Question : NATIONAL RURAL HEALTH MISSION

(a) the salient features of the National Rural Health Mission (NRHM) alongwith the targets set thereunder for the year 2010, State-wise;

(b) the targets set under the Mission alongwith the success rate in achieving those targets during each of the last three years, parameter-wise, year-wise and State-wise;

(c) the details of the population growth benchmarks that have been set under the Mission over the last three years and the extent to which these have been achieved;

(d) the details of the parameters benchmarked to evaluate access to affordable, accountable and reliable primary health services under the Mission alongwith the success achieved in various States especially Punjab in regard to these parameters;

(e) whether the said Mission has been able to integrate different vertical health programmes and decentralize health care delivery at the village level;

(f) if so, the details thereof;

(g) whether any outside audit has been carried out on the performance of NRHM in various States;and

(h) if so, the details alongwith the outcome thereof, State-wise?

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

(a)to(h): A statement is laid on the Table of the House.

STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 519 FOR 30TH APRIL, 2010

(a) NRHM is an initiative for sector wide rejuvenation of Public Health delivery system in accelerated mode over the period 2005-2012. National Rural Health Mission seeks to provide universal access to equitable, affordable and quality healthcare to the rural populace with special focus on people living in the tribal, difficult areas. Nation wise target as per timeline on NRHM has been prepared which is attached as Annexure 1. No State wise target was set under NRHM Framework for Implementation year wise.

(b) State wise details on IMR, CBR, CDR from 2003 to 2008 is attached as Annexure 2.

(c) Population growth can be assessed from Total Fertility Rate. State wise TFR from 2003-08 is attached herewith as Annexure 3.

(d) NRHM reporting system from States involves 121 monitorable parameters of States including demographic indicators, human resources, infrastructure status etc. Status on key indicators for the State of Punjab is attached herewith as Annexure 4.

(e)&(f): All programmes except HIV/AIDS, Cancer, National Mental Health Programme, Non-Communicable diseases etc. have been brought under the umbrella of NRHM.

(g)&(h): The Office of Comptroller & auditor General (CA&G) has done the performance Audit of NRHM. It explains success as well as shortcomings in the implementation of NRHM. The report has stated that the improving health infrastructure and better grass-roots outreach through community health workers such as ASHAs have shown early positive results with outpatients returning to health centres and improved manpower staffing through appointment of contractual staff. However, the Mission has yet to completely mainstream the various State Health Societies implementing disease control programmes. Monitoring of the utilization of the substantial funds released also needs strengthening and institution of systems. New organizations such as Rogi Kalyan Samitis are yet to realize their full potential and decentralized planning has not fully taken off. The states have been asked to have necessary remedial measures on the issues highlighting in the CAG report.

Besides CAG, Community monitoring by Advisory Group for Community Action, International Advisory Panel study by Jeffrey Sachs, Kaveri Gill’s Study for Planning Commission, Citizen’s Reports – Centre for Health and Social Justice, Voluntary Health Association of India, Jan Swasthya Abhiyan; External Evaluation of Janani Suraksha Yojana in 7 States; Common Review Missions of NRHM – Large non-governmental representation on teams etc. are being done for assessing the performance of NRHM in various States.