Utilization of intergovernmental funds to implement maternal and child health Plans of a multi-strategy community intervention in Haryana, North India

A retrospective assessment

Madhu Gupta, F. Angeli, Hans Bosma, Shankar Prinja, Manmeet Kaur, C.P. van Schayck

Research output: Contribution to journalArticleScientificpeer-review

6 Downloads (Pure)

Abstract

Introduction
A multi-strategy community intervention known as the National Rural Health Mission (NRHM) was implemented in India from 2005 to 2012 in an attempt to
reduce maternal and child mortality.
Objective
This study examined the extent to which the NRHM’s maternal and child health (MCH) sector plans were implemented. We observed trends in how intergovernmental (use of central government funds by state governments) budgets were allocated and used to implement MCH plans in Haryana, India.
Methods
We conducted a retrospective assessment of programme implementation plans, MCH budget allocation and expenditure and financial monitoring reports during the NRHM implementation period. The yearly budget utilization rate was calculated for each MCH strategy implemented. On the basis of this budget utilization rate, we classed the extent of MCH strategy implementation as
fully, partially or not implemented. The status of MCH indicators before, during and after the NRHM period was obtained from national demographic surveys. The budget utilization rate was correlated with MCH outcomes.
Results
The overall budget allocated for MCH plans increased from $US6.6 million during the 2005–2006 period to $US66.7 million in the 2012–2013 period. The
rate of budget utilization increased from 20.6% in 2007–2008 to 89% in 2012–2013. Expenditure exceeded the initially allocated budget for patient referral services (111.5%), human resources (110.1%), drugs and logistics
(170%), accredited social health activists (133.3%) and immunization (106.4%). Additional budget was obtained from the state health budget. Plans for referral services, human resources, drug provision, accredited social health activists and immunization were fully implemented, few schemes (\1%) were not implemented, and all other schemes were only partially implemented. MCH indicators improved significantly (p\0.05). The rate of institutional childbirth was highly and positively correlated with rates of budget utilization for implementing accredited social health activists (r = 0.96) and financial incentives for
hospital delivery schemes (r = 0.5).
Conclusions
The trend for increasing use of the allocated budget for MCH strategies, improvement in MCH indicators and their positive correlation indicate better and more effective implementation of NRHM MCH strategies than in the past in Haryana, India. However, overall, the NRHM was only partially implemented.
Original languageEnglish
Pages (from-to)265-278
JournalPharmacoeconomics
Volume1
Issue number4
DOIs
Publication statusPublished - 2017

Fingerprint

Maternal Health
Child Health
Child Mortality
Maternal Mortality
Pharmaceutical Preparations

Cite this

Gupta, Madhu ; Angeli, F. ; Bosma, Hans ; Prinja, Shankar ; Kaur, Manmeet ; van Schayck, C.P. . / Utilization of intergovernmental funds to implement maternal and child health Plans of a multi-strategy community intervention in Haryana, North India : A retrospective assessment. In: Pharmacoeconomics. 2017 ; Vol. 1, No. 4. pp. 265-278.
@article{fefd98080ad448379aacb4f92e84a8a3,
title = "Utilization of intergovernmental funds to implement maternal and child health Plans of a multi-strategy community intervention in Haryana, North India: A retrospective assessment",
abstract = "Introduction A multi-strategy community intervention known as the National Rural Health Mission (NRHM) was implemented in India from 2005 to 2012 in an attempt toreduce maternal and child mortality.Objective This study examined the extent to which the NRHM’s maternal and child health (MCH) sector plans were implemented. We observed trends in how intergovernmental (use of central government funds by state governments) budgets were allocated and used to implement MCH plans in Haryana, India.Methods We conducted a retrospective assessment of programme implementation plans, MCH budget allocation and expenditure and financial monitoring reports during the NRHM implementation period. The yearly budget utilization rate was calculated for each MCH strategy implemented. On the basis of this budget utilization rate, we classed the extent of MCH strategy implementation asfully, partially or not implemented. The status of MCH indicators before, during and after the NRHM period was obtained from national demographic surveys. The budget utilization rate was correlated with MCH outcomes.Results The overall budget allocated for MCH plans increased from $US6.6 million during the 2005–2006 period to $US66.7 million in the 2012–2013 period. Therate of budget utilization increased from 20.6{\%} in 2007–2008 to 89{\%} in 2012–2013. Expenditure exceeded the initially allocated budget for patient referral services (111.5{\%}), human resources (110.1{\%}), drugs and logistics(170{\%}), accredited social health activists (133.3{\%}) and immunization (106.4{\%}). Additional budget was obtained from the state health budget. Plans for referral services, human resources, drug provision, accredited social health activists and immunization were fully implemented, few schemes (\1{\%}) were not implemented, and all other schemes were only partially implemented. MCH indicators improved significantly (p\0.05). The rate of institutional childbirth was highly and positively correlated with rates of budget utilization for implementing accredited social health activists (r = 0.96) and financial incentives forhospital delivery schemes (r = 0.5).Conclusions The trend for increasing use of the allocated budget for MCH strategies, improvement in MCH indicators and their positive correlation indicate better and more effective implementation of NRHM MCH strategies than in the past in Haryana, India. However, overall, the NRHM was only partially implemented.",
author = "Madhu Gupta and F. Angeli and Hans Bosma and Shankar Prinja and Manmeet Kaur and {van Schayck}, C.P.",
year = "2017",
doi = "10.1007/s41669-017-0026-3",
language = "English",
volume = "1",
pages = "265--278",
journal = "Pharmacoeconomics",
issn = "1170-7690",
publisher = "Adis International Ltd",
number = "4",

}

Utilization of intergovernmental funds to implement maternal and child health Plans of a multi-strategy community intervention in Haryana, North India : A retrospective assessment. / Gupta, Madhu; Angeli, F.; Bosma, Hans; Prinja, Shankar ; Kaur, Manmeet ; van Schayck, C.P. .

