Maharashtra

Maharashtra is a state in west-central India. It is one of the richest states of India. Its capital is Mumbai, the economic powerhouse of India.

Maharashtra's population was 96,752,247 according to the 2001 provisional results of Census of India, making it the second most populous state in India. Only eleven countries of the world have a population greater than Maharashtra.

Geography

Maharashtra borders Goa and Karnataka to the south, Andhra Pradesh to the southeast, Gujarat, Dadra and Nagar Haveli, and Madhya Pradesh to the north, Chhattisgarh to the east, and the Arabian Sea to the west.

Maharashtra State Health System

    35  Districts

   350  Talukas - approx.

60,000 Multi Purpose Worker [MPW] - Female
           Auxiliary Nurse Midwife [ANM]

60,000 Multi Purpose Worker [MPW] - Male

60,000 Health Assistant [HA] - Male
           Nurse Midwife / Lady Health Visitor

 5,000  Doctors

55,000 Anganwadi Worker [AWW]

1 Anganwadi worker serves 250 families or 1,000 people

Districts of Maharashtra
 
Maharashtra state is made up of 35 districts, which are grouped into six divisions. Population data is from the 2001 Census of India.
Amravati Division 9,941,903
bullet

Akola 1,629,305

bullet

Amravati 2,606,063

bullet

Buldhana or ( Buldana ) 2,226,328

bullet

Washim 1,019,725

bullet

Yavatmal 2,460,482

Aurangabad Division (Marathwada) 15,589,223

bullet

Aurangabad 2,920,548

bullet

Beed 2,159,841

bullet

Hingoli 986,717

bullet

Jalna 1,612,357

bullet

Latur 2,078,237

bullet

Nanded 2,868,158

bullet

Osmanabad 1,472,256

bullet

Parbhani 1,491,109

Konkan Division 24,807,357

bullet

Mumbai 3,326,837

bullet

Mumbai (Suburban) 8,587,561

bullet

Raigarh 2,205,972

bullet

Ratnagiri 1,696,482

bullet

Sindhudurg 861,672

bullet

Thane 8,128,833

Nashik Division 15,774,064

bullet

Ahmadnagar 4,088,077

bullet

Dhule 1,708,993

bullet

Jalgaon 3,679,936

bullet

Nandurbar 1,309,135

bullet

Nashik 4,987,923

Nagpur Division 10,665,939

bullet

Bhandara 1,135,835

bullet

Chandrapur 2,077,909

bullet

Gadchiroli 969,960

bullet

Gondiya 1,200,151

bullet

Nagpur 4,051,444

bullet

Wardha 1,230,640

Pune Division 19,973,761

bullet

Kolhapur 3,515,413

bullet

Pune 7,224,224

bullet

Sangli 2,581,835

bullet

Satara 2,796,906

bullet

Solapur 3,855,383

 

Health Status of Women - Maharashtra
Findings in National Family Health Survey-2 (1998-99)

 

Fertility and Family planning

Over the six year period between NFSH1 and NFHS-2, the average number of children per women (TFR) has declined by about half a child.

Maharashtra's TFR is much lower than the current National TFR of 2.9.

  • Rural women have half a child more on average than urban women
     
  • Women aged 15-19 account for 26% of total fertility. This young age of child bear ing increases the health and morbidity risks for the mothers and children, and cont ributes to high fertility.
Average no. of children per women
   

 

Many women want to control their fertility 
  • Almost one third of married women want to stop childbearing (20%), postpone their next birth by at least two years (10%), or have already opted for sterilisation (52%)
     
  • The preferences expressed by women indicate a need for contraceptive methods to both space and limit births.
Reproductive preferences among married women
   

 

Modern contraceptive use increased

Modern contraceptive use increased since Married women using the early 1990"s. Urban use increased from contraceptive 51% to 57%, while rural contraceptive use increased from 54% to 62%.
Married women using contraceptive
   

 

Female sterilisation is the most popular family planning method
  • Knowledge of the Pill, IUD and condom has improved, but use of these methods (only 8% of users) remains low. These are useful for women who want to space their next births, a preference expressed by 10 percent of women.
Family Planning Methods Currently Used
   

 

  • Research in low-income countries has  shown that spacing births by at least two years may prevent an average of one in four infant deaths.
     
  • The picture that emerges from NFHS-2 data is one of good progress, but women still marry early having their first child soon after marriage, and use contraception only after completing their childbearing.
Knowledge of Spacing Methods
   

 

Few Contraceptive users receive essential information 
  • Exposure to media is moderately high. About 62 percent saw or heard a message on family planning during the months before the survey. Nevertheless about 2 out of 5 women are not regularly exposed to family planning messages.
     
