THE HINDU Editorial Vocabulary- February 12, 2018 - Topic 1

States of health: On NITI Aayog’s first Health Index

Unsurprisingly, States with a record of investment in literacy, nutrition and primary health care have achieved high scores in NITI Aayog’s first Health Index. Kerala, Punjab, and Tamil Nadu are the best-performing large States, while Uttar Pradesh, Rajasthan, Bihar, Odisha and Madhya Pradesh bring up the rear.

 Health-care delivery is the responsibility of States; the Centre provides financial and policy support. Being able to meet the Sustainable Development Goals over the coming decade depends crucially on the States’ performance. Yet, health care is not a mainstream political issue in India, and hardly influences electoral results. The Index, with all its limitations given uneven data availability, hopes to make a difference here by encouraging a competitive approach for potentially better outcomes. For instance, with political will, it should be possible for Odisha to bring down its neonatal mortality rate, estimated to be the highest at 35 per thousand live births — worse than Uttar Pradesh. A dozen States with shameful under-five mortality rates of over 35 per 1,000 live births may feel the need for remedial programmes. What the Index shows for the better-performing States such as Kerala and Tamil Nadu is that their continuous improvements have, overall, left little room to notch up high incremental scores, but intra-State inequalities need to be addressed.

Coming soon after the announcement of a National Health Protection Scheme in the Union Budget, the Index uses metrics such as institutional deliveries, systematic reporting of tuberculosis, access to drugs for people with HIV/AIDS, immunisation levels and out-of-pocket expenditure. The twin imperatives are to improve access to facilities and treatments on these and other parameters, and raise the quality of data, including from the private sector, to enable rigorous assessments. At the same time, as NITI Aayog points out, data on other key aspects such as non-communicable diseases, mental health, governance systems and financial risk protection lack the integrity to form part of a good composite index. Both the Centre and the States have the responsibility to scale up their investment on health as a percentage of their budgets, to be more ambitious in interventions. While the NHPS may be able to address some of the financial risk associated with ill-health, it will take systematic improvements to preventive and primary care to achieve higher scores in the Index. As the experience from countries in the West and now even other developing economies shows, socialisation of medicine with a reliance on taxation to fund basic programmes is the bedrock of a good health system. If the NITI Aayog Health Index leads to a mainstreaming of health on these lines, that would be a positive outcome.

Vocabulary

Nutrition: the process of providing or obtaining the food necessary for health and growth.

Example: A guide to good nutrition

Synonyms: nourishment, nutriment, aliment, sustenance

Responsibility: the state or fact of having a duty to deal with something or of having control over someone.

Example: Women bear children and take responsibility for child care

Synonyms: authority, control, power, leadership

Antonyms: irresponsibility, irresponsibleness

Crucial: decisive or critical, especially in the success or failure of something.

Example: Negotiations were at a crucial stage

Synonyms: pivotal, critical, key, climacteric, decisive, deciding, life-and-death

Antonyms: immaterial, unimportant, noncrucial

Mainstream: belonging to or characteristic of the mainstream.

Example: Mainstream politics

Synonyms: normal, conventional, ordinary, orthodox, conformist, accepted

Approach: a way of dealing with something.

Example: We need a whole new approach to the job

Synonyms: method, procedure, technique, modus operandi

Shameful: worthy of or causing shame or disgrace.

Example: A shameful accusation

Synonyms: disgraceful, deplorable, despicable, contemptible, dishonorable

Antonyms: honourable, moral, honorable

Imperative: an essential or urgent thing.

Example: Free movement of labor was an economic imperative

Synonyms: absolute, arbitrary, arrogant, authoritative, autocratic

Antonyms: supplicatory, petitionary, importunate, pleading

Rigorous: extremely thorough, exhaustive, or accurate.

Example: The rigorous testing of consumer products

Synonyms: meticulous, conscientious, punctilious, careful, diligent

Antonyms: undemanding, inexact

Ambitious: having or showing a strong desire and determination to succeed.

Example: His mother was hard-working and ambitious for her four children

Synonyms: aspiring, determined, forceful, pushy, enterprising, motivated

Antonyms: shiftless, easy, unambitious, ambitionless

Preventive: designed to keep something undesirable such as illness, harm, or accidents from occurring.

Example: Preventive medicine

Synonyms: preemptive, deterrent, precautionary, protective; prophylactic

Antonyms: bailable, unhealthful, permissive

Mainstream: belonging to or characteristic of the mainstream.

Example: Mainstream politics

Synonyms: normal, conventional, ordinary, orthodox, conformist