Improving health indicators in India

NEW DELHI (INDIA): India has demonstrated reduction in key health indicators such as Infant Mortality Rate, Maternal Mortality Ratio (MMR), Under 5 Mortality Rate.nnFurther, the annual average pace of decline in MMR (for the period 1990 to 2013) was much faster in India (4.5%) as compared to global rate (2.6%).nnAdditionally, mortality due to various diseases has reduced too. For instance, the Global Burden of Disease (2015) reports a decrease in mortality (between the years 2005 and 2015) on account of lower respiratory infections (by 22.6%), diarrhoeal diseases (by 31.7%), tuberculosis (by 30.7%), neonatal preterm birth (by 39.5%), neonatal encephalopathy (by 31%) and road injuries (by 2.7%).nnAs per the Global Burden of Disease report for India, the deaths due to self-harm for the period 2005 to 2015 have declined by 3.9%. The Centrally Sponsored Scheme (CSS) National Health Mission (NHM), has two sub-missions, viz. the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM). While NRHM was launched in April 2005, launch of NUHM was approved by the Cabinet on 1^st May 2013.nnNHM envisages achievement of universal access to equitable, affordable & quality healthcare services that are accountable and responsive to people?s needs. The main programmatic components include Health System strengthening in rural and urban areas, Reproductive-Maternal-Neonatal-Child and Adolescent Health (RMNCH+A) interventions and control of Communicable and Non-Communicable Diseases. Under NHM, support is provided to the States/UTs to strengthen their health care system based on the requirements posed by them under Programme Implementation Plans. Funds allocated, released and expenditure incurred State/UT wise are given below:nnNational Health MissionnnStatement showing States/UTs wise Allocation, Release and Expenditure during 2013-14 to 2015-16 (Rs in crore)n

Sl. No.		States	2013-14			2014-15			2015-16
Sl. No.		States	Allocation	Release	Expenditure	Allocation	Release	Expenditure	Allocation	Release	Expenditure
1		Andaman & Nicobar Islands	23.83	29.06	29.12	28.22	23.36	24.33	28.21	37.30	11.47
2		Andhra Pradesh	1184.24	878.73	1044.81	707.15	519.73	902.91	616.23	643.52	1090.17
3		Arunachal Pradesh	86.31	78.60	92.03	185.65	139.41	69.50	160.01	162.65	146.27
4		Assam	1214.83	1077.81	956.89	1095.38	877.13	915.88	941.29	971.35	1186.01
5		Bihar	1487.65	1110.32	1480.68	1292.13	1148.32	1427.40	1108.61	1159.49	1621.67
6		Chandigarh	18.53	11.46	14.42	19.40	12.15	15.26	14.24	23.89	20.98
7		Chattisgarh	500.72	355.98	805.50	555.66	500.41	716.04	479.38	412.26	758.28
8		Dadra & Nagar Haveli	8.73	9.23	9.83	13.99	8.40	8.56	11.37	14.37	15.54
9		Daman & Diu	6.48	6.50	8.40	9.69	6.91	7.67	9.11	10.53	15.69
10		Delhi	211.46	129.78	132.59	192.59	154.04	222.64	142.81	163.80	137.29
11		Goa	27.12	19.35	30.58	27.63	26.03	29.50	19.41	16.77	24.92
12		Gujarat	833.94	833.72	977.48	858.47	832.86	873.66	677.65	693.78	1272.42
13		Haryana	313.57	315.94	423.79	317.42	273.60	438.18	249.33	291.96	493.23
14		Himachal Pradesh	225.95	205.29	158.60	232.00	185.84	306.92	197.92	246.49	281.26
15		Jammu & Kashmir	433.87	395.10	391.10	435.17	335.51	393.29	368.00	367.90	420.94
16		Jharkhand	582.97	396.38	521.49	563.92	359.62	372.01	493.37	411.50	590.18
17		Karnataka	814.17	611.11	812.56	834.09	697.24	858.18	706.09	740.45	1141.61
18		Kerala	424.15	360.98	673.07	373.58	521.99	509.83	305.87	304.14	632.88
19		Lakshadweep	3.61	3.20	2.28	5.89	5.08	1.36	4.28	5.69	2.72
20		Madhya Pradesh	1141.03	865.94	1583.60	1250.17	1162.50	1738.02	1085.37	1132.19	2046.60
21		Maharashtra	1520.71	1218.51	1806.86	1536.58	1431.76	1834.40	1282.31	1085.92	1734.44
22		Manipur	127.75	88.93	74.57	144.97	128.81	86.91	118.53	112.16	105.51
23		Meghalaya	139.24	125.51	71.53	160.21	104.13	70.72	131.00	102.22	133.55
24		Mizoram	86.20	77.43	91.89	116.53	103.28	93.29	97.87	94.68	172.38
25		Nagaland	114.42	99.73	90.40	131.26	114.92	63.04	108.75	104.85	81.05
26		Odisha	678.99	604.20	901.65	730.09	667.16	944.10	624.71	652.62	1205.77
27		Puducherry	21.29	18.10	25.43	25.46	22.56	23.35	17.77	18.61	21.77
28		Punjab	362.38	333.47	437.57	351.89	379.35	460.59	284.75	295.23	649.49
29		Rajasthan	1091.20	922.93	1457.06	1238.11	1115.96	1722.69	1069.38	1287.84	1799.11
30		Sikkim	42.32	45.91	44.82	51.42	51.60	41.36	45.86	41.01	50.71
31		Tamil Nadu	1020.75	906.24	1430.28	968.18	952.75	2248.06	794.38	1093.22	1633.37
32		Tripura	165.43	140.15	101.93	161.75	123.11	130.15	139.08	136.29	118.77
33		Uttar Pradesh	3584.98	3024.60	2924.38	2650.25	2431.06	3671.26	2299.49	2862.83	4451.78
34		Uttarakhand	310.55	245.25	255.28	308.10	270.55	324.42	256.60	276.41	335.95
35		West Bengal	1179.64	948.51	1271.71	1053.27	1058.62	1196.78	883.49	959.51	1487.62
36		Telangana	0.00	0.00	0.00	506.45	378.72	334.68	440.58	436.63	505.55
	1. Allocation is as per Original outlay/Budget Estimates
	2. Expenditure includes expenditure against central Release, state release & unspent balances at the beginning of the year and it is updated as per FMR submitted by the States/UTs.

