According to a new analysis, nine of India’s 21 big states suffered a drop in health sector performance, with five of these also ranking among the poorest in the country. Bihar witnessed the greatest fall, while Haryana saw the most improvement.
These findings were included in the second edition of the Healthy States Progressive India Report, which was released on June 25, 2019. According to it, the report is “an annual systematic tool for moving states towards undertaking multi-pronged interventions which will bring better health outcomes”.
The paper calculated a health index for each state using 23 health indicators classified into three categories: health outcomes, administration and information, and important inputs and processes.
‘Health outcomes’ included indicators such as neonatal and under-five mortality rate, institutional deliveries, sex ratio at birth, among others; ‘governance and information’ included data integrity measures, i.e. percentage deviation of information provided with survey data, occupancy of officers at key positions at state and district level, while ‘key inputs and processes’ looked at the proportion of vacant care provider positions and the proportion of IT-enabled human resource management.
Kerala received the highest index score (74.01), next to Andhra Pradesh (65.13) and Maharashtra (63.99). Uttar Pradesh scored the lowest (28.61), followed by Bihar (32.11) and Odisha (35.97).
Scores improved in seven states while falling in nine others. Haryana showed the greatest improvement in its index score in 2017-18, while Bihar experienced the greatest fall.
Andhra Pradesh and Maharashtra saw the most gain in rankings, rising six and four positions, respectively, while Tamil Nadu fell from third to ninth place in 2017-18. Mizoram ranked best out of eight smaller states (73.70), while Nagaland ranked bottom (37.38). Tripura and Manipur saw the greatest improvement in scores.
Four of the eight smaller states had a drop in overall health sector performance. Chandigarh had the best overall score of any union territory (63.62), while Daman and Diu had the worst (41.66). Dadra and Nagar Haveli showed the biggest development.
The survey also discovered a general positive relationship between health index scores and economic development levels in states and union territories as evaluated by per capita net state domestic product. According to the research, a few states with low economic growth, such as Jammu & Kashmir, Manipur, Mizoram, Andhra Pradesh, and Punjab, did well in the health index.