Nagaland at eighth position continued to be the lowest ranking Smaller State, both in Base Year (2018-19) and Reference Year (2019-20), according to the NITI Aayog fourth edition of the State Health Index for 2019–20, which was released on Monday.
The report, titled “Healthy States, Progressive India”, ranks states and Union Territories on their year-on-year incremental performance in health outcomes as well as their overall status.
Round IV of the report focuses on measuring and highlighting the overall performance and incremental improvement of states and UTs over the period 2018–19 to 2019–20.
In the overall performance among the smaller states in the Reference Year (2019-20), Mizoram ranked at the top and Nagaland at the bottom. There were wide disparities in the Health Outcomes Domain Index Scores across states and UTs. Among the smaller states, the Index Score of the best performing state Tripura (85.01), was 2.7 times that of the lowest performer Nagaland (32.00).
The gap in the Overall Performance between the best and the worst performing Larger State and
UTs narrowed in the current round of the Health Index, while it increased for the Smaller States.
In case of Smaller States, Mizoram was at the top with Index Score of 75.77 and Nagaland at the bottom with Index Score of 27.00.
Health Index Score for the Base Year (2018-19) and Reference Year (2019-20) revealed wide disparities in Overall Performance across the Smaller States. The Health Index Score ranged from 27.00 in Nagaland to 75.77 in Mizoram in the Reference Year (2019-20), and compared to the Base Year (2018-19), the gap amongst the Smaller States has increased slightly.
Half of the Smaller States fall in the category of Aspirants. Based on the Composite Index Score range for the Reference Year (2019-20), the states are categorised into three categories: Aspirants, Achievers and Frontrunners. Arunachal Pradesh, Manipur, Meghalaya, and Nagaland are categorised as Aspirants. Nagaland and Meghalaya belonging to Aspirants states category, were Moderately Improved and Most Improved states respectively.
Among the Smaller States, Mizoram and Meghalaya secured first and second ranks respectively in terms of Incremental Performance. Positive incremental change was also observed in Nagaland and Tripura.
Among the Smaller States, Tripura ranked at the top in the Health Outcomes domain performance whereas Nagaland ranked at the bottom. There is large variation in Health Outcomes performance (which in the case of Smaller States includes only the intermediate outcome indicators). The Index Score of the best performing state (Tripura) was more than two and half times of the lowest performer (Nagaland) that recorded the lowest levels in several service delivery indicators such as full immunisation, first trimester ANC registration, pregnant women receiving 4 ANCs and institutional delivery.
The lowest ANC registrations were recorded by Meghalaya (32.2 percent) in 2014-15 and by Nagaland (27.3 percent) in 2019-20. The highest increase in first trimester ANC registrations was recorded by Tripura (12.2 percent) and the highest decline was observed by Nagaland (-41.6 percent).
The lowest percentage of institutional deliveries was recorded by Arunachal Pradesh (56.0 percent) in 2014-15 and by Nagaland (58.4 percent) in 2019-20.
In the Governance and Information domain, Mizoram ranked at the top and Nagaland ranked at the bottom in the Reference Year (2019-20). Nagaland had the lowest decline of 1.6 percentage points while Tripura had the highest decline of 30.3 percentage points. The maximum score in this domain was 70.38 for Mizoram and the minimum score was 11.82 for Nagaland, clearly suggesting that Nagaland needs to put tremendous efforts to improve its performance.
The report was released jointly by NITI Aayog vice chairman Dr. Rajiv Kumar, CEO Amitabh Kant, additional secretary Dr. Rakesh Sarwal, and World Bank Senior Health Specialist Sheena Chhabra. The report has been developed by NITI Aayog, with technical assistance from the World Bank, and in close consultation with the Ministry of Health and Family Welfare (MoHFW).