Kerala topped Niti Aayog’s comprehensive Health Index report “Healthy States, Progressive India”, followed by Punjab and Tamil Nadu. Jharkhand, Jammu and Kashmir and Uttar Pradesh were the top ranking states in terms of annual incremental performance.
Seven big states and three small states registered a decline in performance in 2016 as compared to 2015. These include Karnataka, West Bengal, Himachal Pradesh, Haryana, Assam, Uttarakhand, Tripura, Nagaland and Sikkim.
The report ranked states and Union territories on their year-on-year incremental change in health outcomes, as well as overall performance with respect to each other. The Health Index is a weighted composite index, which for the larger states is based on indicators in three domains — health outcomes (70%), governance and information (12%) and key inputs and processes (18%) — with each domain assigned a weight based on its importance. Performance on 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) were taken into account.
Releasing the report, Niti Aayog CEO Amitabh Kant said the index would act as a tool to achieve better health outcomes through cooperative and competitive federalism. Health Secretary Preeti Sudan said incentives linked to states’ performance would soon be announced. Kant said: “By June this year, we will take out the ranking of 730 district hospitals based on performance. We want to encourage the good performers
and name and shame those who don’t.”
Among smaller states, Mizoram ranked first in overall performance followed by Manipur. Manipur and Goa were the top ranked states in annual incremental performance. 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).
The Aayog identified some common challenges across states such as vacancies, establishment of functional district Cardiac Care Units, quality accreditation of public health facilities and institutionalisation of Human Resources Management Information System . Almost all larger states need to focus on improving the Sex Ratio at Birth.