CHANDIGARH HAS bagged the top position among Union Territories in the Health Index report released by NITI Aayog, but has performed poorly behind in certain key parameters. In terms of overall performance, it scored 63.62 points. In terms of incremental performance (2015-16 to 2017-18), it emerged as the most improved UT.
In 2017, NITI Aayog, in collaboration with the World Bank and ministry of health and family welfare (MoHFW), had decided to develop the first comprehensive State Health Index, and published the first edition of Healthy States, Progressive India Report on the Ranks of States and Union Territories to bring about a transformational change in the health of people in India. Around 23 indicators were considered while calculating the health index.
In the category of vacant specialist positions in district hospitals, Chandigarh s situation was the most deteriorated with 11.36 points. In the category of Proportion of low birth weight among newborns , Chandigarh got the deteriorated tag under the incremental indicator performance with 0.12 points only.
Under the Full immunisation coverage category, the city got the most deteriorated tag with a score of -10.18 under the incremental indicator performance. Even in the category of average occupancy of a district chief medical officer in the last three years, the city s performance had deteriorated with a score of -6.60.
However, in terms of overall performance, Chandigarh remained at the top rank. The report stated, The rankings changed completely in the Reference Year compared to the Base Year. Three UTs, namely Chandigarh, Dadra and Nagar Haveli, and Puducherry improved their rankings from Base Year to Reference Year. Chandigarh moved from second to first position.
Based on the composite Index score range for Reference Year (2017-18), the UTs were categorised into three categories: aspirants, achievers, and frontrunners.
The incremental progress had indicators such as full immunisation, institutional deliveries, TB notification rate, TB treatment success rate, average occupancy of state-level key positions and district CMOs, vacancy of staff nurses and specialists, CCUs, first trimester ANC registrations, birth registration, IDSP reporting, quality accreditation of facilities and funds transfer.
The report specified that the indicators where most UTs need to focus include full immunisation, average occupancy of state-level key positions and district CMOs, filling vacancies of specialists at district hospitals, functional 24×7 PHCs and quality accreditation of public health facilities.
Based on administrative data from the MoHFW, only six states and UTs (including Chandigarh) had more than 90 per cent deliveries conducted in private or public health facilities.
The overall performance of UTs had a criteria of domain-specific performance. In the domains of health outcomes, key inputs and processes, Chandigarh was among 4 UTs that had improved in terms of performance. Chandigarh scored highest with 75.3 points, while Delhi scored the lowest with 31.8 points.
As per the report, short average occupancy of district CMO hinders effective implementation of key public health programmes and it was a key indicator in the report. Of the 36 states and UTs, 28 had an average occupancy of 12 months or more for CMOs (or equivalent post heading the health services at the district level) and Chandigarh was among the seven states/UTs that had less than 23 months of average CMO occupancy .
A functioning Cardiac Care Unit (CCU) was an important indicator of the ability of the health system to provide life-saving and critical procedures and interventions. It was stated that there was significant improvement in Chandigarh under this category.