Why in News?

• NITI Aayog has released the fourth edition of the State Health Index for 2019–20 and it has been compiled and published since 2017.
• The report, titled “The 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.
• Earlier, the Global Health Security (GHS) Index 2021, developed in partnership with the Nuclear Threat Initiative (NTI) and the Johns Hopkins Center was released. India, with a score of 42.8 (out of 100) has slipped by 0.8 points since 2019.

Key Points:

• It is a weighted composite index based on 24 indicators grouped under 3 Domains:
  • Health Outcomes:
    • It includes parameters such as neonatal mortality rate, under-5 mortality rate, the sex ratio at birth.
  • Governance and Information:
    • It includes parameters such as institutional deliveries, average occupancy of senior officers in key posts earmarked for health.
  • Key Inputs/Processes:
    • It consists of the proportion of shortfall in health care providers to what is recommended, functional medical facilities, birth, and death registration, and tuberculosis treatment success rate.
  • NITI Aayog, with technical assistance from the World Bank, and in close consultation with the Ministry of Health and Family Welfare (MoHFW).
  • Round IV 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.

Ranking of States:

• To ensure comparison among similar entities, the ranking is categorized as:
  • Larger States:
    • In terms of annual incremental performance, Uttar Pradesh, Assam, and Telangana are the top three ranking states.
  • Smaller States:
    • Mizoram and Meghalaya registered the maximum annual incremental progress.
  • Union Territories:
    • Delhi, followed by Jammu and Kashmir, showed the best incremental performance.
  • Overall:
    • The top-ranking states wereKerala and Tamil Nadu among the ‘Larger States’, Mizoram and Tripura among the ‘Smaller States’, and Dadra and Nagar Haveli and Daman and Diu (DH&DD) and Chandigarh among the UTs.

Significance of the Index:

• Policymaking:
  • States use it in their policymaking and resource allocation and it is an example of both competitive and cooperative federalism.
• Healthy Competition:
  • The index encourages healthy competition and cross-learning among States and UTs.
• Helpful in Achieving SDGs:
  • The exercise is expected to help drive state and union territories’ efforts towards the achievement of health-related Sustainable Development Goals (SDGs).
• Role in National Health Mission:
  • The importance of this annual tool is reemphasized by MoHFW’s decision to link the index to incentives under the National Health Mission.
• Limitations of the Index:
  • Some critical areas such as infectious diseases, noncommunicable diseases (NCDs), mental health, governance, and financial risk protection are not fully captured in the Health Index.
  • For several indicators, the data is limited to service delivery in public facilities due to paucity and uneven availability of private-sector data on health services.
  • For several indicators, Health Management Information System (HMIS)data and programme data were used without any field verification due to the lack of feasibility of conducting independent field surveys.