The document presents vital statistics related to child health in India, highlighting the collection, analysis, and application of health data for community health evaluation, administrative purposes, and legislative support. It discusses various sources of vital statistics, such as civil registration systems, national surveys, and health records, for assessing indicators like infant and neonatal mortality rates. The document also emphasizes the importance of reliable data for evaluating health programs and improving child health outcomes in the country.

1. VITAL
STATISTICS
RELATED TO
CHILD HEALTH IN
INDIA
PRESENTED BY:- NEHA MALIK

2. DEFINITION
The process of maintaining vital statistics is a purposeful mechanism of
collecting, processing, analysing and transmitting the information
required for organizing and operating health services and also for
research and training.
Or
It is a branch of biometry deals with data and law of human mortality,
morbidity and demography.

3. MAJOR VITAL EVENTS
 Death
 Birth
 Marriage
 Divorce

4. PURPOSE pose:-
1) Community Health: To describe the level of community health, to diagnose
community illness & to discover solutions to health problems.
2) Administrative purpose: It provides clues for administrative action to create
administrative standards of health activities.
3) Health programmed organization: To determine success or failure of
specific health programmed or undertake overall evaluation of public health
work.
4) Legislation purpose: To promote health legislation at local, state, & national
level.
5) Government Purpose: To develop, policies, procedure at state and centre.

5. Uses:-
 To evaluate the impact of various National Health
Programmes.
 To plan for better future measures of disease control.
 To explain the hereditary nature of the disease.
 To plan and evaluate economic and social development.
 It is a primary tool in research activities.
 To determine the health status of individual.
 To compare the health status of individual one nation with
others

6. AIMS:
 Providing reliable , relevant ,up to date ,adequate ,timely
and reasonably complete information to the health authority
at all levels.
 Health care providers are able to intervene the health status
of the population ,provided availability of appropriate tools
for measuring health, illness and the well being is there .
 It is the transformation of information through integration
and processing with perception and experience based on
social and political value .

7. WHO Guidelines:
 The system should be population based .
 The system should avoid unnecessary agglomeration of
data.
 The system should be problem oriented.
 Functional and operational terms.
 Should express information briefly and imaginatively.

8. Sources of Vital Statistics:-
1. Civil Registration System:
It is defined as the continuous permanent and compulsory recording of the
occurrence of vital events like live births, deaths, fetal deaths, marriages,
divorces, as well as annulments, judicial separation, adoption. Civil registration is
performed under a law and regulation so as to provide legal basis to the records
and certificate made from system.
2. National Sample Survey:
The data collected from the census are not very reliable and available only once
in 10 years. In absence of reliable data from the civil registration system (SRS),
the need for reliable statistics at national and state levels is being met through
sample surveys launched from time to time.

9. 3. Sample Registration System:
In this system, there is continuous enumeration of births and deaths in a sample of
villages/urban blocks by a resident part time enumerator and then an independent six monthly
retrospective survey by a full time supervisor.
4. Health Surveys:
A few important sources for demographic data have emerged. These are National Family
Health Surveys (NFHS) and the District Levels Household
Surveys (DLHS) conducted for evaluation of reproductive and child health programmes.
NFHS provide estimates of fertility, child mortality and a no. of fertility, child mortality and a
no. of health parameters relating to infants and children at state level.
The DLHS provide information at the district level on a no. of indicators relating to child
health, reproductive health problems and quality of services availability to them.

10. 5. Censes:
A census is the procedure of systematically acquiring and
recording information about the members of a given population. This
term is used mostly in connection with national population and
housing censuses; other common censuses include traditional culture,
business, supplies, and traffic censuses.
6. Epidemiological surveillance
Epidemiological surveillance is the systematic collection, analysis and
dissemination of health data for the planning, implementation and
evaluation of public health programmes

11. 7. Hospital records The terms hospital record, health record, and medical chart are used
somewhat interchangeably to describe the systematic documentation of a
single patient's medical history and care across time within one particular health care provider's
jurisdiction. The medical record includes a variety of types of "notes" entered over time by
health care professionals, recording observations and administration of drugs and therapies,
orders for the administration of drugs and therapies, test results, x-rays, reports, etc. The
maintenance of complete and accurate medical records is a requirement of health care providers
and is generally enforced as a licensing or certification prerequisite.
8. Notification of disease A notifiable disease is any disease that is required by law to be
reported to government authorities. The collation of information allows the authorities to
monitor the disease, and provides early warning of possible outbreaks. In the case of livestock
diseases, there may also be the legal requirement to destroy the infected livestock upon
notification. Many governments have enacted regulations for reporting of both human and
animal (generally livestock) diseases.

12. 10. Disease register surveys
Disease or patient registries are collections of secondary data related
to patients with a specific diagnosis, condition, or procedure, and they
play an important role in post marketing surveillance of
pharmaceuticals. Registries are different from indexes in that they
contain more extensive data.
In its simplest form, a disease registry could consist of a collection of
paper cards kept inside "a shoe box" by an individual physician. Most
frequently registries vary in sophistication from simple spreadsheets
that only can be accessed by a small group of physicians to very
complex databases that are accessed online across multiple institutions

13. 11. Record linkage
Record linkage (RL) is the task of finding records in a data set that
refer to the same entity across different data sources (e.g., data files,
books, websites, and databases). Record linkage is necessary
when joining data sets based on entities that may or may not share a
common identifier (e.g., database key, URI, National identification
number), which may be due to differences in record shape, storage
location, or curator style or preference. A data set that has undergone
RL-oriented reconciliation may be referred to as being cross-linked.
Record linkage is called data linkage in many jurisdictions, but is the
same process.

