Health Review 07-08

HEALTH REVIEW
GUJARAT
2007-2008
Vital Statistics Division

Commissionerate of Health, Medical Services,
Medical Education and Research
Gujarat State, Gandhinagar
January, 2009
HEALTH REVIEW
GUJARAT
2007-2008
Vital Statistics Division

Commissionerate of Health, Medical Services,
Medical Education and Research
Gujarat State, Gandhinagar
January, 2009
FOREWORD
This booklet is prepared with an objective to present basic health statistics and
review of various health programme performance for the year 2007-08 An
attempt has been made to cover all the areas of health activities and initiatives.
It is hoped that this publication will prove useful as ready reference to the
administrators, planners, officials, researchers and others interested in public
health of Gujarat
Any suggestions for improvement/ enriching this document will be appreciated
Gandhinagar Dr. Amarjit Singh IAS

January, 2009 Commissioner
`
Contents
Demographic Indicators
1. 1.1 Population Characteristics 1
1.2 Vital Statistics
2. Key Indicators - National Family Health Survey - Gujarat 26
3. Programme Review 33
4. Health Infrastructure 59
5. Health Finance Indicators 67
Millennium Development Goal 70
Definitions of Various Terms 71
HEALTH REVIEW, GUJARAT, 2007-08
Introduction
The present publication i.e. “Health Review, Gujarat 2007-08” reflects the health profile
and also forms an important component of auditing the adequacy of the available health
services. The present communication reflects a light on the trend of important indicators of
Gujarat, the performance of state in various Health Programs, Performance of Hospitals,
CHCs and PHCs, Medical Manpower / Human Resources, and budgeted outlay and
expenditure which clearly reflects the critical changes taken place in the overall health
situation of the state Various reliable sources like SRS, NFHS, and services data generated by
different forms in the state has been taken to prepare this report.
1. Demographic Indicators
Demographic characteristics of the state provide an overview of population size,
Composition, territorial distribution, Changes therein and the component of changes such as
nationality, mortality and social mobility. These indicators will help in identifying areas that
need policy and programmed interventions, setting near and far term goals and deciding
priorities, besides understanding them in an integrated structure.
1.1 Population Characteristics

Gujarat state, located in the western part of India, has an area of 196,022 sq. km, representing
about 6.2 percent of the total area of the country. The state population as on 1st March, 2001
stood at 506.71 lakhs (263.86 lakhs males and 242.85 lakhs females), which is nearly 5
percent of the total population of the country. Administratively it is divided into 26 districts,
242 cities/towns, 225 talukas, and 18,066 inhabited villages. About 37.4 percent of the State’s
population resides in urban areas, compared to India’s average of 27.8 percent. The
Population of Scheduled Castes and scheduled Tribes in the state have been reported at 7.09
percent and 14.76 percent to total population of the state
Poulation Growth Gujarat - In l akhs
600 507
500 413
341
400
267
300 206
163
137
102 115
200 91 98
100
0
1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001
Census Year
The sex ratio of Gujarat has reduced significantly from 934 (1991) to 920 (2001). The Dangs
District has the highest sex ratio of 987, while Surat district has the lowest sex ratio of 835.
The rural urban distribution for sex ratio shows that in rural area the sex ratio is better (945
females per 1000 males) in comparison to the urban area where the figures are not
encouraging one i.e. 880 females per 1000 males as per 2001 census. Sex ratio in 0-6 age
group was 883. Sex Ratio of the state in the age group of 0-6 is higher than Punjab (798),
1
Chandigarh (845), Harayana (819) and Delhi (868). Remaining all the states have higher sex
ratio than the State.
The density of population in Gujarat was 258 persons per sq. Km. in 2001 The highest
density of 719 persons per sq Km has been observed in Ahmedabad district, while the least
density of 35 persons per sq. Km. has been reported in Kachchh district.
Sex Ratio Gujarat & India 1901-2001-Rural, Urban, Total

Gujarat India
# Year Rural Urban Total Rural Urban Total
1 1901 951 965 954 979 910 972
2 1911 943 960 946 975 872 964
3 1921 948 931 944 970 846 955
4 1931 948 933 945 966 838 950
5 1941 955 898 941 965 831 945
6 1951 964 920 952 965 860 946
7 1961 956 896 940 963 845 941
8 1971 951 893 934 949 858 930
9 1981 959 905 942 951 879 933
10 1991 949 907 934 938 894 927
11 2001 945 880 920 946 901 933
Age distribution of the population shows that 32.8 percent population was in 0-14 age group
while only 6.9 percent population were in 60+ age group
Age and Sex wise percentage distribution of Population- 2001

6.2 60 + 7.7
6.2 50-59 6.4
4.8 45-49 4.7

Males Females
6.0 40-44 5.9
7.2 35-39 7.1
7.6 30-34 8.1
8.3 25-29 8.4
9.6 20-24 9.5
10.5 15-19 10.0
11.4 10-14 10.9
11.4 5-9 11.0
10.6 0-4 10.2
12 10 8 6 4 2 0 2 4 6 8 10 12
Socio – Economic indicators provide a background to understand the Health scenario. These
indicators will help in identifying the linkages between socio economic indicators and
achievement of health goals
The literacy rate in the state has increase from 61.29 per cent to 69.14 per cent during the
decade (1991-2001). In the state 79.7 per cent among males and 57.8 per cent among females
were literate. The literacy rates among scheduled castes and scheduled tribes have been
reported to 70.5 percent and 47.74 percent respectively. Socio-economic indicators of the
state are in general somewhat better than that of India average.
As per census 2001, about 42 percent of state population was engaged in economic activities
(main and marginal and workers)
2
As per the NSSO estimates, about 16.8 percent (2004-05) of Gujarat’s population is
estimated to be living BPL (Rural 19.10 percent, Urban 13.0 percent).
In 2001 census, out of 242 cities/towns, 41 cities / towns of the state had reported slums.
About 9.9 percent of urban population was residing in the slums .Out of total slum
population, 13.9 percent were Scheduled Castes and 4.5 percent were Scheduled Tribes.
Gross State Domestic Product, at a factor cost at constant (1999-2000) prices in 2006-07
has been estimated at Rs. 185802 crore as against Rs 170200 crore in 2005-06, registering a
growth of 9.17 percent during the year. At current prices, GSDP at factor cost in 2006-07 has
been estimated at Rs, 254533 crore as against Rs. 219780 crore in 2005-06, showing an
increase of 15.81 % during the year.
The state Income i.e. Net State Domestic Product (NSDP), at a factor cost at constant
(1999-2000) prices has been estimated in 2006-07 at Rs. 149933 crore as against Rs 139265
crore in 2005-06, showing an increase of 7.7 percent during the year. At current prices, the
NSDP in 2006-07 was estimated at Rs, 208211 crore as against Rs. 180271 crore in 2005-06,
showing an increase of 15.5 per cent during the year.
The per capita income (i.e. per capita NSDP at factor cost ) at constant (1999-2000) prices
has been estimated at Rs. 27027 in 2006-07 as against Rs. 25487 in 2005-06, registering a
growth of 6.04 percent during the year. The per capita income at current prices has been
estimated at Rs .37532 in 2006-07 as against Rs. 32991 in 2005-06, showing an increase of
13.76 per cent during the year.
40000
Per Capita Net State Domestic Product (NSDP) [in Rs.]

37532
35000
32991
30000
28846
26922
27027
25000
25487
22683 23346
22387
20000
19823 At Current Prices
19509
At Constant prices
18864
18200
15000
1999-00 2001-02 2002-03 2003-04 2004-05 2005-06 (P) 2006-07 (Q)
In 2001, 80.40 per cent of total household had electricity and 84.10 percent of the total
household had safe drinking water facilities. In 2001, 47.82 percent household in rural areas
and 7.58 percent households in urban areas had no toilet facilities within the house.
3
Population Statistics
Table : 1.1.1 Demographics Characteristics - Gujarat
# Item Unit 1971 1981 1991 2001
1 2 3 4 5 6 7
1 Area
1.1 Total Geographical Area Sq.km. 195984 196024 196024 196024
1.2 No. of Districts No. 19 19 19 25
1.3 No. of Talukas " 184 184 184 225
1.4 No. of Inhabited Villages " 18275 18114 18026 18066
1.4.1 Villages Classified by Population
1.4.1.1 Less then 200 No. 2054 1386 1019 768
1.4.1.2 200 - 499 " 4352 3472 2875 2297
1.4.1.3 500-999 " 5241 4956 4634 4262
1.4.1.4 1000-1999 " 4398 5108 5432 5615
1.4.1.5 2000-4999 " 1965 2725 3418 4154
1.4.1.6 5000 and above " 265 467 650 960
1.5 No. of Towns & Urban Agglomerations " 216 255 264 242
1.5.1 Towns Classified by Population
1.5.1.1 Less then 5000 No. 5 13 11 18
1.5.1.2 5000 - 9999 " 71 61 51 23
1.5.1.3 10000-19999 " 73 86 92 57
1.5.1.4 20000-49999 " 42 57 58 81
1.5.1.5 50000 - 99999 " 18 27 33 36
1.5.1.6 100000 & above " 7 11 19 27
2 Total Population
2.1 Males Lakh 138.02 175.53 213.55 263.86
2.2 Females " 128.95 165.33 199.54 242.85
2.3 Persons " 266.97 340.86 413.09 506.71
3 Rural Population
3.1 Males Lakh 98.42 119.87 138.84 163.18
3.2 Females " 93.59 114.97 131.79 154.23
3.3 Persons " 192.01 234.84 270.63 317.41
4 Urban Population
4.1 Males Lakh 39.60 55.66 74.71 100.68
4.2 Females " 35.36 50.36 67.75 88.62
4.3 Persons " 74.96 106.02 142.46 189.30
5 Decennial Growth Rate
5.1 Rural % 25.36 22.31 15.24 17.28
5.2 Urban % 40.98 41.44 34.37 32.88
5.3 Total % 29.39 27.68 21.19 22.66
6 % of Urban population to total population % 28.08 31.10 34.49 37.36
7 Density (persons per Sq.Km.) No. 136 174 211 258
8 Sex Ratio (Females per 1000 males)
8.1 Rural No. 951 959 949 945
8.2 Urban " 893 905 907 880
8.3 Total " 934 942 934 920
4
Table: 1.1.1 Demographics Characteristics – Gujarat (contd.)
# Item Unit 1971 1981 1991 2001
1 2 3 4 5 6 7
9 Literate Population
9.1 Total Literates
9.1.1 Males 000 6364 9555 13025 17833
9.1.2 Females " 3191 5341 8106 11995
9.1.3 Persons " 9555 14896 21131 29828
9.2 Rural Literates
9.2.1 Males 000 3831 5736 7680 10116
9.2.2 Females " 1608 2770 4226 6222
9.2.3 Persons " 5439 8506 11906 16338
9.3 Urban Literates
9.3.1 Males 000 2533 3819 5345 7718
9.3.2 Females " 1583 2575 3880 5772
9.3.3 Persons " 4116 6394 9225 13490
10 Effective Literacy Rate (Excluding Population 0-6 age group)
10.1 Total
10.1.1 Males % 46.11 65.14 73.13 79.66
10.1.2 Females % 24.75 38.46 48.64 57.80
10.1.3 Persons % 35.79 52.21 61.29 69.14
10.2 Rural
10.2.1 Males % 38.92 47.85 66.84 74.11
10.2.2 Females % 17.19 24.06 38.65 47.84
10.2.3 Persons % 28.33 36.20 53.09 61.29
10.3.1 Urban
10.3.2 Males % 63.96 68.62 84.56 88.34
10.3.2 Females % 44.77 51.13 67.70 74.50
10.3.3 Persons % 54.90 60.31 76.54 81.84
11 Scheduled Castes Population
11.1 Males Lakh 9.36 12.55 15.90 18.66
11.2 Females " 8.89 11.83 14.70 17.27
11.3 Persons " 18.25 24.38 30.60 35.93
11.4 % age of Scs. population to total pop. % 6.84 7.15 7.41 7.09
12 Scheduled Tribes Population
12.1 Males Lakh 18.97 24.54 31.32 37.90
12.2 Females " 18.37 23.95 30.30 36.91
12.3 Persons " 37.34 48.49 61.62 74.81
12.4 % age of Sts. population to total pop. % 13.99 14.23 14.92 14.76
13 Total workers Lakh 83.96 127.02 166.20 212.55
13.1 Percentage to total Population % 31.45 37.26 40.23 41.95
13.2 Main workers Lakh 83.96 109.84 140.95 170.25
13.4 Marginal workers Lakh - 17.18 25.25 42.31
13.5 Percentage to total Population % - 5.04 6.11 8.35
5
Table: 1.1.1 Demographics Characteristics – Gujarat (concld.)
# Item Unit 1971 1981 1991 2001
1 2 3 4 5 6 7
14 Non-workers Lakh 183.01 213.83 246.89 294.15
15 Classification of main workers
15.1 Cultivators Lakh 36.20 41.15 47.04 47.11
15.1.1 Percentage to total main workers % 43.12 37.46 33.37 27.67
15.2 Total Agricultural Labourers Lakh 18.88 24.88 32.31 30.49
15.3 Workers engaged in HH industries Lakh 2.36 2.69 1.97 3.06
15.4 Workers engaged in Other Activities Lakh 26.52 41.15 59.64 89.59
6
Table : 1.1.2 Population Growth, Crude Birth and Death Rates
and Sex Ratio - Gujarat and India, 1901-2001
Ave. annual
Population % age of Crude Crude
Census Exponential
# (in Decadal Birth Death
Year Growth
million) Variation Rate Rate
Rate
1 2 3 4 5 6 7
Gujarat
1 1901 91 - - - -
2 1911 98 + 7.79 (+) 0.69 N.A. N.A.
3 1921 102 + 3.79 (+) 0.33 N.A. N.A.
4 1931 115 + 12.92 (+) 1.14 N.A. N.A.
5 1941 137 + 19.25 (+) 1.70 N.A. N.A.
6 1951 163 + 18.69 (+) 1.65 41.8 24.9
7 1961 206 + 26.88 (+) 2.38 45.7 23.5
8 1971 267 + 29.39 (+) 2.58 44.2 18.3
9 1981 341 + 27.67 (+) 2.44 39.2 14.2
10 1991 413 + 21.19 (+) 1.92 32.0 10.7
11 2001 507 + 22.66 (+) 2.06 24.9 7.8
India
1 1901 2384 - - - -
2 1911 2521 + 5.75 (+) 0.56 49.2 42.6
3 1921 2513 -0.31 (+) 0.03 48.1 47.2
4 1931 2790 + 11.00 (+) 1.04 46.4 36.3
5 1941 3187 + 14.22 (+) 1.33 45.2 31.2
6 1951 3611 + 13.31 (+) 1.25 39.9 37.4
7 1961 4392 + 21.51 (+) 1.95 41.9 22.8
8 1971 5482 + 24.80 (+) 2.20 41.2 19.0
9 1981 6833 + 24.66 (+) 2.22 37.2 15.0
10 1991 8434 + 23.86 (+) 2.14 32.5 11.4
11 2001 10286 + 21.53 (+) 1.93 25.4 8.4
Source: Registrar General, India, New Delhi
7
Table 1.1.3: Distribution of Population, Sex Ratio, Density and Growth Rate – 2001
Density Average
India / Population 2001 Sex Ratio (Per Decennial Annual
Gujarat Sq.Km.) Growth Rate (%) exponetial
/District Growth Rate
Persons Males Females 1991 2001 1991 2001
‘81-91 ‘91-01 81-91 91-01
1 2 3 4 5 6 7 8 9 10 11 12
India 1028610328 532156772 496453556 987 933 267 325 23.86 21.53 2.14 1.93
Gujarat 50671017 26385577 24285440 934 920 211 258 21.19 22.66 1.92 2.06
Districts
Kachchh 1583225 815152 768073 964 942 28 35 20.22 25.40 1.86 2.29
Banas Kantha 2504244 1297404 1206840 934 930 184 233 30.87 26.38 2.73 2.37
Patan 1182709 612100 570609 944 932 181 206 12.35 14.16 1.17 1.33
Mahesana 1837892 953842 884050 951 927 374 419 17.35 12.05 1.61 1.14
Sabar Kantha 2082531 1069554 1012977 965 947 238 282 17.23 18.25 1.60 1.69
Gandhinagar 1334455 697999 636456 934 912 498 617 24.49 23.86 2.21 2.16
Ahmadabad 5816549 3074556 2741963 897 892 567 719 24.25 26.79 2.19 2.40
Surendranagar 1515148 787650 727498 921 924 115 144 16.89 25.34 1.57 2.28
Rajkot 3169881 1642018 1527863 946 930 224 283 20.12 26.08 1.85 2.34
Jamnagar 1904278 981320 92295 949 941 111 135 12.24 21.79 1.16 1.99
Porbandar 536835 275821 261014 960 946 204 234 10.23 14.35 0.98 1.35
Junagadh 2448173 1252350 1195823 960 955 236 277 15.29 17.07 1.43 1.59
Amreli 1393918 701593 692325 985 987 177 188 14.97 6.50 1.40 0.63
Bhavnagar 2469630 1274920 1194710 944 937 207 247 23.13 19.31 2.10 1.78
Anand 1856872 972000 884872 912 910 559 631 13.39 13.04 1.26 1.23
Kheda 2024216 1052823 971393 924 923 424 480 14.81 13.29 1.39 1.26
Panchmahals 2025277 1044937 980340 934 938 322 388 22.34 20.39 2.04 1.87
Dohad 1636433 824208 812225 976 985 349 449 34.60 28.44 3.02 2.53
Vadodara 3641802 1897368 1744434 913 919 402 482 21.07 19.87 1.93 1.83
Narmada 514404 263986 250418 947 949 163 187 19.85 14.47 1.83 1.36
Bharuch 1370656 713676 656980 925 921 176 210 18.36 19.37 1.70 1.79
Surat 4995174 2722539 2272635 901 835 444 652 36.29 47.01 3.14 3.93
The Dangs 186729 93974 92755 983 987 82 106 26.77 29.59 2.40 2.63
Navsari 1229463 628988 600475 958 955 491 557 19.34 13.24 1.78 1.25
Valsad 1410553 734799 675754 957 920 359 465 25.87 29.65 2.33 2.63
8
Table 1.1.4: Rural and Urban Composition of Population – 2001
Population 2001 Urban Decennial Sex Ratio

India / Gujarat Pop. as % Growth Rate
# age to (%)
/District Total Rural Urban Total Rural Urban
total pop. Rural Urban
1 2 3 4 5 6 7 8 9 10 11
India 1028610328 742490639 286119689 27.82 17.97 31.13 927 946 901
Gujarat 50671017 31740767 18930250 37.36 17.28 32.88 920 945 880
Districts
1 Kachchh 1583225 1108333 474892 30.00 26.72 22.44 942 953 917
2 Banas Kantha 2504244 2228743 275501 11.00 24.84 40.43 930 934 902
3 Patan 1182709 944281 238428 20.16 13.73 15.87 932 938 910
4 Mahesana 1837892 1426175 411717 22.40 10.42 18.07 927 934 901
5 Sabar Kantha 2082531 1857402 225129 10.81 17.86 21.58 947 950 920
6 Gandhinagar 1334455 867195 467260 35.02 13.70 48.47 912 925 888
7 Ahmadabad 5816519 1152986 4663533 80.18 11.70 31.17 892 918 885
8 Surendranagar 1515148 1112700 402448 26.56 31.50 10.95 924 930 907
9 Rajkot 3169881 1544019 1625862 51.29 16.08 37.32 930 947 915
10 Jamnagar 1904278 1068022 836256 43.91 14.51 32.56 941 958 918
11 Porbandar 536835 275460 261375 48.69 7.34 22.80 946 953 940
12 Junagadh 2448173 1736645 711528 29.06 15.93 19.95 955 961 939
13 Amreli 1393918 1080960 312958 22.45 8.09 1.35 987 1001 940
14 Bhavnagar 2469630 1534592 935038 37.86 15.31 26.52 937 962 898
15 Anand 1856872 1348901 507971 27.36 9.74 22.88 910 909 915
16 Kheda 2024216 1617766 406450 20.08 14.28 9.49 923 922 923
17 Panchmahals 2025277 1771915 253362 12.51 19.48 27.13 938 941 919
18 Dohad 1636433 1480110 156323 9.55 27.61 36.84 985 989 952
19 Vadodara 3641802 1995580 1646222 45.20 16.70 23.96 919 929 907
20 Narmada 514404 462298 52106 10.13 14.10 17.86 949 952 916
21 Bharuch 1370656 1018096 352560 25.72 17.89 23.87 921 925 907
22 Surat 4995174 1999357 2995817 59.97 19.03 74.37 835 948 766
23 The Dangs 186729 186729 0 0.00 45.68 - 987 987 -
24 Navsari 1229463 893110 336353 27.36 14.67 9.62 955 970 915
25 Valsad 1410553 1029392 381161 27.02 19.28 69.40 920 955 829
Source : Registrar General of India
9
Table 1.1.5 : Mid Year Projected Population, Gujarat - 2001-2026
As on 1st October (in '000)
# Year Rural Urban Total
Persons Males Females Persons Males Females Persons Males Females
1 2 3 4 5 6 7 8 9 10 11
1 2001 32095 16496 15599 19254 10254 9000 51349 26751 24599
2 2002 32381 16657 15724 19699 10503 9196 52079 27160 24920
3 2003 32763 16860 15903 20182 10777 9405 52944 27636 25308
4 2004 33132 17055 16077 20667 11052 9614 53798 28107 25691
5 2005 33489 17244 16245 21152 11329 9824 54642 28573 26069
6 2006 33835 17428 16408 21640 11606 10033 55475 29034 26441
7 2007 34170 17604 16565 22128 11886 10243 56298 29490 26808
8 2008 34491 17774 16717 22618 12166 10452 57109 29940 27169
9 2009 34801 17938 16863 23109 12447 10662 57910 30386 27525
10 2010 35100 18096 17004 23602 12730 10871 58702 30827 27875
11 2011 35390 18250 17140 24096 13015 11081 59485 31264 28221
12 2012 35668 18397 17271 24591 13300 11291 60259 31697 28562
13 2013 35935 18538 17397 25088 13587 11500 61023 32125 28897
14 2014 36192 18674 17518 25586 13875 11710 61777 32549 29228
15 2015 36439 18805 17634 26085 14165 11920 62524 32970 29554
16 2016 36677 18931 17746 26586 14457 12130 63264 33388 29876
17 2017 36879 19037 17842 27068 14737 12331 63947 33774 30173
18 2018 37074 19140 17934 27555 15021 12534 61628 34160 30468
19 2019 37250 19232 18018 28035 15301 12734 65284 34533 30752
20 2020 37403 19312 18092 28506 15577 12929 65909 34889 31020
21 2021 37531 19378 18153 28965 15846 13119 66496 35224 31272
22 2022 36751 18955 17797 30396 16638 13757 67147 35593 31554
23 2023 36084 18592 17491 31678 17351 14327 67762 35943 31818
24 2024 35057 18036 17021 33318 18256 15062 68375 36292 32083
25 2025 33539 17216 16323 35456 19428 16027 68994 36644 32350
26 2026 31395 16058 15337 38232 20944 17288 69627 37002 32625
Note :- Sub-total and total not may tally due to rounding off.
Source : Registrar General of India, New Delhi
10
1.2 Vital Statistics
The birth rate declined from 28.1 in 1992 to 23.0 in 2007, while the death rate declined from
9.2 to 7.2 per 1000 population over the same period. The natural growth rate declined from
18.9 in 1992 to 15.8 in 2007
The population, however, continues to grow, as the decline in the birth rate is not as rapid as
the decline in the Death rate.
30.0 Birth Rate, Death Rate, and Natural Grow th Rate in Gujarat 1995-2007
27.5 CBR CDR NGR
2 6 .7
25.0 2 5.7 2 5.6 2 5.5 2 5.4 2 5.2 2 4 .9 24 .7 2 4 .6
24 .3
22.5 2 3.7 23 .5
2 3.0
20.0
18 .8
17.5
Rate
18 .1 18 .0
17.6 17.5 17.7 17.4
17.1 17.0 17.0
16 .6 16.3
15.0 15.8
12.5
10.0
7.9 7.6 7.6 7.9 7.9 7.8 7.7 7.6
7.5 7.2 7.2
6 .9 7.1
7.5
5.0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Decrease in CBR- Major States

