BUS 237 †Assignment 1 MIS Article Critique Essay

Transport 237 Assignment 1: MIS Article Critique Due Date/Time: Check Canvas Assignments for the due date/time for your segment! Goal and Background: A large number of the ideas you will learn all through this course are best comprehended just as all the more fascinating in the event that you know about present and developing MIS-related news in scholarly diaries, papers, and magazines. This task will permit you to share an article of your decision from a legitimate source and study it. Key ideas include: New and current innovation; the board data frameworks; advancement; composing business investigates; breaking down media news; and business relational abilities. Headings: Locate an ongoing article (inside about a month and a half of this assignments cutoff time) from either: ï‚ · The Economist Harvard Business Review Bloomberg Business Week Wired The Globe and Mail The Financial Times New York Times itbusiness.ca Your decision of article might be commonly founded on a mechanical development or use of innovation (effective or something else), or all the more explicitly identified with one of the subjects we have talked about or will examine in class (see course plot). You should guarantee that you reference your article accurately utilizing APA referencing style, just as to reference some other sources you use. You ought to give an electronic duplicate of your picked article (PDF position required) with your accommodation. You are required to set up a most extreme two-page rundown report of this article in Microsoft Word, including a scrutinize as well as evaluation of the articles content; and unmistakably bring up how it identifies with at any rate one of the ideas from BUS 237 talks or course reading parts. A note about your report: You ought to devote close to one page to sum up the article with the rest saved for studying the article. You will be investigating the substance of the article. Try not to evaluate the composing style or language utilized in the article. Concentrate your study on the feelings and realities introduced in the article. You should introduce your conclusions upheld by outer sources, for example, scholastic distributions or reports with your study. Instances of such scrutinize incorporate concurring/contradicting the significant takeaways of the article or broadening the central matters of the article with outside exploration or individual perceptions. It is worthy to compose the evaluate utilizing the main individual view. Audit cautiously and alter your review for syntactic and spelling botches missed by MS Words auto-right component. Page 1 of 3 Transport 237 Assignment 1: MIS Article Critique Accommodation Instructions: This task is to be submitted internet, utilizing the Canvas Assignments apparatus. Connect your finished task and required supporting file(s). You will present a 3 page record including a spread page + 2 page report in MS Word. The record ought to be written in a business/proficient arrangement, efficient and simple to peruse. Findings will apply for poor arranging, spelling/linguistic mix-ups, and poor association of thoughts. In particular, you are relied upon to utilize MS Word styles, reference/reference supervisor, and spread page highlights. Allude to Lab Unit 2 notes for detail. Arrangement Requirements: It would be ideal if you utilize the accompanying text styles just: Arial, Times New Roman, Tahoma or Calibri. Try not to utilize text dimension littler than 11 pts. All page edges ought to be at any rate 2.5 cm (i.e., 1 inch or 72 pts). Twofold space section arranging is required. Just MS Word document group is acknowledged for the report every other arrangement (e.g., PDF or MS Works) won't be acknowledged. This is essential to maintain a strategic distance from show irregularities prompting pointless evaluating punishments. The spread page (this page doesn't tally toward your report page limit) ought to obviously show the accompanying data: your name, understudy number, TAs name, and course/instructional exercise segment number. Submit through Canvas Assignments apparatus the accompanying two documents: 1) MS Word Report comprising of your spread page + 2 pages of report content (3 pages altogether) 2) PDF Copy of Article you chose for this task (your task can't be evaluated without article!) Checking Criteria: Assignments are center segments of BUS 237. See the task reviewing key on the last page for the assessment models used to review this task. Literary theft: Students are required to work freely on this task; consequently, a greatest grade of zero (0) will be given to understudies whose entries recommend that they teamed up with others on their assignments. This applies to the first creator of the work, just as to those whose entries look like it! Late entries will be punished at the pace of - 10 for 1 day, - 50 for 2 days, - 90 for 3 days! Missing assignments will bring about a N (not complete) grade for this course!!! This naturally turns into a Failed (F) toward the finish of the semester, if the prerequisites (i.e., presenting the task) are not fulfilled. Contact your TA quickly in the event that you are having any issues with the Canvas accommodation process! Page 2 of 3 Transport 237 Assignment 1: Grading Key Surpasses Expectations (20) Article straightforwardly identified with thoughts in course, and from reputable source Meets Expectations (15) Article in a roundabout way identified with ideas in course, and from reputable source Approaches Expectations (10) Article in a roundabout way related to ideas in course, and not from reputable source Bombs Expectations (5) Article doesn't identify with thoughts in course, as well as isn't from reputable source Structure Association appropriate, appropriate length, good presentation Association alright, reasonable length, sensible introduction A few issues with organization, length, or presentation Wrong organization, length or introduction Content & Tone Presents investigate and examination of key thoughts; Appropriate tone established and maintained throughout report in a business professional style A few issues with presentation of investigate and appraisal of key thoughts; Fitting tone built up but not looked after reliably Poor exertion to investigate and appraise key thoughts; Proper tone neither established nor maintained consistently No push to scrutinize and appraise key thoughts; Inappropriate tone used

Principles of Modern Finance Sample Midterm

What the end of the semester does to Conner 2

What the end of the semester does to Conner 2 Hello readers. Happy Holidays to everyone! The term is over and Im happy to be getting lots and lots of sleep in my FULL SIZE (!) bed at home. Almost all of my grades are in and Im also happy to report that I did much better this semester than last (*grin*), so thats a nice feeling. All thats left from last semester is a bunch of pictures that Im about to share. I walked out of my room one day to discover a huge mess. Well, it may have taken a while for the mess to present itself (perspective and all that). But it had finally reached the point where it was worth documenting, so I took a bunch of pictures. And now Im able to show you just what finals week did to the 213 suite. First of all, everyone is always eating and never doing dishes, so the sink looks like that. Second of all, peopleapparently dont have big enough desks, so they spread their study materials all over the counters, like so. Also, since our walls are not made of dry-erase boards, they improvise. This is the wall of 5.12 (organic chemistry) study material, I believe. (Im not a chem person, dont ask me.) And we clearly dont have enough counter space But who wants to talk about how crazy everyone was studying for finals? Theyre over! Lets talk about the good stuff. Right between the end of classes and finals week (known as reading period, which is when were given a couple of days off to study, which we really spend shopping and catching up on sleep, which are both valid uses of our newfound free time, in my humble opinion), is the annual Conner 2 non-denominational politically correct winter festivities dinner, which is so named really just for the fun of it, since it comes complete with its very own Secret Santa tradition that no one ever complains is politically incorrect. Go figure. Please enjoy the following pictures of Conner 2 residents (in varying states of formal attire) enjoying the non-denominational festivities: Chris (our GRT) and David. Rick and Zach. A week before this picture was taken, some people were handing stuff out in front of Building 7 (the main entrance to main campus). This isnt really unusual, and it comes with varying degrees of annoyance. Protesters and activists hand out pamphlets and chant slogans, and sometimes I find myself able to forgive them for what I think are ridiculous opinions based on the cleverness of their slogans. Anyway, on this particular day I was handed one sticker, no strings attached (not even a website to visit, the one time I actually wanted more information) by a guy who explained that they were trying to get people to think about and get involved in public issues. The sticker said My government is a                  , which totally cracked me up. I really thought this was hilarious. Rick was also handed one of these, which he saved in case he ever needed it. Well, he scratched out the a, filled in the blank, and gave it to Adelaide as part of her Secret Santa gift. Anyway, all of that is a really long way of getting to the point, which is that Adelaide is wearing a sticker that says My government is Stephen Harper, because Adelaide is our resident Canadian. Ha. Mason is clearly the only one who has any idea Im taking this picture. Rick is wearing a cheese head, because hes from Wisconsin. I guess. I dont know, I just post pictures on the Internet, ok? Apparently Conner 2 is really into making its residents into caricatures based on their home towns/cities/nations. (Diana and are the resident New Jerseyans and often get asked such things as So when you go home for semester breaks, is it really like that movie Garden State?) I was debating if I wanted to get dressed up or not, and finally gave in to the temptation because Javier wanted to know what I actually looked like when I was dressed up. Adelaide took this picture, and I kind of think she should title it Girl with Fork because that would be both accurate and artistic, and how often do those two coincide? Seriously. Conner 2 has an additional tradition related to our Secret Santa exchange- instead of just writing the recipients name on the gift (how boring would that be!) we instead attach a poem about them. The fun starts when one person who is elected to begin the exchange picks a gift at random, reads the poem, and then everyone else figures out who the poem refers to. As you can imagine, these poems can getcreative? Amusing? Inappropriate for reposting on the Internet? All of the above? ;-) As for the poems, limericks are a popular choice, although this year even included a real-life honest-to-goodness sonnet. No joke. We take our Secret Santa seriously here on Conner 2. For example, Ricks gift was actually 5 or 6 separate items, separately wrapped. After the barbecue chips and wooden dowel, we were all really, really confused, until he finally unwrapped the stuffed penguin. Apparently theres some inside joke that I totally missed (which sadly ruined my full enjoyment of this moment of unveiling) about Rick wanting to know if rotisserie penguin are kosher. Dont ask me, I wasnt there, and I mean it when I say I really have no idea. In another example of Secret Santa hardcoreness, my gift was wrapped in duct tape (to which someone joked how are you going to open it??), a reference to my duct tape fashion constructions for the Anything But Clothes Party. (Seriously, once you post pictures of yourself wearing nothing but duct tape on the Internet, you can NEVER GO BACK. Just remember that. Forget everything I ever told you about college apps- thats my biggest piece of advice). My poem even started In case the packaging didnt give it away Thanks to Adelaide for some of the pictures! Happy Holidays, everyone! What are you guys doing for New Years? (No pressure, Im probably going to invite a friend to sleep over and stay up all night with my sister watching Season 2 of Veronica Mars on DVD, which I just got for Christmas.) Responses to Comments: Anonymous asked: What classes do freshmen take? Although there is a certain amount of freedom, freshmen usually try to knock off as many of the GIRs as they can. (GIRs are General Institute Requirements, which are core classes that everyone needs to graduate.) Its possible to branch out and start with some other subjects, but that can be hard to do first semester since even a lot of the introductory classes within the majors have GIR pre-requisites. The basic track goes like this: Fall semester: 18.01 (Calculus) 8.01 (Mechanics) 3.091 or 5.111 or 5.112 (different flavors of intro chemistry) ??.??? Humanities class of your choice- its best to pick one that has a HASS-D (distribution requirement) and/or CI-H (communications intensive) label, since these are part of the needlessly complex (in my opinion) Humanities requirement Spring semester: 18.02 (Multi-variable calculus) 8.02 (Electricity and Magnetism) 7.013 or 7.014 (different flavors of intro bio- another flavor offered in the fall as 7.012) ??.??? Another humanites class of your choice- again, HASS-Ds and CI-Hs are useful, but by this point youll have a better grasp of the requirements, which will make it easier to know what you should take Depending on what classes you pass out of with AP credit or advanced standing exams, this schedule can look a lot different. This is just one option for a student that didnt test out of anything. If you get credit for 18.01, you could obviously start at 18.02 in the fall. Or you could take chemistry and bio in the fall and wait until the spring for 18.02. Orwell, you get the idea, there are lots of combinations available. The vast majority of freshmen take some calculus, some physics, and some chemistry first semester. And not that many take biology- its an intro class, but since most majors dont require it as a prereq, its certainly not uncommon to see seniors in 7.012, scrambling to fulfill the requirement for graduation. =) Another common freshmen class is 18.03 (differential equations). 18.03 is not a GIR, strictly speaking, but it can satisfy one of the REST elective requirements (restricted electives in science and technologyeven though its a math classgo figure) and its required for some of the more common majors (Courses 2 and 6- mechanical engineering and EECS, respectively- spring to mind). Also, a good portion of freshmen who test out of the intro classes (common ones to skip are 18.01, 18.02, and 8.01) will take an intro class in their major during the spring semester- like 2.001, 6.001, etc. While this can be a great way to get your feet wet in a subject youre not sure you want to major in, its important to remember that its not remotely necessary- if you come into MIT with no AP/transfer/advanced standing credit whatsoever, you can still graduate on time, take a bunch of cool classes, and be sure you wont be made fun of or anything. By sophomore year, most students will be in a similar place and no one will know/remember/care if you tested out of 18.01 or not. Post Tagged #Burton-Conner House

Italian Verbs Mostrare Conjugations

Who Else Wants to Learn About Good Argumentative Essay Topics about School?

