rsoc national report 2013-14 (final)
TRANSCRIPT
Ministry of Women and Child Development, Government of India
TABLE OF CONTENTS
Particulars Page No.
LIST OF TABLES i LIST OF FIGURES v LIST OF ABBREVIATIONS vii EXECUTIVE SUMMARY ix CHAPTER 1 INTRODUCTION 1
1.1 BACKGROUND 1 1.2 CHAPTER CONTENT 2 1.3 STUDY OBJECTIVES 2 1.4 SURVEY DESIGN AND METHODOLOGY 3 1.5 SURVEY TOOLS 7 1.6 IMPLEMENTATION THROUGH CAPI 8 1.7 SURVEY IMPLEMENTATION 9 1.8 DATA PROCESSING AND ANALYSIS 13 1.9 WEALTH INDEX 13 1.10 STRUCTURE OF THE NATIONAL REPORT 14
CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS 15 2.1 RESPONSE RATES 16 2.2 HOUSEHOLD POPULATION BY AGE, SEX AND MARITAL STATUS 19 2.3 HOUSEHOLD COMPOSITION BY USUAL MEMBERS 37 2.4 PROFILE OF THE HEAD OF THE HOUSEHOLDS 38 2.5 LITERACY AND EDUCATIONAL ATTAINMENT 42 2.6 HOUSING CHARACTERISTICS 57 2.7 WATER, SANITATION AND HYGIENE PRACTICES OF THE HOUSEHOLD 59 2.8 HOUSEHOLD POSSESSION AND WEALTH INDEX 70 2.9 IODINE LEVELS IN COOKING SALT 75
CHAPTER 3 PROFILE OF EVER MARRIED WOMEN AND CHILDREN 78 3.1 INTRODUCTION 78 3.2 SOCIO-ECONOMIC PROFILE OF EVER MARRIED WOMEN 78 3.3 SCHOOL ENROLMENT OF ADOLESCENT GIRLS 80 3.4 MARITAL STATUS 82 3.5 AGE AT FIRST MARRIAGE 84 3.6 AGE AT FIRST PREGNANCY 86 3.7 TEENAGE CHILDBEARING 90 3.8 CHILDREN EVER BORN AND LIVING 91 3.9 BIRTH ORDER 93 3.10 FAMILY PLANNING PRACTICES 95 3.11 PROFILE OF CHILDREN 97 3.12 BIRTH REGISTRATION 99 3.13 PRE-SCHOOL EDUCATION IN INDIA 104
CHAPTER 4 MATERNAL HEALTHCARE 108 4.1 BACKGROUND 108 4.2 ANTENATAL CARE (ANC) 109 4.3 NATAL CARE 132
Particulars Page No.
4.4 POSTNATAL CARE 152 4.5 ROLE OF AWC IN PRENATAL, NATAL AND POSTNATAL CARE 163
CHAPTER 5 CHILD HEALTHCARE 168 5.1 IMMUNIZATION 168 5.2 CHILDHOOD DISEASES 181 5.3 HEALTH CHECK-UP OF CHILDREN 190 5.4 ROLE OF ANGANWADI CENTRES 192
CHAPTER 6 NUTRITION OF CHILDREN AND ADOLESCENT GIRLS 198 6.1 BIRTH WEIGHT 198 6.2 INFANT AND YOUNG CHILDREN FEEDING (IYCF) PRACTICES 202 6.3 MICRO-NUTRIENT SUPPLEMENTATION 216 6.4 NUTRITIONAL STATUS OF CHILDREN 219 6.5 NUTRITIONAL STATUS OF ADOLESCENT GIRLS 228 6.6 ROLE OF ANGANWADI CENTRES 234
CHAPTER 7 UTILIZATION OF ICDS SERVICES 238 7.1 BACKGROUND 238 7.2 AWARENESS OF SERVICES AVAILABLE AT ANGANWADI CENTRE 238 7.3 UTILIZATION OF AWC SERVICES 242 7.4 REASONS FOR NOT AVAILING AWC SERVICES 246 7.5 REASONS FOR NOT AVAILING SUPPLEMENTARY FOOD 247 7.6 TYPE OF SUPPLEMENTARY FOOD PROVIDED AT AWC 248 7.7 REGULARITY OF RECEIVING SUPPLEMENTARY FOOD 251 7.8 SUPPLEMENTARY FOOD CONSUMPTION PATTERN 252 7.9 PLACE OF CONSUMPTION AND LIKING OF SUPPLEMENTARY FOOD 255 7.10 GROWTH MONITORING 256 7.11 QUANTITY OF FOOD GIVEN TO SEVERELY MALNOURISHED CHILDREN 264 7.12 ATTENDANCE AT PSE AND AGE AT ATTENDING PSE 265 7.13 OTHER SERVICES AT AWC 273
ANNEXURE A SAMPLE SIZE DETERMINATION 278 ANNEXURE TABLES 279
CHAPTER 1 279 CHAPTER 3 287 CHAPTER 5 297 CHAPTER 6 301 CHAPTER 7 306
WEIGHT COMPUTATION 330 ANNEXURE B
SURVEY TOOLS 333
RAPID SURVEY ON CHILDREN 2013-14 LIST OF TABLES | i
LIST OF TABLES
Table No. Details Page No.
Table 1.1 Number of households and primary sampling units covered in the RSOC survey, 2013-14
6
Table 2.1 Results of the household and individual interviews and anthropometric measurements
17
Table 2.2 Number of households covered in the survey and ever married women aged 15-49 interviewed and anthropometric measurements taken according to states, RSOC, 2013-14
18
Table 2.3 Household population by age and sex according to residence 20 Table 2.4 Trends in age distribution of household population 21 Table 2.5 Household population by age and state 23 Table 2.6 Sex ratio by states 24 Table 2.7 Marital status of the household population 26 Table 2.8 Early marriage and mean age at marriage by specific characteristics 29 Table 2.9 Early marriage and mean age at marriage by specific characteristics (Comparison) 32
Table 2.10 Marital status of the household population by states: Male 34 Table 2.11 Marital status of the household population by states: Female 35 Table 2.12 Early marriage and mean age at marriage by state 36 Table 2.13 Household size 37 Table 2.14 Characteristics of the head of the household 39 Table 2.15 Characteristics of the head of the household by states 40 Table 2.16 Occupation of the head of the household by state 41
Table 2.17 Literacy and educational attainment of the household population aged 6 and above: Male
43
Table 2.18 Literacy and educational attainment of the household population aged 6 and above: Female
45
Table 2.19 Educational status of the household population aged 6 and above across states: Male
47
Table 2.20 Educational status of the household population aged 6 and above across states: Female
48
Table 2.21 Literacy and educational attainment of the household population aged 7 years and above
49
Table 2.22 Literacy Rate of household population aged 6-24 years 50 Table 2.23 Literacy Rate of household population aged 15-24 years 51 Table 2.24 School attendance ratios 53 Table 2.25 School attendance by sex and residence 55 Table 2.26 School attendance by states 56 Table 2.27 Housing characteristics 58 Table 2.28 Source of drinking water 60 Table 2.29 Source of drinking water 61 Table 2.30 Improving drinking water by state 62 Table 2.31 Usage of household sanitation facilities 63 Table 2.32 Use of toilet facility by social groups and wealth quintiles 64 Table 2.33 Toilet facility by state 65
Table 2.34 Access to improved source of drinking water and use of improved sanitation facility
66
Table 2.35 Access to improved source of drinking water and use of improved sanitation facility by state
67
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Table No. Details Page No.
Table 2.36 Availability of hand washing facilities 69 Table 2.37 Hand wash facilities in households by states 70 Table 2.38 Household possessions 72 Table 2.39 Wealth Quintiles by Social Group and Religion 73 Table 2.40 Wealth Quintile 74 Table 2.41 Households using adequately iodized salt by selected characteristics 76 Table 2.42 Households using adequately iodized salt by state 77 Table 3.1 Socio-economic and demographic characteristics of respondents 79 Table 3.2 Current educational status of adolescent girls aged 10-19 during 2012-13 81 Table 3.3 Marital status of women 83 Table 3.4 Age at first marriage 84 Table 3.5 Age at first marriage among adolescent girls aged 10-19 85 Table 3.6 Age at first pregnancy 87
Table 3.7 Median age at first marriage, first pregnancy and first live birth by background characteristics
89
Table 3.8 Teenage pregnancy and motherhood 90 Table 3.9 Children ever born and living 92
Table 3.10 Children ever born and living by background characteristics 93 Table 3.11 Birth order 94 Table 3.12 Current use of family planning 96 Table 3.13 Profile of children 98 Table 3.14 Birth registration and possession of birth certificate 101 Table 3.15 Birth registration and possession of birth certificate by state 103 Table 3.16 Pre-school education (PSE) 105 Table 3.17 Pre-school education (PSE) by state 107 Table 4.1 Registration of pregnancy 111 Table 4.2 Registration of pregnancy, timing and MCP card 113 Table 4.3 Antenatal care indicators by state 114 Table 4.4 Utilization of Antenatal care service 116 Table 4.5 Utilization of Antenatal care services 117 Table 4.6 Tetanus Toxoid (TT) vaccination 119 Table 4.7 Receipt and consumption of IFA tablets 121 Table 4.8 Antenatal care indicators 123 Table 4.9 Full ANC 124
Table 4.10 Antenatal check-ups by state 126 Table 4.11 Antenatal care indicators by state 128 Table 4.12 Place of antenatal check-ups and type of service provider 130 Table 4.13 Visit by health functionaries at home during pregnancy 131 Table 4.14 Place of delivery 133 Table 4.15 Assistance during delivery by background characteristics 137 Table 4.16 Institutional and safe delivery 139
Table 4.17 Institutional deliveries according to person who advised to deliver at health facility
141
Table 4.18 Type of delivery 143 Table 4.19 Duration of stay at health facility (for institutional births) 145 Table 4.20 Duration of stay at health facility after delivery (institutional births) by states 147 Table 4.21 Awareness and benefits from JSY and JSSK 149 Table 4.22 Utilization of benefits of JSY and JSSK 151 Table 4.23 Visit by health functionaries after delivery/discharge from health facility 153
RAPID SURVEY ON CHILDREN 2013-14 LIST OF TABLES | iii
Table No. Details Page No.
Table 4.24 Timing of first postnatal check-up 156
Table 4.25 Number of postnatal check-ups received by women during first 10 days after delivery
157
Table 4.26 Timing of first postnatal check-up to newborn 160
Table 4.27 Number of postnatal check-ups received by newborn within first 10 days after birth
161
Table 4.28 Postnatal care indicators by states 163 Table 4.29 Role of Anganwadi Centre (AWC) in Maternal Health 165 Table 4.30 Role of AWC in Maternal Health by states 166 Table 5.1 Vaccinations by source of information 171 Table 5.2 Vaccinations by background characteristics 174 Table 5.3 Place of immunization 178 Table 5.4 Vaccinations by state 179 Table 5.5 Receipt of booster dose of DPT and 2nd dose of Measles 180 Table 5.6 Prevalence of diarrhoea, treatment sought and place of treatment 183
Table 5.7 Liquids/fluids given under oral rehydration as a part of diarrhoea treatment and source of ORS
186
Table 5.8 Prevalence and management of fever and symptoms of ARI by selected characteristics
188
Table 5.11 Health check-up of children aged 0-71 months 191 Table 5.13 Role of AWC in child health 194 Table 5.14 Role of AWC in child health by state 197 Table 6.1 Birth weight by selected characteristics 199 Table 6.2 Birth weight by state 201 Table 6.3 Initial breastfeeding among children aged 0-23 months 204 Table 6.4 Type of pre-lacteal liquids given 205 Table 6.5 Breastfeeding practices by state 206 Table 6.6 Exclusive breastfeeding and continued breastfeeding by age one and two 208 Table 6.8 Percentage children 6-8 months who were fed complementary foods 210
Table 6.9 Liquids consumed by children 6-23 months in the day or night preceding the interview
212
Table 6.10 Infant and young child feeding (IYCF) practices 214 Table 6.12 Micro-nutrient supplementation 217 Table 6.14 Nutritional status of children 223 Table 6.15 Nutritional status of children by state 226 Table 6.16 Nutritional status of adolescent girls 230 Table 6.17 Nutritional status of adolescent girls by state 232 Table 6.18 Role of AWC in child nutrition 235 Table 6.19 Role of AWC in Child Nutrition by state 237 Table 7.1 Awareness of services provided at AWC 239 Table 7.2 Awareness of services provided at AWC (any service) 240 Table 7.7 Awareness on services provided at AWC by state 241 Table 7.8 Utilization of AWC services 242 Table 7.9 Utilization of AWC services (any service) 244
Table 7.18 Non-utilization of AWC services by beneficiaries 246 Table 7.19 Non-utilization of AWC services by beneficiaries (reasons) 246 Table 7.20 Reasons for not availing supplementary food 247 Table 7.21 Supplementary food received by children 250 Table 7.24 Frequency of receiving supplementary food 252
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Table No. Details Page No.
Table 7.29 Supplementary food consumed by mothers of children aged 0-5 months 253 Table 7.30 Supplementary food consumed by children aged 6-35 months 253 Table 7.31 Supplementary food consumed by children aged 36-71 months 254 Table 7.32 Supplementary food consumed by currently pregnant women 255 Table 7.33 Place of consumption and perception on taste of supplementary food consumed 256
Table 7.34 Percentage of children aged 0-71 months for whom growth chart is available and percent distribution of those with growth chart by frequency of weighing in the 3 months preceding the survey, by background characteristics
258
Table 7.35 Awareness of weight of the child 261 Table 7.37 Persons who discussed about child’s nutrition status 263 Table 7.38 Quantity of supplementary food received by severely underweight children 264 Table 7.39 Attendance at pre-school education (PSE) at Anganwadi centre 266 Table 7.40 Regularity and quality of attendance at PSE at Anganwadi centre 268 Table 7.41 PSE—time spent by children on PSE activities in a day at AWC 270 Table 7.42 Reasons for not attending PSE at the AWC 271 Table 7.46 Village Health and Nutrition Day 274 Table 7.47 Home visits by AWW 275 Table 7.48 Other services provided at AWC by state 276
RAPID SURVEY ON CHILDREN 2013-14 LIST OF FIGURES | v
LIST OF FIGURES
Table No. Details Page No.
Figure 2.1 Age-Sex Pyramid, India, RSOC, 2013-14 22 Figure 2.2 Age-Sex Pyramid, India, Census of India, 2011 22
Figure 2.3 Mean age at marriage based on marriages that have taken place any time in the past vs marriages that took place in the last 5 years
27
Figure 2.4 Proportion getting married below legal age—marriages any time vs marriages in last 5 years
27
Figure 2.5 Proportion of marriages below legal age—marriages any time in the past and marriages in last 5 years
30
Figure 2.6 Mean age at marriage—marriages any time in the past and marriages in the last 5 years
31
Figure 2.7 Mean age at first marriage for females, RSOC, 2013-14 33
Figure 2.8 Median years of schooling completed for population aged 6 years and above, India between RSOC and NFHS-3
46
Figure 2.9 Source of drinking water—comparison with DLHS-3 61 Figure 2.10 Use of toilet facility across social groups 64
Figure 3.1 Percentage of children aged 0-4 whose birth was registered and for whom birth certificate was available, RSOC, 2013-14.
99
Figure 3.2 Birth registration and possession of birth certificate 102 Figure 3.3 Percent distribution of children aged 3-6 by attendance in pre-school education 104 Figure 3.4 Children attending pre-school education 106 Figure 4.1 Percentage of pregnant women having MCP cards 112
Figure 4.2 Percentage of women who received two or more TT injections by wealth quintiles, as per RSOC and DLHS 2007-08
119
Figure 4.3 Percentage of women receiving various components of antenatal care services 125
Figure 4.4 Percentage of women who delivered in a health institution as per RSOC 2013-14 and DLHS 2007-08
135
Figure 4.5 Percentage of women who delivered in an institution, by different social groups, as per RSOC 2013-14 and DLHS 2007-08
135
Figure 4.6 Percentage of women delivering in an institution, belonging different wealth quintiles, as per RSOC 2013-14 and DLHS 2007-08
135
Figure 4.7 Percentage of deliveries conducted by unskilled persons by age group of women 138 Figure 4.8 Percentage of women by type of delivery, state wise, RSOC, 2013-14 144 Figure 4.9 Level of awareness about JSY and JSSK schemes among the women—state wise 150
Figure 4.10 Percentage of women who were visited by a health worker within seven days of delivery or discharge from a health institution after delivery, by states from RSOC, 2013-14
154
Figure 4.11 Percentage of newborn receiving first postnatal check-up within 10 days of discharge from health facility/birth at home
159
Figure 5.1 Percentage of children aged 12-23 months received vaccines, RSOC, 2013-14 171
Figure 5.2 Percentage of children aged 12-23 months received vaccines, RSOC, 2013-14 (Status of Full Immunization)
172
Figure 5.3 Percentage of children aged 12-23 months who are fully immunized and percentage received no immunization by selected characteristics, RSOC, 2013-14
176
Figure 5.4 Percentage of children aged 12-23 months who received full immunization by state, RSOC, 2013-14
180
Figure 6.1 Percentage of children aged 0-59 months who are stunted, wasted and underweight, India, RSOC, 2013-14
221
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Table No. Details Page No.
Figure 6.2 Change in the child nutritional status 222 Figure 6.3 Percentage of children aged 0-59 months who are stunted by state, RSOC, 2013-14 228 Figure 6.4 The nutritional status of adolescent girls, RSOC, 2013-14 229 Figure 7.1 Percentage of children aged 36-71 months availing any service from AWC 245
Figure 7.2 Percentage of children aged 36-71 months who received supplementary food, by states
251
Figure 7.3 Percentage of children aged 0-35 months covered by an AWC, reported to have growth chart/card by state
257
Figure 7.4 Percentage of children aged 36-71 months covered by an AWC, reported to have growth chart/card by state
257
Figure 7.5 Place of taking weight last time for children aged 0-35 months 260 Figure 7.6 Place of taking weight last time for children aged 36-71 months 260 Figure 7.7 Weight of children aged 0-35 months, by Social Group 262 Figure 7.8 Weight of children aged 36-71 months, by Social Group 262
Figure 7.9 Percentage distribution of children according to number of days attended PSE in one month prior to the survey by place of residence
267
Figure 7.10 State wise percentage of children aged 36-71 months who attended PSE in AWC 272
Figure 7.11 State wise percentage of children aged 36-71 months who attended PSE in AWC for 16 or more days
272
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LIST OF ABBREVIATIONS
AHS Annual Health Survey
ANC Antenatal Check-ups
ANM Auxiliary Nurse Midwife
ARI Acute Respiratory Infections
ASHA Accredited Social Health Activist
AWW Anganwadi Workers
CAPI Computer Aided Personal Interview
CEB Census Enumeration Block
CES Coverage Evaluation Survey
CRC Convention on the Rights of the Child
DHS Demographic Health Survey
ECCE Early Childhood Care and Education
EFA Education for All
EMW Ever Married Women
FC Field Coordinators
FE Field Executives
GAR Gross Attendance Ratios
GMP Growth Monitoring and Promotion
GPI Gender Parity Index
HAF Home Available Fluid
HCM Hot Cooked Meal
HHAS Household Asset Score
HHs Households
HoH Head of the Household
HSC Higher Secondary Certificate
ICDS Integrated Child Development Scheme
IDD Iodine Deficiency Disorders
IFA Iron Folic Acid
IQ Intelligence Quotient
IUD Intra Uterine Device
IYCF Infant and Young Child Feeding
JSSK Janani Shishu Suraksha Karyakram
JSY Janani Suraksha Yojana
LHC Lady Health Visitor
MCP Maternal and Child Protection
MIS Management Information System
MMR Maternal Mortality Ratio
MoHFW Ministry of Health and Family Welfare
MPR Monthly Progress Reports
MWCD Ministry of Women and Child Development
NAR Net Attendance Ratio
NHE Nutrition and Health Education
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NHM National Health Mission
NHRM National Rural Health Mission
ORGI Office of Registrar General of India
ORS Oral Rehydration Solution
ORT Oral Rehydration Therapy
PAPI Pen and Paper Personal Interview
PHC Primary Health Centre
PNC Post-natal Check-up
PPS Probability Proportion to Size
PPSWR Probability Proportional to their Population Size with Replacement
PSE Pre-school Education
PSUs Primary Sampling Units
QA Quality Assurance
RBD Registration of Births and Deaths
RCH Reproductive and Child Health
RMNCH+A Reproductive, Maternal, Newborn, Child and Adolescent
RSOC Rapid Survey of Children
SPSS Statistical Package for Social Science
SSC Secondary School Certificate
TAC Technical Advisory Committee
TBA Trained Birth Attendant
TFR Total Fertility Rate
THR Take Home Ration
ToT Training of Trainers
TPIM Third Party Independent Monitors
TT Tetanus Toxoid
UIP Universal Immunization Programme
VHND Village Health and Nutrition Day
VIP Ventilated Improved Pit Latrine
RAPID SURVEY ON CHILDREN 2013-14 EXECUTIVE SUMMARY| ix
EXECUTIVE SUMMARY
INTRODUCTION
The need for reliable survey based information that would enable validation of the information on
implementation of Integrated Child Development Scheme (ICDS) collected through its information
system affirmed the need to conduct the Rapid Survey on Children (RSOC) in 2013-14—a nationwide
household cum facility survey. The Union Ministry of Women and Child Development (MWCD)
requested UNICEF to support in carrying out the RSOC.
The RSOC covered all 28 states (including undivided Andhra Pradesh) and NCT of Delhi. The set of
indicators identified by the MWCD mainly related to the well-being of children below 6 years and
their mothers. It covered aspects of child development, maternal care, school/college attendance
among persons aged 5-24 years, early childhood care and pre-school education and the enabling
environment like access to drinking water, use of toilet facilities and use of iodized salt at household
level. The survey also collected information on ICDS related infrastructural facilities, profiles of
Anganwadi workers, training received, and their knowledge and awareness about critical care
component, besides awareness and utilization of the six services provided under ICDS.
RSOC interviewed head of the households or any adult member of the household for household
based information, all ever married women (EMW) aged 15-49 who had a live birth in the three
years preceding the survey, currently married pregnant women aged 15-49 for maternal and child
health care. The survey took anthropometric measurements for all children below 5 years and
adolescent girls aged 10-18 living in the selected households. RSOC interviewed Anganwadi workers
(AWW) in the selected Anganwadi centres (AWCs).
RSOC collected information from a nationally representative sample of 105,483 households and
5,630 AWCs. At the national level, a total of 1,11,636 EMWs in the age group of 15-49 years were
interviewed in the households. For estimating nutritional status, measurement of height and weight
of 90,908 children aged 0-4 and over 28,000 adolescent girls aged 10-18 were collected across all
states.
The fieldwork for RSOC was completed in around 23 weeks (from 3rd week of November 2013 to
2nd week of May 2014). For data quality several measures were taken including third party
independent monitors.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
The age structure of the household population at the national level is typical of a society
with a youthful population. Broadly, children under age 15 account for 31 percent, while 64
percent of the country’s residents are in the 15-64 years age group and 5 percent are over
65 years. About 10 percent of the population is under age 5.
Females marry at younger ages compared to males. The average age at the time of marriage among females is almost 5 years lesser than that of males. The mean age at marriage for females and males is 18.6 years and 23.3 years respectively.
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Around eight out of every ten households were in the economically active age group of 18-59 years across rural and urban areas. The proportion of female headed households hovered around 10 percent.
About 66 percent of women were literate with a significant rural-urban divide (60 percent against 78 percent). Around 34 percent of women had no education.
Net Attendance Ratio (NAR) is 75 percent at the primary level, 50 percent at middle school, 37 percent at secondary school and 27 percent at higher secondary school. For middle, secondary and higher secondary levels taken together, NAR is 65 percent.
The Gender Parity Index (GPI) based on NAR is 1.00 in urban areas and is 0.99 in rural areas at primary level suggesting a bridging male-female gap. At the middle, secondary and higher secondary level, the GPI exceeds 1.00 both in urban as well as rural areas. However, the GPI based on gross attendance ratio (GAR) is less than 1.00 for primary as well as for secondary levels across rural and urban areas and also for rural areas at higher secondary level. This indicates a noticeable male-female gap due to low access to age-appropriate education for girls as compared to boys.
Access to an improved source of water is nearly universal in India (91 percent) with more than nine out of every ten households both in urban as well as rural areas using improved source of drinking water. The situation is quite similar even in terms of de jure population.
Around 42 percent of households reported using an improved toilet facility. Urban households are more than twice as likely to use an improved toilet facility as compared to rural households. The proportion of households using improved toilets is significantly lesser among Scheduled Castes (SCs)/Scheduled Tribes (STs) as compared to those of Other Backward Classes (OBCs)/‘Others’ across place of residence. Close to 46 percent of households defecate in open with the proportion of rural households being five times more than in comparison to urban households.
Among the households where a designated place of washing hands was observed, 90 percent had the availability of water and 81 percent had the availability of hand washing materials such as soap, detergent or ash. Significantly, a higher proportion of rural households did not have water and soap, detergent or any cleansing agent as compared to urban households.
About 40 percent of ST and 26 percent of SC population falls in the poorest category as compared to 16 percent for OBCs and 10 percent for ‘Others’. Around 43 percent of urban residents were in the highest wealth quintile, as compared with only 11 percent of rural residents.
Sixty seven percent of households were using adequately iodized salt with a notable rural-urban differential (80 percent in urban areas as compared to 61 percent in rural areas).
PROFILE OF EVER MARRIED WOMEN AND CHILDREN
The age-distribution of EMW shows that only a small proportion (3 percent) of them was married at
the age of 15-19 indicating an increase in marriage age in recent years. Majority of the women were
RAPID SURVEY ON CHILDREN 2013-14 EXECUTIVE SUMMARY| xi
from the 20-34 age-group. The education profile of EMW shows lack of education among sizeable
proportion of women. Two-fifth of women had no education and 12 percent had completed
Secondary School Certificate (SSC) and 14 percent had completed at least Higher Secondary
Certificate (HSC).
The marital status distribution of women aged 15-49 indicates a rapid increase in the proportion of
EMW from 13 percent in the age-group 15-19 to 68 percent in the age-group 20-24 and further to 92
percent in the age-group 25-29. By age 30, practically all the women were married. Data on age at
first marriage indicates prevalence of marriages at early ages in the past. Among the women aged
20-49, six percent were married before completion of age 15, one-third married before 18—the
legal age at marriage—and 60 percent married in their teens before the age of 20. The median age
at marriage for women aged 20-49 was 18 years. A slow change in the median age at marriage over
the period is observed—increasing from 17.26 years among women aged 45-49 to 18.57 years
among women aged 25-29. The marital status distribution of adolescent girls aged 10-18 shows 6
percent of ever married and 4 percent married before attaining age 18.
Data on the fertility performance shows that among all the EMW aged 15-49, about 8 percent never
became pregnant. Among the 92 percent women who ever became pregnant, 2 percent became
pregnant in the age-group 10-14 and another 48 percent in the age-group 15-19. In other words,
one-half of the ever married women had their first pregnancy when they were in their teen ages.
Median age at first pregnancy among younger women aged 20-29 (20.4) was higher than that
among women aged 40-49 (19.1) only by one year.
Among all the women aged 15-19, 3 percent have had a live-birth, and additional 2 percent had no
live-birth but were pregnant at the time of survey. So, in all, 5 percent of the women aged 15-19 had
started childbearing in their teens. The mean number of ever born children increased from 0.4
among the EMW aged 15-19 to 3.5 among the EMW aged 45-49. The mean number of living children
increased from 0.3 in the age-group 15-19 to 3.1 in the age-group 45-49. The birth order statistics
reflect the low level of current fertility. Among the live-births that occurred three years prior to
survey, almost one-half (47 percent) were the first order births and 30 percent were second order
births.
The contraceptive prevalence rate among the currently married women aged 15-49 was 58 percent.
Most (88 percent) of the women using contraception were using modern contraceptive methods
and remaining 12 percent were using traditional methods. Female sterilization was the most
common method used by two-thirds of the users. Among the modern spacing methods, the most
widely used methods were condom (6 percent) and pills (5 percent).
RSOC collected data of about 121,987 children below 6 years from surveyed households in 28 states
and Delhi. The sex ratio of surveyed children was 934 female children per 1,000 male children. The
sex distribution was almost the same in rural and urban areas. The distribution of children by single
year of age in both rural and urban areas shows slightly lower proportion of younger children below
age two.
RAPID SURVEY ON CHILDREN 2013-14 EXECUTIVE SUMMARY| xii
Regarding birth registration, in case of 72 percent of the children below age 5, birth was registered
and for 62 percent of the children registration of the birth was done within 21 days of the birth. For
61 percent of the children birth certificate was available, though only in the case of 37 percent of the
children, respondent could show the birth certificate to the interviewer. The comparison of the birth
registration data with National Family Health Survey-3 (NFHS-3) 2005-06 shows that in the last eight
years since NFHS-3, there has been an increase of 31 percentage points in the extent of birth
registration and of 34 percentage points in possession of birth certificate.
The extent of birth registration varies from the highest of 99 percent in Goa to the lowest of 28
percent in Manipur.
On attendance of pre-school by children aged 3-6, nationally more than two-thirds (70 percent) of
the children aged 3-6 were attending pre-school. Relatively more children (39 percent) aged 3-6
were attending ICDS run pre-schools than privately run pre-schools (31 percent).
There was a large variation in proportion of children attending pre-school across the states ranging
from 19 percent in Nagaland to 90 percent in Tripura. The preference for ICDS run school also varied
substantially from state to state.
MATERNAL HEALTH CARE
Prenatal care
More than four out of every five (84 percent) women registered their pregnancy with health
facilities and AWCs, reflecting greater awareness about maternal health care among women.
Relatively higher proportion of urban women (87 percent) registered their pregnancies in
comparison to rural women (83 percent);
73 percent of all women reported having a Maternal and Child Protection (MCP) card;
Amongst all women, nearly two-third (65 percent) registered their pregnancy during the first
trimester with 71 percent women from the urban areas and 62 percent women residing in
the rural areas;
More than three out of every five (63 percent) women received three or more antenatal
check-ups (ANCs) and almost half (45 percent) reported four or more ANC visits;
Government run health facilities appear to be preferred places of receiving ANC check-ups,
both in rural and the urban areas. Overall, 43 percent of the women had taken check-ups at
government run health facilities. Out of those who received ANC check-ups, more than two-
fifth (84 percent) of the women received the ANC check-ups from a skilled health provider.
RAPID SURVEY ON CHILDREN 2013-14 EXECUTIVE SUMMARY| xiii
Place and type of delivery
More than three-fourth (79 percent) women delivered in a health facility (both government
and private). One-fifth of the deliveries took place at home in contrast to about half of
deliveries taking place at home as per District Level Health Surveys (DLHS) 2007-08.
Higher proportion of women (87 percent) residing in the rural areas reported normal
deliveries in comparison to the urban women (75 percent). Close to a fifth of the women (21
percent) delivering their first baby delivered by caesarean section;
Seven out of every ten (71 percent) women were aware about national flagship programme
on safe motherhood—Janani Suraksha Yojana (JSY) whereas only 43 percent were aware of
Janani Shishu Suraksha Karyakram (JSSK). Overall utilization of either JSY or JSSK benefits by
women were around 54 percent.
Postnatal care
Nearly half of the women (51 percent) reported to have been visited by a health care worker
(AWW/Accredited Social Health Activist (ASHA)/Auxiliary Nurse Midwife (ANM)) within one
week of delivery or discharge.
Little less than half of the women (47 percent) received postnatal check-up within 10 days of
delivery at home or discharge from the facility in case of institutional delivery and another 7
percent received postnatal care (PNC) after the stipulated period;
44 percentage of the newborn received first check-up within 10 days of birth at home or
discharge from health facility after birth and another 16 percent received after the
stipulated period.
Role of Anganwadi centre
Among all the women who had a live birth in the three years preceding this survey, 70 percent
registered their pregnancy in an AWC. However, proportion of women ultimately receiving ANC
check-ups at AWCs was much lower (22 percent).
RAPID SURVEY ON CHILDREN 2013-14 EXECUTIVE SUMMARY| xiv
CHILD HEALTHCARE
Among all the children aged 12-23 months, the extent of full immunization (comprising BCG, three
doses of DPT and polio and measles vaccine) was 65 percent. Seven percent of children did not
receive a single dose of any of these vaccines and remaining 28 percent received only partial
immunization. The drop-outs in the vaccinations were quite high. From the first to the third dose of
DPT and Polio the drop-out rates were 16 percent and 18 percent respectively. AWCs were the
major source for providing child immunization. Almost half (49 percent) of children who received
some immunization, got immunized in AWCs.
The prevalence of diarrhoea during 15 days prior to the survey was estimated at 6.5 per 100 children
aged below five years. More than three-quarters of children suffering from diarrhoea were treated
and about half of them received Oral Rehydration Solution (ORS) or ORS with zinc. About one-
quarter of children with diarrhoea were given home available fluids like plain water, rice water, dal
water, butter milk etc. Thirty-nine percent were given ORS and 13 percent were given ORS as well as
zinc. Though, generally antibiotics are not prescribed for diarrhoea among children, almost every
second (47 percent) child with diarrhoea received antibiotics. The prevalence of fever among
children below age five was 13.6 percent. Among the children with fever, 15 percent got their blood
test done and 18 percent were given an anti-malaria drug. Almost one in six (16 percent) children
below age 5 had cough during 15 days prior to the survey and 8.6 percent had symptoms of acute
respiratory infections (ARI). For more than three-quarters (77 percent) of the children with ARI,
medical advice/treatment was sought. One in every five children (20 percent) had health check-up in
three months prior to the survey. A large proportion (65 percent) of the children who had health
check-up, were taken to a private health facility.
AWCs provide various health and nutrition services for children. The survey shows that in providing
immunization AWCs were playing a major role. However, in providing curative services in case of
childhood diseases like diarrhoea, fever, or cough or respiratory infections, or referral services, the
role of AWCs was only modest.
RAPID SURVEY ON CHILDREN 2013-14 EXECUTIVE SUMMARY| xv
NUTRITION OF CHILDREN AND ADOLESCENT GIRLS
Nearly one-fifth of newborns who were weighed at birth, were low birth-weight babies. A practice of
breastfeeding is almost universal in India and in case of 45 percent of the children breastfeeding was
started within an hour of birth, as recommended. Though for majority of the children breastfeeding was
started after one hour of birth, in case of 86 percent of the children mothers fed them with first yellow
thick milk. The practice of giving pre-lacteal feeding was prevalent. About one-fourth (22 percent) of the
children aged 0-23 months were given pre-lacteal feeds, milk being the most prevalent pre-lacteal feed.
Almost two-thirds (65 percent) of the children aged 0-5 months were exclusively breastfed. Most (85
percent) of the children were breastfed till age one. Even a majority of the children were breastfed till
age two.
Only in case of one-half of the children introduction of complementary food was timely, as 51 percent of
the children aged 6-8 months were introduced to complementary food. Among the children aged 6-23
months, 41 percent received food for minimum number of times, 22 percent were fed food with
minimum dietary diversity and only 11 percent of the children received minimum acceptable diet.
Among all the infants and young children aged 6-23 months, 36 percent consumed foods rich in vitamin
A and 43 percent consumed iron rich food in the day or night preceding the survey.
Less than one-half of children (45 percent) aged 6-59 months received vitamin A supplementation in six
months preceding the survey. Little more than one-fourth of the children received deworming medicine.
The coverage of IFA supplementation was much lower as only 13 percent of the children aged 6-59
months received IFA supplementation in 6 months preceding the survey.
Among the children aged 0-59 months, 39 percent were stunted or short for their age, 15 percent were
wasted or thin for their height and 29 percent were underweight or light for their age. Out of 39 percent
of stunted children, 17 percent were severely stunted, i.e., every sixth child was severely stunted. About
5 percent of the children were severely wasted and 9 percent were severely underweight. These
estimates imply improvement in nutritional status of children since NFHS-3 in 2005-06. The stunting has
decreased by a rate of 1.3 percentage points per year during seven years between 2005-6 and 2013-14,
and underweight proportion has decreased by 2.0 percentage points per year. The level of wasting was
lower compared to that of stunting and underweight and hence decreased at slower rate of 0.7
percentage points per year.
Among adolescent girls, 44 percent of the adolescent girls were severely thin and additional 19 percent
were moderately thin. So in all 63 percent of the girls were thin or under-nourished.
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UTILIZATION OF ICDS SERVICES
Awareness of Services Available at Anganwadi Centre
Among the mothers of children aged 0-71 months, 94 percent were aware of at least one out of
six services provided from AWCs. Maximum awareness was about supplementary food (89
percent), followed by immunization (58 percent), preschool education (47 percent), and health
check-up (31 percent). Only 13 percent mothers were aware of referral services.
Ten percent mothers of children 0-71 months were aware of all six services available from AWCs
and about 6 percent did not have awareness of any service.
Awareness of at least one service was more among rural mothers of 0-71 month old children (95
percent) than the urban mothers (90 percent). The mothers belonging to the lowest wealth
quintile were more aware of at least one service available from AWC (95 percent) than the
mothers from the highest quintile (91 percent).
Utilization of AWC Services
Forty-eight percent lactating mothers of children aged 0-5 months, 46 percent currently
pregnant women, 54 percent children aged 6-35 months and 48 percent children aged 36-71
months reportedly received at least one service from AWCs. The services received were mainly
supplementary food, pre-school education and health check-up.
Eight percent lactating mothers, 9 percent children aged 6-35 months, 8 percent children aged
36-71 months and 7 percent currently pregnant women reported availing all relevant services
from AWC.
Type of Supplementary Food Received by Beneficiaries
Forty two percent of lactating mothers (mothers of children aged 0-5 months) reported to have
received supplementary food. The proportion of children aged 6-35 months and 36-71 months
received supplementary food from AWC was 49 percent and 44 percent, respectively.
Among the beneficiary groups who received supplementary food, 27 percent lactating mothers,
39 percent children aged 6-35 months and 88 percent children aged 36-71 months reported
receiving Hot Cooked Meal (HCM). More than two-thirds lactating mothers and children aged 6-
35 months received Take Home Ration (THR). Twenty-two percent children aged 36-71 months
reportedly received morning snacks.
Receipt of Supplementary Food
One-fifth of the lactating mothers and mothers of children aged 6-35 months, 31 percent
children aged 36-71 months and 28 percent currently pregnant women reported receiving
supplementary food for 21 or more days.
Among the children aged 36-71 months who received supplementary food from the AWC,
around 68 percent consumed it at the AWC itself and 25 percent consumed it at home. The
RAPID SURVEY ON CHILDREN 2013-14 EXECUTIVE SUMMARY| xvii
proportion of children consuming the supplementary food at the AWC was higher in rural areas
(69 percent) as compared to those in urban areas (60 percent).
Attendance at Pre-school Education (PSE) and age at attending PSE
Thirty-nine percent of the children aged 36-71 months attended PSE at the AWC. More rural
children (43 percent) attended PSE than urban children (27 percent). More ST children (51
percent) attended PSE than SC (41 percent), OBC (35 percent) and children belonging to general
castes (38 percent).
The mean age at which the child started attending the PSE was 39 months.
Among the children attending PSE at the AWC, 58 percent attended the PSE for more than 16
days.
Other Services at AWCs
Close to a fourth (23 percent) of the rural EMW were aware of the VHND (village health and
nutrition day) conducted at AWC and out of them 43 percent reportedly participated in at least
one VHND in three months preceding the survey.
Overall 35 percent of the EMW reported that the AWW had visited them at their home at least
once in the three months preceding the survey.
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CHAPTER 1 INTRODUCTION
1.1 BACKGROUND
Considering the children1 at the centre of country’s development, the Government of India re-iterated
its commitment for their well-being through the National Policy for Children,2 2013. It underlines
survival, health, nutrition, development, education, protection and participation as the undeniable
rights of every child. The early childhood period is critical for the survival and development. Recognizing
the need to lay a strong healthy foundation for every child, from an early stage of life and welfare of all
women especially pregnant women and nursing mothers, the Ministry of Women and Child
Development (MWCD) implements several flagship schemes across the country through the state
governments and the Union Territories (UTs). The Integrated Child Development Services (ICDS) scheme,
launched in 1975 is one of the important schemes of the Ministry with the objective to reduce
malnutrition, morbidity, mortality and low learning capacity among children below age six. The ICDS
scheme aims to provide services through a network of village level service centres, named as Anganwadi
centres (AWCs), supported by village level workers, called Anganwadi worker (AWW) and Anganwadi
helper.
The impact of ICDS is measured through an evolving monitoring system for which data from all AWCs
are collected through several registers maintained manually at the AWC level. Like other MIS based
information system, the information system suffers on account of coverage, reliability and timeliness.
During the last 20 years, though many nationwide surveys like National Family Health Survey (NFHS
1992-93, NFHS 1998-99 and NFHS 2005-06) and District Level Health Surveys (DLHS 2007-08) of the
Ministry of Health and Family Welfare (MoHFW), Annual Health Survey (AHS) of Office of the Registrar
General provided useful data on maternal and child health care. These large scale surveys were mainly
planned to focus on family planning, reproductive health of women and child health. It did not cover the
critical information on the implementation of the ICDS scheme. Second, most information that is
available in the public domain on the output/outcome on children and women are not
contemporaneous. This impedes comprehensive analysis of the situation of children and women on a
fixed time frame.
Commitment to achieve the Twelfth Five Year Plan goals by 2017 and the need to measure the progress
made due to Government’s endeavour through national programmes set out the need for up to date
data. This required setting up a robust monitoring mechanism that would enable the triangulation of the
MIS based information. This affirmed the need to conduct the Rapid Survey on Children (RSOC)—a
nationwide household cum facility survey. The MWCD requested UNICEF to support the survey.
1 Persons below 18 years.
2 http://www.wcd.nic.in/policies/nationl-policy-children-2013/ (last accessed 4 January 2016).
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The RSOC has been planned as a nationwide household cum facility survey of the Union MWCD. The
Technical Advisory Committee (TAC) set up by the Ministry was chaired by the Joint Secretary, in charge
of ICDS, MWCD and co-chaired by Prof P.M. Kulkarni, a senior Professor in Jawaharlal Nehru University
(JNU). The committee consisted of members from the Ministry of Women and Child development,
Ministry of Health and Family Welfare (MoHFW), National Institute of Public Co-operation and Child
Development (NIPCCD), Nutrition Foundation of India (NFI), International Institute for Population
Sciences (IIPS), Tata Institute of Social Sciences (TISS) and independent subject experts. A series of TAC
meetings were organized at different stages of the survey. Terms of reference of the Committee were as
follows:
To finalize the list of indicators and standardize the meta information;
To finalize the sample design, determination of sample size, the estimation procedure and the
state wise allocation of the sample;
To develop the technical base paper on the survey;
To develop and finalize the survey tools including Training and Field Manuals and pilot it;
To set up the edit rules including quality control in data capture and processing;
To approve the tabulation plan and the output formats;
To approve finally the results.
1.2 CHAPTER CONTENT
This chapter provides information on the following aspects of RSOC, 2013-14.
Objectives of the survey
Study area
Survey design and methodology
Pilots
Implementation of the survey on CAPI
Survey tools
Computation of wealth index
Details of survey implementation
1.3 STUDY OBJECTIVES
The specific objectives of the survey were to assess the situation of well-being of children and women
based on selected list of indicators provided by the Ministry of Women and Child development. The list
included indicators to assess awareness and utilization of ICDS services at the household level along with
coverage and delivery of ICDS related services through AWCs under ICDS scheme. The survey was also
mandated to collect information on the profile of AWCs and its workers, services provided, utilization of
the services, participation and support from health workers, participation/support of community leaders
and extent of convergence.
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1.4 SURVEY DESIGN AND METHODOLOGY
1.4.1 Approach
The objectives of the RSOC entailed collection of information at the household as well as at the
Anganwadi level. The survey at the household level was planned to provide information relating to
household population and housing characteristics including literacy, educational attainment and gender
parity among household members, housing conditions, water, sanitation and hygiene practices,
marriage, birth registration and birth certificates, early marriage; maternal health care and its
component; child health care including morbidity and its management, child immunization, infant and
young child feeding practices (IYCF), growth-monitoring, nutritional status of children, body mass index
(BMI) of adolescent girls (age 10-18) as well as awareness and utilization of ICDS services. All information
collected at household level and its analysis has been collated in the national report.
From the AWCs, the survey was designed to collect information pertaining to profile of the AWWs and
physical infrastructure of the AWCs, coverage of the target population under different ICDS services;
delivery and utilization of all the six services provided under ICDS including supplementary food, growth
monitoring, pre-school education, Nutrition and Health Education and VHND and referral services;
convergence with health service providers, referral services; correct knowledge about critical service
components; monitoring and supervision activities including community participation in ICDS services.
1.4.2 Sampling design
The sampling strategy for the survey was designed to provide estimates at the national and state levels.
The survey broadly followed a design recommended by the Demographic Health Survey (DHS) and was
similar to the one followed in the different rounds of National Family Health Survey (NFHS). RSOC is a
multi-stage stratified random sampling survey. Census 2011 was used as the frame for selection of
primary sampling units. Within each PSU, a household listing exercise was carried out for selection of
households.
A. Sample size determination
The decisive indicator chosen for determination of sample size for each state was the ‘proportion of
fully-immunized children aged 12-23 months’, as per the Coverage Evaluation Survey conducted in 2009.
The rationale for selection of this indicator is based on the fact that the full immunization is not only a
critical indicator of the survival of children (requiring robust sample size for estimation) but it also
reflects the efficiency and capacity of the programme management. In addition, it also reflects on the
health seeking behaviour of targeted population. The sample size computed based on this indicator
provided a robust sample size for other child and maternal care indicators too. The sample size for each
state was calculated at 95 percent level of confidence with permissible margin of error of 5 percent,
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design effect of 1.5 and adjustment factor of 1.1 for non-response. The state sample so estimated was
deflated3 to arrive at the requisite number of sample households.
The state sample of households was allocated to rural and urban areas, proportional to the size of the
state’s urban and rural population, as per Census 2011. In order to ensure adequate representation of
urban samples in states where level of urbanization is below the national average (31 percent as per
Census 2011) urban samples in these states were increased to the level of national urbanization. On this
analogy, for Delhi which is mainly urban, the rural sample was upwardly adjusted to cover 1,000
households. This was adjusted later by appropriate weights. The state wise samples were further
adjusted by Kish’s compromise allocation to ensure reasonable distribution across the states. Same
methodology was adopted in all states to draw the rural and urban sample separately.
In each state, the rural sample of households were selected in two stages, with the selection of Primary
Sampling Units (PSUs), which are villages, at the first stage, followed by the random selection of
households within PSU in the second stage. In urban areas, a three-stage procedure was followed. In the
first stage, urban wards were selected, followed by random selection of one census enumeration block
(CEB) from each sample ward. In the third stage, households were randomly selected within the
selected CEB.
B. Sampling of Rural PSUs
The list of villages as per Census 2011 was taken as the sampling frame for selection of the rural PSUs.
For selection of PSU in each state, a stratified sampling design was adopted. In order to ensure inclusion
of different socio-economic characteristics, in the sample all districts within a state was divided into
contiguous ‘regions’.4 The state’s required rural sample of villages was allocated to the ‘regions’ in
proportion to their population size. The state wise regions formed for RSOC are given in Table 1.2 at
Annexure A. In each ‘region’ villages were further stratified into ‘clusters’5 on the basis of explicit
stratifying variables (like village size or caste) to maximize homogeneity within the ‘clusters’. Female
literacy was used as an implicit stratification variable.6 The PSUs within each ‘cluster’ were selected
independently following the probability proportion to size (PPS) systematic random sampling procedure.
The state wise comparison of population proportions in the RSOC sample villages with that of Census
2011 by various stratification variables is presented in Table 1.4 of Annexure A. Overall, 2,670 villages
were covered in the survey. Large rural PSUs with 250 households or more were divided into mutually
exclusive and exhaustive segments of more or less of equal size (125 households) and two segments
were selected using systematic random sampling procedure to represent the selected village.
3 Using proportion of EMW age 15-34 per household revealed from DLHS 2007-08.
4 A ‘region’ is a group of contiguous districts within a state.
5 A ‘cluster’ is a group of first stage sampling units (villages) within a region, based on stratification.
6 State-wise best sampling model selected for sampling of rural PSUs is given in Table 1.2 of the Annexure.
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C. Sampling of Urban PSUs
In each state, the required urban sample was allocated to each of the ‘regions’ (as described above) in
proportion to its respective urban population size of the region. In each ‘region’, the list of wards, as per
Census 2011 was considered as the sampling frame for selection of wards. Within each region, the
required numbers of wards were selected using PPS systematic random sampling procedure taking
female literacy (as per Census 2011) as the implicit variable. The state wise comparison of population
proportions in the RSOC sample urban wards with that of Census 2011 by various stratification variables
is presented in Table 1.5 at Annexure A. From the selected wards, the list of CEBs along with its
population size was collected from the Office of Registrar General of India (ORGI) and one CEB was
selected randomly following PPS systematic sampling procedure. If the selected ward was a slum ward,
CEB from among the slum localities was selected. Overall, 1,487 CEBs were covered in the survey.
D. Selection of the households (HHs)
In RSOC, households were grouped in two categories—households with at least one child below 6 years
referred to as Category ‘A’ and the other households with no child in the specified age group, referred to
as Category ‘B’. The Category A households provided the base for all maternal and child related
indicators and the Category B households complemented the universe for indicators at household level.
In each PSU (village/selected segment/CEB), a house listing and mapping exercise was carried out to
construct the necessary sampling frames for selection of households (HHs). During listing operation,
head of the household or any adult member of the household was asked whether there was a child
below 6 years in the household. This enabled in developing two sampling frames—of Category A and
Category B households.
Following circular systematic random sampling, 20 HHs from Category A frame and six HHs from
Category B frame were selected from each PSU. In case of missing households (locked, migrated, out
etc.) a substitution process was adopted. It was decided that to select the next eligible household in the
respective listing frame.
E. Selection of Anganwadi Centres (AWCs)
In order to asses infrastructure, availability and utilization of ICDS services and other components, as
stated earlier, such AWCs that were functioning and providing services to the sample households within
the selected rural/urban PSUs were covered in the survey. Thus, in the rural areas, all AWCs in the
selected villages having less than 250 households were covered in the survey. In large villages (having
250 or more households), all such AWCs in both the selected segments were covered. In the selected
urban areas, only those AWCs providing services to the selected CEB were covered. Overall, 5,630 AWCs
were covered in the survey.
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The state wise number of sample of households and PSUs covered during the survey is given in Table
1.1.
Table 1.1: Number of households and primary sampling units covered in the RSOC survey, 2013-14
States Number of households covered
Number of primary sampling units (PSUs) covered
Total Urban Rural Total Urban Rural
Andhra Pradesh 4,607 1,519 3,088 189 62 127 Arunachal Pradesh 2,357 688 1,669 96 27 69 Assam 3,187 832 2,355 126 33 93 Bihar 6,833 1,737 5,096 273 71 202 Chhattisgarh 2,710 783 1,927 107 31 76 Delhi 3,277 2,295 982 127 89 38 Goa 2,185 1,359 826 85 53 32 Gujarat 3,783 1,625 2,158 150 64 86 Haryana 2,592 908 1,684 100 35 65 Himachal Pradesh 2,704 696 2,008 105 27 78 Jammu & Kashmir 2,354 700 1,654 91 27 64 Jharkhand 2,983 878 2,105 116 34 82 Karnataka 3,516 1,283 2,233 141 51 90 Kerala 2,722 1,287 1,435 109 52 57 Madhya Pradesh 4,489 1,346 3,143 176 53 123 Maharashtra 6,141 2,750 3,391 244 110 134 Manipur 2,144 653 1,491 85 26 59 Meghalaya 2,424 667 1,757 94 26 68 Mizoram 2,136 1,092 1,044 85 44 41 Nagaland 2,057 644 1,413 86 26 60 Odisha 3,525 955 2,570 137 37 100 Punjab 2,632 982 1,650 102 38 64 Rajasthan 4,481 1,317 3,164 174 51 123 Sikkim 2,320 672 1,648 90 26 64 Tamil Nadu 4,244 2,011 2,233 167 80 87 Tripura 2,212 665 1,547 89 26 63 Uttar Pradesh 13,303 4,980 8,323 520 196 324 Uttarakhand 2,292 690 1,602 89 27 62 West Bengal 5,273 1,681 3,592 204 65 139 All States 1,05,483 37,695 67,788 4,157 1,487 2,670
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F. Weight computation
The sampling weights have been computed primarily to enable drawing valid statistical inferences, to
keep the weighted sample distribution close to the actual population distribution, for correcting varying
response rates and varying probability of selection of PSUs and households. This adjusted for (1)
oversampling done while selecting 20 households from category A frame (with at least one child below 6
years) (2) oversampling done in a few states for urban/rural sample and (3) segmentation done in large
villages. For details see Annexure A.
1.5 SURVEY TOOLS
1.5.1 House listing
In order to be able to list all households in the selected village/segment/CEB, a detailed house-listing
was done through a house-listing schedule, along with the mapping operation of the selected PSU. Head
of the household (HoH) or any adult knowledgeable member of the household was the respondent for
this. Identification of Category A, B households and AWCs were done during the listing exercise.
1.5.2 Household Questionnaire
The information at household level was collected through a household questionnaire administered to
the head of the selected household or any other adult knowledgeable person (aged 18 or more years) of
the household. This questionnaire also included a section for collection of information on
anthropometric measurements (height and weight) on children (below 5 years) and the adolescent girls
(10-18 years).
1.5.3 Ever Married Women (EMW) Questionnaire
Individual interviews were conducted among all EMW aged 15-49 in the selected households using an
EMW questionnaire. Interviews were held at the household level. In the selected household the
required information was collected from all EMWs, all children below 5 years,7 all adolescent girls aged
10-18 years, and all currently pregnant women and lactating mothers.
1.5.4 Facility (Anganwadi Centre)
The facility component consisted of interview with AWW based on an Anganwadi questionnaire. All
interviews with AWW were held at the AWCs, as survey required recording of information from the
7 Irrespective whether mother or caregiver were in that household.
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records/registers maintained at AWC level, monthly progress reports (MPR) and observation of facility in
the AWC.
Thus, RSOC used the following four questionnaires.
House-listing Schedule;
Household questionnaire;
EMW questionnaire;
AWC questionnaire:
Household and EMW questionnaires were canvassed using Computer Aided Personal Interview (CAPI)
method using a tablet/mini-laptop and the AWC questionnaire was canvassed through the traditional
Pen and Paper Personal Interview (PAPI) method. All questionnaires were translated in 18 Indian
vernacular languages and each questionnaire was in bilingual format—English and another Indian
vernacular language, specific to that state. Questionnaires are in Annexure D.
1.5.5 Pilots—finalizing survey tool
Questionnaires were piloted in four states, i.e., Rajasthan, Uttar Pradesh, West Bengal and Madhya
Pradesh. In each state, two PSUs8 (one rural and one urban) were covered. The pilot survey was
undertaken to check relevance of response options, flow/sequence of questions, appropriateness of
translation, and appropriateness of local terminology used, time taken for the interview and problems
encountered in approaching the respondents. The inputs from the pilot exercise were documented and
shared with TAC, and tools were modified wherever required.
1.6 IMPLEMENTATION THROUGH CAPI
The software application developed for the CAPI based questionnaires was pilot tested in the states of
Odisha and West Bengal. In each state, two PSUs (one rural and one urban) were covered. From each
PSU, 50 households (40 households having children 0-6 years and 10 other households) were selected
(using the sampling frame prepared on the basis of the mapping and listing exercise) and the household
and EMW questionnaire were canvassed in CAPI. The observations during the pilot testing on each of
the questions, skips, validation instructions, logic and range checks, ease of navigation of the questions
on CAPI. Software applications were suitably modified and finalized. The translations were loaded onto
the software application and reviewed. The final bilingual CAPI software applications were also tested.
For field implementation of pilot, a team of enumerators (in all four persons) were formed. Each of the
two enumerators (other than the health investigator and the supervisor) was given a mini laptop with
additional battery backup, with the bilingual software loaded on the laptops.
8 These were other than the selected PSUs for the survey.
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1.7 SURVEY IMPLEMENTATION
1.7.1 Survey team composition
Each mapping and listing team consisted of two persons and two teams were supervised by an
experienced supervisor. For the main data collection, a survey field team consisted of four members
(two females and one health investigator for taking anthropometric measurements and the supervisor
for the team). Supervisor was a senior person with at least five years of experience. Team members
(enumerators) had basic educational qualification as graduate or higher and at least 2-3 years’
experience of HH surveys like NFHS,9 DLHS,10 AHS11 etc. All enumerators were recruited from the
respective states in order to be familiar with the local language.
1.7.2 Preparation of survey manuals
In order to maintain standardized survey procedures across states and also to minimize non-sampling
errors, two training manuals—(1) manual for household listing and mapping and (2) the interviewer’s
manual for the main survey covering canvassing of household, EMW questionnaire and the facility
(AWC) survey were developed. The manuals had explanations of all questions, their relevance, the
related concepts, terminologies etc. The manuals were also translated into Hindi.
1.7.3 Training of survey teams
Training of Trainers
An extensive 6-day Training of Trainers (ToT) was held in New Delhi. Close to 80 trainers were trained
during the ToT. Officials from UNICEF Delhi and 13 state offices; officials from the MWCD, subject
specialists/professionals from the field, research agencies12 and lead agency, and independent field
monitors attended the TOT. The senior professionals from the lead agency, subject experts from
UNICEF, senior professors from IIPS13 and senior officials from the government imparted the trainings.
The ToT involved detailed discussions on field procedures and protocols, contents of survey instruments,
use of CAPI. General discussions on issues related to health and nutrition were delivered by invited
experts from the respective fields. The training sessions also covered basic information on usage and
care of mini laptops, preparation and set-up of the devices for survey implementation and
demonstration of interviews using CAPI software. Overall training included pedagogy, mock interviews
9 National Family Health Survey.
10 District Level Household Survey.
11 Annual Health Survey.
12 Three agencies were engaged for fieldwork.
13 International Institute for Population Sciences.
INTRODUCTION
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 1 | 10
and practices. Separate demonstration and practice sessions were organized to orient the trainees
about the use of various anthropometric equipments.
Standardized presentations were developed for different sessions of the ToT which were subsequently
used in the state-level trainings. To ensure standardization in state trainings, sessions during the ToT
were video recorded and the same were used during state-level trainings. Professionals from field and
research agencies who participated in the ToT subsequently trained field staff in their respective states
according to the standard procedures discussed in the ToT. State trainings were conducted in all 29
states.
1.7.4 State level trainings
A. State-level trainings for mapping and listing
All listers, mappers and supervisors were given a 3-day training (including one day of field practice) by
the persons trained in the ToT. The training included detailed discussions on procedures to be followed
during mapping and house-listing operations, preparation of location and lay out maps, segmentation
and explanations of each question in the listing schedule.
B. State-level training of field staff for main survey
The enumerators, health investigators and the supervisors recruited for RSOC were given intensive
training by the persons trained in the ToT. Fifty-seven batches of state level trainings were held covering
all the 29 states mainly because in a few big states the state level trainings were organized in more than
two batches. Typically a batch size varied between 35-40 trainees. The state level trainings were
conducted by three trainers, mainly consisting of two trainers from the field agency and one was from
the UNICEF and/or Department of Women and Child Development (DWCD) of the respective state
Government. The state-level trainings were monitored and facilitated by the subject experts from
UNICEF and/or state-level officers from the DWCD and the independent monitor engaged by UNICEF.
The state training agenda was on the lines of the ToT. State-level trainings were given in local language,
using the bilingual questionnaires. In many states, the training extended up to 10 days.
The health investigators were provided special training on taking measurement of height and weight of
children aged 0-5 years and adolescent girls aged 10-18 years, filling up bio-marker forms and
transferring the data from paper schedule to the CAPI. Investigators were also trained about the need
for calibration of the equipment every day before the start of the survey and technique to be used.
Separate training sessions were organized for the supervisors to train them in canvassing the AWC
questionnaire as well as monitoring the work of the interviewers. On the completion of the training
programme, a test was conducted among all the trainees and only those trainees who scored at least 60
percent marks were selected for carrying out the field work of RSOC.
INTRODUCTION
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 1 | 11
1.7.5 Field Work
A. Field work for mapping and house listing
A total of 170 mapping and listing teams were deployed by the three zonal field research agencies in the
29 states. The listing and mapping operations in the different states were carried out during the
period—November 2013 to January 2014.
B. Field work for main survey
The field work for main survey in the states was carried out during the period—November 2013 to May
2014. A total of 168 field survey teams were deployed in all the 29 states and the survey was
undertaken with approximately 350 CAPI devices.
1.7.6 Field Monitoring and Quality Control
Since household interviews were conducted using CAPI method, the software application took care of a
majority of the logical checks (validation of inputs) at the time of data input during the interview itself.
Besides, there were four other layers of quality assurance.
A. Monitoring by the supervisor of the field team
The supervisors, on a sample basis, made accompanied calls, spot-checks and back-checks in 20 per cent
of the households that were completed by the enumerators in the teams. The team supervisors were
provided with a printed version of the questionnaire highlighting 25-30 specific critical questions for the
back checks. Further, the CAPI was programmed in a manner to make voice recording14 for the initial
introduction, including consent of respondent to undertake the interview and for a few identified critical
questions that were to be back-checked by the supervisors. The supervisors checked the audio-
responses vis-à-vis the data collected during back-check and checked the relevance, quality of protocol
followed and accuracy of the responses entered in the CAPI. In case of data mismatch, the supervisors
intimated the change to the investigators who in turn corrected the responses in their master datasets
in presence of the supervisors.
The supervisors organized regular de-briefing sessions at the end of each day with the teams to
overcome the common errors and other field problems encountered by the team.
14 Permission was taken from the respondent for recording the responses.
INTRODUCTION
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 1 | 12
B. Monitoring by Field Executives or Field Coordinators of field research agency
The activities entrusted to the teams’ supervisors were monitored by Field Executives (FEs) or Field
Coordinators (FC) of the field research agencies. The FEs were responsible for the quality of data
collected and were the focal points of co-ordination between the research staff15 and the field teams
from the agency side.
C. Independent monitors (Third Party Independent Monitors)
Independent monitors (TPIM) comprising officers from UNICEF state offices, Population Research
Centres (PRC)16, NIPCCD17 and SIHFW18 were engaged for ensuring overall quality of the RSOC field
survey. The tasks of the monitors were to ensure quality in recruitment of enumerators and team
supervisors, supervision of state trainings; monitoring adherence of the survey protocols and ethical
issues; assessing quality of house-listing operation, achieving desired response rates; ensuring data
consistency, and adherence to timelines in completing survey. In the field, monitors’ activities involved
concurrent observation of the interview (wherever possible and ethically correct) and give feedback to
UNICEF through the fastest available communication mode followed by a written feedbacks within three
days of completion of inspection. Clarifications on technical issues wherever found incorrect or
inadequate were broadcasted on the same day to all the supervisors.
D. Analysis based on field-check tables:
Further, to validate the field data, field check tables were generated for key indicators based on data
downloaded from the server on a weekly basis for all states. This enabled monitoring of the collected
data, team wise. Based on the data analysis, instructions were issued to the respective field agencies on
low response rates of target population, errors in age structure, heaping of age, errors in data recording,
missing data from different sections of the questionnaire etc.
15 Research staffs were mainly located in Delhi which managed the overall performance of the survey including quality of data.
This staff was mainly responsible for data analysis after the data collection was over. 16
A team of researchers/demographers from different universities. 17
National Institute of Public Cooperation and Child Development, popularly known as NIPCCD, is a premier organization devoted to promotion of voluntary action research, training and documentation in the overall domain of women and child development. 18
State Institute for Health and family Welfare, Government of Odisha.
INTRODUCTION
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 1 | 13
1.8 DATA PROCESSING AND ANALYSIS
1.8.1 Processing data collected through CAPI
The data collected through CAPI software was converted into SPSS (Statistical Package for Social
Science) data format for storage, processing and analysis. The data for key indicators like household
composition and other demography, access to improved water and improved toilets, percentage of
children aged 3-6 years attending PSE at AWC, registration of pregnancy for ANC, proportion of women
who have given a live birth in last three years, receipt of at least 3 and 4 ANCs, institutional birth,
immunization indicators, morbidity indicators, etc., were validated with available secondary data.
In order to have a set of standard and uniform validation rules, three data processing and validation
workshops were organized.
1.8.2 Processing of data collected through PAPI
The AWC data collected in PAPI mode was scrutinized and coded in the field before data entry. A data-
entry programme was developed in CS Pro 4.1 with requisite validation for routing, skipping and range
checks. Data was converted into SPSS for storage, processing and analysis.
1.8.3 National and state level sample weights
In order to present weighted results at the National and State level the sample weights were computed
at the household level as well as at AWC level. The procedure adopted for computation of household
and AWC level weights has been presented in Annexure B.
1.9 WEALTH INDEX
In the absence of income and expenditure measures for measuring economic status, household wealth
Index serves as an effective mean to determine a household’s relative economic status. This helps in
assessing the inequalities in household characteristics and their differential impact with respect to
health outcomes or other service utilization. It has been empirically demonstrated that household
wealth index is consistent with expenditure and income measures (Rutstein, 1999). In RSOC, following
DHS pattern like in NFHS 2005-06 questions at household level were asked about household ownership
of certain assets, amenities, facilities and consumer durable items to determine wealth/asset quintiles.
The wealth index used in this survey has been constructed using data on household possession of assets,
infrastructure and housing characteristics collected in the household questionnaire.
INTRODUCTION
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 1 | 14
Based on principal component analysis technique each of the household assets/facilities has been
assigned a weight or a factor loading.19 The Asset Scores have then been computed for each household
by using the following formula:
[Value of Asset Variable- Mean of Asset Variable]
HH Asset Score (AS) = _______________________________________ x Weight of component
Standard deviation of Asset Variable
Subsequently, the Asset Scores of all the variables is added at the household level to get the Total Asset
Score for each household. Thereafter, the households are ranked according to their individual
Household Asset Score (HHAS) and divided into five quintiles at the national level. This provides the cut
off points for each quintile.
1.10 STRUCTURE OF THE NATIONAL REPORT
As stated earlier, the RSOC national report has been structured as follows.
CHAPTER 2: Household Population and Housing Characteristics
CHAPTER 3: Profile of Ever Married Women and Children
CHAPTER 4: Maternal Health Care
CHAPTER 5: Child Health
CHAPTER 6: Nutrition of Children and Adolescent Girls
CHAPTER 7: Utilization of ICDS—Coverage of Target groups and services availed from Anganwadi
Centres (mother of children 0-71 months and currently pregnant and lactating women)
ANNEXURES
Annexure A: Sample design details and Tables (containing tables20 from all chapters) and weight
computation.
Annexure B: Survey Tools
19 The RSOC wealth index is based on the following 39 assets and housing characteristics: type of dwelling, number of rooms
used for sleeping, availability of a separate kitchen for the household, type of flooring; material of exterior walls; type of roofing, ownership of the house, electrification of the household, ownership of a mattress, a pressure cooker, a chair, a cot/bed, a table, an electric fan, a radio/transistor, a black and white television, a colour television, a sewing machine, a mobile telephone, any other telephone, a desktop computer, a laptop computer, an air cooler, an air conditioner, a washing machine, a refrigerator, a watch or clock, a bicycle, a motorcycle or scooter, an animal-drawn cart, a car/jeep, a water pump, a thresher,
and a tractor; drinking water source; location of the water source, type of toilet facility and main type of cooking fuel used.
20 Tables have been numbered according to the chapter to which it belongs; for example a Table from Chapter 4 has been
numbered as Table 4.XX.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 15
CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
This chapter presents the demographic profile and socio-economic characteristics of the sample
households covered under the Rapid Survey on Children (RSOC) 2013-14. The demographic profile and
socio-economic characteristics include population composition in terms of age, sex and marital status,
literacy level and educational attainment, and school/college attending status for those in the age group
5-24 years during 2012-13 as well as 2011-12 and reasons for dropping out. The marital status and
questions to ascertain literacy level and educational attainment were probed from usual residents (de
jure population) in the age-groups 10 years and above and 5 years and above respectively. Information
on social group and religion was collected from the head of the household.
This chapter also provides an overview of the socio-economic characteristics of the household on critical
parameters such as housing conditions (type of dwelling, number of rooms used for sleeping, ownership
of house etc.), having a bank account, availability of electricity, possession of durable goods, means of
transport, type of fuel used, main source of drinking water, sanitation facilities and hand washing.
Information on household assets is used to create a wealth index as an indicator of household economic
status.
Further, the chapter depicts the results of the test done to assess whether the salt used for cooking by
the household is adequately fortified with iodine. As a part of this survey, anthropometric
measurements of children between 0 to 59 months and adolescent girls in the age group of 10 to 18
years were taken to assess their nutritional status and results on these have been discussed in
subsequent chapters.
A household was defined as a group of persons who may be related by blood, marriage or adoption or
unrelated but staying together under the same roof and having food from the same kitchen. A usual
resident of the household was defined as a person who had been living in the household—under the
same roof and sharing the same kitchen for the last six months or more or had an intention to stay here
for the next six months as on the date of survey. Head of the household is a person who is a usual
member of the household; bears the chief responsibility for managing the affairs of the household and
takes decision on behalf of the household and is recognized as such by the household.
The information in this chapter is intended to facilitate interpretation of the key demographic, socio-
economic, and various other themes on the well-being of children and women presented later in the
report. It is also intended to assist in the assessment of the representativeness of the survey sample.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 16
The chapter is structured into the following sub-sections:
2.1 Response Rates
2.2 Household population by age, sex and marital status
2.3 Household composition by usual members
2.4 Profile of the head of the household
2.5 Literacy, education attainment and gender parity of household members
2.6 Housing conditions
2.7 Water, sanitation and hygiene practices of the household
2.8 Household possession and wealth quintiles
2.9 Iodine levels in cooking salt
2.1 RESPONSE RATES
A total of 1,08,082 households were selected in the sample, of which 1,05,483 were successfully
interviewed yielding a household response rate of 97.6 percent. A total of 1,18,027 ever married women
(EMW) aged 15-49 were identified in the 1,05,483 households interviewed (an average of 1.12 EMW per
household). Of the eligible EMW, 1,11,636 were successfully interviewed, yielding a response rate of
94.6 percent. The principal reason for non-response among eligible women was the failure to find
individuals at home despite repeated visits to the household. As per the survey protocol, three visits per
household were mandatory. Table 2.1 presents the response rates for different categories of
respondent groups.
A sample of 99,396 children aged 0-59 months was identified in the interviewed households. Of these,
anthropometric measurements on height and weight were taken for 90,908 rendering a response rate
of 91.5 percent. Under RSOC, all children of this age group were covered for anthropometric
measurements including such children whose mother/caregiver were not living in the household at the
time of survey and also those children whose mother/caregiver had died.
Against 34,704 adolescent girls aged 10-18 identified across households interviewed, the height and
weight could be measured of 28,521 girls, yielding a response rate of 82.2 percent. The non-response
was mainly due to the fact that girls in this age group were not at home during the survey time because
of various reasons, such as being in schools and colleges. Repeat visits (at least three visits) were made
as per the survey protocol. Overall, the response rates do not vary much across urban and rural areas as
seen in Table 2.1.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 17
Table 2.1: Results of the household and individual interviews and anthropometric measurements
Results Residence
Urban Rural Total
Household interviews
Households selected 38,662 69,420 1,08,082
Households interviewed 37,695 67,788 1,05,483
Household response rate 97.5 97.6 97.6
Interviews with ever married women aged 15-49
Number of eligible women in the households 42,472 75,555 1,18,027
Number of eligible women interviewed 40,333 71,303 1,11,636
Eligible women response rate 95.0 94.4 94.6
Anthropometric measurement with children aged 0-59 months
Number of children aged 0-59 months identified in the interviewed households
33,819 65,577 99,396
Number of children aged 0-59 months measured 30,974 59,934 90,908
Anthropometric measurement Response rate 91.6 91.4 91.5
Anthropometric measurement of adolescent girls aged 10-18
Number of adolescent girls aged 10-18 in the interviewed households 10,963 23,741 34,704
Number of adolescent girls aged 10-18 measured 9,147 19,374 28,521
Anthropometric measurement of adolescent girls response rate 83.4 81.6 82.2
Household Response Rate: Households interviewed/households selected *100 Individual Response Rate: Respondents interviewed/eligible respondents *100
Table 2.2 presents the all India and state-wise number of persons interviewed and their response rates
with respect to both category of households, EMW aged 15-49, children aged 0-59 months and
adolescent girls aged 10-18 whose anthropometric measurements were taken.
For category ‘A’ households (with at least one child below six years of age) which provided the base for
all maternal and child related indicators a response rate of 97.6 percent was achieved at the national
level. For category ‘B’ households (without any child below six years of age) which complemented the
universe for indicators at household level the response rate at national level was also around 97.5
percent. Further details on category ‘A’ and ‘B’ households are given in Chapter 1.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 18
Table 2.2: Number of households covered in the survey and ever married women aged 15-49 interviewed and anthropometric measurements taken according to states, RSOC, 2013-14
State
Category A HHs
interviewed
Category B HHs
interviewed
EMW aged 15-49
interviewed
Anthropometric measurements taken
Children 0-59
months
Adolescent girls
aged 10-18
Number RR Number RR Number RR Number RR Number RR
India
Andhra Pradesh
Karnataka
Kerala
Tamil Nadu
Goa
Gujarat
Maharashtra
Chhattisgarh
Madhya Pradesh
Jharkhand
Punjab
Rajasthan
Delhi
Haryana
Himachal Pradesh
Jammu & Kashmir
Uttar Pradesh
Uttarakhand
Assam
Arunachal Pradesh
Manipur
Meghalaya
Mizoram
Nagaland
Sikkim
Tripura
West Bengal
Bihar
Odisha
81,169
3,634
2,736
2,081
3,296
1,685
2,965
4,785
2,106
3,464
2,287
2,020
3,437
2,515
1,992
2,074
1,808
10,183
1,758
2,432
1,781
1,634
1,860
1,633
1,578
1,780
1,678
4,049
5,215
2,703
97.6
96.1
97.0
95.5
98.7
99.1
98.8
98.1
98.4
98.4
98.6
99.0
98.8
99.0
99.6
98.8
99.3
97.9
98.8
96.5
92.8
96.1
98.9
96.1
91.7
98.9
94.3
99.2
95.5
98.6
24,314
973
780
641
948
500
818
1,356
604
1,025
696
612
1,044
762
600
630
546
3,120
534
755
576
510
564
503
479
540
534
1,224
1,618
822
97.5
85.8
92.2
98.0
94.6
98.0
90.9
92.6
94.1
97.1
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
99.9
100.0
100.0
100.0
98.6
92.8
100.0
100.0
100.0
98.8
100.0
1,11,636
4,636
3,716
2,680
4,037
2,186
4,287
6,477
2,788
5,030
3,193
2,965
5,077
3,647
2,966
2,897
2,576
14,728
2,515
3,157
2,291
2,082
2,226
2,117
1,924
2,428
2,430
6,068
6,992
3,520
94.6
95.4
90.3
87.6
91.8
93.9
94.8
91.4
94.6
94.3
99.2
98.6
92.5
96.4
97.6
96.2
97.2
94.8
97.5
93.8
96.7
97.8
89.6
95.2
94.8
94.7
98.8
97.8
92.0
97.0
90,908
4,293
3,285
1,717
3,131
1,802
3,529
5,589
2,481
4,184
2,658
2,208
3,979
2,627
2,443
2,300
2,111
11,781
1,989
2,372
1,953
1,736
2,030
1,611
2,283
1,767
1,637
4,056
6,509
2,847
91.5
94.4
94.6
83.6
81.6
94.7
92.8
92.8
92.3
91.9
95.6
95.2
84.8
90.0
91.5
93.4
88.7
87.6
88.8
94.2
93.4
95.6
95.1
91.5
98.2
93.7
95.1
94.9
92.3
94.1
28,521
655
565
311
721
333
964
1,287
815
1,556
1,111
593
1,591
832
650
531
686
5,587
602
883
519
592
640
313
454
585
405
1,292
2,618
830
82.2
93.8
64.8
67.6
100.0
83.0
86.8
87.7
82.4
86.5
94.4
86.1
82.3
88.8
90.3
80.9
73.1
78.3
75.9
85.2
79.7
89.6
88.4
81.7
99.3
72.0
83.3
86.7
75.2
81.2
The response rates for anthropometric measurements of adolescent girls aged 10-18 across a large number of states is comparatively on the lower side. There are 16 states where it ranges in 80-90 percentage, six states in 70-80 percentage and two states in 60-70 percentage. Across the states, it was seen that the girls were not found at home despite the mandatory three visits to households. Most of the times, girls were either in school or college or were engaged in economic/household activities which rendered them away from home.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 19
2.2 HOUSEHOLD POPULATION BY AGE, SEX AND MARITAL STATUS
Age and sex are the two most critical demographic variables that lay the foundation of demographic
classifications in vital statistics, censuses and surveys. In general, a cross-classification by sex and age is
essential for carrying out an effective analysis of all crucial indicators obtained in surveys. A closer
examination of the age and sex distribution also aids in assessing the quality and statistical rigour of the
entire survey process.
Table 2.3 shows the distribution of the household population by five-year age groups, according to
urban-rural residence and sex. The total estimated population covered in the RSOC 2013-14 was 4,
95,571 (2, 50,566 males and 2, 45,005 females) across 1, 05,483 interviewed households.
The age structure of the household population at the national level is typical of a society with a youthful
population. The sex and age distribution of the population is shown in the population pyramid in Figure
2.1. It depicts a pyramidal age structure due to large number of children below age 15. It is evident that
the pyramid is broad based with the lowest two bases (0- 4 years and 5-9 years) being narrower than 10-
14 years in a reverse order, a pattern that is typically associated with faster decline in fertility in more
recent history. Broadly, children under age 15 account for 31 percent, while 64 percent of the country’s
residents are in the 15-64 age group and 5 percent are over 65.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 20
Table 2.3: Household population by age and sex according to residence
Percent distribution of household population by five-year age groups, according to sex and residence, India, RSOC, 2013-14
Age Urban Rural Total
Male Female Total Male Female Total Male Female Total
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80+
Total
0-2
3-5
0-5
15-24
<18
18+
Number
Sex ratio, all ages1
Sex ratio, age 0-4 years1
Sex ratio, age 0-6 years1*
9.2
9.5
10.0
9.1
8.5
8.9
8.7
7.9
6.6
5.6
5.0
3.5
3.0
1.8
1.3
0.6
0.7
100.0
5.5
5.9
11.5
17.6
34.2
65.8
80,379
na
na
na
8.9
9.3
9.1
8.9
10.1
10.6
8.6
7.9
5.8
6.4
4.1
3.3
2.8
1.8
1.1
0.6
0.8
100.0
5.3
5.7
11.0
19.0
32.7
67.3
77,371
na
na
na
9.1
9.4
9.6
9.0
9.3
9.7
8.7
7.9
6.2
6.0
4.6
3.4
2.9
1.8
1.2
0.6
0.7
100.0
5.4
5.8
11.2
18.3
33.4
66.6
1,57,750
963
931
923
10.8
11.2
11.3
9.8
8.3
7.8
7.0
6.9
5.6
5.2
4.6
3.3
3.1
2.1
1.6
0.7
0.7
100.0
6.6
6.9
13.4
18.1
39.3
60.7
1,70,187
na
na
na
10.3
10.9
10.8
10.2
9.1
9.0
7.3
6.6
5.2
6.0
3.8
3.0
2.9
1.9
1.5
0.6
0.9
100.0
6.2
6.4
12.6
19.3
38.4
61.6
1,67,634
na
na
na
10.6
11.1
11.1
10.0
8.7
8.4
7.2
6.7
5.4
5.6
4.2
3.2
3.0
2.0
1.5
0.7
0.8
100.0
6.4
6.6
13.0
18.7
38.8
61.2
3,37,821
985
936
928
10.3
10.6
10.9
9.6
8.3
8.1
7.6
7.2
5.9
5.3
4.7
3.4
3.1
2.0
1.5
0.7
0.7
100.0
6.2
6.5
12.8
17.9
37.6
62.4
2,50,566
na
na
na
9.8
10.4
10.3
9.8
9.4
9.5
7.7
7.0
5.4
6.1
3.9
3.1
2.9
1.9
1.4
0.6
0.9
100.0
5.9
6.2
12.1
19.2
36.6
63.4
2,45,005
na
na
na
10.1
10.5
10.6
9.7
8.9
8.8
7.7
7.1
5.7
5.7
4.3
3.2
3.0
1.9
1.4
0.6
0.8
100.0
6.1
6.4
12.5
18.6
37.1
62.9
4,95,571
978
934
927
na = Not applicable. 1
Females per 1,000 males. *Inclusive both age groups
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 21
Although the proportion of the population under age 15 remains large (31 percent), this proportion has
been declining consistently since 1991 (38 percent), 2001 (36 percent), 2005-06 (35 percent) and 2011
(31 percent). The proportion of the population under age 15 is somewhat lower in urban areas (28
percent) than in rural areas (33 percent), a pattern consistent with higher fertility in rural than urban
areas. About 10 percent of the population is under age 5.
The proportion in other critical age groups such as adolescents (10-19 years) stands at 20 percent, young
(15-24 years) at 19 percent and adults (18 years or more) at 63 percent. Table 2.4 shows that trend in
age distribution of household population by five year age groups and overall sex ratio at the national
level from 1991 to 2013-14.
Table 2.4: Trends in age distribution of household population
Percent distribution of household population by five-year age groups, overall sex ratio, India, 1991-
2013-14.
Age group Census,
1991
NFHS-1,
1992-93
NFHS-2,
1998-99
Census,
2001
NFHS-3,
2005-06
Census,
2011
NSS 60th
Round, 2006
RSOC,
2013-14
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80+
Total
Sex ratio1
12.3
13.4
11.8
9.5
8.9
8.3
7.0
6.3
5.1
4.3
3.7
2.6
2.7
1.5
1.3
0.5
0.8
100.0
928
12.5
13.4
12.1
10.3
9.1
8.0
6.5
5.9
4.5
3.8
3.1
3.1
2.9
1.9
1.5
0.6
0.8
100.0
957
11.4
12.7
12.0
10.4
8.9
8.2
6.8
6.4
4.9
4.3
3.2
2.9
2.9
2.0
1.6
0.6
0.8
100.0
960
10.8
12.5
12.2
9.8
8.8
8.1
7.2
6.9
5.4
4.6
3.6
2.7
2.7
1.9
1.4
0.6
0.8
100.0
933
10.9
12.0
12.0
9.5
8.6
8.0
6.7
6.8
5.3
4.5
3.7
3.4
3.1
2.2
1.6
0.7
0.9
100.0
1000
9.4
10.5
11.0
10.0
9.2
8.4
7.3
7.1
6.0
5.2
4.1
3.2
3.1
2.2
1.6
0.8
0.9
100.0
943
11.1
12.0
11.7
9.4
8.7
8.2
7.4
6.9
5.5
4.7
3.7
3.7
2.5
2.0
2.4
na
na
100.0
952
10.1
10.5
10.6
9.7
8.9
8.8
7.7
7.1
5.7
5.7
4.3
3.2
3.0
1.9
1.4
0.6
0.8
100.0
978 1Females per 1000 males. na: not applicable.
Further, a comparison of the RSOC age-sex distribution (Figure 2.1) with that of Census 2011 (Figure 2.2)
reveals a very close pattern across age groups which reassures about the robustness of the population
structure revealed through the survey.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 22
Figure 2.1: Age-Sex Pyramid, India, 2013-14 Figure 2.2: Age-Sex Pyramid, India, Census of India, 2011
Table 2.5 portrays the percent distribution of household population by broad age-groups according to
states and all India. A perusal of population composition across these age groups distinctly highlights the
fact that states are at different stages of demographic transition and the overall pattern seems to be
broadly consistent with Census 2011 data. On one hand, there are states like Kerala, Punjab, Goa
reporting less than 25 percent below age 15 population and on the other hand, states like UP,
Meghalaya, Arunachal Pradesh, Jharkhand and Bihar report in excess of 35 percent, Bihar in particular
crossing 40 percent mark.
12 10 8 6 4 2 0 2 4 6 8 10 12
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80+
Percent
Female
Male
12 10 8 6 4 2 0 2 4 6 8 10 12
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80+
Percent
Female
Male
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 23
Table 2.5: Household Population by age and state
Percent distribution of household population by broad age-groups, according to states and India, RSOC, 2013-14
State Age group
Total 0-4 5-9 10-14 15-19 20-24 25-64 65+
India
North
Delhi
Haryana
Himachal Pradesh
Jammu & Kashmir
Punjab
Uttar Pradesh
Uttarakhand
Central
Chhattisgarh
Madhya Pradesh
East
Bihar
Jharkhand
Odisha
West Bengal
Northeast
Arunachal Pradesh
Assam
Manipur
Meghalaya
Mizoram
Nagaland
Sikkim
Tripura
West
Rajasthan
Goa
Gujarat
Maharashtra
South
Andhra Pradesh
Karnataka
Kerala
Tamil Nadu
10.1
9.6
11.1
8.0
9.4
7.2
11.2
9.6
10.3
10.4
13.5
12.2
9.2
8.3
14.3
9.7
11.3
14.8
9.6
18.7
7.5
8.9
11.0
8.3
10.3
9.1
9.3
8.9
7.7
8.5
10.5
9.8
9.5
8.4
10.8
8.1
12.2
10.4
9.5
10.8
14.1
13.7
9.7
8.6
13.8
12.0
11.5
12.8
11.2
7.4
8.5
8.5
12.3
7.7
9.1
8.6
10.1
8.7
8.2
9.4
10.6
9.5
9.0
9.2
10.6
8.5
13.0
12.1
10.5
10.8
13.4
12.1
9.3
9.4
8.8
11.5
10.0
9.1
7.2
5.2
12.5
8.5
11.6
8.3
9.7
9.2
8.4
9.2
7.7
9.9
9.7
9.9
9.6
8.4
10.6
9.7
11.9
11.6
10.6
10.3
9.3
9.8
8.6
10.1
9.1
9.0
7.1
8.8
9.5
15.7
10.9
8.4
9.8
6.2
9.2
8.8
8.6
8.8
7.3
8.5
8.9
9.3
10.4
8.5
8.7
9.5
9.0
8.6
10.2
8.8
6.5
8.3
8.6
9.8
7.4
9.5
8.3
9.9
9.3
10.0
8.9
9.9
8.8
8.0
9.4
9.7
9.9
9.3
7.4
7.4
45.5
48.7
45.3
51.1
44.2
49.5
38.5
42.1
44.5
44.2
38.9
40.5
47.6
48.8
44.9
45.4
47.1
43.1
51.3
42.6
46.8
51.7
41.0
55.7
48.5
49.0
51.1
49.7
54.5
51.4
4.8
3.2
5.0
6.4
5.7
7.5
4.3
5.6
4.3
4.6
4.4
3.4
7.0
5.0
1.6
2.9
4.8
1.6
1.9
0.4
5.0
4.1
5.5
5.8
3.9
5.7
2.8
5.5
7.3
4.9
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
The overall sex ratio is 978 females per 1000 males implying a shortage of 22 females for every 1000
males in the enumerated population. The sex ratio is much higher in rural areas (985 females per 1000
males) than in urban areas (963 females per 1000 males) where it is based on expected lines of more
males migrating to urban areas for work. The sex ratio for population aged 0-6 is 927 girls per 1000 boys
which is quite close to 919 girls per 1000 boys as revealed by Census 2011. RSOC which was done about
three years after Census 2011 hints towards a reversal of trend at least at the national level both in rural
(928 against 923 in Census) as well as urban areas (923 against 905 in the Census). A sleuth of
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 24
population policy measures initiated after the provisional figure of 914 girls per 1000 boys (lowest in the
history of censuses) was released may have helped in this correction. Table 2.6 compares the overall sex
ratio and sex ratio for children aged 0-6 for India and states by residence. The table displays some
worryingly high male to female sex ratios in the 0-6 age group. It is less than 900 in 12 states.
Table 2.6: Sex ratio by states
Sex ratio1 among household population by age-groups and residence, according to states, India, RSOC, 2013-14.
State All ages Age 0-6
Urban Rural Total Urban Rural Total
India
North
Delhi
Haryana
Himachal Pradesh
Jammu & Kashmir
Punjab
Uttar Pradesh
Uttarakhand
Central
Chhattisgarh
Madhya Pradesh
East
Bihar
Jharkhand
Odisha
West Bengal
Northeast
Arunachal Pradesh
Assam
Manipur
Meghalaya
Mizoram
Nagaland
Sikkim
Tripura
West
Rajasthan
Goa
Gujarat
Maharashtra
South
Andhra Pradesh
Karnataka
Kerala
Tamil Nadu
963
913
908
886
934
866
924
1,011
919
962
925
939
1,005
1,000
989
1,005
1,016
998
1,009
1,023
1,027
1,010
979
1,015
928
904
1,072
994
1,060
1,009
985
891
916
1,021
923
908
971
1,014
1,017
970
981
1,019
1,025
985
890
944
975
972
785
985
992
971
998
953
966
943
1,034
1,033
1,087
1,008
978
913
913
1,007
926
892
961
1,013
995
968
974
1,002
1,022
990
915
953
989
978
906
999
1,002
981
994
992
948
924
1,047
1,017
1,074
1,008
923
820
935
1,118
805
868
884
849
907
960
906
922
946
1,045
982
923
912
907
961
874
933
1,127
908
951
865
826
1,032
961
1,135
957
929
821
825
978
824
878
934
917
997
893
905
1,125
895
1,047
848
894
899
855
712
858
944
982
823
920
953
844
1,001
973
1,024
960
927
820
857
990
819
874
924
898
979
910
905
1,091
902
1,046
883
898
903
863
844
862
941
1,008
842
940
913
835
1,013
968
1,075
958
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 25
Marriage
Marriage is one of the factors that has a direct bearing on the level of fertility as marriage signals the
onset of exposure to the risk of pregnancy for most women and therefore their age at the time of
marriage is considered as a proximate determinant of fertility. The practice of marriage and the age at
the time of marriage in India is quite varied and diverse across different sections of population
differentiated on the lines castes, tribes, religion and beliefs. Levels of education and economic status
are other factors which also considerably influence such behaviour.
Information on age at first marriage was collected in respect of all ever married usual residents of age 10
years and more. Ever married persons include those who are currently married or got married any time
in the past. The first category, i.e., currently married also includes usual residents who are married but
for whom gauna has not yet been performed. Gauna is a tradition particularly practiced in northern
Indian states where a young bride lives with her parents till a certain period after which she goes to stay
with her husband. The second category of formerly married includes widowed, divorced or separated.
Table 2.7 presents the percentage of ever-married population by broad age groups, mean age at first
marriage, median age at first marriage and proportion having got married below legal age of marriage (<
21 years for males and < 18 years for females) in respect of those who got married any time prior to the
survey, according to sex and residence. About 62 percent of males and 72 percent of females got
married any time in the past almost maintaining a similar proportion across rural and urban areas. In
general, the proportion of ever married population increases sharply with the increase in age and
touches more than 90 percent at age-group 35-39 years. Sixty-four percent of males and 78 percent of
females aged 15-49 were married any time in the past.
The results further show that females marry at a younger ages compared to males. For example, a
higher proportion of teenage girls aged 15-19 (13 percent) are married against their counter parts
among boys (2 percent) with almost a similar pattern emerging in rural as well as urban areas. The
average age at marriage among females is almost five years lesser than that of males (mean age at
marriage for females and males is 18.6 years and 23.3 years respectively). As regards median age at first
marriage, it also shows a similar differential between females and males both in rural as well as urban
areas.
Marriage in India defines the onset of the socially acceptable time for childbearing and as already stated
the age at marriage varies substantially across states echoing the prevalent diversity. However, the legal
age of marriage is 18 years for females and 21 years for males. Despite the fact that the average age at
marriage in India has been rising gradually over the past twenty years, the practice of child marriage is
still widespread and young girls suffer most as a result of it. Early marriage of females not only renders
them susceptible to the risks of maternal mortality but also affects the health and nutrition conditions of
newborns, which is a major factor for high child mortality.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 26
About 41 percent of females got married before the legal age (< 18 years) as compared to 32 percent
males getting married below 21 years. There is a marked distinction in prevalence between rural and
urban areas. Against 47 percent of females getting married before legal age in rural areas, 30 percent
got married in urban areas. Similarly, 38 percent of males got married before legal age in rural areas as
compared to 21 percent in urban areas.
Table 2.7: Marital status of the household population
Percentage of ever married persons (age 10 and above) by broad age-groups and among those married any time prior to
survey, median age at first marriage, mean age at first marriage and percentage of those married below legal age,
according to gender and residence, RSOC, 2013-14.
Age
Residence Total
Urban Rural
Male Female Male Female Male Female
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55+
Total
15-49
15-54
Median age at first marriage
Mean age at marriage
Married below legal age at marriage1
0.1
0.7
17.6
64.6
89.8
96.2
97.8
98.0
98.8
99.2
62.1
62.7
65.7
24.6
24.7
21.3
0.1
8.9
59.8
89.4
97.4
98.6
98.8
99.5
98.8
98.9
71.9
76.4
77.9
18.6
19.7
29.9
0.1
2.1
30.0
76.8
93.2
97.8
98.1
98.6
98.9
99.2
62.2
64.3
67.2
22.0
22.7
37.9
0.4
14.4
75.0
95.7
98.5
99.3
99.3
99.8
99.6
99.2
71.5
78.3
79.7
17.2
18.0
47.4
0.1
1.7
26.0
72.5
91.9
97.2
98.0
98.4
98.9
99.2
62.2
63.8
66.7
22.9
23.3
32.4
0.3
12.8
69.8
93.5
98.1
99.1
99.1
99.7
99.4
99.1
71.6
77.7
79.1
17.6
18.6
41.7 1 Men < 21 years, Women < 18 years.
Note: Table based on persons married any time prior to survey.
Since mean age at first marriage and percentage of those who got married below legal age discussed in
the preceding section is based on marriages that took place any time in the past, a comparison of the
same with recent marriages (marriages that have taken place in the last five years) would help in
assessing the shift and highlight the current situation. Figure 2.3 depicts that the mean age at first
marriage is about two and half years higher in case of females based on marriages that have taken place
in the last five years (21.1 years) vis-à-vis marriages that took place any time in the past (18.6 years). The
corresponding difference in case of males is about one and a half year (25.0 years and 23.3 years).
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 27
Figure 2.3: Mean age at marriage based on marriages that have taken place any time in the past vs marriages that took place in the last 5 years
Figure 2.4 highlights such variations in case of percentage of females and males who got married below
their respective legal ages. The prevalence of below legal age marriage in case of females (< 18 years)
based on recent marriages (that took place in the last 5 years) is 16 percent as compared to 42 percent
based on all marriages, exhibiting a decline of almost 2.6 times. A sharper decline is seen in case of
urban females (30 percent and 9 percent) as well as rural females (47 percent and 20 percent). Almost a
similar pattern is seen in case of males also across rural and urban areas.
Figure 2.4: Proportion getting married below legal age—marriages any time vs marriages in last 5 years
The data suggests a close association between the mean age at first marriage and social groups as
shown in Table 2.8. There seems to be a stronger shift towards late marriage among Other Backward
Classes (OBCs) and Others as compared to SCs and STs both for males and females in rural as well as
urban areas. The mean age at first marriage for women belonging to Others category is at least one year
24.7
19.7
22.7
18.0
23.3
18.6
26.3
22.2
24.3
20.5
25.0
21.1
Male Female Male Female Male Female
Urban Rural Total
Marriage any time Marriage in last 5 years
21
30
38
47
32
42
9 9
22 20 18 16
Male Female Male Female Male Female
Urban Rural TotalMarriage any time Marriage in last 5 years
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 28
later than that of SCs. This is more marked in case of males showing a shift of 1.2 years for rural, 1.6
years for urban and 1.7 years for total.
Further analysis of the data on mean age at marriage by wealth quintiles as seen in Table 2.8 indicates a
positive and significant relationship between these two. For example, the mean age at marriage for
females belonging to the lowest quintile in rural areas is 17.3 years and it increases gradually with
increase in economic status, the corresponding figure being 19.4 years for the females belonging to the
richest quintile. Almost a similar pattern is seen in case of mean age of marriage for females in urban
areas. The situation with regard to mean age at marriage for males both in rural and urban is also on
expected lines.
A close association is also seen between percentage of men and women getting married below the legal
age and social groups. There is a variation of about 14 percentage points in the proportion of women
getting married before 18 years belonging to SC category (49 percent) than those belonging to Others
(35 percent). Similarly, there is a corresponding variation exceeding 15 percentage points in case of men
getting married before 21 years. Differentiated by the highest and the lowest wealth quintiles, there is a
variation of 31 and 28 percentage points for women and men getting married before their respective
legal age.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 29
Table 2.8: Early marriage and mean age at marriage by specific characteristics
Percentage of ever married men and women (age 10 and above) who got married any time prior to the survey mean age at marriage and percentage of those
married below legal age by social-group and wealth index, according to residence, RSOC, 2013-14.
Characteristic
Residence Total
Urban Rural
Men Women Men Women Men Women
Married
<21
Mean
age at
marriage
Married
<18
Mean
age at
marriage
Married
<21
Mean
age at
marriage
Married
<18
Mean
age at
marriage
Married
<21
Mean
age at
marriage
Married
<18
Mean
age at
marriage
Social—Group
Scheduled Caste
Scheduled Tribe
OBC
Other
No response
Wealth Index
Lowest
Second
Middle
Fourth
Highest
Total
27.8
25.6
22.0
17.0
27.5
37.8
30.0
26.0
21.7
16.7
21.3
24.0
24.1
24.6
25.2
23.9
22.5
23.4
24.0
24.7
25.3
24.7
38.6
29.2
29.3
26.6
54.5
47.6
41.4
37.5
31.5
22.8
29.9
18.9
19.6
19.7
20.0
18.0
17.8
18.6
19.1
19.5
20.4
19.7
42.8
38.6
41.8
27.7
30.5
48.5
40.4
34.9
31.1
26.4
37.9
22.1
22.7
22.3
23.7
23.2
21.6
22.3
22.8
23.4
24.2
22.7
53.5
43.2
49.1
41.5
63.1
57.4
50.6
46.1
40.6
32.1
47.4
17.5
18.5
17.8
18.5
16.8
17.3
17.7
18.0
18.5
19.4
18.0
38.7
36.3
35.3
23.2
29.6
47.8
39.0
32.6
26.9
20.0
32.4
22.6
23.0
23.0
24.3
23.4
21.6
22.5
23.1
24.0
24.9
23.3
49.4
40.7
42.8
35.3
60.4
56.8
49.4
43.9
36.6
26.1
41.7
17.8
18.7
18.4
19.1
17.2
17.3
17.8
18.3
18.9
20.0
18.6
Note: Table based on persons married any time prior to survey.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 30
Figure 2.5 shows the decline in proportion of those getting married below the legal age based on recent
marriages vis-à-vis marriages that took place any time in the past among males and females by their social group
status and also by the lowest and the highest quintiles. Similarly, Figure 2.6 depicts the shift in mean age at first
marriage among males and females of corresponding groups. There is a marked improvement on both the
counts across all categories which is an encouraging sign.
Figure 2.5: Proportion of marriages below legal age—marriages any time in the past and marriages in the last 5 years
`
39 36 35
23
48
20
32
20 23
20
11
31
7
18
49
41 43
35
57
26
42
20
16 17
13
28
6
16
ScheduledCaste
ScheduledTribe
OBC Other Lowest Highest Total
Male Male Female Female
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 31
Figure 2.6: Mean Age at Marriage—marriages any time in the past and marriages in last 5 years
In order to map the improvement in the average age at marriage and also the progress made in reducing the proportion of those getting married below the legal age, a comparison of RSOC results has been done with District Level Health Survey-3 (DLHS-3), which was done in 2007-08. Table 2.9 shows significant improvement on both the parameters and it is encouraging to note that progress has taken place across all categories of social groups and wealth quintiles. Overall, there has been a gain by 1.6 year in case of women and 1.3 year for men in the average age at marriage. It is revealing to note that the gain in terms of delayed marriage for SC (1.7 year), ST (1.9 year) and OBC (2.0 year) women has been more than two times of what is seen in case of women belonging to ‘Others’ category (0.8 year). Almost a similar pattern is noticed across wealth quintiles wherein the gain in case of women belonging to the lowest and the second to lowest quintiles is of 2.9 years and 2.1 years respectively against 0.9 year seen in case of women belonging to the highest quintile. The situation in case of men is also on the same lines. Women marrying below the legal age (< 18 years) has come down by 8 percent points and the reduction is sharper in case of SC (10 percent points), ST (7 percent points), OBC (11 percentage points) women as compared to women pertaining to Others category (2 percent points). The decline across wealth quintiles shows a gradual trend with the maximum reduction observed in case of women belonging to the lowest quintile (19 percent points) and no change, in the highest quintile (0.1 percent points). In case of men marrying below the legal age (< 21 years), almost a similar pattern can be seen both in case of social groups and wealth quintiles.
23 23 23
24
22
25
23
25 25 25
26
24
27
25
18 19 18
19
17
20
19
21 21
21 22
20
23
21
Scheduled Caste Scheduled Tribe OBC Other Lowest Highest Total
Male Male Female Female
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 32
Table 2.9: Early marriage and mean age at marriage by specific characteristics (Comparison)
Mean age at marriage and percentage of those married below legal age for ever married men and women (age 10 years and above) by social groups and wealth Index RSOC, 2013-14 and DLHS-3, 2007-08.
Characteristic
Men married
< 21 year
Women married
< 18 years
Mean age at
marriage for men
Mean age at marriage
for women
RSOC,
2013-14
DLHS-3,
2007-08
RSOC,
2013-14
DLHS-3,
2007-08
RSOC,
2013-14
DLHS-3,
2007-08
RSOC,
2013-14
DLHS-3,
2007-08
Social - Group
Scheduled Caste
Scheduled Tribe
OBC
Other
Wealth Index
Lowest
Second
Middle
Fourth
Highest
Total
18.4
23.2
18.6
9.1
29.5
22.4
19.7
12.4
4.7
16.2
28.7
28.2
26.2
13.5
44.8
37.9
27.8
18.6
7.8
23.2
16.9
14.4
14.3
10.9
25.6
23.0
15.1
9.6
3.9
14.1
27.3
21.9
25.3
12.9
44.5
36.1
24.1
13.6
4.0
21.9
24.8
24.9
25.0
26.2
24.0
24.1
24.5
25.8
27.4
25.3
23.2
23.6
23.7
25.2
21.7
22.2
23.2
24.4
26.1
24.0
20.8
21.9
21.3
21.7
20.5
20.3
20.6
21.6
23.2
21.4
19.1
20.0
19.3
20.9
17.6
18.2
19.2
20.3
22.3
19.8
Note: Table based on person married three years prior to survey.
Table 2.10 depicts the percentage of ever married men (age 10 and above) by broad age-groups, mean age at first marriage, percentage of those marrying below the legal age and median age at first marriage by India and states. The Table shows that by and large in all states the marriages are not taking presently in the ages up to 19 years. The only states where a smaller proportion of males (5-9 percent) got married in the age group of 15-19 are Rajasthan and Nagaland. The mean age at first marriage varies widely across the states exhibiting a range of 8.8 years between Goa (28.6 years) and Rajasthan (19.8 years). The variability in proportion of males getting married below the legal age (< 21 years) varies acutely across states. On one hand, there are states like Kerala and Goa which report just 4.1 percent and 5.8 percent of males having got married below the legal age respectively. On the other hand, more than 50 percent of males got married below the legal age in states like Madhya Pradesh, Bihar, Uttar Pradesh and Rajasthan. Table 2.11 presents similar information for ever married women (age 10 and above). In contrast to males, significant proportions of females are getting married in the age group 15-19 years in states like Bihar, Jharkhand, West Bengal, Assam, Nagaland, Tripura and Rajasthan. Other states including the advanced ones like Kerala, Maharashtra and Tamil Nadu also report marriages in this age group to the tune of 7-10 percent. As observed in the case of males, the mean age at first marriage in case of females also varies substantially across the states. The average age at marriage in Goa, the state reporting the highest (24.5 years), is more than 8 years higher than Rajasthan, the state reporting the lowest (16.3 years). Figure 2.7 portrays the state-wise variation in mean age at marriage.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 33
Figure 2.7: Mean age at first marriage for females, RSOC 2013-14
16
.3
16
.4
17
.3
17
.6
17
.7
18
.0
18
.3
18
.5
18
.6
18
.6
18
.6
18
.7
18
.9
19
.2
19
.7
19
.8
19
.8
19
.9
19
.9
20
.0
20
.0
20
.2
20
.2
20
.5
20
.7
22
.0
22
.3
22
.6
22
.8
24
.5
Raj
asth
an
Bih
ar
Wes
t B
enga
l
Utt
ar P
rad
esh
Ch
hat
tisg
arh
Mad
hya
Pra
de
sh
Jhar
khan
d
Od
ish
a
Ind
ia
Utt
arak
han
d
An
dh
ra P
rad
esh
Trip
ura
Har
yan
a
Mah
aras
htr
a
Del
hi
Him
ach
al P
rad
esh
Sikk
im
Pu
nja
b
Ass
am
Gu
jara
t
Tam
il N
adu
Jam
mu
& K
ash
mir
Kar
nat
aka
Aru
nac
hal
Pra
des
h
Meg
hal
aya
Man
ipu
r
Nag
alan
d
Ker
ala
Miz
ora
m
Go
a
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 34
Table 2.10: Marital status of the household population by states: Male
Percentage of ever married male (age 10 and above) by age, mean age at marriage, percentage married below legal age at marriage and median age at first marriage, according
to states, RSOC, 2013-14.
State 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55+ Total Mean age
at marriage
Percentage below legal age at
marriage (< 21 Years)
15-54 Median
age at first marriage
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Orissa (Odisha) West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
0.1
0.1 0.0 0.0 0.0 0.0 0.0 0.1
0.0 0.0
0.0 0.2 0.0 0.0
0.0 0.0 0.0 0.2 0.0 0.0 0.0 0.0
1.0 0.0 0.5 0.0
0.0 0.0 0.0 0.0
1.7
0.1 2.1 0.2 1.4 0.3 1.2 0.0
0.4 1.2
2.2 0.7 0.2 3.2
0.4 2.7 0.6 0.9 0.1 5.7 2.1 2.4
7.9 0.0 3.4 0.3
0.5 0.3 0.1 0.0
26.0
26.4 30.9 15.0 12.4 13.8 30.0 31.9
30.4 36.7
35.8 42.7 13.8 29.2
19.4 20.7 23.5 28.3 10.8 60.5 24.4 20.7
46.8
4.5 34.7 14.0
22.5 12.4
4.7 11.1
72.5
70.6 76.2 58.1 49.0 62.9 77.1 68.6
74.7 82.5
87.7 76.9 60.0 68.0
70.9 71.7 55.1 76.2 65.4 92.5 71.4 58.3
79.0 27.7 81.4 65.3
82.4 52.8 48.1 64.6
91.9
90.1 94.4 92.7 86.3 87.6 93.8 92.7
94.0 95.5
96.4 95.2 86.3 85.1
92.2 81.8 82.9 90.3 82.1 96.7 89.2 91.1
95.4 66.4 92.1 93.8
96.8 90.5 86.1 87.6
97.2
95.5 96.4 98.6 96.1 95.7 96.6 95.9
97.0 98.6
99.7 98.6 97.0 94.1
97.7 94.2 94.6 95.4 93.7 99.0 98.4 98.8
96.2 85.8 98.1 98.9
99.3 97.7 93.2 97.7
98.0
98.9 97.8 99.1 99.4 95.9 97.4 98.9
98.6 99.5
99.7 98.5 99.5 97.2
98.3 98.1 97.6 96.3 98.5 97.8 93.6 98.6
97.3 94.1 97.0 97.5
96.9 99.3 96.9 98.5
98.4
97.5 97.9 99.5 98.9 99.6 98.6
100.0
99.1 99.6
99.9 99.1 99.3 98.8
97.4 95.4 95.4 96.8 97.0
100.0 99.3 99.6
96.8 97.5 93.4 98.2
100.0
97.5 99.1 99.0
98.9
100.0 99.1 99.9 98.0 97.5 97.6
100.0
100.0 99.8
99.1
100.0 98.1 99.2
97.1 98.6
100.0 97.0 99.9
100.0 96.7 98.5
99.7 99.6 97.1 99.7
100.0
99.3 99.0 98.4
99.2
99.9 98.4 98.7 98.5 97.2 98.1 99.6
99.8 98.8
99.4 99.9 99.7 98.9
98.4 98.2 99.8 98.7 98.9 99.1 97.7
100.0
99.2 99.1 99.4 99.7
99.6 99.8 99.8
100.0
62.2
62.8 63.1 64.3 56.6 60.6 55.6 58.4
60.9 63.2
61.9 60.5 63.6 62.9
62.5 59.8 61.6 60.9 58.2 73.3 60.2 64.8
63.1 59.8 64.8 62.5
69.6 63.0 67.3 65.3
23.3
23.5 22.3 24.5 24.1 23.4 20.8 23.2
22.1 21.4
21.0 21.9 24.4 24.6
25.6 26.3 26.6 24.9 25.8 26.5 24.6 25.8
19.8 28.6 23.2 24.6
23.8 26.3 28.2 26.4
32.4
25.6 35.3 17.4 24.4 27.3 54.2 26.7
41.9 50.4
52.0 45.8 21.0 21.6
16.4 14.6 11.4 16.8 11.1
6.0 24.6 17.2
62.1
5.8 28.9 17.8
25.2 12.2
4.1 11.2
66.7
66.2 65.9 66.9 59.2 60.9 61.9 63.4
65.8 69.2
70.4 68.0 64.4 66.1
68.6 65.6 66.2 67.2 61.5 76.7 66.1 66.2
69.2 58.8 69.9 64.6
74.8 64.4 67.0 69.5
22.9
24.1 21.9 24.4 24.8 23.6 20.9 23.1
21.7 20.6
20.1 21.4 23.7 24.4
26.0 26.5 27.1 25.5 27.2 26.9 24.7 25.8
19.6 28.8 22.4 24.1
23.2 25.9 27.2 26.1
Note: Table based on marriages taken place anytime in the past.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 35
Table 2.11: Marital status of the household population by states: Female Percentage of ever married female (age 10 and above) by age, mean age at marriage, percentage married below legal age at marriage and median age at first marriage,
according to states, RSOC, 2013-14.
State 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55+ Total Mean age at
marriage
Percentage below legal age at marriage
(< 18 Years) 15-49
Median age at first
marriage
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Orissa (Odisha) West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
0.3
0.1 0.0 0.0 0.0 0.0 0.2 0.0
0.0 0.0
0.1 0.2 0.0 0.1
0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.9
3.2 0.0 0.8 0.0
0.0 0.1 0.0 0.0
12.8
4.0 9.8 3.5 2.8 5.2 8.5 6.8
6.7 8.5
17.9 17.0
8.3 31.0
8.3
14.1 9.3 8.8 1.8
44.0 10.5 25.6
21.3
2.7 11.5
9.5
13.8 13.5
8.9 7.2
69.8
56.2 71.6 52.6 38.1 40.7 64.9 54.4
67.2 73.4
90.1 75.3 64.1 80.0
67.4 63.1 48.8 64.5 38.2 57.6 55.7 73.6
79.7 30.0 71.7 69.0
73.8 66.1 48.6 69.4
93.5
90.9 94.7 91.2 79.5 87.1 95.2 91.0
93.2 94.9
99.1 96.2 88.6 90.6
93.1 90.5 77.8 91.1 84.5 95.8 83.2 95.4
97.6 68.7 95.0 93.4
97.8 86.3 93.2 90.5
98.1
98.0 99.2 98.5 94.9 97.6 99.2 99.2
98.1 99.1
99.7 99.1 96.4 98.2
96.3 93.6 90.8 94.0 90.1 97.7 93.4 95.5
98.3 94.3 96.8 97.1
99.5 97.8 97.8 97.4
99.1
99.6 100.0
99.0 99.0 99.0 99.8
100.0
97.2 98.8
99.8 99.6 94.6 98.9
98.8 98.5 95.4 97.9 96.7
100.0 96.0 98.0
100.0
97.3 99.6 99.4
98.7 97.7 98.2 99.9
99.1
99.3 100.0 100.0
97.5 99.9 99.7 99.8
99.9 99.5
99.8 99.8 95.7 99.2
98.1 99.4 94.0 99.1 95.6
100.0 97.1 97.9
99.9 95.1 98.3 99.8
99.0 95.5 99.4 99.9
99.7
99.3 100.0 100.0
99.0 99.9 99.9 98.1
99.3
100.0
100.0 99.9 99.4 99.4
99.8 99.0 96.8 97.9 98.5 99.6 97.8 99.9
100.0
97.5 98.9 99.9
99.9 99.3 99.2 99.8
99.4
99.1 100.0
98.1 99.9 99.5 99.7 99.6
100.0
99.7
99.9 99.8 99.0 98.6
100.0
99.5 98.1
100.0 97.7
100.0 90.4
100.0
99.3 98.6 99.2 99.7
99.9 98.8 97.2 99.3
99.1
100.0 99.7 99.9 97.5 99.6 98.7 98.5
99.5 99.6
99.7 98.1 99.5 98.7
97.2 98.5 98.3 99.4 98.9
100.0 98.0 99.3
99.1 97.6 99.0 98.8
99.1 99.2 98.3
100.0
71.6
69.5 73.9 74.3 64.2 72.9 64.5 66.3
69.8 71.2
70.1 69.9 72.4 76.7
70.7 68.0 68.5 68.3 70.3 70.6 64.7 77.4
73.2 71.3 74.5 75.0
74.3 72.0 77.0 73.4
18.6
19.7 18.9 19.8 20.2 19.9 17.6 18.6
17.7 18.0
16.4 18.3 18.5 17.3
20.5 19.9 22.0 20.7 22.8 22.3 19.8 18.7
16.3 24.5 20.0 19.2
18.6 20.2 22.6 20.0
41.7
27.5 29.4 21.7 25.2 20.4 49.5 35.4
52.8 52.3
67.5 40.2 44.3 59.4
28.8 31.0 16.3 16.2
3.0 12.9 29.3 42.3
61.2 10.1 20.0 34.8
35.9 27.3 13.1 28.7
77.7
75.7 77.8 75.8 67.2 73.8 71.7 70.7
74.2 77.5
82.0 79.7 74.2 82.5
77.5 75.9 72.5 74.9 71.8 76.1 72.7 83.3
81.1 72.1 79.1 79.6
79.8 77.1 79.5 78.5
17.6
19.3 18.2 19.0 19.7 19.3 17.3 18.1
17.0 16.9
15.6 17.5 17.3 16.1
20.2 19.4 21.1 20.0 22.5 23.1 19.5 17.6
15.5 22.1 18.9 17.6
17.9 18.2 19.8 18.8
Note: Table based on marriages taken place anytime in the past.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 36
In order to reflect the temporal change in terms of improvement in the average age at marriage as also the reduction in the proportion of those getting married below the legal age, these two indicators have also been computed on the basis of marriages that have taken place during the last five years preceding the date of survey. A state-wise comparison between the two is presented in Table 2.12. It shows that there have been substantial improvements in mean age at marriage and proportion getting married below the legal age in case of recent marriages as compared to marriages that took place any time in the past across states.
