Public Health And Vital Statistics, India: 2014-2016
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Health indicators (state-wise)
2014>16
From: Mahendra Singh, Six out of 21 big states show decline in health indicators, February 10, 2018: The Times of India
Most-Improved UP Still Last On List: Niti Index
Six of India’s 21 largest states registered a decline in health indicators between 2014-15 and 2015-16 though most improved, a Niti Aayog report ranking states on health parameters showed. While those slipping included top ranked Kerala, what was worrying was that they also included Haryana and Uttarakhand, which were already quite low in the rankings.
Uttar Pradesh was the worst performer among the 21 states as per the Aayog’s Health Index Rankings. Kerala, unsurprisingly, was on top followed by Punjab and Tamil Nadu. The good news for UP was that it was among the three most improved states, though still at the bottom. Jharkhand and J&K registered even better improvements in their scores, but Jharkhand still remained in the bottom half of the rankings at No.14, while Jammu & Kashmir was ranked 7.
The poor show on overall ranking and slow pace of improvement on the health front reflects the massive challenge before UP chief minister Yogi Aditya Nath, who came to power in March 2017, to push the state machinery into action to catch up with performers on critical heath parameters.
The performance of states was judged on health outcomes from base year (2014-15) to reference year (2015-16) on indicators such as neonatal mortality rate, under-five mortality rate, full immunisation coverage, institutional deliveries and people living with HIV on anti-retroviral therapy. The ranking is a weighted composite index based on indicators in three domains — health outcomes (70% weightage), governance and information (12%), and key inputs and processes (18%).
The ‘Healthy States, Progressive India’ report noted that states that started at lower levels of development were generally at an advantage in notching incremental progress over states with high health index scores. “It is a challenge for states with high index scores to even maintain their performance levels,” it said. In that context, Punjab’s performance was creditable as it jumped three places to knock Tamil Nadu off from second place.
Ranking was done in three categories — larger states, smaller states and Union Territories — to ensure comparison among similar entities.
Some specific details, state-wise
February 9, 2018: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
From: Press Information Bureau
See graphics:
1. Rigorous process followed in calculating Healthy States, Progressive India Report, published in February 2018
2. Larger states, overall performance in Healthy States, Progressive India Report, published in February 2018
3. Larger states, overall and incremental performance in Healthy States, Progressive India Report, published in February 2018
4. Larger states, categorisation on incremental and overall performance in Healthy States, Progressive India Report, published in February 2018
5. Helping larger states understand their performance in Healthy States, Progressive India Report, published in February 2018
6. Smaller states, overall performance in Healthy States, Progressive India Report, published in February 2018
7. Smaller states, overall and incremental performance in Healthy States, Progressive India Report, published in February 2018
8. Union Territories, overall performance in Healthy States, Progressive India Report, published in February 2018
9. Union Territories, overall and incremental performance in Healthy States, Progressive India Report, published in February 2018
10. Smaller states and Union Territories, categorisation on incremental and overall performance in Healthy States, Progressive India Report, published in February 2018
NITI Aayog releases “Healthy States, Progressive India” Report
Kerala, Punjab & Tamil Nadu ranked on top in terms of overall performance Jharkhand, Jammu & Kashmir, and Uttar Pradesh ranked top three States in terms of annual incremental performance
NITI Aayog released today a comprehensive Health Index report titled, “Healthy States, Progressive India” at a function in the capital today. The report ranks states and Union territories innovatively on their year-on-year incremental change in health outcomes, as well as, their overall performance with respect to each other. The report was released jointly by the CEO, NITI Aayog; Amitabh Kant, Secretary, Ministry of Health & Family Welfare; Preeti Sudan and World Bank India Country Director, Junaid Ahmad. It is the first attempt to establish an annual systematic tool to measure and understand the heterogeneity and complexity of the nation’s performance in Health. The report has been developed by NITI Aayog, with technical assistance from the World Bank, and in consultation with the Ministry of Health and Family Welfare (MoHFW),
States and UTs have been ranked in three categories namely, Larger States, Smaller States, and Union Territories (UTs), to ensure comparison among similar entities. The Health Index is a weighted composite Index, which for the larger States, is based on indicators in three domains: (a) Health Outcomes (70%); (b) Governance and Information (12%); and (c) Key Inputs and Processes (18%), with each domain assigned a weight based on its importance.
