Vital Health Statistics: India/M.P.

/Indore- A Comparison

Facilitated By: Dr.Veena Yesikar Mam Dr. Rahul Rokade Sir 72

Presented By: Group No.15 Richa Gupta Roll No. 71 Rinku Chauhan Roll No.
Rishi Katiyar Roll No. 73 Ritesh Churihar Roll No.

74 Ritesh Kag Roll No. 75

INTRODUCTION
DEMOGRAPHIC TRENDS DETERMINANTS OF MATERNAL MORTALITY INFANT HEALTH INDICATORS CHILD HEALTH INDICATORS

Introduction
Statistics : A fact or piece of data obtained from a study of a large quantity of numerical data.
Vital Health statistics : It relates to all the important facts i.e. health indicators pertaining to health status of the country or community obtained from various sources

Indicators of Health- Importance

Health indicators are required to
Measure the health status of community. Compare the health status of one country with that of other. Assessment of health care needs. Proper allocation of scarce resources. Monitoring and evaluation of health services , activities and programmes. Measure the extent to which objectives and targets of a programme have been attained.

Indicators of Health- Characteristics

An Ideal health care indicator should be
Valid : they should actually measure what they are supposed to measure Reliable and Objective: answers should be the same when measured by different people in similar circumstances. Sensitive : they should be sensitive to changes in the situation concerned .

Characteristics Cont.
Specific : they should reflect changes only in the situation concerned.
Feasible : they should have the ability to obtain the data needed. Relevant : they should contribute to understanding the phenomenon of interest

Sources of Health statistics

The various sources of health statistics are:
Census Registration of vital events Sample registration system Population surveys- NFHS, DLHS Notification of diseases Hospital records Disease registers Record linkage Epidemiological surveillance

SOME IMPORTANT SOURCES 1.Census

One of the most important source of health information. Definition : total process of collecting, compiling & publishing demographic, economic and social data pertaining at a specified time , to all persons in a country or delimited territory. It need vast organization , preparations and several years to analyze.

 First census 1881 Last census held in March 2001. Census is conducted in the last month of the first quarter of the year, reason being most people are resident in their homes during that period of the year. It provides basic data needed to compute vital statistical rates, and other health, demographic and socioeconomic indicators. Main drawback of census : full results are not available quickly.

2. Registration of vital events

It keeps a continuous check on demographic changes It is defined as legal registration, statistical recording & reporting of occurrences of , and the collection compilation, presentation, analysis and distribution of statistics pertaining to vital events, i.e., live births, deaths, fetal deaths, marriages , divorces, adoptions, legitimations, recognitions, annulments and legal separations. ( United Nations ).

 India has a long tradition of registration of births and deaths. Time limit for registering the event of births and deaths is now 21 days for both. In case of default a fine of Rs. 50 is imposed. A new system has been developed to improve this system :- Lay reporting . It is defined as Collection of information , its use and its transmission to other levels of the health system by non professional heath volunteers.

3.Sample Registration System

Started in mid 1960s.
It is a dual record system :
Continuous enumeration by a enumerator Independent survey every six months by a investigatorsupervisor Advantage-Serves as an independent check on the events recorded by the enumerator.

4.National Family Health SurveyNFHS

It is conducted by the ministry of Health & Family Welfare and International institute for population sciences (IIPS), Mumbai. It uses standardized questionnaires , sample designs & field procedures to collect data which is representative at national and state level. 1st NFHS 1992-93 2nd NFHS- 1998-99

NFHS Cont..
Latest NFHS (3rd )- 2006-07
Important feature of this was that it included face to face interviews of about 2 lakhs people covering all the 29 states.

It is a key resource for evaluation and monitoring family welfare and health of Indian population

4.DISTRICT LEVEL HOUSEHOLD SURVEY

Initiated in 1997 VIEW: To assess the utilization of services provided by the government healthcare facilities and peoples perception about quality of services . DLHS I : 1998-1999 DLHS II : 2002-2004 DLHS III : 2007-2008 Provides information about 1.Indicators of maternal and child health 2.Family planning measures 3.Important interventions of NRHM

The Various Vital Health Statistics are :

Crude Birth Rate Crude Death Rate Growth rate Population density Sex ratio Dependency ratio Family size Literacy and education Life expectancy Maternal mortality rate Infant mortality rate Child mortality rate Under 5 mortality rate Total fertility rate Nutrition indicators etc.