nTo meet the shortfall of human resource in health, the government is implementing a Centrally Sponsored Scheme for ?establishment of new medical colleges by upgrading district/referral hospitals? with fund sharing between the Central Government and States in the ratio of 90:10 for North Eastern /special category states and 60:40 for other states. This scheme was approved in January, 2014. Criteria for identification of Districts under the scheme are i)District Hospitals/referral hospital with bed strength of 200 or more ii)District/Referral hospitals of the districts where there is no medical college iii) Preference to underserved areas. Funds released to the State Governments for the approved districts under the scheme are given below:nn Funds released under the Centrally Sponsored Scheme for Establishment of New Medical Colleges attached with existing District/Referral hospitals during last three yearsnn(Rs. in crore)nn n

S. No.	States/UT	2014-15	2015-16	2016-17 till date
1	Andaman and Nicobar Islands	0	28	20
2	Arunachal Pradesh	0	42.5	10
3	Assam	0	30	19
4	Bihar	0	8	34
5	Chhattisgarh	14	39.02	83
6	Himachal Pradesh	12.53	67.98	114
7	Jharkhand	0	0	48
8	Jammu & Kashmir	0	0	48
9	Madhya Pradesh	14	24	81
10	Maharashtra	6	7	55
11	Mizoram	0	30	10
12	Nagaland	0	36.5	10
13	Odisha	35	85	50
14	Rajasthan	41	89.2	88
15	Uttar Pradesh	0	16	78
16	Uttarakhand	6	8	18
17	West Bengal	0	20	79

nUpgradation of existing State Government/Central Government medical colleges to increase MBBS seats in the country:- This scheme was approved in January, 2014. The funding pattern is 90:10 by Central and State Governments respectively for North Eastern States and Special category States and 60:40 for other States with the upper ceiling cost pegged at Rs.1.20 crore per seat. 22 Medical Colleges have been approved under the scheme to increase UG seats. Funds released under this scheme are given below:nnFunds released under the Centrally Sponsored Scheme for ?Up-gradation of existing State Government/Central Government medical colleges to increase MBBS seats in the Country? during the last three yearsnn nn(Rs. in crore)n

