There is still a long way to go before the target of public health expenditure is achieved and the central allocation for health for 2019-20 was far short of target, stated the Comptroller and Auditor General’s report tabled in the Parliament on July 8. The report also notes that in States, health spending as a percentage of total States expenditure, ranged from 3.29 to 5.32 per cent which shows that this need considerable augmentation.

CAG audited preparedness activities of selected 17 Central Ministries including, NITI Aayog, Ministry of Statistics and Programme Implementation (MoSPI), Ministry of Health and Family Welfare (MoHFW) and seven States - Assam, Chhattisgarh, Haryana, Kerala, Maharashtra, Uttar Pradesh and West Bengal being undertaken under the Sustainable Development Goals (SDGs) and specifically focused on ‘Good Health and Well Being,’ targets.

The UN General Assembly in September 2015, adopted resolution titled ´Transforming our World: the 2030 Agenda for Sustainable Development’ consisting of 17 Sustainable Development Goals (SDGs) and 169 associated targets. “Efforts to raise public awareness about SDGs and initiatives undertaken in the selected States were not comprehensive, focussed or sustained,” said the report.

Vision document

It further says that a road map is yet to be aligned with defined milestones for SDG targets to be achieved in the year 2020, 2025 and 2030 and that the vision document is still under preparation. “States are yet to prepare policy documents. Mapping of goals and targets undertaken by NITI Aayog and selected States is still ongoing. States may need to strengthen institutional arrangements by identifying support departments and defining roles and responsibilities,” it says.

The CAG report points out that the strategy document did not project the financing and budgeting requirements. “While it is recognised that projecting financial resources for achieving the Targets by 2030 is a challenging task, Ministry of Finance and State Governments are yet to integrate SDG related financial resources in national budgeting for implementing SDGs,” it says.

Mapping in respect of health goals was not comprehensive in selected States. Though States had indicated actions to formulate plans and policies in line with the goal, delays and absence of a holistic approach were noted. Also Data for certain health indicators were not regularly or uniformly available.

Public awareness

The CAG report recommends that a comprehensive charter and action plan with well-defined milestones for implementing SDGs, should be formulated after due consultations and finalisation of the vision document should be expedited. “Initiatives for enhancing public awareness and sensitisation about SDGs must be stepped up so that the process of implementation becomes participatory and inclusive. NITI Aayog in association with the Ministry of Finance must make an assessment of requirement and availability of financial resources for implementing SDGs for different time frames. States should also take up similar exercise,” it says.

In addition, CAG has recommended that urgent steps may be taken to integrate SDGs into the accounting and budgeting framework both at the Centre and the States and use of ‘Direct Benefit Transfers’ should be expanded and strengthened to avoid leakages and to improve efficiency in usage of financial resources.

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