chapter: 4 health status in gujarat and surat...

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CHAPTER: 4

HEALTH STATUS IN GUJARAT AND

SURAT DISTRICT

4.1 INTRODUCTION

4.2 INTER-STATE HEALTH DISPARITIES

4.3 INTER-REGIONAL DISPARITIES OF HEALTH INDICATORS IN

GUJARAT

4.4 INTER-DISTRICT DISPARITIES IN HEALTH INDICATORS IN GUJARAT

4.5 INTER-TALUKA DISPARITIES OF HEALTH INDICATORS IN SURAT

DISTRICT: WITH SPECIAL REFERENCE TO OLPAD TALUKA

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4.1 INTRODUCTION

In this chapter we present the health outline of India and Gujarat with a special stress on

certain important aspects concerning Surat District. In this outline, we shall be

discussing the data obtained from NFH surveys. The following paragraphs will be

broadly divided into three. All-India status in section –I., Gujarat Status in section- II

and in section III about Olpad this chapter we shall discuss the health status of India vis-

à-vis the world status. From Table No. 4. 1.0 we can gather the health status among the

major group of countries. These countries are divided into low, medium and high

income countries. The details pertain the GDP, expenditure on health, and health

outcome indicators. From the table we also get an idea about the effect of GDP on health

status. In the case of high income countries the Infant Mortality rate and the maternal

morality rate are low, and in the case where the public expenditure and income are low,

these indicators are high. This indicates a relation between per capita health expenditure

and the indicators. From the table we observe that the average percapita income of high

income countries (HIC) is 26385 dollars. In these countries the average CMR and MMR

is 6.2 and 10.77 percent. Similarly, for the Medium income countries, whose average per

capita income 2665.75 dollars the CMR and MMR is 32.85 and 124.0 respectively.

Whereas, the least income countries (LIC) the respective figures are 81.0 and 425.0. The

respective figures for these three categories of countries for IMR are 5.0., 27.57., and

66.25., indicating a similar relationship as mentioned above.

Detailed observation of the table indicates that with regards to infant mortality, births

attended by skilled professionals, access to improved sanitation and immunization

figures for HIC are 5.0., 99.2., (99.8 and 97.0 rural and urban) and 87.44. The similar

figures for MIC 27.57., 88.9., (87.75 and 67.54 rural and Urban) and 89.42. In the

case of LIC the figures observed from the table indicate as follows. 66.25., 32.55 (74 and

36.25 rural and urban) and 66.25. This denotes that the health indictors are heavily

dependent on the incomes of the countries. From the table we also come to know that

high income countries spend more than six times the lower income countries.

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4.2 INTER-STATE HEALTH DISPARITIES

After this brief review of health indicators for the world level, we now try to find out the

status of health indicators at the all-India level. To analyse the status the researcher has

used the NFH survey data. Wherever possible a comparison of the particular indicator

has been made for all the three surveys. Is there any improvement over the surveys in all

the indicators, would be found out from the survey data compiled by the researcher. The

indicators chosen for the comparison are those which have been focused in the field

work. Table no. 4.1.1 we get the details about the core indicators for all the three surveys.

The indicators included are (a) ANC ., (b) Visits for ANC Care for three times, (c) visits

during the first three months., (d) delivery under health systems (e) delivery by trained

midwife.

Indicators related to ANC depict that the percentage of antenatal care under the NFHS-I

was 64.6 percent which went up to 65.8 percent under NFHS-II. Subsequently under the

NFHS III the figure rose to 76.9. However, there persists a serious rural-urban gap in

the amount of care between the rural and urban areas.

The percentage of minimum three visits has gone up from a total of 43.9 percent in

NFHS I to 44.2 in the second survey and 50.7 in the third. Indicating an awareness

among the women. However, in last two surveys the gap between the rural urban areas

has been over 30 percent. This is a case for correcting the rural urban disparities. With

regards to births assisted by trained midwife the percentage has gone up from 35.1

percent in the NFHS I to 48.8 percent in the NFHS III. The average rural-urban gap in

this case has been to the extent of 38 percent. In all these cases though the performance

of the indicators in total may have improved but there are persistent gaps in the rural-

urban gap.

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Information regarding can be obtained from Table no. 4.1.2 the immunization among the

children under the NFHS I was 35.4 percent this figure came down to 43.5 percent during

the NFHS III. While the Urban immunization percentage of 50.7 percent went up 57.6

the rise was not enough from rural areas which went up from 30.9 to 38.6 percent. There

have been gaps between the rural and urban areas here too.

In the following paragraphs, we deal with the similar aspects concerning infrastructure in

Gujarat and India. (Table no. 4.1.3) For this aspect we have taken the data on rural

health statistics from India, Government of (2008) The table depicts the shortfall in the

health force and some infrastructure related to the three tier health centers in India,

Gujarat and Tribal areas of Gujarat. With regards to health manpower the maximum

shortage observed was in the case of physicians at 72.5 and 100 percent respectively for

India and Gujarat. In the case of tribal areas the respective figures were 83.3 and 100

percent respectively. Total shortage for specialists as a whole was 68 and 93.2 percent

respectively for India and Gujarat. This signifies that at the all India level the shortage of

all specialists taken together was lower compared to Gujarat. In the case of tribal areas

the corresponding figures were still higher at 70.3 and 96.5 percent respectively. Here too

the all-India shortage was far less than the Gujarat. The shortfalls in other categories of

manpower, which too are significant enough for the sake of analysis, have not be taken

up here for reasons of space. From the table we also observe that in the case Sub centers

in position there was a shortfall of 12.9 percent at all India level, while in the case of

Gujarat the number of required sub-centers is higher than that of the requirement.

Similarly in the case of PHC and CHC in position, the shortfall was 17.3 and 32.9

percent respectively in the case of All-India status taken together, where as the respective

figures for Gujarat were 7.5 and 4.1. This signifies that in the case of fulfilling the

number of health centers Gujarat is in a better position.

In case of the shortfall of the SCs., PHCs., and CHCs in tribal areas is concerned, the

respective figures for the all India level are 21.4., 63.6., and 31.9 percent.. Whereas the

respective figures for Gujarat are 3.5.2.3., and 16.4. Signifying a better ranking for

Gujarat in this case

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ANC Care Gujarat

The details of this aspect are given in table no. 4.1.4. Indicators related to ANC in Gujarat

depict that the percentage of antenatal care under the NFHS-I was 77.5 percent which

went up to 87.2 percent under NFHS-II. Subsequently under the NFHS III the figure

came down to to 87.0 However, there persist a serious rural-urban gap in the amount

of care between the rural and urban areas. The average gap during the three surveys has

been around 11 percent. This is a better performance compared to the national scenario

mentioned in the earlier paragraphs.

The percentage of minimum three visits has gone up from a total of 61.3 percent in

NFHS I to 61.2 in the second survey and 64.9 in the third. Indicating awareness among

the women. However, in last two surveys the gap between the rural urban areas has been

averaging over 21.63 percent. Though the performance of Gujarat is better than the

national scenario there is a case for correcting the rural urban disparities.

With regards to births assisted by trained midwife the percentage has gone up from 44.1

percent in the NFHS I to 64.7 percent in the NFHS III. The average rural-urban gap in

this case has been to the extent of 37 percent. In all these cases though the performance

of the indicators in total may have improved but there are persistent gaps in the rural-

urban gap.

With regards to delivering births in health facility, the rural urban disparities in

percentage points has come down from 39.3 under NFHS I to 35.8 under NFHS 3.

However it is worth noting hiere that that total births in the health facility went up from

36.8 percent (rural-urban combined) to 54.6 under the NFHS 3. This is not reflected in

the reduction of rural urban disparities.

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56.3

12.8

50.7

43.5

65.3

80

66.6

8

64.9

45.249.1

80.2

Family Planning Unmet need for family planning

Mother who had three ANC visit for last birth

Children fullyImmunisation

Knowledge of HIV/AIDS among maried women

Knowledge of HIV/AIDS among married men

Chart 4.1.0 Interstate Disparities in Health Indicators

All India Gujarat

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Himachal Pradesh (72.6)

Nagaland (26.1)

Tamil Nadu(96.5) Tamil Nadu

(80.9)

Manipur(98.5)

Manipur(99.3)

Meghalaya (24.3)

AP (4.7)

Bihar (16.9)

Nagaland(21)

Zarkhand (28.9)

Zarkhand(52.7)

Family Planning Unmet need for family planning

Mother who had three ANC visit for last birth

Children fullyImmunisation

Knowledge of HIV/AIDS among maried women

Knowledge of HIV/AIDS among married men

Chart 4.1.1 Interstate Disparities in Health Indicators (Highest and Lowest Value)

Highest Lowest

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This can be observed in table no. 4.1.5. The indictors specified in the table are as follows

.. (a)Using any method for family planning. (b) Unmet need for Family Planning., (c)

Mother who had three ANC visits for last birth., (d) Full Immunization and Vitamin A

Supplementation ., and (e) Knowledge of HIVAIDS among married men and Women.

