UP last again in NITI Aayog Health Index 2019-20, Kerala tops ranking

As good news, India's most populous state shows highest incremental performance between 2018-19 and 2019-20.

Poll-bound Uttar Pradesh has once again figured at the bottom of 19 large states on the fourth NITI Aayog health index for 2019-20, released on Monday.

Kerala, Tamil Nadu, and Telangana are the top three, which means for four times in a row Kerala has emerged the best in overall health performance.

Bihar and Madhya Pradesh were the second- and third-worst performers, respectively (see chart).

For generating ranks and ensuring comparability among entities, the entities have been classified into three categories (larger states, smaller states, and Union Territories) in the index.

All the states and Union Territories (UTs) except West Bengal participated. Ladakh was not included owing to the non-availability of data.

The rankings, which pertain to the period just before the pandemic struck the country, showed though figuring at the bottom of the heap in overall performance, UP is the best state in terms of incremental performance between 2018-19 and 2019-20. Soon after the NITI Aayog report, SP chief Akhilesh Yadav attacked the Yogi Adityanath government in the poll-bound state, saying it is the “real report” of the BJP government.

The index is a weighted composite score incorporating 24 indicators covering key aspects of health performance, largely in three domains: Health outcomes; governance and information; and key inputs and processes.

The indicators are selected from data sources such as the Sample Registration System (SRS), Civil Registration System (CRS), and Health Management Information Systems (HMIS).

“The Health Index Round for 2019-20 does not capture the impact of Covid-19 on health outcomes or any of the other indicators as the Index Performance relates to Base Year (2018-19) and Reference Year (2019-20), largely the pre-Covid-19 period,” the report said.

The index showed though Kerala and Tamil Nadu were the top two, they ranked 12th and eighth, respectively, when it came to incremental improvement.

Telangana performed well both in terms of overall as well as incremental performance and secured third place on both counts.

Among the smallest states, Mizoram emerged the best performer in overall as well as incremental performance while among UTs, Delhi and Jammu and Kashmir ranked among the bottom in terms of overall performance but emerged the leading performers in incremental performance.

The index showed that the gap in overall performance between the best- and the worst-performing larger states and UTs narrowed in the current round of the health index, while it increased for the smaller states.

Releasing the report, NITI Aayog Vice-Chairman Rajiv Kumar said: “States are beginning to take cognizance of indices such as the State Health Index and use them in their policymaking and resource allocation.”

This report is an example of both competitive and cooperative federalism, Kumar added.

It has been prepared in collaboration with the Ministry of Health and Family Welfare (MoHFW) with technical assistance from the World Bank.

According to an official statement, the importance of this annual tool was re-emphasised by the ministry’s decision to link the index to incentives under the National Health Mission.

This has been instrumental in shifting the focus from budget spending and inputs to outputs and outcomes, it added.