NCDs such as, Hypertension, Diabetes and 3 common cancers of Oral, Breast and Cervix) and incrementally adding primary healthcare services for Mental health, ENT, Ophthalmology, Oral health, Geriatric and Palliative care and Trauma care as well as health promotion and wellness activities like yoga. A few States/UTs have already started rolling out these additional packages in a phased manner.

2. The second component is the Ayushman Bharat-Pradhan Mantri Jan ArogyaYojana(AB-PMJAY). Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), around 10.74 crore poor and vulnerable families identified as per Socio-Economic Caste Census are entitled for health cover of Rs. 5.00 lakh per family per year for secondary and tertiary care hospitalization. As of 13.11.2020, 32 States/Union Territories are implementing the scheme and over 1.4 crore hospitalizations amounting to approx. Rs.17,300 Crores have been authorized under the scheme. Additionally, over 1.4 lakh hospitalizations amounting to Rs. 315 crore have been authorized under the inter-State portability feature. Also, so far, 12.66 crore e-cards (including cards issued by the State Governments) have been issued under the Scheme for facilitating easy availing of benefits.

 

2.1 a. Status update on AB-HWCs:

• • The Guidelines for four expanded package of services have been developed in consultation with the States/UTs incorporating the experiences of the States/UTs which have already rolled out the expanded services and remaining three guidelines are under finalization. 
  • App version of the AB-HWC portal was also launched by the Honourable HFM on the 12^th of July to enable geo-tagging the location of these AB-HWCs and entering the daily service delivery parameters by the frontline healthcare workers.
  • A Fit Health Worker Campaign was also launched at these centres to enable the screening and early detection of non-communicable diseases in the Frontline-Health Care Workers. This enabled the screening of more than 12 lakhs in 502 districts till 1^st December 2020 to enable them to take preventive, promotive and curative measures and also caution them towards their risk categorization towards Covid19 as these Frontline Workers (FLWs) were not only involved in ensuring essential services at these centres but also played a crucial role in community-based surveillance and pandemic outbreak management related activities in the community.
  • These centres also conduct various wellness related activities like Yoga, Zumba, Meditation etc. which not only enable improved physical health but also mental wellbeing of the community. It is envisaged that these centres will not only be the point of delivery for healthcare services, but at the same time enable the community to take health in their own hands.  This is in addition to the 39 Health Calendar Days which are being done at these focussing on different health promotion activities.
  • In coordination with School Education Department, School Health and Wellness Ambassadors Initiative has been launched to train two teachers per school as Ambassadors on the preventive and promotive healthcare and it is planned to implement in more than 200 districts in the coming year
  • Similarly, all States/UTs have started training of ‘Eat Right’ and ‘Eat Safe’ module to the primary healthcare team at these functional AB-HWCs.
  • Regional reviews of all the States and UTs are being organized virtually at the National Level to understand the implementation challenges in expanding the roll-out during the Covid19 pandemic. The best practices adopted by the States / UTs to ensure the continuity of healthcare services are also showcased and disseminated to other States / UTs for cross-learning.

 

2.1 b. Achievement and Service Delivery at AB-HWCs :

• So far, approvals for more than 1,04,860 Ayushman Bharat-Health & Wellness Centres have been accorded to the States/UTs (except Delhi) and as reported by the States/UTs on the AB-HWC Portal, 50,927 Health & Wellness Centres have been operationalized till 01^st December, 2020 which includes 28,320 SHC level AB-HWCs, 18,972 PHC level AB-HWCs and 3,635 UPHC level AB–HWCs.
• As per the data update done by the States/UTs in HWC Portal, till date, About 6.5 Crore screenings done for hypertension and around 5 Cr screenings done for Diabetes at these AB-HWCs. Similarly, these functional AB-HWCs have done more than 3.27 Crore screenings for oral cancer, more than 1.21 Crore screenings for cervical cancer in women and more than 1.78 Crore screenings for breast cancer in women.
• Further, as on 01.12.2020, total of 33.07 lakhs Yoga/Wellness Session have been conducted in operational HWCs.
• Primary healthcare team at the Sub Health Centre level AB-HWCs is headed by Community Health Officers (CHO) - who is a BSc/GNM Nurse or an Ayurveda Practitioner trained in primary care and public health skills and certified in a six months Certificate Programme in Community Health or Graduate from Integrated nursing curriculum and other members of the team being, Multi-Purpose Workers (Male and Female) and Accredited Social Health Activists (ASHAs). The training programme is being carried out with support from IGNOU and State specific Public/Health Universities. 276 IGNOU Programme Study Centres (PSCs) have been notified so far and another 272 PSCs have been notified under the state specific Certificate Programme in the state of Maharashtra (107), Tamil Nadu (07), Gujarat (59), Uttar Pradesh (66) and West Bengal (33), taking the total of Programme Study Centres (PSCs) to 548 PSCs across the country.
• Since the screening, prevention and management of chronic illnesses including NCDs, TB and Leprosy have been introduced at AB-HWCs, training and skill upgradation of the primary health team in all the functional AB-HWCs on NCDs and use of IT application is undertaken.
• To promote wellness and healthy life style, orientation of the public on wellness activities for lifestyle modification like increased physical activity (cyclathons and marathons), eating RIGHT and SAFE, cessation of Tobacco and drugs, meditation, laughter clubs, open gyms, etc. besides conduct of Yoga Session is carried out at these centres on regular basis. Through Annual Health Calendar, planned activities at these centres on the health condition of the day are resulting in increased awareness and preventive measures to be adopted by the public
• The telemedicine guidelines have also been provided to the States to initiate specialist consultations from the PHCs to the Hub Hospitals. So far, 23,817 AB-HWCs have initiated the tele-consultations.

 

2.2 Human Resources:

NHM has attempted to fill the gaps in human resources by providing nearly 2.65 lakh additional health human resources to the States including 11,921 GDMOs, 3,789 Specialists, 73,619 Staff Nurses, 81,978 ANMs, 44,314 Paramedics, 460 Public Health Managers and 17,222 Programme Management staffs appointed on contractual basis. Apart from providing financial support for hiring human resources, NHM has also focused on multi skilling of human resources and providing technical support for human resources in health sector in the form of technical guidance and training. NHM also supports co-location of AYUSH services in health facilities such as PHCs, CHCs and DHs. A total of 27,495 AYUSH doctors and 4626 have been deployed in the states with NHM funding support.

2.3 Mainstreaming of AYUSH:

Mainstreaming of AYUSH has been taken up by allocating AYUSH services in 7,785 PHCs, 2,748 CHCs, 496 DHs, 4,022 health facilities above SC but below block level and 371 health facilities other than CHC at or above block level but below district level.

2.4 Infrastructure:

Up to 33% of NHM funds in High Focus states can be used for infrastructure development.  Details of new construction/renovation as on June, 2020 undertaken across the country under NHM are as follows:

 

Facility	New Construction			Renovation/Upgradation
	Sanctioned	Completed	Sanctioned		Completed
SC	28150	21249	23225		16548
PHC	2941	2371	15858		13428
CHC	620	499	7339		6379
SDH	242	159	1238		1011
DH	175	148	3227		2407
Others*	1328	803	1673		847
Total	33456	25229	52560		40620

* These facilities are above SCs but below block level.

 

2.5 National Ambulance Services (NAS):  

As on date, 35 States/UTs have the facility where people can dial 108 or 102 telephone number for calling an ambulance. Dial 108 is predominantly an emergency response system, primarily designed to attend to patients of critical care, trauma and accident victims etc. Dial 102 services essentially consist of basic patient transport aimed to cater the needs of pregnant women and children though other categories are also taking benefit and are not excluded. JSSK entitlements e.g. free transport from home to facility, inter facility transfer in case of referral and drop back for mother and children are the key focus of 102 service. This service can be accessed through a toll-free call to a Call Centre. Presently, 10,599 Dial-108 and 10,480 (Dial-102/104) Emergency Response Service Vehicles are supported under NHM, besides 5,412 empanelled vehicles for transportation of patients, particularly pregnant women and sick infants from home to public health facilities and back.

2.6 National Mobile Medical Units (NMMUs):

 Support has been provided in 504 out of 716 districts for 1677 MMUs under NHM in the country. To increase visibility, awareness and accountability, all Mobile Medical Units have been positioned as “National Mobile Medical Unit Service” with universal colour and design.

2.7 Free Drugs Service Initiative:

Under this Initiative, substantial funding is being given to States for provision of free drugs and setting up of systems for drug procurement, quality assurance, IT based supply chain management system, training and grievance redressal etc. Detailed Operational Guidelines for NHM-Free Drugs Service Initiative were developed and released to the States on 2nd July, 2015. 

All the States and UTs have notified policy to provide essential drugs free in health facilities. Drugs procurement, quality system and distribution has been streamlined through IT enabled Drugs Distribution Management Systems in 30 States/UTs, 36 States/UTs have centralized procurement through a corporation/procurement body, 29 States/UTs have NABL accredited labs to ensure quality of drugs provided, 33 States/UTs have facility wise EDL, 14 States/UTs have prescription audit mechanism and 22 States have established call center based grievance redressal mechanism with dedicated toll free number.

2.8 Free Diagnostics Service Initiative: 

To address the need of accessible and quality diagnostics in public health facilities, Ministry of Health and Family Welfare (MoHFW) launched Operational guidelines on Free Diagnostics Service Initiative in consultation with experts and the States officials and disseminated among States/UTs in July 2015. The government envisaged that this health intervention will reduce both direct costs and Out of Pocket expenditure. This guideline supports States/UTs to provide essential diagnostics-Laboratory services and Radiology services (Tele radiology and CT scan Services) at their public health facilities. As on 1^stNovember 2020, free diagnostics laboratory services have been implemented in 33 States/UTs. (In 11 States/UTs it is implemented in PPP mode and in 22 States/UTs it is in In-house mode). Free Diagnostics CT Scan services have been implemented in 23 States/UTs (In 13 States/UTs it is implemented in PPP mode and in 10 States/UTs it is in In-house mode). Free Tele Radiology Services have been implemented in 11 States/UTs in PPP mode.

The second edition of Free Diagnostics Initiative has been released which provide a broader view of the expanded basket of laboratory services envisaged under National Health Mission. A dissemination workshop was organised by NHSRC to guide States/UTs for implementation of the guidelines. In PIP 2020-21, NHM approved support for 11 States/UTs for implementation of revised guidelines of Free Diagnostics Initiative.

2.9 Biomedical Equipment Maintenance and Management Programme:

To address the issue of non-functional equipment across public health facilities, comprehensive guidelines were designed on Biomedical Equipment Management and Maintenance Program (BMMP) and disseminated among States/UTs. As on 1^st November 2020, BMMP has been implemented in 31 States/UTs (In 24 States/UTs it is implemented in PPP mode and 7 States/UTs it is in In-House mode). The implementation of BMMP has helped in improving diagnostics services in health facilities by making equipment available with 95% uptime, thereby reducing cost of care and improving the quality of patient care in public health facilities. Biomedical Equipment Management and Maintenance Program technical guidance document for in-house support and monitoring of public private partnerships is circulated to States/UTs. A two-day virtual dissemination workshop was organised in September 2020 to guide States/UTs on implementation of guidelines.

2.10 Community Participation:

1. Accredited Social Health Workers: There are 10.61 lakh ASHAs across the country in rural and urban areas under the NHM who act as a link between the community and the public health system.  The Union Cabinet has  approved increase in amount of routine and recurring incentives under National Health Mission for ASHAs that will now enable ASHAs to get at least Rs 2000/- per month against Rs 1000 earlier. The cabinet has also approved proposal to cover all ASHAs and ASHA facilitators meeting eligibility criteria under Pradhan Mantri Jeevan Jyoti Bima Yojana and Pradhan Mantri Suraksha Bima Yojana which would be fully funded by Government of India.

 

Under the Pradhan Mantri Shram Yogi Maandhan (PM-SYM) PM-SYM which has been rolled out nation-wide on 15th February, 2019 and is a voluntary contributory pension scheme to ensure old age protection for unorganized workers between 18 and 40 years of age with a monthly income of Rs.15000/- or below ,the ASHAs and ASHA Facilitators in the specified age group are invariably eligible under the scheme. The scheme requires self-certification, 50% of the monthly contribution for the pension scheme will be contributed by the Central Government while the remaining 50% is to be contributed by the beneficiary. The amount varies with the age of the beneficiary and it will be auto-deducted from the bank account of the beneficiary. The Ministry of Labour and Employment has made the provision of bulk enrolment facility as well through CSC-SPV. The beneficiaries under the scheme will receive minimum assured pension of Rs 3000/- per month after attaining the age of 60 years.

 

2. VHSNCs: 5.53 lakh Village Health Sanitation and Nutrition Committees (VHSNCs) at village level have been constituted across the country to facilitate village level healthcare planning. More than 12.55 crore Village Health & Nutrition Days (VHNDs) have held so far.

 

3. VHSNCs: 5.53 lakh Village Health Sanitation and Nutrition Committees (VHSNCs) at village level have been constituted across the country to facilitate village level healthcare planning. More than 12.55 crore Village Health & Nutrition Days (VHNDs) have held so far.

 

4. The Untied Grants to Sub-Centres (SCs): At the Village Level, the Village Health, Sanitation and Nutrition Committee (VHSNC) monitors the services provided by the Aanganwadi Worker, the ASHA and the sub-centre. These Committees are envisaged to function under the ambit of the Panchayati Raj Institution with adequate representation from women and weaker sections of the society. The VHSNC acts as a subcommittee or statutory body of the Gram Panchayat. The same institutional mechanism is also mandated in urban areas. VHSNCs are provided an untied fund of Rs 10,000 on annual basis which are topped up based on expenditure of previous year. More than 5.53 lakh VHSNC have been set up across the country till June, 2020. The capacity building of VHSNC members with regards to their roles and responsibilities for maintaining the health status of the village is being done in many states.

 

2.11 24 X 7 Services and First Referral facilities:

To ensure service provision for Maternal and Child Health, 24x7 services at the PHCs have been made available. 10,430 PHCs have been made 24x7 PHCs and 2953 facilities (including 698 DH, 712 SDH and 1543 CHCs & other level) have been operationalized as First Referral Units (FRUs) under NHM.

