Kerala tops Niti Aayog's health ranking, UP worst performer

New Delhi: In a major setback to Uttar Pradesh government, which is led by Chief Minister Yogi Adityanath, the state has been ranked lowest on health index by the government's think tank Niti Aayog. Sadly, the state has been adjudged as worst on health index for the second successive year.

According to the Niti Aayog report, which was released on Tuesday, Kerala stand at the top followed by Andhra Pradesh and Maharashtra in terms of overall performance, while Haryana, Rajasthan and Jharkhand are the top three ranking states in terms of annual incremental performance.

Besides UP, as per the think tank's report, the states that performed worst on health index are Bihar, Odisha and Madhya Pradesh. The health index is a composite measure of states and Union Territories based on 23 health indicators with major weightage to the outcomes.

The states of Haryana, Rajasthan and Jharkhand showed the maximum gains in the improvement of health outcomes from base to reference year. The first ranking was released for the period of 2014-15 to 2015-16 and the second health index ranking has been released for the period of 2015-16 to 2017-18.

The states performance has been adjudged on the basis of health indicators such as neonatal mortality rate (NMR), under-five mortality rate (U5MR), proportion low birth weight among new-borns, proportion of districts with functional cardiac care units (CCUs), proportion of ANCs registered within first trimester, proportion of CHCs/PHCs with quality accreditation certificates, full immunisation coverage, institutional deliveries, proportion of specialist positions vacant at district hospitals and proportion of total staff (regular and contractual) with e-pay slip generated in the IT-enabled human resources management information system.

It's worth mentioning that West Bengal government has also performed well on health index as the state is ranked 11 in overall performance. As West Bengal had not submitted data on the portal, so the overall and incremental performance scores of the state were generated on the basis of pre-filled indicator data for 12 indicators and for the remaining 11 indicators, the data from the base year were repeated for the reference year, Aayog report stated.

Kerala championed the larger states with an overall score of 74.01, while Uttar Pradesh was the least performing state with an overall score of 28.61. Among the smaller states, scores varied between 38.51 in Nagaland and 74.97 in Mizoram, while among the UTs, the scores varied between 41.66 in Daman and Diu to 63.62 in Chandigarh.

"Overall, there is room for improvement in all states, even among the best-performing states there is substantial room for improvement," the report said, adding that among the least performing states/UTs, there is an urgent need to accelerate efforts to narrow the performance gap between states and UTs.

In Bihar, the deterioration between the base year and the 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 NHM fund transfer.

In the case of Uttar Pradesh the performance related to low birth weight, TB treatment success rate, the average tenure of key positions at state and district level and level of birth registration accounted for the deterioration.

Similarly, Uttarakhand had a decrease in health index score mainly because of the deterioration in NMR, U5MR, stability of tenure of key administrative positions at the district level, functionality of FRUs, and NHM fund transfer.

Odisha's health index score reduction was mostly due to worsening of the full immunization rate and TB treatment success rate, and Madhya Pradesh had a reduction in level of birth registration and TB treatment success rate, leading to poor health index score.