Highlights
· Massive underutilization of funds
· Ayushman Bharat scheme: Poor execution and lack of infrastructure
· Large-scale mismanagement
· Failure to reach intended beneficiaries
· Negligence in National Health Programs
· Maternity and Child Health schemes in shambles
· Maher Ghar Scheme: A failure in tribal areas
Nagpur: The Maharashtra Government has come under severe scrutiny for its failure in effectively implementing key health schemes under the National Health Mission (NHM) and Ayushman Bharat Programme.
A recent audit by the Comptroller and Auditor General (CAG) of India on the public health infrastructure and management of health services in Maharashtra has revealed severe shortcomings in the state’s public healthcare system, exposing systemic neglect, chronic resource shortages and financial inefficiencies.
Covering the years from 2016 to 2022, the report presents a grim picture of the health sector struggling to meet demands of its population, particularly in rural areas. Audit reports reveal large-scale mismanagement, unutilized funds, and a failure to reach intended beneficiaries, exposing the inefficiency of the State’s health administration.
Massive underutilization of funds
The NHM, which is crucial for strengthening public health infrastructure, has suffered from underutilization of allocated funds. From 2016-17 to 2021-22, Maharashtra failed to spend significant portions of its NHM budget, leading to a waste of crucial resources. Data shows that savings in the budget ranged from 19% in 2021-22 to as high as 51% in 2017-18. The National Urban Health Mission (NUHM) also faced a similar fate, with fund utilization as low as 18% in 2021-22.
Despite having access to ₹3,694.06 crore under NHM in 2021-22, the State failed to fully utilize the funds, leaving ₹688.79 crore unspent. This raises serious concerns about the State Government’s inefficiency in executing health programs meant to benefit the common people.
Ayushman Bharat scheme: Poor execution and lack of infrastructure
Under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the state was expected to provide health insurance coverage to over 83.73 lakh families. However, the implementation has been dismal. As of March 2022, only 74.37 lakh beneficiaries were registered, meaning a staggering 68% of the identified beneficiaries remained out of the scheme’s coverage.
Furthermore, the state failed to meet the hospital empanelment targets. While 1,000 hospitals were empaneled, 98 blocks in 29 districts lacked any empaneled hospitals, severely limiting access to healthcare in rural areas. The government’s failure to meet the empanelment requirements despite policy guidelines reflects a lack of commitment to public health.
Negligence in National Health Programs
Key national health programs such as the National Leprosy Eradication Programme (NLEP) and National Tuberculosis Elimination Programme (NTEP) have also suffered due to Maharashtra’s administrative failures.
* Leprosy cases remain high: Despite achieving the ‘elimination’ target in 2005, the prevalence rate remains above the acceptable limit in 15 districts, including Gadchiroli, Chandrapur, and Nashik. The state also recorded 1,092 child leprosy cases in 2021-22, indicating ongoing transmission.
* Tuberculosis treatment gaps: The state has a 71% shortfall in TB contact tracing, increasing the risk of disease spread. Moreover, essential TB preventive therapy for children was not administered to as many as 96% of eligible children in 2018, with only marginal improvements in subsequent years.
Maternity and Child Health schemes in shambles
The Janani Shishu Suraksha Karyakram (JSSK) and Janani Suraksha Yojana (JSY), aimed at reducing maternal and infant mortality, have been marred by poor execution. Pregnant women in municipal hospitals were denied free diet, a key entitlement under JSSK. In Jalgaon and Nanded, 700 women were denied diet benefits, with medical officers admitting to the lapse.
Under JSY, thousands of beneficiaries were deprived of financial assistance due to bureaucratic hurdles. In Amravati alone, 6,961 out of 20,487 eligible women did not receive incentives between 2016-17 and 2021-22. Such systemic failures defeat the very purpose of these welfare programs.
Maher Ghar Scheme: A failure in tribal areas
Designed to provide accommodation for pregnant women in tribal districts before delivery, the Maher Ghar Scheme witnessed a 44% shortfall in 2017-18 and 31% in 2020-21, proving inadequate in ensuring safe institutional deliveries. The Maharashtra government’s inability to expand and strengthen this scheme continues to put tribal women and newborns at risk.
The audit findings highlight a pattern of gross negligence, financial mismanagement, and inefficiency in Maharashtra’s healthcare system. Despite receiving substantial central funds, the state has failed to effectively implement crucial health schemes, depriving millions of poor and vulnerable citizens of essential medical services.
With Maharashtra struggling to meet its public health targets, urgent corrective measures are needed to address these glaring lapses. The government must ensure better fund utilization, increase healthcare access in rural and tribal areas, and improve accountability in scheme implementation to fulfill the healthcare needs of its citizens.