In: Pharmacoeconomics, Vol. 1, No. 4, 2017, p. 265-278.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Utilization of intergovernmental funds to implement maternal and child health Plans of a multi-strategy community intervention in Haryana, North India

T2 - A retrospective assessment

AU - Gupta, Madhu

AU - Angeli, F.

AU - Bosma, Hans

AU - Prinja, Shankar

AU - Kaur, Manmeet

AU - van Schayck, C.P.

PY - 2017

Y1 - 2017

N2 - Introduction A multi-strategy community intervention known as the National Rural Health Mission (NRHM) was implemented in India from 2005 to 2012 in an attempt toreduce maternal and child mortality.Objective This study examined the extent to which the NRHM’s maternal and child health (MCH) sector plans were implemented. We observed trends in how intergovernmental (use of central government funds by state governments) budgets were allocated and used to implement MCH plans in Haryana, India.Methods We conducted a retrospective assessment of programme implementation plans, MCH budget allocation and expenditure and financial monitoring reports during the NRHM implementation period. The yearly budget utilization rate was calculated for each MCH strategy implemented. On the basis of this budget utilization rate, we classed the extent of MCH strategy implementation asfully, partially or not implemented. The status of MCH indicators before, during and after the NRHM period was obtained from national demographic surveys. The budget utilization rate was correlated with MCH outcomes.Results The overall budget allocated for MCH plans increased from $US6.6 million during the 2005–2006 period to $US66.7 million in the 2012–2013 period. Therate of budget utilization increased from 20.6% in 2007–2008 to 89% in 2012–2013. Expenditure exceeded the initially allocated budget for patient referral services (111.5%), human resources (110.1%), drugs and logistics(170%), accredited social health activists (133.3%) and immunization (106.4%). Additional budget was obtained from the state health budget. Plans for referral services, human resources, drug provision, accredited social health activists and immunization were fully implemented, few schemes (\1%) were not implemented, and all other schemes were only partially implemented. MCH indicators improved significantly (p\0.05). The rate of institutional childbirth was highly and positively correlated with rates of budget utilization for implementing accredited social health activists (r = 0.96) and financial incentives forhospital delivery schemes (r = 0.5).Conclusions The trend for increasing use of the allocated budget for MCH strategies, improvement in MCH indicators and their positive correlation indicate better and more effective implementation of NRHM MCH strategies than in the past in Haryana, India. However, overall, the NRHM was only partially implemented.

AB - Introduction A multi-strategy community intervention known as the National Rural Health Mission (NRHM) was implemented in India from 2005 to 2012 in an attempt toreduce maternal and child mortality.Objective This study examined the extent to which the NRHM’s maternal and child health (MCH) sector plans were implemented. We observed trends in how intergovernmental (use of central government funds by state governments) budgets were allocated and used to implement MCH plans in Haryana, India.Methods We conducted a retrospective assessment of programme implementation plans, MCH budget allocation and expenditure and financial monitoring reports during the NRHM implementation period. The yearly budget utilization rate was calculated for each MCH strategy implemented. On the basis of this budget utilization rate, we classed the extent of MCH strategy implementation asfully, partially or not implemented. The status of MCH indicators before, during and after the NRHM period was obtained from national demographic surveys. The budget utilization rate was correlated with MCH outcomes.Results The overall budget allocated for MCH plans increased from $US6.6 million during the 2005–2006 period to $US66.7 million in the 2012–2013 period. Therate of budget utilization increased from 20.6% in 2007–2008 to 89% in 2012–2013. Expenditure exceeded the initially allocated budget for patient referral services (111.5%), human resources (110.1%), drugs and logistics(170%), accredited social health activists (133.3%) and immunization (106.4%). Additional budget was obtained from the state health budget. Plans for referral services, human resources, drug provision, accredited social health activists and immunization were fully implemented, few schemes (\1%) were not implemented, and all other schemes were only partially implemented. MCH indicators improved significantly (p\0.05). The rate of institutional childbirth was highly and positively correlated with rates of budget utilization for implementing accredited social health activists (r = 0.96) and financial incentives forhospital delivery schemes (r = 0.5).Conclusions The trend for increasing use of the allocated budget for MCH strategies, improvement in MCH indicators and their positive correlation indicate better and more effective implementation of NRHM MCH strategies than in the past in Haryana, India. However, overall, the NRHM was only partially implemented.

U2 - 10.1007/s41669-017-0026-3

DO - 10.1007/s41669-017-0026-3

M3 - Article

VL - 1

SP - 265

EP - 278

JO - Pharmacoeconomics

JF - Pharmacoeconomics

SN - 1170-7690

IS - 4

ER -