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Ahs dlfs 16072012-final Ahs dlfs 16072012-final Presentation Transcript

  • ANNUAL HEALTH SURVEY FACT SHEET KEY FINDINGS Dr. C. ChandramouliRegistrar General & Census Commissioner, India
  • “ Reproductive health and rights are integral tosustainable development and poverty reduction.Investing in universal access to reproductive health iscrucial investment in healthy societies and a moresustainable future”.– Ban Ki-moon, Secretary-General, UN on World Population Day, 2012
  • “ Working for the survival and the well being of women andgirls is a human right imperative. And in order to takeadvantage of women’s full potential in the development oftheir nations, they must be able to plan their lives andfamilies.”– Babatunde Osotimehin, Executive Director, UNFPA on World Population Day, 2012
  • AHS provides key indicators on Reproductive and Child Health at District level in 8 EAG States and AssamVital inputs for evidence based intervention and monitoring
  • “ There should be an Annual Health Survey of alldistricts which could be published/monitored andcompared against benchmarks”-Dr. Manmohan Singh, Prime Minister of India – In the meetingof National Commission of Population, 2005
  • OBJECTIVE OF AHS AHS yields a comprehensive, representative and reliable dataset on core vital indicators including composite ones like IMR, MMR and TFR along with their co-variates (process and outcome indicators) at the district level and maps changes therein on an annual basis. These benchmarks would help in better and holistic understanding and timely monitoring of various determinants on well-being and health of population particularly Reproductive and Child Health.
  • Coverage : Annual Health Survey Uttarakhand Uttar Pradesh Rajasthan Assam Bihar Madhya Pradesh Jharkhand Chhattisgarh Odisha
  • WHY AHS?o AHS States constitute: ● 48 percent of country’s Population ● 59 percent of Births ● 70 percent of Infant Deaths ● 75 percent of Under 5 Deaths ● 62 percent of Maternal Deathso Enable direct monitoring of UN Millennium Development Goals on Child Mortality and Maternal Health at the district(s) level.o Help in identifying high focus districts meriting special attention in view of stark inter-district variations in these States.o Provide critical inputs to assess the milestones of various interventions including NRHM and pave the way for evidence based planning.
  • KEY FEATURESCoverage- All the 284 districts of 8 EAG States and Assam.Sample Units- 20,694 statistically selected sample unit (Census Enumeration Blocks in urban areas and Villages or a part thereof in rural areas)Sample Identification Work- to uniquely identify the sample units on ground, firm up its boundaries, demarcate the localities and prepare a notional map of the sample unit was done by the staff of ORGI.Sample Units per district- 73.Sample Population- About 20.1 million The Largest Sample Survey in the World
  • KEY FEATURES Contd… Sample Population per district - About 71 thousand. Sample Households - 4.1 million households. Sample households per district - About 14.5 thousand. Conduct of Field Work - hybrid approach wherein fieldwork has been outsourced and supervision is being done by the ORGI. Primary Level of Aggregation – District Periodicity- Annual
  • Indicators under AHS •In all, 161 indicators are available from AHS baseline: Fertility- 13  Sex Ratio- 3 Marriage- 5  Mortality- 7 Mother & Child Care- 63 Ante Natal Care: 11  Delivery Care: 8 Post Natal Care: 5  Janani Suraksha Yojana (JSY): 3 Immunization: 8  Vitamin A & Iron Supplements: 2 Birth Weight: 2  Childhood Disease: 6 Birth Registration: 2  Breastfeeding & Supplementation: 12 Awareness in Mothers: 4 Abortion- 6  Family Planning Practices- 15 Disability- 1  Morbidity- 19 Personal Habits:adults-4  Housing & HH Characteristics- 13 Others- 12
  • Indicators under AHS Contd… Under 1st phase of AHS following 9 indicators have already been released:  Crude Birth Rate (CBR)  Crude Death Rate (CDR)  Infant Mortality Rate (IMR)  Neo-Natal Mortality Rate (NNMR)  Under Five Mortality Rate (U5MR)  Maternal Mortality Ratio (MMR)  Sex Ratio at Birth (SRB)  Sex Ratio (0-4 years) and  Sex Ratio (All ages) Remaining 152 indicators are being released under present phase of dissemination.
