The Congress-led United Progressive Alliance (UPA) is credited with effecting income redistribution. It has done so by allowing for more entitlements and at the same time allocated more funds for social sector spending. The big concern has been about the efficacy of this big spend in terms of the outcomes. A review of the Union government's spending on some of these marquee programmes (accounting for nearly 40% of the annual social sector spending) undertaken by the Accountability Initiative of the Centre for Policy Research every year showed that efficacy also depends on other factors. Beginning last year, Mint has been running these outcome reviews as part of the run-up to the Union budget. This year, the first of the four-part series focuses on the National Rural Health Mission (NRHM). Though in absolute sums the funds earmarked for NRHM have increased, the allocations continue to be sticky and still average less than 2% of GDP. This has been compounded by the fact that the programme has been hampered by the human resource deficit, which in turn has created an absorption capacity problem that varies across states. Consequently, the results of the review are mixed.
Shortfall of doctors and primary health centres
The primary health centre (PHC) is the first point of contact in a district with a qualified doctor and a nurse. While Gujarat is among the better performers, MP has the biggest shortfall of doctors and PHCs.
Shortage of specialists
The availability of specialists, such as surgeons, paediatricians, obstetricians and gynaecologists, at community health centres leaves a lot to be desired. Only 28% of the required number of such specialists is available across India
Nurses in short supply
Primary and community health centres do not have an adequate number of nurses and midwives. India
A case for cash incentives
The Janani Suraksha Yojana--a conditional cash transfer for pregnant women--shows that cash incentives manage to influence social behaviour. In 2005-06, 54% women delivered their babies in institutions. By 2009-10, five years after the scheme was introduced, nine out of 10 deliveries were in institutions
(livemint.com)