DEMOGRAPHY
IT IS THE SCINTIFIC STUDY OF HUMAN POPULATION. IT IS MAINLY CONCERNED WITH CHANGE IN POPULATION COMPOSITION OF POPULATION DISTRIBUTION OF POPULATION IN SPACE

HOW DEMOGRAPHY IS RELATED TO HEALTH

COMMUNITY MEDICINE IS VIRTUALLY CONCERNED WITH POPULATION BECAUSE HEALTH IN GROUP DEPENDS UPON THE DYNAMIC RELATIONSHIP BETWEEN NUMBERS OF PEOPLE, THE SPACE WHICH THEY OCCUPY & SKILL THAT THEY HAVE ACQUIRED IN PROVIDING FOR THEIR NEEDS.

POPULATION
INDIA IS SECOND MOST POPULOUS COUNTRY IN THE WORLD. INDIA RANKS SEVENTH IN LAND AREA IN THE WORLD. WITH ONLY 2.4 % OF LAND AREA INDIA IS SUPPORTING ABOUT 16.87% OF WORLDS POPULATION. POPULATION OF INDIA IS

1027.O MILLION.

CONT..
POPULATION OF M.P. IS

60.38 MILLION
POPULATION OF INDORE IS

2465 THOUSAND

AGE AND SEX COMPOSITION

IT SHOWS % OF MALE & FEMALE POPULATION IN A PARTICULAR AGE GROUP.

PERCENT DISTRIBUTION OF POPULATION BY AGE & SEX,INDIA SRS ESTIMATES,2003

Age 0-4 5-9 10-14 15-19 2O-24 25-29 30-34 35-39 4O-44 45-49 5O-54 55-59 6O-64 65-69 70+ Total

Female 10.8 10.3 10.7 10.4 9.7 8.3 7.5 7.0 5.7 5.0 3.7 3.2 2.5 2.2 3.1 100.0

MALE 11.3 10.6 11.0 11.0 9.5 8.4 7.4 6.6 5.8 4.9 3.9 3.1 2.3 1.9 2.5 100.0

Total 11 10.5 10.9 10.7 9.6 8.3 7.5 6.8 5.7 4.9 3.8 3.2 2.4 2.0 2.8 100.0

SEX RATIO
IT IS THE NUMBER OF FEMALES PER 1000 MALES.
SEX RATIO IN INDIA IS

933/1000 Males
SEX RATIO IN M.P. IS

919/1000 Males
SEX RATIO IN INDORE IS

912/1000 Males

DEPENDENCY RATIO
THE PROPORTION OF THE PERSONS ABOVE 65 YEARS OF AGE AND CHILDRENS BELOW 15 YEARS ARE CONSIDERD AS TO BE DEPENDENT ON THE ECONOMICALLY PRODUCTIVE AGE GROUP. RATIO OF COMBINED AGE GROUP O-14YEARS PLUS 65 YEARS AND ABOVE TO THE 15-65 YEARS AGE GROUP IS REFERRED TO AS THE TOTAL DEPENDENCY RATIO. IT REFLECTS NEED FOR ASOCIETY TO PROVIDE FOR TO PROVIDE FOR THEIR YOUNGERS AND OLDER POPULATION GROUPS.

TOTAL DEPENDENCY RATIO OF INDIA ACCORDING TO 2OO4 IS

64.

OF WHICH

CHILD DEPENDENCY RATIO IS 56. AND OLD AGE DEPENDENCY RATIO IS 8.

TOTAL DEPENDENCY RATIO IN M.P. IS

DENSITY OF POPULATION IT IS THE NUMBER. OF PERSONS LIVING PER

SQUARE KILOMETRE. POPULATION DENSITY OF INDIA IS PER SQ. Km.

368

POPULATION DENSITY OF INDORE IS 633 PER SQ. KILOMETER.

