Ministry of Health and Family Welfare Government of India District Level Household and Facility Survey under Reproductive and Child Health Project (DLHS3) District Fact Sheet 278 Kerala Palakkad International Institute for Population Sciences (Deemed University) Mumbai
For further information, please contact: Additional Director General (Stat.) Ministry of Health and Family Welfare Government of India Nirman Bhavan New Delhi Telephone: 236334 Fax: 236334 Email: adgmohfw@nic.in Chief Director (Stat.) Ministry of Health and Family Welfare Government of India Nirman Bhavan New Delhi Telephone: 2362699 Fax: 2362699 Email: cdstat@nic.in Director/ Project Coordinator (DLHS 3) International Institute for Population Sciences (IIPS) Govandi Station Road, Deonar Mumbai 4 88 Telephone: 22 2556 3254/5/6 Fax: 22 2556 3257, 2555 5895 Email: rchpro@iips.net, director@iips.net Website: http://www.rchiips.org
Kerala DLHS3 District : Palakkad About DLHS 3: The District Level Household Surveys (DLHS) was initiated in 997 with a view to assess the utilization of services provided by government health care facilities and people s perceptions about the quality of services. The District Level household Survey3 (DLHS 3) is the third in the series of district surveys, preceded by DLHS in 99899 and DLHS2 in 224. As in DLHS3, the International Institute for Population Sciences (IIPS) was the nodal agency to conduct DLHS and DLHS2. DLHS3, like other two earlier rounds, is designed to provide estimates on important indicators on maternal and child health, family planning and other reproductive health services. In addition, DLHS3 provides information on important interventions of National Health Mission (NRHM). Unlike other two rounds in which only currently married women age 544 years were interviewed, DLHS 3 interviewed evermarried women (age 549) and never married women (age 524). The sample size among the districts in the country varies according to their performance in terms of antenatal care (ANC), institutional delivery, immunization, etc. and it was fixed based on information related to such indicators from DLHS2. For low performing districts, 5 Households (HHs), for medium performing districts, 2 HHs and for good performing districts, HHs were fixed as sample size. In case of Palakkad, sample size was households with % additional HHs to take care of nonresponse/refusal, etc. The survey used twostage stratified random sampling in rural and threestage stratified sampling in urban areas of each district. The information from 2 Census was used as sampling frame for selecting primary sampling units (PSUs). In rural areas, all the villages in the district were stratified into different strata based on population/hh size, percentage of SC/ST population, female literacy (7+), etc. The required number of villages from each strata were selected with probability proportional to size (PPS). In selected primary sampling units (villages), household listing was done and required number of households were selected using systematic random sampling. For larger villages (more than 3 HHs) segmentation was carried out. In case of 3 to 6 HHs, two segments of equal size were made and one was selected using PPS. For PSUs having more than 6 HHs, segments of 5 HHs were created depending on the size and then two segments were selected using PPS. In case of urban areas, number of wards were selected using PPS at first stage. In a selected ward, one enumeration block from 2 Census was selected again using PPS. Procedure for segmentation, houshold selection, etc., was same as in the case of rural PSUs. The uniform bilingual questionnaires, both in English and in local language, were used in DLHS3 viz., Household, Ever Married Women (age 549), Unmarried Women (age 524), Village and Health facility questionnaires. In the household questionnaire, information on all members of the household and the socioeconomic characteristics of the household, assets possessed, number of marriages to usual members of the household since January 24 and deaths in the household since January 24 etc. were collected. In case of female deaths, attempts were made to assess maternal death. The household questionnaire also collected information on respondent s knowledge (seen/read/heard) about messages related to various government health programmes being spread through media and other sources.
