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Covid | Kerala, Tamil Nadu, Telangana Top States, Delhi Worst in UT

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Covid Year: The three southern states of 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, The Indian Express has learnt. While Tripura was the best among the ‘smaller states’, Delhi ranked at the bottom of the Union territories’ list.

The annual health index, which measures the performance of states and UTs on a “weighted composite score incorporating 24 health performance indicators”, was launched by the NITI Aayog in 2017. The Aayog brings out the index in collaboration with the Union Health Ministry and World Bank.

While the 2020-21 (fifth) health index report was supposed to be released by December 2022, it has not been made public yet. The NITI Aayog is learnt to have shared the report – Healthy States Progressive India Report on the Ranks of States and Union Territories – with the Health Ministry.

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When contacted, a NITI Aayog official said the report would be “released in due course”.

The health index assesses states and UTs on two parameters – incremental performance (year-on-year progress) and overall performance. The states and UTs — categorised separately as ‘larger states’, ‘smaller states’ and UTs — are then ranked based on their scores.

Among the 19 ‘larger states’, Kerala, Tamil Nadu and Telangana have emerged as the top three performers, occupying first, second and third place respectively, in terms of overall performance during covid year. Bihar (19th), Uttar Pradesh (18th) and Madhya Pradesh (17th) are at the bottom of the list.

In terms of incremental performance, Rajasthan, Uttarakhand and Odisha emerged as the top three performers in 2020-21, as compared to their performance in 2019-20.

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.

And among the eight UTs, Lakshadweep has been ranked as the top performer in terms of overall performance, while Delhi ranked at the bottom.

In the last (fourth) health index report for 2019-20, released on December 27, 2021, Kerala and Tamil Nadu were ranked as top overall performers among the larger states. Telangana, Uttar Pradesh and Assam were the top three states in terms of annual incremental performance.

Among smaller states, Mizoram, Tripura and Sikkim took the top three slots in terms of overall performance, while Manipur (6th), Arunachal Pradesh (7th) and Nagaland (8th) were at the bottom in 2019-20. Among the UTs, Dadra and Nagar Haveli and Daman and Diu were at the top, while Andaman & Nicobar Islands was last.

According to a statement issued by the NITI Aayog on December 27, 2021, the health index is an “annual tool to assess the performance” of states and UTs. “It is a weighted composite index based on 24 indicators grouped under the domains of ‘health outcomes’, ‘governance and information’, and ‘key inputs/ processes’. Each domain has been assigned weight based on its importance with higher score for outcome indicators,” it said.

The ‘health outcomes’ include indicators like neonatal mortality rate, total fertility rate, sex ratio at birth, immunisation coverage, proportion of institutional deliveries, total case notification rate of tuberculosis, and proportion of people living with HIV on antiretroviral therapy.

The ‘key inputs/ processes’ is a measure of health infrastructure available, including proportion of functional 24X7 primary healthcare centres, districts with functional cardiac care units, and vacancies in healthcare provider positions.

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.

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