Table 2.12: Early marriage and mean age at marriage by state
Percentage of ever married men and women (age 10 and above) who married any time in the past and those married five
years prior to the survey; mean age at marriage and percentage married below legal age by state, India, RSOC, 2013-14.
State
Men Women
Married any time Married in 5 years
preceding the survey Married any time
Married in 5 years
preceding the survey
Married
<21
Mean age at
marriage
Married
<21
Mean age
at marriage
Married
<18
Mean age
at marriage
Married
<18
Mean age
at marriage
India
North
Delhi
Haryana
Himachal Pradesh
Jammu & Kashmir
Punjab
Uttar Pradesh
Uttarakhand
Central
Chhattisgarh
Madhya Pradesh
East
Bihar
Jharkhand
Odisha
West Bengal
Northeast
Arunachal Pradesh
Assam
Manipur
Meghalaya
Mizoram
Nagaland
Sikkim
Tripura
West
Rajasthan
Goa
Gujarat
Maharashtra
South
Andhra Pradesh
Karnataka
Kerala
Tamil Nadu
32.4
25.6
35.3
17.4
24.4
27.3
54.2
26.7
41.9
50.4
52.0
45.8
21.0
21.6
16.4
14.6
11.4
16.8
11.1
6.0
24.6
17.2
62.1
5.8
28.9
17.8
25.2
12.2
4.1
11.2
23.3
23.5
22.3
24.5
24.1
23.4
20.8
23.2
22.1
21.4
21.0
21.9
24.4
24.6
25.6
26.3
26.6
24.9
25.8
26.5
24.6
25.8
19.8
28.6
23.2
24.6
23.8
26.3
28.2
26.4
17.5
9.6
20.8
6.7
8.4
10.6
26.3
19.0
19.2
33.8
33.3
27.1
9.5
15.6
8.9
8.1
6.5
11.9
7.0
8.5
16.0
10.4
41.1
1.8
23.9
6.6
11.4
8.5
0.7
2.7
25.0
25.1
23.7
26.3
26.3
25.5
23.1
24.3
24.1
23.4
22.5
23.4
26.3
25.8
27.0
27.1
27.7
25.2
26.7
24.9
26.0
26.9
22.0
31.0
24.0
26.1
25.2
27.0
29.6
28.0
41.7
27.5
29.4
21.7
25.2
20.4
49.5
35.4
52.8
52.3
67.5
40.2
44.3
59.4
28.8
31.0
16.3
16.2
3.0
12.9
29.3
42.3
61.2
10.1
20.0
34.8
35.9
27.3
13.1
28.7
18.6
19.7
18.9
19.8
20.2
19.9
17.6
18.6
17.7
18.0
16.4
18.3
18.5
17.3
20.5
19.9
22.0
20.7
22.8
22.3
19.8
18.7
16.3
24.5
20.0
19.2
18.6
20.2
22.6
20.0
16.3
6.3
9.2
3.0
5.3
3.8
15.3
4.6
13.0
17.0
35.0
20.8
16.0
31.1
17.3
16.9
8.6
9.6
1.3
21.3
13.7
22.0
30.7
2.1
8.9
10.5
13.1
13.5
2.4
8.0
21.1
22.1
20.7
22.3
23.1
22.3
20.2
21.1
20.5
21.2
18.8
19.8
20.9
19.9
22.3
21.4
24.0
21.6
24.6
20.8
21.9
21.0
19.3
29.1
22.2
22.0
20.4
22.4
25.1
22.4
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 2 | 37
2.3 HOUSEHOLD COMPOSITION BY USUAL MEMBERS
Household composition is a critical factor for understanding family size which is also a determinant of health status and well-being. The household is considered to be the basic social and economic unit of a society, and changes in household composition have repercussions for the family and the economy. Such changes also impact the distribution of goods and services and on the planning and requirements of community institutions, schools, housing stock and health infrastructure. Table 2.13 presents the percent distribution of the households by number of usual members in the household according to residence. The average household size, which is a function of so many social and economic factors, is close to five in India as per Census 2011 (Total 4.8, Rural-4.9 and Urban-4.6). The mean household size as revealed from the survey is 4.7 with rural average household size (4.8) being marginally higher than the urban (4.5). The emergence of nuclear families in the rural areas is seen as a probable reason for this diminishing difference in urban and rural household size over the years. The median as well as modal number of usual members both in rural as well as urban areas is 4. Close to 71 percent of households have two to five members, while 27 percent have more than five members and just 2 percent are single member households. In rural areas, the proportion of households having two to five members is about 9 percentage points less than urban areas is reflected in corresponding increase in case of households with five or more members. Table 2.13: Household size Percent distribution of the households by number of usual members in the household according to residence, India, RSOC, 2013-14.
Characteristic Residence
Total Urban Rural
Number of usual members
1
2
3
4
5
6
7
8
9+
Total percent
Number of households
Mean household size
1.7
7.9
18.7
29.8
19.7
10.3
5.1
2.6
4.1
100.0
34,775
4.5
2.4
9.8
14.2
23.9
19.7
13.2
7.8
4.0
5.0
100.0
70,707
4.8
2.2
9.1
15.7
25.8
19.7
12.3
6.9
3.5
4.7
100.0
1,05,482
4.7
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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2.4 PROFILE OF THE HEAD OF THE HOUSEHOLDS The profile of the head of the household is crucial to understand the overall socio-economic background of other members of the household. Besides the age and sex distribution, other critical factors like social group and religion to which she/he belongs to, her/his education and occupation status determines the trajectory of day-to-day life of the household members. Further, it also aids in mapping the shift in proportion of male headed households to female headed households. Under RSOC, information on social group and religion was collected in respect of the head of household only as in the Indian context variation between head of household and other members would be very minimal. Similarly, the occupational status was also probed in respect of the head of the household only. This was done keeping in view the objective of the survey and the potential use of all this information at the time of analysis stage.
In this section, the age and sex-wise distribution, social group and religious affiliation, educational attainment,
occupational status and distribution by wealth quintiles of head of the households have been discussed.
Table 2.14 shows the percent distribution of households by the age, sex, religion, social group, education, occupation and wealth index of the head of the households according to residence. Around eight out of every ten households were in the economically active age group of 18-59 years across rural and urban areas. The proportion of female headed households hovered around 10 percent. About 81 percent of the head of households followed Hinduism, 13 percent Islam and 3 percent Christianity. Head of households following other religions such as Sikhism, Jainism, and Buddhism etc. accounted for the remaining 3 percent.
The maximum proportion of households (40 percent) belonged to OBC followed by ‘Others’ constituting 29 percent. Scheduled Castes and Scheduled Tribes comprised 19 percent and 11 percent respectively together constituting another 30 percent, which is broadly in consonance with Census 2011 figures (SCs 17 percent and STs 9 percent). As high as 34 percent of head of households had no education with another 8 percent studied up to below primary level. About 16 percent of head of households had attained educational level of higher secondary and above. There is a marked rural-urban differential across educational categories. There is a wide variation in occupational status of the head of households across rural and urban areas. Against 73 percent reported as cultivators or wage labourer in rural areas, 58 percent of head of households were working as self-employed (excluding cultivators) or regular salaried/wage employee in urban areas. Since occupation level of the head of household is one of the key drivers affecting the overall economic status of a household, these differentials would profoundly impact the levels of well-being of women and children captured in this survey. In the absence of household data on income or expenditure, wealth quintiles are relied on as an effective substitute to mirror the economic status of households. The details on how wealth quintiles have been computed under RSOC is discussed in Chapter 1. The distribution of head of households in rural and urban areas follows a strikingly opposite pattern. In contrast to close to 28 percent of the head of the households in rural areas belonging to the poorest quintile, more than 40 percent in urban areas were in the richest quintile.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.14: Characteristics of the head of the household
Percent distribution of the households by selected characteristics of the Head of the Household, according to residence, India, RSOC, 2013-14.
Characteristic Residence
Total Urban Rural
Age-group 18-59 60+
Sex Male Female
Education No Education Below Primary Completed Primary Completed Middle Completed Secondary Completed Higher Secondary and above
Religion Hinduism Islam Christianity Sikhism Jain Buddhism No religion Others
Social - Group Scheduled Caste Scheduled Tribe OBC Other No Response
Occupation Cultivator Agricultural wage labourer Non-agricultural wage labourer Self-employed (excluding cultivators) Regular salaried/wage employee Rentier, pensioner, other remittance recipients Did not work Domestic Chores Others
Wealth index Lowest Second Middle Fourth Highest Total
Total Number of Households
81.9 18.1
89.6 10.4
20.6
6.0 14.3 13.0 19.3 26.9
78.2 15.0
3.4 1.3 0.5 1.1 0.1 0.4
16.0
6.2 39.8 37.3
0.7
3.0 6.6
18.8 30.9 27.2
5.5 4.2 2.4 1.3
4.2 8.7
17.0 28.9 41.2
100.0 34,775
80.0 20.0
90.1
9.9
40.8 8.6
15.7 12.8 11.9 10.2
82.3 12.1
2.6 1.7 0.2 0.6 0.1 0.4
20.9 13.5 39.8 25.0
0.8
30.7 18.6 23.6 11.5
7.2 2.4 3.2 2.2 0.6
27.7 25.6 21.5 15.6
9.6 100.0
70,707
80.6 19.4
89.9 10.1
34.1
7.7 15.3 12.9 14.3 15.7
80.9 13.1
2.9 1.6 0.3 0.8 0.1 0.4
19.3 11.1 39.8 29.0
0.8
21.5 14.6 22.0 17.9 13.8
3.5 3.5 2.3 0.8
20.0 20.0 20.0 20.0 20.0
100.0 105,482
State-wise distribution of head of households by their religious and social group affiliations and occupational status is presented in Tables 2.15 and 2.16 respectively.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.15: Characteristics of the head of the household by states Percent distribution of the households by religion and caste of the head of the household, according to states, RSOC, 2013-14.
State
Religion Social category
Hindu Islam Christian Sikh Jain Buddhism No
religion Other
Scheduled Caste
Scheduled Tribe
OBC Others No
Response Total
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
80.9
84.9 89.7 98.8 30.1 41.7 81.7 79.1
95.1 92.0
85.1 72.8 96.3 72.2
42.0 66.3 51.1 11.8
1.9 8.7
57.4 83.9
90.4 71.2 89.3 79.8
81.5 81.7 63.8 86.1
13.1
11.6 5.5 0.6
67.0 1.6
17.5 19.1
2.6 7.3
14.5 18.9
1.0 26.3
1.6
28.2 4.2 3.4 0.0 2.1 1.3 9.6
7.6 8.0 9.1
10.4
9.4 14.0 22.5
6.7
2.9
0.2 0.4 0.1 0.0 1.2 0.0 0.1
1.3 0.2
0.2 4.8 2.5 0.9
27.5
4.7 33.0 81.3 94.7 89.2 13.0
3.3
0.1 19.3
1.1 0.8
6.6 3.1
13.2 6.9
1.6
1.9 4.3 0.4 1.0
54.8 0.2 1.5
0.5 0.1
0.1 0.0 0.1 0.0
0.0 0.1 0.0 0.4 0.0 0.0 0.1 0.1
1.5 0.2 0.0 0.2
0.7 0.1 0.1 0.1
0.3
0.2 0.0 0.0 0.0 0.7 0.2 0.2
0.0 0.3
0.0 0.0 0.0 0.0
0.1 0.1 0.0 0.0 0.1 0.0 0.3 0.2
0.3 0.1 0.2 0.9
1.0 0.3 0.3 0.0
0.8
0.1 0.0 0.1 1.4 0.0 0.0 0.0
0.4 0.1
0.0 0.1 0.0 0.0
13.5
0.5 0.0 0.1 3.2 0.0
27.7 2.8
0.0 0.0 0.0 6.7
0.3 0.2 0.0 0.1
0.1
0.1 0.0 0.0 0.0 0.0 0.1 0.0
0.0 0.0
0.0 0.4 0.0 0.0
0.2 0.0 0.7 2.3 0.2 0.0 0.0 0.1
0.0 0.0 0.0 0.1
0.2 0.0 0.0 0.1
0.4
0.9 0.0 0.0 0.5 0.0 0.2 0.1
0.1 0.0
0.0 2.9 0.0 0.6
15.1
0.0 11.0
0.7 0.0 0.0 0.4 0.0
0.1 1.1 0.1 1.0
0.3 0.6 0.1 0.0
19.3
21.1 24.1 26.5
8.9 27.2 23.7 13.8
17.3 17.6
24.1 13.7 18.4 25.9
3.6
11.6 0.6 5.2 0.7 5.1 9.5
26.5
18.5 2.4
11.3 14.0
22.2 11.7
7.6 25.3
11.1
2.9 8.8 4.6
10.2 6.6 2.8 6.5
34.5 22.5
2.1
31.7 24.6
5.8
79.2 17.7 32.0 85.4 96.7 86.9 36.5 26.5
13.2
8.6 20.3 10.8
8.8 9.2 4.0 6.1
39.8
28.8 27.5 15.4 16.6 20.0 51.9 20.9
40.0 44.3
55.2 43.5 27.3
7.6
3.5 19.0 27.0
0.8 2.6 5.3
34.4 16.1
47.9 30.7 30.2 32.7
50.1 36.2 67.6 57.5
29.0
47.0 39.4 53.4 63.4 46.0 21.4 57.7
7.5
15.6
18.5 10.6 29.7 55.3
13.7 51.1 39.4
8.5 0.0 2.0
12.5 30.6
20.0 57.7 37.5 42.0
18.6 41.7 20.6 11.0
0.8
0.2 0.3 0.0 0.9 0.2 0.1 1.0
0.6 0.1
0.1 0.5 0.0 5.4
0.0 0.6 1.0 0.1 0.0 0.6 7.1 0.3
0.3 0.7 0.7 0.5
0.4 1.2 0.3 0.1
100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.16: Occupation of the head of the household by state Percentage distribution of the head of the household by occupation according to states, RSOC, 2013-14.
State
Occupation
Total Cultivator
Agricultural wage
labourer
Non-agricultural wage labourer
Self-employed (excluding cultivators)
Regular salaried/ wage employee
Rentier, pensioner, other remittance
recipients
Did not
work
Domestic Chores
Others
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
21.5
1.0 16.2 20.6 16.1 15.3 28.6 14.1
32.8 33.4
20.5 21.5 30.9 13.0
48.3 28.7 28.0 24.8 16.4 15.2 29.4 15.5
32.1
3.1 20.1 27.9
10.8 30.0
5.2 5.8
14.6
0.4 6.1 5.0
11.5 5.0 8.7 5.7
6.4
15.1
10.5 19.8 11.3 14.1
2.7 2.7 4.2 4.4 2.8 5.7 3.3
11.8
5.4 2.0
13.7 13.2
39.8 15.6 11.9 28.1
22.0
11.2 24.0 17.6 19.0 24.2 27.8 17.0
29.5 21.9
38.0 22.4 24.6 25.5
4.4
31.2 11.5 10.3
1.7 3.6
14.9 24.2
21.1
9.6 12.6
9.9
17.6 10.2 27.0 22.2
17.9
26.6 22.3 11.5 19.9 20.5 17.6 18.2
11.1 11.4
16.2 14.4 15.4 18.9
24.8 21.4 28.3 26.1 49.4 43.5 16.4 24.0
14.4 31.1 33.6 20.3
17.5 18.7 20.1 10.3
13.8
48.8 18.2 22.2 14.6 18.3
9.3 21.5
12.6 10.2
5.8
12.8 8.5
12.6
17.5 9.6
13.3 18.1 25.7 24.3 25.4 16.4
12.8 34.5 13.0 21.4
9.7
15.6 14.1 22.3
3.5
6.6 2.9
10.1 7.6 6.5 1.8
13.8
4.2 3.7
1.7 1.4 3.1 4.3
1.2 3.8 6.1 2.3 2.9 1.2 4.0 3.3
7.8
10.5 1.7 2.6
3.0 3.4 5.6 3.0
3.5
3.9 6.7 7.1 3.2 5.8 2.6 2.2
2.5 2.2
2.9 3.7 3.9 6.3
0.2 0.2 5.1 5.1 0.3 5.6 3.9 3.5
2.7 6.7 3.0 2.6
0.6 2.5 9.1 6.7
2.3
1.1 2.9 5.0 2.7 3.7 3.0 6.2
0.6 1.7
3.4 3.3 1.6 3.2
0.4 1.6 1.6 3.1 0.3 0.8 0.8 0.2
3.3 1.5 1.8 1.5
0.6 1.8 6.6 0.7
0.8
0.3 0.6 0.9 5.3 0.7 0.6 1.3
0.3 0.4
0.9 0.7 0.7 2.0
0.6 0.8 2.0 5.6 0.4 0.1 2.0 1.0
0.3 0.9 0.7 0.6
0.4 2.0 0.4 0.8
100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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2.5 LITERACY AND EDUCATIONAL ATTAINMENT The importance of literacy benefitting both individuals and society hardly needs any reiteration and is widely acknowledged so. It is also associated with a number of positive demographic, health and nutrition outcomes. In this survey, literacy status was determined by usual residents’ ability to read and write as perceived by the respondent of the household questionnaire, who was either the head of household or any knowledgeable adult member. This was probed in respect of all usual residents of age 5 years and above. Tables 2.17 and 2.18 present differentials in the educational attainment of males and females by broad age groups, residence and wealth quintiles. Table 2.17 shows that the highest literacy rate is seen for the age group 10-24 years wherein more than nine out of every 10 male household members were literate. This is followed by a gradual fall as the cohort grows older. The low literacy rate in case of 6 to 9 years olds indicated that not all boys are exposed to the basic level of education which can enable them to read and write even in their local language. Table 2.17 further shows that 19 percent of men had no education, 16 percent completed grades below primary, 17 percent primary, 15 percent middle, 14 percent secondary and 19 percent higher secondary and above. There is a gradual drop in the proportions as the level of education goes up. A comparison of educational attainment levels with the NFHS-3 (2005-06) shows that the proportion of men with no education and below primary has declined while there has been an increase in higher classes over time. The proportion of males with no schooling was the lowest in the 10-14 age group, and as expected, it gradually increased in subsequent age groups. The level of education for those in below primary and who had completed primary was the highest in the 10-14 age group, and for those who had completed middle and secondary in the 15-19 age group indicating that school attendance and continuation of education up to secondary levels have improved substantially among younger males in recent years. There is a strong relationship between age and level of schooling which is reflected in decreasing school attendance with age. The percentage of males who have completed below primary, primary and middle was higher in case of rural areas while the percentage of those having completed secondary and higher secondary & above was higher in urban areas. This indicates that a large proportion of rural men complete only middle level of schooling whereas those in urban areas are more likely to continue their education beyond the middle and secondary levels. A perceptible difference in literacy rate, levels of education and median years of completed education is noticed between rural and urban areas. As seen in Table 2.17, literacy rate in urban areas was 12 percent points higher than rural areas (88 percent against 77 percent). Similarly, differentials are significant under ‘no education’, ‘below primary’ and ‘completed higher secondary and above’ across rural and urban areas and they show that urban men are far more likely to be educated than rural men. As regards median years of completed schooling, there was a variation of 3 years in favour of urban men. Ninety-four percent of males in the highest wealth quintile were literate as against 63 percent in the lowest quintile. The differential between the lowest and the highest sharpens from no education category to those having completed higher secondary and above. Similarly, a gap of almost three times was observed in the median years of completed schooling between the lowest and the highest wealth quintiles.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.17: Literacy and educational attainment of the household population of age 6 and above: Male
Percentage of males literate, percent distribution of males aged 6 or more by the highest level of education completed, and median years of schooling completed, according to age and residence, RSOC, 2013-14.
Age/ Residence
Literacy
rate
Level of education Median years of
completed schooling
Number of
males No
education Below
Primary Completed
Primary Completed
Middle Completed Secondary
Completed Higher
Secondary and above
Total
Age 6-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Residence Urban Rural
Wealth Index Lowest Second Middle Fourth Highest
Total
81.3 93.9 92.8 90.8 85.9 82.9 78.6 74.5 70.3 66.3 64.0 61.5 55.5
88.5 76.8
63.4 73.7 81.4 87.7 94.3 80.6
14.3
5.0 7.0 9.1
14.7 17.8 21.9 26.4 30.5 33.9 36.7 39.1 45.2
11.5 22.9
35.5 25.8 18.6 12.7
5.8 19.2
83.7 29.9
3.9 4.2 4.6 5.2 6.5 5.9 7.7 8.7 8.2 8.8
10.8
13.5 17.8
21.7 19.9 16.7 13.6 11.0 16.4
2.1
47.2 13.1 11.3 14.1 14.4 15.0 14.4 14.2 14.7 15.2 16.3 15.0
15.6 17.7
19.2 19.3 19.4 16.4 11.6 17.0
0.0
16.8 30.0 17.6 17.4 16.9 15.5 14.0 14.2 11.9 10.4
9.2 8.2
14.6 15.3
12.8 16.5 17.8 16.4 12.0 15.1
0.0 1.1
28.2 15.4 16.8 17.8 17.6 17.4 15.9 14.7 15.1 13.6 11.6
17.0 12.5
6.6
10.1 13.6 18.4 19.8 13.9
0.0 0.0
17.9 42.4 32.3 27.9 23.5 21.9 17.6 16.1 14.5 12.9
9.2
27.8 13.8
4.2 8.4
13.8 22.5 39.7 18.4
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0
0.9 4.9 8.8 9.7 8.9 8.4 7.7 7.4 6.4 4.9 4.6 4.2 2.6
8.2 5.3
2.8 4.5 6.2 7.8 9.6 6.5
20,460 27,247 24,062 20,882 20,417 19,000 18,046 14,836 13,336 11,840
8,514 7,766
12,123
71,172 1,47,359
39,808 43,605 43,603 44,335 47,180
2,18,531
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.18 presents that 66 percent of women were literate with a significant rural-urban divide (60 percent against 78 percent). The literacy level varies widely across age-groups exhibiting a gradual decline with increase in age. The pace of decline, however, is sharper as compared to males. As expected, a wide variation is also seen in levels of literacy by wealth quintiles. Against 85 percent of women being literate in the highest quintile, there were just 43 percent in the lowest one. Table 2.18 further presents that 34 percent of women had no education, 15 percent had completed below primary, another 16 percent had completed primary, 12 percent had a middle level education, 10 percent had completed secondary and 12 percent had completed higher level of education. The proportion of female population with no education was higher in rural areas (40 percent) than in urban areas (22 percent). Fewer proportion of rural females continue higher level of education after primary level of education as compared to urban females. As observed in the case of males, a decline in proportion with no education and completed below primary is also noticed in case of women in comparison to corresponding educational attainment levels of NFHS-3 (2005-06) over time. However, there is only a marginal rise in educational levels in higher levels of educational attainment. The proportion of females with no schooling across different age-groups followed almost an identical pattern as that of males. The highest proportion of completion for primary, middle and secondary schooling was reported in the 10-19 age group for females also. This is an encouraging sign suggesting that improvement in school attendance and continuation of education up to secondary levels have also benefitted females particularly the younger ones. Significant rural-urban differentials are observed across different levels of educational attainments and this clearly shows that urban women are far more likely to be educated than rural women. With regard to median years of completed schooling, there was a variation of 4.2 years in favour of urban women, almost 2 years more than what was observed between urban and rural men. Against a gap of almost ten times observed between the lowest and the highest wealth quintiles in case of males having completed higher secondary education and above, the corresponding gap in case of females is almost 15 times. The situation is grave in case of women belonging to the lowest wealth quintile category who reported ‘0’ median years of completed schooling. Tables 2.17 and 2.18 indicate that, overall, the levels of educational attainment are higher in urban than in rural areas; the proportions of men and women with no education are lower in urban than in rural areas, while the proportions with a secondary or higher education are greater in urban areas. On an average, men and women living in urban areas had completed at least three more years of schooling than those living in rural areas. A comparison of the NFHS-3 (2005-06) and RSOC (2013-14) surveys show a marked rise in completed median years of schooling, with the median among men and women increasing from 4.9 to 6.5 years and from 1.9 to 4.1 years respectively during this period. Such a comparison is depicted in Figure 2.8.
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.18: Literacy and educational attainment of the household population aged 6 and above: Female
Percentage of females literate, percent distribution of females age 6 or more by the highest level of education completed, and median years of schooling completed, according to age and residence, RSOC, 2013-14.
Age/ Residence
Literacy
rate
Level of education Median years of
completed schooling
Number of
females No
education Below
Primary Completed
Primary Completed
Middle Completed Secondary
Completed Higher
Secondary and above
Total
Age 6-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Residence Urban Rural
Wealth Index Lowest Second Middle Fourth Highest
Total
80.0 93.0 90.7 80.3 72.0 63.9 55.9 48.6 43.9 35.8 34.6 26.5 22.4
78.3 59.8
43.3 56.2 64.8 75.5 85.3 65.7
15.3
6.4 9.4
19.7 28.3 36.3 44.8 51.4 56.6 65.2 65.4 73.9 78.4
21.8 39.7
55.7 43.3 34.7 25.0 14.8 34.0
82.5 26.2
2.8 4.0 5.2 5.7 6.7 6.8 7.5 7.1 7.8 7.2 7.1
13.3 16.1
18.1 18.1 15.6 13.6 11.0 15.2
2.2
48.1 13.2 13.8 14.7 14.8 14.6 12.8 13.8 11.4 10.8
8.0 7.4
15.9 16.2
13.5 17.2 18.1 17.8 13.9 16.1
0.0
17.8 26.1 15.9 15.2 13.3 11.3
9.6 7.7 5.5 6.0 4.2 3.2
13.5 11.7
8.1
11.5 13.6 15.1 12.8 12.3
0.0 1.5
29.9 14.5 14.1 13.0 10.4
9.8 8.1 6.0 5.8 4.0 2.2
14.3
8.6
3.0 6.2
10.1 14.5 17.3 10.4
0.0 0.0
18.7 32.2 22.5 16.8 12.2
9.7 6.3 4.7 4.2 2.7 1.7
21.2
7.7
1.6 3.7 7.9
14.1 30.3 12.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0
1.0 5.1 8.9 8.5 7.2 5.1 3.5 0.0 0.0 0.0 0.0 0.0 0.0
6.8 2.6
0.0 1.5 3.9 6.0 8.5 4.1
19,953 25,186 23,959 23,099 23,227 18,945 17,080 13,197 15,001
9,556 7,524 7,027
11,553
68,848 1,46,460
39,583 42,704 42,886 43,823 46,312
2,15,308
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Figure 2.8: Median years of schooling completed for population age 6 years and above, India between RSOC and NFHS-3
The state-wise results on literates, percentage distribution of population aged 6 and more by level of education, and median years of schooling completed according to sex are presented in Tables 2.19 and 2.20 respectively. The state-wise results are broadly on expected lines. However, what concerns the most is the variation in median years of completed schooling across states particularly in case of females.
8.2
5.3
6.5 6.8
2.6
4.1
7.6
4.0
4.9 5.5
0.0
1.9
Urban Rural Total Urban Rural Total
Male Female
RSOC, 2013-14 NFHS-3, 2005-06
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.19: Educational status of the household population aged 6 and above across states: Male
Percentage of males literate, percent distribution of males aged 6 or more by level of education and median years of schooling
completed, by states, RSOC, 2013-14.
State
Level of Education Median years of
completed schooling
No Education
Below Primary
Completed Primary
Completed Middle
Completed Secondary
Completed Higher
Secondary and above
Total
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
19.2
9.5 17.4
7.2 20.9 17.8 22.9 12.6
15.2 19.9
27.9 23.3 19.8 16.0
16.1 17.1
7.3 13.3
2.6 16.4 11.8
9.1
19.7 6.5
14.6 13.9
33.4 19.7
3.5 11.3
16.4
10.0 11.5 10.4 13.6 10.6 16.7 16.0
18.5 16.6
21.9 18.2 18.8 22.3
21.0 25.3 15.3 22.7 14.4
7.1 21.5 19.5
18.4 14.4 15.5 14.5
10.0 14.2 10.9 13.8
17.0
12.9 14.9 16.1 13.5 14.6 15.6 17.1
19.8 20.3
15.1 18.1 20.5 19.0
17.9 20.3 14.8 17.0 15.4
8.2 23.3 20.8
18.1 13.8 19.5 14.8
14.4 15.3 16.8 21.2
15.1
12.5 12.9 13.6 19.9 14.5 16.0 18.8
20.9 19.0
13.0 15.9 18.8 18.8
18.6 17.5 21.6 17.0 16.6 15.0 18.2 23.0
15.2 15.2 16.5 12.7
6.8
10.3 14.1 17.3
13.9
18.1 17.0 24.0 15.3 20.1 11.2 15.1
10.2 10.0
11.3 11.2
9.2 9.9
13.3
8.6 16.4 12.8 22.2 20.3 11.2 13.4
11.4 20.2 16.2 19.9
14.5 17.2 27.5 16.3
18.4
37.0 26.3 28.7 16.7 22.4 17.7 20.4
15.4 14.2
10.9 13.4 13.0 14.0
13.2 11.1 24.6 17.0 28.8 33.0 14.0 14.2
17.2 29.9 17.7 24.1
21.0 23.3 27.2 20.2
100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
6.5
9.3 7.7 9.1 7.2 7.7 5.4 7.3
6.4 5.6
4.0 5.1 5.7 5.8
6.3 5.0 8.3 6.4 9.1 9.2 6.0 7.1
5.7 9.0 7.1 8.2
5.3 7.2 9.2 7.4
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.20: Educational status of the household population aged 6 and above across states: Female
Percentage of females literate, percent distribution of females age 6 or more by level of education and median years of
schooling completed, by states, RSOC, 2013-14.
State
Level of Education Median years of completed schooling
No Education
Below Primary
Completed Primary
Completed Middle
Completed Secondary
Completed Higher Secondary and above
Total
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
34.0
21.0 33.9 21.7 39.5 27.5 42.0 28.0
37.2 38.3
47.1 41.5 37.6 27.6
23.2 24.8 19.8 17.7
4.1 17.8 20.8 16.9
44.1 15.2 32.1 25.7
41.4 29.5
6.7 20.6
15.2
10.8 11.9
9.6 11.1
9.7 14.8 12.5
15.8 15.0
19.6 19.4 16.4 20.8
24.6 23.6 16.0 22.0 14.7
9.1 18.8 20.6
15.3 14.5 15.0 15.1
9.4
12.9 13.0 12.7
16.1
13.3 14.3 17.7 11.4 15.5 13.4 14.5
17.8 16.7
13.9 14.2 17.4 17.4
19.6 18.0 13.9 19.5 18.4 12.0 20.8 20.4
15.4 14.8 19.4 18.1
15.4 17.7 15.4 18.9
12.3
12.1 11.5 13.0 15.2 12.1 11.0 14.6
15.5 14.7
8.9
10.6 15.1 16.8
15.3 19.8 20.1 15.3 17.7 20.3 17.8 25.2
10.4 15.1 12.1 12.5
7.4 8.1
10.4 16.6
10.4
13.6 11.0 15.0 10.6 15.9
7.4 11.5
6.1 6.4
6.2 6.8 7.4 9.3
9.8 6.7
12.3 13.1 26.2 19.0 11.0
9.4
6.2 18.8
9.9 14.4
13.8 16.8 23.5 14.2
12.0
29.2 17.3 23.0 12.2 19.3 11.5 18.9
7.6 8.9
4.3 7.5 6.1 8.2
7.4 7.1
18.0 12.4 19.0 21.9 10.9
7.5
8.5 21.7 11.5 14.1
12.6 15.0 30.9 17.0
100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
4.1
7.6 4.5 7.1 3.7 6.3 1.8 5.0
3.2 3.2
0.1 1.6 2.9 4.3
4.2 4.3 7.1 5.4 8.4 8.0 5.4 5.7
1.3 7.6 4.5 6.0
3.7 5.6 9.2 6.6
The effective literacy as measured from Census is based on population aged 7 and above. Table 2.21 presents the literacy and educational attainment of the household population (7 years and more) by background characteristics. The literacy rates as revealed from RSOC are quite close to Census 2011 figures (Total: 73.0 percent; Male: 80.9 percent; Female: 64.6 percent; Rural: 67.8 percent and Urban: 84.1 percent).
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.21 Literacy and educational attainment of the household population aged 7 and above
Percentage of literate and percent distribution of the household population aged 7 or more by level of education, and median years of schooling completed by selected characteristics, RSOC, 2013-14.
Characteristics
Literacy
rate
Level of Education Median
years of
completed
schooling
Sample HH
population
aged 7
years &
above
No
Education
Below
Primary
Completed
Primary
Completed
Middle
Completed
Secondary
Completed
Higher
Secondary
and above
Total
Sex
Male 81.0 19.0 15.1 17.4 15.5 14.3 18.8 100.0 6.7 2,13,504
Female 65.8 34.1 14.0 16.5 12.6 10.7 12.2 100.0 4.3 2,10,652
Residence
Urban 83.7 16.4 12.2 16.1 14.4 16.0 25.0 100.0 7.7 1,37,267
Rural 68.5 31.3 15.6 17.4 13.9 10.8 11.0 100.0 4.4 2,86,889
Caste
Scheduled Caste 67.4 32.2 15.5 17.5 14.5 9.9 10.4 100.0 4.3 81,172
Scheduled Tribe 63.2 37.2 15.4 16.3 12.9 9.1 9.2 100.0 3.5 45,634
Other Backward Class 73.9 26.0 14.2 17.4 13.9 13.0 15.5 100.0 5.5 1,71,084
Other 80.7 19.4 13.8 16.1 14.3 14.9 21.5 100.0 7.1 1,23,317
Do not know 68.5 29.4 25.5 19.0 12.8 7.5 5.8 100.0 3.5 2,949
Wealth index
Lowest 53.5 45.7 18.8 16.8 10.8 4.9 3.0 100.0 1.1 77,213
Second 65.2 34.5 17.8 18.7 14.4 8.4 6.2 100.0 3.6 84,233
Middle 73.3 26.6 14.8 19.2 16.1 12.1 11.1 100.0 5.0 84,466
Fourth 81.8 18.7 12.2 17.4 16.1 16.8 18.8 100.0 7.2 86,290
Highest 90.0 10.1 9.8 12.9 12.6 18.9 35.6 100.0 9.3 91,954
Total 73.4 26.5 14.5 17.0 14.0 12.5 15.5 100.0 5.4 4,24,156
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Table 2.22: Literacy Rate of household population aged 6-24
Percentage of literate and percentage currently attending school/college (in the year 2012-13) among household population aged 6-24 by different age groups according to sex, residence, age, social-group, RSOC, 2013-14.
Background characteristic
6-11 12-14 15-17 15-24 6--24 Total
persons age 6-24
Literate Attending
school/ college
Literate Attending
school/ college
Literate Attending
school/ college
Literate Attending
school/ college
Literate Attending
school/ college
Residence Urban 90.2 83.3 95.9 92.1 95.3 80.8 92.5 52.0 92.3 68.5 55,357
Rural 82.7 77.9 92.8 87.3 91.6 72.1 87.0 44.0 86.6 63.0 129,491
Sex
Male 85.4 79.5 94.3 89.1 93.3 74.6 91.9 50.2 90.1 67.0 92,651
Female 84.2 79.4 93.0 88.3 92.1 74.7 85.6 42.9 86.4 62.3 92,197
Caste
Scheduled Caste 82.7 78.1 92.0 86.8 91.2 72.0 86.2 42.9 86.0 62.4 37,550
Scheduled Tribe 80.4 76.3 91.1 83.9 88.9 64.2 81.5 38.0 82.8 59.1 20,618
Other Backward Class 84.3 79.4 93.9 89.9 92.9 76.6 89.1 48.9 88.4 66.4 75,583
Others 89.5 81.9 95.8 90.6 95.3 78.6 92.8 49.3 92.2 66.3 49,697
Do Not Know 86.9 82.4 95.1 83.8 87.6 53.2 83.1 25.6 86.1 54.5 1,400
Wealth Index
Lowest 74.8 71.3 86.9 79.3 83.1 57.8 74.3 33.3 76.9 56.8 36,788
Second 83.0 79.5 92.4 86.1 91.2 68.4 84.3 39.0 85.3 61.5 39,992
Middle 86.7 80.8 95.1 90.4 94.3 74.4 90.5 42.9 90.1 62.9 37,969
Fourth 90.2 83.0 97.4 93.9 97.0 82.7 94.1 51.3 93.5 68.1 36,089
Highest 93.7 85.7 98.5 97.0 98.4 91.9 97.5 63.7 96.6 75.1 34,010
Total 84.8 79.5 93.7 88.7 92.7 74.7 88.7 46.5 88.3 64.7 1,84,848
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Table 2.23: Literacy Rate of household population aged 15-24
Percentage of literate among household population aged 15-24 by sex, residence and state, India, RSOC 2013-14.
State
Residence Total
Urban Rural
Male Female Total Male Female Total Male Female Total
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
93.8
95.3 96.4 99.0 96.8 90.3 88.7 92.4
95.9 96.1
85.8 95.5 92.9 93.9
97.7 99.2 98.7 98.7 99.9 96.5 99.0 99.4
92.8 98.5 94.0 96.3
92.5 95.2 98.7 95.5
91.2
92.4 92.0 96.1 90.6 92.5 85.0 92.9
96.2 94.1
82.3 92.0 90.4 91.4
95.6 94.5 92.6 96.4
100.0 95.7 97.6 96.8
87.9 97.9 89.2 96.4
82.4 92.9 99.5 96.9
92.5
93.9 94.3 97.7 93.7 91.2 86.9 92.7
96.1 95.1
84.1 93.7 91.6 92.6
96.4 96.6 95.6 97.5 99.9 96.0 98.3 98.2
90.2 98.2 91.5 96.3
86.4 94.0 99.1 96.3
91.0
96.2 92.5 99.0 96.7 91.5 85.7 97.7
95.3 87.5
86.6 89.8 93.1 94.0
94.1 95.6 99.1 92.6 99.8 98.0 98.2 97.0
91.7
100.0 92.3 96.8
90.1 90.7 99.3 98.8
83.1
94.2 85.8 99.2 86.5 90.7 76.4 94.5
85.1 82.7
71.3 72.4 85.0 89.4
92.6 89.7 97.6 93.0 96.6 95.3 97.2 96.0
75.4 99.1 80.6 92.3
86.1 88.3 96.7 95.5
87.0
95.3 89.2 99.1 91.7 91.1 81.0 96.0
89.9 85.1
78.6 81.3 88.8 91.6
93.4 92.5 98.3 92.8 98.5 96.5 97.7 96.5
83.5 99.5 86.6 94.6
87.8 89.5 97.9 96.9
91.9
95.3 93.9 99.0 96.7 91.0 86.4 96.3
95.5 89.9
86.5 91.0 93.1 94.0
94.9 96.0 99.0 94.4 99.9 97.4 98.4 97.6
91.9 99.0 93.0 96.5
90.9 92.4 99.0 97.2
85.6
92.4 87.9 99.0 87.5 91.3 78.3 94.0
87.4 85.9
72.7 76.8 85.9 90.1
93.5 90.4 96.1 93.9 98.5 95.4 97.3 96.2
78.6 98.4 84.5 94.3
84.9 90.2 98.0 96.1
88.7
93.9 91.0 99.0 92.2 91.1 82.3 95.1
91.3 88.0
79.4 84.0 89.3 91.9
94.2 93.0 97.4 94.2 99.3 96.3 97.8 96.9
85.2 98.7 88.8 95.5
87.3 91.3 98.5 96.6
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Recognizing the importance of literacy among youths (15-24 years) it is considered as one of the Millennium Development Goal (MDG) indicators to track the progress on achieving universal education under Goal 2. Table 2.22 shows the percentage of literates and those currently attending school/college during 2012-13 among population aged 6-24 by selected background characteristics. The youth literacy is pegged at 89 percent with respective figures for males and females being 92 percent and 86 percent. The differentials are in favour of males over females, persons living in urban areas against those living in rural areas, others/OBCs over SCs/STs and population belonging to the richest quintile vis-à-vis poorest quintile. As expected, these estimates are slightly higher than Census 2011 figures (Total -86.1 percent; Male- 90.0 percent; Female- 81.8 percent) and conform to the projected trend based on census data (Censuses 1991, 2001 and 2011). The state-wise youth literacy by sex and residence is presented in Table 2.23. School Attendance Ratios Data on school and college attendance any time during the academic year 2012-13 was collected for the usual residents’ age 5-24 years. However, the analysis of the net attendance ratios (NARs) and gross attendance ratios (GARs) in this section has been restricted to the official school going age group of 6-17 years only. The NAR measures the participation in primary schooling (classes 1-5 ) for the population aged 6-10, in middle school (classes 6-8) for the population aged 11-13, secondary school (classes 9-10) for the population aged 14-15, and higher secondary school (classes 11-12) for the population age 16-17 years. The GAR on the other hand indicates participation at each level of schooling among those of any age. The GAR therefore is almost always higher than the NAR for the same level because the GAR includes participation by those who may be older or younger than the official age range for that level. An NAR of 100 percent would indicate that all of those in the official age range are attending school at that level. The GAR can exceed 100 percent if there is significant over-age or under-age participation at a given level of schooling. Table 2.24 provides NARs and GARs by sex, residence and by levels of schooling. NAR is 75 percent at the primary level, 50 percent at middle school, 37 percent at secondary school and 27 percent at higher secondary school. For middle, secondary and higher secondary levels taken together, NAR is 65 percent. Though there is a negligible gap of less than 1 percentage point in favour of males at primary level, the situation has reversed at the middle, secondary and higher secondary level which is an encouraging sign. At all the levels of schooling, NARs in urban areas are better than NARs in rural areas. As presented in Table 2.24, the GAR is close to 101 percent (102 percent for males and 99 percent for females) at the primary level, 90 percent (89 percent for males and 90 percent for females) at middle school, 84 percent (85 percent for males and 82 percent for females) at secondary school, and 67 percent (73 percent for males and 62 percent for females) at higher secondary level. For middle, secondary and higher secondary taken together, it was 82 percent (84 percent for males and 80 percent for females). Again GARs are higher for urban areas in comparison to rural at all levels of schooling. Table 2.24 also shows that the Gender Parity Index (GPI), which represents the ratio of the NAR and GAR for females to the corresponding NAR and GAR for males. It is a more precise indicator of gender differences in school attendance rates. A GPI greater than 1.00 indicates that a higher proportion of females than males attend school. The GPI based on NAR is 1.00 in urban areas and is 0.99 in rural areas at primary level suggesting a bridging male-female gap. At the middle, secondary and higher secondary level, the GPI exceeds 1.00 both in urban as well as rural areas. However, the GPI based on GAR is less than 1.00 for primary as well as for secondary levels across rural and urban
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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areas and also for rural areas at higher secondary level. This indicates a noticeable male-female gap due to low access to age-appropriate education for girls as compared to boys.
Table 2.24: School attendance ratios
Net attendance ratios (NAR), gross attendance ratios (GAR), and Gender Parity Index (GPI) for the household population aged 6-17 by level of schooling and sex, according to residence, RSOC, 2013-14.
Residence
Net attendance ratio1
Gender Parity Index
3
from NAR
Gross attendance ratio2
Gender Parity Index
3
from GAR Male Female Total Male Female Total
Primary School
Urban Rural Total
79.1 73.9 75.3
78.9 73.4 74.9
79.0 73.7 75.1
1.00 0.99 0.99
103.1 101.7 102.1
100.0 98.9 99.2
101.6 100.3 100.7
0.97 0.97 0.97
Middle School
Urban Rural Total
55.6 46.3 49.0
59.3 48.7 51.7
57.3 47.5 50.3
1.07 1.05 1.05
92.9 87.1 88.8
95.2 88.4 90.3
94.0 87.7 89.5
1.02 1.02 1.02
Secondary School
Urban Rural Total
42.5 32.6 35.5
47.7 34.8 38.5
45.1 33.7 37.0
1.12 1.07 1.09
96.9 80.2 85.1
89.0 79.1 82.0
93.0 79.7 83.6
0.92 0.99 0.96
1 The NAR for primary school (standards 1-5) is the percentage of the primary-school age population (6-10 years)
that is attending primary school. The numerator is number of household members aged 6 to 10 years attending standards 1 to 5. The denominator is primary school age population aged 6 to 10 years. The NAR for middle school (standards 6-8) is the percentage of the population in the appropriate age group for those school levels (11-13 years) that is attending those school levels. The numerator is number of household members aged 11 to 13 years attending standards 6 to 8. The denominator is middle school age population aged 11 to 13 years. The NAR for secondary school (standards 9-10) is the percentage of the population in the appropriate age group for those school levels (14-15 years) that is attending those school levels. The numerator is number of household members aged 14 to 15 years attending standards 9 to 10. The denominator is secondary school age population aged 14 to 15 years.
2 The GAR for primary school (standards 1-5) is the total number of primary school students, expressed as a
percentage of the official primary-school-age population (6-10 years). The numerator is number of household members attending standards 1-5. The denominator is primary school age population aged 6-10 years. The GAR for middle school (standards 6-8) is the total number of students in those school levels, expressed as a percentage of the official population that is the appropriate age to be attending those school levels. The numerator is number of household members attending standards 6-8. The denominator is primary school age population aged 11-13 years. The GAR for secondary school (standards 9-10) is the total number of students in those school levels, expressed as a percentage of the official population that is the appropriate age to be attending those school levels. The numerator is number of household members attending standards 9-10. The denominator is primary school age population aged 14-15 years.
3The GPI for primary school is the ratio of the primary school NAR (GAR) for females to the NAR (GAR) for males.
The GPI for middle school is the ratio of the NAR (GAR) for females to the NAR (GAR) for males. The GPI for secondary school is the ratio of the NAR (GAR) for females to the NAR (GAR) for males.
Continued…
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
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Table 2.24: School attendance ratios-Continued
Net attendance ratios (NAR), gross attendance ratios (GAR), and Gender Parity Index (GPI) for the household population aged 6-17 by level of schooling and sex, according to residence, RSOC, 2013-14.
Residence
Net attendance ratio1
Gender Parity Index
3
from NAR
Gross attendance ratio2
Gender Parity Index
3
from GAR Male Female Total Male Female Total
Higher Secondary School
Urban Rural Total
29.6 22.5 24.8
39.0 24.2 28.4
34.1 23.4 26.6
1.31 1.07 1.14
82.2 68.6 72.9
85.2 52.8 62.0
83.6 60.4 67.4
1.04 0.77 0.85
Middle, Secondary and Higher Secondary School
Urban Rural Total
70.6 61.0 63.9
72.9 62.2 65.3
71.7 61.6 64.6
1.03 1.02 1.02
91.1 80.4 83.6
90.6 75.9 80.0
90.8 78.1 81.8
0.99 0.94 0.96
1 The NAR for higher secondary school (standards 11-12) is the percentage of the population in the appropriate age
group for those school levels (16-17 years) that is attending those school levels. The numerator is number of household members aged 16 to 17 years attending standards 11 to 12. The denominator is higher secondary school age population aged 16 to 17 years. The NAR for middle, secondary, and higher secondary school (standards 6-12) is the percentage of the population in the appropriate age group for those school levels (11-17 years) that is attending those school levels. The numerator is number of household members aged between 11 to 17 years attending standards 6 to 12. The denominator is primary school age population aged 11 to 17 years.
2
The GAR for higher secondary school (standards 11-12) is the total number of students in those school levels, expressed as a percentage of the official population that is the appropriate age to be attending those school levels. The numerator is number of household members attending standards 11-12. The denominator is primary school age population aged 16-17 years. The GAR for middle, secondary, and higher secondary school (standards 6-12) is the total number of students in those school levels, expressed as a percentage of the official population that is the appropriate age to be attending those school levels. The numerator is number of household members attending standards 6-12. The denominator is primary school age population aged 11-17 years. 3 The GPI for higher secondary school is the ratio of the NAR (GAR) for females to the NAR (GAR) for males. The GPI
for middle school, secondary school, and higher secondary school is the ratio of the NAR (GAR) for females to the NAR (GAR) for males at those levels of school.
Table 2.25 presents the percentage of population aged 6-24 who attended school/college during 2012-13 by broad age-groups according to residence and sex. The proportion of children attending school was higher in urban areas than in rural areas, for both males and females. The highest proportion of children attending school is in the age group 11-13 years, with girls attending in higher proportions in urban as well as in rural areas. Overall, close to two-thirds (65 percent) are attending school clearly hinting at the likely challenges in achieving universal schooling status which is a precursor to universal literacy. The most concerning fact is that as high as 23 percent of children in the age group 6-10 years were not attending the school on the date of survey. This assumes significance in the light of compulsory universal education being promoted by government of India.
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Table 2.25: School attendance by sex and residence
Percentage of household population aged 6-24 attended school in the year 2012-13 by broad age-groups according to residence and sex, RSOC, 2013-14.
Age groups
Residence Total
Urban Rural
Male Female Male Female Male Female
6-10 11-13 14-17 6-13 6-17 15-24 6-24 Total Persons 6-24
81.4 93.2 83.2 85.8 84.9 55.0 70.5
28,028
81.5 94.2 83.3 86.2 85.2 49.1 66.3
27,329
75.9 89.2 76.0 80.7 79.2 48.1 65.5
64,623
75.9 89.0 75.0 80.6 78.8 40.0 60.5
64,867
77.5 90.4 78.2 82.2 80.9 50.2 67.0
92,651
77.4 90.5 77.4 82.2 80.6 42.9 62.3
92,197
When seen from the lens of gender equality, the gap between males and females attendance seems to receding particularly for official age-group 6-17 years. However, the pronounced societal preference towards educating boys and not girls is visible for the age groups 15-24 years which in turn also distorts the situation for 6-24 years. This trend is found across urban and rural areas. With the enactment of Right to Education Act, government has bestowed the right of free and compulsory education for children of age 6-13 years across the country. In order to reflect the current situation, state-wise data on school attendance for children of age 6-13 years is presented in Table 2.26. It is evident from above that low performance in states with high population burden such as Uttar Pradesh, Bihar, Jharkhand, Jammu & Kashmir and Rajasthan pulls the national average down. However, what is heartening is the fact that the attendance in rural areas of 11 states is higher than urban areas and in another 6 states, the gaps is below 3 percentage points. Equally heartening is the fact that the female attendance is higher than their counterparts in urban areas of 12 states and rural areas of 14 states.
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Table 2.26: School attendance by states
Percentage of household population aged 6-13 that attended school during the year 2012-13 by states according to residence and sex, RSOC, 2013-14.
State
Residence Total
Urban Rural
Male Female Total Male Female Total Male Female Total
India 85.8 86.2 86.0 80.7 80.6 80.7 82.2 82.2 82.2 North
Delhi 87.5 91.2 89.3 91.4 92.8 92.0 87.6 91.2 89.4 Haryana 87.8 84.3 86.2 88.4 85.7 87.1 88.2 85.3 86.8 Himachal Pradesh 92.9 81.1 87.5 98.1 94.7 96.5 97.6 93.4 95.7 Jammu & Kashmir 81.4 86.7 83.7 76.0 83.2 79.4 77.2 83.9 80.3 Punjab 88.0 87.1 87.6 89.4 85.3 87.5 88.8 86.0 87.6 Uttar Pradesh 75.5 76.5 76.0 71.9 73.2 72.5 72.6 73.8 73.2 Uttarakhand 88.9 83.8 86.5 81.9 84.3 83.1 84.0 84.2 84.1
Central Chhattisgarh 84.1 86.6 85.2 85.3 79.6 82.5 85.0 80.9 83.0 Madhya Pradesh 88.8 88.6 88.7 83.4 83.2 83.3 84.9 84.5 84.7
East Bihar 72.5 73.9 73.2 75.1 74.4 74.8 74.8 74.4 74.6 Jharkhand 88.2 87.5 87.9 80.1 79.6 79.9 81.8 80.9 81.3 Odisha 89.1 89.8 89.5 82.2 83.0 82.6 83.2 84.0 83.6 West Bengal 87.7 84.6 86.3 84.1 88.8 86.4 85.2 87.7 86.4
Northeast Arunachal Pradesh 98.5 92.8 95.7 91.8 92.3 92.0 93.7 92.4 93.1 Assam 91.0 95.6 93.4 94.1 92.7 93.4 93.7 93.1 93.4 Manipur 84.1 75.1 79.7 88.8 89.4 89.1 87.3 84.3 85.9 Meghalaya 84.7 86.3 85.4 87.1 89.9 88.4 86.5 89.0 87.7 Mizoram 89.0 89.0 89.0 85.4 88.7 86.5 87.5 88.9 88.1 Nagaland 84.1 89.0 86.7 79.2 74.2 76.6 81.1 80.2 80.6 Sikkim 89.8 92.4 91.2 94.4 95.4 94.9 93.2 94.5 93.9 Tripura 90.9 86.2 88.1 86.5 85.2 85.9 87.3 85.5 86.4
West Rajasthan 83.5 85.3 84.3 82.9 78.5 80.8 83.0 80.1 81.6 Goa 90.4 90.6 90.5 97.8 89.3 93.7 92.9 90.2 91.6 Gujarat 90.2 87.3 88.9 86.5 84.7 85.6 88.2 85.8 87.1 Maharashtra 89.2 91.1 90.1 80.6 80.7 80.7 84.4 85.1 84.7
South Andhra Pradesh 82.4 79.9 81.1 83.8 80.0 81.8 83.2 80.0 81.5 Karnataka 87.4 88.4 87.9 83.6 87.2 85.6 85.4 87.7 86.6 Kerala 90.4 92.9 91.7 91.5 91.7 91.6 91.0 92.2 91.6 Tamil Nadu 92.4 95.3 93.7 94.9 95.4 95.1 93.6 95.3 94.4
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2.6 HOUSING CHARACTERISTICS The housing characteristics of a household include access to basic utilities, sources of drinking water, type of and usage of sanitation facilities and housing structure (type of house). The crowding of dwelling spaces (number of rooms used for sleeping), availability of separate kitchen, electricity, type of fuel used for cooking, access to bank account, ownership of the house etc. are the characteristics of a household used to assess the general well-being and socio-economic status of its members. These conditions also provide a deeper understanding of the choices and options available to the household in terms of standard of living, health and educational opportunities. This section therefore provides information on type of house, number of rooms used for sleeping, availability of separate kitchen, availability of electricity, type of cooking fuel, availability of bank account, ownership of the house collected through household questionnaire. Table 2.27 provides information on household characteristics such as type of house, number of rooms used for sleeping, having a separate kitchen for cooking, availability of electricity, type of fuel used for cooking, availability of bank account and ownership status of the house. The categorization of households living in pucca, semi-pucca and kutcha houses was done through observation on the basis of materials used for construction. RSOC reports that about 19 percent of the households in this country were still residing in kutcha houses, another 31 percent in semi-pucca houses and the remaining 50 percent in pucca houses. Against 61 percent of households residing in kutcha and semi-pucca houses in rural areas, there were just 29 percent households living in such houses in urban areas. The number of rooms used for sleeping indicates the extent of crowding in households. Overcrowding affects environment and hygiene and therefore increases the risk of contracting infectious diseases, which particularly affect children and older household members. About 44 percent of households had just one room for sleeping followed by 38 percent with two sleeping rooms and 11 percent with three sleeping rooms. While less than 1 percent reported having no room for sleeping against 6 percent with 4 or more rooms. The data does not show any significant rural-urban differentials. Indoor air pollution has an important implication for the health of the household members. Having a separate place of cooking and the type of fuel used are all related to indoor air quality and the degree to which household members are exposed to the risk of respiratory infections and other diseases. More than half (59 percent) of the households had a separate kitchen with a higher proportion (74 percent) in urban areas in comparison to 52 percent in rural areas. Overall, more than half of the households (55 percent) used solid fuels for cooking. There are substantial urban –rural differences in the use of solid fuel. In urban areas, only 23 percent of households used solid fuel for cooking, while the majority of rural households (71 percent) used solid fuel, including coal or lignite, charcoal, wood, straw, shrubs, grass and animal dung that generate smoke and are unhealthy to breathe. The percentage of households relying on wood for fuel decreased from 53 percent in DLHS-3 (2007-08) to 46 percent 2013-14. As expected, use of LPG/natural gas had gone up to 36 percent from 24 percent in 2007-08 with 72 percent households using it in urban areas against just 16 percent in rural areas. Around 86 percent of the households had access to electricity, compared to 70 percent in 2007-08. The rise has been sharper in case of rural areas (from 60 percent to 81 percent) as compared to urban areas (from 92 percent to 97 percent). As presented in Table 2.24, overall, 78 percent of the
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households had access to at least one bank account. Higher proportions of households from urban India had bank accounts in comparison to rural.
More than four out of five (82 percent) of the households were either living in their own house or
owned a house somewhere else. As expected, more households in rural areas owned a house as
compared to urban.
Table 2.27: Housing characteristics
Percent distribution of the households by type of house, number of rooms used for sleeping and other housing
characteristics according to residence, India, RSOC, 2013-14.
Housing characteristics Residence
Total De jure
population Urban Rural
Type of house Kutcha Semi-pucca Pucca Total
Number of rooms used for sleeping No room 1 2 3 4+ Total Mean number of rooms used for sleeping
Kitchen Separate room used as a kitchen
Electricity HH has electricity
Fuel used for cooking Electricity LPG/Natural Gas Biogas/Gobar gas Kerosene Coke/Coal/Lignite Charcoal Wood Straw/Shrubs/Grass Agricultural Crop Waste Dung Cakes Others No food cooked in the Household Total
Bank Account Has a bank account
Ownership of house Ownership of house*
Total Number of Households
5.9
22.6 71.5
100.0
0.4 42.3 37.9 13.0
6.3 100.0
1.9
74.1
97.3
0.9
71.8 2.5 3.2 1.4 1.7
16.3 0.3 0.2 1.3 0.3 0.1
100.0
83.1
76.5 34,775
24.7 35.6 39.7
100.0
0.5 45.0 38.2 10.8
5.5 100.0
1.8
52.3
80.5
0.5
16.1 0.8 0.5 0.3 1.9
60.9 4.0 3.8
10.1 1.0 0.1
100.0
74.8
85.3 70,707
18.5 31.3 50.2
100.0
0.5 44.1 38.1 11.6
5.7 100.0
1.8
59.5
86.0
0.6
34.5 1.4 1.4 0.6 1.9
46.2 2.8 2.6 7.2 0.7 0.1
100.0
77.5
82.4 1,05,482
18.0 30.7 51.3
100.0
0.4 37.8 39.6 14.0
8.3 100.0
-
59.6
85.6
0.6 32.8
1.3 1.2 0.7 1.8
47.3 2.8 2.5 8.3 0.6 0.1
100.0
79.2
82.3 4,95,571
*Ownership of this house or any other house.
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2.7 WATER, SANITATION AND HYGIENE PRACTICES OF THE HOUSEHOLD
Access to safe water, sanitation and hygiene practices are basic determinants of better health. They help to understand the health related vulnerabilities of the population and suggests critical remedial steps to alleviate them from skin diseases, acute respiratory infections (ARIs), and diarrhoeal diseases. ARIs and diarrhoeal diseases cause substantial number of under five deaths globally and also in India, which otherwise is preventable. Recognizing that access to safe drinking water and improved sanitation is essential for improving the overall health condition of all, this was included as one of the MDGs. 2.7.1 Source of drinking water and access to improved drinking water Table 2.28 presents the percent distribution of households by place of residence and source of drinking water. In this survey, sources that are likely to provide water suitable for drinking are identified as improved sources. These include a piped source within dwelling, yard or plot; a public tap/stand pipe; tube well or borehole; hand pump; a protected well; spring water; and rain water. This is in conformity with WHO and UNICEF definition as adopted under Joint Monitoring Programme for Water Supply and Sanitation. Access to an improved source of water is nearly universal in India (91 percent) with more than nine out of every ten households both in urban as well as rural areas using improved source of drinking water. About 44 percent of households in rural areas relied on hand pump against just 12 percent relying in urban areas. While 39 percent of households depended on piped water supply into dwelling/yard/plot in urban areas, this was 11 percent in case of rural areas. Only in case of 24 percent households, the source of drinking water was within their own dwellings.
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Table 2.28: Source of drinking water
Percent distribution of households by source of drinking water according to residence, RSOC, 2013-14.
Type of water source Residence
Total De jure
population Urban Rural
Improved Sources 92.8 90.2 91.0 91.3
Piped water supply into Dwelling/Yard/Plot 38.8 11.0 20.1 20.0
Public tap/stand pipe 31.5 23.0 25.8 24.1
Tube well or bore well 7.7 8.7 8.4 8.3
Hand pump 12.1 43.6 33.2 35.4
Dug well—protected 2.2 3.3 2.9 2.8
Spring—protected 0.4 0.5 0.4 0.4
Rain water 0.2 0.1 0.2 0.2
Unimproved sources 7.2 9.8 9.0 8.7
Unprotected spring 0.6 1.1 0.9 0.9
Unprotected dug well 1.4 5.4 4.1 4.2
Cart with small tank/Dum 0.8 0.4 0.6 0.5
Tanker/Truck 1.3 0.6 0.8 0.8
Surface water (River/Dam/Lake/Pond/Canal) 0.4 1.0 0.8 0.8
Bottled water 2.2 1.1 1.5 1.2
Others 0.4 0.2 0.2 0.3
Number of households 34,775 70,707 1,05,482 4,95,571
Location of the water source
In own dwelling 34.4 20.1 23.7 24.7
In own yard/plot 21.1 21.4 21.3 22.1
Elsewhere 44.5 58.5 55.0 53.3
Total 100.0 100.0 100.0 100.0
Number of households with no piped water into dwelling/yard/plot
21,294 62,939 84,233 3,96,238
Figure 2.9 shows that there has been an improvement in proportion of households using improved source of drinking water vis-à-vis DLHS-3 (2007-08) primarily on account of increase in rural areas. The situation as revealed under RSOC is quite close to Census 2011 (88 percent) and NSS (2012) (Rural: 88.5 percent and Urban: 95.3 percent) and India is on track to achieve the target of halving the proportion of households without access to safe drinking water.
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Figure 2.9: Source of drinking water—Comparison with DLHS-3
Table 2.29 presents the percent distribution of households by source of improved and unimproved source of drinking water by residence, social groups and wealth quintiles. As expected, the access to improved source of drinking water is the least for ST households among social groups and poorest households by wealth quintiles. Table 2.29: Source of drinking water Percent distribution of households by source of improved drinking and unimproved drinking water according to selected characteristics, RSOC, 2013-14. The state wise picture on proportion of households using improved source of drinking water is presented in Table 2.30. As can be seen, slightly more than half of the states are found to be above the national average.
84 91
80 90 94 93
DLHS-3 (Total) RSOC (Total) DLHS-3 (Rural) RSOC (Rural) DLHS-3(Urban)
RSOC (Urban)
Improved Source
Characteristic
Households having
improved drinking water
1
Households having
unimproved drinking
water
Total Number of households
Residence Urban Rural
Social - Group Scheduled Caste Scheduled Tribe OBC Other No Response
Wealth Index Lowest Second Middle Fourth Highest
Total
92.8 90.2
92.7 85.3 90.3 93.1 91.9
88.7 91.7 92.6 90.9 91.2 91.0
7.2 9.8
7.3
14.7 9.7 6.9 8.1
11.3
8.3 7.4 9.1 8.8 9.0
100.0 100.0
100.0 100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0
34,775 70,707
20,378 11,733 41,955 30,613
802
21,096 21,096 21,099 21,096 21,095
1,05,482 1Improved drinking water includes piped water supply into dwelling/yard/plot, public tap/stand
pipe, tube well or bore well, hand pump, dug well—protected, spring—protected and rain water.
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Table 2.30: Improving drinking water, by state
Percentage of households using improved drinking water by residence, de jure population and state, RSOC, 2013-14.
State Residence
Total De jure
population Urban Rural
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
92.8
90.3 92.1 98.6 96.6 99.8 98.8 99.9
97.0 91.7
98.0 89.1 88.8 95.9
99.9 93.2 60.6 81.0 84.8 60.0 83.4 97.7
96.2 92.4 97.9 99.4
84.2 96.0 55.5 92.5
90.2
78.0 96.1 96.8 83.1 98.7 97.1 96.9
87.7 86.2
97.7 64.8 86.7 94.1
95.5 86.1 41.5 54.0 56.8 63.0 66.4 83.1
85.2 84.5 95.3 91.4
85.7 94.3 48.5 97.7
91.0
90.0 94.6 97.0 86.7 99.1 97.5 97.8
89.8 87.7
97.7 70.0 87.1 94.7
96.7 87.2 48.1 60.1 72.0 62.0 71.3 87.2
88.0 89.5 96.6 95.1
85.2 95.0 51.8 95.1
91.3
89.8 94.7 97.6 85.2 99.1 97.7 97.9
89.3 86.9
97.8 68.5 86.9 94.7
96.5 87.5 47.8 62.3 70.6 64.3 71.6 87.2
87.9 88.6 96.3 95.2
85.8 94.8 51.9 95.0
Improved drinking water includes piped water supply into dwelling/yard/plot, public
tap/stand pipe, tube well or bore well, hand pump, dug well—protected, spring—
protected and rain water.
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2.7.2 Usage of toilet facility Under RSOC, the information on usage of toilet facility was collected through a combination of three questions—kind of toilet facility used by the household, do all members use this facility or not; and whether this facility is shared with other households. This helped in eliciting comprehensive response sets on the basis of which households have been categorized into those using improved toilet facilities and otherwise. A household is classified as having an improved toilet if it is used only by the household members (is not shared with another household) and if it separates waste from human contact. Besides flush/pour flush toilets, ventilated improved pit latrine (VIP), pit latrine with slab and composting toilets are clubbed under improved category. This definition is in conformity with WHO and UNICEF JMP’s standards on water supply and sanitation. Table 2.31 shows the percent distribution of households by type of toilet/latrine facilities and residence. A total of 42 percent of households reported having an improved toilet facility. Urban households are more than twice as likely to use an improved toilet facility as compared to rural households. Flush/pour flush to –septic tank was the most widely used type of toilet across rural and urban households. Close to 46 percent of households defecate in open with the proportion of rural households being five times more than in comparison to urban households. Table 2.31: Usage of household sanitation facilities Percent distribution of households by usage of improved or unimproved toilet facilities, according to residence and de jure population, India, RSOC, 2013-14.
Type of toilet facility Residence
Total
De jure
population Urban Rural
Improved toilet
Flush/pour flush to - piped sewer system
Flush/pour flush to -septic tank
Flush/pour flush to - pit latrine
Ventilated improved pit latrine (VIP)
Pit latrine with slab
Composting toilet
Non-improved toilet
Any facility shared with other households
Flush/pour flush to -elsewhere
Flush/pour flush to - unknown place
Pit latrine without slab/open pit
Bucket
Hanging toilet/hanging latrine
Others
No facilities or bush or field
Total Households
All Members use this toilet
Share the toilet facility with other households
Number of households using a toilet
66.0
18.6
32.0
7.7
2.7
4.7
0.3
34.0
20.1
0.3
0.2
0.3
0.1
0.1
0.1
12.8
34,775
98.1
23.0
30,332
29.9
2.4
13.6
6.6
2.5
4.3
0.5
70.1
6.8
0.2
0.1
0.7
0.1
0.4
0.0
61.6
70,707
94.4
17.6
27,145
41.8
7.7
19.7
7.0
2.5
4.4
0.5
58.2
11.2
0.2
0.1
0.6
0.1
0.3
0.1
45.5
1,05,482
96.3
20.5
57,477
42.0
7.7
19.5
7.6
2.6
4.2
0.5
58.0
10.2
0.2
0.2
0.6
0.1
0.4
0.1
46.1
4,95,571
96.0
19.0
2,66,952
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Table 2.32 captures the variability in usage of sanitation facilities across different social groups and wealth quintiles. As expected, the proportion of households using improved toilets is significantly lesser among SCs/STs as compared to those of OBC/Others across place of residence. The situation is worse in case of STs. Figure 2.10 highlights the differential in use of toilet facilities among social groups distinctly.
Figure 2.10: Use of toilet facility across social groups
Table 2.32: Use of toilet facility by social groups and wealth quintiles Percentage of households using toilet facility according to selected characteristics, RSOC, 2013-14 When examined by wealth quintiles, the differential in proportion of households using improved sanitation becomes sharper both in rural as well as urban households. Against a gap of almost ten times between households belonging to the poorest and the richest quintiles in terms of usage of improved toilet facility seen in case of urban areas, there was a variation of more than 16 times in favour of richest households in rural areas.
Characteristic
Households having access to improved
sanitation
Households having access
to non-improved sanitation
Households not having access to sanitation
Number of households
Residence Urban Rural
Social - Group Scheduled Caste Scheduled Tribe OBC Other No Response
Wealth Index Lowest Second Middle Fourth Highest
Total
66.0 29.9
29.8 22.2 43.3 55.4 35.5
4.5
18.7 37.6 63.6 84.5 41.8
20.6
8.4
11.8 8.7
10.7 16.3 23.6
4.2 9.6
16.0 19.1 13.1 12.4
12.8 61.6
58.1 68.9 45.7 28.0 40.3
91.1 71.4 45.9 16.9
2.3 45.5
34,775 70,707
20,378 11,733 41,955 30,613
802
21,096 21,096 21,099 21,096 21,095
1,05,482
30 22
43
55
12 9 11 16
58
69
46
28
Schedule Caste Schedule Tribe Other BackwardClass
Other
Using improved toilets Using unimproved toilets Open defecation
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The state-wise depiction of sanitation situation in terms usage of any toilet facility and using improved toilet facility is given in Table 2.33. Seven states namely Odisha, Jharkhand, Bihar, Chhattisgarh, Madhya Pradesh, Rajasthan and Uttar Pradesh have proportion of households using any type of toilet below the all India figure. These seven states also rest at the lowest spectrum in terms of using improved toilet facility. On the other hand, at least 9 out of every 10 households in states like Punjab, Sikkim, Mizoram, Tripura, Delhi and Kerala use any type of toilet and consequently they rank very high in terms of using improved toilets also. Table 2.33: Toilet facility by State Percentage of households using any type of toilet facility and using improved toilet facility by residence, de jure population and state, RSOC, 2013-14.
State
Using any type of toilet facility Using improved toilet facility1
Urban Rural Total De jure population
Urban Rural Total De jure population
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
87.2
97.6 91.7 93.3 92.8 97.5 88.8 96.9
74.8 81.2
67.6 65.4 64.3 92.6
95.6 97.0 96.9 97.0 99.3 96.0 98.6 99.2
87.5 90.1 87.8 85.2
86.7 89.2 99.9 83.9
38.4
93.4 64.3 76.4 57.4 85.8 28.3 70.0
17.6 19.7
19.8 13.2 14.3 61.4
58.1 56.1 82.3 61.4 92.5 80.6 94.4 95.4
25.1 79.3 38.4 44.2
46.3 51.0 96.6 30.0
54.5
97.5 74.4 78.2 66.9 90.3 42.3 78.4
30.4 36.6
25.2 24.4 22.3 71.7
68.3 62.5 87.4 69.4 96.2 86.1 95.6 96.5
40.9 86.1 61.9 63.5
60.5 66.8 98.1 56.6
53.9
97.3 75.4 78.2 68.3 90.2 43.3 79.7
31.8 38.8
25.5 25.5 22.3 72.4
68.0 62.1 87.9 70.3 96.1 84.8 96.0 96.6
41.4 86.2 61.2 63.7
61.1 66.2 98.3 55.9
66.0
68.0 74.3 73.3 71.9 74.1 68.2 71.1
44.1 65.6
45.0 51.6 50.1 52.0
80.1 60.1 46.3 60.6 96.8 80.0 68.8 71.7
64.6 68.1 76.6 55.4
75.7 71.4 93.9 66.6
29.9
67.3 55.5 62.3 33.9 71.1 22.5 47.3
10.9 15.8
14.9
5.0 10.7 39.0
45.7 39.1 39.0 40.6 88.3 76.5 75.0 52.7
19.8 64.9 35.8 32.9
39.3 44.3 89.3 26.8
41.8
68.0 62.4 63.5 44.1 72.3 33.1 54.7
18.4 29.5
18.3 15.0 17.0 43.3
55.1 42.4 41.5 45.1 92.9 77.7 73.2 58.0
31.1 67.0 55.2 43.5
52.2 55.5 91.4 46.4
42.0
69.8 64.6 64.6 45.4 74.4 34.8 57.0
20.9 31.9
18.8 15.8 17.5 45.9
54.3 43.2 44.2 45.9 93.1 77.0 74.9 57.9
32.2 66.7 55.3 43.5
53.1 55.7 91.9 46.7
1Improved toilet facility includes f lush/pour flush to—piped sewer system, flush/pour flush to septic tank, flush/pour flush to—pit
latrine, ventilated improved pit latrine (VIP), pit latrine with slab, composting toilet and toilet not shared with any other household.
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Table 2.34 shows that 38 percent of households are using both improved source of drinking water and improved sanitation facilities. As seen in case of improved sanitation, there is a marked rural-urban differential in favour of urban households. Among social groups, the proportion of such households is the least for STs followed by SCs. By wealth quintiles, there is a gap of 18 times between the poorest and the richest households. Table 2.35 presents the state-wise picture. There are 20 states where proportion of households having access to improved source of drinking water and also using improved sanitation is higher than the national average. Table 2.34: Access to improved source of drinking water and use of improved sanitation facility Percentage of households having access to improved source of drinking water and using improved toilet facility according to selected characteristics, RSOC, 2013-14.
Characteristic
Households having access to improved source
of drinking water1
Households using improved
sanitation2
Households having improved source of drinking water and
using improved sanitation
Number of households
Residence Urban Rural
Social - Group Scheduled Caste Scheduled Tribe OBC Other No Response
Wealth Index Lowest Second Middle Fourth Highest
Total
92.8 90.2
92.7 85.3 90.3 93.1 91.9
88.7 91.7 92.6 90.9 91.2 91.0
66.0 29.9
29.8 22.2 43.3 55.4 35.5
4.5
18.7 37.6 63.6 84.5 41.8
60.7 26.7
27.8 19.4 38.3 51.4 32.8
4.2
17.2 34.8 56.8 76.6 37.9
34,775 70,707
20,378 11,733 41,955 30,613
802
21,096 21,096 21,099 21,096 21,095
1,05,482 1
Improved drinking water includes piped water supply into dwelling/yard/plot, public tap/stand pipe, tube well or bore well, hand pump, dug well—protected, spring—protected and rain water. 2Improved toilet facility includes flush/pour flush to—piped sewer system, flush/pour flush to—septic
tank, flush/pour flush to—pit latrine, ventilated improved pit latrine (VIP), pit latrine with slab, composting toilet and toilet not shared with any other household.
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Table 2.35: Access to improved source of drinking water and use of improved sanitation facility by state Percentage of households having access to improved source of drinking water and using improved sanitation by de jure population and state, RSOC, 2013-14.
State
Households having access to improved
source of drinking water
1
De jure population
Households using
improved sanitation
2
De jure population
Households having improved
source of drinking water and using
improved sanitation
De jure population
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
91.0
90.0 94.6 97.0 86.7 99.1 97.5 97.8
89.8 87.7
97.7 70.0 87.1 94.7
96.7 87.2 48.1 60.1 72.0 62.0 71.3 87.2
88.0 89.5 96.6 95.1
85.2 95.0 51.8 95.1
91.3
89.8 94.7 97.6 85.2 99.1 97.7 97.9
89.3 86.9
97.8 68.5 86.9 94.7
96.5 87.5 47.8 62.3 70.6 64.3 71.6 87.2
87.9 88.6 96.3 95.2
85.8 94.8 51.9 95.0
41.8
68.0 62.4 63.5 44.1 72.3 33.1 54.7
18.4 29.5
18.3 15.0 17.0 43.3
55.1 42.4 41.5 45.1 92.9 77.7 73.2 58.0
31.1 67.0 55.2 43.5
52.2 55.5 91.4 46.4
42.0
69.8 64.6 64.6 45.4 74.4 34.8 57.0
20.9 31.9
18.8 15.8 17.5 45.9
54.3 43.2 44.2 45.9 93.1 77.0 74.9 57.9
32.2 66.7 55.3 43.5
53.1 55.7 91.9 46.7
37.9
62.4 59.4 62.5 39.7 71.7 32.6 53.9
17.4 26.8
18.2 12.7 15.7 40.7
54.7 38.9 22.1 33.2 69.3 48.1 53.8 54.9
28.4 60.8 53.7 42.3
44.2 51.8 46.9 43.4
38.4
63.9 61.5 63.7 40.1 73.8 34.3 56.2
19.6 28.6
18.7 13.2 16.2 43.1
53.9 39.6 23.0 33.9 68.2 49.9 55.6 54.9
29.4 59.8 53.8 42.4
45.5 51.8 47.3 43.5
1 Improved drinking water includes piped water supply into dwelling/yard/plot, public tap/stand pipe, tube well or bore well,
hand pump, dug well—protected, spring—protected and rain water. 2
Improved toilet facility includes f lush/pour flush to—piped sewer system, flush/pour flush to septic tank, flush/pour flush to—pit latrine, ventilated improved pit latrine (VIP), pit latrine with slab, composting toilet and toilet not shared with any other household.
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2.7.3 Hand washing practice Observance and promotion of basic hygiene are fundamental for good public health. Hand washing with soap ensures that transmission of germs is restricted, especially among children who are prone to diarrhoea and other childhood illnesses. Using a soap for washing hands, particularly after contact with excreta, can reduce diarrhoeal diseases by over 40 per cent and respiratory infections by 30 per cent. The government of India through various public awareness programmes promotes hand washing with soap which is among the most effective and inexpensive ways to prevent diarrhoeal diseases and pneumonia. Table 2.36 provides information according to social groups and wealth quintiles by residence on designated places for hand washing in households and on the availability of water and cleansing agents for washing hands. In RSOC, interviewers were instructed to observe the place where household members usually wash their hands. They looked for the availability of water supply and observed whether the household had cleansing agents near the place of hand washing. In cases where they did not see the hand washing material, it was further probed by asking about the availability of these items at home. Overall, the interviewers observed designated places for hand washing in 86 percent of households with little variation in urban and rural households (87 percent and 85 percent, respectively). There is not much variation with regard to the observed designated places for hand washing across social groups. There is a gradual rise in proportion of households where place of hand washing was observed across wealth quintiles. Among the households where the place of hand washing was observed, 90 percent have availability of water and 81 percent have availability of hand washing material like soap, detergent or ash. Significantly a higher proportion of rural households did not have water and soap, detergent or any cleansing agent as compared to urban households. The availability increases with higher wealth quintiles establishing a direct relationship between wealth of the household and use of water and soap, detergent or any cleansing agent for hand washing.
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Table 2.36: Availability of hand washing facilities Percentage of households by availability of hand-wash facilities by select characteristics, RSOC, 2013-14.
Characteristic Observed
Location of Hand washing
Availability of water at hand washing place
Availability of soap, detergent or ash
(observed) Residence
Urban Rural
Social - Group Scheduled Caste Scheduled Tribe OBC Other No Response
Wealth Index Lowest Second Middle Fourth Highest
Total
87.4 85.4
84.4 84.5 87.5 86.2 65.4
80.0 84.2 84.8 89.2 92.0 86.0
96.1 86.7
87.4 79.4 91.8 92.7 80.6
74.1 85.4 91.9 96.5 99.1 89.8
91.4 75.3
73.6 74.0 81.8 86.7 57.6
60.4 72.5 80.9 89.0 97.5 80.7
Table 2.37 presents the state-wise data on designated places for hand washing in households and on the availability of water and cleansing agents for washing hands. Barring West Bengal (71 percent), Andhra Pradesh (71 percent) and Karnataka (66 Percent), proportion of households where the designated place of hand washing was observed is in excess of 80 percent. Of these households, water was available at place of hand washing in more than 80 percent of households in majority of states except for Chhattisgarh (65 percent), Jharkhand (67percent) and Odisha (64 percent). As regards availability of soap, detergent, ash or mud/sand at the place of hand washing, all states reported in excess of 70 percent excluding Chhattisgarh (68 percent), Tamil Nadu (66 percent), Odisha (51 percent) and West Bengal (50 percent).
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Table 2.37: Hand wash facilities in households by states Percentage of households by availability of hand-wash facilities across states, RSOC, 2013-14.
State Observed
Location of Hand washing
Availability of
water at hand
washing place
Availability of soap,
detergent, ash and
mud/sand (observed)
India 86.0 89.8 80.7 North
Delhi 83.9 98.6 98.1 Haryana 96.2 97.8 90.7 Himachal Pradesh 95.6 94.5 99.5 Jammu & Kashmir 93.6 88.4 89.6 Punjab 97.7 98.9 98.0 Uttar Pradesh 92.0 95.1 85.4 Uttarakhand 93.0 90.1 92.3
Central Chhattisgarh 98.8 65.2 67.8 Madhya Pradesh 86.3 93.9 90.4
East Bihar 85.7 89.7 74.5 Jharkhand 88.4 67.0 76.4 Odisha 92.9 63.7 51.1 West Bengal 71.0 81.1 49.5
Northeast Arunachal Pradesh 98.6 92.0 94.8 Assam 81.8 81.8 94.8 Manipur 94.6 94.2 89.2 Meghalaya 82.4 87.8 87.0 Mizoram 96.9 99.6 99.6 Nagaland 98.2 97.7 95.6 Sikkim 98.1 97.3 93.1 Tripura 93.0 85.4 73.0
West Rajasthan 92.5 89.1 72.4 Goa 87.2 92.6 92.6 Gujarat 95.2 95.2 91.5 Maharashtra 90.6 96.1 94.3
South Andhra Pradesh 70.7 89.3 82.7 Karnataka 66.0 91.6 89.2 Kerala 92.7 98.0 94.6 Tamil Nadu 88.6 94.3 65.8
2.8 HOUSEHOLD POSSESSION AND WEALTH INDEX
2.8.1 Possession of household assets Possession of durable goods is another useful indicator of a household’s socio-economic well-being. The availability and use of such goods have multiple effects and implications on their living standard. For instance, access to radio/transistor or television or computer keeps the household members updated on daily events, information and educational materials which have a direct bearing on their day–to-day life. Similarly, a refrigerator prolongs food storage and keeps food fresh and hygienic. Availability of means of transportation such as bicycle, motorcycle/scooter, etc. allows greater and faster access to services away from the local area and enhances social and economic activities.
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Under RSOC, information on household possessions of 27 items was collected. Table 2.38 presents the percentages of households possessing these items by place of residence. The table shows that mobile phones are possessed by 84 percent of households. The wider penetration particularly in rural areas (80 percent) is an encouraging sign. Six of 10 households have a television. Urban households are more likely to have a television (86 percent) than rural households (49 percent). Possession of a radio declined from 27 percent in 2007-08 to 5 percent in 2013-14, while ownership of a colour television has gone up from 46 percent to 58 percent. Another important indicator of a household’s socio-economic status is possession of a computer and availability of an internet connection. Close to 6 percent of households possess a computer (Desktop and Laptop taken together), and just 2 percent have access to an internet connection with notable urban-rural variations. For example, 11 percent of urban households and 2 percent of rural households possess a computer. Similarly, 5 percent of urban households have access to an internet connection, as compared with less than 1 percent of rural households. A refrigerator is available in 16 percent households (34 percent in urban areas and 8 percent in rural areas). About 3 percent of households possess an air conditioner and 8 percent a washing machine with higher percentages in urban than rural households. Around 10 percent of households possess an air cooler with 20 percent in urban areas and 5 percent in rural areas. Bicycles and motorcycles/scooters are the most common means of transportation; 53 percent of households possess a bicycle, and 29 percent, a motorcycle/scooter. Bicycle possession is more in rural areas (57 percent) than urban areas (46 percent). On the other hand, 21 percent households possess a motorcycle/scooter in rural areas against 44 percent in urban areas. Only 2 percent of households possess an animal drawn car with 2.3 percent in rural areas as compared to just 0.8 percent in urban areas. Ownership of car/jeep is much higher in urban areas (8 percent) than in rural areas (2.0 percent). Under RSOC, data in respect of households not possessing any of these durable goods was also collected to have an idea about those households who live in abject poverty and deprivation. About 1 percent of households reported not possessing any of these durable goods. As expected, percentage of such households is much higher in rural areas (1.1 percent) than urban areas (0.3 percent).
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Table 2.38: Household possessions Percentage of households by possession of household durable goods, according to place of residence and de jure population, RSOC, 2013-14.
Household assets Residence
Total De jure
population Urban Rural
Mattress made of cotton/foam 67.4 46.2 53.2 55.3
Pressure cooker 75.8 34.8 48.3 49.3
Chair 83.2 65.8 71.5 72.5
Cot/Bed 83.1 79.1 80.4 82.1
Table 61.6 37.6 45.5 46.4
Electric fan 82.8 53.3 63.0 63.4
Radio/Transistor 7.3 4.0 5.1 5.3
Black and White television 3.1 2.8 2.9 3.1
Color television 82.8 46.0 58.2 58.3
Sewing machine 25.6 14.9 18.5 20.9
Mobile telephone 91.0 80.3 83.9 86.4
Landline telephone 6.4 1.7 3.3 3.1
Internet connection 4.9 0.8 2.1 2.1
Desktop computer 5.8 0.9 2.5 2.6
Laptop 7.8 1.3 3.5 3.6
Refrigerator 33.9 7.7 16.3 16.8
Air cooler 19.6 5.3 10.0 10.8
Air conditioner 6.7 0.7 2.7 2.7
Washing machine 19.2 3.1 8.4 8.7
Watch/Clock 79.8 63.1 68.6 70.4
Bicycle 46.2 56.9 53.4 56.9
Motorcycle/Scooter 43.9 21.3 28.8 30.4
Animal Drawn cart 0.8 2.3 1.8 2.2
Car/Jeep 7.9 2.1 4.0 4.2
Water pump 9.9 7.6 8.3 9.0
Thresher 0.3 1.2 0.9 1.2
Tractor 0.3 1.9 1.3 1.9
No assets 0.3 1.1 0.8 0.6
Total households 34,775 70,707 1,05,482 4,95,571
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2.8.2 Wealth Index Table 2.39 presents the distribution of population by wealth quintiles according to their social group and religious affiliations. The economic inequality based on social group status is also corroborated by RSOC data. In terms of economic status, ST and SC population are at the bottom rung. This is evident from the fact that 40 percent of ST and 26 percent of SC population falls in the poorest category as compared to 16 percent for OBCs and 10 percent for Others. At the same time, the share of SC and ST population in their respective richest group is 12 percent and 8 percent respectively. The proportion of population in the richest quintile is the least among Buddhists (17 percent) followed by Hindus (20 percent) and Muslims (21 percent). Christians with 24 percent of population in the highest quintile are comparatively wealthier. About 43 percent of urban residents are in the highest wealth quintile, as compared with only 11 percent of rural residents. More than half (51 percent) of the rural population falls in the last two quintiles, as compared to 12 percent of urban population which illustrates the rural-urban inequality. This, to a large extent, explains the poor performance of rural folks on critical indicators related to education, sanitation and health as compared to their urban counterparts.
Table 2.39: Wealth Quintiles by Social Group and Religion
Percent distribution of the household population by wealth quintile, according to social-group and religion, India, RSOC, 2013-14.
State
Wealth Index Total
Total
population Lowest Second Middle Fourth Highest
Residence Urban Rural
Social - Group Scheduled Caste Scheduled Tribe OBC Other No Response
Religion Hinduism Islam Christianity Sikhism Jain Buddhism No religion Others
Total
3.8
25.8
25.6 39.5 16.2
9.8 25.5
19.7 17.0 11.6
1.3 3.3
15.8 17.8 35.9 18.8
8.3
25.5
25.5 23.0 19.1 16.3 28.7
20.2 20.8 17.8
7.4 17.2 18.0 36.5 22.3 20.0
16.2 21.7
21.1 17.3 20.7 19.1 20.4
20.0 20.0 21.6 12.4 15.3 29.3 18.3 20.9 20.0
28.4 16.3
16.3 12.6 22.5 22.5
9.3
19.8 21.3 24.7 24.5
8.5 20.3 10.2 12.8 20.2
43.3 10.7
11.5
7.5 21.4 32.3 16.0
20.3 20.9 24.4 54.3 55.7 16.6 17.1
8.2 21.1
100.0 100.0
100.0 100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
1,57,750 3,37,821
95,610 53,770
2,00,943 1,41,670
3,580
3,96,380 71,635 12,802
7,876 1,233 3,607
306 1,732
4,95,571
Table 2.40 presents wealth quintiles by states. Across states, there is a large variation in the distribution of households through wealth quintiles. States like Mizoram, Delhi, Kerala, Punjab, Nagaland and Goa report almost negligible proportion of households in the poorest category, but at the same time there are states like Jharkhand (51 percent), Odisha (43 percent), Bihar (36 percent), Madhya Pradesh (34 percent) and Chhattisgarh (33 percent) wherein almost every 3rd person belongs to this category. Consequently, wide variations are also seen in the richest quintile, and how this economic inequality has impacted the state level performance on well-being of children and women will unfold in subsequent sections/chapters.
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Table 2.40: Wealth Quintile
Percent distribution of the household population by wealth quintiles, according to place of residence and states, India, RSOC, 2013-14.
Residence/State Wealth Index
Lowest Second Middle Fourth Highest Total
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh Uttarakhand
Central Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
18.8
0.2 4.0 2.1
11.0 0.8
22.4 4.3
33.2 34.4
35.9 51.4 42.7 22.6
4.9
12.4 7.7 4.8 0.0 0.9 3.5
10.7
13.8 0.8
15.3 12.6
7.1 8.0 0.7 5.0
20.0
1.9 11.8
7.3 19.1
5.3 24.0 12.1
24.7 19.9
28.5 19.4 23.3 23.4
24.2 41.5 27.2 31.9
1.9 27.2 11.8 26.4
19.6
3.4 17.3 14.9
19.4 18.6
3.4 16.2
20.0
10.7 18.1 22.3 24.6
9.6 18.7 19.4
16.4 14.5
17.9 11.8 16.2 22.5
33.8 23.9 28.7 30.4 18.3 29.2 27.9 34.6
21.5
8.7 20.0 21.4
27.8 23.4
7.2 28.8
20.2
21.2 25.7 30.4 20.8 24.0 16.9 28.0
11.5 13.3
10.7
8.2 9.7
18.9
24.1 12.2 22.4 23.6 40.0 24.2 40.2 17.5
20.4 25.1 22.9 24.7
29.7 25.9 29.0 32.4
21.1
65.9 40.5 37.8 24.6 60.3 18.1 36.2
14.1 17.9
7.0 9.2 8.0
12.7
13.0 10.0 13.9
9.2 39.8 18.4 16.7 10.8
24.6 62.0 24.6 26.4
15.9 24.1 59.7 17.6
100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
100.0 100.0 100.0 100.0
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2.9 IODINE LEVELS IN COOKING SALT
Iodine deficiency disorders (IDDs) constitute the single largest cause of preventable brain damage worldwide. Majority of consequences of IDDs are invisible and irreversible but at the same time these are preventable. In India, the entire population is prone to IDD due to deficiency of iodine in the soil of the subcontinent and consequently the food derived from it. To combat the risk of IDD, salt is fortified with iodine. IDD constitutes the single largest cause of preventable brain damage worldwide leading to learning disabilities and psychomotor impairment. Children living in iodine-deficient areas on an average have lower intelligence quotient (IQ), by as much as 13.5 IQ points as compared to children living in iodine-sufficient areas. IDDs have been shown to be associated with at least six of the eight MDG. Under RSOC, the cooking salt used by the households was tested to assess whether the salt is fortified with iodine. This was done using a salt testing kit that instantly yields the iodine content in the salt. Table 2.41 depicts the percentage of households using adequately iodized salt (more than or equal to 15 PPM) by residence, social groups and wealth quintiles. Sixty seven percent of households are using adequately iodized salt with a notable rural-urban differential. About 80 percent households use adequately iodized salt in urban areas as compared to 61 percent in rural areas. When analysed by social groups, 61 percent of SC, 62 percent of ST, 66 percent of OBCs and 76 percent of Other households use adequately iodized salt. Wealth index has a more pronounced impact with regard to use of adequately iodized salt. The proportion of households using adequately iodized salt shows a gradual increase across wealth quintiles both in rural as well as urban areas. The gap between the proportion of households belonging to the poorest and the richest category in terms of using adequately iodized salt is 37 percent at the overall level, and close to 33 percent in case of urban as well as rural households.
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Table 2.41: households using adequately iodized salt by selected characteristics Percentage of households using adequately iodized salt (more than or equal to 15 PPM) by selected background characteristics, according to residence, RSOC, 2013-14.
Background characteristic
Residence Total
Urban Rural
HH using cooking
salt more than or
equal to 15 PPM
Total
number of
households
HH using
cooking salt
more than or
equal to 15
PPM
Total number
of households
HH using
cooking salt
more than or
equal to 15
PPM
Total
number of
households
Social - group
Scheduled Caste 77.5 5,571 54.9 14,808 61.1 20,378
Scheduled Tribe 70.9 2,162 60.2 9,571 62.1 11,733
Other Backward Class 78.6 13,825 59.2 28,130 65.6 41,955
Other 83.2 12,967 70.4 17,646 75.8 30,613
Do not know 84.8 250 72.2 552 76.2 802
Wealth index
Lowest 55.2 1,476 49.1 19,620 49.6 21,096
Second 62.9 3,027 57.7 18,069 58.4 21,096
Middle 73.3 5,906 63.7 15,193 66.4 21,099
Fourth 80.0 10,043 72.3 11,053 76.0 21,096
Highest 88.2 14,323 83.1 6,772 86.6 21,095
Total 79.7 34,775 61.3 70,707 67.4 1,05,482
Table 2.42 presents the state wise picture with regard to use of adequately iodized salt. Seven states namely Nagaland, Mizoram, Meghalaya, Sikkim, Manipur, Assam and Kerala reported more than 90 percent of households using appropriately iodized cooking salt. On the other hand, states like Uttar Pradesh, Madhya Pradesh, Jharkhand, Andhra Pradesh and Tamil Nadu have reported below 60 percent, with Uttar Pradesh recording the least (47.7 percent). There is a substantial urban-rural variation seen in case of Uttar Pradesh, Madhya Pradesh, Jharkhand, West Bengal, Tripura, Rajasthan and Tamil Nadu.
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Table 2.42: Households using adequately iodized salt by state
Percentage of households using adequately iodized salt (more than or equal to 15 PPM) by state, according to
residence, RSOC, 2013-14.
State Residence
Total Urban Rural
India North
Delhi Haryana Himachal Pradesh Jammu & Kashmir Punjab Uttar Pradesh
Uttarakhand Central
Chhattisgarh Madhya Pradesh
East Bihar Jharkhand Odisha West Bengal
Northeast Arunachal Pradesh Assam Manipur Meghalaya Mizoram Nagaland Sikkim Tripura
West Rajasthan Goa Gujarat Maharashtra
South Andhra Pradesh Karnataka Kerala Tamil Nadu
79.7
82.7 91.3 85.7 93.2 90.1 74.8 93.1
80.0 74.3
78.7 76.2 93.0 89.8
88.4 94.4 94.1 96.8 98.9 99.2 98.6 86.7
80.5 84.6 88.2 82.8
62.2 75.1 93.9 68.4
61.3
78.6 83.1 88.6 81.1 86.8 39.5 78.4
65.4 50.1
60.9 49.0 84.3 66.9
80.8 91.5 96.7 96.3 99.5 99.5 94.7 58.5
58.6 80.9 73.0 75.3
50.4 57.5 86.7 46.5
67.4
82.6 86.1 88.3 84.3 88.1 47.7 83.0
68.7 56.7
62.9 54.9 85.7 74.4
82.9 92.0 95.8 96.4 99.2 99.4 95.8 66.4
64.1 83.2 80.2 78.8
54.6 64.8 90.1 57.3
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CHAPTER 3 PROFILE OF EVER MARRIED WOMEN AND CHILDREN
3.1 INTRODUCTION
The focus of RSOC is on the children in India. The survey studies the preventive and curative health
care given to the children and their nutritional status. Young children are under the care of their
mother and other women in the households. The health, nutritional status and utilization of health
care services depend on the characteristics of the women in the households. This chapter provides
details of the demographic and socio-economic characteristics of ever married women (EMW) in the
reproductive ages from the surveyed households. The profile of the women will help in building the
context for studying health and nutritional status of children.
In RSOC, the criterion for a woman to be eligible for individual interview was that a woman should
be ever-married and should be in the reproductive age-group of 15-49. So in RSOC, all the EMW in
reproductive ages of 15-49 from all the surveyed households were interviewed. The chapter
discusses demographic and socio-economic profile of these women. The educational attainment,
age at marriage, fertility performance and family planning practice of these women are discussed in
detail. The chapter also includes discussion on the educational attainment and age at the time of
marriage of adolescent girls.
As RSOC is about children below age six, the discussion on the demographic profile of the children,
birth registration and pre-school attendance is also a part of this chapter.
3.2 SOCIO-ECONOMIC PROFILE OF EVER MARRIED WOMEN
Table 3.1 presents distribution of EMW in rural, urban and total areas by age-group, educational
attainment, religion, social group, occupation and wealth quintile. The proportion of women
increases from three percent in the youngest age-group of 15-19 to 15 percent in 20-24 age-group
and 21 percent in 25-29 age-group. From age 30 onwards, there is a decrease in the proportion of
women in subsequent age-groups. The same pattern is observed in both rural and urban areas. The
small proportion of ever married women aged 15-19 is an indication of increase in marriage age in
recent years.
Among all the ever-married women 40 percent do not have any education, and six percent have
gone to school but did not complete primary schooling. Another 15 and 13 percent of the women
have completed primary and middle school education respectively. All the remaining 26 percent of
the women have completed secondary schooling. Among them 12 percent have completed
Secondary School Certificate (SSC) and 14 percent have completed Higher Secondary Certificate
(HSC). These 14 percent women who have completed HSC also include women who have completed
college or university education.
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Table 3.1: Socio-economic and demographic characteristics of respondents
Percent distribution of ever married women aged 15-49 by background characteristics, RSOC, 2013-14
Background characteristic Residence
Total Urban Rural
Age
15-19 1.6 3.0 2.6
20-24 13.4 16.2 15.3
25-29 21.2 20.6 20.8
30-34 18.8 17.5 18.0
35-39 17.5 15.8 16.4
40-44 13.1 12.4 12.6
45-49 14.4 14.5 14.3
Education
No Education 23.0 47.3 39.3
Below Primary 4.9 6.2 5.8
Completed Primary 14.4 15.4 15.0
Completed Middle 15.0 12.6 13.4
Completed Secondary 17.1 9.9 12.3
Completed Higher Secondary and above 25.6 8.6 14.2
Religion
Hinduism 77.6 82.1 80.6
Islam 16.2 12.5 13.7
Christianity 3.1 2.4 2.6
Sikhism 1.3 1.7 1.6
Jainism 0.4 0.2 0.3
Buddhism/Neo-Buddhism 1.0 0.6 0.7
No Religion 0.1 0.1 0.1
Other 0.4 0.4 0.4
Social-group
Scheduled Caste 16.2 20.8 19.3
Scheduled Tribe 6.1 13.2 10.9
Other Backward Classes 39.6 40.2 40.0
Other 37.3 25.0 29.1
No Response 0.7 0.8 0.8
Wealth Index
Lowest 3.6 24.7 17.7
Second 8.1 25.3 19.7
Middle 16.5 22.2 20.3
Fourth 28.5 16.8 20.7
Highest 43.3 10.9 21.6
Occupation
Cultivator 0.6 10.1 7.0
Wage labourer 7.1 16.8 13.6
Self employed 4.2 2.1 2.8
Regular salaried/Wage employee 4.8 2.2 3.1
Other 1.0 0.5 0.7
Non-working 82.3 68.4 73.0
Total 32,556 66,027 98,583
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The distribution of ever married women by religion, social group and wealth quintile is much similar
to that of surveyed households by these characteristics. Among the ever married women most (81%)
belong to Hindu religion, 14 percent belong to Islam and remaining 5 percent are from all other
religions. The proportion of women from Islam is a little higher in urban areas (16%) than in rural
areas (13%). About one-fifth (19%) of the women are from scheduled castes (SCs), 11 percent are
from scheduled tribes (STs), 40 percent are from other backward classes (OBCs) and remaining 29
percent are from Other castes. The proportion of women from SC and ST is relatively higher in rural
areas and that from Other castes is higher in urban areas. Almost equal proportion of women belong
to each of the wealth quintiles. The economic status of women from urban areas is better than their
rural counterpart, as more than two-thirds (72%) of women in urban areas belong to two highest
wealth quintiles compared to 28 percent of women in rural areas.
Most of the ever married women aged 15-49 (73%) are not engaged in any work besides their own
household work. The proportion of women not engaged in any occupation is higher in urban (82%)
than rural areas (68%). Among the 27 percent of working women, most are occupied as wage
labourers (14%) or cultivators (7%).
The percent distribution of ever married women age 15-49 by social group and educational
attainment and literacy rates across the states are presented in Annexure Table 3.1a and Table 3.2a
respectively.
3.3 SCHOOL ENROLMENT OF ADOLESCENT GIRLS
In RSOC, information on the school attendance during school year 2012-13 was collected for all the
household members aged 5-24. The Head of the household or the respondent of the Household
questionnaire was asked about each household member aged 5-24, whether he/she attended
school/college during 2012-13 and the grade he/she attended during that year. Table 3.2 gives the
percent distribution of adolescent girls by the standard they were attending in 2012-13. More than
three-fourth (78%) of the adolescent girls were attending school in 2012-13. Out of the 22 percent of
the girls who were not attending school, eight percent never attended school at all and remaining 15
percent attended school sometimes but dropped out of school before the school year 2012-13.
Among the 78 percent of the girls who were attending school, 12 percent were in classes 1-4, 35
percent in classes 5-8, 17 percent in classes 9-10 and the remaining 14 percent were in classes above
the 10th standard.
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Table 3.2: Current educational status of adolescent girls aged 10-19 during 2012-13
Percent distribution of adolescent girls age 10-19 by the grade they were attending during the school year
2012-13 according to selected background characteristics, RSOC, 2013-14
Background characteristic
Never
attended
school
Did not
attend
school in
2012-13
Attending grade
Total
Number of
adolescent
girls
Primary
(1-4)
Middle
(5-8)
Secondary
(9-10)
Higher
secondary or
higher (11th
or
higher grade)
Age-group
10-14 6.4 4.1 23.8 57.9 7.6 0.3 100.0 25,187
15-19 9.4 25.9 0.5 11.0 26.0 27.3 100.0 23,959
Residence
Urban 4.6 12.4 10.0 35.8 18.2 19.0 100.0 13,971
Rural 9.1 15.6 13.3 34.7 15.9 11.3 100.0 35,175
Religion
Hinduism 7.2 13.6 12.2 35.0 17.3 14.7 100.0 38,655
Islam 11.8 20.1 14.3 33.2 13.3 7.2 100.0 8,109
Christianity 5.3 15.1 6.8 39.6 17.2 16.0 100.0 1,228
Sikhism 4.4 10.9 14.9 35.7 16.9 17.2 100.0 636
Jainism (6.5) (0.0) (22.6) (41.9) (16.5) (12.9) 100.0 31
Buddhism/Neo-Buddhism 2.8 17.1 7.7 52.6 11.3 8.4 100.0 305
Other 10.3 8.7 11.6 44.3 14.3 10.7 100.0 146
No Response (6.7) (10.0) (13.3) (40.0) (20.0) (10.0) 100.0 20
Social-group
Scheduled Caste 9.7 15.7 14.1 34.5 15.1 10.9 100.0 10,085
Scheduled Tribe 12.3 17.5 11.6 34.2 14.8 9.6 100.0 5,357
Other backward Classes 7.8 13.6 12.4 34.9 16.6 14.7 100.0 20,696
Other 4.6 14.6 11.2 35.8 18.6 15.2 100.0 12,698
No Response 6.0 17.9 21.2 37.5 8.2 9.1 100.0 309
Wealth Index
Lowest 16.4 17.6 18.1 33.9 10.2 3.8 100.0 9,801
Second 10.1 16.1 13.3 37.1 14.7 8.7 100.0 10,889
Middle 6.5 18.1 9.7 34.6 17.8 13.3 100.0 10,256
Fourth 3.3 13.3 10.4 34.8 21.2 17.0 100.0 9,712
Highest 1.8 7.3 10.1 34.2 19.6 27.0 100.0 8,487
Total 7.8 14.7 12.4 35.0 16.6 13.5 100.0 49,145
( ) Based on 25-49 unweighted cases.
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The proportion of girls who never attended school as well as the proportion who did not attend
school in the year 2012-13 was much higher among girls aged 15-19 than 10-14. School attendance
dropped from 90 percent among the young girls aged 10-14, to 65 percent among the girls aged 15-
19. Most of the older girls aged 15-19 were studying in higher grades compared to younger girls.
School attendance was higher in urban areas than in rural areas, as 83 percent of the girls from
urban areas and 75 percent from the rural areas were attending school during school year 2012-13.
Relatively higher proportion of the girls from the urban areas than rural areas were attending higher
grades. Among the adolescent girls from the four social groups, relatively higher proportion of girls
from the OBCs (79%) and Other castes (81%) were enrolled than those from SC (75%) and ST (70%).
Higher economic status leads to substantial increase in school enrolment of girls. The proportion of
girls who never attended school dropped from 16 percent among girls from the lowest wealth
quintile to only 2 percent among those from the highest wealth quintile. Similarly, the proportion of
those who did not attend school in the year 2012-13 also dropped from 18 percent among the girls
aged 10-19 in the lowest wealth quintile to 7 percent among those from the highest wealth quintile.
The proportion of the girls attending grades higher than 10th standard also increased with the better
economic status.
The state-wise percent distribution of adolescent girls by the standard they were attending in 2012-
13 is presented in Annexure Table 3.3a.
3.4 MARITAL STATUS
Marriage marks an important event in an individual’s life. In case of women, it marks the beginning
of the reproductive performance. Marital status and marriage age are determined by many of the
socio-economic and cultural factors and in turn they shape many of the socio-economic factors in
the society. The age at marriage has an impact on fertility, family planning practices, maternal health
and health care as well as infant and child mortality, and child care practices. RSOC collected data on
marital status and age at first marriage for every male and female household member aged 10 and
above, in the household questionnaire. The interviewee was head of the household. From all the
interviewed ever married women aged 15-49, age at marriage was verified by asking them about age
at marriage once again. The marital status distribution of all the women, irrespective of their
interview status, by residence and age-group is presented in Table 3.3. In the age-group of 15-19
most of the women (87%) were never married, one percent was married but their gauna was yet to
be performed, and the remaining 12 percent were married and had started living with their
husband.
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Table 3.3: Marital status of women
Percent distribution of women age 15-49 by marital status, according to age and residence, RSOC,
2013-14
Residence/Age
Marital status
Total
Number
of
women
Never
married
Currently
married
and gauna
performed
Widowed Divorced Separated
Not stated/
married but
gauna not
performed
Urban
15-19 91.1 8.4 0.0 0.0 0.0 0.4 100.0 6,919
20-24 40.2 58.4 0.3 0.2 0.6 0.3 100.0 7,804
25-29 10.6 87.6 0.9 0.4 0.4 0.1 100.0 8,164
30-34 2.6 94.4 1.9 0.3 0.5 0.2 100.0 6,674
35-39 1.4 93.7 3.6 0.4 0.7 0.2 100.0 6,074
40-44 1.2 90.4 7.2 0.3 0.4 0.4 100.0 4,511
45-49 0.5 88.3 10.1 0.5 0.4 0.2 100.0 4,948
15-49 23.6 72.6 2.8 0.3 0.4 0.3 100.0 45,093
Rural
15-19 85.6 12.9 0.0 0 0 1.4 100.0 17,039
20-24 25.0 73.4 0.5 0.1 0.5 0.5 100.0 15,295
25-29 4.3 94.1 0.8 0.2 0.6 0.2 100.0 15,064
30-34 1.5 96.0 1.8 0.2 0.5 0.1 100.0 12,272
35-39 0.7 95.2 3.0 0.3 0.5 0.4 100.0 11,006
40-44 0.7 91.7 6.3 0.5 0.6 0.2 100.0 8,686
45-49 0.2 89.0 9.6 0.5 0.5 0.2 100.0 10,053
15-49 21.7 74.7 2.5 0.2 0.4 0.5 100.0 89,415
Total
15-19 87.2 11.6 0.0 0.0 0.0 1.1 100.0 23,959
20-24 30.2 68.3 0.4 0.1 0.5 0.4 100.0 23,099
25-29 6.5 91.8 0.8 0.2 0.5 0.1 100.0 23,227
30-34 1.9 95.4 1.8 0.2 0.5 0.1 100.0 18,945
35-39 0.9 94.7 3.2 0.3 0.5 0.3 100.0 17,080
40-44 0.9 91.2 6.6 0.4 0.5 0.3 100.0 13,197
45-49 0.3 88.8 9.8 0.5 0.4 0.2 100.0 15,001
15-49 22.3 74.0 2.6 0.2 0.4 0.4 100.0 1,34,508
The proportion of never married women dropped rapidly from 87 percent in the age-group 15-19 to
30 percent in the age-group 20-24 and further to 7 percent in the age-group 25-29. By age 30,
almost all the women were married as in the age-group 30-34 only two percent women were never
married and 99 percent were currently married. The proportion of widowed women was almost
negligible till the age 35, thereafter their proportion increased to 3 percent in the-group 35-39, 7
percent in the age-group 40-44 and further to 10 percent in the age-group 45-49. The pattern of age-
specific marital status distribution in rural and urban areas was quite similar, only the difference was
that in younger age-groups, the proportion of never married women was higher in urban areas than
rural areas. Relatively late marriages in urban areas resulted into higher proportion of never married
women in ages till 30.
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3.5 AGE AT FIRST MARRIAGE
Table 3.4 gives the percentage of women aged 15-49 who were married by specific exact ages, the
percentage who have never married, and the median age at first marriage according to current age
and residence. The percentages are based on the data on marital status of all the household
members aged 10 and above collected in the Household questionnaire.
