DR NAVNEET RANJAN CONSULTANT - PHP,NHSRC 30/04/2013 Jharkhand Monitoring Visit Report Period: Fourth Quarter (January to March-2013) Latehar
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DR NAVNEET
RANJAN
CONSULTANT -PHP,NHSRC 30/04/2013
Jharkhand Monitoring Visit Report
Period: Fourth Quarter (January to March-2013)
Latehar
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Abbreviations
ANC Ante Natal Care ACMO Additional Chief Medical Officer ANM Auxiliary Nurse Midwife AMG Annual Maintenance Grant AYUSH Ayurveda Yoga Unani Siddha Homeopathy BSU Blood Storage Unit BEmOC Basic Emergency Obstetric Care CEmOC Comprehensive Emergency Obstetric Care CHC Community Health Center CMO Chief Medical Officer CS / C-section Caesarean Section DF Deep Freezer DH District Hospital DHAP District Health Action Plan DMO District Malaria Officer DP Delivery Points DPM District Programme Manager DPMU District Programme Management Unit EMRI Emergency Medical Research Institute FRU First Referral Unit HMIS Health Management Information System I/C In-charge IFA Iron Folic Acid IPD In-patient IEC / BCC Information Education communication / Behaviour Change Communication IUD Intra Uterine Device ILR Ice Line Refrigerator JSY Janani Suraksha Yojana LHV Lady Health Visitor LSAS Life Saving Anaesthesia Skills MCTS Mother & Child Tracking System MTC Malnutrition Treatment Centre NBCC New Born Care Corner NRHM National Rural Health Mission NSSK Navjat Shishu Suraksha Karyakram OBGY Obstetric and Gynaecologist ORS Oral Rehydration Salt PNC Post Natal Care PPP Public Private Partnership PPS Post Partum Sterilisation PW Pregnant Woman RIMS Rajendra Institute of medical sciences SC Sub Center SN Staff Nurse SNCU Sick Newborn Care Unit SAM Severely Acute Malnourishment VHND Village Health & Nutrition Day VHSC Village Health & Sanitation Committee
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Executive Summary The Fourth quarter monitoringreport for Jharkhand is based on the HMIS data of the state and
a field visit to Latehar. The visit was conducted during 02nd -05th April 2013. This visit was
carried out by a team with representatives from NHSRC, New Delhi, Govt. of Jharkhand and
District health officials with an objective to review the progress of NRHM/RCH program
including, implementation of JSSK scheme.
Maternal health: Maternal Mortality Ratio (MMR) has been reduced from 312 (SRS 04-06) to 261 (SRS 07-09). However it is higher than the National average of 212 maternal deaths per 100,000 live births (SRS 2007-09). Institutional arrangement:
The state has 23 DH, 188 CHC, 330 PHC, and 3958 SC to cater the health care needs of 32,966,238 people.
In the visited district 19 sub centers, 3 PHC, 6CHC and district hospital are prioritized for
RCH services. The civil works for 2 sub centers are undergoing. In Chandawa block-the
building of Laharsi PHC is completed but not yet notified as PHC.
Health Service delivery indicators:
As per HMIS (2012-13) ANC3 coverage in the district is 71%
However, only 40% pregnant women received IFA tablets. The shortage of IFA tablets
was also observed during the district visit. No record of hemoglobin levels of pregnant
women was maintained to identify high risk pregnancies (anaemic).
47% deliveries are institutional and equal number are home deliveries. Only 1.7%
deliveries are identified as complicated and most of them are attended at district
hospital. The DH started conducting C-sections after the establishment of blood bank.
The post natal care is poor as only few PW remain stayed at facility.
Only district hospital was found to be providing safe abortion services and that too to a
very small number of clients.
JSY:
JSY payments are made through bearer cheques to the beneficiaries. List of JSY
beneficiaries was available at facility.
HMIS 2012-13 statistics shows 88% mothers of reported institutional deliveries received
JSY payment. .
Maternal Death Review:
Total 450 maternal deaths were reported in the state of Jharkhand. The review
highlighted severe hypertension(31%),Bleeding(24%) and Obstructed/prolonged
labour(24%) are the leading cause of maternal deaths.
In Latehar total 5 deaths were reported, which were all were reviewed.
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Janani-Shishu Suraksha Karyakram (JSSK):
The level of awareness about cashless services for pregnant women and sick infants was
found very low. Although signage for JSSK was displayed at facilities visited.
OPD,IPD and diagnostic services are free across the facilities visited.
The prescribed drugs are ensured free of cost to most of the beneficiaries, however few
beneficiaries reported to have incurred OOPs on purchasing medicine from private
pharmacy
. Free diet is available up to CHC level. Nearly 40% of the interviewed women used
Mamta Vahan to reach the facility, while remaining came by hired or personal vehicles.
Informal payments to avail the medical services were also reported by beneficiaries
There
No robust mechanism for redressal of grievances exists in facilities visited.
Human Resources:
Total 28 positions of doctor/specialist are lying vacant in the district. The position of
District Malaria officer, District Filaria officer and District Leprosy officer is vacant.
One paediatrician and two gynaecologists under regular employment are in position at
Balumath CHC and district hospital respectively. However there is no anaesthetist
available in the district. Two and three MOs are trained in LSAS and EmOC respectively,
while 53 SN/ANM are SBA trained
Child Health:
In Latehar district 9 NBCC are present but no NBSU and SNCUs are available. A six bedded NBSU
for DH was approved in FY 2012-13 but not yet to be operationalised. There is an urgent need
to operationalise NBSU with appropriate human resources in DH to improve newborn survival.
Immunization:
As per HMIS analysis (Apr’12-Mar’13) fully immunized against estimated live births was
74%, very close to the last year’s figure (73%).
Malnutrition Treatment Centre (MTC):
There are 3 MTC established in the district.
At Chandawa, a 6 bedded NRC was functional, however only 50% beds were occupied. There is 1 doctor and 3 ANMs deployed at this NRC. So far there were 267 admissions,out of whch 245 were discharged, 7 readmitted, 9 referred and 21 were LAMA cases.
At district hospital only 4 children were admitted against the 15 beds. The utilization of MTCs is poor. There is need to sensitize the community about malnutrition and improved convergence of ASHA and AWW for identification and referral of SAM cases.
Family Planning:
As per HMIS (2012-13) sterilization (34% of all methods) is the most accepted method of family planning..
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There is need to improve the uptake ofspacing methods like IUD and PPIUD.
IEC related to family planning seems to be neglected. Outreach Services:
Out of 4 MMUs, 3 are functional in the district to cover 7 blocks. They are run and managed by NGOs under PPP. There is need to monitor and analyze the performance of MMU. Proactive involvement of ASHA and ANMs is required for effective utilization of MMU.
School Health program (SHP):
Total 466 schools have been covered so far under SHP. Out of 187,074 students 154,637
have been screened and 27,020 health cards distributed.
Adolescent Reproductive and Sexual Health (ARSH):
There are 7 ARSH clinics established in the district and all are functional. Every six
months kishori Swasthya Pakhwara is being observed. During these periods special
focus is given to identify severely anaemic adolescent girl and their further
management.
ASHA
There are 1325 ASHAs in position in the district. During the visit Round one training of
module 6 was undergoing.
District has distributed drug kits to all ASHAs however, many ASHAs complaint about not
refilling of drug kit.
Shayiya Helpdesk was functional at district hospital and Manika CHC. This helpdesk also
redress grievances of patient
Disease Control Program; Status of NPCDCS:
The NPCDCS program was piloted in Bokaro in year 2010-11 andscaled up to two more districts
i.e. Ranchi and Dhanbad next year. The screening statistics shows that proportion of suspected
hypertension cases (6. 6%) is higher than the proportion of suspected diabetics (5.6%).
Quality of Services:
Deep pits for disposal of bio medical waste were found at all the facilities visited. Colour
coded bins for biomedical waste disposal was being used in visited DH & CHCs. The
infection prevention practices were observed in the facility visited but it varied from
facility to facility.
Equipments were available at the facility visited as per the facility norms. The radiant warmers were not functional due to poor power supply and voltage. Stabilizer may be installed to make radiant warmer functional.
Program Management and Support services:
The position of District Data Manager is vacant however recruitment is going on for all 7
Block Data Manager. At block level, position of 2 BPM and 1 BAM is lying vacant.
Power backup and security personnel were available at every facility. Mobile/Internet
connectivity is poor in the district that affects service delivery and data entry
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1.1 Introduction
The Fourth quarter monitoring report for Jharkhand is based on visit to Latehar district and the
HMIS data analysis.
Latehar is one among the 30 districts classified for IAP 1 across the country. The visit was
conducted during 02nd -05th April 2013. There are 97 SC, 07 PHC, 7 CHC, 2 Malnutrition
treatment centre (MTC) and a district hospital functional in Latehar. Out of these 1 SHC, 1 PHC,
2 CHC, 2NRC and DH were selected as sample facilities to visit and understand program
management and implementation at field level. After this visit the findings were shared with
concerned officers at district level and state level. Table 1 shows the visit schedule and team
composition.
Table1- Visit Schedule and Team composition
Date 03rd April 2013 04th April 2013
Facility visited Latehar District Hospital, Chandwa CHC, Latdag SHC, NRC Chandawa, ASHAs training at Latehar
Chipadohar PHC, Manika CHC, NRC Latehar
Team Members Dr Navneet Ranjan,Consultant, NHSRC Mr Deepak Tubid, State Consultant, Quality Assurance. Ms Jaya Reshma Xaxa , DPM Latehar Mr. Pramod kumar sahoo, DAM, Latehar
1.1. Approach and methodology:
The methods used by observations at different facilities, patients’ interviews and interactions
with providers and beneficiaries. In meeting with civil surgeon, planning for the field visit was
discussed. Data was collected from the District Programme Management Unit and the facilities
visited.
