Eight states did not spend more than 40% of their National Rural Health Mission budgets in 2015-16, the Comptroller and Auditor General of India report on National Rural Health Mission found out. The report was presented to the Lok Sabha and Rajya Sabha on Friday.

A total of Rs 4,750 crore was left unspent in 2015-16, amounting to about 15% of the total expenditure for NRHM. But some states have much larger windfall of unspent funds for NRHM. The programme was launched in 2005 to provide quality health care, particularly to mothers and children in the rural areas.

The auditors commented that the financial management at both Central and State level “was not satisfactory.”

Of the states that had unspent health budget funds, Meghalaya fared the worst with an unspent budget shortfall of 76%. Andaman and Nicobar Island had unspent budget shortfall of 69%; Telangana and Uttar Pradesh had a shortfall of 52%; Karnataka had a shortfall of 50%.

The unspent amount included the funds required to carry out essential and recurring healthcare activities. Of the 27 states surveyed by the Comptroller and Auditor General of India, the delay in transferring the funds from state government to the State Health Societies which implements the NRHM ranged from 50 to 271 days. In six states including Andhra Pradesh and Rajasthan, Rs 36.31 crore was diverted to other schemes in the health department.

The lack of facilities in rural areas such as sub-centres at village level, primary health centres and block level, and community health centres is about 30%. The report found as much as a 50% shortfall in the availability of these services in some states such as Bihar, Sikkim, Jharkhand, Uttarakhand, and West Bengal.

The auditors also conducted surveys on the availability of doctors at various health institutions across the country. In 13 states, including Andhra Pradesh, Uttar Pradesh and Rajasthan, 67 primary health centres were functioning without any doctor.

In 17 states surveyed, equipment costing Rs 30.39 crore were lying idle or under-utilised due to non-availability of doctors, and trained manpower to operate equipment or lack of adequate space for their installation.