2022-ம் ஆண்டு மத்திய சுகாதாரம் மற்றும் குடும்பநல அமைச்சகத்தின் குறித்த செயல்பாடுகள் / 2022 YEAR END REVIEW OF HEALTH & FAMILY WELFARE MINISTRY

TAMIL

• கொவிட்-19 தொற்றைக் கட்டுப்படுத்த சிறப்பான கண்காணிப்பு மற்றும் தடுப்பு நடவடிக்கைகள் தொடர்ந்து மேற்கொள்ளப்பட்டன. 
• கொவிட் பாதிப்பைக் கட்டுப்படுத்தும் வகையில் சிவில் விமானப் போக்குவரத்து அமைச்சகம் கப்பல் துறை அமைச்சகம் உள்ளிட்ட பல்வேறு அமைச்சகங்களுடன் சுகாதார அமைச்சகம் ஒருங்கிணைந்து செயல்பட்டது. மாநிலங்கள் மற்றும் யூனியன்பிரதேச அரசுகளுடன் தொடர்ந்து ஆலோசனைகள் மேற்கொள்ளப்பட்டன.
• கொவிட் பாதிப்புச் சூழலைக் கருத்தில் கொண்டு மத்திய அரசு கண்காணிப்பு மற்றும் நோய்த் தடுப்பு நடவடிக்கைகளை தொடந்து சிறப்பாக மேற்கொள்ள முடிவு செய்துள்ளது.
• 06 டிசம்பர் 2022 நிலவரப்படி நாட்டில் தகுதியான 91 சதவீதம் பேருக்கு முதல் தவணை கொவிட் தடுப்பூசியும், 90 சதவீதம் பேருக்கு 2-வது தவணை தடுப்பூசியும், 27 சதவீதம் பேருக்கு முன்னெச்சரிக்கை தடுப்பூசிகள் செலுத்தப்பட்டுள்ளன.
• ஆயுஷ்மான் பாரத் திட்டத்தின் கீழ் ஒரு நடவடிக்கையாக துணை சுகாதார மையங்கள், கிராமப்புற சுகாதார மையங்கள் மற்றும் நகர்ப்புற ஆரம்ப சுகாதார மையங்கள் ஆகியவற்றை மேம்படுத்தும் நோக்கில் 1 லட்சத்து ஐம்பதாயிரம் நலனாய்வு மையங்கள் ஏற்படுத்தப்படுகின்றன.
• ஆயுஷ்மான் பாரத் திட்டத்தில் பிரதமரின் மக்கள் ஆரோக்கிய திட்டத்தின் கீழ் 10 கோடியே 74 லட்சம் ஏழைக் குடும்பங்கள் ஆண்டுக்கு 5 லட்சம் ரூபாய் வரை மருத்துவக் காப்பீடு பெறும் வகையில் நடவடிக்கை மேற்கொள்ளப்பட்டுள்ளது. 20 கோடிக்கும் மேற்பட்ட ஆயுஷ்மான் அட்டைகள் வழங்கப்பட்டுள்ளன.
• மாநிலங்கள் மற்றும் யூனியன் பிரதேசங்களின் தகவல்கள் அடிப்படையில் 26 டிசம்பர் 2022 தேதி அடிப்படையில் நாடு முழுவதும் 1 லட்சத்து 41,830 ஆயுஷ்மான் பாரத் சுகாதாரம் மற்றும் நலவாழ்வு மையங்கள் செயல்பட்டு வருகின்றன.
• தேசிய சுகாதார இயக்கம் சுகாதாரத் துறையில் மனிதவளத்தை அதிகரித்துள்ளது.
• 30.6.2022 நிலவரப்படி தேசிய ஊரக சுகாதார இயக்கத்தின் நிதி உதவியுடன் 27,606 ஆயுஷ் மருத்துவர்களும் 4,337 ஆயுஷ் துணை மருத்துவர்களும் பணியமர்த்தப்பட்டுள்ளனர். 
• ஆயுஷ் மருத்துவம் முறைக்கு முக்கியத்துவம் அளிக்கும் வகையில் பல்வேறு பொது சுகாதார மையங்களில் ஆயுஷ் சேவைகளுக்கான பிரிவு தொடங்கப்பட்டுள்ளதுடன் மாவட்ட மற்றும் அதற்கு கீழ் நிலையில் சிறப்பு மருத்துவநிலையங்கள் ஏற்படுத்தப்பட்டுள்ளன.
• தேசிய ஆம்புலன்ஸ் சேவைகள் (என்ஏஎஸ்) மூலம் தற்போதைய நிலவரப்படி 34 மாநிலங்கள் மற்றும் யூனியன் பிரதேசங்களில் 108 மற்றம் 102 எண் சேவைகள் மூலம் அவசரகால மருத்துவ வாகன வசதிகள் கிடைக்கின்றன. அவசரநிலை மருத்துவ நோயாளிகள், விபத்துகளால் பாதிக்கப்பட்டவர்களில் போன்றவர்களுக்கு உதவ 108 சேவை பயன்படுகிறது. குழந்தைகள் தொடர்பான மருத்துவம் பிரவசகால மருத்துவத்திற்கு 102 என்ற பிரத்தியேகச் சேவை செயல்படுத்தப்படுகிறது.
• ஆஷா பணியாளர்களுக்கு கூடுதல் ஊக்கத்தொகை வழங்குவதற்கு தேசிய சுகாதார இயக்கத்தில் ஏழாவது கூட்டத்தில் 07.09.2022 அன்று ஒப்புதல் அளிக்கப்பட்டது.
• தேசிய நகர்ப்புற சுகாதார இயக்கத்தின் கீழ் 35 மாநிலங்கள் மற்றம் யூனியன் பிரதேசங்களில் 1,162 நகரங்கள் பயன் பெறுகின்றன.
• பிரதமரின் ஆயுஷ்மான் பாரத் சுகாதார இயக்கத்தின் கீழ் 2025-26-ம் ஆண்டு வரை 64,180 கோடி ரூபாய் நிதி ஒதுக்கீடு செய்யப்பட்டுள்ளது. நாட்டில் சுகாதார உள்கட்டமைப்பை வலுப்படுத்துவதற்கான இதுவும் ஒன்றாகும்.
• குழந்தைகள் மற்றும் தாய்மார்களின் நலனுக்காக பல்வேறு தடுப்பூசி திட்டங்களும் செயல்படுத்தப்பட்டுள்ளன. இந்திர தனுஷ் இயக்கத்தின் 4-வது கட்டத்தின் கீழ் பிப்ரவரி 2022 முதல் மே 2022 வரை 59 லட்சத்து 90 ஆயிரம் குழந்தைகளுக்கும் 15 லட்சத்து பத்தாயிரம் கர்ப்பிணிப் பெண்களுக்கும் தடுப்பூசி செலுத்தப்பட்டன.
• தேசிய காசநோய் தடுப்புத் திட்டம் 2025-ம் ஆண்டுக்குள் காசநோயை முற்றிலும் ஒழிக்கும் நோக்கில் முற்றிலும் செயல்படுத்தப்படுகிறது. இத்திட்டம் செயல்படுத்தப்படுவதன் காரணமாக கடந்த 6 ஆண்டுகளில் காசநோய் பாதிப்பு 55 சதவீதம் அளவுக்கு குறைந்துள்ளது.
• 16 எய்ம்ஸ் மருத்துவமனைகளை உருவாக்க மத்திய அமைச்சரவை ஒப்புதல் அளித்துப் பல்வேறு நிலைகளில் அதன் பணிகள் நடைபெற்று வருகின்றன.
• மருத்துவக் கல்லூரிகளும் மருத்துவப் படிப்புகளுக்கான இடங்களும் தொடர்ந்து அதிகரிப்பட்டு வருகின்றன.

