Round 2: Healthy States Progressive India - Report on the Ranks of States and Union Territories

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NITI Aayog
Ministry of Health
& Family Welfare HEALTHY STATES
PROGRESSIVE INDIA
Report on the Ranks of States and Union Territories
NITI Aayog
Ministry of Health
& Family Welfare
HEALTH INDEX 
| June 2019 Visit http://social.niti.gov.in/ to download this report. Table of Contents iii
Table of Contents
FOREWORDvii
Acknowledgementsviii
ABBREVIATIONSix
EXECUTIVE SUMMARY1
BACKGROUND11
1. OVERVIEW12
2. ABOUT THE INDEX – DEFINING AND MEASURING13
2.1. Aim13
2.2. Objective13
2.3. Salient Features13
2.4. Methodology13
2.4.1. Computation of Index scores and rank13
2.4.2. Categorization of States for ranking14
2.4.3. The Health Index score – List of indicators and weightage15
2.5. Limitation of the Index19
3. PROCESS – FROM IDEA TO PRACTICE20
3.1. Key Stakeholders – Roles and Responsibilities20
3.2. Process Flow20
3.2.1. Development of the Index20
3.2.2. Submission of data on the portal21
3.2.3. Independent validation of data21
3.2.4. Index and rank generation22
Results and Findings23
4. UNVEILING PERFORMANCE24
4.1. Performance of Larger States24
4.1.1. Overall performance24
4.1.2. Incremental performance26
4.1.3. Domain–specific performance28
4.1.4. Incremental performance on indicators30
4.2. Performance of Smaller States32
4.2.1. Overall performance32
4.2.2. Incremental performance33 Healthy S tates, Progressive Indiaiv
4.2.3. Domain – specific performance34
4.2.4. Incremental performance on indicators35
4.3. Performance of Union Territories36
4.3.1. Overall performance36
4.3.2 Incremental performance37
4.3.3 Domain–specific performance38
4.3.4. Incremental performance on indicators40
4.4. States and Union Territories Performance on Indicators40
WAY FORWARD71
5. INSTITUTIONALIZATION - T AKING THE INDEX AHEAD72
ANNEXURES73
Annexure 1. Data Validation Process74
Annexure 2. Snapshot: State-wise Performance on Indicators77
Annexure 3. State Factsheets89
LIST OF T ABLES
Table E.1 Categorization of Larger States on incremental performance and overall performance6
Table E.2 Categorization of Smaller States on incremental performance and overall performance7
Table E.3 Categorization of UTs on incremental performance and overall performance8
Table 2.1 Categorization of States and UTs15
Table 2.2 Health Index Summary15
Table 2.3 Health Index: Indicators, definitions, data sources, Base and Reference Years16
Table 3.1 Key stakeholders: roles and responsibilities20
Table 3.2 Timeline for development of Health Index 201821
Table 4.1 Larger States: Overall performance in Reference Year – Categorization26
Table 4.2 Larger States: Incremental performance from Base to Reference Year – Categorization27
Table 4.3 Smaller States: Overall performance in Reference Year – Categorization32
Table 4.4 Smaller States: Incremental performance from Base to Reference Year – Categorization33
Table 4.5 UTs: Overall performance in Reference Year – Categorization37
Table 4.6 UTs: Incremental performance from Base to Reference Year – Categorization38
LIST OF FIGURES
Figure E.1 Larger States - Incremental scores and ranks, with overall performance scores and
ranks in Base and Reference Years5
Figure E.2 Smaller States - Incremental scores and ranks, with overall performance scores and
ranks in Base and Reference Years7
Figure E.3 UTs - Incremental scores and ranks, with overall performance scores and ranks in
Base and Reference Years8
Figure E.4 Composite Index scores in Reference Year and per capita Net State Domestic Product
at current prices (INR) in 2016-179
Figure E.5 Incremental change in Composite Index scores from Base to Reference Year and
Composite Index score in Base Year10
Figure 3.1 Steps for validating data22
Figure 4.1 Larger States: Overall Performance – Composite Index score and rank, Base and
Reference Years25
Figure 4.2 Larger States: Overall and Incremental Performance, Base and Reference Years and
incremental rank27 Table of Contents v
Figure 4.3 Larger States: Overall and domain-specific performance, Reference Year28
Figure 4.4 Larger States: Performance in the Health Outcomes domain, Base and Reference Years29
Figure 4.5 Larger States: Performance in the Key Inputs/Processes domain, Base and Reference Years30
Figure 4.6 Larger States: Number of indicators/sub-indicators, by category of incremental
performance31
Figure 4.7 Smaller States: Overall performance – Composite Index score and rank, Base and
Reference Years32
Figure 4.8 Smaller States: Overall and incremental performance, Base and Reference Years and
incremental rank33
Figure 4.9 Smaller States: Overall and domain-specific performance, Reference Year34
Figure 4.10 Smaller States: Performance in the Health Outcomes domain, Base and Reference Years35
Figure 4.11 Smaller States: Performance in the Key Inputs/Processes domain, Base and
Reference Years35
Figure 4.12 Smaller States: Number of indicators/sub-indicators, by category of incremental
performance36
Figure 4.13 UTs: Overall performance – Composite Index score and rank, Base and Reference Years37
Figure 4.14 UTs: Overall and incremental performance, Base and Reference Years and incremental rank38
Figure 4.15 UTs: Overall and domain-specific performance, Reference Year39
Figure 4.16 UTs: Performance in the Health Outcomes domain, Base and Reference Years39
Figure 4.17 UTs: Performance in the Key Inputs/Processes domain, Base and Reference Years39
Figure 4.18 UTs: Number of indicators/sub-indicators, by category of incremental performance40
Figure 4.19 Indicator 1.1.1 - Neonatal Mortality Rate - Larger States41
Figure 4.20 Indicator 1.1.2 - Under-five Mortality Rate - Larger States42
Figure 4.21 Indicator 1.1.3 - Total Fertility Rate - Larger States42
Figure 4.22 Indicator 1.1.4 - Proportion of Low Birth Weight among newborns - Larger States43
Figure 4.23 Indicator 1.1.4 - Proportion of Low Birth Weight among newborns - Smaller States and UTs44
Figure 4.24 Indicator 1.1.5 - Sex Ratio at Birth - Larger States44
Figure 4.25 Indicator 1.2.1 - Full immunization coverage - Larger States45
Figure 4.26 Indicator 1.2.1 - Full immunization coverage - Smaller States and UT45
Figure 4.27 Indicator 1.2.2 - Proportion of institutional deliveries - Larger States46
Figure 4.28 Indicator 1.2.2 - Proportion of institutional deliveries - Smaller States and UTs47
Figure 4.29 Indicator 1.2.3 - Total case notification rate of tuberculosis - Larger States47
Figure 4.30 Indicator 1.2.3 - Total case notification rate of tuberculosis - Smaller States and UTs48
Figure 4.31 Indicator 1.2.4 - Treatment success rate of new microbiologically confirmed
tuberculosis cases - Larger States49
Figure 4.32 Indicator 1.2.4 - Treatment success rate of new microbiologically confirmed
tuberculosis cases – Smaller States and UTs49
Figure 4.33 Indicator 2.1.1: Data Integrity Measure – ANC registered within first trimester – Larger States50
Figure 4.34 Indicator 2.1.1: Data Integrity Measure – ANC registered within first trimester Smaller
States and UTs50
Figure 4.35 Indicator 2.1.1: Data Integrity Measure – institutional deliveries – Larger States51
Figure 4.36 Indicator 2.1.1: Data Integrity Measure – institutional deliveries – Smaller States and UTs51
Figure 4.37 Indicator 2.2.1 - Average occupancy of an officer (in months), for three key posts at
State level for last three years - Larger States52
Figure 4.38 Indicator 2.2.1 - Average occupancy of an officer (in months), for three key posts at
State level for last three years - Smaller States and UTs52
Figure 4.39 Indicator 2.2.2 - Average occupancy of a District Chief Medical Officer (CMO) or
equivalent post (heading District Health Services full-time) (in months) in last
three years - Larger States53 Healthy S tates, Progressive Indiavi
Figure 4.40 Indicator 2.2.2 - Average occupancy of a District Chief Medical Officer (CMO) or
equivalent post (heading District Health Services full-time) (in months) in last
three years - Smaller States and UTs53
Figure 4.41 Indicator 3.1.1a - Vacancy of ANMs at sub-centres - Larger States54
Figure 4.42 Indicator 3.1.1a - Vacancy of ANMs at sub-centres - Smaller States and UTs54
Figure 4.43 Indicator 3.1.1b - Vacancy of Staff Nurse at PHCs and CHCs – Larger States55
Figure 4.44 Indicator 3.1.1b - Vacancy of Staff Nurse at PHCs and CHCs – Smaller States and UTs55
Figure 4.45 Indicator 3.1.1c - Vacancy of Medical Officers at PHCs – Larger States56
Figure 4.46 Indicator 3.1.1c - Vacancy of Medical Officers at PHCs – Smaller States and UTs56
Figure 4.47 Indicator 3.1.1d - Vacancy of Specialists at district hospitals – Larger States57
Figure 4.48 Indicator 3.1.1d - Vacancy of Specialists at district hospitals – Smaller States and UTs57
Figure 4.49 Indicator 3.1.2 - Proportion of total staff (regular + contractual) with e-payslip generated in the
IT enabled Human Resources Management Information System (HRMIS) – Larger States 58
Figure 4.50 Indicator 3.1.2 - Proportion of total staff (regular + contractual) with e-payslip generated
in the IT enabled Human Resources Management Information System (HRMIS) –
Smaller States and UTs 59
Figure 4.51 Indicator 3.1.3.a - Proportion of facilities functional as First Referral Units - Larger States 59
Figure 4.52 Indicator 3.1.3a - Proportion of facilities functional as First Referral Units - Smaller States
and UTs60
Figure 4.53 Indicator 3.1.3b - Proportion of functional 24x7 PHCs - Larger States60
Figure 4.54 Indicator 3.1.3b - Proportion of functional 24x7 PHCs - Smaller States and UTs61
Figure 4.55 Indicator 3.1.4 - Cardiac Care Units in districts - Larger States62
Figure 4.56 Indicator 3.1.4 - Cardiac Care Units in districts - Smaller States and UTs62
Figure 4.57 Indicator 3.1.5 - Proportion of ANC registered within first trimester against total
registrations - Larger States 63
Figure 4.58 Indicator 3.1.5 - Proportion of ANC registered within first trimester against total
registrations - Smaller States and UTs 63
Figure 4.59 Indicator 3.1.6 - Level of registration of births - Larger States64
Figure 4.60 Indicator 3.1.6 - Level of registration of births - Smaller States and UTs 65
Figure 4.61 Indicator 3.1.7 - Completeness of Integrated Disease Surveillance Programme
reporting of P form - Larger States 65
Figure 4.62 Indicator 3.1.7: Completeness of Integrated Disease Surveillance Programme
reporting of P form - Smaller States and UTs 66
Figure 4.63 Indicator 3.1.7 - Completeness of Integrated Disease Surveillance Programme
reporting of L form - Larger States 66
Figure 4.64 Indicator 3.1.7 - Completeness of Integrated Disease Surveillance Programme
reporting of L form - Smaller States and UTs67
Figure 4.65 Indicator 3.1.8 - Proportion of CHCs with grading of 4 points or above - Larger States 67
Figure 4.66 Indicator 3.1.8 - Proportion of CHCs with grading of 4 points or above – Smaller States
and UTs 68
Figure 4.67 Indicator 3.1.10 - Average number of days for transfer of Central NHM fund from
State Treasury to implementation agency based on all tranches of the last fiscal year -
Larger States 69
Figure 4.68 Indicator 3.1.10 - Average number of days for transfer of Central NHM fund from
State Treasury to implementation agency based on all tranches of the last fiscal
year - Smaller States and UTs70
Foreword vii
Foreword
NITI Aayog is committed to establishing the Health Index as an annual systematic tool to focus the attention
of the States/UTs on achieving better health outcomes. This is further complemented with the MoHFW’s
decision to link a part of NHM funds to the progress achieved by the States on this Index. I am delighted to
present the second edition of the Health Index, which analyses the overall performance and incremental
improvement in the States and the UTs for the period 2015-16 (Base Year) and 2017-18 (Reference Year),
i.e., a two-year period.
It would be recalled that to motivate States to improve population health and reduce disparities in the spirit
of cooperative and competitive federalism, the
National Institution for Transforming India (NITI) Aayog had
brought out a publication in 2018 titled, “Healthy States: Progressive India”. It was a compilation of the
state of health systems prevalent in the State/UTs of India, which was published in collaboration with the
Ministry of Health & Family Welfare (MoHFW) and with technical assistance from the World Bank.
The Health Index highlights the progress reached by the individual States and UTs and is an important
instrument in understanding the variations and complexity of the nation’s performance in health. It
highlights the areas each State should focus on to facilitate improvement in overall health outcomes. The
lessons learned in the first and second rounds of Health Index will guide us in making further improvement
of the Health Index in the coming years. Through the first round of implementation, stakeholders have
gained valuable experience on gathering data to measure and analyse health/performance across States
and UTs over time. The release of the first round of Health Index had triggered many useful discussions,
including how best to measure health performance, how to strengthen the data collection system, how to
identify barriers and motivate actions using data, and how to promote positive competition and learning
among the States and UTs. I expect similar kind of discussions, wherein States/UTs can easily identify
States that have shown marked improvement in performance from Round one. I would also think of this as
a useful stock – taking tool through which progress towards SDG Goal# 3 can be tracked.
I would like to take this opportunity to extend my appreciation to all those who contributed to this edition
of the Health Index. I thank the Union Ministry, State Governments and Union Territory Administrations for
sharing timely information as well as sharing their suggestions for improving the Index. I look forward to
continued support for this Index, which will impact and transform the health of the population and make
India healthy.
Amitabh K ant
Chief Executive Officer
NITI Aayog
Government of India Healthy S tates, Progressive Indiaviii
ACKNOWLEDGEMENTS
NITI Aayog in collaboration with the World Bank and the Ministry of Health and Family Welfare (MoHFW)
embarked on a journey in 2017 to develop the first comprehensive State Health Index and published the
first edition of “Healthy States, Progressive India - Report on the Ranks of States and Union Territories”
to bring about a transformational change in the health of the people in India. The second edition of this
exercise was conducted over a period of eight months in 2018-19. It involved extensive engagement
with the States in the process of data collection; mentoring of States in the data submission process
on an online portal hosted by NITI Aayog and an independent validation of data submitted. The timely
completion of the second round of the State Health Index could not have been possible without the
support and cooperation of all the partners.
We would like to acknowledge various program divisions under Ministry of Health and Family Welfare,
Additional Chief Secretaries/Principal Secretaries (Health) and Mission Directors, National Health Mission
and State Nodal officers of various States and UTs for their complete support during the process and for
working in close co-ordination with NITI Aayog during its entire course.
We are extremely grateful to the World Bank team including Mr. Junaid Kamal Ahmad, Country Director and
the technical team led by Ms. Sheena Chhabra, Senior Health Specialist and Task Team Leader along with Dr.
Rattan Chand, Senior Consultant, Dr. Di Dong, Young Professional, and Dr. Valerie Ulep, Consultant, for their
technical assistance to NITI Aayog during the entire process including the authorship of this report. Support
of Dr. Nikhil Utture, Ms. Manveen Kohli and Ms. Anagha Khot is appreciated. Peer Review of the final report
by the World Bank team comprising of Dr. Rekha Menon, Practice Manager, Dr. Ajay Tandon, Lead Economist,
Dr. Mickey Chopra, Global Lead on Service Delivery, and Dr. Owen Smith, Senior Economist, is also greatly
acknowledged.
We recognize the effort made by the Sambodhi Research and Communication’s Independent Validation
Agency team comprising of Mr. Sudhanshu Malhotra, Mr Vijay Avinandan, Dr Vikash Choudhry and
Mr. Shekhar Kedia for completing the task on time. The online portal was developed and maintained by
Silvertouch Technologies, led by Ms. Surbhi Singhal and Mr. Aman.
We thankfully acknowledge the mentor organizations including RRC - NE, MoHFW (led by Dr. Himanshu
Bhushan and Dr. Bhaswat Das), TERI (led by Ms. Meena Sehgal) and USAID India (Mr. Gautam Chakraborty)
through SWASTI team for the valuable support to the States/UTs during the data submission phase of
the project.
We are grateful to Shri Amitabh Kant, CEO, NITI Aayog for his inspiration and guidance that made this report
possible, the Health Division team led by Dr. K. Madan Gopal, Senior Consultant; Dr. S. Rajesh, Director,
and Mr. Ranganadham Srinadh, Research Assistant who contributed to the planning, implementation and
coordination of the entire exercise.
Alok K umar, IAS
Adviser, Health
NITI Aayog
Government of India
Abbreviations ix
Abbreviations
AHPI Association of Healthcare Providers (India)
ANC Antenatal Care
ANM Auxiliary Nurse Midwife
ART Antiretroviral Therapy
BCG Bacillus Calmette–Guérin vaccine
BY Base Year
CCU Cardiac Care Unit
CEO Chief Executive Officer
CHC Community Health Centre
CMO Chief Medical Officer
CRS Civil Registration System
C-Section Caesarean Section
DH District Hospital
DPT Diphtheria, Pertussis, and Tetanus
EAG Empowered Action Group
ENT Ear-Nose-Throat
FLV First Level Verification
FRU First Referral Unit
HIV Human Immunodeficiency Virus
HMIS Health Management Information System
HRMIS Human Resources Management Information System
IDSP Integrated Disease Surveillance Programme
IMR Infant Mortality Rate
INR Indian Rupees
IVA Independent Validation Agency
ISO International Organization for Standardization
IT Information Technology
LBW Low Birth Weight
L FORM IDSP Reporting Format for Laboratory Surveillance
MIS Management Information System
MMR Maternal Mortality Ratio Healthy S tates, Progressive Indiax
MO Medical Officer
MoHFW Ministry of Health and Family Welfare
NA Not Applicable
NABH National Accreditation Board for Hospitals and Healthcare Providers
NACO National AIDS Control Organization
NCDs Non-communicable Diseases
NE North-Eastern
NFHS National Family Health Survey
NHM National Health Mission
NHP National Health Policy
NITI Aayog National Institution for Transforming India
NMR Neonatal Mortality Rate
NQAS National Quality Assurance Standards
OPV Oral Polio Vaccine
ORGI Office of the Registrar General and Census Commissioner of India
P FORM IDSP Reporting Format for Presumptive Surveillance
PHC Primary Health Centre
PLHIV People Living with HIV
RRC-NE Regional Resource Centre for North Eastern States
RNTCP Revised National Tuberculosis Control Programme
RU Reporting Unit
RY Reference Year
SC Sub-Centre
SDG Sustainable Development Goals
SDH Sub-District Hospital
SRB Sex Ratio at Birth
SRS Sample Registration System
SN Staff Nurse
SNOs State Nodal Officers
TA Technical Assistance
TB Tuberculosis
TFR Total Fertility Rate
U5MR Under-five Mortality Rate
USAID United States Agency for International Development
UTs Union Territories EXECUTIVE
SUMMARY
Executive S ummary 3
Background and Methodology
1. Accompanying the rapid economic growth, India has made significant improvements in health. In
the last decade, millions of Indians were alleviated from poverty. Health system and health outcomes
have also significantly improved. Despite the remarkable progress, health remains a critical area
that needs improvement. When benchmarked against countries with similar levels of economic
development, India is lagging on some critical health indicators. Moreover, there are huge disparities
across States and Union Territories (UTs). The health outcomes of some States are comparable to that
of some upper middle-income countries and high income countries (for example, Neonatal Mortality
Rate (NMR) in Kerala is similar to that of Brazil or Argentina), while some other States have health
outcomes similar to that in the poorest countries in the world (for example, NMR in Odisha is close to
that of Sierra Leone). To motivate States to improve population health and reduce disparities in the
spirit of cooperative and competitive federalism, the National Institution for Transforming India (NITI)
Aayog launched the Health Index to measure the performance of States and UTs. In February 2018,
the first round of the Health Index (referred to as Health Index-2017) was released, which measured
the annual and incremental performance of the States and UTs over the period of 2014-15 (Base
Year) to 2015-16 (Reference Year). NITI Aayog in collaboration with MoHFW and the World Bank,
is committed to establish the Health Index as an annual systematic tool to propel States towards
undertaking multi-pronged interventions that will bring better health outcomes. The second round of
Health Index (referred to as Health Index-2018) examined the overall performance and incremental
improvement in the States and UTs for the period 2015-16 (Base Year) to 2017-18 (Reference Year), i.e.,
a two-year period. The details of the Health Index and indicators can be found in Tables 2.2 and 2.3.
2. Multiple stakeholders contributed to the Health Index-2018. The NITI Aayog provided overall
stewardship in collaboration with the Ministry of Health and Family Welfare (MoHFW), while the
World Bank continued to provide technical assistance, the States and UTs, national and international
experts contributed to the completion of the Health Index exercise.
3. Health Index is a composite score incorporating 23 indicators covering key aspects of health
sector performance. The indicators, methodology and categorization of States and UTs in the Health
Index-2018 are consistent with the 2017 round with a total of 23 indicators grouped into domains
of Health Outcomes, Governance and Information, and Key Inputs/Processes. The interactive web
portal developed and hosted by NITI Aayog with pre-specified format from the 2017 round was used
by the States and UTs to submit data on identified indicators for the Health Index-2018. The States
were informed about the Health Index including indicator definitions, data sources and process for
data submission. Data were submitted by States on the online portal hosted by NITI Aayog except
for 12 indicators for which the data were pre-filled as these were available in the public domain. The
data were then validated by an Independent Validation Agency (IVA) and were used as an input for
Executive S ummary Healthy S tates, Progressive India4
generation of Index values and ranks. For generation of ranks, the States were classified into three
categories (Larger States, Smaller States and UTs) to ensure comparability among similar entities.
Key R esults
4. The Health Index scores for 2017-18 (Reference Year) revealed large disparities in overall
performance across States and UTs. Among the Larger States, the overall Health Index score of the
best-performing State is more than two and half times of the overall score of the least-performing
State. Kerala championed the Larger States with an overall score of 74.01, while Uttar Pradesh was
the least performing State with an overall score of 28.61 (Figure E.1). Among the Smaller States,
scores varied between 38.51 in Nagaland and 74.97 in Mizoram (Figure E.2). Among the UTs, the
scores varied between 41.66 in Daman and Diu to 63.62 in Chandigarh (Figure E.3). Overall, there
is room for improvement in all States, even among the best-performing States there is substantial
room for improvement. Among the least performing States/UTs, particularly, there is an urgent need
to accelerate efforts to narrow the performance gap between States and UTs.
5. States vary in progress towards achieving Sustainable Development Goals (SDG). Several States
have made good progress towards achieving SDG goals included in the Index. Kerala and Tamil
Nadu have already reached the 2030 SDG target for NMR, which is 12 neonatal deaths per 1,000
live births. Maharashtra and Punjab are also close to achieving the target. Kerala, Tamil Nadu,
Maharashtra and Punjab have already achieved the SDG target related to Under-Five Mortality
Rate (U5MR), which is 25 deaths per 1,000 live births. Other States and UTs still need significant
improvements to meet SDG targets.
6. The changes in Health Index scores from 2015-16 to 2017-18 varied significantly across States and
UTs, implying different levels of momentum to improve performance. Only about half the States and
UTs had an improvement in the overall score between 2015-16 and 2017-18. The degree of change
in incremental performance scores differed across the three categories of States. The magnitude of
change was bigger in UTs compared to Larger and Smaller States. The indicators which contributed
to increase or decrease in overall performance scores can be found from the snapshot of State-wise
performance on indicators (Annexure 2).
State-wise factsheets depicting their respective position according to the overall performance and
incremental performance, level of each indicator, and their incremental performance from 2015-16 to
2017-18 is included in Annexure 3. The changes in Health Index scores can be contributed by many
factors. For example, a decline of a State’s Health Index score from Base Year to Reference Year
could be due to worse performance on some indicators in the Reference Year that outweighs the
improvements on other indicators.
7. Among the Larger States, Haryana, Rajasthan and Jharkhand are the top three States in terms of
incremental performance, while Kerala, Andhra Pradesh, and Maharashtra are the top three States in
terms of overall performance. In terms of incremental performance in Index scores from Base Year to
Reference Year, the top three ranked States in the group of Larger States are Haryana (up 6.55 points),
Rajasthan (up 6.30 points) and Jharkhand (up 5.99 points). However, in terms of overall performance,
these States are among the bottom two-third of the range of Index scores, with Kerala (74.01), Andhra
Pradesh (65.13) and Maharashtra (63.99) showing the highest scores. Andhra Pradesh and Maharashtra
are the only two States that are among the top one-third States on both overall performance as well as
incremental performance. Andhra Pradesh has the highest proportion of indicators (63 percent) among
the Larger States which fall in the category of “Most Improved” or “Improved”.
Executive S ummary 5
Note: As West Bengal did not submit data on the portal, the overall and incremental performance scores were generated based
on pre-filled indicator data for 12 indicators and for the remaining 11 indicators the data from the Base Year were repeated for the
Reference Year.
Base Year (2015-16)
Reference Year (2017-18)
States30 40 50 60 70 80
30 40 50 60 70 80
Overall Performance Index Score Incremental Change
Kerala
Jammu & Kashmir
Punjab
Andhra Pradesh
Karnataka
Maharashtra
Jharkhand
Himachal Pradesh
Telangana
Tamil Nadu
Gujarat
Chhattisgarh
West Bengal
Haryana
Assam
Uttarakhand
Rajasthan
Madhya Pradesh
Bihar
Uttar Pradesh
Odisha
33.69
28.61
38.4632.11
39.4335.97
40.0938.39
40.20 45.22
43.1036.79
44.13 48.85
45.33 51.33
53.3652.02
46.97 53.51
58.2557.17
59.0055.39
63.3860.41
61.1458.70
60.3562.37
61.2062.41
63.01 65.21
61.9963.52
63.9961.07
60.16 65.13
74.01
2.02
-5.08
2.92
-6.35
-3.46
-1.70
-2.55
2.44
-2.97
3.61
-1.08
6.30
1.34
5.99
4.72
6.55
-5.02
1.21
-2.20
1.53
4.97
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
Overall
Reference
Year Rank
Incremental
Rank
-10-5 501 0
-10-5 501 0
76.55
Figure E.1   Larger States - Incremental scores and ranks, with overall performance scores and ranks in Base and
Reference Years
8. Among the Larger States, seven of the top ten States on overall performance also continued to
improve on their Health Index scores from the Base Year (2015-16) to the Reference Year (2017-18),
while several of the least-performing States (mostly EAG
1
States) further deteriorated, leading to a
wider performance gap across Larger States (Table E.1). Among the top ten performers, seven had
made further improvements in overall performance scores (Andhra Pradesh, Maharashtra, Gujarat,
Himachal Pradesh, Jammu & Kashmir, Karnataka and Telangana). However, among the six least-
performing States (Uttar Pradesh, Bihar, Odisha, Madhya Pradesh, Uttarakhand, and Rajasthan), five
had decline in the overall performance scores, with the exception of Rajasthan which improved the
score by 6.30 points. Among the eight EAG States, only three of the States Rajasthan, Jharkhand
and Chhattisgarh showed improvement in the overall performance between 2015-16 and 2017-18.
While it is important to identify the challenges faced by the EAG States that hinders improvement in
performance, the impressive improvement in some EAG States provides learning opportunities for the
rest to identify effective actions to improve their overall performance scores.
1. EAG States - Empowered Action Group States includes Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan,
Uttarakhand, Uttar Pradesh, and Odisha. Healthy S tates, Progressive India6
9. The decline in the overall Health Index score for five EAG States (Bihar, Uttar Pradesh, Uttarakhand,
Madhya Pradesh, Odisha) between the Base Year and Reference Year is attributed to the
deterioration of performance in several indicators. The State-wise factsheets provide a good overview
of the variations in performance (Annexure 3). For instance in Bihar, the deterioration between Base
Year and Reference Year was primarily due to the performance related to total fertility rate, low birth
weight, Sex Ratio at Birth, TB treatment success rate, quality accreditation of public health facilities,
and time-taken for NHM fund transfer, while in the case of Uttar Pradesh the performance related to
low birth weight, TB treatment success rate, average tenure of key positions at state and district level
and level of birth registration accounted for the deterioration. Similarly, Uttarakhand had a decrease
in Health Index score mainly because of the deterioration in NMR, U5MR, stability of tenure of key
administrative positions at district level, functionality of FRUs, and NHM fund transfer. Odisha’s Health
Index score reduction was mostly due to worsening of the full immunization rate and TB treatment
success rate, and Madhya Pradesh had a reduction in level of birth registration and TB treatment
success rate, leading to lower Health Index score.
It was observed that though Under-Five Mortality and Neonatal Mortality Rates have improved in most
EAG States (except for Uttarakhand where neonatal and U5MR rates increased), most
intermediate outcome indicators have deteriorated. Full immunization coverage, institutional
delivery and TB treatment success rate are intermediate outcome indicators that need significant
improvement.
10. Kerala, despite the decrease in overall Health Index score, maintained its ranking as the top
performing among the Larger States. However, Tamil Nadu dropped from third position to ninth
position, while Punjab dropped from second position to the fifth. The decline in the overall Health
Index score in Tamil Nadu and Punjab is largely attributed to the decline in several health outcome
indicators.
Table E.1   Categorization of Larger States on incremental performance and overall performance
Incremental Performance
Overall Performance
AspirantsAchieversFront-runners
Not Improved
(0 or less)
Madhya Pradesh
Odisha
Uttarakhand
Uttar Pradesh
Bihar
West Bengal
Kerala
Punjab
Tamil Nadu
Least Improved
(0.01-2.0)
–
ChhattisgarhGujarat
Himachal Pradesh
Moderately Improved
(2.01-4.0)
––
Maharashtra
Jammu & Kashmir
Karnataka
Telangana
Most Improved
(more than 4.0)
Rajasthan
Haryana
Jharkhand
Assam
Andhra Pradesh
Note: The States are categorized on the basis of Reference Year Index score range: Front-runners: top one-third (Index
score >58.88), Achievers: middle one-third (Index score between 43.74 and 58.88), Aspirants: lowest one-third (Index score
<43.74). The States are categorized into four groups based on incremental performance: ‘Not Improved’ (<=0 incremental change), ‘Least
Improved’ (0.01 to 2.0 points increase), ‘Moderately Improved’ (2.01 to 4.0 points increase), and ‘Most Improved’ (>4 points increase).
Executive S ummary 7
11. Among the Smaller States, Mizoram ranked first in overall performance, while Tripura and Manipur
were top two States in terms of incremental performance (Figure E.2 and Table E.2). The overall
performance score of four Smaller States declined in 2017-18. Arunachal Pradesh registered largest
decline in the overall performance score from 49.51 to 46.07. Mizoram remains the best performer in
terms of overall performance, and registered an increased from 73.70 to 74.97 in overall performance.
Compared to the Larger States, the magnitude of change in the overall performance scores among
the Smaller States was smaller.
Among the Smaller States, Sikkim and Arunachal Pradesh had bigger decrease in overall Health Index
scores. Health Index score in Sikkim deteriorated due to poor performance of several indicators
such as institutional deliveries, TB case notification rate, TB treatment success rate, 1st trimester
ANCs, level of birth registration, and IDSP reporting of L-form. However, the decrease in the overall
Health Index score in Arunachal Pradesh was largely attributable to significant deterioration in
performance of five indicators - TB treatment success rate, e-pay slip for all staff, functional 24x7
PHCs, IDSP reporting of L-form, and quality accreditation of public health facilities.
Base Year (2015-16)
Reference Year (2017-18)
States20 30 40 50 60 70 80
20 30 40 50 60 70 80
Overall Performance Index Score
-10-5 50 10
-10-5 501 0
Incremental Change
Overall
Reference
Year Rank
Incremental
Rank
Mizoram
Tripura
Goa
Meghalaya
Sikkim
Nagaland
Arunachal Pradesh
Manipur
38.5137.38
49.5146.07
46.3843.51
53.2050.51
51.9053.13
56.8355.95
57.786 0.60
73.70 74.97
-3,44
1.271
2
3
4
5
6
7
8
3
2
5
6
7
1
8
4
2.82
-0.88
-2.70
2.87
1.13
-1.23
Figure E.2   Smaller States - Incremental scores and ranks, with overall performance scores and ranks in Base
and Reference Years
Table E.2  Categorization of Smaller States on incremental performance and overall performance
Incremental Performance
Overall Performance
AspirantsAchieversFront-runners
Not Improved
(0 or less)
Arunachal Pradesh
Sikkim
Meghalaya
Goa
–
Least Improved
(0.01-2.0)
Nagaland–Mizoram
Moderately Improved
(2.01-4.0)
TripuraManipur–
Most Improved
(more than 4.0)
–––
Note: The States are categorized on the basis of Reference Year Index score range: Front-runners: top one-third (Index score >62.82),
Achievers: middle one-third (Index score between 50.67 and 62.82), Aspirants: lowest one-third (Index score <50.67). The States
are categorized into four groups based on incremental performance: ‘Not Improved’ (<=0 incremental change), ‘Least Improved’
(0.01 to 2.0 points increase), ‘Moderately Improved’ (2.01 to 4.0 points increase), and ‘Most Improved’ (>4 points increase). Healthy S tates, Progressive India8
12. Among the UTs, Chandigarh ranked first in overall performance, while Dadra and Nagar Haveli
improved the most (Figure E.3 and Table E.3). Chandigarh, and Dadra and Nagar Haveli ranked
first and second in terms of overall performance ranking because of the impressive 11 and 22 points
increase respectively in the overall performance.
13. Three UTs registered decline in their overall Health Index scores: Lakshadweep, Andaman and
Nicobar Islands, and Delhi. The large decline in the overall Health Index scores of Lakshadweep
and Andaman & Nicobar Islands is largely driven by the deterioration of health outcome indicators.
Of the five health outcome indicators, 3 indicators deteriorated in Lakshadweep (low birth weight,
full immunization, institutional delivery), and 4 indicators in Andaman & Nicobar (full immunization,
institutional deliveries, TB case notification, and TB treatment success rate).
Table E.3  Categorization of UTs on incremental performance and overall performance
Incremental Performance
Overall Performance
AspirantsAchievers Front-runners
Not Improved
(0 or less)
Andaman and Nicobar
Delhi
Lakshadweep
Least Improved
(0.01–2.0)
Moderately Improved
(2.01–4.0)
Puducherry
Most Improved
(more than 4.0)
Daman and Diu
Chandigarh
Dadra and Nagar Haveli
Note: The States are categorized on the basis of Reference Year Index score range: Front-runners: top one-third (Index
score >56.30), Achievers: middle one-third (Index score between 48.98 and 56.30), Aspirants: lowest one-third (Index
score <48.98). The States are categorized into four groups: ‘Not Improved’ (<=0 incremental change), ‘Least Improved’
(0.01 to 2.0 points increase), ‘Moderately Improved’ (2.01 to 4.0 points increase), and ‘Most Improved’ (>4 points increase).
Base Year (2015-16)
Reference Year (2017-18)
Year
States2030 40 50 60 70 80
2030 40 50 60 70 80
Overall Performance Index Score
-10-5 501 0
-10-5 501 01520
1520
Incremental Change
Overall
Reference
Year Rank
Incremental
Rank
Chandigarh
Andaman & Nicobar
Puducherry
Lakshadweep
Delhi
Daman & Diu
Dadar & Nagar Haveli
41.6636.10
50.0045.36
50.0249.42
47.4849.69
56.31
65.7953.54
34.64
52.27 63.62
-4.64
11.351
2
3
4
5
6
7
2
1
7
4
5
6
3
21.67
-12.25
-0.61
5.56
2.21
Figure E.3  UTs - Incremental scores and ranks, with overall performance scores and ranks in Base and
Reference Years
Executive S ummary 9
14. There was a general positive correlation between the Health Index scores and the economic
development levels of States and UTs as measured by per capita Net State Domestic Product
(NSDP) (Figure E.4). However, a few States with relative low level of economic development
performed well in the Health Index, such as Jammu and Kashmir, Manipur, Mizoram, Andhra Pradesh,
and Punjab. The lessons from these States may provide some insights on how to improve Health
Index scores in States with similarly low level of economic development. On the other hand, some
States and UTs with relative high level of economic development did not perform as well in Health
Index score, such as Goa, Delhi and Sikkim.
15. There is narrowing gap in performance from Base Year to Reference Year among UTs (Figure E.5).
There was a convergence in Health Index scores from Base Year to Reference Year across UTs,
that is, UTs with higher Health Index scores in the Base Year tended to deteriorate whereas least-
performing UTs in the Base Year tended to improve their performance in the Reference Year. Among
the Larger and Smaller States, there was neither divergence nor convergence in Health Index scores
over time.
Figure E.4   Composite Index scores in Reference Year and per capita Net State Domestic Product
at current prices (INR) in 2016-17
Andhra Pradesh
Assam
Bihar
Chhattisgarh
Gujarat
Haryana
Himachal Pradesh
Jammu & Kashmir
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Odisha
Punjab
Rajasthan
Tamil Nadu
Telangana
Uttar Pradesh
Uttarakhand
West Bengal
Arunachal Pradesh
Goa
Manipur
Meghalaya
Mizoram
Nagaland
Sikkim
Andaman & Nicobar
Chandigarh
DelhiPuducherry
20
30
40
50
60
70
80
0 50,000 1,00,000 1,50,000 2,00,000 2,50,000 3,00,000 3,50,000
Larger States
Smaller States
UTs
Per Capita Net State Domestic Product (NSDP) at Current Prices (INR) in 2016-17
Composite Index Scores in Reference Year (2017-18)
Source: Directorate of Economics & Statistics of respective State Governments. Healthy S tates, Progressive India10
Conclusion and Way Forward
16. The Health Index is a useful tool to measure and compare the overall performance and incremental
performance across States and UTs over time. The Health Index is an important instrument in
understanding the variations and complexity of the nation’s performance in health. The first round
of Health Index had triggered many useful discussions, including how best to measure health
performance, how to strengthen the data collection system, how to identify barriers and motivate
actions using data, and how to promote positive competition and learning among the States and
UTs. The report in the second round highlights the areas each State/UT should focus on to facilitate
improvement in overall health outcomes.
Figure E.5  Incremental change in Composite Index scores from Base to Reference Year and
Composite Index score in Base Year
0
5
10
15
20
25
30 35 40 45 50 55 60 65 70 75 80
Larger States
Smaller States
UTs
Incremental Change in Composite Index Scores from
Base Year (2015-16) to Reference Year (2017-18)
Composite Index Score in Base Year (2015-16)
-15
-10
-5
Andhra PradeshAssam
Bihar
ChhattisgarhGujarat
Haryana
Himachal Pradesh
Jammu & Kashmir
Jharkhand
Karnataka
Madhya Pradesh
Maharashtra
Odisha
Punjab
Rajasthan
Tamil Nadu
Telangana
Uttar Pradesh
Uttarakhand
West Bengal
Arunachal Pradesh
Goa
Manipur
Meghalaya
Nagaland
Sikkim
Tripura
Andaman & Nicobar
Chandigarh
Dadra & Nagar Haveli
Daman & Diu
Delhi
Lakshadweep
Puducherry
Kerala
Mizoram BACKGROUND Healthy S tates, Progressive India12
Background
1. OVERVIEW
The National Development Agenda unanimously agreed to by all the State Chief Ministers and the
Lieutenant Governors of Union Territories (UTs) in 2015 had inter alia identified education, health, nutrition,
women and children as priority sectors requiring urgent action. To fulfill the National Development
Agenda, it is imperative to make rapid improvement in these sectors. India, along with other countries,
has also committed itself to adopting the Sustainable Development Goals (SDGs) to end poverty, protect
the planet, and ensure prosperity for all as part of the new global sustainable development agenda to
be fulfilled by 2030.
As the nodal agency responsible for charting India’s quest for attaining the commitments under the SDGs,
the National Institution for Transforming India (NITI Aayog) has been mandated with transforming India
by exercising thought leadership and by promoting co-operative and competitive federalism, among the
Governments of States and UTs to rapidly improve outcomes. It is in this context that NITI Aayog had
spearheaded the Health Index initiative in 2017 in collaboration with the Ministry of Health and Family
Welfare (MoHFW) and with technical assistance from the World Bank, to measure the annual performance
of States and UTs on a variety of indicators – Health Outcomes, Governance and Information and Key
Inputs/Processes.
“Healthy States, Progressive India”- the report on the first round of Health Index (referred to as Health
Index-2017) released in February 2018, measured the annual performance of the States and UTs, over the
period 2014-15 (Base Year) and 2015-16 (Reference Year) and ranked States on the basis of incremental
change, while also providing an overall status of States’ performance and helping identify specific areas
of improvement. NITI Aayog is committed to establish the Health Index as an annual systematic tool that
will propel States towards undertaking multi-pronged interventions that will bring about the much-desired
optimal health outcomes. In this regard, the World Bank continues to provide technical assistance to the
NITI Aayog on the second round of the Health Index (referred to as Health Index-2018) which covers the
period 2015-16 (Base Year) and 2017-18 (Reference Year) and focuses on measuring and highlighting the
overall performance and incremental improvement over a two-year period in the States and UTs.
The indicators, methodology and categorization of States and UTs in the Health Index-2018 are broadly
consistent with the 2017 round with a total of 23 indicators grouped into the domains of Health Outcomes,
Governance and Information, and Key Inputs/Processes. The interactive web portal developed and
hosted by NITI Aayog with pre-designed format from the 2017 round was used by the States and UTs to
submit data on identified indicators for the Health Index-2018. Subsequently, the data was verified by an
Independent Validation Agency (IVA) prior to computing the Index and ranks for all the States and UTs. As
in the 2017 round, the States have been grouped in three categories to ensure comparison among similar
entities - Larger States, Smaller States, and UTs.
Background 13
2. ABOUT THE INDEX – DEF INING AND MEASURING
2.1. Aim
To promote a co-operative and competitive spirit amongst the States and UTs to rapidly bring about
transformative action in achieving the desired health outcomes.
2.2. Objective
To release a composite Health Index based on key health outcomes and other health systems and service
delivery indicators and generate Health Index scores and rankings for different categories of the States
and UTs based on incremental performance and overall performance.
2.3. Salient Features
The Health Index consists of a limited set of relevant indicators categorized in the domains of
Health Outcomes, Governance and Information, and Key Inputs/Processes.
Health Outcomes are assigned the highest weight, as these remain the focus of performance.

