Reproductive and Child Health Care DK Dutta
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Fact on Maternal and Neonatal Mortality and Morbidity in India1

 
INDIA FACT SHEET
 
Economy
–
Human Development Index ranking1
127 of 177 countries
–
Proportion of population below poverty line
–
National poverty line2
  • Combined
  • Rural
  • Urban
26.10%
27.09%
23.62%
International poverty line1
  • US 1 Dollar a day
37.70%
–
Gross National Income per capita3
2570 PPP–US Dollars
–
Gross Domestic Product per capita1
2670 PPP–US Dollars
–
Average annual percent growth of GDP3
4.4%
–
Health expenditure (as % of GPD)1
  • Total
  • Public
  • Private
5.1%
0.9%
4.2%
–
Private out of pocket expenditure (% of total expenditure on health)
82.10%
–
Per capita total expenditure on health4
  • At average exchange rate
  • International Dollar
24 US
Dollars
80 Dollars
2
(Source—STATE OF INDIA'S NEWBORNS.)
–
Per capita Government expenditure on health4
  • At average exchange rate
  • International Dollar
4 US Dollars
14 Dollars
–
External resources for health
As% of total expenditure on health4
0.4%
–
Physicians per 100,000 population1
51
 
DEMOGRAPHY
–
Population3
  • Combined
  • Rural
  • Urban
  • Males
  • Females
1027 million
741.7 million
285.4 million
531.3 million
495.7 million
–
Average annual population growth5
–
Birth rate6
  • Combined
  • Rural
  • Urban
25.0
26.6
19.1
–
Crude death rate6
  • Combined
  • Rural
  • Urban
8.1
8.7
6.1
–
Sex ratio5
933 females per 1000 males
 
MATERNAL, NEWBORN AND CHILD HEALTH
Under 5 mortality rate7
94.9 (per thousand live births)
Under 5 mortality rank8
53 of 193 countries
Infant mortality rate6
64.0 (per thousand live births)
Neonatal mortality rate9
44.4 (per thousand live births)
Early neonatal mortality9
32.0 (per thousand live births)
Life expectancy at birth8
64 years
Maternal mortality ratio7
540 (per thousand live births)
3
Institutional delivery rate7
33.6%
Birth within 24 months of a previous birth7
28.3%
Birth with medical antenatal care7
65.2%
Birth with antenatal care in first trimester7
33.0%
Birth with medical assistance at delivery7
42.3%
Births in a medical facility7
33.6%
Children 12 – 33 months fully vaccinated7
42.0%
 
NUTRITION
–
Low birth weight rate (1998 – 2000)8
30.0%
–
Proportion of under – 5 children suffering from moderate and severe under weight8
47.0%
–
Children under 4 months who are exclusively breastfed7
37.0%
 
EDUCATION
–
Literacy rate5
  • Total
  • Males
  • Females
65.4%
76.0%
54.3%
–
Net primary school enrollment/(1996-2002)8 attendance
76.0%
–
Adult literacy rate: females as % of males8
83.0%
–
Gross enrollment ration: females as % of males8
  • Primary School
  • Secondary School
83.0%
70.0%
GPD – Gross Domestic Product
–
Purchasing power parity (PPP): This refers to a rate of exchange that accounts price differences across countries, allowing international comparison of real output and incomes.
REFERENCES
  1. United Nations Development Programme, Human Development Report 2004,  New York,  2004.
  1. 4 Planning Commission, Government of India, National Human Development Report 2001, New Delhi, 2003.
  1. The World Bank, World Development Report 2004, Washington DC, 2003.
  1. World Health Organization, The World Health Report 2003, Geneva, 2003.
  1. Census of India 2001, www.censusindia.net, Accessed 18th November 2003.
  1. Registrar General of India, Sample Registration System Bulletin 2002, Oct. 2003.
  1. Indian Institute of Population Studies, National Family Health Survey (NFHS – 2) 1998-99. Mumbai 2000.
  1. The United Nations Children's Fund (UNICEF). The State of the World's Children 2004, New York, 2004.
  1. Registrar General of India. Sample Registration System Bulletin (SRS) Statistical Report 2000, New Delhi (Under publication).
 