ENGLISH

Steps taken by the Government of India for COVID-19 containment and management

• The Government of India continued to closely monitor the evolving nature of COVID-19 pandemic in India as well as globally. A close watch was also kept on improving knowledge about the virus, the disease, its long-term impacts, advancements being made in India as well as globally in terms of public health tools, diagnostics, therapeutics and vaccines. 
• The various technical bodies under various Ministries/Departments continued to maintain a close watch over the evolving nature of the causative virus and their public health implications. India continued its graded yet pre-emptive and proactive approach towards COVID-19 management.
• The COVID-19 trajectory in India experiences a sharp increase during March-May 2021, however, since May 2021, the trajectory has witnessed a considerable and sustained decline. Owing to Government of India’s five-fold strategy of test-track-treat-vaccinate and COVID appropriate behavior through a Whole of Government & Whole of Society approach, India has been able to limit its cases and deaths per million to 32,775 cases per million and 389 deaths per million population (as on 25^th November 2022) respectively, which is one of the lowest in the world as compared to similarly affected countries.
• The Hon'ble Prime Minister provided the much required strong and decisive leadership and guidance for national response to the pandemic. The Prime Minister Office and Ministry of Health & Family Welfare has been in regular interactions with the all States and UT administrations to review the preparedness and response measures being taken and also to identify areas for further improvement and coordination. 
• The Committee of Secretaries under Cabinet Secretary took regular reviews with all related Ministries of Health, Defence, Ministry of External Affairs, Civil Aviation, Home, Textiles, Pharma, Commerce and other officials including with State Chief Secretaries.
• The Joint Monitoring Group (JMG) under the Chairmanship of DGHS and National Task Force on COVID-19 under ICMR continue to assess the risk, review the preparedness & response mechanisms and finalize technical guidelines.
• The Government of India, based on its past experience of successfully managing pandemics and epidemics in the past and the evolving evidence based contemporary knowledge about the disease, provided the requisite strategy, plans and procedures to the State Governments and UT administrations. This includes containment plans and guidelines on a wide range of subjects related to travel, behavioral & psycho-social health, surveillance, laboratory support, hospital infrastructure, clinical management, rational use of Personal Protective Equipment (PPE) etc.
• Taking note of the evolving COVID-19 situation globally and emergence of mutant variants of SARS-CoV-2 virus, the guidelines for international arrivals were reviewed from time to time. The last updated guidelines were issued on 21^st November 2022.
• As per the updated guidelines, all international travellers to India should preferably be fully vaccinated as per the approved primary schedule of vaccination against COVID-19 in their Country. 
• The updated guidelines also prescribe precautionary measures to be followed like preferable use of masks and adherence to physical distancing measures. There is no need to submit any details about COVID-19 vaccination status or RT-PCR testing for traveling to India.
• Union Ministry of Health & FW is coordinating and collaborating with other stakeholder Ministries/departments including Ministry of Civil Aviation, Ministry of Ports, Shipping and Waterways, Ministry of Railways etc. Further Port/Airport Health Officers at International ports/ airports have been instructed to ensure strict health screening of all passengers and if passengers found to be symptomatic during screening shall be immediately isolated, taken to a designated medical facility as per health protocol.
• Further, the Union Ministry of Health & Family Welfare is in regular interaction with all States/UTs through formal communication as well as through video conferencing. States/UTs have been urged to undertake the following activities:

• Strict monitoring of International travelers in the community.
• Contact tracing of positive individuals & follow up for 14 days.
• Genome sequencing of positive samples through INSACOG Labs in a prompt manner.
• Continued monitoring of areas where clusters of positive cases emerge.
• Further strengthening of COVID-19 testing infrastructure and ensuring early identification of cases through adequate testing across the States.
• Ensure preparedness of health infrastructure (availability of ICU, Oxygen supported beds, ventilators, etc.) and upgrade health infrastructure under ECRP-II including in rural areas and for pediatric cases.
• Commissioning all PSA plants, ensuring sufficient logistics, drugs etc.
• Ensure rapid COVID-19 vaccine coverage.
• Ensuring adherence to COVID Appropriate Behaviour.
• The laboratory network is continuously being strengthened progressively in the last two years both in terms of testing infrastructure as well as diagnostics. As of  4^th Novemebr 2022, a total of  1453 government laboratories and  1935 Private Laboratories are conducting COVID-19 Testing. At present India is testing around 2 – 2.5 lakh samples a day.
• A three-tier arrangement of health facilities was created for appropriate management of COVID-19 cases, [(i) COVID Care Center with isolation beds for mild or pre-symptomatic cases; (ii) Dedicated COVID Health Centre (DCHC) with oxygen supported isolation beds for moderate cases and (iii) Dedicated COVID Hospital (DCH) with ICU beds for severe cases] has been implemented. Tertiary care hospitals under ESIC, Defence, Railways, paramilitary forces, Steel Ministry etc. have been leveraged for case management.
• As on 25^th November 2022, there are a total of 23988 COVID treatment facilities with 17,93,310 dedicated isolation beds (including   5,15,001oxygen supported isolation beds) and 1,45,014 ICU beds (including 63,850 ventilator beds).
• Guidelines on Clinical management of COVID-19 continue to be updated with emerging scientific evidence. The treatment protocol for adults was last updated on 17^th January 2022 and has been widely circulated. The mainstay of treatment is supplemental oxygen and other supporting therapy. No specific antivirals have been proven effective. However as per National treatment guidelines, drugs like inhalational Budesonide, Dexamethasone, Methylprednisolone and Low Molecular Weight Heparin have been recommended. In addition, provisions for Investigational Therapies have also been made using Remdesivir, and Tocilizumab for defined sub-group of patients under medical supervision.
• Guidelines for management of COVID-19 in children and adolescents were also updated on 20^th January 2022. The guideline covers guidance on management of acute presentation of COVID-19 as well as Multisystem Inflammatory Syndrome (MIS-C) in children and adolescents found temporally related to COVID-19.
• AIIMS, Delhi and similarly placed institutions of the States are designated Centers of Excellence for wider dissemination of latest advancements in COVID management. Telemedicine services using ‘e-sanjeevani’ for tele-consultation is one among the best practices during COVID times.
• States are being supported in terms of supply of logistics including PPE kits, N-95 masks, drugs, ventilators, oxygen cylinders, oxygen concentrators etc. States are also being supported in terms of installation of Oxygen concentrator plants/ PSA (Pressure Swing Adsorption plants) plants.
• In order to extend on-ground support to the State and District Health Authorities, Central multi-disciplinary teams are also being deployed to States from where upsurge of cases has been reported.
• In terms of financial support to States, During the FY 2020-21, funds to the tune of Rs.8257.88 crore have been released to States/UTs towards the India COVID-19 Emergency Response and Health System Preparedness Package.
• In addition, ‘India COVID-19 Emergency Response & Health System Preparedness Package: Phase-II’ has also been approved by the Cabinet with Rs 23,123 crores (with Rs. 15,000 Cr as Central Component & Rs 8,123 Cr as State component) and is being implemented from 1st July 2021. This includes support to State/UT level for ramping up Health Infrastructure including those in rural, tribal and peri-urban areas closer to the community, providing support for procurement of drugs and diagnostics to enhance service delivery at district and sub district levels for management of COVID-19 cases (including paediatric care) and for maintaining a buffer of drugs, support for IT Interventions such as implementation of Hospital Management Information System and expanding access to tele-consultations in all districts, and support for capacity building and training for all aspects of management of COVID-19.
• Government of India through National Disaster Management Authority (NDMA) has issued ‘Guidelines to provide for ex-gratia assistance to kin of the deceased by COVID-19’. NDMA has recommended an amount of Rs. 50,000/- per deceased person including those involved in relief operations or associated in preparedness activities, subject to cause of death being certified as COVID-19. The ex-gratia assistance shall be provided by States from State Disaster Response Funds.
• With the intent to develop long term capacities in preparedness for future surges of COVID-19 and other public health emergencies, PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) has been approved with an outlay of Rs. 64,180 crores over 6 years. The PM-ABHIM envisages increased investments in public health and other health reforms to safeguard against future resurgences of COVID-19, if any, and future public health emergencies by:
• Strengthening of Health and Wellness Centers in villages and cities for early detection of diseases
• Addition of new critical care-related beds at district level hospitals.
• Operationalization of Regional National Centers for Disease Control (NCDC).
• Establishment of metropolitan units in urban areas and BSL-III labs across the country to strengthen the laboratory network.
• Strengthening of existing Viral Diagnostic and Research Labs (VRDLs) and creation of new National institutes of Virology (NIVs) and a National Institute for One Health through ICMR.
• Strengthening of Public Health Units at international Points of Entry (PoEs)
• The Government of India will continue to maintain a close watch over the evolving pandemic.

Ayushman Bharat

• Ayushman Bharat comprises of two components:
• The first component pertains to creation of 1,50,000 Health and Wellness Centres (AB-HWCs) by upgrading the Sub Health Centres (SHCs) and rural and urban Primary Health Centres (PHCs), in both urban and rural areas, to bring health care closer to the community. These centres aim to provide Comprehensive Primary Health Care (CPHC), by expanding and strengthening the existing Reproductive & Child Health (RCH) and Communicable Diseases services and by including services related to Non-Communicable Diseases (common NCDs such as, Hypertension, Diabetes and three common cancers of Oral, Breast and Cervix) and incrementally adding primary healthcare services for mental health, ENT, Ophthalmology, Oral health, Geriatric and Palliative care and Trauma care as well as health promotion and wellness activities like yoga. A few States/UTs have already started rolling out these additional packages in a phased manner.
• The second component is the Ayushman Bharat-Pradhan Mantri Jan ArogyaYojana (AB-PMJAY). Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), around 10.74 crore poor and vulnerable families identified as per Socio-Economic Caste Census are entitled for health cover of Rs. 5.00 lakh per family per year for secondary and tertiary care hospitalization. As on 25th Nov 2022, 3.8 crore hospital admissions have been authorised worth more than ₹47,000 crore, 28,636 hospitals empanelled, 20.02 crore Ayushman cards issued, 33 States/UTs implementing the scheme, approximately 50% of Ayushman card recipients are women and 46% of the hospitals empanelled are private.