Table 3.4: Age at first marriage
Percentage of women age 15-49 married by specific exact age and median age at first marriage, according to
residence and current age, RSOC, 2013-14
Residence/Age
Percent first married by exact age Percent
never
married/not
stated
Number
of
women
Median age
at first
marriage 15 18 20 21 25
Urban
15-19 0.5 na na na na 91.1 6,919 nc
20-24 1.8 13.4 36.6 na na 40.2 7,804 nc
25-29 2.5 17.4 41.9 54.5 81.5 10.6 8,164 19.64
30-34 3.0 21.9 47.6 60.6 84.2 2.6 6,674 19.18
35-39 5.2 27.3 52.9 66.1 86.1 1.4 6,074 18.69
40-44 5.6 29.0 57.4 70.0 88.3 1.2 4,511 18.18
45-49 7.1 33.2 60.1 73.6 90.1 0.5 4,948 17.90
20-49 3.8 22.4 47.8 63.6 85.5 11.4 38,174 19.18
25-49 4.4 24.7 50.6 63.6 85.5 4.0 30,370 18.93
Rural
15-19 1.7 na na na na 85.6 17,712 nc
20-24 4.0 25.1 55.3 na na 25.0 15,295 18.57
25-29 6.0 32.4 61.3 73.1 91.9 4.3 15,064 17.95
30-34 8.1 42.0 69.5 80.0 92.3 1.5 12,272 17.42
35-39 8.9 45.9 73.5 82.9 93.7 0.7 11,006 17.22
40-44 9.7 43.8 71.8 84.0 94.0 0.7 8,686 17.31
45-49 11.9 51.9 75.2 84.5 94.1 0.2 10,053 16.84
20-49 7.6 38.6 66.5 80.1 93.1 6.7 72,375 17.63
25-49 8.6 42.2 69.5 80.1 93.1 1.7 57,080 17.42
Total
15-19 1.4 na na na na 87.2 23,959 nc
20-24 3.2 21.1 49.0 na na 30.2 23,099 19.10
25-29 4.8 27.2 54.5 66.5 88.3 6.5 23,227 18.57
30-34 6.3 34.9 61.8 73.2 89.5 1.9 18,945 17.84
35-39 7.6 39.3 66.2 76.9 91.0 0.9 17,080 17.61
40-44 8.3 38.7 66.9 79.2 92.0 0.9 13,197 17.57
45-49 10.3 45.7 70.2 80.9 92.8 0.3 15,001 17.26
20-49 6.3 33.0 60.0 74.4 90.4 8.3 1,10,549 17.98
25-49 7.1 36.1 62.9 74.4 90.4 2.5 87,451 17.79
na = Not applicable due to censoring. nc = Omitted because less than 50 percent of the women were married for the first time before reaching the beginning of the age group.
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The median age at first marriage is the age by which 50 percent of the women marry. Among
women aged 20-49, six percent of the women married before age 15, 33 percent married before
18—the legal age at marriage and 60 percent married in their teens before age 20. The median age
at marriage for women aged 20-49 is 18 years. A slow change in the median age at marriage over the
period is observed from the increase in it from 17.26 years among women aged 45-49 to 18.57
among women aged 25-29. In recent period there is relatively faster increase in it to 19.1 among
women aged 20-24. The median age at marriage among women in urban areas is higher than that
among women in rural areas and the urban–rural difference in the median age at marriage is
increasing from about one year among women aged 45-49 to about two years among those aged 25-
29.
The extent of marriage among adolescent girls aged 10-19 is presented in Table 3.5. Among the girls
aged 10-19 six percent are married and four percent have married before attaining the legal age of
marriage which is 18. Out of these, a small proportion of 0.3 percent of girls aged 10-14 are married
and obviously all of them have married before attaining the age 18. Every one in eight girls (13%)
aged 15-19 is married and eight percent of them were married by age 18. Extent of early marriage is
at higher side in rural areas. The proportion of ever married and married by age 18 do not vary much
among young women from different social groups. With better economic status there is reduction in
the proportion of women who are ever married and those married by age 18.
Table 3.5: Age at first marriage among adolescent girls aged 10-19
Percentage of adolescent girls aged 10-19 married by age 18 and percentage of ever married, by background
characteristics, RSOC, 2013-14
Background characteristic
Percentage
married at age
below 18 years
Percentage
ever
married
Number of
adolescent
girls
Age
10-14 0.3 0.3 25,186
15-19 7.5 12.8 23,959
Residence
Urban 2.3 4.5 13,970
Rural 4.4 7.2 35,175
Social-group
Scheduled caste 4.3 7.5 10,085
Scheduled tribe 3.5 6.4 5,357
Other Backward Classes 3.7 6.0 20,696
Other 3.4 5.8 12,698
Don’t know 18.7 21.4 309
Wealth Index
Lowest 4.6 6.7 9,801
Second 4.8 7.1 10,889
Middle 4.6 8.6 10,256
Fourth 3.1 5.8 9,712
Highest 1.5 3.2 8,487
Total 3.8 6.4 49,145
Percentage of ever-married women age 15-49 who were ever-pregnant and percentage who had
their first pregnancy by age 18 across states is given in Appendix Table 3.4a.
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3.6 AGE AT FIRST PREGNANCY
Data on the age at first pregnancy and first live birth was collected from all the interviewed ever
married women aged 15-49 who ever became pregnant. Table 3.6 presents the distribution of ever
married by age at first pregnancy and median age at first pregnancy by different background
characteristics of women. Among all the ever married women aged 15-49, eight percent never
became pregnant; among the 92 percent women who ever became pregnant, 2 percent became
pregnant in the age-group 10-14 and another 48 percent in the age-group 15-19. In other words,
one-half of the ever married women had their first pregnancy when they were in their teen ages.
Almost one-half of the women aged 15-19 never became pregnant. However, the proportion of
women who never became pregnant decreased by 11 percent in the age-group 20-29 and then to 4
percent beyond age 30. The proportion of women who never became pregnant was almost equal
(6–8%) for women in different categories of residence, social group or wealth index. With increase in
education, the proportion of women who never became pregnant increased from 6 percent among
women with no education to 12 percent among women with 12 or more years of education.
Median age at first pregnancy among younger women aged 20-29 (20.4) was slightly higher than
that among women aged 40-49 (19.1). Among women in urban areas, the median age at first
pregnancy was more than one year higher than that among women in rural areas. Among women
from the four social groups, the median age at first pregnancy was the lowest among those
belonging to SC (18.4) and the highest among those from Other castes (19.4). With increase in
education as well as wealth quintile there was an increase in the median age at first pregnancy.
Median age at first pregnancy among women who completed secondary (25.2) was six years higher
than that among women with no education (18.7). Similarly, median age at first pregnancy among
women belonging to the highest wealth quintile (20.8) was more than one year higher than that
among women from the lowest wealth quintile (19.5).
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Table 3.6: Age at first pregnancy
Percent distribution of ever married women aged 15-49 by age at first pregnancy and median age at first
pregnancy, by background characteristics, RSOC, 2013-14
Background characteristic
Age at first pregnancy Percenta
ge never
pregnant
Number
of
women
Median
age at first
pregnancy 10-14 15-19 20-24 25-29 30-34 34+
Age
15-19 1.9 49.9 na na na na 48.2 2,533 nc
20-29 1.7 46.3 38.0 3.5 na na 10.5 35,581 20.4
30-39 2.3 48.1 34.4 9.4 1.7 0.2 4.0 33,859 19.3
40-49 2.6 48.8 33.8 7.8 1.6 1.3 4.1 26,610 19.1
Residence
Urban 1.7 40.2 38.8 9.7 1.9 0.1 7.5 32,556 21.8
Rural 2.3 51.3 32.6 5.1 1.1 0.0 7.5 66,027 20.3
Mother's education
No Education 3.2 56.7 28.7 4.4 1.3 0.1 5.7 38,713 18.7
Below Primary 3.1 58.0 27.9 4.8 1.6 0.0 4.5 5,693 19.1
Completed Primary 2.8 52.9 31.8 4.5 1.0 0.1 7.0 14,819 19.7
Completed Middle 1.2 47.3 36.9 5.4 0.8 0.0 8.3 13,200 22.0
Completed Secondary 0.6 38.4 42.1 7.9 1.5 0.0 9.5 12,133 25.2
Completed Higher
Secondary and above 0.2 21.4 48.3 15.7 2.4 0.0 11.9 14,024 nc
Social-group
Scheduled Caste 2.6 53.1 31.2 4.7 1.1 0.1 7.3 18,986 20.1
Scheduled Tribe 2.0 47.7 33.9 6.1 1.3 0.1 8.9 10,726 20.8
Other Backward Classes 1.9 47.9 35.5 6.2 1.3 0.0 7.1 39,405 20.8
Other 2.1 43.3 36.4 8.7 1.7 0.1 7.7 28,670 21.4
No Response 4.2 63.5 24.8 2.7 0.4 0.0 4.5 796 18.6
Wealth Index
Lowest 3.4 55.5 28.4 4.4 1.2 0.1 7.2 17,458 19.5
Second 2.5 54.1 30.8 4.0 1.1 0.0 7.5 19,380 19.9
Middle 2.0 51.3 32.0 5.4 1.0 0.1 8.2 20,013 20.5
Fourth 2.1 45.5 36.9 7.1 1.3 0.0 7.1 20,409 21.0
Highest 0.9 34.0 43.7 11.6 2.1 0.1 7.6 21,323 22.7
Total 2.1 47.7 34.7 6.6 1.4 0.1 7.5 98,583 20.8
na: Not applicable.
nc: Omitted because less than 50 percent of the women were pregnant for the first time before reaching the beginning
of the age group.
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The variation in the median age at marriage, first pregnancy and first live-birth by selected
background characteristics is presented in Table 3.7. It may be noted that all these medians refer to
all women including those who are never married. Hence the median age at first pregnancy
presented in this table is different from the median presented in the previous table, which refers to
ever married women. Median age at first marriage was 18.8 years. Median age at first pregnancy
(20.8) was two years higher than age at marriage (18.8) and median age at first live-birth (22.0) was
one year higher than median age at first pregnancy. In urban areas, all the three, i.e., age at
marriage, first pregnancy and first live-birth are higher than that in rural areas by about two years.
The decreasing trend in the age at marriage, first pregnancy and first live-birth with increase in the
age, in both urban and rural areas suggests an increasing trend in all the three with time period. In
both the urban and rural areas, there is substantial increase in all the three—median age at first
marriage, first pregnancy and first live-birth. The median age at first marriage among women with 12
or more years of schooling was 23.7 as compared to 17.1 among women with no education. Age at
first marriage and first pregnancy and live-birth is relatively lower among women from SC and higher
among those from other castes. Better economic status leads to delay in marriage and childbearing
as reflected in increasing trend in the age at marriage, first pregnancy and first live-birth with age in
both urban and rural areas. All the three ages—median age at first marriage, first pregnancy and first
live-birth—are almost three years higher among women from the highest wealth quintile as
compared to those from the lowest wealth quintile. Among women from different occupations,
marriage and initiation of childbearing is relatively late among those who are salaried/wage
employee and early among those who are either cultivators or wage labourers.
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Table 3.7: Median age at first marriage, first pregnancy and first live birth by background characteristics
Median age at first marriage, first pregnancy and first live birth for women aged 15-49 by residence, according
to background characteristics, RSOC, 2013-14
Background characteristic
Urban Rural Total
Median age at first Median age at first Median age at first
Marriage Pregnancy Live birth
Marriage Pregnancy Live birth
Marriage Pregnancy Live birth
Age 15-19 nc nc nc nc nc nc nc nc nc 20-24 20.5 nc nc 18.6 20.3 21.8 19.1 21.1 nc 25-29 19.6 20.9 21.9 18.0 19.5 20.5 18.6 19.9 21.0 30-34 19.2 20.6 21.6 17.4 19.0 20.0 17.8 19.5 20.5 35-39 18.7 20.0 21.1 17.2 18.6 19.7 17.6 19.0 20.1 40-44 18.2 19.7 20.7 17.3 19.0 20.0 17.6 19.2 20.3 45-49 17.9 19.7 20.8 16.8 18.9 19.9 17.3 19.1 20.2
Education No education 17.6 19.0 20.1 17.0 18.7 19.7 17.1 18.7 19.8 < 5 years complete 17.5 19.1 20.1 17.4 19.1 20.2 17.5 19.1 20.2 5-7 years complete 18.0 19.6 20.7 17.9 19.7 20.9 17.9 19.7 20.8 8-9 years complete 19.4 21.2 22.4 19.6 22.8 24.9 19.5 22.0 23.7 10-11 years complete 20.9 23.4 24.6 21.8 nc nc 21.4 25.2 27.8 12 or more years complete 23.4 26.5 28.7 24.2 nc nc 23.7 nc nc
Religion Hinduism 19.8 21.8 23.0 18.1 20.3 21.5 18.7 20.8 22.0 Islam 19.3 21.1 22.4 17.9 19.8 21.0 18.5 20.3 21.5 Christianity 22.5 24.4 25.7 20.8 22.5 23.6 21.5 23.3 24.5 Sikhism 21.4 23.0 24.0 20.0 21.5 22.8 20.4 21.9 23.1 Jainism 22.3 24.4 26.0 18.4 19.5 20.4 19.8 22.1 23.6 Buddhism/Neo-Buddhism 19.9 22.0 24.7 18.5 20.3 21.3 19.1 20.8 22.2 No Religion 19.4 20.2 21.2 21.3 23.8 24.8 20.3 23.0 24.0 Other 19.1 20.5 21.5 17.9 20.5 22.2 18.4 20.5 21.8
Social-group Scheduled Caste 19.5 21.2 22.5 17.7 19.7 20.8 18.0 20.1 21.3 Scheduled Tribe 19.7 21.8 23.2 18.5 20.6 21.8 18.8 20.8 22.0 Other Backward Classes 19.6 21.7 22.9 18.1 20.4 21.6 18.7 20.8 22.1 Other 20.2 22.3 23.5 18.7 20.7 21.9 19.4 21.4 22.6 No Response 17.4 19.0 20.1 16.8 18.4 19.6 17.0 18.6 19.7
Wealth index Lowest 17.8 19.5 20.6 17.5 19.5 20.7 17.5 19.5 20.7 Second 18.5 20.6 21.9 17.8 19.9 21.0 17.9 19.9 21.1 Middle 19.0 20.8 22.2 18.2 20.4 21.6 18.4 20.5 21.7 Fourth 19.5 21.3 22.5 18.9 20.8 22.2 19.2 21.0 22.3 Highest 21.0 23.0 24.1 19.9 22.2 23.6 20.6 22.7 23.9
Occupation Cultivator 17.1 19.0 20.2 16.8 18.4 19.5 16.8 18.5 19.5 Wage labourer 17.3 18.6 19.7 17.1 18.3 19.3 17.1 18.3 19.4 Self employed 18.2 19.3 20.3 17.4 18.7 19.7 17.8 18.9 20.0 Regular salaried/wage
employee 19.6 20.8 21.9 18.0 19.4 20.5 18.9 20.0 21.1
Other 18.6 19.2 20.5 17.8 20.0 21.1 18.3 19.4 20.6 Non-working 18.7 19.8 20.9 17.5 18.9 20.0 17.9 19.2 20.3
Total 19.8 21.8 23.1 18.2 20.3 21.5 18.8 20.8 22.0
nc: Not calculated because less than 50 percent of the women had a birth before reaching the beginning of the age group
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3.7 TEENAGE CHILDBEARING
Teenage pregnancy is an important public health problem in India as age at marriage in most of the
states is quite low. Teenage pregnancy is a ‘high risk’ pregnancy due to its association with various
adverse maternal and foetal outcomes which result in increased mortality and morbidity of the
mother and the child. In addition to the biological disadvantage due to younger age the teenage
mothers also face risks associated with socio-economic factors like lower level of education, and
thus lesser knowledge of maternal and child health care and its utilization.
Based on the information collected from all ever married women aged 15-19 about number of live
births and current pregnancy status, Table 3.8 presents percentage of women aged 15-19 who have
had a live birth or who are pregnant with their first child, and percentage of those who have begun
childbearing, by background characteristics.
Table 3.8: Teenage pregnancy and motherhood
Percentage of women aged 15-19 who had a live birth, who were pregnant with first child and who began
childbearing by background characteristics, RSOC, 2013-14
Background characteristic
Percentage of women Number of
women Who have had
a live birth
Pregnant with
first child
Who have begun
childbearing
Age
15 0.0 0.0 0.1 5,363
16 0.2 0.4 0.6 5,137
17 1.0 1.0 2.0 4,265
18 4.4 3.6 8.0 5,608
19 13.5 6.2 19.7 3,584
Residence
Urban 2.8 1.2 3.9 6,919
Rural 3.5 2.4 5.9 17,039
Mother's education
No education 9.6 4.1 13.7 2,241
<5 years complete 9.6 2.2 11.8 667
5 -7 years complete 5.0 2.5 7.5 3,156
8 -9 years complete 3.0 2.5 5.5 6,259
10-11 years complete 1.4 0.9 2.3 7,155
12 or more years complete 1.2 2.0 3.2 4,480
Social-group
Scheduled Caste 4.2 2.7 6.9 4,816
Scheduled Tribe 3.6 1.5 5.2 2,576
Other Backward Classes 2.7 1.8 4.5 10,099
Other 3.2 2.1 5.3 6,319
No response 11.4 3.4 14.7 149
Wealth Index
Lowest 4.1 2.0 6.2 4,127
Second 3.9 2.2 6.1 5,124
Middle 3.8 2.7 6.5 5,354
Fourth 3.0 2.3 5.3 4,861
Highest 1.4 0.9 2.3 4,493
Total 3.3 2.1 5.3 23,959
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Among all the women aged 15-19, three percent have had a live-birth, additional two percent had
no live-birth but were pregnant at the time of survey. So in all 5 percent of the women had started
childbearing in their teens. Practically, not a single woman aged 15 was either already a mother or
pregnant at the time of survey. However, by age 18, eight percent had initiated childbearing and by
age 19 the proportion rose to 20 percent. Teenagers in rural areas are more likely to initiate
childbearing in their teens compared to their urban counterparts. However, the rural–urban
differentials in initiation of childbearing in teen ages are quite small. Education seems to bring
substantial reduction in teenage fertility, as only 2-3 percent of the women aged 15-19 having 10 or
more years of schooling have initiated childbearing compared to 14 percent of their counterparts
having no education. The proportion of woman aged 15-19 who have begun childbearing is higher
among women from SC (7%) than women from all other three social groups (5%). The level of
teenage pregnancy and motherhood decreases with increase in wealth index.
State-wise percentage of women aged 15-19 who have had a live birth or who are pregnant with
their first child, and percentage who have begun childbearing, by background characteristics is given
in the Annexure Table 3.5a.
3.8 CHILDREN EVER BORN AND LIVING
From all the ever married women interviewed RSOC collected data on the number of children ever
born to them and the number living at the time of survey. Table 3.9 gives the distribution of women
by the number of ever born and living children. Among the ever married women aged 15-19, 69
percent did not bear any live-birth and 70 percent did not have any living child. The proportion of
women with no live-birth decreased to 25 percent in the age-group 20-24 and to eight percent in 25-
29. About 4-5 percent of women aged 30 and above did not have any live-birth at all. The mean
number of ever born children increased from 0.4 among the women aged 15-19 to 3.5 in the age-
group 45-49. The mean number of living children increased from 0.3 in the age-group 15-19 to 3.1 in
the age-group 45-49.
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Table 3.9: Children ever born and living
Percent distribution of ever married women age 15-49 by number of ever born children, mean number of ever
born children and percent distribution of ever married women by number of living children and mean number
of living children according to age, RSOC, 2013-14
Age group
Children ever born Mean number of ever
born children
Living children Mean number of living children
Number of
women 0 1 2 3 4+ Total 0 1 2 3 4+ Total
15-19 68.9 26.9 3.2 0.6 0.5 100.0 0.4 69.9 26.4 2.8 0.5 0.5 100.0 0.3 2,533
20-24 24.7 43.5 25.0 5.5 1.2 100.0 1.2 26.3 43.6 24.7 4.5 0.8 100.0 1.1 15,036
25-29 8.1 26.3 39.5 17.4 8.6 100.0 2.0 9.4 26.9 40.1 17.1 6.5 100.0 1.8 20,545
30-34 4.9 12.9 36.7 24.3 21.2 100.0 2.6 6.0 13.8 37.9 24.7 17.6 100.0 2.4 17,697
35-39 4.1 9.4 31.8 25.2 29.5 100.0 3.0 5.0 9.7 33.8 25.8 25.7 100.0 2.7 16,161
40-44 4.3 9.8 28.7 22.5 34.7 100.0 3.2 5.1 10.4 29.9 24.2 30.4 100.0 2.9 12,436
45-49 5.0 8.9 23.5 20.9 41.7 100.0 3.5 5.7 9.4 25.7 22.8 36.5 100.0 3.1 14,174
Total 10.0 19.2 30.9 18.8 21.0 100.0 2.4 11.1 19.7 32.0 19.3 17.9 100.0 2.3 98,583
Table on Percentage of ever married women aged 15-49 who ever had a live birth and mean number
of ever born and living children by state is presented in Annexure (Table 3.6a).
Among the women aged 15-49 many women in the younger ages are yet continuing childbearing,
the mean number of ever born children of them may not give correct idea of the fertility. Since most
of the women complete childbearing by age 35, the mean number of ever born children among
women older than this age can provide good idea about the completed cohort fertility. Mean
number of ever born and living children for women aged 35-49 by selected background
characteristics is presented in Table 3.10. About 93 to 96 percent of the women from each category
of residence, education, social group and wealth index have ever given a live-birth. Urban fertility is
much lower than rural fertility. The mean number of ever born children and living children among
women in urban areas (2.6 and 2.5 respectively) is much lower than those among women in rural
areas (3.5 and 3.1 respectively).
Among the four social groups, fertility of women from the other castes is lower compared to that of
women from all the remaining three social groups. With increase in education as well as economic
status there is a sharp fall in the fertility. The mean number of ever born children decreases from 3.8
among women with no education to 2.0 among with 12 or more years of education. Similarly, the
mean number of ever born children decreases from 3.9 among women in the lowest wealth quintile
to 2.5 among women in the highest wealth quintile.
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Table 3.10: Children ever born and living by background characteristics
Percentage of ever married women age 35-49 who ever had a live birth and mean number of ever born and
living by background characteristics, RSOC, 2013-14
Background characteristic
Percentage who
ever had a live
birth
Mean number of
ever born children
Mean
number of
living
children
Number of
ever married
women
Residence
Urban 95.1 2.6 2.5 14,638
Rural 95.8 3.5 3.2 28,133
Woman's education
No education 95.6 3.8 3.4 21,709
<5 years complete 95.8 3.2 2.9 2,862
5-7 years complete 95.1 2.8 2.7 5,893
8-9 years complete 95.7 2.7 2.5 4,190
10-11 years complete 95.2 2.3 2.2 4,086
12 or more years complete 95.9 2.0 2.0 4,033
Social-group
Scheduled Caste 95.3 3.5 3.2 7,881
Scheduled Tribe 93.4 3.2 2.9 4,640
Other Backward Classes 95.4 3.3 3.0 17,202
Other 96.6 2.9 2.7 12,735
No Response 94.1 3.5 3.1 314
Wealth Index
Lowest 94.2 3.9 3.5 7,441
Second 95.2 3.7 3.3 8,340
Middle 96.0 3.2 3.0 8,325
Fourth 95.9 2.9 2.7 8,648
Highest 96.1 2.5 2.4 10,017
Total 95.5 3.2 2.9 42,771
Percentage of ever married women age 35-49 who ever had a live birth and mean number of ever
born and living children by state is annexed in Appendix Table 3.7a.
3.9 BIRTH ORDER
RSOC was not planned to estimate period fertility rates like Total Fertility Rate (TFR). However, the
distribution of live-births in three years preceding the survey, to all interviewed ever married women
aged 15-49, by order of birth indirectly reflects current fertility levels in the population. A larger
proportion of higher order births indicate higher fertility in a population. Table 3.11 presents percent
distribution of live-births in three years preceding the survey by birth order, according to
background characteristics.
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Table 3.11: Birth order
Percent distribution of live-births in three years preceding the survey by order of birth according to
background characteristics, RSOC, 2013-14
Background characteristic Birth order Number of live-
births 1 2 3+ Total
Mother's Age
15-19 87.3 11.1 1.5 100.0 1,539
20-29 51.1 32.8 16.1 100.0 41,225
30-39 26.7 24.7 48.6 100.0 10,867
40-49 30.6 13.0 56.5 100.0 919
Residence
Urban 53.2 31.2 15.6 100.0 16,320
Rural 44.2 29.9 26.0 100.0 38,230
Mother's education
No education 33.1 26.6 40.2 100.0 17,616
<5 years complete 37.3 29.4 33.3 100.0 2,615
5-7 years complete 44.7 34.0 21.3 100.0 8,351
8-9 years complete 50.0 33.9 16.1 100.0 8,562
10-11 years complete 57.0 32.7 10.2 100.0 7,602
12 or more years complete 65.4 28.6 5.9 100.0 9,805
Religion
Hinduism 47.8 31.2 21.0 100.0 42,653
Islam 39.7 25.8 34.5 100.0 9,074
Christianity 52.3 32.4 15.3 100.0 1,278
Sikhism 55.4 32.3 12.3 100.0 825
Jainism 80.5 13.0 6.5 100.0 119
Buddhism/Neo-Buddhism 62.6 26.1 11.3 100.0 338
No Religion 48.5 14.4 37.1 100.0 36
Other 52.7 30.3 17.0 100.0 224
Social-group
Scheduled Caste 44.1 31.0 24.9 100.0 10,976
Scheduled Tribe 45.3 28.8 25.9 100.0 6,311
Other Backward Classes 46.0 30.1 23.9 100.0 21,886
Other 51.4 30.3 18.3 100.0 14,828
No Response 33.4 35.5 31.1 100.0 550
Wealth Index
Lowest 34.0 28.1 37.9 100.0 10,977
Second 41.8 30.2 28.0 100.0 11,248
Middle 48.0 31.2 20.9 100.0 11,213
Fourth 53.9 30.9 15.2 100.0 11,092
Highest 57.7 31.0 11.3 100.0 10,020
Total 46.9 30.3 22.9 100.0 54,550
( ) Based on 25-49 unweighted cases.
Majority (47%) of the births that occurred three years prior to the survey were first order births. The
proportion of second and third order births was 30 and 23 percent respectively. Eighty-seven
percent of the live-births to mothers aged 15-19 were of the first order and only 2 percent were of
the order three and above. On the other hand among mothers aged 40 and above 31 percent were
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of order one and 57 percent were of order three and above. However, in total births the share of
births to mothers below age 20 or above age 40 was quite small. Most of the births occurred to
women aged 20-29 and among them 51 percent were of order one and 16 percent were of order
three and above. The proportion of births that are of order three or higher, is 16 percent in urban
areas and 26 percent in rural areas. The proportion of births of order three and above is relatively
higher among women from Islam religion (35%) and those from STs (26%) in comparison to their
respective counterparts from different religions (7-21%) and social groups (18-25%). With increase in
woman’s education and wealth index there is a sizeable decrease in the births that are of order
three and above. For example, 40 percent of the births to women with no education were of order
three and above compared to only six percent of the births to women having 12 or more years of
education.
Percent distribution of live-births in the three years preceding the survey by order of birth, according
to states is presented in Appendix Table 3.8a.
3.10 FAMILY PLANNING PRACTICES
Contraceptive prevalence rate and method mix are the important determinants of fertility. They also
have an impact on the reproductive health of women. RSOC collected data on the current use of
family planning and the method used from all the currently married non-pregnant respondents of
individual interview. Table 3.12 presents percent distribution of currently married women by the
family planning method they or their husband were using. The prevalence of contraceptive use
among the currently married women aged 15-49 was 58 percent. Most (88%) of the women among
the users were using modern contraceptive methods and 13 percent of the users were using
traditional methods. A small proportion of the users reported use of multiple methods. Female
sterilization was the most common method used by more than two-thirds (67%) of the users. Among
the spacing methods, the most widely used methods were condom (6%) and pills (5%).
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Table 3.12: Current use of family planning Percentage of currently married women aged 15-49 using family planning by method currently using according to background characteristics
Background characteristic
Percentage using
any family
planning method
Modern methods Traditional Methods
Using any modern method
Female sterilization
Male sterilization
IUD Pills Condom Any other modern
method*
Using any traditional
method
Lactational amenorrhoea
Periodic abstinence/Rhythm
Withdrawal Any other traditional
method
Number of
currently married women
Age 15-19 24.2 17.1 4.4 0.1 0.5 5.7 6.9 0.2 8.1 1.7 4.0 3.4 0.7 2,513 20-24 35.9 27.5 12.4 0.3 0.9 6.6 7.7 0.3 9.5 2.4 5.2 2.8 0.8 14,798 25-29 53.6 46.0 30.0 0.5 1.3 6.5 8.2 0.7 9.0 1.6 5.2 2.7 0.8 20,209 30-44 66.7 60.5 49.3 0.7 0.9 4.7 5.6 0.4 7.1 0.9 4.2 2.4 0.8 44,234 45-49 65.6 60.8 55.6 1.0 0.5 1.8 2.5 0.1 5.5 0.6 3.1 1.3 1.4 12,659
Residence
Urban 59.8 54.3 40.2 0.6 1.3 4.9 7.7 0.5 6.6 0.9 4.1 2.1 0.8 31,051 Rural 56.8 49.5 38.4 0.7 0.7 5.1 5.3 0.4 8.2 1.5 4.6 2.6 1.0 63,362
Educational status
No education 58.2 51.4 43.1 0.6 0.5 3.3 4.3 0.3 7.5 1.6 4.1 2.2 0.9 36,548 <5 years complete 67.3 59.4 46.8 0.5 0.9 9.0 2.8 0.5 9.1 1.2 5.1 3.0 1.1 5,350 5-7 years complete 61.1 54.8 43.2 0.4 0.7 6.2 4.7 0.3 7.2 1.3 4.2 2.2 0.6 14,186 8-9 years complete 56.7 48.9 34.1 0.9 1.0 7.2 6.7 0.5 8.9 1.4 5.6 2.9 0.9 12,799 10-11 years complete 56.2 51.1 36.9 0.8 1.2 5.4 7.5 0.4 6.4 0.8 3.9 2.2 0.9 11,790 12 or more years
complete 51.6 45.2 27.3 0.6 1.9 4.4 11.7 0.7 7.9 0.7 4.9 2.6 1.2 13,740
Caste
Scheduled Caste 57.6 50.5 39.8 0.9 0.5 4.5 5.1 0.5 7.9 1.6 4.3 2.4 0.9 18,137 Scheduled Tribe 54.1 48.1 39.4 0.4 0.9 4.4 3.3 0.4 6.6 1.4 3.6 1.8 0.7 10,211 OBC 56.3 51.0 40.7 0.6 1.0 3.0 6.2 0.4 6.1 1.0 3.6 1.8 0.6 37,779 Others 61.0 52.5 36.2 0.6 1.1 8.0 7.7 0.4 10.0 1.4 6.0 3.5 1.4 27,531 Do Not Know 66.5 57.4 32.7 0.3 0.5 20.7 4.1 0.0 10.6 1.4 4.3 5.0 0.3 757
Wealth Index
Lowest 51.2 44.4 34.9 0.9 0.4 5.2 3.6 0.3 7.4 1.7 3.6 2.4 0.7 16,446 Second 56.8 48.8 38.0 0.4 0.7 5.9 4.3 0.3 9.0 1.6 5.1 3.0 1.0 18,557 Middle 57.5 50.6 40.2 0.4 0.6 5.3 4.5 0.4 7.8 1.3 4.5 2.6 1.0 19,059 Fourth 60.5 54.4 42.7 0.7 1.0 4.7 6.0 0.4 7.2 0.9 4.5 2.1 0.9 19,588 Highest 61.4 55.7 38.6 0.9 1.7 4.2 11.2 0.6 7.0 0.9 4.4 2.0 1.0 20,763
Total 57.8 51.1 39.0 0.6 0.9 5.0 6.1 0.4 7.7 1.3 4.4 2.4 0.9 94,413
Other modern method includes: Injectables, Implants, Female condoms, Diaphragm or Foam/Jelly, IUD: intrauterine device
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With increase in age, there is an increase in the prevalence of contraception from 24 percent among
the women aged 15-19 to 66-67 percent among the women aged 30 and above. Use of spacing
methods was more prevalent among younger women and sterilization was more common among
older women. In fact, in the age-group 45-49, 56 percent of women were sterilized, implying that
female sterilization accounted for 85 percent of the family planning users among women aged 45-
49. Among younger women below age 30, 7-8 percent reported use of condom, 6-7 percent was
using pills and 4-5 percent reported adopting periodic abstinence.
The urban-rural differentials in contraceptive use are quite small. The contraceptive use is higher
among women in urban areas than rural areas by three percentage points. Contraceptive prevalence
rate increased from 58 percent among women with no education to 67 percent among those with
less than five years of schooling, but then decreased with increase in education to 52 percent among
women with 12 or more years of education. Though with increase in education there was decrease
in the contraceptive prevalence rate, the use of IUD and condom was increasing with increase in
education. Among the women from four social groups, the contraceptive use is the lowest among
women belonging to STs (54%) and the highest among those from Other castes (61%). Use of spacing
methods—modern as well as traditional—is relatively higher among women from Other castes. With
better economic condition, there is an increase in the contraceptive use. The family planning use
increases from 51 percent among women in the lowest wealth quintile to 61 percent among those in
the highest wealth quintile.
State-wise percentages of women aged 15-49 currently using any method, any family planning
method, or any modern method according to residence has been supplemented in Annexure Table
3.9 (a).
3.11 PROFILE OF CHILDREN
Table 3.13 presents distribution of children below age six by selected demographic and socio-
economic characteristics. RSOC collected data about 1,21,987 children from 28 states and Delhi.
Among these children 70 percent were from rural areas and remaining 30 percent were from the
urban areas. The sex ratio of surveyed children was 934 female children per 1,000 male children. The
sex distribution was almost same in rural and urban areas. The distribution of children by single year
of age in both rural and urban areas shows slightly lower proportion of younger children below age
two.
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Table 3.13: Profile of children
Percent distribution of children below age six by background characteristics according to residence, RSOC,
2013-14
Background characteristics Residence
Total Urban Rural
Gender Male 51.7 51.7 51.7 Female 48.3 48.3 48.3
Age (in completed years) 0 15.7 16.6 16.3 1 16.5 16.2 16.3 2 17.5 17.6 17.6 3 17.2 16.9 17.0 4 16.2 15.6 15.8 5 16.8 17.1 17.0
Social-group Scheduled Caste 16.6 21.7 20.1 Scheduled Tribe 6.2 13.7 11.5 Other Backward Classes 40.8 40.6 40.5 Other 35.4 23.0 26.8 No response 1.0 1.0 1.0
Wealth Index
Lowest 4.6 27.1 20.3 Second 9.3 25.3 20.5 Middle 17.7 22.1 20.8 Fourth 30.0 16.0 20.3 Highest 38.4 9.5 18.2
Total 100.0 100.0 100.0 Number of children aged 0-6 36,842 85,145 1,21,987
The distribution of children by social groups and wealth quintile is consistent with the distribution of
households and ever married women aged 15-49 by these characteristics, presented in Chapter 2
and 3 respectively. One-fifth (20%) of the children were from SCs, 12 percent were from STs, 41
percent belonged to OBCs and remaining 27 percent were from all other castes. Compared to urban
areas, in rural areas, there were relatively more children from the SC (22% vs 17% in urban) and ST
(14% vs 6%). There were almost equal proportions of children in each wealth quintile. The
distribution of children by wealth quintiles was very different in rural and urban areas. More than
two-thirds (68%) of urban children belong to the two highest wealth quintile compared to only 26
percent in rural areas.
The state-wise age distribution of the children aged 0-5 and sex ratios are presented in Annexure
Table 3.10 (a.)
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3.12 BIRTH REGISTRATION
The Article 7 of the 1989 UN Convention on the Rights of the Child (CRC) states ‘the child shall be
registered immediately after birth and shall have the right from birth to a name, the right to acquire
a nationality and as far as possible, the right to know and be cared for by his or her parents’. Birth
registration is a permanent and official record of a child’s existence. The child who is not registered
at birth is in danger of being denied the right to an official identity, a recognized name and a
nationality. As a signatory of UN CRC, India recognizes birth registration as the first right of the child.
Registration of births is also vital for collection of data on vital statistics which has an important role
in national planning process by providing demographic base.
In India, the registration of births, deaths and still births are compulsory in all parts of the country,
under the provisions of Registration of Births and Deaths (RBD) Act, 1969. It is the duty of the head
of the household to report the birth in case of birth occurring at house, and in case of birth occurring
in a health institution, the medical officer in-charge is responsible for reporting. The normal period
of 21 days from the birth date has been prescribed for reporting, within which reporting is free of
charge, beyond which the birth can be registered with payment of the prescribed fee.
In RSOC, data on birth registration was collected in the household questionnaire. The head of the
household was asked about every child under age five in the household, whether the birth of the
child was registered, if registered whether it was registered within 21 days of the birth or later, and
whether child’s birth certificate is available. In case the birth certificate was available, interviewer
asked the respondent to show the birth certificate. Table 3.14 and Figures 3.1 and 3.2 present the
percentage of children whose birth was registered, whose birth was registered within 21 days of the
birth and who have birth certificate by selected characteristics of household and children.
Figure 3.1: Birth registration
72
62
37
61
Registered birth Registered birthwithin 21 days
Has a birthcertificate (seen)
Has a birthcertificate
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The survey shows that in case of 72 percent of the children below age five, birth was registered and
for 62 percent of the children registration of the birth was done within 21 days of the birth. For 61
percent of the children birth certificate was available, though only in case of 37 percent of the
children respondent could show the birth certificate to the interviewer. The National Family Health
Survey (NFHS) conducted in 2005-06 (NFHS-3) showed that in case of 41 percent of children below
age 5, birth was registered and for 27 percent of children birth certificate was available. So, in the
last eight years since NFHS-3, there has been an increase of 31 percentage points in the extent of
birth registration and of 34 percentage points in possession of birth certificate. However,
considering a goal of 100 percent registration of births by the year 2010 by the National Population
Policy, 2000 of India, the extent of birth registration is much on the lower side.
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Table 3.14: Birth registration and possession of birth certificate
Percentage of children below age five whose birth was registered, whose birth was registered within 21 days
of birth, who had a birth certificate and seen by investigator and who had a birth certificate by background
characteristics, RSOC, 2013-14
Background characteristic Registered
birth
Registered the
birth within 21
days
Has a birth
certificate
(Seen)
Has a birth
certificate
Total
number of
children
Age of the child in completed years
0 70.0 60.9 34.3 55.9 19,889 1-2 73.7 63.6 38.8 63.4 41,351 3-4 71.0 60.1 36.6 60.8 40,020
Gender
Male 71.2 61.0 36.2 60.1 52,283 Female 72.6 62.4 38.0 61.7 48,977
Residence
Urban 83.0 74.0 47.4 75.2 30,647 Rural 67.0 56.3 32.6 54.7 70,613
Mother's education
No Education 53.7 42.0 20.9 39.3 32,633 <5 years complete 75.5 61.9 39.9 61.7 4,730 5-7 years complete 76.1 65.1 40.7 64.6 14,732 8-9 years complete 79.4 69.5 46.0 70.2 14,461 10-11 years complete 83.9 75.6 48.9 75.6 13,147 12 or more years complete 86.1 78.1 50.2 79.2 16,065
Religion
Hinduism 71.8 61.7 36.2 60.5 79,115 Islam 69.1 57.6 36.8 58.6 16,723 Christianity 77.8 69.5 49.4 71.0 2,746 Sikhism 85.8 79.0 58.7 82.1 1,384 Jainism 90.8 87.4 52.6 86.2 160 Buddhism/Neo-Buddhism 90.3 82.6 44.1 74.9 673 No Religion 63.6 56.5 21.7 49.7 61 Other 73.2 63.0 38.7 63.3 398
Social-group
Scheduled Caste 67.5 58.3 36.5 56.8 20,383 Scheduled Tribe 70.6 57.9 32.2 54.4 11,653 Other Backward Classes 68.3 58.6 34.1 57.3 41,168 Other 80.7 70.3 43.6 71.9 27,071 No Response 86.4 69.4 49.6 71.8 985
Wealth Index
Lowest 57.0 44.8 22.0 41.0 20,337 Second 65.3 53.8 31.2 53.4 20,678 Middle 72.9 62.8 39.4 62.6 21,177 Fourth 79.6 71.1 45.1 70.5 20,674 Highest 85.9 77.4 48.6 78.7 18,394
Total 71.9 61.7 37.1 60.9 1,01,260
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The proportion of children below age five whose birth was registered and who had birth certificate
was much higher in urban areas (83% and 75% respectively) than in rural areas (67% and 55%),
though even in urban areas one-fourth (25%) of the children did not have birth certificate. The
extent of birth registration by age does not suggest any improvement in the birth registration in
recent years. There is no sizeable difference in the registration of births of male and female children.
Both registrations of birth and possession of a birth certificate for children increased consistently
with the increase in mother’s education. Registration of birth among children whose mothers have
completed 5 years of education is 23 percent more (76% against 54%) than children of mothers who
had no education, which increases to 86 percent for those children whose mothers are educated for
12 and more years. Compared to children from the Hindu (72%) and Islam (69%) households,
children from Christian (78%), Sikh (86%), Jain (91%) and Buddhist (90%) households are more likely
to be registered. Birth registration is higher for the children from other castes (81%) compared to
those from SCs, STs and OBCs (68-71%). The proportion of children below age five whose birth was
registered and who had a birth certificate increased steadily with wealth quintile.
Figure 3.2: Birth registration and possession of birth certificate
71
73
83
67
57
65
73
80
86
72
60
62
75
55
41
53
63
71
79
61
Male
Female
Urban
Rural
Lowest
Second
Middle
Fourth
Highest
Total
Sex
Re
sid
en
ceW
eal
th In
dex
Registered birth and has a birth certificate Total registered birth
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The state-level variation in the percentage of children whose birth was registered and for whom the
birth certificate was available is shown in Table 3.15. There is a large state-wise variation in the
prevalence of birth registration and possession of birth certificate. The extent of birth registration
varies from the highest of 99 percent in Goa to the lowest of 28 percent in Manipur. Similarly, the
proportion of children with birth certificate ranges from 97 percent in Goa to 18 percent in Manipur.
Along with Goa, in Tamil Nadu, Mizoram, Kerala and Gujarat also, birth registration exceeds 95
percent. On the other hand, in Manipur, Jharkhand, Uttar Pradesh and Bihar, in case of majority of
the children birth was not registered. The proportion of children with birth certificate that were seen
by the enumerators ranges from 79 percent in Tamil Nadu to 9 percent in Manipur.
Table 3.15: Birth registration and possession of birth certificate by state
Percentage of children aged 0-4 whose birth is registered, whose birth is registered within 21 days of birth,
who had a birth certificate and seen by investigator and who had a birth certificate by state, RSOC, 2013-14
States Registered the birth
Registered the birth within 21 days
Has a birth certificate (seen)
Has a birth certificate
India 71.9 61.7 37.1 60.9 North
Delhi 85.8 78.6 43.1 80.3 Haryana 86.5 81.9 56.1 80.8 Himachal Pradesh 88.7 80.8 31.8 77.9 Jammu & Kashmir 64.5 51.2 14.2 45.7 Punjab 85.5 79.9 55.2 81.3 Uttar Pradesh 39.1 30.0 10.1 27.1 Uttarakhand 79.5 66.2 23.2 57.6
Central
Chhattisgarh 60.9 48.4 23.2 39.6 Madhya Pradesh 84.5 68.8 29.9 67.4
East
Bihar 39.5 29.5 15.0 31.9 Jharkhand 34.8 24.6 13.5 24.6 Odisha 75.9 54.6 22.4 37.6 West Bengal 94.0 79.9 64.6 85.0
Northeast
Arunachal Pradesh 75.9 55.5 20.1 63.4 Assam 80.9 55.7 52.3 77.6 Manipur 27.7 15.9 9.4 17.6 Meghalaya 78.9 63.2 46.2 65.3 Mizoram 97.2 94.3 55.1 96.3 Nagaland 60.1 42.0 39.8 59.8 Sikkim 88.9 84.5 65.2 85.9 Tripura 90.3 76.5 73.5 87.5
West
Rajasthan 53.5 37.5 14.1 32.8 Goa 98.7 95.7 65.3 96.8 Gujarat 95.0 91.6 57.2 91.2 Maharashtra 92.5 86.6 47.0 80.2
South
Andhra Pradesh 64.4 52.2 34.0 55.8 Karnataka 89.5 80.5 47.7 84.2 Kerala 96.1 93.6 64.6 92.0 Tamil Nadu 97.5 93.9 78.8 93.8
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39
31
27 3
ICDS run PSE Private PSE
Not attending any PSE Don't know
3.13 PRE-SCHOOL EDUCATION IN INDIA
India has a tradition of valuing the early years of a child’s life, and a rich heritage of practices for
stimulating development and inculcating sanskaras or basic values and social skills in children.
Traditionally this was done within a family. However, with changes in the family system as well as
social context in the last few decades the early childhood education outside home, prior to formal
schooling has become an essential activity.
India is a signatory to both the CRC, 1989 and Education for All (EFA) 1990. The latter has postulated
Early Childhood Care and Education (ECCE) as the very first goal to be achieved for ‘Education for
All’, since learning begins at birth. The Government of India recognizes21 the significance of ECCE,
which has been included as a constitutional provision which directs that, ‘The State shall endeavour
to provide ECCE for all children until they complete the age of six years.’ In India ECCE services are
delivered through public, private and non-governmental channels. In the public sector, Integrated
Child Development Services (ICDS) is the world’s largest programme imparting ECCE. The private
sector in an organized or unorganized form, with varied quality, is perhaps, the second largest
service provider of ECCE, and its outreach is steadily percolating even into the rural areas across the
country.
Figure 3.3: Percent distribution of children aged 3-6 by attendance in pre-school education
For all the children below aged six years, RSOC
collected data on pre-school attendance in the
household questionnaire. The head of the
household was asked about every child aged 3-
6, whether the child attends any pre-school,
and if attends the type of pre-school. Table 3.16
presents distribution of children by pre-school
activity. Nationally, 39 percent of the children
aged 3-6 were attending ICDS run pre-schools,
31 percent were attending privately run pre-
schools and in case of a small proportion (4%) of
children information was not available. Little
more than one-fourth (27%) of the children
aged 3-6 were not attending any pre-school.
With increase in age there was an increase in
the proportion of children attending pre-school. Children aged 3 and 4 were more likely to attend
ICDS run pre-school whereas children aged 5 were more likely to attend privately run pre-school.
Among the children aged three, 42 percent were attending ICDS run pre-school and 17 percent were
attending privately run pre-school, but among children aged five, 33 percent were attending ICDS
and 44 percent were privately run pre-school. A little higher proportion of female (40%) than male
(38%) children were attending ICDS run pre-schools.
21 Draft National Early Childhood Care and Education Policy, 2012; Ministry of Women and Child
Development, Government of India
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Table 3.16: Pre-school education (PSE)
Percent distribution of children below age 6 by the type of PSE attended according to background
characteristics, RSOC, 2013-14
Background characteristic
Attending PSE Number of
children
aged 3-6
ICDS run
PSE
Private
PSE
Not
attending
any PSE
Don't
know Total
Age of child in completed years
3 42.2 17.3 35.0 5.5 100.0 20,749
4 41.4 31.2 24.9 2.5 100.0 19,270
5 32.7 43.5 21.4 2.4 100.0 20,727
Gender
Male 37.5 31.7 27.4 3.5 100.0 31,443
Female 40.1 29.6 26.9 3.5 100.0 29,303
Residence
Urban 22.2 50.4 24.5 2.9 100.0 18,493
Rural 46.0 22.0 28.3 3.8 100.0 42,253
Religion
Hinduism 40.0 30.6 25.9 3.5 100.0 47,505
Islam 34.4 27.6 34.0 4.0 100.0 10,033
Christianity 35.2 38.5 25.6 0.7 100.0 1,689
Sikhism 21.9 52.8 23.3 1.9 100.0 812
Jainism 27.4 58.1 12.4 2.1 100.0 56
Buddhism/Neo-Buddhism 49.1 31.4 18.2 1.3 100.0 385
No Religion 25.5 24.8 46.6 3.2 100.0 44
Other 39.3 30.2 26.9 3.7 100.0 222
Social-group
Scheduled Caste 42.3 24.9 29.4 3.4 100.0 12,326
Scheduled Tribe 52.0 17.4 26.9 3.7 100.0 6,885
Other backward classes 35.9 31.9 28.3 4.0 100.0 24,834
Others 34.3 39.3 23.6 2.7 100.0 16,113
No response 49.3 16.9 31.7 2.0 100.0 588
Wealth Index
Lowest 51.9 8.6 34.8 4.8 100.0 12,727
Second 49.5 17.2 29.2 4.0 100.0 12,494
Middle 42.8 27.9 25.9 3.4 100.0 12,507
Fourth 30.1 42.6 24.5 2.8 100.0 12,059
Highest 16.0 61.6 20.3 2.2 100.0 10,959
Total 38.7 30.7 27.1 3.5 100.0 60,746
Children from urban areas were more likely to attend privately run pre-schools whereas rural
children were more likely to attend ICDS run pre-schools. Every second child (50%) in urban areas
was attending privately run pre-school and 22 percent were attending ICDS run pre-school, on the
contrary in rural areas 46 percent and 22 percent of the children were attending ICDS run and
privately run pre-school respectively. Relatively higher proportion of children from SC (42%) and ST
(52%) were attending ICDS run pre-school, in comparison to their counterparts from other castes
and OBC (34-36%). With increase in economic status from the lowest wealth quintile to the highest
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quintile, there was an increase in the proportion of children attending pre-school. Children from the
lower wealth quintile were more likely to attend ICDS run pre-school, whereas those from the higher
wealth quintile were likely to attend privately run pre-school. The proportion of children attending
ICDS run pre-school decreased from 52 percent among the children from the lowest wealth quintile
to 16 percent among those from the highest wealth quintile. Consequently, the proportion of
children who attended privately run pre-school increased from 9 percent among the children from
the lowest wealth quintile to 62 percent among the children from the highest wealth quintile.
Figure 3.4: Children attending pre-school education
Table 3.17 shows the state-level variation in the distribution of children aged 3-6 by pre-school
attendance. There is large variation in proportion of children attending pre-school across the states
ranging from 19 percent in Nagaland to 90 percent in Tripura. In Manipur (88%), Sikkim (87%) and
Goa (89%) also a large proportion of the children aged 3-6 were attending pre-school. At the same
time, in Nagaland, Meghalaya and Uttar Pradesh majority of the children were not attending any
pre-school. The preference for ICDS run school also varies substantially from state to state. In Tripura
(69%) and Odisha (63%) a large proportion of children attend ICDS schools. Even in Chhattisgarh,
West Bengal, Bihar, Assam, Mizoram, Karnataka, Gujarat, and Maharashtra majority of the children
(50-58%) were sent to ICDS run pre-school.
Generally, the proportion of the children attending pre-school is higher in urban than rural areas.
Children from rural areas tend to attend ICDS run pre-school whereas those from urban areas tend
to attend privately run pre-schools. In rural areas of Tripura (74%), Maharashtra (74%), Odisha
(69%), Mizoram (69%), Karnataka (69%) and Gujarat (67%) two-thirds or more children were
attending ICDS run pre-schools.
42 41 33 22 46 38 40 52 50 43 30 16 39
17 31 44
50 22 32 30 9 17 28
43 62 31
3 years 4 years 5 years Urban Rural Male Female Lowest Second Middle Fourth Highest Total
Age of child Residence Sex Wealth Index
Attending Private PSE Attending ICDS run PSE
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Table 3.17: Pre-school education (PSE) by State
Percentage of children aged 3-5 who were attending ICDS run PSE and any PSE by residence, according to
states, RSOC, 2013-14
States
Urban Rural Total
Attending PSE
ICDS run Any PSE ICDS run Any PSE ICDS run Any PSE
India 22.2 72.6 46.0 68.0 38.7 69.4
North
Delhi 9.1 64.7 10.7 63.9 9.1 64.7
Haryana 11.4 71.6 22.2 65.8 18.6 67.7
Himachal Pradesh 12.2 68.7 34.0 82.7 31.8 81.3
Jammu & Kashmir 12.5 70.7 21.0 58.0 18.7 61.4
Punjab 12.0 77.7 23.9 72.1 19.4 74.2
Uttar Pradesh 5.6 51.2 20.3 41.7 17.2 43.7
Uttarakhand 9.9 78.1 33.4 76.5 26.7 77.0
Central
Chhattisgarh 18.8 78.8 65.2 84.0 55.4 82.9
Madhya Pradesh 20.1 71.8 44.4 62.8 37.8 65.2
East
Bihar 31.4 56.1 51.8 60.3 49.5 59.8
Jharkhand 23.0 67.5 48.3 59.6 42.5 61.4
Odisha 36.7 75.4 68.5 79.2 63.3 78.6
West Bengal 26.2 70.5 62.0 73.3 51.1 72.5
North-East
Arunachal Pradesh 18.9 71.6 42.5 69.6 37.5 70.0
Assam 17.0 64.4 56.3 67.7 51.2 67.3
Manipur 25.0 87.8 35.8 87.9 33.0 87.9
Meghalaya 4.4 44.8 19.9 42.5 17.1 42.9
Mizoram 46.1 63.4 68.6 73.5 57.9 68.7
Nagaland 0.2 34.6 1.6 14.4 1.2 19.4
Sikkim 22.0 82.9 44.7 88.7 38.4 87.1
Tripura 47.9 93.4 74.4 89.3 68.8 90.2
West
Rajasthan 11.2 64.5 16.9 50.3 15.5 53.7
Goa 28.7 90.2 48.8 87.1 36.4 89.0
Gujarat 36.8 83.1 67.0 75.7 54.7 78.7
Maharashtra 23.2 78.5 74.3 88.2 51.4 83.9
South
Andhra Pradesh 27.8 71.8 55.4 91.0 46.0 84.4
Karnataka 34.5 80.6 69.3 89.8 57.2 86.6
Kerala 29.4 80.0 23.4 68.2 26.3 73.9
Tamil Nadu 22.9 84.8 38.8 85.2 31.3 85.0
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CHAPTER 4 MATERNAL HEALTHCARE
4.1 BACKGROUND
Making motherhood safe is one of the priorities of the governments at National and State level. The
government’s policy has been revolving around the fact that safe motherhood not only ensures the
safety of the pregnant woman but also the well-being of the child. The challenge in making
motherhood safe and thereby reducing maternal mortality lies majorly on making quality services
available to all prospective mothers, especially reaching out to the most vulnerable women in the
community. Though research and evidences have improved the comprehensive knowledge required
to address these issues, programmatically there are still wide fissures which are quite often not so
difficult to bridge.
The government’s focus has been on a continuum of maternal care which covers the entire pathway,
beginning from conceiving the baby to post-delivery quality care to both the mother and the child.
The critical services that the government’s maternal health programme promises to cover pertain to
not only availing the recommended number of antenatal check-ups with the desired components,
consuming adequate doses of iron supplements but also support safe delivery through trained
nurses or doctors in institutional facilities.
Outcomes of maternal care are measured through several indicators, but the most common being
maternal mortality ratio (MMR). As per the Goal 5 of the MDG framework, India is required to
reduce MMR to 109 per 100,000 live births by 2015, from an estimated MMR level of 437 in 1990.
Latest estimate of MMR published by the Office of Registrar General of India (RGI) in 2014, for the
year 2011-13 was 178 per 100,000 live births. As per the Twelfth Five Year Plan, the government
plans to bring down MMR to 100 by the year 2017. Though, in recent years, decline in maternal
mortality rate has been sharp, it would still be a challenge to achieve the MDG target by 2015.22 This
survey though does not estimate MMR, but estimates the level of several correlated indicators
measuring well-being of women.
Government of India, over the last six decades has been focusing on the issue of improving maternal
care through several nationwide programmes and aptly allocating its resources in the programmes
like Reproductive and Child Health (RCH) and promoting it through the National Rural Health Mission
(NRHM) during 2005-12 and presently under National Health Mission (NHM). The Twelfth Five Year
Plan (2012-2017) also highlighted government’s continued engagement by stating that ‘Maternal
and child health care will continue to be a major focus, especially given the inadequate progress in
reducing IMR and MMR’. As per MDG Report, 2015, India is likely to reach the figure of 140 in 2015
and is likely to miss the MDG target by 31 points.23
22 http://mospi.nic.in/Mospi_New/upload/mdg_26feb15.pdf
23 http://mospi.nic.in/Mospi_New/upload/mdg_26feb15.pdf
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The most recent policy document of the Ministry of Health and Family Welfare ( MoHFW), namely
Strategic Approach to Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A)
(2012-2017) enunciates the focus on expanding the continuum of maternal care by including
reproductive and adolescent care within its fold. The document mentions that all schemes and
programmes that constituted RCH-II under the NRHM have been absorbed into the new national
programme called the National Health Mission which now covers both rural and urban inhabitants.
Two of its safe motherhood schemes mainly for poor pregnant women, namely Janani Suraksha
Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK) are quite popular and have resulted in
improving institutional delivery across the country.
In addition to improving nutrition of pregnant women and lactating mothers, MoWCD through its
Integrated Child Development Services (ICDS) scheme it provides free food supplementation,
referral and counselling on nutrition and health education (NHE) services to women by Anganwadi
workers (AWWs) through more than 1.35 million Anganwadi Centres (AWCs) spread across the
country. AWWs are also mandated to facilitate antenatal care services to all pregnant women at
AWCs and also by visiting the women along with other service providers like ASHA and Auxiliary
Midwife nurses (ANM). AWWs are also to counsel and promote institutional and safe delivery
among the pregnant women.
In RSOC (2013-14) a variety of questions were asked to ever married women in the age group 15-49
who had a live birth during the three years preceding the survey. The reference cut-off date to
provide information on safe motherhood practices and use of services from service providers
including that from the AWC was ‘on or after 1st August of 2010’. The District level Household
Survey (2007-08) also collected information from ever married women aged 15-49 with a reference
period of three years preceding the survey and NFHS 2005-06 collected information from ever
married women aged 15-49, with a reference period of five years. The results on maternal health
indicators of RSOC are comparable with NFHS 2005-06 and DLHS, 2007-08.
Topics covered in this chapter are awareness and utilization of health services during prenatal, intra-
natal and postnatal period of pregnancies, especially antenatal care, delivery, and postnatal care and
role of AWC in care during pregnancy/delivery/post-delivery periods and care provided by service
providers.
Entire analysis in this chapter is based on number live births that were reported by the ever married
women age 15-49, in the three years preceding the survey. EMWs who delivered more than one live
births during the period has been counted as many times. For example, if an eligible woman gave
birth to two live births during the period, that woman has been counted twice. Thus, the number of
live births and number of EMWs are same in the analysis.
4.2 ANTENATAL CARE (ANC)
In India, the safe motherhood programme aims at providing at least four antenatal check-ups as per
the recommendations of the World Health Organization (WHO). Each ANC inter-alia includes weight
and blood pressure check, abdominal examination, immunization against tetanus, intake of 100 iron
MATERNAL HEALTHCARE
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and folic acid tablets or syrup prophylaxis along with anaemia management. This also helps to
establish early contact with the women, and identifies and manages current and potential risks and
complications. For this reason; it is recommended that the pregnant women are registered with the
local health provider in the first trimester itself. This helps in counselling and establishing a delivery
plan. It is recommended that a doctor, an ANM, or other trained health professionals provide the
antenatal check-ups.24
RSOC collected information on ANCs from ever married women aged 15-49 and who had a live birth
in the three years preceding the survey on whether they registered their pregnancies and if so in
what month of pregnancy; who motivated them to register; whether -they received the Mother and
Child Protection (MCP) card and whether their pregnancies were registered in an AWC. From the
respondents who received antenatal care further questions were asked about place where ANC
received, the provider of ANC check-ups, timing of the first antenatal care visit and the total number
of visits made. In addition, the survey asked the women whether they received Tetanus Toxoid (TT)
injections, if yes, how many; whether Iron and Folic Acid (IFA) tablets or syrup were received or
purchased and whether consumed during the pregnancy. Results from each of these questions are
discussed in the subsequent sections.
4.2.1 Registration of pregnancy
The first step towards Maternal Healthcare begins with the registration of pregnancy. It is seen from
the analysis that more than four out of every five (84 percent) women had registered their
pregnancy. Table 4.1 presents the percent distribution of women who had live births in the three
years preceding the survey, by registration of pregnancy for ANC services and timing of the
registration, by place of residence. It is seen from the analysis that more than four out of every five
(84 percent) women had registered their pregnancy. Slightly higher proportion of the urban women
(87 percent) registered their pregnancies in comparison to the rural women (83 percent). This
reflects on the high level of awareness about maternal health care among the women in both rural
and urban areas. Amongst all the women aged 15-49, nearly two-third (65 percent) registered during
the first trimester of the pregnancy with more women from the urban areas (71 percent) than the
women residing in the rural areas (62 percent). It also means that close to one-third women (35
percent) were either not aware of the proper timing of registration or were not motivated about
benefits of early check-ups.
24 NFHS III Report Vol.1, 2005-06.
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Table 4.1: Registration of pregnancy Percent distribution of women who had live births in the three years preceding the survey, by registration of pregnancy for ANC services and timing of the registration, according to place of residence, India, RSOC, 2013-14
Registration of pregnancy and availability of MCP card Residence
Total Urban Rural
Registration of pregnancy 87.4 82.7 84.1 Number of months pregnant at the time of registration
< = 3 month 71.1 61.6 64.5 4-6 months 14.4 19.2 17.8
7 months and above 1.8 1.9 1.9 Not registered 12.6 17.3 15.9
Total 100.0 100.0 100.0 Number of women
25 16,320 38,230 54,550
4.2.2 Registration of pregnancy, timing of registration and having an MCP card
Upon registering pregnancy for ANC services, an MCP card is required to be issued to the pregnant
women. MCP Card is a joint initiative of ICDS and NRHM now known as NHM and has been
developed as a tool for families to learn, understand and follow different types of services which
should be accessed by the mother and the child for achieving continuum of care and enhancing
utilization of services from NRHM and ICDS. The card helps in recoding information on antenatal
care to post-delivery care of the mother and the child. Generally, this card should be kept with the
pregnant women. However, in some states MCP cards are also maintained by the ANMs or AWWs.
RSOC collected information on availability of MCP26 card from all women who had a live birth in the
three years preceding the survey. The woman was asked whether the MCP card was given to her at
the time of registration of pregnancy or not. In some cases cards similar to MCP card designed by the
government were also considered equivalent.27 If the respondent reported availability of such card
then she was requested to show the same. Responses were accordingly coded as ‘yes-shown’, ‘yes-
not shown’ and ‘No’.
25 For those mothers who had more than one live birth during the reference period of last three years, have been counted
as many times in the base. This was necessitated as information on antenatal, natal, postnatal etc. was collected in respect of last two live births under RSOC unlike in NFHS/DLHS where some of the indicators are based on the most recent live births. Thus in RSOC, number of women and number of births are same. 26
Enumerator carried a copy of the MCP card and the same was shown to the women respondent. 27
This was mostly seen for those who took services from private health institutions.
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Figure 4.1: Percentage of pregnant women having MCP cards
From Figure 4.1, it is seen that 73 percent of
the women had an MCP card, but only 34
percent could actually show the card to the
enumerator at the time of the interview.
Almost equal percentage of women from the
urban (36 percent) and the rural (34 percent)
areas reported to have received and also
could show their MCP cards.
The differentials in registration of pregnancy are linked to women’s age, education, social groups
and wealth quintile her family belongs to. As can be seen in Table 4.2, women in the higher age
brackets were less likely to get their pregnancy registered. Close to nine out of every ten women
below 24 years of age had registered their pregnancy; and close to three-forth received an MCP
card. On the other hand, amongst the women aged 30 or above, close to one-fourth had not
registered their pregnancy and one-third not received the MCP card. Among the women with no
education, close to 30 percent had not registered their pregnancy; and around 40 percent had not
received the MCP card at the time of registering their pregnancy.
Registration of pregnancy for ANC services is popular among women from all social groups. More
than four out of every five scheduled caste (SC), scheduled tribe (ST) and other backward class (OBC)
women had registered pregnancy and more than 70 percent received MCP card. However, it is
observed that the women from lowest (poorest) quintile were the most left out from registration
(close to 25 percent) and close to 40 percent had not received MCP card.
40 39 39 36 34 34
12 11 11
Urban Rural Total
Yes - not seen Yes - seen No MCP card
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Table 4.2: Registration of pregnancy, timing and MCP card
Among women who had live births in the three years preceding the survey, percentage who registered their pregnancy, registered in the first trimester and received of MCP card, according to background characteristics , RSOC, 2013-14
Background characteristics Registered pregnancy
for ANC
Registered pregnancy in
first trimester
Received MCP card at the time of registration of pregnancy (seen &
not seen)
Mother’s age 15-19 88.9 67.7 78.7 20-24 87.2 67.5 76.5 25-29 84.6 65.4 73.6 30-34 79.0 59.5 66.8 35-49 73.6 51.6 62.1
Mother’s education
No education 70.6 47.2 57.3 Below Primary 89.6 64.5 78.2 Completed Primary 86.2 65.9 76.4 Completed Middle 92.6 73.0 83.2 Completed Secondary 91.7 75.0 82.8 Completed Higher Secondary & Above 91.9 78.6 80.7
Social-group
Scheduled Caste 82.0 61.0 71.8 Scheduled Tribe 86.1 64.3 71.2 Other Backward Class 82.4 63.2 70.8 Other 87.1 68.7 77.6 Do not know 93.3 71.3 84.1
Wealth index
Lowest 75.9 50.2 62.0 Second 80.3 58.1 69.7 Middle 86.2 66.6 76.8 Fourth 89.5 72.3 78.9 Highest 89.1 76.2 78.2
Total 84.1 64.5 73.1
Registration in first trimester
It is always advisable to register pregnancy in the first trimester. It also helps in planning the entire
pre to natal period. Close to two-third of the women (65 percent) had registered their pregnancy in
the first trimester. However, it is seen that women from the poorer households generally do not
register their pregnancy in time. Fewer women from the poorest households (50 percent) were likely
to register their pregnancy in the first trimester than women from the richest households (76
percent). It is also seen that level of education of the women influences the timing of the
registration. More women with higher level of education registered their pregnancy in the first
trimester. Close to three-fourth of the women with eight or more years of education registered their
pregnancy in the first trimester whereas among women with ‘no education’ less than half (47
percent) had registered their pregnancy in the first trimester.
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Registration of pregnancy, timing and having MCP card by States
State-wise analysis on registration of pregnancy for ANC, registration in the first trimester and
receipt of MCP card has been presented in Table 4.3. There is wide variation in the level of
registration of pregnancy among the states, varying from 57 percent in Nagaland to 99 percent in
Sikkim. While in 13 states, the level of registration is more than or equal to 90 percent, in ten states
namely, Nagaland (57 percent), Uttar Pradesh (64 percent), Bihar (66 percent), Jharkhand (73
percent), Haryana (77 percent), Kerala (79 percent), Punjab (80 percent), Uttarakhand (80 percent),
Delhi (81 percent) and Jammu and Kashmir (83 percent), it was below the national average (84
percent).
Table 4.3: Antenatal care indicators by state
Among women who had a live birth in the three years preceding the survey, percentage who registered pregnancy, registered in first trimester and received MCP card, according to States, India, RSOC, 2013-14
States Registered
pregnancy for ANC Registered pregnancy
in first trimester Received MCP card at the time
of registration of pregnancy
India 84.1 64.5 73.1 North
Delhi 81.3 69.2 72.6 Haryana 76.8 57.6 66.7 Himachal Pradesh 91.9 75.3 85.8 Jammu & Kashmir 82.6 63.9 70.8 Punjab 79.6 66.7 71.0 Uttar Pradesh 64.2 48.5 53.9 Uttarakhand 80.4 67.1 71.5
Central Chhattisgarh 91.2 73.4 71.5 Madhya Pradesh 90.2 69.2 77.2
East Bihar 66.4 33.7 48.4 Jharkhand 73.0 47.3 65.4 Odisha 90.3 62.8 80.3 West Bengal 98.4 72.5 95.0
Northeast Arunachal Pradesh 84.9 46.1 76.0 Assam 95.1 62.0 92.9 Manipur 93.2 80.7 9.0 Meghalaya 85.5 59.8 65.9 Mizoram 89.4 67.5 81.9 Nagaland 56.8 49.1 40.0 Sikkim 99.2 81.1 97.5 Tripura 84.7 64.4 65.0
West Rajasthan 85.2 65.4 73.5 Goa 95.4 86.0 91.8 Gujarat 88.3 76.9 81.3 Maharashtra 92.1 75.1 77.4
South Andhra Pradesh 95.1 73.3 82.1 Karnataka 93.8 77.4 86.2 Kerala 79.3 71.1 66.3 Tamil Nadu 93.6 81.0 83.7
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With regards to timing of the registration too there is wide variation among the states. Registering in
the first trimester varied from 34 percent in Bihar to 86 percent in Goa. Level of registration in first
trimester is more than the national average in 18 states. In states of Nagaland, Uttar Pradesh,
Jharkhand, Arunachal Pradesh and Bihar, more than half of the women had not registered in the first
trimester. With regards to having an MCP card (seen and not seen) there are again large variations
among the states, varying from 98 percent in Sikkim to just 9 percent in Manipur.
4.2.3 Utilization of ANC service, timing of first ANC and number of check-ups taken
It is not about registering pregnancy only but the number of ANC check-ups taken and the timing of
the first check-up that are critical for health of the mother and the outcome of the pregnancy. The
World Health Organization (WHO)28 recommends that all pregnant women should have at least four
ANC check-ups/assessments by or under the supervision of a skilled attendant. These assessments
should be spaced at regular intervals throughout pregnancy, beginning as early as possible in the
first trimester. Skilled attendant are those who are trained professionally for providing medical care.
These are doctors, nurses, ANMs.
In RSOC 2013-14, a question was asked to women who had a live birth in the three years preceding
the survey whether she received any antenatal service. If responded in affirmative, further queries
were made about the time of first check-up received and the number of ANC check-ups taken during
the pregnancy. Table 4.4 presents the percentage of women who had live births in the three years
preceding the survey by receipt of ANC, number of check-up visits and timing of first check-up,
according to the place of residence of the respondent. More than four out of every five women (85
percent) received ANC during pregnancy. In the urban areas the proportion of women (90 percent)
receiving ‘any ANC’ was higher in comparison to that of the women (83 percent) residing in rural
areas. As per DLHS 2007-08, the level of ‘any ANC’ was around 75 percent. Thus, the coverage of
‘any ANC’ has increased over the years.
28 Standards of Maternal and Neonatal Care, Integrated Management of Pregnancy and Childbirth, WHO, 2006.
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Table 4.4: Utilization of Antenatal care service
Percent distribution of women who had a live birth in the three years preceding the survey by receipt of any ANC check-up, number of check-up received and timing of first check-up according to the place of residence, India, RSOC, 2013-14
Number and timing of check-ups Residence
Total Urban Rural
Percentage of women who received any ANC during pregnancy 90.3 83.0 85.2 Number of ANC check-ups received
None 9.5 16.7 14.5 1 3.6 8.9 7.3 2 11.1 15.3 14.1 3 16.0 18.9 18.0 4+ 58.9 39.6 45.4 Do not know 0.9 0.6 0.7 Total 100 100 100
Number of months pregnant at the time of first ANC check-up
No ANC 9.5 16.7 14.5 < = 3 months 69.7 58.5 61.8 4-6 months 17.9 21.5 20.4 7 months or after 2.2 2.7 2.5 Do not know 0.7 0.7 0.7 Total 100 100 100
Median months pregnant at first visit of antenatal check-up
3.0
3.0
3.0
Number of women 16,320 38,230 54,550
More than three out of every five women received three or more (3+) antenatal check-ups. Also,
more than two out of every five (45 percent) women received four or more (4 +) ANC check-ups. A
higher proportion of urban women (59 percent) received four or more number of ANC check-ups in
comparison to women from the rural areas (39 percent). It may be recalled from the previous
section that close to 16 percent women had not registered their pregnancy.
Close to 62 percentage of the women received their first ANC in the first trimester. Women receiving
ANC in the first trimester was more among the urban women (70 percent) in comparison to women
from the rural areas (59 percent). First check-up was delayed in a fifth of the women. Close to 20
percent of the women received first ANC check-up in the second trimester and another 3 percent
received during the seventh month or after. As per DLHS 2007-08, 45 percent women received the
first check-up in the first trimester and 26 percent received in the second trimester. Thus, the
situation on timing of the first antenatal check-up by women since 2007-08 seems to have improved.
Table 4.5 presents the percentage of women who had a live birth in the three years preceding the
survey by number of antenatal check-ups received and timing of first check-up, according to various
background characteristics.
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Table 4.5: Utilization of antenatal care services Percentage of women who had a live birth in the three years preceding the survey by number of antenatal check-up received and timing of first check-up, according to various background characteristics, RSOC, 2013-14
Background characteristics
Percentage who had at least one
ANC check-up
Percentage who had 3 and more
ANC check-ups
Percentage who had 4 and more
ANC check-ups
Percentage who received first ANC check-up in first
trimester of pregnancy
Number of women
Mother’s age 15-19 92.0 68.9 49.4 64.9 1,539 20-24 88.2 67.5 48.5 64.6 20,364 25-29 85.9 63.7 45.9 63.1 20,861 30-34 79.4 57.9 41.1 56.7 8,145 35-49 74.5 48.2 32.3 49.2 3,642
Residence
Urban 90.3 74.9 58.9 69.7 16,320 Rural 83.0 58.5 39.6 58.5 38,230
Birth order
One 88.1 69.8 52.5 66.8 25,575 Two 87.7 66.5 48.2 63.4 16,502 Three and more 75.8 46.2 26.9 49.5 12,473
Mother’s education
No education 71.8 40.3 22.4 46.7 17,616 Below Primary 88.1 64.1 40.2 54.5 2,615 Completed Primary 86.1 65.4 45.4 59.7 8,351 Completed Middle 92.0 74.1 55.5 68.0 8,562 Completed Secondary 93.6 78.8 61.1 72.2 7,602 Completed Higher Secondary & above
95.3 81.7 67.0 79.3 9,805
Social-group
Scheduled Caste 83.8 58.9 41.8 59.6 10,976 Scheduled Tribe 81.8 56.4 37.0 54.7 6,311 Other Backward Class 84.2 60.8 43.3 62.8 21,886 Other 88.8 72.9 54.4 65.1 14,828 Do not know 93.5 78.2 53.1 60.1 550
Religion
Hindu 85.5 62.9 45.6 62.1 42,658 Muslim 82.9 63.9 42.9 58.8 9,074 Christian 87.6 76.0 58.4 65.9 1,278 Sikh 87.1 60.8 40.9 66.9 825 Jain 92.7 51.6 48.9 78.9 119 Buddhist 94.6 68.6 47.1 74.7 338 Other 86.7 65.7 43.2 54.9 224 No religion 88.9 63.3 44.8 73.0 36
Wealth index
Lowest 74.7 43.7 24.5 47.0 10,977 Second 81.5 55.1 35.1 55.7 11,248 Middle 87.2 66.2 47.6 62.0 11,213 Fourth 89.5 73.3 56.8 68.8 11,092 Highest 94.0 80.1 64.4 77.0 10,020
Total 85.2 63.4 45.4 61.8 54,550
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As seen from the previous section, although close to 85 percent of the women received at least one
ANC check-up during pregnancy; 63 percent received three or more check-ups and 45 percent
received the recommended four or more ANCs, it is seen that there was a decline in the proportion
of pregnant women receiving check-ups, with the increase in their age. The women in the younger
age group (15-29) received relatively more number of check-ups than women of the higher age
groups. More than two-third of the women (between 68-69 percent) in the age group 15-24 had
received three or more check-ups in comparison to 48 percent in the case of the women aged 35-49.
Similarly, 49 percent of women in the age group 15-24 received four or more antenatal check-ups,
while the proportion of women in the age group 30-49 years varied between 32 to 41 percent.
Women belonging to the marginalized communities and financially weaker sections are less likely to
receive the recommended four + ANC check-ups, as it is seen that 42 percent of the women from SC
families and 37 percent of the women from the ST families received four or more ANC check-ups in
comparison to higher proportion (54 percent) of the women from Other categories. Similarly, close
to one-fourth women belonging to the poorest families received four or more check-ups, in contrast
to close to two-third of the women (64 percent) from the richest families.
4.2.4 Components of antenatal care
Tetanus Toxoid (TT) injections29
A question was asked in RSOC to women who delivered a live birth in the three years preceding the
survey whether TT injection was received during the pregnancy and if yes, number of injections
received. Those who had not received TT injection were further asked whether TT injection was
taken before that pregnancy and time of receiving that injection. Table 4.6 gives the percentage of
women who had a live birth in the three years preceding the survey, by the number of TT injections
received during pregnancy and percentage who received one TT injection during the current pregnancy
and at least one within one year prior to the pregnancy percentage, according to place of residence. Close
to nine out of every ten women (88 percent) received two doses of TT injections and another 2
percent of the women reported to have received at least one TT injection during this pregnancy and
at least one within one year prior to the current pregnancy. This means that overall 90 percent of
the women were covered under the required doses of TT injections, with 92 percent women from
the urban areas and 89 percent from the rural areas.
29 In order to correctly assess the coverage of women who are adequately immunized against tetanus, women reporting
receipt of less than two doses of TT during current pregnancy were further probed whether they had received any TT injection any time before this pregnancy. among those reporting in affirmative, women who had received any dose of TT in last one year preceding current pregnancy, such women are also included under the category of ‘adequately immunized ones’. It is pertinent to note here that under RSOC, the period for such consideration was ‘last one year of current pregnancy’ against last 3 years used in NFHS.
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Table 4.6: Tetanus Toxoid vaccination Percent distribution age of women who had a live birth in the three years preceding the survey, by number of TT injections received during pregnancy and percentage who received one TT injection during the current pregnancy and at least one within one year prior to the pregnancy percentage, according to place of residence, RSOC, 2013-14
TT injections received Residence
Total Urban Rural
Number of TT injection received
No TT 3.6 5.7 5.1 One 5.7 7.0 6.6
Two or more 90.7 87.3 88.3 Total 100.0 100.0 100.0
Percentage who received one TT injection during the current pregnancy and at least one within one year prior to the
pregnancy 1.5 1.5 1.5
Percentage who received either two TT injection during current pregnancy or one during current pregnancy and one
within a year prior to pregnancy 92.2 88.8 89.8
Number of women 16,320 38,230 54,550
Figure 4.2: Percentage of women who received two or more TT injections during pregnancy by wealth quintiles, as per RSOC and DLHS 2007-08
Figure 4.2 gives the comparison of proportion of women who received two or more TT injections as
per RSOC and DLHS 2007-08. It is seen that the overall situation of receiving two or more TT
injections by women has improved by 21 percentage points since DLHS 2007-08 and a similar
situation is seen across all wealth quintiles too; maximum improvement (36 percentage points) is
seen among the women from the poorest quintile.
83 86 89 91 94 88
47 55
65 75
87
67
Lowest Second Middle Fourth Highest Total
RSOC 2013-14 DLHS 2007-08
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Receipt and Consumption of Iron Folic Acid (IFA) tablets
As per the recommendations, a pregnant woman is required to consume 100 or more IFA tablets
during her pregnancy. In RSOC, a question was asked in the ever married women (EMW)
questionnaire whether IFA tablets/syrup were purchased or received during the pregnancy. If
answered in affirmative, she was asked about the number of tablets/syrup bottles
purchased/received. From Table 4.7 it is observed that slightly over two-third of the women (68
percent) purchased or received IFA tablets and/syrup bottles30 (irrespective of quantity or size of
tablet) during pregnancy. The proportion of the urban women (72 percent) purchasing/receiving IFA
tablets/syrup bottles was relatively higher than that of the rural women (67 percent). However, only
31 percent women received or purchased the requisite31 100 or more tablets/syrup during
pregnancy. Another 37 percent did not receive or procure adequate quantity. Thus, close to one in
every three women (32 percent) neither received nor procured IFA tablets/syrup.
Government has been supplying IFA tablets/syrups to all pregnant women from their health facilities
as part of the RCH programme. Close to half of the women aged 15-49 years (47 percent) cited
government as the main source from where they received or procured the IFA tablets/syrups. This
phenomenon was seen more in the rural areas (51 percent) than in the urban areas (39 percent);
close to a tenth (13 percent) reported to have received from private sources and around 9 percent
received/procured from other sources. More urban women (24 percent) than the rural women (8
percent) procured/received IFA from private sources.
30 Three IFA syrup bottles of 100 ml each is equivalent to 100 IFA large tablets.
31 As per the programme every pregnant women should consume 100 or more IFA tablets/equivalent syrup during pregnancy.
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Table 4.7: Receipt and consumption of IFA tablets Percent distribution of women who had a live birth in the three years preceding the survey by the number of IFA tablets or syrup received/purchased; of those who received/purchased IFA tablets or syrup by source from where received/purchased and the number of IFA tablets consumed, according to place of residence, RSOC, 2013-14
Receipt and consumption of IFA Residence
Total Urban Rural
Number of IFA tablets/syrup32
received or purchased* 72.1 66.9 68.4
1-59 14.5 18.9 17.6 60-89 11.5 11.0 11.1 90-99 10.0 7.9 8.5
100 or more 36.1 29.1 31.2 Neither received nor purchased IFA 27.9 33.1 31.6
Total 100.0 100.0 100.0
Source of IFA tablets/syrup*
Government source 38.7 50.8 47.2
Private source 23.9 7.6 12.5 Other sources 9.5 8.5 8.8
Neither received nor purchased IFA 27.9 33.1 31.6 Total 100.0 100.0 100.0
Number of IFA tablets/syrup consumed*
1-59 20.2 24.8 23.4 60-89 12.3 11.1 11.4 90-99 9.7 7.2 8.0
100 or more 28.8 21.4 23.6 Not received/consumed 29.0 35.6 33.6
Total 100.0 100.0 100.0
Number of women 16,320 38,230 54,550
*Any type of tablets/syrup irrespective of size/quantity.
Low procurement or receipt of iron and folic tablets/syrups significantly affected the consumption of
the requisite quantity of IFA tablets/syrup by the women in both the rural and the urban areas.
Consumption of 100 IFA tablets or equivalent quantity of syrup during pregnancy is critical for health
of the woman and the baby. Close to two-third of the women (68 percent) reported to have
consumed IFA tablet/syrup during pregnancy, with 72 percent from the urban and 67 percent from
the rural areas. But, less than one-fourth (24 percent) reported consuming the requisite quantity
(100 or more IFA tablet/syrup) during pregnancy. In terms of place of residence, 29 percent of the
women from the urban and 21 percent of the women from the rural areas reported to have
consumed the requisite quantity of IFA.
Of the women who had a live birth in three years preceding the survey, analysis of percentage of
women who received/purchased 100 or more IFA tablets, consumed 100 or more IFA tablets and
32 Syrup bottles have been converted to tablets as per the formula.
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received two or more TT injections during pregnancy by various background is presented in the
Table 4.8. As per the analysis, overall receipt and consumption of IFA tablet/syrup was low across all
ages of the women. Regarding receipt, proportion of women receiving 100 or more IFA tablet/syrup
declined from 33 percent for women in the age group 15-19 to 24 percent for the women in the age
group 35-49. Consumption was also low among all age groups. Proportion of women consuming 100
or more IFA tablets/syrup varied between 18 to 23 percent for women in the age group 15-49.
Relatively women from the urban areas are more likely to consume IFA than the women from the
rural areas, as 29 percent of the urban women consumed 100 or more IFA tablet/syrup in
comparison to 21 percent of the rural women. It is also seen from the table that more proportion of
women with the first and second order birth (26 percent for both birth order) consumed required
quantity of IFA than those women with higher (3 or more) birth orders (15 percent).
Level of education of the women and economic condition of the households are important drivers of
improving consumption of IFA. There is a gradual increase in consumption of IFA with increase in the
levels of education, increasing from 13 percent for women with no education to 36 percent for
women who completed higher secondary & above level of education. Similarly, an increasing trend is
seen in consumption pattern of 100 or more IFA tablets amongst the women from different wealth
quintiles, increasing from the lowest to the highest quintiles. Relatively less proportion of the
women (14 percent) from the lowest quintile consumed the requisite 100 or more tablets, in
contrast to 35 percent of the women from the richest families. There are researches and evidences
for the low consumption of IFA tablets. However, it has not been studied in this survey.
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Table 4.8: Antenatal care indicators
Among the women who had a live birth in three years preceding the survey, percentage of women who received/purchased 100 or more IFA tablets, consumed 100 or more IFA tablets and those who received two or more TT injections during pregnancy, according to background characteristics, RSOC, 2013-14
Background characteristics Received/purchas
ed 100 or more IFA tablets*
Consumed 100 or more IFA
tablets*
Received two or more TT injections
during pregnancy
Received one TT injection during
pregnancy and one within a year prior to
current pregnancy
Number of women
Mother’s age 15-19 33.2 22.8 91.0 1.7 1,539 20-24 33.0 24.5 89.5 1.5 20,364 25-29 31.7 24.8 89.2 1.5 20,861 30-34 28.0 20.8 86.2 1.5 8,145 35-49 24.2 17.8 80.2 1.6 3,642
Residence Urban 36.1 28.8 90.7 1.5 16,320 Rural 29.1 21.4 87.3 1.5 38,230
Birth order One 34.3 26.4 91.5 1.4 25,575 Two 34.0 25.8 88.6 1.5 16,502 Three and more 21.0 15.0 81.4 1.6 12,473
Mother’s education No education 18.9 13.3 80.6 1.5 17,616 Below Primary 30.9 19.8 87.5 1.8 2,615 Completed Primary 31.4 23.3 89.3 1.7 8,351 Completed Middle 33.7 24.7 92.4 1.4 8,562 Completed Secondary 40.3 31.7 93.4 1.6 7,602 Completed Higher Secondary & above
43.7 36.1 94.1 1.3 9,805
Social-group Scheduled Caste 29.3 21.6 87.6 1.6 10,976 Scheduled Tribe 30.5 20.6 84.2 1.9 6,311 Other Backward Class 30.3 23.6 88.1 1.3 21,886 Other 34.3 26.6 90.8 1.5 14,828 Do not know 26.7 16.2 88.7 3.2 550
Religion Hindu 31.4 23.8 88.7 1.5 42,658 Muslim 27.9 20.6 86.3 1.2 9,074 Christian 44.9 35.2 86.9 1.5 1,278 Sikh 26.5 21.1 92.7 1.5 825 Jain 48.9 43.2 97.3 0.0 119 Buddhist 38.2 31.8 88.2 3.0 338 Others 41.1 31.0 88.9 2.5 224 No religion 29.2 27.2 88.2 0.2 36
Wealth index Lowest 20.7 13.8 82.8 1.6 10,977 Second 26.9 19.5 85.6 1.6 11,248 Middle 31.3 23.5 88.8 1.6 11,213 Fourth 36.0 27.3 91.2 1.5 11,092 Highest 41.8 35.0 93.7 1.0 10,020
Total 31.2 23.6 88.3 1.5 54,550
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Close to 90 percent of the women had received TT injections during their pregnancy. No significant differential is seen in the receipt of TT injections amongst the women from the different social groups as the variation was between 88 to 91 percent.
Full Antenatal care
As per the requirement of safe motherhood programme under the RCH,33 full ANC includes receipt
of 3+ ANC, at least one dose of TT and consumption of 100 or more IFA tablets/three bottles of IFA
syrup during pregnancy. Table 4.9 presents analysis of percentage of women who received full ANC
according to various background characteristics.
Table 4.9: Full ANC Among the women who had a live birth in the three years preceding the survey, percentage of women who received full ANC according to various background characteristics, RSOC, 2013-14
33 Reproductive and Child Health Programme of the Government of India, http://mohfw.nic.in/ and http://nrhm.gov.in/
Background characteristics Received Full ANC # Number of women
Mother’s age 15-19 18.9 1,539 20-24 20.7 20,364 25-29 20.7 20,861 30-34 17.2 8,145 35-49 13.9 3,642
Residence Urban 25.2 16,320 Rural 17.3 38,230
Birth order One 22.5 25,575 Two 21.6 16,502 Three and more 11.3 12,473
Mother’s education No education 9.3 17,616 Below Primary 15.9 2,615 Completed Primary 19.7 8,351 Completed Middle 21.4 8,562 Completed Secondary 27.1 7,602 Completed Higher Secondary & above 32.1 9,805
Social-group Scheduled Caste 18.0 10,976 Scheduled Tribe 15.0 6,311 Other Backward Class 19.6 21,886 Other 23.2 14,828 Do not know 14.2 550
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# Full ANC includes receipt of 3+ ANC, at least one dose of TT and consumption of 100 or more IFA
tablets/three bottles of IFA syrup
It is observed in Table 4.9 that the overall, the level of full ANC is low as only two out of every ten
(20 percent) women in the age group 15-49 received the full components of antenatal care. It is
however seen, that level of education is an important driver of receiving full ANC. While less than
one in every ten women (9 percent) with ‘no education’ received full ANC, on the other hand, close
to three for every 10 women (32 percent) who completed secondary or higher level of education
received full ANC. Relatively, women from the wealthier families are more likely to receive full ANC
than women from the poor families. The level of receipt of full ANC varied between 10 percent for
women from the poorest families to 31 percent for women from the richest families.
Figure 4.3: Percentage of women who received various components of antenatal care services
Figure 4.3 presents
the percentage of
women receiving
different components
of antenatal care
services. Although 84
percent women
registered their
pregnancy and 73
percent received MCP
card, only 31
percentage of the
women
received/procured IFA tablet/syrup and 24 percent consumed the recommended number. Overall 20
percentage of the women received all the required components of ANC. Quite clearly, low level of
full ANC is linked to inadequate supply as well as consumption of IFA.
Background characteristics Received Full ANC # Number of women
Religion Hindu 19.7 42,658 Muslim 17.9 9,074 Christian 31.9 1,278 Sikh 16.5 825 Jain 26.8 119 Buddhist 22.0 338 Other 25.6 224 No religion 19.8 36
Wealth index Lowest 9.5 10,977 Second 15.5 11,248 Middle 19.8 11,213 Fourth 23.3 11,092 Highest 31.3 10,020
Total 19.7 54,550
84
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4.2.5 Components of ANC across states
Antenatal check-ups by states
Table 4.10 presents percentage of women who had live births in three years preceding the survey by
receipt of number of antenatal check-ups received during pregnancy and by place of residence,
according to state.
Table 4.10: Antenatal check-ups by state Among women who had a live birth in three years preceding the survey, percentage who received antenatal check-ups during pregnancy by number of check-ups and place of residence according to state, RSOC, 2013-14
State
Percentage who had at least one ANC
Percentage who had 3 or more ANC check-ups
Percentage who had 4 or more ANC check-ups
Urban Rural Total Urban Rural Total Urban Rural Total
India 90.3 83.0 85.2 74.9 58.5 63.4 58.9 39.6 45.4 North
Delhi 85.9 84.5 85.9 75.6 70.0 75.5 58.3 54.4 58.3 Haryana 81.7 80.3 80.7 52.8 45.1 47.5 33.0 21.2 24.9 Himachal Pradesh 84.4 91.1 90.5 57.3 57.8 57.8 38.4 34.5 34.8 Jammu & Kashmir 88.6 75.8 79.1 65.8 54.9 57.7 58.6 39.5 44.4 Punjab 88.9 85.2 86.5 67.6 55.7 59.8 49.2 32.9 38.6 Uttar Pradesh 74.7 58.1 61.6 52.9 34.9 38.6 39.8 25.1 28.1 Uttarakhand 89.1 74.1 78.7 68.0 45.0 52.0 50.8 26.6 34.0
Central Chhattisgarh 97.1 95.3 95.7 89.1 76.9 79.6 66.9 48.4 52.4 Madhya Pradesh 82.6 73.0 75.4 52.6 38.1 41.7 33.2 18.8 22.4
East Bihar 89.4 84.1 84.7 53.6 30.3 32.8 17.0 8.9 9.8 Jharkhand 90.5 78.0 80.7 65.6 42.4 47.3 38.3 16.7 21.3 Odisha 94.9 91.5 92.0 83.5 73.7 75.3 67.0 47.0 50.3 West Bengal 96.8 99.0 98.3 90.4 89.3 89.7 77.1 67.3 70.4
Northeast Arunachal Pradesh 92.4 81.1 83.9 88.2 69.1 73.8 72.9 48.7 54.7 Assam 95.9 92.8 93.2 83.1 72.9 74.2 52.7 36.8 38.9 Manipur 96.7 84.5 88.4 92.7 73.1 79.4 82.6 56.8 65.1 Meghalaya 89.3 85.2 86.0 77.6 68.9 70.6 63.3 43.0 46.9 Mizoram 91.0 88.6 89.9 79.8 69.6 75.2 64.0 37.1 51.8 Nagaland 53.5 15.2 25.1 30.5 9.0 14.5 18.8 6.2 9.4 Sikkim 99.2 99.5 99.4 91.6 92.4 92.2 79.9 74.6 75.8 Tripura 91.0 74.0 78.1 85.1 61.1 67.0 73.8 41.5 49.4
West Rajasthan 89.1 79.9 82.2 64.8 46.9 51.2 42.2 27.1 30.8 Goa 98.0 99.3 98.4 93.8 94.7 94.1 87.0 86.4 86.7 Gujarat 90.1 87.0 88.2 79.0 67.9 72.3 68.8 49.5 57.2 Maharashtra 91.8 92.9 92.4 73.7 72.9 73.2 55.3 49.0 51.9
South Andhra Pradesh 93.6 94.2 94.0 78.6 76.2 76.9 58.2 55.9 56.6 Karnataka 94.7 93.1 93.7 92.0 85.5 87.9 86.8 78.4 81.5 Kerala 97.1 95.4 96.2 88.9 86.8 87.8 76.8 76.2 76.5 Tamil Nadu 98.3 98.0 98.2 92.4 91.2 91.8 82.0 76.1 78.8
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The utilization of ANC services varied widely among the states. Women receiving at least one ANC
varied between 99 percent in Sikkim to 25 percent in Nagaland. Except for the six states, namely,
Nagaland (25 percent), Uttar Pradesh (62 percent), Madhya Pradesh (75 percent), Uttarakhand (79
percent), Jammu and Kashmir (79 percent) and Tripura (78 percent), in all other states 80 percent or
more women received at least one ANC check-up.
Among the states, proportion of women receiving three or more ANC check-ups varied between 94
percent in Goa to 15 percent in Nagaland. In seven states, 80 percent or more women received three
or more check-ups. As stated earlier, coming to women receiving four or more ANC check-ups as
recommended by the programme, nationally less than half (45 percent) of the women availed the
requisite number of check-ups. Among the states, women receiving four or more ANC check-ups
varied between 87 percent in Goa to 9 percent in Bihar and Nagaland. In fact there are only two
states, namely Goa and Karnataka where more than 80 percent women received four or more ANC
check-ups. In 17 states, levels of 4 + ANC check-ups were above the national average (45 percent).
Iron and Folic Tablets and Full ANC by states
Table 4.11 presents state wise percentage of women who received or purchased 100 or more IFA
tablets/syrup; percentage of women who consumed 100 or more IFA tablets/syrup and percentage of
women who received two or more TT injections during pregnancy. Percentage of women receiving or
purchasing IFA tablets/syrup varied widely from 73 percent in Goa to 5 percent in Nagaland. In only
eight states, 50 percent or more women purchased/received IFA. Likewise, proportion of women
consuming 100 or more IFA tablets/syrup was low among the states and it varied from 61 percent in
Goa to 4 percent in Nagaland and Uttar Pradesh. In 16 states, the level of consumption was more
than the national average (24 percent). Goa (61 percent women) closely followed by Kerala (59
percent) and also Sikkim (59 percent) were relatively among the better performing states. At the
other end of the spectrum are Bihar and Uttar Pradesh where consumption of recommended doses
of IFA tablets/syrup by the women was below 5 percent.
With regards to receiving the recommended two doses or more of TT injections during pregnancy,
almost all states had done well. Percentage of women aged 15-49 taking two TT injections or more
during pregnancy varied from 69 percent in Nagaland to 97 percent in Andhra Pradesh. In 15 states,
percent of women taking two or more TT injections were more than the national average (88
percent). In 12 states, namely, Himachal Pradesh, Jharkhand, Chhattisgarh, Karnataka, Tamil Nadu,
West Bengal, Sikkim, Odisha, Punjab, Goa, Andhra Pradesh and Kerala more than 90 percent of the
women reported receiving at least two or more doses of TT during pregnancy.
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Table 4.11: Antenatal care indicators by state
Among the women who had a live birth in the three years preceding the survey, percentage who
received/purchased 100 or more IFA tablets/syrup, consumed 100 or more IFA tablets/syrup and received two
or more TT injections during pregnancy, according to states, RSOC, 2013-14
States
Percentage who received/purchased
100 or more IFA tablets/syrup
Percentage who
consumed 100 or more
IFA tablets/syrup
Percentage who received two or
more TT injection during
pregnancy
Percentage who received Full
ANC
India 31.2 23.6 88.3 19.7 North
Delhi 33.5 22.2 88.2 20.6 Haryana 16.3 12.3 85.1 9.7 Himachal Pradesh 50.5 40.0 90.5 26.3 Jammu & Kashmir 27.9 23.1 83.9 16.0 Punjab 25.6 19.7 95.3 15.5 Uttar Pradesh 7.6 4.3 81.4 2.7 Uttarakhand 26.7 21.3 87.7 15.5
Central Chhattisgarh 36.0 22.1 92.2 18.8 Madhya Pradesh 30.3 19.6 88.9 12.1
East Bihar 16.7 14.0 88.6 9.6 Jharkhand 15.2 10.3 90.6 6.9 Odisha 44.8 28.9 95.8 24.6 West Bengal 34.4 22.5 96.0 21.2
Northeast Arunachal Pradesh 52.6 27.7 77.5 23.3 Assam 54.7 27.7 90.2 25.2 Manipur 32.2 27.5 90.0 27.0 Meghalaya 40.6 25.2 73.7 22.2 Mizoram 55.3 52.0 83.8 42.7 Nagaland 5.1 3.7 68.6 3.6 Sikkim 65.9 58.8 94.6 55.7 Tripura 36.7 24.6 89.8 23.1
West Rajasthan 17.5 11.6 82.6 8.6 Goa 72.7 61.0 95.1 58.9 Gujarat 37.4 31.2 87.6 25.7 Maharashtra 36.1 28.7 89.9 24.4
South Andhra Pradesh 52.7 47.0 97.1 38.2 Karnataka 41.3 34.1 93.2 32.4 Kerala 66.0 59.3 95.1 53.6 Tamil Nadu 47.3 37.7 96.4 35.2
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While close to three-fifth (59 percent) of the women from Goa received full ANC, in contrast, three
percentage of the women from Uttar Pradesh received the full components of ANC. In states like
Uttar Pradesh, Nagaland, Jharkhand and Rajasthan, less than 10 percentage of the women received
full ANC. In 13 states, level of full ANC was above the national average (20 percent).
4.2.6 Place of ANC and service provider
The place of antenatal check-ups and the type of service provider are in a sense indicative of the
quality of ANC service received by the women. In RSOC, women who had a live birth in the three
years preceding the survey were asked about the place of receiving ANC check-ups and the type of
healthcare provider who did the check-ups. As women might have received services from more than
one provider, results would not add up to 100 percent. The results are presented in Table 4.12.
Government-run health facilities appear to be preferred places of receiving ANC check-ups, both in
rural and the urban areas. Overall, 43 percent of the women had taken check-ups at government run
health facilities. Little more than one out of every five women (22 percent) reported receiving ANC
from AWCs and 38 percent reported receiving ANC check-ups from private health facilities. More
women (50 percent) from the urban areas accessed private health facilities than women from the
rural areas (33 percent) for ANC services.
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Table 4.12: Place of antenatal check-ups and type of service provider Percentage of women who had a live birth in the three years preceding the survey by place where antenatal check-up taken and type of ANC providers, according to residence, RSOC, 2013-14
Place of ANC and ANC provider
Residence
Total Urban Rural
Place of antenatal check up Anganwadi centre 10.6 27.4 22.4
Government health facilities 44.6 42.7 43.3 Private health facilities 49.7 33.1 38.1
Mobile clinic 0.6 0.5 0.5 Home 1.5 3.0 2.6 Other 1.2 1.6 1.5
Don’t know/can’t say 0.4 0.2 0.3
ANC provider Doctor 71.8 51.5 57.6
Auxiliary Nurse Midwife (ANM) 19.7 35.2 30.5 Lady Health Visitor(LHV)/nurse 14.8 17.4 16.7
Other health professional 2.2 3.0 2.8 Trained Birth Attendant (TBA) 0.5 1.0 0.9
Any skilled provider34
89.0 82.1 84.2 Other 0.9 0.8 0.8
Number of women 16,320 38,230 54,550
Nationally, close to three for every five women (58 percent) reported that a doctor provided ANC
services. Overall, 84 percent of the ANC check-ups were provided by a skilled health provider. The
urban and rural differential as per Table 4.12 indicates that more women living in the urban areas
(72 percent) received ANC services from a doctor than their counterparts in the rural areas (52
percent). Close to one-third women (31 percent) reported receiving services from an ANM whereas
less than a fifth (17 percent) reported receiving ANC services from an LHV/nurse of a health facility.
A substantial proportion of women living in rural areas reported receiving services from an ANM (35
percent) and LHV/Nurse (17 percent).
34 A skilled provider is doctor, ANM, nurses or other health professional
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Visit by health functionaries during pregnancy
One of the job responsibilities of an AWW, ASHA and the ANM is to make routine home visitations to
all pregnant woman and lactating mothers who reside within the jurisdictional boundaries of their
operational area. The AWW and ASHA are required to make allotted home visits every day. The
home visitations by the healthcare workers are necessary to provide individual and family
counselling on issues of diet, rest, use of iodized salt as part of ANC. These visitations are also used
for counselling on issues of birth planning and safe/institutional delivery.35
In RSOC 2013-14, eligible respondents were asked whether any AWW/ASHA/ANM or doctor visited
their home during period of pregnancy. Enumerators read out the options of service providers so
that the women could respond if they were visited by more than one provider. Table 4.13 presents
the percentage of women who had a live birth in the last three years preceding the survey, visited by
AWW, ASHA, ANM or/and doctor at home during pregnancy, according to various background
characteristics. Close to a third (35 percent) women reported that an AWW visited them during
pregnancy; a little less than a third (32 percent) reported she was visited by an ASHA. Fourteen
percent of the women reported visitations by an ANM and around three percent women reported a
visit by a doctor during her pregnancy period.
Table 4.13: Visit by health functionaries at home during pregnancy Among women who had a live birth in the last three years preceding the survey, percentage who were visited by AWW, ANM, ASHA and doctor at home during pregnancy, according to selected background characteristics, RSOC, 2013-14
Background Characteristic
Type of health functionary Number of Women AWW ASHA ANM Doctor
Mothers age
15-19 35.2 38.9 13.0 1.8 1,539 20-24 36.6 32.8 15.4 2.6 20,364 25-29 34.9 30.8 13.8 3.1 20,861 30-34 31.2 28.6 11.3 2.6 8,145 35-49 32.2 32.7 12.1 3.1 3,642
Social-group Scheduled Caste 36.1 33.3 14.3 2.3 10,976 Scheduled Tribe 42.5 37.4 13.8 2.6 6,311 Other Backward Class 33.6 29.4 14.3 3.2 21,886 Other 32.5 30.6 13.0 2.6 14,828 Do Not Know 30.3 42.9 11.1 2.7 550
Wealth index Lowest 33.5 36.8 10.5 1.7 10,977 Second 36.7 38.9 13.2 1.9 11,248 Middle 39.7 34.5 17.3 2.1 11,213 Fourth 36.2 26.6 16.9 3.8 11,092 Highest 27.2 19.7 11.1 4.7 10,020
Total 34.8 31.6 13.9 2.8 54,550
35Letter from MWCD on Role Clarity and Delineation of Roles for Frontline Health Workers, No. 9-1/2012-CD—I (Part), 2013
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4.3 NATAL CARE
The emphasis of the government on timely provision of emergency obstetric and essential obstetric
care and newborn care are the key strategies for natal care. The Twelfth Five Year Plan 2012-17 of
the government envisages to reduce maternal mortality to one per 1000 live births by the end of the
Twelfth Plan. Government is promoting institution based natal care by implementing conditional
cash transfer scheme namely Janani Suraksha Yojna (JSY). Government also implemented Janani
Shishu Suraksha Karykram (JSSK) under the aegis of the NRHM to reduce maternal and infant
mortality.
In RSOC, several questions were asked to eligible respondents on natal care focusing upon whether
she and her family members were advised or counselled to opt for institutional delivery, the place of
delivery, type of provider assisting the delivery. In case the woman opted for institutional delivery,
she was asked about the duration of her stay in the health facility post-delivery. She was also asked
about her awareness of the JSY and JSSK schemes and whether she availed any benefits from these
national flagship schemes.
4.3.1 Place of delivery
The choice of a place of delivery is very crucial in determining the quality of care available to the
mother and her child immediately after birth. In RSOC, mothers who had a live birth in the last three
years preceding the survey were asked about the place of delivery. Table 4.14 presents the percent
distribution of births in the three years preceding the survey by place of delivery and according to
various background characteristics.
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Table 4.14: Place of delivery Percent distribution of live births in the three years preceding the survey, by place of delivery and according to selected characteristics, RSOC, 2013-14
Background characteristics
Place of delivery
Institutional delivery
Number of live births
Government hospital/
health centre
Private hospital/
clinic/nursing home
Home Other Total
Mother’s age 15-19 57.5 24.4 17.9 0.2 100.0 81.9 1,539 20-24 52.0 30.3 17.3 0.4 100.0 82.3 20,364 25-29 47.3 31.4 21.0 0.3 100.0 78.7 20,861 30-34 42.6 31.5 25.6 0.4 100.0 74.0 8,145 35-49 43.0 25.4 30.7 0.9 100.0 68.4 3,642
Birth order One 48.8 37.7 13.2 0.3 100.0 86.4 25,575 Two 50.0 29.8 19.9 0.3 100.0 79.8 16,502 Three and more 45.3 16.3 37.9 0.5 100.0 61.6 12,473
Residence Urban 42.6 45.9 11.2 0.3 100.0 88.5 16,320 Rural 50.8 23.8 25.0 0.4 100.0 74.6 38,230
Number of ANC visits No ANC 38.1 14.7 46.4 0.7 100.0 52.9 7,918 1-3 51.5 23.9 24.2 0.3 100.0 75.5 21,505 4+ 48.8 41.1 9.8 0.3 100.0 89.9 24,742 Do not know 49.6 27.8 22.0 0.7 100.0 77.3 386
Mother’s education No education 47.3 15.4 36.8 0.5 100.0 62.6 17,616 Below Primary 56.1 15.9 27.4 0.5 100.0 72.1 2,615 Completed Primary 54.7 24.7 20.1 0.4 100.0 79.5 8,351 Completed Middle 57.4 26.7 15.6 0.4 100.0 84.0 8,562 Completed Secondary 47.6 43.6 8.7 0.2 100.0 91.1 7,602 Completed Higher Secondary& above
35.5 59.1 5.2 0.2 100.0
94.6 9,805
Social-group Scheduled Caste 55.2 20.8 23.5 0.5 100.0 76.0 10,976 Scheduled Tribe 52.8 17.3 29.7 0.3 100.0 70.1 6,311 Other Backward Class 46.3 32.9 20.4 0.4 100.0 79.2 21,886 Other 44.4 39.8 15.5 0.3 100.0 84.2 14,828 Do not know 44.5 19.8 35.4 0.3 100.0 64.3 550
Wealth index Lowest 51.5 9.3 38.5 0.7 100.0 60.8 10,977 Second 54.8 16.8 28.0 0.3 100.0 71.7 11,248 Middle 54.0 27.1 18.5 0.3 100.0 81.1 11,213 Fourth 46.8 41.5 11.4 0.3 100.0 88.3 11,092 Highest 32.9 60.1 6.7 0.3 100.0 93.0 10,020
Total 48.3 30.4 20.9 0.4 100.0 78.7 54,550
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Overall, more than three-fourth (79 percent) deliveries were in a health institution (covering both
government and private). Thus, according to the findings of RSOC one-fifth of births occurred at
home in contrast to about half of deliveries taking place at home as per DLHS 2007-08.The births in
health institutions show utilization of government hospital/health centres was close to half (48
percent) and another one-third (30 percent) availed facilities of privately-run hospitals, clinics or
nursing homes. Women from urban areas are more likely to deliver in a health institution than their
counterparts in the rural areas. Three-fourth of the births in the rural areas and 89 percent of the
births in the urban areas were delivered in a health facility. It is also seen that there is a gradual
decrease in proportion of deliveries in health institutions with the increase in age of the mother.
While eight among every ten births to mothers in the age group 15-29 years were in a health facility,
in comparison, close to seven out of every ten births to mothers in the age group 30-49 years were
institutional delivery.
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Figure 4.4: Percentage of births in a health institution as per RSOC 2013-14 and DLHS 2007-08
Figure 4.4 presents comparison of institutional
delivery as per RSOC 2013-14 and DLHS 2007-08.
As per Figure 4.4 institutional delivery in both
rural and urban areas have significantly
improved; increasing by 37 percentage points in
rural areas and 19 percentage points in the
urban areas.
Figure 4.5: Institutional delivery among different social groups, as per RSOC 2013-14 and DLHS 2007-08
Figure 4.5 presents
comparison of institutional
delivery among different
social groups as per RSOC
and DLHS 2007-08. It is
observed that more
institutional deliveries
occurred in 2013-14 since
the DLHS held in 2007-08, to mothers from the vulnerable groups like SC and ST.
Figure 4.6 presents percentage of institutional delivery among different wealth quintile groups, as
per RSOC 2013-14 and DLHS 2007-08.
Figure 4.6: Percentage of institutional delivery among different wealth quintile groups, as per RSOC 2013-14 and DLHS 2007-08
Improvement vis-a-vis 2007-08
in proportion of births being
delivered in health institutions
is seen in 20013-14 across all
wealth quintile groups, as per
the Figure 4.6. However,
significant improvement is
seen among the mothers from
families in the lower quintiles.
In the first three quintiles, (Q1 to Q3) improvement is more than 40 percentage points with respect
to that in 2007-08 and in the fourth quintile, improvement is little more than 30 percentage points.
Differential between poorest and richest is still very large.
75
38
89
70
RSOC 2013-14
DLHS 2007-08
Urban Rural
42 33
48 59
76 70 79 84
Scheduled Caste Scheduled Tribe Other BackwardClass
Other
DLHS 2007-08 RSOC 2013-04
61 72
81 88 93
19 29
42
58 80
Lowest Second Middle Fourth Highest
RSOC DLHS 2007-08
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4.3.2 Assistance during delivery and safe delivery36
The RCH programme under NRHM emphasized for safe deliveries conducted by a trained/skilled
birth attendant or a health professional, even if delivered at home. Obstetric care from a trained
provider during delivery is recognized as critical for the reduction of maternal and neonatal mortality
as well as morbidity. In RSOC, 2013-14 a question was asked about who assisted in delivery, to all
eligible respondents.
Among the live births in the three years preceding the survey, type of assistance during delivery, is
presented in Table 4.15. Assistance by a doctor is seen in more than half of the births (55 percent),
in another 27 percent births LHV/nurse or an ANM assisted during delivery. Little less than a tenth (8
percent) deliveries were assisted by traditional birth attendants and similar proportion (9 percent)
was assisted by friends and relatives. Overall, close to four-fifth of the deliveries (81 percent) were
conducted by a doctor or a skilled provider. However, percentage of deliveries (71 percent) assisted
by a doctor or any trained provider was relatively lower among mother in the age group of 35-49
years in comparison to the younger mothers (more than 80 percent) in the age group of 15-29 years.
As per DLHS 2007-08, close to half of the deliveries were safe. This clearly reflects that there is an
overall improvement in the situation of safe delivery in the country. It is noted from Table 4.15 that
around 11 percent of the home deliveries were attended by a doctor or other skilled health
providers.
Safe deliveries or deliveries assisted by skilled health providers (doctors, nurses, LHVs and ANM) in
2013-14 were more likely in the urban areas (90 percent) than in the rural areas (77 percent). As per
DLHS 2007-08, safe delivery among the urban women was 76 percent and 43 percent among the
rural women.
Level of education of the mother and economic condition of the household significantly affect the
place of delivery as well as the person who assisted in the delivery. While 66 percent of births to
mothers with no education delivered in a health institution or were assisted by a trained health
provider, close to 96 percent of births to mothers who completed higher secondary or above level of
education were delivered by a skilled health provider. In fact, a majority (76 percent) of the births to
mothers were assisted by a doctor during delivery. Similarly, in comparison to 64 percent births in
the household from the lowest wealth quintile, 95 percent of births in the household from the
highest quintile were assisted by a skilled health provider. Among religious groups more births from
the Sikh (86 percent), Buddhist (91 percent), and Hindu (83 percent) households were reported to
have received assistance of a skilled health provider than births in the Muslim community (73
percent).
