Government of India launched the National Rural Health Mission in April 2005 throughout the country for providing accessible, affordable, accountable, effective and reliable health care facilities in rural areas. This performance audit of implementation of Mission in Rajasthan revealed that household survey and facility survey were not done adequately. Large number of building construction works was incomplete/ not started. Mobile Medical Units were not in operation. Blood storage units were not started. There were cases of denial and delayed payment of cash assistance to the beneficiaries under Janani Suraksha Yojana. The important findings are indicated below:

1. During 2005-08, only 65 per cent of the total available funds were utilised. Three District Health Societies had taken three to thirty months in transferring funds of Rs 16.87 crore to the implementing agencies.
2. Household survey and facility survey required to identify the health care needs of the rural areas were not conducted adequately. The test checked District Health Societies did not prepare Perspective Plan for the Mission period. Health Action Plan was not prepared in most of the villages, blocks and districts. Village Health and Sanitation Committees were formed in 16 per cent villages against the targets of 30 per cent upto 2007.
3. While 493 residential buildings completed at a cost of Rs 24.81 crore were not taken over even after two to ten months of their completion, 565 buildings were incomplete after incurring an expenditure of Rs 19.34 crore. Construction of 364 new sub-centre buildings was not started.
4. Against 46,624 Accredited Social Health Activists required to be selected by December 2007, 39,325 were selected by March 2008. Eighty per cent medical staff and 60 per cent para-medical staff were not imparted necessary training. There were gross deficiencies in upgradation of Community Health Centers in respect of manpower, infrastructure and equipment, as compared to Indian Public Health Standards norms.
5. Fifty-two Mobile Medical Units could not be made operational for want of vehicles for carrying equipment and diagnostic facilities.
6. Out of 137 blood storage units, 126 could not be set up as the generator sets and other equipment (Rs 2.56 crore) were not installed/ utilised for want of copper cable, earthing pits and construction of platforms.
7. There was significant shortfall (48 to 64 per cent) in DT and TT immunisation. Male participation in family planning was poor (24 per cent of targets).
8. Though there was an increasing trend in institutional delivery, shortfall was 45 per cent of the targets in 2007-08. Under Janani Suraksha Yojana, 2.78 lakh women were not provided cash assistance during 2006-08. In 614 cases, payment of cash assistance delayed by one to 18 months.