MINISTER OF HEALTH AND FAMILY WELFARE AND PARLIAMENTARY AFFAIRS (SMT. SUSHMA SWARAJ)
(a)to(h): A statement is laid on the Table of the House.
STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 251 FOR 6.8..2003
(a) As per the Sample Registration System (SRS) of the Registrar General of India, the crude birth rate (CBR) and infant mortality rate (IMR) as per State-wise for the period 1999-2001 is at Annexure I and Annexure II. Estimates of maternal mortality rate are available only for the years 1997 and 1998. These are enclosed at Annexure III. State-wise information on nutritional status for children and pregnant women during the last three years is not available. A statement showing the nutritional status of children below three years of age as available from National Family Survey (NFHS 1992-1993 and NFHS 1998-1999) is at Annexure IVa & IVb. For pregnant mothers, information is available only on prevalence of anaemia from NFHS (1998-1999). A statement showing prevalence of anaemia among pregnant mothers and children less than three years of age is at Annexure V.
(b) A National Nutrition Policy has been adopted in 1993 and National Plan of Action on nutrition is being implemented through various Departments of Government of India. The Department of Women & Child Development has been implementing the Integrated Child Development Services, nutrition component of Pradhan Mantri Gramodaya Yojana and Nutrition Education programmes of Food and Nutrition Board to improve the overall nutritional status of young children and pregnant and nursing women. Under the National Nutritional Anaemia Control Programme of the Government of India, Iron Folic Acid tablets are distributed to high risk groups such as pregnant women, lactating women, women using IUDs and pre-school children between 1 to 5 years. Government is also implementing the National Maternity Benefit Scheme (NMBS) since 1995, primarily to improve nutritional intake of pregnant women belonging to BPL families.
For bringing down child, infant and maternal mortality rates, various interventions are being implemented as part of the Reproductive and Child Health (RCH) Programme in all districts of the country. For reducing child and infant mortality, the interventions include immunization against six vaccine preventable diseases, control of deaths due to diarrhoeal diseases, control of deaths due to Acute Respiratory Infections, eradication of polio, prophylaxis against blindness due to Vitamin A deficiency and essential new born care.
The interventions for reducing maternal mortality and improving safe motherhood include essential obstetric care; emergency obstetric care; provision of referral transport through Panchayats, provision of drugs and equipment at first referral units; provision of contractual staff like additional Auxiliary Nurse and Mid-wives; staff nurses, doctors and anaesthetists. Funds are also being provided for schemes to improve outreach of services like 24 hours delivery services at selected primary health centers and community health centers; training of Dais in 156 districts and holding of Reproductive and Child Health camps in 178 districts and RCH Outreach Scheme in 151 districts with adverse health indicators. The implementation of these interventions will be further strengthened during the second phase of RCH Programme.
Over the three-year period (1999-2001) for which the details for crude birth rate and infant mortality rate are available, the CBR has declined from 26.1 to 25.4 and infant mortality rate from 70 per thousand births to 66. The State-wise figures during this period are at Annexure I and Annexure II. Proportion of underweight children, less than three years of age has also shown a decline from 53 percent as per National Family Health Survey (1992-1993) to 47 percent in NFHS (1998-1999).
(c)&(d)The programmes and interventions listed above will continue and new interventions included as per the needs of the programme during the Tenth Five Year Plan. As part of the initiatives taken under the National Population Policy –2000, an Empowered Action Group has been constituted under the Chairpersonship of the Honb’le Union Minister for Health and Family Welfare. A new budget head of EAG Schemes has been approved for the Tenth Plan at an outlay of Rs. 250 crores to address the unmet needs of 8 EAG States either under ongoing schemes or through new initiatives. In order to strengthen the delivery of services, 8669 new sub centers are to set up during the 10th Plan. 5176 of these will be in the EAG States.
(e)&(f): Under the RCH programme, grants are released regularly to the States/UTs to implement various interventions, which are aimed primarily to reduce maternal, and child mortality keeping in view state’s requirement as per their annual action plans. A statement showing funds released to the states and UTs in the last three years under the RCH Programme is at Annexure VI.
(g)&(h): As per the Survey of Causes of Death (Rural) conducted by the office of the Registrar General of India, the contribution of deaths due to pregnancy, childbirth and puerperium to overall deaths has declined from 0.9 percent in 1994 to 0.6 percent in 1998. Information for subsequent years is not available.
In order to accelerate the decline, there is a proposal to introduce a centrally sponsored scheme in the name of Janani Suraksha Yojana. The scheme shall not only integrate the existing National Maternity Benefit Scheme and other ongoing maternal health schemes, but will also introduce new initiatives. The scheme primarily aims at improving institutional deliveries and nutrition of lactating mothers belonging to families Below Poverty Line (BPL) so as to reduce maternal, neo-natal and infant mortality.
