Kerala tops the list of large States in overall health performance based on the health index released by NITI Aayog on Friday as part of its ‘Healthy States, Progressive India’ report.

Punjab and Tamil Nadu were ranked second and third among 21 large States evaluated on the basis of various health indicators such as neonatal mortality rates, under-five mortality rate, full immunisation coverage and institutional deliveries.

Jharkhand, J&K and Uttar Pradesh are top-three ranking States in terms of annual incremental performance, according to the report. “It is also important to rank States on the basis of the improvement they have achieved,” Amitabh Kant, CEO, NITI Aayog, pointed out while releasing the report. The next health report on States’ performance will be released in June and district hospitals too would be ranked, Kant said. “We would take out the ranking of 730 district hospitals based on their performance. We want to encourage the good performers and name and shame those who don’t,” he said.

Best performance

Among small States, Mizoram ranked first followed by Manipur on overall performance, while Manipur followed by Goa were the top- ranked States in the annual incremental performance.

Developed by NITI Aayog, with technical assistance from the World Bank, and in consultation with the Health Ministry, the health index ranks States and Union Territories on their year-on-year incremental change in health outcomes as well as their overall performance with respect to each other.

The health index is a weighted composite index, which for the large States, is based on indicators in three domains: health outcomes (70 per cent), governance and information (12 per cent) and key inputs and processes (18 per cent).

Among UTs, Lakshadweep showed both the best overall performance as well as the highest annual incremental performance. The incremental measurement revealed that about one-third of the States, including the top-ranked Kerala, have registered a decline in their performance in 2016 as compared to 2015, stressing the need to pursue domain-specific, targeted interventions. However, the report also noted that it is a challenge for States with high index scores to even maintain their performance levels while it is much easier for States with low levels of development to notch up high incremental changes.

Common challenges for most States and UTs include the need to focus on addressing vacancies in key staff, establishment of functional district Cardiac Care Units, quality accreditation of public health facilities and institutionalisation of Human Resources Management Information System.

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