NITI Aayog released fourth edition of the State Health Index; Tripura & Mizoram Tops Among ‘Smaller States’

NITI Aayog today 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 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.

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 NITI Aayog, with technical assistance from the World Bank, and in close consultation with the Ministry of Health and Family Welfare (MoHFW).

The Findings

The State Health Index is 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’. 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’.

Among the ‘Larger States’, in terms of annual incremental performance, Uttar Pradesh, Assam and Telangana are the top three ranking states.

Categorization of Larger States on Incremental Performance and Overall Performance

Among ‘Smaller States’, Mizoram and Meghalaya registered the maximum annual incremental progress.

Categorization of Smaller States on Incremental Performance and Overall Performance

Among UTs, Delhi, followed by Jammu and Kashmir, showed the best incremental performance.

Categorization of UTs on Incremental Performance and Overall Performance

On overall ranking based on the composite index score in 2019–20, the top-ranking states were Kerala and Tamil Nadu among the ‘Larger States’, Mizoram and Tripura among the ‘Smaller States’, and DH&DD and Chandigarh among the UTs

NITI Aayog as the premier policy ‘Think Tank’ of the Government of India, believes in the mantra ‘what gets measured gets done. As a part of cooperative & competitive federalism, NITI Aayog and the Ministry of Health and Family Welfare (MoHFW) work to continuously nudge states/UTs towards improvements in health outcomes.

In 2017 the National Institution for Transforming India (NITI Aayog) in collaboration with the Ministry of Health and Family Welfare (MoHFW) and the World Bank initiated an annual Health Index for tracking Overall Performance and Incremental Performance on health across all states and Union Territories (UTs). The objective of the Annual Health Index is to track progress on health outcomes and health systems performance, develop a healthy competition and encourage          cross-learning among states and UTs. Health Index Scores and rankings for states and UTs are generated to assess incremental performance (year-to-year progress) and overall performance (current performance). The exercise is expected to help drive state/UT’s efforts towards the achievement of health-related Sustainable Development Goals (SDGs) including those related to Universal Health Coverage (UHC) and other health outcomes.

Health Index is a weighted composite score incorporating 24 indicators covering key aspects of health performance. The domains covered in the report are Health Outcomes, Governance and Information, and Key Inputs and Processes.

These Health Index Reports aims to nudge the States/UTs towards building robust health systems and improving service delivery. The importance of this annual tool is reemphasized by MOHFW’s s decision to link this Health Index to incentives under National Health Mission. This Report has tried to shift the focus from budget spending, inputs, and outputs to outcomes. 

A robust, acceptable mechanism is used for measuring the performance- indicators are agreed, data is collected online through a portal maintained by NITI, which 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, after which data is finalized and used for analysis and report writing.

The Health Index is a useful tool to measure and compare the overall performance and incremental Performance across states/UTs over time and is an important instrument in understanding the variations in performance across various parameters including health outcomes, governance, and data integrity, and key inputs and processes.  It has strengthened the culture of use of data at the state/UT level to monitor performance and is contributing to the agenda of improving the availability, quality, and timeliness of data in most states/UT. Through this report, the annual performance of the state/UT gets monitored at the highest level of the government. The report for the Financial Year 2019-20 will be released on 27th of December 2021 at 12.00 pm.

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