NITI Aayog has released a comprehensive health index report, with Kerala, Punjab and Tamil Nadu wresting top 3 positions in terms of overall performance in the larger sates category.
Among smaller states, Mizoram ranked first followed by Manipur on overall performance.
The report titled, “Healthy States, Progressive India” found Jharkhand, Jammu & Kashmir, and Uttar Pradesh as the top three ranking States in terms of annual incremental performance.
In smaller states list, Manipur followed by Goa were the top ranked states in terms of annual incremental performance.
Among Union Territories (UTs), Lakshadweep showed both the best overall performance as well as the highest annual incremental performance.
Among larger states, Jharkhand, Jammu & Kashmir, and Uttar Pradesh showed the maximum gains in improvement of health outcomes from base to reference year in indicators such as Neonatal Mortality Rate (NMR), Under-five Mortality Rate (U5MR), full immunisation coverage, institutional deliveries, and People Living with HIV (PLHIV) on Anti-Retroviral Therapy (ART).
Among smaller states, Manipur registered maximum incremental 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).
In UT list, Lakshadweep showed the highest improvement in indicators such as institutional deliveries, tuberculosis (TB) treatment success rate, and transfer of National Health Mission (NHM) funds from state treasury to implementation agency.
The health index is a weighted composite Index, which for the larger States, is based on indicators in three domains: (a) health outcomes (70 per cent); (b) governance and information (12 per cent); and (c) key inputs and processes (18 per cent), with each domain assigned a weight based on its importance.
The report ranks states and Union territories innovatively on their year-on-year incremental change in health outcomes, as well as, their overall performance with respect to each other.
The report observed that while states and 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 even maintain their performance levels.
For example, Kerala ranks on top in terms of overall performance but sees 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.
It is the first attempt to establish an annual systematic tool to measure and understand the heterogeneity and complexity of the nation’s performance in health. The report has been developed by NITI Aayog, with technical assistance from the World Bank, and in consultation with the Ministry of Health and Family Welfare (MoHFW),
The report also noted that rich learnings have emerged in the first year and these will guide in refining the index for the coming year and also address some of the limitations.
It called for an urgent need to improve data systems in the health sector, in terms of terms of representativeness of the priority areas, periodic availability for all States and UTs, and completeness for private sector service delivery.
This index is expected to nudge states towards further achieving a rapid transformation of their health systems and population health outcomes.
Pic Source: PIB (The CEO, NITI Aayog, Shri Amitabh Kant, the Secretary, Ministry of Health & Family Welfare, Smt Preeti Sudan and the World Bank Country Director, India, Shri Junaid Ahmad addressing the press conference after releasing the “Healthy States, Progressive India” Report, in New Delhi on February 09, 2018.)