DEMOGRAPHIC TRENDS: VITALS

STATISTICS

Name of Teacher : Miss. Monika Makwana

Name of Course : First year M.Sc. Nursing

Name of the subject : Obstetrics and Gynaecological Nursing

Name of Unit : VIII- Family welfare services

Name of Topic : Demographic trends and vital statistics

Class : First year M.Sc. Nursing

Date : 22 / 08 /2022

Time : 55min.

Venue : Class No. 207

Previous Knowledge level : Students have somewhat knowledge regarding demographic trends
and vital statistics

Method of teaching : Lecture cum discussion

Media of teaching A.V. aids : Power point presentation

 GENERAL OBJECTIVES:
At the end of lecture, the students will able to understand demographic trends and vital statistics in-
depth.

 SPECIFIC OBJECTIVES:
At the end of the lecture, the students will able to:
 Define vital statistics.
 Enumerate the aims of vital statistics.
 List out the purpose of vital statistics.
 Recognize indicators of vital statistics.
 Appraise maternal morbidity and mortality rate, neonatal morbidity and mortality, perinatal
mortality rate, infant mortality rate, fertility rate, abortion rate.
 Conclude the topic.

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 INTRODUCTION

Our country keeps a continuous check on demographic changes through registration of vital events. If
registration of vital events is complete and accurate. It serves as a reliable source of health information.
The process of maintaining vital statistics is a purposeful mechanism of collecting, processing,
analyzing and transmitting the information required for organizing and operating health services and
also for research and training. Dependable vital statistics related to births and deaths are vital to assess
the health of the population, conduct epidemiological research, health planning and for evaluating any
program. Civil registration is the best suited source of statistics on vital events (i.e. births and deaths).
The office of the “registrar-general and census commissioner”, functions under the ministry of home
affairs is the national authority for civil registration in India.

 DEMOGRAPHIC TRENDS

Definition of demography-The scientific study of human population which includes the study of
changes of the population size, the composition and the distribution.

(-According to K Park)

 VITAL STATISTICS

Vital statistics include indicators such as birth rate, death rate, natural growth rate, life expectancy at
birth, mortality and fertility rates. The most common way of collecting information of these events is
through civil registration, an administrative system used by governments to record vital events which
occur in their populations.

 DEFINITION
 Vital statistics are conventionally numerical records of marriage, birth, sickness and death by which
the health and growth of community may be studied.
 It is a branch of biometry that deals with data and law of human mortality, morbidity and
demography.

 AIMS
 Providing reliable, relevant, up to date, adequate, timely and reasonably complete information to the
health authority at all levels.
 Health care providers are able to intervene the health status of the population, provided availability
of appropriate tools for measuring health, illness and the well being is there.
 It is the transformation of information through integration and processing with perception and
experience based on social and political value.

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 INDICATORS
 Demography and vital events.
 Environment health statistics
 Health resources facilities, beds, manpower.
 Utilization and non-utilization of health services attendance.
 Health care indices.
 Financial statistics.

 PURPOSE
 To describe the level of community health, diagnose community illness and solutions of health
problems.
 To determine success or failure of specific health programs.
 To promote health legislation at local and nation level.
 To develop policies and procedure at state and centre level.

 IMPORTANCE OF VITAL STATISTICS

 To evaluate impact of various national health program.
 To plan for better future measures of disease control.
 To explain hereditary nature of disease.
 To evaluate economic and social development.
 It is primary tool of research activity.

 USES OF VITAL INFORMATION

 The vital information of a population are basis of planning, administration and effective management
health services and programs.
 Assessment of health service in terms of effectiveness and efficiency is done by maintaining up to
date record of all events.
 Assessment of attitude and degree of satisfaction of the beneficiaries from the health policies can be
done.
 Measurement of health services status of population.

 SOURCE OF VITAL INFORMATION

 Census.  Registration of vital events.

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  Simple registration system record.  Record linkage.
 Hospital records.  Epidemiological surveillance.
 Notification of disease health.  Health service.
 Disease register.  Population and surveys.