CHILD, INFANT AND NEONATAL DEATHS
Indicator
Value
Reference Year(s)
Population1
1,010 million
2000
Birth rate2,3
25.8 per 1000 population
2000
Estimated number of live births per annum
26.06 million
2000
Under – 5 child mortality rate4
95 per 1000 live births
1993–98
Estimated number of under – 5 child deaths5
2.4 million
2000
Infant mortality rate (IMR)2
68 per 1000 live births
2000
Estimated number of infant deaths
1.77 million
2000
Neonatal mortality rate (NMR)2
44.4 per 10000 live births
2000
Estimated number of neonatal deaths
1.16 million
2000
REFERENCES
  1. www.censusindia.net (Census of India 2001 : Advance release calender). Accessed 24th September 2003. adjusted for the Annual Growth Rate.
  1. Registrar General of India. Sample Registration System (SRS) Bulletin Volume 35; October 2001.
  1. 5 Registrar General of India, Sample Registration System (SRS) Statistical Report 2000, New Delhi 2004 (Under publication).
  1. Indian Institute of Population Studies. National Family Health Survey (NFHS – 2) 1998-99.  Mumbai  2000.
  1. Black RE, Morries SS, Bryce J. Where and why are 10 million children dying every year? Lancer 2003;361:2226–34.
 
STATE-WISE MORTALITY RATES
State-wise neonatal, infant and under-five child mortality rates (per 1000 live births)
State
SRS
NFHS II1998 – 993
IMR 20021
NMR 20002
NMR
IMR
U-5MR
India
64
44.4
43.4
67.6
94.9
Andhra Pradesh
62
45
43.8
65.8
85.1
Assam
70
47
44.6
69.5
89.5
Bihar
61
42
46.5
72.9
105.1
Gujarat
60
42
39.6
62.6
85.1
Haryana
62
38
34.9
56.8
76.8
Himachal Pradesh
58
31
22.1
34.4
42.4
Karnataka
55
40
37.1
51.5
69.8
Kerala
10
10
13.8
16.3
18.8
Madhya Pradesh
85
59
54.9
86.1
137.6
Maharashtra
45
33
32.0
43.7
58.1
Orissa
87
61
48.6
81.0
104.4
Punjab
51
29
34.3
57.1
72.1
Rajasthan
78
49
49.5
80.4
114.9
Tamil Nadu
44
36
34.8
48.2
63.3
Uttar Pradesh
80
53
53.6
86.7
122.5
West Bengal
49
31
31.9
48.7
67.6
Delhi
32
NA
29.5
46.8
55.4
Jammu & Kashmir
47
NA
40.3
65.0
80.1
Arunachal Pradesh
40
NA
41.8
63.1
98.1
Manipur
17
NA
18.6
37.0
56.1
Meghalaya
60
NA
50.7
89.0
122.0
Nagaland
NA
NA
20.1
42.1
63.8
Sikkim
39
NA
26.3
43.9
71.0
Goa
19
NA
31.2
36.7
46.8
REFERENCES
  1. Registrar General of India. Sample Registration System (SRS) Bulletin Volume 37; October 2003.
  1. 6 Registrar General of India. Sample Registration System (SRS) Statistical Report 2000. New Delhi 2004 (Under Publication).
  1. Indian Institute of Population Studies. National Family Health Survey (NFHS-2) 1998–99, Mumbai 2000.
 
BURDEN OF NEONATAL DEATHS
State-wise burden of neonatal deaths in India
Crude birth rate1 (per 1000 population)
Population in millions2 (1999-2000)
Estimated births
Neonatal mortality rate1 (per 1000 live births)
Estimated neonatal deaths
Andhra Pradesh
21.30
75.47
1,607,511
45.00
72,337
Assam
26.20
26.20
704,780
47.00
33,124
Bihar
31.90
99.92
3,187,448
42.00
133,872
Gujarat
25.20
48.25
1,215,900
42.00
51,067
Haryana
26.90
19.84
533,696
38.00
20,280
Himachal Pradesh
22.10
6.71
148,291
31.00
4,597
Karnataka
22.00
52.10
1,146,200
40.00
45,848
Kerala
17.90
32.26
577,454
10.00
5,774
Madhya Pradesh
31.20
79.76
2,488,512
59.00
146,822
Maharashtra
20.90
91.12
1,904,408
33.00
62,845
Orissa
24.30
35.86
871,398
61.00
53,155
Punjab
21.50
23.52
505,680
29.00
14,664
Rajasthan
31.20
53.55
1,670,760
49.00
81,867
Tamil Nadu
19.20
61.78
1,186,176
36.00
42,702
Uttar Pradesh
32.80
170.11
5,579,608
53.00
295,719
West Bengal
20.60
79.01
1,627,606
31.00
50,455
India
25.80
997.13
25,725,954
44.00
1,131,941
REFERENCES
  1. Registrar General of India. Sample Registration System (SRS). Statistical Report 2000. (Under publication).
  1. Planning Commission. Government of India. National Human Development Report 2001. New Delhi : 2003.
7
 
