Performance Audit of National Rural Health Mission (NRHM) in Bihar (2010-2015)

Abstract

Following are the main audit findings of this performance review of National Rural Health Mission in Bihar covering the period 2010-2015: 1. The financial statements of State Health Society, Bihar did not represent the true status of NRHM in the State as different figures were indicated in different financial statements as opening balances, funds received and expenditure for the same components. 2. Action plans were not decentralised with a bottom-up approach resulting in scant community participation in the Mission. 3. Despite completion of Mission period of 2005-12, nearly half of the pregnant women in the State failed to register in the first trimester of pregnancy. This resulted in inadequate antenatal care which along with deliveries at home in nearly half of the cases due to insufficient healthcare facilities caused the Mission to miss the targeted Maternal and Infant mortality rates. 4. Despite shortage of physical infrastructure and availability of funds, construction of buildings for health care units and trauma centres were not completed. 5. Procurement system of drugs was not efficient as liquidated damages and undue advances were not recovered from agencies. Quality of biological drugs were not ensured in the State; 6. AYUSH set up was not provided in each RH/PHC and regular supply of AYUSH drugs were not ensured. 7. The Kala-azar Elimination Programme was marred with shortage of manpower and delayed spray of DDT etc. and missed the target date; 8. National Programme for Control of Blindness Suffered due to inadequate infrastructure and shortage of manpower. National Leprosy Eradication Programme missed the goal of leprosy elimination due to shortage of specialised medical staff. 9. Fifty seven per cent posts of Medical/Specialist Medical Officers was lying vacant while there was shortage of 29 to 72 per cent of para-medical staff in the State. 10. Monitoring and evaluation was deficient due to non- constitution of Health Monitoring Committees at various levels.