At national level average birth rate reduced from 28.2 in 1994-96 to 23.8 in 2004-06. During
these years the rate of decline in average birthrate varies from 25.4 percent in Punjab to 7.5
percent in Bihar. While in Gujarat average birth rate has reduced from 26.5 in 1994-96 to
23.6 in 2004-06 showing a decrease of 10.2 percent.
Percent Decrease in CBR between 1994-96 and 2004-06
30.0
25.4
25.0
% decrease in CBR, Major States
22.2 22.2
21.3
% decrease in CBR, India
19.5 19.2
20.0 18.1
15.7 15.7 14.7 14.6
15.0 13.6
12.7
11.0
10.2
10.0
7.5
5.0
0.0
Gujarat
Andhra
Punjab
Tamil Nadu
W.Bengal
Orissa
Haryana
Kerala
Bihar
M. Pradesh
Assam
UP
Maharastra
Karnataka
Rajasthan
Himachal
11
Change in CDR 1994-96 to 204-06
The following chart shows the percentage change in the level of Crude Death Rate between
the period 1994-96 and 2004-06 for India and bigger states. During this period crude death
rate in India has declined by 17.6 per cent. Among the bigger states, decline in Crude Death
Rate varies from 23.1 pr cent in Bihar and Rajsthan to 6.3 per cent in Tamil Nadu. While in
Gujarat crude death rate has reduced from 8.0 in 1994-96 to 7.1 in 2004-06 showing a
decrease of 11.3 percent.
25.0 2 3 .1 2 3 .1
2 1 .3
2 0 .4
20.0 1 9 .0
1 8 .5
1 7 .6
1 7 .1
15.0 1 3 .3
1 2 .8
1 1 .3
1 0 .8 1 0 .3
10.0 8 .4
6 .3
5.0
-2 .4 -4 .9
0.0
Gujarat
Madhya Prad.
Andhra Prad.
India
Punjab
Tamil Nadu
W. Bengal
Haryana
Orissa
Kerala
Himachal Prad.
Bihar
Assam
Maharastra
Karnataka
Rajasthan
Uttar Prad.
-5.0
-10.0
Life expectancy at birth

Life expectancy at birth has increase from 58.0 years for males and 60.5 years for females in
1988-92 to 64.9 for male and 69.0 for females in 2001-05. Increasing life expectancy leads
to increasing number of elderly persons in the population, for which specific health facilities
will have to be provided
76
PROJECTED VALUES OF EXPECTATION OF LIFE AT BIRTH
2001- 2025
74.9
74
73.7
72 72.5
71.9
71.0 70.7
70
69.0 69.2
68
67.2
66
64.9
64
62
60
Male Female
58
2001-05 2006-10 2011-15 2016-20 2021-26
Infant Mortality Rate is defined as the infant deaths (less than one year) per thousand live
births. At national level IMR for the year 2007 was reported to be 55 and varied from 61 in
rural areas to 37 in urban areas. In Gujarat it was reported to be 52 combined, in rural 60 and
36 in urban areas. In Gujarat, Infant Mortality Rate has declined considerably (71 in 1998)
during last decade and reached 52 per 1000 live births in 2007. However rural and urban
differentials are still very high. Female infants experienced a higher mortality than male
infants. Infants mortality among females were reported 54 in the state
Infant Mortality Rate Gujarat- 2007
Male Female Person
Combined 50 54 52
Rural 59 62 60
Urban 34 38 36
Source : SRS bulletin, October,2008
12
The state has a birth rate of 23.0 per 1000 population (SRS 2007) in comparison to 23.8 per
1000 population of India. It also shows a decreasing trend from the year 2001 where the birth
rate was 25 per 1000 population.
The distribution of current live births by birth order shows that 69.2 percent are being
contributed by 1st & 2nd birth whereas contribution of 3rd & 4th birth order is of 30.8 percent.
The proportion of the same at national level is 65.5 percent and 33.5 percent respectively. In
rural areas, the proportion of 3 and 3+ child birth in current live birth is 34.4 percent where
as in urban the same is 24.3 percent.
The percentage distribution of second and higher order live births by interval and residence
between current and previous live birth is shown below for Gujarat and India
Interval between current and previous live births (in months) – SRS, 2006
10-12 12-24 24-36 36+
Rural 2.3 29.9 31.0 36.8
Gujarat
Urban 2.2 25.6 27.9 44.3
Combined 2.2 28.5 30.0 39.3
Rural 1.3 25.0 28.8 44.9
India Urban 1.3 24.1 27.6 47.0
Combined 1.3 24.8 28.6 45.3
Mean age at effective marriage for females was 20.7 years (2006) in comparison of 20.5
years of India.
As per the SRS,2006 In Gujarat, Out of every 100 births 53.2 births were taking place in the
institutions whereas 30.7 birth are attended by qualified professional.16.1 birth attended by
untrained functionary and others. In 2001 only 36.6% births are taking place in the hospitals.
Percent distribution of live births by type of medical attention received by the mother at delivery
by residence, Gujarat and India,2006
Govt. Private Qualified Untrained
Hospitals Hospitals Professionals and Othes
Total 29.5 23.7 30.7 16.1
Gujarat Rural 21.5 15.2 41.3 22.1
Urban 44.4 39.5 11.1 5.0
Total 22.0 12.9 26.7 38.4
India Rural 16.1 8.8 29.7 45.4
Urban 43.4 27.6 15.6 13.1
Source: SRS- Statistical Report,2006
Out of the total births taking place in the urban area 83.9 % births are being attended by the
medical institutions whereas in rural area 36.1% births are being attended by the medical
institution. These proportions were 74.7 % and 20.1% in 2001.
In Gujarat out of the total institutional delivery 55.8 % births are taking place in government
hospital.
In India 65.1 % deliveries are taking place at home; out of which 59.0 % deliveries are
attended by untrained functionary. Whereas in Gujarat out of the total 46.8 % home deliveries
65.6 % delivery are attended by trained professionals but still around 34.4 % of deliveries are
being attended by untrained functionaries.
Fertility by age of Women

Age of women is an important factor affecting the fertility levels. On the basis of data of
births to women by specific age groups in reproductive span 15-49 years is available from
13
SRS. The distribution of age – specific fertility by residence in 2001 and 2006 along with
percentage change is presented in the following table. The data revels that fertility in all the
age groups is higher in rural areas than in urban areas. Decline has been registered in 2006 in
all the age group except 15-19 age group compared to 2001.
Age Specific Fertility Rates (ASFRs) by Residence, Gujarat, 2001 and 2006
Age 2001 2006 % change

group Total Rural Urban Total Rural Urban Total Rural Urban
15-19 26.4 30.7 17.2 41.3 46.7 31.8 56.4 52.1 84.9
20-24 221.4 240.3 185.8 214.8 227.9 195.2 - 3.0 - 5.2 5.1
25-29 193.8 213.7 157.2 180.8 195.8 161.0 - 6.7 - 8.4 2.4
30-34 84.0 96.4 60.2 68.8 78.0 55.8 - 18.1 - 19.1 - 7.3
35-39 29.7 33.7 22.0 27.4 37.6 13.2 - 7.7 11.6 - 41.6
40-44 13.9 16.6 8.6 9.4 12.0 5.3 -32.4 - 27.7 - 38.4
45-49 3.3 3.2 3.4 2.9 4.2 1.1 - 12.1 31.3 -67.7
It is a matter of concern that Age Specific Fertility Rate in the age group 15-19 years has
shown an abnormal increasing trend.
The cumulative value of the age specific fertility Rates at the end of the child bearing ages
gives a major of fertility known as Total fertility Rate (TFR). TFR indicates the average
number of children expected to be born per woman during her entire span of reproductive
period assuming that the ASFR, to which she is exposed to continued to be the same and that
there is no mortality.
As per SRS Total Fertility Rate for Gujarat was in the year 2006 was 2.7 per woman and
varies from 3.0 in rural areas to 2.3 for urban areas.
As per provisional results of SRS, TFR for Gujarat in the year 2007 is estimated to 2.6
Following chart presents the percentage change in the average level of TFR between the
periods 1994-96 and 2004-06 in India and bigger states. During the period TFR has declined
by 17.1 percent at the national level. Among the bigger states, the decline varies from 27.6
percent in Punjab and 5.6 percent in Kerala. In Gujarat, during this period TFR has reduced
from 3.1 to 2.8, showing a decrease of 9.7 percent
% change in TFR between 1994-96 and 2004-06
30.0
27.6
25.0
25.0
24.1
23.1
22.2
20.0
19.4
19.0
18.8
18.5
18.2
17.1
17.1
16.0
15.0
14.3
10.0
9.7
6.7
5.0
5.6
0.0
Tamil Nadu
Himachal Prd.
Bihar
Gujarat
India
Punjab
Karnataka
Rajasthan
Kerala
W. Bengal
AP
Haryana
Assam
Uttar Prad.
Madhya Prad.
Maharastra
Orissa
14
It is important to note here that after the introduction of Target Free approach, the TFR in
Gujarat has not decreased as fast as other big states.
4.5
4.3 SRS- Decadal trend in TFR of 5 comparable state with Gujarat
4.0 4.0
3.9
3.7
3.6
3.5
3.5
3.4 3.1
3.0
2.9
3.0 3.0 2.8
3 2.7
2.8 2.6
2.8
2.5 2.4
Rate - TFR
2.5 2.2
2.4 2.1
2.3
2.2
2.0
2.0 2.0 2.0
2.0
1.8 1.7 1.7
1.8
1.7 1.7 1.7
1.5 Gujarat
Andhra Pradesh
Kerala
1.0
Maharashtra
Tamil Nadu
0.5
0.0
1981 1985 1991 1995 2001 2005 2006
Decades- years
Total Fertility Rates by education levels for women for India and Gujarat are presented in the
table 1.2.3 Selected Vital Indicators, Gujarat and India, 2006.In Gujarat, TFR for the women
having educational level ‘Illiterate’ for 2006 is 3.8. This is much higher than the ‘literate’
group of women. Among the ‘Literate’ (2.2), there is gradual decline of TFR with the
increase in the level of education. Following chart presents TFR by level of education of
women for Rural, Urban and Total
6.5
6.0
6.0 TFR by level of Education of Women and Residence
Gujarat, 2006
5.5 5.6
5.6 Total Rural Urban
5.0
4.5
4.0 3.8
3.5
3.5 3.8 3.8
3.7
TFR
3.4
3.0
2.6
2.5
2.2 2.6 2.6
2.4 2.0
2.0
2.0 2.2
2.1 2.1
1.8 1.9 1.5 1.5 1.9
1.5 1.8
1.0 1.3 1.3
0.5
0.0
Illiterate Literate Without any Below Primary Primary Middle Class X Class XII Graduate and
formal above
education
15
Table 1.2.1: Fertility Statistics - Gujarat
# Item Unit 2001 2002 2003 2004 2005 2006
1 2 3 4 5 6 7 8 9
[1] Fertility Indicator
1 Birth Rate (CBR)
Total 25.0 24.7 24.6 24.3 23.7 23.5
Per 1000
Rural population 26.7 26.6 26.5 26.3 25.5 25.0
Urban 21.5 20.6 20.5 21.1 21.0 21.1
2 Still Birth Rate
Total 5 8 11 8 8 7
Per 1000 live
Rural birth 5 8 10 8 8 7
Urban 4 9 13 8 8 8
3 General Fertility Rate
Total Live Birth per 99.3 98.7 92.8 95.7 92.2 91.0
'000 woman in a
Rural reproductive age 106.4 107 102.4 106.3 101.2 99.0
group
Urban 85.2 82 73.4 80.5 79 79.1
4 Total Fertility Rate
Total Average children
to be born to a
2.9 2.8 2.8 2.8 2.8 2.7
Rural woman in span 3.2 3.2 3.1 3.2 3.1 3.0
of reproductive
Urban period 2.3 2.1 2.1 2.3 2.3 2.3
5 Mean Age of Fertility Years 26.8 26.8 26.7 26.3 26.5 26.3
6 General Marital Fertility Rate
Total Live birth per 132.8 132.7 127 125..5 122.3 119.9
'000 married
Rural woman in the age 139.8 141.2 138.2 138.6 133.8 129.8
Urban group 15-49 years 118.2 114.7 103.5 106.5 105.3 105.1
7 Total Marital Fertility Rate
Total Avg children to
be born to a
4.2 4.0 4.2 4.1 4.0 4.1
Rural woman during the 4.4 4.4 4.5 4.5 4.3 4.4
entire span of
reproductive
Urban period
3.6 3.1 3.5 3.6 3.5 3.7
8 Gross Reproduction Rate
Avg. no. of
Total daughters, a
1.3 1.3 1.3 1.3 1.3 1.3
Rural woman expected 1.5 1.5 1.4 1.5 1.4 1.4
to give birth
during the
Urban reproductive age
1.0 1.0 1.0 1.0 1.0 1.1
9 Births by type of Medical Attention
Attended by Institutions
9.1 Total % 36.6 36.6 36.7 51.7* 52.5* 53.2
Rural % 22.1 22.7 22.9 35.3* 36.1* 36.7
Urban % 74.7 75.1 75.1 82.6* 83.3* 83.9
Attended by Govt. Hospitals
Total % - - - 28.7 29.2 29.5
Rural % - - - 20.7 21.2 21.5
Urban % - - - 43.8 44.1 44.4
9.3 Attended by Trained Professionals
Total % 38.6 39.1 39.2 30.3 30.6 30.7
Rural % 45.5 45.7 45.8 40.7 41.1 41.3
Urban % 20.5 20.7 20.8 10.6 10.9 11.1
16
Item Unit 2001 2002 2003 2004 2005 2006
9.4 Attended by Untrained Professionals
Total % 22.7 24.3 24.1 18.0 16.9 16.1
Rural % 32.4 31.6 31.3 24.0 22.8 22.1
Urban % 5.4 4.2 4.1 6.8 5.8 5.0
10 Distribution of current live births by Birth Order
10.1 Combined
1st % 37.1 36.6 38.4 39.3 36.6 39.2
2nd % 31.2 30.9 30.1 28.6 30.2 30.0
3rd % 16.9 18.0 16.8 16.6 16.6 15.4
4th & above % 14.8 14.5 14.6 15.5 16.6 15.4
10.2 Rural
1st % 35.7 34.8 36.3 37.3 34.7 36.8
2nd % 30.2 30.4 29.5 26.4 28.7 28.8
3rd % 17.8 19.0 17.5 18.1 16.7 16.1
4th & above % 16.2 15.8 16.7 18.3 19.9 18.3
10.3 Urban
1st % 40.7 41.3 44.3 43 40.2 43.6
2nd % 33.7 32.3 32.0 32.8 33.1 32.1
3rd % 14.6 15.1 14.9 13.8 16.3 14.1
4th & above % 11.1 10.9 8.7 10.4 10.4 10.2
11 Distribution of second and higher order live births by interval
11.1 Combined
10-12 Months % 0.6 0.7 0.9 1.2 2.0 2.2
12-24 Months % 37.8 36.3 37.8 26.9 29.3 28.5
24-36 Months % 29.4 32.9 30.0 30.0 29.6 30.0
36+ Months % 32.2 30.1 31.4 41.9 39.1 39.3
11.2 Rural
10-12 Months % 0.6 0.7 0.8 1.4 2.1 2.3
12-24 Months % 38.7 38.3 38 27.5 29.6 29.9
24-36 Months % 30.6 34.3 31.8 31.8 30.7 31.0
36+ Months % 30.1 26.7 29.4 39.3 37.6 36.8
Urban
10-12 Months % 0.6 0.8 1.1 0.7 1.7 2.2
11.3 12-24 Months % 35.4 30 37 25.8 28.8 25.6
24-36 Months % 25.9 28.7 24.4 26.2 27.3 27.9
36+ Months % 38.1 40.5 37.5 47.3 42.2 44.3
* Including Private Hospitals Source: SRS, Registrar General India, New Delhi
17
Mortality Indicators
Mortality is one of the basic component of population change and essential for demographic
studies and public health administration. It is the principal ingredient for population
projections and life table. The various measures of mortality are Crude Death Rate (CDR),
Infant Mortality Rate(IMR), Still Birth Rate (SBR)and Peri –Natal Mortality Rate (PMR)
Crude Death Rate

The state has a death rate of 7.2 (SRS-2007) per 1000 population in comparison to India’s 7.4
per 1000 population. It has decreased from 7.8 per 1000 population in year 2001 to 7.2 per
1000 population in 2007.The death rate is more in rural area i.e. 8.1 per 1000 population in
comparison to urban area (5.8 per 1000 population). The same figure for India is 8.0 and 6.0
per 1000 live births respectively.
19.0
17.6 Crude Death Rate (Rural, Urban and Combined - Gujarat

17.0
16.4 15.8 Combined Rural Urban
15.0
14.0
12.9
13.0 13.0 13.0
12.4 12.0
12.7
12.0 11.8
11.6
11.0 11.0
10.8 10.7 10.8
10.4
9.5
9.8 9.7
10.0
9.4 8.8
9.2 9.2
9.0 9.0 8.9
8.6 8.7 8.3 8.1
8.3 8.2 8.2 8.2
7.6
7.2
7.6 7.5
7.0
7.2
6.4
6.8
6.2 5.6 5.5 5.8
5.0
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Infant mortality Rate
Infant mortality rate has decreased from 60 per 1000 live birth in 2001 to 52 per 1000 live
birth in 2007, which is lower than the India’s Infant mortality rate of 55 per 1000 live births.
The percent share of infant deaths to total deaths in the year 2006 was 17.0 per cent and
varied from 18.9 per cent in rural areas to 13.1 percent in urban areas.
Out of the total Infant deaths 50.7% infant deaths occurred in early neonatal period i.e. within
7 days of births and 20.1 % incident of Infant deaths occurred within to 29 days of birth.
Thus, 70.8 % of infant deaths are occurred in neo-natal period in 2006.
Infant Mortality in Gujarat by period of Occurrence
100.0
90.0
27.1 31.5 28.3
34.4 38.6 33.3
80.0
70.0
13.6
60.0 14.8 20.8
18.0 24.1
50.0
19.3
40.0
30.0 59.3
47.5 51.9 50.9
20.0 42.1 44.4
10.0
0.0
2001 2002 2003 2004 2005 2006
Early NNMR Late NNMR Post NNMR
18
Child Mortality Rate has gone down by 13.5 % from year 2001 to 2006. It was 18.5 per
1000 population in 2001 which decreased to 16 per 1000 population in 2006. As per SRS
2006, percent share of deaths of children below age five to total deaths for Gujarat is
estimated to 21.9 percent and varied from 24.3 percent in rural areas to 16.5 percent in urban
areas.
Maternal Mortality
Deaths due to pregnancy and child birth are common among women in the reproductive age
groups. Reduction of Mortality of women has thus been an area of concern.
The Maternal Mortality Rate which was estimated to 202 per one lakh live birth (SRS 1999-
01)in the state, has come down to about 172 in 2001-03, registering a decline of 14.9 per
cent.
500
Maternal Mortality Ratio - Selected States ( Per one lakh live births)
450 Gujarat
436
Andhra Prd.
Kerala
400 Maharastra
389 393 Tamil Nadu
365
376
350
336 341
300
284
250
MMR
262 220
200 195
202
169 172
150 167 149
149 134
110
100
87
50
1992-93(UNISEF est) NFHS - II Indirect Est. 1999-01(SRS) 2001-03(SRS)
Medical Attention before Death