 

2.12 MeraAspataal:

'MeraAspataal' is a patient feedback system which was launched in September 2016 with a mandate to integrate Central Government Hospitals (CGHs) & District Hospitals (DHs) on the feedback portal. It has now been extended upto CHC, Rural & Urban Primary Health Centre and private medical colleges and is currently functional in 34 States/UTs. Till 31.03.2020, 4695 facilities were integrated into the ‘MeraAspataal’ portal with 2061 facilities integrated in the F.Y. 2019-20.

2.13 Kayakalp:         
As part of contribution towards the Swachh Bharat Abhiyaan launched by the Prime Minister on 2^nd October 2014, the Ministry of Health & Family Welfare, Government of India launched “Kayakalp - Award to Public Health Facilities. As on 11^th November 2020, 12 Central Government (more than 80%), 352 DHs, 1459 SDHs/CHCs, 3675 PHCs, 808 UPHCs, 7 UCHCs, 307 HWCs have scored more than 70%. Total 6620* facilities have been awarded under this scheme in FY 2019-20.

2.13 Swachh Swasth Sarvatra:

Swachh SwasthSarvatra is a joint initiative of Ministry of Health & Family Welfare and Ministry of Drinking Water and Sanitation was launched in December 2016 to achieve better health outcomes through improved sanitation and increase awareness on healthy lifestyle. Under this initiative, one-time grant of Rs.10 Lakhs is provided to the non-Kayakalp awardee CHC located in the ODF block as a resource for improving the deficiencies found in the Kayakalp assessment, so that at least in the next assessment, they become Kayakalp awardee.

2.14 Prime Minister’s National Dialysis Programme:

PMNDP (Hemo-dialysis) has been implemented in total 35 States / UT in 503 Districts at 882 Dialysis Centres by deploying 5490 machines. Total of 8.52 lakh patients availed Dialysis services and 86.37 Lakh Hemo-dialysis Sessions held as on 30th September 2020. In 2020 alone, a total of 2.76 Lakh patients received 27.9 Lakh Haemodialysis sessions between January to November.

Under PMNDP, Peritoneal dialysis (PD) has been introduced and guidelines for peritoneal dialysis have been launched on 10th October 2019. With the introduction of peritoneal dialysis, home based dialysis treatment with minimal supervision and lesser disruption to normal lifestyle and so does not put additional incremental burden on the existing healthcare infrastructure. PD also reduces travel to the dialysis centers for treatment and allows greater flexibility and freedom in treatment schedule. In PIP 2020-21, NHM approved PD program support for 20 States/UTs for approx. 4000 patients.

2.15 National Quality Assurance Programme:

Quality in delivered health care services is important for improving the health status of the population. It enhances accessibility, increases efficiency, strengthens clinical effectiveness and improves user satisfaction. With the aim of improving quality of care, the Ministry of Health and Family Welfare launched the National Quality Assurance Standards (NQAS) for District Hospitals in 2013 and subsequently for other health facilities. These standards are internally accredited by ISQua (International Society for Quality in Healthcare). These standards are also recognized by IRDA and NHA. At present, a total of 667 Public Health facilities have achieved National Quality Certification nationally.

To promote practice of cleanliness, hygiene & sanitation, and controlling the hospital acquired infection, Kayakalp award scheme was launched in 2015 for Central government institutions and state’s public health facilities. Kayakalp has now been extended to the Health & Wellness centres in all States/UTs. Maternal and Newborn health remains a priority for the country. For ensuring quality and safety in ‘care around birth’, LaQshya initiative was launched in 2017. Incremental growth in LaQshya certified departments has led to national level certification of 264 Labour Rooms and 229 Maternity Operation Theatres.

Apart from this, recognizing the need to captures the voice of patients for enhanced patient experience and continued learning India launched its own centralized IT platform i.e. ‘Mera-Aspataal’/ ‘My Hospital’ in 2018. As of now, more than 5300 government health facilities and around 722 non-governmental health facilities are integrated with Mera-Aspataal across 34 states and UTs. Under Free Drugs Service Initiative, substantial funds have been given to States for provision of free drugs. All States/UTs have notified policy to provide essential drugs free in health facilities. Drugs procurement, quality system and distribution has been streamlined through based Drug Distribution Management System in 29 States.

To provide Comprehensive Primary Health Care (CPHC) through Health and Wellness Centres (AB-HWCs), Essential Medicines List (EML) for SHC and PHC have been finalized. To strengthen the Free Drugs Service Initiative (FDSI), Indian Public Health Standards (IPHS) guidelines are being revised for Sub-Centres, Primary Health Centres (PHCs), Community Health Centres (CHCs), Sub District Hospitals (SDHs), District Hospitals (DHs) and also being developed for Urban Health (U-PHC). Essential Drugs are the integral part of IPHS guidelines to support the healthcare system in achieving sustainable Development Goal.

2.16 National Urban Health Mission

National Urban Health Mission (NUHM) was approved on 1st May, 2013 as a sub-mission under an overarching National Health Mission (NHM), NRHM being the other sub-mission. NUHM envisages strengthening the primary health care delivery systems in urban areas and for providing equitable and quality primary health care services to the urban population with special focus on slum dwellers and vulnerable population. It also seeks to de-congest secondary and tertiary health care facilities (District Hospitals/Sub-District Hospitals/Community Health Centre) by providing robust comprehensive Primary health care services in urban areas.

NUHM covers all cities and towns with more than 50,000 populations and district headquarters and State headquarters with more than 30,000 population. The remaining cities/ towns continue to be covered under National Rural Health Mission (NRHM). As part of Ayushman Bharat, the existing UPHCs are being strengthened as Health & Wellness Centres (HWCs) to provide preventive, promotive and curative services in cities closer to the communities.

9370158. NUHM, the Centre-State funding pattern is 60:40 for all the states w.e.f. FY 2015-16, except all North-Eastern states and other hilly States viz. Jammu & Kashmir, Himachal Pradesh and Uttarakhand, for which the Centre-State funding pattern is 90:10. In the case of UTs, from FY 2017-18, the funding pattern of UT of Delhi and Puducherry has been revised to 60:40 and rest of the UTs without legislature are fully funded by Central Government.

Implementation of NUHM is through the State Health Department or the Urban Local Bodies (ULBs). In seven metropolitan cities, viz., Mumbai, New Delhi, Chennai, Kolkata, Hyderabad, Bengaluru and Ahmedabad the implementation is through the ULBs. For the other cities, the State Health Department decides whether the NUHM is to be implemented through them or the other urban local bodies. So far, 1068 cities have been covered under NUHM in 35 States/UTs.

2. Achievements Of NUHM:

1. Physical Progress:

The programme is being implemented in the States/UTs for more than 6 years period and accounts for presence of augmented infrastructure and human resources dedicated towards urban areas. According to the 4^thQuarterly Progress Report (QPR) i.e. for period Jan-March, 2020 submitted by the States/UTs, the information regarding progress of activities approved under NUHM is as follows: -

· 2331 Medical Officers in-position against 3463 approved

· 178 Specialists in-position against 409 approved

· 6122 Staff Nurse in-position against 9146 approved

· 13151 ANMs in-position against 16321 approved

· 2755 Pharmacist in-position against 3577 approved

· 2923 Lab Technician in-position against 3924 approved

· 406 Public Health Managers in-position against 681 approved

· 1197 Programme Management staff in-position at State/District/City level against 1523 approved

· So far, 1068 cities/ towns covered under NUHM

· 4870 existing facilities approved for strengthening as Urban PHCs

· 782 new U-PHCs construction approved

· 81 new U-CHCs construction approved

· 83 Mobile Health Units approved

· 602 Health Kiosks approved

 

For slum habitations

1. 63025 ASHAs engaged against 74468 approved. (One ASHA covers 200 to 500 households)
2. 81169 MahilaArogayaSamiti (MAS) formed against 92993 approved. (One MAS covers 50-100 households)

Kayakalp and SwachhSwasthSarvatra (SSS) have been expanded to cover urban areas also and U-PHCs have been awarded Kayakalp awards. Out of 35 States/UTs, 12 States and UTs declared Kayakalp awards for FY 2019-20, of which 439 urban health facilities won Kayakalp awards.

To ensure delivery of Comprehensive Primary Health Care (CPHC) services under Health and Wellness Centre component of Ayushman Bharat, the existing UPHCs are being strengthened as Health and Wellness Centres (HWCs). Support for training of PHC staff (Medical Officers, Staff Nurses, Pharmacist, and Lab Technicians), necessary IT infrastructure and the resources required for upgrading laboratory and diagnostics for expanded ranges of services is being provided to the States. So, far 3339 HWCs have been made operationalized in urban areas as on March, 2020.Training and review workshops were conducted for roll-out of CPHC-HWC in urban areas in collaboration with NHSRC.

2. Financial Progress:

Since the launch of NUHM in FY 2013-14 till the Nov 10^th, 2020, funds to the tune of Rs. 7788.48 Crore and Rs. 6205.36 Crore have been allocated and released respectively to the States/ UTs for implementation of the programme activities.

3.Reproductive, Maternal, Newborn, Child, Adolescent Health Plus Nutrition (RMNCAH+N)

3.1 Immunization

1. Electronic Vaccine Intelligence Network (eVIN) rollout: Till FY 2019-20, eVIN system was functional in 24 States/UTs and in FY 2020-21, eVIN has been expanded to the rest of the States/UTs to cover the entire country.

2. Pneumococcal Conjugate Vaccine (PCV) expansion to all the Districts of Uttar Pradesh: Till FY 2019-20, PCV was available in Bihar, Himachal Pradesh, Madhya Pradesh, Rajasthan and 19 Districts of Uttar Pradesh and Haryana (State initiative). In FY 2020-21, PCV has been expanded to all the Districts of UP, thus covering the entire State.

3. Sustaining Routine Immunization during COVID-19 pandemic: Clear strategy & guidelines have been developed and special efforts have been made to sustain Routine Immunization, conduct Sub National Immunization Days for Polio and conduct surveillance for Vaccine Preventable Diseases (VPDs) during the COVID-19 pandemic.

3.2 Maternal Health

1. As per the report of Sample Registration System (SRS) released in  July 2020 by the Registrar General of India (RGI), Maternal Mortality Ratio (MMR) of India has declined from 122 per 100,000 live births in 2015-17 to 113 per 100,000 live births in 2016-18.

 

2. SurakshitMatritvaAashwasan (SUMAN): Ministry of Health & Family Welfare (MoHFW) launched the SUMAN Initiative on 10^th October 2019 with the aims to provide assured, dignified, respectful and quality healthcare, at no cost and zero tolerance for denial of services, for every woman and newborn visiting the public health facility in order to end all preventable maternal and newborn deaths and morbidities and provide a positive birthing experience. Under SUMAN, all existing schemes for maternal and neonatal health have been brought under one umbrella in order to create a comprehensive and cohesive initiative which goes beyond entitlements and provides a service guarantee for the entitlements.
3. Midwifery Educator Training: The Government of India has taken a policy decision to roll out Midwifery Services in the country in order to improve the quality of care and ensure respectful care to pregnant women and newborns. “Guidelines on Midwifery Services in India, 2018” was released during the Partners Forum held in December 2018 at New Delhi. The first batch of 6 months Midwifery Educators training has been initiated on 6^th Nov 2019 at National Midwifery Training Institute, Telangana.
4. Pradhan Mantri SurakshitMatritva Abhiyan (PMSMA):
   • Since inception, more than  2.60 crore Ante-Natal Care (ANC) check-ups conducted, more than  19.61 lakhs High risk pregnancy identified and more than 6,000 volunteers registered under PMSMA.
   • In the FY 2020-21 (upto 9^th December 20),  16.78 lakhs ANC checkups conducted under PMSMA, whereas more than 2.36  lakhs High Risk Pregnancy identified and 274 volunteers registered under PMSMA.
5. LaQshya:
   • Since the inception (December 2017) of LaQshya (upto 9^th November 2020) ,  263 Labour Rooms and 229 Maternity OTs have achieved National Certification under LaQshya.
   • During FY 2020-21 ,  08 Labour Rooms and 08  Maternity OTs have been Nationally certified for LaQshya.
6. JSY:  40.04 lakhs beneficiaries received benefits under JSY during the period of April-September 2020  (provisional data, 2020-21 ).

7. Comprehensive Abortion Care (CAC): More than 14,500 MOs have been trained in CAC trainings upto June, 2020. Virtual training of trainers (ToT) on CAC has been conducted for Ladakh Union Territory in the month of November 2020.

 

3.3 Child Health

1. Facility Based Newborn Care (FBNC) program:  894 Special Newborn Care Units (SNCUs) at District/ Medical College Level and 2,579 Newborn Stabilization Units (NBSUs) at the level of FRUs/ CHC levels are functional to provide services to sick and small newborns. A total of 6.73 lakhs sick newborns received treatment in Special Newborn Care Units (SNCUs) at District Hospitals and Medical Colleges (April-November, 2020).
2. The country has recently celebrated “National Newborn Week-2020” with the commitment of “Ensuring Quality, Equity and Dignity of Newborn Care at Every Health Facility and Everywhere”. Two very important harmonized training packages under Facility Based New-born Care Program – “NavajatShishu Suraksha Karyakaram (NSSK)” and “New-born Stabilization Units (NBSUs)” for capacity building of health care providers were released by Hon’ble Union Minister of Health and Family Welfare (H&FW) on 20^th November 2020.
3. Home Based Newborn Care (HBNC) program: A total of  25.38 lakh newborns received complete schedule of home visits by ASHAs whereas 80,774 identified sick newborns were referred to health facility by ASHAs during the period of April-June 2020.
4. Home Based Care of Young Child (HBYC): For FY 2020-21, the existing 242 Districts (2019-20) have been expanded with additional 275 Districts i.e. total 517 Districts for providing Home Based Care for Young Child (HBYC) program. More than 29.5 Lakhs young children (3 months-15 months) visited by ASHAs during April-September, 2020.