The highest percentage of population using any of the family planning method as per

NFHS 3 was observed in the state of Himachal Pradesh (72.6 percent) and the lowest

was observed in Meghalaya (24.3). The all India figure in this case is 56.3 percent with

Gujarat being 66.66 percent.

Unmet need for family planning was highest in Nagaland (26.1 percent) while the lowest

percentage of population with unmet need was 4.7 in the case of Andhra Pradesh. The

national percentage was 12.8 and in the case of Gujarat it was 8.0 percent.

It is necessary for the mothers to have at least three ANC visits prior to the birth of the

child. Which state had the highest percentage in this indicator ? we observe from the

table that the 96.5 percent of mothers in Tamil Nadu had three ANC visits whereas the

least was in the case of Bihar (16.9). the national average was 50.7 and Gujarat it was

64.9.

In the case of immunization status among the states, 80.9 percent of the children were

fully immunized and in the case of the lowest percentage, the same was observed for

Nagaland (21.0). The all India average was 43.5 whereas for Gujarat it was 45.2.

The average awareness about HIV/AIDS among the married men and women was 72.6

as far as all India average was concerned. As far as the states are concerned the highest

awareness was observed in the case of Manipur (98.9) whereas the lowest was in

Jharkhand (40.8 percent). The similar average in the case of Gujarat was 64.6 Due to

lack of time and space, the researcher has not gone into the comparative status vis-à-vis

NFHS 1 and 2.

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4.3 INTER-REGIONAL DISPARITIES OF HEALTH INDICATORS

IN GUJARAT

Based on Table No. 4.1.6 the researcher has attempted to view of the position of these

indicators in terms of regions in Gujarat. This can be observed from Table nos. 4.1.7 to

4.1.10. For the sake of convenience, we have divided Gujarat as whole into four regions.

These are (a) South Gujarat., (b) Central Gujarat ., (c) North Gujarat and (d) Saurashtra

region. In the following paragraphs we analyse the above mentioned indicators in terms

of the regions.

Antenatal Care

The highest percentage of the cohort having taken benefit of the antenatal care was in

central Gujarat (64.0) where as the lowest performance was in the North Gujarat region

(51.9) under DLHS 2, while under the DLHS -3 best performance was under the

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

ANC TT Injection Contreceptive Dilevery Fully Immunization

Family Planning

Chart 4.1.2 Inter-Regional Health Disparities

South Gujarat Central Gujarat North Gujarat Saurashtra Region

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Saurashtra region (66.6) where as the lowest was in North Gujarat (46.6). Though the

poorest performance was by North Gujarat region under both the surveys it is observed

that the performance had deteriorated between the two surveys.

TT Injection.

The highest percentage of the cohort having taken benefit of the facility of TT Injection

was in Saurashtra region (86.5) where as the lowest performance was in the North

Gujarat region (75.3) under DLHS 2, while under the DLHS -3 best performance was

under the Saurashtra region (80.1) where as the lowest was in North Gujarat (60.8).

Though the best and worst performance was by maintained by both the regions, it is

worth noting that in the case of these two regions the performance showed a serious

deterioration, especially the North Gujarat region between the two surveys.

Contraception

The highest percentage of the people adopting some form of contraception was found in

South Gujarat (64.6) where as the lowest performance was in the North Gujarat region

(52.6) under DLHS 2, while under the DLHS -3 best performance was under the South

Gujarat region (67.36) where as the lowest was in North Gujarat (60.4). We thus find

that not only the respective positions are maintained in between both the surveys, the

adoption percentage of any form of contraception by the people has also gone up. This

welcome trend for a progressive society.

Institutional Delivery

The highest percentage of women going in for institutional delivery in central Gujarat

(57.10) where as the lowest performance was in the Saurashtra region (45.1) under

DLHS 2, while under the DLHS -3 best performance was under the Central region

(67.4) where as the lowest was in South Gujarat (50.6). It can also be observed from the

table that the poorest performer in DLHS -2 performed better in the DLHS 3.

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Full Immunisation

The highest percentage of the cohort having taken benefit of the facility of Immunisation

was in Saurashtra region (62.1) where as the lowest performance was in the North

Gujarat region (45.2) under DLHS 2, while under the DLHS -3 best performance was

under the Saurashtra region (62.7) where as the lowest was in Central Gujarat (54.2).

There was a marginal improvement by the topper in DLHS 2 in DLHS 3.

Adoption of Family Planning

The highest percentage of the population having adopted family planning in North

Gujarat region (20.4) where as the lowest performance was in the South Gujarat region

(16.6) under DLHS 2, while under the DLHS -3 best performance was under the Central

Gujarat region (20.3) where as the lowest was in Saurashtra (17.7) .

4.4 INTER-DISTRICT DISPARITIES IN HEALTH INDICATORS

IN GUJARAT

The data for this section of analysis has been procured form District level Health Surveys

2 and three. Gujarat comprises of twenty five districts. The purpose of this section is not

only get the overall picture of Gujarat but also compare the same with Surat district in

particular. We have tried to select those indicators which have been common to both

these surveys. However, not all the indicators are those covered in the survey. This

analysis helps the reader to have some idea about the prevalent disparities.. These

indicators are (a) Antenatal care., (b) TT Injection., (c) Contraceptive prevalence., (d)

Delivery., (e) Full Immunization., (f) Family Planning. The details about these can be

seen from table No. 4.1.6

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Antenatal Care

The percentage of the cohort having taken benefit of the antenatal care was 60.3 percent

under DLHS 2, while under the DLHS -3 the figure had come down to 58.8. Though the

highest percentage of those availing the ANC was by Navasari District under DLHS 2

the same had come down from 86.9 to 81.1 under the respective survey. Thus, losing its

position to Surat Distict (87.8) a highest in the DLHS 3. Similar was the case of Dangs

district. While it maintained the lowest position – in terms percentage of women taking

the ANC, the same came down drastically from 37.3 under DLHS-2 to 19.3 under

DLHS-3.

In the case of Surat District as a whole the percentage of women taking the benefit of

antenatal care was 51.9 under DLHS-2 while under DLHS-3 the same was 87.8 – highest

under DLHS-3 - Showing that the performance under this category of indicator was

better than All Gujarat taken together

It can also be seen from the table that the performance for the rural areas had worsened in

many of the districts. It can also be seen that there are fifteen districts, which have

performed poorly in DLHS 3 compared to DLHS 2. Surat district is one which has

performed better in the former to the latter. Thus we observe a positive difference of over

37 percentage points.

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58.8

71.2

64.9

59.457.9

19.1

87.8

76.5

85.7

68.972.3

17

ANC T.T Injection Contraceptive Insitutional Delivery Fully Immunisation Family Planning

Chart 4.1.3 Disparities in Health Indicators (Gujarat & Surat)

All Gujarat

Surat

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Surat (87.8) Jamnagar(88.2) Surat (85.7) Mahesana (84.2) Navsari (80.4)

Dahod (36.5)

Dang (19.3)

Vadodara (59.9)Dang (53.2)

Dang (9.4)

Panch Mahal (32.2)

Amreli (10.7)

0

ANC T.T Injection Contraceptive Insitutional Delivery Fully Immunisation Family Planning

Chart 4.1.4 Disparities in Health Indicators (Inter District- Gujarat)

Lowest

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TT Injection

Taking TT injection is an important aspect of health services. From the table we observe

that a maximum percentage of women availing the TT injection under DLHS 2 was under

Amreli district (94.5). While Banaskantha had the lowest percentage (63.0) of women

taking the TT injection during the course of pregnancy period. The figure for all Gujarat

was 80.9 while in the case of Surat district the same was 71.7. Comparing these figures

with DLHS 3 the respective highest and lowest figures were for the districts of Jamnagar

(88.2) and Vadodara (59.9). In the case of Gujarat the figure was 71.2 and that of Surat

District it was 76.5. While in the case of All Gujarat the figure had come down in the

case of Surat there was an improvement in the performance.

