With health funds unused, 24%-38% shortfall in medicines, medical staff

There is a 24%-38% shortfall in the availability of medical personnel at primary health centres, sub-centres, and community health centres in 28 states/union territories of India, according to the latest audit by the Comptroller and Auditor General (CAG) of India.

In the first part of this series on the CAG’s assessment of the National Health Mission (NHM), we looked at issues of financial management. In this concluding part, we detail the lack of physical infrastructure and human resources at public health facilities.

The survey found that 73% of sub-centres were more than 3 km from the remotest village, 28% were not accessible by public transport and 17% were unhygienic. In 24 states, instances of non-availability of essential drugs were observed. In eight of these states, essential medicines/ consumables such as vitamin-A, contraceptive pills, oral rehydration solution (ORS) packets and essential obstetric kits were not available at select health facilities.

NHM, launched in 2005, is India’s largest health programme aimed at providing universal access to healthcare. It passes on funds to state health societies to strengthen local health systems, institutions and capabilities. But, as we reported in the first part of the series, states are not utilising these funds optimally and there has been a 29% rise in the balance left with states in the five years leading to 2016. The results of this are visible in the infrastructure and human resource gaps across health facilities in India.