Uttar Pradesh (UP) continued to be the worst state in terms of overall performance in the second NITI Aayog health index, while Kerala grabbed the top spot for the second successive time.
The Ministry of Health has decided to link a part of National Health Mission (NHM) funds to the progress achieved by states on this index.
The 2018 report also showed that Bihar, which saw a spate of child deaths because of the encephalitis virus that was blamed on the poor primary health care facilities in the state, continued to remain at the bottom of the ranking, just like UP.
When the index was first released in 2017, Bihar was ranked 19 of 21 states, while in the latest ranking it has slipped one notch to be ranked at 20 of 21 states, just above UP. “For Bihar, the deterioration between base year and reference year was primarily due to the performance related to total fertility rate, low birth weight, sex ratio at birth, TB treatment success rate, quality accreditation of public health facilities, and time-taken for National Health Mission fund transfer,” the report said.
While in the case of Uttar Pradesh the performance related to low birth weight, TB treatment success rate, average tenure of key positions at state and district level and level of birth registration accounted for the deterioration, it added. The report also showed that Tamil Nadu slid from third position in 2017 to ninth, while Punjab slipped from second position to the fifth.
Among larger states, Haryana, Rajasthan and Jharkhand were the top three in terms of incremental performances, according to the report.
In the 2017 Health Index Report, the base year was 2014-15 and reference year was 2015-16, while in the 2018 report, 2015-16 was the base year while 2017-18 the reference year.
Both the reports ranked states on 23 major indicators that were grouped into domains such as health outcomes, governance and information, and key inputs/processes. Each was assigned different importance, with outcomes carrying more weight.
States had to fill in the responses in a specially created dashboard while a number of responses were pre-filled while sourced from National Family Health Survey-4 and Health Management Information System. Available state reports were also relied for getting some of the responses.