5th Edition of NITI Aayog’s State Health Index

What’s in today’s article?

• Why in News?
• The State Health Index
• Domains and Indicators of the Index
• Highlights of the 5th Edition of the State Health Index

Why in News?

• According to the NITI Aayog’s annual ‘State Health Index’ (5th edition) for the Covid year of 2020-21, the three southern states of Kerala, Tamil Nadu and Telangana emerged as the top performers among the ‘larger states’.
• The NITI Aayog is learnt to have shared the report – Healthy States Progressive India Report on the Ranks of States and Union Territories – with the Health Ministry.

The State Health Index:

• It was launched by the NITI Aayog in 2017 to measure the performance of states and UTs on a weighted composite score incorporating 24 health performance indicators clubbed under three domains.
• The Aayog brings out the index (annually) in collaboration with the Union Health Ministry and World Bank.
• The objective of 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 and nudges states/UTs towards building robust health systems and improving service delivery through their policymaking and resource allocation.
• As a result, the MoHFW had linked 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.
• This index is an example of both competitive and cooperative federalism.

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Domains and Indicators of the Index:

• The ‘Health outcomes’ include indicators like neonatal mortality rate, total fertility rate, sex ratio at birth, immunisation coverage, proportion of institutional deliveries, etc.
• The ‘Key inputs/processes’ is a measure of health infrastructure available, including proportion of functional 24X7 primary healthcare centres, etc.
• The ‘Governance and Information’ domain includes average occupancy of three key posts at state level, average occupancy of the chief medical officer, days taken for fund transfer, etc.

Highlights of the 5th Edition of the State Health Index:

• Overall performance among the 19 larger states:
  • Top performers: Kerala, Tamil Nadu, and Telangana have secured the top three positions in terms.
  • Worst performer: Bihar, UP and MP occupy the bottom three positions, ranking 19th, 18th, and 17th, respectively.
  • Incremental performance from 2019-20 to 2020-21: Rajasthan, Uttarakhand, and Odisha have emerged as the top three performers among the larger states.
• In the category of smaller states: Tripura has demonstrated the best overall performance, followed by Sikkim and Goa. On the other hand, Arunachal Pradesh, Nagaland and Manipur occupy the bottom three positions.
• Among the UTs: Lakshadweep has secured the top position in terms of overall performance, while Delhi has been placed at the bottom.

Q1) What is cooperative federalism?

Cooperative federalism signifies a horizontal relationship between the Centre and the State – two entities cooperate and tackle shared issues to serve the larger public interest.

Q2) What is competitive federalism?

Competitive federalism professes a vertical relationship between the States and the Central government while states compete among themselves.

Source: Kerala, Tamil Nadu, Telangana top states in Covid year, Delhi worst UT: Health index