[op-ed snap] States of health: On NITI Aayog’s first Health Index

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Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: NITI Aayog Health Index, Sustainable Development Goals, National Health Protection Scheme

Mains level: State of health sector in India


Context

NITI Aayog Health Index

  1. States with a record of investment in literacy, nutrition and primary health care have achieved high scores in NITI Aayog’s first Health Index
  2. The Index, with all its limitations given uneven data availability, hopes to make a difference by encouraging a competitive approach for potentially better outcomes

Responsibilities of different tiers of government

  1. Health-care delivery is the responsibility of States; the Centre provides financial and policy support
  2. Being able to meet the Sustainable Development Goals over the coming decade depends crucially on the States’ performance
  3. Both the Centre and the States have the responsibility to scale up their investment on health as a percentage of their budgets

Lack of sufficient data

  1. The Index uses metrics such as institutional deliveries, systematic reporting of tuberculosis, access to drugs for people with HIV/AIDS, immunization levels, and out-of-pocket expenditure
  2. Data on other key aspects such as non-communicable diseases, mental health, governance systems and financial risk protection lack the integrity to form part of a good composite index

Way forward

  1. National Health Protection Scheme announced in the Union Budget may be able to address some of the financial risk associated with ill-health
  2. But, it will take systematic improvements to preventive and primary care to achieve higher scores in the Index
  3. As the experience from countries in the West and now even other developing economies shows, socialization of medicine with a reliance on taxation to fund basic programmes is the bedrock of a good health system
Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.
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