Statistics in India

SUMMARY OFHEALTH AND FAMILY WELFARE PROGRAMME IN INDIA

Health and Family Welfare Statistics in India 2017 Executive SummaryThe Ministry of Health and Family Welfare has been bringing out a statistical publicationtitled “Family Welfare Statistics in India”. The publication has been renamed in 2013 as“Health and Family Welfare Statistics in India”. The publication presents the most up-to-date data on demographic indicators and performance of various programmes. The2017 edition contains the following eight Sections.Section “A” (Tables: A.1 to A.60) covers Population and Vital Statistics indicatorslike population, sex ratio, rural & urban composition, child population, percentagedistribution of population by age and sex, number of married couples, life expectancyat birth, fertility indicators, age specific fertility rates by educational levels, age specificdeath rates by sex, infant mortality rate by sex, child mortality rate, Maternal MortalityRatio, etc. Analysis of some of the important indicators, is given in the “Over View” (Para1.1 to 5.11).Performances of Family Welfare Programmes, MTP services, etc. are covered inSection-“B” (Tables-B.1 to B.15). Para 6.0 to 6.4.8 discusses some of these importantparameters in the “Overview”.Section “C” (Tables C. 1 to C. 11) of the publication covers State-wise data on Targets/Need Assessed and Achievements of Maternal Health Activities, Tetanus Immunisationfor Expectant Mothers, Prophylaxis against nutritional anaemia among women, Numberof pregnant women received 3 ANC checkups, Number of women given TT2/Booster,Number of women having Hb level < 11 (tested cases), Number of newborn visitedwithin 24 hrs of home delivery, Number of women discharged within 48 hrs of deliveryfrom public facility, Number of Still Births, Number of women receiving post partumcheck-up within 48 hours after delivery, etcThe Section-“D” presents data on Child Health. The Universal ImmunizationProgramme (UIP) includes six vaccine-preventable diseases (tuberculosis, diphtheria,pertussis (whooping cough), tetanus, poliomyelitis, and measles) and services areprovided free of cost to all. State-wise data on Targets and Achievement made in respectof these vaccine-preventable diseases are presented in Tables D-1 to D- 2.6. State-wisedata on Targets and Achievement made in respect of administration of Vitamin – A tochildren (First Dose, Fifth Dose and 9th Dose) is brought in Tables D-2.7 to D-2.9. Dataon number of newborns breastfed within one hour, number of newborns weighed at thetime of birth and found to be weighing less than 2.5 Kg (State-wise) is presented in TablesD-3 to D-5. These data on Maternal and Child Health Indicators is an aggregation offacility/district level data which is uploaded on Health Management Information System(HMIS) portal of the Ministry by States/UTs.The Section- “E” of the report provides data on findings of Surveys on Health andFamily Welfare Key Indicators. A number of large scale surveys are being carried outby the Ministry from time to time to assess the performance of various health and familywelfare programmes. These surveys inter-alia include, National Family Health Survey(NFHS), District Level Household and Facility Survey (DLHS), Annual Health Survey56

Health and Family Welfare Statistics in India 2017(AHS), Coverage Evaluation Survey CES), Rapid Survey on Children (RSOC) etc. Thischapter captures indicators pertaining to Marriage and Fertility, Family Planning, MaternalHealth, Child Health, Other Key Health Indicators like prevalence of HIV, Tuberculosis,Diabetes and Goiter; extent of utilization of health care services by households fromthese large surveys along with rural/urban break-up etc. Findings of the large scalesurveys viz. NFHS, DLHS, CES, RSOC are presented in Tables E.1 to E.29.Data in Section-“F” (Tables F.1 to F.3) provides information on selected indicatorsfrom Annual Health Survey (AHS) and Concurrent Evaluation of National Rural HealthMission.The Section-“G” provides information on Infrastructure. The Health Services areprovided to the community through a network of Sub-centres (SCs), Primary HealthCentres (PHCs) and Community Health Centres (CHCs) in the rural areas and Hospitalsand Dispensaries etc. in the urban areas. Data on availability of physical and humanresource infrastructure, Drinking Water and Latrine Facilities from Census 2011 arepresented in Tables G.1 to G.11Section-“H” covers “Important tables on key health indicators from NSS 71st roundhave been incorporated in this publication in table Nos H.1 to H.7Section-“I” covers information on key health indicators in respect of social categoriesviz. SC ST OBC and others from, National Family Health Survey-3 (2005-06), DistrictLevel Household & Facility Survey-III (2007-08) and Rapid Survey on Children(RSOC), 2013-14 conducted by UNICEF under the directions of M/O Women and ChildDevelopment and presented in Tables I.1 to I.23.The Annexures covers information on Demographic Indicators, Demographic Estimatesfor selected countries, District-wise rural/urban Population by Sex as per 2011 Census,year-wise BE, RE and actual expenditure relating to Department of Family Welfare/NRHM, Definitions and Important Health Days (Annexure I - VII). 57

Health and Family Welfare Statistics in India 2017 Overview Health and Family Welfare Statistics in India, 2017DEMOGRAPHIC PROFILE OF INDIA1.0 Vital Statistics1.1 As on 1st March, 2011 India’s population stood at 121 crore comprising of 62.3crore (51.5%) males and 58.7 crore (48.5%) females. India, which accounts for world’s17.5 percent population, is the second most populous country in the world next only toChina (19.4%). Of the 121 crore Indians, 83.4 crore (68. 9%) live in rural areas while37.7 crore ( 31.1%) live in urban areas.The population living in urban areas increased to 31.1% in 2011 from 27.8% in 2001.Increase in urban population is observed across all the States /UTs. The State of Keralaexperienced explosive increase in urban population from 26% in 2001 to 47.7% in 2011(Table-A 4).One of the important features of the last decade(2001-11) is that, it is the first decade(with the exception of 1911-21) which has actually added lesser population compared tothe previous decade. In absolute terms, the population of India has increased by about182.12 million during the decade 2001-2011 as compared to 182.3 million during 1991-2001.Among the States and Union territories, Uttar Pradesh is the most populous State with199.8 million people and Lakshadweep the least populated with 64,473 people.The contribution of Uttar Pradesh (UP) to the total population of the country is 16.5%followed by Maharashtra (9.3%), Bihar (8.6%), West Bengal (7.5%) and MadhyaPradesh (6.0). These six most populous States in the country accounts for 55% of thecountry’s population58

Health and Family Welfare Statistics in India 2017 Highlights of Census 2011 The rural population (83.3 crore) and urban Population (37.7 crore) constitutes 68.9% and 31.1% respectively of the total population of the country. Decennial growth of population during 2001-11 declined to 17.7% from 21.5% during 1991-2001. The decline is more prominent in rural population. During 2001-2011, for the first time, the growth momentum of population for the EAG States declined by about four percentage points. This, together with a similar reduction in the non-EAG States and Union territories, has brought down the rate of growth of population of the country by 3.8 percent as compared to 1991-2001. Though the child-sex ratio [0 to 6 years] has declined from 927 female per 1000 males in 1991-2001 to 919 females per 1000 males in 2001-2011, increasing trend in the child sex ratio was observed in Himachal Pradesh, Punjab, Chandigarh, Haryana, NCT of Delhi, Arunachal Pradesh, Mizoram, Gujarat, Karnataka, Goa, Kerala, Tamil Nadu and Andaman & Nicobar Islands. Literacy rate increased from 64.8% in 2001 to 73.0% in 2011. Female literacy increased sharply from 53.7% in 2001 to 64.6% in 2011 as compared to male literacy rate (75.3% in 2001 to 80.9% in 2011)1.2 Average Annual Exponential Growth Rate (AAEGR): The Average AnnualExponential Growth Rate (AAEGR) of population dipped sharply to 1.63 percent during2001-2011 from 2.16 percent during 1981-1991 and 1.97 percent during 1991-2001.Among the major States, Bihar, Jammu & Kashmir, Chattisgarh, Jharkhand, Rajasthan,NCT of Delhi, Madhya Pradesh, Uttar Pradesh, Haryana, Uttarakhand and Gujarat 59

Health and Family Welfare Statistics in India 2017recorded higher annual exponential growth rate as compared to the national averageduring 2001-2011. The State of Bihar registered the highest (2.27%) AAEGR and Kerala(0.48) registered the lowest.1.3 Decennial growth rate of population: The Decennial growth of populationduring 2001-11 declined to 17.7% from 21.5% during 1991-2001. It is significant thatthe percentage decadal growth during 2001-2011 has registered the sharpest declinesince independence. It declined from 23.87 percent during 1981-1991 to 21.54 percentduring period 1991-2001, a decrease of 2.33 percentage points. During 2001-2011, thisdecadal growth has become 17.7 percent, a further decrease of 3.8 percentage points.There has been a significant decline in decennial growth of population in rural areas.The decennial growth rate of population declined from 17.9% in 1991-2001 to 12.3% in2001-2011 in rural areas and in urban areas it increased from 31.2% to 31.8% duringthe same period (Table A- 3).At State level, growth rates varied widely. Nagaland with (-) 0.6% had the lowestdecadal growth rate. The phenomenon of low growth has started to spread beyond theboundaries of the Southern States during 2001-11, where in addition to Andhra Pradesh,Tamil Nadu and Karnataka in the South; Himachal Pradesh and Punjab in the North;West Bengal and Odisha in the East; and Maharashtra in the West have registered agrowth rate between eleven to sixteen percent in 2001-2011 over the previous decade.Among the larger States, Bihar registered the highest decadal growth rate of 25.4% andKerala the lowest (4.9%).Out of 35 States/UTs, 9 States/UTs have shown negative decennial growth rate ofpopulation during 2001-11 in rural areas. These States/UTs are Andaman & NicobarIslands (-1.2%), Chandigarh (-68.5%), Lakshadweep (-58.0%), Delhi (-55.6%), Daman& Diu (-40.1%), Kerala (-25.9%), Goa (-18.5%), Nagaland (-14.6%) and Sikkim (-5.0%).The decennial growth rate of population in urban areas of States / UTs varied widely in2001-11. As compared to 1991-2001, 13 States / UTs viz. Andhra Pradesh, ArunachalPradesh, Bihar, Gujarat, Karnataka, Kerala, Manipur, Sikkim, Tripura, West Bengal,Daman & Diu, Lakshadweep and Puducherry had higher decennial growth rate in 2001-11 as compared to the period 1991-2001. (Table-A 4)Traditionally, for historical reasons, some States depicted a tendency of higher growthin population. Recognizing this phenomenon, and in order to facilitate the creationof area-specific programmes, with special emphasis on eight States that have beenlagging behind in containing population growth to manageable limits, the Governmentof India constituted an Empowered Action Group (EAG) in the Ministry of Health andFamily Welfare in March 2001. These eight States were Rajasthan, Uttar Pradesh,Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh and Odisha, whichcame to be known as ‘the EAG States’. During 2001-11, the rate of growth of populationin the EAG States except Chhattisgarh has slowed down (Table-A-4 ). For the first time,the growth momentum of population in the EAG States has given the signal of slowingdown, falling by about four percentage points. This, together with a similar reduction inthe non-EAG States and Union territories, has brought down the rate of growth for thecountry by 3.8 percentage points during 2001-11 as compared to 1991-2001.60