The team interacted with medical officers, ANM, ASHA and discussed the different issues
related to health services at the visited facilities. Interviews were carried out with pregnant
women in the post natal ward of the visited facilities.
1 IAP = Integrated Action Plan (30 Districts) which include backward, tribal and LWE districts. The categorization is
done by statistical division of Ministry of Health & Family Welfare, Govt. of India
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1.2. Background Information
Latehar district was created on 4th April
2001 and falls under Palamu division.
Population is 725,673 as per Census 2011. It
is predominantly tribal district with almost
40% of the population belonging to the
schedule tribes and more than 66 % of total
population comprising of SCs and STs. There
are nine Development Blocks, namely
Latehar, Chandwa, Balumath, Bariyatu,
Herhanj, Manika, Barwadih, Garu and Mahuadar. The fertility of soil is poor due to extensive
erosion, acidic character and low retaining capacity. The district does not have any significant
industrial activities.
Table 2. Status of major health indicators
Health Profile
Indicator Jharkhand Latehar
CBR 23.7 24.8
CDR 6.1 5.9
IMR 41 49
MMR 278
310( Palamu division)
Source: DHAP
Table 3. Health Infrastructure in Latehar:
Source: District Data
Institutions No.
District Hospital 1
Block 09
CHC 07
PHC 07
SC 97
FRU 0
24X7 PHC --
No. of licensed blood banks (include pvt)
1
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2.0 Maternal Health:
Maternal Mortality Ratio (MMR) has been reduced from 312 (SRS 04-06) to 261 (SRS 07-09). There are 51 points drop in MMR. However it is higher than the National average of 212 maternal deaths per 100,000 live births (SRS 2007-09).
2.1. Institutional arrangement: The state has 23 DH, 188 CHC (out of these 150 are under construction) 330 PHC (out of these 92 are under construction), 3958 SC (out of these 775 are under construction) to cater the health care needs of 32,966,238 population.
In Latehar 97 SC, 07 PHC, 7 CHC, 2 Malnutrition treatment centre (MTC) and a district hospital is
functional. Out of these 19 sub centers, 3 PHC, 6CHC and district hospital are prioritized for RCH
services. The civil works for 2 sub centers are undergoing. In Chandawa block-the building of
Laharsi PHC is completed but not yet notified as PHC.
Beside this four private health facilities are accredited for JSY. The presence of private health
care providers is negligible in the district.
Table 3: Functional delivery points in Latehar
SNo. Type of Facility Latehar
Total number Functional Delivery points
Level I facility
1 Sub center 97 19
Level II facility
2 PHC 07 03
3 CHC 07 06
4 Other Hospital 00 00
Level III facility
5 SDH 00 00
6 DH 01 01
Total 112 29
Source: District Data
2.2. ANC Services
As per HMIS 2012-13, total ANC registration against expected pregnancies in district was 93%.
Out of the total registration 71% pregnant women underwent 3 ANC services. However only
40% of women received IFA tablets. The shortage of IFA tablets was confirmed during the visit
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to Chhipadohar PHC. It was also observed that, no record on haemoglobin levels of pregnant
women was maintained at the visited facilities to identify high risk pregnancy (anaemic). There
is need of line listing of high risk pregnant women to avert the maternal death.
2.3. Delivery services/ Labour room:
As per HMIS 2012-13, 47%
deliveries are institutional which is
very close to the state AHS 2011
statistics (45%). The proportion of
unreported deliveries is less (6%)
however home deliveries are same
the institutional deliveries i.e. 47%.
The reason for high proportion of
home deliveries is hilly terrain,
wide geographical stretch and,
scattered population. Also social
condition (LWE affected) of this
area is not conducive for the PW to
reach the facilities particularly at
night. Majority of the home deliveries are reported from Manika block.
98% of institutional deliveries are normal deliveries. However only 1.7% deliveries are
complicated and most of them are attended at district hospital. Only ten pregnancies (0.1%)
were taken up for C-section, which is nearly 100 times less as compared to the estimated no. of
women requiring C sections. The reasons for very few C-section are unavailability of blood bank
at DH. Recently the Blood bank has been operationalzed and the report of next few quarters
will show whether it was only the lack of blood leading to low C section rate.
Chipadohar PHC surrounded by live wire in night to protect building from LWE
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The labour room in district hospital has only 1 Labour table however the DH is conducting
nearly 100 deliveries per month. The Labour room was not found clean and tidy. The NBCC was
found functional. Oxytocin, IV fluid and other essential drugs were available in the emergency
tray. Distribution of institutional deliveries across the blocks of district is shown in the figure
given below.
Figure3.Distribution of institutional deliveries in CHC & DH: Q4
2.4. Post delivery stay / PNC
The infrastructure of the post natal ward of the health facilities visited was insufficient to cater
to mothers’ needs. It is difficult to deliver PNC at the facility as only few women stayed back at
facilities for the mandatory 48 hrs after delivery. The HMIS data suggests that 81% women stay
less than 48 hours in the facility after delivery.
C- section % 0.1%
Complicated Pregnancies attended %
1.7%
Normal deliveries %
98.2%
Figure 2: Latehar- C-Section, Complicated & Normal Deliveries against Reported Institutional Deliveries ( Pvt. & Public) Apr'12 to Mar'13
Balumath 8% Chandwa
9%
Barwadih 15%
Manika 4%
Latehar 7%
Mahuwadar 15%
Garoo 9%
DH 33%
% of institutional delivery
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During the visit it was observed that few facilities (Chipadohar PHC) do not have functional beds
to accommodate the post natal cases. There is need to improve the stay at facilities by providing
free diet and drop back facility. (Details in JSSK section).
2.5. Safe Abortion Services: Table.4: Abortions - Apr'12 to Mar'13
MTP Less than 12 weeks
MTP More than 12 weeks
Abortions (spontaneous/Induced)
Abortions in Pvt Facilities
Abortion Rate against expected
pregnancies
89 7 203 -- 1.6%
Only district hospital was found to be providing safe abortion services and that too to a very
small number of clients. However the rate of abortion against expected pregnancies is 1.6 %
which again is much lower than expected abortions/miscarriages. The concern is that abortion
services were not available in CHCs and PHCs.
2.6. Janani Suraksha Yojna (JSY):
HMIS 2012-13 statistics shows 88% mothers of reported institutional deliveries received JSY
payment. This figure is only for delivery at Public institution. JSY payments are made through
bearer cheques to the beneficiaries. List of JSY beneficiaries was available at facility.
2.7. Maternal Death Review: Total 450 maternal deaths were reported in the state of Jharkhand. The review highlighted
severe hypertension(31%),Bleeding(24%) and Obstructed/prolonged labour(24%) are the
leading cause of maternal deaths.
2.8. Janani shishu suraksha Karyakaram (JSSK)
The exit interviews were conducted at facilities visited where delivery conducted. Total (n=7)
beneficiary were interviewed.The key findings of interview are as follows:
Awareness about entitlements of JSSK
Almost all interviewed PW were not aware about cashless services being provided under JSSK to PW. The service providers also do not know about JSSK. Although signage for JSSK was displayed at facilities visited.
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OPD/IPD charges
The OPD and IPD charges were exempted to PW and sick new born at all facilities visited.
Drugs:
All the women interviewed were getting drugs free of cost from the facilities visited. At Latehar DH two women reported that they purchased medicine from private pharmacy and spent Rs. 50/- and Rs. 90/- respectively.
Blood bank was established recently and C-section was also carried out however adequate utilization of blood bank is stillto be acheived. The lab technician of blood bank reveals that blood was collected through blood donation camp organised by Red Cross but due to poor absorption the blood units were shifted to Palamu DH or RIMS, Ranchi.
Diet:
At DH, diet is being provided through in house kitchen to the pregnant women as
reported by facility in-charge. At Chandawa CHC, single pregnant women was present at
facility and confirmed about getting food from the hospital free of cost. A local
hotel/restaurant is empanelled to supply the cooked diet for pregnant women. During
the visit, l. Generally PW are not willing to stay more than 4-5 hours post delivery. At
Chipadohar PHC remaining visited facilities, the diet was not being arranged for PW
under JSSK..
Informal charges:
Out of 7 Post natal mothers interviewed 2 of them paid informal charges, 150/- and Rs
300/- to service providers.
Diagnostic facilities:
Labouratory tests are
available at the facilities
visited as per the facility
norms. The free diagnostic
services are available for
pregnant women and sick
new born. The line listing
of anaemic PW (whose Hb
level is <7mg) was not
practiced.
There is no OOPS incurred
on the diagnostic tests by
the interviewed PW.
Post Natal ward of Latehar District Hospital
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Transportation:
Seven ambulances are functional in the district out of which four are managed by NGO.
Out of 7 women interviewed only three used ‘Mamta vahan’ to reach facility for
delivery. Remaining PW reached facility either by own vehicle or through hired vehicle.
The out of pocket expense ranged from Rs 50/- to Rs 600/- for transportation depending
upon the distance travelled and type of vehicle used.
One PW revealed that the mobile network connectivity is one of the issues that’s why
she was not able to call Mamta Vahan. Five interviewed PW did not attempt to call
Mamta Vahan because they were not aware about the free transport facility.
Drop back to home is only provided to those who stayed mandatory 48 hours in the
facility. It was also observed through records that utilization of Mamta Vahan for drop
back is very less as beneficiaries left the facility soon after the delivery.
Inter-facility transfer:
For up referral Rs 1000/= is being provided to the PW and sick new born for
transportation. If government vehicle (ambulance) is available then this money is used
for the fuel. However generally the vehicle is arranged by the family member of
beneficiary.
