1. Dr. C. Chandramouli Registrar General & Census Commissioner, India
ANNUAL HEALTH SURVEY FACT SHEET First Updation round( ) KEY FINDINGS
Dr. C. Chandramouli Registrar General & Census Commissioner, India

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

3. “ Working for the survival and the well being of women and girls is a human right imperative. And in order to take advantage of women’s full potential in the development of their nations, they must be able to plan their lives and families.”
– Babatunde Osotimehin, Executive Director, UNFPA on World Population Day, 2012

4. “ There should be an Annual Health Survey of all districts which could be published/monitored and compared against benchmarks”
-Dr. Manmohan Singh, Prime Minister of India – In the meeting of National Commission of Population, 2005

5. Vital inputs for evidence based intervention and monitoring
AHS provides key indicators on Reproductive and Child Health at District level
in 8 EAG States and
Assam
Vital inputs for evidence based intervention and monitoring

6. OBJECTIVE OF AHS
AHS yields a comprehensive, representative and reliable dataset on core vital indicators including composite ones like IMR, MMR and TFR along with their co-variates (process and outcome indicators) at the district level and maps changes therein on an annual basis.
These benchmarks help in better and holistic understanding and timely monitoring of various determinants on well-being and health of population particularly Reproductive and Child Health.

7. Coverage : Annual Health Survey

8. Indicators under AHS In all, 161 indicators are available from AHS :
Fertility- 13  Sex Ratio- 3
Marriage- 5  Mortality- 7
Mother & Child Care- 63
Ante Natal Care: 11  Delivery Care: 8
Post Natal Care: 5  Janani Suraksha Yojana (JSY): 3
Immunization: 8  Vitamin A & Iron Supplements: 2
Birth Weight: 2  Childhood Disease: 6
Birth Registration: 2  Breastfeeding & Supplementation: 12
Awareness in Mothers: 4
Abortion- 6  Family Planning Practices- 15
Disability- 1  Morbidity- 19
Personal Habits:adults-4  Housing & HH Characteristics- 13
Others- 12

9. Indicators under AHS Contd…
Under 1st phase of release, following 9 indicators have already been released in the Bulletin :
Crude Birth Rate (CBR)  Crude Death Rate (CDR)
Infant Mortality Rate (IMR)  Neo-Natal Mortality Rate (NNMR)
Under Five Mortality Rate (U5MR)  Maternal Mortality Ratio (MMR)
Sex Ratio at Birth (SRB)  Sex Ratio (0-4 years) and
Sex Ratio (All ages)
Remaining indicators are being released under present phase of dissemination.

10. Five Core Themes Covered
The presentation focuses on results pertaining to 5 core themes:
Total Fertility Rate
Family Planning: Current Usage & Total Unmet Need
Ante Natal Care
Delivery & Post Natal Care
Immunization and Breast Feeding Practices

11. KEY FINDINGS
Improvement has been noticed in most of the indicators as compared to Baseline.
Replacement level of TFR 2.1 has been achieved in only 29 out of 284 AHS districts whereas in Baseline it was 20 districts.
In 145 districts, on an average a woman bears more than 3 children.
More than half of currently married women aged years are not using any method of family planning in Bihar.

12. KEY FINDINGS
Female Sterilization continues to remain the most dominant method of family planning among the modern methods across all AHS States except Assam.
At least 12.6% currently married women are yet to meet their family planning requirement (Unmet Need) across all AHS States. This was 20.0% in Baseline.
Despite wider penetration of `Any ANC’, the coverage under ‘first trimester ANC’ as well as ‘3 or more ANCs’ needs further improvement.

13. KEY FINDINGS
Poor performance of full ANC is primarily due to low IFA consumption.
Universal coverage of JSY remains a concern even in better performing States like Odisha, MP & Rajasthan.
Seven out of every 10 deliveries are ‘safe’ in Madhya Pradesh, Rajasthan, Odisha and Assam.

14. At least 1 in 7 mothers has not received any PNC among all the AHS States, in Assam it is 1 in 3 mothers.
In full immunization, even the better performing States like Uttarakhand, Chhattisgarh and Rajasthan fall short by percentage points in achieving universal coverage.
Percent of traditional method in any method of family planning is more than 20% in 4 States namely, Uttar Pradesh, Assam, Jharkhand & Odisha.
KEY FINDINGS

15. Performance of Hot Spot Districts
55 districts are hotspots (57 in baseline) i.e. common in top 100 districts in IMR and top 25 Administrative Divisions (111 districts) in MMR.
DISTRICTS FALLING IN BOTH TOP 100 IMR AND DISTRICTS OF TOP 25 MMR
Assam- 6
UP - 31
Bihar -1
MP -16
Odisha -1

16. State wiseTFR of Hot Spot Districts

17. State wise Full ANC of Hot Spot Districts

18. State wise Immunization in Hot Spot Districts

19. State wise Institutional Delivery in Hot Spot Districts

20. TOTAL FERTILITY RATE (TFR)
TFR is the average number of children born to a woman during her entire reproductive span.
Uttarakhand & Odisha and UP & Bihar continue to remain two extremes of the spectrum.

