For further information, please contact:

Additional Director General (Stat.) Ministry of Health and Family Welfare Government of India Nirman Bhavan New Delhi - 110 011 Telephone: 011-23061334 Fax: 011-23061334 E-mail: adg-mohfw@nic.in Chief Director (Stat.) Ministry of Health and Family Welfare Government of India Nirman Bhavan New Delhi - 110 011 Telephone: 011-23062699 Fax: 011-23062699 E-mail: cdstat@nic.in Director/ Project Coordinator (DLHS -3) International Institute for Population Sciences (IIPS) Govandi Station Road, Deonar Mumbai - 400 088 Telephone: 022- 2556 3254/5/6 Fax: 022- 2556 3257, 2555 5895 E-mail: rchpro@iips.net, director@iips.net Website: http://www.rchiips.org

Uttar Pradesh

DLHS-3 District Mirzapur The District Level Household Survey (DLHS) was initiated in 1997 with a :view to assess the utilization of services provided by government health care facilities About DLHS - 3: and peoples perception about the quality of services. The District Level Household Survey - 3 (DLHS -3) is the third in the series of district surveys, preceded by DLHS-1 in 1998-99 and DLHS-2 in 2002-04. As in DLHS-3, the International Institute for Population Sciences (IIPS) was the nodal agency to conduct DLHS-1 and DLHS-2. DLHS-3, like other two earlier rounds, is designed to provide estimates on important indicators on maternal and child health, family planning and other reproductive health services. In addition, DLHS-3 provides information on important interventions of National Rural Health Mission (NRHM). Unlike other two rounds in which all the currently married women age 15-44 years in the selected households (HHs) were interviewed, DLHS -3 interviewed all ever-married women (age 15-49) and all un-married (UM) women (age 15-24) in thethe districts in the country varies according to their The sample size among selected households (HHs).

performance in terms of ante-natal care (ANC), institutional delivery, immunization, etc. and it was fixed based on information related to such indicators from DLHS-2. For low performing districts, 1500 Households (HHs), for medium performing districts, 1200 HHs and for good performing districts, 1000 HHs were fixed as sample size. In case of Mirzapur, sample size was 1200 households with 10% additional HHs to take care of non-response/refusal, etc.

The survey used two-stage stratified random sampling in rural and three-stage stratified sampling in urban areas of each district. The information from 2001 Census was used as sampling frame for selecting primary sampling units (PSUs). In rural areas, all the villages in the district were stratified into different strata based on population /HH size, percentage of SC/ ST population, female literacy (Age 7+), etc. The required number of villages from each stratum were selected with probability proportional to size (PPS). In selected primary sampling units (villages), household listing was done and required number of For larger villages (more than 300 HHs) segmentation was carried out. In case households were selected using systematic random sampling. of 300 to 600 HHs, two segments of equal size were made and one was selected using PPS. For PSUs having more than 600 HHs, segments of 150 HHs were created depending on the size and then two segments were selected using PPS. In case of urban areas, required number of wards were selected using PPS at first stage. In a selected ward, one enumeration block from 2001 census was selected again using PPS. Procedure for segmentation and The uniform bilingual questionnaires, both inwas sameand in the case of rural household selection in a selected urban PSUs English as in local language, were used in DLHS-3 viz., Household, Ever on all the members 15-49), PSUs. household questionnaire, information Married Women (age of the In the Unmarried Women (age 15-24) and Village and Healthof the household, assets household and the socio-economic characteristics facility questionnaires. possessed, number of marriages to usual members of the household since January 2004 and deaths in the household since January 2004 etc. was collected. In case of female deaths, attempts were made to assess maternal deaths. The household questionnaire also collected information on respondents knowledge (seen/read/heard) about messages related to various government health programmes being spread through media and other sources.
1

Uttar Pradesh DLHS-3 District : Mirzapur The ever married woman's questionnaire consists of sections on woman's characteristics, maternal care, immunization and child care, contraception and fertility preferences, reproductive health including knowledge about HIV/AIDS. The unmarried woman's questionnaire contained information on her characteristics, family life education and age at marriage, reproductive health, awareness about contraception, RTI/STI and HIV / AIDS, etc.health, The village questionnaire contained information on availability of

education and other facilities in the village and whether the health For the first time, population-linked facility survey has been conducted in facilities areaaccessible throughout the year. DLHS-3. In district, all the Community Health Centres (CHCs) and the

