Transcript Slide 1

Data Analysis
Gujarat
2010
K.K.PANCHAL
Additional Director(VS)
Demographic Profile
196024
Area (Sq. km)
60383
Total Population (2011) (‘000)
Birth Rate SRS 2009
22.3
Death Rate SRS 2009
6.9
44
% of Urban Population
42.6
IMR SRS 2009
Literacy Rate-2011
79.3
MMR SRS 2007-2009
148
Sex Ratio, 2011
918
Sex Ratio at Birth SRS 2008
898
Sex Ratio in 0-6 age group
886
Sex Ratio in 0-4 age group SRS 2008
883
859
No. of inhabited Villages
18066
19.2
Village Panchayat
13753
Sex Ratio in 0 age group,2001
Decadal Growth Rate
census
172
% of SC Population-2001
7.1
% of ST Population-2001
14.8
Municipal Corporation
Literacy Rate in SCs-2001
70.5
No. of Reporting Unit –Rural
18131
Literacy Rate in ST-2001
47.7
No. of Reporting Unit - Urban
162
N.Panchayat/Municipalities
7
Registration Units - Urban Units: 162 & Rural Units: 18131
Vital Events Trends
Trend in receipt of returns
Year
Rural
Urban
Overall
2004
97.3
98.5
97.4
2005
100.0
100.0
100.0
2006
98.8
100.0
98.8
2007
100.0
100.0
100.0
2008
100.0
100.0
100.0
2009
100.0
100.0
100.0
2010
100.0
100.0
100.0
Trend in Registration of vital events
2009
2010
% increase
over 2009
Live Births
1345861
1327404
-1.4
Deaths
317985
323689
1.8
Infant Deaths
9578
8954
-6.5
Maternal
Deaths
321
151
-53
Still Births
7791
8385
7.6
Trends in Vital Registrations
2004
Registration
Trend
Birth
Death
(%)
(%)
84.2
64.0
2005
89.2
2006
96.7
64.8
73.9
2007
97.7
75.4
2008
102.4
79.4
2009
2010
103.2
101.8
110.0
103.2
79.4
79.7
101.8
96.7
89.2
90.0
84.2
80.2
80.0
75.4
73.9
70.0
64.0
64.8
60.0
% Level of Registration -Birth
79.7
80.2
102.4
97.7
100.0
Percent
Year
% Level of Registration -death
50.0
2004
2005
2006
2007
2008
2009
2010
Birth Registration by Time
Time of
2005
2006
2007
2008
2009
2010
95.1
93.5
94.7
94.6
94.5
94.3
Within 21 to 30
days
2.4
2.7
2.3
2.6
2.5
2.5
After 30 days but
within one year
1.8
2.7
1.8
1.7
1.8
2.0
After one year
0.7
1.1
1.2
1.1
1.2
1.2
Registration
Within time
Birth Registration by Time - Rural
Time of
Registration
2005
2006
2007
2008
2009
2010
Within time
94.7
93.6
93.8
93.7
93.2
92.9
Within 21 to 30 days
2.3
2.5
2.8
2.6
2.9
2.9
After 30 days but within
one year
2.0
2.6
2.1
2.2
2.3
2.5
After one year
1.0
1.3
1.4
1.5
1.6
1.8
Birth Registration by Time - Urban
Time of Registration
2005
2006
2007
2008
2009
2010
Within time
95.4
93.3
95.5
95.3
95.4
95.2
Within 21 to 30 days
2.5
2.9
2.0
2.1
2.1
2.3
After 30 days but within one
year
1.6
2.8
1.6
1.6
1.5
1.6
After one year
0.5
1.0
1.0
1.0
1.0
0.8
Percent Birth Registration by Time, Sex and Residence - 2010
Time of Registration
Rural
Urban
Combined
Within time
92.8
95.3
94.3
Within 21 to 30 days
2.9
2.3
2.5
After 30 days but within one year
2.5
1.6
2.0
After one year
1.8
0.8
1.2
Within time
92.9
95.2
94.3
Within 21 to 30 days
2.8
2.3
2.5
After 30 days but within one year
2.5
1.7
2.0
After one year
1.8
0.8
1.2
Within time
92.9
95.2
94.3
Within 21 to 30 days
2.9
2.3
2.5