Kerala DLHS3 District : Palakkad The ever married women's questionnaire consists of sections on women's characteristics, maternal care, immunization and child care, contraception and fertility preferences, reproductive health including knowledge about HIV/AIDS. The unmarried women's questionnaire contained information on her characteristics, family life education and age at marriage, reproductive healthknowledge and awareness about contraception, HIV / AIDS, etc. The village questionnaire contained information on availability of health, education and other facilities in the village and whether the health facilities are accessible throughout the year. For the first time, populationlinked facility survey has been conducted in DLHS3. In a district, all Community Health Centres (CHCs) and District Hospital (DH) were covered. Further, all Sub Centres (SCs) and Primary Health Centres (PHCs) which were expected to serve the population of the selected PSU were also covered. There were separate questionnaires for SC, PHC, CHC and DH. They broadly include questions on infrastructure, human resources, supply of drugs & instruments, and performance. Note: DLHS2: Information is based on data collected from currently married women 544 years. DLHS3: Information is based on data collected from ever married women 549 years. DLHS2: percentage is adjusted for indicators considering over sampling of urban PSUs in DLHS2. This adjustment is done in those district were urban percentage is less than 3. DLHS2: Includes Tap (Inside Residency/Yard/Plot), Tap (Shared/Public), Hand Pump/Bore Well, Well covered. DLHS3: Includes Pipe into Dwelling, Piped to Yard/Plot, Public Tap/Standpipe. Unmet need for spacing Unmet need for spacing includes the proportion of currently married women who are neither in menopause or had hysterectomy nor are currently pregnant and who want more children after two years or later and are currently not using any family planning method. The women who are not sure about whether and when to have next child are also included in unmet need for spacing. Unmet need for limiting Unmet need for limiting includes the proportion of currently married women who are neither in menopause or had hysterectomy nor are currently pregnant and do not want any more children but are currently not using any family planning method. Unmet need Unmet need refers to unmet need for limiting and spacing. # It is adjusted according to DLHS3 definition. Correct Knowledge of HIV/AIDS The Women who heard about HIV/AIDS and have correct knowledge about transmission of HIV/ AIDS and knowledge of prevention from HIV/AIDS. 2
Kerala District Indicators, Palakkad (2 Census) Indicators DLHS3 District : Palakkad Census 2 Population (in thousands) Decadal Growth Rate (99) Sex Ratio * Percent Urban population Percent SC population Percent ST population Female Literacy Rate (7 years and above) Male Literacy Rate (7 years and above) Sample outcome, DLHS 3, 278 Category No. Covered 267 9.9 66 3.6 6.5.5 79.6 89.5 Response Rate Households Ever Married Women (549 years) Unmarried Women (524 years) Sub Centres (SC) Primary Health Centres (PHC) Community Health Centres (CHC) District Hospital (DH) Population and Household Characteristics, 278 Background Characteristics 2 852 85 42 35 8 92. 85.4 73.7.... DLHS 3 DLHS 2 Percent total literate Population (Age 7 +) 89.9 89.3 Percent literate Male Population (Age 7+) 94.2 93.9 Percent literate Female Population (Age 7+) 86. 85. Percent girls (age 6) attending Schools.. Percent boys (age 6) attending Schools.. Have Electricity connection (%) 89.8 89.4 7.5 68.9 Have Access to toilet facility (%) 9.8 9.6 76.8 75.4 Use piped drinking water (%) 37.8 35.3 33.4 29.8 Use LPG for cooking (%) 29.4 25.6 3.2 26. Live in a pucca house (%) 73.4 7.7 6.4 58.9 Own a house (%) 94.2 94.6 Have a BPL card (%) 24.3 25.7 Own Agricultural Land (%) 9.9 22.4 Have a television (%) 66.4 64.3 39.5 35.3 Have a mobile phone (%) 53.9 5. Have a Motorized Vehicle (%) 23.5 22.2 6.6 2.6 Standard of Living Index Low (%) 2.9 4.5 25.6 27.8 Medium (%) 36.5 38.2 45. 47.6 High (%) 5.6 47.3 29.3 24.7 * Number of Females per Males 3
