Lok Sabha Question No. 1182 (UNSTARRED), answered on 2017-12-22
Subject: Misuse of Funds under NRHM
Ministry: HEALTH AND FAMILY WELFARE
Asked by: MAULANA BADRUDDIN AJMAL

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION NO. 1182 TO BE ANSWERED ON   22ND  DECEMBER, 2017

## MISUSE OF FUNDS UNDE R NRHM

## 1182. SHRI BADRUDDIN AJMAL:

Will the Minister of HEA LTH AND FAMILY WELFARE be pleased to state:

- (a) the present status of implementation of the National Rural Health Mission (NRHM) in country, State - wise particularly in the North East States;
- (b)  the  details  of  the  funds  all ocated,  released  and  utilised  under  the  National  Rural  Healt Mission  (NRHM)  during  each  of  the  last  three  years  and  the  current  year,  year - wise  and State/UT - wise;
- (c)  whether  some  cases  of  misuse  of  funds  under  NRHM  have  come  to  the  notice  of  th Government from various parts of the country;
- (d) if so, the details thereof and the action taken by the Government in this regard; and
- (e) whether the Government has constituted monitoring committee for proper utilisation of funds under NRHM at various levels and if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a):     National Rural Health Mission (NRHM) is now overarching National Health Mission (NHM),  along  with  National  Urban  Health  Mission  (NUHM)  as  the  other  sub - Mission.  It  is implemented in all States /UTs in the country.

NHM is a flagship Programme of the Ministry of Health & Family Welfare that continue to support the State Gover nments in strengthening their health systems. Since inception to date  funds  to  the  tune  of  Rs.1,76,097.44  crore  have  been  released  to  the  States/UTs  t Grants - in - aid for implementation of various health activities. Further, the States have con buted Rs.46,370.55 crore towards State share and have reported expenditure of Rs. 210,149.24 cro

A  statement  showing  State  wise  Central  Grants  released,  State  share  contributed Expenditure reported is at Annexure - 1.

Contd…….

(b): The  details  of  the  funds  allocated/released/utilized  for  various  programmes  unde National Rural Health Mission (NRHM), now National Health Mission (NHM), during each of the last three years, year wise and State - wise is at Annexure - 2.

(c)  &  (d): Certain  instances  of  misuse  of  NRHM  funds  like  mis - appropriation  of  funds, diversion of funds from one pool to another without authorization, excessive and infru purchases  etc.  have  come  to  light  through  Audit  in  States  like  Uttar  Pradesh,  Assam, ar, Jammu & Kashmir, Odisha and Rajasthan. As and when any such instance is brought to th notice of the Government, appropriate action as per extant rules is taken in the matter.

(e): Public  Health  being  a  State  subject,  primary  responsibility  of  imple mentation  and monitoring  of  schemes  under  NHM  rests  with  the  State  Governments.  However,  the  Centra Government has been doing financial monitoring of the schemes under NHM through following mechanism:

I. Performance Audit under NRHM by the CAG,

II. Annua l Statutory Audits by CAG empanelled major Chartered Accountant audit firms;

III. Concurrent Audits by Chartered Accountant audit firms;

IV. Financial review by Institute of Public Auditors of India (IPAI) in several States

IV. Examination of quarterly F inancial Monitoring Reports (FMR) furnished by the States;

V. Visits by the teams of the Financial Management Group of the Department to States periodic review.

VI. Annual visits to states by Common Review Mission (CRM) which inter - alia, looks at finan cial  systems  and  mechanisms.  In  CRM,  Officials  from  related  Ministries,  Civ Societies and NGOs participate.

VII. Implemented Public Financial Management System (PFMS) developed by the office of the CGA, Ministry of Finance for monitoring and management of fu ds on real time basis.

VIII. Integrated monitoring visits by senior officials of the Ministry and National System Resource Centre.

………………….

Annexure - 1 Statement  Showing  State - wise  Release,  State  Share  Credited    and Expenditure  reported under NHM from F.Y. 2005-06 to 2017 -18 (Incl. Infrastructure Maintenance.

