The Health sector is a critical aspect of good governance – it is directly reflective of the state of administrative efficiency and the quality of life and safety assured to the citizens. Projects in the Health sector range from national and state missions and immunisation drives to the use of Information Technology for development of healthcare infrastructure. Over the last two years, with both the immediate crisis of the pandemic and subsequently, the world coming to grips with the reality of living with Covid-19 long-term, the Health sector has been one of the most-discussed aspects of governance, public interest and policy. For 2021, the SKOCH State of Governance analysis has studied the work done in the Health sector by various state administrations. State/UT-wise performance in a sector is a reliable indicator of administrative priorities in a given year.
State Rankings in Health Sector 2021
The top spot for 2021 in the Health Sector goes to Kerala. The state has made progress on its Health sector performance over the two years prior, moving up from the #7 rank in 2019 to #6 in 2020 before jumping up five spots to #1 in 2021. The Digitization of ASHA Programme and Kerala Model Transformation of Urban Primary Health Centers in Malappuram by the National Health Mission, Malappuram and e-Health Kerala by the eHealth Kerala Society have helped Kerala ascertain its position. Susmrutham by Government Ayurveda Research Institute for Mental Diseases is one of the most impactful Health sector projects in 2021. The second spot in the Health sector for 2021 has been awarded to Madhya Pradesh. The state has shown tremendous improvement in the sector in recent times. It was #10 for the same in 2019 before falling to being unranked in 2020 because of no participation. Vaidhya Aapke Dwar (Telemedicine app AyushQure) by the Department of Ayush, Government of Madhya Pradesh, is a highly impactful project in the sector. Haryana is the #3 state for Health in 2021. The ranking represents a minor decline, as the state falls from #1 for the sector in 2020. Haryana ranked #4 in Health in 2019. It continues to feature in the Top 5 for the Health sector over a period of time, proving that the sector remains a top priority for the state government. Ayushman Bharat Haryana Health Protection Mission, Civil Hospital Jind and COVID-19 Management and Its Preparation are important contributions to the Health sector by Haryana. Karnataka ties for third place in the Health sector with Haryana for 2021. The state falls by one spot, from the #2 rank for Health in 2020. However, it continues to feature in the Top 3, which shows commitment to the sector as Karnataka was ranked #9 for the same in 2019. The Department Of Health & Family Welfare Services, Karnataka, is credited with three important projects: the Karnataka State Holistic Empowering-programme For Mental Ailments (kshema), Comprehensive Mental Health Care In Karnataka and the National Tuberculosis Elimination Mission Supplemented by Ayushman Bharat Arogya Karnataka in the State of Karnataka. The Union Territory of Chandigarh has ranked #4 for the Health sector in 2021. This marks a definite trend of improvement as the UT was marked #8 for the same in 2019 before falling to being unmarked in 2020. As such, Chandigarh has both returned to robust participation and improved upon its previous ranked performance. The Hub and Spoke Model for Free-Diagnostic Services by National Health Mission UT Chandigarh is the UT’s contribution to the sector. Delhi also ranks #4 for the sector in 2021, for the second year in a row. The performance in 2020 and 2021 is defined by an improvement of one spot, from the #5 rank in 2019. Swami Dayanand Hospital has done important work in the field. Gujarat ties for the #4 rank in Health in 2021, improving from #8 in 2020. The state was the highest-ranking state for the sector in 2019 before falling seven places but its most recent performance may herald a turning tide. The work done by the State Nodal Agency, Gujarat, with MDIndia Health Insurance TPA Pvt. Ltd. under the Mukhyamantri Amrutum Yojana is behind Gujarat’s improved performance in 2021. Himachal Pradesh joins the others at the #4 rank, improving on its previous years’ performance. The state was ranked #7 for the Health sector in 2020 and #10 for it in 2019. The state’s Health & Family Welfare Department has worked for the Implementation of e-Office in National Health Mission in Himachal Pradesh. The Union Territory of Jammu & Kashmir joins the others at the #4 rank in 2021, after going unranked for the sector in 2020 and being ranked #11 for it in 2019. The Directorate of Health Services, Government of Jammu & Kashmir, is recognised for the Containment & Mitigation of Covid-19 Pandemic in Kashmir Division. Uttar Pradesh also comes in fourth place for the Health sector in 2021. This is an improvement of five places from the rank of #9 in 2020. The state also ranked #5 in Health in 2019. The Blended Learning Model to Ensure Availability of Community Health Officers for Operationalizing Ayushman Bharat Health and Wellness Centers by the National Health Mission, Uttar Pradesh, is an important Health sector project in 2021.
Highly Impactful Health Projects in 2021
Two notably impactful projects, already mentioned above, have come out of the Health sector in 2021. These have made a discernible difference in the lives of their intended beneficiaries and have set a higher standard The first project is Susmrutham by the Government Ayurveda Research Institute for Mental Diseases in Kottakkal, Kerala. The project builds on the potential of alternative and complementary medicine for tackling the onset of Mild Cognitive Impairment with a view to preventing further deterioration and dementia and improving quality of life for those living with MCI. In Phase I of the programme, ASHA workers were trained. In Phase II, medication was dispensed along with a primary evaluation, followed by an evaluation at three months and one year to map response and progress. The other project featured herein is Vaidhya Aapke Dwar (Telemedicine app AyushQure) by the Department of Ayush, Government of Madhya Pradesh, in Bhopal. The project was developed in response to the challenges faced because of the Covid-19 crisis: the unavailability of doctors, restrictions on movement, resource diversion in favour of Covid-19 requirements and the many personal financial hardships making it difficult to seek proper healthcare. The bi-lingual platform (English and Hindi) offered online consultation with doctors and free consults with government doctors to ensure people received medical attention despite the many roadblocks created by the pandemic.
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