Kerala has emerged as the overall best performing State in the first-ever ‘Performance in Health Outcomes’ Index, an initiative spearheaded by NITI Aayog in collaboration with the Ministry of Health and Family Welfare.
The initiative was with technical assistance from the World Bank and other public health experts in the country. The overall performance rankings has been given with 2014-15 as the base year and 2015-16 as the reference year.
Even though Kerala has emerged on top in overall performance, predictably, when it comes to annual incremental progress (progress made by States from base year to reference year), it ranks 21 and is at the bottom. This is because it has already achieved very low levels of neonatal mortality, under-five mortality, and replacement fertility, and has very little room for improvement.
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Thus, the top States in overall performance — Kerala, Punjab and Tamil Nadu— are nearly at the bottom when it comes to annual incremental progress. In fact, between the base year and reference year, Kerala has actually shown a decline in performance by 3.45 points.
In the base year, the Composite Health Index ranged from 28.14 in Uttar Pradesh to 80 in Kerala. In the reference year, Uttar Pradesh, at 33.69, remained the poorest performing State, and Kerala remained the best performing State despite a slight decline in the health index to 76.55.
Additionally, Kerala also registered a decline in sex ratio at birth from base to reference year (974 to 967 females per 1,000 males). In the Health Outcomes domain, Kerala is ranked at the top, and even shown improvement from 82.33 points in base year to 82.89 in reference year. But as far as the Key inputs/Processes score is concerned, Kerala declined from 74.17 points in base year to 69.62 points in reference year.
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The report says the indicators where most larger States including Kerala need to focus on include addressing the issue of sex ratio at birth, establishment of functional district cardiac care units, ensuring quality accreditation of public health facilities, and institutionalisation of the Human Resources Management Information System.