Data Analysis Gujarat

2010

K.K.PANCHAL

Additional Director(VS)

Demographic ProfileArea (Sq. km) 196024

Total Population (2011) (‘000) 60383

% of Urban Population 42.6

Literacy Rate-2011 79.3

Sex Ratio, 2011 918

Sex Ratio in 0-6 age group 886

Sex Ratio in 0 age group,2001 census 859

Decadal Growth Rate 19.2

% of SC Population-2001 7.1

% of ST Population-2001 14.8

Literacy Rate in SCs-2001 70.5

Literacy Rate in ST-2001 47.7

Birth Rate SRS 2009 22.3

Death Rate SRS 2009 6.9

IMR SRS 2009 44

MMR SRS 2007-2009 148

Sex Ratio at Birth SRS 2008 898

Sex Ratio in 0-4 age group SRS 2008 883

No. of inhabited Villages 18066

Village Panchayat 13753

N.Panchayat/Municipalities 172

Municipal Corporation 7

No. of Reporting Unit –Rural 18131

No. of Reporting Unit - Urban 162

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

Year Registration Trend

Birth (%)

Death (%)

2004 84.2 64.0

2005 89.2 64.8

2006 96.7 73.9

2007 97.7 75.4

2008 102.4 79.4

2009 103.2 79.7

2010 101.8 80.2

84.2

89.2

96.797.7

102.4 103.2 101.8

64.064.8

73.975.4

79.4 79.7 80.2

50.0

60.0

70.0

80.0

90.0

100.0

110.0

2004 2005 2006 2007 2008 2009 2010

Per

cent

% Level of Registration -Birth

% Level of Registration -death

Birth Registration by Time

Time of

Registration

2005 2006 2007 2008 2009 2010

Within time 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

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

Male

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

Female

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

Combined

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

Crude Birth Rates

CRS - SRS Comaprison of Crude Birth Rate - Gujarat (1995 and 2001 to 2010`)

25

.2

21

.7

21

.0

20

.9

23

.0

21

.1

22

.5

22

.2

23

.1

23

.0

22

.7

26

.7

25

.0

24

.7

24

.6

24

.3

23

.7

23

.7

23

.0

22

.6

22

.6

22

.3

15.0

17.0

19.0

21.0

23.0

25.0

27.0

29.0

1995 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

CRS SRS

13

1.4

13

0.5

13

0.4

12

2.8

12

3

12

1.9

12

2.3

10

6.9

10

4

11

6.3

10

3.2 1

07

.3

10

0.7

98

94

91

.8

90

.5 92

90

.7

87

.4

74

.2 77

14

9.1

14

8.7

13

5.6

13

5.3

12

9.7

12

5.6

11

8.9

11

6.4

11

2.3

11

0.8

10

6.9

10

3.1

10

3.0

10

2.8

10

2.2

10

0.7

94

.6

90

.4

90

.3

89

.0

88

.1

86

.8

85

.0

74

.2

73

.8

14

0.6

14

4.9

11

4.8

70.0

80.0

90.0

100.0

110.0

120.0

130.0

140.0

150.0

160.0

P.m

ahal

s

Dan

gs

Doh

ad

B'K

anth

a

Pata

n

s' K

anth

a

Bha

vnag

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Kac

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Am

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Nar

mad

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Mah

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S'n

agar

Ana

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Raj

kot

Khe

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Juna

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Porb

anda

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Bha

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Jam

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Gan

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Val

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Ahm

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Vad

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Nav

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2009 2010

Guj-2009 Guj-2010

District wise level of Birth Registration CRS 2009 and 2010

103.2

101.8

District wise CBR Based on Registration -2010

33.2

33.2

30.2

30.2

28.9

28.0

26.5

26.0

25.0

24.7

23.8

23.0

23.0

22.9

22.8

22.5

21.1

20.2

20.1

19.8

19.7

19.4

19.0

16.5

16.5

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0T

he D

angs

Pan

ch M

ahal

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Doh

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Ban

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anth

a

Pat

an

Sab

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anth

a

Bha

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Kac

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Am

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Nar

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Ana

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Sur

endr

anag

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Juna

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Por

band

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Bha

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Sur

at

CBRState - 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

2nd child, 415914, 31%

3rd Child, 156505, 12%

1st Child, 629719, 48%

4th & above, 125266,

9%

Birth Registration by Birth order- CRS, 2010

Rural Urban

1st Child, 241568, 45%

4th & above, 72069, 14%

3rd Child, 63789, 12%

2nd child, 154800, 29%

1st Child, 241568,

45%

4th & above, 72069, 14%3rd Child, 63789,

12%

2nd child, 154800,

29%

Children by level of

Mother’s Education

2+ Children

3+ Children

Primary but below Matric

27%

Not stated8%

Graduate and above

1%Matric but below Graduate

9% Illiterate30%

Below Primary25%

Graduate and above

2%

Matric but below Graduate

12%

Primary but below Matric

29%

Not stated5%

Below Primary27%

Illiterate25%

Crude Death Rates

CRS-SRS Comparison of Death Rate -Gujarat (1995 and 2001 to 2010)

