Lok Sabha Question No. 1230 (UNSTARRED), answered on 2024-02-09
Subject: Health Grants to Local Government
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Pramila Bisoyi

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO.1230 TO BE ANSWERED ON THE 9 th FEBURARY, 2024

## 'HEALTH GRANTS TO LOCALGOVERNMENT'

## 1230. SHRIMATI PRAMILABISOYI:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) the opening balance, funds allocated, fund utilized and closing balance under National Health Mission (NHM) at the end of Financial Years (FY) 2020-21, 2021-22 and 2022-23, 2023-24, State/UT-wise;
- (b) the committed liabilities under NHM for FY 2020-21, 2021-22 and 2022-23, State/UTwise;
- (c) the approved and released Central share under NHM for FY 2020-21, 2021-22 and 202223, State/UT-wise;
- (d) whether the Government is aware about the slow progress in releasing and utilizing Health Grants to Local Governments as recommended by the 15th Finance Commission;
- (e) the steps taken by the Government to expedite the utilisation of such grants; and
- (f) if so, the details of the minutes of the National Level Committee chaired by the Ministry of Health and Family Welfare as of now?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to (f): With the objective of attainment of universal access to equitable, affordable and quality health care services, the Ministry of Health & Family Welfare is implementing National Health Mission. Government provides technical and financial support to the States/UTs for improvement in health infrastructure, availability of adequate human resources to health facilities, improve availability and accessibility to quality health care especially for the underserved and marginalized groups. The details of opening balance, funds allocated, fund utilized and closing balance under the National Health Mission (NHM) from FY 2020-21 to 2023-24, State/UT-wise and year-wise is at Annexure-I.

Further, under NHM, all the States/UTs submit the proposals, through Program Implementation Plan (PIP) annually. Year-wise Record of Proceedings (RoPs) which includes the committed liabilities and PIPs for FY 2020-21, 2021-22 & 2022-23, are available at:

Fifteenth Finance Commission (FC-XV) grants through local governments are for specific components of health sector and spread over five-year period from FY 2021-22 to FY 2025-26 to the tune of Rs.70,051 crore. An amount of Rs.19,409 crore has been released till 2 nd February, 2024 to States and a capital grant has infrastructure components involving lead time/gestation period.

Further, under 15th Finance Commission, regular interactions are held with States. Various mechanisms exist to assess the implementation and progress of 15th Finance Commission like:

-  Implementation of NHM-PMS Portal for monitoring and management of funds.
-  Submission of Grant Transfer Certificate and Utilization Certificate by the States
-  Recommendations to DoE for subsequent instalment is done on the basis of compliance of guidelines of Department of Expenditure, Ministry of Finance along with Technical and Operational guidelines of Ministry of Health & Family Welfare.

Further, monitoring and evaluation of the progress of all states is assessed, through review meetings, video conferences & field visits of senior officials. Further, Common Review Missions (CRM) are conducted periodically to assess and monitor the progress and implementation status of various schemes. The key strategies and priority areas of CRM is to analyze challenges with respect to strengthening health systems, identify trends in progress of key indicators, evaluate the readiness of the state to undertake implementation of new initiatives, and review the progress and coordination mechanisms with various partners. The details of various reports of CRM are available at:

https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=795&lid=195

Further, the minutes of meeting of the National Level Committee (NLC) chaired by the Ministry of Health and Family Welfare are available at:

https://nhsrcindia.org/fc-xv-health-grants/national-committee

## Details of opening balance, funds allocated, fund utilized and closing balance under the National Health Mission (NHM) for FY 2020-21

(Rs. in Cr.)