  • Five Core Themes Covered• The presentation focuses on results pertaining to 5 core themes:  Total Fertility Rate  Family Planning: Current Usage & Total Unmet Need  Ante Natal Care  Delivery & Post Natal Care  Immunization and Breast Feeding Practices
  • Total Fertility Rate (TFR)• TFR is the average number of children born to a woman during her entire reproductive span. Total Fertility Rate Total Rural Urban 4 3.5 3 3.87 2.5 3.9 3.74 3.58 3.55 3.42 3.19 3.3 3.15 3.07 3.1 2.89 2 2.77 2.68 2.7 2.55 2.6 2.42 2.41 2.33 2.4 2.4 2.3 2.3 1.95 1.5 1.9 2 1 Uttarakhand Odisha Assam Chhattisgarh Jharkhand Madhya Pradesh Rajasthan Uttar Pradesh Bihar• Uttarakhand & Odisha and UP & Bihar reflects the two extremes.• Significant Rural-Urban variation across all 9 AHS States, the max. in Uttar Pradesh.
  • Total Fertility Rate (TFR) Contd… Total Fertility Rate (TFR) State State value Minimum Maximum RangeAssam 2.6 Kamrup (2) Hailakandi (4.2) 2.2Bihar 3.7 Patna (2.8) Sheohar (4.7) 1.9Jharkhand 3.1 Purbi Singhbhum (2.4) Lohardagga (4) 1.6Madhya Pradesh 3.1 Indore (2.2) Shivpuri (4.5) 2.3Chhattisgarh 2.9 Koriya (2.4) Kawardha (3.7) 1.3Odisha 2.3 Jharsuguda (2) Boudh (3.7) 1.7Rajasthan 3.2 Kota (2.6) Barmer (4.7) 2.1Uttar Pradesh 3.6 Kanpur Nagar (2.3) Shrawasti (5.9) 3.6Uttarakhand 2.3 Pithoragarh (1.7) Haridwar (3.1) 1.4 Within a State, the minimum variability of 1.3 reported in Chhattisgarh and the maximum, 3.6 in Uttar Pradesh. Across 284 districts in 9 AHS States, it ranges from 1.7 in Pitthoragarh (Uttarakhand) to 5.9 in Shrawasti (UP)- a variability of more than 4 children.
  • Total Fertility Rate (TFR) Contd… Frequency distribution of districts by level of Total Fertility Rate State 0-2.1 2.2-3.0 3.1-4.0 4.1 & above Total Districts Assam 3 16 3 1 23 Bihar 0 1 26 10 37 Chhattisgarh 0 12 4 0 16 Jharkhand 0 8 10 0 18 Madhya Pradesh 0 15 25 5 45 Odisha 10 18 2 0 30 Rajasthan 0 16 13 3 32 Uttar Pradesh 0 9 48 13 70 Uttarakhand 7 5 1 0 13 All States 20 100 132 32 284● 20 districts namely Kamrup, NC Hills, Nalbari (Assam); Puri, Khordha, Angul, Jajpur, Jagatsinghpur, Baleshwar, Sundargarh, Doegarh, Jharsugdha, Bargarh (Odisha); Nainital, Almora, Bageshwar, Pitthoragarh, Rudraprayag, Chamoli, Uttarkashi (Uttarakhand) have already achieved the replacement level of 2.1.● 46 districts have TFR below the current National average of 2.5 (SRS 2010).●● 164 districts have recorded TFR of 3.1 and above, the National level TFR of 2001 (SRS).
  • Total Fertility Rate (TFR) Contd…
  • Family Planning: Current Usage ● Contraceptive Prevalence Rate (CPR) is the percentage of currently married women aged 15-49 yrs who are using any method of contraception (modern/traditional). Current Usage- any method (%) Total Rural Urban706050 69 66 65 64 63 63 63 62 61 6140 60 58 58 58 58 57 56 55 54 53 50 50 48 48 4430 38 3620 Bihar Jharkhand Uttar Pradesh Chhattisgarh Odisha Assam Madhya Pradesh Uttarakhand Rajasthan● Current usage of any method varies from 37.6 in Bihar to 64.5 per cent in Rajasthan.● Rural – Urban divide is significant in Jharkhand and Bihar.