Health and Family Welfare Statistics in India 2017It is significant to note that the decennial growth rate of population has dropped bothin rural and urban areas of Assam, Haryana, Himachal Pradesh, Jammu & Kashmir,Maharashtra, Uttar Pradesh, Rajasthan, Madhya Pradesh, Odisha Meghalaya, Mizoram,Nagaland, Punjab, Andaman & Nicobar Islands, Dadra & Nagar Haveli and Chandigarhwhile in Bihar it is limited to rural areas only during 2001-11 as compared 1991-2001.1.4 Literacy level: According to 2011 census, the literacy rate went up from 64.8 percent in 2001 to 73.0 per cent in 2011 — showing an increase of 8.2 percentage points.Significantly, the female literacy level saw a significant jump as compared to males. Thefemale literacy in 2001 was 53 per cent and it has gone up to 64.6 per cent in 2011. Themale literacy, in comparison, rose from 75.3 to 80.9 per cent (Table A-9).Kerala, with 94.0 per cent literacy, continues to occupy the top position among Statesas far as literacy is concerned while Bihar remained at the bottom of the ladder at 61.8per cent. Ten States and Union territories, including Kerala, Lakshadweep, Mizoram,Tripura, Goa, Daman and Diu, Puducherry, Chandigarh, NCT of Delhi and Andamanand Nicobar Islands have achieved a literacy rate of above 85 per cent.1.5 Sex Ratio: According to Census of India 2011, the sex ratio has shown someimprovement in the last 10 years. It has gone up from 933 in 2001 census to 943 in 2011census. Kerala has the highest sex ratio (1084) followed by Puducherry (1037). Damanand Diu has the lowest sex ratio of 618. The Sex Ratio in Arunachal Pradesh (938), Bihar(918), Gujarat (919), Haryana (879), Jammu & Kashmir (889), Madhya Pradesh(931),Maharashtra (929), Nagaland(931), Punjab(895), Rajasthan(928), Sikkim (890) andUttar Pradesh (912) is lower than the national average. All UTs except Puducherry andLakshadweep also have lower Sex Ratio as compared to national average (Table A- 10). 61

Health and Family Welfare Statistics in India 20171.6 Child Sex Ratio: Census 2011 marks a considerable fall in child sex ratio (0-6years) from 927 to 919 (8 points) during 2001-2011. In rural areas, the fall has been tothe tune of 11 points (934 to 923) and in urban areas, the decline has been of 1 point(906 to 905) over the last decade. Delhi (814) has recorded the lowest and Chhattisgarh(977) the highest child sex ratio in the rural areas. Haryana (832) has recorded thelowest and Puducherry (975) the highest child sex ratio in urban areas.2.0 POPULATION PROJECTIONS2.1 Population Projections: The population projections based on 2001 Census forthe country, individual States and Union territories up to the year 2026 made by theTechnical Group constituted by the National Commission on Population (NCP) underthe Chairmanship of Registrar General & Census Commissioner, India, reveals thatthe country’s population would reach 1.4 billion by 2026. Another Technical Group onPopulation Projection has been formed to give population projections based on thelatest data from Census 2011 and other sources. The report of the Technical Group isawaited.The projected population and proportion (percent) of population by broad age-group ason 1st March, 2001-2026 as per “Report of the Technical Group on Population Projections– Ministry of Health & Family Welfare (May 2006)” are given in the Table below: - Percent Year Population 0-14 15-59 15-49 (years) 60+ (in millions) (years) (years) (Female (years) Population) 2001 1029 35.4 57.7 51.1 6.9 2006 1112 32.1 60.4 53.1 7.5 2011 1193 29.1 62.6 54.5 8.3 2016 1269 26.8 63.9 54.8 9.3 2021 1340 25.1 64.2 54.1 10.7 2026 1400 23.4 64.3 53.3 12.462

Health and Family Welfare Statistics in India 20173.0 DEMOGRAPHIC and HEALTH STATUS INDICATORS3.1 The demographic and health status indicators have shown significantimprovements over time. The Table below captures data on Crude Birth Rate, CrudeDeath Rate, and Life Expectancy etc. S. Parameters 1951 1981 1991 2001 CurrentNo. Levels1 Crude Birth Rate (per 40.8 33.9 29.5 25.4 20.4 (2016) 1000 population2 Crude Death Rate 25.1 12.5 9.8 8.4 6.4 (2016) (per 1000 population)3 Total Fertility Rate 6.0 4.5 3.6 3.1 2.3 (2015)4 Maternal Mortality Ratio NA 398 301 167 (per 100,000 live births) NA SRS (2001- SRS (2011-13) (1997-98) 03) 34 (2016)5 Infant Mortality Rate 146 110 80 66 (per 1000 live births) (1951- 61) Expectation of life at NA 55.4 59.4 63.4 68.3 37.1 55.4 59.0 62.3 66.96 birth (in years) Person 36.1 55.7 59.7 64.6 70.0 -Male (1951) (1981- (1989-93) (1999- (2011-2015) 85) 03) -Female Source: Office of the Registrar General & Census Commissioner, India NA – Not available3.2 Crude Birth Rate (CBR): The Crude Birth Rate declined from 29.5 in the 1991 to25.4 in 2001 and further declined to 20.4 in 2016. The CBR is higher (22.1) in rural areasas compared to urban areas (17.0) in 2016. Bihar recorded the highest CBR (26.8) andAndaman & Nicobar Islands the lowest (11.7). Bihar (26.8), Assam (21.7), Chhattisgarh(22.8), Haryana (20.7) Jharkhand (22.9), Rajasthan (24.3), Madhya Pradesh (25.1),Uttar Pradesh (26.2), Meghalaya (23.7), Dadra & Nagar Haveli (24.5) and Daman & Diu(24.0) 63

Per 000's PopulationHealth and Family Welfare Statistics in India 2017 Crude Birth Rate 40 35 30 25 20 15 1981 1991 2001 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 T otal 33.9 29.5 25.4 23.8 23.5 23.1 22.8 22.5 22.1 21.8 21.6 21.4 21.0 20.8 20.4 Rural 35.6 30.9 27.1 25.6 25.2 24.7 24.4 24.1 23.7 23.3 23.1 22.9 22.7 22.4 22.1 Urban 27.0 24.3 20.3 19.1 18.8 18.6 18.5 18.3 18.0 17.6 17.4 17.3 17.4 17.3 17.0recorded higher CBR as compared to the national average. The CBR is higher in ruralareas as compared to urban areas in all States/UTs except Kerala, Goa, Sikkim, Dadra& Nagar Haveli , Daman & Diu and Puducherry. (Table A-26 & A27).3.3 Expectation of Life at Birth: Data are presented on life expectancy by sexfor India and States for 1970-75 to 2011-15 using data from the Sample RegistrationSystem and other sources in Table A-19.# Excluding Jammu & KashmirThe data reveals that there is a remarkable increase in life expectancy at birth. Thefemale expectation of life at birth in general, is higher than male life expectancy.The life expectancy at birth for males was 66.9 years as compared to females, 70.0years according to SRS Based Abridged Life Tables 2011-15. Urban Male (70.5 years)64

Health and Family Welfare Statistics in India 2017and Urban Female (73.5 years) have longer life span as compared to their rural counterparts.Within the States, the expectation of life (Total population) at birth is higher in urbanareas as compared to rural areas. (Table A-20).According to the projections made by the “Technical Group on Population Projections”life expectancy at birth (e00) in the case of male population is likely to reach 68.8 yearsby 2016-20 and 69.8 years by 2021-25 from the present level. In the case of femalepopulation, it is likely to reach 71.1 years by 2016-20 and 72.3 years by 2021-25(Table-A.21)4.0 FERTILITY INDICATORS4.1 General Fertility Rate (GFR): It is a refined measure of fertility and defined asthe number of live births per thousand women in the reproductive age-group 15-49years. The GFR for all-India and bigger States is given in Table –A-32 for the year 2015.At the national level, 76.2 children were born per thousand women aged 15-49 years in2015. This number varies from 60.8 in urban areas to 83.8 in rural areas in 2015. TheGFR is consistently higher in rural population as compared to urban population. 65

Health and Family Welfare Statistics in India 2017Among the bigger States, GFR varies widely from 53.0 in Kerala to 104.0 in Bihar. TheGFR is higher in 8 bigger States viz. Assam (80.2), Bihar (104.0), Chhattisgarh (83.5),Haryana (78.5), Jharkhand (86.6), Madhya Pradesh (96.2), Rajasthan (91.7) and UttarPradesh (99.5) as compared to national average (76.2) in 2015.4.2 Total Fertility Rate (TFR): The Total Fertility Rate (TFR) of a population is theaverage number of children that would be born to a woman during her reproductive age.The TFR has declined from 2.8 in 2006 to 2.3 in 2015 which accounts for a decline of about17.9%. The TFR in rural areas has declined from 3.1 in 2006 to 2.5 in 2015 whereas thecorresponding decline in urban areas has been from 2.0 to 1.8 during the same period.It is observed that the TFR in urban areas remained at the same level at 1.9 during 2010and 2011 after remaining at 2.0 for four consecutive years (2006-2009) and decreasedto 1.8 in 2012 and remained at the same level till 2015. Among the bigger States, WestBengal has the lowest TFR of 1.6 and the highest TFR recorded is 3.2 for Bihar. ThirteenStates out of 22 bigger States have achieved the replacement level of fertility i.e. TFRof 2.1 in 2015 viz. Andhra Pradesh (1.7), Delhi (1.7), Himachal Pradesh (1.7), Jammu& Kashmir (1.6), Karnataka (1.8), Kerala (1.8), Odisha (2.0), Maharashtra (1.8), Punjab(1.7), Tamil Nadu (1.6) , Telangana (1.8), Uttarakhand (2.0) and West Bengal (1.6).With the exception of Kerala where the TFR is same for both rural and urban Population(1.8) during 2015, in all other bigger States the rural TFR is higher as compared tourban TFR. However, the difference is marginal in Andhra Pradesh, Delhi, Karnataka,Punjab,Tamil Nadu and Uttarakhand –Table A-28.The graph presented below reveals the relationship between TFR and level of education.It is observed that TFR declines as the literacy level increases (Table A-34).66

Health and Family Welfare Statistics in India 20174.3 Fertility by age of women: Age of women is an important factor in determiningthe fertility levels. On the basis of data on births to women by specific age groups in thereproductive span (as available from SRS for 2015), measures such as Age SpecificFertility Rates (ASFR) & Age Specific Marital Fertility Rates (ASMFR) are computed.ASFR is defined as the number of children born to women in the said age group per1000 women in the same age group and ASMFR as the number of children born tomarried women in the said age group per 1000 women in the same age group. TableA-31 presents ASFR and ASMFR data separately for rural and urban areas, for theyears 2006 to 2015.It is observed that ASMFRs are higher than ASFRs in all age groups as ASMFR coversonly married women. The data on these two indicators also reveals that fertility in all theage groups is higher in rural areas than in urban areas. The fertility reaches the peak inthe age group 20-24 and declines thereafter. Both these indicators are lower in urbanareas as compared to rural areas in almost all years. However, the ASMFR increasedto 359.6 in 2015 from 292.9 in 2014 in rural areas but the ASFR marginally decreasedto 192.7 from 195.6 during the same period for the age group 20-24 in the rural areas(Table A-31). In Bihar, Jharkhand, Rajasthan and Uttar Pradesh the fertility contributionof the high age groups (>35 years age group) is relatively high as compared to otherStates. Kerala, Tamil Nadu, Andhra Pradesh, Telangana, Maharashtra, Karnataka,Himachal Pradesh, Punjab and West Bengal are better off as the fertility contribution ofhigh fertility group is lesser (Table A-33).4.4 Mean Age at Effective Marriage (Female): Age at effective marriage (Female)is a very important demographic predictor as it relates to number of years a couple isexposed to pregnancy and the family size. The data reveals that there is no significantchange in the mean age at effective marriage in India as it increased from 20.5 years in2006 to 22.1 in 2015. Jammu & Kashmir (24.8) had the highest and West Bengal (21.0)had the lowest mean age at effective marriage (Table A-22). 67

