Rch ii baseline survey-report

Baseline Survey on Reproductive and Child Health (RCH-II) Andhra Pradesh

Key Findings

P. Satya Sekhar

V. Umadevi

N.V. Rajeswari

Ch.V.S. Sitarama Rao

Commissionerate of Family Welfare GoAP. , Hyderabad – 500 095

Indian Inst i tute of Health and Family Welfare Venga lrao Nagar , Hyderabad – 500 038

September, 2007

CONTENTS

Acknowledgements i

Organizations involved in Field Work iii

Objectives 2

Antenatal Care 3

Components of Antenatal Checkups 6

Problems Self Reported by Mothers 7

Delivery Care 8

Complications/Problems during Delivery 10

Post Natal Care 10

Birth Weight of Newborn 11

Breast feeding and supplementation 12

Child Morbidity and Treatment Patterns 14

Child Immunization 15

Infant Mortality 17

Reproductive Health Problems 19

RCH-II Intervention Programme

Janani Suraksha Yojana 20

Free Travel by the Public Transportation by Pregnant Women 21

Round-the-Clock MCH Centre 22

Women Health Volunteer Scheme (ASHA) 22

Conclusions 23

Notes 27

References 28

Fact Sheet

Andhra Pradesh 29

Coastal Andhra Region

Srikakulam 37

Vizianagaram 45

Visakhapatnam 53

East Godavari 61

West Godavari 69

Krishna 77

Guntur 85

Prakasam 93

Nellore 101

Rayalaseema Region

Kurnool 109

Anantapur 117

Kadapa 125

Chittoor 133

Telangana Region

Ranga Reddy 141

Hyderabad 149

Nizamabad 157

Medak 165

Mahabubnagar 173

Nalgonda 181

Warangal 189

Khammam 197

Karimnagar 205

Adilabad 213

i

ACKNOWLEDGEMENTS

India, as one of the signatory countries of ICPD Plan of Action has been

implementing the Reproductive and Child Health program since early 1997. The

RCH-I recorded marginal contribution in the State’s efforts to improve MCH indicators.

The RCH-II program adopted mission mode by using performance, benchmarking and

accountability tools and meeting long term health and population outcome goals. Until

now analysis of health status at the district and regional levels has been primarily

based on a single indicator, viz., infant mortality. In this backdrop, the State

Government had undertaken the Baseline survey to understand the reproductive

health status at the district level. The present Baseline Survey of Reproductive and

Child Health (RCH-II) was successfully completed thanks to the efforts and

involvement of numerous organizations and individuals at different stages of the

survey. The conduct and analysis of this large-scale survey by the nodal agency

required the cooperation and support of many people for its successful completion.

Although it is not possible to acknowledge each and every one associated with the

survey by name, some persons yet deserve special mention.

First of all, we would like to thank Dr. C.B.S. Venkataramana, IAS, Former

Commissioner (Family Welfare) and Ex-Officio Principal Secretary to Government

(HM & FW) and Mr. Anil Punetha, IAS, Present Commissioner (Family Welfare) and

Ex-Officio Secretary to Government (HM & FW) for their keen interest right from the

beginning of the project and for conducting several meetings to review the progress of

the project.

Special thanks are due to Dr. K. Balasubramanian, Consultant and Former

Director, Centre for Media Studies, Hyderabad, who continued to take an active

interest in the project and provided timely guidance and support. We wish to express

our thanks to Dr. C. Sulochana, Additional Director, Dr. R. Gopalakrishna Rao, Joint

Director, Dr. M.S. Srinivasa Rao, Joint Director and Mr. B. Brahmanandam, Deputy

Director (Demography) of the Commissionerate of Family Welfare for providing useful

comments to finalise the survey instruments and Fact Sheet in dissemination

workshop.

ii

Special mention and thanks are due to Dr. KVR Subrahmanyam and Mr. R.

Madhav Reddy of the Population Research Center, Andhra University,

Visakhapatnam for their participation as Resource Persons in the investigators

training. The hard work put in by the eleven research agencies (field investigators and

supervisors) in collecting data in about 1300 villages and 980 urban blocks of Andhra

Pradesh is gratefully acknowledged. Thanks are due to all District Medical and Health

Officers (DM & HOs) for providing assistance during the field operations.

We appreciate the immense help received from the computer staff (Mr. PVSN

Kumar and Mr. Wajahat Ali) of IIHFW for developing the software package and

carrying out the arduous task of data cleaning, data entry, data processing and

preparation of tables. We also thank Mr. D. Srinivasa Rao, Mrs. Sivaranjani and

Mr. G. Vara Prasad for their help in data analysis and finalization of district Fact

Sheet.

Finally, we would like to record a note of appreciation for all eligible women and

the household respondents who spent their valuable time in responding to the survey

questionnaire and extending co-operation to us to complete the field work.

- Authors

iii

BASELINE SURVEY ON REPRODUCTIVE AND CHILD HEALTH (RCH-II)

ANDHRA PRADESH

Nodal Agency : Indian Institute of Health and Family Welfare

Vengalrao Nagar, Hyderabad – 500 038

Andhra Pradesh

Principal Coordinator : Dr. P. Satya Sekhar

Coordinators : Dr. V. Uma Devi

Dr. N.V. Rajeswari

Mr. Ch.V.S. Sitarama Rao

ORGANIZATIONS INVOLVED IN FIELD WORK

Sl. No. Field Organization Districts

1. Administrative Staff College, Hyderabad

Bella Vista, Hyderabad

West Godavari, Kurnool, Krishna, Hyderabad

2. AMR- A.P Academy of Rural Development

Rajendra Nagar, Hyderabad

Anantapur, Chittoor

3. Centre for Economic and Social Studies

Begumpet, Hyderabad

Khammam, Warangal

4. Centre for Media Studies

65 Jubilee Hills, Hyderabad

Karimnagar, Adilabad

5. Economics Dept, University of Hyderabad

Gatchibowli, Hyderabad

Mahabubnagar

6. Indian Institute of Health and Family Welfare

Vengalrao Nagar, Hyderabad

Medak, Nizamabad

7. Institute of Health Systems

HACA Bhavan, Hyderabad

Nellore, Prakasam, Kadapa

8. Nizam Institute of Medical Sciences

Panjagutta, Hyderabad

Ranga Reddy

9. Population Research Centre, Andhra University

Visakhapatnam

Srikakulam, Vizianagaram

10. SWC Consulting, Golkonda Cross Roads

Hyderabad

Visakhapatnam, East Godavari

11. THRIVE, Volunteers for Rural Health & Education

Nalgonda

Nalgonda, Guntur

1

Baseline Survey on Reproductive and Child Health (RCH-II) Andhra Pradesh

Key Findings

Promotion of maternal and child health has been one of the most important

objectives of the Family Welfare Programmes in India. Different interventions initiated

in the past, such as Maternal and Child Health, Universal Immunization Programme

(UIP), Child survival and Safe Motherhood (CSSM) emphasized either on antenatal

period of pregnant women or on child immunization and childhood diseases but little

stress was laid on natal care and effective safe motherhood aspects. After ICPD

(1994), MDG (2000) a greater emphasis in Reproductive and Child Health has been

placed the need to have safe delivery attended by a health personnel, need for

postnatal checkup, development of round the clock hospitals with blood banks and

blood storage in order to attend complicated deliveries. Only better access, availability

and quality health services to vulnerable groups can reduce the maternal mortality

ratio and infant mortality rate and effect a rise in institutional deliveries. The

Reproductive and Child Health (RCH-II) interventions like one Accredited Social

Health Activist (ASHA) per 1000 population, Janani Suraksha Yojana (JSY),

Emergency Health Transport of pregnant women for delivery, Free Bus Pass to

pregnant women to visit a PHC for antenatal checkup and Round-the-clock Mother

and Child Health Center and other innovative state-specific strategies were initiated

since late 2005 under the National Rural Health Mission (NRHM) in line with the

initiatives of the Government of India for reducing Infant mortality rate and Maternal

mortality ratio.

Responding to the growing need for data at district-level, the Indian Institute of

Health and Family Welfare (IIHFW), with the funding from Commissionerate of Family

Welfare, Government of Andhra Pradesh, conducted household survey at the district

level to obtain information on a number of policy relevant indicators relating to

reproductive and child health. The survey covered an overall sample of 59,117

households (where woman gave a child birth [alive or dead] since January/Sankranti

2004 to the date of survey 1) and interviewed about 59,000 currently married women

in reproductive age period (15-49) in the state. In each of the 23 districts surveyed,

about 2500 households were selected randomly and around an equal number of

eligible women were interviewed.2 Immunization particulars of all children under 2

years of age were also obtained from mother or principal care takers of children. The

field work of the survey was conducted during July-October 2006 by eleven reputed

research organizations in the state. The projections carried out by the National

Commission on Population, 2006 has also emphasized that the number of people in

2

15-54 years will increase from 463 million in 2001 to 558 million by 2011, indicating

the growing number of women, married women and deliveries. The number of married

women (couples) aged 15-49 also increase between the period 2001-2011, indicating

the need for further strengthening and extension of RCH services to all sections of

people in the coming decades.

Objectives

The main objectives of the baseline study were:

1. to provide district level data on the key maternal and child health indicators

such as infant mortality rate, ANC coverage, delivery care, postnatal care,

breastfeeding practices, prevalence of diarrhea and child immunization

coverage

2. to identify regional imbalances in the current status of health and utilization

of reproductive and child health services

3. to formulate district specific interventions and for allocation of more

resources in the lagged and low performing districts

The highlights provide the broad findings of RCH indicators for all 23 districts

and also for the State as a whole by aggregating the district figures an exercise highly

useful for decentralized planning of services at district level. The survey results

provide key policy relevant indicators namely infant mortality rate, antenatal care

coverage, delivery care, postnatal care, breastfeeding practices, prevalence of

diarrhea and ARI, contraceptive use, child immunization and awareness of

interventional programmes - Janani Suraksha Yojana (JSY), Women Health Volunteer

Programme (WHV), Free Bus Pass to Pregnant Women, Round the Clock MCH

Centres etc.

Highlights of the findings

of the survey are presented in

the following paragraphs.

Empirical studies in India and

abroad have established that

the recently delivered mothers

are self selected for their higher

potential fertility in future years.

The main objective of the

Baseline study has been to

Details of Sample Coverage

No. of HHs interviewed in the state

Total - 59117

Rural - 33746

Urban - 25371

No. of Eligible women Interviewed in the state

Total - 59378

Rural - 33902

Urban - 25476

No. of Live births (during Sankranti / Jan 2004 to the

date of Survey)

Total - 65341

Rural - 37237

Urban - 28104

3

measure the infant mortality, neonatal mortality rate at district level and coverage

rates of prenatal, natal and postnatal care. The services of both Government (PHC /

Sub-centre) and private institutions are extensively utilized by the recently delivered

mothers and pregnant women. Hence the baseline survey adopted Birth based

approach and collected information from respondents. This approach allowed us to

analyze the information on 65,000 live births that occurred during the period from

January/Sankranti 2004 to the date of survey. In other words, the survey covered

about 1200-1300 children in each district based on births (with an exposure of child

before completing one year of age in estimating Infant mortality rate).

Antenatal Care

Antenatal Care (ANC) includes pregnancy related care provided by any health

personnel in a medical institution or at home by health staff. It is widely believed that

utilization of antenatal care services contributes to improved maternal health, because

the visits include advice on correct diet, the provision of IFA tablets, and tetanus

toxoid injection to pregnant women in addition to medical care.

� Utilization of antenatal care is universal in the state and across background

characteristics (Social group, Mother’s education, Household assets measured

as Standard of Living Index). Nearly ninetyfour percent of mothers received 3

ANC checkups. The two lowest coverage rates of 83-85 percent were reported

from Anantapur and Kurnool districts.

� About 94 percent of mothers received at least one ANC from a MBBS Doctor.

Eight out of ten (82 percent) mothers in Kurnool and Anantapur received at least

one ANC from a MBBS doctor. Four antenatal check-ups one each during third,

sixth, eighth and ninth month of pregnancy have recommended as the minimum

and necessary [Park, 2002]). In the end-line evaluation, the survey has to

incorporate the number of ANC visits by specific months and number of visits to

MBBS doctors in order to assess outcome indicators. The number of antenatal

checkups and the timing of the first check-up are important for health of the

mother and outcome of the pregnancy.

� The median number of ANC visits in the state has been 5.8 visits (5.0 visits in

rural and 6.0 in urban areas). The median number of weeks a mother availed of

first antenatal care was 12 weeks i.e. only 50 percent of mothers initiated ANC

care in the 12th week of their pregnancy. This has to be improved substantially

by the end of project period.

4

� The number of antenatal

check-ups and the timing

of the first check-up are

important for health of

mother and outcome of

the pregnancy. The

NRHM identified the

proportion of women

registered in first trimester

as a process indicator of

reproductive and child

health. Sixtythree percent of women registered first antenatal check-up in the

first trimester (60 percent in rural areas and 67 percent in urban areas). Districts

reporting lower than 35 percent of ANC registration in first trimester are

Mahabubnagar and Ranga Reddy in Telangana region. More than half of the

women in scheduled caste and tribe (56 percent) sections registered in the first

trimester. The findings highlight that the need to educate the pregnant women

regarding the importance of early registration and motivate them for more than 4

visits in third, sixth, eighth and ninth months of pregnancy. In order to reach the

target of 95 percent by 2010, special emphasis and efficient monitoring are

required.

� Nine out of ten mothers

received 2 or more

doses of tetanus toxoid

injection across

background variables.

63%

95%

34.8

35.8

63.0

82.7

94.8

0 20 40 60 80 100

Ranga Reddy

Mahabubnagar

State

Vizianagaram

Visakhapatnam

50

1000

ANC Registration in First Trimester

Target

Baseline

Percent

63%

95%

52.8

57.5

56.4

67.3

59.7

63.0

0 20 40 60 80

Low SLI

S.T

S.C

Urban

Rural

Total

50

1000

ANC Registration in First Trimester

Target

Baseline

Percent

5

� Nutritional deficiencies in

women are often

exacerbated during

pregnancy because of

the additional nutrient

requirements for foetal

growth (NFHS-2, 1998-

99). For each birth

during the reference

period, the base-line

survey collected

information on whether the mother received or purchased IFA tablets or syrup

during pregnancy. About half (54 percent) of mothers received 100 IFA tablets

or syrup supplied by ANM or purchased from the market. The IFA coverage was

also lower in rural areas (52 percent) than in urban areas (56 percent).

� The percentage of

mothers who consumed

all the IFA tablets

(supplied/purchased)

during ANC was only 33

percent. Marginal

variations are observed

across background

variables (Social group,

Rural/urban and BPL

groups) under RCH-II

project. It is necessary to

improve the management of supply of IFA tablets. Counseling is essential to

increase the consumption of all IFA tablets as anaemia during pregnancy has

been one of the major causes for low birth weight. According to NFHS-3 (2005-

06) survey about 39 percent (46 percent in rural and 36 percent in urban areas)

indicated lower IFA consumption in the reference period of 90 days or more

during pregnancy. The RCH-II programme needs to emphasize the advantages

of IFA to pregnant women and evolve strategies to overcome the problem.

Studies showed that anemia may be one of the important causes for low birth

weight of babies delivered.

54%

95%

32.3

32.4

54.0

75.1

80.6

0 20 40 60 80 100

Ranga Reddy

Kurnool

State

Nellore

East Godavari

50

1000

Women received/purchased 100 or more IFA tablets

Target

Baseline

Percent

33.2%

95%

16.5

18.1

33.2

49.8

55.5

0 10 20 30 40 50 60

Nellore

Kadapa

State

Guntur

Anantapur

50

1000

Women Consumed All IFA tablets

Target

Baseline

Percent

6

� More than 75 percent of mothers reported the supply of 100 IFA tablets in East

Godavari, Nellore and Srikakulam districts but on the other hand, just one-third

of mothers received 100 IFA tablets in Ranga Reddy and Kurnool districts.

However those who consumed all tablets/syrup in the above districts are 29% in

East Godavari, 38% in Srikakulam districts and 17% in Nellore respectively.

� The effectiveness of antenatal check-ups in ensuring safe motherhood depends

in part on the tests and measurements done and advice provided to pregnant

women during check-ups. About 90 percent of mothers reported that they

received at least once the general services like weight measurement, blood

pressure examination, urine examination and abdominal examination as a part

of antenatal checkup at the state level. Marginal variations are observed across

background variables.

Components of Antenatal Checkups

The effectiveness of antenatal check-ups in ensuring safe motherhood depends

in part on the tests and measurements done during and advice provided to pregnant

women during antenatal check-ups.

� Among the births that occurred during survey period for which mothers received

antenatal check-ups, about 89-93 percent of mothers had an abdominal

examination, weight measurement, blood pressure examination as a part of the

antenatal checkup. Marginal variations are reported across background

variables.

� Majority of mothers were

advised /counseled by

health personnel (public

and Private sector)

during their entire

pregnancy period about

newborn care, breast

feeding practice, family

planning, expected date

of delivery and need to

have a delivery at a

medical institution. About

seventysix percent of mothers were advised on expected date of delivery,

having delivery in a hospital and on breast feeding practices. About half of the

mothers reported that they were informed by the health personnel on the danger

Women advised/counseled at least once

60.8

77.0

50.7

76.0

76.0

0 10 20 30 40 50 60 70 80 90 100

Family Planning

Breastfeeding Practices

Information on danger

signs of Pregnancy

To have delivery in a

Hospital

Expected Date of Delivery

Percent

7

signs of pregnancy (Anaemia, short stature, hypertension etc). Six out of ten

mothers received advice on family planning. The proportion who received advice

on different topics varied little by background characteristics like education of

mother, social group and economic group (BPL and SLI).

Problems Self Reported by Mothers

Eligible women delivered in the reference period were asked to report any

pregnancy related problems. The information presented here was based on woman’s

self report and should be interpreted with care.

� The problems most commonly reported are excessive fatigue/anemia (36

percent) followed by swelling of legs, body or face (24 percent).