36 Safe delivery means delivery conducted by doctors, nurses, LHVs and ANM.
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Table 4.15: Type of assistance during delivery by background characteristics Among the live births in the three years preceding the survey, percent distribution of births, delivered by different heath providers and delivered by a skilled health provider according to selected characteristics, RSOC, 2013-14
Background Characteristics
Percentage of births delivered by Delivered by a
skilled health
provider37
Number of births Doctor
ANM/Midwife/LHV/Nu
rse
Trained birth
attendant
Friends/ Relatives/
Family members
Other No one
Mother’s age 15-19 53.1 30.9 4.6 7.8 2.6 0.9 84.1 1,539 20-24 56.5 28.1 6.5 7.1 1.6 0.3 84.5 20,364 25-29 55.6 25.5 8.1 8.7 1.6 0.5 81.1 20,861 30-34 52.1 24.5 9.2 11.3 2.1 0.7 76.6 8,145 35-49 45.6 25.5 10.8 14.9 2.2 1.1 71.0 3,642
Birth order 1 63.9 24.4 5.3 5.2 1.0 0.3 88.3 25,575 2 55.3 26.7 7.6 8.2 1.7 0.4 82.1 16,502 3+ 34.7 30.4 12.9 17.3 3.5 1.1 65.1 12,473
Residence Urban 70.1 20.1 4.7 3.9 0.9 0.3 90.2 16,320 Rural 48.1 29.2 9.0 11.0 2.1 0.6 77.2 38,230
Number of ANC visits No ANC 30.1 26.0 14.8 24.0 3.6 1.5 56.1 7,918 1-3 47.3 31.2 9.8 9.2 2.0 0.6 78.5 21,505 4+ 68.9 22.5 3.7 3.7 0.9 0.2 91.4 24,742 Do not know 57.0 21.9 7.0 11.7 2.0 0.3 78.9 386
Mother’s education No education 37.5 28.4 13.4 16.7 2.9 1.0 65.9 17,616 Below Primary 45.6 29.5 11.4 10.2 2.5 0.7 75.1 2,615 Completed Primary 54.0 28.3 7.2 8.3 1.8 0.4 82.3 8,351 Completed Middle 55.1 31.1 5.8 6.0 1.7 0.3 86.2 8,562 Completed Secondary 70.1 22.7 3.5 3.1 0.5 0.2 92.7 7,602 Completed Higher Secondary & above
76.1 19.5 2.0 1.9 0.5 0.1 95.5 9,805
Social-group Scheduled Caste 48.2 30.6 8.7 9.9 2.0 0.5 78.8 10,976 Scheduled Tribe 47.8 24.9 9.4 14.2 2.0 1.6 72.7 6,311 Other Backward Class 53.7 27.9 7.9 8.3 1.8 0.4 81.6 21,886 Other 63.8 22.2 6.1 6.6 1.1 0.2 86.1 14,828 Do not know 50.0 18.9 9.5 11.9 8.4 1.4 68.8 550
Wealth index Lowest 32.2 31.9 14.0 17.8 2.8 1.3 64.1 10,977 Second 45.5 29.1 9.9 12.3 2.6 0.6 74.6 11,248 Middle 55.9 27.6 6.7 7.5 1.8 0.4 83.5 11,213 Fourth 66.6 23.4 4.7 4.0 1.0 0.3 90.0 11,092 Highest 74.8 19.7 2.9 2.2 0.4 0.0 94.5 10,020
Place of delivery Institutional 67.7 32.3 0.0 0.0 0.0 0.0 100 42,951 Home 6.2 4.4 36.8 41.9 8.3 2.4 10.6 11,391 Other 17.1 23.5 11.2 32.6 6.8 8.8 40.6 208
Total 54.6 26.5 7.7 8.9 1.8 0.5 81.1 54,550
37 Doctors, nurses, LHVs and ANM are considered as skilled providers.
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Deliveries assisted by skilled health providers were found to be inversely proportional to the birth
order. Mothers delivering for the third or more times were less likely to receive assistance of skilled
health provider than the mothers delivering for the first or second time. Close to 65 percent of births
to mothers delivering for the third or more time were assisted by an unskilled health provider
whereas more than 80 percent of the births to mothers delivering for first or second time, were
assisted by a skilled health provider.
Figure 4.7 presents percentage of births delivered by unskilled persons according to age of mother.
It is observed that deliveries by un-skilled health providers are common among mothers of an older
age. A significant proportion of births (between 23-28 percent) to mothers in the age group 30-49
were delivered by TBAs,38 friends, relatives and others. In one-fifth of the births to mothers in age
group (30-49), the deliveries were assisted by TBAs and another one-fourth births were delivered by
other unskilled providers.
Figure 4.7: Percentage of non-institutional births delivered by unskilled persons according to age of mother
Institutional delivery and safe delivery by states
Table 4.16 presents state wise percentage of institutional deliveries and those assisted by a skilled
health provider. Proportion of institutional delivery varied from cent percent in Goa to 19 percent in
Nagaland. In 14 states, level of institutional delivery is more than the national average (79 percent).
In 13 states more than 81 percent of the deliveries were assisted by skilled health providers. In
almost all states except Nagaland, level of institutional delivery was above 55 percent which was the
national average of institutional delivery, as per DLHS 2007-08.
38 TBA: Trained birth attendant
5 7 8 9 11
8 7 9 11
15
3 2 2 2 2
15 15 19
23 28
15-19 20-24 25-29 30-34 35-49
Trained birth attendant Friends/Relatives/Family members
Other Unsafe delivery
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Table 4.16: Institutional and safe delivery
Among the live births in the three years preceding the survey, percentage delivered in a health institution, percentage delivered by skilled health providers, according to states, RSOC 2013-14
States Institutional
delivery Delivered by a skilled
health provider
India 78.7 81.1
North Delhi 83.4 85.5 Haryana 76.4 78.6 Himachal Pradesh 68.7 71.6 Jammu & Kashmir 72.9 74.9 Punjab 80.4 85.4 Uttar Pradesh 62.1 65.1 Uttarakhand 68.5 69.8
Central Chhattisgarh 56.1 64.2 Madhya Pradesh 78.1 79.0
East Bihar 65.3 68.4 Jharkhand 56.6 61.0 Odisha 81.3 83.7 West Bengal 76.3 78.9
North East Arunachal Pradesh 63.7 65.4 Assam 74.2 74.9 Manipur 68.5 73.5 Meghalaya 66.5 68.6 Mizoram 94.1 96.0 Nagaland 18.6 20.5 Sikkim 86.6 87.8 Tripura 79.5 80.4
West Rajasthan 82.7 85.8 Goa 99.5 99.6 Gujarat 87.9 89.6 Maharashtra 90.3 93.0
South Andhra Pradesh 91.1 93.3 Karnataka 92.0 92.6 Kerala 99.4 99.5 Tamil Nadu 99.3 99.5
In all southern states, most deliveries (more than 90 percent) were assisted by skilled health
providers.
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4.3.3 Advice/counselling on place of delivery
The health workers/providers as part of their job responsibilities are required to provide advisory
and counselling services to the pregnant woman and her family on issues of birth preparedness
which mainly includes information on the choice of place of delivery and care of newborn and the
mother. As part of birth preparedness the health care workers impresses upon the pregnant woman
and her family to opt for institutional delivery. Survey collected information from eligible ever
married women who had a live birth in three years preceding the survey, in a health institution,
about who advised them to take this decision. Since, more than one person could have motivated
the women to deliver in a health institution, the total responses would not add up to cent percent in
Table 4.17 which presents advice or counselling received from health providers for institutional
delivery according to various background characteristics. Such information would be of critical
importance in building health related communication strategy.
Overall, family/relatives are seen to be the major advisor/counsellor for delivering in health
institutions. A small proportion was advised by ASHA, followed by AWW and ANM, in that order.
Overall, in 56 percent of the institutional births, family/relatives counselled the mother to deliver in
a health facility. This is more or less true of all age groups of mother. More mothers living in the
urban areas (64 percent) reported to have been motivated by their relatives and friends than the
mothers living in the rural areas (52 percent). In around one-fourth (23 percent) of the births,
mother reported to have been influenced by ASHA, a village level worker; other counsellors were
AWW (in 16 percent cases) and ANM (in 12 percent cases).
Among the rural mothers and in the poorest families delivering in a health facility, ASHA seems to be
a prime advisor (31 percent in rural areas; 42 percent amongst the poorest families). ASHA is also
seen to have advised significant proportion of mothers (delivering in a health facility) with no
education (35 percent) and mothers with below primary level education (36 percent); mothers
belonging to ST (32 percent) and SC families (29 percent).
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Table 4.17: Persons advised/counselled for Institutional deliveries Among the live birth in the three years preceding the survey, percentage of institutional births, whose mothers were advised or counselled to deliver in a health facility, according to background characteristics, India, RSOC, 2013-14
Background Characteristics
Advice/counselling received from heath providers to deliver at a health facility Number of
institutional births AWW ANM ASHA
Any other health
professional
Family/ Relatives/
Other
Self/ No one
Mothers Age
15-19 17.0 15.2 27.0 13.1 58.5 9.9 1,261 20-24 17.8 13.8 23.3 7.7 56.3 13.2 16,752 25-29 15.5 11.7 22.1 7.1 55.8 14.9 16,416 30-34 15.1 10.5 22.3 5.7 57.3 15.5 6,031 35-49 17.4 11.3 26.4 6.6 51.4 14.9 2,492
Birth order One 15.9 12.6 19.4 8.0 57.4 15.2 22,104 Two 17.1 12.7 22.8 7.2 54.9 14.7 13,165 Three and more 17.3 11.3 33.7 5.6 54.1 10.4 7,683
Residence Urban 9.8 7.9 6.4 8.1 63.9 19.9 14,446 Rural 19.9 14.7 31.4 6.9 52.0 11.3 28,505
Number of ANC visits No ANC 14.2 7.0 30.4 3.8 54.4 11.4 4,186 1-3 18.4 11.6 29.6 6.7 54.9 10.7 16,232 4+ 15.6 14.1 16.9 8.4 57.2 17.1 22,235 Do not know 11.3 7.0 15.0 6.1 52.5 24.3 298
Mother education No education 20.6 12.7 34.7 5.7 52.1 9.1 11,030 Below Primary 21.2 15.2 36.2 9.0 53.5 7.1 1,885 Completed Primary 18.4 13.8 25.3 8.7 53.5 13.0 6,638 Completed Middle 15.2 12.9 23.1 8.2 58.4 12.4 7,195 Completed Secondary 15.7 13.5 15.4 7.3 57.3 17.6 6,928 Completed Higher Secondary& above
11.0 9.4 10.4 7.2 60.2 21.3 9,275
Social-group Scheduled Caste 18.5 14.0 29.1 7.4 53.3 11.5 8,343 Scheduled Tribe 27.5 16.5 31.7 6.5 45.2 13.6 4,422 Other Backward Class 15.1 12.1 22.0 6.0 56.2 14.9 17,342 Other 13.4 10.4 17.2 9.2 61.2 15.3 12,491 Do not know 13.2 12.1 24.0 12.5 62.8 9.5 354
Wealth index Lowest 22.2 13.0 41.9 5.7 45.0 7.8 6,674 Second 20.1 14.4 34.2 6.4 50.4 10.4 8,061 Middle 18.4 15.3 24.0 7.5 55.2 13.2 9,099 Fourth 14.6 13.3 14.1 7.9 59.7 17.0 9,796 Highest 9.6 6.6 8.1 8.5 65.8 20.0 9,320
Place of delivery Government hospital/health centre
21.2 14.9 33.0 6.4 51.4 9.9 26,369
Private hospital/clinic/nursing home
9.1 8.5 7.1 8.7 63.3 21.1 16,582
Total 16.5 12.4 23.0 7.3 56.0 14.2 42,951
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AWWs also counselled significant proportion of mothers for delivering in a health institution. In little
more than one-fifth of the births, mothers from the poor families (lowest 22 percent) and second
quintile (20 percent) counselled for institutional delivery. However, in relatively less proportion
births, mothers reported that ANM had counselled them for institutional delivery.
4.3.4 Type of delivery
In RSOC, 2013-14 information was collected from eligible EMW on type of delivery as per normal,
caesarean and others39 for live births in the three years preceding the survey. Table 4.18 presents
percent distribution of births by type of delivery and according to selected characteristics. At the
national level, more than four out of every five deliveries (83 percent) were normal while a little less
than one out of every five births (16 percent) were delivered by caesarean section. As per NFHS
2005-06, close to 9 percent of births were delivered by caesarean section. Clearly, since 2005-06,
there has been an increase in the proportion of deliveries by caesarean section.
A higher proportion of mothers (86 percent) residing in the rural areas reported normal delivery in
comparison to mothers (75 percent) living in urban areas. Relatively higher proportion of the
mothers (21 percent) delivering for the first time (birth order one) delivered by caesarean section
than those who were delivering for second or more times. Both, the level of education of the mother
and the economic condition of the household are inversely proportional to the proportion of births
delivered by normal delivery. More proportion of mothers with higher level of education underwent
caesarean section than mothers with lower level of education. In a third of the births (31 percent),
mother who completed higher secondary or above level of education delivered by caesarean section
in contrast to 7 percent births delivered by caesarean section to mothers with no education.
Similarly, in five percent of the births from households in the lowest wealth quintile, mothers
reported undergoing caesarean section in comparison to 30 percent mothers from households with
the highest wealth index.
39 Others would include assisted, forceps methods etc.
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Table 4.18: Type of delivery Percent distribution of births in the three years preceding the survey by type of delivery, according to selected background characteristics, RSOC, 2013-14
Background characteristics Type of delivery Number of
births Normal Caesarean Other methods Total
Mother’s age
15-19 84.7 13.4 1.9 100.0 1,539
20-24 83.3 16.0 0.7 100.0 20,364
25-29 82.2 17.4 0.5 100.0 20,861
30-34 82.3 17.2 0.5 100.0 8,145
35-49 86.2 13.3 0.5 100.0 3,642
Birth order
One 77.9 21.4 0.7 100.0 25,575
Two 82.1 17.2 0.6 100.0 16,502
Three and more 94.3 5.3 0.4 100.0 12,473
Residence
Urban 74.8 24.7 0.4 100.0 16,320
Rural 86.4 12.9 0.7 100.0 38,230
Mother's education
No education 92.3 7.1 0.6 100.0 17,616
Below Primary 88.8 10.2 1.0 100.0 2,615
Completed Primary 84.3 14.9 0.8 100.0 8,351
Completed Middle 83.6 15.8 0.6 100.0 8,562
Completed Secondary 75.9 23.5 0.7 100.0 7,602
Completed Higher Secondary &
above 68.4 31.2 0.4
100.0 9,805
Social-group
Scheduled Caste 85.9 13.6 0.5 100.0 10,976
Scheduled Tribe 91.6 8.1 0.3 100.0 6,311
Other Backward Class 82.0 17.4 0.6 100.0 21,886
Other 78.5 20.7 0.8 100.0 14,828
Do not know 82.6 15.6 1.9 100.0 550
Wealth index
Lowest 94.2 5.2 0.6 100.0 10,977
Second 89.5 9.8 0.6 100.0 11,248
Middle 83.0 16.1 0.9 100.0 11,213
Fourth 76.7 22.8 0.5 100.0 11,092
Highest 70.1 29.5 0.4 100.0 10,020
Place of delivery
Government hospital/Health
centre 87.5 11.7 0.7
100.0 26,369
Private hospital/Clinic/Nursing
home 64.2 35.4 0.4
100.0 16,582
At home 99.4 0.0 0.6 100.0 11,391
Other 97.8 0.0 2.2 100.0 208
Total 83.0 16.4 0.6 100.0 54,550
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Figure 4.8 presents state wise percentage of live birth in the last three years preceding the survey,
by type of delivery. It is observed that more than one-fourth of the births in the states of Andhra
Pradesh (37 percent), Tamil Nadu (33 percent), Goa (32 percent), Kerala (28 percent), Punjab (26
percent) and Jammu & Kashmir (26 percent) were delivered by caesarean section. States having
higher proportion of institutional delivery seem to have higher proportion of caesarean section.
Figure 4.8: Percentage of women by type of delivery,40
state wise, RSOC, 2013-14
4.3.5 Duration of stay at health facility in case of institutional delivery
The first 48 hours after delivery, vital for detecting any complications and its immediate
management is critical for survival of both the mother and the child. Therefore as per the
programme of the government, mothers are advised to stay up to 48 hours after delivery in the
healthcare facility if the delivery is normal.
On an average, in around three-fifth (58 percent) of the institutional deliveries, mothers stayed in
the facility for 48 hours or more, in another 21 percent, stay was less than 12 hours; in around 6
percent stay was between 12-23 hours and in close to 16 percent, stay in the facility was between
24-47 hours. However, in deliveries by C-section, in 93 percentage of the births, mothers stayed in
the health institution for 48 hours or more. Mothers living in urban areas stayed longer in the health
facility after delivery than mothers from the rural areas. Staying in the facility for 48 hours or more
after delivery among urban mothers was close to 70 percent, in comparison to 52 percent for
mothers from the rural areas. Quite clearly in around two-fifth of births, stay of the mother in the
health facility was less than the recommended number of hours and thus such mothers were
exposed to the risk of mortality and morbidity.
40 C-Section = Caesarean section
37 33 32
28 26 26 23 22 20 20 17 16 16 15 15 14 14 13 11 11 10 9 9 8 8 6 5 5 2 1
63 67 68
72 73 73 75 77 80 80 83 83 84 84 85 86 85 86 89 88 89 90 91 91 92 92 95 95 98 99
An
dh
ra P
rad
esh
Tam
il N
adu
Go
a
Ke
rala
Pu
nja
b
Jam
mu
& K
ash
mir
We
st B
en
gal
Kar
nat
aka
Man
ipu
r
Sikk
im
Mah
aras
htr
a
Ind
ia
De
lhi
Him
ach
al P
rad
esh
Utt
arak
han
d
Gu
jara
t
Trip
ura
Har
yan
a
Od
ish
a
Ass
am
Ch
hat
tisg
arh
Raj
asth
an
Jhar
khan
d
Mad
hya
Pra
des
h
Utt
ar P
rad
esh
Bih
ar
Miz
ora
m
Me
ghal
aya
Aru
nac
hal
Pra
de
sh
Nag
alan
d
C-Section Delivery Normal Delivery
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Table 4.19: Duration of stay at health facility (for institutional births) Among the live birth in the three years preceding the survey, percent distribution of births delivered in a health facility by duration of stay of the mother and according to selected background characteristics, RSOC, 2013-14
Background characteristics
Percentage of births for which
mother stayed at the health
facility after delivery (in hours)
Do
not
know
Total
Number of
Institutional
births <12 12-23 24-47
48 or
more
Mother’s age
15-19 24.1 8.7 16.3 50.7 0.2 100.0 1,261
20-24 19.7 5.7 16.2 58.0 0.4 100.0 16,752
25-29 20.5 5.2 14.8 59.0 0.5 100.0 16,416
30-34 21.0 5.0 15.7 57.5 0.8 100.0 6,031
35-49 24.6 5.7 15.4 53.3 0.9 100.0 2,492
Residence
Urban 11.7 3.7 13.9 70.2 0.4 100.0 14,446
Rural 25.1 6.4 16.4 51.5 0.5 100.0 28,505
Mother’s education
No education 32.3 7.6 17.7 41.7 0.8 100.0 11,030
Below primary 31.5 7.7 16.3 44.1 0.4 100.0 1,885
Completed primary 19.6 6.1 17.3 56.5 0.5 100.0 6,638
Completed middle 19.3 5.9 16.0 58.4 0.4 100.0 7,195
Completed secondary 12.8 4.1 14.4 68.4 0.3 100.0 6,928
Completed higher secondary &
above 12.1 3.0 12.1 72.3 0.4
100.0 9,275
Social-group
Scheduled Caste 25.4 6.1 14.0 54.1 0.4 100.0 8,343
Scheduled Tribe 17.0 7.5 19.8 55.1 0.6 100.0 4,422
Other Backwards Class 22.0 4.9 13.8 58.8 0.6 100.0 17,342
Other 16.8 5.4 17.3 60.1 0.4 100.0 12,491
Do not know 23.1 4.5 19.6 52.6 0.2 100.0 354
Wealth index
Lowest 32.9 9.4 17.8 39.1 0.8 100.0 6,674
Second 27.9 7.1 15.9 48.5 0.5 100.0 8,061
Middle 20.4 5.4 16.7 57.1 0.5 100.0 9,099
Fourth 14.2 4.1 14.3 67.1 0.4 100.0 9,796
Highest 12.6 3.1 13.9 70.1 0.3 100.0 9,320
Place of delivery
Government hospital/health centre 25.5 6.7 16.0 51.2 0.6 100.0 26,369
Private hospital/clinic/nursing home 12.9 3.6 14.8 68.3 0.3 100.0 16,582
Type of delivery
Normal 25.6 6.3 19.1 48.5 0.5 100.0 33,724
Caesarean 1.9 2.4 2.1 93.3 0.3 100.0 8,968
Other 21.2 16.7 20.3 40.9 0.9 100.0 260
Total 20.6 5.5 15.5 57.8 0.5 100.0 42,951
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The duration of stay in the health facility after delivery shows a strong relationship with women’s
education, the type of delivery, place of delivery and the economic status of the household she
belonged to. As seen from Table 4.19, proportion of mothers staying for 48 hours or more after
delivery gradually increases with increase in the level of education. Little less than three-fourth (72
percent) of the births, mothers who completed higher secondary or above stayed for 48 hours and
more in the health facility in comparison to the mothers with no education (42 percent).
Women delivering in a government run health facility are more likely to leave health facility earlier
than those delivering in a private facility. In around a fourth of the institutional deliveries (26
percent), mothers delivering in a government hospital/health centre stayed for less than 12 hours
after delivery, in comparison to 13 percent of the mothers delivering in a private healthcare facility.
More mothers delivering in private institutions (68 percent) stayed for two or more days in the
facility after delivery in comparison to the mothers delivering in government health facilities (51
percent). Another trend that is emerging from the analysis is that mothers from poor households
leave health facilities earlier than those from the rich families. In significant proportion of
institutional deliveries, mothers from households in the highest wealth quintile (71 percent) stayed
for 48 and more hours in the health facilities in comparison to mothers from the households
belonging to the lowest wealth quintile (39 percent).
4.3.6 Stay in a health facility after delivery by states
Table 4.20 presents state wise duration of stay in the health facility after delivery. Proportion of
mothers delivering in a health facility (government and private) and staying in the health facility for
48 or more hours after delivery varied significantly among the states. Goa has the highest
percentage of the institutional births (95 percent) and Nagaland has the lowest percentage (7
percent) whose mothers stayed in the facility for 48 hours or more. In 19 states, proportion of
institutional deliveries where mothers stayed for 48 or more hours after delivery was less than that
of the national average (58 percent). In significant proportion of deliveries in facilities, mothers in
many states, stayed for less than 12 hours in the facility. In more than two-fifth of the institutional
deliveries, mothers stayed for less than 12 hours in the health facility in states of Bihar (69 percent),
Arunachal Pradesh (54 percent), Uttar Pradesh (50 percent), Nagaland (48 percent), Assam (42
percent) and Odisha (40 percent).
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Table 4.20: Duration of stay at health facility after institutional delivery by states Among the live birth in the three years preceding the survey and delivered in a health facility, percentage whose mothers stayed in the health facility for less than 12 hours and for 48 hours or more, , according to state, RSOC, 2013-14
State
Percentage of institutional births whose mothers stayed at health facility after delivery
For less than 12 hours For 48 or more hours
India 20.6 57.8
North
Delhi 9.3 69.1 Haryana 34.2 33.8 Himachal Pradesh 10.3 55.7 Jammu & Kashmir 13.2 57.8 Punjab 21.5 53.3 Uttar Pradesh 49.6 26.0 Uttarakhand 17.4 51.1
Central Chhattisgarh 21.2 56.8 Madhya Pradesh 5.4 72.2
East Bihar 69.1 8.6 Jharkhand 22.6 39.3 Odisha 40.0 23.6 West Bengal 27.9 46.0
Northeast Arunachal Pradesh 53.8 10.1 Assam 42.3 25.4 Manipur 28.1 39.3 Meghalaya 18.8 25.7 Mizoram 18.1 14.4 Nagaland 47.5 6.8 Sikkim 11.0 52.6 Tripura 2.7 53.4
West Rajasthan 15.4 67.3 Goa 1.5 94.9 Gujarat 11.4 51.0 Maharashtra 3.7 80.9
South Andhra Pradesh 3.2 80.7 Karnataka 3.9 79.0 Kerala 2.0 92.9 Tamil Nadu 1.1 94.4
In terms of postnatal care, in Goa, Tamil Nadu and Kerala, over 90 percent of the women reported
that they stayed in the health facility for 48 hours or more after delivery.
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4.3.7 Awareness and utilization of JSY and JSSK schemes
Janani Suraksha Yojna (JSY), launched in 2005 under the then National Rural Health Mission (NRHM)
is a conditional cash transfer scheme promoting safe motherhood intervention. It is implemented
with the objective of reducing maternal and neonatal mortality by promoting institutional delivery
among poor and vulnerable pregnant women. The scheme is being implemented in all states and
Union Territories (UTs).
Government of India also launched the Janani Shishu Suraksha Karyakaram (JSSK) in 2011 to provide
completely free and cashless services to pregnant women to deliver in an institution including
caesarean section delivery and cost of hospitalization of sick new born (up to 30 days after birth) in
government health institutions in both rural and urban areas. The scheme is implemented in all
states and UTs. It is to be noted that a pregnant women can access benefits of either or both
schemes.
In RSOC, women who had a live birth in the three years preceding the survey were asked about their
awareness about each of these schemes (JSY and JSSK). In addition the women were also asked
whether they availed assistance provided under the two schemes: (1) availed benefits of JSY (2)
availed benefits of JSSK (3) availed benefits from JSY and JSSK and (4) not availed any benefit from
any of the schemes.
Findings from the survey are presented in Table 4.21 showing the level of awareness and utilization
of JSY and JSSK among the women who had a live birth in the three years preceding the survey by
various background characteristics. In seven out of every ten women (71 percent) were aware about
JSY; 43 percent of the women were aware of JSSK. Cumulatively in close to three-fourth of the
women (74 percent) were aware about either JSY or JSSK and 40 percent were aware about both the
schemes. Though awareness about JSY is more than that of JSSK, yet more effective steps are
required to further enhance awareness about JSY, considering that the scheme has been under
implementation since 2005. Additionally, level of awareness about JSY was moderate among the
women from the SC (75 percent) and the ST (70 percent) families, though the scheme has special
provisions for such women under the scheme.
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Table 4.21: Awareness and benefits from JSY and JSSK Among women who had a live birth in the three years preceding the survey, percentage aware about JSY and JSSK and out of those who were aware about the scheme, percentage who received benefits under these schemes, according to selected characteristics of women, RSOC, 2013-14
Background characteristics
Percentage of women aware about Out of those who were aware about the
scheme, percentage availed benefits
JSY JSSK Either JSY or JSSK
Both JSY and JSSK
Number of women
JSY JSSK Either JSY or JSSK
Both JSY and JSSK
Number of women
aware of JSY or JSSK
Mother's age 15-19 74.1 42.3 77.1 39.2 1,539 49.0 17.7 57.2 9.5 1,187 20-24 72.5 44.7 75.8 41.5 20,364 50.8 16.1 58.2 8.7 15,438 25-29 70.4 42.8 73.8 39.4 20,861 46.5 13.6 52.6 7.4 15,393 30-34 68.4 40.1 71.5 37.0 8,145 44.4 10.2 48.2 6.4 5,824 35-39 68.9 38.4 72.3 35.0 3,642 43.3 10.9 47.2 7.1 2,632
Residence Urban 62.9 43.4 67.0 39.4 16,320 36.6 13.6 43.6 6.5 10,928 Rural 74.3 42.6 77.3 39.6 38,230 51.8 14.2 57.7 8.3 29,546
Mother's education No education 70.8 35.2 73.8 32.2 17,616 50.4 11.7 54.8 7.2 12,992 Below Primary 77.1 42.2 79.8 39.5 2,615 51.4 15.4 57.4 9.4 2,086 Completed Primary 71.9 44.2 75.9 40.2 8,351 52.4 15.3 58.9 8.8 6,337 Completed Middle 74.9 45.9 77.3 43.5 8,562 52.5 14.6 59.3 7.8 6,619 Completed Secondary
68.4 48.4 72.4 44.4 7,602 43.3 17.1 52.7 7.7 5,506
Completed Higher Secondary & above 67.0 48.5 70.7 44.8 9,805 36.1 14.0 42.4 7.7 6,934
Social - Group Scheduled Caste 74.8 43.9 77.7 41.0 10,976 54.5 15.2 60.1 9.6 8,523 Scheduled Tribe 69.7 42.1 72.3 39.5 6,311 54.7 16.1 62.4 8.4 4,561 OBC 72.4 42.7 75.8 39.2 21,886 47.7 12.8 53.1 7.3 16,598 Other 65.8 42.3 69.7 38.4 14,828 39.4 14.2 46.7 7.0 10,331 No Response 82.7 51.7 83.7 50.7 550 38.8 12.6 45.8 5.6 460
Wealth Quintile Lowest 73.3 34.7 75.9 32.0 10,977 54.3 11.6 58.8 7.1 8,336 Second 72.5 41.0 75.6 37.9 11,248 53.9 14.0 59.9 8.0 8,499 Middle 73.2 45.8 76.3 42.8 11,213 52.6 17.4 60.0 9.9 8,551 Fourth 69.1 46.2 73.1 42.2 11,092 42.9 15.6 50.6 7.9 8,106 Highest 65.9 46.8 69.7 42.9 10,020 31.9 11.0 37.1 5.8 6,983
Place of delivery Government Hospital
81.3 49.2 84.0 46.5 26,369 71.8 18.7 78.9 11.6 22,148
Private Hospital 60.0 41.0 64.5 36.5 16,582 20.1 11.0 27.1 4.0 10,694 Home 62.8 30.9 65.7 27.9 11,391 16.1 4.7 18.7 2.1 7,489 Other 66.9 35.9 68.4 34.3 208 30.1 9.9 34.9 5.1 142
Total 70.9 42.8 74.2 39.5 54,550 47.7 14.0 53.9 7.8 40,474
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With regards to utilization of the benefits of both JSY and JSSK, it is below the awareness level.
Overall in little more than half of the births (54 percent) mothers availed benefits from either JSY or
JSSK scheme. Utilization of benefits from both the schemes was higher among mothers from the ST,
the SC families than those from OBC and Other category families. Close to 60 percentage of the
women from the lowest and the second lowest quintiles availed assistance from either JSY or JSSK. It
is also observed that more women (80 percent) delivering in a government-run health facility availed
benefits from either of the schemes than those women (27 percent) delivering in a private hospital.
Less than a tenth of the women (8 percent) availed benefits of both schemes.
Awareness about JSY and JSSK by states
Figure 4.9 presents state wise the awareness level about JSY and JSSK schemes. In 15 states, level of
awareness is lower than that of the national average.
Figure 4.9: Level of awareness about JSY and JSSK scheme among the mothers, statewise
4.3.8 Availing benefits of JSY and JSSK by states
Statewise percentage of mothers who availed benefits under JSY or/and JSSK scheme has been
presented in Table 4.22. While the overall utilization of JSY was 48 percent, however, in around 54
percent, women either availed JSY or JSSK benefits. In states namely Mizoram (86 percent) and
Odisha (78 percent) more than three-fourth of the women reported to have availed benefits from
either of the schemes. More than sixty percent of the women from Assam (72 percent), Rajasthan
(69 percent), Tamil Nadu (69 percent), Madhya Pradesh (66 percent), Meghalaya (65 percent,
Tripura (61 percent) and Karnataka (65 percent) availed either JSY or JSSK benefits.
Among the two schemes on safe motherhood, awareness as well as utilization of benefits from the
JSY were more than JSSK. In five states namely Mizoram (86 percent), Odisha (78 percent), Assam
(71 percent), Rajasthan (64 percent) and Madhya Pradesh (66 percent) more than two-third of the
women reported to have availed assistance under JSY. However, level of utilization of JSY benefits is
69
57 53 50 50 50 49 49 48 48 47 47 46
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below the national average (48 percent) in 16 states. Moreover, in 18 states, less than half of the
women availed benefits of JSY.
On the other hand, utilization of JSSK scheme is low. Overall in around 14 percent women availed
benefits of JSSK. In 16 states, level of utilization is less than the national average. It varied from less
than one percent in Chhattisgarh to 32 percent in Tamil Nadu. It appears that the scheme is
relatively more popular among the women from the southern states—Tamil Nadu (32 percent),
Andhra Pradesh (23 percent), Karnataka (13 percent) and Kerala (17 percent). There could be many
reasons for the low utilization of this scheme. This survey did not look for the reasons of low
utilization as it was beyond the scope of this survey.
Table 4.22: Utilization of benefits of JSY and JSSK Percentage of women who had a live birth in the last three years preceding the survey, availing benefits of JSY and/or JSSK schemes according to states, RSOC, 2013-14
State
Percentage of women availing benefits under
JSY
Percentage of women availing benefits under
JSSK
Percentage of women availing benefits under
either JSY or JSSK
Percentage of women availing benefits under both JSY and
JSSK
India 47.7 14.0 53.9 7.8 North
Delhi 20.8 15.8 29.7 6.9 Haryana 22.0 13.3 29.8 5.5 Himachal Pradesh 36.2 10.4 41.0 5.6 Jammu & Kashmir 58.7 10.2 60.0 9.0 Punjab 38.1 13.5 40.4 11.3 Uttar Pradesh 46.1 6.0 47.9 4.1 Uttarakhand 45.8 3.6 46.3 3.1
Central Chhattisgarh 48.5 0.3 48.6 0.2 Madhya Pradesh 66.1 2.1 66.4 1.8
East Bihar 48.9 4.1 50.0 3.0 Jharkhand 45.3 15.6 46.8 14.1 Odisha 77.8 24.1 85.1 16.7 West Bengal 32.0 20.1 42.1 10.0
Northeast Arunachal Pradesh 55.8 5.0 57.4 3.3 Assam 71.1 17.5 72.2 16.4 Manipur 20.4 1.1 21.3 0.1 Meghalaya 63.9 16.4 64.5 15.8 Mizoram 85.5 7.8 87.8 5.5 Nagaland 34.3 15.6 35.1 14.9 Sikkim 45.1 11.1 50.9 5.3 Tripura 55.1 11.5 61.4 5.2
West Rajasthan 64.3 16.3 66.9 13.7 Goa 29.3 12.9 39.2 3.0 Gujarat 21.8 25.5 42.4 4.8 Maharashtra 29.0 16.9 40.9 5.1
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State
Percentage of women availing benefits under
JSY
Percentage of women availing benefits under
JSSK
Percentage of women availing benefits under
either JSY or JSSK
Percentage of women availing benefits under both JSY and
JSSK
South Andhra Pradesh 40.4 22.9 53.1 10.2 Karnataka 56.9 12.9 64.8 5.0 Kerala 33.6 16.9 43.7 6.8 Tamil Nadu 54.6 32.2 69.0 17.8
4.4 POSTNATAL CARE
The days and weeks following the delivery—the postnatal period—is a critical phase in the lives of
the mother and her child. The quality of care provided at this period and close monitoring of health
of the mother and the child for early detection of danger signs significantly contributes to their well-
being and also survival. Along with prenatal care, quality postnatal care reduces chances of mortality
substantially.
In RSOC 2013-14, several questions on postnatal care (PNC) were asked to the eligible women. As
per the reproductive health policy of the government, basic health service providers like ANM, AWW
and ASHA should visit all the mothers at home after their delivery/discharge from the health facility.
A question EMW was asked to eligible whether AWW, ANM or ASHA visited them at home, after
delivery or discharge from the hospital/health centre within one week of delivery. In addition,
questions were asked, about the time of first PNC, number of check-ups received by the mother and
the newborn within 10 days of delivery and the place of check-ups.
4.4.1 Visit by health care providers after delivery/discharge41 from health facility
After delivery or discharge from health facility, the visitation by a health provider at home has not
been very significant in number in the three years preceding the survey. Overall only about half of
the mothers (51 percent) reported to have been visited by a health care provider
(AWW/ASHA/ANM) within one week of delivery or discharge. among women who had live births in
the three years preceding the survey, percentage of women who were visited either by an AWW,
ANM or ASHA after delivery or after discharge from hospital/health centre within one week of
delivery is presented in Table 4.23. The Table shows that women’s education level and economic
condition of the household are directly related to visitation by the basic health care providers.
Proportion of women visited by a health care provider after discharge from the health facility or
after home delivery gradually increases with the increase in the level of education.
41 In this section for the purpose of computation of visitation by health providers (a) for mothers who delivered at home
visitation after delivery, and (b) those mothers who delivered in a health facility, visitation after discharge from the facility
has been considered.
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Table 4.23: Visit by health care providers after delivery/discharge from health facility Among women who had live births in the three years preceding the survey, percentage who were visited by either AWW, ANM or ASHA after delivery or after discharge from hospital/health centre within one week of delivery, according to selected background characteristics, RSOC, 2013-14.
Background characteristic Mothers visited by
AWW, ANM or ASHA after delivery
Number of births
Mother’s age
15-19 49.2 1,539 20-24 53.2 20,364 25-29 51.9 20,861 30-34 46.7 8,145 35-49 43.9 3,642
Mother’s education No education 37.7 17,616 Below Primary 50.5 2,615 Completed Primary 52.4 8,351 Completed Middle 54.1 8,562 Completed Secondary 63.9 7,602 Completed Higher Secondary & above 61.3 9,805
Social-group Scheduled Caste 49.0 10,976 Scheduled Tribe 53.5 6,311 Other Backward Class 53.5 21,886 Other 48.3 14,828 Do Not Know 37.6 550
Wealth index Lowest 40.9 10,977 Second 47.9 11,248 Middle 53.9 11,213 Fourth 59.3 11,092 Highest 53.2 10,020
Total 51.0 54,550
Visitation by heath care providers increases from 38 percent, in case of mothers with no education
to 61 percent for the mothers who completed higher secondary or above level of education.
Similarly, proportion of women receiving visits from basic health providers increased with the
increase in the wealth index of the households. It increased from 41 percent for the poorest
households to 53 percent for women from the households with highest wealth index.
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4.4.2 Visit by health care providers after delivery/discharge from health facility by states
Figure 4.10 presents state wise percentage of women who reported to have been visited by a health
care provider within seven days of delivery or discharge from a health facility. It varies from 97
percent in Tamil Nadu to 4 percent in Nagaland.
Figure 4.10: Percentage of women visited by a health care provider within seven days of delivery or discharge from a health facility after delivery, by states from RSOC, 2013-14
It is seen that in all southern states, more than eight for every 10 women were visited within seven
days of delivery or discharge from the health facility. It may be noted that institutional delivery was
very high in these states. In Tamil Nadu, Goa and Kerala, almost all women were visited at home
after delivery, within seven days of delivery. One can perhaps conclude that institutional or safe
delivery also improves postnatal care. A matter of concern is that in the states where maternal and
neonatal mortality is high, visitations by health care workers are low. This is especially seen in
Rajasthan (17 percent), Uttar Pradesh (19 percent), Jharkhand (27 percent) and Bihar (30 percent).
4 13 17 19 20 20 22 24 24 25 27 29 29 30 34 37
51 51 53 54 55 61 64 68 83 84 85
96 96 97
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4.4.3 Timing and number of Postnatal check-ups (PNC)42 received by mother
Timing of Postnatal check-ups
The postnatal check-up by a healthcare provider is critical for both the mother and her child. A
question was asked in RSOC 2013-14 in the EMW questionnaire, about timing of the first postnatal
care check-up after discharge from the health facility in case of institutional delivery and home
delivery.43 In addition, a question was asked about the number of postnatal check-ups received by
the women at the health facility as well as at home during the first 10 days of delivery. Table 4.24
presents percentage distribution of women by timing of receiving of first postnatal check-up after
discharge in case of institutional delivery or after delivery if delivered at home, within the 10 days.
As per the Table below, overall, little less than half of the women (48 percent) received postnatal
check-up within 10 days of delivery/discharge and another 6 percent received PNC after the
stipulated period. In other word, 46 percent of the women never received any PNC (neither within
10 days nor after from discharge/delivery). More women from rural areas never received any PNC.
More than half of the women (52 percent) from the rural areas and about a third of the women (32
percent) from the urban areas did not receive any PNC after delivery/discharge.
Postnatal check-ups are also linked with the birth order of the women. Women with higher birth
order are less probable to receive any PNC than the women with lower birth order. For example, 62
percent of the women delivering for the first time (birth order one) received PNC, in comparison to
than those 54 percent women delivering for second time (birth order 2) or 37 percent women
delivering for third time or more. Proportion of women receiving postnatal check-up within 10 days
of delivery or discharge from the health facility improves with increase in the level of education of
the women. It improves from 32 percent for women with ‘no education’ to 65 percent for women
who completed higher secondary or above. It is also seen that women from richer families are more
probable to get a PNC within ten days than the women from the poor families.
42 This is about postnatal check-ups after discharge from the health facility, in case of institutional delivery and about postnatal check-ups after home delivery.
43 One should be careful in comparing this result from RSOC with that of NFHS or DLHS as questions in RSOC were
different.
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Table 4.24: Timing of first postnatal check-up Among women who had live births in the three years preceding the survey, percent distribution of women by timing of receiving first postnatal check-up within the 10 days of delivery, at home or discharge from the health facility, according to selected characteristics, RSOC, 2013-14
Background characteristics
Time within which first postnatal check-up received
No postnatal check up
Total Number of
women Within 48 hours
2nd to 10th day
After 10th day
Mother’s age 15-19 33.6 7.3 6.2 53.0 100.0 1,539 20-24 41.3 7.7 6.2 44.7 100.0 20,364 25-29 40.4 9.2 6.0 44.5 100.0 20,861 30-34 35.4 8.6 6.9 49.1 100.0 8,145 35-49 31.9 8.1 8.2 51.8 100.0 3,642
Birth order 1 46.6 9.1 6.2 38.1 100.0 25,575 2 39.9 7.8 6.5 45.7 100.0 16,502 3+ 23.2 7.8 6.5 62.5 100.0 12,473
Residence Urban 51.1 8.8 7.6 32.4 100.0 16,320 Rural 34.2 8.2 5.8 51.8 100.0 38,230
Number of ANC visits No ANC 19.7 5.8 4.4 70.1 100.0 7,918 1-3 33.1 8.5 6.3 52.1 100.0 21,505 4+ 50.9 9.1 7.1 32.9 100.0 24,742 Do not know 39.0 9.0 7.5 44.5 100.0 386
Mother’s education No education 23.8 8.0 5.4 62.8 100.0 17,616 Below Primary 27.8 8.2 6.4 57.5 100.0 2,615 Completed Primary 39.6 8.5 6.7 45.2 100.0 8,351 Completed Middle 42.2 7.8 6.5 43.5 100.0 8,562 Completed Secondary 54.1 8.3 6.0 31.5 100.0 7,602 Completed Higher Secondary 55.6 9.8 8.0 26.7 100.0 9,805
Social-group Scheduled Caste 35.3 7.8 5.2 51.7 100.0 10,976 Scheduled Tribe 36.6 9.1 6.9 47.5 100.0 6,311 Other Backward Class 43.3 7.5 5.5 43.7 100.0 21,886 Other 38.0 10.0 8.3 43.7 100.0 14,828 Do Not Know 20.7 6.3 5.9 67.1 100.0 550
Wealth index Lowest 23.0 7.0 5.6 64.5 100.0 10,977 Second 32.2 7.8 4.6 55.4 100.0 11,248 Middle 41.9 7.8 5.8 44.5 100.0 11,213 Fourth 51.2 8.6 6.8 33.5 100.0 11,092 Highest 48.8 11.2 9.3 30.6 100.0 10,020
Place of delivery Government hospital/health centre 40.5 7.8 6.4 45.2 100.0 26,369 Private hospital/clinic/nursing home 55.6 10.4 7.1 26.9 100.0 16,582 Home 13.0 6.8 5.2 75.1 100.0 11,391 Other 18.0 14.2 5.6 62.3 100.0 208
Total 39.2 8.4 6.4 46.0 100.0 54,550
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Close to two-third of the women (65 percent) from the poorest families did not receive any PNC.
Receiving PNC within 10 days is seen to be linked to the place of delivery too. Such women who
delivered at home are less likely to receive PNC within 10 days (20 percent women who delivered at
home received PNC within 10 days) than the women who delivered in a facility. While about a half of
the women (48 percent) who delivered in a government-run health facility received PNC within 10
days, close to two-third (66 percent) of the women who delivered in a private health facility received
the check-ups within 10 days.
Number of PNC check-ups during first 10 days:
An analysis of percentage of women who never received any PNC and percent distribution of women
who received PNC within the first 10 days of delivery or discharge from health facility by number of
postnatal check-ups has been presented in Table 2.25. According to Table, of those women who
received any PNC within first 10 days, 30 percent received just one check-up, 27 percent received
two check-ups and 40 percent received three or more check-ups.
Table 4.25: Number of postnatal check-ups received by women during first 10 days after delivery/discharge from facility Among women who had live births in the three years preceding the survey, percentage who never received any postnatal check-up and percent distribution of women who received PNC within first 10 days of delivery/discharge from health facility, by number of postnatal check-ups and according to selected characteristics, India RSOC, 2013-14
Background characteristics
Percentage of women
not received any PNC
Number of
women
Out of the women who received PNC within first 10 days
Number of
women who
received any PNC
Number of postnatal check-up received
One Two Three
or more
Missing
Mother’s age 15-19 53.0 1,539 31.5 25.7 41.2 1.6 629 20-24 44.7 20,364 29.8 26.0 41.3 3.0 9,988 25-29 44.5 20,861 30.3 26.9 39.2 3.6 10,338 30-34 49.1 8,145 30.0 26.7 39.4 3.9 3,584 35-49 51.8 3,642 35.0 27.1 35.2 2.7 1,459
Birth order
One 38.1 25,575 28.2 26.6 41.9 3.3 14,252 Two 45.7 16,502 30.4 26.7 39.6 3.3 7,876 Three and more 62.5 12,473 38.5 26.0 32.5 3.0 3,869
Residence
Urban 32.4 16,320 28.5 27.8 40.7 3.0 9,784 Rural 51.8 38,230 31.5 25.7 39.3 3.4 16,214
Number of ANC visits
No ANC 70.1 7,918 40.0 24.1 33.0 2.9 2,018 1-3 52.1 21,505 32.2 27.6 37.8 2.4 8,950 4+ 32.9 24,742 28.1 26.1 41.9 3.9 14,843 Do not know 44.5 386 20.8 33.8 45.0 0.4 185
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Background characteristics
Percentage of women
not received any PNC
Number of
women
Out of the women who received PNC within first 10 days
Number of
women who
received any PNC
Number of postnatal check-up received
One Two Three
or more
Missing
Mother’s education No education 62.8 17,616 37.3 26.1 34.8 1.8 5,598 Below Primary 57.5 2,615 36.4 25.0 36.7 1.8 943 Completed Primary 45.2 8,351 30.7 26.0 39.9 3.4 4,018 Completed Middle 43.5 8,562 30.2 25.4 40.7 3.7 4,282 Completed Secondary 31.5 7,602 27.2 27.3 41.8 3.8 4,746 Completed Higher Secondary &
above 26.7 9,805 25.7 27.6 42.7 4.1 6,409
Social-group Scheduled Caste 51.7 10,976 30.4 26.9 37.4 5.4 4,732 Scheduled Tribe 47.5 6,311 30.9 25.6 40.7 2.8 2,881 OBC 43.7 21,886 28.4 26.1 42.2 3.4 11,122 Others 43.7 14,828 32.7 27.3 37.9 2.0 7,114 Do not know 67.1 550 55.1 26.0 19.0 0.0 149
Wealth index
Lowest 64.5 10,977 36.2 27.2 34.3 2.3 3,285 Second 55.4 11,248 32.8 26.2 37.3 3.7 4,497 Middle 44.5 11,213 30.4 26.3 39.3 4.0 5,569 Fourth 33.5 11,092 26.8 27.0 42.9 3.4 6,631 Highest 30.6 10,020 29.2 26.1 41.9 2.8 6,014
Place of delivery Government hospital/health centre 45.2 26,369 24.4 28.0 43.2 4.5 12,741 Private hospital/clinic/nursing home 26.9 16,582 29.2 26.5 41.7 2.6 10,939 Home 75.1 11,391 68.9 18.1 13.0 0.0 2,250 Other 62.3 208 66.3 25.8 7.9 0.0 67
Total 46.0 54,550 30.4 26.5 39.8 3.3 25,997
As stated in the previous sections, education level of the women, place of stay (rural/urban) and
economic condition of the family were the drivers for receiving postnatal check-ups within 10 days
of delivery. Women who delivered in a health facility (public or private), are more likely to receive
more number of PNCs than those delivered at home. Only 13 percent of the women who delivered
at home received three or more PNC check-ups. Similarly 43 percentage of the women who
delivered in a government health facility and 42 percentage of the women delivering in a private
health facility received three or more postnatal check-ups within 10 days of delivery. Differential in
receiving PNC check-ups is seen among different wealth quintile groups. While 34 percent of women
from the lowest wealth quintile group received 3 or more PNC check-ups within first 10 days of the
delivery/discharge from health facility, in case of highest wealth quintile group, more than two-fifth
(42 percent) of the women received the same.
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4.4.4 Timing and number of postnatal check-ups received by newborn within the first 10 days of
birth
Timing of PNC44
The maternal and child health programme recommends for the first PNC to be provided to newborn
within few hours of birth. A question was asked to eligible women about timing of the first check-up
received by the newborn after discharge from the health facility in case of institutional delivery or
after birth in case of home delivery. In addition, a question was asked about the number of check-
ups received during first 10 days of birth or discharge from the facility after birth.
Figure 4.11: Percentage of newborn receiving first postnatal check-up within 10 days of birth at home or discharge from health facility after birth
It is seen from Figure 4.11 that 44
percentage of the newborn
received first check-up within 10
days of birth (home delivery) or
discharge from health facility after
birth and another 16 percent
received after the stipulated
period. Two out of every five
newborn did not receive any PNC.
Such a phenomenon contributes
to increased risk of early neonatal
and neonatal mortality.
The percent distribution of births that received first check-up within 10 days, by the time of receiving
the check-up according to various background characteristics of the mother is given in Table 4.26.
Education level, age, place of residence of the mother and the place of delivery are the main drivers
for the newborn to get the first check-up within 24 hours of birth. Babies born to the mothers with
secondary or higher level of education (more than 40 percent) are more likely to receive the first
check-up within 24 hours than the babies born to mothers with primary or below primary level of
education (ranging from 25-36 percent).
44 One should be careful in comparing this result from RSOC with that of NFHS or DLHS as the questions asked to women are different.
Within 24 hours, 34%
2nd to 10th day, 10%
After 10th day, 16%
No postnatal check up,
40%
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Table 4.26: Timing of first postnatal check-up to newborn Among the live births in the three years preceding the survey, percent distribution of births receiving first check-up within 10 days after birth at home or discharge from health facility after birth by timing of first check-up according to selected characteristics, RSOC, 2013-14
Background characteristic
Time within which the newborn received first check-up after birth at home or after discharge from the health
facility after birth Number of births
Within 24 hours
2nd
to 10th
day
After 10th
day
No postnatal check up
Mother’s age 15-19 28.7 9.8 15.4 46.1 1,539 20-24 35.9 9.9 16.0 38.2 20,364 25-29 34.6 10.4 15.9 39.1 20,861 30-34 29.2 10.4 17.0 43.4 8,145 35-49 27.6 9.8 17.1 45.5 3,642
Birth order 1 38.5 10.9 17.9 32.7 25,575 2 34.6 9.9 16.3 39.2 16,502 3+ 22.6 8.9 12.5 56.0 12,473
Residence Urban 39.8 11.4 21.4 27.3 16,320 Rural 31.0 9.6 14.0 45.5 38,230
Number of ANC visits No ANC 18.9 7.0 7.9 66.2 7,918 1-3 31.7 9.3 13.6 45.4 21,505 4+ 40.0 11.9 21.0 27.1 24,742 Do not know 33.6 12.2 19.8 34.4 386
Mother’s education No education 24.5 8.7 10.3 56.5 17,616 Below Primary 25.5 10.7 14.1 49.6 2,615 Completed Primary 35.6 10.5 15.7 38.1 8,351 Completed Middle 35.0 9.9 17.9 37.3 8,562 Completed Secondary 43.7 11.0 20.0 25.3 7,602 Completed Higher Secondary and
above 41.7 11.8 23.2 23.3 9,805
Social-group Scheduled Caste 31.2 9.0 14.0 45.8 10,976 Scheduled Tribe 34.0 11.0 15.4 39.7 6,311 Other Backward Class 35.8 9.3 16.2 38.7 21,886 Other 32.6 11.9 18.3 37.2 14,828 Do Not Know 18.8 10.5 12.5 58.2 550
Wealth index Lowest 22.9 8.2 11.1 57.8 10,977 Second 29.6 9.7 11.9 48.9 11,248 Middle 36.4 9.5 16.6 37.5 11,213 Fourth 42.1 11.0 18.8 28.1 11,092 Highest 37.6 12.7 23.2 26.6 10,020
Place of delivery Government hospital/health centre 34.9 9.6 17.3 38.2 26,369 Private hospital/clinic/nursing home 46.0 12.1 20.0 21.9 16,582 Home 13.0 8.5 8.3 70.2 11,391 Other 18.5 13.5 6.3 61.7 208
Total 33.6 10.1 16.2 40.0 54,550
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As in the case of the women receiving any PNC check-ups, babies born at home are less probable (13
percent) to receive a check-up within 24 hours than those born in a health facility (35 percent and 46
percent for babies born in a government and a private health facility respectively).
Number of postnatal check-ups received by newborn
Out of the women who had live births in the three years preceding the survey, Table 4.27 presents
the percentage of newborn who received any check-up within first 10 days after birth/discharge and
percent distribution of births that received the check-up within first 10 days by number of check-ups
received, according to background characteristics of the women.
Table 4.27: Number of postnatal check-ups received by newborn within first 10 days after birth Out of the women who had live births in the three years preceding the survey, percentage of the newborn who received any check-ups within 10 days of birth/discharge and percentage distribution of newborn by number of check-up received within first 10 days of birth according to selected characteristics, RSOC, 2013-14
Background characteristic
Received any
checkups after birth
Number of
newborn
New born baby who received any checkups after birth / discharge, within
10 days Number of
newborn who received any
PNC Number of check-up received
One Two Three or
more Missing
Mother's age 15-19 53.9 1,539 34.4 25.6 35.7 4.3 593 20-24 61.8 20,364 32.7 24.8 39.5 3.0 9,321 25-29 60.9 20,861 33.0 25.0 38.7 3.4 9,388 30-34 56.6 8,145 34.4 25.9 36.1 3.6 3,227 35-49 54.6 3,642 39.2 25.7 32.7 2.4 1,361
Birth order 1 67.3 25,575 30.9 25.9 39.9 3.4 12,628 2 60.8 16,502 32.7 25.1 38.7 3.5 7,337 3+ 44.0 12,473 43.1 22.6 31.9 2.4 3,924
Residence Urban 72.6 16,320 31.6 26.3 39.1 3.1 8,370 Rural 54.6 38,230 34.4 24.4 37.8 3.4 15,520
Mother's education No education 43.5 17,616 38.0 25.4 35.1 1.6 5,850 Below primary 50.3 2,615 38.4 24.1 34.5 2.9 948 Completed primary 61.8 8,351 35.1 23.8 37.9 3.1 3,854 Completed middle 62.8 8,562 32.6 24.4 39.1 3.9 3,842 Completed secondary 74.7 7,602 29.9 26.8 39.5 3.8 4,157 Completed higher
secondary & above 76.7 9,805 29.6 25.0 41.1 4.3 5,239
Social-group
Scheduled Caste 54.2 10,976 33.7 24.9 36.7 4.7 4,415 Scheduled Tribe 60.4 6,311 33.3 23.4 40.3 2.9 2,835 OBC 61.3 21,886 31.0 25.6 39.8 3.5 9,878 Others 62.8 14,828 36.4 25.2 36.4 2.1 6,600 Do not know 41.8 550 55.2 21.6 23.2 0.0 161
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Background characteristic
Received any
checkups after birth
Number of
newborn
New born baby who received any checkups after birth / discharge, within
10 days Number of
newborn who received any
PNC Number of check-up received
One Two Three or
more Missing
Wealth index
Lowest 42.2 10,977 37.6 26.8 33.4 2.2 3,410 Second 51.2 11,248 36.6 24.3 35.4 3.7 4,419 Middle 62.5 11,213 32.7 24.4 38.8 4.1 5,142 Fourth 71.9 11,092 30.4 24.1 42.3 3.2 5,884 Highest 73.5 10,020 32.1 26.4 38.7 2.8 5,035
Place of delivery Government hospital /
health centre 61.8 26,369 27.2 26.3 42.1 4.5 11,742
Private hospital / clinic / nursing home
78.1 16,582 31.8 25.5 40.2 2.6 9,631
Home 29.8 11,391 69.1 17.9 13.0 0.0 2,451 Other 38.3 208 66.6 24.3 9.1 0.0 66
Total 59.9 54,550 33.4 25.1 38.2 3.2 23,890
As seen from the analysis close to 60 percent of the newborn received a check-up (within and after
10 days of delivery) and out of the babies that received check-ups, 33 percent received one check-
up, 25 percent received two check-ups and 38 percent received three and more check-ups within
first 10 days of birth. It may also be noted that among the newborn delivered in the government
health facilities, close to a fourth (27 percent) received only one check-up; another 26 percent
received two check-ups and 42 percent received three or more check-ups within 10 days. Babies
born in a private facility (78 percent) are more likely to receive a check-up. Around 32 percent babies
born in private health facilities received one check-up, 26 percent received two check-ups and
around 40 percent received three or more check-ups within 10 days. However, babies born at home
70 percent did not receive any check-ups within 10 days.
4.4.5 Postnatal care indicators by states
State wise information on the five critical indicators of postnatal care of mother and the newborn
has been provided in Table 4.28. Proportion of women receiving a visit within one week after
delivery by any health care provider (AWW, ANM or ASHA) varied across the states, from 13 percent
in Delhi to 97 percent in Tamil Nadu. States like Tamil Nadu (97 percent), Goa (96 percent), Kerala
(96 percent), Karnataka (85 percent), Andhra Pradesh (84 percent) and Maharashtra (83 percent)
have relatively performed better in terms of home visits by healthcare workers. In 13 states, more
than 50 percent of women received a visit by a health care worker. On the other hand, in 10 states,
about a fourth or less proportion of women received a postnatal visit by health workers within a
week of delivery. With regards to postnatal check-ups to women within 48 hours of delivery,
proportion of women receiving a check-up varies from 4 percent in Manipur to 95 percent in Goa. In
seven states, 60 or more percentage of the women received postnatal check-ups. In Goa, Tamil
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Nadu, Kerala, Andhra Pradesh, Karnataka, Maharashtra and Madhya Pradesh, more than 60 percent
of the women reported to have received PNC within 48 hours of delivery. There are at least 20 states
where proportion of women who received PNC within 48 hours was less or equal to 40 percent.
Table 4.28: Postnatal care indicators by states Percentage of women who had live births in three years preceding the survey, by different postnatal services received and according to states, RSOC, 2013-14
State
Percentage of women visited
within one week by AWW, ANM or ASHA after
delivery
Percentage of women who received PNC
within 48 hours of delivery
Percentage of women whose
newborn received check-ups within 24
hours of delivery
Percentage of women received at least 3 check-
ups during first 10 days of delivery*
Percentage of women whose
newborn received at least 3 check-
ups during first 10 days of delivery*
India 51.0 39.3 33.6 39.8 38.2 North
Delhi 13.4 7.8 8.8 27.0 26.2 Haryana 28.5 23.5 24.0 33.1 27.6 Himachal Pradesh 23.5 13.1 14.4 24.4 19.7 Jammu & Kashmir 21.6 10.3 12.0 38.7 30.8 Punjab 20.3 15.6 16.5 22.8 27.7 Uttar Pradesh 19.1 12.1 11.5 12.7 13.5 Uttarakhand 23.8 12.2 11.7 25.2 21.8
Central Chhattisgarh 60.7 45.9 45.5 37.6 38.1 Madhya Pradesh 64.1 60.3 53.5 55.4 58.5
East Bihar 30.1 6.4 9.4 14.1 11.6 Jharkhand 26.5 12.7 13.0 17.9 17.0 Odisha 53.9 10.5 12.6 25.3 23.4 West Bengal 24.8 9.1 9.9 16.0 15.6
Northeast Arunachal Pradesh 37.4 12.8 11.7 30.0 25.6 Assam 51.4 7.0 6.7 9.0 11.0 Manipur 52.8 3.5 3.5 29.1 11.2 Meghalaya 29.4 19.0 18.6 19.0 22.8 Mizoram 20.0 8.1 9.4 16.1 12.2 Nagaland 3.6 5.6 5.2 3.1 3.8 Sikkim 55.2 10.7 32.2 59.7 59.2 Tripura 34.2 15.9 17.8 35.9 34.2
West Rajasthan 17.2 9.5 9.9 22.3 28.8 Goa 96.1 95.0 36.7 55.8 52.0 Gujarat 68.0 47.5 49.4 29.0 30.0 Maharashtra 83.1 77.1 65.2 42.5 44.2
South Andhra Pradesh 84.2 77.9 77.9 52.2 49.7 Karnataka 85.4 75.6 52.2 50.0 46.9 Kerala 95.7 94.0 55.0 54.1 53.5 Tamil Nadu 96.7 94.7 58.7 43.5 40.2
*calculated out of those who received any PNC
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In six states more than half of the women’s babies got a check-up within 24 hours of birth. In three
states, Andhra Pradesh (78 percent), Maharashtra (65 percent) and Tamil Nadu (59 percent) 60
percent and more of women’s newborn got a check-up within 24 hours. In 20 states, proportion of
women whose newborn receiving a check-up within 24 hours was less than equal to 40 percent.
Regarding women whose baby got three check-ups within 10 days of births, in four states more than
50 percent of the women’s babies got three check-ups within 10 days.
4.5 ROLE OF AWC IN PRENATAL, NATAL AND POSTNATAL CARE
The healthcare workers namely ASHA, ANM and AWW are the basic providers and facilitators of
healthcare services as they form the first level of interface between government
programmes/schemes and the targeted beneficiaries. Among the field level workers, the role of the
AWW and her centre, Anganwadi Centre (AWC), is the hub for providing critical services of
improving nutrition, immunization, maternal health care, nutrition and health education for children
below six years, pregnant women, lactating mothers and adolescent girls.
Questions were asked in the EMW questionnaire to eligible women on the role of AWW in
counselling for registration of their pregnancy; whether pregnancy was registered at an AWC and
whether ANC services were provided at the AWC. Women were also asked whether they received
counselling to deliver in a health institution. Table 4.29 presents the percentage of the eligible
women who registered their pregnancies at an AWC; received counselling from the AWW to register
their pregnancies; received ANC at the AWC; visited at home by AWW during pregnancy and
percentage of women who received counselling from an AWW to deliver at a health facility.
Among all the women who had a live birth in the three years preceding this survey, 70 percent
registered their pregnancy in an AWC with relatively younger women aged (15-24) (74 percent) than
the older women, 25-49 years (58-70 percent). Overall, close to 30 percentage of the women
reported that they were advised by AWW to register their pregnancy. However, a small proportion
of the women (22 percent) ultimately received ANC services from the AWCs. This means about two-
third (68 percent) of the women who had registered dropped out and did not receive services from
AWC. Drop out was more in case of women living in urban areas and women from economically
better off families. There could be various reasons for drop out, socio-cultural and economic
conditions along with the quality of care aspired by the client. Research and more evidence would
be critical to determine the causes of the drop out from the system.
Around a third (35 percent) of the women were visited at home by AWW during pregnancy, more
visitations were seen in rural areas (39 percent) than at homes of urban women (26 percent).
Counselling to women by AWW has been poor both with regards to registration of pregnancy (30
percent) and also for delivering in a health facility (11 percent).
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Table 4.29: Role of AWC in Maternal Health Among women who had live births in the three years preceding the survey, percentage who registered their pregnancy at the AWC, received advice/counselling by AWW to register their pregnancy, received ANC check-ups during pregnancy at the AWC, visited at home by at least once by AWW during pregnancy and received advise/counselling by AWW to deliver at a health facility, according to selected characteristics, RSOC, 2013-14
Background characteristic
Women registered
their pregnancy at the AWC
Women received
advise/counselling by AWW to register
their pregnancy
Women received
ANC check-ups during pregnancy at the AWC
Women visited at home at
least once by AWW
during pregnancy
Women received
advise/counselling by AWW to
deliver at a health facility
Number of women
Mothers Age 15-19 74.4 30.0 23.2 35.2 13.9 1,539 20-24 74.2 32.6 23.0 36.6 14.7 20,364 25-29 69.5 29.2 22.2 34.9 12.2 20,861 30-34 62.4 26.6 20.8 31.2 11.2 8,145 35-49 57.7 27.3 23.1 32.2 11.9 3,642
Residence Urban 65.0 18.7 10.6 25.7 8.7 16,320 Rural 71.5 34.8 27.4 38.7 14.8 38,230
Social-group Scheduled Caste 69.6 30.9 24.3 36.1 14.0 10,976 Scheduled Tribe 77.8 45.2 36.5 42.5 19.3 6,311 OBC 69.5 29.1 23.0 33.6 11.9 21,886 Others 65.9 24.5 14.3 32.5 11.3 14,828 Do Not Know 71.7 20.4 13.8 30.3 8.5 550
Wealth Index Lowest 67.7 36.6 32.4 33.5 13.5 10,977 Second 69.3 32.4 26.4 36.7 14.4 11,248 Middle 72.8 33.4 22.4 39.7 14.9 11,213 Fourth 73.3 27.7 17.5 36.2 12.9 11,092 Highest 63.9 18.7 12.3 27.2 8.9 10,020
Total 69.5 30.0 22.4 34.8 13.0 54,550
About 32 percent of women from the poorest families received ANC services at AWCs. Among the
different social groups, high proportion of the women from the ST families availed benefits from
AWCs and services of an AWW. Around 77 percentage of the women from the ST families registered
their pregnancy; 37 percent received ANC check-ups in AWC; 43 percent reported to have been
visited at home by an AWW pregnancy and around a fifth received counselling from AWW for
delivering in a health facility. Better utilization of AWW and AWC services are seen among the
women from the rural areas. Similarly, 72 percent of the women living in rural areas registered their
pregnancy; 27 percent received ANC check-ups in AWC; 39 percent were visited by AWW during
pregnancy and 15 percent women reported to have been counselled to deliver in a health facility.
Better use of services in rural areas and among women from the tribal families can be attributed to
better spread of AWCs in rural and tribal areas and convergence of services at these AWCs.
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4.5.1 Role of AWW in maternal health by states
The state wise percentage of mothers who received selected maternal care services from AWWs is
presented in Table 4.30.
Table 4.30: Role of AWC in maternal health by states Among the live births in the three years preceding the survey, percentage of women who registered their pregnancy at the AWC; received ANC check-ups during pregnancy; visited at home by at least once by AWW during pregnancy; and received advise/counseling by AWW to deliver at a health facility according to selected characteristics, RSOC, 2013-14.
States
Women registered their pregnancy at the AWC
Women received ANC check-ups during pregnancy at the AWC
Women visited at home at least once by AWW during pregnancy
Women received advise/counselling by AWW to deliver at a health facility
India 69.5 22.4 34.8 13.0 North
Delhi 21.0 5.2 13.0 3.0 Haryana 48.9 19.5 22.4 8.7 Himachal Pradesh 78.9 9.7 34.8 11.5 Jammu & Kashmir 29.8 7.4 15.6 3.5 Punjab 47.9 14.3 25.8 6.2 Uttar Pradesh 33.8 17.9 25.3 6.3 Uttarakhand 45.7 13.0 23.7 4.0
Central Chhattisgarh 91.0 55.7 19.0 7.1 Madhya Pradesh 87.2 38.9 23.8 21.2
East Bihar 53.4 27.4 20.5 5.7 Jharkhand 61.0 41.2 29.8 12.0 Odisha 85.3 43.1 51.6 18.4 West Bengal 66.4 9.0 28.4 9.0
Northeast Arunachal Pradesh 27.3 12.9 33.6 13.0 Assam 67.8 17.9 38.8 17.5 Manipur 74.0 0.6 72.8 3.5 Meghalaya 32.0 3.3 18.4 5.1 Mizoram 56.0 17.6 12.5 2.4 Nagaland 35.0 0.2 0.7 0.0 Sikkim 64.3 7.6 43.3 14.9 Tripura 68.8 13.7 41.2 17.2
West Rajasthan 62.3 44.5 37.7 16.5 Goa 94.4 9.5 46.0 15.1 Gujarat 87.0 26.6 40.3 18.2 Maharashtra 90.4 17.7 44.7 14.4
South Andhra Pradesh 92.7 17.0 48.8 22.3 Karnataka 91.9 13.1 48.7 19.3 Kerala 75.2 7.4 55.5 9.3 Tamil Nadu 92.1 12.1 50.6 16.7
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Overall, it is seen in most states, a significant proportion of women (in 20 states, more 50 percent
women registered pregnancy) registered their pregnancy in an AWC. While overall, about 70 percent
of the women registered their pregnancy at AWC, in states of Goa, Andhra Pradesh, Tamil Nadu,
Karnataka, Chhattisgarh and Maharashtra more than 90 percent of the women had registered at
AWCs. Proportion of women registering their pregnancy in AWCs varies between 21 percent in Delhi
to 94 in Goa. There were at least 17 states where registration of ANC in AWCs was lower than the
national average (70 percent).
However, proportion of women ultimately receiving ANC check-ups at AWCs was much lower (22
percent) than those who registered. It varied between less than one percent in Manipur and
Nagaland to close to 56 percent in Chhattisgarh). Other states where relatively higher proportion of
women received ANC services from AWC are Rajasthan (45 percent), Odisha (43 percent), Jharkhand
(41 percent) and Madhya Pradesh (39 percent). In 24 states, not even 30 percent of the women
received ANC check-ups at AWCs. In Delhi, Jammu and Kashmir, West Bengal, Manipur, Meghalaya,
Nagaland, Sikkim and Kerala, less than a tenth of the women received ANC check-ups in AWCs.
Home visits by AWW at least once during pregnancy varied from one percent in Nagaland to 73
percent in Manipur. In four states, namely Tamil Nadu, Odisha, Kerala and Manipur more than 50
percent women reported that they were visited at home by an AWW, during their pregnancy.
Conclusion
It is seen that overall, situation of maternal health of women has improved as compared to results of
the survey conducted in 2005-06 and also in 2007-08. However, the situation significantly differs
among the states, in almost all indicators.
More than four out of every five (84 percent) women registered their pregnancy with health
facilities and Anganwadi centres reflecting greater awareness about maternal health care among
women. More than three-fourth (79 percent) women delivered in a health facility (both government
and private). One-fifth of deliveries took place at home in contrast to about half of deliveries taking
place at home as per DLHS 2007-08.
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CHAPTER 5 CHILD HEALTH CARE
India has the largest population of children below six in the world. As per Census 2011, there were
113 million children below age five accounting for 9.3 percent of the total population in the country.
Although, during the last couple of decades, there has been a reduction in infant and child mortality
in India, still the current level of under-five mortality (49 per 1,000 live-births, Sample Registration
System 2013) and infant mortality rate (40 per 1,000 live births, SRS, 2013) is on the high side. The
Government of India is committed to the Millennium Development Goal of reduction in infant and
child mortality rates. The child health programme under the National Health Mission (NHM) of
Ministry of Health and Family Welfare integrates interventions that improve child survival, and
addresses factors contributing to infant and under-five mortality. Neonatal health, nutrition,
management of common childhood illnesses, and immunization are the main thrust areas of the
child health programme.
The Integrated Child Development Scheme (ICDS) of Ministry of Women and Child Development is
also committed to the development of children. The programme under ICDS covers children below
age six. The scheme provides health and nutrition services to children and pregnant and lactating
women and pre-school education to the children with the aim of breaking the vicious cycle of
malnutrition, morbidity, reduced learning capacity and mortality among children. This chapter on
child health care will help in the assessment of the health care children receive.
The chapter presents findings of RSOC 2013-14 related to the preventive and curative health care
given to young children below age five. It also looks into the role of Anganwadi Centres (AWCs) of
ICDS in providing child health care. The specific topics included in the chapter are: (1) childhood
immunization, (2) prevalence of common childhood diseases, i.e., diarrhoea, fever and acute
respiratory infections (ARI) and treatment given during illness, and (3) role of AWCs of ICDS in
providing child health care in terms of immunization and treatment.
5.1 IMMUNIZATION
Universal immunization is one of the key interventions for protection of children from life
threatening conditions, which are preventable. The Immunization programme in India is a major
public health intervention in the country. Under the Universal Immunization Programme (UIP),
Government of India is providing scheduled vaccination to prevent seven vaccine preventable
diseases as follows:
Bacillus Calmette Guerin (BCG): one dose at birth (up to one year if not given earlier).
DPT (Diphtheria, Pertussis and Tetanus Toxoid): five doses; three primary doses at 6,10,14
weeks and two booster doses one at 16-24 months and another at age five.
Oral Polio Vaccine (OPV): five doses; zero dose at birth, three primary doses at 6, 10 and 14
weeks and one booster dose at 16-24 months of age.
Hepatitis B vaccine: four doses; zero dose within 24 hours of birth and three doses at 6, 10
and 14 weeks of age.
Measles: two doses; first dose at 9-12 months and second dose at 16-24 months of age.
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In all the Government health institutions vaccination is available free of cost. It is also provided in
private clinics and hospitals. In rural areas ANM45 provides immunization at AWCs, where ASHA and
Anganwadi worker (AWW) provide support in planning and implementation of immunization
sessions. At the time of registration of the pregnancy, pregnant women are given the Mother and
Child Protection (MCP) card to track the stages of pregnancy, antenatal care (ANC) services, nutrition
and vaccinations required by the mother and the child. The MCP card is the best source of data on
child immunization.
In RSOC all eligible women with children aged 0-35 months were interviewed and were asked
whether they have an MCP or immunization card. All those having a card, were asked to show it. In
case the mothers were able to produce the card, all the vaccines recorded on the card were copied.
Alternatively, the mother was asked whether the child was given each of the vaccine mentioned
above. All the children who received pentavalent vaccine were considered to have received both
DPT and hepatitis vaccines. Additionally, data on the receipt of second dose of measles and the two
booster doses of DPT vaccine was collected for children aged 36-71 months. By the time of
completion of the first year of life, the child is supposed to have received all vaccines, i.e., 1) BCG, 2)
three injections of DPT, 3) polio at birth and next three doses of polio, 4) measles and 5) Hepatitis B
at birth and next three doses. So the tabulation of primary immunization is restricted to children
aged 12-23 months.
RSOC asked mothers whether they had a vaccination card. If a card was available, the interviewer
was instructed to copy the day, month, and year that each vaccination was received. For
vaccinations not recorded on the card, the mother’s report that the vaccination was or was not
given was recorded. If the mother could not show a vaccination card, she was asked whether the
child had received any vaccinations. If any vaccinations had been received, the mother was asked
whether the child had received a vaccination against each of the following (1) tuberculosis (BCG), (2)
DPT, (3) polio, (4) measles and (5) hepatitis. For DPT and polio, information was obtained on the
number of doses of the vaccine given to the child. Table 5.1 gives the percentage of children aged
12-23 months who received a specific vaccine according to the source of reporting, i.e., from card,
from mother’s report and either from card or from the mother’s report. In 7,551 (42 percent) cases
out of 17,791 children, the MCP/immunization card for the child was available and the mother could
show it to the interviewer. For one percent of children the card was blank with not a single record of
vaccine, indicating that one percent of the children did not receive any vaccine.
The comparison of the immunization coverage indicated on the cards and reported by the mother
shows higher coverage of each of the vaccine among the children having the card. The record on the
cards shows that 96 percent of the children received BCG, 89 percent received three doses of DPT,
85 percent of the children received three doses of polio and the same percentage received measles
vaccine. However, the mother’s report shows much lower coverage of each vaccine. The mother’s
report shows that 88 percent of the children received BCG, 64 percent received three doses of DPT,
45Auxiliary Nursing Midwife
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65 percent received three doses of polio and 75 percent were given the measles vaccine. For
complete protection from the six childhood diseases, it is essential to have all the six vaccines—BCG,
three injections of DPT, three doses of polio and measles. The coverage of full immunization was 58
percent according to mother’s report compared to 76 percent by card’s record. The record on
immunization card showed that one percent of children did not receive any vaccine. On the
contrary, the mother’s report showed that 11 percent of the children did not get any immunization.
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Table 5.1: Vaccinations by source of information
Percentage of children aged 12-23 months who received specific vaccines at any time before the survey, by source of information (vaccination card or mother’s report)
Figure 5.1: Percentage of children aged 12-23 months received vaccines, RSOC, 2013-14
91 89 84
75
63
90 83
74
58 66
53
34
79
BCG DPT 1 DPT 2 DPT 3 Polio 0 Polio 1 Polio 2 Polio 3 Hepatitis0
Hepatitis1
Hepatitis2
Hepatitis3
Measles
Source of information BCG DPT Polio Hepatitis B
Measles Full
immunization*
No immunizati
on
Number of children
aged 12-23 months 1 2 3 0 1 2 3 0 1 2 3
Vaccinated at any time before the survey
Immunisation Card Mother's Report Either Source
95.7 87.8 91.1
96.4 84.2 89.4
93.9 76.9 84.1
88.9 64.4 74.8
77.2 52.2 62.8
95.4 86.1 90.0
92.6 76.6 83.4
85.2 64.8 73.5
48.5 64.4 57.6
89.7 48.9 66.2
85.3 29.7 53.3
80.0 0.9
34.4
84.6 74.6 78.9
75.5 57.7 65.3
1.3 10.6
6.6
7,551 10,240 17,791
* Full Immunization includes 1 dose of BCG, 3 doses of OPV, 3 doses of DPT and one dose of measles
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Combining both records, RSOC shows that among children aged 12-23 months, a large proportion
received BCG (91 percent), first injection of DPT (89 percent) and first dose of polio (90 percent).
However, subsequently, there were dropouts in the vaccination and ultimately, only about three-
fourth of the children received third injection of DPT (75 percent) and third dose of polio (74
percent) and 79 percent of the children received measles vaccine. Two in every three children (66%)
received first dose of hepatitis vaccine, however subsequently only one-third (34%) of children could
complete the schedule of three doses. The dropouts in vaccinations were quite high. From the first
to third dose of DPT, Polio and hepatitis the dropout rates (estimated as ratio of the difference
between the percentage of children who received first and third dose and percentage of children
who received first dose, and expressed in percentage) were 16 percent, 18 percent and 48 percent
respectively. About two in every three children (65 percent) aged 12-23 months received complete
schedule of the vaccination, i.e., they got complete protection from six diseases. At the same time
seven percent of the children did not receive a single vaccine. So among all the children aged 12-23
months, 65 percent received full immunization, seven percent received no immunization and
remaining 28 percent received only partial immunization.
Figure 5.2: Percentage of children aged 12-23 months received vaccines, RSOC, 2013-14
(Status of Full Immunization)
The previous nation-wide survey—NFHS-3—also provided levels of immunization. The comparison of
immunization coverage from NFHS-3 and RSOC suggests improvement in the coverage of BCG, DPT
and measles. The extent of full immunization comprising of BCG, three doses of DPT and polio and
measles, has increased by more than 20 percentage points from 44 percent in 2005-06 to 65 percent
in 2013-14.
Survey Year BCG DPT Polio
Measles All None 1 2 3 1 2 3
NFHS-3 (2005-06) 78.1 76.0 66.7 55.3 93.1 88.8 78.2 58.8 43.5 5.1 RSOC (2013-14) 91.1 89.4 84.1 74.8 90.0 83.4 73.5 78.9 65.3 6.6
6.6
28.1
65.3
No immunization
Partial immunization
Full immunization
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The percentage of children who received specific vaccines by selected household and child
characteristics is presented in Table 5.2. The coverage of each vaccine was higher in urban areas
than in rural areas and the coverage of full vaccination in urban areas was ten percentage points
higher in urban areas (72 percent) than in rural areas (62 percent). Both male and female children
were equally likely to receive immunization. Children of birth order three or higher were less likely to
receive each type of vaccine compared to first or second born children. Eleven percent of the
children of birth order three or more did not receive a single vaccine and 57 percent of them
received full immunization compared to 67-68 percent of the first or second order children receiving
full immunization. Educated mothers were more likely to immunize their children compared to their
lesser educated peers. The proportion of children with no immunization decreased from 13 percent
among children with mothers having no education to less than one percent among children whose
mothers had completed Higher Secondary or had higher education. The extent of full immunization
was 82 percent among children whose mothers completed Higher Secondary or had higher
education, whereas only 49 percent of the children with mothers having no education received full
immunization.
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Table 5.2: Vaccinations by background characteristics
Percentage of children age 12-23 months who received specific vaccines at any time before the survey (according to a vaccination card or mother's report), and percentage
with an immunization card seen by the interviewer, by background characteristics
Characteristics BCG
DPT Polio
Measles Full
immunization* Partial
immunization No
immunization
Hepatitis B Percentage with an immunization card
Number of
children aged 12-
23 months
1 2 3 0 1 2 3 0 1 2 3 Seen Seen/Not
Seen
Sex of the Child
Male 91.3 89.4 84.1 74.3 63.2 90.0 83.3 73.0 79.4 65.0 28.4 6.6 58.7 66.2 53.1 33.8 41.5 84.4 9,388 Female 90.9 89.4 84.1 75.3 62.4 90.0 83.4 73.9 78.3 65.6 27.6 6.7 56.4 66.3 53.5 35.2 43.5 84.2 8,403
Birth order
1 92.4 91.2 86.2 77.4 67.5 91.8 85.7 76.1 81.9 68.3 26.2 5.4 60.7 67.6 53.4 36.1 43.6 87.2 8,802 2 92.2 90.4 85.1 76.5 63.5 90.8 84.1 75.2 79.8 66.8 27.5 5.8 58.2 68.5 56.7 36.6 45.0 84.8 5,090 3+ 86.8 84.2 78.0 66.7 51.4 85.1 77.2 65.3 70.7 56.5 32.9 10.5 50.0 60.1 48.6 28.0 36.4 77.0 3,899
Residence
Urban 94.0 92.3 87.7 80.7 70.5 92.9 88.2 79.5 83.1 72.0 23.5 4.5 63.7 69.2 55.4 35.8 43.1 87.8 5,415 Rural 89.9 88.1 82.6 72.2 59.5 88.8 81.3 70.8 77.0 62.4 30.0 7.6 55.0 64.9 52.4 33.8 42.2 82.8 12,376
Mother education
No Education 83.6 80.0 73.2 60.2 49.9 81.6 72.3 59.5 65.6 48.7 37.9 13.4 49.6 54.6 42.4 24.3 32.7 74.3 5,623 Below Primary 91.6 92.1 86.8 77.3 58.5 91.2 87.1 73.7 81.0 66.2 28.2 5.5 50.5 70.7 60.1 42.9 53.4 87.5 867 Completed Primary 93.3 92.0 85.5 76.0 65.4 92.3 85.1 74.2 80.4 66.7 28.9 4.4 57.3 69.4 55.7 38.2 47.1 87.3 2,744 Completed Middle 92.1 90.8 86.2 76.3 64.0 91.0 83.7 74.5 82.0 66.4 28.0 5.6 56.9 70.2 58.8 38.8 48.7 88.2 2,864 Completed Secondary 95.7 95.3 92.0 85.8 73.3 95.2 91.1 84.2 88.3 77.8 19.3 2.8 65.3 72.6 59.3 40.9 46.3 90.0 2,409 Completed Higher Secondary
and above 97.9 97.1 93.4 88.7 75.3 97.7 93.9 87.9 89.9 82.1 16.9 1.0 68.6 74.2 59.0 37.9 44.0 90.6 3,284
Religion
Hindu 91.7 90.1 84.9 75.7 63.3 90.6 84.0 74.6 79.6 66.2 27.7 6.1 58.1 66.7 53.2 35.0 42.9 84.6 13,987 Islam 87.0 85.0 79.3 69.9 58.6 86.3 79.7 68.2 73.1 60.2 29.9 9.9 53.4 62.5 52.0 31.3 40.4 82.0 2,895 Christian 93.8 91.6 85.0 72.8 68.8 93.1 83.0 67.3 81.8 62.4 32.8 4.8 61.5 61.1 47.6 31.5 38.1 80.6 370 Sikh 97.8 95.0 93.4 86.1 70.6 95.1 93.4 87.1 87.5 81.9 16.2 1.9 65.3 83.2 75.7 43.3 48.7 91.6 269 Jain (100.0) (92.0) (92.0) (84.0) (84.0) (100.0) (88.0) (80.0) (92.0) (80.0) (20.0) (0.0) (68.0) (72.0) (60.0) (24.0) (36.0) (84.0) 43
Buddhist 94.9 93.8 85.5 80.5 73.4 93.0 85.1 69.3 93.2 68.8 26.2 5.0 72.5 76.0 59.4 42.5 51.1 94.1 126 No Religion * * * * * * * * * * * * * * * * * * 07 Other 90.8 88.2 83.5 72.9 49.9 87.5 73.9 68.3 77.4 57.5 35.1 7.4 56.1 69.0 55.8 30.3 36.8 89.3 94
Social Group
Scheduled Caste 88.4 87.3 82.2 72.0 60.0 87.4 80.8 69.8 76.7 61.6 29.6 8.8 51.1 66.2 54.5 38.0 46.8 83.5 3,611 Scheduled Tribe 90.4 86.6 78.6 65.0 55.9 87.9 76.7 63.7 75.4 55.7 36.9 7.4 56.4 58.9 44.3 27.9 36.0 79.3 2,015 OBC 90.6 89.0 83.8 74.9 63.8 90.0 83.6 73.8 77.5 65.4 27.5 7.1 59.0 64.7 50.8 31.7 39.9 82.9 7,136 Others 94.2 92.8 88.2 80.5 66.7 92.9 87.6 79.6 83.8 71.6 24.3 4.1 61.7 71.2 59.1 37.7 44.6 88.9 4,879 Do Not Know
93.3 89.8 85.4 82.2 54.3 89.2 83.9 74.9 83.1 73.2 20.1 6.7 34.9 77.4 73.9 62.3 72.5 87.7 149
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Characteristics BCG
DPT Polio
Measles Full
immunization* Partial
immunization No
immunization
Hepatitis B Percentage with an immunization card
Number of
children aged 12-
23 months
1 2 3 0 1 2 3 0 1 2 3 Seen Seen/Not
Seen
Number of ANC visits
No ANC 72.9 68.8 62.1 49.5 36.4 69.8 61.5 49.8 55.4 39.6 36.6 23.8 39.2 41.4 30.8 14.5 20.6 63.5 2,576 1 86.0 85.3 80.8 69.2 52.0 86.0 78.9 67.4 68.8 54.9 36.1 9.0 43.6 54.1 46.7 31.5 46.1 78.4 1,233 2 93.0 91.0 83.7 72.4 59.4 91.8 82.2 70.0 78.1 60.0 35.6 4.4 60.2 64.1 49.4 28.7 37.9 85.0 2,401 3 92.3 91.2 85.8 76.9 64.6 92.1 85.8 74.7 81.0 66.8 28.4 4.8 59.6 68.9 54.3 33.0 43.1 88.0 3,367 4+ 96.7 95.4 91.1 83.5 73.3 95.8 90.3 82.4 87.2 76.0 21.8 2.2 64.2 75.6 62.4 43.7 50.0 90.0 8,136 Do not know 86.7 85.9 78.8 73.1 45.7 81.3 77.9 69.8 69.7 60.5 27.2 12.4 44.2 45.3 22.9 13.7 24.0 86.9 77
Place of delivery
Government hospital/Health centre
94.1 91.9 86.8 77.6 68.7 92.4 85.4 75.7 81.7 67.5 28.4 4.1 60.0 68.5 56.0 37.5 46.1 88.0 8,657
Private hospital/Clinic/Nursing home
94.4 93.8 88.8 81.6 70.2 94.5 89.0 80.8 84.8 73.7 22.7 3.6 63.2 71.5 56.8 37.6 43.7 87.8 5,518
At home 79.0 77.0 70.8 58.0 37.3 77.8 69.9 57.2 63.2 47.6 35.3 17.2 43.5 52.6 41.5 22.3 31.2 69.9 3,552 Other 75.0 68.7 62.5 47.4 47.9 68.7 63.4 46.5 36.2 28.9 46.0 25.0 39.6 56.0 46.1 19.6 51.3 69.9 63
Wealth Index
Lowest 84.2 81.3 75.1 62.4 49.8 82.7 73.4 60.6 66.5 50.6 36.7 12.6 46.6 55.2 44.6 28.0 37.0 75.6 3,533 Second 88.8 86.1 80.1 69.8 59.0 86.5 78.8 68.4 74.8 59.3 31.9 8.8 52.7 62.3 51.0 32.4 41.9 81.7 3,647 Middle 92.4 90.8 84.8 75.3 63.4 91.4 84.6 73.8 81.2 66.0 28.6 5.4 59.4 67.4 53.5 35.3 43.1 85.7 3,815 Fourth 94.0 93.0 88.5 80.1 68.9 93.4 87.8 78.7 83.8 71.6 24.3 4.1 63.2 70.8 55.1 36.0 43.9 88.0 3,443 Highest 96.6 96.3 92.8 87.2 73.8 96.5 92.9 86.7 88.5 80.0 18.0 2.0 66.8 76.1 62.9 40.8 46.5 90.9 3,352
Total 91.1 89.4 84.1 74.8 62.8 90.0 83.4 73.5 78.9 65.3 28.1 6.6 57.6 66.2 53.3 34.4 42.4 84.3 17,791
( ) Based on 25-49 unweighted cases. *Based Percentages are not shown, based on fewer than 25 unweighted cases.
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Figure 5.3: Percentage of children aged 12-23 months who are fully immunized and percentage received no immunization by selected characteristics, RSOC, 2013-14
Among the four social groups, the vaccination coverage was the lowest among children from the STs
and the highest among those from other castes. The proportion of fully immunized children was 16
percentage points higher among children from other castes (72 percent) compared to those from
STs (56 percent). Better economic status led to a substantial improvement in immunization
coverage. With increase in wealth quintile there was a decrease in the proportion of children with no
immunization and increase in the extent of full immunization. From the lowest wealth quintile (51
percent) to the second lowest quintile (59 percent), there was an increase of 8 percentage points in
the coverage of full immunization.
The immunization coverage is also tabulated by number of ANC visits and place of delivery. The ANC
visits give a chance to health functionaries to advise expecting mothers about child health care.
Similarly, in case of institutional delivery, health functionaries get an opportunity to advise women
about the importance of immunization. Children whose mothers avail ANC and too frequently are
more particular about utilization of health care for their children. The antenatal visits led to
substantial improvement in immunization coverage. Almost one-quarter (24 percent) of children
whose mother received no ANC did not get a single vaccine compared to nine percent of those
whose mother received ANC only once and two percent of those whose mother received ANC for
four or more times. Similarly, the coverage of full immunization increased from 40 percent among
the children whose mother did not receive any ANC to 55 percent among those whose mother
received ANC only once and 76 percent among those whose mother received ANC for four or more
times. Immunization coverage was much higher among those children who were born in health
institutions compared to those born at home. More than two-thirds of the children born in the
health institution (68 percent of those born in government health institutions and 74 percent of
65 66 68 67 57
72 62
49
66 67 66 78 82
7 7 5 6 11 5 8 13
6 4 6 3 1
Mal
e
Fem
ale 1 2
3+
Urb
an
Ru
ral
No
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uca
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Be
low
Pri
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Co
mp
lete
d P
rim
ary
Co
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d M
idd
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Co
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d S
eco
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. Hig
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Se
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+
Sex of Child Birth Order Residence Mother's education
Full immunization* No immunization
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those born in private health institutions) received full immunization compared to 48 percent of
children born at home.
The doses of polio and hepatitis B given at birth and the three doses of hepatitis B are not included
in full immunization. The coverage of these vaccines was lower than the six vaccines included in full
immunization. The proportion of the children who received polio and hepatitis B at birth was 63
percent and 58 percent respectively. The differentials in the coverage of these vaccines across
different characteristics are similar to those in the coverage of six vaccines included in full
immunization. A higher coverage of these vaccines among the children born at health institutions
was expected. However, it may be noted that the coverage of these vaccines was not very high even
among the children born at either government health institutions or private health institutions. Two-
thirds of children received the first dose of hepatitis B and only one-third received the subsequent
three doses of the vaccine. Even among children whose mothers completed Higher Secondary or
have higher educations (38%), or those from the highest wealth quintile (41%), less than half
received three doses of hepatitis B.
For all the children who received at least one vaccine, RSOC collected data on the place where child
received vaccination. If the child received vaccination from more than one source, the place from
where the child had received most of the vaccinations was recorded. Table 5.3 presents the
distribution of children who received at least one vaccine, by place where a child received most of
the vaccination. RSOC shows that in India AWCs are the major providers of child immunization.
Almost half (49 percent) of the children got immunized in AWCs, 35 percent were immunized in
government health facilities and 12 percent received immunization in private health institutions. The
utilization of AWCs for immunization was much higher in rural areas (60 percent), among ST children
(63 percent) and those from the lowest wealth quintile (70 percent). AWC and government health
facility were the two major places for immunization, together providing immunization to 85 percent
of children in India. Only in urban areas (25 percent) and in the highest wealth quintile (31 percent) a
sizeable proportion of children got immunized in private health facility.
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Table 5.3: Place of immunization
Percent distribution of children aged 12-23 months who received any vaccine by place of immunization,
according to background characteristics
Characteristics
Place of Immunization Number of children aged 12-23 months
who received at least one vaccine
Anganwadi Centre
Govt. hospital/health
institution
Pvt Hospital/clinic/nursing home
Home Other
Residence Urban 26.3 47.2 24.6 0.8 1.1 5,174 Rural 59.7 29.9 5.8 2.1 2.5 11,434
Social Group Scheduled Caste 55.0 36.3 5.5 1.1 2.0 3,294 Scheduled Tribe 63.1 27.7 6.3 1.3 1.7 1,866 OBC 52.4 29.6 13.3 2.3 2.4 6,631 Other 36.3 44.7 16.0 1.4 1.7 4,678 No Response 20.6 68.8 9.2 0.7 0.7 141
Wealth Index Lowest 69.7 23.1 2.1 2.9 2.3 3,086 Second 59.6 33.0 3.0 1.8 2.5 3,325 Middle 53.3 36.5 7.1 1.2 1.9 3,610 Fourth 39.0 42.5 15.4 1.3 1.8 3,300 Highest 25.8 40.5 30.7 1.3 1.7 3,286
Total 49.3 35.3 11.7 1.7 2.0 16,609
Table 5.4 presents the variation in the percentage of children receiving full immunization, partial
immunization and no immunization across the states. The coverage of full immunization ranged
from 33 percent in Nagaland to 92 percent in Goa. In three states of Nagaland (33 percent),
Meghalaya (45 percent) and Uttar Pradesh (47 percent) less than half of children received full
immunization.
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Table 5.4: Vaccinations by state
Percentage of children aged 12-23 months by status of immunization and percentage with an immunization
card seen by the interviewer, by state
State Full
Immunization Partial
immunization No
Immunization
Percentage with an immunization card*
Seen by interviewer
Seen/Not Seen by interviewer
India 65.3 28.1 6.6 42.4 84.3 North
Delhi 69.7 25.4 4.9 24.9 89.0 Haryana 70.7 22.8 6.6 28.0 79.8 Himachal Pradesh 80.2 18.2 1.6 46.8 93.4 Jammu & Kashmir 59.0 30.0 11.0 28.5 83.8 Punjab 78.6 19.1 2.3 48.3 89.5 Uttar Pradesh 46.9 38.4 14.6 22.3 67.6 Uttarakhand 68.6 20.7 10.8 28.4 83.0
Central
Chhattisgarh 67.2 31.1 1.7 47.9 78.9 Madhya Pradesh 53.5 37.1 9.3 38.8 82.0
East
Bihar 60.4 28.1 11.6 39.7 77.2 Jharkhand 64.9 24.1 11.0 33.7 81.6 Odisha 62.0 30.0 8.0 64.5 85.8 West Bengal 75.2 22.2 2.6 79.8 97.0
Northeast
Arunachal Pradesh 50.5 40.6 9.0 13.1 80.0 Assam 55.3 38.2 6.5 29.5 93.9 Manipur 55.2 36.0 8.8 39.8 72.4 Meghalaya 44.6 37.9 17.5 24.9 80.5 Mizoram 68.6 26.8 4.6 3.1 92.2 Nagaland 33.2 27.4 39.4 1.6 49.7 Sikkim 77.8 21.6 0.6 66.1 97.9 Tripura 59.2 28.9 11.9 33.8 84.5
West
Rajasthan 60.7 31.1 8.2 33.4 78.0 `Goa 91.9 7.8 0.3 54.9 96.6 Gujarat 56.2 37.6 6.2 31.3 85.7 Maharashtra 77.4 21.2 1.4 39.6 86.5
South
Andhra Pradesh 74.1 23.6 2.3 37.5 86.7 Karnataka 79.4 18.1 2.4 46.6 92.7 Kerala 83.0 16.8 0.2 52.4 95.5 Tamil Nadu 76.3 22.3 1.4 39.9 80.9
* Percentage with an immunization card by state are presented for children aged 0-35 months
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Figure 5.4: Percentage of children aged 12-23 months who received full immunization by state, RSOC, 2013-14
After completion of the schedule of eight doses of six vaccines, BCG, three doses of DPT, three doses
of polio and one dose of measles, children need to be given two booster doses of DPT, one at the
age of 16-24 months and a second at age five and a second dose of measles at age 16-24 months.
RSOC collected data about the first booster of DPT and measles for children aged below three years
of age and about the second booster of DPT and booster of measles for children aged 3-6 years.
Table 5.5 presents coverage of the booster doses among children in urban, rural and total areas.
Table 5.5: Receipt of booster dose of DPT and 2nd
dose of Measles
Percentage of children aged 24-35 months who received 1st dose of DPT and 2nddose of measles and
percentage of children aged 60-71 months who received 2nd booster dose of DPT and 2nddose of measles, by
residence.
Residence
24-35 months 60-71 months
DPT Booster-1
Measles-2 Number of
children age 24-35 months
DPT Booster-2
Measles-2 Number of
children age 60-71 months
Urban 42.4 29.2 5,679 17.9 80.5 5,202 Rural 31.2 25.8 12,923 9.4 67.7 12,051 Total 34.6 26.9 18,602 11.9 71.5 17,253
It is already reported in Table 5.1 that 75 percent of the children aged 12-23 months received three
doses of DPT. However, only 35 percent of the children aged 24-35 months received first booster of
DPT and subsequently only 12 percent of the children aged 60-71 months received second booster
of DPT. The coverage of booster doses of DPT was substantially lower than the three doses of DPT
given in the first year of life. The coverage of first dose of measles was 79 percent among the
children aged 12-23 months. Compared to this level, the coverage of the second dose of measles
among children aged 24-35 months was only 27 percent. However, its coverage among children
aged 60-71 months was much higher at 72 percent. In other words, a majority of children received
the second dose of measles but not at 16-24 months as required, but later.
33 45 47 51 54 55 55 56 59 59 60 61 62 65 65 67 69 69 70 71 74 75 76 77 78 79 79 80 83
92
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The differentials in coverage of both the booster doses of DPT and the second dose of measles by
urban/rural areas are similar to the differentials in the coverage of other vaccines, and full
immunization. The coverage of both the booster doses of DPT was almost 10 percentage points
higher in urban areas than in rural areas. However, even in urban areas less than half (42%) of
children aged 24-35 months received the first booster and only 18 percent of the children aged 60-
71 months received the second booster of DPT.
5.2 CHILDHOOD DISEASES
Pneumonia and the Diarrhoeal diseases are major causes of child mortality in India. Malaria and
fever due to various infections also contribute to morbidity and mortality among young children.
Fever is a major manifestation of malaria and other acute infections among children. Considering the
fact that the leading causes of death beyond the neonatal period are diarrhoea and pneumonia,
Ministry of Health and Family welfare, Government of India, has given priority attention to the
management of these two illnesses. Availability of ORS and Zinc is ensured at all sub-centres and
with all frontline workers. Use of Zinc is actively promoted along with use of ORS in the case of
diarrhoea in children. Use of recommended antibiotics (based on national guidelines) in children
aged two months to five years with non-severe pneumonia is ensured through frontline workers
(ASHA, ANM) and at all levels of health facilities. Timely and prompt referral of children with fast
breathing and/or lower chest in-drawing to higher level facilities is emphasized.
RSOC collected data on three different childhood morbidities for all children aged 0-6, i.e., below 72
months of age. Mothers were asked during 15 days prior to the survey whether the child (1) suffered
from diarrhoea, (2) had symptoms of ARI and (3) had fever. For each of these diseases details of
medical treatment given were asked. The following sections discuss details of prevalence of these
diseases and the pattern of medical treatment given in case of episodes of the diseases.
5.2.1 Diarrhoea
As mentioned previously, Diarrhoea is one of the major causes of mortality among children beyond
the neonatal period. In most cases of diarrhoea, death is caused by dehydration due to loss of water
and electrolytes. Dehydration from diarrhoea can be prevented by giving extra fluids at home, or it
can be treated simply, effectively and cheaply in all age-groups except for the most severe cases.
Treatment is by an adequate glucose-electrolyte solution called Oral Rehydration Salts (ORS)
solution. In order to control diarrhoeal diseases, Government of India has adopted the WHO
guidelines on diarrhoea management. India introduced the low osmolarity ORS, as recommended by
WHO for the management of diarrhoea. Zinc has been approved as an adjunct to ORS for the
management of diarrhoea. Addition of Zinc can cause a reduction in the number and severity of
episodes and the duration of diarrhoea.
RSOC collected information from the interviewed ever married women with children below age six,
whether a child had diarrhoea during 15 days prior to survey. For all the children who had diarrhoea,
information was collected on whether medical treatment/advice had been sought, place of
treatment, whether ORS was given to the child, source of ORS and whether child was given
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antibiotics. The proportion of children who had diarrhoea in the 15 days prior to the survey and the
proportion of children who received treatment by source of treatment are presented in Table 5.6.
Though data was collected for all the children below age six, for the purpose of comparability with
other surveys, data is presented for children below age five. The prevalence of diarrhoea during 15
days prior to the survey was estimated at 6.5 per 100 children aged 0-59 months. The prevalence of
diarrhoea which was 7.4 percent among children below six months of age increased to 10.2 among
children aged 6-11 months. After age one year, prevalence of diarrhoea showed a decreasing trend
with the child’s age. The prevalence was the highest in the age range of 6-11 months, the age mainly
when children are introduced to food other than breast-milk. Both male and female children are
equally likely to suffer from diarrhoea. Except by age, the diarrhoea prevalence did not show any
consistent variation either by residence, mother’s education, religion, social group or wealth
quintile.
More than three-quarters (78 percent) of children suffering from diarrhoea were treated. A higher
proportion (82-84 percent) of young children aged 6-23 months received medical attention
compared to children in other age-groups. In each category of children either by gender, religion,
social group, mother’s education or wealth quintile about 75 percent of the children having
diarrhoea received treatment. Children with diarrhoea were taken to multiple places for treatment.
Among all the facilities, private health facility was the major place for treatment, as 62 percent of
the children having diarrhoea were taken to a private health facility. About a quarter (23 percent) of
children was taken to a government health facility, 11 percent were taken to an AWC and for 10
percent of the children treatment was sought from medical shopkeepers. Utilization of private
health facility was relatively higher in urban areas (69%) than in rural areas (58%), whereas use of
AWC was higher in rural areas (13%) compared to urban areas (5%).
Younger children suffering from diarrhoea were likely to be taken to a private hospital whereas older
children were more frequently taken to AWCs. Almost two-thirds (65 percent) of children aged 0-36
months, compared to 53 percent aged 36-71 months, were taken to private hospital for diarrhoea
treatment and eight percent of children aged 0-35 months compared to 17 percent aged 36-59
months were treated in AWCs. There was not much difference in the utilization of public and private
health facility for treating male and female children having diarrhoea. A relatively higher proportion
of children with mothers having no education or from ST were taken to AWCs for treatment of
diarrhoea. With an increase in mother’s education there was an increase in the utilization of private
health facilities. For example, 70 percent of the children with mothers educated for 12 or more years
were taken to a private health facility compared to 59 percent of the children with mothers having
no education. Use of private health facilities increased with better economic condition; use of AWCs
and government health facilities decreased. Three-quarters of children from the highest wealth
quintile were treated in a private health facility and 24 percent in either an AWC or a government
health facility, compared to 54 percent and 41 percent respectively from the lowest wealth quintile.
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Table 5.6: Prevalence of diarrhoea, treatment sought and place of treatment
Percentage of children aged 0-5 years who had diarrhoea in 15 days preceding the survey, percentage of children with diarrhoea who received treatment and percent
distribution of those who received treatment by place of treatment, according to background characteristics
Characteristics
Percentage of children who had diarrhoea in the last 15
days preceding survey
Number of children aged 0-5
years
Percentage of children who had diarrhoea
and received treatment
Number of children aged 0-5
years with diarrhoea
Place of treatment Number of
children who
sought treatment
Anganwadi Centre
Govt. Hospital/ Health Centre
Pvt Hospital/ Clinic/
Nursing Home
Any Medicine
Shop
Traditional Practitioner
ASHA Other
Age of Child (in months)
<6 7.4 9,281 75.3 688 4.6 21.8 62.4 9.8 1.8 0.5 4.0 518 06-11 10.2 8,489 83.8 868 10.0 19.1 69.8 6.1 1.2 1.6 3.2 727 12-23 8.8 17,791 82.0 1,573 7.0 22.6 64.6 10.6 1.8 0.7 2.7 1,290 24-35 5.7 18,602 76.8 1,067 10.6 24.3 62.9 9.8 2.0 2.0 3.0 820 36-47 4.9 18,993 71.4 933 15.7 25.0 54.7 10.9 2.6 1.5 3.1 666 48-59 4.4 19,449 74.6 864 19.1 25.3 51.1 12.2 3.7 2.7 3.1 645 0-35 7.7 54,163 80.0 4,196 8.1 22.1 65.0 9.3 1.7 1.2 3.1 3,355 36-59 4.7 38,442 72.9 1,798 17.4 25.2 52.9 11.5 3.1 2.1 3.1 1,311
Sex of the Child
Male 6.5 48,453 79.8 3,171 10.4 21.6 61.8 10.4 1.5 1.2 3.1 2,529 Female 6.4 44,151 75.7 2,822 11.2 24.6 61.3 9.4 2.8 1.8 3.1 2,137
Residence
Urban 6.3 28,232 76.4 1,788 5.3 20.0 69.2 6.8 1.7 0.3 2.8 1,366 Rural 6.5 64,372 78.5 4,205 13.0 24.2 58.4 11.2 2.3 1.9 3.2 3,300
Mother education
No Education 5.9 31,443 76.6 1,849 13.1 20.1 58.8 15.3 1.5 1.5 2.6 1,416 Below Primary 6.1 4,573 86.7 277 10.2 27.5 56.4 8.4 2.3 1.8 5.2 240 Completed Primary 7.5 14,298 77.4 1,076 9.0 26.6 58.5 8.6 2.2 0.9 3.3 833 Completed Middle 6.8 13,978 77.4 949 10.7 26.3 58.3 7.9 1.2 2.0 3.7 735 Completed Secondary 6.7 12,720 79.2 854 9.1 23.0 67.1 6.1 2.4 1.1 2.3 677 Completed Higher
Secondary and above 6.3 15,592 77.4 988 9.9 19.8 69.9 7.2 3.7 1.7 3.4 765
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Characteristics
Percentage of children who had diarrhoea in the last 15
days preceding survey
Number of children aged 0-5
years
Percentage of children who had diarrhoea
and received treatment
Number of children aged 0-5
years with diarrhoea
Place of treatment Number of
children who
sought treatment
Anganwadi Centre
Govt. Hospital/ Health Centre
Pvt Hospital/ Clinic/
Nursing Home
Any Medicine
Shop
Traditional Practitioner
ASHA Other
Religion
Hindu 6.6 72,487 77.3 4,769 10.9 23.3 61.1 9.6 2.2 1.6 3.4 3,685 Muslim 6.0 15,269 81.0 919 6.3 19.8 65.6 12.4 1.0 0.6 2.6 744 Christian 5.7 2,339 75.3 134 23.1 24.8 52.7 9.0 5.2 4.0 1.3 101 Sikh 3.7 1,342 76.2 50 (14.0) (20.9) (67.4) (9.3) (4.7) (0.0) (2.3) 38 Jain 12.6 163 * 21 * * * * * * * 19 Buddhist 9.9 573 88.8 57 17.3 50.1 47.2 0.7 3.0 3.0 0.0 50 No religion 8.7 55 * 5 * * * * * * * 4 Other 10.7 372 (73.9) 40 (5.9) (41.2) (41.2) (14.7) (0.0) (0.0) (0.0) 25
Social Group
Scheduled Caste 6.7 18,733 78.9 1,246 8.3 27.6 55.5 11.5 1.6 1.1 4.9 983 Scheduled Tribe 6.3 10,641 73.0 671 17.4 29.4 52.7 8.6 1.8 1.7 2.1 490 OBC 7.0 37,251 77.3 2,601 10.4 18.7 65.6 10.3 1.6 0.9 2.0 2,009 Others 5.7 25,061 79.8 1,434 10.7 23.9 63.8 8.6 3.7 2.6 3.6 1,144 Do Not Know 4.5 919 (86.7) 41 (5.1) (30.8) (48.7) (10.3) (0.0) (0.0) (10.3) 39
Wealth Index
Lowest 6.8 18,922 77.2 1,279 14.5 26.1 54.1 12.5 0.8 1.3 3.7 988 Second 6.2 18,918 79.1 1,182 12.1 24.4 56.6 10.6 1.7 1.4 3.1 935 Middle 6.6 19,139 78.8 1,254 12.6 22.8 60.1 11.2 2.1 2.1 2.6 989 Fourth 6.9 18,756 76.6 1,298 7.6 22.5 66.2 6.8 3.8 1.3 3.5 994 Highest 5.8 16,870 77.6 980 5.9 18.0 73.3 8.2 2.2 1.2 2.5 760
Total 6.5 92,604 77.9 5,993 10.7 23.0 61.6 9.9 2.1 1.5 3.1 4,666
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Table 5.7 provides the percentage of children with diarrhoea who were treated with antibiotics,
home available fluids, ORS, and ORS plus zinc; and source of ORS, by selected characteristics.
Children with diarrhoea were given multiple therapies. Among the children with diarrhoea, 47
percent were given antibiotics. Generally antibiotics is not prescribed for diarrhoea among children,
still a large proportion of the children received this treatment. About 25 percent of the children were
given home available fluids like plain water, rice water, dal water, butter milk etc., 39 percent were
given ORS and 13 percent were given ORS as well as zinc. The main source of ORS was private
facilities. For 47 percent of children who were given ORS, the treatment was obtained from a private
health facility and 15 percent purchased it from the market. For more than one-fifth (22 percent) of
children ORS was obtained from government health facilities. The three primary health workers,
Anganwadi workers in AWCs (17 percent), ANMs (7 percent) and ASHAs (5 percent) were also
reported as sources of ORS.
A slightly higher proportion of young children aged 0-35 months (47%) than older children aged 36-
71 months (44%) received antibiotics. In each category of children by residence, social group or
wealth quintile, at least 40 percent of the children were given antibiotics. Use of ORS and ORS plus
zinc was relatively higher in urban areas (44 percent and 16 percent respectively) than in rural areas
(37 percent and 11 percent respectively). Use of ORS also increased with wealth quintile. For
example, among children from the lowest wealth quintile, 33 percent were given ORS and 9 percent
were given ORS plus zinc, whereas among children from the highest wealth quintile, 45 percent were
given ORS and 15 percent were given ORS with zinc.
The variation in the source of ORS across the categories of residence, social group or wealth quintile
was similar to the source of treatment for diarrhoea. For a higher proportion of children from urban
areas than from rural areas, ORS was obtained from private health facilities (57 percent in urban vs.
42 percent in rural), whereas for a lower proportion of them it was obtained from AWCs (8 percent
in urban vs. 22 percent in rural). For a relatively higher proportion of children from STs (27 percent),
ORS was obtained from AWCs, compared to their counterparts from other social groups (12-19
percent).
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Table 5.7: Liquids/fluids given under oral rehydration as a part of diarrhoea treatment and source of ORS
Among children aged 0-5 years who had diarrhoea in the 15 days preceding the survey, percentage received
antibiotics to treat the diarrhoea, percentage who were given oral rehydration therapy (ORT) and percent
distribution of those who received ORS by its source, according to background characteristics
Characteristics
Percentage
of children
received
antibiotics as
treatment of
diarrhoea
Liquid/fluid given to drink
during diarrhoea Number of
children
sought
treatment
for
diarrhoea
Place from where ORS procured from
Caregiver Institution Other
Any
Home
Availab
le Fluid
(HAF*)
ORS ORS &
Zinc AWC ANM ASHA
Govt.
