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NITI Aayog health index report: Kerala tops again, Uttar Pradesh worst

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NITI Aayog health index report: Kerala tops again, Uttar Pradesh worst

[vc_row][vc_column][vc_column_text]Kerala has once again emerged as the top ranking state in the second health index report of NITI Aayog, while the worst is Uttar Pradesh at the bottom, preceded by Rajasthan, Bihar and Odisha.

The Health Index consists of 24 indicators grouped in the domains of  Health Outcomes, Governance and Information, and Key Inputs/Processes. The States and Union Territories (UTs) have been ranked in three categories to ensure comparison among similar entities – Larger States, Smaller States, and UTs. The second round of the health index accounts for the period 2015-16 (base year) to 2017-18 (reference year).

The report has been prepared in collaboration with the Ministry of Health and Family Welfare with technical assistance from the World Bank. The States were sensitized about the Health Index including indicator definitions, data sources and process for data submission through a series of regional workshops and mentor support was provided to most States.

Data was submitted by States on the online portal hosted by NITI Aayog and data from sources in the public domain was pre-entered. This data was then validated by an IVA and was used as an input into automated generation of Index values and ranks on the portal

Last year, in February the first round of the health index was released, which measured the annual and incremental performances of States and UTs for the period 2014-15(base year) to 2015-16 (reference year).

Here are some excerpts from the report:

In the base year (2014-15), the composite Health Index ranged from 28.14 in Uttar Pradesh to 80 in Kerala. On an average, modest improvement was observed between the base and reference year, with the difference between the worst and best performing States narrowing.

In the reference year 2015-16, Uttar Pradesh at 33.69 remained the poorest performing State,  and Kerala remained the best performing State despite a slight decline in the Health Index to 76.55.

The top five performing States in the reference year based on the composite Index score are  Kerala  (76.55), Punjab (65.21), Tamil Nadu (63.38), Gujarat (61.99), and Himachal Pradesh (61.20).

On the other end of the spectrum, Uttar Pradesh (33.69) scored the lowest and ranks at the bottom preceded by  Rajasthan  (36.79),  Bihar  (38.46),  Odisha  (39.43),  and  Madhya  Pradesh  (40.09).

Among the 21 Larger States, only five States improved their position from base to reference year. These States are Punjab,  Andhra  Pradesh,  Jammu  &  Kashmir, Chhattisgarh and Jharkhand.

The most significant progress was observed in Jharkhand and Jammu & Kashmir. Both States moved up by four positions in the ranking.

Punjab improved its performance in the ranking by three positions. Andhra Pradesh and Chhattisgarh have shown modest improvement – both up by one position.

Despite increases in the composite Health Index scores, the rankings of  Maharashtra, Madhya Pradesh, Bihar, Rajasthan, and Uttar Pradesh did not change between base and reference years.

Kerala continued to be at the top position and the remaining States fell in ranking by 1-2 positions.

There is a large gap in overall performance between the best and the least performing States and UTs; besides, all States and UTs have substantial scope for improvement:

In the reference year (2015-16) among Larger States, the Index score for overall performance ranged widely between 33.69 in Uttar Pradesh to 76.55  in  Kerala.  Similarly,  among  Smaller  States,  the  Index  score  for  overall  performance  varied  between  37.38  in  Nagaland  to  73.70  in  Mizoram,  and  among  UTs  this  varied  between 34.64 in Dadra & Nagar Haveli to 65.79 in Lakshadweep.

Among Larger States, the variation between the best and least performing States and UTs was the widest around 43 points as compared with 36 points in Smaller States and 31 points in UTs. However, based on the highest observed overall Index scores in each category of  States and UTs, clearly there is room for improvement in all States and UTs .

The States and UTs rank differently on overall performance and annual incremental   performance: States and UTs that start at lower levels of the Health Index (lower levels of  development of  their health systems) are generally at an advantage in notching up incremental progress over States with high Health Index score due to diminishing marginal returns in outcomes for similar effort levels. It is a challenge for States at high levels of the Index score even to maintain their performance levels. For  example, Kerala ranks on top in terms of overall  performance  and  at  the  bottom  in  terms  of   incremental progress mainly as it had already achieved a low level of  Neonatal Mortality Rate (NMR) and  Under-five  Mortality  Rate  (U5MR)  and  replacement  level  fertility,  leaving  limited  space  for  any  further improvements.

The incremental measurement shows that about one-third of the States have registered a decline in  their  Health  Indices  in  the  reference  year  as  compared  to  the  base  year:  This  is  a  matter  of   concern and should nudge the States into reviewing and revitalizing their programmatic efforts. Among the Larger States, six States, namely Uttarakhand, Himachal Pradesh, Karnataka, Gujarat, Haryana and Kerala have shown a decline in performance from base year to reference year, despite some of them being  among  the  top  ten  in  overall  performance.  Among the smaller states, Sikkim, Arunachal  Pradesh, Tripura and Nagaland have shown a decline; and among the UTs, Chandigarh and Daman & Diu have shown a decline.

The Health Index will  be  calculated  and  disseminated  annually,  with  a  focus  on  measuring  and  highlighting  annual  incremental improvement in the States and UTs, the NITI Aayog said in the report. The composite Health Index and ranking of  States and   UTs   will   assist   in   monitoring   the   States’   performance,   also   serving   as   an   input   for   performance-based incentives, leading ultimately to improvements in the state of  health in each State.

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Amit Shah counters delimitation concerns, says southern states to gain Lok Sabha seats

Amit Shah assures Parliament that southern states will gain Lok Sabha seats after delimitation, countering opposition criticism during the women’s reservation debate.