Comprehensive Primary Health Care (CPHC) through Ayushman Bharat Health and Wellness Centres (AB-HWCs) 

• Ayushman Bharat aims to holistically address health (covering preventive, promotive, curative, rehabilitative and palliative care), at primary, secondary and tertiary level by adopting a continuum of care approach. In the lifetime of an individual, the primary healthcare services cater to 80-90% of the healthcare needs for improved healthcare outcomes and quality of life of the population.
• The Primary Health Care team ensures that community outreach and population enumeration are done for individuals in their catchment area and screened for communicable diseases and non-communicable diseases for early detection and timely referral for accurate diagnosis. The team further ensures that treatment adherence and follow-up care are provided to the patients in the community. These centres are aimed at delivering primary healthcare services closer to the people and be the first point of contact for healthcare provisioning and referral for secondary and tertiary care. Thus, the essential health services along with the provisioning of essential medicines and diagnostics are provided closer to the community through these centres, as a step towards building stronger and resilient primary healthcare systems which cater to the healthcare needs of the population.

Achievement and Service Delivery at AB-HWCs

• As reported by the States/UTs on the AB-HWC Portal, 1,41,830 Health & Wellness Centres have been operationalized till 26th December, 2022.
• As per the data update done by the States/UTs in HWC Portal, till date, 29,94,26,521screenings have been done for hypertension and 25,55,27,170 screenings done for diabetes at these AB-HWCs. Similarly, these functional AB-HWCs have done 17,43,31,240 screenings for oral cancer, 5,66,37,370 screenings for cervical cancer in women and more than 8,27,00,336   screenings for breast cancer in women.
• Further, as on 26-12-2022, a total of 1,59,56,351 Yoga/wellness Sessions have been conducted in operational AB-HWCs.
• With the objective to provide quality health services to a patient residing in rural areas,1,09,748 Ayushman Bharat Health and Wellness Centres (AB-HWCs) have tele- consultation model, achieving a total of 7,11,58,968 teleconsultations.
• NHM has attempted to fill the gaps in human resources by providing nearly 3.32 lakh additional health human resources to the States including 94308 CHOs, 14,880 GDMOs, 4,456 Specialists, 75,041 Staff Nurses, 77,407 ANMs, 52,883 Paramedics, 429 Public Health Managers and 12,948 Programme Management staffs etc. on contractual basis, as on 30th June, 2022. Apart from providing support for health human resource, NHM has also focused on multi skilling of human resources.
• NHM also focused on multiskilling of doctors at strategically located facilities identified by the States e.g. MBBS doctors are trained in Emergency Obstetric Care (EmOC), Life Saving Anaesthesia Skills (LSAS) and Laparoscopic Surgery. Similarly, due importance is given to capacity building of nursing staff and auxiliary workers such as ANMs. NRHM also supports co-location of AYUSH services in health facilities such as PHCs, CHCs and DHs. As on 30th June, 2022, a total of 27,606 AYUSH doctors and 4,337 AYUSH paramedics have been deployed in the States with NRHM funding support.
• Mainstreaming of AYUSH has been taken up by allocating AYUSH services in 6,571 PHCs, 2,809 CHCs, 456 DHs, 4,236 health facilities above SC but below block level and 237 health facilities other than CHC at or above block level but below district level, as on 30th June, 2022.
• As on date, 34 States/UTs have the facility where people can dial 108 or 102 telephone number for calling an ambulance. Dial 108 is predominantly an emergency response system, primarily designed to attend to patients of critical care, trauma and accident victims etc. Dial 102 services essentially consist of basic patient transport aimed to cater the needs of pregnant women and children though other categories are also taking benefit and are not excluded. Janani Shishu Suraksha Karyakram (JSSK) entitlements e.g., free transport from home to facility, inter facility transfer in case of referral and drop back for mother and children are the key focus of 102 service.
• This service can be accessed through a toll-free call to a dedicated call center. As on 30th June, 2022, 1,856 ALS, 16,859 BLS, 3,253 PTV, 17 Boat and 131 Bike, Emergency Response Service Vehicles are supported under NHM, besides 4,867empanelled vehicles for transportation of patients, particularly pregnant women and sick infants from home to public health facilities and back.
• Support to Mobile Medical Units (MMUs) under NHM, now encompassing both NRHM and NUHM, is a key strategy to facilitate access to public health care particularly to people living in remote, difficult, under-served and unreached areas. As on 30th June, 2022, States/UTs have 1,567 mobile medical units which includes mobile medical units, mobile health units, mobile medical/health vans, boat clinics, eye vans/ mobile ophthalmic units, dental vans under NRHM and NUHM.
• There are 10.52 lakhs ASHAs selected across the country in rural and urban areas under the NHM who act as a link between the community and the public health system, as on 30^th June, 2022. ASHAs are envisaged to be community health volunteer and are entitled to task/activity based incentives. The Union Cabiet has approved increase in amount , for routine and recurring activities under NHM for ASHAs that will now enable ASHAs to receive atleast  fixed monthly incentive of Rs. 2000 per month in the country, against Rs 1000 earlier. 9.74 lakh ASHAs have been provided with drug kits and HBNCs kits across the country in rural and urban areas under the NHM.
•  ASHA Certification: As per NIOS, as on 3^rd April 2022, 60,763 ASHA and ASHA Facilitators have been certified.
•  In the year 2018, the ASHA benefit package was introduced acknowledging significant contribution and commitment of ASHAs. The package providing coverage for:
• Pradhan Mantri Jeevan Jyoti Beema Yojana (PMJJBY) with a benefit Rs. 2.00 Lakh in case of death of the insured (annual premium contributed by GOI).
• Pradhan Mantri Suraksha Beema Yojana (PMSBY) with a benefit of Rs.2.00 lakh for accidental death or permanent disability; Rs. 1.00 lakh for partial disability (annual premium contributed by GOI).
• In Addition, Pradhan Mantri Shram Yogi Maan Dhan (PM-SYM) with pension benefit of Rs. 3000 pm after age of 60 years (50% contribution of premium by GOI and 50% by beneficiaries) is also available for ASHA workers.
• VHSNCs: At the Village Level, the Village Health, Sanitation and Nutrition Committee (VHSNC) monitors the services provided by the Anganwadi Worker, the ASHA and the sub-centre. These Committees are envisaged to function under the ambit of the Panchayati Raj Institution with adequate representation from women and weaker sections of the society. The VHSNC acts as a subcommittee or statutory body of the Gram Panchayat. The same institutional mechanism is also mandated in urban areas. VHSNCs are provided an Untied fund of Rs 10,000 on annual basis which are topped up based on expenditure of previous year. More than 5.55 lakh VHSNC have been set up across the country till 30^th June, 2022.
• To ensure service provision for maternal and child health, 24x7 services at the PHCs have been made available.
• As on 30th June 2022, 11,119 PHCs have been made 24x7 PHCs and 3,117 facilities (including 706DH, 842 SDH and 1569 CHCs & other level) have been operationalized as First Referral Units (FRUs).
• Besides, NHM envisages provision of assured and high-quality maternal and child health services to be delivered with dignity and care at public health institutions. GoI launched MCH wings to facilitate assured admission for institutional delivery of all pregnant women. These wings are equipped with obstetric HDUs, ICUs, maternity OT, Labor rooms ensuring respectful maternity care etc. for managing high-risk pregnancies and those requiring C-sections. These centers also have skill labs for training of nurses and doctors for providing high quality and skilled maternity care.

Mera Aspataal

• Recognizing the need to capture the voice of patients for enhanced patient experience and continued learning, India launched its own centralized IT platform i.e. ‘Mera-Aspataal’/ ‘My Hospital’. 'MeraAspataal' is a patient feedback system which was launched in September 2016 with a mandate to integrate Central Government Hospitals (CGHs) & District Hospitals (DHs). It has now been extended upto CHC, Rural & Urban Primary Health Centre and private medical colleges and is currently functional in 34 States/UTs. As of now, on 15th December’22, 10,287 government health facilities and 738 non-governmental health facilities are integrated with Mera-Aspataal in 34 States and UTs.

Kayakalp

• Kayakalp programme was launched on 15 May 2015 under the ‘Swachh Bharat Abhiyaan’. Kayakalp has received overwhelming response across the nation. Within seven years of its implementation Kayakalp has been able to facelift the public health facilities’ appearance. 
• Kayakalp has made strong influence on the existing hygiene and sanitation conditions of public health facilities. Kayakalp has now been extended to the Health & Wellness Centres in all States/UTs. Total number of Kayakalp Awardee facilities have increased from 100 facilities in the FY 2015-16 to 13,825 facilities in FY 2021-22 (as on 2nd November, 2022)
• ‘Eco-friendly Awards’ have been introduced under the Kayakalp scheme with an award money of Rs 10 Lakh for DH and Rs 5 Lakh for SDH/CHC. In FY 2021-22, 48 facilities awarded as Eco-Friendly Health facility, as on 2nd November, 2022. Further, 408 DHs, 2152 SDHs/CHCs, 5300 PHCs, 1187 UPHCs, 22 UCHCs, 4756 HWCs have been given Kayakalp Awards in 31 States/UTs.

