Modernisation of Rural Healthcare facilities in Uttarakhand

Uttarakhand: Recently, through a written reply to a question in Rajya Sabha, minister of state (independent charge) Ashwini Kumar Choubey informed about the Modernisation of Rural Healthcare facilities in Uttarakhand.

National Health Mission (NHM) is the flagship programme of the Ministry of Health & Family Welfare, encompassing two sub-Missions, National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM).

However, Public Health is a state subject. Under the National Health Mission(NHM), support is provided to States/UTs to strengthen their health systems for provision of accessible, affordable and quality healthcare to all the population in rural areas based on the proposals of States in their Programme Implementation Plans.

Under NHM, funds are released to States/ UTs to strengthen their health-care systems including rural medical facilities so as to provide universal access to equitable, affordable and quality healthcare services.

Details of amount sanctioned for Hospital Strengthening and New Constructions/Renovation for the Financial Year 2014-15 to 2017-18 for the state of Uttarakhand is given below:

Statement Showing the SPIP Approval/ Sanctioned under Hospital Strengthening and New Constructions/ Renovation and Setting up for the F.Y. 2014-15 to 2017-18 for the state of Uttarakhand.
Rs. In Lakhs
S. No	State	2014-15	2015-16	2016-17	2017-18
		SPIP approvals	SPIP approvals	SPIP approvals	SPIP approvals
1	Uttarakhand	1457.04	294.42	1826.23	1113.05
Note:
1. SPIP- State Programme Implementation Plan.

2. The above approvals contain (1) Hospital Strengthening - Up- Gradation of District Hospitals, Sub Divisional Hospitals, Community Health Centres (CHCs), Primary Health Centres (PHCs) and Sub Health Centre (SHCs) (2)New Constructions/ Renovation and Setting up of CHCs, PHCs, SHCs/Sub Centres.

Under NHM, the resource envelope of any State/UT is determined by the socio-economic factor and health indicators of the State/UT.

In view of above, 3 Himalayan hilly states namely Himachal Pradesh, Jammu & Kashmir and Uttarakhand have been given a weightage of 3.2 times over other states.  Apart from this, hilly and tribal areas enjoy special dispensation under NHM, the details are given below:

Special dispensation within NHM provided to hilly and tribal areas

Under National Health Mission (NHM), financial and technical support is provided to States to strengthen the public Health system including up gradation of existing or construction of new infrastructure.

1. The population Norms for setting up of public health facilities in the General areas are as under:

• Sub Centre: 1 per 5,000 population


• Primary Health Centre: 1 per 30,000 population


• Community Health Centre: 1 per 1,20,000 population

2. The populations & other Norms for setting up of public health facilities in the hilly and tribal areas   are as under:

• Sub Centre: 1 per 3,000 populations. A new norm has also been adopted for setting up a SHC based on ‘time to care’ within 30 minutes by walk from a habitation has been adopted for selected district of hilly and Desert areas. It has also been decided to strengthen Sub-Health Centres based on 'time to care' within minutes by walk from habitations has been adopted in selected districts of hilly States and desert areas


• Primary Health Centre: 1 per 20,000 population


• Community Health Centre: 1 per 80,000 population

3. Provision of Mobile Medical Units (MMU) in hilly and tribal areas

Relaxation has been made available on a case to case basis for hilly/tribal/desert areas, where the populations are widely dispersed and the geographical terrain is difficult.

In view of this, relaxednorm of one MMU per 10 lakh population in cases where patients served through existing MMUs exceeds 60 patients per day in plain areas and 30 patients per day in hilly areas, on a case to case basis, have also been approved.