5. Under, Intensified Diarrhoea Control Fortnight (IDCF), 2019,  10.01 crore children up to five years of age were provided with ORS and Zinc against the target of 13.37 crore children of the same age group. The data compilation for the IDCF/Diarrhoea prevention activities for the 2020 round is in process. 
6. National Deworming Day (NDD): During  10^th round of NDD conducted in  February 2020, around  11.02 crore children in the age group of 1-19 years had been provided Albendazole tablets against the target of 11.66  crore children of the same age group. 11^th round of NDD is being implemented in 34 States and UTs during the period of August-November, 2020.
7. Nutrition Rehabilitation Centres: Nearly  2.25 Lakhs Severe Acute Malnutrition (SAM) children with medical complications received treatment at 1,072 Nutrition Rehabilitation Centres during 2019-20. During 2020-21 (April-September’20) , 32,129 Severe Acute Malnutrition (SAM) children with medical complications received treatment at 1,077 Nutrition Rehabilitation Centres (NRCs).
8. Lactation Management Centres (LMCs): As of FY 2020-2021, till June 2020 (1^st quarterly progress report), 15 CLMCs and 2 LMUs are established in 7 States (Maharashtra, West Bengal, Goa, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh).

1. AnemiaMukt Bharat (AMB) program (April-September, 2020)
   •  1.11 crore children of age group 6-59 months were provided 8-10 doses of Iron Folic Acid (IFA) Syrup every month
   • 50.7 lakh children of age group 5-9 years were provided 4-5 IFA Pink tablets every month
   •  62.4 lakh children of age group 10-19 years (in school) provided 4-5 IFA Blue tablets every month
   •  16.7 lakh children of age group 10-19 years (out of school girls) provided 4-5 IFA blue tablets every month
   •  1.04 crore pregnant women and  9.74 lakh lactating women were provided 180 IFA Red tablets.

10. Rashtriya Bal Swasthya Karyakram (RBSK): During FY 2020-21, due to COVID 19 pandemic field activities by Mobile Health Teams of RBSK Program got affected. 19.31 Lakhs newborn screened at Delivery points under RBSK Program during April-September, 2020).
11. Social Awareness and Actions to Neutralize Pneumonia Successfully(SAANS): SAANS Campaign rolled-out in the States/ UTs from 12^th November, 2020 – 28^th February 2021 with aims at accelerating action against Childhood Pneumonia by generating awareness around protect, prevent and treatment aspects of Childhood Pneumonia and to enhance early identification and care seeking behaviours among parents and caregivers.

3.4 Family Planning

1. Total Sterilization: 6.46 lakh sterilizations have been reported  In 2020-21 (upto November 2020)
2. Post-partum IUCD (PPIUCD): A total of 13.41 lakh PPIUCD insertions have been reported in FY 2020-21 (upto November 2020) with PPIUCD acceptance rate of 16.5%.
3. Contraceptive Injectable MPA (Antara Program): A total of  8.10 lakh doses have been administered across the country in FY 2020-21 (upto November 2020) .
4. Non-hormonal Pill Centchroman (Chhaya) - A total of  25.90 lakh strips of Centchroman have been reported in FY 2020-21 (upto November 2020)

e) Mission Parivar Vikas (MPV) - MPV was launched in November 2016 for substantially increasing access to contraceptives and family planning services in 146 High Fertility Districts in seven high focus States with Total Fertility Rate (TFR) of 3 and above. These Districts are from the States of Uttar Pradesh (57), Bihar (37), Rajasthan (14), Madhya Pradesh (25), Chhattisgarh (2), Jharkhand (9) and Assam (2) which constitutes 44% of the country’s population. The performance in FY 2020-21 (upto November 2020) is as follows:

• Number of Sterilizations -    34,633
• Number of PPIUCD insertions -  1.38 lakh

3.5. Rashtriya Kishor Swasthya  Karyakram (RKSK)

12.85 lakh adolescents received counselling and clinical services at Adolescent Friendly Health Clinics (AFHCs). The number of AFHCs increased from 7,980 (in March 2020) to 8,020 in September 2020.

 47.73 lakh adolescents had been provided Weekly Iron Folic Acid Supplementation (WIFS) every month besides Nutrition Health Education till October 2020.

Significant progress has been made in implementation of Peer Education program with selection of 78,098 Peer Educators in FY 2020-21 (upto September 2020).

 10,934 Adolescent Health Days (AHDs), a quarterly village level activity to create awareness about adolescent health issues and available services were conducted till September 2020. .

School Health and Wellness Ambassador Initiative Under Ayushman Bharat:

Government of India has recently launched Health and Wellness Ambassadors Initiative under Ayushman Bharat to promote a healthy lifestyle among students. It is a joint initiative of the Ministry of Health and Family Welfare and the Department of School Education & Literacy, Ministry of Education.

The aim of the programme is to foster the growth, development and educational achievement of school going children by promoting their health and wellbeing. A total of 11 themes have been identified.

3.6Pre-Conception and Pre-Natal Diagnostic Techniques (PC & PNDT):

• As per Quarterly Progress Report (QPR) of June 2020, submitted by the States/UTs, total 68,818 diagnostic facilities have been registered under the PC& PNDT Act. So far, a total of 2,220 machines have been sealed and seized for the violations of the law. A total of 3,116 court cases have been filed by the District Appropriate Authorities under the Act and 6017 convictions have so far been secured, leading to suspension / cancellation of   medical licenses of 145 doctors.

• 28th meeting of Central Supervisory Board (CSB) under PC & PNDT Act, 1994 held on 2nd December, 2020. Due to the pandemic COVID-19, the same was held on a virtual platform.
• Ultrasound equipment is notified vide No. S.O. 3721(E) dated October 16, 2019, as a drug under the Drugs and Cosmetic Act 1945, accordingly, licenses from Drug Controller of India, shall be mandatory for selling / importing/ R&D of Ultrasound Machines. This has come into effect from November 1st, 2020.
• Six Months Training Rules, 2014 are amended vide notification no. G.S.R. 419 (E) dated 26/06/2020. Notification is laid down on Table of both houses of parliament. Amendments have widened scope of the training rules: Teacher to Student Ratio is increased to 1:4 from 1:1 and the criteria for MCI/NHC recognized and number accredited training Institutes has expanded.
• Review meetings were conducted in four states including (Karnataka, Gujarat, Tamil Nadu and Maharashtra).
• Capacity building of District Appropriate Authorities and PNDT Nodal Officers was conducted in the State of Delhi.
• Training of public prosecutors was organized with the support of Delhi Judicial Academy for the state of Delhi.
• The continuous and consistent efforts of the Centre along with the cooperation of States and other stakeholders, the sex ratio at birth is beginning to show an upward increase. The improvement of the sex ratio at birth at the national level is of 3 points going up from from 896 in 2015-17 to 899 in 2016-18.  Further, 15 states out of 22 surveyed states, have shown improvement with maximum of 15 points recorded in Rajasthan followed by Himachal Pradesh (12 points), Gujarat (11 points), Haryana, Assam, and J&K by 10 points.
• Under Five Mortality Rate (U5MR) among Girls, a strong indicator of gender discrimination, has recorded a constant decline from 45 in 2015 to 36 in 2018 as per the latest Sample Registration Survey (SRS) report 2018. Further, the Gender Gap in Under Five Mortality Rate in the Country has fallen to 1 in 2018 from 5 points in 2015. 

4.National Tuberculosis Elimination Programme to (NTEP)

        Given the ambitious target of achieving the Sustainable Development Goal (SDG) of eliminating Tuberculosis (TB) by 2025, five years ahead of the Global Targets, the name and logo of the programme was changed this year from the Revised National Tuberculosis Control Programme (RNTCP) to the National Tuberculosis Elimination Programme to (NTEP) to epitomize the ultimate goal.

        A total of 14.75 lakh TB patients were notified under the programme from January to October 2020, a decrease of 27% (20.28 lakh cases) as compared to the same period in 2019. This decrease in TB notification is due to the impact of the COVID-19 pandemic on TB services, repurposing of available resources and manpower, as well as various restrictions imposed to contain the pandemic. 36,514 Drug Resistant TB patients were notified during this period. Between January and August 2020, about 1, 27,816 persons have been notified from tribal populations.

        From April 2018 onwards, 36.8 lakh TB patients were paid Rs 928.8 Cr under Nikshay Poshan Yojana towards nutritional support till September 2020.

The following steps were taken to mitigate the impact of COVID-19 and provide uninterrupted TB services:

• Advance directives to ensure continuity of TB services were issued and review with States/Districts conducted to monitor the delivery of services.
• Implementation of bi-directional TB-COVID screening: COVID screening for all diagnosed TB patients and TB screening for all COVID positive patients.
• TB screening and testing for all presumptive ILI/SARI/COVID cases in all COVID Zones (Red, Orange, and Green)
• Guidance on TB diagnostic labs to remain functional and usage of Personal Protective Equipment by Laboratory staff were issued.
• Integrated TB-COVID laboratory services including pre-treatment evaluations for DR-TB and DS-TB for optimal utilization of platform technologies were formulated.
• Decentralized molecular diagnostics at block levels for TB & COVID screening –Replacement of smear microscopy by NAAT testing for all presumptive TB cases
• Effective sample collection and transportation system from Sub Centre to PHC, PHC to CHC and from CHC to District /CDST/IRLs
• Home sample collection services in Red Zones / Containment areas
• Active TB case finding campaign in green zone and areas with no / minimal COVID cases

• Contact tracing for close household and workplace contacts for all infectious TB cases
• Home based sample collection and strengthening of transport mechanisms to nearby testing centers.
• Provision of at least one-month supply of drugs to the patients’ doorstep.

5. National Tobacco Control Programme (NTCP)

Tobacco use and COVID-19: In view of the increasing danger of COVID-19 pandemic, advisories/directives were issued to States/UTs, to take necessary measures under the appropriate law to prohibit the use and spitting of chewing smokeless tobacco products in public. Smoking damages lungs and other organs, putting the smokers at higher risk of complications due to COVID-19 and as such States were requested to undertake awareness campaign to make general public aware on risks associated with smoking during COVID-19. The MoHFW has also undertaken awareness campaigns to make people aware about the risk associated with the tobacco use and spitting in public especially during this COVID-19 pandemic.

Prohibition of Electronic Cigarettes: The Government of India prohibited electronic-cigarettes and like devices through ‘The Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement) Ordinance, 2019” on 18^th September, 2019 and the same was replaced by Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement) Act, 2019 on 5^th December, 2019. This prohibition has been brought with the objective of nipping the problem in the bud, anticipating the danger in case of spread of addiction due to e-cigarettes and as such decisive pre-emptive action was taken to prevent the problem rather than trying to solve the problem after it acquires unmanageable.

6. Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)

The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) envisages creation of tertiary healthcare capacity in medical education, research and clinical care, in the underserved areas of the country.  It aims at correcting regional imbalances in the availability of affordable/reliable tertiary healthcare services and also augmenting facilities for quality medical education in the country.  The scheme had two broad components :

• Setting up of AIIMS like Institutions;
• Up-gradation of old Government Medical Colleges (GMCs).

During the last fifteen years, construction of 22 new AIIMS and 75 Government Medical Colleges up-gradation Projects has been approved under this scheme.

6.1 Six AIIMS under Phase-I:

Six AIIMS approved under Phase- I (AIIMS-Bhopal, AIIMS-Bhubaneswar, AIIMS-Jodhpur, AIIMS-Patna, AIIMS-Raipur and AIIMS- Rishikesh) are already fully functional.  All key hospital facilities and services such as Emergency, Trauma, Blood Bank, ICU, Diagnostic and Pathology are functioning.

More than 1000 hospital beds increased during this year.

100 PG seats and 150 MBBS seats have been increased during this year.

Dedicated hospitals block for treatment of CoVID-19 patients and CoVID test Lab made functional in these AIIMS during this year.

6.2 Other New AIIMS under Phase-II, IV, V, VI & VII: 

16 AIIMS have been sanctioned/approved by Cabinet in subsequent phases. For 2^nd new AIIMS in Bihar, site at Darbhanga has been finalized and Cabinet approval obtained during this year.

Limited OPD services was already functional in 5 AIIMS viz. Nagpur, Raebareli, Mangalagiri, Gorakhpur and Bathinda.  Limited OPD facility at Bibinagar and limited IPD Facilities for treatment of CoVID -19 patients started at AIIMS Mangalagiri, AIIMS Nagpur and AIIMS Bathinda during this year. CoVID test Lab is also functional in AIIMS Mangalagiri and AIIMS Nagpur.

Undergraduate MBBS course with 100 seats per annum per AIIMS was already functional at eight new AIIMS viz. Mangalagiri, Nagpur, Raebareli, Kalyani, Gorakhpur, Bathinda, Deoghar and Bibinagar. 1^st session of undergraduate MBBS course with 50 seats started from the current session (2020-21) at four new AIIMS viz. Guwahati, Jammu, Rajkot and Bilaspur.

Construction was already progressing in 9 AIIMS, viz. AIIMS Raebareli, Nagpur, Mangalagiri, Kalyani, Gorakhpur, Bathinda, Bilaspur, Guwahati and Deoghar. Construction of AIIMS at Awantipura( in Kashmir) ,  Sambha ( in Jammu ) and Rajkot ( in Gujarat) started  during this year.

6.3.Up-gradation of existing GMCs  :

Up-gradation programme broadly envisages improving tertiary health infrastructure through construction of Super Speciality Blocks / Trauma Care Centres etc. in existing Government Medical College /Institutions (GMCIs). 

Since inception of the scheme, 46  projects of Super Speciality Hospitals / Trauma Centre in existing Govt Medical Colleges / Institutions  have been completed, adding more than 10000 Super-specialty beds including 2000 ICU beds. Following 3 projects have been completed during this year.

 

 

In addition to above, Construction works of Super Specialty Block completed in following 05 GMCs during this year.

 

 

The SSB and Trauma Centres made functional at 22 GMCs being utilized currently as dedicated hospitals blocks for treatment of CoVID-19 patients. More than 5000 isolation beds and 1250 ICU bed facilities created.

