Public Health is a State subject; hence, the responsibility of providing medical assistance to patients of all income group is of respective State/ UT Governments. However, National Health Mission (NHM) – a flagship programme of the Ministry with its two Sub-Missions, National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM), supports States /UTs to strengthen their health care systems so as to provide universal access to equitable, affordable and quality health care services.
The schemes launched under NHM are available free of cost to all income groups visiting in Public Health Facilities at sub district and district level are given below:
The following programmes/ schemes are run by government under National Health Mission:
Reproductive, Maternal, Neonatal, Child and Adolescent health
- Janani Shishu Suraksha Karyakaram (JSSK)
- Rashtriya Kishor Swasthya Karyakram(RKSK)
- Rashtriya Bal Swasthya Karyakram (RBSK)
- Universal Immunisation Programme
- Mission Indradhanush (MI)
- Janani Suraksha Yojana (JSY)
- Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
- Navjaat Shishu Suraksha Karyakram (NSSK)
- National Programme for Family planning
- LaQshya’ programme (Labour Room Quality Improvement Initiative)
National Nutritional Programmes
- National Iodine Deficiency Disorders Control Programme
- MAA (Mothers’ Absolute Affection) Programme for Infant and Young Child Feeding
- National Programme for Prevention and Control of Fluorosis (NPPCF)
- National Iron Plus Initiative for Anaemia Control
Communicable diseases
- Integrated Disease Surveillance Programme (IDSP)
- Revised National Tuberculosis Control Programme (RNTCP)
- National Leprosy Eradication Programme (NLEP)
- National Vector Borne Disease Control Programme (NVBDCP)
- National AIDS Control Programme (NACP)
- Pulse Polio Programme
- National Viral Hepatitis Control Program (NVHCP)
- National Rabies Control Programme
- National Programme on Containment of Anti-Microbial Resistance (AMR)
Non-communicable diseases
- National Tobacco Control Programme(NTCP)
- National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS)
- National Programme for Control Treatment of Occupational Diseases
- National Programme for Prevention and Control of Deafness (NPPCD)
- National Mental Health Programme
- National Programme for Control of Blindness & Visual Impairment (NPCB&VI)
- Pradhan Mantri National Dialysis Programme (PMNDP)
- National Programme for the Health Care for the Elderly (NPHCE)
- National Programme for Prevention & Management of Burn Injuries (NPPMBI)
- National Oral Health programme
Support under NHM to States/UTs includes provision of a host of free services such as maternal health, child health, adolescent health, family planning, universal immunisation programme, and for major diseases such as Tuberculosis, HIV/ AIDS, vector borne diseases like Malaria, Dengue and Kala Azar, Leprosy etc.
Other major initiatives include Janani Shishu Suraksha Karyakram (JSSK) (under which free drugs, free diagnostics, free blood and diet, free transport from home to institution, between facilities in case of a referral and drop back home is provided), Rashtriya Bal Swasthya Karyakram (RBSK) (which provides newborn and child health screening and early interventions services free of cost for birth defects, diseases, deficiencies and developmental delays to improve the quality of survival), implementation of Free Drugs and Free Diagnostics Service Initiatives and PM National Dialysis Programme.
Mobile Medical Units (MMUs) & Telemedicine are also being implemented with NHM support to improve healthcare access particularly in rural areas.
- The Ayushman Bharat Programme launched last year provides for holistic and integrated health care and is the principal vehicle for achieving Universal Health Coverage (UHC).
- It’s Health and Wellness Centre component (AB-HWC) provides essential primary and community health services such as maternal, neonatal and child health services including immunization and nutrition, thus fostering human capital development during children’s critical early years. These centres also provide services to prevent and manage common NCDs and major communicable diseases.
- The other component, AB-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides free and cashless care to about 500 million poor and deprived people for secondary and tertiary hospitalization care.
- To enhance the facilities for tertiary care of cancer, Strengthening of Tertiary Care for Cancer Scheme is being implemented to support setting up of State Cancer Institutes (SCI) and Tertiary Care Cancer Centres (TCCC) in different parts of the country. Oncology in its various aspects has focus in case of new AIIMS and many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY).
- Financial assistance to patients living below poverty line for life threatening diseases under the schemes such as Rashtriya Arogya Nidhi (RAN), Health Minister’s Cancer Patient Fund (HMCPF) and Health Minister’s Discretionary Grant (HMDG) is also provided.
- Affordable Medicines and Reliable Implants for Treatment (AMRIT) Deendayal outlets have been opened with an objective to make available drugs and implants for Cardiovascular Diseases (CVDs), Cancer and Diabetes at discounted prices to the patients.
Services at Ayushman Bharat – Health and Wellness Centres (AB-HWCs) are free and universal to all individuals residing in the service area.
