Context

NITI Aayog recently released a second edition comprehensive Health Index report titled “Healthy States, Progressive India”.

About

• It is the second edition of Healthy States, Progressive India Report.
• It ranks all states and Union territories based on their year-on-year incremental change and overall performance in health.
• All States and UTs have been ranked in three categories to ensure comparison among similar entities.
• These are accordingly Larger States, Smaller States, and Union Territories (UTs).
• The report has been developed by NITI Aayog with technical assistance from the World Bank.
• Ministry of Health and Family Welfare (MoHFW) was also consulted in the process.
• The report is the first attempt to establish an annual systematic tool to measure and understand the nation’s health performance.
• For generation of Index Values and ranks, data was submitted online and validated by an Independent Validation Agency (IVA)

Outcomes

Larger States

• The Health Index is based on indicators in three domains. These are Health Outcomes (70%), Governance and Information (12%) and Key Inputs and Processes (18%).
• Among the Larger States, Kerala, Punjab and Tamil Nadu ranked on top in terms of overall performance.
• Jharkhand, Jammu & Kashmir, and Uttar Pradesh ranked as top three States in terms of annual incremental performance.
• Uttar Pradesh, Rajasthan, Bihar, Odisha and Madhya Pradesh occupied the bottom ranks.
• Odisha is estimated to have the highest neonatal mortality rate at 35 per thousand live births.

Smaller States

• Among Smaller States, Mizoram ranked first followed by Manipur on overall performance.
• In terms of annual incremental performance Manipur ranked top followed by Goa.

UTs

• Among UTs, Lakshadweep showed best overall performance as well as the highest annual incremental performance.

Inference from Outcomes

• States with a record of investment in literacy, nutrition and primary health care have achieved high scores.
• About one-third of States have registered a decline in their performance in 2016 as compared to 2015.
• All States and UTs have substantial scope of improvement
• The common challenges for most States and UTs include the need to focus on:
  • Addressing vacancies in key staff
  • establishment of functional district Cardiac Care Units (CCUs)
  • quality accreditation of public health facilities
  • institutionalization of Human Resources Management Information System (HRMIS)

Significance

• The Health Index is an important aid in understanding the heterogeneity and complexity of the nation’s performance in Health. The results of this report provide an important insight into the areas in which States have improved, stagnated or declined.
• Both the Centre and the States have to scale up their investment on health as a percentage of their budgets. The findings stress the need for pursuing domain-specific, targeted interventions. The index could be linked to incentives offered under the National Health Mission by the Ministry of Health and Family Welfare.

Key Definitions Neonatal Mortality Rate (NMR) - Number of infant deaths of less than 29 days per thousand live births during a specific year. Under-five Mortality Rate (U5MR) - Number of child deaths of less than 5 years per thousand live births during a specific year. Total Fertility Rate (TFR) - Average number of children that would be born to a woman if she experiences the current fertility pattern throughout her reproductive span (15-49 years), during a specific year. Sex Ratio at Birth (SRB) - The number of girls born for every 1,000 boys born during a specific year.