Lok Sabha Question No. 2756 (UNSTARRED), answered on 2023-08-04
Subject: Allocation of Funds under National Health Mission
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sunil Kumar Soni, Nihal Chand Chauhan, Kanakmal Katara

## GOVERNMENTOFINDIA MINISTRY OFHEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO.2756 TO BE ANSWERED ON THE 04 th AUGUST, 2023

## 'ALLOCATION OF FUNDS UNDER NATIONALHEALTH MISSION'

## 2756. SHRI SUNIL KUMAR SONI: SHRI NIHAL CHAND: SHRI KANAKMALKATARA:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to State:

- a) the funds allocated and utilised during the last three years under the National Health Mission (NHM), State/UT-wise;
- b) the steps taken to assess the implementation and assessment of progress of NHM;
- c) whether the Government has set up any kind of mechanism to have audit of funds spent and utilized by the State/UTs;
- d) if so, the details thereof along with the progress made in this regard;
- e) whether the Government has received proposals from various States including Rajasthan and Chhattisgarh under the National Health Mission;
- f) if so, the details thereof along with the present status of such proposals; and
- g) the details of the Community Health Centres and Public Health Centres established in Rajasthan and Chhattisgarh under NHM since its inception?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

## (DR. BHARATI PRAVIN PAWAR)

(a) to (g): National Health Mission (NHM) is a Centrally Sponsored Scheme under which Government of India provides financial and technical support to States/UTs to strengthen their health care systems.

The details of funds released and utilised under the National Health Mission (NHM) during the last three years, State/UT-wise and year-wise is at Annexure I.

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

-  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 looks at financial systems and mechanisms.
-  Implementation of Public Financial Management System (PFMS) for monitoring and management of funds.
-  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 -II

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.

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 of States/UTs including State of Chhattisgarh and Rajasthan is 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

As per the Management Information System report (as on 31 st March, 2023) the details of CHC and PHC functioning in the State of Chhattisgarh and Rajasthan is as under:

| State        | PHC   | PHC   | CHC   | CHC   |
|--------------|-------|-------|-------|-------|
|              | Rural | Urban | Rural | Urban |
| Chhattisgarh | 792   | 52    | 170   | 4     |
| Rajasthan    | 2474  | 299   | 718   | 12    |

## State/UT wise Central Release and Expenditure under National Health Mission (NHM) from F.Y. 2020-21 to 2022-23

(Rs. in crore)

