June 6, 2021 1:08:05 am
Gujarat has topped among all states when it comes to achieving sustainable development goal (SDG) of good health and well-being (SDG 3), industry, innovation and infrastructure (SDG 9), as per the NITI Aayog’s SDG India Index 2020-21 made public on Thursday.
However, the state continues to be among the poorest performing ones in zero hunger parameter (SDG 2), which deals with nutrition-related indicators, and gender equality (SDG 5).
The state also figured in the middle tier in terms of quality education (SDG 4), decent work and economic growth (SDG 8), reduced inequality (SDG 10), responsible consumption and production (SDG 12) and life on land (SDG 15).
Overall Gujarat ranks 10th in composite SDG score at 69, taking into account all 16 goals on 115 quantitative indicators, against an India average of composite SDG score of 66 and thus figures in the top bracket of ‘front runner’. The state has gained five points compared to the SDG report of 2019 when the score was at 64.
In good health and well-being goal, compared to India’s average, Gujarat saw lower proportion of maternal deaths, and mortality in children under five years, better case notification rate of tuberculosis per one lakh population, lower death rate due to road traffic accidents per one lakh population, greater institutional deliveries, lower monthly out of pocket expenditure on health as a share of monthly per capita consumption rate, and higher number of health staff per 10,000 population.
Principal health secretary Jayanti Ravi says, “This is a big achievement for Gujarat, to be on top and be ranked first for the first time, given historically (Gujarat has not been the best in health and wellness parameter).”
In terms of health staff, the state, however, came down by two points as against the SDG report of 2019 (41 physicians, nurses and midwives per 10,000 population in 2020 report vis-a-vis 43 in 2019 report).
Ravi added, “This will further go up, recruitment is cyclical. For example in the nursing recruitment, GPSC recruitment, promotions, we have set a record in the last one to two years. Last year, we had a sweeping decision to fill vacancies in medical colleges as well as enforcing bonded doctors’ duty.”
The maximum improvement (SDG report of 2019 vis-a-vis 2020) has been in mortality in under-five-year-old children, by 13 percentage points. Ravi says that a key factor in improved child and maternal mortality was owing to consistent tracking of mothers and children.
The state, however, performed lower than the India average when it comes to routine immunisation coverage among
children less than a year old.
The data for this indicator was recorded in pre-pandemic period — from April 2019 until March 2020. Ravi says, there have been extensive campaigns to raise awareness. She also said the state figures in the top five across the country in terms of Covid-19 vaccine coverage.
Most health indicators have relied on data of 2019, as is mentioned in the report, and have non-uniform time periods of various datasets.
Given that some of the datasets are not current, Ravi adds that if one sees Gujarat’s current data in these indicators, it is performing better.
On different datasets over different time periods being used for assessment in the SDG report, Indian Institute of Public Health (IIPH) Gandhinagar director Dr Dileep Mavlankar says that if a uniform time period for assessing all indicators is used, “then everything will be three to four years old” by the time an assessment report is published.
Overall however, Dr Mavlankar agreed that the pandemic would have impacted all other health indicators adversely.
Ravi is optimistic and adds that if anything, the lessons learnt from the pandemic and capacity built during this duration, will only sustain Gujarat’s good performance. “While the focus was on Covid, district teams were well sensitised and clued in on tracking these health parameters among its population. Routine things continued…”
Gujarat is a laggard when it comes to SDG 2 (zero hunger) with a score of 46, and figuring among the 11 poorest performing states. The state performed worse than the national average especially with the indicators dealing with nutritional status in children, and with regard to anemia in adolescents and pregnant women.
While the NITI Aayog report states that the aim is to reduce anaemia in adolescents to 14.2 per cent (nationally), as per Comprehensive National Nutrition Survey Report (CNNS) of 2016-18 of the Ministry of Health and Family Welfare it stands at 28.4 per cent nationally, and at 33.4 per cent in Gujarat.
Gujarat also sees 39 of 100 children under five years as underweight, as per CNNS. The state also sees a low agricultural productivity measured as of 2018-19 — producing 2,640 kilogram of rice and wheat annually per hectare, against the national average of 2,995 kilogram per hectare.
However, SDG 2 does not holistically capture nutrition and only looks at an extreme form of poor nutrition, which translates to hunger.
In the gender equality goal (SDG 5), Gujarat ranks 15th — among the bottom tier of states. While Gujarat fares better in crime rate and domestic violence against women, the state does poorly especially in sex ratio at birth, elected representation of women, female labour force participation rate and percentage of married women whose family planning demands are met.
For sex ratio, the NITI Aayog report has, however, relied on relatively older data of Sample Registration System of 2016-18 and for family planning indicator, the think tank has relied on National Family Health Survey (NFHS-4) of 2015-16.
Among 28 states, Gujarat ranks 21st in the SDG pertaining to achieving reduced inequalities. The state also sees a greater crime rate against scheduled castes per one lakh population (34.8 per lakh population in Gujarat against 22.8 per lakh population across India).
This data point is based on the National Crime Records Bureau report of 2019. The state also has a lower ratio of transgender to male labour force participation rate.
Despite being a business hub, Gujarat fares poorly in ease of doing business indicator score — 20.19 against India average of 71 — and sees fewer percentage of women account holders in Pradhan Mantri Jan Dhan Yojana.
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