Efficiency of Health System in Four States of India : A District Level Analysis

By : Nutan Shashi Tigga, S. Irudaya Rajan

Page No: 9-23

Abstract
India has undoubtedly made impressive improvements in the health system since early independence. These can be validated from the impressive results witnessed in reducing mortality and increasing life expectancy rates which are often celebrated about. The national figures though ascertain huge improvements; but the state-level figures are quite disheartening. There exist stark inequalities across states; for instance, states like Kerala and Tamil Nadu have mortality rates lower than the national average in contrast to states like Madhya Pradesh, Bihar and Odisha. Given this scenario, the present study attempts to analyse the health system of four states of India—Kerala, Tamil Nadu, Madhya Pradesh and Odisha. The study uses a non-parametric approach, Data Envelopment Analysis (DEA), to assess and compare the health system across the districts of these four states. This exercise would enable us to identify those districts whose health systems are performing under the mark. The study limits to three outputs and two inputs for 116 districts of India. It was found that of the 116 districts, 13 per cent were technically efficient, having an efficiency score of 1.00, while the remaining 87 per cent districts were technically inefficient. Undoubtedly, Kerala and Tamil Nadu stand to be the most efficient states, with almost all of its districts having an efficiency score of 1.0 or close. Bhopal district has been identified as a peer for many inefficient districts, following which these inefficient districts could move towards the efficiency frontier.

Authors :
Nutan Shashi Tigga : Doctoral Fellow, Center for Development Studies, Trivandrum,
S. Irudaya Rajan : Professor at the Centre for Development Studies, Trivandrum.