Health
Executive Summary Complete Report Guidebook
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 Health, Nutrition, Education, 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 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, to measure change in performance over the years.
It is anticipated that this framework will assist in State level monitoring of performance and improvement in health outcomes and will thereby meet the citizens’ expectations.
Final Health Index
|
S. No |
Indicator |
Definition |
Data Source |
Base Year (BY) & Reference Year (RY) |
Remarks |
|
DOMAIN 1 – HEALTH OUTCOMES |
|||||
|
SUB-DOMAIN 1.1 - KEY OUTCOMES (Weight - Larger States – 500, Smaller States & UTs – 100) |
|||||
|
1.1.1 |
Neonatal Mortality Rate |
Number of infant deaths of less than 29 days per thousand live births during a specific year. |
Sample Registration System [Pre-filled] |
BY:2014 |
Indicators 1.1.1, 1.1.2, 1.1.3, and 1.1.5 are not applicable for category of Smaller States and UTs |
|
1.1.2 |
Under-five Mortality Rate (U5MR) |
Number of child deaths of less than 5 years per thousand live births during a specific year. |
Sample Registration System [Pre-filled] |
BY:2014 |
|
|
1.1.3 |
Total Fertility Rate (TFR) |
Average number of children that would be born to a woman if she experiences the current fertility pattern throughout her reproductive span (15-49 years), during a specific year. |
Sample Registration System [Pre-filled] |
BY:2014 |
|
|
1.1.4 |
Proportion of Low Birth Weight among newborns |
Proportion of low birth weight (<=2.5 kg) newborns out of the total number of newborns weighed during a specific year born in a public health facility. |
Health Management Information Systems (HMIS) |
BY:2014-15 |
|
|
1.1.5 |
Sex Ratio at Birth |
The number of girls born for every 1,000 boys born during a specific year. |
Sample Registration System [Pre-filled] |
BY:2012-14 |
|
|
SUB-DOMAIN 1.2 - INTERMEDIATE OUTCOMES (Weight: Larger & Smaller States – 300, UTs – 250) |
|||||
|
1.2.1 |
Full immunization coverage (%) |
Proportion of infants 9-11 months old who have received BCG, 3 doses of DPT, 3 doses of OPV and one dose of measles against estimated number of infants during a specific year. |
HMIS |
BY:2014-15 |
|
|
1.2.2 |
Proportion of institutional deliveries |
Proportion of deliveries conducted in public and private health facilities against the number of estimated deliveries during a specific year. |
HMIS |
BY:2014-15 |
|
|
1.2.3 |
Total Case Notification Rate of TB |
Number of new and relapsed TB cases notified (public + private) per 100,000 population during a specific year. |
Revised National Tuberculosis Control Programme (RNTCP) MIS, MoHFW |
BY:2015 |
|
|
1.2.4 |
Treatment success rate of new microbiologically confirmed tuberculosis (TB) cases |
Proportion of new cured and their treatment completed against the total number of new microbiologically confirmed tuberculosis cases registered during a specific year. |
RNTCP MIS, MoHFW |
BY:2014 |
|
|
1.2.5 |
Proportion of people living with HIV (PLHIV) on antiretroviral therapy (ART) |
Proportion of PLHIVs receiving ART treatment against the number of estimated PLHIVs who needed ART treatment for the specific year |
Central MoHFW Data |
BY:2014-15 |
Indicator not applicable for category of UTs. |
|
1.2.6 |
Out of pocket expenditure per delivery in public health facility (in INR). |
Average out of pocket expenditure per delivery in public health facility (in Rupees). |
NFHS – 4 |
RY: 2015-16 |
Indicator applicable only for reference year ranking. Not considered for incremental ranking. |
|
DOMAIN 2 – GOVERNANCE AND INFORMATION |
|||||
|
SUB-DOMAIN 2.1 – HEALTH MONITORING AND DATA INTEGRITY (Weight: 70) |
|||||
|
2.1.1 |
Data Integrity Measure: |
Percentage deviation of reported data from standard survey data to assess the quality/integrity of reported data for a specific period. |
HMIS and NFHS-4 |
BY &RY: 2015-16 (NFHS) BY &RY: 2011-12 to 2015-16 (HMIS) |
The NFHS data were available only for Reference Year and the data for this was repeated for the Base Year and Reference Year. |
|
SUB-DOMAIN 2.2 – GOVERNANCE (Weight – 60) |
|||||
|
2.2.1 |
Average occupancy of an officer (in months), combined for following three posts at State level for last three years |
Average occupancy of an officer (in months), combined for following posts in last three years: |
State report |
BY: April 1, 2012-March 31 March 2015 RY: April 1, 2013-March 31, 2016 |
|
|
2.2.2 |
Average occupancy of a full-time officer (in months) in last three years for all Districts- District Chief Medical Officers (CMOs) or equivalent post (Heading District Health Services)