5.4

4.6 4

.9

4.5

4.9 5

.1

4.6

5.3 5.4 5.5

5.5

5.5

7.6

7.5 7

.8

7.7

7.6

6.9 7

.1

7.1 7.2

6.9

6.9

6.9

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

1995 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

CRS SRS

Death Registered by Medical Attention - 2010

90949, 28%

20486, 6%

212254, 66%

Institutional

Medical Attention other thanInstitution

No Medical Attention

Percent Death Registration by Time, Sex and Residence -2010

Time of Registration Rural Urban Combined

Male

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

Female

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

Combined

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

10

6.5

10

4.0

10

1.8

10

1.0

95

.8

95

.1

92

.9

88

.7

88

.6

81

.9

81

.9

80

.1

79

.3

78

.4

78

.1

75

.2

74

.6

74

.2

72

.8

69

.1

67

.6

64

.2

63

.2

52

.6

41

.8

10

0.7 10

4.1

10

2.9

88

.9

10

0.9

96

.6

94

.0

92

.6

74

.8

92

.4

91

.3

83

.0

82

.5

83

.5

74

.0

73

.4

77

.5

76

.8

75

.7

70

.8

86

.7

72

.5

64

.1

55

.9

41

.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

110.0

Ana

nd

Nav

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2009 2010

Guj-2009 Gug-2010

District wise level of Death Registration 2009 and 2010

District wise CDR based CRS–20107.

2

7.1

7.0

6.9

6.7

6.5

6.4

6.4

6.3

6.1

5.8

5.7

5.7

5.3

5.3

5.2

5.1

5.1

5.1

5.0

4.9

4.6

4.4

3.9

2.8

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

Nav

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Bha

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CDR as per CRS 2008

State CDR as per CRS

CDR as per SRS, 2008

6.9

6.9

Sex Ratio at Birth

Sex Ratio at Birth, Comparison with SRS & CRS

Year SRS Estimates As per CRS

1 2003

Total 862 835

Rural 876 855

Urban 827 813

2 2005

Total 855 824

Rural 876 842

Urban 807 806

3 2007

Total 891 879

Rural 915 881

Urban 848 877

4 2008

Total 898 883

Rural 922 886

Urban 856 881

5 2009

Total 904 905

Rural 929 907

Urban 859 904

6 2010

Total NA 902

Rural NA 920

Urban NA 890

802

826

835

824

845

870

879883

905902

800

820

840

860

880

900

920

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

SEX RATIO AT BIRTH REGISTRATION Gujarat: 2001-10 (CRS)

Comparision of Sex Ratio 0-6 Age Group, 2011 and CRS - 2010

750

800

850

900

950

1000A

hmad

abad

Am

reli

Ana

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Bha

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Bha

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Sur

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Vad

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2011 (0-6 age Group)

2010

CRS 2009

CRS 2010

Medical certification of cause of death

Importance of Mortality dataImpact of health services in community –

Deciding prioritiesAccess the effectiveness of health

programme Detect changes in mortality pattern Scientific base for Medical ResearchEvaluation of Health Indicators

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 of WHO 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

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 (Cont..)

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.

Medical Certification of Cause of Death In Gujarat

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

Legal ProvisionsSection 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.