Indicators have been selected on the basis of their importance and availability of reliable data
at least annually from existing data sources such as the Sample Registration System (SRS), Civil
Registration System (CRS) and Health Management Information Systems (HMIS).
Submission of the data by the States is via the web portal.

Data on indicators and Index calculations are validated by the IVA.
A composite Index is calculated as a weighted average of various indicators, focused on measuring
the health system performance in each State and UT for a Base Year (2015-16) and a Reference
Year (2017-18).
The change in the Index score of each State and UT from the Base Year to the Reference Year

measures the incremental progress of each State.
States and UTs are grouped in three categories to ensure comparability among similar entities,

namely 21 Larger States, 8 Smaller States, and 7 UTs.
2.4. Methodology
2.4.1. Computation of Index scores and ranks
After validation of data by the IVA, data submitted by the States and pre-filled from established sources
were used for the Health Index score calculations. Each indicator value was scaled, based on the nature
of the indicator. For positive indicators, where higher the value, better the performance (e.g. service
coverage indicators), the scaled value (S
i
) for the i
th
indicator, with data value as X
i.
was calculated as
follows:
Scaled value (S
i
) for positive indicator =
(X
i
– Minimum value) x 100
(Maximum value – Minimum value) Healthy S tates, Progressive India14
Similarly, for negative indicators where lower the value, better the performance [e.g. Neonatal Mortality
Rate (NMR), Under-five Mortality Rate (U5MR), human resource vacancies], the scaled value was calculated
as follows:
The minimum and maximum values of each indicator were ascertained based on the values for that indicator
across States within the grouping of States (Larger States, Smaller States, and UTs) for that year.
The scaled value for each indicator lies between the range of 0 to 100. Thus, for a positive indicator such
as institutional deliveries, the State with the lowest institutional deliveries will get a scaled value of 0, while
the State with the highest institutional deliveries will get a scaled value of 100. Similarly, for a negative
indicator such as NMR, the State with the highest NMR will get a scaled value of 0, while the State with the
lowest NMR will get a scaled value of 100. Accordingly, the scaled value for other States will lie between
0 and 100 in both cases.
Based on the above scaled values (S
i
), a composite Index score was then calculated for the Base Year and
Reference Year after application of the weights using the following formula:
The Composite Index score provides the overall performance and domain-wise performance for each
State and UT and has been used for generating overall performance ranks. Incremental performance
from Base Year composite scores to Reference Year composite scores was also measured and used in
ranking.
If data were missing for a State for a particular indicator, that indicator was dropped from the Health Index
calculation of that State, and the indicator weight was re-allocated to other indicators within the same
domain for that State. Missing data from one State does not directly affect the Health Index calculation for
the other States, unless the range of indicator values was changed.
The ranking was primarily based on the incremental progress made by the States and UTs from the
Base Year to the Reference Year. However, rankings based on Index scores for the Base Year and
the Reference Year have also been presented to provide the overall performance of the States and
UTs. A comparison of the change in ranks between the Base and Reference Years has also been
undertaken.
2.4.2. Categorization of States for ranking
As in the case of generating the first Health Index in 2017, based on the availability of data and the fact
that similar States should be compared, the States were ranked in three categories in the present round,
namely Larger States, Smaller States and UTs (Table 2.1).
Scaled value (S
i
) for negative indicator =
(Maximum value – X
i
) x 100
(Maximum value – Minimum value)
Composite Index =
(∑ W
i
x S
i
)
∑ W
i
where W
i
is the weight for i
th
indicator.
Background 15
The SRS data on health outcomes [NMR, U5MR, Total Fertility Rate (TFR) and Sex Ratio at Birth (SRB)]
were not available for eight Smaller States and seven UTs, while the data on the proportion of people
living with HIV (PLHIV) on antiretroviral therapy (ART) were not available for UTs.
2.4.3. The Health Index score – List of indicators and weightage
The Health Index is a weighted composite Index based on 23 indicators grouped into the domains
of Health Outcomes, Governance and Information, and Key Inputs/Processes.
Each domain had been assigned weights based on its importance. Within a domain or sub-domain,
the weight has been equally distributed among the indicators in that domain or sub-domain. Table 2.2
provides a snapshot of the number of indicators in each domain and sub-domain along with weights, while
Table 2.3 provides the list of Health Index indicators, definition, date sources and related details.
Table 2.1  Categorization of States and UTs
Category
Number of
States and UT s
States and UT s
Larger States 21
Andhra Pradesh, Assam, Bihar, Chhattisgarh, Gujarat, Haryana, Himachal
Pradesh, Jammu and Kashmir, Jharkhand, Karnataka, Kerala, Madhya
Pradesh, Maharashtra, Odisha, Punjab, Rajasthan, Tamil Nadu, Telangana,
Uttar Pradesh, Uttarakhand, West Bengal
Smaller States 8
Arunachal Pradesh, Goa, Manipur, Meghalaya, Mizoram, Nagaland,
Sikkim, Tripura
Union Territories 7
Andaman and Nicobar Islands, Chandigarh, Dadra and Nagar Haveli,
Daman and Diu, Delhi, Lakshadweep, Puducherry
Table 2.2  Health Index Summary
DomainSub-domain
Larger S tatesSmaller S tates Union T erritories
Number of
Indicators
Weight
Number of
Indicators
Weight
Number of
Indicators
Weight
Health
Outcomes
Key Outcomes 5 500 1 100 1 100
Intermediate
Outcomes
5 250 5 250 4 200
Governance
and
Information
Health Monitoring
and Data Integrity
1 70 1 70 1 70
Governance2 60 2 60 2 60
Key Inputs/
Processes
Health Systems/
Service Delivery
10 200 10 200 10 200
TOTAL23 1,080 19 680 18 630 Healthy S tates, Progressive India16
Table 2.3  Health Index: Indicators, definitions, data sources, Base and Reference Years
S.
No.
IndicatorDefinitionData Source
Base Year (BY)
and Reference
Year (RY)
Domain: Health Outcomes
1.1.1Neonatal Mortality Rate
(NMR)
2
Number of infant deaths of less than
29 days per thousand live births
during a specific year.
SRS
[pre-filled]
BY:2015
RY:2016
1.1.2Under-five Mortality Rate
(U5MR)
3
Number of child deaths of less than
5 years per thousand live births
during a specific year.
SRS
[pre-filled]
BY:2015
RY:2016
1.1.3Total Fertility Rate (TFR)
4
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.
SRS
[pre-filled]
BY:2015
RY:2016
1.1.4Proportion of Low Birth
Weight (LBW) 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
health facility.
HMISBY:2015-16
RY:2017-18
1.1.5Sex Ratio at Birth
(SRB)
5
The number of girls born for every
1,000 boys born during a specific
year.
SRS
[pre-filled]
BY:2013-15
RY:2014-16
1.2.1Full immunization
coverage
Proportion of infants 9-11 months old
who have received BCG, 3 doses of
DPT, 3 doses of OPV and measles
against estimated number of infants
during a specific year.
HMISBY:2015-16
RY:2017-18
1.2.2Proportion of institutional
deliveries
Proportion of deliveries conducted
in public and private health facilities
against the number of estimated
deliveries during a specific year.
HMISBY:2015-16
RY:2017-18
1.2.3Total case notification rate
of tuberculosis (TB)
Number of new and relapsed TB
cases notified (public + private) per
1,00,000 population during a specific
year.
Revised National
Tuberculosis Control
Programme (RNTCP)
MIS, MoHFW
[pre-filled]
BY:2016
RY:2017
1.2.4Treatment success rate
of new microbiologically
confirmed TB cases
Proportion of new cured and their
treatment completed against the
total number of new microbiologically
confirmed TB cases registered during
a specific year.
RNTCP MIS, MoHFW
[pre-filled]
BY:2015
RY:2016
1.2.5Proportion of people
living with HIV (PLHIV)
on antiretroviral therapy
(ART)
6
Proportion of PLHIVs receiving ART
treatment against the number of
estimated PLHIVs who needed ART
treatment for the specific year.
Central MoHFW Data
[pre-filled]
BY:2015-16
RY:2017-18
2. Not applicable for the category of Smaller States and UTs
3. Not applicable for the category of Smaller States and UTs
4. Not applicable for the category of Smaller States and UTs
5. Not applicable for the category of Smaller States and UTs
6. Not applicable for the category of UTs. Due to change in definition of the indicators, for Larger States and Smaller States, the
Base Year data is repeated for the Reference Year.
Background 17
S.
No.
IndicatorDefinitionData Source
Base Year (BY)
and Reference
Year (RY)
Domain: Governance and Information
2.1.1Data Integrity Measure
7
:
a. Institutional deliveries
b. ANC registered within
first trimester
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
(pre-filled)
BY and RY:
2015-16 (NFHS)
BY and RY:
2011-12 to
2015-16 (HMIS)
2.2.1Average occupancy of
an officer (in months),
combined for following
three posts at State level
for last three years
1. Principal Secretary
2. Mission Director (NHM)
3. Director (Health
Services)
Average occupancy of an officer
(in months), combined for following
posts in last three years:
1. Principal Secretary
2. Mission Director (NHM)
3. Director (Health Services)
State Report BY: April 1,
2013-March 31,
2016
RY: April 1,
2015-March 31,
2018
2.2.2Average occupancy of a
full-time officer (in months)
for all the districts in last
three years - District Chief
Medical Officers (CMOs) or
equivalent post (heading
District Health Services)
Average occupancy of a CMO (in
months) for all the districts in last
three years.
State Report BY: April 1,
2013- March
31, 2016
RY: April 1,
2015-March 31,
2018
Domain: K ey Inputs and Processes
3.1.1Proportion 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:
a. Auxiliary Nurse Mid-wife (ANM) at
sub-centres (SCs)
b. Staff nurse (SN) at Primary Health
Centres (PHCs) and Community
Health Centres (CHCs)
c. Medical officers (MOs) at PHCs
d. Specialists at District Hospitals
(Medicine, Surgery, Obstetrics
and Gynaecology, Pediatrics,
Anesthesia, Ophthalmology,
Radiology, Pathology, Ear-Nose-
Throat (ENT), Dental, Psychiatry)
State Report BY: As on
March 31, 2016
RY: As on
March 31, 2018
3.1.2Proportion of total staff
(regular + contractual)
with e-payslip generated
in the IT enabled Human
Resources Management
Information System
(HRMIS).
Availability of a functional IT enabled
HRMIS measured by the proportion
of staff (regular + contractual)
for whom an e-payslip 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, 2016
RY: As on
March 31, 2018
7. The NFHS data were available only for Base Year and the data for this were repeated for the Reference Year. Healthy S tates, Progressive India18
S.
No.
IndicatorDefinitionData Source
Base Year (BY)
and Reference
Year (RY)
3.1.3a. Proportion of specified
type of facilities
functioning as First
Referral Units (FRUs) as
against required norm
Proportion of public sector facilities
conducting specified number of
C-sections
8
per year (FRUs) against
the norm of one FRU per 5,00,000
population during a specific year.
State Report on
number of functional
FRUs, MoHFW data
on required number
of FRUs
BY:2015-16
RY:2017-18
b. Proportion of functional
24x7 PHCs as against
required norm
Proportion of PHCs providing
healthcare services
9
as per the
stipulated criteria against the norm
of one 24x7 PHC per 1,00,000
population during a specific year.
State Report on
number of functional
24x7 PHCs, MoHFW
data on required
number of PHCs
BY:2015-16
RY:2017-18
3.1.4Average number of
functional Cardiac Care
Units (CCUs) per district
(*100)
Number of functional CCUs [with
desired equipment ventilator,
monitor, defibrillator, CCU beds,
portable ECG machine, pulse
oxymeter etc.), drugs, diagnostics
and desired staff as per programme
guidelines] per districts *100.
State Report BY: As on
March 31, 2016
RY: As on
March 31, 2018
3.1.5Proportion 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.
HMISBY:2015-16
RY:2017-18
3.1.6Level 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)
[pre-filled]
BY:2014
RY:2016
3.1.7Completeness of Integrated
Disease Surveillance
Programme (IDSP) reporting
of P and L forms
Proportion of Reporting Units (RUs)
reporting in stipulated time period
against total RUs, for P and L forms
during a specific year.
Central IDSP,
MoHFW Data
[pre-filled]
BY:2015
RY:2017
3.1.8Proportion of CHCs with
grading 4 points or above
Proportion of CHCs that are graded 4
points or above against total number
of CHCs during a specific year.
HMIS
[pre-filled]
BY:2015-16
RY:2017-18
3.1.9Proportion of public health
facilities with accreditation
certificates by a standard
quality assurance program
(NQAS/NABH/ISO/AHPI)
Proportion of specified type of public
health facilities with accreditation
certificates by a standard quality
assurance program against the total
number of following specified type
of facilities during a specific year.
1. District hospital (DH)/Sub-district
hospital (SDH)
2. CHC/Block PHC
State Report BY: As on
March 31, 2016
RY: As on
March 31, 2018
3.1.10Average 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
10
[pre-filled]
BY:2015-16
RY:2017-18
8. 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).
9. Criteria for functional 24x7 PHCs: 10 deliveries per month (5 deliveries per month for Hilly and North-Eastern States except Assam).
10. 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.
Background 19
2.5. Limitation of the Index
Some critical areas such as infectious diseases, non-communicable diseases (NCDs), mental
health, governance, and financial risk protection could not be fully captured in the Index due to
non-availability of acceptable quality data on an annual basis.
For several indicators, the data are limited to service delivery in public facilities due to the paucity

and uneven availability of private sector data on health services in the HMIS. This is expected to
be a larger problem for States with higher private utilization.
For several key outcome indicators, data were available only for Larger States. Hence, the Health

Index scores and ranks for Smaller States and UTs did not include these indicators.
Data for indicators such as Maternal Mortality Ratio (MMR) were available only for formerly undivided

States, which could not be used in the Index.
Since the integrity of administrative data is to be measured in comparison with reliable

independent data, the National Family Health Survey (NFHS-4) was used for comparison
purposes in this round as well.
For several indicators, HMIS data and program data were used without any field verification by the

IVA due to the lack of feasibility of conducting independent field surveys.
In some instances, such as the TB case notification rate, the programmatically accepted definition

was used, which is based on the denominator per 1,00,000 population. The more refined indicator
of TB cases notified per 1,00,000 estimated number of TB cases would have been used if data
were available.
In some cases, proxy indicators or proxy validation criteria were used. Thus, for the number

of functional First Referral Units (FRUs) and 24x7 Primary Health Centers (PHCs), the annual
number of C-sections and deliveries conducted were respectively used as proxy criteria. The
field validation of functionality based on available human resources and infrastructure was not
viable.
Due to unavailability of detailed records at the State level for a few indicators, such as vacancies of

human resources and districts with functional CCUs, the validation agency had to rely on certified
statements provided by the State.
Due to change in National AIDS Control Programme definition of the indicator, the Base Year data

for the indicator “proportion of people living with HIV on ART” has been repeated for Reference
Year.
As West Bengal did not submit the approved data on the portal, the overall and incremental