|
Average occupancy (in months) of a CMO in last three years for all the Districts |
State report |
BY: April 1, 2012- March 31, 2015 RY: April 1, 2013-March 31, 2016 |
|
|
DOMAIN 3 – KEY INPUTS / PROCESSES |
|||||
|
SUB DOMAIN 3.1 – HEALTH SYSTEMS / SERVICE DELIVERY (Weight – 200) |
|||||
|
3.1.1 |
Proportion of vacant health care provider positions (Regular + Contractual) in public health facilities |
Vacant healthcare provider positions in public health facilities against total sanctioned health care provider positions for following cadres (Separately for each cadre) during a specific year:
|
State report |
BY: As on March 31, 2015 RY: As on March 31, 2016 |
|
|
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). |
Availability of a functional IT enabled HRMIS measured by the Proportion of staff (Regular + Contractual) for whom an e-pay slip can be generated in the IT enabled HRMIS against total number of staff (Regular + Contractual) during a specific year. |
State Report |
BY: As on March 31, 2015 RY: As on March 31, 2016 |
|
|
3.1.3 |
a. Proportion of specified type of facilities functioning as First Referral Units (FRUs) |
Proportion of public sector facilities conducting specified number of C-sections* per year (FRUs) against the norm of 1 FRU per 500,000 population during a specific year |
HMIS |
BY:2014-15 |
Indicator definition modified |
|
|
b. Proportion of functional 24x7 PHCs |
Proportion of PHCs providing all stipulated healthcare services** round the clock against the norm of one 24x7 PHC per 100,000 population during a specific year |
State Report |
BY:2014-15 |
|
|
3.1.4 |
Proportion of Districts with Functional Cardiac Care Units (CCU) |
Proportion of Districts with functional CCU [with desired equipment (ventilator, monitor, defibrillator, CCUs bed, portable ECG machine, pulse oxymeter etc.), drugs, diagnostics and desired staff as per programme guidelines] against total number of districts |
State Report |
BY: As on March 31, 2015 RY: As on March 31, 2016 |
|
|
3.1.5 |
Proportion of ANC registered within first trimester against total registrations |
Proportion of pregnant women registered for ANC within 12 weeks of pregnancy during a specific year. |
HMIS |
BY:2014-15 |
|
|
3.1.6 |
Level of registration of births (%) |
Proportion of births registered under Civil Registration System (CRS) against the estimated number of births during a specific year. |
Civil Registration System (CRS) |
BY:2013 |
|
|
3.1.7 |
Completeness of IDSP reporting of P and L form (%) |
Proportion of Reporting Units (RU) reporting in stipulated time period against total Reporting Units, for P and L forms during a specific year. |
Central IDSP, MoHFW Data |
BY:2014 |
|
|
3.1.8 |
Proportion of CHCs with grading above 3 points |
Proportion of CHCs that are graded above 3 points against total number of CHCs during a specific year. |
HMIS |
BY:2014-15 |
|
|
3.1.9 |
Proportion of public health facilities with accreditation certificates by a standard quality assurance programme (NQAS /NABH/ISO/AHPI) |
Proportion of specified type of public health facilities with accreditation certificates by a standard quality assurance programme against the total number of following specified type of
facilities during a specific year. |
State Report |
BY: As on March 31, 2015 RY: As on March 31, 2016 |
|
|
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 |
Average time taken (in number of days) by the State Treasury to transfer funds to implementation agencies during a specific year. |
Centre NHM Finance Data# |
BY:2014-15 |
|
*Criteria for fully operational FRUs: SDHs/CHCs - conducting minimum 60 C-sections per year (36 C-sections per year for hilly and North-East States except Assam); DHs - conducting minimum 120 C-sections per year (72 C-sections per year for hilly and North-East States except Assam).
**Criteria for functional 24x7 PHCs: 10 deliveries per month (5 deliveries per month for hilly and North-East States except Assam)
#Centre NHM Finance data includes the RCH Flexi pool and NHM-Health System Strengthening Flexi pool data (representing a substantial portion of the NHM funds) for calculating delay in transfer of funds.
Executive Summary Complete Report Guidebook
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 Health, Nutrition, Education, 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 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, to measure change in performance over the years.
It is anticipated that this framework will assist in State level monitoring of performance and improvement in health outcomes and will thereby meet the citizens’ expectations.