7. Medical Education

1. The historic National Medical Commission Act was passed by the Parliament in August, 2019. Now, the National Medical Commission has been constituted with effect from 25^th September, 2020 and the years old MCI has been dissolved and the Indian Medical Council Act, 1956 has been repealed. The principal change in the regulatory mechanism is that the regulator will be primarily ‘selected’ rather than ‘elected’. The National Medical Commission will steer the reforms in medical education. This will include increase in UG  & PG seats alongwithimproved access to quality and affordable medical education and maintaining high ethical standards in medical profession. Some of the key area in which NMC will work include - implementation of National Exit Test (NEXT) for the medical graduates, guidelines for determination of fee for 50% seats in private medical colleges and Deemed Universities, Regulations for Community Health Providers and rating of medical colleges.
2.   During the last six years, MBBS Seats increased by 30,301 (i.e. 55.75%) from 2014 (54,348 seats) to 2020 (84,649 seats) and the number of PG seats increased by 24,084 (i.e. 79.77%) from 2014 (30,191 seats) to 2020 (54,275 seats).
3. Further, during the same period, 179 new medical colleges have been established and now the country has 562 (Govt: 286, Pvt: 276) medical colleges.
4. Under the Central Sponsored Scheme for establishment of new medical colleges, establishment of 157 medical colleges have been approved in three phases, of which 47 are functional and remaining will be functional in few years. Of these 157 colleges, 39 are coming up in the Aspirational Districts of the country thereby addressing the issues of inequity in medical education.
5. Rationalization of Minimum Standards Requirements (MSR): The MSRs for establishment of medical college have been streamlined. This will reduce the cost of establishment of new medical college and increase of intake capacity.
6. Two years post MBBS Diplomas by National Board of Examinations: Keeping in view the importance of Diploma courses to meet the shortfall of postgraduate students and augment healthcare in remote parts of the country, the National Board of Examinations (NBE) has launched diplomas in eight disciplines namely - Anaesthesia, Gynaecology & Obstetrics, Pediatrics, ENT, Opthalmology, Family Medicine, Tuberculosis & Chest Diseases and Medical Radiodiagnosis.
7. District Residency Scheme for Post-Graduation: The MCI has also notified a Scheme known as District Residency Scheme for compulsory three months training of PG medical students at District Hospitals an essential component of postgraduate medical training curriculum. Under the Scheme, the second/third year PG students of medical colleges would be posted in the district hospitals for a period of three months.
8. The constitution of the National Medical Commission has ushered in a landmark reform in the sector of Medical Education. On similar lines, the Government is striving to bring institutional reforms in the sector of nursing and dental education by passage of reformative legislations to replace the existing Indian Nursing Council Act, 1947, and Dentists Act, 1948. The Government is also in the process to address the long standing vacuum of a regulatory body for various professions included in the allied and healthcare sector by providing for a National Commission for Allied and Healthcare Professions, and a Bill to that extent has already been introduced in the Rajya Sabha. The basic premise and principled change that is happening in all these professional education sectors is that the Regulator is now being ‘selected on merits’, as opposed to an ‘elected’ regulator.

8. Central Government Hospitals

8.1Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital (ABVIMS & Dr RML Hospital)

1. Starting of MBBS Course: Directorate General of Health Services/ Ministry mandated PGIMER and Dr. RML Hospital to start MBBS course with intake of 100 students from academic session 2019-20. The name of the Institute has also been changed to “Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital”. Now the Institute has state of art Labs, Dissection Hall, Examination Hall, Lecture Theatres, Museum etc.
2. Super Specialty Block: Hospital has planned to construct a new 600+ bedded Super Specialty Block (SSB) comprise of 3 basements + GF+ 11 Upper Floors at a vacant plot available at G-Point of the Hospital. The EFC in its meeting held on 18.02.2019 approved the project at a total cost of Rs 572.61 Crore. CPWD has been nominated as the Project Management Consultant. Tender has been awarded by CPWD and the expected period of completion of project is 24 months.
3. New Hostel Block: The Institute has planned to construct 824 Rooms New Hostel Block at the vacant land available in the campus. The total cost of the project is 178 crore. HSCC is the Project Management Consultant. The work upto the 5^th Floor level has been completed.
4. Dr. RMLH has already received Paediatric Cath Lab and soon department of Paediatric Cardiology will be started and it will be first of its kind in the country in a Government hospital.
5. Dr. RMLH is in the process of procurement of Robotic System. This will be used by different surgical specialities to perform complex operations. This gives enormous benefit to patients, who have to undergo difficult and complicated surgery.
6. Doctors of Dr. RMLH have already been trained for Liver Transplantation and this will be started in near future after getting all necessary approvals.
7. E-office has been started in Dr.RMLH
8. Dr. RMLH was made the first Corona nodal centre in the country by MoH&FW, GoI. Corona patient management has been done in OPD and also dedicated admission facility and ICU facilities were created. RtPCR tests for all suspected patients were routinely done. In addition to above, 150 bedded COVID Care Centre at Vishwa Yuva Kendra, Chanakyapuri was managed by Dr.RMLH.

 

8.2 Lady Hardinge Medical College & Associated Hospitals.

1. LHMC with Associated Hospital actively participated for providing treatment facilities in COVID-19 PANDEMIC which started in 2020.

Following facilities were created: -

1. Red Zone

I. Ward – 24 + 22 = 46

II. COVID ICU Beds = 30

III. Orange Zone Beds = 103 (for suspected cases)

2. Various infrastructures added for Treatment of COVID-Patients.

I. Capacity of Ventilatory beds increased by 30 beds.

II. Number of BIPAP machines – 32.

III. HHFO-facilities added.

IV. Sufficient quantities of Pulse Oxymeters available, PPE Kits, N-95 masks and others consumables.

V. Number of beds increased with O2 supply >50 beds.

VI. Flu-Clinic for screening of COVID patients.

3. COVID-19 TESTING FACILITY:

I. LHMC was one of the Ist institution to start COVID-19 testing facility in shortest possible time for testing by following methods:

1. RTPCR
2. CB NAAT
3. TRUNAT

Initially services were provided to all major hospitals where testing facilities were not available. More than 40,000 cases have been tested.

II. State of Art- Sampling Centers constructed for taking sample.

4. LHMC team of doctors and paramedical staff ran YMCA COVID-CARE CENTRE.
5. LHMC Doctors were part of Central team for Inspection of facilities and training in various states.
6. LHMC is running facilities for both COVID and NON-COVID patients in all departments. Maternity and child care services are being run with great care.
7. Creative Problem Solving Initiatives:

I. Telemedicine facilities

II. Blended teaching

III. Students focused youth wellness initiatives, including self-help groups by providing counseling facilities.

2. Comprehensive Redevelopment Plan (CRP) of LHMC:-

(a) ONCOLOGY BLOCK and ACADEMIC BLOCK are ready for possession and likely to be handed over to LHMC by HSCC before 31st December 2020.

(b) Accident Emergency and OPD Blocks are likely to be ready by 31st March 2021.

3. Post-Graduate Seats: 24 Post-graduate have been increased in LHMC against EWS quota.

4. Teaching Activities: For Undergraduates, Postgraduates, Post-doctoral courses.

(a) In COVID-Situation, combination of On-line Teaching along with practical training are being carried out keeping COVID-19 protocols under consideration.

(b) Regular clinical meetings are held on ONLINE platform.

(c) Post-graduate examination was held through Video-conferencing testing practical skills and theoretical knowledge.

5. Annual convocation is being held on 12-12-2020 through Video-Conferencing with Hon’ble HFM as Chief Guest.

6. Lab Information System (LIS) as a part by Hospital Management Information System (HMIS) has been initiated in LHMC to provide Computer generated lab report and can be seen by treating doctors for taking quick decisions on treatment of patients.

7. LHMC & Associated Hospitals are in the category of Super-Speciality hospitals for PMJAY.

 

8.3 Safdarjung Hospital

1. COVID – 19 Pandemic Management :-

The Safdarjung Hospital has been actively involved in the management of COVID – 19 patients as per the guidelines of ICMR and the instructions of Dte.GHS& MOHFW i.e hemogram, coagulation profile and biomarkers in Covid 19 positive patient etc.

a). The whole Super specialty Block (SSB) is converted into a dedicated separate block for treatment of COVID-19 patients.

b) A dedicated Control Room established in Safdarjung Hospital to function round the clock.

c) A separate hi-tech COVID-19 Lab. to do RTPCR, and facilities in NEB & other departments for Truenet, Covid 19 Rapid Antigen Test, Covid 19 Elisa test started in Safdarjung Hospital.

d) The SARI Ward was started with concurrence of District Magistrate in New Emergency Block, Safdarjung Hospital for separate management of cases of sub-acute respiratory illness cases. 

e) A dedicated Core team constituted for COVID-19 management consisting of Doctors from Anesthesia, Medicine, Respiratory deptts etc. Separate section was created in SSB for patients of Gyne&Obs and Pediatrics.

f) A Training programmer was being conducted for JR/SR/Nursing staff & Intern on weekly basis to deal with COVID – 19 management.

g) Awareness programme i.e handwashing steps, social distancing, importance of masks and use of sanitizations in hospital for prevention of COVID – 19 infection were conducted for the patients & their relatives coming to the hospital in addition to hospital staff working in various locations of SJH/VMMC.

k) Separate fever clinic & sample collection center (RTPCR) started for COVID-19 patients in  Old Casualty Block, SJH.

i) Uninterrupted patients care services were maintained in most of the departments of Safdarjung Hospital and also regular Dialysis for Non-Covid-19 patients is being conducted regularly.

j)  Separate Ambulances were engaged for Transportation of COVID-19 patients and dead bodies.

k) Teams are being constituted for potential vaccinators for COVID -19 vaccination drive.

l) Fire safety drills, training & awareness progarmme were continuously conducted for fire management in Safdarjung Hospital. 

2.  40 LDC’s and 8 PWD candidate had joined in last three months.

3.  A programme of “AaoSathchale” has been started to provide needful help to the patients and their attendants.

4.  Status of Admission/Operations: -

Total number of In-patients (admitted) and operations conducted in this hospital in 2020: -

Admission Jan - Nov 2020	Major Operation  Jan – Sep 2020	Minor Operation  Jan – Sep 2020	Total Operation  Jan – Sep 2020
101906	6828	4937	11765

 

5. Statistics (X-Ray Examinations)

 

Year	No. of X ray Examinations
January to October	1,51,387

 

6. Statistics Deliveries in Department of Obs&Gynae :-

Year	Number of deliveries
January to Nov 2020	16961

 

7. OPD Attendance :-

Year	Number of OPD Patients
January to Sep 2020	894815

 

8. Sports Injury Centre: - Patients attendance/surgeries 

S.NO.	Year	Ortho OPD	Physiotherapy OPD	IPD	O.T
1	Jan to Nov 2020	23916	10124	852	692

 

8.4 NEIGRIHMS, Shillong

A:        LAND

The District Collector, East Khasi Hills Revenue , has formally handed over the 20 Acres of Additional Land to NEIGRIHMS, on the 23^rd November 2020, for the construction of the Dwelling Units for Faculty, Group A , B & C categories .

B:        Infrastructure Development

Institute set up the COVID-19 ICU of 10 beds, Isolation Wards for 40 beds and Screening Area for COVID patients catering the entire region.

• Institute entered into an agreement with Government of Arunachal for having cashless treatment for the people of Arunachal at NEIGRIHMS under the CMAAY Scheme (Health Insurance Scheme).
• Institute had imparted ICU training to doctors of the State Government with regard to ICU COVID Care.
• Institute has set up the COVID teleconferencing in all OPDs for the benefit of the patients.
• Institute has increased the departments for hospital user charges at subsidised rates in order to generate revenue.
• Institute has taken over the following buildings of the new projects for conversion into COVID Quarantine Centres.

Guest House of 48 rooms.

Nursing Hostel – 1 of 88 bed capacity

Nursing Hostel – 2 of 110 bed capacity

Institute has also taken over the Under Graduate Hostels I & II for accommodating the new batch of MBBS students.

The new Nursing College Building along with hostel will be handed over by 31^st December 2020.

C:        Procurement

• The Institute has procured forty numbers of Alpha Mattress (Make: ArjoHuntleigh Healthcare Ltd., UK; Model: Alpha active3) against buy back of 48 units of old existing obsolete unserviceable Alpha Mattress for its patient care facility, at a total cost of Rs.24.64 lakhs (approx.), with five years of composite warranty period, and thereafter additional five years of CMC period, in this month of the FY 2019-20.