21. TOTAL FERTILITY RATE (TFR)
State
State value
District with Minimum TFR
District with Maximum TFR
Range
First updation
Baseline
First Updation
First
Updation
Assam
2.4
2.6
Kamrup (2.0),
Nalbari (2.0)
Kamrup (2.0),
Nalbari(2.0)
Hailakandi (3.9)
Hailakandi (4.2)
1.9
2.2
Bihar
3.6
3.7
Patna (2.7)
Patna (2.8)
Sheohar (4.6)
Sheohar (4.7)
Chhattisgarh
2.8
2.9
Koriya (2.4),
Kanker (2.4),
Durg (2.4)
Koriya (2.4)
Kawardha (3.7)
1.3
Jharkhand
3.1
Purbi Singhbhum (2.2)
Purbi Singhbhum (2.4)
Pakaur (3.9)
Lohardagga (4.0)
1.7
1.6
Madhya Pradesh
Bhopal (2.1)
Indore (2.2)
Shivpuri(4.4)
Shivpuri (4.5)
2.3
Odisha
Anugul (1.9),
Bargarh (1.9),
Jharsuguda (1.9)
Jharsuguda (2.0)
Baudh (3.5)
Boudh (3.7)
Rajasthan
3.2
Kota (2.5)
Kota (2.6)
Barmer (4.5)
Barmer (4.7)
2.0
2.1
Uttar Pradesh
3.4
Kanpur Nagar (2.2)
Kanpur Nagar (2.3)
Shrawasti (5.8)
Shrawasti (5.9)
Uttarakhand
Pithoragarh (1.7),
Bageshwar (1.7)
Pithoragarh (1.7)
Haridwar (2.9)
Haridwar (3.1)
1.2
1.4
Within a State, the minimum variability of 1.2 is reported in Uttarakhand and the maximum of 3.6 in Uttar Pradesh whereas in Baseline it was 1.3 in Chhattisgarh and 3.6 in Uttar Pradesh respectively .
Across 284 districts in 9 AHS States, it ranges from 1.7 in Pithoragarh and Bageshwar to 5.8 in Shrawasti. In Baseline this varied from 1.7 in Pithoragarh (Uttarakhand) to 5.9 in Shrawasti (UP)- a variability of more than 4 children.

22. TOTAL FERTILITY RATE (TFR)
Frequency distribution of TFR in terms of No. of Districts in each State
 State
4.1 and above
Grand Total
Assam
7 (3)
14 (16)
2 (3)
0 (1) 23
Bihar
0 (0)
1 (1)
28 (26)
8 (10) 37
Chhattisgarh
14 (12)
2 (4) 16
Jharkhand
9 (8)
9 (10) 18
Madhya Pradesh
1 (0)
19 (15)
22 (25)
3 (5) 45
Odisha
12 (10)
17 (18)
1 (2) 30
Rajasthan
18 (16)
12 (13) 32
Uttar Pradesh
14 (9)
45(48)
11 (13) 70
Uttarakhand
9 (7)
4 (5) 13
All States
29 (20)
110 (100)
121 (132)
24 (32)
284
29 districts have already achieved the replacement level of 2.1 whereas it was 20 in baseline.

23. TOTAL FERTILITY RATE (TFR)
Frequency Distribution of change in TFR in Terms of No. Districts in Each State
State
Decreased
by 0.1
by 0.2
Decreased by 0.3
Decreased by 0.4
Decreased by 0.5 or more
Increased
Remained Same
Total
Uttarakhand 6 2 3 13
Rajasthan 14 5 32
Uttar Pradesh 25 7 70
Bihar 16 37
Assam 12 4 23
Jharkhand 11 1 18
Odisha 20 30
Chhattisgarh 8
Madhya Pradesh 9 45
141 68 47
284

24. TOTAL FERTILITY RATE (TFR)
229 districts have recorded less TFR than the baseline estimates and 47 districts remained same.
8 Districts have recorded increase in TFR viz. Indore (M.P.), Baghpat, Budaun, Bulandshahar, Gonda, Lalitpur, Pilibhit and Rampur (U.P.)
8 Districts have recorded maximum decrease in TFR viz. Sehore(M.P.), Basti, Deoria, Gorakhpur, Kaushambi, Kushinagar, Maharajganj, Siddharthnagar (U.P.)