Final Health Index
|
S. No |
Indicator |
Definition |
Data Source |
Base Year (BY) & Reference Year (RY) |
Remarks |
|
DOMAIN 1 – HEALTH OUTCOMES |
|||||
|
SUB-DOMAIN 1.1 - KEY OUTCOMES (Weight - Larger States – 500, Smaller States & UTs – 100) |
|||||
|
1.1.1 |
Neonatal Mortality Rate |
Number of infant deaths of less than 29 days per thousand live births during a specific year. |
Sample Registration System [Pre-filled] |
BY:2014 |
Indicators 1.1.1, 1.1.2, 1.1.3, and 1.1.5 are not applicable for category of Smaller States and UTs |
|
1.1.2 |
Under-five Mortality Rate (U5MR) |
Number of child deaths of less than 5 years per thousand live births during a specific year. |
Sample Registration System [Pre-filled] |
BY:2014 |
|
|
1.1.3 |
Total Fertility Rate (TFR) |
Average number of children that would be born to a woman if she experiences the current fertility pattern throughout her reproductive span (15-49 years), during a specific year. |
Sample Registration System [Pre-filled] |
BY:2014 |
|
|
1.1.4 |
Proportion of Low Birth Weight among newborns |
Proportion of low birth weight (<=2.5 kg) newborns out of the total number of newborns weighed during a specific year born in a public health facility. |
Health Management Information Systems (HMIS) |
BY:2014-15 |
|
|
1.1.5 |
Sex Ratio at Birth |
The number of girls born for every 1,000 boys born during a specific year. |
Sample Registration System [Pre-filled] |
BY:2012-14 |
|
|
SUB-DOMAIN 1.2 - INTERMEDIATE OUTCOMES (Weight: Larger & Smaller States – 300, UTs – 250) |
|||||
|
1.2.1 |
Full immunization coverage (%) |
Proportion of infants 9-11 months old who have received BCG, 3 doses of DPT, 3 doses of OPV and one dose of measles against estimated number of infants during a specific year. |
HMIS |
BY:2014-15 |
|
|
1.2.2 |
Proportion of institutional deliveries |
Proportion of deliveries conducted in public and private health facilities against the number of estimated deliveries during a specific year. |
HMIS |
BY:2014-15 |
|
|
1.2.3 |
Total Case Notification Rate of TB |
Number of new and relapsed TB cases notified (public + private) per 100,000 population during a specific year. |
Revised National Tuberculosis Control Programme (RNTCP) MIS, MoHFW |
BY:2015 |
|
|
1.2.4 |
Treatment success rate of new microbiologically confirmed tuberculosis (TB) cases |
Proportion of new cured and their treatment completed against the total number of new microbiologically confirmed tuberculosis cases registered during a specific year. |
RNTCP MIS, MoHFW |
BY:2014 |
|
|
1.2.5 |
Proportion of people living with HIV (PLHIV) on antiretroviral therapy (ART) |
Proportion of PLHIVs receiving ART treatment against the number of estimated PLHIVs who needed ART treatment for the specific year |
Central MoHFW Data |
BY:2014-15 |
Indicator not applicable for category of UTs. |
|
1.2.6 |
Out of pocket expenditure per delivery in public health facility (in INR). |
Average out of pocket expenditure per delivery in public health facility (in Rupees). |
NFHS – 4 |
RY: 2015-16 |
Indicator applicable only for reference year ranking. Not considered for incremental ranking. |
|
DOMAIN 2 – GOVERNANCE AND INFORMATION |
|||||
|
SUB-DOMAIN 2.1 – HEALTH MONITORING AND DATA INTEGRITY (Weight: 70) |
|||||
|
2.1.1 |
Data Integrity Measure: |
Percentage deviation of reported data from standard survey data to assess the quality/integrity of reported data for a specific period. |
HMIS and NFHS-4 |
BY &RY: 2015-16 (NFHS) BY &RY: 2011-12 to 2015-16 (HMIS) |
The NFHS data were available only for Reference Year and the data for this was repeated for the Base Year and Reference Year. |
|
SUB-DOMAIN 2.2 – GOVERNANCE (Weight – 60) |
|||||
|
2.2.1 |
Average occupancy of an officer (in months), combined for following three posts at State level for last three years |
Average occupancy of an officer (in months), combined for following posts in last three years: |
State report |
BY: April 1, 2012-March 31 March 2015 RY: April 1, 2013-March 31, 2016 |
|
|
2.2.2 |
Average occupancy of a full-time officer (in months) in last three years for all Districts- District Chief Medical Officers (CMOs) or equivalent post (Heading District Health Services)
|
Average occupancy (in months) of a CMO in last three years for all the Districts |
State report |
BY: April 1, 2012- March 31, 2015 RY: April 1, 2013-March 31, 2016 |
|
|
DOMAIN 3 – KEY INPUTS / PROCESSES |