 POINTS OF VITAL STATISTICS

 Maternal mortality rate
 Maternal morbidity rate
 Perinatal mortality, morbidity rate
 Neonatal mortality, morbidity rate
 Post neonatal mortality, morbidity rate
 Infant mortality, morbidity rate
 1-4 year child mortality, morbidity rate
 Under 5 year mortality, morbidity rate

 MATERNAL MORTALITY RATE

 Definition

According to WHO-The annual number of female deaths from any cause related to or aggravated by
pregnancy or its management (excluding accidental or incidental causes) during the pregnancy and
childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of
pregnancy is known as maternal mortality rate.

Total no. of female death due to complication of pregnancy or

within 42 days of delivery from puerperal causes
Maternal mortality rate= X 100

Total no. of liver birth in same area in year

 Causes of maternal mortality

 Abortion  Puerperal sepsis

 Pre-eclampsia  Postpartum hemorrhage
 Ectopic gestation  Ectopic gestation
 Antepartum hemorrhage  Eclampsia

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 MATERNAL MORBIDITY RATE
 Definition:
It is overarching term that refers to any physical or mental illness or disability directly related to
pregnancy and or child birth is not necessary for life threatening.

 Causes of maternal morbidity

 Infection  Abortion
 Poor service  Difficult labour
 Hygiene  Hypertension
 Hemorrhage  Low socioeconomic status
 Anaemia  Living standard

 Preventive measures of MMR and maternal morbidity rate

 Early registration of pregnancy.
 At least 3 antenatal check-ups.
 Dietary supplementation including correct anaemia.
 Clean and aseptic delivery practices.
 Prevention of complications. E.g., Preeclampsia and malpresentation, ruptured uterus.
 Prevention of infection and haemorrhage.
 Treatment of medical conditions.
 Institutional deliveries for women.
 Promotion of family planning.
 Identification of every maternal death and search its cause.

 PERINATAL MORTALITY
 Definition:
The perinatal mortality rate is the sum of the number of perinatal deaths (stillbirths and early neonatal
deaths) divided by the number of pregnancies of seven or more months duration (all live births plus
stillbirths).

Late fetal death (28 weeks of gestation) + early neonatal death

(1stweek) in a year
Perinatal mortality= x 1000
Live birth in the same year

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 Causes of perinatal mortality

Antenatal Intranatal Postnatal

 Maternal disease  Birth injury  Prematurity
 Pelvic disease  Asphyxia  Respiratory distress
 Anatomical defect  Prolonged labor syndrome
 Malnutrition  Obstetric complication  Infection
 Toxemia of pregnancy  Respiratory

 Measures of reduce prenatal mortality

 Need to educate community about age of marriage.
 Adequate immunization, prevention of HIV infection, avoidance of drug abuse.
 Proper nutrition to mother.
 In antenatal period optimum care of mother and need to seek medical advice in emergency,
 In intra-natal period use aseptic techniques by skilled person, safe delivery, control infection and
complications.

 NEONATAL MORTALITY RATE

 Definition:
Number of deaths during the first 28 completed days of life per 1000 live births in a given year or
other period.

No. of deaths of neonates under 28 days of age in year

Neonatal mortality rate= X 1000
Total live births in the same year

 Causes

 Low birth weight  Congenital anomalies

 Prematurity  Birth asphyxia and tetanus
 Birth injury and difficult labor  Condition of placenta and cord
 Sepsis  Hemolytic disease
 Fetal distress  ARI

 INFANT MORTALITY RATE

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 Definition:
Infant mortality rate is the probability of child born in a specific year or period dying before reaching
the age of one, if the subject to age-specific mortality rates of that period.

No. of death under 1 year of age

Infant mortality rate= x1000
Total live birth in year

 IMPORTANCE OF IMR
 It depicts the age-related mortality in vulnerable group with in the society.
 Specific health programme is affected directly and rapidly rather than the general health problems.
 Improved obstetric and perinatal care.
 Improvement in the quality of life.
 Improvement of nutritional status.
 Family planning. Eg., Birth spacing.

