About This Site   Resources   Contact Us   Site Map   Terms of Use
 

your location: home > development > health > health indicators

Health Indicators in Bundelkhand

Our source of information on health indicators is Ranking and Mapping of Districts Based on Socio-economic and Demographic Indicators (RMD) a 2006 publication of International Institute for Population Sciences (IIPS), Mumbai, supported by Ministry of Health and Family Welfare, Government of India and National Commission on Population, New Delhi.

The data in this publication, extracted and shown in tables below, is from Census 2001 and a district-level household sample survey (DHS) undertaken by IIPS, for the Union Ministry of Health and Family Welfare in 2002-2004. Using these two data sources, the authors studied variations in 13 key indicators of development across 591 districts of the country existing at the time of these surveys; most of the indicators related to health. We can thus compare Bundelkhand districts with districts in other parts of the country under some key health parameters (see discussion below the tables).   

UP Bundelkhand health indicators

Indicator Jhansi Lalitpur Jalaun Hamirpur Mahoba Banda Chitrakoot
% decadal pop growth (2001) 23.2 29.9 19.3 17.8 21.8 18.1 34.3
% pop below 6 years of age (2001) 15.4 20.3 15.9 17.6 16.7 19.2 20.7
% contraceptive prevalence rate (2003-04) 55.1 39.9 49.2 51 54.8 39.5 41.6
% women delivering below age of 20 (2001) 7 10 5.2 4.5 6.5 4.6 5
Under-5 mortality (2001) 134.9 159 125 138 132 139 142
% households using safe drinking water (2001) 68.5 55.2 83.8 75.5 40.1 75.3 63
% households with toilets (2001) 35.2 17.2 35.4 24.4 21.8 20.2 12.5
% children who have received complete immunisation (2003-04) 24.5 23.3 12.3 34.5 14.1 15.4 18.2

MP Bundelkhand health indicators

Indicator Datia Chhatarpur Tikamgarh Panna Damoh Sagar
% decadal pop growth (2001) 21.8 27.3 27.8 24.1 20.4 22.7
% pop below 6 years of age (2001) 17 19.3 18.5 19.6 17.7 18.1
% contraceptive prevalence rate (2003-04) 53.7 34 46.6 40.6 58.1 47.4
% women delivering below age of 20 (2001) 7.8 8.1 11.2 5.9 7.8 6.8
Under-5 mortality (2001) 159 158.3 153.8 190.1 166.3 155.6
% households using safe drinking water (2001) 68.1 38.1 35.1 49.2 55.7 57.6
% households with toilets (2001) 21.4 15.3 11 11.1 13.9 21.3
% children who have received complete immunisation (2003-04) 20 29.9 7 12.2 20.2 34.1

Source: Ranking and Mapping of Districts Based on Socio-economic and Demographic Indicators,  International Institute for Population Sciences (IIPS), Mumbai, 2006. 2001 figures from Census 2001. 2003-04 figures from District Level Household Survey on Reproductive and Child Health (DHS) undertaken by IIPS, for the Union Ministry of Health and Family Welfare in 2002-2004.

Population below age of 6 years and population growth

In a country with a huge population and high absolute poverty, lower percentage of population growth is desirable. Lower fertility, through use of family planning methods  allows higher possibilities of a better life to the next generation. A good indicator of fertility level in a region is percentage of population below 6 years of age; higher this percentage, higher is the fertility level.

RMD reported that the lowest percentage of population below 6 years of age (6.2%) was recorded by Census 2001 in Leh district of Jammu and Kashmir. Around 150 districts of the country, including all districts of Bihar, Jharkhand, MP  and UP except one, Kanpur Nagar in UP,  had more than 13% of the population below the age of 6.

In Bundelkhand, highest percentage of population in this age category (20.7%) was recorded in Chitrakoot, followed closely by Lalitpur, Banda, Panna and Chhatarpur.

As noted in Population Growth Trends, Bundelkhand's agro-climatic conditions do not favour high population density; it has been one of the least populated areas of north India. However, population is growing at a rapid pace, threatening to bring enormous pressure on the fragile agriculture economy. In India as a whole, the decadal population growth in 2001 was around 21%; it was higher in the states of MP and UP at around 25%.

