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NRHM to link funds to performance

June 25, 2012

For the first time ever, funds allocated to states under the country’s flagship National Rural Health Mission (NRHM) will be cut by almost 15% if they fail to place doctors and health workers (even on contractual basis) to districts with the worst health index.
States will also have to post performance audits of health facilities online, failing which up to 7.5% of their total outlay will be deducted.
For the first time, NRHM’s programme implementation plan (PIP) for the year 2012-13 has put in place incentives to reward high performing states and also punish those who fail. Rational and equitable deployment of manpower (doctors, nurses, ANMs) has been given the highest priority, failing which states will be financially penalized.
Janani Shishu Suraksha Karyakram (JSSK), under which all pregnant women delivering in public health institutions are entitled to free and cashless delivery — free C-section, exemption from user charges, free drugs, blood, consumables and diagnostics and free diet for three days in case of normal delivery and seven days in case of caesarean section, has received a massive push.
States failing to provide these services will see a 10% cut in their NRHM budget. On the other hand, states which manage to efficiently put in place systems to provide free generic medicines to all public health facilities and also create a separate public health cadre will get an additional 15% of the total outlay. Efficient recording of vital events, including strengthening of civil registration of births and deaths, will earn states an additional 2% of the total outlay.
Responsiveness, transparency and good accountability will earn states an additional 8% of the total outlay while efficient intersectoral convergence will help add 3% funds.
Speaking to TOI, NRHM mission director Anuradha Gupta said: “The Mission Steering Group of NRHM has approved setting aside 10% NRHM funds to incentivize good performance by states. Earlier, allocations were inflexible. States that performed poorly received the money allocated to them and didn’t lose anything.”
States have also been directed to ensure mandatory disclosure on the state NRHM website on facilitywise deployment of all contractual staff with name and designation, mobile medical units and their service delivery data, all procurements, patient transport ambulances and details of all buildings and hospitals under construction.

Categories: Public Health
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