Health
Institut
ions
Pvt
Health
facility
Purcha
sed
from
market
Other
Age of Child (in
months)
<6 37.4 16.8 32.4 10.2 688 9.1 3.9 3.4 23.8 54.1 14.7 3.0
06-11 51.0 19.5 36.7 13.0 868 11.4 2.0 4.2 25.8 52.3 15.5 2.7
12-23 47.6 24.2 40.2 14.8 1,573 13.5 3.8 4.4 23.1 49.2 15.1 2.9
24-35 50.3 26.9 45.8 12.3 1,067 17.0 8.5 4.4 19.9 50.0 12.3 2.6
36-47 43.2 27.3 43.1 10.9 933 30.7 13.6 5.4 19.5 35.1 15.5 1.1
48-59 45.7 30.7 33.7 12.7 864 20.4 10.7 5.0 20.2 39.8 16.4 1.2
0-35 47.3 22.7 39.6 13.0 4,196 13.5 4.8 4.2 22.8 50.7 14.3 2.8
36-59 44.4 28.9 38.6 11.7 1,798 26.3 12.3 5.2 19.8 37.1 15.9 1.1
Sex of the Child
Male 47.1 24.6 40.5 12.4 3,171 16.9 6.2 4.5 21.9 47.3 15.5 1.9
Female 45.8 24.6 38.0 12.8 2,822 17.7 8.1 4.5 22.0 45.9 13.9 2.8
Residence
Urban 44.7 26.1 44.1 16.1 1,788 8.4 3.9 0.9 22.1 56.5 13.0 2.8
Rural 47.2 23.9 37.3 11.2 4,205 21.9 8.7 6.4 21.8 41.5 15.7 2.0
Religion
Hindu 45.8 23.9 39.1 12.0 4,769 17.2 7.0 4.8 21.4 46.9 14.5 2.6
Muslim 46.3 25.7 38.6 15.3 919 15.1 4.7 1.6 23.3 48.1 17.9 1.1
Christian 62.5 33.1 53.7 18.3 134 30.9 24.7 12.8 16.8 42.8 12.1 1.0
Sikh 59.4 23.2 29.1 8.5 50 * * * * * * *
Jain * * * * 21 * * * * * * *
Buddhist 69.0 36.1 38.1 10.1 57 14.2 1.5 5.8 36.3 54.3 0.3 0.1
No religion * * * * 5 * * * * * * *
Other (34.8) (34.8) (67.4) (15.2) 40.0 (3.1) (0.0) (6.3) (40.6) (12.5) (34.4) (3.1)
Social Group
Scheduled Caste 48.4 24.8 39 12.8 1,246 18.8 7.2 5.0 23.4 40.5 14.3 4.4
Scheduled Tribe 42.8 26.2 36.8 13.2 671 26.7 10.1 11.4 25.5 34.3 12.2 1.6
OBC 49.0 23.5 38.5 12.3 2,601 17.4 7.2 3.0 21.8 50.5 13.7 1.2
Others 42.5 25.0 42.3 13.0 1,434 12.1 5.6 3.8 19.4 51.1 17.6 2.9
Do Not Know 26.2 (42.8) (36.9) (8.0) (41.0) * * * * * * *
Wealth Index
Lowest 45.5 24.6 33.4 9.2 1,279 26.0 7.6 7.2 23.5 34.4 14.8 1.3
Second 42.4 22.3 37.0 10.5 1,182 19.3 3.7 4.2 30.2 42.2 10.5 2.6
Middle 47.3 26.8 39.9 14.6 1,254 17.9 10 6.3 21.0 41.8 21.1 2.5
Fourth 49.0 24.8 42.1 14.5 1,298 15.2 9.5 2.0 18.4 49.1 16.1 3.2
Highest 48.0 24.0 45.3 14.8 980 9.0 3.4 3.3 18.0 64.9 10.4 1.6
Total 46.5 24.6 39.3 12.6 5,993 17.3 7.0 4.5 21.9 46.7 14.8 2.3
( ) Based on 25-49 unweighted cases. *Based Percentages are not shown, based on fewer than 25 unweighted cases.
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5.2.2 Fever and Acute Respiratory Infection (ARI)
Fever as it is not a disease, however, is a symptom of infections of various kinds. In areas with
malaria, fever can be due to malarial infection. As with any patient, children with suspected malaria
should have parasitological confirmation of diagnosis before treatment begins, and for confirmed
cases treatment should be provided.46 RSOC asked interviewed women about each child below age
six, whether in the 15 days prior to the survey, the child had fever. For all the children who had
fever, further information was collected about blood test and administration of anti-malarial drug
treatments.
ARI or Pneumonia takes a large toll of children below age five. Early diagnosis and appropriate case
management with rational use of antibiotics remains one of the most effective interventions to
prevent death due to pneumonia. The ARI guidelines by the Government of India are being revised
with the inclusion of the latest available global evidence. The guidelines are: If the child has a cold,
cough and fever with normal respiratory rate and no evidence of chest recession then the child can
be managed at home with paracetamol for fever. If the child has a cold, cough, and fever with
increased respiratory rate, but no evidence of chest recession, then the child is suffering from
pneumonia. Such a child needs to be treated at the nearest health centre. If the child has a cold,
cough and fever, with increased respiratory rate as well as evidence of chest recession along with
colour change on tongue and lips, then the child is suffering from severe pneumonia. Such a child
needs to be treated in the nearest hospital because the child needs admission and injections with
antibiotics.
RSOC asked interviewed women about each child below age six, whether in the 15 days prior to the
survey, the child had an illness with a cough, did the child breathe faster than usual with short, rapid
breaths or had difficulty breathing, and fast breathing or difficulty in breathing was due to a problem
in the chest or to a blocked or runny nose. Furthermore, a question on whether treatment was given
for the illness was also asked. Children with a cough accompanied by chest related short, rapid
breathing are classified as having symptoms of ARI.
Table 5.8 presents prevalence of fever among children aged 0-71 months during 15 days prior to the
survey by selected characteristics. The table also shows the proportion of children with a fever for
whom blood test was carried out and proportion who were given anti-malarial drug. The prevalence
of cough and symptoms of ARI and proportion of children for whom medical treatment/advice was
sought are also presented in the table. The prevalence of fever among children aged 0-71 months
was 13.6 percent, more than twice the prevalence of diarrhoea (6.4 percent), 15 percent of the
children with fever had blood test carried out and 18 percent were given anti-malarial drug. The
prevalence of fever was higher among younger children aged 0-35 months (14.5 percent) than
among older children aged 36-71 months (12.5 percent). The prevalence of fever among children
aged 6-23 months was much higher, at 16 percent.
46www.who.int/malaria/areas/high_risk_groups/children/en/
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Table 5.8: Prevalence and management of fever and symptoms of ARI by selected characteristics
Percentage of children aged 0-5 years, who had fever in 15 days preceding the survey, percentage of children with fever for whom blood was taken from his/her finger for
testing, who took anti-malarial drugs and percentage who had symptoms of acute respiratory infection (ARI) in the last 15 days preceding the survey and percentage
sought advice or treatment for the illness, according to background characteristics.
Characteristics
Fever Symptoms of ARI
Percentage with fever
Number of children 0-5
years
Percentage for whom blood
was taken from his/her finger
for testing
Percentage who took
anti-malarial
drugs
Number of children
with fever
Percentage of children who had cough in the last
15 days preceding the survey
Percentage of children
with symptoms
of ARI
Percentage received
advise/treatment for ARI
Number of children
with symptoms
of ARI
Age of Child (in months) <6 10.6 9,281 8.7 14.0 985 14.8 8.8 82.8 818 06-11 16.6 8,489 13.1 16.2 1,406 19.1 10.7 77.9 911 12-23 16.3 17,791 14.7 18.1 2,899 18.7 10.2 75.7 1,807 24-35 13.7 18,602 14.5 19.5 2,551 16.6 9.2 76.5 1,705 36-47 12.5 18,993 17.7 19.5 2,370 15.0 7.4 76.1 1,413 48-59 12.5 19,449 18.4 19.5 2,426 13.6 6.9 75.6 1,333 0-35 14.5 54,163 13.6 17.7 7,841 17.4 9.7 77.4 5,240 36-59 12.5 38,442 18.1 19.5 4,796 14.3 7.1 75.8 2,746
Sex of the Child Male 13.8 48,453 15.3 19.2 6,671 16.6 8.9 78.1 4,331 Female 13.5 44,151 15.3 17.5 5,965 15.5 8.3 75.4 3,655
Residence Urban 13.2 28,232 16.1 16.4 3,739 14.9 7.6 79.9 2,145 Rural 13.8 64,372 14.9 19.2 8,898 16.6 9.1 75.8 5,841
Mother education No Education 13.4 31,443 12.2 17.7 4,200 15.0 8.6 75.4 2,696 Below Primary 16.0 4,573 11.6 17.3 730 20.2 11.1 71.1 506 Completed Primary 15.7 14,298 16.9 19.8 2,239 18.3 10.3 75.6 1,469 Completed Middle 14.2 13,978 15.3 16.8 1,986 18.0 8.9 79.3 1,243 Completed Secondary 13.1 12,720 18.8 23.6 1,660 15.1 7.7 77.3 985 Completed Higher Secondary and
above 11.7 15,592 18.8 15.6 1,821 14.1 7.0 81.9 1,086
CHILD HEALTH CARE
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Characteristics
Fever Symptoms of ARI
Percentage with fever
Number of children 0-5
years
Percentage for whom blood
was taken from his/her finger
for testing
Percentage who took
anti-malarial
drugs
Number of children
with fever
Percentage of children who had cough in the last
15 days preceding the survey
Percentage of children
with symptoms
of ARI
Percentage received
advise/treatment for ARI
Number of children
with symptoms
of ARI
Religion Hindu 13.2 72,487 16.0 19.3 9,536 16.0 8.5 76.9 6,130 Muslim 16.1 15,269 11.5 14.4 2,461 17.5 9.9 78.5 1,507 Christian 11.2 2,339 27.3 29.5 263 12.3 5.8 49.4 135 Sikh 13.2 1,342 7.4 10.8 178 12.5 7.3 79.6 98 Jain 9.7 163 * * 16 8.2 4.2 * 7 Buddhist 23.3 573 15.1 14.2 134 19.4 12.3 89.8 70 No religion 10.8 60 * * 6 15.6 10.3 * 6 Other (11.5) 372 (28.9) (13.4) 43 14.4 8.6 72.7 32
Social Group Scheduled Caste 14.4 18,733 14.4 18.9 2,689 17.2 9.0 78.0 1,691 Scheduled Tribe 11.6 10,641 19.6 22.6 1,233 14.1 7.9 66.4 844 OBC 13.8 37,251 15.7 19.8 5,141 16.5 8.8 78.1 3,261 Others 13.5 25,057 14.1 15.1 3,390 15.2 8.3 78.1 2,069 Do Not Know 19.5 919 9.1 3.4 179 23.7 13.2 81.5 121
Wealth Index Lowest 14.8 18,922 13.9 19.0 2,795 17.9 10.6 73.9 1,998 Second 13.5 18,918 14.2 16.5 2,555 16.3 8.6 73.0 1,631 Middle 14.3 19,139 15.0 18.5 2,742 16.6 8.9 77.1 1,705 Fourth 13.1 18,756 18.1 20.3 2,458 15.1 7.8 80.0 1,470 Highest 12.4 16,870 15.4 17.5 2,086 14.3 7.0 83.2 1,182
Total 13.6 92,604 15.3 18.4 12,637 16.1 8.6 76.9 7,986
( ) Based on 25-49 unweighted cases. *Based Percentages are not shown, based on fewer than 25 unweighted cases.
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Among the children who had fever, the proportion of children who got their blood test done and
who were given anti-malarial drug showed an increasing trend with the child’s age. However, the
increase was modest. The prevalence of fever among children from urban and rural areas, as well as
male and female children, was almost same. The prevalence of fever did not hold any consistent
relationship with either mother’s education or wealth quintile. Similarly, the proportion of children
who had a blood test and who were given anti-malarial drugs did not vary by gender or residence,
and did not show any trend with either by mother’s education or wealth quintile.
Almost one in every six (16 percent) children aged 0-5 had cough during the 15 days prior to the
survey. However, all those who had cough did not show the symptoms of ARIs. Only about 50
percent of the children (8.6 percent of all children) having cough had breathing faster than usual
with short, rapid breaths or had difficulty in breathing, and the difficulty in breathing was due to a
problem in the chest or to a blocked or runny nose (i.e. symptoms of ARI). For more than three-
quarters (77 percent) of the children with ARI, medical advice/treatment was sought.
Similar to the prevalence of fever, the prevalence of cough and symptoms of ARI was relatively
higher among younger children (17.4 percent and 9.7 percent respectively) aged 0-35 months than
the older children (14.3 percent and 7.1 percent respectively) aged 36-71 months. A relatively
smaller proportion (8.8 percent) of infants below six months had symptoms of ARI, however the
proportion increased to 10.7 percent among older infants aged 6-11 months and decreased
thereafter. For at least 75 percent of children in each age-group advice or treatment was sought.
There was no or minor difference in the prevalence of symptoms of ARI among male and female
children, and in proportion for whom medical help was sought. The prevalence of ARI symptoms was
a little higher in rural areas (9.1 percent) than in urban areas (7.6 percent), though in both areas
medical help was sought for 76-80 percent of affected children. With increases in mother’s
education and wealth quintile, there was a decrease in the prevalence of symptoms of ARI and an
increase in the proportion of children who received medical help, though the differences were not
very significant. For example, 10.6 percent of the children from the lowest wealth quintile showed
symptoms of ARI and 74 percent of them received medical help as against 7.0 percent from the
highest wealth quintile showing symptoms and 83 percent receiving medical help.
Annexure Table 5.9 presents prevalence and management of diarrhoea and fever across the states,
and Annexure Table 5.10 shows the state-level variation in the prevalence and management of ARI.
5.3 HEALTH CHECK-UP OF CHILDREN
Generally, children are taken to a health facility only in the event of a health problem. As the first
five years of life are very critical, it is essential that children’s health is regularly monitored by health
professionals. To assess how far this routine monitoring of health happens, RSOC asked all mothers
of children aged 0-71 months, whether the health of the child was checked in the three months prior
to the survey either when child was ill or even when he/she was not ill. For all the children who had
a check-up, it was further asked what had been the place of the check-up. Table 5.11 shows the
percentage of children who had check-ups, either when they were ill or otherwise and percentage
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distribution of such children by place where the latest check-up was done. These percentages give
an idea about the proportion of young children who are currently under medical supervision.
Table 5.11: Health check-up of children 0-71 months
Percentage of children aged 0-6 years, who had health check-up done in the six months preceding the survey,
and percent distribution of those who had health check- up by place of last check-up, by background
characteristics
Characteristics
Percentage who
had health
check-up at least
once in the 3
months
preceding the
survey47
Number
of
Children
Place of last check-up48
Number of
children aged 0-6
years who had
health check-up in
3 months
preceding the
survey
Govt.
Hospital
/Health
Centre
Private
Hospital
/Clinic
AWC Other Don't
know
Age of the child
(Months)
<6 25.5 9,281 23.0 63.2 5.7 3.2 4.9 2,363
06-11 31.2 8,489 21.5 66.6 5.7 1.6 4.6 2,649
12-23 27.9 17,791 19.0 66.6 6.1 2.5 5.8 4,965
24-35 24.6 18,602 22.8 63.9 5.9 2.3 5.1 4,575
36-47 15.0 18,993 20.1 67.0 10.3 2.5 0.1 2,858
48-59 13.8 19,449 20.4 66.6 10.9 2.0 0.1 2,675
60-71 12.3 17,253 23.6 62.2 10.4 3.5 0.3 2,120
Child age
0-35 26.9 54,163 21.3 65.2 5.9 2.4 5.2 14,552
36-71 13.7 55,694 21.2 65.5 10.5 2.6 0.2 7,653
Sex of the Child
Male 21.0 57,567 20.6 66.0 7.5 2.4 3.4 12,073
Female 19.4 52,290 22.0 64.5 7.6 2.5 3.5 10,131
Residence
Urban 21.9 33,434 18.5 73.8 3.5 1.5 2.7 7,332
Rural 19.5 76,423 22.6 61.1 9.5 2.9 3.9 14,872
Wealth Index
Lowest 16.2 22,672 23.5 57.3 9.9 3.5 5.8 3,681
Second 17.6 22,576 25.8 58.3 8.2 2.4 5.2 3,983
Middle 20.8 22,491 22.7 62.6 9.0 2.6 3.1 4,668
Fourth 23.0 22,027 21.7 67.9 6.6 1.5 2.3 5,071
Highest 23.9 20,091 13.9 77.1 4.6 2.6 1.9 4,801
Total 20.2 1,09,857 21.3 65.3 7.5 2.5 3.5 22,204
47Health check-up done in last three months preceding survey irrespective of any illness
48Last check-up refers to the most recent health check-up done in the 3 months preceding the survey
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One in every five children (20 percent) had a health check-up in three months prior to survey. A large
proportion (65 percent) of children who had a health check-up, were taken to a private health
facility. About one-fifth (21 percent) had a check-up in a government health facility and a small
proportion (8 percent) had check-ups in AWCs. Younger children were more likely to be taken for
health check-ups than their older counterparts. More than one-quarter (27 percent) of children aged
0-35 months had health a check-up in comparison to only 14 percent of children aged 36-71 months.
In fact, almost one-third (31 percent) of children aged 6-11 were taken to a health facility. The
discussion in the earlier sections has shown that the prevalence of all the childhood diseases was the
highest among these children aged 6-11 months. So, the highest proportion of infants aged 6-11
months was under medical supervision. Almost equal proportion of male and female children and
children from urban and rural areas had health check-ups. The only difference was that utilization of
government health facilities and AWCs was higher in rural areas and utilization of private health
facilities was higher in urban areas. With an increase in the wealth quintile, there was an increase in
the practice of taking children for a health check-up, though the increase was modest. The
proportion of children taken for health check-up increased from 16 percent among children in the
lowest wealth quintile to 24 percent in the highest wealth quintile. With better economic status,
there was an increase in the utilization of private health facilities with a corresponding decrease in
the use of government health facilities and AWCs.
Annexure Table 5.12 presents the state-wise percentage of children who had check-ups when they
were ill or otherwise and percent distribution of such children by place where the latest check-up
was done.
5.4 ROLE OF ANGANWADI CENTRES
With the objective to improve the nutritional and health status of children in the age-group 0-6
years the ICDS’s AWCs provide a package of services comprising: (1) supplementary nutrition, (2)
immunization, (3) health check-up, and (4) referral services for all children below age six. The various
health services provided for children in AWCs by AWW and Primary Health Centre (PHC) staff,
include regular health check-ups, recording of weight, immunization, management of malnutrition,
treatment of diarrhoea, de-worming and distribution of simple medicines etc. During health check-
ups and growth monitoring, AWWs are supposed to refer sick or malnourished children in need of
prompt medical attention to the PHC or its sub-centre. The AWW has also been oriented to detect
disabilities in young children. She is supposed to enlist all such cases in a special register and refer
them to the medical officer of the PHC/sub-centre.
To assess the role of AWCs in providing immunization and health services, both in the form of
providing basic treatment in case of child morbidity and referral service, the percentage of children
for whom AWC services were used for different purposes were brought together in Table 5.10. The
various purposes for which AWC services are used are: (1) immunization, (2) treatment/advice
during diarrhoea episode and receipt of ORS, (3) health check-up, and (4) referral in case of
morbidity or disability. It may be noted that the percentages not only reflect the role AWCs play in
providing preventive and curative health services for young children, but also reflect the extent to
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which AWC services are utilized by people. The proportion of children who received immunization
from AWC was 49 percent (Table 5.10). About 11 percent of the children received advice or
treatment from AWC in case of diarrhoea. Seventeen percent of those who were given ORS for
diarrhoea, received it from AWCs. About eight percent of children who had a health check-up in the
three months preceding the survey had it in an AWC. Only a small proportion (7 percent) of children
was referred to health facilities during illness by an AWW. In short, the Table 5.13 shows that in
providing immunization AWCs are playing major role, whereas in providing curative or referral
service their role is modest.
There was no difference in the extent to which all the AWC services were provided to male and
female children. In rural areas, AWCs are playing a major role in providing various child health
related services. A majority of children in rural areas received immunization (59%) from AWCs. The
proportion of children in rural areas for whom different services were availed from AWCs was
almost twice of that in urban areas. AWCs are playing a major role in providing services to the
children from socially and economically disadvantaged communities. The proportions of children
from STs, children whose mother had less education and children from the lower wealth quintiles for
whom different services were availed from AWCs were much higher in comparison to their
respective counterparts. For example, among the ST children, 62 percent received immunization
from AWC.
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Table 5.13: Role of Anganwadi Centre in child health Percentage of children according to various services received from AWC for health, by background characteristics
Characteristics
Aged 0-35 Months Aged 0-71 Months
Immunization Diarrhoea and its management Health check-up Referral to any health facility
Percentage of children who received most
of the vaccination in
AWC
Number of children who received at least one vaccine
Percentage of children who had
diarrhoea in the 15 days preceding the survey for whom advice/treatment
was sought
Number of children who had diarrhoea in the 15 day preceding the
survey
Percentage of children who had diarrhoea in the
15 days preceding the survey
received ORS from AWC49
Number of children who had diarrhoea in the 15 day preceding the
survey and received ORS
Percentage of children who
had last health check-up3 in an
AWC in last 3 months
Number of children who
had health check-up in 3
months preceding the
survey
Percentage referred to any health facility
during Illness50
Number of children
Sex of the Child
Male 48.5 24,270 10.0 2,778 16.6 1,601 7.5 12,073 6.6 14,200 Female 49.1 21,470 11.6 2,270 18.1 1,316 7.6 10,131 6.6 12,465
Residence
Urban 24.7 13,875 5.5 1,501 8.8 1,022 3.5 7,332 4.6 7,838 Rural 59.3 31,866 12.9 3,547 21.9 1,895 9.5 14,872 7.4 18,828
Mother education
No Education 63.8 13,893 13.3 1,534 24.0 738 7.8 5,700 5.9 8,515 Below Primary 55.3 2,127 10.6 262 20.1 166 10.6 1,065 3.9 1,593 Completed Primary 54.3 7,109 9.0 885 16.6 486 9.0 3,717 8.2 4,616 Completed Middle 48.5 7,283 9.8 810 19.9 494 8.5 3,519 5.5 4,425 Completed Secondary 39.6 6,621 9.5 734 9.5 491 7.1 3,519 8.1 3,471 Completed Higher Secondary and above 25.8 8,707 9.9 823 12.5 543 4.8 4,684 7.1 4,046
Religion
Hindu 51.9 36,215 11.1 3,952 17.4 2,275 8.0 17,448 7.0 20,613 Muslim 37.2 7,139 5.8 823 14.2 462 5.6 3,562 4.1 4,742 Christian 30.7 1,053 20.7 122 29.3 95 1.6 550 11.4 591 Sikh 35.6 735 (12.2) 44 * 20 4.6 239 4.4 331 Jain 41.8 105 * 19 * 6 (0.0) 53 (14.8) 44 Buddhist 46.2 280 15.3 58 12.4 31 12.9 243 11.7 220 No religion (35.3) 26 * 5 * 5 * 13 * 19 Other 37.3 188 (5.4) 25 * 23 11.2 96 4.1 105
49Children who had diarrhoea in the last 15 days preceding the survey. 50 Children received health check-up in last three months irrespective of any illness. ( ) Based on 25-49 unweighted cases. * Percentage not shown; based on fewer than 25 unweighted cases.
CHILD HEALTH CARE
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Characteristics
Aged 0-35 Months Aged 0-71 Months
Immunization Diarrhoea and its management Health check-up Referral to any health facility
Percentage of children who received most
of the vaccination in
AWC
Number of children who received at least one vaccine
Percentage of children who had
diarrhoea in the 15 days preceding the survey for whom advice/treatment
was sought
Number of children who had diarrhoea in the 15 day preceding the
survey
Percentage of children who had diarrhoea in the
15 days preceding the survey
received ORS from AWC49
Number of children who had diarrhoea in the 15 day preceding the
survey and received ORS
Percentage of children who
had last health check-up3 in an
AWC in last 3 months
Number of children who
had health check-up in 3
months preceding the
survey
Percentage referred to any health facility
during Illness50
Number of children
Social Group
Scheduled Caste 54.4 9,043 8.7 1,057 19.5 603 6.0 4,171 7.2 5,630 Scheduled Tribe 62.1 5,308 17.4 532 27.3 308 13.9 2,123 8.9 2,759 OBC 51.5 18,370 10.3 2,170 17.1 1,242 5.2 9,321 6.8 11,003 Others 35.9 12,665 10.5 1,240 11.8 746 9.7 6,374 4.9 6,940 Do Not Know 29.1 354 (4.4) 49 * 18 7.0 215 3.6 333
Wealth Index
Lowest 69.0 8,745 14.1 1,068 25.7 519 9.9 3,681 6.2 5,769 Second 59.1 9,265 12.5 995 19.7 523 8.2 3,983 6.7 5,487 Middle 52.3 9,510 12.0 1,070 18.0 606 9.0 4,668 8.0 5,631 Fourth 38.6 9,436 7.8 1,075 15.7 698 6.6 5,071 7.3 5,306 Highest 24.8 8,785 6.5 840 8.5 570 4.6 4,801 4.3 4,472
Total 48.8 45,741 10.7 5,048 17.3 2,917 7.5 22,204 6.6 26,665
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The state-wise percentages of utilization of AWC services for various purposes are shown in Table
5.14. There is a large variation in the utilization of AWCs for availing specific services across the
states. Similarly, within a state there is a difference in the extent to which different services are
availed for children.
In Nagaland (1 percent), Manipur (3 percent), Jammu & Kashmir (4 percent) and Meghalaya (5
percent) AWCs have played a very modest role in providing immunization services. In these four
states five percent or less of immunized children got their immunization in AWCs. In contrast, in
Jharkhand (79 percent), Odisha (83 percent) and Bihar (81 percent), more than three-quarters of
children received immunization in AWCs. Not a single child in Assam, West Bengal and Manipur
received either treatment or advice during diarrhoea episodes or ORS from AWC. In Jammu &
Kashmir, Bihar, Uttarakhand and Sikkim less than five percent of the children received treatment and
ORS from AWCs. Only in Jharkhand (30 percent), Andhra Pradesh (21 percent) and Maharashtra (19
percent) more than one-fifth of children for whom treatment for diarrhoea was sought, received it in
AWCs. Even in these three states more than one-fifth of children who were given ORS for diarrhoea,
received it from AWCs.
It was already pointed out that the role of AWC in health check-ups is quite modest, as only eight
percent of the children who had health check-up in the three months preceding the survey had it in
AWCs. In many states, like Assam, Jammu & Kashmir, Meghalaya, Manipur, and Uttarakhand, less
than one percent of the children who had health check-up in three months preceding the survey,
had it in AWCs. Only in Sikkim (25 percent) and Gujarat and Maharashtra (18 percent in both) a
relatively larger proportion of children had health check-ups in AWCs. At national level, AWCs’ role
in referral service was modest. In most of the states like Nagaland, Mizoram, Rajasthan, Assam, West
Bengal and Haryana not even two percent of the children were referred to a health facility. Only in
Andhra Pradesh a relatively large proportion (22 percent) of mothers reported that AWW referred
their child to a health facility. The preceding discussion points out that overall, in many states—
Nagaland, Mizoram, Assam, Jammu & Kashmir, Meghalaya, Manipur and Uttarakhand—AWCs are
playing a minimal role in providing preventive and curative health care services to children. In
contrast, in Jharkhand, Chhattisgarh, Gujarat and Andhra Pradesh AWCs play a relatively larger role.
Even in Bihar and Madhya Pradesh they are playing a role in providing preventive and curative
health care services.
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Table 5.14: Role of AWC in child health by state
Percentage distribution of children according to various services received from AWC for child health, by state
State
Immunization Diarrhoea and
its management Health check-up Weight and Growth
Referral to any health
facility
Aged 0-35 Months
Aged 0-71 Months
Percentage of children who received most
of the vaccination in
AWC
Percentage of children who had diarrhoea in the
15 days preceding the
survey for whom advice/treatment
was sought
Percentage of children who had diarrhoea in the 15
days preceding the survey received ORS from
AWC
Percentage of children who had
last health check-up3 in an AWC
in last 3 months
Percentage of children weighed last in an AWC in 3 months
preceding the survey
Percentage of children
whose mother
had discussion with AWW
on nutritional status of the child
Percentage referred to any health
facility during Illness
India 48.8 10.7 17.3 7.5 59.4 24.6 6.6 North
Delhi 8.1 11.8 9.3 3.2 9.1 7.4 5.7 Haryana 48.6 7.3 12.7 10.0 44.3 12.7 1.9 Himachal Pradesh 23.0 6.9 26.1 6.7 79.6 42.7 9.4 Jammu & Kashmir 4.4 1.1 (2.0) 0.4 (7.2) (9.4) 2.1 Punjab 29.1 5.6 * 3.8 (21.1) (18.9) 2.8 Uttar Pradesh 49.9 3.1 7.4 2.0 36.1 16.3 2.6 Uttarakhand 28.6 3.4 (3.0) 0.1 16.3 4.9 3.9
Central Chhattisgarh 71.8 2.3 9.6 8.7 90.3 44.4 2.4 Madhya Pradesh 74.4 8.9 21.7 6.1 73.2 47.9 3.6
East Bihar 80.9 0.1 2.3 1.6 62.9 23.3 2.6 Jharkhand 79.2 30.3 40.9 8.3 79.6 51.6 6.2 Odisha 83.2 14.1 23.7 9.5 86.0 24.1 4.1 West Bengal 12.4 0.0 0.0 10.8 52.1 11.7 1.8
Northeast Arunachal Pradesh 10.2 17.3 18.6 2.7 (51.7) (24.1) 3.3 Assam 27.0 0.0 0.0 0.0 21.1 2.5 1.8 Manipur 2.5 0.0 0.0 0.3 * * 2.4 Meghalaya 5.2 3.8 10.8 0.2 9.2 3.3 2.0 Mizoram 20.9 15.8 11.3 2.4 87.9 8.6 1.0 Nagaland 1.4 * * * * * 0.6 Sikkim 18.9 3.3 4.5 25.1 60.8 53.5 12.5 Tripura 31.9 (9.8) (11.6) 1.3 51.5 37.2 8.5
West Rajasthan 62.0 4.1 6.8 2.5 39.5 11.2 1.3 Goa 8.7 6.3 9.5 2.8 43.0 23.1 3.6 Gujarat 53.0 11.6 22.7 18.0 63.2 36.1 13.7 Maharashtra 38.4 19.0 25.3 17.9 72.0 31.6 7.8
South Andhra Pradesh 60.5 21.3 (29.1) 3.3 71.1 28.1 21.8 Karnataka 42.6 6.8 13.7 2.8 55.8 22.9 12.5 Kerala 8.8 12.4 15.0 3.9 27.1 12.4 9.4 Tamil Nadu 17.8 10.4 18.1 2.8 42.7 20.4 10.2
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CHAPTER 6 NUTRITION OF CHILDREN AND ADOLESCENT GIRLS
Adequate nutrition is a basic human need and prerequisite for health and well-being of all, especially for
children and adolescents. Promotion of nutrition is one of the key essential elements of primary health
care. Though, the nutritional status of all the population groups is of concern, maternal and child
nutrition acquires greater importance. The level of child malnutrition in India is a matter of serious
concern.
This chapter on ‘Nutrition of Children and Adolescent Girls’ presents the findings of RSOC 2013-14
related to nutritional status of children and childhood feeding practices. It also looks into the role of
Anganwadi Centres (AWCs) of Integrated Child Development services (ICDS) in growth monitoring of the
children. Additionally, the chapter also discusses nutritional status of adolescent girls. The specific topics
included in the chapter are: (1) birth-weight and extent of low birth-weight (2) infant and young child
feeding (IYCF) practices, (3) nutritional status of children, (4) Weight monitoring of young children, (5)
Nutritional status of adolescent girls and (6) role of AWCs of ICDS in weight monitoring of the children.
6.1 BIRTH-WEIGHT
Achieving reduction in the incidence of low birth-weight babies is one of the measures for the reduction
in morbidity and mortality during infancy, especially during the neo-natal stage. World Health
Organization (WHO) has defined low birth-weight as weight at birth of less than 2,500 grams; which is
based on epidemiological observations that infants weighing less than 2,500 grams are approximately 20
times more likely to die than heavier babies. A birth-weight below 2,500 gram contributes to a range of
poor health outcomes. A baby’s low weight at birth is either the result of preterm birth (before 37
weeks of gestation) or due to restricted foetal (intrauterine) growth. Low birth-weight is closely
associated with foetal and neonatal mortality and morbidity, inhibited growth and cognitive
development, and chronic diseases later in life. In case of institutional births, babies are generally
weighed immediately after the birth. In case of home births, Anganwadi worker (AWW) and the primary
health workers like ANM or ASHA are expected to make home visits to weigh the baby within 24 hours
of birth.51
For every live-birth that occurred during the three year period prior to the survey to ever married
women interviewed, RSOC collected information on whether a baby was weighed within 24 hours of
birth, and for all the babies weighed, baby’s birth-weight was asked. Table 6.1 presents data on
51United Nations Children’s Fund and World Health Organization, Low Birthweight: Country, regional and global estimates.
UNICEF, New York, 2004.
Home Based Newborn Care Operational Guidelines, Ministry of Health and Family Welfare, Government of India, 2011.
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percentage of babies weighed within 24 hours of birth and percent distribution of babies who were
weighed by birth-weight, according to selected characteristics. Little more than two-thirds (69 percent)
of the babies were weighed within 24 hours of birth. In case of a small proportion of babies, though they
were weighed, mother could not recall baby’s birth-weight. Among the babies whose birth-weight was
reported, 19 percent weighed less than 2,500 grams.
Table 6.1: Birth-weight by selected characteristics
Percentage of live births in three years preceding the survey, who were weighed within 24 hours of birth, and
percent distribution of births with reported birth-weight by weight at birth, according to selected characteristics.
Characteristics
Weighed
within 24
hours of
birth
Number of
live births in
the last three
years
Birth-weight of the
child
Number of live-
births whose birth-
weight was
reported < 2.5 Kg
2.5 kg and
more
Mother's age at birth (years)
<20 72.3 4,182 20.2 79.8 3,025
20-34 69.0 47,977 18.5 81.5 33,117
35-49 56.7 2,391 18.4 81.6 1,355
Birth order
1 77.1 25,575 19.1 80.9 19,727
2 70.7 16,502 17.9 82.1 11,661
3+ 49.0 12,473 18.5 81.5 6,108
Mother’s education
No Education 47.3 17,616 22.7 77.3 8,340
Below Primary 67.5 2,615 19.5 80.5 1,764
Completed Primary 72.5 8,351 19.3 80.7 6,055
Completed Middle 74.9 8,562 18.7 81.3 6,411
Completed Secondary 84.6 7,602 18.4 81.6 6,433
Completed Higher
Secondary and above 86.6 9,804 14.0 86.0 8,493
Residence
Urban 79.7 16,319 18.4 81.6 13,006
Rural 64.1 38,230 18.7 81.3 24,491
Social Group
Scheduled Caste 65.3 10,976 19.6 80.4 7,167
Scheduled Tribe 63.7 6,311 21.6 78.4 4,018
OBC 67.4 21,886 18.0 82.0 14,759
Others 75.5 14,827 17.6 82.4 11,196
Do Not Know 64.8 550 20.6 79.4 357
Wealth Index
Lowest 49.9 10,977 22.3 77.7 5,483
Second 61.2 11,248 19.3 80.7 6,882
Middle 71.7 11,213 19.7 80.3 8,039
Fourth 79.1 11,092 17.6 82.4 8,779
Highest 83.0 10,020 15.6 84.4 8,314
Total 68.7 54,550 18.6 81.4 37,497
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The percentage of babies weighed within a day of birth was decreasing with mother’s age and order of
the birth. Among babies of order three or more, only 49 percent were weighed within a day of birth
compared to 77 percent of first order babies. The percentage of babies weighed within a day of birth
was higher in urban areas (80%) compared to rural areas (64%). The proportion of babies weighed was
higher among babies from Other castes (76%) compared to their counterparts from the other three
social groups (64-67%). With an increase in mother’s education as well as household economic status,
indicated by wealth index, there was a sharp increase in the proportion of babies weighed. The
proportion of the babies weighed increased from 47 percent among those whose mother had no
education to 87 percent among those having mothers who completed Higher Secondary or had higher
education. Similarly, the percentage of babies weighed within a day of birth increased from 50 percent
in the lowest wealth quintile to 83 percent in the highest wealth quintile.
The proportion of babies reported to be low birth-weight babies did not vary much with either residence
or mother’s age and baby’s order of the birth. Though, among the babies from different social groups
the incidence of low birth-weight babies did not differ much, a slightly higher proportion of babies from
the ST (22%) had low birth-weight. The incidence of low birth-weight babies decreased monotonically
with both, mother’s education and household wealth quintile. Almost one-fourth (23%) of the babies to
mothers with no education had birth-weight below 2,500 grams compared to only 14 percent of babies
to mothers who completed Higher Secondary or had higher education. Similarly, the proportion of low
birth-weight babies decreased from 22 percent among babies from the lowest wealth quintile to 16
percent among the highest wealth quintile.
The state-level variation in the proportion of babies weighed within 24 hours and proportion of low-
birth weight babies is presented in Table 6.2. The proportion of babies reported to be weighed at birth
varied from the lowest of 17 percent in Nagaland to the highest of 98 percent in Kerala and Tamil Nadu.
In five states—Nagaland (17%), Uttar Pradesh (28%), Jammu & Kashmir and Bihar (46% in both) and
Uttarakhand (47%)—less than 50 percent of the babies were weighed at birth. On the contrary, in Goa
(95%), Tamil Nadu and Kerala (98% in both) practically all the babies got weighed within 24 hours of
birth. In all the states, higher proportion of babies in urban areas was weighed than those in rural areas.
The urban-rural differences were much wider in the states where only a smaller proportion of babies got
weighed, whereas they were much smaller in the states where a large proportion of babies got weighed.
NUTRITION OF CHILDREN AND ADOLESCENT GIRLS
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Table 6.2: Birth weight by state
Among live-births in the three years preceding the survey, the percentage who were weighed within 24 hours of
birth, and percent distribution of those with reported birth weight by birth weight by residence, according to
states
State
Urban Rural Total
Weighed
within 24
hours of
birth
Birth weight of
the child Weighed
within 24
hours of
birth
Birth weight of
the child Weighed
within 24
hours of
birth
Birth weight of
the child
< 2.5
Kg
2.5 kg
and
more
< 2.5
Kg
2.5 kg
and
more
< 2.5
Kg
2.5 kg
and
more
India
North
Delhi
Haryana
Himachal Pradesh
Jammu & Kashmir
Punjab
Uttar Pradesh
Uttarakhand
Central
Chhattisgarh
Madhya Pradesh
East
Bihar
Jharkhand
Odisha
West Bengal
Northeast
Arunachal Pradesh
Assam
Manipur
Meghalaya
Mizoram
Nagaland
Sikkim
Tripura
West
Rajasthan
Goa
Gujarat
Maharashtra
South
Andhra Pradesh
Karnataka
Kerala
Tamil Nadu
79.7
76.4
73.5
82.5
67.5
68.3
35.0
66.2
79.8
74.2
54.9
71.4
92.6
82.7
86.8
86.6
85.8
87.9
95.7
32.2
93.3
93.7
72.1
95.2
88.7
89.5
91.7
93.9
99.1
97.3
18.4
21.9
17.2
13.4
15.0
20.0
21.6
13.0
15.6
22.7
13.5
15.0
20.8
16.6
6.0
16.0
6.7
12.1
3.0
13.5
8.9
14.4
20.3
16.2
19.7
19.1
18.6
17.3
13.4
18.0
81.6
78.1
82.8
86.6
85.0
80.0
78.4
87.0
84.4
77.3
86.5
85.0
79.2
83.4
94.0
84.0
93.3
87.9
97.0
86.5
91.1
85.6
79.7
83.8
80.3
80.9
81.4
82.7
86.6
82.0
64.1
74.7
74.1
74.2
38.3
63.6
26.4
38.7
64.3
56.6
44.9
51.7
83.7
74.9
57.9
71.0
58.1
58.9
86.8
11.0
86.3
73.1
53.2
93.9
87.4
87.4
91.8
86.8
97.5
98.2
18.7
23.4
22.6
18.1
17.0
21.2
22.8
15.2
17.4
23.3
15.2
14.6
18.5
17.1
14.2
13.1
7.6
9.8
1.1
24.4
10.4
20.2
24.5
17.7
19.4
21.9
18.4
17.2
12.6
15.6
81.3
76.6
77.4
81.9
83.0
78.8
77.2
84.8
82.6
76.7
84.8
85.4
81.5
82.9
85.8
86.9
92.4
90.2
98.9
75.6
89.6
79.8
75.5
82.3
80.6
78.1
81.6
82.8
87.4
84.4
68.7
76.4
73.9
74.9
45.9
65.3
28.2
47.1
67.6
61.0
46.0
55.9
85.2
77.4
65.1
73.0
67.0
64.6
91.7
16.5
87.8
78.1
57.8
94.7
87.9
88.4
91.8
89.5
98.2
97.8
18.6
21.9
20.9
17.7
16.2
20.7
22.5
14.2
16.9
23.1
15.0
14.7
18.9
16.9
11.5
13.6
7.3
10.4
2.2
18.9
10.0
18.5
23.2
16.7
19.5
20.6
18.4
17.2
13.0
16.7
81.4
78.1
79.1
82.3
83.8
79.3
77.5
85.8
83.1
76.9
85.0
85.3
81.1
83.1
88.5
86.4
92.7
89.6
97.8
81.1
90.0
81.5
76.8
83.3
80.5
79.4
81.6
82.8
87.0
83.3
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The incidence of low birth-weight babies varied across the states, from the lowest of two percent in
Mizoram to 23 percent in Madhya Pradesh, Rajasthan and Uttar Pradesh. Along with Mizoram, in four
other states from the North-east region—Manipur (7%), Sikkim and Meghalaya (10% in both) and
Arunachal Pradesh (12%)—incidence of low birth-weight was at lower side. At the same time, in many
states such as Uttar Pradesh, Madhya Pradesh, Rajasthan, Maharashtra, Punjab, Haryana and Delhi 20 to
23 percent of the babies had low birth weight. In most of the states, incidence of low birth weight was
lower in urban than rural areas.
6.2 INFANT AND YOUNG CHILDREN FEEDING PRACTICES
Indian children have the same growth and development potential as all children worldwide. Optimal
nutrition in the first two years of life—including good breastfeeding, complementary feeding and care
and hygiene practices—are critical to prevent stunting in infancy and early childhood and break the
intergenerational cycle of under nutrition. The correct or good breastfeeding practices include initiation
of breastfeeding within the first hour of life, exclusive breastfeeding for the first six months and
continued breastfeeding for at least two years. After the completion of six months, children need to be
fed the right foods both in quantity and quality along with mother’s milk. RSOC collected detailed data
on IYCF practices for all the children below the age of 24 months. The IYCF practices are assessed using
the indicators recommended by WHO and UNICEF. IYCF is a set of well-known and common
recommendations for appropriate feeding of new-born and children under two years of age. IYCF
includes the following care practices: Optimal IYCF practices include:
a) Early initiation of breastfeeding; immediately after birth, preferably within one hour.
b) Exclusive breastfeeding for the first six months of life, i.e, 180 days (no other foods or
fluids, not even water; but allows infant to receive ORS, drops, syrups of vitamins,
minerals and medicines when required).
c) Timely introduction of complementary foods (solid, semi-solid or soft foods) after the
age of six months, i.e. 180 days.
d) Continued breastfeeding for two years or beyond
e) Age appropriate complementary feeding for children 6-23 months, while continuing
breastfeeding. Children should receive food from four or more food groups: [(1) grains,
roots and tubers, legumes and nuts; (2) dairy products ; (3) flesh foods (meat fish,
poultry); (4) eggs, (5) vitamin A rich fruits and vegetables; (6) other fruits and
vegetables] and fed for a minimum number of times (two times for breastfed infants, 6-
8 months; three times for breastfed children, 9-23 months; four times for non-breastfed
children, 6-23 months)
f) Active feeding for children during and after illness.52
52Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held on 6–8 November 2007 in
Washington D.C., USA.
UNICEF, Nutrition Wins. How Nutrition Makes Progress in India, Unicef, 2013, New Delhi, India.
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6.2.1 Initiation of breastfeeding
There is an ample research indicating benefits of early initiation of breastfeeding. Early initiation of
breastfeeding means breastfeeding all normal new-borns (including those born by caesarean section) as
early as possible after birth, ideally within the first hour. Initiation of breastfeeding within one hour of
birth reduces neo-natal mortality by up to 22 percent by averting deaths due to sepsis, pneumonia,
diarrhoea and hypothermia. From the first breast milk the baby receives colostrum, which protects the
baby in a number of ways. Colostrum is rich in immunologically active cells, antibodies and other
protective proteins, and thus serves as the baby’s first immunization and protects it against many
infections. It helps to regulate the baby’s own developing immune system. Colostrum contains growth
factors, which help the infant’s intestine to mature and function effectively. This makes it more difficult
for micro-organisms and allergens to get into the baby’s body. Colostrum is rich in Vitamin A, which
helps protect the eyes and reduce infection. Colostrum, the milk secreted in the first two-three days,
must not be discarded but should be fed to the newborn as it contains high concentration of protective
immunoglobulins and cells. No pre-lacteal fluid should be given to the newborn.53
All the eligible interviewed women who delivered a live birth in 24 months prior to survey were asked
whether they ever breastfed the child and if breastfed, when the breastfeeding was started, since in
many cases women squeeze out the first breastmilk before they start feeding the child. Further, it was
asked whether they fed the child first yellow thick breastmilk, i.e., colostrum. It was also asked whether
they fed the child any other thing before starting breastfeeding.
Table 6.3 presents percentage of children aged 0-23 months ever breastfed; percentage breastfed
within an hour of birth and within a day; and the percentage of children who were given pre-lacteal
feeds. Practice of breastfeeding is almost universal in India, as all but four percent of the children were
ever breastfed. However, only 45 percent children were breastfed within an hour, in all, 81 percent of
the children were breastfed within a day. RSOC shows that most of the babies (86 percent) were fed first
yellow thick milk.
Almost equal proportion of children from each category of gender, residence, religion, social group,
mother’s education or wealth index was ever breastfed. Initiation of breastfeeding was also not
influenced by any of these variables. Practice of early initiation of breastfeeding was more prevalent in
Christian and Buddhist religions. More than one-half of children from the Christian (58 percent) and
Buddhist (51 percent) religions were breastfed within an hour as compared to 32 to 45 percent in other
religions. Relatively higher proportion of children from STs (55 percent) was breastfed in comparison 42
to 45 percent from the remaining three social groups. Mother’s education or wealth index did not show
any uniform pattern in the practice of early initiation of breastfeeding.
FACT SHEET: Compiled by UNICEF Malaysia Communications,2007; Sources: UNICEF and WABA BREASTFEEDING – THE REMARKABLE FIRST HOUR OF LIFE: GUIDELINES FOR ENHANCING OPTIMAL INFANT AND YOUNG CHILD FEEDING PRACTICES; Ministry of Health and Family Welfare, Government of India, 2013 Programming Guide Infant and Young Child Feeding June 2012, Nutrition Section, Programmes, UNICEF New York Infant and Young Child 53
Factors associated with the introduction of prelacteal feeds in Nepal: findings from the Nepal Demographic and Health Survey 2011
Vishnu Khanal1*, Mandira Adhikari2, Kay Sauer13 and Yun Zhao1 International Breastfeeding Journal 2013, 8:9 doi:10.1186/1746-4358-8-9
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Table 6.3: Initial breastfeeding among children aged 0-23 months
Percentage of children aged 0-23 months, who were ever breastfed, the percentage who started breastfeeding
within an hour, and one day of birth, the percentage who were fed colostrum (first yellow thick breast milk/khees),
received a pre-lacteal feed, by background characteristics.
Characteristics Ever
breastfed
Initiation of breastfeeding Percentage fed first
yellow thick breastmilk
Percentage received a pre-lacteal
feed*
Number of children
aged 0-23 months
Immediately/within an hour of
birth
Within one day of birth
Age of the Child in months
Less than 6 97.0 44.9 81.4 87.0 21.2 9,377 6-11 97.4 45.1 81.8 87.6 22.2 8,568 12-23 94.6 44.2 80.4 84.6 22.7 18,002
Sex of the Child
Male 95.7 43.8 80.6 85.5 22.6 18,996 Female 96.0 45.5 81.4 86.4 21.7 16,949
Residence
Urban 95.7 45.6 80.6 88.2 21.1 10,640 Rural 96.0 44.2 81.1 85.0 22.6 25,306
Mother education
No Education 94.9 39.9 77.4 80.7 25.8 11,508 Below Primary 95.9 47.5 81.1 85.3 19.0 1,701 Completed Primary 97.1 47.6 83.2 88.3 20.4 5,466 Completed Middle 96.4 46.3 83.4 87.7 20.3 5,650 Completed Secondary 96.0 47.0 83.0 88.9 19.3 4,986 Completed Higher Secondary and above 96.2 46.3 81.8 89.6 21.8 6,636
Religion of the head of the household
Hindu 96.1 45.1 81.2 86.7 21.9 28,208 Muslim 95.5 41.4 80.1 82.7 23.5 5,959 Christian 94.8 58.0 87.9 87.7 14.8 756 Sikh 93.1 32.3 70.5 82.0 33.7 540 Jain 83.5 34.6 64.5 70.3 36.0 90 Buddhism 95.2 50.6 82.6 90.0 8.9 222 No Religion (96.9) (53.1) (84.4) (93.8) (12.5) 17 Other 92.4 47.8 82.8 87.6 23.8 155
Caste
Scheduled Caste 96.7 43.1 81.5 87.2 22.0 7,361 Scheduled Tribe 96.0 54.7 84.2 87.3 19.3 4,205 OBC 95.8 42.3 80.3 84.0 24.3 14,381 Others 95.4 44.8 80.3 87.3 20.5 9,666 Do Not Know 98.0 43.3 78.3 88.7 21.0 334
Wealth Index
Lowest 95.6 42.5 80.6 83.2 21.9 7,250 Second 95.8 44.3 81.2 84.6 21.9 7,405 Middle 96.3 46.1 81.7 86.8 21.3 7,481 Fourth 96.6 47.6 82.6 87.9 22.5 7,180 Highest 95.1 42.3 78.7 87.5 23.4 6,629
Total 95.9 44.6 81.0 86.0 22.2 35,947
( ) Based on 25-49 unweighted cases.
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In India, there is a practice of feeding a baby with some food before the initiation of breastfeeding which
is a pre-lacteal feed. The type of pre-lacteal feeds depends on the culture. It may include ghee, honey,
sugar, sugar juice, cow/goat milk etc. All pre-lacteal feeds are mainly provided for non-nutritional
reasons such as clearing the throat/bowel; or thinking that mother’s milk is insufficient or the colostrum
is too heavy for the new born to digest. Pre-lacteal feeds have lesser nutrients and immunological values
and often likely to introduce contaminants. RSOC collected information from eligible women with child
aged 0-23 months, whether child was fed anything in the first three days of birth, and the type of food
given. Nearly one-fourth (22 percent) children aged 0-23 months were given pre-lacteal feeds. The
practice of giving pre-lacteal feeds was more or less uniform across all the categories of gender,
residence, social group, mother’s education or wealth index.
Milk was the most common pre-lacteal feed; one in every eight children (12 percent) was given milk
(Table 6.4). Other pre-lacteal feeds included honey, plain water, sugar or glucose water and janamghuti.
Table 6.4: Type of pre-lacteal liquids given
Percentage of children under two years of age who received a pre-lacteal feed, by type of pre-lacteal feed given to
the child during first 3 days of delivery, according to residence
Particulars Residence
Urban Rural Total
Percentage of children aged 0-23 months received any pre-
lacteal feed 21.1 22.6 22.2
Number of children 0-23 aged months 10,640 25,306 35,947
Type of pre-lacteal liquids given
Milk other than breast milk 11.4 12.0 11.8
Plain water 3.5 4.3 4.1
Sugar or Glucose water 2.1 2.1 2.1
Gripe Water 0.9 0.9 0.9
Sugar-Salt-Water Solution 0.6 0.7 0.6
Fruit Juice 0.4 0.2 0.3
Infant Formula 2.2 1.4 1.6
Honey 3.6 4.4 4.2
Janamghuti 2.1 2.5 2.4
Other 1.6 2.1 1.9
Number of children 0-23 months received a pre-lacteal feed 2,247 5,722 7,969
The data on children ever breastfed, children breastfed within an hour of birth, fed colostrum and given
pre-lacteal feeds across the states are presented in Table 6.5. In all the states 90 percent or more
children were ever breastfed; and except in Delhi (94 percent), Haryana and Jammu & Kashmir (91
percent in both) in all the remaining states at least 95 percent of the children were ever breastfed.
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Table 6.5: Breastfeeding practices by state
Percentage of children under two years of age, by various breastfeeding practices, by states*
State
Percentage of children who were
Ever breastfed Initiated breastfeeding
within one hour of birth
Fed first yellow thick
breast milk
Received a pre-
lacteal feed
India 95.9 44.6 86.0 22.2
North
Delhi 93.6 39.1 95.9 18.8
Haryana 91.3 38.4 96.2 35.8
Himachal Pradesh 99.4 52.4 92.8 23.8
Jammu & Kashmir 91.0 13.9 94.2 27.3
Punjab 96.6 34.5 90.2 42.6
Uttar Pradesh 97.4 23.2 84.1 35.1
Uttarakhand 99.5 52.1 90.2 28.2
Central
Chhattisgarh 99.7 47.2 95.4 9.8
Madhya Pradesh 97.2 43.1 86.9 18.0
East
Bihar 98.7 37.1 86.3 27.3
Jharkhand 96.5 28.2 82.0 22.2
Odisha 99.1 76.4 96.5 19.6
West Bengal 100.0 45.4 93.9 12.9
North-east
Arunachal Pradesh 98.0 73.1 99.7 5.3
Assam 96.1 72.1 86.0 5.1
Manipur 98.2 62.9 95.2 26.6
Meghalaya 99.6 65.5 96.7 7.8
Mizoram 98.1 93.8 99.0 4.0
Nagaland 99.0 66.7 95.3 1.2
Sikkim 100.0 60.5 90.3 5.5
Tripura 99.0 43.9 96.2 6.8
West
Rajasthan 98.2 39.6 91.3 28.6
Goa 98.7 53.6 95.5 13.4
Gujarat 98.1 44.0 89.3 20.5
Maharashtra 96.0 57.6 93.9 15.8
South
Andhra Pradesh 94.7 55.4 92.8 13.2
Karnataka 96.2 50.5 86.2 20.4
Kerala 99.5 70.3 97.7 8.5
Tamil Nadu 100.0 74.4 94.2 11.2
* Percentages at state level are calculated for children aged 0-5 months.
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Though breastfeeding was nearly universal across the states, there was wide variation in the practice of
early initiation of breastfeeding. Early initiation of breastfeeding within one hour varied from the lowest
of 14 percent in Jammu & Kashmir to the highest of 94 percent in Mizoram. In most of the states from
the north, central, east and west regions the extent of early initiation of breastfeeding was low. The
exception is in Himachal Pradesh and Uttarakhand (52 percent in both), Odisha (76 percent), Goa (54
percent) and Maharashtra (58 percent) where in case of majority of the children breastfeeding was
initiated within an hour of birth. In all the states from southern region and north-eastern region, with
the exception of Tripura, majority of the children were breastfed within one hour of birth. Though, there
was variation in the extent of early initiation of breastfeeding in all the states, 80 percent or more
children were fed with first yellow thick milk. At national level, the proportion of children who received
pre-lacteal feeds was 22 percent. The proportion varied across the states from the lowest of one
percent in Nagaland to 43 percent in Punjab. In general, the practice of giving pre-lacteal feeding was
more prevalent in those states where initiation of breastfeeding was delayed.
6.2.2 Exclusive Breastfeeding and Continuation of Breastfeeding by Age One and Two
For all the children born during two years prior to survey and surviving at the time of survey,
information on whether the child was breastfed on the day and night before the survey day, was
collected. In addition, data on the liquids and solid food given on the day and night before the survey
day was also collected. Table 6.6 presents percentage of children aged 0-5 months who were breastfed
and exclusively breastfed by selected characteristics. Exclusive breastfeeding for the first six months
means that an infant receives only breast milk from his or her mother or a wet nurse, or expressed
breast milk, and no other liquids or solids, not even water. The only exceptions include administration of
oral rehydration solution, oral vaccines, vitamins, minerals supplements or medicines. Most (96%) of the
children aged 0-5 were breastfed at the time of survey. However, in addition to breast milk, many of
these children were given some other fluids or semi-solid or soft foods. So in all 65 percent of the
children aged 0-5 months were exclusively on breast milk. The extent of exclusive breastfeeding was
almost same among the male and female babies and in both the rural and urban areas. Educated
women are expected to be more aware of benefits of exclusive breastfeeding. However, the extent of
exclusive breastfeeding was decreasing with mother’s education. The proportion of children aged 0-5
months who were exclusively breastfed decreased from 67 percent among children with mother having
no education to 62 percent among children with mother having secondary and above education. The
extent of exclusively breastfeeding also decreased with better economic status. The proportion of
children aged 0-5 months who were exclusively breastfed decreased from 70 percent in the lowest
wealth quintile to 62 percent in the highest wealth quintile.
As mentioned previously the optimal breastfeeding practices include continuation of breastfeeding up
to two years and beyond. The recommended indicators for measuring the continuation of breastfeeding
are proportion of children breastfed tillage one (measured by proportion of children aged 12-15 months
with continued breastfeeding) and age two years (measured by proportion of children aged 20-23
months with continued breastfeeding). Eighty-five percent of the children were continued to be given
breastfeeding till age one and 68 percent of the children were breastfed by age two.
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The prevalence of continued breastfeeding by age one and two was almost same among male and
female children. The practice of continuing breastfeeding was much prevalent in rural than urban areas;
71 percent of the children in rural areas were breastfed by age two as compared to only 60 percent in
the urban areas. among the children from four social groups, the highest proportion of children from the
STs (90 percent by age one and 74 percent by age two) were continued to be breastfed by age one and
two.
Table 6.6: Exclusive breastfeeding and continued breastfeeding by age one and two
Percentage of children aged 0-5 months who are currently breastfed and who are currently exclusively breastfed,
percentage of children aged 12-15 months and 20-23 months who are currently breastfed according to selected
characteristics.
Characteristics
Children aged 0-5 months Children aged 12-15
months
Children aged 20-23
months
Currently
breastfed
Exclusive
breast
feeding
Number
of
children
Currently
breastfed
Number of
children
Currently
breastfed
Number of
children
Sex of child
Male 95.3 64.9 4,912 85.2 3,500 68.2 2,696
Female 95.9 64.8 4,368 84.3 3,154 66.6 2,395
Residence
Urban 95.3 64.2 2,549 79.3 2,029 59.7 1,574
Rural 95.7 65.1 6,731 87.1 4,626 70.9 3,517
Mother education
No Education 95.8 67.0 3,206 88.9 1,996 75.4 1,630
Below Primary 96.6 67.8 438 89.5 296 74.6 279
Completed Primary 96.0 64.6 1,389 85.4 1,036 68.3 780
Completed Middle 95.1 65.3 1,383 83.9 1,116 66.7 820
Completed Secondary 95.0 61.7 1,287 83.1 858 60.7 700
Completed Higher
Secondary and above 95.3 62.3 1,577 78.9 1,352 55.8 882
Religion
Hindu 96.0 65.7 7,331 85.0 5,236 68.6 3,933
Islam 94.3 62.6 1,521 85.1 1,059 66.3 882
Christian 95.0 58.8 194 73.2 136 55.2 125
Sikh 93.0 53.8 130 85.7 104 50.7 83
Jain * * 26 * 24 * 10
Buddhism 91.2 76.8 43 85.7 45 51.5 37
No Religion * * 6 * 3 * 3
Other 90.8 63.9 29 78.0 47 (78.6) 18
Social-group
Scheduled Caste 95.5 67.1 1,935 87.6 1,390 70.2 958
Scheduled Tribe 95.9 64.3 1,125 89.6 697 73.6 604
Other Backward Class 94.8 64.0 3,680 81.6 2,618 65.0 2,068
Others 96.6 64.5 2,452 85.0 1,903 65.7 1,413
Do Not Know 99.2 69.5 89 97.0 46 (90.7) 48
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Characteristics
Children aged 0-5 months Children aged 12-15
months
Children aged 20-23
months
Currently
breastfed
Exclusive
breast
feeding
Number
of
children
Currently
breastfed
Number of
children
Currently
breastfed
Number of
children
Wealth Index
Lowest 96.2 70.0 2,022 90.2 1,257 78.8 999
Second 95.7 67.2 1,977 87.3 1,306 75.0 1,135
Middle 95.4 61.6 1,892 85.4 1,433 63.7 1,031
Fourth 96.4 62.8 1,784 82.4 1,334 59.2 953
Highest 94.0 61.7 1,606 78.8 1,324 59.1 974
Total 95.6 64.9 9,281 84.8 6,654 67.5 5,091
( ) Based on 25-49 unweighted cases.
* Percentage not shown; based on fewer than 25 unweighted cases.
Mother’s education and better economic status had led to early discontinuation of breastfeeding. With
increase in mother’s education the proportion of breastfed children by age one has decreased from 89-
90 percent among children whose mothers either had no education or studied below primary level to 79
percent among children whose mothers had completed higher secondary school. The decrease in the
proportion of breastfed children by age two with mother’s education was much sharper from 75 percent
among children whose mothers had no education to 56 percent among children with mother having
higher secondary schooling. The drop in the continuation of breastfeeding with higher economic status
also followed the same pattern.
The state-level variation in the prevalence of exclusive breastfeeding among children below the age of
six months, continuation of breastfeeding by age one and two is presented in Annexure-A Table 6.7.
6.3.3 Complementary Feeding
By the time child completes six months of life, breast milk alone is no longer enough to meet the
nutritional needs of the infant, and at this age complementary foods need to be added to the diet of the
child. The transition from exclusive breastfeeding to family foods, referred to as complementary
feeding, typically from six months of age. It is recommended by WHO that complementary feeding
should be timely, meaning that all infants should start receiving foods in addition to breast milk from six
months onward, when the need for energy and nutrients exceeds what can be provided through
exclusive breastfeeding.54However, infants are vulnerable during the transition phase, from exclusive
breast milk to introduction of complementary feeding over and above breast milk. For ensuring the
54www.who.int/nutrition/topics/complementary_feeding/en/
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nutritional needs of a young child are met, breastfeeding must continue along with observing the
following practices for appropriate complementary feeding.
For the assessment and monitoring of the practice of complementary feeding WHO has developed an
indicator of complementary feeding. The indicator, ‘Introduction of solid, semi-solid or soft foods’ is the
proportion of infants 6-8 months of age who receive solid, semi-solid or soft foods during the previous
day of measurement.
Data was collected from eligible women on liquids and solid, semi-solid and soft foods fed to all children
aged 6-23 months during 24 hours preceding the survey. Using this data, the percentage of children
aged 6-8 months introduced complementary food is estimated (Table 6.8). The data reveals that 51
percent children aged 6-8 months in India received complementary foods; in other words in case of 51
percent of children, introduction of complementary food is timely. It also implies that, remaining 49
percent of the children are still on just breast milk. Little higher proportion of male children aged 6-8
months (53 percent) got complementary food than female children (48 percent). Children from urban
areas are more likely to receive complementary food, as 58 percent of children aged 6-8 months from
urban areas were receiving complementary food compared to 47 percent from rural areas.
Table 6.8: Percentage of children aged 6-8 months who were fed complementary foods
Percentage of children aged 6-8 months who were fed complementary food
Characteristics
Percentage of children aged 6-8
months who were fed
complementary food
Number of children
6-8 months
Sex of the Child
Male 52.9 2,369
Female 47.8 2,134
Residence
Urban 58.1 1,384
Rural 47.1 3,118
Social Group
Scheduled Caste 45.2 878
Scheduled Tribe 45.5 558
OBC 50.8 1,806
Others 55.6 1,196
Do Not Know 61.5 65
Wealth Index
Lowest 41.2 850
Second 44.5 826
Middle 49.9 912
Fourth 53.7 1,057
Highest 62.1 857
Total 50.5 4,502
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The proportion of children aged 6-8 months receiving complementary food increased from 41 percent
among children from the lowest wealth quintile to 62 percent among children in the highest wealth
quintile. The practice of feeding complementary food seems to be positively associated with better
economic status, though even for more than one-third of the children aged 6-8 months in the highest
wealth quintile complementary feeding was not timely.
The state-level variation in the percentage of children aged 6-8 months who were introduced
complementary feeding is presented in Annexure-A Table 6.7.
Type of complementary food items
Table 6.9 shows the types of complementary food items given to the children aged 0-23 months on the
day and night preceding the survey, according to their breastfeeding status. Even though, it is
recommended that children aged below six months should be only breastfed, a large proportion of them
were given liquid and solid food items. Five percent of breastfed babies below the age of two months
were given animal milk and three percent were given powder milk/formula. With increase in age the
proportion of babies given other liquid food increased. The proportion of breastfed children decreases
from 95 percent among children below age nine months to 71 percent among children aged 18-23
months (not shown in the table). About 11 percent of the breastfed babies aged 4-5 months were given
cow/buffalo milk and seven percent were given formula/powder milk. By age 18-23 months, 38 percent
of the breastfed children received animal milk and 15 percent received powder milk. Higher proportion
of non-breastfed than children in each age-group received other milks as compared to their breastfed
counterpart. However, among the non-breastfed children aged 0-23 months, 22 percent received
formula/powder milk and 54 percent received animal milk. In other words, many of the non-breastfed
children did not receive any milk. Even among the very young non-breastfed children in the age-group 0-
5 months only 26-39 percent received animal milk and 13-17 percent received formula. The practice of
giving water to the baby was quite prevalent. Even nine percent of the breastfed children aged 0-2
months were given water to drink.
With increase in age there was a sharp increase in the proportion of babies given different kind of solid
or semi-solid food items. In each age-group, a higher proportion of non-breastfed than breastfed
children received solid/semi-solid food. However, after completion of age one when the frequency of
breastfeeding decreases substantially, almost equal proportion of breastfed and non-breastfed children
received solid/semi-solid food. The most common solid/semi-solid food both breastfed and non-
breastfed children aged 6-23 months received were food items made from grain/roots/tubers (70
percent of breastfed and 83 percent of non-breastfed children) and those made from pulses/lentils (40
percent of breastfed and 48 percent of non-breastfed children). Feeding babies with fruits, vegetables,
eggs or flesh food is not common. Even among the older children aged 18-23 months, 28-35 percent of
either breastfed or non-breastfed children received vitamin A rich fruits/vegetables, 27-31 percent
received dark leafy vegetables and 15-21 percent received other fruits and vegetables. Similarly, about
9-13 percent of the babies aged 18-23 months received eggs and 10-12 percent received meat/fish etc.
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Table6.9: Liquids consumed by children aged 6-23 months in the day or night preceding the interview
Percentage of children 6-23 months of age, consumed any liquids in the day or night preceding the interview, by breastfeeding status and age
Liquids Solid or Semi-solid foods
Number
of
children
6-23
months
Age
(Months)
Plain
water
Water
items
such as
Dal/Rice
water
Powder
milk/
Formula
Cow's/Buffalo's/
Goat's/
Other animal’s
milk
Juice or
Juice
drinks
(mango,
orange,
apple,
lemon
etc.)
Butter
milk/beaten
curd
Any
other
Liquids
Fortified
baby
foods
such as
Cerelac
etc.
Food
made
from
grains,
roots
and
tubers
Food
made
from
pulses/
lentils/
legumes
and
nuts
Dairy
products
(cheese,
paneer,
dahi and
other
food
made
from
milk)
Flesh
foods
(meat,
fish, and
liver/organ
meats)
Eggs
Vitamin A
rich fruits
and
vegetables
Any dark,
green
leafy
vegetables
Any other
fruits and
vegetables
Any
other
solid
or
semi-
solid
food
BREASTFEEDING CHILDREN
<2 9.3 2.7 3.4 5.4 0.7 0.5 0.9 1.9 3.0 1.5 0.7 0.6 0.3 0.8 0.6 0.6 0.6 2,395
02-03 15.8 4.6 5.2 8.5 0.6 0.7 2.2 4.4 5.6 3.6 1.2 0.8 0.8 1.6 1.4 1.1 0.9 3,180
04-05 25.0 7.1 6.6 11.3 1.5 1.1 1.6 7.4 8.6 3.7 1.3 0.7 0.4 1.4 1.5 1.1 1.2 3,296
06-08 58.7 27.5 12.9 21.5 4.6 2.0 5.8 19.2 39.7 17.1 4.2 2.3 2.1 7.9 5.9 3.9 7.1 4,225
09-11 77.7 45.7 13.7 27.3 7.0 3.3 7.5 23.0 64.0 34.3 6.0 3.8 4.9 16.7 13.4 7.9 9.7 3,643
12-17 85.1 56.9 14.5 35.2 10.9 5.5 10.0 24.7 78.1 45.9 7.9 7.7 7.3 25.4 21.9 13.0 12.6 8,154
18-23 88.3 62.2 15.3 37.5 11.9 6.8 10.5 24.1 83.1 50.3 9.1 9.9 8.6 28.4 26.8 15.2 13.5 5,599
06-23 79.5 50.6 14.3 31.8 9.3 4.8 8.9 23.2 69.5 39.5 7.2 6.6 6.2 21.3 18.6 10.9 11.3 21,622
Total 61.5 37.4 11.6 25.1 6.9 3.6 6.8 17.8 51.0 28.9 5.4 4.9 4.5 15.5 13.6 8.0 8.3 30,493
NON- BREASTFEEDING CHILDREN
<2 43.8 25.1 12.5 25.5 11.7 7.2 12.6 7.1 25.9 19.3 7.9 4.2 4.5 12.6 17.7 11.0 8.1 115
02-03 43.8 30.1 15.8 28.6 7.7 5.4 10.2 13.5 26.3 21.4 12.4 5.3 4.7 12.2 9.0 8.4 4.5 136
04-05 56.8 35.2 17.3 39.0 8.9 6.9 14.1 10.5 40.9 29.3 9.6 8.7 5.5 16.9 13.6 10.5 5.3 159
06-08 71.7 51.6 25.4 49.5 9.9 15.2 9.8 28.2 58.2 27.7 11.8 6.8 5.5 17.1 14.8 15.4 6.0 230
09-11 79.7 48.1 25.4 47.9 13.3 6.2 10.7 35.5 70.7 38.7 8.2 6.1 5.4 24.4 19.1 11.9 11.1 390
12-17 89.4 62.3 20.5 56.9 19.8 11.8 14.7 31.5 83.7 49.1 14.6 10.6 9.5 33.8 27.3 18.6 17.4 1,712
18-23 90.2 64.9 22.2 56.2 19.6 11.5 11.8 28.5 86.3 50.4 11.7 12.3 13.0 35.2 31.0 21.0 15.2 2,325
06-23 88.1 61.9 22.0 55.5 18.6 11.3 12.7 30.2 82.6 47.8 12.5 10.9 10.7 32.9 27.8 19.1 15.2 4,658
Total 84.9 59.4 21.5 53.6 17.9 10.9 12.7 28.6 78.5 45.9 12.3 10.5 10.3 31.4 26.7 18.3 14.5 5,067
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Age appropriate complementary feeding for children 6-23 months
In addition to the indicator of timely complementary feeding, three more globally agreed indicators of
age appropriate complementary feeding are: (1) minimum dietary diversity, (2) minimum meal
frequency and (3) minimum acceptable diet. These indicators better reflect the quality and quantity of
food given to children aged 6-23 months. The ‘Minimum dietary diversity’ is the proportion of children
6-23 months of age who receive foods from four or more food groups out of seven groups. The seven
food groups include the following:
a. Grains, roots and tubers
b. Legumes and nuts
c. Dairy products (milk, yoghurt, cheese)
d. Flesh foods (meat, fish, poultry, and liver/organ meats)
e. Eggs
f. Vitamin A rich fruits and vegetables
g. Other fruits and vegetables
The indicator of ‘minimum meal frequency’ is the proportion of breastfed and non-breastfed children 6-
23 months of age who receive solid, semi-solid, or soft foods (but also including milk feeds for non-
breastfed children) the minimum number of times or more: two for 6-8 months, three for 9-23 months,
and four for 6-23 months (if not breastfed). The indicator of ‘minimum acceptable diet’ is the proportion
of children 6-23 months of age who had both minimum meal frequency and dietary diversity (in both
breastfed and non-breastfed children). This is a composite indicator which reflects both quality of diet
and frequency of complementary feeding.
Table 6.10 presents percentage of breastfed and non-breastfed children, who on the day and night prior
to survey received food with minimum dietary diversity, minimum meal frequency and minimum
acceptable diet. In the age-group of 6-23 months, most (82 percent) of the children are breastfed.
Among these breastfed children, 36 percent were fed the recommended number of times, only 20
percent children met the required dietary diversity and only 11 percent breastfed children received
minimum acceptable diet. In other words, for most of the children aged 6-23 months complementary
feeding was not of acceptable quality. Among the non-breastfed children, though a relatively larger
proportion of them received food for recommended minimum number of times (63 percent) and with
minimum dietary diversity (33 percent), only 12 percent of the non-breastfed children received
minimum acceptable diet. For the combined group of breastfed and non-breastfed children aged 6-23
months, only 11 percent received minimum acceptable diet.
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Table6.10: Infant and young child feeding (IYCF) practices Percentage of children 6-23 months who were fed a minimum number of times, with minimum dietary diversity and a minimum acceptable diet during the day
or night preceding the survey, by background characteristics.
Characteristics
Among breastfed children, percentage fed:
Number of
breastfed children
6-23 months
Among non-breastfed children, percentage fed:
Number of non-
breastfed children
6-23 months
Among all (both breastfed or non-breastfed) children, percentage fed:
Number of
children 6-23
months
Minimum number of
times55
Minimum dietary
diversity56
Minimum acceptable
diet57
Minimum number of
times
Minimum dietary
diversity
Minimum acceptable
diet
Minimum number of
times
Minimum dietary
diversity
Minimum acceptable
diet
Age of child (Months)
06-08 38.1 6.7 5.4 4,225 55.6 17.5 4.5 230 39.0 7.3 5.4 4,455
09-11 26.3 14.2 7.0 3,643 60.7 20.8 9.9 390 29.7 14.8 7.3 4,034
12—17 36.7 24.1 12.2 8,154 62.2 34.0 13.3 1,712 41.1 25.8 12.4 9,867
18-23 40.9 27.4 15.1 5,599 65.2 36.6 12.9 2,325 48.0 30.1 14.4 7,924
Sex of the Child
Male 36.8 20.7 11.5 11,479 62.7 32.0 11.6 2,393 41.2 22.6 11.5 13,872
Female 35.8 19.0 9.9 10,142 63.8 34.8 13.2 2,264 40.9 21.9 10.5 12,406
Residence
Urban 37.7 23.0 11.5 6,247 65.3 37.2 15.2 1,769 43.8 26.1 12.4 8,016
Rural 35.7 18.6 10.4 15,375 62.0 31.0 10.7 2,888 39.9 20.6 10.4 18,263
Mother education
No Education 35.1 16.3 9.7 6,939 60.8 27.6 8.3 1,159 38.8 17.9 9.5 8,098
Below Primary 42.5 18.6 10.4 1,074 58.0 21.2 7.0 174 44.7 18.9 9.9 1,248
Completed Primary 36.0 18.8 10.0 3,354 64.6 34.0 12.6 659 40.7 21.3 10.4 4,013
Completed Middle 35.9 22.1 10.7 3,462 63.6 35.0 13.5 754 40.9 24.4 11.2 4,216
Completed Secondary 35.5 21.9 11.5 2,885 61.7 34.6 14.3 788 41.1 24.6 12.1 3,674
Completed Higher Secondary and above
37.9 24.2 12.8 3,907 66.7 38.8 15.3 1,123 44.3 27.4 13.3 5,030
55Minimum number of times means feeding solid or semi-solid food at least twice a day for breastfed children aged 6-8 months; feeding solid or semi-solid food 3 or more times a
day for breastfed children 9-23 months and feeding solid or semi-solid food 4 or more times a day including milk feeding for non-breastfed children during the previous day. 56
Minimum dietary diversity means children received three or more food groups for breastfed children and four or more food groups for non-breastfed children (Food groups are: a. foods made from grains or roots and tubers, including bread, chapatti, rice, chichi, noodles, porridge, biscuits, idli or any other food, also includes fortified baby food like Cerelac etc. ; b. Food made from pulses/lentils/legumes and nuts; c. Dairy products (cheese, paneer, dahi and other food made from milk); d. Flesh foods (meat, fish, and liver/organ meats); e. eggs; f. vitamin A-rich fruits and vegetables; g. any other fruits and vegetables) 57
Minimum acceptable diet: Breastfed children6-23 months of age who had at least minimum dietary diversity and minimum meal frequency during the previous day and non- breastfed children6-23 months of age who receive at least 2 milk feedings, had at least minimum dietary diversity (not including milk feeds) and the minimum meal frequency during the previous day.
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Characteristics
Among breastfed children, percentage fed:
Number of
breastfed children
6-23 months
Among non-breastfed children, percentage fed:
Number of non-
breastfed children
6-23 months
Among all (both breastfed or non-breastfed) children, percentage fed:
Number of
children 6-23
months
Minimum number of
times55
Minimum dietary
diversity56
Minimum acceptable
diet57
Minimum number of
times
Minimum dietary
diversity
Minimum acceptable
diet
Minimum number of
times
Minimum dietary
diversity
Minimum acceptable
diet
Religion
Hindu 36.3 19.6 10.6 16,993 62.8 33.6 12.5 3,580 40.9 22.0 11.0 20,573
Muslim 36.5 20.4 11.1 3,599 65.9 32.1 11.9 763 41.6 22.4 11.3 4,362
Christian 35.9 28.0 10.9 415 56.9 46.1 18.5 144 41.3 32.7 12.8 560
Sikh 35.0 19.6 10.7 315 61.6 12.7 5.3 92 41.0 18.1 9.4 407
Jain (34.5) (24.1) (10.3) 44 * * * 19 43.3 24.1 6.8 63
Buddhist 39.9 20.3 10.4 144 (57.5) (57.5) (20.0) 34 43.9 23.5 10.0 178
No religion * * * 8 * * * 2 * * * 11
Other 41.2 23.0 13.7 103 * * * 23 47.0 28.3 14.7 126
Total 36.3 19.9 10.7 21,622 63.3 33.4 12.4 4,658 41.1 22.3 11.0 26,279
( ) Based on 25-49 unweighted cases. * Percentage not shown; based on fewer than 25 unweighted cases.
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Majority of the children (50 percent or more) in each age-group did not meet the minimum dietary
diversity nor they were fed for the minimum number of times. Even among the children aged 18-23
months only 14 percent received minimum acceptable diet. There was no difference in feeding practices
followed while feeding male and female children and in rural and urban areas. Feeding practices
improved with increase in mother’s education and wealth index. The better feeding practices with either
mother’s education or wealth index were mainly because of the fact that educated or wealthy mothers
feed their children from diverse food groups.
The percentages of breastfed and non-breastfed children, who on the day and night prior to survey
received food with minimum dietary diversity, minimum meal frequency and minimum acceptable diet
across the states, are presented in the Annexure-A Table 6.11.
6.3 MICRO-NUTRIENT SUPPLEMENTATION
Micro-nutrients are essential vitamins and minerals required in small quantity for healthy body. Regular
intake of vitamins and nutrients such as vitamin A, iron and iodine is essential to ensure good growth
and development in infants, and optimal cognitive development among the pre-school children. In
addition, supplementation and deworming improves health and nutrition. Vitamin A deficiency is a
leading cause of preventable blindness, morbidity and mortality among pre-school children.
To understand whether infants and young children below two years are fed food rich in vitamin A and
iron, RSOC collected data on the vitamin A rich and iron rich food consumed by children aged 6-23
months during 24 hours preceding survey. Children who consumed meat and organ meats, fish, eggs,
pumpkin, carrots, sweet potatoes that are yellow or orange inside, dark green leafy vegetables, ripe
mango, papaya, cantaloupe and jackfruit are considered as given vitamin A rich food. The iron rich food
included meat and organ meats, fish, poultry, eggs or dark green leafy vegetables. For all the children
aged 6-71 months data on vitamin A supplementation, Iron and Folic Acid (IFA) dose and deworming
medicine given during six months preceding the survey was also collected. Table 6.12 presents the
percentage of children aged 6-23 months that received vitamin A and iron rich food in 24 hours prior to
survey. The table also gives percentage of children aged 6-59 months who received vitamin A
supplementation, IFA dose and deworming medicine during six months preceding the survey. Among all
the infants and young children aged 6-23 months, 36 percent were fed with vitamin A-rich food and 43
percent were fed iron-rich food.
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Table 6.12: Micro-nutrient supplementation
Percentage of children aged 6-23 months who consumed Vitamin A rich and iron rich foods in the day or night preceding the survey, percentage of children 6-
59 months given Vitamin A and Iron Folic acid supplements in the last 6 months and percentage given deworming medication in the last six months preceding
the survey, by background characteristics.
Characteristics
Children aged 6-23 Months Children aged 6-59 Months
Percentage who
consumed foods
rich in Vitamin A
in last 24 hours58
Percentage who
consumed foods
rich in iron in last
24 hours59
Number of
children 6-
23 months
Percentage
given Vitamin A
supplements in
last 6 months
Percentage
given Iron &
Folic
supplements in
last 6 months
Percentage
given de-
worming
medication in
last 6 months
Number of
children 6-
59 months
Sex of the Child
Male 36.0 42.8 13,872 44.8 13.1 27.8 43,541
Female 36.9 42.5 12,407 45.6 13.8 27.4 39,783
Residence
Urban 38.9 49.8 8,016 48.3 15.2 30.0 25,683
Rural 35.4 39.5 18,263 43.8 12.7 26.6 57,640
Mother education
No Education 32.2 35.0 8,098 37.5 9.9 20.1 28,237
Below Primary 42.1 43.4 1,248 43.2 9.8 30.4 4,135
Completed Primary 36.1 41.8 4,013 46.0 14.6 30.0 12,909
Completed Middle 38.0 44.4 4,216 45.4 12.1 29.7 12,594
Completed Secondary 37.5 46.2 3,674 54.9 18.7 33.1 11,433
Completed Higher Secondary
and above 40.1 51.6 5,030 52.3 17.5 33.3 14,015
58Includes meat and organ meats, fish, eggs, pumpkin, carrots, sweet potatoes that are yellow or orange inside, dark green leafy vegetables, ripe mango, papaya, cantaloupe,
and jackfruit.
59Includes meat and organ meats, fish, poultry, eggs or dark green leafy vegetables.
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Characteristics
Children aged 6-23 Months Children aged 6-59 Months
Percentage who
consumed foods
rich in Vitamin A
in last 24 hours58
Percentage who
consumed foods
rich in iron in last
24 hours59
Number of
children 6-
23 months
Percentage
given Vitamin A
supplements in
last 6 months
Percentage
given Iron &
Folic
supplements in
last 6 months
Percentage
given de-
worming
medication in
last 6 months
Number of
children 6-
59 months
Religion
Hindu 35.6 41.6 20,573 46.5 14.0 28.0 65,156
Muslim 39.5 45.9 4,362 37.5 9.5 24.8 13,748
Christian 48.9 62.9 560 54.5 21.4 32.4 2,145
Sikh 30.9 36.9 407 37.7 5.9 13.2 1,213
Jain 27.8 30.3 63 53.1 27.7 51.1 136
Buddhist 35.4 35.8 178 65.1 25.2 61.3 529
No religion * * 11 30.1 16.0 27.7 53
Other 43.5 54.7 126 35.8 13.5 28.3 343
Social Group
Scheduled Caste 34.3 38.6 5,334 43.4 12.3 24.4 16,797
Scheduled Tribe 36.3 39.6 3,043 46.0 15.4 28.2 9,515
OBC 34.4 41.4 10,513 45.5 13.7 25.5 33,571
Others 40.9 48.5 7,147 46.4 13.5 32.8 22,610
Do Not Know 45.2 50.6 242 24.6 1.9 33.2 830
Wealth Index
Lowest 32.8 35.4 5,125 37.5 8.7 23.0 16,899
Second 35.3 38.9 5,333 42.8 10.9 25.3 16,941
Middle 36.8 42.2 5,515 46.8 15.8 27.7 17,247
Fourth 36.5 45.9 5,344 50.2 16.7 31.3 16,972
Highest 40.9 51.3 4,961 48.8 15.1 31.2 15,264
Total 36.4 42.7 26,279 45.2 13.4 27.6 83,324
* Percentage not shown; based on fewer than 25 unweighted cases.
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There was no difference in feeding vitamin A and iron rich food to both male and female children.
Almost equal proportion of both male and female children was fed vitamin A and iron rich foods. A
higher proportion of children from urban areas was fed vitamin A rich foods (39 percent urban vs 35
percent rural) and iron rich foods (50 percent urban vs 40 percent rural). The proportion of children who
were fed vitamin A rich foods did not show any specific pattern with mother’s education, though the
proportion of children who received iron rich foods shows an increase with mother’s education.
Children from the wealthier households were more likely to receive vitamin A and iron rich foods. The
proportion of children who were fed vitamin A rich foods and iron rich foods, both, showed positive
association with wealth index.
RSOC shows that less than one-half of children (45 percent) aged 6-59 months received vitamin A
supplementation in six months preceding the survey. In government programmes, deworming medicine
is given along with vitamin A supplementation. However, only 28 percent of the children received it. The
coverage of IFA supplementation was much lower as only 13 percent of the children aged 6-59 months
received IFA supplementation in six months preceding the survey. The coverage of all the three, i.e.,
vitamin A, IFA and deworming medicine was same among male and female children. It was higher in
urban areas than rural areas, though the urban-rural difference in each of the proportions of children
who received vitamin A, IFA and deworming medicine was less than five percentage points. Among the
children from four social groups, there was no difference in the coverage of vitamin A, IFA and
deworming medicine. With increase in both, mother’s education as well as wealth index, there was an
increase in the coverage of vitamin A and iron supplementation and deworming medicine, though the
increase was moderate and not uniform across the categories of mother’s education or wealth quintile.
The percentage of children aged 6-23 months that received vitamin A and iron rich food in 24 hours
prior to survey and the percentage of children aged 6-59 months who received vitamin A
supplementation, IFA dose and deworming medicine during six months preceding the survey by states is
shown in Annexure-A Table 6.13.
6.4 NUTRITIONAL STATUS OF CHILDREN
Undernutrition among the pre-school children is one of the major public health concerns in India.
Malnutrition limits development and the capacity to learn. It also costs lives: about 50 per cent of all
childhood deaths are attributed to malnutrition. Malnutrition in early childhood has serious, long-term
consequences because it impedes motor, sensory, cognitive, social and emotional development.
Malnourished children are less likely to perform well in school and more likely to grow into
malnourished adults, at greater risk of disease and early death.
Government of India is committed to tackling child malnutrition. The National Policy for children, 2013
states that, ‘Every child has a right to adequate nutrition and to be safeguarded against hunger,
deprivation and malnutrition. The state commits to securing this right for all children through access,
provision and promotion of required services and supports for holistic nurturing, well-being with
NUTRITION OF CHILDREN AND ADOLESCENT GIRLS
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nutritive attainment of all children.’ The AWCs under ICDS) provide take home rations for children aged
6-35 months and morning breakfast and hot cooked meal to children aged 36-71 months.
For the anthropometric measurement each interviewing team included one health investigator who was
responsible for all the anthropometric measurements. Each health investigator carried a scale and a
measuring board. The digital salter scale was used for weight measurement. The scale had an accuracy
level of 100 grams and could measure weights ranging from 5 kg to 150 kg. The length of children below
two years of age was measured using an infantometer and the height of children aged two to five years
was measured using a stadiometer. Both the infantometer and stadiometer could be used to measure
the length/height up to an accuracy level of 0.1 cm (one tenths of a centimetre). In cases where the
child or infant was not able to stand on the scale on her own, then a differential method of capturing
weight of the child/infant was used. The mother/caregiver of the child was asked to hold the child and
stand on the scale. The combined weight of the mother/caregiver and child was recorded. Once this was
done the mother was asked to stand on the scale without the child/infant and the weight of the
mother/caregiver alone was recorded. The difference in the two weight recordings was the actual
weight of the child.
For the assessment of nutritional status of children WHO child growth standards were used. The
nutritional status of children was assessed using three indicators; (1) height for age (stunting), (2) weight
for height (wasting) and (3) weight for age (underweight). The data on height, weight and age in months
was converted into Z scores using WHO’s ANTHRO software.
Children whose Z score for height for age below minus three standard deviations (-3 SD) from the
median of the reference population are considered to be severely stunted or too short for their age.
Children with Z score between minus three standard deviation (- 3SD) and minus two standard deviation
(- 2SD) are considered as moderately stunted. Stunting is associated with chronic malnutrition. Studies
have documented an inverse correlation between stunting, cognitive and physical development in pre-
schoolers and consequently lower intelligence levels in older children and functional impairment in
adulthood both in terms of intellectual and physical aspects.
Children whose weight for height Z score below minus three standard deviation (-3 SD) from the median
of the reference population are considered to be severely wasted or too thin for their height. Children
with Z score between minus three standard deviation (- 3SD) and minus two standard deviation (- 2SD)
are considered as moderately wasted. Wasting is the result of acute malnutrition in the recent period.
While stunting has long term implications for adult health and productivity; wasting is closely linked to
child mortality.
The weight for age or underweight is a composite index of height-for-age and weight-for-height. It takes
into account both acute and chronic malnutrition. Children whose weight for age Z score below minus
three standard deviation (-3 SD) from the median of the reference population are considered to be
severely underweight or too light for their age. Children with Z score between minus three standard
deviation (-3SD) and minus two standard deviation (-2SD) are considered as moderately
NUTRITION OF CHILDREN AND ADOLESCENT GIRLS
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underweight.60Table 6.14 and Figure 6.1 present proportion of children who are stunted, wasted and
underweight according to selected characteristics. RSOC shows that in India among the children aged 0-
59 months 39 percent are stunted, i.e., they are short for their age, 15 percent are wasted or thin for
their height and 29 percent are underweight or light for their age. Out of 39 percent of stunted children,
17 percent are severely stunted and remaining 21 percent are moderately stunted. In other words,
every sixth child in India is severely stunted. About 5 percent of the children are severely wasted and 10
percent are severely underweight.
Figure 6.1: Percentage of children age 0-59 months who are Stunted, Wasted and Underweight, India, RSOC, 2013-14
Prior to RSOC, the nutritional status of Indian children was assessed in NFHS-3 in 2005-06. NFHS-3
estimated the proportion of stunted, wasted and underweight children at 48 percent, 20 percent and 43
percent respectively. The RSOC results imply improvement in nutritional status of children as measured
by all the three indicators of height for age, weight for height and weight for age as shown in Figure 6.2.
The stunting has decreased by a rate of 1.3 percentage points per year during seven years between
2005-6 and 2013-14, and underweight proportion has decreased by 2.0 percentage points per year. The
level of wasting was lower compared to that of stunting and underweight and hence decreased at
slower rate of 0.7 percentage points per year.
60Mata, L., Simhon, A., Urrutia, J.J., Kronmal, R.A. Natural History of Rotavirus Infection in the Children of Santa MaríaCauqué. Prog Food Nutr
Sci.7(1983): 167–177.
De Onis, M. Measuring Nutritional Status in Relation to Mortality. Bull World Health Organ. 78(2000): 1271-1214.
Pelletier, D.L. The Relationship between Child Anthropometry and Mortality in Developing Countries: Implications for Policy, Programs and Future Research. J Nutr.124 (10 Suppl, 1994): 2047S-2081S.
17
39
5
15
10
29
Severely stunted Stunted Severely wasted Wasted Severleyunderweight
Underweight
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Figure 6.2: Change in the child nutritional status
Percentage of children aged 0-59 months who are Stunted, Wasted and Underweight, India, NFHS-3 and RSOC, 2013-14
Among the youngest children aged below six months, 17 to 18 percent are stunted, wasted as well as
underweight. The proportion of stunted and underweight children increases with age, thereafter. By the
time of completion of two years, 46 percent of the children are stunted and 33 percent are
underweight. From age two onwards there is slight decrease in both the proportions but beyond age
two, they fluctuate thereafter.
There are no gender differentials in the nutritional status of Indian children. Children from rural areas
are more likely to be stunted (42 percent rural vs 32 percent urban) and underweight (32 percent rural
vs 24 percent urban) in comparison to their urban counterparts. However, children from both the areas
are equally likely to be wasted. Considering the levels of all the three indicators of nutrition, among
children from all the different religion groups, those from the Sikh and Jain religion are least likely to be
undernourished and those from Hindu and Islam are more likely to be undernourished. The proportion
of children who are stunted, wasted as well as underweight is the highest among ST (42 percent, 19
percent and 37 percent respectively) children and the lowest among those belonging to Other castes (34
percent, 14 percent and 24 percent respectively). With the increase in mother’s education as well as in
the wealth index, there is a decrease in the prevalence of undernutrition. The proportion of stunted and
underweight children decreases monotonically from the lowest to the highest wealth quintile. The
extent of wasting also reduces with wealth quintile, however the reduction is small. Though,
undernutrition is the lowest among children from the highest wealth quintile, even in this wealthiest
group every fourth (27 percent) child is stunted and every fifth child (19 percent) is underweight.
48
20
43 39
15
29
Stunted Wasted Underweight
NFHS-3 (2005-06)
RSOC (2013-14)
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Table 6.14: Nutritional status of children
Percentage of children aged 0-59 months classified by their nutritional status according to three anthropometric indices—height-for-age, weight-for-height,
weight-for-age by background characteristics
Characteristics
Height-for-age Weight-for-height Weight-for-age
Percentage below
Mean
Z-
Score
Number
of
Children
0-59
months
Percentage below
Mean
Z-
Score
Number
of
Children
0-59
months
Percentage below
Mean
Z-
Score
Number
of
Children
0-59
months
-3 SD
(Severely
Stunted)
-2 SD
(Stunted)
-3 SD
(Severely
Wasted)
-2 SD
(Wasted)
-3 SD
(Severely
Underweig
ht)
-2 SD
(Underwei
ght)
Age of the child (months)
<6 8.3 17.1 0.0 8,841 6.3 17.8 -0.3 8,069 7.4 17.8 -0.5 9,451
06-08 11.3 23.9 -0.7 4,313 5.8 16.5 -0.4 4,115 9.5 22.9 -0.9 4,525
09-11 12.2 29.5 -0.9 3,955 5.8 18.1 -0.5 3,829 10.0 26.6 -1.1 4,151
12-17 17.1 37.7 -1.3 9,638 5.3 16.2 -0.5 9,203 9.5 26.4 -1.1 10,010
18-23 22.7 45.8 -1.7 7,802 5.6 16.5 -0.5 7,529 12.0 33.3 -1.4 8,214
24-35 18.5 42.8 -1.5 18,272 4.3 14.3 -0.5 17,825 9.1 30.1 -1.3 19,082
36-47 18.7 44.1 -1.7 18,608 3.6 13.7 -0.5 18,236 9.4 31.6 -1.4 19,188
48-59 19.5 43.1 -1.8 16,142 3.8 13.7 -0.6 15,810 9.6 35.0 -1.6 16,654
Sex of the Child
Male 17.6 39.5 -1.4 45,149 4.8 15.6 -0.5 43,384 10.0 30.0 -1.3 47,150
Female 16.9 37.9 -1.3 42,423 4.4 14.5 -0.5 41,231 8.9 28.7 -1.2 44,124
Residence
Urban 13.2 32.0 -1.1 26,624 4.8 15.0 -0.4 25,516 6.9 24.3 -1.1 27,680
Rural 19.1 41.6 -1.5 60,947 4.5 15.1 -0.5 59,099 10.6 31.6 -1.3 63,593
Mother education
No education 25.1 48.7 -1.8 28,478 4.5 15.3 -0.6 27,718 14.2 37.9 -1.6 29,799
Below Primary 19.2 44.1 -1.6 4,279 3.8 15.2 -0.6 4,122 10.6 34.3 -1.5 4,406
Completed Primary 16.0 39.8 -1.4 13,208 4.7 15.2 -0.6 12,775 8.7 30.9 -1.3 13,685
Completed Middle 13.9 35.4 -1.3 12,808 4.7 15.2 -0.5 12,443 7.3 25.8 -1.2 13,278
Completed Secondary 12.2 31.3 -1.1 11,656 4.9 14.5 -0.4 11,161 5.7 22.4 -1.0 12,129
Higher Secondary and
above 10.3 26.3 -0.9 14,204 4.7 14.5 -0.3 13,584 5.2 18.7 -0.8 14,822
Mother not interviewed 13.7 32.5 -1.0 2,939 5.1 17.2 -0.5 2,812 9.8 27.6 -1.0 3,154
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Characteristics
Height-for-age Weight-for-height Weight-for-age
Percentage below
Mean
Z-
Score
Number
of
Children
0-59
months
Percentage below
Mean
Z-
Score
Number
of
Children
0-59
months
Percentage below
Mean
Z-
Score
Number
of
Children
0-59
months
-3 SD
(Severely
Stunted)
-2 SD
(Stunted)
-3 SD
(Severely
Wasted)
-2 SD
(Wasted)
-3 SD
(Severely
Underweig
ht)
-2 SD
(Underwei
ght)
Religion
Hindu 17.0 38.6 -1.4 68,461 4.7 15.5 -0.5 66,149 9.4 29.7 -1.3 71,338
Muslim 19.9 42.1 -1.5 14,430 4.2 13.4 -0.4 14,058 10.3 30.5 -1.3 15,046
Christian 14.0 32.2 -1.1 2,302 4.4 15.4 -0.2 2,213 7.5 21.9 -1.0 2,443
Sikh 12.7 28.7 -1.1 1,261 3.7 10.7 0.1 1,144 6.1 17.4 -0.5 1,257
Jain 10.3 20.0 -0.6 128 4.5 11.9 0.2 125 2.9 15.9 -0.2 157
Buddhist 8.5 26.7 -0.9 587 5.3 22.0 -0.7 545 5.4 26.2 -1.0 614
No Religion 20.1 34.5 -1.2 52 3.9 11.3 0.0 51 3.4 26.4 -1.1 56
Other 13.7 34.8 -1.2 351 2.8 16.5 -0.5 330 12.0 29.2 -1.2 361
Social Group
Scheduled Caste 19.3 42.4 -1.5 17,756 4.9 15.5 -0.6 17,160 10.8 32.7 -1.4 18,509
Scheduled Tribe 19.5 42.3 -1.5 10,122 5.3 18.7 -0.6 9,642 13.0 36.7 -1.5 10,594
OBC 17.8 38.9 -1.4 34,993 4.4 14.8 -0.5 33,881 9.3 29.3 -1.3 36,580
Others 14.2 33.9 -1.2 23,790 4.4 13.6 -0.4 23,047 7.0 23.6 -1.0 24,666
Do Not Know 16.1 43.9 -1.5 911 5.3 15.4 -0.9 884 11.2 35.1 -1.6 924
Wealth Index
Lowest 25.8 50.7 -1.8 17,869 5.0 17.0 -0.7 17,335 16.3 42.1 -1.7 18,650
Second 20.4 43.9 -1.6 17,815 4.5 15.4 -0.5 17,315 11.3 34.0 -1.5 18,652
Middle 16.1 38.3 -1.3 17,953 4.7 14.8 -0.5 17,304 8.1 28.0 -1.2 18,768
Fourth 12.7 32.7 -1.1 17,879 4.3 14.9 -0.4 17,227 6.0 23.1 -1.0 18,565
Highest 10.7 26.7 -0.9 16,056 4.4 13.0 -0.3 15,434 5.1 18.6 -0.8 16,639
Total 17.3 38.7 -1.4 87,572 4.6 15.1 -0.5 84,615 9.5 29.4 -1.3 91,273
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Table 6.15 presents state-wise percentage of stunted, wasted and underweight children. The
nutritional status of children below age five varies substantially across the states. The variation is
quite noticeable in prevalence of stunted and underweight children. The proportion of stunted
children varies from the lowest of 19 percent in Kerala to 50 percent in Uttar Pradesh. Along with
Kerala, in Goa (21 percent) and Tamil Nadu (23 percent) also the extent of stunting is relatively
low. In these three states less than one-fourth of the children are stunted and less than 10 percent
are severely stunted. Except these three states, in all the remaining states at least 10 percent of
the children are severely stunted and at least 25 percent are severely or moderately stunted. At
the other extreme of the spectrum of stunting are the states of Uttar Pradesh (50 percent) and
Bihar (49 percent) where every second child is stunted and every fourth child is severely stunted.
Along with these two states, even in Jharkhand (47 percent), Chhattisgarh and Meghalaya (43
percent in both), Gujarat, Madhya Pradesh and Assam (41-42 percent) stunting is at higher side
compared to national level. Though, the stunting is the lowest in Kerala, Goa and Tamil Nadu, the
prevalence of underweight children is not low in these states. Rather in Manipur and Mizoram (14-
15 percent) the proportion of underweight children is the lowest. In the states of Jharkhand (42
percent), Bihar (37 percent), Madhya Pradesh (36 percent), Uttar Pradesh, Chhattisgarh, Gujarat
and Odisha (34 percent in each) nutritional status of children is worse even considering the
proportion of underweight children, where one-third or more children are underweight. Wasting
is the lowest in Sikkim (5 percent) and the highest in Tamil Nadu, Maharashtra, Andhra Pradesh,
and Gujarat (19 percent in each).
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Table 6.15: Nutritional status of children by state
Percentage of children aged 0-59 months classified by their nutritional status according to three anthropometric indices, height-for-age, weight-for-height,
weight-for-age, by state
State
Height-for-Age Weight-for-Height Weight-for-Age
Percentage below
Mean Z-
Score
Percentage below
Mean Z-
Score
Percentage below
Mean Z-
Score
-3 SD (Severely
Stunted)
-2 SD
(Stunted)
-3 SD (Severely
Wasted)
-2 SD
(Wasted)
-3 SD (Severely
Underweight)
-2 SD
(Underweight)
India 17.3 38.7 -1.4 4.6 15.1 -0.5 9.5 29.4 -1.3
North
Delhi 14.1 29.1 -0.8 4.6 14.3 -0.2 4.9 19.4 -0.8
Haryana 19.3 36.5 -1.4 2.7 8.8 -0.1 7.5 22.7 -1.0
Himachal Pradesh 16.2 34.2 -1.3 3.9 10.1 -0.3 5.5 19.5 -1.0
Jammu & Kashmir 12.6 31.7 -1.2 2.5 7.1 0.1 5.3 15.4 -0.7
Punjab 13.1 30.5 -1.1 3.2 8.7 0.3 4.3 16.0 -0.4
Uttar Pradesh 28.4 50.4 -1.9 2.9 10.0 -0.3 12.9 34.3 -1.5
Uttarakhand 13.9 34.0 -1.2 2.6 9.3 -0.4 5.9 20.6 -1.1
Central
Chhattisgarh 16.4 43.0 -1.7 2.4 12.9 -0.8 9.9 33.9 -1.6
Madhya Pradesh 18.6 41.6 -1.5 5.4 17.5 -0.8 12.1 36.1 -1.5
East
Bihar 26.1 49.4 -1.9 3.9 13.1 -0.5 14.7 37.1 -1.6
Jharkhand 23.7 47.4 -1.7 3.7 15.6 -0.8 16.1 42.1 -1.6
Odisha 15.5 38.2 -1.5 4.9 18.3 -0.8 11.0 34.4 -1.5
West Bengal 12.8 34.7 -1.4 3.9 15.3 -0.8 8.9 30.0 -1.4
Northeast
Arunachal Pradesh 19.6 28.4 -0.9 7.1 17.0 -0.3 13.3 24.6 -1.2
Assam 21.0 40.6 -1.7 2.7 9.7 0.0 7.0 22.2 -1.2
Manipur 12.6 33.2 -1.2 2.4 7.1 -0.2 3.5 14.1 -0.8
Meghalaya 29.4 42.9 -1.8 5.2 13.1 0.5 16.0 30.9 -1.4
Mizoram 15.3 26.9 -0.7 6.2 14.3 0.4 6.1 14.8 -0.5
Nagaland 15.8 29.1 -1.3 4.8 11.8 1.0 7.9 19.5 -0.4
Sikkim 11.0 28.0 -1.2 1.4 5.1 0.1 6.4 15.8 -0.9
Tripura 15.0 31.0 -1.1 7.0 17.1 -0.3 16.8 30.5 -1.4
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State
Height-for-Age Weight-for-Height Weight-for-Age
Percentage below
Mean Z-
Score
Percentage below
Mean Z-
Score
Percentage below
Mean Z-
Score
-3 SD (Severely
Stunted)
-2 SD
(Stunted)
-3 SD (Severely
Wasted)
-2 SD
(Wasted)
-3 SD (Severely
Underweight)
-2 SD
(Underweight)
West
Rajasthan 17.3 36.4 -1.4 2.9 14.1 -0.7 11.2 31.5 -1.4
Goa 6.6 21.4 -0.7 4.9 15.4 -0.4 2.0 16.1 -0.7
Gujarat 18.3 41.7 -1.4 6.7 18.6 -0.5 10.1 33.5 -1.4
Maharashtra 10.0 35.4 -1.1 6.3 18.7 -0.5 5.7 25.1 -1.1
South
Andhra Pradesh 12.0 35.3 -1.0 6.0 19.1 -0.5 4.7 22.3 -0.9
Karnataka 15.0 34.2 -1.1 6.3 17.0 -0.5 9.8 28.9 -1.3
Kerala 8.0 19.4 -0.6 5.4 15.5 -0.1 5.7 18.5 -0.6
Tamil Nadu 9.3 23.3 -0.7 6.3 19.0 -0.5 6.1 23.3 -0.9
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Figure 6.3: Percentage of children aged 0-59 months who are stunted by state, RSOC, 2013-14
6.5 NUTRITIONAL STATUS OF ADOLESCENT GIRLS
Healthy and well-nourished adolescent girls hold the key to unlock India’s child nutrition challenge. The
poor nutritional status of adolescent girls in India and their poor diets perpetuate the vicious cycle of
nutrition deprivation that passes on from mothers to daughters, from one generation to the next. To
assess the magnitude of undernutrition among adolescent girls, RSOC measured nutritional status of all
the girls aged 10-18 in all surveyed households. The weight and height were converted into Body Mass
Index (BMI) using the following formula;
BMI = 100* Weight in kilograms/(Height in metres)2
All the girls with BMI below 17.0 and BMI between 17 and 18.5 are classified as severely thin and
moderately thin, respectively. Similarly, those with BMI above 30 and BMI between 25 and 30 are
classified as overweight and obese respectively.
19 21
23
27 28 28 29 29 31 31 32
33 34 34 34 35 35 35 36 37 38 39
41 42 42 43 43
47 49 50
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adu
Miz
ora
m
Sikk
im
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nac
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Pra
de
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Him
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en
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esh
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a
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an
Har
yan
a
Od
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a
Ind
ia
Ass
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Mad
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Pra
des
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NUTRITION OF CHILDREN AND ADOLESCENT GIRLS
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Figure 6.4: The nutritional status of adolescent girls, RSOC, 2013-14
Table 6.16 presents distribution of adolescent girls aged 10-18 with different characteristics by their
nutritional status. RSOC shows that 44 percent of the adolescent girls aged 10-18 were severely thin and
additional 19 percent were moderately thin or under-nourished, so in all 63 percent of the girls were
thin or undernourished. A small proportion of the girls were either overweight (2 percent) or obese (1
percent). Only about one-third (34 percent) of the adolescent girls were neither underweight nor
overweight. The percentage of undernutrition was relatively higher among girls from rural areas (64
percent) than those from the urban areas (59 percent).
Undernutrition was much widespread among the girls aged 10-14, as 77 percent of them were thin
compared to 45 percent of the girls aged 15-18. The prevalence of undernutrition was much higher
among girls who were never married (63 percent) than those who were ever married (29 percent). Most
probably, the differentials by marital status are really the differentials by age as most of the married
girls are older than never married girls.
Among the girls from four social groups, the prevalence of thin girls was lower among those belonging
to Other castes (59 percent) compared to the other three groups (63-66 percent). The nutritional status
of the girls improved with economic status, as the proportion of thin girls decreased from 66 percent
among the girls from the lowest wealth quintile to 57 percent among the girls from the highest wealth
quintile. It may be noted that even in the households from the highest wealth quintile, majority of the
girls (57 percent) are thin.
43.6
18.9
34
2.2 1.3
Severely thin
Moderately thin
Normal
Over-weight
Obese
NUTRITION OF CHILDREN AND ADOLESCENT GIRLS
RAPID SURVEY ON CHILDREN 2013-14 CHAPTER 6 | 230
Table 6.16: Nutritional status of adolescent girls
Percent distribution of adolescent girls aged 10-18 by BMI level according to background characteristics
Characteristics
Body Mass Index (BMI) in kg/m2
Mean
BMI
Number of
adolescent
girls
Underweight Normal Overweight/obese
<17
(severely
thin)
17.0-18.4
(moderately
thin)
<18.5
(total
thin)
18.5-24.9
≥25.0
(overweight
or obese)
25.0-29.9
(over-
weight)
≥30.0
(obese)
Age of Girl
(Years)
10-14 61.4 15.8 77.2 20.1 2.7 1.6 1.1 17.04 25,186
15-18 22.0 22.6 44.7 50.9 4.5 2.9 1.6 19.33 20,374
Marital status*
Never married 44.6 18.9 63.6 33.1 3.4 2.1 1.3 18.00 44,030
Ever married 12.4 16.7 29.1 64.4 6.6 5.0 1.6 20.47 1,521
Not stated * * * * * * * * 9
Residence
Urban 40.2 18.7 59.0 35.2 5.8 3.4 2.4 18.56 12,903
Rural 44.9 18.9 63.9 33.5 2.6 1.7 0.9 17.88 32,658
Social Group
Scheduled
Caste 46.4 19.2 65.7 31.6 2.7 1.9 0.8 17.67 9,360
Scheduled
Tribe 45.1 19.8 64.9 31.8 3.3 2.1 1.2 18.67 4,942
OBC 43.4 19.2 62.6 34.1 3.4 2.0 1.4 17.98 19,241
Others 40.8 17.7 58.5 37.1 4.4 2.9 1.5 18.32 11,728
Do Not Know 52.9 21.7 75.0 22.3 3.1 0.8 2.3 17.14 289
School
attendance
Ever attended 24.8 23.1 48.0 47.6 4.4 2.9 1.5 19.27 4,697
Never
attended 37.0 20.2 57.2 38.1 4.7 1.6 3.1 19.90 3,433
Currently
attended 46.9 18.1 65.0 31.7 3.3 2.2 1.1 17.75 36,560
Dropout 33.7 23.5 57.3 40.9 1.8 1.2 0.5 18.25 870
Wealth Index
Lowest 47.9 18.5 66.4 31.3 2.3 1.4 0.9 17.94 9,349
Second 45.1 19.1 64.3 33.1 2.7 1.5 1.2 17.80 10,237
Middle 43.4 20.5 63.9 33.2 2.9 1.6 1.3 17.94 9,372
Fourth 41.8 18.0 59.8 34.7 5.5 3.9 1.6 18.38 8,920
Highest 38.7 18.1 56.9 38.7 4.4 2.9 1.6 18.39 7,682
Total 43.6 18.9 62.5 34.0 3.5 2.2 1.3 18.07 45,561
( ) Based on 25-49 unweighted cases. * Percentage not shown; based on fewer than 25 unweighted cases.
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Table 6.17 presents the distribution of adolescent girls by nutritional status across the states. There is a
large variation in the nutritional status of adolescent girls across the states. The proportion of under-
nourished or thin girls was the lowest at 35 percent in Mizoram. Along with Mizoram, in Sikkim (38
percent), Meghalaya (40 percent) and Tripura (48 percent) the nutritional status of adolescent girls was
better. Except these four states, in all the remaining states, majority (50 percent or more) of the
adolescent girls were undernourished (thin). The prevalence of undernutrition was the highest in Goa
and Rajasthan (74 percent each) where three in every four girls were thin. Even in Andhra Pradesh,
Karnataka, Bihar (68-69 percent in each state) and Madhya Pradesh, Odisha, Maharashtra, Jharkhand,
Gujarat and Chhattisgarh (65 percent in each state) and Himachal Pradesh (64 percent) the prevalence
of under-nutrition were higher than national level.
The proportion of overweight or obese girls was low in most of the states. Only in Andhra Pradesh,
Tripura and Tamil Nadu (8 percent in each), the proportion of overweight/obese girls was at a higher
side. In most of the states the proportion of thin girls was higher in rural areas than in urban areas. At
the same time, the proportion of overweight/obese girls was relatively higher in urban than rural areas,
though the urban-rural differentials were not very large.