� The population projections of Andhra Pradesh indicate an increase in number of

women in 15-44 years in the coming years from 202 lakhs in 2001 to 239 lakhs

in 2011 and beyond due to past decadal population momentum. Hence the

findings suggest that, there is a need to cater to the needs of currently married

women in the next decade by extending quality RCH services like early

registration, promoting delivery at a medical institution, information on danger

sings of high risk pregnancy, advice on breast feeding and family planning in

order to achieve set goals by 2010 and beyond.

� Overall, only 46 percent

of the mothers had

received full ANC care,

i.e. two doses of TT

injection, the required

number of IFA tablets

and at least 3 ANC

visits during their

pregnancy period. The

study indicates that

health workers have to

educate women on the

importance of all components of ANC and provide them quality services. The

urban areas recorded slightly higher full ANC coverage (49 percent) as

compared to 44 percent in rural areas.

46.5%

95%1000

Women received full ANC (2 TT + IFA 100 tablets + 3 ANC)

Target

Baseline

25.8

26.2

46.5

67.1

68.6

0 20 40 60 80

Kurnool

Ranga Reddy

State

Visakhapatnam

Nellore

Percent

8

� The full ANC coverage was above 60 percent in the districts Srikakulam,

Visakhapatnam, East Godavari, Guntur and Nellore. Special emphasis is

required in the districts namely Kurnool, Ranga Reddy, Mahabubnagar,

Nalgonda and Warangal districts which recorded below 35% of full ANC

coverage.

Delivery Care

Encouraging deliveries in proper hygienic conditions under the supervision of

trained health professional has been one of the major goals of NRHM for reduction in

MMR and IMR. Investing more funds to increase institutional deliveries in low

performing districts without quality health delivery system may yield lower results for

the resources spent under NRHM.

� About 76 percent of births during the reference period of survey were delivered

in health facility and less than one-fourth of the mothers (24 percent) were

delivered at home. Overall, 82 percent of deliveries were attended by doctors or

nurses/ midwives.

� Institutional deliveries

increased from 49.8 percent

in 1998-99 (NFHS-2) to 69

percent (based on last 2

births in the 3 years before

the survey) in 2005-06

(NFHS-3) and reached 76

percent in 2005-06. The log-

linear trend regression

equation fitted to the

institutional deliveries indicates that institutional deliveries could reach 90

percent by the end of 2010 as per the Goals set by the Government of Andhra

Pradesh.

� The district differentials indicate that an overwhelming majority of mothers had

availed institutional deliveries in all districts except in Rayalaseema region.

� The first two NFHS surveys conducted in the state during 1992 and 1998

indicated higher proportion of private institutional deliveries as compared to

deliveries conducted in public institutions (refer to deliveries of women in 15-49

years in the last three years reference period). The period exactly coincides with

the implementation of CSSM programme in Indian states with marginal impact

Trends in Institutional Deliveries in

Andhra Pradesh

76.0

32.9

49.8

61.4 63.769.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

1992 (NFHS-1) 1998 (NFHS-2) 2002-04(DLHS) 2003 (EC-

Survey)

2005-06

(NFHS-3)

2006

(Baseline)

Percent

9

on improving institutional deliveries conducted in public hospitals. One possible

explanation for higher private institutional deliveries during the period was the

improvement in socio-economic factors, availability of nursing homes in majority

of towns in the state. However, Balasubramanian and Satya Sekhar (2004) in

the Eligible Couple and Child Immunization study indicated that the deliveries in

public sector institutions improved due to implementation of ICPD initiatives and

RCH interventions. The baseline survey strengthens the argument and public

sector is playing a crucial role in delivery care in the state.

� Mothers who had child birth at home indicated the following reasons for not

seeking institutional delivery care:

- Not necessary and not customary : 33%

- Costs too high in a health facility : 7%

- Lack of transport to shift : 5%

- Lack of time to reach a health facility : 28%

� More than a quarter (27 percent) of deliveries were either by caesarian or other

interventions. The percentage of mothers who underwent caesarian section was

23 percent in rural and 32 percent in urban areas. Only 21 percent of mothers

belonging to Scheduled caste and Scheduled Tribe underwent caesarian

sections.

� The top five districts

that recorded the

highest caesarian

section deliveries

were Warangal

(48%), Karimnagar

(47%), Hyderabad

(37%), Khammam

(36%) and

Nizamabad (35%).

Highly developed

districts in

Telangana region reported higher proportion of caesarian section deliveries

whereas it was below 30 percent in West Godavari, Krishna and East Godavari

districts of Coastal Andhra region.

Caesarian Section

Percent of births by Caesarian Section

Top 5 districtsWarangal - (47.8)

Karimnagar - (46.8)

Hyderabad - (36.7)

Khammam - (36.2)

Nizamabad - (35.2)

Bottom 5 districtsEast Godavari - (17.5)

Kurnool - (16.0)

Anantapur - (11.8)

Chittoor - (11.3)

Visakhapatnam - ( 9.4)

State Average

Total : 26.5 Rural : 22.6 Urban : 31.6

S.C : 22.0 S.T : 18.4 BPL : 24.1

10

Complications/Problems during Delivery

Out of those who had reported complications/ problems during last delivery

14.1 percent had premature labour, 9.8 percent had obstructed labour, 9.9 percent

prolonged labour, 6.9 percent excessive bleeding and 2.4 percent breach

presentation. The percentages were marginally lower in urban areas as compared to

rural areas and also higher among background characteristics.

Post Natal Care

Health of a mother and her new born child depends not only on the health care

she received during her pregnancy and delivery, but also on continued care that she

and the infant received during first few weeks after delivery.

� Three out of four mothers who delivered in a medical institution availed postnatal

checkup within one week of birth.

� Sixty percent of non institutional births were followed up by a post natal checkup

within one week of delivery (59 percent in rural and 63 percent in urban areas)

either the mother visited the health facility or a health personnel visited the

home. Among non-institutional deliveries, mothers percentage who availed

postnatal check-up within two months was 64 percent (64 percent in rural and 67

percent in urban areas).

64.1%

95.2

93.8

20.1

64.1

25.2

0 20 40 60 80 100

Kadapa

Anantapur

State

Khammam

Warangal

50

1000

Postpartum check-up within two months in Non-institutional deliveries

Target

Baseline

Percent

� Contrary to the expectation, mothers are less likely to have received post natal

checkup even though they have had continuous interaction with health provider

through their pregnancy and delivery at medical institution or at home.

� Six out of ten (64 percent) of scheduled caste and scheduled tribe mothers who

delivered at home availed post natal care within one week of delivery.

11

� Out of those mothers who received post natal checkup, about 77 percent (71

percent in rural and 84 percent in urban) received checkup from M.B.B.S doctor.

Around 67 percent of scheduled caste and scheduled tribe mothers availed of

post natal checkup from a doctor. Across districts the postnatal care below 40

percent were recorded in Kurnool, Kadapa and Anantapur districts.

� There is urgent need to have a total coverage of postnatal checkup by a MBBS

Doctor or a trained medical professional in order to reduce the Neonatal

mortality rate by the end of the NRHM project period. New interventions and

packages need to be introduced with better monitoring of local health personnel

by the PHC medical officer. Mothers have to be educated through IEC

campaigns on the importance of postnatal care.

Birth Weight of New Born

Irrespective of primary

causes, over 2/3 of neonatal

deaths occur among infants

who weighed less than 2500

grams at birth. The low birth

weight may be due to poor

nutritional status,

hypertension, anaemia,

malaria and other infections

during pregnancy. Among

social and economic factors,

low maternal education, pregnancy at young age, frequent pregnancies and poor care

during pregnancy add greatly to the risk of low birth weight.

� About 77 percent of infants

were weighed at birth.

Nearly half (49 percent) of

the newborn were weighed

at births in Kurnool district.

More than 85 percent of

children weighed at birth

are in Hyderabad (urban)

Visakhapatnam, Chittoor,

Nizamabad and Warangal

districts. The proportion of

Low Birth Weight in Andhra Pradesh

NA

23.3%

NA

MICS *

(2000)

0.4%NAPercent of children weighed less

than 1500 grams

17.0%7.3%Percent of children weighed less

than 2500 grams

76.9%39.0%Percent of Children weighed at birth

Baseline +

(2006)

NFHS-2

(1998-99)

MICS * : Includes all children below age 5 years

+ : Subject to reporting errors by mothers

Birth Weight Measurement

Percent of children weighed at birth

Above 85%Hyderabad (91.1) Visakhapatnam (87.8) Nizamabad (87.3)

Warangal (87.0) Chittoor (85.4)

_____________________________________________________________

70 % to 84%Nellore (84.4) Nalgonda (84.4) Adilabad (82.5) Khammam (82.4)

Kadapa (82.2) Karimnagar (82.0) Guntur (81.8) Krishna (81.4)

East Godavari (75.7) Ranga Reddy (74.2) Medak (73.7) West Godavari (71.9)

______________________________________________________________

Below 70%Vizianagaram (68.3) Anantapur (67.0) Prakasam (64.3)

Srikakulam (62.2) Mahabubnagar (61.6) Kurnool (49.8)

______________________________________________________________

State Average

Total: 76.9 Rural: 69.9 Urban: 86.1

12

infants weighed at birth was 70 percent in rural and 86 percent in urban areas.

About 70 percent of scheduled caste and scheduled tribe mothers reported that

their infants were weighed at birth. Less than 70 percent of newborns were

weighed at birth in the districts of Vizianagaram, Srikakulam, Prakasam,

Anantapur, Kurnool and Mahabubnagar

� Slightly less than one fifth

(17.5) of newborn babies

weighed less than 2500

grams in the state (18

percent in rural and 16

per cent in urban areas).

About 19 per cent of

newborns among

scheduled caste and

scheduled tribe

communities weighed

less than 2500 grams. As compared to the UNICEF MICS study (2000), the

proportion of low birth weight babies reduced from 23 percent to 17 percent

between 2000 and 2006. Developed districts namely Krishna, West Godavari

and Chittoor recorded about 20-23 percent of low birth weight babies which was

higher than state average. Backward districts namely Visakhapatnam, Kurnool

which recorded lower than state average may require further insights and

explanation.

� With the WHV (ASHA) in every village and collaborative work with AWWs and

ANMs, there is further scope to weigh all the new born babies. Appropriate

strategies to improve nutritional status and identification of high risk pregnancies

require immediate attention to further reduce low birth weight in newborn babies

in the state.

Breast feeding and Supplementation

The Government of India recommends that breast feeding should begin

immediately after childbirth and that infants should be exclusively breastfed for the first

four months of life. It is recommended that colostrums the first milk, should be given to

infants because it provides natural immunity and important nutrients.

23.6

21

19.7

17

14.1

13.6

12.8

0 5 10 15 20 25

West godavari

Chittoor

Krishna

State

Nizamabad

Kurnool

Visakhapatnam

There is a 11

point differential

between the

highest and

lowest district

level children’s

birth weight less

than 2500 grams

Percent of children with birth weights less

than 2.5 kgs

13

� Breast feeding is nearly universal

in Andhra Pradesh and four-fifths

(81 percent) of all infants born in

the reference period preceding

the survey had been breastfed.

Breastfeeding was lower in urban

areas (76 percent) than in rural

areas (84 percent). More than 85

percent of mothers among SC

and ST and lower SLI breastfed

their infants.

� Initiation of breastfeeding immediately after childbirth is important because it

benefits both mother and the infant. It is recommended that the first breast milk

(colostrum) should be given to the child rather than squeezed out from the

breast and discarded. Less than one-third mothers (28 percent) mothers

squeeze the first milk from the breast before they start breast feeding their

babies (31 percent in rural and 26 percent in urban areas). The recorded

percentage was higher among Scheduled caste (30 percent) and Scheduled

tribe (35 percent) respectively.

� A substantial proportion (38-42 percent) of women squeeze out the first milk

containing colostrum from the breast before breastfeeding their infants in

Srikakulam, Vizianagaram, Guntur, Nalgonda and Ranga Reddy districts.

� One-third (32 percent) of infants in the state were reported to be breastfed within

one hour of birth. Less than one-fifth of infants were reported to be breastfed

within one hour in Ranga Reddy, Nalgonda, Kadapa, Medak and Mahabubnagar

districts. The Baseline survey results reveal the urgent need for an intensive IEC

campaigns on the importance of breastfeeding immediately after birth and

colostrum feeding in all campaigns undertaken under NRHM.

� More than half (54 percent) of

infants were breastfed

exclusively for four months.

About 34-49 percent of

mothers reported exclusive

breast feeding for four months

in Vizianagaram,

Visakhapatnam, East

Breast fed within one hour of birth

10.3

31.8

22.4

0 5 10 15 20 25 30 35

RCH Baseline

Survey

NFHS-3 (2005-06)

NFHS-2 (1998-99)

31.8

50.2

76.5

15

16.7

0 20 40 60 80 100

Mahabubnagar

Medak, Kadapa

State

Vizianagaram

Visakhapatnam

Percent

Percent

54.4%

90%

33.9

35.2

41.4

54.4

74.5

79.5

0 20 40 60 80 100

Hyderabad

Warangal

Visakhapatnam

State

Kadapa

Anantapur

50

1000

Infants Exclusively Breastfed Atleast Four Months

Target

Baseline

Percent

14

Godavari, Chittoor, Hyderabad, Nizamabad, Mahabubnagar and Warangal

districts.

� Mean time after birth when baby was put to breast was 3.6 hours (3.2 hours in

rural and 4.1 hours in urban)

� At the age 6-9 months, all infants should be given solid or mushy food in addition

to breast milk to provide sufficient nutrients. However, only 61 percent of

children age 6-9 months (58 percent in rural and 66 percent in urban) received

the recommended combination of breast milk and solid or mushy food.

� WHO recommended an outcome indicator namely continued breast feeding for

one year for children in 12-15 months age who are still breastfed. The survey

revealed that about eightynine percent of infants were breastfed for more than

one year (92 percent in rural and 86 percent in urban).

� The practice of breastfeeding within one hour of birth was lower among the

mothers who had not received ANC (27 percent) as compared to mothers with 3

or more ANC visits (32 percent).

Child Morbidity and Treatment Patterns

An attempt has been made to arrive at the proportion of children who suffered

from diarrhoea and Acute Respiratory Infection (ARI). Mothers of children born since

January/Sankranti 2004 till the date of survey were asked if their infants suffered from

diarrhoea and ARI during the two weeks preceding the survey, and if so, the type of

treatment given.

� Early diagnosis and treatment with antibiotics can prevent a large proportion due

to ARI/pneumonia. During the two weeks preceding the survey, 18.2 percent of

children under two and half years (January/Sankranti 2004 to Survey date) had

symptoms of Acute respiratory infection (cough accompanied by fast breathing).

The NFHS-2 (1998-99) reported that 19 percent of children under age three

years in Andhra Pradesh suffered from ARI.

� Only 32.5 percent of the women are aware of danger signs of pneumonia (30

percent in rural areas and 35 percent in urban areas). About 31-32 percent of

mothers among SC and ST community are aware of pneumonia. Higher

awareness of ARI (more than 35 percent) were recorded in Kurnool (37%),

Chittoor (38%), Ranga Reddy (36%), Hyderabad Urban (43%) and more than 50

percent in Khammam and Nalgonda districts.

15

� The important danger signs of pneumonia as reported by mothers were ‘difficulty

in breathing’ (76 percent), ‘wheezing/whistling’ (41 percent), ‘Pain in the chest

and productive cough with fever’ (40 percent) and ‘Chest in-drawing’ (35

percent).

� About 12 percent of children suffered from diarrhea (12 percent in rural areas

and 11 percent in urban areas) in the two-week period before the interview. Due

to seasonal variations in the prevalence of diarrhea, this cannot be assumed to

reflect the situation throughout the year.

� Knowledge and use of Oral Rehydration Salt (ORS) packets for the treatment of

diarrhea was not widespread. Children with diarrhea in the previous two weeks

who received ORS were 49 percent (47 percent in rural and 51 percent in urban

areas) as compared to 36 percent reported in the NFHS-3 (2005-06) survey

(based on the information on the last 2 births in the 3 years before the survey).

� The use of antibiotics and other anti-diarrhoeal drugs is not generally

recommended for the treatment of childhood diarrhea. About 86 percent of

children who had diarrhea in the last two weeks were treated through pills and

syrup, and 34 percent received an injection. Marginal variations were reported

between rural and urban and background variables.

� Across the districts, the usage of ORS by mothers was below 35 percent in

Krishna, Mahabubnagar and Nalgonda districts respectively. Under the NRHM,

there is a need for intensive and effective IEC campaigns on diarrhea disease

emphasizing the importance of ORT, increased fluid intake and continued

feeding and discouraging the use of drugs/injections.

Child Immunization

Immunization particulars of children under 2 years were obtained from mothers

or principal care takers. Children in the age span 12-23 months who received BCG,

three doses of DPT and OPV and measles are considered to be fully immunized.

� Coverage of full immunization was 80 percent or more in the coastal districts

with the exception of Nellore (79 percent) and Prakasam (77 percent). In the

Rayalaseema region, Kurnool reached 87 percent, whereas Kadapa, Anantapur

and Chittoor reached a coverage level of around 71-80 percent. In the

Telangana region, immunization coverage varied from 73-77 percent in the

districts of Mahabubnagar and Adilabad to 90 percent in Khammam district. In

16

the district of Hyderabad, which is entirely urban, the coverage of full

immunization was 82.7 percent.

� For the state as a whole, the

coverage of full

immunization was 82.7

percent. As compared to the

Eligible Couple and Child

Immunization Survey

(IIHFW, 2004), full

immunization coverage has

become more uniform

throughout the state and

among different back

ground variables. The full immunization among Scheduled caste and Scheduled

tribe communities was lower (78 percent) than the state average.

� The utilization level of individual vaccines was higher than the percentage fully

vaccinated. Ninetyeight percent of children had been vaccinated against

tuberculosis, 92 percent received all three doses of polio, same percentage

received all three doses of DPT injections and 88 percent had all three doses of

Hepatitis-B injection. The measles vaccine coverage was 88 percent at the state

level.

� The coverage rate of full immunization was comparatively better among children

(87 percent) of literate mothers than in children (76 percent) of illiterate mothers.