After 30 days but within one year
2.5
1.6
2.0
After one year
1.8
0.8
1.2
Male
Female
Combined
Crude Birth Rates
29.0
26.7
CRS - SRS Comaprison of Crude Birth Rate - Gujarat
(1995 and 2001 to 2010`)
21.0
22.3
22.7
22.6
23.0
22.6
23.1
23.0
21.1
20.9
21.0
21.7
23.0
22.2
22.5
23.0
23.7
24.3
24.6
24.7
25.0
25.0
SRS
23.7
CRS
25.2
27.0
19.0
17.0
15.0
1995
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Navsari
Guj-2010
Surat
Guj-2009
77
73.8
90.7
86.8
Ahmadabad
116.3
2010
87.4
85.0
92
88.1
Valsad
100.7
100.7
107.3
102.2
103.2
102.8
103.0
104
103.1
122.3
121.9
123
2009
Vadodara
90.5
89.0
Gandhinagar
91.8
90.3
70.0
Jamnagar
74.2
74.2
80.0
94
90.4
90.0
Bharuch
98
94.6
100.0
Porbandar
Junagadh
Kheda
Rajkot
Anand
S'nagar
110.8
125.6
122.8
118.9
116.4
112.3
106.9
106.9
110.0
Mahesana
Narmada
Amreli
Kachchh
Bhavnagar
s' Kantha
120.0
114.8
130.5
135.3
130.4
129.7
130.0
Patan
B'Kantha
131.4
135.6
140.0
Dohad
149.1
148.7
144.9
140.6
150.0
Dangs
P.mahals
160.0
District wise level of Birth Registration
CRS 2009 and 2010
103.2
101.8
16.5
Surat
19.0
Vadodara
16.5
19.4
Ahmadabad
Navsari
19.7
Valsad
23.8
22.8
22.9
23.0
22.5
26.0
24.7
23.0
21.1
19.8
0.0
Gandhinagar
5.0
20.1
10.0
Jamnagar
15.0
20.2
20.0
Bharuch
Porbandar
Junagadh
Kheda
Rajkot
Surendranagar
Anand
Mahesana
Narmada
28.0
26.5
25.0
25.0
Amreli
Kachchh
Bhavnagar
Sabar Kantha
30.2
30.2
28.9
30.0
Patan
Banas Kantha
Dohad
Panch Mahals
33.2
33.2
35.0
The Dangs
District wise CBR Based on Registration -2010
CBR
State - CRS
State - SRS, 2009
22.7
22.6
%age Distribution of Birth Registered by type of Medical Attention – CRS 2010
Institutional Delivery by type – CRS 2010
Birth Registration by Birth Order, Total-2010
4th & above,
125266,
9%
3rd Child, 156505,
12%
1st Child, 629719,
48%
2nd child, 415914,
31%
Birth Registration by Birth order- CRS, 2010
Rural
Urban
4th & above, 72069,
14%
3rd Child, 63789,
12%
3rd Child, 63789,
12%
1st Child,
241568,
45%
1st Child, 241568,
45%
2nd child, 154800,
29%
4th & above,
72069,
14%
2nd child,
154800,
29%
Graduate and
above
2%
Not stated
5%
Illiterate
25%
Matric but
below Graduate
12%
Primary but
below Matric
29%
Children by level
of Mother’s
Education
3+ Children
Below Primary
27%
2+ Children
Graduate and
above
1%
Matric but
below Graduate
9%
Not stated
8%
Illiterate
30%
Primary but
below Matric
27%
Below Primary
25%
Crude Death Rates
CRS-SRS Comparison of Death Rate -Gujarat
(1995 and 2001 to 2010)
5.5
6.9
5.5
6.9
5.5
6.9
7.2
5.4
7.1
5.3
2006
2007
2008
2009
2010
4.6
6.9
5.1
4.9
4.5
5.0
4.9
4.6
5.4
7.0
6.0
7.1
7.6
7.7
7.8
8.0
7.5
7.6
9.0
4.0
3.0
2.0
1.0
0.0
1995
2000
2001
2002
2003
2004
CRS
2005
SRS
Death Registered by Medical Attention - 2010
90949, 28%
Institutional
Medical Attention other than
Institution
No Medical Attention
20486, 6%
212254, 66%
Percent Death Registration by Time, Sex and Residence -2010
Time of Registration
Rural
Urban
Combined
Within time
94.2
88.2
91.5
Within 21 to 30 days
2.0
2.5
