Report on Rank of States and Union Territories | Economic Survey & Government Reports - UPSC PDF Download

 Page 1


Healthy States, Progressive India
Report on the Ranks of States and Union Territories
Ministry of Health 
& Family Welfare
Page 2


Healthy States, Progressive India
Report on the Ranks of States and Union Territories
Ministry of Health 
& Family Welfare
Foreword
NITI Aayog has been mandated with transforming India by exercising thought leadership and by invoking 
the instruments of co-operative and competitive federalism, focussing the attention of the State 
Governments and Union Ministries on achieving outcomes. As the nodal agency responsible for charting 
India’s quest for attaining the commitments under the Sustainable Development Goals (SDGs), it was 
necessary to devise a mechanism for measuring outcomes particularly in the critical social sectors – such as 
Health and Education, where India’s record has been less than stellar. This was intended to provide 
feedback to all stakeholders as to whether we are on course to what we have set out to achieve, and 
deviations, if any , to be pointed out in time to ensure necessary mid-course correction. 
It is important to realize that implementation of social sector programs is squarely in the domain of the 
State Governments and India’s achievement of SDGs is therefore critically dependent on the action in the 
States. Nudging States towards improving their social outcomes therefore requires developing indices that 
would capture annual increments in performance through an independent third party process and publish 
these. It is true that summarizing the complexities of a given sector and condensing it in an Index has its own 
limitations. However, in an environment where the focus is on budget spends and outputs with limited 
attention on outcomes, there is a need to increase competition among States to encourage them to strive 
evermore for increasing the pace of change.
The Health of its population is central to a nation’s well-being and productivity . While India has made some 
significant gains in improving life expectancy and reducing infant and maternal mortality, our rates of 
improvement have been inadequate as a nation.
 Further, there are large variations in health system performance and outcomes achieved across States. The 
“Performance in Health Outcomes” Index seeks to capture the annual progress of States and Union 
Territories (UTs) on a variety of indicators – Outcomes, Governance and Processes. While we have also 
reported the overall levels of performance of States, the focus of the NITI Index is to propel change, 
highlighting those States that have shown most improvement. The exercise has been spearheaded by NITI 
Aayog in collaboration with the Ministry of Health and Family Welfare, with technical assistance from the 
World Bank, the authors of this report on the ranks and their interpretation.
The exercise, which is the first of its kind attempted by the Union Government was conducted over a period 
of eighteen months. In addition to the technical expertise of the World Bank, experts in public health, 
economics, statistics and health systems were consulted in the development of the Index. It involved 
extensive engagement with the States for finalization of the indicators, sensitization workshops for sharing 
the methodology, process of data submission and addressing concerns; mentoring of States for the data 
submission process on an online portal and independent data validation. 
The process of Index development and implementation highlighted the large gaps in data availability on 
health outcomes.The need for making outcome data available for smaller states, more frequent and updated 
outcomes for non-communicable diseases and financial protection, and the need for robust programmatic 
data that can be used for continuous monitoring, were important issues that despite our efforts, could not be 
addressed optimally in this first round. Despite these challenges and limitations, it was decided to launch the 
Index in the first year as a model to measuring performance and ranking States on change. We thereby hope 
to spur action on several fronts in bringing about national level transformation. We will strive to address the 
lessons learned in this first round and refine the Index in the successive years of its implementation. The 
linking of the Health Index with incentives under the National Health Mission by the Ministry of Health 
and Family Welfare underlines the importance of such an exercise. It re-emphasizes the move towards 
performance based financing for better outcomes. 