In assessing the overall performance of the districts we observe from the table that out of

25 districts, the performance of nineteen districts came down, while six of the districts

could improve their performance. One of them was Surat whose performance improved

by 6.69 percent or 4.8 percentage points. In the case of rural population improvement

was observed in only three districts, while the performance of the rest of the districts

deteriorated. Among the three whose performance had improved Surat District was one

of them. That too an improvement by 12.1 percent

Contraception

The percentage of contraception by the population is an important aspect in a health

policy and an important feature of the health system. The percentage of population

adopting any methods of contraception in Gujarat as a whole was 59.3 under DLHS 2

while the same was 64.9 under DLHS 3. The highest in the former was in the district of

Surat (90.7) while the lowest was in the district of Dahod (38.0). In the case of the latter

survey the highest was in the district of Surat (85.7) while the lowest percentage of

contraception was observed in Dangs (53.2). We observe from the table that Surat

district maintained its top ranking position under both the surveys.

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Assessing the overall position of the districts, we observe that twenty districts improved

their performance, while five of them could not improve their performance. In the case

of rural areas 21 districts could improve their performance under this indicator. In the

case of rural Surat the percentage of contraception was more than the total i.e., 94.6

percent.


Under this category of indicator it is observed from the table that highest percentage of

institutional delivery was observed in the district of Mehasana (74.1) while the lowest

was in Dangs District (10.7) under the DLHS-2. In the case of DLHS-3 the highest and

Lowest figures were maintained by these districts. The respective figures are 84.2 and

9.4. In the case of Dangs the performance had deteriorated, whereas in the case of

Mehasana not only the district maintained its top position, but also came up with an

improved performance on this count.

If we take the case of All-Gujarat we observe that the respective figures for both the

surveys are 50.2 and 59.4 percent. Whereas, in the case of Surat District the respective

figures are 69.8 and 68.9. While overall performance of Gujarat improved between the

two surveys, the performance deteriorated slightly in the case of Surat District.

In terms of all Districts, the performance of twenty two districts improved while in the

case of only three the performance had deteriorated. In the case of performance by rural

areas twenty one districts saw an improved performance and only four had deteriorated

performance. The performance was slightly improved in the case of Surat.

Full Immunisation

This indicator is very important determinant to understand Child-health in a community

or a nation. Under this category of indicator it is observed from the table that highest

percentage of immunisation was observed in the district of Navsari (91.4) while the

lowest was in Dahod District (17.6) under the DLHS-2. In the case of DLHS-3 while the

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the highest percentage of immunisation was maintained by Navsari District (80.4) the

lowest figures came under the district of Panchamahal (32.2). In the case of Navsari,

though it maintained the top position in the subsequent survey, its overall performance

deteriorated by eleven percentage points or 13.7 percent.



figures are 56.5 and 72.3. We can see that the performance of Guajrat and Surat showed

marked improvement between the two surveys.

In terms of all Districts, thirteen districts showed and improved performance over the

earlier survey, while in the case of twelve the same showed a deteriorated performance

In the case of rural areas, seventeen districts showed an improved performance whereas

the rest showed a deteriorated performance.

Adoption of Family Planning

This indicator is very important determinant to understand the reception to the various

family planning methods by the citizens of a nation. Under this category of indicator it

is observed from the table that highest percentage of people adopting any of the family

planning method was observed in the district of Rajkot (41.4) while the lowest was in

Amreli District (9.1) under the DLHS-2. In the case of DLHS-3 while the highest

percentage of adoption of any family planning method was under the district of District

of Dahod (36.5) the lowest figures came under the district of Amreli (10.7).



figures are 12.4 and 17.0. We can see that the performance of Gujarat and Surat showed

marked improvement between the two surveys.

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In terms of all Districts, seventeen districts showed and improved performance over the

earlier survey, while in the case of eight districts the same showed a deteriorated

performance In the case of rural areas, similar performance was observed

4.5 INTER-TALUKA DISPARITIES OF HEALTH INDICATORS IN

SURAT DISTRICT: WITH SPECIAL REFERENCE

TO OLPAD TALUKA

After taking up the All-India and interstate health disparities, followed by Inter-district

Health Disparities in Gujarat, in the following sections we shall deal with the inter-taluka

health disparities under the Surat District. Since Olpad taluka is the focus of this study,

we shall discuss it vis-à-vis its position in Surat district. There are fourteen talukas

(Sub-districts) under Surat district –this is inclusive of talukas covered under the recently

bifurcated Vyara taluka.

The indicators covered here are (a) Early ANC Registration., (b)Institutional deliveries

(Government/Private)., (c)Home Delivery (d) Immunisation status.

From Table No. 4.1.11 we find details about important health indicators pertaining to

Surat district. The data is taken from the report brought out by the government of

Gujarat’s “Surat Action Plan.

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69.9

10.7

40.4

48.8

89.5

57.661

16

63

31

92

69

Block wise early registered

Institutional Delivery in (Govt)

Institutional Dilivery in (Private)

Home delivery Fully Immunisation Institutional Delivery in (Govt)

4.1.4 Disparities in Health Indicators (Surat District and Olpad)

Surat Olpad

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Vyara (84)

Songadh (21)

Choryasi (70)

Umarpada (90)

Nizar (142)

Choryasi (80)

Choryasi (50)

Umarpada (5)

Umarpada (5)

Choryasi (20)

Bardoli (80)

Umarpada (10)

Block wise early registered Institutional Delivery in (Govt)

Institutional Dilivery in (Private)

Home delivery Fully Immunisation Institutional Delivery in (Govt)

4.1.5 Disparities in Health Indicators (Inter Taluka- Surat District)

Highest Lowest

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Early ANC Registrations

Early Antenatal registrations play an important role in improving the health of the

expectant mothers and child. This helps the state to tract the health status of the

expectant mothers with regards to timely immunisation, nutrient supplements, handling

emergencies, pregnancy related complications etc. Further an important measure of safe

mother hood. From the table we observe that the district average of early registrations in

the year 2006-07 was 69.4 while in the year 2007-08 the same was 69.9, showing a

marginal increase, The highest early antenatal registrations in the year 2006-07 was

registered in Vyara Taluka (81.0 percent) whereas in Choriyasi it was 49.0 percent. The

similar figures for the year in the year 2007-08 were 84.0 percent - jointly by Vyara and

Valod, while the lowest was Choriyasi. Of the fourteen talukas five of them showed a

decline in early antenatal registrations. In the case of Olpad Taluka there was a Marginal

increase in the same, which went up from 60 to 61 percent in the reference period.

Institutional deliveries (Government/Private)

It is a well established fact that giving birth in a medical institution under the care and

supervision of trained health care providers promote child survival and reduces the risk of

maternal mortality. In India both the child mortality (especially neonatal mortality) and

maternal mortality are vey high. To prevent this the institutional deliveries need to go up.

From the table we observe that the institutional deliveries as whole in the district was

averaging 53.5 in the year 2006-07. This came down to 51.6 in the year 2007-08. Thus,

showing a decline at the district level. The highest institutional delivery percentage in the

reference years of 2006-07 and 2007-08 were 88.0 and 80.0, both in the Choriyasi

Taluka. While the respective lowest institutional deliveries were found the Umarpada

Taluka (14.0 and 10.0 percent). In the case of Olpad Taluka the respective figures for

both the years 65.0 and 69.0. Thus we observe that while the district level percentages

showed a decline, the case of Olpad taluka is better because the percentage of

institutional deliveries went up during the reference period.

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In the case of Institutional deliveries in government facilities the average figures for the

district as a whole during the respective years were 12.7 and 10.7. The highest observed

institutional deliveries in the government facilities was observed in Uchhal and Songadh

Taluka (21.0 percent) in the year 2006-07, whereas the lowest in the same year was 5.0

percent in Vyara Taluka. In the year 2007-08 the highest institutional deliveries in the

government facilities was 21.0 percent in Songarh taluka, whereas the lowest was

observed in Umarpada (5.0 ). In the case of Olpad Taluka the respective figures for both

the years were 12.0 and 16 percent. Thus, indicating a rise in the usage of government

facilities for the same

In the case of Institutional deliveries in private facilities the average figures for the

district as a whole during the respective years were 39.6 and 40.4. The highest observed

institutional deliveries in the private facilities was observed in Choriyasi (73.0 and 70.0

percent) for both the years in the reference, whereas the lowest in the same year was 5.0

and 5.0 percent in Umarpada Taluka for both the years. In the case of Olpad Taluka the

respective figures for both the years were 54.0 and 63.0 percent. Thus, indicating a rise

in the usage of private facilities for the same.