Annexure I
CRUDE BIRTH RATE (CBR)
Sl.No. States/Union Territories 1999 2000 2001 #
1 Andhra Pr. 21.7 21.3 20.8
2 Assam 27.0 26.9 26.8
3 Bihar 30.4 31.9 31.2
4 Chhatisgarh 26.9 26.7 26.3
5 Gujarat 25.4 25.2 24.9
6 Haryana 26.8 26.9 26.7
7 Jharkhand 26.3 26.5 26.3
8 Karnataka 22.3 22.0 22.2
9 Kerala 18.0 17.9 17.2
10 Madhya Pr. 30.7 31.4 30.8
11 Maharashtra 21.1 21.0 20.6
12 Orissa 24.1 24.3 23.4
13 Punjab 21.5 21.6 21.2
14 Rajasthan 31.1 31.4 31.0
15 Tamil Nadu 19.3 19.3 19.0
16 Uttar Pr. 32.1 32.8 32.1
17 W. Bengal 20.7 20.7 20.5
18 Arunachal Pr. 22.3 22.3 22.0
19 Delhi 20.3 20.3 18.7
20 Goa 14.3 14.3 39.0
21 Himachal Pr. 23.8 22.1 21.0
22 J & K 20.9 19.7 20.1
23 Manipur 18.6 18.3 18.2
24 Meghalaya 28.7 28.5 28.3
25 Mizoram 17.0 16.0 15.7
26 Nagaland 11.8 NA NA
27 Sikkim 21.6 21.8 21.6
28 Tripura 17.0 16.5 16.1
29 Uttaranchal 19.6 20.2 18.5
30 A&N Islands 18.1 19.1 16.8
31 Chandigarh 17.9 17.5 16.1
32 D&N Haveli 34.2 34.9 29.3
33 Daman & Diu 26.9 23.7 22.3
34 Lakshadweep 25.1 26.1 20.4
35 Pondicherry 17.7 17.8 17.9
ALL INDIA 26.1 25.8 25.4
Source: Sample registration system
Annexure II
INFANT MORTALITY RATE (IMR)
Sl.No. States 1999 2000 2001#
1 Andhra Pr. 66 65 66
2 Assam 76 75 73
3 Bihar 63 62 62
4 Chhatisgarh 78 79 76
5 Gujarat 63 62 60
6 Haryana 68 67 65
7 Jharkhand 71 70 62
8 Karnataka 58 57 58
9 Kerala 14 14 11
10 Madhya Pr. 90 87 86
11 Maharashtra 48 48 45
12 Orissa 97 95 90
13 Punjab 53 52 51
14 Rajasthan 81 79 79
15 Tamil Nadu 52 51 49
16 Uttar Pr. 84 83 82
17 W. Bengal 52 51 51
18 Arunachal Pradesh 43 44 39
19 Delhi 31 32 29
20 Goa 21 23 19
21 Himachal Pr. 62 60 54
22 J & K NA 50 48
23 Manipur 25 23 20
24 Meghalaya 56 58 56
25 Mizoram 19 21 19
26 Nagaland NA NA NA
27 Sikkiim 49 49 42
28 Tripura 42 41 39
29 Uttaranchal 52 50 48
30 A&N Islands 25 23 18
31 Chandigarh 28 28 24
32 D&N Haveli 56 58 58
33 Daman & Diu 35 48 40
34 Lakshadweep 32 27 33
35 Pondicherry 22 23 22
ALL INDIA# 70 68 66
Source SRS
# = Provisional
NA = Not Available.
Annexure III
MATERNAL MORTALITY RATE (per 1,00,000 live births) India and bigger states
1997 1998
India 408 407
Andhra Pradesh 154 159
Assam 401 409
Bihar 451 452
Gujarat 29 28
Haryana 105 103
Karnataka 195 195
Kerala 195 198
Madhya Pradesh 498 498
Maharashtra 135 135
Orissa 361 367
Punjab 196 199
Rajasthan 677 670
Tamil Nadu 76 79
Uttar Pradesh 707 707
West Bengal 264 266
Source:SRS
Note:
(i) Due to small sample size , the estimates for smaller States are not reliable.
(ii) Registrar General`s Office has discontinued the release of this data beyond 1998.
