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In the last three years (2017-18 to 2019-20), the Central government has released ₹79,403.73 crore to the States under National Health Mission (NHM) and Uttar Pradesh, Madhya Pradesh and Rajasthan are the top three States to get maximum grants followed by Maharashtra and Assam.
These top five States received 41 per cent of the total NHM grant during the period. However, Uttar Pradesh got the highest allocation of ₹12,603.21 crore, which is 16 per cent of the total allocation to all the States.
Madhya Pradesh, Rajasthan, Maharashtra, Assam, Bihar, Tamil Nadu, West Bengal and Karnataka have received 5-6 per cent of the total grant allocation. Uttarakhand, Arunachal Pradesh and Delhi are among the States which received just 1 per cent allocation. Most of the North-East States have got less than 1 per cent of NHM grants.
Key components
The main components of NHM include Health System Strengthening, Reproductive-Maternal- Neonatal-Child and Adolescent Health (RMNCH+A), and Communicable and Non-Communicable Diseases. The NHM envisages the achievement of universal access to equitable, affordable, and quality healthcare services that are accountable and responsive to people’s needs. NHM is implemented for universal benefit and services are offered to everyone visiting the public healthcare facilities with a special focus on the vulnerable section of society.
Tamil Nadu and West Bengal, which are not among the top five States in receiving Central grants, are among top five when it comes to expenditure (including expenditure against Central release, State release, and unspent balances at the beginning of the year).
Top spender
UP tops the expenditure chart but Maharashtra has spent more funds under NHM compared to Madhya Pradesh and Rajasthan, which have received more grants than Maharashtra. Karnataka, Bihar, Odisha, Gujarat, and Andhra Pradesh have utilised more funds than Assam, which has received more grants than these States.
Per the provisions of the General Financial Rule (GFR) 2017, all releases under NHM are made after the receipt of Provisional/Audited Utilisation Certificates from the States/UTs.
NHM in 2021
The NHM consists of two sub missions, the National Rural Health Mission (NRHM) (focused on rural areas) and the National Urban Health Mission (NUHM) (focussed on urban areas). PRS Legislative Research points out that the allocation for NHM in 2021-22 (₹36,576 crore) is 4 per cent higher than the revised estimates of 2020-21.
Under the NHM, the National Rural Health Mission has been allocated ₹30,100 crore, (0.2 per cent annual increase over 2019-20). The allocation for National Urban Health Mission is ₹1,000 crore in 2021-22 (8 per cent annual increase over 2019-20).
The PRS research highlights that overall India’s public health expenditure has increased from 0.9 per cent of GDP in 2015-16 to 1.1 per cent of GDP in 2020-21. The Economic Survey 2020-21 observed that India ranks 179th among 189 countries in prioritising healthcare in the government budget. The National Health Policy, 2017 aims to increase public health expenditure to 2.5 per cent of the GDP by 2025.
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