LITERACY & EDUCATION

A PERSON IS DEEMED AS LITERATE IF HE/SHE CAN READ WRITE WITH UNDERSTANDING IN ANY LANGUAGE. A PERSON WHO CAN READ BUT CANT WRITE IS NOT CONSIDERD AS LITERATE. EDUCATION IS CRUCIAL ELEMENT IN ECONOMIC AND SOCIAL DEVELOPMENT. THE LITERATE RATE TAKING IN ACCOUNT THE TOTAL POPULATION IN THE DENOMINATOR TERMED AS CRUDE LITERACY RATE. LITERACY RATE IN INDIA IS 53.7%.(2001). LITERACY RATE IN M.P 5O.3%. LITERACY RATE IN INDORE IS 75% .

LIFE EXPECTANCY
IT IS DEFINED AS AT GIVEN AGE IS THE AVERAGE NU. OF YEARS WHICH A PERSON OF THAT AGE MAY EXPECT TO LIFE , ACCORDING TO MORTALITY PATTERN PREVALANT IN THAT COUNTRY. IT IS BEST INDICATOR OF LEVEL OF DEVELOPMENT AND OF THE OVERALL HEALTH STATUS OF ITS POPULATION. LIFE EXPECTANCY IN INDIA AT BIRTH IS 79& 89 FOR MALE & FEMALE RESPECTAVILY.

FAMILY SIZE
IT REFERS TO THE TOTAL NU. OF PERSONS IN A FAMILY. FAMILY SIZE MEANS THE TOTAL NU. OF CHILDREN A WOMEN HAS BORNE AT A POINT IN TIME. TOTAL FERTILITY RATE GIVES APPROXIMATE MAGNITUDE OF THE COMPLETED FAMILY SIZE. TOTAL FERTILITY RATE IS THE AVERAGE NU. OF CHILDREN A WOMEN WOULD HAVE IF SHE WERE TO PASS THROUGH HER REPRODUCTIVE YEARS BEARING CHILDREN AT THE SAME RATES AS THE WOMEN NOW IN EACH AGE GROUP.

TFR OF INDIA IS 4.1 /2.7. TFR OF M.P. IS 3.1. TFR OF INDORE IS

BIRTH RATE
THE NUMBER OF LIVE BIRTHS PER 1000 ESTIMATED MIDYEAR POPULATION, IN A GIVEN YEAR.

BIRTH RATE= ( NU. OF LIVE BIRTHS DURING THE YEAR

/ ESTIMATED MID-YEAR POPULATION ) * 1000

BIRTH RATE OF INDIA (SRS O7) IS 23.1 PER 1000 MIDYEAR POPULATION. BIRTH RATE OF M.P. (SRS 07) 28.5 PER 1000 MID-YEAR POPULATION. BIRTH RATE OF INDORE

DEATH RATE
NUMBER OF DEATHS PER 1000 POPULATION PER YEAR IN A GIVEN COMMUNITY. IT PROVIDES A GOOD TOOL FOR ASSESING THE OVER ALL HEALTH IMPROVEMENT IN A POPULATION. CRUDE DEATH RATE OF INDIA (SRS 07) IS 7.4 PER 1000 POPULATION. CRUDE DEATH RATE OF M.P. (SRS 07) IS 8.7 PER 1000 POPULATION. CRUDE DEATH RATE OF INDORE

MATERNAL HEALTH

MEDICAL CAUSES

SOCIAL CAUSES
AGE AT CHILD BIRTH PARITY TOO CLOSE PERGNANCY FAMILY SIZE MALNUTRITION POVERTY ILLITERACY SHORTAGE OF HEALTH MAN POWER DELIVERY BY UNTRAINED DAIS POOR ENVIRONMENT SANITATION POOR COMMUNICATION AND TRANSPORT FACILITIES SOCIAL CUSTOMS.

HYPERTENSI ON5%

OBSTRUCTED LABOUR5% ABORTION8

% OTHER CONDITIONS 34%

SEPSIS 10%

38% HAEMORRHA GE

MATERNAL MORTALITY RATE (2001-2003)

Health Institution Medical College Distri

Number 242 -

Referral Hospitals
City Family Welfare Centre Rural Dispensaries Health Institution Ayurvedic Hospitals Medical College Ayurvedic PHC Dispensaries UnaniHospiTALS Hospitals Referral Unani Dispensaries Homeopathic Hospitals Homeopathic Dispensary Number 34 144988 1427 3 3910 50 21 146

22670

STATISTICAL REPORT, REGISTRAR GENERAL OF INDIA, 2004, PER 100000 BIRTH

Medical College Distri Referral Hospitals City Family Welfare Centre Rural Dispensaries