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Table 6.17: Nutritional status of adolescent girls by state
Percent distribution of adolescent girls age 10-18 years by BMI levels according to states
State
Urban Rural Total
Body Mass Index (BMI) in kg/m2
Mean
BMI
Body Mass Index (BMI) in kg/m2
Mean
BMI
Body Mass Index (BMI) in kg/m2
Mean
BMI
Under-
weight
(<18.5)
Normal
(18.5-
24.9)
Overweight/
obese
(≥25.0)
Under-
weight
(<18.5)
Normal
18.5-
24.9)
Overweight
/obese
(≥25.0)
Under-
weight
(<18.5)
Normal
(18.5-
24.9)
Overweight/
obese
(≥25.0)
India 59.0 35.2 5.8 18.56 63.9 33.5 2.6 17.88 62.5 34.0 3.5 18.07
North
Delhi 59.8 34.0 6.2 18.29 53.3 43.3 3.4 19.49 59.6 34.2 6.2 18.32
Haryana 56.1 37.4 6.4 18.67 62.0 34.6 3.4 18.08 59.9 35.6 4.5 18.29
Himachal Pradesh 52.7 43.0 4.3 18.68 64.8 34.4 0.8 17.66 63.8 35.1 1.1 17.74
Jammu & Kashmir 36.4 54.4 9.2 20.03 56.9 36.2 6.9 18.76 52.2 40.4 7.4 19.06
Punjab 51.2 44.3 4.5 18.87 59.9 37.0 3.1 18.09 56.9 39.5 3.6 18.36
Uttar Pradesh 58.5 38.4 3.1 18.13 59.1 40.0 0.9 17.77 59.0 39.7 1.4 17.84
Uttarakhand 54.6 43.3 2.1 18.24 56.2 42.0 1.7 18.03 55.9 42.3 1.8 18.08
Central
Chhattisgarh 64.4 31.9 3.7 17.99 65.4 33.5 1.1 17.70 65.2 33.2 1.5 17.75
Madhya Pradesh 60.8 38.2 1.0 17.66 65.7 32.1 2.2 19.30 64.5 33.6 1.9 18.90
East
Bihar 61.0 36.0 3.1 18.20 69.0 30.0 1.0 17.30 68.0 30.7 1.3 17.41
Jharkhand 58.7 36.9 4.5 18.20 66.5 30.7 2.7 17.33 64.8 32.1 3.1 17.52
Odisha 55.5 37.8 6.7 19.08 66.4 31.8 1.8 17.52 64.5 32.8 2.6 17.78
West Bengal 51.8 40.5 7.6 19.00 60.6 36.4 3.0 17.85 58.1 37.6 4.4 18.19
Northeast
Arunachal Pradesh 45.3 53.9 0.8 17.96 62.1 35.2 2.8 17.14 56.4 41.5 2.1 17.42
Assam 56.2 37.2 6.5 18.93 61.7 35.7 2.6 18.04 60.9 35.9 3.2 18.17
Manipur 51.6 44.6 3.8 18.92 55.6 43.7 0.7 18.31 54.3 44.0 1.7 18.50
Meghalaya 31.0 55.8 13.2 20.84 44.3 50.9 4.8 18.89 40.3 52.3 7.3 19.47
Mizoram 36.8 57.6 5.6 24.80 32.5 63.7 3.8 20.05 35.2 59.8 5.0 23.04
Nagaland 56.0 42.4 1.6 17.99 52.4 46.9 0.7 18.46 53.7 45.2 1.0 18.28
Sikkim 40.8 51.1 8.1 20.35 36.9 56.0 7.0 20.07 37.9 54.8 7.3 20.14
Tripura 59.8 32.1 8.0 18.50 44.3 47.6 8.1 19.32 47.8 44.1 8.1 19.13
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State
Urban Rural Total
Body Mass Index (BMI) in kg/m2
Mean
BMI
Body Mass Index (BMI) in kg/m2
Mean
BMI
Body Mass Index (BMI) in kg/m2
Mean
BMI
Under-
weight
(<18.5)
Normal
(18.5-
24.9)
Overweight/
obese
(≥25.0)
Under-
weight
(<18.5)
Normal
18.5-
24.9)
Overweight
/obese
(≥25.0)
Under-
weight
(<18.5)
Normal
(18.5-
24.9)
Overweight/
obese
(≥25.0)
West
Rajasthan 64.5 30.8 4.7 17.99 77.3 21.6 1.1 16.80 74.4 23.7 1.9 17.07
Goa 75.2 21.1 3.7 16.55 72.1 25.4 2.5 17.11 74.0 22.8 3.2 16.77
Gujarat 63.2 29.5 7.2 18.68 66.1 30.6 3.3 17.19 64.9 30.1 5.0 17.83
Maharashtra 64.5 31.7 3.8 18.01 64.7 30.5 4.8 18.20 64.6 31.1 4.4 18.12
South
Andhra Pradesh 65.8 22.6 11.6 19.80 70.4 23.0 6.6 17.98 68.7 22.9 8.4 18.65
Karnataka 65.9 29.0 5.1 18.10 69.7 27.8 2.5 17.74 68.3 28.2 3.4 17.88
Kerala 57.8 38.8 3.4 17.99 52.5 46.1 1.4 18.09 54.6 43.1 2.2 18.05
Tamil Nadu 47.7 43.0 9.3 19.32 52.2 41.2 6.7 19.08 50.1 42.0 7.9 19.19
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6.6 ROLE OF ANGANWADI CENTRES
With the objective to improve the nutritional status of children in the age-group 0-6 years the ICDS
Programme provides supplementary food to all the children below age six years. In AWCs, all children
below three years of age are weighed once in a month and children aged 3-6 are weighed once in three
months. AWWs are trained to plot the weight of children in growth chart, classify the children according
to nutritional status and counsel the mothers.
Table 6.18 provides data on role of AWCs in providing deworming medicine and weight monitoring
according to selected characteristics of children. It may be noted that the percentages not only reflect
the role AWCs play in providing these services to young children, but also reflect the extent to which
AWC services are utilized by people. Little more than one-half (51 percent) of those children who
received deworming medicine in six months prior to the survey, received it in AWCs. Among those
children who had a growth chart and weighed in the three months preceding the survey, 59 percent
were weighed in AWCs and in case of 25 percent of the children who were weighed; mother had
discussion with AWW on nutritional status of the child.
There is no difference in the extent to which all the AWC services were provided to male and female
children. In rural areas, AWCs are playing a major role in providing various child health related services.
Majority of the children in rural areas received deworming medicine (62%) from AWCs. Seventy-two
percent of the children in rural areas, who had a growth chart and weighed in the three months
preceding the survey, were weighed in AWCs. The proportions of children in rural areas for whom
different services were availed from AWCs were almost twice of those in urban areas. AWCs are playing
a major role in providing services to the children from socially and economically disadvantaged children.
The proportions of children from STs, children whose mother had less education and children from the
lower wealth quintiles for whom different services were availed from AWCs were much higher in
comparison to their respective counterparts. For example, among the ST children, 69 percent received
deworming medicine from AWC and 78 percent of those who were weighed, were weighed in AWC.
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Table 6.18: Role of AWC in child nutrition by state
Percentage distribution of children according to various services received from AWC for Child Nutrition, by
selected characteristics.
Characteristics
Deworming Medicine Weight and Growth
Aged 6-59 Months Aged 0-71 Months Percentage of children who
received deworming
medicines from AWC in the 6
months preceding the survey
Number of children received
deworming medicines in 6
months preceding the survey
Percentage of children
weighed last in an AWC in 3
months preceding the
survey
Percentage of children whose
mother had discussion with
AWW on nutritional status
of the child
Number of children
weighed in last 3
months
Sex of the Child
Male 51.0 12,113 57.5 24.3 5,305 Female 51.1 10,897 61.6 25.1 4,719
Residence
Urban 30.3 7,693 35.7 16.6 3,254
Rural 61.5 15,317 70.8 28.5 6,770 Mother education
No Education 65.4 5,689 76.8 27.7 1,776 Below Primary 54.5 1,257 73.1 22.5 522 Completed Primary 58.6 3,872 70.3 31.6 1,756 Completed Middle 51.1 3,736 63.8 25.8 1,598 Completed Secondary 47.1 3,789 55.2 24.6 1,878 Completed Higher
Secondary and above 29.7 4,667 37.0 17.3 2,494
Religion
Hindu 55.0 18,243 61.5 25.7 8,307
Muslim 33.6 3,408 47.7 18.1 1,226 Christian 35.6 695 51.2 22.0 334 Sikh 37.6 160 (37.8) (11.1) 40 Jain 47.0 70 * * 19 Buddhist 59.6 324 71.1 43.2 68 No religion * 15 * * 5 Other 33.6 97 55.1 11.9 39
Social Group
Scheduled Caste 59.5 4,095 64.3 26.4 1,929
Scheduled Tribe 69.1 2,684 78.3 36.0 1,191 OBC 51.3 8,544 58.3 24.3 3,930 Others 40.9 7,411 49.6 19.7 2,863 Do Not Know 16.4 275 66.7 10.0 111
Wealth Index
Lowest 69.9 3,879 81.1 29.0 1,475
Second 61.1 4,282 73.4 30.2 1,770 Middle 55.4 4,779 70.5 31.6 2,165 Fourth 45.4 5,308 52.7 22.5 2,372 Highest 28.7 4,762 30.6 12.9 2,242
Total 51.1 23,010 59.4 24.6 10,024
( ) Based on 25-49 unweighted cases. * Percentage not shown; based on fewer than 25 unweighted cases.
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The state-wise percentages of utilization of AWC services for various purposes are shown in Table
6.19. There is a large variation in the percentage of children who received deworming medicine from
AWCs. In Meghalaya, Manipur and Nagaland among those children who received deworming
medicine, less than two percent received it in AWCs, whereas in Madhya Pradesh (84 percent),
Odisha (85 percent) and Rajasthan (82 percent) more than three-fourths of them received it in
AWCs.
It was already pointed out that AWCs are playing a major role in weight monitoring, as majority (59
percent) of those children who had a growth chart and weighed in the three months preceding the
survey, were weighed at AWCs. In many states like Mizoram (88 percent), Chhattisgarh (90 percent),
Odisha (86 percent), Jharkhand (80 percent) and Himachal Pradesh (80 percent) more than four-fifth
of the children who were weighed, were weighed at AWCs.
The preceding discussion points out that overall, in many states—Nagaland, Mizoram, Assam,
Jammu & Kashmir, Meghalaya, Manipur and Uttarakhand—AWCs are playing minimal role in
providing preventive and curative health care services to children and their growth monitoring. On
the contrary, in Jharkhand, Chhattisgarh, Gujarat and Andhra Pradesh they are playing relatively
larger role. Even in Bihar and Madhya Pradesh they are playing a role in providing preventive and
curative health care services to children and growth monitoring.
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Table 6.19: Role of AWC in child nutrition by state
Percentage distribution of children according to various services received from AWC for Child Nutrition, by
state
State
Deworming Medicine Weight and Growth
Aged 6-59 Months Aged 0-71 Months
Percentage of children who received
deworming medicines from AWC in
the 6 months preceding the survey
Percentage of children
weighed last in an AWC
in 3 months preceding
the survey
Percentage of children whose
mother had discussion with AWW
on nutritional status of the child
India 51.1 59.4 24.6
North
Delhi 32.5 9.1 7.4
Haryana 46.4 44.3 12.7
Himachal Pradesh 68.2 79.6 42.7
Jammu & Kashmir 6.8 (12.5) (9.4)
Punjab 23.4 (27.0) (18.9)
Uttar Pradesh 44.5 36.1 16.3
Uttarakhand 12.7 16.3 4.9
Central
Chhattisgarh 48.6 90.3 44.4
Madhya Pradesh 83.5 73.2 47.9
East
Bihar 46.6 62.9 23.3
Jharkhand 74.3 79.6 51.6
Odisha 85.0 86.0 24.1
West Bengal 7.7 52.1 11.7
Northeast
Arunachal Pradesh 17.8 (51.7) (24.1)
Assam 25.1 21.1 2.5
Manipur 1.5 * *
Meghalaya 2.8 9.2 3.3
Mizoram 16.1 87.9 8.6
Nagaland 1.6 * *
Sikkim 16.8 60.8 53.5
Tripura 27.3 51.5 37.2
West
Rajasthan 82.1 39.5 11.2
Goa 22.1 43.0 23.1
Gujarat 57.2 63.2 36.1
Maharashtra 55.5 72.0 31.6
South
Andhra Pradesh 60.5 71.1 28.1
Karnataka 52.9 55.8 22.9
Kerala 12.3 27.1 12.4
Tamil Nadu 24.8 42.7 20.4
( ) Based on 25-49 unweighted cases. * Percentage not shown; based on fewer than 25 unweighted cases.
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CHAPTER 7 UTILIZATION OF ICDS SERVICES
7.1 BACKGROUND
Under the ICDS programme, a package of six services are provided through Anganwadi centres
(AWC), comprising supplementary food, immunization, health check-up, referral services, pre-school
non-formal education and nutrition and health education. Supplementary food includes
supplementary feeding, growth monitoring and promotion; and prophylaxis against vitamin A
deficiency and control of nutritional anaemia. Children below the age of six, pregnant and nursing
mothers are identified in the community by the Anganwadi worker (AWW) and are provided
supplementary feeding support. The children are weighed regularly to monitor their growth. Health
check-ups include recording of weight, immunization, management of malnutrition, treatment of
diarrhoea, de-worming etc. During health check-ups and growth monitoring, sick or malnourished
children, in need of prompt medical attention, are referred to the Primary Health Centre (PHC) or
sub-centre. The non-formal pre-school education for children aged 3-6 years is a significant input for
providing a sound foundation for learning and development of the child. Another component of the
ICDS programme is Nutrition, Health and Education (NHE) with a goal of capacity-building of women
so that they can take care of their own and child’s health, nutrition and development.
The information on awareness and utilization of relevant services provided at AWC and other related
issues were collected from the lactating mothers (for children aged 0-5 months), mothers of children
aged 6-71 months, and currently pregnant women aged 15-49 years. The data collected was
analysed and is presented in the following sections.
7.2 AWARENESS OF SERVICES AVAILABLE AT ANGANWADI CENTRE
The mothers of children aged 0-71 months were probed regarding their awareness of all the six
services available at AWCs and such a probing was also done amongst currently pregnant women
regarding the five services, which are relevant to them. The mothers and currently pregnant women
were first asked to respond spontaneously about the services provided at AWC, failing which they
were further probed by prompting. However, for the present analysis only spontaneous responses
on awareness were considered. Table 7.1 shows that among the mothers of children aged 0-71
months, 94 percent were aware of at least one service. As expected the maximum awareness was
about supplementary food (89 percent), followed by immunization (58 percent), pre-school
education (47 percent), health check-up (31 percent), nutrition and health education (18 percent)
and referral services (13 percent). Only 10 percent mothers of children aged 0-71 months were
aware of all the six services whereas about 6 percent of the mothers did not have awareness of any
service. Awareness of at least one service was more among the mothers of 36-71 months old
children (97 percent) than the mothers of 0-35 months-old children (90 percent). Even by type of
services provided at AWC, a higher proportion of mothers of 36-71 months children were aware of
services like supplementary food, immunization and pre-school education as compared to mothers
of 0-35 months-old children. About 93 percent of currently pregnant women were aware about at
least one of the five services about which they were probed.
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Table 7.1: Awareness of services provided at AWC
Percentage of mothers of children aged 0-35 months, 36-71 months, 0-71 months and currently pregnant
women aged 15-49 years covered by an AWC, aware of various services provided at AWC, RSOC 2013-14.
Services
Mothers of
children aged
0-35 months
Mothers of
children aged
36-71 months
Mothers of
children aged
0-71 months
Currently
pregnant
women
Percentage aware of any services 90.2 96.6 94.0 93.4
Services provided at AWC
Supplementary food 85.1 91.0 88.5 87.7
Immunization 57.4 59.8 58.4 59.6
Pre-school Education* 41.7 49.9 46.6 -
Health Check-up 29.4 30.5 30.6 29.9
Referral Services 12.2 13.4 13.2 11.0
Nutrition and Health education 17.2 18.6 18.3 16.5
Percentage not aware of any services 9.8 3.4 6.0 6.6
Percentage aware of all the 6 services 9.3 9.7 9.5 8.3
Number of women 44,485 42,944 70,209 5,247
* Awareness of preschool education was not asked to currently pregnant women
Table 7.2 shows that awareness of at least one service was more among the rural mothers of 0-71
month’s old children (95 percent) than their counterparts from the urban areas (90 percent). This
may be due to the fact that ICDS services are primarily given in rural areas and urban slums. The
awareness of any service was the lowest among mothers aged 15-19 years and it increased gradually
with the age of the mother. A little higher proportion of mothers belonging to the lowest wealth
quintile were aware of at least one service (95 percent) than the mothers from the highest quintile
(91 percent). This may be because mostly the mothers belonging to the lowest quintiles are
dependent on AWC services. However, no differential in awareness of at least one service was seen
among mothers by their religious affiliations and social group composition. Tables 7.3 to 7.6 given
in Annexure-A present awareness by different services for mothers of children aged 0-35 months,
mothers of children aged 36-71 months, mothers of children aged 0-71 months and in respect of
currently pregnant women by few select characteristics. Analysis based on these tables further
shows that a higher proportion of mothers from the lowest quintile were aware of the
supplementary food from AWC. On the contrary, awareness of other services such as immunization,
pre-school education and health check-up from AWC was more amongst the mothers from the
highest quintile.
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Table 7.2: Awareness of services provided at AWC (any service)
Percentage of mothers of children aged 0-35 months, 36-71 months, 0-71 months and currently pregnant
women aware of any services provided at AWC by background characteristics, RSOC, 2013-14.
Characteristics
Aware of any services
Percentage Mothers of
children 0-35 months
Number of
mothers
Percentage Mothers of children 36-71 months
Number of
mothers
Percentage Mothers of children 0-71 months
Number of
mothers
Percentage Currently pregnant women
Number of
currently pregnant women
Age
15-19 91.6 1,349 99.1 140 93.0 1,419 94.1 240
20-24 91.4 16,634 96.0 7,889 93.2 20,211 92.7 2,352
25-29 89.7 16,824 96.1 18,312 93.7 26,880 94.2 1,905
30-34 89.0 6,615 97.2 10,254 94.9 13,661 94.7 531
35-39 88.6 2,266 97.8 4,379 95.6 5,604 87.7 182
40-44 89.0 542 97.9 1,360 96.4 1,646 (96.3) 23
45-49 92.0 256 97.9 609 97.4 788 * 14
Residence
Urban 84.1 11,853 95.3 11,176 90.3 19,093 91.3 1,205
Rural 92.5 32,632 97.1 31,767 95.4 51,116 94.0 4,042
Mother’s education
No education 90.5 14,272 96.1 16,335 94.4 23,304 92.2 1,842
Below Primary (Class - 1 to 4)
94.3 2,217 97.9 2,429 96.7 3,740 93.2 281
Completed Primary (Class 5-7)
93.2 6,904 97.7 6,873 95.8 11,003 96.3 854
Completed Middle (Class 8 -9)
91.2 7,190 96.6 6,218 94.6 10,880 94.2 817
Completed Secondary (Class 10-11)
89.4 6,268 96.4 5,404 93.3 9,747 94.4 617
Completed Higher Secondary (Class 12)
85.6 7,634 96.3 5,686 90.9 11535 91.8 836
Religion
Hindu 90.4 34,877 96.7 33,905 94.2 55,464 93.6 3,942
Muslim 89.5 7,192 95.7 6,786 93.3 10,858 92.0 1,045
Christian 88.5 1,135 97.4 1,222 93.5 1,957 97.9 118
Sikh 90.7 693 97.5 585 94.1 1,066 97.0 77
Jain 88.8 105 (97.5) 42 90.8 128 * 13
Buddhist/Neo-Buddhist
92.4 285 98.4 247 95.1 446 (90.2) 35
No religion (95.8) 31 (94.9) 26 98.3 47 * 1
Other 93.0 167 97.6 130 95.2 242 83.1 16
Social Group
Scheduled Caste 91.5 9,125 96.8 9,105 94.7 14,428 93.1 1,121
Scheduled Tribe 93.9 5,300 97.8 5,073 96.2 8,182 95.9 616
OBC 90.0 17,721 96.3 17,446 93.8 28,017 92.8 2,217
Other 88.0 11,890 96.4 10,869 92.8 18,839 93.4 1,231
No Response 93.3 450 98.7 451 96.1 743 95.2 62
Wealth index
Lowest 91.8 9,133 96.3 9,517 94.8 14,059 93.2 1,146
Second 92.3 9,419 96.9 9,345 95.4 14,739 93.0 1,183
Middle 92.8 9,358 97.3 9,129 95.6 14,916 94.4 1,115
Fourth 89.1 8,975 96.8 8,178 93.3 14,275 92.1 970
Highest 84.1 7,600 95.4 6,775 90.5 12,219 94.5 833
Total 90.2 44,485 96.6 42,944 94.0 70,209 93.4 5,247
*Percentage not shown; based on fewer than 25 unweighted cases., ( ) Percentage based on 25-49 unweighted cases
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Awareness on services provided at AWCs among mothers of children aged 0-71 months by states is
shown in Table 7.7. The table shows that the awareness of at least one service from AWC ranges
from 82 percent in Delhi to almost 100 percent in Odisha and Chhattisgarh. The awareness on
supplementary food provided by AWC was the lowest in Haryana (66 percent) and almost universal
in Odisha (99 percent). Awareness of immunization services from AWC was low (below 20 percent)
in West Bengal, Nagaland, Sikkim and Manipur and was reported high (more than 75 percent) in
Haryana, Andhra Pradesh, Rajasthan and Jharkhand.
Table 7.7: Awareness on services provided at AWC by state
Percentage of mothers of children aged 0-71 months covered by an AWC, aware of any service and specific services provided at AWC by states, RSOC, 2013-14.
State
Percentage aware of
any one of the
services
Type of Services provided at AWC Percentage
aware of all the 6 services
Supplementary Food
Immunization Pre-school Education
Health Check-
up
Referral Services
Nutrition and Health education
India 94.0 88.5 58.4 46.6 30.6 13.2 18.3 9.5 North
Delhi 81.5 76.8 59.6 47.9 35.1 13.3 16.4 8.8 Haryana 88.1 66.1 75.5 38.5 27.2 16.3 15.2 9.7 Himachal Pradesh 92.6 91.5 49.6 55.7 43.6 22.6 31.6 19.7 Jammu & Kashmir 89.3 87.4 33.5 57.5 19.8 8.7 13.8 6.6 Punjab 92.2 85.6 69.4 58.9 24.8 8.9 13.8 5.9 Uttar Pradesh 91.3 82.7 63.7 39.0 16.2 6.8 7.3 3.8 Uttarakhand 93.3 84.7 64.2 62.9 26.3 5.6 13.6 3.4
Central Chhattisgarh 99.2 97.2 57.5 33.0 19.4 3.4 8.1 1.9 Madhya Pradesh 94.6 87.0 69.9 43.3 31.5 17.6 17.9 11.4
East Bihar 92.1 79.1 68.7 50.0 14.9 8.0 10.1 3.1 Jharkhand 97.8 93.7 87.0 54.6 38.8 9.7 14.6 4.5 Odisha 99.8 99.4 30.6 22.8 17.1 2.1 2.8 1.1 West Bengal 98.3 97.5 7.8 43.4 21.6 0.8 4.2 0.4
Northeast Arunachal Pradesh 97.7 97.1 33.6 87.6 18.3 4.0 25.2 3.2 Assam 97.9 97.2 34.4 60.4 13.9 2.7 6.7 1.9 Manipur 98.1 96.5 15.9 78.5 3.3 0.8 35.7 0.1 Meghalaya 93.2 91.0 33.7 41.3 16.3 6.9 12.4 5.0 Mizoram 97.9 97.0 66.7 84.9 47.9 9.6 78.7 8.4 Nagaland 84.3 82.3 8.3 25.8 4.2 1.9 4.4 0.9 Sikkim 90.5 86.3 13.0 38.3 34.1 14.4 29.0 2.8 Tripura 98.4 96.2 68.5 71.9 29.3 5.1 28.7 2.3
West Rajasthan 97.7 93.3 82.3 53.9 24.7 4.4 7.1 2.1 Goa 95.7 94.0 40.4 48.2 29.3 5.9 15.9 3.6 Gujarat 86.7 82.5 74.2 50.1 50.8 15.5 26.1 13.0 Maharashtra 91.4 86.6 60.4 46.7 48.7 10.7 21.5 5.8
South Andhra Pradesh 98.0 93.1 78.7 59.1 57.1 40.2 53.5 30.8 Karnataka 94.1 92.5 60.2 44.9 31.8 16.4 19.7 14.0 Kerala 94.5 87.5 65.3 65.8 49.9 29.7 40.7 25.4 Tamil Nadu 92.4 86.8 44.6 36.7 33.7 27.1 33.5 24.6
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7.3 UTILIZATION OF AWC SERVICES
The mothers of children aged 0-71 months and currently pregnant women were first asked to
spontaneously report on the type of services received by them or their children from Anganwadi
centre. In case of services where they failed to give any spontaneous response, were further probed.
The analysis on utilization of services is based on both the responses and is presented in Tables 7.8
and 7.9.
Table 7.8: Utilization of AWC services
Percentage of mothers of children aged 0-5 months, children aged 6-35 months and children aged 36-71
months and currently pregnant women, availing any service, specific services and all services, RSOC, 2013-14.
Services
Mothers of
Children aged
0-5 months
Children aged
6-35 months
Children aged
36 - 71 months
Currently
Pregnant
women
Percentage availing any services from
AWC 47.8 53.6 47.5 45.9
Type of services availed
Supplementary food 42.4 49.2 44.2 40.7
Immunization 33.0 41.9 34.1 35.9
Pre-school education - - 38.7 -
Health check-up 29.6 31.7 26.7 26.7
Referral services 11.8 12.1 10.7 11.0
Nutrition and health education or
advice on feeding and care of young
children*
16.1 18.5 16.6 -
Other 6.5 4.9 5.4 2.8
Availed all services 8.2 9.1 8.1 7.0
Number of children/pregnant women
availing any service from AWC 8,469 41,181 47,873 5,247
* Not asked to pregnant women
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Table 7.8 show that 48 percent mothers of children aged 0-5 months and 46 percent currently
pregnant women reported receiving at least one service from AWC. Comparatively more children
aged 6-35 months (54 percent) or their mothers received at least one service from AWC than
children aged 36-71 months, lactating mothers and currently pregnant women. The services mostly
received were supplementary food, immunization, pre-school education and health check-up. As
regards other services such as health and nutrition education and referral services, they were
reported to be availed by less than one fifth of the mothers each. The table further shows that 8
percent lactating mothers, 9 percent children aged 6-35 months or their mothers, 8 percent children
aged 36-71 months or their mothers and 7 percent currently pregnant women reported availing all
the six services from the AWCs.
Table 7.9 shows that a higher proportion of lactating mothers (mothers of children 0-5 months) in
the rural areas (53 percent) availed at least one service from AWC than their counterparts in the
urban areas (33 percent). Almost a similar pattern was observed in case of children aged 0-35
months; children aged 36-71 months and currently pregnant women. Table 7.9 further shows that
education level of mothers has no definitive bearing on utilization of services from the Anganwadi
centres. For instance, amongst the illiterate mothers of children aged 36-71 months, 49 percent had
received at least one service from the AWCs against 31 percent amongst the children whose
mothers had completed higher secondary. Similarly, the utilization of at least one service from the
AWCs had an inverse relationship with the rise in wealth index. Against 57 percent children aged 36-
71 months using at least one service from the AWCs from the lowest wealth quintile reported, the
corresponding percentage from the highest quintile was just 28 percent. Similar patterns were also
observed in the utilization of services from the AWCs amongst other beneficiary groups. Tables 7.10
to 7.13 in Annexure-A provide the details of type of services by background characteristics for
different beneficiary groups.
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Table 7.9: Utilization of AWC services (any service)
Percentage among mothers of children aged 0-5 months, children aged 6-35 months and 36-71 months and currently pregnant women residing in the area being covered by AWC, availing any service by background characteristics, RSOC, 2013-14.
Characteristics
Percentage availing any services from AWC
Mothers
of
Children
aged 0-5
months
Number
of
mothers
Children
aged 6-35
months
Number
of
Children
Children
aged 36-
71
months
Number
of
Children
Currently
Pregnant
women
Number
of
currently
Pregnant
women
Residence
Urban 32.9 2,023 40.3 10,913 34.9 12,268 33.8 1,205
Rural 52.5 6,446 58.4 30,268 51.9 35,605 49.6 4,042
Mother's education
No education 47.6 2,953 52.6 13,376 48.5 18,598 44.4 1,842
Below Primary (Class - 1 to 4) 57.7 423 66.7 2,060 66.4 2,691 44.1 281
Completed Primary (Class 5-7) 53.7 1,278 61.1 6,456 54.5 7,666 48.7 854
Completed Middle (Class 8 -9) 53.3 1,297 57.2 6,678 49.1 6,875 47.9 817
Completed Secondary (Class
10-11)
44.5 1,182 51.4 5,726 42.6 5,937 47.5 617
Completed Higher Secondary
(Class 12)
37.3 1,335 43.0 6,885 30.5 6,105 44.1 836
Religion
Hindu 50.2 6,718 54.9 32,257 48.5 37,609 49.2 3,942
Muslim 39.2 1,356 48.7 6,719 44.1 7,787 32.6 1,045
Christian 36.0 185 55.2 1,028 47.1 1,342 58.3 118
Sikh 23.0 117 32.0 644 28.4 646 25.4 77
Jain * 23 (31.3) 82 (35.7) 45 * 13
Buddhist/Neo-Buddhist 45.2 41 65.3 264 59.8 266 (46.3) 35
No Religion * 6 * 26 (57.1) 31 * 1
Other 34.4 64 52.9 160 51.8 147 53.5 16
Social Group
Scheduled Caste 51.3 1,801 57.0 8,436 49.6 10,193 47.4 1,121
Scheduled Tribe 59.2 1,041 65.7 4,893 60.6 5,665 60.5 616
OBC 46.4 3,373 50.2 16,583 43.1 19,520 43.0 2,217
Other 41.3 2,171 50.1 10,837 46.1 11,994 41.8 1,231
Do Not Know 59.9 83 68.3 431 64.8 502 60.7 62
Wealth index
Lowest 59.3 1,909 62.0 8,446 57.1 10,749 50.6 1,146
Second 51.0 1,877 59.2 8,824 55.3 10,533 48.2 1,183
Middle 48.5 1,778 57.5 8,716 49.7 10,191 49.2 1,115
Fourth 41.6 1,581 49.3 8,390 40.9 9,046 46.3 970
Highest 33.3 1,324 36.3 6,804 27.7 7,353 31.5 833
Total 47.8 8,469 53.6 41,181 47.5 47,873 45.9 5,247
*Percentage not shown; based on fewer than 25 unweighted cases. ( ) Percentage based on 25-49 unweighted cases
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Tables 7.14-7.17 given in Annexure-A present the state-wise utilization of services across different
groups, i.e., lactating mothers, children aged 6-35 months, children aged 36-71 months and currently
pregnant women.
As is seen from these tables, there is a wide variation among the states by different types of services
availed from AWC. Figure 7.1 portrays such a variation for utilization of at least one service from
AWC among the children aged 36-71 months. It ranged from 14 percent in Nagaland to 79 percent in
Tripura. There are 13 states wherein the level of utilization of at least one service is below the
national average (48 percent). The states reporting higher percentage of children utilizing at least
one Anganwadi service were Tripura (79 percent), Assam (75 percent), West Bengal (74 percent),
Gujarat (72 percent) and Manipur (71 percent). States reporting low utilization of at least one service
from AWC were Nagaland (14 percent), Delhi (14 percent), Punjab (21 percent), Haryana (21
percent), Rajasthan (23 percent) and Uttar Pradesh (24 percent).
Figure 7.1: Percentage of children aged 36-71 months availing any service from AWC
When analysed by individual services, almost a similar variation is observed in terms of utilization of
supplementary food and pre-school education amongst children aged 36-71 months. The top five
states in terms of utilization of supplementary food were Tripura (79 percent), Assam (73 percent),
Manipur (71 percent), Gujarat (70 percent) and West Bengal (70 percent) whereas the bottom five
states were Delhi (14 percent), Nagaland (14 percent), Haryana (18 percent), Punjab (21 percent)
and Rajasthan (22 percent). As regards utilization of pre-school education services, it ranged
between Nagaland reporting the minimum (2 percent) and Gujarat, the maximum (60 percent). Such
variations were also observed in other category of respondents namely, lactating mothers (Table
7.14); children aged 6-35 months (Table 7.15) and currently pregnant women (Table 7.17).
79 75 74 72 71 69 68
64 64 63 63 62 58 57
49 48 48 47 42
38
30 29 27 26 24 23 21 21
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7.4 REASONS FOR NOT AVAILING AWC SERVICES
At the national level, around half of the respondents residing in areas covered by AWC (lactating
mothers: 52 percent; mothers of children aged 6-35 months: 46 percent; mothers of children aged
36-71 months: 53 percent; and currently pregnant women: 54 percent) reportedly did not avail any
service from AWCs. The corresponding proportions were higher in the urban areas as compared to
the rural areas.
Table 7.18: Non-utilization of AWC services by beneficiaries
Percentage of lactating mothers, mothers of children aged 6-35 months, children aged 36-71 months and currently pregnant women residing in area covered by AWC, who did not avail any service from AWC, RSOC, 2013-14.
Characteristics
Urban Rural Total
Mothers of children aged (in months)
Pregnant woman
Mothers of children aged (in months)
Pregnant woman
Mothers of children aged (in months)
Currently Pregnant women 0-5 * 6-35 36-71 0-5 * 6-35 36-71 0-5 * 6-35 36-71
Percentage not availing any services from AWC
67.1 59.7 65.1 66.2 47.5 41.6 48.1 50.4 52.2 46.4 52.5 54.1
Number living in an area covered by an AWC
2,023 10,913 12,268 1,205 6,446 30,268 35,605 4,042 8,469 41,181 47,873 5,247
* Mothers with children aged 0-5 months are lactating mothers
The respondents who did not receive any service from AWCs were further probed about the reasons
for not availing the services. Table 7.19 shows that the majority of the respondents across the four
categories cited, ‘Did not feel the need of services from AWC’ as the reason. This was followed by
‘AWC is far off’, ‘Quality of services not up to the mark’ and ‘AWW’s/AWH’s behaviour is bad’.
Table 7.19: Non-utilization of AWC services by beneficiaries (reasons)
Percentage of lactating mothers, mothers of children aged 6-35 months, mothers of children aged 36-71 months and currently pregnant women residing in AWC area, who reported not taking any service from AWC by reasons for non-utilization, RSOC, 2013-14.
Reasons Mothers of children aged Currently
Pregnant women
0-5 months 6-35 months 36-71 months
Quality of services not up to the mark/good 8.6 8.6 7.8 6.2 Did not feel the need of services from AWC 22.6 23.2 22.5 19.0 Nobody to accompany the child/me 6.3 8.8 7.9 5.1 AWW's/AWH’s behaviour is bad 6.7 7.2 8.7 10.0 I feel me/my child is discriminated 4.1 4.3 2.8 3.9 AWC is far off 12.8 14.2 15.8 12.4
Number not availing any services from an AWC 4,419 19,106 25,114 2,837
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7.5 REASONS FOR NOT AVAILING SUPPLEMENTARY FOOD
The respondents who received at least one service from AWC but did not receive supplementary
food were probed about the reasons for the same as supplementary food forms the most basic and
essential service. Table 7.20 shows that of those who were availing at least one service from AWC at
the national level around 11 percent lactating mothers, 8 percent children aged 6-35 months, 7
percent children aged 36-71 months and 11 percent currently pregnant women did not avail
supplementary food. The major reasons cited for not receiving supplementary food is ‘Food is not
distributed in AWC’ in case of lactating mothers (12 percent) and children aged 6-35 months (19
percent), ‘Not aware that mother/child is eligible to get food from AWC’ for children aged 36-71
months, and ‘Do not need food from AWC’ in case of currently pregnant women (27 percent). As is
seen from the table 7.20, there are other concomitant reasons also, mostly emanating from supply
side issues, which prevent the beneficiaries from availing the benefits of supplementary food.
Table 7.20: Reasons for not availing supplementary food
Percentage of mothers of children aged 0-5 months, children aged 6-35 months, children aged 36-71 months and currently pregnant women covered by an AWC, who reported not availing supplementary food from AWC by reasons thereof , RSOC 2013-14
Reasons Mothers of
children aged 0-5 months
Children 6-35 months
Children 36 - 71 months
Currently Pregnant women
Percentage not taking supplementary food from AWC
11.2 8.1 7.1 11.3
Number who received at least one service from AWC
4,050 22,075 22,758 2,410
Reasons for not taking supplementary food
AWC often remains closed 2.9 3.4 5.9 11.0
AWC far away from home 9.9 10.1 13.3 16.2
Food is not distributed in AWC 12.4 18.8 12.6 0.0
Supplementary food is out of stock for most of the days
4.4 4.9 6.8 0.0
Quality of food provided at AWC is generally not edible
2.4 2.9 3.7 11.9
Mother/my child does not like AWC food 3.1 4.4 5.6 0.0
Do not need food from AWC 5.7 7.4 6.8 26.6
Family members oppose 2.7 2.0 1.0 0.0
Unable to go to AWC for receiving food as all are working people
7.0 16.4 7.3 0.0
Not aware about food supplementation at AWC
10.2 8.4 8.2 0.0
Not aware that mother/child is eligible to get food from AWC
6.9 13.2 17.7 0.0
Feel mother/child is discriminated 7.8 6.6 2.4 12.9
Treatment at AWC not well 0.0 0.0 0.0 11.7
Number not taking supplementary food 455 1,793 1,617 272
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7.6 TYPE OF SUPPLEMENTARY FOOD PROVIDED AT AWC
There are different types of food provided in AWCs under ICDS programme and it varies for different
target groups depending upon the place of serving and also in order to meet their specific
requirements. These are—hot cooked meal (HCM), ready to eat (RTE), take home ration (THR) and
morning snacks.
Beneficiary Type of supplementary food suggested/provided under ICDS
Children 6-35 months THR/RTE (Take Home Ration/Ready to Eat)
Children 36-71 months HCM (Hot Cooked Meal) and Morning Snacks
Pregnant and Lactating Women THR (Take Home Ration)/RTE (Ready to Eat)
It is observed that the type of supplementary food given to different target groups is not uniform
across the states.
Table 7.21 presents type of supplementary foods received by the lactating mothers and children
aged 6-71 months according to their background characteristics. Around 42 percent of the lactating
mothers reported to have received supplementary food. The proportion of children aged 6-35
months and 36-71 months receiving supplementary food from AWC was 49 percent and 44 percent
respectively. As expected, utilization of supplementary food is better in the rural areas than in the
urban areas. There do not seem to be any definitive differential in utilization basis education level of
mothers. Lactating mothers as well as children aged 6-71 months belonging to SC and ST categories
were availing supplementary food in a higher proportion as compared to their counterparts
belonging to OBC and Others categories.
With regard to wealth quintiles, the receipt of supplementary food from AWC is negatively
correlated with the rise in wealth index. For instance, 53 percent lactating mothers from the lowest
wealth quintile reported receiving supplementary food from AWC against 27 percent from the
highest wealth quintile. Similarly, a higher proportion of children aged 36-71 months from the
lowest quintile (54 percent) received supplementary food as compared to their counterparts from
the highest quintile (24 percent).
As per the laid down standard, HCM is prescribed for children aged 36-71 months. However, it is
seen that only 88 percent children aged 36-71 months received HCM. Close to 25 percent children of
36-71 months age-group had received RTE/THR or a combination of HCM and RTE/THR during the
month under reference. Deviating from the prescribed protocol, 27 percent lactating mothers and
39 percent children aged 6-35 months had received HCM. More than two-thirds lactating mothers
(79 percent) and children aged 6-35 months (70 percent) received THR.
The reasons for such deviations could be many and this study has not probed into this matter
deeply. However, one can attribute this mainly to the delay in replenishment of ingredients of HCM
in the AWCs. It was reported by a few AWWs that whenever, stock of the main ingredients are not
replenished in time; children are fed with THR or RTE food item available in the AWC.
Further only 22 percent children aged 36-71 months reportedly received morning snacks. There
were no rural urban differentials in the type of food received by lactating mothers and children aged
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36-71 months. However, more children aged 6-35 months from urban areas (43 percent) received
HCM than children from rural areas (37 percent).
State-wise analysis on utilization of supplementary food from AWC and types of food thereof for
children aged 6-35 months and 36-71 months is given in Table 7.22 given in Annexure-A.
State-wise analysis on utilization of supplementary food and services provided at AWC for lactating
women (mothers with child aged 0-5 months) and pregnant women is given in Table 7.23 in
Annexure-A.
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Table 7.21: Supplementary food received by children Percentage of mothers of children aged 0-5 months, children aged 6-35 months and 36-71 months covered by AWCs, by receipt of supplementary food and type of food received, by selected background characteristics, RSOC 2013-14
Characteristics
Children aged 0-5 months Children aged 6-35 months Children aged 36-71 months
Percentage received
Supplementary food
Number* HCM RTE/ THR
Number@
Percentage received
Supplementary food
Number* HCM RTE/ THR
Number@
Percentage received
Supplementary food
Number* HCM RTE/ THR
Morning Snacks
Number@
Residence Urban 28.7 2,023 27.6 76.0 579 36.7 10,913 43.1 66.3 4,000 31.1 12,268 88.5 25.4 19.7 3,816 Rural 46.7 6,446 26.6 79.0 3,009 53.8 30,268 37.3 70.6 16,259 48.7 35,605 87.7 24.4 22.1 17,323
EMW's education No Education 41.4 2,953 20.7 84.5 1,224 47.0 13,376 34.0 74.9 6,280 45.2 18,598 85.7 26.1 20.8 8,404 Below Primary (Class 1 - 4)
54.0 423 32.6 72.8 229 63.2 2,060 45.1 61.5 1,303 63.3 2,691 93.5 17.3 24.8 1,704
Completed Primary (Class 5-7)
48.1 1,278 29.6 76.3 613 57.4 6,456 40.1 68.3 3,704 50.9 7,666 89.9 22.5 22.0 3,902
Completed Middle (Class 8 -9)
48.4 1,297 30.3 74.1 627 52.7 6,678 42.0 65.7 3,516 45.2 6,875 88.5 25.4 22.7 3,109
Completed Secondary (Class 10-11)
39.7 1,182 29.1 75.3 470 47.3 5,726 41.3 66.8 2,707 39.7 5,937 89.7 22.1 19.7 2,356
Completed H.S. and above(Class 12+)
31.8 1,335 28.7 77.9 425 39.9 6,885 35.9 71.9 2,750 27.2 6,105 83.8 30.6 22.4 1,664
Social Group Scheduled Caste 46.7 1,801 23.8 78.8 841 53.0 8,436 37.9 69.8 4,470 46.6 10,193 87.3 23.6 19.6 4,747 Scheduled Tribe 53.8 1,041 21.0 86.3 559 62.8 4,893 34.5 76.5 3,071 57.9 5,665 91.2 23.5 27.4 3,278 OBC 40.4 3,373 19.8 85.8 1,363 45.1 16,584 30.1 78.2 7,481 39.1 19,520 84.6 28.8 21.9 7,635 Other 35.9 2,171 42.4 64.2 780 45.7 10,837 51.6 55.6 4,955 43.0 11,994 90.3 21.2 20.0 5,160 Don’t know 53.6 83 (75.0) (25.0) 32 65.6 431 82.3 20.9 283 63.5 502 98.4 3.6 11.0 319
Wealth index Lowest 53.1 1,909 18.6 85.1 1,014 57.0 8,446 34.6 72.3 4,811 53.7 10,749 87.9 20.7 20.7 5,770 Second 46.4 1,877 30.5 75.9 871 54.9 8,824 37.6 69.3 4,846 52.3 10,533 89.2 23.9 22.1 5,507 Middle 43.8 1,778 33.4 73.0 779 53.2 8,716 42.2 66.1 4,634 46.3 10,191 87.7 25.2 20.6 4,719 Fourth 35.9 1,581 25.6 80.0 567 45.3 8,391 41.6 69.0 3,796 37.3 9,046 88.5 26.4 22.8 3,377 Highest 26.8 1,324 27.9 75.9 355 32.0 6,804 35.4 74.4 2,172 24.0 7,353 82.7 33.7 23.7 1,766
Total 42.4 8,469 26.7 78.5 3,587 49.2 41,181 38.5 69.8 20,259 44.2 47,873 87.8 24.5 21.6 21,139
( ) Percentage based on 25-49 unweighted cases. HCM=Hot Cooked Meal, RTE=Ready To Eat, THR=Take Home Ration. * Number of children residing in area covered by AWC, @ Number of children
received supplementary food.
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Figure 7.2 presents the proportion of children aged 36-71 months who received supplementary food from AWCs
by states. The percentage of such children ranged from 78 percent in Tripura to 14 percent in Delhi. The
percentage of children aged 36-71 months receiving supplementary food was higher than the national average
in all the north-eastern states except for Nagaland. In fourteen states, the proportion was lesser than the
national average.
Figure 7.2: Percentage of children aged 36-71 months who received supplementary food, by states
7.7 REGULARITY OF RECEIVING SUPPLEMENTARY FOOD
The mothers and currently pregnant women were further asked about the number of days they or their children
received supplementary food from AWCs in one month prior to the survey. The analysis is presented in Table
7.24. It shows that one-fifth of the lactating mothers, 21 percent of the children aged 6-35 months, 31 percent
children aged 36-71 months and 28 percent pregnant women reported receiving supplementary food for 21 or
more days. While the receipt of the supplementary food was reported by a slightly higher proportion of lactating
mothers in the rural areas (21 percent) as compared to the urban areas (19 percent). However, in case of
children in the age group 6-35 months and 36-71 months and currently pregnant women, it was more in the
urban areas than in the rural areas. The average number of days on which supplementary food was received
from AWCs also varies across different beneficiaries. It varied from 11 days for lactating mothers, 12 days for
mothers of children aged 6-35 months and 16 days in case of children aged 36-71 months. Pregnant women, on
an average, received supplementary food for 14 days. The details on these by select characteristics are
presented in Tables 7.25-7.28 given in Annexure-A.
78 73 71 70 70 69 67
63 61 61 60
52 52 48 47 44 43 42 42
36
29 27 27 24 23 22 21 18 14 14
Trip
ura
Ass
am
Man
ipu
r
Gu
jara
t
Wes
t B
enga
l
Miz
ora
m
Od
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a
Aru
nac
hal
Pra
des
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Meg
hal
aya
Mah
aras
htr
a
Ch
hat
tisg
arh
An
dh
ra P
rad
esh
Sikk
im
Mad
hya
Pra
des
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Kar
nat
aka
Ind
ia
Bih
ar
Him
ach
al P
rad
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Go
a
Ker
ala
Jam
mu
& K
ash
mir
Jhar
khan
d
Tam
il N
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and
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a
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Del
hi
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Table 7.24: Frequency of receiving supplementary food
Percentage of mothers of children aged 0-5 months, children aged 6-35 months, children aged 36-71 months and currently
pregnant women covered by an AWC reported to have received supplementary food from AWC for 21 days or more and
the average number of days of receipt in one month preceding the survey by place of residence, RSOC, 2013-14.
Residence
Mothers of child 0-5
months Child 6-35 months Child 36-71 months Pregnant women
Percentage Number Percentage Number Percentage Number Percentage Number
Received supplementary food for 21 or more days
Rural 20.5 3,011 20.5 16,256 30.9 17,325 27.0 1,778
Urban 18.9 580 24.3 3,999 31.7 3,816 31.4 359
Total 20.3 3,590 21.3 20,255 31.0 21,140 27.8 2,137
Average Number of days received Supplementary Food
Average Number Average Number Average Number Average Number
Rural 10.7 2,735 11.3 13,475 15.7 16,159 13.6 1,543
Urban 9.6 531 12.4 3,381 15.1 3,570 14.7 303
Total 10.5 3,266 11.5 16,856 15.6 19,729 13.8 1,847
7.8 SUPPLEMENTARY FOOD CONSUMPTION PATTERN
A question was asked to the mother receiving food from AWC about the quantum of food consumed by her or the child. There were four options to this question.
a. Entire stuff/quantity b. Shared with other siblings/family members c. He/she does not like the food and so does not consume at all d. Cannot say/Don’t remember
The question was asked with the intention to understand whether mothers, children and currently pregnant
women liked the food supplied from the AWC. However, the options to this question may have several
interpretations. Table 7.29 presents percentage distribution of mothers of children aged 0-5 months according
to consumption pattern of the supplementary food received from the AWCs and by select background
characteristics. Nearly one-third (32 percent) of the lactating mothers reported consuming the entire food
received and another 48 percent shared it with other family members and 12 percent did not like the taste,
hence, did not consume the food at all. An analysis by residence shows that the proportion of lactating mothers
reporting consumption of entire quantity was slightly higher in the urban areas (35 percent) as compared to
those in the rural areas (32 percent). On the other hand, a higher proportion of lactating mothers (49 percent) in
the rural areas reported the practice of sharing with other members in the family when compared with the
mothers (44 percent) in the urban areas. Analysis by different levels of wealth indices shows that the practice of
sharing supplementary food with other family members was more common among mothers belonging to the
lowest wealth index (56 percent) and it decreased with the increase in index value.
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Table 7.29: Supplementary food consumed by mothers of children aged 0-5 months
Percentage distribution of mothers of children aged 0-5 months according to pattern of consumption of the foods received
from AWC by background characteristics, RSOC, 2013-14.
Characteristics
Consumption of supplementary food Number of mothers of children aged 0-5 months receiving
supplementary food from AWC
Entire stuff/quantity
Shared with other siblings/family
members
Does not like the food and so does not
consume at all
Can't say/Don’t remember
Mother of children 0-5 months
32.1 48.0 11.6 8.3 3,589
Residence Urban 34.9 44.3 11.4 9.4 580 Rural 31.5 48.7 11.7 8.1 3,009
Wealth index Lowest 28.5 55.7 7.4 8.4 1,014 Second 33.6 47.9 10.8 7.7 872 Middle 35.2 46.7 10.3 7.8 779 Fourth 33.0 39.2 17.9 9.9 568 Highest 30.2 42.9 18.7 8.1 355
Table 7.30: Supplementary food consumed by children aged 6-35 months
Percentage distribution of children aged 6-35 months according to pattern of consumption of the foods received from AWC
by background characteristics, RSOC, 2013-14.
Characteristics Consumption of supplementary food Number of mothers of children aged 6-35
months receiving supplementary food
from AWC
Entire stuff/qua
ntity
Shared with other
siblings/family members
Does not like the food and so does not
consume at all
Can't say/Don’t remember
Children aged 6-35 months 31.1 52.4 9.7 6.7 20,272 Residence
Urban 33.5 49.9 11.0 5.6 4,000 Rural 30.5 53.0 9.4 7.0 16,272
Wealth index Lowest 25.6 61.8 6.7 5.8 4,817 Second 28.3 54.3 9.7 7.6 4,847 Middle 35.6 47.8 10.4 6.1 4,637 Fourth 36.4 45.6 10.4 7.5 3,797 Highest 30.5 48.9 13.4 7.0 2,175
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Table 7.30 presents percentage distribution of children aged 6-35 months according to consumption of the
supplementary food received from AWC by background characteristics. Around 31 percent children aged 6- 35
months reportedly consumed the entire quantity of supplementary food received from the AWC and 52 percent
shared the food with other siblings/family members in the house. There were 10 percent children who reported
that they did not like the taste of the supplementary food hence did not consume it at all. The proportion of
children consuming entire quantity of food was slightly higher in the urban areas (34 percent) as compared to
those in the rural areas (31 percent). Analysis across children belonging to different wealth indices shows that
the practice of sharing supplementary food with other family members or siblings was more common among
children belonging to the lowest wealth index (62 percent) and it gradually decreased with increase in wealth
indices.
Table 7.31 presents percentage distribution of children aged 36-71 months according to consumption pattern of
supplementary food received from AWC by background characteristics. While analysing the data, those children
who ate supplementary food at AWC were considered to be consuming the entire quantity of supplementary
food. Around 79 percent children aged 36-71 months reportedly consumed the entire quantity of
supplementary food given at the AWC. Such children were higher (80 percent) in the rural areas as compared to
that (72 percent) in the urban areas. Data disaggregated by wealth index revealed a higher proportion of
children in the lowest wealth index (80 percent) consuming entire quantity of supplementary food received
from AWC against 69 percent in the highest wealth index. Notably, the consumption pattern in this age group
was different from other categories of beneficiaries.
Table 7.31: Supplementary food consumed by children aged 36-71 months
Percentage distribution of children aged 36-71 months according to pattern of consumption of the foods received from
AWC by background characteristics, RSOC, 2013-14.
Characteristics
Consumption of supplementary food Number of children aged
36-71 months receiving
supplementary food from
AWC
Entire
stuff/quantity
Half Less than
Half
Did not
consume at
all
Children aged 36-71 months 78.8 12.7 5.7 2.8 21006
Residence
Urban 71.5 15.8 8.2 4.5 3,784
Rural 80.4 12.0 5.2 2.4 17,221
Wealth index
Lowest 80.3 12.5 5.2 2.1 5,748
Second 81.6 11.6 4.8 2.0 5,467
Middle 79.3 13.7 4.6 2.5 4,690
Fourth 75.9 11.8 8.1 4.1 3,354
Highest 69.4 15.9 9.1 5.7 1,747
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The pregnant women receiving supplementary food from AWC were also asked about the portion of food
consumed by her. Table 7.32 presents the percentage distribution of currently pregnant women according to
the consumption of supplementary food received from AWC by background characteristics. Amongst the
pregnant women receiving supplementary food, around 47 percent reported consuming the entire portion
themselves; another 41 percent shared the food with other family members and around 6 percent did not like it
and so did not consume it at all. The proportion of currently pregnant women consuming the entire quantity
was higher in the rural areas (48 percent) as compared to those in the urban areas (41 percent). Analysis of the
data by different wealth indices showed that consumption of entire quantity was almost at the same level
among the pregnant women belonging to different wealth quintiles except for those in the highest index
wherein it was slightly lower.
Table 7.32: Supplementary food consumed by currently pregnant women
Percentage distribution of currently pregnant women according to pattern of consumption of the foods received from AWC
by background characteristics, RSOC, 2013-14.
Characteristics
Consumption of supplementary food Number of
currently pregnant
receiving
supplementary
food from AWC
Entire
stuff/quantity
Shared with
other
siblings/family
members
Does not like
the food and
so does not
consume at all
Can't
say/Don’t
remember
Pregnant Women 46.9 41.0 6.3 5.9 2,137
Residence
Urban 41.4 43.7 8.6 6.3 359
Rural 48.0 40.4 5.8 5.8 1,778
Wealth index
Lowest 46.1 42.6 5.6 5.7 501
Second 47.5 45.3 3.9 3.3 526
Middle 49.0 35.6 6.8 8.6 492
Fourth 48.9 38.1 7.5 5.5 393
Highest 38.9 44.1 9.9 7.1 225
7.9 PLACE OF CONSUMPTION AND LIKING OF SUPPLEMENTARY FOOD
Supplementary food for children aged 36-71 months is generally provided in the form of hot cooked meal to be
eaten at AWC. Mother was probed for the place of consumption of the food given to the child in the sense
whether s/he consumed at AWC, at home or partially at AWC. Another question was asked about mother’s
perception whether the child liked the taste of the food. Table 7.33 presents place of consumption of
supplementary food and mother’s perception about liking of the food for children aged 36-71 months. Among
the children aged 36-71 months who received supplementary food from the AWC, around 68 percent consumed
it at the AWC itself and 25 percent consumed it at home. The proportion of children consuming the
supplementary food at the AWC was higher in the rural areas (69 percent) as compared to those in the urban
areas (60 percent).
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As regards the taste of the supplementary food, around 52 percent mothers of children 36-71 months old
reported that the child always liked the taste of the food, while about 17 percent said that the child liked it most
of the times, and another 21 percent mentioned that the child liked it sometimes. The perception of mothers
about child’s liking of supplementary food was almost similar in both rural and urban areas.
Table 7.33: Place of consumption and perception on taste of supplementary food consumed
Percent distribution of children aged 36-71 months receiving supplementary food from an AWC by place of consumption of food and whether child liked the taste of food, according to place of residence, RSOC, 2013-14.
Characteristics Residence
Total Urban Rural
Place of consumption of supplementary food
AWC 59.7 69.2 67.5
Home 28.8 24.1 25.0
Partly at AWC 8.0 4.8 5.4
Did not consume 3.6 1.9 2.2
Number of children receiving supplementary food from an AWC 3,816 17,323 21,139
Mother’s report on whether child likes the taste of the food received from AWC
Always likes 52.2 52.4 52.4
Likes most of the times 16.0 17.5 17.2
Likes sometimes 22.8 20.4 20.8
Indifferent 3.3 3.1 3.1
Does not like 3.7 3.3 3.3
Number of children who consumed supplementary food received from an AWC 3,680 16,993 20,673
7.10 GROWTH MONITORING
Mothers of children aged 0-35 months and 36-71 months were asked if the child has growth chart/card. Overall
19 percent children aged 0-35 months and 9 percent children aged 36-71 months reportedly had growth
chart/card. There are large variations between the states with respect to child having growth chart/card. The
state wise picture for children aged 0-35 months and 36-71 months is shown in Figures 7.3 and 7.4 respectively.
The percentage of children aged 0-35 months having growth chart ranged from 2 percent in Manipur to 50
percent in Goa exhibiting a variation of 25 times. The top five states reporting growth chart for children aged 0-
35 months are Goa (50 percent), West Bengal (43 percent), Karnataka (43 percent), Sikkim (42 percent) and
Odisha (41 percent) and the bottom five states are Manipur (2 percent), Jammu & Kashmir (3 percent),
Nagaland (4 percent), Uttar Pradesh (5 percent) and Arunachal Pradesh (5 percent). The percentage of children
aged 36-71 months having growth chart ranged from less than 1 percent in Manipur to 30 percent in Kerala, a
variation of more than 30 times. The situation in case of children aged 36-71 months in this regard seems to be
relatively bad as compared to children aged 0-35 months as there are seven states where the percentage of
children having growth chart is 2 percent or less. Similarly, the percentage of children having growth chart in the
best performing state for 36-71 months (Kerala-30 percent) is 20 percentage points less than for the best
performing state in case of 0-35 months (Goa- 50 percent).
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Figure 7.3: Percentage of children aged 0-35 months covered by an AWC, reported to have growth chart/card by state
Figure 7.4: Percentage of children aged 36-71 months covered by an AWC, reported to have growth chart/card by state
50
43 43 42 41
36 33
30 26
23 21
19 19 17 13 13 12 12 11 11 10 10
7 7 6 5 5 4 3 2
Go
a
We
st B
en
gal
Kar
nat
aka
Sikk
im
Od
ish
a
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Gu
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Tam
il N
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Ind
ia
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d
Har
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Raj
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Bih
ar
Trip
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b
De
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Mah
aras
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a
Miz
ora
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Jhar
khan
d
Mad
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Pra
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Aru
nac
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Pra
de
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Utt
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Nag
alan
d
Jam
mu
& K
ash
mir
Man
ipu
r
30
27 27 24
21 19
16 14 14 14
12 11
9 9 8 6 6 6
4 4 3 3 3 2 2 2 2 2 2
0
Ke
rala
Kar
nat
aka
Gu
jara
t
Go
a
Me
ghal
aya
Tam
il N
adu
Him
ach
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Ch
hat
tisg
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Od
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Har
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Sikk
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An
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Ind
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Mah
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a
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Utt
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d
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Trip
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Jhar
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Ass
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We
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Pu
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b
Nag
alan
d
Aru
nac
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Pra
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Pra
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Jam
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Bih
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Man
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r
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Table 7.34: Weight monitoring of children 0-71 months Percentage of children aged 0-71 months for whom growth chart is available and percent distribution of those with growth chart by frequency of weighing in the 3 months
preceding the survey, by background characteristics
Characteristics
Percentage of children
with growth
chart/card)
Number of
children 0-71
months
Frequency of weighing in the 3 months preceding the survey
Percentage of children 0-
35 months weighed at
least once in last 3 months
preceding the survey
number of
children 0-35
months
Percentage of children 36-71
months weighed at least once in
3 months preceding the
survey
Number of
children 36-71
months who had growth
chart/card
1 2 3 or
more
Do not
know
Not weighted
Age of the child (months) 0-35 19.2 54,163 21.7 20.4 21.9 3.1 33.0 64.0 10,374 na na 36-71 9.2 55,694 18.3 21.2 26.6 4.7 29.2 na na 66.1 5,130
Sex of the Child Male 14.1 57,567 20.7 21.1 23.7 3.5 31.1 64.7 5,515 66.9 2,593
Female 14.1 52,290 20.4 20.3 23.1 3.8 32.4 63.1 4,859 65.2 2,537 Residence
Urban 14.8 33,434 25.2 20.4 20.2 3.2 31.0 67.2 3,118 63.5 1,824 Rural 13.8 76,423 18.4 20.8 24.9 3.8 32.1 62.6 7,255 67.5 3,306
Mother education No Education 8.4 38,358 13.9 19.8 21.4 5.3 39.6 51.6 2,153 62.1 1,070
Below Primary 15.4 5,523 20.4 19.5 21.5 2.7 35.9 63.0 630 57.0 220 Completed Primary 16.2 16,910 19.4 20.8 23.9 4.0 31.8 65.1 1,800 62.4 935 Completed Middle 16.0 16,390 19.8 19.4 21.8 4.3 34.7 60.6 1,861 62.1 758 Completed Secondary 18.2 14,692 23.5 21.4 25.3 2.8 27.0 70.6 1,724 69.5 950
Completed Higher Secondary and above 18.9 17,984 26.0 22.2 25.1 2.2 24.6 73.0 2,206 73.8 1,197 Religion
Hindu 14.6 85,854 20.3 21.7 24.5 3.6 29.9 66.1 8,291 67.2 4,206 Muslim 11.9 18,251 23.2 16.7 16.6 3 40.5 56.1 1,566 57.5 604 Christian 17.8 2,795 21.5 14.7 31.1 3.6 29.1 60.7 285 76.2 212 Sikh 11.8 1,611 7.7 10.6 3 3.3 75.5 18.3 128 27.3 62 Jain 3.2 174 * * * * * * 5 * 0 Buddhist 12.0 672 23.8 29 31.9 13.1 2.2 86.3 47 82.5 33 No religion 8.7 75 * * * * * * 5 * 2 Other 13.4 425 9.4 32.1 27.3 8.6 22.6 65.9 46 80.9 11
Social Group Scheduled Caste 13.9 22,309 19.0 20.7 22.8 3.7 33.9 62.1 2,219 63.3 872
Scheduled Tribe 13.4 12,501 18.7 21.2 31.2 5.1 23.7 67.7 1,090 77.8 582 OBC
14.0 44,273 20.1 19.3 23.7 3.5 33.3 62.5 3,851 64.3 2,367 Others 14.4 29,679 23.4 22.7 20.9 3.1 29.9 67.0 2,995 66.8 1,283 Do Not Know 22.4 1,095 14.4 16.9 14.2 5.0 49.6 48.6 219 19.3 27
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Characteristics
Percentage of children
with growth
chart/card)
Number of
children 0-71
months
Frequency of weighing in the 3 months preceding the survey
Percentage of children 0-
35 months weighed at
least once in last 3 months
preceding the survey
number of
children 0-35
months
Percentage of children 36-71
months weighed at least once in
3 months preceding the
survey
Number of
children 36-71
months who had growth
chart/card
1 2 3 or
more
Do not
know
Not weighted
Wealth Index Lowest 10.0 22,672 18.3 20.2 26.4 4.4 30.7 61.8 1,626 72.7 646
Second 12.8 22,576 17.7 19.9 23.9 4.7 33.9 60.6 2,060 63.5 822
Middle 14.9 22,491 18.0 23.2 23.4 3.8 31.6 64.6 2,291 64.5 1,060 Fourth 16.4 22,027 22.2 19.9 23.5 2.9 31.5 65.2 2,327 66.3 1,289
Highest 16.8 20,091 25.2 20.1 20.9 2.8 30.9 66.8 2,069 65.4 1,313 Total 14.1 1,09,857 20.6 20.7 23.4 3.6 31.7 64.0 10,374 66.1 5,130
na: Not Applicable, *Percentage not shown; based on fewer than 25 unweighted cases.
Table 7.34 shows the proportion of children for whom growth chart is available and distribution of such children by frequency of weighing in
three months preceding the survey. Out of all the children aged 0-71 months, for 14 percent of the children mother reported of having a growth
chart. Among them 65 percent were weighed at least once in three months. Mothers of younger children are more likely to have growth chart
than mothers of older children. Almost one in five mothers (19%) of children aged 0-35 months reported to have growth chart, compared to
nine percent of mother of children aged 36-71 months. Though, there was a difference in the proportion having growth chart, about 64-66
percent of the children from both the age-groups were weighed at least once in three months prior to survey. The proportion of children with
growth card increased from the group of children whose mother had no education (8 percent) to those whose mother had below primary
education (15 percent). However, thereafter, with increase in mother’s education there was only a small increase in the proportion of children
with growth chart. For about one-fifth (19 percent) of the children whose mother had education of higher secondary or more, growth chart was
available. With increase in mother’s education, there was increase in the proportion of children aged 0-35 months and 36-71 months who were
weighed at least once in three months period prior to survey; though the increase was not uniform. The proportion of children with growth card
and the proportion of children aged 0-35 months who weighed at least once in three months preceding the survey, both hold positive
relationship with wealth quintile. However the proportion of children aged 36-71 months who weighed at least once in three months preceding
the survey holds negative relationship with wealth quintile.
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35
5
16
39
4 2
76
2 9 10
1 2
62
3 11
20
2 2
AnganwadiCentre
At Home Govt. hospital/Health Centre
Private Hospital / Private Doctor’s
clinic
Others Don’t know
Urban Rural Total
The mothers who reported that their child was weighed at least once in the last three months were further
asked about the place where the child was weighed last. The data was analysed separately for children aged 0-
35 months and 36-71 months. Figure 7.5 shows that among the children aged 0-35 months, the maximum (58
percent) were weighed at an AWC, followed by private hospital/clinic (21 percent) and government
hospital/health centre (15 percent). Among the children aged 36- 71 months, 62 percent were weighed at AWC,
20 percent at private hospital/clinic and 11 percent at government hospital/health centre (Figure 7.6). The
figures 7.5 and 7.6 further show that more rural children were weighed at AWC whereas more urban children
were reportedly weighed at private hospital/clinic as well as at government hospital/health centre.
Figure 7.5: Place of taking weight last time for children aged 0-35 months
Figure 7.6: Place of taking weight last time for children aged 36-71 months
36
3
19
39
1 3
69
3
13 12
1 3
58
3
15 21
1 3
AnganwadiCentre
At Home Govt. hospital/Health Centre
Private Hospital / Private Doctor’s
clinic
Others Don’t know
Urban Rural Total
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The mothers who reported that their child was weighed at any facility were further asked whether they are
aware of the present weight of the child. Table 7.35 shows that 83 percent mothers of children aged 0-35
months and 80 percent mothers of children aged 36-71 months were aware of the weight of the child. The table
further shows that there was a differential on mother’s awareness regarding weight of the child by educational
level of mothers. For example, 88 percent mothers of children aged 0-35 months having completed higher
secondary were aware of the weight of their child as compared to 76 percent illiterate mothers. Comparatively
less ST mothers of children aged 36-71 months (67 percent) were aware of weight of the child than mothers
belonging to SC (80 percent), OBC (82 percent) and other castes (84 percent). The analysis by wealth quintiles
shows that mothers from lowest wealth quintile were less aware of weight of their child than the mothers from
the higher quintiles. Awareness of mothers regarding child’s weight in various states is presented in Table 7.36
given in Annexure-A.
Table 7.35: Awareness of weight of the child
Percentage of mothers of children aged 0-35 months and 36-71 months aware of the present weight of the child by
selected background characteristics, RSOC, 2013-14.
Characteristics
Percent aware of weight of child aged 0-35 months
Number of Children aged 0-35 months
Percent aware of weight of child aged 36-71 months
Number of Children aged 36-71 months
Mother's education No education 75.8 1,112 73.1 664
Below Primary (Class - 1 to 4) 78.2 397 63.9 125
Completed Primary (Class 5-7) 80.4 1,172 80.5 584
Completed Middle (Class 8 -9) 79.9 1,127 79.8 471
Completed Secondary (Class 10-11) 87.3 1,218 82.4 660
Completed Higher Secondary (Class 12) 87.7 1,610 86.9 884
Social Group
Scheduled Caste 80.7 1,377 79.9 552
Scheduled Tribe 75.4 738 67.2 452
OBC 85.2 2,407 82.3 1,522
Other 83.1 2,006 84.3 857
Do Not Know 79.5 106 * 5
Wealth index
Lowest 74.1 1,006 64.8 470
Second 79.9 1,249 79.0 522
Middle 83.7 1,481 80.7 684
Fourth 82.6 1,518 81.9 854
Highest 89.4 1,382 88.0 859
Total 82.5 6,635 80.4 3,389
*Percentage not shown; based on fewer than 25 unweighted cases.
The mothers were further asked whether weight of the child was normal or the child was moderately
underweight or severely underweight. Figure 7.7 shows that more than three-fourth mothers of children aged 0-
35 months reported that the child’s weight was normal, 12 percent said that the child was moderately
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underweight and 2 percent reported child as severely underweight. Comparatively more mothers of children
aged 0-35 months belonging to OBC (79 percent) and Other castes (84 percent) reported child’s weight as
normal than SC (73 percent) and ST (73 percent) mothers. Among the children aged 36-71 months, 84 percent
were reported to be normal, 8 percent moderately underweight and around one percent severely underweight
(Figure 7.8). Eight percent mothers of children aged 0-35 months and seven percent mothers of children aged
36-71 months did not know that in which category her child falls respectively.
Figure 7.7: Weight of children aged 0-35 months, by social group
Figure 7.8: Weight of children aged 36-71 months, by social group
All those mothers who reported that the child’s weight was taken were asked if anyone had previously discussed
her child’s nutritional status with her. This is a multiple response question and all those who discussed child’s
nutrition status with mother were recorded. Table 7.37 presents the analysis of responses received from
mothers of children aged 36-71 months. The table shows that half of the mothers (51 percent) reported that no
one discussed with her about her child’s nutrition status. Nearly one fourth (26 percent) mothers reported
AWW, 6 percent ANM and 12 percent reported doctor discussing the nutritional status of the child. The table
further shows that in rural areas it was mainly the AWW who did discuss the nutritional status whereas in urban
areas it was predominantly done by doctors.
73 73 79 84
55
78
15 11 12 9 19
12 3 2 2 1 1 2
9 14
7 6
26
8
ScheduledCaste
Scheduled Tribe OBC Other castes Do Not Know Total
Normal Moderately underweight Severely underweight Don’t know
85 76
84 90
72
84
7 9 8 6
20
8 1 2 2 1 0 1
8 13 6 3
8 7
ScheduledCaste
Scheduled Tribe OBC Other castes Do Not Know Total
Normal Moderately underweight Severely underweight Don’t know
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Table 7.37: Persons who discussed about child’s nutrition status
Percentage of mothers of children aged 36-71 months reporting persons who discussed about child’s nutrition status by
background characteristics, RSOC, 2013-14.
Characteristics No one
discussed AWW ANM Doctor Others
Number of children aged 36-71 months
Mother’s age 15-19 * * * * * 7 20-24 49.2 26.9 7.8 10.7 5.4 766 25-29 49.8 27.1 5.7 10.8 6.5 1,478 30-34 52.3 23.0 3.1 13.9 7.7 755 35-39 56.1 21.8 3.9 14.0 4.2 283 40-44 51.4 32.6 4.1 8.9 3.0 73 45-49 (51.7) (27.6) (3.4) (6.9) (10.3) 26
Residence
Urban 51.8 17.7 3.1 20.1 7.2 1,158
Rural 50.4 30.0 6.7 7.3 5.7 2,231
Mother's education
No education 55.3 29.7 6.2 3.9 4.9 664
Below Primary (Class - 1 to 4) 57.7 23.3 5.0 3.6 10.5 125
Completed Primary (Class 5-7) 45.7 35.6 7.2 5.5 6.1 584
Completed Middle (Class 8 -9) 49.9 26.8 8.8 8.6 5.9 471
Completed Secondary (Class 10-11) 51.0 23.5 5.4 13.2 6.9 660
Completed Higher Secondary (Class 12) 50.4 17.9 2.1 23.2 6.4 884
Religion
Hindu 51.0 26.9 5.3 10.8 5.9 2,825
Muslim 46.5 20.2 4.9 17.9 10.5 347
Christian 54.5 18.8 11.0 13.7 2.0 161
Sikh * * * * * 17
Buddhist/Neo-Buddhist (50.2) (34.3) (0.2) (6.9) (8.5) 28
No Religion * * * * * 1
Other * * * * * 9
Social Group
Scheduled Caste 50.3 27.0 7.6 8.3 6.9 552
Scheduled Tribe 52.9 36.6 2.6 3.7 4.1 452
OBC 51.6 25.3 4.9 12.6 5.7 1,522
Other 48.9 20.4 6.6 16.2 8.0 857
Do Not Know * * * * * 5
Wealth index
Lowest 57.8 33.9 4.5 1.9 2.0 470
Second 46.1 33.8 7.4 4.8 7.8 522
Middle 49.0 31.9 7.0 4.5 7.6 684
Fourth 50.5 25.0 5.0 13.6 6.0 854
Highest 51.8 12.4 4.1 24.9 6.8 859
Total 50.9 25.8 5.5 11.7 6.2 3,389
*Percentage not shown; based on fewer than 25 unweighted cases. ( ) Percentage based on 25-49 unweighted cases.
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7.11 QUANTITY OF FOOD GIVEN TO SEVERELY MALNOURISHED CHILDREN
Severely underweight children are given more quantity of food (24-25 gm of protein) than children with normal
weight (12-15 gm of protein). Mothers were asked a series of questions to know about the child’s nutritional
status. As shown in Figures 6.7 and 6.8 there were 1.8 percent children aged 0-35 month and 1.4 percent aged
36-71 months reported to be severely underweight. Mothers of such children were asked about the quantity of
food child received when he/she was severely underweight. Table 7.38 presents percentage of children who
received additional quantity of supplementary food. Among severely underweight category, nearly 33 percent
children aged 6-35 months received same quantity of supplementary food as they used to receive earlier and
another 32 percent received slightly more than the usual quantity and only 5 percent received double the
quantity that they used to receive earlier.
Table 7.38: Quantity of supplementary food received by severely underweight children
Percentage of severely underweight children aged 0-35 months and 36-71 months by quantity of supplementary
food received, RSOC, 2013-14.
Quantity of supplementary food received Children aged 0-35
months
Children aged 36-71
months Total
Same as earlier 33.3 (42.9) 33.8
Slightly more 31.8 (25.7) 33.7
Almost double of what received earlier 4.5 (0.0) 3.2
Don't remember 16.5 (2.9) 13.7
Not Applicable 13.8 (28.6) 15.6
Number of children severely underweight 103 45 148
*Percentage not shown; based on fewer than 25 unweighted cases.
( ) Percentage based on 25-49 unweighted cases
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7.12 ATTENDANCE DURING PRE-SCHOOL EDUCATION AND AGE AT ATTENDING PRE-SCHOOL
EDUCATION
As per the national policy on Early Childhood Care and Education (ECCE) pre-school education is an
indispensable foundation for lifelong learning and development, and has critical impact on success at the
primary stage of education. Provision of pre-school education (PSE) for children aged 36-71 months is another
important component of the ICDS programme. This is a joyful playway daily activity, to be undertaken for 2-4
hours a day for all children 3-6 years, for all working days of the week. The information on attendance in the PSE
was collected for all children aged 36-71 months in areas covered by an AWC.
Mothers of children aged 36-71 months were asked to mention all the services that they avail for the child from
the AWC in their area. Their spontaneous as well as prompted responses regarding each of the specific services
reportedly availed from the AWC for the children aged 36-71 months were recorded. Table 7.39 presents the
percentage of the mothers who reported utilization of AWC for PSE by children aged 36-71 months according to
their background characteristics. Overall two-fifth of the children aged 36-71 months attended PSE at the AWCs.
The analysis of attendance in PSE at the AWC by background characteristics shows that more rural children (43
percent) attended PSE at AWC than their urban counterparts (27 percent). More children belonging to STs (51
percent) and SCs children (41 percent) received PSE at the AWC than children from OBC (35 percent) and
general castes (38 percent). It is also observed that more children from the lowest wealth quintile (47 percent)
attended PSE in the AWCs than those in the higher wealth quintiles. The attendance at the AWC did not vary
much according to the gender and religion of the child.
The information on age since when the child started attending PSE at the AWC as well as number of days the
child attended PSE in the last month and in the last three months preceding the survey was collected for all the
children from mother who reported attendance in the PSE at the AWC. The results have also been presented in
Table 7.39.
The mean age at which the child started attending the PSE was 39 months. The mean age at attending PSE at
AWC was slightly lower for children in rural areas and children belonging to the lowest and the second lowest
wealth quintiles.
Among the children who attended PSE at AWC, mean number of days of attendance in PSE in one and three months preceding the survey were 17 and 43 days, respectively with marginal variations across background characteristics of the children.
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Table 7.39: Attendance at pre-school education (PSE) at AWCs
Percentage of children aged 36-71 months residing in the area covered by an AWC according to their attendance in PSE,
mean age at attendance and the average number of days attended PSE by background characteristics, RSOC, 2013-14.
Characteristics Percentage attending
PSE in AWC
Number of children
living in an area covered by an AWC
Mean age at which started
attending PSE
Average number of days attended PSE in one full month
prior to survey
Average number of days
attended in 3 months prior to
the survey
Age of Child (months)
36-47 42.5 16,402 39.1 17.0 41.4 48-59 40.5 16,695 38.8 17.3 44.1 60-71 32.4 14,776 38.7 16.1 42.2
Sex of Child
Male 37.5 24,682 38.8 16.7 42.5 Female 39.9 23,191 38.9 17.0 42.6
Residence Urban 26.9 12,268 39.7 16.3 38.3 Rural 42.7 35,605 38.7 17.0 43.5
EMW's education No Education 39.1 18,598 38.5 16.7 41.6 Below Primary (Class - 1 to 4) 55.2 2,691 38.4 16.8 44.7 Completed Primary (Class 5-7) 44.6 7,666 39.0 16.8 43.2 Completed Middle (Class 8 -9) 39.7 6,875 38.7 16.5 42.9 Completed Secondary (Class 10-11) 36.1 5,937 39.8 18.2 43.4 12+ (Class 12 and above) 24.0 6,105 39.6 16.5 41.9
Religion
Hindu 39.6 37,609 39.0 17.1 43.0 Muslim 34.9 7,787 38.1 16.1 41.8 Christian 38.7 1,342 38.6 16.3 35.9 Sikh 23.2 646 36.9 17.5 42.9 Jain (26.2) 45 * * * Buddhist/Neo-Buddhist 50.8 266 40.5 16.3 36.7 No Religion (26.2) 31 * * * Other 44.9 147 37.4 15.6 41.6
Social Group
Scheduled Caste 40.6 10,193 38.9 16.8 42.9 Scheduled Tribe 50.6 5,665 39.2 17.3 41.2 OBC 34.5 19,520 39.2 16.8 42.4 Other 37.8 11,994 38.2 16.9 43.5 Do not know 46.3 502 36.7 14.2 40.2
Wealth index
Lowest 46.6 10,749 38.3 16.7 42.9 Second 45.5 10,533 38.4 16.8 42.8 Middle 41.1 10,191 39.2 17.2 43.1 Fourth 33.2 9,046 39.6 17.0 42.0 Highest 20.7 7,353 39.7 16.4 40.8
Total 38.7 47,873 38.9 16.9 42.6
*Percentage not shown; based on fewer than 25 unweighted cases. ( ) Percentage based on 25-49 unweighted cases
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Table 7.40 shows the percentage of children who attended PSE for 16 or more days, average number of hours
attended PSE in one month prior to the survey and percentage of children who attended PSE for four hours or
more hours. At the national level, among the children attending PSE at the AWC, 58 percent attended the PSE
for more than 16 days. The frequency distribution of the number of days of PSE attended by the children among
those attending the PSE has been presented in Figure 7.9.
Figure7.9: Percentage distribution of children according to number of days attended PSE in one month prior to the survey by place of residence
Analysis of attendance at PSE for 16 or more days by residence shows that slightly higher proportion of children
in rural areas compared to their urban counterparts reportedly attended PSE for 16 days or more in one month
prior to the survey. The attendance at PSE for 16 or more days was slightly higher for girls than boys. Across the
social category, a relatively higher proportion of children from other castes general caste group reported
attendance in PSE for 16 or more days.
Table 7.40 further shows that in case of one-fourth of children attending PSE in AWCs, the number of hours
generally spent for PSE at the AWC was four hours or more. The percentage distribution of children attending
PSE according to number of hours spent for PSE at the AWC presented in Table 7.41 shows that 40 percent of
the children were attending PSE just for one to two hours in a day and another 28 percent attended PSE for two
to four hours per day. The analysis by background characteristics reveal that the children in urban areas,
children whose mothers have higher level of education, children belonging to two upper wealth quintiles and
children from OBC category are more likely to attend PSE at AWC for four or more hours.
The mean number of hours generally spent for PSE was 2.8 in both rural and urban areas. The mean number of
hours generally spent for PSE was relatively lower for children belonging to other caste groups and children from
the lowest wealth quintile.
8
23
59
6 4 8
21
56
10 5 8
22
58
7 4
1-6 7-15 16 or more Not at all Don't know
Rural Urban Total
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The percentage of children whose mothers participated in parent’s meet in the three months prior to survey is
also presented in Table 7.40. Among the children attending PSE, the mothers of 28 percent children participated
in parent’s meet in the three months prior to the survey. The corresponding percentage was relatively lower for
children in the age group of 60-71 months. A higher percentage of mothers residing in urban areas as well as
mothers having secondary and above level education reported participation in parent's meet at the AWC for the
PSE of their child. The percentage of mothers participating in the parent's meet increased with the increase in
the wealth quintiles. Across social groups the participation in the parents meet was marginally higher in case of
mothers coming from general caste groups.
Table 7.40: Regularity and quality of attendance at pre-school education at AWC
Percentage of children aged 36-71 months who attended PSE at AWC for 16 or more days, and for 4 hours or more hours in
a day, average number of days attended PSE and percentage of children whose mothers participated in parent's meet by
background characteristics, RSOC, 2013-14.
Characteristics
Percentage of
children
attended PSE 16
days or more in
one month
prior to the
survey
Average
number of
hours attended
PSE in one
month prior to
the survey
Percentage of
children
attended PSE
for 4 hours or
more
Percentage of
children whose
mothers
participated in
parent's meet in
the 3 months
prior to survey
Number of
children living in
an area covered
by an AWC
attending PSE in
AWC
Age of Child (months)
36-47 57.8 2.8 26.0 29.5 6,965
48-59 59.5 2.8 24.9 28.3 6,763
60-71 56.5 2.8 24.3 24.7 4,782
Sex of Child
Male 57.2 2.8 24.1 28.1 9,247
Female 58.9 2.9 26.3 27.6 9,262
Residence
Urban 55.5 2.8 29.0 29.3 3,296
Rural 58.6 2.8 24.4 27.5 15,213
EMW's education
No Education 56.5 2.8 25.0 20.9 7,278
Below Primary (Class - 1 to 4) 60.2 2.5 14.7 21.8 1,487
Completed Primary (Class 5-7) 58.6 2.8 23.3 30.7 3,414
Completed Middle (Class 8 -9) 56.5 2.7 20.1 27.5 2,727
Completed Secondary (Class 10-11) 65.4 3.2 35.1 41.3 2,141
12+ (Class 12 and above) 54.5 3.1 36.3 42.5 1,463
Religion
Hindu 58.4 2.9 26.1 28.0 14,899
Muslim 55.9 2.5 19.2 23.8 2,717
Christian 57.6 3.2 33.8 44.0 520
Sikh 66.3 3.0 22.9 18.5 150
Jain * * * * 15
Buddhist/Neo-Buddhist 58.6 2.4 14.8 40.0 135
No Religion * * * * 6
Other 45.0 2.6 17.9 21.7 66
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Characteristics
Percentage of
children
attended PSE 16
days or more in
one month
prior to the
survey
Average
number of
hours attended
PSE in one
month prior to
the survey
Percentage of
children
attended PSE
for 4 hours or
more
Percentage of
children whose
mothers
participated in
parent's meet in
the 3 months
prior to survey
Number of
children living in
an area covered
by an AWC
attending PSE in
AWC
Social Group
Scheduled Caste 57.2 2.9 26.1 26.9 4,142
Scheduled Tribe 58.0 2.7 19.1 27.8 2,864
OBC 58.5 3.0 32.0 28.1 6,734
Other 58.9 2.5 19.1 28.9 4,536
Do not know 46.2 2.0 4.9 16.7 232
Wealth index
Lowest 56.6 2.6 18.6 21.2 5,010
Second 57.1 2.7 22.4 23.0 4,795
Middle 60.4 3.0 29.6 32.1 4,185
Fourth 59.6 3.0 30.6 35.1 2,999
Highest 56.7 3.0 33.1 38.6 1,520
Total 58.1 2.8 25.2 27.8 18,509
*Percentage not shown; based on fewer than 25 unweighted cases.
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Table 7.41: Pre-school education —time spent by children on PSE activities in a day at AWC
Percentage of children aged 36-71 months residing in area covered by AWC, by time spent by children on PSE activities in a
day at AWC, according to background characteristics, RSOC, 2013-14.
Characteristics
Time spent by children on PSE activities in a day at AWC Number of children
living in an area
attending ICDS run PSE
Less than
1 hour 1-2 hours 2-4 hours 4 hours or more
Age of child (months)
36-47 2.1 41.4 26.5 26.0 6,967
48-59 2.0 40.0 28.5 24.9 6,763
60-71 3.1 39.3 29.3 24.3 4,782
Sex of child
Male 2.4 41.4 27.8 24.1 9,249
Female 2.2 39.3 28.1 26.3 9,262
Residence
Urban 3.5 41.6 21.4 29.0 3,296
Rural 2.1 40.1 29.4 24.4 15,215
Mother's education
No Education 1.8 41.3 28.1 25.0 7,278
Below Primary (Class - 1 to 4) 1.8 51.6 28.6 14.7 1,487
Completed Primary (Class 5-7) 2.5 41.6 27.9 23.3 3,416
Completed Middle (Class 8 -9) 2.6 44.5 28.7 20.1 2,727
Completed Secondary (Class 10-11) 2.6 29.9 28.1 35.1 2,141
Completed Higher Secondary and above 4.3 28.6 25.1 36.3 1,463
Religion
Hindu 2.4 38.0 29.3 26.1 14,899
Muslim 1.8 55.0 20.2 19.2 2,719
Christian 3.8 32.9 23.7 33.8 520
Sikh 1.7 19.5 48.9 22.9 150
Jain * * * * 15
Buddhist/Neo-Buddhist 4.4 50.7 22.3 14.8 135
No religion * * * * 6
Other 0.0 46.9 29.1 17.9 66
Social Group
Scheduled Caste 1.7 39.4 28.2 26.1 4,142
Scheduled Tribe 1.7 47.3 28.5 19.1 2,864
OBC 2.5 30.2 30.6 32.0 6,737
Other 3.0 50.3 24.1 19.1 4,536
No Response 1.0 72.4 14.6 4.9 232
Wealth Index
Lowest 1.4 46.2 29.9 18.6 5,010
Second 1.8 43.3 27.7 22.4 4,795
Middle 2.2 36.5 28.0 29.6 4,185
Fourth 3.3 36.2 26.0 30.6 2,999
Highest 5.3 30.9 26.1 33.1 1,522
Total 2.3 40.4 27.9 25.2 18,511
*Percentage not shown; based on fewer than 25 unweighted cases. ( ) Percentage based on 25-49 unweighted cases
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The children who reportedly received at least one service from AWC but did not receive PSE were asked the
reasons for the same. Table 7.42 shows, in both rural and urban areas, the reason cited for not attending PSE at
the AWC by almost one-fifth of the children was ‘AWC is far off’. Another 14 percent of the children did not
attend PSE at AWC as no PSE sessions were organized at the AWC. The corresponding percentage was higher in
rural than the urban areas. The other reasons mentioned by 5 to 8 percent of the children for not attending PSE
at the AWC included ‘AWW not qualified or trained’, ‘AWW not coming to AWC regularly’, ‘Not aware about PSE
in AWC’, ‘Not aware PSE is conducted in AWC’.
Table 7.42: Reasons for not attending PSE at the AWC
Percentage of mothers of children aged 36-71 months covered by an AWC, who reported not attending PSE at the AWC by
reasons for not attending PSE, RSOC, 2013-14.
Reasons Residence
Total Urban Rural
Percentage not attending PSE at AWC 73.1 57.3 61.3
Base* 12,268 35,605 47,873
Reasons for not taking supplementary food
AWW not qualified or trained 5.3 4.8 4.9
PSE curriculum is not relevant or appropriate 8.9 8.0 8.2
PSE not conducted in AWC 8.9 15.4 13.9
AWW not coming to AWC regularly 2.7 5.9 5.2
AWC remains closed/not regularly opened 1.8 3.9 3.4
Not aware about PSE in AWC 5.9 6.3 6.2
I feel my child is discriminated 2.2 2.1 2.1
AWC is too far away 19.5 19.0 19.1
Not aware PSE is conducted in AWC 5.4 7.8 7.3
Base** 983 3,264 4,247
*All children aged 36-71 months residing in the area covered by AWC
**Those who received at least one service from AWC but did not receive PSE at AWC
Figure 7.10 shows state-wise proportion of children aged 36-71 months who reportedly attended PSE at AWC.
Percentage of children attending PSE at AWCs ranges from 74 percent in Tripura to as low as 1 percent in
Nagaland. In 14 states the proportion of children attending PSE was higher than national average of 39 percent.
Percentage of children attending PSE in AWC was below 20 percent in most of the Northern states (Punjab-18
percent, Rajasthan-17 percent, Uttar Pradesh-16 percent, Jammu and Kashmir-15 percent, Haryana-15 percent
and Delhi-11 percent).
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Figure 7.10: State wise percentage of children aged 36-71 months who attended PSE in AWC
The state wise percentage of children 36 to 71 months who attended PSE for 16 or more days is given in Figure
7.11. The attendance at PSE for 16 or more days was much lower in the states of Nagaland (3), Manipur (24),
Meghalaya (26), Uttar Pradesh (34), Jammu & Kashmir (36) and Madhya Pradesh (37). The corresponding
percentages were much better than the national average for the states of Goa (82), Karnataka (78), Sikkim (75),
Bihar (72) and Tripura (70).
Figure 7.11: State wise percentage of children aged 36-71 months who attended PSE in AWC for 16 or more days
The state wise analysis on age since when the child was attending PSE at the AWC, number of days attended PSE
in the last month and in the last three months, number of hours for which generally attended PSE at the AWC
74
65 63 63 61 58 57 57 57
54 51
45 45 42
39 37 35 35 32 30
25 25 23 18 17 16 15 15
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and participation of the mothers at the parents meet at the AWC in the last three months is presented in Tables
7.43-7.45 given in Annexure-A.
7.13 OTHER SERVICES AT AWC
The Village Health and Nutrition Day (VHND) is to be organized once a month on a fixed day at the AWCs in the
villages. AWC is identified as the hub for service provision under National Health Mission and also as a platform
for inter-sectoral convergence. VHND also acts as a platform for interfacing between the community and the
health system. On the appointed day, ASHAs, AWWs, and other health workers mobilize the villagers, especially
women and children, to assemble at the nearest AWC. The ANM and other health personnel are also to be
present on time. On the VHND, the villagers interact with the health personnel and obtain basic services and
information. They also would learn about the preventive and promotional aspects of health care to encourage
them to seek health care at proper facilities.
Table 7.46 presents the awareness among ever married women with regards to VHND and their participation in
the past three months according to background characteristics. The table shows that 23 percent of the rural
ever married women were aware of the VHND conducted at AWC and out of them close to 43 percent reported
participating in at least one VHND in the past three months. Mothers’ education plays a role in the awareness
and attendance at VHND. For instance 27 percent mothers who passed at least higher secondary were aware of
VHND as compared to 16 percent illiterate women. Comparatively more educated women reported to have
participated in VHND than illiterate women.
Across the social category, a slightly higher proportion of women belonging to ST (25 percent) and those
belonging to SC (25 percent) reported their awareness of VHND than that of OBCs (21 percent). Analysis across
different wealth indices show that the awareness regarding VHND was relatively lower (21 percent) among ever
married women belonging to the lowest wealth index as compared to the women from highest wealth index (23
percent). Participation in the VHND was almost similar among women from different wealth quintiles.
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Table 7.46: Village Health and Nutrition Day
Percentage of ever married women (EMW) in rural areas who were aware of VHND or Mother's day held at AWC and
percentage attended any such meeting in the last 3 months prior to survey, according to background characteristics, RSOC,
2013-14.
Characteristics
Percentage of
EMW aware of
VHND or
Mother's day
held at AWC
Number of
EMW in rural
area
Percentage of
EMW attended
any VHND or
Mother's day in
the 3 months prior
to survey
Number of EMW
aware of VHND
or Mother's day
EMW's education
No Education 16.2 29,443 41.2 4,760
Below Primary (Class - 1 to 4) 27.8 4,030 36.0 1,120
Completed Primary (Class 5-7) 26.6 11,157 42.6 2,963
Completed Middle (Class 8 -9) 26.3 10,275 43.1 2703
Completed Secondary (Class 10-11) 30.6 8,321 48.1 2,550
12+ (Class 12 and above) 27.3 7,960 46.3 2,175
Social Group
Scheduled Caste 24.5 15,196 46.2 3,727
Scheduled Tribe 25.0 9,523 50.4 2,384
OBC 20.6 28,657 41.9 5,913
Other 23.5 17,109 39.4 4,018
No Response 32.9 700 20.2 230
Wealth index
Lowest 20.5 17,839 43.7 3,663
Second 22.8 17,557 43.7 3,999
Middle 24.5 15,910 42.7 3,900
Fourth 24.5 12,004 45.6 2,935
Highest 22.5 7,874 38.1 1,776
Total 22.9 71,185 43.2 16,273
One of the roles and responsibilities of the AWWs is to make home visits for educating parents and to enable
mothers to plan an effective role in the child’s growth and development with special emphasis on the new born
child. Table 7.47 presents the details of the visits made by AWW as reported by the EMW. Overall 35 percent of
the EMW reported that the AWW had visited them least once in the three months preceding the survey. The
average number of visits reported by the EMW was 2.6.
Analysis by social categories shows that comparatively higher proportion of women belonging to STs (38
percent) reported visit by AWW in the last three months prior to the survey than women belonging to other
castes (34 percent). The average number of visits reported by women from different social categories was more
or less similar ranging from 2.5 to 2.7. Analysis by wealth indices shows that average number of visits reported
by the women belonging to the lowest wealth index was 2.4 while it was 2.5 visits reported by women from the
highest wealth quintile.
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Table 7.48 presents the awareness of VHND and participation in VHND in three months prior to the survey.
Overall 23 percent of the EMW reported their awareness of the VHND. These were ranged state variations in the
awareness of VHND. In states like Tripura and Sikkim more than 60 percent women were aware of the VHND
followed by Gujarat (51 percent), Goa (50 percent) and Odisha (49 percent). The states where the awareness
regarding VHND was the lowest are Nagaland (1 percent), Delhi (6 percent), Haryana (6 percent), Uttar Pradesh
(8 percent), Jammu and Kashmir (8 percent), Chhattisgarh (8 percent) and Punjab (9 percent). Therefore any
subsequent analysis of these states should be done with caution.
Among the women who were aware of VHND, close to 44 percent reported having attended the event at least
once in the past three months of RSOC. However, there were wide state-wise variations with more than 50
percent of women who were aware attended the VHND in states like Sikkim (64 percent), Andhra Pradesh (60
percent), Himachal Pradesh (59 percent), Maharashtra (57 percent), Tamil Nadu (59 percent) and Jharkhand (54
percent). A much lower proportion of women reported attending such events in states like Delhi (26 percent)
and Arunachal Pradesh (17 percent).
Table 7.47: Home visits by AWW
Percentage of EMW in rural area who were visited at home by AWW at least once in last 3 months prior to the survey and
the average number of visits made in three months, according to selected background characteristics, RSOC, 2013-14.
Characteristics
Percentage of
EMW visited at
home by AWW in
last 3 months
Number of
EMWs in rural
areas
Average number
of visits made by
AWW
Number of EMW
visited by AWW
EMW's education
No Education 30.5 29,443 2.7 8,978
Below Primary (Class - 1 to 4) 33.8 4,030 2.6 1,361
Completed Primary (Class 5-7) 35.4 11,157 2.6 3,953
Completed Middle (Class 8 -9) 36.3 10,275 2.5 3,726
Completed Secondary (Class 10-11) 41.2 8,321 2.7 3,426
12+ (Class 12 and above) 39.9 7,960 2.7 3,175
Social Group
Scheduled Caste 35.7 15,196 2.7 5,423
Scheduled Tribe 37.7 9,523 2.6 3,596
OBC 33.4 28,657 2.7 9,568
Other Castes 33.9 17,109 2.5 5,808
No Response 32.3 700 2.1 226
Wealth index
Lowest 29.9 17,839 2.4 5,342
Second 34.3 17,557 2.7 6,020
Middle 37.9 15,910 2.7 6,038
Fourth 37.6 12,004 2.8 4,514
Highest 34.3 7,874 2.5 2,707
Total 34.6 71,185 2.6 24,621
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With regard to the home visits undertaken by AWW, an overall 35 percent of the women reported been visited
by an AWW in the past three months (Table 7.48). State-wise variations showed that more than 50 percent of
the women reported been visited by AWW in states like Manipur (78 percent), Himachal Pradesh (59 percent),
Gujarat (60 percent), Andhra Pradesh (52 percent) and Sikkim (50 percent). The proportion of mothers
reporting visits by AWW were around or less than a fifth in States like Madhya Pradesh (22 percent), Jammu &
Kashmir (17 percent), Mizoram (14 percent) and Nagaland (1 percent).
Table 7.48: Other services provided at AWC by state
Percentage of rural EMW who reported their awareness of VHND day or mother day's held at AWC and number of VHNDs
or mother’s day attended in the last 3 months prior to the survey, percent of EMWs reporting AWW’s visit to their home at
least once in the last 3 months prior to the survey and average number of times visited at home in last 3 months prior to
the survey across states, RSOC, 2013-14.
State
Village Health and Nutrition Day Home Visits by AWW
Percentage of
EMW aware of
VHND or Mother's
day held at AWC
Percentage of EMW
attended any VHND or
Mother's day in 3
months prior to survey
Percentage of EMW
visited at home by
AWW in 3 months
prior to survey
Average number of
times visited at home
in 3 months prior to
survey
India 22.9 43.2 34.6 2.6
North
Delhi 6.2 25.6 25.0 2.5
Haryana 5.8 30.0 23.8 2.5
Himachal Pradesh 37.3 58.6 58.8 2.5
Jammu & Kashmir 7.5 40.0 16.8 2.6
Punjab 8.6 38.7 24.6 2.4
Uttar Pradesh 7.8 35.1 26.8 3.1
Uttarakhand 9.2 45.8 27.0 2.3
Central
Madhya Pradesh 26.2 35.3 22.0 2.9
Chhattisgarh 8.1 48.4 27.6 2.2
East
Bihar 20.7 36.4 32.0 2.2
Jharkhand 22.2 53.5 27.8 2.3
Odisha 48.5 34.9 36.6 2.2
West Bengal 34.9 24.1 27.5 1.9
North east
Arunachal Pradesh 14.7 16.5 45.5 2.2
Assam 14.2 36.0 30.0 1.7
Manipur 27.3 50.3 77.7 2.6
Meghalaya 16.3 29.7 22.5 1.9
Mizoram 38.5 36.1 14.1 1.4
Nagaland 0.6 41.1 0.7 1.8
Sikkim 60.5 64.1 49.9 1.9
Tripura 63.8 47.5 33.5 2.4
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State
Village Health and Nutrition Day Home Visits by AWW
Percentage of
EMW aware of
VHND or Mother's
day held at AWC
Percentage of EMW
attended any VHND or
Mother's day in 3
months prior to survey
Percentage of EMW
visited at home by
AWW in 3 months
prior to survey
Average number of
times visited at home
in 3 months prior to
survey
West
Rajasthan 13.6 26.0 27.7 2.5
Goa 49.5 50.5 47.5 1.9
Gujarat 50.9 46.7 60.4 2.7
Maharashtra 28.5 57.4 48.0 2.9
South
Andhra Pradesh 34.5 59.6 52.2 3.2
Karnataka 30.5 43.6 33.1 2.5
Kerala 28.8 47.3 40.6 2.2
Tamil Nadu 21.8 58.8 41.8 3.0
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ANNEXURE A:
SAMPLE SIZE DETERMINATION The sample size in terms of children has been worked out for each state on the basis of the following formula:
Where,
N = required sample size
P = Percent of children aged 12-23 months covered under full Immunization (as per CES
2009)
Q = 1-P
D = design effect*
d = permissible margin of error (5%)
Kα/2 = Z score at 95 percent level of confidence
C = adjustment factor for non-response (taken as 1.1)
*Design effect was taken as 1.5 as per other DHS surveys (NFHS 2005-06 survey also used similar design effect)
The state sample so estimated was deflated (using proportion of ever married women aged 15-34 per household
as revealed from DLHS 2007-08) to arrive at the requisite number of sample households. The state wise number
of sample of households and PSUs in RSOC is given in Table 1.1.
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ANNEXURE A TABLES CHAPTER 1 Table 1.2: State wise number of regions formed in RSOC for sampling of rural and urban PSUs
State Regions formed
for RSOC Name of the districts in the region as per census 2011
Andhra Pradesh
I Srikakulam, Vizianagaram, Visakhapatnam
II East Godavari, West Godavari, Krishna, Guntur
III Prakasam, Nellore
IV Chittoor, Cuddapah, Anantapur, Kurnool
V Mahbubnagar, Rangareddi, Hyderabad, Medak, Nizamabad, Adilabad, Nalgonda
VI Karimnagar, Warangal, Khammam
Arunachal Pradesh
I Tawang, West Kameng, East Kameng
II Papumpare, Lower Subansiri, Upper Subansiri
III West Siang, East Siang, Upper Siang
IV Darrang, Lohit
V Tirap, Changlang
Assam
I Goalpara, Kamrup, Marigaon, Nagaon, Darrang
II Dhubri, Bongaigaon, Barpeta, Nalbari, Sonitpur
III Golaghat, Jorhat, Sibsagar, Dibrugarh, Tinsukia, Karimganj, Hailakandi, Cachar
IV Lakhimpur, Dhemaji
V Karbi Anglong
Bihar
I Saran, Siwan, Gopalganj, Pashchim Champaran, Purba Champaran
II Sitamarhi, Vaishali, Darbhanga, Madhubani, Samastipur, Muzaffarpur, Saharsa, Sheohar, Supaul
III Purnia, Araria, Katihar, Madhepura
IV Patna, Bhojpur, Rohtas, Buxor, Kaimur (Bhabua)
V Munger, Khagaria, Bhagalpur, Banka, Jamui, Lakhisarai, Sheikhpura
VI Nalanda, Gaya, Jehanabad, Aurangabad, Nawada, Begusarai
VII Kishanganj
Chhattisgarh
I Koriya, Surguja, Bilaspur, Korba, Janjgir-champa, Jashpur, Raigarh
II Kawaedha, rajnandgao, Durg, Raipur, Mahasamund, Dhamtari
III Kanker, Bastar, Dantewada
Goa I and II Each district in Goa is considered as a region.
Gujarat
I Jamnagar, Rajkot
II Surendranagar, Bhavnagar, Amreli
III Junagadh, Porbandar
IV Kachchh, Banaskantha
V Sabarkantha, Mahesana, Patan
VI Gandhinagar, Ahmedabad
VII Kheda, Anand
VIII Panch Mahals, Vadodara, Dohad
IX Bharuch, Surat, Valsad, The Dangs, Narmada, Navsari
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State Regions formed
for RSOC Name of the districts in the region as per census 2011
Haryana
I Faridabad, Gurgaon, Sonipat
II Ambala, Kaithal, Karnal, Kurukshetra, Panipat, Yamunanagar, Panchkula
III Bhiwani, Mahendragarh, Rewari, Sirsa
IV Hissar, Jind, Rohtak, Fatehbad, Jhajjar
Himachal Pradesh
I Chamba, Lahaul-Spiti, Kinnaur
II Kangra, Hamirpur, Una, Mandi, Kullu
III Bilaspur, Shimla, Solan, Sirmaur
Jammu & Kashmir
I Kargil, Leh
II Anantnag, Pulwama, Srinagar, Badgam, Baramulla
III Kupwara, Rajouri, Poonch
IV Doda, Udhampur, Kathua, Jammu
Jharkhand16
I Deogarh, Godda, Sahibganj, Pakaur, Dumka
II Chatra, Hazaribagh, Kodarma, Giridh, Bokaro, Dhanbad
III Garhwa, Palamu, Lohardagga, Gumla, Ranchi, Pashchim Singhbhum, Purbi Singhbhum
Karnataka
I Bidar, Bijapur, Gulbarga, Raichur, Bagalkot, Koppal
II Belgaum, Dharwad, Gadag, Haveri
III Dakshina Kannada, Kodagu, Uttara Kannada, Udupi
IV Chikmagalur, Shimoga
V Bangalore rural, Bellary, Chitradurga, Kolar, Tumkur, Davangere
VI Hassan, Mandya, Mysore, Chamrajnagar
Kerala I to XIV Each district in Kerala is considered as a region.
Madhya Pradesh
I Panna, Rewa, Satna, Sidhi, Shahdol, Chhatarpur, Tikamgarh, Umaria
II Raisen, Sagar, Damoh, Vidisha, Bhopal, Sehore
III Dewas, Dhar, Indore, Jhabua, Ujjain, Rajgarh, Ratlam, Mandsaur, Shajapur, Neemuch
IV Mandla, Jabalpur, Seoni, Narsimhapur, Chhindwara, Balaghat, Dindori, Katni
V Betul, Hoshangabad, East Nimar, West Nimar, Barwani, Harda
VI Gwalior, Bhind, Morena, Datia, Guna, Shivpuri, Sheopur
Maharashtra
I Thane, Raigad, Ratnagiri, Sindhudurg
II Nasik, Jalgaon
III Ahmednagar, Pune, Satara, Sangli, Solapur, Kolhapur
IV Aurangabad, Jalna, Parbhani, Bid, Latur, Osmanabad, Buldhana, Akola, Amaravati, Washim, Hingoli
V Yeotmal, Wardha, Nagpur, Nanded
VI Bhandara, Chandrapur, Gadchiroli, Gondiya
VII Dhule and Nandurbar
Manipur
I Senapati, Tamenglang, Ukhrul
II Churchandpur, Chandel
III Bishnupur , Imphal West, Imphal East, Toubal
Meghalaya
I West Garo Hills
II East Garo Hills, South Garo Hills
III West Khasi Hills
IV Ri Bhoi, East Khasi Hills
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State Regions formed
for RSOC Name of the districts in the region as per census 2011
V Jantia Hills
Mizoram
I Kolasib, Mamit, Aizwal, Champhal, Serchip
II Lunglei
III Lawangttai, Saita
Nagaland
I Tuensang, Mon
II Mokakchung, Zunhebota
III Wokha , Dimapur
IV Kohima , Phek
NCT of Delhi I to XI Each district in NCT of Delhi is considered as a region.
Odisha
I Sundargarh, Kendujhar, Mayurbhanj
II Phulabani, Koraput, Baudh, Malkangiri, Navarangapur, Rayagada
III Sambalpur, Balangir, Kalahandi, Bargarh, Debagarh, Jharsuguda, Nuapada, Sonapur
IV Baleshwar, Cuttack, Ganjam, Puri, Dhenkanal, Anugul, Bhadrak, Gajapati, Jagatsinghpur, Jajapur, Kendrapara, Khordha, Nayagarh
Punjab
I Gurdaspur, Amritsar, Firozpur
II Jalandhar, Kapurthala, Hoshiarpur, Rupnagar, Nawashahr
III Ludhiana, Patiala, Sangrur, Fatehgarh Sahib
IV Bhatinda, Faridkot, Mansa, Moga, Muktsar
Rajasthan
I Ganganagar, Bikaner, Churu, Jaisalmer, Jodhpur, Nagaur,Barmer, Sirohi, Hanumangarh
II Jhunjhunun, Alwar, Bharatpur, Dhaulpur, Sawai Madhopur, Jaipur, Sikar, Ajmer, Tonk, Dausa, Karauli
III Dungarpur, Banswara, Udaipur
IV Chhitaurgarh, Bundi, Kota, Jhalawar, Baran
V Bhilwara, Rajasamand, Jalor and Pali
Sikkim I to IV Each district in Sikkim is considered as a region.
Tripura
I Dhalai
II North Tripura
III South Tripura
IV West Tripura
Tamil Nadu
I Coimbatore, Dindigul Anna (Dindigul), Madurai (Madura and Theni), Periyar (Erode), Nilgiri
II North Arcot-Ambedkar (Vellore), Dharmapuri, Tiruvannamalai-Sambuvarayan, Salem (Salem and Namakal), Tiruchirappalli (Tiruchirapalli, Karur and Perambalur), Ariyalur
III Kanniyakumari
IV Chengalpattu-MGR (Kanchipuram and Tiruvallur), South Arcot (Cuddalore and Villupuram),Thanjavur, (Thanjavur, Nagappattinam and Tiruvarur), ChennaI
V Pudukkottai, Pasumpon, Muthuramalinga Thevar (Sivagangai), Kamarajar (Virudhunagar),Ramanathapuram, Chidambaranar (Thootukudi), Tirunelveli Kattabomman (Tirunelveli)
Uttarakhand I Dehradun, Haridwar, Udham Singh Nagar
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State Regions formed
for RSOC Name of the districts in the region as per census 2011
II UttarkKashi, Tehri Garhwal, Rudra Prayag, Pauri Garhwal
III Chamoli, Bageshwar, Pitorgarh, Almora, Nainital, Champawat
Uttar Pradesh
I Bijnor, Ghaziabad, Meerut, Moradabad, Rampur, Saharanpur, Muzzafarnagar, Agra, Aligarh, Bareilly, Budaun, Bulandshahr, Etah, Farrukhabad, Firozabad, Mainpuri, Pilibhit, Shahjahanpur, Etawah, Mathura, Auraiya, Baghpat, Goutam Buddha Nagar, Hathras, Jyotiba Phule Nagar, Kannauj
II Kheri, Hardoi, Rae Bareli, Sitapur, Barabanki, Fatehpur, Kanpur Dehat, Kanpur Nagar, Lucknow, Unnao
III Allahabad, Gonda, Pratapgarh, Sultanpur, Bahraich, Faizabad, Azamgarh, Basti, Deoria, Gorakhpur, Jaunpur, Maharajganj, Mau, Siddharthnagar, Ballia, Gazipur, Varanasi, Mirzapur, Sonbhadra, Ambedkar Nagar, Balrampur, Chandauli, Kaushambi, Kushinagar, Sant Kabir Nagar, Sant Ravidas Nagar, Shrawasti
IV Banda, Lalitpur, Hamirpur, Jalaun, Jhansi, Chitrakoot, Mahoba
West Bengal
I Jalpaiguri, Darjeeling
II Koch Bihar, West Dinajpur (Dakshin Dinajpur)
III Nadia, Haora, Hugli, North Twenty-Four Parganas, South Twenty-Four Parganas, Barddhaman
IV Medinipur, Bankura, Birbhum
V Puruliya
VI Maldah, Murshidabad and Uttar Dinajpur 16 In Jharkhand the regions were not considered for sampling of rural PSUs.
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Table 1.3: State wise sampling model selected for sampling of rural PSUs
State Region Explicit variable Implicit variable
Any modifications in NFHS Regions
Andhra Pradesh NFHS regions Village Size (3 levels - <=250, 250-1000 & 1000+ HH)
Female Literacy
None
Arunachal Pradesh NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Assam NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Bihar NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
Kishanganj District was removed from Region III
and formed as Region VII.
Chhattisgarh NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Delhi Each district is considered as a
region
NA Female Literacy
Each district in Delhi is considered as a region
sorted according to female literacy and
sampling is taken up according to PPS
Goa NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Gujarat NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Haryana NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Himachal Pradesh NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Jammu & Kashmir NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Jharkhand Village Size (3 levels - <=250,
251-499 &500+ HH)
Percentage of Non-SC/ST (3 levels - 33%, 34% and 33%)
Female Literacy
None
Karnataka NFHS regions Village Size (3 levels - <=250, 250-1000 & 1000+ HH)
Female Literacy
None
Kerala NFHS regions None Female Literacy
None
Madhya Pradesh NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Maharashtra NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
Dhule and Nandurbar were removed from Region II and a new
Region VII was created
Manipur Each district is considered as a
region
None Female Literacy
None
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State Region Explicit variable Implicit variable
Any modifications in NFHS Regions
Meghalaya Each district is considered as a
region
None Female Literacy
None
Mizoram NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Nagaland NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Odisha NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Punjab NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Rajasthan NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
Bhilwara, Rajasamand, Jalor and Pali have been
removed and put in a new Region - Region V
Sikkim NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Tamil Nadu NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Tripura NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
Uttar Pradesh NFHS regions Village Size (3 levels - <=250, 250-1000 & 1000+ HH)
Female Literacy
None
Uttarakhand NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
None
West Bengal NFHS regions Village Size (2 levels - <=250, 250+ HH)
Female Literacy
Maldah, Uttar Dinajpur and Murshidabad were removed from Region II
and a new Region VI was created.
