1. Financial Management Practices under NHM

2. Problem Statement
Financial planning for 15 schemes keeping in view the status of IMR, MMR, TFR and disease burdens of the State with limited resources.
Treasury route financing delaying the release to implementers.
Direct Benefit Transfer:
a. Payment of incentives to more than ASHAs.
b. Payment of benefit to more than 5 lakh beneficiaries under JSY and more than 1.60 lakh beneficiaries under FP every year.
c. Payment of remuneration to around staff every month.

3. Problem Statement
IV. Implementation of PFMS in approximately facilities across the State.
V. Enhancing transparency and effective internal control mechanism for approximately 800 FMR heads linked to more than 1500 PIP line items.

4. Financial Planning
Limited Resources Vs too many schemes with lots of interventions.
Identifying the key activities linking to the goals and within permissible resources.
Special attention on high focus areas and allocating funds accordingly. The allocation for High Focus districts is around 1.50 times of that of non-High focus districts.
Data from MCTS/RCH Portal, HMIS, DHIS used to identify the poor performers and accordingly special strategies are planned for them.

5. Treasury Route Financing & release of funds to implementers
Instant submission of requisition to State Govt. on receipt of sanction orders from Govt. of India.
Pro-activeness in issuing Sanction Orders and submitting bills to Treasury.
Single Sanction Order for both Central & corresponding State share.
Special attention by the Treasury to meet the conditionality of GoI.
Fund Release
Fund release through Flexi-pool mechanism from SHS to DHS and DHS to sub-district level facilities.
Fund release to DHS in just 48 hours of receipt of funds against the prescribed timeline of 15 days.

6. Treasury Route Financing & release of funds to implementers
Outcomes:
Funds for the major programmes have been received within days from the date of issue of the SOs by GoI thereby ensuring implementation of activities in time.
The average time taken for the entire cycle is around days.
Prompt release of funds to DHS compensates the delay occurred in getting the money through Treasury route up to some extent and ensures timely execution of the activities.

7. Direct Benefit Transfer
Beneficiaries covered:
Payment of incentives to more than ASHAs for multiple (40) activities under multiple (9) schemes from multiple (6) bank accounts at one go in every month.
Payment of benefit to more than 5 lakh beneficiaries under JSY and more than 1.60 lakh beneficiaries under FP every year.
Payment of remuneration to around staff every month.

8. Direct Benefit Transfer
1. ASHA Payment:
a. ASHA Matrix for payment of incentives to all ASHAs (46500), for all activities (40) from all bank accounts (6) at one go.
b. PFMS software is customized to accommodate accordingly.
c. Fixed day payment from one place i.e. CHC.
d. Information to the ASHAs on their payments in the Sector meeting every month.
2. Payment under JSY & FP:
a. Ensuring opening of bank accounts during ANC.
b. Importing information from MCTS / RCH Portal.
c. Payment through DBT at the facilities CHC or above.
d. DBT at CHC level for the deliveries at PHC / SC on weekly basis.

9. JSY Payment to many beneficiaries at one go

10. ASHA Payment to all beneficiaries in a single stroke

11. Direct Benefit Transfer
3. Contractual staff:
a. Registration of all staff at different levels in the PFMS Portal.
b. Transfer of benefit every month through DBT under PFMS.

12. Implementation of PFMS
Process Followed:
Training and registration of facilities in a campaign mode.
Opening of bank accounts in a campaign mode.
Payment module in PFMS customized for states needs.
Cell in the SHS for prompt action to redress the technical issues and provide handholding support.
Detailed step wise instructions issued to the field.
Refresher orientation / trainings as per the need of the districts.

13. Enabling Factor:
Instruction of State Govt. to all Rural banks to be NEFT enabled in order which has resulted in 98% registration of facilities.
Outcomes:
Cash / paper less transactions leading to better internal control in the system.
Better fund management and tracking of idle funds.
Reduction in transaction time.
Transfer of funds to beneficiaries under NHM through DBT at one go.

14. Strengthening Financial Management to ensure better Internal Control
Assessment of financial management system of districts through indicators.
PIP based reporting system, in place of GoI FMR format, to have better monitoring of the progress of activities as per PIP.
Submission of BRS along with the FMR on monthly basis.
FMR Analysis and feedback for corrective action.
Ageing of advances on quarterly basis.
Monthly concurrent audit and ensuring compliance to the adverse audit observations of the previous month from the authority before taking up the audit of the subsequent month.
Detailed guidelines for fund management at the time of fund constraint.

15. Outcomes:
Better maintenance of financial records thus improving transparency.
Early liquidation of advances. Advances reduced by about 30% in last three years.
PIP based reporting leading to better monitoring of the implementation of activities.
Assessment of district performance and awarding encourages healthy competition among district.
Continuous corrective measures.

16. Overall Outcomes of Financial Management Initiatives
Indicators
Status in
Status in
Avg. duration of Fund Release from the date of receipt
State to districts : 7-10 days District to blocks : days
State to districts : 2-3 days
District to blocks : 7-10 days
Advance position as on 31st March Cr
Cr (decline by 30%)
Age of advance
RCH Flexible pool - < 3 months Mission Flexible pool - > 9 but < 12 months
RCH Flexible pool - Negative unspent balance Mission Flexible pool - > 6 but < 9 months

17. Overall Outcomes (Cont.)
Indicators
Status in
Status in
Timeliness & quality of FMR
Average delay of 5-6 days No physical reporting with FMR No reporting for NCDs and NUHM
Received on time FMR with physical reporting FMR for all schemes in state customised format
Cycle of settlement of advances
More than 45 days
Within 45 days
Submission on SoE/UC from the community
Quarterly basis , irregular submission
Regular submission on monthly basis
Payment to JSY beneficiaries (DBT) and time taken
34%
76%

18. Way forward
Reduce average cycle of release from the current average of 25 days for all programmes under NHM.
Improve quality of action taken on concurrent audit .
100% DBT through ADDHAAR seeded bank accounts along with expenditure filing under PFMS.
Further improvement in Internal Control mechanism.

19. Thank You…..