25. TOTAL FERTILITY RATE (TFR) Replacement level of TFR
Baseline
First Updation
Replacement level of TFR

26. Family Planning: Current Usage
Contraceptive Prevalence Rate (CPR) is the percentage of currently married women aged yrs who are using any method of contraception (modern/traditional).
Current usage of any method varies from 43.0 in Bihar to 66.4 in Rajasthan whereas it was in Bihar to 64.5 per cent in Rajasthan in Baseline.

27. Family Planning: Current Usage
Any Method of Family Planning (%)
State
State Value
District with Minimum FP
District with Maximum FP
Range
First
Updation
baseline
Assam
65.1
57.9
Dhubri (45.1)
Dhubri (33.2)
Kamrup (76.0)
Lakhimpur (67.6)
30.9
34.4
Bihar
43.0
37.6
Nawada (31.5)
Siwan (26.0)
Supaul (60.8)
Muzaffarpur (52.2)
29.3
26.2
Jharkhand
56.5
47.8
Gumla (39.0)
Paschimi Singhbhum
(32.7)
Hazaribagh (69.8)
Dhanbad (61.9)
30.8
29.2
Madhya Pradesh
63.4
61.2
Sidhi (44.6)
Sidhi (45.9)
Damoh (75.7)
Damoh (74.9)
31.1
29.0
Chhattisgarh
58.6
53.9
Dantewada (33.4)
Kawardha (68.2)
Dhamtari (68.7)
34.8
35.3
Odisha
59.4
56.2
Baudh (29.8)
Kandhamal (28.6)
Baleshwar (78.1)
Baleshwar (73.4)
48.3
44.8
Rajasthan
66.4
64.5
Jaisalmer (53.3)
Dhaulpur (49.0)
Hanumangarh (89.1)
Ganganagar (79.2)
35.8
30.2
Uttar Pradesh
49.9
Sitapur (33.8)
Sitapur (21.9)
Jhansi (74.4)
Jhansi (74.1)
40.6
52.2
Uttarakhand
61.7
62.7
Haridwar (56.2)
Haridwar (53.7)
Pithoragarh (78.2)
Dehradun (67.1)
22.0
13.4
Within a State, the least variation is reported in Uttarakhand and the most, in Odisha whereas in Baseline it was Uttarakhand and Uttar Pradesh respectively.
At district level, current usage of family planning ranges from 29.8 in Baudh (Odisha) to 89.1 in Hanumangarh (Rajasthan)- a variability of 3 times-whereas in Baseline it varied from 21.9 in Sitapur (UP) to 79.2 in Ganganagar (Rajasthan) exhibiting a variability of 4 times.

28. Family Planning: Current Usage
Frequency distribution of current usage in terms of number of districts in each State
 State
0-30
30-50
50-70
70 & above
Total Districts
Assam
0 (0)
2 (3)
15 (20)
6 (0) 23
Bihar
0 (4)
29 (31)
8 (2) 37
Chhattisgarh
3 (7)
13 (9) 16
Jharkhand
7 (13)
11 (5) 18
Madhya Pradesh
1 (2)
40 (40)
4 (3) 45
Odisha
1 (1)
8 (9)
16 (19)
5 (1) 30
Rajasthan
0 (1)
21 (24)
11 (7) 32
Uttar Pradesh
0 (3)
20 (24)
44 (42)
6 (1) 70
Uttarakhand
6 (13)
7 (0) 13
All States
1 (8)
70 (90)
174 (174)
39 (12)
284
As high as 71 districts are reporting less than 50% current usage of any method of family planning whereas in Baseline it was 98.
39 districts feature in 70% & above category whereas in Baseline it was only 12 districts.
29 out of 37 districts of Bihar have reported less than 50% usage of any method of family planning. In Baseline it was 35 districts.

29. Family Planning: Current Usage
CURRENT USAGE OF ANY METHOD OF FAMILY PLANNING (%)
Baseline
First Updation
Dist. with > 60% Usage

30. Family Planning: Current Usage
FEMALE STERILIZATION (%)
Share of sterilization in any modern method of family planning (%)
Assam
Uttar Pradesh
Jharkhand
Bihar
Odisha
Uttarakhand
Rajasthan
Chhattisgarh
Madhya Pradesh
Female
35.1 (35.3)
50.4 (55.0)
74.3 (76.3)
81.2 (86.7)
69.7 (68.4)
51.9 (58.7)
77.1 (76.7)
87.4 (92.3)
81.8 (83.6)
Male
0.8 (0.6)
0.5 (0.6)
1.4 (1.2)
0.8 (0.9)
0.4 (0.7)
3.0 (2.8)
0.7 (0.7)
1.8 (2.0)
1.5 (1.7)

31. Unmet Need for Family Planning
Unmet need of Family Planning broadly means requirement of Family Planning methods among Currently Married Women but not using any method of Family Planning .
Total unmet need varies from a minimum of 12.6% in Rajasthan to 33.5% in Bihar. In Baseline it varied from 19.6% in Rajasthan to 39.2% in Bihar.
Unmet need for Family Planning is a crucial indicator for assessing the future demand for Family Planning services / supplies.

