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This Report contains 32 paragraphs, three performance reviews and one integrated audit of a Department. The draft audit paragraphs and performance reviews were sent to the concerned Secretaries to the State Government with a request to furnish replies within eight weeks. However, in respect of the three performance reviews/integrated audit and 30 paragraphs included in the Report, no replies were received from the State Government. The audit findings relating to the performance reviews were also discussed with the Secretaries to the State Government and the views of the Government were incorporated wherever appropriate.
A synopsis of the important findings contained in the Report is presented in this overview.
The National Rural Health Mission (NRHM) was launched in Himachal Pradesh in April 2005 to provide accessible, affordable and reliable healthcare to the rural population, especially the vulnerable sections of the society. The programme envisaged convergence of various existing stand alone health programmes, decentralisation of the planning process with special emphasis on bottom-up approach in decision making and creating better linkages and co-operation among various social sector departments.
A mid-term review of the implementation of the programme in the fourth year of the Mission period (2005-2012) highlights the areas of concern and issues which need to be addressed for successful achievement of the objectives set out for the Mission. The review underlines glaring gaps in planning, implementation and monitoring activities. Absence of a household survey and perspective plan and lack of inputs from the community at the grass root level in the annual plans rendered the planning process an exercise in futility. While the number of health centres exceeded the norm, these could not ensure reliable and accessible health care to the targeted beneficiaries due to inadequate infrastructure and insufficient manpower. Some of the key initiatives of NRHM like ASHA and village health and sanitation committees have not received the required attention. Public spending on health sector also remained constant during the last four years.