  • Among women currently using contraception, few were told about other methods or side effect of their current method. This reflects a low quality of services.
     
  • The situation is better for follow up services: about 75% of users received follow up after accepting their current method.
 

 

Public  medical sector remains an important source of contraceptives. 
  • 75% of users of modern contraceptives obtained their method from the public medical sector, the same as in NFHS-1 Government sources are particularly important in rural areas ( 86 %)
     
  • In both urban and rural areas, the public medical sector is the main source of supply for sterilisation. However, in urban areas, 28 percent of female sterilisations occur in the private sector, compared to only 9 percent on the rural areas.
Public Medical sector as source of modern contraceptives
   

 

WOMEN'S HEALTH
 
Many women are still not involved in personal health care decisions
  • Only half of the women report having a voice in decisions about their own health
     
  • Younger women are much less likely than older women to participate in decisions about their own health care.
     
  • Urban, non-slum women, and women with a middle school or higher education are more likely to be involved in decisions regarding their health care.
% of women in decisionmaking
   

 

Maternal health services improve.
  • 90 percent of mothers received at least one ante-natal check up from 1992 (85% of births)
     
  • 75 percent of mothers received 2 or more doses of tetanus toxoid vaccine, up slightly from NFHS-1
     
  • 85 percent of mothers received iron folic acid supplementation. Of those, only 84 percent received the recommended 3 month course.
     
  • Professional assistance at delivery increased to 60% in NFHS-2.
Maternal Care
   

 

Women's nutritional status poor
  • About two-fifths of women are malnourished, with a body Mass Index below 18.5 Kg/ m
     
  • Nearly one -third of pregnant have moderate to severe Anaemia, compared to non- pregnant women.
     
  • Anaemia can undermine women's health and is associated with an increased risk of maternal mortality and pregnancy loss. Anaemia may also lead to lower energy and reduced work capacity.
Anaemia in Women
   

 

Child survival and Infant survival still a challenge
  • Infant mortality declined from 58 deaths per 1000 births during 1984-1988 to 44 deaths in 1994-1998, an average rate of decline of 1.4 infant deaths per 1000 live births per year.
  • Maharashtra has the seventh lowest infant mortality rate in the country, however, despite the decline, one every 23 infants die be fore age one and one in 17 die before reaching age five
     
  • Infant mortality is 55 % higher among children born to mothers under age 20, than among children born to mothers age 20-29.
Trends in I.M.R.
   

 

Immunisation coverage high
  • Between NFHS-1 & NFHS-2, the proportion of children who received no immunisation dropped from 8% to 2%.
     
  • The proportion of children who received at least one vaccine is nearly 98%, while 78% are fully immunised.
  • Despite high rates, more than 1 in 3 of illiterate mothers and children belonging to schedule tribes are not fully immunised.
Immunisation Coverage
   

 

Many children are Anaemic
  • Overall three-fourths of children under age three are Anaemic. Most of these children suffer from mild to moderate Anaemia.
     
  • Anaemic children are at greater risk of infection, impaired mental skills, physical development and poor school performance. 
Anaemia in children
   

 

Malnutrition levels remain high
  • Half of children under age three suffer from low weight for age-also called as under weight, a measure of both short and long term under nutrition.
     
  • The same proportion are undernourished to the extent their growth has been stunted, they suffer from low height-for-age(40%)

    About one in five children have both low height and low weight, also called as Wasting.
     
  • Wasting is associated with a failure to receive adequate nutrition in the period immediately before the survey and may be the result of seasonal variations in food supply or recent episodes of illness.
     
  • The percentage of under weight children has remained unchanged since the early 1990's.
     
  • Poor feeding practices begin in infancy. Only about two in five infants under four months are exclusively breastfed, and only 31 % of those aged 6-9 months are being fed solid and mushy foods. Starting food supplements at 6 months is critical for meeting Protein, Energy and micronutrient needs
Malnutrition in Children
Underweight Trend
 
 

Source: http://hetv.org

 
 
Demographic and Reproductive Health Situation
  • SIGNIFICANT IMPROVEMENTS IN THE HEALTH OF WOMEN AND CHILDREN
  • SUBSTANTIAL FERTILITY DECLINE IN LAST FOUR DECADES
TFR  :   2.52
CBR : 21.1
IMR  : 48
MMR  :   3.1
  • HOWEVER CURRENT LEVELS OF FERTILITY, MORBIDITY AND MORTALITY ARE VERY HIGH BY INTERNATIONAL STANDARDS
  • UNWANTED FERTILITY             : 26 %
  • MEDIAN AGE AT FIRST BIRTH  : 19 YRS

