Parliament Q&A: Health & Family Welfare (February 11, 2020)

Measures To Improve Rural Healthcare

“Public Health & Hospital” being a State subject, the primary responsibility of improving the health facilities across the country including rural areas lies with the State Governments.


To address the healthcare challenges, particularly in rural areas, the National Rural Health Mission (NRHM) was launched in 2005 to supplement the efforts of the State/UT governments to provide accessible, affordable and quality healthcare to all those who access public health facilities.

National Health Mission (NHM)

Currently, NRHM is a sub-mission of National Health Mission (NHM).

NHM support is provided to States/ UTs for setting up of new facilities as per norms and upgradation of existing facilities for bridging the infrastructure gaps and to fill up the vacancies of Human Resource on contractual basis based on the requirement posed by them.

NHM support is also provided for provision of a host of free services related to maternal health, child health, adolescent health, family planning, universal immunisation programme, and for major diseases such as Tuberculosis, vector borne diseases like Malaria, Dengue and Kala Azar, Leprosy etc.

Other major initiatives supported under NHM

  • 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
  • PM National Dialysis Programme
  • Implementation of National Quality Assurance Framework in all public health facilities including in rural areas.
  • Mobile Medical Units (MMUs) & Telemedicine are also being implemented with NHM support to improve healthcare access particularly in rural areas.
  • Under the National Health Mission (NHM) support is also provided to States/ UTs for Rogi Kalyan Samitis (RKS)/Patient Welfare Committees (PWC), Village Health Sanitation & Nutrition Committee (VHSNC) and ASHAs.
Ayushman Bharat

As part of Ayushman Bharat, the Government is supporting the States for transformation of Sub Health Centres and Primary Health Centres into 1.5 lakh Health and Wellness Centres across the country by December, 2022 for provision of comprehensive primary care that includes preventive healthcare and health promotion at the community level with continuum of care approach.


ASHAs are trained to work as an interface between the community and the public health system. ASHAs have not only played a critical role in progress on maternal and child health targets, but have also become the key support at community level in rollout of a variety of public health interventions in the area of communicable diseases also.

(The Minister of State (Health and Family Welfare), Ashwini Kumar Choubey stated this in a written reply in the Rajya Sabha on February 11, 2020.)

National Health Policy with Emphasis on EWSs

The Government has formulated the National Health Policy, 2017, which aims at attainment of the highest possible level of good health and well-being, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence.

  • One of the key principles of the policy is to reduce inequity which would mean affirmative action to reach the poorest. It would mean minimizing disparity on account of gender, poverty, caste, disability, other forms of social exclusion and geographical barriers.
  • The policy also recognizes the special health needs of tribal and socially vulnerable population groups and recommends situation specific measures in provisioning and delivery of services.

(The Minister of State (Health and Family Welfare), Ashwini Kumar Choubey stated this in a written reply in the Rajya Sabha on February 11, 2020.)

“State of the World’s Children Report 2019” of UNICEF

As per UNICEF’s State of the World’s Children Report 2019, the Under 5 Mortality Rate in India is 37 per 1,000 live births against Global average of 39 per 1,000 live births in 2018, which translates to more than 8 lakhs under 5 deaths in India.

Major Causes of Child Morality (Important for UPSC Mains Exam)

As per the Sample Registration System (SRS) 2010-13 report of Registrar General of India, major causes of child mortality in India are:

  • Prematurity & low birth weight (29.8%)
  • Pneumonia (17.1%)
  • Diarrheal diseases (8.6%)
  • Other non-communicable diseases (8.3%)
  • Birth asphyxia & birth trauma (8.2%)
  • Injuries (4.6%)
  • Congenital anomalies (4.4%)
  • Ill-defined or cause unknown (4.4%)
  • Acute bacterial sepsis and severe infections (3.6%)
  • Fever of unknown origin (2.5%)
  • All Other Remaining Causes (8.4%)
Nutrition Situation of Children (Important for UPSC Prelims & Mains Exams)

As per the UNICEF 2019 report, Globalization, urbanization, inequities, humanitarian crises and climate shocks are driving unprecedented negative changes in the nutrition situation of children around the world.


Government of India has launched POSHAN (Prime Minister Overarching Scheme for Holistic Nourishment) Abhiyaan, to address malnutrition challenges in India by engaging all the important stakeholders in a convergent approach.

The goals of POSHAN Abhiyaan is to prevent and reduce stunting, underweight and low birth weight by 2% per annum and the reduction of anemia by 3% per annum.

Other Schemes to Tackle Nutrition

The Government of India has also launched several schemes under the aegis of Ministry of Women and Child Development (MWCD) to tackle malnutrition in the country including Anganwadi Services, Scheme for Adolescent Girls (SAG) and Pradhan Mantri Matru Vandana Yojna (PMMVY) to improve the nutritional and health status of children in the age-group 0-6 years. The Anganwadi Services scheme provides a package of six services i.e. Supplementary Nutrition, Pre School Non-formal Education, Nutrition and Health Education, Immunization, Health checkups and referral services.


In order to address child mortality and morbidity, the Government of India is supporting all States/UTs under National Health Mission in implementation of Reproductive, Maternal, Newborn, Child, Adolescent health and Nutrition (RMNCAH+N) strategy, which has following interventions:

  • Strengthening essential newborn care at all delivery points, establishment of Sick Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies.
  • Home Based Newborn Care (HBNC) and Home-Based Care of Young Children (HBYC) by ASHAs to improve child rearing practices and to identify sick new-born and young children.
  • Early initiation and exclusive breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted under Mothers’ Absolute Affection (MAA) in convergence with Ministry of Women and Child Development.
  • Universal Immunization Programme (UIP) is being supported to provide vaccination to children against life threatening diseases.
  • Mission Indradhanush is targeted to immunize children who are either unvaccinated or partially vaccinated i.e. those that have not been covered during the rounds of routine immunization for various reasons. Intensified Mission Indradhanush (IMI) 2.0 is rolled-out as per road-map for achieving 90% full immunization coverage across the country.
  • Nutrition Rehabilitation Centres (NRCs) have been set up at public health facilities to treat and manage the children with Severe Acute Malnutrition (SAM) admitted with medical complications.
  • Defeat Diarrhoea (D2) initiative has been launched for promoting ORS and Zinc use and eliminating the diarrhoeal deaths by 2025.
  • Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative for reduction of Childhood morbidity and mortality due to Pneumonia.
  • Anaemia Mukt Bharat (AMB) strategy as a part of Poshan Abhiyan aims to strengthen the existing mechanisms and foster newer strategies to tackle anaemia.
  • National Deworming Day (NDD) is implemented biannually every year for deworming of children (one to nineteen year of age).
  • All the children from 0 to 18 years of age are screened for 30 health conditions classified into 4Ds – Diseases, Deficiencies, Defects and Developmental delay under “Rashtriya Bal Swasthya Karyakaram” (RBSK) to improve the quality of survival and to reduce out of pocket expenditure of families.
  • District early intervention centre (DEIC) at district health facility level are established for confirmation and management of the 4D’s.
  • Village Health Sanitation and Nutrition Days (VHSNDs) are observed for provision of maternal and child health services and awareness on maternal and child Health and nutrition education through mass and social media to improve healthy practices and to generate demand for service uptake.
  • Name based tracking of mothers and children till two years of age is done through RCH portal to ensure complete antenatal, intranatal, postnatal care and immunization as per schedule.
  • Promotion of Institutional deliveries through cash incentive under Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK). 

(The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Rajya Sabha here today.)