ANNUAL HEALTH SURVEY FACT SHEET First Updation round(2011-12) KEY FINDINGS

Dr. C. ChandramouliRegistrar General & Census Commissioner,

India

“ Reproductive health and rights are integral to sustainable development and poverty reduction. Investing in universal access to reproductive health is crucial investment in healthy societies and a more sustainable future”. – Ban Ki-moon, Secretary-General, UN on World Population Day, 2012

“ Working for the survival and the well being of women and girls is a human right imperative. And in order to take advantage of women’s full potential in the development of their nations, they must be able to plan their lives and families.”

– Babatunde Osotimehin, Executive Director, UNFPA on World Population Day, 2012

“ There should be an Annual Health Survey of all districts which could be published/monitored and compared against benchmarks”

-Dr. Manmohan Singh, Prime Minister of India – In the meeting of National Commission of Population, 2005

AHS provides key indicators on Reproductive and Child Health at

District levelin 8 EAG States and

Assam

Vital inputs for evidence based intervention and monitoring

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 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

Odisha

Chhattisgarh

J harkhandMadhya Pradesh

BiharAssamRajasthan

Uttar Pradesh

Uttarakhand

•In all, 161 indicators are available from AHS : Fertility- 13 Sex Ratio- 3Marriage- 5 Mortality- 7Mother & Child Care- 63Ante Natal Care: 11 Delivery Care: 8Post Natal Care: 5 Janani Suraksha Yojana (JSY): 3Immunization: 8 Vitamin A & Iron Supplements: 2Birth Weight: 2 Childhood Disease: 6Birth Registration: 2 Breastfeeding & Supplementation: 12Awareness in Mothers: 4

Abortion- 6 Family Planning Practices- 15 Disability- 1 Morbidity- 19Personal Habits:adults-4 Housing & HH Characteristics- 13Others- 12

Under 1st phase of release, following 9 indicators have already been released in the Bulletin 2011-12:

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 indicators are being released under present phase of dissemination.

• 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

KEY FINDINGS Improvement has been noticed in most of the

indicators as compared to Baseline.

Replacement level of TFR 2.1 has been achieved in only 29 out of 284 AHS districts whereas in Baseline it was 20 districts.

In 145 districts, on an average a woman bears more than 3 children.

More than half of currently married women aged 15-49 years are not using any method of family planning in Bihar.

KEY FINDINGS

Female Sterilization continues to remain the most dominant method of family planning among the modern methods across all AHS States except Assam.

At least 12.6% currently married women are yet to meet their family planning requirement (Unmet Need) across all AHS States. This was 20.0% in Baseline.

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.

Seven out of every 10 deliveries are ‘safe’ in Madhya Pradesh, Rajasthan, Odisha and Assam.

KEY FINDINGS

• At least 1 in 7 mothers has not received any PNC among all the AHS States, in Assam it is 1 in 3 mothers.

• In full immunization, even the better performing States like Uttarakhand, Chhattisgarh and Rajasthan fall short by 22-30 percentage points in achieving universal coverage.

• Percent of traditional method in any method of family planning is more than 20% in 4 States namely, Uttar Pradesh, Assam, Jharkhand & Odisha.

KEY FINDINGS

55 districts are hotspots (57 in baseline) i.e. common in top 100 districts in IMR and top 25 Administrative Divisions (111 districts) in MMR.

Performance of Hot Spot Districts

DISTRICTS FALLING IN BOTH TOP 100 IMR AND DISTRICTS

OF TOP 25 MMR

UP - 31

Bihar -1

Odisha -1

MP -16

Assam- 6

State wiseTFR of Hot Spot Districts

State wise Full ANC of Hot Spot Districts

State wise Immunization in Hot Spot Districts

State wise Institutional Delivery in Hot Spot Districts

TOTAL FERTILITY RATE (TFR)

• TFR is the average number of children born to a woman during her entire reproductive span.

• Uttarakhand & Odisha and UP & Bihar continue to remain two extremes of the spectrum.