Percentage of children (12-23 months) fully immunized(BCG+DPT(1-3)+OPV(1-3)+Measles)

Coverage rates 85% or more

Krishna (92.3) Khammam (90.2) West Godavari (88.7) Guntur (88.0)

Kurnool (87.2) Warangal (86.7) Karimnagar (86.9) Srikakulam (86.0)

Medak (84.5)________________________________________________________________

Coverage rates 75% to 84%Vizianagaram (84.3) Visakhapatnam (83.9) Hyderabad (82.9)

East Godavari (82.7) Ranga Reddy (80.7) Nalgonda (80.2)

Chittoor (76.4) Nellore (79.7) Kadapa (79.7) Prakasam (77.3)

Adilabad (76.8)________________________________________________________________

Coverage rates <75%Mahabubnagar (72.8) Anantapur (71.3)

____________________________________________________________

State Average


S.C : 80.2 S.T : 72.8 BPL : 82.5

� The dropout rate from DPT3 to measles declined from 9 percent in Eligible

Couple and Child Immunization Survey, 2003 to below 5 percent in the Baseline

survey (2006).

Child Immunization

84.2

57.2

81.5

42.9

82.7

46.0

Baseline

2006

NFHS-3

73.470.371.4EC 2003

% Fully immunized4.

90.087.388.5Baseline

2006

30.521.124.4EC 2003% received Hep – B3 vaccine3.

88.188.588.3Baseline

2006

EC 2003

Baseline

2006

EC 2003

78.076.877.3% received measles vaccine2.

60.058.659.2

50.245.947.4% of children whose

vaccination card that was

shown to the interviewer

1.

UrbanRuralTotalChild ImmunizationSl.

No.

17

� The percentage of children in 12-23 months who were not immunized at all

remained at 1.1 percent having declined from 2.3 percent reported in Eligible

Couple and Child Immunization Survey (Balasubramanian and Satya Sekhar,

2004). There is a need to identify and convert partial immunization cases to

complete immunization in moping up Annual Census Surveys as proposed in the

RCH-II PIP document (CFW, 2005). Further, the dropout rate declined from 24

percent from 2003 to 17 percent in the present baseline survey.

� At the district level, full immunization coverage was almost on par with the PATH

study conducted in 2005 by the Government of Andhra Pradesh.

Infant Mortality

Infant mortality rate is a

sensitive indicator of the socio-

economic development of any

country/region. This rate reflects

the quality of life and is also used

for monitoring and evaluating

population and health related

programmes and policies. The

Sample Registration System is

the only source in the country

providing time series estimates of

IMR on an annual basis for India and its states. The Millennium Development Goals

(MDG, 2000) and the national and state population policies set the target of 30 per

1000 live births by 2010. The availability of IMR data at district level and by social

group provides ample information for preparation of district health action plans.

� The baseline survey adopted birth

based approach methodology to

estimate infant mortality rate at

district level. The infant mortality

rate was worked out based on the

probabilities of dying before first

birthday. IMR was calculated

based on all births occurred during

January 2004 to July 2005 but not

surviving till their first birth day. The neonatal mortality rates (the probabilities of

dying in the first month of life) for all districts of Andhra Pradesh are also worked

IMR – Trends in Andhra PradeshNeed to accelerate Decline

46

2630

75 72

66

52

20

30

40

50

60

70

80

1989-91 1994-96 1999-01 2003-05 2010 2015

Log-Linear trend fitted to the data

R2 = .953 Rr = .949, F=261.2

77.981 -1.189 t

Triennial averages

58

52%

30%

26.4

36.3

32.7

52.8

65.0

72.0

40.3

62.3

55.3

92.9

111.0

0 20 40 60 80 100 120

Hyderabad

West Godavari

Krishna

State

Medak

Mahabubnagar

Rural

Urban

BPL group

Scheduled Caste

Scheduled Tribe

1000

Infant Mortality Rate (per 1000 live births)

Target

Baseline

Districts

18

out. The total number of births within 12 months of age varied from 1390 in

Anatapur district to 1876 in Chittoor district.

� The neonatal mortality

comprises about 70

percent of all infant

deaths in the state.

� One in 16 infants in rural

areas and one in 26

infants in urban areas

die before celebrating

their first birth day.

� The baseline survey estimated IMR as 52.2 deaths per 1000 live births in 2005

which is on par with the SRS estimate of 57 per 1000 live births in 2005 and 53

per 1000 live births as reported by NFHS-3 (2005-06) study.

� Trend analysis of infant mortality over the period 1989-91 to 2003-05 indicates

that special emphasis and effective monitoring of different RCH-II interventions

are required to bring down IMR to 30 per 1000 live births by 2010 and 26 per

1000 live births by 2015.

� The reduction in IMR in Andhra Pradesh mostly depends on the reduction of

high IMR levels in rural areas and among Scheduled caste and Scheduled tribe

categories.

� Districts which recorded the

highest infant mortality rate

between 72-63 deaths per 1000

live births were in

Mahabubnagar, Medak,

Adilabad, Nizamabad, Nalgonda

and Khammam districts in

Telangana regions, Srikakulam

and Vizianagaram districts in

Coastal Andhra and Anantapur

in Rayalaseema region.

36.9%

15%

20.3

20.5

21.3

36.9

48.0

52.5

43.2

28.6

38.2

59.5

70.6

0 10 20 30 40 50 60 70 80

Hyderabad

Krishna

West Godavari

State

Nizamabad

Mahabubnagar

Rural

Urban

BPL group

Scheduled Caste

Scheduled Tribe

1000

Neonatal Mortality Rate (per 1000 live births)

Target

Baseline

Districts

50

Infant Mortality Rate

(All births since January 2004 to July 2005)

IMR above 60 (per 1000 live births)

Mahabubnagar (72) Medak (65) Adilabad (64)

Nizamabad (63) Nalgonda (63) Srikakulam (62)

Vizianagaram (60) Anantapur (60) Khammam (60) ______________________________________________IMR between 50 to 60 (per 1000 live births)

Kurnool (58) Visakhapatnam (52) Warangal (52)

Kadapa (51) Prakasam (50) Karimnagar (50)______________________________________________IMR below 50 (per 1000 live births)

Nellore (48) Chittoor (46) East Godavari (45)

Ranga Reddy (44) Guntur(42) West Godavari (36)

Krishna (33) Hyderabad (26)______________________________________________

State Average


19

� The most challenging part of infant mortality is the large proportion of neonatal

deaths contributing to 60-70 percent of all infant deaths. This stresses the need

to increase the efforts in order to meet the IMR goal of NRHM by allocating

higher number of CEMONC and BEMONC centers with quality delivery care

from specialist medical personnel.

� Rural infant mortality rates are

considerably higher than urban

infant mortality rates. Infant

mortality seems to be relatively

higher among infants of scheduled

castes and scheduled tribes.

Neonatal and infant mortality

declined substantially with increase

in the household standard of living.

Male infants have a higher risk of

dying than female infants.

� The infant mortality rate decline consistently with increasing education of mother

as expected, ranging from a high of 99.2 deaths per 1000 live births for illiterate

mothers to a low of 14.2 deaths per 1000 live births for mothers who have had

high school and above education.

Reproductive Health problems

In order to assess the prevalence of reproductive tract infection among

respondents a few questions were put in privacy during interview time. Respondents

were assessed whether they contacted a disease through sexual contact, experienced

bad smelling, and abnormal genital discharge or had a genital sore or ulcer.

� Sixteen percent of

respondents reported

reproductive tract infection.

Higher prevalence was

reported in Medak,

Nizamabad and Ranga Reddy

districts. As per RCH-II norms,

it is required to reduce the RTI

incidence to a half from its

current level and this needs

special emphasis.

16%

8%

2.9

4.7

16.0

26.5

29.6

35.1

0 10 20 30 40

Kurnool

Kadapa

State

Ranga Reddy

Nizamabad

Medak

50

1000

Reproductive Tract Infections* (halved by end of RCH-II)

Target

Baseline

Percent

* Women who contacted a disease through sexual contact, experienced bad smelling abnormal

genital discharge and had a genital sore or ulcer.

Infant Mortality Rate in Andhra Pradesh by

Background Characteristics

52.2

39.1

62.2

92.9

111

85.1

55.3

20

30

40

50

60

70

80

90

100

110

120

Total

Urban

Rural

S.CS.T

Low SLI

BPL

RCH-II BaselineSurvey, 2006

Based on births occurred during January 2004 to July 2005 before a child completing one year

20

� Women who sought advice/treatment for RTI problems were only 46 percent (48

percent in rural and 45 percent in urban areas). No variation was recorded

between background variables. Majority of women availed of the services from

private sector and NGO as compared to Government doctor/health personnel.

46.6%

30.0

30.8

46.6

55.0

57.2

58.2

0 20 40 60 80

Anantapur

Kurnool

State

Kadapa

Visakhapatnam

Karimnagar

1000

Women seeking Advice/Treatment for RTI Problem

Baseline

Percent

RCH-II Intervention Programme

The Department of Family Welfare, Government of Andhra Pradesh has

formulated various interventions under NRHM (Reproductive and Child Health Project-

II). The major objectives of these interventions are to improve health conditions of

women and children and increase institutional deliveries. Some of the interventions

which are being implemented in the state are (1) Janani Suraksha Yojana (2) Free

Bus Pass to Pregnant Women (3) Women Health Volunteer (ASHA / WHVs) and (4)

Round the Clock Mother and Child Health Centre. Information was collected from all

the respondents about the awareness of these RCH-II interventions initiated under

NRHM.

Janani Suraksha Yojana

Government of India

launched the scheme ‘Janani

Suraksha Yojana’ in modification

of the National Maternity Benefit

Scheme. This 100 percent

centrally sponsored scheme

provides Rs.700/- as an

incentive to all women (both in

rural and urban areas) aged 19

Knowledge of Janani Suraksha Yojana

Scheme (District wise)

Above 76% Khammam (81.3) Srikakulam (80.7) Vizianagaram (79.9)

West Godavari (77.9) Prakasam (76.1)_________________________________________________

65% to 75%Medak (74.3) Nizamabad (71.8) Chittoor (71.6)

Nalgonda (71.1) Guntur (71.0) Visakhapatnam (66.3)

Mahabubnagar (65.8) Krishna (65.2) Kadapa (65.2)_________________________________________________

Below 65%Warangal (62.2) Anantapur (51.7) Karimnagar (50.1)

Ranga Reddy (49.6) East Godavari (48.0) Kurnool (41.8)

Adilabad (38.3) Nellore (33.4) Hyderabad (21.9)_________________________________________________

State Average

Total : 61.6 Rural: 65.6 Urban: 56.3

21

years and more, women belonging to households below poverty line are eligible for

availing the benefit. The Government of Andhra Pradesh added Rs.300/- (under

Sukhibhava Scheme) and used to release Rs.1000/- to the beneficiary

� About 62 percent of mothers were aware of the JSY intervention. The

awareness levels appear to be better in rural areas (65 percent) as compared

to urban areas (56 percent).

� Out of those women aware of JSY scheme, about 31 percent have benefited

from the scheme. Among the beneficiaries, 17 percent of mothers faced

problems in realizing the scheme incentive. Extensive IEC activities are

required to propagate the benefits of the scheme to the public and consistent

and timely flow of funds will definitely improve the institutional deliveries among

vulnerable groups in the state.

� Districts which reported below state average were East Godavari and Nellore

from Coastal Andhra region, Anantapur and Kurnool from Rayalaseema region

and Ranga Reddy, Karimnagar, Adilabad from telangana region.

Free Travel by the Public Transportation by Pregnant Women

Every pregnant woman will have to have at least one antenatal checkup by

PHC medical officer for screening of high-risk cases and receive advice for

institutional delivery. The scheme provides for free travel by the public transportation

for pregnant women from their village to the nearest PHC or FRU help in achieving the

goal.

� Twentyseven percent of

respondents were aware of

the free bus pass scheme

(35 percent in rural areas

and 18 percent in urban

areas) and 21 percent

availed the facility at state

level.

� The proportion aware of

free bus pass facility to

pregnant women varied from 10 percent in East Godavari district and more than

40 percent in West Godavari, Kadapa and Khammam districts.

Knowledge of Free Bus Pass to Pregnant

Women Scheme

Top 5 districtsKhammam - (43.5)

West Godavari - (43.1)

Kadapa - (40.4)

Krishna - (38.5)

Nizamabad - (36.8)

Bottom 5 districtsKarimnagar - (16.8)

Ranga Reddy - (16.5)

Nellore - (14.6)

Adilabad - (12.0)

East Godavari - (10.0)

State Average

Total : 27.5 Rural : 34.9 Urban :17.6

S.C : 31.2 S.T : 28.2 BPL :28.2

22

Round-the-Clock MCH Centre

In order to promote institutional deliveries at PHCs, the existing 470 units of 24

hour Maternal and Child Health Centers have to ensure the availability of one basic

emergency obstetric care facility per 1,00,000 rural population in the state. The

intervention was initiated under RCH-I programme and strengthened in RCH-II.

� Less than one-fifth (15

percent) of respondents

indicated the awareness of

a RCMCHC in their village/

Mandal. The awareness

level was below seven

percent in West Godavari,

Vizianagaram, Guntur,

Kadapa and Warangal

districts.

� Among those who visited the MCH centre, only one-third (34 percent) of

respondents or their relatives visited the RCMCMC for services particularly at

night time.

� Out of the respondents or their relatives who visited RCMCHC at night time,

about 77 percent received services from hospital staff.

Women Health Volunteer Scheme (ASHA)

The Woman Health Volunteer scheme (ASHA under the NRHM) has been one

of the major interventions introduced under RCH-II. This scheme seeks to identify,

train and position women health volunteers in the Gram Panchayat in the state to act

as health resource persons-of-first-resort in all maternal and child health matters in the

villages and act as link-persons between the community and the service providers in

the village. Out of 52,000 volunteers, more than half of the ASHAs were functioning in

different districts. An evaluation of the scheme strengthens the programme which is

powered by the AP Government.

� A quarter (24 percent) of respondents were aware of the WHV scheme in their

villages. Excluding Hyderabad urban district, the awareness of WHV was

reported to be below 15 percent in Nellore, Kurnool, Kadapa, Khammam, and

Adilabad districts.

Knowledge of Round the Clock Mother & Child

Health Centers

Top 5 districtsNizamabad - (43.8)

Mahabubnagar - (35.2)

Visakhapatnam - (29.9)

Srikakulam - (29.7)

Prakasam - (24.7)

Bottom 5 districtsWest Godavari - (7.0)

Warangal - (7.0)

Kadapa - (5.1)

Vizianagaram - (4.9)

Guntur - (3.7)

State Average


S.C : 13.6 S.T : 10.5 BPL : 14.7

23

Conclusions

Responding to the

growing need for

generating district-level

data, Indian Institute of

Health and Family

Welfare (IIHFW), with

the funding from

Commissionerate of

Family Welfare

conducted the

household survey at

district level to obtain the

baseline information on a number of policy relevant indicators relating to Reproductive

and child health. The log frame of sampling, methodology, questionnaire preparation,

training of investigators, analysis was carried out by the Nodal agency (IIHFW) and

the data collection and data entry undertaken by eleven research agencies in Andhra

Pradesh. It is also proposed to conduct mid-term and end line surveys in order to

assess the impact of various interventions formulated under NRHM and in particular

on RCH-II interventions. The population projections for Andhra Pradesh indicate that

the women in 15-49 year would increase from 209 to 239 lakhs between 2001 and

2011. Hence there will be a continuous and sustainable demand for the reproductive

and child health services in the years to come. The conclusions of the study are given

below.

The interventions introduced require intertwining of direct and indirect

interventions to achieve NRHM goals of IMR and MMR. The quality care health

facilities in CEMONC and BEMONC centres with efficient blood banks and broad

storage centres in the mandals of different districts (with high IMR and MMR) are

crucial. The indirect interventions like Emergency health transport, Free bus pass to

pregnant women, Janani suraksha yojana and ASHA programme will be effective only

if health care delivery system are strengthened. The success of direct and indirect

interventions will be crucial for the overall health care delivery of NRHM/RCH

services.

1. Three ANC checkups is Universal across regions and background variables.

2. About sixtythree percent of mothers received ANC in the first trimester of their

pregnancy. Districts indicating lower than 35 percent of ANC in the first trimester

Knowledge of Women Health Volunteer Scheme

(District wise)

Above 35%Mahabubnagar (53.2) Visakhapatnam (52.1) Chittoor (41.9)

Nizamabad (37.8)_________________________________________________

20% to 34%Srikakulam (33.6) Krishna (30.1) Vizianagaram (28.8)

Warangal (28.3) West Godavari (26.4) Ranga Reddy (25.6) Guntur (24.7)

East Godavari (24.3) Medak (22.1) Prakasam (20.8)_________________________________________________

Below 20%Anantapur (17.9) Karimnagar (16.7) Kadapa (13.1)

Khammam (11.7) Adilabad (11.0) Nalgonda (10.4)

Nellore (9.3) Kurnool (7.2) Hyderabad (2.6)_________________________________________________

State Average


S.C : 27.0 S.T : 27.9 BPL : 25.4

24

were Mahabubnagar and Ranga Reddy districts. In order to reach 95 percent of

target by the end of project period, strengthening of monitoring by PHC medical

officer and substantial improvement in low performing districts are essential.

3. Even though 94 percent of mothers received at least one ANC from a MBBS

doctor, there is a need to increase the AN checkups to a minimum of four by a

MBBS doctor in the months of third, sixth, eighth and ninth months as per the

Safe Motherhood norms.

4. Slightly more than a half (54 percent) of mothers received/ purchased IFA

tablets. There is a need to streamline the supply of IFA tablets from district level

to sub-centre village. Less than 40 percent of mothers in Warangal,

Mahabubnagar, Ranga Reddy and Kurnool districts had received/ purchased

100 or more IFA tablets during the pregnancy pertaining to the last child.

5. About half of mothers received/purchased IFA tablets at state level but the

consumption was below 33 percent. Marginal variations were reported across

background variables. Mother’s education, standard of living and occupation do

not appear to have played any role in consuming of IFA tablets.

