LIST OF DIFFICULT MOST DIFFICULT AND INACCESSIBLE AREAS
LIST OF DIFFICULT, MOST DIFFICULT AND INACCESSIBLE AREAS Infrastructure Division, NRHM
Name of State the state Source of information PIP/NPCC Criteria Whether the criteria used is objective or not No criteria mentioned Can't say as no criteria by the state. given BIHAR Remarks The information is included as Annexure in their PIP, the Criterion is not indicated. Only number of facilities identified, district wise. Name of facility identified not given. Incomplete information Chhattisgarh Rural Medical core Scheme CHATTISGARH They have classified into remote areas, tribal areas, naxallite affected areas, State has provided the list of the facilities, further detailing is required. Name of CHCs given but not the name of PHCs. Objective Partially completed information
State Name of the state Jammu & Kashmir Jharkhand Source of information PIP/NPCC 3 rd CRM Criteria Whether the criteria used is objective or not Difficult and Most difficult on the basis of accessibility of area concerned, existence and status of road connectivity, availability of other Objective facilities in the areas etc Road connectivity of the health facility, Amenities available at health facility, Location of health Objective facility, Position of human resource at health facility. Remarks GOI has asked the state to conduct more thorough exercise to rationalise the list of difficult, most difficult and inaccessible areas. State has identified into category A(very difficult) and category B(difficult) only. Partially Complete Information The state has provided total numbers of such facilities. List classifying the difficult, most difficult of some districts is incomplete. Incomplete information.
Name of State the state Madhya Pradesh Orissa Source of information Letter; RCH/MH/09/308 PIP/NPCC Criteria Tribal population, distance from state and National highways, Naxalite areas, availability of contractual and regular staff. Whether the criteria used is objective or not Objective General backwardness such as blocks in KBK plus district or in tribal blocks. Inaccessibility due to Objective no road connectivity or far away from highway, Disaster prone block and life threatening conditions such as left extremism Remarks State has provided the complete list of facilities falling into difficult, most difficult and inaccessible areas. Complete information State has developed a scoring system for categorising facilities into difficult, most difficult and inaccessible areas. Though they have not done this exercise and have not yet provided any list of such facilities. They have categorised their 50 blocks as most difficult, 47 as difficult and 12 as LWE affected area. Incomplete information.
Name of State the state Rajasthan Source of information 3 rd CRM Criteria Whether the criteria used is objective or not Road connectivity of the health facility, Amenities available at health facility, Objective Location of health facility, Position of human resource at health facility. Remarks The state has provided the list of number of facilities, the detailed complete list categorising dfficult, most difficult and inaccessible is available for the maximum districts. All the facilities in desert area can’t be difficult. Only for very few district information available is incomplete. Partially incomplete information. Uttar Pradesh letter- 2346/5 -9 -2009 - No criteria indicated 9(97)/09 by the state. No criteria mentioned The state has not provided the list of number of facilities. They have identified their janpads as most difficult and more difficult in place of facilities. Incomplete information
Name of the state Uttarakhand Source of information PIP/NPCC Criteria Whether the criteria used is objective or not Height from sea level, Distance from National highway, Distance from nearest road. availability Objective of water/electricity/residenti al quarters, Distance of secondary school from the facility. Remarks The state has proposed criterion for classification which is submitted for approval purpose. No list is provided. Incomplete information.
Name of State the state Andhra Pradesh Source of information 3 rd CRM Criteria Whether the criteria used is objective or not Road connectivity of the health facility , Amenities available at health facility, Location of health Objective facility, Position of human resource at health facility. DHS/FW/NRHM /2009 Only Tribal and hilly Need to be further -10 areas mentioned. developed Remarks The State has provided the name of all health facilities but haven’t categorised them under difficult, most difficult and inaccessible Incomplete information. The state has provided complete list of the areas falling in hilly and tribal areas but the list do not specify the health facilities falling in difficult, most difficult or inaccessible areas. Goa Incomplete Information
Name of State the state Gujarat Source of information 3 rd CRM Criteria Whether the criteria used is objective or not Remarks State has provided only numbers of such facilities, neither any list nor any criteria is mentioned. No criteria mentioned by the state. No criteria Incomplete information Karnataka PIP/NPCC The criteria used are road connectivity, naxallite or terrorist affected area, if the block is surrounded by forest etc, high Objective maternal death, high infant death & availability of medical staff. seperate criteria for difficult and most difficult are mentioned. The state has proposed criteria for categorizing PHC as most difficult and more difficult. But the exercise needs to be done for other facilities, if needed. Complete information.
