While Kerala remains the healthiest State in India, Uttar Pradesh remains the most unhealthy, said NITI Aayog as it released the second edition of its State Health Index.
Some States such as Rajasthan have improved their health status, but what is worrisome is that States such as Madhya Pradesh, Odisha, Uttarakhand, Uttar Pradesh and Bihar have not improved at all, it said.
The index analyses overall performance and incremental improvement in the States and the Union Territories for the period with 2015-16 as the base year and 2017-18 as the reference year.
“In Bihar, the deterioration between, Base Year of 2015-16 and Reference Year of 2017-18 was primarily due to the performance related to total fertility rate, low birth weight, Sex Ratio at Birth, Tuberculosis treatment success rate, quality accreditation of public health facilities, and time-taken for National Health Mission fund transfer,” said the report.
Only 56 per cent of mothers deliver babies in health facilities in Bihar, which is worse than the national average. Also, Bihar is in red because more low birth weight babies are being born as compared to 2015-16.
“Uttarakhand’s Health Index score decreased mainly because of deterioration in neo-natal mortality rate, Under-five mortality rate, stability of tenure of key administrative positions at district level, functionality of First Referral Units (FRUs), and NHM fund transfer,” the report said.
The slide in Odisha’s Health Index score was mostly due to worsening of the full immunisation rate and TB treatment success rate; and in the case of Madhya Pradesh it was reduction in level of birth registration and TB treatment success rate, it said.
Even in the better-performing States, Tamil Nadu dropped from third position to ninth position, while Punjab dropped from second position to the fifth. The position of the second-best State has been taken by Andhra Pradesh, and the third by Maharashtra.
Incremental performance
NITI Aayog CEO Amitabh Kant also lauded among the larger States, Haryana, Rajasthan and Jharkhand that were the top three in terms of incremental performance.
The report has also compared health outcomes of Kerala to that of Argentina or Brazil, with neo-natal mortality rate (NMR) which is the probability of a baby dying in first 28 days of birth, being as low as six per 1,000 live births. NMR in Odisha which stands at as high as 32 per 1,000 live births is close to that of Sierra Leone, states the report.
“It is imperative that the States spare at least eight per cent of their budget for health,” said VK Paul, Member (Health), NITI Aayog.