EARLY NEONATAL MORTALITY RATES
Early neonatal mortality rates1 (per 1000 live births), by residence, India, and larger states
India and larger states
Early neonatal mortality rate
Total
Rural
Urban
India
32
35
19
Andhra Pradesh
35
39
22
Assam
31
32
16
Bihar
31
32
20
Gujarat
31
32
20
Haryana
33
38
20
Himachal Pradesh
26
27
12
Karnataka
31
37
14
Kerala
6
7
4
Madhya Pradesh
44
46
32
Maharashtra
23
26
16
Orissa
45
47
27
Punjab
18
20
11
Rajasthan
33
35
21
Tamil Nadu
25
29
16
Uttar Pradesh
41
43
29
West Bengal
21
23
12
REFERENCES
  1. Registrar General of India. Sample Registration System (SRS) Statistical Report 2000. New Delhi : 2004 (Under publication).
 
TRENDS IN MORTALITY RATES
Trends in infant morality rate, neonatal morality rate and post-neonatal morality rate (per 1000 live births).8
Year
Infant mortality rate
Neonatal mortality rate
Post-neonatal mortality rate
Total
Rural
Urban
Total
Rural
Urban
Total
Rural
Urban
1971
129
138
82
75.2
80.6
45.4
54.2
57.4
36.6
1972
139
150
85
71.6
76.1
44.9
68.2
73.4
40.1
1973
134
143
89
68.2
72.1
47.5
66.2
70.8
41.4
1974
126
136
74
70.1
75.7
44
55.8
60.2
32.9
1975
140
151
84
78.3
84.3
46.2
62.1
66.7
37.8
1976
129
139
80
77
83
49
52
56
31
1977
130
140
81
80.2
88
42
49.8
52
39
1978
127
137
74
77.4
85.2
38
49.6
51.8
36
1979
120
130
72
71.7
77.7
42.4
48.3
52
29.5
1980
114
124
65
69.3
75.5
39.1
44.6
18.3
26.1
1981
110
119
63
69.9
75.6
38.5
40.5
43.5
24
1982
105
114
65
66.7
72.9
38.8
38.1
40.8
26.4
1983
105
114
66
67.2
73.6
39.3
37.7
40.2
26.5
1984
104
113
66
65.8
72.2
39.7
38.2
41.1
26.4
1985
97
107
59
60.1
66.6
33.3
37.1
39.9
25.6
1986
96
105
62
59.8
65.5
36.2
36.6
39.1
25.8
1987
95
104
61
57.7
63.6
33.3
37.7
40.5
27.3
1988
94
102
62
56.8
62
34.6
37.7
40.1
27.5
1989
91
98
58
56.4
62.1
31.4
34.5
36.4
26.3
1990
80
86
50
52.5
57.4
30.9
27.2
28.9
19.5
1991
80
87
53
51.1
55.4
32.2
29.3
31.3
20.6
1992
79
85
53
50
53.6
33
29.4
31.4
20
1993
74
82
45
47.1
52.3
28.4
25.5
28.2
15.8
1994
74
80
52
47.7
52
32.6
26
27.5
19.6
1995
74
80
48
48.1
52.3
29.2
25.9
27.5
19
1996
72
77
46
47
50
28
25
27
17
1997
71
77
45
46.1
50.5
26.2
25.1
26.5
19
1998
70
75
44
45.1
49
27
26.5
28.4
17.9
1999
70
75
44
44.8
49.2
27.7
27.9
25.9
16.1
2000
68
74
43
44.4
48.7
27.5
23.4
25.3
16.1
2001
66
72
42
Not available
2002
64
69
40
SRS Data
9
 
