New Delhi: Already weighed down by a shortage of qualified medical personnel, the National Rural Health Mission (NRHM) is likely to face another setback, with a small increase expected in the Budget allocation for the ministry of health’s flagship programme.
While in 2009, NRHM received a hike of 17% in the budget, two senior ministry officials involved in the budgetary process said this year, the hike would be between 10% and 15% due to the government’s “budgetary constraints”.
Watch former consultant to the Planning Commission, Kaveri Gill, talk about India’s health expenditure levels, why allocations are underutilized and why states need to be more involved in the NRHM
The total allocation for NRHM for the current fiscal was Rs13,930 crore.
NRHM aims at taking healthcare services to rural households, seeking to reduce the infant and maternal mortality rates, prevent disease, control population and ensure gender balance, according to the government website. It has been hamstrung by a shortage of medical staff.
To tackle the issue of shortage of doctors in rural areas, health minister Ghulam Nabi Azad recently said doctors who opt for a rural posting would get a 10-40% increase in their salaries depending on the number of years they agree to spend in villages.
A December report of the Comptroller and Auditor General of India (CAG) showed that the funds for local action through annual maintenance grants and untied grants to healthcare centres under NRHM remained mostly unspent.
A draft report of the third Common Review Mission released in January also found that the “capacity of states to absorb funds was found to vary considerably across states”.
States such as Bihar and Haryana could achieve only around 20% of the approved project implementation plan for 2009-10. Bihar spent only Rs35 crore per month during April-September while it actually needed to have spent Rs100 crore per month.
“There are unspent funds… but it will take us a while (to tackle that) because we are building community participation, which is still a new concept here. We most humbly accept the suggestions made here in CAG,” said Amarjit Sinha, joint secretary (NRHM), ministry of health.
Health is a state subject so funds allocated for NRHM are further devolved to the states depending upon their requirements. Some experts say states should learn how to use their allocations better rather than have their funding cut.
“Allocation should be increased for NRHM because the states’ ability to utilize funds is getting better with improved efficiency in management. But efficiency in fund management is very important for better fund utilization,” said K. Srinath Reddy, director, Public Health Foundation of India.
India spends around 1% of gross domestic product on healthcare, one of the world’s lowest. “Clearly, there is a case of placing more money,” Sinha said.