2.2
After 30 days but within one year
2.8
7.5
4.9
After one year
1.1
1.6
1.3
Within time
94.1
88.0
91.1
Within 21 to 30 days
2.1
2.6
2.4
After 30 days but within one year
2.7
7.7
5.1
After one year
1.2
1.6
1.4
Within time
94.1
88.2
91.3
Within 21 to 30 days
2.0
2.6
2.3
After 30 days but within one year
2.7
7.6
5.0
After one year
1.1
1.6
1.4
Male
Female
Combined
41.8
40.0
30.0
41.0
78.4
79.3
80.1
81.9
81.9
55.9
63.2
64.2
64.1
67.6
69.1
77.5
75.7
76.8
72.5
70.8
72.8
74.2
74.6
86.7
83.5
82.5
83.0
88.6
88.7
92.4
92.6
102.9
104.1
100.9
96.6
94.0
91.3
92.9
95.1
95.8
101.0
101.8
104.0
2009
2010
Guj-2009
Gug-2010
Dohad
B'Kantha
Kachchh
S.nagar
P'Mahals
Surat
Jamnagar
S'Kantha
Gandhinagar
75.2
73.4
52.6
50.0
Bhavnagar
60.0
78.1
74.0
70.0
Junagadh
Patan
Porbandar
Amreli
Valsad
Vadodara
74.8
80.0
Rajkot
Mahesana
Kheda
A'Bad
Narmada
88.9
90.0
Dangs
Bharuch
Navsari
106.5
100.7
100.0
Anand
110.0
District wise level of Death
Registration 2009 and 2010
2.0
1.0
0.0
5.1
5.1
5.1
5.2
5.3
5.3
Dohad
Banas Kantha
Kachchh
Panch Mahals
4.4
4.6
4.9
2.8
3.0
Surat
3.9
4.0
5.0
5.0
Surendranagar
Bhavnagar
Junagadh
Rajkot
Jamnagar
Sabar Kantha
Gandhinagar
Amreli
Porbandar
5.7
5.7
6.5
6.4
6.3
6.9
6.7
6.4
6.1
5.8
6.0
Patan
Dangs
Valsad
Mahesana
Vadodara
Kheda
Ahmadabad
Anand
7.1
7.2
7.0
7.0
Narmada
Bharuch
Navsari
District wise CDR based CRS–2010
8.0
6.9
CDR as per CRS 2008
State CDR as per CRS
CDR as per SRS, 2008
6.9
Sex Ratio at Birth
Sex Ratio at Birth, Comparison with SRS & CRS
Year
1
2
3
4
5
6
2003
2005
2007
2008
2009
2010
SRS Estimates
As per CRS
Total
862
835
Rural
876
855
Urban
827
813
Total
855
824
Rural
876
842
Urban
807
806
Total
891
879
Rural
915
881
Urban
848
877
Total
898
883
Rural
922
886
Urban
856
881
Total
904
905
Rural
929
907
Urban
859
904
Total
NA
902
Rural
NA
920
Urban
NA
890
SEX RATIO AT BIRTH REGISTRATION Gujarat: 2001-10 (CRS)
920
905
902
900
883
879
880
870
860
845
840
835
826
824
820
802
800
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Valsad
Vadodara
Surat
S'nagar
s' Kantha
Rajkot
Porbandar
Patan
P.mahals
Navsari
Narmada
Mahesana
1000
Kheda
Kachchh
Junagadh
Jamnagar
Gandhinagar
Dohad
Dangs
B'Kantha
Bhavnagar
Bharuch
Anand
Amreli
Ahmadabad
Comparision of Sex Ratio 0-6 Age Group, 2011 and CRS - 2010
2011 (0-6 age Group)
2010
CRS 2009
CRS 2010
950
900
850
800
750
Medical certification of cause of death
Importance of Mortality data
 Impact of health services in community – Deciding priorities
 Access the effectiveness of health programme
 Detect changes in mortality pattern
 Scientific base for Medical Research
 Evaluation of Health Indicators
MEDICAL CERTIFICATION OF CAUSE OF
DEATH
 Based on provision of Registration of Birth and Death Act 1969
 Part of Civil Registration System, operational in many states in the
beginning of 70s.
 Based on ICD 10 ofWHO
 National List of Mortality
21 Major Groups (chapter), 3 volumes and structure of coding pattern is
alphanumeric of ICD 10.