14. STATISTICS RELATED TO CHILD HEALTH IN INDIA
Vital statistics are considered as indicators of health. Important vital statistics are birth rate
and death rate.
Child health status is assessed through the measurement of mortality and morbidity.
Measurement of growth and development is also an important indicator of child health
status.

15. The frequently used mortality indicators of child health
care are the following
• Perinatal mortality rate.
• Neonatal mortality rate.
• Post neonatal mortality rate
• Infant mortality rate
• Under five mortality

16. PERINATAL MORTALITY RATE
• Late fetal and early neonatal deaths
Weighing over 1000 grams at birth x 1000
Total live births weighing over 1000 grams
at birth
•PMR; per 1000 births ranged from 61.5 10 161 in India
and 13.8 to 38.6 in UK.
•It was observed that PMR decreased from 131.2 to 114
per 1000 births, primarily due to reduction in early
neonatal deaths

18. •Neonatal deaths are deaths occurring during the neonatal
period i.e. from birth to 28 completed days of life.
Number of deaths of children under 28 days of age in a year x 1000
Total live births in the same year
•The neonatal period is the most vulnerable time for a child. The
good news is that it is declining globally. The worldwide neonatal
mortality rate Fell by 47 % between 1990 and 2015 from 36 to 19
deaths per 1000 live births over the same period, the number of
newborn babies who died within the first 28days of life declined from
5.1 million to 2.7 million in the same year

19. POST NEONATAL MORTALITY RATE
•Post neonatal mortality rate is defined as the ratio of the post
neonatal death in a given year to the total number of live
births in the same year usually expressed as a rate /1000
No. of deaths of children between 28 days
and one year of age in a given year x 1000
Total live births in the same year
•In India post neonatal mortality rate is estimated to be 16/1000 live
births in urban areas and 26 /1000 live births in rural areas

21. INFANT MORTALITY RATE
•The ratio of infant’s deaths registered in a given year to the total
number of live births registered in the same year usually expressed as
a ratio / 1000 live birth.
Number of deaths of children less than
one year of age in a year x 100
Number of live births in the same year
IMR is usually regarded as the most sensitive indicator of the
health status the community.

22. India - Mortality Rate, Infant (per 1,000 Live Births)

23. • Infant mortality is down and there is improvement in immunization coverage in
13 states. The survey was conducted in Andraparesh, Bihar, Goa, Haryana,
Karnataka, MP , Meghalaya ,Sikkim , Tamilnadu, Telangana, Tripura ,
Uttarakhand, West Bengal and union territories of Andaman and Nicobar islands
and Puducherry.
• The Union Health Ministry released the results for the phase of the National
Family Health Survey (NFHS) 2015-2016 that showed dramatic improvements in
maternal and infant mortality, immunization coverage, nutrition, and such criteria
in 13 states that were covered in this phase. The earlier survey was conducted in
2005-2006.
• The results show that all these places have an infant mortality rate (IMR) of less
than 51 deaths per 1000 live births, with Andaman recording the lowest of 10
deaths and Madhya Pradesh recording 51. The current national IMR is 37.

24. Child Health Indicator Current status NHP Target
IMR (Infant Mortality Rate) 34 (SRS 2016) 28 by 2019
Neonatal Mortality rate 24 (SRS 2016) 16 by 2025
Under 5 Mortality Rate 39 ( SRS 2016) 23 by 2025

25. SAMPLE REGISTRATION SYSTEM (SRS)
Registration of birth and death is an important source of demographic data.
• Voluntary basis, no uniformity.
• In order to unify the civil registration , registration of birth death act 1969
was established.
• For generating reliable and continuous data , office of general registrar of
India initiated the scheme of sample registration of birth and death ,known as
Sample registration survey (SRS) 1964-1965 on a pilot basis, full scale
from1969-1970.
SRS is a dual reporting system with continuous and retrospective recording of
events by two independent functionaries.

26. The main objective of SRS is:
 To provide reliable annual estimates of birth and death rates
at the State and National level separately for rural and urban
areas.
 Monitoring changes in vital indicators Collection of
additional data- Proof of age, registration of birth,
residential status.
 Integration of survey of causes of death in SRS.

27. Vital indicators collected
 Crude birth rate
 Age-specific fertility
 General fertility rate (GFR)
 Total fertility rate (TFR)
 Gross reproduction rate (GRR)
 General marital fertility Fertility rate (GMFR)
 Total marital fertility rate (TMFR)
 Crude death rate(CDR)
 Age-specific mortality rate (ASMR)
 Infant mortality rate(IMR)
 Neo-natal mortality rate (NMR)
 Early neo-natal mortality rate
 Late neo-natal mortality rate
 Post neo-natal mortality rate(PNMR)
 Peri-natal mortality Rate (PMR)
 Still birth rate

28. Advantages
 Done every year
Elimination of errors of duplication
 Self evaluating technique
 Dual reporting system
 Sampling frame changes every 10 years once.
Wider representation of population and overcoming
previous limitations.