Lok Sabha Question No. 56 (STARRED), answered on 2022-12-09
Subject: Implementation of NHM
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kuldeep Rai Sharma, Amol Ramsing Kolhe

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO. 56

## TO BE ANSWERED ON THE 09 th  DECEMBER, 2022

## IMPLEMENTATION OF NHM

## *56.  SHRI KULDEEP RAI SHARMA: DR. AMOL RAMSING KOLHE:

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

- (a) the details of funds allotted and utilised under the National Health Mission (NHM) during  each  of  the  last  three  years,  State/UT-wise  including  Maharashtra,  Bihar, Rajasthan and Andaman & Nicobar Islands;
- (b) the  details  of  Community  Health  Centres  (CHCs)  and  Public  Health  Centres (PHCs)  established  under  NHM  during  each  of  the  last  three  years  in  the  State  of Maharashtra and UT of Andaman & Nicobar Islands;
- (c) the details of each of the proposals received under NHM during last three years, State/UT-wise  along  with  the  action  taken  by  the  Government  on  each  of  such proposals;
- (d) whether the Government  has  formulated any mechanism  to check proper utilization of the funds by States/UTs and measure their progress and if so, the details thereof; and
- (e) the other steps taken by the Government to assess the implementation and progress of NHM along with its present status?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. MANSUKH MANDAVIYA)

- (a) to (e): A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. *56 FOR 09 th  DECEMBER, 2022

(a) to (e): The details of funds released and utilised under the National Health Mission (NHM)  during  the  last  three  years,  State/UT-wise  including  Maharashtra,  Bihar, Rajasthan and Andaman & Nicobar Islands is at Annexure-I.

The details  of  Community  Health  Centres  (CHCs)  and  Primary  Health  Centres (PHCs)  established  under  NHM  from  FY  2018-19  to  2020-21  in  the  State  of Maharashtra and UT Andaman & Nicobar Islands is at Annexure-II.

Under National Health Mission (NHM), Ministry of Health and Family Welfare (MoHFW) provides the technical and financial support to States/UTs for strengthening of their healthcare systems. The proposals from State/UT Governments are received in the form of Programme Implementation Plans (PIPs) under NHM and Government of India provides approval for the proposals in the form of Record of Proceedings (RoPs) as per norms & available resources. The proposals received in the form of PIPs from State/ UT are accorded approval by Government of India as per the detailed discussion during the meeting of National Programme Coordination Committee (NPCC) which are jointly  attended  by  both  the  State  and  Central  officials  within  their  overall  Resource Envelope.

The details of PIPs and RoPs in the last three years for all States/UTs are available at website of National Health Mission i.e. https://nhm.gov.in at the Uniform Resource Locator (URL) as under:

https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=1377&lid=744

Public  health  and  hospitals  is  a  State  subject,  hence  the  primary  responsibility  for proper  utilisation  of  the  scheme  lies  with  the  State/UT  Governments.  Under  NHM,  to ensure utilization of funds, the following steps have been taken up by the Ministry:

-  Performance Audit by the Comptroller and Auditor General (CAG) of India,
-  Annual  Statutory  Audit  by  Chartered  Accountant  firms  empanelled with C&AG and eligible for conducting audit of major PSUs,
-  Concurrent Audit by Chartered Accountants Audit firms,
-  Public Financial Management System (PFMS) in NHM to track flow of funds on Real time basis,
-  Submission of Financial Monitoring Reports (FMRs) and Statement of Fund Position (SFP) by the States/UTs,
-  Review and monitoring of scheme components.

Under NHM, various mechanisms exist to assess the implementation and progress of NHM like:

-  Review of key deliverables of Record of Proceedings of previous financial year during the NPCC meetings,
-  Annual visits  to  States  by  Common  Review  Mission  which  interalia, looks at financial systems and mechanisms. The report of 14th CRM is available in public domain as under: https://nhm.gov.in/New\_Updates\_2018/Monitoring/14th\_CRM/ 14th\_CRM.pdf
-  Implementation of Public Financial Management System for monitoring and management of funds.
-  Regular monitoring visits by senior officials of the Ministry.

