Feature Medicine in India

How free healthcare became mired in corruption and murder in a key Indian state

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e453 (Published 06 February 2012) Cite this as: BMJ 2012;344:e453
  1. Patralekha Chatterjee, journalist
  1. 1 New Delhi, India
  1. patralekha.chatterjee{at}gmail.com

The deaths of three medical officials in India’s most populous state have taken the sheen off an ambitious attempt to bring free healthcare to the country’s poorest citizens. Patralekha Chatterjee reports from Uttar Pradesh on how the organised looting of government funds has crippled the National Rural Health Mission

Over the past year, India has been rocked by a series of corruption scandals involving public figures. Among the most notorious is that currently engulfing the National Rural Health Mission (NRHM), an ambitious, centrally sponsored, health initiative to improve the health of the countries poorest citizens (box). The saga—centred on India’s most populous state, Uttar Pradesh—has so far claimed the lives of four people, including two chief medical officers, and the jobs of several leading government figures. Eight people have been arrested in connection with suspected irregularities in the use of the public money allocated to the NRHM, and inquiries by India’s Central Bureau of Investigation (CBI) into other cases continue. As new, startling, facts come out in the media almost every day it seems much of the 10 000 crore rupees (£1.3bn; €1,5bn; $2bn) allotted to Uttar Pradesh under the initiative was siphoned away by the current and previous state government and did not reach or benefit the people for whom it was intended.

What is the National Rural Health Mission?

The NRHM was launched in 2005 to provide effective healthcare to rural populations, with special focus on 18 states with weak public health indicators or infrastructure. Its key goals are to reduce the infant mortality rate and maternal mortality ratio. The NRHM was meant to overhaul healthcare by building new clinics and hiring many more health workers.

The story really hit public attention when two chief medical officers in the state were murdered, one killed in broad daylight in October 2010 and another outside his home in …

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