Funds not being utilised, staff shortage: Several lapses in the implementation of the Delhi State Health Mission (DSHM) were found in the CAG report tabled in the Assembly on Friday.
It said not enough efforts were made by the previous Delhi government to achieve the goals of programmes of the National Health Mission (NHM) as funds approved were not fully utilised. Delhi was one of the states selected to implement the National Health Mission Reproductive, Maternal, New-born, Child and Adolescent Health (RMNCH+A) programme, the most important one under the NHM.
As per the report, DSHM could not utilise funds released under the NHM as Rs 510.71 crore was lying unspent in bank accounts of Delhi State Health Society and its 11 Integrated District Health Societies (March 2022).
“Underutilisation of funds ranged from 58.90% in 2016-17 to 93.03% in 2019-20, indicating the Delhi government was not implementing the programme adequately. Audit noted significant shortfalls in implementation of RMNCH+A as only 48.33% registered pregnant women were provided… ante-natal care… and only 36.18% and 18.91% were tested for HIV and sexually transmitted infection/ reproductive tract infection respectively during April 2016 to September 2022,” the report mentioned.
The report said there were many instances of delay in releasing funds from the state treasury to DSHM, responsible for executing programmes under NHM.
It noted that neither was a budget demanded by DSHM nor were funds released by the Central government, except for Rs 62 lakh released by the Centre under the National Viral Hepatitis Control Programme in 2019-20, which remained unspent.
There was also a 36% shortage of staff for implementing NHM schemes in the state. This happened despite an agreement between the Centre and Delhi government, which decided to hire outsourced staff under NHM. While the Centre approved 2,581 posts of doctors, nurses, technicians and other para-medical staff, only 1,643 posts were filled and 938 posts (3%) remained vacant as of March 2021.
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There were significant vacancies in important posts: Medical Officers (29%), Nurses (27%), Pharmacists (27%), Lab Assistants (43%) and Counsellors (86%). There were no psychiatrists appointed under the DSHM and the five positions remained vacant.
In February 2018, the DSHM approved procurement of two Advanced Life Support (ALS) ambulances for infant transportation; funds to purchase them, amounting to Rs 56 lakh, were approved in August 2018. The Director of Family Welfare was required to issue a detailed proposal for their operation through the Centralised Accident and Trauma Services.
The audit, however, noted these were not procured by CATS as of June 2022. In its reply, CATS stated (January 2022) that an approval letter was received from DGHS, but funds were not released.