|||||
|
SUB DOMAIN 3.1 – HEALTH SYSTEMS / SERVICE DELIVERY (Weight – 200) |
|||||
|
3.1.1 |
Proportion of vacant health care provider positions (Regular + Contractual) in public health facilities |
Vacant healthcare provider positions in public health facilities against total sanctioned health care provider positions for following cadres (Separately for each cadre) during a specific year:
|
State report |
BY: As on March 31, 2015 RY: As on March 31, 2016 |
|
|
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). |
Availability of a functional IT enabled HRMIS measured by the Proportion of staff (Regular + Contractual) for whom an e-pay slip can be generated in the IT enabled HRMIS against total number of staff (Regular + Contractual) during a specific year. |
State Report |
BY: As on March 31, 2015 RY: As on March 31, 2016 |
|
|
3.1.3 |
a. Proportion of specified type of facilities functioning as First Referral Units (FRUs) |
Proportion of public sector facilities conducting specified number of C-sections* per year (FRUs) against the norm of 1 FRU per 500,000 population during a specific year |
HMIS |
BY:2014-15 |
Indicator definition modified |
|
|
b. Proportion of functional 24x7 PHCs |
Proportion of PHCs providing all stipulated healthcare services** round the clock against the norm of one 24x7 PHC per 100,000 population during a specific year |
State Report |
BY:2014-15 |
|
|
3.1.4 |
Proportion of Districts with Functional Cardiac Care Units (CCU) |
Proportion of Districts with functional CCU [with desired equipment (ventilator, monitor, defibrillator, CCUs bed, portable ECG machine, pulse oxymeter etc.), drugs, diagnostics and desired staff as per programme guidelines] against total number of districts |
State Report |
BY: As on March 31, 2015 RY: As on March 31, 2016 |
|
|
3.1.5 |
Proportion of ANC registered within first trimester against total registrations |
Proportion of pregnant women registered for ANC within 12 weeks of pregnancy during a specific year. |
HMIS |
BY:2014-15 |
|
|
3.1.6 |
Level of registration of births (%) |
Proportion of births registered under Civil Registration System (CRS) against the estimated number of births during a specific year. |
Civil Registration System (CRS) |
BY:2013 |
|
|
3.1.7 |
Completeness of IDSP reporting of P and L form (%) |
Proportion of Reporting Units (RU) reporting in stipulated time period against total Reporting Units, for P and L forms during a specific year. |
Central IDSP, MoHFW Data |
BY:2014 |
|
|
3.1.8 |
Proportion of CHCs with grading above 3 points |
Proportion of CHCs that are graded above 3 points against total number of CHCs during a specific year. |
HMIS |
BY:2014-15 |
|
|
3.1.9 |
Proportion of public health facilities with accreditation certificates by a standard quality assurance programme (NQAS /NABH/ISO/AHPI) |
Proportion of specified type of public health facilities with accreditation certificates by a standard quality assurance programme against the total number of following specified type of
facilities during a specific year. |
State Report |
BY: As on March 31, 2015 RY: As on March 31, 2016 |
|
|
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 |
Average time taken (in number of days) by the State Treasury to transfer funds to implementation agencies during a specific year. |
Centre NHM Finance Data# |
BY:2014-15 |
|
*Criteria for fully operational FRUs: SDHs/CHCs - conducting minimum 60 C-sections per year (36 C-sections per year for hilly and North-East States except Assam); DHs - conducting minimum 120 C-sections per year (72 C-sections per year for hilly and North-East States except Assam).
**Criteria for functional 24x7 PHCs: 10 deliveries per month (5 deliveries per month for hilly and North-East States except Assam)
#Centre NHM Finance data includes the RCH Flexi pool and NHM-Health System Strengthening Flexi pool data (representing a substantial portion of the NHM funds) for calculating delay in transfer of funds.
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 Health, Nutrition, Education, 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 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, to measure change in performance over the years.
It is anticipated that this framework will assist in State level monitoring of performance and improvement in health outcomes and will thereby meet the citizens’ expectations.