6. Eightynine percent of mothers received the general services (weight

measurement, blood pressure, blood examination and abdominal checkup) at

least once during ANC.

7. About seventysix percent of mothers were advised on expected date of delivery,

having delivery in a hospital and on breastfeeding practices. Only a half of the

mothers reported receiving advice/ counseling from health personnel on the

danger signs of pregnancy. More emphasis has to be given to these aspects

during IEC activities by the field level staff and PHC personnel.

8. Less than a half (46 percent) of mothers received full ANC care, i.e. two doses

of TT injection, required number of IFA tablets and at least 3 ANC visits during

their pregnancy period. There is a need to strengthen the full ANC coverage in

the districts of Kurnool, Ranga Reddy, Mahabubnagar, Nalgonda and Warangal

districts.

9. About 76 percent of mothers delivered in a health facility and 82 percent of

deliveries were attended by a doctor or nurse/midwives

10. The survey results point to the need to a) strengthen the JSY, Free bus pass to

pregnant women and other RCH interventions and b) improvement of

institutional deliveries in low performing districts.

25

11. More than a quarter (27 percent) of deliveries were either caesarian or other

interventions. Twentyone percent of mothers belonging to Scheduled caste and

Scheduled tribe underwent Caesarian section. Highly developed districts in

Telangana region reported higher proportion of caesarian section deliveries as

compared to the West Godavari, Krishna and East Godavari districts of Coastal

Andhra region.

12. Ninety percent of mothers who delivered in a medical institution availed post

natal checkup within one week of birth. Only sixty percent of non institutional

births were followed up by a post natal checkup within one week of delivery (59

percent in rural and 63 percent in urban).

13. Out of those mothers who received post natal checkup, about 77 percent

received checkup from MBBS doctor. Keeping the high neonatal mortality in the

state, there is a need to strengthen the monitoring of the field health

functionaries to educate the pregnant mothers during ANC counseling.

14. With the WHV in every village and collaborative work with AWWs and ANMs, it

is possible to increase the proportion of newborns weighed from 70 percent at

state level. The low birth weight (below 2500 grams) reduced from 23 percent to

17 percent during 2000-2006 period. It is surprising to note that the developed

districts of Krishna, West Godavari and Chittoor recorded higher proportion of

newborns with low birth weight than the state aggregate.

15. About 21 percent of mothers squeeze out the first milk from the breast before

they start breast feeding their babies. One-third of the infants were reported to

be breastfed within one hour of birth. Less than 20 percent of infants were

reported to have been breastfed within one hour in Ranga Reddy, Nalgonda,

Kadapa, Medak and Mahabubnagar districts.

16. More than a half (54 percent) of infants were breastfed exclusively for four

months. Among infants in age 6-9 months, only 61 percent received the

recommended combination of breast milk and solid or mushy food.

17. The full immunization (BCG + OPV 1-3 + DPT 1-3 + Measles) at the state level

recorded 82.7 percent. The inter-district variations of full immunization were

marginal.

18. Infant mortality rate was calculated based on all births that occurred during

January 2004 to July 2005 and not surviving till their first birth day. Neonatal

mortality accounts for 70 percent of infant deaths that occurred in the reference

26

period. The reduction in infant mortality depends on reduction in neonatal

mortality among rural, Scheduled caste and Scheduled tribe categories.

19. There is a need to increase the efforts in order to meet the IMR goal of NRHM

by allocating higher number of CEMONC and BEMONC centers with quality

delivery care from specialist medical personnel.

20. Male infants have higher risk of dying than female infants. The infant mortality

rate declines consistently with increasing education of mother

21. Sixtytwo percent of mothers were aware of the Janani Suraksha Yojana

scheme. The awareness is more in rural areas (66 percent) as compared to

urban areas (56 percent). The awareness was 63 percent among Scheduled

caste and 62 percent in Scheduled tribe. Out of those women who were aware

of JSY scheme, only a half (31 percent) benefited from the scheme. Among the

beneficiaries, 17 percent of mothers faced problems in realizing the incentive.

22. Twentyseven percent (35 percent in rural and 18 percent in urban) of

respondents were aware of the free bus pass scheme and 21 percent availed

the benefit.

23. A quarter (24 percent) of respondents were aware of the WHV scheme in their

villages. Excluding Hyderabad urban district, the awareness of WHV was

reported below 15 percent in Nellore, Kurnool, Kadapa, Khammam, and

Adilabad districts.

27

Notes:

1. Empirical research studies (Srinivasan and Rajaretnam, IDPAD study, 2006) indicated that the recently delivered mothers are self-selected for higher potential fertility. Women who have recently delivered (within one year) have 35% high fertility in the future years as compared to other women who have not recently delivered. Majority of these women demand the services related to reproductive and child health and family planning services.

2. Sampling Details

The sampling adopted a two-stage stratified systematic random sampling method. In the first stage, primary sampling units or clusters (Villages in rural areas and blocks in urban areas) were selected by probability proportional to size (PPS) method. The second stage involved the selection of secondary sampling units, i.e. households within each selected cluster.

Rural sampling

A list of villages in the district with their population from the 2001 census served as the sampling frame in rural areas. A sample size of between 25-28 households was thought to be adequate to represent the village population. Accordingly it was decided to select 60 villages and 25 households in each selected village in order to achieve a minimum sample of 1800 households on the assumption that the non-response rate would be around 10%.

All villages in the district were classified into three strata based on 2001 census population figures.

Stratum 1 : population < 1500

Stratum 2 : population 1500 – 2500

Stratum 3 : population > 2500

It was decided to exclude all small villages with population size of less than 100 from the frame. Sample villages were allocated to three strata (20 villages from each stratum) using PPS method.

Selection of Households

A house-listing operation was carried out in each of the selected village prior to the data collection, which provided the necessary frame for the selection of households. All households with eligible women (i.e., women who delivered birth during the last two years and all currently pregnant women) were identified. This provided the necessary frame for the selection of households.

A complete house listing was carried out in the villages with the estimated households of up to 500. In case of villages with the estimated number of households above 500, the village was divided into 3 or more number of segments of about same size and 2 segments selected randomly. Lastly, with systematic random sampling procedure, a sample of 25 households was selected from each of the sample villages to arrive at the required number of households in rural areas of the district.

Urban sampling

A three stage systematic random sampling design was used to obtain urban sample of households, the wards being the unit of selection at first stage, census enumeration blocks at the second stage and households within the selected block at the third stage.

All wards in the district according to 2001 census frame were arranged and 20 wards will be selected by PPS method. Two blocks from each of the selected wards were selected again by PPS method. All the households in the selected blocks were listed and 25 households in each block were selected by systematic random sampling method.

28

The survey was designed and conducted by the collaborating institute namely the Indian Institute of Health and Family Welfare, Hyderabad, under the guidance of the Commissionerate of Family Welfare. Eleven research agencies with experience in conducting health surveys were selected by the Commissionerate of Family Welfare. The Log frame of the survey, initiation of background seminars, preparation and finalization of questionnaires, printing and supply to the research agencies, training of 320 investigators from 11 research agencies, development of software and data entry training were undertaken by Indian Institute of Health and Family Welfare (Nodal Agency). The data CDs after data entry were brought back to IIHFW and scrutinized for data inconsistencies, data validation, data cleaning and final data preparation was done using EPI-Info and SPSS Package. The analysis and preparation of Fact Sheet for all districts were submitted in record time of 5 months to the funding agency for policy interventions.

Household Standard of Living Index (SLI)

The household standard of living index (SLI) has been calculated by summing the individual scores assigned to each of the household items: 4 for car; 3 each for TV, telephone, motor cycle/scooter; 2 each for fan/radio/transistor, sewing machine, bicycle, water pump, bullock cart, thresher; type of house (4 for pucca, 2 for semi-pucca and 1 for kachcha type); ration card (4 for pink card, 2 for white card and o for no card). Index scores range from 0-14 for a low SLI (13.1%), 15-23 for a medium SLI and 24 and above for a high SLI.

References

Balasubramanian, K and P. Satya Sekhar (2004), Sample Survey of Eligible Couples and

Child Immunization Coverage in Andhra Pradesh: Fact Sheet-2003, (Mimeo), Indian

Institute of Health and Family Welfare, Hyderabad.

International Institute for Population Sciences (1995): National Family Health Survey (1992-

93), Andhra Pradesh State. International Institute for Population Sciences, Mumbai.

International Institute for Population Sciences (1995): National Family Health Survey (1998-

99), Andhra Pradesh State. International Institute for Population Sciences, Mumbai.

International Institute for Population Sciences (2006): ‘Key Findings for Andhra Pradesh from

NFHS-3’ (Fact Sheet).

Park (2002), Text Book of Preventive and Social Medicine (17th edition), M/S Banarsidas

Bhanot Publishers, Jabalpur

PATH (2005), Andhra Pradesh Progress in Immunization Performance, Government of

Andhra Pradesh.

Srinivasan K, C.P. Prakasam, T. Rajeretnam and Puruhit Praharaj (2006), Expanding Basic

Maternal and Child Health Services: An Operations Research Project with Birth-based

Approach, International Institute for Population Sciences, Mumbai.

29

BASELINE SURVEY ON REPRODUCTIVE AND CHILD HEALTH (RCH-II), ANDHRA PRADESH 2006

ANDHRA PRADESH

FACT SHEET

INDICATOR TOTAL RURAL URBAN SC ST SLI(Low) BPL

Sample Population

• Number of households interviewed 59117 33746 25371 13128 4371 7724 45119

• Number of eligible women interviewed1 59378 33902 25476 13162 4385 7745 45302

• Number of live births2 65341 37237 28104 14467 4856 8485 49895

• Population in the sample 310881 179111 131770 13128 4371 59117 239544

Population and Household Characteristics3

• Mean household size 5.2 5.3 5.1 5.1 5.0 5.2 5.3

• Percent of pucca houses 48.5 37.1 63.6 42.9 31.8 5.8 45.5

• Percent of households with separate kitchen 54.8 46.0 66.4 42.9 37.1 18.3 52.7

• Percent of households with electricity 91.8 88.2 96.5 88.1 76.1 54.8 91.6

• Percent of households using piped water as main source of drinking 94.2 91.3 98.1 94.6 90.2 89.6 94.1

• Percent of households using cleaner cooking fuels (LPG, Electricity and Kerosene)

38.6 16.0 68.6 26.5 18.9 1.5 34.3

• Percent of households with no toilet / latrine facility 49.5 71.9 19.8 60.3 70.8 94.0 53.1

• Percent of households with white ration card 76.3 78.5 73.4 82.4 74.5 73.0 -

• Percent of scheduled caste households 22.2 25.8 17.4 - - 33.0 24.0

• Percent of scheduled tribe households 7.4 9.9 4.1 - - 17.9 7.2

• Percent of backward caste households 46.9 46.9 46.9 - - 39.6 48.0

30


Maternal Health Care4

• Percent of mothers received any ANC 96.8 95.3 98.7 96.1 92.7 91.1 96.6

• Percent of mothers received at least 3 ANC checkups 93.6 91.5 96.4 91.5 87.3 85.1 93.3

• Percent of mothers registered in first trimester 63.0 59.7 67.3 56.4 57.5 52.8 61.8

• Percent of women received check up at least once by a M.B.B.S doctor

94.3 92.1 97.3 93.0 88.6 86.0 94.1

• Percent of mothers received 2 or more TT injections 95.3 95.0 95.7 94.4 91.6 91.7 95.3

• Percent of mothers received 100 or more IFA tablets 54.0 52.4 56.0 51.4 53.5 50.2 54.1

• Percent of mothers consumed all the IFA tablets received 33.2 32.5 34.1 30.7 31.6 31.8 32.4

Components5 of Antenatal Checkup/Advice

• Weight measured 96.2 95.2 97.6 95.6 93.1 91.7 96.1

• Blood pressure checked 95.4 93.7 97.6 94.5 91.2 89.4 95.2

• Blood sample examined 94.2 92.1 96.9 92.8 89.5 87.1 93.9

• Urine sample examined 93.3 91.2 96.0 92.0 88.6 86.3 93.0

• Abdomen examined 95.4 94.2 96.9 94.5 91.9 90.7 95.2

• Informed about expected date of delivery 76.1 75.0 77.6 73.2 70.8 68.3 75.4

• Advised to have delivery in a health facility 76.6 77.7 75.2 75.8 70.8 73.1 76.7

• Advised about proper nutrition during pregnancy 87.8 88.4 87.0 87.1 84.5 85.6 87.5

Percent of Women Reporting health complications

• Worms in intestines 3.1 3.5 2.4 3.3 4.5 3.1 3.1

• Difficulty of vision during day light 2.6 2.9 2.1 2.8 6.0 3.5 2.6

• Suffered from night blindness 2.2 2.8 1.4 2.9 4.7 3.8 2.3

• Suffered with convulsions but not due to fever 4.0 4.3 3.6 3.9 6.0 4.6 3.9

• Swelling of legs, body or face 24.4 24.1 24.9 24.5 29.3 23.0 24.0

• Felt excessive fatigue/anemic 36.0 35.5 36.7 38.0 36.6 32.3 36.0

31


Percent of women received advise/counseling at least once on the following aspects:

• About additional diet 94.2 93.8 94.7 93.8 93.2 91.3 94.0

• Necessity of adequate rest / sleep 90.6 90.6 90.5 90.5 90.5 87.5 90.5

• Information about danger signs of pregnancy 50.7 51.0 50.3 50.7 44.6 48.7 50.9

• About breast feeding practice 77.0 76.6 77.7 76.3 76.1 74.2 76.7

• Need to keep the new born warm 67.0 67.6 66.2 66.7 67.3 66.4 66.6

• About cleanliness during delivery time 67.5 68.1 66.6 68.1 64.0 66.3 67.2

• About family planning 60.8 59.5 62.5 60.6 54.7 56.3 61.0

Delivery Care6

• Percent of deliveries in public hospitals 34.7 33.1 36.7 39.0 34.5 33.3 36.7

• Percent of deliveries in private hospital/NGO/Trust/Clinic 41.3 34.1 50.8 32.2 25.1 22.9 37.7

• Percent of domiciliary/Other deliveries 24.1 32.8 12.5 28.8 40.4 43.7 25.6

Percent of women who had

• Normal delivery 72.7 76.6 67.5 77.4 80.8 84.6 75.1

• Caesarian section 26.5 22.6 31.6 22.0 18.4 14.7 24.1

• Other intervention 0.8 0.8 0.9 0.6 0.8 0.7 0.8

• Safe deliveries7 81.6 74.2 91.4 76.7 67.6 63.7 80.5

Main reason reported by women for not going to health facility for delivery8

• Not necessary 31.1 31.8 28.2 30.9 25.3 27.2 30.5

• Not customary 1.3 1.2 1.7 1.1 1.4 1.4 1.2

• Costs too high in a health facility 7.4 7.6 6.7 7.4 9.5 10.6 7.6

• Too far/Inconvenient 2.3 2.3 2.2 2.4 2.6 2.0 2.2

• Transport not available 5.1 5.9 2.1 4.2 11.8 7.1 5.2

32


• Poor quality service 1.6 1.6 1.9 2.2 2.1 2.9 1.5

• Due to lack of time to reach a health facility 28.2 27.5 31.0 31.1 21.0 25.6 28.0

• Husband/Family did not allow 0.6 0.6 0.5 0.9 0.6 0.6 0.6

• Family felt better care at home 19.7 18.9 22.7 17.5 22.4 19.8 20.4

• Lack of knowledge 1.2 1.3 1.2 1.1 2.6 1.4 1.3

• Other 1.4 1.3 1.7 1.2 0.8 1.4 1.4

Use of Safe delivery practices9

• Disposable delivery kit 44.6 44.4 45.6 46.3 49.6 40.2 44.2

• Clean blade to cut umbilical cord 91.3 91.5 90.8 92.5 90.4 91.6 91.4

• Baby immediately wiped dry and wrapped without being bathed 80.0 80.0 79.8 82.1 82.6 80.7 79.6

Percent of women reported complications / problems during last delivery

• Pre-term labour 14.1 16.3 11.1 15.4 20.8 17.9 14.1

• Excessive bleeding 6.9 7.7 5.7 7.2 13.0 8.3 6.7

• Prolonged labour 9.9 10.2 9.6 10.0 9.7 9.1 9.7

• Obstructed labour 9.8 9.4 10.3 8.3 8.1 6.4 9.3

• Breach birth 2.4 2.3 2.7 2.3 2.3 1.9 2.4

Birth Weight

• Percent of children weighed at birth 76.9 69.9 86.1 72.7 65.0 56.4 75.4

• Percent of children weighed less than 2500 grams at birth 17.0 17.6 16.3 19.1 16.9 22.8 17.2


Post natal Checkup

• Percent of mothers received first postnatal checkup within a day 87.6 83.4 93.1 85.9 84.3 75.8 86.7

• Percent of mothers received first postnatal checkup within a week 90.2 86.8 94.8 88.9 89.1 80.5 89.6

33


• Among those with post partum checkups (non-institutional births)

1. Percent seen within one week of birth 60.3 59.5 63.1 60.2 73.4 56.6 60.4

2. Percent of mothers received post partum

checkup within 2 months of birth 64.2 63.5 66.9 64.8 75.8 60.5 64.3

• Out of those women who received post natal check up, percent of women received checkup from a doctor

76.9 71.0 84.1 73.6 60.8 61.9 75.5

Breast Feeding Practices

• Percent of children ever breastfed 98.0 98.3 97.7 98.5 98.3 98.6 98.1

• Percent of children who were currently breastfed 80.6 83.8 76.3 84.4 85.0 86.1 81.5

• Percent of children started breastfeeding within half an hour 11.7 12.1 11.3 14.0 14.8 12.1 12.4

• Percent of neonates started breastfeeding within one hour of birth 31.6 32.8 30.0 35.7 37.0 33.8 33.0

• Percentage of children started breastfeeding within one day of birth 68.5 68.2 68.8 72.6 73.9 66.8 69.3

• Percentage of children whose mother squeezed out the first milk from breast

28.5 30.7 25.7 28.7 33.0 34.7 28.7

• Percent of children exclusively breastfed for 4 months 54.4 56.5 51.6 57.6 54.2 58.0 55.2