District Hospital (DH) were covered. Further, all Sub-centres (SCs) and Primary Health Centres (PHCs), which were expected to serve the population of the selected PSUs were also covered. There were separate questionnaires for SC, PHC, CHC and DH. They broadly include questions on infrastructure, human resources, supply of drugs & instruments, and performance. Note: -2 information is based on data collected from the currently married DLHS women aged 15-44 years DLHS -3 information is based on data collected from the evermarried women aged 15-49 years DLHS-2: In total percentage is adjusted for indicators considering over sampling of urban PSUs in DLHS-2. This adjustment is done in those districts where urban percentage is less than 30. DLHS-2: Includes Tap (Inside Residency/Yard/Plot), Tap (Shared/Public), Hand pump / Bore well, Well covered. DLHS-3: Includes Pipe into Dwelling, Piped to Yard/Plot, Public Tap/Standpipe. Unmet need for spacing includes the proportion of currently married Unmet need for spacing in menopause nor had hysterectomy nor women, who are neither currently pregnant and who want more children after two years or later and are currently not using any family planning method. The women who are not sure about whether and when to have next child are also included in unmet need for spacing. Unmet need for limiting includes the proportion of currently married Unmet need for limiting women who are neither in menopause nor had hysterectomy nor currently pregnant and do not want any more children but are currently not using any family planning method. Unmet need Unmet need refers to unmet need for limiting and spacing put together. # It is adjusted according to DLHS -3 definition. Correct Knowledge of HIV/AIDS The Women, who heard about HIV/AIDS and have correct knowledge about transmission of HIV/AIDS and knowledge of prevention from HIV/AIDS.

Uttar Pradesh

DLHS-3

District :

Mirzapur

District Indicators, Mirzapur, (2001 Census).

Indicators
Population (in thousands) Decadal Growth Rate (1991-01) Sex Ratio * Percent Urban population Percent SC population Percent ST population Female Literacy Rate (7 years and above) Male Literacy Rate (7 years and above)

Census 2001
2,116 27.62 897 13.54 26.75 0.06 39.25 69.59

Sample outcome, DLHS -3, 2007-08

Category
Households Ever Married Women (15-49 years) Unmarried Women (15-24 years) Sub Centres (SCs) Primary Health Centres (P H Cs) Community Health Centres (C H Cs) District Hospital (D H)

No. covered
1,279 1,332 280 41 10 16 1

Response Rate
93.15 87.41 82.06 100.0 100.0 100.0 100.0

Population and Household Characteristics, 2007-08

Background Characteristics
Percent total literate Population (Age 7 +) Percent literate Male Population (Age 7+) Percent literate Female Population (Age 7+) Percent girls (age 6-11) attending Schools Percent boys (age 6-11) attending Schools Have Electricity connection (%) Have Access to toilet facility (%) Use piped drinking water (%) Use LPG for cooking (%) Live in a pucca house (%) Own a house (%) Have a BPL card (%) Own Agriculture Land (%) Have a television (%) Have a mobile phone (%) Have a Motorized Vehicle (%) Standard of Living Index Low (%) Medium (%) High (%) * Number of Females per 1000 Males 3 66.4 17.9 15.7 72.8 16.8 10.4 63.4 20.3 16.3 77.2 16.2 6.6

DLHS - 3 Total
66.6 78.8 54.1 98.3 98.8 49.3 22.8 7.4 10.1 22.8 98.5 34.0 64.9 34.7 29.6 17.2

DLHS - 2 Total Rural

14.8 7.8 12.7 3.2 11.8 18.8 10.9

Rural
65.2 78.0 52.4 98.5 99.2 42.6 16.1 0.0 4.6 16.8 99.1 38.7 71.5 28.7 25.4 15.1

30.0 22.4 24.1 15.3 26.1

28.7

12.3

Uttar Pradesh

DLHS-3

District :

Mirzapur

Indicators

DLHS - 3

DLHS - 2
Total
65.7 100.0 -

Marriage and Fertility, (Jan 2004 to 2007-08) Total Rural

Percentage of girl's marrying before completing 18 years Percentage of Births of Order 3 and above Sex Ratio at birth Percentage of women age 20-24 reporting birth of order 2 & above. Percentage of births to women during age 15-19 out of total births Current Use : Any Method (%) Any Modern method (%) Female Sterilization (%) Male Sterilization (%) IUD (%) Pill (%) Condom (%) Unmet Need for Family Planning: Total unmet need (%) For spacing (%) For limiting (%) 50.4 39.9 33.6 0.1 1.0 1.7 3.4 22.3 10.7 11.6 49.8 40.1 34.6 0.1 0.9 1.6 2.8 22.6 11.3 11.3 43.3 34.5 119 66.3 10.9 46.2 34.5 111 67.3 11.4

Rural
70.6 56.3 -

Family planning (currently married women, age 15-49)

38.1 33.5 26.5 0.4 1.7 1.8 2.8 30.3 13.3 17 37.1 32.0 27.8 0.2 1.3 0.5 1.9 31.0 13.9 17.1