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Table 1.4: Comparison of proportions of populations in the RSOC sample villages and Census 2011 by various stratification variables
State
%Effective Female Literacy
% Non-SC/ST % Non-Agricultural
Workers % of villages with
<250 HHs Number of
districts covered
RSOC sample villages
Census 2011
RSOC sample villages
Census 2011
RSOC sample villages
Census 2011
RSOC sample villages
Census 2011
RSOC sample villages
Census 2011
Delhi 71.7 73.1 81.1 80.4 89.8 85.3 7.9 17.5 7 7
Haryana 59.3 60.0 75.5 77.5 43.8 39.6 36.9 37.7 21 21
Himachal Pradesh 74.6 74.6 62.0 67.9 53.7 55.5 94.9 95.5 11 12
Jammu & Kashmir 49.1 51.6 70.0 76.3 62.1 59.3 67.2 66.3 19 22
Punjab 66.5 65.7 60.8 62.5 40.1 42.3 62.5 61.4 18 20
Uttar Pradesh 53.8 53.7 78.3 76.3 26.1 26.3 62.6 62.6 70 71
Uttarakhand 64.8 66.2 78.5 75.0 53.2 46.3 91.9 92. 9 13 13
Chhattisgarh 56.5 55.6 48.7 50.3 25.3 19.2 68.4 67.9 17 18
Madhya Pradesh 53.3 52.4 58.1 57.1 17.9 16.7 71.5 71.6 48 50
Bihar 49.2 49.0 82.2 82.0 21.6 22.2 49.5 49.9 36 38
Jharkhand 49.6 48.9 50.2 56.0 34.6 37.9 80.5 81.5 23 24
Odisha 60.8 60.7 53.9 56.5 32.4 35.2 79.0 78.6 28 30
West Bengal 65.4 65.5 66.9 64.7 47.1 38.8 54.7 54.9 18 19
Arunachal Pradesh 58.7 52.1 40.6 26.1 56.0 38.0 92.7 98.3 16 16
Assam 62.5 63.0 78.6 79.5 49.7 42.8 69.9 70.4 25 27
Manipur 74.5 68.9 44.0 51.7 52.2 41.8 35.6 14.1 9 9
Meghalaya 69.8 68.4 13.8 9.4 31.7 32.4 83.8 97.2 7 7
Mizoram 81.3 79.8 2.2 3.4 20.0 18.8 82.9 85.3 8 8
Nagaland 71.1 71.5 12.6 7.2 46.0 32.4 78.3 76.7 11 11
Sikkim 72.7 72.4 58.6 59.0 54.4 52.0 71.9 70.5 4 4
Tripura 81.0 79.5 50.4 42.6 45.4 45.0 19.1 19.7 4 4
Rajasthan 45.6 45.8 57.7 64.6 29.6 33.1 71.5 71.6 31 33
Goa 82.6 81.6 81.3 82.4 85.7 86.0 46.9 46.2 2 2
Gujarat 63.1 61.4 77.3 70.3 20.1 26.5 46.5 46.3 24 26
Maharashtra 71.0 68.5 75.5 73.2 32.5 23.5 55.2 55.6 32 35
Andhra Pradesh 52.3 51.5 73.2 71.5 31.4 28.4 8.4 8.1 22 23
Karnataka 59.8 59.7 68.4 70.8 34.1 31.9 25.3 25.1 26 30
Kerala 91.2 90.8 87.9 87.1 75.9 75.4 0.0 0.6 14 14
Tamil Nadu 66.9 65.0 76.5 72.8 48.0 42.2 27.6 26.0 28 31
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Table 1.5: Comparison of proportions of populations in the RSOC sample urban wards and Census 2011 by various stratification variables
State
% Effective Female Literacy
% Non-SC/ST % Non-Agricultural Workers
Number of districts covered
RSOC sample wards
Census 2011
RSOC sample wards
Census 2011
RSOC sample wards
Census 2011
RSOC sample wards
Census 2011
Delhi 79.9 80.9 81.6 83.3 99.3 99.2 9 9
Haryana 76.3 76. 9 88.3 84.2 95.4 93.9 18 21
Himachal Pradesh 88.6 88.4 81.3 79.6 97.2 97.0 10 11
Jammu & Kashmir 63.9 69.0 94.4 92.4 96.0 95.5 10 22
Punjab 79.3 79.2 80.6 77.3 97.6 94.5 16 20
Uttar Pradesh 75.3 69.2 86.9 87.0 94.8 89.6 56 71
Uttarakhand 77.5 79.3 87.9 86.1 97.3 95.8 7 13
Chhattisgarh 78.5 77.2 82.0 77.2 96.5 91.5 12 18
Madhya Pradesh 75.6 76.5 86.1 79.5 96.6 89.9 25 50
Bihar 75.1 70.5 89.5 89.0 89.9 82.6 30 38
Jharkhand 75.5 75.5 79.3 79.7 97.4 96.3 13 24
Odisha 82.3 80.4 79.0 77.6 96.8 94.1 18 30
West Bengal 80.9 81.0 82.9 83.5 96.3 96.0 17 19
Arunachal Pradesh 76.7 76.7 49.0 49.0 96.1 96.1 16 16
Assam 85.2 84.4 86.7 85.8 97.5 96.4 15 27
Manipur 82.6 79.3 72.7 80.7 90.2 80.5 7 9
Meghalaya 89.2 89.1 31.1 28.7 95.4 95.1 7 7
Mizoram 97.6 97.3 8.0 7.4 77.1 77.6 8 8
Nagaland 86.5 87.4 36.2 29.2 96.6 94.3 9 11
Sikkim 85.2 84.7 67.8 69.3 98.8 98.4 4 4
Tripura 90.6 91.4 69.4 72.3 95.0 93.5 4 4
Rajasthan 75.5 70.7 82.4 81.1 96.8 94.2 26 33
Goa 85.5 86.6 89.8 91.4 98.2 98.2 2 2
Gujarat 84.9 81.0 92.9 89.6 98.7 95.1 17 26
Maharashtra 85.0 84.9 90.2 85.7 98.9 95.4 23 36
Andhra Pradesh 75.9 74.4 87.0 86.8 95.6 92.3 20 23
Karnataka 84.8 81.4 88.4 83.9 97.8 94.2 22 30
Kerala 92.8 93.4 91.9 92.0 95.0 94.9 14 14
Tamil Nadu 85.0 82.3 85.7 85.4 97.2 91.5 24 32
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CHAPTER 3
Table 3.1a: Social-group of respondents by states
Percent distribution of ever-married women aged 15-49 by social-group, according to state, RSOC, 2013-14.
States
Social Group
Scheduled
Caste
Scheduled
Tribe
Other Backward
Classes Other
No
Response Total
India 19.3 10.9 40.0 29.1 0.8 100.0
North
Delhi 20.9 2.8 28.1 48.0 0.2 100.0
Haryana 23.7 8.8 28.4 38.8 0.3 100.0
Himachal Pradesh 27.3 4.9 15.9 51.8 0.1 100.0
Jammu & Kashmir 8.1 10.1 16.4 64.5 1.0 100.0
Punjab 26.9 6.4 19.9 46.5 0.3 100.0
Uttar Pradesh 23.1 2.7 52.4 21.6 0.1 100.0
Uttarakhand 14.1 5.8 20.9 58.1 1.1 100.0
Central
Chhattisgarh 17.9 32.7 42.0 7.0 0.4 100.0
Madhya Pradesh 17.2 21.1 45.7 15.9 0.1 100.0
East
Bihar 24.0 2.0 55.7 18.2 0.1 100.0
Jharkhand 13.8 29.6 45.3 10.8 0.5 100.0
Odisha 18.1 23.0 27.8 31.1 0.0 100.0
West Bengal 26.1 5.9 8.0 54.5 5.5 100.0
Northeast
Arunachal Pradesh 3.9 79.2 3.5 13.3 0.0 100.0
Assam 11.2 17.8 20.0 50.3 0.7 100.0
Manipur 0.5 30.9 25.7 41.7 1.2 100.0
Meghalaya 5.2 84.1 0.9 9.7 0.1 100.0
Mizoram 0.7 96.3 2.9 0.0 0.0 100.0
Nagaland 5.8 86.4 5.3 1.9 0.6 100.0
Sikkim 9.8 35.3 35.2 12.5 7.2 100.0
Tripura 27.8 25.6 16.0 30.4 0.3 100.0
West
Rajasthan 18.4 11.8 49.8 19.7 0.3 100.0
Goa 2.9 8.7 30.3 57.2 0.8 100.0
Gujarat 10.8 21.0 30.8 36.7 0.7 100.0
Maharashtra 14.1 10.7 33.3 41.5 0.4 100.0
South
Andhra Pradesh 22.0 9.9 49.2 18.4 0.4 100.0
Karnataka 11.8 10.0 37.7 39.4 1.2 100.0
Kerala 7.6 3.7 67.5 21.0 0.2 100.0
Tamil Nadu 26.0 6.3 57.1 10.4 0.1 100.0
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Table 3.2a: Literacy and educational attainment of respondents by states
Percent distribution of ever-married women aged 15-49 by educational attainment, according to state, RSOC, 2013-14.
States
Years of education completed
Percentage
literate No
education
Below
Primary
(<5 years)
Primary
(5-7
years)
Middle (8
-9 years)
Secondary
(10-11
years)
Higher
Secondary and
above (12 or
more years )
India 39.3 5.8 15.0 13.4 12.3 14.2 61.2
North
Delhi 24.6 1.0 8.8 12.8 16.5 36.4 76.4
Haryana 33.5 3.1 15.0 11.7 14.1 22.6 65.9
Himachal Pradesh 15.6 3.2 17.6 14.1 20.4 29.1 85.6
Jammu & Kashmir 53.3 1.5 6.4 14.5 10.0 14.4 47.4
Punjab 25.5 2.0 14.3 13.5 21.6 23.1 74.8
Uttar Pradesh 55.2 1.6 9.9 12.1 7.4 13.9 45.0
Uttarakhand 31.3 0.9 12.2 18.2 11.6 25.8 70.8
Central
Chhattisgarh 44.4 8.3 16.8 16.9 5.9 7.8 56.1
Madhya Pradesh 47.0 5.0 15.6 14.8 6.8 10.9 53.1
East
Bihar 62.0 4.9 11.0 9.1 7.3 5.8 38.8
Jharkhand 53.7 6.4 11.0 11.0 7.0 10.9 47.5
Odisha 37.9 10.1 19.4 15.7 9.5 7.4 63.5
West Bengal 29.7 14.5 18.4 18.5 10.4 8.4 70.4
Northeast
Arunachal Pradesh 28.7 17.0 22.3 15.8 9.1 7.0 72.2
Assam 32.1 15.1 14.2 21.8 8.2 8.7 68.2
Manipur 14.9 5.3 13.8 24.8 16.5 24.6 83.9
Meghalaya 18.5 15.3 20.6 18.5 15.0 12.1 83.5
Mizoram 3.1 5.8 17.9 21.5 32.1 19.7 98.2
Nagaland 19.2 3.7 12.0 23.1 20.1 21.9 88.0
Sikkim 24.2 13.5 21.6 16.0 12.2 12.5 76.7
Tripura 14.2 15.5 20.9 30.9 10.6 7.8 88.2
West
Rajasthan 54.7 3.2 15.2 11.5 5.5 9.9 46.0
Goa 9.7 7.8 15.2 17.8 24.0 25.6 89.9
Gujarat 35.7 7.1 19.6 12.6 11.0 13.9 63.6
Maharashtra 23.9 6.7 17.3 15.8 19.3 17.0 78.3
South
Andhra Pradesh 48.8 1.9 15.8 6.0 15.2 12.3 53.4
Karnataka 31.1 6.1 16.7 8.8 21.1 16.3 67.2
Kerala 2.2 3.1 9.3 9.9 32.7 42.7 97.2
Tamil Nadu 19.5 6.8 20.4 19.3 14.8 19.2 79.5
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Table3.3a: Current educational status of adolescent girls age 10-19 during 2012-13 by state
Percent distribution of adolescent girls age 10-19 by the grade they were attending during the school year 2012-13
according to state, RSOC, 2013-14.
States
Never
attended
school
Did not
attend
school in
2012-13
Attending
Total Primary
(1-4)
Middle
(5-8)
Secondary
(9-10)
Higher secondary or
higher (11th
or higher
grade)
India 7.8 14.7 12.4 35.0 16.6 13.5 100.0
North
Delhi 3.0 5.6 11.5 43.7 19.4 17.0 100.0
Haryana 6.5 12.9 10.5 34.7 17.6 17.8 100.0
Himachal Pradesh 0.6 5.5 4.7 39.1 25.7 24.4 100.0
Jammu & Kashmir 6.1 9.8 11.0 41.0 21.8 10.3 100.0
Punjab 7.5 9.7 12.7 32.7 22.2 15.2 100.0
Uttar Pradesh 13.6 13.4 16.8 31.2 12.5 12.7 100.0
Uttarakhand 2.7 8.5 13.3 33.6 22.7 19.2 100.0
Central
Chhattisgarh 3.6 14.5 11.3 43.9 15.0 11.8 100.0
Madhya Pradesh 6.3 16.4 11.4 37.9 16.9 11.1 100.0
East
Bihar 13.6 8.0 23.9 34.7 13.1 6.7 100.0
Jharkhand 9.0 9.1 16.9 40.0 17.6 7.3 100.0
Odisha 5.8 26.8 7.8 32.0 18.8 8.8 100.0
West Bengal 2.5 20.5 12.1 35.2 19.8 9.9 100.0
Northeast
Arunachal Pradesh 2.5 10.4 12.5 42.1 18.6 14.0 100.0
Assam 4.2 21.2 9.6 42.6 16.9 5.6 100.0
Manipur 1.4 12.6 17.0 39.8 17.9 11.2 100.0
Meghalaya 2.1 12.7 14.7 39.1 20.6 10.8 100.0
Mizoram 0.3 12.4 6.3 33.6 24.9 22.5 100.0
Nagaland 12.0 30.7 5.3 15.0 18.1 18.8 100.0
Sikkim 0.9 7.7 10.8 50.7 20.3 9.7 100.0
Tripura 2.0 16.0 12.2 45.6 19.1 5.0 100.0
West
Rajasthan 11.5 15.4 14.7 33.5 12.0 12.9 100.0
Goa 0.9 6.9 10.5 46.6 19.0 15.9 100.0
Gujarat 8.0 25.8 6.9 35.7 12.9 10.6 100.0
Maharashtra 3.0 16.2 10.5 35.8 17.0 17.6 100.0
South
Andhra Pradesh 9.2 14.9 3.6 28.2 21.5 22.6 100.0
Karnataka 5.6 15.1 8.5 37.5 18.2 15.1 100.0
Kerala 1.4 5.2 8.9 38.3 19.8 26.4 100.0
Tamil Nadu 0.3 12.9 3.0 39.4 23.5 21.0 100.0
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Table 3.4a: Percent ever-pregnant and pregnant before age across states
Percentage of ever-married women aged 15-49 who were ever-pregnant and percentage who had their first pregnancy by
age 18 across states, RSOC, 2013-14.
States
Percentage
Ever pregnant Pregnant before
age 18
India 92.5 21.6
North
Delhi 91.1 15.7
Haryana 93.0 13.8
Himachal Pradesh 95.1 7.8
Jammu & Kashmir 94.4 15.1
Punjab 93.6 9.3
Uttar Pradesh 92.3 18.4
Uttarakhand 92.2 14.7
Central
Chhattisgarh 91.8 26.5
Madhya Pradesh 94.2 19.3
East
Bihar 94.8 34.1
Jharkhand 91.3 23.4
Odisha 93.3 23.9
West Bengal 92.3 38.4
Northeast
Arunachal Pradesh 96.3 24.5
Assam 93.4 25.3
Manipur 94.3 12.5
Meghalaya 94.6 16.9
Mizoram 95.2 6.4
Nagaland 76.6 3.1
Sikkim 94.7 20.7
Tripura 92.8 32.0
West
Rajasthan 92.5 25.6
Goa 93.2 5.6
Gujarat 92.6 11.2
Maharashtra 90.1 17.5
South
Andhra Pradesh 93.5 23.8
Karnataka 92.4 15.8
Kerala 93.2 8.0
Tamil Nadu 90.1 18.3
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Table 3.5a: Teenage pregnancy and motherhood by states
Percentage of women aged 15-19 who have had a live birth or who are pregnant with their first child and percentage who
have begun childbearing, by background characteristics, RSOC, 2013-14.
States
Percentage of women
Who have had a live birth Pregnant with first child Who have begun
childbearing
India 3.3 2.1 5.3
North
Delhi 1.6 0.0 1.6
Haryana 2.4 1.9 4.3
Himachal Pradesh 0.9 1.8 2.7
Jammu & Kashmir 1.7 0.2 2.0
Punjab 0.7 1.0 1.7
Uttar Pradesh 1.6 1.1 2.8
Uttarakhand 1.5 0.9 2.4
Central
Chhattisgarh 3.2 1.6 4.8
Madhya Pradesh 1.8 0.8 2.6
East
Bihar 4.8 2.0 6.7
Jharkhand 3.8 4.3 8.1
Odisha 4.1 2.2 6.4
West Bengal 9.6 6.6 16.2
Northeast
Arunachal Pradesh 6.6 0.5 7.1
Assam 4.8 2.7 7.5
Manipur 6.0 2.2 8.2
Meghalaya 5.6 1.1 6.8
Mizoram 1.7 0.2 1.8
Nagaland 0.5 0.0 0.5
Sikkim 4.3 1.2 5.5
Tripura 15.4 3.3 18.7
West
Rajasthan 3.4 1.6 5.1
Goa 1.5 1.0 2.5
Gujarat 2.8 0.9 3.7
Maharashtra 2.4 0.8 3.2
South
Andhra Pradesh 3.1 4.4 7.5
Karnataka 3.2 2.8 6.0
Kerala 2.5 0.9 3.4
Tamil Nadu 2.4 0.5 2.9
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Table 3.6a: Number of children ever born and surviving across states
Percentage of ever married women aged 15-49 who ever had a live birth and mean number of ever born and living children
by state, RSOC, 2013-14.
States Percentage who ever had
live birth
Mean number of
children ever born
Mean number of
children survived
India 90.0 2.4 2.3
North
Delhi 90.2 2.1 2.0
Haryana 90.8 2.3 2.2
Himachal Pradesh 91.1 2.1 2.1
Jammu & Kashmir 90.5 2.7 2.6
Punjab 92.1 2.2 2.1
Uttar Pradesh 90.1 3.2 2.9
Uttarakhand 89.4 2.5 2.5
Central
Chhattisgarh 88.7 2.7 2.4
Madhya Pradesh 91.7 2.8 2.6
East
Bihar 92.6 3.3 3.0
Jharkhand 89.2 2.7 2.5
Odisha 89.5 2.3 2.1
West Bengal 89.1 2.2 2.0
Northeast
Arunachal Pradesh 95.6 2.4 2.3
Assam 89.8 2.4 2.3
Manipur 91.2 2.3 2.2
Meghalaya 93.1 2.4 2.3
Mizoram 94.2 2.1 2.0
Nagaland 76.4 1.6 1.6
Sikkim 93.1 2.3 2.1
Tripura 90.1 1.8 1.8
West
Rajasthan 90.6 2.8 2.5
Goa 91.6 1.8 1.7
Gujarat 89.9 2.2 2.1
Maharashtra 88.0 2.0 2.0
South
Andhra Pradesh 89.7 1.9 1.9
Karnataka 90.7 2.0 1.9
Kerala 91.8 1.7 1.7
Tamil Nadu 87.5 1.9 1.8
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Table 3.7a: Number of children ever born and surviving across states
Percentage of ever married women age 35-49 who ever had a live birth and mean number of ever born and living children
by state, RSOC, 2013-14.
States Percentage who ever had a
live birth
Mean number of ever
born children
Mean number of living
children
India 95.5 3.2 2.9
North
Delhi 96.2 2.7 2.6
Haryana 97.3 3.1 2.9
Himachal Pradesh 98.7 2.6 2.5
Jammu & Kashmir 96.2 3.4 3.3
Punjab 98.2 2.8 2.6
Uttar Pradesh 97.1 4.5 4.0
Uttarakhand 95.3 3.2 3.1
Central
Chhattisgarh 92.5 3.6 3.1
Madhya Pradesh 97.2 3.8 3.4
East
Bihar 97.5 4.6 4.1
Jharkhand 94.3 3.5 3.3
Odisha 94.8 3.0 2.8
West Bengal 96.7 2.9 2.6
Northeast
Arunachal Pradesh 96.0 2.9 2.9
Assam 96.7 3.3 3.1
Manipur 95.5 3.0 2.8
Meghalaya 96.2 3.3 3.1
Mizoram 93.7 2.3 2.3
Nagaland 97.0 2.4 2.4
Sikkim 98.3 3.0 2.8
Tripura 96.1 2.4 2.3
West
Rajasthan 98.4 3.9 3.5
Goa 91.9 2.0 1.9
Gujarat 95.8 2.7 2.6
Maharashtra 91.5 2.4 2.3
South
Andhra Pradesh 94.0 2.4 2.4
Karnataka 96.1 2.4 2.2
Kerala 95.9 2.0 2.0
Tamil Nadu 91.4 2.3 2.2
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Table 3.8a: Birth order by states
Percent distribution of live-births in the three years preceding the survey by order of birth by state, RSOC, 2013-14.
States Birth order
1 2 3+
India 46.9 30.2 22.9
North
Delhi 60.7 27.6 11.7
Haryana 54.5 27.4 18.0
Himachal Pradesh 57.5 30.8 11.7
Jammu & Kashmir 41.3 29.9 28.8
Punjab 50.8 33.1 16.2
Uttar Pradesh 41.1 24.8 34.2
Uttarakhand 40.4 29.0 30.6
Central
Chhattisgarh 37.2 30.0 32.9
Madhya Pradesh 45.6 29.3 25.2
East
Bihar 22.9 32.0 45.1
Jharkhand 40.3 23.4 36.3
Odisha 39.5 37.6 22.9
West Bengal 46.0 33.9 20.0
Northeast
Arunachal Pradesh 26.8 36.3 36.9
Assam 40.8 32.1 27.1
Manipur 38.3 35.9 25.9
Meghalaya 29.5 39.0 31.5
Mizoram 38.6 38.0 23.4
Nagaland 23.0 49.0 28.0
Sikkim 47.5 35.2 17.3
Tripura 53.8 33.5 12.6
West
Rajasthan 40.5 29.0 30.5
Goa 64.1 26.1 9.8
Gujarat 49.2 30.3 20.5
Maharashtra 52.7 33.1 14.2
South
Andhra Pradesh 62.8 31.4 5.8
Karnataka 61.0 28.1 10.9
Kerala 70.3 24.4 5.3
Tamil Nadu 57.1 34.6 8.3
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Table 3.9a: Current use of family planning by states
Percentage of currently married women aged 15-49 using any method and any modern method by residence, according to
states, RSOC, 2013-14.
States
Residence Total
Urban Rural
Any method Any modern
method Any method
Any modern method
Any method
Any modern method
India 59.8 54.3 56.8 49.5 57.8 51.1 North
Delhi 50.5 48.8 50.8 48.7 50.5 48.8 Haryana 56.4 51.6 54.3 48.3 55.0 49.4 Himachal Pradesh 62.7 61.7 63.4 59.8 63.4 60.0 Jammu & Kashmir 61.0 52.1 55.9 42.4 57.2 44.9 Punjab 69.9 60.2 63.8 58.3 66.1 59.0 Uttar Pradesh 51.6 43.6 48.5 35.4 49.2 37.3 Uttarakhand 64.2 57.5 60.9 55.3 62.0 56.0
Central
Chhattisgarh 55.5 52.0 54.1 50.5 54.4 50.8 Madhya Pradesh 54.7 50.4 58.4 53.8 57.3 52.8
East
Bihar 49.6 45.4 39.8 35.8 40.9 37.0 Jharkhand 45.3 41.3 40.8 36.5 41.8 37.6 Odisha 59.1 49.3 45.3 37.3 47.6 39.3 West Bengal 76.6 51.7 76.0 60.6 76.2 57.7
Northeast Arunachal Pradesh 71.4 55.8 69.8 49.7 70.3 51.3 Assam 74.7 44.4 71.5 36.0 71.9 37.2 Manipur 29.9 13.9 23.0 14.2 25.5 14.1 Meghalaya 34.6 29.8 33.3 23.9 33.6 25.2 Mizoram 85.8 83.5 53.8 53.7 71.2 69.9 Nagaland 28.2 25.9 19.9 18.4 22.9 21.1 Sikkim 76.6 49.0 70.3 55.6 72.2 53.6 Tripura 67.9 57.1 57.8 52.3 60.6 53.6
West Rajasthan 67.2 60.0 66.0 58.6 66.3 59.0 Goa 47.4 41.7 43.9 38.5 46.2 40.6 Gujarat 57.0 52.2 54.5 50.8 55.7 51.5 Maharashtra 63.8 63.2 61.2 59.6 62.4 61.4
South Andhra Pradesh 61.4 61.4 66.2 66.2 64.6 64.6 Karnataka 62.7 61.9 66.2 64.9 64.7 63.7 Kerala 56.6 55.5 50.0 48.9 53.2 52.1 Tamil Nadu 54.3 54.0 55.4 55.4 54.8 54.7
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Table 3.10a: Age distribution and sex ratio of children by states
Percent distribution of children age 0-5 by single year of age and sex ratio according to state, RSOC, 2013-14.
States
Age
Total
Sex ratio
(females per
1,000
males)
0 1 2 3 4 5
India 16.3 16.3 17.6 17.0 15.8 17.0 100.0 933
North
Delhi 17.5 15.8 17.4 14.6 14.8 19.9 100.0 858
Haryana 18.6 17.2 18.2 16.0 16.3 13.6 100.0 838
Himachal Pradesh 14.8 16.6 18.7 16.2 16.6 17.2 100.0 985
Jammu & Kashmir 16.5 16.5 17.7 16.0 16.5 16.9 100.0 841
Punjab 15.3 17.6 17.3 15.5 15.0 19.2 100.0 891
Uttar Pradesh 16.1 15.6 17.3 16.2 15.7 19.1 100.0 913
Uttarakhand 15.1 15.5 17.3 18.6 18.7 14.8 100.0 887
Central
Chhattisgarh 18.3 15.2 17.9 16.7 16.2 15.7 100.0 1,002
Madhya Pradesh 16.7 17.2 16.8 16.6 15.4 17.4 100.0 908
East
Bihar 15.5 16.3 16.8 17.1 15.6 18.8 100.0 902
Jharkhand 16.9 15.4 18.4 18.0 14.8 16.5 100.0 1092
Odisha 15.7 16.6 16.7 16.1 17.4 17.5 100.0 931
West Bengal 16.4 16.5 17.5 17.1 15.5 16.9 100.0 1,024
Northeast
Arunachal Pradesh 10.2 12.7 22.5 12.5 20.1 22.1 100.0 866
Assam 15.3 15.3 15.8 17.9 15.6 20.1 100.0 908
Manipur 16.7 14.2 16.8 16.8 15.5 20.0 100.0 909
Meghalaya 14.5 12.4 22.3 13.6 14.9 22.2 100.0 883
Mizoram 15.5 12.4 17.4 15.7 17.6 21.5 100.0 865
Nagaland 15.9 7.6 22.9 16.6 20.4 16.6 100.0 849
Sikkim 18.2 18.2 17.8 16.8 14.3 14.7 100.0 931
Tripura 14.4 18.0 20.4 14.0 15.7 17.3 100.0 975
West
Rajasthan 17.6 16.4 17.1 16.0 15.2 17.7 100.0 872
Goa 15.6 17.7 18.7 15.7 16.1 16.2 100.0 941
Gujarat 17.8 16.9 19.2 17.0 15.5 13.6 100.0 916
Maharashtra 15.8 16.7 18.3 17.0 16.6 15.6 100.0 863
South
Andhra Pradesh 16.5 16.0 17.2 20.2 15.5 14.6 100.0 1,009
Karnataka 17.1 17.8 17.6 18.4 14.5 14.7 100.0 1,010
Kerala 13.8 14.4 17.5 17.1 16.7 20.5 100.0 995
Tamil Nadu 15.4 16.8 18.5 16.2 16.7 16.4 100.0 964
UTILIZATION OF ICDS SERVICES
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CHAPTER 5
Table 5.9: Prevalence and management of diarrhoea and fever by state
Percentage of children aged 0-5 years, who had diarrhoea in 15 days preceding the survey, percentage with diarrhoea who received
treatment and ORS, percentage who had fever in the last 15 days preceding the survey, percentage with fever for whom blood was taken
from his/her finger for testing and who took anti-malarial drugs, by state.
States
Percentage suffered from
diarrhoea in 15 days preceding
the date of survey
Percentage received
treatment for the
diarrhoea
Percentage received
ORS/HAF any time during
the diarrhoea
Percentage of children with fever in the last 15 days
preceding the survey
Percentage for whom blood
was taken from his/her finger
for testing
Percentage who took
anti-malarial drugs
India 6.5 77.9 54.4 13.6 15.3 18.4 North
Delhi 4.5 66.7 55.3 7.1 18.1 18.5 Haryana 8.5 73.8 44.5 11.9 19.0 13.0 Himachal Pradesh 5.5 76.3 74.7 13.6 11.2 8.4 Jammu & Kashmir 4.4 79.7 68.8 12.2 9.2 14.8 Punjab 2.6 74.4 26.4 11.5 6.8 6.3 Uttar Pradesh 5.2 75.4 31.7 11.3 8.2 12.9 Uttarakhand 3.2 73.2 39.1 9.3 6.6 3.5
Central Chhattisgarh 6.8 80.2 35.1 16.1 14.4 13.1 Madhya Pradesh 5.6 74.6 39.8 10.0 11.0 11.6
East Bihar 4.5 86.4 38.5 16.3 6.2 14.4 Jharkhand 5.5 74.8 74.0 16.1 17.5 17.2 Odisha 9.2 83.5 70.9 13.7 33.6 33.9 West Bengal 3.5 85.8 76.8 17.0 5.0 9.3
Northeast Arunachal Pradesh 4.2 71.7 87.8 9.3 5.6 2.0 Assam 2.1 79.9 75.2 10.4 5.8 1.2 Manipur 16.5 56.6 73.3 15.0 6.3 23.8 Meghalaya 3.1 76.0 79.2 8.1 2.5 8.1 Mizoram 4.6 54.6 83.6 6.3 17.3 72.4 Nagaland 0.4 30.5 40.4 0.5 * * Sikkim 7.1 76.9 76.4 8.8 8.0 26.9 Tripura 3.0 75.3 84.4 9.8 40.0 51.4
West Rajasthan 5.6 76.2 37.3 16.0 7.6 14.6 Goa 5.8 82.2 78.0 12.3 23.1 13.3 Gujarat 8.8 82.5 56.5 12.7 17.5 25.0 Maharashtra 12.5 78.6 51.6 17.5 17.9 16.2
South Andhra Pradesh 8.0 74.0 73.7 13.6 41.5 51.6 Karnataka 9.3 83.9 64.8 14.6 18.4 21.8 Kerala 3.6 72.1 76.4 9.8 15.4 23.2 Tamil Nadu 5.1 65.1 68.7 12.7 18.8 13.2
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 298
Table 5.10: Prevalence and management of ARI by state
Among children aged 0-5 years, percentage who had fever in the last 15 days preceding the survey, percentage who had symptoms of acute respiratory infection (ARI) in the last
15 days preceding the survey, sought advice or treatment for the illness, by state.
State
Residence Total
Urban Rural
Percentage of
children who
had cough in
the last 15 days
preceding the
survey
Percentage
of children
with
symptoms
of ARI**
Percentage of
children with
symptoms of ARI
sought
advise/treatment
Percentage of
children who
had cough in
the last 15
days preceding
the survey
Percentage
of children
with
symptoms
of ARI**
Percentage of
children with
symptoms of ARI
sought
advise/treatment
Percentage of
children who
had cough in
the last 15 days
preceding the
survey
Percentage
of children
with
symptoms
of ARI**
Percentage of
children with
symptoms of ARI
sought
advise/treatment
India 14.9 7.6 79.9 16.6 9.1 75.8 16.1 8.6 76.9
North
Delhi 9.0 4.9 89.0 15.6 7.9 84.1 9.2 5.0 88.8
Haryana 13.1 7.3 79.4 17.4 11.9 79.0 16.0 10.4 79.1
Himachal Pradesh 10.1 5.3 * 15.2 7.2 93.2 14.7 7.1 92.1
Jammu & Kashmir 16.4 13.0 85.0 13.0 9.8 86.9 13.9 10.6 86.3
Punjab 12.6 7.4 89.6 10.4 6.4 76.7 11.2 6.7 81.7
Uttar Pradesh 10.3 5.1 78.4 11.3 6.7 78.6 11.1 6.3 78.6
Uttarakhand 16.5 8.7 86.5 9.0 5.0 86.4 11.2 6.1 86.5
Central
Chhattisgarh 24.6 8.2 78.4 22.4 11.8 76.5 22.9 11.0 76.8
Madhya Pradesh 20.8 12.4 89.8 18.9 9.7 80.8 19.4 10.4 83.6
East
Bihar 17.0 9.5 92.6 22.7 12.4 86.9 22.0 12.0 87.4
Jharkhand 20.0 12.3 67.6 21.0 13.8 51.0 20.8 13.4 54.3
Odisha 16.0 10.3 92.0 13.9 8.7 69.7 14.3 9.0 73.9
West Bengal 26.4 10.7 67.5 27.4 15.2 66.9 27.1 13.8 67.1
Northeast
Arunachal Pradesh 7.0 3.7 * 7.0 2.9 (53.1) 7.0 3.1 63.0
Assam 15.0 7.6 * 6.8 3.8 54.5 7.9 4.3 61.4
Manipur 26.1 8.1 (51.8) 16.6 6.1 58.1 19.4 6.7 55.9
Meghalaya 11.3 3.1 * 4.9 1.6 * 6.1 1.9 (79.3)
Mizoram 8.2 3.3 (70.9) 2.1 0.6 * 5.3 2.0 (75.1)
Nagaland 2.2 0.8 * 0.4 0.1 * 0.9 0.3 *
Sikkim 12.8 6.6 (87.7) 7.8 4.2 83.5 9.0 4.8 84.8
Tripura 17.5 10.4 (82.9) 13.1 6.0 46.0 14.2 7.0 59.0
West
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 299
State
Residence Total
Urban Rural
Percentage of
children who
had cough in
the last 15 days
preceding the
survey
Percentage
of children
with
symptoms
of ARI**
Percentage of
children with
symptoms of ARI
sought
advise/treatment
Percentage of
children who
had cough in
the last 15
days preceding
the survey
Percentage
of children
with
symptoms
of ARI**
Percentage of
children with
symptoms of ARI
sought
advise/treatment
Percentage of
children who
had cough in
the last 15 days
preceding the
survey
Percentage
of children
with
symptoms
of ARI**
Percentage of
children with
symptoms of ARI
sought
advise/treatment
Rajasthan 18.0 8.7 90.1 18.1 9.5 80.5 18.1 9.3 82.8
Goa 12.0 4.5 (88.1) 15.1 5.6 94.4 13.2 4.9 90.7
Gujarat 15.9 9.5 74.7 17.6 11.0 74.4 17.0 10.4 74.5
Maharashtra 16.3 9.5 82.2 17.3 10.5 80.3 16.8 10.1 81.1
South
Andhra Pradesh 7.7 5.3 63.6 15.1 7.7 71.6 12.6 6.9 69.6
Karnataka 14.1 5.4 89.2 13.9 5.9 78.7 13.9 5.7 82.3
Kerala 7.9 3.3 (76.3) 6.5 1.8 * 7.1 2.5 (82.1)
Tamil Nadu 13.6 4.7 75.1 15.8 5.0 63.0 14.8 4.8 68.5
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 300
Table 5.12: Health check-up of children aged 0-71 months by state
Percentage of children aged 0-6 years who had health check-up in the three months preceding the survey, by
state.
State
Percentage whose health was checked up at
least once in 3 months preceding the survey
Residence Total
Urban Rural
India 21.9 19.5 20.2
North
Delhi 13.9 14.6 13.9
Haryana 14.0 15.8 15.2
Himachal Pradesh 16.5 22.8 22.3
Jammu & Kashmir 15.2 15.0 15.1
Punjab 16.6 11.9 13.6
Uttar Pradesh 12.4 10.7 11.0
Uttarakhand 21.5 10.1 13.5
Central
Chhattisgarh 28.8 26.8 27.2
Madhya Pradesh 17.9 14.6 15.5
East
Bihar 13.2 18.3 17.7
Jharkhand 16.1 12.8 13.5
Odisha 17.2 14.5 14.9
West Bengal 20.9 18.6 19.3
Northeast
Arunachal Pradesh 11.6 6.9 8.0
Assam 19.6 7.0 8.7
Manipur 26.5 15.3 18.5
Meghalaya 20.1 9.8 11.7
Mizoram 15.5 6.0 10.8
Nagaland 1.5 0.2 0.6
Sikkim 21.7 26.4 25.3
Tripura 17.2 9.0 10.9
West
Rajasthan 21.9 20.1 20.6
Goa 35.0 45.7 38.9
Gujarat 23.8 28.4 26.5
Maharashtra 29.4 39.6 35.0
South
Andhra Pradesh 29.3 27.0 27.7
Karnataka 33.6 33.0 33.2
Kerala 29.4 26.4 27.8
Tamil Nadu 17.7 15.1 16.3
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 301
CHAPTER 6
Table 6.7: Exclusive breastfeeding, continued breastfeeding by age one and two and complementary feeding at age 6-8 months by states
Percentage of children aged 0-5 months who are currently breastfed and who are currently exclusively breastfed,
percentage of children aged 12-15 months and 20-23 months who are currently breastfed and percentage of
children aged 6-8 months who were fed complementary food, by state.
States
Children aged 0-5 months* Children aged 12-
15 months* Children aged
20-23 months* Children aged 6-8
months
Currently breastfed
Exclusive breast feeding
Currently breastfed
Currently breastfed
Fed complementary food
India 95.6 64.9 84.8 67.5 50.5 North
Delhi 95.8 67.8 73.5 62.0 43.3 Haryana 88.3 53.6 79.2 59.7 28.7 Himachal Pradesh 95.3 55.2 77.0 53.4 61.8 Jammu & Kashmir 95.8 60.4 83.6 73.3 47.4 Punjab 98.4 60.2 86.1 60.2 53.8 Uttar Pradesh 93.5 62.2 83.7 68.7 32.0 Uttarakhand 86.5 48.1 78.9 67.8 60.4
Central Chhattisgarh 98.7 82.3 89.5 79.8 59.9 Madhya Pradesh 97.7 74.8 91.5 71.9 46.3
East Bihar 97.9 70.8 87.6 72.9 45.7 Jharkhand 98.4 64.3 95.7 90.6 53.7 Odisha 99.7 68.5 97.0 96.4 55.5 West Bengal 99.5 59.4 94.6 84.3 67.7
Northeast Arunachal Pradesh 100.0 59.8 98.4 86.9 64.9 Assam 99.6 64.7 99.6 90.9 76.1 Manipur 98.3 66.8 87 77.5 83.0 Meghalaya 97.9 54.9 79.4 59.1 65.2 Mizoram 99.4 44.5 79.6 58.4 60.9 Nagaland 98.0 58.1 36.9 25.4 18.7
Sikkim 98.0 57.7 70.6 65.2 68.8 Tripura 97.6 63.0 97.1 87.9 60.8
West Rajasthan 85.8 49.9 79.3 66.2 45.9 Goa 98.4 62.6 79.9 71.6 75.6 Gujarat 96.1 74.4 83.4 60.4 43.4 Maharashtra 95.1 73.4 87.2 68.0 53.4
South Andhra Pradesh 96.5 69.2 85.7 64.9 40.1 Karnataka 98.0 55.1 78.7 50.4 63.4 Kerala 99.4 58.6 74.1 65.8 72.6 Tamil Nadu 91.9 57.0 61.9 30.0 64.0
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 302
Table 6.11: Infant and young child feeding (IYCF) practices by state
Percentage of children 6-23 months of age, fed with appropriate feeding practices based upon number of food groups and times they are fed during the day or
night preceding the survey by breastfeeding status and by state.
State
Among breastfed children, percentage fed: Among non-breastfed children, percentage fed: Among all (both breastfed or non-breastfed)
children, percentage fed:
Minimum
number of
times
Minimum
dietary
diversity
Minimum
acceptable
diet
Minimum
number of
times
Minimum
dietary
diversity
Minimum
acceptable
diet
Minimum
number of
times
Minimum
dietary
diversity
Minimum
acceptable
diet
India 36.3 19.9 10.7 63.3 33.4 12.4 41.1 22.3 11.0
North
Delhi 31.6 19.5 11.3 55.9 26.3 13.6 37.8 21.2 11.9
Haryana 18.8 9.2 3.1 61.2 22.7 9.8 29.9 12.7 4.8
Himachal Pradesh 46.4 20.8 10.4 76.6 32.4 14.6 54.8 24.0 11.6
Jammu & Kashmir 41.0 16.9 8.0 76.2 44.2 25.3 46.8 21.5 10.9
Punjab 35.2 19.1 11.4 67.0 13.3 5.0 41.2 18.0 10.2
Uttar Pradesh 30.2 15.1 9.2 64.2 29.4 10.3 36.5 17.8 9.4
Uttarakhand 47.7 21.4 13.3 75.7 26.3 8.9 53.7 22.4 12.4
Central
Chhattisgarh 57.5 8.6 6.5 72.4 25.0 5.6 59.1 10.3 6.4
Madhya Pradesh 37.8 20.9 13.4 64.7 31.9 10.4 41.4 22.4 13.0
East
Bihar 45.7 16.1 11.0 81.4 26.9 5.8 50.2 17.4 10.4
Jharkhand 35.7 17.8 9.0 70.1 43.0 22.1 37.2 18.9 9.6
Odisha 41.9 25.8 10.7 * * * 42.5 26.6 10.6
West Bengal 41.6 33.7 16.6 79.7 42.6 21.8 44.3 34.3 16.9
Northeast
Arunachal Pradesh 41.2 34.7 16.3 * * * 40.6 34.4 15.8
Assam 25.6 17.8 5.6 * * * 25.6 17.9 5.7
Manipur 29.7 22.5 8.3 49.6 33.3 17.1 32.4 24.0 9.5
Meghalaya 36.3 28.7 12.0 46.6 32.7 8.7 38.6 29.6 11.3
Mizoram 20.0 10.5 3.5 34.8 23.3 2.8 23.4 13.5 3.4
Nagaland 12.6 2.6 1.1 49.2 15.9 1.5 27.1 7.9 1.2
Sikkim 55.3 46.5 24.8 (60.7) (57.1) (21.4) 55.6 46.1 24.3
Tripura 51.9 21.0 13.8 61.7 33.5 8.8 54.4 24.2 12.5
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 303
State
Among breastfed children, percentage fed: Among non-breastfed children, percentage fed: Among all (both breastfed or non-breastfed)
children, percentage fed:
Minimum
number of
times
Minimum
dietary
diversity
Minimum
acceptable
diet
Minimum
number of
times
Minimum
dietary
diversity
Minimum
acceptable
diet
Minimum
number of
times
Minimum
dietary
diversity
Minimum
acceptable
diet
West
Rajasthan 45.8 14.5 10.1 71.1 28.0 10.0 50.8 17.2 10.1
Goa 38.5 38.0 15.7 71.5 53.5 23.6 45.1 41.1 17.3
Gujarat 30.4 20.2 11.1 49.5 37.7 10.6 34.6 24.1 10.9
Maharashtra 34.0 19.2 8.6 59.1 49.9 16.5 37.8 23.8 9.8
South
Andhra Pradesh 24.1 17.8 7.2 49.2 27.3 12.7 29.4 19.8 8.3
Karnataka 44.3 21.8 14.4 67.3 37.9 10.2 50.3 26.0 13.3
Kerala 38.1 36.6 22.2 49.3 38.7 23.2 40.3 37.0 22.4
Tamil Nadu 30.0 21.4 9.4 64.5 36.3 16.1 44.0 27.4 12.1
( ) Based on 25-49 unweighted cases. * Percentage not shown; based on fewer than 25 unweighted cases.
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 304
Table 6.13: Micro-nutrient supplementation by state
Percentage distribution of children 6-23 months who consumed Vitamin A rich and iron rich foods in the day or
night preceding the survey, percentage of children 6-59 months given Vitamin A and Iron Folic acid
supplements in the last six months and percentage given deworming medication in the last six months
preceding the survey, by State
State
Children aged 6-23 Months Children aged 6-59 Months
Consumed foods
rich in vitamin A in
last 24 hours
Consumed foods
rich in iron in last 24
hours
Given Vitamin A
dose in last 6
months
Given IFA
supplements in
last 6 months
Given deworming
medicine in last 6
months
India 36.4 42.7 45.2 13.4 27.6
North
Delhi 27.0 48.6 48.0 15.5 28.2
Haryana 21.5 34.2 21.1 5.4 5.9
Himachal Pradesh 35.6 43.5 57.0 8.3 28.0
Jammu & Kashmir 31.9 42.0 38.8 4.8 15.7
Punjab 30.5 36.5 39.6 5.2 10.8
Uttar Pradesh 29.6 30.2 26.6 2.5 7.5
Uttarakhand 28.6 35.6 16.3 5.3 8.7
Central
Chhattisgarh 36.0 32.9 44.7 10.7 23.3
Madhya Pradesh 30.9 31.9 45.3 10.7 31.7
East
Bihar 37.3 37.8 46.0 4.4 16.0
Jharkhand 33.2 41.5 18.7 6.3 11.7
Odisha 49.0 56.5 57.2 14.7 57.8
West Bengal 58.5 60.7 21.7 1.7 29.5
Northeast
Arunachal Pradesh 51.3 75.6 51.4 2.9 16.4
Assam 34.7 53.2 50.3 4.5 24.6
Manipur 49.9 69.9 23.9 3.4 15.6
Meghalaya 53.4 58.8 46.2 12.1 24.7
Mizoram 27.2 77.7 75.5 42.3 55.1
Nagaland 30.0 47.3 7.9 0.6 17.8
Sikkim 69.1 61.5 43.5 9.8 29.8
Tripura 38.4 67.0 51.2 5.3 33.0
West
Rajasthan 26.3 27.6 27.3 4.3 19.0
Goa 52.2 77.4 77.1 17.5 66.3
Gujarat 36.8 37.2 55.7 12.8 11.4
Maharashtra 35.8 44.8 62.0 21.9 61.5
South
Andhra Pradesh 29.7 44.6 66.9 45.6 42.4
Karnataka 43.9 55.3 62.1 22.0 37.2
Kerala 49.2 67.1 67.6 19.8 37.2
Tamil Nadu 40.7 50.6 55.3 23.3 27.7
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 305
Table 6.18: Growth monitoring of children by state
Percentage of children aged 0-71 months for whom growth chart was available and percentage of children
aged 0-35 and 36-71 months with growth chart who were weighed at least once in three months prior to
survey, by state.
State
Have a
growth
chart/card
Percentage of children 0-35
months weighed at least once in
last 3 months preceding the
survey
Percentage of children 36-71
months weighed at least once in
last 3 months preceding the
survey
India 14.1 64.0 66.1
North
Delhi 9.0 68.2 64.0
Haryana 13.5 70.8 62.4
Himachal Pradesh 19.4 73.1 64.4
Jammu & Kashmir 2.2 53.7 44.8
Punjab 6.9 14.2 15.4
Uttar Pradesh 3.2 20.7 13.0
Uttarakhand 11.1 27.6 30.5
Central
Chhattisgarh 17.9 88.2 78.5
Madhya Pradesh 4.2 40.2 41.9
East
Bihar 6.7 15.9 16.3
Jharkhand 5.4 56.2 39.1
Odisha 27.2 86.5 76.6
West Bengal 23.2 62.2 56.9
Northeast
Arunachal Pradesh 3.5 27.5 31.5
Assam 7.4 47.1 70.0
Manipur 1.1 72.5 23.1
Meghalaya 23.1 21.7 14.8
Mizoram 6.5 41.3 52.0
Nagaland 3.2 0.0 3.6
Sikkim 28.3 80.2 81.0
Tripura 8.0 52.0 42.7
West
Rajasthan 9.5 24.8 18.8
Goa 37.4 85.8 76.8
Gujarat 30.1 81.6 79.1
Maharashtra 9.4 85.5 85.0
South
Andhra Pradesh 14.9 91.7 94.4
Karnataka 35.0 71.1 66.1
Kerala 32.3 75.0 71.1
Tamil Nadu 24.3 53.8 51.9
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 306
CHAPTER 7
Table 7.3: Awareness of services provided at AWC
Percentage of mothers with child aged 0-35 months covered by an AWC, aware of any services and specific
services provided at AWC by background characteristics.
Characteristics
Services provided at AWC Percentage not
aware of any of
the services
Percentage aware of all the
6 services
Number of
mothers
Supplementary food
Immuni--zation
Pre-school education
Health Check-
up
Referral Services
Nutrition and Health
education
Mothers of child 0-35 months
85.1 57.4 41.7 29.4 12.2 17.2 9.8 9.3 44,485
Age
15-19 87.9 43.5 36.6 25.4 10.5 13.7 8.4 8.2 1,349 20-24 86.4 57.2 40.9 31.3 13.0 18.2 8.6 10.4 16,634 25-29 84.6 58.5 42.9 30.0 13.2 18.1 10.3 9.9 16,824 30-34 83.9 57.9 42.2 25.8 9.8 14.2 11.0 6.7 6,615 35-39 81.9 56.7 41.1 26.3 9.8 15.7 11.4 6.8 2,266 40-44 82.5 55.6 31.6 17.1 3.2 12.0 11.0 2.6 542 45-49 87.3 67.1 51.8 29.1 10.4 16.0 8.0 8.0 256
Residence
Urban 79.3 52.5 41.1 31.0 13.3 18.4 15.9 10.3 11,853 Rural 87.2 59.2 41.9 28.8 11.8 16.7 7.5 8.9 32,632
Mother's education
No education 84.3 61.5 38.9 23.5 9.5 13.2 9.5 6.7 14,272 Below Primary (Class - 1 to 4)
89.7 47.9 41.2 26.8 6.8 12.5 5.7 5.0 2,217
Completed Primary (Class 5-7)
88.8 56.4 41.1 30.1 11.7 17.8 6.8 9.4 6,904
Completed Middle (Class 8 -9)
87.0 53.7 42.7 29.7 11.2 15.6 8.8 8.1 7,190
Completed Secondary (Class 10-11)
84.5 57.3 45.1 36.0 17.4 23.1 10.6 14.0 6,268
Completed Higher Secondary (Class 12)
80.7 56.9 43.7 34.8 16.1 22.2 14.4 12.7 7,634
Religion
Hindu 85.2 58.9 41.3 29.7 12.4 17.1 9.6 9.3 34,877 Muslim 84.3 50.5 41.3 26.4 9.9 14.8 10.5 7.7 7,192 Christian 84.3 46.9 46.4 32.1 16.6 27.9 11.5 14.1 1,135 Sikh 87.2 64.9 53.9 25.4 8.8 15.0 9.3 6.3 693 Jain 86.2 71.0 59.7 62.6 49.0 53.1 11.2 46.8 105 Buddhist/Neo-Buddhist
85.0 65.8 48.0 51.2 25.4 35.3 7.6 21.7 285
No religion (95.8) (37.5) (37.5) (18.8) (14.6) (25.0) (4.2) (14.6) 48 Other 89.7 51.5 37.8 31.4 6.5 14.2 7.0 3.3 167
Social Group
Scheduled Caste 86.5 56.0 39.0 27.6 11.6 15.6 8.5 8.6 9,125 Scheduled Tribe 89.2 62.8 41.6 29.8 11.9 17.6 6.1 9.4 5,300 Other Backward Classes
84.0 61.8 41.6 28.7 13.5 17.9 10.0 10.2 17,721
Other 83.6 50.9 44.3 32.0 11.2 17.6 12.0 8.8 11,890 No Response 91.1 21.4 32.1 17.8 3.3 5.1 6.7 2.0 450
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 307
Characteristics
Services provided at AWC Percentage not
aware of any of
the services
Percentage aware of all the
6 services
Number of
mothers
Supplementary food
Immuni--zation
Pre-school education
Health Check-
up
Referral Services
Nutrition and Health
education
Wealth index
Lowest 86.0 55.3 33.8 21.0 7.1 10.5 8.2 4.4 9,133 Second 86.9 56.6 41.0 26.3 10.0 13.9 7.7 7.2 9,419 Middle 88.1 59.0 44.1 32.8 14.2 20.4 7.2 11.4 9,358 Fourth 84.3 58.0 44.3 34.2 15.5 21.2 10.9 12.4 8,975 Highest 79.1 58.3 46.0 33.3 14.8 20.7 15.9 11.6 7,600
( ) Percentage based on 25-49 unweighted cases
Table 7.4: Awareness of services provided at AWC
Percentage of mothers with child aged 36-71 months covered by an AWC, aware of any services and specific
services provided at AWC by background characteristics.
Characteristics
Services provided at AWC Percentage not
aware of any of
the services
Percentage aware of all the 6 services
Number of
mothers Supplementary food
Immunization
Pre-school Educati
on
Health Check-
up
Referral Services
Nutrition and Health education
Mothers of child 0-35 months
91.0 59.8 49.9 30.5 13.4 18.6 3.4 9.7 42,944
Age 15-19 93.2 46.2 51.6 41.0 15.5 15.3 0.9 7.8 140 20-24 91.3 55.8 48.2 32.3 13.7 20.5 4.0 10.4 7,889 25-29 90.6 60.2 49.5 32.0 14.9 20.0 3.9 10.8 18,312 30-34 90.9 61.5 50.7 28.9 12.0 16.5 2.8 8.4 10,254 35-39 91.5 60.8 52.6 29.0 12.3 16.9 2.2 8.9 4,379 40-44 92.7 61.3 47.9 20.7 8.7 14.8 2.1 6.3 1,360 45-49 92.4 64.5 52.7 20.8 7.3 10.4 2.1 3.1 609
Residence Urban 89.5 59.0 51.6 35.2 16.4 22.3 4.7 12.2 11,176 Rural 91.5 60.1 49.3 28.9 12.3 17.3 2.9 8.8 31,767
Mother's education No education 89.6 62.5 47.3 24.6 10.2 14.0 3.9 7.0 16,335 Below Primary (Class - 1 to 4)
93.9 47.3 48.2 25.9 9.1 14.0 2.1 5.7 2,429
Completed Primary (Class 5-7)
93.2 56.8 48.9 31.7 13.0 19.7 2.3 9.1 6,873
Completed Middle (Class 8 -9)
92.5 55.0 50.6 30.6 12.9 18.2 3.4 9.6 6,218
Completed Secondary (Class 10-11)
90.9 61.9 53.8 39.0 19.9 25.4 3.6 15.2 5,404
Completed Higher Secondary (Class 12)
89.6 64.1 54.7 39.8 19.0 26.4 3.7 14.3 5,686
Religion Hindu 91.0 61.3 49.2 30.8 13.5 18.7 3.3 9.8 33,905 Muslim 90.4 52.4 49.8 26.8 10.7 15.3 4.3 7.5 6,786 Christian 92.6 55.9 61.6 40.1 25.1 34.5 2.6 19.5 1,222 Sikh 94.5 70.0 62.2 26.0 11.3 16.1 2.5 6.8 585
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 308
Characteristics
Services provided at AWC Percentage not
aware of any of
the services
Percentage aware of all the 6 services
Number of
mothers Supplementary food
Immunization
Pre-school Educati
on
Health Check-
up
Referral Services
Nutrition and Health education
Jain (95.0) (77.5) (60.0) (42.5) (20.0) (20.0) (2.5) (12.5) 40
Buddhist/Neo-Buddhist
93.7 57.8 50 44.8 18.9 26.9 1.6 7.5 247
No religion (94.9) (30.8) (38.5) (10.3) (5.1) (15.4) (5.1) (5.1) 39
Other 93.3 51.6 48.4 31.2 7.6 16.5 2.4 3.4 130 Social Group
Scheduled Caste 91.5 56.3 46.3 27.6 12.2 16.4 3.2 8.4 9,105 Scheduled Tribe 93.1 64.7 50.1 31.6 12.6 18.1 2.2 9.1 5,073 Other Backward Classes
89.5 64.5 49.4 29.8 14.1 19.2 3.7 10.1 17,446
Other 91.7 54.3 54.0 34.1 13.9 20.1 3.6 10.6 10,869 No Response 95.7 22.4 39.8 17.4 4.2 7.9 1.3 2.9 451
Wealth index Lowest 90.7 55.8 42.1 21.6 7.4 10.8 3.7 4.2 9,517 Second 91.7 56.3 48.7 26.2 10.8 15.0 3.1 7.3 9,345 Middle 92.2 61.2 52.2 34.3 16.2 22.4 2.7 12.5 9,129 Fourth 90.5 62.3 52.4 36.1 16.5 22.5 3.2 12.2 8,178 Highest 89.5 65.5 56.3 37.1 17.8 24.5 4.6 13.7 6,775
( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 309
Table 7.5: Awareness of services provided at AWC
Percentage of mothers with child aged 0-71 months covered by an AWC, aware of any services and specific services provided at AWC by background characteristics
Characteristics
Services provided at AWC Percentage not
aware of any of
the services
Percentage
aware of all
the 6 services
Number of
mother Supplementary
food Immunization
Pre-school
Education
Health Check-
up
Referral
Services
Nutrition and
Health
education
Mothers of child 0-35 months 88.5 58.4 46.6 30.6 13.2 18.3 6.0 9.5 70,209
Age
15-19 88.4 43.1 37.7 25.7 10.7 14.0 7.0 7.4 1,419
20-24 88.0 57.0 43.6 32.0 13.4 19.2 6.8 9.9 20,211
25-29 88.3 59.1 47.6 32.0 14.7 19.7 6.3 10.7 26,880
30-34 88.7 59.5 48.3 28.4 11.6 16.3 5.1 8.1 13,661
35-39 89.2 59.3 50.1 28.4 11.9 16.8 4.4 8.5 5,604
40-44 90.9 60.3 44.8 20.8 7.7 14.1 3.6 5.5 1,646
45-49 92.3 65.9 53.9 23.6 8.5 12.1 2.6 4.3 788
Residence
Urban 84.7 55.6 46.9 33.5 15.1 20.6 9.7 11.2 19,093
Rural 89.9 59.4 46.5 29.5 12.5 17.5 4.6 8.9 51,116
Mother's education
No education 87.9 62.0 44.5 24.6 10.3 14.1 5.6 7.2 23,304
Below Primary (Class - 1 to 4) 92.5 46.9 44.7 26.6 8.2 13.3 3.3 5.3 3,740
Completed Primary (Class 5-7) 91.4 56.2 46.3 31.2 12.6 18.8 4.2 9.1 11,003
Completed Middle (Class 8 -9) 90.1 54.1 46.8 30.5 12.1 17.0 5.4 8.7 10,880
Completed Secondary (Class 10-
11) 87.8 59.5 49.9 37.9 18.6 24.4 6.7 14.1 9,747
Completed Higher Secondary
(Class 12) 84.8 59.9 48.8 37.2 17.5 24.2 9.1 12.9 11,535
Religion
Hindu 88.5 59.8 46.1 30.9 13.3 18.3 5.8 9.6 55,464
Muslim 87.9 50.9 46.1 27.0 10.5 15.4 6.7 7.6 10,858
Christian 88.8 52.9 55.4 37.2 21.7 31.9 6.5 17.2 1,957
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 310
Characteristics
Services provided at AWC Percentage not
aware of any of
the services
Percentage
aware of all
the 6 services
Number of
mother Supplementary
food Immunization
Pre-school
Education
Health Check-
up
Referral
Services
Nutrition and
Health
education
Sikh 90.5 67.3 58.3 25.8 10.6 15.3 5.9 6.8 1,066
Jain 88.7 72.1 61.6 62.7 45.2 48.5 9.2 40.0 128
Buddhist/Neo-Buddhist 88.9 61.6 50.5 50.3 24.4 33.1 4.9 16.7 446
No religion (97.0) (40.9) (39.4) (19.7) (13.6) (24.2) (3.0) (13.6) (66)
Other 90.6 51.9 43.1 31.3 7.5 16.9 4.8 4.1 242
Social Group
Scheduled Caste 89.5 55.7 43.6 28.4 12.0 16.3 5.3 8.3 14,428
Scheduled Tribe 91.3 63.7 46.7 30.8 12.6 18.2 3.8 9.2 8,182
Other Backward Classes 87.3 63.3 46.3 30.1 14.5 19.3 6.2 10.3 28,017
Other 88.0 52.2 49.8 33.3 12.7 19.0 7.2 9.7 18,839
No Response 93.4 21.6 35.9 16.4 3.5 5.9 3.9 2.3 743
Wealth index
Lowest 89.1 54.7 38.4 21.3 7.2 10.6 5.2 4.1 14,059
Second 89.9 56.1 45.7 26.8 10.8 15.0 4.6 7.4 14,739
Middle 90.6 59.6 48.9 33.9 15.4 21.6 4.4 11.8 14,916
Fourth 87.6 59.9 48.9 35.7 16.4 22.3 6.7 12.2 14,275
Highest 84.5 61.9 51.7 35.7 16.4 22.7 9.5 12.5 12,219
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 311
Table 7.6: Awareness of services provided at AWC Percentage of currently pregnant women covered by an AWC, aware of any services and specific services provided at AWC by background characteristics.
Characteristics
Services provided at AWC Percentage not aware of any
services
Percentage aware of all
the 6 services
Number of currently pregnant women Supplementary food Immunization
Health Check-up
Referral Services
Nutrition and Health education
Pregnant women 87.7 59.6 29.9 11.0 16.5 6.6 8.3 5,247 Age
15-19 89.3 46.8 28.8 5.1 13.2 5.9 4.1 240 20-24 87.6 58.3 30.4 11.0 17.0 7.3 8.7 2,352 25-29 87.5 63.4 30.9 13.1 18.0 5.7 9.9 1,905 30-34 89.1 61.8 29.2 8.5 14.5 5.3 5.0 531 35-39 84.3 45.2 17.5 2.7 6.3 12.3 1.4 182 40-44 (88.9) (63.0) (22.2) (7.4) (22.2) (3.7) (3.7) 27 45-49 * * * * * * * 12
Residence Urban 85.8 58.6 34.3 14.9 19.3 8.7 11.9 1,205 Rural 88.3 59.9 28.6 9.8 15.7 6.0 7.2 4,042
Mother's education No education 86.2 61.6 23.3 7.7 12.5 7.8 5.7 1,842 Below Primary (Class - 1 to 4) 87.4 48.8 25.7 7.9 11.0 6.8 5.9 281 Completed Primary (Class 5-7) 90.7 61.7 33.4 10.5 19.6 3.7 8.5 854 Completed Middle (Class 8 -9) 89.2 53.8 26.1 8.4 13.0 5.8 6.0 817 Completed Secondary (Class 10-11) 90.5 60.0 36.0 13.7 22.9 5.6 9.9 617 Completed Higher Secondary (Class 12) 84.5 62.1 41.3 20.2 23.0 8.2 15.3 836
Religion Hindu 87.8 60.9 30.1 10.9 16.3 6.4 8.0 3,942 Muslim 85.9 54.0 25.3 8.2 12.6 8.0 6.0 1,045 Christian 94.9 63.4 47.9 23.8 44.1 2.1 23.3 118 Sikh 90.5 60.2 32.2 11.1 16.7 3.0 7.2 77 Jain * * * * * * * 6 Buddhist/Neo-Buddhist (87.8) (43.9) (31.7) (14.6) (24.4) (9.8) (7.3) 41 No religion * * * * * * * 3 Other (92.9) (19.6) (10.7) (5.4) (14.3) (5.4) (1.8) 56
Social Group Scheduled Caste 88.4 59.1 33.1 11.4 19.0 6.9 9.5 1,121 Scheduled Tribe 91.0 62.5 27.7 11.9 14.2 4.1 9.0 616 OBC 86.2 62.7 27.2 11.2 16.2 7.2 7.8 2,217 Other 87.6 55.4 33.7 10.2 16.9 6.6 8.0 1,231 No Response 95.2 10.8 13.9 0.8 1.3 4.8 0.8 62
Wealth index Lowest 86.4 53.5 20.8 5.6 10.2 6.8 2.6 1,146 Second 88.8 59.5 26.3 9.5 13.8 7.0 7.7 1,183 Middle 89.5 62.0 36.0 12.9 20.0 5.6 11.0 1,115 Fourth 86.0 61.6 34.3 12.4 21.9 7.9 10.2 970 Highest 87.3 62.5 34.0 16.3 18.3 5.5 10.8 833
*Percentage not shown; based on fewer than 25 unweighted cases. ( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 312
Table 7.10: Utilization of AWC services
Among the mothers of children aged 0-5 months residing in area covered by AWC, percentage availing specific
services by background characteristics
Characteristics
Type of services availed Number of mothers of
children aged 0-5 months
Supplementary food
Immunization Health
check-up Referral services
Nutrition and health education or advice on feeding and care
of young children
Other
Residence Urban 28.7 20.6 20.4 7.3 11.0 5.4 2,023 Rural 46.7 36.9 32.5 13.3 17.7 6.9 6,446
Mother's education No education 41.4 34.6 26.5 8.8 12.3 5.8 2,953 Below Primary (Class - 1 to 4) 54.0 37.0 36.6 14.9 19.8 7.4 423 Completed Primary (Class 5-7) 48.1 37.9 35.3 12.7 18.2 6.4 1,278 Completed Middle (Class 8 -9) 48.4 34.8 32.2 13.4 17.3 6.0 1,297 Completed Secondary (Class 10-11)
39.7 30.2 31.1 14.9 19.6 8.2 1,182
Completed Higher Secondary (Class 12)
31.8 24.2 24.7 12.4 17.1 7.1 1,335
Religion Hindu 44.4 36.0 31.9 12.9 17.3 7.1 6,718 Muslim 35.0 21.5 20.1 6.6 10.6 4.0 1,356 Christian 34.1 22.1 23.6 9.3 12.5 4.6 185 Sikh 19.4 13.3 10.3 2.1 4.6 4.0 117 Jain * * * * * * 10 Buddhist/Neo-Buddhist (38.8) (16.5) (20.4) (6.8) (20.4) (6.8) 103 No religion * * * * * * 6 Other (29.7) (17.2) (20.3) (7.8) (7.8) (0.0) 64
Social Group Scheduled Caste 46.7 36.6 29.4 11.8 16.1 7.9 1,801 Scheduled Tribe 53.8 41.5 40.3 14.3 21.3 6.7 1,041 OBC 40.4 33.3 28.2 11.7 16.2 6.0 3,373 Others 35.9 26.4 27.1 10.9 14.0 6.3 2,171 Do Not Know 53.6 11.5 20.2 12.4 1.4 3.8 83
Wealth Index Lowest 53.1 43.9 34.8 10.8 15.8 7.8 1,909 Second 46.4 35.7 30.9 11.5 16.3 5.6 1,877 Middle 43.8 31.9 31.3 14.5 18.9 5.8 1,778 Fourth 35.9 26.9 27.1 12.3 15.6 6.3 1,581 Highest 26.8 22.4 21.0 9.6 13.1 7.2 1,324
Total 42.4 33.0 29.6 11.8 16.1 6.5 8,469
*Percentage not shown; based on fewer than 25 unweighted cases. ( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 313
Table 7.11: Utilization of AWC services
Among children aged 6-35 months residing in area covered by AWC, percentage availing specific services by
background characteristics
Characteristics
Type of services availed
Number of
children Supplementary
food Immunization
Health check-
up
Referral services
Nutrition and health education
or advice on feeding and
care of young
children
Other
Residence Urban 36.7 29.5 24.5 9.6 15.0 4.4 10,913 Rural 53.8 46.3 34.3 13.0 19.8 5.1 30,268
Mother's education No education 47.0 43.5 27.1 9.5 14.6 3.4 13,376 Below Primary (Class - 1 to 4) 63.2 44.9 43.2 9.8 19.4 4.2 2,060 Completed Primary (Class 5-7) 57.4 47.2 37.2 13.7 21.0 5.7 6,456 Completed Middle (Class 8 -9) 52.7 43.2 34.1 12.3 20.5 5.2 6,678 Completed Secondary (Class 10-11) 47.3 40.3 34.2 14.8 22.5 6.1 5,726 Completed Higher Secondary (Class 12)
39.9 32.7 27.8 14.1 18.6 5.9 6,885
Religion Hindu 50.5 44.7 33.2 12.9 19.3 5.3 32,257 Muslim 44.1 30.2 25.8 7.9 14.3 3.1 6,719 Christian 53.2 38.2 31.5 17.1 24.4 6.7 1,028 Sikh 27.4 21.8 10.9 3.2 5.4 1.4 644 Jain 57.7 52.3 55.9 40.3 54.2 2.7 82 Buddhist/Neo-Buddhist 60.1 58.9 52.9 21.9 31.2 2.0 264 No religion (61.0) (29.3) (14.6) (7.3) (14.6) 0 41 Other 52.4 37.8 36.6 8.8 16.7 6.7 160
Social Group Scheduled Caste 53.0 44.2 33.7 13.8 19.3 5.1 8,436 Scheduled Tribe 62.8 54.2 39.8 13.3 22.1 5.9 4,893 OBC 45.1 42.6 28.3 12.6 18.1 4.8 16,583 Others 45.7 34.1 31.2 10.0 16.9 4.5 10,837 Do Not Know 65.6 23.8 48.4 3.7 23.2 3.3 431
Wealth Index Lowest 57.0 50.4 35.3 10.8 17.2 4.0 8,446 Second 54.9 45.2 32.9 11.5 18.6 5.0 8,824 Middle 53.2 44.7 34.7 14.3 21.9 5.4 8,716 Fourth 45.3 38.5 31.6 13.9 19.4 5.0 8,390 Highest 32.0 27.5 22.3 9.5 14.9 5.1 6,804
Total 49.2 41.9 31.7 12.1 18.5 4.9 41,181
( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 314
Table 7.12: Utilization of AWC services
Among children aged 36-71 months residing in area covered by AWC, percentage availing specific services by
background characteristics
Characteristics
Type of services availed
Number of children
Supplementary food
Pre-school education
Immunization Health
check-up Referral services
Nutrition and health education
or advice on feeding and care of young children
Other
Residence Urban 31.1 26.9 24.3 21.1 9.1 13.8 4.8 12,268
Rural 48.7 42.7 37.5 28.6 11.2 17.6 5.6 35,605
Mother's education
No education 45.2 39.1 34.6 22.8 8.6 13.5 4.1 18,598
Below Primary (Class - 1 to 4) 63.3 55.2 41.0 39.3 13.3 21.1 8.2 2,691
Completed Primary (Class 5-7) 50.9 44.6 39.0 33.2 13.1 20.4 6.2 7,666
Completed Middle (Class 8 -9) 45.2 39.7 33.9 28.8 10.0 17.3 5.9 6,875
Completed Secondary (Class 10-11)
39.7 36.1 33.9 29.7 14.5 20.9 6.3 5,937
Completed Higher Secondary (Class 12)
27.2 24.0 23.5 19.5 10.0 14.3 5.5 6,105
Religion
Hindu 44.8 39.6 36.7 27.6 11.2 17.1 5.6 37,609
Muslim 41.6 34.9 23.3 23.2 7.6 14.0 4.2 7,787
Christian 45.3 38.7 31.1 26.6 15.9 22.6 7.4 1,342
Sikh 27.5 23.2 17.1 8.0 3.5 5.8 1.2 646
Jain (28.6) (26.2) (28.6) (28.6) (11.9) (16.7) (11.9) 42
Buddhist/Neo-Buddhist 57.2 50.8 45.8 43.6 17.5 27.3 7.0 266
No religion (57.1) (26.2) (9.5) (9.5) (2.4) (16.7) (0.0) 42
Other 50.9 44.9 30.2 27.5 8.1 13.2 3.3 147
Social Group
Scheduled Caste 46.6 40.6 35.5 27.4 12.1 17.3 5.6 10,193
Scheduled Tribe 57.9 50.6 46.6 33.5 13.0 20.1 6.0 5,665
OBC 39.1 34.5 33.9 22.9 10.6 15.6 5.2 19,520
Others 43.0 37.8 27.9 28.4 8.9 15.9 5.1 11,994
Do Not Know 63.5 46.3 17.3 43.9 3.0 17.2 4.4 502
Wealth Index
Lowest 53.7 46.6 40.3 28.8 9.3 15.6 5.3 10,749
Second 52.3 45.5 37.3 28.7 10.4 16.3 5.4 10,533
Middle 46.3 41.1 36.6 29.5 13.2 20.0 5.3 10,191
Fourth 37.3 33.2 30.6 26.4 11.9 17.6 5.6 9,046
Highest 24.0 20.7 21.0 17.3 8.1 12.6 5.2 7,353
Total 44.2 38.7 34.1 26.7 10.7 16.6 5.4 47,873
( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 315
Table 7.13: Utilization of AWC services
Among currently pregnant women residing in area covered by AWC, percentage availing AWC services, by
background characteristics.
Characteristics
Type of services availed Number of
currently pregnant women
Supplementary food
Immunization Health check-
up
Referral services
ANC IFA supplementation
Other
Residence Urban 29.8 25.5 19.8 8.4 14.5 11.0 2.6 1,205 Rural 44.0 39.0 28.7 11.7 22.0 17.2 2.8 4,042
Mother’s education No education 39.1 37.2 24.7 10.0 18.9 14.2 2.0 1,842 Below Primary (Class - 1 to 4)
39.5 32.9 27.0 8.0 17.2 14.1 0.7 281
Completed Primary (Class 5-7)
41.8 36.6 26.8 9.2 18.4 14.6 3.0 854
Completed Middle (Class 8 -9)
42.0 37.4 27.8 10.3 22.2 15.5 2.6 817
Completed Secondary (Class 10-11)
43.3 33.8 30.5 13.7 25.5 18.6 2.4 617
Completed Higher Secondary (Class 12)
40.6 33.8 26.8 14.5 20.4 19.1 5.3 836
Religion Hindu 43.7 39.5 28.7 11.9 21.7 16.9 3.0 3,942 Muslim 28.1 21.6 16.1 4.5 12.2 8.8 1.7 1,045 Christian 57.4 42.1 38.8 22.5 34.5 30.4 4.7 118 Sikh 19.0 20.8 19.3 4.1 9.1 5.7 1.5 77 Jain * * * * * * * 6 Buddhist/Neo-Buddhist (43.9) (19.5) (26.8) (12.2) (24.4) (24.4) (7.3) 41 No religion * * * * * * * 3 Other (21.4) (19.6) (16.1) (5.4) (7.1) (7.1) (3.6) 56
Social Group Scheduled Caste 43.9 37.4 27.5 15.0 21.5 18.7 3.2 1,121 Scheduled Tribe 55.6 48.7 35.9 11.9 26.0 16.3 2.2 616 OBC 36.7 36.2 24.7 10.8 19.0 15.1 2.6 2,217 Others 36.7 28.4 24.8 7.5 19.0 13.9 3.2 1,231 Do Not Know 60.7 23.0 28.9 3.1 11.5 19.6 0.1 62
Wealth Index Lowest 43.7 40.2 27.9 8.4 17.8 15.5 2.3 1,146 Second 44.4 38.1 29.1 12.8 23.7 15.6 2.5 1,183 Middle 44.2 38.4 28.6 12.3 23.4 19.7 3.6 1,115 Fourth 40.5 35.3 26.7 12.7 20.0 15.9 2.9 970 Highest 27.1 24.4 18.9 8.0 15.0 10.9 2.6 833
Total 40.7 35.9 26.7 11.0 20.3 15.8 2.8 5,247 *Percentage not shown; based on fewer than 25 unweighted cases.
( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 316
Table 7.14: Utilization of services provided at AWC by state
Among mother with children aged 0-5 months covered by an AWC, percentage utilizing specific services provided
at AWC, according to states.
State
Percentage
availing any
service from AWC
Type of services availed
Number of
mothers Supplementary
Food Immunization
Health Check-up
Referral Services
Nutrition and Health
education or advice on
feeding and care of young
children
Other
India 47.8 42.4 33.0 11.8 16.1 6.5 8.2 8,469 North
Delhi 7.7 4.3 3.4 6.0 1.3 1.3 0.8 199 Haryana 26.5 11.8 19.5 14.6 6.4 7.6 7.8 236 Himachal Pradesh 67.4 65.2 27.5 34.5 19.0 25.1 15.6 208 Jammu & Kashmir 16.7 14.2 2.2 2.5 0.0 3.0 0.7 174 Punjab 16.4 15.5 8.6 7.4 3.1 5.1 3.2 185 Uttar Pradesh 26.5 23.6 18.1 11.5 5.0 3.2 2.7 1,254 Uttarakhand 28.2 21.0 17.9 5.0 1.8 2.4 2.8 169
Central Chhattisgarh 83.3 81.5 61.4 51.2 20.1 35.6 11.1 264 Madhya Pradesh 67.5 54.0 44.3 35.1 12.7 19.2 12.6 461
East Bihar 51.3 39.3 42.7 21.7 7.9 11.2 10.4 679 Jharkhand 73.6 72.9 61.9 60.3 20.3 26.1 6.2 271 Odisha 81.7 76.5 72.0 68.4 20.0 28.3 2.9 286 West Bengal 50.2 46.5 7.1 24.3 3.4 7.0 3.3 394
Northeast Arunachal Pradesh 27.1 25.9 4.6 8.5 2.0 13.3 10.6 112 Assam 41.5 41.4 13.8 11.6 2.3 7.2 1.2 226 Manipur 25.8 25.8 7.0 0.0 0.0 2.6 0.0 209 Meghalaya 32.3 29.6 8.5 4.5 1.1 3.0 1.6 208 Mizoram 48.3 46.4 11.7 19.3 2.8 30.9 17.8 234 Nagaland 3.1 3.0 0.9 0.1 0.0 0.0 0.0 228 Sikkim 53.2 43.9 15.9 34.7 11.5 25.9 4.3 189 Tripura 31.3 27.2 19.2 16.9 5.4 12.5 3.3 156
West Rajasthan 41.9 35.5 30.7 28.0 5.7 5.0 3.0 441 Goa 70.8 70.2 30.6 34.8 12.3 34.7 14.6 132 Gujarat 54.4 49.4 42.5 46.9 13.9 24.6 4.4 357 Maharashtra 49.7 42.0 39.2 40.8 12.3 20.5 11.2 348
South Andhra Pradesh 62.2 60.1 50.2 45.0 28.6 38.2 10.6 344 Karnataka 53.3 52.3 39.6 38.1 23.6 26.2 4.5 283 Kerala 17.2 15.0 12.3 11.9 7.6 8.9 4.4 119 Tamil Nadu 36.0 30.5 22.2 21.7 20.4 23.5 10.1 232
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 317
Table 7.15: Utilization of services provided at AWC by state
Among children aged 6-35 months covered by an AWC, percentage utilizing specific services provided at AWC,
according to states
State
Percentage availing any
service from AWC
Type of services availed
Number of
Children Supplementary
Food Immunization
Health Check-up
Referral Services
Nutrition and Health education
or advice on feeding and care of young children
Other
India 53.6 49.2 41.9 31.8 12.1 18.6 4.9 41,167
North
Delhi 14.5 11.9 10.7 7.9 3.2 4.1 0.9 906
Haryana 25.6 17.8 22.1 9.7 4.1 4.2 1.5 943
Himachal Pradesh
70.8 70.3 37.0 36.1 20.4 27.7 14.9 1,187
Jammu & Kashmir
29.7 28.8 7.1 8.4 3.3 5.4 3.5 868
Punjab 26.4 23.1 17.3 9.6 3.8 4.6 2.0 1,063
Uttar Pradesh 27.0 22.7 23.0 7.8 2.6 3.4 0.7 5,438
Uttarakhand 22.2 18.4 15.6 9.8 2.1 4.4 1.4 817
Central
Chhattisgarh 84.0 82.8 76.2 54.9 17.2 34.9 8.0 1,218
Madhya Pradesh
71.3 63.6 64.8 37.7 15.7 22.1 8.3 2,043
East
Bihar 50.2 36.6 47.6 16.3 6.0 10.9 3.3 3,013
Jharkhand 61.5 59.3 60.3 40.3 14.0 22.0 3.2 1,333
Odisha 89.5 89.2 84.7 72.5 22.8 26.4 5.7 1,298
West Bengal 74.1 71.9 15.4 47.5 2.5 15.8 2.2 1,977
North east
Arunachal Pradesh
51.2 51.1 24.7 19.4 9.3 22.7 18.8 949
Assam 71.3 71.2 29.3 12.4 2.7 7.1 1.0 1,072
Manipur 44.3 44.3 13.7 2.7 0.9 14.2 2.5 781
Meghalaya 49.3 47.1 23.1 17.0 11.5 14.0 6.1 918
Mizoram 64.3 63.4 33.8 33.4 3.5 39.0 15.3 673
Nagaland 9.0 9.0 0.5 0.2 0.0 0.1 0.0 822
Sikkim 68.7 65.7 17.1 50.1 17.0 42.3 5.2 906
Tripura 70.9 70.0 55.4 39.0 8.3 32.7 1.0 874
West
Rajasthan 38.4 33.7 34.4 17.7 2.9 4.7 1.0 1,856
Goa 67.4 66.5 38.6 41.2 9.0 40.1 12.5 871
Gujarat 60.0 54.5 52.6 43.2 11.6 23.0 4.5 1,634
Maharashtra 57.5 51.4 48.3 48.7 12.1 25.8 7.7 2,103
South
Andhra Pradesh
67.5 65.3 63.5 47.3 34.0 43.4 8.2 1,637
Karnataka 57.5 56.3 48.9 39.3 20.5 26.2 4.1 1,507
Kerala 44.4 43.2 30.6 27.8 18.7 21.6 12.6 884
Tamil Nadu 44.3 42.3 31.5 29.3 23.3 25.1 11.2 1,508
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 318
Table 7.16: Utilization of services provided at AWC by state
Among children age 36-71 months covered by an AWC, percentage utilizing specific services provided at AWC,
according to states
State
Percentage availing
any service from AWC
Type of services availed
Number of
Children Supplementary
Food Immunization
Pre-school Education
Health Check-up
Referral Services
Nutrition and Health
education or advice on
feeding and care of young
children
Other
India 47.5 44.2 38.7 34.1 26.7 10.7 16.6 5.4 47,873 North
Delhi 14.3 13.7 10.7 8.2 8.5 3.1 3.7 1.3 963 Haryana 21.4 17.9 14.6 17.3 8.3 2.8 3.6 1.7 953 Himachal Pradesh
42.4 42.2 35.2 25.2 26.0 18.6 24.7 12.1 1,258
Jammu & Kashmir
29.3 28.5 15.4 7.8 7.4 3.2 6.3 3.7 851
Punjab 21.3 20.9 17.9 11.7 6.2 3.4 5.0 2.0 1,134 Uttar Pradesh 23.7 22.5 16.4 16.7 6.0 3.4 3.2 1.1 6,503 Uttarakhand 26.0 24.2 25.1 10.1 6.2 2.4 4.9 1.8 999
Central Chhattisgarh 63.0 60.2 57.0 51.0 34.0 12.9 23.2 6.4 1,339 Madhya Pradesh
64.0 47.5 37.1 55.5 30.2 11.7 19.2 7.2 2,362
East Bihar 47.0 42.9 42.5 37.7 14.8 8.3 13.6 7.0 3,827 Jharkhand 30.1 27.0 25.5 24.5 15.5 6.0 9.1 2.3 1,489 Odisha 68.2 67.3 62.7 59.9 48.9 12.8 17.7 3.2 1,714 West Bengal 74.2 69.6 53.6 14.9 47.2 3.7 17.9 6.9 2,297
North east Arunachal Pradesh
63.2 63.2 57.2 28.3 23.1 11.2 24.7 19.9 1,260
Assam 74.5 72.9 64.6 23.8 9.4 2.4 5.5 2.6 1,473 Manipur 71.1 70.6 62.8 11.9 2.5 0.8 21.1 1.7 1,080 Meghalaya 61.9 61.3 30.3 31.2 21.0 15.2 19.0 11.2 1,092 Mizoram 69.2 68.9 60.9 38.3 32.6 3.6 44.0 15.5 1,113 Nagaland 13.9 13.8 1.4 1.8 1.1 0.0 1.2 0.0 1,142 Sikkim 58.0 51.8 44.9 13.7 44.8 16.7 37.7 4.7 800 Tripura 78.5 78.4 74.2 57.7 37.1 6.5 33.7 1.0 886
West Rajasthan 22.9 22.0 17.0 18.2 9.2 1.8 2.9 0.6 2,153 Goa 47.7 41.8 35.4 24.9 30.5 5.7 28.9 13.3 879 Gujarat 72.4 69.8 57.4 60.4 47.0 14.4 23.3 6.4 1,588 Maharashtra 63.7 60.7 58.4 53.7 54.6 13.8 30.8 11.4 2,379
South Andhra Pradesh
56.9 52.4 50.6 51.8 39.0 28.2 35.6 6.7 1,835
Karnataka 49.2 47.1 45.5 43.9 36.9 22.6 25.0 5.3 1,631 Kerala 38.3 36.4 32.0 27.3 24.1 17.3 20.6 10.6 1,175 Tamil Nadu 27.2 26.5 23.1 20.8 19.5 15.7 17.5 5.9 1,817
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 319
Table 7.17: Utilization of services provided at AWC by state
Among currently pregnant woman covered by an AWC, percentage utilizing specific services provided at AWC,
according to states.
State
Percentage availing any
service from AWC
Type of services availed Number of
currently pregnant women
Supplementary Food
Immunization Health Check-
up
Referral Services
ANC IFA Other
India 45.9 40.7 35.9 26.7 11.0 20.3 15.8 2.8 5,247 North
Delhi 13.7 8.8 9.6 8.1 3.4 3.4 1.7 3.2 102 Haryana 25.1 19.6 24.1 17.6 6.2 14.6 7.9 0.5 168 Himachal Pradesh
70.1 65.7 30.1 21.5 16 15.1 18.2 10.6 138
Jammu & Kashmir
15.6 14.9 4.8 1.8 0.0 0.4 1.1 0.7 96
Punjab 22.1 14.9 16.3 11.4 2.0 3.3 2.5 1.1 125 Uttar Pradesh 27.6 23.8 23.2 12.2 4.6 6.8 4.4 0.7 789 Uttarakhand 21.7 12.3 18.1 15 4.9 12.5 3.4 3.3 119
Central Chhattisgarh 70.4 65.4 59.1 49.2 17.9 42.1 41.8 6.4 183 Madhya Pradesh 59.1 47.7 54.5 28.0 8.1 20.7 12.8 3.8 293
East Bihar 33.8 21.7 30.1 10.4 3.8 10.1 8.5 1.0 498 Jharkhand 49.1 47.0 45.9 31.5 13.6 29.6 9.3 3.2 202 Odisha 63.5 60.6 61.2 47.8 10.5 19.8 27.5 0.0 146 West Bengal 55.6 55.6 10.6 20.6 2.3 8.5 4.8 0.9 223
North east Arunachal Pradesh
(17.2) (17.2) (6.9) (6.9) (1.7) (1.7) (10.3) (3.4) 58
Assam 29.8 29.8 9.6 10.1 0.0 7.7 0.7 0.0 89 Manipur 44.3 44.3 3.1 2.7 0.5 0.5 1.2 1.0 102 Meghalaya 35.0 34.3 13.4 13.8 5.5 11.0 11.0 1.1 93 Mizoram (44.0) (42.0) (30.0) (26.0) (2.0) (16.0) (14.0) (8.0) 50 Nagaland (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) 54 Sikkim (52.1) (47.9) (6.3) (35.4) (14.6) (18.8) (27.1) (2.1) 48 Tripura (57.1) (55.7) (37.1) (31.4) (5.7) (31.4) (15.7) (0.0) 70
West Rajasthan 39.9 33.5 36.5 23.1 2.2 14.3 7.7 2.0 285 Goa 52.2 49.2 23.3 35.9 3.5 14.7 17.2 2.2 66 Gujarat 58.0 49.0 46.6 42.1 11.6 26.6 20.9 4.5 183 Maharashtra 53.8 47.4 41.1 41.7 11.4 37.5 32.5 4.7 224
South Andhra Pradesh 79.9 78.3 73.6 63.6 50.0 55.9 48.7 8.1 192 Karnataka 49.1 48.8 38.9 33.2 15.6 29 17.2 1.7 164 Kerala 23.6 23.0 17.6 14.1 8.4 12.7 13.2 8.3 82 Tamil Nadu 47.9 45.7 28.6 26.2 21.8 24.9 23.9 3.5 163
( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 320
Table 7.22: Intake of supplementary food by states
Among children aged 6-35 months and 36-71 months covered by an AWC by utilization of supplementary foods services provided at AWC, by state.
State
Children 36-71 months Children 6-35 months
Percentage
received
Supplementary
food
Type of Supplementary food
received
Percentage
received
Supplementary
food for 21 or
more days
Percenta
ge
consume
d entire
quantity
of the
food
received
from the
AWC
Percentage
received
Supplemen
tary food
Type of Supplementary
food received Percenta
ge
received
Supplem
entary
food for
21 or
more
days
Percenta
ge
consum
ed
entire
quantity
of the
food
received
from the
AWC
Hot
Cooked
meal
Ready
To Eat
(RTE)/
Take
Home
Ration
(THR)
Morning
Snacks
Hot
Cooked
Meal
(HCM)
Ready To
Eat (RTE)/
Take
Home
Ration
(THR)
India 44.2 41.6 12.0 10.6 14.9 36.9 49.2 21.6 38.5 11.8 17.3
North
Delhi 13.7 13.6 1.3 2.3 4.7 6.7 11.9 13.6 5.0 3.1 3.2
Haryana 17.9 25.7 3.8 1.9 10.0 10.6 17.8 24.8 5.6 9.4 8.9
Himachal
Pradesh
42.2 37.9 8.7 9.2 17.5 33.9 70.3 31.6 55.2 33.7 23.5
Jammu &
Kashmir
28.5 23.4 12.6 5.3 5.5 22.1 28.8 18.9 19.6 7.4 8.8
Punjab 20.9 17.9 9.0 4.0 7.2 13.8 23.1 14.7 19.2 6.6 6.3
Uttar Pradesh 22.5 10.8 17.5 5.1 3.1 13.1 22.8 2.8 25.8 4.3 6.0
Uttarakhand 24.2 18.9 5.1 5.1 3.2 20.4 18.6 9.2 15.6 3.2 5.8
Central
Chhattisgarh 60.2 58.7 3.7 16.0 18.0 55.7 82.8 4.7 81.2 42.0 8.8
Madhya Pradesh 47.5 39.7 20.5 11.1 9.7 36.5 63.6 15.7 62.8 18.5 17.2
East
Bihar 42.9 42.0 3.2 3.1 16.6 40.6 36.6 6.1 37.9 0.0 9.9
Jharkhand 27.0 25.5 6.7 6.5 7.2 26.0 59.3 9.0 57.7 18.5 8.9
Odisha 67.3 63.1 7.6 45.3 23.6 61.0 89.2 2.7 88.2 0.0 12.3
West Bengal 69.6 68.0 0.3 2.0 22.3 40.4 71.9 73.5 0.2 0.0 13.3
North east
Arunachal
Pradesh
63.2 52.4 58.0 18.4 0.6 56.6 51.1 30.3 48.7 0.2 3.4
Assam 72.9 60.0 40.9 27.0 4.0 63.1 71.2 7.7 70.0 0.0 7.0
Manipur 70.6 52.2 60.7 35.3 4.1 34.8 44.3 22.5 39.3 0.0 8.5
Meghalaya 61.3 51.7 30.3 12.6 6.0 43.8 47.1 31.9 40.4 0.0 17.4
Mizoram 68.9 55.5 60.8 50.4 10.8 38.0 63.4 41.6 63.0 0.0 18.5
Nagaland 13.8 1.5 16.7 6.7 0.0 3.3 9.0 2.0 10.4 0.0 0.6
Sikkim 51.8 48.4 23.1 31.5 21.7 50.0 65.7 34.1 55.7 0.0 46.3
Tripura 78.4 70.5 8.6 9.5 29.1 69.7 70.0 55.3 20.9 0.0 40.8
West
Rajasthan 22.0 16.8 13.5 7.9 6.9 14.6 33.7 5.1 33.3 9.5 3.9
Goa 41.8 39.4 5.5 6.7 29.4 40.4 66.5 15.8 57.6 44.8 21.2
Gujarat 69.8 65.7 31.8 26.2 30.2 59.0 54.5 36.4 49.4 16.8 42.3
Maharashtra 60.7 61.2 12.0 13.1 25.0 51.3 51.4 36.8 31.1 21.2 28.1
South
Andhra Pradesh 52.4 50.8 12.0 7.0 16.5 50.2 65.3 32.6 42.9 17.0 40.6
Karnataka 47.1 46.4 4.0 15.8 25.3 45.5 56.3 16.1 47.6 24.2 19.8
Kerala 36.4 29.0 17.8 9.7 12.1 23.1 43.2 14.8 38.1 11.7 14.0
Tamil Nadu 26.5 24.1 7.1 2.0 10.0 26.1 42.3 22.7 29.5 16.8 26.4
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 321
Table 7.23: Intake of supplementary food among lactating and pregnant women by state
Percentage of mothers with child aged 0-5 months and pregnant women covered by an AWC, utilizing supplementary foods and services provided at AWC, by state
State
Mothers of children 0-5 months (Lactating mothers) Currently Pregnant women
Percentage received
Supplementary food
Type of Supplementary food received Percentag
e received Supplementary food for 21 or
more days
Percentage consumed
entire quantity received
from AWC
Percentage received
Supplementary food
Percentage received
Supplementary food for 21 or more
days
Percentage consumed
entire quantity received
from AWC
Hot Cooked
Meal (HCM)
Ready to eat
(RTE)/Take Home Ration (THR)
India 42.4 26.7 78.5 20.3 32.1 40.7 27.8 46.9 North
Delhi 4.3 100 29.2 26.0 37.1 8.8 44.2 30.9 Haryana 11.8 93.6 20.9 41.3 27.8 19.6 22.8 31.7 Himachal Pradesh 65.2 22.6 85.0 44.0 23.0 65.7 37.9 36.4 Jammu & Kashmir 14.2 60.4 44.0 35.1 63.3 14.9 31.6 48.7 Punjab 15.5 19.9 90.8 9.3 27.6 14.9 5.8 45.3 Uttar Pradesh 23.6 8.2 93.5 18.4 26.6 23.8 12.7 34.6 Uttarakhand 21.0 0.0 100.0 8.8 33.5 12.3 0.0 44.4
Central Chhattisgarh 81.5 1.5 99.4 49.9 13.8 65.4 62.0 15.1 Madhya Pradesh 54.0 9.0 96.3 30.3 23.9 47.7 24.4 35.8
East Bihar 39.3 4.0 97.7 0.0 16.0 21.7 33.2 41.9 Jharkhand 72.9 8.8 93.8 28.5 15.6 47.0 21.6 19.6 Odisha 76.5 2.8 98.1 0.0 17.0 60.6 24.8 22.2 West Bengal 46.5 98.6 1.4 0.0 47.3 55.6 35.6 68.4
North East Arunachal Pradesh 25.9 74.3 100.0 0.0 0.0 20.6 0.0 0.0 Assam 41.4 10.4 100.0 0.0 14.8 29.8 1.9 33.1 Manipur 25.8 11.8 98.1 0.0 8.0 44.3 5.0 34.0 Meghalaya 29.6 61.5 85.3 0.0 37.4 34.3 26.9 30.1 Mizoram 46.4 56.0 94.4 0.0 30.1 44.1 4.7 23.8 Nagaland 3.0 11.7 100 0.0 0.0 0.0 0.0 83.8 Sikkim 43.9 18.0 83 0.0 40.4 55.1 19.3 86.1 Tripura 27.2 77.2 28.1 0.0 58.1 60.0 49.5 0.0
West Rajasthan 35.5 5.7 96.8 23.9 7.4 33.5 28.9 9.5 Goa 70.2 15.7 84.3 69.9 32.8 49.2 76.3 36.0 Gujarat 49.4 39.8 82.7 19.6 62.5 49.0 20.2 63.4 Maharashtra 42.0 56.9 48.9 27.3 36.8 47.4 19.0 55.6
South Andhra Pradesh 60.1 44.4 67.0 22.3 52.2 78.3 29.9 80.7 Karnataka 52.3 13.3 87.6 37.6 41.0 48.8 40.7 45.0 Kerala 15.0 26.4 73.6 11.8 4.4 23.0 28.5 60.8 Tamil Nadu 30.5 30.8 72.2 31.3 57.7 45.7 24.5 53.3
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 322
Table 7.25: Frequency of receiving supplementary food
Percent distribution of mothers with children aged 0-5 months covered by an AWC who receive supplementary
food from AWC, by frequency of receiving supplementary food in month prior to survey, according to background
characteristics
Characteristics
Number of days received supplementary food Average number of days received supplementary
food
Number of mothers of child aged 0-5
months who received
supplementary food
Not at all
1-7 8-14 15-20 21 or more
Not present in
last month
Don't know/can't say
Mother of children aged 0-5 months
7.8 43.5 6.2 13.3 20.3 4.5 4.4 10.5 3,590
Residence Urban 11.1 44.9 5.2 11.5 18.9 3.8 4.4 9.6 580 Rural 7.2 43.2 6.3 13.6 20.5 4.7 4.4 10.7 3,011
Mother's education
No Education 7.5 42.8 7.5 14.4 17.2 4.9 5.4 9.9 1,224 Below Primary (Class - 1 to 4)
6.6 57.2 7.6 7.4 14.8 3.3 3.0 7.8 229
Completed Primary (Class 5-7)
10.9 46.7 5.2 12.4 18.3 2.9 3.3 10.1 614
Completed Middle (Class 8 -9)
7.9 45.4 4.8 8.5 21.9 6.9 4.6 10.1 628
Completed Secondary (Class 10-11)
6.1 39.0 5.2 17.0 25.6 3.1 4.0 12.9 470
Higher Secondary and above (Class 12)
6.5 35.6 5.8 17.4 26.5 4.5 3.8 12.4 426
Religion Hindu 8.1 42.3 6.6 12.6 21.4 4.3 4.5 10.8 2,982 Muslim 6.2 47.4 3.7 18.0 15.4 5.9 3.3 9.4 475 Christian 0.9 60.4 8.4 11.8 7.0 6.6 5.1 6.7 63 Sikh (20.7) (27.6) (10.3) (10.3) (17.2) (6.9) (6.9) (8.9) 29 Jain * * * * * * * * 4 Buddhist/Neo-Buddhist
(2.5) (77.5) (2.5) (5.0) (5.0) (5.0) (2.5) (4.2) 40
No religion * * * * * * * * 8 Other * * * * * * * * 19
Social Group Scheduled Caste 7.3 44.7 5.5 12.7 22.3 4.5 3.0 11.2 843 Scheduled Tribe 9.0 38.5 7.4 14.2 26.0 1.3 3.7 11.8 560 OBC 6.8 40.1 7.0 14.7 19.9 4.5 6.8 11.0 1,363 Other 9.5 49.2 4.9 11.4 15.8 6.7 2.4 8.7 780
Wealth Index Lowest 7.4 46.4 8.3 11.8 16.5 4.3 5.3 9.4 1014 Second 6.4 48.0 4.1 14.0 18.8 4.9 3.7 9.8 872 Middle 8.5 41.0 5.8 14.0 21.6 5.8 3.1 11.4 779 Fourth 8.8 40.9 6.3 10.9 23.7 3.7 5.5 10.9 568 Highest 9.2 33.5 5.9 17.8 26.4 2.8 4.5 13.1 357
( ) Percentage based on 25-49 unweighted cases. *Percentage not shown; based on fewer than 25 unweighted cases.
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 323
Table 7.26: Frequency of receiving supplementary food
Percent distribution of children aged 6-35 months covered by an AWC who receive supplementary food from AWC,
by frequency of receiving supplementary food in month prior to survey, according to background characteristics.
Characteristics
Number of days received supplementary food Average
number of
days
received
supplement
ary food
Number of
children who
received
supplementa
ry food
Not
at all 1-7 8-14 15-20
21 or
more
Not
present in
last
month
Don't
know/can't
say
Children aged 6-35
months
0.0 42.2 5.9 13.9 21.3 5.3 11.5 11.5 20,255
Residence
Urban 0.0 40.1 5.5 14.6 24.3 4.5 11.0 12.4 3,999
Rural 0.0 42.7 6.0 13.7 20.5 5.5 11.6 11.3 16,256
Mother's education
No Education 0.0 42.3 7.2 15.4 17.7 5.3 12.1 10.9 6,281
Below Primary
(Class - 1 to 4)
0.0 53.9 4.5 8.9 16.7 5.5 10.4 9.1 1,303
Completed Primary
(Class 5-7)
0.0 41.9 5.9 13.7 22.2 4.8 11.5 11.8 3,703
Completed Middle
(Class 8 -9)
0.0 44.2 5.2 11.9 20.9 6.1 11.8 11.0 3,516
Completed
Secondary (Class
10-11)
0.0 40.3 5.6 14.1 26.0 4.1 10.0 12.5 2,704
Higher Secondary
and above (Class
12)
0.0 36.3 4.7 15.1 26.2 6.2 11.5 13.3 2,749
Social -Group
Scheduled Caste 0.0 44.7 5.7 12.8 20.8 4.6 11.4 11.0 4,467
Scheduled Tribe 0.0 37.6 7.3 15.0 24.8 4.2 11.3 12.8 3,071
OBC 0.0 36.4 5.6 15.8 23.7 6.3 12.2 12.8 7,480
Other 0.0 49.9 5.8 11.8 16.7 5.3 10.5 9.7 4,955
Don’t know 0.0 72.4 1.8 4.1 5.6 4.2 11.8 4.7 283
Wealth Index 0.0 42.2 5.9 13.9 21.3 5.3 11.5 11.5 20,255
Lowest 0.0 49.0 6.7 11.6 16.8 4.7 11.3 9.7 4,811
Second 0.0 45.5 5.4 12.3 19.0 6.4 11.4 10.5 4,843
Middle 0.0 40.1 5.3 16.7 21.6 5.6 10.7 12.1 4,634
Fourth 0.0 37.2 6.5 14.9 25.6 4.3 11.5 13.0 3,796
Highest 0.0 33.3 5.3 14.4 28.0 5.4 13.5 13.9 2,171
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 324
Table 7.27: Frequency of receiving supplementary food
Percent distribution of children aged 36-71 months covered by an AWC who receive supplementary food from AWC, by frequency of receiving supplementary food in month prior to survey, according to background characteristics.
Characteristics
Number of days received supplementary food from AWC in last
month
Average
number
of days
received
suppleme
ntary
food
Number
of
children
received
suppleme
ntary
food
Not at
all 1-7 8-14 15-20
21 or
more
Not
present
in last
month
Do not
know/c
an't say
Children aged 36-
71 months
9.1 12.2 11.4 29.6 31.0 2.6 4.0 15.6 21,140
Residence
Urban 11.7 13.1 10.5 26.5 31.7 3.1 3.3 15.1 3,816
Rural 8.5 11.9 11.6 30.3 30.9 2.5 4.2 15.7 17,325
Mother's
education
No Education 8.0 12.6 12.5 31.6 28.1 2.1 5.1 15.4 8,404
Below Primary
(Class - 1 to 4)
10.8 13.5 11.9 27.5 30.8 2.0 3.5 15.0 1,704
Completed
Primary (Class 5-
7)
10.6 10.0 11.3 30.2 32.0 2.5 3.4 15.7 3,902
Completed
Middle (Class 8 -
9)
9.6 12.3 11.7 28.9 30.7 3.4 3.4 15.4 3,109
Completed
Secondary (Class
10-11)
7.7 11.9 8.6 27.1 38.7 3.3 2.7 16.7 2,358
Higher Secondary
and above (Class
12)
10.3 13.9 9.2 25.2 33.9 3.5 4.1 15.3 1,664
Social Group
Scheduled Caste 7.8 13.1 11.4 28.5 31.6 2.9 4.7 15.8 4,747
Scheduled Tribe 6.2 12.3 12.7 30.0 33.1 2.0 3.8 16.1 3,279
OBC 8.1 12.5 10.9 31.0 29.8 3.0 4.8 15.6 7,635
Others 12.6 10.7 11.7 28.8 31.3 2.3 2.5 15.1 5,160
Do Not Know 25.2 12.9 6.5 23.6 26.9 2.4 2.4 12.6 319
Wealth Index
Lowest 7.7 11.7 13.3 30.7 29.9 1.9 4.8 15.6 5,770
Second 9.4 12.3 12.3 29.4 29.7 2.8 4.0 15.3 5,507
Middle 9.5 11.8 10.0 29.9 31.9 2.9 3.9 15.8 4,720
Fourth 8.3 12.6 9.8 29.7 32.5 3.2 3.9 15.8 3,377
Highest 13.0 13.2 9.4 25.5 33.9 2.6 2.4 15.0 1,766
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 325
Table 7.28: Frequency of receiving supplementary food
Percent distribution of currently pregnant women covered by an AWC who receive supplementary food from AWC, by frequency of receiving supplementary food in month prior to survey, according to background characteristics.
Characteristics
Number of days received supplementary food Average
number of
days received
supplementary
food
Number of
currently pregnant
women who
received
supplementary
food
Not at
all 1-7 8-14 15-20
21 or
more
Don't
know/can't
say
Not
present
in last
month
Pregnant women 5.1 34.8 7.8 15.9 27.8 4.7 3.9 13.8 2,137
Residence
Urban 6.8 33.2 4.8 15.1 31.4 5.1 3.6 14.7 359
Rural 4.7 35.2 8.5 16.1 27.0 4.6 3.9 13.6 1,778
Mother's
education
No Education 6.5 35.2 9.4 14.0 25.7 6.2 3.0 13.3 720
Below Primary
(Class - 1 to 4)
5.5 41.8 5.4 13.6 28.3 2.3 3.1 12.7 111
Completed
Primary (Class 5-
7)
5.3 31.4 8.8 18.9 28.2 3.7 3.6 14.7 357
Completed
Middle (Class 8 -
9)
5.2 27.2 5.5 16.2 34.1 5.2 6.6 15.9 343
Completed
Secondary (Class
10-11)
4.2 39.2 7.2 16.3 25.3 4.3 3.5 12.6 267
Higher
Secondary and
above (Class 12)
2.2 39.6 7.3 17.3 26.9 2.8 3.8 13.3 339
Social Group
Scheduled Caste 4.2 32.1 6.8 11.5 37.1 3.8 4.4 15.2 492
Scheduled Tribe 5.4 33.9 10.4 14.0 26.8 6.2 3.2 13.7 342
OBC 4.0 39.2 7.5 17.2 23.3 5.1 3.7 12.8 813
Other 7.0 33.2 6.8 19.5 25.4 3.6 4.5 13.7 452
Don’t know (6.5) (19.4) (12.9) (22.6) (29.0) (6.5) (3.2) (15.5) 31
Wealth Index
Lowest 4.0 32.7 10.8 14.3 26.6 7.0 4.6 13.9 501
Second 7.4 35.7 8.9 16.3 25.1 3.3 3.3 13.2 526
Middle 5.6 35.3 4.8 15.8 30.6 3.9 4.1 14.2 492
Fourth 3.6 36.7 6.2 17.0 28.4 4.1 3.9 13.9 393
Highest 3.4 33.3 8.1 17.3 29.3 5.3 3.3 14.0 225
( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 326
Table 7.36: Awareness regarding child’s weight normal or underweight
Percentage distribution of children aged 0-35 months and 36-71 months residing in areas covered by Anganwadi centre (AWC), by state.
States
Percent mothers
aware that child’s
weight was normal
Number of
children aged 0-
35 months
Percent mothers aware
that child’s weight was
normal
Number of
children aged
36-71 months
North
Delhi 97.3 112 95.4 88
Haryana 89.3 134 96.0 112
Himachal Pradesh 86.3 244 87.8 143
Jammu & Kashmir 85.2 17 78.2 9
Punjab 68.9 21 100.0 6
Uttar Pradesh 59.5 77 94.8 17
Uttarakhand 88.6 52 91.6 22
Central
Chhattisgarh 79.3 284 73.0 161
Madhya Pradesh 77.3 65 82.9 22
East
Bihar 65.2 74 54.1 11
Jharkhand 93.5 62 95.0 28
Odisha 74.3 592 78.0 193
West Bengal 68.7 680 64.6 44
North-East
Arunachal Pradesh 87.7 16 100.0 9
Assam 76.4 79 92.8 35
Manipur 91.6 14 100.0 1
Meghalaya 95.6 67 98.6 37
Mizoram 100.0 25 97.3 38
Nagaland 0.0 0 29.2 1
Sikkim 90 381 92.3 93
Tripura 71.7 62 77.2 18
West
Rajasthan 77.0 81 75.7 27
Goa 92.2 454 96.0 184
Gujarat 87.3 592 88.2 403
Maharashtra 85.4 249 91.6 242
South
Andhra Pradesh 85.7 390 91.4 229
Karnataka 71.0 560 77.0 310
Kerala 93.2 277 93.4 266
Tamil Nadu 73.2 301 71.9 201
Total 78.2 6635 84.4 3389
*Percentage not shown; based on fewer than 25 unweighted cases.
( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 327
Table 7.43: Pre-School Education (PSE)- frequency of attending PSE at AWC in last month*
Percentage distribution of children aged 36-71 months residing in area covered by Anganwadi centre (AWC), by frequency of attending Pre- School education in last month* , according to background characteristics
Characteristics
Number of days PSE attended in last month* (in days) Mean
number
of days
attended
PSE at
AWC
Number of
children
covered by
an AWC
attending
ICDS run
PSE
Not at
all 1-6 7-15
16 or
more
Do not
Know/can't
remember
Sex of Child Male 7.2 8.4 22.9 57.2 4.2 18.1 9,249 Female 6.7 8.2 21.8 58.9 4.3 18.3 9,262
Residence Urban 10.5 8.1 20.8 55.5 5.2 18.3 3,296 Rural 6.2 8.4 22.7 58.6 4.0 18.2 15,215
Mother's education No education 5.6 9.6 24.0 56.5 4.3 17.8 7,278 Below Primary (Class 1-4) 6.9 8.7 20.8 60.2 3.4 18.1 1,487 Completed Primary (Class 5-7) 8.7 6.5 22.2 58.6 3.9 18.5 3,416 Completed Middle (Class 8 -9) 7.3 9.3 22.5 56.5 4.4 17.9 2,727 Completed Secondary (Class 10-11)
6.2 6.4 18.0 65.4 3.9 19.5 2,141
Completed Higher Secondary (Class 12)
10.5 7.0 22.4 54.5 5.6 18.5 1,463
Religion Hindu 6.3 8.5 22.3 58.4 4.4 18.3 14,899 Islam 10.0 7.3 23.7 55.9 3.0 17.9 2,719 Christian 9.3 7.2 21.9 57.6 4.1 18.0 520 Sikh 8.8 9.7 10.9 66.3 4.3 19.3 150 Jain * * * * * * 11 Buddhist/Neo- Buddhist 7.3 9.6 20.4 58.6 4.2 17.6 135 No Religion * * * * * * 11 Other 6.7 3.3 34.6 45.0 10.3 16.8 66
Social Group Scheduled Caste 6.1 10.2 21.7 57.2 4.8 17.9 4,142 Scheduled Tribe 4.2 9.3 24.5 58.0 4.0 18.1 2,864 OBC 7.0 8.4 21.0 58.4 5.1 18.2 6,737 Other 9.2 5.7 23.6 58.9 2.6 18.7 4,536 Do Not Know 13.5 12.6 24.2 46.2 3.4 16.5 232
Wealth Index Lowest 5.1 9.5 24.9 56.6 3.8 17.7 5,010 Second 6.3 8.9 23.1 57.1 4.6 18.0 4,795 Middle 8.1 7.1 20.2 60.4 4.3 18.8 4,185 Fourth 8.0 7.7 19.9 59.6 4.9 18.6 2,999 Highest 10.1 7.1 22.9 56.6 3.1 18.3 1,522
Total 7.0 8.3 22.4 58.1 4.2 18.2 18,511
*Percentage not shown; based on fewer than 25 unweighted cases.
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 328
Table 7.44: Pre-School Education (PSE)- time spent by children on PSE activities in a day at AWC
Percentage of children aged 36-71 months residing in area covered by Anganwadi centre (AWC), by time spent by children on PSE activities in a day at AWC, according to background characteristics.