Health and Family Welfare Statistics in India 2017Fertility reduction takes place as the age at effective marriage (Female) increases. Thedata reveals that the percentage of females who had the effective marriage in the agegroup of <18 years and 18-20 years has dropped while it increased in the 21+ age group(Table A-24).The data also reveals that in 2015, the highest percentage of female effective marriageoccurred in the age group 18-20 years in rural areas (40.4%) and in the age group of21+ years in the urban areas (72.1%).68

Health and Family Welfare Statistics in India 2017Percentage of females who had their effective marriage before 18 years has comedown over the years (2006 to 2015) in almost all major States (rural and urban), while ithas increased in the age group 21+. The State with the highest percentage of femaleswho had their effective marriage before 18 is West Bengal (3.7%) and the Delhi (0.8%)having the lowest percentage - Table A-24.5.0 MORTALITY INDICATORS5.1 Crude Death Rate (CDR): It gives the number of deaths that occur per 1000people in a year. The CDR, which was stagnant during 2007 and 2008 at 7.4, camedown to 7.2 in 2010 and further declined to 6.4 in 2016. The CDR has been consistentlyhigher in rural areas as compared to urban areas over the years. (Table A.41)The CDR varies widely across the States. Odisha has the highest (7.8) CDR and Delhiand Dadra & Nagar Haveli has the lowest (4.0) in 2016. Thirteen States/UTs viz. AndhraPradesh (6.8) ,Assam (6.7), Chhattisgarh (7.4), Karnataka (6.7), Kerala (7.6), MadhyaPradesh (7.1), Odisha (7.8) Uttar Pradesh (6.9),Uttarakhand (6.7) Goa (6.7),HimachalPradesh (6.8), Meghalaya (6.6) and Puducherry (7.2) had higher CDR as compared tonational average. The CDR is higher in rural areas as compared to urban areas acrossall States and UTs except in the case of Kerala, West Bengal Manipur, Tripura, andChandigarh, where the CDR is higher in urban areas as compared to rural areas (TableA-41).5.2 Age-specific Death Rates (ASDR): The ASDR for the year 2014 was 10.6 per1000 population in the age-group 0-4 years; it drastically declined in the next age-group(5-9 years) to 0.6. Thereafter, the ASDR gradually increased in each age-group to reachto the level 17.8 per 1000 in the age-group 60-64 years and continued to increase toreach finally to the level 242.1 per 1000 population in the last age-group, 85+. 69

Health and Family Welfare Statistics in India 2017The Crude Death Rate (CDR) or Age-specific Death Rate (ASDR) for all ages isdeclining over the years (7.5 in 2006 to 6.5 in 2015) but the rural-urban and Male –Female differentials are still high (Table A- 46)70

Health and Family Welfare Statistics in India 20175.3 Infant Mortality Rate (IMR): Infant and childhood mortality-reduction continuedto be national priority since the First Five Year Plan. According to SRS, the IMR atnational level was 34 per 1000 live births in 2016 as compared to 37 in 2015.In 2016, the highest infant mortality was in Madhya Pradesh (47) and the lowest inKerala (10) among the bigger States. Assam (44), Bihar (38), Chhattisgarh (39), Odisha(44), Madhya Pradesh (47), Odisha (44), Rajasthan (41) , Uttar Pradesh (43) andUttarakhand (38) recorded higher IMR as compared to the national average. Amongthe smaller States Arunachal Pradesh (36), Meghalaya (39), reported the highest IMRwhile Goa (8) the lowest (Table-A-44).Female infants continue to experience a higher mortality than male infants in 2016. It ishigher in respect of female infants (36) as compared to male infants (33). This variationis prevalent among all the major States (Table A-44).The IMR is higher in rural areas (38 per 1000 live births) as compared to urban areas(23). Rural areas of Madhya Pradesh registered the highest IMR (50) followed by Assam,Uttar Pradesh and Odisha (46) and Rajasthan (45)- (Table-A-45). 71

Health and Family Welfare Statistics in India 20175.4 Neo-natal Mortality Rate (NMR): According to the Sample Registration Systemestimates -, the Neonatal Mortality Rate in 2015 was 25 per 1000 live births, neo-natalmortality accounts for 67.8% of infant mortality at the national level and varies from59.8% in urban areas to 69.6% in rural areas. Among the bigger States, Jammu &Kashmir registered the highest percentage (76.2%) of neo-natal to infant deaths andKerala registered the lowest (52.1%).Neo-natal mortality refers to number of infants dying within four weeks of birth. Neo-natal health care is concerned with the condition of the newborn from birth to 4 weeks(28 days) of age. Neo-natal survival is a very sensitive indicator of population growthand socio-economic development. The survival rate of female infants correlates tosubsequent population replacement. The neo-natal mortality rate which was stagnantat 37 per 1000 live births during 2003 to 2006 marginally came down to 36 in 2007,35 in 2008, 34 in 2009, 33 in 2010, 31 in 2011, 29 in 2012, 28 in 2013 and stood at 25during 2015. The neo-natal mortality rate is very high in rural areas (29 per 1000 livebirths) as compared to 15 in urban areas in 2015. The neonatal mortality rate also variesconsiderably among States. Bihar (28), Chhattisgarh (27), Madhya Pradesh (34), UttarPradesh (31), Odisha (35) and Rajasthan (30) recorded higher neo-natal mortality rateas compared to national average. The Neo-natal mortality rate is the lowest in Kerala(6) – (Table A-47).5.5 Post-Neo-Natal Mortality Rate (PNMR): Refers to number of infant deathsbetween 28 days and one year of age per 1000 live births. The Post Neo natal MortalityRate came down to 12 in 2015 from 16 in 2009. It is higher in rural areas (13) ascompared to urban areas (10) (Table A-43)5.6 Peri–natal Mortality Rate: Refers to number of still birth and deaths within 1stweek of delivery per 1000 live births. The Peri-natal Mortality Rate decreased from 3772

Health and Family Welfare Statistics in India 2017in 2007 to 23 in 2015. It is higher in rural areas (26) as compared to urban areas (15)during 2015. The Peri-natal Mortality Rate significantly varied across the States. Keralawith the Peri-natal Mortality Rate of 9 is the best performing State and Odisha with theRate of 33 is the least performing State during 2015 (Table A- 49)5.7 Still Birth Rate (SBR): The SBR came down to 4 in 2015 from 5 in 2012.The rural and urban variation is vague at All India level though wide variations areprominently noticed across Major States during 2015(Table A-50). The reporting of stillbirth for registration from domiciliary events is almost negligible and there is scope forthe improvement in netting of still birth events.5.8 Under-five Mortality Rate (U5MR): The U5MR, representing deaths of childrenof age under 5 per 1000 live births, has started declining over the years. Accordingto the SRS data released by Registrar General of India, the U5MR declined from 69deaths per 1000 live births in 2008 to 64 in 2009, to 59 in 2010 to 55 in 2011 to 52 in2012, 49 in 2013, 45 in 2014 and further to 43 in 2015 in India. The U5MR is higher inrural areas as compared to urban areas.Large variations are observed in Under Five Mortality Rate across the State both in ruraland urban areas (Table A-51). 73

Health and Family Welfare Statistics in India 2017Rural areas of Madhya Pradesh (67) had the highest U5MR in 2015 closely followed byAssam (65), Odisha (59) Rajasthan (55) and Uttar Pradesh (54). In urban areas, Biharhad the highest U5MR (47) and Kerala (11) the least in 2015.5.9 Causes of Death among Infants: Reduction in infant and child morality hasbeen the priority area over the Plan periods. Latest available data from SRS on top 10Causes of Death in India 2010-2013 (Table A-56) indicate that Prematurity & low birthweight, Pneumonia, Birth asphyxia & birth trauma, Other noncommunicable diseasesand Diarrhoeal diseases are the five major causes of death among infants. Causes of death among infant (age below 1 as %) - India (2010-13) Prematurity & low birth weight Pneumonia Birth asphyxia & birth trauma Other noncommunicable diseases Diarrhoeal diseases III defined or cause unknown Congenital anomalies Acute bacterial spesis and and severe infections Injuries5.10 Maternal Mortality Ratio (MMR): MMR is the number of women who die due tocauses relating to pregnancy, childbirth & abortion per 100,000 live births. Deaths dueto pregnancy and during the child birth are common among women in the reproductiveage groups. Reduction of mortality of women has thus been an area of concern and theGovernment has set time bound targets to achieve it.India has made impressive achievement in MMR over the years. According to the latestSRS estimates, the Maternal Mortality Ratio (MMR) of India was 167 per one lakh livebirth (2011-13) as compared to 178 in 2010-12. Some States like Kerala (61), Tamil Nadu(79), and Maharashtra (68) have made remarkable progress in 2011-13 while someothers are lagging behind. The MMR is the highest in Assam (300) closely followed byUttar Pr/Uttarkhand (285) and Rajasthan (244). Kerala is the best performing State withMMR of 61 (Table-A 52)74

Health and Family Welfare Statistics in India 20175.11 Causes of Maternal Deaths: Prevailing high maternal morbidity and mortality hasalways been cause of concern. Available data from SRS for 2001-03 (Special Survey ofDeaths) indicate that the major causes of maternal mortality are Hemorrhage, Sepsis,Abortion, Hypertensive disorders and Obstructed Labour. In India, State/district specificmaternal morbidity/mortality data is not available (Table –A54).6.0 Achievements under various Programmes6.1 Reproductive Child Health (RCH) Programme: Reproductive and Child HealthProgramme, is an integral component of the National Health Mission. Important stepshave been taken within the mandate of this programme to ensure universal and equitableaccess to quality maternal and child health services based on the principle of continuumof care. RCH focussed on reducing social and geographical disparities in access toand utilisation of reproductive and child health services in order to accelerate theachievement of its goals. The major components of the RCH programme are MaternalHealth, Child Health, Nutrition, Family Planning, Adolescent and Reproductive Health(ARSH), Preconception and Prenatal Diagnostic Techniques Act etc. 75

Health and Family Welfare Statistics in India 2017India was the first country in the world to introduce a national family planning programmeas early as during the first five year Plan (1951-56), to address the issues of high fertilityand rapid population growth. Over the years, the programme has been expanded toencompass maternal and child health, family welfare and nutrition. The services aredelivered through a network of Community Health Centres, Primary Health Centres& Sub-centres in rural areas and Urban Family Welfare Centres, Urban Health Posts,Post Partum Centres and Hospitals in the urban areas.The figures given in the publication are based on the data reported by the State/UTs atdistrict/facility level on the HMIS portal of the Ministry of Health & Family Welfare ( https:// nrhm-mis.nic.in)and consolidated at State and National level.6.2 FAMILY PLANNING: According to the latest data, the total number of familyplanning acceptors in India decreased by 0.16% between 2015-16 and 2016-17. Thedata revealed that condom is the most preferred method of family planning whilesterilizations the least adopted means.The number of couples adopting various methods for family planning, including spacingmethods in 2016-17 was found to be 25.5 million with 10.1 million preferring condomsto any other means. The total number of Family Planning Acceptors in India has showna gradual decreasing trend after 2007-08. (Table-B.1)761980-81 1990-91 2000-01 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17