(Rs. in Crore)

| Sl. No.   | States                    | Total Central Releases   | State share Credited   | Total Expenditure reported by States   |
|-----------|---------------------------|--------------------------|------------------------|----------------------------------------|
| 1         | Andaman & Nicobar Islands | 238.93                   | 39.22                  | 225.49                                 |
| 2         | Andhra Pradesh            | 8,848.41                 | 2,286.48               | 10,320.95                              |
| 3         | Arunachal Pradesh         | 1,074.65                 | 97.47                  | 989.57                                 |
| 4         | Assam                     | 9,704.32                 | 1,160.81               | 10,683.76                              |
| 5         | Bihar                     | 12,045.80                | 2,942.72               | 14,272.34                              |
| 6         | Chandigarh                | 134.98                   | 18.39                  | 144.02                                 |
| 7         | Chattisgarh               | 4,474.68                 | 1,801.29               | 6,039.83                               |
| 8         | Dadra & Nagar Haveli      | 95.55                    | 12.37                  | 97.53                                  |
| 9         | Daman & Diu               | 60.83                    | 11.6                   | 75.01                                  |
| 10        | Delhi                     | 1,549.99                 | 230.78                 | 1,461.90                               |
| 11        | Goa                       | 212.94                   | 59.8                   | 275.22                                 |
| 12        | Gujarat                   | 7,888.81                 | 2,559.05               | 9,509.93                               |
| 13        | Haryana                   | 3,202.77                 | 976.62                 | 4,106.83                               |
| 14        | Himachal Pradesh          | 1,918.62                 | 239.67                 | 2,254.21                               |
| 15        | Jammu & Kashmir           | 3,024.43                 | 343.03                 | 3,041.71                               |
| 16        | Jharkhand                 | 4,223.47                 | 993.27                 | 4,611.91                               |
| 17        | Karnataka                 | 7,476.20                 | 2,059.45               | 9,074.79                               |
| 18        | Kerala                    | 4,545.74                 | 1,097.01               | 5,371.86                               |
| 19        | Lakshadweep               | 36.19                    | 5.85                   | 32.47                                  |
| 20        | Madhya Pradesh            | 11,385.35                | 3,780.02               | 14,117.55                              |
| 21        | Maharashtra               | 13,132.36                | 3,829.48               | 15,973.87                              |
| 22        | Manipur                   | 846.43                   | 94.2                   | 797.46                                 |
| 23        | Meghalaya                 | 1,045.24                 | 118.48                 | 973.52                                 |
| 24        | Mizoram                   | 827.13                   | 80.33                  | 954.22                                 |
| 25        | Nagaland                  | 995.72                   | 103.53                 | 939.86                                 |
| 26        | Orissa                    | 6,797.39                 | 2,275.52               | 8,849.52                               |
| 27        | Puducherry                | 210.63                   | 26.93                  | 224.03                                 |
| 28        | Punjab                    | 3,574.44                 | 1,124.87               | 4,382.71                               |
| 29        | Rajasthan                 | 11,622.26                | 3,551.32               | 14,317.10                              |
| 30        | Sikkim                    | 419.85                   | 46.38                  | 426.87                                 |
| 31        | Tamil Nadu                | 9,582.85                 | 2,901.55               | 13,303.71                              |
| 32        | Telangana                 | 1,479.99                 | 849.59                 | 1,940.67                               |
| 33        | Tripura                   | 1,270.72                 | 130.37                 | 1,228.56                               |
| 34        | Uttar Pradesh             | 29,105.79                | 7,230.49               | 34,286.59                              |
| 35        | Uttarakhand               | 2,426.91                 | 250.09                 | 2,657.30                               |
| 36        | West Bengal               | 9,924.50                 | 3,042.53               | 11,768.69                              |
|           | Others                    | 692.57                   | 0.00                   | 417.68                                 |
|           | Grand Total               | 1,76,097.45              | 46,370.55              | 2,10,149.24                            |

[Note: Central release is up to 05.12.2017 and expenditure is up to 30.09.2017. The release is inclusive of Kind Grants under Immunization.]

