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NITI Aayog Releases Report on “Healthy States, Progressive India”

Published on February 12, 2018
NITI Aayog has released a comprehensive Health Index report titled, "Healthy States, Progressive India".
  • The report was released jointly by the CEO, NITI Aayog, Amitabh Kant, Secretary, Ministry of Health & Family Welfare; Preeti Sudan and World Bank India Country Director, Junaid Ahmad.
  • The report ranks states and Union territories innovatively on their year-on-year incremental change in health outcomes, as well as, their overall performance with respect to each other. 
  • It was an effort to better assess health outcomes across India.
  • The report is the first step to establish an annual systematic tool to measure and understand the complexity of nation’s performance in health.


  • The report has been developed by NITI Aayog, with technical assistance from the World Bank, and in consultation with the Ministry of Health and Family Welfare (MoHFW), States and UTs.
  • The States and UTs have been ranked in three categories namely, Larger States, Smaller States, and Union Territories (UTs), to ensure comparison among similar entities.
  • According to the report, “in the reference year (2015-16), among the larger states, the index scope for overall performances ranged widely between 33.69 in Uttar Pradesh to 76.55 in Kerala”.
  • The list was topped by Kerala, followed by Punjab, Tamil Nadu and Gujarat. Rajasthan, Bihar and Odisha were among those that performed poorly on the index.

The Health Index is a weighted composite Index, which for the larger States, is based on indicators in three domains:
  1. Health Outcomes (70%)
  2. Governance and Information (12%)
  3. Key Inputs and Processes (18%)
  • Among the Larger States, Kerala, Punjab, and Tamil Nadu topped the list in terms of overall performance, while Jharkhand, Jammu & Kashmir, and Uttar Pradesh are the top three ranking States in terms of annual incremental performance.
  • Jharkhand, Jammu & Kashmir, and Uttar Pradesh showed the maximum gains in improvement of health outcomes from base to reference year in indicators such as Neonatal Mortality Rate (NMR), Under-five Mortality Rate (U5MR), full immunization coverage, institutional deliveries, and People Living with HIV (PLHIV) on Anti-Retroviral Therapy (ART).
  • Among Smaller States, Mizoram ranked first followed by Manipur on overall performance, while Manipur followed by Goa were the top ranked States in terms of annual incremental performance.
  • Manipur registered maximum incremental progress on indicators such as PLHIV on ART, first trimester antenatal care (ANC) registration, grading quality parameters of Community Health Centres (CHCs), average occupancy of key State-level officers and good reporting on the Integrated Disease Surveillance Programme (IDSP).
  • Among UTs, Lakshadweep showed both the best overall performance as well as the highest annual incremental performance. 
  • Lakshadweep showed the highest improvement in indicators such as institutional deliveries, tuberculosis (TB) treatment success rate, and transfer of National Health Mission (NHM) funds from State Treasury to implementation agency.
  • The incremental measurement reveals that about one-third of the States have registered a decline in their performance in 2016 as compared to 2015.
  • Common challenges for most States and UTs include the need to focus on addressing vacancies in key staff, establishment of functional district Cardiac Care Units (CCUs), quality accreditation of public health facilities and institutionalization of Human Resources Management Information System (HRMIS). Basically almost all Larger States need to focus on improving the Sex Ratio at Birth (SRB).


  • Health Index has been developed as a tool to leverage co-operative and competitive federalism to accelerate the pace of achieving health outcomes. It would nudge States towards further achieving a rapid transformation of their health systems and population health outcomes.
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