Sunday, 14 August 2011

India - Annual Health Survey of 9 states with worst ill health

Ministry of Health and Family Welfare 10-August, 2011 17:37 IST
Results of Annual Health Survey Conducted in Nine States

Bageshwar in Uttarakhand has reported minimum Crude Birth Rate (CBR) of 14.7 while Dhemaji in Assam has reported the Minimum Crude Death Rate (CDR) of 4.5 as per the findings of the Annual Health Survey (AHS) in 284 districts of nine states. The survey results were released by Secretary, Health & Family Welfare Shri K. Chandramouli at a press conference in New Delhi today in the presence of Registrar General of India Shri C. Chandramouli. The CBR which is measure of live births per 1000 population was maximum at 40.9 in Shrawasti in Uttar Pradesh. CBR in rural areas of districts is generally higher than that in urban areas. CDR which denotes number of deaths per 1000 population was also maximum in Shrawasti at 12.6. Further, rural death rate in districts is significantly higher than the corresponding urban death rate. Low female death rates have also been observed as compared to male death rates.

Infant Mortality Rate (IMR) which denotes the number of infant deaths (age below one year) per 1000 live births has been reported to be minimum at 19 in Rudraprayag in Uttarkhand while in Shrawasti in Uttar Pradesh it was maximum at103 exhibiting a variation of 5 times. Six districts namely Purbi Singhbhum & Dhanbad (Jharkhand) and Chamoli, Rudraprayag, Pithoragarh & Almora (Uttarakhand) have already achieved the UN Millennium Development Goal (MDG)-4 National target of 28 by 2015. Another 4 districts viz. Bokaro & Ranchi (Jharkhand) and Bageshwar & Nainital (Uttarakhand) are in closer vicinity. Female infants in districts experience a higher mortality than male infants. IMR in rural areas of districts is significantly higher than that in urban areas.

Neo-Natal Mortality Rate (NNMR) measures the number of infant deaths (age below 29 days) per 1,000 live births. Rudraprayag in Uttarkhand has reported the minimum NNMR at 11 while Balangir in Orissa, the maximum at75 showing a variability of 7 times. Out of every 10 infant deaths 6 -7 pertain to Neo Natal Deaths. Rural NNMR in districts is significantly higher than the urban.

Under Five Mortality Rate (U5MR) which denotes the number of children who died before reaching their fifth birthday per 1,000 live births has been reported in Pithoragarh district of Uttarakhand as minimum at 24 and maximum in Kandhmal district of Orissa at 145. More number of females in districts die before reaching age 5 years as compared to their counterparts. In all, 7 districts viz. Pithoragarh, Almora, Rudraprayag, Chamoli, Nainital & Bagheswar (Uttarakhand) and Purbi Singhbhum (Jharkhand) have already achieved the MDG -4 National target of 42 by 2015. Another 10 districts viz. Dhanbad, Bokaro, Kodarma, Hazaribagh & Giridih (Jharkhand) and Kota (Rajasthan) and Champawat, Udham Singh Nagar, Dehradun & Uttarkashi (Uttarakhand) are in closer vicinity. Rural U5MR in districts is significantly higher than the urban.

In order to facilitate direct intervention, the Maternal Mortality Ratio (MMR) measuring the proportion of maternal deaths per 1,00,000 live births has been published for a group of districts. The grouping of districts has been done on the basis of existing administrative divisions (Commissionraits) in the respective AHS States. In all, there are 62 such divisions across 9 AHS States. Among these divisions, the minimum MMR of 183 has been reported for Kumaon HQ in Uttarakhand and the maximum 451 in Faizabad Mandal in UP.

Sex Ratio at Birth (SRB) defined as the number of female live births per 1,000 male live births has been reported the lowest at 764 in Pithoragarh district of Uttarakhand and the maximum 1030 in Moradabad district of Uttar Pradesh. SRB in rural areas of districts is generally higher than in urban areas.

The survey has been implemented by the Office of Registrar General, India in all the 284 districts in eight Empowered Action Group States which include Bihar, Jharkhand, Uttar Pradesh, Uttarakhand, Madhya Pradesh, Chhattisgarh, Orissa and Rajasthan and in Assam for a three year period of XI Five Year Plan. It has been designed to yield benchmarks of core vital and health indicators at the district level on fertility and mortality; prevalence of disabilities, injuries, acute and chronic illness and access to health care for these morbidities; and access to maternal, child health and family planning services. The objective is to monitor the performance and outcome of various health interventions of the Government including those under National Rural Health Mission (NRHM) at closer intervals through benchmark indicators.

These nine States, which account for about 48 percent of the total population in the country, are the high focus States in view of their relatively higher fertility and mortality indicators. A representative sample of 18 million population and 3.6 million households is to be covered in 20,694 statistically selected PSUs (Census Enumeration Blocks in case of urban areas and villages or a segment thereof in case of villages in rural areas) in these 9 AHS States every year. Even with the present coverage, the AHS is the largest demographic survey in the world and is two and half times that of the Sample Registration System.

The fieldwork for Baseline Survey was carried out during July, 2010 to March, 2011. The first set of data was released today in the form of a State-wise bulletin. These indicators would provide requisite inputs for better planning of health programmes and pave the way for evidence based intervention strategies.

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