In India out of the total deaths, 16.1 percent received medical attention in government
hospitals, 12 percent in private hospitals, 38.5 percent received medical attention from
qualified professional and 33.4 percent received medical attention from untrained functionary
& others. Whereas in Gujarat out of the total deaths 18.7 percent of deaths received medical
attention in government hospitals, 14.0 percent in private hospitals, 49.5 percent deaths
received medical attention from qualified professional and only 17.7 percent deaths received
medical attention from untrained functionary and others, which is lower in all the states after
Punjab (9.2 percent)
In Gujarat, Death rate in the age group 15-59 is estimated to be 3.7 and it varies from4.2 in
rural areas to 3.0 in urban areas. The female death rate is found lower than that of males.
The death rate of persons above 60 years also shows decreasing trends which is a strong
indicator of increase in life span.
The natural growth rate in Gujarat, which is difference between the birth rate and death rate,
was estimated 1.58 percent in 2007 against 1.71 percent in 2001
19
Table 1.2.2: Mortality Indicators
# Item Unit 2001 2002 2003 2004 2005 2006
1 2 3 4 5 6 7 8 9
1 Death Rate
Combined 7.8 7.7 7.6 6.9 7.1 7.3
Rural 8.9 8.3 8.2 7.8 8.0 8.2
Per 1000
Urban 5.6 6.4 6.3 5.5 5.8 5.9
population
Males 8.3 8.3 8.3 7.3 7.6 7.8
Females 7.3 7.0 6.9 6.3 6.6 6.8
2 Infant Mortality Rate
Combined 60 60 57 53 54 53
Per '000 live
Males 61 55 54 50 52 52
births
Females 60 66 61 57 55 54
2.1 Rural
Combined 68 68 65 62 63 62
Per '000 live
Males 69 60 63 62 61 60
births
Females 66 76 67 62 64 64
2.2 Urban
Combined 42 37 36 38 37 37
Per '000 live
Males 41 39 28 30 36 36
births
Females 42 34 44 48 38 37
3 Prop. of Infant Deaths in Total Deaths
Total % 23.4 19.2 18.4 18.9 17.8 17.0
Rural % 23.8 21.8 20.8 20.9 19.9 18.9
Urban % 19.4 12 11.6 14.6 13.3 13.1
4 % age of Neo-Natal Deaths to Total Infant Deaths
Total % 65.8 72.6 61.4 68.8 66.3 70.8
Rural % 66.4 74.2 59.8 67.4 63.9 66.2
Urban % 61.7 64.9 69.9 73 74.1 85.2
5 Neo-Natal Mortality Rate
Total 40 43 35 37 36 38
Per 1000 live
Rural 45 50 39 42 40 41
births
Urban 26 24 25 27 27 31
6 Early Neo-Natal Mortality Rate
Total 29 35 24 24 28 27
Per 1000 live
Rural 33 41 25 25 31 29
births
Urban 19 19 20 21 21 23
7 Post-Neo Natal Mortality Rate
Total 21 16 22 17 18 15
Per 1000 live
Rural 22 18 26 20 23 21
births
Urban 16 13 11 10 9 5
8 Peri-Natal Mortality Rate
Total Per 1000 live 34 43 35 32 36 34
Rural and still 38 49 35 33 39 36
Urban births 23 28 33 29 29 31
Contd..
20
# Item Unit 2001 2002 2003 2004 2005 2006
9 Child Mortality Rate
9.1 Combined
Total Per '000 Pop. 18.5 18.4 16.7 16.0 16.0 16.2
Males of the same 18.4 16.6 15.8 14.9 15.3 15.2
Females age group 18.6 20.7 17.8 17.2 16.8 17.4
9.2 Rural
Total Per '000 Pop. 21.3 22.0 19.5 18.9 20.3 19.6
Males of the same 21.2 19.4 19.3 18.7 19.7 18.6
9.3 Urban
Total Per '000 Pop. 11.9 9.9 9.7 11.0 8.6 10.5
Males of the same 11.8 9.9 7.4 8.7 8.0 9.9
10 Percent Distribution of deaths by broad age group
< 1 year % 19.3 19.2 18.4 18.9 17.8 17.0
1 - 4 Year % 5.3 5.7 4.1 5.4 4.4 4.8
0 - 4 Year % 24.7 24.9 22.5 24.3 22.2 21.9
5 - 14 year % 3.4 2.9 2.4 3.6 3.2 2.7
15 - 59 year % 28.5 30.4 30.3 27.5 30.6 31.2
60+ year % 43.5 41.8 44.7 44.6 43.9 44.2
11 Death rates for children age 5 -14 years
11.1 Combined
Persons Per'000 pop. 1.3 1.1 0.9 1.2 1.1 0.9
Males of same age 1.4 1.1 0.9 1.2 1.2 1.0
Females group 1.2 1 0.9 1.1 1 0.8
11.2 Rural
Persons Per'000 pop. 1.6 1.3 1.1 1.4 1.3 1.2
Males of same age 1.7 1.5 1.2 1.5 1.5 1.4
Females group 1.6 1.1 1 1.3 1.1 1.0
11.3 Urban
Persons Per'000 pop. 0.6 0.5 0.5 0.7 0.7 0.4
Males of same age 0.9 0.2 0.4 0.7 0.6 0.4
Females group 0.2 0.9 0.6 0.7 0.8 0.5
12 Death rates for persons age 15-59 years
12.1 Combined
Persons Per'000 3.6 3.8 3.7 3.1 3.5 3.7
Males pop. of 4.1 4.7 4.7 3.5 4.4 4.5
same age
Females group 3.1 2.7 2.6 2.6 2.6 2.8
12.2 Rural
Persons Per'000 4.1 4.0 3.9 3.5 3.8 4.2
Males pop. of 4.7 4.8 4.8 4.2 4.8 5.2
same age
Females group 3.6 3.1 2.9 2.8 2.8 3.1
Contd..
21
# Item Unit 2001 2002 2003 2004 2005 2006
12.3 Urban
Persons Per'000 2.5 3.3 3.4 2.5 3.1 3.0
Males pop. of 2.8 4.4 4.5 2.6 3.9 3.5
same age
Females group 2.2 2.0 2.1 2.4 2.2 2.4
13 Death rates for persons age 60 years and above
13.1 Combined
Persons Per 1000 45.8 43.6 45 43.4 44.6 44.7
Pop. of the
Males same age 52.9 52.2 51.9 52.4 48.9 49.9
Females group 39.8 36.6 39.2 35.4 40.8 40.3
13.2 Rural
Persons Per 1000 46.4 40.3 44 45.1 45.6 45.6
Pop. of the
Males same age 51.5 48.7 51.6 55.3 52.7 50.6
Females group 42.1 33.4 37.7 36.1 39.3 41.2
13.3 Urban
Persons Per 1000 44.1 53.2 47.4 40.5 42.9 43.3
Pop. of the
Males same age 56.6 62.2 52.5 47.6 42.4 48.3
Females group 33.1 45.7 43.2 34.1 43.4 38.6
14 % distribution of deaths by type of medical attention received before deaths
14.1 Government Hospital
Total % NA NA NA 18.4 18.6 18.7
Rural % NA NA NA 14.5 14.7 14.8
Urban % NA NA NA 26.9 27.1 27.2
14.2 Private Hospitals
Total % NA NA NA 14.4 14.2 14.0
Rural % NA NA NA 12.3 12.1 12.0
Urban % NA NA NA 18.8 18.6 18.5
14.3 Qualified Professional
Total % NA NA NA 49.8 49.7 49.5
Rural % NA NA NA 53.1 52.9 52.8
Urban % NA NA NA 42.8 42.7 42.5
Percent distribution of deaths by type of medical attention received before
14
deaths
14.1 Government Hospital
Total % NA NA NA 18.4 18.6 18.7
Rural % NA NA NA 14.5 14.7 14.8
Urban % NA NA NA 26.9 27.1 27.2
14.2 Private Hospitals
Total % NA NA NA 14.4 14.2 14.0
Rural % NA NA NA 12.3 12.1 12.0
Urban % NA NA NA 18.8 18.6 18.5
14.3 Qualified Professional
Total % NA NA NA 49.8 49.7 49.5
Rural % NA NA NA 53.1 52.9 52.8
Urban % NA NA NA 42.8 42.7 42.5
Contd..
22
# Item Unit 2001 2002 2003 2004 2005 2006
14.4 Untrained functionaries & others
Total % NA NA NA 17.4 17.5 17.7
Rural % NA NA NA 20.1 20.3 20.5
Urban % NA NA NA 11.4 11.6 11.8
Maternal 1999-2001 2001-03
Mortality Rate
15
(per one lakh 202 172
live birth)
16 Expectation of Life at Birth *
1996-2001 01-05 06-10 11-15 16-20
Male Years 61.5 64.9 67.2 69.2 70.7
Female Years 62.8 69.0 71.0 72.5 73.7
Source : * Report of the technical Group on Population Projections, May 2006,
Sample Registration System, Registrar General India, New Delhi
23
Table – 1.2.3: Selected Vital Indicators at a Glance - Gujarat and India, 2006
Gujarat India
# Indicators
Total Rural Urban Total Rural Urban
I Percentage distribution of population by broad age groups
0-14 30.9 31.8 29.9 33.1 34.8 28.7
15-59 61.9 61.7 61.9 59.6 57.8 64.4
60+ 7.2 6.4 8.0 7.3 7.5 6.9
II Fertility Indicators
1 Crude Birth Rate 23.5 25.0 21.1 23.5 25.2 18.8
2 General Fertility Rate 91.0 99.0 79.1 93.3 103.4 69.1
3 Age-specific Fertility rate
15-19 41.3 46.7 31.8 45.2 52.6 25.7
20-24 214.8 227.9 195.2 208.1 227.7 159.7
25-29 180.8 195.8 161.0 168.0 180.9 138.2
30-34 68.8 78.0 55.8 79.1 87.5 58.2
35-39 27.4 37.6 13.2 32.7 42.5 20.3
40-44 9.4 12.0 5.3 15.0 18.8 5.9
45-49 2.9 4.2 1.1 6.0 8.0 1.7
4 Total Fertility Rate 2.7 3.0 2.3 2.8 3.1 2.0
5 Gross Reproduction Rate 1.3 1.4 1.1 1.3 1.5 1.0
6 General Marital Fertility Rate 119.9 129.8 105.1 127.2 137.8 99.5
7 Total Marital Fertility Rate 4.1 4.4 3.7 4.4 4.6 3.9
Mean Age at effective marriage for
8 20.7 20.0 22.0 20.5 20.0 22.0
Females
III Total Fertility Rate by level of education of the mother
Illiterate 3.8 3.8 3.8 3.9 4.0 3.1
Literate 2.2 2.4 2.1 2.2 2.4 1.8
Without any formal education 6.0 5.6 5.6 3.4 3.5 2.9
Below Primary 3.5 3.4 3.7 2.9 3.0 2.6
Primary 2.6 2.6 2.6 2.4 2.5 2.1
Middle 2.0 2.2 1.8 2.2 2.3 1.9
Class X 2.0 1.9 2.1 1.9 2.0 1.8
Class XII 1.5 1.8 1.3 1.6 1.8 1.3
Graduate and above 1.5 1.9 1.3 1.7 1.9 1.6
IV Percentage distribution of live births by birth order
1 39.2 36.8 43.6 36.7 34.9 42.9
2 30.0 28.8 32.1 28.8 28.0 31.6
3 15.4 16.1 14.1 15.8 16.5 13.5
4+ 15.4 18.3 10.2 18.7 20.6 11.9
V Percentage Distribution of Current live births by birth interval (in months)
10-12 2.2 2.3 2.2 1.3 1.3 1.3
12-18 9.7 9.9 9.3 10.2 10.3 9.9
18-24 18.9 20.1 16.3 14.5 14.6 14.3
24-30 18.8 19.9 16.5 19.4 19.8 18.0
30-36 11.2 11.0 11.5 9.1 9.0 9.6
36+ 39.3 36.8 44.3 45.3 44.9 47.0
24
Gujarat India
# Indicators
Total Rural Urban Total Rural Urban
VI Mortality Indicators
1 Crude Death Rate 7.3 8.2 5.9 7.5 8.1 6.0
%age of Infant deaths to total
2 17.0 18.9 13.1 17.9 19.5 12.1
deaths
%age of deaths of less than one
3 50.7 47.0 62.2 49.0 50.5 40.5
week to total infant deaths
4 Infant Mortality Rate 53 62 37 57 62 39
5 Neo-natal Mortality Rate 38 41 31 37 41 23
6 Earely neo-natal Mortality Rate 27 29 23 28 32 16
7 Late neo-natal Mortality Rate 11 12 8 9 9 7
8 Post neo-natal Mortality Rate 15 21 5 20 22 16
9 Peri-natal Mortality Rate 34 36 31 37 41 24
10 Still Birth Rate 7 7 8 9 9 8
VII Percentage distribution of births by type of medical attention at delivery
Government Hospital 29.5 21.5 44.4 22.0 16.1 43.4
Private Hospital 23.7 15.2 39.5 12.9 8.8 27.6
Quallified Professional 30.7 41.3 11.1 26.7 29.7 15.6
Untrained Functionary and others 16.1 22.1 5.0 38.4 45.4 13.3
VIII Percentage distribution of deaths by type of medical attention before death
Government Hospital 18.7 14.8 27.2 16.1 13.0 27.2
Private Hospital 14.0 12.0 18.5 12.0 10.0 19.1
Quallified Professional 49.5 52.8 42.5 38.5 39.3 35.7
Untrained Functionary and others 17.7 20.5 11.8 33.4 37.7 18.1
Source: Sample Registration System Statistical Report, 2006
25
2. National Family Health Survey - Key Indicators for Gujarat
The 2005-06 National Family Health Survey (NFHS-III) is the third in the NFHS series
of surveys. The first NFHS was conducted in 1992-93, and the second (NFHS-2) was
conducted in 1998-99. All three NFHS surveys were conducted under the stewardship
of the Ministry of Health and Family Welfare (MOHFW), Government of India. The
MOHFW designated the International Institute for Population Sciences (IIPS), Mumbai,
as the nodal agency for the surveys.
In Gujarat NFHS-3 interviewed 3729 women of age group 15-49 and 1428 men of age
group 15-54 to obtain information on population, health and nutrition. The survey is
based on a sample of households that is representative at the national and state levels.
The survey provides trend data on key indicators and includes information on several
new topics, such as HIV/AIDS-related behavior, attitudes toward family life education
for girls and boys, use of Integrated Child Development Scheme (ICDS) services,
men’s involvement in maternal care, and health insurance. For the first time, NFHS-3
provides information on men and unmarried women. In addition, HIV prevalence is
measured at the national level and for selected states. The NFHS-3 field work was
conducted in two phases by 18 research organizations between November 2005 and
August 2006. Fieldwork for Gujarat was conducted from December 2005 to Match,
2006 by the TALEEM Research Foundation, Ahmedabad
Fertility levels
At current fertility levels, a woman in Gujarat has an average 2.4 children in her
lifetime. Fertility decreased by 0.3 children between NFHS-1 and NFHS-2; it decreased
at same rate between NFHS-2 and NFHS-3. Fertility in rural areas is 2.8 children per
woman, much higher than in urban areas where the replacement level fertility rate of
2.1 children per woman has been recorded. The greatest differentials in fertility are by
wealth and education. At current fertility rates, women in the lowest wealth quintile will
have two children more than women in the highest wealth quintile.
3.50 NFHS-1 (1992-93)
Total Fertility Rate- India and Selected States, NFHS NFHS-2 (1998-99)
3.39
2.99
NFHS-3 (2005-06)
2.92
2.85
2.86
2.85
2.72
3.00
2.68
2.59
2.52
2.48
2.42
2.25
2.50
2.19
2.21
2.13
2.11
2.08
2.00
1.99
1.96
1.93
1.79
1.80
2.00
1.50
1.00
0.50
0.00
INDIA Gujarat Maharastra Karnataka Tamil Nadu Panjab Kerala Andhra
Teenage pregnancy
Among young women age 15-19, 12.7 percent have already begun child bearing. Young
women in rural areas are more than twice as likely to be mothers as young women in
urban areas
Birth Interval
The medium interval between births in Gujarat is 29.2 months.12.1 percent birth take
place within 18 months of the last birth, and 29 percent occur within 24 months.. More
than 65 % occur within 36 months. Research shows that waiting at least three years
between children reduces the risk of infant mortality.
26
Fertility preferences
Seventy-two percent man and 68 percent women either want no more children, are
already themselves sterilized, or have a spouse who is sterilized. Many peoples show a
strong preference for sons. About one in five women and men want more sons than
daughters, but only 2 percent want more daughters than sons. However, most men and
women would like to have at least one son and at least one daughter.
If all women were to have only the number of children they wanted, the total fertility
rate would be 1.8 instead of 2.4. Unplanned pregnancies are relatively common.
Unmet need
Unmet need for family planning is defined as the percentage of currently married
women who either want to space their next birth or stop childbearing entirely but are
not using contraception According to this definition, 8.0 percent of married women
have unmet need for family planning, down from 13.0 percent in NFHS-1 and 8.5
percent in NFHS-2. Currently, 89.2 percent of the demand for family planning is being
met.
Unmet need for FP - India and Selected States - NFHS
5.0
Andhra 7.7 NFHS-3 (2005-06)
10.4
9.0 NFHS-2 (1998-99)
Kerala 11.7 NFHS-1 (1992-93)
11.7
7.4
Panjab 7.3
13.0
8.9
Tam il Nadu 13.0
14.6
10.2
Karnataka 11.5
18.2
9.6
Maharastra 13.0
14.1
8.2
Gujarat 8.5
13.1
13.2
INDIA 15.8
19.5
Maternal Care
Antenatal care
Among mothers who gave birth in the five years preceding the survey, almost 84
percent received antenatal care from a health professional (63 percent from a doctor and
21 percent from other health personnel). 55 percent of women received antenatal care
during the first trimester of pregnancy, as is recommended. 67.5 percent mothers had
three or more antenatal care visits; urban women were much more likely to receive three
or more visits than women in rural areas. For 82 percent of births, mothers received iron
and folic acid supplements, but only 37 percent consumed them for the recommended
90 days or more. 80.4 percent mothers received two or more doses of tetanus toxoid
vaccine. Only 7 percent took a deworming drug during pregnancy.
Delivery care
Three out of every five births in Gujarat take place in a health facility; two in five births
take place at home. However, the percentage of births in a health facility has increased
steadily since NFHS-1
25.6 percent mother received all recommended type of antenatal care, 52.7 percent of
births delivered in health facilities and 63 percent deliveries were assisted by health
27
personnel.61.4 percent deliveries received post netal check up and 57 percent deliveries
had a post netal check-up within two days of Birth
Infant Mortality
The infant mortality rate in Gujarat is steadily decreasing; infant mortality is currently
estimated at 50 deaths before the age of one year per 1,000 live births, down from the
NFHS-2 estimate of 63 and the NFHS-1 estimate of 69. However, more than 1 in 20
children still die within the first year of life.
Vaccination of children
Less than half (45%) of children of 12-23 months are fully vaccinated against the six
major childhood illnesses i.e. tuberculosis, diphtheria, pertusis, tetanus, polio, and
measles. However, most children are at least partially vaccinated: only 5 percent have
received no vaccinations at all. Eighty six percent of children have received a BCG
vaccination, and 66 per cent have received at least the recommended three doses of polio
vaccine and measles. Sixty one per cent have received all the recommended doses of
DPT. The DPT and polio vaccines are given in a series. Many children receive the first
dose but do not finish the series. Between the first and third doses, the dropout rate for
DPT is 21 percent, and the dropout rate for polio is 27 percent.
% age Fully Immunized Children - India and Selected States-NFHS
88.8
90.0 NFHS-1 (1992-93)
80.8
79.7
78.4
NFHS-2 (1998-99)
75.3
NFHS-3 (2005-06)
72.1
80.0 65.1
64.3
61.9
70.0
60.1
60.0
58.8
58.7
55.0
54.4
52.2
53.0
60.0
50.0
46.0
45.2
45.4
43.5
42.0
50.0
35.5
40.0
30.0
20.0
10.0
0.0
INDIA Gujarat Maharastra Karnataka Tamil Nadu Panjab Kerala Andhra
As per NFHS- III, though percentage of fully immunized children is higher than that of
national average, it is lower than states like Maharashtra, Karnataka, Tamil Nadu, Punjab
and Andhra Pradesh. Further, It has gone down from 53.0 percent in NFHS II to 45.2
percent in NFHS III which is matter of concern.
Childhood illnesses
In the two weeks before the survey, 5 percent of children under age five had symptoms
of an acute respiratory infection (cough and short, rapid breathing that was chest-related
and not due to a blocked or runny nose). Of these children, 69 percent were taken to a
health facility or health provider
Breastfeeding, Nutrition, and Anaemia
Infant feeding
Although breastfeeding is nearly universal in Gujarat, only 48 percent of children under
6 months are exclusively breastfed, as WHO recommends. In addition, only 58 percent
are put to the breast feeding within the first day of life, which means many infants are
deprived of the highly nutritious first milk (colostrums) and the antibodies it contains.
However, mothers in Gujarat breastfeed for an average of 23 months, which is slightly,
28
lower than the minimum of 24 months recommended by WHO for most children. It is
recommended that nothing be given to children other than breast milk even in the first
three days when the milk has not begun to flow regularly. However, more than half of
children are given something other than breast milk during that period. WHO offers
three recommendations for infant and young child feeding (IYCF) practices for those 6-
23 months old: (i) continued breastfeeding or feeding with appropriate calcium-rich
foods if not breastfed; (ii) feeding solid or semi-solid food for a minimum number of
times per day according to age and breastfeeding status; and,(iii) including foods from a
minimum number of food groups per day according to breastfeeding status. Less than
half of children age 6-23 months is fed the recommended minimum times per day and
about one-third are fed from the minimum number of food groups. However, only 21
percent are fed according to all three recommended practices.
Adults’ nutritional status
Adults in Gujarat suffer from a dual burden of malnutrition; more than one-third of
adults are too thin, and 17 percent women and eleven percent men are overweight or
obese. Only 53 percent of men and 52 percent of women are at a healthy weight for their
height.
Anaemia
Anaemia is characterized by a low level of hemoglobin in the blood.
Anaemia is a major health problem in Gujarat, especially among women and children.
Anaemia can result in maternal mortality, weakness, diminished physical and mental
capacity, increased morbidity from infectious diseases, perinatal mortality, premature
delivery, low birth weight, and (in children) impaired cognitive performance, motor
development, and scholastic achievement. Among children between the ages of 6 and 59
months, the great majority (70 percent) are anaemic. This includes 25 percent who are
mildly anaemic, 41 percent who are moderately anaemic and 4 percent who suffer from
severe anaemia. Boys and girls are equally likely to have anaemia. Children of mothers
who have anaemia are much more likely to be anaemic. More than half of women in
Gujarat ( 55 percent) have anaemia, including 36 percent with mild anaemia, 16 percent
with moderate anaemia, and 3 percent with severe anaemia.
Anaemia is particularly high for women with no education, women from scheduled
tribes, and women in the two lowest wealth quintiles. Women who are breastfeeding or
pregnant are also more likely to have anaemia. 22 percent men are anaemic, with men
under 20 and over 40 more likely to suffer from anaemia.
29
Table : 2.1 National Family Health Survey -III Key Indicators for Gujarat
NFHS-III (2005 -06)
(1992-93 )
(1998-99)
NFHS-II
NFHS-I
# Key Indicators Residence
State
Urban Rural
1 2 3 4 5 6 7
A Marriag and Fertillity
1 Women age 20-24 married by age 18 (%) 33.4 40.7 33.5 27.3 37.9
2 Men age 25-29 married by age 21 (%) na na 31.4 23.1 37
3 Total fertility rate (children per women) 2.99 2.72 2.42 1.92 2.8
4 Women age 15-19 who were already mothers or
pragant at the time of the survey )%) na na 12.7 7.4 16.3
5 Median age at first birth for women age 25-49 20.2 20.1 20.6 21.2 20.2
6 Married women with 2; living children wanting
no more children(%) 72 75.9 85.7 87.9 83.6
6a Two sons 88.1 89.5 94.8 93.3 96