Final Health Index
|
S. No |
Indicator |
Definition |
Data Source |
Base Year (BY) & Reference Year (RY) |
Base Year (BY) data available for computing Incremental Performance (Yes/No) |
Remarks |
|
|
DOMAIN 1 – HEALTH OUTCOMES |
|||||||
|
SUB-DOMAIN 1.1 - KEY OUTCOMES (Weight - Larger States – 300, Smaller States & UTs – 0) |
|||||||
|
1.1.1 |
Neonatal Mortality Rate |
Number of infant deaths of less than 29 days per thousand live births during a specific year. |
Sample Registration System [Pre-filled] |
BY:2017 |
Yes |
Indicators 1.1.1, 1.1.2 and 1.1.3 are not applicable for category of Smaller States and UTs |
|
|
1.1.2 |
Under-five Mortality Rate (U5MR) |
Number of child deaths of less than 5 years per thousand live births during a specific year. |
Sample Registration System [Pre-filled] |
BY:2017 |
Yes |
||
|
1.1.3 |
Sex Ratio at Birth(SRB)* |
The number of girls born for every 1,000 boys born during a specific year. |
Sample Registration System [Pre-filled] |
BY:2017 |
Yes |
||
|
SUB-DOMAIN 1.2 - INTERMEDIATE OUTCOMES (Weight: Larger & Smaller States – 350, UTs – 300) |
|||||||
|
1.2.1 |
Modern Contraceptive Prevalence |
Percentage of women of reproductive age who are using (or whose partner is using) a modern contraceptive method at a specific point in time. |
Family Planning Division, MOHFW |
BY:2017 |
Yes |
1.2.1 and 1.2.7 are not applicable for category of UTs |
|
|
1.2.2 |
Full immunization coverage (%) |
Proportion of infants 9-11 months old who have received BCG, 3 doses of DPT, 3 doses of OPV and one dose of measles against estimated number of infants during a specific year. |
HMIS for number of infants fully immunized and MOHFW for estimated number of infants |
BY:2017-18 |
Yes |
||
|
1.2.3 |
Proportion of Antenatal Care (ANC) registered within first trimester against total registrations |
Proportion of pregnant women registered for ANC within 12 weeks of pregnancy during a specific year. |
HMIS |
BY:2017-18 |
Yes |
||
|
1.2.4 |
Proportion of institutional deliveries |
Proportion of deliveries conducted in public and private health facilities against the number of estimated deliveries during a specific year. |
HMIS for number of institutional deliveries and MOHFW for estimated number of deliveries |
BY:2017-18 |
Yes |
||
|
1.2.5 |
Total Case Notification of TB |
Proportion of new and previously treated TB cases notified (public + private) against the target of TB cases to be notified during a specific year. |
Revised National Tuberculosis Control Programme (RNTCP) MIS, MoHFW [pre-entered] |
BY:2017-18 |
Yes |
||
|
1.2.6 |
TB Treatment Success Rate |
Proportion of total TB notified cases (public) with successful treatment outcome (cured + treatment completed) out of the TB cases notified prior to the specific reporting year. |
RNTCP MIS, MoHFW [pre-entered] |
BY:2017-18 |
Yes |
||
|
1.2.7 |
Proportion of people living with HIV (PLHIV) on antiretroviral therapy (ART)+ |
Proportion of PLHIVs receiving ART treatment against the number of estimated PLHIVs who needed ART treatment for the specific year. |
NACO, MoHFW [pre-entered] |
BY:2017-18 |
Yes |
||
|
DOMAIN 2 – GOVERNANCE AND INFORMATION |
|||||||
|
SUB-DOMAIN 2.1 – HEALTH MONITORING AND DATA INTEGRITY (Weight: 100) |
|||||||
|
2.1.1 |
Data Integrity Measure: |
Percentage deviation of reported data from standard survey data to assess the quality/integrity of reported data for a specific period. |
HMIS and National Family Health Survey (NFHS)-4 |
BY &RY: 2015-16 (NFHS) BY &RY: 2011-12 to 2015-16 (HMIS) |
Yes. Data repeated for the BY and RY.. |
||
|
SUB-DOMAIN 2.2 – GOVERNANCE (Weight – 90) |
|||||||
|
2.2.1 |
Average occupancy of an officer (in months), combined for three key posts at State level for last three years |
Average occupancy of an officer (in months), combined for following posts in last three years: |
State report |
BY: April 1, 2015-March 31, 2018 |
Yes |
||
|
2.2.2 |
Average occupancy of a full-time officer (in months) in last three years for all Districts-District CMOs or equivalent post (heading District Health Services)
|
Average occupancy (in months) of a CMO in last three years for all the Districts |
State report |
BY: April 1, 2015- March 31, 2018 |
Yes |
||
|
2.2.3 |
Number of days for transfer of Central NHM fund from the State treasury to the implementation agency (Department / Society) based on largest tranche of the last financial year +
|
Average time taken (in number of days) by the State Treasury to transfer funds to implementation agencies during a specific year. |
Centre NHM Finance Data [pre-entered] |
BY:2017-18 RY:2018-19 |
Yes |
2.2.3 not applicable for category of UTs. |
|
|
DOMAIN 3 – KEY INPUTS / PROCESSES |
|||||||
|
SUB DOMAIN 3.1 – HEALTH SYSTEMS / SERVICE DELIVERY (Weight Larger States: 200, Smaller States & UTs: 180) |
|||||||
|
3.1.1 |
Proportion of shortfall of health care providers (regular + contractual) against required number of health care providers in public health facilities |