performance scores were generated by using the pre-filled indicator data for 12 indicators and for
the remaining 11 indicators the data were repeated for the Reference Year. Healthy S tates, Progressive India20
3. PROCESS – FRO M IDEA TO PRACTICE
3.1. Key Stakeholders – Roles and Responsibilities
Multiple stakeholders were involved in the entire exercise and their roles and responsibilities are
summarized in Table 3.1.
3.2. Process Flow
The process of the generation of Health Index-2018 involved various steps summarized in Table 3.2.
3.2.1. Development of the Index
To ensure consistency and comparability, the same 23 indicators were used for the Health Index-2018
as in the case of the first round. Initially these 23 indicators were selected following a rigorous process
wherein all stakeholders including States, MoHFW, national and international experts, donor partners, and
World Bank (TA agency) were involved. Through an iterative process, taking into account importance and
availability (at least annually) of reliable data, the 23 indicators were included in the Health Index.
Table 3.1  Key stakeholders: roles and responsibilities
NITI AayogStates
Technical
Assistance (T A)
Agency (The World
Bank)
Mentor Agencies
Independent
Validation Agency
(Sambodhi)
Review, finalize and
disseminate - the
Health Index-2018
along with necessary
guidance in close
partnership with
MoHFW
Adopt and share
Health Index-
2018 with various
departments and
districts as needed
TA to NITI Aayog
in reviewing and
finalizing the Health
Index-2018 and
protocols and
guidelines
Mentor the States on
data definitions and
data requirements
for the Health Index-
2018
Validation and
acceptance of the
data submitted by
the States for various
indicators including
comparison with
other data sources
as needed
Facilitate interaction
between States and
TA agency, mentor
agencies, and the IVA
Enter and submit
data in a timely
manner on the
indicators as per
identified sources in
web portal
Technical oversight
to the mentor
agencies, portal
agency and the IVA
Provide guidance
to the States for
submission of data
including visiting
State Health
Departments/
Directorates as
needed
Review of supporting
documents and
participation in
data validation
consultations with
States
Host a web portal for
States to enter data,
its validation
Coordination with
different districts,
mentor agencies
and the IVA
Provide technical
support for
generation of
composite Index
Follow up with
States for timely
submission of
data/supporting
documents on the
on web portal
Final certification of
data and generation
and validation of
Index scores and
ranks
Overall coordination
and management
Provide technical
support for drafting
and disseminating
the report
Submission of a
comprehensive
report on validation
with details to NITI
Aayog
Background 21
3.2.2. Submission of data on the portal
The States were sensitized about the Health Index-2018 on July 14, 2018 through a video conference
chaired by the Chief Executive Officer (CEO), NITI Aayog, where the details about the Health Index-2018
were presented and related issues discussed. During the discussions with the States, an agreement was
reached that for this round, the Base Year would be 2015-16, while the Reference Year would be 2017-18.
The States were requested to timely upload the required information on the web portal developed for this
purpose.
Mentors were assigned to States by the NITI Aayog to provide support and facilitate data collection
and submission on the portal. The task of providing mentor support to States was assigned to Swasti
Catalyst. One national level mentor was stationed at the NITI Aayog headquarters to handle requests
from different States. Other mentors covered the States of Bihar, Chandigarh, Chhattisgarh, Haryana,
Himachal Pradesh, Jharkhand, Madhya Pradesh, Punjab, Uttar Pradesh, Uttarakhand and West
Bengal.
Data were entered in the portal by the States and UTs, except some designated indicators which
were pre-filled based on data sources identified at the outset. For State-level data entry, options were
provided to the States to either enter data at the State level or assign this to the districts. However, the
final submission of data on the portal was done by the designated State-level competent authority. The
process of data entry and submission by the States began in July 2018 and ended in August 2018.
3.2.3. Independent validation of data
An Independent Validation Agency (IVA), namely, Sambodhi Research and Communications Private
Limited, was hired by NITI Aayog through a competitive selection process to review and validate the data,
Index scores and rankings of States and UTs. The data submitted on the portal was validated by the IVA
from September to December 2018 following the process summarized in Figure 3.1.
Table 3.2  Timeline for development of Health Index 2018
June
2018
July-August
2018
September-
November
2018
December
2018-February
2019
May-June
2019
1
Finalization of Guidebook and
dissemination to States
2
Selection and training of mentors,
guidance to States and submission
of data on portal
3
Selection and training of IVA,
Validation of data by IVA, North
East Regional Data Validation
Workshop and Video Conference
with all States on finalization of
validated data
4
Index and rank generation and
report writing
5 Dissemination of ranks Healthy S tates, Progressive India22
Field visits were conducted for physical validation of the data in Haryana, Chandigarh, Punjab, Puducherry
and Uttarakhand. A regional workshop was also held to cover all North-Eastern States on October 4,
2018. Further, the data discrepancies were discussed with the States’ officers through series of video
conferences held during November 6-15, 2018. A brief note on data validation process is provided in
Annexure 1.
3.2.4. Index and rank generation
The data validated and finalized by the IVA after resolving issues with the States were used in Index
generation and ranking. The final Index scores and rankings were certified by the IVA. The activity of Index
and rank generation was undertaken in December 2018.
Figure 3.1  Steps for validating data
Desk 
Review
Interaction with 
State Nodal Officers
Field Visits to 
State & Districts
Documenting Gaps 
and Inconsistencies
��Review of data for 
completeness, accuracy, 
consistency & compari-
son with published 
sources like NFHS etc. 
as specified
��Discrepancies found 
during the desk review 
validated with the State 
Nodal Officers
��Sample States visited to 
validate reults/figures 
claimed by the State for 
specific indicators
��In case the nodal officer 
is unable to address the 
discrepancies gaps and 
inconsistencies were 
documented for sample 
field visits
PROCESS FLOW Results and
Findings Healthy S tates, Progressive India24
Results and Fi ndings
4. UNVEILING PERFORMANCE
This section provides States’ overall and incremental performance on the Health Index-2018. The results
are presented for each group of States separately: Larger States, Smaller States, and UTs. Overall
performance is measured using the composite Index scores for Base and Reference Years, and incremental
performance is calculated as the change in composite Index scores from Base to Reference Year. For each
State and UT, snapshot on performance of indicators and individual factsheets are provided in Annexure 2
and Annexure 3 respectively.
4.1. Performance of Larger States
4.1.1. Overall performance
In the Reference Year (2017-18), the average composite Health Index score among Larger States was 53.22,
compared to the Base Year (2015-16) average of 52.59. There was a wide disparity of Health Index score
across States, ranging from 28.61 in Uttar Pradesh to 74.01 in Kerala. There is no indication that the gap
between poorest performing State and best-performing State is narrowing. Compared to the Base Year, the
Health Index scores have increased in twelve States in the Reference Year. However, the index score has
declined both for the poorest performing State (Uttar Pradesh) and the best performing State (Kerala).
Figure 4.1 displays the composite Health Index scores for Base and Reference Years for the Larger States
and ranks the States based on their overall performance. The lines depict changes in the ranking: an
orange line denotes a negative change in the State’s ranking from Base to Reference Year, a green line
indicates a positive change, and a blue line indicates no change in ranking. The top five best performing
States in the Reference Year based on the overall performance were Kerala (74.01), Andhra Pradesh
(65.13), Maharashtra (63.99), Gujarat (63.52) and Punjab (63.01). While the 5 least performing States in the
reference period were: Uttar Pradesh (28.61), Bihar (32.11), Odisha (35.97), Madhya Pradesh (38.39), and
Uttarakhand (40.20).
Among the 21 Larger States, seven States improved their rankings from Base to Reference Year. These
States are Andhra Pradesh, Maharashtra, Karnataka, Telangana, Haryana, Assam and Rajasthan. The most
significant progress in ranks has been observed in Andhra Pradesh followed by Rajasthan, improving their
ranking by six and four positions respectively. Maharashtra has improved its ranking by three positions
while Karnataka, Telangana, Haryana and Assam improved their ranking by one position each.
Nine States observed a decline in their ranking position from Base to Reference Year whereas the ranking
of five States, i.e., Kerala, Gujarat, Jammu and Kashmir, Jharkhand and Uttar Pradesh have remained
unchanged. Kerala remained the top performing State despite a decline in Health Index score from Base
Results and F indings 25
to Reference Year. Tamil Nadu, on the other hand, registered the largest decline in ranking from third
place in 2015-16 to ninth place in 2017-18. The States of Punjab and Uttarakhand saw a decline of three
and two positions respectively in their ranking whereas the remaining six States observed a decline of
one point each.
Based on the composite Health Index scores range for the Reference Year (2017-18), the States are grouped
into three categories: Aspirants, Achievers, and Front-runners (Table 4.1). Aspirants are the bottom one-
third States with an Index score below 43.74. These States are the EAG States
11
and given the substantial
Figure 4.1  Larger States: Overall performance - Composite Index score and rank, Base and Reference Years
Base Year (2015-16)Reference Year (2017-18)
Base Year Rank
Reference Year Rank
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21Uttar PradeshUttarPradesh
Rajasthan
Rajasthan
Bihar
Bihar
Odisha
Odisha
Madhya Pradesh
Madhya Pradesh
Assam
AssamUttarakhand
Uttarakhand
JharkhandJharkhand
Haryana
HaryanaChhattisgarh
Chhattisgarh
Telangana
TelanganaWest Bengal
West Bengal
Karnataka
KarnatakaAndhra Pradesh
Andhra Pradesh
Jammu & KashmirJammu & Kashmir
Maharashtra
Maharashtra
Himachal Pradesh
Himachal Pradesh
GujaratGujarat
Tamil Nadu
Tamil Nadu
Punjab
Punjab
KeralaKerala
65.21
63.38
61.99
61.20
61.07
60.35
60.16
58.70
58.25
55.39
52.02
46.97
45.33
45.22
44.13
40.09
39.43
38.46
36.79
33.69
74.01
65.13
63.99
63.52
63.01
62.41
62.37
61.14
60.41
59.00
57.17
53.51
53.36
51.33
48.85
43.10
40.20
38.39
35.97
32.11
28.61
76.55
65.21
63.38
61.99
61.20
61.07
60.35
60.16
58.70
58.25
55.3952.02
46.97
45.33
45.22
44.13
40.09
39.43
38.46
36.79
33.69
74.01
65.13
63.99
63.52
63.01
62.41
62.37
61.14
60.41
59.00
57.17
53.51
53.36
51.33
48.85
43.10
40.20
38.39
35.97
32.11
28.61
11. EAG States include Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh, and Uttarakhand. Healthy S tates, Progressive India26
scope for improvement, require concerted efforts. Achievers represent the middle one-third States with
an Index score between 43.74 and 58.88. Overall, these States have made good progress and can move
to the next group with sustained efforts. Front-runners, the States falling in top one-third score range
(score above 58.88) are the best performing States. Despite relatively good performance, however, even
the Front-runners could further benefit from improvements in certain indicators as the highest observed
Index score of 74.01 is well below 100.
4.1.2. Incremental performance
Incremental performance measures the change in the Health Index score from Base to Reference Year,
which is masked by the year-specific rankings based on the Index score. It is important to identify the
year-on-year pace of improvement made by States. This measure is particularly important for identifying
the States with the highest and the lowest incremental progress.
In Figure 4.2, the left side, presents the State-wise movement in Health Index from Base to Reference Year
along with their relative position and on the right side, actual increments are presented.
Among the 21 Larger States, twelve States displayed a positive incremental change in the Index score and
the remaining nine States showed negative incremental change. Based on their incremental performance,
States are categorized into four groups: ‘Not Improved’ (<=0 incremental change); ‘Least Improved’ (0.01
to 2.0 points increase); ‘Moderately Improved’ (2.01 to 4.0 points increase), and ‘Most Improved’ (>4 point
increase) (Table 4.2).
The State of Haryana (ranked at the top) followed by Rajasthan, Jharkhand, Andhra Pradesh and Assam
have made significant incremental progress with four or more percentage points increase in their Index
scores from Base to Reference Year. Among the EAG States, only Rajasthan, Jharkhand and Chhattisgarh
have a positive incremental progress. The rest of the EAG States fall in the category of ‘Not Improved’
along with States like Kerala, Punjab, Tamil Nadu and West Bengal.
Haryana, attained the position of the ‘Most Improved’ State because it registered progress in most of the
health outcome indicators from based to Reference Years such as NMR, U5MR, LBW among newborns and
SRB. Haryana also observed improvement in full immunization, institutional delivery, average occupancy
of CMOs, vacancies of staff nurses and Medical Officers, e-payslip, functional FRUs, CCUs, first trimester
ANC registrations, CHC grading and accreditation of facilities.
Table 4.1  Larger States: Overall performance in Reference Year - Categorization
AspirantsAchieversFront-runners
Rajasthan
Uttarakhand
Madhya Pradesh
Odisha
Bihar
Uttar Pradesh
West Bengal
Haryana
Chhattisgarh
Jharkhand
Assam
Kerala
Andhra Pradesh
Maharashtra
Gujarat
Punjab
Himachal Pradesh
Jammu and Kashmir
Karnataka
Tamil Nadu
Telangana
Note: The States are categorized on the basis of Reference Year Index score range: Front-runners: top one-third (Index score
>58.88), Achievers: middle one-third (Index score between 43.74 and 58.88), Aspirants: lowest one-third (Index score <43.74).
Results and F indings 27
Figure 4.2  Larger States: Overall and incremental performance, Base and Reference Years and incremental rank
Base Year (2015-16)
Reference Year (2017-18)
States0204 06 08 0100
02 04 06 08 0100
Overall Performance Index Score
-10-50 51 0
Incremental Change
Haryana
Rajasthan
Jharkhand
Andhra Pradesh
Assam
Telangana
Maharashtra
Karnataka
Jammu & Kashmir
Gujarat
Chhattisgarh
Himachal Pradesh
West Bengal
Madhya Pradesh
Punjab
Kerala
Tamil Nadu
Odisha
Uttarakhand
Uttar Pradesh
Bihar 38.4632.11
33.6928.61
45.2240.20
39.4335.97
63.3860.41
76.5574.01
65.2163.01
40.0938.39
58.2557.17
61.2062.41
52.0253.36
61.9963.52
60.3562.37
58.7061.14
61.0763.99
55.3959.00
44.13 48.85
60.16 65.13
45.33 51.33
36.79 43.10
46.97 53.51
-6.35
-5.08
-5.02
-3.46
-2.97
-2.55
-2.20
-1.70
-1.08
1.53
6.55
1.21
2.02
2.44
2.92
3.61
4.72
4.97
5.99
6.30
1.3411
20
19
18
17
16
15
14
13
10
21
12
9
8
7
6
5
4
3
2
1
Incremental Ra nk
Note: As West Bengal did not submit data on the portal, the overall and incremental performance scores were generated based
on pre-filled indicator data for 12 indicators and for the remaining 11 indicators the data from the Base Year were repeated for the
Reference Year.
Table 4.2  Larger States: Incremental performance from Base to Reference Year – Categorization
Not ImprovedLeast ImprovedModerately ImprovedMost Improved
West Bengal
Madhya Pradesh
Punjab
Kerala
Tamil Nadu
Odisha
Uttarakhand
Uttar Pradesh
Bihar
Gujarat
Chhattisgarh
Himachal Pradesh
Telangana
Maharashtra
Karnataka
Jammu and Kashmir
Haryana
Rajasthan
Jharkhand
Andhra Pradesh
Assam
Bihar (ranked at the bottom) registered the most negative incremental change, and this is reflected in the
deterioration of most health indicators such as TFR, LBW, SRB, institutional delivery, TB notification rate,
TB treatment success rate, ANM and staff nurse vacancies, functional 24x7 PHCs, birth registration, IDSP
reporting, CHC grading, accreditation of facilities and fund transfer.
Note: The States are categorized on the basis of incremental Index score range into categories: ‘Not Improved’ (incremental Index
score <=0), ‘Least Improved’ (incremental Index score between 0.01 and 2.0), ‘Moderately Improved’ (incremental Index score
between 2.01 and 4.0), ‘Most Improved’ (incremental Index score >4). Healthy S tates, Progressive India28
The indicators where most States need to focus include addressing the issue of SRB, TB treatment
success rate, vacancies among ANMs, functional 24x7 PHCs, birth registration and fund transfer delays.
The facility of e-payslip generation through HRMIS and quality accreditation of facilities are yet to be
taken up in many States.
On average, the incremental performance is not always associated with overall Index score. Some of
the Front-runner Larger States (Table 4.1) such as Kerala, Punjab and Tamil Nadu, have made negative
incremental progress, whereas the others observed positive incremental progress: Andhra Pradesh,
Gujarat, Himachal Pradesh, Maharashtra, Jammu and Kashmir, Karnataka, and Telangana.
Out of the twelve States that observed positive incremental change in Index scores from Base to Reference
Year, only seven States (Haryana, Rajasthan, Andhra Pradesh, Assam, Telangana, Maharashtra and Karnataka)
observed increase in their overall performance ranks from Base Year to Reference Year (Figure 4.1). This
shows that these seven States made significant incremental progress leading to improvement in the overall
performance position. The States of Jharkhand, Jammu and Kashmir and Gujarat retained their Base Year
position and the ranking of Chhattisgarh and Himachal Pradesh moved down by one position each.
4.1.3. Domain–specific performance
Overall performance is an aggregate measure based on indicators in different domains and does not reveal
specific areas requiring further attention. To identify such areas, the Index is disaggregated into the domains
of Health Outcomes, Governance and Information, and Key Inputs/Processes. The information on domain
of Governance and Information is not presented in this section as it has limited number of indicators.
The overall performance of the States is not always consistent with the domain-specific performance
(Figure 4.3). Some top performing States fare significantly better in one domain suggesting that there is
scope to improve their performance in the lagging domain with specific targeted interventions. Half of the
States showed a better performance in health outcomes, however, Andhra Pradesh, Gujarat, Tamil Nadu,
West Bengal, Haryana, Assam, Rajasthan and Odisha performed better in terms of Key Inputs/Processes.
Figure 4.3  Larger States: Overall and domain-specific performance, Reference Year
Reference Year (2017–18) score
Health Outcomes
Key Inputs/Processes
Overall Performance
0
20
40
60
80
100
Kerala
Maharashtr a
Gujarat
Punjab
Karnataka
Telangana
Haryan a
Chhattisgarh
Jharkhand
Assam
Rajastha n
Uttarakhand
Odisha
Bihar
Andhra Pradesh
Himachal Pradesh
Jammu & Kashmir
Tamil Nadu
West Bengal
Madhya Pradesh
Uttar Pradesh
Results and F indings 29
Figure 4.4  Larger States: Performance in the Health Outcomes domain, Base and Reference Years
Base Year (2015-16)
Reference Year (2017-18)
States0102030405060708090100
0102030405060708090100
Health Outcomes Index Score
-10 -5 0510
Incremental Change
Kerala
Jammu & Kashmir
Punjab
Andhra Pradesh
Karnataka
Maharashtra
Jharkhand
Himachal Pradesh
Telangana
Tamil Nadu
Gujarat
Chhattisgarh
West Bengal
Haryana
Assam
Uttarakhand
Rajasthan
Madhya Pradesh
Bihar
Uttar Pradesh
Odisha33.8625.85
33.2227.94
38.8332.18
37.0035.34
29.58 36.94
45.5640.64
42.7543.30
46.05 50.99
56.4353.81
53.9055.57
59.7858.76
62.5658.90
64.8062.57
65.8962.69
51.82 62.71
61.4164.39
62.3065.05
62.5766.31
69.8769.43
66.5470.38
82.8979.90
10.89
-8.01
-0.44
-5.28
-6.65
-1.66
-2.99
-3.20
-2.23
-3.66
-1.03
-4.92
-2.62
4.93
0.55
1.67
7.36
2.98
2.75
3.74
3.85
Figure 4.4 and Figure 4.5 present the performance of Larger States in the domain of Health Outcomes and
Key/Inputs Processes respectively for Base and Reference Year. In these figures, from top to bottom, States
are presented in descending order of Health Index score for the Reference Year. For Health Outcomes
domain, Kerala was ranked at the top and Odisha was at the bottom. For Key Inputs/Processes, Andhra
Pradesh had the highest and Bihar had the lowest ranking.
About half of the Larger States registered an increase in the Health Outcomes Index scores from Base to
Reference Year: Jammu and Kashmir, Andhra Pradesh, Karnataka, Maharashtra, Jharkhand, Chhattisgarh,
Haryana, Assam and Rajasthan. Jharkhand registered the largest increase (11 percentage points) followed
by Rajasthan (7 points). Five EAG States posted large decline in Health Outcomes Index score: Odisha,
Uttar Pradesh, Bihar, Madhya Pradesh and Uttarakhand.
Note: a) States ranked based on their Reference Year Score in the Health Outcomes domain; b) As West Bengal did not submit data
on the portal, the overall and incremental performance scores were generated based on pre-filled indicator data for 12 indicators
and for the remaining 11 indicators the data from the Base Year were repeated for the Reference Year. Healthy S tates, Progressive India30
In the Key Inputs/Process domain, half (11) of the States have improved their performance from Base to
Reference Year. The highest increase was observed in the State of Haryana (17 percentage points) followed
by Telangana (14 points). The Key Inputs/Process score declined in the following States: Tamil Nadu, Kerala,
Karnataka, Punjab, Rajasthan, Jammu and Kashmir, Madhya Pradesh, Uttarakhand, Jharkhand and Bihar.
Large decline was noted in Tamil Nadu (9 percentage points) and Bihar (17 percentages points). The
best performing State (Kerala) in terms of overall Health Index score, also registered large decrease of
6 percentage points.
4.1.4. Incremental performance on indicators
Figures 4.6 captures the incremental performance on indicators and sub-indicators and provides the
number of indicators and sub-indicators in each category i.e., ‘Most Improved’, ‘Improved’, ‘No Change’,
‘Deteriorated’ and ‘Most Deteriorated’. Andhra Pradesh has the highest proportion of indicators
(63 percent) among the Larger States which fall in the category of ‘Most Improved’ and ‘Improved’. On
the other hand, Bihar has the highest proportion of indicators which fall in the category of ‘Deteriorated’
Figure 4.5  Larger States: Performance in the Key Inputs/Processes domain, Base and Reference Years
Base Year (2015-16)
Reference Year (2017-18)
States0102030405060708090100
0102030405060708090100
Key Inputs/Processes Index Score
-20-15-10-50 5101520
Incremental Change
Andhra Pradesh
Tamil Nadu
Kerala
West Bengal
Haryana
Gujarat
Odisha
Maharashtra
Himachal Pradesh
Assam
Karnataka
Chhattisgarh
Punjab
Rajasthan
Telangana
Jammu & Kashmir
Madhya Pradesh
Uttarakhand
Uttar Pradesh
Jharkhand
Bihar32.5415.48
29.4122.31
25.0226.42
40.4933.89
41.3034.86
42.6138.86
31.92 45.71
49.8045.95
51.9047.49
44.2948.33
55.9653.15
45.23 54.39
49.80 54.63
53.1655.89
55.16 61.74
57.30 62.35
46.41 63.17
61.9963.21
69.6263.92
78.0668.92
58.69 69.89
-17.06
13.79
11.20
16.76
-4.41
-7.10
-6.60
-6.44
-3.75
-9.14
-5.70
-3.85
-2.81
4.04
9.16
4.83
2.73
6.58
1.40
5.05
1.22
Note: a) States ranked based on their Reference Year Score in the Key Inputs/Processes domain; b) As West Bengal did not submit
data on the portal, the overall and incremental performance scores were generated based on pre-filled indicator data for 12
indicators and for the remaining 11 indicators the data from the Base Year were repeated for the Reference Year.
Results and F indings 31
Figure 4.6  Larger States: Number of indicators/sub-indicators, by category of incremental performance
1
0
3
6
2
3
7
3
5
3
3
1
2
6
7
3
9
6
10
5
7
7
9
7
5
9
8
5
9
8
11
11
14
13
9
9
13
8
11
8
14
16
4
3
1
2
4
0
5
4
2
1
3
1
3
5
0
4
2
2
5
1
2
8
9
9
8
7
9
8
9
7
8
4
6
8
3
9
5
3
7
3
4
1
6
4
7
4
3
5
1
1
2
3
5
4
1
3
2
0
5
1
1
2
4
4
5
3
5
5
5
4
4
6
4
4
4
3
4
3
5
3
3
3
4
0510 15 20 25 30
West Bengal
Uttarakhand
Kerala
Bihar
Himachal Pradesh
Punjab
Tamil Nadu
Assam
Chhattisgarh
Odisha
Maharashtra
Uttar Pradesh
Karnataka
Madhya Pradesh
Telangana
Haryana
Jammu & Kashmir
Gujarat
Rajasthan
Jharkhand
Andhra Pradesh
Most ImprovedImprovedNo change Deteriorated Most Deteriorated Not Applicable
0
Note: For a State, the incremental performance on an indicator is classified as ‘Not Applicable’ (NA) in instances such as: (i) If State
has achieved TFR <= 2.1 in both Base and Reference Years; (ii) Data Integrity Measure indicator wherein the same data have been
used for Base Year and Reference Year due to non-availability of updated NFHS data; (iii) PLHIV indicator, (iv) Service coverage
indicators with 100 percent values or vacancy of 0 percent in both Base and Reference Years; (v) The data value for a particular
indicator is NA in Base Year or Reference Year or both.
and ‘Most Deteriorated’. Detailed indicator-specific performance snapshot of States is presented in
Annexure 2, which provides the direction as well as the magnitude of the incremental change of indicators
from Base Year to Reference Year. Healthy S tates, Progressive India32
4.2. Performance of Smaller States
4.2.1. Overall performance
In the Reference Year (2017-18), the average Health Index score among the Smaller States was 53.11
compared to the Base Year (2015-16) average of 53.13. The Index score ranged from 38.51 in Nagaland to
74.97 in Mizoram (Figure 4.7). Both States retained their respective Base Year rankings in the Reference
Year. Mizoram exhibited a small improvement in Health Index scores in Reference Year with score rising
to 74.97. The Health Index score for the States of Tripura, Arunachal Pradesh and Nagaland was less than
50 which shows that there is large scope for improvement in these States.
Among the eight Smaller States, only two States improved their position from Base Year to Reference
Year. Goa improved its position from fifth to fourth and Tripura from seventh to sixth. Four States retained
their Base Year ranking in the Reference Year including Mizoram, Manipur, Meghalaya and Nagaland. The
ranking of Sikkim dropped from fourth place in the Base Year to fifth place in the Reference Year. Arunachal
Pradesh ranking dropped from sixth place in the Base Year to the seventh place in the Reference Year.
Based on the Health Index score range for Reference Year (2017-18), Sikkim, Tripura, Arunachal Pradesh
and Nagaland are categorized as Aspirants, and have substantial scope for improvement (Table 4.3).
Manipur, Meghalaya and Goa are categorized as Achievers as they exhibited better performance, but still
have significant room for improvement. The States of Mizoram have been categorized as Front-runner
with the highest overall performance among the Smaller States.
Figure 4.7  Smaller States: Overall performance – Composite Index score and rank, Base and Reference Years
Mizoram
Tripura
Goa
Meghalaya
Sikkim
Nagaland
Arunachal Pradesh
Manipur
Mizoram
Tripura
Goa
Meghalaya
Sikkim
Nagaland
Arunachal Pradesh
Manipur
Base Year (2015-16)Reference Year (2017-18)
Base Year Rank
Reference Year Rank
1
2
3
4
5
6
7
8
1
2
3
4
5
6
7
8
73.7074.97
57.7860.60
56.8355.95
53.2051.90
53.1350.51
49.5146.38
43.5146.07
37.3838.51
Note: Lines depict changes in Composite Index score rank from Base to Reference Year. The composite Health Index score is
presented in the circle.
Table 4.3  Smaller States: Overall performance in Reference Year – Categorization
AspirantsAchieversFront-runners
Sikkim
Tripura
Arunachal Pradesh
Nagaland
Manipur
Meghalaya
Goa
Mizoram
Note: The States are categorized on the basis of Reference Year Index score range: Front-runners: top one-third (Index score
>62.82), Achievers: middle one-third (Index score between 50.67 and 62.82), Aspirants: lowest one-third (Index score <50.67).
Results and F indings 33
Figure 4.8  Smaller States: Overall and incremental performance, Base and Reference Years and incremental rank
Base Year (2015-16)
Reference Year (2017-18)
States02 04 06 08 0100
02 04 06 08 0100
Overall Performance Index Score
-10- 5051 0
Incremental ChangeIncremental Rank
Tripura
Manipur
Mizoram
Nagaland
Meghalaya
Goa
Sikkim
Arunachal Pradesh49.5146.07
53.2050.51
53.1351.90
56.8355.95
37.3838.51
73.7074.97
57.7860.60
43.5146.38
-3.44
-2.70
-1.23
-0.88
2.87
1.27
2.82
1.13
1
2
3
4
5
6
7
8
4.2.2. Incremental performance
From Base to Reference Year, four States show positive incremental progress: Tripura, Manipur, Mizoram
and Nagaland, while the remaining four States: Meghalaya, Goa, Sikkim, and Arunachal Pradesh
registered negative incremental change (Figure 4.8). Arunachal Pradesh (ranked at the bottom) exhibited
the largest decline in Health Index score with 3.44 percentage points, while Tripura (ranked at the top)
observed the highest increase of 2.87 percentage points.
Table 4.4  Smaller States: Incremental performance from Base to Reference Year – Categorization
Not ImprovedLeast ImprovedModerately ImprovedMost Improved
Meghalaya
Goa
Sikkim
Arunachal Pradesh
Nagaland
Mizoram
Tripura
Manipur
–
Note: The States are categorized on the basis of incremental Index score range into categories: ‘Not Improved’ (incremental Index
score <=0), ‘Least Improved’ (incremental Index score between 0.01 and 2.0), ‘Moderately Improved’ (incremental Index score
between 2.01 and 4.0), ‘Most Improved’ (incremental Index score >4).
Based on their incremental performance from Base to Reference Years, States are grouped into four
categories: ‘Not Improved’, ‘Least Improved’, ‘Moderately Improved’, and ‘Most Improved’. None of the
Smaller States were categorized as ‘Most Improved’ because incremental change of all States is less
than 4.0 points (Table 4.4). The States of Tripura and Manipur are categorized as ‘Moderately Improved’,
Mizoram and Nagaland as ‘Least Improved’ whereas Meghalaya, Goa, Sikkim and Arunachal Pradesh
are categorized as ‘Not Improved’. Arunachal Pradesh at the bottom of the ‘Not Improved’ States has
observed deterioration in TB treatment success rate, e-payslip, average occupancy of State level key
posts, functional 24x7 PHCs, first trimester ANC registration, IDSP reporting and quality accreditation of
facilities. The State of Tripura has been able to register the highest increase in Index scores from Base
Year to Reference Year due to better performance in indicators such as full immunization, institutional
deliveries, average occupancy of state-level key positions and district CMOs, vacancies of ANMs
and MOs, e-payslip, functional FRUs and 24x7 PHCs, birth registration, accreditation of facilities and
fund transfer. Healthy S tates, Progressive India34
The indicators where most Smaller States need to focus include LBW, TB treatment success rate, average
occupancy of State level key positions, functional 24x7 PHCs, first trimester ANC registration and IDSP
reporting. The quality accreditation of public health facilities and HRMIS are yet to be initiated by most
States.
Although four States (Tripura, Manipur, Mizoram and Nagaland) have observed positive incremental
change in Index scores from Base Year to Reference Year, only Tripura has been able to improve its
overall performance rank from Base to Reference Year. The other three States have retained their Base
Year positions.
4.2.3. Domain – specific performance
The overall performance of the States is not always consistent with the domain-specific performance.
Except for Tripura, all Smaller States showed a better performance on Health Outcomes as compared to
Key Inputs/process (Figure 4.9).
In the domain of Health Outcomes, only three States (Manipur, Goa, and Nagaland) improved their
performance from Base Year to Reference Year, and the performance of the remaining Smaller States
suffered large decline in Health Outcomes Index score (Figure 4.10). Tripura had the largest decline of
9 percentage points followed by Mizoram with 7.5 points. Mizoram has the highest Index score of 85.48
while Tripura had the lowest score of 30.73.
In the Key Inputs/Processes domain, five of the eight Smaller States registered a decline in Index scores:
Goa, Sikkim, Nagaland, Arunachal Pradesh and Manipur (Figure 4.11). Arunachal Pradesh and Nagaland
registered a decrease of 11 and 9 points respectively, whereas Mizoram and Tripura registered about 13
and 15 percentage point increase, respectively. The maximum score in this domain was 57.6 for Mizoram
and the minimum score was 25.3 for Manipur. This suggests that all States need to put tremendous efforts
to improve their performance.
Figure 4.9  Smaller States: Overall and domain-specific performance, Reference Year
Reference Year (2017–18) Score
Health Outcomes
Key Inputs/Processes
Overall Performance
0
20
40
60
80
100
Mizoram Manipur Meghalaya Goa Sikkim TripuraArunachal PradeshNagaland
Results and F indings 35
Figure 4.10  Smaller States: Performance in the Health Outcomes domain, Base and Reference Years
Figure 4.11  Smaller States: Performance in the Key Inputs/Processes domain, Base and Reference Years
Base Year (2015-16)
Reference Year (2017-18)
States0102030405060708090100
0102030405060708090100
Health Outcomes Index Score
-10- 5051 0
Incremental Change
Mizoram
Manipur
Meghalaya
Goa
Nagaland
Sikkim
Arunachal Pradesh
Tripura39.5630.73
45.9845.99
50.1746.93
44.80 50.17
52.79 56.57
63.4060.20
66.07 74.35
92.97
85.48 -7.49
-3.24
-3.20
-8.83
5.37
8.28
0.01
3.79
Base Year (2015-16)
Reference Year (2017-18)
States0102030405060708090100
0102030405060708090100
Key Inputs/Processes Index Score
-15-10-5 05 10 1520
Incremental Change
Mizoram
Tripura
Goa
Meghalaya
Sikkim
Nagaland
Arunachal Pradesh
Manipur32.1825.25
41.0329.92
40.1930.86
41.3137.85
38.3839.80
44.6540.00
36.38 51.64
44.64 57.64
-11.11
13.00
15.27
-4.65
-3.46
-9.33
-6.93
1.42
4.2.4. Incremental performance on indicators
Figure 4.12 captures the incremental progress on indicators and sub-indicators and provides the
number of indicators and sub-indicators in each category, i.e, ‘Most Improved’, ‘Improved’, ‘No Change’,
‘Deteriorated’and ‘Most Detriorated’. Among the Smaller States, Arunachal Pradesh and Tripura had
improved on twelve indicators, whereas Nagaland improved on five indicators only. All other Smaller
States (except Arunachal Pradesh and Tripura) made improvements in less than 46 percent of the
indicators. Detailed indicator-specific performance snapshot of States is presented in the Annexure 2,
which provides the direction as well as the magnitude of the incremental change of indicators from Base
Year to Reference Year.
Note: States ranked based on their Reference Year Score in the Health Outcome domain.
Note: States ranked based on their Reference Year Score in the Key inputs/Process domain. Healthy S tates, Progressive India36
Figure 4.12  Smaller States: Number of indicators/sub-indicators, by category of incremental performance
Most ImprovedImprovedNo change Deteriorated Most Deteriorated Not Applicable
4
3
4
6
8
5
7
7
1
3
3
3
0
6
5
5
6
6
5
4
6
3
3
3
4
2
3
5
4
2
2
2
5
7
8
4
4
6
5
4
6
5
3
4
4
4
4
5
01611162126
Nagaland
Sikkim
Goa
Manipur
Mizoram
Meghalaya
Arunachal Pradesh
Tripura