Who Else Wants to Learn About Good Argumentative Essay Topics about School? The above-mentioned topic selection may give you a crystal clear comprehension of what things to write about. The important thing is to locate a very good topic to write about. The topic has to be interesting, the topic has to be essential and finally the topic has to be informative. Learn which of the topics, you presently have a fairly good background on which will make it possible for you to have a relative edge. In choosing your topic, it's frequently a good notion to start out with a subject which you already have some familiarity with. Unique-make the topic so distinctive and captivating that an individual reading the title would want to go through the whole paper. Actually, you can make up any topic you want all on your own, as long because there is unlimited amount of those. When you are requested to pick a great topic for your argument, start with something you're familiarized with. Introducing Good Argumentative Essay Topics about School The thesis gives you a guideline on how best to go about with writing the essay. Writing a thesis is actually quite simple if you follow a fundamental formula. Researching the topic will permit you to find out more about what fascinates you, and should you pick something you really like, writing the essay will be more enjoyable. Argumentative essay topics are so important since they are debatableand it's essential to at all times be critically c ontemplating the world around us. The trick to the top quality essay writing is, obviously, TIME! It's important to select debatable argumentative essay topics since you need opposing points you can counter to your own points. When you finish your research notes you can begin writing with confidence that you have all of the pieces you have to create a fantastic essay. To compose a strong argumentative essay, students should start by familiarizing themselves with a number of the common, and frequently conflicting, positions on the research topic so they can write an educated paper. In this kind of situation, it's more convenient to locate ready-made essays and use them as an example. You may continue to keep your argumentative essays for your upcoming job portfolio in case they're highly graded. You don't need to acquire super technical with legal argumentative essays, but make certain to do your homework on what the recent laws about your preferred topic actually say. Before you commence writing an argumentative essay, you're supposed to conduct a comprehensive research that will make it possible for you to prove that it is possible to think in a crucial way on the subject you're assigned with. Where to Find Good Argumentative Essay Topics about School Whatever the topic that you're exploring in your argumentative essay, following principles of the structure needs to be maintained to have a decent level. Always keep in mind that you're not just arguing about your stand but in addition counter the potential stand of the opposing standpoint. Prior exposure or knowledge about a specific subject provides better hindsight that may bring much better arguments on the issue. Even if you think in a specific argument very strongly, if you lack the evidence to show your point, then your argument might just be as great as lost. It is preferable to grow up in a family with plenty of brothers and sisters. There's no problem in discussing sex now, but there's hardly anyone who can speak about cheating with no embarrassment. Moreover, at a young age, twins need each other since they give each other a feeling of support and security. The twins become married and become involved with their very own new families. By way of example, in college, you might be requested to compose a paper from the opposing viewpoint. Lastly, the original article argued that kids in high-risk areas don't have enough time to cope with personal finance in school since they're only trying to survive. Even when you ultimately decide it isn't for you, you will find o ut more about what a terrific school board can do in order to improve high schools and get ideas for how you're able to contribute. English language classes usually take a lot of writing. The Bizarre Secret of Good Argumentative Essay Topics about School You may also get several discounts on our site which will help you to save some more money for future orders or anything you want to spend them on. Innovations in businesses should be cautiously thought out since they don't only make positive alterations but also carry a wide selection of risks. Droz If the money doesn't serve you, it is going to rule over you. Very good news is that we've got a solution.

Generational Wealth and Economics Analysis Free Essays

Today African American communities are falling apart tremendously. Crime is rising; children are killing more than they are working. Economics are lowering; people tend to spend their money in other communities where businesses look more professional than that of their own, and families are fighting over material things that do not have value or meaning. We will write a custom essay sample on Generational Wealth and Economics: Analysis or any similar topic only for you Order Now There is also a rise in welfare, section eight housing, abortion, credit card and calling card charges, and layaway spending that keeps an individual in bondage; bondage of his mind. I would like to suggest that there is a lack of generational wealth in the African-American community. The lack of generational wealth is a direct result of our knowledge of economics and understanding economics. In order to understand the two, generational wealth and economics, you first have to go back to the beginning of time when God created the man and woman (Adam and Eve) and gave them their job description. In the book of Genesis the first chapter and the 28th verse, God said, â€Å"Be fruitful and multiply; fill the earth and subdue it; have dominion over the fish of the sea, over the birds of the air, and over every living thing that moves on the earth. And God also said, â€Å"See, I have given you every herb that yields seed which is on the face of all the earth, and every tree whose fruit yields seed; to you it shall be for food† (Question about Quoting Bible). At this time God gave a charge to Adam and Eve giving them dominion. They were producers of the world. But when they decided to mess up in the garden by eating the forbidden fruit, they went from being producers into being consumers. This is one of the problems today in the black community. Out of a lack of understanding of who we are and what our purpose is, we consume all things of others but rarely move into the understanding of producing our own. In this light, increasing the number of blacks in ownership positions appears to be an important prerequisite for ending black community unrest (McKersie pg 84). If blacks are upset because they lack control over the institutions of their community, because they are charged high prices for inferior merchandise, victimized by credit racketeers, and exploited by employers, then perhaps some would argue, greater black ownership will help end this condition. If the black community lacks leadership and a stable middle class, then enlarging the number of black entrepreneurs may provide such leadership and foster stability. If the problem is lack of racial confidence, the success of black capitalists would build pride. Today in the black community, crime is rising; children are killing children and spending more money in the communities than their parents. There is an increasing number of males killing for what they think are respect. There is also a mindset on children that, it is better to kill, steal, and destroy, to get what is gratifying to self. Children have become lazy. They have depended on the former generations to get things done rather than them. Today also, there is an increased number of welfare, section 8 housing, and abortion participants, which are considered to be popular in the community. This is nothing but bondage. Society has a way of keeping people focused on minor issues and making them think that they are major. Welfare is not a major problem but rather one that is minor. The major problem today, which has always been a problem, is economics. Economics is a problem because many African Americans don†t know what economics are and how to manage it. Out of one†s lack of understanding the economical breakdown of society, he cannot teach his child about generational wealth. Generational wealth is what a family has accumulated over its lifetime along with those resources that have been inherited across generations. Generational wealth is not riches. When one is rich, they are materially content for the moment but not necessarily content in their private lives. One who is just rich, will become a private failure but public success. In essence, riches are the successes of the world. On the other hand, wealth is generated through the family unit and is passed down generationally. In Proverbs 13:22, it reads, a good man leaves an inheritance to his children†s children. In order for one to truly understand generational wealth, he must first understand economics and vice versa. Economics is the study of heart and wallet. Meaning, if you want to touch people, you have to reach them in their pockets. Matthew 6:21 states, â€Å"For where your treasure is, there your heart will be also. Let†s break down economics. The Greek meaning of the word echo means family. Therefore, economics is the study of the family management. This is so awesome that God decided to give us an assignment in His daily word. In Luke 19:13, God says, â€Å"do business until I return. † He didn†t just throw business in there for anything. To do business until God return means, to occupy; take dominion; handle things in decency and in order to the word of God. Sad to say, but some people only understand economics when it comes to selling drugs. Young men and even some young women understand that you can buy large quantities of drugs at wholesale and make profit by way of retail. On the other hand, if you ask them to turn the television to the stock market channel and decipher the information run on the station, they can†t even relate. So when do we come to an understanding that there is a world wide problem of the family unit that is affecting our economics? One of the major problems in the black community is that everyone is out for self. We have gained a mindset that everyone is supposed to work for his or her own stuff and keep their stuff to themselves. Out of understanding who you are, you understand that the father is the one who formulate the vision, the son is the one who demonstrates the vision, while the grandson authenticates the vision. It takes the fortitude of a father to persevere through the storm of formulation. It takes the zeal of a son to pay the cost of demonstration. It takes the integrity of a grandson to handle the glory of authentication. There are a lot of individuals who don†t understand this so, therefore they operate trying to be the father, son, and grandson. This brings about the mindset of selfish thinking and single generational. Thinking selfishly and single families operate in false wisdom. For example, when most children turn 18, they are kicked out of the house and told by their parents that they are grown enough to make it on their own, but was never equipped to pay their bills and even maintain their payments. Therefore we have a generation that had already achieved their successes, forcing our children to grow up in a fast paced society that prefers self-gratification, without restraint. The family exists at the heart of every society†¦ No society has succeeded without it. But today we see a fraying of all connections that have defined our families. We are neglecting our children emotionally and educationally, marriage is increasingly unstable, we are slipping deeper and deeper into acceptance of violence, and we are absorbed into materialism and competitiveness. If we allow these trends to continue, there lie ahead, families that slip further into chaos. As you can see, we are living in a time where there is much help needed. It is time for African-Americans to wake up and take the dominion that God has given them. It is also, time out for just talking about the decay of the community but rather offer solutions to the problems of the community. Having been empowered to understand that true wealth and economics is generated through the family unit and is passed down generationally, one has the ability to empower another so that we can move forward to begin building our communities economically, emotionally, and physically. I pray that this empowerment will not inspire one but rather, transform one to make a change for the generations to come. It†s just like Bishop says, â€Å"Lack of information is ignorance but the inability to use information is stupidity. † Therefore, those who are not prepared will not survive. How to cite Generational Wealth and Economics: Analysis, Essay examples

Parallel Arrays free essay sample

An array of structures are usually equivalent to parallel arrays of the components. For example, if each student record consists of an ID number and a GPA value, then a list of students can be represented as an array of structure: The same data can be stored as two arrays that parallel to each other, in the sense that the same index in them indicate data for the same student: Usually the first way is more natural and convenient. Advantages and disadvantages Against Arrays Compared to arrays, linked data structures allow more flexibility in organizing the data and in allocating space for it. With arrays, we must choose a size for our array once and for all; this can be a potential waste of memory. A linked Data structure is built dynamically and never needs to be bigger than the programmer requires. It also requires no guessing in terms of how much space you must allocate when using a linked data structure. We will write a custom essay sample on Parallel Arrays or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page This is a feature that is Key in saving wasted memory. The nodes of a linked data structure can also be moved individually to different locations without affecting the logical connections between them, unlike arrays. With due care, a process can add or delete nodes to one part of a data structure even while other processes are working on other parts. On the other hand, access to any particular node in a linked data structure requires following a chain of references that stored in it. If the structure has n nodes, and each node contains at most b links, there will be some nodes that cannot be reached in less than log b n steps. For many structures, some nodes may require worst case up to n -1 steps. In contrast, many array data structures allow access to any element with a constant number of operations, independent of the number of entries. General Disadvantages Linked data structures also may also incur in substantial memory allocation overhead (if nodes are allocated individually) and frustrate memory paging nd processor caching algorithms (since they generally have poor locality of reference). In some cases, linked data structures may also use more memory (for the link fields) than competing array structures. This is because linked data structures are not contiguous. Instances of data can be found all over in memory, unlike arrays. In some theoretical models of computation that enforce the constraints of linked structures, such as the pointer machine, many prob lems require more steps than in the unconstrained random access machine model.

The Value of Knowledge Essays - British Films, Cold War Films

The Value of Knowledge Essays - British Films, Cold War Films Manroop Bhogal ENG4U0-I Mr. Gellert March 4, 2016 The Value of Knowledge Knowledge is an important element in life that shapes the way a person sees the world. Although knowledge is not something that can be seen, it holds tremendous value to those who are capable of having it. In George Orwells Animal Farm, the downfall of the farm is caused by the unequal possession of knowledge amongst the animals. This possession of knowledge goes hand-in-hand with those who control leadership and power, life and death, and manipulation. The pigs achieve their superiority and power through their academic abilities. Due to the pigs already having more knowledge than the rest of the animals in the beginning of the novel, they automatically take their positions as the leaders of the Animal Farm, The pigs [do] not actually work, but [direct] and [supervise] the others. With their superior knowledge, it was natural that they should assume the leadership (Orwell 11). In turn, their positions as higher authorities allow them to gain access to Mr. Jones farmhouse, using his childrens old spelling book to teach themselves how to read and write. Having gained these skills, and examined the concepts of economics, Napoleon suggests that they engage in trade with the neighbouring farms in order to obtain certain materials which were urgently necessary, mainly rations. Napoleons knowledge of the trades gives him the ability to order Mr. Whymper to acquire rations for the animals and continue to report that there was no food sho rtage on the farm. Thus, with having no other contact with humans while allowing rations into the farm, as well as implying to the outside world that there is no food shortage, Napoleon has demonstrated to both the parties, that he is capable of running the animal farm without any humans, justifying his position as a powerful leader. This, in turn, begins the downfall of the Animal Farm. The other animals on the farm, however, due to their lack of intelligence, have only been led to their downfall. Many are unable to completely learn the alphabet while others do not feel the need to learn to read or write at all, Clover learnt the whole alphabet, but could not put words together. Boxer could not get beyond the letter DNone of the other animals on the farm could get further than the letter A (Orwell 13). The sheep, hens, and ducks, were unable to learn the Seven Commandments by heart. Their inability to effectively read or write stops them from averting Boxers murder, when they cannot read the sign on the van that takes him away (save Benjamin): Fools! Fools! shouted Benjamin, prancing round them and stamping the earth with his small hoofs. Fools! Do you not see what is written on the side of that van?Horse Slaughterer and Glue Boiler Do you not understand what that means? They are taking Boxer to the knackers (Orwell 47). A spark of realization has occurred, and the animals soon understand the importance of being able to read and write. As they watch their fellow comrade being driven towards his death, their guilt has consumed them, for it is their illiteracy which has caused the incident. Had the pigs taught the animals how read or write with ease, or had the animals taken the effort to learn to do so, Boxer would have been spared from this terrible incident. Through their extensive knowledge of reading and writing English, the pigs are able to easily manipulate the other animals minds through the changes made to the Seven Commandments. Squealer manipulates the minds of the animals by using a method called gas-lighting, a form of mental abuse in which information is twisted or spun with the intent of making victims doubt their own memory. When the changes made to the Seven Commandments are questioned, Squealer simply replies that there was no such thing written, questioning their memory, completely aware of their inability to read the Seven Commandments in the first place: Squealer [asks] them shrewdly, Are you certain that this is not something that you have dreamed, comrades? Have you any record of such a resolution? Is it written down anywhere? And since it was certainly true that nothing of the kind existed

