Kerala tops in NITI Aayog’s Health Index, yet slips on many counts

Lags behind in incremental performance

June 25, 2019 11:38 pm | Updated December 03, 2021 08:30 am IST - Thiruvananthapuram

The second round of State Health Index, 2018 published by NITI Aayog has established Kerala as the best overall performing State with a total score of 74.01.

However, despite being a frontrunner State and the best overall performer, when it comes to incremental performance, Kerala falls in the “not improved” category.

In fact, when compared to the scores in the base year (2015-16), Kerala seems to have actually gone down slightly on many counts in the reference year (2017-18)

The overall performance score of the State has also gone down slightly from 76.56 in the first Health Index in 2015-16 to 74.01 in 2017-18. Health Index, 2018 examined the overall performance and incremental improvement in the States and Union Territories for the period from 2015-16 to 2017-18.

Health Index is a composite score incorporating 23 indicators covering key aspects of health sector performance, grouped into domains of Health Outcomes, Governance and Information, and Key Inputs/Processes.

In the Health Outcomes domain, Kerala has gone down slightly by 2.99 points, while it is 5.7 points down when it comes to performance in Key Inputs/Processes domain.

Sex ratio

Significantly, while Kerala and Chhattisgarh are the only two States with a Sex Ratio at Birth (SRB) of more than 950, Kerala’s SRB has shown a decline from 967 in 2013-15 to 2014-16. The SRB measures the number of girls born for every 1,000 boys born. It reflects the extent to which gender discrimination leads to sex-selective abortion.

Kerala has already surpassed the Sustainable Development Goals target when it comes to neonatal mortality, at 6 per 1,000 live births. Under-5 mortality has, however, gone up from 11 per 1,000 live births to 13.


The proportion of fully immunised children between nine and 11 months of age in Kerala shows an increase from 94.6 % in 2015-16 to 100 % on 2017-18. However, the proportion of institutional deliveries in the State during the same period has shown a decline from 92.6 % to 90.9 %. TB total case notification rate in Kerala declined from 139 (per one lakh population) to 67 between 2016 and 2017.

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