Note: For a State, the incremental performance on an indicator is classified as ‘Not Applicable’ (NA) in instances such as:
(i) Data Integrity Measure wherein the same data have been used for Base and Reference Year due to non-availability of updated
NFHS data; (ii) PLHIV indicator (iii) Service coverage indicators with 100 percent values or vacancy of 0 percent in both Base and
Reference Year; (iv) The data value for a particular indicator is NA in the Base or Reference Year or both.
4.3. Performance of Union Territories
4.3.1. Overall performance
The overall performance based on the Health Index score of UTs for the Reference Year (2017-18)
ranged from 41.66 in Daman and Diu to 63.62 in Chandigarh. Some improvements were observed in
the Reference Year, but the scores for the best and worst performing State still differed by more than
20 points.
The rankings changed completely in the Reference Year compared to the Base Year (Figure 4.13). Three
UTs, namely Chandigarh, Dadra and Nagar Haveli, and Puducherry improved their rankings from Base
Year to Reference Year. Dadra and Nagar Haveli had huge improvement from seventh to second position,
Chandigarh moved from second to first, and Puducherry from fifth to fourth position. Four UTs dropped in
the ranking: Lakshadweep from first to third, Delhi from third to fifth, Andaman and Nicobar Islands from
fourth to sixth, and Daman and Diu from sixth to seventh.
Based on the composite Index score range for Reference Year (2017-18), the UTs are categorized into
three categories: Aspirants, Achievers, and Front-Runners (Table 4.5). Andaman and Nicobar Islands
and Daman and Diu are categorized as Aspirants and are among the bottom one third UTs and have
substantial scope for improvement. The UTs of Lakshadweep, Puducherry and Delhi are grouped as
Achievers but have significant room for improvement. The UTs of Chandigarh and Dadra and Nagar
Haveli are categorized as Front-runner and could also benefit from improvements in their Index score
which are well below 100.
Results and F indings 37
Figure 4.13  UTs: Overall performance – Composite Index score and rank, Base and Reference Years
Base Year (2015-16)Reference Year (2017-18)
Base Year Rank
Reference Year Rank
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Lakshadweep
Lakshadweep
Chandigarh
Chandigarh
Delhi
Delhi
Andaman & Nicobar
Andaman & Nicobar
Puducherry
Puducherry
Daman & Diu
Daman & DiuDadra & Nagar Haveli
Dadra & Nagar Haveli 65.79
52.27
50.02
50.00
47.48
36.10
34.64
63.62
56.31
53.54
49.69
49.42
45.36
41.66
Note: Lines depict changes in composite index score rank from Base to Reference Year. The composite index score is presented
in the circle.
Table 4.5  UTs: Overall performance in Reference Year – Categorization
AspirantsAchieversFront runners
Andaman and Nicobar Islands
Daman and Diu
Lakshadweep
Puducherry
Delhi
Chandigarh
Dadra and Nagar Haveli
Note: The States are categorized on the basis of Reference Year Index score range: Front-runners: top one-third (Index score
>56.30), Achievers: middle one-third (Index score between 48.98 and 56.30), Aspirants: lowest one-third (Index score <48.98).
4.3.2. Incremental performance
Figure 4.14 shows that from Base Year to Reference Year, four UTs (Dadra and Nagar Haveli, Chandigarh,
Daman and Diu, and Puducherry) have registered positive incremental progress and the remaining three
UTs (Delhi, Andaman and Nicobar Islands, and Lakshadweep) registered negative incremental change.
From Base Year to Reference Year, the UT of Dadra and Nagar Haveli (ranked at the top) observed the
highest incremental progress of 21.67 points, next to the UT of Chandigarh with an incremental progress
of 11.35 points. The UTs of Daman and Diu and Puducherry had modest increases between 2 to 6 points.
The UT of Lakshadweep had the largest decrease of 12 points, and the UT of Delhi had a small decrease
of less than a percentage point.
The categorization of States based on incremental performance is shown in Table 4.6. Dadra and Nagar
Haveli is the ‘Most Improved’ UT and ranked at the top registered good incremental progress from
Base to Reference Year for indicators such as full immunization, institutional deliveries, TB notification
rate, TB treatment success rate, average occupancy of State level key positions and District CMOs,
vacancy of staff nurses and specialists, CCUs, first trimester ANC registrations, birth registration, IDSP
reporting, quality accreditation of facilities and funds transfer. Among the UTs which did not register any
incremental progress between the Base and Reference Years, Lakshadweep fared poorly on indicators
such as LBW, full immunization, institutional deliveries, average occupancy of State level key positions,
and birth registration. Healthy S tates, Progressive India38
Figure 4.14  UTs: Overall and incremental performance, Base and Reference Years and incremental rank
Base Year (2015-16)
Reference Year (2017-18)
States02 04 06 08 0100
02 04 06 08 0100
Overall Performance Index Score
-10- 50 51 0
Incremental Change Incremental Rank
Dadra & Nagar Haveli
Chandigarh
Daman & Diu
Puducherry
Delhi
Andaman & Nicobar
Lakshadweep65.7953.54
50.0045.36
50.0249.42
47.4849.69
36.1041.66
52.27 63.62
34.64 56.31
-12.25
11.35
21.67
-0.61
-4.64
5.56
2.21
1
2
3
4
5
6
7
15 20
Table 4.6  UTs: Incremental performance from Base to Reference Year – Categorization
Not ImprovedLeast ImprovedModerately ImprovedMost Improved
Delhi
Andaman and Nicobar
Lakshadweep
– PuducherryDadra and Nagar Haveli
Chandigarh
Daman and Diu
Note: The UTs are categorized on the basis of incremental Index score range into categories: ‘Not Improved’ (incremental Index
score <=0), ‘Least Improved’ (incremental Index score between 0.01 and 2.0), ‘Moderately Improved’ (incremental Index score
between 2.01 and 4.0), ‘Most Improved’ (incremental Index score >4).
The indicators where most UTs need to focus include full immunization, average occupancy of State level
key positions and District CMOs, filling vacancies of specialists at district hospitals, functional 24x7 PHCs
and quality accreditation of public health facilities.
4.3.3. Domain–specific performance
The overall performance of the UTs differs with the domain-specific performance and suggests some
opportunities to improve the performance in the lagging domain(s) (Figure 4.15). Dadra and Nagar Haveli
and Daman and Diu had lower Health Outcomes Index scores than other UTs. Lakshadweep and Delhi
had the lowest Key Inputs/Processes Index scores among all UTs.
In the domain of Health Outcomes, all UTs except Lakshadweep and Andaman and Nicobar Islands
have improved their performance from Base Year to Reference Year (Figure 4.16). In the Reference
Year, the UT of Chandigarh scored highest with 67.2 points compared to Daman and Diu’s lowest score
of 36. The gaps in index scores across UTs got narrower in the Reference Year as compared to the
Base Year.
In the Key Inputs and Processes domain, four UTs (Chandigarh, Dadra and Nagar Haveli, Daman and
Diu, and Andaman and Nicobar Islands) improved their performance; whereas the performance of the
other three UTs (Puducherry, Lakshadweep, and Delhi) has fallen (Figure 4.17). In this domain, Chandigarh
scored highest with 75.3 points, while Delhi scored the lowest with 31.8 points.
Results and F indings 39
Figure 4.15  UTs: Overall and domain-specific performance, Reference Year
Figure 4.16  UTs: Performance in the Health Outcomes domain, Base and Reference Years
Figure 4.17  UTs: Performance in the Key Inputs/Processes domain, Base and Reference Years
Key Inputs/Processes
Overall Performance
ChandigarhDadra & Nagar
Haveli
Lakshadweep Puducherry Delhi Andaman &
Nicobar
Daman &
Diu
0
20
40
60
80
100
Reference Year (2017-18) Score
Health Outcomes
States0102030405060708090100
0102030405060708090100
Health Outcomes Index Score
-20- 10 01 02 0
Incremental Change
Chandigarh
Lakshadweep
Delhi
Puducherry
Andaman & Nicobar
Dadra & Nagar Haveli
Daman & Diu15.89 35.97
23.64 37.24
60.8540.78
53.58 57.66
56.83 59.65
74.3764.18
63.58 67.16
-10.18
-20.07
20.08
13.60
3.58
2.82
4.08
Base Year (2015-16)
Reference Year (2017-18)
Base Year (2015-16)
Reference Year (2017-18)
States0102030405060708090100
0102030405060708090100
Key Inputs/Processes Index Score
-20- 10 01 02 03 0
Incremental Change
Chandigarh
Dadra & Nagar Haveli
Puducherry
Daman & Diu
Andaman & Nicobar
Lakshadweep
Delhi45.9631.75
38.3333.14
26.75 39.69
36.11 40.24
52.9947.52
40.9769.65
52.1075.26
-14.21
28.68
12.94
23.16
-5.47
-5.19
4.13
Note: States ranked based on their Reference Year Score in the Health Outcomes domain.
Note: States ranked based on their Reference Year Score in the Key Inputs/Processes domain. Healthy S tates, Progressive India40
4.3.4. Incremental performance on indicators
Figure 4.18 captures the incremental progress on indicators and sub-indicators and provides the
number of indicators and sub-indicators in each category, i.e., ‘Most Improved’, ‘Improved’, ‘No Change’,
‘Deteriorated’and ‘Most Deteriorated’.
Dadra and Nagar Haveli had the highest number of indicators (around 60 percent) where performance
has improved between the Reference and Base Years. Chandigarh had the second highest number of
indicators (around 50 percent) improved in the Reference Year. All other UTs had most of their indicators
stagnant or worsened in the Reference Year. This shows that there is substantial scope of improvement for
UTs to improve their performance on various indicators. Detailed indicator-specific performance snapshot
of UTs is presented in Annexure 2, which provides direction as well as the magnitude of the incremental
change of indicators from Base Year to Reference Year.
4.4. States and Union Territories Performance on Indicators
Domain 1: Health Outcomes
Indicator 1.1.1 - Neonatal Mortality Rate (NMR)
The first month after birth of a child (more specifically the first 28 days) is called the neonatal period. NMR
is measured as the number of neonatal deaths per 1,000 live births. Death occurred during this period is
of great concern because it reflects the availability and quality of the prenatal, intrapartum, and neonatal
care services. In India, neonatal mortality remains a public health concern, as more than two-thirds of
infant deaths occur during the neonatal period.
This indicator is available only for Larger States (Figure 4.19). There is a huge disparity in NMR across India.
Some States have a relatively low NMR, with levels comparable to upper-middle income countries, while
Figure 4.18  UTs: Number of indicators/sub-indicators, by category of incremental performance
Most ImprovedImprovedNo change Deteriorated Most Deteriorated Not Applicable
1
7
2
7
6
11
8
3
1
6
2
3
2
7
9
6
4
5
1
3
4
2
1
5
4
5
2
2
3
8
4
5
7
2
1
7
2
4
2
3
5
3
0510152025
Lakshadweep
Daman & Diu
Puducherry
Andaman & Nicobar
Delhi
Chandigarh
Dadra & Nagar Haveli
Note: For a UT, the incremental performance on an indicators is classified as ‘Not Applicable’ (NA) in instances such as: (i) Data
Integrity Measure indicator wherein the same data have been used for Base Year and Reference Year due to unavailability of
updated NFHS data; (ii) PLHIV indicator (iii) Service coverage indicators with 100 percent values or vacancy of 0 percent in both
Base and Reference Years; (iv) The data value for a particular indicator is NA in Base Year or Reference Year or both.
Results and F indings 41
others have NMR way above the average for low-income countries. Among the Larger States, Odisha and
Madhya Pradesh had the highest NMR, while Kerala had the lowest. From the period 2015 to 2016, NMR
declined or hovered in all Larger States except for Uttarakhand, where NMR increased from 28 to 30
neonatal deaths per 1,000 live births. Although Odisha and Madhya Pradesh had the highest NMR, the
NMRs significantly declined in both States (from 35 to 32 neonatal deaths per 1,000 live births in Odisha,
and from 34 to 32 neonatal deaths per 1,000 live births in Madhya Pradesh) during 2015 to 2016.
Among the 21 Larger States, Kerala and Tamil Nadu have already reached the 2030 SDG target for NMR, which
is 12 neonatal deaths per 1,000 live births. Maharashtra and Punjab are also close to achieving the target.
Indicator 1.1.2 - Under-five Mortality Rate (U5MR)
U5MR, 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 nutritional status of
women and children, maternal education, availability of basic public health interventions (e.g. immunization,
oral rehydration therapy, water and sanitation), and socio-economic status. This indicator is only available
for the Larger States.
Compared to countries with similar level of economic development, U5MR remains high (39 per 1,000 live
births) in India with large variation across States (Figure 4.20). Madhya Pradesh had the highest U5MR
among the Larger States, while Kerala had the lowest. From 2015 to 2016, U5MR declined or remained
steady in all States, except for Uttarakhand and Chhattisgarh. U5MR increased from 38 to 41 deaths per
1,000 live births in Uttarakhand, and from 48 to 49 deaths per 1,000 live births in Chhattisgarh. Although
Assam and Madhya Pradesh were the two States with the highest U5MR in 2016, these States reported
impressive decline in U5MR by 10 and 7 points, respectively, compared to the national average of 4 points.
The States of Kerala, Tamil Nadu, Maharashtra and Punjab had already achieved the SDG target on U5MR,
which is 25 deaths per 1,000 live births.
Figure 4.19  Indicator 1.1.1 - Neonatal Mortality Rate - Larger States
66
14
12
1313
15
13
19
16
18
17
19
18
20
18
23
21
23
21
23
21
24
22
24
23
25
23
27
26
28
27
30
2828
30
31
30
34
32
35
32
0
5
10
15
20
25
30
35
40
Kerala
Tamil Nadu
Punjab
Maharashtra
Himachal Pradesh
Jammu & Kashmir
Andhra Pradesh
West Bengal
Karnataka
Telangana
Jharkhand
Gujarat
Haryana
Assam
Chhattisgarh
Bihar
Rajasthan
Uttarakhand
Uttar Pradesh
Madhya Pradesh
Odisha
Neonatal deaths per 1, 000 live births
Base Year (2015)Reference Year (2016)
Source: SRS Healthy S tates, Progressive India42
Indicator 1.1.3 - Total Fertility Rate (TFR)
TFR is the most commonly used measure of fertility. It represents the number of children that would be
born to a woman if she experiences the current fertility rate throughout her reproductive age of 15 to 49
years. In developing countries, high level of fertility is linked to poverty, low maternal education, gender
inequality, low female labour participation rates, and other measures of social and economic development.
This indicator is available only for the Larger States (Figure 4.21).
Figure 4.20  Indicator 1.1.2 - Under-five Mortality Rate - Larger States
Figure 4.21  Indicator 1.1.3 - Total Fertility Rate - Larger States
Under five child deaths per 1, 000 live births
Base Year (2015)Reference Ye ar (2016)
13
20
11
19
24
21
27
24
28
26
30
27
33
27
31
29
39
33
39
33
3434
43
37
39
37
38
41
48
43
50
45
51
47
48
49
56
50
62
52
62
55
0
10
20
30
40
50
60
70
Kerala
Tamil Nadu
Maharashtra
Punjab
Jammu & Kashmir
West Bengal
Himachal Pradesh
Karnataka
Gujarat
Jharkhand
Telangana
Haryana
Andhra Pradesh
Uttarakhand
Bihar
Rajasthan
Uttar Pradesh
Chhattisgarh
Odisha
Assam
Madhya Pradesh
Source: SRS
Base Year (2015)Reference Year (2016)
1.6
1.6
1.6
1.6
1.7
1.7
1.8
1.7
1.7
1.7
1.6
1.7
1.7
1.7
1.8
1.8
1.8
1.8
1.8
1.8
2.0
1.9
2.0
2.0
2.2
2.2
2.3
2.3
2.2
2.3
2.5
2.5
2.7
2.6
2.7
2.7
2.8
2.8
3.1
3.1
3.2
3.3
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
West Bengal
Tamil Nadu
Punjab
Telangana
Andhra Prades h
Jammu & Kashmir
Himachal Pradesh
Kerala
Maharashtr a
Karnataka
Uttarakhan d
Odisha
Gujarat
Assa m
Haryana
Chhattisgarh
Jharkhan d
Rajastha n
Madhya Prades h
Uttar Pradesh
Bihar
Births per women
Source: SRS
Results and F indings 43
In 2016, 12 of the 21 Larger States (Tami Nadu, West Bengal, Andhra Pradesh, Himachal Pradesh, Jammu
and Kashmir, Punjab, Telangana, Karnataka, Kerala, Maharashtra, Uttarakhand, and Odisha) had TFR below
replacement level (TFR<2.1). TFR remained high in Bihar, Uttar Pradesh, Madhya Pradesh, and Rajasthan.
From 2015 to 2016, TFR hovered in most Larger States, but slight increases were observed in Jammu &
Kashmir, Haryana and Bihar; while decreases were observed in Telangana, Uttarakhand, and Jharkhand.
Indicator 1.1.4 - Proportion of Low Birth Weight (LBW) among newborns
LBW is used to describe babies who are borne with less than 2,500 grams. LBW could be either the result
of preterm birth or of restricted fetal growth. It is associated with fetal and neonatal deaths and illnesses,
and long-term consequences such as impaired cognitive development, and onset of chronic diseases
later during adult life. This indicator reflects the effects of physical environment of the infant and the
mother, which played a key role in determining the infant’s birth weight and future health. This indicator is
available for all States and UTs.
Administrative data from MoHFW showed that the percentage of LBW among newborns varied across States
and UTs. Among the Larger States, Jammu & Kashmir had the lowest proportion (5.5 percent) of newborns
with LBW, while Odisha had the highest proportion (18.2 percent) (Figure 4.22). For Smaller States, the
proportion of newborns with LBW varied from 4.1 percent in Nagaland to 15.6 percent in Goa (Figure 4.23).
Among the UTs, the proportion varied between 7.4 percent for Lakshadweep and 36.9 percent for Dadra
and Nagar Haveli. From 2015-16 to 2017-18, there was a noticeable decline in LBW. Rajasthan and Haryana
had the largest improvement, with over 40 percent decline in the proportion of LBW newborns. Rajasthan
and Haryana attributed this decline to measures such as early registration of pregnancies, early detection
and management of high risk pregnancies, regular monitoring of HMIS data. Some of the States and UTs
reported a slight increase in the proportion of newborns with LBW. However, 2 percentage points or more
increase were noted in Bihar, Tamil Nadu, Tripura and Dadra and Nagar Haveli.
Figure 4.22  Indicator 1.1.4 - Proportion of Low Birth Weight among newborns - Larger States
14.1
5.9
5.5
6.7
5.6
7.4
7.1
5.7
7.1
7.3
8.2
6.9
8.4
14.9
8.5
7.2
9.2
11.5
10.0
12.2
10.1
9.6
11.2
11.7
11.4
13.7
12.1
10.5
12.3
12.6
12.6
25.5
14.0
14.3
16.7
14.4
13.0
15.5
16.4
16.4
19.2
18.2
0
5
10
15
20
25
30
Proportion of low birth weight among newborns (%)
Jammu & Kashmir
Andhra Pradesh
Jharkhand
Telangana
Uttarakhand
Punjab
Haryan a
Biha r
Karnataka
Chhattisgarh
Uttar Pradesh
Kerala
Maharashtr a
Gujarat
Himachal Pradesh
Rajastha n
Madhya Pradesh
Assam
Tamil Nadu
West Bengal
Odisha
Base Year (2015-16)Reference Year (2017-18)
Source: HMIS Healthy S tates, Progressive India44
Figure 4.23  Indicator 1.1.4 - Proportion of Low Birth Weight among newborns - Smaller States and UTs
Base Year (2015-16)Reference Year (2017-18)
5.6
15.5
17.2
21.4
24.4
20.8
29.4
7.4
14.6
16.6
19.6
20.7
20.9
36.9
0
5
10
15
20
25
30
35
40
Lakshadweep
Puducherry
Andaman &
Nicobar Islands
Delhi
Daman & Diu
Chandigarh
Dadra &
Nagar Haveli
Low birth weight among newborns (%)
Base Year (2015-16)Reference Year (2017-18)
3.9
3.5
4.6
6.6
7.8
7.6
11.1
15.6
4.1
4.4
4.7
6.4
7.6
7.7
13.5
15.6
0
2
4
6
8
10
12
14
16
Nagalan d
Manipu r
Mizoram
Arunachal
Prades h
Sikkim
Meghalay a
Tripura
Goa
Low birth weight among newborns (%)
Source: HMIS
Smaller StatesUnion Territories
Indicator 1.1.5 - Sex Ratio at Birth (SRB)
SRB measures the number of girls born for every 1,000 boys born. It reflects the extent to which gender
discrimination leads to sex-selective abortion. The low SRB in India relative to global average has received
considerable attention. This indicator is available only for the Larger States.
Out of the 21 Larger States, only two States (Chhattisgarh and Kerala) had SRB of more than 950 girls for
every 1,000 boys. Chhattisgarh had the highest SRB (963), whereas Haryana had the lowest (832). From
2013-15 to 2014-16, the SRB decreased in twelve Larger States (Kerala, Odisha, West Bengal, Karnataka,
Himachal Pradesh, Andhra Pradesh, Bihar, Telangana, Assam, Maharashtra, Rajasthan and Gujarat), while
it increased in the remaining nine States (Figure 4.24).
Figure 4.24  Indicator 1.1.5 - Sex Ratio at Birth - Larger States
961
963
967
959
950
948
951
937 939
935
919
922
902
918
924
917 911
915
918
913
916
908
899
906
918
901
900
896 889
893 879
882
878
876
861
857
844
850
854
848
831
832
750
800
850
900
950
1000
Chhattisgarh
Kerala
Odisha
West Bengal
Karnataka
Madhya Pradesh
Jharkhand
Himachal Pradesh
Tamil Nadu
Andhra Pradesh
Bihar
Jammu & Kashmir
Telangana
Assam
Punjab
Uttar Pradesh
Maharashtra
Rajasthan
Uttarakhand
Gujarat
Haryana
Number of girls born for every 1,000 boys born
Base Year (2013-15)Reference Year (2014-16)
Source: SRS
Results and F indings 45
Figure 4.26  Indicator 1.2.1 - Full immunization coverage - Smaller States and UTs
0
20
40
60
80
100
120
0
20
40
60
80
100
120
Full immunization coverage among infants
between ages of 9-11 months (%)
Full immunization coverage among infants
between ages of 9-11 months (%)
96.3
100.0
95.2
97.0
100.0
90.8
84.3
86.1
93.3
77.6
74.4
70.0
65.0
65.5
63.9
58.2
Manipur
Goa
Mizoram
Tripura
Meghalaya
Sikkim
Arunachal
Pradesh
Nagaland
Base Year (2015-16)Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
96.2
99.8
93.6
83.4
77.1
79.1
100.0
77.2
100.0
77.1
77.6
69.5
79.7
52.8
Delhi
Chandigarh
Dadra &
Nagar Haveli
Andaman &
Nicobar Islands
Lakshadweep
Puducherry
Daman & Diu
Source: HMIS
Smaller StatesUnion Territories
Indicator 1.2.1 - Full Immunization Coverage
Full coverage has been the cornerstone of immunization program in India. An infant is said to have
been fully immunized if he or she has received BCG, 3 doses of DPT, 3 doses of OPV and measles. Full
immunization is one of the most cost-effective interventions to reduce preventable child mortality. This
indicator is available for all States and UTs.
Figure 4.25  Indicator 1.2.1 - Full immunization coverage - Larger States
0
20
40
60
80
100
120
Full immunization coverage among infants between
ages of 9-11 months (%)
Jammu & Kashmir
Andhra Pradesh
Jharkhand
Telangana
Uttarakhan d
Punjab
Haryan a
Bihar
Karnataka
Chhattisgarh
Uttar Pradesh
Kerala
Maharashtr a
Gujarat
Himachal Pradesh
Rajasthan
Madhya Pradesh
Assam
Tamil Nadu
West Benga l
Odisha
Base Year (2015-16)Reference Year (2017-18)
100.0 100.0
94.6
100.0
88.1
100.0
91.6
100.0
95.8 95.8
98.2
95.7
99.3
95.0
96.2
94.1
99.6
92.7
90.6
92.0
89.1
90.3 89.7 89.7
83.5
88.9
90.5
86.9
84.8 84.7
88.0
83.3
78.1
81.6
95.2
79.4
74.8
78.0
82.7
76.1
85.3
59.8
Source: HMIS Healthy S tates, Progressive India46
Based on the administrative data from the MoHFW, five States and UTs reported 100 percent full
immunization coverage (Kerala, Jharkhand, Jammu and Kashmir, Andhra Pradesh, Manipur), and
additional ten States and UTs reported 90 percent or higher full immunization coverage (Figure 4.25
and 4.26). Odisha, Nagaland, and Daman and Diu were the States and UTs with the lowest percentage
of full immunization coverage (52.8-59.8 percent). From 2015-16 to 2017-18, coverage of fully-immunized
children declined or hovered in many States and UTs. Alarmingly, Himachal Pradesh, Odisha, Meghalaya,
Andaman and Nicobar Islands, Lakshadweep and Daman and Diu reported more than 15-percentage
point decline in the percentage of fully-immunized children.
Indicator 1.2.2 - Proportion of institutional deliveries
It is critical for pregnant mothers to deliver in health facilities. Life-saving equipment and hygienic conditions
reduce the risk of death and complications among mothers and infants. In developing countries, home
delivery is a strong predictor of infant and maternal deaths. The percentage of deliveries in public or private
healthcare facilities reflects the level of access to basic healthcare services. This indicator is available for
all States and UTs.
Based on the administrative data from the MoHFW, only six States and UTs had more than 90 percent
deliveries conducted in private or public health facilities: Telangana, Gujarat, Kerala, Mizoram, Puducherry
and Chandigarh (Figure 4.27 and 4.28). Some States and UTs have low levels of institutional deliveries:
only about half of total deliveries in Uttar Pradesh, Nagaland, and Daman and Diu were conducted in
health facilities. From 2015-16 to 2017-18, the percentage of institutional deliveries hovered or slightly
changed in most States, and significantly changed in only a few States and UTs. In Chhattisgarh and
Jharkhand, institutional deliveries increased by more than 10 percentage points. However, the institutional
deliveries declined by 20.4 points in Lakshadweep and 24.6 points in Daman and Diu.
Figure 4.27  Indicator 1.2.2 - Proportion of institutional deliveries - Larger States
0
20
40
60
80
100
120
Institutional deliveries (%)
Jammu & Kashmir
Andhra Prades h
Jharkhan d
Telangana
Uttarakhan d
Punjab
Haryana
Bihar
Karnataka
Chhattisgarh
Uttar Pradesh
Kerala
Maharashtr a
Gujarat
Himachal Pradesh
Rajastha n
Madhya Prades h
Assam
Tamil Nadu
West Bengal
Odisha
Base Year (2015-16)Reference Year (2017-18)
85.4
97.8
92.6
85.3
67.4
87.1
80.5
80.2
82.3
81.3
81.8
78.8
64.5
73.8
74.3
73.5
67.5
62.6
64.8
57.1
52.4
91.7
91.6
90.9
89.8
88.2
85.9
85.5
84.2
82.2
81.3
80.5
79.6
75.8
74.8
72.0
70.9
67.6
67.0
62.3
56.0
50.6
Source: HMIS
Results and F indings 47
Indicator 1.2.3 - Total case notification rate of tuberculosis (TB)
India has the highest disease burden of tuberculosis (TB) globally. Total case notification rate is one of the
critical indicators on TB management and control in a country. It reflects the progress in detecting and
reporting TB cases. Total case notification rate is defined as the number of new and relapsed TB cases
notified in both public and private facilities per 1,00,000 population during a specific year.
Figure 4.28  Indicator 1.2.2 - Proportion of institutional deliveries - Smaller States and UTs
Source: HMIS
Smaller StatesUnion Territories
Figure 4.29  Indicator 1.2.3 - Total case notification rate of tuberculosis - Larger States
207
226
224
193
164
167
145
161
164
159
99
159
136
153
138
151
138
145
172
145
137
140
143
139
105
123
123
119
125
119
108
118
123
107
93
100 84
82 72
74
139
67
0
50
100
150
200
250
Gujarat
Himacha l
Prades h
Madhya
Prades h
Andhra
Prades h
Maharashtr a
Odisha
Punjab
Uttarakhand
Chhattisgarh
Haryan a
Uttar
Prades h
Rajasthan
Karnataka
Assam
Tamil Nadu
Jharkhand
Telangana
West Bengal
Biha r
Jammu &
Kashmir
Kerala
Total case notification rate of TB per 1, 00,000 population
Base Year (2016) Reference Year (2017)
Source: RNTCP MIS, MoHFW
Institutional deliveries (%)
Base Year (2014) Reference Year (2016)Base Year (2014) Reference Year (2016)
Institutional deliveries (%)
100.0
100.0
100.0
100.0
0
20
40
60
80
120
Chandigarh
Puducherry
Delhi
Dadra &
Nagar Haveli
Andaman &
Nicobar Islands
Lakshadweep
Daman & Diu
0
20
40
60
80
120
Mizoram
Goa
Tripura
Arunachal
Pradesh
Manipur
Meghalaya
Nagaland
Sikkim
87.1
80.6
80.2
85.4
72.0
87.2
82.8
75.7
65.0
47.4
100100
96.3
95.1
79.4
88.4
92.5
86.6
73.5
79.7
70.2
66.3
56.5
63.0
62.1
62.6
58.1
54.3 Healthy S tates, Progressive India48
There were big variations in TB notification rates across States. Among the Larger States, Himachal Pradesh
reported the highest case notification rate of 226 per 1,00,000, compared to 67 per 1,00,000 in Kerala
(Figure 4.29). Also, there were wide variations in incremental performance from 2016 to 2017. Among
the Larger States, Odisha had an impressive increase in case notification of 60 per 1,00,000 population.
Significant increases were also noted in several States and UTs (Chandigarh, Dadra and Nagar Haveli,
Odisha, Lakshadweep, Gujarat, Arunachal Pradesh, Himachal Pradesh, Karnataka, Punjab and Andhra
Pradesh) (Figure 4.30). On the other hand, large decreases were noted in Haryana, Kerala, Sikkim, and
Andaman and Nicobar Islands.
Indicator 1.2.4 - Treatment success rate of new microbiologically confirmed tuberculosis
cases
Successful treatment of TB is essential to prevent further spread of the infection. Treatment success rate of
new microbiologically confirmed TB cases is defined as the proportion of new microbiologically confirmed
cases that have successfully completed treatment against the total number of new microbiologically
confirmed TB cases registered during a given period. It is an important indicator on the performance of
India’s National TB Program.
The Government of India established a target of ≥85 percent success rate for TB treatment. Only ten
Larger States, one Smaller State and five UTs have treatment success rates of 85 percent or above in
2016 (Figure 4.31 and 4.32). From 2015 to 2016, TB treatment success rates declined in States, except
for Jharkhand, Telangana, and Andhra Pradesh. More than 15 percent point decreases were seen in
Uttar Pradesh, Arunachal Pradesh, Bihar, Tripura, Mizoram and Odisha. Four of the seven UTs had some
improvement in treatment success rates (Lakshadweep, Daman and Diu, Dadra and Nagar Haveli and
Chandigarh), while the other three had a decline in treatment success rate. Nine Larger States, 4 Smaller
States and one UT that previously had TB treatment success rates above 85 percent in 2015 noted decline
below the target of 85 percent in 2016.
Figure 4.30  Indicator 1.2.3 - Total case notification rate of tuberculosis - Smaller States and UTs
Source: RNTCP MIS, MoHFW
Smaller StatesUnion Territories
183
203
241
197
186
186
139
148
131
128
137
116
81
94
0
50
100
150
200
250
300
Arunachal
Prades h
Sikkim
Mizoram
Nagaland
Goa
Meghalaya
Manipur
61
44
Tripura
Base Year (2016) Reference Year (2017)
Base Year (2016) Reference Year (2017)
Total case notification rate of TB
per 1,00,000 population
Total case notification rate of TB
per 1,00,000 population
348
305
523
360
133
225
166
151
103
114
139
76
35
70
0
100
200
300
400
500
600
Chandigarh
Delhi
Dadra &
Nagar Haveli
Daman & Diu
Puducherry
Andaman &
Nicobar Islands
Lakshadweep
Results and F indings 49
Indicator 1.2.5 - Proportion of people living with HIV (PLHIV) on antiretroviral therapy (ART)
This indicator relates to treatment of PLHIV. Data for this indicator were only available for the Larger and
Smaller States, and not for UTs. Due to the change in the program guidelines related to treatment, the
data for the Reference Year (2017-18) is not comparable to the Base Year (2015-16) data. Due to changes
in definition, 2015-16 data were repeated for 2017-18. The National Health Policy 2017 set a specific goal
to ensure that 90 percent of all people tested positive for HIV receive sustained ART by 2020. Out of 29
Source: RNTCP MIS, MoHFW
Figure 4.31   Indicator 1.2.4 - Treatment success rate of new microbiologically confirmed tuberculosis cases -
Larger States
Treatment success rate of new microbiologically
confirmed TB cases (%)
Base Year (2015)R eference Year (2016)
90.9
89.6
90.3
89.6
88.5
89.1
88.9
87.2
86.5
88.3
87.5
90.3
84.7
84.2
87.5
86.0
86.2
85.4
88.9
89.7
87.5
91.7
90.4
89.9
89.0
89.0
88.6
88.1
85.9
85.7
85.0
83.7
82.5
79.7
79.5
78.9
77.6
77.5
75.9
72.5
71.9
64.0
0
50
40
30
20
10
100
90
80
70
60
Jharkhand
Telangana
Rajasthan
Himachal Pradesh
Andhra Pradesh
Chhattisgarh
Gujarat
Punjab
West Bengal
Jammu & Kashmir
Kerala
Madhya Pradesh
Karnataka
Maharashtra
Haryan a
Uttarakhan d
Assam
Tamil Nadu
Odisha
Bihar
Uttar Pradesh
90.9
Source: RNTCP MIS, MoHFW
Smaller StatesUnion Territories
Treatment success rate of new
microbiologically confirmed TB cases (%)
87.3
85.8
82.6
90.6
88.5
71.9
77.2
86.4
85.4
79.7
79.5
73.5
70.9
67.6
66.2
64.8
0
20
40
60
80
100
Goa
Meghalaya
Manipu r
Mizoram
Tripura
Nagaland
Sikki m
Arunachal
Pradesh
Base Year (2015)Reference Year (2016)
91.3
79.5
86.3
89.2
85.6
86.7
91.5
93.8
92.6
89.6
88.8
86.8
84.8
83.9
70
75
80
85
90
95
Lakshadweep
Daman & Diu
Dadra &
Nagar Haveli
Puducherry
Chandigarh
Delhi
Andaman &
Nicobar Islands
Treatment success rate of new
microbiologically confirmed TB cases (%)Base Year (2015)Reference Year (2016)
Figure 4.32   Indicator 1.2.4 - Treatment success rate of new microbiologically confirmed tuberculosis cases -
Smaller States and UTs Healthy S tates, Progressive India50
Figure 4.33  Indicator 2.1.1: Data Integrity Measure – ANC registered within first trimester - Larger States
Source: HMIS and NFHS-4
0.9
2.1
5.6
7.3
8.2
9.2
10.0
10.8
13.5
15.4
15.8
16.3
18.4
19.1
21.2
22.1
22.8
24.9
25.9
42.4
53.5
0
10
20
30
40
50
60
Uttar Pradesh
Deviation of HMIS data with NFHS-4 data for
ANC registered within first trimester (%)
Gujarat
Maharashtr a
Himachal Pradesh
Karnataka
Madhya Pradesh
Punjab
Uttarakhand
Jammu & Kashmir
Andhra Prades h
Telangana
Bihar
Rajastha n
Haryan a
Assam
Odisha
Tamil Nadu
Kerala
Chhattisgarh
West Benga l
Jharkhand
Figure 4.34  Indicator 2.1.1: Data Integrity Measure – ANC registered within first trimester - Smaller States and UTs
5.6
10.6
10.9
18.7
23.7
26.8
28.2
107.9
0
20
40
60
80
100
120
Arunachal Pradesh
Meghalaya
Tripura
Mizoram
Goa
Sikki m
Manipur
Nagalan d
Deviation of HMIS data with NFHS-4 data for 
ANC registered within first trimester (%)
Deviation of HMIS data with NFHS-4 data for
ANC  registered within first trimester (%)
2.8
12.2
15.3
22.1
27.8
27.9
48.8
0
10
20
30
40
50
60
Lakshadweep
Andaman &
Nicobar Islands
Daman & Diu
Dadra &
Nagar Haveli
Delhi
Chandigarh
Puducherry
Smaller StatesUnion Territories
States, three (Jammu & Kashmir, Meghalaya and Mizoram) have achieved this target while five have 80
to 90 percent of PLHIV on ART in the Base Year (2015-16). Eight States have less than 50 percent of the
PLHIV on ART (Base Year 2015-16), namely Bihar, Jharkhand, Odisha, Rajasthan, West Bengal, Arunachal
Pradesh, Sikkim, and Tripura. Significant improvements are needed to achieve 90 percent coverage.
Domain 2: Governance and Information
Indicator 2.1.1 - Data Integrity Measure: (a) Institutional deliveries; (b) ANC registered within
first trimester
This indicator captures the percentage deviation of HMIS reported data from NFHS-4 data in order to assess
the quality and integrity of reported data. Specifically, data from HMIS for last five years on the proportion of
institutional deliveries and ANC registered within the first trimester were compared with NFHS-4 conducted
during 2015-16. There are huge disparities in the data integrity measures across States and UTs (Figure 4.33,
4.34, 4.35 and 4.36). The data integrity of a State or UT also varies by the specific indicators evaluated. Among
the Larger States, Gujarat and Maharashtra had the lowest deviation in both the indicators, whereas in the
case of Smaller States and UTs, Arunachal Pradesh and Tripura had lowest deviation in both indicators.
Source: HMIS and NFHS-4
Results and F indings 51
Figure 4.35  Indicator 2.1.1: Data Integrity Measure – institutional deliveries - Larger States
Source: HMIS and NFHS-4
0.3
0.7
1.2
2.1
3.7
4.6
7.9
10.9
12.4
12.4
12.4
12.7
13.8
14.9
18.2
21.1
21.2
22.3
23.1
23.5
36.6
0
5
10
15
20
25
30
35
40
Assam
Deviation of HMIS data with
NFHS-4 data for institutional deliveries (%)
Gujarat
Maharashtra
West Benga l
Kerala
Haryana
Jharkhan d
Tamil Nadu
Punjab
Jammu & Kashmir
Rajasthan
Himachal Pradesh
Odisha
Uttarakhand
Bihar
Telangan a
Karnataka
Chhattisgarh
Madhya Pradesh
Andhra Pradesh
Uttar Pradesh
Figure 4.36  Indicator 2.1.1: Data Integrity Measure – institutional deliveries - Smaller States and UTs
Source: HMIS and NFHS-4
0
10
20
30
40
50
60
1.4
Arunachal Pradesh
Deviation of HMIS data with
NFHS-4 data for institutional deliveries (%)
2.9
Manipur
3.4
Tripur a
5.0
Goa
13.4
Meghalaya
22.0
Mizora m
29.2
Sikkim
54.8
Nagalan d
0
10
20
30
40
50
60
70
80
90
100
10.8
15.1
17.4
18.1
29.3
58.0
90.5
Delhi
Deviation of HMIS data with
NFHS-4 data for institutional deliveries (%)
Dadra & Naga r
Haveli
Daman & Diu
Andaman &
Nicobar Islands
Lakshadweep
Chandigarh
Puducherr y
Smaller StatesUnion Territories
Indicator 2.2.1 - Average occupancy of an officer (in months), for three key posts at State level
for last three years
A stable tenure for key administrative positions is critical to ensure the effectiveness and sustainability