TOTAL FERTILITY RATE (TFR) Total Fertility Rate

State

State value District with Minimum TFR District with Maximum TFR Range

First updation

Baseline First Updation Baseline First Updation BaselineFirst

UpdationBaseline

Assam 2.4 2.6Kamrup (2.0), Nalbari (2.0)

Kamrup (2.0),Nalbari(2.0)

Hailakandi (3.9) Hailakandi (4.2) 1.9 2.2

Bihar 3.6 3.7 Patna (2.7) Patna (2.8) Sheohar (4.6) Sheohar (4.7) 1.9 1.9

Chhattisgarh 2.8 2.9Koriya (2.4),

Kanker (2.4), Durg (2.4)

Koriya (2.4) Kawardha (3.7) Kawardha (3.7) 1.3 1.3

Jharkhand 2.9 3.1Purbi Singhbhum

(2.2)Purbi Singhbhum

(2.4)Pakaur (3.9)

Lohardagga (4.0)

1.7 1.6

Madhya Pradesh

3.1 3.1 Bhopal (2.1) Indore (2.2) Shivpuri(4.4) Shivpuri (4.5) 2.3 2.3

Odisha 2.3 2.3Anugul (1.9), Bargarh (1.9),

Jharsuguda (1.9)Jharsuguda (2.0) Baudh (3.5) Boudh (3.7) 1.6 1.7

Rajasthan 3.1 3.2 Kota (2.5) Kota (2.6) Barmer (4.5) Barmer (4.7) 2.0 2.1

Uttar Pradesh 3.4 3.6 Kanpur Nagar (2.2) Kanpur Nagar (2.3) Shrawasti (5.8) Shrawasti (5.9) 3.6 3.6

Uttarakhand 2.1 2.3Pithoragarh (1.7),Bageshwar (1.7)

Pithoragarh (1.7)Haridwar (2.9)

Haridwar (3.1)1.2 1.4

Within a State, the minimum variability of 1.2 is reported in Uttarakhand and the maximum of 3.6 in Uttar Pradesh whereas in Baseline it was 1.3 in Chhattisgarh and 3.6 in Uttar Pradesh respectively .

Across 284 districts in 9 AHS States, it ranges from 1.7 in Pithoragarh and Bageshwar to 5.8 in Shrawasti. In Baseline this varied from 1.7 in Pithoragarh (Uttarakhand) to 5.9 in Shrawasti (UP)- a variability of more than 4 children.


29 districts have already achieved the replacement level of 2.1 whereas it was 20 in baseline.

Frequency distribution of TFR in terms of No. of Districts in each State

State 0 - 2.1 2.2 - 3.0 3.1 - 4.0 4.1 and above Grand Total

Assam 7 (3) 14 (16) 2 (3) 0 (1) 23

Bihar 0 (0) 1 (1) 28 (26) 8 (10) 37

Chhattisgarh 0 (0) 14 (12) 2 (4) 0 (0) 16

Jharkhand 0 (0) 9 (8) 9 (10) 0 (0) 18

Madhya Pradesh 1 (0) 19 (15) 22 (25) 3 (5) 45

Odisha 12 (10) 17 (18) 1 (2) 0 (0) 30

Rajasthan 0 (0) 18 (16) 12 (13) 2 (3) 32

Uttar Pradesh 0 (0) 14 (9) 45(48) 11 (13) 70

Uttarakhand 9 (7) 4 (5) 0 (1) 0 (0) 13

All States 29 (20) 110 (100) 121 (132) 24 (32) 284

Frequency Distribution of change in TFR in Terms of No. Districts in Each State

State Decreased by 0.1

Decreased by 0.2

Decreased by 0.3

Decreased by 0.4

Decreased by 0.5 or more

Increased Remained Same

Total

Uttarakhand 6 2 2 0 0 0 3 13

Rajasthan 13 14 0 0 0 0 5 32

Uttar Pradesh 25 14 3 7 0 7 14 70

Bihar 16 13 3 0 0 0 5 37

Assam 12 5 2 0 0 0 4 23

Jharkhand 11 5 1 0 0 0 1 18

Odisha 20 4 0 0 0 0 6 30

Chhattisgarh 8 2 0 0 0 0 6 16

Madhya Pradesh 30 9 1 1 0 1 3 45

Total 141 68 12 8 0 8 47 284



•229 districts have recorded less TFR than the baseline estimates and 47 districts remained same.

•8 Districts have recorded increase in TFR viz. Indore (M.P.), Baghpat, Budaun, Bulandshahar, Gonda, Lalitpur, Pilibhit and Rampur (U.P.)

•8 Districts have recorded maximum decrease in TFR viz. Sehore(M.P.), Basti, Deoria, Gorakhpur, Kaushambi, Kushinagar, Maharajganj, Siddharthnagar (U.P.)


Baseline

First UpdationReplacement

level of TFR

Family Planning: Current Usage

Current usage of any method varies from 43.0 in Bihar to 66.4 in Rajasthan whereas it was 37.6 in Bihar to 64.5 per cent in Rajasthan in Baseline.

Contraceptive Prevalence Rate (CPR) is the percentage of currently married women aged 15-49 yrs who are using any method of contraception (modern/traditional).


Within a State, the least variation is reported in Uttarakhand and the most, in Odisha whereas in Baseline it was Uttarakhand and Uttar Pradesh respectively.