Swachh Swasth Sarvatra

• SwachhSwasthSarvatra is a joint initiative of the Ministry of Health & Family Welfare and Ministry of Drinking Water and Sanitation (Now Ministry of Jal Shakti) to achieve better health outcomes through improved sanitation and increase awareness on healthy lifestyles.
• This initiative was launched in December 2016, to build on and leverage the achievements of the two programmes – Swachh Bharat Mission (SBM) and Kayakalp – of the Ministry of Drinking Water and Sanitation and Ministry of Health and Family Welfare, respectively.
• Based on its result and success in rural areas, ‘’Swachh Swasth Sarvatra’’ was implemented in urban areas in Year 2019. In urban areas it is implemented through joint initiatives of the Ministry of Housing and Urban Affairs and Ministry of Health and Family welfare.
• Enabling Gram Panchayat, cities and wards, where Kayakalp awardee PHCs/UPHCs are located, in sustaining ODF and promoting healthy behaviour.
• Strengthening CHC/UCHCs/UPHCs in ODF blocks/Wards/Cities to achieve a high level of cleanliness to meet Kayakalp standards through a support of Rs 10.0 L for CHCs/UCHCs and Rs 50K for UPHCs under NHM.
• Build capacity through training in Water, Sanitation and Hygiene (WASH) to nominees from such CHCs and PHCs.
• Under this initiative, one-time grant of Rs. 10 Lakhs is provided to the non-Kayakalp  awardee CHC located in the Open Defecation Free (ODF) Blocks as a resource for improving the deficiencies found in Kayakalp assessment, so that by the time the next assessment is due they can become Kayakalp awardee.
• Financial support is provided to 374 health facilities in FY 2022-24 under SSS initiative  through annual PIP.

National Quality Assurance Programme

• Quality in delivery health care services is important for improving the health status of the population. It enhances accessibility, increases efficiency, strengthens clinical effectiveness, and improves user satisfaction. 
• With the aim of improving quality of care, the MoHFW launched the National Quality Assurance Standards (NQAS) for District Hospitals in 2013 and subsequently for other levels of health facilities. These standards are accredited by ISQua (International Society for Quality in Healthcare) and are also recognized by IRDA and NHA.
• As on 30th September 2022, a total of 3415 public health facilities have achieved National Quality Certification (1807 nationally certified which includes recertification also and 1608 at state level) ). In 2022, a total of 304 health facilities have been NQAS certified till 30th September 2022.The details are provided below:

National Urban Health Mission (NUHM)

• National Urban Health Mission (NUHM) was approved on 1st May, 2013 as a sub-mission under an overarching National Health Mission (NHM), NRHM being the other sub-mission. NUHM envisages strengthening the primary health care delivery systems in urban areas and for providing equitable and quality primary health care services to the urban population with special focus on slum dwellers and vulnerable population. 
• It also seeks to decongest secondary and tertiary health care facilities (District Hospitals/Sub-District Hospitals/Community Health Centre) by providing robust comprehensive Primary health care services in urban areas.
• NUHM covers all cities and towns with more than 50,000 populations and district headquarters and State headquarters with more than 30,000 population. Also below UPHC, U-HWCs (Urban Health & Wellness Centers) on the population of 15,000-20,000 have been approved under 15^th FC and PM-ABHIM. These U-HWCs are linked to the nearest UPHC –HWCs for administrative, financial, reporting, and supervisory purpose. The remaining cities/ towns are covered under National Rural Health Mission (NRHM). As part of Ayushman Bharat, the existing UPHCs are being strengthened as Health & Wellness Centres (HWCs) to provide preventive, promotive and curative services in cities closer to the communities.
• Under NUHM, the Centre-State funding pattern is 60:40 for all the states w.e.f. FY 2015-16, except all North-Eastern states and other hilly States viz. Jammu & Kashmir, Himachal Pradesh and Uttarakhand, for which the Centre-State funding pattern is 90:10. In the case of UTs, from FY 2017-18, the funding pattern of UT of Delhi and Puducherry has been revised to 60:40 and rest of the UTs without legislature are fully funded by the Central Government.
• Implementation of NUHM is through the State Health Department or the Urban Local Bodies (ULBs). In seven metropolitan cities, viz., Mumbai, New Delhi, Chennai, Kolkata, Hyderabad, Bengaluru and Ahmedabad the implementation is through the ULBs. For the other cities, the State Health Department decides whether the NUHM is to be implemented through them or the other urban local bodies. So far, 1162 cities have been covered under NUHM in 35 States/UTs.

Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)

• Pradhan Mantri Atmanirbhar Swasth Bharat Yojana scheme (now renamed as Pradhan Mantri Ayushman Bharat Health Infrastructure Mission, PM-ABHIM) with an outlay of about Rs. 64,180 Cr over till FY 2025-26 was launched by Hon’ble Prime Minister on 25th October, 2021. This is the largest pan-India scheme for strengthening healthcare infrastructure across the country.
• The measures under the scheme focus on developing capacities of health systems and institutions across the continuum of care at all levels viz. primary, secondary and tertiary and on preparing health systems in responding effectively to the current and future pandemics/disasters.
• The Pradhan Mantri Ayushman Bharat Health Infrastructure Mission targets to build an IT enabled disease surveillance system by developing a network of surveillance laboratories at block, district, regional and national levels, in Metropolitan areas & strengthening health units at the Points of Entry, for effectively detecting, investigating, preventing, and combating Public Health Emergencies and Disease Outbreaks.
• Increased investments are also targeted to support research on COVID-19 and other infectious diseases, including biomedical research to generate evidence to inform short-term and medium-term response to COVID-19 like pandemics and to develop core capacity to deliver the One Health Approach to prevent, detect, and respond to infectious disease outbreaks in animals and humans.
• The main interventions under the ‘Pradhan Mantri Ayushman Bharat Health Infrastructure Mission’ scheme to be achieved by FY 2025-26 are:
• Support for 17,788 rural Health and Wellness Centres in 10 High Focus States. Support for other States/UTs under XV Finance Commission Health Sector Grants and NHM.
• Establishing 11,024 urban Health and Wellness Centres in all the States.
• 3382 Block Public Health Units in11 High Focus states. Support for other States/UTs under XV Finance Commission Health Sector Grants and NHM.
• Setting up of Integrated Public Health Labs in all districts.
• Establishing Critical Care Hospital Blocks in all districts with population more than 5 lakhs.
• 12 Central Institutions as training and mentoring sites with 150 bedded Critical Care Hospital Blocks.
• Strengthening of the National Centre for Disease Control (NCDC), 5 New Regional NCDCs and 20 metropolitan health surveillance units;
• Expansion of the Integrated Health Information Portal to all States/UTs to connect all public health labs;
• Operationalisation of 17 new Public Health Units and strengthening of 33 existing Public Health Units at Points of Entry, that is at 32 Airports, 11 Seaports and 7 land crossings;
• Setting up of 15 Health Emergency Operation Centres and 2 container based mobile hospitals; and
• Setting up of a national institution for One Health, 4 New National Institutes for Virology, a Regional Research Platform for WHO South East Asia Region and 9 Biosafety Level III laboratories.
• In the first year of support (2022-23), a total of 33 labs will be strengthened as per target. Fund release for 20 labs has been processed.
• Land allocation for new NIVs and One health Institute at Dibrugarh, Jabalpur, Jammu, Bangalore and Nagpur (One Health) has been completed. Contracts awarded to CPWD. Tenders in process.
• Building comprehensive surveillance system with more than 4000 labs.
• Digitisation of analytics, forecasting & early warning systems through the Integrated Health Information Platform (IHIP). It is designed to capture real-time, case-based epidemiological data of more than 33 plus health conditions.
• 37,000 new critical care beds with ICU & Oxygen.
• Health units at 50 International Points of Entry: 32 Airports, 11 Seaports & 7 land crossings.

Pneumococcal Conjugate Vaccine (PCV) nationwide expansion

• PCV was launched in phased manner in May 2017 and it was available in five States in the country till FY 2019-20. In FY 2021-22, in line with the Budget announcement 2021-2022, PCV has been expanded nationwide and is now available across all States/UTs. PCV has been expanded to all States/UTs across the country. Till October 2022, a total of 11.9 crore doses of PCV have been administered across the country since introduction.
• India’s FIC as per NFHS-5: NFHS 5 survey report has shown 14.4 percentage points increase in Full Immunization Coverage as compared to NFHS-4.
• Mission Indradhanush 4.0 was conducted from February 2022 to May 2022 vaccinating 59.9 lakh children and 15.1 lakh pregnant women
• India has committed to Measles and Rubella Elimination by 2023 and has achieved a Non Measles Non Rubella (NMNR) Discard Rate of 3.9/lakh population. 