I would like to acknowledge here the large number of individuals who contributed to the initiative being 
brought to completion of its first round. The Ministry of Health and Family Welfare under the guidance of 
Mr. C.K. Mishra, former Secretary , Department of Health & Family Welfare; Ms. Preeti Sudan, Secretary , 
i
Page 3


Healthy States, Progressive India
Report on the Ranks of States and Union Territories
Ministry of Health 
& Family Welfare
Foreword
NITI Aayog has been mandated with transforming India by exercising thought leadership and by invoking 
the instruments of co-operative and competitive federalism, focussing the attention of the State 
Governments and Union Ministries on achieving outcomes. As the nodal agency responsible for charting 
India’s quest for attaining the commitments under the Sustainable Development Goals (SDGs), it was 
necessary to devise a mechanism for measuring outcomes particularly in the critical social sectors – such as 
Health and Education, where India’s record has been less than stellar. This was intended to provide 
feedback to all stakeholders as to whether we are on course to what we have set out to achieve, and 
deviations, if any , to be pointed out in time to ensure necessary mid-course correction. 
It is important to realize that implementation of social sector programs is squarely in the domain of the 
State Governments and India’s achievement of SDGs is therefore critically dependent on the action in the 
States. Nudging States towards improving their social outcomes therefore requires developing indices that 
would capture annual increments in performance through an independent third party process and publish 
these. It is true that summarizing the complexities of a given sector and condensing it in an Index has its own 
limitations. However, in an environment where the focus is on budget spends and outputs with limited 
attention on outcomes, there is a need to increase competition among States to encourage them to strive 
evermore for increasing the pace of change.
The Health of its population is central to a nation’s well-being and productivity . While India has made some 
significant gains in improving life expectancy and reducing infant and maternal mortality, our rates of 
improvement have been inadequate as a nation.
 Further, there are large variations in health system performance and outcomes achieved across States. The 
“Performance in Health Outcomes” Index seeks to capture the annual progress of States and Union 
Territories (UTs) on a variety of indicators – Outcomes, Governance and Processes. While we have also 
reported the overall levels of performance of States, the focus of the NITI Index is to propel change, 
highlighting those States that have shown most improvement. The exercise has been spearheaded by NITI 
Aayog in collaboration with the Ministry of Health and Family Welfare, with technical assistance from the 
World Bank, the authors of this report on the ranks and their interpretation.
The exercise, which is the first of its kind attempted by the Union Government was conducted over a period 
of eighteen months. In addition to the technical expertise of the World Bank, experts in public health, 
economics, statistics and health systems were consulted in the development of the Index. It involved 
extensive engagement with the States for finalization of the indicators, sensitization workshops for sharing 
the methodology, process of data submission and addressing concerns; mentoring of States for the data 
submission process on an online portal and independent data validation. 
The process of Index development and implementation highlighted the large gaps in data availability on 
health outcomes.The need for making outcome data available for smaller states, more frequent and updated 
outcomes for non-communicable diseases and financial protection, and the need for robust programmatic 
data that can be used for continuous monitoring, were important issues that despite our efforts, could not be 
addressed optimally in this first round. Despite these challenges and limitations, it was decided to launch the 
Index in the first year as a model to measuring performance and ranking States on change. We thereby hope 
to spur action on several fronts in bringing about national level transformation. We will strive to address the 
lessons learned in this first round and refine the Index in the successive years of its implementation. The 
linking of the Health Index with incentives under the National Health Mission by the Ministry of Health 
and Family Welfare underlines the importance of such an exercise. It re-emphasizes the move towards 
performance based financing for better outcomes. 
I would like to acknowledge here the large number of individuals who contributed to the initiative being 
brought to completion of its first round. The Ministry of Health and Family Welfare under the guidance of 
Mr. C.K. Mishra, former Secretary , Department of Health & Family Welfare; Ms. Preeti Sudan, Secretary , 
i
Department of Health & Family Welfare; Mr. Manoj Jhalani, Additional Secretary and Mission Director, 
National Health Mission, as well as the Joint Secretaries and their teams from the programme divisions 
provided their complete support to the initiative and worked in close co-ordination with NITI Aayog during 
its entire course. 
