Rs 2265.38 crore approvals provided for drugs under NHM for FY 2014-15 (up to December, 2014)

Public health being a state subject, under the National Health Mission (NHM), financial support is provided to the States/UTs for strengthening their healthcare delivery system including support for provision of free drugs to those who access public health facilities. The Government of India has provided for NHM-Free drug service initiative under NHM.

The support under NHM is provided based on requirements posed by States/UTs in their Programme Implementation Plans under NHM. The number of free drugs provided by the States varies from State to State.

The state-wise approvals provided for drugs under NHM for financial years 2012-13, 2013-14 and 2014-15 (up to December, 2014) is given below:- 

*Support for Drugs Under National Health MissionStates/UTs 2012-13 2013-14 2014-15#Andaman & Nicobar Islands 1.59 0.38 0.29Andhra Pradesh 35.06 59.26 109.65Arunachal Pradesh 3.41 5.72 6.06Assam 159.83 132.1 155.6Bihar 91.12 155.7 150.64Chandigarh 1.09 0 0Chhattisgarh 8.23 51.67 94.44Dadra & Nagar Haveli 0.67 0.37 0.98Daman & Diu 0.22 0.12 0.17Delhi 17.33 36.96 27.09Goa 2.05 2.55 3.2Gujarat 22.67 77.63 41.83Haryana 22.65 40.78 57.57Himachal Pradesh 4.89 11.22 28.82Jammu & Kashmir 10.76 18.01 28.32Jharkhand 35.48 39.51 41.58Karnataka 58.47 67.14 79.33Kerala 15.59 11.6 24.03Lakshadweep 0.03 0.29 0.06Madhya Pradesh 81.27 133.66 141.42Maharashtra 83.43 275.81 336.81Manipur 3.94 2.83 6.47Meghalaya 8.37 5.57 10.97Mizoram 4.82 4.31 5.19Nagaland 9.64 2.44 6.02Orissa 54.91 32.88 26.21Puducherry 2.52 2.49 3.2Punjab 45.14 74.77 67.29Rajasthan 50.67 160.54 202.12Sikkim 1.35 0.62 3.31Tamil Nadu 71.19 71.35 90.31Telangana NA NA 72.29Tripura 11.05 5.82 13.12Uttar Pradesh 196.45 242.21 292.24Uttarakhand 12.02 10.97 9.18West Bengal 84.93 136.75 129.6Grand Total 1212.83 1874.04 2265.38* Does not include kind grants. # upto December 2014. Source: State RoPs. (Rs. Crore)

As regards proper monitoring of free availability of quality drugs in public health care facilities, substantial support to States/UTs for provision of free drugs under NHM is subject to the State fulfilling the following conditions:

It notifies or has a clearly notified policy of providing free essential drugs to all patients coming to public sector health facilities at least uptodistrict hospital level,

It has/ creates a robust procurement, logistics & supply chain system that is IT backed,

It has differential facility-wise essential drug list depending on the nature of the facility,

It has a sound drug regulatory and quality assurance system,

It lays down standard treatment guidelines and provides for prescription audits to ensure rational use of drugs.

The drugs procurement and logistics systems of the States are also reviewed by the National Health Systems Resource centre.

With regard to steps taken/being taken by the Government for proper monitoring of the funds, besides provision of annual audit by Comptroller and Auditor General, some of the key monitoring mechanisms put in place by the Central Government for adherence to finance procedures and proper financial utilization are as follows:

Submission of quarterly Financial Monitoring Reports by the States;

Annual Statutory Audits;

Concurrent Audits;

Implementation of Public Management System (PFMS) in NHM. The PFMS has been developed by the office of the CGA of the Ministry of Finance for monitoring and management of funds on just in time basis. Capacity building and sensitization of staff have been done. Efforts are being made to ensure registration up to the village level.

Regular reviews on NHM including on financial matters with State/UT government officials.

Visits by the team of Financial Management Group of the Department to States for periodical review;

Annual visits to States by Common Review Mission, which inter-alia, looks at financial system and mechanisms.

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