Union Minister of Health and Family Welfare
After the Prime Minister’s letter to Chief Ministers on TB, several States/UTs have established review committees under the Chairmanship of Health Minister or Secretary (Health) at the State level. Similarly, the States/UTs have also established review committees under the District Collectors / Magistrates at the district level. The State level reviews are conducted quarterly, and the District level reviews are conducted monthly. The Central Government is regularly monitoring the State Governments on implementation of the Revised National Tuberculosis Control Programme (RNTCP) and has guided the States to establish State / District level forums involving all stakeholders for ensuring a holistic approach and community led response towards addressing the problem related to Tuberculosis These State / District level reviews track progress on key priorities and help the State and District to improve performance on newer initiatives undertaken by RNTCP like Daily Regimen, Universal Drug Susceptibility testing, active TB case finding in vulnerable groups, molecular diagnostics expansion, Bedaquiline based drug resistant TB treatment expansion, incentives under Nikshay Poshan Yojana for nutritional support, etc. The Minister of State (Health and Family Welfare), Shri Ashwini Kumar Choubey stated this in a written reply in Rajya Sabha.
Special Provision for Treatment of BPL/AAY Patients in Hospitals
The Ministry of Health & Family Welfare is implementing Rashtriya Swasthya Bima Yojna (RSBY). Under this scheme, Health Insurance Coverage of Rs. 30,000/- per family per annum is provided to BPL and 11 defined categories of unorganized workers, on the approved packages and package rates in the empanelled hospitals (both public and private). The Government has approved the launch of Ayushman Bharat- National Health Protection Mission (ABNHPM) during the year 2018-19 which will cover over 10 crore poor and vulnerable families (approx. 50 crore beneficiaries) providing coverage upto Rs. 5 lakh per family per year for secondary and tertiary hospitalization. The beneficiary families under the AB-NHPM are identified based on SECC deprivation criteria for rural area and 11 defined occupational categories for urban areas. Also, the Government of India has enacted Clinical Establishments (Registration and Regulation) Act, 2010 for registration and regulation of all clinical establishments (both Government and Private) in the country. In accordance with the Clinical Establishments (Central Government) Rules, 2012 under the said Act, the clinical establishments in the States / Union Territories where the said Act is applicable are inter-alia required to display the rates charged for each type of services provided and facilities available, at a conspicuous place and charge the rates for each type of procedure and services within the range of rates determined from time to time in consultation with the State Governments. The National Council for Clinical Establishments has approved a standard list of medical procedures and a standard template for costing
of medical procedures and shared the same with the States and Union Territories for appropriate action by them. The clinical establishments are also required to follow standard Treatment Guidelines issued by the Central Government or State Government. The Act is currently applicable in eleven States and all Union Territories except Delhi. The implementation and enforcement of the said Act falls within the remit of the States/Union territories. The Minister of State (Health and Family Welfare), Smt Anupriya Patel stated this in a written reply in the Rajya Sabha.
Multi Drug Resistant TB population in India
As per Global TB report 2017, estimated number of Multi Drug Resistant ( MDR) TB patients are 6,01,000 globally, of which 147000 (1/4th) are estimated from India. Bedaquiline drug was introduced in India in 2016 under conditional access programme for selective group of the Multi drug resistant TB patients based on drug sensitivity results of second line anti TB drugs. Bedaquiline drug is manufactured by Janssen & Janssen, a subsidiary of Johnson and Johnson, at 100% export Special Economic Zone (SEZ), Bangalore, India. In India, this drug is available through Revised National TB Control Programme (RNTCP) only and open market sale of Bedaquiline is not permitted by Drug Control General – India as of now. As published in a media report, Nobel Laureate Sir John Walker had raised concern about the already known cardiotoxicity associated with the drug Bedaquiline. The Minister of State (Health and Family Welfare), Shri Ashwini Kumar Choubey stated this in a written reply in the Rajya Sabha.
Centralised health record for citizens
Government of India has issued guidelines/ standards with an objective to introduce a uniform standards based system for creation of Electronic Health Records (EHRs) by the Health care providers by formulation EHR Standards 2016. This uniform standard helps ensure the interoperability within different system. The Ministry has set up National Resource Centre for EHR Standards (NRCeS) to augment facilitation for adoption of the notified EHR Standards in technical association with Centre for Development of Advanced Computing (C-DAC), Pune for providing assistance in developing, implementing and using EHR standards effectively in healthcare Information Technology (IT) applications. The estimated cost is Rs. 23.59 Crores, out of which an amount of Rs.4 crores have been released to Centre for Development of Advanced Computing (C-DAC), Pune for setting up of National Resource Centre for EHR Standards (NRCeS). The Minister of State (Health and Family Welfare), Smt Anupriya Patel stated this in a written reply in the Rajya Sabha.
