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ANNEXURE
GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
LOK SABHA
UNSTARRED QUESTION NO: 4443
ANSWERED ON:  08.08.2014
REPRODUCTIVE AND CHILD HEALTH PROGRAMMES
M. B. RAJESH
Will the Minister of



HEALTH AND FAMILY WELFARE be pleased to state:-




(a) whether the Government has been implementing the Reproductive and Child Health (RCH) programme under the umbrella of National Rural Health Mission for providing health facilities to women and children in the country;

(b) if so, the details thereof and the major components of the programme;

(c) the extent to which the interventions through the RCH programme have been helpful in improving the child health and addressing the mortality and morbidity of children in the country along with reduction in the infant and maternal mortality rate, State/UT-wise including Kerala;

(d) the funds allocated, released and utilised during each of the last three years and the current year under the said programme, State/UT-wise including Kerala; and

(e) the steps taken by the Government to monitor the expenditure incurred thereunder?


ANSWER


THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. HARSH VARDHAN)

(a): Yes.

(b): A brief note on the RCH Programme is attached as Annexure I.

(c): A statement of trend on reduction in IMR and MMR during 2006-2012 is attached as Annexure-II

(d): A statement showing allocation, release and expenditure under Reproductive and Child Health Programme for F.Ys 2011-12 to 2014 -15 in respect of all States/UTs is Annexed as Annexure-III.
(e): The following monitoring mechanisms have been put in place by Ministry of Health & Family Welfare for adherence to financial procedures and proper financial utilization:
i. Monitoring the expenditure through quarterly Financial Management Report from States/ UTs.
ii. Implementation of the CAG Audit from 2011-12 onwards, Implemented statutory audit and concurrent audit to capture the accurate expenditure from State/UTs.

iii. Issuance of Model accounting hand books for sub district level finance/accounts personnel for community Health Centers, Villages Health sanitation and nutrition committees sub Centre, Rogi Kalyan Samities (RKS) and Block Accountants.
iv. Dissemination of hand book on operational guidelines on financial Management.

v. Implementation of Central Plan Scheme Monitoring Systems (CPSMS/PFMS) in NHM. The COPSMS developed by the office of the CGA of Ministry of Finance for monitoring and management of funds on just in Times basis.
vi. Implementation of NHM in the States is reviewed though Joint Review Mission (JRMs), Common Review Missions (CRMs) other periodical review by the ministry.
vii. Sr. Officers of the rank of Additional Secretary and Joint Secretaries have been visiting the States / UTs to settle pending UCs in the State/ UTs

Annexure-I

Brief Notes on RCH Programme
I. Background

Reproductive and Child Health (RCH) programme is a comprehensive sector wide flagship programme, under the bigger umbrella of the Government of India’s (GoI) National Rural Health Mission (NRHM) ( Now part of National Health Mission), to deliver the RCH targets for reduction of maternal and infant mortality and total fertility rates. RCH program aims to reduce social and geographical disparities in access to, and utilisation of quality reproductive and child health services. Launched in April 2005 in partnership with the state governments, it is consistent with GoI’s National Population Policy-2000, the National Health Policy-2001 and the Millennium Development Goals.

The Millennium Development Goals (MDGs) are eight goals to be achieved by 2015 that respond to the world`s main development challenges, the focus being the human dimension. Out of the eight goals MDG 4 and 5 relates to improving the health of maternal and child.

RCH goals and achievements
S.no Indicator MDG NRHM Goals Achievement Source 1 Infant Mortality 28 30 per 1,000 42 per 1,000 SRS 2012 Rate live births live births 2 Maternal Reduce 100 per 178 per 1,00,000 SRS 2010-12 Mortality Ratio this by ¾ 1,00,000 live births by 2015 live births 3 Total Fertility - 2.1 2.4 SRS 2012 Rate
To achieve the MDG and NRHM goals the RCH programme is being implemented with flexible programming approach by allowing the States to develop need based annual plans known as State Programme Implementation Plan.
The major components of the RCH programme are Maternal Health, Child Health, Immunization, Family Planning, Adolescent Health (AH) and PC-PNDT. The details on each of the components of RCH Programme are already available on public domain on the official website at the links provided below:
Maternal Health http://nrhm.gov.in/nrhm-components/rmnch-a/maternal-health/background.html
Child Health and Immunization http://nrhm.gov.in/nrhm-components/rmnch-a/child-health-immunization.html
Family Planning http://nrhm.gov.in/nrhm-components/rmnch-a/family-planning/background.html
Adolescent Health http://nrhm.gov.in/nrhm-components/rmnch-a/adolescent-health/adolescent-health/background.html
PCPNDT http://mohfw.nic.in/index1.php?lang=1&level=3&sublinkid=4121&lid=2730
II. Funds allocation under the programme
Fund allocations to States for Reproductive and Child Health programme has been increased from 1699.16 crores in 2005-06 to 5700.00 crores in 2014-15.

Allocation
Year (Rs. in Crores) 2005-06 1699.16 2006-07 1998.22 2007-08 1966.50 2008-09 3126.04 2009-10 3545.00 2010-11 3850.00 2011-12 4212.75 2012-13 4935.51 2013-14 5347.01 2014-15 5700.00
III. Programme review and monitoring
Review Missions To assess the progress made by the States in RCH programme, annual review in the form of Common Review Mission (CRM) is being conducted. The review is being led by GoI officials with representation from other Ministries, public health institutions, development partners and civil society. Based on the field observations, CRM report is prepared with the recommendations and shared with the States and Programme Divisions of the Ministry. So, far seven CRMs have been held. The seventh CRM was held during 8-15 November 2013.
Monitoring and Evaluation
In addition to the annual review missions, several other mechanisms are put in place to assess the programme implementation of the States. The monitoring is being done both internally by the officials of MoHFW as well in support from the externally agencies.

As a part of internal monitoring a team of officials and consultants of the ministry regularly visits the states for a week. During the visit the team observes various technical components of the RCH programme in terms of services delivery at the health facilities. The monitoring also concentrates in the other parts of the programmes i.e. training, human resources, programme management etc. Based on the field observation recommendations in the form of report is being shared with the States.

Evaluation Surveys: M & E division organizes periodic surveys namely National Family Health Survey (NFHS) District Level Household Surveys (DLHS), Facility Surveys.

Regional Evaluation Survey (RET): RET’s monitor and evaluate the programme implementation.

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