  • Family Planning: Current Usage Contd… Current Usage of Family Planning- any Method (%) State State value Minimum Maximum RangeAssam 57.9 Dhubri (33.2) Lakhimpur (67.6) 34.4Bihar 37.6 Siwan (26) Muzaffarpur (52.2) 26.2Jharkhand 47.8 Paschimi Singhbhum (32.7) Dhanbad (61.9) 29.3Madhya Pradesh 61.2 Sidhi (45.9) Damoh (74.9) 29.0Chhattisgarh 53.9 Dantewada (33.4) Dhamtari (68.7) 35.2Odisha 56.2 Kandhamal (28.6) Baleshwar (73.4) 44.8Rajasthan 64.5 Dhaulpur (49) Ganganagar (79.2) 30.2Uttar Pradesh 49.9 Sitapur (21.9) Jhansi (74.1) 52.2Uttarakhand 62.7 Haridwar (53.7) Dehradun (67.1) 13.4 Within a State, the least variation is reported in Uttarakhand whereas the most, in Uttar Pradesh. At district level, current usage of family planning ranges from 21.9 in Sitapur (UP) to 79.2 in Ganganagar (Rajasthan) exhibiting a variability of 4 times.
  • Family Planning: Current Usage Contd… Frequency distribution of districts by current usage of family planning- any method (%) State 0-30 30-50 50-70 70 & above Total Districts Assam 0 3 20 0 23 Bihar 4 31 2 0 37 Chhattisgarh 0 7 9 0 16 Jharkhand 0 13 5 0 18 Madhya Pradesh 0 2 40 3 45 Odisha 1 9 19 1 30 Rajasthan 0 1 24 7 32 Uttar Pradesh 3 24 42 1 70 Uttarakhand 0 0 13 0 13 All States 8 90 174 12 284 As high as 98 districts are reporting less than 50% current usage of any method of family planning. Only 12 districts namely Damoh, Betul, Jabalpur (MP), Baleshwar (Odisha), Ganganagar, Hanumangarh, Jhunjhunu, Alwar, Udaipur, Dungarpur, Banswara (Rajasthan) and Jhansi (UP) feature in 70% & above category. 35 out of 37 districts of Bihar have reported less than 50% usage of any method of family planning.
  • Family Planning: Current Usage Contd…
  • Family Planning: Current Usage Contd… Share of sterilization in any modern method of family planning (%) Assam Uttar Pradesh Jharkhand Bihar Odisha Uttarakhand Rajasthan Chhattisgarh Madhya PradeshFemale 35.3 55.0 76.3 86.7 68.4 58.7 76.7 92.3 83.6Male 0.6 0.6 1.2 0.9 0.7 2.8 0.7 2.0 1.7
  • Unmet Need for Family Planning  Currently Married Women who are not using any method of contraception but who do not want any more children or want after a period of 2 years are defined as having an unmet need. 45 Unmet Need for Family Planning (%) Total Rural Urban 40 35 30 40.6 39.2 25 33.64 31.53 30.48 29.72 27.13 20 30 26.38 24.96 24.69 23.99 23.67 23.52 23.27 23.22 23.16 22.38 23.2 21.66 20.55 20.46 21.5 19.58 19.56 19.48 16.94 15 10 Rajasthan Madhya Pradesh Uttarakhand Odisha Assam Chhattisgarh Uttar Pradesh Jharkhand Bihar Total unmet need varies from a minimum of 19.6% in Rajasthan to 39.2% in Bihar. Rural- Urban gap is prominent in Jharkhand, Bihar and Uttar Pradesh. Unmet need for Family Planning is a crucial indicator for assessing the future demand for Family Planning services / supplies.