In Bundelkhand, decadal population growth was higher than state averages in Lalitpur, Chitrakoot, Tikamgarh and Chhatarpur districts, with highest growth (34.3%) recorded in Chitrakoot. The abnormal growth in Chitrakoot needs to be investigated. It is perhaps not coincidental that all these four districts score poorly on many other human development indicators - families have more children when there is higher risk of death during infancy and early childhood. More children also means more members in the family who can earn from labour.

RMD data shows that all districts of Bundelkhand other than Jhansi had over 17% of population below the age of 6. Lalitpur and Chitrakoot were among the three worst performing districts of UP on this score, with over 20% population in this age bracket.  In MP Bundelkhand, Panna was among the districts of the state at the bottom on this indicator.

Percentage of birth order three and above

Percentage of birth order three and above tells us how many women were having their third or higher order child out of total women who had delivered at the time of the survey. Higher order births entail higher risk for mother and child, and a high percentage of such births indicates weak impact of family welfare programmes.

Using Census 2001 figures, RMD reported that the lowest percentage of births of order three and above was observed in Alappuzha district of Kerala (12.3%) and highest percentage was estimated in Tuensang district of Nagaland (72.9%). The first 100 districts of India on this indicator, with maximum 34% births of order three and above, were mostly from southern Indian states. Among northern Indian states, only some districts of Himachal Pradesh were in the top 100 districts.

In Bundelkhand, all districts other than Jhansi had over 50% births of order three and above with the maximum recorded in Banda and Chitrakoot (around 60%). Higher percentages were reported in 17 districts of UP, including Aligarh, Etah, Hardoi and Sitapur. In MP Bundelkhand, Panna recorded the highest percentage (58.8%); in four districts of the state higher percentages were reported.

Contraceptive prevalence rate

DHS reported that around 53% of married women in India between the age of 15 and 44 used some method of family planning, but the majority of them (35%) had adopted a permanent method of family planning. This suggests that unmet need for family planning remains high, especially in Bihar, Uttar Pradesh and Northeastern states, which accounted for the majority of the bottom 100 districts on this indicator. In the top 100 districts on this indicator, the rate was up to 66.7%. The maximum use of family planning method among married women between the age 15 and 44  was observed in Leh (Ladakh) district of Jammu and Kashmir (90.7%) and the minimum was observed in Chandel district of Manipur (4.9%).

In Bundelkhand, below 50% use of family planning methods was reported  in Lalitpur, Jalaun, Banda, Chitrakoot, Chhatarpur, Panna and Sagar; the lowest use was in Chhatarpur (34%), which ranked above only Sidhi among all districts of MP on this score.

Births below age of 20

Percentage of women delivering below age of 20 indicates prevalence of early marriages - before the legal age. Early childbearing aggravates health and survival risks to both mother and child and deprives women of their rights. Early marriage may also result in more births.

Using Census 2001 figures, RMD reported that the lowest percentage of births below age 20 was observed in Una district of Himachal Pradesh (0.81%) and highest percentage was in Nalgonda district of Andhra Pradesh (20.5%). In the top 100 districts of the country on this indicator, which included all districts of Jammu and Kashmir and many districts of Kerala, Maharashtra, Punjab, Himachal Pradesh and Tamil Nadu, the maximum percentage was 3.1%. Some districts of UP also figured in the top 100. The majority of the bottom 100 districts on this indicator were from the states of Andhra Pradesh, Karnataka, Madhya Pradesh, Rajasthan and West Bengal.

In Bundelkhand, the percentage generally ranged between 5 to 8%. Tikamgarh ranked at the bottom of all MP districts with 11.2% births below age of 20.

Mortality under age of 5

Mortality under age of 5 is a good indicator of availability of skilled care at birth,  nutritional status of mothers and availability of complementary feeding. Overall, it reflects health of children. Major causes of child mortality are neonatal problems, pneumonia and diarrhoea. Using Census 2001 figures, RMD reported that lowest under-5 mortality was in South Goa district, where mortality was 43 per 1000 live births - slightly higher than the UN Millennium Development Goal of 41 per 1000 for the whole country by the year 2015. The rate was highest in East Kameng district of Arunachal Pradesh (263 per 1000 live births). The majority of the bottom 100 districts on this indicator belong to the states of Arunachal Pradesh, Madhya Pradesh, Orissa, Rajasthan, and Uttar Pradesh. The majority of the top 100 districts are from Kerala, Maharashtra, Andhra Pradesh and Tamil Nadu, with a maximum rate of 75 per 1000.