• The Institute has awarded contract for the supply and installation of one unit of Automated Capillary Electrophoresis System (Make: Sebia; Model: Capillary 2 flex piercing) for the department of Biochemistry for its laboratory, at a total cost of Rs.48.38 lakhs (approx.), with five years of composite warranty period followed by five years of CMC period including spares and services, in this month of the FY 2019-20.
• The Institute has awarded contract for the supply and installation of one set of Thromboelstograhphy system (Make: Instumentation Laboratory; Model: Rotem Delta 4) for the department of Anaesthesiology, at a cost of Rs.14.54 lakhs (approx.), with five years of composite warranty period followed by five years of CMC period including spares and services, in this month of the FY 2019-20.
• The Institute has awarded contract for the supply and installation of one set of Ultrasound System (Make: Mindray, P.R. China; Model: DC-80) against buy back of old existing obsolete unserviceable Ultrasound System for the department of Radiology & Imaging, at a cost of Rs.24.10 lakhs (approx.), with five years of composite warranty period followed by five years of CMC period including spares and services, in this month of the FY 2019-20.
• The Institute has also awarded contract for the supply and installation of one set of Electro Surgical Unit with Smoke Evacuator (Make: Johnson & Johnson Private Ltd.; Model: Mega 1000 & 2200J) with necessary accessories, one unit of Radio Frequency Ablation System (Make: Stryker; Model: Cross Fire 2), and one number of High speed burr system (Make: Stryker; Model: Rem B) for the department of Orthopaedics, at a total cost of Rs.11.93 lakhs (approx.), with five years of composite warranty period followed by five years of CMC period including spares and services, in this month of the FY 2019-20.
• The Institute has procured one unit of Thompson Retractor System (Make: Thompson Surgical Instruments INC, USA) for its patient care facility in the department of General Surgery, at a cost of Rs.30.64 lakhs (approx.), with five years of composite warranty period, and thereafter additional five years of CMC period, in this month of the FY 2020-21.
• The Institute has awarded contract for the supply and installation of two units of Air Decontamination Unit (Make: airinspace; Model: Plasmair Guardian T- 2006) for ICU and Isolation areas of the hospital in view of COVID-19 outbreak, at a total cost of Rs.94.40 lakhs (approx.), with five years of composite warranty period followed by five years of CMC period, including all the consumables and spare parts for the machine, in this month of the FY 2020-21.
• The Institute has also awarded contract for the supply and installation of eight units of Electro Surgical Unit (Make: Johnson & Johnson Model:Mega 1000 & 2200J)with Smoke Evacuator and necessary accessories with five years of composite warranty period & five years of CMC period, against buy back for different OT's of the hospital, at a total cost of Rs.77.50 lakhs (approx.), in this month of the FY 2020-21.
• The Institute has also awarded contract for the supply of fifty numbers of Metallic Bed (Make: M/s Godrej Interio; Model: EQ Bed with Head board) with 5 yrs warranty for its Nursing hostel and quarantine centre as well, 8500 numbers of Protective Personal Equipment (PPE) Kit (Make: Padam Shree Implex; Model: PPE) in view of COVID-19 outbreak, at a total cost of Rs.46.78 lakhs (approx.), in this month of the FY 2020-21.
• The Institute has procured one unit of OT table (Make: Mindray/P.R. China; Model: HyBase 8300) with mayfield attachment and with other mandatory accessories against buy back for its operation theatre, at a cost of Rs. 36.70 lakhs (approx.), with five years of composite warranty period, and thereafter additional five years of CMC period, in this month of the FY 2020-21.
• Department of Orthopaedics of the Institute has been added with one number of High speed burr system (Make: Stryker; Model: Rem B), at a cost of Rs. 11.12 lakhs (approx.), with five years of composite warranty period, and thereafter additional five years of CMC period, in this month of the FY 2020-21.
• The Institute has procured four numbers of Automated Cuff Pressure Monitoring & Measurement (Make: Hamilton; Model: Intellicuff), four numbers of Software for High Flow Oxygen Therapy (HFO) on Hamilton C3S (Make: Hamilton; Model: HFO) and one numbers Thromboelastography System (Make: Instrumentation Laboratory; Model: Rotem Delta 4) for the department of Anesthesiology, at a total cost of Rs. 37.31 lakhs (approx.), with five years of composite warranty period, and thereafter additional five years of CMC period, in this month of the FY 2020-21.
• The Institute has also procured two units of Air Decontamination Unit (Make: airinspace; Model: Plasmair Guardian T- 2006) for ICU and Isolation areas, seven units ofICU ventilators with necessary accessories (for CCU/ICCU/PICU) against buy back, in view of COVID-19 outbreak, at a total cost of Rs.01.76 cr (approx.), with five years of composite warranty period followed by five years of CMC period, including all the consumables and spare parts for the machine, in this month of the FY 2020-21.
• The Institute has procured six numbers of Humidifier for Ventilator (Hamilton H900) for the department of Anesthesiology with five years of composite warranty period, at a total cost of Rs. 09.76 lakhs (approx.), in this month of the FY 2020-21.
• The Institute has awarded contract for the supply and installation of one unit of MRI Compatible Anesthesia Workstation (Make: Draeger India Pvt. Ltd.; Model: Fabius MRI) for the department of Anesthesiology, at a cost of Rs.38.25 lakhs (approx.), with five years of composite warranty period followed by five years of CMC period including spares and services, in this month of the FY 2019-20.
• The Institute has also awarded contract for the supply and installation of three units of 4-Body Mortuary Chamber against buy back (Make: Draeger India Pvt. Ltd.; Model: Fabius MRI), at a total cost of Rs.98.90 lakhs (approx.), with five years of composite warranty period followed by five years of CMC period, in this month of the FY 2019-20.
• The Institute has also awarded contract for the supply and installation of six numbers of UVC Disinfection System (Make: Ibis Medical Equipment and System Pvt. Ltd.; Model: RAZE COV), at a total cost of Rs.25.54 lakhs (approx.), with five years of composite warranty period followed by five years of CMC period, in this month of the FY 2019-20.

8.5 Regional Institute of Medical Sciences, Imphal

• Regional Institute of Medical Sciences (RIMS), Imphal is the only Medical College from the entire North East to figure amongst the top 40 Medical Institutions of India.

· RIMS is in the 28th Position in NIRF ranking 2019, released by the Ministry of Human Resource Development, Government of India.

· The number of MBBS seats at RIMS, Imphal increased from 100 to 125 per annum. Out of the 25 seats increased 11, 10 and 4 seats are reserved for Economically Weaker Section (EWS), NE open and All India Quota (Al Q) respectively.

· A DM (Nephrology) course has been started from the academic session 2019-20 with an intake of 2 seats annually.

· MSc Nursing course started in the College of Nursing, RIMS, Imphal from the academic session 2019 with an intake of 8 seats annually.

• 51 number of beds have been increased in the Radiotherapy Ward.

 

 

 

8.6 Regional Institute Of Paramedical And Nursing Sciences (RIPANS), Aizawl, Mizoram

Regional Institute of Paramedical and Nursing Science (RIPANS), Aizawl was set up by the Ministry of Home Affairs, Government of India in 1995-96 to provide Nursing, Pharmacy and Paramedical education to the people of North East including Sikkim and to maintain the pace of nursing education and nursing services with other developments medical and technological services. The institute was transferred to Ministry of Health and Family Welfare w.e.f. 01.04.2007.

At present the institute is conducting the following Courses:

 

Sl. No.	Name of Course	Duration
1.	B.Sc.Nursing	4 years
2.	B.Sc. MLT (Medical Laboratory Technology)	4 years
3.	B. Pharm	4 years
4.	B.Sc.RIT (Radio Imagining Technology)	4 years
5.	B.Optom (Optometry)	4 years
6.	M.Pharm	2 years

 

Achievements during the year 2019-20:

 

1. No.of students newly admitted for various Courses        -           194
2. The total strength of students in various Courses             -           683
3. Total number of passed out students                                -           172
4. The project of Creation of Additional Facilities at RIPANS viz. Academic Block-III, Library cum Examination Hall, Boys’ and Girls’ Hostel was completed and the buildings were handed over to RIPANS ON 5.7.2019.
5. Approval of Recruitment Rules of 27 new posts (including the posts of Professor, Associate Professor, Assistant Professor, Tutor, Section Officer, Accounts Officer etc.) was received from the Ministry on 22.01.2020.
6. E-Tender for Civil Works of the Project of Development of RIPANS was published on 01.09.2019 (Rs.229.46 crore). Technical bid and financial bid were opened and recommendation to award the work to the lowest bidder at Rs.217.97 crore was submitted to the Ministry on 5.2.2020. The estimated cost of the Project is Rs.480.12 crore.

Financial Position during the year 2019-20: (Rs. in lakh)

 

Sl. No.	Particulars	BE (In crore)	Unspent Balance of the previous year	Amount released by the Ministry	Internal resources generated	Expenditure as on 31.3.2019	Unspent Balance as on 31.3.2019
1.	GIA General	15.00	104.80	1500.00	-	1,336.96	267.84
2.	Grants for Creation of Capital Assets	9.18	1,125.98	1,468.00	-	2,593.34	0.64
3.	GIA Salaries	11.00	140.41	1,080.00	83.81	1,038.53	265.69
TOTAL		35.18	1,371.19	4,048.00	83.81	4968.83	534.17

 

9. National Leprosy Eradication Programme (NLEP)

 

• Percentage of Grade II Disability (G2D) /visible deformity in new cases is decreased from 2.41% in 2019-20 to 2.21% as on 30^th September, 2020.
• The G2D amongst new cases/ million population is decreased from 1.96/million population as on 31st March, 2020 to 0.81/million population (annualised) as on 30^th September, 2020.
•  Child cases percentage has reduced from 6.87% as on 31st March, 2020 to 5.30% as on 30^th September, 2020.
• Central Leprosy Division has introduced new Operational strategy for Active Case Detection and Regular Surveillance both in rural and urban areas in order to ensure detection of leprosy cases on regular basis and at an early stage in order to prevent grade II disabilities.
• District level Representatives from 34 States/UTs have been trained for data entry into NIKUSTH web based reporting system for leprosy cases. A total of 1422 participants have been trained.
• In order to strengthen the integrated approach, leprosy screening has been converged under Rashtriya Bal Swasthya Karyakram (RBSK) and Rashtriya Kishore Swasthya Karyakram (RKSK) for screening of children (0-18 years) and under Ayushman Bharat for screening of people above 30 years of age. Collaborative training on the screening tools, referral protocols and reporting has  been completed with State Nodal Officers of RBSK, RKSK and NLEP on virtual platform on 20^th& 21^st October, 2020.
• In order to spread awareness about leprosy, three short films involving direct testimonials of cured leprosy patients have been developed, which are being telecast through Doordarshan channels in 18 states as per media plan.
• In addition to above activities, Differential strategy guidelines for carrying out various activities under NLEP during COVID – 19 pandemic were issued to all States/ UTs in order to ensure the following:-
  • •  
• Uninterrupted supply of MDT to leprosy patients during the lockdown due to COVID – 19
• Uninterrupted DPMR services to leprosy patients suffering from physical disabilities.
• Besides, guidelines were issued to track the leprosy patients on treatment among the returnee migrants during COVID – 19 pandemic, and to ensure that their treatment is continued in a seamless manner at the places they migrate to.  A number of such patients have been successfully tracked and treated by various states/ UTs.

 

10. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)

Under National Programme for Cancer, Diabetes, Cardio-vascular Diseases and Stroke Programme, 3,89,10,383 were screened for Hypertension, Diabetes, Oral Cancer, Breast Cancer and Cervical Cancer for period January to November 2020 (Source: Ayushman Bharat, NHSRC).

11. National Vector Borne Disease Control Programme(NVBDCP)

11.1 Malaria

• World Malaria Reports for 3 consecutive years have hailed India’s progress in Malaria Programme, and India has been acknowledged as the fastest moving /best performing country in the world in this regard.
• Malaria cases reported in 2019 were 338494 in comparison to 429928 cases in 2018, indicating a decline of 21.26% over the year 2019.  Similarly, malaria cases have declined by 47.77% and Pf cases by 25.15 % as on 31st October 2020, as compared to the corresponding period.
• Malaria has been made a notifiable disease in 31 states/UTs (Andhra Pradesh, Arunachal Pradesh, Assam,Chhattisgarh, Goa, Gujarat, Haryana, Himachal Pradesh, Jammu & Kashmir, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Manipur, Mizoram, Nagaland, Odisha, Punjab, Rajasthan, , Sikkim, Tamil Nadu,Telangana, Tripura Uttar Pradesh,Uttarakhand, West Bengal, Pudducherry Chandigarh, Daman &Diu, D&N Haveli and Lakshadweep).
• Till 2020, 24 states have constituted State Task force for Malaria Elimination and District Task Forces. The remaining States/UTs are in the process of constituting State Task Force and District Task Forces.
• 2.24 crore Long lasting Insecticidal Nets (LLINs) have been supplied/distributed during year 2019-20 to high Malaria burden areas. The process of procurement of additional 2.52 crore LLINs is in full swing, and is likely to be completed by 31^st December, 2020. Use of LLINs has been highly accepted by the community at large and has been one of the main contributors to the drastic malaria decline in the country.
• Dte. of NVBDCP organized 2nd Batch of National Malaria Microscopy Refresher Training at RoHFW, Bhubaneswar, Odisha from 3-13 January, 2020.
• Dte. of NVBDCP in collaboration with WHO and National Institute of Malaria Research organized the External Competency Assessment (ECA) for certification of the Lab Technicians from different States w.e.f 20 -24 January, 2020 (1st Batch) and 27-31 January, 2020 (2nd Batch) on malaria Microscopy by WHO ECAMM Facilitator at NIMR, Delhi.
• Malaria microscopy, the gold standard for malaria elimination has also been strengthened by National Refresher trainings and certification of a core group of Laboratory Technicians from different States. There are 11 L-1 and 13 L-2 WHO certified Laboratory technicians trained and certified so far for strengthening microscopic activity and lab capacity building.

11.2 Kala-Azar

• 1735 cases have been reported during 2020 upto October in comparison to 2863 cases reported during corresponding period of 2019.  A reduction of 39.4% of cases with no death was reported till October, 2020.
• Till October 2020 98% Kala-azar endemic blocks have achieved the elimination target of <1 KA case per 10,000 population at block level. 13 blocks (Bihar-3 and Jharkhand-10 blocks) are yet to achieve the target.
• Based on the KA Independent Assessment findings, implementations of KA activities has been strengthened. High priority villages have been identified for intensified action plan. SOPs for active case detection and outbreak management have been prepared and duly disseminated in the field formations.

11.3 Dengue & Chikungunya

• The number of identified Sentinel Surveillance Hospitals (SSHs) has been increased from 680 in 2019 to 695 in 2020.
• Case Fatality Rate (CFR) for Dengue (deaths per 100 cases) was maintained at <1%. 
• Guidelines on Mosquito and other Vector Control Response (MVCR) were prepared and released through a webinar on 23rd & 24th July jointly organized by NVBDCP and WHO.
• National Guidelines on the management of cases with Dengue and Covid-19 co- infections during Covid-19 Pandemic were finalised and shared with all the States and Stake holders.

11.4 Japanese Encephalitis

• Out of 60 PICUs, 38 PICUs have been made functional (Assam-6.  Bihar-7, Tamil Nadu-5, Uttar Pradesh -10 and West Bengal-10).
• Funds have been provided for all 10 Physical medicine & Rehabilitation (PMR)  Deptts. 8 PMRs are functional (Assam-2, Tamil nadu-1, Uttar Pradesh-3 and West Bengal-2)
• JE vaccination Campaigns in children (1-15 yrs.) have been completed in *243 JE endemic districts. 60 more districts have been identified to be covered under JE vaccination campaign. (*Immunization Div. has increased the number to 276 districts, based on the separation of districts over the years.)

• 31 districts (Assam (9), Uttar Pradesh (7) and West Bengal (15) have been covered under Adult JE Vaccination.
• 143 Sentinel sites and 15 Apex Referral Laboratories have been identified for diagnosis of JE. 932 kits were supplied in 2019. 372 Kits have been supplied in 2020 (till 31.10.2020)

11.5 Lymphatic Filariasis

• Out of 272 (257 + 15 new) endemic districts, 98 districts have cleared Transmission Assessment Survey (TAS)-1 and have consequently stopped Mass Drug Administration (MDA). Out of 98, TAS-2 is cleared by 87 districts and TAS-3 is cleared by 42 districts till October, 2020. During 2020 (till October), 5 districts have cleared 2nd TAS and 11 districts have cleared 3rd TAS.

· During 2020 (till October), 84 districts have conducted MDA including 7 districts where MDA was conducted with triple drug therapy (IDA) i.e. Ivermectin + DEC + Albendazole.