Grievance Redressal Cell:
There is no mechanism to redress grievances under JSSK in facilities visited. Not even a suggestion box has been placed at the facility visited.
None of the interviewed PW knew where to contact in case they are charged for the cashless services under JSSK
3.0. Human Resources
Table: 5. Human resources available in the District
Required
Regular Contractual
Sanctioned posts
In position from State
Sanctioned
posts
In position (through
state/other sources)
In position from NRHM
Total in positio
n
1st ANM 119 119 82 0 0 0 82
2nd ANM 150 0 0 150 0 102 102
MPW/ Male HW 18 18 16 0 0 0 0
Staff Nurse total 59 3 0 0 2 29 31
DH 20 0 0 20 2 2 4
FRU/ CHC 36 0 0 36 0 7 7
24X7 PHCs 21 0 0 0 0 0 0 LHV/ PHNs Other supervisory cadre
7 7 5 0 0 0 5
LTs 23 23 4 23 4 11 19
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DH 4 4 0 4 1 2 3
FRU/ CHC 12 12 2 12 4 6 12
24X7 PHCs 14 14 4 14 7 3 14
Other facilities (Pls. specify)
0 0 0 0 0 0 0
Pharmacists 23 23 0 14 9 4 4
AYUSH Pharmacists 0 0 0 0 0 0 0
MOs total 15 9 6 1 0 3
AYUSH MOs 8 8 6 0 6 0 0
DENTAL MOs 8 1 0 0 8 0 1
Specialists total 10 2 0 0 8 0 0
Obstetricians &Gynaecologist
4 2 0 0 4 0 2
Anaesthetist 3 0 0 0 3 0 0
Paediatrician 3 0 0 0 0 0 Source: District Data
The details of the human resources available in the district are depicted in the table 5. One
paediatrician and two gynaecologists under regular employment are in position at Balumath
CHC and district hospital respectively. However there is no anaesthetic available in the district.
3.1. Vacancies: Total 28 positions of doctor/specialist are lying vacant in the district. The
position of District Malaria officer, District Filaria officer and District Leprosy officer are vacant.
3.2. Trainings: Two and three MOs are trained in LSAS and EmOC respectively. Total 53
SN/ANM is SBA trained
4.0 . Child health
In FY 12-13, total 7 SCNU were proposed out of which 2 were functional at Ghatshila in East
Singhbhum and Department of Pediatrics-RIMS, Ranchi. Also 32 NBSU were proposed out of
which 7 are functional.
In Latehar district 9 NBCC are present and situated in 6 CHC and 2 PHC and District hospital.
There is no NBSU and SNCU available in the district. A six bedded NBSU for DH was approved in
FY 2012-13 but not yet operationalise. There is an urgent need to operationalise NBSU with
appropriate human resources in DH to improve newborn survival.
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4.1. Immunization:
Table: 6.Immunization in Jharkhand & Latehar
Indicator Jharkhand Latehar
April'12 to Mar'13
Last Year 2011-12
April'12 to Mar'13
Last Year 2011-12
BCG to Measles dropout rate
6% 1% 6% 11%
Fully Immunized against estimated Live Births
75% 83% 74% 73%
Immunisation session held as % of required VHNDs
94% 99% 122% 73%
Childhood Diseases Measles 2908 8415 16 115
Source: HMIS 2012-13
As per HMIS (Apr’12-Mar’13) analysis fully immunized children against the estimated live births
was 74%. This is very close to the last year’s figure (73%). The dropout rate of BCG to measles
was 6%. The HMIS statistics also show 122% immunization sessions held as against the
required number of VHNDs in Latehar.
4.2. Malnutrition Treatment Centre (MTC): There are 3 MTC established in the district- at Chandawa CHC 6 bedded, Mahuadar CHC 6
bedded and district hospital 15 beded. The team visited to MTC wards of district hospital and
Chandawa CHC.
At Chandawa MTC it was observed that a 6 bedded MTC was functional. Out of six beds only
three beds were found occupied during the visit. Separate kitchen was created for NRC. There is
1 doctor and 3 ANM deployed at this NRC. So far 267 admissions have been recorded, out of
these 245 were discharged, 7 readmitted, 9 were referred and 21 were LAMA cases. After
discharge from NRC, ASHA follow up the cases. At district hospital only 4 children were
admitted against the 15 beds. The utilization of MTCs is poor. The facility in-charge told that
due to festivals the admissions are low. There is need to sensitize the community about
malnutrition and convergence of ASHAs and AWWs for identification and referral of SAM cases.
5.0. Family Planning:
The Total Fertility Rate (TFR) of Jharkhand is 3.2 whereas TFR of India is 2.6 (SRS 2008).
Jharkhand has high fertility rate and fall under the group of states having >3 TFR. The unmet
need for spacing is 16.2% and limiting is 14.2% in the state (AHS 2010).
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Table 07. Family Planning Methods in Latehar
Reported %age of All Reported FP
Methods
Total Reported FP Method (All types) Users
6,695 -
Sterilizations 2,272 34%
IUD 1,743 26%
Condom Users 1,421 21%
OCP Users 1,259 19%
Limiting Methods 2,272 34%
Spacing Methods 4,423 66% Source: HMIS (2012-13)
As per HMIS (2012-13) sterilization is the most accepted method of family planning. The proportion of sterilization is 34% in all reported FP methods. Table 8 shows that 96% female sterilization was conducted in Latehar district. The district hospital has Fixed Day Service. There is need to strengthen, with focus of spacing methods like IUD and PPIUD. IEC related to family planning seems to be neglected.
Table: 08. Status of Sterilizations in Latehar
Reported %age of Reported Sterilization
Total Sterilization 2,272
NSV 99 4%
Laparoscopic 15 1%
MiniLap 1,834 81%
Post Partum 324 14%
Male Sterilization 99 4%
Female Sterilization 2,173 96%
Source: HMIS (2011-12)
6.0. Outreach Services:
MMUs
Out of 4 MMUs, 3 are functional in the district covering 7 blocks. One MMU is allocated for 2
blocks and remaining three blocks are covered by one MMU. Two are run and managed by
Vikas Bharti and one by ICERT; both NGOs under PPP. There is need to monitor and analyze the
performance of MMUs which currently is lacking. Also, involvement of ASHA and ANMs is
required for effective utilization of MMU.
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7.0. School Health program (SHP):
Total 466 schools have been covered so far under SHP. Out of 187,074 students 154,637 are
screened and 27,020 health cards have been distributed.
8.0. Adolescent Reproductive and Sexual Health (ARSH):
There are 7 ARSH clinic established in the district and all are functional. The ARSH training
Module is made available in local language. There is one MOi/c, 3 LHV/ANM are engaged in this
program. Beside this a counselor was appointed in each facility. Every six months kishori
Swasthya Pakhwara is being observed. During these periods special focus was given to identify
severely anemic adolescent girl and their further management. Also supplementation of WIFS is
priority as told by civil surgeon.
9.0. ASHA Program:
ASHA Selection:
ASHA is known as Sahiya in Jharkhand. 1325 ASHAs have been selected in the district. The in-depth interview with ASHA shows that the workload and incentive varies, for some it is full time job whereas for some only few cases to attend. ASHAs Training: All ASHAs have been trained up to 5th Module. The training was ongoing on module 6 B during the visit. The district has proposed to train all 1325 ASHAs in Module 6 and 7 in FY 2013-14. The State has 15 State Trainers for Module 6 & 7.
Sahiyas undergoing Training of Module 6b at district
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Drug Kit:
All 1325 ASHAs in Latehar are equipped with drug kit. The drugs are replenished at facilities but
this is not a regular event. Many ASHAs complaint about not getting a drug kit refill.
ASHA Support Structure:
There are 69 ASHA facilitators and one District Program coordinator (equivalent to ASHA
coordinator) is in place in the district. 7 positions of block level ASHA coordinators are vacant. It
was observed that ASHA help desk was well functioning in the district hospital & Manika CHC.
10.0. Status of NPCDCS programme:
The NPCDCS program was piloted in Bokaro in year 2010-11, and further scaled up to two more
districts i.e. Ranchi and Dhanbad in 2011-12. The screening data under this program is given in
the table 9.
Table: 9. Status of screening
Districts No. of
persons screened
Suspected for Diabetes (
>140 )
Hypertension ( >90 )
% of Diabetes
suspected
% of Hypertension
Bokaro 185,420 10,529 18,778 5.67 10.12
Dhanbad 140,044 10,710 11,505 7.65 8.21
Ranchi 304,914 14,020 11,061 4.60 3.63
Total 630,378 35,259 41,344 5.59 6.56
The table 9 shows that proportion of suspected hypertension cases (6. 6%) is higher than the
proportion of suspected diabetics (5.6%).
11.0. Program Management
Programme Management Units has been established at districts & block levels to coordinate &
implement different activities of NRHM. The position of District data Manager is vacant
however recruitment is going on for all 7 Block Data Managers. At block level position of 2 BPM
and 1 BAM is lying vacant.
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12.0. Quality of Services:
12.1. Infection prevention practices and Biomedical
waste disposal:
Deep pit for disposal of bio medical waste was found
at all the facilities visited. Colour coded bins for
biomedical waste disposal were being used at visited
DH & CHCs. The infection prevention practices were
observed in the facility visited, but it varied from
facility to facility.
12.2. Information Display:
Shayiya Helpdesk was functional at district hospital and manika CHC.This helpdesk also redress
grievances of patient. The list of diagnostic tests performed was also displayed. IEC material
pertaining to various programmes including JSSK is displayed in the facilities visited however
name and contact number of the nodal person of JSSK should be displayed. There is need to
display the entitlements with pictorial diagram.