In the case of home deliveries the average figures for the district as a whole during the

respective years were 47.6 and 48.8. The highest observed home deliveries was

observed in for Nizar taluka 77.0 percent in the in the year 2006-07, whereas the

lowest in the same year was 12.0 percent in Choriyasi Taluka. In the year 2007-08 the

highest home delivery was observed in Umarpada Taluka ( 90.0 percent), whereas the

lowest was observed in Choriyasi Taluka (20.0) In the case of Olpad Taluka the

respective figures for both the years were 35.0 and 31.percent. This aspects shows us

that while the home deliveries rose at the district level, the performance of the Olpad

taluka has improved, signifying a fall in the percentage of home deliveries.

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Full Immunisation

With regards to immunisation there was a drastic improvement in the efforts. All the

talukas have seen commendable increase in this aspect. There was an overall rise in the

percentage of immunisation in the district. The percentage of immunisation on average at

the district rose from 88.6 to 89.5 during the reference period. However, the percentage

of immunisation during the reference period came down from 94.0 in the year for 2006-

07 to 92.0 percent in the year 2007-08.

Co-Variance in Health Indicators

Apart from the above interstate, district and inter-taluka analysis, the researcher has tried

to find out co-variance between two surveys. In the case of variance among the states at

all India level, coefficient of variance has been for NFHS data, while in the case of inter-

district and taluka variance the results are based on DLHS data. With regards to the

indicators that have been used are, (a) Family Planning (with relation to use of any

methods) by the population in the states., (b) Unmet need for Family Planning (Total

unmet need for family planning among the population in the various states., (c)

Percentage of mothers in different states who had three ANC visits for the last birth., (d)

Percentage of children who are fully immunized in the states ., (e) Percentage of men

and women who have the knowledge about HIV/AIDS .The results for these indicators

are as follows. (Table No. 4.1.12). The comparative figures of co-variance for the first

four indicators could be computed. With regards to HIV/AIDS comparative figures

could not be obtained and result based on NFHS 3 data is available. (a) Family

Planning. The mean has gone up from 41.20 in (NFHS 1) to 55.11 (NFHS 3) and the

respective co-variance among the states came down came from .36 to .23 signifying a fair

amount of equitious efforts on the part of the states. While the mean in the case of

indicator of unmet need for family planning is concerned, the mean of all the states is

seen to have come down 13.5 in NFHS 3 over NFHS 1, the co-efficient of variance has

gone up from .28 to .50 during the reference period. This shows that inter-state variations

have gone up, though the overall need for family planning has gone up among all the

79 | P a g e

states. In the case of the indicator pertaining to mother who had three ANC visits during

the last birth. Mean during the reference period has gone up from 46.21 to 59.68 and the

coefficient of variance among the states too came down from .53 to .35 from NFHS 1

to NFHS 3. Performance by the indicator of full immunisation too saw a progress with

mean moving from 37.51 to 51.11 and covariance coming down from .54 to .34. In the

case of the knowledge about HIV/AIDS, the co-efficient of variance with regards to

knowledge about HIV/AIDS among the married males is lower (.15) compared to

Females(.30) under the NFHS 3

Table no. 4.1.13 depicts the inter-district variance among the districts of Gujarat, The

data pertains to DLHS 2 and 3. The indicators that could be studied for this section are

(a)Early ANC Registration., (b) Taking of TT Injections., (c) Contraceptions ., (d) Place

of Delivery – Institutional ., (e) Full Immunisation., and (f) Family planning – methods.

In the case of the first two indicators the co-efficient of variance has gone up, vis-à-vis

the two surveys, while in the rest it has comedown signifying equitious performance of

the indicators among the district in Gujarat.

Table no.4.1.14 depicts the inter-taluka variations. There has been a rise in the

coefficient of variation in the case literacy rate from .10 to .15, with a decline in mean

literacy over the DLHS 2. Encouraging performance of indicator related to ANC

registration showed a marginal fall in the co-variance. The mean for home delivery has

gone up, with co-efficient of variation marking almost no change. Similarly the mean for

full immunisation has registered a growth from 88.69 to 100.23 with a marginal decline

in the covariance with regards to these indicators among the talukas of the Surat District.

80 | P a g e

Table No: 4.1.0: Health status Across Major Group of Nations: Some important Indicators

HIC

GDP

(PCI) IN $

EXPENDITURE ON HEALTH

HEALTH OUTCOMES Public

As%

GDP

(2000)

Private

As%

GDP

(2000)

Total CMR

/1000

Live Births

(2000)

MMR

/10000

Live Births

(1995)

IMR

/1000

Live

Births

Births

Attended by

Skilled

Professio-nals

Access to

Improved

Sanitation

Immun

isation

Urban Rural

HIC

Switzerland 37930 5.9 4.8 3573 6 08 5 NA 100 100 81

USA 35060 5.8 7.2 4499 8 12 7 99 99 86 91

Japan 33550 6.0 1.8 2908 5 12 3 100 NA NA 98

UK 25250 5.9 1.4 1747 7 10 6 99 100 100 85

Germany 22670 8.0 2.6 2422 5 12 4 NA NA NA 89

Canada 22300 6.6 2.5 2058 7 06 5 98 100 99 96

France 22010 7.2 2.3 2057 6 20 5 NA NA NA 84

Australia 19740 6.0 2.3 1698 6 06 5 100 100 100 93

Italy 18960 6.0 2.1 1498 6 11 5 NA NA NA 70

Avg. HIC 26385 6.37 3.00 2506 6.22 10.77 5 99.2 99.8 97.0 87.44

MIC

Mexico 5910 2.5 2.9 311 29 65 25 85.7 88 34 95

Malasiya 3540 1.5 1.0 101 08 39 08 96.2 NA 98 92

Brazil 2850 3.4 4.9 267 36 260 37 87.4 84 43 95

South Africa 2600 3.7 5.1 255 71 340 49 84.4 93 80 72

Thailand 1980 2.1 1.6 71 28 44 27 85 96 96 94

China 940 1.9 3.4 45 39 60 31 89.3 68.5 25.8 79

Sri Lanka 840 1.8 1.8 31 19 60 16 94.1 97 93 99

Avg. MIC 2665.75 2.41 2.95 154 32.85 124 27.57 88.9 87.75 67.54 89.42

LIC

Indonesia 710 0.9 2.1 19 45 470 39 55.8 69 46 76

India 480 0.9 4.3 23 93 440 77 42.3 61 15 56

Pakistan 410 0.9 3.2 18 109 200 86 20 95 43 57

Bangladesh 360 1.4 2.4 14 77 600 63 12.1 71 41 76

Avg. LIC 490 0.95 03 18.5 81 425.50 66.25 32.55 74 36.25 66.25

Source: WHO (2000, 2004)

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Table: 4.1.1 Information about Maternal care in India

No. Indicators of Mortality care NFHS-1 (1992-93) NFHS-2 (1998-99) NFHS-3 (2005-06)

U R T U R T U R T

1. ANM care 83.0 59.2 64.6 86.5 59.9 65.8 90.7 72.2 76.9

Rural –Urban disparities - 23.8 - - 26.6 - - 18.5 22.9

2 Three visits in pregnancy care

(In percentage)

66.8 57.3 43.9 70.1 36.9 44.2 73.8 42.8 50.7


3 First three months pregnancy

care (In percentage)

40.9 20.2 24.9 55.8 26.7 33.1 63.0 36.1 43.0


4 Delivery from Health care (in

percentage)

58.4 16.7 26.1 65.1 24.7 33.6 69.4 31.1 40.8


5 Delivery by Trainee Dai 66.4 25.9 35.1 73.3 33.5 42.4 75.3 39.9 48.8


Sources: NFHS Report-III,Vol-I,Page-222 U=Urban, R=Rural, T= Total

82 | P a g e

Tabel :4.1.2 Immunization of child over 12-13 months in India

No Immunization NFHS-I(1992-93) NFHS-II(1998-99) NFHS-III (2005-06)

