NITI Aayog : Annual Health Index (Healthy States, Progressive India)

Why in News ?

NITI Aayog released the Second Edition of "Healthy States, Progressive India", 2019. The report is annually systematic performance tool to measure the performance of the States or UTs.

The Health Index can be a gamechanger as it can shift the focus from budget spends, inputs and outputs to outcomes. Tracking incremental performance ensures that there is no room for complacency among historically better performing states, while at the same time providing opportunity to states that have lagged in performance to demonstrate perceptible improvement.

About Report :

• It is the systematic exercise for tracking the progress on health outcomes and health systems' performance across all the States and Union Territories (UTs) in India on an annual basis.

• The report ranks States and Union Territories innovatively on their year-on-year incremental change in health outcomes, as well as, their overall performance.

• The Health Index is a weighted composite Index based on 23 and indicators grouped into the domains of Health Outcomes, Governance and Information, and Key Inputs/Processes.

• Health Index published by NITI Aayog (National Institution for Transforming India) with the help World Bank and Ministry of Health and Family Welfare (MoHFW).

Rankings  Categorised as :

# Larger States

# Smaller States and

# Union Territories (UTs), 

to ensure comparison among similar entities.

How are States ranked ?

The Larger States ranked is based on indicators in three domain : 

* Health Outcomes (70%)

* Governance and Information (12%)

* Key Inputs and Processes (18%),

with each domain assigned a weight based on its importance.

How to cotegorized States Index Score Range ?

The States are cotegorized on the basis of reference year Index score range : 

* Front Runners - Top three

* Achiever - middle three

* Aspirants - last three

Four groups based on Incremental Performance :

* Not improved (<=0 incremental change);

* Least improved (0.01 to 2 point increase);

* Moderately Improved (2.01 to 4 points) ;

* Most Improved (>4 points increase).

Performance of States :

• Kerala has been designated for the best performing State in the Second Edition of Health Index among the 21 large States.

• The 2nd, 3rd, 4th and 5th position states are Andhra Pradesh, Maharashtra, Haryana and Rajasthan respectively.

• Among the larger States, Uttar Pradesh is a Worst performing state. 

• Among the smaller States, Top performing state - Mizoram. Tripura and Manipur improve the most.

• Among the UTs, Chandigarh ranked first in overall performance and followed by Dadar and Nagar Haveli.

Limitations :

• The index as no single index can purport to comprehensively capture the complex story of evolution of health system.

• Due to constraints of availability of quality data critical areas such as non-communicable diseases, mental health and private sectors service utilisation could not be captured.

• Risk of unhealthy competitive federalism.

Advantages of NITI Aayog Health Index :

• To leverage cooperative and competitive federalism to accelerate the pace of achieving health outcomes and encourage cross-learning among states.

•  It can shift the focus from budget spends, inputs and outputs to outcomes.

• It can help States in focussing attention on better targeting of interventions and improving the delivery of health services and also an opportunity of sharing best practices.

• It is not only fosters competition among states by comparing similar states to each other but also nudges them to better their own performance in the previous year.

• Timelines of the report so that it stimulates action and not merely academic discussions.

• Provision of financial incentives based on the annual incremental performance of states under the National Health Mission.

• Verification of self-reported data by a third party, independent verification agency to enhance credibility.

The Health Index is a work in progress and continuous refinements will be made a additional quality data becomes available and data systems improve.

References

NITI Aayog Report

Yojana

Also Read : Health Systems in India