32. Unmet Need for Family Planning
Total Unmet need (%)
State
State Value
District with Minimum unmet need
District with Maximum unmet need
Range
First Updation
baseline
Assam
15.9
24.0
Kamrup (8.4)
Sibsagar (15.3)
Karimganj (33.6)
Dhubri (42.9)
25.2
27.6
Bihar
33.5
39.2
Patna (20.2)
Patna (24.6)
Katihar (46.5)
Kishanganj (52.5)
26.3
27.9
Jharkhand
22.6
30.5
Hazaribagh (13.2)
Bokaro (18.2)
Gumla (33.2)
Godda (42.8)
20.0
24.6
Madhya Pradesh
21.6
22.4
Datia(14.4)
Dewas(14.4)
Jabalpur (14.3)
Sidhi(38.3)
Rewa (34.2)
23.9
19.9
Chhattisgarh
24.8
26.4
Dhamtari (13.9)
Dhamtari (14.5)
Dantewada (48.7)
Bastar (36.0)
34.8
21.5
Odisha
19.1
23.2
Kendujhar (9.7)
Baleshwar (6.1)
Baudh (45.3)
Boudh (48.3)
35.6
42.2
Rajasthan
12.6
19.6
Jhunjhunun (3.1)
Ganganagar (10.0)
Jaisalmer (28.1)
Dhaulpur (32.4)
25.0
Uttar Pradesh
24.1
29.7
Jhansi (12.7)
Mahoba (15.1)
Sultanpur (48.1)
Sitapur (61.3)
35.4
46.2
Uttarakhand
18.1
Dehradun (12.8)
Dehradun (16.8)
Almora (27.4)
Haridwar (29.2)
14.6
12.4
The minimum variability within a State is in Uttarakhand and the maximum in Odisha whereas in Baseline it was in Uttarakhand and in Uttar Pradesh respectively.
Jhunjhunun (3.1) in Rajasthan and Dantewada (48.7) in Chhattisgarh are the two extremes across 284 districts. In Baseline it was Baleshwar (6.1) in Odisha and Sitapur (61.3) in Uttar Pradesh.

33. Unmet Need for Family Planning
Frequency distribution of unmet need in terms of number of districts in each State
 State
0-20
20-40
40-60
60 & above
Total Districts
Assam
16 (6)
7 (16)
0 (1)
0 (0) 23
Bihar
29 (20)
8 (17) 37
Chhattisgarh
3 (4)
12 (12)
1 (0) 16
Jharkhand
5 (2)
13 (13)
0 (3) 18
Madhya Pradesh
12 (18)
33 (27) 45
Odisha
14 (12)
13 (15)
3 (3) 30
Rajasthan
26 (16)
6 (16) 32
Uttar Pradesh
23 (9)
42 (52)
5 (8) 70
Uttarakhand
6 (2)
7 (11) 13
All States
105 (69)
162 (182)
17 (32)
284
In 105 out of 284 districts, the total unmet need for family planning is below 20%. It was 69 in Baseline.
Bihar and Uttar Pradesh continue to dominate in 40% & above category.

34. Unmet Need for Family Planning
Baseline
First Updation
TOTAL UNMET NEED FOR FAMILY PLANNING (%)
Unmet need of <=20

35. Mean Age at Marriage- Female
Mean Age at Marriage is based on the marriages taken place during
Mean age at marriage of females varies from 20.1 in Bihar to 22.4 years in Odisha whereas in Baseline it was 19.7 in Bihar & Rajasthan to 22.0 years in Uttarakhand.

36. Marriages among Females below Legal Age (18 yrs)
Based on marriages taken place during
Varies from 2.3% in Uttarakhand to 16.5% in Bihar whereas in Baseline it was 3.0% in Uttarakhand to 21.9% in Rajasthan.