• Regional Programme Review Group (RPRG) WHO meeting (virtual) was held on 13-16 July, 2020.
• Social media tool kit was prepared and successfully used for spreading awareness about MDA rounds during COVID-19 pandemic.

12. Food Safety and Standards Authority of India (FSSAI)

1. Two new Scientific Panels on Packaging and Alcoholic Beverage have been established raising the total number of Scientific Panels to 21 comprising  11 vertical (aspects related to a particular commodity e.g. Oils and Fats) and 10 horizontal panels (Aspects across different commodities e.g. Pesticides residues).

2.  A total of 19 final notifications and 16 draft amendment regulations have been   issued during 2020. Final notifications,inter-alia, include:

 

 (i) Food Safety and Standards (Safe food and balanced diets for school children) Regulations, 2020.    This regulation aims to encourage schools to adopt safe food and balanced diets amongst school children as per the guidelines issued by   the National Institute of Nutrition.  Further, foods which are referred to as food product high in saturated fat or trans-fat or added sugar or sodium(HFSS) cannot be sold to school children in school canteens/mess premises/hostel kitchens or in an area within fifty meters from the school gate in any direction.

 

(ii)  Food Safety and Standards (Packaging and Labelling) Amendment Regulations, 2020 relating to display of information in food service establishments: These provide that Food service establishments (restaurants) having central licenses or outlets at 10 or more locations will need to display the ‘calorific value in kcal per serving and serving size’ of food items on menu cards, booklets or board. Even e-commerce food business operators will need to get their restaurants partners to display calorie information of food products on their digital platforms. 

(iii)  Food Safety and Standards (Prohibition and Restrictions on Sales) Third Amendment Regulations, 2020 relating to limit of Total Polar Compounds unused/fresh vegetable oil/fat.

3. With a view to reduce compliance burden on food businesses, rationalising licensing/registration, reducing paper work etc., draft amendment FSS(Licensing and Registration) Regulations, 2011 has been finalised and is being draft notified. 

4. To address concerns of Food Business Operators , facilitate ease of  doing  business, ensuring consumer safety and also simultaneously enhancing punishment for wrongdoers to work as deterrent, FSSAI has proposed a number of amendments in Food Safety and Standards Act, 2006. Important changes proposed in the present Act include bringing ‘export’ and ‘animal feed’  within the purview of FSSAI; harmonization of definitions with Codex and other Acts etc.; defining the  role and duties of Chairperson; reviewing processes to ensure expeditious finalization of regulations; bringing more clarity to certain existing provisions; provision for reference  laboratories; protecting retailer and distributor from liability in case of  untampered packaged food; rationalization of  penal provisions; including strengthening in certain cases; provision for creation of fund etc.The Ministry issued a public notice thereon and the response received are under examination in FSSAI.

5. All Food Business Operators are required to be registered or licensed under Section 31 of Food Safety and Standards Act, 2006. Considerable progress has been made in issuance of Licenses and Registrations. As on 30.11.2020, 70,589 Central licenses, 15,09,846 State licenses and 67,32,447 Registrations have been issued.

 FSSAI has launched cloud based upgraded new online portal called Food Safety Compliance System (FoSCoS) replacing existing Food Licensing and Registration System in the States/UTs. FoSCoS is conceptualised to provide one point stop for all engagement of an FBO with FSSAI for any regulatory compliance transaction.   It was initially launched in 9 States/UTs from 01st June 2020 and has since been launched in all remaining States/UTs from 1st November, 2020.   Initially FoSCoS will be offering licensing, registration, inspection and annual return modules. However, other activities/ modules will be enabled in phased mannerand it will provide one stop for all engagements  of an FBO with FSSAI related to regulatory transactions. 

6.   To protect the interest of consumers, instructions have been issued requiring the container/tray holding non-packaged/loose Indian sweets at the outlet for sale to display mandatory ‘Best Before Date’. In addition, FBO may also display the ‘Date of Manufacturing ‘which shall be purely voluntary and non-binding.  The order has been made effective from 1st October 2020.  

7. As directed by the Government, directions under Section 16(5) issued on 23rd September, 2020 operationalising the proposed draft FSS(Prohibition and Restrictions on Sales) Amendment Regulations, 2020prohibiting blending in mustard oil with a view to facilitate manufacture and sale of pure mustard oil for domestic consumption in public interest. This has been made effective from 1.10.2020.   However, the Hon’ble High Court of Delhi has stayed the order for the time being.

8. An Advisory dated 8th September, 2020 has been issued to all Food Safety Commissioners /Central Licensing Authorities  to file complaint in courts for violation of provisions of IMS Act for violation of Sections 3,4,9 etc. of IMS Act relating to banning /prohibiting advertising, promotions and incentivizing the use or sale of infant milk substitutes or feeding bottles or infant foods , or inducement to   health workers for promoting use of infant milk substitutes etc including funding of a seminar, meeting, conference  educational course, contest, fellowship, research  work or sponsorship 

9. To  give relief to FBOs, a  list of labelling defects categorized into  exceptions (minor labelling defects of insignificant nature and without any food safety concern) and mandatory cases (against which adjudication action could be taken) has been prepared and shared with States/UTs  which have been advised to issue necessary instructions to State DOs and FSOs to deal with the  cases involving minor labelling defects not posing any food safety concern  by issue of improvement notices under Section 32 .

10. FSSAI has developed State Food Safety Index to measure the performance of States on various parameters of Food Safety. Index is based on performance of States/UTs on five significant parameters, namely Human Resource and Institutional Data (weightage -20%), Compliance (30%), Food Testing Infrastructure and Surveillance (20%), Training and Capacity Building (10%) and Consumer empowerment (20%).   For the year 2019-20,   the ranking was released on 7th June, 2020. Among the larger States, Gujarat was the top ranking State, followed by Tamil Nadu and Maharashtra. Among the smaller States, Goa came first followed by Manipur and Meghalaya. Among UTs, Chandigarh, Delhi and Andaman Islands secured top ranks.    With the release of the Index Rankings, States/UTs have become more vigilant and have been working towards improving in various parameters listed in the index.

11.An order has been issued on 06.11.2020 for exclusion of food category (13) (foodstuffs intended for particular nutritional uses) from the scope of Proprietary Foods.

12. In order to address the gaps in the food safety eco-system of States/UTs and to promote the culture of safe and wholesome food through pooling of technical knowledge and best practices, as a shared responsibility, it is proposed to extend both technical and financial support to the States/UTs.  Accordingly, a Memorandum of Understanding (MoU) for strengthening of Food Safety Eco-system in the country is proposed to be signed between FSSAI and States/UTs. Proposals have been received from 23 States/UTs so far .  Work plans have been finalised for 18 States/UTs and assistance will be provided to the States/UTs after signing of the MoU.

13. During the Covid-19 pandemic, FSSAI has taken a series of steps to facilitate uninterrupted supply of safe food. Import clearances of food items and national food testing laboratories were declared essential services. Food imports were   expedited through Provisional Clearance of certain food items. Certain regulatory compliances for Food Businesses have been relaxed/deferred as necessitated by the circumstances emerged during the pandemic period.  A detailed guidance note ‘Food Hygiene and Safety Guidelines for Food Businesses during Coronavirus Disease (COVID-19) Pandemic’ has been released. FSSAI also released an e-handbook on “Eat Right during COVID-19” for citizens, which highlights safe food practices to be followed diligently and tips on health and nutrition. FSSAI is also disseminating information for public awareness through books such as ‘Do You Eat Right’ and social media on fortified foods, dietary diversity and healthy recipes to combat micronutrient deficiencies and reduction of salt, sugar and fat to reduce NCDs.

14.  5 more food laboratories have been recognised and notified under Section 43 (1) of Food Safety and Standards Act, 2006 by FSSAI. This has raised the total number of notified food laboratories from 183 to 188 till date. In addition, 58 State Food testing labs are also functioning under transitory provisions of Section 98 of FSS Act.

15.Under Central Sector Scheme for upgradation of food testing infrastructure in States/UTs, a grant of Rs.43.88 crore has been released during the year to 25 States/UTs for procurement of Basic/High-end Equipment and setting up of Microbiology testing facilities (with CAMC and manpower) towards upgradation of 29 State Food Laboratories. With this, a total Grant in aid of Rs.312.98 Crore has been sanctioned/released to 29 States/UTs for upgradation of 39 State Food Laboratories, including setting up microbiological laboratories in 24 SFTLs. 

16. A grant of Rs. 1.21 crore (approx..) has been released to two referral labs viz ICAR-National Research Centre on Meat, Hyderabad and IIFPT, Thanjavur towards procurement of high-end equipment. A balance grant of Rs. 50 lakhsis also likely to be released to PBTI, Mohali, Punjab towards procurement of high end equipment. 

17. 36 more Food Safety on Wheels along with Rs. 5 lakh/FSW for fuel and Consumables have been sanctioned to 15 States/UTs. This has raised the total number of FSWs from 54 to 90 across the country covering 33 States/UTs.

18. FSSAI has also released a grant of Rs. 19.92 crore to 21 States/UTs for procurement of 3 basic equipment viz. i.e. HPLC system with photodiode Array (PDA), Florescence & Refraction Index (RI) indicator, GC with FID, NPD & ECD and UV- Visible Spectrophotometer preferably through GeM. FSSAI is in the process of signing MoU with States and one of the components of the MoU is Strengthening of Food Testing System under which some more grant is likely to be released.

19. FSSAI has provided rapid handheld kits/devices to States/UTs across the country that would make the testing easier, faster and cost effective. This includes distribution of 363 Frying Oil Monitor - to check Total Polar compound and acid value in oil and 69 Raptor Diagnostic Reader - to identify Antibiotics in various food samples to 27 States/UT.  Similarly, 210 Microbial Identification kits have also been provided to 30 States/UTs for detection of 9 pathogenic microorganism   in various food items.

20. FSSAI is implementing Sample Management System (SMS) across the country under which cold chain facilities for storage and transportation of food samples are being provided to States/UTs. FSSAI has provided 548 Compact Cabinets, 539 Vehicle Mounted Mobile Freezer Boxes, 2328 Portable Chill Boxes and 2328 Backpack Style Bags to 21 States/UTs. SMS would be provided to remaining States/UTs subject to readiness of the State/UT Governments. This would integrate the entire cold chain across all districts of India to bring in better compliance and monitoring.  

21.FSSAI has conducted PAN India Edible Oil Quality survey in the month of August, 2020. The result of the survey is being compiled.  FSSAI has also conducted  a PAN India Sampling of Milk Products (Khoa, Paneer, Channa, Khoa based &Paner based sweets) during the festival period Diwali to identify hotspots of adulteration During this exercise  , 50 samples from each metro cities and 5 samples from other cities and districts were drawn in November, 2020 with the objective to assess the quality and safety of Milk products sold during festival period in the country and to identify hotspots of adulterated and unsafe milk products, if any; and put in place a continuous surveillance framework for assessing quality of Milk products sold in the country. The results of samples would be available shortly.

 FSSAI is addressing micronutrient deficiencies by notifying standards for fortification of key staple viz. edible oil and milk (with Vitamin A & D) , wheat flour and rice (with iron, folic acid and vitamin B12 )  and  salt with iron (in addition to iodine) for which  it has  notified Food Safety and Standards (Fortification of Foods ) Regulations, 2018 on 02.08.2018 . The standards prescribe minimum and maximum range of fortification.  FSSAI has proposed to make these standards mandatory for oil and milk.  .

Food import is being regulated at 150 points of entry. FSSAI has its presence at 22 points of entry under 6 locations namely Chennai, Kolkata, Mumbai, Delhi, Cochin and Tuticorin and at other 128   points of entry, Customs officers have been notified as Authorised Officers to regulate the clearance of food consignments as per the norms prescribed by FSSAI for which they   have been provided requisite training.

 To regulate imports, some important instructions issued during the year include:

 To ensure the quality of honey and to contain the misuse of imported Golden syrup/Invert Sugar Syrup/Rice syrup in production of honey, all the importers/Food Business Operators,  which are importing golden Syrup/Invert Sugar Syrup/Rice Syrup into India have been directed vide order dated 20th May, 2020 to submit necessary documents to Authorised Officers at scrutiny stage before clearance,   regarding details of manufacturers with end use as to whom the aforesaid imported food items will be supplied.

 FSSAI issued an order dated 07.07.2020 clarifying that import of Blended Edible Vegetable Oils (BEVO) without AGMARK certification is not allowed in India and further the BEVO shall also comply with the rules and regulations made under FSS Act, 2006.

iii) To ensure that only non-GM crops are imported into India , pending  framing of regulations related to GM in Section 22 of FSS Act, 2006 , FSSAI  issued an Order dated 21.08.2020   prescribing requirement of non-GM origin –cum-GM free certificate issued by Competent National Authority of the exporting country, for every consignment of imported 24  food crops  as mentioned therein. The order shall be effective from 01.01.2021.

22. Under Training and capacity building initiatives to promote food safety and self compliance, more than 1.30 lakh food handlers have been trained this year already through 241 Training Partners and more than 2000 Trainers.  Further, FSSAI also launched 2 hour online training programme for food business operators exclusively on COVID-19 preventive guidelines.  The training is being delivered online by the trained & certified trainers. More than 1.07 lakh food handlers have been trained. Further, induction/refresher courses have also been conducted for more than 170 regulatory personnel  during the  period.  FSAI has also conducted 6 offline training and 306online training programs, including live training sessions 9practical sessions) for laboratory personnel.

To foster innovation and cooperation in the field of research areas related to food safety and nutrition, FSSAI has created the Network for Scientific Cooperation for Food Safety and Applied Nutrition (NetSCoFaN). This network comprises of research and academic institutions working in the area of food and nutrition and will ensure scientific cooperation, exchange of information development and implementation of joint projects, exchange of expertise and best practices.

 FSSAI had developed framework of national Food Safety Emergency Response (FSER) system which outlines multi-sectorial coordination, their roles, responsibilities and management actions during food safety emergency situation as envisaged under Section 16(3)(v)(&(vi) of FSS Act. Under this framework, Food Safety Risk Assessment Committee (FSRAC) has been constituted as a risk assessment body and shall be responsible for providing technical and scientific support both in normal or emergency situations.

