DEMOGRAPHICS &

VITAL STATISTICS
DR NIRANJANI R
OBGYN
SENIOR RESIDENT
DEMOGRAPHY
 DEMOGRAPHY is the study of human
population in a given area, usually a
country with regard to Size,
Composition and Distribution.
 It deals with five demographic processes
: Fertility, Mortality, Marriage,
Migration and Social Mobility.
VITAL STATISTICS
 It refers to the study of
vital events like births,
deaths, diseases and
divorce.
DEFINITIONS

WHAT IS


INTRAUTERINE FETAL
DEMISE/ IUFD?
  IUFD

 Foetal death means death

that occurs prior to
complete expulsion or
extraction from the mother
irrespective of the duration
of pregnancy and which is
not an induced termination
 NON-VIABLE FETUS - < less
than 24 weeks gestation and
where there is no evidence of
life at delivery
 LATE INTRAUTERINE FETAL

DEATH- after 24 completed

weeks of pregnancy of a
singleton foetus.
 STILL BIRTH more than 28 weeks
gestation/ fetus weighing >1000g
or with a Crown heel length of
>35cm and where there is no
evidence of life at delivery

STILL BIRTH RATE INDIA-

22/1000(WHO)
CAUSES OF IUFD &
STILLBIRTH
DEVELOPED COUNTRIES DEVELOPING COUNTRIES
Congenital and karyotypic anomalies Obstructed and prolonged labor
and associated asphyxia,
infection, and birth injury
Growth restriction and placental Infections:syphilis and gram-
anomalies negative infections.
Medical disorders like Hypertensive disorders and
diabetes,SLE,Renal disease, sequalae
thyroid disorders and cholestasis
of pregnancy
Hypertensive disorders and pre- Congenital anomalies
eclampsia, multiple gestations
Infections such as parvovirus Poor nutritional status
B19, syphilis, streptococcus and
listeria
Smoking Malaria and sickle cell disease
PERINATAL PERIOD
 Perinatal mortality: all fetal &
neonatal deaths weighing 500g
or more between 22weeks of
gestation to first week of
neonatal life(WHO)

 Perinatal mortality rate:

expressed in terms of perinatal
deaths per 1000 total births
PMR
Late foetal and early neonatal deaths
weighing over 1000 g at birth X1000

Total live+ still births weighing over

1000 g at birth in that year
PMR IN INDIA 2016-19 SRS- 22/1000

PMR LOWEST KERALA 5/1000, TN-10/1000

PMR HIGHEST MADHYAPRADESH 35/1000, UP-32/1000

 Factors affecting PNM
• Maternal age
– Teenage pregnancies, elderly
gravida
• Parity
– Anemia, inadequate prenatal care,
inadequate rest, Malpresentation,
multiple births
• Socioeconomic factors
– Lower socioeconomic status vs
upper strata
• Obstetric factors
 Causes of PNM
• Antenatal causes
– Maternal diseases, APH
• Intranatal causes
– Birth injuries, prolonged & difficult labor
– Birth asphyxia
• Postnatal causes
– Prematurity
– RDS
– Respiratory, alimentary tract infections
– Congenital malformations
• Unknown: 30-35%
At risk pregnancies
 Low socioeconomic status
 Elderly gravida,
 Teenage pregnancy
 Poor past obstetric history
 Malnutrition & severe anemia
 Multiple pregnancy
 Present pregnancy complications
REASONS FOR HIGH PMR IN
INDIA
• 3 DELAYS:

 Delay in recognizing the danger signs

and decision to seek help
 Reaching an appropriate source of care
 Obtaining adequate and appropriate
treatment
 NEONATAL DEATH - death upto 28
days of birth after live birth
irrespective of gestation at birth.
 INFANT MORTALITY- Dealth after

28days of life upto 1 year of age.

NEONATAL MORTALITY
 Neonatal deaths are deaths occurring during the neonatal
period, commencing at birth and ending 28 completed days
after birth.
 The neonatal mortality rate is tabulated as :

Number of deaths of children under 28 days of age in a year

x 1000

Total live births in the same year

NMR – 24.9 per 1000 live births according to NFHS -5

CAUSES

 Preterm
 Intrapartum related complications
 Sepsis
 Congenital malformations
 Pneumonia
 Tetanus
 Diarrhoea
OVERVIEW OF DEFINITIONS & TIMELINE
STATISTICS
 The current infant mortality rate for India in
2023 is 26.619 deaths per 1000 live births,
a 3.89% decline from 2022.

Nearly 3.5 million babies in India are born

too early, 1.7 million babies are born with
birth defects, and one million new-borns
are discharged each year from Special
New-born Care Units (SNCUs). These new-
borns remain at high risk of death,
stunting, and developmental delay.
STATISTICS
There are nearly nearly one
million fewer newborn deaths
and ten thousand fewer
maternal deaths each month in
India in 2017 as compared to
2000.

This is a result of more and

GLOBAL RATES
DID YOU KNOW?
 Around 1.9 million stillbirths – babies born
with no sign of life at 28 weeks of
pregnancy or later – occurred worldwide in
2021. Many of these might have been
prevented with proper care.
 According to the latest data, the global
stillbirth rate last year was 13.9 stillbirths
per 1,000 total births. This equates to 1 in
72 total births resulting in a stillborn
baby, or one every 17 seconds.

