1. Financial Management under NRHM
P. K. Aggarwal
Director (NRHM-Finance)

2. Funds Flow Fund Flow to States under 2 routes:
Treasury Route: primarily salary component.
salaries of the posts of Auxiliary Nurse Midwife (ANMs) & LHVs
training of ANMs.
support to Family Welfare Bureaux at state and district levels.
Society Route:
for programme implementation
salaries for the contractual employees hired for strengthening of programme implementation under the Mission

3. Fund Release through Society Route
A tentative budgetary envelope is communicated to all States/UTs in the beginning of the year (around March/April)
The States/UTs are required to submit a NRHM Programme Implementation Plan (PIP) for a Financial Year in advance with complete projections of funds required to implement the PIP.
The PIPs are appraised and approved by National Programme Coordination Committee (NPCC) of the MoHFW.

4. Fund Release… As per GFR provisions:
the first tranche (to the extent of 75% of PIP) can be released on submission of Utilization Certificates on a provisional basis for the funds released during the previous year to a State/UT.
Unspent balance are taken in to account
The second tranche (i.e. the balance 25% of the approved budget under the PIP) is released after the receipt of audited statements and audited Utilization Certificates for the previous FY

5. Present Arrangement for Fund Release at MoHFW
Fund Release for RCH Flexble pool and Mission Flexible pool to be done by NRHM Finance Division (FMG).
So all the UCs etc pertaining to RCH and Mission Flexible pool are to be sent to Director (NRHM-Finance).
Fund release for Immunization and other NDCPs are to be done by concerned programme divisions themselves.
UCs for these programmes are to be directly sent to concerned programme divisions.

6. Mechanism for Fund Transfer
Funds under NRHM (leaving 7 National Disease Control Programmes) to 31 States/UTs are being transferred electronically through Real Time Gross Settlement (RTGS) within hours.
Rest of the 4 States/UTs are likely to open their bank accounts in RTGS enabled branches very soon, after which the funds transfers to all States/UTs will be electronic.
Out of these 4 States, Assam and Sikkim have already communicated their codes, therefore, fund transfer to these 2 States would be electronic in future

7. Monitoring Financial Monitoring Reports – Quarterly
Statement of Fund Position – Quarterly,
Bank Statement position – Monthly,
Audit Report – Annually by September of the following year.
A consolidated audit report for the Society (including all the programmes) from onwards.

8. Challenges
There is a need to track the fund flow from the District downward as large portions of funds are devolved to blocks and below. Under NRHM funds are being devolved for:
Janani Suraksha Yojana (JSY) revolving funds being maintained and regularly recouped by CHC/PHC, ANM, ASHA, etc.
Untied and annual maintenance grants to CHCs/PHCs/Sub-Centres
untied grants to Village Health and Sanitation Committees (VHSCs) in each of the village in India
numerous payments to ASHAs for their services provided for a whole gamut of activities; training needs of ASHA;
consultation with Panchayati Raj institutions on grassroots level health issues; preparation of village Health Action Plan

9. Challenges…
Timeliness of financial reporting (such as FMRs, Statement of Fund Position, Audit Reports etc)
Cut the delays in fund transfer once the PIP is approved.
Adequate delegation of administrative and financial powers.
To eliminate the mismatches between the narrative portion of SPIP and budget sheet of State PIP.
Integration of District Health Action Plan in to SPIP

10. Quantum of Funds under various Schemes under NRHM
Rs Crores under NRHM for
Schemes Rs in Crores
Mission Flexible Pool
Infrastructure Maintenance
RCH Flexible Pool
Pulse Polio
Routine Immunization
Procurement of Supplies
Social Mkt
IEC/BCC

11. Under NDCPs the budgets are:
Schemes Rs in Crores
NVBDCP
RNTCP
NLEP
IDD

12. Financial Analysis of RCH Flexipool

13. Analysis…

16. State wise Analysis High Focussed States (Other than NE):
1. Most of the High Focussed states have picked up during the last quarter. MP has utilized 100% of its PIP.
2. Chattisgarh, Himachal Chattisgarh, Rajasthan have also utilized more than 70% of its PIP. Although UP has been able to utilized only 43% of its PIP but situation has significantly improved over the last year and last quarters of
3. Bihar is the only State, which is lagging far behind (utilized only 20% of its PIP) and needs attention.

19. NE States
Arunachal Pradesh, Assam Mizoram, Sikkim and Tripura are doing well.
Mizoram PIP seems to be on lower side. They could manage this utilization of Rs 8.45 Crores against the approved PIP of Rs 4.83 Crores as they had enough fund available from last year

22. Non-High Focused States
A glance shows that infact it is NON-EAG States, which are pulling down the overall RCH Flexible Pool expenditure.
Andhra Pradesh is the only State to have exceeded its PIP amount (due to unspent balance available from last year). Gujarat (utilized 57% of PIP) and Tamilnadu (utilized 53% of PIP) are the only other 2 States which are doing moderately well.
Rest of the Non-EAG States such as Kerala, Maharashtra, Punjab and West Bengal are in fact performing as bad as Bihar on fund utilization. All these 4 States have been able to utilize only 14% to 22% of their PIP.

25. Thank You