 Medical Certification of Cause of Death (Cont..)
However, the implementation and coverage of MCCD scheme
is not uniform at all levels. The office of the Registrar General,
India is reviewing proper implementation of MCCD scheme
along with the implementation of RBD Act.
Medical Certification of Cause of Death
In Gujarat
The Registration of Births and Deaths Act, 1969 came into
force in the state of Gujarat from 01-04-1970. With the
introduction of Gujarat Registration of Births and Deaths
Rules, 1973 from 18-04-1973, all civil surgeons and medical
officers of referral hospitals were intimated to introduce the
certification of death as per prescribed Performa under the
rule.
Legal Provisions
 Medical Certification of Cause of Death under Civil
Registration System has got statutory backing under
sections 10(2) and 10(3) of the Registration of Births &
Deaths Act, 1969.
 The Act also incorporates a clause (section 17(1)(b)) about
the confidentiality of the information on cause of death,
forbidding to disclose this in any extract provided from the
registration records.
Legal Provisions
Section 10(2):
 In any area, the state Govt. having regard to the facilities
available therein in this behalf, may require that a certificate as
to the cause of death shall be obtained by the Registrar from
such person and in such form as may be prescribed.
Legal Provisions
Section 10(3):
Where the state Govt. has required under subsection 10(2) that a
certificate as to the cause of death shall be obtained, in the event of
the death of any person who during his last illness, was attended by a
medical practitioner, the medical practitioner shall, after the death of
that person, forthwith, issue cause of death certificate according to
best of his/her knowledge and experience, without charging any fee, to
the person required under this Act to give information concerning the
death.
Legal Provisions
 Section 17(1)(b):
Subject to any rules made in this behalf by the State Govt. including
rules relating to the payment of fees and postal charges, any person
may obtain an extract from such registrar relating to any birth or death;
provided that no extract relating to any person, shall disclose the
particulars regarding the cause of death as entered in the register.
Legal Provisions
 Under Section 23(3) of the RBD Act, any Medical Practitioner who
neglects or refuses to issue a certificate under section 10(3) and any
person who neglects or refuses to deliver such certificate shall be
punishable with fine, which may extend to fifty rupees.
Status of MCCD in Gujarat
 The MCCD scheme has initially been implemented at four teaching
hospitals- Ahmedabad, Vadodara, Surat and Jamnagar. Later Rajkot and
Bhavnagar included in the scheme. Currently apart from above all six
medical college, all municipal corporation reports MCCD data. And From
2009 all 27 district hospitals are going to report MCCD data.