Proportion of shortfall of healthcare provider positions in public health facilities against total number of required health care providers (essential number as per IPHS 2012) for each of the
following cadres during a specific year: |
State report |
RY: As on March |
No |
3.1.10 not applicable for category of Smaller States and UTs |
|
|
3.1.2 |
Proportion of total staff (regular + contractual) covered under a functional IT enabled integrated Human Resources Management Information System (HRMIS) |
Proportion of staff (regular + contractual) for whom pay-slip and transfer / postings are generated in the IT enabled HRMIS against total number of staff (regular + contractual) during a specific year. |
State Report |
RY: As on March 31, 2019 |
No |
||
|
3.1.3 |
a. Proportion of specified type of facilities functioning as First Referral Units (FRUs) |
Proportion of public sector facilities conducting specified number of C-sections# per year (FRUs) against the norm of 1 FRU per 500,000 population during a specific year |
State Report on number of functional FRUs, MoHFW data on required number of FRUs (Pre-entered) |
BY:2017-18 |
Yes |
||
b. Proportion of public health facilities with Kayakalp score >70% against total number of public health facilities |
Proportion of public health facilities (district hospitals, sub- district hospitals, CHCs, PHCs and UPHCs) with Kayakalp score of >70% against total number of public health facilities (district and sub- district hospitals, CHCs, PHCs and UPHCs). |
MoHFW data (pre-entered) |
RY: 2018-19 |
No |
|||
|
3.1.4 |
Proportion of functional Health and Wellness Centres |
Proportion of sub-centres, PHCs and UPHCs functional as Health and Wellness Centres at the end of specific year against the total number of sub-centres, PHCs, and UPHCs. |
MoHFW data (pre-entered) |
RY: As on March 31, 2019 |
No |
||
|
3.1.5 |
Proportion of District Hospitals with Functional Cardiac Care Units (CCUs) |
Proportion of district hospitals with functional CCUs [with ventilator, monitor, defibrillator, CCU beds, portable ECG machine, pulse oxymeter etc.), drugs, diagnostics and desired staff as per programme guidelines] against total number of district hospitals. |
State Report |
RY: As on March 31, 2019 |
No |
||
|
3.1.6 |
Level of registration of births (%) |
Proportion of births registered under Civil Registration System (CRS) against the estimated number of births during a specific year. |
CRS |
BY:2017 |
Yes |
||
|
3.1.7 |
Completeness of IDSP reporting of P and L form (%) |
Proportion of Reporting Units (RU) reporting in stipulated time period against total Reporting Units, for P and L forms during a specific year. |
Central IDSP, MoHFW Data |
BY:2017 |
Yes |
||
|
3.1.8 |
Proportion of CHCs/SDH with grading of 4 points or above |
Proportion of CHCs/SDH that are graded 4 points or above against total number of CHCs/SDH during a specific year. |
HMIS |
BY:2017-18 |
Yes |
||
|
3.1.9 |
a. Proportion of public health facilities with accreditation certificates by a standard quality assurance programme (NQAS/NABH) |
Proportion of specified type of public health facilities with accreditation certificates by a standard quality assurance programme against the total number of following during a specific year.
|
State Report |
BY: As on March 31, 2018 RY: As on March 31, 2019 |
Yes |
||
b. Proportion of DH and CHC certified under LaQshya |
Proportion of facilities (DH and CHCs) certified under LaQshya separately for labour room and maternity OT) against total number of DH and CHCs. |
MoHFW data [pre-entered] |
RY: As on March 31, 2019 |
No |
|||
|
3.1.10 |
Proportion of State Government Health Expenditure to Total State Expenditure* |
Proportion of State government health expenditure to total State expenditure, during the specific year. |
National Health Profile/ National Health Accounts Cell MoHFW [pre-entered] |
BY:2015-16 |
Yes |
||
* Applicable for Larger States only;
+ Applicable for Larger and Smaller States only; not applicable for UTs;
# Criteria for fully operational FRUs: SDHs/CHCs - conducting minimum 60 C-sections per year (36 C-sections per year for hilly and north-eastern states except for Assam); DHs - conducting minimum 120 C-sections per year (72 C-sections per year for hilly and north-eastern states except Assam).
$ The delay is computed by considering the maximum amount released under NHM instead of number of tranches.
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 Health, Nutrition, Education, 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 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, to measure change in performance over the years.
It is anticipated that this framework will assist in State level monitoring of performance and improvement in health outcomes and will thereby meet the citizens’ expectations.
