Health Outcome Index : Analysis


This index (Health outcomes index by the NITI Aayog) will help nudge states towards improving their health sector outcomes in the spirit of cooperative and competitive federalism


Index Analysis:

  • “Healthy States, Progressive India” report has spurred a vibrant debate on the status and future of India’s health sector
  • Through this report, the focus has been on the performance and annual progress of states and Union territories on a countless health indicator
  • Kerala is the leader among large states, closely followed by Punjab and Tamil Nadu
  • Uttar Pradesh, Rajasthan and Bihar are the least-performing states
  • The goal of the index is not just to rank the states based on their historical performance, but also on their incremental performance
  • The attempt is to capture the change made during the course of the year
  • For example, Jharkhand, Jammu and Kashmir, and Uttar Pradesh are ranked first, second and third in their incremental performance ranking
  • The “Performance On Health Outcomes” index is made up of 24 indicators in three different domains—
    1. health outcomes,
    2. governance and information, and
    3. key inputs and processes
  • The “health outcomes” account for 70% of the weight, and the other two domains weighs 12% and 18%, respectively
  • The “health outcomes” domain has indicators such as total fertility rate (TFR), neonatal mortality rate (NMR), sex-ratio at birth (SRB), etc.
  • The governance and information domain measures the quality of data (data integrity indicator) and the average occupancy in important health-related posts such as principal secretary (health), chief medical officer, etc.
  • Key inputs and processes measure the current status of healthcare professional vacancies, infrastructure at district hospitals, and the speed of financial governance in the states
  • NITI Aayog is creating a framework to track the performance of government hospitals based on outcome metrics
  • Together with the upgrading and setting up of health and wellness centres under the Ayushman Bharat Scheme and the National Health Protection Scheme these measures will help us realize the goal of “good health and well-being”( one of the UN-SDG) for all citizens


Results that emerge from the health index

  • First, there are large gaps between states
  • The gap between the best-performing states and the least-performing states is worrisome—Kerala and Uttar Pradesh are separated by 42.86 points
  • Second, incremental performance reveals that there has been a decline in performance on some states
  • Six states’ scores have declined—Kerala, Haryana, Gujarat, Karnataka, Himachal Pradesh, and Uttarakhand
  • Third, India has made significant strides in achieving the goals set out under the UN-SDG and our own National Health Policy
  • Some of our states have already met or exceeded the goals a decade ahead of 2030



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