India - Demographic and Health Survey - 2017

Publication date: 2017

India National Family Health Survey (NFHS-4) 2015-16 International Institute for Population Sciences Deonar, Mumbai 400 088 Ministry of Health and Family Welfare Government of India NATIONAL FAMILY HEALTH SURVEY (NFHS-4) 2015-16 INDIA DECEMBER 2017 Suggested citation: International Institute for Population Sciences (IIPS) and ICF. 2017. National Family Health Survey (NFHS-4), 2015-16: India. Mumbai: IIPS. For additional information about the 2015-16 National Family Health Survey (NFHS-4), please contact: International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai-400 088 Telephone: 022-4237 2442 Fax: 022-2556 3257 Email: nfhs42013@gmail.com, director@iips.net For related information, visit http://www.rchiips.org/nfhs or http://www.iipsindia.org CONTRIBUTORS Balram Paswan S.K. Singh Hemkhothang Lhungdim Chander Shekhar Fred Arnold Sunita Kishor Abhishek Singh Dhananjay W. Bansod Manoj Alagarajan Laxmi Kant Dwivedi Sarang Pedgaonkar Manas R. Pradhan Contents Ȉ v CONTENTS TABLES AND FIGURES . xi KEY MESSAGE FROM SECRETARY OF MINISTRY OF HEALTH AND FAMILY WELFARE . xxi FOREWORD . xxiii PREFACE .xxv )520�',5(&725¶6�'(6. . xxvii ACKNOWLEDGEMENTS . xxix CHAPTER 1 INTRODUCTION . 1 1.1 Survey Objectives . 1 1.2 Sample Design . 1 1.3 Questionnaires . 2 1.4 Biomarker Measurements and Tests . 3 1.5 Pretest . 6 1.6 Training of Field Staff . 6 1.7 Fieldwork . 6 1.8 Strategy to Ensure Data Quality . 6 1.9 Data Processing . 7 1.10 Response Rates . 8 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS . 13 2.1 Drinking Water Sources and Treatment . 14 2.2 Sanitation . 15 2.3 Exposure to Smoke inside the Home and Other Housing Characteristics . 15 2.3.1 Exposure to Smoke inside the Home. 15 2.3.2 Other Housing Characteristics . 15 2.4 Household Wealth . 16 2.5 Hand Washing . 16 2.6 Household Population and Composition . 17 2.7 Birth Registration . 18 2.8 Children’s Living Arrangements and Parental Survival . 19 2.9 Schooling . 19 2.9.1 Educational Attainment . 19 2.9.2 School Attendance. 20 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS . 53 3.1 Basic Characteristics of Survey Respondents . 53 3.2 Schooling and Literacy . 54 3.3 Mass Media Exposure . 55 3.4 Employment . 56 3.5 Occupation . 56 Contents z�v Contents Ȉ�� vi CHAPTER 4 FERTILITY AND FERTILITY PREFERENCES . 79 4.1 Current Fertility . 79 4.2 Children Ever Born and Living . 81 4.3 Birth Order . 81 4.4 Birth Intervals . 81 4.5 Age at First Birth . 82 4.6 Menstrual Protection . 82 4.7 Teenage Childbearing . 83 4.8 Desire for Another Child . 84 4.9 Ideal Family Size . 85 4.10 Fertility Planning Status . 86 4.11 Wanted Fertility Rates . 87 CHAPTER 5 FAMILY PLANNING.111 5.1 Contraceptive Knowledge and Use .111 5.2 Source of Modern Contraceptive Methods .113 5.3 Informed Choice.114 5.4 Discontinuation of Contraceptives .115 5.5 Exposure to Family Planning Messages .115 5.6 Demand for Family Planning .116 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY .155 6.1 Marital Status .155 6.2 Age at First Marriage .156 6.3 Consanguineous Marriages .157 6.4 Age at First Sexual Intercourse .158 6.5 Recent Sexual Activity .159 6.6 Insusceptibility to Pregnancy .159 6.7 Pregnancy Outcomes .160 6.7.1 Characteristics of Abortions .161 CHAPTER 7 INFANT AND CHILD MORTALITY .185 7.1 Infant and Child Mortality.186 7.2 Biodemographic Risk Factors .187 7.3 Perinatal Mortality .188 CHAPTER 8 MATERNAL HEALTH .201 8.1 Pregnancy Registration .202 8.1.1 Registration of Pregnancies .202 8.1.2 Mother and Child Protection Card (MCP Card) .202 8.2 Antenatal Care Coverage and Content .202 8.2.1 Skilled Providers .202 8.2.2 Timing and Number of ANC Visits .203 8.3 Components of ANC Visits .204 8.4 Protection against Neonatal Tetanus .204 8.5 Ultrasound Testing during Pregnancy .205 8.6 Delivery Services .205 8.6.1 Institutional Deliveries .205 8.6.2 Skilled Assistance during Delivery .207 8.6.3 Delivery by Caesarean Section .208 vi z Contents Contents Ȉ vii 8.7 Delivery Costs .209 8.8 Postnatal Care .209 8.8.1 Postnatal Health Check for Mothers.209 8.8.2 Postnatal Health Checks for Newborns .210 CHAPTER 9 CHILD HEALTH .251 9.1 Birth Weight .252 9.2 Vaccination of Children .252 9.3 Symptoms of Acute Respiratory Infection .255 9.4 Fever .256 9.5 Diarrhoeal Disease .256 9.5.1 Prevalence of Diarrhoea .256 9.5.2 Treatment of Diarrhoea .257 9.5.3 Feeding Practices .258 9.5.4 Knowledge of ORS Packets .259 9.6 Disposal of Children’s Stools .259 9.7 Utilization of Integrated Child Development Services (ICDS) .260 9.7.1 Utilization of ICDS by Pregnant and Lactating Mothers .260 CHAPTER 10 NUTRITION AND ANAEMIA .291 10.1 Nutritional Status of Children .292 10.1.1 Nutritional Status among Young Children .292 10.1.2 Levels of Child Malnutrition .293 10.2 Infant and Young Child Feeding Practices .294 10.2.1 Initiation of Breastfeeding .294 10.2.2 Exclusive Breastfeeding .295 10.2.3 Median Duration of Breastfeeding .296 10.2.4 Complementary Feeding .296 10.2.5 Minimum Acceptable Diet .296 10.3 Anaemia Prevalence in Children .298 10.4 Presence of Iodised Salt in Households .299 10.5 Micronutrient Intake and Supplementation among Children .299 10.6 Nutritional Status in Adults .300 10.7 Anaemia Prevalence in Adults .301 10.8 Food Consumption of Women and Men .303 CHAPTER 11 MORBIDITY AND HEALTH CARE .343 11.1 Tuberculosis .343 11.1.1 Prevalence of Tuberculosis .343 11.1.2 Knowledge and Attitudes toward Tuberculosis .344 11.2 Health Problems .345 11.3 Use of Tobacco .345 11.3.1 Consumption of Tobacco .345 11.3.2 Quitting Tobacco .346 11.4 Alcohol Use, Health Insurance, and Sources of Health Care .347 11.4.1 Use of Alcohol .347 11.5 Health Insurance Coverage .347 11.6 Sources of Health Care .348 11.7 Reasons for Not Using Government Health Care .349 11.8 Recent Contact with Health Workers .349 11.9 Problems in Accessing Health Care .349 Contents z�vii CHAPTER 12 OTHER ADULT HEALTH ISSUES .385 12.1 Coverage of Testing for Blood Pressure and Random Blood Glucose Measurements .386 12.2 Blood Pressure .386 12.2.1 Self Reports of Blood Pressure Measurement and Medication .386 12.2.2 Blood Pressure Levels and Treatment Status .386 12.3 Random Blood Glucose .387 12.4 Health Examinations .388 12.5 Age-Specific Death Rates and Crude Death Rates .389 12.6 Adult Mortality.389 CHAPTER 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR .411 13.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods .412 13.2 Comprehensive Knowledge .413 13.3 Knowledge about Mother-to-Child Transmission .415 13.4 Accepting Attitudes toward People Living with HIV .415 13.5 Attitudes toward Negotiating Sex with Husband .416 13.6 Multiple Sexual Partners .417 13.7 Paid Sex.418 13.8 Coverage of HIV Testing Services .418 13.8.1 Awareness of HIV Testing Services and Experience with HIV Testing .418 13.8.2 HIV Testing of Pregnant Women .419 13.9 Self-Reporting of Sexually Transmitted Infections .420 13.10 HIV/AIDS-related Knowledge and Behaviour among Young People .421 13.10.1 Knowledge of HIV/AIDS .421 13.10.2 First Sex .421 13.10.3 Premarital Sex .422 13.10.4 Multiple Sexual Partners .422 13.10.5 Coverage of HIV Testing Services .423 CHAPTER 14 HIV PREVALENCE .473 14.1 Coverage Rates for HIV Testing .474 14.2 HIV Prevalence .475 14.2.1 HIV Prevalence by Age and Sex .475 14.2.2 HIV Prevalence by Sexual Risk Behaviour and Prior HIV Testing .477 14.2.3 HIV Prevalence among Couples .478 14.2.4 HIV Prevalence among Young People .478 CHAPTER 15 :20(1¶6�(032:(50(17 .507 15.1 Currently Married Women’s and Men’s Employment .508 15.2 Control over Women’s Earnings .509 15.3 Control over Men’s Earnings .510 15.4 Participation in Household Decision Making .510 15.5 Men’s Attitudes toward Women’s Roles in Decision Making .512 15.6 Women’s Access to Money and Microcredit .512 15.7 Freedom of Movement .513 15.8 Attitudes toward Wife Beating .514 15.9 Attitudes toward Negotiating Safer Sexual Relations with Husband .515 15.10 Women’s and Men’s Ownership of Assets .516 15.11 Ownership and Use of a Mobile Phone .516 viii z Contents CHAPTER 16 DOMESTIC VIOLENCE .563 16.1 Measurement of Violence .564 16.2 Women’s Experience of Physical Violence .565 16.2.1 Perpetrators of Physical Violence .566 16.3 Experience of Sexual Violence .566 16.3.1 Prevalence of Sexual Violence .566 16.3.2 Perpetrators of Sexual Violence .567 16.4 Experience of Different Types of Violence.567 16.5 Marital Control by Husband .567 16.6 Forms of Spousal Violence .568 16.6.1 Prevalence of Spousal Violence .568 16.7 Injuries to Women due to Spousal Violence .571 16.8 Violence Initiated by Women against Husbands .571 16.9 Help-seeking among Women who have Experienced Violence .572 16.9.1 Sources of Help .572 APPENDIX A ORGANIZATIONS INVOLVED IN NFHS-4 FIELDWORK AND HIV TESTING .601 APPENDIX B NFHS-4 SURVEY STAFF .603 APPENDIX C SAMPLE DESIGN .609 1.1 Introduction . 