Poorer states lost out in health drive 10-30% Less Funds Given, Finds CAG Audit

New Delhi: Some of the poor states in the country that were the focus of the big-ticket National Rural Health Mission (NRHM) have actually ended up being discriminated against in the Central allocation as compared to funds released to some of the rich and efficient states that were already high on the basic health parameters. 

    This has been found in a review of NRHM, the UPA government's most ambitious welfare scheme after the National Rural Employment Guarantee Act. The NRHM aims to bring the underprivileged under the universal health programme, particularly designed to cater to the rural population. 
    A performance audit conducted by the Comptroller and Auditor General (CAG) has found that some of the poor states, in fact, got as much as 10% to 30% less. 
    Bihar and Assam, where the health infrastructure was believed to be in a shambles, got the least. While Bihar was allocated nearly Rs 540 crore less in the three years between 2005 and 2008 for which audit was conducted, Assam got Rs 332 crore less than what it should have been allocated, according to the CAG findings. 
    The loss to poor states was at the cost of their rich and efficient counterparts who spent most of their allocated money within the stipulated timeframe and managed to get more funding from the share of the poor states. 
    While implementing NRHM, grants were to be allocated to states according to norms developed on the basis of a composite index incorporating population, disease burden, health indicators, state of public health infrastructure, etc. On these parameters, states like Bihar, Assam, Jharkhand, UP, Manipur, Meghalaya and Tripura should have got more funds than other states. 
    However, the Centre continued to allocate grants among various states mainly on the population-based state factor. The existing formula was not applied equitably across the board during 2005-06 to 2007-08, the CAG observed. In fact, the Centre failed to even formulate a composite index for allocation of grants among the states which was mandatory under the mission. 
    The government's official auditor said this defeated the goal of the mission as the respective state weightages in accordance with which funds were allocated were based on total population and not on rural population. 
    The Union health ministry, however, justified the fund allocation saying lesser grants to some high focus states was due to presence of substantial unspent balances with them. On the other hand, after assessing utilisation of funds in states like Andhra Pradesh, Gujarat, Kerala and Tamil Nadu larger grants were released to them, the ministry said.