|     |                           |            |         | Statement   | Showing    | Statewise Allocation,   |         | Release and   | Expenditure under   | NHM     |            |         | Annexure 2   |
|-----|---------------------------|------------|---------|-------------|------------|-------------------------|---------|---------------|---------------------|---------|------------|---------|--------------|
| Sl. |                           |            | 2014-15 |             |            | 2015-16                 |         |               | 2016-17             |         | 2017-18    | 2017-18 | 2017-18      |
| No. | States                    | Allocation | Release | Exp         | Allocation | Release                 | Exp     | Allocation    | Release             | Exp     | Allocation | Release | Exp          |
| 1   | Andaman & Nicobar Islands | 28.36      | 23.36   | 24.33       | 28.21      | 37.30                   | 11.47   | 46.20         | 44.81               | 28.83   | 37.97      | 17.25   | 8.11         |
| 2   | Andhra Pradesh            | 642.99     | 519.73  | 902.91      | 656.34     | 643.52                  | 1090.17 | 605.87        | 590.14              | 1247.63 | 644.40     | 601.66  | 583.40       |
| 3   | Arunachal Pradesh         | 185.28     | 139.41  | 69.50       | 160.01     | 162.65                  | 146.27  | 166.20        | 160.35              | 165.16  | 184.88     | 101.61  | 43.46        |
| 4   | Assam                     | 1114.50    | 877.13  | 915.88      | 973.90     | 971.35                  | 1186.01 | 985.73        | 1040.46             | 1331.77 | 1056.25    | 528.79  | 404.99       |
| 5   | Bihar                     | 1319.10    | 1148.32 | 1427.40     | 1217.95    | 1159.49                 | 1621.67 | 1105.70       | 958.11              | 1536.72 | 1305.33    | 801.79  | 312.29       |
| 6   | Chandigarh                | 19.40      | 12.15   | 15.26       | 14.24      | 23.89                   | 20.98   | 22.23         | 21.22               | 20.36   | 18.68      | 9.84    | 8.85         |
| 7   | Chattisgarh               | 604.40     | 500.41  | 716.04      | 479.38     | 412.26                  | 758.28  | 554.64        | 575.05              | 987.40  | 565.46     | 396.44  | 402.75       |
| 8   | Dadra & Nagar Haveli      | 13.60      | 8.40    | 8.56        | 11.37      | 14.37                   | 15.54   | 21.24         | 16.99               | 17.22   | 18.77      | 14.06   | 10.37        |
| 9   | Daman & Diu               | 10.71      | 6.91    | 7.67        | 9.11       | 10.53                   | 15.69   | 15.00         | 11.25               | 9.97    | 13.93      | 4.31    | 4.26         |
| 10  | Delhi                     | 187.84     | 154.04  | 222.64      | 142.22     | 163.80                  | 137.29  | 203.78        | 234.38              | 147.56  | 203.95     | 133.71  | 121.32       |
| 11  | Goa                       | 32.34      | 26.03   | 29.50       | 19.41      | 16.77                   | 24.92   | 24.75         | 19.29               | 40.52   | 21.43      | 14.11   | 18.01        |
| 12  | Gujarat                   | 943.75     | 832.86  | 873.66      | 677.65     | 693.78                  | 1272.42 | 837.27        | 844.90              | 1376.91 | 870.19     | 677.94  | 455.52       |
| 13  | Haryana                   | 335.53     | 273.60  | 438.18      | 303.02     | 291.96                  | 493.23  | 315.38        | 310.46              | 510.00  | 262.90     | 209.85  | 226.73       |
| 14  | Himachal Pradesh          | 232.00     | 185.84  | 306.92      | 249.58     | 246.49                  | 281.26  | 213.63        | 209.30              | 343.39  | 309.14     | 243.12  | 115.98       |
| 15  | Jammu & Kashmir           | 433.50     | 335.51  | 393.29      | 365.90     | 367.90                  | 420.94  | 400.12        | 357.30              | 414.43  | 492.18     | 371.66  | 170.20       |
| 16  | Jharkhand                 | 485.98     | 359.62  | 372.01      | 472.07     | 411.50                  | 590.18  | 496.76        | 391.70              | 570.60  | 563.86     | 359.02  | 235.34       |
| 17  | Karnataka                 | 834.10     | 697.24  | 858.18      | 835.64     | 740.45                  | 1141.61 | 713.85        | 695.77              | 1268.33 | 1028.40    | 818.01  | 608.63       |
| 18  | Kerala                    | 583.57     | 521.99  | 509.83      | 305.87     | 304.14                  | 632.88  | 476.34        | 445.06              | 737.69  | 318.55     | 430.41  | 232.65       |
| 19  | Lakshadweep               | 6.01       | 5.08    | 1.36        | 4.28       | 5.69                    | 2.72    | 6.63          | 3.81                | 4.32    | 6.50       | 4.61    | 2.10         |
| 20  | Madhya Pradesh            | 1305.16    | 1162.50 | 1738.02     | 1089.37    | 1132.19                 | 2046.60 | 1524.99       | 1458.76             | 1956.84 | 1434.69    | 1066.55 | 582.55       |