 FACTORS AFFECTING IMR

There are three factors include
(2) Economical factors
(1) Biological factors
 Birth weight (3) Socio-cultural factors
 Age of mother  Breastfeeding
 Birth spacing  Religion and caste
 Birth order  Early marriage
 Multiple birth  Sex of child
 Family size high fertility  Maternal education
 Quality of health care and mother
care
 Broken families

 REDUCE IMR MEASURE

 Improve health status of people.
 Raise female literacy.
 Primary health care.
 Environment sanitation.
 Prenatal nutrition.
 Socio economic development.

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 UNDER 5 YEAR MORTALITY RATE
 Definition:
According to WHO:- The mortality rate of children aged under 5 years is the probability that a child
born in a specific year or period will die before reaching the age of 5 years, subject to the age-specific
mortality rates of that period.

no. of death of children aged 1-4 year during a year

x 1000
Under 5 years mortality rate=
Total no. of children aged 1-4 year at the middle of year

 Causes
 Communicable diseases like diarrhea, measles, whooping cough, diphtheria, ARI, malnutrition.
 Accidents.
 Congenital anomalies.
 Malignant neoplasm.
 Pneumonia.
 Death.

 Preventive measures

 Prenatal nutrition and routine check-ups.  Sanitation.

 Prevention of infection and aseptic.  PHC and immunization.
 Breastfeeding.  Socio economic development.
 Family planning.  National health program.

 FERTILITY RATE

General fertility rate

The general fertility rate (GFR) is defined as the total number of live births per 1000 women of
reproductive age (age 15 to 49 years) in a population per year.

General marital fertility rate = General marital fertility rate (GMFR) is defined as the number of live
birth per 1000 married women in the reproductive age group (15-49) in a given year.

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 Total fertility rate = Average no. of children that would be born to a married woman.

Fecundity rate = fertility should not be confused with fecundity which refers to the child bearing
capacity of a women.

Marriage rate = total no. of marriage during a calendar year per 1000 total mid year population.

 ABORTION RATE
 Definition:
According to WHO, Abortion refers to the termination of pregnancy from whatever cause before the
fetus is capable of extra uterine life.
It is defined as the number of abortions of all types in a year to number of live births over the same
period.

Abortion ratio=
Number of all types of abortion
X 1000
Number of live births

 CONCLUSION
Major importance of vital statistics and vital records that are reported locally become state and national
data, many of the functions are basic to any data collection system such as ensuring complete, accurate,
and timely reporting. It is especially challenging in an environment that involves creating legal
documents.

 ASSIGNMENT
Define maternal mortality and morbidity rate.

 REFERENCES
 Manivannam Shyamala D, Textbook of Community Health Nursing II, 1 st edition (2018), CBS
Publishers and Distributors, New Delhi, page no.-80-84.
 Nima Bhaskar, Midwifery and Obstetrical nursing, EMMESS Medical Publications, 2nd
edition, P.No. 19-25
 Annamma jacob, A comprehensive textbook of midwifery and gynecological nursing 5th
edition, jaypee , page no. 14-17
 Reena J Wani, Textbook of Midwifery for Nurses 1st edition. (2017) CBS Publishers and
distributors Pvt. Ltd, page no. 18-21

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 MATERNAL AND CHILD TRACKING SYSTEM

 Mother and Child Tracking System (MCTS) is an initiative of Ministry of Health & Family
Welfare to leverage information technology for ensuring delivery of full spectrum of healthcare
and immunization services to pregnant women and children up to 5 years of age.
 India’s Mother and Child Tracking System (MCTS) is an information system for tracking maternal
and child health beneficiaries in India’s public health system, and improving service delivery
planning and outcomes.
 Among the most vulnerable populations, pregnant women and children in resource-poor settings
need health systems that are capable of delivering timely and quality care.
 At the forefront of service delivery in many Low and Middle Income Countries (LMICs) are
Frontline Health Workers (FHWs), who are responsible for identifying all eligible beneficiaries
within their catchment areas and ensuring that each beneficiary receives the full schedule of
services.
 Generation of work plans of ANMs, sending regular alerts to the service providers as well as
beneficiaries about the services due and a user-friendly dash board for health managers at various
levels to monitor delivery of services will go a long way in ensuring quality service delivery, micro
birth planning, ensuring universal immunization
 It will have positive impact on important health indicators like Infant Mortality Rate and Maternal
Mortality Ratio.
 It will also help in evidence based planning and continuous assessment of service delivery to
pregnant women and children.