Technical Assistance to NITI Aayog was provided through the entire duration by The World Bank, along 
with authorship of this report. We are grateful to Mr. Junaid Kamal Ahmad, Country Director and the 
technical team led by Ms. Sheena Chhabra, Senior Health Specialist along with Dr. Rattan Chand, Senior 
Consultant; Dr . Nikhil Utture, Consultant; and Dr . Iryna Postolovska, Y oung Professional with support from 
Ms. Manveen Kohli, Consultant. Peer review of the final report by Dr. Rekha Menon, Practice Manager; 
Dr. Ajay Tandon, Lead Economist; Dr. Mickey Chopra, Global Lead on Service Delivery; and Dr. Owen 
K. Smith, Senior Economist is gratefully acknowledged.
Inputs from statistical, economics and sector experts including Prof. Pulak Ghosh, IIM-Bangalore; Prof. 
Karthik Muralidharan, University of California, San Diego; Prof. Ladu Singh, International Institute of 
Population Sciences; Prof. Arvind Pandey, ICMR; Prof. Mudit Kapoor, Indian Statistical Institute; Dr. 
Shamika Ravi, Brookings India (and currently a Member of the Economic Advisory Council to the Prime 
Minister), were obtained at various stages of the project. Support provided by the Registrar General and 
Census Commissioner of India and the officials from the Office of Registrar General and Census 
Commissioner, India is gratefully acknowledged. Inputs received from Technical Organizations including 
UNICEF and DFID are also acknowledged. 
NITI Aayog is most grateful to senior officials of the Health departments, nodal officers and their teams in 
all the States and UTs for their extensive co-operation throughout the project, including providing inputs 
and feedback during the development of the index, participation in regional sensitization workshops, 
submission of data on the online portal and provision of required supporting documentation/evidence for 
validation of data. 
The mentor organizations, USAID (led by Mr. Xerxes Sidhwa and Mr. Gautam Chakraborty , and the team 
led by Ms. Alia Kauser and Dr. Rashmi Kukreja), Regional Resource Centre for the North Eastern States, 
branch of National Health Systems Resource Centre, MoHFW (led by Dr. Bamin Tada and Mr. Bhaswat 
Das), Centre for Innovations in Public Systems (led by Dr. Nivedita Haran) and TERI (led by Ms. Meena 
Sehgal) provided their valuable support to the States during the data submission phase of the project. 
Extended mentor support provided by Mr. Pankaj Gupta, USAID is also gratefully acknowledged. The data 
validation was conducted by the team at IPE Global led by Mr. Soumitro Ghosh and Ms. Daljeet Kaur. The 
online portal was developed by Silvertouch Technologies, led by Ms. Surbhi Singhal and Mr. Rushiraj Yadav . 
The project was designed and executed under the guidance of the senior leadership of NITI Aayog,
Dr. Arvind Panagariya, former Vice Chairman, NITI Aayog; Dr. Rajiv Kumar, Vice Chairman, NITI 
Aayog; Dr. Bibek Debroy , Member and Dr. Vinod Paul, Member, NITI Aayog. The  Health Division team 
led by Mr. Alok Kumar, Adviser; Mr. Sumant Narain, former Director; Dr. Dinesh Arora, Director, and Dr. 
Kheya Furtado, Research Assistant, with support from Ms. Jyoti Khattar, Senior Research Officer planned, 
implemented and co-ordinated the entire project. 
ii
Amitabh Kant
Chief Executive Ofcer, NITI Aayog
Page 4


Healthy States, Progressive India
Report on the Ranks of States and Union Territories
Ministry of Health 
& Family Welfare
Foreword
NITI Aayog has been mandated with transforming India by exercising thought leadership and by invoking 
the instruments of co-operative and competitive federalism, focussing the attention of the State 
Governments and Union Ministries on achieving outcomes. As the nodal agency responsible for charting 
India’s quest for attaining the commitments under the Sustainable Development Goals (SDGs), it was 
necessary to devise a mechanism for measuring outcomes particularly in the critical social sectors – such as 
Health and Education, where India’s record has been less than stellar. This was intended to provide 
feedback to all stakeholders as to whether we are on course to what we have set out to achieve, and 
deviations, if any , to be pointed out in time to ensure necessary mid-course correction. 