Maternal Health:
Mothers registered in the first trimester when they were pregnant with last live birth/still birth (%) Mothers who had at least 3 AnteNatal care visits during the last pregnancy (%) Mothers who got at least one TT injection when they were pregnant with their last live birth / still birth (%) # Institutional births (%) Delivery at home assisted by a doctor/nurse /LHV/ANM(%) Mothers who received post natal carel within 48 hours of delivery of their last child (%) 19.3 18.5 18.4 16.0 20.9 16.2

62.8 25.2 19.9

59.7 23.0 18.4

50.3 20.9 11.3

46.8 14.2 8.8

29.5

27.2

Child Immunization and Vitamin A supplementation:

Children (12-23 months) fully immunized (BCG, 3 doses each of DPT, and Polio and one dose of Measles) (%) Children (12-23 months) who have received BCG (%) Children (12-23 months) who have received 3 doses of Polio Vaccine (%) 23.3 22.2 22.0 22.1

51.1 28.9

47.7 28.2

45.8 34.8

41.8 33.6

Children (12-23 months) who have received 3 doses of DPT Vaccine (%) Children (12-23 months) who have received Measles Vaccine (%)

29.6 30.9

28.5 28.7

34.6 27.9

33.6 27.0 4

Uttar Pradesh

DLHS-3

District : Mirzapur

Total Rural Total Child Immunization and Vitamin A supplementation: (Contd..)

Children (9-35 months) who have received at least one dose of Vitamin A (%) Children (above 21 months) who have received three doses of Vitamin A (%) 28.5 5.8 29.1 6.4 -

Indicators

DLHS - 3

DLHS - 2
Rural
-

Treatment of childhood diseases (children under 3 years based on last two surviving children)
Children with Diarrhoea in the last two weeks who received ORS (%) Children with Diarrhoea in the last two weeks who were given treatment (%) Children with acute respiratory infection/fever in the last two weeks who were given treatment (%) Children had check-up within 24 hours after delivery (based on last live birth)(%) Children had check-up within 10 days after delivery (based on last live birth) (%) Children breastfed within one hour of birth (%) Children (age 6 months above) exclusively breastfed (%) Children (6-24 months) who received solid or semisolid food and still being breastfed (%). 19.0 56.3 56.6 36.6 38.2 20.9 53.6 56.4 34.9 36.9 18.0 53.0 12.7 54.6 -

Child feeding practices (Children under 3 years)

12.3 4.1 77.1 11.8 4.0 77.1 -

Knowledge of HIV/AIDS and RTI/STI among Ever married Women (age 15-49)
Women heard of HIV/AIDS (%) Women who knew that consistent condom use can reduce the chances of getting HIV/AIDS (%) Women having correct knowledge of HIV/ AIDS (%) Women underwent test for detecting HIV/ AIDS (%) Women heard of RTI/STI (%) 39.1 41.7 89.2 2.5 22.0 35.4 38.3 88.7 1.9 19.1 28.5 18.1 90.1 19.6 14.3 50.1

Knowledge of HIV/AIDS among Un-married Women (age 15-24)

UM Women heard of HIV/AIDS (%) UM Women who knew that consistent condom use can reduce the chances of getting HIV/AIDS (%) UM Women having correct knowledge of HIV/ AIDS (%) UM Women underwent test for detecting HIV/ AIDS (%) UM Women heard of RTI/STI (%) 68.8 33.4 90.2 0.5 28.5 64.4 31.5 88.9 0.6 26.7 -

Women facilitated/motivated by ASHA for

Ante-natal Care (%) Delivery at Health Facility (%) 1.2 0.2 1.4 0.3 -

Use of Family Planning Methods (%)

0.9

1.0

Uttar Pradesh

DLHS-3

District : Mirzapur

Village
Indicators
Villages that have implemented Janani Suraksha Yojana (JSY) Villages with Health & Sanitation Committee Villages with Rogi Kalyan Samiti (RKS) Villages where PRI aware of untied fund by Government Health facility within village - ICDS (Anganwadi) If health facility is not in the village, whether accessible to the nearest health facility throughout the year-ICDS (Anganwadi) Health facility within village- Sub-Centre If health facility is not in the village, whether accessible to the nearest health facility throughout the year-Sub-Centre Health facility within village- PHC If health facility is not in the village, whether accessible to the nearest health facility throughout the year-PHC Health facility within village- Block PHC If health facility is not in the village, whether accessible to the nearest health facility throughout the year-Block PHC Health facility within village- Govt. Dispensary If health facility is not in the village, whether accessible to the nearest health facility throughout the year-Govt. Dispensary Health facility within village- Private Clinic If health facility is not in the village, whether accessible to the nearest health facility throughout the year-Private Clinic Health facility within village- AYUSH Health Facility If health facility is not in the village, whether accessible to the nearest health facility throughout the year-AYUSH Health Facility

Number
36 22 1 16 34 8 8 31 3 36 2 39 1 40 10 31 7 31

Facility Survey Community Health Centre (CHC) N = 16

Indicators
Infrastructure :

Number

Indicators
Performance In-patient admissions in last one month. Referred cases for serious ailments from CHC to higher centres during the last one month Deliveries performed in the last one month Blood transfusion done in the last one month Sterilization conducted in the last one month

Number

CHCs having Personal Computer

1,409

CHCs having Operation Theatre CHCs having Labour Room CHCs having Blood Storage Facility CHCs having large deep freezer CHCs prepared a CHC plan for the current year CHCs having water supply for 24 hours CHCs having Ambulance on road.

