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NEW DELHI: Bihar, West Bengal, Madhya Pradesh along with hill states of Himachal Pradesh , J&K and Uttarakhand have not fared well in improving health indicators and hence will miss out on 20% of the Centre’s payout under National Health Mission.

The health ministry on Wednesday released ‘Health Systems Strengthening -Conditionality Report of States for 2018-19’, which will form the basis for disbursement of performance-based incentive or penalty under NHM budget.

The report shows Haryana, Kerala and Punjab along with Assam and Dadar & Nagar Haveli as the top five performers on key health indicators.

The Conditionalities Framework for 2018-19 comprised seven key indicators based on which states and Union Territories were ranked. The parameters include operationalisation of health and wellness centres (HWCs), provisioning of mental health services in districts covered under the NHM programme, screening of 30 plus population for non-communicable diseases and grading of primary health centres (both urban and rural), among others.

The incremental improvement as per the NITI Aayog ranking of states on ''Performance on Health Outcomes'' is one of the major conditionalities and has been given the highest weightage.

In light of PM Narendra Modi’s call to save children from vaccine-preventable diseases, full immunisation coverage was set as a qualifying criterion to be able to claim incentives. The states and UTs were eligible for conditionality assessment only if they were able to achieve at least 75% full immunisation coverage in case of Empowered Action Group states (which lag behind in demographic transition), North-Eastern (NE) and hill states and 80% for the rest.

In 2018-19, the Mission Steering Group of NHM, under the chairmanship of health minister, decided to increase the performance-based incentive/penalty from 10% to 20% of the NHM budget, sending a clear message to all states that good performance would be monitored and rewarded.

This meant while 80% of the resource would be assured for the state, 20% of the resource would depend on its performance on agreed conditionalities. The states which do not fulfil the criteria could lose up to 20% of funding under NHM. Around Rs 3265 crore of the NHM funds were put aside for disbursement to the states on the basis of performance.

Among the eight EAG states, four were incentivised, one earned no incentives or penalty while two received penalty.

J&K, Himachal Pradesh and Uttarakhand received penalty due to non-fulfilment of conditionalities.

Among the eight N-E states, four could not meet the eligibility criteria while Assam, Tripura and Manipur earned incentives, the report stated.

Of the 11 other states, nine were incentivised and two received penalty.

According to the report, for 2018-19, 20 states or UTs were able to earn incentives, two states or UTs earned neither incentive nor penalty, while remaining states received penalty.

Arunachal Pradesh, Meghalaya , Nagaland and Sikkim could not meet the minimum criteria of full immunisation of 75 per cent, therefore progress made by the states was not considered for assessment.

On NITI Aayog rankings, 20 out of the 36 states and UTs have shown progress, whereas 16 states or UTs have shown a decline in their performance.