|   Sl. No. | State/UT                           | Opening Balance as on 01-04- 2020   | Central Share Released during the FY2020-21   | Expenditure for the FY 2020-21   | Closing Balance as on 31-03-2021   |
|-----------|------------------------------------|-------------------------------------|-----------------------------------------------|----------------------------------|------------------------------------|
|         1 | Andaman and Nicobar Islands        | 2.49                                | 36.91                                         | 42.68                            | 9.01                               |
|         2 | Andhra Pradesh                     | 292.98                              | 1,097.81                                      | 2,385.48                         | 235.24                             |
|         3 | Arunachal Pradesh                  | 104.77                              | 243.04                                        | 209.06                           | 240.54                             |
|         4 | Assam                              | 280.62                              | 1,807.48                                      | 1,846.86                         | 341.76                             |
|         5 | Bihar                              | 1,494.26                            | 1,814.63                                      | 2,415.34                         | 1,929.39                           |
|         6 | Chandigarh                         | 3.61                                | 22.21                                         | 19.52                            | 3.87                               |
|         7 | Chhattisgarh                       | 582.81                              | 979.41                                        | 1,521.30                         | 649.91                             |
|         8 | Dadra &Nagar Haveli and Daman &Diu | 6.43                                | 36.39                                         | 35.74                            | 7.58                               |
|         9 | Delhi                              | 306.58                              | 125.73                                        | 210.83                           | 329.28                             |
|        10 | Goa                                | 18.74                               | 34.81                                         | 67.43                            | 44.53                              |
|        11 | Gujarat                            | 522.67                              | 1,005.66                                      | 1,894.46                         | 460.49                             |
|        12 | Haryana                            | 256.74                              | 531.50                                        | 829.12                           | 430.67                             |
|        13 | Himachal Pradesh                   | 65.97                               | 441.94                                        | 425.58                           | 103.24                             |
|        14 | Jammu and Kashmir                  | 190.08                              | 667.46                                        | 657.53                           | 186.60                             |
|        15 | Jharkhand                          | 1,041.46                            | 602.80                                        | 999.71                           | 1,045.30                           |
|        16 | Karnataka                          | 542.21                              | 1,232.19                                      | 2,320.37                         | 614.03                             |
|        17 | Kerala                             | 265.45                              | 788.22                                        | 1,457.75                         | 409.29                             |
|        18 | Lakshadweep                        | 0.62                                | 7.11                                          | 6.99                             | 0.75                               |
|        19 | Madhya Pradesh                     | 727.26                              | 2,377.14                                      | 3,397.82                         | 719.48                             |
|        20 | Maharashtra                        | 536.08                              | 1,833.59                                      | 3,503.62                         | 527.73                             |
|        21 | Manipur                            | 83.18                               | 189.49                                        | 112.79                           | 108.30                             |
|        22 | Meghalaya                          | 167.25                              | 202.63                                        | 213.36                           | 123.38                             |
|        23 | Mizoram                            | 6.29                                | 143.73                                        | 131.36                           | 50.93                              |
|        24 | Nagaland                           | 55.56                               | 188.21                                        | 159.72                           | 102.05                             |
|        25 | Odisha                             | 1,090.72                            | 1,617.63                                      | 2,347.24                         | 1,435.46                           |
|        26 | Puducherry                         | 30.57                               | 25.55                                         | 47.32                            | 33.13                              |
|        27 | Punjab                             | 61.49                               | 568.14                                        | 908.98                           | 177.33                             |
|        28 | Rajasthan                          | 1,450.98                            | 2,000.58                                      | 2,943.21                         | 1,563.70                           |
|        29 | Sikkim                             | 5.59                                | 70.13                                         | 52.06                            | 5.65                               |
|        30 | Tamil Nadu                         | 803.17                              | 1,522.71                                      | 2,172.33                         | 903.28                             |
|        31 | Tripura                            | 76.45                               | 225.91                                        | 249.74                           | 77.20                              |
|        32 | Uttar Pradesh                      | 2,821.05                            | 3,772.95                                      | 7,080.45                         | 2,951.51                           |
|        33 | Uttarakhand                        | 86.23                               | 583.25                                        | 503.53                           | 135.59                             |
|        34 | West Bengal                        | 761.36                              | 1,895.01                                      | 2,598.62                         | 885.17                             |
|        35 | Telangana                          | 214.52                              | 671.88                                        | 1,354.93                         | 734.85                             |
|        36 | Ladakh                             | -                                   | 91.89                                         | 38.56                            | 62.66                              |

## Note:

1. The above releases relate to Central Govt. Grants & do not include State share contribution.
2. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year. Expenditure is as per FMRs submitted by States/UTs and is provisional.
3. After the reorganization of Jammu & Kashmir the funds has been first released to the UT of Ladakh in the FY 2020-21.
4. There is no relevance of allocation after the closure of the financial year.

## Details of opening balance, funds allocated, fund utilized and closing balance under the National Health Mission (NHM) for FY 2021-22

(Rs. in Cr.)

