Kerala: NHM Programmes Hit by Fund Cuts, Centre Focusing Only on Co-Branding, say Employees

The National Health Mission (NHM) was launched with the aim of providing universal access to equitable, affordable and quality healthcare. The NHM oversees the various initiatives aimed at controlling communicable and non-communicable diseases, but the budgetary allocation for the scheme has witnessed massive cuts in recent years, leading to the weakening of the scheme itself. 

With massive fund cuts leading to the burdening of the state governments, the Union government is refusing funds under the different programme heads implemented under NHM to a few states, including Kerala, citing flimsy reasons, according to employees and government sources. 

The Centre has set a precondition to upload logos of six Union departments in the Community and Family Health Centres for the fund release.

This has led to the NHM Employees Federation (NHMEF) accusing the Union government and the Union Health Ministry of focusing on merely co-branding and not on the services and functioning of the centres, which seems to have taken a backseat. 

The NHMEF is charting out protest programmes against the Union government and the Health Ministry for the fund cuts, insistence on photo-ops and co-branding. 

‘FUND CUTS AFFECTING BENEFICIARIES’

The NHM launched in 2005, with a 60% share from the Union government and 40% from the respective state governments, has been suffocating from reduced Union budgetary allocations under the Bharatiya Janata Party (BJP) regime. Further, the denial of funds to certain states is affecting the implementation of the programmes and disbursal of wages to the employees. 

Speaking with NewsClick, Meera Nair, general secretary of the NHMEF, affiliated to the Centre of Indian Trade Unions (CITU), accused the Centre of specifically targeting Kerala. “The state mission has not received any funds from the Centre since April this year. It looks like the main focus of the Centre is on how better co-branding is done and not the quality of services provided,” she said. 

The Union Ministry of Health has insisted on displaying six different logos in the centres and uploading the photograph in the mobile app for the disbursal of funds. “Despite the heavy workload, the NHM workers have completed the task, which serves no purpose for the beneficiaries. Even then, the fund distribution has not happened, Nair added. 

The NHMEF has also accused the Union ministry of refraining from allocating funds under different programme heads, including Janani Shishu Suraksha Karyakram (JSSK) and Rashtriya Bal Swasthya Karyakram (RBSK), among others. 

“The different schemes are rolled out with larger aims. Kerala has always remained a state with better health infrastructure and facilities. But, we are forced to paint buildings with logos to get the funds,” Nair said.

‘STATE GOVERNMENT ALLOCATED FUND FOR SALARY’

With fund disbursal being stuck for almost nine months, the state government, led by the Left Democratic Front (LDF), had to step in to ensure wages are paid to NHM employees. 

“The wages of the NHM employee were revised after a sustained struggle. However, the Union government did not disburse the funds required for paying the arrears from April 2023. The state government had to allocate Rs 50 crore for paying the arrears and the wages for the last month,” she said. 

The NHMEF had held sustained protests against the Centre’s “neglect” and reduction in Central share in the programme. From 90% share during the launch of the NHM in 2005, the share of the Union government has come down to 60%. With the share of tax revenues falling continuously for the state governments under the BJP regime, states are struggling to find resources. 

“We are planning further struggles in the immediate future against the Union government against the deprival of funds for Kerala,” Nair said. 

Though launched with the aim of ensuring affordable healthcare in rural areas, with the launch of submissions including National Urban Health Mission (NUHM), reducing maternal and infant mortality rates, the reduced share front the Centre and lower budgetary allocations are hardly helping the mission. Besides, a large section of the employees remain on contract with stagnant wages and a lack of social welfare measures.