6b One son, one daughter 79.6 79.6 90.1 93.7 86
6c Two daughters 31.1 32 48.8 47.5 50
B Family Planning (currently married women age (15-49)
(a) Current Use
1 Any FP method (%) 49.3 59.0 66.6 67.6 65.9
2 Any modern method (%) 46.9 53.3 56.5 57.7 55.5
2a Female sterilization (%) 37.5 43.0 42.9 37.5 47.0
2b Male sterilization (%) 3.5 2.3 0.6 0.6 0.6
2c IUD (%) 3.0 3.1 4.5 6.9 2.7
2d Pills (%) 1.0 1.5 2.6 4.2 1.5
2e Condom (%) 1.8 3.5 6.0 8.9 3.8
(b) Unmet need for family Planning
1 Total unmet need (%) 13.1 8.5 8.2 8.2 8.2
1a For spacing (%) 7.6 4.8 4.4 3.9 4.8
1b For Limiting (%) 5.5 3.7 3.8 4.4 3.4
C Maternal and Child Health
(a) Maternity care ( for births in the last 3 years)
Mothers who had at least 3 antenatal care visits
1 for their last birth (%) 61.3 61.2 64.9 81.5 55.8
Mothers who consumed IFA for 90 days or
2 more when they were pregnat with their last na na 35.7 48.3 28.9
child (%)
Births assisted by a doctor /Nurse /LHV /ANM
3 /Other Health Personnel (%)1 43.4 53.5 64.7 83.9 54.6
4 Institutional births (%)1 36.8 46.3 54.6 78 42.2

Mothers who received postnatal care from a
Doctors/Nurse/LHV/ANM/Other Health
na na 54 72.7 43.8
Personnel within 2 days of delivery for their last
5 birth (%)1
(b) Child Immunization and vitamin A Supplementation 1
Children 12-23 months fully immunized (BCG,
50 53 45.2 54.7 40.1
1 measles and 3 doses each of Polio & DPT)(%)
2 Children 12-23 months who have received BCG (%) 77.1 84.7 86.4 89.6 84.7
30
(1992-93 )
(1998-99)
NFHS-III (2005 -06)
NFHS-II
NFHS-I
State
Urban Rural
1 2 3 4 5 6 7
Children 12-23 months who have received 3
3 63.6 68.6 65.3 71.7 61.9
doses of polio vaccine (%)
Children 12-23 months who have received 3
4 63.8 64.1 61.4 67 58.4
doses of DPT vaccine (%)
Children 12-23 months who have received
5 55.9 63.6 65.7 73.6 61.4
measles vaccine (%)
Children 12-35 months who received a vitamin
6 na na 17.1 15.7 17.9
A dose in last 6 months (%)
(c) Treatment of childhood diseases(children under 3 years)1
Children with diarrhoea in the last 2 weeks who
7 12.8 28.9 28.3 31.7 26.3
received ORS (%)
Children with diarrhoea in the last 2 weeks
8 62.1 63.1 59.8 68.3 54.5
taken to a health facility (%)
Children with acute repiratory infrecation of fever in
9 the last 2 weeks taken to a health facility (%)
na na 72 83.6 64
(d) Child Feeding Practices and Nutritional Status of Children

Children under 3 years breastfed within one
10 13.9 10.1 27.1 30.3 25.3
hour of birth (%)
Children age 0-5 months exclusively breastfed
11 na na 47.8 46.7 48.4
(%)
Children age 6-9 months receiving solid or
12 na na 57.1 71.4 50.8
semi-solid food and breastmilk(%)
13 Children under 3 years who are stunted (%) 44.1 43.6 42.4 36.7 45.6
14 Children under 3 years who are wasted %) 19.8 16.2 17 15.7 17.7
15 Children under 3 years who are underweight(%) 48.1 45.1 47.4 42.7 50
(e) Nutritional Status of Ever Married Adults (age 15-49 )
Women whose Body Mass Index is below
16 na 37 32.3 19.5 41.9
normal(%)
17 Men whose Body Mass Index is below normal (%) na na 28.2 18.3 35.2
18 Women who are overweight or obese (%) na 15.8 20.3 32 11.5
19 Men who are overweight or obese(%) na na 15.4 24.1 9.1
(f) Anaemia among Children and Adults
1 Children age 6-35 months who are anaemic(%) na 74.5 80.1 73.8 83.6
Ever-married women age 15-49 who are
2 na 46.3 55.5 50.5 59.2
anaemic(%)
3 Pregnant women age 15-49 who are anaemic(%) na 47.4 60.8 59.1 61.7
4 Ever-married men age 15-49 who are aanaemic(%) na na 22.1 16.3 26.3
(g) Knowledge of HIV\AIDS among Ever Married Adults (age 15-49)
1 Women who have heard of AIDS (%) 10.6 29.8 49.3 68.8 34.8
2 Men who have heard of AIDS (%) na na 80.2 90.1 72.9
Women who know that consistent condom use
3 na na 36.1 50.5 25.4
can reduce the chances of getting HIV / AIDS (%)
Men who know that consistent codom use can
na na 72.1 84.5 62.9
4 reduce the chances of getting HIV /AIDS(%)
31
(1992-93 )
(1998-99)
NFHS-III (2005 -06)
NFHS-II
NFHS-I
State
Urban Rural
1. 2. 3. 4. 5. 6. 7.
(h) Women's Empowerment
Currently married women who usually
5 na na 56.7 62.4 52.4
participate in household decisions(%)
Ever-married women who have ever
6 na na 27.6 24.2 30.2
experienced spousal violence (%)
na : not available
* Not shown; based on fewer than 25 unweighted cases
( 1.)Based on the last 2 births in the 3 years before the survey;
(2) For children the education refers to the mothers education. .
Note: Children with missing information on the mother's education are not included in the education
columes.
32
3. Programme Review
Family Planning
Deep - rooted customs, traditions and socio cultural beliefs favor large family size in many
parts of the state and impede the process of change which would accelerate the willing
adoption of the small family norms.
According to NFHS-III, 8 percent of currently married women in Gujarat have an unmet
need for family planning. The unmet need for spacing (4.3 per cent) is higher than for
limiting (3.7 per cent). 66.6 % women have met the need of family planning. Including unmet
and met need, 74.6 per cent of currently married women in Gujarat have a demand for
Family Planning, of which 89 percent is satisfied.
The impact of unwanted fertility can be measured by comparing the total wanted fertility with
the total fertility rate. The total wanted fertility rate represents the level of fertility that
theoretically would results if all unwanted births were prevented.
As per NFHS-III, In Gujarat, overall, the total wanted fertility rate of 1.8 is lower by 0.6
child (i.e. by 25 per cent).This means that if unwanted birth could be eliminated, the TFR
would drop the to below the replacement level of fertility (1.8 children per woman)
Socio economic factors such as female literacy, age at marriage of girls, status of women in
the society, strong son preference, and position of employment of women have a crutial
bearing of the fertility behaviour of the people.
50.0
% use of Contraceptive- Gujarat 50.0
45.0
43.0
42.9
40.0 41.0
38.0
NFHS-I NFHS-II NFHS-III
35.0
33.4
30.0
25.0
20.0
15.0
10.0 10.2
5.0 5.8 5.6

4.0 4.4
0.6 3.1 3.5
2.3 2.6 3.0 2.0
1.0 1.5 2.0
0.0
Female Male Sterilisation Pills IUD C. C. Users Any other Not using
Sterilisation Method Contrceptive
Method
The year 2007-08 ended with 23.25 lakh total family planning acceptors in the state
comprising 3.10 lakh sterilizations, 4.95 lakh IUD insertions, 12.24 lakh CC users and 2.96
lakh OP users as against 20.53 lakh ( 2.68 lakh sterilizations, 4.64 lakh IUD insertions, 10.83
lakh CC users and 2.37 lakh OP users) in 2006-07.A total 310064 sterilization were done in
the state during the year 2007-08 which were 16 per cent higher than previous year. The
proportion of vasectomy to total sterilization was 6.7 percent in 2007-08 as against 0.4
percent in 2006-07.It was only possible due to training of 175 surgeons in the NSV
technique. A sharp increase in the NSV acceptors was noticed within a year. The Government
of India honored the state as the state had achieved first position in NSV at national level
during 2007-08.
33
During the year 2007-08, 494529 IUD insertions were reported as against 464484 in 2006-07
(6.5 percent higher).
The mean age of wives of vasectomy acceptors in 2001-02 was 27.6 years and it has been
increased 31.5 years in 2007-08. Similarly, mean age at tubectomy acceptors was 28.9. It
increased to 29.0 years in 2007-08. The highest proportion of family planning acceptors were
having wife in the age group of 25-29 years. IUD acceptors in the age group of 20-24 years
have considerably increased in last few years. In the year 2007-08 out of total IUD acceptors
42.5 percent acceptors from this age group which were reported to37.4 percent in 2003-04.
The age group of 20-29 years which has highest fertility contributed 39.8 percent of
vasectomy acceptors, 60.4 percent of tubectomy acceptors and 78.0 per cent of IUD acceptors
in the year 2007-08.The proportion of total sterilization acceptors in the age group of 20-29
years in the state is lower than national average.
The mean number of living children in the case of sterilization acceptors and IUD acceptors
remains stagnant without showing any significant change in last seven years The proportion
sterilization acceptors and IUD acceptors by child is presented in the following table.
Sterilization acceptors
Year Mean age Average % age Acceptors by living Children
of acceptor. children to
One Two Three Four & above
acceptor
2001-02 28.9 2.9 2.6 34.8 40.1 22.6
2002-03 28.8 2.9 4.7 35.3 38.4 21.7
2003-04 29.1 2.9 4.7 36.4 37.6 21.3
2004-05 28.4 2.5 2.2 36.5 37.4 23.9
2005-06 28.7 2.9 2.2 39.4 36.8 21.6
2006-07 29.9 2.8 4.1 40.8 35.5 19.7
2007-08 29.2 2.9 3.5 36.9 38,0 21.6
IUD insertion
Year Mean age Average % age Acceptors by living Children
of acceptor. children to
One Two Three Four & above
acceptor
2001-02 27.2 1.7 35.7 34.9 21.9 7.5
2002-03 26.8 1.9 39.9 37.3 16.6 6.3
2003-04 26.9 1.9 37.6 35.9 17.7 8.8
2004-05 26.3 1.9 38.4 36.1 17.2 8.3
2005-06 26.4 1.8 44.1 36.0 14.5 5.4
2006-07 26.7 1.7 45.3 36.2 13.8 4.8
2007-08 26.3 1.9 45.0 35.9 13.6 5.5
34
9.00
Sterilization and IUD insertion Sterilization and IUD insertion per ‘000 Population
2001-02 to 2007-08 (In. Nos) 8.78
8.50
per ‘000 Population 8.53
8.37
8.00
Year Sterilization IUD 8.11
7.93
7.84 7.81
7.50
2001-02 4.96 7.84
7.00
2002-03 5.22 8.11

6.50
2003-04 4.97 7.81

6.00
2004-05 5.17 7.93 5.50

5.51
2005-06 5.13 8.53 5.00 5.22
5.17 5.13
4.96 4.97
2006-07 4.82 8.37 4.82
4.50
Sterilisation per '000 Pop. IUD Insertions per '000 Pop.
2007-08 5.51 8.78 4.00
2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08
To achieve the goal of population stabilization (i) it is necessary to achieve and maintain
remarkable growth in FP acceptor over previous year and (ii) qualitative improvement in FP
services. Characteristics of Sterilization and IUD acceptors given in the above tables are not
enough encouraging.
Since inception of the programme till March-2008, about 94.48 lakh sterilization (Male 15.37
lakh) has been performed and 101.17 lakh women have been covered under IUD method. It is
estimated that up to March-2007 about 2.91 crore births have been averted by use of various
Family Planning methods in the State.
Maternal Health Care

Under Maternal Health Antenatal care services, Delivery services and postnatal care services
are being provided by the Government through the network of Public Health infrastructure.
The performance under these components for last 3 years is as under.
Performance (% age against expected)

Services Unit
2005-06 2006-07 2007-08
Antinetal Registration Nos. in lakh 13.91 (94.0) 13.66 (92.8) 13.71 (91.3)
2 dose of TT to PW Nos. in lakh 13.24 (89.5) 13.06 (88.8) 12.64 (84.2)
Delivery Registration Nos. in lakh 11.91 (88.6) 12.01 (89.8) 11.82 (86.7)
Institutional Delivery % of total Del. 63.0 67.6 77.8
Home Delivery % of total Del. 37.0 32.4 22.2
Trend of % Institutional Delivery in Rural Gujarat. 60
Trend of Institutional Deliveries in Gujarat-SRS
55 52.5 53.2
MICS-2007 67.5 51.7
HFHS-3( 2005-06) 42.2 50
2006 36.7 45
2005 36.1
40
36.6 36.5 36.3 36.3 36.4 36.6 36.6 36.7
2004 35.3
35
2003 22.9
30
2002 22.7
25 23.5
2001 22.1
NFHS-2 (1998-99) 32 20
1998 21.8
15
NFHS-1(1992-93) 26.3
10
0 10 20 30 40 50 60 70 80 1991 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
35
Chiranjivi Yojana
Though Gujarat is industrially developed state MMR of Gujarat is quite high as compared to
the states of Tamil Nadu and Kerala whose per capita income is less than Gujarat.
Under the Reproductive and Child Health Program II (RCH II) the major objectives to be
achieved by 2010 are as follows.
• Reduction of Maternal Mortality Ratio from 172 (SRS:2001-03) to less than 100 per
100,000 live births
• Reduction of Total Fertility Rate from its present level 2.7 to 2.1
• Reduction of Infant Mortality Rate from 52 (SRS 2007) to 30 per 1,000 live births.
The major causes contributing to maternal mortality are Hemorrhage, Eclampsia, Obstructed
Labor, Sepsis and Unsafe abortion. These causes are also responsible for increasing Infant
Mortality Rate. It was found that lack of access to specialist services by socially and
economically backward section was one of the main reasons responsible for maternal
mortality.
In Gujarat there are shortages of obstetricians for providing specialized obstetric services in
Government Hospitals. Only 37% of the CHCs and FRUs are staffed with obstetricians. This
shortage of obstetricians in government set up affects primarily the weaker section of the
society who are availing the government health services. This section of the society is also
the target group for reduction of MMR, as maximum maternal deaths are also reported in this
group.
On the other hand about 2000 Obstetricians are available in private sector. On understanding
the limitation of public health facilities in reaching out to the weaker section of the
population, Govt. had analyzed various options available. It was found that private sector
involvement was the most acceptable option. This is also a model of Public Private
Partnership (PPP). Accordingly, a scheme Chiranjivi Yojana, involving private sector
specialists in providing services related to safe delivery, primarily for socio economically
weaker sections initiated. The scheme was launched on pilot basis in December 2005. The
beneficiaries under the scheme are the pregnant women from BPL families.
Under the scheme, members of FOGSI were enrolled after they were oriented about the
Chiranjivi scheme. District Health Society signed a MOU with each of them in each five
district. As per MoU they had to provide the maternity services to the BPL mothers as
beneficiaries of the scheme at their nursing homes/Hospitals. The Obstetricians were paid Rs.
1,79,500/- for a package of 100 deliveries (@ Rs. 1795/- per delivery). The package of 100
deliveries includes normal and complicated deliveries and also cesarean section operations.
Selection criteria for private obgyns for enrolment in to the PPP scheme
1. Doctor must be having post-graduate qualification in Obgyn
2. Must have his/her own hospital - preferably minimum of 15 beds
3. Must have labour room and operating room
4. Must be able to access blood in emergency situation
5. Must be able to arrange for anesthetists and do emergency surgery
6. Facility should be preferably accredited for sterilization procedures for FP by the
government.
7. Norm would be to select 2-3 private obgyns per sub-district All the available and
willing obgyns were contacted.
The above Rs. 1795/- per delivery includes all normal and complicated deliveries (including
necessary facilities, investigation and medication). The beneficiary will have not to borne any
type of charges related to delivery, medicine, anesthesia, laboratory investigations or
operation. The package also includes Rs. 200/- for transportation to the pregnant mother and
Rs. 50/- for the TBA or the person escorting the pregnant mother. If the Private Gynecologist
offers his/her services in the Government Hospital, than Rs. 65,900/- (Rs. 659/- per delivery)
will be paid for every 100 deliveries (including normal and complicated).
36
UNFPA Gujarat and Indian Institute of Management Ahmedabad have carried out the
evaluation of the scheme. Their reports also have encouraging remarks. Looking to these
results the Government of Gujarat has launched the scheme in all the districts of the state
from 8th September 2006.
Following table presents year wise data on the enrollment of obgyns and deliveries done in
the whole state after it was scaled up. As of now more than 800 obgyns have joined the
scheme. Thus the availability of human resources (specialist obgyns) to provide skilled births
and EmOC services to poor women has increased from 7 government obgyns in rural
hospitals in 2005 to above 800 in less than 2 years through this innovative PPP arrangement
involving private providers. Table also presents data on total deliveries, cesareans and
complications treated as well as cesarean rate. Only in 3 of the 20 districts the cesarean
section rate is more than 15 per cent. One must keep in mind that these are facility based
cesarean rates and hence very difficult to interpret to conclude over use of cesarean section.
Deliveries, LSCS, complications and doctors Enrolled under Chiranjivi since inception
Deliveries conducted Doctors
%
Year Normal LSCS Other complications Total enrolled
LSCS
(cummu.)
2005-06 6809 417 567 7793 5.4 163
2006-07 40828 2913 3965 47706 6.1 742
2007-08 106080 7651 7312 121043 6.3 865
The scheme was scaled up since January 2007 to the whole state. First three months were
spent in making the contractual arrangements with doctors in various districts. Since April
2007 the scaled up scheme is fully operational in the whole state. In the whole state about
282,000 deliveries to poor women per year, this means about 23,500 deliveries per month.
The coverage of deliveries among the poor in the state under the scheme has increased from
27 per cent in April 2007 to 48 per cent in December 2007.
Results of the scheme were encouraging. On basis of the existing MMR of Gujarat State, 265
mothers would have died out of above 153717 deliveries. However only 37 maternal deaths
were recorded among these deliveries. In other words we are able to save 228 mothers.
Janani Suraksha Yojana (JSY)
Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural
Health Mission (NRHM) being implemented with the objective of reducing maternal and
neo-natal mortality by promoting institutional delivery among the poor pregnant women. The
Yojana, launched on 12th April 2005, by the Hon’ble Prime Minister, is being implemented in
all states and UTs with special focus on low performing states.
JSY is a 100 % centrally sponsored scheme and it integrates cash assistance with delivery and
post-delivery care. The Yojana has identified ANM/ASHA, the accredited social health
activist as an effective link between the Government and the poor pregnant women
Role of ASHA or other link health worker associated with JSY would be to:
o Identify pregnant woman as a beneficiary of the scheme and report or facilitate registration for ANC,
o Assist the pregnant woman to obtain necessary certifications wherever necessary,
o Provide and / or help the women in receiving at least three ANC checkups including TT injections, IFA
tablets,
o Identify a functional Government health centre or an accredited private health institution for referral
and delivery,
o Counsel for institutional delivery,
o Escort the beneficiary women to the pre-determined health center and stay with her till the woman is
discharged,
o Arrange to immunize the newborn till the age of 14 weeks,
o Inform about the birth or death of the child or mother to the ANM/MO,
o Post natal visit within 7 days of delivery to track mother’s health after delivery and facilitate in
obtaining care, wherever necessary
o Counsel for initiation of breastfeeding to the newborn within one-hour of delivery and its continuance
till 3-6 months and promote family planning.
37
The scheme provides a mechanism for individual tracking and follow up of each woman of
the marginalized sections (Scheduled Castes, Scheduled Tribes, and BPL) during the entire
pregnancy and post delivery period. Cash assistance of Rs.500/- for nutrition support and Rs.
200/- for transport support is provided to each pregnant woman.
During the year 2007-08 about 182724 pregnant women have been covered in the scheme
Mamta Abhiyan (Movement towards Healthy Mothers and Children)

Mamta Abhiyan is a comprehensive package of Matru Vandana Scheme providing
preventive, promotive, curative and referral services under the Reproductive and Child
Health Programme (RCH) initiated in 2006. It caters through Mamta Divas (Village Health
and Nutrition Day), Mamta Mulakat (Post Natal care visit), Mamta Sandharb (Referral
Services) and Mamta Nondh (Records and Reports).
Mamta Abhiyan is a shining example of integrating the services of the Health and the
Women and Child Development Departments where the grassroots level workers work
together in harmony and provide quality services through community support.
Services of Paediatricians have been commissioned on call basis to provide specialist
medical care to the children screened on MAMTA divas found with acute and chronic illness.
Mamta Divas Outreach Performance : 2007-2008

