The NITI Aayog’s first Health Index, prepared jointly with the Ministry of Health and Family Welfare and World Bank, has predictably ranked Kerala, Punjab, Tamil Nadu and Gujarat in the top rung. Also predictably, Uttar Pradesh, Rajasthan, Bihar and Odisha are at the bottom. The ranking was done under three categories—larger states, smaller states and union territories—to ensure comparison among similar entities.
The three indicators factored in while ranking the states were health outcomes (70 per cent), governance and information (12 per cent) and key inputs and processes (18 per cent), with each domain assigned a weight based on its importance. The reason why Kerala, Punjab, etc., are at the top while others bring up the rear is quite clear: state governments that give priority to healthcare and nutrition have done well.
Healthcare has hardly been given the attention it deserves by almost all governments. The evidence of this is visible in any government hospital or primary healthcare centre. It is not uncommon to read about rats nibbling at unsuspecting babies even when they are supposed to be inside sterilised zones. The reason for this pathetic state of affairs is that investment in healthcare does not yield political or electoral dividends. Vote bank politics is all that matters to political parties and issues such as caste, community and quota are more important.
A case in point is the recent decision of poll-bound Rajasthan and Madhya Pradesh to woo the farming community with loans and bonuses. That the ongoing farmer distress hurt the BJP was clear from the elections in Gujarat, where the party laboured to a victory.
While Rajasthan announced a one-time crop loan waiver for small and marginal farmers up to `50,000, Madhya Pradesh said it would pay farmers a `200 bonus on every quintal of produce sold to the government. So as long as it is elections first and development later for political parties, governments will continue to neglect healthcare.