The latest Annual Health Survey data show that infant and maternal mortality rates have fallen in all the nine high-priority states that the survey is carried out in. While this is welcome news, the problem is that the districts that were the worst-performing in 2011-2012—the latest survey results are from 2012-13—have pretty much remained the worst-performing. Twenty two districts saw infant mortality rate (IMR) climb while 16 recorded no change. The states themselves record a poorer performance than the national average on the health indicators for women and infants. Given that the government has hinged the National
Rural Health Mission (NRHM) on maternal and infant health, the findings of the survey indicate a proverbial slip between the cup and the lip. A costly one, at that, given the Central allocation for NRHM was R20,822 crore for 2012-13.
While there could be many reasons for this, the most likely one is that NRHM, which was supposed to be decentralised to the extent that districts could draw up their own plans and direct interventions according to their needs, is not so actually. The states have taken away the planning and funds utilisation powers from the districts. Uttar Pradesh is the best example of this—the state, where the R5,754-crore NRHM scam was uncovered in 2012, recorded the highest IMR in the country, at 68 per 1,000 live births.