Eleventh Five Year Plan

Health and Family Welfare and AYUSH 59Scenario in Relation to Tenth Plan Goals3.1.10 Of the 11 monitorable targets for the TenthPlan, three were related to the health sector. Theirgoals and achievements are summarized in Table3.1.2.DECADAL RATE OF POPULATION GROWTH/TOTAL FERTILITY RATE (TFR)3.1.11 The decadal growth of population during1991–2001 had been 21.5%, on account of the momentumbuilt from high levels of fertility in the past. Thegood news is that we are right on course with respectto the first of the three Tenth Plan monitorable targetsrelated to the health sector. The projected decadalpopulation growth rate is 15.9% for 2001–11. The twoimportant demographic goals of the National PopulationPolicy (2000) are: achieving the populationreplacement level (TFR 2.1) by 2010 and a stable populationby 2045. TFR, which in the early 1950s was 6.0,has declined to 2.9 in 2005. Thus, India is moving towardsits goal of replacement-level fertility of 2.1. Thepercentage of married women using contraception hasincreased from a level of just over 10% in the early1970s to 41% in 1992–93, 48% in 1998–99, and to56% by 2005–06 (Figure 3.1.1). However, there are hugedifferentials amongst various States.MATERNAL MORTALITY RATIO (MMR)3.1.12 The MMR during 2001–03 has been 301 per100000 live births (RGI, 2006). Levels of maternalmortality vary greatly across the regions due to variationin access to emergency obstetric care (EmOC),prenatal care, anaemia rates among women, educationlevel of women, and other factors. There has been asubstantial decline during the seven year period of1997–2003. However, the pace of decline is insufficient.At the present rate of decline, it will be difficult toachieve the goal of 100 by 2012 (Figure 3.1.2). Thisreinforces that rapid expansion of skilled birth attendanceand EmOC is needed to further reduce maternalmortality in India.INFANT MORTALITY RATE (IMR)3.1.13 IMR is 58 per 1000 live births (Sample RegistrationSystem [SRS], 2005). It is higher in rural areas(64) and lower in the urban areas (40) of the country.TABLE 3.1.2Goals and Achievements during the Tenth PlanIndicator Goal for Tenth Plan AchievementsDecadal Rate of Population Growth 16.2% 15.9% for 2001–11 (Projected) 1IMR 45 per 1000 live births 58 per 1000 live births 2MMR 2 per 1000 live births 3.01 per 1000 live births 3Notes: 1. Technical Group on Population Projections set up by National Commission on Population (December 2006), RGI, GoI;2. SRS 2005; 3. 2001–03 Special Survey of Deaths using RHIME (routine, re-sampled, household interview of mortality with medicalevaluation), RGI (2006), GoI.706050403020100375141Source: NFHS-3, IIPS (2005–06).4558 645348NFHS-I, 1992–93 NFHS-II, 1998–99 NFHS-III, 2005–06Rural Urban TotalFIGURE 3.1.1: Trends in Contraceptive Use (%)(currently married women in 15–49 age group)56It also varies across States. Neo-natal mortality (at 37per 1000 live births) constitutes nearly 60%–75% of theIMR in various States. The coverage of immunizationhas increased marginally from 42% in 1998–99 to 44%in 2005–06 (Figure 3.1.3). Polio continues to be a problemand usage of Oral Rehydration Solution (ORS)among children with diarrhoea continues to be low(according to NFHS-3, 26.2% of children with diarrhoeain the last two weeks received ORS). The trendof reduction in IMR has been shown in Figure 3.1.4.Concerted efforts will be required under Home BasedNewborn Care (HBNC) to reduce the IMR and NeonatalMortality Rate (NMR) further.