State of Health in India

• The NITI Aayog’s health index is a useful tool even if there are flaws as it identifies areas of concern in health and public healthcare
• There is also scope to make the index more comprehensive.

State Health Index

• It was initiated by the NITI Aayog in 2017 in collaboration with the Ministry of Health and Family Welfare and the World Bank
• It ranks states across the three broad categories namely health outcomes, governance and information and key inputs/processes

Aim:

• To track progress on health outcomes and health systems performance, develop healthy competition and encourage cross-learning among states and UTs
• To guide states/UTs towards building robust health systems and to improve service delivery in the sector

Categories:

• The index has three categories as ‘Larger states ’, ‘Smaller states ’ and ‘Union Territories’.

Key findings:

• Kerala and Tamil Nadu are the two top-ranking states in category of Larger States
• Uttar Pradesh, Assam and Telangana are the top three ranking states In terms of annual incremental performance
• Mizoram has been ranked as the best performing state in this category in smaller States
• Mizoram and Meghalaya registered the maximum annual incremental progress.
• DH&DD (Dadra and Nagar Haveli and Daman and Diu) and Chandigarh have been ranked as the best performing among the UTs.
• Delhi showed the best incremental performance followed by Jammu & Kashmir

Other key takeaways:

• Kerala is on top and poll-bound Uttar Pradesh , which is at the bottom of the list,has registered the biggest incremental improvement over 2018-19, albeit over a low base in terms of government spending on health and bolstering health workforce
• Bihar recorded the highest fall in neonatal mortality rate (NMR), from 28 to 25, in the reference period over the base period; Kerala ranks 13th in this list where the NMR remained unchanged at 0,
• Eight of the larger states had managed to reduce delays between the base period and the reference period in efficiency on health spending while for the remaining the time taken to transfer had increased
• Punjab clocked the sharpest reduction in the time to transfer the funds from 342 days to 134 days, while Himachal Pradesh, at the bottom, recorded a worsening from 34 days to 186 days.

Shortcomings in the Index:

• This Index is useful but there is scope to make the index more comprehensive.
• The Index doesn’t assess states on mental health and non-communicable diseases (NCDs), both of which should be top concerns for policymakers.
• There is a grouping of states problem in the comparison according to some experts as they have disparate demographics and endemic epidemiological problems

Significance of the Index:

• The index gives us a picture of how far most of our states are from the desired levels of health and healthcare.
• It is a useful tool to identify areas of concern in health and public healthcare