12.3. Equipments
All equipments are available at the facility visited as per the facility norms. O2 Cylinder was functional and SN was trained to operate them. The radiant warmerwas not functional due to poor power supply and voltage.
12.4. Records:
Labour room:
The labour room are clean and well
maintained at district hospital but at CHC
& PHC the cleanliness was lacking.
Technical protocols were not displayed in
the labour room at Chipadohar PHC. It was
also observed there is no consistency in
Partograph preparation. Emoc drugs (e.g.
Oxytocin, Prostaglandin etc) are available
in the labour room. The delivery records
were well maintained in all the facilities
visited.
Sahiya Help desk at Manika CHC
Page 20 of 48
Laboratory Records:
Laboratory records were maintained at the facilities visited in the district. Routine Lab tests are conducted. However Line listing of anemic pregnant women is not done at the facilities.
13.0. Support services:
Power Back up:
Power back up as generator and inverter was available in all the facilities visited.
Security: Security personnel are hired for security purposes at every facility. Mobile/Internet connectivity: This is poor in the district that affects service delivery and data entry.
Page 21 of 48
Annexure: - Comparison with Last Year Performance using HMIS data from National Web
portal :
Jharkhand - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 3,29,66,238 Estimated Pregnancies
8,77,048 ANC
CBR (AHS-2011) 23.7 Estimated Deliveries 7,97,316
ANC Check-up in first trimester 56.3
Apprehended Infant Deaths ( IMR = 41 taken from AHS - 2011 )
32033 Estimated Live Births 7,81,300
3 or more ANC Check-up 56.3
Estimated Eligible couples ( 17% of population)
56,04,260
Estimated Maternal Complications( 15% of
Estimated pregnancies)
1,31,557
Atleast 1 TT received
85.7
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
15.1
3ANC Check up against estimated pregnancies
44% 53% 51%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
46% 55% 46%
Institutional Delivery
37.6
Met need for EmOC * 20.57% 25% 14.17%
Home Delivery 62.0
Reported Live Births against estimated Live Births
66% 79% 75%
Home Delivery by SBA
24.7
BCG to Measles dropout rate 6% 6% 1%
New born & post natal care
Fully Immunised against estimated Live Births
68% 82% 83%
Abortion (Induced + Spontaneous) 4.2
Immunisation session held as % of required VHNDs
102% 102% 99%
Still Birth
Childhood Disease Diphtheria 104 124.8 186
Live Birth
Childhood Disease Pertussis 58 69.6 75
Breastfed within 1 hour of birth 37.9
Childhood Disease Measles 2702 3242.4 8415 PNC within 48 hrs of delivery 59.1
Childhood Disease Malaria 19872 23846.4 38516 Immunisation Sterilization - Female per 1000 eligible couple
11.93
14.32
20.94 BCG
91.8
Sterilization - Male per 1000 eligible couple
1.16
1.40
2.33 DPT3
71.8
Reported Abortion Rate per 1000 Estimated live births
26.8
32.2 28.3
Measeles
79.0
OPD All (per 1000 population) 287.0
344.4 327.8
Full immunisation
63.7
IPD (per 1000 population) 14.2
17.0 18.4 Unmet need for FP
Page 22 of 48
Operation Major (per Lakh population)
53.6
64.3 77.907 Spacing
16.2
Reported Infant and Child Deaths 1187
1,424.4 925 Limiting
14.3
Reported Maternal Deaths 395
474.0 372 Total
30.5
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 23 of 48
Jharkhand-Pashchimi Singhbhum - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1501619
Estimated Pregnancies
43,788 ANC
CBR (AHS-2011) 25.8 Estimated Deliveries 39,807
ANC Check-up in first trimester 51.4
Apprehended Infant Deaths ( IMR = 55 taken from AHS - 2011 )
2131 Estimated Live Births 38,742
3 or more ANC Check-up 51.5
Estimated Eligible couples ( 17% of population)
2,55,275
Estimated Maternal Complications( 15% of
Estimated pregnancies)
6,568
Atleast 1 TT received
74.3
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
21.1
3ANC Check up against estimated pregnancies
64% 77% 68%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
45% 54% 40%
Institutional Delivery
28.0
Met need for EmOC * 1.32% 2% 0.69%
Home Delivery 71.3
Reported Live Births against estimated Live Births
73% 87% 81%
Home Delivery by SBA
15.9
BCG to Measles dropout rate -4% -4% 1%
New born & post natal care
Fully Immunised against estimated Live Births
81% 97% 82%
Abortion (Induced + Spontaneous) 6.5
Immunisation session held as % of required VHNDs
164% 164% 145%
Still Birth
Childhood Disease Diphtheria 0 0 10
Live Birth
Childhood Disease Pertussis 0 0 2
Breastfed within 1 hour of birth 45.2
Childhood Disease Measles 234 280.8 481 PNC within 48 hrs of delivery 32.6
Childhood Disease Malaria 1620 1944 3888 Immunisation
Sterilization - Female per 1000 eligible couple
2.97
3.57
6.75
BCG
90.7
Sterilization - Male per 1000 eligible couple
1.77
2.12
3.65
DPT3
70.4
Reported Abortion Rate per 1000 Estimated live births
20.1
24.1 12.4
Measeles
79.0
OPD All (per 1000 population) 391.7
470.0 422.0
Full immunisation
64.7
IPD (per 1000 population) 6.6
7.9 6.9 Unmet need for FP
Operation Major (per Lakh population)
6.5
7.8 3.263 Spacing
19.4
Reported Infant and Child Deaths 198
237.6 139 Limiting
20.2
Page 24 of 48
Jharkhand-Bokaro - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 2061918
Estimated Pregnancies
54,304 ANC
CBR (AHS-2011) 23.6 Estimated Deliveries 49,367
ANC Check-up in first trimester 60.6
Apprehended Infant Deaths ( IMR = 29 taken from AHS - 2011 )
1411 Estimated Live Births 48,661 3 or more ANC Check-up 71.4
Estimated Eligible couples ( 17% of population)
3,50,526
Estimated Maternal Complications( 15% of
Estimated pregnancies)
8,146
Atleast 1 TT received
95.0
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
19.3
3ANC Check up against estimated pregnancies
52% 62% 60%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
42% 51% 44%
Institutional Delivery
48.9
Met need for EmOC * 5.46% 7% 7.16%
Home Delivery 50.7
Reported Live Births against estimated Live Births
59% 70% 67% Home Delivery by SBA 16.3
BCG to Measles dropout rate 2% 2% 4%
New born & post natal care
Fully Immunised against estimated Live Births
77% 92% 87%
Abortion (Induced + Spontaneous) 2.5
Immunisation session held as % of required VHNDs
93% 93% 86% Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 0
Breastfed within 1 hour of birth 40.6
Childhood Disease Measles 42 50.4 135 PNC within 48 hrs of delivery 75.5
Childhood Disease Malaria 150 180 509 Immunisation
Sterilization - Female per 1000 eligible couple
14.89
17.87
29.52
BCG
94.5
Sterilization - Male per 1000 eligible couple
6.02
7.22
7.08
DPT3
86.2
Reported Abortion Rate per 1000 Estimated live births
111.7
134.0 89.0
Measeles
84.0
OPD All (per 1000 population) 196.1
235.4 214.9
Full immunisation
79.0
Reported Maternal Deaths 33
39.6 28 Total
39.6
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 25 of 48
IPD (per 1000 population) 4.3
5.1 4.9 Unmet need for FP
Operation Major (per Lakh population)
4.3
5.1 22.406 Spacing
11.2
Reported Infant and Child Deaths 35
42.0 38 Limiting
7.0
Reported Maternal Deaths 13
15.6 23 Total
18.2
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 26 of 48
Jharkhand-Chatra - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1042304
Estimated Pregnancies
28,585 ANC
CBR (AHS-2011) 24.3 Estimated Deliveries 25,987
ANC Check-up in first trimester 42.7
Apprehended Infant Deaths ( IMR = 52 taken from AHS - 2011 )
1317 Estimated Live Births 25,328 3 or more ANC Check-up 41.8
Estimated Eligible couples ( 17% of population)
1,77,192
Estimated Maternal Complications( 15% of
Estimated pregnancies)
4,288
Atleast 1 TT received
70.3
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
7.7
3ANC Check up against estimated pregnancies
34% 41% 43%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
31% 38% 36%
Institutional Delivery
25.5
Met need for EmOC * 0.58% 1% 1.03%
Home Delivery 74.3
Reported Live Births against estimated Live Births
55% 66% 63%
Home Delivery by SBA
17.9
BCG to Measles dropout rate 18% 18% -3%
New born & post natal care
Fully Immunised against estimated Live Births
57% 69% 76%
Abortion (Induced + Spontaneous) 1.7
Immunisation session held as % of required VHNDs
90% 90% 87%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 0
Breastfed within 1 hour of birth 27.9
Childhood Disease Measles 76 91.2 470 PNC within 48 hrs of delivery 55.9
Childhood Disease Malaria 1874 2248.8 3161 Immunisation
Sterilization - Female per 1000 eligible couple
7.71
9.25
19.10
BCG
82.8
Sterilization - Male per 1000 eligible couple
0.78
0.94
6.13
DPT3
55.7
Reported Abortion Rate per 1000 Estimated live births
1.0
1.2 9.9
Measeles
65.2
OPD All (per 1000 population) 268.2