609 1.2 Sampling Frame . 609 Table C.1 Distribution of residential households by state/union territory and type of residence . .610 1.3 Sampling Design and Selection. . .611 Table C.2 Sample allocation of clusters by state/union territory and type of residence .612 Table C.3 Sample allocation of households by state/union territory and type of residence .613 Table C.4 Sample allocation of expected interviewed women and men by state/union territory and type of residence. . 614 1.4 Sampling Weight. .615 Table C.5 Sample implementation: Women .617 Table C.6 Sample implementation: Men .621 APPENDIX D ESTIMATES OF SAMPLING ERRORS .625 Table D.1 List of variables for sampling errors, India, 2015-16 .625 Table D.2 Sampling errors: Total sample, India, 2015-16 .626 Table D.2 Sampling errors: Urban sample, India, 2015-16 .627 Table D.2 Sampling errors: Rural sample, India, 2015-16 .628 APPENDIX E DATA QUALITY TABLES .629 Table E.1 Household age distribution.629 Table E.2.1 Age distribution of eligible and interviewed women .631 Table E.2.2 Age distribution of eligible and interviewed men .632 Table E.3 Completeness of reporting .633 Table E.4 Births by calendar years .634 Table E.5 Reporting of age at death in days .635 Table E.6 Reporting of age at death in months .636 APPENDIX F SURVEY INSTRUMENTS .637 Contents z�ix TABLES AND FIGURES CHAPTER 1 INTRODUCTION . 1 Table 1.1 Results of the household and individual interviews . 10 Table 1.2 Number of households, women, and men interviewed by state/union territory . 11 Figure 1.1 HIV Testing Algorithm . 5 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS . 13 Table 2.1 Household drinking water . 24 Table 2.2 Household sanitation facilities . 25 Table 2.3 Housing characteristics . 26 Table 2.4 Housing characteristics by state/union territory . 28 Table 2.5 Wealth quintiles by state/union territory . 30 Table 2.6 Religion and caste/tribe by wealth quintiles . 31 Table 2.7 Religion and caste/tribe of household head by state/union territory . 32 Table 2.8 Household possessions . 34 Table 2.9 Household ownership of agricultural land, house, and farm animals . 35 Table 2.10 Hand washing . 36 Table 2.11 Household composition . 37 Table 2.12 Household population by age, residence, sex, and possession of an Aadhaar card . 38 Table 2.13 Birth registration of children . 39 Table 2.14 Birth registration of children by state/union territory . 40 Table 2.15 Children's living arrangements and orphanhood . 41 Table 2.16 Children's living arrangements and orphanhood by state/union territory . 42 Table 2.17 Educational attainment of household population . 43 Table 2.18 Educational attainment of household population by state/union territory . 45 Table 2.19 School attendance by state/union territory . 47 Table 2.20 School attendance ratios . 49 Table 2.21 Reasons for children currently not attending school . 51 Figure 2.1 Household Drinking Water by Residence . 14 Figure 2.2 Household Toilet Facilities by Residence . 15 Figure 2.3 Household Wealth by Residence . 16 Figure 2.4 Population Pyramid . 17 Figure 2.5 Birth Registration by State/UT . 18 Figure 2.6 Orphanhood by Child’s Age . 19 Figure 2.7 School Attendance by Age, Sex, and Residence . 21 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS . 53 Table 3.1 Background characteristics of respondents . 59 Table 3.2.1 Respondent's level of schooling: Women . 61 Table 3.2.2 Respondent's level of schooling: Men . 62 Table 3.3.1 Literacy: Women . 63 Table 3.3.2 Literacy: Men . 65 Table 3.4.1 Respondent's level of schooling and literacy by state/union territory: Women . 67 Table 3.4.2 Respondent's level of schooling and literacy by state/union territory: Men . 68 Tables and Figures z�xi Table 3.5.1 Exposure to mass media: Women . 69 Table 3.5.2 Exposure to mass media: Men . 70 Table 3.6.1 Employment status: Women. 72 Table 3.6.2 Employment status: Men . 73 Table 3.7 Employment status of women and men by state/union territory . 74 Table 3.8 Occupation . 76 Table 3.9 Type of employment . 77 Figure 3.1 Education of Survey Respondents . 54 Figure 3.2 Secondary or Higher Education by Residence . 54 Figure 3.3 Exposure to Mass Media . 55 Figure 3.4 Employment Status by Schooling . 56 CHAPTER 4 FERTILITY AND FERTILITY PREFERENCES. 79 Table 4.1 Current fertility . 89 Table 4.2 Fertility by background characteristics . 90 Table 4.3 Fertility by state/union territory . 91 Table 4.4 Age-specific fertility rates . 92 Table 4.5 Children ever born and living . 93 Table 4.6 Birth order . 94 Table 4.7 Birth intervals . 95 Table 4.8 Age at first birth . 96 Table 4.9 Median age at first birth . 97 Table 4.10 Menstrual protection . 98 Table 4.11 Teenage pregnancy and motherhood . 99 Table 4.12 Teenage pregnancy and motherhood by state/union territory.100 Table 4.13 Fertility preferences by number of living children .101 Table 4.14 Desire to limit childbearing .102 Table 4.15 Desire to limit childbearing by state/union territory .103 Table 4.16.1 Indicators of sex preference: Women .104 Table 4.16.2 Indicators of sex preference: Men .105 Table 4.17 Indicators of sex preference by state/union territory .106 Table 4.18 Fertility planning status .107 Table 4.19 Wanted fertility rates .108 Table 4.20 Wanted fertility rates by state/union territory .109 Figure 4.1 Trends in Fertility by Residence . 80 Figure 4.2 Fertility by Household Wealth . 80 Figure 4.3 Trends in Age-Specific Fertility Rates . 80 Figure 4.4 Birth Intervals . 81 Figure 4.5 Median Age at First Birth by Schooling . 82 Figure 4.6 Teenage Childbearing by State/UT . 84 Figure 4.7 Currently Married Women and Men Age 15-49 with Two Children Who Want No More Children by Number of Living Sons . 85 Figure 4.8 Trends in Wanted and Actual Fertility . 87 CHAPTER 5 FAMILY PLANNING .111 Table 5.1 Knowledge of contraceptive methods .119 Table 5.2 Current use of contraception by state/union territory .122 Table 5.3.1 Current use of contraception .127 Table 5.3.2 Contraceptive use by men with last sexual partner .129 Table 5.4 Knowledge of contraceptive methods among adolescents .131 xii z Tables and Figures Table 5.5 Current use of contraception by age .132 Table 5.6 Number of living children at first use of contraception .134 Table 5.7 Timing of sterilization .135 Table 5.8 Source of modern contraceptive methods .136 Table 5.9 Public sector as source of modern contraceptives methods by state/union territory .139 Table 5.10 Use and source of emergency contraceptive pills .140 Table 5.11 Informed choice .141 Table 5.12 Informed choice by state/union territory .142 Table 5.13 Twelve-month contraceptive discontinuation rates .143 Table 5.14 Twelve-month contraceptive discontinuation rates by state/union territory .144 Table 5.15.1 Exposure to family planning messages: Women .145 Table 5.15.2 Exposure to family planning messages: Men .146 Table 5.16 Men's contraception-related perceptions and knowledge .147 Table 5.17 Men's contraception-related perceptions and knowledge by state/union territory .148 Table 5.18 Need and demand for family planning .149 Table 5.19 Need and demand for family planning by state/union territory .151 Table 5.20 Hysterectomy .153 Table 5.21 Hysterectomy by state/union territory .154 Figure 5.1 What Contraceptive Methods do Women Use? .112 Figure 5.2 Use of Modern Contraceptive Methods by Household Wealth .112 Figure 5.3 Use of Contraceptive Methods by State/UT .113 Figure 5.4 Source of Modern Contraceptive Methods .114 Figure 5.5 Contraceptive Discontinuation Rates for Modern Spacing Methods.115 Figure 5.6 Demand for Family Planning .116 Figure 5.7 Unmet Need for Family Planning by State/UT .117 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY .155 Table 6.1 Current marital status .163 Table 6.2 Age at first marriage .165 Table 6.3.1 Median age at first marriage: Women .166 Table 6.3.2 Median age at first marriage: Men .167 Table 6.4 Age at first marriage by state/union territory .168 