Further, Government of India also reviews /assesses the implementation of NHM through external surveys such as, National Family Health Survey, Annual Health  Survey  and  Sample  Registration  System.  The  present  status  of  progress under NHM is placed at Annexure-III.

## State/UT  wise  Central  Release  and  Utilisation  under  National  Health  Mission (NHM) from F.Y. 2019-20 to 2021-22

(Rs. in crore)

| Sl. No.   | State/UT                 | 2019-20         | 2019-20     | 2020-21         | 2020-21     | 2021-22         | 2021-22     |
|-----------|--------------------------|-----------------|-------------|-----------------|-------------|-----------------|-------------|
| Sl. No.   | State/UT                 | Central Release | Utilisation | Central Release | Utilisation | Central Release | Utilisation |
| 1         | Andaman &Nicobar Islands | 34.92           | 41.66       | 36.91           | 42.68       | 43.68           | 31.20       |
| 2         | Andhra Pradesh           | 1111.07         | 1820.15     | 1097.81         | 2385.48     | 1199.37         | 2448.67     |
| 3         | Arunachal Pradesh        | 185.95          | 186.21      | 243.04          | 209.06      | 188.53          | 248.51      |
| 4         | Assam                    | 1749.24         | 1856.33     | 1807.48         | 1846.86     | 1955.93         | 2194.36     |
| 5         | Bihar                    | 1510.68         | 2842.26     | 1814.63         | 2415.34     | 1748.76         | 1905.35     |
| 6         | Chandigarh               | 22.77           | 20.97       | 22.21           | 19.52       | 17.47           | 26.86       |
| 7         | Chhattisgarh             | 816.07          | 1464.47     | 979.41          | 1521.30     | 969.61          | 1833.45     |
| 8         | Dadra &Nagar Haveli      | 25.33           | 23.67       |                 |             |                 | 45.02       |
| 9         | Daman &Diu               | 16.79           | 11.36       | 36.39           | 35.74       | 38.59           |             |
| 10        | Delhi                    | 138.74          | 173.28      | 125.73          | 210.83      | 127.37          | 237.79      |
| 11        | Goa                      | 35.47           | 58.47       | 34.81           | 67.43       | 26.01           | 60.56       |
| 12        | Gujarat                  | 1110.80         | 1864.73     | 1005.66         | 1894.46     | 1094.48         | 1835.81     |
| 13        | Haryana                  | 567.71          | 792.64      | 531.50          | 829.12      | 577.07          | 879.91      |
| 14        | Himachal Pradesh         | 504.84          | 469.60      | 441.94          | 425.58      | 555.09          | 525.09      |
| 15        | Jammu &Kashmir           | 702.20          | 662.56      | 667.46          | 657.53      | 459.10          | 779.61      |
| 16        | Jharkhand                | 830.63          | 1090.11     | 602.80          | 999.71      | 640.18          | 1176.55     |
| 17        | Karnataka                | 1173.77         | 2384.28     | 1232.19         | 2320.37     | 1274.71         | 2200.92     |
| 18        | Kerala                   | 836.14          | 1023.94     | 788.22          | 1457.75     | 771.47          | 1230.96     |
| 19        | Lakshadweep              | 6.16            | 6.55        | 7.11            | 6.99        | 8.41            | 7.26        |
| 20        | Madhya Pradesh           | 1728.73         | 3102.89     | 2377.14         | 3397.82     | 2295.66         | 3714.92     |
| 21        | Maharashtra              | 1724.99         | 3097.08     | 1833.59         | 3503.62     | 1769.67         | 4227.31     |
| 22        | Manipur                  | 185.65          | 196.06      | 189.49          | 112.79      | 95.59           | 154.09      |
| 23        | Meghalaya                | 141.17          | 166.24      | 202.63          | 213.36      | 282.46          | 227.08      |
| 24        | Mizoram                  | 127.24          | 105.70      | 143.73          | 131.36      | 93.82           | 153.16      |
| 25        | Nagaland                 | 123.23          | 130.37      | 188.21          | 159.72      | 126.66          | 192.16      |
| 26        | Odisha                   | 1475.14         | 2220.82     | 1617.63         | 2347.24     | 1263.07         | 2587.72     |
| 27        | Puducherry               | 31.56           | 44.21       | 25.55           | 47.32       | 21.33           | 46.36       |
| 28        | Punjab                   | 712.02          | 923.31      | 568.14          | 908.98      | 349.21          | 918.96      |
| 29        | Rajasthan                | 1781.83         | 2559.51     | 2000.58         | 2943.21     | 1924.95         | 3230.01     |
| 30        | Sikkim                   | 53.55           | 54.84       | 70.13           | 52.06       | 51.86           | 46.06       |
| 31        | Tamil Nadu               | 1424.22         | 2557.62     | 1522.71         | 2172.33     | 1631.91         | 3039.39     |
| 32        | Tripura                  | 239.47          | 208.37      | 225.91          | 249.74      | 217.95          | 237.24      |
| 33        | Uttar Pradesh            | 4749.05         | 7453.90     | 3772.95         | 7080.45     | 3235.46         | 6210.20     |
| 34        | Uttarakhand              | 348.83          | 504.02      | 583.25          | 503.53      | 553.47          | 606.07      |
| 35        | West Bengal              | 1749.32         | 2340.84     | 1895.01         | 2598.62     | 1654.26         | 2229.46     |
| 36        | Telangana                | 964.34          | 949.96      | 671.88          | 1354.93     | 725.67          | 1556.65     |
| 37        | Ladakh                   | 0.00            | 0.00        | 91.89           | 38.56       | 44.79           | 62.81       |