Childhood Diseases (Diarrhoea and ARI)10

• Percent of children who had diarrhea during last two weeks prior to the survey

11.7 11.9 11.4 11.5 12.2 11.7 11.5

• Among the children who had diarrhea in the past two weeks, percentage received

1. Oral rehydration therapy (ORS packet) 48.8 47.4 50.6 49.0 43.5 41.6 48.9

2. Gruel made from rice or other cereal 14.4 15.2 13.1 13.3 17.2 13.6 14.5

3. Pill / syrup 85.9 84.6 87.5 84.5 81.7 82.7 86.6

4. Injection 34.0 36.8 30.4 35.9 39.2 35.5 34.8

5. Intravenous (I.V / Drip / Bottle) 8.2 8.8 7.4 8.5 11.7 9.5 7.7

34


• Percent women aware of danger signs of Pneumonia 32.5 30.4 35.2 31.0 32.2 25.1 31.2

• Percent of children suffering from Pneumonia during last two weeks preceeding the survey

18.2 18.0 18.3 18.4 20.6 18.1 17.8

Child Rights Indicators

• Percent of births registered with civil authority 57.0 52.7 62.6 54.8 47.1 41.9 56.7

• Percent of births possessing birth certificates 46.2 40.3 53.9 44.5 34.2 31.4 45.4

• Percent of children with vaccination card shown to interviewer 59.1 58.4 60.0 57.3 54.2 51.6 59.0

Child Immunization

Among Children Age 12-23 months

• Percent received BCG 98.1 98.1 98.1 97.9 95.6 95.3 98.1

• Percent received OPV 1 97.9 98.1 97.7 98.0 95.8 95.8 97.9



• Percent received DPT 1 97.9 98.1 97.6 97.9 95.4 95.5 97.9



• Percent received Hepatitis- B1 97.0 97.1 96.8 97.1 93.4 94.3 97.0



• Percent received Measles vaccine 87.9 88.0 87.8 85.8 81.6 82.2 87.7

• Percent fully immunized (BCG + OPV 1-3 + DPT 1-3 + Measles) 82.7 81.5 84.2 80.2 72.8 73.6 82.5

• Percent received Vitamin A dose at least once 87.0 87.6 86.2 86.9 83.3 82.7 87.1

35


Pregnancy11

• Percent of current pregnancies among currently married women (CMW ) interviewed

12.5 12.6 12.3 12.4 11.8 11.9 12.6

• Number of currently pregnant women 4149 2408 1741 933 312 540 3178

1. Percent of pregnant women below 20 weeks of pregnancy 34.1 34.6 33.5 36.5 36.5 36.7 33.8

2. Percent of pregnant women 20-32 weeks of pregnancy 57.0 65.4 57.8 55.3 54.2 54.1 57.0

3. Percent of pregnant women 33+ weeks of pregnancy 8.9 9.0 8.7 8.1 9.3 9.3 9.2

Contraceptive Use

• Percent of CMW using any method of contraception 43.2 42.8 43.8 42.0 38.8 39.9 43.8

• Percent of CMW using permanent method of contraception 41.3 41.5 40.9 40.3 37.8 39.5 42.2

• Percent of CMW using spacing method of contraception 1.9 1.3 2.9 1.6 1.0 0.5 1.6

• Place of providing sterilization services

1) Govt. hospital 78.8 84.1 71.5 84.6 87.5 91.2 81.8

2) Private hospital/NGO/Trust hospital/clinic/other 21.2 15.9 28.5 15.4 12.5 8.8 18.2

Childhood Mortality

• Neonatal Mortality rate 36.9 43.2 28.6 59.5 70.6 57.5 38.2

• Post neonatal mortality rate 15.9 19.0 11.8 33.4 40.3 27.6 17.1

• Infant mortality rate 52.8 62.3 40.4 92.9 111.0 85.1 55.3

Awareness of Health Interventions under RCH-II12

Percent of women who are aware of

• Janani Suraksha Yojana 61.6 65.6 56.3 62.8 62.0 59.0 63.0

• Rural Emergency Health Transport System 13 10.6 12.1 8.4 10.0 7.9 5.5 9.9

• Free Bus Pass to Pregnant Women 27.5 34.9 17.6 31.2 28.2 26.5 28.2

• Women Health Volunteer Scheme 23.9 31.5 13.8 27.0 27.9 26.9 25.4

• Round-the-Clock-Mother and Child Health Centre 14.5 13.0 16.4 13.6 10.5 11.9 14.7

36


Reproductive Tract Infections14

• Percent of women who contracted a disease through sexual contact 7.4 8.3 6.3 8.0 9.4 8.7 7.5

• Percent of women who experienced a bad smelling abnormal genital discharge

12.6 13.7 11.1 12.8 16.4 14.6 12.7

• Percent of women who had a genital sore or ulcer 2.2 2.4 1.8 2.5 3.1 2.6 2.2

• Percent of women who had any one of the above three problems 16.1 17.8 14.0 16.8 20.4 18.4 16.4

Of those who had RTI problem

• Percent of women who sought advice / treatment 46.6 47.6 45.0 46.0 45.8 46.0 46.3

Source of taking advice or treatment

• Government doctor 29.9 29.2 31.2 32.5 45.1 40.5 31.3

• NGO worker 16.8 16.5 17.2 15.1 12.5 12.8 16.0

• Private doctor 38.1 35.2 43.3 33.0 26.5 29.8 36.5

SC : Scheduled Caste ST : Scheduled Tribe SLI(Low) : Standard of Living Index Lower group BPL : Below Poverty Level (white ration card) households

Notes 1) Eligible women are those who had a delivery during the period from January/Sankranti, 2004 to the date of survey. 2) Live births occurred during the period from January / Sankranti 2004 to the date of survey. 3) The estimates do not represent the district since the sample was not drawn from the general population 4) Based on last pregnancy of all eligible women. 5) Based on last pregnancy of all eligible women. 6) Based on last delivery of all eligible women. 7) Deliveries attended by Doctor/ Nurse/ Mid-wife/ANM. 8) Based on non-institutional deliveries. 9) Percentages based on all domiciliary deliveries. 10) Based on children born during the period from January / Sankranti 2004 to the date of survey. 11) Based on all eligible women who are currently married. 12) Based on all eligible women interviewed. 13) Based on all eligible women from four districts Mahbubnagar, Nizamabad, Kurnool and Cuddapah districts. 14) Based on all eligible women.

37


DISTRICT: SRIKAKULAM

FACT SHEET

INDICATOR TOTAL RURAL URBAN SC ST SLI (Low)

BPL

Sample Population











• Percent of households using cleaner cooking fuels ( LPG, Electricity and Kerosene)

28.0 14.0 49.0 11.4 16.0 1.1 21.9






38


BPL





• Percent of women received check up at least once by a M.B.B.S doctor 96.4 95.1 98.3 93.8 79.4 91.0 96.0





• Weight measured 96.4 96.1 96.9 95.6 91.5 92.5 96.0















39


BPL









Delivery Care6





• Normal delivery 72.3 74.6 68.8 78.6 83.5 84.7 74.1



• Safe deliveries7 73.0 66.2 83.2 64.2 53.6 55.8 70.6


• Not necessary 23.8 23.3 25.2 19.4 16.4 23.6 23.1

• Not customary 1.3 1.6 0.7 1.2 1.8 2.7 1.4




40


BPL






• Other 2.8 2.4 3.7 1.2 3.6 3.8 2.9






• Pre-term labour 3.3 2.9 3.8 3.5 4.1 2.3 3.2




• Breach birth 1.6 1.4 2.0 2.9 2.1 1.8 1.5

Birth Weight




Post natal Checkup



41


BPL



2. Percent of mothers received post partum checkup within 2 months of birth

65.8 65.5 66.3 59.4 60.0 54.4 65.7


69.8 63.4 78.5 64.8 56.2 55.4 67.6







• Percentage of children whose mother squeezed out the first milk from breast 37.6 37.1 38.3 40.1 45.8 41.0 38.3



• Percent of children who had diarrhea during last two weeks prior to the survey 19.0 17.1 21.8 16.1 20.6 17.2 18.8




3. Pill / syrup 94.0 93.2 95.0 93.5 94.7 84.8 93.9

4. Injection 37.8 38.9 36.7 50.0 42.1 39.4 39.4




15.6 13.2 19.2 15.0 11.3 14.4 15.9

42


BPL





Child Immunization















Pregnancy11


15.9 15.9 15.9 17.4 12.3 12.7 16.0





43


BPL

Contraceptive Use





1) Govt. hospital 88.9 91.4 85.0 90.4 93.5 96.7 91.1


Childhood Mortality












• Percent of women who experienced a bad smelling abnormal genital discharge 7.1 7.7 6.3 7.3 10.3 5.6 7.5



44


BPL




1. Government doctor 34.7 30.4 41.0 54.5 60.0 23.1 35.7

2. NGO worker 4.2 5.4 2.6 0.0 0.0 0.0 4.8

3. Private doctor 54.7 55.4 53.8 54.5 20.0 46.2 53.6

SC : Scheduled Caste

ST : Scheduled Tribe

SLI (Low) : Standard of Living Index Lower group

BPL : Below Poverty Level (white ration card) households Notes

1) Eligible women are those who have delivery during the period from January/Sankranti, 2004 to the date of survey.

2) Refers to the period from January / Sankranti 2004 to the date of survey.

3) The estimates do not represent the district since the sample was not drawn from the general population.

4) Based on all eligible women.

5) All eligible women who are currently married.

6) Based on last pregnancy of all eligible women.


8) Based on last delivery of all eligible women.

9) Deliveries attended by Doctor/ Nurse/ Mid-wife/ANM.

10) Based on non-institutional deliveries.

11) Percentages based on all domiciliary deliveries.

12) Based on children born during the period from January / Sankranti 2004 to the date of survey.


45


DISTRICT : VIZIANAGARAM

FACT SHEET


BPL

Sample Population












31.2 12.3 59.5 17.1 8.0 2.0 24.3






46


BPL










• Weight measured 97.7 97.2 98.5 97.0 85.7 94.0 97.5















47


BPL









Delivery Care6





• Normal delivery 81.6 86.8 73.8 90.3 93.1 89.8 83.9



• Safe deliveries7 80.4 72.6 91.9 72.2 58.6 67.8 78.3


• Not necessary 11.9 11.3 13.9 8.1 6.0 9.1 11.8

• Not customary 1.6 1.1 3.3 1.6 2.0 2.1 1.2




48


BPL






• Other 2.5 2.4 2.8 1.6 2.0 1.7 2.2






• Pre-term labour 8.0 5.2 12.1 9.0 4.6 9.4 7.4




• Breach birth 1.7 1.6 1.7 1.0 1.1 1.4 1.6

Birth Weight




Post natal Checkup



49


BPL




66.3 64.9 71.1 75.6 72.0 62.0 65.9


65.2 55.5 78.4 47.3 36.1 48.7 62.2








41.0 38.6 44.6 44.4 52.9 40.1 41.4




10.6 10.7 10.6 14.0 9.2 12.0 11.1




3. Pill / syrup 94.6 94.7 94.4 90.9 100.0 91.4 95.1

4. Injection 14.6 18.6 8.3 4.5 50.0 22.9 14.0



50


BPL


15.4 12.7 19.6 18.1 10.3 15.4 15.4





Child Immunization













• Percent fully immunized (BCG+OPV 1-3 + DPT 1-3 + Measles) 84.3 83.2 85.9 82.1 83.9 70.5 83.5


Pregnancy11


16.5 18.0 14.1 14.7 7.3 16.0 17.1

51


BPL





Contraceptive Use





1) Govt. hospital 88.2 92.2 81.8 91.7 93.0 93.3 89.7


Childhood Mortality













8.2 8.5 7.9 10.0 9.2 10.6 8.8

52


BPL







• NGO worker 45.7 41.7 54.5 14.3 33.3 30.6 41.4

• Private doctor 12.1 14.6 6.8 9.5 0.0 13.9 12.5



SLI(Low) : Standard of Living Index Lower group


1) Eligible women are those who had a delivery during the period from January/Sankranti, 2004 to the date of survey.

2) Live births occurred during the period from January / Sankranti 2004 to the date of survey.









11) Based on all eligible women who are currently married.

12) Based on all eligible women interviewed.


53


DISTRICT: VISAKHAPATNAM

FACT SHEET


BPL

Sample Population












38.7 18.7 69.1 32.0 18.0 2.2 37.3






54


BPL










• Weight measured 99.0 98.4 99.8 99.3 94.7 96.3 98.9















55


BPL









Delivery Care6





• Normal delivery 90.5 91.1 89.5 93.0 94.5 94.5 91.1



• Safe deliveries7 91.0 88.8 94.4 88.2 66.1 76.0 90.8


• Not necessary 6.2 5.9 7.3 7.7 7.0 7.4 6.2

• Not customary 3.4 3.0 4.9 3.8 2.1 2.8 3.6




56


BPL






• Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0






• Pre-term labour 6.5 8.9 2.9 7.9 4.8 9.2 6.2




• Breach birth 1.3 1.1 1.6 1.2 2.1 1.8 1.2

Birth Weight




Post natal Checkup



57


BPL




91.9 91.7 92.7 93.6 88.1 87.0 91.7


75.4 72.1 80.4 74.3 45.8 52.5 75.3








6.6 8.6 3.5 8.3 9.2 7.5 6.4




7.9 9.4 5.5 7.7 10.4 10.0 7.8




3. Pill / syrup 90.7 90.8 90.5 100.0 90.9 83.3 90.5

4. Injection 23.3 27.7 9.5 25.0 18.2 41.7 23.0


58


BPL



5.6 6.3 4.5 7.9 5.9 3.0 5.1





Child Immunization















Pregnancy11


14.5 14.9 14.0 20.4 12.8 12.3 15.5

59


BPL





Contraceptive Use





1) Govt. hospital 96.4 98.2 93.8 95.8 100.0 98.0 96.6


Childhood Mortality













12.2 14.8 8.3 11.8 16.6 17.0 12.1

60


BPL


• Percent of women who had any of the above three problems 16.3 20.2 10.5 16.3 20.8 20.7 16.2





• NGO worker 9.7 7.5 16.1 9.1 4.2 3.4 10.0

• Private doctor 22.5 27.6 8.1 15.2 8.3 24.1 23.7


















61

BASELINE SURVEY ON REPRODUCTIVE AND CHILD HEALTH

(RCH-II), ANDHRA PRADESH 2006

DISTRICT : EAST GODAVARI

FACT SHEET

INDICATOR TOTAL RURAL URBAN SC ST SLI

(Low) BPL

Sample Population











• Percent of households using cleaner cooking fuels ( LPG, Electricity and

Kerosene) 35.1 17.9 59.6 33.7 14.5 1.5 33.2






62


(Low) BPL










• Weight measured 99.2 99.0 99.4 98.9 98.4 98.9 99.2















63


(Low) BPL









Delivery Care6





• Normal delivery 82.4 84.5 79.4 85.1 92.3 88.6 83.5



• Safe deliveries7 87.3 83.0 93.5 85.5 80.5 76.3 87.4


• Not necessary 16.0 15.7 17.5 27.7 5.8 7.0 15.0

• Not customary 2.2 2.0 2.9 2.2 2.3 2.0 1.8





64


(Low) BPL





• Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0






• Pre-term labour 24.7 34.5 10.9 25.0 62.5 37.9 25.2




• Breach birth 2.1 2.2 2.0 2.4 2.1 2.2 2.0

Birth Weight




Post natal Checkup



65


(Low) BPL



2. Percent of mothers received post partum checkup within 2 months of

birth 91.4 90.7 94.2 87.6 95.9 86.9 91.8

• Out of those women who received post natal check up, percent of women

received checkup from a doctor 79.3 73.9 87.0 77.9 54.7 58.9 87.8







• Percentage of children whose mother squeezed out the first milk from

breast 20.9 26.9 12.6 16.5 42.0 41.7 20.4



• Percent of children who had diarrhea during last two weeks prior to the

survey 8.0 9.3 6.2 7.4 9.7 7.4 7.5

• Among the children who had diarrhea in the past two weeks, percentage

received



3. Pill / syrup 68.2 63.4 80.6 78.8 18.5 37.9 70.4

4. Injection 34.9 34.4 36.1 33.3 14.8 27.6 35.2


66


(Low) BPL


• Percent of children suffering from Pneumonia during last two weeks

preceeding the survey 9.8 11.5 7.4 8.0 15.6 13.4 9.3





Child Immunization















Pregnancy11

• Percent of current pregnancies among currently married women (CMW )

interviewed 17.5 19.8 14.5 18.9 14.6 14.3 18.3

67


(Low) BPL





Contraceptive Use





1) Govt. hospital 81.5 82.1 80.5 82.9 95.6 87.1 82.1


Childhood Mortality












• Percent of women who experienced a bad smelling abnormal genital

discharge 8.8 11.6 4.9 9.4 19.5 13.8 9.2

68


(Low) BPL







• NGO worker 0.6 0.0 3.0 0.0 1.5 0.0 0.7

• Private doctor 29.0 31.6 18.2 29.3 19.7 23.6 27.8



SLI(Low) : Social Living Index Lower group

BPL : Below Poverty Level (white ration card) households

Notes



3) The estimates do not represent the district since the sample was not drawn from the general population











69


DISTRICT: WEST GODAVARI

FACT SHEET


BPL

Sample Population












33.2 16.0 59.0 20.1 18.5 1.3 28.7






70


BPL










• Weight measured 95.2 95.6 94.6 94.7 94.4 93.4 95.0















71


BPL









Delivery Care6





• Normal delivery 67.8 68.7 66.6 75.1 67.6 77.9 69.4



• Safe deliveries7 85.8 82.6 90.6 76.1 77.8 75.6 84.5


• Not necessary 46.4 46.6 45.6 50.4 51.5 42.6 47.1

• Not customary 0.5 0.2 1.4 0.0 3.0 0.0 0.6




72


BPL






• Other 1.5 1.7 0.7 1.1 0.0 2.0 1.3





Percent of women reported complications /problems during last delivery

• Pre-term labour 18.7 17.9 19.8 17.9 13.9 15.4 18.6




• Breach birth 2.4 2.2 2.7 1.4 0.9 1.3 2.2

Birth Weight




Post natal Checkup



73


BPL




86.9 87.3 85.7 85.5 90.9 81.2 87.7


78.8 76.6 82.0 69.2 68.0 66.9 77.0








15.5 15.4 15.5 17.8 9.4 17.9 15.6




12.9 13.0 12.8 12.9 11.1 17.0 13.6




3. Pill / syrup 91.4 90.6 92.5 89.4 83.3 89.5 91.8

4. Injection 30.8 35.8 23.4 28.2 50.0 28.9 31.8


74


BPL



12.1 12.5 11.4 13.0 12.0 12.8 11.9





Child Immunization















Pregnancy11

• Percent of current pregnancies among currently married women (CMW) interviewed

17.9 19.0 16.3 17.8 18.5 20.5 19.1

75


BPL





Contraceptive Use





1) Govt. hospital 74.9 77.8 70.3 84.6 86.0 90.3 78.4


Childhood Mortality













12.0 12.7 10.8 12.2 22.2 13.5 11.8

76


BPL







• NGO worker 15.4 14.2 17.3 16.3 13.3 14.3 14.1

• Private doctor 45.7 49.6 40.0 40.8 33.3 28.6 43.0





Notes 1) Eligible women are those who had a delivery during the period from January/Sankranti, 2004 to the date of survey.













