A study to analyse the fund utilisation pattern of the National Health Mission in various health facilities at district, taluk and panchayat levels has pointed out that the delay in the disbursement of funds, lack of clarity regarding fund utilisation guidelines, and poor awareness of guidelines among the implementing officials as the major hurdles in the way of effective fund utilisation.
The findings of the study team, led by K. Vijayakumar, the then Head of the Department of Community Medicine, Government Medical College , Thiruvananthapuram, and the State Health System Resource Centre in 2011-12, was released here earlier in the week.
It pointed out that review and modification of the fund utilisation guidelines is the need of the hour as many of the scheduled activities tend to have overlapping domains, causing confusion amongst implementing officials.
Scrutiny
The researchers also pointed out that the authenticity of the Statement of Expenditures (SOEs) submitted to the NHM from the district, taluk and panchayat levels warrants stringent scrutiny and cross verification by authorities.
Researchers looked at the real extent of utilisation of the funds and the factors which affected the utilisation of these funds – Hospital Management Committee (HMC) fund, Annual Maintenance Grant and Untied Funds at different levels of health facilities (like primary/ community health centres, taluk and district hospitals).
A total of 225 institutions at various levels were chosen for the study in Thiruvananthapuram, Thrissur, and Kozhikode districts.
At those institutions which have optimum fund utilisation, the chief medical officer was able to identify the needs of the institution and had clarity about what was needed to be done on a priority basis.
In most institutions, the HMC fund was used mainly for infrastructure improvements and purchase of hospital equipment, while very little funds were being used for disease prevention activities in the community such as source reduction or sanitation activities.
