Baseline Survey On Child and Related Maternal Health Care-Revised Report - Rajasthan-494 - 1

NIPI Baseline Survey report for the state of Rajasthan
BASELINE SURVEY ON
CHILD AND RELATED
MATERNAL HEALTH CARE
Revised Report
Prepared For:
Norway India Partnership Initiative,

New Delhi
Client Contact:
Mr P.K. Hota
Director, NIPI,
NIPI Secretariat
11 – Golf Links,
New Delhi - 110003
DRS Pvt. Ltd.
GVL Narsimha Rao

Development & Research Services Private Limited
1st Floor, A1/19
Safdarjung Enclave
New Delhi - 110029
India
e: nrao@drsindia.org
August , 2009
Development & Research Services Pvt Ltd Page 0 of 123

CONTENTS
Page No.
Fact Sheets…………………………………………………………………………………………………..7
Chapter 1 Introduction ..................................................................................................................... 9
1.1 Background of NIPI ......................................................................................................... 9

1.2 Research Objectives ..................................................................................................... 10
1.3 Study Phases ................................................................................................................ 10
1.4 Study Area ..................................................................................................................... 10
1.4.1 Ongoing health related programs in Rajasthen ............................................................ 10
1.5 Profile of Rajasthan & NIPI Districts .............................................................................. 11
1.5.1 Profile of Rajasthan ..................................................................................................... 11
1.5.2 Profile of Alwar District .................................................................................................. 13
1.5.3 Profile of Bharatpur District .......................................................................................... 14
1.5.4 Profile of Dausa District ............................................................................................... 17
1.6 Survey Design ............................................................................................................... 19
1.6.1 Sampling strategy at District level ................................................................................. 19
1.7 Quantitative and Qualitative instruments ...................................................................... 21
1.7.1 Quantitative data collection ........................................................................................... 21
1.7.2 Qualitative data collection ............................................................................................. 22
1.8 Recruitment, training and Field work ............................................................................. 23
1.8.1 Recruitment of the field staff.......................................................................................... 23
1.8.2 Translation of the schedules and Pre-testing ................................................................ 23
1.8.3 Field Training & Data collection Manuals ...................................................................... 23
1.9 Quality assurance processed adopted during baseline field survey ............................. 24
1.9.1 Quality assurance adopted during the training ............................................................. 24
1.9.2 Role of Supervisor ......................................................................................................... 24
1.9.3 Quality assurance visits by the central teams ............................................................... 24
1.9.4 Monitoring visits by NIPI team ....................................................................................... 24
1.9.5 Other quality control measures ..................................................................................... 24
1.10 Data Processing ............................................................................................................ 24
1.11 Achieved Sample……………………………………………………………………………..25
Chapter 2 Household Characteristics ............................................................................................ 26
2.1 Household demographic profile .................................................................................... 26

2.2 Socio-economic profile of household ............................................................................ 28
2.3 Education level of the household population ................................................................ 29
2.4 Household characteristics ............................................................................................. 30
2.5 Household possessions ................................................................................................ 34
2.6 Construction of Wealth Index…………………………………………….………………..36
Chapter 3 Characteristics of Survey Respondents ....................................................................... 36
3.1 Background characteristics ........................................................................................... 38

3.2 Exposure to mass media ............................................................................................... 40
3.3 Employment Status ....................................................................................................... 40
3.4 Age at first cohabitation ................................................................................................. 42
3.5 Children ever born and living……………………………………………………………...42

.................................................................................................................. Page No.
Chapter 4 Maternal Health ............................................................................................................ 44
4.1 Antenatal Care .............................................................................................................. 44

4.1.1 Pregnancy registration and ANC provider ..................................................................... 44
4.1.2 Timing and number of ANC ........................................................................................... 46
4.1.3 Components of Antenatal Care ..................................................................................... 47
4.1.4 Health problems and treatment seeking behaviour during pregnancy ......................... 49
4.2 Delivery Care ................................................................................................................. 52
4.2.1 Influence of background characteristics choice of place of delivery ............................. 52
4.2.2 Arrangement and cost of transport ................................................................................ 54
4.2.3 Institutional delivery ....................................................................................................... 54
4.2.4 Janani Suraksha Yojana (JSY) ..................................................................................... 57
4.2.5 Training and Capacity Building of ASHA……………………………………………….58
4.2.5 Home deliveries ............................................................................................................. 59
4.3 Postnatal care ............................................................................................................... 63
Chapter 5 Newborn Care ............................................................................................................... 65
5.1 Preamble ....................................................................................................................... 65

5.2 Infant Mortality……………………………………………………………………………….65
5.3 Child Mortality………………………………………………………………………………..65
5.4 Birth weight .................................................................................................................... 66
5.5 Breastfeeding and Supplementation…………………………………………………….67
Chapter 6 Child Morbidity and Treatment ..................................................................................... 72
6.1 Prevalence of illness in children under study ................................................................ 72

6.1.1 Point prevalence of diarrhea and illness ....................................................................... 72
6.1.2 Awareness of Diarrheoa ................................................................................................ 73
6.1.3 Treatment of Dirrahoea ................................................................................................. 73
6.2 Acute Respiratory Infection ........................................................................................... 74
6.2.1 Knowledge about pneumonia ........................................................................................ 74
6.3 Fever ............................................................................................................................. 75
6.3.1 Illness with fever and cough and treatment seeking behaviour .................................... 75
6.3.2 Preventive Measures for child‟s sickness ..................................................................... 76
6.3.3 Feeding Practices During Illness ................................................................................... 76
Chapter 7 Child Immunization ....................................................................................................... 77
7.1 Preamble ....................................................................................................................... 77

7.2 Vaccination coverage .................................................................................................... 77

Page No.
Chapter 8 Status of Health Facilities ......................................................................................... 82
8.1 Status of District hospital (DHs) .................................................................................... 82

8.1.1 Physical Infrastructure ................................................................................................... 82
8.1.2 Availabillity of human resources ............................................................................... 82
8.1.3 Services Delivered by District Hospitals .................................................................. 82
8.1.4 A Monitoring and Supervision Activities .................................................................. 83
8.1.5 Equipment ..................................................................................................................... 83
8.2 Status of Community Health Centre (CHCs)................................................................. 83

8.2.1 Infrastructure ................................................................................................................. 84
8.2.2 Availability of Human Resource ................................................................................ 84
8.2.3 Trainings Status of CHC Staff .................................................................................... 84
8.2.4 Investigation Facility ................................................................................................... 84
8.2.5 Labor Room and Operation Theatre .......................................................................... 84
8.2.6 Storage Facility ........................................................................................................... 84
8.2.7 Laboratory .................................................................................................................... 85
8.2.8 Physical Facilities ....................................................................................................... 85
8.2.9 Furniture/Instrument ................................................................................................... 85
8.2.10 OT Equipments ............................................................................................................ 85
8.2.11 Cold Equipments ......................................................................................................... 85
8.2.12 Vaccines and Prophylactic Drugs ............................................................................. 85
8.2.13 Essential Services ....................................................................................................... 85
8.2.14 Maternal and Child Health Services .......................................................................... 85
8.3 Status of Primary Health Centre (PHCs) ................................................................... 85

8.3.1 Infrastructure ............................................................................................................... 86
8.3.2 Availability of Human Resources .............................................................................. 86
8.3.3 Training Status of PHC Staff ...................................................................................... 86
8.3.4 Stock of Vaccines and Prophylactic Drugs .............................................................. 87
8.3.5 Equipment .................................................................................................................... 87
8.4 Status of Sub Centre (SCs) ........................................................................................ 87
8.4.1 Availability of Human Resource at SCs .................................................................... 87
8.4.2 Training Status in SCs ................................................................................................ 87
8.4.3 Physical Infrastructure ............................................................................................... 88
8.4.4 Staying facility of ANM ............................................................................................... 88
8.4.5 Furniture Availability................................................................................................... 88
8.4.6 Availability of Equipment ........................................................................................... 88
8.4.7 Availability of Essential Kits ...................................................................................... 88
8.4.8 Labor Room ................................................................................................................. 88
8.4.9 Availability of Specific Services ................................................................................ 88
8.4.10 Monitoring and Supervision Activities ...................................................................... 89
Annexure Tables……………………………………………………………………………..90

LIST OF TABLES
Table 1.1: Key Health Indicators of the state
Table 1.2: Coverage by Target Group and Research Technique (State Level)
Table 1.3: Coverage by Target Group and Research Technique (District Level)
Table 1.4: Coverage by Target Group and Research Technique (Block level)
Table 1.5: District wise sample coverage status
Table 2.1: Household population by age and sex, Rajasthan, NIPI-08
Table 2.2: Household population by age and sex, District Alwar, NIPI-08
Table 2.3: Percent distribution of household population by age, sex and residence, District
Bharatpur, NIPI-08
Table 2.4: Household population by age and sex, District Dausa, NIPI-08
Table 2.5: Household composition, NIPI-08
Table 2.6: Household composition, NIPI-08
Table 2.7: Education attainment by gender of household member in terms of years of schooling,
NIPI-08
Table 2.8: Educational attainment by location of PSU in terms of years of schooling, NIPI-08
Table 2.9: Type of house
Table 2.10: Source of Drinking Water
Table 2.11: Drinking water storage and filtration practices, NIPI-08
Table 2.12: Sanitation Facility, NIPI-08
Table 2.13: Cooking Environment, NIPI-08
Table 2.14: Ownership of Immovable Assets, NIPI-08
Table 2.15: Main Source of Household Income, NIPI-08
Table 2.16: Household Wealth Index, NIPI-08
Table 2.17: Financial Access, NIPI-08
Table 3.1: Age distribution of women respondents, NIPI-08
Table 3.2: Distribution of Women Respondents by religion and ethnicity, NIPI-08
Table 3.3: Education status of women respondents, NIPI-08
Table 3.4: Frequency of Exposure , NIPI-08
Table 3.5: Employment Status of eligible women by background characteristics, NIPI-08
Table 3.6: Membership in SHGs and Mahila mandals, NIPI-08
Table 3.7: Age at first cohabitation, NIPI-08
Table 4.1: Percentage of pregnancies registers vs. key background variables, NIPI-08
Table 4.2: Received ANC Card
Table 4.3: Incidence of receiving ANC during last pregnancy, NIPI-08
Table 4.4: Place of ANC
Table 4.5: ANC Provider, NIPI-08
Table 4.6: Number of ANC received and timing of ANCs received, NIPI-08
Table 4.7: Proportion of eligible women having received different components of ANC care, NIPI-
08
Table 4.8: Nature of ANC services received, NIPI-08
Table 4.9: TT injections vs. number of ANCs, NIPI-08
Table 4.10: Knowledge about health problems during pregnancy, NIPI-08
Table 4.11: Incidence of Health Problems during pregnancy, NIPI-08
Table 4.12: Nature of health problems faced during last pregnancy, NIPI-08
Table 4.13: Percentage of women who sought advice for health problem during pregnancy, NIPI-
08
Table 4.14: Person persuaded for treatment during pregnancy
Table 4.15: Place of delivery v/s age of respondents, NIPI-08
Table 4.16: Place of delivery v/s years of schooling, NIPI-08
Table 4.17: Place of Delivery v/s number of live children, NIPI-08
Table 4.18: Place of Delivery v/s economic status of respondent‟s household, NIPI-08
Table 4.19: Average Transportation Expenses, NIPI-08
Table 4.20: Nature of Institutional Delivery, NIPI-08
Table 4.21: Cost Incurred on Institutional Delivery
Table 4.22: Problems experienced during delivery by woman of different age groups, NIPI-08
Table 4.23: Nature of advice received after delivery by source, NIPI-08
Table 4.24: Mother‟s perception about environment of health facility and behavior of staff
Table 4.25: Awareness about JSY, NIPI-08

Table 4.26: Training of ASHA‟s
Table 4.27: Accompaniment of ASHA during Institutional Delivery
Table 4.28: Duration of stay of the mother at health facility after delivery
Table 4.29: Reason for Home Delivery
Table 4.30: Home Delivery Practices
Table 4.31: Person who conducted delivery at home, NIPI-08
Table 4.32: Reasons behind choosing a specific person to conduct the delivery
Table 4.33: The Delivery Process, NIPI-08
Table 4.34: Cost Incurred In Home Delivery
Table 4.35: Nature of advice received
Table 4.36: Number of times PNC recieved
Table 5.1: Trends in Infant Mortality Rate of Rajasthan and India
Table 5.2: Trends in Under five mortality Rate for Rajasthan and India
Table 5.3: Recorded weight of baby
Table 5.4: Mother‟s perception about adequacy of size of newborn
Table 5.5: Timing of first neonatal check-up
Table 5.6: Time of first neonatal check-up by Districts
Table 5.7: Breastfeeding Practices
Table 5.8: Initiation of Breastfeeding and gender of child
Table 5.9: Initiation of Breastfeed and education of mother
Table 5.10: Initiation of Breastfeed and number of live children
Table 5.11: Feeding of Prelacteal liquids
Table 5.12: Period of exclusive breastfeeding by background variables
Table 6.1: Prevalence of illness in children under study
Table 6.3: Point prevalence of Diarrhoea and illness
Table 6.4: Period prevalence of diarrhea and illness
Table 6.5: Advice received from ANM or health worker
Table 6.6: Place of treatment
Table 6.7: Proportion of mothers aware of pneumonia
Table 6.8: Treatment of Pneumonia
Table 6.9: Incidence of fever and cough among children in last 2 weeks prior to survey contact
Table 6.10: Duration of treatment sought during illness
Table 7.1: Immunization Schedule
Table 7.2: Vaccination from card and Recall
Table 7.3: Polio vaccine coverage by background variables
Table 7.4: Child Immunization Coverage in NIPI Districts, Rajasthan
Table 7.5: DPT vaccine coverage by background variables
Table 7.6: Coverage of Measles vaccine and Vitamin A by background variable
Table 7.7: Place of Immunization received

LIST OF FIGURES
Figure 4.1: Percent of Mothers who received three or more antenatal checkups
Figure 4.2: Percent of Mothers who consumed IFA for 90 days and Received 2 or more TT during
Pregnancy
Figure 4.3: Institutional delivery and births assisted by health personnel
Figure 6.1: Type of practices to be followed if child gets diarrheoa
Figure 6. 2: Awareness of symptoms of pneumonia
Figure 6.3: Preventive measures taken for avoiding child sickness
FACT SHEETS

RAJASTHAN
District: ALWAR
Baseline Summary Indicators
Indicator N %
Mothers registered in the first trimester when they were pregnant with last live birth/still birth 703 69.1
Mothers who had at least 3 Ante-Natal Care visits during the last pregnancy 472 49.3
Total number of deliveries (home plus institutional) 1281 NA
Institutional deliveries 803 46.4
Average Retention period (hours) in case of institutional delivery 34.4 NA
Post natal care provided to mother and neonates - Children had check-up within 24 hours after delivery (based
622 48.4
on last live birth)
Post natal care provided to mother and neonates -Children had check-up within 10 days after delivery (based on
706 54.9
last live birth)
Mothers who received post natal care within 48 hours of delivery of their last child 50 41.7
Referral done for mothers with illness and complications during pregnancy 752 78.1
Children with Diarrhoea in the last two weeks who received ORS 32 18.8
Children with Diarrhoea in the last two weeks who were given treatment 100 58.8
Children with acute respiratory infection/fever in the last two weeks who were given treatment 105 77.2
Children (age 6 months above) exclusively breastfed 301 38.6
Children (12-23 months) fully immunized (BCG, 3 doses each of DPT, and Polio and Measles) 89 60.5
New born Babies immunized with zero dose polio and BCG 1 33.3
New born Babies – breastfed within 1 hour of birth 261 20.8
Newborn with birth weight taken after delivery at home 26 5.4
District: BHARATPUR
Indicator N %
Mothers who had at least 3 Ante-Natal Care visits during the last pregnancy 472 49.3
Institutional deliveries 851 53.1
675 50.7
on last live birth)
858 64.7
last live birth)
Children (12-23 months) fully immunized (BCG, 3 doses each of DPT, and Polio and Measles) 84 64.6
New born Babies immunized with zero dose polio and BCG 2 100

District: DAUSA
Indicator N %
Mothers who had at least 3 Ante-Natal Care visits during the last pregnancy 565 47
Institutional deliveries 934 71
670 50.5
on last live birth)
858 64.7
last live birth)
Children (12-23 months) fully immunized (BCG, 3 doses each of DPT, and Polio and Measles) 104 69
New born Babies immunized with zero dose polio and BCG 2 50

CHAPTER 1
INTRODUCTION
1.1 Background of NIPI
As per the Millennium Development Goal 4 (MDG), India has to reduce its Child Mortality Rate (CMR)
by two-thirds between 1990 and 2015. It implies that India has to reduce its under five mortality rates to
38 er 1000 live births by 2015 (UNICEF, SOWC 2008) to achieve the MDGs. However, the office of the
registrar general of India has recently cautioned that, after a rapid decline during 1980-90, the IMR in
India has stagnated since 1993 at the level of 72 [GoI 2000] This means that the programs which
addressed the problem of child mortality (reproductive and child health program, immunization
program, ICDS) were no longer effective in further reducing the IMR, and a larger proportion of infant
deaths were now contributed by neonatal deaths because this component is influenced little by the
current programs [GoI 2000]. India has made progress in the reduction of child mortality with the
average annual rate of reduction in U5 mortality between 1990 and 2006 being around 2.6 per cent.
If India is to reach the MDG Goal of 38 by 2015, the average annual rate of reduction over the next
nine years must be far higher, or around 7.6 per cent. (Source: UNICEF, SOWC 2008)
Efforts of Norway India Partnership Initiative
For India‟s success in achieving Millennium Development Goal four (MDG 4), Norway-India
Partnership Initiative (NIPI) collaborated towards the reduction of child mortality in Indian states.
Norway and India have agreed to collaborate towards achieving MDG 4 based on commitments made
by the Prime Ministers of the two countries.
The NIPI intends to provide an up-front, catalytic and strategic support to accelerate the
implementation of National Rural Health Mission (NRHM 2005-2012) in five states that comprise 40%
of India‟s total population and account for around 60% of child deaths viz., Uttar Pradesh, Bihar,
Madhya Pradesh, Rajasthan and Orissa and evolve multiple partners, including UNICEF and WHO.
About 2.4 million children under the age of five die every year in India, of which 1.4 million die in the 5
NIPI focus states. These states pose an enormous challenge in implementation because of the socio-
economic factors, large inequalities, weak health system and poor program management capacity.
The initiative aims to achieve measurable outcomes in line with the fourth ''millennium development
goals'' (MDG-4) including a sustained routine immunization coverage rate at 80 per cent or more from
2007 onwards and saving an additional 0.5 million under-5 children each year from 2009.
The Norway India Partnership Initiative will focus on four core areas in the five high-prevalence states
 Strengthening the National Rural Health Mission, by supporting an independently managed

enabling network and facilitating delivery of MDG-4 related services
 Testing and introduction of new ways of scaling up quality services by community health workers
(ASHAs) at the village level in the five states including their support needs and referral
requirements
 Involving the private sector in the delivery of MDG 4 related services at all levels
 Exploring and providing upfront catalytic financial and strategic support for new opportunities under
the NRHM-MDG-4 related activities
NIPI is planned to test some innovative ideas and provide various inputs to the existing RCH programs
under NRHM. These interventions are expected to have impact on the service delivery and outcome. In
order to achieve the monitoring and evaluation objectives, the initiative will have a comprehensive
baseline assessment on child and related maternal health care in the four NIPI focus states.

This baseline study is conducted during the year 2008-2009 in three phases (each phase covered
three Districts from NIPI states) in 12 Districts. For the study in 2 states (MP and Orissa ) Taylors &
Nielsen Sofreys (TNS Pvt. Ltd) was designated as research agency and for 2 states (Bihar and
Rajasthan) Development & Research Society (DRS) was designated as research agency,
additionally, TNS Pvt Ltd was also assigned the Executive Summary report of findings from all 4 states
1.2 Research Objectives
The present baseline survey on child and related maternal health care has the following objectives:
1. Identifying gaps in the existing service delivery mechanism to reduce infant mortality and to
improve maternal health
2. Assessment of Needs and opportunities at various levels
3. Developing benchmark indicators for the implementation of the project
1.3 Study Phases
This current baseline study comprises of three phases, viz.,
1 Review of available literature on child health and related maternal health, desk research and
field review to identify information gaps
2 Collection of data on the identified gaps (not limited to) by using qualitative and quantitative
research techniques
3 Dissemination of study findings and summary report generation
The Phase 1 of NIPI Baseline survey was conducted during the year 2008 in the month of February-
March. In Phase 1, information about child and related maternal health care was collected through
desk research and interviews were conducted with the health functionaries and other stakeholders at
state and district levels.
In Phase 2, the survey was conducted during December 2008 and January 2009. For Phase 2,
interviews were conducted at block and village level with the service providers and block officials who
cater to the needs of child and maternal activities. The study states were Orissa, Madhya Pradesh,
Bihar and Rajasthan. This report contains the detailed findings for the state of Rajasthan.
1.4 Study area
In this baseline survey, the data were collected from the three NIPI focus districts; Alwar, Bharatpur
and Daus and relevant information from the State level. The districts are selected by NIPI in
consultation with the State NRHM for implementation of the interventions.
1.4.1 Ongoing health related programs in Rajasthan
In order to improve the implementation of several child and related maternal health activities, certain
programs are ongoing currently such as of Janani Suraksha Yojana, Yashoda and IMNCI (Integrated
Management of Neonatal Childhood) program.

1.5 Demographic Profile of NIPI states
1.5.1 About Rajasthan and NIPI districts
Rajasthan is the largest state of the Republic of India in terms of area. It encompasses most of the
area of the large, inhospitable Great Indian Desert (Thar Desert), which has an edge paralleling the
Sutlej-Indus river valley along its border with Pakistan. The reghion borders Pakistan to the west,
Gujrat to the south-west, Madhya Pradesh to the southeast, Uttar Pradesh and Haryana to the
northeast and Punjab to the north. Rajasthan covers an area of 3,42,269 sq.km, the largest for any
Indian state.
The state capital is Jaipur, which is famous to the world as the “Pink City”, attracting foreigners from all
over the globe to have a glimpse at its rich heritage. Rajasthan‟s economy is primarily agricultural and
pastoral. Wheat and barley are cultivated over large areas, as are pulses, sugarcane and oilseeds.
Cotton and tobacco are the major cash crops. Rajasthan is also the biggest wool-producing state in
India and main opium producer and consumer.
According to the 2001 Census, Rajasthan had a population of 56.5 million, of which around 13.2 million
dwell in the urban areas, while 43.3 million live in the rural areas.
There are 33 districts in Rajasthan, of which three districts namely Alwar, Bharatpur and Dausa are
selected by NIPI for specific intervention programs.
The literacy rate is 61.03% for the state of Rajasthan as a whole with 75.70% of males and 43.85% of
females being literate. The 2001 census data has revealed that the population density for the state is
165 persons per sq. km, which is quite low as compared to the national average. The sex-ratio for the
state is 921 females per thousand male population. Table 1.1 presents the key health indicators for the
state of Rajasthan as well as the three selected districts of Alwar, Bharatpur and Dausa.

Table 1.1: Key Health Indicators of the state
Birth rate SRS-2003 30.3

SRS-2004 29
SRS-2005 28.6
Trends in Fertility (TFR) N.F.H.S.-II 3.78
N.F.H.S.-III 3.21
Trends in Contraceptive Prevalent Rate N.F.H.S.-II 40.3
N.F.H.S.-III 47.2
Contraceptive Prevalence Rate (Modern Methods) N.F.H.S.-II 38.1
N.F.H.S.-III 44.4
Trend in Contraceptive Prevalence Rate
Modern Spacing Methods (IUD, Pills and Condom)
N.F.H.S.-II 6
N.F.H.S.-III 10
Women with 2 Children Who Want No More Children (%) N.F.H.S.-II 58.3
N.F.H.S.-III 72.8
Women with 2 Daughters Who Want No More Children (%) N.F.H.S.-II 12.5
N.F.H.S.-III 33.1
Trend in Antenatal Care (3 ANC visits)-% of women who received 3 ANC
visits
N.F.H.S.-II 23.6
N.F.H.S.-III 41.2
Trends in Institutional Delivery N.F.H.S.-II 21.5
N.F.H.S.-III 32.2
Trends in Vaccination Coverage N.F.H.S.-II
N.F.H.S.-III
Percentage of Children Age 12-23 Months Received BCG N.F.H.S.-II 53.9
N.F.H.S.-III 68.5
Percentage of Children Age 12-23 Months Received 3 Polio N.F.H.S.-II 44.6
N.F.H.S.-III 65.2
Percentage of Children Age 12-23 Months Received Measles N.F.H.S.-II 27.1
N.F.H.S.-III 42.7
Percentage of Children Age 12-23 Months Received 3 DPT N.F.H.S.-II 26.1
N.F.H.S.-III 38.7
Immunization Coverage (% of children age 12-23 months received BCG+3
Polio+3 DPT+ Measles)
N.F.H.S.-II 17.3
N.F.H.S.-III 26.5

1.5.2 Alwar District
Alwar district is situated in the north-east of Rajasthan between 27 4‟ and 28 4‟ north latitudes and
76 7‟ and 77 13‟ east longitudes. It is bounded on the north and north-east by Gurgaon district of
Haryana State and Bharatpur district and on the north-west by Mahendragarh district of Punjab State,
on the south-west by Jaipur district and on the south by Sawai Madhopur and Jaipur district. The total
area of the district is 8380 sq kms. The district headquarters is located at Alwar.
As of 2001India census, Alwar had a population of 29, 90,862. Males constitute 53% of the population
and females 47%. Alwar has an average literacy rate of 73%, higher than the national average of
59.5%; with 59% of the males and 41% of females literate. 13% of the population is under 6 years of
age. Sex Ratio is 887 females per 1000 males.
The health infrastructure available with the district is as follows:
District Headquarters Hospital - 1
City Dispensaries - 5
P.H.C - 70
CHC - 24

NIPI
DLHS-2 DLHS-3
INDICATORS BASELINE
(2002 – 04) (2007 – 08)
(2008-09)
Maternal Health Total Rural Total Rural Total Rural
Mothers registered in the first trimester when they were pregnant with last
- - 21.7 18.9 69.1 67.1
live birth/still birth (%)
Mothers who had at least 3 Ante-Natal Care visits during the last
23.7 20.8 14.4 11.5 49.3 44.1
pregnancy (%)
Mothers who got at least one TT injection when they were pregnant with
62.3 58.9 36.7 34.2 90.9 89.9
their last live birth / still birth (%) #
Institutional births (%) 22.2 15.0 45.9 42.7 46.4 46.3
Delivery at home & other places assisted by a doctor/nurse /LHV/ANM (%) 14.5 9.7 10.6 10.1 8.5 8.6
Mothers who received post natal care within 48 hours of delivery of their
- - 28.3 25.9 41.7 41.9
last child (%)
Child Immunization and Vitamin A supplementation:
Children (12-23 months) fully immunized (BCG, 3 doses each of DPT, and
23.5 20.9 25.1 24.3 60.5 58.8
Polio and Measles) (%)
Children (12-23 months) who have received BCG (%) 67.6 59.5 75.7 73.9 97.3 96.6
Children (12-23 months) who have received 3 doses of Polio Vaccine (%) 36.6 35.5 55.6 55.8 81.6 79.0
Children (12-23 months) who have received 3 doses of DPT Vaccine (%) 34.5 32.4 28.5 26.6 79.6 77.3
Children (12-23 months) who have received Measles Vaccine (%) 39.0 33.6 54.7 51.3 63.3 62.2
Children (9-35 months) who have received at least one dose of Vitamin A
- - 30.4 28.6 50.3 48.7
(%)
Children (above 21 months) who have received three doses of Vitamin A
- - 12.5 12.1 8.2 7.4
(%)
Treatment of childhood diseases (children under 3 years based on
last two surviving children)
Children with Diarrhoea in the last two weeks who received ORS (%) 28.0 21.0 22.3 19.3 13.2 13.3
Children with Diarrhoea in the last two weeks who were given treatment
51.6 54.0 38.1 37.9 58.8 58.5
(%)
Children with acute respiratory infection/fever in the last two weeks who
- - 57.3 54.2 77.2 75.8
were given treatment (%)
Children had check-up within 24 hours after delivery (based on last live
- - 29.7 27.3 53.7 52.0
birth)(%)
Children had check-up within 10 days after delivery (based on last live
- - 27.9 25.9 54.9 52.9
birth) (%)
Child feeding practices (Children under 3 years)
Children breastfed within one hour of birth (%) - - 35.8 34.3 20.8 21.2
Children (age 6 months above) exclusively breastfed (%) - - 40.3 41.9 20.4 16.7
Children (6-24 months) who received solid or semisolid food and still being
- - 90.1 90.2 41.1 38.9
breastfed (%).
1.5.3 Bharatpur District
Bharatpur district lies in the north-eastern part of the state. It forms boundaries with Gurgaon district of
Haryana in the north and north-east. Dhaulpur district lies in the south and Sawai Madhopur, Dausa
and Alwar district in its west. It shares common boundaries with the district Dausa in south-west and
district Alwar in the North-West. Bharatpur is also being called as Lohagarh.The population of the
district is nearly 2.10 million, with a population density of 414 persons per sq.km. The literacy rate
stands at 64.24 percent, which is higher in comparison to the state literacy rate (61.03%). The total
working population is 27.05 percent, which is composed of both main workers and marginal workers.

P.H.C - 57
CHC - 13

DLHS-2 DLHS-3 NIPI BASELINE

INDICATORS
(2002 – 04) (2007 – 08) (2008-09)
Mothers registered in the first trimester when they were pregnant
- - 16.6 13.6 50.20 50.20
with last live birth/still birth (%)
21.7 21.7 8.0 6.1 35.7 38.7
pregnancy (%)
Mothers who got at least one TT injection when they were pregnant
65.5 64.6 24.0 20.0 93.4 92.8
with their last live birth / still birth (%) #
Delivery at home & other places assisted by a doctor/nurse
7.0 6.5 4.4 4.7 4.0 3.9
/LHV/ANM (%)
Mothers who received post natal care within 48 hours of delivery of
- - 23.8 22.4 37.5 35.9
their last child (%)
Children (12-23 months) fully immunized (BCG, 3 doses each of
12.5 8.2 16.9 15.5 64.6 59.1
DPT, and Polio and Measles) (%)
Children (12-23 months) who have received 3 doses of Polio Vaccine
21.2 17.9 30.1 27.2 76.2 73.1
(%)
Children (12-23 months) who have received 3 doses of DPT Vaccine
21.2 17.9 25.3 23.1 79.2 75.3
(%)
Children (9-35 months) who have received at least one dose of
- - 17.6 15.8 63.1 54.8
Vitamin A (%)
Children (above 21 months) who have received three doses of
- - 8.5 7.1 2.8 -
Vitamin A (%)
Treatment of childhood diseases (children under 3 years based on
last two surviving children)
Children with Diarrhoea in the last two weeks who were given
76.2 76.7 48.1 45.8 69.9 69.6
treatment (%)
Children with acute respiratory infection/fever in the last two weeks
- - 56.1 53.4 83.6 81.1
who were given treatment (%)
Children had check-up within 24 hours after delivery (based on last
- - 24.1 22.6 53.7 48.4
live birth)(%)
Children had check-up within 10 days after delivery (based on last
- - 25.1 23.4 56.1 51.4
live birth) (%)
Children (6-24 months) who received solid or semisolid food and still
- - 89.9 90.5 44.1 40.3
being breastfed (%).

1.5.4 Dausa district (Distt Profile and Map)
Dausa is situated in the eastern part of Rajasthan. It is bound in the north by Alwar district, in the south
by Sawai Madhopur district, in the west by Jaipur district and in the east by Bharatpur district. The
population of the district is nearly 1.30 million, with a population density of 384 persons per sq.km. The
literacy rate stands at 62.75 percent, which is higher in comparison to the state literacy rate (61.03%).
The total working population is 30.70 percent, which is composed of both main workers and marginal
workers. Dausa district lies at 26 52 N latitude and 76 20 E longitude with a total area of 2, 950 Sq.
Km's. As of 2001 India census, Dausa had a population of 13, 16,790.

P.H.C - 29
CHC - 7

NIPI
DLHS-2 DLHS-3
INDICATORS BASELINE
(2002 – 04) (2007 – 08)
(2008-09)
Mothers registered in the first trimester when they were pregnant with
- - 25.2 23.6 55.80
last live birth/still birth (%) 55.10
27.9 27.9 22.1 20.5 43.5 47.0
pregnancy (%)
Mothers who got at least one TT injection when they were pregnant
62.8 61.6 47.1 45.9 92.4 92.1
with their last live birth / still birth (%) #
Delivery at home & other places assisted by a doctor/nurse /LHV/ANM
14.4 13.7 12.0 11.9 9.0 8.3
(%)
Mothers who received post natal care within 48 hours of delivery of
- - 44.7 42.2 33.3
their last child (%) 33.3
Children (12-23 months) fully immunized (BCG, 3 doses each of DPT,
19.0 16.0 48.0 47.3 69.3
and Polio and Measles) (%) 79.1
Children (12-23 months) who have received 3 doses of Polio Vaccine
27.4 25.2 73.3 74.2 83.3 86.3
(%)
Children (12-23 months) who have received 3 doses of DPT Vaccine
27.6 25.5 53.2 52.5 82.0 84.9
(%)
Children (9-35 months) who have received at least one dose of Vitamin
- - 40.6 39.2 56.0 59.0
A (%)
Children (above 21 months) who have received three doses of Vitamin
- - 22.6 22.6 7.2 7.3
A (%)
Treatment of childhood diseases (children under 3 years based
on last two surviving children)
Children with Diarrhoea in the last two weeks who were given
50.6 48.9 65.5 64.9 70.1 67.7
treatment (%)
Children with acute respiratory infection/fever in the last two weeks
- - 62.9 61.7 92.8
who were given treatment (%) 91.2
Children had check-up within 24 hours after delivery (based on last live
- - 46.1 44.0 62.1 60.0
birth)(%)
Children had check-up within 10 days after delivery (based on last live
- - 44.5 42.2 64.7 62.3
birth) (%)
Children (6-24 months) who received solid or semisolid food and still
- - 91.8 91.8 47.9 47.0
being breastfed (%).

