Niti Aayog's Health Index

Kerala remains at the top of the heap among larger states in terms of various health parameters, followed by Andhra Pradesh and Maharashtra. Uttar Pradesh, Odisha and Bihar are the worst performers, according to Niti Aayog’s latest health index. Haryana, Rajasthan and Jharkhand top the charts based on incremental performance.

The health index—which took into account 23 health indicators during 2015-16 (base year) to 2017-18 (reference year)—depicts huge disparities across states and UTs.

The report, prepared by Niti Aayog in collaboration with the health ministry and with technical assistance from World Bank, has three categories—larger states, smaller states and Union territories —to ensure comparison among similar entities.

Among the smaller states, Mizoram ranked first in overall performance, while Tripura and Manipur were the top two states in terms of incremental performance.

Sikkim and Arunchal Pradesh registered the biggest decline in overall health index scores.

Among UTs, Chandigarh ranked first in overall performance, while Dadra and Nagar Haveli showed the biggest improvement.

Among the top ten performers, seven states have improved in overall performance scores (Andhra Pradesh, Maharashtra, Gujarat, Himachal Pradesh, Jammu & Kashmir, Karnataka and Telangana). However, among the six least performing states (Uttar Pradesh, Bihar, Odisha, Madhya Pradesh, Uttarakhand, and Rajasthan), all saw decline in overall performance scores with the exception of Rajasthan, which improved by 6.3 points.

Among the eight empowered action group states, only three—Rajasthan, Jharkhand and Chhattisgarh showed an improvement in their overall performance during the period taken into consideration.

While it is important to identify the challenges faced by EAG states that hinder improvement in performance, impressive improvement in some states provides learning opportunities for the rest to identify effective actions to improve their overall performance scores,” report said.

The decline in the overall health index score of five empowered action group states (states that lag behind in demographic indicators and have high infant mortality rates)—Bihar, UP, Uttarakhand, Madhya Pradesh and Odisha—is attributed to the deterioration of performances in several indicators.

For instance in Bihar, the deterioration was primarily due to performance related to total fertility rate, low birth weight, sex ratio at birth, tuberculosis treatment success rate, quality accreditation of public health facilities and time taken for National Health Mission fund transfer. In UP, the poor performance related to low birth weight, TB treatment success rate, average tenure of key positions at state and district level and level of birth registration. The report also pointed to a general positive correlation between the health index scores and economic development levels of states and UTs as measured by per-capita net state domestic product

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