Vital Rates (Maharashtra)
Sr. No. Year C.B.R. C.D.R. I.M.R.
1 1981 28.5 9.6 79
2 1982 29.8 8.8 70
3 1983 29.8 9.2 79
4 1984 31.1 9.4 76
5 1985 29.0 1.4 68
6 1986 30.1 8.4 63
7 1987 28.9 8.3 66
8 1988 29.4 8.9 68
9 1989 28.5 8.0 59
10 1990 27.5 7.4 58
11 1991 26.2 8.2 60
12 1992 25.3 7.9 59
13 1993 25.2 7.3 50
14 1994 25.1 7.5 55
15 1995 24.5 7.5 55
16 1996 23.4 7.4 48
17 1997 23.1 7.3 47
18 1998 22.5 7.7 49
19 1999 21.1 7.5 48
20 2000 20.9 7.5 48

Health status Indicators in some states:

State Crude Birth Rate Crude Death Rate Infant Mortality Rate
Kerala  18  6.4 14
Tamilnadu  19.3 8 52
Maharashtra  21.1 7.5 48
Andhra Pradesh 21.7 8.2 66
Karnataka  22.3 7.7 68
INDIA  26.1 8.7 70

 

DISTRICTWISE SEX RATIO - MAHARASHTRA 1991-2001

Sr. No. Name of the District 1991 2001
1 Ratnagiri 1205 1135
2 Sindhudurg 1137 1077
3 Satara 1029 995
4 Raigad 1010 975
5 Gondia 995 1005
6 Bhandara 980 982
7 Gadchiroli 976 976
8 Nandurbar 975 975
9 Kolhapur 961 949
10 Jalna 958 952
11 Sangli 958 957
12 Parbhani 954 957
13 Buldhana 953 946
14 Hingoli 952 953
15 Yeotmal 951 942
16 Ahmednagar 949 941
17 Chandrapur 948 961
18 Washim 948 939
19 Nanded 945 943
20 Dhule 945 945
21 Beed 944 927
22 Latur 942 934
23 Jalgaon 940 932
24 Nashlk 940 924
25 Wardha 939 936
26 Osmanabad 937 930
27 Amravati 936 940
28 Solapur 934 937
29 Akola 934 938
30 Pune 933 917
31 Aurangabad 922 919
32 Nagpur 922 933
33 Thane 879 857
34 Mumbai suburb 831 826
35 Mumbai 791 774
  Maharashtra 934 922

Districtwise Health Institutions

Sr. No. District R.H. P.H.C Sub-Centre P.H.U M.H.U
1 Thane 14(9) 77(50) 470(314) 23(21) 3(3)
2 Raigad 12(1) 54(3) 277(19) 4  -
3 Ratnagiri 10 67 374  - -
4 Nasik 25(10) 100(46) 530(256) 10(10) 7(7)
5 Dhule 5(3) 41(41) 174(54) - -
6 Nandurbar 11(7) 49(46) 257(240) 7(7) 11(11)
7 Jalgaon 18(1) 80(2) 397(16) - -
8 Ahmednagar 13(2) 89(10) 485(66) 5(5) 1
9 Pune 15(1) 86(6) 501(58) 19(5) 2
10 Solapur 11 68 329 1 -
11 Satara 12 71 309 5 -
12 Kolhapur 13 72 371 7 -
13 Sangli 9 59 270 2 -
14 Sindhudurga 10 38 246 - -
15 Akola 5 30 173 2 2
16 Washim 6 25 153 1 1
17 Amravati 12(3) 56(11) 320(95) 12(6) 8(8)
18 Yavatmal 15(3)10 62(17) 374(60) 2(1) 2(2)
19 Buldhana 10 52 265 - -
20 Aurangabad 7 47 248 - 1
21 Beed 9 47 253 2 -
22 Jalna 7 38 171 2 -
23 Parbhani 8 31 216 4 -
24 Hingoli 5 20 135 4 -
25 Nanded 14(3 64(13) 374(81) 11(7) 5(5)
26 Latur 9 46 234 1 -
27 Osmanabad 8 42 204 - -
28 Nagpur 9(1) 48(3) 300(22) 1 4(3)
29 Bhandara 5 30 190 - -
30 Gondia 10(4) 42(20) 237(115) - 4(4)
31 Chandrapur 13(3) 58(8) 336(104) 1 7(6)
32 Wardha 8 27 180 7 -
33 Gadchiroli 12(12) 45(45) 372(372) 34(34) 3(3)
  Total 350(63) 1764(294) 9725(1872) 167(96) 61(52)

 

Source: http://hetv.org