Health and Family Welfare Statistics in India 20176.2.1 Sterilizations: About 3.94 million people underwent sterilization during 2016-17.The number of Sterilization decreased by 2.08 lakhs (5.0%) in 2016-17 as compared to2015-16. Of the total sterilizations conducted, vasectomy (male sterilization) comprisedonly 1.9%.Of the total number of Sterilisations, Andaman & Nicobar had the highest percentageof vasectomies (30.5%) in 2016-17 while no vasectomy has been reported in the State/UT of Mizoram and Lakshadweep. The number of vasectomies carried out in almost allbigger States is quite insignificant as compared to number of tubectomies (Table- B.8).Of the total tubectomy operations carried out in the country, 36.4% reported accountsfor Laparoscopic tubectomies during 2016-17. Laparoscopic Tubectomies are moreprominent in Himachal Pradesh (87.5%) followed by Madhya Pradesh (84%), Rajasthan(79.7%), Tripura(73.7%), Assam (71.7%), Uttar Pradesh (69.3%), Uttarakhand (61%),Nagaland (58.8%), Delhi (57.8%), Jammu & Kashmir (57.8%), Daman & Diu (53.6%)and Dadra & Nagar Haveli (52.3%). (Table-B.9).6.2.2 IUD Insertions: At the national level, the number of IUD insertions during 2016-17 showed an increase of 7.76% as compared to 2015-16. The bigger States showingincrease in performance during 2016-17 are Andhra Pradesh, Assam, Chhattisgarh,Gujarat, Jharkhand, Maharashtra, Odisha, Rajasthan, Jammu & Kashmir, Uttar Pradeshand West Bengal while usage has gone down in Bihar, Haryana, Karnataka, Kerala,Madhya Pradesh, Punjab, Tamil Nadu and Telangana (Table–B.5).6.2.3 Use of Condoms: According to the available data, the number of equivalentcondom users increased marginally from 4.42 million in 2015-16 to 4.57 million in2016-17 under Free Distribution Scheme but under Social Marketing Scheme, it hasdecreased from 6.5 million in 2015-16 to 5.6 million in 2016-17. So overall at India level,the condom users has decreased from 10.9 million in 2015-16 to 10.1 million in 2016-17.The increase in condom users under free distribution during 2016-17 has been observedin 9 major States viz. Andhra Pradesh, Assam, Bihar, Gujarat, Haryana, Karnataka,Kerala, Odisha, Tamil Nadu, Telangana and West Bengal as compared to 2015-16. Thesignificant observation is that the number of takers of free condoms increased by 3.4%in 2016-17 as compared to previous year whereas in 2015-16. However, the number ofusers has decreased in the case of Social Marketing Scheme. (Table–B.6). 77

Health and Family Welfare Statistics in India 20176.2.4 Oral Contraceptive Pill Users: During the year 2016-17, 3.47 million Oral PillUsers were worked out under free distribution scheme as against 3.3 million in 2015-16.Among major States, Andhra Pradesh, Assam, Gujarat, Haryana, Jharkhand, Karnataka,Kerala, Maharashtra, Punjab, Tamil Nadu, Telangana, Uttar Pradesh and West Bengalhave reported increased number of Oral Pill Users in 2016-17 as compared to 2015-16under free distribution scheme while in respect of other major States, there was dropin the number of users. Under social marketing scheme, the oral pill users have alsoimproved and increased from 1.65 million in 2015-16 to 1.99 million oral pill users during2016-17. In overall at India level, the oral pill users increased from 4.97 million in 2015-16 to 5.45 million during 2016-17 (Table B-7).6.3 Maternal Health: Maternal health refers to the health of women during pregnancy,childbirth, aborton and the postpartum period.6.3.1 Antenatal care (ANC): ANC is the systemic medical supervision of women duringpregnancy. Its aim is to preserve the physiological aspect of pregnancy and labour and toprevent or detect, as early as possible, all pathological disorders. Early diagnosis duringpregnancy can prevent maternal ill-health, injury, maternal mortality, foetal death, infantmortality and morbidity. During 2015-16, 28.5 million women got registered for ANC checkupand 22.9 million underwent 3 ANC check -ups during the pregnancy period.6.3.2 Tetanus Immunization for Expectant Mothers (II + Booster): The TetanusToxoid (TT) vaccine is given during pregnancy to prevent tetanus to the expectantmother as well as the baby. According to data reported on HMIS portal, 23.2 Millionexpectant mothers were immunized against tetanus during 2016-17 accounting for anachievement of 78.0 % as against the need assessed. Wide variations were observedacross the States / UTs in achievement as against the target. The achievement was thelowest in Arunachal Pradesh (47.7%) (Table-C-2).6.3.3 Prophylaxis against Nutritional Anaemia: The conception and the subsequentweeks afterwards is the time when the expectant mother needs extra nutrients. Tomeet the requirement of additional nutrients, expectant mothers are given nutritionalsupplements. During 2016-17 23.6 million pregnant women benefitted against the targetof 29.7 million pregnant women accounting for an achievement of 79.6%. State-widevariations in achievement are quite glaring (Table- C-3).6.3.4 Institutional Deliveries: Maternal and Child Health Programmes haveaggressively promoted Institutional Deliveries in India. Out of 20.6 million deliveries(Institutional + home) reported on the HMIS portal in 2016-17 more than 18.6 milliondeliveries were reported institutional which account for 90.3% of total reported deliveriesas compared to 88.4 % in 2015-16. The percentage of institutional deliveries steadilyincreased from 81.7% in 2011-12 to 90.3% in 2016-17. States/UTs reported with anachievement of more than 90% institutional deliveries in 2016-17 include AndhraPradesh (98.5%), Chhattisgarh (92.1%), Gujarat (98.9%), Haryana (92.5%), Jharkhand(90.5%), Karnataka (99.6%), Kerala (99.9%), Madhya Pradesh (91.1%), Maharashtra( 99.1%), Odisha (92.4%), Punjab (95.1%), Rajasthan (96.9%), Tamil Nadu (100%),Telangana ( 99.3%), West Bengal (92.6%), Arunachal Pradesh (93.0%), Delhi (93.9%),78

Health and Family Welfare Statistics in India 2017Goa (99.9%), Jammu & Kashmir (92.5%), Sikkim (98.4%), Tripura (90.3%), Andaman &Nicobar Islands (97.5%), Chandigarh (99.6%), Dadra & Nagar Haveli (99.5%), Daman& Diu (99.4%), Lakshadweep (100.0) and Puducherry (100.0%) (Table- C-6).6.3.5 Number of Deliveries Conducted at Home: The current policy of Governmentof India under NHM is to encourage institutional delivery which is an important stepin lowering the maternal mortality. However, home based deliveries are still prevalentin the country though the number is decreasing over the years. According to the dataavailable on HMIS Portal, the number of deliveries conducted at home has come downto 19.9 lakhs in 2016-17 from 38.8 lakhs in 2011-12. It is observed that medical attentionprovided to new born at home has significantly increased over the years. The percentageof newborns visited within 24 hours of home delivery has increased from 62.3 in 2011-12 to 67.4% in 2016-17. No. of newborns visited within 24 hours of home deliveryPostpartum checkups are extremely important for a woman after the delivery. Accordingto the HMIS data, the percentage of women receiving postpartum check-up within 48hours of delivery increased during 2016-17 as compared to 2015-16 (Table C.8).6.3.6 Medical Termination of Pregnancy (MTP): To provide safe abortions, mostcountries have enacted laws whereby only qualified Gynecologists / doctors andapproved clinics / hospitals can perform abortions under certain laid down conditions.During the reference period (2016-17), 7,32,349 MTPs were performed as against7,02,403 in 2015-16. Maharashtra with 1,95,343 MTPs tops the list in bigger Stateswhile Telangana is at the bottom of the ladder ( 2435) -Table B.15.6.4 Child Health6.4.0 Immunization: Immunization programme aims to reduce mortality andmorbidity due to Vaccine Preventable Diseases (VPDs), particularly for children. India’simmunization programme is one of the largest in the world in terms of quantities of 79

Health and Family Welfare Statistics in India 2017vaccines used, numbers of beneficiaries, number of immunization sessions organizedand the geographical area covered. Under the immunization program, vaccines used toprotect children and pregnant mothers include the following: • Tuberculosis • Diphtheria • Pertussis • Polio • Measles • TetanusIn India, some other vaccinations like Hepatitis B, Japanese Encephalitis etc. are alsoundertaken.6.4.1 DPT Immunization for Children: The DPT is an immunization or vaccine toprotect against the diseases of Diphtheria (D), Pertussis (P) and Tetanus (T). During2016-17, 2.6% lakhs children were given three doses of DPT against the corresponding8.3 million in 2015-16. The reasons for decrease in the achievement of DPTvaccine are due to the introduction of pentavalent vaccine. (Table - D1 and D2). TheGovernment of India had introduced pentavalent vaccine in the national immunizationprogramme in selected states. Pentavalent vaccine provides protection to a child from5 life-threatening diseases – Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib. DPT(Diptheria+Pertussis+Tetanus) and Hep B are already part of routine immunization inIndia; Hib vaccine is a new addition. Together, the combination is called Pentavalent.Hib vaccine can prevent serious diseases caused by Haemophilus influenzae type blike pneumonia, meningitis, bacteremia,epiglottitis, septic arthritis etc. Giving pentavalent vaccine reduces the number of pricksto a child, and provides protection from all five diseases.6.4.2 Polio: As compared to the 88.6% achievement in 2015-16, 87.5% percentchildren received the third dose of Polio vaccine in 2016-17. The percentage of childrenwho received third dose of polio ranges from 66.1% in Nagaland to more than 100% inStates like Jammu & Kashmir and Manipur during 2016-17. (Table - D1& D2.1).6.4.3 BCG: BCG vaccine is given for protection against tuberculosis, mainly severeforms of childhood tuberculosis. 23.8 million children of below one year age wereadministered BCG vaccine during 2016-17. The achievement in 2016-17 was 91.5%as against 94.3% in 2015-16. 9 States / UTs achieved more than 100% immunizationduring 2016-17. Puducherry achieved the highest percentage immunization in 2016-17and 2015-16. (Table D1 & D2.2).6.4.4 Measles: 23.11 million children of below one year age received measles vaccineduring 2016-17 as against 23.07 million children accounting for an achievement of 88.9%as against 89.8% in 2015-16. Jammu & Kashmir, Manipur, Mizoram, A&N Islands andLakshadweep achieved more than 100% vaccination in 2016-17 (Table- D1&D2.3).80