MAMTA Divas Session Held 337770
No. of visits of Pregnant women 2290127
% of women weighed 50.1
Total Delivered mothers with three PNC Visits 903392
No. of visits of children 2339836
% of children wighed 83.5
Integrated Management of Neonatal and Childhood Illness (IMNCI)
In the areas of child health, there has been a paradigm shift in terms of appropriate training of
the services providers and implementation of programme to reduce neonatal and childhood
mortality. Medical colleges, State Institute of Health and Family Welfare (SIHFW) and
District Training Canters (DTCs) are instrumental in providing intensive training to all
grassroots-level service providers. Manuals and materials for training have been designed,
printed and disseminated widely amongst the Health and Integrated Child Development
Schemes (ICDS) functionaries.
The programme that started in 2005 as a pilot in two districts is planned to be extended to the
entire state in a phased manner by 2009-10; Gujarat has been the pioneer in this programme;
the largest number of districts have been covered under IMNCI in Gujarat.
The training in IMNCI has now been extended to pre-service level during medical and
nursing education and Anganwadi training. The use of IMNCI training tools and methods
equips these students with necessary skills for new born and child care when they start their
practice.
Performance in IMNCI training
Person trained
Doctors 1,056
Female Health Workers (FHW) 3,567
Female Health Supervisors (FHS) 538
Anganwdi Worker (AWW) 16,028
ICDS Supervisors 564
Total Staff trained 23,824
38
To further strengthen quality service delivery and enhance the technical skills of the staff, a
programme for training Medical Officers in Emergency Newborn Care (ENBC) has been
designed and initiated in the State, which is the first of its kind in the country. This would
help fill up the shortfall of specialist Paediatricians in the remote rural areas.
Nirogi Bal Varsh (The Year of Healthy Child)
With the aim of seeing every child smiling, healthy and playful, and enabled through
education, the year 2008 has been launched in Gujarat as ‘Nirogi Bal Varsh’, the year of
healthy child.
The focus is on reducing maternal and child mortality, through increasing institutional
deliveries, taking care of neonates; reducing malnutrition in mothers and children and
increasing school enrolment, reducing school drop-outs.
The goals of Nirogi Bal Varsh will be achieved through convergence between various
Government Departments, Non Governmental Organizations and the community. It is an
enabling mechanism for coordination, planning, implementation and evaluation for
sustainable outcomes in child health and development. The emphasis will be on evidence
based interventions with proven outcomes.
Addressing Malnutrition
It is a painful paradox that while there is enough food to feed every mouth in the rapidly
developing State, about 47% children are still suffering from malnutrition (NFHS-3). This is
a major cause of infant and child mortality.
Strategies adopted State-wide to curb malnutrition include micro-nutrient supplementation,
protein substitution, treatment of infections, and provision of safe drinking water and
sanitation facilities. Early and exclusive breast feeding for the first six months, appropriate
complementary feeding, fortification of wheat flour, calcium and vitamin-A supplements to
pregnant mothers, use of iodized salt and provision of nutritious Mid-Day Meals in schools
have been promoted.
Fourteen Child Development and Nutrition Canters are being set up in tribal blocks to treat
and rehabilitate children with grade III/IV malnutrition.
The efforts to reduce malnutrition in the State were earlier being divided between the
programmatic interventions of the Department of Health and Women and Child Development
(WCD). In order to avoid duplication of efforts and synergies the achievements, Gujarat has
taken a bold step to synchronize the activities of Integrated Child Development Services
(ICDS) Scheme (undertaken by WCD) with the nutrition interventions of the Health
Department.
Routine Immunization Performance in Gujarat
Immunization is a form of preventive medicine. Its aim is to protect individuals and
communities from infectious diseases. Immunization operates like an early warning system.
It prepares the body to fight against infection. Following the successful global eradication of
smallpox in 1975 through effective vaccination programmes and strengthened surveillance,
the Expanded Programme on Immunization (EPI) was launched in Gujarat in 1978 to control
other VPDs. The aim was to cover 80% of all infants. Subsequently, the programme was
universalized and renamed as Universal Immunization Programme (UIP) in 1985 targeting all
infants with the primary immunization schedule and all pregnant women with Tetanus
Toxoid immunization. Following the successful launch & implementation of universal
immunization programme in 1985, there has been considerable reduction in vaccine
preventable diseases.
39
In 1992, the UIP became a part of the Child Survival and Safe Motherhood Programme
(CSSM), and in 1997, it became an important component of the Reproductive and Child
Health Programme (RCH).
Although the reported performance of Immunisation programme is good but survey results
are not satisfactory. Percent full immunization is still not satisfactory as per NFHS III.
Infant Immunisation Status In Gujarat- NFHS

90.0
86.4
84.7
80.0
77.1
68.6
70.0
65.3
62.9
65.7
63.6
60.0
55.9
50.0 53.0
49.8
45.2
40.0
30.0
20.0 BCG
POLIO-3
MEASLES
10.0 6.6 4.5
Fully Immunised Children
No vactionation
0.0
NFHS - I NFHS - II NFHS - III
Strategies for improving immunization Coverage in Gujarat

Mamta Divas
The main objective of “Mamta Divas” is to strengthen routine immunization, reduce infant
mortality as well as malnutrition among children through effective delivery of Health &
Nutrition services on the same day and under the same roof .On the Mamta Divas, a mother
and child friendly environment is created at the anganwadi, exhibition panels on maternal and
child health are displayed, to educate the community about new born caring practices, health
and hygiene.
Mapping of Poor Performing Blocks
Routine mapping activities are carried out to identify poor performing blocks & PHC’s so
that intensive training & special interventions can be carried out to improve immunization
coverage.
Routine Immunization Monitoring System (RIMS)
For a complex and extensive programme like immunization an efficient management
information system is necessary to get timely reports at State level. It is also equally
important to provide feedback to the Districts for undertaking management interventions. To
address these issues and to collect data from District/PHC level a computer based monitoring
system (RIMS software) which was developed by GOI is implemented in the State.
Appointment of State Routine Immunization Monitors (SRIM)
For improving the monitoring of immunization programme SRIM are appointed and their
orientation was carried out.The SRIMS have to monitor the routine Immunization activity i.e.
MAMTA Divas on every Wednesday of the month in their allocated district/corporation and
help the ANMs to carry out the process effectively and efficiently.
40
Coverage of remote areas through Mobile Health Units
Many areas in the State, predominantly tribal and hilly areas, lack basic health care
infrastructure limiting access to health services. Gujarat has operationlize Mobil Health Care
unit for these areas successfully. Currently 85 MHU’s are working all over the state
Measles Surveillance
Measles is one of the major causes of infant mortality and thus it is very important to keep a
track of the measles outbreak and cases reporting. The state is keeping a close watch on the
measles cases and their outbreak and started measles surveillance in collaboration with the
NPSU regional teams.
Adverse sex Ratio - Save the Girl Child Campaign
The declining of sex ratio has been a cause of worry for now. To address this issue the State
has initiated a number of steps under its Beti Bachao Abhiyan.
First and foremost the State updated the village wise data on sex ratio in the different parts of
the State. Based on the census data 43 most adversely affected talukas (having sex ratio
below 850 in the age group 0-6) were identified for focused attention. An intensive awareness
campaign was launched in these talukas.
Pre-Natal Diagnostic Techniques (P.N.D.T.) Act: The Pre- Natal Diagnostic Techniques
(Regulation and Prevention of Misuse) Act, 1994 was enacted as an attempt to reduce the imbalance
in sex ratio. Keeping in view the emerging technologies and slow implementation of the Act, it has
been amended in February-2003. 3050 Centers were registered under this act in the state, which
includes Genetic Counseling Centers, Genetic laboratories, Genetic clinics, Ultrasound clinic/
Imaging centers and Mobile clinics. Till to day 148 sonography machines have been sealed
and 79 cases filed in the courts. Two sting operations were also carried out by a special task
force constituted for this purpose at the State level which has had a strong deterrent impact.
A high level conference was organized with the higher judiciary to create greater awareness
amongst the higher judiciary. A historic Unanimous resolution was passed in the state
assembly to address the issue of adverse sex ratio
Efforts of the state Government reflect in the following graph, shows the improvement in sex
ratio at birth registration.
900
SEX RATIO AT BIRTH REGISTRATION Gujarat
879
870
859
845
850
800
750
700
650
600
550
500
2001 as per census in age 2005- CRS at registration 2006 CRS at registration 2007CRS at registration
below 1 year
We have done a lot, yet we have to do very hard work to achieve our goal 950 female against
1000 male child by end of 2010.
41
Control of Epidemic prone diseases
The aim of epidemic control programme is to prevent spread and prevalence of
communicable disease and controlling morbidity and mortality particularly due to water
borne diseases (Diarrhea, Vomiting, Cholera, Jaundice, Enteric fever) and water related
diseases like Leptospirosis, Air borne disease and Meningitis etc.
Some Important Achievements
Leptospirosis disease which spreads from saliva, urine and stool of Rats and other domestic
animals is prevalent in the South Gujarat districts viz. Surat, Valsad and Navsari. State
Government had provided Rs. 300 lakhs for prevention and control of Leptospirosis in the
year 2007-08. Due to this mortality rate which was 24 percent in year 1997 had been reduced
to 20.66 percent in the year 2005 and to 18.6 percent in the 2006
Revised National T.B. Control Programme (RNTCP)
The Government of India initiated National Tuberculosis Control Programme in 1962. The
objective was to reduce the morbidity and mortality due to tuberculosis to the extent that it no
more remains a public health problem. But because of low priority, managerial weakness,
over dependence on X-ray for diagnosis and inadequate funding, this programme could not
achieve its objectives.
Review of NTCP was done in the year 1992 in which the shortcomings of NTCP were taken
care of and full proof Revised National Tuberculosis Control Programme with DOTS strategy
was adopted by the Government of India in year 1993 which was implemented as a pilot -
project in rural area of Chanasma and Patan Taluka of Mehsana District in Gujarat. After
achieving its successful results this Programme was expanded to all the districts of Gujarat in
phased manner from 1998 and by April 2004, we have covered whole Gujarat State under
the RNTCP.
Achievements at a Glance
o 56.4 million Populations covered - projected population 2006.
o Gujarat is in the target zone for the whole year 2007 including all four quarters and in
1st quarter of 2008.
o 87 percent Cure Rate (against the norm of > 85 percent) and 79 Case Detection Rate of
new smear positive (NSP) cases (against the norms of > 70 percent) during 2007.
o 87 percent success cure rate, 92 percent conversion rate and 77 percent Case Detection
Rate (NSP) in 1st quarter 2008
o Till 31st March 2008, 5, 66,167 TB Patients put on DOTs treatment, out of which2,
28,076 patients are New Sputum Positive.
Achievement of RNTCP indicators in Gujarat
Annualized New Smear 3 months conversion rate Cure rate of

Year Positive Case Detection of new smear positive new smear
Rate patients positive
Target 70% 90% 85%
2005 69% 91% 85%
2006 77 % 91% 86%
2007 79 % 91% 87%
National Leprosy Eradication Programme
National Leprosy Control Programme (NLCP) in Gujarat was started from 1955, with the
strategy of identification of new cases and life long treatment with Dapsone Monotherapy.
With the advent of MDT (Multi Drug Treatment) this national programme re-designated as
National Leprosy Eradication Programme (NLEP) in the year 1983. MDT has been
introduced in phased manner and whole state was covered through MDT in the year 1991.
42
Goal of NLEP is to eliminate leprosy from the state, where elimination means to reduce the
proportion of leprosy cases to very low levels specifically below the level of one case/10000
population, through the effective application of technology i.e. MDT), so that it will not
remain as public health problem. The Prevalence Rate of Leprosy in the state was around
21.1/ 10000 population in March-1985. With the implementation of MDT for treatment of
Leprosy, the prevalence rate of leprosy for Gujarat State came down to 0.82 /10000 at the
end of March–08.
G ujar at towar ds Elimination….
25
21.1
20
15
Prevalence
10
0.76 0.82
0
1
5
20 0
8
-0
-8
-8
-8
-8
-8
-9
-9
-9
-9
-9
-9
-9
-9
-9
-9
-0
-0
-0
-0
-0
-0
-0
-0
00
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
01
02
03
04
05
06
07
Gujarat achieved status of Elimination in Oct-2004 at state level. Now our goal is to achieve
elimination of leprosy at district & sub district level. Out of total 25 districts, 16 districts
already achieved elimination but 9 districts (South Gujarat) are having PR > 1.
March-07 March-08
PB 1318 1673
Patients on treatment MB 3014 3079
Total 4332 4752
PB 4124 3846
New Cases Detection MB 3528 3382
Total 7652 7228
Prevalence Rate 0.76/10000 Pop. 0.82/10000 Pop.
Out of 25 district in Gujarat 9 districts are having high case load & therefore called as high
endemic district. These are
District PR as on Mar -07 PR as on March-08
Dahod 1.97 2.40
Panchmahal 1.97 1.90
Vadodara 1.37 1.42
Narmada 1.90 2.16
Bharuch 2.55 2.83
Surat 1.44 1.62
Navsari 1.95 2.54
Dangs 3.32 2.61
Valsad 2.46 2.91
Out of total 68 talukas in high endemic districts, 7 talukas have achieved elimination. Still 61
talukas needs elimination of leprosy.
National Programme for Control of Blindness (NPCB)
Blindness is a major public health problem in most developing countries where eye care
facilities are still limited. Cataract is the leading cause accounting for 50% to 70 % of total
blindness. 80% of the world's blindness is avoidable.
43
India is the first country in the world to launch blindness prevention related Programme as
early as in 1963 as National Programme for Trachoma Control. After few changes in the
names, this programme was re designated, since 1976 as" National Programme for Control of
Blindness" (NPCB) .In Gujarat NPCB is implemented since 1978.
Prevalence of Blindness was 1.44% in 1986 which was reduce to 1.16% in 1992 and in 1998
1.07%. Our aim is to reduce it up to 0.3%.In 2006 GOI has done a rapid survey which shows
prevalence rate in Gujarat is 0.57 %.
Prevalence Rate of Blindness
1.6
1.44
1.38
1.4
1.2 1.16
1.07
0.8
0.57
0.6
0.4
0.2
0
1971 1986 1992 2001-02 2006-07
Cataract Surgery
Cataract is the leading cause for blindness. The state has done a commendable job and during
2003-04 to 2007-08, percentage surgery to target has been more than 100 percent. The year
wise data of cataract surgery for last five years is given in the following table
Achievement of Cataract Operation

% surgery to IOL % IOL surgery to
No. Year Target Total Surgery
target surgery total surgery
1 2003-04 410000 449234 109.57 431620 96.1
2 2004-05 450000 490205 108.93 467427 95.00
3 2005-06 500000 548232 109.65 538669 98.26
4 2006-07 500000 610958 122.19 602919 98.68
5 2007-08 550000 644389 117.16 639389 99.22
1300
1200
Catract Surgical Rate ( Per 0ne lakh Population) 1213
1150
1100
1032
1000
941
900 863
846
827 815 802
800
700
600 582
552
496
500 467
400 383
300
200
1994-95 1995-96 1996-97 1997-98 1998-99 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08
CSR 383 467 496 552 582 827 815 802 846 863 941 1032 1150 1213
44
Epidemic Control
Epidemic control programme covers communicable diseases mainly waterborne diseases,
such as Cholera, Gastro-enteritis, Typhoid and Infective Hepatitis, Zoonotic Diseases like
Plague and Leptospirosis, Arthropod borne disease like Dengue fever, Airborne disease like
Meningococcal Meningitis and health relief services in the wake of natural calamities like
heavy rain, flood, drought, cyclone, earthquake etc. to prevent post calamity disease
outbreaks. Details of cases and death reported since 2006 are under
2006 2007 2008 (Up to Oct.08.)
Diseases
Cases Deaths Cases Deaths Cases Deaths
G.E. 165684 30 144952 20 104125 6
Jaundice 14252 186 8152 102 8378 69
Typhoid 13198 0 12563 0 10724 0
Cholera 100 2 122 0 36 1
Year wise Out Breaks of Viral Hepatitis
Year wise Out Breaks of Diarrhea & Vomiting
55
95 50
48
90 86 44
85 45
80
75 40
70
67
65 35
60 30
55
50 42 25
45
40 20
18
35
30 15
25 21
20 15 10 6
15
5
3
10
5 0
0
2004 2005 2006 2007 2008 (Up 2004 2005 2006 2007 2008 (Up toSEP
toSEPT 08) 08)
No. of Out Breaks of Diarrhea& Vomiting No. of Out Breaks of Viral Hepatitis
Linear (No. of Out Breaks of Diarrhea& Vomiting) Linear (No. of Out Breaks of Viral Hepatitis)
Year wise Out Breaks of Enteric Fever (Typhoid) Year wise Out Breaks of Cholera
12
40
10 33 34
10 35
30
8
25
6 20
4 4 14
4 15
2 2 10 7
2 4
5
0 0
2004 2005 2006 2007 2008 (Up 2004 2005 2006 2007 2008 (Up to
toSEPT 08) SEP 08)
No. of Out Breaks of Enteric Fever

No. of Out Breaks of Cholera Linear (No. of Out Breaks of Cholera)
Linear (No. of Out Breaks of Enteric Fever)
Leptospirosis
Leptospirosis is Zoonotic disease. Within five years of its appearance, it has posed significant
risk not only to the South Gujarat region, but also foreseeable risk looms over entire Gujarat
State. All of sudden along with plague epidemic in Surat city during 1994 Leptospirosis has
surfaced in the neighbourhood district Valsad, since then it has expanded and entrenched to
north-east ward in Surat district posing risk to lives of agricultural, dairy and animal husbandry
labourers. The cases have increased posing threat to health of the rural people inspite of
continuous efforts of state Health and Medical Department.
A calendar of activity was chalked out and funds were made available by State Health
Department. Accordingly surveillance is strengthened, early detection of cases and prompt
treatment is made available at doorsteps. Special treatment is provided in well-equipped
hospitals. Diagnosis facilities are made available at Surat Medical College Hospital. Research
activities, epidemiological surveillance to detect disease burden in the affected and non-
affected areas is carried out. Anti-rodent activities are carried out by District Agricultural
Department and sufficient health activities are also done to create awareness among people.
45
All these activities are planned, co-ordinated and monitored by District Collector. Necessary
guidance is provided by State Health and Medical Department.
Details of Leptospirosis cases and deaths registered during last 3 years is shown in the
following table
Year 2005 2006 2007
No of Suspected Cases 392 657 521
Deaths 81 124 135
CFR percent 20.51 18.55 25.91
The Guinea worm Eradication Programme is launched in Gujarat has been functioning from
1983-84 with the goal to Guinea worm Eradication by 2000 AD as per guideline from Govt.
of India.
In Gujarat disease surveillance and health education activities are carried out through present
health infrastructure of PHCs under supervision of district and state health authorities and
safe drinking water supply was instituted by GWSSB and local self-Govt. in all affected
villages.
Active search for Guinea worm cases was carried out twice in a year since December 1997
and passive surveillance by PHC, CHCs and Hospital in OPD. WHO declared India "Guinea
Worm Free" from February - 2000. However, surveillance activities and search activities are
being carried out.
Yaws is a severe, disfiguring, disability creating non-veneral treponemal infection. It is a
chronic and contagious disease more prevalent in tribal population. It can be prevented and
eradicated by detection of all cases in short period of time by house to house visit in yaws
endemic areas and treatment of cases and contacts by single doze of long acting penicillin.
In the year 1982, 2 cases of yaws were clinically confirmed in district of Dangs One active
case in April – 2000 and one case in February-2001 was detected. In the active search in YEP
Dangs district 30 suspected cases during 2005, 28 cases during 2006 and 9 suspected cases
were found but no cases were confirmed during detailed investigation. In the year 2008, 6
suspected cases are found but no case confirmed yet.
National Vector Borne Disease Control Programme (NVBDCP)
NVBDCP is a partially centrally sponsored scheme on 50:50 sharing of expenditure between
the center and the state for procuring insecticides, larvicide's, anti malaria drug, vehicles and
operational cost for Urban Malaria Scheme, vector control team etc.
The objectives of the programme are :
o To prevent deaths due to vector borne diseases.
o To reduce morbidity due to vector borne diseases.
o To consolidate the achievements attained so far.
These objectives are sought to be achieved through
o Government efforts.(case detection, treatment and integrated vector management)
o People’s participation and health education.
o Research on malaria and control
The main features of the Government efforts are:
Case detection and treatment
Case detection through active and passive surveillance with presumptive treatment to all
fever cases and examination of blood smears of fever cases collected through these agencies
and administration of complete treatment to the malaria cases detected is being carried out. In
those areas where active and passive surveillance is not available, 7815 Fever Treatment
Depots (FTDs) are established for providing treatment to the fever cases by taking blood
smears.
46
More over, under the World Bank assisted Enhanced Malaria Control Project 2772 Malaria
link Volunteers (MLV) are appointed for ensuring early diagnosis and prompt treatment to
that population which resides in highly malarious and tribal area. In addition to that 2000 link
volunteers were also appointed from the state fund.
The data related to malaria cases given in the Table below
Percent Increase
Blood Total
PF Decrease
Year Smear Malaria ABER API SPR SFR
Cases
Collected Cases Malaria
PF Cases
Cases
2004 9761255 222807 66440 18.03 4.12 2.28 0.68 70.41 109.6
2005 10976660 177936 31199 20.2 3.2 1.62 0.28 -20.1 -59.8
2006 10951405 92649 19422 19.4 1.64 0.85 0.18 -47.62 -37.01
2007 9504240 71121 18407 16.4 1.23 0.75 0.19 -23.45 -6.68
ABER = Annual Blood Examination Rate per 100 population.
API = Annual Parasite Index per 1000 population.
SPR = Slide Positivity Rate percentage of positive cases to total blood smear collected.
SFR = Slide Falciparum Rate percentage of PF cases to total blood smear collected.
The proportion of cases of malaria is constantly reducing from the year 2004. This proportion
has reduced to 0.8 per thousand population in the year 2008 from 1.2 per thousand population
in the year 2007, which is as per prevailing situation before the norms set by WHO for
elimination of malaria
Malaria Situation in Gujarat 1962 to 2007 % age of

No. of Cases Falsiparum
Malaria Cases Falsiparum Cases % of P.F.
1400000 50.0
45.0
1200000
40.0
1000000 35.0
30.0
800000
25.0
600000
20.0
400000 15.0
10.0
200000
5.0
0 0.0
1962
1963
1964
1965
1966
1967
1968
1969 1972
1971
1970 1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003 2005
2004 2006
2007
Year
As per norms Annual blood examination rate should be 10 per annum. Against this target
during 2006 and 2007, 19.4 and 16.04 ABER was achieved respectively.
Use of Insecticide Treated Bed Nets (ITBN)
900353 mosquito nets were distributed in the community and 603299 were treated with
insecticide. As this is an ongoing activity remaining nets will be treated. In addition to this
out of 175612 mosquito nets received under different projects are treated and distributed to
the community. During 2008, 576750 mosquito nets were procured and supplied to the highly
malarious districts from the state as well as Govt. of India’s fund which will be treated and
distributed.
47
Biological Control
149154 permanent breeding sites are identified for the introduction of larvivorus fishes, out
of which fishes were introduced in 94089 sites (63.08 % coverage) during the year 2007.
Prevention and Control of Lymphatic Filariasis
Filariasis is mainly prevalent in the coastal areas of South Gujarat and Saurashtra Region.
Main activities carried out to prevent and control Filariasis are (1) Larvicidal treatment of
breeding places of vector mosquitoes, (2) Night Blood survey to detected and treat micro
filarial, (3) Collection, identification and dissection of mosquitoes, and (4) minor engineering
work to remove breeding places.
Details of blood smears examined and micro Filaria cases detected during last five year in the
state are as under:
Year BSE MF cases MF rate
2003 66993 142 0.21
2004 98788 332 0.22
2005 98088 336 0.34
2006 73160 125 0.20
2007 77996 121 0.16
Prevention and Control of Dengue

