NEW DELHI/T’PURAM: Justifying Kerala’s sustained claims to be ahead of others’ health indices, the NITI Aayog report card on Friday adjudged the state as top and said it would remain there in the coming years with the pace of programmes initiated by its government.The ‘Healthy States, Progressive India’ said though Kerala is ranked atop overall, it was at the bottom in terms of incremental progress as it has already achieved a low level of neonatal mortality rate (NMR) under-five mortality rate (U5MR) and replacement-level fertility.
Despite being on top, the state has shown a decline in performance from base year (2014-15) to reference year (2015-16), the report, said. The report, which is the first-of-its-kind analysis of health systems in the country, has been prepared by NITI Aayog with technical assistance from the World Bank and in consultation with the Ministry of Health and Family Welfare.
WHILE Kerala top-scored with 76.55 points, Punjab (65.21) and Tamil Nadu (63.38) came second and third, respectively. Uttar Pradesh (33.69) remained the least performed state. Among smaller states, Mizoram was on the top followed by Manipur on overall performance. Meanwhile, Manipur, followed by Goa, topped the ranks in terms of annual incremental performance among smaller states. Among Union Territories, Lakshadweep put up the best overall and highest annual incremental performances.
Kerala registered a decline in sex ratio at birth from base year to reference year (974 to 967 females per 1,000 males).
It was a leader with respect to proportion of low birth weight among newborns, total fertility rate, U5MR, NMR, sex ratio at birth and institutional deliveries. With respect to the public health institutions also, the state came on top. The report said the vacancy of medical officers at PHCs was lowest in Kerala (six per cent) followed by Tamil Nadu (8) and Punjab (8). Kerala also had the highest rates of e-payments. It also has the notable distinction of surpassing the Sustainable Development Goals 2030 target.
The state is also credited with having cardiac care units in 50 per cent or more districts. However, the report said the state lagged behind in having 24x7 PHC. It also pointed to the delay of fund transfer from state treasury to implementation agencies. There was a decline in immunisation coverage. The report is a weighted composite index based on indicators in three domains: Health outcomes (70 per cent weightage), governance and information (12 per cent), and key inputs and processes (18 per cent).
“The Health Index will act as a tool to leverage co-operative and competitive federalism, accelerating the pace of achieving health outcomes,” Niti Aayog CEO Amitabh Kant said while releasing the report on Friday.