Meena Sehgal

Developing a women’s health index is particularly important in the Indian context due to the pronounced disparities in women’s health across various social, economic, and geographical segments. This paper focuses on the development and validation of a comprehensive Women’s Health Index (WHI) for India. In contrast to previous efforts that predominantly focused on indicators related to pregnancy, childbirth, and the postpartum period, often limited to reproductive or maternal health services, our index adopts a multi-dimensional approach. The WHI comprises 17 variables, representing life stages of women and encompassing a diverse range of factors. Utilizing Principal Component Analysis, we computed the index and conducted statistical tests for internal and external validation. The spatial pattern of WHI reveals substantial inter-district and inter-state disparities. This study thus provides a valuable tool for characterizing women’s health and identifying health inequalities at a smaller administrative level in India.

This paper presents the development, testing, and spatial variation of an innovative India Health Index. Unlike previous approaches that focused on specific health aspects (e.g., health resources, child health, or health coverage), our index takes a comprehensive and multi-dimensional approach. It covers indicators across various life stages: child, adolescent, and adult. It encompasses six domains influencing health: socio-cultural factors, health status, health determinants (both risk and protective factors), household environment, and health system and policy. We used data from the latest round of the National Family Health Survey and employed Principal Component Analysis for constructing the India Health Index. Subsequent statistical tests confirmed its internal reliability and construct validity. External validity was indicated by its association with under-five mortality rates, and the sub-national human development index for India. Spatial analyses revealed significant inter-district and inter-state variation in India Health Index scores. The findings underscore the utility of the India Health Index as a measurement tool and its potential for tracking progress and policy intervention for improving health equity in India.

While developing a child health index is of interest, it is particularly important in the Indian context, because of a high burden of poor child health, the disparities in child health between different social, economic, and geographical regions and the absence of such a comprehensive index. This paper focuses on the development and validation of a Child Health Index (CHI) for India. Using publicly available data at the district level and principal component analysis, this index is composed of 16 variables representing six domains namely socio-cultural, child health status, determinants of child health (both risk and protective factors), household environment and health system and policy. Several statistical tests were conducted to provide internal and external validation. The application to predict child mortality confirmed its validation. This study thus provides a new tool for characterising child health and detecting child health inequalities at a district level in India. Consequently, it can be used by policymakers, health service providers and other stakeholders involved in child welfare to monitor and improve child health over time and space.

The composite indices have been widely used in different fields and different settings to measure and quantify a variety of multidimensional and complex concepts into a single construct. While many composite health indices are produced and applied in developed countries, there are relatively few studies for developing countries, and even considerably less in Asia. However, the indicators of health relevant in high-income countries will not be suitable for use in developing countries such as India due to differences in health system characteristics, differences in disease patterns, and data availability and quality. Therefore, it is important to consider the specific context and characteristics of a country when developing a composite health index to ensure its relevance and usefulness for policy and decision-making. In this paper, we review published studies on the multidimensional composite health indices in India, specifically focussing on the purpose of the index, the indicators chosen to represent population health, methods used in the calculation of the indices, geographical level of aggregation, sources of data, the application and validation of index. While doing so, we also assessed the policy or practical relevance of such indices.