Health and Family Welfare Statistics in India 20176.4. 5 Tetanus: Vaccination against Tetanus was administered to 16.59 million (Needassessed: 25.44 Million) children of 5 years age (DT/DPT-5), 14.96 million children of10 years age (Need assessed: 25.1 million) and 14.6 million children of 16 years age(Need assessed: 27.8 Million) during 2016-17. The achievement against the assessedneed works out to 65.2%, 59.6% and 52.5% respectively for children in the age groupsof 5, 10 and 16 years. In the State of Bihar, only 25.2% children of age 5 years, 22.5%children of age 10 Years and 36.4% children of age 16 years, received TT immunizationduring 2016-17 (Tables- D 2.4 to D2.6).6.4. 6 Prophylaxis against Blindness due to Vitamin ‘A’ Deficiency: Vitamin A is animportant micronutrient for maintaining normal growth, regulating cellular proliferationand differentiation, controlling development, and maintaining visual and reproductivefunctions. Vitamin A deficiency has now been accepted as one of the major nutritionproblems among pre-school children and an important cause of childhood blindness.One of the approaches to control the childhood blindness is periodic administration ofthe vitamin-A doses. First dose is administered at below one year of age and secondto fifth doses are administered above one year. State-wise data on achievement madeagainst the need assessed for the years 2010-11 to 2016-17 are presented in Tables D2.7 to D.2.9. i) First dose of Vitamin- A was administered to 20.5 million children (Need assessed-26.0 million) of age over 6 months but under 1 year during 2016-17 accounting for an achievement of 78.7% as compared to 79.5% during 2015- 16. State-wise variations are quite visible. Among major States, Meghalaya had the highest percentage of achievement while Uttarakhand had the lowest. The percentage of achievement is lower than the national average in 16 States / UTs (Table 2.7). ii) Fifth dose of Vitamin- A was administered to more than 17.8 million children of under 3 years of age as against the assessed need of 24.74 million during 2016-17 accounting for an achievement of 72.0% as compared to 71.2% in 2015-16. State-wide variations are quite significant. Madhya Pradesh had the highest achievement while Bihar had the least (28.7%) among major States. The percentage of achievement is lower than the national average in 22 States / UTs (Table D. 2.8). iii) Ninth (9th) dose of Vitamin- A was administered to 16.4 million children of under 5 years of age as against the assessed need of 25.4 million during 2016-17 as compared to 16.2 million children in 2015-16. The achievement varies widely across the States / UTs. The percentage is lower than the national average of 64.2% in 23 States / UTs (Table D. 2.9).6.4. 7 Breastfeeding Practices: Breastfeeding has many health benefits for both themother and infant. Early initiation of breastfeeding ensures that the infant receives thecolostrum (“first milk”), which is rich in protective factors. According to the data availableon HMIS portal, the number of newborns breastfed within one hour increased significantlyduring 2010-11 to 2014-15. As compared to total number of live births reported (20.51 81

Health and Family Welfare Statistics in India 2017Million) during 2016-17, 89.17% newborns were breastfed within one hour of birth asagainst 87.7% in 2015-16. (Table D.3)6.4. 8 Weight of Newborns at Birth: Infants born with a low birth weight are atincreased risk of long-term disability and impaired development. Infants born weighingless than 2.5 Kg are considered as under-weight babies.According to the HMIS data, out of 20.51 million live births occurred during 2016-17,19.51 million were weighed at birth and 2.32 million babies ( 11.9%) were found to behaving weight less than 2.5 Kgs. (Table D.4 & D.5)7.0 HEALTHCARE INFRASTRUCTUREThe Ministry of Health and Family Welfare is responsible for implementation of variousprogrammes and schemes in areas of health and family welfare. The term health82

Health and Family Welfare Statistics in India 2017care infrastructure includes physical infrastructure and also human resources as thehealthcare centres, dispensaries, or hospitals need to be manned by well trained staffto provide services. Tables in Section – G presents Data on Health Infrastructure.The health care infrastructure in rural areas has been developed as a three tier systemand is based on the following population norms: Centre Population NormsSub Centre Plain Area Hilly/Tribal/Difficult AreaPrimary Health CentreCommunity Health Centre 5000 3000 30,000 20,000 1,20,000 80,0007.1 Sub Centres (SCs): The Sub Centre is the most peripheral and first contact pointbetween the primary health care system and the community. Sub Centres are assignedtasks relating to interpersonal communication in order to bring about behavioral changeand provide services in relation to maternal and child health, family welfare, nutrition,immunization, diarrhoea control and control of communicable diseases programmes.Each Sub Centre is required to be manned by at least one auxiliary nurse midwife(ANM) / female health worker and one male health worker. Under NRHM, there is aprovision for one additional second ANM on contract basis. One lady health visitor (LHV)is entrusted with the task of supervision of six Sub Centres. Government of India bearsthe salary of ANM and LHV while the salary of the Male Health Worker is borne by theState governments. There were 1,56, 231 Sub Centres functioning in the country as on31st March, 2017. (Table G-1)7.2 Primary Health Centres (PHCs)PHC is the first contact point between village community and the medical officer. ThePHCs were envisaged to provide an integrated curative and preventive health careto the rural population with emphasis on preventive and promotive aspects of healthcare. The PHCs are established and maintained by the State governments under theMinimum Needs Programme (MNP)/ Basic Minimum Services (BMS) Programme. Asper minimum requirement, a PHC is to be manned by a medical officer supported by 14paramedical and other staff Under NRHM, there is a provision for two additional staffnurses at PHCs on contract basis. It acts as a referral unit for 6 Sub Centres and has4 - 6 beds for patients. The activities of PHC involve curative, preventive, promotive andfamily welfare services. There were 25,650 PHCs functioning in the country as on 31stMarch, 2017.7.3 Community Health Centres (CHCs)CHCs are being established and maintained by the State government under MNP/BMS programme. As per minimum norms , a CHC is required to be manned by fourmedical specialists i.e. surgeon, physician, gynecologist and pediatrician supported by21 paramedical and other staff (See Annexure-I for IPHS norms). It has 30 in-door bedswith one OT, X-ray, labour room and laboratory facilities. It serves as a referral centrefor 4 PHCs and also provides facilities for obstetric care and specialist consultations.As on 31st March, 2017, there were 5,624 CHCs functioning in the country. (Table G-1) 83

Health and Family Welfare Statistics in India 2017Data on availability of Infrastructure, staff and services at CHC, PHC and Sub-Centre(in terms of percentage) as per District Level Household and Facility Survey, 2012-13 isgiven at Table G-2.Data on actual requirement, sanctioned strength and vacancy position of Health Workers(Female) / AMM at Sub-Centres and Primary Health Centres for 2017 as comparedto 2005 is given in Table- G3. Data on availability and shortfall of human resourcesfor PHCs (Doctors) and CHCs (Surgeons, Obstetrician and gynaecologist, physicians,paediatricians) for 2017 is presented in table G3 to G5. Number of sub-centres withoutANMs or and Health Workers (M), with and without doctor/lab technician/pharmacist,is given at table G-6 and G-7. State/UT-wise No. of Government hospitals and beds inrural and urban areas (including CHCs) in India 2017 is given at G-8 and State-wisedetails of medical colleges for the year 2017-18 is at G-9. Distribution of householdsby availability or drinking water facility and type of latrine facility as per Census 2011 isgiven at G-10 and G-11 respectively.8.0 MONITORING AND EVALUATION SYSTEM8.1. Introduction: The National Health Mission (NHM) has quantifiable goals to beachieved through specific road maps with appropriate linkages and financial allocationsfor strengthening the health infrastructure. A continuous flow of good quality informationon inputs, outputs and outcome indicators is essential for monitoring the progress ofNHM at closer intervals. Integral to this process is using information for decentralizedplanning where the States prepare Integrated District Health Action Plans culminating inthe State Health Action Plans or Programme Implementation Plans (PIP) through whichresource allocation takes place.Important M & E activities being undertaken are as under:8.2. Web based Health Management Information System (HMIS): HealthManagement Information System (HMIS) (http://nrhm-mis.nic.in) is a web-basedMonitoring system put up in place by Ministry of Health & Family Welfare (MoHFW)to monitor its health programmes and provide key inputs for policy formulation andinterventions. It was launched during October, 2008 with uploading of district consolidatedfigures. To make HMIS more robust and effective and in order to facilitate local levelmonitoring, “facility based reporting” was initiated since April, 2011. The HMIS portal hasled to faster flow of information. GIS enabled HMIS application was launched by Hon’bleHFM on 29th March, 2016. GIS enabled HMIS application is a repository of 1.84 lakhHealth facilities across country and it is in the public domain. GIS application providesvisual/ spatial depiction of HMIS data on maps. Presently, approx. 2 lakh health facilities(across all districts of the country) upload facility wise data on monthly basis on HMISweb portal.HMIS captures facility wise information on:• Infrastructure (Manpower, Equipment, Cleanliness related, Medical Services available etc.)• Service Delivery (Reproductive, Maternal and Child Health related, OPD, IPD, Surgeries etc.)84

Health and Family Welfare Statistics in India 2017Data are presently being made available to various stakeholders in the form of standardand customized reports, factsheets, score-cards etc.Further, to improve the quality of HMIS data, score cards and dash-boards along withGIS application have been developed which are being used at the State and districtlevel consultations to highlight the poor performing regions and the programme areaswhich need more attention. To promote use of HMIS data, pre-generated ready to usereports giving National, State, district and sub-district level key indicators are beinggenerated and refreshed on daily / weekly basis. HMIS data is being used at variousforums like NPCC meeting at MoHFW level. HMIS data is also being used to generategrading of health facilities.Apart from HMIS reports, survey reports, publications etc. are also available on theHMIS portal under the link Statistical reports and Publications.8.3 Sustainable Development Goal for Health Sector (SDG-3)The Sustainable Development Goals (SDGs), otherwise known as the Global Goals,are a universal call to action to end poverty, protect the planet and ensure that all peopleenjoy peace and prosperity.The SDGs work in the spirit of partnership and pragmatism to make the right choicesnow to improve life, in a sustainable way, for future generations. They provide clearguidelines and targets for all countries to adopt in accordance with their own prioritiesand the environmental challenges of the world at large. The SDGs are an inclusiveagenda. They tackle the root causes of poverty and unite us together to make a positivechange for both people and planet.In the Millennium Summit held in 2000 at the UN HQ in New York, eight developmentgoals known as MDG were adopted to pursue countries national development strategiesfrom 2000 to 2015. The MDG targets were unevenly achieved across the countries andto assess the usefulness of the MDGs and need was felt to explore possible successorto guide development cooperation in the world beyond 2015. The UN Conference onSDG held in Rio de Janeiro, Brazil in 2012, the UN General Assembly in its 70th sessionconsidered and adopted the SDGs for the next 15 years and SDG came into force witheffect from 1 January,2016As per the resolution of UN General Assembly in September, 2015 the SustainableDevelopment Goals (SDGs) have been adopted by 193 member nations. Thesecountries agree upon 17 Sustainable Development Goals (SDGs), that include thefollowing:Goal 1: End poverty in all its forms everywhereGoal 2: End hunger, achieve food security and improved nutrition and promote sustainable agricultureGoal 3: Ensure healthy lives and promote well-being for all at all agesGoal 4: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all 85