It is important to realize that implementation of social sector programs is squarely in the domain of the 
State Governments and India’s achievement of SDGs is therefore critically dependent on the action in the 
States. Nudging States towards improving their social outcomes therefore requires developing indices that 
would capture annual increments in performance through an independent third party process and publish 
these. It is true that summarizing the complexities of a given sector and condensing it in an Index has its own 
limitations. However, in an environment where the focus is on budget spends and outputs with limited 
attention on outcomes, there is a need to increase competition among States to encourage them to strive 
evermore for increasing the pace of change.
The Health of its population is central to a nation’s well-being and productivity . While India has made some 
significant gains in improving life expectancy and reducing infant and maternal mortality, our rates of 
improvement have been inadequate as a nation.
 Further, there are large variations in health system performance and outcomes achieved across States. The 
“Performance in Health Outcomes” Index seeks to capture the annual progress of States and Union 
Territories (UTs) on a variety of indicators – Outcomes, Governance and Processes. While we have also 
reported the overall levels of performance of States, the focus of the NITI Index is to propel change, 
highlighting those States that have shown most improvement. The exercise has been spearheaded by NITI 
Aayog in collaboration with the Ministry of Health and Family Welfare, with technical assistance from the 
World Bank, the authors of this report on the ranks and their interpretation.
The exercise, which is the first of its kind attempted by the Union Government was conducted over a period 
of eighteen months. In addition to the technical expertise of the World Bank, experts in public health, 
economics, statistics and health systems were consulted in the development of the Index. It involved 
extensive engagement with the States for finalization of the indicators, sensitization workshops for sharing 
the methodology, process of data submission and addressing concerns; mentoring of States for the data 
submission process on an online portal and independent data validation. 
The process of Index development and implementation highlighted the large gaps in data availability on 
health outcomes.The need for making outcome data available for smaller states, more frequent and updated 
outcomes for non-communicable diseases and financial protection, and the need for robust programmatic 
data that can be used for continuous monitoring, were important issues that despite our efforts, could not be 
addressed optimally in this first round. Despite these challenges and limitations, it was decided to launch the 
Index in the first year as a model to measuring performance and ranking States on change. We thereby hope 
to spur action on several fronts in bringing about national level transformation. We will strive to address the 
lessons learned in this first round and refine the Index in the successive years of its implementation. The 
linking of the Health Index with incentives under the National Health Mission by the Ministry of Health 
and Family Welfare underlines the importance of such an exercise. It re-emphasizes the move towards 
performance based financing for better outcomes. 
I would like to acknowledge here the large number of individuals who contributed to the initiative being 
brought to completion of its first round. The Ministry of Health and Family Welfare under the guidance of 
Mr. C.K. Mishra, former Secretary , Department of Health & Family Welfare; Ms. Preeti Sudan, Secretary , 
i
Department of Health & Family Welfare; Mr. Manoj Jhalani, Additional Secretary and Mission Director, 
National Health Mission, as well as the Joint Secretaries and their teams from the programme divisions 
provided their complete support to the initiative and worked in close co-ordination with NITI Aayog during 
its entire course. 
Technical Assistance to NITI Aayog was provided through the entire duration by The World Bank, along 
with authorship of this report. We are grateful to Mr. Junaid Kamal Ahmad, Country Director and the 
technical team led by Ms. Sheena Chhabra, Senior Health Specialist along with Dr. Rattan Chand, Senior 
Consultant; Dr . Nikhil Utture, Consultant; and Dr . Iryna Postolovska, Y oung Professional with support from 
Ms. Manveen Kohli, Consultant. Peer review of the final report by Dr. Rekha Menon, Practice Manager; 
Dr. Ajay Tandon, Lead Economist; Dr. Mickey Chopra, Global Lead on Service Delivery; and Dr. Owen 
K. Smith, Senior Economist is gratefully acknowledged.
Inputs from statistical, economics and sector experts including Prof. Pulak Ghosh, IIM-Bangalore; Prof. 
Karthik Muralidharan, University of California, San Diego; Prof. Ladu Singh, International Institute of 
Population Sciences; Prof. Arvind Pandey, ICMR; Prof. Mudit Kapoor, Indian Statistical Institute; Dr. 