242 -

Health Institution

Number

Ayurvedic Hospitals Ayurvedic Dispensaries

34 1427

Medical College

144988

Unani Hospitals
Unani Dispensaries

3
50

PHC

22670

Homeopathic Hospitals

21

Referral HospiTALS

3910

Homeopathic Dispensary

146

(Source: RHS Bulletin, March 2007, M/O Health & F.W., GO Health Infrastructure of Madhya Pradesh

Particulars
Sub-centre Primary Health Centre Community Health Centre Multipurpose worker (Female)/ANM at Sub Centres & PHCs

Required 10402 1670 417 9983

In position 8834 1149 270 8590

shortfall 1568 521 147 1393

Health Worker (Male) MPW(M) at Sub Centres

8834

6560

2274

Health Assistant (Female)/LHV at PHCs

1149

350

799

Health Assistant (Male) at PHCs Doctor at PHCs

1149 1149

1168 869

280

Obstetricians & Gynaecologists at CHCs

Physicians at CHCs Paediatricians at CHCs Total specialists at CHCs Radiographers Pharmacist Laboratory Technicians Nurse/Midwife

270
270 270 1080 270 1419 1419 3039

41
287 49 503 NA 215 489 901

229
221 577 NA 1204 930 2138

HEALTH MAN POWER IN INDORE

AS PER ANNUAL REPORT ON HEALTH 2007-08

HEALTH SUPERVISORS LHV

23 49 2 99 225

BLOCK EXTENSION EDUCATOR

MALE HEALTH WORKER FEMALE HEALTH WORKER

STAFF NURSE
ANM TBA AGANWADI WORKERS

34
713 645 892

Antenatal care
Percent distribution of women who had a live birth in the five years preceding the survey by antenatal care (ANC) provider during pregnancy for the most recent live birth, according to state, India, 2005-06

INDIA Doctor 50.2

M.P. 32.6

INDORE 43.4

Anm
Others Attendants Dai Aaganwadi worker Others No one

23
1 1.2 1.6 22.8 0.1

41.1
0.3 2.2 3.5 20.3 0.0

21.5
0.3 2.0 1.5 21.3 0.0

Total

100

100

100

Although 76 percent of women who had a live birth in the five years preceding the survey received antenatal care. Only 44 percent started antenatal care during the first trimester ofpregnancy, as recommended. Another 22 percent had their first visit during the fourth or fifth month of pregnancy. Just over half of mothers (52 percent) had three or more antenatal care visits. Urban women were much more likely to have three or more antenatal visits than ruralwomen. Half of men with a child under age three years said that they were at an antenatal care visit with the childs mother. Only 37 percent were ever told what to do if the mother had a major complication of pregnancy. Sixty-five percent received (or bought) iron and folic acid (IFA) supplements for their most recent birth, only 23 percent took IFA for at least 90 days, as recommended. Only 4 percent of women took a drug for intestinal parasites during their pregnancy.

Among women who had a live birth in the five years preceding the survey percentage who experienced specific health problems during pregnancy for the most recent live birth, by residence,

Problem during pregnancy

India, 2005-06
Urban
3.8

Rural
7.2

Total
6.3

Difficulty with vision during daylight Night blindness Convulsions not from fever Swelling of the legs, body or face Excessive fatigue Vaginal bleeding Total Number of women

3.7 7.4 28.0 45.2 5.2 10,626

10.8 11.3 24.1 48.7 4.1 29,051

8.9 10.3 25.1 47.8 4.4 39,677

 Reasons for not delivering in a health facility

Percentage of women who had a live birth in the five years preceding the survey by reasons for not delivering the most recentlive birth in a health facility, according to residence, 2005-06 Reason for not delivering in a health facility Urban Rural Total Costs too much 21.5 26.9 26.2 Facility not open 2.3 3.6 3.4 Too far/no transport 5.5 11.8 11.0 Dont trust facility/ poor quality service 4.0 2.4 2.6 No female provider at facility 1.3 1.1 1.1 Husband/family did not allow 6.0 5.9 5.9 Not necessary 69.6 72.1 71.8 Not customary 5.5 6.5 6.3 Other 5.0 2.7 3.0 Number of women 3,127 20,008 23,135 Note: Percentages do not add to 100.0 because multiple responses were permitted.