National COVID-19 Vaccination Programme

• On 16th January 2021, India launched the National COVID Vaccination Programme. COVID vaccination in the country commenced with vaccination to all Health Care Workers followed by Front line Workers, population aged ≥60 years and has subsequently expanded to cover the population aged 12 years and above. 
• The Vaccination Programme is being guided by immaculate planning based on a regular review of scientific and global test practices by National Expert Group on Vaccine Administration for COVID-19 (NEGVAC).
• Since the start of the COVID Vaccination drive, it has focused on taking decisions guided by science. Prioritizing our health workers, frontline workers and other vulnerable populations in a phased manner has been an excellent way to scale up the vaccination program.
• Under the programme, all citizens irrespective of their income status are entitled to free vaccination. While those who have the ability to pay are encouraged to use private hospital’s vaccination centres.
• Presently, several vaccines are being used in COVID Vaccination Drive, these include Serum Institute of India’s Covishield, Bharat Biotech’s Covaxin, ZyCoV-D (private hospitals only), World’s first plasmid DNA Vaccine, by Zydus Life Sciences, Corbevax, Nation’s first protein subunit vaccine by Biological E, COVOVAX SARS-CoV-2 rS Protein (COVID-19) recombinant spike protein Nanoparticle Vaccine of M/s Serum Institute of India Pvt. Ltd. (private hospitals only), GEMCOVAC-19, Nation’s first mRNA Vaccine by Gennova Biopharmaceuticals (private hospitals only) and the Russian Sputnik V(private hospitals only).
• In just 9 months of the start of the COVID vaccination drive, India achieved a significant milestone of administering over 100 crore doses of COVID vaccines to its eligible adult population. India became one of the few countries to achieve this milestone. Subsequently, another set of 100 crores vaccine doses have been administered in the next 9 months, depicting sustainability.
• Out of the total eligible population, as on 6th December 2022, over 97% citizens have received 1st dose of COVID Vaccine while over 90% eligible citizens have received 2nd dose of the vaccine. Additionally, 22.30 crore precaution doses have also been administered across the country covering 27% of the eligible adult population.

Har Ghar Dastak

• A nation-wide COVID-19 vaccination campaign Har Ghar Dastak was implemented from 3^rd Nov till 31^st Dec 2021 and from 1^st June 2022 to 31^st July 2022, which included  awareness, mobilization and vaccination campaign through reaching out to all missed out and dropped out eligible beneficiaries through intensive rounds of House to House visit. Intensive rounds of door-to-door vaccination. 
• It also focused on School-based vaccination campaign for children aged 12-18 years population along with emphasis on vaccination of beneficiaries in prisons, old-age homes, ashrams, mental health institutions etc.
• The campaign aimed to ensure that all eligible beneficiaries are vaccinated with 1^st dose, all due beneficiaries with 2^nd dose and eligible for precaution dose of COVID-19 vaccines. The Ministry had created and shared an operational guideline that was shared with all State/UT.
• With a special focus on the low performing districts, nodal officers (Joint Secretaries) were identified for regular follow ups and visits to the assigned states. 
• Further, Hon’ble Health & Family Welfare Minister also held an orientation session with NGOs & CSOs from across the country on the Har Ghar Dastak campaign. He discussed how an enhanced partnership between the government and these organizations would strengthen the campaign.

Covid-19 Vaccination Amrit Mahotsava

• As part of the celebration of 75 years of India’s Independence, Azadi ka Amrit Mahotsav is being observed across the country. Under the aegis of ‘Azadi ka Amrit Mahotsava’, GoI launched the ‘COVID Vaccination Amrit Mahotsava’ initiative from 15^th July 2022 to 30^th September 2022 under which free precaution doses were administered to all eligible beneficiaries (persons aged 18 years & above who have completed 6 months or 26 weeks after the 2^nd dose) at all Government CVCs. 
• A camp-based strategy was implemented wherein special vaccination sessions were organized at various places such as public & private offices, schools, colleges, routes of religious yatras, industrial establishments etc.
• During the initiative, more than 76.56 lakh first dose, 2.37 crore second dose and 16.07 crore precaution dose have been administered. More than 24.94 lakh doses per day have been administered including 20.87 lakh doses precaution dose per day. Further, a total of 13,01,778 such camps have been organized for free covid vaccination.
• As on 15^th July 2022, only 8% of the eligible population aged 18 years and above had received the precaution dose. However, with the help of this initiative, 27% of the eligible population has received their precaution dose.

Maternal Health

• As per the Special Bulletin on MMR released by the Registrar General of India (RGI), the Maternal Mortality Ratio (MMR) of India has improved further by a spectacular 6 points and now stands at 97/ lakh live births. The Maternal Mortality Ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births.
• As per the statistics derived from Sample Registration System (SRS), the country has witnessed a progressive reduction in MMR from 130 in 2014-2016, 122 in 2015-17, 113 in 2016-18, 103 in 2017-19 and to 97 in 2018-20.
• Upon achieving this, India has accomplished the National Health Policy (NHP) target for MMR of less than 100/lakh live births and is on the right track to achieve the SDG target of MMR less than 70/ lakh live births by 2030.
• The outstanding progress made in terms of the number of states which have achieved Sustainable Development Goal (SDG) target, the number has now risen from six to eight leading with Kerala (19), followed by Maharashtra (33), then Telangana (43) and Andhra Pradesh (45), subsequently Tamil Nadu (54), Jharkhand (56), Gujarat (57) and lastly Karnataka (69).

Child Health

• a)  As per the latest report of Sample Registration System (SRS) released in October 2021 by the Registrar General of India (RGI), Infant Mortality Ratio (IMR) of India has declined from 32 per 1000 live births for the year 2018 to 30 per 1000 live births for the year 2019.
• 27 States/ UTs namely Mizoram, Nagaland, Sikkim, Kerala, A & N Islands, Goa, Lakshadweep, Puducherry, Manipur, Delhi, D & N Haveli, Chandigarh, Tamil Nadu, Maharashtra, Daman & Diu, Punjab, Himachal Pradesh, Jammu & Kashmir including Ladakh, West Bengal, Karnataka, Tripura, Telangana, Andhra Pradesh, Gujarat, Haryana, Jharkhand, Uttarakhand have achieved National Health Policy Target (28 per 1000 live births by 2019).
• Facility Based Newborn Care (FBNC) program:  914 Special Newborn Care Units (SNCUs) at District/ Medical College Level and 2,579 Newborn Stabilization Units (NBSUs) at the level of FRUs/ CHC levels are functional to provide services to sick and small newborns. A total of 7.53 lakhs newborns received treatment in Special Newborn Care Units (SNCUs) at District Hospitals and Medical Colleges (April-November, 2021).
• National Newborn Week is observed from 15^th to 21^st November every year to reinforce the importance of newborn health as a key priority area and reiterates its commitment at the highest level. In the year 2021 also, a virtual event for the National Newborn Week was organized by MoHFW on 15^th November 2021. The theme of National Newborn Week for this year is “Safety, Quality and Nurturing care – Birth Right of Every Newborn”. National Newborn Week and SAANS Campaign IEC posters were also released by MoHFW on this day for dissemination of information and for triggering behaviour change and demand generation on newborn health.
•  
• d) MusQan - Quality improvement initiative of Child Health services: The Hon'ble Union Minister of Health and Family Welfare launched “MusQan” initiative on 17^th September 2021 for ensuring child friendly services in Public Health facilities on the occasion of World Patient Safety Day. The initiative will be focusing on improving the quality parameters for ensuring safety and availability of infrastructure, equipment, supplies, skilled human resources, clinical protocols, evidence based practices etc. at public health facilities. National dissemination of "MusQan - Quality improvement initiative of Child Health services" was conducted on 3^rd December 2021.
• Home Based Newborn Care (HBNC) program: A total of 98.63 lakh newborns received complete schedules of home visits by ASHAs whereas 3.6 lakhs identified sick newborns were referred to health facilities by ASHAs during the period of January-September 2021.
• Home Based Care of Young Child (HBYC):  In FY 2021-22, approval has been accorded for 604 Districts including all Aspirational Districts to implement HBYC across States/UTs except Goa.  More than 1.2 crores home visits conducted to young children (3 months-15 months) by ASHAs during January-September, 2021. In addition, a supportive supervision handbook for ASHA Facilitators and ANM/MPW on HBNC and HBYC programs has been shared with all States/UTs aiming to improve on job mentoring and supervision by AF/ANM/MPW to ensure quality home visits by ASHAs.
• Under Intensified Diarrhoea Control Fortnight (IDCF), 2021, approximately 8 crore children up to five years of age were provided with ORS and Zinc against the target of 13.37 crore children of the same age group. The data compilation for the IDCF/Diarrhoea prevention activities for the year 2021 round is in process.
• National Deworming Day (NDD): During 12^th round of NDD conducted in February 2021, around 17.75 crore children in the age group of 1-19 years had been provided Albendazole tablets against the target of 20.94 crore children of the same age group. The 13th round of NDD is being implemented in 34 States / UTs during the period of August-November, 2021.
• Nutrition Rehabilitation Centres (NRCs): Nearly 1.04 Lakhs Severe Acute Malnutrition (SAM) children with medical complications received treatment at 1073 Nutrition Rehabilitation Centres during FY 2020-21. During FY 2021-22 (April-September 2021), 59,424 Severe Acute Malnutrition (SAM) children with medical complications received treatment at 1080 NRCs.
• Lactation Management Centres (LMCs): As of FY 2020-21, 15 CLMCs and 3 LMUs are established in 7 States (Maharashtra, West Bengal, Goa, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh).
• Rashtriya Bal Swasthya Karyakram (RBSK):  During FY 2021-22, due to COVID- 19 pandemic, community level screening activities by Mobile Health Teams of RBSK got affected. As reported by States/UTs in HMIS during April-November, 2021, 4.2 crores children have been screened by Mobile Health Teams.  1.11 crores newborn have been screened at Delivery points under RBSK Program during April-November, 2021.
• Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS):  SAANS Campaign has been rolled-out in the States/ UTs from 12^th November, 2021 – 28^th February 2022 with the aim to accelerate the action against Childhood Pneumonia by generating awareness around protect, prevent and treatment aspects of Childhood Pneumonia and to enhance early identification and care seeking behaviours among parents and caregivers. Additionally, awareness generation, promotion and administration of Pneumococcal Vaccine (PCV) has also been included under SAANS campaign for the year 2021.
• India COVID-19 Emergency Response and Health Systems Preparedness Package (Phase II): Under India COVID-19 Emergency Response and Health Systems Preparedness Package (Phase II), the focus has been given on strengthening of Paediatric Care Facilities at Medical College, District Hospital and Sub-District level facilities.  As part of ECRP-II, support has been provided for Paediatric ICU beds, Paediatric HDU beds and Paediatric Oxygen supported beds under dedicated COVID Care Unit at District level. Also, augmentation of Paediatric ICU beds at various levels of facilities has been supported.
• “Guidelines on Operationalization of COVID-19 Care Services for Children & Adolescents” was released on 14^th June 2021 and “Guidelines for Management of COVID 19 in Children (below 18 years)” on 18^th June 2021. The Guidelines focus on all aspects of Paediatric Care which includes additional bed capacity for paediatric care during the peak daily cases considering projections for paediatric cases and admissions at different level of facilities; Augmentation of facilities - requirement of drugs, equipment, consumables, Human Resources, capacity building etc; Designating specific areas in the COVID facilities for paediatric care and accompanying parents’/ family members of child; Facility and community level planning; Transport linkages; Management of CoVID in the community settings; IEC Plan; Governance mechanism etc.