Table 6.5 Consanguineous marriages .169 Table 6.6 Consanguineous marriages by state/union territory .170 Table 6.7 Age at first sexual intercourse .171 Table 6.8.1 Median age at first sexual intercourse: Women .172 Table 6.8.2 Median age at first sexual intercourse: Men .173 Table 6.9.1 Most recent sexual activity: Women .174 Table 6.9.2 Most recent sexual activity: Men .175 Table 6.10 Postpartum amenorrhoea, abstinence, and insusceptibility .176 Table 6.11 Median duration of postpartum amenorrhoea, postpartum abstinence, and postpartum insusceptibility .177 Table 6.12 Menopause .178 Table 6.13 Non-live births .179 Table 6.14 Non-live births by state/union territory .180 Table 6.15 Pregnancy outcome .181 Table 6.16 Pregnancy outcome by state/union territory .182 Table 6.17 Characteristics of abortions .183 Tables and Figures z�xiii Figure 6.1 Marital Status .156 Figure 6.2 Women's Median Age at First Marriage by Schooling .157 Figure 6.3 Consanguineous Marriages by State/UT .158 CHAPTER 7 INFANT AND CHILD MORTALITY .185 Table 7.1 Early childhood mortality rates .190 Table 7.2 Early childhood mortality rates by background characteristics .191 Table 7.3 Early childhood mortality rates by demographic characteristics .194 Table 7.4 Early childhood mortality rates by state/union territory .197 Table 7.5 Perinatal mortality .198 Table 7.6 Perinatal mortality by state/union territory .199 Table 7.7 High-risk fertility behaviour .200 Figure 7.1 Trends in Early Childhood Mortality Rates .186 Figure 7.2 Under-five Mortality Rate by State/UT .187 Figure 7.3 High-risk Births Have Higher Mortality Rates .188 CHAPTER 8 MATERNAL HEALTH .201 Table 8.1 Pregnancy registration and Mother and Child Protection Card .213 Table 8.2 Health problems during pregnancy .214 Table 8.3 Antenatal care .215 Table 8.4 Antenatal care by state/union territory .216 Table 8.5 Number of antenatal care visits and timing of first visit .217 Table 8.6 Number of antenatal care visits and timing of first visit by source .218 Table 8.7 Components of antenatal care .219 Table 8.8 Antenatal care services and information received .220 Table 8.9 Male involvement in antenatal care .222 Table 8.10 Reasons why child's mother did not receive antenatal care: Men .224 Table 8.11 Antenatal care indicators by state/union territory .225 Table 8.12 Pregnancies for which an ultrasound test was done .226 Table 8.13 Place of delivery .228 Table 8.14 Reasons for not delivering in a health facility .229 Table 8.15 Institutional delivery of youngest child: Men .230 Table 8.16 Delivery and other related information given to men: Men's reports .231 Table 8.17 Delivery and other related information given to men by state/union territory: Men's reports .232 Table 8.18 Adherence to delivery protocol for home delivery .233 Table 8.19 Assistance during delivery .234 Table 8.20 Delivery costs .236 Table 8.21 Timing of first postnatal check for the mother .237 Table 8.22 Type of provider of first postnatal check for the mother .239 Table 8.23 Timing of first postnatal check for the newborn .241 Table 8.24 Type of provider of first postnatal check for the newborn .243 Table 8.25 Symptoms of postpartum complications .244 Table 8.26 Maternal care indicators by state/union territory .245 Table 8.27 Trends in maternal care indicators .246 Table 8.28 Advice received during pregnancy .247 Table 8.29 Delivery and postnatal care by state/union territory .248 Table 8.30 Birth order and delivery characteristics by state/union territory .249 xiv z Tables and Figures Figure 8.1 Trends in Antenatal Coverage .203 Figure 8.2 Components of Antenatal Care (ANC) .204 Figure 8.3 Trends in Health Facility Births .205 Figure 8.4 Health Facility Births by Schooling .206 Figure 8.5 Health Facility Births by State/UT .207 Figure 8.6 Assistance during Delivery.208 Figure 8.7 Skilled Assistance at Delivery by Household Wealth .208 Figure 8.8 Postnatal Care by Place of Delivery . 210 CHAPTER 9 CHILD HEALTH .251 Table 9.1 Child's weight and size at birth .262 Table 9.2 Child's weight and size at birth by state/union territory .264 Table 9.3 Vaccinations by source of information .265 Table 9.4 Vaccinations by background characteristics .266 Table 9.5 Vaccinations by state/union territory .268 Table 9.6 Trends over time in vaccinations .270 Table 9.7 Prevalence and treatment of symptoms of ARI .271 Table 9.8 Prevalence and treatment of symptoms of ARI by state/union territory .273 Table 9.9 Prevalence and treatment of fever .274 Table 9.10 Prevalence of diarrhoea .275 Table 9.11 Diarrhoea treatment .276 Table 9.12 Diarrhoea treatment by state/union territory.278 Table 9.13 Feeding practices during diarrhoea.280 Table 9.14 Feeding practices during diarrhoea by state/union territory .282 Table 9.15 Knowledge of ORS packets.284 Table 9.16 Disposal of children's stools .285 Table 9.17 Disposal of children's stools by state/union territory .286 Table 9.18 Indicators of utilization of ICDS services .287 Table 9.19 Indicators of utilization of ICDS services by state/union territory .288 Table 9.20 Utilization of ICDS services during pregnancy and while breastfeeding . 289 Table 9.21 Indicators of women’s utilization of ICDS services during pregnancy and while breastfeeding by state/union territory .290 Figure 9.1 Childhood Vaccinations .253 Figure 9.2 Trends in Childhood Vaccinations .253 Figure 9.3 Coverage with All Basic Vaccinations by Mother's Schooling .254 Figure 9.4 Coverage with All Basic Vaccinations by State/UT .255 Figure 9.5 Prevalence of Diarrhoea by Age .256 Figure 9.6 Treatment of Diarrhoea .257 Figure 9.7 Prevalence and Treatment of Childhood Illness .258 Figure 9.8 Feeding Practices during Diarrhoea .259 CHAPTER 10 NUTRITION AND ANAEMIA .291 Table 10.1 Nutritional status of children .305 Table 10.2 Nutritional status of children by state/union territory .308 Table 10.3 Trends in nutritional status of children .309 Table 10.4 Initial breastfeeding .310 Table 10.5 Initial breastfeeding by state/union territory.311 Table 10.6 Breastfeeding status by age .312 Table 10.7 Median duration of breastfeeding .313 Table 10.8 Median duration of breastfeeding by state/union territory .314 Tables and Figures z�xv Table 10.9 Foods and liquids consumed by children in the day or night preceding the interview .315 Table 10.10 Minimum acceptable diet .316 Table 10.11 Minimum acceptable diet by state/union territory .318 Table 10.12 Prevalence of anaemia in children .320 Table 10.13 Prevalence of anaemia in children by state/union territory .322 Table 10.14 Trends in prevalence of anaemia in children .323 Table 10.15 Presence of iodized salt in household .324 Table 10.16 Presence of iodized salt in household by state/union territory .325 Table 10.17 Micronutrient intake among children .326 Table 10.18 Micronutrient intake among children by state/union territory .328 Table 10.19.1 Nutritional status of women .330 Table 10.19.2 Nutritional status of men .331 Table 10.20.1 Nutritional status of women by state/union territory .332 Table 10.20.2 Nutritional status of men by state/union territory .333 Table 10.21.1 Prevalence of anaemia in women .334 Table 10.21.2 Prevalence of anaemia in men .336 Table 10.22 Prevalence of anaemia in women and men by state/union territory .337 Table 10.23 Women's and men's food consumption .338 Table 10.24.1 Women's food consumption .339 Table 10.24.2 Men's food consumption .340 Table 10.25.1 Women's food consumption by state/union territory .341 Table 10.25.2 Men's food consumption by state/union territory .342 Figure 10.1 Trends in Nutritional Status of Children .293 Figure 10.2 Stunting in Children by State/UT .294 Figure 10.3 Breastfeeding Practices by Age .295 Figure 10.4 IYCF Indicators on Minimum Acceptable Diet (MAD) .297 Figure 10.5 Trends in Childhood Anaemia .298 Figure 10.6 Nutritional Status of Women and Men .300 Figure 10.7 Trends in Nutritional Status.301 Figure 10.8 Trends in Anaemia Status .302 CHAPTER 11 MORBIDITY AND HEALTH CARE .343 Table 11.1 Prevalence of tuberculosis .351 Table 11.2 Prevalence of tuberculosis by persons per sleeping room and cooking fuel/cooking arrangements.352 Table 11.3 Prevalence of tuberculosis by state/union territory .353 Table 11.4.1 Knowledge and attitudes toward tuberculosis: Women .354 Table 11.4.2 Knowledge and attitudes toward tuberculosis: Men .355 Table 11.5.1 Self-reported health problems: Women .356 Table 11.5.2 Self-reported