## Note:

1. National Health Mission (NHM) comprises of two sub Missions viz. National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM).
2. The above releases relate to Central Govt. Grants & do not include State share contribution.
3. Expenditure includes expenditure against Central Release, State Release & unspent balances at the beginning of the year. Expenditure is as per available Financial Management Reports submitted by the States/UTs.
4. After the Reorganisation of the State of Jammu and Kashmir (J&K) into the Union Territory of J&K and Union Territory of Ladakh, NHM funds to the UT of Ladakh were disbursed for the first time during 2020-21.

## Annexure-II

| NUMBER OF PHCs and CHCs FUNCTIONING IN RURAL &URBANAREAS   | NUMBER OF PHCs and CHCs FUNCTIONING IN RURAL &URBANAREAS   | NUMBER OF PHCs and CHCs FUNCTIONING IN RURAL &URBANAREAS   | NUMBER OF PHCs and CHCs FUNCTIONING IN RURAL &URBANAREAS   | NUMBER OF PHCs and CHCs FUNCTIONING IN RURAL &URBANAREAS   | NUMBER OF PHCs and CHCs FUNCTIONING IN RURAL &URBANAREAS   | NUMBER OF PHCs and CHCs FUNCTIONING IN RURAL &URBANAREAS   | NUMBER OF PHCs and CHCs FUNCTIONING IN RURAL &URBANAREAS   |
|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|
| Facilities                                                 |                                                            |                                                            |                                                            |                                                            | Andaman &Nicobar Islands                                   | Andaman &Nicobar Islands                                   | Andaman &Nicobar Islands                                   |
|                                                            | Localit                                                    | 2018- 19                                                   | 2019- 20                                                   | 2020- 21                                                   | 2018- 19                                                   | 2019- 20                                                   | 2020- 21                                                   |
|                                                            | y                                                          | (As on 31st March 2019)                                    | (As on 31st March 2020)                                    | (As on 31st March 2021)                                    | (As on 31st March 2019)                                    | (As on 31st March 2020)                                    | (As on 31st March 2021)                                    |
| Primary Health                                             | Rural                                                      | 1828                                                       | 1829                                                       | 1839                                                       | 22                                                         | 22                                                         | 22                                                         |
| Centres                                                    | Urban                                                      | 538                                                        | 846                                                        | 651                                                        | 2                                                          | 5                                                          | 5                                                          |
| Community Health                                           | Rural                                                      | 364                                                        | 278                                                        | 270                                                        | 4                                                          | 4                                                          | 4                                                          |
| Centres                                                    | Urban                                                      | 37                                                         | 140                                                        | 131                                                        | 0                                                          | 0                                                          | 0                                                          |