U R T U R T U R T

1 B.C.G 77.6 57.6 62.2 86.8 67.1 71.6 86.9 75.1 78.1

2 D.P.T-3 68.8 46.6 51.7 73.4 49.8 55.1 69.1 50.4 55.3

3 Polio-3 70.4 48.6 53.6 78.2 58.3 62.8 83.1 76.5 78.2

4 Ory 57.5 37.3 42.2 69.2 45.3 50.7 71.8 54.2 58.8

5 Full

immunization

50.7 30.9 35.4 60.5 36.6 42.0 57.6 38.6 43.5

Sources:NFHS Report III. Vol-1 Page-232 U:Urban, R:Rural, T:Total

83 | P a g e

Table: 4.1.3 Health status in Gujarat and India (Figures in Brackets indicate percentage)

No

India

Short Fall Item Gujarat Short Fall Situated Require

1 Sub Centers 7263 7274 - 158792 146036

2047

(12.9)

2. PHC 1172 1073

99

(8.0) 26022 23458

4477

(17.2)

3. CHC 293 273

20

(7.2) 6491 4276

2337

(36.0)

4. Multipurpose Workers(Female)

ANM Sub Center 8347 7060

1287

(15.5) - - -

5. Heatlh Worker (Male) PMW in Sub

Center 7274 4456

2818

(38.7) 146036 60147

7932

(5.4)

6. Health Helper (Female) in PHC 1073 267

806

(74.9) 23458 17608

6481

(27.6)

7. Health Helper (Male) in PHC 1073 2421 - 23458 17976

8831

(37.6)

8. Doctor in PHC 1073 1019

54

(5.0) 23458 24375

3537

(15.0)

9. Health experts and Delivery Expets

in PHC 273 06

267

(97.2) 4276 1174

2693

(62.9)

10. Physician in CHC 273 00 273 4276 1126

2702

(63.1)

11. Pediatric Doctor in CHC 06 267 4276 866

2662

(62.2)

12. Total Experts 1092 81 1011 1704 4279

11033

(64.5)

13. Radiographer 273 124 149 4276 1695

2280

(53.3)

14. Pharmacist 1346 781 565 27734 20956

7022

(25.3)

15. Laboratory Technician 1346 987 449 27734 12886

14134

(50.9)

16. Nurse 2984 1585 1399 53390 44936

18021

(33.7)

Source: RHS Bulletin march, 2008 M/O Health & F.W.GOI.

84 | P a g e

Table No: 4.1.4: Antenatal Care in Gujarat

No. Indicators

NFHS-I(1992-93) NFHS-II(1998-99) NFHS-III(2005-06)

U R T U R T U R T

1. Percentage of who received antenatal

care 85.6 73.7 77.5 92.6 84.0 87.2 94.8 82.7 87.0

R-U Disparities 11.9 - - 8.6 - - 12.1 - -

2. Percentage of who had at least three

antenatal care visits 72.6 55.9 61.3 75.3 52.8 61.3 81.5 55.8 64.9

R-U Disparities 16.7 - - 22.5 - - 25.7 - -

3. Percentage of who received antenatal

care within the first trimester of

pregnancy 42.1 29.9 33.8 56.8 24.7 36.6 69.7 44.0 53.1

R-U Disparities 12.2 - - 32.1 - - 25.7 - -

4. Percentage births delivered in a

health facility 63.7 24.4 36.8 69.2 33.1 46.3 78.0 42.2 54.6

R-U Disparities 39.3 - - 36.1 - - 35.8 - -

5. Percentage of deliveries assisted by

health personnel 68.6 32.9 44.1 74.2 41.6 53.5 83.9 54.6 64.7

R-U Disparities 35.7 - - 32.6 - - 29.3 - -

Sources: NFHS- Report III (2005-06), page-68 R- rural U-urban T- total

85 | P a g e

Table No. 4.1.5 Inter-State Disparities in Health Indicators

STATE

Family Planning (Current Married

Women) Currant Use Any Method

Unmet Need For Family Planning. (Total

Unmet Need %)

Mother Who Had Three ANC Visit For

Last Birth (%)

No.

1 2 3 4 5 6 7 8 9

NFHS-1 NFHS-2 NFHS-3 NFHS-1 NFHS-2 NFHS-3 NFHS-1 NFHS-2 NFHS-3

1 A.P 47.4 59.6 67.6 10.4 7.7 4.7 75.3 80.2 86

2 Assam 43 43.3 56.5 21.7 17 10.5 24.9 30.9 36.3

3 Chaatishghad N.A 45 53.2 N.A 13.5 10.1 N.A 33.2 54.7

4 Goa 47.8 47.5 48.2 15.7 17.1 13.1 89.8 96.3 95

5 Gujarat 49.3 59 66.6 13.1 8.5 8 61.3 61.2 64.9

6 Hariyana 49.7 62.4 63.4 16.4 7.6 8.3 45.8 38.2 58.8

7 Jarkhand N.A 27.6 35.7 N.A 21 23.1 N.A 24.5 36.1

8 Kerala 63.3 63.7 68.6 11.7 11.7 8.9 95.4 98.6 93.9

9 Maharstra 54.1 60.9 66.9 14.1 13 9.4 63.3 66.2 75.3

10 Meghlaya 20.7 20.2 24.3 25.1 35.5 35 41.4 32 53.4

11 Nagaland 13 30.3 29.7 26.7 30.2 26.1 15 21.9 31.6

12 Punjab 58.7 68.7 63.3 13 7.3 7.3 62.2 58.4 72.8

13 Sikkim N.A 53.8 57.6 N.A 23.1 16.9 N.A 44.1 69.4

14 Tripura 56.4 55.5 65.7 13.5 17.7 10.3 38.4 47.2 58.7

15 Uttankhand N.A 43.1 59.3 N.A 21 10.8 N.A 19.7 44.8

16 Arunachal Paradesh 23.6 35.4 43.2 20.4 26.5 18.8 31.9 40.9 36.4

17 Bihar N.A 23.5 34.1 N.A 25.7 22.8 N.A 15.9 16.9

18 Delhi 60.3 63.8 66.9 15.4 13.4 7.8 72.2 68.9 74.4

19 Himachal Pradesh 58.4 67.7 72.6 14.9 8.6 7.2 41 61.1 62.6

20 Jammu and Kasmir N.A 49.3 52.6 N.A 20 14.5 N.A 67.2 74.2

21 Karnataka 40.4 58.3 63.6 18.2 11.5 9.6 73.5 72.4 79.3

22 M.P N.A 44.1 55.9 N.A 17.1 11.3 N.A 27.1 40.2

23 Manipur 34.9 38.7 48.7 21.7 23.6 12.4 41.3 54.1 70.1

24 Mizoram 53.8 57.7 59.9 11.9 15.5 17.3 69.2 75.1 57.8

25 Orissa 36.3 46.8 50.7 22.4 15.5 14.9 34.9 48 60.9

26 Rajasthan 31.9 40.3 47.2 19.8 17.6 14.6 18.1 23.6 41.2

27 Tamil Nadu 49.8 52.1 61.4 14.6 13 8.5 88.4 90.9 96.5

28 U.P N.A 27.1 43.6 N.A 25.4 21.2 N.A 14.6 26.3

29 W. Bangal 57.7 66.6 71.2 17.4 11.8 8 50.3 57.4 62.4

30 All India 40.7 48.2 56.3 19.5 15.8 12.8 43.9 44.2 50.7

86 | P a g e

Table No. 4.1.5 Inter-State Disparities in Health Indicators (Contd.)