Geography Facts of the United States

Geography Facts of the United States The United States of America is one of the largest countries in the world based on both population and land area. It has a relatively short history compared to other world nations, has one of the worlds largest economies, and one of the worlds most diverse populations. As such, the United States is highly influential internationally. Ten Unusual and Interesting Facts to Know About the  US The United States is divided into 50 states. However, state each varies in size considerably. The smallest state is Rhode Island with an area of just 1,545 square miles (4,002 sq km). By contrast, the largest state by area is Alaska with 663,268 square miles (1,717,854 sq km).Alaska has the longest coastline in the United States at 6,640 miles (10,686 km).Bristlecone pine trees, believed to be some of the worlds oldest living things, are found in the western United States in California, Utah, Nevada, Colorado, New Mexico and Arizona. The oldest of these trees is in California. The oldest living tree itself is found in Sweden.The only royal palace used by a monarch in the U.S. is located in Honolulu, Hawaii. It is the Iolani Palace and belonged to the monarchs King Kalakaua and Queen Liliuokalani until the monarchy was overthrown in 1893. The building then served as the capitol building until Hawaii became a state in 1959. Today the Iolani Palace is a museum.Because the major mountain ranges in the United States run in a north-south direction, they have a large impact on the climate of the countrys various regions. The west coast, for example, has a milder climate than the interior because is moderated by its proximity to the ocean, whereas places like Arizona and Nevada are very hot and dry because they are on the leeward side of mountain ranges. Although English is the most commonly spoken language used in the U.S. and is the language used in government, the country has no official language.The tallest mountain in the world is located in the United States Mauna Kea, located in Hawaii, is only 13,796 feet (4,205 m) in altitude above sea level, however, when measured from the seafloor it is over 32,000 feet (10,000 meters) high, making it taller than Mount Everest (Earths tallest mountain above sea level at 29,028 feet or 8,848 meters).The lowest temperature ever recorded in the United States was at Prospect Creek, Alaska on January 23, 1971. The temperature was -80 °F (-62 °C). The coldest temperature in the contiguous 48 states was at Rogers Pass, Montana on January 20, 1954. The temperature there was -70 °F (-56 °C).The hottest temperature recorded in the United States (and in North America) was in Death Valley, California on July 10, 1913. The temperature measured 134 °F (56 °C).The deepest lake in the U.S. is Crater Lake located in Oregon. At 1,932 feet (589 m) it is the worlds seventh deepest lake. Crater Lake was formed via snowmelt and precipitation that gathered in a crater created when an ancient volcano, Mount Mazama, erupted about 8,000 years ago. Sources Genzmer, Herbert, and Christian Schà ¼tz. (2008). Questions and Answers: Countries and Continents. Paragon Publishing: Bath, United Kingdom.Geology.com. (n.d.). Highest Mountain in the World - Tallest Mountain Geology.com. Retrieved from: https://geology.com/records/highest-mountain-in-the-world.shtmlInfoplease. (n.d.). Fifty States and Fifty Fun Facts - Infoplease.com. Retrieved from: infoplease.com/ipa/A0770175.htmlInfoplease. (n.d.). The World and U.S. Extremes of Climate - Infoplease.com. Retrieved from: infoplease.com/ipa/A0001382.html

Reply to Sor Filotea de la Cruz Essay Example | Topics and Well Written Essays - 750 words

Reply to Sor Filotea de la Cruz - Essay Example The letter highlights the efforts this lady has taken to gain knowledge in order to alleviate ignorance. It campaigns for equality in opportunities to both men and women by women rising to their feet and grabbing chances of obtaining erudition. Women lack competence because of deficient of education. In the most important parts of the letter, the nun talks about stereotyping. How she fought odds and wished to be treated like a man with respect and being given equal opportunities like them. She however was respectful to orders and instructions so that her religious values cannot be eroded. It was also mandatory for a woman to be reverential and submissive to men and any one of older age. She yearned for education and dreamt of even going to the university as boys did. She abstained from certain foods for fear of being dumb as they claim they made one. She wanted an equal place as the other gender but it clearly was not possible at that time. She had a thirst for knowledge and did what she could in her capacity to learn of the most important things she felt she wanted to know about. In this letter she has claimed that the people in her relation criticized her inclination to knowledge citing that it would make her lose her religious strength and make her weak (Stephanie 45)Â  . Th is was the most difficult time for her because obviously support in any person’s Endeavour is always helpful. She loved their companionship and sometimes thought it deprived her of the chance to study. Jealousy, she learned was bound to happen towards an intelligent person especially if the person is a woman. Women are despised and their place regarded as the home only and it would be struggle if they ventured in territories where they are supposedly not to be. One particular example she has used is that of Peter who gained knowledge and was executed. The crown of thorns she has cited, after it witnessed Christ’s persecution declare that aptitude is scorned.

E-commerce Marketing Plan Essay Example | Topics and Well Written Essays - 1250 words

E-commerce Marketing Plan - Essay Example Market Summary â€Å"FISH FIELD LLC is a fishing tackle manufacturer, importer and wholesaler in Oregon.† (Fish Field, 2011) The company is a specialist in fishing equipments. Fish Field focuses more on ocean fishing though the company has significant presence in fresh water fishing too. What started as just a small company is now an established fishing equipment brand in the region. Being located in Oregon, the major market of the company is Oregon itself. But the company also has reasonable sales from other major states through its online sales of the equipments. The current customer groups of the company include both professional fishermen as well as hobbyists. But the larger portion consists of professional fishermen. The company has a huge portfolio of products that cater to the various needs of the customers. The products of the company are currently classified under categories such as fly fishing, general fishing, sea fishing, centerpin fishing and outdoor sport. The co mpany sells around sixty three products through these categories. Fish Field is planning to expand its market by targeting more customer groups. In order to increase the sales of the products, the company will have to expand to other markets outside Oregon through its online presence. ... This marketing plan is also intended to target more of students of the age group 10 – 20. This is a very lucrative market segment for the company. Competition Some of the major fishing equipment suppliers in Oregon are Anglers Manufacturing Inc, Bandon Bait & Tackle Sea Food, Caddis Fly Angling Shop, Cascade Anglers, Cascade Crest Tools, Charlton Deep Sea Charters, Dan Craft Enterprises, Englund Marine Supply Company, Fish Rite Inc Boats, and Glenn Struble MFG. Most of these players have fishing boats in their product portfolio compared to that of Fish Filed. Though Fish Field does not have boat among its product categories, the fishing equipment portfolio of Fish Field is very large than most of these players. This is where the company differentiates itself from other major players in the market. Fish Filed also differentiates from its competitors through its sophisticated online sales presence. Most of the products of Fish Field are sold through its online portal. Most of th e competitors maintain their own websites. Some of the competitors’ websites are just informative in nature. Such companies don’t sell products online. Caddis Fly, Bandon Bait, Cascade Anglers, Englund Marine and Fish Rite are the companies that just maintain informative websites. All other players listed above sells their merchandise online. If Fish Field is able to leverage more on its existing online presence, it can generate more sales than that of its competitors. Most of the competitors are not established brands in fishing equipments though there are few companies that have years of experience. Therefore, to generate better sales, Fish Field should first establish its brand name or make its brand name visible to the prospective customers. Since Fish Field

