BENGALURU: IN a major embarrassment to the state government, especially in the run-up to the state election, Karnataka’s health index ranking has dropped from 7th to 9th in 2015-16 compared to 2014-15, as per NITI Aayog Health Index rankings released for all states and Union territories in the country on Friday.
Karnataka got a negative incremental score of -1.03 showing its decline in health indicators. Its score dropped from 59.73 to 58.70. As per NITI Aayog’s categorisation, the state was ranked among 21 large states, eight small states and seven Union territories.
The states are ranked on parameters like neonatal mortality rate, under-five mortality, replacement-level fertility, full immunisation coverage, institutional deliveries and number of people living with HIV on anti-retroviral therapy among other indicators.
In Low Birth Weight (<2.5 kg), the state witnessed a rise in proportion from 10.8 to 11.5. In sex ratio, too, the state has fared poorly with the number of girls to 1,000 boys dropping from 950 to 939 – indicating lax implementation of Pre-Conception and Pre-Natal Diagnostics Techniques Act. Not a single individual has been convicted for female foeticide in the state since the inception of the Act in the past 14 years. This also reflects the probable occurrence of sex-selective abortions.
The NMR (neonatal mortality rate) or the number of neonatal deaths (occurring in the first 28 days of life) per 1,000 live births during a specific year reflects the quality of prenatal, intrapartum, and neonatal care services. This is an important indicator as approximately 68 per cent of infant deaths in India occur during the neonatal period. In Karnataka, the NMR decreased from 20 to 19 in 2015-16 compared to 2014-15.
In Under 5 Mortality Rate (U5MR) reflecting probability of dying before the age of five, calculated per thousand births, Karnataka remained stagnant at 31 in 2015 as in 2014. It reflects a combination of several factors, such as the nutritional status of children, health knowledge of mothers, level of immunisation and oral rehydration therapy, access to maternal and child health services, income of the family, and availability of safe drinking water and basic sanitation services.
Full immunisation coverage
This indicator reflects upon the success of the immunisation programme and captures the proportion of infants between ages of 9-11 months who have received one dose of BCG, three doses of DPT, three of OPV, and one dose of measles vaccine. Karnataka’s immunisation coverage increased from 92.3 per cent in 2014 to 96.2 per cent in 2015.
Total case notification rate is the number of new and relapsed TB cases notified, in both public and private facilities per 1,00,000 population during a specific year. It is an important indicator reflecting diagnosis and reporting of TB cases in the National Surveillance System and is an essential element for effective implementation of the End TB Strategy. This has gone up from 100 to 105 in Karnataka.
Giridhar Babu, a public health expert, said, “ We are poor in TB notification rates, out-of-pocket expenditure per delivery in public health facility, institutional deliveries, (fifth from bottom) poorest performance in the average occupancy of an officer (in months) combined for three key posts at State-level for last three years – (bottom most), third from the bottom in proportion of vacant healthcare provider positions – ANMs at sub-centres, and third worst in average number of days for transfer of Central National Health Mission funds from State Treasury to implementation agency.”
Kerala ranks best in healthcare, UP worst
New Delhi: Kerala has emerged as the best state in the country in terms of healthcare performance, reveals a latest Health Index report, jointly prepared by the World Bank and Niti Aayog. Kerala was followed by Punjab, Tamil Nadu and Gujarat. While Uttar Pradesh has shown large improvement in healthcare outcome, it was still ranked at bottom of the Health Index report, place behind Rajasthan and Bihar. “Jharkhand, Jammu and Kashmir and UP showed the maximum gains in improvement of health outcomes from base (2014-15) to reference year (2015-16).