health problems: Men .358 Table 11.6 Self-reported health problems by state/union territory .360 Table 11.7 Tobacco use by women and men .362 Table 11.8 Use of tobacco by background characteristics .363 Table 11.9 Quitting tobacco use and advice by a health care provider .365 Table 11.10 Quitting tobacco use and advice by a health care provider by state/union territory .367 Table 11.11.1 Use of alcohol: Women .369 Table 11.11.2 Use of alcohol: Men .370 Table 11.12 Use of alcohol by state/union territory .371 Table 11.13 Health scheme/health insurance coverage .372 xvi z Tables and Figures Table 11.14.1 Health scheme/health insurance coverage: Women .373 Table 11.14.2 Health scheme/health insurance coverage: Men .374 Table 11.15 Health scheme/health insurance coverage among women and men by state/union territory .375 Table 11.16 Source of health care .376 Table 11.17 Reasons for not using a government health facility by state/union territory .377 Table 11.18 Recent contacts with health workers .378 Table 11.19 Matters discussed during contacts with a health worker .380 Table 11.20 Contacts with health workers and visit to a health facility or camp by state/union territory .381 Table 11.21 Problems in accessing health care .382 Figure 11.1 Tobacco Use by Sex and Residence .346 Figure 11.2 Health Insurance Coverage of Households by State/UT .348 CHAPTER 12 OTHER ADULT HEALTH ISSUES .385 Table 12.1 Coverage of testing for blood pressure and random blood glucose measurements .391 Table 12.2 Self reports of blood pressure measurement and medication .392 Table 12.3.1 Blood pressure levels and treatment status: Women .393 Table 12.3.2 Blood pressure levels and treatment status: Men .395 Table 12.4.1 Blood pressure levels and treatment status by state/union territory: Women .397 Table 12.4.2 Blood pressure levels and treatment status by state/union territory: Men .398 Table 12.5.1 Random blood glucose levels: Women .399 Table 12.5.2 Random blood glucose levels: Men.400 Table 12.6.1 Random blood glucose levels by state/union territory: Women .402 Table 12.6.2 Random blood glucose levels by state/union territory: Men .403 Table 12.7 Health examinations .404 Table 12.8 Health examinations by state/union territory .405 Table 12.9 Age-specific death rates and crude death rates .406 Table 12.10 Crude death rates by state/union territory .407 Table 12.11 Adult mortality .408 Table 12.12 Adult mortality by state/union territory .409 Figure 12.1 Prevalence of Hypertension by Age and Sex .387 Figure 12.2 Health Examinations for Women .388 CHAPTER 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR .411 Table 13.1 Knowledge of HIV or AIDS .425 Table 13.2 Knowledge of HIV/AIDS prevention methods .426 Table 13.3.1 Comprehensive knowledge about HIV/AIDS: Women.428 Table 13.3.2 Comprehensive knowledge about HIV/AIDS: Men .430 Table 13.4 Knowledge of prevention of HIV/AIDS transmission from a mother to her baby .433 Table 13.5 HIV/AIDS awareness indicators by state/union territory .436 Table 13.6 Accepting attitudes toward those living with HIV/AIDS .437 Table 13.7.1 Accepting attitudes toward those living with HIV/AIDS by state/union territory: Women .438 Table 13.7.2 Accepting attitudes toward those living with HIV/AIDS by state/union territory: Men .439 Table 13.8 Attitudes toward negotiating sex with husband .440 Table 13.9 Attitudes toward negotiating sex with husband by state/union territory .442 Table 13.10.1 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months: Women .443 Tables and Figures z�xvii Table 13.10.2 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months: Men .445 Table 13.11 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months by state/union territory .447 Table 13.12 Payment for sexual intercourse and condom use at last paid sexual intercourse: Men .448 Table 13.13.1 Coverage of prior HIV testing: Women .450 Table 13.13.2 Coverage of prior HIV testing: Men.452 Table 13.14.1 Coverage of prior HIV testing by state/union territory: Women .454 Table 13.14.2 Coverage of prior HIV testing by state/union territory: Men .455 Table 13.15 Coverage of prior HIV testing during antenatal care (ANC) or labour .456 Table 13.16 Coverage of prior HIV testing during antenatal care (ANC) or labour by state/union territory .457 Table 13.17 Self-reported prevalence of sexually transmitted infection (STI) and/or STI symptoms .459 Table 13.18 Self-reported prevalence of sexually transmitted infection (STI) and/or STI symptoms by state/union territory .461 Table 13.19 Comprehensive knowledge about HIV/AIDS and knowledge of a source of condoms among youth .462 Table 13.20 Comprehensive knowledge about HIV/AIDS and knowledge of a source of condoms among youth by state/union territory .464 Table 13.21 Age at first sexual intercourse among youth .465 Table 13.22 Sexual intercourse and condom use among never married youth .467 Table 13.23 Higher-risk sexual intercourse among youth and condom use at last higher-risk intercourse .469 Table 13.24 Recent HIV tests among youth .471 Figure 13.1 Knowledge of HIV or AIDS by Household Wealth .412 Figure 13.2 Comprehensive Knowledge of HIV/AIDS by Schooling .413 Figure 13.3.1 Women’s Knowledge of Condom Use for HIV/AIDS Prevention by State/UT: Women .414 Figure 13.3.2 Men’s Knowledge of Condom Use for HIV/AIDS Prevention by State/UT: Men .414 Figure 13.4 Discriminatory Attitudes Toward People Living with HIV/AIDS .416 Figure 13.5 Knowledge of Where to Get Tested for HIV by Schooling .418 Figure 13.6 HIV Testing Prior to NFHS-4 .419 Figure 13.7 HIV Testing during ANC or Labour by Household Wealth .420 Figure 13.8 Trend in Comprehensive Knowledge among Youth .421 CHAPTER 14 HIV PREVALENCE .473 Table 14.1.1 Coverage of HIV testing by state/union territory: Women and Men .481 Table 14.1.2 Coverage of HIV testing by state/union territory: Women .482 Table 14.1.3 Coverage of HIV testing by state/union territory: Men .483 Table 14.2.1 Coverage of HIV testing: Women .484 Table 14.2.2 Coverage of HIV testing: Men .485 Table 14.3 HIV prevalence by age and residence .486 Table 14.4 HIV prevalence by background characteristics .487 Table 14.5 HIV prevalence by demographic characteristics .488 Table 14.6 HIV prevalence by groups of states/union territories .489 Table 14.7 HIV prevalence by sexual behaviour.490 Table 14.8 HIV prevalence by other characteristics .492 Table 14.9 Prior HIV testing by current HIV status .493 Table 14.10 HIV prevalence among couples .494 Table 14.11 HIV prevalence among couples by groups of states/union territories .496 xviii z Tables and Figures Table 14.12 HIV prevalence among young people by background characteristics .497 Table 14.13 HIV prevalence among young people by sexual behaviour .498 Table 14.14 HIV prevalence among young people by groups of states/union territories .499 Appendix Table 1 Coverage of HIV testing by social and demographic characteristics: Women .500 Appendix Table 2 Coverage of HIV testing by social and demographic characteristics: Men .501 Appendix Table 3 Coverage of HIV testing by sexual behaviour characteristics: Women .502 Appendix Table 4 Coverage of HIV testing by sexual behaviour characteristics: Men .504 Figure 14.1 Percentage of Women and Men Age 15-49 who are HIV Positive .475 Figure 14.2 Trend in Percentage of Women and Men age 15-49 who are HIV Positive .476 Figure 14.3 Percentage of Women and Men who are HIV Positive by Age .476 Figure 14.4 Percentage of Women and Men Age 15-49 who are HIV Postive by Marital Status . 