Mental Health Legislation In Uk Social Work Essay

Mental Health Legislation In Uk Social Work Essay One adult in six in the UK suffers from one or more forms of mental illness at any time. Incidence of mental ailments can as such be considered as prevalent as asthma (Ray et al, 2008, p 2 to 13). Mental ailments range from very common conditions like depression to ailments like schizophrenia, which affect less than 1% of the population. Mental ailments cost the nation approximately 77 billion GBP every year in terms of expenses on health and social care (Ray et al, 2008, p 2 to 13). Such ailments are not really well understood even today and often frighten people and stigmatise people with such ailments (Sheppard, 2002, p 779 to 797). Individuals with long term mental health issues are likely to face discrimination and social exclusion, phenomena that can lead to unemployment or underemployment, poverty, inadequate housing, social isolation and stigmatisation (Sheppard, 2002, p 779 to 797). Whilst UK society is progressively coming to terms with and accept modern day phenomena like homosexuality and same sex marriages, people continue to be very apprehensive about mental disorders and often associate such conditions with lunacy and the need for isolation and detention of people with severe and long term mental health conditions (Angermeyer Matschinger, 2003, p 304 to 309). Legislation and social policy towards mentally ill people has however evolved substantially over the course of the 20th century and more so in the last 25 years. I am placed in a residential unit that houses people that both sexes who are over 16 and have mental health issues. This assignment focuses on mental health law and policy in the UK and the various ways in which Ii am using my knowledge and understanding of these issues to inform my practice. Mental Health Legislation in UK Poor mental health continues to have substantial economic and personal impact in the UK. Stigma and discrimination increase such impacts (Angermeyer Matschinger, 2003, p 304 to 309). Social research has consistently found the presence of extremely negative attitudes towards individuals with mental health issues (Angermeyer Matschinger, 2003, p 304 to 309). There persists the view that such people represent dangers to their communities, perceptions which are also on occasion reinforced by the media. Such negative attitudes do not occur only in the media and the general public but also among mental health workers and professionals (Angermeyer Matschinger, 2003, p 304 to 309). Such elements increase social distancing, cause social exclusion and reduce the probability of such individuals to gain employment or access social and health care services (Angermeyer Matschinger, 2003, p 304 to 309). Whilst discriminatory attitudes towards the mentally ill still exists in substantial measure and adversely affect the life chances and social exclusion of such people, it also needs to be recognised that substantial progress has been made over the course of the 20th century and especially in the last 25 years to improve the physical, mental, economic and social conditions of such people (Mind.Org, 2010, p 1). Such changes have basically been brought about through changes in legislation and in social policy (Mind.Org, 2010, p 1). People with mental illnesses have traditionally been perceived negatively by society, with attitudes towards them varying from being harmless nuisances to violence prone and dangerous individuals (Mind.Org, 2010, p 1). Families with members with mental illnesses have often tried to hide such conditions for fear of social stigmatisation and the state, right until the end of the 19th century, was comfortable with locking such people up in lunatic asylums (Mind.Org, 2010, p 1). The Madhouse Act 1774 led to the creation of a commission with authority to give licences to premises for accommodating lunatics (Mind.Org, 2010, p 1). Succeeding legislation gave mental hospitals the authority to detain people with mental ailments (Mind.Org, 2010, p 1). The Lunacy Act 1890 was repealed with the passing of the Mental Health Act 1959. The Mental Health Act 1959 strengthened the Mental Treatment Act 1930 and allowed most psychiatric admissions to happen on a voluntary basis (Mind.Org, 2010, p 1). The Act aimed at providing informal treatment for most individuals with mental ailments, even as it created a legal framework for detention of certain people (Mind.Org, 2010, p 1). The recommendations made in the Percy Report led to decisions on compulsory detention of mentally ill persons changing from judicial to administrative prerogatives (Mind.Org, 2010, p 1). The 1959 Act however did not clarify whether legal detention orders for people with mental disorders authorised hospitals to treat such people without their consent (Mind.Org, 2010, p 1). The passing of the Mental Health Act 1983 provided a range of safeguards for people in hospitals. The act also imposed a duty on the district health authorities and social service departments to pr ovide after care services to the people discharged from hospital (Mind.Org, 2010, p 1). The Mental Health Act 1983 covered the assessment, treatment and the rights of people with mental health conditions and specified that people could be detained only if the strict criteria specified in the act were met (Mind.Org, 2010, p 1). The Mental Health Act 2007 aimed to modernise the Mental Health Act 1983 and incorporated changes that widened the definition of mental disorder and gave greater say to patients about who their nearest relatives were (Ray et al, 2008, p 2 to 13). The act also decreased the situations where electroconvulsive therapy could be given without permission, gave detained patients rights to independent mental health advocates, gave 16 and 17 year olds rights to agree or refuse admission to hospital without such decisions being superseded by parents and introduced supervised community treatment (Ray et al, 2008, p 2 to 13). The amendment of the Mental Health Act was followed by the publication of a code of practice that provides guidance to health care professionals on the interpretation of the law on a regular basis (Ray et al, 2008, p 2 to 13). The code of practice has five important additions to guiding principles, which deal with purpose, least restriction, participation, and effectiveness , efficiency and equity (Ray et al, 2008, p 2 to 13). The code importantly states that the specific needs of patients need to be recognised and patients should be involved to the greatest possible extent in the planning of their treatment (Ray et al, 2008, p 2 to 13). Whilst The Mental Health Act 1983, as amended in 2007, constitutes the most important mental health legislation in the country, the rights of people with mental health ailments is also governed by other acts like The Mental Capacity Act 2005, The Disability Discrimination Act 1995, The Health and Social Care Act 2008, The Care Standards Act 2007, The Mental Health (Patients in the Community) Act 1995, The Carers (Recognition and Services) Act 1996 and The Community Care (Direct Payment) Act 1996. All of these acts by way of certain provisions provide for the rights and entitlements of young and old individuals with mental ailments (Mind.Org, 2010, p 1). Progressive legislation in areas of mental health has been accompanied by changes in social care policy for people with such ailments (Brand et al, 2008, p 3 to 7). The beginning of social work in the area of mental health commenced with the engagement of a social worker by the Tavistock Clinic in 1920 (Brand et al, 2008, p 3 to 7). Whilst social work in the area of mental health was subdued until the 1950s, it subsequently assumed larger dimensions and led to the realisation of the utility of non medical social interventions for treatment of medical health issues (Brand et al, 2008, p 3 to 7). The publication of the Beverage Report in 1942 was instrumental in altering government policy and shifting the treatment of people with mental disorders from hospitals to the community (Brand et al, 2008, p 3 to 7). The 1950s saw the establishment of day hospitals, greater flexibility in provisioning of psychiatric services and reduction in hospital beds (Brand et al, 2008, p 3 to 7). The introduction of advanced drugs, the establishment of therapeutic bodies and development of greater outpatient services led to the decrease of numbers of psychiatric inpatients from 1955 (Brand et al, 2008, p 3 to 7). Much of such decrease was prompted by the introduction of social rehabilitation and resettlement methods, introduction of anti psychotic medication and availability of welfare benefits (Brand et al, 2008, p 3 to 7).Intensive debate and discussion in the media and among the community on the need to improve the conditions of people with mental health issues led to the introduction of specific programmes like the Care Programme Approach (CPA) in 1991 and other government initiatives (Ray et al, 2008, p 2 to 13). The guidance on Modernising Mental Health Services stressed upon the need for providing ca re at all times of the day and night and access to a comprehensive array of services (Ray et al, 2008, p 2 to 13).The introduction of the National Service Framework for Mental Health in 1999 elaborated the national standards for mental health, their objectives, how they were to be developed and delivered and the methods for measuring performance in different parts of the country (Sheppard, 2002, p 779 to 797).Social workers are now playing important roles in the treatment of people with mental health disorders and their greater inclusion in the community (Brand et al, 2008, p 3 to 7. Social work theory and practice has always espoused the use of the social model for dealing with people with mental health problems and have contributed to the development of a range of approaches that are holistic, empowering and community based in approach (Brand et al, 2008, p 3 to 7.Apart from being responsible for the introduction of numerous new person centred and community oriented approaches dea ling with mental health issues, mental health legislation, by way of The Mental Health Acts of 1983 and 2007 empowered appropriately trained social workers with a range of powers for assessment and intervention of people with mental health disorders (Ray et al, 2008, p 2 to 13). Application of Disability Knowledge in Practice Setting I am currently placed for my social work practice in a residential unit for people with mental health problems, who are furthermore homeless, more than 16 years of age, and fall under the purview of the Care Programme Approach (CPA). The CPA, which was introduced in 1991 for people with mental illnesses, requires health authorities, along with social service departments, to make specific arrangements for the care and medical treatment of people in the community with mental ailments (Care Programmeà ¢Ã¢â€š ¬Ã‚ ¦, 2010, p 1). The CPA requires that all individuals who receive treatment, care and support from mental health services should receive high quality care, which should furthermore be based upon individual assessment of their choices and needs. The needs of service users and their carers should essentially be central to delivery of services (Care Programmeà ¢Ã¢â€š ¬Ã‚ ¦, 2010, p 1). Mentally ill and homeless people are liable to pose special challenges to health and social care workers. The majority of those who suffer major mental illness live in impoverished circumstances somewhere along the continuum of poverty. Homelessness, however defined, is the extreme and most marginalised end of this continuum, and it is here that we find disproportionate numbers of the mentally ill. (Timms, 1996, P 159) It is very possible that the levels of cooperation and motivation of the mentally ill, who are also homeless, could be lesser than that of other patients (Net Industries, 2010, p 1). Whilst their limited resources often result in difficulties in their obtaining transportation to treatment centres, such people often forget to keep appointments or take their medications. Frequently unkempt in dress and appearance, their engagement in drug abuse can render them unresponsive and unruly (Net Industries, 2010, p 1). My practice setting provides specialised and supported residences for people with severe and long lasting mental health problems. Each resident has his or her own bedroom and is required to share the use of kitchens and bathrooms. Some of the residents have histories of multiple admissions in hospitals, combined with lack of compliance with medication and disengagement with services. Some of them also have histories of alcohol and substance abuse. Our organisation provides residents with a helpful and supportive environment for the carrying out of comprehensive assessment of needs (Timms, 1996, p 158 to 165). Assessments and care plans of our residents need to consider a range of requirements. These include assessing the requirements of parents with regard to physical health, housing, vocation and employment, dual diagnosis, history of abuse and violence, carers and medication (Timms, 1996, p 158 to 165). Assessment and care plans for such users need to essentially address risk management and plan for crises and contingencies (Timms, 1996, p 158 to 165). I, along with the other staff of the residential unit, work with mental health services for carrying out of detailed need assessments and for helping residents in development of independent living skills. My academic training and my knowledge of legislation and policy, whilst substantial, has not really provided me with the wherewithal to meet the practical challenges of my current position. It is still not widely recognised that social and economic disadvantages can lead to mental health problems (Timms, 1996, p 158 to 165). It is clear from my interaction with the residents that many of them come from disturbed and abused backgrounds and feel insecure about the social exclusion and stigma attached with mental ailments. They often have a multiplicity of needs that includes dual diagnosis as well as physical and mental health issues. I have to constantly refresh my knowledge of anti-oppressive and anti-discriminatory theory and ensure that personalised, cultural and socialised biases do not affect my responses towards the inmates of the residential unit and that I am able to help them with their social service needs. My work includes involvement and help in assessments, assisting residents in finding educational agencies that can help them in improving their skills and earning ability, arranging for medical appointments and counselling sessions in line with their intervention requirements, making them aware of their various social services benefits and entitlements, and helping them to access such benefits. I am aware of the need to adopt a person-centred approach, and take care to ascertain the needs of service users as also their opinions on what they feel is best for them before I make suggestions. I try to adopt a uniformly cheerful and cooperative approach that is based upon respect and helpfulness in my routine interaction with them and strive to ensure that my responses are free of condescension and patronage. I find that some members of the health and social care professions, despite such significant progress in legislation and policy, approach the mental health and other problems of our residents in traditional and bureaucratic ways, (much in the manner of Dominellis portrayal of the current state of social services), and appear to be constrained by resources as well as entrenched attitudes (Dominelli, 2004, p 18 to 95). I am doing my best to ensure that the opinions of the residents are taken into account in the satisfaction of their needs, that they are helped to overcome their mental health issues, and are made more self sufficient to look after their needs. Conclusion Significant changes have occurred in the last 40 years in the ways in which disabled people are perceived in society. Whilst many of these changes are outcomes of legislative and policy action by UK governments, the growing awareness of (a) the relevance of the social model, and (b) the fundamental flaws of the medical model, in dealing with disabled people has driven both legislative and policy changes. Social workers, with their commitment towards bringing about of social inclusion of excluded and disadvantaged segments of society, their specialised education and training, and the resources and authority at their disposal, are particularly well placed to bring about attitudinal changes among the members of health and social services, as well as among members of the community. My practice experience has convinced me that much more will have to be done in the application of legislative provisions and social policy at the ground level, especially so by the people responsible for delivery of social and health care, before the disabled can truly be integrated into mainstream society.

