For the fourth year in a row, Kerala has topped a ranking of States on health indicators; Uttar Pradesh has come in at the bottom. The ‘Health Index’ is part of a report commissioned by the NITI Aayog, World Bank and Ministry of Health and Family Welfare.
Kerala was followed by Tamil Nadu and Telangana.
The Health Index score is prepared based on States’ performance across a large set of indicators that are divided into three broad domains — health outcomes, governance and information, and key inputs and processes.
Range of indicators
Health outcomes, for instance, includes parameters such as neonatal mortality rate, under-5 mortality rate, sex ratio at birth. Governance includes parameters such as institutional deliveries, average occupancy of senior officers in key posts earmarked for health. And the ‘key inputs’ domain consists of proportion of shortfall in health care providers to what is recommended, functional medical facilities, birth and death registration and tuberculosis treatment success rate.
Several States are significantly better in one domain suggesting that there was scope to improve their performance in the other domains with specific targeted interventions. For instance, 47% of States showed the highest performance in health outcomes and governance and information domains and only one State showed the highest performance in the key inputs and processes domain. The better performing States such as Kerala, Tamil Nadu, Telangana, Andhra Pradesh and Maharashtra performed comparatively better on the health outcomes domain, but performed badly on key inputs and processes, the report notes.
Ten States including Kerala, Tamil Nadu, Maharashtra, Chhattisgarh, Haryana, Jharkhand, Rajasthan, Madhya Pradesh, Bihar and Uttar Pradesh retained their rank while four States improved their rankings from the base year-to-reference year.
Telangana moves up
Telangana improved its position from fourth to third, Gujarat from seventh to sixth, and Punjab from ninth to eighth. The most significant progress was observed in Assam as it improved its ranking by three positions, from 15 to 12.
However, five States recorded a decline in their ranking . Odisha had the steepest decline of two positions, while the ranking of Andhra Pradesh, Himachal Pradesh, Karnataka and Uttarakhand declined by one position each.