37. Marriages among Females below Legal Age (18 yrs)
MARRIAGES AMONG FEMALES BELOW LEGAL AGE (BELOW 18 YEARS) %

38. Ante Natal Care (ANC) Any ANC exceeds 80% in all AHS States.
ANC in 1st trimester: 46.5% in UP & Bihar to 70% in Chhattisgarh & Madhya Pradesh. In Baseline, this was 40% in UP & Bihar to 65% in Chhattisgarh & Madhya Pradesh.
Mothers receiving 3 or more ANCs: UP-32.5% to Odisha-78.5% This was UP-29.6% to Odisha-76.0 % in Baseline.
Mothers who consumed IFA 100 days or more: 8.1% in UP to 26.0% in Odisha. It was 6.5% in UP to 23.8% in Chhattisgarh in Baseline.
Low performance in IFA consumption is the main reason for sluggish full ANC: 5% in UP to 22.7% in Odisha. In Baseline, 3.9% in UP to 19.5% in Chhattisgarh.

39. Full Ante Natal Check-up
Full ANC comprise 3 or more ANC, at least one TT injection and consumption of IFA for 100 or more days.
Uttar Pradesh reports the minimum coverage of 5.0 % and Odisha, the maximum 22.7 whereas in Baseline it was 3.9% in Uttar Pradesh & 19.5% in Chhattisgarh.

40. Full Ante Natal Check-up
Mothers who had Full Antenatal Check-up (%)
State
State Value
District with Minimum value
District with Maximum value
Range
First Updation
Baseline
Assam
13.3
11.9
Dhubri (4.0)
Dhubri (2.1)
Dibrugarh (25.2)
Jorhat (18.2)
21.2
16.1
Bihar
6.1
5.9
Samastipur (2.0)
Madhepura (2.4)
Patna (13.8)
Patna (16.4)
11.8
14.0
Jharkhand
14.4
13.1
Garhwa (5.0)
Garhwa (3.6)
Purbi Singhbhum (32.1)
Purbi Singhbhum (31.6)
27.1
28.0
Madhya Pradesh
15.3
Sheopur (1.9)
Sheopur (1.8)
Indore (32.1)
Balaghat (30.8)
30.2
29.0
Chhattisgarh
20.2
19.5
Kawardha (11.5)
Korba (10.9)
Dhamtari (42.6)
Dhamtari (34.5)
31.1
23.6
Odisha
22.7
18.6
Jajapur (13.4)
Jajapur (5.4)
Jagatsinghapur (43.5)
Jagatsinghapur (36.0)
30.1
30.6
Rajasthan
9.2
8.5
Karauli (3.0)
Karauli (1.7)
Jaipur (19.7)
Jaipur (19.5)
16.7
17.8
Uttar Pradesh
5.0
3.9
Balrampur (0.9)
Balrampur (0.6)
Jhansi (17.9)
Kanpur Nagar (14.8)
17.0
14.2
Uttarakhand
16.0
11.1
Rudraprayag (3.8)
Rudraprayag (3.7)
Dehradun (29.7)
Dehradun (22.7)
25.9
19.0
Bihar has reported the minimum variability among the districts in a State compared to Chhattisgarh reporting the maximum. It was Bihar and Odisha in Baseline.
Balrampur (0.9), less than 1% coverage and Jagatsinghapur (43.5), the maximum coverage of full ANC. In Baseline also the position was same with values 0.6 and 36.0 respectively.

41. Full Ante Natal Check-up
Frequency distribution of full ANC in terms of number of districts in each State
 State
<5
5 - 10
15-20
20-25
25 & above
Total Districts
Assam
1 (6)
9 (7)
7 (6)
3 (4)
2 (0)
1 (0) 23
Bihar
15 (17)
18 (17)
4 (2)
0 (1)
0 (0) 37
Chhattisgarh
6 (4)
2 (4)
3 (5)
5 (3) 16
Jharkhand
0 (3)
7 (7)
3 (3)
1 (1) 18
Madhya Pradesh
5 (7)
10 (11)
11 (10)
6 (6) 45
Odisha
4 (7)
7 (10)
9 (3)
10 (7) 30
Rajasthan
6 (7)
16 (16)
8 (7)
2 (2) 32
Uttar Pradesh
45 (52)
17 (15)
6 (3) 70
Uttarakhand
1 (2)
2 (7)
5 (2)
3 (1) 13
All States
73 (94)
79 (83)
57 (45)
29 (32)
22 (15)
24 (15)
284
73 out of 284 districts report less than 5% coverage of full ANC whereas in Baseline it was 94.
24 districts reported 25% & above coverage of full ANC . In Baseline it was only 15 districts.

