Niti Aayog State Health Index: Odisha Languishes At Bottom-6

A year-ender dampener for Odisha. The State has grossly failed to qualify as a 'healthy state' in the country. The Niti Aayog report 'Healthy States, Progressive India' measures a deterioration in Odisha's health outcomes.

As per the Niti report, the State finished in the bottom-6 among the 19 larger states. Dropping down by 2 ranks, Odisha placed at 14th in the Niti Aayog State Health Index -2019-20 as against 12th in 2018-19.

With the Omicron variant posing a real danger for the State, the Niti Aayog report red flags a dip in the immunisation coverage among children and the total case notification rate of TB in the State.

Moreover, when the pandemic is breathing down the State's neck, the report highlighted how the State has posted a worst deterioration in reporting disease outbreaks - weekly reports on the number of samples tested for a particular disease and the number of positives detected for the particular disease.

In sum, the report hints at the prevalence of poor disease reporting systems in the State. And above all, Odisha with health expenditure amounting to only 4.95 percent of the total expenditure, has been ranked in the Aspirant category in overall indicator performance.

What Does Aspirant State Mean?

As per Niti Aayog, an Aspirant State is one that forms the bottom one-third states in the country that have substantial scope for improvement.

Why A Dampener For Odisha? 

Neighbour Chhattisgarh continue to stay put in the 'Achievers' group when Odisha continues languishing in the 'Aspirant' club. More so, in the reference year 2019-20, down by 2 ranks vis-a-vis 2018-19 base year, Odisha, in fact, recorded a deterioration in the State Health Index.

For Odisha's score of 44.31, Chhattisgarh secured 50.70 out of 100. The western neighbour of Odisha has been ranked 10th  vis-a-vis 14th by Odisha.

Significantly, northern neighbour Jharkhand notched up smart gain in 2019-20 to score 47.55 as against 44.17 in 2018-19. As a consequence, the neighbouring State held on to its rank of 13 in 2019-20, when Odisha slipped behind.

Odisha Vs Uttar Pradesh 

Even as the largest state in the country finishes at the bottom in the State Health Index, the silver lining has been its top performance in incremental change.

Uttar Pradesh posted the highest incremental change of over 5.5 percent in the country in 2019-20, whereas Odisha registered a negligible 0.13 percent incremental change.

While Odisha scored 44.31 against 44.18 in 2018-19, UP took a long jump to score 30.57 from 25.06 in 2018-19.

A detailed glance at the report reveals that when UP recorded 'most deterioration' in incremental change in one indicator/sub-indicator, Odisha fared poorly with 5 indicators showing 'most deterioration' in 2019-20.

Against Odisha's 8 indicators, where either no change or deterioration has been observed, UP has limited it to only 9.

Odisha Vs Bihar

The big howler for the State is when Bihar has been ranked at 11th in Incremental performance, here too Odisha was ranked at 14th slot. This shows Odisha ramping up change slowly vis-a-vis Bihar.  

Odisha Fine Print

• In Health Outcomes Index, Odisha registered a decline in 2019-20.
• Health outcomes cover neo-mortality rate,U-5 mortality rate, MMR, Immunisation rate, Sex ratio at birth, the proportion of people living with HIV, TB notification and cure rate.
• The State posted a performance slide in immunisation rate, TB notification rate
• It has registered a minimal change in neo-mortality rate.
• The girl child ratio posted a sharp drop in 2019-20.
• Recorded an 18 points decline in Maternal Mortality Rate (MMR), second to Rajasthan (24 points down).
• As a consequence, Odisha has been placed in the 'Achievers' club in MMR.
• The State has been listed as 'Worst' in the indicator of the tenure of CMO (Chief Medical Officer) in each district.
• The tenure of CMO in the State slid to 5.2 months.
• As per the report, this shows frequent transfers at the district level in Odisha. This will carry a negative effect on stability and continuity impacting effectiveness and accountability.
• In the indicator of tenure for 3 key posts (Principal Secretary, Health, Mission Director, NHM and Director, Health Services)  at the State level, the State saw a decline to 19.35 months from 19.50.
• In the indicator of transferring central NHM fund to implementing agencies, Odisha displayed a poor show.
• The days of fund release in Odisha posted a rise vis-a-vis drop in neighbouring Chhattisgarh.
• Odisha has a high shortfall of nurses, medical officers and specialists.
•  State slips in increasing First Referral Units (FRUs) in 2019-20.
• Against the requirement of 100 percent FRUs, Odisha has 61 percent.
• Odisha languishes at the bottom with Bihar in health expenditure (4.4%), Assam (7.5%) tops the list in 2019-20. 
• Odisha performs well in Kayakalp scheme.