477 CHAPTER 15 :20(1¶6�(032:(50(17 .507 Table 15.1 Employment and cash earnings .519 Table 15.2 Employment and cash earnings by state/union territory .520 Table 15.3.1 Control over women's cash earnings and relative magnitude of women's cash earnings: Women's reports .521 Table 15.3.2 Control over women's cash earnings and relative magnitude of women's cash earnings: Men's reports .523 Table 15.4 Control over men's cash earnings .525 Table 15.5 Control over women's and men's cash earnings and relative magnitude of women's cash earnings by state/union territory .527 Table 15.6 Participation in decision making .529 Table 15.7.1 Women's participation in decision making by background characteristics .530 Table 15.7.2 Men's participation in decision making by background characteristics .532 Table 15.8 Women's participation in decision making by state/union territory .534 Table 15.9 Men's attitudes toward a wife's participation in decision making .535 Table 15.10 Men's attitudes toward a wife's participation in decision making .536 Table 15.11 Women's access to money and credit .537 Table 15.12 Women's access to money and credit and freedom of movement by state/union territory .538 Table 15.13 Women's freedom of movement by background characteristics .540 Table 15.14.1 Attitudes toward wife beating: Women .542 Table 15.14.2 Attitudes toward wife beating: Men .544 Table 15.15 Attitudes toward wife beating by state/union territory .546 Table 15.16.1 Attitudes toward refusing sexual intercourse with husband: Women .548 Table 15.16.2 Attitudes toward refusing sexual intercourse with husband: Men .550 Table 15.17 Attitudes toward refusing sexual intercourse with husband by state/union territory .552 Table 15.18 Men's attitudes toward a husband's rights when his wife refuses to have sexual intercourse .554 Table 15.19 Men's attitudes toward a husband's rights when his wife refuses to have sexual intercourse by state/union territory .556 Table 15.20 Ownership of assets .558 Table 15.21 Ownership of assets by state/union territory .560 Figure 15.1 Employment by Age .508 Figure 15.2 Control Over Women’s Earning .509 Figure 15.3 Women’s Participation in Decision Making.511 Figure 15.4 Attitudes toward Wife Beating .514 Figure 15.5 Ownership of Assets .516 Figure 15.6 Ownership of Financial Assets and Mobile Phone .517 Tables and Figures z�xix CHAPTER 16 DOMESTIC VIOLENCE .563 Table 16.1 Experience of physical violence .574 Table 16.2 Experience of violence during pregnancy .576 Table 16.3 Persons committing physical violence .577 Table 16.4 Experience of sexual violence .578 Table 16.5 Age at first experience of sexual violence .579 Table 16.6 Persons committing sexual violence.580 Table 16.7 Experience of different types of violence .581 Table 16.8 Degree of marital control exercised by husbands .583 Table 16.9 Forms of spousal violence .585 Table 16.10 Violence by any husband in the past 12 months .586 Table 16.11 Spousal violence by background characteristics .587 Table 16.12 Spousal violence by husband's characteristics and empowerment indicators .589 Table 16.13 Spousal violence by state/union territory .591 Table 16.14 Experience of spousal violence by duration of marriage .592 Table 16.15 Injuries to women due to spousal violence .593 Table 16.16 Violence by women against their husband .595 Table 16.17 Help seeking to stop violence .597 Table 16.18 Sources from where help was sought .599 Figure 16.1 Violence during Pregnancy by Level of Schooling .565 Figure 16.2 Women's Experience of Violence by Marital Status .566 Figure 16.3 Types of Spousal Violence .568 Figure 16.4 Trends in Spousal Violence .569 Figure 16.5 Spousal Violence by Husband's Alcohol Consumption .570 Figure 16.6 Spousal Violence by State/UT .570 Figure 16.7 Help Seeking by Type of Violence Experienced .572 xx z Tables and Figures Message z�xxi Foreword Ȉ xvii Foreword z�xxiii Foreword Ȉ xix Preface z�xxv xxvi z Preface From Director's Desk z�xxvii From Director’s Desk ‡ xxiii ACKNOWLEDGEMENTS The 2015-16 National Family Health Survey (NFHS-4) was successfully completed due to the efforts and involvements of numerous organizations and individuals at different stages of the survey. At the outset, we are grateful to the Ministry of Health and Family Welfare, Government of India, New Delhi, for their overall guidance and support. We wish to place on record our sincere thanks to Ms. Preeti Sudan, Secretary, Health and Family Welfare, Ms. Vijaya Srivastava, Special Secretary and Financial Advisor, and former secretaries of the department namely, Mr. C. K. Mishra, Mr. Bhanu Pratap Sharma, Mr. Lov Verma, Mr. K. Desiraju, and Mr. P. K. Pradhan for their guidance, support and contribution to the survey. We also express our gratitude to Mr. Manoj Jhalani, AS & MD, NHM, Ms. Shalini Ashok Bhoyar, Director General (Stats.), Dr. V. K. Srivastava, Chief Director (Stats.), Mr. Janardhan Yadav, DDG (Stats.), Mr. Biswajit Das, Director (Stats.), and Ms. A. P. Meera Dy. Director (Stats.) for their constant support at every stage of the survey. Thanks are also due to Mr. C. R. K. Nair, former Additional DG (Stats.), Dr. Ratan Chand, former Chief Director (Stats.), Mr. P. C. Cyriac, former DDG (Stats.). The coordinators of NFHS-4 wish to place special thanks to Dr. F. Ram, the then Director & Sr. Professor of IIPS during the planning and implementation of the project for his technical, and administrative guidance during his tenure. We also appreciate the continuing interest and efforts made by Dr. L. Ladusingh, Offg. Director and Sr. Professor of IIPS. We express our sincere gratitude to all the members of Technical Advisory Committee, Project Management Committee, Administrative & Financial Management Committee, and Steering Committee for their contribution and providing valuable guidance for successful execution of the survey. We appreciate and acknowledge the untiring efforts and initiative taken by Dr. Fred Arnold, Dr. Sunita Kishor, and other staff members/consultants of ICF, USA in successful completion of NFHS-4. We also acknowledge the generous financial support from different development partners namely, United States Agency for International Development, UKaid, Bill and Melinda Gates Foundation, United Nations International Children's Emergency Funds, United Nations Population Fund, and MacArthur Foundation. We acknowledge the participation and support provided by Indian Council of Medical Research (ICMR), the National AIDS Control Organization (NACO), and the National AIDS Research Institute (NARI) for the HIV component of the survey, including HIV testing. We gratefully acknowledge the services rendered by different laboratories namely, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, National Centre for Disease Control (NCDC), Delhi, SRL, Kohima, School of Tropical Medicine, Kolkata, GMC & Sir J.J. Group of Hospitals, Mumbai, and Christian Medical College (CMC), Vellore. Acknowledgements Ȉ xxiv Acknowledgements z�xxix We also acknowledge the contribution of NFHS-4 Senior Research Officers, Research Officers and other staff members for their untiring contribution during the entire duration of the survey. We would like to acknowledge the contribution of staff members of IIPS, especially from the Administration, Accounts, Information Communication and Technology Unit, and Library for their continuous cooperation and support during the entire survey period. Our sincerely thank to the Heads and staff of the 14 Field Agencies (FAs) for successfully carrying out the task of data collection, despite many hardships in the field. This acknowledgement cannot be completed without expressing our appreciation for the hard work put in by the interviewers, health investigators, and supervisors in collecting and maintaining the quality of data. Last but not the least, credit goes to all the eligible women, men, and children who spent their valuable time and responded with patience and without any expectation from NFHS-4. NFHS-4 Coordinators Acknowledgements Ȉ xxvxxx z Acknowledgements INTRODUCTION 1 he 2015-16 National Family Health Survey (NFHS-4), the fourth in the NFHS series, provides information on population, health, and nutrition for India and each state and union territory. All four NFHS surveys have been conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW), Government of India. MoHFW designated the International Institute for Population Sciences (IIPS), Mumbai, as the nodal agency for all of the surveys. Funding for NFHS-4 was provided by the United States Agency for International Development (USAID), the United Kingdom Department for International Development (DFID), the Bill and Melinda Gates Foundation (BMGF), UNICEF, UNFPA, the MacArthur Foundation, and the Government of India. ICF provided technical assistance through the DHS Program, which is funded by USAID. Assistance for the HIV component of the survey was provided by the National AIDS Control Organization (NACO) and the National AIDS Research Institute (NARI), Pune. NFHS-4 fieldwork was conducted by 14 Field Agencies (FAs), and 7 laboratories conducted the HIV testing (see Appendix A). 