NITI Aayog, National Institution for Transforming India, Government of India


Performance on Health Outcomes index

Despite significant economic growth over the past decades in India, our achievements in population health have not been commensurate. The National Development Agenda, unanimously agreed to by all the State Chief Ministers and Lieutenant Governors of Union Territories in 2015, had, inter alia, identified Education, Health, Nutrition, Women and Children as priority sectors. In order to achieve the National Development Agenda, it is imperative to make rapid improvement in these sectors. While the responsibility in this regard is shared between the Centre and the States, Health being a State subject, implementation is largely done by the States.

India along with other countries has committed to the adoption of Sustainable Development Goals (SDGs) to end poverty, protect the planet, and ensure prosperity for all as part of a new global sustainable development agenda to be achieved by 2030. There is renewed commitment in India, to accelerate the pace of achievement of the SDGs including Goal 3 related to ensuring healthy lives and promoting the well-being for all at all ages.

In this regard, in order to rapidly bring about transformative action in achieving the desirable outcomes, a priority for NITI Aayog and Ministry of Health & Family Welfare is to prompt States towards improvements in outcomes in the coming years.In this context, NITI Aayog and MoH&FW are spearheading the Health Index initiative.

It is anticipated that this framework will assist in State level monitoring of performance and improvement in health and nutrition outcomes and will thereby meet the citizens’ expectations.

Index - Summary Table

Domain Sub-Domain Sr. No Indicators Weights
1. Health Outcomes (14) 1.1. Key Outcomes (7) 1.1.1 Still Birth Rate (SBR) 700
1.1.2 Neonatal Mortality Rate (NMR)
1.1.3 Maternal Mortality Ratio (MMR)
1.1.4 Maternal Mortality Ratio (MMR)
1.1.5 Total Fertility Rate (TFR)
1.1.6 Proportion of low birth weight among new-borns
1.1.7 Sex ratio at birth (number of females per 1000 males)
1.2. Intermediate outcomes (7) 1.2.1 Full immunization coverage (%) 350
1.2.2 Proportion of institutional deliveries
1.2.3 Proportion of pregnant women age 15-49 years who are anemic
1.2.4 Treatment success rate of new smear positive tuberculosis (TB) cases
1.2.5 Treatment success rate of new smear positive tuberculosis (TB) cases
1.2.6 Proportion of people living with HIV (PLHIV) on antiretroviral therapy (ART)
1.2.7 Out of pocket expenditure on drugs and diagnostics incurred per delivery in public health facilities (using Pregnant Women as proxy to all patients)
2. Governance and information (3) 2.1. Health monitoring data integrity (1) 2.1.1 Data integrity measure: (Institutional deliveries, ANC registered within first trimester) 70
2.2. Governance (2) 2.2.1 Percentage occupancy of an officer, combined for following three posts at State level for last three years –
1. Principal Secretary
2. Mission Director (NHM)
3. Director- Health Services
2.2.2 Percentage occupancy of a full time officer in last three years for all the Districts- District Chief Medical Officers (CMOs) or equivalent post (Heading District Health Services)
3. Key inputs/ processes (11) 3.1. Health Systems/Service Delivery (11) 3.1.1 Proportion of vacant health care provider positions (Regular + Contractual) in public health facilities 220
3.1.2 Proportion of total staff (regular + contractual) for whom an e-pay slip can be generated in the IT enabled Human Resource Management Information System (HRMIS).
3.1.3 a. Proportion of specified type of facilities functioning as First Referral Units (FRUs)
b. Proportion of functional 24x7 PHCs
3.1.4 Proportion of districts with functional Cardiac Care Units (CCU)
3.1.5 Proportion of ANC registered within first trimester against total registrations
3.1.6 Level of registration of births (%)
3.1.7 Completeness of IDSP reporting of P and L form (%)
3.1.8 Proportion of CHCs with grading above 3 points
3.1.9 Proportion of public health facilities with accreditation certificates by a standard quality assurance programme (NQAS /NABH/ISO/AHPI etc.)
3.1.10 Average number of days for transfer of Central NHM fund from State Treasury to implementation agency (Department/Society) based on all tranches of the last financial year
3.1.11 Proportion of National Health Mission (NHM) funds utilized by the end of 3rd quarter