1.6 Survey Design
In Phase II, the sampling frame took into consideration district, village, and household units. The target
population included was women who gave birth within the past two years, as these are the main
beneficiaries of the interventions to be provided by NIPI and the outcome indicators needed for the
study was generated by interviewing them.
Note: The sampling strategy given below describes the methods of selecting the respondents from a
study district.
1.6.1 Sampling strategy at district level
We used a two-stage stratified cluster sampling technique for the selection of respondents (women
who gave birth during the past two years) in this study. We covered 50 PSUs from each of the study
districts. The number of clusters covered in a district was allocated according to the proportion of rural
and urban population in the district. At the first stage, number of rural PSUs/villages was selected using
probability proportional to size (PPS) sampling technique. Within the PSU/village, selection of the
eligible respondents was done using systematic random sampling approach.
Similarly the allocated number of urban PSUs/wards was selected using probability proportional to size
(PPS) sampling technique. Within the PSU/ward, selection of the eligible respondents was done using
systematic random sampling approach. The 2001 Census list of towns/cities and villages of the study
districts served as the sampling frame for the selection of PSUs. As the selection of the respondents is
done randomly using two-stage sampling strategy each individual member of the target group of
respondents in the district had an equal chance of inclusion in the survey.
Inclusion Criteria
- Households with currently married women who delivered a child in last two
years or who were pregnant in the last two years.
- Oral informed consent of the selected respondent
Sample size determination in NIPI Baseline study

The following formula was used to determine the sample size required in a district:
nD
 2 P(1  P) Z1  P1 (1  P1 )  P2 (1  P2 ) Z1  
2
2
Where:
D = Design effect
P1 = the estimated proportion at the time of the baseline survey;
P2 = the proportion at end line such that the quantity (P2 - P1) is the size of the magnitude of change it
is desired to be able to detect;
P = (P1 + P2) / 2;
Z1- = the z-score corresponding to the probability with which it is desired to be able to conclude that
an observed change of size (P2 - P1) would not have occurred by chance; and

Z1- = the z-score corresponding to the degree of confidence with which it is desired to be certain of
detecting a change of size (P2 - P1) if one actually occurred.
 =0.05 (Z1- = 1.96); =0.20 (Z1-=0.84); D = 2
With a power of 80 percent and with 5% precision, the sample size required at 95% confidence is
obtained for different variable values for both Bihar and Rajasthan. We considered 3 variables namely,
IMR, NMR and percentage deliveries taken place in institutions.
The objective of NIPI program is to act as a catalyst in the process, which leads to reduction in infant
and neonatal mortality. Percentage of institutional deliveries is an indicator of the improvement in
service delivery, which will have direct bearing on the survival of newborn. Taking a bigger sample size
has implications on cost and time. So a sample size of 1200 was decided for each district, which
provided us statistically viable estimates for most of the indicators under consideration.
Sampling procedure
Primary sampling units
The allocated number of villages/wards (PSUs) within a district was selected using Probability
proportional to size (PPS) technique and by involving all the villages/wards in the district. The sampling
interval was obtained by dividing the total cumulative population of the district by the total number of
villages/wards. All villages/wards were listed in one column, their corresponding population in another
column and the cumulative population in yet another column. A random start of villages/wards was
included and was done by selecting a random number between 1 and the maximum number in the
sampling interval. The remaining villages/wards were then selected by adding the sampling interval to
the cumulative population of villages/wards.
Listing of eligible women in a PSU
Each selected PSU was initially listed for the identification of eligible respondents (woman who
delivered a baby in the last two years or woman who was pregnant in the last two years). After listing
the eligible respondents in a PSU, from each PSU we covered 24 eligible respondents using
systematic random sampling approach. It implies that from each PSU we have information about 24
pregnancies irrespective of their outcome and from a district, we have information about 24x50=1200
pregnancies at baseline. Thus we covered a total sample size of 3600 pregnancies in a state.
As suggested by earlier by TAC, it was decided to cover 1200 samples of children in the age group of
12-23 months, 600 infants (in less than one year) and all the neonates (0-28 days) in the PSU. With the
understanding of covering 10 percent of the samples, a sample size of 24 children/respondents per
PSU was worked out with 10 percent of over sampling to avoid the risk of unresponsive candidates.
With a sample size of 24 children aged 0-23 months per PSU, we got one neonate per PSU resulting in
a total sample size of 50 neonates in the study. In order to get statistically robust estimates of
indicators of newborn care practices and contacts by health worker, a sampling size of 136 was
derived. So with the proposed quota sampling wherein, from each PSU, we selected 2-3 neonates (<1
month), 9-10 children of 1-11 months and 12 children of 12-23 months. This sample size was adequate
to get an estimate of the indicator under consideration with 95% confidence, 10% precision and a
design effect of 2.
Proposed Sample Size Confidence Precision

per district Limit
Neonates (0 – 28 days) 136 95% 10%
Infants including neonates 550 95% 5%
Children 12-23 months 600 95% 5%

1.7 Quantitative and Qualitative instruments
The baseline data needed for the present study was obtained by using qualitative and quantitative data
collection techniques and the target groups for the surveys were different stakeholders who were the
beneficiaries and the implementers of the maternal and child health care interventions in the selected
study districts and the states.
1.7.1 Quantitative data collection
As part of Quantitative survey we conducted cross-sectional survey based on the WHO and UNICEF
Rapid Assessment Procedure.
1.7.1.1 Questionnaires
Information on various indicators pertaining to MCH was collected that would assist policy makers and
program managers to formulate and implement the goals set for NIPI program. TAC steering
committee had reviewed and made necessary modifications in one of the Questionnaires: Women
Questionnaires. These questionnaires were discussed and finalized in training cum workshop during
the first week of November 2008
All the questionnaires were bilingual, with questions in both regional and English language.
The details of questionnaires are as follows:
Household Questionnaires: The household questionnaire lists all usual residents in sample
household including visitors who stayed in the household the night before the interview. For each listed
household member, the survey collected basic information on age, sex and education. Information was
also collected on the household characteristics such as main source of drinking water, type of toilet
facility, source of cooking fuel, religion and caste of household head and ownership of other durable
goods in the household.
Women Questionnaire: Women questionnaire is designed to collect information from currently

married women 15-45 years who gave birth in last two years. The women questionnaire covered the
following sections:
Section I: Women characteristics: In this section the information collected on age, educational status
and birth and death history of biological children including still birth, induced and spontaneous
abortions.
Section II: In this section the questionnaire collect information only from the women who had live birth,
still birth, spontaneous or induced abortion during last two years preceding the survey date. The
information on whether women received antenatal and postpartum care, who attended the delivery and
the nature of complication during pregnancy for recent births were also collected.
Section III: Institutional Delivery: This section gives information about women who went to health facility
for delivery, mode of transport arranged for delivery, assistance provided by ASHA, experience of
health problems during the time of delivery and advises given by health practitioners on newborn care
practices.
Section IV: Home Delivery: This section covers the information about deliveries conducted at home,
place used for home delivery, health personnel attended to conduct the delivery, clean practices
adopted for delivery, check up conducted by ASHA
1.7.1.2 Facility Survey Questionnaires
Under facility survey, District Hospitals, Community Health Centres (CHCs), Primary Health Centres
(PHCs), and Sub-Centres (SCs) are covered in each of the NIPI intervention district. For each of the
health facility, a separate questionnaire was designed and information was collected in the following
areas:
 Availability of Human Resources

 Training
 Investigative & Laboratory services
 Availability of Infrastructure
 Residential Facility for Staff
 Equipments
 Availability of drugs
In each of the facility, various information under above mentioned heads was collected keeping in mind
the IPHS guidelines. In each district, District Hospital, one CHC, 6 PHCs and 30 SCs were decided to
cover to get a fair understanding of the status of health facilities in the district.
1.7.2 Qualitative data collection
As part of Qualitative study, we conducted in-depth interviews (IDI) with various stakeholders involved
in maternal and newborn care issues at village, block, district and state level. The purpose of
qualitative study was to assess the input, process and output indicators of the interventions proposed.
It may be noted that the main purpose of quantitative survey was to understand the different aspects of
program delivery and management as a facilitating/debilitating factor to contain mortality levels of
infants and P/L mothers.
Qualitative study was carried out through In-depth interview of various health
functionaries/stakeholders in a state, district and block level.
Table 1.2: Coverage by Target Group and Research Technique (State Level)
Target Group Research Per Per
Technique district state
Health/ FW/RCH Director IDI 2 6
NRHM-PMU/ Mission Director IDI 1 3
ICDS-PD/ Commissioner IDI 1 3
NGO Coordinator IDI 1 3
PO - Immunisation IDI 1 3
Consultant – Child Health IDI 1 3
PO – Planning/SPM IDI 1 3
DD-Statistics IDI 1 3
Finance Officer IDI 1 3
State IEC Officer IDI 1 3
Table 1.3: Coverage by Target Group and Research Technique (District Level)
DM/DC IDI 1 3
CMHO IDI 1 3
DIO IDI 1 3
DIECO IDI 1 3
NRHM-DPM IDI 1 3
DAM IDI 1 3
MIS Offficer IDI 1 3
RKS IDI 1 3
ICDS-PO IDI 1 3
NGO IDI 1 3
Provider Association – IMA, Pvt Doctor Association, Nurses IDI 1 3
Association
District hospital, Civil Surgeon IDI 1 3

Table 1.4: Coverage by Target Group and Research Technique (Block level)
ASHAs of the surveyed PSUs IDI 50 150

AWWs of the surveyed PSUs IDI 50 150
PRI leader IDI 50 150
VHSC IDI 50 150
ANM IDI 25 75
ANM FGD 3 9
BEE IDI 5 15
BMO IDI 5 15
CDPO IDI 5 15
LHV IDI 5 15
1.8 Recruitment, training and Field work
1.8.1 Recruitment of the field staff
For this baseline household survey, supervisors and interviewers from the respective states were
recruited, with relevant background and previous experience in similar large-scale social research
studies. We recruited graduates only for the job of Supervisors and Interviewers and with the fix
minimum experience in social surveys for interviewers as 2 years and for supervisors as 5 years. The
qualitative survey was monitored by a researcher who has previous experience in handling such
surveys.
1.8.2 Translation of the schedules and Pre-testing
All the qualitative and quantitative instruments of the present study were translated into regional
languages by DRS panel of expert translators. The translated schedules were translated back into
English and variations if any will be sorted out.
All the prepared instruments were pre-tested on eligible respondents by the local investigators from
study states. All the questions were assessed for consistency, comfort of the investigator to enquire
and the respondent‟s convenience to respond.
The client modified the instruments according to the feedback provided by us. Then the instruments
were sent for printing. We printed the required number of instruments + 10% more to be used in
training and field practice.
1.8.3 Field Training & Data collection Manuals
Intensive training was given to the recruited personnel by DRS, regarding the nature of interviews and
specific skills required for eliciting data. We conducted a 4-day training session for the qualitative and
quantitative teams. The training sessions were held at respective states.
Training sessions included introductory session on the study objectives, target groups, importance of
the study and implications of the study findings. The methods were used to impart the training include
lectures, discussion, role-play, demonstration interview, mock interview, field practice interview etc.
1.9 Quality assurance processes adopted during baseline field survey
1.9.1 Quality assurance processes adopted during the training

The members of survey team were selected from the study states that were involved in data collection
in the previous RCH surveys and qualitative data collection.
Training on Quantitative and Qualitative questionnaires was conducted at the state level by the senior
researchers from Delhi accompanied by the field coordinators to ensure the content and quality of
training. Apart from discussing the questionnaires and other important sessions on immunization and
newborn care practices were discussed. During the training, each question item and the mode of
administering the question were discussed.
Training was followed by 1-day field practice by the teams, which was monitored by Senior Researcher
to ensure the quality of field work and consistencies in the questionnaires.
The state level NIPI Program Officers also made special spot checks to facilitate the quality of the
training.
1.9.2 Role of Supervisor
During the fieldwork, the field supervisor was responsible for planning and executing the data
collection. The supervisor was responsible in informing the block level officers and service providers in
the PSUs about the purpose of the field teams‟ visit to the place and seeks their cooperation. This
helped the field teams in conducting data collection smoothly.
If there were any issues in terms of quality or completeness of data collection by the field executives,
the supervisors immediately informed field coordinators and hence adequate measures were taken
without any delay.
1.9.3 Quality assurance visits by the central teams
The survey teams were visited by the central survey coordination team members on field to check the
process and quality of data collection.
1.9.4 Monitoring visits by NIPI team
Members from NIPI team (NIPI Secretariat and NIPI State Offices) visited some of the survey teams
during survey and assessed the process of data collection and completeness of data.
1.9.5 Other quality control measures
In order to control quality, we adopted rigorous checks such as spot checks, back checks and
accompaniment interviews. We adopted 10% (or 20%) back checks to ensure whether the correct
households were covered or not and 15% accompanied audit norm to ensure the questionnaire is
being administered as per the instructions in the training. These were the quality control checks
adopted by supervisors, field executives and researchers during their field visits. The field executives
and researchers visited the field in such a way that one or the other was in the field during the entire
data collection period.
As a practice of quality control for any social research study the supervisor accompanied 20% of the
interviews.
1.10 Data Processing
The hard copies of the collected forms were collected at the Central coordination office at Delhi. All the
forms were screened again for the completeness. The collected raw data was entered in Cs Pro
keeping in view the objectives of the study. Double data entry was done for 20% of the data. The data
entered were correlated with the house listing to cross check the index candidates and also the other
related parameters.
Analysis for various pre-identified indicators and other program relevant indicators was generated in
SPSS program.
The analysis was undertaken in consultation with TNS and NIPI program officers.
1.11 Achieved Sample
Table 1.5 below gives the district-wise coverage status for the state of Rajasthan.
Table 1.5: District wise sample coverage status

Per
District Alwar Bharatpur Dausa Rajasthan
Research Tools Target
Household Survey
Household 1200 1266 1314 1292 3872
Women 1200 1266 1314 1292 3872
Facility Survey
District Hospital 1 1 1 1 3
PHC 6 6 6 6 18
CHC 1 2 1 1 4
SC 30 28 29 26 83
Qualitative Discussions
IDI with ANMs 25 24 21 25 70
1 per
IDI with ASHAs village 40 32 41 113
1 per
IDI with AWW village 39 45 41 125
FGD with PRI 50 43 45 43 131
IDI with BMO 5 5 3 6 14
IDI with LHV 5 5 4 7 16
IDI with CDPO 5 3 3 4 10

CHAPTER 2
HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
This chapter reflects on the demographic and socio-economic characteristics of the households in the
district level Baseline Household survey about child health and related maternal care, for Norway India
Partnership Initiative (NIPI) in the state of Rajasthan and describes the key household characteristics
that provides a basis to the understanding of the socio-economic status of the area, focusing on the
basic demographic parameters like sex-ratio, religious status, educational attainment etc.
Information was collected from all usual residents as well as visitors who stayed in the selected
households the night before the household interview. Usual residents or visitors staying at the
household on the night before the scheduled survey together form the de facto population while on the
other hand, usual residents, irrespective of whether they stayed in the household on the previous night
or not, form the de jure population. These two types of population will differ from each other due to
temporary population movements. In this report, unless otherwise stated, all the tables are based on de
facto population.
2.1 Household Demographic Profile
Age and sex are basic demographic characteristics that play an important role in the study of any
baseline survey related to family health and welfare. Table 2.1 shows the percent distribution of
household population by residence, age and sex in the three selected districts of Alwar, Bharatpur and
Dausa in the state of Rajasthan. The variables covered include age-specific distribution of the
household population by nature of the primary sampling unitas well as gender of family member.
Table 2.2: Household population by age and sex – Rajasthan, NIPI-08

RAJASTHAN Rural Urban
Age Total Male Female Total Male Female Total Male Female
% % % % % % % % %
0-4 26.9 28.1 25.8 27.3 28.3 26.2 24.8 26.6 22.9
5-9 11.6 10.6 12.6 11.8 10.8 12.9 10.0 9.2 10.8
10-14 4.7 4.0 5.5 4.8 4.1 5.6 3.9 3.1 4.7
15-19 5.2 4.3 6.0 5.3 4.6 6.0 4.2 2.9 5.5
20-24 13.8 10.0 17.5 13.8 10.1 17.5 13.4 9.3 17.4
25-29 13.8 15.9 11.8 13.5 15.6 11.3 16.1 17.2 14.9
30-34 6.2 8.4 4.0 6.0 8.1 3.9 7.4 10.2 4.7
35-39 2.7 3.7 1.8 2.6 3.6 1.7 3.4 4.4 2.3
40-44 1.9 1.6 2.2 1.9 1.5 2.2 2.0 2.0 2.0
45-49 3.1 2.6 3.6 3.1 2.7 3.6 2.9 2.1 3.7
50-54 3.1 3.2 2.9 3.0 3.1 2.8 3.8 3.8 3.8
55-59 2.5 2.6 2.4 2.4 2.5 2.3 3.3 3.4 3.1
60+ 4.6 5.2 4.0 4.5 5.1 3.9 4.9 5.7 4.2
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total HH
25,206 12,481 12,725 21,748 10,751 10,997 3,458 1,730 1,728
Members

Table 2.2: Household population by age and sex, District Alwar, NIPI-08
ALWAR Rural Urban
% % % % % % % % %
0-4 26.7 27.7 25.6 26.9 27.9 26.0 25.0 26.7 23.3
5-9 10.7 9.7 11.7 11.0 9.8 12.1 9.0 9.1 8.9
10-14 4.4 3.5 5.2 4.6 3.9 5.2 3.0 1.2 4.9
15-19 4.9 4.2 5.7 5.2 4.4 6.1 3.0 2.8 3.2
20-24 14.3 10.3 18.3 14.4 10.3 18.3 14.2 10.2 18.5
25-29 14.3 16.8 11.9 13.9 16.6 11.2 17.1 17.9 16.3
30-34 5.9 7.8 4.1 5.7 7.5 4.0 7.3 9.8 4.5
35-39 2.7 3.5 1.9 2.5 3.3 1.8 3.9 5.1 2.6
40-44 2.4 1.7 3.1 2.4 1.7 3.1 2.4 1.8 3.0
45-49 3.7 3.3 4.1 3.8 3.5 4.1 3.5 2.6 4.3
50-54 3.5 3.9 3.1 3.3 3.7 2.9 4.8 5.1 4.5
55-59 2.2 2.5 1.8 2.0 2.3 1.7 3.4 4.0 2.6
60+ 4.2 4.9 3.5 4.3 5.1 3.5 3.4 3.5 3.2
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total HH
8,332 4,155 4,177 7,234 3,586 3,648 1,098 569 529
Members
Table 2.3: Household population by age and sex, District Bharatpur, NIPI-08
BHARATPUR Rural Urban
% % % % % % % % %
0-4 27.5 28.6 26.5 27.9 28.7 27.0 25.8 28.0 23.7
5-9 12.2 11.3 13.1 12.5 11.7 13.2 10.7 8.9 12.4
10-14 5.3 4.7 5.8 5.5 4.8 6.2 4.2 4.1 4.3
15-19 4.9 4.0 5.8 5.0 4.4 5.5 4.5 2.0 6.9
20-24 13.8 9.7 17.6 13.8 9.7 17.8 13.6 10.0 17.0
25-29 13.0 15.2 10.9 12.5 14.7 10.3 15.5 17.6 13.5
30-34 6.0 8.0 4.1 5.9 7.9 3.9 6.8 8.8 5.0
35-39 3.2 4.2 2.2 3.2 4.2 2.1 3.3 4.2 2.3
40-44 1.6 1.9 1.4 1.6 1.7 1.5 1.8 2.6 1.0
45-49 2.4 2.0 2.8 2.5 2.2 2.8 2.1 1.3 2.9
50-54 2.5 2.4 2.6 2.4 2.2 2.5 3.1 3.1 3.2
55-59 2.6 2.5 2.6 2.6 2.6 2.7 2.3 2.3 2.2
60+ 5.0 5.5 4.6 4.8 5.1 4.4 6.3 7.0 5.7
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total HH
8,247 4,049 4,198 6,839 3,366 3,473 1,408 683 725
Members

Table 2.4: Household population by age and sex, District Dausa, NIPI-08
DAUSA Rural Urban
% % % % % % % % %
0-4 26.6 27.9 25.3 27.1 28.3 25.8 23.0 24.7 21.3
5-9 11.8 10.7 13.0 12.0 10.8 13.3 10.2 9.8 10.5
10-14 4.5 3.6 5.4 4.5 3.6 5.4 4.4 3.8 5.1
15-19 5.6 4.8 6.4 5.7 4.8 6.5 5.1 4.4 5.9
20-24 13.2 9.8 16.6 13.4 10.1 16.5 12.1 7.3 16.9
25-29 14.1 15.6 12.7 13.9 15.5 12.3 15.8 15.9 15.6
30-34 6.5 9.3 3.8 6.3 8.9 3.8 8.5 12.6 4.4
35-39 2.3 3.3 1.3 2.3 3.3 1.2 2.8 3.8 1.9
40-44 1.7 1.3 2.0 1.6 1.2 2.0 1.9 1.5 2.3
45-49 3.2 2.5 3.8 3.1 2.5 3.8 3.4 2.5 4.2
50-54 3.2 3.4 3.1 3.2 3.4 3.0 3.5 3.1 3.8
55-59 2.7 2.7 2.7 2.5 2.6 2.5 4.6 4.2 5.1
60+ 4.5 5.1 3.8 4.4 5.0 3.9 4.7 6.5 3.0
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total HH
8,627 4,277 4,350 7,675 3,799 3,876 952 478 474
Members
2.2 Socio-economic Profile of Household
This section looks at the profile of sample households in terms of type of familial structure, its economic
status as per Government of India nomenclature specified through the type of ration card ownership,
religious affinity, caste, and the number of household members.
Table 2.5: Household composition, NIPI - 08
ALWAR BHARATPUR DAUSA Total

RUR URB URBA TOTA RURA URBA TOT URB Tot
TOTAL RURAL RURAL
AL AN N L L N AL AN al
% % % % % % % % % % % %
52.
JOINT 55.4 61.9 56.2 47.1 62.3 49.8 48.7 63.4 50.1 50.4 62.5
1
NUCLEA 47.
44.6 38.1 43.8 52.9 37.7 50.2 51.3 36.6 49.9 49.6 37.5
R 9
District Alwar is found to be continuing with the old trend of Joint families which in the other two districts
is found to be almost equivalent to the percentage of nuclear families. Going by the national trend,
three in five households in India are nuclear. Nuclear households are defined as households that are
composed of a married couple or a man or a woman living alone or with married unmarried children
(biological, adopted or fostered), with or without unrelated individuals. According to the survey findings
in NIPI Baseline Household survey, 52.1 percent of all the households live in joint families while 47.9
percent are nuclear families. This trend is somewhat different from the national level information as a
higher proportion of our sample population is from the rural areas and it has been found that proportion
of nuclear households is less in rural areas than the urban areas.
About one-fourth (27%) of the households in India have a BPL card. It has been found during the
present survey that 16.9 percent of the population lives below the poverty line, which is quite low,
compared to the national average. The proportion of BPL households is comparatively higher in rural
areas (18.2%) than the urban areas (9.0 percent). Another important aspect is that around 27.8 percent
of all the households do not possess any card, the proportion being much higher for the urban
households (30.8%). 8.9 percent of the population were of the opinion that they live below the poverty
line but they do not possess any BPL card. Table 2.5 presents district-wise rural-urban information on
the category of households.
Table 2.6: Household Composition, NIPI-08

ALWAR BHARATPUR DAUSA STATE TOTAL
Years of TOTA RURA URBA TOTA RURA URBA TOTA RURA URBA TOTA RURA URBA
Schooling L L N L L N L L N L L N
% % % % % % % % % % % %
Religion
HINDU 86.3 85.2 93.4 85.0 83.3 93.1 94.9 96.8 78.4 88.8 88.6 89.6
MUSLIM 13.2 14.6 4.4 14.2 15.7 6.9 4.8 2.9 21.6 10.7 10.9 9.7
SIKH 0.3 0.2 1.1 0.8 0.9 0.0 0.4 0.4 0.4
CHRISTIAN 0.1 0.1 0.0 0.0 0.0 0.0
JAIN 0.2 0.0 1.1 0.3 0.3 0.0 0.2 0.1 0.4
Caste
SC 24.7 26.9 10.6 32.9 32.4 35.1 30.8 33.1 10.5 29.5 30.8 21.0
ST 7.7 7.9 6.7 2.1 2.0 2.2 25.8 27.8 7.5 11.9 13.0 5.0
OBC 47.0 49.4 32.2 55.8 58.7 42.0 28.9 27.1 45.9 43.9 44.5 39.7
None of
20.6 15.8 50.6 9.3 6.8 20.8 14.4 12.0 36.1 14.8 11.6 34.4
these
Total 1.14 1.15 1.11 1.2 1.2 1.1 2.3 2.2 3.1 1.12 1.12 1.12
Total of
1,321 1,140 181 1,314 1,083 231 1,338 1,204 134 3,973 3,427 546
Members
The distribution of households by religion (determined here by the religion of the head of the
household) is more or less similar to the national pattern with the majority of the population belonging
to the Hindu community (Table 2.4). Around 86.3 percent of the selected households are Hindus in the
district of Alwar, while the figure stands at 85.0 percent for Bharatpur and 94.9 percent for Dausa. The
proportion of Muslim population stands at 13.2 percent, 14.2 percent and 4.8 percent respectively for
the districts of Alwar, Bharatpur and Dausa.
Based on the caste / tribe status of the head of the household, around one-third (29.5%) of the
households belong to the Scheduled Caste (SC) category, while around 11.9 percent population is
Scheduled Tribes (ST). A sizeable proportion of households (43.9%) come from the Other Backward
Caste (OBC) community, while 14.8 percent of households belong to none of the three above-
mentioned castes. The district-wise rural-urban caste distribution is depicted in Table 2.4.
2.3 Educational Level of the Household Population
Education plays an important role in the progress of an individual‟s mind and country. Ignorance and
poverty are major speed-breakers in a swift developing country and can be easily overcome through
imparting proper education. Education is not only one of the most important socio-economic factors
that is known to significantly influence individual behavior and attitudes, but educational attainment is a
fundamental indicator of a country‟s level of human capital development.

Table 2.7: Education attainment by gender of household member in terms of years of schooling,
NIPI-08
ALWAR BHARATPUR DAUSA STATE TOTAL
FEMA FEMA FEMA FEMA
Years of Schooling TOTAL MALE TOTAL MALE TOTAL MALE TOTAL MALE
LE LE LE LE
% % % % % % % % % % % %
No Schooling 37 23 51 41 24 56 37 21 53 38 23 53
< 5Years complete 10 10 11 12 12 12 12 11 13 11 11 12
5-7 Years complete 14 13 14 12 13 12 13 13 14 13 13 13
8-9 Years complete 14 16 11 14 18 10 14 17 11 14 17 11
10-11 Years complete 11 17 6 10 15 4 10 16 5 10 16 5
12 or more years
14 21 7 11 18 5 13 22 5 13 20 6
complete
Total 100 100 100 100 100 100 100 100 100 100 100 100
Total of Members 6,111 3,004 3,107 5,978 2,891 3,087 6,331 3,082 3,249 18,420 8,977 9,443
Consistently among al Districts, illiteracy has been observed to be highest among females. The State
average for illiteracy stands at 37 percent, almost similar to that for District Dausa and Alwar. The stark
difference in illiteracy among genders is witnessed in all the districts thereby reaffirming the backward
social practices in the state of Rajasthan.
Table 2.8: Educational attainment by location of PSU in terms of years of schooling, NIPI-08
RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total
Years of
Schooling % % % % % % % % % % % %
No Education 40.8 15.3 37.3 42.8 29.6 40.5 39.1 23.9 37.3 40.8 23.5 38.4
<1 or not attented 1.0 1.1 1.0 1.3 1.6 1.3 1.2 1.0 1.2 1.2 1.3 1.2
1 to 4 9.5 8.1 9.4 10.9 9.2 10.6 11.1 10.2 11.0 10.5 9.2 10.3
5 to 7 14.1 9.8 13.5 12.6 11.8 12.5 13.4 11.3 13.2 13.4 11.0 13.0
8 to 9 13.5 13.7 13.5 14.1 14.4 14.2 14.1 12.4 13.9 13.9 13.6 13.9
10 to 11 10.9 14.8 11.4 9.4 10.8 9.6 9.9 12.7 10.2 10.0 12.6 10.4
12 or More 10.2 37.2 13.9 9.0 22.7 11.4 11.2 28.5 13.2 10.2 28.9 12.8
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total # of
5288 823 6111 4933 1045 5978 5598 733 6331 15819 2601 18420
members
The table above depicts the district-wise rural – urban educational stature of the head of the
households. A large proportion of the population continues to have little or no education at all and this
proportion is much higher in the rural areas than the urban areas. 38.4 percent of all the households
are not endowed with the light of education, the proportion being 23.5 percent for urban areas and 40.8
percent for rural areas. Around 10.3 percent of the total households have studied up to primary level,
26.9 percent have done middle level schooling while another 10.4 percent have studied up to
secondary level. Only 12.8 percent of the households have gone for higher education, the proportion of
urban households being nearly thrice than the rural households in this case. Among the three districts,
the percentage of illiterates is found to be most in Bharatpur compared to the other two districts of
Alwar and Dausa.
2.4 HOUSEHOLD CHARACTERISTICS
Access to basic amenities such as proper housing, safe drinking water and sanitation, clean cooking
fuel, separate hygienic kitchen etc is not only an important measure of the socio-economic status of the
household, but is also fundamental to the health of the members. In this section, type of houses the
respondents reside in is discussed followed by their access to safe drinking water, sanitation facilities
and use of a proper kitchen. Information on household characteristics is based on questions answered
by the respondents of the household questionnaire and in the case of type of housing, through
interviewer observations.
Table 2.9: Type of house, NIPI-08
SEMI Total No.

KACCHA PUCCA Total
PUCCA of HH
RURAL 15.5 34.9 49.6 100 1140
ALWAR URBAN 5.5 3.9 90.6 100 181
Total 14.2 30.7 55.2 100 1321
RURAL 16.2 46.8 37.0 100 1083
District BHARATPUR URBAN 6.5 18.2 75.3 100 231
Total 14.5 41.8 43.8 100 1314
RURAL 15.2 40.8 44.0 100 1204
DAUSA URBAN 2.2 9.7 88.1 100 134
Total 13.9 37.7 48.4 100 1338
RURAL 15.6 40.7 43.7 100 3427
NIPI Baseline
URBAN 5.1 11.4 83.5 100 546
Survey
Total 14.2 36.7 49.1 100 3973
Rajasthan
RURAL 41.1 27.6 100
DLHS-3 URBAN 8.2 77.7 100
Total 34.5 37.7 40,052
Throwing light on the type of housing, it has been seen that 14.2 percent of the sampled households
reside in kuccha houses, 36.7 percent reside in semi-pucca houses while the rest 49.1 percent live in
pucca houses. It is noted here that proportion of households residing in pucca houses is much more
(83.5%) in the urban region as compared to its rural counterpart (43.7%). The district-wise rural-urban
distribution of the type of housing of the sampled households is depicted in the above table.
Respondents to the household questionnaire were asked for the main source of drinking water for the
household and their usual method of storage It is seen that majority of the households (53.8 percent)
drink water from the Tube Well, while around 1.7 percent households have their source of drinking
water from unprotected wells. The percentage of rural population drinking water from unprotected wells
is comparatively higher at 11.9 percent.
Table 2.10: Source of Drinking Water, NIPI-08

Rural Urban Total Rural Urban Total Rural Urban Total Rural Urban Total
% % % % % % % % % % % %
Piped into dwelling 3.5 36.5 8.0 3.3 22.5 6.7 5.1 49.3 9.6 4.0 33.7 8.1
Piped to yard 18.2 39.2 21.0 2.1 24.2 6.0 7.3 41.8 10.8 9.3 33.5 12.6
Public tap 11.1 6 10.4 7.9 9.5 8.2 2.7 0.0 2.5 7.1 6.0 7.0
Tube well 55.9 17.1 50.6 56.8 25.5 51.3 65.0 9.0 59.3 59.4 18.7 53.8
Protected well 5.2 0.6 4.5 3.0 1.3 2.7 5.6 0.0 5.1 4.7 0.7 4.1
Unprotected well 3.2 0.0 2.7 20.2 7.8 18.0 12.7 0.0 11.4 11.9 3.3 10.7
Protected spring 0 0 0 0.0 0 0.0 0 0 0 0.1 0 0.1
Unprotected spring 0.1 0 0.1 1.4 1 1.3 0.4 0.0 0.4 0.6 0.4 0.6
Surface water 0 0 0 1 0.0 0.5 0 0 0 0 0.0 0.2
Other 2.9 1 2.6 5 8 5 0.7 0 0.7 2.7 4 2.8
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total No. of HH 1,140 181 1,321 1,083 231 1,314 1,204 134 1,338 3,427 546 3,973
Respondents were also asked about the storage practices used by the households for storing drinking
water. Around 71.0 percent of households use covered earthen pots for storage purposes, while
around 19.1 percent kept water in covered buckets. It is seen that urban households are more likely to
storing water in covered buckets than the rural households. The treatment of water ranges from boiling
it to using alum, adding bleach / chlorine tablets, straining the water through a cloth, using water filter
or electronic purifiers. Urban households are somewhat more likely than rural households to treating
drinking water.
Table 2.11: Drinking water storage and filtration practices, NIPI-08

% % % % % % % % % % % %
Usual Method of storage of drinking water
Covered
bucket 13.2 28.2 15.3 19.0 19.9 19.2 21.8 32.1 22.8 18.1 25.6 19.1
Covered
earthen pot 79.8 69.6 78.4 76.7 73.6 76.2 58.4 50.0 57.5 71.3 66.5 70.7
Open
Container 5.8 0.0 5.0 0.7 1.3 0.8 7.1 7.5 7.1 4.6 2.4 4.3
Open bucket 0.7 2.2 0.9 2.0 3.5 2.3 12.6 10.4 12.4 5.3 4.8 5.2
Don't store 0.3 0.0 0.2 1.4 0.4 1.2 0.2 0.0 0.1 0.6 0.2 0.5
Others 0.2 0 0.2 0.1 1.3 0.3 0.0 0 0.0 0.1 0.5 0.2
Methods adopted to make water safer to drink
Boil 0.4 1.1 0.5 0.5 4.3 1.1 0.1 6.0 0.7 0.3 3.7 0.8
Use Alum 0.0 2 0.3 0.5 1.3 0.6 0 1 0 0.2 1.5 0.4
Add Bleach / Chlorine
tables 0 4 1 0.2 2 0.5 0.7 4.5 1.1 0.5 3.1 0.8
Strain Through a Cloth
5.8 27 8.6 9 14 10 10.4 47.8 14.1 8.5 26.6 11.0
Use Water Filter
(Ceramic/Sand/Composit 0.4 13.3 2.1 0.3 4.8 1.1 0.2 4 0.7 0.3 7.5 1.3
e/etc. )
Use Electronic Purifier
0.2 7 1.1 0 0 0 0 0 0 0.1 2 0.4
Let it Stand and Settle
0.1 0 0.1 0.0 0.0 0.0 0 0 0 0.0 0.0 0.0
Other 0.0 0.6 0.1 0.0 0 0.0 0 1 0 0.0 0.4 0.1
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total No. of HH 1,141 181 1,322 1,083 231 1,314 1,204 134 1,338 3,428 546 3,974
The proportion of households without toilet facilities is much higher at 81.1 percent, as compared to the
national average of 56 percent population. Overall, 17.7 percent of households have improved toilet
facilities that are not shared by anyone else. Improved toilet facilities include toilet facilities with a flush
or a pour flush connected to sewer system, septic tank or pit latrine, a ventilated improved pit latrine, a
pit latrine with slab or without slab. If a household has any one of these toilet facilities but needs to
share them with other households, that household is considered not to have an improved toilet facility.
Urban households are three times as likely as rural households having access to improved toilet
facilities.

Table 2.12: Sanitation Facility, NIPI-08

% % % % % % % % % % % %
Flush to
piped
0.4 21.0 3.2 0.2 15.6 2.9 0.6 3.0 0.8 0.4 14.3 2.3
sewer
system
Flush to
septic tank 5.0 59.1 12.4 5.9 37.2 11.4 7.3 75.4 14.1 6.1 53.8 12.7
Flush to pit
latrine 7.1 5.5 6.9 0.2 2.6 0.6 0.5 3.0 0.7 2.6 3.7 2.7
Flush to
somewhere 0.1 0 0.1 0.1 0.4 0.2 0 0 0 0.1 0.2 0.1
else
Flush don't
know 0.1 0.6 0.2 0 0 0 0 0 0 0.0 0.2 0.1
Pit latrine
with slab 0.7 1.7 0.8 0.5 0.4 0.5 0 0 0 0.4 0.7 0.4
Pit latrine
without 0 0.6 0.1 0.1 0 0.1 0.2 0 0.1 0.1 0.2 0.1
slab
Twin pit 0 0 0 0.1 0 0.1 0 0 0 0.0 0 0.0
Dry toilet 0 0 0 0.2 0 0.2 0.3 1.5 0.4 0.2 0.4 0.2
No facility 86.4 11.6 76.2 92.8 43.3 84.1 90.4 17.2 83.1 89.8 26.4 81.1
Public
facility 0.3 0 0.2 0 0.4 0.1 0.7 0 0.6 0.3 0.2 0.3
N 1,140 181 1,321 1,083 231 1,314 1,204 134 1,338 3,427 546 3,973
To study the potential for exposure to cooking smoke from solid fuels, NIPI Baseline household survey
collected information on the type of fuel used by the household for cooking purposes, the place where
the cooking is done and whether cooking is done under a chimney or not. According to survey findings,
around 62.9 percent households use wood for cooking purposes. The proportion of rural households
using wood is much more at 67.4 percent compared to 34.6 percent of urban households. A majority of
urban households (56.0%) use LPG for cooking purposes compared to just 5.2 percent of rural
households using LPG. A very small proportion of rural households also use coal in the open (0.2%),
thus exposing them to severe health hazards. Few households are also found to use Biogas, kerosene
oil, dung or agricultural wastes for cooking their food.