| 21        | Maharashtra   |   1618.30 |   1431.76 |   1834.40 |   1282.31 |   1085.92 |   1734.44 |   1264.34 | 1221.34   | 1773.47   |   1590.03 | 1108.89   | 719.86   |
|-----------|---------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|----------|
| 22        | Manipur       |    144.97 |    128.81 |     86.91 |    115.16 |    112.16 |    105.51 |    117.1  | 78.50     | 78.99     |    130.45 | 13.92     | 31.89    |
| 23        | Meghalaya     |    136.83 |    104.13 |     70.72 |    107.62 |    102.22 |    133.55 |    165.94 | 159.86    | 145.68    |    140.32 | 84.87     | 36.79    |
| 24        | Mizoram       |    116.53 |    103.28 |     93.29 |     97.5  |     94.68 |    172.38 |     98.99 | 80.66     | 90.45     |    101.79 | 63.74     | 43.47    |
| 25        | Nagaland      |    135.26 |    114.92 |     63.04 |    108.75 |    104.85 |     81.05 |    106.96 | 94.88     | 134.55    |    113.67 | 71.77     | 39.32    |
| 26        | Orissa        |    752.19 |    667.16 |    944.1  |    656.78 |    652.62 |   1205.77 |    758.4  | 685.20    | 1255.88   |    798.79 | 510.46    | 530.87   |
| 27        | Puducherry    |     27.64 |     22.56 |     23.35 |     17.77 |     18.61 |     21.77 |     36.42 | 35.50     | 32.56     |     36.32 | 26.37     | 11.24    |
| 28        | Punjab        |    429.49 |    379.35 |    460.59 |    284.75 |    295.23 |    649.49 |    285.32 | 284.99    | 687.75    |    403.11 | 356.42    | 172.59   |
| 29        | Rajasthan     |   1238.11 |   1115.96 |   1722.69 |   1256.97 |   1287.84 |   1799.11 |   1246.08 | 1204.84   | 1856.77   |   1349.79 | 1002.83   | 703.78   |
| 30        | Sikkim        |     51.09 |     51.6  |     41.36 |     43.54 |     41.01 |     50.71 |     46.62 | 41.67     | 50.57     |     48.33 | 28.49     | 16.09    |
| 31        | Tamil Nadu    |   1086.58 |    952.75 |   2248.06 |   1039.16 |   1093.22 |   1633.37 |    789.84 | 752.76    | 1816.97   |    974.47 | 780.22    | 983.78   |
| 32        | Tripura       |    164.24 |    123.11 |    130.15 |    139.07 |    136.29 |    118.77 |    145.53 | 123.89    | 141.27    |    149    | 69.23     | 46.04    |
| 33        | Uttar Pradesh |   3026.05 |   2431.06 |   3671.26 |   3092.96 |   2862.83 |   4451.78 |   3272.74 | 3095.17   | 4901.10   |   3388.37 | 2662.27   | 2020.68  |
| 34        | Uttarakhand   |    328.63 |    270.55 |    324.42 |    296.8  |    276.41 |    335.95 |    271.88 | 260.87    | 346.01    |    354.3  | 247.89    | 112.49   |
| 35        | West Bengal   |   1243.75 |   1058.62 |   1196.78 |   1075.83 |    959.51 |   1487.62 |    820.02 | 741.99    | 1743.92   |    930.01 | 698.01    | 642.98   |
| 36        | Telangana     |    479.7  |    378.72 |    334.68 |    440.58 |    436.63 |    505.55 |    440.46 | 384.47    | 687.15    |    465.3  | 234.86    | 367.98   |
| Sub Total | Sub Total     |  20297.5  |  17124.5  |  23076.9  |  18071.1  |  17370.1  |  26396.9  |  18603    | 17635.67  | 28458.73  |  20331.5  | 14764.96  | 11027.34 |
| Others    | Others        |    122.24 |     35.83 |      0    |      0    |     92.82 |      0    |    153.03 | -         | -         |    162.86 |           |          |
| Total     | Total         |  20419.7  |  17160.3  |  23076.9  |  18071.1  |  17462.9  |  26396.9  |  18756    | 17635.67  | 28458.73  |  20494.3  | 14764.96  | 11027.34 |

Note:

1. Allocation is as per original outlay/B.E. after revising the allocation under Infrastructure Maintenance to the extent of releases made.

2. For the F.Y. 2016 - 17, the allocation under Health System Strengthening under NRHM is revised to the extent of additional allocation made availa ble for Revised Estimate.
3. Release  for the F.Y. 2017 - 18 is updated upto 05.12.2017 and is provisional.
4. The above releases relate to Central Govt. Grants & do not include State share contribution.
5. Expenditure includes expenditure against central Release, State release & unspent balances at the beginning of  the year. Expenditure for the F.Y. 2017 - 18 (upto 30.09.2017 as per FMR are provisional.
6. The above releases does not include kind grants under Immunisation.