he CAG has discovered several shortcomings in the implementation of the National Rural Health Mission (NRHM) including financial mismanagement, shortage of doctors and paramedical staff and non-availability of essential drugs in healthcare centres.
The CAG has discovered several shortcomings in the implementation of the National Rural Health Mission (NRHM) including financial mismanagement, shortage of doctors and paramedical staff and non-availability of essential drugs in healthcare centres. In its report on performance audit of reproductive and child health under the NRHM, which was tabled in Parliament on Friday, the Comptroller and Auditor General (CAG) noted that financial management under the mission was not “satisfactory” with substantial amounts persistently remaining unspent with the State Health Societies at the end of each year.
“In 27 states, the unspent amount increased from Rs 7,375 crore in 2011-12 to Rs 9,509 crore in 2015-16,” the report said. It added that many states diverted the fund meant for the mission to other schemes. The CAG recommended that the funds flow management should be rationalised and the Health Ministry should monitor and maintain the details of interest earned on the unspent balances by these societies to ensure better utilisation of funds. The performance audit, which covered the period from 2011-12 to 2015-16, also pointed out several shortcomings in the primary health centres, community health centres and sub-centres covered under the study.
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“In 17 states, 428 equipment costing Rs 30.39 crore were lying idle/unutilised due to non-availability of doctors and trained manpower to operate the equipment and lack of adequate space for their installation,” it said. According to the report, non-availability of essential drugs was observed in 24 states. “Shortage of doctors and paramedical staff were observed in almost all selected facilities, compromising the quality of healthcare being administered to the intended beneficiaries.”In the selected community health centres of 27 states, the average shortfall of five types of specialists — general surgeon, general physician, obstetrician/gynaecologist, pediatrician and anesthetist — ranged between 77 per cent to 87 per cent,” the report said.
It added that in the 236 selected community health centres in 24 states and Union Territories, only 1,303 nurses were posted against the required 2,360. The CAG recommended that availability of all essential drugs and equipment should be ensured at all health facilities apart from filling up of all sanctioned posts of healthcare professionals to meet the NRHM requirements.