23. FSSAI has signed an MoU with CSIR on 7.8.2020. The MOU aims towards collaborative research and information dissemination in the area of food and nutrition.

24.  FSSAI has also  signed a Memorandum of Understanding with National Institute of Open Schooling on collaboration with vocational ad academic verticals for food safety education and integration  . 

25. From time to time, FSSAI is issuing Guidance Notes to guide Food Businesses, consumers and other stakeholders on issues of food safety and dispel myths.     Guidance Notes issued in the year include:

Guidance Note on Food for Special Medical Purposes

Guidance Note   on Clean and Fresh Fruit and Vegetable Market

Guidance Note on Food Hygiene & Safety Guidelines for Food Businesses during            Corona Pandemic

Metal Contaminants in Foods-Potential Risk & Mitigation measures

Safety and Quality of  Traditional Milk products

Pesticides –Food Safety Concerns-Precautions and Safety Measures.

26. A monthly newsletter is being published to disseminate information relating to all important activities of FSSAI undertaken during the month for information of all stakeholders and public at large. This is being published even during the pandemic period.

27. FSSAI is focussing on improving the infrastructure to facilitate better functioning across levels. The staff strength of FSSAI has increased from 356 to 824 in the year 2018. With the new strength, 11 new offices of the Authority and two food laboratories are in the process of being set up throughout the country. These offices will facilitate food licensing, imports, surveillance and enforcement thereby benefitting food business operators and consumers, both.

28. FSSAI’s Eat Right Toolkit developed as an easy to use comprehensive package with simple messages and interactive material (games, AVs, posters etc.) to inculcate right eating habits at grassroots level of the country. The toolkit is integrated in Health and wellness centre’s under Ayushman Bharat and has been included under State PIPs (programme implementation plan) by Ministry of Health and Family Welfare (MoHFW). The toolkit is also being translated in regional languages to be used across India.

29. Training of the Trainers: A plan has been proposed to create a pool of national and state trainers to smoothly conduct ASHA trainings. In view on the COVID-19 pandemic, virtual training sessions were planned.

National trainers: The training of national trainers was conducted in two batches. A total of six national level resource personnel (from FSSAI, NHSRC and VHAI), trained the National Trainers (38) from Arunachal Pradesh, Assam, Chhattisgarh, Delhi, Haryana, Jharkhand, Karnataka, Madhya Pradesh, Maharashtra, Manipur, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh, Uttarakhand and West Bengal. The trainings were conducted on virtual platform, in two batches in June and July, 2020.

State Trainers:The training of state trainers was organized by the National trainers with help of national level resource personnel from FSSAI, NHSRC and VHAI. The training was organised by NHSRC in collaboration with the States and was organised for three days to effectively deliver the messages. Till date,09 batches of online training of State Trainers have been conducted covering 252 State Trainers and 45 State Observers.

30. The ‘Eat Right India’ movement initiated by FSSAI under the aegis of Ministry of Health & Family Welfare, has gone a long way in creating awareness amongst people about eating safe, healthy and sustainably. Recently, FSSAI has been adjudged among top ten finalists for the Food System Vision Prize by the Rockefeller Foundation, United States for its Eat Right India initiative and vision 2050, among a pool of more than 1,300 applicants from 110 countries.

31. FSSAI has undertaken several activities to amplify the Eat Right India initiative:

Launches:

• An annual competition known as ‘The Eat Right Challenge’ for districts and cities to recognize their efforts in adopting and scaling up various initiatives under Eat Right India. 179 cities and districts have participated in this challenge from States/ UTs all over the country.
• Eat Right Creativity Challenge for schools, a poster and photography competition that aims to promote healthy dietary habits amongst Children through interactive activities.
• ‘Eat Smart City’ (Challenge) by FSSAI in partnership with Smart City Mission under Ministry of Housing and Urban Affairs with an aim to create an environment of right food practices and habits in India’s smart cities and can set an example for other cities to follow.

Releases:

• The ‘Eat Right Handbook’, a comprehensive guide for the Food Safety Commissioners and district officials to adopt and scale-up Eat Right India (ERI) initiatives. The handbook provides detailed information, SOPs, resources and success stories about various ERI initiatives.
• e-handbook on “Eat Right during COVID-19” for citizens which highlights safe food practices to be followed diligently with simple tips on health and nutrition
• The ‘Food Safety and Hygiene Guidelines for Safe Reopening of School Canteen/Mess’ document that highlights the best practices to be followed in the ‘New normal of COVID-19’ by all the stakeholders. It also includes tips on personal and environmental hygiene and common myths with their clarifications.
• ‘Do you Eat Right?’ An eBook which translates technical concepts on foodand nutrition and Eat Right initiatives into simple conventional style for the general public.
• The ‘Orange Book’ for Eat Right Campus that serves as a resource guide to implement the mandatory food safety and hygiene requirements in campus canteens, ensure provision of healthy and environmentally sustainable food and build awareness among the individuals in workplaces, colleges, universities, institutions, hospitals etc. across the country.
• Daily Recommendations and Food Fortification- A handbook for States that will provide answers to the prime concerns around food fortification to State government officials. It will further elaborate the difference in the average consumption of micronutrients such as Vitamin A, Vitamin D, iron, folic acid and Vitamin B12 in a regular diet when compared with inclusion of fortified staples in everyday meals.

13. NACO

1. Hon'ble Minister (HFM) Dr. Harsh Vardhan participated in the virtual Ministerial Meeting of the Global Prevention Coalition (GPC) – HIV Prevention 2021-2025, on 18-11-2020 for taking stock, planning the future, hosted by UNAIDS and UNFPA. The meeting focused on strengthening HIV Prevention and Roadmap. India reaffirmed its commitment for expanding and amplifying HIV prevention efforts in the next five years.
2. To achieve NACP fast track targets, NACO envisaged nine output indicators and three outcome indicators. HIV testing has increased from 1.25 crore to 2.65 crore among pregnant women and 1.6 crore to 2.89 crore among vulnerable population in last five years. Around 73 lakh blood units are being collected in NACO supported blood banks to ensure availability of safe blood in the country. In addition of this, during the same period number of PLHIV taking free lifelong ART has increased from around 9.4 lakh to 14.86 lakh.
3. National AIDS Control organization (NACO), periodically undertakes HIV sentinel surveillance and estimation process to provide the updated information on the status of HIV epidemic in India. The national HIV Sentinel Surveillance (HSS) is mainstay of second generation HIV surveillance in India. This is one of the largest HIV Survey system across the globe providing evidences on the magnitude and directions of HIV epidemic in various population groups and geographical areas and, thus, provides inputs to programme for strengthening prevention and control activities. Along with HSS, First HIV estimation in India was also done in 1998 while last round was done in 2019. NACO has released India HIV Estimates 2019: Report; which provides evidence on how much progress has been made on at least three of the 2020 fast-track targets.
4. NACO has released topline findings of national level key indicators of Behavioural Surveillance Survey lite, 2020.
5. NACO has developed district specific integrated action plan for states of Nagaland, Manipur, Mizoram and Meghalaya. It includes full details and granularity with measurable indicators to be required in addition to routine activities.
6. NACO has developed SBCC package for key population, bridge population and service providers with objective to influence and support behaviour change among key population and bridge population/high-risk population with respect to HIV services in India and to enhance the skills of service providers to conducted improved interpersonal communication sessions. The package include various type of material like TVC, short animated Videos, GIFs, Radio jingle, comic strips, posters and flip book etc. The material is developed to improve the information seeking behavior among HRGs and Bridge population, promote correct and consistent use of condom, seek regular testing including Community based screening, facilitate ART adherence, reduce stigma and discrimination and to promote HIV and AIDS (Prevention &Control ) Act, 2017 The objective of this SBCC package is as below:

7. The ART reduces the HIV-related morbidity and mortality; prevents HIV transmission by suppressing the viral load improving the quality of life of People Living with HIV (PLHIV). ART being a life-long treatment, retention in care remains the essential component for achieving viral suppression. Keeping in view, NACO has developed IEC material on treatment literacy to promote treatment adherence and address related issues to the treatment. This material has been developed provide correct information about HIV treatment and how to manage side effects, promote ART adherence, promote positive living, promote timely viral load testing and to provide information about social protection schemes.

8. As per the ART Technical Resource Group recommendations and in line with WHO recommendations Dolutegravir based regimen has been rolled out across country and currently more than 1 lakh PLHIV are on DTG based regimen. Currently all newly HIV diagnosed  patients are initiated on  Dolutegravir based ART regimen.
9. NACO has rolled out Blended Clinical training project for capacity building of health staff involved in delivery of HIV care services. This is a unique model to train health staff by using blend of virtual and class room training mode.

10. HIV-1 Viral Load testing was disrupted throughout the country from 24th March, 2020 due to Country wide lockdown owing to Covid pandemic as there were no patients coming to the ART centres for testing and the phlebotomists were not able to reach the ART centres for sample collection.Therefore, efforts were made by NACO and Communication was sent to Ministry of Civil Aviation and Ministry of Home Affairs by Secretary (MOHFW) to allow transport of blood samples of HIV patients through Govt/ private cargo flights and also allow free movement of PLHIVs to the ART centres and personnel involved in blood sample collection.

 

11. On the request of ICMR, NACO has set aside 30 out of 64 Public sector HIV-1 viral load labs for the purpose of Covid-19 testing.

14. E-Health

National telemedicine services

The National Telemedicine Service "eSanjeevani" is a digital health initiative of the Ministry supports two types of teleconsultation services-Doctor-to-Doctor (eSanjeevani) and Patient-to-Doctor (eSanjeevani OPD) Tele-consultations. eSanjeevani was rolled out in November 2019 as an important component of the Ayushman Bharat Health and Wellness Centre (AB-HWCs) programme. It aims to implement tele-consultation in all the 1.5 lakh Health and Wellness Centres in a 'Hub and Spoke' model, by December 2022. NHM in States identify and set up dedicated 'Hubs' in Medical Colleges and District hospitals to enable tele-consultations services to 'Spokes', set up at SHCs and PHCs.

On the 13th April 2020, the MoHFW rolled out 'eSanjeevaniOPD' - the patient to doctor tele-consultation service owing to the COVID-19 pandemic during the lockdown when OPDs in the country were shut down.

eSanjeevani has completed 8 lakh consultations on 20 November 2020. Over 11,000 patients are seeking health services on a daily basis in 27 States/UTs. The top ten States which have registered highest consultations through eSanjeevani and eSanjeevaniOPD platforms are Tamil Nadu (259904), Uttar Pradesh (219715), Kerala (58000), Himachal Pradesh (46647), Madhya Pradesh (43045), Gujarat (41765), Andhra Pradesh (35217), Uttarakhand (26819), Karnataka (23008), Maharashtra (9741).

National Digital Health Mission (NDHM): On 15th August 2020, the Hon'ble Prime Minister announced the implementation of National Digital Health Mission (NDHM) in the country with a vision to create a national digital health ecosystem as proposed in NDHB.

The NDHM is envisaged to be implemented in phase wise manner.

• Phase 1 to cover 6 UTs on pilot basis.
• Phase 2 will cover additional States with expansion of the services.
• Phase 3 will target nation-wide roll-out, operationalizing and converging with all health schemes across India along with promotion, on-boarding, and acceptance of NDHM across the country.

Currently, the NDHM is being implemented in 6 Union Territories (Andaman & Nicobar Islands, Chandigarh, Dadra & Nagar Haveli and Daman & Diu, Lakshadweep, Ladakh and Puducherry) in Phase: I, on pilot basis. Services like issue of Health ID, creation of registries for Doctors & health facilities and creation of personal health record have been initiated.

National Medical College Network (NMCN) is being established with the purpose of e-Education and e-Healthcare delivery, wherein 50 Government Medical Colleges are being interconnected, riding over NKN (National Knowledge Network — high speed bandwidth connectivity). National Resource Centre (NRC) with required centralized infrastructure and 7 Regional Resource Centres (RRCs) have been established as below:

• NRC cum Central RRC -SGPGIMS, Lucknow

15. National Centre for Disease Control (NCDC)

National Centre for Disease Control (NCDC) is the key premier institute of the country and is mandated for surveillance, response, epidemiological investigation with its ten divisions (headquarters in Delhi) and has 8 branches (located at Alwar (Rajasthan), Bengaluru (Karnataka), Kozhikode (Kerala), Coonoor (Tamil Nadu), Jagdalpur (Chhattisgarh), Patna (Bihar), Rajahmundry (Andhra Pradesh) and Varanasi (Uttar Pradesh).

The technical Centres/Divisions at the headquarters:

1. Integrated Disease Surveillance Programme (IDSP)
2. Division of  Epidemiology
3. Division of Microbiology (including Centre for AIDS & related Diseases and Biotechnology)
4. National Program for Surveillance of Viral Hepatitis
5. Division of Parasitic Diseases
6. Centre for Medical Entomology and Vector Management,
7. Division of Zoonosis
8. Division of Zoonotic Disease Programme,
9. Division of Malariology & Coordination (M&C),
10. Centre for Environmental & Occupational Health, Climate Change & Health
11. Centre for Non Communicable Diseases

During 2020 NCDC has been at the centre of surveillance and response for Covid-19 pandemic since January. As the pandemic gradually spread from one district to over 700 districts in various states, nearly all the divisions and officers were involved. NCDC Public health specialists assisted Key surveillance and response activities.  Microbiologists and Biotechnologists supported the testing and genomic sequencing by NCDC.

