5th September 2024 (11 Topics)
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Gap between allocations for Health, outcomes in States
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Context
The Union Budget's allocations for the health sector, including major Centrally Sponsored Schemes (CSS) like the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) and Human Resources for Health and Medical Education (HRHME), are facing low utilisation rates. This underperformance affects the planned improvements in health infrastructure and medical education.
Low Utilisation of Funds
- PM-ABHIM Fund Absorption: In the PM-ABHIM initiative, the expenditure in 2022-23 was only 29% of the Budget Estimate, with a slight improvement to 50% in 2023-24, but likely lower in actuals.
- HRHME Fund Utilisation: Utilisation under HRHME was approximately 25% of Budget Estimates in both 2022-23 and 2023-24, prompting budget cuts.
- Challenges with Grants: Utilisation issues are partly due to low absorption of 15th Finance Commission health grants and complex execution structures.
Implementation Challenges
- Execution Structure: The AB-HWC component faces delays due to the complex structure of health grants and reorganisation needs for IDPHLs.
- Construction Delays: The construction-focused components like BPHUs and CCHBs are delayed by rigid procedures and overlapping funding sources.
- Faculty Shortages: Under HRHME, a significant shortage of teaching faculty (over 40%) in newly established medical institutions hinders effective utilisation of infrastructure.
Fiscal and Operational Issues
- Maintenance Costs: States must cover recurring maintenance costs for new infrastructure built under PM-ABHIM and HRHME, beyond the Union government’s support period ending in 2025-26.
- Fiscal Space: States need additional fiscal capacity to support these ongoing expenses and other health initiatives.
- Human Resource and Management: Effective utilisation of capital expenditure requires addressing human resource shortages and improving public financial management.
Practice Question
Q. What are the factors contributing to the low utilisation of funds in Centrally Sponsored Schemes (CSS) like PM-ABHIM and HRHME? Examine the implications of these challenges on the overall health infrastructure development in India.
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