No. State

Child Fully Immunization And

Vitamin A Supplementation

Knowledge Of HIV/AIDS Among

Married Women

Knowledge Of HIV/AIDS Among

Married Men

10 11 12 13 14 15 16 17 18

NFHS-1 NFHS-2 NFHS-3 NFHS-1 NFHS-2 NFHS-3 NFHS-1 NFHS-2 NFHS-3

1 Andra Pradesh 45.4 58.7 46 55.3 73.6 N.A N.A 92.9

2 Assam 19.4 17 31.4 8.4 33.7 53.2 N.A N.A 75.4

3 Chhatisgarh N.A 21.8 48.7 N.A 19.6 40.7 N.A N.A 66.9

4 Goa 74.9 82.6 78.6 41.7 76.3 83.3 N.A N.A N.A

5 Gujarat 50 53 45.2 10.6 29.8 49.1 N.A N.A 80.2

6 Hariyana 53.8 62.7 65.3 N.A 44.3 60 N.A N.A 87.1

7 Jharkhand N.A 8.8 34.2 N.A 15.4 28.9 N.A N.A 52.7

8 Kerala 54.4 79.7 75.3 N.A 86.9 95 N.A N.A 98.6

9 Maharshtra 64.3 78.4 58.8 18.6 61.1 79.2 N.A N.A 90.1

10 Meghlaya 9.70 14.3 32.9 26.7 44.2 56.8 N.A N.A 62.6

11 Nagaland 3.8 14.1 21 40.9 72.4 80.9 N.A N.A 90.8

12 Punjab 61.9 72.1 60.1 N.A 54.6 69.7 N.A N.A 92.2

13 Sikkim N.A 47.4 69.6 N.A 53.6 74.8 N.A N.A 88.8

14 Tripura 19 40.7 49.7 13.2 49 72.8 N.A N.A 89.0

15 Uttarakhand N.A 40.9 60 N.A 35.6 64.3 N.A N.A 91.0

16 Arunachal Pradesh 22.5 20.5 28.4 16.2 60.4 66.2 N.A N.A 74.9

17 Bihar N.A 11.6 32.8 N.A 10.5 35.2 N.A N.A 70.0

18 Delhi 57.8 69.8 63.2 35.8 79.2 88.1 N.A N.A 97.0

19 Himachal Pradesh 63.2 83.4 74.2 N.A 60.9 78.9 N.A N.A 92.0

20 Jammu & Kashmir N.A 56.7 66.7 N.A 31.9 60.5 N.A N.A 88.1

21 Karnataka 52.2 60 55 N.A 58.1 66.4 N.A N.A 84.9

22 Madhya Pradesh N.A 22.6 40.3 N.A 23.7 45.3 N.A N.A 68.3

23 Manipur 29.1 42.3 46.5 72.5 92.9 98.5 N.A N.A 99.3

24 Mizoram 56.9 59.6 51.8 84.8 93.2 93.5 N.A N.A 96.1

25 Orissa 36.1 43.7 51.8 N.A 39 62.1 N.A N.A 72.6

26 Rajasthan 21.1 17.3 26.5 N.A 20.8 33.8 N.A N.A 74.2

27 Tamil Nadu 65.1 88.8 80.9 23.4 87.3 94 N.A N.A 97.7

28 Uttar Pradesh N.A 20.2 23 N.A 19.2 40 N.A N.A 74.3

29 West Bengal 34.2 43.8 64.3 9.8 26.4 50.2 N.A N.A 73.5

30 All India 35.5 42 43.5 N.A 40.3 65.3 N.A N.A 80

Source: Compiled from NFHS-3 Sheets.

87 | P a g e

Table No. 4.1.6 Inter-District Disparities of Health Indicators in Gujarat

DISTRICT ANC TT INJECTION CONTRESPTIVE

DLHF-2 DLHF-3 DLHF-2 DLHF-3 DLHF-2 DLHF-3

TOTAL RURAL TOTAL RURAL TOTAL RURAL TOTAL RURAL TOTAL RURAL TOTAL RURAL

1 2 3 4 5 6 7 8 9 10 11 12

Porbander 70.4 64.8 71.4 65.1 93.9 92.6 86.6 81.5 62.2 63.3 62.2 65

Sabarkantha 60.2 57.8 48.4 45.1 77.3 76.2 66.1 64.9 56.7 56 56.6 56.3

Vadodara 71.1 62.1 47 32.2 89.2 83.2 59.9 48.8 61.5 58 68.9 65

Anand 67.2 66.8 70.5 64.1 86.5 87 86 83.4 61.1 60.3 61.9 61.2

Dahod 38.4 34.8 48.5 48.6 71.8 70.3 67.3 67.9 38 35.5 44.3 42.3

Kachchha 47.8 39.1 44.5 38.3 72.5 68.1 54.8 49.3 47.4 43.9 55.1 51.4

Panchmahal 55.3 57.8 55 51 79.3 68.9 76.7 65.9 52.9 51 64.8 64.8

Valsad 79.5 67.8 56.6 58.3 75.5 72.5 71 70.3 55.6 54.7 64.3 63.7

Bharuch 70.2 65.7 64.3 59.5 87.4 83.4 77.4 74.5 62.5 60.9 70.3 72.6

Dangs 37.3 36.2 19.3 19.3 65.6 65.6 34.9 34.9 45.1 44.7 53.2 53.2

Jamnagar 60.2 52.3 73.5 73.2 79 78.4 88.2 85.3 64 63.3 69.3 71.5

Mehasana 57.7 52.9 59.2 53.8 74.9 71.3 69.1 65.9 57.3 54.7 64 63.7

Patan 56.5 50.8 56.4 52.9 79.2 75.8 70.7 68.7 53.6 51.1 67.1 67.5

Rajkot 61.4 54.2 79.6 71.3 85.1 83.7 86.9 83.9 66.9 64..1 73.4 68.7

Suredranagar 49 43.1 40.6 31.8 81.9 78.4 51.7 42.9 55.9 52.2 62.1 63.9

Ahmedabad 77.6 40.7 65.7 31.3 88.5 70.2 79.9 47.9 56.3 52.6 63.2 63.5

Banaskatha 36.2 34.6 28.5 28 63 60.5 46.5 45.5 39.4 38.5 54.6 53.5

Junagadh 60.6 54.5 75.4 70.9 88.5 86.8 85.6 82 62.9 62.6 64.8 64.8

Narmada 58.1 54.4 45.1 42.4 82.5 81.3 60.7 59.2 65.3 64.1 63.8 63.4

Bhavnagar 61.5 52.6 57.3 49.3 91.8 90.1 76.8 71.6 67 66 64.2 65.7

surat 51.9 48.7 87.8 89 71.7 69.9 76.5 82 90.7 94.6 85.7 85.9

Amreli 63.6 66.5 64.4 64.5 94.5 94.4 82.4 83.1 67.3 66.6 76.8 76.5

Gandhinagar 69.8 65.4 64.6 61.6 92.4 91.7 70.2 66.4 56.7 53.8 65.2 67.8

Kheda 68.9 65.6 67.7 63.5 84.9 82.4 77.8 75.5 64.7 62.6 69.2 69.6

Navsari 86.9 84.4 81.1 82.9 74 92.6 87.1 91.1 68.7 68.5 66.4 67.9

Gujarat 60.3 54.4 58.8 53.8 80.9 78.5 71.2 67.2 59.3 57.3 64.9 64.7

88 | P a g e

Table No. 4.1.6 Inter-District Disparities of Health Indicators in Gujarat (Contd.)