Health Ministry signs MoU with Ministry of Electronics and Information Technology to facilitate access of AB–NHPM to the last mile
National Health Agency (NHA) under Ministry of Health and Family Welfare, the apex body for the implementation of Ayushman BharatNational Health Protection Mission (AB-NHPM), and Common Service Centres (CSC) scheme under the Digital India Programme, have signed an MoU to provide information and eligibility validation services to beneficiaries, especially in remote areas. Shri J P Nadda, Minister of Health and Family Welfare and Shri Ravi Shankar Prasad, Union Minister for Law and Justice & Information Technology presided over the MoU signing ceremony. As the benefits under AB-NHPM are based on entitlement and not on enrolment, over 3 lakh CSCs spread across the rural India can become the key point of information for potential beneficiaries and help in validating their entitlement. The MoU was signed by Dr. Indu Bhushan, CEO, National Health Agency (NHA) and Dr. Dinesh Tyagi, CEO, CSC-SPV. Shri JP Nadda, Union Health Minister said “With this MoU, the dream of Digital India is taking a big leap. In Ayushman Bharat shall benefit 55 Cr people across the country. The 3 lakh CSCs in 2.5 lakh Panchayats shall be a great help in the implementation of the scheme. ” He added, “I am confident that CSCs would be a big milestone in the access of universal healthcare in our country.” Shri Ravi Shankar Prasad said that, “Today, I am very happy that CSC
VLEs are going to be the soldiers of healthcare-Ayushman Bharat in India. The identity and registrations of beneficiaries would be done through CSCs. I would like to congratulate Shri J.P. Nadda that his ministry has chosen CSCs for the implementation of the largest healthcare scheme of the world.” Dr. Indu Bhushan, CEO, National Health Agency (NHA), said that this integration will not only create more accessibility and transparency in the beneficiary validation process, but will also spread awareness among the targeted beneficiaries. The network of CSCs is the cornerstone of Digital India and they will provide support to the flagship mission for building a healthy India. AB-NHPM targets approximately 10.74 crore poor, deprived families and has identified occupational category of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data, for both rural and urban India. CSC will be provided access to Beneficiary Identification System (BIS), which helps in confirming application from ‘entitled’ beneficiaries using SECC and RSBY databases. Validation of entitled beneficiary through BIS will ensure timely information upto the last mile, facilitating benefits under Ayushman Bharat. The BIS has already been designed and pilot testing is underway across various States.
Lifestyle diseases in India
Indian Council of Medical Research (ICMR) and other Institutes conduct studies on lifestyle disease. According to ICMR India State-Level Disease Burden Study report “India: Health of the Nation’s States”, the estimated proportion of all deaths due to Non-Communicable Diseases (NCDs) has increased from 37.09% in 1990 to 61.8% in 2016. As per the National Family Health Survey (NFHS); 2015-16, 11% of women (1 in 10) and 15% of men (1 in 7) of age 15-49 are hypertensive. The survey has also found that about 60.4% of persons screened have ever had their blood pressure measured. As per ICMR’s cancer registry data, the estimated incidences of cancer patients in India are 13,28,229, 13,88,397, 14,51,417 and 15,17,426 during the years 2014, 2015, 2016 and 2017, respectively. While estimated deaths due to cancer during these years are 670541, 701007, 732921 and 766348, respectively. The Government has formulated the National Health Policy, 2017, which aims attainment of the highest possible level of good health and well-being for all at all ages, through a preventive and promotive health care orientation in all the developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence. The policy seeks to move away from Sick- care to Wellness, with thrust on prevention and Health promotion. The policy, inter alia, seeks to reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases. Government of India is also implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke ( NPCDCS) under the National Health Mission. The objective of the programme includes awareness generation for Cancer prevention, screening, early detection and referral to an appropriate level institution for treatment. For Cancer, the focus is on three Cancer namely breast, cervical and oral. Further, for early diagnosis, population level initiative of prevention, control and screening of common NCDs (diabetes, hypertension and cancers viz. oral, breast and cervical cancer) has been rolled out in over 150 districts of the country in 2017-18 under NHM, as a part of comprehensive primary healthcare. This initiative will not only help in early diagnosis but also will generate awareness on risk factors of common NCDs. Under Pradhan Mantri Swasthya Suraksha Yojana(PMSSY), 6 new AIIMS have been set up and upgradation of identified medical colleges has been undertaken which will also improve tertiary care facilities for NCDs including Diabetes. In collaboration with the Ministry of AYUSH, an initiative to use the knowledge available in AYUSH system of medicines for prevention and control of Non-communicable Diseases is being implemented in 6 districts on pilot basis. The Minister of State (Health and Family Welfare), Smt Anupriya Patel stated this in a written reply in the Rajya Sabha.
JP Nadda, Union Minister of Health and Family Welfare
Anupriya Patel, Minister of State for Health and Family Welfare
Ashwini Kumar Choubey, Minister Of State Ministry Of Health And Family Welfare