42. Full Ante Natal Check-up
Baseline
First Updation
MOTHERS WHO HAD FULL ANTENATAL CHECK UP (%)

43. MOTHERS WHO RECEIVED ANY ANTENATAL
Ante Natal Check-up
MOTHERS WHO RECEIVED ANY ANTENATAL
CHECK-UP (%)
Baseline
First Updation
90% and above coverage

44. MOTHERS WHO HAD ANTENATAL CHECK UP IN FIRST TRIMESTER (%)
Baseline
First Updation
Above 50 % coverage

45. MOTHERS WHO RECEIVED 3 OR MORE ANTENATAL CARE (%)
Ante Natal Check-up
Baseline
First Updation
MOTHERS WHO RECEIVED 3 OR MORE ANTENATAL CARE (%)

46. Institutional Delivery

47. Institutional Delivery
Institutional Delivery: Ranges from 40.4% in Chhattisgarh to 79.7% in MP. In Baseline it was 34.9% in Chhattisgarh & 76.1% in MP.
More than 85% of total births have taken place in Govt. Institutions in Madhya Pradesh & Odisha and it is more than 60% in remaining States except Jharkhand. In Baseline also, the situation was same except for Uttarakhand, which stood at 63% from 59% in Baseline.
Jharkhand continues to remain the only State where more than 50% of the births are taking place in Private Hospitals.
Balrampur (UP) recorded the least 22.2% institutional delivery whereas Puri(Odisha) the most 94.0%, showing a variability of more than 4 times. In Baseline, Balrampur was in the least category with 16.8% and Indore(MP),the highest with 92.5%.

48. INSTITUTIONAL DELIVERY (%)
Balrampur, UP
Puri, Odisha
Institutional delivery is below 60% in 141 districts whereas it was 170 districts in baseline.

49. Safe Delivery
Safe delivery comprise institutional deliveries and domiciliary deliveries assisted by doctor/nurse/ANM/LHV.
Safe Delivery: 51.8% in Jharkhand to 85.9% in Madhya Pradesh. It was 47.1% in Jharkhand & 82.2% in MP.

50. District with Minimum Value District with Maximum Value
Safe Delivery
Safe Delivery (%)
State
State Value
District with Minimum Value
District with Maximum Value
Range
First Updation
Baseline
Assam
68.1
64.2
Hailakandi,
Karimganj (41.4)
Karimganj,
Hailakandi (34.8)
Sibsagar (89.9)
Sibsagar (88.2)
48.5
53.4
Bihar
59.9
53.5
Sitamarhi (36)
Sheohar (30.2)
Patna (81.4)
Munger (80.4)
45.4
50.2
Jharkhand
51.8
47.1
Pakaur (31.8)
Pakaur (24.8)
Purbi Singhbhum
(71.9)
Purbi Singhbhum (69.0)
40.1
44.2
Madhya Pradesh
85.9
82.2
Dindori (55.4)
Dindori (45.5)
Indore (97)
Indore (96.3)
41.6
50.8
Chhattisgarh
56.9
49.5
Surguja (41.6)
Surguja (32.6)
Kanker (75.8)
Kanker (69.4)
34.2
36.8
Odisha
80.8
75.2
Malkangiri (48)
Nabarangpur (35.6)
Puri (94.7)
Puri (92.7)
46.7
57.1
Rajasthan
80.0
76.2
Jaisalmer (55.5)
Jaisalmer (48.6)
Baran (93.6)
Jaipur (92.2)
38.1
43.6
Uttar Pradesh
57.4
51.3
Balrampur (30)
Balrampur (22.0)
Jhansi (90.1)
Jhansi (89.4)
60.1
67.4
Uttarakhand
61.0
Tehri Garhwal (49.4)
Tehri Garhwal
(43.1)
Nainital (81.4)
Nainital (79.5)
32.0
36.4
Uttarakhand has exhibited the least variability among districts of a State and Uttar Pradesh, the most, the same as in Baseline.
Balrampur (UP) & Indore (MP) continue to remain the minimum and maximum in safe delivery.

51. Safe Delivery
Frequency distribution of safe delivery in terms of No. of districts in each State
State
<30
30-50
50-70
70-90
90 & above
Total Districts
Assam
0 (0)
3 (2)
11 (12)
9 (9) 23
Bihar
6 (12)
22 (19)
9 (6) 37
Chhattisgarh
4 (9)
9 (7)
3 (0) 16
Jharkhand
0 (3)
11 (9)
6 (6)
1 (0) 18
Madhya Pradesh
0 (1)
5 (5)
27 (29)
13 (10) 45
Odisha
2 (3)
4 (5)
20 (20)
4 (2) 30
Rajasthan
5 (8)
25 (21)
2 (2) 32
Uttar Pradesh
0 (4)
12 (20)
40 (39)
17 (7) 70
Uttarakhand
1 (3)
8 (7)
4 (3) 13
All States
0 (7)
39 (60)
110 (108)
115 (95)
20 (14)
284
About 1/7th of the districts have reported less than 50% of the safe deliveries. It was 1/4th in baseline.
Out of 20 districts reporting 90% & above safe deliveries, 13 districts belong to Madhya Pradesh. It was 10 for MP in Baseline.

