The second round of the Niti Aayog Health Index took into account healthcare performance of states between 2015-16 and 2017-18. (Photographer: Prashanth Vishwanathan/Bloomberg)

Kerala Tops Niti Aayog’s Health Index Again, Uttar Pradesh Fares Worst

Kerala retained its spot as the healthiest state on the Niti Aayog’s state-wise healthcare rankings while Uttar Pradesh stood at the bottom.

Kerala was followed by Andhra Pradesh and Maharashtra in terms of overall performance in the health sector, according to a Niti Aayog’s report titled ‘Healthy States Progressive India: Report on Rank of States and UTs.

While Gujarat, Punjab and Himachal Pradesh stood at fourth, fifth and sixth spots, the report ranked Haryana, Rajasthan and Jharkhand as the top three states in terms of incremental performance.

The health index is a composite score incorporating 23 health indicators such as neonatal mortality rate, sex ratio at birth, average occupancy for an officer (in months), proportion of vacant health care provider positions in public health facilities etc.

The government’s think tank had first come out with its state-wise health rankings in in February 2018. The index, known as Health Index-2017, measured the annual and incremental performance of states and union territories over financial year 2014-15 (base year) to 2015-16 (reference year).

The second round of health index referred to as Health Index-2018 examined the overall performance and incremental performance in the states and union territories for the period 2015-16 (base year) to 2017-18 (reference year).

The ranking was done under three categories—large states, small states and union territories—to ensure comparison among similar entities.

Among larger states, seven of the top 10 states continued to improve their health index scores from the base year to the reference year whereas scores of several least performing states further deteriorated.

Larger states that improved their rankings include Andhra Pradesh, Maharashtra, Gujarat, Himachal Pradesh, Jammu and Kashmir, Karnataka and Telangana.

Least Performing States

Among the least performing states, overall health scores of Uttar Pradesh, Bihar, Odisha, Madhya Pradesh and Uttarakhand declined during the period. Rajasthan, however, was the only outlier in the category as it improved its score by 6.3 points. The decline in overall health index score for the five states between the base year and the reference year was due to the deterioration of performance on several indicators, the report said.

For instance, in Bihar, the deterioration between the base year and reference year was primarily due to the performance related to total fertility rate, low birth weight, sex ratio at birth, Tuberculosis treatment success rate, quality accreditation of public health facilities and time taken for National Health Mission Transfer.

While in the case of Uttar Pradesh, the performance related to low birth weight, tuberculosis treatment success rate, average tenure of key positions at state and district level and level of birth registration accounted for the deterioration.

Smaller States

Among the smaller states, Mizoram ranked first in overall performance, while Tripura and Manipur were the top-two states in terms of incremental performance. Sikkim and Arunchal Pradesh had the biggest decrease in overall health index scores.

Union Territories

Among union territories, Chandigarh ranked first in overall performance, while Dadra and Nagar Haveli improved the most.

Niti Aayog Member Vinod Kumar Paul said the government should spend 2.5 percent of gross domestic product on healthcare in India. “And state governments should increase their spending on health from an average of 4.7 percent to 8 percent of their budget (net state domestic product) on health,” Paul said.

Niti Ayog, in collaboration with the Ministry of Health and Family Welfare and World Bank, had launched the health index to motivate states to improve key health indicators.

(With Inputs From PTI)

Bloomberg Quint

Add BloombergQuint App to Home screen.