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NEW DELHI : The southern trio of Kerala, Tamil Nadu and Telangana are the best performers in healthcare among large states, while last year’s laggard, Uttar Pradesh, continues to languish at the bottom of the table, according to the latest rankings by NITI Aayog, the health ministry and World Bank.

The Healthy States Progressive India report, released on Monday, said Kerala was the topper in overall performance for the fourth consecutive round. Uttar Pradesh, which ranked at the bottom among 19 large states in last year’s and this year’s ranking, topped in the latest report in terms of incremental performance.

Uttar Pradesh improved its overall score, topping in ‘incremental improvement’ in health outcomes such as maternal, neonatal and child mortality rate, immunization coverage, the sex ratio at birth and tuberculosis treatment success rate.

On the other hand, the top two overall performers—Kerala and Tamil Nadu—ranked 12th and eighth, respectively, in incremental performance from the previous ranking.

Telangana came third in both overall and incremental performance.

Among smaller states, Mizoram emerged as the best in overall as well as incremental performance. Among Union territories, Delhi and Jammu and Kashmir emerged leaders in incremental performance, although they ranked among the bottom in overall performance. Dadra and Nagar Haveli and Daman and Diu and Chandigarh were the top overall performers.

The health index is a weighted composite score, incorporating 24 indicators covering key aspects of health performance.

For a vast majority of the states and Union territories, there has been a shift in overall performance ranking from 2018-19 to 2019-20. Among the 19 large states, four improved their rankings while five states slipped, and 10 retained their base year (2018-19) ranks.

Assam made the most improvement among smaller states by moving up three ranks (from 15 to 12) while Andaman and Nicobar registered the maximum drop in rank, down from fourth to seventh place, the report showed.

A “robust and acceptable mechanism" is used for measuring performance, and data is collected online through a portal maintained by NITI, said the policy think tank.

“States are beginning to take cognizance of indices such as the state health index and use them in policymaking and resource allocation. This report is an example of both competitive and cooperative federalism," the NITI Aayog said, citing vice-chairman Rajiv Kumar.

The index’s objective is not just to look at states’ historical performance but also assess their incremental performance, and it encourages healthy competition and cross-learning among states and Union territories, NITI Aayog chief executive officer Amitabh Kant said.

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