 Presently we are in phase III of the training schedule. Means training of
CHC’s doctors and coders with sub district hospitals. Then letter on
PHC’s doctors and some of remaining private doctors will train.
Medical certified deaths reported 2002- 10
67181
70000
58940
60000
51248
50000
35122
40000
32210
30000
22140
17719
19367
18052
20000
10000
2002
2003
2004
2005
2006
2007
2008
2009
2010
Year wise deaths covered under MCCD 2002 to 2010
Units
2002
2003
2004
2005
2006
2007
2008
2009
2010
AHMEDABAD*
4727
4933
3627
5025
14762
17212
18455
19074
19057
VADODARA*
2619
3006
3130
2069
3029
3001
5387
7117
6943
SURAT*
5409
5881
6349
8576
8033
7394
17212
16753
18626
JAMNAGAR*
1518
1632
1375
1309
2178
1748
1785
2371
5104
RAJKOT*
1706
2222
1950
2397
2598
3281
2851
6517
8379
BHAVNAGAR*
1743
1693
1621
1764
1610
1870
676
1483
2929
KARMSAD
-
-
-
-
-
-
-
-
577
DIST. HOSP.**
-
-
-
-
-
616
4973
5625
4489
CHC
-
-
-
-
-
-
-
-
1077
TOTAL
17719
19367
18052
22140
32210
35122
51248
58940
67181
* = INCLUDE DATA OF MUNICIPAL CORPORATION AREA & PRIVATE HOSPITAL
** = INCLUDE ALL DIST. HOSPITAL DATA
AGE AND GENDER WISE DISTRIBUTION OF DEATHS
Age
Group
<1
1–4
5 – 14
15 – 24
25 – 34
35 – 44
45 – 54
55 – 64
65 – 69
70+
Total
Male
Nos.
% age
3918
9.5
Female
Nos. % age
2702
10.5
Total
Nos.
% age
6620
9.8
782
1097
2699
1.9
2.6
6.5
671
822
2371
2.6
3.2
9.2
1453
1919
5070
2.2
2.9
7.5
3784
5044
6413
6457
9.1
12.2
15.5
15.6
2491
2353
2708
2969
9.6
6.1
10.5
11.3
6275
7397
9121
9426
9.3
11.0
13.6
14.0
3268
7916
41378
7.9
19.1
100.0
1846
6871
25803
7.1
26.6
100.3
5114
14786
67181
7.6
22.0
100.0
SIX major causes of deaths 2005 to 2010
2005
2006
2007
2008
2009
2010
Diseases of the Circulatory System
(I00-I99)
16.88
22.64
20.66
20.50
20.92
18.62
I
Certain Infectious and Parasitic
Diseases (A00-A99)
21.01
18.68
16.41
14.36
13.49
14.66
X
Diseases of the Respiratory System
(J00-J99)
4.14
5.67
6.31
6.06
9.46
10.52
XVI
Certain Conditions Originating in the
Peri natal Period (P00-P99)
11.79
10.15
8.50
6.60
6.48
5.93
XIX
Injury, Poisoning, and certain other
Consequences of External Causes
(S00-T98)
12.70
4.67
10.31
6.34
5.77
7.10
16.78
17.20
14.28
25.69
24.13
23.29
MG
IX
Major Categories of ICD10
Symptoms, Signs and Abnormal
Clinical and Laboratory FindingsXVIII Not classified Else where
(R00-R99)
Leading cause of deaths according to Major categories MCCD, 2010
Othe r Gr oups
19.8%
Sym ptom
Signs and
Abnor m al
clinical
Findings NEC
(R00-R99)
23.3%
Ce r tain
Condition
Or iginating in
the pe r inatal
pe r iod (P00P96) 5.9%
Injur y,
Pois oning and
Ce r tain Othe r
Cons e que nce
s of Exte r nal
