ITANAGAR, 27 Dec: Arunachal Pradesh dropped by one place to seventh in the overall health performance among the smaller states, according to the 4th health index released by the NITI Aayog.
Arunachal and Manipur emerged as poor performers both in terms of incremental performance and overall performance.
Among the smaller states, Mizoram emerged as the best performer, both in terms of incremental performance and overall performance, while Nagaland ranked at the bottom.
Among the larger states, Kerala emerged as the best overall performer. In terms of annual incremental performance, Uttar Pradesh, Assam and Telangana are the top three ranked states.
Tripura, Manipur and Arunachal dropped in the ranks by one place each from the base year to the reference year. Goa dropped by two places and moved from the second place to the fourth place. Nagaland continues to be the lowest ranked smaller state at the eighth position.
On the other hand, Mizoram, Sikkim and Meghalaya improved their rankings from the base year (2018-19) to the reference year (2019-20).
The health index scores for the base year (2018-19) and the reference year (2019-20) revealed wide disparities in overall performance across the smaller states.
The health index score ranged from 27 in Nagaland to 75.77 in Mizoram in the reference year (2019-20), and compared to the base year (2018-19), the gap amongst the smaller states has increased slightly, the report said.
“Only half of the smaller states reached the halfway mark in terms of the composite index score for overall performance. Even the best performers could benefit from improvement in certain indicators, as the highest observed overall index score of 75.77 in 2019-20, for Mizoram, is quite a way from the frontier score of 100,” it said.
“There is substantial scope for improving the performance by all smaller states and there is an urgent need to accelerate efforts to minimize the performance gap between the states,” the report said.
Half of the smaller states fall in the category of aspirants.
Based on the composite index score range for the reference year, the states are categorized into three categories – aspirants, achievers and frontrunners.
Arunachal, Manipur, Meghalaya and Nagaland are categorized as aspirants and are among the bottom one-third states, and have substantial scope for improvement.
Among the smaller states, Mizoram and Meghalaya secured the first and the second rank, respectively, in terms of incremental performance.
The incremental change in the health index scores from the base year to the reference year varied significantly across smaller states with half of the states recording improvement.
The four states that registered negative incremental change are Sikkim, Arunachal Pradesh, Manipur and Goa.
In all the smaller states, at least 40 percent of the indicators either registered negative incremental change or observed no change from the base year to the reference year.
This shows that there is substantial scope for the states to improve their performance on various indicators.
The state health index is an annual tool to assess the performance of states and UTs. It is a weighted composite index based on 24 indicators grouped under the domains of health outcomes, governance and information, and key inputs/processes.
On Monday, the NITI Aayog 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.
Round 4 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.
The report was released jointly by NITI Aayog Vice Chairman Dr Rajiv Kumar, CEO Amitabh Kant, Additional Secretary Dr Rakesh Sarwal, and World Bank Senior Health Specialist Sheena Chhabra.
The report has been developed by the NITI Aayog, with technical assistance from the World Bank, and in close consultation with the ministry of health & family welfare.
Each domain has been assigned weights based on its importance, with higher score for outcome indicators.
To ensure comparison among similar entities, the ranking is categorized as ‘larger states’, ‘smaller states’ and ‘union territories’.
A robust and acceptable mechanism is used for measuring performance. Data is collected online through a portal maintained by the NITI Aayog on agreed indicators. The data is then validated through an independent validation agency selected through a transparent bidding process. The validated data sheets are shared with the states for verification, followed by videoconferences with the states for resolving any disagreements or disputes.
The final sheets thus settled are shared with the states, and after agreement, the data are finalized and used for analysis and report-writing.
“States are beginning to take cognizance of indices such as the state health index and use them in their policymaking and resource allocation. This report is an example of both competitive and cooperative federalism,” said the NITI Aayog VC.
“Our objective through this index is to not just look at the states’ historical performance but also their incremental performance. The index encourages healthy competition and cross-learning among states and UTs,” said the NITI Aayog CEO.
The index is being compiled and published since 2017. The reports aim to nudge states and UTs towards building robust health systems and improving service delivery.
The importance of this annual tool is reemphasized by the union health & family welfare ministry’s decision to link the index to incentives under the National Health Mission. This has been instrumental in shifting the focus from budget spending and inputs to outputs and outcomes. (With PIB inputs)