Kerala Indicators Marriage and Fertility (Jan 24 to 278) Percentage of girl's marrying before completing 8 years Percentage of Births of Order 3 and above Sex Ratio at birth Percentage of women age 224 reporting birth of order 2 & above Percentage of births to women during age 59 out of total births DLHS3 Family planning (currently married women, age 549) 2.5 5.5 4 45.7 9.8 DLHS 3 DLHS 2.6 6.. 46.9 8.3 7.4 5.4 District : Palakkad 8. 6.3 Current Use : Any Method (%) Any Modern method (%) Female Sterilization (%) Male Sterilization (%) IUD (%) Pill (%) Condom (%) Unmet Need for Family Planning: unmet need (%) For spacing (%) For limiting (%) 52.2 48.6 4.4. 2.5. 3.6 25.. 4. 5.6 48.2 4.5. 2..8 3.7 25.7. 4.7 62.6 55.2 43.9.3 4.4. 4.9 7.4. 7.3 62. 55. 44.4.3 4.8. 4. 7.6.5 7. Maternal Health: Mothers registered in the first trimester when they were pregnant with last live birth/still birth (%) 95. 94.9 Mothers who had at least 3 AnteNatal care visits during the last pregnancy (%) Mothers who got at least one TT injection when they were pregnant with their last # live birth/still birth (%) 88.2 98.6 87.4 95.8 99. 86.4 96.2 86.4 Institutional births (%) Delivery at home assisted by a Doctor/Nurse/LHV/ANM(%) 99.3. 99.2 98.3.. 98.6. Mothers who received post natal care within 48 hours of delivery of their last child (%) 99.7 99.6 Child Immunization and Vitamin A supplementation: Children (223 months) fully immunized (BCG, 3 doses each of DPT, and Polio and Measles) (%) Children (223 months) who have received BCG (%) Children (223 months) who have received 3 doses of Polio Vaccine (%) Children (223 months) who have received 3 doses of DPT Vaccine (%) Children (223 months) who have received Measles Vaccine (%) 65.. 7.6 76.8 82. 69.2 66.3.. 73.4 82.8 73.4 8. 79.5 86.8 67.2. 82.5 79.3 87.7 4
Kerala DLHS3 District : Palakkad Indicators DLHS 3 DLHS 2 Child Immunization and Vitamin A supplementation: (Contd...) Children (935 months) who have received at least one dose of Vitamin A (%) 45.8 48. Children (above 2 months) who have received three doses of Vitamin A (%) Treatment of childhood diseases (children under 3 years based on last two surviving children).3.6 Children with Diarrhoea in the last two weeks who received ORS (%) 54.4 55. 43. 36.2 Children with Diarrhoea in the last two weeks who were given treatment (%) 92.4 92.3 87.5 89. Children with acute respiratory infection/fever in the last two weeks who were given treatment (%) 85.6 87.4 Children had checkup within 24 hours after delivery (based on last live birth)(%) 99.7 99.6 Children had checkup within days after delivery (based on last live birth) (%) 98.5 98.3 Child feeding practices (Children under 3 years) Children breastfed within one hour of birth (%) 58.5 59.3 Children (age 6 months above) exclusively breastfed (%) 7.5 8.7 Children (624 months) who received solid or semisolid food and still being breastfed (%) 93.2 93. Knowledge of HIV/AIDS and RTI/STI among Ever married Women (age 549) Women heard of HIV/AIDS (%) 95. 94.5 85.5 83.7 Women who knew that consistent condom use can reduce the chances of getting HIV/AIDS (%) 2.8 2.4 9.3 8.6 Women having correct knowledge of HIV/ AIDS (%) 96. 95.6 Women underwent test for detecting HIV/ AIDS (%) 4.5 4.6 Women heard of RTI/STI (%) 7. 69.5 26. 22.5 Knowledge of HIV/AIDS among Unmarried Women (age 524) Women heard of HIV/AIDS (%) 99.5 99.5 Women who knew that consistent condom use can reduce the chances of getting HIV/AIDS (%) 24.6 23.5 Women having correct knowledge of HIV/AIDS (%) 96.5 96. Women underwent test for detecting HIV/ AIDS (%).8.8 Women heard of RTI/STI (%) 69.9 67. Women facilitated/motivated by ASHA for Antenatal Care (%) Delivery at Health Facility (%) Use of Family Planning Methods (%)...... 5
Kerala DLHS3 District : Palakkad Village Indicators Villages that have implemented Janani Suraksha Yojana (JSY) Villages with Health & Sanitation Committee Villages with Rogi Kalyan Samiti (RKS) Villages where PRI aware of untied fund by Government Health facility within village ICDS (Anganwadi) throughout the year ICDS (Anganwadi) Health facility within village Sub Centre throughout the year Sub Centre Health facility within village PHC throughout the year PHC Health facility within village Block PHC throughout the year Block PHC Health facility within village Govt. Dispensary throughout the year Govt. Dispensary Health facility within village Private Clinic throughout the year Private Clinic Health facility within village AYUSH Health Facility If health facility is not in the