The NITI Aayog Health Index (officially known as “Healthy States, Progressive India”) is a critical tool for promoting “Competitive and Cooperative Federalism” in India.
Objectives of the Index
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- Evidence-Based Policy: To move health governance toward data-driven decision-making.
- Competitive Federalism: To foster healthy competition among States by ranking them publicly.
- Incremental Progress: To incentivize states that show improvement year-on-year, even if their baseline is low.
Structure and Indicators
The Index is a weighted composite score based on 24 indicators grouped into three broad domains:
| Domain | Weightage | Key Indicators |
|---|---|---|
| Health Outcomes | 70% | Neonatal Mortality Rate (NMR), TFR, Sex Ratio at Birth, TB notification rate, HIV treatment. |
| Governance & Information | 12% | Tenure of key health officials (DHs), data integrity, institutional delivery rates. |
| Key Inputs/Processes | 18% | Shortage of specialists at DHs/CHCs, functional PHCs, birth registration, healthcare worker vacancies. |
Latest Rankings (2025–2026 Edition)
In the most recent reports released in March 2026, the states were categorized into Achievers, Front Runners, Performers, and Aspirational.
Larger States
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- Top Performers (Achievers): Kerala continues to lead the index, followed by Tamil Nadu and Telangana.
- Most Improved (Incremental): Uttar Pradesh and Assam have consistently shown the highest incremental progress from their baseline scores.
- Bottom Performers: Bihar and Madhya Pradesh remain in the Aspirational category due to high mortality rates and specialist shortages.
Smaller States
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- Top Rankers: Mizoram and Tripura are the leaders among smaller states.
Union Territories
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- Top Ranker: Chandigarh and Dadra & Nagar Haveli and Daman & Diu lead the UT category.
Note on “Fiscal Health Index”: In early 2026, NITI Aayog also released a separate Fiscal Health Index, where states like Odisha and Goa topped, focusing on expenditure quality and debt management. Do not confuse this with the “Health (Medical) Index.”
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