Health and Family Welfare Statistics in India 2017 Goal 5: Achieve gender equality and empower all women and girls Goal 6: Ensure availability and sustainable management of water and sanitation for all Goal 7: Ensure access to affordable, reliable, sustainable and modern energy for all Goal 8: Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all Goal 9: Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation Goal 10: Reduce inequality within and among countries Goal 11: Make cities and human settlements inclusive, safe, resilient and sustainable Goal 12: Ensure sustainable consumption and production patterns Goal 13: Take urgent action to combat climate change and its impacts Goal 14: Conserve and sustainably use the oceans, seas and marine resources for sustainable development Goal 15: Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss Goal 16: Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels Goal 17: Strengthen the means of implementation and revitalize the global partnership for sustainable developmentThese 17 Goals build on the successes of the Millennium Development Goals,while including new areas such as climate change, economic inequality, innovation,sustainable consumption, peace and justice, among other priorities. The goals areinterconnected – often the key to success on one will involve tackling issues morecommonly associated with another. There are 169 targets covering a broad range ofsustainable development issues. These included ending poverty and hunger, improvinghealth and education, making cities more sustainable, combating climate change, andprotecting oceans and forests.Though Goal -3 is devoted to Good Health and Well-being, but it touches life everywhere.There are the targets of other Goals that also influences and are influenced by targets ofGoal-3. India is committed to achieve Sustainable Development Goals (SDG) by 2030.In so far as the Health Sector is concerned, a National Task Force on SDG-3 has beenset up by the Ministry under the Chairmanship of Secretary (Health & Family Welfare)for developing rnonitorinq framework for SDG-3 in India with a rollout plan, supportthe States with rollout of the SDG health agenda and set up review mechanisms. Two86

Health and Family Welfare Statistics in India 2017working groups (WGs) namely, WG on Monitoring Framework and WG on SDG roll outat State level were formed for detailed deliberations.The NITI Aayog oversees the implementation of SDGs from policy perspective andM/O Statistics and Programme Implementation (MoSPI) has been assigned with thetask of development of measurement framework for tracking/monitoring the progressof nationally defined SDGs and targets. The MoSPI organized National Workshop onIndicator Framework for SDG with all the Ministries/Departments and representativesfrom State Govt. on the implementation and monitoring framework. . The NITI Aayoghas mapped out all the SDGs on the Central Ministries, Centrally-Sponsored Schemes,and major government initiatives. The draft mapping has been circulated among CentralMinistries and States/ UTs and placed in public domain. The MoHFW in collaborationwith WHO, India organized a National consultation on Transitioning from MDG to SDGs– “Ensure healthy live and promote well being for all Indian at all ages. The ‘MissionSteering Group on NHM is envisaged to provide the oversight to the SDG-3 in India.National Health policy 2017 is key step for improving the Health standard by definingrole of Government in shaping health systems in all its dimensions like investment,organisations, financing etc. Also, within the umbrella of National Health Mission,Ministry of Health and Family Welfare is running various initiatives and schemes likeFree Drugs Initiatives, Free Diagnostics Initiative, PM National Dialysis Programme,Kayakalp, Quality Assurance etc. for improving Healthcare system, providing universalhealthcare and improving health outcomes.The draft Monitoring Framework for Health SDG has been developed to facilitate andinform the discussions of the National SDG-3 Task Force. The core indicators havebeen derived from global list and segregated into 4 broad groups- Reproductive,Maternal, Newborn Child and Adolescent Health (RMNCHA), Communicable disease(CDs), Non-communicable Disease (NCDs) including injuries and the Health Systems.Additionally, certain relevant indicators from other goals have also been included. Mostof the presented indicators have standardized definitions and metadata.For this Monitoring Framework to be holistic, besides agreement amongst thestakeholders on indicators, equity stratifiers and data sources, it is vital to; 1) identifyadditional data sources including other ministries responsible for collecting data 2) agreeon frequency, format and flow of reporting and 3) suggest measures for strengtheningHealth information systems capable of providing reliable, timely and disaggregateddata 4) set the national and state level targets in line with global level of ambition butconsidering local capacities and realities. States are expected to set own targets and willneed to report on all indicators from National Framework, but can also choose additionalindicators as per local context. The targets of Goal3 are as follows:8.3.1 Reproductive, Maternal, New Born Child and Adolescent Health (RMNCH+A)Targets:8.3.2 By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000live births 87

Health and Family Welfare Statistics in India 20178.3.3 By 2030, end preventable deaths of newborns and children under 5 years of age,with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000live births and under-5 mortality to at least as low as 25 per 1000 live births8.3.4 By 2030, ensure universal access to sexual and reproductive health-careservices, including for family planning, information and education, and the integration ofreproductive health into national strategies and programmes8.4 Communicable Diseases (CD) Targets8.4.1 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropicaldiseases and combat hepatitis, waterborne diseases and other communicable diseases8.4.2 Strengthen the capacity of all countries, in particular developing countries, forearly warning, risk reduction and management of national and global health risks8.5 Non communicable disease (NCD) and Injuries Targets8.5.1 By 2030, reduce by one third premature mortality from non-communicablediseases through prevention and treatment and promote mental health and well-being8.5.2 Strengthen the prevention and treatment of substance abuse, including narcoticdrug abuse and harmful use of alcohol8.5.3 By 2020, halve the number of global deaths and injuries from road traffic accidents8.5.4 Strengthen the implementation of the World Health Organization FrameworkConvention on Tobacco Control in all countries.8.6 Health Systems8.6.1 Targets: Achieve universal health coverage, including financial risk protection,access to quality essential health-care services and access to safe, effective, qualityand affordable essential medicines and vaccines for all8.6.2 Support the research and development of vaccines and medicines for thecommunicable and non-communicable diseases that primarily affect developingcountries, provide access to affordable essential medicines and vaccines in accordancewith the Doha Declaration on the TRIPS Agreement and Public Health, which affirmsthe right of developing countries to use to the full the provisions in the Agreement onTrade-related Aspects of Intellectual Property Rights regarding flexibilities to protectpublic health, and, in particular, provide access to medicines for all8.6.3 Substantially increase health financing and the recruitment, development,training and retention of the health workforce in developing countries, especially inleast- developed countries and small island developing states8.7  Large Scale Surveys: The Ministry has been conducting large scale surveysperiodically to assess the level and impact of health interventions. These surveys includeNational Family Health Survey (NFHS), District level Household Survey (DLHS), AnnualHealth Survey (AHS) etc. The main aim of these surveys is to assess the impact of thehealth programmes and to generate various health related indicators at the District/State/ National level.88

Health and Family Welfare Statistics in India 2017The details of the Surveys related to health are summarised below: S. Name Nodal Periodicity Availability of InformationNo. Agency (Year of Surveys) National and State level indicators1.    National IIPS, relating to population, fertility, mortality, Family Mumbai Earlier health, nutrition, reproductive and child Health 5 – 7 years health, health seeking behavior etc. Survey and 3 years HIV/AIDS estimates provided for the (NFHS) since NFHS- first time in NFHS-3 (2005-06). NFHS- 4. 4, for the first time, provides district- level estimates for many important (Four rounds indicators. The contents of previous conducted in rounds of NFHS are generally retained 2015-16, and additional components are added 2005-06, from one round to another. In NFHS- 1998-99, 4(2015-16), information on malaria 1992-93) prevention, migration in the context of HIV, abortion, violence during Initiated the pregnancy etc. have been added. preparatory activities for The scope of clinical, anthropometric, NFHS-5. and biochemical testing (CAB) or Biomarker component has been expanded to include measurement of blood pressure and blood glucose levels. NFHS-4 sample has been designed to provide district and higher level estimates of various indicators covered in the survey. However, estimates of indicators of sexual behaviour, husband’s background and woman’s work, HIV/AIDS knowledge, attitudes and behaviour, and, domestic violence are/ will be available at State and national level only. 89

Health and Family Welfare Statistics in India 2017 S. Name Nodal Periodicity Availability of InformationNo. Agency (Year of Surveys)2.    District IIPS 5 – 6 years National/ State / district level estimates ( Four rounds on reproductive and child health and level Mumbai conducted in other related indicators. 2012-13, Household 2007- 08,  2002-04, Survey and 1998-99) Since (DLHS) discontinued.3.    Sample ORGI Annual National/ State level estimates on CBR, CDR, IMR, U5MR, TFR etc. Registration System (SRS), Registrar General of India, Ministry of Home Affairs4.    Annual ORGI Annual Core vital and health Indicators at the Health (Three State/ District/ Commissionrait level for Survey rounds 8 EAG States and Assam conducted during 2010- 11, 2011-12 and 2012-13 and CAB survey in 2014) Since discontinued.The latest status relating to these is as under:8.7.1 National Family Health Survey: The field work of fourth round of National FamilyHealth Survey (NFHS-4) (2015-16) has been completed in all States and UTs. Ministryhas released the results in the form of fact sheets containing data on key indicatorsfor India and for all the States/UTs. The fact sheets are available on the website of90

Health and Family Welfare Statistics in India 2017Ministry/ IIPS. MoHFW has initiated the preparatory activities for next round of NFHS(NFHS-5). International Institute for Population Sciences (IIPS), Mumbai has beendesignated as the Nodal agency for NFHS-5. For the smooth implementation of NFHS-5, four Committees viz. Steering Committee, Financial Management Committee (FMC),Project Management Committee (PMC) and Technical Advisory Committee (TAC) areconstituted.8.7.2 District level Household Survey: The fourth round of District Level HouseholdSurvey (2012-13) was completed and factsheets containing important indicators for 21States / UTs (Andhra Pradesh, Arunachal Pradesh, Goa, Haryana, Himachal Pradesh,Karnataka, Kerala, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Punjab,Sikkim, Tamil Nadu, Telangana, Tripura, West Bengal, Andaman and Nicobar Islands,Chandigarh and Puducherry) and  18 State Reports are available on the website of theMinistry “nrhm-mis.nic.in”.  Reports of the ‘Facility Survey’ component of DLHS-4, for9 AHS States (8 EAG States and Assam), are also available separately on Ministry’swebsite.8.7.3 Annual Health Survey:  Three rounds (2010-11, 2011-12 and 2012-13) of AnnualHealth Survey (AHS) and CAB component of AHS (2014) was undertaken through theOffice of Registrar General & Census Commissioner, India (ORGI) in 284 districts of9 States namely Assam, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha,Rajasthan, Uttar Pradesh and Uttarakhand.  The results of the survey are available onthe website of ORGI “censusindia.gov.in”.8.8 Regional Evaluation Teams (RETs): There are 7 Regional Evaluation Teams(RETs) located in the Regional Offices of the Ministry which undertake evaluation of theNRHM activities including Reproductive and Child Health Programme (RCH) on a samplebasis by visiting the selected Districts and interviewing the beneficiaries. Reports of theRETs are sent to the States and programme divisions for taking corrective measures onissues highlighted in the reports. During 2015-16, 95 districts were visited by RETs andreport issued and during 2016-17, 102 districts have been allocated.8.9 Population Research Centres: The Ministry of Health and Family Welfare hasestablished a network of 18 Population Research Centres (PRCs) scattered in 17 majorStates. These PRCs are located in various Universities (12) and other Institutions (6) ofnational repute. The PRCs are responsible for carrying out research on various topics ofpopulation stabilization, demographic, socio-demographic surveys and communicationaspects of population and family welfare programme. During 2012-13 to 2016-17, thePRC completed 547 research studies in addition to monitoring of State ProgrammeImplementation Plan (PIP) of NHM in 721 districts.For the first time, a compendium ofimportant research publication of the PRCs was prepared. 91