village, whether accessible to the nearest health facility throughout the year AYUSH Health Facility Facility Survey Community Health Centre (CHC) N = 8 Infrastructure : CHC having Personal Computer CHC having Operation Theatre Number Indicators Number Indicators Number Performance : Inpatients admission in last one 2 month 2636 8 Referred cases for serious ailments from CHC to higher centres during last one month 43 43 4 5 43 43 37 6 8 35 36 7 4 2 262 CHC having Labour Room 7 Deliveries performed in last one month 69 CHC having Blood Storage Facility CHC having large deep freezer 6 Blood transfusion done in last one month Sterilization conducted in last one month 43 CHC prepared a CHC plan for the current year 8 CHC having water supply for 24 hours CHC having Ambulance on road 8 6 6
Kerala DLHS3 District : Palakkad Facility Survey Community Health Centre (CHC) N = 8 (Contd...) Indicators Number Indicators Number Human Resource : CHC having General Surgeon Supply : CHC with 24 hours normal 5 delivery services CHC having Obstetrician/Gynaecologist CHC with 24 hours New born care 5 M.O. received training of NonScalpel Vasectomy (NSV) during last five years M.O. received training for Prevention, Care and Support for HIV/AIDS during last five years M.O. received training of basic Emergency Obstetric Care during last five years M.O. received training of Integrated Management of Neonatal and Childhood illness during last five years Primary Health Centre (PHC) N= 35 CHC recongnized as Integrated Counseling and Testing Centre (ICTC) 3 3 Infrastructure : PHC having Residential Quarter for Medical Officer 6 Performance : Haemoglobin tests (TLC/DLC) conducted during last one month 52 PHC having separate Labour Room Blood smear examinations for malaria parasite conducted during last one month 293 PHC having Personal Computer Inpatient admissions during last one month PHC having Normal Delivery Kit Referral cases for serious ailments from PHC to higher centres during last one month PHC having Large Deep Freezer 7 Deliveries performed during last one month PHC having regular water supply 33 Beneficiaries of JSY during last one month PHC having Neonatal Warmer (Incubator) Women provided with postnatal care services during last one month 96 PHC having Operation Theatre with Boyle's Apparatus New born care provided during last one month 682 PHC having Operation Theatre with anaesthetic medicine Infants and children immunized during last one month 47 Condoms distributed during last one month 994 PHC prepared the PHC plan for current year 34 7
Kerala DLHS3 District : Palakkad Facility Survey Primary Health Centre (PHC) N= 35 (Contd...) Human Resource : Indicators Number Indicators Number PHC having Lady Medical Officer (LMO) Supply : PHC that received the untied fund in previous financial year 35 PHC having Laboratory Technician PHC organized any training programme in their PHC during last year PHC having at least one MO, who received Integrated Skill Development Training for 2 days during last five years PHC having at least one MO, who received IMNCI training during last five years Sub Centre (SC) N=42 Infrastructure : Sub Centre located in government building Sub Centre having communication facility Sub Centre having separate labour room ANM staying in Sub Centre village Sub Centre having staff quarter for ANM Sub Centre having regular water supply Human Resource : Sub Centre where Male Health Worker in postion ANM had Integrated Skill Development Training in last 5 years ANM ever been trained in Integrated Skill Development Training ANM trained in Integrated Management of Neonatal and Childhood Illnesses (IMNCI) in last 5 years 33 7 Performance : Number of Infants and children 4 immunized 639 4 36 29 Supply : Sub Centre having autodisposable 22 syringes 35 Sub Centre reporting IFA tablets out of stock for more than days 34 during last one month 4 3 Sub Centre reporting Vitamin A out of stock for more than days during last one month Sub Centre reporting ORS packets out of stock for more than days during last one month 8 ANM ever been trained in Integrated Management of Neonatal and Childhood Illnesses (IMNCI) 4 Sub Centre that received untied fund in previous financial year 37 ANM who attended Skilled Birth Atttendant (SBA) training 3 8
Kerala DLHS3 District : Palakkad Performance at a Glance 9