New Delhi: Kerala took the top spot among larger states for overall performance on health indicators in a NITI Aayog report, followed by Andhra Pradesh and Maharashtra, while Uttar Pradesh, Bihar, and Odisha languish at the bottom.
The Kerala government takes health concerns very seriously, according to the second edition of the Healthy States, Progressive India report released by NITI Aayog on Tuesday.
The report focuses on measuring and highlighting the overall performance and incremental improvement over a two-year period (2016-17 and 2017-18) in the states and the Union territories (UTs), which are categorised as larger states, smaller states and UTs, to ensure comparison among similar entities.
Haryana, Rajasthan and Jharkhand showed the maximum improvement of health outcomes from base to reference year in indicators such as neonatal mortality rate (NMR), under-five mortality rate (U5MR), proportion of low birth weight among newborns, proportion of community health centres and public health centres with quality accreditation certificates, full immunization coverage, institutional deliveries, and proportion of specialist positions vacant at district hospitals.
“The country will need to spend at least 2.5% of its gross domestic product on health. The state governments should also scale up their health spends from an average of 4.7% to 8% of their budget," said Vinod Kumar Paul, member, NITI Aayog.
The report highlighted a decline in the overall health index score of the five empowered action group (EAG) states of Bihar, Uttar Pradesh, Uttarakhand, Madhya Pradesh, and Odisha because of deterioration in various parameters.
“In Bihar, the deterioration between the base year and the reference year was primarily because of the performance related to total fertility rate, low birth weight, sex ratio at birth, tuberculosis (TB) treatment success rate, quality accreditation of public health facilities, and the time taken for NHM (National Health Mission) fund transfer," the report said.
“Bihar or Odisha would take some more time to catch up. More investment in developing healthcare infrastructure along with skilled human resources and with better health governance would pay dividends in the coming years," said Dinesh Aggarwal, senior technical advisor, health, nutrition and Wash from IPE Global, a health and development consultancy.
“Also, Bihar has a significantly high vacancy rates for doctors in the public health system resulting in total dependence on medical colleges or district hospitals, which turn out to be congested," he said.
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. Among the UTs, Chandigarh ranked first in overall performance, while Dadra and Nagar Haveli improved the most.
The health index has been developed by NITI Aayog, with technical assistance from the World Bank, in consultation with the ministry of health and family welfare.