Shamika Ravi, Brookings India (and currently a Member of the Economic Advisory Council to the Prime 
Minister), were obtained at various stages of the project. Support provided by the Registrar General and 
Census Commissioner of India and the officials from the Office of Registrar General and Census 
Commissioner, India is gratefully acknowledged. Inputs received from Technical Organizations including 
UNICEF and DFID are also acknowledged. 
NITI Aayog is most grateful to senior officials of the Health departments, nodal officers and their teams in 
all the States and UTs for their extensive co-operation throughout the project, including providing inputs 
and feedback during the development of the index, participation in regional sensitization workshops, 
submission of data on the online portal and provision of required supporting documentation/evidence for 
validation of data. 
The mentor organizations, USAID (led by Mr. Xerxes Sidhwa and Mr. Gautam Chakraborty , and the team 
led by Ms. Alia Kauser and Dr. Rashmi Kukreja), Regional Resource Centre for the North Eastern States, 
branch of National Health Systems Resource Centre, MoHFW (led by Dr. Bamin Tada and Mr. Bhaswat 
Das), Centre for Innovations in Public Systems (led by Dr. Nivedita Haran) and TERI (led by Ms. Meena 
Sehgal) provided their valuable support to the States during the data submission phase of the project. 
Extended mentor support provided by Mr. Pankaj Gupta, USAID is also gratefully acknowledged. The data 
validation was conducted by the team at IPE Global led by Mr. Soumitro Ghosh and Ms. Daljeet Kaur. The 
online portal was developed by Silvertouch Technologies, led by Ms. Surbhi Singhal and Mr. Rushiraj Yadav . 
The project was designed and executed under the guidance of the senior leadership of NITI Aayog,
Dr. Arvind Panagariya, former Vice Chairman, NITI Aayog; Dr. Rajiv Kumar, Vice Chairman, NITI 
Aayog; Dr. Bibek Debroy , Member and Dr. Vinod Paul, Member, NITI Aayog. The  Health Division team 
led by Mr. Alok Kumar, Adviser; Mr. Sumant Narain, former Director; Dr. Dinesh Arora, Director, and Dr. 
Kheya Furtado, Research Assistant, with support from Ms. Jyoti Khattar, Senior Research Officer planned, 
implemented and co-ordinated the entire project. 
ii
Amitabh Kant
Chief Executive Ofcer, NITI Aayog
Abbreviations
AHPI  Association of Healthcare Providers (India)
ANC Antenatal Care
ANM  Auxiliary Nurse Midwife
ART  Antiretroviral Therapy
BCG Bacillus Calmette–Guérin 
BY Base Year
CCU  Cardiac Care Unit
CHC  Community Health Centre
CIPS Centre for Innovation in Public Systems
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
GBD  Global Burden of Disease
FLV First Level Verification
FRU First Referral Unit
Hb Hemoglobin
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
JSSK Janani Shishu Suraksha Karyakram
JSY Janani Suraksha Yojana
LBW Low Birth Weight
L Form  IDSP Reporting Format for Laboratory Surveillance
MCTS  Mother and Child Tracking System
MCTFC  Mother and Child Tracking Facilitation Centre
MIS  Management Information System
MMR  Maternal Mortality Ratio
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  National Institution for Transforming India
iii
Page 5


Healthy States, Progressive India
Report on the Ranks of States and Union Territories
Ministry of Health 
& Family Welfare
Foreword
NITI Aayog has been mandated with transforming India by exercising thought leadership and by invoking 
the instruments of co-operative and competitive federalism, focussing the attention of the State 
Governments and Union Ministries on achieving outcomes. As the nodal agency responsible for charting 
India’s quest for attaining the commitments under the Sustainable Development Goals (SDGs), it was 
necessary to devise a mechanism for measuring outcomes particularly in the critical social sectors – such as 
Health and Education, where India’s record has been less than stellar. This was intended to provide 
feedback to all stakeholders as to whether we are on course to what we have set out to achieve, and 
deviations, if any , to be pointed out in time to ensure necessary mid-course correction. 
