NITI Aayog's Health Index

Why in news?

NITI Aayog recently released a comprehensive Health Index report titled “Healthy States, Progressive India”.

What is the report on?

It ranks all states and Union territories based on their year-on-year incremental change and overall performance in health.
All States and UTs have been ranked in three categories to ensure comparison among similar entities.
They are accordingly Larger States, Smaller States, and Union Territories (UTs).
The report has been developed by NITI Aayog with technical assistance from the World Bank.
Ministry of Health and Family Welfare (MoHFW) was also consulted in the process.
The report is the first attempt to establish an annual systematic tool to measure and understand the nation’s health performance.

What are the highlights?

Larger States - The Health Index is a weighted composite Index, which for the larger States, is based on indicators in three domains.
These are Health Outcomes (70%), Governance and Information (12%) and Key Inputs and Processes (18%).

Among the Larger States, Kerala, Punjab and Tamil Nadu ranked on top in terms of overall performance.
Jharkhand, Jammu & Kashmir, and Uttar Pradesh ranked as top three States in terms of annual incremental performance.
Some of the indicators for incremental performance ranking include:

Uttar Pradesh, Rajasthan, Bihar, Odisha and Madhya Pradesh occupied the bottom ranks.
Odisha is estimated to have the highest neonatal mortality rate at 35 per thousand live births.

Smaller States - Among Smaller States, Mizoram ranked first followed by Manipur on overall performance.
In terms of annual incremental performance Manipur ranked top followed by Goa.
Manipur registered maximum incremental progress on indicators such as:

UTs - Among UTs, Lakshadweep showed best overall performance as well as the highest annual incremental performance.
It showed the highest improvement in indicators such as:

institutional deliveries
tuberculosis (TB) treatment success rate
transfer of National Health Mission (NHM) funds from State Treasury to implementation agency

What does it imply?

Trend - Clearly, States with a record of investment in literacy, nutrition and primary health care have achieved high scores.
States and UTs that start at lower levels of development are generally at an advantage in notching up incremental progress.
Whereas for States with high Health Index scores, it is a challenge to even maintain their performance levels.
E.g. Kerala ranks on top in terms of overall performance but sees the least incremental change.
However, the incremental measurement reveals that about one-third of States have registered a decline in their performance in 2016 as compared to 2015.
Significance - Health-care delivery is the responsibility of States, with Centre providing the financial and policy support.
States’ performance in health is crucial for meeting the Sustainable Development Goals over the coming decade.

The Index hopes to make a difference by leveraging co-operative and competitive federalism for potentially better health outcomes.

What does it call for?

Intra-State inequalities in health performance have to be addressed.
Both the Centre and the States have to scale up their investment on health as a percentage of their budgets.
The findings stress the need for pursuing domain-specific, targeted interventions.
Common challenges for most States and UTs include the need to focus on:

Additionally, almost all Larger States need to focus on improving the Sex Ratio at Birth (SRB).
The index could be linked to incentives offered under the National Health Mission by the Ministry of Health and Family Welfare.

Source: PIB, The Hindu