In Bundelkhand, Lalitpur and all districts of MP Bundelkhand reported mortality of over 150 per 1000 live births. Other UP Bundelkhand districts reported relatively lower mortality rates - but remained very far from the UN Millennium Development Goal. Highest figures across the region were reported in Panna (190/1000), which was the worst performing district of MP on this indicator.

Households using safe drinking water

Safe drinking water reduces risk of illness due to diarrhoea, jaundice and other water-borne diseases; it hence increases a person's productivity and reduces chances of medical expenses and possible loss of income. A large number of children below the age of five die due to water-borne diseases.

Census 2001 assumed that taps, handpumps and tubewells are safe drinking water sources. A household using water for drinking purposes from any of these three sources was defined as one using safe or improved drinking water. RMD reported that the highest proportion of such households was found in Chandigarh district (99.8%) and lowest was found in Lakshadweep district (4.6%). The majority of the bottom 100 districts on this indicator belonged, interestingly, to the states of Jammu and Kashmir and Kerala, along with Madhya Pradesh and Northeastern states. In the top 100 districts were several districts from UP's Gangetic belt, with up to 96% households reportedly enjoying safe drinking water.

In Bundelkhand, safe drinking water coverage is generally poor all over, and the problem is particularly serious in the districts of Mahoba, Tikamgarh, Chhatarpur and Panna where over half the households did not have access to safe drinking water sources, according to Census 2001 data.

Households with toilets

Access to toilet to everyone improves sanitation and hygiene conditions in a settlement. It is of enormous benefit to rural women, who otherwise generally defecate in the night, to enjoy some privacy. In most social groups, access to toilet provides dignity.

In Census 2001, any kind of toilet (pit, with/without water closets) was considered a toilet and by this criterion, RMD reported, the maximum percentage of households with a toilet was found in Mamit district of Mizoram (97.3%). The lowest percentage was found in Jashpur district, Chhatisgarh, where less than 5% households had a toilet. Among all parts of India, toilets are most available in the North East and many of the top 100 districts of India on this indicator were from this region, with over 60% of households having access to toilets. In the bottom 100 districts, where less than 15% households have toilets, were many districts of Bihar, Chattisgarh, Jharkhand, Madhya Pradesh, Orissa and Uttar Pradesh.

Four districts of Bundelkhand were in the bottom 100 districts list: Chitrakoot (12.5%), Tikamgarh (11%), Panna (11.1%) and Damoh (13.9%). In all other districts except Jhansi and Jalaun, less than a fourth of the households had toilets.

Percentage of children getting complete immunisation

Complete immunisation means vaccination of children against six diseases: measles, whooping cough  tetanus, tuberculosis, polio and diptheria.  Most of these diseases are the cause of high infant mortality. Immunisation protects children from these diseases, at the age when they are most vulnerable. Under the central government's immunisation programme, every infant should receive vaccination against these six diseases in the first year of their life. The universal immunisation programme, launched in 1985-86, aimed at 85% coverage by 1990. Actual coverage, till the end of the 1990s was much lower, at around 53%. Another target, of 100% immunisation by the year 2010,  was set by the National Population Policy (2000). Reviews of achievements by WHO and UNICEF showed that in 2003 even in urban areas, around 40% of  children had not received full immunisation; in urban areas of Bihar and Rajasthan the percentage of children who had received immunisation was less than 20% and 30% respectively.

DHS figures show that in around 270 districts of the country, over 60% of children had not received full immunisation. The bottom 100 districts were mostly from the Northeast, Bihar, Madhya Pradesh, Jammu & Kashmir, Rajasthan and Uttar Pradesh, with less than 20% full immunisation coverage.

Eight of the 13 districts of Bundelkhand figure in the bottom 100 list: Jalaun (12.3%), Mahoba (14.1%), Banda (15.4%), Chitrakoot (18.2%), Panna (12.2%), Datia (20%) and Tikamgarh, where only 7% children have received full immunisation.

| Public Health | Health Indicators |

 
Health
> Public Health
> Health Indicators