While southern states top NITI’s health index, inadequate pandemic pivot likely eroded nationwide gains. Critically analyse core bottlenecks and strategic reforms needed.

Kerala, Tamil Nadu lead NITI health rankings based on governance, access beyond just facilities; Karnataka slipped while UP showed progress from low base. But COVID diverted focus from rising non-communicable diseases, mental health issues. Pandemic exposed systemic bottlenecks like poor surveillance infrastructure, lack of medics in rural regions, low testing capacity especially in BIMARU states.

• Core issues include significant shortage of grassroot health workers catering to remote villages, lack of decision making powers at local levels affecting last-mile service delivery. For example, Bihar has just 48% of required sub-centers while Jharkhand operates at 12% doctor vacancy with rural healthcare suffering the most.
• Need strategic reforms via boosting recruitment of village-level health workers on urgent priority, decentralizing healthcare decision making powers to district and block levels empowering local officers for needs-based infrastructure upgrades.
• Additional investments by center and states required in health infrastructure upgrades conforming to ICMR standards for sub-center clinics, primary health centers catering last-mile access. Improved state-center coordination critical for effective rollout of National Digital Health Mission, TB elimination programs through real-time data analytics, patient tracking and personalized consultation leveraging technology.

Alongside boosting pandemic preparedness, dedicated focus on rising burden of non-communicable diseases through early screening programs, mental wellness campaigns and affordable medicare access to be institutionalized within decentralized health policy framework.

Topics: GS-II: Social Sector Services Education Human Resources