Annexure IV(a)
Nutritional status of children by state
Percentage of children under age 4 years classified as under nourished on three anthropometric indices of nutritional status, according to state, India , 1992-93
S.No. State Weight for age Height for age Weight for height
% below -3 SD % below -2 SD# % below -3 SD % below -2 SD# % below -3 SD % below -2 SD#
India 20.6 53.4 28.9 52.0 3.2 17.5
1 Andhra Pradesh 15.6 49.1 NA NA NA NA
2 Assam 18.7 50.4 26.3 52.2 1.7 10.8
3 Bihar 31.1 62.6 39.5 60.9 4.1 21.8
4 Gujarat 17.6 50.1 25.3 48.2 3.7 18.9
5 Haryana 9.0 37.9 19.3 46.7 0.6 5.9
6 Karnataka 19.4 54.3 22.7 47.6 2.6 17.4
7 Kerala 6.1 28.5 9.0 27.4 1.3 11.6
8 Madhya Pradesh 22.3 57.4 NA NA NA NA
9 Maharashtra 21.3 54.2 23.5 48.5 4.2 20.2
10 Orissa 22.7 53.3 25.2 48.2 3.6 21.3
11 Punjab 14.2 45.9 15.7 40.0 2.8 19.9
12 Rajasthan 19.2 41.6 26.6 43.1 5.2 19.5
13 Tamil Nadu 13.3 48.2 NA NA NA NA
14 Uttar Pradesh 24.6 59.0 35.6 59.5 2.7 16.1
15 West Bengal 18.4 56.8 NA NA NA NA
16 Arunachal Pr. 14.5 39.7 27.9 53.9 3.6 11.2
17 Delhi 12.0 41.6 19.3 43.2 2.7 11.9
18 Goa 8.9 35.0 11.0 32.5 2.4 15.3
19 Himachal Pr. 12.9 47.0 NA NA NA NA
20 Jammu & Kashmir 13.8 44.5 18.6 40.8 3.4 14.8
21 Manipur 7.2 30.1 16.0 33.6 1.2 8.8
22 Meghalaya 17.2 45.5 38.4 50.8 4.8 18.9
23 Mizoram 5.3 28.1 16.0 41.3 0.6 2.2
24 Nagaland 7.6 28.7 13.2 32.4 2.3 12.7
25 Tripura 18.6 48.8 21.3 46.0 0.7 17.5
# = Includes children who are below -3 SD from the International Reference Population median
Source : NFHS-II; 1992-93
NA – Not available.
Annexure IV(b)
Nutritional status of children by state
Percentage of children under age 3 years classified as under nourished on three anthropometric indices of nutritional status, according to state, India , 1998-99
S.No. State Weight for age Height for age Weight for height
% below -3 SD % below -2 SD# % below -3 SD % below -2 SD# % below -3 SD % below -2 SD#
India 18.0 47.0 23.0 45.5 2.8 15.5
1 Andhra Pradesh 10.3 37.7 14.2 38.6 1.6 9.1
2 Assam 13.3 36.0 33.7 50.2 3.3 13.3
3 Bihar 25.5 54.4 33.6 53.7 5.5 21.0
4 Chhatisgarh 25.9 60.8 35.1 57.9 3.5 18.5
5 Gujarat 16.2 45.1 23.3 43.6 2.4 16.2
6 Haryana 10.1 34.6 24.3 50.0 0.8 5.3
7 Jharkhand 26.8 54.3 29.4 49.0 4.6 25.4
8 Karnataka 16.5 43.9 15.9 36.6 3.9 20.0
9 Kerala 4.7 26.9 7.3 21.9 0.7 11.1
10 Madhya Pradesh 24.3 55.1 28.3 51.0 4.3 19.8
11 Maharashtra 17.6 49.6 14.1 39.9 2.5 21.2
12 Orissa 20.7 54.4 17.6 44.0 3.9 24.3
13 Punjab 8.8 28.7 17.2 39.2 0.8 7.1
14 Rajasthan 20.8 50.6 29.0 52.0 1.9 11.7
15 Tamil Nadu 10.6 36.7 12.0 29.4 3.8 19.9
16 Uttar Pradesh 21.9 51.7 31.0 55.5 2.1 11.1
17 West Bengal 16.3 48.7 19.2 41.5 1.6 13.6
18 Arunachal Pr. 7.8 24.3 11.9 26.5 2.0 7.9
19 Delhi 10.1 34.7 18.0 36.8 4.1 12.5
20 Goa 4.7 28.6 4.8 18.1 0.7 13.1
21 Himachal Pr. 12.1 43.6 18.1 41.3 3.3 16.9
22 Jammu & Kashmir 8.3 34.5 17.3 38.8 1.2 11.8
23 Manipur 5.3 27.5 11.2 31.3 1.8 8.2