Table 2.13: Cooking Environment, NIPI-08

ALWAR BHARATPUR DAUSA RAJASTHAN
Rura Urba Rura Urba Rura Urba Rura Urba
Total Total Total Total
l n l n l n l n
Fuel Used For Cooking
Electricity 0 1 0 0 0 0 0.0 0 0.0 0.1 0 0.1
Lpg 6.8 76.8 16.4 3.6 38.1 9.7 5.1 59.0 10.5 5.2 56.0 12.2
Biogas 0.0 0 0.0 0.2 3.0 0.7 0.2 3 0.4 0.1 2.0 0.4
Kerosene 0.0 0 0.0 0.0 0.0 0.0 0 1.5 0.2 0.0 0.4 0.1
Coal 0.0 0.0 0.0 0.3 0.0 0.2 0.2 0.0 0.2 0.2 0.0 0.2
Charcoal 0.5 0 0.5 1.1 0.4 1.0 2 0.0 2.1 1.3 0.2 1.2
Wood 55.7 20.4 50.9 85.0 51.9 79.2 62.6 23.9 58.7 67.4 34.6 62.9
Dung 11.0 1.7 9.7 7.5 6.5 7.3 13.0 5.2 12.2 10.6 4.6 9.7
Agricultura 26.0 0.6 22.5 2.1 0.0 1.8 16.5 7.5 15.6 15.1 2.0 13.3
l wastes
Cooking done under a Chimney
YES 1.3 0.6 1.2 1.1 1.3 1.1 1.0 2.2 1.1 1.1 1.3 1.2
NO 98.7 99.4 98.8 98.9 98.7 98.9 99.0 97.8 98.9 98.9 98.7 98.8
Separate Room used as a Kitchen
YES 35.0 78.5 41.0 19.0 43.7 23.4 46.6 73.1 49.3 34.0 62.5 37.9
NO 65.0 21.5 59.0 81.0 56.3 76.6 53.4 26.9 50.7 66.0 37.5 62.1
1,32 1,31 1,33 3,97
Total 1,140 181 1,083 231 1,204 134 3,427 546
1 4 8 3
Overall, these data show the vast majority of rural households using solid fuels for cooking. In both
rural and urban areas, 99 in 100 households cook on an open fire, without diverting the smoke through
a chimney. Another important aspect that requires mention here is the provision of a separate kitchen
for cooking. 62.1 percent of the households do not have a separate kitchen for cooking purposes,
leading to an unhygienic and unhealthy atmosphere. However, 62.5 percent urban households have a
separate kitchen as compared to 34.0 percent of rural households, again spelling out the disparity
between rural and urban standards of living (Table 2.7).
2.5 HOUSEHOLD POSSESSIONS
In order to assess the living standard of the population, NIPI Baseline Household survey collected
information on household ownership of nineteen different types of durable goods and five different
modes of transportation, possession of a bank account and coverage by a health scheme.
Of the items asked about, only a few are owned by a majority of the households: a mattress (86.9%), a
cot / bed (98.2%), a watch / clock (86.6%). Various forms of media or communication are owned by just
a handful of population. Around 48.6 percent of the households have access to a television, 30.9
percent have a radio, 60.7 percent have a mobile phone and only 12.0 percent have other (non-mobile)
telephones. Computers are owned by only 5.7 percent of all the households but the figure stands at
12.8 percent for all urban households. In general, households in rural areas are much less likely to
have consumer goods than the urban areas. A considerable proportion of both rural and urban
households possess a water pump (19.8%). Threshers and tractors are owned by 4.7 percent and 8.0
percent of the households respectively.

Table 2.14: Ownership of Immovable Assets, NIPI-08

% % % % % % % % % % % %
House owned or rented
OWN 98.2 86.2 96.5 97.3 94.4 96.8 97.8 83.6 96.3 97.8 89.0 96.6
RENTED 1.8 13.8 3.5 2.7 5.6 3.2 2.2 16.4 3.7 2.2 11.0 3.4
Ownership of Agricultural Land
YES 70.5 23.2 64.0 68.1 25.5 60.7 73.9 29.9 69.5 71.0 25.8 64.8
NO 29.5 76.8 36.0 31.9 74.5 39.3 26.1 70.1 30.5 29.0 74.2 35.2
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total no
1,140 181 1,321 1,083 231 1,314 1,204 134 1,338 3,427 546 3,973
of HH
Nearly all residents of rural areas lived in their own house, the owner occupancy being as high as 98.2
percent. Even in urban areas, the average for all Districts comes out to be very less at 11 percent.
Information on ownership of agricultural land by households shows that around 64.8 percent of all the
households own agricultural land. Actually, these households depend on the parcels of land for their
living. However, the proportion of rural households owning agricultural land is much more at 71.0
percent than the urban households, 25.8 percent of who only have their own agricultural land.
Table 2.15: Main Source of Household Income, NIPI-08

Rura Urba Tota Rura Urba Tota Rura Urba Tota Rura Urba Tota
l n l l n l l n l l n l
% % % % % % % % % % % %
Farming 34.9 1.1 30.3 31.7 9.1 27.7 37.2 4.5 33.9 34.7 5.3 30.7
Agriculture 26.6 12.7 24.7 23.6 5.2 20.4 19.0 6.0 17.7 23.0 7.9 20.9
Livestock 5.4 4.4 5.3 2.8 2.2 2.7 1.1 0.0 1.0 3.1 2.4 3.0
Mining 0.6 0 0.5 4.1 3 3.8 1.0 3.7 1.3 1.8 2.0 1.9
Manufacturin
1.8 1.7 1.7 5.4 6 5.4 2.0 5.2 2.3 3.0 4.2 3.1
g
Construction 1.8 1 1.7 4.5 16 6.5 8.5 3 7.9 5.0 8 5.4
Petty Trader 3.2 5.5 3.6 7.7 17.3 9.4 1.9 3.7 2.1 4.2 10.1 5.0
Artisan 0.6 0.6 0.6 0.6 0.4 0.5 0.4 1.5 0.5 0.5 0.7 0.6
Business 7.3 33.1 10.8 3.9 9.5 4.9 13.5 35.1 15.6 8.4 23.6 10.5
Service 11.0 27.1 13.2 11.9 29.0 14.9 10.4 32.1 12.6 11.1 29.1 13.5
Others 6.8 12.7 7.6 4.0 3.0 3.8 5.1 5.2 5.1 5.3 6.8 5.5
100. 100. 100. 100. 100. 100. 100. 100.
Total 100.0 100.0 100.0 100.0
0 0 0 0 0 0 0 0
Total no. of 1,14 1,32 1,08 1,31 1,20 1,33 3,42 3,97
181 231 134 546
HH 0 1 3 4 4 8 7 3
In the rural areas of all the three Districts, farming and agriculture account for the main source of
income for majority of households. Apart from that, Job service comes out to be the next highest
source of household income, thus affirming the fact that education and the modern times are
encouraging people to change their traditional occupations and accept new jobs.
Only a very small proportion of households are covered under a health insurance scheme (6.9%). The
percentage is slightly higher in the urban areas (15.6%) than the rural households (5.5%). Generally,
any member of the households employed with the Central Government, are covered under Central
Government Health Insurance Scheme. A small proportion of households are also covered under

Employees State Insurance Scheme. Tables 2.13 & 2.14 throw light on the households covered under
any form of health insurance and their types.
2.6 Construction of Wealth Index
To construct the wealth index, all the data records of women have been considered in the state. The
selected assets/ indicators for the construction of index are:
S.No. Assets S.No. Assets

1 Toilet used 14 Ownership of Refrigerator
2 Fuel used for cooking 15 Ownership of Computer
3 Ownership of Mattress 16 Ownership of Mobile phone
4 Ownership of Mosquito net 17 Ownership of Land phone
5 Ownership of Chair 18 Ownership of Water pump
6 Ownership of Table 19 Ownership of Thresher
7 Ownership of Pressure cooker 20 Ownership of Tractor
8 Ownership of Radio/ transistor 21 Ownership of Car/ Jeep
9 Ownership of Watch or clock 22 Ownership of Two / Four wheeler
10 Ownership of Sewing machine 23 Ownership of Bus/ truck
11 Ownership of Electricity 24 Ownership of Cot/ bed
12 Ownership of Electric fan 25 Ownership of Bicycle
13 Ownership of Television 26 Ownership of animal drawn chart
Calculation Procedure
The first 2 indicators are derived from collected information from the available information as follows:
a) Toilet facility used – If a household is having an improved toilet facilities then it is given a score
1, otherwise it is given a 0 score.
b) Fuel used for cooking – If a household is using modern forms of fuel for cooking purposes then
the household is awarded a score of 1, otherwise it is given a 0 score.
The next 24 indicators are considered directly from the ownership. If a household has that particular
asset then it is given a score of 1 for that asset, otherwise 0.
This procedure first standardizes the indicator variables (calculating z-scores); then the factor
coefficient scores (factor loadings) are calculated; and finally, for each household, the indicator values
are multiplied by the loadings and summed to produce the household‟s index value. In this process, we
used only factors of first component. The resulting sum is itself a standardized score with a mean of
zero and a standard deviation of one.
Using these 26 reconstructed variables we have carried out Principal component analysis. In the
process of PCA we have dropped 8 variables due to their low or negative effect on index. Based on the
remaining 18 variables, in the Principal component analysis the components with integer values
greater than 1 are explaining a variation of around 55% in the data, with the first component explaining
33% of variation.
Wealth index quartiles Percent of women

Quintile 1 42.3
Quintile 2 17.6
Quintile 3 14.4
Quintile 4 11.0
Quintile 5 14.6
Total 100.0

Table 2.16: Household Wealth Index, NIPI-08

% % % % % % % % % % % %
Lowest 41.5 7.2 36.8 50.8 19.5 45.3 48.8 9.7 44.8 47.0 13.0 42.3
Second 17.4 2.2 15.4 18.0 12.1 17.0 22.4 3.7 20.6 19.4 6.8 17.6
Middle 17.0 5.0 15.4 14.5 13.0 14.2 14.4 6.7 13.6 15.3 8.8 14.4
Fourth 12.6 11.6 12.5 10.1 15.6 11.0 8.3 21.6 9.6 10.3 15.8 11.0
Highest 11.4 74.0 20.0 6.6 39.8 12.5 6.1 58.2 11.4 8.1 55.7 14.6
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total
no. of 1,141 181 1,322 1,083 231 1,314 1,204 134 1,338 3,428 546 3,974
HH
It is very much evident that majority of households in the rural areas belong to the lowest quintile, while
it is more or less reverse for the urban areas, with majority population in the Urban areas belonging to
the highest quintile.
Table 2.17: Financial Access, NIPI-08

ALWAR BHARATPUR DAUSA RAJASTHANl
% % % % % % % % % % % %
Member having a bank account
YES 35.4 65.7 39.6 29.9 36.4 31.1 51.2 74.6 53.5 39.2 55.5 41.5
NO 62.4 33.1 58.4 69.2 63.2 68.1 45.4 23.1 43.2 58.6 43.4 56.5
DK 2.2 1 2.0 0.9 0.4 0.8 3.4 2.2 3.3 2.2 1.1 2.1
Any member covered with Insurance
YES 5.4 9.4 6.0 6.9 23.8 9.9 4.3 9.7 4.9 5.5 15.6 6.9
NO 89.6 86.2 89.1 91.1 73.6 88.1 89.9 82.1 89.1 90.2 79.9 88.7
DK 5.0 4 4.9 1.9 2.6 2.1 5.8 8 6.1 4.3 4.6 4.4
Total no
1,140 181 1,321 1,083 231 1,314 1,204 134 1,338 3,427 546 3,973
of HH
Nationally, two in five households have a bank account or an account with the post – office. The trend
is found to be more or less similar in our present household survey with 41.5 percent of all the
households possessing a bank account or have a savings account in the post – office. Urban
households, as expected, enjoy a higher share in terms of possession of a bank account than the rural
households. Another important aspect that needs to be mentioned here is that 2.1 percent of the
respondents have no idea whether any member of the household possesses a bank account or not.

CHAPTER 3
CHARACTERTISTICS OF SURVEY RESPONDENTS
The health, nutrition, and demographic behaviors of women vary by their own characteristics, such as
age, marital status, and caste, as well as the economic characteristics of their households, such as
wealth status. Additionally, education and media exposure are also important catalysts for health and
demographic change. Socio economic differentials are of particular concern for the population and
health policies of the Government of India that seek to improve the health of all population groups,
including minorities and vulnerable groups.
The present chapter presents a profile of the demographic and socio economic characteristics of de
facto female respondents from the districts of Alwar, Bharatpur and Dausa in Rajasthan who were
identified as eligible respondents for the study, after a listing of households for selection of women
under 3 categories viz.,
- mothers having children in the age group of 0 - 28 days,

- mothers having children in the age group of 29 days – 365 days,
- mothers having children in the age group of one to 2 years.
The characteristics of respondents are profiled in some detail in the remainder of this chapter, and
include characteristics such as age, residence, education, marital status and economic status that
furnish the basis for socio-demographic analyses in subsequent chapters.
3.1 Background Characteristics (Age, Residence, Wealth Index)
Table 3.1 presents the percentage distribution of female respondents by age, residence and wealth
index. The overall age distribution of female respondents shows that the percentage of respondents is
lowest (3 percent) in the age group of 15 – 18 years which gradually increases and peaks at 42 percent
in the age group of 22 – 25 years, followed by a decline to the lowest of one percent in the age group
of 41 – 49 years. A similar trend can be observed when a district wise analysis is made. Overall, the
highest number of respondents (42 percent) belonged to the age group of 22 – 25 years with the next
largest number (25 percent) belonging to the age group of 26 – 30 years.
Table 3.1: Age distribution of women respondents, NIPI-08

DISTRICT
Age Group % % % %
15-18 2 4 3 3
19-21 22 22 20 21
22-25 43 41 41 42
26-30 26 23 27 25
31-40 7 10 7 8
41-49 1 1 0 1
No. of women 1,285 1,330 1,327 3,942

Table 3.2: Distribution of Women Respondents by religion and ethnicity, NIPI-08

% % % %
Religion
HINDU 86.3 85.0 94.9 88.8
MUSLIM 13.2 14.2 4.8 10.7
SIKH 0.3 0.8 0.0 0.4
CHRISTIAN 0.0 0.1 0.0 0.0
JAIN 0.2 0.0 0.3 0.2
Caste/Tribe
SCHEDULE CASTE 24.7 32.9 30.8 29.5
SCHEDULE TRIBE 7.7 2.1 25.8 11.9
OBC 47.0 55.8 28.9 43.9

NONE OF THEM 20.6 9.3 14.4 14.8
No of women 1,321 1,314 1,338 3,973
The majority of the eligible women interviewed were from the Hindu faith with a little chunk (13 percent)
belonging to the Muslim religion. OBC families were found to be the largest group, the second being
the Schedule caste.
Table 3.3: Education status of women respondents, NIPI-08

% % % %
Education (Years of Schooling)
No Education 47 58 54 53
<5 1 2 2 2
5-7 17 14 17 16
8-9 17 14 14 15
10-11 9 6 7 7
12 & Above 10 6 6 8
Total 1,285 1,330 1,327 3,942
Table 3.3 shows that of the total women surveyed in the age group of 15 – 18 years, 49 percent had no
education at all which is almost similar for the age groups of 19 – 21 (45%) and 22 – 25 years (50%). In
the age group of 26 – 30, 31 – 40 and 41 – 49, this percentage is 58 percent, 76 percent and 94
percent respectively. When analyzed district wise, it can be observed that in the districts of Bharatpur
and Dausa, 100 percent of women in the age group of 41 – 49 and 86 percent of women in the same
age group from Alwar have no education. This shows that in this age group, women from Alwar are
more literate compared to the other two districts.
The distributions of women by wealth index shows that the proportion (42 percent) of women is in the
lowest wealth quintile. Only 11 percent women are in the fourth wealth quintile while it has again
marginally increased to 15 percent in the highest wealth quintile. The situation is more or less similar
across all the districts.
3.2 Exposure to Media (News Paper, Radio, TV and Cinema)

In this study, exposure to print and electronic media (Radio & Television) was measured by asking
women about the frequency (almost every day; at least once a week; less than once a week; or not at
all) with which they read a newspaper or magazine, watch television or listen to the radio, (Table 3.3.1).
In addition, the respondents were also asked whether they „usually go to a cinema hall or theatre to
see a movie. Women who do not read a newspaper or magazine, watch television, or listen to the radio
at least once a week, or see a movie at least once a month are considered as not regularly exposed to
any media. The tables shows that in Rajasthan, in comparison to the other age groups, the lowest and
highest studied age group of 15 – 18 years and 31 to 40 years, the women are not much exposed to
the print or electronic media, which implies that there may be some socio cultural problems for women
of these age groups due to which they are deprived of this.
Specifically analyzing exposure of women respondents to print media by background characteristics,

data reveals that about 45 percent of women in the age group of 22 - 25 years are not at all exposed to
the print media. Of those who read, we find that the highest i.e 48 percent in the age group of 22 – 25
years reads a newspaper / magazine almost every day. Under all the categories of respondents i.e.
ones „who reads a newspaper or magazine almost every day, at least once a week, less than once a
week or not at all„, we find that, there is a gradual increase in the percentage of readers as the age
increases from the group 15 – 18 to 22 -25 years followed by a gradual decline from age group 26 – 30
to 41 – 49 years. If we analyze exposure to print media with the education of the respondent, we find
that a good percentage (64 percent) of women having received twelve or more years of education are
regular newspaper / magazine readers, whereas only 27 percent of this category reads a newspaper /
magazine at least once a week.
Though in today‟s time television is the most common form of media in both rural and urban areas,
Radio also holds a place of importance in most of the households especially in the rural areas. The
same table shows that the age group of 22 -25 years are quite active radio listeners. As high as 52
percent of women in this age group are regular radio listeners. If we see this against the education
level of the respondent, we find that 30 percent with education level of 12 and above are regular radio
listeners. The next highest percentage of 22 percent with no education at all are also regular radio
listeners. The table also highlights that a very high percentage (60 percent) of women with no
education at all do not listen to the radio at all which shows that women with no education are deprived
of exposure to the radio. This also shows just how much the factor of education affects women‟s
exposure to the media.
Table 3.4: Frequency of Exposure, NIPI-08

Less
Almost At least once Not at
than a Total
everyday a week all
week
% % % % %
Frequency of reading newspaper
12.3 15.1 27.2 45.4 100
and magazine
Frequency of listening to the
4 5.3 11.7 79 100
radio
Frequency of watching television 27.7 11.4 10.2 50.7 100
3.3 Employment Status (Earn something, member of SHG, Mahila Mandal)
The ability of a country‟s economy to provide gainful employment to its population is an important
aspect of the country‟s level of development. Paid employment of women, in particular, has been
recognized as important for achieving the goal of population stabilization in India (Ministry of Health
and Family Welfare, 2000). However, the empowering effects of employment for women in particular
are likely to depend on their occupation, the continuity of their workforce participation, and whether
they earn income.
Table 3.5: Employment Status of eligible women by background characteristics, NIPI-08


YES YES YES YES
N % N % N % N %
AGE
15-18 2 7 12 24 6 14 20 17
19-21 25 9 37 13 38 14 100 12
22-25 61 11 67 12 65 12 193 12
26-30 57 17 61 20 70 19 188 19
31-40 16 19 34 26 26 27 76 24
41-49 2 29 3 50 1 20 6 33
Total no. of earning
163 214 206 583
women
EDUCATION
No education 98 16.4 140 18 138 19 376 18
Below 5 2 12.5 5 25 6 21 13 20
5-7 23 10.7 24 12.8 29 13 76 12
8-9 18 8.4 24 13.4 23 12 65 11
10-11 2 1.8 6 7.3 3 3 11 4
12 & above 20 15.4 15 17.6 7 9 42 14
Total no. of earning
163 214 206 583
women
Table 3.5 gives the percent distribution of women by their age group, educational level and residence.
It can be seen that overall about 33 percent of women in the age group of 41 – 49 years are earning
whereas as high as 88 percent of women aged 22 – 25 years are not earning anything. The same thing
when analyzed district wise, it can be observed that in comparison to Alwar and Dausa, where only 29
percent and 20 percent of women in the age group of 41 – 49 years are earning something, it is 50
percent in the case of Bharatpur. Likewise in the age group of 15 – 18 years, we can see a higher
percentage (24 percent) of women of Bharatpur earning something in comparison to the other 2
districts of Alwar and Dausa which is 7 percent and 14 percent respectively. This shows that in
comparison to the other two districts, women aged 15 – 18 years from Bharatpur starts earning earlier
and its Bharatpur again which also has more percentage of women earning at the age group of 41 – 49
years.
Analyzing this by education level of the women, we find that overall higher the educational attainment
of women, there is a gradual decline in the percentage of women earning something, except for the
women having completed twelve or more years of education which again shows an increased
percentage. The same is the case for every individual district. This shows that a higher percentage of
women who have completed standard five or less and those who have completed standard twelve or
more are earning something. As far as women with no education are concerned, the overall and district
wise percentages of earning women do not show any significant difference.
When analyzed by residence, overall there is not much difference among the rural and urban earners
but when observed district wise, in Bharatpur (Rural – 17 %, urban –19 %) and Dausa (Rural – 16 %,
urban –14%) slight differences are seen between the two.
The women respondents were also asked if they are a member of any SHG or Mahila Mandal. It was
observed that a negligible percentage of women, i.e 1.1 percent responded in the affirmative. In Alwar,
only 0.4 percent, in Bharatpur, only 0.8 percent and in Dausa, 2.1 percent are member s of any SHG or

Table 3.6: Membership in SHGs and Mahila mandals, NIPI-08

% % % % % % % % % % % %
YES 0.54 0.00 0.46 0.72 0.86 0.75 2.24 0.74 2.09 1.20 0.55 1.11
NO 99.46 100.00 99.54 99.28 99.14 99.25 97.76 99.26 97.91 98.80 99.45 98.89
Total 1,113 181 1,294 1,109 233 1,342 1,203 135 1,338 3,425 549 3,974
3.4 Age at First Cohabitation
In Many parts of India, there exists the practice of the child bride staying at home for some time before
she moves into her husband‟s residence. There are many socio-cultural reasons behind this but the
more important aspect of this issue is that the day she moves in with her husband, is marked with
festivities and is know as “gauna”. Health research has, for all practical purposes, always taken the
date of gauna to be of more relevance for cohabitation purposes than actual date of marriage. Overall,
it is observed that a very high percentage of women (64 percent) started to live with their husband
when still in their teens, specifically 15 – 18 years. Further, only about 28 percent of women started
living with their husband at the age of 19 – 21 years. A similar kind of situation was observed in both
the districts of Alwar and Bharatpur where there were more than 60 percent cases of women who
started living with their husbands when still in their teens. In Dausa however, the figure under this
category was less than 60 percent, i.e. 59 percent.
Table 3.7: Age at first cohabitation, NIPI-08

Age at Cohabitation (in
N % N % N % N %
Years)
15-18 829 65 906 68 784 59 2,519 64
19-21 351 27 332 25 430 32 1,113 28
22-25 93 7 80 6 90 7 263 7
26-30 12 1 10 1 21 2 43 1
31-40 2 0 2 0 4 0
Total 1,285 100 1,330 100 1,327 100 3,942 100
The question now is, does age at first cohabitation get influenced by the education level of the qomen
concerned or the economic well-being of her household? The following table elaborates.
3.5 Children Ever Born and Living
The number of children a woman has ever borne is a cohort measure of fertility. Because it reflects
fertility in the past, it provides a somewhat different picture of fertility levels, trends, and differentials
than do period measures of fertility such as the CBR and the TFR. Table 3.6.1 shows the percent
distribution of all women by the number of children ever born (CEB).
Eighty Four percent of all women age 15 – 18 have already had a child. This shows that early child
bearing is fairly common in Rajasthan. For women age 41 – 49, the number of children ever born is of
particular interest because these women have virtually completed their childbearing. Among all women,
92 percent have reached the end of child bearing with more than 4 children ever born.
The same thing when analyzed by education level of the women it can be observed that, women who
have attained 12 or more years of education, 52 percent have only one child, followed by 37 percent
having two,8 percent having three and only 3 percent having four or more than four children. In the
case of women with no education, 33 percent have four or more than four children while only about 18
percent has only 1 child.
When analyzed by wealth index, as expected we can find that 31 percent of births to women in
households in the lowest wealth quintile were of order four or higher, compared with just 8 percent of
births to women in households in the highest wealth quintile.

CHAPTER 4
MATERNAL HEALTH
4.1 ANTENATAL CARE
4.1.1 Pregnancy Registration and ANC Provider

NFHS trends of antenatal care in Rajasthan show a drastic improvement in ANC visits from 23.6 per
cent during NFHS-2 to 41.2 per cent in NFHS-3 while at the national level; it has improved from 44 per
cent to 51 per cent during the same period. It has been estimated that Rajasthan will have to maintain
the same pace to achieve at least the national average of 51 per cent
Antenatal registration is a key event in the care of the pregnant mothers. In order to have proper and
timely antenatal care, registration of pregnancy is a must. In Bharatpur and Dausa 85 and 84 percent
women visited any health facility for ANC respectively compared to about 71 percent women visited
health facility in Alwar. About 7 percent in Dausa, 5 percent in Bharatpur and 4 percent women in Alwar
reported that heath personnel visited their home for ANC. Hence, about 14 percent on an average did
not have contact with any health facility nor any health personnel visited their home during their
pregnancy. In Alwar, one out of four women did not have any contact with any health facility or health
personnel during pregnancy. Visit to health facility for antenatal check-up increases with the increase in
wealth index and decreases with increase in age and number of living children. It is interesting to note
that the visit of health personnel to home for ANC decreases with the increase in education of mother
and wealth index of household.
Table 4.1: Percentage of pregnancies registers vs. key background variables, NIPI-08
ALWAR BHARATPUR DAUSA Rajasthan
% % % %
Age Group
15-18 78.6 80.0 93.0 84.3
19-21 83.7 84.1 93.3 86.9
22-25 82.5 81.3 90.8 84.8
26-30 75.3 82.2 89.7 82.6
31-40 64.3 79.2 84.4 76.8
41-49 57.1 66.7 80.0 66.7
Years of Schooling
No Education 68.2 80.3 86.9 79.1
<5 87.5 90.0 96.4 92.2
5-7 84.6 82.4 94.1 87.3
8-9 88.3 83.2 93.2 88.3
10-11 94.6 87.8 97.7 93.6
12 & Above 94.6 83.5 97.5 92.2
HH Wealth Index
Lowest 68.1 80.3 87.9 79.5
Second 80.4 82.7 91.4 85.5
Middle 83.7 84.2 92.2 86.6
Fourth 88.2 80.7 92.9 87.0
Highest 90.8 84.1 95.9 90.2
Total 1018 1087 1191 3296
It is important to note that in Rajasthan, health workers like ANM/Nurse/Midwife/LHV are quite
effective, as nearly 4 out of five (82%) women visiting them for ANC. About 16.5 percent women
received ANC by a government doctors. ASHAs and AWW were also providing some ANC related care
in around 6 and 7percent women respectively.
Table 4.2: Received ANC Card, NIPI-08

Received ANC
Card Yes Not Yes Not Yes Not Yes Not
Yes Seen Yes Seen Yes Seen Yes Seen
Seen Seen Seen Seen
Total 35.25 41.41 14.49 77.48 40.28 52.38 30.21 57.29
The presence of an ANC card could be verified from only 30 percent women. Availability of ANC card
was the lowest for Bharatpur district with Dausa leading the way with more than 40 percent.
Table 4.3: Incidence of receiving ANC during last pregnancy, NIPI-08
Alwar Bharatpur Dausa Rajasthan

ANC Received Rural Urban Total Rural Urban Total Rural Urban Total Rural Urban Total
Yes went to health
68.1 86 905 82.7 97.8 1134 83 95.4 1108 78.1 93.3 3147
facility
Yes health personnel
4.7 0 52 6.2 0.4 69 7.6 2.3 93 6.2 0.7 214
visited
No 27.1 14 324 11.1 1.7 126 9.4 2.3 114 15.7 5.9 564
Total 1102 179 1281 1099 230 1329 1185 130 1315 3386 539 3925
Overall, most women have gone in for some form of ANC service, whether its going to the health
facility or a health personnel visiting them at home.
Table 4.4: Place of ANC, NIPI-08

% % % %
Government/ municipal hospital 18.5 14.9 18.1 17.0
CHC/ rural hospital 12.4 15.8 16.4 15.0
PHC 10.1 9.8 22.7 14.4
SUBCENTRE ANM 19.2 34.8 26.0 27.2
AWW/AWC 21.7 21.0 16.1 19.4
NGO/Trust Hospital / Clinic 0.6 0.1 0.1 0.2
Govt. Ayush hospital / clinic 0.3 0.3 0.2
Private ayush hospital / clinic 3.9 0.6 0.9 1.7

Private hospital / clinic 14.8 6.1 11.7 10.6
Total no. of women 905 1134 1108 3147
Across all the three Districts, the most frequented source of ANC was the Sub-Center or the ANM
followed by Anganwadi worker. Private Hospitals/Clinics were also an important source especially in
Alwar (15 percent).

Table 4.5: ANC Provider, NIPI-08

Who provided ANC
(multiple response) % % % %
GOVERNMENT DOCTOR 15.0 9.3 24.7 16.5
ANM/ NURSE/ MIDWIFE/LHV 74.7 94.8 74.0 81.7
ASHA 6.2 2.7 8.2 5.7
PRIVATE DOCTOR 10.9 3.2 11.1 8.2
DAI 0.4 0.5 0.2 0.4
ANGANWADI / ICDS WORKER 2.7 5.5 12.8 7.3
NO ONE 85.8 82.5 78.9 82.1
OTHER 0.4 0.1 0.1
Total no. of women 957 1203 1201 3361
Among all the women who went in for ANC services either by visiting the service facility or having
someone visiting them at home, in majority cases the care has been provided by the ANM, Nurse or
LHV. Government doctors do not play an important role in the provision of ANC to the women. Majority
of the women have also stated that they were not provided ANC by anyone.
4.1.2 Timings and Number of ANC

th
About 58 percent women registered their pregnancy before 4 month of pregnancy and 35 percent
th th
registered during 4 and 5 month of pregnancy in the state. In Alwar, a high proportion of women
th
(69%) registered their pregnancy before 4 month of pregnancy whereas in Bharatpur, only 50 percent
of the mothers registered during first trimester.
Figure 4.1: Percent of mothers who received 3 or more antenatal checkups - NFHS
60
52
50
43.8
41.2
40
Rajasthan
30
23.6 India
20
10
0
NFHS-2 NFHS-3
As per DLHS-3, in Alwar (23.7%) and Dausa (27.9 %) districts, slightly more than one-fifth of the
pregnant women had at least 3 ANC visits or more during their last pregnancy as against Bharatpur
district where the corresponding figure was 21.7 percent.

