Skip to navigationSkip to content
A WORLD APART

What makes infant deaths five times as likely in Uttar Pradesh than in Kerala?

uttar-pradesh-kerala-health-infant-niti
REUTERS/Vivek Prakash
Many states, many fates.
By Kuwar Singh
Published Last updated This article is more than 2 years old.

A staggering divide exists between India’s best and worst states in public health.

Healthcare in the southern state of Kerala is more than twice as good as it is in the northern state of Uttar Pradesh, according to a new report by the government think tank NITI Aayog.

The difference is stark when it comes to infant deaths, five times as likely in Uttar Pradesh than in Kerala.

The report also points to the reasons that contribute to this divide.

Almost half of all childbirths in Uttar Pradesh in financial year 2016 did not take place at a health institution, while nearly all babies in Kerala were delivered under the care of professionals. Additionally, far more number of expecting mothers in Kerala enrol for early pregnancy care during their first trimester.

Out-of-pocket expenses during infant delivery at a public health facility are also more than three times as much in Kerala than in Uttar Pradesh. This correlates with a similar difference in the two states’ per capita income.

Health-related data from multiple official sources in Uttar Pradesh suffers from a large discrepancy of 36.6%, while in Kerala the deviation is only 3%, the report adds.

On most other health parameters, too, Kerala outperforms Uttar Pradesh.

Deaths of children under the age of 5 for every 1000 live births
13
51
Girls born for every 1000 boys born
967
879
Average out-of-pocket expenses in infant delivery at a public health facility
Rs6,901
Rs1,956
Vaccine coverage among infants
94.6%
84.8%
Birth registrations
100%
68.3%
Share of people living with HIV who have been enrolled in antiretroviral therapy
66.7%
57.8%
Overall health score out of 100
76.55
33.69

However, Uttar Pradesh fares significantly better than Kerala when it comes to the tenure of key state-level bureaucrats—principal secretary to government, director of national health mission, director of health services—and the top district-level public health official.

State governments have the power to transfer these officials from one role or station to another. “A stable tenure for key administrative positions is very critical for effective implementation of the programs,” the report says.

📬 A periodic dispatch from the annual session of the United Nations General Assembly in NYC.

By providing your email, you agree to the Quartz Privacy Policy.