DISTRICT DELIVERY FULLY IMMUNIZATION FAMILY PLANNING



13 14 15 16 17 18 19 20 21 22 23 24

Porbander 50.4 31.9 68.1 53.4 72.7 71.4 74.8 83.2 14.2 11.8 20.5 18.5

Sabarkantha 57.6 53.8 61.5 57.8 43.1 40.3 46.8 46.9 19.8 19.9 21.8 21.5

Vado'ra 55.8 38.6 54.4 38.7 69.8 75.7 63 54.7 16.5 16.8 15.5 19.2

Anand 69.7 64.1 78.3 74.7 63.6 66.3 77 73.2 16.4 17.3 20 20.8

Dahod 43.2 35.6 60.4 59.4 17.6 13.4 34.6 35.8 25.7 27.1 36.5 37.7

Kachchha 40.3 57.1 30.9 52.2 54 47.9 46.4 46.8 28.7 28.1 24.8 26.6

Panch mahal 34.5 28.3 52.4 48.1 47.1 47 32.2 26.2 15.4 15.6 18.5 19

Valsad 66 47.5 68.4 63.5 64.7 62.4 51.1 53.6 18.7 18 20 21.8

Bharuch 37.7 25.7 47.8 35.5 82.5 78.8 59.9 58.2 12.3 11.9 16 14

Dangs 10.7 10 9.4 9.4 29.5 29.5 36.4 36.4 27.8 27.8 26.2 26.2

Jamnagar 49.7 34.1 69.3 61.8 56.8 48.9 55.1 50.2 19.6 20.6 15.2 12.6

Mehasana 74.1 68.6 84.2 81.6 54.3 52.5 72.7 75.9 20.5 20.8 16.8 17.3

Patan 52.3 43.4 61.8 57.4 53.7 50 69.2 67.5 20.3 14.6 19.6 14

Rajkot 55.7 39 68.3 55.1 70.5 62.2 74 70.9 41.4 14 14.4 19.3

Suredranagar 41.4 31.3 49 38 48.7 43.9 48.7 48.7 17 18.8 20.4 19.1

Ahmedabad 71.7 37.8 80.3 37.3 65.6 76.9 50.2 80.3 18.2 20.8 20.5 17

Banaskatha 47.7 43.4 61.8 60.6 26.1 23.2 35.1 34.5 24.3 24 21.5 22.5

Junagadh 35.8 26.7 56.3 48.4 61.1 59.6 77.6 75.9 12.5 11.7 17.5 18.6

Narmada 19.3 13.3 28.4 24.4 44.8 41.4 60.9 60.7 14.9 15.3 19.2 19.2

Bhavnagar 43.6 27.5 58.4 48.5 57.4 43.8 50.8 48.3 10.1 9.6 20.8 20.6

surat 69.8 66.4 68.9 75.3 56.5 40.7 72.3 56.4 12.4 12.1 17 13.2

Amreli 40.1 36.4 50.8 48.2 62.2 64.1 60.5 62.2 9.1 9.7 10.7 10.6

Gandhinagar 73.6 68.1 77 68.9 47.9 39.3 60.8 62.6 15.5 14.8 16 13.9

Kheda 51.3 41.9 69 66.3 60.7 57.8 61.8 55.5 9.8 10.3 15.5 14.8

Navsari 70.7 63.9 80.8 80.9 91.4 91.1 80.4 84.9 13.4 12.7 16.6 15.3

Gujarat 50.2 41.2 59.4 53.7 55.9 52.9 57.9 57.4 18.3 17.1 19.1 18.8


89 | P a g e

Table No. 4.1.7 Inter-Regional Disparities of Health Indicators in Gujarat - Districts of South Gujarat Region




1 2 3 4 5 6 7 8 9 10 11 12

Valsad 79.5 67.8 56.6 58.3 75.5 72.5 71 70.3 55.6 54.7 64.3 63.7

Bharuch 70.2 65.7 64.3 59.5 87.4 83.4 77.4 74.5 62.5 60.9 70.3 72.6

Dangs 37.3 36.2 19.3 19.3 65.6 65.6 34.9 34.9 45.1 44.7 53.2 53.2

Narmada 58.1 54.4 45.1 42.4 82.5 81.3 60.7 59.2 65.3 64.1 63.8 63.4

Surat 51.9 48.7 87.8 89 71.7 69.9 76.5 82 90.7 94.6 85.7 85.9

Navsari 86.9 84.4 81.1 82.9 74 92.6 87.1 91.1 68.7 68.5 66.4 67.9

Average 63.98 59.53 59.03 58.57 76.12 77.55 67.93 68.67 64.65 64.58 67.28 67.78

(Cont…) Table No. 4.1.7 Inter-Regional Disparities of Health Indicators in Gujarat - Districts of South Gujarat Region




13 14 15 16 17 18 19 20 21 22 23 24

Valsad 66 47.5 68.4 63.5 64.7 62.4 51.1 53.6 18.7 18 20 21.8

Bharuch 37.7 25.7 47.8 35.5 82.5 78.8 59.9 58.2 12.3 11.9 16 14

Dangs 10.7 10 9.4 9.4 29.5 29.5 36.4 36.4 27.8 27.8 26.2 26.2

Narmada 19.3 13.3 28.4 24.4 44.8 41.4 60.9 60.7 14.9 15.3 19.2 19.2

Surat 69.8 66.4 68.9 75.3 56.5 40.7 72.3 56.4 12.4 12.1 17 13.2

Navsari 70.7 63.9 80.8 80.9 91.4 91.1 80.4 84.9 13.4 12.7 16.6 15.3

Average 45.70 37.80 50.62 48.17 61.57 57.32 60.17 58.37 16.58 16.30 19.17 18.28


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Table No. 4.1.8 Inter-Regional Disparities of Health Indicators in Gujarat - Districts of Central Gujarat Region DISTRICT ANC TT INJECTION CONTRESPTIVE



1 2 3 4 5 6 7 8 9 10 11 12

Vadodara 71.1 62.1 47 32.2 89.2 83.2 59.9 48.8 61.5 58 68.9 65

Dahod 38.4 34.8 48.5 48.6 71.8 70.3 67.3 67.9 38 35.5 44.3 42.3

Panchmahal 55.3 57.8 55 51 79.3 68.9 76.7 65.9 52.9 51 64.8 64.8

Ahmedabad 77.6 40.7 65.7 31.3 88.5 70.2 79.9 47.9 56.3 52.6 63.2 63.5

Kheda 68.9 65.6 67.7 63.5 84.9 82.4 77.8 75.5 64.7 62.6 69.2 69.6

Gandh'ar 69.8 65.4 64.6 61.6 92.4 91.7 70.2 66.4 56.7 53.8 65.2 67.8

Anand 67.2 66.8 70.5 64.1 86.5 87 86 83.4 61.1 60.3 61.9 61.2

AVERAGE 63.52 54.40 58.08 48.03 84.35 77.78 71.97 62.07 55.02 52.25 62.60 62.17

Table No. 4.1.8 Inter-Regional Disparities of Health Indicators in Gujarat - Districts of Central Gujarat Region (Contd…) DISTRICT DELIVERY FULLY IMMUNIZATION FAMILY PLANNING



13 14 15 16 17 18 19 20 21 22 23 24

Vadodara 55.8 38.6 54.4 38.7 69.8 75.7 63 54.7 16.5 16.8 15.5 19.2

Dahod 43.2 35.6 60.4 59.4 17.6 13.4 34.6 35.8 25.7 27.1 36.5 37.7

Panchmahal 34.5 28.3 52.4 48.1 47.1 47 32.2 26.2 15.4 15.6 18.5 19

Ahmedabad 71.7 37.8 80.3 37.3 65.6 76.9 50.2 80.3 18.2 20.8 20.5 17

Kheda 51.3 41.9 69 66.3 60.7 57.8 61.8 55.5 9.8 10.3 15.5 14.8

Gandhinagar 73.6 68.1 77 68.9 47.9 39.3 60.8 62.6 15.5 14.8 16 13.9

Anand 69.7 64.1 78.3 74.7 63.6 66.3 77 73.2 16.4 17.3 20 20.8

AVERAGE 55.02 41.72 65.58 53.12 51.45 51.68 50.43 52.52 16.85 17.57 20.42 20.27


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Table No. 4.1.9 Inter-Regional Disparities of Health Indicators in Gujarat - Districts of North Gujarat Region

Table No. 4.1.9 Inter-Regional Disparities of Health Indicators in Gujarat - Districts of North Gujarat Region (Contd…)




13 14 15 16 17 18 19 20 21 22 23 24

Sabarkantha 57.6 53.8 61.5 57.8 43.1 40.3 46.8 46.9 19.8 19.9 21.8 21.5

Patan 52.3 43.4 61.8 57.4 53.7 50 69.2 67.5 20.3 14.6 19.6 14

Suredraganar 41.4 31.3 49 38 48.7 43.9 48.7 48.7 17 18.8 20.4 19.1

Banas'kth 47.7 43.4 61.8 60.6 26.1 23.2 35.1 34.5 24.3 24 21.5 22.5

Mehasana 74.1 68.6 84.2 81.6 54.3 52.5 72.7 75.9 20.5 20.8 16.8 17.3

Average 54.62 48.1 63.66 59.08 45.18 41.98 54.5 54.7 20.38 19.62 20.02 18.88





1 2 3 4 5 6 7 8 9 10 11 12

Sabarkantha 60.2 57.8 48.4 45.1 77.3 76.2 66.1 64.9 56.7 56 56.6 56.3

Patan 56.5 50.8 56.4 52.9 79.2 75.8 70.7 68.7 53.6 51.1 67.1 67.5

Suredraganar 49 43.1 40.6 31.8 81.9 78.4 51.7 42.9 55.9 52.2 62.1 63.9

Banas'kth 36.2 34.6 28.5 28 63 60.5 46.5 45.5 39.4 38.5 54.6 53.5

Mehasana 57.7 52.9 59.2 53.8 74.9 71.3 69.1 65.9 57.3 54.7 64 63.7

AVERAGE 51.92 47.84 46.62 42.32 75.26 72.44 60.82 57.58 52.58 50.5 60.88 60.98

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Table No. 4.1.10 Inter-Regional Disparities of Health Indicators in Gujarat - Districts of Saurastra Region