of public health programs. Based on the data from States in 2015-18, the average occupancy of Principal
Secretary, Mission Director (NHM), and Director (Health Services) or equivalent positions in a period of three
years was highest in West Bengal (28 months), and lowest in Nagaland (5.8 months) (Figure 4.37 and 4.38).
Out of the 36 States and UTs, 21 had an average occupancy of twelve months or more per officer. From
Base Year to Reference Year, among the Larger States, Tamil Nadu, Andhra Pradesh, Assam, Bihar, and
Telangana reported significant increases of about six months or more in the average occupancy per officer.
However, large declines above six months were observed in some of the States such as Punjab, and Uttar
Pradesh. Among the Smaller States and UTs, Goa, Manipur, Meghalaya, Lakshadweep and Daman and Diu
reported significant decreases above six months in the average occupancy. Healthy S tates, Progressive India52
Indicator 2.2.2 - Average occupancy of a District Chief Medical Officer (CMO) or equivalent
post (heading District Health Services full-time) (in months) in last three years
Short average occupancy of district CMO hinders effective implementation of key public health programs.
Out of the 36 States and UTs, 28 had an average occupancy of twelve months or more for CMOs (or
equivalent post heading the Health Services at the district level). The seven States/UTs that had less than
twelve months of average CMO occupancy were Uttar Pradesh, Uttarakhand, Jharkhand, Andhra Pradesh,
Punjab, Tamil Nadu, and Chandigarh (Figure 4.39 and 4.40). From Base Year to Reference Year, Tripura,
Assam, Delhi, Dadra and Nagar Haveli, Rajasthan, Telangana, Himachal Pradesh, Manipur and Meghalaya
reported large increases, whereas Daman and Diu, Chhattisgarh, Uttar Pradesh, Uttarakhand, Andhra
Pradesh and Chandigarh, reported large decreases. In Lakshadweep, there was no CMO or equivalent
position and hence this indicator is not applicable.
Smaller StatesUnion Territories
Figure 4.38  Indicator 2.2.1 - Average occupancy of an officer (in months), for three key posts at State level for last
three years - Smaller States and UTs
20.0
14.4
12.0
15.0
26.8
21.0
9.6
24.7
19.0
18.0
14.3
14.0
10.8
7.0
0
5
10
15
20
25
30
Puducherry
Dadra & Nagar
Haveli
Chandigarh
Andaman &
Nicobar Islands
Lakshadweep
Daman & Diu
Delh i
Base Year (2013-16) Reference Year (2015-18)
Average occupancy of an ofcer (in months)
for three key posts for the last 3 year s
Average occupancy of an ofcer (in months)
for three key posts for the last three year s
24.0
21.7
9.8
21.0
10.9
13.9
19.3
7.3
24.0
14.0
13.9
12.0
11.8
11.3
10.0
5.8
0
5
10
15
20
25
30
Sikki m
Goa
Mizoram
Manipu r
Tripura
Arunachal
Pradesh
Meghalaya
Nagalan d
Base Year (2013-16)Reference Year (2015-18)
Figure 4.37  Indicator 2.2.1 - Average occupancy of an officer (in months), for three key posts at State level for last
three years - Larger States
28.0
16.5
17.5
22.0
20.7
12.1
16.0
13.0
7.8
12.0
12.4
20.4
12.0
10.4
12.0
15.7
19.6
13.8
11.4
11.2
6.5
28.0
26.4
24.0
24.0
22.2
22.0
20.0
19.0
16.0
15.9
15.7
14.4
11.7
11.0
10.8
10.0
9.7
9.0
9.0
7.3
6.7
0
5
10
15
20
25
30
West Bengal
Average occupancy of an officer (in months)
for three key posts for last three years
Tamil Nadu
Andhra Pradesh
Rajasthan
Gujarat
Assam
Madhya Pradesh
Bihar
Telangana
Odisha
Himachal Pradesh
Punjab
Kerala
Uttarakhand
Jharkhand
Maharashtra
Uttar Pradesh
Jammu & Kashmir
Chhattisgarh
Haryana
Karnataka
Reference Year (2015-18)Base Year (2013-16)
Source: State Report
Source: State Report
Results and F indings 53
Smaller StatesUnion Territories
Figure 4.40  Indicator 2.2.2 - Average occupancy of a District Chief Medical Officer (CMO) or equivalent post
(heading District Health Services full-time) (in months) in last three years - Smaller States and UTs
Source: State Report
0
5
10
15
20
25
30
35
40
26.0
17.3
25.5
17.3
19.9
14.8
17.5
12.0
26.0
25.9
25.5
24.9
23.4
22.7
18.2
12.0
Mizoram
Manipur
Sikkim
Tripura
Nagaland
Meghalaya
Arunachal
Pradesh
Goa
Reference Year (2015-18)Base Year (2013-16)
Reference Year (2015-18)Base Year (2013-16)
Average occupancy of a CMO (in months)
for all districts for last three years
Average occupancy of a CMO (in months)
for all districts for last three years
18.0
36.0
16.7
25.0
25.3
22.5
36.0
18.0
17.4
13.3
15.6
9.0
0
5
10
15
20
25
30
35
40
Delhi
Dadra &
Nagar Haveli
Puducherry
Andaman &
Nicobar Islands
Daman & Diu
Chandigarh
Lakshadweep
NA
Figure 4.39  Indicator 2.2.2 - Average occupancy of a District Chief Medical Officer (CMO) or equivalent post
(heading District Health Services full-time) (in months) in last three years - Larger States
Average occupancy of a CMO (in months)
for all districts for last three years
Base Year (2013-16)Reference Year (2015-18)
18.1
10.5
25.4
15.6
11.9
11.2
13.2
17.6
14.1
8.0
13.9
11.8
11.9
12.6
11.7
14.2
13.9
11.5
13.2
10.2
7.3
19.0
18.3
18.1
17.4
17.3
16.5
15.7
14.7
14.1
13.8
13.5
13.3
13.3
13.2
13.1
10.5
10.1
10.0
9.3
8.4
7.7
0
5
10
15
20
25
30
Gujarat
Himachal Pradesh
Chhattisgarh
Maharashtra
Rajasthan
Telangana
Karnataka
Madhya Pradesh
West Bengal
Assam
Odisha
Jammu & Kashmir
Bihar
Haryana
Kerala
Uttar Pradesh
Uttarakhand
Jharkhand
Andhra Pradesh
Punjab
Tamil Nadu
Source: State Report
Domain 3: Key Inputs/Processes
Indicator 3.1.1 - Proportion of vacant health care provider positions (Regular + Contractual) in
public health facilities
The lack of manpower in public health facilities is one of main reasons of healthcare underutilization.
The vacancy status of health professionals in relation to sanctioned positions shows how States address
supply-side resources in relation to the need. Healthy S tates, Progressive India54
a. ANMs at sub-centres: Among all the Larger States, less than 25 percent of ANM positions were vacant
except for Karnataka and Bihar, which reported 33.4 percent and 59.5 percent vacancies respectively
(Figure 4.41). Odisha, Uttar Pradesh and West Bengal had almost no vacancy of ANM positions.
Similarly, no vacancy of ANMs was reported in Nagaland, Sikkim, Daman & Diu and Lakshadweep.
From 2015-16 to 2017-18, the vacancy of ANM at sub-centres hovered in most States. However, in
Gujarat, the percentage of vacant ANMs decreased by almost three folds and increased by more
or less two folds in Himachal Pradesh. Among the smaller States and UTs, Meghalaya, Arunachal
Pradesh, Goa, Tripura, Delhi and Chandigarh reported decline in vacancy of ANMs (Figure 4.42).
Figure 4.41  Indicator 3.1.1a – Vacancy of ANMs at sub-centres - Larger States
Reference Year (2017-18)Base Year (2015-16)
0.0
0.0
0.0 0.0
0.8
0.8
9.0
4.6
4.5
5.3
10.3
9.4
9.2
9.5
9.5
9.7
16.0
9.8
28.1
10.3
8.5
12.0
14.2
13.8
18.0
14.6 15.2
15.2
16.9
16.9
15.7
17.1
19.7
19.2
9.9
22.6
19.2
24.2
22.6
33.4
59.3 59.5
0
10
20
30
40
50
60
70
Uttar Pradesh
Vacancy of ANMs at SCs (%)
Odisha
West Bengal
Assam
Kerala
Jammu & Kashmir
Chhattisgarh
Maharashtra
Tamil Nadu
Gujarat
Punjab
Madhya Pradesh
Telangana
Haryana
Uttarakhand
Andhra Pradesh
Jharkhand
Himachal Pradesh
Rajasthan
Karnataka
Bihar
Figure 4.42  Indicator 3.1.1a – Vacancy of ANMs at sub-centres - Smaller States and UTs
Vacancy of ANMs at SCs (%)
Base Year (2015-16)Reference Year (2017-18)
0
10
20
30
40
11.0
0.0
Nagaland
0.0
0.0
Sikkim
20.0
10.7
Meghalaya
30.1
20.0
Goa
16.1
20.2
Mizoram
38.9
24.6
Tripura
29.9
27.3
Manipur
22.4
13.5
Arunachal
Pradesh
Base Year (2015-16)Reference Year (2017-18)
Vacancy of ANMs at SCs (%)
0.0
11.9
0.0
19.7
7.8
8.7
29.4
0.0
0.0
0.9
8.9
9.8
11.7
14.7
0
5
10
15
25
35
30
Andaman &
Nicobar Islands
20
Lakshadweep
Daman & Diu
Dadra &
Nagar Haveli
Delhi
Chandigarh
Puducherry
Smaller StatesUnion Territories
Source: State Report
Source: State Report
Results and F indings 55
Figure 4.43  Indicator 3.1.1b - Vacancy of Staff Nurse at PHCs and CHCs - Larger States
Vacancy of SNs at PHCs and CHCs (%)
Base Year (2015-16) Reference Year (2017-18)
Tamil Nadu
Chhattisgarh
Himachal Pradesh
Assam
Odisha
Kerala
Karnataka
Andhra Pradesh
Gujarat
West Bengal
Punjab
Maharashtr a
Haryan a
Jammu & Kashmir
Madhya Pradesh
Rajasthan
Bihar
Uttarakhand
Jharkhand
Telangana
Uttar Pradesh
1.9
0.0
5.3
12.8
9.7
8.9
20.5
34.0
15.7
20.0
27.5
19.1
26.0
36.5
43.2
37.3
33.5
27.2
47.3
50.3
74.9
0.0
0.0
3.6
7.2
9.7
11.8
12.7
12.9
15.3
16.3
17.9
18.8
21.7
23.7
35.4
41.3
42.2
47.5
50.5
50.7
54.2
0
10
20
30
40
50
60
70
80
Figure 4.44  Indicator 3.1.1b - Vacancy of Staff Nurse at PHCs and CHCs - Smaller States and UTs
Base Year (2015-16) Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
Nagaland
Sikkim
Meghalaya
Goa
Mizoram
Tripura
Manipur
Arunachal
Pradesh
6.2
0.0
4.9
7.5
2.4
0.0
40.8
0.0
0.0
2.1
4.3
4.6
8.9
46.9
0
10
20
30
40
50
Chandigarh
Lakshadweep
Puducherry
Daman & Diu
Delhi
Vacancy of SNs at PHCs and CHCs (%)
0.0
0.0
6.1
31.1
28.8
19.0
11.7
62.0
0.0
0.0
7.1
12.6
15.6
20.1
28.6
30.4
0
10
20
30
40
50
60
70
Vacancy of SNs at PHCs and CHCs (%)
Dadra &
Nagar Haveli
Andaman &
Nicobar Islands
Smaller StatesUnion Territories
Source: State Report
Source: State Report
b. Staff nurses at PHCs and CHCs: Among the Larger States, Chhattisgarh, Madhya Pradesh, Himachal
Pradesh and Rajasthan, Bihar and Jharkhand reported more than 40 percent of vacancies of staff
nurses, whereas Uttar Pradesh and Odisha reported no vacancy of staff nurses (Figure 4.43).
Among the Smaller States and UT, only Delhi had more than 40 percent vacancy. From Base Year
to Reference Year, the percentage of vacant staff nurse positions increased in Assam, Chhattisgarh,
Madhya Pradesh, Himachal Pradesh and Rajasthan (Figure 4.44). Some States and UT such as
Telangana, Andhra Pradesh, Punjab, Gujarat, Haryana, Jammu & Kashmir, Jharkhand, Meghalaya,
Arunachal Pradesh, and Sikkim reported large decreases in staff nurses vacancies. Healthy S tates, Progressive India56
c. Medical officers at PHCs: Among the Larger States, the percentage of vacant positions of
medical officers in PHCs was more than 40 percent in West Bengal, Jharkhand, Madhya Pradesh,
Chhattisgarh and Uttarakhand (Figure 4.45). The States of Uttar Pradesh, Karnataka and Kerala had
less than five percent vacancies. Among the Smaller States and UTs, only Manipur reported more
than 40 percent vacancy (Figure 4.46). From Base to Reference Year, a handful of States reported
large decrease or increase in vacancy. Uttarakhand reported large and significant increase from 12
percent to 70 percent, whereas Bihar and Uttar Pradesh reported large decline. Among the Smaller
States, large decreases were also noted in Nagaland, Mizoram, Arunachal Pradesh, Chandigarh
and Andaman and Nicobar Island.
Figure 4.45  Indicator 3.1.1c - Vacancy of Medical Officers at PHCs - Larger States
Vacancy of MOs at PHCs (%)
Base Year (2015-16) Reference Year (2017-18)
5.9
2.4
11.5
4.6
26.7
4.8
12.8
10.6
14.9
12.2
22.3
15.0
7.6
15.1
7.8
17.7
25.3
22.4
17.0
22.8
17.8
25.5
30.2
28.8
32.0
30.2
26.9
31.9
21.7
32.1
63.6
34.1
41.2
41.2
48.7
46.3
58.3
55.1
45.0
57.3
12.2
69.6
0
10
20
30
40
50
60
70
80
Kerala
Karnataka
Uttar Pradesh
Andhra Prades h
Rajasthan
Telangana
Tamil Nadu
Punjab
Haryan a
Maharashtr a
Assam
Jammu & Kashmir
Gujarat
Odisha
Himachal Pradesh
Bihar
West Benga l
Jharkhand
Madhya Pradesh
Chhattisgarh
Uttarakhand
Figure 4.46  Indicator 3.1.1c - Vacancy of Medical Officers at PHCs – Smaller States and UTs
Base Year (2015-16) Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
0.0
0.0
Vacancy of MOs at PHCs (%)
Vacancy of MOs at PHCs (%)
27.4
0.0
0.0
0.0
2.1
0.0
38.1
2.4
14.2
20.2
38.8
30.2
35.7
30.9
42.8
43.1
0
10
20
30
40
50
Nagaland
Sikkim
Tripura
Mizoram
Goa
Arunachal
Pradesh
Meghalaya
Manipur
69.2
0.0
36.4
10.6
12.8
16.1 16.7 16.7
14.2
26.3
7.1
28.6
0
10
20
30
40
50
60
70
80
Chandigarh
Lakshadweep
Andaman &
Nicobar Islands
Puducherry
Dadra &
Nagar Haveli
Delhi
Daman & Diu
Smaller StatesUnion Territories
Source: State Report
Source: State Report
Results and F indings 57
Figure 4.47  Indicator 3.1.1d - Vacancy of Specialists at district hospitals - Larger States
Vacancy of Specialists at DHs (%)
Base Year (2015-16)Reference Year (2017-18)
21.5
13.5
NA
16.7
15.8
47.7
18.4
20.2 20.2
55.5
21.0
0.0
21.1
45.8
22.4
30.4
25.1
22.2
25.4
19.0
27.4
32.4
28.7
21.5
37.7
41.7
47.0
50.3
47.2
30.3
47.3
51.0
49.1
54.8
53.5
60.6 59.7 60.3
68.0
77.7
70.8
0
10
20
30
40
50
60
70
80
Himachal Pradesh
Kerala
Tamil Nadu
Punjab
West Bengal
Gujarat
Haryana
Rajasthan
Andhra Pradesh
Jammu & Kashmir
Odisha
Uttar Pradesh
Karnataka
Assam
Jharkhand
Maharashtra
Madhya Pradesh
Telangana
Bihar
Uttarakhand
Chhattisgarh
Figure 4.48  Indicator 3.1.1 d - Vacancy of Specialists at district hospitals – Smaller States and UTs
Base Year (2015-16)Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
Vacancy of Specialists at DHs (%)
Vacancy of Specialists at DHs (%)
0
20
40
60
80
100
40.2
40.8
Delhi
0.0
0.0
NA
1.4
15.2
15.6
34.4
31.3
39.7
36.7
29.7
41.5
0
10
20
30
40
50
60
70
80
90
100
Nagaland
Tripura
Mizoram
Sikkim
Goa
Meghalaya
Manipur
Arunachal
Pradesh
89.1
70.0
47.7
45.1
0.0
11.4
Chandigarh
18.2
12.5
Dadra &
Nagar Haveli
20.6
35.1
Puducherry
76.5
46.1
Lakshadweep
47.1
Daman & Diu
56.4
100.0
71.4
Andaman &
Nicobar Islands
Smaller StatesUnion Territories
Source: State Report
Source: State Report
d. Specialists at district hospitals: Among the Larger States, significant vacancy of specialists were
reported by most States (Figure 4.47). Only three States (Kerala, Tamil Nadu and Punjab) have
reported less than 20 percent vacancies of specialists in district hospitals. Among the Smaller
States and UTs, Meghalaya, Manipur, Arunachal Pradesh, Delhi, Lakshadweep, Daman and Diu,
and Andaman and Nicobar Islands had more than 40 percent vacancy (Figure 4.48). Among the
Larger States, Haryana, Karnataka, and Maharashtra reported large increases, whereas Punjab,
Gujarat and Rajasthan reported more than 20 percentage point decrease. Among the Smaller
States and UTs, Arunachal Pradesh, Lakshadweep and Andaman and Nicobar Islands also reported
19 percentage points or more decrease. Healthy S tates, Progressive India58
Indicator 3.1.2 - Proportion of total staff (regular + contractual) with e-payslip generated in the
IT enabled Human Resources Management Information System (HRMIS)
This indicator captures the availability of a functional IT-enabled HRMIS. It is measured as the proportion
of staff (regular + contractual) for whom an e-payslip can be generated in the IT-enabled HRMIS against
total number of staff (regular + contractual) during a specific year. A well-functioning HRMIS is expected to
lead to efficient financial and personnel management. Among the 21 Larger States, fourteen States used
e-payslips in HRMIS to disburse staff salaries in 2017-18, compared to nine States in 2015-16, implying wider
adoption of HRMIS (Figure 4.49). In 2017-18, Kerala, Himachal Pradesh, Andhra Pradesh and Haryana had
fully operationalized HRMIS for 100 percent of staff, whereas other ten States partially operationalized the
HRMIS for 12 to 86 percent of staff. Among the eight Smaller States, only two used e-payslips in HRMIS
(Tripura and Arunachal Pradesh) (Figure 4.50). Three of the seven UTs (Chandigarh, Puducherry and Delhi)
had operationalized HRMIS. It is important for States and UTs to initiate and fully operationalize HRMIS for
effective human resource management.
Figure 4.49  Indicator 3.1.2 - Proportion of total staff (regular + contractual) with e-payslip generated in the IT
enabled Human Resources Management Information System (HRMIS) - Larger States
Base Year (2015-16)Reference Year (2017-18)
0
20
40
60
80
100
120
58.7
100.0
8.1
100.0
100.0
100.0
0.0
100.0
67.6
86.3
84.7
84.4 81.2
81.2 75.8
76.4
0.0
69.4
0.0
54.6
49.4
45.0
35.6
39.5
0.0
33.0
0.0
12.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Proportion of total staf (regular + contractual) with e-payslip generated in the 
IT-enabled Human Resource Management Information System (HRMIS) (%)
Tamil Nadu
Himachal Pradesh
Kerala
West Bengal
Punjab
Maharashtr a
Andhra Prades h
Gujarat
Haryan a
Odisha
Jammu & Kashmir
Rajasthan
Karnataka
Uttarakhand
Madhya Pradesh
Bihar
Chhattisgarh
Uttar Pradesh
Assam
Jharkhand
Telangana
Source: State Report
Indicator 3.1.3.a - Proportion of facilities functioning as First Referral Units (FRUs)
The number of functional FRUs is determined through a proxy indicator. It captures the number of
facilities conducting a specifi¬ed number of C-sections per year against the number of required FRUs
per MoHFW guidelines. Functional FRUs provide specialized services close to the community and can
help to improve access and decongest the patient load at higher level facilities. To be considered as
fully operational FRUs a sub-district hospital or CHC should be conducting a minimum of 60 C-sections
per year (36 C-sections per year for Hilly and North-Eastern States, except Assam), and at a district
hospital should be conducting a minimum of 120 C-sections per year (72 C-sections per year for Hilly and
North-Eastern States, except Assam).
Results and F indings 59
Smaller StatesUnion Territories
Figure 4.50  Indicator 3.1.2 - Proportion of total staff (regular + contractual) with e-payslip generated in the IT
enabled Human Resources Management Information System (HRMIS) – Smaller States and UTs
Source: State Report
Figure 4.51  Indicator 3.1.3.a - Proportion of facilities functional as First Referral Units - Larger States
Functional FRUs as against required number (%)
Base Year (2015-16) Reference Year (2017-18)
0
50
100
150
200
250
196.0
220.0
Bihar
122.9
134.0
Uttar Pradesh
141.8
130.9
Chhattisgarh
116.4
121.3
Jharkhand
80.0
114.3
Rajasthan
121.4
107.1
Madhya Pradesh
West Bengal
120.9
107.5
72.6
90.3
Haryan a
57.6
89.9
Maharashtr a
65.5
69.1
Gujarat
95.0
65.0
Uttarakhand
43.0
63.6
Odisha
32.4
63.1
Andhra Prades h
51.0
52.9
Assam
49.7
51.0
Himachal Pradesh
49.2
49.2
Kerala
29.2
32.9
Telangana
22.7
30.3
Karnataka
23.5
27.5
Punjab
15.8
25.8
Tamil Nadu
11.5
15.4
Jammu & Kashmir
Source: State Report and MoHFW
Many States have achieved the target of functional FRU: Jammu and Kashmir, Tamil Nadu, Punjab,
Karnataka, Telangana, Kerala, Himachal Pradesh, all Smaller States and UTs (except Tripura, Meghalaya,
Manipur, Delhi, and Andaman and Nicobar Islands) (Figure 4.51 and 4.52). Between 2015-16 to 2017-18,
among the States that had not reached the target, there was marginal improvement except for
Uttarakhand. None of the facilities in Andaman and Nicobar Islands functions as FRU despite the need
of one functional FRU, per MoHFW guidelines.
Proportion of total staff (regular + contractual) with
e-payslip generated in the IT -enabled Human
Resource Management Information System (HRMIS) (%)
Base Year (2015-16) Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
Proportion of total staff (regular + contractual) with
e-payslip generated in the IT -enabled Human Resource
Management Information System (HRMIS) (%)
0
20
40
60
80
120
Chandigarh
Puducherry
Delhi
Dadra &
Nagar Haveli
Andaman &
Nicobar Islands
Lakshadweep
Daman & Diu
0
20
40
60
80
120
Tripura
Arunachal
Pradesh
100100
0.0
100.0
38.8
21.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Mizoram
Manipur
Nagaland
Sikkim
Meghalaya
Goa
61.3
100.0
78.4
90.2
68.8
55.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0 Healthy S tates, Progressive India60
Indicator 3.1.3.b - Proportion of functional 24x7 PHCs
The presence of 24x7 Primary Health Centres are critical for providing basic package of health services
to the community and for reducing the workload at higher level facilities. The required number of
functional 24x7 PHCs per State was calculated using a standard of one 24x7 PHC per 1,00,000
population.
Figure 4.53  Indicator 3.1.3.b - Proportion of functional 24x7 PHCs - Larger States
Source: State Report and MoHFW
Figure 4.52  Indicator 3.1.3.a - Proportion of facilities functional as First Referral Units - Smaller States and UTs
Base Year (2015-16) Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
Functional FRUs as against
required number (%)
Functional FRUs as against
required number (%)
200.0
400.0
150.0
250.0
100.0
200.0
100.0
100.0
100.0
100.0
100.0
82.4
0.0
0.0
0
50
100
150
200
250
300
350
400
Puducherry
Chandigarh
Daman & Diu
Dadra &
Nagar Haveli
Lakshadweep
Delhi
Andaman &
Nicobar Islands
133.3
200.0
100.0
200.0 200.0 200.0
100.0 100.0
125.0
100.0
57.1
85.7
66.766.7
100.0
66.7
0
50
100
150
200
Arunachal
Pradesh
Mizoram
Sikkim
Goa
Nagaland
Tripura
Manipur
Meghalaya
Smaller StatesUnion Territories
Source: State Report and MoHFW
Base Year (2015-16)Reference Year (2017-18)
40.4
111.4
176.9
83.0
56.5
68.3
77.6
67.3 69.2
62.7
31.5
56.3
73.6
53.8 54.5
50.5
68.0
43.5 45.6
38.4
46.7
35.1 33.0
29.4
26.4 27.1
30.0
26.4 27.0 25.6
35.0
24.1
29.1
22.7
17.4
20.4
5.9 5.9 5.8 5.8
0.0
0.0
0
20
40
60
80
100
120
140
160
180
200
Chhattisgarh
Assam
Madhya Pradesh
Haryana
Karnataka
Gujarat
Bihar
Uttarakhand
Rajasthan
Jammu & Kashmir
Maharashtra
Jharkhand
Punjab
Odisha
Telangana
Tamil Nadu
Andhra Pradesh
Uttar Pradesh
West Bengal
Himachal Pradesh
Kerala
Functional 24x7 PHCs as against required
number (%)
Results and F indings 61
Figure 4.54  Indicator 3.1.3.b - Proportion of functional 24x7 PHCs - Smaller States and UTs
Smaller StatesUnion Territories
Source: State Report and MoHFW
Many States, particularly the Larger States have yet to achieve the target (Figure 4.53 and 4.54). Only
Chhattisgarh, Sikkim, Meghalaya, Nagaland, Tripura, Mizoram, and Daman & Diu have achieved the
target of the required number of 24x7 PHCs, whereas Kerala, Goa, Puducherry, Lakshadweep, Delhi,
Chandigarh, and Andaman and Nicobar Islands are yet to operationalize any 24x7 PHC. From 2015-16 to
2017-18, Chhattisgarh championed among the 21 Larger States to achieve this goal and the percentage
of functional 24x7 PHC increased by about three folds in the last two years. The functional 24x7 PHCs in
Gujarat also increased by two folds but still below the target. In Smaller States, 24x7 PHC increased by
around two-fold in Sikkim, and the State now has functional FRUs four times the target.
Indicator 3.1.4 - Cardiac Care Units (CCUs) in districts
A functioning CCU is an important indicator of the ability of the health system to provide life-saving and
critical procedures and interventions. Among all States and UTs (Figure 4.55 and 4.56), Assam, Jharkhand,
Telangana, Uttar Pradesh, Arunachal Pradesh, Manipur, Meghalaya, Sikkim, Tripura, Andaman and Nicobar
Islands, and Daman and Diu have no functional CCUs in the district hospitals. Tamil Nadu, Himachal
Pradesh, Kerala, West Bengal, Punjab, Maharasthra, Andhra Pradesh, Goa, and UTs with the exception
of Andaman and Nicobar Islands and Daman and Diu have made satisfactory progress by establishing
at least one CCU for every two districts. From Base Year to Reference Years, there was a singificant
improvement in Tamil Nadu, Maharashtra, Haryana, Odisha, Goa, Chandigarh, Dadra and Nagar Haveli,
and Puducherry whereas a significant decline in Rajasthan and Karnataka was noted.
Indicator 3.1.5 - Proportion of ANC registered within first trimester against total registrations
The ANC registration in the first trimester is a critical indicator depicting the effectiveness of a health
service delivery system to enrol pregnant women in early pregnancy, this being necessary for maternal
and foetal well-being. Among the 21 Larger States, 13 have more than 70 percent of ANCs registered in
the first trimester (Figure 4.57). Jharkhand, Telangana, and Uttar Pradesh need to improve performance
in this regard. Almost all States except Uttar Pradesh, Telangana, Uttarakhand, and Madhya Pradesh have
shown incremental progress in the registration of ANCs in the first trimester.
0
100
200
300
400
500
600
50.0
100.0
Daman & Diu
133.3
66.7
Dadra &
Nagar Haveli
0.0
0.0
Chandigarh
0.0
0.0
Lakshadweep
0.0
0.0
Puducherry
0.6
0.0
Delhi
500.0
0.0
Andaman &
Nicobar Islands
Functional 24x7 PHCs as against
required number (%)
Base Year (2015-16) Reference Year (2017-18)
216.7
366.7
180.0
203.3
165.0
150.0
116.2
121.6
136.4
118.2
65.5
44.8 42.9
35.7
6.7
0.0
0
50
100
150
200
250
300
350
400
Manipur
Goa
Tripura
Meghalaya
Nagaland
Sikkim
Arunachal
Pradesh
Mizoram
Functional 24x7 PHCs as against
required number (%)
Base Year (2015-16)Reference Year (2017-18) Healthy S tates, Progressive India62
Figure 4.55  Indicator 3.1.4 - Cardiac Care Units in districts - Larger States
Source: State Report
Functional CCUs per district*100
Base Year (2015-16)Reference Year (2017-18)
56.3
90.6
91.7
83.3
64.3
78.6
76.9 76.9
63.6 63.6
22.9
58.3
53.853.8
48.5 48.5
19.1
38.1
3.3
33.3
27.3
31.8
70.6
24.2
43.3
20.0
0.0
15.4
9.89.8
0.0
5.3
3.7 3.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
10
20
30
40
50
60
70
80
90
100
Tamil Nadu
Himachal Pradesh
Kerala
West Bengal
Punjab
Maharashtr a
Andhra Prades h
Gujarat
Haryana
Odisha
Jammu & Kashmir
Rajastha n
Karnataka
Uttarakhan d
Madhya Prades h
Bihar
Chhattisgarh
Uttar Pradesh
Assa m
Jharkhan d
Telangana
Figure 4.56  Indicator 3.1.4 - Cardiac Care Units in districts - Smaller States and UTs
Smaller StatesUnion Territories
Source: State Report
Among the Smaller States, Sikkim and Mizoram have achieved more than 75 percent first trimester
registration and the remaining States need to put in special effort to increase first trimester registrations
(Figure 4.58). From Base Year to Reference Year, some incremental progress was noted in Mizoram and
Meghalaya, whereas slight decrease was observed for the rest of other States. Among UTs, Dadra and
Nagar Haveli, Daman and Diu, Lakshadweep, and Andaman and Nicobar Islands, have achieved satisfactory
performance levels (ranging between 75 to 96 percent). Incremental progress was also observed except
for Andaman and Nicobar Islands, Puducherry and Delhi.
Functional CCU per district *100
Base Year (2015-16)Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
Functional CCU per district *100
Chandigarh
Dadra &
Nagar Haveli
Andaman &
Nicobar Islands
Lakshadweep
Daman & Diu
0.0
200.0
0.0
100.0
100.0
100.0
90.9
72.7
25.0
50.0
0.0
0.0
0.0
0.0
0
50
100
150
200
250
Arunachal
Pradesh
Manipur
Meghalaya
Mizoram
Nagaland
Goa
Tripura
Sikkim
0.0
11.1
9.1
50.0
11.1
9.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
10
20
30
40
50
60
Puducherry
Delh i
Results and F indings 63
Figure 4.57  Indicator 3.1.5 - Proportion of ANC registered within first trimester against total registrations - Larger States
Source: HMIS
94.4
94.1
74.6
89.5
81.4
85.1
80.6
84.8
75.7
83.6
80.6
83.2
71.2
79.1
74.4
78.7
74.9
78.4
77.0
77.0 73.0
75.2
66.8
71.5 62.2
71.5
52.9
64.8
63.8
62.8 60.7
62.8
55.5
61.7
62.5
61.0
36.4
51.6
55.9
47.3
48.7
45.2
0
10
20
30
40
50
60
70
80
90
100
Tamil Nadu
Chhattisgarh
Himachal Pradesh
Assam
Odisha
Kerala
Karnataka
Andhra Prades h
Gujarat
West Bengal
Punjab
Maharashtr a
Haryan a
Jammu & Kashmir
Madhya Pradesh
Rajasthan
Biha r
Uttarakhand
Jharkhand
Telangana
Uttar Pradesh
ANC registered within 1st trimester against total
registrations (%)
Base Year (2015-16)Reference Year (2017-18)
Smaller StatesUnion Territories
Source: HMIS
Figure 4.58  Indicator 3.1.5 - Proportion of ANC registered within first trimester against total registrations -
Smaller States and UTs
ANC registered within 1st trimester
against total registrations (%)
Base Year (2015-16) Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
84.8
95.9
49.3
80.8
73.2
79.7
76.9
75.1
36.8
66.3
39.5
33.6 33.7
33.2
0
20
40
60
80
100
Dadra &
Nagar Haveli
Daman & Diu
Lakshadweep
Andaman &
Nicobar Islands
Chandigarh
Puducherry
Delhi
79.9
73.6
63.2
61.9
58.7
37.0
32.1
35.8
77.0
75.4
61.1
60.9
55.3
34.7
34.4
29.7
0
10
20
30
40
50
60
70
80
90
Sikkim
Mizoram
Manipur
Tripura
Goa
Arunachal
Pradesh
Meghalaya
Nagaland
ANC registered within 1st trimester
against total registrations (%) Healthy S tates, Progressive India64
Indicator 3.1.6 - Level of registration of births
Registration of birth not only provides the child with an official identification document, but also allows
for area-specific estimation of birth rates. The level of registration is defined as the proportion of births
registered under the Civil Registration System (CRS) against the estimated number of births during a
specific year. Several States including Uttarakhand, Tamil Nadu, Rajasthan, Punjab, Karnataka, Chhattisgarh,
Assam, Haryana, Nagaland, Mizoram, Meghalaya, Manipur, Arunachal Pradesh, Puducherry, Delhi and
Chandigarh have achieved universal, that is 100 percent registration of births (Figure 4.59 and 4.60). The
other States and UTs need to make considerable progress in this regard especially the following States
with less than 80 percent registration: Jammu and Kashmir, Madhya Pradesh, Uttar Pradesh, Bihar, Sikkim,
Andaman and Nicobar Islands, Lakshadweep and Daman and Diu. From Base Year to Reference Year,
slight declines in birth registration were observed in Bihar, Uttar Pradesh, Madhya Pradesh, Himachal
Pradesh, Maharashtra, Andhra Pradesh, Kerala, Odisha, Sikkim, Goa, Lakshadweep, and Daman and Diu.
Indicator 3.1.7 - Completeness of Integrated Disease Surveillance Programme (IDSP) reporting
of P and L form
Timely collection of surveillance data is a critical component of disease control and prevention programs.
This indicator is the percentage of Reporting Units (RU) submitting data in the stipulated time for P and L
forms.
Among States and UTs, Andhra Pradesh, Telangana, Assam, Kerala, Karnataka, West Bengal, Odisha, Sikkim,
Mizoram, Tripura, Meghalaya, Puducherry, Daman and Diu, Dadra and Nagar Haveli, and Chandigarh had
at least 90 percent of the reporting units submitting P forms in a timely manner. In contrast, Uttar Pradesh,
Jharkhand, Manipur, and Nagaland had relatively poor performance in this regard. From Base Year to
Reference Year, there has been a decline of 10 percentage points in reporting in Gujarat and Tamil Nadu. All
Smaller States and UTs showed significant increase except for Tripura and Nagaland (Figure 4.61 and 4.62).
Figure 4.59  Indicator 3.1.6 - Level of registration of births - Larger States
Source: CRS
Level of registration of births (%)
Base Year (2014) Reference Year (2016)
100.0 100.0 100.0 100.0
86.0
100.0 100.0 100.0
98.2
100.0 100.0 100.0
97.8
100.0 100.0 99.9
95.0
98.8
92.5
97.9 98.5 97.5
95.6
97.3
100.0
97.1
100.0
95.7
100.0
94.0
82.0
90.2
93.1
89.2
75.5
77.6
82.6
74.6
68.3
60.7
64.2
60.7
0
20
40
60
80
100
Assam
Tamil Nadu
Uttarakhand
Punjab
Rajasthan
Chhattisgarh
Karnataka
Haryan a
Gujarat
West Bengal
Odisha
Telangana
Kerala
Andhra Pradesh
Maharashtr a
Jharkhand
Himachal Pradesh
Jammu & Kashmir
Madhya Pradesh
Uttar Pradesh
Bihar
Results and F indings 65
Smaller StatesUnion Territories
Source: CRS
Figure 4.60 
Indicator 3.1.6 - Level of registration of births - Smaller States and UTs
Source: Central IDSP, MoHFW
Base Year (2015)R eference Year (2017)
99100
88
93
97
93
95
92
96
92
78
91
83
90
66
88
79
88
93
88
84
87
95
85
88
84 8483
8080
73
80
73
76
90
76
80
75
7373
42
69
0
10
20
30
40
50
60
70
80
90
100
Andhra Prades h
Assam
Telangana
Karnataka
Kerala
West Bengal
Odisha
Himachal Pradesh
Maharashtr a
Uttarakhand
Chhattisgarh
Gujarat
Bihar
Haryan a
Jammu & Kashmir
Rajasthan
Punjab
Tamil Nadu
Madhya Pradesh
Jharkhand
Uttar Pradesh
Completeness of IDSP reporting of P form (%)
Figure 4.61  Indicator 3.1.7 - Completeness of Integrated Disease Surveillance Programme reporting of P form -
Larger States
Level of registration of births (%)
Base Year (2014)Reference Year (2016)Base Year (2014) Reference Year (2016)
Level of registration of births (%)
100.0
100.0
100.0
100.0
100.0
100.0
65.1
86.2
71.9
75.6
59.5
54.5
76.4
49.9
0
20
40
60
80
100
Chandigarh
Puducherry
Delhi
Dadra &
Nagar Haveli
Andaman &
Nicobar Islands
Lakshadweep
Daman & Diu
100.0
100.0
100.0
100.0
100.0
81.7
74.1
100.0
100.0
100.0
100.0
100.0
100.0
84.4
82.4
66.2
0
20
40
60
80
100
Arunachal
Pradesh
Manipur
Meghalaya
Mizoram
Nagaland
Goa
Tripura
Sikkim
The status of L form reporting is similar to the P form reporting. Thus, Chhattisgarh, Jammu and Kashmir,
Jharkhand, Madhya Pradesh, Rajasthan, Tamil Nadu, Uttar Pradesh, Arunachal Pradesh, Nagaland, Manipur,
and Lakshadweep (0 percent), which have less than 80 percent timely reporting, need to make concerted
efforts to raise the reporting in L form (Figure 4.63 and 4.64). Healthy S tates, Progressive India66
Smaller StatesUnion Territories
Source: Central IDSP, MoHFW
Figure 4.62  Indicator 3.1.7: Completeness of Integrated Disease Surveillance Programme reporting of P form -
Smaller States and UTs
Source: Central IDSP, MoHFW
Completeness of IDSP reporting of L form (%)
Base Year (2015)R eference Year (2017)
99100
9595 9695
88
95 94
90
96
89
85
88
93
88 8887
80
87
62
86
76
84
87
84
74
82 82
79
68
78
7576
87
75
80
75
72
74
57
67
0
20
40
60
80
100
Andhra Prades h
Telangana
Kerala
Assam
Karnataka
Gujarat
Punjab
Uttarakhand
Haryan a
West Bengal
Himachal Pradesh
Maharashtr a
Bihar
Odisha
Chhattisgarh
Rajasthan
Jammu & Kashmir
Tamil Nadu
Madhya Pradesh
Jharkhand
Uttar Pradesh
Figure 4.63  Indicator 3.1.7 - Completeness of Integrated Disease Surveillance Programme reporting of L form -
Larger States
Completeness of IDSP reporting
of P form (%)
Base Year (2015) Reference Year (2017)Base Year (2015) Reference Year (2017)
Completeness of IDSP reporting
of P form (%)
0
20
40
60
80
100
91
100
Dadra &
Nagar Haveli
75
100
Daman & Diu
90
100
Puducherry
78
94
Chandigarh
50
82
Andaman &
Nicobar Islands
57
78
Delhi
0.0
0.0
Lakshadweep
97
100
48
96 97
93
84
91
82 82
79 80
63
77
79
71
0
20
40
60
80
100
Sikkim
Mizoram
Tripura
Meghalaya
Arunachal Pradesh
Goa
Manipur
Nagaland
Results and F indings 67
Smaller StatesUnion Territories
Source: Central IDSP, MoHFW
Figure 4.64  Indicator 3.1.7: Completeness of Integrated Disease Surveillance Programme reporting of L form -
Smaller States and UTs
Indicator 3.1.8 - Proportion of CHCs with grading 4 points or above
CHCs are graded under the MoHFW’s grading system using the data on service utilization, client orientation,
service availability, drugs and supplies, human resources and infrastructure. This indicator represents the
proportion of CHCs that receive a score of four points or higher (out of 5 points) among the total number
of CHCs in that State.
Figure 4.65  Indicator 3.1.8 - Proportion of CHCs with grading of 4 points or above - Larger States
Source: HMIS
CHCs with grading 4 points or above (%)
Base Year (2015-16) Reference Year (2017-18)
37.2
87.4
53.7
74.4
57.2
67.6
47.7
67.1
31.1
62.4
76.1
62.1 61.9 62.1
38.5
59.3
54.5
56.3
54.4 55.3
31.3
50.2
44.1
48.2
22.8
46.4
22.0
41.5
26.7
38.4
11.6
36.6
49.4
29.8
20.3
19.0
8.3
11.8
5.1
2.6
0.40.4
0
10
20
30
40
50
60
70
80
90
100
Andhra Prades h
West Bengal
Madhya Pradesh
Chhattisgarh
Assam
Tamil Nadu
Jammu & Kashmir
Maharashtr a
Rajasthan
Jharkhand
Karnataka
Uttar Pradesh
Odisha
Haryan a
Punjab
Telangana
Gujarat
Bihar
Uttarakhand
Himachal Pradesh
Kerala
Completeness of IDSP reporting
of L form (%)
Base Year (2015) Reference Year (2017)Base Year (2015) Reference Year (2017)
Completeness of IDSP reporting
of L form (%)
0
20
40
60
80
100
75
100
Daman & Diu
88
100
Puducherry
88
93
Chandigarh
89
92
Dadra &
Nagar Haveli
21
82
Andaman &
Nicobar Islands
56
81
Delhi
0
0
Lakshadweep
58
96
100
95
82
89
94
86
88
82
77
74
6565
38
60
0
20
40
60
80
100
Mizoram
Sikkim
Meghalaya
Tripura
Goa
Arunachal
Pradesh
Nagaland
Manipur Healthy S tates, Progressive India68
Smaller StatesUnion Territories
Figure 4.66  Indicator 3.1.8 - Proportion of CHCs with grading of 4 points or above – Smaller States and UTs
Source: HMIS
Among the Larger States, only Andhra Pradesh and West Bengal have more than 70 percent of CHCs with
a grade of four or above (Figure 4.65). Most States need to improve on this indicator, particularly the States
of Kerala, Himachal Pradesh, Uttarakhand and Bihar, which had less than 20 percent of CHCs receiving
a score of 4 or above. From Base Year to Reference Year, many States made substantial improvements.
Andhra Pradesh, West Bengal, Chhattisgarh, Assam, Maharashtra, Karnataka, Odisha and Telangana had