S. No.	States/UT	2014-15	2015-16	2016-17 till date
1	Andhra Pradesh	0	6	10.2
2	Gujarat	0	4.5	11.56
3	Madhya Pradesh	0	12	27.48
4	Odisha	0	5	12
5	Punjab	0	4	6.8
6	Rajasthan	0	7	15.4
7	Tamil Nadu	0	9.5	23.16
8	Uttarakhand	0	2	3.4

nStrengthening and upgradation of State Government Medical colleges for starting new PG disciplines and increasing PG seats:- The scheme was launched in the XI Plan period with the objective to strengthen and upgrade State/Central Government Medical Colleges to create new PG seats. The funding pattern between Centre and States is in the ratio of 60:40. A total of 72 Government Medical colleges are covered under the scheme for increasing PG seats. Funds released under the scheme are given below:nnFunds Released under the scheme for ?Strengthening and up-gradation of State Government Medical Colleges for starting new PG disciplines and increasing PG seats? during the last three years ( Rs in crore)n

S. No.	State/UT	2013-14	2014-15	2016-17 Till date
1	Assam	0	0	3
2	Andhra Pradesh	0	0
3	Bihar	0	0
4	Chandigarh	0	0
5	Chhattisgarh	0	0
6	Goa	0	0
7	Gujarat	0	0
8	Himachal Pradesh	0	0
9	Jammu & Kashmir	0	0
10	Jharkhand	0	0
11	Kerala	0	0
12	Madhya Pradesh	0	5	1.94
13	Maharashtra	0	0
14	Odisha	0	0	3.06
11	Punjab	30.92	0
16	Rajasthan	0	0
17	Telangana	0	0	2
18	Tripura	0	0
19	Uttarakhand	0	5
20	Uttar Pradesh	0	0
21	West Bengal	0	0
	Note: There was no release in 2015-16

nRashtriya Swasthya Bima Yojana (RSBY), a centrally sponsored health insurance scheme is being implemented by this Ministry which covers BPL families (a unit of five) and other categories namely Building & Other Construction Workers, licensed Railway porters, Street Vendors, MGNREGA workers (who have worked for more than fifteen days during preceding financial year), Beedi workers, Domestic workers, Sanitation Workers, Mine Workers, Rickshaw pullers, Rag pickers and Auto/Taxi drivers, who are enrolled under RSBY. They are entitled for health insurance coverage of Rs.30,000/- cashless per annum per family. Under RSBY there is no state/UT-wise allocation of funds. Central Government releases its share of premium to State Governments on the receipt of their proposals. The State/UT-wise details of the funds released to State Governments during last three years are given below:nnCentral share of Premium released to State Governments under RSBY during last three years (Amount in Crore)n

Sr. No.	Name of State/UT	2013-14	2014-15	2015-16
1	Arunachal Pradesh	–	–	–
2	Assam	35.68	1.06	23.24
3	Bihar	152.71	34.07	–
4	Chandigarh	0.00	–	–
5	Chhattisgarh	48.34	58.81	88.77
6	Delhi	–	–	–
7	Goa	–	–	–
8	Gujarat	60.59	18.47	74.24
9	Haryana	13.01	5.38	4.67
10	Himachal Pradesh	9.03	3.75	13.90
11	Jammu & Kashmir	0.53	–	–
12	Jharkhand	51.25	5.51	–
13	Karnataka	31.59	–	94.99
14	Kerala	115.49	110.43	112.37
15	Madhya Pradesh	2.82	8.21	1.00
16	Maharashtra	13.88	–	–
17	Manipur	2.52	1.73	1.17
18	Meghalaya	1.79	1.25	4.10
19	Mizoram	4.31	10.35	9.43
20	Nagaland	2.07	4.66	–
21	Odisha	70.51	93.64	59.55
22	Puducherry	–	–	0.17
23	Punjab	5.58	2.59	2.80
24	Rajasthan	10.72	32.10	53.57
25	Tamil Nadu	–	–	–
26	Tripura	18.70	14.29	15.64
27	Uttar Pradesh	72.56	36.47	11.91
28	Uttarakhand	1.78	–	10.20
29	West Bengal	160.45	101.65	93.38