77


DISTRICT : KRISHNA

FACT SHEET

INDICATOR TOTAL RURAL URBAN SC) ST SLI (Low)

BPL

Sample Population

• Number of households selected 2632 1584 1048 803 129 328 2118









• Percent of households with protected drinking water (Piped water, Tube well / Bore well, Tanker/Truck and Bottled water)

93.2 89.1 99.2 91.8 95.3 90.2 92.5

• Percent of households using cleaner cooking fuels ( LPG+ Electricity+ Kerosene)

36.4 15.9 67.3 19.9 14.0 0.9 27.8






78


BPL










• Weight measured 97.8 98.0 97.6 98.1 93.0 93.8 97.9

• Blood Pressure checked 94.5 92.6 97.4 92.9 89.8 89.5 94.0














79


BPL


• About Additional diet 89.8 88.3 92.0 89.2 76.2 86.3 89.4







Delivery Care6

• Percent of deliveries in Public Hospitals 35.0 36.4 32.9 40.7 34.6 45.6 38.7

• Percent of deliveries in private Hospital/NGO/Trust/Clinic 49.5 42.8 59.7 35.2 29.2 20.4 43.4

• Percent of Domiciliary/other deliveries 15.5 20.9 7.4 24.1 36.2 34.0 17.9


• Normal Delivery 70.7 75.9 62.9 77.5 80.8 84.8 74.1



• Safe deliveries 89.7 86.5 94.5 84.7 75.4 74.8 87.9


• Not necessary 35.8 36.9 31.1 33.7 40.0 25.9 36.2

• Not customary 0.5 0.6 0.0 0.5 0.0 0.9 0.3




80


BPL






• Other 2.2 2.1 2.7 2.1 0.0 2.7 2.4






• Pre-term labour 4.5 5.5 3.1 4.7 4.6 4.6 4.8




• Breach birth 1.7 1.4 2.3 1.4 0.8 2.1 1.6

Birth Weight




Post natal Checkup



81


BPL




76.6 75.0 83.3 73.2 74.5 69.6 77.2


82.0 79.1 86.3 75.6 71.8 69.2 79.6








23.4 25.3 20.4 23.2 34.4 25.5 24.0




10.8 9.5 12.8 10.2 9.2 10.3 11.1


1. Oral Rehydration Therapy (ORS packet) 33.2 31.1 35.6 29.3 33.3 32.4 35.7


3. Pill / syrup 92.9 92.5 93.2 94.9 100.0 100.0 93.7

4. Injection 16.2 22.4 9.7 23.7 22.2 28.0 17.8


82


BPL



21.8 20.5 23.6 21.4 10.8 19.1 22.0





Child Immunization















Pregnancy11

• Percent of current pregnancies among currently married women interviewed

16.1 17.2 14.5 15.8 20.5 16.1 17.5

83


BPL





Contraceptive Use





1) Govt. Hospital 74.5 81.4 63.3 87.6 81.4 89.9 80.3

2) Private Hospital/NGO/Trust Hospital/Clinic/Other 25.5 18.6 36.7 12.4 18.6 10.1 19.7

Childhood Mortality













8.3 7.7 9.3 7.3 8.5 9.4 8.7

84


BPL







• NGO worker 8.2 3.6 12.1 5.3 0.0 0.0 10.0

• Private doctor 54.3 60.6 48.6 54.2 50.0 36.6 51.7





Notes














85


DISTRICT : GUNTUR

FACT SHEET


BPL

Sample Population










• Percent of households using piped water as main source of drinking

93.1 90.8 96.5 92.5 90.6 86.9 92.9


35.3 12.7 69.3 18.2 16.2 1.2 32.7






86


BPL






97.0 95.8 98.9 95.5 91.6 92.8 96.8





• Weight measured 98.2 97.7 98.9 97.1 96.1 96.6 98.3















87


BPL









Delivery Care6





• Normal delivery 71.7 76.0 65.1 78.0 78.0 82.5 73.2



• Safe deliveries7 85.6 79.4 94.9 80.1 71.2 75.8 84.5


• Not necessary 29.2 31.1 20.3 25.9 41.9 25.9 28.9

• Not customary 0.7 0.5 1.3 0.5 0.0 0.0 0.9




88


BPL






• Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0






• Pre-term labour 8.0 6.7 10.0 9.4 8.9 8.6 8.3




• Breach birth 3.9 3.5 4.5 4.1 3.7 3.5 4.3

Birth Weight




Post natal Checkup


• Percent of mothers received first postnatal checkup within a week

92.8 89.2 98.3 90.5 82.7 88.1 92.0

89


BPL




61.2 56.5 83.5 61.1 51.6 57.4 58.9


74.2 70.8 78.7 69.7 62.1 68.0 72.9





• Percent of neonates started breastfeeding within one hour of birth

43.1 45.8 39.1 52.0 46.0 50.4 44.6

• Percentage of children started breastfeeding within one day of birth

75.4 78.0 71.4 81.8 75.9 80.5 75.4


40.1 45.2 32.4 40.5 49.7 43.4 40.8




9.2 10.5 7.3 9.8 10.5 10.9 8.4




3. Pill / syrup 82.7 82.0 84.2 74.6 84.2 75.7 81.4

4. Injection 34.1 35.9 29.8 31.3 26.3 35.1 35.4


90


BPL



14.7 12.9 17.2 14.2 18.8 12.1 14.0





Child Immunization













• Percent fully immunized (BCG + OPV 1-3 + DPT 1-3 + Measles)

88.0 89.4 85.9 85.3 87.0 87.4 88.3


Pregnancy11


14.7 17.0 11.2 15.3 15.1 10.8 14.7

91


BPL





Contraceptive Use





1) Govt. hospital 79.1 86.5 66.9 87.3 91.3 96.9 81.7


Childhood Mortality











• Percent of women who contracted a disease through sexual contact

5.4 7.2 2.6 4.5 7.3 7.7 5.2


10.5 12.6 7.3 10.7 13.6 13.3 9.6

92


BPL


• Percent of women who had any one of the above three problems

13.7 16.7 9.1 12.8 17.8 16.8 12.5





• NGO worker 5.7 5.7 5.8 5.9 11.1 4.8 6.1

• Private doctor 43.6 37.5 53.8 29.4 22.2 23.8 38.8





Notes














93


DISTRICT: PRAKASAM

FACT SHEET


BPL

Sample Population












31.5 11.6 60.9 19.9 14.0 1.3 30.4






94


BPL










• Weight measured 93.1 95.3 89.9 92.4 84.5 90.0 93.0















95


BPL









Delivery Care6





• Normal delivery 74.5 84.2 60.2 80.9 88.4 88.8 74.5



• Safe deliveries7 76.7 68.2 89.2 73.1 56.1 61.2 77.3


• Not necessary 15.0 17.8 6.2 15.0 12.6 9.4 15.3

• Not customary 1.6 2.1 0.0 0.9 3.4 2.0 1.4




96


BPL






• Other 0.9 0.7 1.7 0.9 1.1 0.5 1.2






• Pre-term labour 24.2 24.9 23.2 26.6 25.4 54.9 22.9




• Breach birth 3.0 2.6 3.5 3.9 0.6 2.1 3.2

Birth Weight




Post natal Checkup



97


BPL




55.3 51.5 67.4 58.8 51.7 53.2 58.6


81.1 77.8 85.3 75.3 72.1 73.1 80.4








33.3 40.5 22.5 33.7 35.5 32.3 32.2




15.5 15.8 15.0 17.8 12.7 14.2 16.0




3. Pill / syrup 79.2 69.3 91.3 74.6 80.0 79.3 78.8

4. Injection 50.2 44.9 56.7 52.4 70.0 41.4 51.2


98


BPL



29.9 29.2 31.0 29.5 34.1 29.6 30.2





Child Immunization















Pregnancy11


13.4 12.8 14.3 15.5 13.8 11.7 13.6

99


BPL





Contraceptive Use





1) Govt. hospital 74.7 84.1 61.9 85.0 88.2 88.7 74.9


Childhood Mortality













16.4 12.7 21.8 15.0 13.9 14.2 16.8

100


BPL







• NGO worker 11.3 10.3 12.3 13.8 0.0 7.3 10.7

• Private doctor 51.6 49.2 53.8 43.1 41.7 43.9 53.4


ST : Scheduled Tribe SLI(Low) : Standard of Living Index Lower group


Notes














101


DISTRICT: NELLORE

FACT SHEET


BPL

Sample Population












31.6 12.4 58.9 16.8 7.9 1.5 25.6






102


BPL










• Weight measured 98.9 98.7 99.1 98.4 98.1 98.3 98.8















103


BPL









Delivery Care6





• Normal delivery 71.9 77.4 64.0 76.4 84.6 81.5 74.4



• Safe deliveries7 88.0 84.1 93.6 83.3 71.9 75.8 87.7


• Not necessary 10.9 12.2 5.6 8.9 23.6 15.9 9.4

• Not customary 0.3 0.4 0.0 0.6 0.0 0.7 0.4




104


BPL






• Other 1.7 1.8 1.4 1.9 1.1 1.3 2.2






• Pre-term labour 11.5 13.6 8.6 11.5 13.1 15.1 12.1




• Breach birth 2.7 3.0 2.3 2.2 1.9 2.3 2.7

Birth Weight




Post natal Checkup



105


BPL




88.3 85.6 98.6 83.4 91.0 82.8 87.4


84.9 80.1 91.4 79.0 65.0 69.9 84.2








27.1 30.6 22.0 29.0 35.6 33.3 28.7




9.2 7.1 12.2 8.4 6.7 6.2 8.5




3. Pill / syrup 86.6 87.1 86.3 92.2 72.7 86.4 89.3

4. Injection 39.0 49.4 30.4 43.1 63.6 45.5 42.7


106


BPL



18.4 14.0 24.5 18.5 14.2 16.6 18.1





Child Immunization















Pregnancy11


12.4 11.2 14.1 15.2 8.8 10.5 12.0

107


BPL





Contraceptive Use





1) Govt. hospital 77.8 86.1 65.1 85.6 96.9 91.9 82.0


Childhood Mortality













10.4 10.5 10.2 9.3 9.7 13.2 10.1


108


BPL






• NGO worker 9.5 9.4 9.8 3.8 17.6 4.0 6.6

• Private doctor 56.4 59.4 49.0 55.8 29.4 50.0 55.9


















109


DISTRICT : KURNOOL

FACT SHEET


BPL

Sample Population












25.7 5.8 55.4 17.5 17.0 0.5 21.5






110


BPL






81.3 71.5 96.0 78.9 58.3 58.0 80.2





• Weight measured 87.1 79.3 97.7 86.0 76.3 75.0 86.3















111


BPL









Delivery Care6





• Normal delivery 84.0 90.7 74.0 86.6 93.8 95.1 85.6



• Safe deliveries7 62.6 49.4 82.2 58.1 41.7 37.6 61.2


• Not necessary 61.9 64.5 51.6 51.7 62.1 58.8 62.6

• Not customary 1.3 1.0 2.3 1.7 0.0 1.6 1.0




112


BPL






• Other 0.2 0.1 0.4 0.0 0.0 0.0 0.1






• Pre-term labour 7.4 8.8 5.3 7.7 0.0 6.3 7.4




• Breach birth 1.8 0.8 3.2 2.0 0.0 1.2 1.6

Birth Weight




Post natal Checkup



113


BPL




39.1 33.9 59.3 35.0 37.9 33.8 36.1


75.4 66.8 83.6 74.5 58.6 50.7 75.3








31.5 36.0 24.8 29.4 37.5 45.0 32.0




8.7 6.3 12.2 9.7 6.3 7.0 8.5




3. Pill / syrup 98.9 100.0 98.2 100.0 100.0 100.0 99.3

4. Injection 42.1 38.3 45.0 46.3 100.0 41.7 44.1


114


BPL



26.2 22.9 31.2 27.5 6.3 24.8 25.2





Child Immunization















Pregnancy11


13.3 14.3 11.8 9.0 16.1 11.4 12.9

115


BPL





Contraceptive Use





1) Govt. hospital 89.7 96.3 78.4 95.0 96.2 98.1 91.5


Childhood Mortality







• Rural Emergency Health Transport System 9.0 7.7 11.1 9.7 4.2 2.7 8.1







2.4 1.4 3.8 2.3 8.3 1.0 2.4

116


BPL







• NGO worker 29.2 0.0 50.0 50.0 0.0 50.0 33.3

• Private doctor 37.5 30.0 42.9 25.0 0.0 16.7 38.9





Notes














117


DISTRICT: ANANTHAPUR

FACT SHEET


BPL

Sample Population











99.7 99.7 99.6 99.6 97.3 100.0 99.9


27.6 10.3 53.4 17.2 40.0 3.0 23.2






118


BPL






82.2 77.5 89.3 78.5 84.9 70.0 80.9





• Weight measured 94.6 92.5 97.6 95.7 95.5 89.7 94.8















119


BPL









Delivery Care6





• Normal delivery 88.1 90.2 84.9 90.5 82.2 93.6 89.1



• Safe deliveries7 70.0 58.5 87.1 60.5 77.8 54.2 69.0


• Not necessary 61.4 62.2 58.2 58.7 43.1 50.5 59.2

• Not customary 0.8 0.5 1.5 0.4 0.0 0.0 0.7




120


BPL






• Other 2.2 2.5 1.0 1.3 0.0 1.1 2.1






• Pre-term labour 6.5 7.3 5.3 6.1 9.7 2.7 6.3




• Breach birth 2.8 2.6 3.2 2.6 5.4 1.5 2.5

Birth Weight




Post natal Checkup



121


BPL




25.2 24.3 28.9 29.3 33.3 32.6 27.5


73.6 65.8 81.9 67.2 80.1 56.5 72.7







86.5 83.9 90.4 84.1 87.8 87.4 87.1


23.2 24.1 21.9 27.2 25.0 21.2 22.0




8.0 7.6 8.6 9.1 2.7 6.4 8.3




3. Pill / syrup 69.1 56.5 82.0 63.6 100.0 84.6 70.4

4. Injection 8.9 8.1 9.8 4.5 0.0 0.0 10.2


122


BPL



6.9 6.7 7.3 6.1 5.9 5.5 6.7





Child Immunization














71.3 68.5 75.4 68.6 67.1 71.1 71.9


Pregnancy11


6.6 5.9 7.7 4.4 5.3 4.7 6.8

123


BPL





Contraceptive Use





1) Govt. hospital 82.9 87.9 75.0 89.3 68.4 91.4 85.9


Childhood Mortality












5.0 4.4 6.0 3.0 1.6 3.0 5.0


6.7 7.7 5.2 7.3 6.5 4.5 6.3

124


BPL







5. NGO worker 4.7 0.0 10.0 0.0 0.0 0.0 6.0

6. Private doctor 53.1 44.1 63.3 0.0 33.3 25.0 52.0





Notes














125

BASELINE SURVEY ON REPRODUCTIVE AND CHILD HEALTH

(RCH-II), ANDHRA PRADESH 2006

DISTRICT : KADAPA

FACT SHEET


(Low) BPL

Sample Population












46.1 20.9 83.4 37.6 34.8 0.0 45.0






126


(Low) BPL










• Weight measured 96.6 95.7 98.0 94.7 95.6 90.1 96.6















127


(Low) BPL









Delivery Care6





• Normal delivery 81.3 81.9 80.4 87.3 81.5 93.1 81.9



• Safe deliveries7 84.3 79.2 91.9 80.1 83.7 68.1 83.7


• Not necessary 7.4 7.9 5.3 7.4 4.8 3.6 7.1

• Not customary 0.2 0.2 0.0 0.0 0.0 0.0 0.2




128


(Low) BPL






• Other 1.0 0.7 2.1 1.1 0.0 0.0 1.1






• Pre-term labour 27.4 30.0 23.6 26.5 25.0 40.3 27.5




• Breach birth 2.7 2.2 3.4 1.2 3.3 1.4 2.5

Birth Weight




Post natal Checkup



129


(Low) BPL




20.1 22.6 9.5 24.0 19.0 19.6 19.6


69.1 64.2 75.3 65.2 62.0 89.5 68.9








20.4 23.9 15.2 21.7 28.7 31.9 20.2




9.0 10.4 6.9 9.0 7.6 11.8 9.2




3. Pill / syrup 88.7 86.8 92.6 83.7 100.0 84.6 87.6

4. Injection 41.1 34.2 55.6 39.5 50.0 46.2 39.9


130


(Low) BPL



15.6 16.9 13.7 14.0 12.0 13.2 15.7





Child Immunization















Pregnancy11


7.8 9.0 5.7 5.4 3.6 8.6 7.6

131


(Low) BPL





Contraceptive Use





1) Govt. hospital 73.8 82.8 60.7 80.1 85.5 79.0 74.7


Childhood Mortality














3.4 4.4 1.9 4.7 4.3 6.3 3.5

132


(Low) BPL







• NGO worker 21.2 21.6 20.0 14.3 0.0 12.5 17.5

• Private doctor 18.2 17.6 20.0 19.0 25.0 12.5 19.3





Notes














133


DISTRICT: CHITTOOR

FACT SHEET


BPL

Sample Population












46.0 29.0 71.6 37.1 31.6 1.7 43.0






134


BPL










• Weight measured 98.0 97.1 99.5 99.0 98.2 95.5 98.1















135


BPL









Delivery Care6





• Normal delivery 88.7 87.7 90.1 90.4 90.6 93.3 89.4



• Safe deliveries7 80.2 75.6 87.1 70.7 64.9 58.4 79.3


• Not necessary 37.9 35.9 52.8 35.3 0.0 44.2 38.3

• Not customary 3.6 3.7 2.8 5.9 0.0 4.7 3.0




136


BPL






• Other 1.6 1.8 0.0 0.0 0.0 2.3 1.5






• Pre-term labour 18.0 19.8 15.3 43.6 45.0 44.9 16.9




• Breach birth 2.6 2.6 2.7 2.7 3.5 2.2 2.5

Birth Weight




Post natal Checkup



137


BPL




54.0 51.2 78.4 39.6 57.1 54.9 54.4


85.6 80.9 92.0 92.0 88.1 53.5 85.2








25.7 31.3 17.2 20.6 17.6 43.2 25.8




11.6 13.4 8.8 13.2 10.5 9.6 10.7




3. Pill / syrup 96.6 97.1 95.7 94.9 100.0 75.0 96.9

4. Injection 13.9 14.4 13.0 17.9 25.0 25.0 15.0


138


BPL



31.6 36.4 39.5 26.4 26.3 34.3 31.2




• Percent of children with vaccination card shown to interviewer 80.0 76.7 84.9 73.3 69.6 42. 79.8