India,

 Postnatal check-ups soon after delivery help safeguard the health of mother and baby, particularly for births occurring outside of health care facilities. Almost 6 in 10 women (58 percent) did not receive any postnatal check-up after their most recent birth. About one-quarter of women (27 percent) received a health check-up in the first four hours after delivery, and 37percent received a health check-up within the critical first two days after delivery. It is notable that 15-24 percent of births even in institutions did not receive a postnatal check-up. Among births delivered at home, only 9-12 percent of births received a postnatal checkup within two days of delivery. Several states consistently perform well below the national average on each of the five safe motherhood indicators. These states include Rajasthan in the North Region, all states in the Central Region (Chhattisgarh, Madhya Pradesh, and Uttar Pradesh), Bihar and Jharkhand in the East Region, and Arunachal Pradesh, Assam, Meghalaya, and Nagaland in the Northeast Region. Uttaranchal also performs poorly on all the indicators except antenatal care. By contrast,Mizoram performs above the national average on the delivery care indicators and postnatal care indicators, but poorly on the antenatal care indicator.

Mothers registered in the first trimester when they were pregnant with last live birth/still birth (%) TOTAL 64.9 IN RURAL 31.1 Mothers who had at least 3 Ante-Natal care visits during the last pregnancy (%) TOTAL 66.3 IN RURAL 37.1 Mothers who got at least one TT injection when they were pregnant with their last live birth / still birth (%) TOTAL 87.1 IN RURAL 68.6 Institutional births (%) TOTAL 79.7 IN RURAL 66.0 Delivery at home assisted by a doctor/nurse /LHV/ANM (%) TOTAL 24.5 IN RURAL 7.1 Mothers who received post natal care within 48 hours of delivery of their last child (%) TOTAL 75.0 IN RURAL51.0

 CHILD DEATH RATE IS THE NUMBER OF DEATHS OF CHILDREN AGED 1-4 YEAR PER 1000 CHILDREN IN THE SAME AGE GROUP IN A GIVEN YEAR. THE CHILD DEATH RATE IS A MORE REFINED INDICATOR OF THE SOCIAL SITUATION IN A COUNTRY THAN INFANT MORTALITY RATE. THE INFECTIOUS DISEASES OF CHILDHOOD SUCH AS MEASLES, WHOOPING COUGH, DIPHTHERIA, DIARRHOEA AND ACUTE RESPIRATORY INFECTIONS AFFECT MOSTLY THIS AGE GROUP AND CAN LEAD TO HIGH CASE FATALITY RATE IN MALNOURISHED CHILDREN. I N INDIA FOR THE YEAR 2003, 1-4 YEARS AGE MORTALIY WAS ESTIMATED TO BE 5.2 % OF TOTAL DEATHS. IN M.P. 8.1 %, HIGHER THAN THE NATIONAL AVERAGE.

LEADING CAUSES OF DEATH IN 1-4 YEAR AGE GROUP IN INDIA

DIARRHOEAL DISEASES RESPIRATORY INFECTIONS MALNUTRITION INFECTIOUS DISEASES (e.g. MEASLES, WHOOPING COUGH) OTHER FEBRILE DISEASES ACCIDENTS & INJURIES

CHILD MORTALITY RATE / UNDER 5 MORTALITY RATE

UNICEF DEFINES THIS AS THE ANNUAL NUMBER OF DEATHS OF CHILDREN AGE UNDER 5 YEAR, EXPRESSED AS A RATE PER 1000 LIVE BIRTHS. MORE SPECIFICALLY , IT MEASURES THE PROBABILTY OF DYING BETWEEN BIRTH & EXACTLY 5 YEAR OF AGE . ARROUND 10.6 MILLION CHILDREN STILL DIE EVERY YEAR BEFORE REACHING THEIR FIFTH BIRTH DAY. MOST OF THESE DEATHS OCCUR IN LOW INCOME AND MIDDLE INCOME COUNTRIES

SRS ESTIMATES FOR CHILD DEATH (1-4 YEARS) & UNDER FIVE MORTALITY IN INDIA, MP & INDORE, 2003
CHILD DEATH AREA (1-4 YEAR ) (% OF DEATHS) UNDER - FIVE MORTALITY RATE PER 1000 UNDER FIVE CHILDREN RURAL URBAN TOTAL