Final Health Index
|
S. No |
Indicator |
Definition |
Data Source |
Base Year (BY) & Reference Year (RY) |
Base Year (BY) data available for computing Incremental Performance (Yes/No) |
Remarks |
|
|
DOMAIN 1 – HEALTH OUTCOMES |
|||||||
|
SUB-DOMAIN 1.1 - KEY OUTCOMES (Weight - Larger States – 300, Smaller States & UTs – 0) |
|||||||
|
1.1.1 |
Neonatal Mortality Rate |
Number of infant deaths of less than 29 days per thousand live births during a specific year. |
Sample Registration System [Pre-filled] |
BY:2017 |
Yes |
Indicators 1.1.1, 1.1.2 and 1.1.3 are not applicable for category of Smaller States and UTs |
|
|
1.1.2 |
Under-five Mortality Rate (U5MR) |
Number of child deaths of less than 5 years per thousand live births during a specific year. |
Sample Registration System [Pre-filled] |
BY:2017 |
Yes |
||
|
1.1.3 |
Sex Ratio at Birth(SRB)* |
The number of girls born for every 1,000 boys born during a specific year. |
Sample Registration System [Pre-filled] |
BY:2017 |
Yes |
||
|
SUB-DOMAIN 1.2 - INTERMEDIATE OUTCOMES (Weight: Larger & Smaller States – 350, UTs – 300) |
|||||||
|
1.2.1 |
Modern Contraceptive Prevalence |
Percentage of women of reproductive age who are using (or whose partner is using) a modern contraceptive method at a specific point in time. |
Family Planning Division, MOHFW |
BY:2017 |
Yes |
1.2.1 and 1.2.7 are not applicable for category of UTs |
|
|
1.2.2 |
Full immunization coverage (%) |
Proportion of infants 9-11 months old who have received BCG, 3 doses of DPT, 3 doses of OPV and one dose of measles against estimated number of infants during a specific year. |
HMIS for number of infants fully immunized and MOHFW for estimated number of infants |
BY:2017-18 |
Yes |
||
|
1.2.3 |
Proportion of Antenatal Care (ANC) registered within first trimester against total registrations |
Proportion of pregnant women registered for ANC within 12 weeks of pregnancy during a specific year. |
HMIS |
BY:2017-18 |
Yes |
||
|
1.2.4 |
Proportion of institutional deliveries |
Proportion of deliveries conducted in public and private health facilities against the number of estimated deliveries during a specific year. |
HMIS for number of institutional deliveries and MOHFW for estimated number of deliveries |
BY:2017-18 |
Yes |
||
|
1.2.5 |
Total Case Notification of TB |
Proportion of new and previously treated TB cases notified (public + private) against the target of TB cases to be notified during a specific year. |
Revised National Tuberculosis Control Programme (RNTCP) MIS, MoHFW [pre-entered] |
BY:2017-18 |
Yes |
||
|
1.2.6 |
TB Treatment Success Rate |
Proportion of total TB notified cases (public) with successful treatment outcome (cured + treatment completed) out of the TB cases notified prior to the specific reporting year. |
RNTCP MIS, MoHFW [pre-entered] |
BY:2017-18 |
Yes |
||
|
1.2.7 |
Proportion of people living with HIV (PLHIV) on antiretroviral therapy (ART)+ |
Proportion of PLHIVs receiving ART treatment against the number of estimated PLHIVs who needed ART treatment for the specific year. |
NACO, MoHFW [pre-entered] |
BY:2017-18 |
Yes |
||
|
DOMAIN 2 – GOVERNANCE AND INFORMATION |
|||||||
|
SUB-DOMAIN 2.1 – HEALTH MONITORING AND DATA INTEGRITY (Weight: 100) |
|||||||
|
2.1.1 |
Data Integrity Measure: |
Percentage deviation of reported data from standard survey data to assess the quality/integrity of reported data for a specific period. |
HMIS and National Family Health Survey (NFHS)-4 |
BY &RY: 2015-16 (NFHS) BY &RY: 2011-12 to 2015-16 (HMIS) |
Yes. Data repeated for the BY and RY.. |
||
|
SUB-DOMAIN 2.2 – GOVERNANCE (Weight – 90) |
|||||||
|
2.2.1 |
Average occupancy of an officer (in months), combined for three key posts at State level for last three years |
Average occupancy of an officer (in months), combined for following posts in last three years: |
State report |
BY: April 1, 2015-March 31, 2018 |
Yes |
||
|
2.2.2 |
Average occupancy of a full-time officer (in months) in last three years for all Districts-District CMOs or equivalent post (heading District Health Services)
|
Average occupancy (in months) of a CMO in last three years for all the Districts |
State report |
BY: April 1, 2015- March 31, 2018 |
Yes |
||
|
2.2.3 |
Number of days for transfer of Central NHM fund from the State treasury to the implementation agency (Department / Society) based on largest tranche of the last financial year +
|
Average time taken (in number of days) by the State Treasury to transfer funds to implementation agencies during a specific year. |
Centre NHM Finance Data [pre-entered] |
BY:2017-18 RY:2018-19 |
Yes |
2.2.3 not applicable for category of UTs. |
|
|
DOMAIN 3 – KEY INPUTS / PROCESSES |
|||||||
