Fourteen states and Union territories were penalised under the National Health Mission for not performing well enough on various health parameters, according to a government report released on Wednesday. These states include Bihar, Uttarakhand, West Bengal, Madhya Pradesh and Mizoram.

The top ranked states on the report were Dadra and Nagar Haveli, Haryana, Assam, Kerala and Punjab, which will get incentives for performing well on the parameters, according to the Health Systems Strengthening – Conditionality Report of States for 2018-’19.

The parameters included operationalisation of Health and Wellness Centres, provisioning of mental health services in applicable districts, screening of population above the age of 30 for non-communicable diseases and grading of primary health centres.

Twenty states earned incentives and two received neither incentives nor penalties. Four states – Arunachal Pradesh, Meghalaya, Nagaland and Sikkim – were given the maximum penalty as they were unable to meet the minimum criterion of full immunisation of 75%. Among the states that qualified on that criterion, Bihar was the worst performing one. The three hilly states – Jammu and Kashmir, Himachal Pradesh and Uttarakhand – were also penalised.

The National Health Mission introduced conditionalities and performance-based incentives and penalties to encourage productivity, increase efficiency and boost growth, Union Health Minister Harsh Vardhan said. The government had allocated around Rs 3,265 crore of the funds under the mission for performance-based disbursement. While 80% of the funds are assured to states, 20% are based on performance indicators.

“The aim is to instill a sense of healthy competition amongst the states and stimulate better health outcomes across the country,” he said. “Keeping this aspect in mind, we have increased the NHM funds for performance linked conditionalities from 10% to 20% of the resource envelope. The pools under NHM have been so designed that funds from high-focus states do not go to better performing states and do not disturb the equity in fund distribution.”

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