Among the Larger States, Kerala, Punjab, and Tamil Nadu ranked on top in terms of overall performance, while Jharkhand, Jammu & Kashmir, and Uttar Pradesh are the top three ranking States in terms of annual incremental performance. Jharkhand, Jammu & Kashmir, and Uttar Pradesh showed the maximum gains in improvement of health outcomes from base to reference year in indicators such as Neonatal Mortality Rate (NMR), Under-five Mortality Rate (U5MR), full immunization coverage, institutional deliveries, and People Living with HIV (PLHIV) on Anti-Retroviral Therapy (ART).
Among Smaller States, Mizoram ranked first followed by Manipur on overall performance, while Manipur followed by Goa were the top ranked States in terms of annual incremental performance. Manipur registered maximum incremental progress on indicators such as PLHIV on ART, first trimester antenatal care (ANC) registration, grading quality parameters of Community Health Centres (CHCs), average occupancy of key State-level officers and good reporting on the Integrated Disease Surveillance Programme (IDSP).
Among UTs, Lakshadweep showed both the best overall performance as well as the highest annual incremental performance. Lakshadweep showed the highest improvement in indicators such as institutional deliveries, tuberculosis (TB) treatment success rate, and transfer of National Health Mission (NHM) funds from State Treasury to implementation agency.
The Health Index report notes that while States and UTs that start at lower levels of development are generally at an advantage in notching up incremental progress over States with high Health Index scores, it is a challenge for States with high Index scores to even maintain their performance levels. For example, Kerala ranks on top in terms of overall performance but sees the least incremental change as it had already achieved a low level of Neonatal Mortality Rate (NMR) and Under-five Mortality Rate (U5MR) and replacement level fertility, leaving limited space for any further improvements.
However, the incremental measurement reveals that about one-third of the States have registered a decline in their performance in 2016 as compared to 2015, stressing the need to pursue domain-specific, targeted interventions. Common challenges for most States and UTs include the need to focus on addressing vacancies in key staff, establishment of functional district Cardiac Care Units (CCUs), quality accreditation of public health facilities and institutionalization of Human Resources Management Information System (HRMIS). Additionally, almost all Larger States need to focus on improving the Sex Ratio at Birth (SRB).
Linking this Index to incentives under the National Health Mission by the Ministry of Health and Family Welfare underlines the importance of such an exercise. The report also notes that rich learnings have emerged in the first year and these will guide in refining the Index for the coming year and also address some of the limitations. It notes that there is an urgent need to improve data systems in the health sector, in terms of terms of representativeness of the priority areas, periodic availability for all States and UTs, and completeness for private sector service delivery. This Index is expected to nudge States towards further achieving a rapid transformation of their health systems and population health outcomes.
Health Index has been developed as a tool to leverage co-operative and competitive federalism to accelerate the pace of achieving health outcomes. It would also serve as an instrument for “nudging” States & Union Territories (UTs) and the Central Ministries to a much greater focus on output and outcome based measurement of annual performance than is currently the practice. With the annual publication of the Index and its availability on public domain on a dynamic basis, it is expected to keep every stakeholder alert to the achievement of Sustainable Development Goals (SDGs) Goal number 3.
The process of index refinement involved inputs from the States and UTs, national and international sector experts, and development partners. Data submitted by the States & UTs was validated by an Independent Validation Agency, following which index values and ranks were generated on the web portal (http://social.niti.gov.in), and certified by the Independent Agency.
See also
Public Health And Vital Statistics: India
Public Health And Vital Statistics, 1909: India
Public Health And Vital Statistics, India: 2014-2016
Public Health And Vital Statistics, India: 2016-2017
Public Health And Vital Statistics, India: 2017-2018
Healthcare and public health: Delhi
...and on several other states
