Posted August 2, 2010on:
Former Madhya Pradesh chief minister Digvijay Singh is fond of saying that one has to have thick skin to survive in politics. Fewer in the Manmohan Singh cabinet must be having the skin as thick as minister of health and family welfare Ghulam Nabi Azad. He has not only survived in politics without any mass base but is brazen enough to publicly honour corruption and, thereby, show his utter disregard for the suffering masses.
Early this year his ministry invited over 30 officers and employees of the Madhya Pradesh health department to honour them and the department for doing “commendable” work in providing health services in the rural areas of the State, particularly in the implementation of his ministry’s National Rural Health Mission (NRHM): in spite of the fact that the health department of the Madhya Pradesh government tops in scandals –– loot of the funds, administration to human beings the medicines meant for the cattle, misbehaviour with patients, refusal to attend to women having labour pains or whatever other wrongful conduct one can think of. The function to honour them was arranged by Azad at the Vigyan Bhavan in Delhi and vice-president Hamid Ansari was roped in to give the awards.
Now the Comptroller and Auditor General of India (CAG) has to say a lot about the “commendable” work of the health department officials who were invited by Azad to Delhi for honouring them. The CAG’s report for the financial year ending March 31, 2009, points out grave irregularities in the implementation of NRHM in Madhya Pradesh. The report was tabled in the State Assembly on July 28.
The CAG carried out test checks in 12 districts and found that 49 to 58 per cent pregnant women had not even been registered in health centres during their first trimester. The maternal and infant mortality rate continued to be high. Spectacles were not supplied to as many as 30,715 children out of 57,191 suffering from vision problems from 2005 to 2009 in these 12 districts.
The NRHM envisions bringing down the maternity mortality rate to 100 per one lakh live births and the infant mortality rate to 30 per one thousand live births by 2012. The programme chalked by the State for the period 2006-2012 had fixed the target of less than 220 maternal mortality rate (per one lakh live births) and 60 infant mortality rate per one thousand live births. The current maternal mortality rate in the State, according to the findings of CAG, is 379 and infant mortality rate 72. It records that “both these targets were far below the targets envisioned under the NRHM”. The official explanation offered to CAG was that the targets could not be achieved due to shortage of manpower.
Shivraj Singh Chauhan and his finance minister Raghavji are never tired of proclaiming that there will be no dearth of money for the schemes to help the people. However, the CAG notes that the State government did not contribute its share of Rs 83.44 crore during 2007-2008. Not only that, an amount of Rs 212 crore from the NRHM funds was spent by the Chauhan government on a State sector scheme. Besides, the government was keeping the unspent balance of Rs 195.86 crore in banks at various places.
None of the health centres, according to the report, has been upgraded to Indian Public Health standards. The CAG test checked 17 Community Health Centres declared as Comprehensive Emergency Obstetric and Neonatal Care but none of these had the required infrastructure; 25 test-checked Primary Health Centres were found to be non-functional or functioning only partially because of lack of sufficient staff and infrastructure and 101 Primary Health Centres were functioning without doctors.
The State had recruited only 42,777 accredited social health activists (ASHAs) as against the requirement of 44,379. These ASHAs were mostly functioning as motivators under the Janani Suraskha Yojana of the State’s health department, leaving other functions under the NRHM unattended, according to the report.
Another flaw detected by the CAG in the implementation of the NRHM project was that monitoring committees to review the mission activities had not been formed at the Primary Health Centre, Community Health Centre and district levels.
What the CAG report has confirmed now had been in public knowledge for some time. According to a survey conducted last year by the Asian Legal Resource Centre (ALRC), an affiliate of the United Nations Human Rights Council, the Madhya Pradesh government had not opened even a single Primary Health Centre in the past six years in spite of an increase in the population. In the government hospitals, there was only one bed for 2,425 patients. As many as 1,300 posts out of a total sanctioned strength of 5005 doctors in hospitals were lying vacant.
The findings of this survey had been highlighted in the media long before Ghulam Nabi Azad decided to spend lakhs of rupees of public money on the air travel and the room and board of over 30 officials and employees of the health department to honour them in Delhi for their “commendable” work in the implementation of NRHM.