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Healthy States, Progressive India Report

This topic provides information about Healthy States, Progressive India Report of NITI Aayog.

"Healthy States, Progressive India" is a comprehensive Health Index report released by the NITI Aayog. 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. 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).

Salient features

  • States and UTs have been ranked in three categories namely, Larger States (21), Smaller States (8), and Union Territories (UTs)(8), to ensure comparison among similar entities.
  • The Health Index is a weighted composite Index, which for the larger States, is based on indicators in three domains: (a) Health Outcomes (70%); (b) Governance and Information (12%); and (c) Key Inputs and Processes (18%), with each domain assigned a weight based on its importance. The Index includes 23 indicators which are used to calculate the composite index score and generate overall performance ranks and incremental ranks.
  • Indicators selected based on importance and availability of reliable data from existing data sources (at least annually)
  • The composite index score is calculated for a Base Year , which largely covers the 2014 - 15 period and a Reference year, which largely covers the 2015 - 16 period. The process of index refinement involved inputs from the States and UTs, national and international sector experts, and development partners. Data submitted by the States & UTs was validated by an Independent Validation Agency, following which index values and ranks were generated on the web portal (http://social.niti.gov.in), and certified by the Independent Agency.
  • The web portal (http://social.niti.gov.in) provides all the details of the index – about index, guidebook on performance on health outcomes, state/UT category wise overall, incremental and domain - wise results (in form of tables, graphs etc.), indicator wise data (options available for download of data and results) and the health index report.

Key results

  • Among the Larger States, Kerala, Punjab, and Tamil Nadu ranked on top 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 Health Index report notes that while States and UTs that start at lower levels of development are generally at an advantage in notching up incremental progress over States with high Health Index scores, it is a challenge for States with high Index scores to even maintain their performance levels. For example, Kerala ranks on top in terms of overall performance but sees the least incremental change as it had already achieved a low level of Neonatal Mortality Rate (NMR) and Under-five Mortality Rate (U5MR) and replacement level fertility, leaving limited space for any further improvements.

However, the incremental measurement reveals that about one-third of the States have registered a decline in their performance in 2016 as compared to 2015, stressing the need to pursue domain-specific, targeted interventions. 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). Additionally, 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 also serve as an instrument for “nudging” States & Union Territories (UTs) and the Central Ministries to a much greater focus on output and outcome based measurement of annual performance than is currently the practice. With the annual publication of the Index and its availability on public domain on a dynamic basis, it is expected to keep every stakeholder alert to the achievement of Sustainable Development Goals (SDGs) Goal number 3.

Source : NITI Aayog

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