The Health Policy Project has ended, but work continues under a new USAID five-year project, Health Policy Plus (HP+).
Author(s): Alexander Paxton, Arin Dutta, Ashutosh Kandwal, Ashish Mishra
Primary Language: English
India's National Rural Health Mission (NRHM) is one of the world's largest government-funded primary healthcare programs. Improving the effectiveness of financing for this program is crucial for both the central and state governments in India. In partnership with the National Institute of Health and Family Welfare and the National Health System Resource Centre, the USAID-funded Health Policy Project examined the allocation and spending of funds for NRHM in Uttarakhand, one of the program's "high focus states." This report summarizes the results of the first phase of the analysis, which examined fund flows from the state to the 13 districts using financial records from fiscal years 2008–09 to 2011–12. The analysis explored three questions: 1) whether funds are allocated to districts according to their health needs, 2) whether districts are able to spend the funds allocated to them, and 3) how districts spend funds relative to health needs. Results indicate that NRHM funding in Uttarakhand could be made more efficient by aligning allocations and spending with health needs, and improving districts’ ability to spend all the funds available to them.