321.9 276.2
Full immunisation
49.0
IPD (per 1000 population) 37.8
45.3 35.5 Unmet need for FP
Operation Major (per Lakh population)
6.4
7.7 54.207 Spacing
21.8
Reported Infant and Child Deaths 0 5 Limiting 17.2
Page 27 of 48
Jharkhand-Deoghar - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1491879
Estimated Pregnancies
37,662 ANC
CBR (AHS-2011) 22.5 Estimated Deliveries 34,239
ANC Check-up in first trimester 55.8
Apprehended Infant Deaths ( IMR = 40 taken from AHS - 2011 )
1343 Estimated Live Births 33,567
3 or more ANC Check-up 48.9
Estimated Eligible couples ( 17% of population)
2,53,619
Estimated Maternal Complications( 15% of
Estimated pregnancies)
5,649
Atleast 1 TT received
79.3
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
10.6
3ANC Check up against estimated pregnancies
35% 42% 52%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
43% 52% 57%
Institutional Delivery
32.1
Met need for EmOC * 2.16% 3% 0.90%
Home Delivery 67.6
Reported Live Births against estimated Live Births
59% 71% 80%
Home Delivery by SBA
24.3
BCG to Measles dropout rate 19% 19% 4% New born & post
natal care
Fully Immunised against estimated Live Births
66% 80% 93%
Abortion (Induced + Spontaneous) 2.4
Immunisation session held as % of required VHNDs
97% 97% 111% Still Birth
Childhood Disease Diphtheria 0 0 0 Live Birth
Childhood Disease Pertussis 0 0 4
Breastfed within 1 hour of birth 29.3
Childhood Disease Measles 103 123.6 500 PNC within 48 hrs of delivery 63.7
Childhood Disease Malaria 45 54 1056 Immunisation Sterilization - Female per 1000 eligible couple
19.38
23.26
32.70 BCG
87.6
Sterilization - Male per 1000 eligible couple
0.17
0.20
0.51
DPT3
55.8
Reported Abortion Rate per 1000 Estimated live births
13.1
15.8 19.8
Measeles
61.5
-
Reported Maternal Deaths 2
2.4 0 Total
39.0
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 28 of 48
OPD All (per 1000 population) 227.3
272.8 299.6 Full immunisation
40.6
IPD (per 1000 population) 14.7
17.6 15.9 Unmet need for FP
Operation Major (per Lakh population)
3.7
4.4 5.765 Spacing
18.4
Reported Infant and Child Deaths 16
19.2 16 Limiting
18.1
Reported Maternal Deaths 11
13.2 0 Total
36.5
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 29 of 48
Jharkhand-Dhanbad - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 2682662
Estimated Pregnancies
72,711 ANC
CBR (AHS-2011) 24.3 Estimated Deliveries 66,101
ANC Check-up in first trimester 60.6
Apprehended Infant Deaths ( IMR = 28 taken from AHS - 2011 )
1825 Estimated Live Births 65,189
3 or more ANC Check-up 70.6
Estimated Eligible couples ( 17% of population)
4,56,053
Estimated Maternal Complications( 15% of
Estimated pregnancies)
10,907
Atleast 1 TT received
90.8
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
20.3
3ANC Check up against estimated pregnancies
49% 59% 28%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
47% 56% 34%
Institutional Delivery
46.9
Met need for EmOC * 51.99% 62% 25.07%
Home Delivery 52.7
Reported Live Births against estimated Live Births
59% 70% 51%
Home Delivery by SBA
35.6
BCG to Measles dropout rate 3% 3% -1%
New born & post natal care
Fully Immunised against estimated Live Births
77% 93% 67%
Abortion (Induced + Spontaneous) 6.4
Immunisation session held as % of required VHNDs
90% 90% 78%
Still Birth
Childhood Disease Diphtheria 4 4.8 3
Live Birth
Childhood Disease Pertussis 0 0 8
Breastfed within 1 hour of birth 34.1
Childhood Disease Measles 176 211.2 1389 PNC within 48 hrs of delivery 79.2
Childhood Disease Malaria 116 139.2 384 Immunisation
Sterilization - Female per 1000 eligible couple
11.45
13.74
20.26
BCG
89.3
Sterilization - Male per 1000 eligible couple
0.47
0.56
1.79
DPT3
70.1
Reported Abortion Rate per 1000 Estimated live births
6.4
7.6 7.9
Measeles
77.8
OPD All (per 1000 population) 131.1
157.3 169.6
Full immunisation
60.2
IPD (per 1000 population) 2.5
3.0 1.5 Unmet need for FP
Operation Major (per Lakh population)
35.9
43.1 66.166 Spacing
12.8
Reported Infant and Child Deaths 20 32 Limiting 6.3
Page 30 of 48
Jharkhand-Dumka - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1321096
Estimated Pregnancies
38,188 ANC
CBR (AHS-2011) 25.7 Estimated Deliveries 34,716 ANC Check-up in first trimester 53.0
Apprehended Infant Deaths ( IMR = 45 taken from AHS - 2011 )
1528 Estimated Live Births 33,952 3 or more ANC Check-up 58.8
Estimated Eligible couples ( 17% of population)
2,24,586
Estimated Maternal Complications( 15% of
Estimated pregnancies)
5,728
Atleast 1 TT received
85.4
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
16.2
3ANC Check up against estimated pregnancies
41% 49% 48%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
36% 43% 42%
Institutional Delivery
19.4
Met need for EmOC * 9.08% 11% 10.51%
Home Delivery 80.4
Reported Live Births against estimated Live Births
64% 76% 78%
Home Delivery by SBA
14.9
BCG to Measles dropout rate 3% 3% 0%
New born & post natal care
Fully Immunised against estimated Live Births
64% 77% 74%
Abortion (Induced + Spontaneous) 3.8
Immunisation session held as % of required VHNDs
138% 138% 135%
Still Birth
Childhood Disease Diphtheria 0 0 30
Live Birth
Childhood Disease Pertussis 0 0 6 Breastfed within 1 hour of birth 39.1
Childhood Disease Measles 141 169.2 395 PNC within 48 hrs of delivery 53.8
Childhood Disease Malaria 1145 1374 2879 Immunisation
Sterilization - Female per 1000 eligible couple
8.99
10.79
15.32
BCG
89.2
Sterilization - Male per 1000 eligible couple
0.68
0.82
0.63
DPT3
71.8
Reported Abortion Rate per 1000 Estimated live births
49.2
59.0 46.6
Measeles
75.2
24.0
Reported Maternal Deaths 6
7.2 29 Total
19.1
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 31 of 48
OPD All (per 1000 population) 363.5
436.1 445.0
Full immunisation
59.8
IPD (per 1000 population) 13.7
16.5 14.6 Unmet need for FP
Operation Major (per Lakh population)
98.3
118.0 93.407 Spacing
15.7
Reported Infant and Child Deaths 23
27.6 25 Limiting
14.8
Reported Maternal Deaths 23
27.6 28 Total
30.5
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Garhwa - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1322387
Estimated Pregnancies
35,312 ANC
CBR (AHS-2011) 23.8 Estimated Deliveries 32,102
ANC Check-up in first trimester 38.6
Apprehended Infant Deaths ( IMR = 40 taken from AHS - 2011 )
1259 Estimated Live Births 31,473 3 or more ANC Check-up 22.1
Estimated Eligible couples ( 17% of population)
2,24,806
Estimated Maternal Complications( 15% of
Estimated pregnancies)
5,297
Atleast 1 TT received
70.0
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
4.4
3ANC Check up against estimated pregnancies
36% 43% 42%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
53% 64% 51%
Institutional Delivery
30.2
Met need for EmOC * 0.76% 1% 0.93% Home Delivery 69.5
Reported Live Births against estimated Live Births
67% 80% 72%
Home Delivery by SBA 50.1
BCG to Measles dropout rate 17% 17% 2%
New born & post natal care
Fully Immunised against estimated Live Births
65% 78% 82% Abortion (Induced + Spontaneous) 2.2
Immunisation session held as % of required VHNDs
87% 87% 84%
Still Birth
Childhood Disease Diphtheria 0 0 12 Live Birth
Childhood Disease Pertussis 33 39.6 0
Breastfed within 1 hour of birth 18.6
Childhood Disease Measles 193 231.6 419 PNC within 48 hrs of delivery 49.9
Childhood Disease Malaria 3519 4222.8 4730 Immunisation
Sterilization - Female per 1000 eligible couple
13.25
15.90
39.57
BCG
89.4
Sterilization - Male per 1000 eligible couple
0.09
0.11
0.24
DPT3
74.9
Page 32 of 48
Reported Abortion Rate per 1000 Estimated live births
1.4
1.6 3.4
Measeles
79.9
OPD All (per 1000 population) 267.6
321.1 336.2
Full immunisation
68.0
IPD (per 1000 population) 15.7
18.8 12.7 Unmet need for FP
Operation Major (per Lakh population)
63.9
76.7 43.860 Spacing
13.8
Reported Infant and Child Deaths 69
82.8 35 Limiting
10.7
Reported Maternal Deaths 35
42.0 12 Total
24.5
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Giridih - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 2445203
Estimated Pregnancies
61,608 ANC
CBR (AHS-2011) 22.5 Estimated Deliveries 56,007
ANC Check-up in first trimester 52.7
Apprehended Infant Deaths ( IMR = 36 taken from AHS - 2011 )
1981 Estimated Live Births 55,017
3 or more ANC Check-up 55.9
Estimated Eligible couples ( 17% of population)
4,15,685
Estimated Maternal Complications( 15% of
Estimated pregnancies)
9,241
Atleast 1 TT received
78.4
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
11.7
3ANC Check up against estimated pregnancies
39% 46% 36%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
42% 51% 26%
Institutional Delivery