Table 4.6: Number of ANC received and timing of ANCs received, NIPI-08
Number of ANC
visits % % % % % % % % % % % %
and timing
Received one ANC 16.4 12.0 15.3 7.4 5.4 6.8 12.1 7.1 11.2 11.7 8.0 10.8
Received two ANC 38.9 23.9 34.9 56.3 48.3 54.0 43.3 28.1 40.8 46.5 34.1 43.9
Received three ANC 44.1 64.1 49.3 35.7 46.3 38.7 43.5 64.1 47.0 41.0 57.7 44.7
Don't Know 0.6 0.5 0.6 0.5 1.1 0.7 1.0 0.8 0.2 0.7
Number of months
pregnant at 1st ANC
<4 61.5 72.1 64.2 47.7 51.7 48.8 51.9 59.8 53.1 53.2 60.6 54.7
4-5 30.6 24.3 28.6 43.7 44.3 43.6 36.3 31.7 35.8 37.3 33.9 36.5
6-7 5.7 2.8 5.2 7.2 3.4 6.3 8.9 7.1 8.7 7.4 4.5 6.8
8+ 1.4 0.8 1.4 0.9 0.3 0.7 1.6 0.7 1.4 1.3 0.6 1.2
Don't Know 0.7 0.6 0.5 0.3 0.5 1.2 0.7 1.1 0.8 0.4 0.7
120 107 120 285
N 803 154 957 977 226 127 507 3361
3 4 1 4
NIPI-08 baseline survey clearly reveals that the women who had more than 3 Antenatal care visits
during pregnancy come to be a little less than half of the total number. This is indicative of higher levels
of awareness of women regarding maternal health practice. For Bharatpur it has come out to be 38.7
percent, way higher than the DLHS-3 findings. Consistently across all Districts the propensity to get
more ANC check-ups was higher in Urban areas than the rural areas. Nearly all the women had
th
received their first ANC by the 5 month of their pregnancy and these findings are constant across all
three districts.
4.1.3 Components of Antenatal Care
Important elements of antenatal care include examination of the pregnant mother, provision of iron
supplementation and two doses of tetanus toxoid vaccine. Nutritional deficiencies in women are often
exacerbated during pregnancy because of the additional nutrient requirements of foetal growth. Iron
deficiency anemia is the most common micronutrient deficiency in the world. It is major threat to safe
motherhood and to the health and survival of infants.
For the most recent birth during two years preceding the survey, information regarding use of IFA
tablets was collected. Overall, only 13 percent of women consumed IFA tablets at least for 3 months.
Proportion of women consumed IFA tablets in Alwar, Bharatpur and Dausa were 15.3, 14.1 and 10.6
percent respectively. Consumption of IFA tablets for at least 3 months in urban areas of the study
districts varied from 26 percent in Bharatpur to 11 percent in Dausa. IFA tablets were mostly consumed
by young (age 19-30) as well as by those mothers having up to 4 living children.
According to DLHS-3, 65.5 percent in Bharatpur received at least one TT followed by 63 percent in
Dausa and the lowest at 62 percent women in Alwar.
Table 4.7: Proportion of eligible women having received different components of ANC care,
NIPI-08
ALWAR BHARATPUR DAUSA ALL DISTRICTS
% % % %
2 or more TT 90.9 93.4 92.4 92.4
Took IFA for 90 or more Days 15.3 14.1 10.6 13.2
More than 90 percent women received two or more tetanus toxoid (TT) injections during pregnancy for
their most recent birth. In urban areas of all the three study districts, more than 95 percent mothers

received 2 or more TT injections during their most recent birth. In rural areas, 2 or more TT injections
received by 9 out of 10 women of all the three districts. It indicates the awareness and selective
preference of TT injections over ANC checkup. (Table 4.1.9 & 10)
Discussions with ASHAs reveal that they give emphasis on spreading awareness about
proper hygiene and nutrition during the time of delivery. They also help pregnant women in
4.1.2 Antenatal Care
her registration, Services
arranging and Awareness
transport, proper about Pregnancy
rest, ANC Complications
check-ups, accompanying mother
for institutional delivery etc. It was found that in Rajasthan, ASHAs are performing their
The effectiveness of antenatal care in ensuring safe motherhood depends on the assessments and the
advices given as part of antenatal care. Baseline survey collected information on thisgo
responsibilities quite well but many families do not inform them when they to institution
important aspect
of antenatal care by asking women who received antenatal care whether they received each in
for delivery for their additional benefit. ASHA’s absence is the main problem many
of several
villages
types of Rajasthan.
of service or information at any time as part of their antenatal care. All of these measurements
and tests are part of essential obstetric care or are required for monitoring high risk pregnancies.
Anganwadi
Among womenWorkers (AWW)
who received consider
antenatal nutrition
care for their advice
most and food
recent provision
birth, andhad
69 percent immunization
their weight
measured, 57 percent
as their prime hadfeel
job. They an that
abdominal examination
other ANC and 56 percent
related activities such ashad theirvisits,
home bloodproviding
pressure
checked. Blood and urine tests were conducted
IFA tablets, conducting periodic check-ups forare not so important because few ofdelivery
49 percent of women. Expected date of them
th
and
mentioned about these activities when they women.
advice for delivery was given to nearly 2/5 of were askedWomen to intellurban areas
about receiving
their better
pregnancy
antenatal care services with compared to rural areas. District wise data on
related activities. Few AWW mentioned about consumption of IFA tablets as an advice to antenatal care services
shows that Dausa has relatively better ANC services in comparison to Bharatpur and Alwar.
pregnant women.
Table 4.8: Nature of ANC services received, NIPI-08

ANC ALWAR BHARATPUR DAUSA Rajasthan
Components RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total
Received
% % % % % % % % % % % %
Weight
65.8 74.9 68.5 65.8 72.6 67.7 69.7 77.6 70.9 67.3 75.0 69.1
measured
Blood
Pressure 46.7 71.3 53.3 46.7 68.6 53.0 58.8 76.9 62.3 51.2 72.2 56.4
checked
Urine Tested 44.5 72.9 51.3 33.8 51.7 39.2 52.7 72.6 56.0 43.9 65.2 48.6
Blood tested 44.3 67.3 50.6 35.5 56.1 41.5 51.0 68.0 54.4 43.8 63.5 48.7
Abdomen
54.7 62.9 57.2 51.6 67.6 56.4 55.6 71.2 58.5 54.0 67.4 57.4
examined
Delivery Date
35.7 52.2 40.5 29.6 54.7 35.9 35.7 51.6 39.3 33.6 52.9 38.4
declared
Delivery
41.0 41.4 42.6 43.0 58.8 47.0 30.9 43.8 33.1 37.9 48.4 40.8
advice given
Received
advice
72.0 79.7 74.3 47.4 66.9 52 61.6 63.3 62.2 59.7 69.6 62
regarding
diet
Received
advice on 16.7 22.7 18.5 15.1 20.9 17.4 25.1 27.4 25.5 19.3 23.7 20.6
danger signs
Received
advice on 28.4 37.5 30.3 32.5 32.4 32.5 29.7 30.6 30 30.3 33.3 31.0
Delivery Care
Breast
feeding 30.1 34.7 31.5 28.1 21.6 27.4 27.3 30.6 28.1 28.4 28.6 28.8
advice
New Born
30.3 34.3 31.2 26.9 34.8 28.4 16.8 17.8 18 24 28.9 25.5
Care advice
Received
advice on
12.3 11.2 12.5 1.9 7.8 2.9 12.4 13.5 12.6 8.8 10.7 9.1
Previous
Pregnancy
Total 803 154 957 977 226 1203 1074 127 1201 2854 507 3361

The above table provides details of the nature of ANC received by the pregnant mothers during their
last pregnancy. It may be noted that the most common ANC components received were measurement
of weight and advice regarding diet. There is a slight rural-urban variation and women in the urban
areas have received slightly different components of ANC than their rural counterparts.
Common Advices given by AWW/ASHA during pregnancy:
Samay par khana khaye, khane mein paushtik ahar lein, bhari saman na uthaye, samay
par jaanch karwaye, tetnus ka teeka lein, folic acid aur iron ka tablet time se lein aur
aaraam karen.(Take nutritious food meals on time, do not lift heavy weights, take TT
injection, folic acid and iron tablets on time, rest and timely go for check-up) ASHA,
Dausa, Rajasthan
Har do ghante par kuchh khayen, samay par doctor se janch karwayen aur doctor ki salah
menein.(Take food on every two hours, get tested by doctors on time and and follow the
advice of doctor) AWW, Alwar, Rajasthan
Table 4.9: TT injections vs. number of ANCs, NIPI-08

One TT Two TT Two or more TT
Count % Count % Count %
Recived one
84 47.70% 219 8.70% 8 7.10%
ANC
Recived two
Rural 44 25.00% 1237 49.40% 28 25.00%
ANC
Recived three
47 26.70% 1034 41.30% 75 67.00%
ANC
Recived one
9 52.90% 19 4.00% 0 0.00%
ANC
Recived two
Urban 3 17.60% 143 30.00% 1 11.10%
ANC
Recived three
5 29.40% 315 66.00% 8 88.90%
ANC
Recived one
93 48.20% 238 8.00% 8 6.60%
ANC
Recived two
Total 47 24.40% 1380 46.30% 29 24.00%
ANC
Recived three
52 26.90% 1349 45.20% 83 68.60%
ANC
The above table makes it quite obvious that there is a positive relationship between the number of TT
injections and the number of ANC visits and its visible across both urban and rural areas.
4.1.4 Health Problems and Treatment seeking behaviour during Pregnancy
This section looks at the general level of awareness among the women respondents regarding the
types of complications/health problems that can occur during pregnancy. It also looks at the incidence
of occurrence of health problems during last pregnancy as well as explores the details of treatment
seeking behavior.

Table 4.10: Knowledge about health problems during pregnancy, NIPI-08
ALWAR BHARATPUR DAUSA NIPI STATES

Pregnancy
complicatio
n
% % % % % % % % % % % %
Vaginal
13.5 22.1 14.9 18.8 33.8 21.8 24.4 35.7 25.7 19.4 30.7 21.2
Bleeding
Convulsions 26.3 37.0 28.1 22.9 26.8 23.7 16.9 27.0 18.1 21.7 29.9 23.0
Prolonged
18.5 27.3 20.0 25.3 19.7 24.2 37.0 42.1 37.6 27.7 27.6 27.7
Labour
Swelling Of
Hand And 38.7 51.9 40.9 58.4 70.2 60.8 66.3 71.4 66.9 55.8 65.0 57.2
Feet
Other 3.6 4.5 3.7 4.4 0.9 3.7 1.6 2.4 1.7 3.1 2.4 3.0
Personal who told about these complication
Health
Personnel / 10.4 40.3 15.5 5.8 14.9 7.6 11.7 31.7 14.0 9.3 26.8 12.1
Doctor
Anm/ Nurse /
40.3 19.5 36.8 57.1 66.2 58.9 58.0 30.2 54.8 52.6 43.1 51.1
Midwife/ LHV
Asha 7.4 0.0 6.1 3.1 1.8 2.8 8.1 1.6 7.3 6.2 1.2 5.4
Other Health 0.1 0.6 0.2 0.5 0.0 0.4 0.8 2.4 1.0 0.5 0.8 0.6
Other Person
0.4 0.6 0.4 0.1 0.4 0.2 1.0 0.0 0.9 0.5 0.4 0.5
Dai / Tba
Anganwadi /
6.5 1.3 5.6 2.5 0.4 2.1 9.9 7.1 9.6 6.4 2.4 5.7
Icds Worker
Family 11.8 31.2 15.0 27.1 12.3 24.1 34.8 64.3 38.1 25.6 30.9 26.4
Other 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.1 0.0 0.0 0.0
Total 757 154 911 916 228 1144 992 126 1118 2665 508 3173
Most of the women seemed to have been aware of swelling of hands and feet as a pregnancy
complication, perhaps because they may have experienced it first hand or heard about it from others.
Apart from this, a little more than a fifth of the respondents were aware of Vaginal Bleeding as a health
problem during pregnancy. Most of the eligible women seemed to have come to know about these
complications from the ANM/Nurse/LHV (51.1%) and from family members (26.4%).
Table 4.11: : Incidence of Health Problems during pregnancy, NIPI-08

.
ALWAR BHARATPUR DAUSA All District
RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total
% % % % % % % % % % % %
YES 20.2 35.4 22.3 21.1 12.4 19.6 25.4 37.1 26.5 22.3 26.0 22.8
NO 79.8 64.6 77.7 78.9 87.6 80.4 74.6 62.9 73.5 77.7 74.0 77.2
Total 1109 181 1290 1108 233 1341 1194 132 1326 3411 546 3957
23 percent of women in our sample had experienced some sort of health problems during their last
pregnancy. In the Districts of Alwar and Dausa more urban women faced problems than their rural
counterparts but the situation was reverse in Bharatpur.

Table 4.12: Nature of health problems faced during last pregnancy, NIPI-08
ALWAR BHARATPUR DAUSA ALL DISTRICT
Pregnancy
complicatio
n
% % % % % % % % % % % %
Swelling of 62.1 56.3 60.8 64.1 65.5 64.3 62.4 63.3 62.5 62.8 60.6 62.5
hands & Feet
Paleness 12.5 4.7 10.8 25.2 17.2 24.3 17.8 18.4 17.9 18.5 12.0 17.5
Visual
10.3 14.1 11.1 7.3 6.9 7.2 10.6 2.0 9.4 9.5 8.5 9.3
Disturbances
Excessive
6.3 12.5 7.6 8.1 6.9 8.0 11.2 8.2 10.8 8.8 9.9 9.0
Bleeding
Convulsions 15.6 28.1 18.4 17.9 10.3 17.1 11.6 14.3 11.9 14.7 19.7 15.5
Abnormal
Position of 5.4 12.5 6.9 3.4 10.3 4.2 10.9 8.2 10.5 7.0 10.6 7.5
Foetus
Weak or No
Movement of 5.4 12.5 6.9 7.3 6.9 7.2 21.5 18.4 21.0 12.4 13.4 12.5
Foetus
Others 25.0 51.6 30.9 27.8 31.0 28.1 30.4 28.6 30.1 28.0 39.4 29.8
Total 224 64 288 234 29 263 303 49 352 761 142 903
As mentioned earlier, the relatively higher awareness of swelling of hands and feet could be a result of
having experienced this complication first-hand, and the above table validates the assumption. Apart
from this awareness and experience regarding other symptoms were observed to be quite low. The
pregnancy related health problems most commonly reported by women are swelling of hands and feet
(62%), paleness (17%), Convulsions (15%), weak or no movement of foetus (13%), and visual
disturbances (9%). In all the districts, swelling of hands and feet is the most common health problem
during pregnancy.
Table 4.13: Percentage of women who sought advice for health problem during pregnancy,
NIPI-08
ALWAR BHARATPUR DAUSA Rajasthan
RURA URBA Tota RURA URBA Tota RURA URBA Tota RURA URBA Tota
L N l L N l L N l L N l
% % % % % % % % % % % %
67. 65. 74.
64.3 66.7 63.5 58.2 73.0 77.1 67.5 80.3 69.5
YES 7 3 2
32. 34. 25.
35.7 33.3 36.5 41.8 27.0 22.9 32.5 19.7 30.5
NO 3 7 8
Total no. of
221 64 285 230 29 259 300 49 349 751 142 893
women
On asking, who persuaded women to go to health facility for treatment, 36 percent women said their
husband persuaded followed by friends/relatives (29.1%), ANM (25%) and mother in law (14.5%).
Discussions were done with ASHA to know about the complications faced by mothers
during pregnancy. Most of the ASHA said that swelling of face and feet is the most
common symptoms followed by anemia and weakness.
Similar discussions with AWW reveals that AWW usually look for factors like anemia and
swelling of body parts in the pregnant mothers that can lead be dangerous to mothers.
AWW if encounter a high risk case they soon advice the mother to get the help from
doctor. They also provide them with IFA tablets.

Table 4.14: Person persuaded for treatment during pregnancy, NIPI-08

Alwar Bharatpur Dausa Rajasthan
% % % % % % % % % % % %
ANM 22.5 1.7 16.6 41.1 21.9 37.9 26.0 8.1 22.4 29.4 8.5 24.8
ASHA 13.4 1.7 9.8 6.2 6.3 5.9 7.8 6.8 6.6 8.9 4.9 7.4
DAI 1.4 1.0 0.7 0.6 0.6 0.5
Mother -in-law 14.8 17.2 16.1 17.8 9.4 17.2 11.0 10.8 11.6 14.0 12.8 14.5
Husband 33.8 48.3 38.3 37.7 62.5 42.0 27.9 35.1 30.9 32.3 45.1 36.2
23.2 32.8 25.4 16.4 15.6 16.0 38.4 48.6 40.5
Friends / Relatives 27.8 36.6 29.1
Other 1.4 5.2 2.6 0.9 1.4 0.8 0.8 2.4 1.1
Total no. of
142 51 193 146 23 169 219 40 259 114
women 507 621
In majority cases it was found that it was the husband (36%) who persuaded the woman to go in for
treatment during pregnancy for any kind of complication. This finding is fairly consistent among all the
three districts. Bharatpur is the only district where the ANM comes second close to the husband as a
counselor.
4.2 DELIVERY CARE
One of the important thrusts of the program is to encourage deliveries under proper hygienic conditions
(delivering under clean conditions, washing hands with disinfectant before delivery, etc.) and under the
supervision of qualified/ experience health professional. For each live/still birth during two years
preceding the survey, we had asked the women place of delivery, who assisted during the deliveries in
case of home deliveries, characteristics of delivery and any problems that occurred during the delivery
process. This section provides the details.
As per DLHS-3, the institutional deliveries for the state of Rajasthan comes out to be 45.5 percent
whereas NIPI-Baseline-08 has put the the Institutional Deliveries at 65 percent.
4.2.1 Influence of background characteristics on choice of Place of Delivery

In order to encourage deliveries in proper hygienic conditions under the supervision of trained health
professionals, a number of programmes have been launched since the first and second five years plan
but still a lot needs to be done. During survey, women were asked about the place of delivery for the
most recent birth. Nearly 52 percent women reported the place of delivery as government health
facility, 14 percent women visited private health facility for delivery. Of the total home deliveries, 31
percent took place in in-laws home, 1.4 percent each in Parental home and in others home.
Table 4.15: Place of delivery v/s age of respondents, NIPI-08

Institutional Home Total
Age IN LAWS PARENTAL
Group GOVERNMENT NGO PRIVATE HOME HOME OTHER All Births
N % N % N % N % N % N % N %
15-18 60 49.6 0 0.0 16 13.2 40 33.1 4 3.3 0 0.0 121 100.0
19-21 459 55.0 1 0.1 120 14.4 233 27.9 9 1.1 9 1.1 835 100.0
22-25 858 52.1 4 0.2 235 14.3 494 30.0 26 1.6 26 1.6 1646 100.0
26-30 512 51.5 0 0.0 132 13.3 327 32.9 12 1.2 10 1.0 995 100.0
31-40 143 46.1 0 0.0 40 12.9 113 36.5 3 1.0 9 2.9 310 100.0
41-49 6 33.3 0 0.0 3 16.7 9 50.0 0 0.0 0 0.0 18 100.0
Total 2038 51.9 5 0.1 546 13.9 1216 31.0 54 1.4 54 1.4 3925 100.0

No age-group wise preference for Institutional or Home delivery is apparent for the findings which are
quite generalized for all the age-groups.
Institutional deliveries, particularly in private sector facilities, increase sharply with the mother‟s
education and with household wealth index. With regard to deliveries at home, the proportion of
deliveries decreases with the mother‟s education.
When asked to women who advised them to go to health facility for delivery, about 45 percent reported
they were advised by ANM/Nurse/Midwife followed by doctor (23.9%) and ASHA (6.7%). A
considerable proportion of women (23.1%) mentioned that they have not been advised by any body or
th
any one to go to institution for delivery. In Bharatpur, nearly 3/4 women were advised by
ANM/Nurse/Midwife whereas in Alwar and Dausa 35 and 29 percent women were advices by them.
Table 4.16: Place of delivery v/s years of schooling, NIPI-08

Educational IN LAWS PARENTAL
Status GOVERNMENT NGO PRIVATE HOME HOME OTHER All Births
N % N % N % N % N % N % N %
No
997 1 200 800 35 41
Education 47.9 0.0 9.6 38.4 1.7 2.0 2082 100.0
<5 36 56.3 0 0.0 6 9.4 21 32.8 1 1.6 0 0.0 64 100.0
5-7 347 55.8 3 0.5 74 11.9 175 28.1 14 2.3 6 1.0 622 100.0
8-9 342 58.8 0 0.0 102 17.5 129 22.2 3 0.5 5 0.9 582 100.0
10-11 165 58.7 1 0.4 65 23.1 49 17.4 0 0.0 1 0.4 281 100.0
12 & Above 151 51.4 0 0.0 99 33.7 42 14.3 1 0.3 1 0.3 294 100.0
Women with higher educational status are more inclined to go in for Institutional delivery irrespective of
the type of PSU, whether rural or urban. Women with less or no education at all are seen going for
Home deliveries.
Table 4.17: Place of Delivery v/s number of live children, NIPI-08

Birth In Laws Parental
Order Government NGO Private Home Home Other All Births
N % N % N % N % N % N % N %
1-2 1282 54.3 4 0.2 384 16.3 626 26.5 34 1.4 23 1.0 2361 100.0
3-4 612 49.9 1 0.1 136 11.1 434 35.4 16 1.3 24 2.0 1226 100.0
5+ 144 42.6 0 0.0 26 7.7 156 46.2 4 1.2 7 2.1 338 100.0
Total 2038 51.9 5 0.1 546 13.9 1216 31.0 54 1.4 54 1.4 3925 100.0
The hypothesis that younger women having their first child would rather have a risk free institutional
delivery rather than have it at home is not quite validated with the findings, as the findings are quite
generalized for all the groups of women in the above table. In Home deliveries it is starkly clear that
women with more than 3-4 children go in for Home Delivery than Institutional delivery.
Table 4.18: Place of Delivery v/s economic status of respondent’s household, NIPI-08
Wealth IN LAWS PARENTAL
Index GOVERNMENT NGO PRIVATE HOME HOME OTHER All Births
N % N % N % N % N % N % N %
Lowest 820 49.2 0 0.0 155 9.3 623 37.4 29 1.7 33 2.0 1667 100.0
Second 368 53.4 2 0.3 84 12.2 215 31.2 7 1.0 10 1.5 689 100.0
Middle 317 56.0 0 0.0 72 12.7 161 28.4 8 1.4 6 1.1 566 100.0
Fourth 229 53.0 1 0.2 80 18.5 111 25.7 7 1.6 4 0.9 432 100.0
Highest 304 53.2 2 0.4 155 27.1 106 18.6 3 0.5 1 0.2 571 100.0
Total 2038 51.9 5 0.1 546 13.9 1216 31.0 54 1.4 54 1.4 3925 100.0
The general trend that has been witnessed is that women with lower economic profile tend to have
deliveries at government facilities as against those who belonged to better income households and
could afford to go to Private Institutions for delivery.
“Pehle log ko hospital nahin jana chahte the par jab se hospital mein deliveri ke liye paisa
milne laga hai tab se ve vahan jyada jane lage hain. Abhi sarkari hospital ke dekh rekh
mein bhi badlaw aaya hai. Pahle doctor log rogi par kam dhyan dete the ab jyada de rahe
hain. Sadk ki suvidha bhi pahle se jyada ho gayee hai isliye bhi ab hospital jana aasan ho
gaya hai” (Earlier people do not go to hospitals but after introduction of money factor for
institution delivery they are going to hospitals. Earlier doctors were not so careful towards
patients but not they are giving much attention. Due to improved road connectivity now
women are more able to go to the health facility for delivery) ASHA, Bharatpur
(Rajasthan)
4.2.2 Arrangement and Cost of Transport
In nearly 77 percent cases, family members made the arrangement for transport. A significant
percentage of Husbands (30%) arranging transport in urban as well as rural areas for delivery. ASHA‟s
are not playing any significant role in the arrangement of transport. Only 4 percent women reported that
ASHA arranged transport.
On an average cost incurred on transportation is Rs. 248 in all the districts. In urban areas average
cost of transportation varies from Rs.101/- in Bharatpur to Rs.194/- in Dausa while in rural areas it
varies from Rs.223/- in Bharatpur to Rs.304/- in Dausa in the study districts.
Table 4.19: Average Transportation Expenses (In Rupees), NIPI-08

RURAL URBAN TOTAL RURAL URBAN TOTAL RURAL URBAN TOTAL RURAL URBAN TOTAL
MEAN 292 89 257 223 101 196 304 194 291 274 119 248
N 614 131 745 638 177 815 721 93 814 1973 401 2374
4.2.3 Institutional Delivery
In Rural areas, most of the institutional deliveries (86.1%) were normal vaginal delivery or assisted
vaginal delivery (1.1%). Caesarian deliveries were 12.5 percent. Nearly four-fifth (83.9%) deliveries
occurred in the study districts were normal and about 15 percent were caesarian and the rest were
assisted in urban areas. Highest number of normal deliveries (90%) observed in Dausa and highest
number of caesarian deliveries (20.6%) occurred in Alwar. In rural as well as in urban areas, nearly 50
percent deliveries were conducted by ANM. In urban and rural areas, after ANM, more deliveries are
conducted by govt. doctors followed by private doctors.
Table 4.20: Nature of Institutional Delivery, NIPI-08

Who ALWAR BHARATPUR DAUSA RAJASTHAN
Conducted RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total
the Delivery % % % % % % % % % % % %
Government
44.3 38.3 43.3 22.5 15.5 20.1 41.8 36.4 42.2 36.6 30.0 35.3
Doctor
Private
14.2 17.7 15.6 9.9 15.5 11.6 15.1 24.7 16.1 13.2 19.4 14.5
Doctor
ANM 41.6 44.0 41.1 67.6 68.9 68.3 43.1 39.0 41.6 50.2 50.5 50.2
Type of Delivery
Normal 82.7 78.9 81.6 87.6 85.8 87.3 90.0 86.6 89.0 87.0 83.9 86.1
Caesarian 15.7 20.6 16.9 10.9 13.7 11.4 8.7 11.3 9.7 11.6 15.0 12.5
Assisted 1.7 0.5 1.5 1.5 0.5 1.3 1.2 2.2 1.3 1.4 1.1 1.4

Total no of
664 139 803 667 184 851 823 112 935 2154 435 2589
women
Table 4.21: Cost Incurred on Institutional Delivery (In Rupees), NIPI-08

RURA URBA Tota RURA URBA Tota RURA URBA Tota RURA URBA Tota
Rupees L N l L N l L N l L N l
% % % % % % % % % % % %
<500 3.0 0.0 2.5 3.9 3.3 3.8 2.6 0.0 2.2 3.1 1.4 2.8
500-1000 26.8 17.3 25.2 46.0 60.9 49.2 28.4 21.4 27.6 33.4 36.8 34.0
1001-
14.9 7.9 13.7 13.3 6.5 11.9 12.6 12.5 12.6 13.6 8.5 12.7
1500
1501-
21.4 24.5 21.9 18.9 11.4 17.3 25.0 15.2 23.9 22.0 16.6 21.1
2000
2001-
6.6 6.5 6.6 2.2 2.2 2.2 5.1 4.5 5.0 4.7 4.1 4.6
2500
2501-
8.9 11.5 9.3 5.7 4.3 5.4 9.5 6.3 9.1 8.1 7.1 8.0
3000
3001-
4.7 6.5 5.0 1.6 2.2 1.8 5.3 8.9 5.8 4.0 5.3 4.2
4000
4001-
4.4 10.8 5.5 1.8 2.2 1.9 3.3 8.9 4.0 3.2 6.7 3.7
5000
5001 + 9.3 15.1 10.3 6.4 7.1 6.6 8.1 22.3 9.8 8.0 13.6 8.9
258
664 139 803 667 184 851 823 112 935 2154 435
Total 9
Survey also tried to get an idea about the cost incurred on institutional delivery including transportation
th
cost. More than 2/5 women spent any where between Rs. 500 – 1500 on institutional delivery;
another 26 percent women spent Rs. 1501 to 2500. More than Rs.5000/- have also been spent on
delivery by around 9 percent women and around 3 percent women also spent less than Rs.500/- on
delivery. Data reveals that delivery expenses in urban areas are more than rural areas.
Table 4.22: Problems experienced during delivery by woman of different age groups, NIPI-08
Premature Excessive Prolonged Obstructed Breech
Other Total
Labour Bleeding Labour Labour Presentation
YES YES YES YES YES YES YES
Age N % N % N % N % N % N % N %
15-18 37 62.7 5 8.5 10 16.9 6 10.2 1 1.7 0 0.0 59 100
19-21 268 54.4 38 7.7 83 16.8 87 17.6 13 2.6 4 0.8 493 100
22-25 544 54.3 60 6.0 211 21.1 151 15.1 28 2.8 8 0.8 1,002 100
26-30 304 51.5 42 7.1 126 21.4 99 16.8 14 2.4 5 0.8 590 100
31-40 98 58.3 15 8.9 32 19.0 21 12.5 2 1.2 0 0.0 168 100
41-49 4 57.1 0 0.0 1 14.3 2 28.6 0 0.0 0 0.0 7 100
Premature Labor has been found to be the major problem experienced by women during delivery,
being faced by more than a half of the women respondents. Less than one-fifth of the women also
faced Prolonged Labor and Obstructed Labor.
Nature of advice received after delivery
Most of the mothers who received advice from Nurse were given advice about spacing method (72.5%)
followed by routine checkup (69.9%), Immunization (68.5%), breastfeeding practices (67.5%), and
newborn care (64.1%). Doctors mostly provided advice about newborn care (29%), breastfeeding
practices (27.8%), and routine check-up (26.7%).
Table 4.23: Nature of advice received after delivery by source, NIPI-08

ALWAR
Advice DOCTOR NURSE WARD ATTENDANT ANM Total
% % % % %

New born care practices 32.0 59.4 0.3 8.4 100

Breast Feeding 28.1 64.6 0.0 7.3 100
Immunization 27.8 63.7 0.0 8.5 100
Routine check up 32.1 66.4 0.0 1.5 100
Spacing method 18.8 79.7 0.0 1.4 100
Any other advice 0.0 100 0.0 0.0 100

BHARATPUR
% % % % %
New born care practices 21.6 68.3 0.3 9.9 100.0
Breast Feeding 25.4 70.6 0.4 3.7 100.0
Immunization 18.6 75.4 0.0 6.0 100.0
Routine check up 21.2 72.7 0.0 6.1 100.0
Spacing method 21.0 74.6 0.0 4.3 100.0
Any other advice 46.7 53.3 0.0 0.0 100.0
DAUSA
% % % % %
New born care practices 32.1 64.6 0.7 2.6 100.0
Breast Feeding 29.1 67.3 0.8 2.8 100.0
Immunization 29.3 66.3 1.5 3.0 100.0
Routine check up 27.9 69.8 0.6 1.7 100.0
Spacing method 26.0 66.1 1.6 6.3 100.0
Any other advice 9.1 91 0.0 0.0 100.0
Mother’s perception about environment of health facility and behavior of staff
In order to understand the perception of mothers about environment of health facility, a five point scale
is used to rate the perception about general cleanliness, toilets availability and cleanliness and
behaviour of staff. In Dausa, 31.4 percent women perceived that cleanliness of ward and labour room
is good and very good while in Bharatpur and Alwar, only 27.4 and 23.8 percent women perceived the
same respectively. Toilets availability and cleanliness have been rated good and very good by 29.7
percent women in Dausa followed by Bharatpur (22.9%) and Alwar (21.6%). Regarding behaviour of
staff and overall perception of mothers about the environment in health facility, Dausa relatively better
rated in comparison to Bharatpur and Alwar. Hence it indicates that environment of health facilities in
Dausa is relatively better in all respect when compared with other two study NIPI intervention districts.
Table 4.24: Mother’s perception about environment of health facility and behavior of staff, NIPI-
08

% % % %
Services &Stay in the Health Facility
Very poor 1.1 1.4 1.2 1.2
Poor 11.5 13.4 11.3 12.1
Average 63.6 57.8 54.9 58.6
Good 18.3 24.2 28.4 23.9
Very good 5.5 3.2 3.0 3.8
DK/CS 1.2 0.4
Environment of the Health Facility
Very poor 0.5 0.1 0.1 0.2
Poor 3.1 9.4 4.7 5.8
Average 62.3 48.4 30.3 46.2
Good 31.8 35.4 58.7 42.7
Very good 2.4 6.7 4.2 4.4
DK/CS 2.0 0.7
Behavior of the Staff in the Health Facility
Very poor 0.6 0.2 0.3
Poor 7.7 1.6 7.5 5.6
Average 63.6 48.8 29.5 46.4

% % % %
Good 24.9 42.8 56.8 42.3
Very good 3.1 6.7 5.1 5.0
DK/CS 1 8 9
803 851 935 2589
4.2.4 Janani Suraksha Yojana (JSY)
Janani Suraksha Yojana (JSY) under the overall umbrella of National Rural Health Mission (NRHM)
integrates the cash assistance with antenatal care during the pregnancy period, institutional care
during delivery and immediate post-partum period in a health centre by establishing a system of
coordinated care by field level health worker. The JSY is a 100 percent centrally sponsored scheme.
The vision of the scheme is to reduce overall maternal mortality ratio and infant mortality rate and to
increase institutional deliveries in BPL families. In Rajasthan, JSY has been implemented for both the
categories of families i.e. BPL and APL. In order to assess the knowledge about JSY among mothers,
they were asked whether they are aware of JSY.
Of the 3942 interviewed mothers in Rajasthan, around 83 percent was aware about JSY. In Dausa, 87
percent, Bharatpur, 86 percent and Alwar 77 percent of the women were aware about JSY. Mothers
mentioned AWW, ASHA and ANM are equally responsible for providing information about JSY to
villagers. In Dausa, 44 percent mothers received information about JSY from AWW whereas in
Bharatpur, 57 percent and in Alwar 43 percent women received information from ANM and ASHA
respectively.
Table 4.25: Awareness about JSY, NIPI-08

All Districts Total
YES NO
N
N % N %
Age Group
15-18 96 79.3 25 20.7 121 100.0
19-21 671 80.3 165 19.7 836 100.0
22-25 1401 84.7 253 15.3 1654 100.0
26-30 855 85.5 145 14.5 1000 100.0
31-40 241 77.0 72 23.0 313 100.0
41-49 15 83.3 3 16.7 18 100.0
Years of Schooling
No Education 1687 80.7 403 19.3 2090 100.0
<5 54 84.4 10 15.6 64 100.0
5 to 7 529 84.6 96 15.4 625 100.0
8 to 9 505 86.5 79 13.5 584 100.0
10 to 11 240 85.1 42 14.9 282 100.0
12 & Above 264 88.9 33 11.1 297 100.0
Nature of PSU
RURAL 2782 81.8 618 18.2 3400 100.0
URBAN 497 91.7 45 8.3 542 100.0
Wealth Index
Lowest 1361 81.3 313 18.7 1674 100.0
Second 564 81.5 128 18.5 692 100.0
Middle 475 83.5 94 16.5 569 100.0
Fourth 368 84.8 66 15.2 434 100.0
Highest 511 89.2 62 10.8 573 100.0
Total 3279 83.2 663 16.8 3942 100.0
Janani suraksha
Development & Researchyojana sePvt
Services sansthagat
Ltd prasav mein bhadotrui hui hai aur Page
ab prasv mein
58 of 123
paise bhi kam lagte hain”(After the implementation of JSY there has been increase in
the institutional delivery and cost incurred for delivery has also gone down)..ASHA,
Dausa (Rajasthan)
Among those women who delivered at home, 72.9 percent in Dausa, 69.2 percent in Alwar and 67.9
percent in Bharatpur were aware about JSY. Hence, despite having knowledge about JSY, a
considerable number of women delivered at
4.2.5 Training and Capacity building of ASHAs

Accredited Social Health Activist (ASHA) supposed to accompany pregnant women for institutional
delivery under JSY. Women were asked whether they were accompanied by ASHA and did ASHA
reach later on, if not accompanied. Thirty five percent institutional deliveries in Alwar, 36 percent in
Bharatpur and 19 percent in Dausa are accompanied by ASHA. Three percent women in Dausa, 4.3
percent in Alwar and 5.1 percent in Bharatpur reported that ASHA did not accompany for delivery but
reached later on to health facility for the same.
Table 4.26: Training of ASHA’s

Total ASHAs to be Round 1 Training in
District Round 2 Training 07-08
Recruited & Selected the year 05-06
Ongoing in
Target Selected Target Completed Target Completed
phases
Alwar 2575 2380 2380 2380 2380 2100 280
Bharatpur 1553 1523 1523 1523 1553 1003 550
Dausa 1056 917 917 917 917 917 0
Table 4.27: Accompaniment of ASHA during Institutional Delivery, NIPI-08

RAJASTHAN
RURAL URBAN Total
N % N % N %
Did the ASHA accompany you?
YES 722 33.5 83 19.1 758 29.3
NO 1326 61.6 231 53.1 1557 60.1
NOT APP 106 4.9 121 27.8 274 10.6
Total 2154 100 435 100 2589 100.0
If no, did she reach later on?

YES 57 4.3 6 2.6 59 3.8
NO 1269 95.7 225 97.4 1498 96.2
Total 1326 100 231 100 1557 100
Why did ASHA not accompany you?
We did not inform her 1103 86.9 204 89.1 1309 87.4
We informed but she refused to come 30 2.4 1 0.3 30 2.0
along
She was not present in the village or 90 7.1 11 5.0 99 6.6
she was not well
Don‟t Know 33 2.6 7 2.9 39 2.6
Other 13 1.0 6 2.6 21 1.4
Total N 1269 100 229 100 1498 100.0
While asking the reason of not accompaniment of ASHA from mothers, nearly 88 percent in Dausa and
89 percent in Bharatpur and about 84 percent in Alwar reported that they did not inform to ASHA.
Around 2 percent women informed ASHA about delivery but she refused to come along. Seven percent

women mentioned ASHA was not present in the village or she was not well as the reason of not
accompaniment for delivery.
“Janani suraksha yojana ke antargat yadi ASHA ke saath delivery ke liye mahila jati hai
to use 1400 rupye milte hain aur yadi ASHA saath nahin jaati hai to use 1700 rupaye
milte hain. Isiliye mahilayen ASHA ko saath lekar nahin jana chahti hain”(in JSY if
ASHA accompanies the women for delivery to the institution the women get Rs. 1400
and if they go alone then they get Rs1700. that is the reason they do not inform ASHA
for accompaniment). ASHA, Dausa, Alwar & Bharatpur (Rajasthan)
Under JSY, every mother supposed to stay in the health facility for a minimum period of 48 hours for
optimal care and qualify as JSY beneficiary. Due to increase in demand and non availability of required
infrastructure facilities, government relaxed the norm from 48 hours to 24 hours. Survey revealed that
in spite of 24 hours minimal norm, a considerable percentage (40%) of mothers has been discharged
within 12 hours. Fifty percent mothers in Bharatpur, 38 percent each in Alwar and 32.6 percent in
Dausa were discharged within 12 hours of delivery.
Nearly half (59%) of the women reported that ASHA stayed with them for less than a day. In all the 3
study districts ASHAs staying with 30 -35 percent mothers for 1 – 2 days.
Table 4.28: Duration of stay of the mother at health facility after delivery, NIPI-08
Stay of
Mothers RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total
% % % % % % % % % % % %
<=6 Hrs 22.1 12.9 18.9 34.5 24.2 31.6 20.5 11.7 19.1 25.3 16.2 23.2
7-12 Hrs 16.3 21.1 17.8 16.9 21.9 18.4 13.1 14.7 13.5 15.3 19.1 16.5
13-23 Hrs 0.0 0.5 0.1 0.6 0.9 0.6 0.1 0.4 0.2 0.2 0.6 0.3
1-2 Days 44.0 45.9 44.5 38.2 40.6 39.4 49.2 49.4 49.2 44.2 45.4 44.5
3-6 Days 15.4 18.2 16.4 7.8 10.5 8.1 15.9 21.6 16.6 13.2 16.8 13.8
Week of
2.2 1.4 2.2 1.9 1.8 1.9 1.1 2.2 1.4 1.7 1.8 1.8
More
Mothers were also asked whether they have received any cash incentive after institutional delivery
(govt. institutions). About 29 percent mothers reported to have received cash incentive in rural areas
and 26 percent received in urban areas of the study districts.
“JSY scheme achi hai, kam se kam paise ke lalach mein hi log hospital mein delivery
karwate hain” (the JSY scheme is good, atleast people go for institutional delivery to avail
the incentive attached with it) ANM, Dausa (Rajasthan)
4.2.6 HOME DELIVERY
This section deals with the details of home delivery cases, including reasons behind choosing to have
the baby delivered at home and not in an institution, the actually place where the delivery took place
and whether it is influenced by the background of the pregnant mother to be, the person who actually
conducted the delivery and finally, why was this person chosen to begin with.
Out of 3843 women interviewed in three districts, 1336 women delivered at home. So, overall 34.1
percent of mothers delivered at home. In Alwar, 37.3 percent mothers delivered at home followed by
Bharatpur (36%) and Dausa (28.8%).