At district level, current usage of family planning ranges from 29.8 in Baudh (Odisha) to 89.1 in Hanumangarh (Rajasthan)- a variability of 3 times-whereas in Baseline it varied from 21.9 in Sitapur (UP) to 79.2 in Ganganagar (Rajasthan) exhibiting a variability of 4 times.

Any Method of Family Planning (%)

State State Value District with Minimum FP District with Maximum FP Range

First Updation

baselineFirst

Updationbaseline

First Updation

baselineFirst

Updationbaseline

Assam 65.1 57.9 Dhubri (45.1) Dhubri (33.2) Kamrup (76.0) Lakhimpur (67.6) 30.9 34.4

Bihar 43.0 37.6 Nawada (31.5) Siwan (26.0) Supaul (60.8) Muzaffarpur (52.2) 29.3 26.2

Jharkhand 56.5 47.8 Gumla (39.0)Paschimi Singhbhum (32.7)

Hazaribagh (69.8) Dhanbad (61.9) 30.8 29.2

Madhya Pradesh

63.4 61.2 Sidhi (44.6) Sidhi (45.9) Damoh (75.7) Damoh (74.9) 31.1 29.0

Chhattisgarh 58.6 53.9 Dantewada (33.4) Dantewada (33.4) Kawardha (68.2) Dhamtari (68.7) 34.8 35.3

Odisha 59.4 56.2 Baudh (29.8) Kandhamal (28.6) Baleshwar (78.1) Baleshwar (73.4) 48.3 44.8

Rajasthan 66.4 64.5 Jaisalmer (53.3) Dhaulpur (49.0) Hanumangarh (89.1) Ganganagar (79.2) 35.8 30.2

Uttar Pradesh

58.6 49.9 Sitapur (33.8) Sitapur (21.9) Jhansi (74.4) Jhansi (74.1) 40.6 52.2

Uttarakhand 61.7 62.7 Haridwar (56.2) Haridwar (53.7) Pithoragarh (78.2) Dehradun (67.1) 22.0 13.4

Family Planning: Current UsageFrequency distribution of current usage in terms of number of districts in each State

State 0-30 30-50 50-70 70 & above Total Districts

Assam 0 (0) 2 (3) 15 (20) 6 (0) 23

Bihar 0 (4) 29 (31) 8 (2) 0 (0) 37

Chhattisgarh 0 (0) 3 (7) 13 (9) 0 (0) 16

Jharkhand 0 (0) 7 (13) 11 (5) 0 (0) 18

Madhya Pradesh 0 (0) 1 (2) 40 (40) 4 (3) 45

Odisha 1 (1) 8 (9) 16 (19) 5 (1) 30

Rajasthan 0 (0) 0 (1) 21 (24) 11 (7) 32

Uttar Pradesh 0 (3) 20 (24) 44 (42) 6 (1) 70

Uttarakhand 0 (0) 0 (0) 6 (13) 7 (0) 13

All States 1 (8) 70 (90) 174 (174) 39 (12) 284

As high as 71 districts are reporting less than 50% current usage of any method of family planning whereas in Baseline it was 98.

39 districts feature in 70% & above category whereas in Baseline it was only 12

districts.

29 out of 37 districts of Bihar have reported less than 50% usage of any method of family planning. In Baseline it was 35 districts.


CURRENT USAGE OF ANY METHOD OF

FAMILY PLANNING (%)

CURRENT USAGE OF ANY METHOD OF

FAMILY PLANNING (%)

BaselineFirst Updation

Dist. with > 60% Usage

Share of sterilization in any modern method of family planning (%)

AssamUttar

PradeshJharkhand Bihar Odisha Uttarakhand Rajasthan Chhattisgarh

Madhya Pradesh

Female 35.1 (35.3) 50.4 (55.0) 74.3 (76.3) 81.2 (86.7) 69.7 (68.4) 51.9 (58.7) 77.1 (76.7) 87.4 (92.3) 81.8 (83.6)

Male 0.8 (0.6) 0.5 (0.6) 1.4 (1.2) 0.8 (0.9) 0.4 (0.7) 3.0 (2.8) 0.7 (0.7) 1.8 (2.0) 1.5 (1.7)


FEMALE STERILIZATION (%)

Unmet Need for Family Planning Unmet need of Family Planning broadly means requirement of Family Planning

methods among Currently Married Women but not using any method of Family Planning .

Total unmet need varies from a minimum of 12.6% in Rajasthan to 33.5% in Bihar. In Baseline it varied from 19.6% in Rajasthan to 39.2% in Bihar.

Unmet need for Family Planning is a crucial indicator for assessing the future demand for Family Planning services / supplies.

