The Comptroller and Auditor General (CAG) of India has expressed dissatisfaction over the funds flow management under the National Rural health Mission (NRHM) and recommended that it be rationalised with appropriate norms and criteria.
The maintenance of accounts at the State, district and below levels is not proper and concurrent audit of accounts, which has been initiated under the Mission, is only in a nascent stage, it said.
Pointing out that during 2005-08, the budgetary provision of Rs. 27,079 crore was made by the Centre for the NRHM against which an expenditure of only Rs. 24,151 crore was incurred.
Delay in implementation
Creation of a parallel fund flow route through a set of societies at the State and district levels had not resulted in faster disbursement of funds. There were delays in release of funds from the State health societies (SHSs) to the district health societies (DHSs) and finally to the health centres which led to delay in implementation of the Mission, according to the report.
Also, the Ministry’s efforts at e-banking suffered from delays and most States were yet to adopt e-banking. More over, many high focus States, where health indicators were poor, received relatively lesser central grants, as high unspent balances of previous years remained indicating that capacity building needs to be focused on.
The reports states that the management of funds and accounts were below par resulting in suboptimal use of money and improper accounting. For instance, during 2007-08, the Ministry incorrectly released Rs. 174.84 crore under the Mission Flexible Pool to four States due to deficient assessment of State Programme Implementation (PIPs) or non-observance of National Programme Coordination Committee’s directive issued while according approval to the PIPs. Similarly, Rs. 337.04 crore was short accounted as unspent balance and an excess release of the same amount under the Flexi-Pool had been made in 2007-08.
Various existing programmes such as the Empowered Action Group Scheme, Reproductive and Child Health-I, National Maternity Benefit Scheme had been closed down with the initiation of the NRHM, but the unutilised balances of Rs. 133.40 crore under these programmes had not been settled and remained with States. Also, there was a diversion of Rs. 223.02 crore, released under the NRHM for various activities, for funding activities other than for which funds were released.
Contribution
Importantly, State governments were required to contribute 15 per cent towards the Mission since 2007-08. But during this period, only four States (Andhra Pradesh, Bihar, Gujarat and West Bengal) and during 2008-09 nine States (Andhra Pradesh, Andaman and Nicobar Islands, Chhattisgarh, Gujarat, Haryana, Himachal Pradesh, Madhya Pradesh, Mizoram and Nagaland) had contributed the full or more than the required share. As many as 18 States and two Union Territories did not contribute at all while the contribution made by others in 2007-08 was less than 15 per cent.
