States of health

States of health

Context:

NITI Aayog’s first Health Index has provided a platform for wider public debate.

About the Report:

• The report titled “Healthy States, Progressive India”, measured the health index through various indicators
• The reference year for most indicators is 2015 or 2016 and the base years to gauge improvement are between one and three years before the reference year.
• The health index has been evolved through comprehensive study and inputs from World Bank and Ministry of Health and Family Welfare
• Health Index report, for the first time, has attempted to establish an annual systematic tool to measure and understand the heterogeneity and complexity of India’s performance in the health sector

Highlights of the Report:

• Kerala, Punjab and Tamil Nadu were the top rankers in the Health Index
• Uttar Pradesh was the worst performing state.
• Manipur registered maximum incremental progress in indicators such as PLHIV on ART, first trimester antenatal care registration, grading quality parameters of Community Health Centres, average occupancy of key state-level officers and good reporting on the Integrated Disease Surveillance Programme (IDSP).
• Lakshadweep showed the highest improvement in indicators such as institutional deliveries, TB treatment success rate, and transfer of National Health Mission funds from the state treasury to implementation agency.
• Kerala has ranked first in overall performance. However, there has been least incremental change as it had already achieved low levels of Neonatal Mortality Rate, Under-five Mortality Rate and replacement level fertility, leaving limited space for any further improvement

What are the common challenges for most states and UTs which need to be addressed?

• The need to focus on addressing vacancies in key staff,
• 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

Significance of the Index

• The Index is expected to nudge states towards further achieving a rapid transformation of their health systems and population health outcomes
•  Health care is not a mainstream political issue in India. The Index, with all its limitations given uneven data availability, is expected to make a difference in this by encouraging a competitive approach for potentially better outcomes.