Key highlights of NFHS-5 (2019-21)

• India has achieved a replacement level of Total Fertility Rate (TFR)It is currently at 2.0 . 31 States/UTs have achieved replacement level of TFR.
• Total unmet need has reduced substantially to 9.4% (NFHS-5) from 12.9% (NFHS-4)
• Use of modern contraceptives has increased substantially.
• IUCD use has shown an increase for the first time since NFHS-1. It has increased by 0.6% points, from 1.5 % in NFHS-4 to 2.1 % in NFHS-5.
• 29 States have >70% eligible couples in need of contraception (as against 12 States in NFHS 4). It shows that Family Planning demand generation activities have shown a positive result.
• Overall positive shift towards spacing methods (increase in all spacing methods).

Mission Parivar Vikas (MPV)

• Mission Parivar Vikas (MPV) - MPV was launched in November, 2016 to substantially increase access to contraceptives and family planning services in 146 High Fertility Districts in seven high focus States with a Total Fertility Rate (TFR) of 3 and above. These Districts are from the States of Uttar Pradesh (57), Bihar (37), Rajasthan (14), Madhya Pradesh (25), Chhattisgarh (2), Jharkhand (9) and Assam (2).  
• MPV has been expanded to the remaining Districts of seven high focus States and six North Eastern States (Arunachal Pradesh, Manipur, Meghalaya, Tripura, Nagaland and Mizoram) in October, 2021.  
• MPV Districts have shown substantial increase in improving access to contraceptives.

Rashtriya Kishor Swasthya Karyakram (RKSK)

• a) Adolescent Friendly Health Clinics (AFHCs): 41.38 lakh adolescents received counselling and clinical services at Adolescent Friendly Health Clinics (AFHCs).
• b)   Weekly Iron Folic Acid Supplementation (WIFS): 3 crore adolescents had been provided Weekly Iron Folic Acid Supplementation (WIFS) every month besides Nutrition Health Education till November 2021.
• c)  Peer Educator program: Significant progress has been made in implementation of Peer Educator program with selection of 1.69 lakhs Peer Educators in FY 2021-22 (upto September 2021) to cover for those who have left, grown up or selected fresh in the newer selected districts
• d)   Adolescent Health Days (AHDs): 64,577 Adolescent Health Days (AHDs), quarterly community & school level activities were conducted till September 2021 to create awareness about adolescent health issues.
• e)  Ayushman Bharat School Health and Wellness:
• School Health & Wellness Programme (launched in February 2020) is being implemented in government and government aided schools in Districts (including most of the Aspirational Districts) of the country in the first phase of the implementation.
• Two teachers, preferably one male and one female, in every school, designated as “Health and Wellness Ambassadors” (HWAs) shall be trained to transact health promotion and disease prevention information on 11 thematic areas in the form of interesting joyful activities for one hour every week.
• The States have initiated the Health and Wellness Ambassadors training.
• Till 30^th November 2021, 1.29 Lakh HWAs have been trained and about 67,391 principals are oriented under the Programme. HWA sessions are gradually starting in the States with reopening of schools.

Pre-Conception and Pre-Natal Diagnostic Techniques (PC & PNDT):

• As per Quarterly Progress Report (QPR) of June 2021, submitted by the States/UTs, total 72,965 Diagnostic facilities have been registered under the PC& PNDT Act. So far, a total of 2589 machines have been sealed and seized for the violations of the law. A total of 3,201 court cases have been filed by the District Appropriate Authorities under the Act and 617 convictions have so far been secured, leading to suspension / cancellation of   medical licenses of 145 doctors.
• NFHS-5 (2019-21) has also recorded improvement of 10 points in the sex ratio at birth at the national level from 919 in NFHS-4 to 929. 23 States/UTs have shown improvement whereas 13 States/UTs show decline in sex ratio at birth.
• Review meetings were conducted in all 36 States/UTs and implementation of PC&PNDT Act was reviewed in all aspects.
• Capacity building of District Appropriate Authorities and PNDT Nodal Officers was conducted in the State of Bihar, Telangana and Andhra Pradesh.
• Training of public prosecutors was organized in Chhattisgarh and Telangana.

NATIONAL TUBERCULOSIS ELIMINATION PROGRAMME

• With the target of achieving Sustainable Development Goals related to TB by 2025, five years ahead of the global targets of 2030, the Ministry implements National TB Elimination Programme with the following objectives: -
• Early diagnosis of TB patients, prompt treatment with quality assured drugs and treatment regimens.
• Engaging with the patients seeking care in the private sector.
• Prevention strategies including active case finding and contact tracing in high risk /vulnerable population.
• Airborne infection control.
• Multi-sectoral response for addressing social determinants.

National Programme for Tobacco Control and Drug Addiction Treatment [NPTCDAT]

• Continuous steps are being taken to increase awareness on ill-effects of tobacco use. Under the National Tobacco Control Programme, digitization has been encouraged and an online portal/Management of Informatics System has been developed for the States to provide online reporting of the activities down from the district level. States too are appreciating the importance of the Online reporting / real time data and are participating in this wholeheartedly.
• India has been committed towards tobacco control. Taking forward the agenda and pursuing the international commitments, India assumed the Presidency of the Meeting of Parties Bureau, to support Parties (countries) to implement the Protocol to Eliminate Illicit Trade in Tobacco Products.
• The Ministry under the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA 2003) has notified the new specified health warnings to be displayed on all tobacco product packs, which came into effect on 1^st December, 2022. 
• The Image 1 will be effective from December 2022 and Image 2 will be displayed from 1^st December 2023. The graphic health warnings are a potent tool to create awareness about the serious and adverse health consequences of tobacco usage especially among the youth, children and illiterate persons.

Non Nicotine Replacement Therapy (NRT)

• The Non Nicotine Replacement Therapy (NRT) has been included in the National List of Essential Medicine (NLEM), 2022. This will facilitate the States to procure the NRT through National Health Mission and hence the availability of the drug would be more to the potential clients/patients.
• Substance Use Disorders (SUDs) includes a spectrum of problems caused by the persistent misuse of mind altering substances, and can range from a harmful use to dependence. Considering the importance that physicians are able to effectively identify, diagnose and manage the problems of substance use disorder, the “Standard Treatment Guidelines for the Management of Substance Use Disorders and Behavioural Addictions'' was released. 
• These Guidelines have been developed as a resource material for the general physicians in primary care setting to provide them necessary know-how for assessment and management of these disorders. 
• Pocket book on Standard Treatment Guidelines for Substance Use Disorders and Behavioural Addictions and Mobile APP (Android & iOS) “Addiction-Rx” has also been developed for assisting physicians to provide quality care in substance use disorders, under Drug De-Addiction Programme

Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)

• The Pradhan MantriSwasthya Suraksha Yojana (PMSSY) envisages creation of tertiary healthcare capacity in medical education, research and clinical care, in the underserved areas of the country.  It aims at correcting regional imbalances in the availability of affordable/reliable tertiary healthcare services and also augmenting facilities for quality medical education in the country.  The scheme has two broad components:
• (i)Setting up of All India Institute of Medical Sciences (AIIMS);
• (ii)Up-gradation of existing Government Medical Colleges/Institutions (GMCIs).
• So far, establishment of 22 new AIIMS and 75 up-gradation Projects of existing Government Medical Colleges/Institutions (GMCIs) have been approved under this scheme.