reported increases of around 20 percentage points or more, whereas Tamil Nadu and Gujarat reported
decline by 14 and 20 percentage points respectively.
Among the Smaller States and UTs, Mizoram, Nagaland, Sikkim, Tripura, Andaman and Nicobar Islands,
Daman and Diu, and Lakshadweep did not have any CHC with a grading of 4 or above (Figure 4.66).
Indicator 3.1.9 - Proportion of public health facilities with accreditation certificates by a
standard quality assurance programme (NQAS/NABH/ISO/AHPI)
To ensure a high quality of health services, the Government of India encourages public health facilities
across States to apply for quality assurance programs such as the National Quality Assurance Standards
(NQAS), National Accreditation Board for Hospitals and Healthcare Providers (NABH), International
Organization for Standardization (ISO), and Association of Healthcare Providers (India) (AHPI).
The performance of health facilities is assessed against pre-determined standards. Among the Larger
States, Assam, Chhattisgarh, Jammu and Kashmir, Jharkhand, Telangana, Uttarakhand, and West Bengal
had not yet initiated any accreditation of hospitals. In 2017-18, most Larger States had less than 15 percent
of their district hospitals accredited, with the exception of Gujarat (31.0 percent), and Odisha (15.3 percent).
Among the Smaller States, Goa, Nagaland, and Sikkim, none of their hospitals accredited, whereas
Mizoram, Meghalaya, and Tripura had less than 10 percent of district/sub-district hospitals accredited.
Among the UTs, Dadra and Nagar Haveli had 50 percent district/sub-district hospitals accredited, and
Delhi achieved 7 percent. All other UTs had not initiated the accreditation process.
The accreditation of CHCs and PHCs is yet to be taken up by any of the UTs.
0
20
40
60
80
100
120
Base Year (2015-16)Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
100.0
100.0
CHCs with grading 4 points or above (%)
CHCs with grading 4 points or above (%)
0.0
0.0
0.0
0.0
25.0
25.0
Chandigarh
Lakshadweep
Andaman &
Nicobar Islands
Puducherry
Dadra & Nagar Haveli
Delhi
Daman & Diu
75.0
29.4
7.4
0.0
100.0
23.5
10.3
0.0
3.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
20
40
60
80
100
120
Goa
Manipur
Meghalaya
Arunachal
Pradesh
Mizoram
Nagaland
Sikkim
Tripura
0.0
50.0
NA
100.0
0.0
4.0
Results and F indings 69
Indicator 3.1.10 - Average number of days for transfer of Central National Health Mission
(NHM) fund from State Treasury to implementation agency (Department/Society) based on all
tranches of the last fiscal year
To ensure that vertical public health programs are efficiently implemented at the ground-level, funds
should be transferred in a timely manner to implementing agencies. The average number of days taken
to transfer Central NHM fund from the State treasury to departments or societies varied from transfer
on the same day in Telangana to more than eight months in Jharkhand and Bihar (Figure 4.67). Huge
variations were observed across States and UTs. From 2015-16 to 2017-18, on average, the number of
days for transfer of funds in fact increased in most Larger States expect for Telangana, Odisha, Assam,
Madhya Pradesh, Tamil Nadu, Andhra Pradesh, and Karnataka. Among Smaller States and UTs, there
was a significant reduction of days in the transfer of funds except for Meghalaya, Puducherry, and
Delhi (Figure 4.68).
Source: Central NHM Finance Data
Average number of days for transfer of NHM funds from
State treasury to implementing agency
Base Year (2015-16)Reference Year (2017-18)
287
0
59
19
242
28
41
37
50
46 47
58
4242
58 57
61
51
64
24
68
127
93
66
95
139
105 107107
48
109
27
109
93
118
107
137
78
148
67
187
40
191
0
50
100
150
200
250
300
Telangana
Odisha
Assam
Madhya Pradesh
Tamil Nadu
Himachal Pradesh
Haryan a
Chhattisgarh
West Benga l
Gujarat
Andhra Pradesh
Maharashtr a
Karnataka
Kerala
Rajasthan
Uttarakhand
Uttar Pradesh
Jammu & Kashmir
Punjab
Jharkhand
Bihar
Figure 4.67  Indicator 3.1.10 - Average number of days for transfer of Central NHM fund from State Treasury to
implementation agency based on all tranches of the last fiscal year - Larger States Healthy S tates, Progressive India70
Source: Central NHM Finance Data
Figure 4.68  Indicator 3.1.10 - Average number of days for transfer of Central NHM fund from State Treasury to
implementation agency based on all tranches of the last fiscal year - Smaller States and UTs
Smaller StatesUnion Territories
55
85
89
123
0
0
0
0
62
0
35
0
78
0
Base Year (2015-16) Reference Year (2017-18)Base Year (2015-16)Reference Year (2017-18)
0
20
40
60
80
100
120
140
Andaman &
Nicobar Islands
Chandigarh
Dadra &
Nagar Havel i
Daman & Diu
Lakshadweep
Puducherr y
Delhi
Average number of days for transfer of
NHM funds from State treasury to
implementing agency
69
38 38
58
177
61
213
94
143
108
258
119
153
133
154 151
0
50
100
150
200
250
300
Tripura
Meghalaya
Mizoram
Nagaland
Arunachal
Pradesh
Manipur
Sikkim
Goa
Average number of days for transfer of
NHM funds from State treasury to
implementing agency Way
Forward Healthy S tates, Progressive India72
Way Forward
5. INSTITUTIONALIZATION - TAKING THE INDEX AHEAD
Last year, the composite Health Index 2017 was disseminated for the first time as an attempt to promote
co-operative and competitive spirit among the States and UTs and to rapidly bring about transformative
action in achieving the desired health outcomes. The Health Index-2018 is the second such attempt
focusing on measuring and highlighting incremental improvements by the States and UTs over a two year
period. The MoHFW had underlined the importance of such an exercise to link the Index with budget
incentives to States and UTs under the NHM. The Index is also a tool for States and UTs to identify problem
areas and focus their interventions in these areas.
During the process of development of the Health Index, rich learnings have emerged which will guide
the refining of the Index in future. It is envisaged that a thorough review of indicators will be undertaken
to include new thrust areas and data sources. The current methodology will also be reviewed further.
The exercise calls for urgent improvement of the data system in health in terms of their timely availability,
accuracy and relevance. The quality of HMIS and program-specific MIS data needs to be improved in
terms of consistency between Central and State data, coverage of private sector data, data scrutiny,
thrust area indicators and data definitions. The MIS also needs strengthening to provide appropriate
denominators. For example, the HMIS captures the number of anaemic women but does not provide data
on the appropriate denominator (i.e. total number of women tested for anaemia). Furthermore, the SRS
needs to generate data in a timely manner and should explore the possibility of generating the data on
key health outcomes including NMR, U5MR, TFR, MMR and SRB for all States and UTs. Data sources at
the State-level on key areas such as human resources and finances need to be strengthened in terms of
availability and its quality. Thus, in the successive rounds, continuous improvement of both the methods
and the data will be undertaken to refine the Index further. Annexures Healthy S tates, Progressive India74
Annexures
Annexure 1. D ata Validation Process
The overall objective of the validation exercise was to ensure reliability of data and subsequent rankings
for the Health Index-2018. The exercise was carried out from September to December 2018. The major
activities undertaken by the IVA can be grouped into three phases namely – (1) Designing the validation
process; (2) Roll-out of validation, and; (3) Generation of composite Index scores and ranks. A brief
description of activities undertaken for each phase is described as follows:
1. Designing the validation process
Orientation workshop: NITI Aayog arranged a workshop to orient the IVA about the scope of work,
reference guidelines and strategies to be followed for reviewing data during the validation exercise. The
orientation workshop also introduced the IVA to the pool of “mentors” who would facilitate the discussion
between States/UTs and the IVA.
Review of validation documents: The IVA undertook a desk review of relevant documents which included
study of the previous Health Outcomes Index 2017, reference guide for validation, report by the IVA
for Health Outcomes Index 2017, the NITI Aayog portal for Health Outcomes Index etc. Parallel to the
desk review, the IVA also consulted team members at NITI Aayog, World Bank and mentors on indicator
definitions, methods used previously for validating data and ways to ensure reliability of data. An inception
report encapsulating the proposed validation approach along with timelines was shared by the IVA with
NITI Aayog.
Pre-testing of the validation process: The IVA developed process maps and checklists for collecting,
reviewing and validating data for the States. Before initiating the validation process, the IVA facilitated
by NITI Aayog, World Bank and mentors undertook a pre-testing exercise to understand strengths and
limitations of the process. The pre-testing exercise was conducted in the States of Haryana, Chandigarh
and Punjab. Learnings from the pre-test were incorporated to augment the IVA process.
2. Roll-out of the validation exercise
Collection of relevant evidence from States/UT s: The IVA adopted a comprehensive consultative
approach to review, validate and finalize data received from States/UTs. Evidences were collected from
States/UTs through e-mails as well as primary data collection. Assistance of mentors was sought to procure
evidences for some States/UTs. The IVA maintained a constant line of communication with the State/UT
nodal officers through phone, e-mails or face-to-face interactions. Field visits to collect information were
undertaken for the States/UTs of – Haryana, Punjab, Chandigarh, Puducherry and Uttarakhand. In addition,
Annexures 75
a workshop was held at Regional Resource Centre (RRC), Guwahati to validate data for all North-Eastern
States and Sikkim. Weekly reviews were held at NITI Aayog to update the progress of the validation
exercise and State/UT specific concerns.
Review of the evidences received: The evidence shared by States/UTs were reviewed by IVA using the
worksheet-based validation proforma, and shared with NITI Aayog and World Bank team before finalization.
Review process included checks on items such as – Completeness – whether all necessary evidence has
been received; Quality – whether evidence is in line with the reference guide; Consistency – whether
evidence matches the data previously entered by States/UTs in NITI portal, and Reliability – whether States/
UTs have valid reasons explaining sharp changes in data values from Base Year to Reference Year.
The IVA undertook the review of the evidence shared by States/UTs and flagged inconsistencies with
respective State nodal officers. After receiving clarifications, the IVA compiled the revised data using
worksheet-based validation proformas. After this, the compiled data was presented at NITI Aayog to identify
data trends and flag sharp changes (increase/decrease) in the data points from Base Year to Reference
Year, if any. Similarly, centrally pre-filled indicators were examined, and anomalies were highlighted to
the respective nodal officers through NITI Aayog. Lastly, the IVA conducted video conferencing with all
States/UTs, facilitated by NITI Aayog, to gather clarification on sharp changes in data from Base to the
Reference Years. After receiving satisfactory responses, finalized data was shared with States/UTs for their
acceptance in a time-bound manner. Multiple rounds of review and consultations were undertaken by the
IVA, with States/UTs for finalization of data and generation of ranks.
3. Generation of Index scores and ranks
Based on the finalized data set, the IVA undertook the process of rank generation for each category of
States/UTs. As a sample, the rank generation formulas and worksheets consistent with the previous year’s
methodology were shared with the IVA by NITI Aayog. The process of Index generation involved the use of
pre-decided weights, and measured States/UTs on incremental progress made from the Base Year to the
Reference Year. The ranks along with the consolidated data sets underwent several internal and external
checks before finalization. The finalized data and Index scores were subsequently used for generation of
the Health Index-2018 report. The IVA also shared a separate report on the validation exercise and the
progress made by the States/UTs in each indicator value along with their final ranks.
• Video-conferencing with
States/UTs to procure
clarifications
• Finalization of data after
receiving satisfactory
response from States/UTs
First
review
Second
review
Finalization
• IVA reviews for
completeness, quality,
consistency and reliability
• Flagging data gaps and
issues with States/UTs Healthy S tates, Progressive India76
The following flowchart depicts the process followed by the IVA to collect, review and validate the data
received from States/UTs.
Snapshot of the Validation Process
IVA initiates communication with State Nodal
officers requesting evidence(s)
Complete evidences received
Email submission + Primary visits
Review of data (Completeness,
Quality, Consistency, Reliability)
No discrepancy
Data shared with NITI Aayog and
WB for review (Data presentations and
sharing of worksheets)
Data consistent
Inconsistency(s) observed
(Sharp changes from base
to reference years)
Video conferencing with States/UTs
requesting clarifications
Clarifications not received
or not satisfactory
(State/UT unable to explain
discrepancy
Clarifications received and satisfactory
Data finalized
(States/UTs requested for
agreement in a time-bound manner)
Ranks generated
Incomplete evidences received
Discrepancy(s) observed
(Incomplete data, Inconsistent
with portal entry or validation
guidelines etc.)
Annexures 77
Annexure 2. S napshot: S tate-wise Performance on
Indicators
Section 4 of the report on ‘Unveiling Performance’, provides insights about the overall, incremental and
domain-specific performance. This Annexure presents a quick snapshot of State-wise performance on
all indicators included in the Index. This can help the States to easily identify specific areas requiring
attention through a horizontal comparison. The tables present data for Base Year (BY) and Reference
Year (RY) of each indicator for all States. The direction as well as the magnitude of incremental
change in the value of indicators from the Base Year to Reference Year is depicted by categorization
(‘Most Improved’, ‘Improved’, ‘No Change’, ‘Deteriorated’, ‘Most Deteriorated’, ‘Not Applicable’) and
is visually identifiable by respective color coding (dark green, light green, yellow, orange and red
respectively) as follows:
1. Incremental change in performance for an indicator is calculated by subtracting Base Year value
from Reference Year value. For indicators, such as NMR, U5MR, and vacancies, a negative change
from Base to Reference Year denotes improvement, while a positive change denotes deterioration.
In the case of Indicators such as those that reflect service coverage, a positive change denotes
improvement, while a negative change denotes deterioration. The range of improvement is
calculated by subtracting the minimum value of change from the maximum value of change. This
range is then divided into two equal parts and for indicators such as service coverage the half
towards maximum value of change is termed as 'Most Improved' (dark green) and the half towards
the minimum value of change is termed as 'Improved' (light green).
2. Similarly, the range of deterioration is calculated by subtracting the minimum value of change
from the maximum value of change. This range is then divided into two equal parts and the
half towards maximum value of change is termed as 'Deteriorated' (orange) and the other half
towards minimum value of change is termed as 'Most Deteriorated' (red) respectively. The yellow
color denotes that the indicator value is stagnant and there has been no incremental change from
Base to Reference Year.
3. The grey color indicates ‘Not Applicable’ (NA) category. For a State and UT, the incremental
performance on an indicator is classified as NA in instances such as: (a) If State has achieved
TFR <= 2.1 in both Base and Reference Year; (b) Data Integrity Measure indicator wherein the
same data has been used for Base and Reference Year due to non-availability of updated NFHS
data; (c) Service coverage indicators with 100 percent values in both Base and Reference Year;
(d) The data value for a particular indicator is NA in Base or Reference Year or both. Healthy S tates, Progressive India78
Table A.4.1. Larger States: Health Outcomes domain indicators, Base and Reference Years
State
1.1.1. NMR
(per 1,000 live
births)
1.1.2. U5MR
(per 1,000 live
births)
1.1.3. TFR* 1.1.4. LBW
(percentage)
1.1.5. Sex Ratio
at Birth
(no. of girls
born for every
1,000 boys
born)
BY RY BY RY BY RY BY RY BY RY
Andhra Pradesh 24 23 39 37 1.7 1.7 6.735.58 918 913
Assam25 23 62 52 2.3 2.3 16.6814.41900 896
Bihar28 27 48 43 3.2 3.3 7.229.23 916 908
Chhattisgarh 27 26 48 49 2.5 2.5 12.1510.05961 963
Gujarat23 21 39 33 2.2 2.2 10.5112.33854 848
Haryana24 22 43 37 2.2 2.3 14.908.47 831 832
Himachal Pradesh 19 16 33 27 1.7 1.712.6312.59924 917
Jammu & K ashmir 20 18 28 26 1.6 1.7 5.93 5.48 899 906
Jharkhand 23 21 39 33 2.7 2.6 7.42 7.12902 918
Karnataka 19 18 31 29 1.8 1.8 11.4910.01939 935
Kerala6 6 13 11 1.8 1.8 11.7211.42967 959
Madhya Pradesh 34 32 62 55 2.8 2.8 14.1014.30919 922
Maharashtra 15 13 24 21 1.8 1.8 13.7412.06878 876
Odisha35 32 56 50 2.0 2.0 19.1618.25950 948
Punjab13 13 27 24 1.7 1.7 6.88 8.41 889 893
Rajasthan 30 28 50 45 2.7 2.7 25.5114.01861 857
Tamil Nadu14 12 20 19 1.6 1.613.0315.49 911 915
Telangana 23 21 34 34 1.8 1.7 5.70 7.14 918 901
Uttar Pradesh 31 30 51 47 3.1 3.1 9.60 11.18879 882
Uttarakhand 28 30 38 41 2.0 1.9 7.268.23 844 850
West Bengal 18 17 30 27 1.6 1.616.4516.45951 937
* The data shown in grey color is for ‘Not Applicable’ category wherein the States with TFR <= 2.1 (replacement level fertility) in both
Base and Reference Years are not considered for incremental change.
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable
Annexures 79
Table A.4.1. (Continued) - Larger States: Health Outcomes domain indicators, Base and Reference Years
State
1.2.1. Full
immunization
(percentage)
1.2.2.
Institutional
delivery
(percentage)
1.2.3. TB case
notification rate
(per 1,00,000
population)
1.2.4. TB
treatment
success rate
(percentage)
1.2.5. PLHIV
on ART**
(percentage)
BY RY BY RY BY RY BY RY BY/RY
Andhra Pradesh 91.62100.0087.0885.90 145 16188.5089.00 76.11
Assam88.0083.3474.2572.04 123 11986.2077.50 64.58
Bihar89.7389.74 57.1056.01 84 82 89.7071.90 37.18
Chhattisgarh 90.5386.9364.5175.82 138 145 89.1088.60 53.06
Gujarat 90.5592.00 97.7891.58 193 224 88.9088.10 52.43
Haryana 83.4788.8680.2584.19 172 145 87.5078.90 51.53
Himachal Pradesh95.22 79.3767.4967.64 207 226 89.6089.00 79.89
Jammu & K ashmir100.00100.0080.5185.49 72 74 88.3085.00 96.41
Jharkhand 88.10100.0067.3688.15 108 11890.9091.70 39.40
Karnataka 96.2494.0778.7879.60 105 123 84.7079.70 88.68
Kerala 94.61100.0092.6290.90 139 67 87.5083.70 66.72
Madhya Pradesh 74.7877.9764.7962.27 164 167 90.3082.50 61.01
Maharashtra 98.2295.7085.3089.78 164 159 84.2079.50 87.71
Odisha 85.32 59.8173.4970.90 99 159 88.9072.50 32.95
Punjab 99.6492.7382.3382.24 136 153 87.2085.90 84.62
Rajasthan 78.06 81.5973.8574.83 143 139 90.3089.90 46.41
Tamil Nadu82.66 76.1081.8280.50 125 11985.4075.90 87.06
Telangana 89.09 90.3185.3591.68 123 107 89.6090.40 76.11
Uttar Pradesh 84.8284.6852.3850.56 137 140 87.5064.00 57.81
Uttarakhand 99.3094.9662.6367.02 138 15186.0077.60 65.25
West Bengal 95.8595.85 81.2881.28 93 100 86.5085.70 35.92
** Data repeated for Reference Year due to change in indicator definition necessitated by change in program guidelines.
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable Healthy S tates, Progressive India80
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable
Table A.4.2. Larger States: Governance and Information domain indicators, Base and Reference Years
State
2.1.1.a. Data
integrity:
institutional
delivery
(percentage)+
2.1.1.b Data
integrity: First
trimester ANC
registration
(percentage)+
2.2.1. Average
occupancy: S tate-
level 3 key posts
(in months)
2.2.2. Average
occupancy: CMOs
(in months)
BY/RY BY/RY BY RY BY RY
Andhra Pradesh 23.53 15.42 17.51 23.99 13.22 9.25
Assam0.25 21.16 12.11 21.99 7.95 13.76
Bihar18.21 16.33 13.01 18.98 11.88 13.25
Chhattisgarh22.34 25.90 11.40 8.97 25.40 18.07
Gujarat0.68 2.06 20.71 22.21 18.09 18.98
Haryana4.62 19.08 11.21 7.35 12.56 13.20
Himachal Pradesh 12.72 7.30 12.39 15.65 10.50 18.33
Jammu & K ashmir 12.42 13.50 13.81 8.98 11.77 13.32
Jharkhand7.95 53.48 12.00 10.77 11.46 10.01
Karnataka21.22 8.20 6.49 6.69 13.23 15.69
Kerala3.71 24.86 12.02 11.72 11.72 13.14
Madhya Pradesh23.09 9.19 16.00 19.98 17.62 14.73
Maharashtra1.16 5.61 15.74 9.98 15.64 17.37
Odisha13.82 22.09 12.01 15.86 13.95 13.48
Punjab12.41 9.97 20.42 14.36 10.19 8.41
Rajasthan12.44 18.43 22.02 23.98 11.94 17.32
Tamil Nadu10.92 22.75 16.51 26.39 7.29 7.74
Telangana21.06 15.80 7.81 15.98 11.19 16.48
Uttar Pradesh36.59 0.92 19.64 9.67 14.15 10.53
Uttarakhand14.93 10.77 10.35 10.99 13.93 10.06
West Bengal2.12 42.44 28.02 28.02 14.10 14.10
+ Same data have been used for Base and Reference Years due to non-availability of updated NFHS data.
Annexures 81
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable
Table A.4.3. Larger States: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.1.a. Vacancy:
ANMs at SCs
(percentage)
3.1.1.b. Vacancy:
SNs at PHCs
and CHCs
(percentage)
3.1.1.c. Vacancy:
MOs at PHCs
(percentage)
3.1.1.d. Vacancy:
Specialists at
DHs
(percentage)
3.1.2. E-pay slip
(percentage)
BY RY BY RY BY RY BY RY BY RY
Andhra Pradesh 15.6717.0820.4812.7512.7610.5730.4125.0558.65100.00
Assam8.99 4.608.95 11.8117.7725.4641.7246.990.00 0.00
Bihar59.3059.4550.2850.7463.6034.0860.5859.720.00 0.00
Chhattisgarh 9.23 9.4737.2841.2645.0257.2577.6870.830.00 12.04
Gujarat28.0810.3236.4623.6732.0330.2355.5021.0035.6139.54
Haryana 15.2315.2543.2435.3925.3522.360.0021.080.0099.98
Himachal Pradesh 9.8722.5827.1947.5221.7332.06 NA NA 8.07100.00
Jammu & K ashmir 10.289.4427.4817.9330.1528.8022.2225.400.00 0.00
Jharkhand 19.7319.1874.9454.2348.6746.3350.3247.180.00 0.00
Karnataka 22.5933.3925.9721.7311.484.6121.5337.6649.3544.96
Kerala4.495.305.30 3.625.86 2.4121.4813.50100.00100.00
Madhya Pradesh 14.2313.8433.5042.2258.3455.0850.9849.130.00 0.00
Maharashtra 9.46 9.7515.6715.3316.9622.7930.3447.2567.6086.29
Odisha0.000.000.000.0026.9131.8719.0427.3875.7976.38
Punjab8.4811.9933.9812.917.7717.6647.7218.410.00 0.00
Rajasthan 19.2424.2247.2650.4614.8612.1545.7722.400.0069.38
Tamil Nadu15.979.7819.0918.827.5815.0616.7315.7884.7284.38
Telangana 18.0114.6412.797.2222.3114.9954.8153.530.0033.03
Uttar Pradesh 0.000.00 1.890.0026.734.7832.4128.660.0054.58
Uttarakhand 16.8816.8820.0216.3212.1969.6560.3368.000.00 0.00
West Bengal 0.770.779.709.7041.2341.2320.1820.1881.2381.23 Healthy S tates, Progressive India82
Table A.4.3. (Continued) - Larger States: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.3.a.
Functional
FRUs
(percentage)
3.1.3.b.
Functional 24/7
PHC
(percentage)
3.1.4. Functional
CCUs per
district *100
(percentage)
3.1.5. Proportion
of first
trimester ANC
registration
(percentage)
3.1.6. L evel
of birth
registration
(percentage)
BY RY BY RY BY RY BY RY BY RY
Andhra Pradesh 57.5889.9029.1522.6753.8553.8574.3878.68100.0095.70
Assam72.5890.32176.9283.010.00 0.0080.5584.76100.00100.00
Bihar11.5415.3873.5853.790.00 5.2655.4761.7564.2060.70
Chhattisgarh 23.5327.4540.39111.373.70 3.7074.6089.49100.00100.00
Gujarat 42.9863.6431.4656.2948.4848.4874.9178.4095.0098.80
Haryana 50.9852.9477.5667.3219.0538.1062.2071.46100.0099.90
Himachal Pradesh121.43107.145.80 5.8091.6783.3381.3985.1493.1089.20
Jammu & K ashmir196.00220.0045.6038.4027.2731.8252.9564.8375.5077.60
Jharkhand 22.7330.3033.0329.390.00 0.0036.3651.6582.0090.20
Karnataka 116.39121.3169.2362.6843.3320.0071.2279.0997.80100.00
Kerala 120.90107.460.00 0.0064.2978.5780.6383.22100.0097.10
Madhya Pradesh 49.6651.0356.4768.329.80 9.8063.7962.7882.6074.60
Maharashtra 32.4463.1446.7135.1422.8658.3366.8271.50100.0094.00
Odisha 65.4869.0530.0026.433.3333.3375.7583.6498.5097.50
Punjab 141.82130.9126.3527.0863.6463.6473.0175.17100.00100.00
Rajasthan 29.2032.8568.0343.5070.5924.2460.6662.7798.20100.00
Tamil Nadu122.92134.0334.9524.1356.2590.6294.3594.11100.00100.00
Telangana 80.00114.2926.9925.570.00 0.0055.9047.2795.6097.30
Uttar Pradesh 15.7525.7517.4220.420.00 0.0048.7245.2168.3060.70
Uttarakhand 95.0065.0054.4650.500.0015.3862.4760.9686.00100.00
West Bengal 49.1849.185.91 5.9176.9276.9277.0077.0092.5097.90
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable
Annexures 83
Table A.4.3. (Continued) - Larger States: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.7. IDSP
reporting of
P form
(percentage)
3.1.7. IDSP
reporting
L form
(percentage)
3.1.8. CHC
grading
(percentage)
3.1.9. Quality
accreditation
DH-SDH
(percentage)
3.1.9. Quality
accreditation
CHC-PHC
(percentage)
3.1.10. Fund
transfer (no.
of days)
BY RY BY RY BY RY BY RY BY RY BY RY
Andhra Pradesh 99 100 99 10037.2487.370.0012.820.000.51127 93
Assam88 93 88 9531.1362.420.000.000.000.00242 28
Bihar88 84 87 8420.3419.0527.160.001.520.0040 191
Chhattisgarh 84 87 82 7947.7467.070.000.000.000.0057 61
Gujarat95 85 96 8949.4029.782.9931.030.608.2624 68
Haryana 84 83 88 8722.0241.540.009.300.007.5642 58
Himachal Pradesh 66 88 62 865.062.601.370.000.000.0047 58
Jammu & K ashmir 80 80 75 7661.9062.070.000.000.000.00107137
Jharkhand 73 73 72 7454.4055.310.000.000.000.0067 187
Karnataka 95 92 94 9031.2750.240.531.600.000.00139105
Kerala96 92 96 950.440.4310.007.596.524.64107107
Madhya Pradesh 80 75 80 7557.1967.590.002.560.570.5841 37
Maharashtra 79 88 76 8438.5259.300.000.000.270.2866 95
Odisha83 90 74 8222.8146.4215.2515.250.000.0059 19
Punjab73 76 85 8826.6738.360.007.940.000.0078 148
Rajasthan 73 80 68 7854.4856.300.001.820.000.0048 109
Tamil Nadu90 76 87 7576.1062.084.292.264.941.5650 46
Telangana 97 93 95 9511.6336.590.000.000.000.00287 0
Uttar Pradesh 42 69 57 6744.1348.210.007.500.000.0093 118
Uttarakhand 93 88 93 888.3311.760.000.000.000.0027 109
West Bengal 78 91 80 8753.7474.430.000.000.000.0051 64
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable Healthy S tates, Progressive India84
Table A.4.4. Smaller States: Health Outcomes domain indicators, Base and Reference Years
State
1.1.4. LBW
(percentage)
1.2.1. Full
immunization
(percentage)
1.2.2.
Institutional
delivery
(percentage)
1.2.3. TB case
notification
rate
(per 1,00,000
population)
1.2.4. TB
treatment
success rate
(percentage)
1.2.5. PLHIV
on ART**
(percentage)
BY RY BY RY BY RY BY RY BY RY BY/RY
Arunachal Pradesh6.556.4164.9565.5056.4663.0018320386.4064.80 28.19
Goa15.5615.5695.2497.0592.4686.6013112887.3085.40 72.75
Manipur3.534.4596.3299.9973.4779.7381 9482.6079.50 63.87
Meghalaya 7.657.7093.3477.6162.1162.6513711685.8079.70 100.00
Mizoram4.654.72100.0090.7696.2995.1018618690.6073.50 100.00
Nagaland 3.894.0963.8658.2358.0754.3013914871.9067.60 73.80
Sikkim7.767.6374.4470.0470.1966.3324119777.2066.20 33.51
Tripura 11.1113.5584.3386.1379.3688.4161 4488.5070.90 5.80
** Data repeated for Reference Year due to change in indicator definition necessitated by change in program guidelines.
Table A.4.5.
Smaller States: Governance and Information domain indicators, Base and Reference Years
State
2.1.1.a. Data
integrity:
institutional
delivery
(percentage)+
2.1.1.b Data
integrity: First
trimester ANC
registration
(percentage)+
2.2.1. Average
occupancy: S tate-level 3
key post (in months)
2.2.2. Average
occupancy: CMOs
(in months)
BY/RY BY/RY BY RY BY RY
Arunachal Pradesh 1.365.62 13.87 11.35 17.50 18.21
Goa5.0123.74 21.69 13.99 12.00 11.98
Manipur2.8728.19 21.02 11.98 17.31 25.92
Meghalaya13.44 10.56 19.25 9.97 14.76 22.67
Mizoram22.0018.71 9.77 13.91 25.98 25.98
Nagaland54.79 107.87 7.25 5.81 19.94 23.44
Sikkim29.16 26.76 24.02 23.99 25.52 25.49
Tripura3.3510.89 10.87 11.85 17.26 24.90
+ Same data have been used for Base and Reference Years due to non-availability of updated NFHS data.
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable
Annexures 85
Table A.4.6. Smaller States: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.1.a. Vacancy:
ANMs at SCs
(percentage)
3.1.1.b. Vacancy:
SNs at PHCs
and CHCs
(percentage)
3.1.1.c. Vacancy:
MOs at PHCs
(percentage)
3.1.1.d. Vacancy:
Specialists at
DHs
(percentage)
3.1.2. E-payslip
(percentage)
BY RY BY RY BY RY BY RY BY RY
Arunachal Pradesh22.3713.5128.7815.6338.7530.2389.1169.9638.7521.49
Goa30.1020.0011.6828.5714.2220.1939.7036.740.00 0.00
Manipur 29.8927.2718.9820.1242.7643.0647.6745.100.00 0.00
Meghalaya 20.0010.7131.0512.5635.6730.9029.7341.550.00 0.00
Mizoram16.0720.23 6.11 7.1238.102.3815.2215.580.00 0.00
Nagaland 11.010.00 0.00 0.0027.360.00 0.00 0.00 0.00 0.00
Sikkim0.00 0.0061.9630.430.00 0.0034.3831.250.00 0.00
Tripura 38.9024.630.00 0.00 2.06 0.00 NA 1.410.00100.00
Table A.4.6. (Continued) - Smaller States: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.3.a.
Functional FRUs
(percentage)
3.1.3.b.
Functional
24/7 PHC
(percentage)
3.1.4.
Functional
CCUs per
district *100
(percentage)
3.1.5.
Proportion
of first
trimester ANC
(percentage)
3.1.6. L evel
of birth
registration
(percentage)
BY RY BY RY BY RY BY RY BY RY
Arunachal Pradesh133.33200.0042.8635.710.000.0036.9934.73100.00100.00
Goa100.00100.006.67 0.000.0050.0058.7455.33100.0084.40
Manipur66.6766.6765.5244.830.000.0063.2361.14100.00100.00
Meghalaya 100.0066.67180.00203.330.000.0032.0734.38100.00100.00
Mizoram100.00200.00136.36118.1811.1111.1173.6175.36100.00100.00
Nagaland 125.00100.00165.00150.009.099.0935.8329.73100.00100.00
Sikkim200.00200.00216.67366.670.000.0079.8976.9774.1066.20
Tripura57.1485.71116.22121.620.000.0061.8560.9281.7082.40
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable Healthy S tates, Progressive India86
Table A.4.6. (Continued) - Smaller States: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.7. IDSP
reporting of
P form
(percentage)3.1.7. IDSP
reporting
L form
(percentage)
3.1.8. CHC
grading
(percentage)
3.1.9. Quality
accreditation
DH-SDH
(percentage
3.1.9. Quality
accreditation
CHC-PHC
(percentage)
3.1.10. Fund
transfer (no.
of days)
BY RY BY RY BY RY BY RY BY RY BY
RY
Arunachal Pradesh 82 82 77 74 0.00 3.235.000.000.000.00 143 108
Goa79 80 88 82 75.00100.000.000.000.000.00 154 151
Manipur63 77 38 60 29.4123.5312.500.000.000.00258 119
Meghalaya 84 91 82 89 7.4110.340.009.090.000.00 38 58
Mizoram48 96 58 96 0.00 0.00 0.0010.000.000.00 177 61
Nagaland79 71 65 65 0.00 0.00 0.000.000.000.00 213 94
Sikkim97 100100 95 0.00 0.00 0.000.000.000.00 153 133
Tripura97 93 94 86 0.00 0.00 0.005.560.000.00 69 38
Table A.4.7 .
Union Territories: Health Outcomes domain indicators, Base and Reference Years
State
1.1.4. LBW
(percentage)
1.2.1. Full
immunization
(percentage)
1.2.2.
Institutional
delivery
(percentage)
1.2.3. TB case
notification rate
(per 1,00,000
population)
1.2.4. TB
treatment
success rate
(percentage)
BY RY BY RY BY RY BY RY BY RY
Andaman & Nicobar
Islands
17.1716.63100.0077.2280.2075.71139 76 91.5083.90
Chandigarh 20.7720.8993.5883.40100.00100.00305 523 85.6086.80
Dadra & Nagar
Haveli
29.3936.8877.0679.1287.0987.21133 225 86.3089.60
Daman & Diu 24.3720.6879.6752.8372.0047.37166 15179.5092.60
Delhi21.4319.6096.2199.8280.6082.84348 360 86.7084.80
Lakshadweep 5.56 7.44100.0077.0885.4065.00 35 70 91.3093.80
Puducherry 15.5014.6177.6069.50100.00100.00103 11489.2088.80
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable
Annexures 87
Table A.4.8. Union Territories: Governance and Information domain indicators, Base and Reference Years
State 2.1.1.a. Data
integrity:
institutional
delivery
(percentage)+
2.1.1.b Data
integrity: First
trimester ANC
registration
(percentage)+
2.2.1. Average
occupancy: S tate-level
3 key posts
(in months)
2.2.2. Average
occupancy: CMOs
(in months)
BY/RY BY/RY BY RY BY RY
Andaman & Nicobar
Islands
18.05 2.84 15.01 14.35 17.43 13.29
Chandigarh57.98 27.88 12.01 17.96 15.55 8.95
Dadra & Nagar
Haveli
15.11 22.12 14.41 18.98 18.01 36.00
Daman & Diu17.43 15.27 21.02 10.78 36.03 17.98
Delhi10.76 27.77 9.63 6.98 16.72 25.02
Lakshadweep29.35 12.19 26.79 13.98 NA NA
Puducherry90.52 48.82 19.98 24.69 25.32 22.48
+ Same data have been used for Base and Reference Years due to non-availability of updated NFHS data.
Table A.4.9.
Union Territories: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.1.a. Vacancy:
ANMs at SCs
(percentage)
3.1.1.b.
Vacancy: SN
at PHCs and
CHCs
(percentage)
3.1.1.c. Vacancy:
MOs at PHCs
(percentage)
3.1.1.d.
Vacancy:
Specialists
at DHs
(percentage)
3.1.2. E-payslip
(percentage)
BY RY BY RY BY RY BY RY BY RY
Andaman & Nicobar
Islands
7.84 9.80 7.454.3536.3610.61100.0071.430.00 0.00
Chandigarh 29.4114.716.190.0069.170.00 0.0011.3661.33100.00
Dadra & Nagar
Haveli
0.00 0.934.88 2.1316.6716.6718.1812.500.00 0.00
Daman & Diu 11.860.000.008.89 7.1428.5747.0656.410.00 0.00
Delhi19.758.9140.7546.9414.2126.2940.2140.8168.8155.77
Lakshadweep 0.00 0.000.000.000.00 0.0076.4746.150.00 0.00
Puducherry 8.73 11.722.384.6212.7816.1420.5635.1178.3590.20
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable Healthy S tates, Progressive India88
Table A.4.9. (Continued) - Union Territories: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.3.a.
Functional
FRUs
(percentage)
3.1.3.b.
Functional
24/7 PHC
(percentage)
3.1.4. Functional
CCUs per
district *100
(percentage)
3.1.5.
Proportion
of first
trimester ANC
(percentage)
3.1.6. L evel
of birth
registration
(percentage)
BY RY BY RY BY RY BY RY BY RY
Andaman &
Nicobar Islands
0.00 0.00500.000.00 0.00 0.0076.9475.1171.9075.60
Chandigarh 150.00250.000.00 0.00 0.00200.0036.7966.34100.00100.00
Dadra & Nagar
Haveli
100.00100.00133.3366.670.00100.0084.7795.9065.1086.20
Daman & Diu 100.00200.0050.00100.000.00 0.0049.2680.7976.4049.90
Delhi 100.0082.350.60 0.0090.9172.7333.6933.18100.00100.00
Lakshadweep 100.00100.000.00 0.00100.00100.0073.2479.7259.5054.50
Puducherry 200.00400.000.00 0.0025.0050.0039.5433.58100.00100.00
Table A.4.9 (Continued) - Union Territories: Key Inputs/Processes domain indicators, Base and Reference Years
State
3.1.7. IDSP
reporting of
P form
(percentage)
3.1.7. IDSP
reporting
L form
(percentage)
3.1.8. CHC
grading
(percentage)
3.1.9. Quality
accreditation
DH-SDH
(percentage)
3.1.9. Quality
accreditation
CHC-PHC
(percentage)
3.1.10. Fund
transfer
(no. of days)
BY RY BY RY BY RY BY RY BY RY BY RY
Andaman &
Nicobar Islands
50 82 21 82 0.0050.000.000.000.000.0078 0
Chandigarh 78 94 88 93100.00100.000.000.000.000.0035 0
Dadra & Nagar
Haveli
91 100 89 92 NA100.000.0050.000.000.0062 0
Daman & Diu 75 100 75 1000.000.000.000.000.000.00 0 0
Delhi57 78 56 810.004.008.937.020.000.0089 123
Lakshadweep 0 0 0 0 0.000.000.000.000.000.00 0 0.00
Puducherry 90 100 88 10025.0025.000.000.000.000.0055 85
Most Improved Improved No Change Deteriorated Most Deteriorated Not Applicable
Annexures 89
Annexure 3. S tate F actsheets
This annexure provides a detailed snapshot of State-wise performance in the Reference Year and the
incremental performance from Base Year to Reference Year on all indicators in the Index, relative to the
performance of other States and UTs. This is to help the States to better interpret their performance on
specific indicators.
The first part of a State factsheet captures Health Index scores for that State/UT. Overall Health Index
scores in the Reference Year and incremental changes in scores from Base Year to Reference Year are
calculated and classified into different performance categories. Using the overall Health Index scores