Unmet Need for Family Planning Total Unmet need (%)

State State Value District with Minimum unmet need District with Maximum unmet need Range

First Updation

baseline First Updation baseline First Updation baselineFirst

Updationbaseline

Assam 15.9 24.0 Kamrup (8.4) Sibsagar (15.3) Karimganj (33.6) Dhubri (42.9) 25.2 27.6

Bihar 33.5 39.2 Patna (20.2) Patna (24.6) Katihar (46.5) Kishanganj (52.5) 26.3 27.9

Jharkhand 22.6 30.5 Hazaribagh (13.2) Bokaro (18.2) Gumla (33.2) Godda (42.8) 20.0 24.6

Madhya Pradesh

21.6 22.4Datia(14.4) Dewas(14.4)

Jabalpur (14.3) Sidhi(38.3) Rewa (34.2) 23.9 19.9

Chhattisgarh 24.8 26.4 Dhamtari (13.9) Dhamtari (14.5) Dantewada (48.7) Bastar (36.0) 34.8 21.5

Odisha 19.1 23.2 Kendujhar (9.7) Baleshwar (6.1) Baudh (45.3) Boudh (48.3) 35.6 42.2

Rajasthan 12.6 19.6 Jhunjhunun (3.1) Ganganagar (10.0) Jaisalmer (28.1) Dhaulpur (32.4) 25.0 22.4

Uttar Pradesh 24.1 29.7 Jhansi (12.7) Mahoba (15.1) Sultanpur (48.1) Sitapur (61.3) 35.4 46.2

Uttarakhand 18.1 23.2 Dehradun (12.8) Dehradun (16.8) Almora (27.4) Haridwar (29.2) 14.6 12.4

The minimum variability within a State is in Uttarakhand and the maximum in Odisha whereas in Baseline it was in Uttarakhand and in Uttar Pradesh respectively.

Jhunjhunun (3.1) in Rajasthan and Dantewada (48.7) in Chhattisgarh are the two extremes across 284 districts. In Baseline it was Baleshwar (6.1) in Odisha and Sitapur (61.3) in Uttar Pradesh.

Unmet Need for Family Planning

Frequency distribution of unmet need in terms of number of districts in each State

State 0-20 20-40 40-60 60 & above Total Districts

Assam 16 (6) 7 (16) 0 (1) 0 (0) 23

Bihar 0 (0) 29 (20) 8 (17) 0 (0) 37

Chhattisgarh 3 (4) 12 (12) 1 (0) 0 (0) 16

Jharkhand 5 (2) 13 (13) 0 (3) 0 (0) 18

Madhya Pradesh 12 (18) 33 (27) 0 (0) 0 (0) 45

Odisha 14 (12) 13 (15) 3 (3) 0 (0) 30

Rajasthan 26 (16) 6 (16) 0 (0) 0 (0) 32

Uttar Pradesh 23 (9) 42 (52) 5 (8) 0 (1) 70

Uttarakhand 6 (2) 7 (11) 0 (0) 0 (0) 13

All States 105 (69) 162 (182) 17 (32) 0 (1) 284

In 105 out of 284 districts, the total unmet need for family planning is below 20%. It was 69 in Baseline.

Bihar and Uttar Pradesh continue to dominate in 40% & above category.

Unmet Need for Family Planning


TOTAL UNMET NEED FOR FAMILY PLANNING (%)

TOTAL UNMET NEED FOR FAMILY PLANNING (%)Unmet need of

<=20

Mean Age at Marriage- Female

Mean Age at Marriage is based on the marriages taken place during 2008-2010.

Mean age at marriage of females varies from 20.1 in Bihar to 22.4 years in Odisha whereas in Baseline it was 19.7 in Bihar & Rajasthan to 22.0 years in Uttarakhand.

Marriages among Females below Legal Age (18 yrs)

Based on marriages taken place during 2008-2010.

Varies from 2.3% in Uttarakhand to 16.5% in Bihar whereas in Baseline it was 3.0% in Uttarakhand to 21.9% in Rajasthan.

MARRIAGES AMONG FEMALES BELOW LEGAL AGE (BELOW 18 YEARS) %

Marriages among Females below Legal Age (18 yrs)

Any ANC exceeds 80% in all AHS States.

ANC in 1st trimester: 46.5% in UP & Bihar to 70% in Chhattisgarh & Madhya Pradesh. In Baseline, this was 40% in UP & Bihar to 65% in Chhattisgarh & Madhya Pradesh.

Mothers receiving 3 or more ANCs: UP-32.5% to Odisha-78.5%. This was UP-29.6% to Odisha-76.0 % in Baseline.

Mothers who consumed IFA 100 days or more: 8.1% in UP to 26.0% in Odisha. It was 6.5% in UP to 23.8% in Chhattisgarh in Baseline.

Low performance in IFA consumption is the main reason for sluggish full ANC: 5% in UP to 22.7% in Odisha. In Baseline, 3.9% in UP to 19.5% in Chhattisgarh.

Ante Natal Care (ANC)

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.

Uttar Pradesh reports the minimum coverage of 5.0 % and Odisha, the maximum 22.7 whereas in Baseline it was 3.9% in Uttar Pradesh & 19.5% in Chhattisgarh.

Full Ante Natal Check-up Mothers who had Full Antenatal Check-up (%)

State State Value District with Minimum value District with Maximum value Range

First Updation


UpdationBaseline

Assam 13.3 11.9 Dhubri (4.0) Dhubri (2.1) Dibrugarh (25.2) Jorhat (18.2) 21.2 16.1

Bihar 6.1 5.9 Samastipur (2.0) Madhepura (2.4) Patna (13.8) Patna (16.4) 11.8 14.0

Jharkhand 14.4 13.1 Garhwa (5.0) Garhwa (3.6)Purbi Singhbhum


(31.6)27.1 28.0

Madhya Pradesh 15.3 13.3 Sheopur (1.9) Sheopur (1.8) Indore (32.1) Balaghat (30.8) 30.2 29.0

Chhattisgarh 20.2 19.5 Kawardha (11.5) Korba (10.9) Dhamtari (42.6) Dhamtari (34.5) 31.1 23.6

Odisha 22.7 18.6 Jajapur (13.4) Jajapur (5.4)Jagatsinghapur

(43.5)Jagatsinghapur (36.0) 30.1 30.6

Rajasthan 9.2 8.5 Karauli (3.0) Karauli (1.7) Jaipur (19.7) Jaipur (19.5) 16.7 17.8

Uttar Pradesh 5.0 3.9 Balrampur (0.9) Balrampur (0.6) Jhansi (17.9) Kanpur Nagar (14.8) 17.0 14.2

Uttarakhand 16.0 11.1 Rudraprayag (3.8) Rudraprayag (3.7) Dehradun (29.7) Dehradun (22.7) 25.9 19.0

Bihar has reported the minimum variability among the districts in a State compared to Chhattisgarh reporting the maximum. It was Bihar and Odisha in Baseline.

Balrampur (0.9), less than 1% coverage and Jagatsinghapur (43.5), the maximum coverage of full ANC. In Baseline also the position was same with values 0.6 and 36.0 respectively.

Full Ante Natal Check-upFrequency distribution of full ANC in terms of number of districts in each State

State<5 5 - 10 10 - 15 15-20 20-25

25 & above

Total Districts

Assam 1 (6) 9 (7) 7 (6) 3 (4) 2 (0) 1 (0) 23

Bihar 15 (17) 18 (17) 4 (2) 0 (1) 0 (0) 0 (0) 37

Chhattisgarh 0 (0) 0 (0) 6 (4) 2 (4) 3 (5) 5 (3) 16

Jharkhand 0 (3) 7 (7) 6 (4) 3 (3) 1 (0) 1 (1) 18

Madhya Pradesh 5 (7) 10 (11) 11 (10) 7 (7) 6 (6) 6 (4) 45

Odisha 0 (0) 0 (3) 4 (7) 7 (10) 9 (3) 10 (7) 30

Rajasthan 6 (7) 16 (16) 8 (7) 2 (2) 0 (0) 0 (0) 32

Uttar Pradesh 45 (52) 17 (15) 6 (3) 2 (0) 0 (0) 0 (0) 70

Uttarakhand 1 (2) 2 (7) 5 (2) 3 (1) 1 (1) 1 (0) 13

All States 73 (94) 79 (83) 57 (45) 29 (32) 22 (15) 24 (15) 284

73 out of 284 districts report less than 5% coverage of full ANC whereas in Baseline it was 94.

24 districts reported 25% & above coverage of full ANC . In Baseline it was only 15 districts.

Full Ante Natal Check-up


MOTHERS WHO HAD FULL ANTENATAL CHECK UP (%)

MOTHERS WHO HAD FULL ANTENATAL CHECK UP (%)

Ante Natal Check-up

MOTHERS WHO RECEIVED ANY ANTENATAL

CHECK-UP (%)


MOTHERS WHO RECEIVED ANY ANTENATAL

CHECK-UP (%) 90% and above coverage

Ante Natal Check-up

MOTHERS WHO HAD ANTENATAL CHECK

UP IN FIRST TRIMESTER (%)

MOTHERS WHO HAD ANTENATAL CHECK

UP IN FIRST TRIMESTER (%)


Above 50 % coverage

Ante Natal Check-up


MOTHERS WHO RECEIVED 3 OR MORE ANTENATAL

CARE (%)

MOTHERS WHO RECEIVED 3 OR MORE ANTENATAL

CARE (%)

Institutional Delivery

Institutional Delivery

Institutional Delivery: Ranges from 40.4% in Chhattisgarh to 79.7% in MP. In Baseline it was 34.9% in Chhattisgarh & 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. In Baseline also, the situation was same except for Uttarakhand, which stood at 63% from 59% in Baseline.

Jharkhand continues to remain the only State where more than 50% of the births are taking place in Private Hospitals.

Balrampur (UP) recorded the least 22.2% institutional delivery whereas Puri(Odisha) the most 94.0%, showing a variability of more than 4 times. In Baseline, Balrampur was in the least category with 16.8% and Indore(MP),the highest with 92.5%.

Institutional delivery is below 60% in 141 districts whereas it was 170 districts in baseline.

INSTITUTIONAL DELIVERY (%)

Balrampur, UP

Puri, Odisha

Safe Delivery

Safe delivery comprise institutional deliveries and domiciliary deliveries assisted by doctor/nurse/ANM/LHV.

Safe Delivery: 51.8% in Jharkhand to 85.9% in Madhya Pradesh. It was 47.1% in Jharkhand & 82.2% in MP.

Safe Delivery Safe Delivery (%)

State State Value District with Minimum Value District with Maximum Value Range

First Updation


UpdationBaseline

Assam 68.1 64.2Hailakandi,

Karimganj (41.4)Karimganj,

Hailakandi (34.8)Sibsagar (89.9) Sibsagar (88.2) 48.5 53.4

Bihar 59.9 53.5 Sitamarhi (36) Sheohar (30.2) Patna (81.4) Munger (80.4) 45.4 50.2

Jharkhand 51.8 47.1 Pakaur (31.8) Pakaur (24.8)Purbi Singhbhum


(69.0)40.1 44.2

Madhya Pradesh

85.9 82.2 Dindori (55.4) Dindori (45.5) Indore (97) Indore (96.3) 41.6 50.8

Chhattisgarh 56.9 49.5 Surguja (41.6) Surguja (32.6) Kanker (75.8) Kanker (69.4) 34.2 36.8

Odisha 80.8 75.2 Malkangiri (48) Nabarangpur (35.6) Puri (94.7) Puri (92.7) 46.7 57.1

Rajasthan 80.0 76.2 Jaisalmer (55.5) Jaisalmer (48.6) Baran (93.6) Jaipur (92.2) 38.1 43.6

Uttar Pradesh 57.4 51.3 Balrampur (30) Balrampur (22.0) Jhansi (90.1) Jhansi (89.4) 60.1 67.4

Uttarakhand 61.0 56.9Tehri Garhwal

(49.4)Tehri Garhwal

(43.1)Nainital (81.4) Nainital (79.5) 32.0 36.4

Uttarakhand has exhibited the least variability among districts of a State and Uttar Pradesh, the most, the same as in Baseline.

Balrampur (UP) & Indore (MP) continue to remain the minimum and maximum in safe delivery.

Safe DeliveryFrequency distribution of safe delivery in terms of No. of districts in each State

State <30 30-50 50-70 70-90 90 & above Total

Districts

Assam 0 (0) 3 (2) 11 (12) 9 (9) 0 (0) 23

Bihar 0 (0) 6 (12) 22 (19) 9 (6) 0 (0) 37

Chhattisgarh 0 (0) 4 (9) 9 (7) 3 (0) 0 (0) 16

Jharkhand 0 (3) 11 (9) 6 (6) 1 (0) 0 (0) 18

Madhya Pradesh 0 (0) 0 (1) 5 (5) 27 (29) 13 (10) 45

Odisha 0 (0) 2 (3) 4 (5) 20 (20) 4 (2) 30

Rajasthan 0 (0) 0 (1) 5 (8) 25 (21) 2 (2) 32

Uttar Pradesh 0 (4) 12 (20) 40 (39) 17 (7) 1 (0) 70

Uttarakhand 0 (0) 1 (3) 8 (7) 4 (3) 0 (0) 13

All States 0 (7) 39 (60) 110 (108) 115 (95) 20 (14) 284

About 1/7th of the districts have reported less than 50% of the safe deliveries. It was 1/4th in baseline.

Out of 20 districts reporting 90% & above safe deliveries, 13 districts belong to Madhya Pradesh. It was 10 for MP in Baseline.