1.1 SURVEY OBJECTIVES The primary objective of the 2015-16 National Family Health Survey is to provide essential data on health and family welfare, as well as data on emerging issues in these areas. The clinical, anthropometric, and biochemical (CAB) component of NFHS-4 is designed to provide vital estimates of the prevalence of malnutrition, anaemia, hypertension, HIV, and high blood glucose levels through a series of biomarker tests and measurements. The information collected through NFHS-4 is intended to assist policymakers and programme managers in setting benchmarks and examining progress over time in India’s health sector. Besides providing evidence on the effectiveness of ongoing programmes, NFHS-4 data will help to identify the need for new programmes in specific health areas. 1.2 SAMPLE DESIGN Decisions about the overall sample size required for NFHS-4 were guided by several considerations, paramount among which was the need to produce indicators at the district, state/union territory (UT), and national levels, as well as separate estimates for urban and rural areas in the 157 districts that have 30-70 percent of the population living in urban areas as per the 2011 census, with a reasonable level of precision. In addition, the NFHS-4 sample was designed to be able to produce separate estimates for slum and non-slum areas in eight cities (Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai, and Nagpur), and to provide general population estimates of HIV prevalence for women and men for India as a whole, for urban and rural areas of India, and for 11 groups of states/union territories. NFHS-4 was designed to provide information on sexual behaviour; husband’s background and women’s work; HIV/AIDS knowledge, attitudes, and behaviour; and domestic violence only at the state level (in the state module), while most indicators in the district module are reported at the district level. A subsample of 15 percent of households was selected for the implementation of the state module, in addition to the district module. In the 15 percent of households selected for the state module, a long questionnaire was administered that included all the questions needed for district-level estimates plus additional questions for the topics listed above. To achieve a representative sample of 15 percent of households, NFHS-4 conducted interviews in every alternate selected household in 30 percent of the selected clusters. In all, 28,586 Primary Sampling Units (PSUs) were selected across the country in NFHS-4, of which fieldwork was completed in 28,522 clusters. The NFHS-4 sample is a stratified two-stage sample. The 2011 census served as the sampling frame for the selection of PSUs. PSUs were villages in rural areas and Census Enumeration Blocks (CEBs) in urban areas. PSUs with fewer than 40 households were linked to the nearest PSU. Within each rural stratum, villages were selected from the sampling frame with probability proportional to size (PPS). In each stratum, six approximately equal substrata were created by crossing three substrata, each created based on the estimated number of households in each village, with two substrata, each created based on the percentage of the population belonging to scheduled castes and scheduled tribes (SCs/STs). T Introduction z�1 Within each explicit sampling stratum, PSUs were sorted according to the literacy rate of women age 6+ years. The final sample PSUs were selected with PPS sampling. In urban areas, CEB information was obtained from the Office of the Registrar General and Census Commissioner, New Delhi. CEBs were sorted according to the percentage of the SC/ST population in each CEB, and sample CEBs were selected with PPS sampling. In every selected rural and urban PSU, a complete household mapping and listing operation was conducted prior to the main survey. Selected PSUs with an estimated number of at least 300 households were segmented into segments of approximately 100-150 households. Two of the segments were randomly selected for the survey using systematic sampling with probability proportional to segment size. Therefore, an NFHS-4 cluster is either a PSU or a segment of a PSU. In the second stage, in every selected rural and urban cluster, 22 households were randomly selected with systematic sampling. 1.3 QUESTIONNAIRES Four survey questionnaires (Household Questionnaire, Woman’s Questionnaire, Man’s Questionnaire, and Biomarker Questionnaire) were canvassed in 17 local languages using Computer Assisted Personal Interviewing (CAPI). The Household Questionnaire listed all usual members of the household and visitors who stayed in the household the night before the interview. Basic demographic information was collected on the characteristics of each person listed, such as age, sex, marital status, schooling, and relationship to the head of the household. Ownership of an Aadhaar card was determined for each person listed. The parents’ survival status was determined for children under age 18. For children under age five, information was collected on whether each child has a birth certificate or whether the birth was registered with the civil authority. The information on age and sex of household members obtained in the Household Questionnaire was used to identify women and men who were eligible for individual interviews. The Household Questionnaire also collected information on characteristics of the household’s dwelling unit such as source of water; water treatment; type of toilet facilities; type of cooking fuel; materials used for the floor, roof, and walls of the dwelling unit; and ownership of various durable goods. The Household Questionnaire also collected information on the ownership and use of mosquito nets, exposure to second-hand smoke, and the reported prevalence of tuberculosis. A sample of cooking salt used in the household was tested for iodine content. The Woman’s Questionnaire collected information from all eligible women age 15-49, who were asked questions on a large variety of topics, including the following: y Background characteristics: age, literacy, schooling, religion, caste/tribe, media exposure y Reproduction: children ever born, birth history, current pregnancy, pregnancy terminations y Prevalence of hysterectomy y Menstrual hygiene (for women age 15-24 years) y Family planning: knowledge and use of contraception, sources of contraceptive methods, information on family planning y Contacts with community health workers y Maternal and child health, breastfeeding, and nutrition: antenatal care; delivery care; postnatal care; postpartum amenorrhoea; breastfeeding and child feeding practices; vaccination coverage; prevalence and treatment of diarrhoea: symptoms of acute respiratory infection (ARI), and fever; use of oral rehydration therapy (ORT); utilization of ICDS services 2 Ȉ Introduction2 z Introduction y Marriage and sexual activity: marital status, age at first marriage, lifetime number of unions, polygyny, consanguinity, age at first sexual intercourse, recent sexual activity, number and type of sexual partners, use of condoms y Fertility preferences: desire for more children, ideal number of children, gender preferences for children, intention to use family planning y Husband’s background and woman’s work: husband’s age, schooling, and occupation, and the woman’s employment and type of earnings (state module subsample only) y Women’s empowerment: household decision making, mobility, use of a bank account and a mobile phone, ownership of a house or land, barriers to medical treatment (state module subsample only) y HIV/AIDS: knowledge of HIV and AIDS, methods of HIV transmission, sources of HIV information, ways to avoid HIV, previous HIV testing, HIV stigma, other sexually-transmitted infections (state module subsample only) y Other health issues: tobacco and alcohol use, knowledge of tuberculosis, current morbidity (diabetes, asthma, goitre, heart disease, cancer), and household decision making (state module subsample only) y Domestic violence: only one eligible woman per household was randomly selected to answer the questions in the domestic violence section to comply with ethical requirements. Women who were victims of domestic violence were provided with a list of appropriate local organizations that they could contact if they wanted help (state module subsample only) The Man’s Questionnaire was administered only in the subsample of households selected for the state module. The questionnaire covered the man’s background characteristics, media exposure, marriage, employment, number of children, presence