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Amit Shah

Union Home Minister Amit Shah on Thursday addressed concerns over the proposed delimitation exercise, asserting in the Lok Sabha that southern states will not lose representation but instead see an increase in their number of seats.

His remarks came during a heated debate linked to the implementation of women’s reservation, where opposition parties have raised fears that population-based delimitation could reduce the political weight of southern states.

Shah rejected these claims, calling them misleading, and said the proposed framework ensures fairness while expanding the overall strength of the Lok Sabha.

Seat count to rise with expansion of Lok Sabha

The government has indicated that the total number of Lok Sabha seats could increase significantly as part of the delimitation process. In this expanded House, the combined representation of southern states is expected to rise from 129 seats at present to around 195 seats.

Shah emphasised that no state will lose seats in absolute terms, and the exercise is designed to reflect population changes while maintaining balance across regions.

State-wise projections shared in Parliament

During his address, Shah also provided indicative figures for individual southern states, suggesting notable increases in representation. According to the projections:

  • Tamil Nadu could see its seats rise substantially
  • Kerala, Telangana, and Andhra Pradesh are also expected to gain additional seats
  • Karnataka’s representation may increase as well

These figures were presented to counter the argument that delimitation would disproportionately favour northern states.

Political debate intensifies over linkage with women’s quota

The delimitation exercise has been closely linked to the rollout of women’s reservation, which proposes one-third seats for women in Parliament and state assemblies.

Opposition leaders have questioned this linkage, arguing that tying reservation to delimitation could delay its implementation and raise federal concerns. Some leaders have also warned that the move could impact national unity if apprehensions among states are not addressed.

The government, however, maintains that the reforms are necessary to ensure equitable representation and to align the electoral system with demographic realities.

Centre dismisses ‘false narrative’ on southern states

Shah reiterated that concerns about southern states losing influence are unfounded. He said the delimitation process will increase representation across regions and described the criticism as a “false narrative” aimed at creating confusion.

The issue is expected to remain a key flashpoint as Parliament continues discussions on the women’s reservation framework and related legislative changes.

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PM Modi assures no discrimination in women’s quota, delimitation debate intensifies in Parliament

PM Narendra Modi has assured that women’s reservation will be implemented without discrimination, amid a heated debate over delimitation in Parliament.

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PM modi

Prime Minister Narendra Modi has assured that there will be no discrimination in the implementation of women’s reservation, as Parliament witnessed a sharp debate over the proposed linkage between the quota and delimitation exercise.

During the ongoing special session, the government reiterated its commitment to ensuring fair representation while addressing concerns raised by opposition parties regarding the timing and structure of the legislation.

The proposed framework aims to reserve 33 percent of seats for women in the Lok Sabha and state assemblies. However, its implementation is tied to a fresh delimitation exercise, which is expected after the next census.

Opposition questions timing and intent

Opposition leaders have raised concerns that linking the women’s quota to delimitation could delay its implementation. They argue that the process of redrawing constituencies may push the actual rollout further into the future.

The issue has triggered a broader political confrontation, with multiple parties questioning whether the move could alter representation across states.

Some critics have also alleged that the delimitation exercise could disproportionately benefit certain regions based on population, a charge the government has rejected.

Government reiterates commitment to fair implementation

Responding to these concerns, the Centre has maintained that the reforms are necessary to ensure accurate and updated representation based on population data.

Leaders from the ruling side have repeatedly emphasized that the process will be carried out transparently and without bias. The assurance that there will be “no discrimination” is aimed at addressing fears among states and opposition parties.

The debate marks a key moment in Parliament, with both sides engaging in intense exchanges over one of the most significant electoral reforms in recent years.

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Give all tickets to Muslim women, Amit Shah says, attacking Akhilesh Yadav on sub-quota demand

A sharp exchange between Amit Shah and Akhilesh Yadav in Parliament over sub-quota for Muslim women highlights key divisions on women’s reservation implementation.

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A heated exchange broke out in Parliament during discussions on the women’s reservation framework, with Union Home Minister Amit Shah and Samajwadi Party chief Akhilesh Yadav locking horns over the demand for a sub-quota for Muslim women.

The debate unfolded as the government pushed forward key legislative measures to implement 33% reservation for women in the Lok Sabha and state assemblies.

Akhilesh Yadav argued that the proposed reservation must ensure representation for women from marginalised communities, including Other Backward Classes (OBCs) and Muslim women. He said that without such provisions, large sections could remain excluded from political participation.

He also questioned the timing of the bill, alleging that the Centre was avoiding a caste census. According to him, a census would lead to renewed demands for caste-based reservations, which the government is reluctant to address.

Government rejects religion-based quota

Responding to the demand, Amit Shah made it clear that reservation based on religion is not permitted under the Constitution.

He stated that any proposal to provide quota to Muslims on religious grounds would be unconstitutional, firmly rejecting the idea of a separate sub-quota for Muslim women within the broader reservation framework.

The government has maintained that the existing framework already includes provisions for Scheduled Castes (SC) and Scheduled Tribes (ST) women within the overall reservation structure.

Wider political divide over implementation

The issue of sub-categorisation within the women’s quota has emerged as a major flashpoint, even as most opposition parties broadly support the idea of women’s reservation.

Samajwadi Party leaders reiterated that their support for the bill depends on inclusion of OBC and minority women, while the government continues to defend its constitutional position.

The debate is part of a broader discussion during the special Parliament session, where multiple bills linked to delimitation and implementation of the women’s quota are being taken up.

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