INDIA

5.2

19.2

10.2

17.4

MADHYA PRADESH

8.1

28.6

15.8

26.7

INDORE

THE CAUSES OF DEATH OF CHILDREN UNDER FIVE YEAR, 2000-03

NEONATAL DIARRHOEAL DISEASE HIV/AIDS MEASLES 4% ACUTE RESPIRATORY INFECTIONS MALARIA INJURIES OTHER CAUSES

3%

3%

10% 36%

8%

17% 19%

 EACH YEAR 27 MILLION CHILDREN ARE BORN IN INDIA. ARROUND 10% OF THEM DO NOT SURVIVE TO 5 YEARS OF AGE . IN ABSOLUTE FIGURES, INDIA CONTRIBUTES TO 25 % OF THE OVER 10.6 MILLION UNDER FIVE DEATHS OCCURRING WORLDWIDE EVERY YEAR . NEARLY HALF OF THE UNDER FIVE DEATHS OCCUR IN NEONATAL PERIOD. THE MORTALITY RATE IN FEMALE CHILDREN IS HIGHER THAN THE MALE CHILDREN.

DETERMINANTS OF THE LEVEL OF CHILD MORTALITY IN INDIA

SOCIO- ECONOMIC STATUS

PLACE OF RESIDENCE MOTHERS EDUCATION AGE AT BIRTH PREVIOUS BIRTH INTERVEL IN INDIA ABOUT 30% OF THE BABIES ARE BORN WITH LOW BIRTH WEIGHT, WHO RUN HIGHER RISK OF MORBIDITY AND MORTALITY. IN ADDITION , MALNUTRITION IS AN IMPORTANT UNDERLYING CAUSE OF INFANT & CHILD MORTALITY. ABOUT 50% OF CHILDHOOD DEATHS IN INDIA ARE ATTRIBUTABLE TO MALNUTRITION.

UNDER FIVE MORTALITY RATE IN INDIA,M.P.& INDORE

AREA 1990 2004

INDIA

123

85

MP

INDORE

CHILD SURVIVAL INDEX

THE BASIC MEASURE OF INFANT AND CHILD SURVIVAL IS THE UNDER FIVE MORTALITY (NUMBER OF DEATHS UNDER THE AGE OF 5 YEARS, PER 1000 LIVE BIRTHS ) . A CHILD SERVIVAL RATE PER 1000 BIRTHS CAN BE SIMPLY CALCULATED BY SUBTRACTING THE UNDER -5 MORTALITY RATE FROM 1000 . DIVIDING THIS FIGURE BY TEN SHOWS THE PERSENTAGE OF THOSE WHO SURVIVE TO THE AGE OF 5 YEARS. CHILD SURVIVAL RATE DURING 1990 & 2004 IN INDIA 87.7 & 91.5 RESPECTIVELY

MORTALITY RATES ARE GOOD INDICATORS TO MEASURE THE LEVEL OF HEALTH & HEALTH CARE IN DIFFERENT COUNTRIES. IT HAS BECOME CUSTOMARY TO CONSIDER MORTALITY IN & ARROUND INFANCY IN A NUMBER OF TIME PERIODS CONVINENT FROM BOTH THE ANALYTICAL & PROGRAMMATIC POINT OF VIEW AS UNDER:1.PERINATAL PERIOD 2.EARLY NEONATAL PERIOD 3.LATE NEONATAL PERIOD 4.NEONATAL PERIOD 5.POST NEONATAL PERIOD

EARLY NEONATAL AREA MORTALITY RATE

NEONATAL

PERINATAL STILL BIRTH RATE

POST NEONATAL

MORTALITY RATE

MORTALITY RATE

MORTALITY RATE

RURAL URBAN TOTAL RURAL URBAN TOTAL

RURAL URBAN TOTAL

RURAL URBAN TOTAL

RURAL URBAN TOTAL

INDIA

28

12

25

41

22

37

36

20

33

25

16

23

MADHYA PRADESH

35

23

33

53

36

50

41

31

39

33

19

31

INDORE

DEFINED AS DEATH AFTER THE 20th OR 28th WEEK OF GESTATION (THE DEFINATION OF LENGTH OF GESTATION VRIES BETWEEN COUNTRIES ) SOME OBSEVERS HAVE EXPRESSED THE VIEW THAT VITAL SATASTICAL REPORTS ARE LESS RELIABLE ON FOETAL DEATHS OCCURRING AT 20-27 WEEKS THAN ON THOSE OCCURRING AFTER 28 COMPLETED WEEKS, AND HAVE PREFERRED TO ANALYSE THE DATA SEPARATELY FOR THE TWO INTERVELS STILL BIRTHS ARE SELDOM REPORTED IN DEVELOPING COUNTRIES