26.5
Met need for EmOC * 19.25% 23% 1.05%
Home Delivery 73.2
Reported Live Births against estimated Live Births
69% 83% 55%
Home Delivery by SBA
26.7
BCG to Measles dropout rate 7% 7% 8% New born & post
natal care
Fully Immunised against estimated Live Births
86% 103% 70%
Abortion (Induced + Spontaneous) 4.1
Immunisation session held as % of required VHNDs
81% 81% 86%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 0
Breastfed within 1 hour of birth 26.2
Childhood Disease Measles 153 183.6 682 PNC within 48 hrs of delivery 63.0
Page 33 of 48
Childhood Disease Malaria 926 1111.2 1740 Immunisation
Sterilization - Female per 1000 eligible couple
10.95
13.14
6.36
BCG
84.4
Sterilization - Male per 1000 eligible couple
0.94
1.13
1.61
DPT3
40.4
Reported Abortion Rate per 1000 Estimated live births
6.7
8.0 10.5
Measeles
59.1
OPD All (per 1000 population) 101.9
122.3 118.2
Full immunisation
28.0
IPD (per 1000 population) 3.6
4.3 3.5 Unmet need for FP
Operation Major (per Lakh population)
0.4
0.5 42.982 Spacing
21.0
Reported Infant and Child Deaths 11
13.2 8 Limiting
19.5
Reported Maternal Deaths 12
14.4 8 Total
40.5
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 34 of 48
Jharkhand-Godda - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1311382
Estimated Pregnancies
35,133 ANC
CBR (AHS-2011) 23.6 Estimated Deliveries 31,939
ANC Check-up in first trimester 42.1
Apprehended Infant Deaths ( IMR = 64 taken from AHS - 2011 )
1981 Estimated Live Births 30,949 3 or more ANC Check-up 29.7
Estimated Eligible couples ( 17% of population)
2,22,935
Estimated Maternal Complications( 15% of
Estimated pregnancies)
5,270
Atleast 1 TT received
66.7
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
9.8
3ANC Check up against estimated pregnancies
53% 64% 55%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
51% 61% 48%
Institutional Delivery
24.4
Met need for EmOC * 3.74% 4% 5.10%
Home Delivery 75.2
Reported Live Births against estimated Live Births
73% 87% 82%
Home Delivery by SBA
35.3
BCG to Measles dropout rate 9% 9% 14%
New born & post natal care
Fully Immunised against estimated Live Births
67% 81% 83%
Abortion (Induced + Spontaneous) 1.9
Immunisation session held as % of required VHNDs
110% 110% 105%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 0
Breastfed within 1 hour of birth 34.7
Childhood Disease Measles 193 231.6 423 PNC within 48 hrs of delivery 51.4
Childhood Disease Malaria 579 694.8 1079 Immunisation
Sterilization - Female per 1000 eligible couple
13.95
16.75
21.19
BCG
87.2
Sterilization - Male per 1000 eligible couple
1.12
1.34
3.15
DPT3
55.3
Reported Abortion Rate per 1000 Estimated live births
6.2
7.4 8.8
Measeles
69.1
OPD All (per 1000 population) 222.6
267.1 246.6
Full immunisation
44.1
IPD (per 1000 population) 16.8
20.1 34.7 Unmet need for FP
Operation Major (per Lakh population)
35.5
42.6 79.458 Spacing
21.6
Page 35 of 48
Jharkhand-Gumla - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1025656
Estimated Pregnancies
30,038 ANC
CBR (AHS-2011) 26 Estimated Deliveries 27,307 ANC Check-up in first trimester 53.0
Apprehended Infant Deaths ( IMR = 48 taken from AHS - 2011 )
1280 Estimated Live Births 26,667 3 or more ANC Check-up 41.2
Estimated Eligible couples ( 17% of population)
1,74,362
Estimated Maternal Complications( 15% of
Estimated pregnancies)
4,506
Atleast 1 TT received
92.1
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets 12.2
3ANC Check up against estimated pregnancies
46% 55% 55%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
47% 56% 51%
Institutional Delivery
25.6
Met need for EmOC * 5.39% 6% 9.23%
Home Delivery 74.3
Reported Live Births against estimated Live Births
63% 75% 81%
Home Delivery by SBA
17.6
BCG to Measles dropout rate -5% -5% 0%
New born & post natal care
Fully Immunised against estimated Live Births
58% 70% 75%
Abortion (Induced + Spontaneous) 2.0
Immunisation session held as % of required VHNDs
156% 156% 151%
Still Birth
Childhood Disease Diphtheria 0 0 27
Live Birth
Childhood Disease Pertussis 0 0 0 Breastfed within 1 hour of birth 40.5
Childhood Disease Measles 80 96 241 PNC within 48 hrs of delivery 34.5
Childhood Disease Malaria 623 747.6 752 Immunisation
Sterilization - Female per 1000 eligible couple
7.85
9.41
13.97
BCG 94.3
Sterilization - Male per 1000 eligible couple
4.03
4.83
7.44
DPT3 76.8
Reported Abortion Rate per 1000 Estimated live births
104.3
125.2 100.8
Measeles
85.3
Reported Infant and Child Deaths 3
3.6 5 Limiting
21.2
Reported Maternal Deaths 5
6.0 4 Total
42.8
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 36 of 48
OPD All (per 1000 population) 393.0
471.6 423.5
Full immunisation
71.5
IPD (per 1000 population) 19.8
23.8 19.2 Unmet need for FP
Operation Major (per Lakh population)
24.1
28.9 47.092 Spacing
18.7
Reported Infant and Child Deaths 102
122.4 33 Limiting
15.1
Reported Maternal Deaths 31
37.2 18 Total
33.8
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Hazaribagh - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1734005
Estimated Pregnancies
39,825 ANC
CBR (AHS-2011) 20.5 Estimated Deliveries 36,205 ANC Check-up in first trimester 64.1
Apprehended Infant Deaths ( IMR = 37 taken from AHS - 2011 )
1315 Estimated Live Births 35,547 3 or more ANC Check-up 64.5
Estimated Eligible couples ( 17% of population)
2,94,781
Estimated Maternal Complications( 15% of
Estimated pregnancies)
5,974
Atleast 1 TT received
90.8
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets 9.4
3ANC Check up against estimated pregnancies
39% 47% 59%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
64% 76% 63%
Institutional Delivery
44.0
Met need for EmOC * 10.26% 12% 11.78%
Home Delivery 55.6
Reported Live Births against estimated Live Births
91% 109% 101%
Home Delivery by SBA
34.2
BCG to Measles dropout rate 12% 12% 9%
New born & post natal care
Fully Immunised against estimated Live Births
79% 94% 103%
Abortion (Induced + Spontaneous) 5.6
Immunisation session held as % of required VHNDs
88% 88% 83%
Still Birth
Childhood Disease Diphtheria 33 39.6 3
Live Birth
Childhood Disease Pertussis 0 0 0 Breastfed within 1 hour of birth 30.5
Childhood Disease Measles 140 168 360 PNC within 48 hrs of delivery 75.0
Childhood Disease Malaria 333 399.6 811 Immunisation
Sterilization - Female per 1000 eligible couple
16.29
19.54
36.44
BCG 97.0
Page 37 of 48
Sterilization - Male per 1000 eligible couple
0.22
0.27
0.49
DPT3 82.9
Reported Abortion Rate per 1000 Estimated live births
14.8
17.8 17.9
Measeles
84.3
OPD All (per 1000 population) 216.5
259.8 232.2
Full immunisation
76.4
IPD (per 1000 population) 54.0
64.8 90.6 Unmet need for FP
Operation Major (per Lakh population)
18.2
21.8 34.487 Spacing
14.4
Reported Infant and Child Deaths 75
90.0 62 Limiting
12.9
Reported Maternal Deaths 25
30.0 41 Total
27.3
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Jamtara - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 790207
Estimated Pregnancies
18,149 ANC
CBR (AHS-2011) 20.5 Estimated Deliveries 16,499
ANC Check-up in first trimester 64.1
Apprehended Infant Deaths ( IMR = 37 taken from AHS - 2011 )
599 Estimated Live Births 16,199
3 or more ANC Check-up 64.5
Estimated Eligible couples ( 17% of population)
1,34,335
Estimated Maternal Complications( 15% of
Estimated pregnancies)
2,722
Atleast 1 TT received
90.8
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
9.4
3ANC Check up against estimated pregnancies
49% 59% 65%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
47% 57% 50%
Institutional Delivery
44.0
Met need for EmOC * 0.48% 1% 3.31%
Home Delivery 55.6
Reported Live Births against estimated Live Births
79% 94% 101%
Home Delivery by SBA
34.2
BCG to Measles dropout rate -8% -8% 15%
New born & post natal care
Fully Immunised against estimated Live Births
76% 91% 90%
Abortion (Induced + Spontaneous) 5.6
Immunisation session held as % of required VHNDs
128% 128% 122%
Still Birth
Childhood Disease Diphtheria 24 28.8 37
Live Birth
Childhood Disease Pertussis 0 0 17 Breastfed within 1 hour of birth 30.5
Page 38 of 48
Childhood Disease Measles 58 69.6 212 PNC within 48 hrs of delivery 75.0
Childhood Disease Malaria 184 220.8 272 Immunisation
Sterilization - Female per 1000 eligible couple
10.27
12.32
21.16
BCG 97.0
Sterilization - Male per 1000 eligible couple
0.19
0.22
0.69
DPT3 82.9
Reported Abortion Rate per 1000 Estimated live births
12.5
15.0 14.0 Measeles
84.3
OPD All (per 1000 population) 343.8
412.5 328.7 Full immunisation
76.4
IPD (per 1000 population) 20.6
24.7 34.7 Unmet need for FP
Operation Major (per Lakh population)
10.6
12.8 0.000 Spacing
14.4
