According to the fourth health index launched by NITI Aayog, Kerala has again emerged as the top performer in terms of overall health performance among large states, while Uttar Pradesh is the worst. The fourth round of the health index took into account the period of 2019-20.
The government think tank report said Tamil Nadu and Telangana are the second and third best performers respectively on health parameters. Bihar and Madhya Pradesh are the second and third worst performers respectively. Despite being the worst ranked, Uttar Pradesh topped in terms of incremental performance by registering the highest incremental change from the base year (2018-19) to the reference year (2019-20).
Among smaller states, Mizoram emerged as the best performer in overall performance as well as incremental performance. Among the Union Territories, Delhi and Jammu and Kashmir are at the bottom in terms of overall performance. However, both of them were leading performers in terms of incremental performance. The report said that Kerala has emerged as the best performing country in terms of overall performance for the fourth consecutive round.
Kerala and Tamil Nadu were the top two performers in terms of overall performance with the highest reference year index scores, but ranked 12th and eighth respectively in terms of incremental performance. Telangana performed well in terms of both overall performance as well as incremental performance and secured the third position in both the instances.
It pointed out that Rajasthan was the weakest performer in terms of both overall performance and incremental performance. In the case of smaller states, Mizoram and Tripura recorded strong overall performance as well as showed improvement in incremental performance, the report said.
According to the report, the Health Index is a weighted composite score consisting of 24 indicators covering key aspects of health performance. It said that the health index includes select indicators in three areas – health outcomes, governance and information, and key inputs and processes.
Releasing the report, NITI Aayog Vice Chairman Rajiv Kumar said: “States have started taking cognizance of indices like State Health Index and use them in policy making and resource allocation.” The report is an example of both competitive and cooperative federalism, Kumar added. According to the report, the gap in overall performance between the best and worst performing large states and union territories in the current round of health indices narrowed. , whereas it increased for smaller states.
The report states that the maximum index score of a state/UT is 100, adding that in case of large states, the highest observed composite index score of 82.20 is for Kerala, followed by Tamil Nadu at 72.42, For Telangana it is 69.96. 69.95 for Andhra Pradesh which is a long way from marginal (100 points). “Nearly half of the states and union territories did not reach the halfway mark in the overall composite index score, and despite good performance, the top ranking states and union territories may also benefit from further reforms,” it said. In the case of smaller states, the report said that the leading state was Mizoram with an index score of 75.77, followed by Tripura with an index score of 70.16. Among UTs, the leading states were DH and DD and Chandigarh, with index scores of 66.19 and 62.53 respectively. “This clearly indicates that there is scope for improvement in all States/UTs including the best performing States/UTs,” it said. Forty-seven percent of large states and 29 percent of union territories performed better in the ‘Governance and Information’ domain than any other domain. As per the report, forty-seven percent of large states, 88 percent of smaller states and 71 percent of union territories performed better in health outcomes than any other domain. It said that only 5 per cent of the large states and 12 per cent of the small states and no union territory performed best in the ‘key inputs and processes’ domain as compared to any other domain. The report has been prepared in collaboration with the Ministry of Health and Family Welfare (MoHFW) with technical assistance from the World Bank.
According to an official statement, the MoHFW’s decision to link the index to incentives under the National Health Mission re-emphasized the importance of this annual tool. It has played a key role in budget spending and shifting focus from inputs to outputs and outcomes.
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