Caus e (S00T98) 7.1%
Dis e as e s of
the Cir culator y
Sys te m (I00I99) 18.6%
Dis e as e s of
the
Re s pir ator y
Sys te m (J00J98) 10.6%
Ce r tain
Infe ctious and
Par as itic
dis e as e s (A00B99) 14.7%
80
90
10
0
Death by Six Major Category and Age Group
CATEGORY IX
CATEGORY I
CATEGORY X
CATEGORY XVI
CATEGORY XIX
0
10
20
30
40
50
60
70
CATEGORY XVIII
I
<1
1-
4
5-
14
4
-2
5
1
4
-3
5
2
4
-4
5
3
4
-5
5
4
4
-6
5
5
9
-6
5
6
0
>7
XVI
Certain condition originating in the perinatal period
IX
Certain Infectious and Parasitic
Diseases
Diseases of circulatory system
XVIII
X
Diseases of the respiratory system
XIX
Symptoms, signs and abnormal clinical and laboratory
findings not elsewhere classified
Injury, poisoning and certain other consequences of
external causes
PREGNANCY, CHILD BIRTH AND
PUERPERIUM (O00-O99)
PREGNANCY WITH
ABORTIVE OUTCOME
(O00-O08)
3.57%
OTHER OBSTETRIC
CONDITIONS, NOT
ELSEWHERE CLASSIFIED
(O95-O99)
17.43%
OTHER DIRECT OBSTETRIC
DEATHS (O10-O92)
79%
Oedema, proteinuria
and hypertensive
disorder 17.56%
Other complication of
pregnancy 63.51%
obstructed labour
1.35%
Complication predominantly related to
the puerperium
17.56%
INFANT DEATHS <1 YEARS
(SPECIFIC CAUSE OF MORTALITY)-2010
CAT: XVII Conge nital
M alfor m ation,
De for m ation &
Chr om os om al
Abnor m alitie s (Q00-Q99)
6.7%
CAT: IX Dis e as e s of the
Cir culator y s ys te m (I00I99) 1.9%
Othe r m ajor Gr oups
8.1%
CAT: X Dis e as e s of
Re s pir ator y Sys te m (J00J98)
7.4%
CAT:XVI Ce r tain
Conditions Or iginating in
the Pe r inatal Pe r iod (P00P96)
60.2%
CAT: I Ce r tain Infe ctious
& Par as itic Dis (A00-B99)
15.5%
All other conditions
orignating in the
perinatal periosd
33.98%
Slow fetal grow th, fetal
m alnutrition and
im m atury
23.6%
Birth traum a
0.35%
Haem olytic diseases of
fetus and new -born
0.88%
Hypoxia,birth traum a and
other respiratory
conditions
41.29%
COMPERISION OF CERTAIN CONDITION ORIGINATING IN
THE PERINATAL PERIOD (<1YEAR)
CERTAIN CONDITION ORIGINATING IN THE PERINATAL
PERIOD (P00-P96)
2008
2009
2010
NO.
%
NO.
%
NO.
%
1802
53.30
1313
34.37
941
23.6
2
0.06
17
0.45
14
0.35
HYPOXIA,BIRTH ASPHYXIA AND OTHER RESPIRATORY
CONDITIONS (P20-P28)
977
28.90
1337
35.00
1645
41.29
HAEMOLYTIC DISEASES OF FETUS AND NEW BORN
(P55)
10
0.30
15
0.39
35
0.88
OTHER PERINATAL JAUNDICE (P58-P59)
8
0.24
8
0.21
5
0.12
582
17.21
1130
29.58
1354
33.98
SLOW FETAL GROWTH, FETAL MALNUTRITION AND
IMMATURITY (P05-P07)
BIRTH TRAUMA (P10-P15)
ALL OTHER CONDITIONS ORIGINATING IN THE
PERINATAL PERIOD (P00-P04,P08,P29-P54,P56-P57,P60P96)
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