As it has been mentioned above, nearly one-third of the total surveyed women delivered at home. They
were also asked the reasons why they did not deliver in the health facility. Forty nine percent women
mentioned going to health facility for delivery is not necessary and another 25 percent mentioned they
did not have time to go to health facility, 13 percent feel that cost of delivery is too much, 9 percent
women sited non availability of transportation facility and another 9 percent reported no body was there
to accompany for delivery as the main reasons of home delivery. The most important reasons
emerging in all the districts for not going to health facility for delivery are not necessary and did not get
time.
During qualitative discussions, it has come out that people generally do not prefer to go to health
facility if they feel that there is no serious problem or any complication to pregnant women. Non
availability of transportation also emerged as an important reason during qualitative discussions.
Table 4.29: Reason for Home Delivery, NIPI-08

Reasons
(multiple
reasons)
% % % % % % % % % % % %
Costs too
15.0 17.5 15.5 9.3 6.5 9.5 13.4 8.9 13.3 12.5 11.3 12.7
Much
Facility not
1.2 0.9 1.1 4.2 1.3 4.0 1.6 0.7 1.5
open
Too far/ no
11.6 6.1 11.0 5.3 2.8 5.0 10.9 8.9 10.3 9.2 5.6 8.7
transportation
Don't trust
facility/poor 2.5 0.9 2.3 1.6 1.5 4.2 2.5 4.2 2.7 1.0 2.6
quality service
No one to
5.6 7.9 5.9 7.2 6.5 7.1 15.3 10.1 15.1 9.0 8.0 9.0
accompany
Did not get
18.5 26.3 18.9 23.0 19.4 22.7 35.1 32.9 34.7 25.0 25.6 24.8
time/no time
No female
provider at 2.3 0.9 2.3 1.4 0.9 1.3 1.1 1.3 1.1 1.6 1.0 1.6
facility
Husband/famil
8.3 10.5 7.6 5.6 3.7 5.5 8.6 2.5 8.2 7.5 6.0 7.0
y did not allow
Not necessary 57.6 54.4 56.3 47.9 57.4 48.1 43.2 38.0 42.4 50.0 51.2 49.4
Not customary 13.9 22.8 15.9 18.8 19.4 20.6 11.4 24.1 14.1 14.9 21.9 17.1
Other 6.7 8.8 6.8 2.6 3.7 2.5 0.8 0.8 3.5 4.7 3.5
Total 432 39 471 430 46 476 359 18 377 1221 103 1324
“Normal dard hua aur aspatal le jane ki tayari mein ghar par hi ho jata hai.” (Because of
the untimely delivery and lack of preparations in advance many deliveries happen at
home) ANM...Bharatpur (Rajasthan)

Home delivery Practices
Survey also tried to capture the various prevailing practices in relation to home delivery. For a safe
delivery at home, besides trained health personnel hygienic environment and sterilized equipments is a
must. Women who delivered at home were asked about the place used for delivery at home, ventilation
condition of room and personnel involved in conducting the delivery.
Table 4.30: Home Delivery Practices, NIPI-08

On the ground
On the ground On the cot with On the cot
with clean Don‟t
without clean without Other
clothes/plastic remember
clothes/plastic clothes/plastic cloth/plastic
underneath…
Year of Schooling
No
64.4 77.1 52.6 65.5 70.0 77.8
Education
<5 1.7 0.8 2.3 1.8 10.0 0.0
5-7 15.1 11.2 19.1 14.5 20.0 11.1
8-9 11.5 6.1 14.4 12.7 0.0 11.1
10-11 4.0 2.5 6.0 3.6 0.0 0.0
12 & Above 3.3 2.2 5.6 1.8 0.0 0.0
Location of PSU
RURAL 93.7 92.2 86.5 98.2 80.0 88.9
URBAN 6.3 7.8 13.5 1.8 20.0 11.1
Wealth Index
Lowest 54.1 55.3 34.4 65.5 30.0 55.6
Second 15.9 20.9 19.5 10.9 30.0 33.3
Middle 13.9 10.1 16.3 12.7 30.0 0.0
Fourth 9.2 6.7 13.5 3.6 10.0 11.1
Highest 6.8 7.0 16.3 7.3 0.0 0.0
This has clearly come out from the data that women from rural locations, with no education and lowest
wealth index, did not follow the standard precautionary measures during the delivery.
Table 4.31: Person who conducted delivery at home, NIPI-08

Delivery Rura Urba Tota Rura Urba Tota Rura Urba Tota Rura Urba Tota
Specification l n l l n l l n l l n l
% % % % % % % % % % % %
Mid Wife/LHV 1.2 2.6 1.7 0.2 0.2 3.3 3.2 1.5 1.0 1.6
Trained Dai 51.6 43.9 49.3 30.7 34.3 31.3 41.5 49.4 42.7 41.3 41.9 40.9
Untrained Dai 35.9 43.9 37.6 57.7 53.7 57.1 42.1 31.6 40.6 45.4 44.2 45.5
ASHA 0.2 0.2 1.2 1.9 1.1 0.3 1.3 0.3 0.6 1.0 0.5
ANM 7.4 3.5 6.8 3.7 2.8 3.8 5.0 11.4 5.8 5.4 5.3 5.4
Family Member 9.5 9.6 10.0 8.1 9.3 8.2 10.9 13.9 10.9 9.4 10.6 9.6
Relatives/Frien
6.9 12.3 7.4 1.6 1.9 1.5 6.7 5.1 6.4 5.0 6.6 5.0
ds
132
Total 432 39 471 430 46 476 359 18 377 103
1221 4
Women were also asked about the personnel who conducted the delivery, in rural as well as urban
areas of study districts, more than two-fifth deliveries are conducted by untrained dai (46%) and a
similar proportion of deliveries are conducted by trained dai (41%) also. In Alwar, Bharatpur and
Dausa 49, 31 and 43 percent deliveries are conducted by trained dai.

On asking about the condition of the room where delivery was taken place, about 54 percent women
reported there was proper ventilation, around 60 percent women perceived that the light was adequate
and 58 percent said that floor was clean. In Alwar, the condition of the rooms (i.e. ventilation, adequacy
of light and cleanliness of floor) where delivery was conducted was relatively better than the rooms of
other two districts.
Table 4.32: Reasons behind choosing a specific person to conduct the delivery, NIPI-08
Specification Rural Urban Total Rural Urban Total Rural Urban Total Rural Urban Total
% % % % % % % % % % % %
Why did you choose the person to conduct delivery
Past experience 40.3 32.5 38.6 28.8 22.2 29.2 37.0 41.8 37.4 35.3 31.2 34.9
Economical 2.1 5.3 2.3 1.2 1.9 1.5 8.9 5.1 8.8 3.8 4.0 3.9
Safe delivery 50.9 45.6 49.9 28.6 28.7 28.8 41.8 43.0 41.6 40.4 38.9 40.0
Reliable 4.6 10.5 5.7 18.4 17.6 17.4 6.1 5.1 5.8 9.9 11.6 10.0
Behavior of the
0.9 5.3 2.1 10.5 13.9 10.7 1.4 2.5 1.9 4.4 7.6 5.1
service provider
Recommended 0.9 0.9 1.1 12.6 15.7 12.4 4.7 2.5 4.5 6.1 6.6 6.1
Other 0.2 0.2 0.1 0.1
Total 432 39 471 430 46 476 359 18 377 1221 103 1324
Reason of choosing particular person to conduct delivery at home was also asked and past experience
of the person (35%) and past record of conducting safe deliveries (40%) are the two important reasons
mentioned. Person being economical, reliable and recommended by somebody are the other reasons
expressed for choosing the person to conduct home delivery.
At the time of delivery person who is conducting delivery needs to take certain essential precautions.
Questions pertaining to these precautions were asked. Of the total women who delivered at home, 14
percent reported using of Disposable Delivery Kit (DDK) by health personnel. Nearly two-third women
observed new-born baby was immediately wiped, dried and wrapped without being bathed. The
practice of using clean cloth to wrap the baby and clean blade to cut the cord is quite prevalent as
reported by 81 and 90 percent women respectively. Practice of using sterile/boiled thread to tie the
cord is also prevalent to some extent. Only 57 percent women observed the health personnel doing the
same. On asking what was applied on the cut cord, 35 percent mentioned powder followed by Oil
(21%) and medicine (11%). About 27 percent reported nothing was applied on the cut cord. About 32
percent mothers reported that the child was given bath between 1 – 12 hours and another 34 percent
mothers reported that the child was given bath after 24 hours of birth.
Table 4.33: The Delivery Process, NIPI-08

RAJASTHAN
Specification Rural Urban Total
% % %
Was she/he contacted before the labor pain started?
YES 62.7 66.4 63.7
NO 35.1 31.6 34.3
DONT KNOWN 2.1 2.0 2.0
Did she/he mentioned the requirements before attending the delivery?
YES 66.2 57.5 66.1
NO 33.3 42.0 33.4
DONT KNOWN 0.5 0.5 0.5
Did the person who attended the delivery wash his/her hands before attending the delivery?
YES 75.6 74.1 76.4
NO 12.5 14.0 12.7
DONT KNOWN 11.9 12.0 11.0

RAJASTHAN
Specification Rural Urban Total
% % %
What was used for washing?
WATER ONLY 13.3 13.0 13.8
SOAP 85.2 83.4 84.6
ASH/MUD 0.3 0.4 0.3
CANT SAY/DONT KNOWN 1.2 3.1 1.3
Total 923 88 1011
Table 4.34: COST INCURRED IN HOME DELIVERY, NIPI-08

DISTRICT
RURA URBA RURA URBA RURA URBA Tota RURA URBA
Total Total Total
L N L N L N l L N
N 293 34 327 363 41 404 279 16 295 935 91 1026
408.2 364.9 462. 406.7
Mean 405.32 433.85 360.38 405.37 465.42 407.81 405.81 416.44
8 5 3 5
Media
300 400 351 300 300 300 500 450 500 400 400 400
n
So far as the amount spent on home deliveries are concerned, 45 percent spent less than Rs.500/- and
another 44 percent spent between Rs.500 – 1000. In Bharatpur, expenditure on most of the home
deliveries (57%) was less than Rs.500/- while in Alwar and Dausa, it was between Rs.500/ - to
Rs.1000/- in 41 percent and 57 percent cases.
Table 4.35: Nature of advice received, NIPI-08

RAJASTHAN
Rural Urban Total
N % N % N %
New Born Care Practices 502 40.7 46 44.2 548 41.0
Breast Feeding Practices 482 39.1 52 50.0 534 40.0
Immunization 253 20.5 30 28.8 283 21.2
Routine Check Up 70 5.7 18 17.3 88 6.6
Spacing Method 72 5.8 8 7.7 80 6.0
Any Other 5 0.4 0 0.0 5 0.4
No Advice 363 29.5 24 23.1 387 29.0
Total 1232 100 104 100 1336 100
Majority of persons (71%) who conducted home deliveries gave advises to mothers regarding some of
the important aspects. About 41 percent mothers received advice on new born care practices, 40
percent received on breastfeeding practices and 21 percent received on immunization. A considerable
number of mothers (29%) did not receive any advice.
4.3 POST NATAL CARE
The health of a mother and newborn child depends not only on the health care she receives during her
pregnancy and delivery, but also on the care she and the infant receive during the first few weeks after
delivery. Postnatal care check-ups soon after the delivery are particularly important for births that take
place in non-institutional settings. Recognizing the importance of postnatal check-ups, government
programme (RCH) recommends three postnatal visits.
“Chatri mata ko khana nahi diya jata, chai bhi kali di jati hai jisse mata aur bacche ke
swasth par vipreet prabhav padta hai “( Mother is not given anything to eat, black tea is
given her to drink which is harmful to both mother and the new born) …ASHA,
Development & Research Services Pvt Ltd
Alwar
Page 64 of 123
(Rajasthan)
Table 4.36: Number of times PNC received, NIPI-08
RAJASTHAN
ALWAR BHARATPUR DAUSA TOTAL
N % N % N % N %
1 29 24.2 46 57.5 39 46.4 114 40.1
Number of Visits 2 47 39.2 16 20.0 18 21.4 81 28.5
3+ 44 36.7 18 22.5 27 32.1 89 31.3
Total 120 100.0 80 100.0 84 100.0 284 100.0
A large proportion of maternal and neo-natal deaths occur during the 48 hours after delivery. Hence
safe motherhood programmes have increasingly emphasized the importance of postnatal care,
recommending that all women receive a check up within two days of delivery. The World Health
Organization (WHO) recognizes several „crucial moments when contact with the health
system/informed caregiver could be instrumental in identifying and responding to needs and
complications‟ (WHO, 1998). It is most important to have the first postnatal check-up within a few hours
of birth. Another important time for a postnatal check-up is six weeks (42 days) after the birth. By this
time, a woman‟s body should generally have returned to its per-pregnancy state. To assess the extent
of postnatal care check-ups, women were asked whether any health personnel check on her health
after last delivery.
A very less number of women (40.1%) have received only 1 postnatal check-up and lesser than that
have received 3+ Postnatal Checkups (31.3%).

CHAPTER 5
NEWBORN CARE
5.1 Preamble
The majority of newborn problems are specific to the perinatal period. They cause not only deaths but
also substantial morbidity and disability. These problems are the result of poor maternal health,
inadequate care during pregnancy, inappropriate management and poor hygiene during delivery, lack
of newborn care and discriminatory care. Death among newborn infants is so frequent that it is
accepted as routine by many families and community members. If a mother dies during childbirth, her
baby has smaller chance of survival, and if survives she is at high risk for neglect, malnutrition and
morbidity. Keeping this in view, government has launched nationwide programme for the care of
pregnant women as well age newborns.
During this survey, an attempt was made to capture some important issues related to newborn health
and family practices from the mothers. Newborn care related information was also collected from
service providers and program managers. This chapter presents the findings related to newborn care.
5.2 Infant Mortality
For decades, Rajasthan has been one of the infamous states with high Infant Mortality Rate. But in the
last few years a positive change has been witnessed and the mortality rates have reduced
considerably.
Table 5.1: Trends in Infant Mortality Rate of Rajasthan and India
Source/Year Infant Mortality Rate

Rajasthan India
NFHS 1 (1992-93) 73 79
NFHS 2 (1998-99) 80 68
NFHS 3 (2005-06) 65 57
SRS 1997 83 71
SRS 2003 75 60
SRS 2006 68 57
NRHM Goal by 2012 32 45
Source: NFHS 2 and 3, SRS Bulletin (1997), SRS (2003), SRS (2006) & State PIP (2007-08)
5.3 Child Mortality
Table 5.2: Trends in Under five mortality Rate for Rajasthan and India
Under 5 Mortality Rate

Source/Year
Rajasthan India
NFHS1 (1992-93) 103 109
NFHS2 (1998-99) 115 95
NFHS3 (2005-06) 85.4 75
NRHM Goal by 2012 <50 <50
Direct estimates of infant and child mortality indicators at district level are not available, though
estimates using census data on children ever born and children surviving are available but are
inconsistent and not reliable. Hence this data is not presented in this report. The District Level
Household Survey (DLHS 2002-03) does not provide district level infant and child mortality estimates.
Thus no reliable estimate of infant and child mortality is available at the district level.

5.4 Birth weight
Low birth weight babies are at higher risk of the infant mortality. To avert the risk and provide timely
treatment it is necessary to identify these high risk babies by taking weight soon after birth and
provision of appropriate care. In the case of institutional deliveries, most of the babies are weighed
after birth. But in the case of home deliveries, it is not so. During this survey the birth weight of the
babies delivered at home has been captured to explore the process of weighing these babies under the
existing mechanism.
Table 5.3: Recorded weight of baby, NIPI-08

Alwar Bharatpur Dausa All Districts
<2.5 Kg >=2.5 Kg <2.5 Kg >=2.5 Kg <2.5 Kg >=2.5 Kg <2.5 Kg >=2.5 Kg
N % N % N % N % N % N % N % N %
8 32 17 68 6 54.5 5 45.5 5 62.5 3 37.5 19 43.2 25 56.8
Incidence of weighing baby after birth is extremely rare in Rajasthan. Out of total home deliveries only
4 percent babies were reportedly weighed and out of them 93 percent mothers had a card with weight
recorded on it. In three cases there was no card available with them and neither could they recall the
baby‟s weight. Out of the 41 babies who had weight card 43 percent of them were low birth weight
baby with a birth weight below 2.5 kilograms . With 96 percent babies not weighed after birth in case of
home deliveries, raises a serious issue of Low-Birth Weight (LBW) babies not being identified and
given the importance it deserves.
Weighing machine is not working since last two years and nobody is ready to hear my
complaints. I cannot buy a machine from my pocket for the sake of job. If government will provide
machine then we are ready to take weight. Till now baby determined on the basis of size. –
ANM, Dausa (Rajasthan)
The information from FGD with ANM and in-depth interview with ANMs, ASHAs and Anganwadi
Workers revealed that most of them were equipped with weighing machine and weighed the babies in
order to identify LBW babies. Due to in-availability of weighing machine with all health personnel, a few
of them rely on the physical appearance to identify LBW babies, which is an inadequate method.
Certain steps like advising the pregnant mother regarding nutrition and exclusive breastfeeding are
also taken by these health personnel.
Table 5.4: Mother’s perception about adequacy of size of newborn, NIPI-08

JAHANABAD NALANDA SHEKIPURA All NIPI District
Size of the
Rural Urban Rural Urban Rural Urban Rural Urban
Baby
N % N % N % N % N % N % N % N %
LARGER
THAN THE 86 21.1 7 28.0 103 21.5 22 33.3 110 24.8 13 19.7 299 22.5 42 26.8
AVERAGE
AVERAGE 304 74.7 15 60.0 340 71.0 38 57.6 320 72.1 50 75.8 964 72.5 103 65.6
CANNOT
THE 17 4.2 3 12.0 36 7.5 6 9.1 14 3.2 3 4.5 67 5.0 12 7.6
DEFINE
TOTAL 407 100.0 25 100.0 479 100.0 66 100.0 444 100.0 66 100.0 1,330 100.0 157 100.0
“Mahilayen baccho ka vajan lene se mana karti hain wo kehti hain ki vajan lene se
bacchon ka vajan ghatta hai” (Mothers in village believe that the weight of the child
decreases with weighing so they do not get their child weighted). ANM, Bharatpur
(Rajasthan)
5.5 Neonatal Checkups

First check of the baby after delivery is extremely crucial for overall assessment, exclusive
breastfeeding and appropriate care. The study has collected the information regarding first health
checkup, contact with care provider within ten days of birth and vaccination within one month of birth
for all babies either delivered at hospital or home. Average 47 percent respondents in the three districts
have reported first health checkup of the new-born within six hours of birth. Close to two fifth (41%) of
babies did not have contact with any health worker in first 10 days after birth for the state of Rajasthan.
Table 5.5: Timing of first neonatal check-up, NIPI-08

RURAL URBAN Total
N % N % N %
<6 Hrs 1503 44.2 475 49.0 1845 46.8
6-23 Hrs 105 3.1 33 3.4 122 3.1
1-2 Days 219 6.4 75 7.7 262 6.6
3-4 Day 38 1.1 14 1.4 47 1.2
5-6 Days 9 0.3 5 0.5 12 0.3
Week or more 20 0.6 6 0.6 22 0.6
No Checkup 1506 44.3 361 37.3 1632 41.4
Total base 3400 100 969 100 3942 100
The district with the lowest percent of new-borns with no contact with the health personnel for the first
ten days of life was Alwar. 60 percent of babies did have contact with any health worker in first 10 days
after birth and this includes around 50 percent babies who had contact with health personnel within the
first 24 hours after birth. The variation in these figures across the 3 study districts was minimal. Rural -
urban variation in this practice was not much evident.
Table 5.6: Time of first neonatal check-up by Districts, NIPI-08

ALWAR BHARATPUR DAUSA
Rural Urban Total Rural Urban Total Rural Urban Total
N % N % N % N % N % N % N % N % N %
<6 Hrs 495 44.8 149 45.8 603 46.9 493 44.8 189 57.8 660 49.6 515 43.1 137 43.2 582 43.9
6-23
19 1.7 3 0.9 19 1.5 11 1.0 7 2.1 15 1.1 75 6.3 23 7.3 88 6.6
Hrs
1-2
61 5.5 9 2.8 68 5.3 32 2.9 10 3.1 40 3.0 126 10.6 56 17.7 154 11.6
Days
3-4 Day 7 0.6 4 1.2 10 0.8 20 1.8 4 1.2 21 1.6 11 0.9 6 1.9 16 1.2
5-6
2 0.2 3 0.9 5 0.4 3 0.3 3 0.2 4 0.3 2 0.6 4 0.3
Days
Week
1 0.1 1 0.1 6 0.5 1 0.3 7 0.5 13 1.1 5 1.6 14 1.1
or more
No
Checku 521 47.1 157 48.3 579 45.1 535 48.6 116 35.5 584 43.9 450 37.7 88 27.8 469 35.3
p
Total
1106 100 325 100 1285 100 1100 100 327 100 1330 100 1194 100 317 100 1327 100
Base
District wise analysis indicates that across all the three districts the timing of first neonatal checkup
within 6 hours happens for less than one half of the interviewed mothers. It is highest for Bharatpur with
46.6 percent neonates receiving a check-up within 6 hours. The highest percent of neonates going
without check-up were found in District Alwar where 45 percent neonates were not checked within 6
hours.
5.5 BREASTFEEDING AND SUPPLEMENTATION
Breastfeeding is one of the main pillars of newborn care. Educating mothers on correct breast-feeding
practices and child nutrition is an important component of newborn care. In this survey, the breast
feeding practices among the index children was explored.

Initiation of breastfeeding immediately after the birth is beneficial for both the infant as well as the
mother. About 98 percent women in Rajasthan had ever breastfed their child. Approximately 65
percent of the mothers received help from somebody in initiation of breastfeeding. District analysis
shows that in Alwar and Bharatpur greater number of women had received help in initiation of
breastfeeding as compared to Dausa.
Table 5.7: Breastfeeding Practices, NIPI-08
Alwar Bharatpur Dausa

Rural Urban Rural Urban Rural Urban
Did you breastfeed
your child? N % N % N % N % N % N %
Yes 1078 97.5 315 96.9 1064 96.7 321 98.2 1186 99.3 315 99.4
No 28 2.5 10 3.1 36 3.3 6 1.8 8 0.7 2 0.6
Total 1106 325 1100 327 1194 317
Any body helped in initiating the breastfeeding
Yes 788 73.1 248 78.7 719 67.6 249 77.6 594 50.1 171 54.3
No 290 26.9 67 21.3 345 32.4 72 22.4 592 49.9 144 45.7
Total 1078 315 1064 321 1186 315
Sources helped in initiating breastfeeding
Government Doctor 14 1.8 9 3.6 32 4.5 15 6 15 2.5 3 1.8
Private Doctor 23 2.9 22 8.9 32 4.5 18 7.2 22 3.7 4 2.3
Nurse 123 15.6 69 27.8 238 33.1 72 28.9 176 29.6 58 33.9
ANM/ASHA/LHV 72 9.1 27 10.9 65 9 19 7.6 42 7.1 14 8.2
Dai 56 7.1 17 6.9 103 14.3 25 10 47 7.9 9 5.3
Mother/ Mother in
421 53.4 81 32.7 204 28.4 77 30.9 224 37.7 65 38
Law
Friends/ Relatives 78 9.9 20 8.1 44 6.1 23 9.2 62 10.4 17 9.9
Othres 1 0.1 3 1.2 1 0.1 6 1 1 0.6
Total 788 248 719 249 594 171
Role of government doctors in initiation of breastfeeding was found to be very low with the highest
being 5 percent in Bharatpur. Around 36 percent of the mothers received support from nurse and
ANM/ASHA. Mother or mother-in-law, friends and relatives were responsible for initiation of
breastfeeding in about one-fourth of the mothers.
Table 5.8: Initiation of Breastfeeding and gender of child, NIPI-08
SAME DAY
IMMEDIATELY,
AFTER AN AFTER 3 STILL NOT
WITHIN AN HOUR OF 1-3 DAYS
HOUR OF DAYS BREASTFED
BIRTH…
BIRTH..…
% % % % %
BOYS 36.60% 43.80% 15.10% 3.70% 0.80%
GIRLS 35.30% 44.90% 15.70% 3.60% 0.50%
It is quite clear from the above table that the gender of the child did not have any influence on the time
of initiation of breastfeeding.

Table 5.9: Initiation of Breastfeed and education of mother, NIPI-08

Immediately 1-3 Days After 3 days
within an hour of Same day after
birth an hour of birth
% % % %
No Education 50.6 51.5 62.2 54.2
<5 1.8 1.7 1.2 2.1
5-7 17.2 15.1 14.5 18.3
8-9 15.8 15.7 11.1 11.3
10-11 6.2 8.6 5.1 7.7
12 & Above 8.4 7.5 5.9 6.3
Education does not come out to be a major determinant in initiation of breastfeeding as is evident from
the above table.
Around 36 percent women started breast feeding the child within one hour of delivery and another 44
percent started after one hour but on the same day. About 19 percent of the women started breast
feeding after the first day, and of these, 3.7 percent started after three days of birth. Initiation of breast
feeding within one hour of delivery, for girl child (44.7 percent) was lower than boys (55.3%) indicating
the gender preferences.
Table 5.10: Initiation of Breastfeed and number of live children, NIPI-08

Immediately within Same day after 1-3 Days After 3 days
an hour of birth an hour of birth
% % % %
1 to 2 60.7 62.1 56 61.3
3 to 4 32.2 30.7 28.7 28.2
5+ 7.1 7.2 15.3 10.6
In Rajasthan around 65 percent of women have delivered in health institutions. In the health institutions
doctor/nurse/ANM attending on the delivery is expected to advise women to start breastfeeding
immediately after the birth of the child. However, in Rajasthan the percent of the women initiating
breastfeeding within one hour of childbirth is substantially less than the proportion of institutional
deliveries, suggesting that even in health institutions also early initiation of breastfeeding was not
ensured.
In-depth interview with ANMs, ASHAs and Anganwadi Workers revealed that the customary practices
for breastfeeding are not very prominent in the region, with mostly mothers not feeding colostrum to the
child after birth. Though; some of the ANMs revealed that they counsel women on breastfeeding
practices but the facts don‟t support these claims. ASHAs are more close to mothers than any other
health workers in rural areas and they counsel them on breast feeding practices like feeding colostrum
to the child, exclusive breast feeding up to six months, mother‟s milk enhances the immunity of the
child etc. but change in customary system will take some time. The role of Anganwadi Workers (AWW)
is quite limited to distribution of Supplementary Nutrition and gathering mothers and children for
Immunization at the Anganwadi Centre.
“Gramin logon ki manyata hai ki maan ka pratahm doodh bekar hota hai, isliye wo us
doodh ko nahi pilate” ( Rural people believe that the first milk is not of any use so they
discard that and do not feed that to child)… AWW, Dausa (Rajasthan).
“Maa ko salah dete hain ki bacche ko 6 mahine tak apna doodh pilaye aur koi dravya
ahaar na dein” ( We advice mothers to exclusively breastfeed child for 6 months and to
not give any other liquid)…ASHA, Lakshmangarh, Alwar (Rajasthan)

Exclusive breastfeeding is very important for the well being of child. But there are many prevalent
customary practices in the families and communities regarding giving prelacteal feeds. During this
survey we attempted to capture this practice.
Table 5.11: Feeding of Prelacteal liquids, NIPI-08

N % N % N % N % N % N % N % N %
Exclusively 4 1.7 1 1.4 25 10.6 4 7.7 1 0.6 1 2.4 30 4.6 6 3.7
breastfeed
Milk (other than 29 12 10 14.3 22 9.3 2 3.8 26 15.3 10 23.8 77 11.9 22 13.4
breast milk)
Plain water 2 0.8 8 3.4 2 3.8 16 9.4 3 7.1 26 4 5 3
Sugar or 33 13.7 13 18.6 52 22 7 13.5 25 14.7 7 16.7 110 17 27 16.5

glucose water
Sugar-salt- 9 3.7 1 1.4 13 5.5 1 1.9 6 3.5 2 4.8 28 4.3 4 2.4
water solution
Fruit juice 1 0.4 1 0.6 2 0.3
Infant formula 2 0.8 1 1.9 2 1.2 4 0.6 1 0.6
Tea 23 9.5 14 20 53 22.5 16 30.8 55 32.4 8 19 131 20.2 38 23.2

Honey 96 39.8 21 30 37 15.7 7 13.5 16 9.4 2 4.8 149 23 30 18.3
Janam ghutti 31 12.9 4 5.7 22 9.3 10 19.2 11 6.5 5 11.9 64 9.9 19 11.6
Other 14 5.8 6 8.6 1 0.4 2 3.8 11 6.5 4 9.5 26 4.1 12 7.3
Total 241 100 70 100 236 100 52 100 170 100 42 100 647 100 164 100
It appears that about three fourth of the newborn babies were given some top milk (other than the
breast milk) before initiating breastfeeding. District wise analysis shows that around 17 percent of
children in Dausa, 13 percent in Alwar and 9 percent in Bharatpur were given milk other than their
mother‟s milk before initiation of breastfeeding. A sizable proportion of babies were given other liquids
like plain water, sugar water or local home made liquids before initiating breastfeeding. Very small
proportions (only 5 percent in Rajasthan) of babies were initiated on exclusive breastfeeding. In Alwar,
the prelacteal feeding practice is a little different from other two districts, with 37 percent of babies
being fed honey after birth. This may be due to the population composition and associated rituals.
Dausa leads the way with tea being given to 31 percent babies before initiating breastfeeding.
Table 5.12: Period of exclusive breastfeeding by background variables, NIPI-08

< 6 Months 6 months and more months
N % N %
BOYS 730 55.1 595 44.9
GIRLS 616 54.2 520 45.8
Total 1346 54.7 1115 45.3
Age of the Respondent(in Years)
15-18 30 44.8 37 55.2
19-21 236 46.7 269 53.3
22-25 574 54.5 480 45.5
26-30 380 61.0 243 39.0
31-40 119 58.9 83 41.1
41-49 7 70.0 3 30.0
Total
Years of schooling
No Education 746 56.7 569 43.3
<5 22 53.7 19 46.3
5-7 211 55.5 169 44.5

< 6 Months 6 months and more months

N % N %
8-9 190 52.8 170 47.2
10-11 98 53.0 87 47.0
12 & Above 79 43.9 101 56.1
Total 1346 54.7 1115 45.3
Number of live children
1-2 782 52.7 703 47.3
3-4 441 56.8 336 43.2
5+ 123 61.8 76 38.2
Total 1346 54.7 1115 45.3
Location of PSU
Rural 1165 55.5 935 44.5
Urban 181 50.1 180 49.9
Total 1346 54.7 1115 45.3
Wealth Index
Lowest 613 58.9 427 41.1
Second 223 51.9 207 48.1
Middle 196 55.7 156 44.3
Fourth 130 48.7 137 51.3
Highest 184 49.5 188 50.5
Total 1346 54.7 1115 45.3
Exclusive Breastfeeding Practices & Supplementation
Exclusive breastfeeding up to six months after birth is required for the healthy growth of the baby.
Analysis below is based on the response of mothers whose child is above six months of age and
currently breastfeeding.
The situation is not very encouraging in Rajasthan with only 4.8 percent mothers exclusively
breastfeeding the child. In Districts Bharatpur has the highest percentage of approximately 11 percent
mothers who breastfeed their child exclusively. Among the infants aged more than 6 months,
approximately 45 percent children were exclusively breastfed up to 6 months after birth. District wise
analysis showing almost similar pattern; except in Bharatpur where this figure went greater than 50
percent (51.7).
Exclusivity of breastfeeding was not influenced by educational status of women, locality of residence of
women, birth order of the child or economic status of the family. But exclusive breastfeeding is highest
(42.8 percent) among young mothers (22 to 25 years of age) and lowest (0.4 percent among oldest
mothers (41 to 49 years of age).
The mothers who were not breastfeeding their child at the time of survey were asked about the period
of initiation of supplementary food to the child.
During the discussion with ASHA it was reveled that they prime activities performed by
her for the new born includes advising about breastfeeding and suggesting her to
breastfeed the child in one hour interval.
Some ASHAs also told that the people in their village follow some rituals like newborn
should not be breastfeed just after delivery, newborn should not take bath, outsiders
should not be allowed in the house, and child should be given sweet water.
Anganwadi workers were also interviewed about the awareness programs practices by
them for new born care. According to many of the AWW the programs are mainly aimed
to sensitize the mothers about colostrum feeding, exclusive breastfeeding for 6 months.
CHAPTER – 6
CHILD MORBIDITY AND TREATMENT
Diarrhoea and Acute respiratory infections have been globally identified, as posing major threats to the
survival of children under the age of five. This is also true for India, where these two diseases, have
been the major causes behind infant mortality. Prevention as well as effective treatment of these
diseases depends on a host of individual, household and community level behavioral factors. One of
the objectives of this study is to estimate the role played by such factors in determining the utilization of
formal health care to cure diarrhea and certain respiratory illnesses plaguing newborn. The
Reproductive Child Health programme includes components like treatment of diarrhea and ARI and
health education to mothers on management of Diarrhea and danger signs of ARI. The paramedical
and medical staffs are trained to diagnose the cases of pneumonia among the children and treat the
cases of pneumonia and diarrhea. All the government health institutions are supplied with the
medicines necessary for the treatment of pneumonia and diarrhea. The major findings of the study are
as follows:
6.1 Prevalence of illness in children at the time of survey
Table 6.1: Prevalence of illness in children under study, NIPI-08

Indicator N % N % N % N % N % N % N % N %
% of children with diarrhoea in last two weeks
Yes 147 13.3 31 9.5 112 10.2 34 10.4 158 13.2 50 15.8 417 12.3 115 11.9
% of children with fever in last two weeks
Yes 124 11.2 24 7.4 53 4.8 14 4.3 91 7.6 29 9.1 268 7.9 67 6.9

Rajasthan India
Indicator NFHS-3 NFHS-2 NFHS-1 NFHS-3 NFHS-2 NFHS-1
(2005-06) (1998-99) (1992-93) (2005-06) (1998-99) (1992-93)
Prevalence of ARI during
6.9 22 5.8 19.3 6.5
two weeks prior to survey
Prevalence of Diarrhoea
during two weeks prior to 10.3 19.8 9.0 19.2 10
survey
Source: NFHS 2 and 3 (fact sheets)
6.1.1 Point prevalence of Diarrhoea and illness
The table below presents that overall the diarrhoea point prevalence rate (at the time of the survey
contact) was 20.7 % while only cough is at 14%.
Table 6.3: Point prevalence of Diarrhoea and illness

N % N % N % N %
Diarrhoea 24 24 22 23.2 21 16.3 67 20.7
Fever Only 18 13.2 5 8.2 29 26.1 52 16.9
Cough Only 18 13.2 4 6.6 21 18.9 43 14
Total 136 100 61 100 111 100 308 100
Around 21 percent of children were suffering from diarrhea at the time of survey. Diarrhea prevalence
was lowest among the children of Dausa during the survey period. About 17 percent of children were
suffering from fever, 14 percent from cough and 62 percent from both fever and cough during the
survey period.
Table 6.4: Period prevalence of diarrhea and illness, NIPI-08