Reported Infant and Child Deaths 18
21.6 16 Limiting
12.9
Reported Maternal Deaths 11
13.2 2 Total
27.3
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Kodarma - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 717169
Estimated Pregnancies
18,632 ANC
CBR (AHS-2011) 23.2 Estimated Deliveries 16,938
ANC Check-up in first trimester 62.6
Apprehended Infant Deaths ( IMR = 36 taken from AHS - 2011 )
599 Estimated Live Births 16,638
3 or more ANC Check-up 65.9
Estimated Eligible couples ( 17% of population)
1,21,919
Estimated Maternal Complications( 15% of
Estimated pregnancies)
2,795
Atleast 1 TT received
89.5
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
10.0
3ANC Check up against estimated pregnancies
39% 47% 39%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
71% 85% 71%
Institutional Delivery
45.8
Met need for EmOC * 61.97% 74% 61.79%
Home Delivery 53.9
Reported Live Births against estimated Live Births
82% 98% 89%
Home Delivery by SBA
54.5
BCG to Measles dropout rate 29% 29% 11%
New born & post natal care
Fully Immunised against estimated Live Births
65% 78% 73%
Abortion (Induced + Spontaneous)
2.8
Immunisation session held as % of required VHNDs
81% 81% 73%
Still Birth
Page 39 of 48
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 12
Breastfed within 1 hour of birth 31.8
Childhood Disease Measles 46 55.2 115 PNC within 48 hrs of delivery 82.6
Childhood Disease Malaria 241 289.2 951 Immunisation
Sterilization - Female per 1000 eligible couple
35.75
42.90
42.02
BCG
95.8
Sterilization - Male per 1000 eligible couple
0.37
0.44
1.10 DPT3
70.9
Reported Abortion Rate per 1000 Estimated live births
10.6
12.7 4.2 Measeles
78.1
OPD All (per 1000 population) 186.5
223.8 244.6
Full immunisation
58.5
IPD (per 1000 population) 10.4
12.5 10.0 Unmet need for FP
Operation Major (per Lakh population)
0.0 -
0.000 Spacing 18.3
Reported Infant and Child Deaths 23
27.6 17 Limiting
16.0
Reported Maternal Deaths 6
7.2 13 Total
34.3
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Kodarma - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 717169
Estimated Pregnancies
18,632 ANC
CBR (AHS-2011) 23.2 Estimated Deliveries 16,938
ANC Check-up in first trimester 62.6
Apprehended Infant Deaths ( IMR = 36 taken from AHS - 2011 )
599 Estimated Live Births 16,638 3 or more ANC Check-up 65.9
Estimated Eligible couples ( 17% of population)
1,21,919
Estimated Maternal Complications( 15% of
Estimated pregnancies)
2,795
Atleast 1 TT received
89.5
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
10.0
3ANC Check up against estimated pregnancies
39% 47% 39%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
71% 85% 71%
Institutional Delivery
45.8
Met need for EmOC * 61.97% 74% 61.79%
Home Delivery 53.9
Reported Live Births against estimated Live Births
82% 98% 89%
Home Delivery by SBA
54.5
Page 40 of 48
BCG to Measles dropout rate 29% 29% 11%
New born & post natal care
Fully Immunised against estimated Live Births
65% 78% 73%
Abortion (Induced + Spontaneous) 2.8
Immunisation session held as % of required VHNDs
81% 81% 73%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 12
Breastfed within 1 hour of birth 31.8
Childhood Disease Measles 46 55.2 115 PNC within 48 hrs of delivery 82.6
Childhood Disease Malaria 241 289.2 951 Immunisation Sterilization - Female per 1000 eligible couple
35.75
42.90
42.02
BCG 95.8
Sterilization - Male per 1000 eligible couple
0.37
0.44
1.10 DPT3
70.9
Reported Abortion Rate per 1000 Estimated live births
10.6
12.7 4.2 Measeles
78.1
OPD All (per 1000 population) 186.5
223.8 244.6
Full immunisation
58.5
IPD (per 1000 population) 10.4
12.5 10.0 Unmet need for FP
Operation Major (per Lakh population)
0.0 -
0.000 Spacing 18.3
Reported Infant and Child Deaths 23
27.6 17 Limiting
16.0
Reported Maternal Deaths 6
7.2 13 Total
34.3
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Latehar - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 717169
Estimated Pregnancies
18,632 ANC
CBR (AHS-2011) 23.2 Estimated Deliveries 16,938 ANC Check-up in first trimester 62.6
Apprehended Infant Deaths ( IMR = 36 taken from AHS - 2011 )
599 Estimated Live Births 16,638 3 or more ANC Check-up 65.9
Estimated Eligible couples ( 17% of population)
1,21,919
Estimated Maternal Complications( 15% of
Estimated pregnancies)
2,795
Atleast 1 TT received
89.5
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets 10.0
3ANC Check up against estimated pregnancies
59% 70% 39%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
43% 52% 71%
Institutional Delivery
45.8
Met need for EmOC * 0.29% 0% 61.79%
Home Delivery 53.9
Page 41 of 48
Reported Live Births against estimated Live Births
87% 105% 89%
Home Delivery by SBA
54.5
BCG to Measles dropout rate 5% 5% 11%
New born & post natal care
Fully Immunised against estimated Live Births
68% 82% 73%
Abortion (Induced + Spontaneous) 2.8
Immunisation session held as % of required VHNDs
134% 134% 73%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 12 Breastfed within 1 hour of birth 31.8
Childhood Disease Measles 16 19.2 115 PNC within 48 hrs of delivery 82.6
Childhood Disease Malaria 456 547.2 951 Immunisation
Sterilization - Female per 1000 eligible couple
12.36
14.83
42.02
BCG 95.8
Sterilization - Male per 1000 eligible couple
0.55
0.66
1.10
DPT3 70.9
Reported Abortion Rate per 1000 Estimated live births
15.7
18.8 4.2
Measeles
78.1
OPD All (per 1000 population) 596.9
716.3 244.6
Full immunisation
58.5
IPD (per 1000 population) 10.5
12.6 10.0 Unmet need for FP
Operation Major (per Lakh population)
49.1
58.9 0.000 Spacing
18.3
Reported Infant and Child Deaths 40
48.0 17 Limiting
16.0
Reported Maternal Deaths 5
6.0 13 Total
34.3
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Lohardaga - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 461738
Estimated Pregnancies
14,553 ANC
CBR (AHS-2011) 27.9 Estimated Deliveries 13,230 ANC Check-up in first trimester 54.0
Apprehended Infant Deaths ( IMR = 54 taken from AHS - 2011 )
696 Estimated Live Births 12,882 3 or more ANC Check-up 50.0
Estimated Eligible couples ( 17% of population)
78,495
Estimated Maternal Complications( 15% of
Estimated pregnancies)
2,183
Atleast 1 TT received
93.7
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets 12.3
3ANC Check up against estimated pregnancies
41% 49% 49%
Deliveries
Page 42 of 48
Institutional Deliveries (Public+Private) against estimated deliveries
57% 68% 60%
Institutional Delivery
38.6
Met need for EmOC * 27.90% 33% 34.49%
Home Delivery 60.5
Reported Live Births against estimated Live Births
66% 79% 83%
Home Delivery by SBA
15.2
BCG to Measles dropout rate -4% -4% 7%
New born & post natal care
Fully Immunised against estimated Live Births
71% 85% 78%
Abortion (Induced + Spontaneous) 5.8
Immunisation session held as % of required VHNDs
146% 146% 135%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 0 Breastfed within 1 hour of birth 60.2
Childhood Disease Measles 26 31.2 65 PNC within 48 hrs of delivery 52.6
Childhood Disease Malaria 120 144 254 Immunisation
Sterilization - Female per 1000 eligible couple
13.50
16.20
22.15
BCG 95.5
Sterilization - Male per 1000 eligible couple
2.45
2.94
5.08
DPT3 83.8
Reported Abortion Rate per 1000 Estimated live births
22.7
27.2 45.6
Measeles
95.1
OPD All (per 1000 population) 421.2
505.4 445.1
Full immunisation
82.5
IPD (per 1000 population) 10.9
13.1 38.0 Unmet need for FP
Operation Major (per Lakh population)
21.7
26.0 186.036 Spacing
17.4
Reported Infant and Child Deaths 11
13.2 9 Limiting
10.8
Reported Maternal Deaths 4
4.8 1 Total
28.2
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Pakaur - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 899200
Estimated Pregnancies
30,243 ANC
CBR (AHS-2011) 29.7 Estimated Deliveries 27,494
ANC Check-up in first trimester 39.4
Apprehended Infant Deaths ( IMR = 59 taken from AHS - 2011 )
1576 Estimated Live Births 26,706 3 or more ANC Check-up 49.7
Estimated Eligible couples ( 17% of population)
1,52,864
Estimated Maternal Complications( 15% of
Estimated pregnancies)
4,537
Atleast 1 TT received
90.0
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
4.4
Page 43 of 48
Jharkhand-Palamu - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1936319
Estimated Pregnancies
49,753 ANC
CBR (AHS-2011) 22.8 Estimated Deliveries 45,230
ANC Check-up in first trimester 38.4
3ANC Check up against estimated pregnancies
33% 39% 41%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
28% 34% 28%
Institutional Delivery
20.8
Met need for EmOC * 1.06% 1% 2.91%
Home Delivery 79.2
Reported Live Births against estimated Live Births
54% 65% 65%