SOURCE: UNICEF
NEONATAL MORTALITY
 The first 28 days of life – the neonatal
period – is the most vulnerable time
for a child’s survival. Children face the
highest risk of dying in their first
month of life at an average global rate
of 18 deaths per 1,000 live births
in 2021, down by 51 per cent from
37 deaths per 1,000 live births in
1990.
 Globally, 2.3 million
children died in the first
month of life in 2021 –
approximately 6,400
neonatal deaths every
day.
CAUSES
 Major causes of neonatal MORBIDITY &
MORTALITY—

1. INFECTIONS(33%)- pneumonia, sepsis,

Umblical cord infections
2. PREMATURITY(35%)
3. ASPHYXSIA(20%)
4. Congenital Malformations(9%)
FACTORS RESPONSIBLE
 Home delivery by unskilled persons
 Lack of essential newborn care for
asphyxsia and hypothermia
 Poor childcare practices
 Lack of early detection of sick newborn
 Inadequate or delayed referral
 Inadequate infrastructure at health care
facilities for specialized care of sick
newborns.
STRATEGIES TO REDUCE PERINATAL
MORTALITY

 General Measures:
1. Prenatal nutrition

2. Improving ANC

3. Delivery by Skilled Birth Assistants

4. Training of midwives and traditional

birth attendants in NB care
5. Socioeconomic development and
education.
Let’s end preventable neonatal deaths and ensure Every
Child ALIVE.
INFERENCE
 Death during and after delivery
is largely preventable by
enabling access to skilled
birth attendants and
emergency obstetric care.
 In the post-new-born period,

survival rates also rise

sharply with early and
exclusive breastfeeding and
UNICEF GOALS
 seeks to reduce inequities of care
 strengthen health systems
 incorporate resilience and risk-informed planning.
 UNICEFs focus on equitable reduction of neonatal deaths is in line
with the Government of India’s India New-born Action Plan

ENAP :Every NB an Action Plan to end

preventable Deaths
--- aims to significantly reduce preventable
new-born deaths and stillbirths and bring
down neonatal mortality(<10) and stillbirth
rate(<12) to a ‘single digit’ by 2030.
SUSTAINABLE DEVELOPMENTAL GOAL
“2030”

 Target 3.2
 By 2030, end preventable deaths of
newborns and children under 5 years of age,
with all countries aiming to reduce neonatal
mortality to at least as low as 12 per 1,000
live births and under-5 mortality to at
least as low as 25 per 1,000 live births
PREVENTION STRATEGIES
 UNICEF emphasizes
demand generation through social and
behaviour change initiatives that
promote institutional deliveries and the
stay of mothers recovering in health
facilities.
 During their stay, key messages on family
planning, early and exclusive
breastfeeding, handwashing
and newborn care are frequently
promoted.
 Community interventions are backed up by
efforts to improving access of pregnant
INTERVENTIONS IN INDIA
 Facility Based New-born Care:Sick New-born Care
Units (SNCUs) are established at District Hospital and
Medical College level, New-born Stabilization Units
(NBSUs) are established at First Referral Units (FRUs)/
Community Health Centres (CHCs) for care of sick and
small babies.
 Community Based care of New-born and Young
Children:Under Home Based New-born Care (HBNC)
and Home-Based Care of Young Children (HBYC)
program, home visits are performed by ASHAs to
improve child rearing practices and to identify sick
new-born and young children in the community.
 Mothers’ Absolute Affection (MAA):Early initiation
and exclusive breastfeeding for first six months and
appropriate Infant and Young Child Feeding (IYCF)
 Social Awareness and Actions to Neutralize
Pneumonia Successfully (SAANS) initiative
implemented since 2019 for reduction of Childhood
morbidity and mortality due to Pneumonia.
 Universal Immunization Programme (UIP) is
implemented to provide vaccination to children against
life threatening diseases such as Tuberculosis,
Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B,
Measles, Rubella, Pneumonia and Meningitis caused by
Haemophilus Influenzae B. The Rotavirus vaccination
has also been rolled out in the country for prevention of
Rota-viral diarrhoea. Pneumococcal Conjugate Vaccine
(PCV) has been introduced in all the States and UTs.
 Rashtriya Bal Swasthya Karyakaram
(RBSK): Children from 0 to 18 years of age are
screened for 30 health conditions (i.e. Diseases,
Deficiencies, Defects and Developmental delay) under
Rashtriya Bal SwasthyaKaryakaram (RBSK) to improve
child survival. District Early Intervention Centres
(DEICs) at district health facility level are established
for confirmation and management of children
screened under RBSK.
 Nutrition Rehabilitation Centres (NRCs)are set up
at public health facilities to treat and manage the
children with Severe Acute Malnutrition (SAM)
admitted with medical complications.
 Intensified Diarrhoea Control Fortnight / Defeat
Diarrhoea (D2) initiative implemented for promoting
ORS and Zinc use and for reducing diarrhoeal deaths.
 Anaemia Mukt Bharat (AMB) strategy as a part of
POSHANAbhiyan aims to strengthen the existing
mechanisms and foster newer strategies to tackle
anaemia which include testing & treatment of anaemia
in school going adolescents & pregnant women,
addressing non nutritional causes of anaemia and a
comprehensive communication strategy.
 Capacity Building: Several capacity building programs
of health care providers are taken up for improving
maternal and child survival and health outcomes.
 Globally UNICEF is focused on
#EveryChildALIVE, a signature
neonatal campaign that
supports and accelerates
UNICEF India’s efforts to
eliminate preventable neonatal
deaths by 2030, with a focus on
the girl child.
LEVELS OF NEWBORN CARE
PROBABLE LIVES SAVED…
THANKYOU !