Bengaluru, (DHNS):Karnataka fares worse than its neighbours Kerala, Tamil Nadu and Goa in preventing collective premature deaths from 32 select diseases, including cancer, heart disease, TB and respiratory complications, said a global ranking released on Wednesday. Among 33 Indian states, Karnataka comes in the 16th position, with Kerala and Goa at the top and Assam and Uttar Pradesh at the bottom, according to the analysis by health researchers from India and other countries. The Healthcare Access and Quality (HAQ) Index has ranked India at 145th position out of 195 countries of the world.

The study, published in the journal Lancet, has measured HAQ by assessing capacities of countries and states to prevent deaths from a set of 32 infectious and non-communicable diseases. For seven countries, including the populous India and China, the report delves deeper to look into the performance of individual states. Karnataka's 16th position means the southern state needs to improve its healthcare delivery mechanism. Among the states, there is a vast difference in terms of healthcare access. Goa and Kerala had the highest scores (each exceeding 60 points in the index) whereas Assam and Uttar Pradesh got the lowest score as each of them fetched below 40 points in the index.

Karnataka's rank was 46.6 in the index – marginally better than Andhra Pradesh (45.5). What is even more worrying is the increasing gap between the best and worst performing states in India. There was a gap of 23 points between the best and worst performing states in 1990, which zoomed to a hiatus of nearly 31 points in 2016, illustrating how wide the disparity is among Indian states in providing healthcare access. India's overall ranking was 41.2 — up from 24.7 in 1990 and 28 in 2000. But the best-performing nations are much ahead. The five countries with the highest levels of healthcare access and quality in 2016 were Iceland (97.1 points), Norway (96.6), Netherlands (96.1), Luxembourg (96.0) and Finland and Australia (each with 95.9).

The 32 diseases used in the analysis include 10 communicable diseases, 21 non-communicable diseases and one injury. The ranking reflects on how many premature deaths of persons, aged between 0-74 years (with the exception of measles, diabetes and chronic respiratory troubles that strike early in life), were prevented because of access to healthcare. "These results emphasises on the urgent need to improve both access to and quality of healthcare, otherwise health systems could face widening gaps between the health services they provide and the disease burden in their population," said senior author of the study Rafael Lozano at Institute of Health Metrics and Evaluation at the University of Washington.

The results, Dandona said, were not unexpected. But the HAQ rank can be complementary to a Niti Ayog exercise in which states were categorised on the basis of their performance in the healthcare sector. "The future (Niti Ayog) approaches can be refined further on the basis of this computation," he added.