ANTENATAL CARE AND DELIVERY
Distribution of antenatal care coverage, institutional births, skilled attendance by state
State
Proportion (%) who received all recommended types of antenatal care1
Proportion (%) of births delivered in a medical institution
Proportion (%) of deliveries assisted by a health professional2
India North
20.0
33.6
42.3
Delhi
32.8
59.1
65.9
Hariyana
20.8
22.4
42.0
Himachal Pradesh
30.2
28.9
40.2
Jammu and Kashmir
30.7
35.6
42.4
Punjab
31.7
37.5
62.6
Rajasthan
8.3
21.5
35.8
Central
Madhya Pradesh
10.9
20.1
29.7
Uttar Pradesh
4.4
15.5
22.4
East
Bihar
6.4
14.6
23.4
Orissa
21.4
22.6
33.4
West Bengal
19.7
40.1
44.2
North-east
Arunachal Pradesh
17.3
31.2
31.9
Assam
15.8
17.6
21.4
Manipur
18.3
34.5
53.9
Meghalaya
10.4
17.3
20.6
Mizoram
13.5
57.7
67.5
Nagaland
8.9
12.1
32.8
Sikkim
15.3
31.5
35.1
West
Goa
60.6
90.8
90.8
Gujarat
25.0
46.3
53.5
Maharashtra
31.0
52.6
59.4
South
Andhra Pradesh
35.6
49.8
65.2
Karnataka
41.5
51.1
59.1
Kerala
64.9
93.0
94.0
Tamil Nadu
50.8
79.3
83.8
Note: Table includes only the two most recent births during the three years preceding the survey. Three or more antenatal check-ups (with the first check-up within the first trimester of pregnancy), two or more.2Doctor, auxiliary nurse midwife, nurse, lady health visitor, or other health professional.
10
REFERENCES
  1. Indian Institute of Population Studies. National Family Health Survey (NFHS-2) 2000; 1998-99.
 
PLACE OF DELIVERY
Rural-urban and socio-economic differential in place of delivery1 (percent distribution)
Characteristic
Health facility/institutions
Home
Other
Public
NGO/Trust
Private
Total
Own
Parents
Total
Place of residence
Rural
12.5
0.5
11.6
24.6
60.5
13.8
74.3
1.0
Urban
29.1
1.5
34.5
65.1
27.6
6.3
33.9
1.0
Caste/tribe
Scheduled caste
16.0
0.5
10.3
26.8
60.1
12.0
72.1
1.1
Scheduled tribe
10.7
0.7
5.7
17.1
70.4
11.4
81.8
1.1
Other backward clases
16.3
0.8
19.0
36.1
49.8
13.0
62.8
1.1
Others
17.9
0.9
21.3
40.1
47.1
11.9
59.0
0.9
Standard of Living index
Low
11.9
0.4
6.2
18.5
66.1
14.2
80.3
1.2
Medium
18.1
0.8
16.0
34.9
51.8
12.3
64.1
1.0
High
20.3
1.1
43.2
64.6
27.6
7.0
34.6
0.7
Mother's Education
Illiterate
10.2
0.4
6.8
17.4
68.1
13.4
81.5
1.1
Literate (<middle school)
23.3
1.1
19.0
53.4
42.3
13.4
55.7
0.9
Middle school Complete
28.5
1.0
25.6
55.1
32.8
11.1
43.9
High school and above
24.2
1.5
49.3
75.0
17.9
6,424.3
0.7
1.1
Total
16.2
0.7
16.7
33.6
53.2
12.2
65.4
1.0
Date from 32,393 births.
REFERENCES
  1. Indian Institute of Population Studies, National Family Health Survey (NFHS-2) 2000; 1998-99.
11
 
ASSISTANCE DURING DELIVERY
Rural-urban and socio-economic differential in assistance during delivery1 (percent distribution)
Characteristic
Skilled attendant
TBA
Other
Missing
Doctor
ANM/nurse/midwife LHV
Other health prefessional
Total
Place of residence
Rural Urban
23.0
9.8
0.7
33.5
39.6
26.6
0.3
Caste/tribe
55.8
17.2
0.3
73.3
18.8
7.6
0.2
Scheduled caste
23.5
12.1
1.2
36.8
37.7
25.1
0.5
Scheduled tribe
14.5
8.3
0.2
23.4
44.4
32.2
0.5
Other backward classes
31.8
12.3
0.8
44.9
34.9
19.9
0.3
Other
37.7
11.3
0.3
49.3
31.4
19.5
0.2
Standard of Living
Low
15.8
8.5
1.1
25.4
43.5
30.7
0.5
Medium
31.1
12.8
0.4
44.3
34.3
21.1
0.3
High
60.9
14.5
0.3
75.7
17.5
6.8
0.1
Mother's education
Illiterate
15.6
9.0
0.8
25.4
44.7
29.6
0.4
Literate (<Middle school)
37.3
15.4
0.4
53.1
28.4
18.1
0.3
Middle school Complete
49.5
17.1
0.3
66.9
21.0
11.7
0.3
High school and above
70.3
12.9
0.2
83.4
11.8
4.7
0.1
Total
30.3
11.4
0.6
42.3
35.0
22.4
0.3
REFERENCES
  1. Indian Institute of Population Studies. National Family Health Survey (NFHS-2) 1998–99. Mumbai : 2000.