Medical Education

• The historic National Medical Commission Act was passed by the Parliament in August, 2019. Now, the National Medical Commission has been constituted with effect from 25^th September, 2020 and the years old MCI has been dissolved and the Indian Medical Council Act, 1956 has been repealed. 
• The principal change in the regulatory mechanism is that the regulator will be primarily ‘selected’ rather than ‘elected’. The National Medical Commission will steer the reforms in medical education. 
• This will include increase in UG & PG seats along with improved access to quality and affordable medical education and maintaining high ethical standards in medical profession. Some of the key areas in which NMC will work include - implementation of National Exit Test (NEXT) for the medical graduates, guidelines for determination of fee for 50% seats in private medical colleges and Deemed Universities, Regulations for Community Health Providers and rating of medical colleges.
• During the last six years, MBBS Seats increased by 87%, from 51,348 seats in 2014 to 96,077 seats in 2022 and the number of PG seats increased by 105% from 2014 (31,185 seats) to 2022 (63,842 seats).
• Further, during the same period, 261 new medical colleges have been established and now the country has 648 (Govt: 355, Pvt: 293) medical colleges.
• Under the Central Sponsored Scheme for establishment of new medical colleges, establishment of 157 medical colleges have been approved in three phases, of which 93 are functional and remaining will be functional in a few years. Of these 157 colleges, 39 are coming up in the Aspirational Districts of the country thereby addressing the issues of inequity in medical education.
• Rationalization of Minimum Standards Requirements (MSR): The MSRs for establishment of medical colleges have been streamlined. This will reduce the cost of establishment of new medical colleges and increase intake capacity.
• Two years post MBBS Diplomas by National Board of Examinations: Keeping in view the importance of Diploma courses to meet the shortfall of postgraduate students and augment healthcare in remote parts of the country, the National Board of Examinations (NBE) has launched diplomas in eight disciplines namely - Anaesthesia, Gynaecology & Obstetrics, Pediatrics, ENT, Ophthalmology, Family Medicine, Tuberculosis & Chest Diseases and Medical Radiodiagnosis.
• District Residency Scheme for Post-Graduation: The MCI has also notified a Scheme known as District Residency Scheme for compulsory three months training of PG medical students at District Hospitals, an essential component of postgraduate medical training curriculum. Under the Scheme, the second/third year PG students of medical colleges would be posted in the district hospitals for a period of three months.
• The constitution of the National Medical Commission has ushered in a landmark reform in the sector of Medical Education. On similar lines, the Government is striving to bring institutional reforms in nursing and dental education sectors by bringing reformative legislations to replace the existing Indian Nursing Council Act, 1947 and Dentists Act, 1948. To address the long standing vacuum of a regulatory body for various professions included in the allied and healthcare sector, a National Commission for Allied and Healthcare Professions Act 2021 has already been enacted. The basic premise and principled change that is happening in all these professional education sectors is that the Regulator is now being ‘selected on merits’, as opposed to an ‘elected’ regulator.

Indian Council of Medical Research (ICMR)

• Indian Council of Medical Research (ICMR), New Delhi, is the apex body in India for the formulation, coordination and promotion of biomedical research and is one of the oldest medical research bodies in the world now under the Department of Health Research (DHR) in the Ministry of Health and Family Welfare, Govt of India.
• The Council's research priorities coincide with the National health priorities such as control and management of communicable diseases, fertility control, maternal and child health, focussing on nutritional disorders, developing alternative strategies for health care delivery, containment within safety limits of environmental and occupational health problems; research on major non-communicable diseases like cancer, cardiovascular diseases, blindness, diabetes and other metabolic and haematological disorders; mental health and drug research (including traditional remedies). All these efforts are undertaken with a view to reduce the total burden of disease and to promote health and well-being of the population.
• ICMR has also demonstrated its commitment to the future of medical research through its professional development training and capacity building. This includes training programs, workshops, and short-term research studentships for those preparing for a career in medicine and medical research. 
• It also includes research fellowships and short-term visiting fellowships for upcoming researchers to expand their skills and knowledge early in their career. ICMR also offers Emeritus Scientist positions to enable retired medical scientists and teachers to continue to carry out research on specific topics. 
• The impact of ICMR spans across the globe with research collaborations spanning every continent.  Through ICMR’s Memoranda of Understandings (MoUs), ICMR has partnered with leading universities from around the world to concentrate efforts on leading health issues such as cancer, diabetes, infectious diseases, and vaccine development. These collaborations facilitate the exchange of scientific information, training, joint projects, and co-authorship of meetings, workshops, seminars, and symposia presentations.

India Hypertension Research Initiative (IHMI)

• IHCI is ICMR’s collaborative initiative with MoHFW, WHO & state governments aimed to reduce deaths from heart attacks & strokes. It is playing a critical role in regularizing hypertension treatment across primary care facilities in 100 districts in 23states by providing free drugs & quality treatment to 34lakh patients. 
• This initiative is a progression towards ensuring availability of quality healthcare for Indians The tech driven innovations in the IHCI program allowed India to track over 2 million patients digitally, with minimal burden on human resources and on clinics. 
• 50% patients tracked in real time achieved BP control. The initiative was awarded 2022 UN Inter-Agency Task Force and the WHO special program on Primary Health Care Award during United Nation General Assembly on 21st September 2022.

National List of Essential Medicines (NLEM) 

• Recently, The National List of Essential Medicine (NLEM) was launched by Hon’ble HFM, Dr Mansukh Mandaviya. The revised NLEM was developed under the chairmanship of Secretary, DHR & DG, ICMR. 
• The primary purpose of NLEM is to promote rational use of medicines considering the three important aspects i.e., cost, safety and efficacy. It also helps in optimum utilization of healthcare resources and budget; drug procurement policies, health insurance; improving prescribing habits; medical education and training for UG/PG; and drafting pharmaceutical policies. 
• In NLEM, the medicines are categorized based on level of healthcare system as- P- Primary; S- Secondary and T- Tertiary.384 drugs have been included in this list with addition of 34 drugs, while 26 from the previous list have been dropped. The medicines have been categorized into 27 therapeutic categories.
• Launched National Hospital based Registry on Venous Thromboembolic Disorders ((i-RegVeD) that aims to establish a nationwide surveillance network through selected hospitals and collect data for generating evidence on VTE prevalence for planning response, and strengthening healthcare facilities across different treatment settings.
• Launched Indian catalogue of Mycobacterium TB mutation & their association with drug resistance interim report.
• ICMR with collaboration of WHO India Released mapping, size estimation and risk behaviour survey among key population groups in virtual space - a basic guide.

International Collaborations

• Launched ICMR-NIAID-BMGF Clinical Research Fellowship Programme. This fellowship will advance discovery to improve clinical practices and serve public health causes in both the countries.
• MoU signed between ICMR and NIH for Cooperation on An International Center of Excellence in Research in Chennai, India
• LoI signed between the Indian Council of Medical Research (ICMR), Department of Health Research (DHR) and the Ministry of Health & Social Protection and The Ministry of Science, Technology & Innovation, Colombia
• MoU signed between the ICMR, Department of Health Research (DHR), Ministry of Health & Family Welfare, Government of India and the University of Oxford, United Kingdom in the field of collaborative research on infectious diseases commonly affecting socially marginalized groups
• MoU between the ICMR, Department of Health Research (DHR), Ministry of Health & Family Welfare, Government of India and Deutsche Forschungsgemeinschafte.V. (DFG), Germany. The MoU will focus on Indo-German collaborative research in the areas of Toxicology, Neglected tropical diseases and Rare diseases.
• A Tripartite MoU between ICMR, Department of Biotechnology, Govt. of the Republic of India (DBT) and International AIDS Vaccine Initiative (IAVI), USA. It focusses on to participate and collaborate to prevent, diagnose and/or treat diseases of concern in India and globally, including HIV, Tuberculosis, emerging infectious diseases like COVID-I9 and other global health threats, across Product development including translational research, preclinical and clinical development, community engagement and socio-behavioural research, low cost manufacturing, public health access, etc

North Eastern Indira Gandhi Regional Institute Of Health And Medical Sciences (NEIGRIHMS), Shillong, Meghalaya

• NEIGRIHMS is a Super Specialty teaching Institute established in 1987 in Shillong under the Meghalaya Registration of Societies Act 1983 with an objective to provide advanced and specialized medical facilities of the highest level in selected specialties, and to serve as a Regional Referral Service Centre for comprehensive health care to the people in North Eastern States. 
• It has been designed as a Postgraduate Medical Institute in the lineage of AIIMS, New Delhi and PGIMER, Chandigarh. The Institute is under the administrative control of the Ministry of Health & Family Welfare, Government of India. 
• The Institute is presently having 30 fully functional Super Speciality and Speciality departments. It is offering super specialty services in Cardiology, CTVS, Neurology, Neurosurgery, Surgical Oncology and Urology, besides specialty services in General surgery, General Medicine, Paediatrics, Obstetrics & Gynaecology, ENT, Orthopaedics, Dentistry, Psychiatry, Radiotherapy, TB & Respiratory Diseases, Dermatology and Ophthalmology. These departments are very well supported by the departments of Radiology, Anaesthesiology, Pathology, Microbiology, Forensic Medicine, Biochemistry, Anatomy, Community Medicine, Pharmacology, Hospital Administration and Physiology. It is well equipped with all basic as well as advanced equipment like CT scan, 1.5 Tesla MRI, Digital Mammography system, Fully automated High Vacuum Double Door Steam Sterilizer Unit and Washer Disinfector, etc.
• The hospital presently has 628 beds including 104 ICU beds with ventilators, out of which 280 beds are designated for COVID-19 including 43 ICU beds designated for COVID-19, other ICU beds includes Medical Critical Care Unit with 15 beds, Anaesthesia Critical Care Unit with 16 beds, CTVS ICU with 10 beds, ICCU with 11 beds, Paediatric ICU with 14 beds, Neonatal ICU with 6 beds each.
• NEIGIRHMS is also designated as Mentor institute for the entire North Eastern States for COVID Testing facilities by ICMR. Various Covid -19 Testing facilities like RTPCR, TruNAT & CB NAAT are available in the Institute round the clock.

