Will achieve the target, says state NHM director
ITANAGAR, Dec 23: Arunachal Pradesh has lost 20 percent of its performance-based funds for 2019-20 from the National Health Mission (NHM) after it failed to meet immunization targets in 2018-19.
Three other Northeast states – Sikkim, Meghalaya and Nagaland – have also lost their chance to earn the funds from the NHM, India’s largest public health programme.
In 2017-18, 90 percent of the central government’s share of the NHM budget had been assured to the states. The remaining 10 percent was dependent on each state’s performance towards the targets given by the Ministry of Health & Family Welfare (MoHFW).
Now, 80 percent is assured while 20 percent depends on a state’s performance.
The performance-based funding for health aims to push states to improve results. States earn or lose funds based on their performance on seven indicators determined by the MoHFW.
These indicators form the conditionality framework, which includes improving incremental performance based on the NITI Aayog report; making health and wellness centres operational; implementing human resources information system; grading district hospitals; providing mental health services in districts as per the rights-based mental health framework; screening 30+ population for non-communicable diseases; and rating primary health centres on the 12 functionalities.
On being contacted, Health & Family Welfare Secretary and state NHM Director, P Parthiban, said, “Our full coverage is 75 percent for this year.”
“At present, Mission Indradhanush 2.0 is successfully implemented in all targeted districts,” he added. “We can definitely achieve the target.”
The NHM has 55 percent of the country’s health budget. To receive NHM funding, each state must prepare and submit a programme implementation plan, which should include key strategies to address public health challenges in the state and budgetary requirements for the year. The MoHFW then approves the budget and allocates funds based on these plans.
In many cases, states only receive approval for a certain percentage of the funds requested. Two of the disqualified states – Nagaland and Arunachal – had the lowest proportion of funds approved for their state budgets in 2018-19, at 55 percent and 61 percent, respectively, according to Accountability Initiative (AI), a Delhi-based public policy research institute.
Both the central and state governments contribute funds to the state NHM budget, but the central government provides the larger portion, according to AI.
In 2018-19, to qualify for the performance-linked funds for 2019-20, the less developed empowered action group states of Jharkhand, Uttarakhand, Rajasthan, Madhya Pradesh, Bihar, Chhattisgarh and Odisha, and hilly and northeastern Indian states should have fully immunized at least 75 percent of children under the age of one year, while the rest of the states should have fully immunized 80 percent of children.
Arunachal, Sikkim, Meghalaya and Nagaland failed to achieve this goal, and were disqualified from receiving any performance-based funds. (Parts of this article first appeared on HealthCheck.)
