Annual Health Survey released: Health indicators in some States show improvement

All major health indicators in the country’s worst-performing States are showing a gradual improvement over the years but inter-State variations persist.

Districts with the highest and lowest values of Crude Birth Rate and Infant Mortality Rate remained the same over the three rounds. Top 100 districts constitute about 51 per cent of total infant deaths across 9 States (284 districts), whereas it was 50 per cent during the baseline.

The nine States for which AHS is conducted — Rajasthan, Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Odisha, Madhya Pradesh, Chhattisgarh and Assam — have 50 per cent of the country’s population, 60 per cent of births, 71 per cent of infant deaths, 72 per cent of under 5 deaths and 62 per cent of maternal deaths. The reference period for the current round is January to December 2011.

As far as IMR is concerned, 9 districts — Purbi Singhbhum, Dhanbad, Bokaro, Giridih and Kodarma (Jharkhand); Chamoli, Rudraprayag, Pithoragarh and Almora (Uttarakhand) — have already achieved the Millennium Development Goal-4 national target of 28. During the first update and baseline, there were 7 and 6 districts respectively. Another 11 districts — Ranchi, Deoghar, Hazaribagh and Garhwa (Jharkhand), Nainital, Bageshwar, Champawat, Udham Singh Nagar and Dehradun (Uttarakhand), Patna (Bihar), and Durg (Chhattisgarh) — are in closer vicinity of achieving the target.

Importantly, 100 districts account for 52 per cent of under-5 mortality rate whereas it was 63 at the baseline. In U5MR, 15 districts — Pithoragarh, Almora, Rudraprayag, Chamoli, Nainital, Bagheswar, Dehradun and Champawat (Uttarakhand) and Purbhi Singhbum, Hazaribagh, Dhanbad, Bokaro, Girdih, Deoghar and Kodarma (Jharkhand) — have already achieved the MDG national level target of 42. During the first update and baseline, there were 12 and 7 districts. Champawat, Hazaribagh, Dhanbad, Bokaro, Kodarma (first update), Giridih, Deoghar and Dehradun (second update) are new additions.

Another 11 districts — Ranchi and Garhwa (Jharkhand); Durg (Chhattisgarh); Udham Singh Nagar and Pauri Garhwal (Uttarakhand); Dhemaji and Kamrup (Assam); Indore (M.P.); Kota (Rajasthan); Jharsuguda (Odisha); and Patna (Bihar) — are in closer vicinity. Chhattisgarh and Bihar recorded the highest fall (7), while UP and Uttarakhand recorded the lowest (3) from the baseline to the second update round.

More female infants die, compared with males. In Rajasthan, the female IMR is 60, compared with 51 for males, the difference is the highest. 

In the baseline also, Rajasthan recorded the maximum difference with female IMR as 65 compared with 55 for males.

Twenty-five administrative divisions, comprising 100 districts (104 districts in baseline), constitute 45 per cent of the total maternal deaths, whereas it was 41 per cent in baseline. Forty-two districts are hotspots (57 in baseline) — with the worst indicators.

The Annual Health Surveys for these nine States are conducted to monitor the impact of targeted interventions in the low performing districts so as to remove disparities. The indicators in these States also bring down the national averages.