| Sl. No.   | States                             | 2020-21         | 2020-21     | 2021-22         | 2021-22     | 2022-23         | 2022-23     |
|-----------|------------------------------------|-----------------|-------------|-----------------|-------------|-----------------|-------------|
| Sl. No.   | States                             | Central Release | Expenditure | Central Release | Expenditure | Central Release | Expenditure |
| 1         | Andaman and Nicobar Islands        | 36.91           | 42.68       | 43.68           | 31.20       | 45.26           | 42.28       |
| 2         | Andhra Pradesh                     | 1097.81         | 2385.48     | 1199.37         | 2448.67     | 1,489.45        | 1,914.34    |
| 3         | Arunachal Pradesh                  | 243.04          | 209.06      | 188.53          | 248.51      | 233.82          | 424.78      |
| 4         | Assam                              | 1807.48         | 1846.86     | 1955.93         | 2194.36     | 1,981.83        | 2,307.00    |
| 5         | Bihar                              | 1814.63         | 2415.34     | 1748.76         | 1905.35     | 1,586.57        | 3,717.81    |
| 6         | Chandigarh                         | 22.21           | 19.52       | 17.47           | 26.86       | 38.09           | 26.98       |
| 7         | Chhattisgarh                       | 979.41          | 1521.30     | 969.61          | 1833.45     | 1,195.08        | 2,152.45    |
| 8         | Dadra & Nagar Haveli & Daman & Diu | 36.39           | 35.74       | 38.59           | 45.02       | 58.28           | 41.61       |
| 9         | Delhi                              | 125.73          | 210.83      | 127.37          | 237.79      | 35.15           | 1,037.33    |
| 10        | Goa                                | 34.81           | 67.43       | 26.01           | 60.56       | 55.42           | 84.64       |
| 11        | Gujarat                            | 1005.66         | 1894.46     | 1094.48         | 1835.81     | 1,120.06        | 2,292.35    |
| 12        | Haryana                            | 531.50          | 829.12      | 577.07          | 879.91      | 681.21          | 1,185.43    |
| 13        | Himachal Pradesh                   | 441.94          | 425.58      | 555.09          | 525.09      | 494.65          | 567.83      |
| 14        | Jammu and Kashmir                  | 667.46          | 657.53      | 459.10          | 779.61      | 651.52          | 917.02      |
| 15        | Jharkhand                          | 602.80          | 999.71      | 640.18          | 1176.55     | 810.30          | 1,495.17    |
| 16        | Karnataka                          | 1232.19         | 2320.37     | 1274.71         | 2200.92     | 1,246.67        | 2,376.94    |
| 17        | Kerala                             | 788.22          | 1457.75     | 771.47          | 1230.96     | 1,036.76        | 1,592.96    |
| 18        | Lakshadweep                        | 7.11            | 6.99        | 8.41            | 7.26        | 9.97            | 9.29        |
| 19        | Madhya Pradesh                     | 2377.14         | 3397.82     | 2295.66         | 3714.92     | 2,582.10        | 4,489.15    |
| 20        | Maharashtra                        | 1833.59         | 3503.62     | 1769.67         | 4227.31     | 2,187.13        | 4,501.75    |
| 21        | Manipur                            | 189.49          | 112.79      | 95.59           | 154.09      | 61.40           | 214.69      |
| 22        | Meghalaya                          | 202.63          | 213.36      | 282.46          | 227.08      | 261.56          | 319.08      |
| 23        | Mizoram                            | 143.73          | 131.36      | 93.82           | 153.16      | 111.82          | 107.46      |
| 24        | Nagaland                           | 188.21          | 159.72      | 126.66          | 192.16      | 91.38           | 161.93      |
| 25        | Odisha                             | 1617.63         | 2347.24     | 1263.07         | 2587.72     | 1,284.69        | 3,402.50    |
| 26        | Puducherry                         | 25.55           | 47.32       | 21.33           | 46.36       | 20.73           | 48.51       |
| 27        | Punjab                             | 568.14          | 908.98      | 349.21          | 918.96      | 448.89          | 1,054.39    |
| 28        | Rajasthan                          | 2000.58         | 2943.21     | 1924.95         | 3230.01     | 1,460.80        | 3,726.21    |
| 29        | Sikkim                             | 70.13           | 52.06       | 51.86           | 46.06       | 73.30           | 68.05       |
| 30        | Tamil Nadu                         | 1522.71         | 2172.33     | 1631.91         | 3039.39     | 1,652.24        | 3,191.84    |
| 31        | Tripura                            | 225.91          | 249.74      | 217.95          | 237.24      | 231.90          | 287.20      |
| 32        | Uttar Pradesh                      | 3772.95         | 7080.45     | 3235.46         | 6210.20     | 5,133.59        | 8,828.29    |
| 33        | Uttarakhand                        | 583.25          | 503.53      | 553.47          | 606.07      | 505.01          | 647.13      |
| 34        | West Bengal                        | 1895.01         | 2598.62     | 1654.26         | 2229.46     | 1,252.32        | 3,509.86    |
| 35        | Telangana                          | 671.88          | 1354.93     | 725.67          | 1556.65     | 683.77          | 2062.92     |
| 36        | Ladakh                             | 91.89           | 38.56       | 44.79           | 62.81       | 94.94           | 109.67      |

## 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 and is provisional.
4. After the Re-organisation 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 Statement showing State/UT-wise Physical Achievement/Progress under National Health Mission (As on March, 2023)

|        |                       | 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                                              |
|--------|-----------------------|-------------------------------------|------------------------------------|----------------------------|---------------------------------------------|--------------------------------|-----------------------------------|----------------------------------------|-------------------------------------------------------------|
| Sl.No. | State                 | Health Human Resources Augmentation | Mobile Medical Units (Operational) | Ambulances (Operational)   | Accrediated Social Health Activists (ASHAs) | Setting up Rogi Kalyan Samitis | No. of PHCs working on 24X7 basis | Functional FRUs (First Referral Units) | Village Health Sanitation &Nutrition Committees Constituted |
| 1      | Bihar                 | 19371                               | 0                                  | 1669                       | 94351                                       | 1927                           | 496                               | 68                                     | 8406                                                        |
| 2      | Chhattisgarh          | 7461                                | 30                                 | 615                        | 72014                                       | 996                            | 267                               | 50                                     | 19180                                                       |
| 3      | Himachal Pradesh      | 1318                                | 12                                 | 404                        | 7833                                        | 797                            | 0                                 | 24                                     | 7914                                                        |
| 4      | Jammu & Kashmir       | 9112                                | 10                                 | 489                        | 13061                                       | 741                            | 185                               | 56                                     | 6494                                                        |
| 5      | Jharkhand             | 8335                                | 56                                 | 1970                       | 42273                                       | 600                            | 114                               | 53                                     | 30012                                                       |
| 6      | Madhya Pradesh        | 20158                               | 0                                  | 2052                       | 70175                                       | 1835                           | 834                               | 144                                    | 49567                                                       |
| 7      | Orissa                | 5851                                | 9                                  | 1130                       | 48881                                       | 1814                           | 108                               | 79                                     | 46064                                                       |
| 8      | Rajasthan             | 7357                                | 299                                | 1495                       | 53335                                       | 3552                           | 1179                              | 89                                     | 43440                                                       |
| 9      | Uttar Pradesh         | 32351                               | 170                                | 4720                       | 167317                                      | 1818                           | 439                               | 334                                    | 76768                                                       |
| 10     | Uttarakhand           | 4905                                | 17                                 | 388                        | 12018                                       | 325                            | 87                                | 50                                     | 14915                                                       |
| 11     | Arunachal Pradesh     | 1999                                | 16                                 | 239                        | 4170                                        | 228                            | 64                                | 14                                     | 3772                                                        |
| 12     | Assam                 | 17890                               | 130                                | 800                        | 32670                                       | 1252                           | 314                               | 69                                     | 28149                                                       |
| 13     | Manipur               | 1593                                | 9                                  | 33                         | 4114                                        | 132                            | 66                                | 7                                      | 3878                                                        |
| 14     | Meghalaya             | 1608                                | 4                                  | 50                         | 7076                                        | 173                            | 65                                | 9                                      | 6310                                                        |
| 15     | Mizoram               | 1271                                | 9                                  | 65                         | 1091                                        | 86                             | 41                                | 15                                     | 830                                                         |
| 16     | Nagaland              | 1015                                | 11                                 | 93                         | 2094                                        | 175                            | 33                                | 15                                     | 1346                                                        |
| 17     | Sikkim                | 375                                 | 0                                  | 9                          | 676                                         | 30                             | 24                                | 3                                      | 641                                                         |
| 18     | Tripura               | 583                                 | 0                                  | 50                         | 7663                                        | 161                            | 83                                | 13                                     | 1178                                                        |
| 19     | Andhra Pradesh        | 8182                                | 67                                 | 628                        | 43420                                       | 1388                           | 1145                              | 244                                    | 13130                                                       |
| 20     | Goa                   | 518                                 | 0                                  | 29                         | 0                                           | 37                             | 13                                | 2                                      | 247                                                         |
| 21     | Gujarat               | 11577                               | 74                                 | 418                        | 43928                                       | 2337                           | 511                               | 130                                    | 17648                                                       |
| 22     | Haryana               | 9267                                | 59                                 | 636                        | 20400                                       | 663                            | 238                               | 44                                     | 6049                                                        |
| 23     | Karnataka             | 15476                               | 8                                  | 881                        | 41123                                       | 2904                           | 960                               | 173                                    | 26087                                                       |
| 24     | Kerala                | 5700                                | 35                                 | 315                        | 26448                                       | 1327                           | 171                               | 87                                     | 19936                                                       |
| 25     | Maharashtra           | 23968                               | 30                                 | 4486                       | 70267                                       | 3607                           | 1591                              | 220                                    | 39723                                                       |
| 26     | Punjab                | 4482                                | 33                                 | 0                          | 20130                                       | 749                            | 211                               | 185                                    | 12968                                                       |
| 27     | Tamil Nadu            | 33446                               | 425                                | 1353                       | 4858                                        | 2619                           | 1316                              | 576                                    | 15015                                                       |
| 28     | Telangana             | 13316                               | 0                                  | 426                        | 26649                                       | 1004                           | 314                               | 122                                    | 10434                                                       |
| 29     | West Bengal           | 19116                               | 49                                 | 3234                       | 65743                                       | 1115                           | 234                               | 159                                    | 48429                                                       |
| 30     | A&N Island            | 351                                 | 0                                  | 26                         | 422                                         | 34                             | 20                                | 1                                      | 275                                                         |
| 31     | Chandigarh            | 570                                 | 0                                  | 6                          | 0                                           | 6                              | 0                                 | 4                                      | 0                                                           |
| 32     | D&N Haveli/Daman& Diu | 410                                 | 3                                  | 11                         | 450                                         | 12                             | 9                                 | 8                                      | 89                                                          |
| 33     | Delhi                 | 1657                                | 2                                  | 177                        | 9063                                        | 33                             | 1                                 | 34                                     | 0                                                           |
| 34     | Ladakh                | 1277                                | 1                                  | 28                         | 608                                         | 42                             | 12                                | 7                                      | 247                                                         |
| 35     | Lakshadweep           | 234                                 | 0                                  | 0                          | 110                                         | 9                              | 4                                 | 6                                      | 9                                                           |

Source: As per MIS Report as on 31.03.2023