Home Delivery by SBA
7.3
BCG to Measles dropout rate -10% -10% 13%
New born & post natal care
Fully Immunised against estimated Live Births
55% 66% 64%
Abortion (Induced + Spontaneous) 2.4
Immunisation session held as % of required VHNDs
115% 115% 115%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 0
Breastfed within 1 hour of birth 24.1
Childhood Disease Measles 8 9.6 42 PNC within 48 hrs of delivery 67.6
Childhood Disease Malaria 435 522 414 Immunisation
Sterilization - Female per 1000 eligible couple
8.90
10.68
12.87
BCG
91.3
Sterilization - Male per 1000 eligible couple
0.29
0.35
0.88
DPT3
72.4
Reported Abortion Rate per 1000 Estimated live births
8.2
9.8 2.4
Measeles
61.6
OPD All (per 1000 population) 220.2
264.3 274.1
Full immunisation
45.7
IPD (per 1000 population) 9.2
11.0 9.3 Unmet need for FP
Operation Major (per Lakh population)
1.1
1.3 7.451 Spacing
17.1
Reported Infant and Child Deaths 3
3.6 1 Limiting
23.1
Reported Maternal Deaths 4
4.8 2 Total
40.2
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 44 of 48
Apprehended Infant Deaths ( IMR = 49 taken from AHS - 2011 )
2163 Estimated Live Births 44,148
3 or more ANC Check-up 34.8
Estimated Eligible couples ( 17% of population)
3,29,174
Estimated Maternal Complications( 15% of
Estimated pregnancies)
7,463
Atleast 1 TT received
75.2
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
8.3
3ANC Check up against estimated pregnancies
51% 61% 62%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
46% 56% 46%
Institutional Delivery
31.0
Met need for EmOC * 33.70% 40% 5.78%
Home Delivery 68.9
Reported Live Births against estimated Live Births
67% 81% 73%
Home Delivery by SBA
19.1
BCG to Measles dropout rate 7% 7% 8%
New born & post natal care
Fully Immunised against estimated Live Births
70% 84% 80%
Abortion (Induced + Spontaneous) 2.9
Immunisation session held as % of required VHNDs
89% 89% 90%
Still Birth
Childhood Disease Diphtheria 4 4.8 10
Live Birth
Childhood Disease Pertussis 0 0 7
Breastfed within 1 hour of birth 31.7
Childhood Disease Measles 98 117.6 383 PNC within 48 hrs of delivery 56.4
Childhood Disease Malaria 777 932.4 2772 Immunisation Sterilization - Female per 1000 eligible couple
15.00
18.00
32.65 BCG
91.1
Sterilization - Male per 1000 eligible couple
0.42
0.50
2.04 DPT3
65.2
Reported Abortion Rate per 1000 Estimated live births
5.9
7.1 9.8 Measeles
69.2
OPD All (per 1000 population) 317.5
381.0 390.5 Full immunisation
54.2
IPD (per 1000 population) 17.7
21.2 24.2 Unmet need for FP
Operation Major (per Lakh population)
63.8
76.5 33.362 Spacing
16.6
Reported Infant and Child Deaths 1
1.2 7 Limiting
16.9
Reported Maternal Deaths 24
28.8 1 Total
33.5
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Jharkhand-Purbi Singhbhum - Apr'12 - Jan'13 AHS 2011
Page 45 of 48
Population (Census-2011) 2291032
Estimated Pregnancies
53,611 ANC
CBR (AHS-2011) 21 Estimated Deliveries 48,737 ANC Check-up in first trimester 72.3
Apprehended Infant Deaths ( IMR = 26 taken from AHS - 2011 )
1251 Estimated Live Births 48,112 3 or more ANC Check-up 76.4
Estimated Eligible couples ( 17% of population)
3,89,475
Estimated Maternal Complications( 15% of
Estimated pregnancies)
8,042
Atleast 1 TT received
95.0
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets 35.1
3ANC Check up against estimated pregnancies
52% 62% 67%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
53% 63% 62%
Institutional Delivery
63.0
Met need for EmOC * 43.66% 52% 37.38%
Home Delivery 36.8
Reported Live Births against estimated Live Births
63% 75% 78%
Home Delivery by SBA
25.2
BCG to Measles dropout rate 9% 9% 10%
New born & post natal care
Fully Immunised against estimated Live Births
67% 81% 82%
Abortion (Induced + Spontaneous) 3.5
Immunisation session held as % of required VHNDs
77% 77% 82%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 0 Breastfed within 1 hour of birth 52.0
Childhood Disease Measles 181 217.2 334 PNC within 48 hrs of delivery 67.5
Childhood Disease Malaria 516 619.2 887 Immunisation
Sterilization - Female per 1000 eligible couple
13.26
15.92
16.68
BCG 97.1
Sterilization - Male per 1000 eligible couple
0.36
0.43
0.54
DPT3 86.4
Reported Abortion Rate per 1000 Estimated live births
33.9
40.7 41.0
Measeles
93.0
OPD All (per 1000 population) 559.4
671.2 683.5
Full immunisation
82.7
IPD (per 1000 population) 16.6
20.0 25.6 Unmet need for FP
Operation Major (per Lakh population)
336.7
404.0 494.057 Spacing
11.5
Reported Infant and Child Deaths 174
208.8 170 Limiting
9.6
Reported Maternal Deaths 36
43.2 52 Total
21.1
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
Page 46 of 48
Jharkhand-Ranchi - Apr'12 - Jan'13
AHS 2011
Population (Census-2011) 2912022
Estimated Pregnancies
76,593 ANC
CBR (AHS-2011) 23.5 Estimated Deliveries 69,630
ANC Check-up in first trimester 69.9
Apprehended Infant Deaths ( IMR = 35 taken from AHS - 2011 )
2395 Estimated Live Births 68,433
3 or more ANC Check-up 63.2
Estimated Eligible couples ( 17% of population)
4,95,044
Estimated Maternal Complications( 15% of
Estimated pregnancies)
11,489
Atleast 1 TT received
93.0
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
14.8
3ANC Check up against estimated pregnancies
35% 42% 47%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
50% 60% 60%
Institutional Delivery
52.3
Met need for EmOC * 63.57% 76% 54.46%
Home Delivery 47.0
Reported Live Births against estimated Live Births
61% 74% 78%
Home Delivery by SBA
36.4
BCG to Measles dropout rate 11% 11% -24%
New born & post natal care
Fully Immunised against estimated Live Births
50% 59% 99%
Abortion (Induced + Spontaneous)
5.2
Immunisation session held as % of required VHNDs
82% 82% 91%
Still Birth
Childhood Disease Diphtheria 0 0 23
Live Birth
Childhood Disease Pertussis 0 0 0
Breastfed within 1 hour of birth 46.5
Childhood Disease Measles 144 172.8 520 PNC within 48 hrs of delivery 63.3
Childhood Disease Malaria 2163 2595.6 3695 Immunisation
Sterilization - Female per 1000 eligible couple
9.09
10.91
15.18
BCG
94.5
Sterilization - Male per 1000 eligible couple
1.60
1.92
2.03
DPT3
80.9
Reported Abortion Rate per 1000 Estimated live births
56.3
67.5 68.4
Measeles
89.7
OPD All (per 1000 population) 367.6
441.1 364.7
Full immunisation
76.4
IPD (per 1000 population) 9.1
10.9 8.4 Unmet need for FP
Operation Major (per Lakh population)
0.5
0.7 57.795 Spacing
16.2
Reported Infant and Child Deaths 40 31 Limiting 15.9
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Jharkhand-Sahibganj - Apr'12 - Jan'13 AHS 2011
Population (Census-2011) 1150038
Estimated Pregnancies
31,778 ANC
CBR (AHS-2011) 24.4 Estimated Deliveries 28,889
ANC Check-up in first trimester 49.1
Apprehended Infant Deaths ( IMR = 59 taken from AHS - 2011 )
1656 Estimated Live Births 28,061
3 or more ANC Check-up 35.4
Estimated Eligible couples ( 17% of population)
1,95,506
Estimated Maternal Complications( 15% of
Estimated pregnancies)
4,767
Atleast 1 TT received
78.0
Indicator Apr'12 - Jan'13
Projected for April'12 to Mar'13
Last Year Apr'11-Mar'12
100 IFA Tablets
4.1
3ANC Check up against estimated pregnancies
33% 39% 41%
Deliveries
Institutional Deliveries (Public+Private) against estimated deliveries
61% 73% 42%
Institutional Delivery
22.8
Met need for EmOC * 9.25% 11% 7.78%
Home Delivery 76.9
Reported Live Births against estimated Live Births
80% 96% 78%
Home Delivery by SBA
13.1
BCG to Measles dropout rate 7% 7% 5%
New born & post natal care
Fully Immunised against estimated Live Births
65% 78% 84%
Abortion (Induced + Spontaneous) 2.5
Immunisation session held as % of required VHNDs
102% 102% 97%
Still Birth
Childhood Disease Diphtheria 0 0 0
Live Birth
Childhood Disease Pertussis 0 0 0
Breastfed within 1 hour of birth 28.6
Childhood Disease Measles 75 90 146 PNC within 48 hrs of delivery 49.6
Childhood Disease Malaria 458 549.6 709 Immunisation Sterilization - Female per 1000 eligible couple
8.28
9.94
14.50 BCG
88.0
Sterilization - Male per 1000 eligible couple
0.11
0.13
0.31 DPT3
71.7
Reported Abortion Rate per 1000 Estimated live births
12.2
14.6 22.0 Measeles
63.5
48.0
Reported Maternal Deaths 38
45.6 19 Total
32.1
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication
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OPD All (per 1000 population) 281.3
337.6 372.7 Full immunisation
54.9
IPD (per 1000 population) 26.6
32.0 25.8 Unmet need for FP
Operation Major (per Lakh population)
60.2
72.2 95.127 Spacing
20.6
Reported Infant and Child Deaths 70
84.0 57 Limiting
18.0
Reported Maternal Deaths 33
39.6 24 Total
38.6
* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication