ANNUAL HEALTH SURVEY FACT SHEET First Updation round(2011-12)
KEY FINDINGS Dr. C. Chandramouli Registrar General & Census
Commissioner, India Slide 2 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 Slide
3 Working for the survival and the well being of women and girls is
a human right imperative. And in order to take advantage of womens
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 Slide 4
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 Slide 5 AHS provides key indicators
on Reproductive and Child Health at District level in 8 EAG States
and Assam Vital inputs for evidence based intervention and
monitoring Slide 6 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. Slide 7 Coverage :
Annual Health Survey Slide 8 Indicators under AHS In all, 161
indicators are available from AHS : 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
Slide 9 Indicators under AHS Contd Under 1 st 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. Slide 10 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 Slide 11 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. Slide 12 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. Slide 13 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 Slide 14 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 Slide 15
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 Slide 16 State wiseTFR of Hot
Spot Districts Slide 17 State wise Full ANC of Hot Spot Districts
Slide 18 State wise Immunization in Hot Spot Districts Slide 19
State wise Institutional Delivery in Hot Spot Districts Slide 20
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. Slide 21 TOTAL FERTILITY RATE (TFR) Total Fertility
Rate State State valueDistrict with Minimum TFRDistrict with
Maximum TFRRange First updation BaselineFirst UpdationBaselineFirst
UpdationBaseline First Updation Baseline Assam2.4 2.6 Kamrup (2.0),
Nalbari (2.0) Kamrup (2.0), Nalbari(2.0) Hailakandi (3.9)
Hailakandi (4.2) 1.9 2.2 Bihar3.6 3.7 Patna (2.7) Patna (2.8)
Sheohar (4.6) Sheohar (4.7) 1.9 Chhattisgarh2.8 2.9 Koriya (2.4),
Kanker (2.4), Durg (2.4) Koriya (2.4) Kawardha (3.7) 1.3
Jharkhand2.9 3.1 Purbi Singhbhum (2.2) Purbi Singhbhum (2.4) Pakaur
(3.9) Lohardagga (4.0) 1.7 1.6 Madhya Pradesh 3.1 Bhopal (2.1)
Indore (2.2) Shivpuri(4.4) Shivpuri (4.5) 2.3 Odisha2.3 Anugul
(1.9), Bargarh (1.9), Jharsuguda (1.9) Jharsuguda (2.0) Baudh (3.5)
Boudh (3.7) 1.6 1.7 Rajasthan3.1 3.2 Kota (2.5) Kota (2.6) Barmer
(4.5) Barmer (4.7) 2.0 2.1 Uttar Pradesh3.4 3.6 Kanpur Nagar (2.2)
Kanpur Nagar (2.3) Shrawasti (5.8) Shrawasti (5.9) 3.6
Uttarakhand2.1 2.3 Pithoragarh (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. Slide 22 TOTAL FERTILITY RATE (TFR) 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 State0 - 2.12.2 - 3.03.1 -
4.04.1 and aboveGrand Total Assam7 (3)14 (16)2 (3)0 (1)23 Bihar0
(0)1 (1)28 (26)8 (10)37 Chhattisgarh0 (0)14 (12)2 (4)0 (0)16
Jharkhand0 (0)9 (8)9 (10)0 (0)18 Madhya Pradesh1 (0)19 (15)22 (25)3
(5)45 Odisha12 (10)17 (18)1 (2)0 (0)30 Rajasthan0 (0)18 (16)12
(13)2 (3)32 Uttar Pradesh0 (0)14 (9)45(48)11 (13)70 Uttarakhand9
(7)4 (5)0 (1)0 (0)13 All States29 (20)110 (100)121 (132)24 (32)284
Slide 23 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 622000313 Rajasthan
13140000532 Uttar Pradesh 25143707 70 Bihar 16133000537 Assam
1252000423 Jharkhand 1151000118 Odisha 2040000630 Chhattisgarh
820000616 Madhya Pradesh 3091101345 Total 141681280847284 TOTAL
FERTILITY RATE (TFR) Slide 24 229 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.) Slide 25 TOTAL FERTILITY RATE
(TFR) Baseline First Updation Replacement level of TFR Slide 26
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). Slide 27 Family Planning: Current Usage
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 ValueDistrict with Minimum
FPDistrict with Maximum FPRange First Updation baseline First
Updation baseline First Updation baseline First Updation baseline
Assam65.1 57.9 Dhubri (45.1) Dhubri (33.2) Kamrup (76.0) Lakhimpur
(67.6) 30.9 34.4 Bihar43.0 37.6 Nawada (31.5) Siwan (26.0) Supaul
(60.8) Muzaffarpur (52.2) 29.3 26.2 Jharkhand56.5 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 Chhattisgarh58.6 53.9 Dantewada
(33.4) Kawardha (68.2) Dhamtari (68.7) 34.8 35.3 Odisha59.4 56.2
Baudh (29.8) Kandhamal (28.6) Baleshwar (78.1) Baleshwar (73.4)
48.3 44.8 Rajasthan66.4 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 Uttarakhand61.7 62.7 Haridwar (56.2) Haridwar (53.7)
Pithoragarh (78.2) Dehradun (67.1) 22.0 13.4 Slide 28 Family
Planning: Current Usage Frequency distribution of current usage in
terms of number of districts in each State State 0-3030-5050-7070
& aboveTotal Districts Assam0 (0)2 (3)15 (20)6 (0)23 Bihar0
(4)29 (31)8 (2)0 (0)37 Chhattisgarh0 (0)3 (7)13 (9)0 (0)16
Jharkhand0 (0)7 (13)11 (5)0 (0)18 Madhya Pradesh0 (0)1 (2)40 (40)4
(3)45 Odisha1 (1)8 (9)16 (19)5 (1)30 Rajasthan0 (0)0 (1)21 (24)11
(7)32 Uttar Pradesh0 (3)20 (24)44 (42)6 (1)70 Uttarakhand0 (0) 6
(13)7 (0)13 All States1 (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. Slide 29 Family Planning: Current Usage CURRENT USAGE
OF ANY METHOD OF FAMILY PLANNING (%) BaselineFirst Updation Dist.
with > 60% Usage Slide 30 Share of sterilization in any modern
method of family planning (%) Assam Uttar Pradesh
JharkhandBiharOdishaUttarakhandRajasthanChhattisgarh Madhya Pradesh
Female35.1 (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) Male0.8 (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) Family
Planning: Current Usage FEMALE STERILIZATION (%) Slide 31 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. Slide 32 Unmet Need for Family Planning Total Unmet need
(%) State State Value District with Minimum unmet needDistrict with
Maximum unmet needRange First Updation baselineFirst
UpdationbaselineFirst Updationbaseline First Updation baseline
Assam15.9 24.0 Kamrup (8.4) Sibsagar (15.3) Karimganj (33.6) Dhubri
(42.9) 25.227.6 Bihar33.5 39.2 Patna (20.2) Patna (24.6) Katihar
(46.5) Kishanganj (52.5) 26.327.9 Jharkhand22.6 30.5 Hazaribagh
(13.2) Bokaro (18.2) Gumla (33.2) Godda (42.8) 20.024.6 Madhya
Pradesh 21.6 22.4 Datia(14.4) Dewas(14.4) Jabalpur (14.3)
Sidhi(38.3) Rewa (34.2) 23.919.9 Chhattisgarh24.8 26.4 Dhamtari
(13.9) Dhamtari (14.5) Dantewada (48.7) Bastar (36.0) 34.821.5
Odisha19.1 23.2 Kendujhar (9.7) Baleshwar (6.1) Baudh (45.3) Boudh
(48.3) 35.642.2 Rajasthan12.6 19.6 Jhunjhunun (3.1) Ganganagar
(10.0) Jaisalmer (28.1) Dhaulpur (32.4) 25.022.4 Uttar Pradesh24.1
29.7 Jhansi (12.7) Mahoba (15.1) Sultanpur (48.1) Sitapur (61.3)
35.446.2 Uttarakhand18.1 23.2 Dehradun (12.8) Dehradun (16.8)
Almora (27.4) Haridwar (29.2) 14.612.4 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. Slide 33 Unmet Need for Family Planning Frequency
distribution of unmet need in terms of number of districts in each
State State 0-2020-4040-6060 & aboveTotal Districts Assam16
(6)7 (16)0 (1)0 (0)23 Bihar0 (0)29 (20)8 (17)0 (0)37 Chhattisgarh3
(4)12 (12)1 (0)0 (0)16 Jharkhand5 (2)13 (13)0 (3)0 (0)18 Madhya
Pradesh12 (18)33 (27)0 (0) 45 Odisha14 (12)13 (15)3 (3)0 (0)30
Rajasthan26 (16)6 (16)0 (0) 32 Uttar Pradesh23 (9)42 (52)5 (8)0
(1)70 Uttarakhand6 (2)7 (11)0 (0) 13 All States105 (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.
Slide 34 Unmet Need for Family Planning BaselineFirst Updation
TOTAL UNMET NEED FOR FAMILY PLANNING (%) Unmet need of
