NITI Aayog CEO Amitabh Kant (centre), Ministry of Health and Family Welfare Secretary Preeti Sudan and World Bank Country Director, India, Junaid Ahmad, release the Healthy States Progressive India report in New Delhi Friday. (Express photo)
The health index report, prepared by NITI Aayog, has ranked Punjab second in overall performance by larger states in the country. As per the report, released in New Delhi on Friday, the overall performance index score of Punjab is 65.21 in reference year 2015-16, a jump by 3.19 points from base year 2014-15, when it scored 62.02 . Neighboring Haryana, however, has ranked 13 by achieving an overall performance index score of 46.97 in the reference year.
According to the report titled ‘Healthy States Progressive India’, Punjab has shown improvement by three positions, from base to the reference year. Haryana, which had scored 49.87 in the base year, was ranked 12 then.
The report is the first attempt of the central government to measure the annual performance of states and Union Territories (UT) and then rank them. There were three categories — larger states, smaller states and UTs.
Punjab Health Minister Brahm Mohindra told The Indian Express that the report is a major development for the state. “We are working hard to further improve the health infrastructure in the state. In future, I think we will perform better and become number one,” he said.
According to the report, among the larger states (21), Kerala has topped the list, followed by Punjab and Tamil Nadu.
Neonatal deaths
The report further states Punjab is among the four states which have already attained the NMR goal for 2025. NMR is number of neonatal deaths per 1,000 live births. Haryana was among the three states according to the report, where NMR increased marginally.
Total fertility rate
The NITI Aayog report states that Punjab is also among the 12 out of 21 larger states, which have achieved the replacement level fertility (TFR< 2.1). The TFR represents the average number of children that will be born to a woman throughout her reproductive years. A high level of fertility is associated with extreme poverty and other factors. The report says Haryana was close to achieving the replacement level of fertility with TFR levels between 2.2 and 2.3.
Under-five mortality rate (U5MR)
The report states that the statistics remained stagnant in Punjab as compared to the base year. In Haryana, the U5MR increased between the base and reference year.
Sex Ratio at Birth
Punjab has also recorded an improvement in Sex Ratio at Birth (SRB). While the SRB has declined in most states, Punjab was among the three states where improvement in the SRB was found.
Expenditure per delivery
About the average out of pocket expenditure per delivery in public health facility, the NITI Ayog says in 2015-16, it was found to be Rs 1,890 in Punjab, with Madhya Pradesh recording much cheaper at 1,387. Out of pocket expenditure in West Bengal was highest at Rs 7,782. In Haryana, it is 1,503. Haryana has also figured among the States with a high (?15 per cent) proportion of low birth weight newborns.
Vacancies
The NITI Aayog maintains that average occupancy of an officer (in months) was found to be 20.4 for the year 2013-16 as compared to 20.0 for the base year in 2012-14. Three key posts are principal secretary (health), mission director (NHM) and director, health services. For Haryana and Chhattisgarh, the report said that many states “have an average occupancy per officer for the three key administrative positions of less than 12 months”.
On vacancy of medical officers (MO) at Primary Health Care centres (PHCs), the report says it is lowest in Kerala, followed by Tamil Nadu and Punjab. Vacant super specialist position in district hospitals was found 48 per cent in Punjab. It adds, “from base to reference year, there has been reduction in MO vacancies from 5 to 25 percentage points in Uttarakhand, Andhra Pradesh, Haryana.”
About the vacancy of staff nurses in PHCs and CHCs, the report said it was more than 40 percent in Haryana (43 percent). The report has also said that Punjab showed an improvement in areas like treatment of new microbiology-confirmed TB cases, proportion of people living with HIV on Anti-retroviral therapy.