Family Welfare Statistics 2011

FAMILY  WELFARE  STATISTICS  Ã‚   IN  Ã‚   INDIA 2011 Statistics  Division   Ministry  of  Health  and  Family  Welfare   Government  of  IndiaAbbreviations AIDS AHS ANC ANM ANC APL ARI ASHA AWW AYUSH BCG BE BMS BPL CBR CDR CES CHC CNAA CPR CPR DLHS DPT DT EAG ECR EmOC FP FRUs HIV HMIS ICDS IDSP IDDCP IIPS IPHS IEC IFA Acquired Immunodeficiency Syndrome Annual Health Survey Antenatal Care Auxiliary Nurse Mid-wife Ante Natal Care Above Poverty Line Acute Respiratory Infection Accredited Social Health Activist Anganwadi Worker Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy Bacillus Calmette Guerin Budget Estimates Basic Minimum Services Programme Below Poverty Line Crude Birth Rate Crude Death Rate Coverage Evaluation Survey Community Health Centre Community Needs Assessment Approach Contraceptive Prevalence Rate Couples Protection Rate District Level Household Survey Diphtheria, Pertussis and Tetanus Diphtheria and Tetanus Empower ed Action Group Eligible Couple Register Emergency Obstetric Care Family Planning First Referral Units Human Immunodeficiency Virus Health Management Information Systems Integrated Child Development Services Integrated Disease Surveillance Programme Iodine Deficience Disorder Control Programme International Institute for Population Sciences Indian Public Health Standards Information, Education and Communication Iron and Folic Acid IMR IPHS IUCD IUD JSK JSY LHV MCTS M&E MIES MIS MMR MNP MoH&FW MPW-F/M MTP NACP NACO NCP NFHS NGO NLEP NIHFW NNMR NPCB NPP NPSF NRHM NSV NVBDCP NUHM Obs/gyn OP OPV ORS PC&PNDT PHC PHN PIP PMG PMUInfant Mortality Rate Indian Public Health Standards Intra Uterine Contraceptive Device Intra Uterine Device Jansankhya Sthirtha Kosh Janani Suraksha Yojana Lady Health Visitor Mother and Child Tracking System Monitoring and Evaluation Monitoring, Information & Evaluation System Management Information System Maternal Mortality Ratio Minimum Needs Programme Ministry of Health and Family Welfare Multi Purpose Worker – Female / Male Medical Termination of Pregnancy National AIDS Control Program National AIDS Control Organisation National Commission on Population National Family Health Survey Non-Governmental Organization National Leprosy Eradication Programme National Institute of Health and Family Welfare Neonatal Mortality Rate National Programme for Control of Blindness National Population Policy National Population Stabilisation Fund National Rural Health Mission No Scalpel Vasectomy National Vector Borne Disease Control Programme National Urban Health Mission Obstetrics and Gynecology Oral Pills Oral Polio Vaccine Oral Rehydration Solution Pre-conception & Pre-natal Diagnostic Techniques Primary Health Centre Public Health Nurse Programme Implementation Plan Programme Management Group Programme Management Unit PNC PPP PRCs RCH RHS RKS RGI RNTCP RTI SBA SC SC/ST SRS STDs STI TBAs TFR TT UIPPost Natal Care Public Private Partnership Po pulation Research Centres Reproductive and Child Health Rapid Household Survey Rogi Kalyan Samiti, Registrar General of India Revised National Tuberculosis Control Programme Reproductive Tract Infection Skilled Birth Attendants Sub Centre Scheduled- Caste / Scheduled- Tribe Sample Registration System Sexually Transmitted Diseases Sexually Transmitted Infections Traditional Birth Attendants Total Fertility Rate Tetanus Toxoid Universal Immunization Program CONTENTS Page No. Preface †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Abbreviations Executive Summary and overview of Family Welfare Programme in India (Hindi & English version)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. LIST OF TABLES SECTION – A Population & Vital Statistics TABLE NO. A. 1 TITLEPopulation Growth, Crude Birth Rate, Death Rate & Sex Ratio India 1901-2001 Distribution of Population, Sex Ratio, Density and Growth Rate of Population Census 2001 Rural and Urban Composition of Population, Census 1991 Total Population, Population of Scheduled Castes and Scheduled Tribes and their proportions to the total population Total Urban Population, Population of Cities/Towns Reporting Slums and Slum Population in Slum Areas – India, States, Union Territories Child Population in the age-group 0-6 by sex – Census 2001 & 2011 Population Aged 7 years and above 2011 (Provisional) Literates and Literacy Rates by sex, 2001 and 2011(Provisional) census Sex-ratio of total population and child population in the age-group 0-6 and 7+ years 2001 & 2011 Distribution of Population by Age Groups 2001(Census) Percentage Distribution of Population by Age and Sex, India, 1951-2001 census Projected Population Characteristics 2001-2012 Proportion of Population in Age Groups 0-4 and 5-9 a A. 2 A. 3 A. 3. 1 A. 3. 2 A. 3. 3 A. 3. 4 A. 3. 5 A. 3. 6 A. 4 A. 5 A. 6 A. 7 Child-Woman Ratio, and Dependency Ratio, 2001 A 8. Number of Married Couples (With Wife Aged Between 15-44 Years), All India 2001 Percentage Distribution of Married Couples (With Wife Aged Between 15-44 years) by Age Group, Censuses 1961, 1971 , 1981, 1991 & 2001 Number of Married Females in Rural Areas by Age,2001 Number of Married Females in Urban Areas by Age,2001. A. 9 A. 10 A. 11 A11. 1 Estimated eligible couples per 1000 population – 1991 & 2001 Census A. 12 A. 3 Expectation of Life at Birth 1901-2016 Projected Levels of the Expectation of Life at Birth By Sex ,1996-2016 A13. 1 Expectancy of life at birth by sex and residence, India and bigger States, 2002-06 A. 14 A. 15 A. 16 A. 17 A. 18 Fertility Indicators 1996-2009 – All India Time Series Data on CBR, CDR, IMR and TFR – India Crude Birth and Death Rates in Rural and Urban Areas 1981-2009 Estimated Birth and Death Rates in Different States/UTs – à ¢â‚¬ ¦1981,1991,2001-2009 Estimated Age-specific Death Rates by Sex, 2005-2009- India A. 18. 1 Estimated Age-specific Death Rates by Sex, 2005-2009- Rural A. 18. 2 Estimated Age-specific Death Rates by Sex, 2005-2009- Urban A. 19 A. 20 A. 21 A22 A. 2 A23 A24 Infant Mortality Rates by Sex, 1980 to 2009 – All India Infant Mortality Rates by Sex, 2001 to 2009 – India and Major States Mortality Indicators by Residence: All India 1980-2009 Infant Mortality Rate by Residence – All states/UTs Child Mortality Rate by Residence Mortality Indicators, India and Major States 2005 to 2009 Age Specific Fertility Rates (ASFR*) and Age Specific Marital Fertility Rates (ASMFR*): India, 2005-2009 Fertility Indicators for Major States -2005-2009 Estimated Age Specific Fertility Rates by Major States, 2005-2009 b A. 25 A. 26 A. 27 Age Specific Fertility Rates by Educational Level of the Woman, 2005 to 2009(All India) Mean Age at Effective Marriage (Female), India and Major States, 2005 to 2009 Mean age at effective marriage of females , by residence India and Major States ,2005 to 2009 Percentage of Females by Age at Effective Marriage by Residence, India and Major States, 2005 to 2009 Percent Distribution of Live Births by Order of Birth , India and Major States, 2005-2009 Percentage Distribution of Births By Order of Births By Residence, 2005 to 2009 Average Number of Children Born per Woman by Age – 2001 A. 28 A. 29 A. 30 A. 31 A. 32 A. 33 A. 34Proportion of Ever-married Womwn of parity (i+1) and above to 1000 Ever-married women of parity (i) and above 2001 Percentage of Ever-Married Women (Aged 50 and Above) With No Live Birth 2001 Percent distribution of live Births by Type of Medical Attention Received by the Mother at Delivery by Residence –All India Percentage of Deaths by Causes Related to Child Birth & Pregnancy (Maternal) – All India (Rural) – 1985, 1990 , 1995,1997 & 1998 Percentage Distribution of Deaths due to Specifi c Causes under the Major Group â€Å"Causes Peculiar to Infancy† for selected States 1996-98 Maternal Mortality Ratio, 1997-98 to 2007-09 Under-five Mortality Rates(U5MR) by sex and residence, 2008 & 2009 Sex-ratio of child (age group 0-4) 2004-06 to 2007-09 – SRS A. 35 A. 36 A. 37 A. 38 A. 39 A. 40 A. 41 SECTION – B Family Welfare Programme Statistics i) Immunisation Coverage & MTP Services B. 1 Year-Wise Achievement of Targets of MCH Activities – All India c B. 2 B. 3 B. 4State-wise Targets and Achievements of M. C. H. Activities, 2004-05 to 2007-08 Year-Wise Medical Termination of Pregnancy Performed – All India State-Wise Medical Termination of Pregnancy Performed (ii) Family Planning Acceptance & Impact of the programme B. 5 B. 6 B. 7 B. 8 B. 9 B. 10 B. 11 B. 12 Family Planning Acceptors by Methods – All India Sex-wise Break up of Sterilisation Performed Year-Wise Achievement of Family Planning Methods-All India State-Wise Achievements in respect of Sterilisations State-Wise Achievements in respect of IUD Insertions State-Wise Achievements in respect of Condom Users State-Wise Achievements in respect of O. P.Users State-Wise Vasectomies, Tubectomies and % share of Tubectomy to total Sterilisations State-Wise Number of Laparoscopic Tubectomies Along with Total Number Tubectomy Operations Performed State-wise Number of NSV & Total Number of Vasectomy Operations Performed State-Wise Distribution of Condom Pieces State-Wise Number of Oral Pill Centres Functioning and Distribution of Oral Pill Cycles of B. 13 B. 14 B. 15 B. 16 B. 17 B. 18 B. 19 Number of Condom pieces and Oral Pill Cycles Distributed – All India Information Relating to Maternal Health, 2007 to 2011 Couples Currently and Effectively Protected in India By Various Methods of Family Planning Percentage effective CPR due to all Methods Couples Currently and Effectively Protected Number of Births Averted dB. 20 B. 21 B. 22 SECTION – C HMIS- New Key Indicators C. 1 C. 2 C. 3 C. 4 C. 5 C. 6 C. 7 C. 8 C. 9 C. 10 Number of pregnant women received 3 ANC Checkups Number of women given TT2/Booster Number of women having Hb level < 11 (tested cases) Number of newborn visited within 24 hrs of home delivery Number of women discharged under 48 hrs of delivery from public facility Number of Still Births Number of newborns weighed at Birth Number of newborns having weight less than 2. 5 Kgs Number of Newborns breastfed within 1 hour Number of women receiving post partum check-up within 48 hours after delivery SECTION – D Survey Findings D. 1 D. 2 D. 3 D. Key Indicators NHFS-III Comparative Key Indicators – NFHS-III, NFHS-II and NFHS-I Comparative Key Indicators- DLHS-1, DLHS-2 and DLHS-3 Comparison of Key Indicators – NFHS(2005-06), DLHS (2007-08) and Converage Evaluation Survey(CES) 2009 conducted by UNICEF Concurrent Evaluation NRHM – India Facts (2009) Results of Annual Health Survey, 2010-11 D. 5 D. 6 S ECTION –E Infrastructure facilities E. 1 E. 2 Number of Sub-Centres, PHCs & CHCs functioning as on March, 2010 Facility Survey, DLHS ,2007-2008 e E. 3 E. 4 E. 5 E. 6 E. 7 Health Worker (Female)/ANM at Sub-Centre Health Worker (Female) Sub-Centre and PHCs Number of sub-centres without ANMs or and Health Workers(M) Doctors+ at Primary Health Centres Number of PHCs with Doctors and without Doctors/Lab Technician/Pharmacist SECTION –F Outlay and Expenditure on Family Welfare F. Year Wise BE, RE and Actual Expenditure relating to Department of Family Welfare Plan Outlay on Health Family Welfare in Different Plan Periods Centre, States and Union Territories Scheme-wise breakup of actual expenditure during 2007-08 and outlay for 2008-09 Details of External Assistance fro RCH Programme and Immunization Strengthening Project External Funding Assistance for Polio Programme F. 2 F. 3 F. 4 F. 5 Annexures Annex1 Annex 2 Annex 3 Demographic Indicators Demographic Estimates for Selec ted Countries, 2008 Definitions f SUMMARY  OF  FAMILY  WELFARE   PROGRAMME  IN  INDIA Executive Summary The Ministry of Health and Family Welfare brings out a statistical publication titled â€Å"Family Welfare Statistics in India†. The publication presets the most up-to-date data on the performance of various family welfare programmes and various demographic indicators. The 2011 edition contains six sections. Section â€Å"A† (Tables: A. 1 to A. 1) of the report covers Vital Statistics and captures data on population, sex ratio, rural & urban composition, child population, percentage distribution of population by age and sex, number of married couples, life expectancy at birth, fertility indicators, age specific fertility rates by educational levels, age specific death rates by sex, infant mortality rate by sex, child mortality rate, Maternal Mortality Ratio, etc. Analysis of some of the important indicators, is given in the â€Å"Over View† (Para 1 . 0 to 5. 0). Performance of immunization activities, family planning programmes, MTP services, etc. are covered in Section-B (Tables-B. 1 to B. 22). Para 6. 0 to 6. 9 discusses some of these important parameters in the â€Å"Overview†. The â€Å"Section-C† (Tables C. 1 to C. 0) of the Report covers State-wise data on some of the indicators like; Number of pregnant women received 3 ANC checkups, Number of women given TT2/Booster, Number of women having Hb level < 11 (tested cases), Number of newborn visited within 24 hrs of home delivery, Number of women discharged within 48 hrs of delivery from public facility, Number of Still Births, Number of newborns weighed at Birth, Number of newborns having weight less than 2. 5 Kgs. , Number of Newborns breastfed within 1 hour, Number of women receiving post partum check-up within 48 hours after delivery, etc. This data is an aggregation of district level data which is uploaded on Health Management Information System (HMIS) por tal of the Ministry by States/UTs.A number of large scale surveys are being carried out by the Ministry from time to time to assess the performance of various health and family welfare programmes. These surveys inter-alia include, National Family Health Survey (NFHS), District Level Household and Facility Survey (DLHS), Annual Health Survey (AHS), Facility Survey, Concurrent Evaluation Survey (CES) of NRHM, etc. Section-D focuses on the indicators covered in these large surveys. Data on key indicators (State-wise) covered in NFHS-III (2005-06) as compared with NFHS-II (1998-99) and NFHS-I (1992-93) are given in Tables D. 1 and D. 2. Tables D-3 captures data on key indicators covered in DLHS-III (2007-08) as compared with DLHS-II(2002-04) and DLHS-I (1998-99). Concurrent Evaluation of NRHM was carried out in 2009.The indicators covered include (a) health infrastructure facilities (b) Communitisation of services (c) Functioning of ANM (d) Availability of Human Resources (e) Service Ou tcomes. The results of the evaluation survey i are presented in Table D-5. A comparative data on common indicators covered in NFHS-III, DLHS-III and CES-2009 are brought out in Table D-4. The Ministry of Health & Family Welfare, in collaboration with the Registrar General of India (RGI), had launched an Annual Health Survey (AHS) in the erstwhile Empowered Action Group States (Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa and Rajasthan) and Assam.The aim of the survey was to provide feedback on the impact of the schemes under NRHM in reduction of Total Fertility Rate (TFR), Infant Mortality Rate (IMR) at the district level and the Maternal Mortality Ratio (MMR) at the regional level by estimating these rates on an annual basis for around 284 districts in these States. The results of the first round of AHS for some of the indicators viz. Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under F ive Mortality Rate, Maternal Mortality Ratio (MMR), Sex Ratio, etc. have since become available and are given in Section-D (Tables D. 6. 1 to D. 6. 