OBJECTIVES:

 Registration of Pregnant Women

 Ante-Natal Care (ANC), Delivery & Post-Natal Care (PNC) Services
 During the pregnancy period, MCTS records 4 ANC services given to pregnant women and then
captures delivery details like date of delivery, place of delivery and its outcome and then PNC
Service
 Work plan for the ANM/ASHA is generated so that no women are left without services.
Registration of Children for Immunization In order to give 30 immunizations to every child,
she/he is registered in MCTS application.

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  Immunization Services to Children Immunization is given to every child as per the schedule and
Work plan is generated to be consumed by ANM/ASHA from the MCTS application so that no
child is left.
 Integration with other applications like PFMS, MDR, MCTFC, Mobile Academy, Kilkari etc.

 National Conference Proceedings (NCP) 2019 MCTS benefit – States:

 At a Glance real time State progress report of the entire state.
 Facilitate in identification of poor performing Districts, health facilities, SubCenters.
 Graphical dashboard for pictorial representation of the reports
 Special reports of high-risk cases
 Dedicated helpdesk for feedback and suggestion
 Focused deployment of health workers & any supplementary immunization activity planning
 Better data analysis for preparation of District /Block health action plans
 Improved supply chain management of vaccines and Drugs
 Effective IEC and communication with field workers and beneficiaries

 Expectations of MOHFW
 100% Registration of Pregnant Women & Children
 100% timely Update of Services Delivered to Pregnant Women & Children on MCTS Portal
 Use of MCTS application by all levels Health workers.
 Service Delivery to Pregnant Women and Children ensured.
 Work-plan generation and utilization
 Near Real time update of Data on MCTS
 Use of MCTS data for review and action-for follow up on various schemes and programs related to
RCH services.
 Use of MCTS data for policy formulation, micro planning at different levels .
 Advice DMHO and BMHO for continuous monitoring, field visit and taking of corrective action
based on MCTS information
 Improve civil registration

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 Death Registration completed within prescribed time limit of 21 days

Death
S. No. State/ Union Territory Registration Registered %
Completed Deaths
Within 21 days
1. Punjab 227158 229846 98.8
2. Chandigarh 17906 18370 97.5
3. Mizoram 6508 6703 97.1
4. Haryana 197966 212238 93.3
5. West Bengal 564466 606714 93.0
6. A & N Islands 2730 2951 92.5
7. Puducherry 11892 12923 92.0
8. Himachal Pradesh 40852 44449 91.9
9. Tamil Nadu 629473 687212 91.6
10. Andhra Pradesh 412468 455000 90.7
11. Gujarat 472348 523892 90.2
12. D & N Haveli and Daman 3059 3414 89.6
& Diu
13. Odisha 323739 362982 89.2
14. Goa 12712 14654 86.7
15. Lakshadweep 296 342 86.5
16. Meghalaya 16572 19191 86.4
17. Chhattisgarh 161899 191938 84.3
18. Madhya Pradesh 424997 524454 81.0
19. Bihar 320970 425047 75.5
20. Tripura 23464 31645 74.1
21. Karnataka 374670 551808 67.9
22. Rajasthan 321759 477151 67.4
23. Telangana 132130 203127 65.0
24. Kerala 138741 250983 55.3
25. Jharkhand 60377 119037 50.7
26. Uttar Pradesh 436710 873419 50.0
27. Uttarakhand 27471 62219 44.2
28. Jammu & Kashmir 21064 53070 39.7
29. Nagaland 847 2509 33.8
30. Manipur 810 2709 29.9

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 31. Ladakh 171 742 23.0
32. Assam 38424 187085 20.5
33. Arunachal Pradesh 469 3475 13.5
Note:
- Total Registered Deaths in respect of Goa and Manipur include all delayed Deaths
registered and may not tally with Registered Deaths of State/UT.
- Partial Information has been Provided by Maharashtra, Sikkim and Delhi and
therefore not included in statement.
- Data in respect of Karnataka is Provisional.