SAFE DELIVERY (%)

Safe Delivery

Janani Suraksha Yojana

Mothers availing JSY: 19.9% in Jharkhand to 69.3% in MP. It was 14.6% in Jharkhand to 61.6% in Odisha in Baseline.

Janani Suraksha Yojana

MOTHERS WHO AVAILED FINANCIAL ASSISTANCE FOR DELIVERY UNDER

JSY (%)

Abortion

Varies from 2.1% in Chhattisgarh to 7.6% in Assam, in Baseline too these two States were at the extremes.

Across 284 districts in 9 AHS States, it ranges from 0.7% in Jaisalmer(Rajasthan) Kanker & Dantewada(Chhattisgarh), to 19.6% in Jorhat(Assam).

Abortion

Varies from 2.6 in Assam to 3.3 in Chhattisgarh.

Across 284 districts in 9 AHS States, it ranges from 2.0 in Sheopur (Madhya Pradesh) to 5.4 in Rayagada (Odisha) & Jaisalmer (Rajasthan).

Abortion

Abortion taking place in institution varies from 32.0% in Chhattisgarh to 73.9% in Assam.

Across 284 districts in 9 AHS States, it ranges from 12.4% in Kishanganj (Bihar) to 100% in Jaisalmer (Rajasthan).

Abortion

Varies from 41.8% in Chhattisgarh to 76.4% in Assam.

Across 284 districts in 9 AHS States, it ranges from 19.6% in Madhepura (Bihar) to 100% in Rayagada (Odisha) and Jaisalmer (Rajasthan) – a variability of 5 times.

More than 50% of the abortion is performed by skilled health personnel in all the States except Chhattisgarh.

Post Natal Care

Mothers receiving PNC within 48 hrs of delivery varies from 59.6% in Assam to 80.0% in Odisha. It was 57.0 in Assam and 74.5% in Odisha in Baseline.

At least 1 in every 7 mothers did not receive any post natal check up across all AHS States. The situation was 1 in 5 in baseline.

Post Natal Care

MOTHERS WHO AVAILED POST-NATAL CHECK UP

WITHIN 48 HRS. OF DELIVERY (%)

Post Natal Care

MOTHERS WHO DID NOT RECEIVE ANY POST-

NATAL CHECK UP (%)

New Born Check up

New born checked up within 24 hrs of birth exceeds 50% in all AHS States. Across the 284 districts, as high as 246 districts reported more than 50% coverage.

It varies from 57.6% in Bihar to 79.7% in Odisha whereas in Baseline it was 52.6% in Bihar and 74.9 in Odisha.

Across 284 districts in 9 AHS States, it ranges from 32.2 in Karimganj(Assam) to 92.6 in Bargarh(Odisha). In Baseline, this varied from 24.2 in Karimganj & Hailakandi (Assam) to 92.9 in Allahabad(Uttar Pradesh).

New Born Check up

NEW BORNS WHO WERE CHECKED UP WITHIN 24 HRS.

OF BIRTH (%)

Full Immunization Children are considered fully immunized when they have received vaccination

against Tuberculosis, 3 doses of DPT & Polio and 1 dose of measles.

All States except Uttar Pradesh continue to remain having received at least half of their children aged 12-23 months fully immunized.

Uttar Pradesh & Uttarakhand continue to remain minimum & maximum in children fully immunized.

Full Immunization Children aged 12-23 months Fully Immunized (%)

State State Value Minimum Maximum Range

First Updation


UpdationBaseline

Assam 61.4 59.0 Dhubri (39.2) Dhubri (29.9) Dibrugarh (85.5) Dibrugarh (83.8) 46.3 53.9

Bihar 65.6 64.5 Kishanganj (26.6)Kishanganj

(26.6)Madhubani (82.8) Samastipur (83.9) 56.2 57.3

Jharkhand 69.1 63.7 Giridih (43.0) Giridih (28.0) Lohardaga (86.5)Purbi Singhbhum

(82.7)43.5 54.7

Madhya Pradesh

59.7 54.9 Umaria (27.1) Jhabua (23.8) Indore (83.2) Indore (77.6) 56.1 53.8

Chhattisgarh 74.1 74.1 Surguja (52.8) Surguja (55.3) Kanker (94) Kanker (93.2) 41.2 37.9

Odisha 62.3 55.0 Rayagada (17.7) Rayagada (11.9) Kendrapara (84.9) Kendrapara (82) 67.2 70.1

Rajasthan 69.2 70.8 Dhaulpur (41.5) Dhaulpur (37.4)Hanumangarh

(95.9)Hanumangarh (91.4) 54.4 54.0

Uttar Pradesh 48.1 45.3 Bahraich (21.6) Etah (13.5) Saharanpur (72.2) Basti (73.8) 50.6 60.3

Uttarakhand 77.9 75.4 Haridwar (59.6) Haridwar (55.3) Pithoragarh (87.6) Pithoragarh (87.5) 28.0 32.2

The variability among the districts within a State ranges from 28.0% in Uttarakhand to 67.2% in Odisha, it was 32.2% in Uttarakhand to 70.1% in Odisha in Baseline.