5).Data on key indicators covered in â€Å"Facility Survey-2007-08† conducted as part of DLHS-III are given in â€Å"Section E†. Latest data received from States /UTs regarding availability of Human resource & infrastructure facilities at Sub Centre, Primary Health Centre (PHC) and Community Health Centre (CHC) are also given in â€Å"Section-E† (Tables E. 1 to E. 7). Section-F covers â€Å"Outlay and Expenditure on Family Welfare† 2010-11 programmes for the year ii Overview Family Welfare Programme in India, 2011 DEMOGRAPHIC PROFILE OF INDIA 1. 0 Vital Statistics 1. 1 As on 1st March, 2011 India's population stood at 1. 21 billion comprising of 623. 72 million (51. 54%) males and 586. 47 million (48. 46%) females. India, which accounts for world's 17. percent population, is the second most populous country in the world next only to China (19. 4%). One of the important features of the present decade is that, 2001-2011 is the first decade (with the exception of 1911-21) which has actually added lesser population compared to the previous decade. In absolute terms, the population of India has increased by about 181. 46 million during the decade 2001-2011. Of the 121 crore Indians, 83. 3 crore (68. 84%) live in rural areas while 37. 7 crore (31. 16%) live in urban areas, as per the Census of India's 2011. Highlights of Census 2011 The average annual exponential growth declined to 1. 64% per annum during 2001-2011 from 1. 97% per annum during 1991-2001.Decadal growth during 2001-2011 declined to 17. 64% from 21. 54% during 1991-2001. The decade is the first, with the exception of 1911-21, which has actually added fewer people compared to the previous decade. The rural population (83. 31 crore) and urban Population (37. 71 crore) constitutes 68. 84% and 31. 16% respectively to the total popula tion of the country. During 2001-2011, for the first time, the growth momentum of population for the EAG States declined by about four percentage points. This, together with a similar reduction in the non-EAG States and Union Territories, has brought down the rate of growth of population for the country by 3. 9 percent as compared to 1991-2001. iiiThough the child-sex ratio [0 to 6 years] has declined from 927 female per 1000 males in 1991-2001 to 914 females per 1000 males, increasing trend in the child sex ratio was seen in Punjab, Haryana, Himachal Pradesh, Gujarat, Tamil Nadu, Mizoram and Andaman and Nicobar Island. Literacy rate increased from 64. 83% in 2001 to 74. 04% in 2011; 82. 14% male literacy, 65. 46% female literacy. Among the States and Union Territories, Uttar Pradesh is the most populous State with 199. 6 million people and Lakshadweep the least populated with 64,429 people. The contribution of Uttar Pradesh (UP) to the total population of the country is 16. 5% foll owed by Maharashtra (9. 3%), Bihar (8. 6%), West Bengal (7. 6%), Andhra Pradesh (7. 0%) and Madhya Pradesh (6. ). The combined contribution of these six most populous States in the country accounts for 55% to the country’s population 1. 2 The country's headcount is almost equal to the combined population of the United States of America (USA), Indonesia, Brazil, Pakistan, Bangladesh and Japan — all put together. The combined population of UP and Maharashtra is bigger than that of the USA. Population of many Indian States is comparable with countries like United Kingdom (UK), Germany, Italy, Japan, Mexico, etc. States in India vs Countries in the World (In Millions) State in India Population- Country @ [email  protected] 2011 Uttar Pradesh 199. 6 Brazil 195. Maharashtra 112. 4 Japan 127. 0 Bihar 103. 8 Mexico 110. 5 iv West Bengal Andhra Pradesh Madhya Pradesh Tamil Nadu Rajasthan Karnataka 91. 3 84. 7 72. 6 72. 1 68. 6 61. 1 Philippines Germany Turkey 93. 6 82. 1 72. 7 Thailand 68. 1 France 62. 8 United 61. 9 Kingdom Gujarat 60. 4 Italy 60. 1 Orissa 41. 9 Argentina 40. 7 Kerala 33. 4 Canada 33. 9 Jharkhand 33. 0 Morocco 32. 4 Assam 31. 2 Iraq 31. 5 Punjab 27. 7 Malaysia 27. 9 Chhattisgarh 25. 5 Saudi 26. 2 Arabia Haryana 25. 4 Australia 21. 5 @Source: State of World Population 2010 1. 3 The Average Annual Exponential Growth Rate (AAEGR) for 2001-2011 dipped sharply to 1. 64 percent per annum from 2. 6 percent during 1981-1991 and 1. 97 percent per annum during 1991-2001. Among the major States, Bihar, J&K, Chattisgarh, Jharkhand, Rajasthan, NCT of Delhi, Madhya Pradesh, Uttar Pradesh, Haryana, Uttarakhand and Gujarat recorded higher annual exponential growth rate as compared to the national average during 2001-2011. The State of Bihar registered the highest (2. 26%) AAEGR and Kerala (0. 48) registered the lowest. v 1. 4 The decadal rate of growth of population has slowed down to 17. 64% in 2001-2011 as compared to 21. 54% in 1991-2001. At the St ate level, growth rates varied widely. Nagaland with (-) 0. 47% had the lowest decadal growth rate.The phenomenon of low growth has started to spread beyond the boundaries of the Southern States during 2001-11, where in addition to Andhra Pradesh, Tamil Nadu and Karnataka in the South, Himachal Pradesh and Punjab in the North, West Bengal and Orissa in the East, and Maharashtra in the West have registered a growth rate between eleven to sixteen percent in 2001-2011 over the previous decade. Among the larger States, Bihar registered the highest decadal growth rate of 25% and Kerala the lowest (4. 86%). It is significant that the percentage decadal growth during 2001-2011 has registered the sharpest decline since independence. It declined from 23. 87 percent for 1981-1991 to 21. 54 percent for the period 1991-2001, a decrease of 2. 33 percentage point. During 20012011, this decadal growth has become 17. 64 percent, a further decrease of 3. 90 percentage points (Table A-1). 1. Traditio nally, for historical reasons, some States depicted a tendency of higher growth in population. Recognizing this phenomenon, and in order to facilitate the creation of area-specific programmes, with special emphasis on eight States that have been lagging behind in containing population growth to manageable limits, the Government of India constituted an Empowered Action Group (EAG) in the Ministry of Health and Family Welfare in March 2001. These eight States were Rajasthan, Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh and Orissa, which came to be known as ‘the EAG States'. During 2001-11, the rate of growth of population in the EAG States except Chhattisgarh has slowed down (Table-A-2).For the first time, the growth momentum of population in the EAG States has given the signal of slowing down, falling by about four percentage points. This, together with a similar reduction in the non-EAG States and Union Territories, has brought down the rate of gr owth for the country by 3. 9 percentage points during 2001-11 as compared to 1991-2001. vi 1. 6 Natural Growth Rate: The natural growth rate, which is the difference between the birth rate and death rate, was estimated as 1. 52% in 2009 against 1. 97 % in 1991. 1. 7 Sex Ratio: According to Census of India 2011, the sex ratio has shown some improvement in the last 10 years. It has gone up from 933 in 2001 census to 940 in 2011 census. Kerala with 1084 has the highest sex ratio followed by Pondicherry with 1038.Daman and Diu has the lowest sex ratio of 618. The Sex Ratio in Arunachal Pradesh (920), Bihar (916), Gujarat (918), Haryana (877), J(883), Madhya Pradesh(930), Maharashtra (925), Nagaland(931), Punjab(893), Rajasthan(926),Sikkim (889) and Uttar Pradesh (908) is lower than the national average. All UTs except Puducherry and Lakshadweep also have lower Sex Ratio as compared to national average (Table A-2). 1. 8 Child Sex Ratio: The child sex ratio (0-6 years), has declined to 91 4 in 2011 Census as compared to 927 in 2001. It showed a continuing preference for male children over females in the last decade. Increasing trend in the child sex ratio was seen in States/UTs viz.Punjab, Haryana, Himachal Pradesh, Gujarat, Tamil Nadu, Mizoram, Chandigarh and Andaman & Nicobar Islands but in all the remaining States / Union Territories, the child sex ratio showed decline over Census 2001 (Table-A-3. 6). Literacy level: According to the provisional data of the 2011 census, the literacy rate 1. 9 went up from 64. 83 per cent in 2001 to 74. 04 per cent in 2011 — showing an increase of 9. 21 percentage points. Significantly, the female literacy level saw a significant jump as compared to males. The female literacy in 2001 was 53 per cent and it has gone up to 65. 46 per cent in 2011. The male literacy, in comparison, rose from 75. 3 to 82. 14 per cent (Table A-3. 5). Kerala, with 93. 1 per cent, continues to occupy the top position among States as far as literacy is concerned while Bihar remained at the bottom of the ladder at 63. 82 per cent. vii Ten States and Union Territories, including Kerala, Lakshadweep, Mizoram, Tripura, Goa, Daman and Diu, Puducherry, Chandigarh, NCT of Delhi and Andaman and Nicobar Islands have achieved a literacy rate of above 85 per cent. 2. 0 POPULATION PROJECTIONS 2. 1 Population Projections: The projections for the country, individual States and Union Territories up to the year 2026 made by the Technical Group constituted by the National Commission on Population (NCP) under the Chairmanship of Registrar General, India, reveals that the country’s population would reach 1. 4 billion by 2026. Projected Population of India (In Millions)The projected population and proportion (percent) of population by broad age-group as on 1st March, 2001-2026 as per â€Å"Report of the Technical Group on Population Projections – Ministry of Health & Family Welfare (May 2006)† are given in the Table below: Ye ar Population (in millions) Proportion (percent) 15-59 15-49 (years) (years) (Female Population) 35. 4 57. 7 51. 1 32. 1 60. 4 53. 1 29. 1 62. 6 54. 5 0-14 (years) 60+ (years) 6. 9 7. 5 8. 3 2001 2006 2011 1029 1112 1193 (1210 )* 1269 1340 1400 2016 2021 2026 26. 8 25. 1 23. 4 63. 9 64. 2 64. 3 54. 8 54. 1 53. 3 9. 3 10. 7 12. 4 *As per provisional figures of Census 2011. viii 2. 2 National Population Policy (NPP), 2000: Government has adopted a National Population Policy in February, 2000. The main objective is to provide or undertake activities aimed to achieve population stabilisation, at a level consistent with the needs of sustainable economic growth, social development and environment protection, by 2045.The other objectives are: †¢ †¢ †¢ To promote and support schemes, programmes, projects and initiatives for meeting the unmet needs for contraception and reproductive and child health care. To promote and support innovative ideas in the Government, private and v oluntary sector with a view to achieve the objectives of the National Population Policy 2000. To facilitate the development of a vigorous people’s movement in favour of the national effort for population stabilisation. 2. 3 National Commission on Population (NCP): With a view to monitor and direct the implementation of the National Population Policy, the NCP was constituted in 2000 and it was re-constituted in 2005.The Chairman of the re-constituted Commission continued to be Hon’ble Prime Minister of India, whereas Deputy Chairman of the Planning Commission and the Minister of Health & FW are the two Vice-Chairmen and Secretary, H, is the Member-Secretary of the Commission. State Population Commissions: State Population Commissions have been 2. 4 constituted in 20 States/UTs. viz. Andhra Pradesh, Arunachal Pradesh, Assam, Haryana, Himachal Pradesh, J, Kerala, Madhya Pradesh, Gujarat, Uttar Pradesh, Maharashtra, West Bengal, Meghalaya, Mizoram, Punjab, Rajasthan, Sikki m, Tamil Nadu, Andaman & Nicobar Island and Lakshadweep. Janasankhya Sthirata Kosh (JSK): The Jansankhya Sthirata Kosh (JSK) has been set 2. 5 up as an autonomous body in the Ministry of Health and Family Welfare, duly registered as a Society under the Societies Registration Act, 1860.The objective of JSK is to facilitate the attainment of the goals of National Population Policy 2000 and support projects, schemes, initiatives and innovative ideas designed to help population stabilization both in the Government and Voluntary sectors and provide a window for canalizing resources through voluntary contributions from individuals, industry, trade organizations and other legal entities in furtherance of the national cause of population stabilization. 3. 0 DEMOGRAPHIC and HEALTH STATUS INDICATORS 3. 1 The demographic and health status indicators have shown significant improvements. The Table below captures data on Crude Birth Rate, Crude Death Rate, and Life Expectancy etc. ix Sl. No. 1 2 3 4Parameters Crude Birth Rate (per 1000 population Crude Death Rate (per 1000 population) Total Fertility Rate Maternal Mortality Ratio (per 100,000 live births) Infant Mortality Rate (per 1000 live births) Child Mortality Rate (0-4 yrs. ) per 1000 children Couple Protection Rate (%) Expectation of life at birth (in years) -Male -Female 1951 40. 8 25. 1 6. 0 NA 1981 33. 9 12. 5 4. 5 NA 1991 29. 5 9. 8 3. 6 398 SRS (199798) 80 26. 5 2001 25. 4 8. 4 3. 1 301 (2001-03) Current Levels 22. 5 (2009) 7. 3 (2009) 2. 6(2009) 212 SRS (2007-09) 50(2009) 14. 1(2009) 5 6 146 (1951-61) 57. 3 (1972) 10. 4 (1971) 110 41. 2 66 19. 3 7 8 22. 8 44. 1 45. 6 40. 4(2011) 37. 1 36. 1 (1951) 54. 1 54. 7 60. 6 61. 7 (199196) 61. 8 63. 5 (1999-03) 62. 6 64. 2 (2002-06)Source: Office of Registrar General of India, except 7 above which is based on estimation done by statistics Division of Ministry of Health and Family Welfare. NA – Not available 3. 2 Crude Birth Rate (CBR): The Crude Birth Rate decline d from 29. 5 in the 1991 to 22. 5 in 2009. The CBR is higher (24. 1) in rural areas as compared to urban areas (18. 3). Uttar Pradesh recorded the highest CBR (28. 7) and Goa the lowest (13. 5). Assam (23. 6), Bihar (28. 5), Chhattisgarh (25. 7), Jharkhand (25. 6), Madhya Pradesh (27. 7), Rajasthan (27. 2), Uttar Pradesh (28. 7) recorded higher CBR as compared to the national average. Among the Smaller States / UTs, D Haveli (27. 0) and Meghalaya (24. ) recorded higher CBR as compared to the national average while Tripura (14. 8) recorded the lowest CBR during 2009-Table A-15, A16 & A17. x 3. 3 Life Expectancy: The life expectancy at birth for male was 62. 6 years as compared to females, 64. 2 years according to 2002-06 estimates. Urban Male (67. 1 years) and Urban Female (70 years) have longer life span as compared to their rural counter parts. The life expectancy in Kerala is the highest (74 years) and the lowest in Madhya Pradesh (58 years) Table A-13. 1. xi 4. 0 MORTALITY INDICA TORS 4. 1 Crude Death Rate (CDR): The CDR, which was stagnant during 2007 and 2008 at 7. 4, came down to 7. 3 in 2009. The CDR is higher in rural areas (7. ) as compared to urban areas (5. 8). The death rate is highest (8. 8) in Orissa and lowest in Nagaland (3. 6) – (Table A-17). Age-specific Death Rates: The ASDR for the year 2009 was 14. 1 per 1000 in the age-group 0-4; it drastically declined in the next age-group (5-9) to 1 per 1000. The ASDR gradually increased in each age-group to reach to the level 20. 4 per 1000 in the age-group 60-64 and continued to increase to reach finally to the level 173. 9 per 1000 in the last age-group, 85+. ) The Age-specific Mortality rates are declining over the years; the rural-urban and Male – Female differentials are still high (Table A-18 to A-18. 