Uttar Pradesh, which holds assembly elections next year, has once again figured at the bottom of the 19 states in the Niti Aayog's health index for 2019-20 released Monday.

       Kerala, Tamil Nadu and Telangana have emerged as the top three states in rankings, which refer to the period before the coronavirus pandemic struck the country. They show that though UP figures at the bottom of the heap in overall performance, it is the best state showing highest incremental performance between 2018-19 and 2019-20.

       “The Health Index Round for 2019-20 does not capture the impact of COVID-19 on health outcomes or any of the other indicators as the Index Performance relates to Base Year (2018-19) and Reference Year (2019-20), largely the pre-COVID-19 period,” said the report containing the rankings.

       In rankings for 2018-19, UP was at the bottom and Kerala at the top in overall performance.

       The index is a weighted composite score incorporating 24 indicators on health performance largely in three domains of a) Health Outcomes; (b) Governance and Information; and (c) Key Inputs and Processes.

       The indicators are selected from existing data sources such as the Sample Registration System (SRS), Civil Registration System (CRS) and Health Management Information Systems (HMIS).

       For generation of ranks, to ensure comparability among entities, the states are classified into three categories (Larger States, Smaller States and UTs) in the index.

       Though Kerala and Tamil Nadu were the top two states in terms of overall performance, they ranked twelfth and eight when it came to incremental improvement in performance.

       Telangana performed well both in terms of overall performance as well as incremental performance and secured the third position in both instances.

       For the fourth consecutive time, Kerala emerged as the best performer in terms of overall performance.

       The index also showed that among the smaller states, Mizoram emerged as the best performer in Overall Performance as well as Incremental Performance while among UTs, Delhi and Jammu and Kashmir ranked among the bottom UTs in terms of Overall Performance but emerged as the leading performer in terms Incremental Performance.

       The index also showed that the gap in the Overall Performance between the best and the worst performing larger states and UTs narrowed in the current round of the Health Index, while it increased for the smaller states.