  • Unmet Need for Family Planning Contd… Total unmet need for Family Planning(%) State State value Minimum Maximum value RangeAssam 24.0 Sibsagar (15.3) Dhubri (42.9) 27.6Bihar 39.2 Patna (24.6) Kishanganj (52.5) 27.9Jharkhand 30.5 Bokaro (18.2) Godda (42.8) 24.6Madhya Pradesh 22.4 Jabalpur (14.3) Rewa (34.2) 19.9Chhattisgarh 26.4 Dhamtari (14.5) Bastar (36) 21.5Odisha 23.2 Baleshwar (6.1) Boudh (48.3) 42.3Rajasthan 19.6 Ganganagar (10.0) Dhaulpur (32.4) 22.3Uttar Pradesh 29.7 Mahoba (15.1) Sitapur (61.3) 46.3Uttarakhand 23.2 Dehradun (16.8) Haridwar (29.2) 12.4 The minimum variability within a State is in Uttarakhand whereas the maximum in Uttar Pradesh. Baleshwar (6.1%) in Odisha and Sitapur (61.3%) in Uttar Pradesh are the two extremes across 284 districts.
  • Unmet Need for Family Planning Contd… Frequency distribution of districts by total unmet need for family planning (%) State 0-20 20-40 40-60 60 & above Total DistrictsAssam 6 16 1 0 23Bihar 0 20 17 0 37Chhattisgarh 4 12 0 0 16Jharkhand 2 13 3 0 18Madhya Pradesh 18 27 0 0 45Odisha 12 15 3 0 30Rajasthan 16 16 0 0 32Uttar Pradesh 9 52 8 1 70Uttarakhand 2 11 0 0 13All States 69 182 32 1 284 Only in 69 out of 284 districts, the total unmet need for family planning is below 20%. Bihar and Uttar Pradesh dominate in 40% & above category.
  • Mean Age at Marriage- Female Mean Age at Marriage is based on the marriages taken place during 2007-2009.25 Mean Age at Marriage- Female Total Rural Urban 23 23 23 22 22 22 22 22 22 22 22 22 21 21 21 21 21 21 21 21 20 20 20 20 20 2020 1915 Rajasthan Bihar Jharkhand Madhya Pradesh Chhattisgarh Uttar Pradesh Odisha Assam Uttarakhand Mean age at marriage of females varies from 19.7 in Rajasthan to 22.0 years in Uttarakhand. Rural – Urban differential is of at least 1.4 years in all AHS States. This is quite prominent (2.3 years) in Madhya Pradesh & Rajasthan.
  • Marriages among Females below Legal Age (18 yrs) Based on marriages taken place during 2007-2009. Marriages among Females below legal age (%) Total Rural Urban 30 27 22 22 21 20 20 18 17 13 11 11 11 10 10 9 9 8 7 7 6 6 5 4 4 4 3 3 3 1 0 Uttarakhand Odisha Chhattisgarh Uttar Pradesh Assam Madhya Pradesh Jharkhand Bihar Rajasthan Varies from 3.0% in Uttarakhand to 21.9% in Rajasthan. In rural areas, every 4th marriage among females in Rajasthan and every 5th in Bihar & Jharkhand take place below the legal age. Rural- Urban differential is quite significant across all AHS State.
  • ● Ante Natal Care (ANC) Any ANC exceeds 80% in all AHS States. ANC in 1st trimester: 40% in UP & Bihar to 65% in Chhattisgarh and Madhya Pradesh. ● Mothers receiving 3 or more ANCs: UP-29.6% to Orissa -76.0 % Mothers who consumed IFA 100 days or more: 6.5% in UP to 23.8% in Chhattisgarh. Low performance in IFA consumption is the main reason for sluggish full ANC: 3.9% in UP to 19.5% in Chhattisgarh.
  • Full Ante Natal Check-up Full ANC comprise 3 or more ANC, at least one TT injection and consumption of IFA for 100 or more days.35 Full Ante Natal Check-up (%) 2930 Total Rural Urban 2625 22 20 19 19 19 1920 18 17 17 17 13 1315 12 11 11 11 1010 9 8 8 6 6 55 4 30 Uttar Pradesh Bihar Rajasthan Uttarakhand Assam Jharkhand Madhya Pradesh Odisha Chhattisgarh Uttar Pradesh reports the minimum coverage of 3.9%; Chhattisgarh, the maximum 19.5%. Full ANC coverage in urban areas is remarkably better than the rural areas. In 5 States, namely Bihar, UP, Rajasthan, Uttarakhand and Jharkhand urban coverage is more than double that of Rural.