|   Sl. No. | State/UT                           | Opening Balance as on 01-04- 2021   | Central Share Released during the FY2021-22   | Expenditure for the FY 2021-22   | Closing Balance as on 31-03-2022   |
|-----------|------------------------------------|-------------------------------------|-----------------------------------------------|----------------------------------|------------------------------------|
|         1 | Andaman and Nicobar Islands        | 9.01                                | 43.68                                         | 31.20                            | 9.04                               |
|         2 | Andhra Pradesh                     | 235.24                              | 1,199.37                                      | 2,448.67                         | 386.81                             |
|         3 | Arunachal Pradesh                  | 240.54                              | 188.53                                        | 248.51                           | 167.96                             |
|         4 | Assam                              | 341.76                              | 1,955.93                                      | 2,194.36                         | 303.37                             |
|         5 | Bihar                              | 1,929.39                            | 1,748.76                                      | 1,905.35                         | 2,946.03                           |
|         6 | Chandigarh                         | 3.87                                | 17.47                                         | 26.86                            | 1.28                               |
|         7 | Chhattisgarh                       | 649.91                              | 969.61                                        | 1,833.45                         | 704.98                             |
|         8 | Dadra &Nagar Haveli and Daman &Diu | 7.58                                | 38.59                                         | 45.02                            | 7.88                               |
|         9 | Delhi                              | 329.28                              | 127.37                                        | 237.79                           | 398.72                             |
|        10 | Goa                                | 44.53                               | 26.01                                         | 60.56                            | 19.83                              |
|        11 | Gujarat                            | 460.49                              | 1,094.48                                      | 1,835.81                         | 241.91                             |
|        12 | Haryana                            | 430.67                              | 577.07                                        | 879.91                           | 435.63                             |
|        13 | Himachal Pradesh                   | 103.24                              | 555.09                                        | 525.09                           | 69.14                              |
|        14 | Jammu and Kashmir                  | 186.60                              | 459.10                                        | 779.61                           | 32.03                              |
|        15 | Jharkhand                          | 1,045.30                            | 640.18                                        | 1,176.55                         | 864.15                             |
|        16 | Karnataka                          | 614.03                              | 1,274.71                                      | 2,200.92                         | 712.64                             |
|        17 | Kerala                             | 409.29                              | 771.47                                        | 1,230.96                         | 131.33                             |
|        18 | Lakshadweep                        | 0.75                                | 8.41                                          | 7.26                             | 0.94                               |
|        19 | Madhya Pradesh                     | 719.48                              | 2,295.66                                      | 3,714.92                         | 1,508.91                           |
|        20 | Maharashtra                        | 527.73                              | 1,769.67                                      | 4,227.31                         | 436.41                             |
|        21 | Manipur                            | 108.30                              | 95.59                                         | 154.09                           | 92.66                              |
|        22 | Meghalaya                          | 123.38                              | 282.46                                        | 227.08                           | 107.25                             |
|        23 | Mizoram                            | 50.93                               | 93.82                                         | 153.16                           | 15.03                              |
|        24 | Nagaland                           | 102.05                              | 126.66                                        | 192.16                           | 36.59                              |
|        25 | Odisha                             | 1,435.46                            | 1,263.07                                      | 2,587.72                         | 914.84                             |
|        26 | Puducherry                         | 33.13                               | 21.33                                         | 46.36                            | 21.51                              |
|        27 | Punjab                             | 177.33                              | 349.21                                        | 918.96                           | 83.06                              |
|        28 | Rajasthan                          | 1,563.70                            | 1,924.95                                      | 3,230.01                         | 932.17                             |
|        29 | Sikkim                             | 5.65                                | 51.86                                         | 46.06                            | 19.82                              |
|        30 | Tamil Nadu                         | 903.28                              | 1,631.91                                      | 3,039.39                         | 1,018.71                           |
|        31 | Tripura                            | 77.20                               | 217.95                                        | 237.24                           | 77.20                              |
|        32 | Uttar Pradesh                      | 2,951.51                            | 3,235.46                                      | 6,210.20                         | 2,163.31                           |
|        33 | Uttarakhand                        | 135.59                              | 553.47                                        | 606.07                           | 152.92                             |
|        34 | West Bengal                        | 885.17                              | 1,654.26                                      | 2,229.46                         | 1,014.25                           |
|        35 | Telangana                          | 734.85                              | 725.67                                        | 1,556.65                         | 397.82                             |
|        36 | Ladakh                             | 62.66                               | 44.79                                         | 62.81                            | 36.00                              |

## Note:

1. The above releases relate to Central Govt. Grants & do not include State share contribution.
2. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year. Expenditure is as per FMRs submitted by States/UTs and is provisional.
3. There is no relevance of allocation after the closure of the financial year.

