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Annual Health Index 2020-21 : NITI Aayog’s

Kerala, Tamil Nadu and Telangana emerged as the top performers among the ‘larger states’ in the NITI Aayog’s annual ‘health index’.


Kerala, Tamil Nadu and Telangana emerged as the top performers among the ‘larger states’ in the NITI Aayog’s annual ‘health index’ for the Covid year of 2020-21.

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What are the Major Highlights of the Index?

Based on Overall Performance:
Larger States:
  • Among the 19 ‘larger states’, Kerala, Tamil Nadu and Telangana have occupied first, second and third place respectively, in terms of overall performance.
  • Bihar (19th), Uttar Pradesh (18th) and Madhya Pradesh (17th) are at the bottom of the list.
Smaller States:
  • Among the eight smaller states, Tripura has recorded the best overall performance, followed by Sikkim and Goa; Arunachal Pradesh (6th), Nagaland (7th) and Manipur (8th) are at the bottom.
Union Territories(UT):
  • And among the eight UTs, Lakshadweep has been ranked as the top performer in terms of overall performance, while Delhi ranked at the bottom.
Based on Incremental Performance:
  • Rajasthan, Uttarakhand and Odisha emerged as the top three performers in 2020-21, as compared to their performance in 2019-20.

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What is NITI Aayog’s Annual Health Index?
  • In 2017, the National Institution for Transforming India (NITI Aayog) in collaboration with the Ministry of Health and Family Welfare (MoHFW) and the World Bank initiated an annual Health Index for tracking Overall Performance and Incremental Performance across all states and Union Territories (UTs).
  • The objective of the Annual Health Index is to track and rank progress on health outcomes and health systems performance, develop healthy competition and encourage cross learning among states and UTs.
  • The health index assesses states and UTs on two parameters – incremental performance (year-on-year progress) and overall performance.
  • The ranking is done under three categories: larger states, smaller states and Union territories (UTs) to ensure comparison among similar entities.

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  • The Health Index is a composite score that reflects the achievements and incremental improvements of the states and UTs on 24 indicators across three domains: health outcomes, governance and information, and key inputs and processes.
  • The ‘health outcomes’ include indicators like neonatal mortality rate, total fertility rate, sex ratio at birth, immunization coverage, proportion of institutional deliveries, total case notification rate of tuberculosis, and proportion of people living with HIV on antiretroviral therapy.
  • The ‘governance and information’ domain includes indicators like proportion of institutional deliveries, average occupancy (in months) of three key posts at state level, average occupancy (in months) of the chief medical officer, and days taken for fund transfer.
  • The ‘key inputs/ processes’ is a measure of health infrastructure available, including the proportion of functional 24X7 primary healthcare centers, districts with functional cardiac care units, and vacancies in healthcare provider positions.

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