CAG finds large scale irregularities in Assam
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Last Updated: Tuesday, December 15, 2009, 18:07
Guwahati: Financial irregularities, procurement of substandard medicines and unsatisfactory maternal heath care achievement by the National Rural Health Mission programme in Assam are some of the findings of the CAG.

"Serious financial irregularities were noticed with fund management being quite poor," Principal Accountant General (Audit) Assam, Mukesh P Singh today said while speaking on the Stand-alone Performance Audit Report of the Comptroller and Auditor General of India.

"Basic accounting records were not maintained at both the state and the district level, leaving scope for fraud and misappropriation.

"There were irregular and unauthorised release of maintenance grant of Rs 2.77 crore to 2,794 health care centres not housed in own/government buildings. Rupees 43.80 lakh was released during 2005-06 and 2006-07 to 180 non-existent centres," he pointed out.

"The state had not released its share of funds for implementation of the National Rural Health Mission programme. However, in some cases funds released to the health centres were in excess of the prescribed norms," he said briefing the media here on the CAG report, tabled in the assembly on December 11.

Though the state government increased its outlay on health during the review period in keeping with the programme guidelines, "It failed to utilise the available funds optimally to strengthen the healthcare infrastructure and delivery at the grassroot level," he said quoting the report.

According to the CAG report: "41-65 per cent of the funds remained unutilised with the government agency State Health Society during 2005-08. In the five test-checked districts, balance of Rs 1.48 crore of Reproductive and Child Health programme was not carried forward to the NRHM programme".

"Procurement of medicines and medical equipment was ad-hoc and the quality of drugs procured remained questionable. Considering that drug management is a critical input, delays, shortages or poor quality of drugs are likely to jeopardise the implementation of the programme," it said.

The planning process was another area of concern for the CAG, which, it felt, required the state government's attention on a priority basis.

"Community-owned, decentralised planning as envisaged by NHRM was not achieved as yet in the state," the report said.

Household survey was not completed at the village, block and district levels and time bound action plans were not drawn up to achieve the programme's objectives. Community based monitoring committees were also not formed, Singh said.

"Infrastructure, both physical and human, was an area the state fared badly in achieving targets set by NHRM. The number of health centres, especially in the tribal areas, was woefully inadequate resulting in non-achievement of the primary objective of providing accessible health facilities to the rural population", the report said.

In a number of the health centres sampled during audit, the basic facilities and diagnostic services were not available. This coupled with shortage of medical and support staff affected the quality and reliability of health services in rural areas, he said.

The report pointed out: There was considerable improvement in the registration of pregnant women. But they were not administered the prescribed dosage of medicines apparently due to their non-availability in sufficient numbers.

"The overall achievement in terms of maternal health was far from satisfactory and registration of pregnant women for systematic ante-natal check up and tracking was not in place. Scrutiny revealed that essential obstetrics care facilities were lacking in almost all the health centres," it said.

With wide variations among the districts in achievement of immunisation targets the overall achievement, especially secondary immunisation, was quite poor.

Hundred per cent coverage of pulse polio immunisation was not done for children below five years to achieve zero transmission of polio by March 2008. Besides, the incidence of malaria was high and many of the community and primary health centres did not have full diagnostic services for treatment of tuberculosis, the report said.

The state was also criticised for failing to spread awareness about the rural people’s rights and available health facilities owing to lack of planning and implementation strategy.

The performance review, however, brought out positives relating to maternal and childcare services like increase in institutional deliveries as envisaged in the programme. Diseases like polio were contained and there were no cases of 'kala azar' during 2005-07, besides a significant improvement in the cure rate of tuberculosis, the report said.


First Published: Tuesday, December 15, 2009, 18:07

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