at antenatal care visits, contraceptive knowledge and use, fertility preferences, nutrition, sexual behaviour, attitudes toward gender roles, HIV/AIDS, tobacco and alcohol use, knowledge of tuberculosis, current morbidity (diabetes, asthma, goitre, heart disease, cancer), and household decision making. The Biomarker Questionnaire covered measurements of height, weight, and haemoglobin for children, and measurements of height, weight, haemoglobin, blood pressure, and random blood glucose for women age 15-49 and (in the state module subsample of households only) men age 15-54. In addition, eligible women and men were requested to provide a few drops of blood from a finger prick for laboratory testing for HIV. In contrast to the data collection procedure for the household and individual interviews, data related to the biomarkers were initially recorded on the Biomarker Questionnaire and subsequently entered into the interviewers’ mini-computers. This report provides information on key indicators and trends for India. The NFHS-4 figures and those of earlier NFHS rounds may not be strictly comparable due to differences in sample size, and NFHS-4 will be a benchmark for future surveys. The protocol for the NFHS-4 survey, including the content of all the survey questionnaires, was approved by the IIPS Institutional Review Board and the ICF Institutional Review Board. The protocol was also reviewed by the U.S. Centers for Disease Control and Prevention (CDC). 1.4 BIOMARKER MEASUREMENTS AND TESTS Except for HIV testing, the results of all measurements and tests were immediately given to the respondents (or a parent or other adult responsible for children) in the field, along with information brochures. The results were explained to respondents by the specially trained health investigators who conducted the tests. All women and men who were eligible for HIV testing were given a referral card for free HIV counselling and testing. Introduction Ȉ 3Introduction z�3 Anthropometry: Height and weight were measured for children age 0-59 months, women age 15-49, and (in the state module subsample of households only) men age 15-54. The Seca 874 digital scale was used to measure the weight of children and adults. The height of adults and children age 24-59 months was measured with the Seca 213 stadiometer. The Seca 417 infantometer was used to measure the recumbent length of children under two years or less than 85 cm. Anaemia testing: Blood specimens for anaemia testing were collected by health investigators from eligible women age 15-49, (in the state module subsample of households) men age 15-54, and children age 6-59 months. Consent for the test was taken from eligible women and men. For children age 6-59 months, consent was obtained from a parent or an adult responsible for the child. Blood samples were drawn from a drop of blood taken from a finger prick (or a heel prick for children age 6-11 months) and collected in a microcuvette. Haemoglobin analysis was conducted on-site with a battery-operated portable HemoCue Hb 201+ analyser. Respondents found to have severe anaemia (a haemoglobin level below 9 grams/decilitre (g/dl) for pregnant women and below 7 g/dl for women who were not pregnant, men, and children) were referred to a health facility for further evaluation and treatment. Blood pressure measurement: Blood pressure was measured for eligible women age 15-49 and (in the state module subsample of households only) eligible men age 15-54, using an Omron Blood Pressure Monitor to determine the prevalence of hypertension. Blood pressure measurements for each respondent were taken three times with an interval of five minutes between readings. Respondents whose average systolic blood pressure (SBP) was >140 mm Hg or average diastolic blood pressure (DBP) was >90 mm Hg were considered to have elevated blood pressure readings and they were encouraged to see a doctor for a full evaluation. Blood glucose testing: Random blood glucose was measured using a finger-stick blood specimen for eligible women age 15-49 and (in the state module subsample of households only) eligible men age 15-54 using the FreeStyle Optium H glucometer with glucose test strips. A referral form to a health facility for additional medical evaluation was provided for any respondent with D�UDQGRP�EORRG�JOXFRVH�OHYHO�•200 mg/dl. HIV testing: In a random subsample of households, health investigators collected finger-prick blood specimens from eligible women age 15-49 and men age 15-54 who consented to laboratory HIV testing. The protocol for blood specimen collection and analysis was based on the anonymous linked protocol developed for The DHS Program. This protocol allows for the merger of HIV test results with the sociodemographic data collected in the individual questionnaires after removal of all information that could potentially identify an individual. Interviewers explained to eligible respondents the procedure, the confidentiality of the data, and the fact that the test results would not be made available to them. If a respondent consented to HIV testing, five blood spots from the finger prick were collected on a filter paper card to which a barcode label unique to the respondent was affixed. A duplicate label was attached to the Biomarker Questionnaire. A third copy of the same barcode was affixed to the dried blood spot (DBS) transmittal sheet to track the blood samples from the field to the laboratory. Respondents were also asked whether they would consent to allow their blood sample to be stored for future unspecified testing. If respondents did not consent to additional testing, it was indicated on the Biomarker Questionnaire that they UHIXVHG�DGGLWLRQDO�WHVWV�RQ�WKHLU�VSHFLPHQ��DQG�WKH�ZRUGV�³QR�DGGLWLRQDO�WHVWLQJ´�ZHUH�ZULWWHQ�RQ�WKH�ILOWHU�SDSHU�Fard. All respondents, whether they provided consent for HIV testing or not, were given an informational brochure on HIV and a referral card for a free HIV test at a local government health facility. The blood samples were dried overnight and packaged the next day (or when they were completely dry). The filter paper cards with the DBS were placed in low-gas permeable zip-lock bags with a sachet of desiccant and a humidity indicator card. Next, multiple small bags were placed in a large air-tight zip-lock bag along with a dried blood spot (DBS) transmittal sheet. A few sachets of desiccants were placed in the large plastic bag and the bag was zipped closed. At the end of fieldwork in each PSU, samples were sent by Speed Post to the laboratory designated to conduct HIV tests for that state. Upon arrival at the laboratory, each blood sample was logged into the CSPro HIV Test Tracking System database, given a laboratory number, and stored at -��Û&�XQWLO�WHVWHG� 4 z Introduction The HIV testing protocol (Figure 1.1) stipulated that blood could be tested only after the questionnaire data collection had been completed for each state, the data had been verified and cleaned, and all unique identifiers other than the anonymous barcode number had been removed from the data file. The testing algorithm calls for testing all samples with the first assay, the Microlisa HIV enzyme-linked immunoassay (ELISA I). All samples that tested positive on ELISA I were subjected to a second ELISA test (ELISA II), SD Bioline 1/2. Similar to samples that tested positive on ELISA I, a random selection of 2 percent of the samples that tested negative on the ELISA I were also tested on ELISA II, while the remaining 98 percent of samples that were negative on ELISA I were recorded as negative. To monitor the quality of HIV testing and assess the validity of test results, two levels of quality control steps were employed. During HIV testing at the primary laboratory, an internal quality control process was established through the use of control materials and retesting of a random selection of 2 percent of negative samples, as mentioned above. Concordant negative results on ELISA I and ELISA II were recorded as negative. If the results on ELISA I and ELISA II were discordant, the two ELISAs were repeated in parallel. If the results remained discordant after the second set of ELISA tests, a third test was conducted using a Western Blot Test (Bio-Rad) at the National AIDS Research Institute (NARI), Pune, and the result of this test was considered definitive. For the purpose of internal quality control: 1) positive and negative serum controls supplied by the manufacturer with the test kits were included on each microtiter plate of samples, and 2) known HIV-negative, low-positive, and high-positive DBS controls were tested in parallel with the kit controls on every microtiter plate of samples. After HIV testing had been completed, the test results were entered into a spreadsheet with a barcode as the unique identifier. The barcode linked the HIV test results with the individual interview data. Figure 1.1 HIV Testing Algorithm Introduction Ȉ 5Introduction z�5 1.5 PRETEST The pretest training was held in Kharghar, Navi Mumbai, from 25 November to 7 December 2013, and the pretest fieldwork was conducted from 8-12 December 2013. The pretest fieldwork was conducted in five enumeration areas in and around Panvel Taluka that had not been selected for the main survey. A pretest debriefing session was held on 13 December 2013. In all, 37 interviewers and 11 health investigators participated in the training. The pretest field practice covered 147 KRXVHKROG� LQWHUYLHZV�� ���� ZRPDQ¶V� LQWHUYLHZV�� DQG� ���� PDQ¶V� LQWHUYLHZV�� %LRPDUNHU� PHDVXUHPHQW� DQG� WHVWLQJ� ZDV� conducted on 29 children and 181 adults. 