Despite India's rapid economic growth and successful poverty alleviation in the past decade, healthcare remains a critical area that needs improvement, according to a report by government think-tank NITI Aayog. When benchmarked against countries with similar levels of economic development, India is lagging on some critical health indicators. Moreover, there are huge disparities across states and union territories, according to NITI Aayog's second edition of 'Healthy States, Progressive India.'
The health outcomes of some states are comparable to that of some upper-middle-income countries and high-income countries. For example, Sustainable Development Goals in Kerala are similar to that of Brazil or Argentina. But some other states have health outcomes similar to that in the poorest countries in the world. For example, neonatal mortality rate in Odisha is close to that of Sierra Leone.
Among the larger states, the overall health index score for 2017-18 (reference year) of the best-performing state is more than two-and-a-half times of the overall score of the least-performing state, said the report. Kerala championed the larger states with an overall score of 74.01 while Uttar Pradesh was the least performing state with an overall score of 28.61. Among the smaller states, scores varied between 38.51 in Nagaland and 74.97 in Mizoram. Among the union territories, the scores varied between 41.66 in Daman and Diu to 63.62 in Chandigarh.
"Overall, there is room for improvement in all states. Even among the best-performing states, there is substantial room for improvement. Among the least performing states and union territories particularly, there is an urgent need to accelerate efforts to narrow the performance gap."
Kerala and Tamil Nadu have already reached the 2030 Sustainable Development Goals (SDGs) target for neonatal mortality rate which is 12 neonatal deaths per 1,000 live births. Maharashtra and Punjab are also close to achieving the target. Other states and union territories still need significant improvements to meet SDG targets. The report was prepared with technical assistance from the World Bank and in consultation with the Ministry of Health and Family Welfare. The ranking is categorized as larger states, smaller states and union territories to ensure comparison among similar entities.
The health index is a weighted composite index based on 23 indicators grouped into the domains of health outcomes, governance and information, as well as key inputs and processes. Each domain has been assigned weights based on its importance and has been equally distributed among indicators.