3) xii 4. Infant Mortality Rate (IMR): According to SRS 2009, the IMR at national level was 50 per 1000 live births in 2009 as compared to 53 in 2008. The IMR is higher in respect of F emale (52) as compared to Male (49). The highest infant mortality rate has been reported from Madhya Pradesh (67) and lowest from Kerala (12). Assam (61), Bihar (52), Chhattisgarh (54), Haryana (51), Madhya Pradesh (67), Orissa (65), Rajasthan (59) and Uttar Pradesh (63) recorded higher IMR as compared to the national average (Table-A-20) Infant Mortality Rates – Rural/Urban (All India) xiii The IMR is very high in rural areas (55 per 1000 live births) as compared to urban areas (34). Rural areas of Madhya Pradesh registered the highest IMR (72) followed by Orissa (68), Uttar Pradesh (66).Rural areas of Kerala State recorded the Lowest IMR (12) in the country. Uttar Pradesh and Chhattisgarh recorded highest IMR in urban areas. Kerala had the lowest IMR (11) in urban areas. Amongst the smaller states, Rural and Urban areas of Goa recorded lowest IMR during 2009 (Table-A-22). The increase in medical attention to the pregnant women at the time of live births may have resulted in decline in IMR over the period. But in the rural areas, the medical attention is still on the lower side (Table-A36) Distribution of Live Births by Type of Medical Attention Received by the Mother-2009 (%) Neo-natal Mortality Rate: Neo-natal mortality refers to number of infants dying within one month.Neo-natal health care is concerned with the condition of the newborn from birth to 4 weeks (28 days) of age. Neo-natal survival is a very sensitive indicator of population growth and socio-economic development. The survival rate of female infants correlates to subsequent population replacement. The neo-natal mortality rate which was stagnant at 37 per 1000 live births during 2003 to 2006 marginally came down to 36 in 2007, 35 in 2008 and stood at 34 during 2009. The neo-natal mortality rate is very high in rural areas (38 per 1000 live births) as compared to 21 in urban areas in 2009. The neonatal mortality rate also xiv varies considerably among Indian States.Madhya Pradesh (47), Utt ar Pradesh (45), Orissa (43), Rajasthan (41), J (37), Himachal Pradesh (36), Haryana(35), Gujarat(34), Chhattisgarh(38) recorded higher neo-natal mortality rate as compared to national average. The Neo-natal mortality rate is lowest in the Kerala State (7). The significant feature is that, the Neo-natal Mortality Rate came down or remained stagnant in 2009 as compared to 2008 except in the case of Haryana, Himachal Pradesh, Jharkhand and Karnataka (Table A23) Post-Neo-Natal Mortality Rate: Refers to number of infant deaths at 28 days to one year of age per 1000 live births. The Post Neo natal Mortality Rate came down to 16 in 2009 from 24 in 2002.The Post Neo Natal Mortality Rate is high in rural areas (17) as compared to urban areas (13) (Table A-21) Peri–natal Mortality Rate: Refers to number of still birth and deaths within 1st week of delivery per 1000 live births. The Peri-natal Mortality Rate varies in the range of 37 to 35 since 2001 and stood at 35 in 2009. It is high in rural areas (39) as compared to urban areas (23) during 2009. The Peri-natal Mortality Rate significantly varied across the States. Kerala with 13 is the best performing State, Madhya Pradesh and Chhattisgarh (45) are least performing States during 2009. Still Birth Rate (SBR): The SBR came down to 8 in 2008 from 9 in 2007. However, it remained stagnant at 8 in 2009 also.The number of Still Births varied across the States between 1 (Bihar) and 17 (Karnataka) in 2009 (TableA-23). 4. 3 Child Mortality Rate (0-4): Child Mortality Rate is measured in terms of death of number of children (0-4 years) taking place per 1000 children (0-4 year’s age). As per SRS estimates, the Child Mortality Rate (CMR) has come down from 57. 3 in 1972 to 26. 5 in 1991 and 14. 1 in 2009. The CMR is very high in rural areas (15. 7) as compared to urban areas (8. 7) in 2009 and this observation is relevant for almost all States uniformly. The highest Child Mortality Rate was recorded in Madhya Prade sh (21. 4) closely followed by Uttar Pradesh (20. 1) and Assam (19. 0). Kerala with 2. 6 CMR is the best Performing State (Table A22. 1) 5. 0FERTILITY INDICATORS The three common measures of fertility are; (a) Crude Birth Rate (CBR), (b) Age-Specific Fertility Rates (ASFR), and (c) Total Fertility Rate (TFR). CBR has already been discussed in para 3 . 2 above. 5. 1 Age Specific Fertility Rates (ASFR) & Age Specific Marital Fertility Rates (ASMFR): ASFR is defined as the number of children born to women in the said age group per 1000 women in the same age group and ASMFR as the number of children born to married women in the said age group per 1000 women in the same age group. Table A-24 presents ASFR and ASMFR data separately for rural and urban areas, for the years 2004 to 2009. It is xv bserved that ASMFRs are higher than ASFRs in respect of all age groups as ASMFR covers only married women. Throughout the period 2004-2009, the age group 20-24 continued to have peak fertility rate s in rural and urban areas, but both these indicators are lower in urban areas as compared to rural areas. The ASMFR increased to 326 in 2009 from 303 in 2008 and the ASFR increased to 227. 8 in 2009 from 218. 6 in 2008 for the age group 20-24. Data on Age Specific Fertility Rate (ASFR) reveals that the fertility rate in 15 to 19 years age group has moderately declined in 2009 (38. 5) as compared to 2008 (41. 6). Lower fertility rates are observed in U. P. Bihar only after attaining the age 40 years while in Kerala, Tamil Nadu, Andhra Pradesh, Maharashtra, Karnataka, Himachal Pradesh and Punjab, this stage is reached in the earlier age groups namely 30-34 and 35-39 (Table A-26). ASFR is showing a decreasing trend as the literacy level increases in the age group of 20-24 (the peak fertility age group)-Tables A-27. 5. 2 Age at Effective Marriage (AEM): The Mean age at effective marriage is the age at consummation of marriage, is almost stagnant and hovering around 20 years between 200 5 and 2009. The State level data show variations in the AEM. It is the highest in J (23. 6) followed by Kerala (22. 7), Delhi & Tamil Nadu (22. 4), Himachal Pradesh (22. 2), and Punjab (22. 1) in 2009. Rajasthan (19. ) has the lowest AEM. The AEM in urban areas is higher than the rural one but the difference is just two years. The rural- urban difference is highest (3. 1 years) in Assam and least in Kerala (0. 1 years). The AEM in respect of more than 50% female in rural areas is 18-20 years whereas in urban areas, the AEM in respect of more than 60% female is 21+ (Tables A-28 to A-30) xvi 5. 3 Total Fertility Rate (TFR): The TFR for the country remained constant at 2. 6 during 2008 and 2009 with Bihar reporting the highest TFR at 3. 9 while Kerala and Tamil Nadu continued its outstanding performance with the lowest TFR of 1. 7. Among the major States, the TFR level of 2. has been attained by Andhra Pradesh (1. 9), Karnataka (2. 0), Kerala (1. 7), Maharashtra (1. 9), Punjab (1. 9), Tamil Nadu (1. 7) and West Bengal (1. 9). The rural woman is having higher TFR (2. 9) as compared to urban (2. 0) women (TableA-25). 6. 0 FAMILY PLANNING PROGRAMME: In 1952, the Indian Government was one of the first in the world to launch a national family planning programme, which was later expanded to encompass maternal and child health, family welfare and nutrition. The figures given in the publication are based on the data reported by the State/UTs at district level and then consolidated at State and National level on HMIS portal.Percentage of districts reported in 2009-10 and 2010-11 was 98%. 6. 1 Maternal Health: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Antenatal care (ANC) is the systemic medical supervision of women during pregnancy. Its aim is to preserve the physiological aspect of pregnancy and labour and to prevent or detect, as early as possible, all pathological disorders. Early diagnosis during pregnancy ca n prevent maternal ill-health, injury, maternal mortality, foetal death, infant mortality and morbidity. During 2010-11, 28. 30 million women got registered for ANC checkup and more than 20 million underwent 3 check-ups during the pregnancy period. vii The institutional deliveries to total deliveries (Institutional +home) increased from 56. 7% in 2006-07 to 78. 5% in 2010-11. Kerala and Tamil Nadu (99. 8%) are the best performing States in the country during 2010-11 (Table B-18). 6. 2 Medical Termination of Pregnancy: To avoid the misuse of induced abortions, most countries have enacted laws whereby only qualified Gynecologists under conditions laid down and done in clinics/hospitals that have been approved, can do abortions. The Medical Termination of Pregnancy Act was enacted by the Indian Parliament in 1971 and came into force from 01 April, 1972. The MTP Act was again revised in 1975.The MTP Act lays down the condition under which a pregnancy can be terminated, especially the pe rsons and the place to perform it. During 2010-11, 620472 MTPs were performed by 12510 approved institutions in the country. Uttar Pradesh with 576 approved institutions performed maximum number (81420) MTPs in the country followed by Maharashtra (78047) during 2010-11. xviii About 60% MTPs in the country were performed in 6 States viz. Assam, Maharashtra, West Bengal, Tamil Nadu, Uttar Pradesh and Haryana in 2010-11(Table B4). 6. 3 Child Health Immunization programmes aim to reduce mortality and morbidity due to Vaccine Preventable Diseases (VPDs), particularly for children.India's immunization programme is one of the largest in the world in terms of quantities of vaccines used, numbers of beneficiaries, number of immunization sessions organized and the geographical area covered. Under the immunization program, vaccines are used to protect children and pregnant mothers against six diseases. They are: †¢ †¢ †¢ †¢ †¢ †¢ Tuberculosis Diphtheria Pertussis Polio Measles Tetanus In India, under Universal Immunization Programme (UIP) vaccines for six vaccinepreventable diseases (tuberculosis, diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, and measles) are provided free of cost to all. Tetanus Immunization for expectant Mother: During 2010-11, 78. 14% of the estimated need for vaccinating 29. 68 million expectant mothers was achieved. As compared to 200910 the achievement is on lower side (83. 82%).The achievement varied widely across the States, the highest percentage of achievement is observed in Lakshadweep (112. 1%) followed by the Mizoram (106. 8%). Among major States, Tamil Nadu immunized 98. 5% of the targeted numbers and Bihar recorded the lowest immunization (58%). The achievement xix of Bihar is the lowest among the major States consecutively for the third year (TableB1&B2). DPT Immunization for Children: The DPT is an immunization or vaccine to protect against the diseases of Diphtheria (D), Pertussis (P), and Tetanus (T). The III dose of DPT vaccination was to be administered to 25. 54 Million children (Target) and achieved 89. 20% during 201011 as against the achievement of 99. 0% in 2009-10. Andhra Pradesh (100. 3%), Tamil Nadu (102. %), Himachal Pradesh (105. 7%), J&K (105. 3%), Manipur (118. 8%), Meghalaya (108. 5%) and Mizoram (134. 2%) achieved more than 100% targeted numbers (Table- B1&B2). Polio: More than 89 percent children received the third dose of Polio vaccine in 2010-11 but the percentage dropped from 98. 6% in 2009-10. The percentage of children who received third dose of polio ranges from 31. 4% in A&N Islands to 133. 8% in Mizoram. Eight States viz. Andhra Pradesh, Orissa, Tamil Nadu, Himachal Pradesh, J&K, Manipur, Meghalaya and Mizoram achieved more than 100% targeted numbers during 2010-11. Achievement of Bihar State is the lowest (69. 1%) among the major States (Table- B1&B2).BCG: BCG vaccine is given for protection against tuberculosis, mainly severe forms of chil dhood tuberculosis. 23. 88 million Children of below one year were targeted for administering BCG vaccine during 2010-11 as against 25. 19 million in 2009-10. The achievement in 2010-11 was 93. 5% as against 101. 7 % in 2009-10. 14 States / UTs achieved more than 100% immunization during 2010-11 as against 20 States/UTs in 2009-10. Pondicherry achieved the highest percentage immunization (179. 8%) in 2010-11. Measles: 22. 10 million Children of below one year age received measles vaccine during 2010-11 as against 25. 54 million children accounting for an achievement of 86. 6% as against 95. 0% in 2009-10.Himachal Pradesh, J&K, Manipur, Meghalaya and Mizoram achieved more than 100% vaccination in 2010-11 (Table- B1&B2). Tetanus: Vaccination against Tetanus was administered to 9. 7 million (Target: 25. 1 Million) children of 5 years age (DT), 14. 30 million children of 10 years age (Target: 25. 66 million) and 13. 0 million children of 16 years age (Target: 26. 01 Million) during 2010 -11. The achievement as against the set target works out to 38. 6%, 54. 8% and 50. 0% respectively in respect of the above age group of children. Bihar State is lagging behind in achievement as compared to all other major States. The achievement is only 5. 6% (of the target) in the case of children 5 years of age, 14. 8% for children of 10 Years and 20. % for children of 16 years during 2010-11. Except Sikkim (for the age group children 10 years), no other State vaccinated the children to the extent of 100% of the target during 2010-11(Table- B1&B2). 6. 4 Family Planning: Birth control pills, condoms, sterilization, IUD (Intrauterine device) etc. are most commonly practiced Family Planning methods in the country. The efforts of the Government in implementing the Family Planning Programme in the country have significant impact. However, Social factors like reluctance, traditions and socio-cultural beliefs towards large family emerge as the major constraints towards adopting Family Pl anning methods. Female xx iteracy, age at marriage of girls, status of women, strong son preference, and lack of male involvement in family planning, are also significant factors associated with adoption of small family norm. IMPACT OF FAMILY WELFARE ACTIVITIES †¢ †¢ Knowledge of contraception is nearly universal: 98 percent of women and 99 percent of men age 15-49 know one or more methods of contraception. Among the permanent modern Family Planning methods, female sterilization was the most popular Over 97 percent of women and 95 percent men know about female sterilization. Male sterilization, by contrast, is known only by 79 percent of women and 87 percent of men. Ninety-three percent of men know about condoms, compared with 74 percent of women. More than 80 percent women and men know about contraceptive pills.Knowledge of contraception is widespread even among adolescents: 94 percent of young women and 96 percent of young men have heard of a modern method of contracepti on Source: NFHS-3 †¢ †¢ †¢ 6. 5 Family Planning Performance The year 2010-11 ended with 34. 9 million total family planning acceptors at national level comprising of 5. 0 million Sterilizations, 5. 6 million IUD insertions, 16. 0 million condom users and 8. 3 million O. P. users as against 35. 6 million total family planning acceptors in 2009-10 (Table B. 5) xxi Total FP Acceptors 60000 50000 40000 30000 20000 10000 0 6. 6 A total of 50. 09 Lakh sterilizations were performed in the country during 2010-11 as against 49. 98 Lakh in 2009-10. States/UTs viz.Assam, Bihar, Gujarat, Jharkhand, Madhya Pradesh, Orissa, Punjab. Arunachal, Manipur, Meghalaya, Nagaland, Tripura, Uttarakhand, Daman & Diu, Lakshadweep and Puducherry have shown improved performance in 2010-11 as compared to 2009-10. (Nos. 000†²) Sterilisations 6,000 5,000 (Nos. 000†²) 4,000 3,000 2,000 1,000 0 The proportion of tubectomy operations to total sterilizations was 95. 6 percent in 2010-11 as ag ainst 94. 6 percent in 2009-10 (Table B-6). xxii Though the share of vasectomy operations to total sterilizations is increasing, it is quite insignificant. 