DAUS
ALWAR BHARATPUR A RAJASTHAN
RURA URBA RURA URBA RURA URBA
L N L N L N RURAL URBAN Total
% % % % % % N % N % N %
11
13.3 9.5 10.2 10.4 13.2 15.8 417 12.3 11.9 490 12.4
YES 5
296 84 343
85.6 89.5 89.6 89.6 86.6 83.6 87.3 87.6 87.1
NO 7 9 5
DK 1.1 0.9 0.2 0.2 0.6 16 0.5 5 0.5 17 0.4
Tota 340 100. 96 100. 394 100.
1106 325 1100 327 1194 317
l 0 0 9 0 2 0
6.1.2 Awareness of Diarrhea
About 43.9 percent of the women whose child suffered from diarrhea in last two weeks were counseled
by ANM/health workers towards the treatment of the disease. The counseling was higher in Dausa
(50%) than the other two districts.
About two-third of the children who had suffered with diarrhea had received advice or treatment from
any source. District wise response is in line except Alwar, where only 58.8 percent of children had got
advice or treatment for diarrhea. Table 6.1 shows the places of diarrhea treatment in Rajasthan, which
are mainly private sources for around 38 percent children.
Those who had suffered from pneumonia; about 96 percent of them had consulted someone for the
treatment. Most common source of treatment was qualified doctors in case of more than three fourth
children followed by ANM / Nurse / LHV (14.8%) and Chemists (6.2%). Visit to qualified doctors for
treatment of pneumonia is prominent in urban areas as compared the rural counterparts .
As per DLHS-2, the percentage of children aged 0-35 months with diarrhoea during the two weeks
preceding the survey was 35.5 per cent in Bharatpur, 20 per cent in Dausa and 14.7 per cent in Alwar.
Number of children with diarrhoea treated with ORS was the highest in Alwar (43.3 per cent) followed
by Dausa (21.4 per cent) and Bharatpur (7.6 per cent). Data reveals that mothers in Alwar are relatively
well aware about the treatment of diarrhoea as compared to other two districts.
Treatment seeking behavior in case of fever/cough is quite common. Around 84 percent children with
fever/cough had taken advice or treatment from any source. Dausa had highest proportion (92.8%) of
children with fever/cough taking advice or treatment. Most (80.3%) of the children had received advice
or treatment after 2 days of start of symptoms. Major source of the advice or treatment for children with
fever/cough was private doctors in about 41 percent of cases followed by CHC/Rural hospital. Advice
or treatment from government sources was negligible
6.1.3 Treatment of Diarrhea
The following section shows the percentage of women who sought treatment whose child suffered from
diarrhoea and source of treatment, according to place of residence and availability of health facility in
program Districts.
Table 6.5: Advice received from ANM or health worker, NIPI-08

All NIPI Districts
Rural Urban Total
N % N % N %
Yes 173 41.5 60 52.2 215 43.9
No 244 58.5 55 47.8 275 56.1

Total 417 100 115 100 490 100
Around 90 percent of the children had taken drugs for the illness. Bharatpur is showing the lowest
(80.3%) and Dausa is highest (97.3%) among the districts in taking medicines for the illness. Around
53.1 percent children had taken medicines for the fever next day of the occurrence followed by same
day (36.5%) and two days after fever (7.6%).
Table 6.6: Place of treatment, NIPI-08

Rajasthan
Place of treatment Alwar (%) Bharatpur (%) Dausa (%) (%)
Government/municipal hospital 11.0 9.5 8.5 9.6
Government dispensary 1.0 0.0 1.6 0.9
UHC/UHP/UFWC 0.0 1.1 0.0 0.3
CHC/ RURAL HOSPITAL 5.0 8.4 16.3 10.5
PHC 9.0 27.4 26.4 21.3
Sub Center 7.0 17.9 6.2 9.9
Govt.Ayush Hospital/Clinic 2.0 0.0 0.0 0.6
Private ayush hospital/clinic 11.0 2.1 2.3 4.9
6.2 Acute Respiratory Infection
6.2.1 Knowledge about pneumonia

An attempt was made to understand the awareness level of term pneumonia, and mother‟s awareness
on symptoms of pneumonia. The Findings are presented below:
Table 6.7: Proportion of mothers aware of pneumonia, NIPI-08

Alwar Bharatpur Dausa All NIPI Districts
Rural Urban Rural Urban Rural Urban Rural Urban Urban
% % % % % % N % N % N %
Yes 84.4 91.1 91.4 92 92.2 96.2 3040 89.4 902 93.1 3555 90.2
No 15.6 8.9 8.6 8 7.8 3.8 360 10.6 67 6.9 387 9.8
Total 100 100 100 100 100 100 3400 100 969 100 3942 100
Around 90 percent of the mothers were aware about the danger signs of pneumonia in which about 45
percent were aware about wheezing/whistling followed by chest in-drawing (59%), rapid breathing
(46.5%), difficulty in breathing (67.3%) and pain in chest and productive cough (21.4%). Findings are
almost similar across the districts.
Figure 6.1: Awareness among mothers about symptoms of Pneumonia

100
Aware about features of Pneumonia Wshistling
90 Chest indrawing Rapid breathing
Difficulty in breathing Pain in chest
80 Not able to take feed Others
70 Difficult to keep awake Condition gets worse than before
60
50
40
30
20
10
0
In majority of cases children were taken to a qualified doctor for treatment of Pneumonia, followed by
ANM/LHV.
Table 6.8: Treatment of Pneumonia, NIPI-08

Sought Alwar Bharatpur Dausa All Districts
Treatmen Rural Urban Rural Urban Rural Urban Rural Urban Total
t N % N % N % N % N % N % N % N % N %
Yes 283 95.3 68 98.6 281 95.9 87 98.9 238 96.7 74 98.7 802 95.9 229 98.7 947 96.3
No 14 4.7 1 1.4 12 4.1 1 1.1 8 3.3 1 1.3 34 4.1 3 1.3 36 3.7
Total 297 100.0 69 100.0 293 100.0 88 100.0 246 100.0 75 100.0 836 100.0 232 100.0 983 100.0
Percentage distribution of women who seek treatment by
Doctor 214 75.6 54 79.4 165 58.7 44 50.6 199 83.6 66 89.2 578 72.1 164 71.6 684 72.2
ANM/nurse
20 7.1 5 7.4 70 24.9 20 23.0 30 12.6 5 6.8 120 15.0 30 13.1 140 14.8
/LHV
Trained dai 1 1.1 1 0.4 1 0.1
UMP/RMP 11 3.9 4 5.9 38 13.5 8 9.2 2 0.8 51 6.4 12 5.2 55 5.8
Relatives/fr
2 0.7 3 3.4 2 0.8 1 1.4 4 0.5 4 1.7 6 0.6
iends
Chemist/m
38 13.4 5 7.4 5 1.8 11 12.6 4 1.7 2 2.7 47 5.9 18 7.9 59 6.2
edical shop
Ayush
1 0.4 1 0.4 2 0.2 2 0.2
practitioner
Total 283 100.0 68 100.0 281 100.0 87 100.0 238 100.0 74 100.0 802 100.0 229 100.0 947 100.0
6.3 Fever
6.3.1 Illness with fever and cough and treatment seeking behavior
Table 6.9: Incidence of fever and cough among children in last 2 weeks prior to survey contact,
NIPI-08
Alwar Bharatpur Dausa All NIPI Districts
Rural Urban Rural Urban Rural Urban Rural Urban Urban
% % % % % % N % N % N %
Yes 11.2 7.4 4.8 4.3 7.6 9.1 268 7.9 67 6.9 308 7.8
No 88.3 92.6 95.2 94.5 92.1 89.9 3124 91.9 895 92.4 3622 91.9
Total 100 100 100 100 100 100 623 100.0 172 100.0 724 100.0

Around 8 percent of children had suffered with fever and cough in two weeks prior to the survey in both
rural and urban areas. Among those who had fever and cough, around 41 percent children had it since
more than one week and 28 percent had been caught with it since last two days.
When it comes to medication, around 16 percent had faced problems in getting it form different
sources. The source of medication used for the treatment was qualified doctors in 55 percent cases
followed by chemists (22.4%) and ANM/Nurse/LHV (14.3%). Medicines from ANM/Nurse/LHV were
mainly sought in rural areas. The district of Bharatpur shows the highest percentage of consultation
with ANM/Nurse/LHV (32.8%) compared to the other two districts of Alwar and Dausa.

Table 6.10: Elapsed time before treatment was sought, NIPI-08

RAJASTHAN
RURAL URBAN Total
N % N % N %
2 days ago 178 28.6 41 23.8 204 28.2
3 - 4 days ago 100 16.1 30 17.4 115 15.9
5 - 6 days ago 91 14.6 28 16.3 107 14.8
week or more than a week ago 254 40.8 73 42.4 298 41.2
Total 623 100.0 172 100.0 724 100.0
The children who had an illness with fever/cough, he/she did breathe faster than usual with short, rapid
breaths or have difficulty breathing in around 68 percent of cases. These symptoms were more in rural
areas than urban. Around 35 percent of children had problems of runny nose, 14 percent had problem
in chest and around 47 percent had both.
Treatment seeking behavior in case of fever/cough is quite common. Around 84 percent children with
fever/cough had taken advice or treatment from any source. Dausa had highest proportion (92.8%) of
children with fever/cough taking advice or treatment. Most (80.3%) of the children had received advice
or treatment after 2 days of start of symptoms. Major source of the advice or treatment for children with
fever/cough was private doctors in about 41 percent of cases followed by CHC/Rural hospital. Advice
or treatment from government sources was negligible.
“Aniyamit aur asantusht ahaar, bacchon mein bimari aur mrityu ke mukhya karan hai”
(Irregular and nutrition less diet are the main reasons of children that lead to morbidity
and mortality)…ANM, Rajasthan
6.3.2 Preventive Measures for child’s sickness
For prevention of the child from the diseases like diarrhea, Malaria and pneumonia most (49.1%) of the
respondents were keeping the baby covered followed by using mosquito nets (9.5%) and using purified
drinking water (28.4%). A very small proportion (3.1%) of respondents used other methods to prevent
their child from these diseases.
6.3.3 Feeding Practices during Illness
Feeding practices during fever/cough shows that around half of the children given the same amount of
liquid to drink what they were taking prior to the illness followed by somewhat less (35%) than the
previous amount.

CHAPTER 7
IMMUNIZATION
7.1 Preamble
Universal immunization of children against the six vaccine preventable diseases (namely tuberculosis,
diphtheria, whooping cough, tetanus, polio and measles) is crucial for reducing infant and child
mortality. Differences in vaccination coverage among subgroups of the population are useful for
programme planning and targeting resources to areas most in need. Additionally, information on
immunization coverage is important for monitoring and evaluation of the Expanded Programmes on
Immunization (EPI).
NIPI Baseline Survey collected information on immunization coverage for all living children born during
two years‟ period preceding the survey. According to the guidelines developed by the World Health
Organization (WHO), Children are considered fully immunized when they have received a vaccination
against tuberculosis (BCG), three doses of diphtheria, whooping cough (pertussis), and tetanus (DPT)
vaccine; three doses of the poliomyelitis (polio) vaccine; and one dose of the measles vaccine by the
age of 12 months. BCG should be given at birth or at first clinical contact, DPT and polio require three
vaccinations at approximately 6, 10 and 14 weeks of age, and measles should be given at or soon after
reaching 9 months of age.
The immunization schedule for children is given in Table 7.1 presented below:
TABLE 7.1: Immunization Schedule

Age Vaccines
Birth BCG, OPV 0
6 weeks DPT 1, OPV 1
9 months Measles,
Yellow fever*
7.2 Vaccination Coverage

In this chapter, vaccination coverage is given for those children whose vaccination card was available
and they are more than or equal to 12 months old.
The following Table 7.2 presents status of vaccinations received in the study districts
Table 7.2: Vaccination from card and Recall, NIPI-08
Source of Bharatpu Rajastha

Information Alwar % r % Dausa % n %
25. 18. 23.
Vaccine with card 336 8 247 1 369 27.3 952 7
57. 72. 61.
Vaccine without card 754 9 989 5 735 54.4 2478 7
16. 14.
No Vaccination 212 3 128 9.4 248 18.3 588 6
Total 1302 100 1364 100 1352 100 4018 100
Evidently, there is a wide gap of 38% in the data based on vaccination card and recall method. While
as per vaccination cards about 24% children received the vaccination, as per recall approach the
percentage of such children had been at the level of 62%. In order to have some degree of reliability
and accuracy in the study findings, the data based on vaccination cards constitute the service data of
the study.
The following section presents analysis of vaccination coverage given to children, aged one year or
more, for whom vaccination card was available.
Children who received BCG, measles and three doses each of DPT and polio (excluding polio 0) are
considered to be fully vaccinated. Based on information obtained from a card , 65% of children of age
12-23 months are fully vaccinated in Rajasthan, with all basic vaccines, with Dausa district showing
highest percentage of children (69%) receiving all basic vaccination and 3 percent (Rajasthan) who did
not receive any vaccination. Here Bharatpur (1.2%) has least percentage of no vaccination and Alwar
with highest percentage of 4.5 percent.
Coverage for BCG, DPT and polio (except polio 0) vaccinations is much higher than for “all
vaccinations”.
DPT and Polio vaccinations are given at the same time as part of the routine immunization programme.
The study also reveals that polio vaccine has coverage of about 81 percent children which is at par
with the percentage of children (80%) receiving DPT 3. Not all children who begin the DPT and polio
vaccination series complete them.
Table 7.3: Polio vaccine coverage by background variables, NIPI-08

POLIO1 POLIO2 POLIO3 Total
N % N % N % N %
Alwar 139.9 95.2 129.9 88.4 120.0 81.6 147 100
Bharatpur 123.0 94.6 115.1 88.5 99.1 76.2 130 100
Dausa 141.0 94.0 134.0 89.3 125.0 83.3 150 100
RAJASTHAN 403.9 94.6 379.2 88.8 344.2 80.6 427 100
Sex of Child
Boy 243.0 96.8 230.9 92.0 212.1 84.5 251 100
Girl 161.0 91.5 148.0 84.1 132.0 75.0 176 100
Locality
RURAL 334.2 95.2 313.1 89.2 281.9 80.3 351 100
URBAN 70.0 92.1 66.0 86.8 62.0 81.6 76 100
Living Children
1.0 122.0 96.1 115.1 90.6 107.1 84.3 127 100
2 to 3 204.0 94.9 193.9 90.2 176.1 81.9 215 100
4 to 5 66.0 94.3 59.0 84.3 52.0 74.3 70 100
6+ 12.0 80.0 11.0 73.3 9.0 60.0 15 100
Education
No education 179.9 91.8 166.0 84.7 146.0 74.5 196 100
Below 5 6.0 100.0 6.0 100.0 6.0 100.0 6 100
5 to 7 63.0 98.4 58.0 90.6 52.0 81.3 64 100
8 to 9 79.0 98.8 76.0 95.0 72.0 90.0 80 100
10 to 11 42.0 95.5 39.0 88.6 35.0 79.5 44 100
12 & above 34.0 91.9 34.0 91.9 33.0 89.2 37 100
The incidence of Polio 1,2 and 3 having been given to the index child is very high and with little
variations across background variables. The difference between the percentages of children receiving
the first and third doses is almost 14 percentage points both for polio and DPT. Sixty seven percent of
children of age 12-23 months have been vaccinated against measles. The relatively low percentages of
children vaccinated with the third doses of polio, DPT and that of measles are mainly responsible for
the low proportion of children fully vaccinated.
Vaccination for each type of vaccine is much higher in urban areas than in rural areas, which clearly
depicts the better services and low level of ignorance among people in former than the rural area. As
per general perception and also supported by NFHS survey, it has been found that boys receive better
services than their female counterparts. There are70 percent of boys against 57 percent girls who
received some vaccination. Barring few cases, boys have received more vaccines in comparison to
girls.
At the state level, in Rajasthan it has been found that the coverage of „any vaccination‟ and that of
„individual vaccination‟ is higher in case of the first child and it decreases with the increase in birth
order. In the families consisting of only one living child, the percentage of immunization for all basic
vaccines is 69 percent , where as it is found to be 47 percent for the families who had more than 6
children.
Table 7.4: Child Immunization Coverage in NIPI Districts, Rajasthan

Alwar Bharatpur Dausa RAJASTHAN
BCG 97.3 96.9 99.3 97.9
POLIO3 81.6 76.2 83.3 80.6
DPT3 79.6 79.2 82 80.3
MEASLES 63.3 70 69.3 67.4
Vitamin A 50.3 63.1 56 56.2
All Basic Vaccinations 60.5 64.6 69.3 64.9
N 147 130 150 427
With the use of maternal health care services, a strong positive relationship exists between mother‟s
education and children‟s vaccination coverage. In Rajasthan not much difference is observed in the
level of immunization with respect to the level of education. On one side it is showing only 60 percent
immunization coverage for illiterate women which is quite acceptable as the ignorance level is high in
illiterate people, but when we see the mother‟s who has attained education of 5-7 or 10-12 years, the
immunization coverage of children remain at a lower level of around 61 percent.
Table 7.4 given below shows vaccination coverage rates for each recommended vaccination and the
percentage of girl or boy receiving that vaccine in the three study districts.
Table 7.5: DPT vaccine coverage by background variables, NIPI-08

DPT 1 DPT 2 DPT 3
DISTRICTS N % N % N %
Alwar 139 94.6 132 89.8 117 79.6
Bharatpur 122 93.8 115 88.5 103 79.2
Dausa 140 93.3 134 89.3 123 82
RAJASTHAN 401 93.9 381 89.2 343 80.3
During discussion with ASHA it was revealed that their main responsibility is to check for
the complete immunization of children in the village. They consider immunization card as
the best means to ensure immunization of children. They also visit home to home for
checking and registering children for the immunization as registration is the best way to
keep a track of immunization of children in the village. To improve the immunization
coverage in their area the ASHAs take women and children every month to PHC/CHC for
immunization.
Discussion with AWW reveals that they consider immunization of mothers and children as
their main responsibility. They said that still there are many people who deny getting the
pregnant women and children vaccinated and for this AWW advice people by home visits,
spread information in the village, gather people at AWC and educate them.

Table 7.6: Coverage of Measles vaccine and Vitamin A by background variables, NIPI-08
MEASLES Vitamin A Total
N % N % N %
Alwar 93.051 63.3 73.941 50.3 147 100
Bharatpur 91 70 82.03 63.1 130 100
Dausa 103.95 69.3 84 56 150 100
RAJASTHAN 287.798 67.4 239.974 56.2 427 100
Sex of Child
Boy 182.979 72.9 149.094 59.4 251 100
Girl 105.072 59.7 90.992 51.7 176 100
Locality
RURAL 233.064 66.4 190.944 54.4 351 100
URBAN 55.024 72.4 49.02 64.5 76 100
Living Children
1 89.027 70.1 76.962 60.6 127 100
2 to 3 147.92 68.8 127.065 59.1 215 100
4 to 5 42.98 61.4 31.01 44.3 70 100
6+ 7.995 53.3 4.995 33.3 15 100
Education
No education 124.068 63.3 99.96 51 196 100
Below 5 4.998 83.3 3 50 6 100
5 to 7 41.984 65.6 38.976 60.9 64 100
8 to 9 60 75 51.04 63.8 80 100
10 to 11 27.016 61.4 20.02 45.5 44 100
12 & above 30.007 81.1 27.01 73 37 100
There are considerable variations in coverage of measles and Vitamin A, not only across Districts but
also across different background characteristics of the mother. The coverage of Measles vaccine and
Vitamin A in District Bharatpur is the highest from among all the districts. The difference in the
coverage does not vary significantly with the location of the PSU and no stark difference has been
observed.
Place of receiving vaccination
Table 7.7: Place of Immunization received, NIPI-08

Alwar Bharatpur Dausa RAJASTHAN
Place of
Vaccination N % N % N % N %
In Laws Home 38 10.8 14 2.7 20 4.5 72 5.4
Parent's Home 2 0.6 1 0.2 3 0.7 6 0.5
Other Home 2 0.6 6 1.1 2 0.5 10 0.8
Govt. /
Municipal 24 6.8 27 5.1 25 5.7 76 5.7
Hospital
Govt.
11 3.1 7 1.3 9 2.0 27 2.0
Dispensary
UHC/UHP/UFWC 0.0 1 0.2 0.0 1 0.1
CHC/Rural
22 6.2 53 10.0 35 7.9 110 8.3
Hospital
PHC 14 4.0 81 15.3 66 15.0 161 12.2
Sub Centre 86 24.4 231 43.8 107 24.3 424 32.1

Table 7.7: Place of Immunization received, NIPI-08

NGO/Trust
3 0.8 1 0.2 0.0 4 0.3
Hospital/Clinic
Govt./Ayush
0.0 2 0.4 0.0 2 0.2
Hospital/Clinic
Pvt.
5 1.4 3 0.6 3 0.7 11 0.8
Hospital/Clinic
Other 146 41.4 101 19.1 171 38.8 418 31.6
Total 353 100.0 528 100.0 441 100.0 1322 100.0
During discussions with ANM they suggested for mobile vaccination to cater to larger mass
and increase the coverage area of immunization. ANM, Bharatpur (Rajasthan)
Immunization coverage- All basic vaccines, NIPI-08

Districts N %
Alwar 147 100
Bharatpur 130 100
Dausa 150 100
All basic vaccines cover the following:
 BCG
 DPT 1, 2 and 3
 OPV 1, 2 and 3
 Measles
The above table shows the place at which most of childhood vaccinations received in program Districts
were other health facilities. About 6% of children were immunized at the government and municipal
hospital. Further, among the children immunized, 32% of them were immunized from the Sub Centre,
12% from Public Health Center and 8 % from Community Health Centre/ Rural hospital. The
percentage or children receiving vaccination from the Private hospital/clinic in the overall program
Districts is very low.
Vaccination Dropout Rates
In all the three districts, there is considerable drop from the first to the third dose both for DPT and
polio, and in almost every district fewer children have received measles vaccines (highest drop out rate
of 34% is found in Alwar) than any of the other vaccinations except polio 0. There is not much
difference in the drop out rates of first dose of polio and DPT among districts. But a wide gap has been
administered between the first and third doses of polio and DPT. Alwar has shown the highest drop out
percentage of 15 percent in the first and the third dose of DPT and Bharatpur showed highest
percentage of drop out percentage(18%) in DPT 1 and DPT 3 cases.
Reasons for partial or no vaccination and problems faced
The main reasons given by mothers for not giving any vaccination to the children ware as follows:
The study reveals that the immunization coverage in the three districts of Rajasthan is low and this
leads to high morbidity and mortality rates among infant and children in the state. Lack of awareness,
Ignorance and illiteracy among the mothers and population as a whole are some of the reasons which
lead to the low level of immunization of children. Of the three districts Alwar hold the bottom position in
vaccination coverage
Mev ki striyan bukhar ke dar se bacchon ko teeka nahi lagwati hain aur ghar ane se bhi
mana kar deti hain. ( Mothers do not prefer immunization because of the fear of fever and
they even tell AWW not to come to their home)….AWW, Dausa (Rajasthan)
CHAPTER 8
STATUS OF HEALTH FACILITIES
8.1 STATUS OF DISTRICT HOSPITAL (DHs)
In the hierarchical health care system of the Government of India in a district, the district hospital is the
apex body, which provides specialized health care services to people on subsidized costs. Every
district is expected to have a district hospital. The information collected and analyzed in this section
relates to 3 district hospitals of Rajasthan.
8.1.1 Infrastructure
Physical infrastructure was fair for all the three study district hospitals. All three had a designated
government building with 24 hour water supply. All the district hospitals had three phase electricity
connection and the standby facility in the form of generator was available in all the hospitals. All the
three district hospitals had functional toilet facility separately for male and female.
Telephone facility was available in all district hospitals but all section of the hospital does not had a
telephone facility in two hospitals. Personal Computers were also available in all District Hospitals. All
the DHs had at least one vehicle and one ambulance. 10 Ambulance were available for the 3 District
Hospitals in total.
All the District Hospitals also had an established Integrated Counseling and Testing Centre.
Residential Facility for Medical Superintendent was available in only one District Hospital and
Residence for Doctors and Specialist was available at two District Hospitals.
An aseptic and clean Labor Room was available in all District Hospitals and currently in use as well.
Delivery room was present in only 2 District Hospitals and in use as well. Neo-Natal room was present
in 2 District Hospitals but currently it was in use in only one District Hospital.
General Medicine Ward was available in all the District Hospitals with an average 60 number of beds in
each District Hospital. General Surgery Ward was also available in all District Hospitals with an
average of 56 beds in each District Hospital. Antenatal Care Ward and Post-partum Care Ward were
available in only one District Hospital with an average of 3 beds each. Postnatal Care Ward was
present in 2 District Hospitals with average 31 beds each.
8.1.2 Availability of Human Resource
All the District Hospitals had one Medical Superintendent in position. In total for all District Hospitals
there were at least one of the following available, i.e. 5 Specialist (Medicine), 6 Specialist (Surgery), 8
Obstetrician/Gynecologists, 6 Pediatricians, 2 Dermatologists, 6 Ophthalmologists, 25 General Duty
Doctors, 4 AYUSH physicians and 3 Blood Bank Officers.
No permanent Anesthetist was available at any of the District Hospitals. Only two District Hospitals had
the services of a contractual anesthetist. Only 2 District Hospitals had the services of a permanent
Pathologist and Radiologist was available only at one District Hospital.
There were 146 total nurses in position at the 3 District Hospitals. On an average each District Hospital
has 49 nurses available. There were 33 Nurses working in Obs-Gynae Department, averaging 11
nurses per District Hospital.
8.1.3 Services Delivered by District Hospitals
The Laboratory Services which were available at all the 3 District Hospitals were:
Urine and Stool Analysis, Sputum analysis, Tests for Blood Sugar, Blood Urea, Blood Creatinin,
Pregnancy. Coomb‟s test, WIDAL, ELISA, Rh factor, VDRL tests were also available. ECG, 2D-ECHO,

X-Ray, Ultrasound were also available at all District Hospitals. Fully operational blood bank and blood
donation facility was also available at all District Hospitals.
Hematology, Pap smear, Histopathology and Stress Test (TMT) were available only in one District
Hospital and a fully functional Physiotherapy Unit was also present in one District Hospital only.
In all the District Hospitals, there was availability of Obstetrician/Gynecologists for 24 hours. Nurse was
also available for 24 hours in Obs/Gynae Department in all the District Hospitals.
Anesthetist was available for 24 hours only in 2 District Hospitals.
In all the 3 District Hospitals, OPD Services, Emergency Services (24 Hours), Referral Services were
available.
Separate room for Sterilization and X-Ray was also available in all the 3 District Hospitals.
All the three District Hospitals had MCH services like Antenatal care, Intranatal Care, Postnatal Care
and Newborn Care.
24-hour delivery services including normal and assisted deliveries and Emergency Obstetric Care
including C-section were available in all the District Hospitals.
All District Hospitals also provide Child care services including Immunization, MTP facility and facilities
under Janani Suraksha Yojana.
8.1.4 Monitoring and Supervision Activities
Medical Audits had been conducted in all the three District Hospitals. Rogi Kalyan Samiti (RKS) has
been established in all District Hospitals and also monitors the work regularly.
Monitoring and Supervision of activities of PHCs and SCs was also done through regular meetings in
all District Hospitals.
8.1.5 Equipment
Elective OT-Major was present in all District Hospitals. Only two District Hospitals had Emergency
OT/Family Welfare OT, ENT/Ophthalmology OT and Orthopedic OPD.
Phototherapy Unit, Emergency Resuscitation Kit for baby and Forceps Delivery Kit was available in all
the District Hospitals and all were functional as well.
Baby Incubator, Radiant warmer, Fetal Doppler, CTG Monitor and Delivery Kit were available at only 2
District Hospitals and were functional at all of them.
All the three District Hospitals provide Nutrition services, organize school health programmes,
HIV/AIDS control programmes.
Certain behavior change communication programmes were also organized by all District Hospitals.
8.2 STATUS OF COMMUNITY HEALTH CENTRE (CHCs)
Though not designated as such, community health centres are also first referral units where referral
cases from lower level health care establishments are sent. The CHCs have to take care of these
cases besides their usual health care activities. In three study districts of Rajasthan there were 4 CHCs
so the section deals with a total of 4 CHCs.

A Designated government building was available for all 4 CHCs, and only 2 of them had 24 hour water
supply. Regular supply of electricity was available in only 2 CHCs and standby facility in the form of
generator was available in only one CHC. Only three CHCs had functional toilet facility with 2 of them
having facility separately for male and female.
Telephone facility was available in 3 CHCs. Personal Computers were available in 2 CHCs. Ambulance
was available in 3 CHCs.
All the CHCs had intercom facility.
Residential facility for General Surgeon was available in 2 CHCs. Only at one CHC residential facility
for the Physician and Obstetrician/Gynecologist was available.
8.2.2 Availability of Human Resource
There was less than the required number of Specialists available in all CHCs.
There was only one General Surgeon available in one CHC, 2 Physicians, 2
Obstetrician/Gynaecologists, one Anaesthetist and 10 General Medical Officers in total for all the
CHCs.
There was no Pediatrician and Eye Surgeon either in position or on contract in any of the CHCs.
2 Public Health Nurse were available, 7 ANMs in position with 3 ANM on Contractual basis and 3 Staff
Nurse in position.
At least one staff doctor/nurse/LHV/ANM at CHC was available for 24 hours in all the CHCs and a
Gynecologist and Anesthetist was available on call basis in emergency in only one CHC.
8.2.3 Training Status of CHC Staff
Training statistics for the Medical Officers of CHC in the last 5 years was as below:
2 Medical Officers had received training on Emergency Obstetric Care including C-Section and Mini
laprotomy training.
One MO had received Newborn Care training as well.
Training for Para-Medical staff included:
Training on RTI/STI was imparted to 10 Para-medical personnel. 8 para-medical personnel received

Skilled Birth Attendant training. None of them received any training on IMNCI.
8.2.4 Investigation Facility
ECG and X-Ray facility was available only in 2 CHCs of Rajasthan.
8.2.5 Labor Room and Operation Theatre
All the four CHCs surveyed had Labor Room and Operation theatre available at the CHC premises.
8.2.6 Storage Facility
All the four CHCs had separate room for drug storage and separate waiting area for the patients in the
OPD of the CHC.

8.2.7 Laboratory
Operational Laboratory was present in 3 CHCs of Rajasthan. Blood storage facility was not available in
any of the CHCs.
8.2.8 Physical Facilities
Total number of functional beds available in all CHCs was 64 averaging 16 beds per CHC. There were
separate wards for males and females in all the CHCs.
8.2.9 Furniture/Instrument
Examination Table, Delivery table, Bedside Screens, B.P Instruments were available in all the CHCs.
Stretcher or Trolley was available in only 2 CHCs.
8.2.10 OT Equipments
Boyles Apparatus was available in all the CHCs. Oxygen Cylinder 660 liters with regulator and mask,
Emergency Drug tray and Normal Delivery kit were available in 3 CHCs.
Equipment for neo-natal resuscitation was available in 2 CHCs. IUD insertion kit was available in all the
CHCs.
8.2.11 Cold Equipments
Large and small deep freezers were available and also in functional condition in 3 CHCs. Walk in
coolers and freezers were also available in 2 CHCs.
8.2.12 Vaccines and Prophylactic Drugs
All vaccines, namely BCG, DPT, OPV, DT, Tetanus Toxoid and Measles were available in all the CHCs
of the state.
IFA tablets, Vitamin A syrup, ORS packets was also available at all the CHCs. Tablets Cotrimaxazole
was also available at all the CHCs.
8.2.13 Essential Services
Essential Services like OPD services, 24 hour Emergency Services, Referral Services were available
in all the CHCs.
Blood Storage facility was not available at any of the surveyed CHCs.
8.2.14 Maternal and Child Health Services
All the four CHCs had MCH services like Antenatal care, Intranatal Care, Postnatal Care and Newborn
Care.
24-hour delivery services including normal and assisted deliveries was available in all the CHCs and
Emergency Obstetric Care including C-section was available in only 2 CHCs.
Child care services including Immunization were provided at 3 CHCs. MTP facility and facilities under
Janani Suraksha Yojana were being provided by all the CHCs surveyed.
8.3 STATUS OF PRIMARY HEALTH CENTRE (PHCs)
The Primary Health Centres have the major responsibility of providing both preventive and curative
health care services in the area. This includes delivery of reproductive child health services, such as
antenatal care and immunization in addition to routine inpatient and out patient services. Compared to
DHs and Sub-divisional Hospitals, PHCs are accessible to a larger population. However, just the
availability of PHCs is not sufficient for the effective delivery of these services. They should also have
essential infrastructure, staff, equipment and supplies. This section presents the status of the 18 PHCs
surveyed in three districts of Rajasthan with respect to the availability of selected infrastructure, staff,
equipment and supplies, besides training of medical and para-medical staff.
In all the study districts of Rajasthan around 83 percent of the PHCs function from a designated
Government building.
In around 94 percent PHCs had functional toilet facility available in which 39 percent had separate
toilet for males and females.
Around 44 percent of PHCs in Rajasthan had tapped water supply and all the PHCs had regular water
supply in the form of Piped water, Tube/Bore Well and Hand Pump.
Around 6 percent of PHCs function without electricity. Those having electricity 16 percent of them had
regular power supply. Two-thirds of the PHCs had Occasional Power supply. Standby facility of
generator was available at around 28 percent of PHCs.
In around 72 percent PHCs labor room and in 33 percent of these Operation Theater was available and
same was functional as well.
About 83 percent PHCs telephone facility was available. 17 percent PHCs had personal computers in
which 6 percent had NIC terminal and 11 percent having access to internet facility.
6 percent PHCs had access to at least one vehicle for transporting patients during emergency.
Only 89 percent of PHCs had in-patient facilities. On an average 5 beds were available at the PHCs
where inpatient facility available. 28 percent PHCs had separate wards for male and female.
All the PHCs surveyed had an Examination Table available in the centre. 89 percent of them had a
Delivery Table and Bed-side Screen as well. Only 54 percent PHCs reported to having a Stretcher or
Trolley. Waiting bench for patients was available in 78 percent of the PHCs.
8.3.2 Availability of Human Resources
94 percent of the surveyed PHCs had one medical officer in position. While only 11 percent PHCs had
a lady medical officer.
94 percent PHCs having LHV/Health assistants in position and the same number of PHCs had
ANM/female health workers.
Less than half of the PHCs (44%) had male health assistants. But 94 percent PHCs had laboratory
technicians in position.
8.3.3 Training Status of PHC Staff
89 percent PHCs had organized at least one training programme in last one year.
The Main topics covered in these trainings were Pulse Polio, ASHA‟s training and training for
ANM/Male health workers.
The information collected from the Medical Officers (MO) regarding their training in the last five years
yielded the following information:
55 percent MOs had received training on Vector Borne Disease Control Programme, Directly Observed
Treatment-Short Course and Immunization.
About 50 percent MOs had received Reproductive Tract Infection/Sexually Transmitted Infection
(RTI/STI) training. One-thirds of the MOs were also trained in Integrated Management of Neo-natal and
Childhood Illnesses, Skilled Birth Attendant and Integrated Skill Development.
8.3.4 Stock of Vaccines, Contraceptives and Prophylactic Drugs
94 percent PHCs were stocked with BCG, DPT, OPV, Measles and Tetanus vaccines. Diptheria-
Tetanus vaccine was available at 89 percent of the PHCs. All the PHCs had a regular supply of the
vaccines.
All the PHCs reported to having full stock of Iron Folic Acid (IFA) Tablets. Vitamin A syrup and Oral
Rehydration Solution (ORS) solution was available at 94 percent PHCs. 89 percent PHCs also had
Cotrimaxazole available. All the PHCs had a regular supply of the above-mentioned Prophylactic
Drugs.
8.3.5 Equipment
Normal Delivery Kits were available in 89 percent PHCs. 83 percent PHCs had a weighing machine.
Only one-fifth PHCs were equipped with Infant Resuscitation Bag with mask, Equipment for Assisted
Vacuum Delivery and Assisted Forceps Delivery.
In Cold Equipments, 90 percent of the PHCs had Small Deep Freezers and two-thirds had a Large
Deep Freezer. Vaccine Carriers were available in 94 percent of PHCs.
Two-thirds of the PHCs had Chemical for Hb estimation, Light and Binocular Microscope available.
8.3.6 Essential Services
94 percent PHCs were providing Out-Patient Department (OPD) Services to the patients and Referral
Services were being provided by 83 percent PHCs.
8.3.7 Maternal and Child Health Services
Ante-natal Care services and Medical termination of Pregnancy (MTP) services were available at 89
percent of the PHCs. 83 percent PHCs were providing Post-Natal and New born care services.
78 percent facilities also provided Intra-Natal Care and facilities under Janani Suraksha Yojana. Facility
for normal delivery for 24 hours was available at one-third PHCs and 44 percent PHCs also had Facility
for internal examination for gynecological conditions.
8.4 STATUS OF SUB CENTRE (SCs)
Sub-centers are most peripheral health institutions catering to the health care needs of the rural
population. It is the most peripheral contact point between the Primary Health Care system and the
community. It is manned by one multipurpose worker (male) and one multipurpose worker
(female)/ANM. This section presents the findings of 83 SCs from three districts of Rajasthan.
8.4.1 Availability of Human Resource at SCs
All the SCs had an ANM/Female Health Worker working on a regular basis. Only 12 percent SCs had a
Male Health Worker and an Additional ANM on a Contractual basis was present in less than 5 percent
SCs.
8.4.2 Training Status of SCs
The ANM/Female Health Worker was asked about the Training received by them in the last 5 years.
The following information was obtained:
Integrated Skill Development Training for 12 days (RCH-1) was attended by 54 percent ANMs. Two-
third ANMs also attended training for Immunization and only one-third had attended IMNCI training.
Skilled Birth Attendant training was received by 57 percent ANMs.
The details of trainings received by Male Health Workers (MHW) were given below:

62.5 percent MHWs received training on Integrated Skill Development for 12 days (RCH-1). Training
on Immunization was imparted to 87.5 percent MHWs. Only one-fourth MHWs received training on
IMNCI.
8.4.3 Physical Infrastructure
A Designated Government building was available for the SC in 75 percent cases. In case of the SC
functioning in a non-government building, 60 percent such SCs were located in a society building and
one-fourth were located in a rented building.
Water Supply: Two-thirds of the SCs don‟t had a water supply at all. Out of the SCs with water supply,
45 percent had a Hand Pump and one-tenth had a well available. Only one-fourth SCs had 24 hour
water supply available.
Power Supply: 62 percent SCs do not had any electricity connection. In 29 percent SCs there was
only Occasional power supply, and only 7.5 percent SCs had regular power supply.
Toilet Facility: Only 40 percent SCs had a functional toilet facility available.
Communication Facility: Only one-fourth SCs (25.4 percent) had a Government provided Telephone
or Mobile facility.
8.4.4 Staying Facility of ANM
In 15 percent cases it was found that the ANM was residing in the quarter attached to the SC.
8.4.5 Furniture Availability
Examination Table was available in 83.6 percent SCs and out of these it was functional in around 96
percent SCs. Labor Table was available in 42 percent SCs and functional in 78.6 percent of these SCs.
In 22.4 percent SCs Bedside screens were available, but were functional in only half of these SCs.
8.4.6 Availability of Equipment
Instrument Sterilizer was available in 45 percent SCs and functional in 76.7 percent of these SCs. Auto
Disposable Syringes were available in 89.6 percent SCs and functional in 95 percent of these. Blood
Pressure Instrument was available in 95.5 percent SCs and functional in 93.8 percent of these SCs. An
Adult Weighing machine was available in 95.5 percent SCs and was functional in 90.6 percent of these
SCs. 91 percent SCs had Infant Weighing Machine, and it was functional at 95 percent SCs.
Haemoglobinometer was available at 60 percent SCs and functional at 70 percent of these. All the SCs
had Vaccine Carriers available but they were functional in only 98.5 percent of them.
8.4.7 Availability of Essential Kits
Drug Kit-A was available in the majority of SCs i.e. 56.7 percent cases. 91 percent SCs had IFA tablets
available and Vitamin A Syrup was available with 86.6 percent ANMs.
ORS packets were available at 91 percent SCs and 64.2 percent SCs had Disposable Delivery Kits.
8.4.8 Labor Room
Only one-fifth SCs reported having a labor room and in these SCs 42.9 percent deliveries were carried
out in these Labor rooms.
8.4.9 Availability of Specific Services
88.1 percent SCs were visited by a Doctor at least once a month and in37.3 percent of these cases the
day and time of this visit is fixed. In 77.6 percent of cases the SC was visited by Health Assistant
(Male) or LHV at least once a week.