Child Immunization















Pregnancy11


9.5 7.7 13.9 8.1 9.2 5.7 9.2

139


BPL





Contraceptive Use





1) Govt. hospital 98.6 98.6 98.7 99.0 97.9 98.8 98.6


Childhood Mortality













12.8 15.4 8.9 10.8 9.4 29.2 13.3

140


BPL







2. NGO worker 0.9 1.3 0.0 0.0 0.0 0.0 0.7

3. Private doctor 9.9 12.0 5.5 6.6 0.0 10.3 5.8





Notes














141


DISTRICT : RANGA REDDY

FACT SHEET


BPL

Sample Population












38.8 21.5 64.6 27.2 29.5 1.7 34.7






142


BPL










• Weight measured 95.5 94.3 97.3 95.3 83.8 90.2 95.1















143


BPL









Delivery Care6





• Normal delivery 76.2 77.6 74.1 79.7 82.6 87.1 77.2



• Safe deliveries7 80.9 76.1 88.0 77.6 72.1 63.1 80.6


• Not necessary 19.4 20.9 15.1 20.1 13.6 22.5 20.2

• Not customary 2.0 2.3 1.3 3.4 1.5 3.4 1.8




144


BPL






• Other 1.4 1.8 0.0 0.6 3.0 0.5 1.3






• Pre-term labour 28.3 37.6 14.3 33.5 39.5 40.4 28.9




• Breach birth 1.0 1.1 0.9 0.7 1.1 1.3 1.0

Birth Weight




Post natal Checkup



145


BPL




50.5 50.5 50.7 52.3 40.9 39.2 52.3


86.4 84.9 88.5 85.5 82.4 78.3 86.0








41.9 39.8 45.0 42.5 50.5 43.5 42.8




17.2 15.0 20.4 14.8 24.2 13.8 17.1




3. Pill / syrup 85.3 89.4 80.7 85.9 83.3 87.0 83.3

4. Injection 34.0 38.5 29.0 39.1 30.6 30.4 34.0


146


BPL



21.7 21.8 21.5 22.0 21.6 18.1 22.1





Child Immunization















Pregnancy11

• Percent of current pregnancies among currently married women (CMW) interviewed

10.2 9.1 11.9 11.4 11.2 10.1 10.0

147


BPL





Contraceptive Use





1) Govt. hospital 87.2 88.3 85.1 92.4 87.3 94.3 89.2


Childhood Mortality













21.7 22.7 20.3 24.5 26.3 26.0 22.3

148


BPL


• Percent of women who had all the above three problems 26.5 27.4 25.0 30.9 33.7 30.8 26.9





2. NGO worker 14.3 15.7 12.0 16.0 25.0 16.7 13.6

3. Private doctor 42.1 40.4 45.1 42.5 37.5 35.0 43.4





Notes














149


DISTRICT : HYDERABAD

FACT SHEET

INDICATOR TOTAL URBAN SC ST SLI (Low)

BPL

Sample Population

• Number of households interviewed 2614 2614 396 75 36 1719

• Number of eligible women interviewed1 2618 2618 396 75 36 1723

• Number of live births2 3028 3028 463 87 45 2003

• Population in the sample 14732 14732 2164 364 2614 9705


• Mean household size 5.64 5.64 5.46 4.85 5.64 5.65

• Percent of pucca houses 89.1 89.1 84.3 76.0 5.6 87.5

• Percent of households with separate kitchen 72.1 72.1 66.9 57.3 2.8 66.7

• Percent of households with electricity 98.6 98.6 96.7 90.7 50.0 98.4

• Percent of households using piped water as main source of drinking 99.8 99.8 99.7 98.7 97.2 99.8


95.6 95.6 91.9 82.7 27.8 95.1

• Percent of households with no toilet / latrine facility 2.7 2.7 6.8 14.7 63.9 3.5

• Percent of households with white ration card 65.8 65.8 75.0 61.3 55.6 -

• Percent of scheduled caste households 15.1 15.1 - - 38.9 17.3

• Percent of scheduled tribe households 2.9 2.9 - - 27.8 2.7

• Percent of backward caste households 41.7 41.7 - - 30.6 42.4

150


BPL


• Percent of mothers received any ANC 99.1 99.1 98.7 94.7 83.3 98.9

• Percent of mothers received at least 3 ANC checkups 97.9 97.9 96.5 93.3 91.7 97.7

• Percent of mothers registered in first trimester 58.7 58.7 52.7 45.9 21.9 54.3


98.4 99.1 96.7 92.0 75.0 98.3

• Percent of mothers received 2 or more TT injections 93.2 95.3 91.2 85.3 66.7 92.7

• Percent of mothers received 100 or more IFA tablets 48.8 48.8 56.7 34.8 30.8 47.9

• Percent of mothers consumed all the IFA tablets received 25.6 19.1 23.1 27.5 34.6 22.9


• Weight measured 97.2 97.2 96.7 89.3 80.6 96.7

• Blood pressure checked 95.7 95.7 93.9 88.0 80.6 95.9

• Blood sample examined 96.6 96.6 94.9 90.7 75.0 96.1

• Urine sample examined 89.4 89.4 86.6 84.0 77.8 88.5

• Abdomen examined 94.4 94.4 94.2 92.0 83.3 93.8

• Informed about expected date of delivery 85.4 85.4 86.6 80.0 63.9 84.3

• Advised to have delivery in a health facility 51.8 51.8 62.6 54.7 55.6 51.9

• Advised about proper nutrition during pregnancy 65.3 65.3 72.7 80.0 66.7 65.0


• Worms in intestines 0.4 0.4 0.5 1.3 0.0 0.4

• Difficulty of vision during day light 1.9 1.9 2.3 5.3 5.6 2.0

• Suffered from night blindness 0.6 0.6 0.5 1.3 5.6 0.6

• Suffered with convulsions but not due to fever 3.8 3.8 3.5 5.3 0.0 3.5

• Swelling of legs, body or face 23.2 23.2 26.3 22.7 16.7 22.6

• Felt excessive fatigue/anemic 49.2 49.2 56.6 46.7 25.0 49.6

151


BPL


• About additional diet 89.5 89.5 89.6 90.7 77.8 89.1

• Necessity of adequate rest / sleep 76.1 76.1 79.3 70.7 58.3 74.5

• Information about danger signs of pregnancy 31.7 31.7 35.1 32.0 19.4 30.5

• About breast feeding practice 59.6 59.6 62.1 58.7 50.0 59.3

• Need to keep the new born warm 34.8 34.8 44.9 34.7 30.6 34.2

• About cleanliness during delivery time 34.3 34.3 40.7 30.7 19.4 33.3

• About family planning 37.5 37.5 46.2 33.3 38.9 38.0

Delivery Care6

• Percent of deliveries in public hospitals 44.4 44.4 53.3 41.3 41.7 52.6

• Percent of deliveries in private hospital/NGO/Trust/Clinic 49.2 49.2 37.4 41.3 30.6 40.3

• Percent of domiciliary/Other deliveries 6.5 6.5 9.3 17.3 27.8 7.1


• Normal delivery 63.3 63.3 63.6 68.0 83.3 67.0

• Caesarian section 36.7 36.7 36.4 32.0 16.7 33.0

• Other intervention 0.0 0.0 0.0 0.0 0.0 0.0

• Safe deliveries7 94.3 94.3 91.9 82.7 72.2 93.7


• Not necessary 33.7 33.7 40.5 46.2 70.0 30.3

• Not customary 0.0 0.0 0.0 0.0 0.0 0.0

• Costs too high in a health facility 3.6 3.6 2.7 0.0 0.0 3.3

• Too far/Inconvenient 4.1 4.1 5.4 7.7 0.0 5.7

• Transport not available 3.6 3.6 5.4 7.7 10.0 4.9

152


BPL

• Poor quality service 0.0 0.0 0.0 0.0 0.0 0.0

• Due to lack of time to reach a health facility 47.3 47.3 35.1 30.8 20.0 48.4

• Husband/Family did not allow 1.2 1.2 5.4 0.0 0.0 0.8

• Family felt better care at home 5.9 5.9 5.4 7.7 0.0 5.7

• Lack of knowledge 0.6 0.6 0.0 0.0 0.0 0.8

• Other 0.0 0.0 0.0 0.0 0.0 0.0


• Disposable delivery kit 17.8 17.8 18.9 7.7 0.0 18.0

• Clean blade to cut umbilical cord 88.2 88.2 81.1 100.0 100.0 90.2

• Baby immediately wiped dry and wrapped without being bathed 61.5 61.5 56.8 92.3 70.0 59.0


• Pre-term labour 1.1 1.1 1.5 0.0 0.0 1.0

• Excessive bleeding 0.8 0.8 1.0 0.0 0.0 0.8

• Prolonged labour 6.8 6.8 3.8 4.0 2.8 6.6

• Obstructed labour 7.3 7.3 5.6 13.3 8.3 6.6

• Breach birth 2.6 2.6 2.5 5.3 2.8 2.4

Birth Weight

• Percent of children weighed at birth 91.1 91.1 88.9 81.3 63.9 89.9

• Percent of children weighed less than 2500 grams at birth 17.5 17.5 19.1 19.7 9.1 17.5

• Percent of children weighed less than 1500 grams at birth 0.6 0.6 0.3 0.0 0.0 0.8

Post natal Checkup

• Percent of mothers received first postnatal checkup within a day 94.5 94.5 94.4 84.0 72.2 94.0

• Percent of mothers received first postnatal checkup within a week 95.5 95.5 95.5 85.3 77.8 95.1

153


BPL


1. Percent seen within one week of birth 36.7 36.7 51.4 23.1 40.0 37.7


42.6 42.6 54.1 38.5 40.0 43.4


87.0 87.0 84.7 90.9 69.0 85.2


• Percent of children ever breastfed 98.5 98.5 98.7 98.7 100.0 98.2

• Percent of children who were currently breastfed 74.5 74.5 84.1 90.5 91.7 77.6

• Percent of children started breastfeeding within half an hour 10.1 10.1 14.3 16.2 27.8 9.7

• Percent of neonates started breastfeeding within one hour of birth 21.5 21.5 27.1 37.8 41.7 21.1

• Percentage of children started breastfeeding within one day of birth 75.0 75.0 79.5 87.8 69.4 74.6


24.2 24.2 26.1 24.3 13.9 25.1

• Percent of children exclusively breastfed for 4 months 33.9 33.9 45.3 40.5 44.4 33.2



8.4 8.4 9.3 13.3 8.3 8.5


1. Oral rehydration therapy (ORS packet) 53.2 53.2 48.6 70.0 66.7 54.1

2. Gruel made from rice or other cereal 6.4 6.4 2.7 20.0 0.0 4.8

3. Pill / syrup 93.9 93.9 0.0 100.0 100.0 94.3

4. Injection 12.2 12.2 0.0 16.7 0.0 15.2

5. Intravenous (I.V / Drip / Bottle) 1.2 1.2 0.0 0.0 0.0 1.0

154


BPL

• Percent women aware of danger signs of Pneumonia 43.0 43.0 44.7 21.3 11.1 39.7


11.0 11.0 12.9 8.0 11.1 11.6


• Percent of births registered with civil authority 86.3 86.3 86.7 82.4 65.1 84.5

• Percent of births possessing birth certificates 83.8 83.8 82.6 81.2 60.5 81.7

• Percent of children with vaccination card shown to interviewer 58.9 58.9 56.7 54.1 32.6 58.5

Child Immunization


• Percent received BCG 97.2 97.2 96.1 96.7 90.9 96.1

• Percent received OPV 1 94.9 94.9 96.1 90.0 90.9 93.3



• Percent received DPT 1 94.9 94.9 96.1 90.0 90.9 93.3



• Percent received Hepatitis- B1 94.2 94.2 96.1 86.7 72.7 92.6



• Percent received Measles vaccine 84.2 84.2 81.9 80.0 54.5 81.2

• Percent fully immunized (BCG + OPV 1-3 + DPT 1-3 + Measles) 82.9 82.9 78.7 80.0 45.5 79.6

• Percent received Vitamin A dose at least once 79.0 79.0 77.4 80.0 54.5 76.6

Pregnancy11


13.1 13.1 9.9 16.1 12.5 14.0

155


BPL

• Number of currently pregnant women 209 209 22 9 3 148

1. Percent of pregnant women below 20 weeks of pregnancy 34.4 34.4 22.7 22.2 33.3 33.8

2. Percent of pregnant women 20-32 weeks of pregnancy 59.8 59.8 68.2 77.8 66.7 62.2

3. Percent of pregnant women 33+ weeks of pregnancy 5.7 5.7 9.1 0.0 0.0 4.1

Contraceptive Use

• Percent of CMW using any method of contraception 38.6 38.6 43.5 25.3 33.3 38.3

• Percent of CMW using permanent method of contraception 34.1 34.1 40.8 25.3 33.3 34.8

• Percent of CMW using spacing method of contraception 4.5 4.5 2.8 0.0 0.0 3.6


1) Govt. hospital 68.6 68.6 72.4 88.5 87.5 75.8

2) Private hospital/NGO/Trust hospital/clinic/other 31.4 31.4 27.6 11.5 12.5 24.2

Childhood Mortality

• Neonatal Mortality rate 20.3 20.3 59.8 78.9 117.6 22.5

• Post neonatal mortality rate 6.1 6.1 12.8 78.9 0.0 5.6

• Infant mortality rate 26.4 26.4 72.6 157.9 117.6 28.1



• Janani Suraksha Yojana 21.9 21.9 31.1 32.0 25.0 24.2

• Free Bus Pass to Pregnant Women 5.9 5.9 10.1 9.3 22.2 5.3

• Women Health Volunteer Scheme 2.6 2.6 4.3 2.7 5.6 2.3

• Round-the-Clock-Mother and Child Health Centre 2.5 2.5 3.5 2.7 0.0 2.3


• Percent of women who contracted a disease through sexual contact 5.5 5.5 6.3 9.3 2.8 5.6


9.4 9.4 9.1 13.3 2.8 10.0

156


BPL

• Percent of women who had a genital sore or ulcer 1.8 1.8 0.8 0.0 0.0 1.6

• Percent of women who had any one of the above three problems 10.6 10.6 9.6 13.3 2.8 11.1


• Percent of women who sought advice / treatment 43.5 43.5 34.2 40.0 100.0 42.9


• Government doctor 28.9 28.9 38.5 25.0 0.0 35.4

• NGO worker 4.1 4.1 0.0 25.0 0.0 6.1

• Private doctor 66.9 66.9 53.8 25.0 100.0 59.8





Notes














157


DISTRICT : NIZAMABAD

FACT SHEET


BPL

Sample Population










• Percent of households using piped water as main source of drinking 99.8 99.8 99.8 99.5 99.4 - 99.9