It is important to realize that implementation of social sector programs is squarely in the domain of the 
State Governments and India’s achievement of SDGs is therefore critically dependent on the action in the 
States. Nudging States towards improving their social outcomes therefore requires developing indices that 
would capture annual increments in performance through an independent third party process and publish 
these. It is true that summarizing the complexities of a given sector and condensing it in an Index has its own 
limitations. However, in an environment where the focus is on budget spends and outputs with limited 
attention on outcomes, there is a need to increase competition among States to encourage them to strive 
evermore for increasing the pace of change.
The Health of its population is central to a nation’s well-being and productivity . While India has made some 
significant gains in improving life expectancy and reducing infant and maternal mortality, our rates of 
improvement have been inadequate as a nation.
 Further, there are large variations in health system performance and outcomes achieved across States. The 
“Performance in Health Outcomes” Index seeks to capture the annual progress of States and Union 
Territories (UTs) on a variety of indicators – Outcomes, Governance and Processes. While we have also 
reported the overall levels of performance of States, the focus of the NITI Index is to propel change, 
highlighting those States that have shown most improvement. The exercise has been spearheaded by NITI 
Aayog in collaboration with the Ministry of Health and Family Welfare, with technical assistance from the 
World Bank, the authors of this report on the ranks and their interpretation.
The exercise, which is the first of its kind attempted by the Union Government was conducted over a period 
of eighteen months. In addition to the technical expertise of the World Bank, experts in public health, 
economics, statistics and health systems were consulted in the development of the Index. It involved 
extensive engagement with the States for finalization of the indicators, sensitization workshops for sharing 
the methodology, process of data submission and addressing concerns; mentoring of States for the data 
submission process on an online portal and independent data validation. 
The process of Index development and implementation highlighted the large gaps in data availability on 
health outcomes.The need for making outcome data available for smaller states, more frequent and updated 
outcomes for non-communicable diseases and financial protection, and the need for robust programmatic 
data that can be used for continuous monitoring, were important issues that despite our efforts, could not be 
addressed optimally in this first round. Despite these challenges and limitations, it was decided to launch the 
Index in the first year as a model to measuring performance and ranking States on change. We thereby hope 
to spur action on several fronts in bringing about national level transformation. We will strive to address the 
lessons learned in this first round and refine the Index in the successive years of its implementation. The 
linking of the Health Index with incentives under the National Health Mission by the Ministry of Health 
and Family Welfare underlines the importance of such an exercise. It re-emphasizes the move towards 
performance based financing for better outcomes. 
I would like to acknowledge here the large number of individuals who contributed to the initiative being 
brought to completion of its first round. The Ministry of Health and Family Welfare under the guidance of 
Mr. C.K. Mishra, former Secretary , Department of Health & Family Welfare; Ms. Preeti Sudan, Secretary , 
i
Department of Health & Family Welfare; Mr. Manoj Jhalani, Additional Secretary and Mission Director, 
National Health Mission, as well as the Joint Secretaries and their teams from the programme divisions 
provided their complete support to the initiative and worked in close co-ordination with NITI Aayog during 
its entire course. 
Technical Assistance to NITI Aayog was provided through the entire duration by The World Bank, along 
with authorship of this report. We are grateful to Mr. Junaid Kamal Ahmad, Country Director and the 
technical team led by Ms. Sheena Chhabra, Senior Health Specialist along with Dr. Rattan Chand, Senior 
Consultant; Dr . Nikhil Utture, Consultant; and Dr . Iryna Postolovska, Y oung Professional with support from 
Ms. Manveen Kohli, Consultant. Peer review of the final report by Dr. Rekha Menon, Practice Manager; 
Dr. Ajay Tandon, Lead Economist; Dr. Mickey Chopra, Global Lead on Service Delivery; and Dr. Owen 
K. Smith, Senior Economist is gratefully acknowledged.
Inputs from statistical, economics and sector experts including Prof. Pulak Ghosh, IIM-Bangalore; Prof. 
Karthik Muralidharan, University of California, San Diego; Prof. Ladu Singh, International Institute of 
Population Sciences; Prof. Arvind Pandey, ICMR; Prof. Mudit Kapoor, Indian Statistical Institute; Dr. 