## Details of opening balance, funds allocated, fund utilized and closing balance under the National Health Mission (NHM) for FY 2022-23

(Rs. in Cr.)

|   Sl. No. | State/UT                           | Opening Balance as on 01-04- 2022   | Central Share Released during the FY2022-23   | Expenditure for the FY 2022-23   | Closing Balance as on 31-03-2023   |
|-----------|------------------------------------|-------------------------------------|-----------------------------------------------|----------------------------------|------------------------------------|
|         1 | Andaman and Nicobar Islands        | 9.04                                | 45.26                                         | 42.28                            | 7.23                               |
|         2 | Andhra Pradesh                     | 386.81                              | 1,489.45                                      | 1,914.34                         | 233.26                             |
|         3 | Arunachal Pradesh                  | 167.96                              | 233.82                                        | 424.78                           | 36.91                              |
|         4 | Assam                              | 303.37                              | 1,981.83                                      | 2,307.00                         | 141.64                             |
|         5 | Bihar                              | 2,946.03                            | 1,586.57                                      | 3,717.81                         | 2,250.83                           |
|         6 | Chandigarh                         | 1.28                                | 38.09                                         | 26.98                            | 4.48                               |
|         7 | Chhattisgarh                       | 704.98                              | 1,195.08                                      | 2,152.45                         | 712.88                             |
|         8 | Dadra &Nagar Haveli and Daman &Diu | 7.88                                | 58.28                                         | 41.61                            | 17.38                              |
|         9 | Delhi                              | 398.72                              | 35.15                                         | 298.11                           | 196.20                             |
|        10 | Goa                                | 19.83                               | 55.42                                         | 84.64                            | 16.32                              |
|        11 | Gujarat                            | 241.91                              | 1,120.06                                      | 2,292.35                         | 539.79                             |
|        12 | Haryana                            | 435.63                              | 681.21                                        | 1,185.43                         | 445.66                             |
|        13 | Himachal Pradesh                   | 69.14                               | 494.65                                        | 567.83                           | 88.62                              |
|        14 | Jammu and Kashmir                  | 32.03                               | 651.52                                        | 917.02                           | 34.30                              |
|        15 | Jharkhand                          | 864.15                              | 810.30                                        | 1,495.17                         | 714.20                             |
|        16 | Karnataka                          | 712.64                              | 1,246.67                                      | 2,376.94                         | 593.43                             |
|        17 | Kerala                             | 131.33                              | 1,036.76                                      | 1,592.96                         | 273.99                             |
|        18 | Lakshadweep                        | 0.94                                | 9.97                                          | 9.29                             | 4.22                               |
|        19 | Madhya Pradesh                     | 1,508.91                            | 2,582.10                                      | 4,489.15                         | 1,668.94                           |
|        20 | Maharashtra                        | 436.41                              | 2,187.13                                      | 4,501.75                         | 809.65                             |
|        21 | Manipur                            | 92.66                               | 61.40                                         | 214.69                           | 20.62                              |
|        22 | Meghalaya                          | 107.25                              | 261.56                                        | 319.08                           | 83.35                              |
|        23 | Mizoram                            | 15.03                               | 111.82                                        | 135.33                           | 34.58                              |
|        24 | Nagaland                           | 36.59                               | 91.38                                         | 161.93                           | 24.46                              |
|        25 | Odisha                             | 914.84                              | 1,284.69                                      | 3,402.50                         | 917.77                             |
|        26 | Puducherry                         | 21.51                               | 20.73                                         | 48.51                            | 4.58                               |
|        27 | Punjab                             | 83.06                               | 448.89                                        | 1,054.39                         | 18.18                              |
|        28 | Rajasthan                          | 932.17                              | 1,460.80                                      | 3,726.21                         | 588.09                             |
|        29 | Sikkim                             | 19.82                               | 73.30                                         | 88.69                            | 8.13                               |
|        30 | Tamil Nadu                         | 1,018.71                            | 1,652.24                                      | 3,191.84                         | 610.00                             |
|        31 | Tripura                            | 77.20                               | 231.90                                        | 287.20                           | 61.45                              |
|        32 | Uttar Pradesh                      | 2,163.31                            | 5,133.59                                      | 8,828.29                         | 3,155.95                           |
|        33 | Uttarakhand                        | 152.92                              | 505.01                                        | 647.13                           | 407.02                             |
|        34 | West Bengal                        | 1,014.25                            | 1,252.32                                      | 3,509.86                         | 408.45                             |
|        35 | Telangana                          | 397.82                              | 683.77                                        | 2,062.93                         | -                                  |
|        36 | Ladakh                             | 36.00                               | 94.94                                         | 109.67                           | 18.63                              |

## Note:

1. The above releases relate to Central Govt. Grants & do not include State share contribution.
2. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year. Expenditure is as per FMRs submitted by States/UTs and is provisional.
3. There is no relevance of allocation after the closure of the financial year.