1. In the initial phase:
   1. IDSP Program supported the surveillance of International traveler (who had history of exposure/travel to COVID affected Countries) in coordination with PH(IH) division.
   2. All the suspects were kept under quarantine.
   3. Testing of samples from all the suspects and contacts was done in 3 labs. Initially samples from nearly all the states in northern and central region.
   4. NCDC Coordinated with Defence and para-military forces in managing quarantine of returnees from Wuhan and Iran in ITBP / Army quarantine facilities.
   5. Around 39 lakhs persons were kept under community surveillance (14 days home quarantine and 14 days self-health monitoring)
   6. Over 1crore contact were traced and samples were tested in the community.
   7. ILI & SARI Surveillance cases were detected by active house to house searches by field teams in non-affected areas to detect hidden transmission
   8. Epidemiological investigation into super-spreader events. Important events were:
   9. Italian tourist group related suspects in 7 districts of Rajasthan
   10. Famous artist related contacts in Lucknow and other cities
   11. TabligeeJamat related spread into 18 States
   12. Vegetable market spread in Chennai and 8 other districts.
2. Preparation of guidelines for contact tracing, quarantine in home & health facilities, surveillance in containment zones, house to house case search, Trainings at land border crossing, District control room, Dead body management, Disinfection of health facilities and quarantine centres.
3. Laboratory testing capacity was significantly enhanced by new COBAS-6800, automated RNA extractors and Next Generation Sequencer for Genome sequencing.
4. Central teams were deployed to various States for cluster containment. Important once are:-Agra cluster, Bhilwara cluster, SAS Nagar cluster in rural areas of Punjab, Dharavi clusters in Mumbai
5. Central teams deployed to bordering districts of Nepal and Bangladesh to coordinate screening at International check posts and quarantine of suspects.
6. Central teams for periodic review of surveillance and containment measures in high case load districts. Delhi, Gujarat, MP, Maharashtra, TN, Karnataka, NE states, J&K, Laddakh, UP and others state were supported during various stages with special review and modified containment strategy.
7. Strategic Health Operation Centre (SHOC), NCDC managed by IDSP has been activated for coordinating surveillance & monitoring of CoVID-19 response activities from 8^th February’ 2020 and is actively monitoring the situation.
8. Sero-surveillance in Delhi, Indore (MP), Bhopal and Gujarat to assess the infection exposure.
9. Online trainings for competency building for use of IT tools like Arogya Setu and ITIHAAS in States of Delhi, Punjab, Srinagar, Maharashtra, etc.
10. Coordinated regular data uploading on IT portal for regular situation assessment and planning effective containment strategies.
11. IEC: technical review of IEC material for community awareness. Preparing IEC material and various guidelines to help the States in various phases of the pandemic
12. Trained more than 500 participants from various institutes and organizations, viz. BSF, ITBP, INMAS, DRDO, ICMR, MAMC, LHMC, Delhi Government, Supreme Court of India, National Human Rights Commission, etc. on COVID-19 Diagnosis and Management including RT-PCR testing, rapid card testing, BMW management, Sample collection & transport, PPE donning & doffing, Maintaining hand & respiratory hygiene, etc.

NCDC’s mandate is to strengthen public health capacity and infrastructure at State level and enable NCDC expertise to effectively cover the entire country. A proposal (concept note) on strengthening of Surveillance and lab testing capacity was developed and submitted under PM-ASBY. Main components were Regional NCDC, Metropolitan surveillance units, SHOC, AMR, Bio-security, One Health, Zoonotic lab capacity etc.

NCDC is the Nodal division for National AMR containment programme. National Guidelines on Infection Prevention and Control developed for Healthcare facilities. Annual AMR surveillance data to Global AMR Surveillance System (GLASS) in time. Further, annual Tripartite AMR country self-assessment survey (TrACSS) and Virtual trainings on ECHO platform done for the 29 state medical colleges in 24 states for standardisation of laboratory techniques.   IEC, Media material for awareness developed. National reference laboratory conducted EQAS for network labs and carried out confirmation and characterisation of emerging AMR strains submitted by network sites.

Centre For Arboviral And Zoonotic Diseases:  COVID-19 testing by RT-PCR and Referral sample testing for zoonotic pathogens and hands-on Workshop on Diagnostic Rickettsiology for Microbiologists and Laboratory Staff of institutions from Delhi NCR. Five scientific publications in the year.

IDSP covers all states and UTs with the objective to strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases and to monitor disease trends to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs). This year, IDSP is also coordinating overall surveillance activities in India regarding CoVID – 19 pandemic.A total of 474 outbreaks of epidemic prone diseases like Kyasanur Forest Disease, Crimean-Congo Haemorrhagic Fever, Seasonal Influenza A (H1N1), Anthrax, Leptospirosis, Scrub Typhus etc., outbreaks were successfully detected, epidemiology division assisted the epidemiological investigation and containment by the State/ District units. A near real time, web enabled electronic health information system called Integrated Health Information Platform (IHIP) was launched in 7 States namely Andhra Pradesh, Himachal Pradesh, Karnataka, Odisha, Uttar Pradesh, Kerala and Karnataka. Till date, IHIP has been formally launched in 9 States.

Department of Parasitic Diseases (DPD):Soil Transmitted Helminths (STH) prevalence assessment re-surveys conducted in Odisha (6 districts) and Andhra Pradesh (6 Districts). Assisted field data of STH survey collection and prevalence in Kerala, Meghalaya, Maharashtra, Sikkim, Odisha, Andhra Pradesh and Dadra Nagar Haveli. The reports have been submitted to Child Health Division, MoHFW

8 NCDC branches were also involved in support to state governments in COVID-19 screening and contact tracing of international passengers in Varanasi and other districts. In addition routine filarial clinics, trainings, entomological surveys were also conducted at every weeks.IEC and Morbidity Management and Disability Prevention (MMDP) Programme on Lymphatic Filariasis to Filaria patients at PHC, Dwarapudi, East Godavari district.Calicut branch also assisted investigation on first three cases of COVID-19 in Kerala and India.

Upgradation of NCDC branches: The NCDC Branch will provide State of Art Laboratory with sophisticated equipments to provide diagnostic support to State Government in diagnosis of emerging and re-emerging diseases. The manpower support of experts in Public Health, Microbiology, Entomology and other Paramedics/ Technocrats will be provided by NCDC. It will enhance the capacity and capability of Disease surveillance, outbreak/s investigation and rapid response to combat outbreak in State.

Status of establishing New NCDC branches: in 13 states land has been identified and made available by the states and MoU has been signed. Jharkhand-. Building construction work of NCDC branch is near completion.

Biotechnology Division: The division provides molecular diagnostic services, molecular epidemiology, specialized training and applied researchonvarious important epidemic-prone diseases of public health. The Division procured and installed the COBAS 6800 fully Automated Diagnostic Machine for COVID-19 and carried out testing of approx. 175000 samples during the past 7 months.

Whole Genome Sequencing: Standardized whole genome sequencing of SARS-CoV-2. In addition Whole Genome Sequencing of 352 COVID-19 positive samples were carried and submitted to the GISAID in collaboration with IGIB. Phylogenetic analysis revealed local transmission and persistence of genomes A4, A2a and A3. The most prevalent genomes with patterns of variance (confined in a cluster) remain unclassified, and are here proposed as A4-clade based on its divergence within the A cluster (Fig.1).

 

Fig. 1. Phylogenetic analysis of SARS-CoV-2 genomes sequenced by NCDC-IGIB

Nucleotide sequencing was carried out for identification and differentiation of various viral genotypes and serotypes of dengue, hepatitis and microbial samples. Biotechnology division was able to identify annual changes in dominant serotype of dengue virus in Delhi over the years (2015-2020). Identification of antibiotic resistance genes in bacterial isolates was also performed to study the AMR profiles. Hepatitis outbreak samples from Bhatinda, Punjab were also sequenced at the Division.

Applied Research: Detection of other respiratory pathogens using nested multiplex PCR in samples received for Covid 19 diagnosis: A total of 600Covid19 negative samples and 400 COVID-19 positive samples were tested for the presence of other respiratory pathogens by nested multiplex PCR technique. Gene sequencing for the positive samples is currently underway.

National Program For Surveillance Of Viral Hepatitis: The National Program for Surveillance of Viral Hepatitis under the aegis of National Centre for Disease Control, DGHS is a central sector scheme with a budget outlay of Rs 38.34 crores. The program has got extension for one year till 31^st March 2021. The program has expanded to all fifteen regional laboratories for carrying out surveillance of acute viral hepatitis. The guidelines, Procurement of testing kits and equipment for initiation ofsurveillance of acute viral hepatitis from 1^st week of Jan 2021 completed. The viral hepatitis markers for Anti HAV IgM, Anti HEV IgM, HBsAg, Anti HBc, HBeAg, Anti HCV tested.

Centre For Environmental Occupational Health And Climate Change & Health Division (Ceoh-Cch)- conducts of activities and undertakes coordination with other sectors including non-health to address the health related issues pertaining to climate and environmental factors. After introduction of “Mission on Health” in year 2015 under the Prime Minster Council on Climate Change (PMCC), National Action Plan for Climate Change and Human Health (NAPCCHH) was prepared and in February 2019, National Programme on Climate Change and Human Health (NPCCHH) under National Health Mission (NHM) was approved by MoHFW. Key activities are focused on Air pollution (development of sentinel surveillance for, development of HAP, IECs and coordination with COEs), Heat related illnesses, Vector borne illnesses etc..

Applied Research:  Detection of other respiratory pathogens using nested multiplex PCR in samples received for Covid 19 diagnosis (in 600Covid19 negative and 400 Covid 19 positive samples) for the presence of other respiratory pathogens by nested multiplex PCR technique. These pathogens are divided into 5 groups and their corresponding primers were used for amplification of that particular target pathogen/ group. A total of 55 PCR products of Dengue Virus, which were received from Zoonosis division for Nucleotide Sequencing during 2015 to 2020 were resolved using Bioinformatics tools to find out the serotype. The bioinformatics analysis revealed that the sequences belonged to serotype DENV1, DENV2, DENV3 and DENV4. During 2019-20 DENV1, DENV3 & DENV4 have been detected.

16. National Viral Hepatitis Control Program (NVHCP)

National Viral Hepatitis Control Program under the National Health Mission in alignment with SDG 3.3 aims to target the management of 5 crore people possibly harbouring the infection. Under the program, free diagnostics and drugs are being made available to all in need, not only for treatment of hepatitis C, but also for life-long management of hepatitis B. The key strategies adopted under the program include preventive, promotive and curative interventions with the focus on awareness generation, increasing access, promoting diagnosis and providing treatment for viral hepatitis.

Achievements (Till September 2020):

• No of serological tests done for diagnosis of viral hepatitis C – 11,99,524
• No of new patients initiated on treatment of hepatitis C – 49,590
• No. of new patients completed treatment of HCV (End of treatment) – 12,086
• No of serological tests done for diagnosis of viral hepatitis B – 21,11,238
• Establishment of 456 Treatment sites for management of viral hepatitis across 362 districts

Amidst COVID 19 pandemic, Viral hepatitis services were included in non-COVID essential health care services and guidelines for multi month dispensation were issued to ensure uninterrupted supply of drugs for management of viral hepatitis. Coordination among the states was ensured for uninterrupted treatment.  During lockdown period a good inter-state coordination was observed to address the needs of all patients. Electronic communications played a pivotal role to enable prompt response to the key concerns for all in real time. During lockdown the tracking of patients was attempted by the states through various modes of communication like WhatsApp, SMS by State Nodal Officers and facilitated by the Program Division. Door step delivery of drugs in various states was done leveraging on other health schemes. Movement passes were issued to avail treatment services with the help of District Administration in some states like Punjab. A few States provided teleconsultation services to viral hepatitis patients.

With ongoing COVID 19 pandemic, all states /UTs are being supported virtually to build capacities at all levels of healthcare facilities such that there is access to diagnosis and management till health and wellness centres in a phased manner.

In order to strengthen the NVHCP- Management Information System under M&E framework, a web portal for Hepatitis B has been launched on 28th July 2020 on the occasion of World Hepatitis Day.

17. Central Government Health Services (CGHS)

CGHS is providing healthcare facilities to 12.92 Lakh primary Card holders ( and 37.71 Lakh- total beneficiaries) through a network of 331 Allopathic Wellness Centres and 88 Ayush Centres located in 74 Cities across India.

17.1 Opening of New Allopathic Wellness Centers

Opening of New Allopathic Wellness Centers during the year at

• Kannur
• Kozhikode

 

17.2 Other Achievements:

1. CGHS Medical Officers and Staff have been part of the fight against COVID-19 Infection — performing duties at Air-ports and Quarantine Centres.
2. Special Provisions to CGHS beneficiaries in view of the COVID-19 Infection:

•           Option to purchase OPD Medicines for Chronic illnesses till 31st December 2020 and claim reimbursement

•           Temporary extension of validity of Card in case of pensioner CGHS beneficiaries availing card on annual basis and expiring on 31St March onwards

•           Temporary provision of CGHS facilities till 31st July 2020 for Central Government employees superannuating from 31st March 2020 onwards

•           Directions to open separate 'Fever Clinic' at Wellness Centres for screening beneficiaries for Fever and other suggestive symptoms and referral to Nodal Centres

•           Directions to CGHS Wellness Centres to provide assistance to COVID 19 +ve CGHS beneficiaries under Home Quarantine and permission to such CGHS beneficiaries to purchase one Pulse Oxymeter (@ Rs1200/-) per family

•           Tele- consultation facility with Govt. Specialists through      e-Sanjeevani

•           Online payment of subscription through `Bharatkosh'

 

17.3 Settlement of Hospital Bills:

Special Attention to settlement of Hospital Bills to ensure availability of Liquidity with private hospitals empanelled under CGHS so that they extended facilities to CGHS beneficiaries , particularly pensioners.

Hospitals bills of about Rs.952 Cr are cleared during current financial year till date.

 

18. Drug Regulation

• Doorstep delivery of drugs to consumers under Section 26B of the Drugs and Cosmetics Act, 1940, published vide G.S.R. 220(E) dated 26.03.2020, applicable only for retail chemists having retail sale license in Form-20 or Form-21 under the Drugs and Cosmetics Rules, 1945 vide gazette notification GSR No. 220(E) dated 26.03.2020
• National Institute of Biologicals, Noida has been notified for testing of COVID-19 vaccines in addition to the existing Central Drugs Laboratory, Kasauli for temporary period (12 months) under Section 26B of the Drugs and Cosmetics Act, 1940 in the wake of COVID-19 pandemic vide gazette notification No. SO 4206 (E) dated 24.11.2020
• Cosmetics Rules, 2018 has been published  vide gazette notification GSR No. 763(E) dated 15.12.2020.

 

19. Dental Education

19.1 Increase in MDS seats:

Permission for increase of 461 additional MDS seats was granted for academic session 2020-21 taking the total number of MDS seats in the country to 6,689.

19.2 Increase in BDS seats:

Permission for increase of 575 additional BDS seats was granted for academic session 2020-21 taking the total number of BDS seats in the country to 27,595. Two new Dental Colleges were also established in the current academic session taking the count of number of Dental Colleges in the country to 315.

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MV/SJ

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