40.4 21.0 69.6 27.1 24.1 2.5 35.6






158


BPL






96.4 95.0 98.6 94.3 92.8 85.7 96.6





• Weight measured 99.2 99.4 99.0 99.0 100.0 96.8 99.3















159


BPL









Delivery Care6





• Normal delivery 64.8 67.1 61.5 65.9 64.1 85.1 67.1



• Safe deliveries7 85.9 80.3 5.9 82.2 77.8 67.1 85.6


• Not necessary 29.1 27.5 36.3 25.0 31.0 22.4 29.9

• Not customary 3.7 3.2 6.3 4.3 9.5 3.4 3.6




160


BPL






• Other 1.9 2.0 1.3 2.2 2.4 5.2 1.8






• Pre-term labour 7.9 7.3 8.9 4.5 15.0 8.7 7.3




• Breach birth 4.6 4.6 4.6 3.8 2.4 0.6 4.8

Birth Weight




Post natal Checkup



161


BPL




71.3 72.8 65.0 68.5 71.4 56.9 71.0


83.9 79.1 90.9 80.2 80.0 66.4 83.7








34.6 35.8 32.8 40.7 34.1 40.3 35.0




11.5 10.7 12.6 9.5 14.4 9.9 10.7




3. Pill / syrup 97.9 97.1 99.0 97.0 94.1 91.7 97.7

4. Injection 26.8 30.7 21.6 33.3 29.4 16.7 32.2


162


BPL



9.3 10.0 8.3 10.4 11.4 8.1 9.7





Child Immunization















Pregnancy11


10.1 9.5 11.0 7.1 9.5 7.4 9.5

163


BPL





Contraceptive Use





1) Govt. hospital 75.3 79.3 68.7 80.2 78.3 96.4 78.8


Childhood Mortality














23.3 24.7 21.2 25.6 22.2 23.0 23.9

164


BPL







• NGO worker 31.9 33.3 28.8 31.4 15.8 12.5 30.7

• Private doctor 19.2 15.4 27.0 10.0 42.1 12.5 16.1





Notes














165


DISTRICT : MEDAK

FACT SHEET


BPL

Sample Population



• Number of live births2 2849 1710 1139 515 127 33.8 2225









35.7 14.7 67.5 24.3 25.5 1.6 31.8






166


BPL






95.5 93.8 98.0 94.8 88.2 85.3 95.8





• Weight measured 90.9 88.9 93.9 87.3 85.0 77.4 91.2















167


BPL









Delivery Care6





• Normal delivery 70.1 74.1 64.1 72.0 78.2 84.6 71.4



• Safe deliveries7 74.9 65.0 89.9 69.3 56.4 51.6 73.3


• Not necessary 9.7 10.2 7.4 10.8 15.7 9.9 8.7

• Not customary 2.9 2.0 6.7 1.8 2.0 1.9 3.2




168


BPL






• Other 5.3 4.7 8.1 7.8 3.9 6.2 4.3






• Pre-term labour 14.2 13.8 14.8 12.7 16.4 16.3 14.1




• Breach birth 1.9 1.7 2.1 0.8 0.0 1.3 1.9

Birth Weight




Post natal Checkup



169


BPL




90.6 90.8 89.6 91.6 86.3 85.7 91.8


73.7 64.9 86.8 69.2 54.4 55.6 72.1








33.6 33.4 33.9 33.3 33.3 43.2 34.7




16.2 17.7 14.0 14.6 20.0 18.6 17.1




3. Pill / syrup 86.0 84.3 89.4 87.0 87.5 87.2 87.2

4. Injection 25.3 28.9 18.3 23.9 18.8 28.2 25.7


170


BPL



15.0 14.7 15.5 16.7 14.5 21.2 15.0





Child Immunization















Pregnancy11


11.7 12.7 10.1 11.1 12.7 10.7 11.5

171


BPL





Contraceptive Use





1) Govt. hospital 71.4 75.8 64.1 78.8 69.6 88.7 72.9


Childhood Mortality













30.7 36.0 22.6 35.3 40.9 34.3 33.3

172


BPL







• NGO worker 12.0 11.9 12.3 15.1 12.5 15.9 11.5

• Private doctor 47.4 44.2 56.6 50.0 29.2 28.6 47.5





Notes














173


DISTRICT : MAHBUBNAGAR

FACT SHEET


BPL

Sample Population












28.1 10.1 53.4 15.3 7.6 1.5 22.3






174


BPL






92.3 88.3 97.9 90.4 83.8 84.0 91.7





• Weight measured 89.4 85.3 95.0 83.8 78.7 84.6 88.6















175


BPL









Delivery Care6





• Normal delivery 77.2 81.7 70.9 80.1 84.3 84.9 80.0



• Safe deliveries7 69.5 56.1 88.4 61.6 47.0 48.9 66.1


• Not necessary 20.0 19.9 20.4 23.5 15.2 15.9 19.7

• Not customary 0.5 0.2 2.2 0.0 1.1 0.4 0.6




176


BPL






• Other 2.5 2.2 3.6 2.2 3.3 2.4 2.7






• Pre-term labour 25.9 24.5 28.0 26.0 16.8 33.2 26.5




• Breach birth 1.9 1.8 2.1 0.6 1.1 1.3 1.7

Birth Weight




Post natal Checkup



177


BPL




67.6 67.2 69.3 73.2 65.2 58.8 67.1


72.4 64.5 82.2 65.7 56.4 58.2 69.5








23.6 25.4 21.2 22.7 27.2 27.9 25.1




14.3 14.6 13.7 11.6 16.8 12.0 14.1




3. Pill / syrup 90.1 91.1 88.7 97.5 95.8 88.9 90.2

4. Injection 32.9 39.3 24.2 32.5 41.7 35.6 35.3


178


BPL



16.3 17.9 14.1 18.9 18.4 18.5 16.1





Child Immunization















Pregnancy11


13.2 14.1 11.9 12.8 14.7 15.2 13.4

179


BPL





Contraceptive Use





1) Govt. hospital 78.1 85.2 67.9 82.8 93.8 92.9 80.4


Childhood Mortality














21.9 23.4 19.8 26.0 31.4 27.3 22.5

180


BPL







• NGO worker 26.8 28.1 24.6 36.2 13.9 18.0 23.3

• Private doctor 33.8 28.1 43.2 23.2 25.0 30.3 34.9


















181


DISTRICT: NALGONDA

FACT SHEET


BPL

Sample Population











96.3 94.6 98.7 95.9 93.3 92.8 96.5


39.4 21.4 66.2 26.2 17.9 1.7 37.6






182


BPL






96.4 95.3 98.1 96.8 87.1 90.4 96.3





• Weight measured 96.1 94.1 98.9 95.1 88.0 88.1 96.4















183


BPL









Delivery Care6





• Normal delivery 54.4 59.5 46.8 59.4 65.4 64.8 55.7



• Safe deliveries7 82.6 76.7 91.3 80.9 62.1 65.9 82.9


• Not necessary 24.7 26.3 18.9 24.2 23.4 23.3 25.2

• Not customary 0.6 0.5 0.9 0.8 1.1 1.0 0.6




184


BPL






• Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0


• Disposable delivery kit 39.1 36. 6 48.1 36.3 45.7 29.1 40.5




• Pre-term labour 15.1 19.2 9.0 16.9 20.4 22.9 15.2




• Breach birth 5.7 4.6 7.2 6.8 3.8 3.8 6.2

Birth Weight




Post natal Checkup



185


BPL




69.1 69.2 68.9 74.2 66.0 64.1 70.6


76.0 73.8 79.2 72.2 68.0 71.7 73.8








41.1 40.7 41.6 39.2 53.6 50.5 42.0




13.4 15.7 10.0 11.6 19.6 16.4 12.8




3. Pill / syrup 87.7 86.3 91.0 85.2 86.1 86.7 86.7

4. Injection 50.7 47.9 57.7 51.9 52.8 53.3 52.6


186


BPL



24.7 28.1 19.6 21.7 37.1 31.1 24.4





Child Immunization















Pregnancy11


12.9 12.3 13.7 12.6 15.0 13.8 13.1

187


BPL





Contraceptive Use





1) Govt. hospital 74.8 78.3 69.4 80.4 85.8 82.6 77.8


Childhood Mortality













12.9 12.3 13.9 13.8 13.3 13.3 13.8

188


BPL







• NGO worker 31.0 26.8 39.7 21.2 25.0 16.0 32.7

• Private doctor 53.1 52.3 54.8 48.1 68.8 40.0 53.3





Notes














189


DISTRICT : WARANGAL

FACT SHEET


BPL

Sample Population












36.9 10.1 75.4 23.0 12.2 0.4 30.8






190


BPL










• Weight measured 97.4 96.8 98.3 97.1 93.8 93.5 97.1















191


BPL









Delivery Care6





• Normal delivery 52.1 55.7 47.0 58.6 65.4 63.6 54.4



• Safe deliveries7 83.2 73.8 96.6 75.2 62.8 61.1 82.5


• Not necessary 28.4 28.4 28.2 27.7 20.9 24.7 30.3

• Not customary 0.0 0.0 0.0 0.0 0.0 0.0 0.0




192


BPL






• Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0






• Pre-term labour 17.7 24.1 8.6 24.1 27.5 30.5 19.6




• Breach birth 1.6 2.1 0.9 2.0 3.4 2.5 1.7

Birth Weight




Post natal Checkup



193


BPL




95.2 94.9 97.4 94.1 94.8 95.7 94.1


77.6 70.7 87.3 68.7 58.9 58.3 76.6








29.9 31.8 27.3 32.1 30.0 33.5 31.2




20.7 22.6 18.0 19.9 23.2 28.5 20.9




3. Pill / syrup 48.5 54.0 40.9 37.3 67.3 50.0 49.0

4. Injection 48.2 56.3 37.0 61.0 63.3 61.8 50.6


194


BPL



32.8 39.5 23.3 28.1 50.3 41.0 33.5





Child Immunization















Pregnancy11


11.8 11.7 12.0 9.7 10.7 9.8 12.5

195


BPL





Contraceptive Use





1) Govt. hospital 65.3 72.5 54.1 72.7 71.4 78.7 70.3


Childhood Mortality













19.4 19.4 19.4 20.6 18.1 18.8 20.0

196


BPL







• NGO worker 17.1 16.5 17.9 18.2 10.8 22.2 16.4

• Private doctor 59.5 56.7 63.4 52.7 62.2 51.9 57.3





Notes










10) Based on children born during the period from January/Sankranti 2004 to the date of survey.




197


DISTRICT: KHAMMAM

FACT SHEET


BPL

Sample Population












37.9 14.9 71.9 28.3 13.8 0.6 34.5






198


BPL






97.1 95.5 99.3 96.6 93.3 97.1 97.1





• Weight measured 98.2 97.5 99.1 98.0 96.8 94.4 98.1















199


BPL









Delivery Care6





• Normal delivery 63.8 67.9 57.7 66.2 77.6 78.5 65.7



• Safe deliveries7 81.5 72.6 94.6 77.1 62.8 65.5 80.9


• Not necessary 50.9 53.8 32.4 59.7 49.5 50.4 52.1

• Not customary 1.1 1.3 0.0 0.0 0.9 0.0 1.0




200


BPL






• Other 1.1 0.4 5.6 0.0 0.0 1.6 1.0






• Pre-term labour 7.7 8.6 6.5 7.2 7.2 5.8 7.8




• Breach birth 1.6 1.6 1.5 1.0 1.7 1.8 1.8

Birth Weight




Post natal Checkup



201


BPL




93.8 93.5 95.8 91.9 96.8 93.6 93.3


63.6 54.2 77.2 59.5 44.7 46.8 62.2








33.2 36.0 29.0 34.8 41.1 42.8 33.3




12.4 11.0 14.5 13.3 10.2 12.9 12.7




3. Pill / syrup 88.8 86.9 90.6 84.4 84.8 86.4 88.9

4. Injection 48.8 41.4 55.7 48.9 27.3 27.3 50.7


202


BPL



39.3 35.9 44.2 39.0 34.8 32.6 40.2





Child Immunization















Pregnancy11


15.2 14.7 16.0 14.5 11.9 12.8 13.7

203


BPL





Contraceptive Use





1) Govt. hospital 76.5 79.6 71.5 77.5 89.0 86.6 79.3


Childhood Mortality













17.2 18.7 15.1 18.3 21.7 19.7 18.2

204


BPL







• NGO worker 31.3 29.8 34.2 35.3 18.8 26.5 25.8

• Private doctor 13.7 9.3 22.4 9.8 4.2 0.0 14.7





Notes














205


DISTRICT : KARIMNAGAR

FACT SHEET

INDICATOR TOTAL RURAL URBAN SC

(Total) ST

(Total) SLI (Low)

BPL

Sample Population












45.3 19.4 85.5 30.3 14.6 0.6 42.9


• Percent of households with white ration card 64.7 63.3 66.9 70.7 76.7 56.7 100.0

• Percent of scheduled caste households 17.5 20.7 12.5 100.0 - 39.3 19.1

• Percent of scheduled tribe households 4.2 5.5 2.2 - 100.0 5.6 5.0


206


(Total) ST

(Total) SLI (Low)

BPL










• Weight measured 99.4 99.5 99.4 98.6 98.1 98.3 99.4















207


(Total) ST

(Total) SLI (Low)

BPL









Delivery Care6





• Normal delivery 53.2 53.3 52.9 58.7 57.3 62.4 55.8



• Safe deliveries7 91.6 88.6 96.3 85.7 85.4 78.1 91.1


• Not necessary 56.0 55.1 77.8 72.1 13.3 50.0 54.3

• Not customary 0.4 0.4 0.0 0.0 0.0 0.0 0.6




208


(Total) ST

(Total) SLI (Low)

BPL






• Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0






• Pre-term labour 16.6 16.5 16.8 16.4 20.4 13.5 17.0




• Breach birth 1.7 2.0 1.2 1.4 1.9 1.1 1.6

Birth Weight




Post natal Checkup



209


(Total) ST

(Total) SLI (Low)

BPL




68.7 69.3 65.1 64.4 81.0 61.2 68.2


69.7 64.8 77.2 66.2 46.5 86.4 68.1








24.1 24.2 24.1 26.4 9.1 26.0 25.6




5.5 6.3 4.2 5.6 9.7 4.5 5.0




3. Pill / syrup 81.4 85.1 71.0 72.7 100.0 100.0 81.7

4. Injection 58.5 59.8 54.8 59.1 60.0 62.5 59.2


210


(Total) ST

(Total) SLI (Low)

BPL



10.5 11.2 9.5 12.0 11.7 11.8 10.2





Child Immunization















Pregnancy11


7.2 7.6 6.6 6.4 5.4 7.5 7.5

211


(Total) ST

(Total) SLI (Low)

BPL


• Percent of pregnant women below 20 weeks of pregnancy 24.8 20.3 32.5 29.4 33.3 25.0 15.1

• Percent of pregnant women 20-32 weeks of pregnancy 61.5 63.8 57.5 70.6 66.7 62.5 67.1

• Percent of pregnant women 33+ weeks of pregnancy 13.8 15.9 10.0 0.0 0.0 12.5 17.8

Contraceptive Use





1) Govt. hospital 55.3 64.0 41.6 67.9 64.9 80.9 58.3


Childhood Mortality













7.3 9.4 4.0 8.5 16.5 8.4 8.2

212


(Total) ST

(Total) SLI (Low)

BPL







2. NGO worker 36.4 32.6 55.6 13.6 41.7 10.0 41.9

3. Private doctor 45.5 35.9 94.4 72.7 0.0 40.0 41.9





Notes

1) Eligible women are those who had a delivery during the period from January/Sankranti, 2004 to the date of survey. 2) Live births occurred during the period from January / Sankranti 2004 to the date of survey. 3) The estimates do not represent the district since the sample was not drawn from the general population. 4) Based on last pregnancy of all eligible women. 5) Based on last pregnancy of all eligible women. 6) Based on last delivery of all eligible women. 7) Deliveries attended by Doctor/ Nurse/ Mid-wife/ANM. 8) Based on non-institutional deliveries. 9) Percentages based on all domiciliary deliveries. 10) Based on children born during the period from January / Sankranti 2004 to the date of survey. 11) Based on all eligible women who are currently married. 12) Based on all eligible women interviewed. 13) Based on all eligible women.

213


DISTRICT : ADILABAD

FACT SHEET


BPL

Sample Population











89.9 84.9 96.9 93.6 79.6 76.5 84.2

• Percent of households using cleaner cooking fuels (LPG, Electricity and Kerosene)

42.4 20.6 73.3 33.6 18.8 1.4 40.4






214


BPL






94.4 91.5 98.6 95.8 85.8 82.9 94.2





• Weight measured 97.5 96.1 99.4 98.0 92.2 92.9 97.4















215


BPL









Delivery Care6





• Normal delivery 71.5 79.4 60.4 70.7 91.2 86.7 72.8



• Safe deliveries7 78.1 69.6 90.2 77.5 63.5 56.6 77.4


• Not necessary 46.2 44.3 55.0 46.4 38.2 48.2 45.1

• Not customary 0.8 0.8 0.8 1.4 0.6 0.8 0.6




216


BPL






• Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0






• Pre-term labour 22.0 23.4 20.0 24.3 42.7 15.9 23.0




• Breach birth 2.9 2.8 3.2 2.2 3.1 1.7 2.8

Birth Weight




Post natal Checkup


• Percent of mothers received first postnatal checkup within a week

86.4 81.2 93.7 86.9 82.3 68.7 86.1

217


BPL



2. Percent of mothers received post partum

checkup within 2 months of birth 64.5 62.8 72.5 67.1 73.9 51.4 65.5


79.2 70.1 90.6 78.2 55.1 67.9 77.6





• Percent of neonates started breastfeeding within one hour of birth

28.6 32.0 23.7 32.4 34.2 41.9 28.4


65.7 69.6 60.2 73.2 82.7 71.8 65.3


22.7 22.1 23.5 22.6 14.6 24.4 23.3




7.1 6.7 7.7 9.2 4.2 4.7 6.9




3. Pill / syrup 88.5 80.0 97.0 80.6 100.0 81.8 91.5

4. Injection 31.3 38.5 24.2 35.5 33.3 36.4 30.2


218


BPL



11.3 10.1 13.1 10.7 8.1 7.3 11.1





Child Immunization














76.8 72.3 82.9 76.5 67.3 58.1 76.7


Pregnancy11


9.5 8.9 10.3 12.7 8.2 11.5 9.0

219


BPL





Contraceptive Use





1) Govt. hospital 70.1 78.6 59.3 71.0 92.0 86.8 72.3


Childhood Mortality












2.5 2.5 2.5 1.3 3.8 2.1 2.4


4.5 4.9 3.9 2.4 4.2 5.5 4.5

220


BPL







• NGO worker 9.6 12.9 4.8 0.0 20.0 12.5 9.1

• Private doctor 50.0 41.9 61.9 50.0 20.0 12.5 50.0





Notes 1) Eligible women are those who had a delivery during the period from January/Sankranti, 2004 to the date of survey. 2) Live births occurred during the period from January / Sankranti 2004 to the date of survey. 3) The estimates do not represent the district since the sample was not drawn from the general population 4) Based on last pregnancy of all eligible women. 5) Based on last pregnancy of all eligible women. 6) Based on last delivery of all eligible women. 7) Deliveries attended by Doctor/ Nurse/ Mid-wife/ANM. 8) Based on non-institutional deliveries. 9) Percentages based on all domiciliary deliveries. 10) Based on children born during the period from January / Sankranti 2004 to the date of survey. 11) Based on all eligible women who are currently married. 12) Based on all eligible women interviewed. 13) Based on all eligible women.

Rch ii baseline survey-report

Healthcare

Transcript of Rch ii baseline survey-report