Dengue is prevalent in almost all the districts of the state, but major portion of the cases are
reported from the urban areas Details of the Dengue cases reported during last 5 year in the
state are as under:
Year # of serum Dengue Deaths due
samples taken cases to Dengue
2003 1359 278 9
2004 386 120 4
2005 1045 454 11
2006 3264 545 5
2007 3224 640 2
Government Medical Colleges in the state are identified as Regional Diagnostic Centers for
serological investigation for dengue The medical college attached hospitals and the district
level hospitals are identified as sentinel centers for dengue.
Prevention and Control of Chikungunya
The Chikunguniya fever was first time reported during 2006 in Gujarat Year wise Cases
reported in the state are as under
Year Suspected cases Serum samples tested Confirm cases Death
2006 118846 1400 225 11
2007 3407 238 122 0
All the medical colleges in the state are having facility to diagnosis Chikunguniya
School Health checkup
School Health Check Up Programme is being organized in Gujarat every year since 1996-97.
Medical officer examine all going, non-school going children of 0-18 years age group
Children with minor ailments are treated on the spot. Children requiring examination by
specialist are being sent to the related referral centers where different expert like ophthalmic
surgeon, physician, pediatrician, dentist, skin specialist and E.N.T. surgeons examine and
treat them. Those children who require spectacles are provided free of cost.
48
Children suffering from Heart, Kidney and Cancer diseases are being examined by super-
specialty hospitals for further diagnosis and operative treatment is also being given to needy
children free of cost. Children suffering from complicated Heart disease are being sent to
super specialty hospital out of state for further treatment.
The yearwise data for last five years for such health check up is given below.
Services at a glance
Children Children
Children
Total children provided provided
Year treated on
children examined referral free
spot
services spectacles
2003-04 9184141 8767421(95.5%) 1338266 46499 34582
2004-05 8900345 8507684(95.6%) 1617648 75168 38424
2005-06 8692436 8324611(95.8%) 1426099 70533 40749
2006-07 8832343 8434997(95.5%) 1226213 51338 34540
2007-08 11139271 10587247(95.1%) 1303943 78014 52361
Referral Services provided during last five years under School Health Check- up Prog.
Year Pediatrician Ophthalmic Dental Skin E.N.T.
Surgeon Specialist Specialist Surgeon
2003-04 11139 21142 5737 3651 3669
2004-05 17792 32480 10439 4973 6303
2005-06 15531 27696 7959 5664 5284
2006-07 13327 21474 5362 4917 3828
2007-08 18616 34334 7320 5766 8869
Following table provides the details of Super Specialty Care provided to the children under
the programme since last 5 years under school Health
Year Heart Kidney Cancer

2003-04 821 39 9
2004-05 2875 205 38
2005-06 2751 251 43
2006-07 817 336 184
2007-08 1061 390 216
Following table provides the details of diseases wise children treated under school health
check up programme during last five years
Worm Ear Skin Vision Dental
Year Anemia
Infestations discharge Disease Problem Problem
2003-04 409142 267583 74400 261062 38565 97267
2004-05 519378 360659 88287 120570 73235 141272
2005-06 446126 362230 71017 94556 91604 119703
2006-07 323099 333489 54880 84155 67926 94390
2007-08 18616 34334 7320 5766 8869 18616
49
During the year 2007-08, 120 children were sent by the state Government to other state for
treatments for which treatment is not available in the state.
Vital Registration
Under the Civil Registration System, there are 18131 rural and 164 urban registration /
reporting units in the state for registering vital events i.e. births and deaths. The level of
registration of births and deaths in the state against expected in the year 2007 have reported to
97.8 percent and 75.3 percent as against 96.7 percent and 73.9 percent in the previous year.
Trend of CRS in Gujarat is presented in the chart below.
100.0
level of Civil Registration against expected 97.8

96.7
94.6
90.0
89.2
87.1
85.9
84.6 84.2
80.0
75.3
73.9
74.0
70.0
Percent
64.8
63.3 64.0
60.0 62.4
58.1
50.0
% Level of Registration -Birth % Level of Registration -death
40.0
2001 2002 2003 2004 2005 2005 2006 2007
National Aids Control Programme

National Aids Control Programme was initiated in the year 1992 for the Control of HIV/AIDS with
the financial aid from World Bank. For its implementation, “National AID Control Organization
(NACO)” at the National level was formed. With the guidance of “National AID Control
Organization (NACO)” the State Government has implemented AIDS programme under the
supervision of State level committee. For quick and effective implementation of this programme,
“The State Aids Control Society” has been formed by the Government of Gujarat as directed by
Central Government. The activities undertaken for the reduction of HIV/AIDS by Gujarat Aids
Control Society are as below
o Under Targeted Intervention Programme 76 Non Government Organization (NGOs) of the
State are engaged at present.
o In partnership with 17 NGOs Integrated Rural HIV/AIDS Awareness Programme (IRHAP)
was started with the overall objective to reach the rural population in an intensive manner and
to build the capacity of the village level institutions. This programme is under implementation
in 1425 villages of 57 blocks of 6 districts of the state.
o Under the Blood Safety Programme, the collection of blood by the Blood Bank supported by
State AIDS Control Society and Gujarat Council for blood transfusion has increased
considerably since 1994. The total blood collection in the year 2007-08 was 5,88,850 units of
which voluntary donation was 68.3 percent. The total blood collection during the year 2006
was 571900 units
o Under Sexually Transmitted Infection Control Programme the facilities of counseling,
behavior change communication, use of condom and drugs for the treatment for STI/RTI are
50
made available in each medical college and district hospital. In the year 2007-08 patients
attended at 41 STD clinics were 74,787 out of which 29,326 were detected and treated for
sexually Transmitted Diseases.
o Integrated Counseling and Testing Centers (ICTCs) : There are 283 Integrated Counseling
and Testing Centers (ICTCs) functional in the State. Out of which 257 Centers are Common,
13 Centers are exclusively functional for General Clients and 13 for exclusively for ante natal
mother. During the year 2007-08 total 1, 45,042 clients have taken benefit at these centers and
1,31,714 of them were tested for HIV, out of them 12,848 persons were found positive.
o Prevention of Parents of Child Transmission (PPTCT): Presently there are 270
centres functional for pregnant women (PPTCT). During the year 2007-08 total
1,18,197 pregnant women were tested in these centres and out of these 542 women
were found positive. Nevirapine were provided to 250 Mother-Baby Pairs.
o Anti Retroviral Treatment (ART): ART center have stared in Ahmedabad, Surat,
Rajkot, Bhavnagar and Mehsana. At the end of October-2008 patients ever registered
at 6 ART Centers were 20,940. Out of which 11,251 patients ever started treatment at
ART and at the moment 7,340 patients are alive and on ART.
HIV Sentinel Surveillance 2007 was carried out at 41 sites in the states. The results show evidences of decreasing
HIV prevalence trend in general. However, there are still pockets of high epidemic in the state. Amreli and
Porbandar emerged as a new high prevalence districts.
There were considerable differences in the prevalence rates from sites to sites. On an average 0.4 % of antenatal
mothers, 5.0 % of STD patients, 6.53 % of female sex workers and 8.4 % of MSMs (Men who have sex with Men)
were infected with HIV
Median HIV prevalence among ANC, STD, FSW, as well as MSMs had shown decreas trend in comparison to
previous year.
HIV prevalence was ≥1 % among antenatal mothers at 4 ANC sites (Amreli, Jamnagar, Porbandar and Surat).
Notably, 9 ANC sites (Vadodara, Surat, Rajkot, Amreli, Dahod, Jamnagar, Kheda Navsari and Porbandar) had
shown seropositivity of ≥1 % among rural participants.
HIV Prevalence was ≥5.0 % at 2 FSW sites across the state (Vadodara and Surat) It has shown increasing trend at
Vadodara Similarly, HIV prevalence was ≥5.0 % at 2 MSN sites across the state (Rajkot and Surat ) with
increasing trend at Rajko
108 Emergency Ambulance Services

Emergency Management and Research Institute, Hyderabad (EMRI) is a non-profit
organization based on the Public Private Partnership (PPP) model. The 108 Emergency
Services was launched by the State Government in collaboration with EMRI to cater to wide
ranging medical emergencies including cardiac arrests, which now form the largest group of
cases attended by the service. 400 ambulances are on the road catering to all the 25 districts
of the State.
The dial-up number 108 has become the password with the public for emergency assistance.
The patients are attended to by trained paramedics with the basic first aid at the first point of
contact. Response time in urban areas is between 7-14 minutes and rural areas between 30-45
minutes depending upon the remoteness of the locale. The time taken to reach a health care
facility is reduced substantially and the first ‘delay’ in health care delivery is dealt with
efficiently.
The ambulance is a well-equipped state-of-the-art vehicle with all necessary modern
instruments and paraphernalia. The cleanliness and hygiene are maintained at all times and its
sterile environment reduces chances of secondary infection as soon as the patient is brought
in contact with the services.
Pregnancy related cases handled by EMRI
Medical Emergencies 142755
Pregnancy related cases 32309
deliveries in ambulances 512
51
Project Implementation Unit
Health facilities at all levels are being renovated with the support of Project Implementation
Unit for providing maternal, child health and family planning services under one roof. 253
PHCs are being upgraded for functioning on 24x7 basis out of which infrastructure of 51
PHCs has been completed as per the Indian Public Health Standards (IPHS), 273 CHCs have
been identified for up gradation to Indian Public Health Standards. The facility survey for the
same has been completed.
The services of a number of public health facilities has been strengthened and upgraded
through the involvement of private enterprises thus promoting public private partnership to
achieve effective health care delivery.
Progress 2007-08: Post Earthquake Redevelopment Programme
#
Store OrganizationT
Ayurvadic Hospital
General Hospital
Primary Hospital
Programme Care
Anganwadi Care
Centre Medical
Total Structure
Development
Staff Quarter
Community
Community
Dispensary
Sub Centre
Hospital
1 RSRR
Completed 4 50 121 7 300 541 1023
Total 4 0 50 121 7 300 541 0 1023
2 New Construction
Completed 0 3 0 16 6 27 263 258 6 2 581
Under Progress 0 0 1 11 1 21 66 88 5 2 195
Total const. 0 3 1 27 7 48 329 346 11 4 776
Quality Assurance in Health Services Delivery

Oft-quoted limitations in the public systems such as limited capacity, lack of programme
standards and guidelines, and an obsession with quantified targets rather than client
satisfaction have been identified and addressed at the District and Tertiary hospitals for
building trust and confidence towards public hospitals in the hearts of the citizens of the
State.
Quality Improvement Programme in PHCs and CHCs mainly focuses on achieving IPHS
standards, while District Hospitals and Medical College Hospitals have been geared towards
Total Quality Management System as per the National Accreditations Board for Hospitals
and Health Care Providers (NABH) and National Accreditations Board for Testing and
Calibration Laboratories (NABL) Standards. A total of 39 health facilities including district
hospitals and medical colleges have been taken up for NABH/NABL accreditation in
collaboration with Quality Council of India. It will provide quality medical care services that
are accessible, affordable and equitable.
Journey towards NABH & NABL accreditation
Ist Phase (2007-08) 2nd Phase (2008-09) 3rd Phase (2009-10)
District Hospital, Rajpipla, District Hospital, Surendranagar, District Hospital, Dahod, Kheda,
Godhara, Valsad, Junagadh, Porbander, Petlad, Nadiad, Navsari, Patan, Morvi Limbadi, ahwa-Dang,
Kutchch, Sola, G’nagar, Mahsana Amreli, Himatnagar Jamana Hospital, Bharuch, Khambhaliya
and PDU,Rajkot Rajkot SSG, Baroda, New Civil Old Civil Hospital, Surat
Hospital, Surat, G.G. Hospital,
Jamnagar Sir T Hospital, Bhavnagar
Civil Hospital, Ahmedabad
o All Six Medical College Laboratories are taken for NABL e.g. Surat, Jamnagar, Bhavnagar, Rajkot, Baroda
and Ahmedabad in Ist Phase (year 2007-08)
o All Mental Hospitals e.g. Ahmedabad, Jamnagar, Kutchch & Baroda ara taken in 2nd Phase year 2008-09.
o All Dental Hospitals e.g. Ahmedabad and Jamnagar are taken in 2nd phase year 2008-09.
52
Hospital Management Information System (HMIS)
The Hospital Management Information System is being implemented in 30 hospitals in the
state with the active support of Tata Consultancy Services (TCS). One of the unique features
of the Rs. 250 million HMIS project is that a patient registered in a government hospital in a
District can avail of his medical history at any time in the future. This ensures continuity of
quality medical treatment.
Achievement of the project is as follows:
o Reduction in patient waiting time
o Process re-engineering
o Continuity of care
o Better medical data storage and retrieval
After its implementation, the HMIS has enabled provision of better care to patient by
facilitating medical information flow between all the major functional area of the hospitals
and the State headquarters.
The HMIS project implemented by the Government of Gujarat has won the best e-
governance project award by the Computer Society of India in 2007. it has also received the
SKOCH Challenger award in 2008.
No. of users 9000+

No. of modules 29(MIS/EIS)
No. of hospitals covered 30
53
Table 3.1 Programme Achievements
# Item Unit 2001-02 2004-05 2005-06 2006-07 2007-08
1 2 3 4 5 6 7 8
[1] Reproductive Child Health (RCH)
[a] Maternal Health
1 Antenatal Registration
i Workload No 1348200 1464000 1480000 1471500 1500800
ii Achievement No 1250134 1363599 1390861 1365681 1370588
iii % age of workload achieved No 92.73 93.14 93.98 92.81 91.32
2 Early Registration (within 12 weeks) % 39..98 49.44 50.83 55.49 56.81
3 T.T. ( Pregnant Mothers)
i Workload No 1348200 1464000 1480000 1471500 1500800
iii % age of workload achieved % 94.21 89.5 89.46 88.75 84.23
4 Delivery Registration
i Workload No 1213400 1227239 1251775 1337800 1363360
5 Institutional Delivery % 51.43 57.03 63.24 67.63 77.83
6 Postnatal Care Provided
i Workload No 1121163 1155148 1191569 1200653 1182457
ii Achievement No 851961 979097 1032117 782344* 903392
7 Prophlaxis (Women)
i Workload No 1348200 1464000 1480000 1471500 1370588
* Three visit for post netal care
[B] Child Health ( Immunisation)
1 BCG ( 0-1 years)
i Workload No 1233700 1257113 1264300 1282000 1290900
2 DPT 3rd Dose ( 0-1 years)
i Workload No 1233700 1257113 1264300 1282000 1290900
3 Polio 3rd Dose ( 0-1 years)
i Workload No 1233700 1257113 1264300 1282000 1290900
4 Measles ( 0-1 years)
i Workload No 1233700 1257113 1264300 1282000 1290900
5 D.T. ( 5 Years)
i Workload No 993600 1231000 1244371 1246600 1270246
6 T.T. ( 10 Years)
i Workload No 990600 1189000 1201770 1204200 1227057
iii % age of workload achieved % 82.15 79.65 74 70.46 75.16
7 T.T. ( 16 Years)
i Workload No 902900 533000 573245 536700 1170613
54
# Item Unit 2001-02 2004-05 2005-06 2006-07 2007-08
1 2 3 4 5 6 7 8
8 Vitamin ' A '
(a) 1st Dose
i Workload No 1233700 1257113 1264300 1282000 1290900
(b) 2nd Dose
i Workload No 1054100 1257113 1264300 1282000 1290900
(c) Dose 3 -5
i Workload No 3162300 3753000 3792900 3846000 3872700
9 Pulse Polio Campaign
i Workload - I & II Round No 7219409 7856000 8006000 8078000 8222000
ii Achievement - I Round No 7207865 7832627 7989469 8152519 8273568
iv Achievement - IInd Round No. 7345087 7863946 7998730 8210724 8222000
v % age of workload achieved % 101.74 100.1 99.91 101.64 101.72
[c] Family Welfare Programme
1 Sterilisation
i Workload No. 278139 304500 327000 341000 354794
ii Achievement No. 254904 278133 280334 267549 310064
iii % age of workload Achieved % 91.65 91.34 85.73 78.46 87.39
2 IUD
i Workload No. 435958 483000 590000 566000 593696
3 C.C.Users
i Workload No. 978275 1159000 1173000 1159600 1217600
4 O.P. Users
i Workload No. 213054 252000 253000 274300 288000
Estimated Couple in Reproductive
5 Lakh 89.3 92.35 99.02 101.76 104.04
Age-Group( 15-44)
6 Couple Effectively Protected by
i Sterilisation % 34.4 32.6 30.6 29.8 29.64
ii IUD % 11.1 10.7 10.3 10.2 10.3
iii C.C.Users % 5.2 6.3 5.1 5.3 5.9
iv O.P.Users % 2.1 2.3 2.5 2.3 2.9
v Total couple effectively protected % 52.8 51..9 48.4 47.6 48.7
7 Birth Averted by using varios FP methods
i Sterilisation Lakh 5.99 6.03 6.07 6.11 6.13
ii IUD Lakh 3.61 3.62 3.65 3.77 3.86
iii C.C. & O.P. Lakh 1.75 2.2 2.18 2.09 2.26
iv Total Lakh 11.35 11.85 11.9 11.97 12.25
Medical Termination of Pregnancy
8 No. 33998 29669 28115 29500 27837
reported
Contd..
55
# Item Unit 2001-02 2004-05 2005-06 2006-07 2007-08
1 2 3 4 5 6 7 8
[2] National Leprosy Eradication Programme
1 New Cases Detection
Target* No. 3000 - - - -
Achievement No. 10949 6900 6399 7652 7228
% age of target achieved % 365 - - - -
2 Cases brought under treatment
Target* No. 3000 - - - -
Achievement No. 10948 6900 6399 7652 7228
% age of target achieved % 364 - - - -
3 Cases Relieved from Treatment
Target No. 11000 - - - -
Achievement No. 11251 9109 5755 7093 6505
% age of target achieved % 102.28 - - - -
Total No. of Patients (as on 31st
4 No. 7681 3651 4082 4332 4752
March)
5 No. of Patients under treatment * No. 7680 3651 4082 4332 4752
Prevalence Rate( per 10000
6 1.5 0.67 0.73 0.76 0.82
population)
[3] National Tuberculosis Control Programme
1 No.of Sputum Examined No. 189658 327007 313485 348473 357333
Out of (1) No.of Sputum Positive
2 No. 34138 56092 54729 60231 60881
Patients Dignosed
No.of New Smear Positive Patients
3 No. 19635 30614 30289 48749 35096
put on DOTS treatment
Annuualised New Smear Posittive
4 % 53% 72% 69% 77% 79%
Case Detection Rate ( 70 % )
Total T.B.Patients Registered & Put
5 No. 50551 79784 77087 33601 80029
on Dots treat.
Annualized Total Case Detection
6 No. 117 151 140 583 144
Rate per Lac (>150)
7 Sputum Conversion Rate ( 90 %) % 87% 91% 90% 91% 92%
Cure Rate of New Smear Positive
8 % 78% 85% 85% 86% 87%
Patients ( 85 %)
[4] Vector Borne disease control programme
1 Blood Smear Collected No. 7026708 9761255 10976660 10968376 9504240
2 Malaria Cases No. 84131 222807 177936 93062 71121
3 P.F. Cases No. 19716 66440 31199 19647 18407
4 Annual Blood Examination Rate % 13.89 18.03 19.9 19.4 18.46
Annual Parasite Incidence ( per '000
5 1.66 4.12 3.23 1.65
population ) 1.23
Slide Positivity (% age of Positive
6 % 1.2 2.28 1.62 0.85
Cases ) 0.75
7 Falciparum Rate % 0.28 0.68 0.28 0.18 0.19
[5] National Aids Control Programme
1 Lisensed Blood Banks No. 160 164 164 162 147
2 Blood Safety-Blood Units Collected No. 376264 482481 513203 576932 589167
3 Elisa Positive in Blood Banks No. 1679 1676 1665 1540 1433
4 Persons tested at VCTC No. 44495 39694 63593 123539 249630
5 HIV Positive at VCTC No. 2528 4432 5824 8257 13390
6 AIDS Cases Reported No. 713 1416 1659 1262 1534
[6] National Blindness Control Programme
1 Target No. 400000 450000 500000 500000 550000
2 Achievement (cataract operations) No. 414540 490205 548232 610958 644389
3 % age of target achieved % 103.7 108.93 109.65 122.19 117.16
56
# Item Unit 2001-02 2004-05 2005-06 2006-07 2007-08
4 I.O.L. No. 210047 467427 538669 602919 639389
5 % age to total Surgery % 50.66 95 98.26 98.25 99.22
6 Spectacles Distributed No. 6420 39936 43980 38297 75862
7 Eye Bank Collection
i Eye Collected No. 6552 3961 5846 6151 7372
ii Eye Utilised No. 5109 2982 1128 3875 2359
[7] School Health Programme
1 Total School No. 34904 37405 38357 38700 46134
2 School Covered No. 37830 37293 38331 38625 46017
3 Children enrolled No. 8826056 8900345 8692436 8832343 11139271
4 Children examined No. 8262880 8507684 8324661 8434997 10587252
5 Children with ailment No. 1368656 1661630 1485721 1309773 1355994
6 Children treated on the Spot No. 1329889 1617648 1426099 1227213 1299943
Children referred to Hospital &
7 No. 38693 75664 72456 58223
CHC 80734
8 Tertiary Cases
8a Children with ailment
i Heart No. 704 3118 4027 4144 2672
ii Kidney No. 45 205 593 891 737
iii Cancer No. 6 38 136 532 390
8b Children Examined
i Heart No. 645 2875 4027 4144 2672
ii Kidney No. 37 205 593 891 737
iii Cancer No. 4 38 136 532 390
[8] Communicable Diseases
1 Cholera
Cases No. 109 65 84 100 122
Death No. 0 0 1 2 0
2 Gastroenteritis
Cases No. 46406 64660 91289 165684 144952
Death No. 111 30 41 30 20
3 infective Hepatitis
Cases No. 4617 7467 15557 14252 8152
Death No. 33 28 29 187 102
4 Enteric Fever - Cases No. 3197 4946 5551 13198 12563
- Death No. 3 0 1 0 0
5 Dengue Fever - cases No. 96 93 454 545 640
- Death No. - 1 11 5 2
6 Leptospirosis
Cases No. 4 630 391 656 521
Death No. 0 92 81 124 135
57
Table : 3.2 Zoonotic diseases in Human, 2005 to 2007
2005 2006 2007
Diseases
Cases Death Cases Death Cases Death
Dog bite 62048 0 44298 0 56417 0
Snake bite 2079 20 1490 29 1310 14
Anthrax 0 0 6 0 0 0
Hydatid diseases 0 0 0 0 0 0
Leptospirosis 392 81 657 124 521 135
Japanese encephalitis 0 0 0 0 0 0
Food borne disease 1585 11 524 0 5725 6
Plague 0 0 0 0 0 0
K. F. D. 0 0 0 0 0 0
Leishmaniasis 0 0 2 0 0 0
Recketsiasis 0 0 0 0 0 0
Dengue fever 454 11 545 5 640 2
Toxoplasmosis 0 0 0 0 0 0
Scorpion bite 1434 4 1087 0 832 0
Total 68030 141 48638 164 59911 176
3.2. a. Hydrophobia (Rabies)
Year Hydrophobia cases Outcome
Reported Expired Discharged DAMA Absconded
after Cure
2006 71 34 0 36 1
2007 59 28 0 31 0
2008 40 26 0 14 0
Table : 3.3 Annual Status of