All the SCs provide Antenatal Care (TT, IFA tablets, Weight and B.P check). 24 hour facility for referral
of complicated cases of pregnancy/delivery was available at 44.8 percent SCs. In 73 percent cases the
ANM reported to had accompanied the woman in labor to the referred care facility at the time of
referral.
8.4.10 Monitoring and Supervision Activities
92.5 percent ANMs reported to had prepared the SC Plan for this year. All the surveyed SCs had
Registers, Reports and Immunization Cards in enough quantity and 91 percent had enough ANC
Cards.
In 90 percent of SCs Training of Traditional/Skilled Birth Attendants and ASHA was done. All the ANMs
reported to had co-ordinated their services with AWWs, ASHA, PRI and Village Health and Sanitation
Committee.
Proper maintenance of records and registers was being done by 97 percent of ANMs at their
respective SCs.
The scheme of ASHA was being implemented in 76 percent SCs.

ANNEXURE TABLES
A1:Household possession - NIPI Districts

DISTRICTS
RURA URBA Tot RURA URBA Tot RURA URBA Tot RURA URBA Tot
L N al L N al L N al L N al
% % % % % % % % % % % %
88. 79. 92. 86.
Mattress 87.5 93.9 78.7 85.3 91.9 95.5 86.3 90.7
3 8 3 9
19. 17. 18. 18.
Mosquito net 14.7 46.4 15.0 28.6 15.3 47.8 15.0 39.2
1 4 5 3
98. 98. 97. 98.
A cot/bed 98.2 99.4 99.0 98.7 97.2 98.5 98.1 98.9
3 9 3 2
68. 61. 58. 62.
A chair 65.1 90.6 58.1 76.6 54.7 90.3 59.2 84.6
6 3 3 7
49. 35. 25. 36.
Table 44.1 80.1 31.0 57.6 21.0 64.9 31.9 66.8
1 7 4 7
34. 28. 23. 28.
Pressure cooker 26.6 83.4 22.0 56.3 16.9 77.6 21.7 70.5
4 0 0 4
33. 24. 35. 30.
Radio or transistor 32.3 38.1 23.0 29.4 34.6 41.8 30.1 35.3
1 1 3 9
86. 84. 89. 86.
Watch or clock 85.2 92.8 82.4 92.6 89.0 91.8 85.6 92.5
2 2 3 6
52. 39. 41. 44.
Sewing machine 48.9 77.9 36.8 51.9 38.0 72.4 41.3 65.6
8 5 5 6
82. 71. 82. 78.
Electricity 80.5 95.0 67.5 88.3 80.7 97.0 76.5 92.7
5 2 4 7
72. 64. 74. 70.
Electric fan 69.4 95.0 59.2 87.9 72.5 96.3 67.3 92.3
9 2 9 7
53. 47. 44. 48.
Television 48.2 88.4 41.6 73.2 40.9 80.6 43.6 80.0
7 1 9 6
22. 16. 12. 16.
Refrigerator 15.4 64.6 11.9 38.1 8.6 43.3 11.9 48.2
1 5 1 9
Computer 5.7 16.0 7.1 4.0 7.4 4.6 4.1 17.9 5.5 4.6 12.8 5.7
62. 54. 64. 60.
Mobile phone 60.6 76.2 52.4 62.8 63.7 75.4 59.1 70.3
8 3 9 7
Any Other type of 15. 11. 12.
12.8 28.7 7.8 16.5 9.3 8.8 36.6 9.8 25.5
telephone 0 6 0
18. 31. 19.
A water pump 15.3 40.3 9.4 7.8 9.1 31.7 28.4 19.2 23.6
7 4 8
Thresher 5.3 2.2 4.8 3.4 1.3 3.0 6.1 6.7 6.2 5.0 2.9 4.7
10.
Tractor 11.2 3 9.3 3.0 8.2 5.6 5.2 5.6 8.7 3.5 8.0
1
46. 39. 42. 42.
Bicycle 46.9 39.8 38.0 48.1 44.0 32.1 43.1 41.4
0 8 8 9
An animal drawn
3.4 4.4 3.6 3.5 0.9 3.0 5.7 3.7 5.5 4.3 2.7 4.1
cart
A car/Jeep 2.5 9.9 3.6 1.8 3.0 2.0 2.0 6.7 2.5 2.1 6.2 2.7
Two wheeler/ 33. 25. 30. 29.
28.0 69.1 22.8 37.7 28.7 49.3 26.6 50.9
motorbike 6 4 7 9
A Bus / Truck 1.1 1 1.1 1.8 0 1.6 0.3 5.2 0.8 1.1 1.8 1.2
A2: Type of health schemes- NIPI

Districts
DISTRICTS
Wealth ALWAR BHARATPUR DAUSA Total
Index RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total RURAL URBAN Total
% % % % % % % % % % % %
Lowest 41.5 7.2 36.8 50.8 19.5 45.3 48.8 9.7 44.8 47.0 13.0 42.3
Second 17.4 2.2 15.4 18.0 12.1 17.0 22.4 3.7 20.6 19.4 6.8 17.6
Middle 17.0 5.0 15.4 14.5 13.0 14.2 14.4 6.7 13.6 15.3 8.8 14.4
Fourth 12.6 11.6 12.5 10.1 15.6 11.0 8.3 21.6 9.6 10.3 15.8 11.0
Highest 11.4 74.0 20.0 6.6 39.8 12.5 6.1 58.2 11.4 8.1 55.7 14.6

N 100 100 100 100 100 100 100 100 100 100 100 100
Total
number 1,141 181 1,322 1,083 231 1,314 1,204 134 1,338 3,428 546 3,974
of HH
A3: Education Attainments vs age of respondent
NIPI State wise Education

RURAL
Year of
Schooling Total
15-18 19-21 22-25 26-30 31-40 41-49
N % N % N % N % N % N % N %
No
76 69% 334 57% 706 60% 701 71% 412 82% 30 100% 2259 67%
Education
<5 4 4% 27 5% 33 3% 25 3% 11 2% 0 0% 100 3%
5 to 7 8 7% 65 11% 135 12% 82 8% 23 5% 0 0% 313 9%
8 to 9 13 12% 60 10% 108 9% 58 6% 17 3% 0 0% 256 8%
10 to 11 10 9% 70 12% 154 13% 86 9% 20 4% 0 0% 340 10%
12 &
0 0% 29 5% 41 4% 36 4% 17 3% 0 0% 123 4%
Above
Total 111 100% 585 100% 1177 100% 988 100% 500 100% 30 100% 3391 100%
URBAN
Year of Total
15-18 19-21 22-25 26-30 31-40 41-49
Schooling
N % N % N % N % N % N % N %
No
8 67% 45 58% 70 47% 82 56% 44 73% 5 83% 254 56%
Education
<5 0 0% 6 8% 3 2% 2 1% 0 0% 0 0% 11 2%
5 to 7 1 8% 8 10% 13 9% 15 10% 5 8% 0 0% 42 9%
8 to 9 2 17% 7 9% 17 11% 15 10% 4 7% 0 0% 45 10%
10 to 11 1 8% 6 8% 28 19% 18 12% 3 5% 0 0% 56 12%
12 &
0 0% 6 8% 19 13% 14 10% 4 7% 1 17% 44 10%
Above
Total 12 100% 78 100% 150 100% 146 100% 60 100% 6 100% 452 100%
TOTAL
Year of Total
15-18 19-21 22-25 26-30 31-40 41-49
Schooling
N % N % N % N % N % N % N %
No
84 68% 379 57% 776 59% 783 69% 456 81% 35 97% 2513 65%
Education
<5 4 3% 33 5% 36 3% 27 2% 11 2% 0 0% 111 3%
7-May 9 7% 73 11% 148 11% 97 9% 28 5% 0 0% 355 9%
9-Aug 15 12% 67 10% 125 9% 73 6% 21 4% 0 0% 301 8%
11-Oct 11 9% 76 12% 182 14% 104 9% 23 4% 0 0% 396 10%

12 &
0 0% 35 5% 60 5% 50 4% 21 4% 1 3% 167 4%
Above
Total 123 100% 663 100% 1327 100% 1134 100% 560 100% 36 100% 3843 100%
A4:Frequency of reading a newspaper or magazine vs key background variables

Less
Almost At least once a than a
every day week week Not at all Total
Print Media % % % % %
Age Group
15-18 1 4 2 5 3
19-21 13 21 24 30 25
22-25 48 46 48 42 45
26-30 32 26 21 20 23
31-40 7 4 4 3 4
41-49 0 0
Total 100 100 100 100 100
Year of
schooling
<5 0 0 3 6 4
5-7 4 11 35 49 34
8-9 14 30 40 32 32
10-11 19 31 14 10 15
12 & Above 64 27 8 4 16
Total 100 100 100 100 100
Total number
227 280 505 840 1,852
of women
A5: Frequency of listening to the radio vs key background variables

Less
Age Group
15-18 2 3 2 3 3
19-21 16 22 22 21 21
22-25 52 45 41 41 42
26-30 25 24 28 25 25
31-40 5 6 5 9 8
41-49 0 1 1
Total 100 100 100 100 100
Year of
schooling
No Education 22 23 33 60 53
<5 2 3 2 1 2
5-7 13 18 23 15 16
8-9 20 23 22 13 15
10-11 13 17 10 6 7
12 & Above 30 16 11 5 8
Total 100 100 100 100 100

Standard of living Index

Lowest 6 15 40 69 42
Second 12 24 23 18 18
Middle 18 27 17 9 14
Fourth 22 18 12 3 11
Highest 41 16 8 1 15
Total 100 100 100 100 100
Total number
1,089 449 404 2,000 3,942
of women
A6: Frequency of watching Television vs key background variables

Less
Age Group
15-18 3 3 2 4 3
19-21 21 25 20 21 21
22-25 46 45 42 39 42
26-30 25 22 28 26 25
31-40 6 5 8 10 8
41-49 0 0 0 1 1
Total 100 100 100 100 100
Year of
schooling
No Education 20 40 50 75 53
<5 1 2 2 2 2
5-7 16 21 21 14 16
8-9 24 20 19 8 15
10-11 16 11 5 2 7
12 & Above 23 6 3 1 8
Total 100 100 100 100 100
Standard of living Index
Lowest 6 15 40 69 42
Second 12 24 23 18 18
Middle 18 27 17 9 14
Fourth 22 18 12 3 11
Highest 41 16 8 1 15
Total 100 100 100 100 100
Total number
1,089 449 404 2,000 3,942
of women
A7- Employment Status

Alwar Bharatpur Dausa Total
Any source of Any source of Any source of Any source of
Income Income Income Income
Yes Yes Yes Yes Yes Yes Yes Yes
Age Group N % N % N % N %
15-18 2 7 12 24 6 14 20 17
19-21 25 9 37 13 38 14 100 12
22-25 61 11 67 12 65 12 193 12
26-30 57 17 61 20 70 19 188 19
31-40 16 19 34 26 26 27 76 24
41-49 2 29 3 50 1 20 6 33
Total
Education and years of schooling

No
6 14 20 17
education 98 16.4 140 18
Below 5 2 12.5 5 25 38 14 100 12
5-7 23 10.7 24 12.8 65 12 193 12
8-9 18 8.4 24 13.4 70 19 188 19
10-11 2 1.8 6 7.3 26 27 76 24
12 & above 20 15.4 15 17.6 1 20 6 33
Total
Residence
Rural 140 13 189 17 196 16 525 15
Urban 65 20 62 19 45 14 172 18
Total
A8 : Children ever born vs. age of mother
Districts
JAHANABAD
Age of the
Respondent(in Number of Children Ever Born
Years)
1 2 3 4 5 6 7 8 9
N % N % N % N % N % N % N % N % N %
15-18 44 88% 5 10% 0 0% 0 0% 1 2% 0 0% 0 0% 0 0% 0 0%
19-21 143 60% 65 27% 24 10% 5 2% 1 0% 0 0% 1 0% 0 0% 0 0%
22-25 99 23% 160 38% 106 25% 39 9% 14 3% 5 1% 1 0% 2 1% 0 0%
26-30 26 7% 53 14% 101 27% 86 23% 42 11% 45 12% 13 4% 2 1% 1 0%
31-40 6 4% 7 4% 30 17% 33 19% 40 23% 21 12% 19 11% 9 5% 4 2%
41-49 1 17% 0 0% 0 0% 0 0% 1 17% 0 0% 2 33% 0 0% 2 33%
Total 319 25% 290 23% 261 21% 163 13% 99 8% 71 6% 36 3% 13 1% 7 1%
NALANDA
Age of the Number of Children Ever Born
Respondent(in
Years) 1 2 3 4 5 6 7 8 9
N % N % N % N % N % N % N % N % N %
15-18 18 64% 8 29% 1 4% 0 0% 1 4% 0 0% 0 0% 0 0% 0 0%
19-21 116 58% 53 27% 23 12% 4 2% 1 1% 0 0% 2 1% 0 0% 0 0%
22-25 141 30% 154 32% 104 22% 54 11% 9 2% 10 2% 1 0% 2 0% 1 0%
26-30 27 7% 85 22% 114 29% 78 20% 53 14% 20 5% 2 1% 5 1% 2 1%
31-40 1 1% 8 4% 19 10% 28 14% 36 18% 49 25% 22 11% 21 11% 8 4%
41-49 1 7% 0 0% 0 0% 0 0% 2 13% 2 13% 4 27% 2 13% 1 7%
Total 304 23% 308 24% 261 20% 164 13% 102 8% 81 6% 31 2% 30 2% 12 1%
Sheikhpura
Age of the Number of Children Ever Born
Respondent(in
Years) 1 2 3 4 5 6 7 8 9
N % N % N % N % N % N % N % N % N %
15-18 32 71% 11 24% 2 4% 0 0% 0 0% 0 0% 0 0% 0 0% 0 0%
19-21 116 52% 77 34% 24 11% 6 3% 0 0% 0 0% 1 0% 1 0% 0 0%
22-25 113 27% 130 31% 103 24% 52 12% 18 4% 6 1% 0 0% 2 1% 0 0%
26-30 35 9% 63 17% 85 23% 92 25% 50 13% 33 9% 11 3% 3 1% 1 0%
31-40 5 3% 3 2% 17 9% 21 11% 48 26% 34 18% 22 12% 23 12% 5 3%
41-49 0 0% 1 7% 1 7% 1 7% 5 33% 2 13% 2 13% 1 7% 1 7%
Total 301 24% 285 22% 232 18% 172 14% 121 10% 75 6% 36 3% 30 2% 7 1%

A9:Treatment seeking behavior

GIVE
SALT AND CONTINUE PLENTY
SUGAR NORMAL CONTINUE OF ANY DONT
GIVE ORS SOLUTION FOOD BREASTFEEDING FLUIDS OTHER KNOWN
N % N % N % N % N % N % N % TOTAL
15-18 4 3.1 6 8.6 1 1.8 8 6.8 0 0.0 1 0.8 0 0.0 15
19-21 27 20.9 10 14.3 11 19.6 26 22.2 7 31.8 28 21.7 16 25.8 105
22-25 60 46.5 34 48.6 23 41.1 50 42.7 12 54.5 61 47.3 32 51.6 223
26-30 35 27.1 18 25.7 16 28.6 29 24.8 3 13.6 31 24.0 10 16.1 123
31-40 3 2.3 2 2.9 5 8.9 4 3.4 0 0.0 6 4.7 4 6.5 22
41-49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.6 0 0.0 2
Total 129 70 56 117 22 129 62 490
Education of the Respondent
No Education 49 20.7 38 16.0 27 11.4 58 24.5 10 4.2 60 25.3 32 13.5 237
<5 6 7.5 1 3.1 0 0.0 6 10.2 1 8.3 4 5.8 1 3.3 15
5-7 18 22.5 6 18.8 10 34.5 22 37.3 3 25.0 23 33.3 11 36.7 81
8-9 23 28.8 10 31.3 12 41.4 21 35.6 3 25.0 17 24.6 15 50.0 82
10-11 18 22.5 10 31.3 4 13.8 4 6.8 2 16.7 13 18.8 1 3.3 42
12 & Above 15 18.8 5 15.6 3 10.3 6 10.2 3 25.0 12 17.4 2 6.7 33
Total 129 70 56 117 22 129 62 490
Number of Living Children
1-2 86 66.7 52 74.3 30 53.6 75 64.1 18 81.8 81 62.8 36 58.1 308
3-4 39 30.2 16 22.9 20 35.7 34 29.1 3 13.6 39 30.2 21 33.9 153
5+ 4 3.1 2 2.9 6 10.7 8 6.8 1 4.5 9 7.0 5 8.1 29
Total 129 70 56 117 22 129 62 490
LOCALITY
RURAL 105 81.4 65 92.9 50 89.3 103 88.0 19 86.4 105 81.4 47 75.8 417
URBAN 24 18.6 5 7.1 6 10.7 14 12.0 3 13.6 24 18.6 15 24.2 73
Total 129 70 56 117 22 129 62 490
Wealth Index
Lowest 42 32.6 23 32.9 21 37.5 51 43.6 7 31.8 44 34.1 24 38.7 184
Second 25 19.4 11 15.7 13 23.2 27 23.1 3 13.6 28 21.7 8 12.9 94
Middle 18 14.0 16 22.9 8 14.3 13 11.1 4 18.2 22 17.1 11 17.7 78
Fourth 18 14.0 6 8.6 5 8.9 14 12.0 4 18.2 7 5.4 13 21.0 59
Highest 26 20.2 14 20.0 9 16.1 12 10.3 4 18.2 28 21.7 6 9.7 75
Total 129 70 56 117 22 129 62 490

A10 : Diarrhoea Practices
Jahanabad Nalanda Sheikhpura Total

Rural Urban Rural Urban Rural Urban Rural Urban Total
N % N % N % N % N % N % N % N % N %
Continue the breastfeeding/ other feedings when child had diarrhoea
Yes 9 69% 9 69% 36 71% 2 50% 39 72% 4 57% 84 71% 6 55% 90 70%
No 3 23% 3 23% 14 28% 2 50% 13 24% 2 29% 30 25% 4 36% 34 26%
Not Applicable 1 8% 1 8% 1 2% 0 0% 2 4% 1 14% 4 3% 1 9% 5 4%
Total 13 100% 13 100% 51 100% 4 100% 54 100% 7 100% 118 100% 11 100% 129 100%
Liquid given to drink during Diarrhoea
Much less 1 7.7% 1 2% 0 0% 14 26% 0 0% 16 14% 0 0% 16 12%

Some less 6 46% 21 41% 3 75% 18 33% 4 57% 45 38% 7 64% 52 40%
About the same 22 43% 1 25% 11 20% 3 43% 33 28% 4 36% 37 29%
more 4 31% 2 4% 0 0% 4 7% 0 0% 10 9% 0 0% 10 8%
Nothing to drink 2 15% 4 8% 0 0% 2 4% 0 0% 8 7% 0 0% 8 6%
Don't know 1 2% 0 0% 5 9% 0 0% 6 5% 0 0% 6 5%
Total 13 100% 51 100% 4 100% 54 100% 7 100% 118 100% 11 100% 129 100%
Food given to eat during Diarrhoea
Much less 2 15% 3 6% 0 0% 13 24% 0 0% 18 15% 0 0% 18 14%
Some less 6 46% 21 41% 1 25% 16 30% 4 57% 43 36% 5 46% 48 37%
About the same 1 8% 18 35% 1 25% 11 20% 1 14% 30 25% 2 18% 32 25%
more 1 8% 3 6% 0 0% 5 9% 0 0% 9 8% 0 0% 9 7%
Nothing to drink 3 23% 5 10% 2 50% 2 4% 2 29% 10 9% 4 36% 14 11%
Don't know 1 2% 0 0% 7 13% 0 0% 8 7% 0 0% 8 6%

Total 13 100% 51 100% 4 100% 54 100% 7 100% 118 100% 11 100% 129 100%
Mothers given advice to give ORS during Diarrhoea
Yes 3 23% 20 39% 4 100% 25 46% 4 57% 48 41% 8 73% 56 43%
No 10 77% 31 61% 0 0% 29 54% 3 43% 70 59% 3 27% 73 57%
Total 13 100% 51 100% 4 100% 54 100% 7 100% 118 100% 11 100% 129 100%
Personnel adviced for ORS
Governmenmt
0 0% 1 25% 4 16% 0 0% 4 8% 1 13% 5 9%
Doctor
Private Doctor 3 100% 15 75% 3 75% 19 76% 3 75% 37 77% 6 75% 43 77%
ANM/ASHA/LHV 1 4% 0 0% 1 2% 0 0% 1 2%
Nurse 2 10% 0 0% 2 4% 0 0% 2 4%
Friends/Relatives/
0 0% 1 25% 0 0% 1 13% 1 2%
Family Memebers
Others 3 15% 0 0% 1 4% 0 0% 4 8% 0 0% 4 7%
Total 3 100% 20 100% 4 100% 25 100% 4 100% 48 100% 8 100% 56 100%
Place of getting ORS
ASHA 0 0% 1 25% 1 4% 0 0% 1 2% 1 13% 2 4%
ANM 1 5% 0 0% 1 4% 0 0% 2 4% 0 0% 2 4%
Govt.Dispencery 1 4% 0 0% 1 2% 0 0% 1 2%
UHC / UHP /
1 4% 0 0% 1 2% 0 0% 1 2%
UFWC
PHC 1 5% 0 0% 1 2% 0 0% 1 2%
Private AYUSH 2 10% 0 0% 1 4% 0 0% 3 6% 0 0% 3 5%
Private hospital 9 45% 2 50% 12 48% 2 50% 21 44% 4 50% 25 45%

Medical/ chemist
3 100% 6 30% 1 25% 7 28% 2 50% 16 33% 3 38% 19 34%
shop
Other 1 5% 0 0% 1 4% 0 0% 2 4% 0 0% 2 4%
Total 3 100% 20 100% 4 100% 25 100% 4 100% 48 100% 8 100% 56 100%

A-11 Quantity of food and drink taken while

having fever
Jahanabad Nalanda Sheikhpura Total

N % N % N % N % N % N % N % N % N %
Much
11 14% 0 0% 7 4% 2 7% 17 15% 2 12% 35 9% 4 8% 39 9%
Less
Some
23 28% 0 0% 75 38% 16 52% 59 52% 12 71% 157 40% 28 56% 185 42%
what less
About
20 25% 0 0% 100 51% 11 36% 22 19% 2 12% 142 36% 13 26% 155 35%
the same
More 11 14% 2 100% 7 4% 0 0% 6 5% 0 0% 24 6% 2 4% 26 6%
Nothing
10 12% 0 0% 5 3% 1 3% 8 7% 0 0% 23 6% 1 2% 24 5%
to Drink
Don't
6 7% 0 0% 4 2% 1 3% 2 2% 1 6% 12 3% 2 4% 14 3%
Know
Total 81 100% 2 100% 198 100% 31 100% 114 100% 17 100% 393 100% 50 100% 443 100%
Quantity of food given during illness
Much
14 17% 0 0% 8 4% 1 3% 33 29% 3 18% 55 14% 4 8% 59 13%
Less
Some
26 32% 0 0% 72 36% 18 58% 52 46% 10 59% 150 38% 28 56% 178 40%
what less
About
19 24% 0 0% 80 40% 5 16% 14 12% 1 6% 113 29% 6 12% 119 27%
the same
More 5 6% 2 100% 8 4% 1 3% 2 2% 0 0% 15 4% 3 6% 18 4%
Stopped
3 4% 0 0% 5 3% 1 3% 4 4% 0 0% 12 3% 1 2% 13 3%
food
Never
gave 12 15% 0 0% 21 11% 5 16% 7 6% 3 18% 40 10% 8 16% 48 11%
food
Don't
2 3% 0 0% 4 2% 0 0% 2 2% 0 0% 8 2% 0 0% 8 2%
know
Total 81 100% 2 100% 198 100% 31 100% 114 100% 17 100% 393 100% 50 100% 443 100%

A 12 Advice received from sources & duration of treatment for illness

N % N % N % N % N % N % N % N % N %
Advice or Treatment
Same Day 21 14 3 8.1 5 2.8 2 3.5 10 5.3 1 2 36 6.9 6 4.2 36 5.9
2 days ago 108 72 28 76 148 83 47 83 155 82 42 86 411 79 117 82 490 80
3 - 4 days ago 12 8 5 14 15 8.4 3 5.3 18 9.5 4 8.2 45 8.7 12 8.4 51 8.4
5 - 6 days ago 8 5.3 1 2.7 8 4.5 4 7 6 3.2 1 2 22 4.2 6 4.2 26 4.3
week or more than a
1 0.7 3 1.7 1 1.8 1 0.5 1 2 5 1 2 1.4 7 1.1
week ago
Total 150 100 37 100 179 100 57 100 190 100 49 100 519 100 143 100 610 100
Advice receiveed from sources during illness
GOVERNMENT/
18 19 3 16 9 21 15 18 4 14 42 19 7 12 47 18
MUNICIPAL HOSPITA
GOVERNMENT
2 2.1 1 2.3 3 1.4 3 1.2
DISPENSARY
CHC/ RURAL
10 11 4 9.3 2 17 11 13 7 24 25 11 9 15 31 12
HOSPITAL
UMP/RMP 2 2.1 1 5.3 1 2.3 3 3.6 6 2.7 1 1.7 7 2.7
PHC 7 7.4 8 19 2 17 14 17 2 6.9 29 13 4 6.7 31 12
SUB CENTER 2 2.1 1 5.3 7 16 4 4.8 1 3.4 13 5.9 2 3.3 13 5
GOVT. AYUSH
4 4.3 3 3.6 3 10 7 3.2 3 5 10 3.9
HOSPITAL/CLINIC
PRIVATE AYUSH
48 51 13 68 13 30 7 58 27 33 9 31 88 40 29 48 107 41
HOSPITAL/CLINIC
PRIVATE HOSPITAL/
1 1.1 1 5.3 2 2.4 3 1.4 1 1.7 3 1.2
CLINIC
HOME 1 8.3 4 4.8 3 10 4 1.8 4 6.7 7 2.7
OTHER 94 100 19 100 43 100 12 100 83 100 29 100 220 100 60 100 259 100
Total 5 4 2 8.3 7 13 6 6.6 2 6.9 18 6.7 4 6 20 6.5
A 13- Child Having health problem during illness

N % N % N % N % N % N % N % N % N %
CHEST ONLY 9 7.3 2 8.3 11 20.8 2 14.3 17 18.7 6 20.7 37 13.8 10 14.9 43 14.0
NOSE ONLY 33 27 8 33 19 35.8 6 42.9 40 44.0 11 37.9 92 34.3 25 37.3 109 35.4
BOTH 73 59 13 54 22 41.5 6 42.9 34 37.4 10 34.5 129 48.1 29 43.3 144 46.8
DON‟T KNOW 4 3.2 1 4.2 1 1.9 5 1.9 1 1.5 5 1.6
OTHER 5 4 2 6.9 5 1.9 2 3.0 7 2.3
Total 124 100 24 100 53 100 14 100 91 100 29 100 268 100 67 100 308 100

A 14- Problem faced during availing treatment for illness

N % N % N % N % N % N % N % N % N %
Doctor came
15 1.4 8 2.5 6 0.5 12 1 2 0.6 33 1 10 1 41 1
late
Long Waiting
20 1.8 8 2.5 25 2.3 9 2.8 20 1.7 5 1.6 65 1.9 22 2.3 78 2
time
Long Queue
13 1.2 7 2.2 9 0.8 2 0.6 11 0.9 4 1.3 33 1 13 1.3 43 1.1
of patients
Non
availability of 29 2.6 6 1.8 18 1.6 5 1.5 23 1.9 6 1.9 70 2.1 17 1.8 81 2.1
medicines
Too Far/ No
38 3.4 3 0.9 10 0.9 1 0.3 25 2.1 6 1.9 73 2.1 10 1 79 2
Transportation
Don't Trust
Facility/Poor
19 1.7 5 1.5 7 0.6 2 0.6 11 0.9 2 0.6 37 1.1 9 0.9 43 1.1
Quality
Services
No One To
9 0.8 2 0.6 11 1 3 0.9 19 1.6 4 1.3 39 1.1 9 0.9 46 1.2
Accompany
Any others (pl
1 0.1 1 0.3 3 0.3 19 1.6 4 1.3 23 0.7 5 0.5 27 0.7
Specify)
NO
72 6.5 11 3.4 52 4.7 13 4 91 7.6 37 11.7 215 6.3 61 6.3 244 6.2
PROBLEM
Total 1106 100 325 100 1100 100 327 100 1194 100 317 100 3400 100 969 100 3942 100
A 15- Medicine taken during illness

N % N % N % N % N % N % N % N % N %
Yes 110 88.7 19 79.2 41 77.4 13 92.9 88 96.7 28 96.6 239 89.2 60 89.6 277 89.9
No 14 11.3 5 20.8 12 22.6 1 7.1 3 3.3 1 3.4 29 10.8 7 10.4 31 10.1
Total 124 100 24 100 53 100 14 100 91 100 29 100 268 100 67 100 308 100
Duration of first medicines given after fever
SAME DAY 45 40.9 6 31.6 6 14.6 2 15.4 33 37.5 17 60.7 84 35.1 25 41.7 101 36.5
NEXT DAY 51 46.4 11 57.9 27 65.9 10 76.9 49 55.7 9 32.1 127 53.1 30 50 147 53.1
TWO DAYS
11 10 1 5.3 5 12.2 1 7.7 5 5.7 2 7.1 21 8.8 4 6.7 21 7.6
AFTER NFEVER
THREE DAYS
1 0.9 1 2.4 2 0.8 2 0.7
AFTER FEVER
FOUR OR MORE
DAYS AFTER 2 1.8 1 2.4 1 1.1 4 1.7 4 1.4
FEVER
DON‟T KNOW 1 5.3 1 2.4 1 0.4 1 1.7 2 0.7
Total 110 100 19 100 41 100 13 100 88 100 28 100 239 100 60 100 277 100

A 16- Money spent on treatment while having illness

N % N % N % N % N % N % N % N %
No money spent 17 8.8 23 11.1 10 13.2 13 4.8 4 4.8 53 7.9 14 6.8
<100 35 18 6 13 47 22.6 15 19.7 33 12.3 15 17.9 115 17.1 36 17.5
101-200 42 21.6 7 15.2 43 20.7 12 15.8 41 15.2 10 11.9 126 18.8 29 14.1
201-300 36 18.6 7 15.2 36 17.3 13 17.1 55 20.4 18 21.4 127 18.9 38 18.4
301 - 500 37 19.1 16 34.8 44 21.2 22 28.9 88 32.7 27 32.1 169 25.2 65 31.6
501-1000 23 11.9 9 19.6 15 7.2 4 5.3 36 13.4 6 7.1 74 11 19 9.2
>1000 4 2.1 1 2.2 3 1.1 4 4.8 7 1 5 2.4
Total 194 100 46 100 208 100 76 100 269 100 84 100 671 100 206 100
A17: Child feeding practices and nutritional status of children (Rajasthan)
Rajasthan India
NFSH- NFSH- NFSH- NFSH- NFSH-
NFSH- 2(1998- 1(1992- 2(1998- 2(1998- 1(1992-
Indicator 3(2005) 99) 93) 99) 99) 93)
Children under 3 years breastfed 17.15 4.8 7.9 26.5 15.8 9.5
within one hour of birth(%)
Children age 0-5 months exclusively 27.4 53.7 65.9 43.3 25.3 23.2
breastfed(%)
49.7 17.5 9.4 58.9 35 31.4