Shamika Ravi, Brookings India (and currently a Member of the Economic Advisory Council to the Prime 
Minister), were obtained at various stages of the project. Support provided by the Registrar General and 
Census Commissioner of India and the officials from the Office of Registrar General and Census 
Commissioner, India is gratefully acknowledged. Inputs received from Technical Organizations including 
UNICEF and DFID are also acknowledged. 
NITI Aayog is most grateful to senior officials of the Health departments, nodal officers and their teams in 
all the States and UTs for their extensive co-operation throughout the project, including providing inputs 
and feedback during the development of the index, participation in regional sensitization workshops, 
submission of data on the online portal and provision of required supporting documentation/evidence for 
validation of data. 
The mentor organizations, USAID (led by Mr. Xerxes Sidhwa and Mr. Gautam Chakraborty , and the team 
led by Ms. Alia Kauser and Dr. Rashmi Kukreja), Regional Resource Centre for the North Eastern States, 
branch of National Health Systems Resource Centre, MoHFW (led by Dr. Bamin Tada and Mr. Bhaswat 
Das), Centre for Innovations in Public Systems (led by Dr. Nivedita Haran) and TERI (led by Ms. Meena 
Sehgal) provided their valuable support to the States during the data submission phase of the project. 
Extended mentor support provided by Mr. Pankaj Gupta, USAID is also gratefully acknowledged. The data 
validation was conducted by the team at IPE Global led by Mr. Soumitro Ghosh and Ms. Daljeet Kaur. The 
online portal was developed by Silvertouch Technologies, led by Ms. Surbhi Singhal and Mr. Rushiraj Yadav . 
The project was designed and executed under the guidance of the senior leadership of NITI Aayog,
Dr. Arvind Panagariya, former Vice Chairman, NITI Aayog; Dr. Rajiv Kumar, Vice Chairman, NITI 
Aayog; Dr. Bibek Debroy , Member and Dr. Vinod Paul, Member, NITI Aayog. The  Health Division team 
led by Mr. Alok Kumar, Adviser; Mr. Sumant Narain, former Director; Dr. Dinesh Arora, Director, and Dr. 
Kheya Furtado, Research Assistant, with support from Ms. Jyoti Khattar, Senior Research Officer planned, 
implemented and co-ordinated the entire project. 
ii
Amitabh Kant
Chief Executive Ofcer, NITI Aayog
Abbreviations
AHPI  Association of Healthcare Providers (India)
ANC Antenatal Care
ANM  Auxiliary Nurse Midwife
ART  Antiretroviral Therapy
BCG Bacillus Calmette–Guérin 
BY Base Year
CCU  Cardiac Care Unit
CHC  Community Health Centre
CIPS Centre for Innovation in Public Systems
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
GBD  Global Burden of Disease
FLV First Level Verification
FRU First Referral Unit
Hb Hemoglobin
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
JSSK Janani Shishu Suraksha Karyakram
JSY Janani Suraksha Yojana
LBW Low Birth Weight
L Form  IDSP Reporting Format for Laboratory Surveillance
MCTS  Mother and Child Tracking System
MCTFC  Mother and Child Tracking Facilitation Centre
MIS  Management Information System
MMR  Maternal Mortality Ratio
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  National Institution for Transforming India
iii
NMR Neonatal Mortality Rate
NQAS  National Quality Assurance Standards
OPV Oral Polio Vaccine
ORGI Office of the Registrar General and Census Commissioner, India
OOP Out-of-Pocket 
PCPNDT Pre-Conception and Pre-Natal Diagnostic Techniques
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
R Y Reference Year
SBR  Still Birth Rate
SC Sub-Centre
SDGs  Sustainable Development Goals
SDH  Sub-District Hospital
SLV Second Level Verification
SRB Sex Ratio at Birth
SRS  Sample Registration System
SN Staff Nurse
SNO State Nodal Officer
TA  Technical Assistance
TB  Tuberculosis
TERI The Energy Research Institute
TFR  Total Fertility Rate
U5MR  Under-Five Mortality Rate
USAID United States Agency for International Development
UTs Union Territories
iv