6. 7 IUD Insertions: During the year 2010-11, 5. 6 million IUD insertions were reported as against 5. 7 million in 2009-10.Assam, Bihar, Gujarat, Jharkhand, Uttar Pradesh, Arunachal Pr, Delhi, Goa, Meghalaya, Mizoram, Sikkim, D&N Haveli reported better performance in 2010-11 than in 2009-10 (Table B-9). 6. 8 Condom Users and O. P. Users: Based on the distribution figures reported, there were 16. 0 million equivalent users of Condoms and 83. 07 million equivalent users of Oral Pills during 2010-11 (Table B-10, B-11). 6. 9 Number of Births Averted: Implementation of various Family Planning measures averted 16. 335 million births in the country during 2010-11 as compared to 16. 605 million in 2009-10. The cumulative total of births avoided in the country up to 2010-11 was 442. 75 million (Table B-22). 7. 0 PROGRAMMES and SCHEMES 7. The National Rural Health Mission (NRHM): NRHM launched by the Hon’ble Prime Minister on 12th April 2005 throughout the country with special focus on 18 States, including eight Empowered Action Group (EAG) States, the North-Eastern States, Jammu & Kashmir and Himachal Pradesh, seeks to provide accessible, affordable and quality health care xxiii services to rural population, especially the vulnerable sections. The NRHM operates as an omnibus broadband programme by integrating all vertical health programmes of the Departments of Health and Family Welfare including Reproductive & Child Health Programme and various diseases control Programmes.The NRHM has emerged as a major financing and health sector reform strategy to strengthen States Health systems. The NRHM has been successful in putting in place large number of voluntary community health workers in the programme, which has contributed in a major way to improved utilisation of health facilities and increased health awarenes s. NRHM has also contributed by increasing the human resources in the public health sector, by up-gradation of health facilities and their flexible financing, and by professionalization of health management. The current policy shift is towards addressing inequities, through a special focus on inaccessible and difficult areas and poor performing districts.This requires also improving the Health Management Information System, an expansion of NGO participation, a greater engagement with the private sector to harness their resources for public health goals, and a greater emphasis on the role of the public sector in the social protection for the poor. †¢ †¢ †¢ †¢ †¢ †¢ †¢ 7. 2 NRHM GOALS Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR) Universal access to public health services such as Women’s health, child health, water, sanitation & hygiene, immunization, and Nutrition. Prevention and control of communicable and nonco mmunicable diseases, including locally endemic diseases Access to integrated comprehensive primary healthcare Population stabilization, gender and demographic balance. Revitalize local health traditions and mainstream AYUSH. Promotion of healthy life styles.Primary Health Care services Health Services are provided to the community through a network of Sub-centres, Primary Health Centres (PHCs) and Community Health Centres (CHCs) in the rural areas and Hospitals and Dispensaries etc. in the urban areas. The Primary Health Care infrastructure in rural areas has been developed as a three-tier system. The norms for establishing Sub centres, PHCs and CHCs are as under: xxiv Centre Plain Area Sub Centre PHC CHC 5000 30000 120000 Population Norms Hilly/Tribal Area 3000 20000 80000 7. 3 Sub-Centres (SCs): The Sub-Centre is the most peripheral and first contact point between the primary health care system and the community.Each Sub-Centre is manned by one Auxiliary Nurse Midwife (ANM) and on e Male Health Worker MPW (M). One Lady Health Worker (LHV) is entrusted with the task of supervision of six Sub-Centres. SubCentres are assigned tasks relating to interpersonal communication in order to bring about behavioural change and provide services in relation to maternal and child health, family welfare, nutrition, immunization, diarrhoea control and control of communicable diseases programmes. The Sub-Centres are provided with basic drugs for minor ailments needed for taking care of essential health needs of men, women and children. There were 147069 Sub Centres functioning in the country as on March 2010. An Auxiliary Nurse Midwife (ANM), a female aramedical worker posted at the Sub-Centre and supported by a Male Multipurpose Worker MPW (M) is the front line worker in providing the Family Welfare services to the community. ANM is supervised by the Lady Health Visitor (LHV) posted at PHC. 7. 4 Primary Health Centres (PHCs): PHC is the first contact point between village comm unity and the Medical Officer. The PHCs were envisaged to provide an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care. The PHCs are established and maintained by the State Governments under the Minimum Needs Programme (MNP)/Basic Minimum Services Programme (BMS).There were 23673 PHCs functioning as on March 2010 in the country. A PHC is manned by a Medical Officer supported by 14 paramedical and other staff. It acts as a referral unit for 6 Sub Centres. It has 4-6 beds for patients. The activities of PHC involve curative, preventive, primitive and Family Welfare Services. 7. 5 Community Health Centres (CHCs): CHCs are being established and maintained by the State Government under MNP/BMS programme . It is manned by four medical specialists i. e. Surgeon, Physician, Gynaecologist and Paediatrician supported by 21 paramedical and other staff. It has 30 in-door beds with one OT, X-ray, Labour Room an d Laboratory facilities.It serves as a referral centre for 4 PHCs and also provides facilities for obstetric care and specialist consultations. As on March, 2010, there were 4535 CHCs functioning in the country. 7. 6 Reproductive Child Health (RCH) Programme: Reproductive and Child Health Programme is a major component of NRHM and aims at reduction of Infant Mortality Rate, Maternal Mortality Ratio and Total Fertility Rate xxv 7. 7 Janani Suraksha Yojana: The Jannani Suraksha Yojana (JSY) is a 100% centrally sponsored scheme and it integrates cash assistance with delivery and post delivery care. The scheme was launched with focus on demand promotion for institutional deliveries in States and regions where these are low.It targeted lowering of MMR by ensuring that deliveries were conducted by Skilled Birth Attendants at every birth. The Yojana has identified the Accredited Social Health Activist (ASHA), as an effective link between the Government and the poor pregnant women in 18 low performing States, namely the 8 EAG States and Assam and J&K and the remaining NE States. In other States and UTs, wherever, AWW and TBAs or ASHA like activist has been engaged for this purpose, they can be associated with this Yojana for providing the services. The JSY scheme has shown phenomenal growth in the last three years. Starting with a modest number of 7. 39 Lakhs beneficiaries in 2006-07, the total number reached 113. 89 lakh during 2010-11. 7. Family Welfare Linked Health Insurance Scheme: Family Planning Linked Insurance Scheme was introduced w. e. f. 29th November, 2005 to take care of the cases of failure of Sterilisation, medical complications for death resulting from Sterilisation, and also provide indemnity cover to the doctor / health facility performing Sterilisation procedure. The scheme is in operation for the last 5 years and is renewed with ICICI Lombard Insurance Company for the sixth year w. e. f. 01-01-2011 based on 50 lakh sterilization acceptors. The tot al liability of the company is limited to Rs. 25 crore under Section-I and Rs. 1 crore under Section-II. Benefits of the Scheme w. e. f. 1. 1. 011( 6th Year) Section Coverage Financial compensation I following IA Death sterilization (inclusive of Rs. 2 Lakhs death during process of sterilization operation) within 7 days from the date of discharge from the hospital. IB Death following Rs. 50,000 sterilization within 8 – 30 days from the date of discharge from the hospital IC Failure of Sterilization Rs. 30,000 ID Cost of treatment upto Actual not exceeding 60 days arising out of Rs. 25,000 complication following the sterilization operation (inclusive of xxvi II complication during process of sterilization operation) from the date of discharge. Indemnity Insurance per Upto Rs. 2 Lakh per Doctor/facility but not claim more than 4 cases in a year. 7. Compensation for Acceptors of Sterilisation: As a measure to encourage people to adopt permanent method of Family Planning, this Mi nistry has been implementing a Centrally Sponsored Scheme since 1981 to compensate the acceptors of sterilization for the loss of wages for the day on which he/she attended the medical facility for undergoing sterilization. Compensation for Acceptors of Sterilisation Public facilities Vasectomy Tubectomy Focus 1500 1000 1500 (Rs. ) Accredited Private/NGO facilities Vasectomy Tubectomy 1500 1500 1500 (BPL/SC/ST) High States Non-high Focus States 1000 (BPL/SC/ST) 1500 650 (APL) 8. 0 MONITORING AND EVALUATION SYSTEMThe Information System to measure the process and impact of the NRHM including Family Welfare Programme is as below: a) Service Statistics through HMIS and Routine Monitoring b) Sample Registration System & Population Census, Office of Registrar General India c) Large scale surveys- National Family Health Surveys, District Level Household and Facility Surveys. Annual Health Survey d) Area specific surveys by Population Research Centres e) Other specific surveys by National & International agencies f) Field Evaluation through Regional Evaluation Teams xxvii 8. 1 Service Statistics/Routine Monitoring The Statistics Division in the Ministry of Health & Family Welfare is responsible for Monitoring & Evaluation activities. 8. 2 Health Management Information System (HMIS) Health services are provided through the network of health centers spread throughout rural and urban areas of the country. Each centre maintains record of its activities in one or more of the primary registers.The performance data collected and compiled primarily at peripheral levels (Rural/Urban) such as Sub-centre, Primary Health Centres, Urban Family Welfare Centres / Post Partum Centres / Hospitals / Dispensaries are presented in Tables C-1 to C-10. For capturing information on the service statistics from the peripheral institutions, an exercise was undertaken to rationalize the facility level data capturing format by removing redundant information, reducing the number of forms and focu sed on facility based reporting. The revised forms were finalized in September 2008 and disseminated to the States. A web based Health MIS (HMIS) portal was also launched in October, 2008 http://nrhm-mis. nic. n to facilitate data capturing at District level. The HMIS portal has led to faster flow of information from the district level and about 98% of the districts are reporting monthly data since 2009-10. The HMIS portal is now being rolled out to capture information at the facility level. Some of indicators for which data has been captured through HMIS portal (district level) are included for the first time in the publication (Detailed tables are given in Section–C (Tables C1 to C-10). Data for these indicators are provisional and may only be compared with DLHS-III indicators keeping in view the methodological differences. 8. 3 Tracking of Mothers and ChildrenIt has been decided to have a name-based tracking whereby pregnant women and children can be tracked for their ANCs and immunisation along with a feedback system for the ANM, ASHA etc to ensure that all pregnant women receive their Ante-Natal Care (ANCs) and postnatal care (PNCs) Checkups; and the children receive their full immunisation. All new pregnancies detected/being registered from 1st April, 2010 at the first point of contact of the pregnant mother are being captured as also all births occurring from 1st December, 2009. A number of States have established the system and other are putting in place systems to capture such information on a regular basis. Mother and Child Tracking System require intense capacity building at various levels primarily at the Block and Sub-Centre levels. The National Informatics Centre (NIC) has developed software application. The rollout is being monitored centrally. xxviii 8. 4 Large Scale/Demographic SurveysA number of large scale surveys are being conducted by the Ministry of Health & Family Welfare as enumerated below: National Family Health Survey (NFHS): The 2005-06, National Family Health Survey (NFHS-3) was the third in a series of national surveys preceded by earlier NFHS surveys carried out in 1992-93 (NFHS-1) and 1998-99 (NFHS-2) with the objective to provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes, and to provide information on important emerging health and family welfare issues. Annual Health Survey (AHS): The Ministry of Health & Family Welfare, in collaboration with the Registrar General of India (RGI), had launched an Annual Health Survey (AHS) in the erstwhile Empowered Action Group States (Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa and Rajasthan) and Assam. AHS will provide District-wise data on Total Fertility Rate (TFR), Infant Mortality Rate (IMR) and the Maternal Mortality Ratio (MMR) at the regional level. Other RCH indicators like Ante-natal care, Institutional delive ry, immunisation, use of contraceptives will also be available.The aim of the survey was to provide feedback on the impact of the schemes under NRHM in reduction of Total Fertility Rate (TFR), Infant Mortality Rate (IMR) at the district level and the Maternal Mortality Ratio (MMR) at the regional level by estimating these rates on an annual basis for around 284 districts in these States. The results of the first round of AHS for some of the indicators viz. Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under Five Mortality Rate, Maternal Mortality Ratio (MMR), Sex Ratio at Birth (SRB), Sex Ratio (0-4 years) and Total Sex Ratio have been released by the Registrar General of India (RGI).The District-wise data in respect of the above indicators for the nine States viz. Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa, Rajasthan and Assam are given in Table D. 6. 0 (Section D). Comparison of State -wise AHS results and SRS: 2009, in respect of five indicators namely Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate and Maternal Mortality Ratio (MMR), Sex Ratio at Birth (SRB) reveals that they are broadly comparable (Table D. 6. 1). All 284 districts covered in the AHS (first round) have been ranked by arranging them in ascending order based on the rank of the individual indicators viz.Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under 5 Mortality Rate and Maternal Mortality Ratio (MMR) and presented in Table D. 6. 2. Tables D. 6. 3 and D. 6. 4 give details of bottom 100 districts as per the rankings and also covered under High Focus Districts identified under National Rural Health Mission, xxix The second Round of AHS (2011-12) would also cover additional parameters viz. height & weight measurement, blood test for anemia and sugar, blood pressure measurement and testing of iodine in the salt used by households thro ugh a separate questionnaire on Clinical, Anthropometric and Biochemical (CAB) test and measurements in addition to the indictors covered in AHS first round.District Level Household and Facility Survey (DLHS): The District Level Household and Facility S