Furthering the agenda for cooperative federalism, NITI Aayog has launched SATH, a program providing ‘Sustainable Action for Transforming Human capital’ with the State Governments. The vision of the program is to initiate transformation in the education and health sectors. The program addresses the need expressed by many states for technical support from NITI .

SATH aims to identify and build three future ‘role model’ states for health systems. NITI will work in close collaboration with their state machinery to design a robust roadmap of intervention, develop a program governance structure, set up monitoring and tracking mechanisms, hand-hold state institutions through the execution stage and provide support on a range of institutional measures to achieve the end objectives. The program will be implemented by NITI along with McKinsey & Company and IPE Global consortium, who were selected through a competitive bidding process.

To select the three model states, NITI defined a three-stage process – expression of interest, presentations by the states and assessment of commitment to health sector reforms. NITI invited all states and UTs to participate in the program. Sixteen states expressed prima facie interest, of which fourteen made their presentations. Andhra Pradesh, Assam, Bihar, Chandigarh, Goa, Gujarat, Haryana, Jharkhand, Karnataka, Madhya Pradesh, Odisha, Punjab, Telangana and Uttar Pradesh presented their project proposal to a Committee headed by Member of NITI Aayog, Shri Bibek Debroy and comprising of CEO, Amitabh Kant as well as a representative from the Ministry of Health and Family Welfare.

Of these fourteen states, five have been shortlisted. Subsequently, three will be selected on the basis of further evaluations and objective assessment of criteria affecting the potential for impact and likelihood of success. Metrics such as MMR, IMR, incidence of malaria and others have been considered for determining potential impact while density of doctors and nurses, compliance to IPHS norms are some of the metrics used to determine likelihood of success. The program will be launched in the three selected states after the signing of MoUs.

Cooperative federalism partnership expands technical assistance to states for health system reform, formalised through MoUs and objective selection. SATH creates a state-center partnership under cooperative federalism for technical assistance and institutional strengthening in health and education, to be implemented with competitively procured partners and formalised through MoUs. States are selected through a three stage process-expression of interest, presentations, and commitment assessment-using impact metrics (maternal and infant mortality, disease incidence) and capacity metrics (health workforce density, facility norm compliance) to determine potential for impact and likelihood of success, with NITI providing governance design, monitoring and execution support.