Question : FUNDS UNDER NRHM

(a) the present status of implementation of the National Rural Health Mission (NRHM) in the country particularly in the North Eastern Region and tribal dominated areas;

(b) the details of the funds allocated, released and utilized under the NRHM during each of the last three years and current year, scheme and State/UT-wise;

(c) whether the Government has received any proposals from the States/ UTs for allocation of more funds under NRHM to improve healthcare facilities, if so, the details of such proposals and the action taken by the Government on each of the proposals, State/UT-wise;

(d) whether certain cases of misuse of funds under NRHM have come to the notice of the Government and if so, the details thereof and the reasons therefor, State/UT-wise; and

(e) the action taken by the Government in this regard and the steps taken/being taken by the Government for proper utilization of funds and continuous monitoring of implementation of NRHM at various levels along with the finding thereof?

THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI GHULAM NABI AZAD)

(a): Information is at Annexure-A.

(b): Information is at Annexure-B.

(c): Specific requests have been received from States/UTs of Kerala, Jammu & Kashmir, Himachal Pradesh, Lakshadweep and Uttarakhand for allocation of more funds under NRHM to improve health care facilities. The funds are allocated to the States on equity based formula under NRHM and not merely on the basis of requests of individual States.

(d): Some instances of misuse of NRHM funds like mis-appropriation, misuse of untied funds, diversion of funds from one pool to another without authorisation, excessive and infructuous purchases etc. have come to light through Audit in States like Uttar Pradesh, Assam, Bihar, Haryana, Jammu & Kashmir, Orissa and Rajasthan. Such irregularities may occur due to poor enforcement of financial discipline, inadequate availability and inadequate capacities of financial staff etc.

The observations have been duly communicated to the concerned States for taking necessary remedial action.

(e): The Department requested the Comptroller & Auditor General (CAG) for conducting annual transaction audits of the National Rural Health Mission (NRHM) in all the States from the Financial Year 2011-12 in order to identify the existing gaps, facilitate independent monitoring and timely corrective measures so that a quality and timely audit assessment becomes available to assist the State Governments in undertaking remedial measures and achieving the targets of NRHM. The CAG has agreed to undertake annual audit.

Besides provision of annual CAG audit, following monitoring mechanisms have been put in place by the Department of Health & Family Welfare for adherence to financial procedures and proper financial utilization:

# Submission of quarterly Financial Monitoring Reports by the States;

# Annual Statutory Audits;

# Concurrent Audits;

# Visits by the teams of the Financial Management Group of the Department to states for periodical review;

# Annual visits to states by Common Review Mission, which inter-alia, looks at financial systems and mechanisms.

In some of the States during the visit, it was observed that proper books of accounts were not being maintained at Sub district levels viz. books of accounts were not being maintained in Double Entry System, bank reconciliation statements were not being prepared at regular intervals, fixed assets registers were not maintained properly, tax returns on TDS deducted were not filed on time, age-wise analysis of advances was not maintained, etc.

The deficiencies/shortcomings noticed during the reviews have been brought to the notice of the States for remedial action.