52. Safe Delivery
SAFE DELIVERY (%)

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

54. Janani Suraksha Yojana
MOTHERS WHO AVAILED FINANCIAL ASSISTANCE FOR DELIVERY UNDER JSY (%)

55. Abortion
Varies from 2.1% in Chhattisgarh to 7.6% in Assam, in Baseline too these two States were at the extremes.
Across 284 districts in 9 AHS States, it ranges from 0.7% in Jaisalmer(Rajasthan) Kanker & Dantewada(Chhattisgarh), to 19.6% in Jorhat(Assam).

56. Abortion Varies from 2.6 in Assam to 3.3 in Chhattisgarh.
Across 284 districts in 9 AHS States, it ranges from 2.0 in Sheopur (Madhya Pradesh) to 5.4 in Rayagada (Odisha) & Jaisalmer (Rajasthan).

57. Abortion
Abortion taking place in institution varies from 32.0% in Chhattisgarh to 73.9% in Assam.
Across 284 districts in 9 AHS States, it ranges from 12.4% in Kishanganj (Bihar) to 100% in Jaisalmer (Rajasthan).

58. Abortion Varies from 41.8% in Chhattisgarh to 76.4% in Assam.
Across 284 districts in 9 AHS States, it ranges from 19.6% in Madhepura (Bihar) to 100% in Rayagada (Odisha) and Jaisalmer (Rajasthan) – a variability of 5 times.
More than 50% of the abortion is performed by skilled health personnel in all the States except Chhattisgarh.

59. Post Natal Care
Mothers receiving PNC within 48 hrs of delivery varies from 59.6% in Assam to 80.0% in Odisha. It was 57.0 in Assam and 74.5% in Odisha in Baseline.
At least 1 in every 7 mothers did not receive any post natal check up across all AHS States. The situation was 1 in 5 in baseline.

60. MOTHERS WHO AVAILED POST-NATAL CHECK UP WITHIN 48 HRS. OF DELIVERY (%)
Post Natal Care
MOTHERS WHO AVAILED POST-NATAL CHECK UP WITHIN 48 HRS. OF DELIVERY (%)

61. MOTHERS WHO DID NOT RECEIVE ANY POST-NATAL CHECK UP (%)
Post Natal Care
MOTHERS WHO DID NOT RECEIVE ANY POST-NATAL CHECK UP (%)

62. New Born Check up
New born checked up within 24 hrs of birth exceeds 50% in all AHS States. Across the 284 districts, as high as 246 districts reported more than 50% coverage.
It varies from 57.6% in Bihar to 79.7% in Odisha whereas in Baseline it was 52.6% in Bihar and 74.9 in Odisha.
Across 284 districts in 9 AHS States, it ranges from 32.2 in Karimganj(Assam) to 92.6 in Bargarh(Odisha). In Baseline, this varied from 24.2 in Karimganj & Hailakandi (Assam) to 92.9 in Allahabad(Uttar Pradesh).

63. NEW BORNS WHO WERE CHECKED UP WITHIN 24 HRS. OF BIRTH (%)
New Born Check up
NEW BORNS WHO WERE CHECKED UP WITHIN 24 HRS. OF BIRTH (%)

64. Full Immunization
Children are considered fully immunized when they have received vaccination against Tuberculosis, 3 doses of DPT & Polio and 1 dose of measles.
All States except Uttar Pradesh continue to remain having received at least half of their children aged months fully immunized.
Uttar Pradesh & Uttarakhand continue to remain minimum & maximum in children fully immunized.

65. Children aged 12-23 months Fully Immunized (%)
Full Immunization
Children aged months Fully Immunized (%)
State
State Value
Minimum
Maximum
Range
First Updation
Baseline
Assam
61.4
59.0
Dhubri (39.2)
Dhubri (29.9)
Dibrugarh (85.5)
Dibrugarh (83.8)
46.3
53.9
Bihar
65.6
64.5
Kishanganj (26.6)
Madhubani (82.8)
Samastipur (83.9)
56.2
57.3
Jharkhand
69.1
63.7
Giridih (43.0)
Giridih (28.0)
Lohardaga (86.5)
Purbi Singhbhum
(82.7)
43.5
54.7
Madhya Pradesh
59.7
54.9
Umaria (27.1)
Jhabua (23.8)
Indore (83.2)
Indore (77.6)
56.1
53.8
Chhattisgarh
74.1
Surguja (52.8)
Surguja (55.3)
Kanker (94)
Kanker (93.2)
41.2
37.9
Odisha
62.3
55.0
Rayagada (17.7)
Rayagada (11.9)
Kendrapara (84.9)
Kendrapara (82)
67.2
70.1
Rajasthan
69.2
70.8
Dhaulpur (41.5)
Dhaulpur (37.4)
Hanumangarh (95.9)
Hanumangarh (91.4)
54.4
54.0
Uttar Pradesh
48.1
45.3
Bahraich (21.6)
Etah (13.5)
Saharanpur (72.2)
Basti (73.8)
50.6
60.3
Uttarakhand
77.9
75.4
Haridwar (59.6)
Haridwar (55.3)
Pithoragarh (87.6)
Pithoragarh (87.5)
28.0
32.2
The variability among the districts within a State ranges from 28.0% in Uttarakhand to 67.2% in Odisha, it was 32.2% in Uttarakhand to 70.1% in Odisha in Baseline.
Across all 284 districts, Rayagada of Odisha continue to remain the minimum. However the maximum is observed in Hanumangarh of Rajasthan. In Baseline the maximum was in Kanker of Chhattisgarh.