## Details of opening balance, funds allocated and fund utilized under the National Health Mission (NHM) for FY2023-24

(Rs. in Cr.)

|   Sl. No. | State/UT                            | Opening Balance as on 01-04-2023   | Central Share Released during the FY2023-24   | Expenditure for the FY2023-24   |
|-----------|-------------------------------------|------------------------------------|-----------------------------------------------|---------------------------------|
|         1 | Andaman and Nicobar Islands         | 7.23                               | 25.22                                         | 21.89                           |
|         2 | Andhra Pradesh                      | 233.26                             | 783.75                                        | 1,770.44                        |
|         3 | Arunachal Pradesh                   | 36.91                              | 265.90                                        | 202.06                          |
|         4 | Assam                               | 141.64                             | 1,462.03                                      | 1,457.49                        |
|         5 | Bihar                               | 2,250.83                           | 1,448.13                                      | 1,774.42                        |
|         6 | Chandigarh                          | 4.48                               | 20.06                                         | 25.00                           |
|         7 | Chhattisgarh                        | 712.88                             | 564.18                                        | 783.48                          |
|         8 | Dadra& Nagar Haveli and Daman & Diu | 17.38                              | 18.16                                         | 24.86                           |
|         9 | Delhi                               | 196.20                             | 138.21                                        | 266.16                          |
|        10 | Goa                                 | 16.32                              | 35.52                                         | 60.67                           |
|        11 | Gujarat                             | 539.79                             | 889.48                                        | 1,261.59                        |
|        12 | Haryana                             | 445.66                             | 435.16                                        | 823.64                          |
|        13 | Himachal Pradesh                    | 88.62                              | 387.48                                        | 328.08                          |
|        14 | Jammu and Kashmir                   | 34.30                              | 535.37                                        | 473.50                          |
|        15 | Jharkhand                           | 714.20                             | 596.05                                        | 796.17                          |
|        16 | Karnataka                           | 593.43                             | 838.66                                        | 1,039.66                        |
|        17 | Kerala                              | 273.99                             | 168.73                                        | 682.65                          |
|        18 | Lakshadweep                         | 4.22                               | 3.75                                          | 4.01                            |
|        19 | Madhya Pradesh                      | 1,668.94                           | 1,797.84                                      | 3,136.84                        |
|        20 | Maharashtra                         | 809.65                             | 1,872.78                                      | 3,100.86                        |
|        21 | Manipur                             | 20.62                              | 129.56                                        | 41.18                           |
|        22 | Meghalaya                           | 83.35                              | 176.04                                        | 143.54                          |
|        23 | Mizoram                             | 34.58                              | 70.04                                         | 89.81                           |
|        24 | Nagaland                            | 24.46                              | 130.53                                        | 81.43                           |
|        25 | Odisha                              | 917.77                             | 1,178.97                                      | 1,292.29                        |
|        26 | Puducherry                          | 4.58                               | 17.23                                         | 29.87                           |
|        27 | Punjab                              | 18.18                              | 62.29                                         | 477.36                          |
|        28 | Rajasthan                           | 588.09                             | 1,672.40                                      | 2,457.87                        |
|        29 | Sikkim                              | 8.13                               | 54.56                                         | 38.42                           |
|        30 | Tamil Nadu                          | 610.00                             | 1,136.31                                      | 1,583.01                        |
|        31 | Tripura                             | 61.45                              | 217.79                                        | 150.65                          |
|        32 | Uttar Pradesh                       | 3,155.95                           | 3,730.51                                      | 4,960.62                        |
|        33 | Uttarakhand                         | 407.02                             | 475.21                                        | 389.96                          |
|        34 | West Bengal                         | 408.45                             | 831.55                                        | 1,608.64                        |
|        35 | Telangana                           | -                                  | 540.58                                        | 899.92                          |
|        36 | Ladakh                              | 18.63                              | 61.44                                         | 67.35                           |

## Note:

1. The above releases relate to Central Govt. Grants & do not include State share contribution.
2. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year. Expenditure is as per FMRs submitted by States/UTs and is provisional.
3. Release for the F.Y. 2023-24 is updated up-to 20.01.2024 and is provisional.
4. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year. Expenditure is as per FMRs submitted by States/UTs. The expenditure is updated up-to 31.12.2023 except Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Jharkhand, Puducherry, Uttar Pradesh, West Bengal (updated up-to 30.11.2023), Chandigarh, Karnataka, Manipur, Meghalaya, Odisha, Punjab, Tamil Nadu, Tripura (updated up-to 31.10.2023), Lakshadweep (updated up-to 30.09.2023).