National Center for Vector Borne Diseases Control (NCVBDC)

• World Malaria Reports for 3 consecutive years have hailed India’s progress in achieving malaria elimination by 2030. As per recently launched, World Malaria Report (WMR) 2021, India is the only high endemic country which has reported a decline of 25.24% in malaria cases and 4.67% in malaria
• deaths in 2020 as compared to 2019. Malaria cases reported in 2021 across the country were 161753 in comparison to 186532 cases in 2020, indicating a decline of 13.28% over the year 2021. In 2022 (till October 2022-Provisionally), there is 15.97% increase in malaria cases, 5.79% increase in falciparum malaria and. 37.50% decrease in malaria deaths compared to corresponding period of 2021.
• On World Malaria Day 2022, 18 states /UTs (Andaman and Nicobar Islands, Andhra Pradesh, Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Daman Diu Dadra & Nagar Haveli, Gujarat, Jharkhand, Karnataka, Madhya Pradesh, Meghalaya, Nagaland, Odisha, Tamil Nadu, Telangana, Uttar Pradesh, and West Bengal were awarded for significant progress towards malaria elimination.
• Malaria program review (MPR) of nine states was conducted in April 2022 by independent multi-disciplinary technical expert teams. Based on the MPR recommendations, formulation of National Strategic Plan (NSP) for Malaria elimination 2023-2027 is under process.
• In 2020-21, 2.52 crore LLINs were centrally supplied to 11 states (Andhra
• Pradesh, Bihar, Chhattisgarh, Gujarat, Jharkhand, Karnataka, Maharashtra, Odisha, Telangana, West Bengal and Dadar Nagar Haveli and Daman & Diu) in the high endemic areas and 11.45 lakh LLINs were supplied to the Chhattisgarh state in 2021-22.

Status and key achievements of National AIDS Control Programme for the Year 2021

• The Government of India is currently implementing the phase-V of the National AIDS and STD Control Programme (NACP).  Like the previous phase, NACP phase-V is a Central Sector Scheme fully funded by the Government of India from 1^st April 2021 to 31^st March 2026 with an outlay of Rs 15471.94 crore. 
• The NACP phase-V will anchor the national AIDS and STD response in the country till 2025-26 towards the attainment of the United Nations’ Sustainable Development Goals 3.3 of ending the HIV/AIDS epidemic as a public health threat through a comprehensive package of prevention, detection, and treatment services.
• NACP phase-V builds upon the game-changer initiatives undertaken during phase-IV including HIV/AIDS Prevention and Control Act (2017), Test and Treat Policy, Universal Viral Load Testing, Mission Sampark, Community-Based Screening, Transition to Dolutegravir-based Treatment Regimen etc. NACP phase-V introduces newer strategies consolidating and augmenting the gains to attain the stated goal by 2025-26.

National Telemedicine Services

• The National Telemedicine Service "eSanjeevani" is a digital health initiative of the Ministry supports two types of teleconsultation services-Doctor-to-Doctor (eSanjeevani) and Patient-to-Doctor (eSanjeevani OPD) Tele-consultations. 
• eSanjeevani was rolled out in November 2019 as an important component of the Ayushman Bharat Health and Wellness Centre (AB-HWCs) programme. 
• It aims to implement tele-consultation in all the 1.5 lakh Health and Wellness Centres in a 'Hub and Spoke' model, by December 2022. NHM in States identify and set up dedicated 'Hubs' in Medical Colleges and District hospitals to enable tele-consultations services to 'Spokes', set up at SHCs and PHCs.
• In wake of COVID 19 Pandemic, on the 13th April 2020, the MoHFW rolled out 'eSanjeevaniOPD' first of its kind to facilitate online health services to patients directly in the confines of their home at no cost to ensure continuity of care.
• eSanjeevani has completed around 7.7 crore consultations. Over 3,50,000 patients are seeking health services on a daily basis in 36 States/UTs. The top ten States which have registered highest consultations through eSanjeevani and eSanjeevaniOPD platforms are Andhra Pradesh (27853960), West Bengal (9813829), Karnataka (9166769), Tamil Nadu (8349601), Maharashtra (3966846), Uttar Pradesh (3637856), Madhya Pradesh (3081029), Bihar (2575590), Telangana (2136862), Gujarat (1608160).

Ayushman Bharat Digital Mission (ABDM)

• In year 2019, Ministry of Health and Family Welfare released National Digital Health Blueprint (NDHB) as an architectural framework for effective implementation of Digital Health interventions.
• With a vision to create a national digital health ecosystem as proposed in NDHB, on 15^th August 2020, Hon’ble Prime Minister Shri Narendra Modi announced the launch of the National Digital Health Mission (now known as Ayushman Bharat Digital Mission) in six union territories (Andaman & Nicobar Islands, Chandigarh, Dadra & Nagar Haveli and Daman & Diu, Lakshadweep, Ladakh and Puducherry) on pilot basis. Three key registries of NDHM namely Health ID, Health Professional Registry (HPR), Health Facility Registry (HFR) and digital infrastructure for data exchange have been developed and implemented in these UTs.
• On 27^th September, 2021, the Hon'ble Prime Minister announced the nationwide rollout of the Ayushman Bharat Digital Mission (ABDM) (earlier known as National Digital Health Mission) with aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. 

National Centre for Disease Control (NCDC)

• National Centre for Disease Control (NCDC) has its headquarters in Delhi and has 8 branches located at Alwar (Rajasthan), Bengaluru (Karnataka), Kozhikode (Kerala), Coonoor (Tamil Nadu), Jagdalpur (Chhattisgarh), Patna (Bihar), Rajahmundry (Andhra Pradesh) and Varanasi (Uttar Pradesh).
• The technical Centres/Divisions at the headquarters of the institute are:
• Integrated Disease Surveillance Programme (IDSP)
• Division of Epidemiology
• Division of Microbiology
• Division of Biotechnology and Viral Hepatitis
• National Program for Surveillance of Viral Hepatitis
• Division of Parasitic Diseases
• Centre for Arboviral & Zoonotic Diseases
• Division of Zoonotic Disease Programme,
• Centre for Environmental & Occupational Health, Climate Change & Health
• Centre for Non-Communicable Diseases

Integrated Disease Surveillance Programme (IDSP)

• IDSP covers all states and UTs with the objective to strengthen/maintain decentralized laboratory-based IT enabled disease surveillance system for epidemic prone diseases and to monitor disease trends to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs). 
• IDSP has also been coordinating the overall surveillance activities in India regarding CoVID – 19 pandemic. CSU, IDSP has been assisting the States/UTs in their epidemiological investigation aAnd containment.

International Health Regulations

• NCDC is designated National Focal Point for India. India has declared itself IHR compliant in July 2016. Functions of NFP include: capacity building for IHR(2005) in the country, review progress of IHR implementation by using WHO IHR monitoring tool and share with WHO annually, coordination and communication with WHO, NFP of other countries and local stakeholders for event verification, notification, contact tracing(TB), etc.

INSACOG

• The Indian SARS-CoV-2 Genomics Consortium (INSACOG) is a national multi-agency consortium of Genome Sequencing Laboratories (RGSLs) laboratories established by the Government of India on 30^th December 2020.
• The network carries out whole genome sequencing of SARS-CoV-2 virus across the nation, aiding the understanding of how the virus spreads and evolves, and provides information to aid public health response.
• A summary of the cumulative data of INSACOG and other state sequencing initiatives can be found in the INSACOG data portal along with other INSACOG related information at https://ibdc.rcb.res.in/
• Presently, INSACOG is keeping a close watch and monitoring the emergence and evolution of XBB and XBB.1 and any new sub-lineages.

National Program for Surveillance of Viral Hepatitis

• National Program for Surveillance of Viral Hepatitis is a central sector scheme under Umbrella Scheme of National Centre for Disease Control with the objective of strengthening the existing infrastructure for establishing surveillance of viral hepatitis and estimating burden of viral hepatitis infection in India
• Laboratories of 15 medical colleges/institutions strengthened across the country to carry out surveillance of viral hepatitis. 
• Program has expanded its network and included a total of 30 laboratories in FY 2021-22 as compared to 15 in FY 2020-21. 
• Viral Hepatitis Laboratory at NCDC has been designated as Centre of Excellence under the program and is involved in testing of referral samples for biomarkers for hepatitis for both serology and viral load. 
• The program division is in the process of obtaining NABL accreditation of the Viral Hepatitis laboratory at NCDC.