66. Full Immunization
Frequency distribution of Full Immunization in terms of number of districts in each State
 State
0-30
30-50
50-70
70-90
90 & above
Total Districts
Assam
0 (1)
4 (4)
14 (14)
5 (4)
0 (0) 23
Bihar
1 (1)
2 (2)
18 (23)
16 (11) 37
Chhattisgarh
6 (6)
9 (9) 16
Jharkhand
2 (4)
9 (7)
7 (6) 18
Madhya Pradesh
3 (2)
8 (14)
26 (24)
8 (5) 45
Odisha
5 (8)
2 (6)
14 (9) 30
Rajasthan
3 (4)
9 (10)
19 (17) 32
Uttar Pradesh
6 (11)
30 (31)
31 (20)
3 (8) 70
Uttarakhand
1 (2)
12 (11) 13
All States
15 (24)
58 (66)
116 (112)
93 (80)
284
73 districts are below 50% level of full immunization whereas it was 90 in Baseline.
Only 2 districts 1 each from Chhattisgarh & Rajasthan continue to remain in 90% & above category.

67. Constituents of full immunization

68. CHILDREN AGED 12-23 MONTHS FULL IMMUNIZED (%)
Full Immunization
CHILDREN AGED MONTHS FULL IMMUNIZED (%)

69. Vitamin A Supplementation to Children
At least every 2nd child aged 6-35 months has received Vitamin A supplement in all AHS States except Uttar Pradesh where it is every 3rd child, the same as in Baseline.
Across 284 districts in 9 AHS States, it ranges from 16.2 in Shrawasti(Uttar Pradesh) to 88.5 in Udaipur(Rajasthan). In Baseline, it varied form 15.1 in Shrawasti to 91.3 in Lohardaga(Jharkhand).
Across the 284 districts,193 districts have reported more than 50 % coverage.

70. Vitamin A Supplementation to Children
CHILDREN ( AGE 6-35 MONTHS WHO RECEIVED VITAMIN A DOSE DURING LAST SIX MONTHS (%)
Vitamin A Supplementation to Children

71. IFA Supplement to Children
IFA supplement to children aged 6-35 months during last 3 months ranges from 10.9% in Rajasthan to 38.7% in Chhattisgarh. It was 9.4% in Rajasthan to 37.7% in Chhattisgarh in Baseline.
Situation merit attention across all AHS States however it is quite alarming in Rajasthan, Uttar Pradesh & Uttarakhand.

72. IFA Supplement to Children
CHILDREN ( AGE 6-35 MONTHS WHO RECEIVED IFA TABLETS/SYRUPS DURING LAST 3 MONTHS (%)

73. Breast Feeding Practices
Bihar & UP and Assam & Odisha continue to remain two extremes of the spectrum.

74. Breast Feeding Practices
CHILDREN UNDER 3 YEARS BREASTFED WITHIN 1
HOUR OF BIRTH (%)

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

76. Breast Feeding Practices
CHILDREN AGED 6-35 MONTHS EXCLUSIVE BREASTFED FOR AT LEAST SIX MONTHS (%)

77. Some Additional Facts Among AHS States:-
4 out of the 5 top States in female literacy and full ANC coverage are common.
57 districts are common in top 100 districts in female literacy and full ANC.
3 out of the 5 top States in female literacy also exist among 5 States with least MMR .
Top 5 States in full immunization coverage are the same who have the least NNMR & IMR.
3 out of the 5 top States in exclusive breast feeding practice also exist among 5 States with minimum NNMR.

78. WAY FORWARD
The fieldwork for 2nd updation round is over and the indicators on vital rates reflecting the change vis-à-vis baseline and first updation round surveys are likely to be released shortly.
A Component of Clinical-Anthropometric & Bio-chemical (CAB) Test on a sub-sample basis is in progress in the AHS States.

79. THANK YOU