Characteristics
Time spent by children on PSE activities in a day at
AWC
Number of
children living in
an area
attending ICDS
run PSE
Less than
1 hour 1-2 hours 3 hours
4 hours or
more
Age of child (months)
36-47 2.1 41.4 26.5 26.0 6,967
48-59 2.0 40.0 28.5 24.9 6,763
60-71 3.1 39.3 29.3 24.3 4,782
Sex of child
Male 2.4 41.4 27.8 24.1 9,249
Female 2.2 39.3 28.1 26.3 9,262
Residence
Urban 3.5 41.6 21.4 29.0 3,296
Rural 2.1 40.1 29.4 24.4 15,215
Mother's education
No education 1.8 41.3 28.1 25.0 7,278
Below Primary (Class - 1 to 4) 1.8 51.6 28.6 14.7 1,487
Completed Primary (Class 5-7) 2.5 41.6 27.9 23.3 3,416
Completed Middle (Class 8 -9) 2.6 44.5 28.7 20.1 2,727
Completed Secondary (Class 10-11) 2.6 29.9 28.1 35.1 2,141
Completed Higher Secondary and
above
4.3 28.6 25.1 36.3 1,463
Religion
Hindu 2.4 38.0 29.3 26.1 14,899
Islam 1.8 55.0 20.2 19.2 2,719
Christian 3.8 32.9 23.7 33.8 520
Sikh 1.7 19.5 48.9 22.9 150
Jain * * * * 11
Buddhist/Neo- Buddhist 4.4 50.7 22.3 14.8 135
No Religion * * * * 11
Other 0.0 46.9 29.1 17.9 66
Social Group
Scheduled Caste 1.7 39.4 28.2 26.1 4,142
Scheduled Tribe 1.7 47.3 28.5 19.1 2,864
OBC 2.5 30.2 30.6 32.0 6,737
Other 3.0 50.3 24.1 19.1 4,536
No response 1.0 72.4 14.6 4.9 232
Wealth Index
Lowest 1.4 46.2 29.9 18.6 5,010
Second 1.8 43.3 27.7 22.4 4,795
Middle 2.2 36.5 28.0 29.6 4,185
Fourth 3.3 36.2 26.0 30.6 2,999
Highest 5.3 30.9 26.1 33.1 1,522
Total 2.3 40.4 27.9 25.2 18,511
*Percentage not shown; based on fewer than 25 unweighted cases.
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 329
Table 7.45: Pre-School Education (PSE) in Anganwadi Centre (AWC) by state
Percentage of children aged 36-71 months residing in area covered by AWC, by various PSE indicators according to state.
State
Percentage
attending
PSE in AWC
Number
of
Children
Mean
age at
which
started
attending
PSE
Average
number
of days
attended
PSE in
one
month
prior to
survey
Average
number
of days
attended
PSE in
the 3
months
prior to
survey
Percenta
ge of
children
attended
PSE 16
days or
more in
one
month
prior to
survey
Average
number
of hours
attended
PSE in
one
month
prior to
survey
Percentage of
children attended
PSE for 4 hours or
more
Percentage
whose
mothers
participated
in parent's
meet in the
3 months
prior to
survey
Number
of
children
living in
an area
covered
by an
AWC
India 38.7 47874 38.9 16.9 42.6 58.1 2.8 25.2 27.8 18,509
North
Delhi 10.7 963 19.6 17.1 34.4 61.7 2.1 8.1 8.4 103
Haryana 14.6 953 13.3 16.6 41.9 53.3 2.4 6.4 16.8 139
Himachal Pradesh 35.2 1258 13.0 17.9 45.9 62.9 2.9 18.8 52.5 442
Jammu & Kashmir 15.4 851 13.3 11.2 26.4 35.6 1.9 5.2 21.3 131
Punjab 17.9 1134 16.3 17.0 40.6 61.5 2.9 16.1 19.5 203
Uttar Pradesh 16.4 6502 15.1 13.8 34.8 34.4 2.6 11.9 12.6 1,063
Uttarakhand 25.1 999 18.3 16.5 39.7 49.0 2.8 8.0 13.6 251
Central
Chhattisgarh 57.0 1339 11.4 16.2 40.9 48.9 3.0 21.7 9.8 763
Madhya Pradesh 37.1 2362 9.3 13.9 36.1 37.4 2.4 16.9 13.8 876
East
Bihar 42.5 3827 19.2 18.9 54.5 72.2 3.3 44.7 15.8 1,625
Jharkhand 25.5 1489 12.6 16.0 34.6 52.3 2.7 24.0 32.7 379
Odisha 62.7 1714 6.6 17.3 48.1 62.9 2.4 5.4 30.4 1,075
West Bengal 53.6 2297 10.0 15.1 42.9 55.1 1.8 0.6 18.3 1,232
North east
Arunachal Pradesh 57.2 1260 14.9 15.5 37.5 45.6 2.3 9.8 8.6 721
Assam 64.6 1473 10.3 14.8 37.1 46.4 2.1 1.7 13.3 951
Manipur 62.8 1080 24.8 10.7 27.0 23.7 1.9 1.4 44.0 678
Meghalaya 30.3 1092 9.9 12.4 31.8 25.6 1.9 0.4 9.8 331
Mizoram 60.9 1113 11.1 16.9 25.2 53.7 2.3 9.1 30.8 678
Nagaland 1.4 1142 (7.0) (4.0) (5.0) (3.6) (1.7) (0.0) (10.7) 28
Sikkim 44.9 800 12.9 18.7 50.6 74.8 3.0 44.7 70.0 359
Tripura 74.2 886 10.1 18.8 47.8 70.0 2.4 1.8 45.7 657
West
Rajasthan 17.0 2153 11.9 14.7 38.5 48.8 2.6 22.1 16.4 366
Goa 35.4 879 16.6 21.6 60.9 81.9 3.2 40.9 57.1 311
Gujarat 57.4 1588 9.3 16.9 36.8 63.3 2.5 16.4 38.3 912
Maharashtra 58.4 2379 16.0 18.8 45.6 64.2 2.5 15.0 35.2 1,390
South
Andhra Pradesh 50.6 1835 10.3 18.1 39.9 65.7 3.6 48.4 50.5 929
Karnataka 45.5 1631 14.3 20.4 47.6 77.5 3.8 65.4 43.4 742
Kerala 32.0 1175 12.0 17.5 46.0 62.4 4.2 71.3 42.5 376
Tamil Nadu 23.1 1817 15.9 15.4 37.6 46.3 4.4 54.8 33.8 419
( ) Percentage based on 25-49 unweighted cases
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 330
WEIGHT COMPUTATION
Household level
Sampling weights have been computed mainly for the four considerations, namely (i) to enable drawing
valid statistical inferences (ii) for correcting the bias primarily due to varying response rates (iii) varying
probability of selection of PSUs and households (HH) at state level and (iv) to keep the weighted sample
distribution close to the actual population distribution in view of oversampling done while selecting
households and also oversampling done in a few states for urban/rural sample.
Broadly, two types of weights have been computed: one to be used for generating national-level
indicators and another to be used for generating state-level indicators.
The probability (f) of selecting a HH is the product of (i) probability of selecting a PSU (f1), (ii) probability
of selecting a segment (fs) and (iii) probability of selecting a HH in the selected segment (f2).
(Probability of selecting a household)= f = f = f1*fs*f2 ; fs =1 if PSU is not segmented;
As PSUs were selected with probability proportional to their population size with replacement (PPSWR),
probability of selection of a PSU would be:
Where,
a = Number of PSUs selected from the stratum
pi = Population of the ith PSU in the as per Census 2011
P = Total population of the stratum as per Census 2011
Households within a PSU were selected using circular systematic random sampling. Probability of
selection of a household would be:
Where,
ni = Number HHs to be selected in a PSU
Li = Number of HHs listed in the ith PSU of the ‘cluster’
Adjustment due to segmentation: For large villages (with population >= 250 households) segmentation
was undertaken and two segments were selected randomly. The probability of selecting a segment is:
Where,
2 = Number of segments selected
Ki = Total number of segments made in the ith PSU
The household level weight at ‘cluster’ level, is computed as:
In order take care of differential response rates across the PSUs in the
‘cluster’, the design weight (wi) has been divided by the response rate, i.e.:
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 331
Where,
Ri is the response rate achieved in ith PSU.
Adjustment for over sampling in category A: In order to correct for the oversampling in category ‘A’ households in rural areas the rural household weights of a state are normalized so that the total number of weighted cases is equal to the total number of un-weighted cases in the rural areas of the state. This is done by multiplying the rural household weights by the ratio of total number of un-weighted cases to total number of weighted cases (obtained by applying weights before normalization to the number of cases in rural areas of the state). The final rural household weight in a state is calculated as:
Similar treatment has been done for adjusting weights in urban areas. (Whu) is the adjusted weight for
urban areas.
After normalization of the rural and urban household weights separately for each state the next step
was to compute the combined normalized state weights for the respective states as there was
disproportionate allocation in the rural and urban areas of state. For each state, this was done by
multiplying the rural normalized weights (Whr) by factor PR/pr and similarly the urban normalized weight
(Whu) was multiplied by PU/pu.
Where PR/PU refers to: proportion of rural population/proportion of urban population to the total
population of the state as per census and pr/pu refers to: proportion of rural sample/proportion of
urban sample to the total state sample.
Finally, weights have been normalized to keep the total weighted state sample size same as un-weighted
state sample size.
National Weights: Since the size of the population varies widely across the states covered in RSOC there
is a need to apply National level weights for presenting the combined National level estimates. Thus, in
order to take care of the disproportionate allocation of the sample across different states the National
level weights were computed. To obtain national normalized weights the state weights were multiplied
by factor PSi/psi.
Where,
PSi = proportion of the ith state population to the national population ps i= proportion of the ith state sample to the total sample at national level.
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 332
AWC level
In the absence of data on number of Anganwadis for each of the stratum/PSU, the weights for AWCs
have been computed with the assumptions that every AWC in both the rural and urban areas of a given
state has equal probability of being selected. For computation of the AWC weight, the total number of
AWCs functioning in the rural and the urban areas of each state were collected from the Department of
Women and Child Development of each state.
The Anganwadi weights (Aw) have been computed as under:
Anganwadi weights (Aw) = Total number of AWCs (N) in the state/Number of AWCs covered in the
state (n)
Separate weights have been computed for rural and urban areas. As in case of household based weights,
two types of weights have been computed in case of AWCs also-one for generating state-level indicators
and another for generating national-level indicators.
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 333
ANNEXURE B – SURVEY TOOLS:
E1 –LISTING FORMAT
RAPID SURVEY ON CHILDREN (2013-14)
COVER SHEET FOR LISTING
A1 State (Name and Census Code)
A2 District (Name and Census Code)
A3 Name and Census Code of Tehsil/Taluka/Community Development
Block/Mandal
Name ____________________________
Code
A4 Location of PSU RURAL 1
URBAN 2
A5 Name and code number of village/town
If urban PSU, please note ward number and CEB number (As per
census 2011)
VILLAGE/TOWN NAME ___________________________
VILLAGE/TOWN CODE
WARD NUMBER
CEB NUMBER
A6 Cluster Number
A7 PSU population as per Census 2011
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 334
A8
Type of Village/CEB
RURAL STRATUM-NOT SEGMENTED 1
RURAL STRATUM -SEGMENTED 2
URBAN 3
A9 Number of segments formed in the village
A10 Serial number of selected segment SEGMENT 1
SEGMENT 2
A11 Name, address and Serial Number of AWCs in the PSU
1._________________________________________
2._________________________________________
3.________________________________________
4._________________________________________
5._________________________________________
6._________________________________________
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 335
A12 Summary of the Coverage in Listing Total number of households (HHs) with at least
one EMW
Total number of EMWs in the PSU
Number of households (HHs) with at least one child
aged 0-6 years
Number of other households (Not having
any child aged 0-6 years)
Total number of 0-35 month old children
Total number of 36-71 month old children
Total number of lactating mothers
Total number of pregnant women
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 336
*CODES FOR TYPE OF HOUSE: Residential/partly residential -1, Non-residential -2, Vacant -3, Locked -4, Refused -5, Other -6. ** Y = Yes , N = No
HOUSE-LISTING SCHEDULE
STATE NAME
__________________
DISTRICT NAME
__________________
TYPE OF PSU
(RURAL/URBAN)
RURAL PSU URBAN PSU SERIAL NUMBER
OF SELECTED
SEGMENT
VILLAGE/TOWN NAME
__________________
WARD NUMBER
STATE CODE
DISTRICT CODE
RURAL=1 URBAN = 2 VILLAGE/TOWN CODE
CEB NUMBER
Serial No.
House No.
Type of house (REFER CODES*
)
HH No. (IF CODE 1 IN
COL 3 RECORD
HOUSEHOLD NO. ELSE
SKIP TO NEXT
HOUSE)
Address
Name of
Head of the Hous
e
Is there any
EMW (15-49
years) in
your HH? (Y-1, N-2) **
IF YES, record numbe
r of EMWs
Does the HH have any
children age 0-6
years? (Y-1, N-2) **
IF YES, record number of children
Does the HH have any
lactating
mother?
(Y-1, N-2) **
IF YES, record
the numbe
r
Does the HH have
any currentl
y pregnan
t women?
(Y-1, N-2) **
IF YES, record
the numbe
r
IF YES IN COL 9, 12, OR 14,
Is any member in
your HH availing
supplementary food from
AWC Y 1 N 2
Code number of AWC
from where
the member
is accessin
g the services
Type of HH for
Selection (A= HH
with atleast 1 child 0-6 years; B
= HH with no child 0-6
years
0-3 years (0 – 35
MONTHS)
3-6 years (36 - 71
MONTHS)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
19
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 337
S
e
r
i
a
l
N
o
.
H
o
u
s
e
N
o.
Type
of
house
(REFE
R
CODE
S*)
HH No. (IF
CODE 1 IN COL
3 RECORD
HOUSEHOLD
NO. ELSE SKIP
TO NEXT
HOUSE)
A
d
d
r
e
s
s
Nam
e of
Head
of
the
Hous
e
Is there
any EMW
(15-49
years) in
your HH?
(Y-1, N-2)
**
IF
YES,
recor
d
numb
er of
EMW
s
Does the
HH have
any
children
age 0-6
years?
(Y-1,
N-2)
**
IF YES,
record
number of
children
Does
the HH
have
any
lactatin
g
mother
?
(Y-1,
N-2)
**
IF
YES,
reco
rd
the
num
ber
Does the
HH have
any
currently
pregnant
women?
(Y-1,
N-2)
**
IF
YES,
reco
rd
the
num
ber
IF YES IN COL 9, 12,
OR 14, Is any
member in your HH
availing
supplementary
food from AWC Y 1
N 2
Code number
of AWC from
where the
member is
accessing the
services
Type of HH for
Selection (A= HH
with atleast 1 child
0-6 years; B = HH
with no child 0-6
years 0-3
years
(0 –
35
MON
THS)
3-6
year
s (36
- 71
MO
NTH
S)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 338
*CODES FOR TYPE OF HOUSE: Residential/partly residential -1, Non-residential -2, Vacant -3, Locked -4, Refused -5, Other -6. ** Y = Yes, N = No
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 339
Confidential for Research
Purpose only
E2 - Household Questionnaire
RAPID SURVEY ON CHILDREN (2013-2014)
INTRODUCTION & CONSENT
My name is (NAME) _____________, and I am working as an interviewer with ……………………., a leading
research organization. We do lot of surveys on various social issues like health, nutrition, education, poverty,
drinking water and sanitation, etc. [PAUSE]. At present, we are conducting a study for UNICEF, an UN
organization to assess the health and nutrition status of women and children across the country. We would like to
speak to you in this regard and ask some questions on health and nutrition related issues [PAUSE]. There are no
right or wrong answers for these questions. We only seek your responses and opinions regarding some of these
issues [PAUSE]. We will also be recording the height and weight of the children below 5 years and adolescent girls
aged between 10 to 19 years. We assure that your personal details as well as the information given by you will be
kept confidential. The interview is conducted with the help of a computer and might take around 1-2 hours. During
the survey, your voice will be recorded for some of the basic factual questions. [PAUSE] We seek your cooperation
in this regard. May we proceed? ...........Thank you.
Respondent signature or thumb impression to be taken on log sheet
H.1 IDENTIFICATION PARTICULARS
H1.1 State (NAME AND CODE)
STATE NAME ______________________________________
STATE CODE
H1.2 District (NAME AND CODE)
DISTRICT NAME____________________________________
DISTRICT CODE
H1.3 Tehsil/taluka/community
development block/mandal (NAME
AND CODE)
TEHSIL/TALUKA/BLOCK NAME _____________________
TEHSIL/TALUKA/BLOCK CODE
H1.4 Residence RURAL
URBAN
1
2
H1.5 If rural PSU, name and code
number (village/town)
VILLAGE/TOWN NAME ___________________________
VILLAGE/TOWN CODE
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 340
If urban PSU, town name and code,
ward number and CEB number
WARD NUMBER
CEB NUMBER
H1.6 PSU population as per census 2011
H1.7 Type of village/CEB
RURAL STRATUM-NOT SEGMENTED
RURAL STRATUM -SEGMENTED
URBAN
1
2
3
H1.10
H1.10
H1.8 Number of segments formed in the
village
NUMBER OF SEGMENTS
H1.9 Serial number of selected segment
SEGMENT SERIAL NUMBER
H1.10 House number
(HOUSE NUMBER TO BE FILLED
FROM INTERVIEWER’S
ASSIGNMENT SHEET )
H1.11 Household number
(HOUSEHOLD NUMBER TO BE
FILLED FROM INTERVIEWER’S
ASSIGNMENT SHEET)
H1.12 Name of head of household
FIRST NAME _________________________________
MIDDLE NAME ________________________________
SURNAME_____________________________________
H1.13 Address
HOUSE NO. _________________________________
STREET NAME/NO. __________________________
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 341
LOCALITY _________________________________
H1.14 Please specify the number of usual
members living in your household
TOTAL NUMBER OF USUAL MEMEBERS
H
1.14A
Does your household have a
MGNREGA job card?
YES
NO
NOT ELIGIBLE
1
2
3
H1.15
H1.14
B
When was the Job Card prepared?
Month is to recorded in two digits (
e.g.: January – 01)
Years to be recorded in two digits (
e.g.: 2013 to be recorded as ‘13’)
Month and Year
H
1.14C
Did any member of your household
get work under MGNREGA
scheme during last 365 days?
YES
NO
1
2
H1.15
H
1.14D
For how many days did member(s)
of your household work under
MGNREGA in the last 365 days?
(IF MORE THAN ONE MEMBER
OF THE HOUSEHOLD WORKED
UNDER MGNREGA IN THE
LAST 365 DAYS, ADD THE
NUMBER OF DAYS WORKED
BY ALL MEMBERS AND
RECORD).
TOTAL DAYS
H1.15 Date and time of first visit
(PLEASE RECORD DATE AS
DD/MM/YY AND TIME IN 12
HOUR FORMAT)
DATE DD/MM/YY
START TIME aM/PM
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 342
H1.16 Date and time of second visit
(PLEASE RECORD DATE AS
DD/MM/YY AND TIME IN 12
HOUR FORMAT)
DATE DD/MM/YY
START TIME AM/PM
NOT APPLICABLE..................................................9999
H1.17 Date and time of third visit
(PLEASE RECORD DATE AS
DD/MM/YY AND TIME IN 12
HOUR FORMAT)
DATE DD/MM/YY
START TIME aM/PM
NOT APPLICABLE.........................................................9999
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 343
H2.0 HOUSEHOLD ROSTER AND OTHER INFORMATION
Ser
ial
no
.
Please give me the
names of the
persons who usually live in your
household starting
with the head of the household.
Name
(start with head of the household)
Sex
(M
AL
E-1
, F
EM
AL
E-2
)
Rel
atio
nsh
ip t
o h
ead
of
the
hou
seho
ld (
CO
DE
) A
ge
(IN
CO
MP
LE
TE
D Y
EA
RS
)
FOR
AGED
10 YEARS
AND
ABOVE
FOR
AGE
GRO
UP
3-6
YEA
RS
FOR
AGE
GROU
P
18YEA
RS OR
OLDE
R
FOR AGE 5 YEARS
OR OLDER
FOR AGE 5 YEARS – 24 YEARS
BIRTH
REGISTRATION
(CHILDREN
BELOW 5
YEARS)
Ser
ial
Nu
mb
er o
f th
e M
oth
er (
for
chil
dre
n l
ess
than
6 y
ears
of
age)
Mar
ital
sta
tus
(CO
DE
) IF
CO
DE
D 1
0R
7 S
KIP
TO
C
OL
H
2.8
Ag
e at
fir
st m
arri
age
(IN
CO
MP
LE
TE
D Y
EA
RS
)
Is (n
ame)
cu
rren
tly at
tend
ing
any
pre
-sch
ool?
(I
F Y
ES
, C
OD
E T
HE
SO
UR
CE
OF
PR
E-S
CH
OO
L E
DU
CA
TIO
N)
CH
EC
K H
.14
C –
IF
CO
DE
D Y
ES
TH
EN
AS
K H
2.8
A
Wh
ether
he/
she
has
wo
rk e
d u
nd
er M
GN
RE
GA
sch
eme
in t
he
last
365
day
s? (
YE
S –
1,
N0
– 2
)
Can
(nam
e) r
ead
and
wri
te (
YE
S-1
, N
O-2
)
Has
(n
ame)
ev
er a
tten
ded
sch
oo
l? (
YE
S-1
, N
O-2
) IF
CO
DE
D 2
,
SK
IP T
O H
2.1
7
Wh
at
is
the
hig
hes
t ed
uca
tional
g
rad
e co
mp
lete
d?
(PL
EA
SE
RE
CO
RD
T
HE
N
UM
BE
R
OF
Y
EA
RS
A
S
PE
R
GR
AD
E
ME
NT
ION
ED
)
CO
DE
S T
O B
E U
SE
D A
S R
EF
ER
EN
CE
F
OR
C
OD
ING
TH
E N
UM
BE
R O
F Y
EA
RS
Du
ring
the
201
2-1
3 s
chool
yea
r d
id (
nam
e) a
tten
d s
chool/
coll
ege
at
any
tim
e? (
YE
S-1
, N
O-2
) IF
CO
DE
D 2
, S
KIP
TO
CO
L H
2.1
4
Du
ring
20
12
-13
(s
choo
l y
ear)
, w
hat
st
andar
d/y
ear
was
(n
ame)
atte
ndin
g?
(CO
DE
)
CO
DE
S T
O B
E U
SE
D A
S R
EF
ER
EN
CE
FO
R C
OD
ING
TH
E N
UM
BE
R O
F Y
EA
RS
Du
ring
the
pre
vio
us
schoo
l y
ear
that
is
201
1-1
2,
did
(n
ame)
att
end
scho
ol
or
coll
ege
at a
ny
tim
e? (
YE
S-1
, N
O-2
) I
F C
OD
ED
2,
SK
IP
TO
CO
L H
2.1
7
Duri
ng
2
011
-12
(p
revio
us
schoo
l yea
r),
what
st
andar
d/y
ear
was
(nam
e) a
tten
din
g?
(CO
DE
)
CO
DE
S T
O B
E U
SE
D A
S R
EF
ER
EN
CE
FO
R C
OD
ING
TH
E N
UM
BE
R O
F Y
EA
RS
IF
C
OD
ED
2
IN
C
OL
H
2.1
2
AS
K:
What
w
as
the
mai
n
reas
on
(nam
e) d
id n
ot
atte
nd
sch
oo
l/co
lleg
e? –
(C
OD
E)
, Wh
ether
th
e bir
th o
f (n
ame)
is
regis
tere
d?
(YE
S-1
, N
O-2
) I
F C
OD
E
2 T
HE
N S
KIP
TO
TH
E N
EX
T M
EM
BE
R
Was
the
bir
th o
f (n
ame)
reg
iste
red
wit
hin
21
day
s o
f b
irth
? (Y
ES
-1,
NO
-2 )
Do
es (
nam
e) h
ave
a bir
th c
erti
fica
te?
(YE
S,
SH
OW
N -
1,
YE
S,
BU
T
NO
T S
HO
WN
-2,
NO
-3 )
H2.1 H2.2 H2.
3 H2.4
H2
.5
H2.
5A
H2.6 H2.7 H2.8
H2.8A
H2
.9
H2.1
0 H2.11
H2.1
2 H2.13
H2.14
H2.15
H2.1
6
H2.1
7
H2.1
8 H2.19
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 344
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 345
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 346
CODES FOR HOUSEHOLD ROSTER
COL. H2.4. RELATIONSHIP TO HEAD OF
HOUSEHOLD
01 = HEAD
02 = WIFE OR HUSBAND
03 = SON OR DAUGHTER
04 = SON-IN-LAW OR DAUGHTER-IN-
LAW
05 = GRANDCHILD
06 = PARENT
07 = PARENT-IN-LAW
08 = BROTHER OR SISTER
09 = BROTHER- IN – LAW/SISTER-IN-
LAW
10 = NIECE/NEPHEW
11 = OTHER RELATIVE
12 = ADOPTED/FOSTER/STEPCHILD
13 = NOT RELATED
98 = DON'T KNOW
Col H2.5. aGE
00 = AGE LESS THAN ONE YEAR
00 =
95 = AGE 95 YEARS OR MORE
95 =
COL H2.6. MARITAL STATUS
1= UNMARRIED
2= MARRIED BUT GAUNA NOT
PEFORMED
3= MARRIED AND GAUNA PERFORMED
4= WIDOW/WIDOWER
5= DIVORCED
6= SEPARATED
7= NOT STATED
COL H2.8. SOURCE OF PRE- SCHOOL
EDUCATION
01 = ATTENDING ICDS RUN PSE
02 = ATTENDING PRIVATE RUN PSE
(PLAY SCHOOL, NURSERY ETC.)
03 = DO NOT ATTEND ANY PSE
98 = DO NOT KNOW
COL H2.16. REASONS OF NOT ATTENDING
SCHOOL/COLLEGE
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 347
.
01 = SCHOOL/COLLEGE TOO FAR
AWAY
02 = TRANSPORT NOT AVAILABLE
03 = FURTHER EDUCATION NOT
CONSIDERED NECESSARY
04 = REQUIRED FOR HOUSEHOLD
WORK
05 = REQUIRED FOR WORK ON
FARM/FAMILY BUSINESS
06 = REQUIRED TO EARN IN CASH OR
KIND BY WORKING OUTSIDE
07 = COSTS TOO MUCH
08 = LACK OF PROPER FACILITIES FOR
GIRLS IN SCHOOLS/COLLEGE
09=NOT SAFE TO SEND GIRLS
10 = NO FEMALE TEACHER
11 = REQUIRED FOR CARE OF
SIBLINGS
12 = NOT INTERESTED IN STUDIES
13 = REPEATED FAILURES
14 = GOT MARRIED
15= DID NOT GET ADMISSION
16 = CULTURALLY NOT ACCEPTABLE
96 = OTHER, SPECIFY…………
98 = DON'T KNOW
COL H2.11 H2.13 & H2.15- CODES TO BE USED AS REFERNCE FOR CODING THE NUMBER OF YEARS
AS PER GRADE MENTIONED
00 = <LESS THAN 1 YEAR COMPLETED
00= (FOR COL. H2.11 ONLY. THIS CODE IS ALLOWED FOR COL. H2.13 AND COL.H2.15)
98 = DON’T KNOW
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 348
THIS SECTION (H2.20- H2.23) WILL BE AUTO-PULATED FROM HOUSEHOLD ROSTER.
LIST ALL MEMBERS WHO ARE 18 YEARS AND ABOVE BY THEIR NAME, SERIAL
NUMBER, AGE AND SEX. SELECT THE RESPONDENT.
(NAME, SERIAL NUMBER, AGE AND SEX OF THE RESPONDENT WILL BE
AUTOMATICALLY POPULATED AFTER SELECTING THE RESPONDENT)
No. Questions/Filters
Response/Codes
Skip
H2.20 Name of respondent
FIRST NAME _________________________________
MIDDLE NAME ________________________________
SURNAME_____________________________________
H2.21 Serial number of the respondent
H2.22 Age (IN COMPLETED YEARS)
H2.23 Sex of respondent
MALE
FEMALE
1
2
Now I am going to ask some questions that relate to the head of this household.
H2.24 What is the religion of the head
of the household?
HINDUISM
ISLAM
CHRISTIANITY
SIKHISM
JAINISM
BUDDHISM
NO RELIGION
OTHER
01
02
03
04
05
06
07
96
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 349
H2.25 What is the caste/tribe of the
head of the household? Is this a
scheduled caste, scheduled
tribe, other backward caste or
other group?
SCHEDULED CASTE
SCHEDULED TRIBE
OBC
OTHER
DO NOT KNOW/DO NOT WANT TO RESPOND
01
02
03
04
98
H2.26 What is the main occupation of
the head of the household with
reference to last one year?
CULTIVATOR
AGRICULTURAL WAGE LABOURER
NON-AGRICULTURAL WAGE LABOURER
SELF-EMPLOYED
REGULAR SALARIED/WAGE EMPLOYEE
RENTIER, PENSIONER, OTHER REMITTANCE
RECIPIENTS
DID NOT WORK
DOMESTIC CHORES
OTHER
01
02
03
04
05
06
07
08
96
Now, I am going to ask you questions about your house, the number and kind of rooms it has, the ownership
status/possession and information on some of your household assets.
H2.27 Type of the dwelling where
household is living?
RECORD OBSERVATION
KUTCHA
SEMI-PUCCA
PUCCA
1
2
3
H2.28 How many rooms are used for
sleeping?
NUMBER OF ROOMS
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 350
H2.29 Do you have a separate room,
which is used, as kitchen?
YES
NO
1
2
H2.30 MAIN MATERIAL OF THE
FLOOR
RECORD OBSERVATION.
NATURAL FLOOR
MUD/CLAY/EARTH
SAND
RUDIMENTARY FLOOR
RAW WOOD PLANKS
PALM/BAMBOO
BRICK
STONE
FINISHED FLOOR
PARQUET OR POLISHED WOOD
VINYL OR ASPHALT
CERAMIC TILES
CEMENT
CARPET
POLISHED STONE/MARBLE
GRANITE
OTHER
11
12
21
22
23
24
31
32
33
34
35
36
37
96
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 351
H2.31 MAIN MATERIAL OF THE
ROOF.
RECORD OBSERVATION
NATURAL ROOFING
THATCH/PALM LEAF/REED/GRASS
MUD
SOD/MUD AND GRASS MIXTURE
PLASTIC/POLYTHENE SHEETING
RUDIMENTARY ROOFING
RUSTIC MAT
PALM/BAMBOO
RAW WOOD PLANKS/TIMBER
UNBURNT BRICK
LOOSELY PACKED STONE
FINISHED ROOFING
METAL/GI
WOOD
CALAMINE/CEMENT FIBER
ASBESTOS SHEETS
RCC/RBC/CEMENT/CONCRETE
ROOFING SHINGLES
TILES
SLATE
BURNT BRICK
OTHER
11
12
13
14
21
22
23
24
25
31
32
33
34
35
36
37
38
39
96
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 352
H2.32 MAIN MATERIAL OF THE
EXTERIOR WALLS.
RECORD OBSERVATION
NATURAL WALLS
CANE/PALM/TRUNKS/BAMBOO
MUD
GRASS/REEDS/THATCH
RUDIMENTARY WALLS
BAMBOO WITH MUD
STONE WITH MUD
PLYWOOD
CARDBOARD
UNBURNT BRICK
RAW WOOD/REUSED WOOD
FINISHED WALLS
CEMENT/CONCRETE
STONE WITH LIME/CEMENT
BURNT BRICKS
CEMENT BLOCKS
WOOD PLANKS/SHINGLES
GI/METAL/ASBESTOS SHEETS
OTHER
11
12
13
21
22
23
24
25
26
31
32
33
34
35
36
96
H2.33 Does this household own this
house or any other house?
YES
NO
1
2
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 353
H2.34 Does any member of this
household have a bank account
or a post office account?
YES
NO
DON’T KNOW
01
02
98
H2.35 Does your household have:
(PLEASE READ THE LIST
AND CIRCLE YES OR NO
APPROPRIATELY FOR
EACH ITEM)
YES
NO
ELECTRICITY 1 2
MATTRESS MADE OF COTTON/FOAM
1 2
PRESSURE COOKER
1 2
CHAIR
1 2
COT/BED
1 2
TABLE
1 2
ELECTRIC FAN
1 2
RADIO/TRANSISTOR
1 2
BLACK AND WHITE TELEVISION
1 2
COLOUR TELEVISION
1 2
SEWING MACHINE
1 2
MOBILE TELEPHONE
1 2
LAND LINE TELEPHONE
1 2
INTERNET CONNECTION
1 2
DEKSTOP COMPUTER 1 2
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 354
LAPTOP 1 2
REFRIGERATOR
1 2
AIR COOLER
1 2
AIR CONDITIONER
1 2
WASHING MACHINE
1 2
WATCH/CLOCK-
1 2
BICYCLE
1 2
MOTORCYCLE/SCOOTER
1 2
ANIMAL DRAWN CART
1 2
CAR/JEEP
1 2
WATER PUMP
1 2
THRESHER
1 2
TRACTOR
1 2
H2.36 What type of fuel does your
household mainly use for
cooking?
ELECTRICITY
01
LPG/NATURAL GAS
02
BIOGAS/GOBAR GAS
03
KEROSENE
04
COKE/COAL/LIGNITE
05
CHARCOAL
06
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 355
WOOD
07
STRAW/SHRUBS/GRASS
08
AGRICULTURAL CROP WASTE
09
DUNG CAKES
10
OTHER 96
NO FOOD COOKED IN THE HOUSEHOLD 95
Now I am going to ask about the drinking water and toilet arrangements that your household has.
H2.37 What is the main source of
drinking water for your
household?
IMPROVED/SAFE
PIPED WATER INTO DWELLING YARD/PLOT
01
PUBLIC TAP/STAND PIPE
02
TUBEWELL OR BOREWELL
03
HANDPUMP
04
DUG WELL – PROTECTED
05
SPRING – PROTECTED
06
RAIN WATER
07
UNIMPROVED/UNSAFE-
UNPROTECTED SPRING
08
UNPROTECTED DUG WELL
09
CART WITH SMALL TANK/DRUM 10
H2.39
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 356
TANKER/TRUCK
11
SURFACE WATER (RIVER/DAM/ LAKE/POND/CANAL)
12
BOTTLED WATER
13
OTHER 96
H2.38 Where is that water source
located?
IN OWN DWELLING
IN OWN YARD/PLOT
ELSEWHERE
1
2
3
H2.39 What kind of toilet facility
does your household use?
(PLEASE OBSERVE)
IMPROVED TOILET
FLUSH/POUR FLUSH TO - PIPED SEWER SYSTEM
01
FLUSH/POUR FLUSH TO -SEPTIC TANK
02
FLUSH/POUR FLUSH TO - PIT LATRINE
03
VENTILATED IMPROVED PIT LATRINE (VIP)
04
PIT LATRINE WITH SLAB
05
COMPOSTING TOILET
06
UNIMPROVED TOILET
FLUSH/POUR FLUSH TO –ELSEWHERE
07
FLUSH/POUR FLUSH TO - UNKNOWN PLACE
08
PIT LATRINE WITHOUT SLAB/OPEN PIT 09
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 357
BUCKET
10
HANGING TOILET/HANGING LATRINE
11
OTHER
96
NO TOILET FACILITY/USES OPEN SPACE/FIELD
13
H2.42
H2.40 Do all members of your
household use this toilet
facility?
YES
NO
1
2
H2.41 Do you share this toilet facility
with other households?
YES
NO
1
2
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 358
Now I am going to ask you some questions related to the hand washing practices in your household.
H2.42 Can you please show me where
members of your household most
often wash their hands?
(PLEASE OBSERVE)
OBSERVED
NOT OBSERVED
NOT IN DWELLING/PLOT/YARD
NO PERMISSION TO SEE
OTHER (SPECIFY)______________________
01
02
03
96
H2.45
H2.43 OBSERVE PRESENCE OF
WATER AT THE PLACE FOR
HANDWASHING.
VERIFY BY CHECKING THE
TAP/PUMP, OR BASIN,
BUCKET, WATER CONTAINER
OR SIMILAR OBJECTS FOR
PRESENCE OF WATER.
(PLEASE OBSERVE)
WATER IS AVAILABLE
WATER IS NOT AVAILABLE
1
2
H2.44 Is soap, detergent or ash/mud/sand
present at the place for hand
washing?
MULTIPLE CHOICE POSSIBLE
FOR FIRST 4 CODES
(PLEASE OBSERVE)
SOAP
DETERGENT
ASH
MUD/SAND
NONE
A
B
C
D
E
H2.47
H2.45 Do you have any soap or detergent
or ash/mud/sand in your house for
washing hands?
YES
NO
1
2
H2.47
H2.46 Can you please show it to me?
(PLEASE OBSERVE)
YES, SHOWN
NO, NOT SHOWN
1
2
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 359
SALT TESTING
H2.47 Could you please give me a
teaspoon of the salt that your
household uses for cooking
purpose?
Test salt for Iodine.
RECORD PPM (Parts per
Million)
0 PPM(NO IODINE)
1
LESS THAN 15 PPM
2
MORE THAN OR EQUAL TO 15 PPM
3
NO SALT IN HOUSEHOLD
4
SALT NOT TESTED
5
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 360
Confidential for Research
Purpose only
E3: Ever Married Women (15-49 years) Questionnaire
Rapid Survey on Children (2013-14)
0.0 IDENTIFICATION PARTICULARS OF HOUSEHOLD
0.01 State name and code
STATE NAME _____________________
STATE CODE
0.02 District name and code
DISTRICT NAME ______________
DISTRICT CODE
0.03
Tehsil/taluka/community development
block/mandal name and code
TEHSIL/TALUKA/CD BLOCK NAME
___________________
TEHSIL/TALUKA/CD BLOCK CODE
0.04 Residence
RURAL
URBAN
1
2
0.05 If rural PSU, name and code number of
village
If urban PSU, town name and code, ward
number and CEB number
VILLAGE/TOWN NAME _______________________
PSU CODE
WARD NUMBER
CEB NUMBER
0.06 Type of village/CEB RURAL STRATUM-NOT SEGMENTED
RURAL STRATUM -SEGMENTED
URBAN
1
2
3
0.09
0.09
0.07 Number of segments formed in the village
NUMBER OF SEGMENTS
0.08 Serial number of segment selected
SEGMENT NUMBER
0.09 (A) House(Structure) Number
(B) HOUSEHOLD NUMBER
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(HOUSE NO. & HOUSEHOLD NO. TO BE
POPULATED FROM LISTING SCHEDULE)
0.10 Result Status
COMPLETED 01
PARTIALY
COMPLETED 04
NOT AT HOME
02
OTHER
96
REFUSED
03
0.11 Name and code of investigator
NAME ___________________CODE
0.12 Name and code of supervisor
NAME ___________________CODE
0.13 Date of interview
(DD/MM/YY)
0.14 Time of interview
START(AM/PM)
END(AM/PM)
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No. Questions/Filters Response Codes/Skip
1.0 PARTICULARS OF THE EVER MARRIED WOMAN(15-49 YEARS)
QUESTIONS 1.1 TO 1.14 WILL BE PROBED IN RESPECT OF THE ELIGIBLE EMW IN THE
HOUSEHOLD.
QUESTIONS 1.1 TO 1.6 TO BE AUTOMATICALLY POPULATED (EDITABLE) FROM THE HOUSEHOLD ROSTER
AND ALSO QUESTIONS 1.2 TO 1.6 TO BE ASKED TO ELIGIBLE EMW AND VERIFIED. IN CASE, THE
RESPONSE IN ANY QUESTION IS DIFFERENT FROM THE AUTO-POPULATED RESPONSE, THEN
PREFERENCE WILL BE GIVEN TO WOMEN’S RESPONSE, AND WILL BE CORRECTED ACCORDINGLY.
1.1 Serial number in household roster
SERIAL NUMBER
1.2 What is your NAME?
___________________________________
1.3 What is your current age?
AGE (IN COMPLETED YEARS)
1.4 What is your marital status?
CURRENTLY MARRIED BUT GAUNA NOT
PERFORMED
CURRENTLY MARRIED AND GAUNA
PERFORMED
WIDOWED
DIVORCED
SEPARATED
NOT STATED
01
02
03
04
05
92
1.5 What was your age at the time of your
(first) marriage?
AGE (IN COMPLETED YEARS)
1.6 What is the highest educational standard
completed by you?
PLEASE CODE NUMBER OF YEARS
AS PER GRADE COMPLETED
CODE ‘00’ IF LESS THAN 1 YEAR
NUMBER OF YEARS
1.7 Apart from your own household chores,
have you done any work in last one
month?
YES
NO
1
2 1 .9
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No. Questions/Filters Response Codes/Skip
1.8 What type of occupation you were
engaged in last one month?
IF ENGAGED IN MORE THAN ONE
OCCUPATION RECORD THE
OCCUPATION IN WHICH SHE HAS
WORKED FOR MORE DURATION OF
TIME.
CULTIVATOR
WAGE LABOURER
SELF EMPLOYED (excluding cultivator)
REGULAR SALARIED/WAGE EMPLOYEE OTHER
01
02
03
04
96
1.9 CHECK Q 1.4
THE MARITAL STATUS OF THE
WOMAN IS CURRENTLY MARRIED
BUT GAUNA NOT PERFORMED OR
MARITAL STATUS NOT STATED
(RESPONSE CODE 01 or 92)?
YES
NO
1
Terminate
Interview
2
1.10 What is the NAME of your husband?
___________________________________
CHECK IF CODED 3, 4 OR 5 IN 1.4, SKIP TO 1.12
1.11 Serial number of husband in household
roster
TO BE AUTO POPULATED FROM
HOUSEHOLD ROSTER
RECORD ‘00’ IF NOT USUAL
RESIDENT OF THE HOUSEHOLD
SERIAL NUMBER
(NOT LISTED IN HOUSEHOLD ROSTER)
00
1.12
Have you ever been pregnant?
YES
NO
1
2 C1.1
1.13 What was your age at the time of first
pregnancy?
AGE(IN COMPLETED YEARS)
1.14 Have you ever given a live birth?
YES
NO
1
2 1.17
1.15
How many children had been born alive
and how many of them are surviving
(STATUS TO BE ASSESSED AS ON
DATE OF SURVEY)?
BOYS
GIRLS
TOT
AL
CHILDREN
BORN ALIVE
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No. Questions/Filters Response Codes/Skip
CHILDREN
SURVIVING
1.16 What was your age at the time of first live
birth?
AGE (IN COMPLETED YEARS)
1.17 Has the outcome of any pregnancy(s) resulted
in live birth/still birth/abortion during the last
three years (STARTING ON OR AFTER 1ST
AUGUST 2010) preceding the date of survey?
YES
NO
1
2 B1.1
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A1.
0
MODULE FOR 0-35 MONTHS CHILDREN – OUTCOME OF PREGNANCY
A1.
1
RECORD THE HISTORY OF OUTCOME(S) OF ALL PREGNANCIES IN LAST THREE YEARS.
START WITH THE LAST PREGNANCY EXCLUDING THE CURRENT ONE YOU ARE
PREGNANT WITH. USE SEPARATE LINES FOR TWINS/TRIPLETS. SAME PREGNANCY NO.
TO BE RECORDED FOR TWINS/TRIPLETS.
PREGN
ANCY
NUMBE
R
OUTCO
ME OF
PREGN
ANCY
IF CODE 1 OR 2 IN A1.3,
ASK A1.4 AND A1.5
ELSE ASK ABOUT
NEXT PREGNANCY. IN
CASE THERE IS NO
OTHER PREGNANCY
SKIP TO A2.1
IF LIVE BIRTH (CODE 1. IN a1.3)
WAS THE
OUTCOM
E SINGLE
OR
MULTIPL
E?
SEX OF
BABY
SURVI
VAL
STATU
S (TO
BE
ASSESS
ED AS
ON
DATE
OF
SURVE)
IF
CODE’1’
IN A1.6
(SURVIVI
NG),
A1.6
Record the
serial
number of
child from
HH
schedule
IF CODE ‘2’ IN a1.6( NOT
SURVIVING) ,
A1.6Record age at death
RECORD DAYS IF BELOW 1
MONTH, RECORD IN
COMPLETED MONTHS IF 1
TO 11 MONTHS
& RECORD IN COMPLETED
YEARS IF 1 YEAR AND
ABOVE
A1.2 A1.3 A1.4 A1.5 A1.6 A1.7 A1.8
LAST
PREGN
ANCY
(……)
LIVE
BIRTH-
1STILL
BIRTH-
2
ABORT
ION-3
SINGLE-1
MULTIPL
E-2
MALE-1
FEMALE-2
SURVI
VING-1
NOT-
SURVI
VING-2
SERIAL
NUMBER.
OF CHILD
DAYS 1
MONTHS 2
YEARS 3
PREVIO
US TO
LAST
PREGN
ANCY
(……)
LIVE
BIRTH-
1STILL
BIRTH-
2
ABORT
ION-3
SINGLE-1
MULTIPL
E-2
MALE-1
FEMALE-2
SURVI
VING-1
NOT-
SURVI
VING-2
SERIAL
NUMBER.
OF CHILD
DAYS 1
MONTHS 2
YEARS 3
SECON
D
FROM
LAST
PREGN
ANCY
(…….)
LIVE
BIRTH-
1STILL
BIRTH-
2
ABORT
ION-3
SINGLE-1
MULTIPL
E-2
MALE-1
FEMALE-2
SURVI
VING-1
NOT-
SURVI
VING-2
SERIAL
NUMBER.
OF CHILD
DAYS 1
MONTHS 2
YEARS 3
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No. Questions/Filters
Response/Codes
Skip
A2.0 DETAILS OF LAST TWO LIVE BIRTHS (SURVIVING/NOT SURVIVING) DURING LAST
THREE YEARS (START WITH THE YOUNGEST CHILD)
A2.1 CHECK a1.3
OUTCOME OF ANY PREGNANCY RESULTED IN LIVE BIRTH
OUTCOME OF ALL PREGNANCIES RESULTED IN STILL BIRTH OR ABORTION
1
2 B1.1
A2.2 PREGNANCY NUMBER (TO BE POPULATED
AUTOMATICALLY FROM QUESTION A1.2)
PREGNANCY NUMBER (LAST 3
YEARS)
A2.3 What is/was the date of birth of baby?
(ASK FOR BIRTH CERTIFICATE. IF NOT
AVAILABLE, CHECK WITH MCP CARD. IF
MCP CARD NOT AVAILABLE CONSIDER
OTHER DOCUMENT OR VERBAL RESPONSE)
(IN CASE THERE IS NO CONCLUSIVE PROOF
OF DATE OF BIRTH, FOLLOW THE
GUIDELINES AS GIVEN IN THE MANUAL TO
SOLICIT CORRECT INFORMATION.)
DATE OF BIRTH
DD MM YYYY
(IN CASE THE AGE OF THE CHILD IS MORE
THAN 35 MONTHS, MOVE TO NEXT LIVE
BIRTH IN LAST 3 YEARS. IF NO OTHER LIVE
BIRTH GO TO B1.1)
A2.4 What is the order of this live birth?
IF THE ORDER OF BIRTH IS 9 OR MORE
RECORD 9
BIRTH ORDER
A2.5 IF BIRTH ORDER>=2, what is the interval
between previous and current live birth?
INTERVAL (IN COMPLETED
MONTHS)
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A3.0 ANTENATAL CARE ( ANC)
A3.1 Did you register your pregnancy for getting antenatal
care services when you were pregnant with (NAME)?
YES
NO
1
2 A3.6
A3.2 Did you get a card (Mother & Child Protection/any
other similar card) at the time of registration?
(PLEASE SHOW THE MCP CARD)
YES, SHOWN
YES, BUT NOT SHOWN
NO
1
2
3
A3.3 How many months pregnant were you when you
registered for ANC?
MONTHS OF PREGNANCY
(COMPLETED MONTHS)
A3.4 Who advised/motivated you to get registered?
ANY OTHER PERSON?
(NOT TO BE PROMPTED)
RECORD ALL PERSONS MENTIONED
AWW
ASHA
ANM
GOVT. DOCTOR
PVT. DOCTOR/HEALTH
PERSONNEL
DAI/TBA
NGOWORKER
RELATIVES/NEIGHBOUR/FRIENDS/
FAMILY MEMBERS
NONE/SELF MOTIVATED
OTHER
A
B
C
D
E
F
G
H
I
X
A3.5 Did you register the pregnancy associated with this
birth at the AWC?
YES
NO
NO ANGANWADI CENTRE/NOT
APPLICABLE
01
02
99
A3.6 Did you receive any antenatal check-up during this
pregnancy?
YES
NO
DON’T KNOW/CAN’T SAY
01
02 A3.11
98 A3.11
A3.7 How many months pregnant were you, when you
first received an antenatal check-up?
MONTHS OF PREGNANCY
(COMPLETED MONTHS) DON’T KNOW
98
A3.8 How many times did you receive antenatal check-
ups during pregnancy associated with this birth?
(RECORD ‘5’ ONLY IN CASE IT IS MORE
THAN 4 TIMES)
NUMBER OF TIMES
DON’T KNOW
98
A3.9 Where did you receive ANC(s) for pregnancy
associated with this birth?
ANGANWADI CENTRE
GOVERNMENT HEALTH
FACILITIES
PRIVATE HEALTH FACILITIES
MOBILE CLINIC
A
B
C
D
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 368
ANY OTHER PLACE?
RECORD ALL PLACES MENTIONED
AT HOME
OTHER
DON’T KNOW/CAN’T SAY
E
X
Y
A3.10 Who did the check-up(s) during these ANCs?
ANY OTHER PERSON?
RECORD ALL PERSONS MENTIONED
DOCTOR
ANM
LHV/NURSE
OTHER HEALTH PROFESSIONAL
TRAINED BIRTH ATTENDANT
OTHER
A
B
C
D
E
X
A3.11 Did you receive TT (Tetanus Toxoid) injection
during pregnancy associated with this birth?
YES
NO
1
2 A3.13
A3.12 How many times did you receive TT?
NUMBER OF TIMES
IF ‘2’ OR MORE, GO TO
A3.15
A3.13 At any time before this pregnancy, did your receive
any tetanus toxoid injection?
YES
NO
1
2 A3.15
A3.14 When was the last TT injection taken before this
pregnancy?
WITHIN THE LAST ONE YEAR
BEFORE THE CURRENT
PREGNANCY
MORE THAN ONE YEAR BEFORE
THE CURRENT PREGNANCY
DON’T REMEMBER
01
02
98
A3.15 Did you receive or purchase any iron folic acid
(IFA) tablets/bottles during the pregnancy
associated with this birth?
YES
NO
1
2 A3.19
A3.16 If yes, how many tablets/bottles of
IFA did you receive/purchase?
TABLETS BOTTLES
Large Small Small –
50 ml
Large –
100 ml
RECEIVED
FROM GOVT.
SOURCES
PURCHASED
PRIVATELY
A3.17 If yes, how many tablets/bottles of
IFA did you consume?
IF THERE IS NO CONSUMPTION
SKIP TO A3.19
TABLETS BOTTLES
Large Small Small –
50 ml
Large –
100 ml
Number of
tablets/bottle
consumed
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A 3.18 For how many days did you consume iron & folic
acid (IFA) tablets/bottles of Syrup during pregnancy
with this child?
NUMBER OF DAYS
A3.19
Did the following visit you at home during period of
pregnancy?
READ OUT OPTIONS
AWW YES-1 NO -2
ASHA YES-1 NO -2
ANM YES-1 NO -2
Doctor YES-1 NO -2
A3.20 CHECK Q A3.19 CODE 1 IN ANY OF THE 3 OPTIONS
- AWW OR ASHA OR ANM
CODE 2 IN ALL 3 - AWW, ASHA
AND ANM
1
2A4.1
A3.21 How many times did AWW/ANM/ASHA visit your
home during the entire period of this pregnancy?
RECORD ‘0’ IF NOT VISITED AT ALL
NUMBER OF VISITS AWW
ANM ASHA
A4.0 DELIVERY CARE
A4.1
Where did you deliver this birth/child?
GOVERNMENT HOSPITAL/HEALTH
CENTRE
PVT. HOSPITAL/CLINIC/NURSING
HOME
AT HOME
OTHER
01
02
03
96 A4.4
A4.2
Who advised/counselled you to deliver at a health
facility?
ANY OTHER PERSON?
RECORD ALL MENTIONED PERSONS.
AWW
ANM ASHA
ANY OTHER HEALTH
PROFESSIONALFAMILY/RELATIVE
S/OTHER SELF/NONE
A
B
C
D
E
F
A4.3 How long did you stay at the health facility after
delivery?
IF <=48 HOURS RECORD HOURS OTHERWISE
RECORD NUMBER OF DAYS.
HOURS
DAYS
DON’T KNOW
98
A4.4 Who assisted with the delivery?
(IN CASE MORE THAN ONE PERSON WAS
INVOLVED, CODE WILL BE GIVEN TO THOSE
WHO WERE THE HIGHEST IN HIERARCHY.)
DOCTOR (GOVT/PVT)
ANM/MIDWIFE/LHV/NURSE
TRAINED BIRTH ATTENDANT
FRIENDS/RELATIVES/FAMILY
MEMBERS
OTHER
NO ONE
01
02
03
04
96
05
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A4.5 What type of delivery was it?
CHECK: CODE 02 WILL BE CODED ONLY IF
CODED ‘01’ OR ‘02’ IN A4.1
NORMAL
CAESAREAN
OTHER
01
02
96
A4.6 Did the AWW, ANM or ASHA visit you at home, after deliver or after discharge from hospital/health centre within one week of delivery?
YES
NO
1
2
A4.7 CHECK Q A 4.1
IN CASE OF INSTITUTIONAL DELIVERY
(CODE01 OR 02 IN Q A4.1) ASK,
When did the first postnatal care (PNC) check-up
take place after discharge from the health facility?
IN CASE OF HOME DELIVERY (CODE03
OR 96 IN Q A4.1)ASK,
When did the first check-up take place after
delivery?
CHECKED UPWITHIN 48HRS 2ND TO 3RD DAY
4TH DAY TO 7TH DAY 7TH DAY TO 10TH DAY
AFTER 10TH DAY
NOT CHECKED UP AT ALL
1
2
3
4
5 A4.10
6
A4.8 How many postnatal check-ups (s) did you receive
at the health facility and at home during first 10
days of delivery?
NUMBER AT THE HEALTH
FACILTY
AT HOME
A4.9 Where did the first PNC check-up take place?
HOME INSTITUTION
1
2
A4.10 CHECK Q A 4.1
IN CASE OF INSTITUTIONAL DELIVERY
(CODES 01 OR 02 IN Q A4.1) ASK,
When was the new born baby checked up after
discharge from the health facility?
IN CASE OF HOME DELIVERY (CODE 03 OR
96 IN Q A4.1) ASK,
When was the new born baby checked up first after
birth?
CHECKED UPWITHIN 24 HRS WITHIN 24 TO 72 HRS
4TH TO 7TH DAY 7TH DAY TO 10TH DAY
AFTER 10TH DAY
NOT CHECKED UP AT ALL
1
2
3
4
5
6 A4.13
A4.11 How many check-up(s) did the new born baby
receive at the health facility and at home during first
10 days of delivery?
NUMBER AT THE HEALTH
FACILTY
AT HOME
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A4.12 Where did the first postnatal check-up take place for
your baby?
HOME INSTITUTION
1
2
A4.13 Were you ever referred for health problem by the AWW during pregnancy/delivery/post-delivery with this child?
YES
NO
DID NOT GO TO AWC
NO AWC IN OUR LOCALITY
NO HEALTH PROBLEM
1
2
3 A4.16
4
5
A4.14 Where were you referred?
(IN CASE A PERSON WAS REFERRED MORE
THAN ONCE FOR DIFFERENT HEALTH
PROBLEMS AND TO DIFFERENT HEALTH
INSTITUTIONS, THIS QUESTION PERTAINS
TO THE LAST REFERRAL)
SUB-CENTRE
PHC
CHC
OTHER
01
02
03
96
A4.15 Did you receive the service for which you were
referred?
YES
NO
SENT TO SOME OTHER FACILITY
DID NOT GO AT ALL
1
2
3
4
A 4.16 Are you aware of Janani Suraksha Yojana (JSY),
run by the Government?
YES
NO
1 A4.18
2
A 4.17 Are you aware about any scheme under which
financial assistance is given to women for delivering
the child at the health facility?
YES
NO
1
2
A 4.18 Are you aware of Janani Shishu Suraksha
Karyakaram (JSSK), run by the Government?
YES
NO
1 A4.20
2
A4.19 Are you aware about any scheme under which free
and cashless maternity services and newborn care in
all Government healthcare institutions including
diet, no out-of-pocket expenditure for drugs,
disposables, diagnostics, blood transfusion, referral
transport and drop back facility is provided.
YES
NO
IF NO IN A 4.16 TO A4.19, SKIP TO
A4.21.
1
2
A 4.20 Did you receive any assistance under JSY/JSSK
schemes?
YES, FROM JSY
YES, FROM JSSK
YES FROM BOTH JSY AND JSSK
NONE
1
2
3
4
A 4.21 Was the baby weighed within 24 hours of birth?
YES
NO
DON’T KNOW
01
02
98 A5.1
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A4.22 How much did he/she weigh?
(ASK FOR ANY DOCUMENT/MCP CARD IN
SUPPORT, IF AVAILABLE)
KG. &GRAMS . COPIED FROM MCP/HEALTH CARD ..................... 01
VERBAL RESPONSE OF THE MOTHER 02
DON’T KNOW………………..…………… 98
A5.0 INFANT AND YOUNG CHILD FEEDING PRACTICES FOR CHILDREN AGED 0-23
MONTHS (BORN AFTER 1st AUGUST 2011)
A 5.1 CHECK Q A 2.3
CHILD IS 23 MONTHS OR BELOW
CHILD IS MORE THAN 23 MONTHS
1
2A6.1
A 5.2 Did you ever breastfeed (NAME)?
YES
NO
1
2 A5.7
A5.3 How long after birth did you first put (NAME) to
the breast?
IF WITHIN AN HOUR, RECORD 00; IF LESS
THAN 24 HOURS, RECORD HOURS.
OTHERWISE, RECORD DAYS.
IMMEDIATELY/WITHIN AN HOUR HOURS
DAYS
A 5.4 Did you feed first yellow thick breast milk
(Colostrum)/Khees to the baby?
YES
NO
1
2
A 5.5 In the first 3 days after delivery, was (NAME) given
anything to drink other than breast milk?
YES
NO
1
2 A5.7
A5.6 What was (NAME) given to drink?
ANYTHING ELSE?
RECORD ALL LIQUID MENTIONED?
MILK (OTHER THAN BREASTMILK)
PLAIN WATER
SUGAR OR GLUCOSE WATER
GRIPE WATER
SUGAR-SALT-WATER SOLUTION
FRUIT JUICE
INFANT FORMULA
HONEY
JANAMGHUTTI
OTHER
A
B
C
D
E
F
G
H
I
X
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A 5.7 CHECK Q A1.6
THE CHILD IS SURVIVING-1 A5.8
THE CHILD IS NOT SURVIVING-2
IF CODED 2 ASK FOR NEXT LIVE BIRTH (A2.2). IF
NO OTHER LIVE BIRTH GO TO B1.1
A 5.8 Are you still breastfeeding this child?
YES
NO
1 A5.10
2
A5.9 How many days/months did you breastfeed the
child?
RECORD NUMBER OF DAYS IF BREASTFED
FOR LESS THAN ONE MONTH OTHERWISE
RECORD IN MONTHS.
DAYS
MONTHS
A 5.10 Was (NAME) breastfed yesterday during the day or
at night?
YES
NO
DON’T KNOW
01
02
98
A 5.11 Was (NAME) given any vitamin drops or other
medicines as drops yesterday during the day or at
night?
YES
NO
DON’T KNOW
01
02
98
A 5.12 Was (NAME) given ORS yesterday during the day
or at night?
YES
NO
DON’T KNOW
01
02
98
A 5.13 Yesterday during the day or night, did
(NAME) have any liquids (item from the
list)?
READ THE LIST OF LIQUIDS
STARTING WITH PLAIN WATER
LIST OF LIQUIDS YES 01,
NO 02,
DON’T
KNOW
98
IF CODED
01 IN ‘C
ORD OR F’
THEN ASK
5.14, ELSE
SKIP TO
A5.15 a) PLAIN WATER
b) WATERY ITEMS SUCH AS
DAL/RICE WATER
c) POWDER MILK/FORMULA
d)
COW'S/BUFFALO'S/GOAT'S/OTHE
R ANIMAL MILK
e) JUICE OR JUICE DRINKS
(MANGO, ORANGE, APPLE,
LEMON ETC.)
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 374
f) BUTTER MILK/BEATEN CURD
g) ANY OTHER LIQUIDS
A5.14 How many times yesterday during the day or at
night did (NAME) consume the following?
READ OUT OPTIONS
RECORD 00 IF NOT CONSUMED
RECORD ‘98’ FOR DON’T KNOW.
NUMBER OF TIMES
POWDER MILK/FORMULA
COW'S/BUFFALO'S/GOAT'S/OTHER
ANIMAL MILK
BUTTER MILK/BEATEN CURD
A5.15 Yesterday during the day or night, did (NAME)
drink/eat any (FOOD GROUP ITEMS)?
YES 01; NO 02; DON'T KNOW98
a) ANY COMMERCIALLY FORTIFIED BABY FOOD SUCH AS
CERELAC ETC. IF CODED
01IN
ATLEAST
ONE
OPTION
THEN SKIP
TO A5.17
b) BREAD, ROTI, CHAPATI, RICE, KITCHDI, NOODLES, PORRIDGE,
BISCUITS, IDLI, OR ANY OTHER FOODS MADE FROM GRAINS?
c) PULSES/LENTILS/BEANS OR FOOD PREPARED WITH MIXING
PULSES/LENTILS/LEGUMES
d) PUMPKIN, CARROTS, OR SWEET POTATOES THAT ARE
YELLOW OR ORANGE INSIDE?
e) POTATOES, WHITE YAMS, OR ANY OTHER FOODS MADE FROM
ROOTS?
f) ANY DARK GREEN, LEAFY VEGETABLES?
g) RIPE MANGOES, PAPAYAS, CANTALOUPE, OR JACKFRUIT?
h) ANY OTHER FRUITS OR VEGETABLES?
(i) LIVER, KIDNEY, HEART OR OTHER ORGAN MEATS?
j) ANY MEAT SUCH AS CHICKEN, BEEF, PORK, LAMB, GOAT OR
DUCK?
k) EGGS?
l) FRESH OR DRIED FISH OR SHELLFISH?
m) ANY FOODS MADE FROM NUTS SUCH AS PEANUTS, CASHEW
NUTS, ALMONDS ETC.?
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n) CHEESE, PANEER, DAHI OR OTHER FOOD MADE FROM MILK?
ANY OTHER SOLID OR SEMI-SOLID FOOD?
A 5.16 Did (NAME) eat any solid, semi-solid, or soft foods
yesterday during the day or at night?
RECORD FOOD EATEN YESTERDAY
YES
NO
DON’T KNOW
01 A5.15
02
A6.1 98
A5.17 How many times did (NAME) eat solid, semi-solid,
or soft foods other than liquids yesterday during the
day or at night?
NUMBER OF TIMES
DON'T KNOW
98
A6.0
IMMUNIZATION
(FOR ALL CHILDREN AGED 0-35 MONTHS – BORN AFTER 1st AUGUST 2010 )
A6.1 Do you have an Immunisation card/Mother Child
Protection (MCP) card for this child (NAME) where
details of all his/her vaccinations are written down.
IF YES, OBSERVE THE CARD.
SHOW A SAMPLE OF THE CARD AND THEN
ASK.
YES, SHOWN
YES, BUT NOT SHOWN
NO
1
2 A6.3
3
A 6.2
(1) COPY DATES FROM THE
CARD.
(2) WRITE ‘44’ IN ‘DAY’
COLUMN IF CARD SHOWS
THAT A DOSE WAS GIVEN
BUT NO DATE IS RECORDED.
(3) IF ONLY A PART OF
DATE OF IMMUNIZATION IS
SHOWN ON CARD RECORD
98 (DAYS/MONTHS) OR 9998
(YEAR) FOR DO NOT KNOW
IN THE COLUMN FOR
WHICH INFORMATION IS
NOT WRITTEN
(4) IF ANY OF THE VACCINE
IS NOT RECORDED IN THE
CARD PLEASE ASK,
FOR POLIO 0, OPV1, OPV 2
AND OPV3 QUESTIONS A 6.7,
A 6.8 AND A 6.9
PENTAVALENT1
IF PENTAVALEN
T RECORDED
POPULATE THE DATES
AUTOMATICA
LLY IN DPT1,DPT2 and
DPT3 AND
HEPB1, HEPB2 AND HEPB3
FOR
PENTAVALENT 1,2 AND 3
RESPECTIVEL
Y
IF
PENTAVAL
ENT ‘1’ TO
MEASLES 2
ALL RECORDED,
GO TO A6.16
A
PENTAVALENT 2
PENTAVALENT 3
POLIO 0
HEPB0
BCG
DPT1
HEPB1
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 376
A 6.7, A 6.8 a 6.9
FOR HEP B0, HEPB1, HEPB2
AND HEPB3 QUESTIONS A
6.12 AND A 6.13
A 6.12 a 6.13
FOR BCG QUESTION A 6.4
A 6.4
FOR DPT1 , DPT2 AND DPT3
QUESTIONS A 6.5 aND a 6.6
A 6.5 A 6.6
FOR MEASLES QUESTIONS A
6.10 AND A 6.11
A 6.5A 6.6
OPV1
DPT2
HEPB2
OPV2
DPT3
HEPB3
OPV3
MEASLES1
MEASLES2
VITAMIN A 1ST
DOSE
DPT BOOSTER 1
A6.3 Did (NAME) ever receive any vaccination to
prevent him/her from getting disease?
YES
NO
DON’T KNOW
01
02
98 a6.16
A 6.4 A BCG vaccination against tuberculosis, that is, an
injection in the left shoulder that caused a scar?
YES
NO
DON’T KNOW
01
02
98
A 6.5
A DPT vaccination against diphtheria, whooping
cough and tetanus given as an injection? This is an
injection given in the thigh or buttocks, sometimes
at the same time as polio drop.
YES
NO
DON’T KNOW
01
02
98 A6.7
A6.6 How many times?
NUMBER OF TIMES
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 377
A 6.7 Was Polio vaccine, that is, drops in the mouth, been
given to this child (NAME)?
YES
NO
DON’T KNOW
01
02
98 A6.10
A6.8
Was the first Polio vaccine received in the first two
weeks after birth or later?
FIRST TWO WEEK
LATER DON’TKNOW
01
02
98
A6.9 How many times (Excluding Polio '0' & excluding '
pulse polio) '?
NUMBER OF TIMES
A6.10 Was an injection against measles given? A measles
injection or an MMR injection is a shot in the arm at
the age of 9 months or older.
YES
NO
DON’T KNOW
01
02
98 A6.12
A6.11 How many times?
NUMBER OF TIMES
A6.12 Was an injection against Hepatitis-B given to child
(NAME)?
YES
NO
DON’T KNOW
01
02
98 A6.14
A 6.13 How many times?
NUMBER OF TIMES
A 6.14 Has (NAME) given the 1stbooster dose of DPT?
(1st booster dose is given between 15-18 months)
YES
NO
DON’T KNOW
01
02
98
A 6.15 Where did (NAME) receive most of his/her
vaccinations?
ANGANWADI CENTRE
GOVT. HOSPITAL/HEALTH
INSTITUTIONS
PVT. HOSPITAL/CLINIC/NURSING
HOME
HOME
OTHER
01
02
03
04
96
A 6.16 CHECK Q A 2.3
CHILD IS 6 MONTHS OR MORE BUT
< 36 MONTHS
CHILD IS BELOW 6 MONTHS
1
2 A7.1
A 6.17 Has (NAME) ever been given any dose of Vitamin
'A'?
YES
NO
DON’T KNOW
01
02
98 a6.20
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A 6.18 How many doses of Vitamin A was given in the last
one year?
RECORD ‘0’ IF NO DOSE GIVEN.
NO OF DOSES
IF ‘0’ IS RECORDED, SKIP TO A
6.20.
A 6.19 Has (NAME) received Vitamin ‘A’ dose in the last
six months?
YES
NO
DON’T KNOW
01
02
98
A 6.20 Was a dose of deworming given to (NAME) in the
last six months?
YES
NO
DON’T KNOW
01
02
98 a6.22
A 6.21 Where did (NAME) get the deworming medicine?
RECORD ALL MENTIONED
AWC
SUB-CENTRE (ANM)
MEDICINE SHOP
OTHER
A
B
C
X
A 6.22 Was (NAME) given Iron & Folic supplements in
the last six months?
YES
NO
DON’T KNOW
01
02
98
A7.0 MORBIDITY (ASK TO ALL MOTHERS OF 0 – 35 MONTHS CHILDREN)
A7.1 Did (NAME) suffer from any episode of diarrhoea
during last 15 days?
YES
NO
1
2 A7.7
A7.2 Did you seek advice or treatment for the diarrhoea
from any source?
YES
NO
1
2 A7.4
A7.3 Where did you seek advice or treatment?
RECORD ALL MENTIONED
ANGANWADI CENTRE
GOVT. HOSPITAL/HEALTH CENTRE
PVT. HOSPITAL/CLINIC/NURSING
HOMES
FROM ANY MEDICINE SHOP
TRADITIONAL PRACTITIONER
ASHA
OTHER
A
B
C
D
E
F
A 7.4 Was (NAME) given any of the following to drink at
any time since he/she started having the diarrhoea?
PROMPT THE OPTIONS
ANY HOME AVAILABLE
FLUID (HAF*)
YES 1 NO 2
ORS YES 1 NO 2
ORS & ZINC YES 1 NO 2
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 379
*HAF REFERS TO HOME aVAILABLE FLUID OF
WATER, SALT AND SUGAR AND IT ALSO
INCLUDES RICE CONJEE AND DAL KA PANI WITH
ADDED SALT
A 7.5 If ORS was given, from where did you
receive/procure the ORS?
ANY OTHER SOURCE?
RECORD ALL SOURCE MENTIONED.
AWC
ANM
ASHA
GOVT. HEALTH INSTITUTIONS
PRIVATE HEALTH FACILITIES
PURCHASED FROM THE MARKET
OTHER
A
B
C
D
E
F
X
A 7.6 Was antibiotics (tablets/injections) given to treat the
Diarrhoea?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
A 7.7 Has (NAME) been ill with a fever at any time in the
last 15 days?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98 A7.10
A 7.8 At any time during illness, did (NAME) have blood
taken from his/her finger for testing?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
A 7.9 At any time during the illness, was (NAME)given
any anti- malarial drugs for the illness?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
A 7.10 Has (NAME) had an illness with a cough at any
time in the last 15 days?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98 A7.14
A 7.11 When (NAME) had an illness with a cough, did
he/she breathe faster than usual with short, rapid
breaths or have difficulty breathing?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98 A7.13
A 7.12 Was there any fast breathing or difficulty in
breathing due to a problem in the chest or to a
blocked or runny nose?
CHEST ONLY
NOSE ONLY
BOTH
OTHER
DON’T KNOW/CAN’T SAY
01
02
03
96
98
A 7.13 Did you seek advice or treatment for the illness
from any source?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 380
A 7.14 Was the health of (NAME) checked up in last 3
months even if he/she was not ill?
YES
NO
1
2 A7.17
A 7.15
How many times?
Number
A 7.16
Where was the last check-up done? GOVT. HOSPITAL/HEALTH CENTRE
PRIVATE HOSPITAL/CLINIC
AWC
OTHER
DON’T KNOW
01
02
03
96
98
A 7.17 CHECK Q A7.1, A7.7 AND A7.10
If coded 1 in 7.1, or in 7.7 or in 7.10 then ask A 7.18 and A 7.19 else skip to A8.1
A7.18 Has (NAME) been referred to any health facility by
AWW during his/her illness?
YES
NO
DON’T KNOW
01
02
98 A8.1
A7.19
Where the child has been referred
SHC
PHC
CHC
OTHER GOVT HOSPITAL
PVT. HOSPITAL/CLINIC
OTHER
01
02
03
04
05
96
A8.0 WEIGHT AND GROWTH, (0 – 35 MONTHS)
A8.1 Does (NAME) have a growth chart/card?
INVESTIGATOR TO CARRY A SAMPLE OF
MCP CARD.
YES
NO
DON’T KNOW
01
02
98
A 8.2 How many times was (NAME) weighed in the last 3
months?
NUMBER OF TIMES
IF NOT WEIGHED RECORD ‘00’
DON'T KNOW ……98
A 8.3 Where (NAME) was weighed last?
AWC
AT HOME
GOVT. HOSPITAL/HEALTH CENTRE
PVT. HOSPITAL/PVT. DOCTOR’S
CLINIC
OTHER
DON'T KNOW
01
02
03
04
96
98
A9.1
A9.1
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 381
A 8.4 Do you know, what is the present weight of
(NAME)?
(PRESENT WEIGHT REFERS TO THE MOST
RECENT WEIGHT THAT WAS TAKEN IN
LAST 3 MONTHS?)
YES
NO
DON’T KNOW
01
02
98
A8.5 Can you tell me whether the child’s weight is
normal or moderately underweight or severely
underweight?
(PROMPT RESPONSES)
NORMAL
MODERATELY UNDERWEIGHT
SEVERELY UNDERWEIGHT
DON'T KNOW
01
02
03 A8.7
98
A8.6 Did (NAME) ever fall in the category of severely
underweight children in the last 3 months?
YES
NO
DON’T KNOW/CANT SAY
01
02
98
A8.7 Did anyone discuss with you about (NAME)’s
nutritional status?
RECORD ALL MENTIONED PERSONS
NO ONE DISCUSSED
AWW
ANM
DOCTOR
OTHER
A
B
C
D
X
A9.0 AWARENESS OF SERVICES AT ANGANWADI CENTRE (0 – 35
MONTHS)
A9.1 Are you aware what all
services are provided at
the AWC?
FIRST RECORD ALL
THE SPONTANEOUS
RESPONSES AND
THEN PROMPT FOR
THE REMAINING
CODES
SPONTANEOU
S
PROMPT
YES NO
SUPPLEMENTARY FOOD
IMMUNISATION
PRE-SCHOOL EDUCATION
HEALTH CHECK UP
REFERRAL SERVICES
NUTRITION & HEALTH
EDUCATION
NO ANGANWADI CENTER
IN MY LOCALITY
A
B
C
D
E
F
G B1.1
1
1
1
1
1
1
2
2
2
2
2
2
A 9.2 Do you avail any services
for child (NAME) from
AWC in your area?
(ASK ABOUT HER
DESIGNATED AWC
AND INFORM YOUR
SUPERVISOR, IF
THERE IS ANY
DISCREPANCY)
YES
NO
01A9.4
02
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 382
A9.3 What are the reason(s) for
not availing services from
AWC?
ANY OTHER
REASON?
RECORD ALL
REASONS
MENTIONED.
AFTER ANSWERING
A9.3, SKIP TO B1.1
AWC OFTEN REMAINS
CLOSED
QUALITY OF SERVICES
NOT UPTO THE MARK
DID NOT FEEL THE NEED
OF SERVICES FROM AWC
NO BODY TO
ACCOMPANY THE CHILD
AWW’S/AWH BEHAVIOUR
IS BAD
I FEEL ME/MY CHILD IS
DISCRIMINATED
AWC IS FAR OFF
OTHER
A
B
C
D
E
F
G
X
A 9.4 CHECK Q A 2.3
CHILD IS BELOW 6
MONTHS
CHILD IS EQUAL TO OR
MORE THAN 6 MONTHS
BUT < 36 MONTHS
1 A11.1
2
A 9.5 Since what age did
(NAME) start availing
service(s) at the AWC?
AGE (IN COMPLETED MONTHS)
A 9.6 What services are availed
for (NAME) from the
AWC?
FIRST RECORD ALL
THE SPONTANEOUS
RESPONSES AND
THEN PROMPT FOR
THE REMAINING
CODES
SPONTANEO
US
PROMPT
YES NO
SUPPLEMENTARY FOOD
IMMUNISATION
HEALTH CHECK UP
REFERRAL SERVICES
HEALTH AND NUTRITION
EDUCATION OR ADVICE
ON FEEDING AND CARE
OF YOUNG CHILDREN
OTHER
A
B
C
D
E
X
1
1
1
1
1
1
2
2
2
2
2
2
A9.7 IF CODE A
(SUPPLEMANTARY
FOOD) IS NOT CODED
IN A9.6 THEN ASK
A9.7
What are the reason(s) for
not taking food from
AWC?
AWC OFTEN REMAINS
CLOSED
AWC FAR AWAY FROM
MY HOME
FOOD IS NOT
DISTRIBUTED BY AWW
FOOD IS OUT OF STOCK
FOR MOST OF THE DAYS
QUALITY OF FOOD
GENERALLY NOT EDIBLE
A
B
C
D
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 383
ANY OTHER?
RECORD ALL
MENTIONED
REASONS.
MY CHILD DOES NOT
LIKE AWC FOOD
DO NOT NEED FOOD
FROM AWC
FAMILY MEMBERS
OPPOSE
UNABLE TO GO TO AWC
FOR RECEIVING FOOD
NOT AWARE ABOUT
FOOD
SUPPLEMENTATION
NOT AWARE THAT MY
CHILD IS ELIGIBLE
OTHER
I FEEL ME/MY CHILD IS
DISCRIMINATED
E
F
G
I
J
K
L
X
M
A
10.0 INTAKE OF SUPPLEMENTARY FOOD FROM ANGANWADI CENTRE FOR
CHILDREN AGED 7 – 35 MONTHS
A 10.1 CHECK Q A 9.6
A9.6 CODED ‘A’
A9.6 IS NOT CODED ‘A’
1 2B1.1
A10.2 What type of food,
(NAME) is generally
received from AWC?
RECORD ALL
MENTIONED
HOTCOOKED MEAL
READY-TO-EAT (RTE)/TAKE
HOME RATION (THR)
A
B
A 10.3 If THR/RTE in A10.2
Are you aware about the
fortnightly (two weeks)
entitlement of
supplementary food from
AWC for the child
(NAME) ?
YES
NO
1
2
A 10.4 For how many days did
(NAME) receive
supplementary food from
AWC in the last month?
IF NIL, RECORD '00'.
LAST MONTH (IN DAYS)
NOT PRESENT IN LAST MONTH
DON’T KNOW/CAN'T SAY
95
98
A 10.5 Of the food received, can
you tell me generally
how much food is
consumed by the child
(NAME)?
ENTIRE STUFF/QUANTITY
SHARED WITH OTHER
SIBLINGS/FAMILY MEMBERS
HE DOES NOT LIKE THE FOOD
AND SO DOES NOT CONSUME aT
ALL
CANNOT SAY/DON'T REMEMBER
01
02
03
98
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 384
A10.5
A CHECK: Q. A2.3/A8.5/A8.6: If A2.3 is >= 7 months and A8.5 is coded 03 (Severely
underweight) or A8.6 is coded 1(yes) -1; Otherwise- 2( skip to A11.1)
A 10.6
How much quantity of
supplementary food did
(NAME) receive at that
point of time?
SAME AS EARLIER
SLIGHTLY MORE
ALMOST DOUBLE OF WHAT
RECEIVED EARLIER
DON'T REMEMBER
NOT APPLICABLE
01
02
03
98
99
A 11.0
INTAKE OF SUPPLEMENTARY FOOD FROM ANGANWADI CENTRE BY
LACTATING MOTHERS ( BELOW 6 MONTHS CHILDREN)
A11.1 What services are
availed by you from the
AWC?
MULTIPLE
RESPONSES
POSSIBLE
FIRST RECORD ALL
THE SPONTANEOUS
RESPONSES AND
THEN PROMPT FOR
THE REMAINING
CODES
SPONTANEO
US PROMPT
YE
S N
O
SUPPLEMENTARY FOOD
HEALTH CHECK UP
REFERRAL SERVICES
HEALTH AND NUTRITION
EDUCATION OR ADVICE ON
FEEDING AND CARE OF YOUNG
CHILDREN
OTHER
A
B
C
D
X
1
1
1
1
1
2
2
2
2
2
CHECK Q A 11.1
A11.1 CODED ‘A’
A11.1 IS NOT CODED ‘A’
1 A11.3 2
A11.2 What are the reason(s) for
not taking food from
AWC?
RECORD ALL
MENTIONED
REASONS.
AFTER ANSWERING
A11.2, GO TO Q B1.1
NOT AWARE ABOUT FOOD
SUPPLEMENTATION
NOT AWARE THAT I AM ELIGIBLE
SUPPLEMENTARY FOOD IS OUT OF
STOCK FOR MOST OF THE DAYS
QUALITY OF FOOD PROVIDED AT
AWC IS GENERALLY NOT EDIBLE
FOOD IS NOT DISTRIBUTED BY
AWW
AWC OFTEN REMAINS CLOSED
AWC FAR AWAY FROM MY HOME
I AM WORKING aND SO CANNOT
GO TO AWC FOR RECEIVING FOOD
I DO NOT NEED FOOD FROM AWC
FAMILY MEMBERS OPPOSE
DO NOT LIKE AWC FOOD
A
B
C
D
E
F
G
H
I
J
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 385
NOT AWARE WHEN AWC
DISTRIBUTES FOOD
OTHER
I FEEL I AM DISCRIMINATED
K
L
X
M
A11.3 What type of food do you
generally receive from
AWC?
HOTCOOKED MEAL
READY-TO-EAT (RTE)/
TAKE HOME RATION (THR)
A
B
A11.4 If THR/RTE in A 11.3
Are you aware about the
fortnightly (two weeks)
entitlement of
supplementary food from
AWC?
YES
NO
1
2
A11.5 For how many days did
you receive
supplementary food from
AWC in the last month?
IF NIL, RECORD '00'.
IN CASE HOUSEHOLD
NOT PRESENT IN THE
LAST 3 MONTHS,
THEN CODE 95
LAST MONTH(IN DAYS)
NOT PRESENT IN LAST MONTH
DON’T KNOW/CAN’T SAY
95
98
A11.6 Of the food received,
generally how much is
consumed by you?
ENTIRE STUFF/QUANTITY
SHARED WITH OTHER FAMILY
MEMBERS
I DON’T LIKE THE FOOD AND SO
DO NOT CONSUME aT ALL
CANNOT SAY/DON'T REMEMBER
01
02
03
98
A11.7 CHECK Q A1.3 FOR ANY OTHER LIVE BIRTH IN LAST 3 YEARS. IN CASE THERE
IS ANOTHER LIVE BIRTH IN LAST 3 YEARS START THE LOOP FOR THE NEXT
LIVE BIRTH (A2.2) ELSE PROCEED TO MODULE FOR 3-6 YEARS
B1.0 MODULE FOR 36 - 71MONTHS CHILDREN
B 1.1 Do you have a child aged
36 to71months?
TO BE AUTO
POPULATED
FROM THE HH
ROSTER
YES
NO
1
2 C1.1
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 386
B 1.2 How many children aged
36 -71months do you
have?
TO BE AUTO
POPULATED
FROM THE HH
ROSTER
NUMBER
B 2.0 BACKGROUND (START WITH THE YOUNGEST CHILD)
B2.1 Name of the child
-------------------------------------------------
B2.2 Sex of the child
TO BE POPULATED
FROM HH ROSTER
BOY
GIRL
1
2
B2.3 Date of Birth of the child
(DD/MM/YYYY) AFTER RECORDING THE DATE OF BIRTH INCASE IT IS FOUND
THAT THE AGE OF THE CHILD IS ACTUALLY 0-35 MONTHS
THE LOOP FOR 0-35 MONTHS SHOULD BE OPENED. HOWEVER,
IF IT IS FOUND THAT THE CHILD IS MORE THAN 71 MONTHS
OLD THEN THE MODULE FOR 36-71 MONTHS WILL NOT BE
APPLICABLE. IN SUCH CASE, PROBE FROM THE INDEX EMW
ABOUT ANY ANOTHER CHILD OF THIS AGE GROUP ELSE
MOVE TO MODULE C ON FAMILY PLANNING.
B3.0 CHILD HEALTH (36 – 71 MONTHS)
B3.1 Was (NAME) given the
2nd booster dose of
DPT?
VERIFY THE ANSWER
BY EXAMINING THE
IMMUNIZATION
CARD OF THE CHILD,
IF AVAILABLE. .
DPT BOOSTER DOSE
IS GIVEN TO
CHILDREN BETWEEN
4 – 6 YEARS.
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
B3.1A Was (Name) given the 2nd
dose of Measles? ? (2nd
dose of measles is usually
given between 15-18
months)
VERIFY THE ANSWER
BY EXAMINING THE
IMMUNIZATION
CARD OF THE CHILD,
IF AVAILABLE.
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 387
B3.2 Has (NAME) ever been
given any dose of
Vitamin 'A'?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98 B3.5
B3.3 How many doses of
Vitamin A were given to
(NAME) in the last one
year?
RECORD ‘0’ IF NO
DOSE IS GIVEN.
NUMBER OF DOSES
IF ‘0’ IS RECORDED, SKIP TO B3.5
B3.4 Has (NAME) been given
Vitamin 'A' dose in the
last six months?
YES
NO
1
2
B3.5 Was deworming done to
(NAME) in the last six
months?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
B3.6 From where did (NAME)
get the deworming
medicine?
AWC
SUB CENTRE (ANM)
MEDICINE SHOP
OTHER
A
B
C
X
B3.7 Has (NAME) been given
Iron & Folic supplements
in the last six months?
YES
NO
DON’T KNOW
01
02
98
B3.8 Did (NAME) suffer from
any episode of diarrhoea
during last 15 days?
YES
NO
1
2 B3.14
B3.9 Did you seek advice or
treatment for the
diarrhoea from any
source?
YES
NO
1
2 B3.11
B3.10 Where did you seek
advice or treatment?
RECORD ALL
MENTIONED
ANGANWADI CENTRE
GOVT. HOSPITAL/HEALTH CENTRE
PVT. HOSPITAL/CLINIC/NURSING
HOMES
FROM ANY MEDICINE SHOP
TRADITIONAL PRACTITIONER
ASHA
OTHER
A
B
C
D
E
F
X
B3.7
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 388
B3.11 Was (NAME) given any
of the following to drink
at any time since he/she
started having the
diarrhoea?
PROMPT THE
OPTIONS
ANY HOME
AVAILABLE FLUID
(HAF*)
YES 1 NO- 2
ORS YES 1 NO- 2
ORS & ZINC YES 1 NO—2
*HAF REFERS TO HOME AVAILABLE FLUID OF WATER, SALT
AND SUGAR AND IT ALSO INCLUDES RICE CONJEE AND DAAL
KA PANI WITH ADDED SALT
B3.12 If ORS was given, from
where did you
receive/procure the ORS?
ANY OTHER SOURCE?
RECORD ALL
SOURCES
MENTIONED
AWC
ANM
ASHA
GOVT. HEALTH INSTITUTIONS
PRIVATE HEALTH FACILITIES
PURCHASED FROM THE MARKET
OTHER
A
B
C
D
E
F
X
B3.13 Were antibiotic
(tablet/injection)
medicines given to treat
the diarrhoea?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
B3.14 Has (NAME) been ill
with a fever at any time
in the last two weeks?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98 B3.17
B3.15 At any time during illness
did (NAME) have a
blood taken from his/her
finger for testing?
YES
NO
DON’T KNOW/CAN’T SAY
01
02
98
B3.16 At any time during the
illness, was (NAME)
given any anti-malarial
drugs for the illness?
YES
NO
DON’T KNOW
01
02
98
B3.17 Has (NAME) had an
illness with a cough at
any time in the last 15
days?
YES
NO
DON’T KNOW
01
02
98
B3.18 When (NAME) had an
illness with a cough, did
he/she breathe faster than
usual with short, rapid
breaths or had difficulty
in breathing?
YES
NO
DON’T KNOW
01
02
98
B3.21
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 389
B3.19 Was there any fast
breathing or difficulty in
breathing due to a
problem in the chest or to
a blocked or runny nose?
CHEST ONLY
NOSE ONLY
BOTH
OTHER
DON’T KNOW/CAN’T SAY
01
02
03
96
98
B3.20 Did you seek advice or
treatment for the illness
from any source?
YES
NO
DON’T KNOW
01
02
98
B3.21 Was the health of
(NAME) checked up in
last 3 months even if
he/she was not ill?
YES
NO
1
2 B3.24
B3.22 How many times?
IN NUMBER
B3.23 Where was the last
check-up done?
GOVT. HOSPITAL/HEALTH CENTRE
PRIVATE HOSPITAL/CLINIC
AWC
OTHER (
DON’T KNOW
01
02
03
96
98
B3.24 CHECK Q B3.8 or B3.14 or B3.17
IF CODED 1 IN B3.8 OR B3.14 OR B3.17 THEN ASK B3.25 AND B3.26 ELSE SKIP TO B4.1
B3.25 Has (NAME) been
referred to any health
facility by AWW during
his/her illness?
YES
NO
DON’T KNOW
01
02
98
B3.26 Where the child has been
referred?
SHC
PHC
CHC
OTHER GOVT HOSPITAL
PVT. HOSPITAL/CLINIC
OTHER
01
02
03
04
05
96
B.4.0 WEIGHT AND GROWTH ( 36 – 71 MONTHS CHILDREN)
B4.1 Does (NAME) have a
growth chart/card?
INVESTIGATOR TO
CARRY A SAMPLE OF
MCP CARD.
YES
NO
DON’T KNOW
01
02
98 B5.1
B4.1
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 390
B4.2 How many times was
(NAME) weighed in the
last 3 months?
NUMBER OF TIMES
IF NOT WEIGHED RECORD ‘00’
DON'T KNOW ……….98
B 5.1
B4.3 Where (NAME) was
weighed last?
AWC
AT HOME
GOVT. HOSPITAL/HEALTH CENTRE
PVT. HOSPITAL/PVT. DOCTOR’S
CLINIC
OTHER
DON'T KNOW
01
02
03
04
96
98
B4.4 Do you know, what is the
present weight of
(NAME)?
PRESENT WEIGHT
REFERS TO THE
MOST RECENT
WEIGHT THAT WAS
TAKEN IN LAST 3
MONTHS?
YES
NO
DON’T KNOW
01
02
98
B4.5 Can you tell me whether
the child’s weight is
normal or moderately
underweight or severely
underweight?
(PROMPT
RESPONSES)
NORMAL
MODERATELY UNDERWEIGHT
SEVERELY UNDERWEIGHT
DON'T KNOW
01
02
03 B4.7
98
B4.6 Did (NAME) ever fall in
the category of severely
underweight children in
the last 3 months?
YES
NO
DON’T KNOW/CANT SAY
01
02
98
B4.7 Did any one discuss with
you about (NAME)’s
nutritional status?
RECORD ALL
MENTIONED
PERSONS.
NO ONE DISCUSSED
AWW
ANM
DOCTOR
OTHER
A
B
C
D
X
B5.0 AWARENESS OF SERVICESAT ANGANWADI CENTRE ( 36 – 71 MONTHS)
B 5.1 CHECK Q A 1.6
A 1.6
THE EMW HAS A SURVIVING
CHILD BORN DURING LAST 3
YEARS
THE EMW DOES NOT HAVE A
SURVIVING CHILD AGED 0-3
YEARS AND HAS 3 – 6 YEARS
CHILD
1 B5.3
2
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 391
B5.2 Are you aware of what all
services are provided at the
AWC?
FIRST RECORD ALL
THE SPONTANEOUS
RESPONSES AND THEN
PROMPT FOR THE
REMAINING CODES
SPON
TANE
OUS
PROMPT
YES NO
SUPPLEMENTARY FOOD
IMMUNISATION
PRE-SCHOOL EDUCATION
HEALTH CHECK UP
REFERRAL SERVICES
NUTRITION & HEALTH
EDUCATION
NO ANGANWADI CENTER IN MY
LOCALITY
A
B
C
D
E
F
G C1.1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
B5.3 Do you avail any anganwadi
services for (NAME) from the
AWC of your area?
(ASK ABOUT HER
DESIGNATED AWC AND
INFORM YOUR
SUPERVISOR, IF THERE IS
ANY DISCREPANCY)
YES
NO
1B5.5
2
B5.4 What are the reason(s) for not
availing services from the
AWC?
ANY OTHER REASON?
RECORD ALL REASONS
MENTIONED.
AFTER ANSWERING B5.4
GO TO C1.1
AWC OFTEN REMAINS CLOSED
QUALITY OF SERVICES NOT UPTO
THE MARK
DID NOT FEEL THE NEED OF
SERVICES FROM AWC
NO BODY TO ACCOMPANY THE
CHILD
AWW’S/AWH BEHAVIOUR IS BAD
I FEEL MY CHILD IS
DISCRIMINATED
AWC IS FAR OFF
OTHER
A
B
C
D
E
F
G
X
B5.5 Since what age did (NAME)
start availing service(s) at the
AWC?
AGE (IN COMPLETED MONTHS)
DON’T KNOW 98
B5.6 For how many days, did
(NAME) visit AWC in the last
30 days?
RECORD '00' IF NOT
VISITED. AT ALL
DAYS
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 392
B5.7 How long does (NAME)
normally spend at the AWC in
a day?
GOES FOR COLLECTING FOOD
ONLY
< 1 HOUR
1-2 HOURS
2-3 HOURS
3-4 HOURS
4 HOURS AND MORE
1
2
3
4
5
6
B5.8 Does anyone accompany
(NAME) to AWC?
ACCOMPANIED BY
MOTHER/FAMILY MEMBERS
ALONE
AWW/AWH COLLECTS
ALONG WITH OTHER CHILDREN
1
2
3
4
B5.9 What are the services availed
by (NAME) at the AWC?
FIRST RECORD ALL
THE SPONTANEOUS
RESPONSES AND THEN
PROMPT FOR THE
REMAINING CODES
SPON
TANE
OUS
PROMPT
YES NO
SUPPLEMENTARY FOOD
PRE-SCHOOL EDUCATION
IMMUNIZATION
HEALTH CHECK UP
REFERRAL SERVICES
HEALTH & NUTRITION
EDUCATION OR ADVICE ON
FEEDING AND CARE OF YOUNG
CHILDREN
OTHER
A
B
C
D
E
F
X
1
1
1
1
1
1
2
2
2
2
2
2
B.5.1
0 CHEK Q B5.9:
IF CODED A (SUPPLEMENTARY FOOD) –1: GO TO B6.2
IF NOT CODED A (SUPPLEMENTARY FOOD) – 2
B6.0: INTAKE OF SUPPLEMENTARY FOOD FROM ANGANWADI CENTRE FOR
CHILDREN AGED 36 - 71 MONTHS
B.6.1 What are the reason(s) for not
taking food from AWC?
RECORD ALL MENTIONED
REASONS.
AFTER ANSWERING B6.1,
SKIP TO B6.12
NOT AWARE ABOUT THE
SERVICES FROM AWC
NOT AWARE THAT MY CHILD IS
ELIGIBLE
SUPPLEMENTARY FOOD NOT
AVAILABLE FOR MOST OF THE
DAYS
QUALITY OF FOOD PROVIDED AT
AWC IS GENERALLY NOT EDIBLE
TASTE OF THE FOOD IS NOT
GOOD/GIVES BAD SMELL
A
B
C
D
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 393
FOOD IS NOT DISTRIBUTED BY
AWW
AWC OFTEN REMAINS
CLOSED/NOT AWARE WHICH
DAYS AWC REMAINS OPEN OR
DISTRIBUTES FOOD
AWC FAR AWAY FROM MY HOME,
CHILD CANNOT GO
WE ARE WORKING PEOPLE AND
SO CANNOT GO AWC FOR
COLLECTING FOOD
WE DO NOT NEED SUPPORT FOR
FOOD
FAMILY MEMBERS OPPOSE US IF
WE TAKE FOOD FROM AWC
CHILD DOES NOT LIKE AWC FOOD
OTHER
I FEEL MY CHILD IS
DISCRIMINATED
E
F
G
H
I
J
K
L
X
M
B6.2 What type of food (NAME)
generally receives from
AWC?
RECORD ALL MENTIONED
HOT COOKED MEAL
READY-TO-EAT (RTE)/
TAKE HOME RATION (THR)
MORNING SNACKS
A
B
C
B6.3 For how many days did
(NAME) receive
supplementary food from
AWC in the last month?
IF NIL, RECORD '00'.
LAST MONTH (IN DAYS)
NOT PRESENT IN LAST MONTH
DON’T KNOW/CAN'T SAY
95
98
B6.4 For how many days did
(NAME) receive Breakfast
(Morning Snacks) during last
month?
IF NIL, RECORD '00'
LAST MONTH (IN DAYS)
NOT PRESENT IN LAST MONTH
DON’T KNOW/CAN'T SAY
95
98
B6.5
A
CHECK Q. B4.5/B4.6: IF B4.5 IS CODED 03 (SEVERELY UNDERWEIGHT) OR
B4.6 IS CODED 1(YES) -1; OTHERWISE- 2 (SKIP TO B6.7)
B6.6 How much quantity of
supplementary food did
(NAME) receive at that point
of time?
SAME AS EARLIER
SLIGHTLY MORE
ALMOST DOUBLE OF WHAT
RECEIVED EARLIER
DON'T REMEMBER
NOT APPLICABLE
01
02
03
98
99
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 394
B6.7 Where does (NAME) consume
supplementary food given by
AWC?
AWC
HOME
PARTLY AT AWC
DO NOT CONSUME
1B6.10
2
3
4 B6.12
B6.8 Is the supplementary food
given by AWC shared with
others?
YES
NO
DON’T KNOW
01
02
98
B6.9 Of the last received food, can
you tell me generally, how
much food did (NAME)
consume?
ENTIRE STUFF
HALF
LESS THAN HALF
NOT AT ALL
DON'T REMEMBER
01
02
03
04
98
B6.1
0 Can you tell me, does
(NAME) like the taste of the
food given?
ALWAYS
MOST OF THE TIMES
SOME TIMES
INDIFFERENT
DOES NOT LIKE
DON’T KNOW
01
02
03
04
05
98
B6.1
1 Is (NAME) getting different
HCM on different days of the
week?
YES
NO
DON’T KNOW
NOT APPLICABLE
01
02
98
99
B6.1
2 CHEK QB5.9:
IF CODED B (PSE) –1 : GO TO B7.3
IF NOT CODED B (PSE) – 2
B7.0: PRE-SCHOOL EDUCATION (36 – 71 MONTHS CHILDREN)
B7.1 What are the reason(s) for not
going to Anganwadi Center
for pre-school education?
RECORD ALL
MENTIONED REASONS.
AWW NOT QUALIFIED OR
TRAINED
PSE CURRICULUM IS NOT
RELEVANT OR APPROPRIATE
PSE NOT CONDUCTED IN AWC
AWW NOT COMING TO AWC
REGULARLY
AWC REMAINS CLOSED/NOT
REGULARLY OPENED
NOT AWARE ABOUT PSE IN AWC
I FEEL MY CHILD IS
A
B
C
D
E
F
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 395
DISCRIMINATED
AWC IS TOO FAR AWAY
NOT AWARE PSE IS CONDUCTED
IN AWC
OTHER
G
H
I
X
B7.2 If not in the AWC, where does
(NAME) go for pre-school
education?
AFTER ANSWERING B7.2,
GO TO C1.1
GOVT. SCHOOL
PVT. SCHOOL
DOES NOT ATTEND PSE
1
2
3
B7.3 Since what age (Name) is attending pre-
school at AWC?
AGE IN MONTHS
B7.4 How many days did (Name) attend PSE
at AWC in the last month and last 3
months?
RECORD '00' IF NOT AT ALL
ATTENDED
LAST MONTH(IN DAYS)
LAST 3 MONTHS(IN DAYS)
DK/CAN’T REMEMBER
98
B7.5 Generally, for how long does (NAME)
stay at the preschool at AWC in a day?
HOURS MINUTES
GOES FOR COLLECTING FOOD ONLY 97
DON’T KNOW 98
B7.6 Did you participate in any Parent's meet
in the last 3 months?
YES
NO
NOT AWARE ABOUT
PARENTS MEET
1
2
3
C 1.0 FAMILY PLANNING
C1.1 CHECK Q 1.4
CODE OF MARITAL
STATUS OF THE WOMAN
IS 2 (CURRENTLY
MARRIED AND GAUNA
PERFORMED)
CODE IN MARITAL
STATUS OF THE WOMAN
IS OTHER THAN 2
1
2E1.1
C1.2 I WOULD LIKE TO TALK ABOUT
FAMILY PLANNING.
Are you pregnant now?
YES, CURRENTLY
PREGNANT
NO
UNSURE OR DON’T KNOW
01D 1.1
02
98
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 396
C1.3 COUPLES USE VARIOUS WAYS OR
METHODS TO DELAY OR AVOID A
PREGNANCY.
Are you/your husband currently doing
something or using any method to delay
or avoid getting pregnant?
YES
NO
1
2 D1.1
C 1.4 Which method you or your husband are
using/used to avoid pregnancy?
DO NOT PROMPT.
IF MORE THAN ONE METHOD
IS MENTIONED, CIRCLE EACH
ONE.
FEMALE STERILIZATION A
MALE STERILIZATION B
IUD C
INJECTABLES D
IMPLANTS E
PILLS F
MALE CONDOM G
FEMALE CONDOM H
DIAPHRAGM I
FOAM/JELLY J
LACTATIONAL
AMENORRHOEA METHOD
(LAM)
K
PERIODIC
ABSTINENCE/RHYTHM L
WITHDRAWAL M
OTHER X
D1.0 CURRENTLY PREGNANT WOMEN
D1.1 CHECK QC 1.2
C 1.1
EMW IS CURRENTLY
PREGNANT
EMW IS NOT CURRENTLY
PREGNANT
1
2E1.1
ANTENATAL CARE
D1.2 How many months pregnant are you
currently?
MONTHS
D1.3 Have you registered your current
pregnancy for ANC?
YES
NO
1
2 D1.6
D1.4 Did you get a card (MCP/any other
similar card) at the time of registration?
PLEASE SHOW THE MCP CARD
YES, SHOWN
YES, BUT NOT SHOWN
NO
1
2
3
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 397
D1.5 Did you register the pregnancy at the
AWC?
YES
NO
1
2
D1.6 Did you receive any antenatal check-up
during the current pregnancy?
YES
NO
1
2 D1.8
D1.7 How many months pregnant were you,
when you first received an antenatal
check-up?
MONTHS OF PREGNANCY
(COMPLETED MONTHS)
DON’T KNOW
98
IF THE EMW HAS A CHILD AGED 0 TO 3 YEARS, SKIP TO D 1.11
D1.8 Are you aware of Janani Suraksha Yojana
(JSY) run by the Government?
YES
NO
1 D1.10
2
D1.9 Are you aware about any scheme under
which financial assistance is given to
women for delivering the child at the health
facility?
YES
NO
1
2
D1.1
0 Are you aware of Janani Sishu Suraksha
Karyakaram (JSSK) run by the
Government?
YES
NO
1 D1.11
2
D1.1
0A
Are you aware about any scheme under
which free and cashless maternity services
and newborn care in all Government
healthcare institutions including diet, no
out-of-pocket expenditure for drugs,
disposables, diagnostics, blood transfusion,
referral transport and drop back facility is
provided?
YES
NO
IF ‘NO’ IN D1.8 TO
D1.10A, SKIP TO D1.12
1
2
D1.1
1 Did you receive any assistance under
JSY/JSSK schemes?
YES, FROM JSK
YES, FROM JSSK
YES FROM BOTH JSK
AND JSSK
NONE
1
2
3
4
D1.1
2 Did the following visit you at home during
present pregnancy?
(READ OUT THE OPTIONS)
AWW YES-1 NO-2
ASHA YES -1 NO -2
ANM YES -1 NO -2
DOCTOR YES -1 NO -2
D1.1
3
CHECK Q D1.12
CODE 1 IN ANY OF THE
3 OPTIONS (- AWW OR
ASHA OR ANM)
CODE 2 IN ALL 3 (-
AWW, ASHA AND
ANM)
1
2D2.1
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 398
D1.1
4 How many times did AWW/ANM/ASHA
visit your home during since you became
pregnant?
Number of Visits AWW
ANM
ASHA
D 2.0 SERVICES AVAILED FROM AGANWADI CENTRE (CURRENTLY
PREGNANT WOMEN)
D2.1 CHECK Q A 1.6 AND B1.1
EMW IS HAVING A
SURVIVING CHILD AGED
0-35MONTHS OR A CHILD
AGED 36-71MONTHS
EMW IS NEITHER HAVING
A SURVIVING CHILD
AGED 0-35 MONTHS NOR
A CHILD AGED 36-71
MONTHS
1D2.3
2
D2.2 Are you aware of what all services are
provided at the AWC?
FIRST RECORD ALL THE
SPONTANEOUS RESPONSES
AND THEN PROMPT FOR THE
REMAINING CODES
SPON
TANE
OUS
PROMPT
YES NO
SUPPLEMENTARY FOOD
IMMUNISATION
HEALTH CHECK UP
REFERRAL SERVICES
NUTRITION & HEALTH
EDUCATION
NO ANGANWADI CENTRE
IN MY LOCALITY
A
B
C
D
E
FF1
1
1
1
1
1
2
2
2
2
2
D2.3 Have you availed any services from
AWC in your area during current
pregnancy?
(ASK ABOUT HER DESIGNATED
AWC AND INFORM YOUR
SUPERVISOR, IF THERE IS ANY
DISCREPANCY)
YES
NO
01 D2.5
02
D2.4 Why are you not availing any services
from your AWC; the reason(s) thereof?
RECORD ALL MENTIONED
REASONS.
AWC IS FAR OFF
AWC OFTEN REMAINS
CLOSED
QUALITY OF SERVICES NOT
GOOD
DID NOT FEEL THE NEED
FAMILY OPPOSES
NO BODY TO ACCOMPANY
A
B
C
D
E
F
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 399
SKIP TO E1.1
ME
AWW BELONGS TO OTHER
CASTE/RELIGION
TREATMENT AT AWW NOT
WELL
OTHER
I FEEL I AM DISCRIMINATED
G
H
X
I
D2.5 What services are availed by you at the
AWC?
FIRST RECORD ALL THE
SPONTANEOUS RESPONSES
AND THEN PROMPT FOR THE
REMAINING CODES
SPON
TANE
OUS
PROMPT
YES NO
SUPPLEMENTARY FOOD
IMMUNISATION
(TETANUS)
HEALTH CHECK UP
REFERRAL SERVICES
ANC
IFA SUPPLEMENTATION
OTHER
A
B
C
D
E
F
X
1
1
1
1
1
1
2
2
2
2
2
2
D2.6 CHECK Q D2.5
CODED ‘A’
NOT CODED ‘A’
1 D3.2 2
D3.0 INTAKE OF SUPPLEMENTARY FOOD FROM aNGANWADI CENTRE
D3.1 What are the reason(s) for not taking
food from AWC?
RECORD ALL MENTIONED
REASONS.
ANSWERS D3.1 AND GO SKIP TO
E1.1
AWC OFTEN REMAINS
CLOSED
QUALITY OF SERVICES
NOT UPTO THE MARK
DID NOT FEEL THE NEED
OF SERVICES FROM AWC
AWW’S BEHAVIOUR IS
BAD
I FEEL I AM
DISCRIMINATED
AWC IS FAR OFF
OTHER
A
B
C
D
E
F
X
D3.2 For how many days did you receive
supplementary food from AWC in the
last month?
IF NIL, RECORD '00'.
THEN CODE (NOT
LAST MONTH (IN DAYS)
NOT PRESENT IN LAST
MONTH
DON’T KNOW/CAN’T SAY
99
98
D3.3 Of the food received, generally how
much is consumed by you?
ENTIRE STUFF/QUANTITY
SHARED WITH OTHER
01
02
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 400
FAMILY MEMBERS
I DON’T LIKE THE FOOD
AND SO DO NOT
CONSUME aT ALL
CANNOT SAY/DON'T
REMEMBER
03
98
E 1.0 NUTRITION, HEALTH EDUCATION AND VISIT TO AWC
(FOR ALL EMWs I N RURAL PSUs ONLY)
E1.1 CHECK 0.05
PSU IS RURAL (CODE 1IN
Q0.05)
PSU IS URBAN (CODE 2 IN
Q0.05)
12E2.1
E1.2 Are you aware that a meeting on health
and nutrition popularly called as Village
Health and Nutrition Day (VHND) or a
mother’ meeting OR MOTHER’S DAY
is held at AWC?
YES
NO
1
2 E2.1
E1.3 Have you attended any such meeting in
the last 3 months?
YES
NO
NOT APPLICABLE
01
02
99
E.2.0 VISITS BY AWW
E2.1 Did the Anganwadi Worker visit you at
home during the last 3 months?
YES
NO
1
2 F1.0
E2.2 If yes, how many times did she visit
your home during the last 3 months?
NUMBER OF TIMES
F1.0 HEIGHT AND WEIGHT MEASUREMENT FOR CHILDREN AGED 0-59
MONTHS
F1.1 Any child is
between 0-59
months
(Autocode
from HH
Roster)
Yes
No
1
2TERMINATE
INTERVIEW
F1.2 NAME of the
child
(Autocode
from HH
Roster)
------------------------
--
-----------------------
---
-------------------------
-
F1.3 Serial number
from column 1 in
HH roster
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 401
(Autocode
from HH
Roster)
F1.4 Sex of the child
(Autocode
from HH
Roster)
MALE 1
FEMALE 2
MALE 1
FEMALE 2
MALE 1
FEMALE 2
F1.5 Date of birth
Auto code if
mention in
A2.3 or B1.3
for this child if
not mentioned
in A2.3 and
B1.3 ask the
date of birth
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
F1.6 Status of weight
measurement
MEASURED 1
NOT PRESENT 2
REFUSED 3
MEASURED 1
NOT PRESENT 2
REFUSED 3
MEASURED 1
NOT PRESENT 2
REFUSED 3
F1.7 Weight of the
mother
(in case of 0-2
years children
KG
KG
KG
F1.8 Weight of the
mother and the
child (in case of 0-
2 years children)
KG
AKG
KG
F1.9 Weight of the
child (in case of
children 2-5 years)
KG
KG
KG
F1.9A Correction Factor
(mention the
weight required to
correct the fault)
Mention –ve or +ve in first box
Grams
F1.10 Status of
height/length
Measurement
MEASURED 1
NOT PRESENT 2
REFUSED 3
MEASURED 1
NOT PRESENT 2
REFUSED 3
MEASURED 1
NOT PRESENT 2
REFUSED 3
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 402
F1.10 A Height/length of
the child
HEIGHT 1
LENGTH 2
HEIGHT 1
LENGTH 2
HEIGHT 1
LENGTH 2
F1.11 Height/length of
the child
(centimetres)
CM
CM
CM
REPEAT THIS FOR ALL CHILDREN AGED 0-59 MONTHS
HEIGHT AND WEIGHT MEASUREMENT FOR ADOLESECENT GIRLS 10-19 YEARS (18
COMPLETED)
SERIAL NUMBER, NAME, SEX AND AGE (IN COMPLETED YEARS) OF ALL ADOLESCENTS AGED 10-
19 YEARS (18 COMPLETED) WILL BE AUTOPOPULATED FROM THE HOUSEHOLD ROSTER. FOR
EACH ADOLESCENT GIRL , ASK QUESTIONS
F1.12 F1.13 F1.14 F1.15 F1.16 F1.17 F1.18
Serial
Number
of the
adolesce
nt girl
(Autoco
de from
HH
Roster)
Name of
adolesce
nt girl
(Autoco
de from
HH
Roster)
Age
(IN
COMPLETE
D YEARS)
(Autocode
from HH
Roster)
Weight of
adolescent
girl
(KG )
Status of weight
measurement
Height of
adolescent
girl
(CENTIMET
RES)
Status of height
measurement
KG
MEASURED 1
NOT PRESENT
2
REFUSED 3
CM
MEASURED 1
NOT PRESENT 2
REFUSED 3
KG
MEASURED 1
NOT PRESENT 2
REFUSED 3
CM
MEASURED 1
NOT PRESENT 2
REFUSED 3
G1.0 SUMMARY OF TARGET POPULATION COVERED IN THE INTERVIEW (TO BE
AUTO-POPULATED BY PROGRAMME)
G1.1 The number of EMW, children
aged 0 – 35months, children aged
36 – 71 months lactating women
and pregnant women will be
calculated by the programme and
TARGET POPULATION NUMBER
EMW
RAPID SURVEY ON CHILDREN 2013-14 ANNEXURE | 403
populated here.
INTERVIEWER: PLEASE COPY
THIS SUMMARY IN THE
INTERVIEWER ASSIGNMENT
SHEET.
CHILDREN AGED 0 – 35MONTHS
CHILDREN AGED 36 – 71MONTHS
LACTATING WOMEN
PREGNANT WOMEN
H1.0 STATUS OF COMPLETION
H1.1 Result status of the questionnaire
COMPLETED BUT PAUSED
INCOMPLETE
COULD NOT BE INTERVIEWED
1
2
3
H1.3
H1.2 Please mention the reason if the
household could not be interviewed
HOUSEHOLD ABSENT
REFUSED
DWELLING VACANT/ADDRESS
NOT A DWELLING
DWELLING DESTROYED
DWELLING NOT FOUND
OTHER
01
02
03
04
05
96
H1.3 End time of first visit
(PLEASE RECORD TIME IN 12
HOUR FORMAT)
END TIME AM/PM
CHECK IF A16 HAS START TIME, ASK H1.4
IF A17 HAS START TIME, ASK H1.5
H1.4 End time of second visit
(PLEASE RECORD TIME IN 12
HOUR FORMAT)
END TIME AM/PM
H1.5 End time of third visit
(PLEASE RECORD TIME IN 12
HOUR FORMAT)
END TIME AM/PM
THANK THE RESPONDENT FOR HER INVALUABLE TIME AND END THE INTERVIEW