15 15 0 7 5 16 9

22 338 0 1,954

Uttar Pradesh

DLHS-3

District : Mirzapur

Facility Survey Community Health Centre (CHC) N = 16 (Contd..)

Indicators Human Resource : CHCs having General Surgeon CHCs having Obstetrician/ Gynecologist M.Os. received training of NonScalpel Vasectomy (NSV) during last five years. M.Os. received training for Prevention, Care and Support for HIV/AIDS during last five years. M.Os. received training of basic Emergency Obstetric Care during last five years. M.Os. received training of Integrated Management of Neonatal and Childhood illness during last five years. 3 3 Number Supply : CHC with 24 hours normal delivery services. CHC with 24 hours New born care CHC recognized as Integrated Counseling and Testing Centre (ICTC). 16 15 Indicators Number

Primary Health Centre (PHC) N= 10

Infrastructure : PHCs having Residential Quarter for Medical Officer 1 Performance : Haemogram tests (TLC/DLC) conducted during last one month Blood smear examinations for malaria parasite conducted during last one month In-patient admissions during last one month Referral cases for serious ailments from PHC to higher centres during last one month Deliveries performed during last one month Beneficiaries of JSY during last one month Women provided with post-natal care services during last one month New born care provided during last one month Infants and children immunized during last one month Condoms distributed during last one month PHCs prepared the PHC plan for current year 0

PHCs having separate Labour Room PHCs having Personal Computer

3 0

0 0

PHCs having Normal Delivery Kit PHCs having Large Deep Freezer PHCs having regular water supply PHCs having Neonatal Warmer (Incubator) PHCs having Operation Theater with Boyles Apparatus PHCs having Operation Theater with anaesthetic medicine

4 0 6 0 0 0

34 48 6 59 42 308 338

Uttar Pradesh

DLHS-3

District : Mirzapur

Facility Survey Primary Health Centre (PHC) N = 10 (Contd..)

Indicators
Human Resource : PHCs having Lady Medical Officer (LMO) PHCs having Laboratory Technician PHCs organized any training programme in their PHC during last year. PHCs having at least one MO ,who received Integrated Skill Development Training for 12 days during last five years. PHCs having at least one MO, who received IMNCI training during last five years. 0 1 0

Number
Supply :

Indicators
PHCs that received the untied fund in previous financial year.

Number

Sub Centre (SC) N =41

Infrastructure : Sub Centres located in government building Sub Centres having communication facility Sub Centres having separate labour room ANMs staying in Sub Centre village Sub Centres having staff quarter for ANM Sub Centres having regular water supply Human Resource : Sub Centres where Male Health Worker was in position 2 34 0 39 4 37 32 Supply : Sub-Centres having auto-disposable syringes Sub-Centres reporting IFA tablets out of stock for more than 10 days during last one month Sub-Centres reporting Vitamin A out of stock for more than 10 days during last one month Sub-Centres reporting ORS packets out of stock for more than 10 days during last one month 41 Performance : Number of Infants and children immunized 2,786

ANMs had Integrated Skill Development Training in last 5 years ANMs ever been trained in Integrated Skill Development Training ANMs trained in integrated management of neonatal and childhood Illnesses (IMNCI) in last 5 years ANMs ever been trained in integrated management of neonatal and childhood Illnesses (IMNCI) ANMs who attended Skilled birth attendant (SBA) training

17

41

30

3 8

Sub-Centres that received untied fund in previous financial year

34

Uttar Pradesh

DLHS-3

District :

Mirzapur

Performance at a Glance
Women had Minimum of Three Ante-natal Check-up by Residence Women Received Atleast One TT Injection by Residence Contraceptive Use (Any Method) by Residence 30 80 60 60 20

Percent

Percent

40

10

Percent
DLHS - 2 DLHS - 3

40

20
DLHS - 2 DLHS - 3

20

DLHS - 2

DLHS - 3

30

Total Unmet Need for Family Planning by Residence Institutional Deliveries by Residence Children (Age 12-23 Months) Received Measles Vaccine by Residence Percent of 40 40

30 20

30

Percent

Percent

Percent
DLHS - 2 DLHS - 3

20

20

10 10
DLHS - 2 DLHS - 3

10
DLHS - 2 DLHS - 3