Jaipur, 26 June: The Department of Medical Health and Family Welfare, Rajasthan launched “Missal” - the monthly district health rankings basis a balanced public health scorecard. This is an effort to strengthen the governance model of the state by transparent performance sharing with the districts and driving competition among the districts to improve delivery of public health services.


Additional Chief Secretary (Health), Mrs. Veenu Gupta and Mission Direction (NHM), Mr. Naveen Jain rolled out the first set of rankings basis districts performance in May 2018 in the district review conducted on 26th June 2018.Sikar emerged to be the best performing district followed by Ajmer and Sri Ganganar.Jhalawar, Dungarpur and Prataphgarh were identified as the bottom three districts. The leadership congratulated the respective district teams and nudged the low performing districts to take inspiration from the top performers and push themselves to improve delivery of health services and reporting of the services conducted.


In a first of its kind effort, the department devised a balanced public health scorecard by evaluating districts performance across outcome, intermediate outcome and inputs / process indicators. Outcomes such as neo natal mortality, SNCU survival rate, patient satisfaction etc. are assigned a weightage of 25%, intermediate outcomes such as ANC4 coverage, Institutional deliveries etc. are assigned a weightage of 55% and inputs / processes such as doctor attendance, medicine availability etc. are assigned a weightage of 20%. The department has decided to lay more emphasis on intermediate outcomes as they can be actioned by the field level health workers immediately before influencing actual health outcomes.

Performance of districts was also discussed by programs such as Maternal Health, Child Health, Water Borne diseases (Pneumonia, Diarrhea), Non-communicable diseases (Diabetes, Hypertension) etc. Categorizing districts into “Top, Middle and Bottom performers” provided a clear understanding to the district officers of their performance and compare it with the top performers in the state across indicators. To ensure the review is actionable for the districts, the blocks that are pulling down the district scores were highlighted as well. This helped identify trends of select facilities/blocks in a district that were pulling down a districts performance.


To drive the validity of reported data used to drive the rankings on an on-going basis, a facility inspection app “RajDharaa Survey” was also launched. The app will be used by district, block and facility level officers to conduct inspections and record inspection data from the PHCs and Sub-centers visited.


Going forward, the health department will issue the district health rankings every month basis the performance of the districts on the balance public health scorecard.The districts will be sent district performance packs and block performance packs to standardize district and block reviews. The monthly district health rankings will be made publicly accessible.