Data Source: Rural Health Statistics

Annexure-III Statement showing State/UT-wise physical achievement/Progress under National Health Mission

## (as on 30.06.2022 )

|       |                        | In Rural and Urban Areas               | In Rural and Urban Areas             | In Rural and Urban Areas     | In Rural and Urban Areas                       | In Rural and Urban Areas            | In Rural Areas                     | In Rural Areas                            | In Rural Areas                                                       |
|-------|------------------------|----------------------------------------|--------------------------------------|------------------------------|------------------------------------------------|-------------------------------------|------------------------------------|-------------------------------------------|----------------------------------------------------------------------|
| S. No | State/UTs              | Health Human Resources Augemen- tation | Mobile Medical Units (opera- tional) | Ambula -nces (Opera- tional) | Accre -dited Social Health Acti- vists (ASHAs) | Setti ng up Rogi Kal- yan Sam- itis | No of PHCs work- ing on 24X7 basis | Funct- ional FRUs (First Referra l Units) | Village Health Sanita- tion and Nutrition Commi- ttees constitu- ted |
| 1     | Bihar                  | 10692                                  | 0                                    | 1186                         | 92867                                          | 1927                                | 496                                | 66                                        | 8406                                                                 |
| 2     | Chhattisgarh           | 6630                                   | 30                                   | 624                          | 72002                                          | 996                                 | 265                                | 37                                        | 19180                                                                |
| 3     | Himachal Pradesh       | 1164                                   | 12                                   | 404                          | 7964                                           | 784                                 | 0                                  | 24                                        | 7916                                                                 |
| 4     | Jammu &Kashmir         | 8422                                   | 10                                   | 489                          | 12686                                          | 741                                 | 190                                | 59                                        | 6494                                                                 |
| 5     | Jharkhand              | 8119                                   | 56                                   | 1970                         | 47223                                          | 586                                 | 114                                | 51                                        | 30012                                                                |
| 6     | Madhya Pradesh         | 19474                                  | 0                                    | 1237                         | 83614                                          | 1793                                | 771                                | 148                                       | 49567                                                                |
| 7     | Odisha                 | 5771                                   | 9                                    | 1130                         | 48977                                          | 1809                                | 115                                | 75                                        | 46064                                                                |
| 8     | Rajasthan              | 6625                                   | 299                                  | 1484                         | 53676                                          | 3550                                | 1179                               | 83                                        | 43440                                                                |
| 9     | Uttar Pradesh          | 32320                                  | 170                                  | 4720                         | 166824                                         | 1790                                | 439                                | 334                                       | 72880                                                                |
| 10    | Uttarakhand            | 3956                                   | 16                                   | 400                          | 12018                                          | 325                                 | 87                                 | 50                                        | 14915                                                                |
| 11    | Arunachal Pradesh      | 1914                                   | 16                                   | 240                          | 4143                                           | 228                                 | 64                                 | 14                                        | 3772                                                                 |
| 12    | Assam                  | 16362                                  | 130                                  | 1035                         | 32670                                          | 1249                                | 314                                | 70                                        | 28149                                                                |
| 13    | Manipur                | 1526                                   | 9                                    | 33                           | 4009                                           | 132                                 | 66                                 | 7                                         | 3878                                                                 |
| 14    | Meghalaya              | 1520                                   | 4                                    | 50                           | 7311                                           | 173                                 | 65                                 | 9                                         | 6310                                                                 |
| 15    | Mizoram                | 1203                                   | 9                                    | 62                           | 1099                                           | 86                                  | 41                                 | 15                                        | 830                                                                  |
| 16    | Nagaland               | 972                                    | 11                                   | 93                           | 2038                                           | 175                                 | 33                                 | 15                                        | 1346                                                                 |
| 17    | Sikkim                 | 375                                    | 0                                    | 9                            | 676                                            | 30                                  | 24                                 | 3                                         | 641                                                                  |