in the Reference Year, States and UTs were categorized into three categories: (1) ‘Front-runners’ (top
one-third); (2) ‘Achievers’ (middle one-third); and (3) Aspirants (lowest one-third). Using the incremental
Health Index scores from Base Year to Reference Year, States and UTs were categorized into four
categories: (1) ‘Not Improved’ (incremental Index score <=0); (2) ‘Least Improved’ (incremental Index score
between 0.01 and 2.00); (3) ‘Moderately Improved’ (incremental Index score between 2.01 and 4); and
(4) ‘Most Improved’ (incremental Index score >4.00).
The second part of the State factsheet captures the State’s performance on each specific indicator that
were used to compute the Health Index. For each indicator, the overall indicator performance was used to
classify States and UTs into three categories: (1) ‘Front-runners’ (top one-third); (2) ‘Achievers’ (middle one-
third); and (3) Aspirants (lowest one-third). These classifications were done separately for Larger States,
Smaller States and UTs. The two classification cutoff points for each indicator within each class of entities
were calculated as min + (max-min)/3 and min + (max-min)*2/3. The only exception was for total fertility
rate (TFR) where external cutoff points were used to align with policy objectives: ‘Front runner’ (TFR <=2.1);
‘Achievers’ (TFR between 2.1 and 2.6); and ‘Aspirants’ (TFR >2.6). A fourth category was added for ‘Not
Applicable’ (or N//A) for the missing data.
Using the incremental indicator values, States and UTs were categorized into five categories of
incremental performance: (1) ‘No Change, (2) ‘Improved’, (3) ‘Most Improved’, (4) ‘Deteriorated’, and
(5) ‘Most Deteriorated’. A sixth category was added as ‘Not Applicable (or N/A)’ where data were not
available or when a State had reached the best possible scenario for an indicator and had no room for
further improvement.
West Bengal did not submit data on the portal, the overall and incremental performance scores were
generated based on pre-filled indicator data for 12 indicators and for the remaining 11 indicators, the data
from the Base Year was repeated for the Reference Year. Healthy S tates, Progressive India90
*Overall PerformanceThe Larger States are categorized based on Reference Year Index score range: Front-
runners: top one-third (Index score>58.88), Achievers: middle one-third (Index score
between 43.74 and 58.88), Aspirants: lowest one-third (Index score<43.74).
The Smaller States are categorized based on Reference Year Index score range:
Front-runners: top one-third (Index score>62.83), Achievers: mid one-third (Index
score between 50.66 and 62.83), Aspirants: lowest one-third (Index score<50.66).
The UTs are categorized based on Reference Year Index score range: Front-runners:
top one-third (Index score>56.30), Achievers: mid one-third (Index score between
48.98 and 56.30), Aspirants: lowest one-third (Index score<48.98).
**Incremental
Performance
The States are categorized based on incremental Index score range: ‘Not Improved’
(incremental Index score<=0), ‘Least Improved’ (incremental Index score between
0.01 and 2.00), ‘Moderately Improved’ (incremental Index score between 2.01 and
4.00), ‘Most Improved’ (incremental Index score >4.00).
# Overall Indicator
Performance
The States performance on a specific indicator in the Reference Year is categorized
into 3 categories based on Reference Year range of indicator value - Front-runners:
top one-third, Achievers: middle one-third, Aspirants: lowest one-third.
Overall Indicator
Performance
Front-runners Achievers Aspirants
## Incremental
Indicator Performance
The States incremental performance on a specific indicator is categorized into 6
categories based on incremental change from Base Year (2015-16) to Reference Year
(2017-18)- ‘No Change, ‘Improved’, ‘Most Improved’, ’Deteriorated’, ‘Most Deteriorated’,
and “Not Applicable” (Details in Annexure 2).
Incremental
Indicator
Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Explanation to Factsheet legend and remarks
Annexures 91
HEALTHY STATES, PROGRESSIVE INDIA
ANDHRA PRADESH - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)65.13 2Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 4.97 4 Most Improved**
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)23-1
1.1.2 Under five Mortality Rate (SRS)37-2
1.1.3 Total Fertility Rate (SRS)1.700.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)5.58-1.15
1.1.5 Sex ratio at Birth (SRS)913-5
1.2.1 Full immunization coverage (HMIS)100.00 8.38
1.2.2 Proportion of institutional deliveries (HMIS)85.90-1.18
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)16116.00
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
89.000.50
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
76.11 N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
23.53N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
15.42N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
23.996.48
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
9.25-3.97
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 17.081.41
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs
(State Report)
12.75 -7.73
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)10.57 -2.19
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)25.05 -5.36
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
100.00 41.35
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
89.90 32.32
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
22.67 -6.48
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 53.850.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 78.684.30
3.1.6 Level of birth registration (CRS)95.70 -4.30
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 1001
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 1001
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)87.37 50.13
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)12.82 12.82
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.510.51
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
93-34
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable Healthy S tates, Progressive India92
HEALTHY STATES, PROGRESSIVE INDIA
ASSAM - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)48.85 15Achiever*
Incremental Performance (From 2015-16 to 2017-18) 4.72 5 Most Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)23-2
1.1.2 Under five Mortality Rate (SRS)52-10
1.1.3 Total Fertility Rate (SRS)2.30
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)14.41 -2.27
1.1.5 Sex ratio at Birth (SRS)896-4
1.2.1 Full immunization coverage (HMIS)83.34-4.66
1.2.2 Proportion of institutional deliveries (HMIS)72.04-2.21
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)119-4
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
77.50-8.70
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
64.58N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
0.25N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
21.16N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
21.999.88
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
13.765.81
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 4.60-4.39
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)11.81 2.86
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)25.467.69
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)46.995.27
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
90.3217.74
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
83.01 -93.91
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 84.764.21
3.1.6 Level of birth registration (CRS)100.00 0.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 935
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 957
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)62.4231.29
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
28-214
Annexures 93
HEALTHY STATES, PROGRESSIVE INDIA
BIHAR - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)32.11 20Aspirant*
Incremental Performance (From 2015-16 to 2017-18) -6.35 21 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)27-1
1.1.2 Under five Mortality Rate (SRS)43-5
1.1.3 Total Fertility Rate (SRS)3.30.1
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)9.232.01
1.1.5 Sex Ratio at Birth (SRS)908-8
1.2.1 Full immunization coverage (HMIS)89.740.01
1.2.2 Proportion of institutional deliveries (HMIS)56.01 -1.09
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)82-2
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
71.90 -17.80
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
37.18 N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
18.21 N/A
2.1.1.b Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
16.33N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
18.98 5.97
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
13.251.37
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 59.450.15
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)50.74 0.46
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)34.08 -29.52
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)59.72 -0.86
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
15.38 3.84
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
53.79 -19.79
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 5.265.26
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 61.75 6.28
3.1.6 Level of birth registration (CRS)60.70 -3.50
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 84-4
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 84-3
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)19.05 -1.29
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.00-27.16
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.00-1.52
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
191151 Healthy S tates, Progressive India94
HEALTHY STATES, PROGRESSIVE INDIA
CHHATTISGARH - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)53.36 13Achiever*
Incremental Performance (From 2015-16 to 2017-18) 1.34 11 Least Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)26-1
1.1.2 Under five Mortality Rate (SRS)491
1.1.3 Total Fertility Rate (SRS)2.50
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)10.05-2.10
1.1.5 Sex Ratio at Birth (SRS)9632
1.2.1 Full immunization coverage (HMIS)86.93-3.60
1.2.2 Proportion of institutional deliveries (HMIS)75.8211.31
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)1457
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
88.60-0.50
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
53.06N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
22.34N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
25.90N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
8.97-2.43
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
18.07-7.33
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 9.470.24
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State
Report)
41.263.98
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)57.2512.23
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)70.83-6.85
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
12.04 12.04
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
27.453.92
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
111.37 70.98
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 3.700.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 89.4914.89
3.1.6 Level of birth registration (CRS)100.00 0.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 873
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 79-3
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)67.0719.33
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
614
Annexures 95
HEALTHY STATES, PROGRESSIVE INDIA
GUJARAT - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)63.52 4Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 1.53 10 Least Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)21-2
1.1.2 Under five Mortality Rate (SRS)33-6
1.1.3 Total Fertility Rate (SRS)2.20
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)12.331.82
1.1.5 Sex ratio at Birth (SRS)848-6
1.2.1 Full immunization coverage (HMIS)92.001.45
1.2.2 Proportion of institutional deliveries (HMIS)91.58 -6.20
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)22431
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
88.10 -0.80
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
52.43N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
0.68N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
2.06N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
22.211.50
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
18.980.89
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 10.32 -17.76
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs
(State Report)
23.67 -12.79
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)30.23-1.80
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)21.00 -34.50
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
39.543.93
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
63.64 20.66
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
56.29 24.83
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 48.480.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 78.403.49
3.1.6 Level of birth registration (CRS)98.803.80
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 85-10
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 89-7
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)29.78 -19.62
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)31.03 28.04
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)8.267.66
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
6844 Healthy S tates, Progressive India96
HEALTHY STATES, PROGRESSIVE INDIA
HARYANA - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)53.51 12Achiever*
Incremental Performance (From 2015-16 to 2017-18) 6.55 1 Most Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)22-2
1.1.2 Under five Mortality Rate (SRS)37-6
1.1.3 Total Fertility Rate (SRS)2.30.1
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)8.47-6.43
1.1.5 Sex ratio at Birth (SRS)8321
1.2.1 Full immunization coverage (HMIS)88.865.39
1.2.2 Proportion of institutional deliveries (HMIS)84.19 3.94
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)145-27
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
78.90 -8.60
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
51.53N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
4.62N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
19.08N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
7.35-3.86
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
13.200.64
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 15.25 0.02
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)35.39 -7.85
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)22.36 -2.99
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)21.08 21.08
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
99.98 99.98
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
52.941.96
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
67.32 -10.24
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 38.10 19.05
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 71.46 9.26
3.1.6 Level of birth registration (CRS)99.90-0.10
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 83-1
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 87-1
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)41.54 19.52
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)9.309.30
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)7.567.56
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
58
16
Annexures 97
HEALTHY STATES, PROGRESSIVE INDIA
HIMACHAL PRADESH - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)62.41 6Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 1.21 12 Least Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)16-3
1.1.2 Under five Mortality Rate (SRS)27-6
1.1.3 Total Fertility Rate (SRS)1.70.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)12.59 -0.04
1.1.5 Sex ratio at Birth (SRS)917-7
1.2.1 Full immunization coverage (HMIS)79.37 -15.85
1.2.2 Proportion of institutional deliveries (HMIS)67.640.15
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)22619
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
89.00-0.60
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
79.89N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
12.72N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
7.30N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
15.653.26
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
18.337.83
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 22.5812.71
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs
(State Report)
47.52 20.33
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)32.0610.33
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)N/AN/A
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
100.00 91.93
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
107.14 -14.29
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
5.800.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 83.33-8.34
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 85.143.75
3.1.6 Level of birth registration (CRS)89.20-3.90
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 8822
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 8624
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)2.60-2.46
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.00-1.37
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
5811 Healthy S tates, Progressive India98
HEALTHY STATES, PROGRESSIVE INDIA
JAMMU & KASHMIR - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)62.37 7Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 2.02 9 Moderately Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)18-2
1.1.2 Under five Mortality Rate (SRS)26-2
1.1.3 Total Fertility Rate (SRS)1.70.1
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)5.48-0.45
1.1.5 Sex ratio at Birth (SRS)9067
1.2.1 Full immunization coverage (HMIS)100.00 0.00
1.2.2 Proportion of institutional deliveries (HMIS)85.494.98
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)742
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
85.00-3.30
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
96.41N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
12.42N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
13.50N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
8.98-4.83
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
13.321.55
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 9.44-0.84
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs
(State Report)
17.93 -9.55
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)28.80-1.35
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)25.43.18
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
220.00 24.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
38.40-7.20
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 31.824.55
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 64.8311.88
3.1.6 Level of birth registration (CRS)77.602.10
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 800
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 761
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)62.070.17
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
13730
Annexures 99
HEALTHY STATES, PROGRESSIVE INDIA
JHARKHAND - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)51.33 14Achiever*
Incremental Performance (From 2015-16 to 2017-18) 5.99 3 Most Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)21-2
1.1.2 Under five Mortality Rate (SRS)33-6
1.1.3 Total Fertility Rate (SRS)2.6-0.1
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)7.12-0.30
1.1.5 Sex ratio at Birth (SRS)91816
1.2.1 Full immunization coverage (HMIS)100.00 11.90
1.2.2 Proportion of institutional deliveries (HMIS)88.15 20.79
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)11810
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
91.700.80
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
39.40N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
7.95N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
53.48N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
10.77-1.23
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
10.01-1.45
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 19.18 -0.55
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)54.23 -20.71
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)46.33-2.34
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)47.18-3.14
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
30.307.57
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
29.39-3.64
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 51.65 15.29
3.1.6 Level of birth registration (CRS)90.208.20
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 730
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 742
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)55.310.91
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
187
120 Healthy S tates, Progressive India100
HEALTHY STATES, PROGRESSIVE INDIA
KARNATAKA - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)61.14 8Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 2.44 8 Moderately Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)18-1
1.1.2 Under five Mortality Rate (SRS)29-2
1.1.3 Total Fertility Rate (SRS)1.80.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)10.01 -1.48
1.1.5 Sex ratio at Birth (SRS)935-4
1.2.1 Full immunization coverage (HMIS)94.07-2.17
1.2.2 Proportion of institutional deliveries (HMIS)79.600.82
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)12318
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
79.70 -5.00
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
88.68N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
21.22N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
8.20N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
6.690.20
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
15.692.46
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 33.39 10.80
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)21.73 -4.24
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)4.61-6.87
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)37.6616.13
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
44.96 -4.39
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
121.31 4.92
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
62.68 -6.55
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 20.00 -23.33
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 79.097.87
3.1.6 Level of birth registration (CRS)100.00 2.20
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 92-3
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 90-4
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)50.24 18.97
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)1.601.07
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
105-34
Annexures 101
HEALTHY STATES, PROGRESSIVE INDIA
KERALA - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)74.01 1Front-runner*
Incremental Performance (From 2015-16 to 2017-18) -2.55 16 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)60
1.1.2 Under five Mortality Rate (SRS)11-2
1.1.3 Total Fertility Rate (SRS)1.80.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)11.42 -0.30
1.1.5 Sex ratio at Birth (SRS)959.00-8
1.2.1 Full immunization coverage (HMIS)100.00 5.39
1.2.2 Proportion of institutional deliveries (HMIS)90.90-1.72
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)67.00-72
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
83.70 -3.80
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
66.72N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
3.71N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
24.86N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
11.72 -0.30
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
13.14 1.42
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 5.300.81
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)3.62-1.68
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)2.41-3.45
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)13.50 -7.98
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
100.00 0.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
107.46 -13.44
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
0.000.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 78.57 14.28
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 83.222.59
3.1.6 Level of birth registration (CRS)97.10 -2.90
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 92-4
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 95-1
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)0.43-0.01
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)7.59-2.41
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)4.64-1.88
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
1070 Healthy S tates, Progressive India102
HEALTHY STATES, PROGRESSIVE INDIA
MADHYA PRADESH - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)38.39 18Aspirant*
Incremental Performance (From 2015-16 to 2017-18) -1.70 14 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)32-2
1.1.2 Under five Mortality Rate (SRS)55-7
1.1.3 Total Fertility Rate (SRS)2.80
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)14.30 0.20
1.1.5 Sex ratio at Birth (SRS)9223
1.2.1 Full immunization coverage (HMIS)77.973.19
1.2.2 Proportion of institutional deliveries (HMIS)62.27 -2.52
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)1673
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
82.50-7.80
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
61.01N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
23.09N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
9.19N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
19.98 3.98
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
14.73 -2.89
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 13.84 -0.39
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)42.228.72
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)55.08 -3.26
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)49.13 -1.85
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
51.031.37
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
68.3211.85
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 9.800.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 62.78-1.01
3.1.6 Level of birth registration (CRS)74.60 -8.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 75-5
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 75-5
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)67.59 10.40
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)2.562.56
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.580.01
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
37-4
Annexures 103
HEALTHY STATES, PROGRESSIVE INDIA
MAHARASHTRA - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)63.99 3Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 2.92 7 Moderately Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)13-2
1.1.2 Under five Mortality Rate (SRS)21-3
1.1.3 Total Fertility Rate (SRS)1.80.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)12.06 -1.68
1.1.5 Sex ratio at Birth (SRS)876-2
1.2.1 Full immunization coverage (HMIS)95.70 -2.52
1.2.2 Proportion of institutional deliveries (HMIS)89.78 4.48
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)159-5
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
79.50 -4.70
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
87.71 N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
1.16N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
5.61N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
9.98-5.76
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
17.37 1.73
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 9.750.29
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)15.33 -0.34
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)22.79 5.83
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)47.25 16.91
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
86.29 18.69
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
63.14 30.70
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
35.14 -11.57
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 58.33 35.47
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 71.50 4.68
3.1.6 Level of birth registration (CRS)94.00 -6.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 889
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 848
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)59.30 20.78
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.280.01
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
9529 Healthy S tates, Progressive India104
HEALTHY STATES, PROGRESSIVE INDIA
ODISHA - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)35.97 19Aspirant*
Incremental Performance (From 2015-16 to 2017-18) -3.46 18 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)32-3
1.1.2 Under five Mortality Rate (SRS)50-6
1.1.3 Total Fertility Rate (SRS)2.00.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)18.25 -0.91
1.1.5 Sex ratio at Birth (SRS)948-2
1.2.1 Full immunization coverage (HMIS)59.81 -25.51
1.2.2 Proportion of institutional deliveries (HMIS)70.90 -2.59
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)15960
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
72.50 -16.40
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
32.95N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
13.82N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
22.09N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
15.86 3.85
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
13.48 -0.47
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 0.000.00
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)0.000.00
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)31.87 4.96
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)27.38 8.34
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System (State
Report)
76.38 0.59
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
69.053.57
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
26.43 -3.57
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 33.33 30.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 83.647.89
3.1.6 Level of birth registration (CRS)97.50 -1.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 907
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 828
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)46.42 23.61
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)15.25 0.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
19-40
Annexures 105
HEALTHY STATES, PROGRESSIVE INDIA
PUNJAB - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)63.01 5Front-runner*
Incremental Performance (From 2015-16 to 2017-18) -2.20 15 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)130
1.1.2 Under five Mortality Rate (SRS)24-3
1.1.3 Total Fertility Rate (SRS)1.70.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)8.411.53
1.1.5 Sex ratio at Birth (SRS)8934
1.2.1 Full immunization coverage (HMIS)92.73 -6.91
1.2.2 Proportion of institutional deliveries (HMIS)82.24 -0.09
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)15317
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
85.90-1.30
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
84.62N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
12.41 N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
9.97N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
14.36 -6.06
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
8.41-1.78
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 11.99 3.51
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)12.91 -21.07
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)17.66 9.89
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)18.41 -29.31
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
130.91 -10.91
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
27.080.73
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 63.640.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 75.17 2.16
3.1.6 Level of birth registration (CRS)100.00 0.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 763
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 883
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)38.36 11.69
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)7.947.94
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
14870 Healthy S tates, Progressive India106
HEALTHY STATES, PROGRESSIVE INDIA
RAJASTHAN - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)43.10 16Aspirant*
Incremental Performance (From 2015-16 to 2017-18) 6.30 2 Most Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)28-2
1.1.2 Under five Mortality Rate (SRS)45-5
1.1.3 Total Fertility Rate (SRS)2.70
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)14.01 -11.50
1.1.5 Sex ratio at Birth (SRS)857-4
1.2.1 Full immunization coverage (HMIS)81.59 3.53
1.2.2 Proportion of institutional deliveries (HMIS)74.83 0.98
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)139-4
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
89.90 -0.40
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
46.41N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
12.44N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
18.43N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
23.981.96
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
17.32 5.38
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 24.224.98
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)50.463.20
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)12.15 -2.71
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)22.4 -23.37
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
69.38 69.38
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
32.853.65
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
43.50 -24.53
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 24.24 -46.35
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 62.772.11
3.1.6 Level of birth registration (CRS)100.00 1.80
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 807
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 7810
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)56.301.82
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)1.821.82
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
10961
Annexures 107
HEALTHY STATES, PROGRESSIVE INDIA
TAMIL NADU - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)60.41 9Front-runner*
Incremental Performance (From 2015-16 to 2017-18) -2.97 17 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)12-2
1.1.2 Under five Mortality Rate (SRS)19-1
1.1.3 Total Fertility Rate (SRS)1.60.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)15.49 2.46
1.1.5 Sex ratio at Birth (SRS)9154
1.2.1 Full immunization coverage (HMIS)76.10 -6.56
1.2.2 Proportion of institutional deliveries (HMIS)80.50-1.32
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)119-6
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
75.90 -9.50
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
87.06N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
10.92N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
22.75N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
26.399.88
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
7.740.45
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 9.78-6.19
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)18.82 -0.27
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)15.067.48
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)15.78 -0.95
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
84.38 -0.34
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