  • Full Ante Natal Check-up Contd… Mothers who had full antenatal check-up (%) State State value Minimum Maximum RangeAssam 11.9 Dhubri (2.1) Jorhat (18.2) 16.1Bihar 5.9 Madhepura (2.4) Patna (16.4) 14.0Jharkhand 13.1 Garhwa (3.6) Purbi Singhbhum (31.6) 28.1Madhya Pradesh 13.3 Sheopur (1.8) Balaghat (30.8) 28.9Chhattisgarh 19.5 Korba (10.9) Dhamtari (34.5) 23.6Odisha 18.6 Jajpur (5.4) Jagatsinghpur (36.0) 30.6Rajasthan 8.5 Karauli (1.7) Jaipur (19.5) 17.8Uttar Pradesh 3.9 Balrampur (0.6) Kanpur Nagar (14.8) 14.3Uttarakhand 11.1 Rudra Prayag (3.7) Dehradun (22.7) 19.0 Bihar has reported the minimum variability among the districts compared to Odisha reporting the maximum. Less than 1% coverage of full ANC has been reported in Balrampur of Uttar Pradesh; on the other hand Jagatsinghpur of Odisha has reported the maximum 36%.
  • Full Ante Natal Check-up Contd… Frequency distribution of the districts by level of full antenatal check up (%) State <5 5-10 10-15 15-20 20-25 25 & above Total DistrictsAssam 6 7 6 4 0 0 23Bihar 17 17 2 1 0 0 37Chhattisgarh 0 0 4 4 5 3 16Jharkhand 3 7 4 3 0 1 18Madhya Pradesh 7 11 10 7 6 4 45Odisha 0 3 7 10 3 7 30Rajasthan 7 16 7 2 0 0 32Uttar Pradesh 52 15 3 0 0 0 70Uttarakhand 2 7 2 1 1 0 13All States 94 83 45 32 15 15 284 As high as 94 out of 284 districts report less than 5% coverage of full ANC. Only 15 districts namely Raigarh, Mahasamund, Dhamtari (Chhattisgarh), Purbi Singhbhum (Jharkhand), Indore, Bhopal, Narsimhapur, Balaghat (MP) and Jharsuguda, Mayurbhanj, Jagatsinghpur, Cuttack, Ganjam, Kandhamal, Naupada (Odisha) have reported 25% & above coverage of full ANC.
  • Ante NatalCheck-up
  • Institutional Delivery Institutional Delivery (%) Share of Govt. & Private Hospitals in Total Instritutional Delivery 100 14 13 90 23 21 80 31 31 76 39 80 40 70 71 70 55 70 60 50 60 58 Private 86 86 40 77 79 69 69 Govt. 51 30 59 61 50 48 46 20 42 10 40 38 35 0 Jharkhand Uttar Pradesh Bihar Rajasthan Odisha 30 Chhattisgarh Uttar Pradesh Uttarakhand Rajasthan Madhya Pradesh Institutional Delivery: Ranges from 34.9% in Chhattisgarh to 76.1% in MP. More than 85% of total births have taken place in Govt. Institutions in Madhya Pradesh & Odisha and it is more than 60% in remaining States except Jharkhand & Uttarakhand. Jharkhand is the only State where more than 50% of the births are taking place in Private Hospitals.
  • Balrampur, UP Indore, MP Institutional delivery is below 60% in 170 districts. Balrampur (UP) recorded the least 16.8% institutional delivery whereas Indore (MP) the most 92.5%, showing a variability of more than 5 times.
