New Delhi: Health indicators in India occupy two extremes. On the one hand, Kerala, Andhra Pradesh and Maharashtra ranked top on the basis of overall performance, while five states — Bihar, Uttar Pradesh, Uttarakhand, Madhya Pradesh and Odisha — saw a decline in the overall health index score and “only about half the states and UTs had an improvement in the overall score between 2015-16 and 2017-18, according to the second edition of health index launched by NITI Aayog on Tuesday.
The health index is a composite measure of states and union territories calculated on the basis of health indicators with weightages on the basis of outcome. In other words, the index is supposed to prove a comprehensive view of health outcomes, while taking into account the efficacy of governance, policies, processes and interventions.
The report was prepared in collaboration with the ministry of health and family welfare (MoHFW) and the World Bank.
The decline in the overall health index score for five Empowered Action Group (EAG) states or states that lag behind in demographic indicators and have high infant mortality rates — Bihar, UP, Uttarakhand, Madhya Pradesh and Odisha — is attributed to “deterioration of performance in several indicators”, the report said.
In Bihar, for instance, this was due to “performance related to total fertility rate, low weight, sex ratio at birth, TB treatment success rate, quality accreditation of public health facility and time-taken for NHM (National Health Mission) fund transfer,” it added.
In Uttar Pradesh, the decline was attributed to "low birth weight, TB treatment success rate, average tenure of key positions at state and district and level of birth registration."
In Odisha, the decline was attributed to the “worsening of the full immunisation rate and TB treatment success rate”, while in MP there has been a "reduction in level of birth registration and TB treatment success," added the report. In Uttarkhand, the report cited a decline in neonatal mortality, unstable administrative appointments and issues with NHM fund transfers.
The report pointed out that while Kerala and Tamil Nadu had “already reached the 2030 SDG (sustainable development goal) target for NMR (neonatal mortality rate)” with Maharashtra and Punjab close to achieving the target, “other states and UTs still need significant improvements to meet SDG targets”.
“Among the larger states, the overall health index score of the best performing state is more than two and half times of the overall score of the least performing state," said the report and pointed out that Kerala's score was 74.01, while UP had a score 28.61.
The report added that by and large, the degree of change in incremental scores or improvements from earlier years was greater in smaller UTs and states. But among the larger states, "Haryana, Rajasthan and Jharkhand" were the top three in terms of incremental performance.
Among the smaller states, Mizoram ranked first in overall performance, while Tripura and Manipur were top two states in terms of incremental performance. Among UTs, Chandigarh ranked top in overall performance, while Lakshwadeep, Andaman and Nicobar Islands and Delhi registered a decline in overall health index scores.