Despite his state mourning the deaths of scores of children in a hospital in his constituency less than two months ago, Uttar Pradesh Chief Minister Adityanath said on Wednesday that Kerala should learn how to run hospitals from Uttar Pradesh. The comment by the chief minister, known to his followers as Yogi, may have been noteworthy because of how soon it came after the Gorakhpur incident. But it is also remarkable considering how far behind Uttar Pradesh is compared to Kerala when it comes to healthcare.
“How to run hospitals, Kerala government should learn from Uttar Pradesh,” the chief minister said. This was in response to a comment from the ruling Communist Party of India (Marxist), which invited him to visit and learn from hospitals in Kerala. “In the last year, in Kerala, from dengue, there have been more than 300 deaths. Uttar Pradesh is such a big state, yet it had fewer deaths from dengue,” Adityanath said. “Many people have died from Chikungunya here, there hasn’t been a single Chikungunya death in Uttar Pradesh. These people are hiding the realities here.”
The specific comments regarding dengue and Chikungunya Fever may have some credence to them. Although Uttar Pradesh had a much higher rate of both in 2016, this year has been much worse for Kerala. It has had a higher number of deaths due to dengue than Uttar Pradesh, despite the huge difference in populations.
But Adityanath is spreading false information when he says “many have died due to Chikungunya” in Kerala. The Nation Vector Borne Disease Control Programme, which tracks this, has not found Chikungunya to be a cause of death in any case. Nevertheless, Adityanath is again accurate here in pointing out how bad 2017 has been for Kerala, at least in number of suspected Chikungunya fever cases.
But neither of those diseases is a good proxy for healthcare delivery. Indeed, those indicators say more about public sanitation and control of mosquitoes than about delivery of healthcare in the state. To draw conclusions about that one would need to look at broader indicators that are a better measure of the state’s ability to impact people’s health. On those measures, Uttar Pradesh trails not only Kerala, but every South Indian state, by a huge distance.
Take maternal mortality rate, which shows us how many mothers die per 1,00,000 live births. Uttar Pradesh is nearly five times worse than Kerala here.
Life expectancy is similarly instructive. A child born in Kerala today can expect to live, on average, 10 years more than one who is born in Uttar Pradesh – a huge difference.
Infant mortality rate measures the number of deaths per 1,000 live births for children up to the age of one. Here too the disparity is huge. In Kerala that number is just 10 per 1,000, while in Uttar Pradesh is 43. Yet again, Uttar Pradesh is far behind not just Kerala, but all the other South Indian states and the Indian average.
Another useful indicator of the state providing access to healthcare is how many people on average are served by one government allopathic doctor. Here too Kerala offers the most access to government doctors, with one doctor serving just 6,810 people on average, compared to nearly three times that in Uttar Pradesh.
It is arguable that Adityanath, having taken charge of Uttar Pradesh six months ago, has not had enough time to make an impact on broad health indicators and so cannot be measured on this account. But Kerala Chief Minister Pinarayi Vijayan also came to power just last May. Moreover, Adityanath explicitly says that Kerala should learn from Uttar Pradesh in how to deliver health care. On the basis of these figures, it seems evident that the opposite needs to happen.