Children age 6-9 months receiving
solid or semisolid food and breast milk
A18: Indicators of Nutritional status in Orissa and NIPI Districts,DLHS_RCH,2002-03
State/ Anemia anomg pegnant

Weight for age Anemia among children
District women
- 3SD - 2SD Mild Moderate Severe Mild Moderate Severe
India 20 49 96 49 44 51 43 3
Rajasthan 28.4 58.1 54.4 39.7 2.4 49 43.9 3.3
Alwar 23.6 57.6 51.7 45.4 2.8 36.7 55 8.3
Bharatpur 22.1 45.4 56 34.4 0.6 43.2 44.3 1.1
Dausa 24.6 54.2 45.9 50.4 3.3 50 48.8 1.3
Note: 1. This index is expresses in standard deviation units (SD) from the median pf the international reference
population.2 includes children who are below –3 SD from the international reference population median.3 children aged
0-71 months. * Based on districts surveyed in Phase 1 of DLHS-RCH (2002-04)

A19: Fund distributed by districts
District Total Cumulative %

Funds Expenditure utilization
Available (in Rs.)
(in Rs.)
Alwar 164210000 27500000 16.75

Bharatpur 147600000 25420000 17
Dusa 75190000 3600000 4.7
A20: Fund utilization status - Alwar
Total Available Used Unused

Fund (In for MCH (In Percent
Lacs) (In Lacs) (In Lacs) Lacs) Used
Training 15.8 12.8 6.7 6.2 52
HR 15.5 14.3 11.5 2.8 80.2
Immunization 88.9 88.9 62.2 26.7 70
IEC 1.1 0.3 0 0.3 0
Infrastructure 152.5 152.5 121.6 30.9 79.7
Additionalities
617.3 409.2 300.7 108.5 73.5
under NRHM
A21: Fund utilization status - Bharatpur

Training 23.1 9.6 6.7 2.8 70.6
HR 35.3 20.9 10.9 10 52
Immunization 33.5 33.5 36.9 -3.4 110.1
IEC 0.5 0.5 0.3 0 61.2
Infrastructure 221.5 161.9 99.8 62.1 61.6
Additionalities
232.3 104.5 96.7 7.8 92.6
under NRHM
A22: Fund utilization status - Dausa

Training 32.9 29.4 22.3 7.1 75.9
HR 26.1 20.6 15.5 5.1 75.5
Immunization 62.9 62.9 62.9 0 100
IEC 0.8 0.8 0 0.8 0
Infrastructure 102.9 101.6 82.7 19 81.4
Additionalities
670 331.7 305.9 25.8 92.2
under NRHM

A22-A34
District Hospitals
Table A22 : AVAILABILITY OF HUMAN RESOURCE (CLINICAL)

Rajasthan
PERSONNEL In Position On contract
Specialist (Medicine)1 5 0
Specialist (Surgery) 6 0
Obstetrician / Gyneacologist 8 0
Pediatrician 6 0
Anesthetist 0 2
Pathologist / Microbiologist 2 0
Radiologist 1 0
Dermatologist / Vanerologist 2 0
N=3
Table A23: AVAILABILITY OF HUMAN RESOURCE

Rajasthan
PERSONNEL In Position On contract
Nurses 146 18
Nurse working in OBS-GYNIC department 33 5
ANM / PHN 13 5
Technicians 9 4
Radiographer 6 0
Pharmacist 2 0
N=3
Table A24: Availability of Investigative and Laboratory services

Rajasthan
Yes
Haematology 1
Urine analysis 3
STOOL ANALYSIS 3
PAP SMEAR 1
SPUTUM 3
HISTOPATHOLOGY 1
MICROBIOLOGY 2
BLOOD UREA 3
BLOOD CREATINEN 3
PREGNANCY TEST 3
COOMB‟S TEST 3
ELISA FOR HIV TEST 3
VDRL TEST 3
ECG 3
2D-ECHO 3
X-RAY 3
ULTRASOUND 3
FULLY OPERNATIONAL BLOOD BANK 3
BLOOD DONATION FACILITY 3
N=3

Table A25: AVAILABILITY OF PHYSICAL INFRASTRUCTURE

Rajasthan
Yes
CHC is within the block head quarter 3
Designated government building available for the
3
CHC
Water supply for 24 hours 3
Three- Phase connection 3
Standby facility (generator/invertors) available in
3
working condition
Functional toilet facility available 3
Separate toilets for males and females 3
N=3
Table A26: AVAILABILITY FO WASTE DISPOSAL

Rajasthan
Yes
Incineration 2
Autoclaving / Microwaving 2
Shredder 1
Needle and Syring destroyer 2
Any other 1
N=3
Table A27: AVAILABILITY OF COMMUNICATION FACILITIES

Rajasthan
Yes
Telephone facility available in all section 1
Personal Computer available 3
NIC Terminal available at DH 2
Access to internet facility available at DH 2
DH outsourcing data compilation and tabulation
work 2
Ambulance 10
Jeep 3
Car 0
Whether CSSD is there in DH 2
Critical care area 3
Integrated counseling and testing centre(ICTC) 3
N=3
Table A28: AVAILABILITY OF RESIDENTIAL FACILITY FOR THE MEDICAL STAFF

Rajasthan
AVAILABLE STAYING IN QUARTER

Yes Yes
Doctors and Specialist 2 1
Other Nurses 2 1
Other staff 1 1
N=3

Table A29: AVAILABILITY OF OTHER PHYSICAL FACILITIES

Rajasthan
Yes
Prominent display boards regarding service
availability in local language at DH 3
Separate registration counter in DH 3
Pharmacy for drug dispensing and drug storage at
DH 3
Any suggestion / complaint box kept at DH 3
N=3
Table A30: AVAILABILITY OF WARDS AND BEDS

Rajasthan
AVAILABLE Total number of
Yes beds Male Female
Pediatric ward 3 41 0 0
Intensive medicine care unite 3 16 8 3
Post operetive ward 3 61 10 46
Labour room 3 31
Ante Natal care ward 1 10
PNC ward 2 62
Post partum ward 1 10
N=3
Table A31: AVAILABILITY OF OT EQUIPMENTS

Rajasthan
Currently in
AVAILABLE use
Yes Yes
ElectiveOT-Major 3 3
Emergency OT / Familt welfare OT 2 2
Opthalmology / ENT OT 2 2
Orthopedic OPD 2 2
N=3
Table A32: AVAILABILITY OF DELIVERY SUIT UNIT

Rajasthan
Currently in
AVAILABLE use
Yes Yes
Labour room (Aseptic and clean) 3 3
Delivery room 2 2
Neo-natal room 2 1
Delivery suit unit including facility of
accomodation
Examination and prepretion room 3 3
Labour room (Aseptic and clean) 3 3
Delivery room 2 2
Neo natal room 2 2
Scrubbing room 1 1
N=3

Table A33: AVAILABILITY OF LABOUR WARD AND NEO NATAL EQUIPMENT FOR NURSERY
WARD
Rajasthan
AVAILABLE
Yes Number FUNCTIONAL
Baby incubator 2 10 8
Phototherapy unit 3 6 6
Emergency resuscitation kit baby 3 8 8
Radiant warmer 2 4 4
Room warmer 2 3 3
Foetal doppler 2 4 4
CTG monitor 2 4 3
Delivery Kit 2 30 30
Episiotomy Kit 1 10 10
Forceps delivery Kit 3 5 5
Crainotomy 1 1 1
Vaccume extractor metal 1 2 2
Silastic vaccum extractor 1 2 2
N=3

A34 – A55
Community Health Centres (CHC)
Table A34 - AVAILABILITY OF HUMAN RESOURCE

Rajasthan
In Position On contract
General Surgeon 1 0
Physician 2 0
Obstetrician /Gynecologist 2 0
Pediatrician 0 0
Anesthetist/ trained MO 1 0
General Medical Officer 10 1
N=4
AVAILABILITY OF HUMAN RESOURCE
Public Health Nurse (PHN) 2 0
Auxiliary Nurse Midwife (ANM) 7 3
Staff Nurse 3 0
Nurse/ Midwife 1 0
Lab. Technician 6 1
Radiographer 11 1
OT Attendant 0 0
N=4
Table A35: AVAILABILITY OF PARA MEDICAL

Rajasthan
Yes
At least one staff doctor/ nurse/LHV/ANM at
CHC available round the clock 4
Gynecologist and Anesthetist /Trained
Anesthetist available on call in case of
emergency 1
N=4
Table A36: NUMBER OF MO RECEIVED TRAINING

Rajasthan
Last 5 Years Ever
Non Scalpel Vasectomy(NSV) training 2 0
Minilaprotomy Training 2 0
HIV/AIDS Prevention, Care and Support training 4 2
Emergency Obstetric Care(including C-Section)
2 0
training
Newborn Care training 1 0
Basic Emergency Obstetric Care training 1 0
Integrated Management of Neonatal and
0 2
Childhood Illnesses training
Medical Termination of Pregnancy (MTP)
1 1
training
Anesthesia training to the MO 0 1
N=4

Table A37: NUMBER OF PARA MEDICAL STAFF RECEIVED TRAINING

Rajasthan
TYPE OF TRAINING
Last 5 Years Ever
Reproductive Tract Infection /Sexually
10 1
Transmitted Infection (RTI/STI) training
Integrated Management of Neonatal and
0 0
Childhood Illnesses (IMNCI) training
Skilled Birth Attendant training 8 0
Electro Cardiogram (ECG) training 3 0
Ultra Sound training 1 0
N=4
Table A38: NUMBER OF CHC’s WHERE PARTICULAR INVESTIGATIVE FACILITIES

AVAILABLE
Rajasthan
Available Functional
Yes
ECG facility 2 2
X- Ray facility 2 2
Ultrasound facility 0 0
Table A39: AVAILABILITY OF PHYSICAL INFRASTRUCTURE

Rajasthan
Yes
CHC is within the block head quarter 2
Designated government building available for
4
the CHC
Main source of water supply
Piped 3
Hand Pume 1
Water supply for 24 hours 1
Regular Power supply 2
Occasional power supply 2
Standby facility (generator/invertors) available in
1
working condition
Functional toilet facility available 3
Separate toilets for males and females 2
Laundry facility available at CHC 2
N=4
Table A40: AVAILABILITY OF WASTE DISPOSAL

Rajasthan
Yes
Incineration 1
Autoclaving / Microwaving 1
Shredder 2
Needle and Syring destroyer 2
Any other 0
No specific facility 4
N=4
Table A41: AVAILABILITY OF COMMUNICATION FACILITIES

Rajasthan

Yes
Telephone facility available in CHC 3
CHC has intercom facility 4
Whether CHC has Personal Computer 2
NIC Terminal available at CHC 4
Access to internet facility available at CHC 4
Ambulance 3
Jeep 1
Car 0
CHC have access to vehicle for transporting
3
patients during emergency
N=4
Table A42: AVAILABILITY OF RESIDENTIAL FACILITY FOR THE MEDICAL STAFF

Rajasthan
STAYING IN
AVAILABLE
QUARTER
Yes Yes
General Surgeon 2 1
Physician 1 0
Obstetrician /Gynecologist 1 1
Pediatrician 0 0
Staff Nurse 2 2
N=4
Table A43: AVAILABILITY OF LABOUR ROOM AND OPERATION THEATRE

Rajasthan
CURRENTLY IN
AVAILABLE
USE
Yes Yes
Labour Room 4 4
Operation Theatre 4 4
N=4
Table A44: AVAILABILITY OF STORAGE FACILITIES

Rajasthan
Yes
Whether CHC has separate room for drug storage 4
Separate waiting area for the patients in the OPD

4
of CHC
N=4
Table A45:AVAILABILITY OF OPERATIONALLABORATORY

Rajasthan
Yes
Operational laboratory in the CHC 3
Blood Storage Facility there in the CHC 0
N=4
Table A46:AVAILABILITY OF PHYSICAL FACILITIES

Rajasthan

Yes
Prominent display boards regarding service
3
availability in local language at CHC
Separate registration counter in CHC 4
Pharmacy for drug dispensing and drug storage
2
at CHC
Any suggestion / complaint box kept at CHC 1
OPD rooms / cubicles at CHC 4
If yes number of OPD room 8
Separate waiting area in OPD for patients at
4
CHC
Minor OT in the CHC 4
Injection Room and Dressing Room in the CHC 4
Emergency Room / Casualty room in the CHC 2
Patient Services 4
Total Number of functional beds in each CHC 64
Separate wards for males and females there in
4
the CHC
Number of functional beds for Male 27
Number of functional beds for Female 30
Number of functional Pediatric beds 12
N=4
Table A47: AVAILABILITY OF FURNITURE / INSTRUMENT

Rajasthan
AVAILABLE FUNCTIONAL
Yes Yes
Examination Table 4 4
Delivery Table 4 4
Bed Side Screen 4 4
Saline stand 3 3
Wheel chair 2 2
Stretcher on trolley 2 2
Oxygen cylinder with regulator and Mask 4 4
BP Instrument 4 4
Instrument trolley 3 3
Instrument tray 3 3
N=4
Table A48: AVAILABILITY OF OT EQUIPMENTS

Rajasthan
Yes Yes
Boyles Apparatus 4 3
Cardiac monitor 2 2
Ventilator 1 1
Horizontal high pressure sterilizer 4 0
Vertical high pressure sterilizer 2/3 drum capacity 1 1
Shadow less lamp ceiling track mounted 1 1
Shadow less lamp pedestal for minor OT 2 2
Oxygen Cylinder 660 Ltrs with regulator and Mask 3 3
Nitrous oxide cylinder 1780 Ltrs 4 0
Hydraulic operation table 2 2
Emergency drug tray 3 3
IUD Insertion Kit 4 4
Normal Delivery Kit 3 3
Equipment for Neo-Natal Resuscitation 2 2

Standard Surgical Set-I 3 3

Standard Surgical Set-II Instrument 2 2
CHC Standard Surgical Set III 3 3
Standard Surgical Set IV 1 1
Standard Surgical Set V 1 1
Standard Surgical Set VI 1 1
Equipments for Anesthesia 1 1
Equipments for laboratory test and blood transfusion. 1 1
Materials Kit for blood Transfusion 1 1
Equipment for Radiology 3 3
N=4
Table A49: AVAILABILITY OF LABORATORY EQUIPMENTS

Rajasthan
Yes Yes
Binocular microscope with oil immersion 2 2
Refrigerator 4 4
Stool transport carrier 1 1
Centrifuge 4 4
Rapid Diagnostic Kit for Typhoid 3 3
Rapid test kit for faecal contamination 4 0
Blood culture bottles with broth 4 0
Cold Box 3 3
Rapid Plasma Reagin (RPR) test kits for syphilis 1 1
Kits for ABO blood grouping 3 3
HIV test kits 3 3
N=4
Table A50: AVAILABILITY OF COLD EQUIPMENTS

Rajasthan
Yes Yes
Walk in cooler 2 2
Walk in freezer 2 2
ILR Large 3 3
ILR Small 3 3
Deep freezer Large 3 3
Deep freezer Small 3 3
N=4
Table A51: AVAILABILITY OF VACCINE

Rajasthan
SUPPLY
AVAILABLE
REGULAR
Yes Yes
BCG 4 4
DPT 4 4
OPV 4 4
MEASELES 4 4
DT 4 4
TT 4 4
N=4
Table A52: AVAILABILITY OF PROPHYLACTIC DRUGS

Rajasthan

Yes
IFA Tablets 4
Vitamin A Solution 4
ORS Packets 4
Contramaxazol 4
N=4
Table A53: AVAILABILITY OF ESSENTIALSERVICES

Rajasthan
Yes
OPD Services 4
Emergency Services (24 Hours) 4
Referral Services 4
blood Storage Facility 0
X ray room 4
Average Daily OPD Attendance (MALE) 148
Average Daily OPD Attendance(FEMALE) 191
N=4
Table A54: AVAIALIBILITY OF MCH SERVICES

Rajasthan
Yes
24-hour delivery services including normal and
4
assisted deliveries
Emergency Obstetric Care including Caesarean
2
Sections
Ante-natal care 4
Intra-natal care (24 - hour delivery services both
4
normal and assisted)
Post-natal care 4
New born Care 4
Child care including immunization 3
MTP facility 4
Facilities under Janani Suraksha Yojana 4
Antenatal clinics organized regularly 2
Facility for normal delivery available for 24 hours 2
Facility for internal examination for gynecological

3
conditions available at the CHC
Treatment for gynecological disorders like
leucorrhoea, menstrual disorders available at the 4
CHC
Facility for MTP (abortion) available at the CHC 3
Treatment for anemia given to both pregnant as well
4
as non-pregnant women
Low birth weight babies managed at the CHC 4
Fixed immunization day 4
BCG and Measles vaccine given regularly in the CHC 4
Treatment of children with pneumonia available at the

4
CHC
Management of children suffering from diarrhea with
3
severe dehydration done at the CHC
N=4
Table A55: AVAILABILITY OF OTHER FUNCTIONS AND

SERVICES

Rajasthan
Yes
Nutrition services 3
School Health programmes 4
Promotion of safe water supply and basic
4
sanitation
Disease surveillance and control of epidemics 4
HIV/AIDS control programmes 4
Rogi Kalyan Samiti (RKS) monitor your work
3
regularly
Monitoring and supervision of activities of Sub-
4
Centres and PHCs through regular meetings
N=4

A56 – A64
Primary Health Centres (PHC)
Table A56: Availability of Human Resources

In Position
Rajasthan
ALWAR BHARATPUR DAUSA Total Percentage
Medical officer 5 6 6 17 94
Lady Medical officer 0 1 1 2 11
Medical officer contractual 0 3 0 3 17
Staff Nurse 4 6 6 16 89
LHV / Health Assistant 5 7 5 17 94
Laboratory Technician 5 6 6 17 94
ANM / Female healthy worker 5 7 5 17 94
Additional staff Nurse / ANM (Contractual) 1 7 4 12 67
N=18
Table A57: Any training Received in 5 Years

RAJASTHAN
ALWAR BHARATPUR DAUSA Total Percentage
Any training programme was organized at
PHC last year 4 7 5 16 89
What were the trainings organized (N=16)
PULSE POLIO TRAINING 4 7 5 16 100

TRAINING OF ASHA 2 6 2 10 62
TRAINING FOR ANM/MALE HEALTH
WORKER 1 6 2 9 56
N=18
Table A58: Training Received in Last 5 years

District
Integrated skill development training for 12 Last 5 year 1 4 2 7
days Ever 1 0 3
Last 5 year 2 5 3 10
Immunization training
Ever 1 0 2
Last 5 year 0 2 1 3
NSV –Non Scalpel Vasectomy training
Ever 5 5 5
MTP- Medical Termination of Pregnancy Last 5 year 0 3 2 5
training Ever 5 4 4
Last 5 year 0 2 2 4
Minilap training
Ever 5 5 4
Reproductive Tract Infection/Sexually Last 5 year 1 4 4 9
Transmitted Infection(RTI/STI) training Ever 2 0 0
Management of obstetric complications Last 5 year 2 3 1 6
(BEmOC-Basic Emergency Obstetric
Care) training Ever 0 0 0
IMNCI- Integrated Management of Last 5 year 0 5 0 5
Neonatal and Childhood Illnesses training Ever 0 0 0
Last 5 year 1 4 1 6
Skilled Birth Attendant training
Ever 1 0 0
N=18

Table A59: Availability of Physical Infrastructure
Designated government building available

Yes 3 6 6 15
for the CHC
PHC is in other government building Yes 0 1 0 1
Society building Yes 1 0 0 1
Others Yes 1 0 0 1
N=18
Pipe Yes 3 2 3 8
Bore well / Tube well Yes 0 2 2 4
Hand pump Yes 2 4 4 10
Well Yes 5 7 6 18
No water supply Yes 5 7 6 18
N=18
Table- A60: Electricity, Toilet and Waste Disposal Availability

Regular Power supply Yes 1 2 0 3
Occasional Power supply Yes 4 5 3 12
Power cut in summer only Yes 0 0 1 1
Regular power cut Yes 0 0 1 1
No electricity Yes 0 0 1 1
Stantby of generator available in working
Yes 0 4 1 5
condition
N=18
Functional Toilet facility available Yes 4 7 6 17
Separate toilet facility for male and female Yes 0 4 3 7
N=18
Bury in Pit Yes 5 6 3 14
Thrown in common / Public disposal pit Yes 0 1 0 1
Thrown outside PHC compund Yes 0 0 0 0
Thrown inside PHC compund Yes 0 2 1 3
Burning Yes 2 3 5 10
Any other Yes 0 1 0 1
N=18
Table A61: Availability of Communication, Quarters, Operation theatres facility
Telephone facility available in PHC Yes 4 6 5 15

Whether CHC has Personal Computer Yes 0 2 1 3
NIC Terminal available at PHC Yes 1 0 0
Access to internet facility available at PHC Yes 1 1 0 2
PHC have access to vehicle for transporting
Yes 0 1 0 1
patients during emergency
Complaint box / suggestion box kept at PHC Yes 1 4 0 5
N=18
Available: Medical officer Yes 2 6 5
Whether Residing: Medical officer Yes 2 4 3
Available: Pharmacist Yes 0 3 2
Whether Residing: Pharmacist Yes 0 2 2
Available: LHV Yes 1 5 3
Whether Residing: LHV Yes 1 4 0
Available: Staff Nurse Yes 2 6 2

Whether Residing: Staff Nurse Yes 2 4 1

Available: Labour Room Yes 3 5 5
Whether Residing: Labour Room Yes 3 5 5
Available: Operation Theatre Yes 0 4 2
Whether Residing: Operation Theatre Yes 0 2 1
N=18
Table:A62 Availability of Physical Facility
PHC have in-patient facility Yes 4 6 6 16

Number of functional beds in PHC (N=16) Yes
Separate wards for male and female Yes 0 3 2 5
Number of functional beds for male Yes 0 9 4 13
Number of functional beds for female Yes 0 13 4 10
Number of pediatric beds Yes 0 10 0 0
N=18
Table:A63: Availability of Selected Furniture / Instrument
Available 5 7 6 18
Examination Table
Functional 5 6 6
Available 4 6 6 16
Delivery Table
Functional 3 6 6
Available 5 6 5 16
Bed Side Screen
Functional 5 6 5
Available 5 7 5 17
Saline stand
Functional 5 6 5
Available 1 3 3 7
Wheel chair
Functional 1 3 3
Available 2 5 3 10
Stretcher on trolley
Functional 1 5 3
Available 1 4 4 9
Oxygen trolley
Functional 0 4 3
Available 0 2 2 4
Height measuring stand
Functional 0 2 2
Available 3 5 6 14
Dressing trolley
Functional 2 5 6
Available 1 2 2 5
Mayo trolley
Functional 1 1 2
Available 2 1 3 6
Instrument cabinet
Functional 2 1 3
Available 2 3 3 5
Instrument trolley
Functional 2 3 3
Available 4 6 5 15
Instrument tray
Functional 4 6 4
Available 5 5 5 15
Wooden table
Functional 5 5 5
Available 3 1 2 6
Swab rack
Functional 3 1 1
Available 5 5 4 14
Waiting bench for patient
Functional 5 5 4
Available 3 4 2 9
Medicine cabinet
Functional 3 4 2
Available 1 2 0 3
Side rail
Functional 1 2 0
N=18

Table:A64: Availability of Equipments
Available 3 5 3 11
Kit A Drugs (sub-centre)
Functional 3 5 3
Available 2 5 3 10
Kit B Drugs (sub-centre)
Functional 2 5 3
Available 0 4 2 6
Kit C Equipments (sub-centre)
Functional 0 4 2
Available 2 1 3 6
Kit D Equipments (PHC)
Functional 2 1 3
Available 1 5 1 7
Kit of Essential obstetric care drugs (PHC)
Functional 1 5 1
A:New Born Care:
Available 1 3 0 4
Infant resuscitation bag with mask
Functional 1 3 0
Available 4 6 5 15
Weighing machine
Functional 4 6 5
Available 1 3 0 4
Paddle operated suction machine
Functional 1 3 0
Available 0 3 0 3
Mounted lamp with bulb
Functional 0 3 0
Available 0 4 1 5
Baby Bassinet
Functional 0 4 1
B: Other Equipments
Available 3 7 6 16
Normal Delivery Kit
Functional 3 7 6
Available 0 4 0 4
Equipment for assisted vacuum delivery
Functional 0 4 0
Available 0 4 0 4
Equipment for assisted forceps delivery
Functional 0 4 0
Equipment for New Born Care and Neonatal Available 0 5 0 5
Resuscitation Functional 0 5 0
Standard Surgical Set (for minor procedures like Available 1 5 3 9
episiotomies stitching) Functional 1 5 3
Available 0 4 0 4
Equipment for Manual Vacuum Aspiration
Functional 0 4 0
Available 0 1 0 1
Baby warmer/incubator.
Functional 0 1 0
N=18

A65 – A76
Sub Centers (SC)
Table A65: Availability of Human resources

District
Total
ANM/Female health Worker YES 100.0 100.0 100.0 100.0
Additional ANM (Contractual) YES 0 8.7 4.5 4.5
N=83
Table A66: Training received by ANM / Female health worker

District
Total
Integrated skill development training for LAST 5 YRS 68.2 56.5 36.4 53.7
12 days (RCH-I) EVER 42.9 20.0 35.7 32.3
Directly Observed Treatment Short
LAST 5 YRS 86.4 65.2 90.9 80.6
course (DOTS) training
LAST 5 YRS 81.8 78.3 40.9 67.2
EVER 33.3 73.3 48.1
Intra Uterine Device (IUD) Insertion LAST 5 YRS 71.4 63.6 47.4 61.3
training EVER 42.9 25.0 66.7 48.1
Integrated Management of Neonatal and LAST 5 YRS 9.1 78.3 13.6 34.3
Childhood Illnesses (IMNCI) training EVER 10.0 20.0 5.3 9.1
LAST 5 YRS 59.1 56.5 54.5 56.7
Skilled Birth Attendant training
EVER 11.1 0 0 3.4
EVER-Vector Borne Disease Control
EVER 14.3 5.6 18.8 12.5
Programme (VBDCP) training
N=83
Table A67: Training received by Male health worker

District
Total
Integrated skill development training for LAST 5 YRS 50.0 66.7 66.7 62.5
12 days (RCH-I) EVER 100.0 100.0 100.0 100.0
Vector Borne Disease Control LAST 5 YRS 100.0 33.3 66.7 57.1
Programme (VBDCP) training EVER 0 100.0 100.0 100.0
Directly Observed Treatment Short
LAST 5 YRS 50.0 66.7 66.7 62.5
course (DOTS) training
LAST 5 YRS 50.0 100.0 100.0 87.5
EVER 0 100.0 100.0 66.7
Intra Uterine Device (IUD) Insertion LAST 5 YRS 0 33.3 66.7 37.5
training EVER 50.0 0 0 20.0
Integrated Management of Neonatal and LAST 5 YRS 0 66.7 0 25.0
Childhood Illnesses (IMNCI) training EVER 100.0 100.0 100.0 100.0
N=83

Table A68: Physical Infrastructure

District
Total
Designated government building
YES 86.4 65.2 72.7 74.6
available for thr subcentre
Government building YES 0 28.6 0 18.2
Rented building YES 0 37.5 0 25.0
Rent free YES 0 0 50.0 12.5
Society building YES 100.0 28.6 80.0 60.0
School building Yes 0 0 33.3 8.3
ANM House YES 0 14.3 0 9.1
Type of water supply
Piped YES 4.5 4.3 18.2 9.0
Bore well YES 4.5 4.3 9.1 6.0
Hand pump YES 31.8 34.8 73.7 45.3
Well YES 18.8 5.9 0 10.0
No water supply YES 76.2 72.7 16.7 67.3
24 hour water supply YES 18.2 26.1 31.8 25.4
N=83
Table A69: Physical Infrastructure

District
Total
Regular power supply YES 9.1 13.0 7.5
Occasional power supply YES 25.0 30.4 31.8 29.2
Power cut in summers YES 5.0 1.9
Regular power cut YES 5.3 5.0 12.5 7.3
No electricity connection YES 72.7 61.9 47.1 61.7
Functional toilet facility available YES 31.8 47.8 40.9 40.3
Waste disposal 72.7 78.3 50.0 67.2
Bury in pit YES 8.7 3.0
Thrown in common / Public disposal pit YES 4.5 22.7 9.0
Thrown outside SC compound YES 8.7 4.5 4.5
Thrown inside SC compound YES 31.8 52.2 72.7 52.2
Burning YES 4.5 4.3 3.0
Sub- Centre has Government provided
YES 50.0 17.4 9.1 25.4
Telephone /Mobile phone facility
ANM residing in the quarter attached to
YES 4.5 30.4 9.1 14.9
the sub centre
N=83
Table A70: Availability of selected furniture

District
Total
Available 72.7 87.0 90.9 83.6
Examination Table
Functional 100.0 100.0 90.0 96.4
Available 27.3 30.4 68.2 41.8
Labour Table
Functional 83.3 100.0 66.7 78.6
Foot Step Functional 100.0 100.0 85.7 95.5
Available 4.5 26.1 36.4 22.4
Bedside Screen
Functional 100.0 100.0 12.5 53.3
N=83

Table A71: Availability of Equipments

District
Total
Available 59.1 43.5 31.8 44.8
Instrument Sterilizer
Functional 76.9 90.0 57.1 76.7
Available 90.9 91.3 86.4 89.6
Auto Disposable (AD) Syringes
Functional 95.0 95.2 94.7 95.0
Available 90.9 91.3 86.4 89.6
Hub Cutter (OBSERVE)
Functional 100.0 90.5 84.2 91.7
Available 86.4 100.0 100.0 95.5
B.P. Instrument
Functional 78.9 100.0 100.0 93.8
Available 72.7 95.7 95.5 88.1
Stethoscope
Functional 93.8 100.0 90.5 94.9
Available 95.5 91.3 100.0 95.5
Weighing machine (adult)
Functional 85.7 100.0 86.4 90.6
Available 90.9 91.3 90.9 91.0
Weighing machine (infant)
Functional 90.0 100.0 95.0 95.1
Available 27.3 73.9 77.3 59.7
Haemoglobinometer
Functional 50.0 94.1 52.9 70.0
Available 77.3 82.6 59.1 73.1
Foetoscope
Functional 100.0 94.7 100.0 98.0
Available 72.7 78.3 31.8 61.2
SIMS Speculum
Functional 93.8 94.4 100.0 95.1
Available 100.0 100.0 100.0 100.0
Vaccine Carrier
Functional 95.5 100.0 100.0 98.5
N=83
Table A72: Availability of Essential Kits

District
Total
Drug Kit -A YES 77.3 52.2 40.9 56.7
Drug Kit -B YES 9.1 17.4 4.5 10.4
Drug Kit -C YES 8.7 3.0
IFA Tablets YES 86.4 87.0 100.0 91.0
Vitamin A Solution YES 81.8 100.0 77.3 86.6
ORS Packets YES 95.5 87.0 90.9 91.0
Cotrimaxazole tablet (Pediatric) YES 63.6 87.0 81.8 77.6
Disposal Delivery KIt YES 54.5 73.9 63.6 64.2
N=83
Table A73: Labour Room-SERVICES PROVIDED

District
Total
Sub-Centre is having a labour room YES 18.2 13.0 31.8 20.9
If labour room is present, are deliveries
YES 25.0 66.7 42.9 42.9
carried out in the labour room
Number of deliveries were conducted in
5 5 8 38
the last three months
N=83

Table A74: Availability of specific service & Other Services

District
Total
Doctor visit the Sub-centre at least once
YES 90.9 100.0 72.7 88.1
in a month
Antenatal care (Inj. T.T, IFA tablets,

weight and BP checkup) provided by YES 100.0 100.0 100.0 100.0
those in the Sub centre
Facility for referral of complicated cases
of pregnancy / delivery available at Sub YES 50.0 69.6 13.6 44.8
centre for 24 hours
ANM/any trained personnel accompany
the woman in labour to the referred care YES 90.9 82.6 45.5 73.1
facility at the time of referral
Immunization services as per
Government schedule provided by the YES 95.5 100.0 100.0 98.5
Sub-centre
ORS for prevention of diarrhea and
YES 95.5 100.0 90.9 95.5
dehydration available in the Sub-centre
Promotion of sanitation YES 100.0 100.0 100.0 100.0
Field visits and home care YES 100.0 100.0 100.0 100.0
N=83
Table A75: Monitoring and Supervision Activities

District
Total
Immunization card YES 100.0 100.0 100.0 100.0
ANC card YES 100.0 82.6 90.9 91.0
Any othre YES 100.0 100.0
Training of traditional/Skilled birth
YES 86.4 100.0 81.8 89.6
attendants and ASHA
Coordinated services with AWWs,
ASHA, Village Health and Sanitation YES 100.0 100.0 100.0 100.0
Committee, PRIs
Coordination and supervision of
YES 95.5 95.7 72.7 88.1
activities of ASHA
Scheme of ASHA implemented in Sub
YES 59.1 95.7 72.7 76.1
Centre
Any woman from the Sub- Centre
villages die during pregnancy, delivery
YES 86.4 95.7 77.3 86.6
or during six weeks after delivery since 1
April 2007 to 31 March 2008
N=83
Table A76: Morbidity

District
Total
YES 60.0 25.0 32.1
Number of such maternal deaths, since
<3 71.4 75.0 100.0 78.9
1 April 2007 to 31 March 2008
3 to 5 28.6 25.0 21.1
RECORD AVAILABLE YES 76.9 55.0 20.0 47.2
Number of newborn deaths, since 1 April <3 75.0 100.0 100.0 92.3
2007 to 31 March 2008 3 to 5 25.0 7.7
N=83

Baseline Survey On Child and Related Maternal Health Care-Revised Report - Rajasthan-494 - 1

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Baseline Survey On Child and Related Maternal Health Care-Revised Report - Rajasthan-494 - 1

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NIPI Baseline Survey report for the state of Rajasthan

Norway India Partnership Initiative,

DRS Pvt. Ltd.

GVL Narsimha Rao

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1.1 Background of NIPI ......................................................................................................... 9

Chapter 2 Household Characteristics ............................................................................................ 26

2.1 Household demographic profile .................................................................................... 26

Chapter 3 Characteristics of Survey Respondents ....................................................................... 36

3.1 Background characteristics ........................................................................................... 38

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.................................................................................................................. Page No.

Chapter 4 Maternal Health ............................................................................................................ 44

4.1 Antenatal Care .............................................................................................................. 44

Chapter 5 Newborn Care ............................................................................................................... 65

5.1 Preamble ....................................................................................................................... 65

Chapter 6 Child Morbidity and Treatment ..................................................................................... 72

6.1 Prevalence of illness in children under study ................................................................ 72

Chapter 7 Child Immunization ....................................................................................................... 77

7.1 Preamble ....................................................................................................................... 77

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8.1 Status of District hospital (DHs) .................................................................................... 82

8.2 Status of Community Health Centre (CHCs)................................................................. 83

8.3 Status of Primary Health Centre (PHCs) ................................................................... 85

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Table 4.25: Awareness about JSY, NIPI-08

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1.1 Background of NIPI

Efforts of Norway India Partnership Initiative

 Strengthening the National Rural Health Mission, by supporting an independently managed

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1.2 Research Objectives

1.3 Study Phases

This current baseline study comprises of three phases, viz.,

3 Dissemination of study findings and summary report generation

1.4 Study area

1.4.1 Ongoing health related programs in Rajasthan

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1.5 Demographic Profile of NIPI states

1.5.1 About Rajasthan and NIPI districts

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Table 1.1: Key Health Indicators of the state

Birth rate SRS-2003 30.3

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1.5.2 Alwar District

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1.5.3 Bharatpur District

The health infrastructure available with the district is as follows:

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DLHS-2 DLHS-3 NIPI BASELINE

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1.5.4 Dausa district (Distt Profile and Map)

The health infrastructure available with the district is as follows:

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1.6 Survey Design

1.6.1 Sampling strategy at district level

- Oral informed consent of the selected respondent

Sample size determination in NIPI Baseline study

P1 = the estimated proportion at the time of the baseline survey;