Communicable Diseases in Gujarat -2007
2007
Name of Disease
Cases Deaths
Acute Diarrhoeal Diseases (Including GE etc) 337610 0
Diphtheria 168 0
Acute Poliomyelitis (New listed Cases) 31 0
Tetanus other than Neonatal 83 0
Neonatal Tetanus 31 1
Whooping Cough 25 0
Measles 549 0
Acute Respiratory Infection (Including 609501 8
Influenza & excluding Pneumonia)
Pneumonia 5883 41
Enteric Fever 5724 0
Viral Hepatitis A 2038 0
Viral Hepatitis B 83 0
Viral Hepatitis C,D,E 1368 0
Meningococcal Meningitis 63 3
Rabies 39 0
AIDS (As reported to NACO) 505 0
Syphilis 1485 0
Gonococcal Infection 886 0
Other STD Diseases 68842 0
Pulmonary Tuberculosis 30988 65
Total 1065902 118
58
4. Health Infrastructure
Health Infrastructure is an important indicator to understand the healthcare delivery

provisions and mechanisms.
Gujarat health care service delivery is divided into three parts on the basis of national
common structure as well as the need of the community. Distribution of these facilities has
been done on the basis of population and geographical situations. These layers are not just
different in terms of population only but they also differ in nature of services delivered.
Primary health care basically provides basic minimum care with more focus on preventive
aspects and public contact. Curative services are also provided there but they are minimal in
nature. While secondary care is mix of both curative as well as preventive. Tertiary care is
basically meant for high level of curative care and research studies.
Primary Level Care Secondary Level Care Tertiary level care

Primary Health Center Civil Hospitals Medical College Hospitals
Sub center/Dispensaries Sub District Hospitals Super Specialty Hospitals
Village Level Workers Cottage Hospitals / Referral
Hospitals, Community Health
Centers
Proper referral linkages between all these facilities have been developed. A proper
mechanism is there to refer a patient from Sub-centre to PHC and further to the CHC or DH
and then if needed to higher level facilities too. But there is no restriction for patient in
approaching the General Hospital directly.
Gujarat state is in the forefront of establishing and maintaining good health infrastructure at
various levels. Currently 1424 health institutions are functioning at various levels. (1073
Primary Health Centres, 273 community health centres, 23 sub- district level Hospitals, 25
district level Hospitals, 30 others).
During the year 2007-08, 337.07 lakh patients were treated in the outdoor while 32.11 lakh
patients were treated indoor through the above mentioned Government medical institutions.
As per norms of Government of India, a Community Health Centre is having 30 beds with
one Operation Theatre, X-Ray, Labour Room and Laboratory facilities. It serves as referral
centre for 4 Primary Health Centres on an average. Each CHC covers about 1.21 lakh rural
population against norm of one lakh.
The State Government has built up a fairly extensive network of sub centre and Primary
Health Centre in rural areas for providing health care services to the remote area of the State.
86 Mobile health care units have also been made functional for providing health care services
in tribal areas and in slum areas for urban poor.
Public Health Services are provided to the community through a network of sub centers ,
Primary Health Centers ( PHCs) and Community Health Centers (CHCs) in the rural areas
and Hospital and Dispensaries etc. in Urban areas
An Auxiliary Nurses Midwife (ANM), a female paramedical worker posted at the sub-centers
and supported by a male Multipurpose Worker is the front line worker in providing the health
services to the community. ANM is supervised by the lady Health Visitor (LHV) posted at
PHC
59
The norms for establishing sub centers, Primary Health Centers and Community Health
centers are as under
Population norms
Centre
Plain Area Hilly/ tribal area
Sub - Centre 5000 3000
PHC 30000 20000
CHC 100000 80000
There are 7274 Sub-centers, 1073 primary Health centers and 273 community Health centers
in the state.
In the state, under Medical services, there are 59 Medical institutions having 6648 bed
capacity in the state, which includes 3 infectious diseases hospitals / eye hospitals with 170
bed and 4 mental hospitals with the 683 bed capacity. Over and above this, there are 124 GIA
institutions having 5041 bed capacity under medical services
Under Medical Education, there are 6 Government Teaching Hospitals having 7677 bed
capacity and 2 government dental Hospitals having 25 beds in the state. There are 7 non
government hospitals, having 3295 beds and 7 non government dental colleges are
functioning in the Medical Education in the state.
Over and above this, one Kidney, one Cardiology and one cancer GIA specialty hospitals
having 450, 200 and 650 bed capacity is functioning under ME in the state.
With 7274 Sub Center, 1073 PHC, 273 CHC, 106 Urban Family Welfare Centers, 88 Post
Partum Units and 27 TB Centers; Gujarat Health department is serving the community with
quality health services. Parallel to that 13 Allopathic, 9 Dental, 11 Ayurvedic, 16
Homeopathic and 16 Physiotherapy medical colleges are producing approximately 4000
doctors per year. By looking at need of nurses in rural setup this year 2 nursing colleges and 2
nursing schools were opened and government encourages the private players to start new
medical and nursing colleges. Also to strengthen the Indian System of Medicine (AYUSH) 2
Ayurvedic and 3 Homeopathic medical colleges were opened this year. On the other hand 7
big government training institutes were rolled out in the state to strengthen the existing
system.
Utilization of government laboratories and X-Ray machines has been increased by 30 percent
and 16 percent respectively during last two years. This is due to trained staff and rich
resources at institute level. The average OPD and IPD at CHC and PHC has increased by 8
percent (approx.) during last two years. If we look at OPD/IPD data in district hospital, it
seems that IPD/OPD has marginally decreased. But this is due to reporting system only.
Earlier it was manual but now in every district hospital HMIS is working greatly which
reduce the false reporting.
5 years back 1487 people were served by one doctor but now one doctor has to serve only
1314 people which mean doctor can give more time to one patient. These all are result of
increased number of medical and paramedical institutes in the state. Same story is there for
nurses and ANM also.
Number of total registered doctors, dentist and nurses has been increased by more then 20
percent over last 6 years. Registered Homeopathic doctors have been increased by 42 percent
in last 6 years. ANM and midwives are two key persons at community level in public health.
Government of Gujarat has built their capacity at field level by introducing new institutes and
trainings. The total number of Midwives has increased by 50 percent over last 5 years.
60
Table: 4.1 Hospital Performance
PHC + Medical Medical

# Indicators Year Unit ESIS Total
CHC Services Education
1 2 3 4 5 6 7 8 9
Nos. of 05-06 No 1345 59 8 11 1423
i Institutions 06-07 No 1346 59 8 11 1424
/Hospitals 07-08 No 1346 59 8 11 1424
05-06 No 16355 6648 7496 870 31369
Indoor
ii 06-07 No 16064 6648 7702 870 31284
Capacity
07-08 No 16064 6648 7702 935 31349
05-06 Lakh 212.42 93.38 42.33 2.38 350.51
Annual
iii 06-07 Lakh 241.68 87.23 37.88 2.39 369.18
OPD
07-08 Lakh 223.72 72.72 35.26 5.37 337.07
05-06 Lakh 11.08 16.82 6.56 0.17 34.62
Annual
iv 06-07 Lakh 12.57 16.8 2.97 0.19 32.53
IPD
07-08 Lakh 12.81 16.03 3.00 0.27 32.11
Average 05-06 Nos 53 534 2352 72 82
v OPD per 06-07 Nos 60 492 2105 72 86
day 07-08 Nos 67 411 1959 176 88
Average 05-06 Nos 2 79 300 4 8
vi IPD per 06-07 Nos 3 78 135 5 8
day 07-08 Nos 3 74 137 6 8
05-06 No 38599 57214 56538 754 153105
Major
vii 06-07 No 34216 67420 63579 2155 167370
Operations
07-08 No 36284 73272 66761 2207 178524
05-06 No 90726 108082 147349 2050 348207
Minor
viii 06-07 No 84264 94626 191515 6202 376607
Operation
07-08 No 110565 83158 181737 5302 380762
05-06 No 1863396 3733981 4154287 396212 10147876
ix Lab.Tests 06-07 No 2144506 3608514 8908923 1024405 15686348
07-08 No 3903556 3743418 6391616 878792 14917382
05-06 No 71341 289456 871428 27633 1259858
x X-ray 06-07 No 73477 282529 953512 80452 1389970
07-08 No 81358 292739 977898 80199 1432194
61
4.2 Health infrastructure in Gujarat - Health, Medical services and Medical Education
# Item Unit 03-04 04-05 05-06 06-07 07-08
1 2 3 5 6 7 8 9
[1] Health Services
1 Community Health Centres No. 271 272 273 273 273
2 Primary Health Centres No. 1067 1070 1072 1073 1073
3 Urban Family Welfare Centres No. 106 106 106 106 106
4 Post Partum Units No. 88 88 88 88 88
5 Sub Centres No. 7274 7274 7274 7274 7274
6 T.B. Demonstration and Training Centres No. 1 1 1 1 1
No. 27 27 27 29 29
7 Additional/District T.B. Centres
Beds 515 515 305 305 305
8 T.B. Clinics No. 1 1 1 1 1
No. 3 3 2 2 0
9 T.B. Sanatoria
Beds 389 314 237 237 0
No. 12 12 12 11 11
10 Grant-in Aid T.B. Hopitals
Beds 2200 2026 2026 1944 1944
11 TB Units No. 115 119 125 129 132
12 Dignostic Micro Scopic Centre No. 582 613 632 669 633
13 Trained Dots Provider No. - 20057 21168 24126
14 District/Zonal Leprosy Units No. 8 8 8 8 8
15 Leprosy Control Units No. 1$ 0 0 0 0
16 Modified Leprosy Control Units No. 1$ 1 1 1 1
17 Urban Leprosy Control Units No. 21 21 21 21 21
18 Leprosy Training Centres No. 1 1 1 1 1
19 Reconstructive Surgery Units No. 2 2 2 2 2
20 S. S. A Units ** No. 1 1 1 1 1
21 Survey Education & Treatment Unit No. 372 372 372 372 372
No. 8 0 0 0 0
22 Temporary Hospitalisation Wards
Beds 80 * * * *
No. 3 3 3 3 2
23 Govt. Leprosy Hospitals
Beds 370 370 370 370 300
No. 4 4 4 4 3
24 Grant-In-Aid Leprosy Hospitals
Beds 590 590 590 550 300
25 District Nucleaus Centre (Dist. TB Centres) No. - 16 16 16 16
26 Upgraded Urban Leprosy Centre No. - 3 3 3 3
27 Ophthalmic Unit in Dist. Hosp. No. 25 25 25 25 25
28 Dist. Mobile Units (Ophth) No. 14 14 14 14 14
29 Central Mobile Units (Ophth) No. 6 6 6 6 6
30 District Blindness Society No. 25 25 25 25 25
31 Vector Borne Disease Control Programme:
i Fever Treatment Depots. No. 12092 12045 12068 7902 7815
ii Drugs Distribution Centres No. 22159 23583 22200 23873 22137
iii Malaria Clinics No. 1285 1341 1304 1276 1406
Contd..
62
# Item Unit 03-04 04-05 05-06 06-07 07-08
1 2 3 5 6 7 8 9
32 AIDS
i Zonal blood Testing Centres. No. 6 6 6 6 6
ii Clinics for Sexually transmitted Disease No. 35 35 35 35 41
iii Voluntary counselling & Testing Centres No. 31 33 34 34 193
iv Tele counselling Centre ** No. 6 6 6 6 6
[2] Medical Services
No. 25 25 23 23 23
1 General Hospitals Class - I
Beds 4286 4286 3932 3932 3932
No. 21 21 23 23 23
2 Government Hospitals Class - I ***
Beds 1444 1444 1809 1809 1809
No. 1 2 3 3 3
3 Infectious Diseases Hospital / Eye Hospitals
Beds 50 100 170 170 170
No. 4 4 4 4 4
4 Mental Hospitals
Beds 683 683 683 683 683
No. 6 6 6 6 6
5 Govt. Hospitals Class - II $$
Beds 54 54 54 54 54
6 Grant-in-Aid Institution No. 93 100 125 125 124
Beds 4027 4986 5486 5486 5041
7 Total Beds ( 1 to 6 ) Beds 10544 11553 12080 12080 11689
8 Dispensaries
i Government No. 41 41 41 41 41
ii S.R.P. Group Hosp. No. 11 11 11 11 11
iii Govt. Police Dispen. No. 4 4 4 4 4
iv Dam Site Dispen. No. 4 4 4 4 4
[3] Medical Education & Research
1 Govt. Teaching Hospitals No. 6 6 6 6 6
Beds 7471 7471 7471 7677 7677
2 Non Govt. Teaching Hosp. No. 4 7 7 7 7
Beds 1495 3295 3295 3295 3295
No. 2 2 2 2 2
3 Govt. Dental Hospitals
Beds 25 25 25 25 25
4 Non Govt. Dental Hospitals No. 2 2 2 7 7
5 Grant-in-Aid Specialised Hospital
i Kidney Beds 250 250 250 250 450
ii Cardiology Beds 200 200 200 200 202
iii Cancer Beds 450 450 450 450 650
6 Total Beds ( 1 to 5 ) No. 9891 11691 11691 11897 12299
Total Beds ( Medi. Ser. & Medi. Edu.) No. 20435 23244 23825 23447 23988
[4] E.S.I.S.
No. 12 12 11 11 10
1 Hospital
Beds 1470 1470 870 870 635
2 Dispensaries No. 125 125 125 125 125
$ L.C.U. / M.L.C.U. merged with DLO as per guidelines of India
* Beds merged in Dist. / Taluka Hospitals. ** Strengthen under Aids Control Programme *** Includes Govt. Hospitals & Taluka Level Hospitals
$$ Chhala (G'nagar), Varasiya (Vadodara), Adipur (Kachchh), Umarpada (Surat), Unjha (Mahesana) & Shahibag (Ahmedabad)
63
Table: 4.3 Health Infrastructure in Gujarat
# Details Unit 03-04 04-05 05-06 06-07 07-08
1 2 3 4 5 6 7 8
[A] : Govt Medical Institutions
1 Community Health Centres No 271 272 273 273 273
2 Primary Health Centres No 1067 1070 1072 1073 1073
3 Sub Centres No 7274 7274 7274 7274 7274
4 Urban Family Welfare Centres No 106 106 106 106 106
5 Post Partum Units No 88 88 88 88 88
6 Additional/District T.B Centres No 27 27 27 29 29
[B] : Medical Education Institutions
(i) : Medical Education
1 Allopathic Medical Colleges No 11 13 13 13 13
2 Dental Colleges No 5 5 5 9 9
3 Pharmacy Colleges No 14 25 37 17 19
4 Ayurvedic Colleges No 9 9 9 9 11
5 Homeopathic Colleges No 14 14 13 13 16
6 Physiotherapy Colleges No 7 10 10 17 16
(ii) : Para Medical Institutions
1 Nursing Colleges No 1 3$ 2$ 4$ 6
2 Nursing schools No 17 25$ 26$ 31$ 33
3 Public Health Nursing School No 1 1 1 1 1
Multipurpose Health Worker Training
4 No 17 17 17 16 16
School (Male & Female)
Multipurpose female Supervisor trg.
5 No 2 2 2 2 2
Inst.
6 6.Others Institutions No 14 14 14 14 14
[C] : Man-Power
1 Doctors Registered No 38013 39461 41049 41180 42855
2 Dentist Reegistered No 1667 1954 1889 2359 2708
3 Nurses Registered No 16299 16755 17468 17499 17551
4 Midwives Registered No 6409 6504 6597 6600 9585
5 Ayurved Registered No 22583 22979 23035 23391 24104
6 Unani doctors registered No 244 250 252 261 266
7 Homeopathic doctors registered No 7273 7316 7900 8443 9509
[D] : Taining Institutions
1 T.B.Demonstration and Trg. Centre No 1 1 1 1 1
2 Leprosy Training.Centre No 1 1 1 1 1
State Health & Family Welfare
3 No 1 1 1 1 1
Institution
Health & F.W - Regional training
4 No 4 4 4 4 4
Centres
$ Govt and Non Govt
64
Table : 4.4 Performance of PHCs and CHCs
# Item Unit 2002 2004 2005 2006 2007
1 2 3 4 5 6 7 8
[A] Cumunity Health Centres No 237 271 273 273 273
i Out Door Patients No 7797132 9775564 9620793 10317549 9174358
ii In Door Patients No 665908 847195 957444 1106585 1075412
iii Average OPD per day per Hosp. No. 110 117 118 126 120
iv Average IPD per day per Hosp. No. 8 8 10 12 12
[B] Primary Health Centres No 1027 1070 1072 1073 1073
i Out Door Patients No 16145590 11844713 11621596 13854170 13197852
ii In Door Patients No 159120 146370 150623 537738 206525
iii Average OPD per day per Hosp. No. 52 37 36 45 40
Table : 4.5 Medical Manpower / Human Resources

# Item Unit 2002 2003 2004 2005 2006 2007 2008
1 Doctors Registered ** No. 35086 36831 38013 39461 41049 41180 42855
2 Population Served per Doctor No. 1484 1439 1415 1385 1351 1367 1314
3 Dentists Registered *** No. 1430 1624 1667 1954 1889 2359 2708
4 Population Served per Dentist No. 36418 32601 32272 27964 29367 23865 20790
5 Registered Practitioners @
i Ayurved No. 21827 22337 22583 22979 23035 23391 24104
ii Unani No. 241 242 244 250 252 261 266
Registered Homeopathic
6 No. 5644 6634 7273 7316 7900 8443 9509
practioners #
7 Population Served per Practitioner
i Ayurved No. 2386 2370 2382 2378 2408 1826 2336
ii Unani No. 216095 218777 220484 218668 220139 215701 211647
iii Homeopathic No. 9227 7981 7397 7469 7022 8444 5921
11. Nursing Staff
1 Registered Nurses No. 15478 15801 16299 16755 17468 17499 17551
2 Registered A.N.M. No. 6276 6365 6409 6504 6597 6600 6638
3 Population Served Per
i General Nurse No. 3365 3351 3301 3261 3176 3217 3208
ii A.N.M. No. 8298 8318 8394 8401 8409 8530 8481
* Under Training
** Gujarat Medical Council - as on 31st. Dec. @' Gujarat Board of Ayurved and Unani System of Medicine
*** Gujarat State Dental Council # Under Council of Homeopathic System of Medicine, Gujarat State.
Source- Gujarat Nursing Council, Ahmedabad
65
Table: 4.6 Medical & Para Medical Education Institutions
# Item Unit 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08
[1] Colleges
1 Allopathic Medical College No. 11 11 13 13 13 13
2 Pharmacy College
i Degree No. 13 14 25 37 50 64
ii Diploma No. 9 9 9 18 26 21
3 Dental College No. 4 5 5 5 9 9
4 Ayurvedic College No. 9 9 9 9 9 11
5 Homeopathic College No. 14 14 14 13 13 16
6 Physiotherapy College No. 7 7 10 10 17 16
[2] Admission Capacity
1 Allopathic Medical College No. 1375 1375 1525 1525 1755 1555
2 Pharmacy College
i Degree No. 765 825 1485 2205 2925 3825
ii Diploma No. 570 570 570 1140 1365 1230
3 Dental College No. 280 280 320 320 620 670
4 Ayurvedic College No. 375 375 375 375 375 475
5 Homeopathic College No. 1300 1300 1375 1275 1375 1375
6 Physiotherapy College No. 220 220 320 320 775 765
[3] Student Admitted and Qualified
1 Medical College
i Student Admitted # No. 1073 1270 1087 1087 1069 955
ii Student Qualified ## No. 1051 1050 880 880 818 975
2 Pharmacy College
2a Degree
i Student Admitted No. 760 817 1394 1852 2495 3781*
ii Student Qualified No. 565 542 780 1677 1757 893*
2b Diploma
i Student Admitted No. 564 682 655 756 759 1164*
ii Student Qualified No. 512 496 509 521 553 759*
3 Dental College
i Student Admitted $ No. 138 236 223 223 205 144
ii Student Qualified $$ No. 95 177 156 156 139 158
4 Ayurvedic College
i Student Admitted No. 374 375 374 375 375 475
ii Student Qualified No. 177 185 135 119 66 36
5 Homeopathic College
i Student Admitted No. 1279 1012 779 948 367**
ii Student Qualified No. @ @ @ @ 290**
6 Physiotherapy College
i Student Admitted No. 78 170 190 190 133 198
ii Student Qualified No. 45 86 95 95 82 49
@ = Information awaited. **= Only Govt.Institutions
# in First M.B.B.S. $ in First B.D.S.
## in Final M.B.B.S. $$ in Final B.D.S. * Provisonal
66
5. Health Finance Indicators
Health finance indicators provide an understanding of patterns of investments, expenditure,
sources of funding and proportion of allocations vis a vis other total allocations. It also
provides an important tool to understand health outcomes in relation to the expenditure.
During the year 1979-80 only 1.22 percent plan outlay to state plan was provided to Medical
and Public Health. In the year 1990-91, 1.72 percent plan outlay to state plan was provided to
the Public Health and Medical sector. From the year 2003-04 more than 3 percent of total
state plan outlay provided to this sector .In the year 2008-09 plan allocation to this sector
increased substantially by the State Government and its reached to Rs. 824.75 crore i.e. 4.33
percent to state Plan. Following statement provides year wise details of Plan and Non plan
allocation from the state budget to public Health and medical services
Outlay Rs in Crore
# Item 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08
1 State Annual Plan Outlay 7600.0 7860.0 8300.0 11000.0 12503.5 15506.0
Plan Outlay for Medical and
2 213.0 252.2 252.9 434.9 459.9 555.2
Public Health
Percent allocation of Medical
3 2.80 3.21 3.05 3.95 3.68 3.58
and Public Health to State Plan
4 State Annual Non-Plan Outlay 23454.0 24197.4 23900.1 26143.0 25801.0 27247.8
Non-Plan Outlay for Medical
5 735.7 667.2 678.4 720.1 745.2 752.5
and Public Health
Percent of NP outlay for
6 Medical and Public Health to 3.14 2.76 2.84 2.75 2.89 2.76
State Non-Plan
7 Total State Plan & Non Plan 31054.0 32057.4 32200.1 37143.0 38304.5 42753.8
Plan and Non Plan Outlay for
8 948.7 919.4 931.3 1155.0 1205.2 1307.7
Medical and Public Health
Percent of Medical and Public
9 3.06 2.87 2.89 3.11 3.15 3.06
Health outlay to total outlay
Following table provides the year wise details of expenditure on Health and allied services
and % of expenditure to these sector against the GDP from the year 2002-03. Government
spending to health and allied sectors is estimated to 1.1% against estimated GDP at current
prices and about 0.5 percent of GDP only for Health services.
Expenditure from Health and allied sectors from the State Government Account
Year Expenditure (Rs. In Crore) GDP of % of Exp. to
the GDP
Health Nutrition Water & Total Gujarat Against
Against
Sanitation (Rs. In Col. 5
Health
Cr.) Exp.
1 2 3 4 5 6 7 8
2003-2004 886.7 329.8 613.2 1829.6 168080 1.09 0.53
2004-2005 971.1 359.6 900.3 2231.0 189118 1.18 0.51
2005-2006 1069.3 399.3 885.8 2354.5 219780 1.07 0.49
2006-2007 1146.1 463.4 1202.2 2811.7 254533 1.10 0.45
2007-2008 1321.8 524.1 1316.9 3162.8 281259 1.12 0.47
Source : Various Issue of Finance Account, Government of Gujarat And Budget book, GOG
67
Following table provides the comparative picture of Health expenditure against state
expenditure of Gujarat, Haryana, Karnataka, Kerala, Maharashtra, Punjab Tamil Nadu and
West Bengal. Health expenditure of Gujarat is lowest among all these states.
% Health Exp. To State Exp. - State budget

