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HEALTH

National Health Mission 

Public health 

Government of India's largest public health programme, NHM provides medical and referral services at the local level. It consists of two sub-missions: the National Rural Health Mission, and the National Urban Health Mission. 

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STRUCTURE

The rural healthcare system in India has three tiers.

  • Sub-Centres (SCs) : 1,58,417 exist;

  • Primary Health Centres (PHCs): 25,743 exist; and 

  • Community Health Centres (CHCs) : 5,624 exist. 

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*As on 31 March 2018 

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INFRASTRUCTURE

The Indian Public Health Standards (IPHS) set measures for the quality of health infrastructure in all SCs, PHCs and CHCs.

 

The proportion of functioning facilities that meet IPHS norms has been declining steadily.

 

As of March 2018, there were only 7% SCs, 12% PHCs, and 13% CHCs functioning as per IPHS norms.

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OUTCOMES

There have been improvements in the Maternal Mortality Ratio (MMR) – measured as proportion of maternal deaths per 1,00,000 live births. MMR decreased to 122 in 2015-17 from 167 in 2011-2013 (all-India).

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SPENDING

The utilisation of funds by states remains low. For instance, in Financial Year 2016-17, 57% of the total available budget was spent which slightly increased to 59% in the subsequent two years.

India has the capacity of only 1 government hospital bed for every 3,143 people in rural areas.

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Ayushman Bharat

Public health insurance

The scheme provides up to Rs 5 lakh cashless cover to 10 crore poor and vulnerable households. All claims are to be settled within 14 days. In Budget 2020, the scheme was allocated Rs 6,400, just like the previous financial year. 

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There are close to 20,000 empanelled hospitals and centres (EHCPs) under the scheme. Of these, 46% are privately run.

Health and Wellness Centres are an important part of Ayushman Bharat. The aim is to transform 1.5 lakh Sub-Centres (SCs) and Primary Health Centres  (PHCs) in the NHM by 2022. Part of the funds come from the NHM. 

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As on 30 December 2019, 27,020 HWCs were functional, or 66% of the cumulative target till 31 March 2020.  Only 36% of the target SCs had been operationalised. However, 174% of target PHCs had been operationalised. 

There are various components in NHM's scheme design. As per latest data available, between 2017 and 2019, funds were allocated for components related to making infrastructure stronger (including HWCs) increased. 

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But, allocations for patient health-related components fell.

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Reproductive and Child Health Flexipool Component

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Rs 1,817 crore

24%

15%

Health System Strengthening Component 

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Rs 1,344 crore

31%

Non-Communicable Diseases Flexipool Component

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Rs 819 crore

33%

Health and Wellness Centres 

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Rs 400 crore

41%

Flexipool for Communicable Diseases Component

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Rs 389 crore

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