Lok Sabha Question No. 2226 (UNSTARRED), answered on 2017-07-28
Subject: NRHM
Ministry: HEALTH AND FAMILY WELFARE
Asked by: SUNIL KUMAR MONDAL, LAXMI NARAYAN YADAV

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

LOK SABHA UNSTARRED QUESTION NO. 2226 TO BE ANSWERED ON 28 TH JULY, 2017

## NRHM

## 2226. SHRI SUNIL KUMAR MONDAL: SHRI LAXMI NARAYAN YADAV:

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

(a) whether the Government has received any proposals from the States and UT for allocation of more funds under National Rural Health Mission (NRHM) to improve healthcare facilities and f so,the details of such proposals and the action taken by the Government thereon, State/ UT - wise;

(b) whether cases of misuse of funds have been reported and if so, the details thereof along with the action taken by the Government in this regard;

(c)the steps taken/being taken by the Government for proper utilisation of funds and continuous monitoring and implementation of NRHM at various levels;

(d)  whether  the  Government  has  fixed any  monetary  incentive  regarding sterilisation  u nder NRHM and if so, thedetails thereof;

(e) whether the Government proposes to increase the monetary incentive in view of rising prices and if so, the details thereof and if not, the reasons the for; and

(f) the reaction of the Government there o?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

(a) : The States/UTs regularly seek more allocation of funds under NRHM to improve heal care facilities. However, allocation to a State/UT is determined by the budgetary provision for NRHM and the formula approved by the Mission Steering Group for allocation of NRHM - RCH flexi pool funds among States.

(b): Certain  instances  of  misuse  of  NRHM  funds  like  mis - appropriation,  misuse  of  untied funds,  diversion  of  fund s  from  one  pool  to  another  without  authorisation,  excessive  a infructuous purchases etc. have come to light through Audit in States like Uttar Pradesh Bihar,  Haryana,  Jammu  &  Kashmir,  Odisha  and  Rajasthan.  The  observations  have  been  dul communic ated to the concerned States for taking necessary remedial action.

(c) : Besides provision of annual CAG audit, following monitoring mechanisms are put in p for  adherence  to  financial  procedures  and  proper  financial  utilization  for  implement of NRHM at various levels:

- Annual Statutory Audit by CAG empanelled major CA audit firm;
- Concurrent Audit by CAG audit firm;
- Implementation of Public Financial management System (PFMS) developed by the office o the  Controller  General  of  Accounts  (CGA)  of Ministry  of  Finance  for  monitoring  and management of funds on just in time basis.
- Submission of Financial Management Reports (FMRs) by the States/UTs,
- Release  of  subsequent  instalments  is  based  on  the  extent  of  utilization  of  earli released,
- Annua l  visits  to  States  by  Common  Review  Mission  (CRM),  which  inter - alia,  looks  at financial system and mechanism.
- Integrated monitoring visits by senior officials of the Ministry and National Healt Resource Centre (NHSRC).
- 2  or  more  signatories  for  all NHM  accounts  and  Double  Entry  Accounting  system  are followed.

(d) : Yes,  the  Government  has  fixed  monetary  compensation  regarding  sterilisation  un NRHM, the details of which are annexed at Annexure -I.

(e) & (f): Yes, the Government has increased the m onetary compensation in view of rising prices in 11 High Focus States w.e.f. 20 - 10- 2014, the details of which are annexed at Annexure -II.

## Compensation Scheme in Sterilisation for all the states w.e.f. 07.09.2007

## A. Public (Government) Facilities: (all amounts in Rupees)

| S.No.   | Procedure                          | Tubectomy   | Vasectomy   |
|---------|------------------------------------|-------------|-------------|
| 1       | Acceptor                           | 600         | 1100        |
| 2       | Motivator/ASHA                     | 150         | 200         |
| 3       | Drugs and dressings                | 100         | 50          |
| 4       | Surgeons' compensation             | 75          | 100         |
| 5       | Anasthetist/ Assisting MO (if any) | 25          | -           |
| 6       | Nurse/ANM                          | 15          | 15          |
| 7       | OT technician/ helper              | 15          | 15          |
| 8       | Clerks/ documentation              | -           | -           |
| 9       | Refreshment                        | 10          | 10          |
| 10      | Miscellaneous                      | 10          | 10          |
|         | TOTAL                              | 1000        | 1500        |

## B. Accredited Private/NGO Facilities: (all amounts in Rupees)

| S.No.   | Procedure   |   Tubectomy |   Vasectomy |
|---------|-------------|-------------|-------------|
| 1       | Facility    |        1350 |        1300 |
| 2       | Motivator   |         150 |         200 |
|         | TOTAL       |        1500 |        1500 |

The  revised  scheme  in  11  high  focus  states  (UP,  Bihar, MP,  Chattisgarh, Rajasthan,  Jharkhand,  Orissa,  Uttarakhand,  Haryana,  Assam,  Gujarat)  w.e.f. 20.10.2014 wherein Government has increased the monetary compensation in view of rising prices are:

1. Tubectomy  compensations  have  been  increased  from  Rs.1000  to  Rs.2000. (public Facility)
2. Vasectomy  compensations  have  been  increased  from  Rs.1500  to  Rs.2700. (public Facility)
3. Accredited Private/NGO compensations have been increased from Rs.1500 to Rs.3000 for both tubectomy and vasectomy.
4. More over a new post-partum sterilisation package has been introduced for Rs.3000.

## A. Public (Government) Facilities: (all amounts in Rupees)

| S.No.   | Procedure                          | Tubectomy   | Tubectomy   | Vasectomy   |
|---------|------------------------------------|-------------|-------------|-------------|
|         |                                    |             | PPS         |             |
| 1       | Acceptor                           | 1400        | 2200        | 2000        |
| 2       | Motivator/ASHA                     | 200         | 300         | 300         |
| 3       | Drugs and dressings                | 100         | 100         | 50          |
| 4       | Surgeons' compensation             | 150         | 250         | 250         |
| 5       | Anasthetist/ Assisting MO (if any) | 50          | 50          | -           |
| 6       | Nurse/ANM                          | 30          | 50          | 30          |
| 7       | OT technician/ helper              | 30          | 50          | 30          |
| 8       | Clerks/ documentation              | 20          | -           | 20          |
| 9       | Refreshment                        | 10          | -           | 10          |
| 10      | Miscellaneous                      | 10          | -           | 10          |
|         | TOTAL                              | 2000        | 3000        | 2700        |

*PPS: (Post Partum Sterilisation)

## B. Accredited Private/NGO Facilities: (all amounts in Rupees)

| S.No.   | Procedure              | Tubectomy   | Vasectomy   |
|---------|------------------------|-------------|-------------|
|         | Details of the package |             |             |
| 1       | Facility               | 2000        | 2000        |
| 2       | Acceptor               | 1000        | 1000        |
|         | TOTAL                  | 3000        | 3000        |