The government data indicates the three states have outpaced their peers by ensuring consistent progress and utilising over 80% of the budget allocation. Interestingly, the same states have been lauded for proactively implementing NREGA as well.
During 2008-09, Madhya Pradesh has used up to 81%, Rajasthan and Gujarat utililised 156% and 117% of the sum released, respectively. Other states that have managed to use over more than 100% approved sum include Himachal Pradesh (109%), Jharkhand (248%), Orissa (94%), Uttar Pradesh (117%), the southern states of Karnataka(114), Kerala (91%) along with some northeastern states of Tripura, Mizoram and Sikkim. However, in case of Himachal Pradesh and Jammu and Kashmir, work under the NRHM inched slowly for the first three years (2005-08) with the states spending 44% and 36% of the funds respectively during 2005-2008. Though Karnataka and Kerala have performed better than their northern counterparts by using up 84% and 63% of resources, their performance has picked up late after a sluggish start.
NRHM aims at increasing public expenditure in health sector particularly across 18 states which have a weak public health indicators and infrastructure. The programme currently is running on the mission mode also targets at increasing public expenditure on health sector from 0.9% of GDP to 2-3% of the GDP.
According to the findings of the second common review mission, the biggest independent review exercise of its kind in any flagship programme of the government, has recently stated that the NRHM has made a difference.
The report also claimed that over 50,000 nurses and auxilary nurses and mid-wives have been added on contract under the programme besides nearly 15,000 Specialists, MBBS doctors and Ayush Doctors. Such large-scale addition of human resources has translated into improved availability of health care services in rural areas, the report said.
According to the government evaluation, although Orissa has been able to use up 67% of allocation in the first three years and up it to 94% in the last year and the state government has distributed work among PSUs , the construction activities show signs of fatigue