Fourth Edition of State Health Index

• 28 Dec 2021

For Prelims: About the Index, Ranking of States.

For Mains: Challenges of the Health Sector in India and Initiatives taken to address it

Why in News

NITI Aayog has released the fourth edition of the State Health Index for 2019–20.

• The report, titled “Healthy States, Progressive India”, ranks states and Union Territories on their year-on-year incremental performance in health outcomes as well as their overall status.
• Earlier, the Global Health Security (GHS) Index 2021, developed in partnership by the Nuclear Threat Initiative (NTI) and the Johns Hopkins Center was released. India, with a score of 42.8 (out of 100) has slipped by 0.8 points since 2019.

Key Points

• About:
  • The State Health Index is an annual tool to assess the performance of states and UTs, which has been compiled and published since 2017.
  • It is a weighted composite index based on 24 indicators grouped under the domains of ‘Health Outcomes’, ‘Governance and Information’, and ‘Key Inputs/Processes’.
    • Health Outcomes:
      • It includes parameters such as neonatal mortality rate, under-5 mortality rate, sex ratio at birth.
    • Governance and Information:
      • It includes parameters such as institutional deliveries, average occupancy of senior officers in key posts earmarked for health.
    • Key Inputs/Processes:
      • It consists of proportion of shortfall in health care providers to what is recommended, functional medical facilities, birth and death registration and tuberculosis treatment success rate.
• Developed By:
  • NITI Aayog, with technical assistance from the World Bank, and in close consultation with the Ministry of Health and Family Welfare (MoHFW).
• Focus of the Fourth Edition:
  • Round IV of the report focuses on measuring and highlighting the overall performance and incremental improvement of states and UTs over the period 2018–19 to 2019–20.
• Ranking of States:
  • To ensure comparison among similar entities, the ranking is categorized as:
    • Larger States:
      • In terms of annual incremental performance, Uttar Pradesh, Assam and Telangana are the top three ranking states.
    • Smaller States:
      • Mizoram and Meghalaya registered the maximum annual incremental progress.
    • Union Territories:
      • Delhi, followed by Jammu and Kashmir, showed the best incremental performance.
    • Overall:
      • The top-ranking states were Kerala and Tamil Nadu among the ‘Larger States’, Mizoram and Tripura among the ‘Smaller States’, and Dadra and Nagar Haveli and Daman and Diu (DH&DD) and Chandigarh among the UTs.

• Significance of the Index:
  • Policymaking:
    • States use it in their policy making and resource allocation.
      • This report is an example of both competitive and cooperative federalism.
  • Healthy Competition:
    • The index encourages healthy competition and cross-learning among States and UTs.
    • The aim is to nudge states/UTs towards building robust health systems and improving service delivery.
  • Helpful in Achieving SDGs:
    • The exercise is expected to help drive state and union territories' efforts towards the achievement of health-related Sustainable Development Goals (SDGs) including those related to Universal Health Coverage (UHC) and other health outcomes.
  • Role in National Health Mission:
    • The importance of this annual tool is reemphasized by MoHFW’s decision to link the index to incentives under the National Health Mission.
• Limitations of the Index:
  • Not Covered Critical Areas:
    • Some critical areas such as infectious diseases, noncommunicable diseases (NCDs), mental health, governance, and financial risk protection are not fully captured in the Health Index due to non-availability of acceptable quality of data on an annual basis.
  • Limited Data:
    • For several indicators, the data is limited to service delivery in public facilities due to paucity and uneven availability of private sector data on health services.
      • For outcome indicators, such as Neonatal Mortality Rate, Under-five Mortality Rate, Maternal Mortality Ratio and Sex Ratio at Birth, data are available only for Larger States.
  • Without any Field Verification:
    • For several indicators, Health Management Information System (HMIS) data and programme data were used without any field verification due to the lack of feasibility of conducting independent field surveys.

Related Initiatives

• National Health Mission (NHM)
• Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)
• Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
• Pradhan Mantri Bhartiya Janaushadhi Pariyojana.
• Ayushman Bharat Digital Mission

Source: PIB