134.03 11.11
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
24.13 -10.82
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 90.63 34.37
3.1.5 Proportion of ANCs registered within first trimester (HMIS)94.11 -0.24
3.1.6 Level of birth registration (CRS)100.00 0.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 76-14
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 75-12
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)62.08 -14.02
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)2.26-2.03
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)1.56-3.38
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
46-4 Healthy S tates, Progressive India108
HEALTHY STATES, PROGRESSIVE INDIA
TELANGANA - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)59.00 10 Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 3.61 6 Moderately Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)21-2
1.1.2 Under five Mortality Rate (SRS)340
1.1.3 Total Fertility Rate (SRS)1.7-0.1
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)7.141.44
1.1.5 Sex ratio at Birth (SRS)901-17
1.2.1 Full immunization coverage (HMIS)90.311.22
1.2.2 Proportion of institutional deliveries (HMIS)91.68 6.33
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)107-16
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
90.400.80
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
76.11 N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
21.06N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
15.80N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
15.988.17
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
16.48 5.29
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 14.64 -3.37
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)7.22-5.57
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)14.99 -7.32
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)53.53-1.28
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
33.03 33.03
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
114.29 34.29
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
25.57-1.42
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 47.27 -8.63
3.1.6 Level of birth registration (CRS)97.301.70
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 93-4
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 950
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)36.59 24.96
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
0-287
Annexures 109
HEALTHY STATES, PROGRESSIVE INDIA
UTTAR PRADESH - FACTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)28.61 21Aspirant*
Incremental Performance (From 2015-16 to 2017-18) -5.08 20 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)30-1
1.1.2 Under five Mortality Rate (SRS)47-4
1.1.3 Total Fertility Rate (SRS)3.10
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)11.18 1.58
1.1.5 Sex ratio at Birth (SRS)8823
1.2.1 Full immunization coverage (HMIS)84.68-0.14
1.2.2 Proportion of institutional deliveries (HMIS)50.56-1.82
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)1403
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
64.00 -23.50
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
57.81N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
36.59N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
0.92N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
9.67-9.97
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
10.53 -3.62
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 0.000.00
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)0.00-1.89
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)4.78 -21.95
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)28.66 -3.75
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
54.58 54.58
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
25.75 10.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
20.423.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 45.21 -3.51
3.1.6 Level of birth registration (CRS)60.70 -7.60
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 6927
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 6710
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)48.21 4.08
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)7.507.50
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
11825 Healthy S tates, Progressive India110
HEALTHY STATES, PROGRESSIVE INDIA
UTTARAKHAND - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)40.20 17Aspirant*
Incremental Performance (From 2015-16 to 2017-18) -5.02 19 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)302
1.1.2 Under five Mortality Rate (SRS)413
1.1.3 Total Fertility Rate (SRS)1.9-0.1
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)8.230.97
1.1.5 Sex ratio at Birth (SRS)8506
1.2.1 Full immunization coverage (HMIS)94.96 -4.34
1.2.2 Proportion of institutional deliveries (HMIS)67.024.39
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)15113
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
77.60 -8.40
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
65.25N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
14.93N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
10.77N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
10.990.64
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
10.06 -3.87
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 16.88 0.00
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)16.32 -3.70
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)69.65 57.46
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)68.007.67
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
65.00 -30.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
50.50 -3.96
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 15.38 15.38
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 60.96-1.51
3.1.6 Level of birth registration (CRS)100.00 14.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 88-5
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 88-5
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)11.76 3.43
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
10982
Annexures 111
HEALTHY STATES, PROGRESSIVE INDIA
WEST BENGAL - FA CTSHEET 2018
Category: 21 Larger StatesIndex Score Rank Performance Category
Overall Performance (2017-18)57.17 11Achiever*
Incremental Performance (From 2015-16 to 2017-18) -1.08 13 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)17-1
1.1.2 Under five Mortality Rate (SRS)27-3
1.1.3 Total Fertility Rate (SRS)1.60.0
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)16.45 0.00
1.1.5 Sex ratio at Birth (SRS)937-14
1.2.1 Full immunization coverage (HMIS)95.850.00
1.2.2 Proportion of institutional deliveries (HMIS)81.28 0.00
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)1007
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
85.70 -0.80
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
35.92N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
2.13N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
42.44N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
28.020.00
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
14.10 0.00
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 0.770.00
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)9.690.00
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)41.23 0.00
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)20.18 0.00
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
81.23 0.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
49.18 0.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
5.910.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 76.920.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 77.000.00
3.1.6 Level of birth registration (CRS)97.905.40
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 9113
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 877
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)74.43 20.69
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
6413 Healthy S tates, Progressive India112
HEALTHY STATES, PROGRESSIVE INDIA
ARUNACHAL PRADESH - FACTSHEET 2018
Category: 8 Smaller StatesIndex Score Rank Performance Category
Overall Performance (2017-18)46.07 7Aspirant*
Incremental Performance (From 2015-16 to 2017-18) -3.44 8 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)6.41-0.14
1.1.5 Sex ratio at Birth (SRS)N/AN/A
1.2.1 Full immunization coverage (HMIS)65.500.55
1.2.2 Proportion of institutional deliveries (HMIS)63.006.54
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)20320
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
64.80-21.6
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
28.19N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
1.36N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
5.62N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
11.35 -2.52
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
18.210.71
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 13.51 -8.86
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)15.63 -13.15
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)30.23 -8.52
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)69.96 -19.15
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
21.49 -17.26
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
200.00 66.67
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
35.71 -7.15
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 34.73 -2.26
3.1.6 Level of birth registration (CRS)100.00 N/A
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 820
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 74-3
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)3.233.23
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.00-5.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
108-35
Annexures 113
HEALTHY STATES, PROGRESSIVE INDIA
GOA - FA CTSHEET 2018
Category: 8 Smaller StatesIndex Score Rank Performance Category
Overall Performance (2017-18)51.90 4Achiever*
Incremental Performance (From 2015-16 to 2017-18) -1.23 6 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16 to
2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)15.560
1.1.5 Sex ratio at Birth (SRS)N/AN/A
1.2.1 Full immunization coverage (HMIS)97.051.81
1.2.2 Proportion of institutional deliveries (HMIS)86.60 -5.86
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)128-3
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
85.40-1.9
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
72.75N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
5.01N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
23.74N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
13.99 -7.70
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
11.98 -0.02
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 20.00 -10.10
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)28.57 16.89
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)20.19 5.97
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)36.74 -2.96
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
100.00 0.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
0.00-6.67
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 50.00 50.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 55.33-3.41
3.1.6 Level of birth registration (CRS)84.40 -15.60
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 801
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 82-6
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)100.00 25.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
151-3 Healthy S tates, Progressive India114
HEALTHY STATES, PROGRESSIVE INDIA
MANIPUR - FA CTSHEET 2018
Category: 8 Smaller StatesIndex Score Rank Performance Category
Overall Performance (2017-18)60.60 2Achiever*
Incremental Performance (From 2015-16 to 2017-18) 2.82 2 Moderately Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)4.450.92
1.1.5 Sex ratio at Birth (SRS)N/AN/A
1.2.1 Full immunization coverage (HMIS)99.993.67
1.2.2 Proportion of institutional deliveries (HMIS)79.73 6.26
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)9413
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
79.50-3.1
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
63.87N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
2.87N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
28.19N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
11.98 -9.04
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
25.928.61
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 27.27 -2.62
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)20.121.14
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)43.06 0.30
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)45.10 -2.57
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
66.67 0.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
44.83 -20.69
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS)61.14 -2.09
3.1.6 Level of birth registration (CRS)100.00 N/A
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 7714
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 6022
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)23.53 -5.88
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.00 -12.50
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
119-139
Annexures 115
HEALTHY STATES, PROGRESSIVE INDIA
MEGHALAYA - FA CTSHEET 2018
Category: 8 Smaller StatesIndex Score Rank Performance Category
Overall Performance (2017-18)55.95 3Achiever*
Incremental Performance (From 2015-16 to 2017-18) -0.88 5 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)7.700.05
1.1.5 Sex ratio at Birth (SRS)N/A N/A
1.2.1 Full immunization coverage (HMIS)77.61 -15.73
1.2.2 Proportion of institutional deliveries (HMIS)62.650.54
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)116-21
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
79.70-6.1
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
100.00 N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
13.44N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
10.56N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
9.97-9.28
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
22.677.91
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 10.71 -9.29
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)12.56 -18.49
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)30.90 -4.77
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)41.55 11.82
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
66.67 -33.33
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
203.33 23.33
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 34.382.31
3.1.6 Level of birth registration (CRS)100.00 N/A
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 917
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 897
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)10.34 2.93
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)9.099.09
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
5820 Healthy S tates, Progressive India116
HEALTHY STATES, PROGRESSIVE INDIA
MIZORAM - FACTSHEET 2018
Category: 8 Smaller StatesIndex Score Rank Performance Category
Overall Performance (2017-18)74.97 1Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 1.27 3 Least Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)4.720.07
1.1.5 Sex ratio at Birth (SRS) N/AN/A
1.2.1 Full immunization coverage (HMIS)90.76 -9.24
1.2.2 Proportion of institutional deliveries (HMIS)95.10 -1.19
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)1860
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
73.50-17.1
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
100.00 N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
22.00N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
18.71 N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
13.91 4.14
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
25.980.00
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 20.234.16
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)7.121.01
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)2.38 -35.72
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)15.58 0.36
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
200.00 100.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
118.18 -18.18
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 11.11 0.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 75.361.75
3.1.6 Level of birth registration (CRS)100.00 N/A
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 9648
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 9638
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)0.000.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)10.00 10.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
61-116
Annexures 117
HEALTHY STATES, PROGRESSIVE INDIA
NAGALAND - FA CTSHEET 2018
Category: 8 Smaller StatesIndex Score Rank Performance Category
Overall Performance (2017-18)38.51 8Aspirant*
Incremental Performance (From 2015-16 to 2017-18) 1.13 4 Least Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)4.090.2
1.1.5 Sex ratio at Birth (SRS) N/AN/A
1.2.1 Full immunization coverage (HMIS)58.23 -5.63
1.2.2 Proportion of institutional deliveries (HMIS)54.30-3.77
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)1489
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
67.60-4.3
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
73.80N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
54.79N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
107.87 N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
5.81-1.44
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
23.443.50
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 0.00-11.01
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)0.000.00
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)0.00 -27.36
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)0.000.00
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
100.00 -25.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
150.00 -15.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 9.090.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 29.73 -6.10
3.1.6 Level of birth registration (CRS)100.00 N/A
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 71-8
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 650
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)0.000.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
94-119 Healthy S tates, Progressive India118
HEALTHY STATES, PROGRESSIVE INDIA
SIKKIM - FA CTSHEET 2018
Category: 8 Smaller StatesIndex Score Rank Performance Category
Overall Performance (2017-18)50.51 5Aspirant*
Incremental Performance (From 2015-16 to 2017-18) -2.70 7 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)7.63-0.13
1.1.5 Sex ratio at Birth (SRS)N/A N/A
1.2.1 Full immunization coverage (HMIS)70.04-4.4
1.2.2 Proportion of institutional deliveries (HMIS)66.33 -3.86
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)197-44
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
66.20-11
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
33.51N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
29.16N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
26.76N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
23.99 -0.03
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
25.49 -0.03
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 0.000.00
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)30.43 -31.53
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)0.000.00
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)31.25 -3.13
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
200.00 0.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
366.67 150.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 76.97 -2.92
3.1.6 Level of birth registration (CRS)66.20 -7.90
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 1003
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 95-5
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)0.000.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
133-20
Annexures 119
HEALTHY STATES, PROGRESSIVE INDIA
TRIPURA - FA CTSHEET 2018
Category: 8 Smaller StatesIndex Score Rank Performance Category
Overall Performance (2017-18)46.38 6Aspirant*
Incremental Performance (From 2015-16 to 2017-18) 2.87 1 Moderately Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)13.55 2.44
1.1.5 Sex ratio at Birth (SRS)N/A N/A
1.2.1 Full immunization coverage (HMIS)86.13 1.80
1.2.2 Proportion of institutional deliveries (HMIS)88.41 9.05
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)44-17
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
70.90-17.6
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
5.80N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
3.35N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
10.89N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
11.85 0.98
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
24.907.64
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 24.63 -14.27
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)0.000.00
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)0.00-2.06
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)1.41N/A
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
100.00 100.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
85.71 28.57
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
121.62 5.40
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 60.92 -0.93
3.1.6 Level of birth registration (CRS)82.400.70
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 93-4
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 86-8
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)0.000.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)5.565.56
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
38-31 Healthy S tates, Progressive India120
HEALTHY STATES, PROGRESSIVE INDIA
ANDAMAN & N ICOBAR - FA CTSHEET 2018
Category: 7 Union TerritoriesIndex Score Rank Performance Category
Overall Performance (2017-18)45.36 6Aspirant*
Incremental Performance (From 2015-16 to 2017-18) -4.64 6 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)16.63 -0.54
1.1.5 Sex ratio at Birth (SRS) N/AN/A
1.2.1 Full immunization coverage (HMIS)77.22 -22.78
1.2.2 Proportion of institutional deliveries (HMIS)75.71 -4.49
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)76-63
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
83.90 -7.60
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
 N/AN/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
18.05N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
2.84N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
14.35 -0.66
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
13.29 -4.14
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 9.801.96
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)4.35-3.10
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)10.61 -25.75
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)71.43 -28.57
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
0.000.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
0.00 -500.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS)75.11 -1.83
3.1.6 Level of birth registration (CRS)75.603.70
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 8232
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 8261
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)50.00 50.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
0-78
Annexures 121
HEALTHY STATES, PROGRESSIVE INDIA
CHANDIGARH - FACTSHEET 2018
Category: 7 Union TerritoriesIndex Score Rank Performance Category
Overall Performance (2017-18)63.62 1Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 11.35 2 Most Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)20.890.12
1.1.5 Sex ratio at Birth (SRS) N/AN/A
1.2.1 Full immunization coverage (HMIS)83.40 -10.18
1.2.2 Proportion of institutional deliveries (HMIS)100.00 0.00
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)523218
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
86.801.20
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
N/A N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
57.98N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
27.88N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
17.96 5.95
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
8.95-6.60
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 14.71 -14.70
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)0.00-6.19
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)0.00-69.17
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)11.36 11.36
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
100.00 38.67
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
250.00 100.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
0.000.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 200.00 200.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 66.34 29.55
3.1.6 Level of birth registration (CRS)100.00 0.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 9416
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 935
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)100.00 0.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.00 0.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
0-35 Healthy S tates, Progressive India122
HEALTHY STATES, PROGRESSIVE INDIA
DADRA & NA GAR HAVELI - FACTSHEET 2018
Category: 7 Union TerritoriesIndex Score Rank Performance Category
Overall Performance (2017-18)56.31 2Front-runner*
Incremental Performance (From 2015-16 to 2017-18) 21.67 1 Most Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)36.887.49
1.1.5 Sex ratio at Birth (SRS) N/AN/A
1.2.1 Full immunization coverage (HMIS)79.12 2.06
1.2.2 Proportion of institutional deliveries (HMIS)87.210.12
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)22592
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
89.603.30
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
 N/AN/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
15.11 N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
22.12N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
18.98 4.57
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
36.00 17.99
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 0.930.93
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)2.13 -2.75
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)16.67 0.00
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)12.50 -5.68
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
100.00 0.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
66.67 -66.66
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 100.00 100.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 95.9011.13
3.1.6 Level of birth registration (CRS)86.2021.10
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 1009
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 923
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)100.00 N/A
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)50.00 50.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.00 0.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
0-62
Annexures 123
HEALTHY STATES, PROGRESSIVE INDIA
DAMAN & D IU - FACTSHEET 2018
Category: 7 Union TerritoriesIndex Score Rank Performance Category
Overall Performance (2017-18)41.66 7Aspirant*
Incremental Performance (From 2015-16 to 2017-18) 5.56 3 Most Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)20.68 -3.69
1.1.5 Sex ratio at Birth (SRS) N/AN/A
1.2.1 Full immunization coverage (HMIS)52.83 -26.84
1.2.2 Proportion of institutional deliveries (HMIS)47.37 -24.63
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)151-15
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
92.6013.10
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
N/A N/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
17.43 N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
15.27N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
10.78 -10.24
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
17.98 -18.05
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 0.00-11.86
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)8.898.89
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)28.57 21.43
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)56.41 9.35
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
200.00 100.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
100.00 50.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 0.000.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 80.79 31.53
3.1.6 Level of birth registration (CRS)49.90 -26.50
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 10025
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 10025
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)0.000.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
0.000 Healthy S tates, Progressive India124
HEALTHY STATES, PROGRESSIVE INDIA
DELHI - FA CTSHEET 2018
Category: 7 Union TerritoriesIndex Score Rank Performance Category
Overall Performance (2017-18)49.42 5Achiever*
Incremental Performance (From 2015-16 to 2017-18) -0.61 5 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)19.60 -1.83
1.1.5 Sex ratio at Birth (SRS) N/AN/A
1.2.1 Full immunization coverage (HMIS)99.823.61
1.2.2 Proportion of institutional deliveries (HMIS)82.842.24
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)36012
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
84.80-1.90
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
 N/AN/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
10.76N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
27.77N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
6.98-2.65
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
25.028.30
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 8.91 -10.84
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)46.946.19
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)26.29 12.08
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)40.81 0.60
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
55.77 -13.04
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
82.35 -17.65
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
0.00-0.60
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 72.73 -18.18
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 33.18 -0.51
3.1.6 Level of birth registration (CRS)100.00 0.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 7821
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 8125
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)4.004.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)7.02-1.91
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
12334
Annexures 125
HEALTHY STATES, PROGRESSIVE INDIA
LAKSHADWEEP - FACTSHEET 2018
Category: 7 Union TerritoriesIndex Score Rank Performance Category
Overall Performance (2017-18)53.54 3Achiever*
Incremental Performance (From 2015-16 to 2017-18) -12.25 7 Not Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)7.441.88
1.1.5 Sex ratio at Birth (SRS) N/AN/A
1.2.1 Full immunization coverage (HMIS)77.08 -22.92
1.2.2 Proportion of institutional deliveries (HMIS)65.00 -20.40
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)7035
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
93.80 2.50
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
 N/AN/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
29.35N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
12.19 N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
13.98 -12.81
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
N/AN/A
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 0.000.00
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)0.000.00
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)0.000.00
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)46.15 -30.32
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
0.000.00
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
100.00 0.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
0.000.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 100.00 0.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 79.72 6.48
3.1.6 Level of birth registration (CRS)54.50 -5.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 00
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 00
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)0.000.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
00 Healthy S tates, Progressive India126
HEALTHY STATES, PROGRESSIVE INDIA
PUDUCHERRY - FA CTSHEET 2018
Category: 7 Union TerritoriesIndex Score Rank Performance Category
Overall Performance (2017-18)49.69 4Achiever*
Incremental Performance (From 2015-16 to 2017-18) 2.21 4 Moderately Improved**
Overall Indicator Performance Front-runnersAchieversAspirants
Incremental Indicator Performance
Most
Improved
ImprovedNo Change Deteriorated
Most
Deteriorated
Not
Applicable
Indicator (Source of Data)
Overall
Indicator
Performance#
(2017-18)
Incremental Indicator
Performance##
(From 2015-16
to 2017-18)
HEALTH OUTCOMES DOMAIN
1.1.1 Neonatal Mortality Rate (SRS)N/AN/A
1.1.2 Under five Mortality Rate (SRS)N/AN/A
1.1.3 Total Fertility Rate (SRS)N/AN/A
1.1.4 Proportion Low Birth Weight (LBW) among newborns (HMIS)14.61 -0.89
1.1.5 Sex ratio at Birth (SRS)N/A N/A
1.2.1 Full immunization coverage (HMIS)69.50-8.10
1.2.2 Proportion of institutional deliveries (HMIS)100.00 0.00
1.2.3 Total case notification rate of Tuberculosis (RNTCP MIS)11411
1.2.4 Treatment success rate of new microbiologically confirmed TB cases
(RNTCP MIS)
88.80 -0.40
1.2.5 Proportion of people living with HIV on antiretroviral therapy
(Central MoHFW data)
 N/AN/A
GOVERNANCE AND INFORMATION DOMAIN
2.1.1.a Data Integrity Measure – Percent deviation of HMIS reported data from
NFHS for institutional deliveries (NFHS 4 & HMIS)
90.52N/A
2.1.1.b Data Integrity Measure - Percent deviation of HMIS reported data from
NFHS for ANC registered within Ist trimester (NFHS 4 HMIS)
48.82N/A
2.2.1 Average occupancy of an officer (in months) for 3 key State posts for last
3 years (State Report)
24.694.71
2.2.2 Average occupancy of a District Chief Medical Officer (in months) for last
three years (State Report)
22.48 -2.84
KEY INPUTS/PROCESSES DOMAIN
3.1.1.a Proportion of ANMs positions vacant at Sub Centers (State Report) 11.72 2.99
3.1.1.b Proportion of Staff Nurses positions vacant at PHCs and CHCs (State Report)4.622.24
3.1.1.c Proportion of MO positions vacant at PHCs (State Report)16.14 3.36
3.1.1.d Proportion of Specialist positions vacant at District Hospitals (State Report)35.11 14.55
3.1.2 Proportion of total staff (regular and contractual) with e-pay slip generated
in the IT enabled Human Resources Management Information System
(State Report)
90.2011.85
3.1.3.a Proportion of facilities functional as FRUs (one FRU per 5,00,000
population) (State Report & MoHFW Data)
400.00 200.00
3.1.3.b Proportion of facilities functional as 24x7 PHCs (one 24X7 PHC per
1,00,000 population) (State Report & MoHFW data)
0.000.00
3.1.4 Functional Cardiac Care Units per District *100 (State Report) 50.00 25.00
3.1.5 Proportion of ANCs registered within first trimester (HMIS) 33.58 -5.96
3.1.6 Level of birth registration (CRS)100.00 0.00
3.1.7.a Completeness of IDSP Reporting of P form (Central IDSP, MoHFW data) 10010
3.1.7.b Completeness of IDSP Reporting of L form (Central IDSP, MoHFW data) 10012
3.1.8 Proportion of CHCs with grading 4 points or above (HMIS)25.000.00
3.1.9.a Proportion of DH/SDH with Quality Accreditation Certificates (State Report)0.000.00
3.1.9.b Proportion of CHCs/PHCs with Quality Accreditation Certificates (State Report)0.000.00
3.1.10 Average number of days for transfer of Central NHM fund to
implementation agency (Central NHM Finance Data)
8530