What determines performance gap index of health care in Gujarat?

Abstract

The health performance of Gujarat viewed in terms of the Human Development Index (HDI) portrays it as a medium performer in the country. However, the index of health component for Gujarat is found to be positively contributing to the HDI ranking of the state. It is, therefore, crucial to review the status of health performance of Gujarat among the other states for improving its relative standing in human development. In this context, the present article attempts to identify the gaps in performance of the health-related outcome, output and input indicators from the best performers in each indicator. Moreover, the article also reviews the trends in health performance of Gujarat over time and also estimates the effectiveness of the state in converting its health inputs to outputs and outputs to outcomes. The results indicate that the outcome indicators have improved in the absolute sense but have high performance gaps except the maternal mortality rate (MMR). Majority of the output and input indicators, however, show poor absolute performance and high performance gaps that have been expanding over time. The effectiveness of conversion of health indicators in Gujarat suggests that while the state has moved above average in conversion of outputs to outcomes, it has moved at a slightly below-average level in converting its inputs to outputs over time. Improving the health status of Gujarat requires targeted efforts in specific areas such as controlling neonatal deaths, improving coverage of children under immunization and addressing malnourishment. Additionally, building adequate health infrastructure and employing the required manpower are also relevant.