Niti Aayog on February 9, 2019 released a comprehensive 'Healthy States, Progressive India' report in New Delhi. The health index ranks the states on the basis of their performance on measurable indicators such as infant mortality rate, sex ratio at birth and functional 24x7 public health centres.
The healthy state progressive report ranked Kerala, Punjab and Tamil Nadu at the top among the larger states in terms of overall performance. The report was released by NITI Aayog CEO Amitabh Kant in New Delhi.
The index has been evolved through comprehensive study and inputs from World Bank India and Ministry of Health.
• The report ranked the states and Union Territories in three categories namely larger states, smaller states and Union territories.
• In terms of annual incremental performance, the states that were ranked at the top three positions in the larger states category included Jharkhand, Jammu and Kashmir and Uttar Pradesh.
• The high rank of the states is courtesy their good performance in indicators such as Neonatal Mortality Rate (NMR), Under-five Mortality Rate (U5MR), full immunization coverage, institutional deliveries, and People Living with HIV (PLHIV) on Anti-Retroviral Therapy (ART).
• Among the smaller states, Mizoram was ranked first followed by Manipur and Goa in terms of annual incremental performance.
• The states’ high ranks are due to progress on indicators such as PLHIV on ART, first-trimester antenatal care (ANC) registration, grading quality parameters of Community Health Centres (CHCs), average occupancy of key State-level officers and good reporting on the Integrated Disease Surveillance Programme (IDSP).
• Among the Union territories, Lakshadweep showed the best overall performance as well as the highest annual incremental performance, with an improvement in institutional deliveries, tuberculosis (TB) treatment success rate and transfer of National Health Mission (NHM) funds from the state treasury to implementation agency.
The study of the incremental performance of states aims to help the government ensure better health outcomes.
According to the report, about one-third of the states registered a decline in their performance in 2016 as compared to 2015. The common challenges faced by the states include addressing the vacancies in key staff, the establishment of Cardiac Care Units and quality accreditation of public health facilities.
The index also noted that while the states and the UTs that start at lower levels of development are generally at an advantage in notching up incremental progress over states with high health index scores, it is a challenge for states with high index scores to maintain their performance levels.
The best example for the same is Kerala, as the state ranks at the top in terms of overall performance but it saw the least incremental change as it had already achieved a low level of Neonatal Mortality Rate (NMR) and Under-five Mortality Rate (U5MR) and replacement level fertility, leaving limited space for any further improvements.
Besides this, the report noted that almost all large states need to focus on improving the Sex Ratio at Birth (SRB).
About the Health Index
The Health Index is a tool to leverage co-operative and competitive federalism to accelerate the pace of achieving health outcomes.
It aims to serve as an instrument for nudging states, union territories and central ministries to place greater emphasis on output and outcome-based measurement of annual performance.