| 18    | Tripura                | 489                                    | 0                                    | 50                           | 8118                                           | 158                                 | 83                                 | 13                                        | 1178                                                                 |
| 19    | Andhra Pradesh         | 8238                                   | 67                                   | 628                          | 43137                                          | 1390                                | 1142                               | 249                                       | 13065                                                                |
| 20    | Goa                    | 463                                    | 0                                    | 29                           | 0                                              | 37                                  | 13                                 | 2                                         | 247                                                                  |
| 21    | Gujarat                | 11639                                  | 74                                   | 418                          | 49549                                          | 2219                                | 511                                | 130                                       | 17648                                                                |
| 22    | Haryana                | 9276                                   | 59                                   | 636                          | 23954                                          | 656                                 | 241                                | 39                                        | 6049                                                                 |
| 23    | Karnataka              | 15114                                  | 8                                    | 893                          | 41544                                          | 2904                                | 960                                | 173                                       | 26087                                                                |
| 24    | Kerala                 | 5595                                   | 31                                   | 315                          | 30724                                          | 1323                                | 171                                | 87                                        | 19692                                                                |
| 25    | Maharashtra            | 20500                                  | 30                                   | 3644                         | 69236                                          | 3552                                | 1591                               | 268                                       | 39770                                                                |
| 26    | Punjab                 | 4508                                   | 33                                   | 0                            | 21972                                          | 749                                 | 211                                | 185                                       | 12982                                                                |
| 27    | Tamil Nadu             | 33061                                  | 425                                  | 1284                         | 5434                                           | 2595                                | 1316                               | 576                                       | 15015                                                                |
| 28    | Telangana              | 10942                                  | 0                                    | 476                          | 32854                                          | 964                                 | 314                                | 116                                       | 10434                                                                |
| 29    | West Bengal            | 18500                                  | 49                                   | 3152                         | 64904                                          | 1105                                | 234                                | 154                                       | 48429                                                                |
| 30    | A&N Island             | 356                                    | 0                                    | 26                           | 422                                            | 33                                  | 20                                 | 1                                         | 275                                                                  |
| 31    | Chandigarh             | 381                                    | 0                                    | 6                            | 0                                              | 6                                   | 0                                  | 4                                         | 0                                                                    |
| 32    | D&N Haveli/ Daman &Diu | 438                                    | 3                                    | 11                           | 700                                            | 12                                  | 9                                  | 8                                         | 89                                                                   |
| 33    | Delhi                  | 1662                                   | 2                                    | 220                          | 8942                                           | 33                                  | 1                                  | 32                                        | 0                                                                    |
| 34    |                        |                                        | 1                                    | 18                           |                                                |                                     |                                    | 7                                         |                                                                      |
|       | Ladakh                 | 1212                                   |                                      |                              | 608                                            | 42                                  | 12                                 |                                           | 247                                                                  |
| 35    | Lakshadweep            | 159                                    | 0                                    | 0                            | 110                                            | 9                                   | 4                                  | 9                                         | 9                                                                    |
| 36    | Puducherry             | 409                                    | 4                                    | 11                           | 317                                            | 49                                  | 23                                 | 4                                         | 100                                                                  |
|       | TOTAL                  | 269987                                 | 1567                                 | 26983                        | 1052322                                        | 34210                               | 11119                              | 3117                                      | 555116                                                               |

Source: - NHM-MIS report, as on 30.06.2022.