Section APopulation & Vital Statistics

Health and Family Welfare Statistics in India 2017 TABLE - A.1 Population Growth, Crude Birth and Death Rates & Sex-Ratio: Census 1901-2011 Year Population Percentage Average annual Crude Crude Sex Ratio (in million) Decadal exponential Birth Death (females growth rate Rate Rate per 1000 variation (percent) males) (1) (2) (3) (4) (5) (6) (7) 1901 238.4 - - 45.8 44.4 972 1911 252.1 5.75 (+) 0.56 49.2 42.6 964 1921 251.3 - 0.31 (-) 0.03 48.1 47.2 955 1931 279.0 11.00 (+) 1.04 46.4 36.3 950 1941 318.7 14.22 (+) 1.33 45.2 31.2 945 1951 361.1 13.31 (+) 1.25 39.9 27.4 946 1961 439.2 21.64 (+) 1.96 41.7 22.8 941 1971 548.2 24.80 (+) 2.20 41.2 19.0 930 1981 683.3 24.66 (+) 2.22 37.2 15.0 934 1991 846.4 23.87 (+) 2.16 32.5 11.4 927 2001 1028.7 21.54 (+)1.97 24.8 8.9 933 2011 1210.9 17.70 (+) 1.63 21.8 7.1 943Source:- Registrar General & Census Commissioner, India *SRS Population of India (in million)14001200 1210.9 1028.71000 846.4800 683.3600 548.2 439.2400 318.7 361.1 238.4 252.1 251.3 279.0200 0 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 2011 1901 Census Year94

Health and Family Welfare Statistics in India 2017 TABLE - A2 Number of administrative units - Census of India, 2011 2001 2011 S. India/State/Union Sub- No. of Towns Sub- No. of TownsNo. Districts Districts Territory Districts Statutory Census Villages * Districts Statutory Census Villages * Towns Towns Towns Towns(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) India 593 5,463 3,799 1,362 638,588 640 5,924 4,041 3,894 640,8671 Andhra Pradesh 23 1,125 117 93 28,123 23 1,128 125 228 27,800 13 149 0 17 4,0652 Arunachal 23 142 45 26,312 16 188 26 1 5,589 Pradesh 803 Assam 27 153 88 126 26,3954 Bihar 37 533 125 5 45,098 38 534 139 60 44,8745 Chhattisgarh 16 97 75 22 20,308 18 149 168 14 20,1266 Goa 2 11 14 30 359 2 11 14 56 3347 Gujarat 25 226 168 74 18,539 26 225 195 153 18,2258 Haryana 19 67 84 22 6,955 21 74 80 74 6,8419 Himachal Pradesh 12 109 56 1 20,118 12 117 56 3 20,69010 Jammu & Kashmir 14 59 72 3 6,652 22 82 86 36 6,55111 Jharkhand 18 210 44 108 32,615 24 260 40 188 32,39412 Karnataka 27 175 226 44 29,406 30 176 220 127 29,34013 Kerala 14 63 60 99 1,364 14 63 59 461 1,01814 Madhya Pradesh 45 259 339 55 55,393 50 342 364 112 54,90315 Maharashtra 35 353 251 127 43,711 35 355 256 279 43,66316 Manipur 9 38 28 5 2,391 9 38 28 23 2,58817 Meghalaya 7 32 10 6 6,026 7 39 10 12 6,83918 Mizoram 8 22 22 0 817 8 26 23 0 83019 Nagaland 8 93 8 1 1,317 11 114 19 7 1,42820 NCT of Delhi 9 27 3 59 165 9 27 3 110 11221 Odisha 30 397 107 31 51,349 30 476 107 116 51,31322 Punjab 17 72 139 18 12,673 20 77 143 74 12,58123 Rajasthan 32 241 184 38 41,353 33 244 185 112 44,67224 Sikkim 4 9 8 1 452 4 9 8 1 45225 Tamil Nadu 30 201 721 111 16,317 32 215 721 376 15,97926 Tripura 4 38 13 10 870 4 40 16 26 87527 Uttar Pradesh 70 300 638 66 107,452 71 312 648 267 106,70428 Uttarakhand 13 49 74 12 16,826 13 78 74 42 16,79329 West Bengal 18 341 123 252 40,782 19 341 129 780 40,203 2 7 1 2 547 3 9 1 4 55530 Andaman & 1 1 1 0 24 11155 Nicobar Islands31 Chandigarh32 Dadra & Nagar 1 1 0 2 70 1 1 1 5 65 Haveli33 Daman & Diu 2 2 2 0 23 2 2 2 6 1934 Lakshadweep 1 4 0 3 24 1 10 0 6 2135 Puducherry 4 10 6 0 92 4 8 6 4 90• includes un-inhabited villagesSource:- Registrar General & Census Commissioner, India 95

Health and Family Welfare Statistics in India 2017 TABLE - A.3Distribution of Population, Sex Ratio, Density and Growth Rate of Population - Census, 2001 & 2011 PopulationS.No. India/State/Union 2001 2011 Territory Males Males Persons Females Persons Females (1) (2) (3) (4) (5) (6) (7) (8) India 1,028,737,436 532,223,090 496,514,346 1,210,854,977 623,270,258 587,584,719 1 Andhra Pradesh (old) 76,210,007 38,527,413 37,682,594 84,580,777 42,442,146 42,138,631 2 Arunachal Pradesh 1,097,968 579,941 518,027 1,383,727 713,912 669,815 3 Assam 26,655,528 13,777,037 12,878,491 31,205,576 15,939,443 15,266,133 4 Bihar 82,998,509 43,243,795 39,754,714 104,099,452 54,278,157 49,821,295 5 Chhatisgarh 20,833,803 10,474,218 10,359,585 25,545,198 12,832,895 12,712,303 6 Delhi 13,850,507 7,607,234 6,243,273 16,787,941 8,987,326 7,800,615 7 Goa 1,347,668 687,248 660,420 1,458,545 739,140 719,405 8 Gujarat 50,671,017 26,385,577 24,285,440 60,439,692 31,491,260 28,948,432 9 Haryana 21,144,564 11,363,953 9,780,611 25,351,462 13,494,734 11,856,728 10 Himachal Pradesh 6,077,900 3,087,940 2,989,960 6,864,602 3,481,873 3,382,729 11 Jammu & Kashmir 10,143,700 5,360,926 4,782,774 12,541,302 6,640,662 5,900,640 12 Jharkhand 26,945,829 13,885,037 13,060,792 32,988,134 16,930,315 16,057,819 13 Karnataka 52,850,562 26,898,918 25,951,644 61,095,297 30,966,657 30,128,640 14 Kerala 31,841,374 15,468,614 16,372,760 33,406,061 16,027,412 17,378,649 15 Madhya Pradesh 60,348,023 31,443,652 28,904,371 72,626,809 37,612,306 35,014,503 16 Maharashtra 96,878,627 50,400,596 46,478,031 112,374,333 58,243,056 54,131,277 17 Manipur 2,293,896 1,161,952 1,131,944 2,855,794 1,438,586 1,417,208 18 Meghalaya 2,318,822 1,176,087 1,142,735 2,966,889 1,491,832 1,475,057 19 Mizoram 888,573 459,109 429,464 1,097,206 555,339 541,867 20 Nagaland 1,990,036 1,047,141 942,895 1,978,502 1,024,649 953,853 21 Odisha 36,804,660 18,660,570 18,144,090 41,974,218 21,212,136 20,762,082 22 Punjab 24,358,999 12,985,045 11,373,954 27,743,338 14,639,465 13,103,873 23 Rajasthan 56,507,188 29,420,011 27,087,177 68,548,437 35,550,997 32,997,440 24 Sikkim 540,851 288,484 252,367 610,577 323,070 287,507 25 Tamil Nadu 62,405,679 31,400,909 31,004,770 72,147,030 36,137,975 36,009,055 26 Tripura 3,199,203 1,642,225 1,556,978 3,673,917 1,874,376 1,799,541 27 Uttar Pradesh 166,197,921 87,565,369 78,632,552 199,812,341 104,480,510 95,331,831 28 Uttarakhand 8,489,349 4,325,924 4,163,425 10,086,292 5,137,773 4,948,519 29 West Bengal 80,176,197 41,465,985 38,710,212 91,276,115 46,809,027 44,467,088 30 Andaman & Nicobar 356,152 192,972 163,180 380,581 202,871 177,710 Islands 31 Chandigarh 900,635 506,938 393,697 1,055,450 580,663 474,787 32 Dadra & Nagar Haveli 220,490 121,666 98,824 343,709 193,760 149,949 33 Daman & Diu 158,204 65,692 243,247 150,301 34 Lakshadweep 92,512 29,519 64,473 92,946 35 Puducherry 60,650 31,131 33,123 31,350 974,345 486,961 487,384 1,247,953 612,511 635,442Source:- Registrar General & Census Commissioner, India96

Health and Family Welfare Statistics in India 2017 TABLE - A.3 (CONTD..)Distribution of Population, Sex Ratio, Density and Growth Rate of Population - Census, 2001 & 2011S.No. India/State/Union Sex ratio Density (per Deceennial growth Average Annual Expo- Territory sq.km) rate(%) nential Growth Rate (%) 2001 2011 2001 2011 1991-2001 2001-2011 1991-2001 2001-2011(1) (2) (9) (10) (11) (12) (13) (14) (15) (16) India 933 943.0 325 382 21.5 17.7 1.97 1.631 Andhra Pradesh (old) 978 993 277 308 14.6 11.0 1.37 1.042 Arunachal Pradesh 893 938 13 17 27.0 26.0 2.42 2.313 Assam 935 958 340 398 18.9 17.1 1.75 1.584 Bihar 919 918 881 1106 28.6 25.4 2.55 2.275 Chhatisgarh 989 991 154 189 18.3 22.6 1.69 2.046 Delhi 821 868 9340 11320 47.0 21.2 3.93 1.927 Goa 961 973 364 394 15.2 8.2 1.43 0.798 Gujarat 920 919 258 308 22.7 19.3 2.06 1.769 Haryana 861 879 478 573 28.4 19.9 2.53 1.8110 Himachal Pradesh 968 972 109 123 17.5 12.9 1.63 1.2211 Jammu & Kashmir 892 889 100 124 29.4 23.6 2.61 2.1212 Jharkhand 941 949 338 414 23.4 22.4 2.12 2.0213 Karnataka 965 973 276 319 17.5 15.6 1.63 1.4514 Kerala 1058 1084 820 860 9.4 4.9 0.90 0.4815 Madhya Pradesh 919 931 196 236 24.3 20.3 2.20 1.8516 Maharashtra 922 929 315 365 22.7 16.0 2.07 1.4817 Manipur 974 985 97 115 24.9 18.6 2.25 2.1918 Meghalaya 972 989 103 132 30.7 27.9 2.71 2.4619 Mizoram 935 976 42 52 28.8 23.5 2.57 2.1120 Nagaland 900 931 120 119 64.5 (-)0.6 5.11 -0.0621 Odisha 972 979 236 270 16.3 14.0 1.52 1.3122 Punjab 876 895 484 551 20.1 13.9 1.85 1.3023 Rajasthan 921 928 165 200 28.4 21.3 2.53 1.9324 Sikkim 875 890 76 86 33.1 12.9 2.90 1.2125 Tamil Nadu 987 996 480 555 11.7 15.6 1.11 1.4526 Tripura 948 960 305 350 16.0 14.8 1.50 1.3827 Uttar Pradesh 898 912 690 829 25.9 20.2 2.33 1.8428 Uttarakhand 962 963 159 189 20.4 18.8 1.87 1.7229 West Bengal 934 950 903 1028 17.8 13.8 1.65 1.3030 Andaman & Nicobar 846 876 43 46 26.9 6.9 2.41 0.66 Islands31 Chandigarh 777 818 7900 9258 40.3 17.2 3.44 1.5932 Dadra & Nagar Haveli 812 774 449 770 59.2 55.9 4.76 4.4433 Daman & Diu 710 618 1425 2191 55.7 53.8 4.53 4.3034 Lakshadweep 948 947 2022 2149 17.3 6.3 1.61 0.6135 Puducherry 1001 1037 1989 2547 20.6 28.1 1.89 2.47Source:- Registrar General & Census Commissioner, India 97

