On October 9, 2019, Health System Strengthening Conditionality Report of States 2018-19 was released by the Ministry of Health and Family Welfare (MOHFW). 14 states and union territories (UTs) were penalised under National Health Mission (NHM) for their worst performances on various health parameters in 2018-19.

Key Points:

  • Parameters: The states were assessed based on various health system strengthening parameters of NHM like immunisation status, Health and Wellness Centres (HWCs), provisioning of mental health services in districts, screening of 30 plus population non-communicable diseases and grading of primary health centres (both urban and rural), among others. The incremental improvement as per the NITI Aayog (National Institution for Transforming India) ranking of states on ‘Performance on Health Outcomes’ was given the highest weightage. The Conditionalities Framework for 2018-19 comprised of 7 indicators.
  • Incentive-based payments: 20% of NHM funds i.e Rs 3,000 crore is set aside for incentive-based payments.
  • Result based funding: Union Ministry of Health and Family Welfare runs this initiative and the penalised states will lose funds from the central government due to their poor performance.
  • Top 5 states/UTs: Dadra and Nagar Haveli, Haryana, Assam, Kerala and Punjab were the top five states/UTs which performed well.
  • Worst states: 14 states and UTs with Bihar, Uttarakhand, West Bengal, Madhya Pradesh and Mizoram were the worst-performing states. 3 hilly states Jammu and Kashmir, Himachal Pradesh and Uttarakhand received penalty due to non-fulfilment of conditionality. Among the 8 North-Eastern (NE) states, 4 did not meet the eligibility criteria. But Assam, Tripura and Manipur earned incentives.
  • EAG states: 8 Empowered Action Group (EAG) states were assessed. Among them, 4 were incentivised, 1 state earned no incentives or penalty and 2 states received penalty.
  • HRIS: Assam, Chhattisgarh, Haryana, Kerala, Punjab and Tripura earned full incentive for implementation of the Human Resource Information System (HRIS). Andhra Pradesh, Odisha and Uttar Pradesh partially achieved the target.
  • NITI Aayog’s ranking: On NITI Aayog ranking of states on ‘Performance on Health Outcomes’ indicator, 20 out of the 36 states and UTs showed improvement. Daman and Diu among the UTs and Punjab among the states was the top performing state in terms of operationalisation of HWCs. West Bengal, Jammu and Kashmir, Andaman and Nicobar Islands, Bihar and Nagaland were penalised for poor performance in the Mental Health Programme. Among the EAG states, Odisha showed the highest achievement.
  • 30 plus population: Tamil Nadu topped by 100% screening of 30 plus population followed by Goa (68%) and Daman and Diu (57%).

About MoHFW:
Headquarters: New Delhi
Minister In-charge: Dr Harsh Vardhan (Constituency: Chandni Chowk, New Delhi)

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