STILL BIRTH RATE

DEATH OF A FOETUS WEIGHING 1000g (THIS IS EQUIVALENT TO 28 WEEKS OF GESTATION OR MORE OCCURRING DURING ONE YEAR IN EVERY 1000 TOTAL BIRTHS ).
IN INDIA THE SRS ESTIMATES FOR THE YEAR 2003 FOR THE WHOLE COUNTRY IS ABOUT 9 PER 1000 BIRTHS (9 FOR THE RURAL & 8 FOR THE URBAN AREAS).

PERINATAL MORTALITY RATE

PERINATAL MORTALITY INCLUDES BOTH LATE FOETAL DEATH AN EARLY NEONATAL DEATHS THE EIGHT REVISION OF THE INTERNATIONAL CLASSIFICATION OF DISEASE DEFINED THE PERINATAL PERIOD AS LASTING FROM THE 28th WEEK OF GESTATION TO THE 7th DAY AFTER BIRTH THE NINTH REVISION OF ICD ADDED THAT : BABIES CHOSEN FOR INCLUSION IN PERINATAL STATISTICS SHOULD BE THOSE ABOVE A MINIMUM BIRTH WEIGTH i.e. 1000g AT BIRTH IF THE BIRTH WEIGHT IS NOT AVAILABLE A GESTATION PERIOD OF AT LEAST 28 WEEKS SHOULD BE USED AND WHERE ABOVE ARE NOT AVAILABLE, BABY LENGTH OF AT LEAST 35cm SHOULD BE USED

WHO DEFINED :LATE FOETAL DEATHS (28 WEEKS GESTATION AND MORE) + EARLY NEONATAL DEATHS (FIRST WEEK) IN ONE YEAR PMR (IN PER 1000) = LIVE BIRTHS IN THE SAME YEAR

MAIN CAUSES :INTRAUTERINE & BIRTH ASPHYXIA LOW BIRTH WEIGHT BIRTH TRAUMA & INTRAUTERINE OR NEONATAL INFECTIONS

 NEONATAL DEATHS ARE DEATHS OCCURRING DURING THE NEONATAL PERIOD, COMMENCING AT BIRTH & ENDING 28 COMPLETED DAYS AFTER BIRTH . NEONATAL MORTALITY RATE IS THE NUMBER OF DEATHS IN A GIVEN YEAR PER 1000 LIVE BIRTHS IN THAT YEAR CUASES OF NEONATAL MORTALITY : LOW BIRTH WEIGHT & PREMATURITY BIRTH INJURY & DIFFICULT LABOUR SEPSIS CONGENITAL ANOMALIES HAEMOLYTIC DISEASES OF NEWBORN CONDITIONS OF PLACENTA & CORD DIARRHOEAL DISEASES ACUTE RESPIRATORY INFECTIONS TETANUS

INFANT MORTALITY RATE

DEFINE AS THE RATIO OF INFANT DEATHS REGISTERED IN A GIVEN YEAR TO THE TOTAL NUMBER OF LIVE PER 1000 LIVE BIRTHS

INFANT MORTALITY IN INDIA, MP & INDORE

AREA RURAL URBAN COMBINED

INDIA

64

40

58

MADHYA PRADESH

84

56

79

INDORE

CAUSES OF INFANT MORTALITY IN INDIA

IN B R OAD C AT E G OR Y T HE C AUS E S
P R E MATUR ITY AC UTE R E S P IR ATO R Y INF E C TIO N DIAR R HO E AL DIS E AS E S C O NG E NITAL MAL F O R MATIO N B IR TH INJ UR IE S C O R D INF E C TIO N O THE R C AUS E S 18% 2% 3% 5% 4% 17% 51%