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

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

1771919367

18052

22140

3221035122

51248

58940

67181

10000

20000

30000

40000

50000

60000

70000

2002 2003 2004 2005 2006 2007 2008 2009 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

Year wise deaths covered under MCCD 2002 to 2010

AGE AND GENDER WISE DISTRIBUTION OF DEATHS

Age

Group

Male Female Total

Nos. % age Nos. % age Nos. % age

<1 3918 9.5 2702 10.5 6620 9.8

1 – 4 782 1.9 671 2.6 1453 2.2

5 – 14 1097 2.6 822 3.2 1919 2.9

15 – 24 2699 6.5 2371 9.2 5070 7.5

25 – 34 3784 9.1 2491 9.6 6275 9.3

35 – 44 5044 12.2 2353 6.1 7397 11.0

45 – 54 6413 15.5 2708 10.5 9121 13.6

55 – 64 6457 15.6 2969 11.3 9426 14.0

65 – 69 3268 7.9 1846 7.1 5114 7.6

70+ 7916 19.1 6871 26.6 14786 22.0

Total 41378 100.0 25803 100.3 67181 100.0

SIX major causes of deaths 2005 to 2010

MG Major Categories of ICD10 2005 2006 2007 2008 2009 2010

IXDiseases of the Circulatory System (I00-I99)

16.88 22.64 20.66 20.50 20.92 18.62

ICertain Infectious and Parasitic Diseases (A00-A99)

21.01 18.68 16.41 14.36 13.49 14.66

XDiseases of the Respiratory System (J00-J99)

4.14 5.67 6.31 6.06 9.46 10.52

XVICertain Conditions Originating in the Peri natal Period (P00-P99)

11.79 10.15 8.50 6.60 6.48 5.93

XIXInjury, Poisoning, and certain other Consequences of External Causes (S00-T98)

12.70 4.67 10.31 6.34 5.77 7.10

XVIII

Symptoms, Signs and Abnormal Clinical and Laboratory Findings- Not classified Else where

(R00-R99)

16.78 17.20 14.28 25.69 24.13 23.29

Leading cause of deaths according to Major categories MCCD, 2010

Symptom Signs and Abnormal

clinical Findings NEC

(R00-R99) 23.3%

Diseases of the Circulatory

System (I00-I99) 18.6%

Certain Infectious and

Parasitic diseases (A00-

B99) 14.7%

Diseases of the

Respiratory System (J00-

J98) 10.6%

Injury, Poisoning and Certain Other Consequences of External Cause (S00-

T98) 7.1%

Certain Condition

Originating in the perinatal period (P00-

P96) 5.9%

Other Groups 19.8%

I Certain Infectious and Parasitic Diseases

XVI Certain condition originating in the perinatal period

IX Diseases of circulatory system XVIII Symptoms, signs and abnormal clinical and laboratory findings not elsewhere classified

X Diseases of the respiratory system XIX Injury, poisoning and certain other consequences of external causes

Death by Six Major Category and Age Group

CATEGORY XVIII CATEGORY IX CATEGORY I

CATEGORY X CATEGORY XVI CATEGORY XIX

PREGNANCY, CHILD BIRTH AND PUERPERIUM (O00-O99)

PREGNANCY WITH ABORTIVE OUTCOME

(O00-O08) 3.57%

OTHER DIRECT OBSTETRIC DEATHS (O10-O92)

79%

OTHER OBSTETRIC CONDITIONS, NOT

ELSEWHERE CLASSIFIED (O95-O99)

17.43%

Oedema, proteinuria and hypertensive disorder 17.56%

obstructed labour 1.35%

Complication pre-dominantly related to

the puerperium 17.56%

Other complication of pregnancy 63.51%

INFANT DEATHS <1 YEARS(SPECIFIC CAUSE OF MORTALITY)-2010

CAT:XVI Certain Conditions Originating in the Perinatal Period (P00-

P96) 60.2%

CAT: I Certain Infectious & Parasitic Dis (A00-B99)

15.5%

CAT: X Diseases of Respiratory System (J00-

J98) 7.4%

CAT: XVII Congenital Malformation, Deformation & Chromosomal

Abnormalities(Q00-Q99) 6.7%

CAT: IX Diseases of the Circulatory system (I00-

I99) 1.9% Other major Groups 8.1%

Slow fe tal grow th, fe tal m alnutrition and

im m atury 23.6%

Birth traum a 0.35%

Hypoxia,birth traum a and other respiratory

conditions 41.29%

Haem olytic diseases of fe tus and new -born

0.88%

All other conditions orignating in the

perinatal periosd 33.98%

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. %

SLOW FETAL GROWTH, FETAL MALNUTRITION AND IMMATURITY (P05-P07)

1802 53.30

1313

34.37

941 23.6

BIRTH TRAUMA (P10-P15) 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

ALL OTHER CONDITIONS ORIGINATING IN THE PERINATAL PERIOD (P00-P04,P08,P29-P54,P56-P57,P60-P96)

582 17.21

1130

29.58

1354

33.98

Thanks

Challenges only accelerate the development Journey.