Kolkata: The Output-Outcome monitoring framework is a welcome step aimed at bringing-in greater accountability and transparency for the agencies involved in the execution of Government schemes and projects, according to Dr. Soumya Kanti Ghosh, Group Chief Economic Adviser, State Bank of India.
The Government began the output-outcome monitoring framework in mid-2017, whereby in addition to the financial outlays of schemes of the Ministries being indicated in the Union Budget document, the expected outputs and outcomes of the schemes are also being presented in a consolidated Outcome Budget document.
Thus outlay (amount that is provided for a given scheme or project), output (direct and measurable product of program activities, often expressed in physical terms or units) and outcome (collective results or qualitative improvements brought about by delivery of services) are presented during the annual budget exercise.
The purpose of the output-outcome monitoring framework, however, depends on how effectively, clearly and logically the outcomes are defined.
“In this context, we looked at the outcome budget given for various schemes of the Ministry of Health and Family Welfare for the past four years with outlay of more than Rs 500 crore as there has been significant coverage of health programmes by the Government of India in recent years, ” Ghosh said.
“For example, the health data as put out by Government of India National Data Analytics platform shows that we have made significant strides in terms of various health indicators over the years,” he added.
For instance, during 2017-19, Primary Health Centers/PHCs have increased by 70.6 per cent and 50 per cent in urban areas and rural areas, respectively. Infant Vaccination has also improved considerably in the two year period with 7.8 per cent increase in Hepatitis vaccination and 3.9 per cent increase in oral Polio vaccination.
Even maternal deaths and still births have reduced by 10.5% and 5.3%, respectively in 2019 compared to 2017.
However, such data are available with a lag of four years now, and such remarkable progress is not reflected in the outcome budget with the proper indicators.\\\\, he said. Both these issues of timeliness in data dissemination and link with the outcome budget are crucial issues that needs to be addressed at the earliest.
Coming to the issue of outcomes stated in the outcome budget, he said some of them need to be tweaked to reflect the significant achievements made by the country.
For instance, in case of National AIDS and STD Control Programme the outcome is the number of people who know their HIV status. Targeting the number of people who know their status does not seem to be a good indicator in achieving the goal of reducing the spread and increasing our capacity to respond to HIV/AIDS.
Next, in some cases various outcomes have been defined with the same indicator, which in turn makes them redundant. For instance, Under NRHM RCH flexipool including various immunization programs has stated outcomes as reduction in anemia, increased access to safe delivery services, assured quality and respectful maternity care at birth, quality care at birth all which are linked to one target: as reduction in MMR per one lakh live births.
Noting that the government has achieved a 38% increase in testing in severe anemic women in 2019 in comparison to 2017, he said this has been possible particularly because of increase in testing capacity and awareness about Government efforts. Thus Government efforts are not getting adequately reflected because of unstructured targets.
“We can make our outlook output framework successful by defining outcomes ministry wise. Other key improvement that can be made in the output outcome monitoring framework is to make the achievements available against all the targets set in the public domain just like the annual budget, ” Ghosh opined.
Further, if the ministry wise targets and achievements are presented then the ministries can be ranked based on their success, thereby increasing the overall efficiency of the framework. The States can also be then encouraged to adopt the framework at their level as health is also a state subject, by adding new indicators like say mobile health clinics in villages, he added.