Across all 284 districts, Rayagada of Odisha continue to remain the minimum. However the maximum is observed in Hanumangarh of Rajasthan. In Baseline the maximum was in Kanker of Chhattisgarh.

Full ImmunizationFrequency distribution of Full Immunization in terms of number of districts in each State

State 0-30 30-50 50-70 70-90 90 & above Total

Districts

Assam 0 (1) 4 (4) 14 (14) 5 (4) 0 (0) 23

Bihar 1 (1) 2 (2) 18 (23) 16 (11) 0 (0) 37

Chhattisgarh 0 (0) 0 (0) 6 (6) 9 (9) 1 (1) 16

Jharkhand 0 (1) 2 (4) 9 (7) 7 (6) 0 (0) 18

Madhya Pradesh 3 (2) 8 (14) 26 (24) 8 (5) 0 (0) 45

Odisha 5 (8) 9 (7) 2 (6) 14 (9) 0 (0) 30

Rajasthan 0 (0) 3 (4) 9 (10) 19 (17) 1 (1) 32

Uttar Pradesh 6 (11) 30 (31) 31 (20) 3 (8) 0 (0) 70

Uttarakhand 0 (0) 0 (0) 1 (2) 12 (11) 0 (0) 13

All States 15 (24) 58 (66) 116 (112) 93 (80) 2 (2) 284

73 districts are below 50% level of full immunization whereas it was 90 in Baseline.

Only 2 districts 1 each from Chhattisgarh & Rajasthan continue to remain in 90% & above category.

Constituents of full

immunization

Full Immunization

CHILDREN AGED 12-23 MONTHS FULL IMMUNIZED

(%)

Vitamin A Supplementation to Children

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, the same as in Baseline.

Across 284 districts in 9 AHS States, it ranges from 16.2 in Shrawasti(Uttar Pradesh) to 88.5 in Udaipur(Rajasthan). In Baseline, it varied form 15.1 in Shrawasti to 91.3 in Lohardaga(Jharkhand).

Across the 284 districts,193 districts have reported more than 50 % coverage.

CHILDREN (AGE 6-35 MONTHS WHO RECEIVED VITAMIN A DOSE DURING

LAST SIX MONTHS (%)

Vitamin A Supplementation to Children

IFA Supplement to Children

IFA supplement to children aged 6-35 months during last 3 months ranges from 10.9% in Rajasthan to 38.7% in Chhattisgarh. It was 9.4% in Rajasthan to 37.7% in Chhattisgarh in Baseline.

Situation merit attention across all AHS States however it is quite alarming in Rajasthan, Uttar Pradesh & Uttarakhand.

CHILDREN (AGE 6-35 MONTHS WHO RECEIVED IFA

TABLETS/SYRUPS DURING LAST 3 MONTHS (%)

IFA Supplement to Children

Breast Feeding Practices

Bihar & UP and Assam & Odisha continue to remain two extremes of the spectrum.

CHILDREN UNDER 3 YEARS BREASTFED

WITHIN 1 HOUR OF BIRTH (%)



Children exclusively breastfed for at least 6 months ranges from 19.4% in UP to 49.9% in Chhattisgarh whereas it was 17.7% in UP to 47.5 % in Chhattisgarh in Baseline.


CHILDREN AGED 6-35 MONTHS EXCLUSIVE BREASTFED FOR AT

LEAST SIX MONTHS (%)

Some Additional Facts

Among AHS States:-

4 out of the 5 top States in female literacy and full ANC coverage are common.

57 districts are common in top 100 districts in female literacy and full ANC.

3 out of the 5 top States in female literacy also exist among 5 States with least MMR .

Top 5 States in full immunization coverage are the same who have the least NNMR & IMR.

3 out of the 5 top States in exclusive breast feeding practice also exist among 5 States with minimum NNMR.

• The fieldwork for 2nd updation round is over and the indicators on vital rates reflecting the change vis-à-vis baseline and first updation round surveys are likely to be released shortly.

• A Component of Clinical-Anthropometric & Bio-chemical (CAB) Test on a sub-sample basis is in progress in the AHS States.

WAY FORWARD

Documents

ANNUAL HEALTH SURVEY FACT SHEET First Updation round(2011-12) KEY FINDINGS