NUMBER OF BIRTHS REGISTERED BY SEX AND STATES/UTs (RURAL/URBAN), 2020

India/ States/ Rural Urban Total

Union Male Female Person Male Female Person Male Female Person
Territories
India 5905859 5460718 11367009 6690841 6164215 12855435 12596700 11624933 24222444

States

Andhra Pradesh 125777 115622 241399 244881 227737 472618 370658 343359 714017
Arunachal Pradesh 10679 12180 22859 8340 8294 16634 19019 20474 39493
Assam 280617 269532 550149 105452 96093 201545 386069 365625 751694
Bihar 1145635 1028374 2174266 455124 415420 870665 1600759 1443794 3044931
Chhattisgarh 136791 129671 266527 129233 119830 249091 266024 249501 515618
Goa 2828 2642 5470 6581 6265 12846 9409 8907 18316
Gujarat 165772 153982 319763 412018 371442 783478 577790 525424 1103241
Haryana 83716 76958 160688 226029 205169 431226 309745 282127 591914
Himachal Pradesh 20221 19031 39252 26617 24902 51520 46838 43933 90772
Jharkhand 228024 209275 437299 111187 99967 211154 339211 309242 648453
Karnataka 85055 80195 165250 424863 398030 822893 509918 478225 988143
Kerala 70820 68080 138910 156233 151729 307981 227053 219809 446891
Madhya Pradesh 321190 288530 609720 546548 497361 1043909 867738 785891 1653629
Maharashtra 228115 208382 436520 666859 608605 1275483 894974 816987 1712003
Manipur 6305 6219 12524 6408 4963 11371 12713 11182 23895
Meghalaya 45356 46583 91939 10860 9665 20525 56216 56248 112464
Mizoram 4365 4292 8657 7569 7094 14663 11934 11386 23320
Nagaland 14461 13845 28306 8701 9072 17773 23162 22917 46079
Odisha 149004 141365 290369 198661 182325 380986 347665 323690 671355
Punjab 29014 27104 56118 169573 155509 325082 198587 182613 381200
Rajasthan 484646 444967 929652 492675 446996 939731 977321 891963 1869383
Sikkim 417 401 818 3267 3104 6371 3684 3505 7189
Tamil Nadu 95679 89432 185111 386168 362740 748908 481847 452172 934019
Telangana 114311 105507 219818 231230 218272 449502 345541 323779 669320
Tripura 19921 19016 38944 14101 13536 27645 34022 32552 66589
Uttarakhand 45721 43177 88898 74093 68678 142771 119814 111855 231669
Uttar Pradesh 1550118 1435788 2985906 973859 894333 1868192 2523977 2330121 4854098
West Bengal 381715 363695 745410 377108 352892 730000 758823 716587 1475410

Union Territories
A & N Islands 665 617 1282 1665 1670 3335 2330 2287 4617
Chandigarh 0 0 0 12083 11383 23475 12083 11383 23475
Dadra and Nagar 1787 1750 3538 4486 3892 8378 6273 5642 11916
Haveli and
Daman and Diu

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Delhi 14338 13273 27618 141635 132324 274027 155973 145597 301645
Jammu & Kashmir 40200 38678 78878 41962 40767 82729 82162 79445 161607
Ladakh 788 823 1611 1142 1267 2409 1930 2090 4020
Lakshadweep 553 529 1082 - - - 553 529 1082
Puducherry 1255 1203 2458 13630 12889 26519 14885 14092 28977

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