  • Safe Delivery  Safe delivery comprise institutional deliveries and domiciliary deliveries assisted by doctor/nurse/ANM/LHV. Safe Delivery (%)100 93 87 8990 82 8280 78 78 75 75 76 73 73 73 73 7070 68 6560 57 53 51 51 49 48 4950 47 44 394030 Jharkhand Chhattisgarh Uttar Pradesh Bihar Uttarakhand Assam Odisha Rajasthan Madhya Pradesh  Safe Delivery: 47.1 % in Jharkhand to 82.2% in Madhya Pradesh.  Rural- Urban differential is quite prominent in Jharkhand, Chhattisgarh and Uttarakhand.
  • Safe Delivery Contd… Safe delivery (%) State State value Minimum Maximum RangeAssam 70.1 Karimganj, Hailakandi (34.8) Sibsagar (88.2) 53.4Bihar 53.5 Sheohar (30.2) Munger (80.4) 50.2Jharkhand 47.1 Pakaur (24.8) Purbi Singhbhum (69.0) 44.2Madhya Pradesh 82.2 Dindori (45.5) Indore (96.3) 50.9Chhattisgarh 49.5 Surguja (32.6) Kanker (69.4) 36.8Orissa 75.2 Nabarangpur (35.6) Puri (92.7) 57.1Rajasthan 76.2 Jaisalmer (48.6) Jaipur (92.2) 43.6Uttar Pradesh 51.3 Balrampur (22.0) Jhansi (89.4) 67.4Uttarakhand 56.9 Tehri Garhwal (43.1) Nainital (79.5) 36.4 Uttarakhand has exhibited the least variability among districts whereas Uttar Pradesh, the most. Balrampur (UP) has reported the minimum against Indore (MP) reporting the maximum.
  • Safe Delivery Contd… Frequency distribution of districts by safe delivery (%) State <30 30-50 50-70 70-90 90 & above Total DistrictsAssam 0 2 12 9 0 23Bihar 0 12 19 6 0 37Chhattisgarh 0 9 7 0 0 16Jharkhand 3 9 6 0 0 18Madhya Pradesh 0 1 5 29 10 45Odisha 0 3 5 20 2 30Rajasthan 0 1 8 21 2 32Uttar Pradesh 4 20 39 7 0 70Uttarakhand 0 3 7 3 0 13All States 7 60 108 95 14 284 About 1/4th of the districts have reported less than 50% of the safe deliveries. Out of 14 districts reporting 90% & above safe deliveries, 10 belongs to Madhya Pradesh.
  • Janani Suraksha Yojana 70 Mothers who availed Financial Assistance under JSY (%) 60 50 Total Rural Urban 40 69 63 62 61 30 54 54 54 53 50 46 45 20 40 31 30 29 27 27 27 22 22 10 22 18 18 16 15 14 9 0 Jharkhand Uttar Pradesh Chhattisgarh Uttarakhand Bihar Assam Rajasthan Madhya Pradesh Odisha Mothers availing JSY: 14.6% in Jharkhand to 61.6% in Odisha. Rural- Urban differential is acute in the States of Madhya Pradesh, Odisha and Jharkhand.
  • Post Natal Care 90 Mothers who received Post-natal Check up within 48 hrs of delivery (%) Total Rural Urban 80 70 87 86 85 83 82 60 79 77 75 75 74 74 73 73 70 69 68 67 65 61 61 50 59 59 59 57 53 53 51 40 Assam Uttarakhand Jharkhand Bihar Chhattisgarh Uttar Pradesh Rajasthan Madhya Pradesh Odisha Mothers receiving PNC within 48 hrs of delivery varies from 57% in Assam to 74.5% in Odisha. 50 Mothers who did not receive any Post-natal Check up (%) 45 40 35 Total Rural Urban 30 25 43 41 20 40 37 36 34 31 15 30 29 28 26 26 26 25 23 23 22 21 21 10 20 19 16 16 12 11 10 10 5 0 Odisha Madhya Pradesh Rajasthan Chhattisgarh Uttar Pradesh Bihar Jharkhand Uttarakhand Assam At least 1 in every 5 mothers did not receive any post natal check up across all AHS States..