|
SUB DOMAIN 3.1 – HEALTH SYSTEMS / SERVICE DELIVERY (Weight Larger States: 200, Smaller States & UTs: 180) |
|||||||
|
3.1.1 |
Proportion of shortfall of health care providers (regular + contractual) against required number of health care providers in public health facilities |
Proportion of shortfall of healthcare provider positions in public health facilities against total number of required health care providers (essential number as per IPHS 2012) for each of the
following cadres during a specific year: |
State report |
RY: As on March |
No |
3.1.10 not applicable for category of Smaller States and UTs |
|
|
3.1.2 |
Proportion of total staff (regular + contractual) covered under a functional IT enabled integrated Human Resources Management Information System (HRMIS) |
Proportion of staff (regular + contractual) for whom pay-slip and transfer / postings are generated in the IT enabled HRMIS against total number of staff (regular + contractual) during a specific year. |
State Report |
RY: As on March 31, 2019 |
No |
||
|
3.1.3 |
a. Proportion of specified type of facilities functioning as First Referral Units (FRUs) |
Proportion of public sector facilities conducting specified number of C-sections# per year (FRUs) against the norm of 1 FRU per 500,000 population during a specific year |
State Report on number of functional FRUs, MoHFW data on required number of FRUs (Pre-entered) |
BY:2017-18 |
Yes |
||
b. Proportion of public health facilities with Kayakalp score >70% against total number of public health facilities |
Proportion of public health facilities (district hospitals, sub- district hospitals, CHCs, PHCs and UPHCs) with Kayakalp score of >70% against total number of public health facilities (district and sub- district hospitals, CHCs, PHCs and UPHCs). |
MoHFW data (pre-entered) |
RY: 2018-19 |
No |
|||
|
3.1.4 |
Proportion of functional Health and Wellness Centres |
Proportion of sub-centres, PHCs and UPHCs functional as Health and Wellness Centres at the end of specific year against the total number of sub-centres, PHCs, and UPHCs. |
MoHFW data (pre-entered) |
RY: As on March 31, 2019 |
No |
||
|
3.1.5 |
Proportion of District Hospitals with Functional Cardiac Care Units (CCUs) |
Proportion of district hospitals with functional CCUs [with ventilator, monitor, defibrillator, CCU beds, portable ECG machine, pulse oxymeter etc.), drugs, diagnostics and desired staff as per programme guidelines] against total number of district hospitals. |
State Report |
RY: As on March 31, 2019 |
No |
||
|
3.1.6 |
Level of registration of births (%) |
Proportion of births registered under Civil Registration System (CRS) against the estimated number of births during a specific year. |
CRS |
BY:2017 |
Yes |
||
|
3.1.7 |
Completeness of IDSP reporting of P and L form (%) |
Proportion of Reporting Units (RU) reporting in stipulated time period against total Reporting Units, for P and L forms during a specific year. |
Central IDSP, MoHFW Data |
BY:2017 |
Yes |
||
|
3.1.8 |
Proportion of CHCs/SDH with grading of 4 points or above |
Proportion of CHCs/SDH that are graded 4 points or above against total number of CHCs/SDH during a specific year. |
HMIS |
BY:2017-18 |
Yes |
||
|
3.1.9 |
a. Proportion of public health facilities with accreditation certificates by a standard quality assurance programme (NQAS/NABH) |
Proportion of specified type of public health facilities with accreditation certificates by a standard quality assurance programme against the total number of following during a specific year.
|
State Report |
BY: As on March 31, 2018 RY: As on March 31, 2019 |
Yes |
||
b. Proportion of DH and CHC certified under LaQshya |
Proportion of facilities (DH and CHCs) certified under LaQshya separately for labour room and maternity OT) against total number of DH and CHCs. |
MoHFW data [pre-entered] |
RY: As on March 31, 2019 |
No |
|||
|
3.1.10 |
Proportion of State Government Health Expenditure to Total State Expenditure* |
Proportion of State government health expenditure to total State expenditure, during the specific year. |
National Health Profile/ National Health Accounts Cell MoHFW [pre-entered] |
BY:2015-16 |
Yes |
||
* Applicable for Larger States only;
+ Applicable for Larger and Smaller States only; not applicable for UTs;
# Criteria for fully operational FRUs: SDHs/CHCs - conducting minimum 60 C-sections per year (36 C-sections per year for hilly and north-eastern states except for Assam); DHs - conducting minimum 120 C-sections per year (72 C-sections per year for hilly and north-eastern states except Assam).
$ The delay is computed by considering the maximum amount released under NHM instead of number of tranches.