Bahujan Samaj Party President Mayawati on Thursday asked what use was the “double-engine” Bharatiya Janata Party government at the Centre and Uttar Pradesh if the state was the worst on the NITI Aayog’s Health Index. The NITI Aayog had released a report titled “Healthy States, Progressive India” on Tuesday.

“The NITI Aayog’s report is embarrassing for the government,” Mayawati tweeted. “So what use is such a double-engine BJP government at the Centre and the state? What use is such development if the lives of crores of people are totally hell?”

The Health Index of the report ranked Kerala the top performer in health, followed by Andhra Pradesh and Maharashtra, while Bihar and Uttar Pradesh were the worst performing states.

The index measured various indicators such as child mortality rates, sex ratios at birth, immunisation rates, proportion of people living with HIV/AIDS, notification of tuberculosis and health care facilities. It was prepared in collaboration with the Ministry of Health and Family Welfare and the World Bank.

The reference years for most indicators is 2017-’18 and the base years to gauge improvement are between one and three years before the reference year. The BJP came to power in Uttar Pradesh in March 2017, after five years of rule by the Samajwadi Party.

The ranking was done in three categories – larger states, smaller states and Union territories. Among the larger states, Kerala, with a score of 74.01, Andhra Pradesh (65.13), Maharashtra (63.99), Gujarat (63.52) and Punjab (63.01) were the best in overall performance, while Uttarakhand (40.2), Madhya Pradesh (38.39), Odisha (35.97), Bihar (32.11) and Uttar Pradesh (28.61) were the worst.

In terms of incremental performance in index scores from the base year to reference year, however, the top three ranked states were Haryana (up 6.55 points), Rajasthan (up 6.3 points) and Jharkhand (up 5.99 points). Bihar (down 6.35 points) and Uttar Pradesh (down 5.08 points) registered the biggest decrease.

Meanwhile, state Health Minister Sidharth Nath Singh said the report pertained to 2017 and the BJP had just come to power that year, The Hindu reported. “Some things take time to improve,” Singh said. “A mango tree gives mangoes four years after it is planted.”