  • New Born Check up90 New Born Checked up within 24 hrs of birth (%) Total Rural Urban8070 86 86 83 8160 79 75 75 75 75 73 73 70 68 68 67 66 65 6150 59 57 56 55 53 51 51 51 5140 Bihar Assam Jharkhand Uttarakhand Chhattisgarh Uttar Pradesh Rajasthan Madhya Pradesh Odisha New born checked up within 24 hrs of birth exceeds 50% in all AHS States. It varies from 52.6% in Bihar to 74.9% in Odisha. Significant Rural- Urban divide is noticed in Uttarakhand, Jharkhand, Assam and Chhattisgarh.
  • Full Immunization Children are considered fully immunized when they have received vaccination against Tuberculosis, 3 doses of DPT & Polio and 1 dose of measles.80 Children aged 12-23 months fully immunized (%) Total Rural Urban 7060 80 79 77 75 74 74 73 50 71 71 69 66 65 64 64 64 64 61 59 59 58 55 55 5440 51 48 45 45 30 Uttar Pradesh Madhya Pradesh Odisha Assam Jharkhand Bihar Rajasthan Chhattisgarh Uttarakhand All States except Uttar Pradesh have at least half of their children aged 12-23 months fully immunized. Uttar Pradesh reports the minimum percentage of children fully immunized whereas Uttarakhand, the maximum. Rural-Urban gap exceeds 10% in Madhya Pradesh & Jharkhand.
  • Full Immunization Contd… Children age 12-23 months Fully Immunized (%) State State value Minimum Maximum RangeAssam 59.0 Dhubri (29.9) Dibrugarh (83.8) 53.9Bihar 64.5 Kishanganj (26.6) Samastipur (83.9) 57.3Jharkhand 63.7 Giridih (28.0) Purbi Singhbhum (82.7) 54.8Madhya Pradesh 54.9 Jhabua (23.8) Indore (77.6) 53.9Chhattisgarh 74.1 Surguja (55.3) Kanker (93.2) 37.9Odisha 55.0 Rayagada (11.9) Kendrapara (82) 70.0Rajasthan 70.8 Dhaulpur (37.4) Hanumangarh (91.4) 54.0Uttar Pradesh 45.3 Etah (13.5) Basti (73.8) 60.3Uttarakhand 75.4 Haridwar (55.3) Pithoragarh (87.5) 32.2 The variability among the districts within a State ranges from 32.2% in Uttarakhand to 70.0% in Odisha. Across all 284 districts, the minimum has been observed in Rayagada of Odisha and the maximum in Kanker of Chhattisgarh.
  • Full Immunization Contd… Frequency distribution of districts by children age 12-23 months Fully immunized (%) State 0-30 30-50 50-70 70-90 90 & above Total DistrictsAssam 1 4 14 4 0 23Bihar 1 2 23 11 0 37Chhattisgarh 0 0 6 9 1 16Jharkhand 1 4 7 6 0 18Madhya Pradesh 2 14 24 5 0 45Odisha 8 7 6 9 0 30Rajasthan 0 4 10 17 1 32Uttar Pradesh 11 31 20 8 0 70Uttarakhand 0 0 2 11 0 13All States 24 66 112 80 2 284 90 districts are below 50% level of full immunization. Only 2 districts 1 each from Chhattisgarh & Rajasthan feature in 90% & above category.
  • 100 Children age 12-23 months who have received BCG(%) Children age 12-23 months who have received 3 doses of Polio vaccine(%) 97.5 90 96.8 94.2 85 82.3 83.2 95 93.9 93.3 79.9 91.8 91.9 80 77.5 78.1 90.6 75.5 74.7 90 75 69.4 70 85 83.4 65 60 58.5 80 55 50 75 UP Orissa Jharkhand Bihar Uttarakhand UP Jharkhand Assam Madhya Pradesh Orissa Constituents of full immunization Children age 12-23 months who have received 3 doses of DPT vaccine(%) Children age 12-23 months who have received Measles vaccine (%) 90 83 90 86.7 87.9 82 80 79 82.6 77 80.7 81.8 72 72 73 80 79.0 77.3 75.7 70 67 70 60 56 60.5 50 60 UP Jharkhand Odisha Bihar Uttarakhand 50 UP Assam Madhya Pradesh Uttarakhand Chhattisgarh
  • FULLIMMUNIZATION
  • Full Immunization Contd…
  • Vitamin A Supplementation to ChildrenChildren aged 6-35 months who received a Vitamin A dose during last six months (%) 80 72 72 70 63 62 59 60 60 55 55 50 40 37 30 Uttar Pradesh Uttarakhand Jharkhand Odisha Assam  At least every 2nd child aged 6-35 months has received Vitamin A supplement in all AHS States except Uttar Pradesh where it is every 3rd child.
