Health Index 2019 - NITI Aayog

Why in news?

The second edition of NITI Aayog’s Health Index was recently released in its report titled ‘Healthy States, Progressive India: Report on Rank of States and UTs’.

What is the index on?

• The Index ranks the States and Union Territories based on 23 health-related indicators which include –

1. neonatal mortality rate
2. under-five mortality rate
3. proportion of low birth weight among new-borns
4. progress in treating tuberculosis and HIV
5. full immunisation coverage
6. improvements to administrative capability and public health infrastructure
7. proportion of districts with functional Cardiac Care Units
8. proportion of specialist positions vacant at district hospitals

• The report has ranking in three categories - larger States, smaller States and Union Territories, to ensure comparison among similar entities.
• The Health Index does not capture other related dimensions, such as non-communicable diseases, infectious diseases and mental health.
• It also does not get uniformly reliable data, especially from the growing private sector.

What are the report highlights?

• Kerala continued to top the list for the best performing State in the health sector among the 21 large States.
• Kerala was followed by Andhra Pradesh, Maharashtra, Gujarat and Punjab, Himachal Pradesh, Jammu and Kashmir, Karnataka and Tamil Nadu.
• Andhra Pradesh and Maharashtra have had the additional distinction of making incremental progress from the base year.
• Uttar Pradesh retains the worst performer tag in the index.
• Uttar Pradesh continued to be at the bottom of the list with its score falling to 28.61; Kerala got a score of 74.01.
• Other States at the bottom of the list are Bihar (32.11), Odisha (35.97) and Madhya Pradesh (38.39).
• Among the UTs, Chandigarh jumped one spot to top the list with a score of (63.62).
• It is followed by Dadra and Nagar Haveli, Lakshadweep, Puducherry, Delhi, Andaman and Nicobar and Daman and Diu (41.66).
• Overall, only about half the States and UTs showed an improvement in the overall score between 2015-16 (base year) and 2017-18 (reference year).
• Among the 8 Empowered Action Group States, only 3 States (Rajasthan, Jharkhand and Chhattisgarh) showed improvement in the overall performance.

What does the trend imply?

• Some States and Union Territories are doing better on health and well-being even with a lower economic output.
• In contrast, others are not improving upon high standards, and some are actually slipping in their performance.
• In the assessment during 2017-18, a few large States showed less encouraging progress.
• This reflects the low priority their governments have accorded to health and human development since the first edition of the ranking for 2015-16.
• The disparities are very evident in the rankings, with the populous and politically important Uttar Pradesh being in the bottom of the list.

What is the way forward?

• For the Health Index concept to encourage States into action, public health must become part of the mainstream politics.
• The Centre has paid attention to tertiary care and reduction of out-of-pocket expenses through financial risk protection initiatives such as Ayushman Bharat.
• But several States lag behind when it comes to creating a primary health care system with well-equipped PHCs (Primary Health Centres) as the unit.
• Neglect of such a reliable primary care approach affects States such as Bihar where infant and neonatal mortality and low birth weight are high.
• Special attention is needed to raise the standards of primary care in low performing states such as Odisha, Madhya Pradesh, Uttarakhand, Rajasthan, Assam and Jharkhand.
• State governments now have greater resources at their command under the new scheme of financial devolution.
• So States, in partnership with the Centre, must use the funds to upgrade and transform the primary health care.

Source: The Hindu