Smaller families becoming norm in Odisha: Survey

Bhubaneswar: Odisha has made quantum leap with 25 point decline in infant mortality rate (IMR) from 65 (NFHS-3) to 40 (NFHS-4). This is better than the national average decline of 16 point and better than major states like Gujarat (16 point), Rajasthan (24 point) Chhattisgarh (17 point), MP (18 point), Bihar (13 point), Maharastra (13 point), according to the Odisha state report of the 2015-16 National Family Health Survey (NFHS-4) that released here on Tuesday.

Secretary, Health and Family Welfare, Dr P K Meheda released the report at a seminar, organized by International Institute for Population Sciences, Mumbai. NFHS-4 coordinators Prof S.K. Singh, Dr Manas Ranjan Pradhan, Dr L K Dwivedi and Dr S Pedgaonkar were present. Dr. Manas Ranjan Pradhan (NFHS-4 coordinator for the state of Odisha) presented the key findings of the state report. The findings relating to Odisha highlight several critical health indicators pertaining to institutional delivery, utilization of public health facilities for institutional delivery and post-natal care, full immunization coverage, reduction in anemia and reduction in IMR and U5 Mortality rate.

According to the report, smaller families are becoming the norm in Odisha. At current fertility levels, women in Odisha would have two children during their lifetime. Fertility has declined by 0.3 children in the 10 years between NFHS-3 and NFHS-4. Most states in India have reached replacement level fertility (just over two children per woman) or below replacement level fertility and Odisha is one of them. The total fertility rate (TFR) in Odisha is 2.1 children per woman. In urban areas, fertility is 1.7 children per woman (well below the replacement level). Even rural areas fertility is at the replacement level (2.1 children per woman).

In Odisha, early marriage before age of 18 for women age 20-24 has declined substantially from 37 percent in NFHS-3 however about one-tenth of men(11%) age 25-29 got married before the legal minimum age at marriage of 21, down from 22 percent in NFHS-3.

The percentage of currently married women who use a contraceptive method is 57 percent, an increase of6 percentage points since NFHS-3.Women in urban areas of Odisha are more likely to use a method (61%) than women in rural areas (57%). Contraceptive prevalence in Odisha is also above the national average of 54 percent. Female sterilization accounts for 49 percent of all contraceptive use in Odisha. Likewise, the Use of contraceptive pills has increased from 7 percent in NFHS-3 to 12 percent in NFHS-4.

The report said, three-fifths of women (62%) have had at least four antenatal care (ANC) visits during their last pregnancy, against national average of 51.2%, which has been substantially increased from 36.9% in NFHS-3. About 64 percent received antenatal care in the first trimester of pregnancy. Significantly, 97.2% of registered pregnant women had received Mother and Child Protection Card.

More than four-fifths (85%) of births take place in a health facility and institutional delivery rates have substantially increased from 35.6 to 85.4% in Odisha in the last decade. This is better than the national average of 78.9%. Moreover, 75.9% institutional deliveries have been conducted in public heath facilities. Odisha recorded 47.1% point increase in Institutional Births in Public Facility from 28.8% in 2005-06 to 75.9% in 2015-16. This is better than the all India average of 52.1 %. During last 1 decade, Odisha has made significant improvement in increasing institutional delivery by 62.8 point, which is 2nd highest in the country after Sikkim (63.28 point) and far better than National average of 45.3 point improvement. Odisha’s achievement is also much better than major States like Gujarat (42.4 point), Maharashtra (37.7point), MP (60.7point), Bihar (49.2 point) and many other States.

Overall, 79 percent of women had a postnatal check within two days of birth, but only half of women who had a home birth had a postnatal check within two days of birth. Seventy-three percent of women have received financial assistance under Janani Suraksha Yojana (JSY) for births in the five years preceding the survey that were delivered in a health facility, which is the highest among all the states in India.

By the time they are one year old, children are supposed to receive a BCG vaccination against tuberculosis, a measles vaccination, and three doses each of polio and DPT vaccines. Significant percentage of 79% of children age 12-23 months have received all basic vaccinations against six major childhood illnesses, which is more than the national average (62%).Overall, there has been a substantial increase in coverage of all basic vaccinations in the 10 years since NFHS-3 (52%). Also, coverage of each of the required vaccines has increased between NFHS-3 and NFHS-4 in Odisha. Moreover, the % of improvement which is 26.8 points for Odisha, is far better than national average of 18.5 points as well as better than major states like Gujurat (5.2 points), Maharastra (-2.5 points), Tamilnadu (-11.2 points), Madhya Pradesh (13.3 points).

The report said diarrhoea is one of the challenges for health of young children in Odisha. However, very good progress has been observed in use of ORS, as 97% of women who gave birth in the last 5 years know about Oral Rehydration Salts (ORS) for the treatment of diarrhoea, and majority of 69% (NFHS-4) of children under five years of age who had diarrhea in the past two weeks received a solution made from ORS packets which has been increased from 39.8% (NFHS-3). Overall, 19 percent of children with diarrhoea were given gruel and three-fourths were treated with some kind of oral rehydration therapy (ORT) including gruel, increased fluids, or ORS.

According to the report, in comparison to NFHS-3, fewer children under 5 years of age were found to be stunted during NFHS-4. A little more than one-third of children (34%) under age five years are stunted, or too short for their age. 20% are wasted, or too thin for their height, which results from inadequate food intake or a recent illness. 34% of children are underweight, which takes into account both chronic and acute under-nutrition. In the 10 years since NFHS-3, stunting decreased substantially (from 45% to 34%) and underweight decreased from 41%to 34%.

One in 4 women and 1 in 5 men are too thin (which represents a substantial improvement from 41 percent of women and 36 percent of men in NFHS-3).However, about 1 in 6 women and men (17%) are overweight or obese (up from 7 percent of women and 6 percent of men in NFHS-3). About 3 in 5 women and men in the age group 15-49 years, have a healthy weight for their height.

Going by the report, anaemia in India is primarily linked to poor nutrition, but it can also be caused by malaria, chronic infections and other conditions. Almost half (45%) of children age 6-59 months are anaemic. This includes 25 percent who are mildly anaemic, 19 percent who are moderately anaemic, and 1 percent who suffer from severe anaemia.

The other highlights include:

Anaemia among children in Odisha has dramatically declined (by 20 percentage points) in the 10 years since NFHS-3. Anaemia among pregnant women has decreased by 20.5% from 68.1% in NFHS-3 to 47.6% in NFHS-4, which is better than national average of 50.3%.Forty-eight percent of women who are pregnant and 55 percent of women who are breastfeeding are anaemic.

About 28% of women age 15-49 were employed in the 12 months preceding the survey. 56% of women have a bank or savings account that they themselves use. 63% of women own a house alone or jointly with someone else.39% percent of women have a mobile phone that they themselves use.