  • IFA Supplement to ChildrenChildren aged 6-35 months who received IFA tablet/syrup during last 3 months (%) 40 38 29 30 28 25 23 20 14 14 9 11 10 0 Rajasthan Jharkhand Odisha Assam Chhattisgarh IFA supplement to children aged 6-35 months during last 3 months ranges from 9.4 in Rajasthan to 37.7% in Chhattisgarh. Situation merit attention across all AHS States however it is quite alarming in Rajasthan & Uttar Pradesh.
  • Breast Feeding Practices Children under 3 Years breastfed within one hour of birth (%) 80 71.5 69.6 70 63.2 63.9 61.5 60 50 48.6 40 37.9 32.9 30.3 30 20 Bihar Jharkhand Madhya Pradesh Chhattisgarh Odisha Bihar & UP and Assam & Odisha constitute 2 extremes.
  • Breast Feeding Practices Children age 6-35 months exclusively breastfed for at least six months (%)50 47.5 45.640 39.2 38.2 36.830 28.5 24.7 24.820 17.710 Uttar Pradesh Odisha Madhya Pradesh Assam Chhattisgarh Children exclusively breastfed for at least 6 months ranges from 17.7 in UP to 47.5 % in Chhattisgarh.
  • KEY FINDINGS Replacement level of TFR 2.1 has been achieved in only 20 out of 284 AHS districts. In 164 districts, on an average a woman bears more than 3 children. More than half of currently married woman aged 15-49 years are not using any method of family planning in UP, Jharkhand and Bihar. Female Sterilization constitutes the most dominant method of family planning among the modern methods across all AHS States except Assam. Male Sterilization is the least preferred modern method across all AHS States. At least 1/5th of currently married women are yet to meet their family planning requirement (Unmet Need) across all AHS States.
  • KEY FINDINGS Contd… Marriages among female taking place below legal age (18 years) is rampant in rural areas as compared to urban areas. Despite wider penetration of `Any ANC’, the coverage under `first trimester ANC’ as well as `3 or more ANCs’ needs further improvement. Poor performance of full ANC is primarily due to low IFA consumption. Universal coverage of JSY remains a concern even in better performing States like Odisha, MP & Rajasthan; the situation in Jharkhand & UP needs immediate attention. Seven out of every 10 deliveries are `safe’ in Madhya Pradesh, Rajasthan, Odisha and Assam whereas it is less than 5 in Jharkhand and Chhattisgarh.
  • KEY FINDINGS Contd…• In spite of better reach of Post Natal Care to Mothers and New-borns in Odisha, MP & Rajasthan, every fifth mother has not received any PNC.• In full immunization, even the better performing States like Uttarakhand, Chhattisgarh and Rajasthan fall short by 25-30 percentage points in achieving universal coverage.• Improvement has been noticed in most of the indicators as compared to NFHS-3 as well as DLHS-3.• Availability of 63 indicators (co-variates) on various facets of Mother & Child Care at the district level will help in understanding the dynamics of composite indicators like IMR, U5MR and MMR.• For the first time, the data on TFR, Injury, Morbidity, Personal Habits are available at the district level. This would provide new insight in evidence-based planning and facilitate appropriate interventional strategies.
  • WAY FORWARD• The fieldwork for 1st updation round is over and the indicators on vital rates reflecting the change vis-à-vis baseline survey are likely to be released shortly.• A Component of Clinical-Anthropometric & Bio-chemical (CAB) Test on a sub-sample basis is scheduled to be introduced in October.
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