Under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the State/ UT wise number of hospital admissions is given below:
|
Status as on 24.06.2019
|
|
Sl. No.
|
State
|
No of Hospital Admissions
|
|
1
|
Andaman And Nicobar Islands
|
22
|
|
2
|
Andhra Pradesh
|
135,346
|
|
3
|
Arunachal Pradesh
|
652
|
|
4
|
Assam
|
47,631
|
|
5
|
Bihar
|
48,711
|
|
6
|
Chandigarh
|
835
|
|
7
|
Chhattisgarh
|
564,568
|
|
8
|
Dadra And Nagar Haveli
|
12,081
|
|
9
|
Daman and Diu
|
4,465
|
|
10
|
Goa
|
1,415
|
|
11
|
Gujarat
|
487,636
|
|
12
|
Haryana
|
27,811
|
|
13
|
Himachal Pradesh
|
19,145
|
|
14
|
Jammu And Kashmir
|
19,303
|
|
15
|
Jharkhand
|
184,760
|
|
16
|
Karnataka
|
197,799
|
|
17
|
Kerala
|
531,740
|
|
18
|
Lakshadweep
|
-
|
|
19
|
Madhya Pradesh
|
96,029
|
|
20
|
Maharashtra
|
139,906
|
|
21
|
Manipur
|
3,289
|
|
22
|
Meghalaya
|
15,404
|
|
23
|
Mizoram
|
13,422
|
|
24
|
Nagaland
|
945
|
|
25
|
Sikkim
|
122
|
|
26
|
Tamil Nadu
|
239,438
|
|
27
|
Tripura
|
17,505
|
|
28
|
Uttar Pradesh
|
119,204
|
|
29
|
Uttarakhand
|
49,815
|
|
30
|
West Bengal
|
17,636
|
|
Grand Total
|
2,996,635
|
AB-PMJAY provides health coverage of up to Rs 5.00 lakh per family per year to 10.74 crore poor, deprived families as per Socio Economic Caste Census (SECC) database. Details of the entitlement criteria are given below:
- Ayushman Bharat - PMJAY is an entitlement-based scheme with entitlement to be decided on the basis of deprivation and occupational criteria in the SECC database.
- The different categories in rural area include:
Automatically included households (based on fulfilling any of the 5 parameters of inclusion):
- Households without shelter.
- Destitute, living on alms.
- Manual scavenger families.
- Primitive tribal groups.
- legally released bonded labour
Total of (a) to (e) = 15.95 lakh
|
Standard Deprivation Parameter
|
Households
|
|
Only one room with kucha walls and kucha roof (D1)
|
2.38 crore
|
|
No adult member between age 16 to 59 (D2)
|
65.33 lakh
|
|
Female headed households with no adult male member between age 16 to 59 (D3)
|
69.43 lakh
|
|
Disabled member and no able bodied adult member (D4)
|
7.20 lakh
|
|
SC/ST households (D5)
|
3.87 crore
|
|
No literate adult above 25 years (D6)
|
4.22 crore
|
|
Landless households deriving major part of their income from manual casual labour (D7)
|
5.40 crore
|
|
Total deprived Households targeted for PM-JAY who belong to one of the six deprivation criteria amongst D1, D2, D3, D4, D5 and D7
|
8.03 crore
|
For urban areas, 11 defined occupational categories are entitled under the scheme. Targeted Urban Household categories proposed to be included in PM-JAY : 2.33 crore
|
Sr. No.
|
Worker Category
|
Households
|
|
1
|
Rag picker
|
23,825
|
|
2
|
Beggar
|
47,371
|
|
3
|
Domestic worker
|
6,85,352
|
|
4
|
Street vendor/ Cobbler/hawker / Other service provider working on streets
|
8,64,659
|
|
5
|
Construction worker/ Plumber/ Mason/ Labor/ Painter/ Welder/ Security guard/ Coolie and other head-load worker
|
1,02,35,435
|
|
6
|
Sweeper/ Sanitation worker / Mali
|
6,06,446
|
|
7
|
Home-based worker/ Artisan/ Handicrafts worker / Tailor
|
27,58,194
|
|
8
|
Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller
|
27,73,310
|
|
9
|
Shop worker/ Assistant/ Peon in small establishment/ Helper/ Delivery assistant / Attendant/ Waiter
|
36,93,042
|
|
10
|
Electrician/ Mechanic/ Assembler/ Repair worker
|
11,99,262
|
|
11
|
Washer-man/ Chowkidar
|
4,60,433
|
|
Total Targeted Urban Households
|
2.33 crore
|
Total families covered under PMJAY
|
Sr. No.
|
Categories
|
Households (number in crore)
|
|
1
|
i) Rural (based on deprivation criteria)
|
8.03
|
|
|
ii) Rural (automatically included)
|
0.16
|
|
2
|
Urban
|
2.33
|
|
3
|
Such number of families that are currently enrolled under RSBY but not in targeted SECC data
|
0.22
|
|
Total
|
10.74
|
The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha here today.
*****
MV/LK