24 Meghalaya 11.3 37.9 24.5 44.9 1.0 13.3
25 Mizoram 5.0 27.7 13.9 34.6 2.8 10.2
26 Nagaland 7.4 24.1 11.7 33.0 2.4 10.4
27 Sikkim 4.2 20.6 9.7 31.7 0.8 4.8
28 Tripura 14.4 42.6 22.0 40.4 1.9 13.1
29 Uttaranchal 16.0 41.8 5.7 46.6 1.1 7.6
# = Includes children who are below -3 SD from the International Reference Population median
Source : NFHS-II; 1998-99
Annexure V
Anaemia among Pregnant Women & Children
Sl. India/State/Union % of Pregnant % of Children with Anaemia
No. Territory Women with Anaemia
INDIA 49.7 74.3
1 Andhra Pr. 41.8 72.3
2 Assam 62.3 63.2
3 Bihar 49.8 81.3
4 Chattisgarh 68.3 87.7
5 Gujarat 47.4 74.5
6 Haryana 55.5 83.9
7 Jharkhand 64.0 82.4
8 Karnataka 48.6 70.6
9 Kerala 20.3 43.9
10 Madhya Pr. 53.8 75.0
11 Maharashtra 52.6 76.0
12 Orissa 60.5 72.3
13 Punjab 37.1 80.0
14 Rajasthan 51.4 82.3
15 Tamil Nadu 57.1 69.0
16 Uttar Pr. 46.0 73.9
17 West Bengal 56.9 78.3
18 Arunachal Pr. 49.2 54.5
19 Delhi 44.7 69.0
20 Goa 35.0 53.4
21 Himachal Pr. 31.8 69.9
22 J&K 56.3 71.1
23 Manipur 36.7 45.2
24 Meghalaya 58.6 67.6
25 Mizoram 45.7 57.2
26 Nagaland 38.2 43.7
27 Sikkim 47.6 76.5
28 Tripura 53.6 61.8
29 Uttaranchal 49.8 77.4
Source : National family Health survey -II (1998-99)
ANNEXURE-VI
FUND RELEASED UNDER RCH PROGRAMME
(Rs. In lakhs)
Sl.no Name of the State/UT Funds Release during the year
2000-01 2001-02 2002-03 Total
1 Andhra Pradesh 1662.15 2021.72 720.92 4404.80
2 Arunachal Pradesh 175.72 153.26 34.04 363.02
3 Assam 474.86 1244.53 312.90 2032.29
4 Bihar 2711.64 1676.45 2388.13 6776.22
5 Jharkhand 37.00 515.35 374.01 926.36
6 Goa 13.40 22.08 9.26 44.74
7 Gujarat 983.39 7776.26 500.36 9260.00
8 Harayana 1664.30 1236.25 496.38 3396.93
9 Himachal Pradesh 427.02 249.07 71.33 747.43
10 Jammu & Kashmir 555.39 297.90 164.04 1017.33
11 Karnataka 1671.15 1782.66 488.07 3941.87
12 Kerala 1165.32 768.03 201.28 2134.63
13 Madhya Pradesh 3553.34 1377.96 702.09 5633.38
14 Chattisgarh 314.10 880.07 223.99 1418.16
15 Maharashtra 1256.71 3195.03 926.14 5377.88
16 Manipur 421.71 860.86 59.70 1342.27
17 Meghalaya 67.61 146.28 64.40 278.30
18 Mizoram 729.58 747.62 22.23 1499.44
19 Nagaland 146.96 116.51 41.61 305.07
20 Orissa 1524.79 1930.77 327.76 3783.32
21 Punjab 686.25 621.10 249.77 1557.13
22 Rajasthan 2313.58 3954.41 757.10 7025.10
23 Sikkim 43.07 69.30 13.68 126.05
24 Tamilnadu 2373.39 541.25 515.71 3430.35
25 Tripura 166.18 446.87 70.35 683.40
26 Uttar Pradesh 4654.45 7567.00 4390.66 16612.11
27 Uttranchal 208.59 440.98 132.80 782.37
28 West Bengal 2073.46 1949.32 749.10 4771.87
29 A&N Islands 31.04 134.89 7.36 173.29
30 Chandigarh 117.61 23.20 8.59 149.40
31 D&N Haveli 3.88 14.02 2.64 20.53
32 Daman & Diu 4.87 8.66 2.09 15.61
33 Delhi 311.22 297.60 338.97 947.79
34 Lakshadweep 21.44 11.42 1.55 34.41
35 Pondicherry 21.79 21.58 8.54 51.91
TOTAL: 32586.94 43100.26 15377.55 91064.76
figures provisional