Name of the state State Kerala Tamil Nadu Source of information Criteria Whether the criteria used is objective or not PIP/NPCC No criteria mentioned No criteria by the state. PIP/NPCC PHC located away from the state/national highway. Road connectivity, location in forest, whether in Objective tribal/hilly areas or some other social reasons. Remarks Rural criteria included in the list is not acceptable. Very high number of rural facilities identified for incentives. State need to examine criteria of classifying PHC located more than 6 km away from state/national highway as difficult (111 PHCs) Partially complete information.
Name of State the state A & N Islands Source of information Letter; 11/MD/UTHM/2008/845 Criteria Whether the criteria used is objective or not Remarks State has given a detailed note for every category. The exercise is done in very detailed manner. The state has provided justification for each facility lying in any category. Unserved & underserved tribal area category also included. Complete information. Chandigarh DO. NRHM-UT 09/2805 UT has not proposed difficult, most difficult area as all areas are planned, it is neither hilly nor desert although they are talking about slums.
Name of the State state Source of information Criteria Whether the criteria used is objective or not Road connectivity, amenities available at D. O. No. SCOVA/RCH/ health centres and also Dadra & Nagar Haveli 234/2006/1974 dated difficulty to retain Objective 15 sep 2009 manpower for particular places Remarks The UT has good road connectivity and all required amenities available at the health centres. The reason for classification under difficult area is only due to difficulty to retain manpower in those area Complete Information Daman & Diu 3 rd CRM Road connectivity of the health facility, Amenities available at health facility, Location of health facility, Position of human resource at health facility. Objective The UT has provided complete data required. In Daman & Diu no health facility is in difficult, most difficult or inaccessible area. Complete Information.
Name of State the state Lakshadweep Source of information Criteria Whether the criteria used is objective or not Remarks Neither any list nor any objective criteria is given, . . They have only focused on distance letter; from the mainland as their only Criteria not mentioned DO. FL. NO. 1/1/2009. R criteria, They should also focus on by the UT. CH/NRHM other objective criteria's such as presence of any other difficulty. Incomplete information. Puducherry letter; PSHM/B 1/200910/429 Criteria not mentioned by the UT. Criteria not mentioned UT has no facility falling into difficult , most difficult and inaccessible area.
Name of the State state Arunachal Pradesh Source of information PIP Criteria Whether the criteria used is objective or not Criteria not mentioned by the state Remarks State has provided complete list of facilities falling into difficult, most difficult and inaccessible areas. Complete Information Assam PIP Health institutions situated near borders, unserved and unserved Objective tribal areas, extremist affected area and poor connectivity. State has provided complete list of facilities falling into difficult, most difficult and inaccessible areas. Complete Information
Name of State the state Meghalaya Manipur Source of information PIP Criteria Whether the criteria used is objective or not Road connectivity of the health facility, Amenities available at health facility, Location of health Objective facility, Position of human resource at health facility. Criteria not mentioned Remarks State has provided number and complete list of facilities falling into difficult, most difficult and inaccessible areas. They have also provided justification of each facility for the categorisation. Complete information State has provided complete list of facilities falling into difficult, most difficult and inaccessible areas. Complete Information
Name of State the state Mizoram Sikkim Source of information PIP Criteria Whether the criteria used is objective or not Road connectivity of the health facility, Amenities available at health facility, Objective Location of health facility, Position of human resource at health facility. Criteria not mentioned Remarks State has provided complete list of facilities falling into difficult, most difficult and inaccessible areas. Complete Information
Name of State the state Tripura Source of information PIP Criteria Whether the criteria used is objective or not No criteria mentioned No criteria by the state. Remarks State has provided complete list of facilities falling into difficult, most difficult and inaccessible areas Complete Information. Nagaland PIP No criteria mentioned No criteria by the state. State has provided complete list of facilities falling into difficult, most difficult and inaccessible areas Complete Information.
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