A performance study on National Rural Health Mission (NRHM) in the State done for Karnataka Evaluation Authority (KEA) has concluded that there is no clear prioritising of fund flow to districts identified as vulnerable.
The study conducted by Mysore-based Grassroots Research and Advocacy Movement (GRAAM) for KEA, an autonomous body, was set up by the State government as part of its ‘Evaluation Policy Framework’ to improve the efficiency of public programmes.
The NRHM was introduced in 2005 as a flagship programme of the United Progressive Alliance (UPA) government to rejuvenate public healthcare in the country.
The performance evaluation report points out that many districts like Bangalore Urban, Hassan and Shimoga, with comparatively lesser rural population, have received more funds than other districts which may have needed more funds.
For instance, Bangalore Urban has received Rs 87.65 crore since 2005 under NRHM. But, Koppal, which has a significantly larger rural population, has received Rs 47.65 crore during the same period.
Again, Hassan has received Rs 55.84 crore of NRHM grants during the last seven years, which is significantly higher than what has been allotted to Gadag (Rs 31.1 crore), which has a large rural base.
Larger funds
At the same time, the report has given credit saying that districts which have been identified as vulnerable like Gulbarga, Raichur and Bijapur have received larger funds - Rs 87.7 crore, Rs 60.59 crore and Rs 57.85 crore, respectively.
Among several of its recommendations, the evaluator has suggested that in Bagalkot, Bidar, Bijapur, Gulbarga, Koppal and Raichur, the focus should be on improvement of infrastructure and field presence, especially of Accredited Social Health Activists (ASHAs).
In other districts, the focus should be on demand and need-based funding mechanism, the report has recommended.