Table No. 4.1.10 Inter-Regional Disparities of Health Indicators in Gujarat - Districts of Saurastra Region(Cont…)




13 14 15 16 17 18 19 20 21 22 23 24

Porbander 50.4 31.9 68.1 53.4 72.7 71.4 74.8 83.2 14.2 11.8 20.5 18.5

Kachchha 40.3 57.1 30.9 52.2 54 47.9 46.4 46.8 28.7 28.1 24.8 26.6

Jamnagar 49.7 34.1 69.3 61.8 56.8 48.9 55.1 50.2 19.6 20.6 15.2 12.6

Rajkot 55.7 39 68.3 55.1 70.5 62.2 74 70.9 41.4 14 14.4 19.3

Junagadh 35.8 26.7 56.3 48.4 61.1 59.6 77.6 75.9 12.5 11.7 17.5 18.6

Bhavnagar 43.6 27.5 58.4 48.5 57.4 43.8 50.8 48.3 10.1 9.6 20.8 20.6

Amreli 40.1 36.4 50.8 48.2 62.2 64.1 60.5 62.2 9.1 9.7 10.7 10.6

Average 45.09 36.10 57.44 52.51 62.10 56.84 62.74 62.50 19.37 15.07 17.70 18.11





1 2 3 4 5 6 7 8 9 10 11 12

Porbander 70.4 64.8 71.4 65.1 93.9 92.6 86.6 81.5 62.2 63.3 62.2 65

Kachchha 47.8 39.1 44.5 38.3 72.5 68.1 54.8 49.3 47.4 43.9 55.1 51.4

Jamnagar 60.2 52.3 73.5 73.2 79 78.4 88.2 85.3 64 63.3 69.3 71.5

Rajkot 61.4 54.2 79.6 71.3 85.1 83.7 86.9 83.9 66.9 64.1 73.4 68.7

Junagadh 60.6 54.5 75.4 70.9 88.5 86.8 85.6 82 62.9 62.6 64.8 64.8

Bhavnagar 61.5 52.6 57.3 49.3 91.8 90.1 76.8 71.6 67 66.0 64.2 65.7

Amreli 63.6 66.5 64.4 64.5 94.5 94.4 82.4 83.1 67.3 66.6 76.8 76.5

Average 60.79 54.86 66.59 61.80 86.47 84.87 80.19 76.67 62.53 60.95 66.54 66.23

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Table No 4.1.11 Inter-Taluka Disparities of Health Indicators in Surat District: With special reference to Olpad taluka

Name of

Taluka

Block wise ANC

Regi.

Block wise

early ANC

Regi.

Delivery Regi. Institutional

Delivery

Institutional

Delivery in Govt.

06-07 07-08 06-07 07-08 06-07 07-08 06-07 07-08 06-07 07-08

1 2 3 4 5 6 7 8 9 10

Choryasi 25 37 49 50 24 34 88 80 15 11

Olpad 43 42 60 61 47 42 65 69 12 16

Palsana 47 38 62 53 38 31 68 67 14 12

Kamrej 50 54 60 62 46 44 67 71 13 11

Bardoli 39 40 74 71 34 34 67 66 10 15

Valod 41 36 72 84 42 43 57 58 9 16

Mandvi 46 40 78 83 39 41 48 47 15 12

Mangrol 54 59 68 68 48 55 63 67 10 8

Umarpada 40 42 72 68 34 37 14 10 8 5

Yyara 48 49 81 84 43 45 42 43 5 7

Songadh 40 39 79 78 38 36 47 44 21 21

Mahuva 45 51 80 81 38 38 59 57 13 7

uchhal 66 60 70 69 53 55 41 25 21 14

Nizar 66 67 66 67 36 40 23 19 13 11

Surat 48.5 47.9 71.8 72.3 40.7 41.6 49.6 47.8 12.6 11.6

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Table No 4.1.11 Inter-Taluka Disparities of Health Indicators in Surat District: With special reference to

Olpad taluka (Contd…)

Name of

Taluka

Institutional

Delivery in Pvt.

Total home

Delivery

Fully

Immuunisation

Literacy

Rate (%)

06-07 07-08 06-07 07-08 06-07 07-08 Male Female

11 12 13 14 15 16 17 18

Choryasi 73 70 12 20 62 92 75.73 61.01

Olpad 54 63 35 31 94 92 69.43 56.9

Palsana 54 55 32 33 84 98 64.7 49.28

Kamrej 54 60 33 29 92 107 59.68 48.55

Bardoli 57 52 33 34 71 80 62.34 52.34

Valod 48 42 43 42 75 92 62 48.72

Mandvi 30 35 54 53 96 92 58.3 43.75

Mangrol 53 53 37 40 93 108 59.75 43.75

Umarpada 5 5 86 90 114 121 54.35 44.25

Yyara 37 37 58 57 82 92 61.45 48.11

Songadh 26 24 53 56 90 109 52.63 36.63

Mahuva 47 50 40 43 82 89 67.71 54.07

Uchchhal 6 11 73 75 90 88 60.21 45.68

Nizar 11 9 77 81 115 142 53.05 32.6

Surat 35.7 36.1 51.6 52.8 90.3 101.5 59.7 45.6

Source: Compiled from Surat District Action Plan, 2008

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Table no. 4.1.12 Inter-district variance in health indicators

DLHF-2 DLHF-3

Total Rural Total Rural

ANC

Std. Deviation 12.5 12.08 15.95 17.24

Mean 60.68 54.92 58.89 53.91

CV 0.206 0.21996 0.27084 0.31979

TT Injection

Std. Deviation 8.54 9.36 13.68 15.09

Mean 81.22 78.99 71.61 67.67

CV 0.10515 0.1185 0.19103 0.22299

Contraceptive

Std. Deviation 10.39 11.54 7.98 8.45

Mean 59.19 57.47 64.47 64.39

CV 0.17554 0.2008 0.12378 0.13123

Delivery

Std. Deviation 16.29 16.1 17.18 16.85

Mean 50.5 41.37 59.82 53.81

CV 0.32257 0.38917 0.28719 0.31314

Fully Immunization

Std. Deviation 16.15 17.87 14.3 15.6

Mean 56.08 53.11 58.08 57.96

CV 0.28798 0.33647 0.24621 0.26915

Family Planning

Std. Deviation 7.04 5.46 4.81 5.48

Mean 18.18 16.96 19.25 18.92

CV 0.387239 0.321934 0.24987 0.289641

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Table no. 4.1.13 Inter-state variance in health indicators NFHS-1 NFHS-2 NFHS-3

Family Planning (Current married women) Current use any methods

Std. Deviation 14.98 14.01 12.8

Mean 41.28 48.69 55.11

CV 0.3629 0.2877 0.2323

Unmet need for family planning (Total unmet need %)

Std. Deviation 5.09 7.16 6.85

Mean 18.36 17.14 13.5

CV 0.2772 0.4177 0.5074

Mother who had three ANC visit for last birth (%)

Std. Deviation 24.7 24.46 20.99

Mean 46.21 50.68 59.68

CV 0.5345 0.4826 0.3517

child fully immunization and vitamin A supplementation

Std. Deviation 20.35 25.19 17.39

Mean 37.51 45.95 51.11

CV 0.5425 0.5482 0.3402

Knowledge of HIV/AIDS among Married Women

Std. Deviation NA 24.72 19.77

Mean 30.6 49.49 65.34

CV 0.49949 0.30257

Knowledge of HIV/AIDS among Married Men

Std. Deviation N.A N.A 12.34

Mean N.A N.A 82.9

CV 0.148854

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Tabel no. 4.1.14 Inter Taluka Variation in Health Indicators

2006 2007

Block wise ANC Registration

Std. Deviation 10.29 9.62

Mean 46.57 46.79

CV 0.2210 0.2056

Block wise early ANC Registration


Mean 69.52 70.07

CV 0.1283 0.1527

Delivery Registration


Mean 40.05 41.11

CV 0.175 0.168



Mean 53.24 51.39

CV 0.351 0.400

Institutional Delivery in Govt. Hospital


Mean 12.77 11.84

CV 0.338 0.353

Institutional Delivery in Private Hospital


Mean 39.38 40.14

CV 0.516 0.507

Total Home Delivery


Mean 47.84 49.12

CV 0.413 0.412

Fully Immunization


Mean 88.69 100.23

CV 0.159 0.155

Literacy Rate (%)


Mean 61.4 47.42

CV 0.101 0.152

chapter: 4 health status in gujarat and surat...

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