2003-04 2004-05 2005-06 2006-07
Gujarat 2.69 2.78 3.13 3.24
Haryana 2.37 2.71 3.14 3.45
Karnataka 3.40 3.05 3.46 3.48
Kerala 4.32 4.54 4.97 4.96
Maharashtra 3.16 2.73 3.33 3.42
Punjab 3.00 2.91 3.63 3.73
Tamil Nadu 3.76 3.24 4.23 4.01
West Bengal 3.65 4.23 4.14 4.59
Following table provides the percentage of Public Health expenditure against GDP by
Gujarat, Haryana, Karnataka, Kerala, Maharashtra, Punjab, Tamil Nadu and West Bengal for
the year 2003-04,2004-05 and 2005-06.
% Health Exp.by State Govt To GDP

2003-04 2004-05 2005-06
Gujarat 0.53 0.52 0.49
Haryana 0.46 0.44 0.47
Karnataka 0.77 0.70 0.72
Kerala 0.88 0.85 0.98
Maharashtra 0.57 0.52 0.55
Punjab 0.68 0.63 0.78
Tamil Nadu 0.72 0.67 0.77
West Bengal 0.75 0.69 0.77
2005-06 Revised Estimates , 2006-07 BE
Source: 1) Public Finance CMIE November - 2006 issue
2) State Domestic Product of Gujarat State - 2005-06
In the following two table per capita health Expenditure and percentage health Expenditure to
GDP for the year 2001-02 is presented. The source of this data is National Health Account,
2001-02
68
Per Capita Health Exp. (In Rs.) in Major State, 2001-02
State Public Private Total
Kerala 240 1618 1858
Haryana 163 1408 1570
Punjab 258 1273 1530
Himachal Pradesh 493 812 1305
Uttar Pradesh 84 1040 1124
Jammu & Kashmir 271 790 1061
Andhra Pradesh 182 858 1039
Maharashtra 196 815 1011
Madhya Pradesh 132 733 864
Tamil Nadu 202 644 846
Gujarat 147 670 816
Bihar 92 687 779
West Bengal 181 593 775
Karnataka 206 506 712
Rajasthan 182 415 597
Orissa 134 449 582
Assam 176 393 569
Source : National Health Account, India - 2001-02
Percent Health Expenditure to GDP: 2001-02

Health Expenditure (Rs GDP % Health
State In.Cr) 2001-02 2001-02 (Rs. Exp. to
In Cr) GDP
Public Private Total
Gujarat 749 3417 4166 123573 3.37
Haryana 346 2998 3344 63489 5.27
Karnataka 1097 2692 3789 107933 3.51
Kerala 769 5189 5958 76451 7.79
Maharashtra 1912 7957 9869 271293 3.64
Punjab 632 3123 3755 79690 4.71
Tamil Nadu 1272 4045 5317 149074 3.57
West Bengal 1465 4793 6258 156328 4.00
Source: National Health Account, 2001-02
2) State Domestic Product of Gujarat State - 2005-06
69
Millennium Development Goals
The Millennium Declaration adopted by the General Assembly of the United Nations in its
Fifty-fifth session during September 2000 reaffirmed its commitment to the right to
development, peace, security and gender equality, to the eradication of many dimensions of
poverty and to overall sustainable development. These are intended for the Member
Countries to take efforts in the fight against poverty, illiteracy, hunger, lack of education,
gender inequality, infant and maternal mortality, diseases and environmental degradation.
The Millennium Declaration adopted 8 development goals, 18 time-bound targets and 48
indicators to be achieved by 2015:
Goal-1 Eradicate extreme poverty and hunger

Target -1 Reduce by half the proportion of people living on less than a dollar a day
Target - 2 Reduce by half the proportion of people who suffer from hunger
Goal-2 Achieve universal primary education
Target -3 Ensure that all boys and girls complete a full course of primary schooling
Goal-3 Promote gender equality and empower women
Target -4 Eliminate gender disparity in primary and secondary education preferably by
2005, and at all levels by 2015
Goal-4 Reduce child mortality
Target -5 Reduce by two thirds the mortality rate among children under five
Goal-5 Improve maternal health
Target -6 Reduce by three quarters the maternal mortality ratio
Goal-6 Combat HIV/AIDS, malaria and other diseases
Target -7 Halt and begin to reverse the spread of HIV/AIDS
Target -8 Halt and begin to reverse the incidence of malaria and other major diseases
Goal-7 Ensure environmental sustainability
Target -9 Integrate the principles of sustainable development into country policies and
programme; reverse loss of environmental resources
Target -10 Reduce by half the proportion of people without sustainable access to safe
drinking water
Target - 11 Achieve significant improvement in lives of at least 100 million slum dwellers, by
2020
Goal-8 Develop a global partnership for development
Target - 12 Develop further an open, rule-based, predictable, non-discriminatory trading and
financial system Includes a commitment to good governance, development, and
poverty reduction — both nationally and internationally
Target - 13 Address the special needs of the least developed countries Includes: tariff and
quota free access for least developed countries’ exports; enhanced programme of
debt relief for HIPCs and cancellation of official bilateral debt; and more generous
ODA for countries committed to poverty reduction
Target – 14 Address the special needs of landlocked countries and small island developing
States
Target - 15 Deal comprehensively with the debt problems of developing countries through
national and international measures in order to make debt sustainable in the long
term.
Target – 16 In cooperation with developing countries, develop and implement strategies for
decent and productive work for youth.
Target - 17 In cooperation with pharmaceutical companies, provide access to affordable
essential drugs in developing countries
Target - 18 In cooperation with the private sector, make available the benefits of new
technologies, especially information and communications
70
Definitions of Various Terms
Population: All inhabitants of a country, territory, or geographic area, for a given sex and/or age group,
at a specific point of time. In demographic terms it is the number of inhabitants of a given sex and/or age
group that actually lives within the border limits of the country, territory, or geographic area.
Proportion of Urban Population: The percentage of total population of a country, territory, or
geographic area living in places defined as urban.
Urban: The term urban refers to towns (places with municipal corporation, municipal area committee,
notified area committee or cantonment board); also, all places having 5000 or more inhabitants, a density
of not less than 1000 persons per sq mile or 400 per sq km, pronounced urban characteristics and at least
three-fourths of the adult male population employed in pursuits other than agriculture.
Proportion of Rural Population: The percentage of total population of a country, territory, or
geographic area living in places defined as rural.
Density of Population: Number of persons, living per square kilometer.
Growth Rate: The exponential average annual rate of population growth, expressed as a percentage.
Annual Population Growth Rate: The annual average rate of change of population size during a
specified period. It expresses the ratio between the annual increase in the population size and the total
population for that year, usually multiplied by 100.
Sex Ratio: The number of females per 1000 males
Dependency Ratio: The average number of economically dependent population per 100 economically
productive population. In demographic terms, economically dependent population is defined as the sum
of the population under 15 years of age plus the population 65 years of age and over. Economically
productive population is defined as the population between 15 and 64 years of age.
Old Age Dependency Ratio: The proportion of persons above 65 years of age are considered to be
dependent on the economically productive age group (15-64 years)
Life expectancy at Birth: The average number of years that a newborn could expect to live, if he or she
were to pass through life exposed to the age and sex-specific death rates prevailing at the time of his or
her birth.
Birth Rate: The number of live births per 1000 estimated mid year population, in a given year.
Case Fatality Rate: Usually expressed as the proportion of persons diagnosed as having a specified
disease who die within a given period of Hme as a result of acquiring that disease.
Crude Birth Rate: The crude birth rate (CBR) is defined as the number of live births in a year per 1,000
of the mid year population.
Crude Death Rate: The crude death rate (CDR) is defined as the number of deaths in a year per 1,000 of
the midyear population.
Infant Mortality Rate (IMR): Infant mortality rate (or IMR) is defined as the number of infant deaths in
a year per 1,000 live births during the year
Maternal Mortality Ratio (MMR): Annual number of maternal deaths per 100,000 live births. A
maternal death is the death of a woman while pregnancy or within 42 days of termination of pregnancy,
from any cause related to or aggravated by the pregnancy or its management, but not from accidental or
incidental causes.
Neo-natal Mortality Rate: Number of neonatal deaths in a given year per 1000 live births in that year.
Neonatal deaths are deaths occurring during the neonatal period, commencing at birth and ending 28
completed days after birth.
Early neonatal Mortality Rate: Number of infants deaths less than seven days of life per thousand live
births.
71
Post-natal Mortality Rate: Number of deaths of children between 28 days and one year of age in a given
year per 1000 total live births in the same year.
Peri-natal Mortality Rate: Peri-natal mortality rate is defined as the number of still births to gather with
infant deaths of less than seven days per one thousand live births in the same year.
Still Birth Rate: Death of a foetus weighing 1000g (equivalent to 28 weeks of gestation) or more, during
one year in every 1000 total births.
Fertility: Fertility means the actual bearing of children during a woman’s reproductive period i.e. roughly
from 15 to 45, a period of 30 years.
General Fertility Rate: The number of live births during a year per 1000 female population aged 15-49
years.
Total Fertility Rate: Number of children that would be born per woman during her entire span of
reproductive period assuming that the age-specific fertility rates, to which she is exposed to, continue to
be the same and that there is no mortality.
Poverty: It is a situation in which a person is unable to get minimum basic necessities i.e. food, clothing
and shelter for his /her sustenance.
Poverty Line: Poverty estimates in our country are derived from the household consumer expenditure
data collected by National Sample Survey Organization (NSSO) every fifth year. The ‘Poverty line’ has
been calculated to be Rs. 327 per month per capita for rural India and Rs.454 per month per capita for
urban India. The Planning Commission updates the ‘poverty lines’ according to relevant price indices.
The planning commission identified the expenditure group from the NSSO consumer expenditure data,
whose expenditure on food fulfilled the calorie norms. The average per capita per month expenditure of
this group was fixed as the ‘poverty line’. The calorie norms for rural India, was 2400 Kcal per capita per
diem and for urban India it was 2100 Kcal per capita per diem.”
Gross Domestic Product/ Capita: The average per capita market value of the sum of gross values added
of all resident institutional units engaged in production, for a given national economy, at a given period in
time, usually a year. The Gross Domestic Product (GDP) at market prices is the sum of gross value added
by all resident producers in the economy plus any taxes and minus any subsidies that are not included in
the valuation of output. GDP measures the total output of goods and services for final use occurring
within the domestic territory of a given country. It provides an aggregate measure of production.
Annual GDP Growth Rate: The annual average rate of change of the gross domestic product (GDP) at
market prices based on constant local currency, for a given national economy, during a specified period of
time. It expresses the difference between GDP values from one period to the next as a proportion of the
GDP from the earlier period, usually multiplied by 100.
Gross National Product (GNP): The sum of gross value added by all resident producers, plus any taxes
(less subsidies) that are not included in the valuation of output, plus net receipts of primary income
(employee compensation and property income) from nonresident sources, divided by the mid-year
population.
Employment: Any type of work performed or services rendered in exchange for compensation.
Compensation may include money (cash) or the equivalent in fees, books, supplies, room, or for any
other benefit.
Household: A group of persons normally living together and taking food from a common kitchen
constituted a household. The members of a household might or might not be related by blood to one
another.
House: Every structure, tent, shelter, etc. was considered as a house irrespective of its use. It might be
used for residential or non-residential purposes or both or might even be vacant.
Communicable diseases: An illness due to a specific infectious agent or its toxic products capable of
72
being directly or indirectly transmitted from man to man , animal to animal or from the environment(
through air, dust, soil, water, food etc) to man or animal.
Mortality Rate from Communicable Diseases: The total number of deaths from communicable
diseases in a population of a given sex divided by the corresponding total number of this population, after
removing the effect of differences in the age distribution, expressed per 100,000 population for a given
year.
Non-communicable Diseases: Diseases that cannot be directly transmitted from man to man, animal to
animal or from the environment (through air, dust, soil, water, food etc) to man or animal are deemed as
non communicable diseases.
Mortality Rate from Non-communicable Diseases: The total number of deaths from non-
communicable diseases in a population of a given sex divided by the corresponding total number of this
population, after removing the effect of differences in the age distribution, expressed per 100,000
population for a given year, in a given country, territory, or geographic area.
Accidental Deaths: The total number of deaths from accidents in a population of a given sex and age,
divided by the total number of this population, expressed per 100000 population, for a given year, in a
given country, territory, or geographical area.
Infanticide: Putting to the death to a newborn with the consent of the parent, family, or community.
Foeticide: Induced termination of a pregnancy with destruction of the fetus or embryo; therapeutic
abortion.
Maternal and Child Health: The term maternal and child health refers to the promotive, preventive,
curative & rehabilitative health care for mother and children which includes the sub areas of maternal
health, child health, family planning and health aspects of care of children.
Family Planning: Family planning refers to practices that help individuals or couples to attain certain
objectives:
o to avoid unwanted births
o to bring about wanted births
o to regulate the intervals between pregnancies
o to control the time at which births occur in relation to the ages of the parent
o to determine the number of children in the family.
ANC (ante natal care): It is the care of the woman during pregnancy, aim of which is to achieve at the
end of a pregnancy a healthy mother and a healthy baby. Minimum ante-natal care includes at least three
antenatal checkups, TT immunization and IFA supplement.
Proportion of Deliveries attended by Trained Personnel: The number of deliveries assisted by trained
personnel in a specific year, regardless of their site of occurrence, expressed as a percentage of the total
number of births in that same year.Trained personnel include medical doctors, certified nurses and
midwifes; not included are traditional birth attendants, trained or not.
Prevalence: The number of events, e.g., instances of a given disease or other condition, in a given
population at a designated time; sometimes used to mean “prevalence rate”. When used without
qualification, the term usually refers to the situation at a specified point in time (point
prevalence).Prevalence rate (ratio) is the total number of all individuals who have an attribute or disease
at a particular time (or during a particular period) divided by the population at risk of having the attribute
or disease at this point in time or midway through the period.
Percentage of Contraceptive Users: Percentage of eligible couples effectively protected against
childbirth by one or the other approved methods of family planning, viz sterlization, IUD (intra-uterine
devices), condom or oral pills.
Contraceptive Methods: Preventive methods that help women to avoid unwanted pregnancies. Which
73
include all temporary and permanent measures to prevent pregnancy resulting from coitus
Percentage of Infants Immunized: The percentage of infants reaching their first birthday that have been
immunized against each of the six EPI-target diseases (diphtheria, pertussis, tetanus, polio, measles and
tuberculosis). The denominator used in the calculation is the number of infants surviving to age one.
One-year-olds immunized against measles: Percentage of 1-year-olds who have received one dose of
measles.
Malnutrition: Malnutrition is a general term for the medical condition in a person caused by an
unbalanced diet-either too little or too much food, or a diet missing one or more important nutrients. Most
commonly, malnourished people either do not have enough calories in their diet, or are eating a diet that
lacks protein, vitamins, or trace minerals.
Calorie: A calorie is a unit of measurement for energy. In most fields, it has been replaced by the joule,
the SI unit of energy. However, it is used for the amount of energy obtained from food.
Daily Calorie Requirement Per Capita: The average number of calories needed to sustain a person at
normal levels of activity and health, taking into account the distribution of the population by age, sex,
body weight and environmental temperature.
Low Birth Weight: Birth weight less than 2500 grams (up to and including 2499 grams)
Health expenditures: Health expenditure covers the provision of preventive and curative health services,
public health affairs and services, health applied research, and medical supply and delivery systems, but it
does not include provision of water and sanitation
Annual national health expenditure as a proportion of the GDP: The value of the sum of public and
private expenditures on health care goods and services for a given national economy, at a given period in
time, usually a year, expressed as a percentage of the corresponding gross domestic product (GDP).
Physicians Ratio: The average number of physicians available per every 10,000 inhabitants in a
population, at a given year.
Dentists Ratio: The average number of dentists available per every 10,000 inhabitants in a population, at
a given year.
Population Nurses Ratio: The average number of certified nurses available per every 10,000 inhabitants
in a population, at a given year. Certified nurses not include auxiliary and unlicensed personnel.
Pharmacists Ratio: The average number of pharmacists available per every 10,000 inhabitants in a
population, at a given year.
Primary Health Care: Essential health care that is technically valid, economically feasible and socially
acceptable. Primary health care includes eight essential elements: education concerning prevailing health
problems and the methods of preventing and controlling them; promotion of food supply and proper
nutrition; an adequate supply of safe water and basic sanitation; maternal and child health care, including
family planning; immunization against the major infectious diseases; prevention and control of locally
endemic diseases; appropriate treatment of common diseases and injuries; and provision of essential
drugs.
74

Health Review 07-08

Caricato da

Informazioni sul documento

Descrizione originale:

Copyright

Formati disponibili

Condividi questo documento

Condividi o incorpora il documento

Opzioni di condivisione

Hai trovato utile questo documento?

Questo contenuto è inappropriato?

Copyright:

Formati disponibili

Health Review 07-08

Caricato da

Copyright:

Formati disponibili

HEALTH REVIEW

Vital Statistics Division

Vital Statistics Division

Gandhinagar Dr. Amarjit Singh IAS

1.1 Population Characteristics

Poulation Growth Gujarat - In l akhs

Sex Ratio Gujarat & India 1901-2001-Rural, Urban, Total

Age and Sex wise percentage distribution of Population- 2001

6.2 50-59 6.4

4.8 45-49 4.7

6.0 40-44 5.9

7.2 35-39 7.1

7.6 30-34 8.1

8.3 25-29 8.4

9.6 20-24 9.5

10.5 15-19 10.0

11.4 10-14 10.9

11.4 5-9 11.0

10.6 0-4 10.2

Per Capita Net State Domestic Product (NSDP) [in Rs.]

Population 2001 Urban Decennial Sex Ratio

27.5 CBR CDR NGR

Decrease in CBR- Major States

Percent Decrease in CBR between 1994-96 and 2004-06

Life expectancy at birth

Fertility by age of Women

Age 2001 2006 % change

% change in TFR between 1994-96 and 2004-06

1.0 1.3 1.3

Crude Death Rate

17.6 Crude Death Rate (Rural, Urban and Combined - Gujarat

16.4 15.8 Combined Rural Urban

2001 2002 2003 2004 2005 2006

Early NNMR Late NNMR Post NNMR

Medical Attention before Death

Unmet need for FP - India and Selected States - NFHS

6a Two sons 88.1 89.5 94.8 93.3 96

4 Institutional births (%)1 36.8 46.3 54.6 78 42.2

(d) Child Feeding Practices and Nutritional Status of Children

5.0 5.8 5.6

2002-03 5.22 8.11

2003-04 4.97 7.81

2004-05 5.17 7.93 5.50

Maternal Health Care

Performance (% age against expected)

HFHS-3( 2005-06) 42.2 50

Mamta Abhiyan (Movement towards Healthy Mothers and Children)

Mamta Divas Outreach Performance : 2007-2008

Infant Immunisation Status In Gujarat- NFHS

Strategies for improving immunization Coverage in Gujarat

Annualized New Smear 3 months conversion rate Cure rate of

Achievement of Cataract Operation

No. of Out Breaks of Enteric Fever

Malaria Situation in Gujarat 1962 to 2007 % age of

Prevention and Control of Dengue

Year Heart Kidney Cancer

level of Civil Registration against expected 97.8

National Aids Control Programme

108 Emergency Ambulance Services

Quality Assurance in Health Services Delivery

No. of users 9000+

Table : 3.3 Annual Status of

Health Infrastructure is an important indicator to understand the healthcare delivery