Health and Family Welfare Statistics in India 2017 TABLE-A.4 Rural and Urban Composition of Population Census- 2001, 2011 S. India/State/Union Total 2001 Urban Total 2011 UrbanNo. Territory Rural Rural (8)(1) (2) (3) (4) (5) (6) (7) 377,106,125 28,219,075 India 1,028,737,436 742,617,718 286,119,718 1,210,854,977 833,748,852 317,369 4,398,5421 Andhra Pradesh(old) 76,210,007 55,401,067 20,808,940 84,580,777 56,361,702 11,758,016 5,937,2372 Arunachal Pradesh 1,097,968 870087 227,881 1,383,727 1066358 16,368,899 906,8143 Assam 26,655,528 23,216,288 3,439,240 31,205,576 26,807,034 25,745,083 8,842,1034 Bihar 82,998,509 74,316,709 8,681,800 104,099,452 92,341,436 688,552 3,433,2425 Chhattisgarh 20,833,803 16,648,056 4,185,747 25,545,198 19,607,961 7,933,061 23,625,9626 Delhi 13,850,507 944,727 12,905,780 16,787,941 419,042 15,934,926 20,069,4057 Goa 1,347,668 677,091 670,577 1,458,545 551,731 50,818,259 834,1548 Gujarat 50,671,017 31,740,767 18,930,250 60,439,692 34,694,609 595,450 571,7719 Haryana 21,144,564 15,029,260 6,115,304 25,351,462 16,509,359 570,966 7,003,65610 Himachal Pradesh 6,077,900 5,482,319 595,581 6,864,602 6,176,050 10,399,146 17,048,08511 Jammu & Kashmir 10,143,700 7,627,062 2,516,638 12,541,302 9,108,060 153,578 34,917,44012 Jharkhand 26,945,829 20,952,088 5,993,741 32,988,134 25,055,073 961,453 44,495,06313 Karnataka 52,850,562 34,889,033 17,961,529 61,095,297 37,469,335 3,049,338 29,093,00214 Kerala 31,841,374 23,574,449 8,266,925 33,406,061 17,471,135 143,48815 Madhya Pradesh 60,348,023 44,380,878 15,967,145 72,626,809 52,557,404 1,026,45916 Maharastra 96,878,627 55,777,647 41,100,980 112,374,333 61,556,074 160,595 182,85117 Manipur 2,293,896 1,717,899 575,997 2,855,794 2,021,640 50,332 852,75318 Meghalaya 2,318,822 1,864,711 454,111 2,966,889 2,371,43919 Mizoram 888,573 447,567 441,006 1,097,206 525,43520 Nagaland 1,990,036 1,647,249 342,787 1,978,502 1,407,53621 Odisha 36,804,660 31,287,422 5,517,238 41,974,218 34,970,56222 Punjab 24,358,999 16,096,488 8,262,511 27,743,338 17,344,19223 Rajasthan 56,507,188 43,292,813 13,214,375 68,548,437 51,500,35224 Sikkim 540,851 480,981 59,870 610,577 456,99925 Tamil Nadu 62,405,679 34,921,681 27,483,998 72,147,030 37,229,59026 Tripura 3,199,203 2,653,453 545,750 3,673,917 2,712,46427 Uttar Pradesh 166,197,921 131,658,339 34,539,582 199,812,341 155,317,27828 Uttarakhand 8,489,349 6,310,275 2,179,074 10,086,292 7,036,95429 West Bengal 80,176,197 57748946 22,427,251 91,276,115 6218311330 Andaman & 356,152 239,954 116,198 380,581 237,093 Nicobar Islands31 Chandigarh 900,635 92,120 808,515 1,055,450 28,99132 D&N Haveli 220,490 170,027 50,463 343,709 183,11433 Daman & Diu 158,204 100,856 57,348 243,247 60,39634 Lakshadweep 60,650 33,683 26,967 64,473 14,14135 Puducherry 974,345 325,726 648,619 1,247,953 395,200Source:- Registrar General & Census Commissioner, India98

Health and Family Welfare Statistics in India 2017 TABLE-A.4 (CONTD...) Rural and Urban comosition of Population : Census-2001, 2011 % of Urban S. India/State/ Population to Total Decennial Growth Rate of Population (percent)No. Union Territory Population 2001 2011 1991-2001 2001-2011 Total Rural Total Rural Urban (14) (15) Urban (13) (16)(1) (2) (9) (10) (11) (12) 31.2 17.7 12.3 31.8 27.8 31.14 India 21.5 17.9 27.3 33.41 Andhra Pradesh 14.6 13.6 14.6 11.0 1.7 35.6 (old) 20.8 22.92 Arunachal 12.9 14.1 27.0 15.2 10.3 26.0 22.6 39.3 Pradesh 10.5 11.3 20.1 23.23 Assam 93.2 97.5 18.9 16.7 36.2 17.1 15.5 27.9 49.8 62.24 Bihar 37.4 42.6 28.6 28.3 29.3 25.4 24.3 35.4 28.9 34.95 Chhattisgarh 18.3 NA NA 22.6 17.8 41.8 9.8 10.06 Delhi 47.0 1.5 51.3 21.2 -55.6 26.8 24.8 27.47 Goa 15.2 -2.2 39.4 8.2 -18.5 35.2 22.2 24.08 Gujarat 34.0 38.7 22.7 17.1 32.7 19.3 9.3 36.0 26.0 47.79 Haryana 26.5 27.6 28.4 20.6 50.8 19.9 9.8 44.6 42.4 45.210 Himachal 25.1 29.2 17.5 16.1 32.4 12.9 12.7 15.6 Pradesh 19.6 20.1 49.6 52.111 Jammu & 17.2 28.9 29.4 25.6 40.7 23.6 19.4 36.4 Kashmir 15.0 16.7 33.9 37.512 Jharkhand 23.4 24.9 23.4 NA NA 22.4 19.6 32.4 11.1 25.213 Karnataka 44.0 48.4 17.5 12.1 28.8 15.6 7.4 31.5 17.1 26.214 Kerala 20.8 22.3 9.4 10.1 7.6 4.9 -25.9 92.8 25.7 30.215 Madhya Pradesh 28.0 31.9 24.3 22.0 31.2 20.3 18.4 25.716 Maharastra 32.6 37.7 22.7 15.2 34.3 16.0 10.4 23.617 Manipur 89.8 97.3 24.9 36.6 12.8 24.5 17.7 44.8 22.9 46.718 Meghalaya 36.2 75.2 30.7 28.3 37.1 27.9 27.2 31.1 44.5 78.119 Mizoram 66.6 68.3 28.8 21.0 38.7 23.5 17.4 29.720 Nagaland 64.5 63.4 69.4 -0.6 -14.6 66.621 Odisha 16.3 13.8 29.8 14.0 11.8 26.922 Punjab 20.1 12.3 37.6 13.9 7.8 25.923 Rajasthan 28.4 27.5 31.2 21.3 19.0 29.024 Sikkim 33.1 30.1 62.1 12.9 -5.0 156.525 Tamil Nadu 11.7 -5.2 42.8 15.6 6.6 27.026 Tripura 16.0 13.4 28.8 14.8 2.2 76.227 Uttar Pradesh 25.9 24.1 32.9 20.2 18.0 28.828 Uttarakhand 20.4 NA NA 18.8 11.5 39.929 West Bengal 17.8 16.9 20.2 13.8 7.7 29.730 Andaman & 26.9 16.6 26.9 6.9 -1.2 23.5 Nicobar Islands31 Chandigarh 40.3 39.2 40.5 17.2 -68.5 27.032 D&N Haveli 59.2 34.1 330.3 55.9 7.7 218.233 Daman & Diu 55.7 86.4 20.6 53.8 -40.1 218.834 Lakshadweep 17.3 48.9 -7.4 6.3 -58.0 86.635 Puducherry 20.6 12.0 25.4 28.1 21.3 31.5Source:- Registrar General & Census Commissioner, India 99

Health and Family Welfare Statistics in India 2017 TABLE-A.5Total Population, Population of Scheduled Castes and Scheduled Tribes And their proportions to the total Population-Census 2011S.No. India/State/Union Total Population Scheduled % of SC % of ST Territories Tribes (ST) population population Scheduled Castes (SC)(1) (2) (3) (4) (5) (6) (7) India 1,210,854,977 201,378,086 104,281,034 16.6 8.61 Andhra Pradesh 84,580,777 13,878,078 5,918,073 16.4 7.02 Arunachal Pradesh 1,383,727 0 951,821 0.0 68.83 Assam 31,205,576 2,231,321 3,884,371 7.2 12.44 Bihar 104,099,452 16,567,325 1,336,573 15.9 1.35 Chhattisgarh 25,545,198 3,274,269 7,822,902 12.8 30.66 Delhi 16,787,941 2,812,309 0 16.8 0.07 Goa 1,458,545 25,449 149,275 1.7 10.28 Gujarat 60,439,692 4,074,447 8,917,174 6.7 14.89 Haryana 25,351,462 5,113,615 0 20.2 0.010 Himachal Pradesh 6,864,602 1,729,252 392,126 25.2 5.711 Jammu & Kashmir 12,541,302 924,991 1,493,299 7.4 11.912 Jharkhand 32,988,134 3,985,644 8,645,042 12.1 26.213 Karnataka 61,095,297 10,474,992 4,248,987 17.1 7.014 Kerala 33,406,061 3,039,573 484,839 9.1 1.515 Madhya Pradesh 72,626,809 11,342,320 15,316,784 15.6 21.116 Maharashtra 112,374,333 13,275,898 10,510,213 11.8 9.417 Manipur 2,855,794 97,042 902,740 3.4 31.618 Meghalaya 2,966,889 17,355 2,555,861 0.6 86.119 Mizoram 1,097,206 1,218 1,036,115 0.1 94.420 Nagaland 1,978,502 0 1,710,973 0.0 86.521 Odisha 41,974,218 7,188,463 9,590,756 17.1 22.822 Punjab 27,743,338 8,860,179 0 31.9 0.023 Rajasthan 68,548,437 12,221,593 9,238,534 17.8 13.524 Sikkim 610,577 28,275 206,360 4.6 33.825 Tamil Nadu 72,147,030 14,438,445 794,697 20.0 1.126 Tripura 3,673,917 654,918 1,166,813 17.8 31.827 Uttar Pradesh 199,812,341 41,357,608 1,134,273 20.7 0.628 Uttarakhand 10,086,292 1,892,516 291,903 18.8 2.929 West Bengal 91,276,115 21,463,270 5,296,953 23.5 5.830 Andaman & Nicobar Islands 380,581 0 28,530 0.0 7.531 Chandigarh 1,055,450 199,086 0 18.9 0.032 Dadra & Nagar Haveli 343,709 6,186 178,564 1.8 52.033 Daman & Diu 243,247 6,124 15,363 2.5 6.334 Lakshadweep 64,473 0 61,120 0.0 94.835 Puducherry 1,247,953 196,325 0 15.7 0.0Source:-Registrar General & Census Commissioner, India#old Andhra Pradesh100