Haryana betters health index score, ranks 12

Bhartesh Singh Thakur 

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A NITI Aayog report —Healthy States Progressive India: Report on the Ranks of States and UTs — has put Haryana at the top in terms of incremental performance on the health index, but it is still far behind neighbouring Punjab and Himachal Pradesh (HP).  

In its second edition of evaluating the health index, the NITI Aayog looked at the overall performance and incremental improvement in the states and Union Territories from 2015-16 (base year) to 2017-18 (reference year) on 23 health indicators. Haryana, Punjab and Himachal Pradesh are evaluated in the category of 21 larger states. 

Haryana’s overall performance index score increased from 46.97 to 53.51, an increase of 6.55 points, which is the highest in India. But its overall rank is 12, a place higher than 13 earlier. Punjab’s score has decreased from 65.21 to 63.01, and its rank slipped from second to fifth in the country. 

The score of Himachal Pradesh has increased from 61.20 to 62.41 but its rank too has slipped from fifth to sixth. Kerala remains at the top with an overall score of 74.01 though it has reduced from 76.55 earlier. Among UTs, Chandigarh is at the top while it was placed second earlier. Its score has jumped from 52.27 to 63.62.  

Neonatal mortality rate

The first month after birth of a child (more specifically first 28 days) is called the neonatal period. The neonatal mortality rate (NMR) is measured as the number of neonatal deaths per 1,000 live births. “A death occurring during this period is of great concern because it reflects the availability and quality of prenatal, intrapartum, and neonatal care services,” says the report. 

Kerala with an NMR of 6 is placed at the top. Punjab is at the third spot with an NMR of 13 and Himachal Pradesh is fourth with 16 NMR. Haryana has an NMR of 22 though better than 24 earlier.  

Under five mortality rate

The Under Five Mortality Rate (U5MR), which is the probability of dying before completing the age of five, is a critical indicator of child survival. “It reflects a gamut of health and non-health factors that affect child survival, such as the nutritional status of women and children, maternal education, availability of basic public health interventions (immunisation, oral rehydration therapy, water and sanitation), and socio-economic status,” says the report.  

Kerala is at the top with an U5MR of 11, while Punjab is at the fourth place with 24 and Himachal Pradesh is seventh with an U5MR of 27. Haryana is at the eleventh spot with 37 U5MR though better than 43 earlier.

Low birth weight

The proportion of low birth weight (LBW) is used to describe babies who are less than 2.5 kg at birth. “The low birth weight can be either the result of preterm birth or restricted fetal growth. It is associated with fetal and neonatal deaths and illnesses, and long-term consequences such as impaired cognitive development, and the onset of chronic diseases later during adult life,” says the report. 

In this regard, Haryana has performed better than Kerala and Himachal Pradesh. However, Punjab is still ahead. The proportion of the LBW in Haryana is 8.5, though earlier it was 14.9. 

Sex ratio at birth  

The sex ratio at birth (SRB) measures the number of girls born to every 1,000 boys. “It reflects the extent to which gender discrimination leads to sex-selective abortions,” it says. 

Haryana has the worst SRB of 832, while Punjab with 893 SRB is at the 15th spot. Himachal Pradesh is at the eighth place with an SRB of 917. Chhattisgarh is at the top with 963 SRB while Kerala with 959 SRB is second. 

Stable tenure of top health officers

“A stable tenure for key administrative positions is critical to ensure the effectiveness and sustainability of public health programmes,” says the report. 

Based on the data from the states during 2015-18, the average occupancy of Principal Secretary (Health), Mission Director (National Health Mission), and Director (Health Services) or equivalent positions in three years was the highest in West Bengal (28 months). Among larger states, it was the second worst in Haryana with 7.3 months while Himachal Pradesh with 15.7 months and Punjab 14.4 months fared better.