1.6 TRAINING OF FIELD STAFF Training was conducted in a tiered fashion. For each of the two fieldwork phases, a Training of Trainers (TOT) course was conducted by IIPS, Mumbai, and ICF. The TOT for the 17 states and union territories included in the first phase (plus the Eastern Region of Uttar Pradesh) was conducted in Puri, Odisha, from 18 August to 2 September 2014, with additional training conducted from 27 October to 3 November 2014 at IIPS, Mumbai. The TOT for the remaining 18 states (plus the Central and Western Regions of Uttar Pradesh) was conducted from 14 November to 1 December 2015 in Chandigarh. The trainees in both TOT courses included project coordinators, health coordinators, statisticians/ demographers, and information technology coordinators from the Field Agencies, and Project Officers/Senior Project Officers from IIPS. The coordinators were responsible for training fieldworkers at the state/UT level. 1.7 FIELDWORK Data collection was conducted in two phases (from 20 January 2015 to 4 December 2016) by 789 field teams. Each team consisted of one field supervisor, three female interviewers, one male interviewer, two health investigators, and a driver. The number of interviewing teams in each state varied according to the sample size. In each state, interviewers were hired by the selected Field Agencies, taking into consideration their educational background, experience, and other relevant qualifications. Female and male interviewers were assigned to interview respondents of the same sex. The assignment of Primary Sampling Units (PSUs) to the teams and various logistical decisions were made by the survey coordinators from each Field Agency. Each interviewer was required to make a minimum of three callbacks if no suitable informant was available for the household interview or if an eligible woman or man in the household was not present at the time of the LQWHUYLHZHU¶V�YLVLW� The field supervisor was responsible for the overall management of the field teams. In addition, the field supervisor conducted spot-checks to verify the accuracy of key information, particularly with respect to the eligibility of respondents. IIPS also appointed one or more project officers or senior project officers in each state for monitoring and supervision throughout the training and fieldwork period to ensure that correct survey procedures were followed and that data quality was maintained. Project directors and other senior staff from the Field Agencies, NFHS-4 faculty coordinators from IIPS, and technical consultants from The DHS Program at ICF also visited the field sites to monitor data collection operations. 1.8 STRATEGY TO ENSURE DATA QUALITY Due to the size and complexity of the NFHS-4 survey, considerable thought went into devising strategies to minimize the non-sampling error and ensure data quality. Some of the procedures adopted are summarized below. y NFHS-4 was conducted in two phases to make the administration of the training and fieldwork more manageable. y In the states included in each phase, fieldwork was conducted in a group of five adjacent districts at a time to facilitate close monitoring and supervision of the training of field staff and the implementation of the fieldwork. y 7R�PDLQWDLQ�XQLIRUP�SURFHGXUHV�DFURVV�VWDWHV��VHYHUDO�FRPSUHKHQVLYH�PDQXDOV�ZHUH�SUHSDUHG��LQFOXGLQJ�D�6XSHUYLVRU¶V� 0DQXDO��DQ�,QWHUYLHZHU¶V�0DQXDO��D�+HDOWK�,QYHVWLJDWRU¶V�0DQXDO� a Household Mapping and Listing Manual, Data Processing Guidelines, and Training Guidelines. 6 z Introduction y There were multiple levels of monitoring and supervision of the fieldwork, including monitoring by district coordinators from the Field Agencies; monitoring by senior staff from the state offices of the Field Agencies; positioning two IIPS project officers with each Field Agency for the entire duration of the survey, in addition to monitoring and supervision by senior project officers, project coordinators, IIPS faculty coordinators, staff and consultants from ICF, and representatives from the development partners and the Ministry of Health and Family Welfare, Government of India. Immediate corrective measures were taken in case there were any deviations from the survey protocols. y The field supervisor on each interviewing team was required to observe interviews in a subsample of households and to conduct back-checks with respondents as a further check on the quality of the fieldwork. y Use of computer assisted personal interviewing (CAPI) and the transfer of field data to IIPS on a daily basis was instrumental in remotely monitoring of progress of field teams. Use of CAPI also enabled IIPS and ICF to run extensive data quality checks on the data from the field and to provide real-time feedback to Field Agencies and teams to help improve data quality. A standard set of 42 field-check tables were produced frequently throughout the fieldwork, covering such topics as response rates, age heaping and age displacement, completeness of reporting, sex ratios for children, patterns of height/length and weight measurements, and the contraceptive prevalence rate. y To ensure uniformity in the implementation of the fieldwork protocols in every state, a centrally-organized Training of Trainers Workshop of four weeks duration was conducted in each phase. Four persons from each Field Agency participated in the workshop (two social scientists, one IT specialist, and one health coordinator). These trained persons were responsible for organizing the state-level training programmes in local and regional languages, for a minimum of four weeks’ duration, which were supported and supervised by IIPS and ICF. y To ensure that biomarker tests were conducted properly in a uniform manner, training videos in English and Hindi were produced to indicate the correct procedures for conducting height/length and weight measurements and to demonstrate in detail how to conduct anaemia and blood glucose testing and how to collect blood samples on filter paper cards for HIV testing in the lab. y Extensive internal and external quality control measures were implemented for the laboratory testing of dried blood spot samples for HIV. The protocol included retesting of a random subsample of 2 percent of HIV-negative samples at the primary testing lab with a second ELISA test, complete retesting of all discordant results on the first two ELISA tests, and conducting a tie-breaker Western Blot test at the National AIDS Research Institute (NARI) for all samples that still had discrepant results on the two ELISA tests after repeat testing. External Quality Control (EQC) involved the re-testing of all HIV-reactive and 2 percent of HIV samples rendered negative at NARI using the full testing algorithm. To ensure independence of the tests, NARI was blind to the results from the primary testing laboratory. 1.9 DATA PROCESSING Electronic data collected in the 2015-16 National Family Health Survey were received on a daily basis via the Internet File Streaming System (IFSS) at the International Institute for Population Sciences, where the data were stored on a password-protected computer. Secondary editing of the data, which required resolution of computer-identified inconsistencies and coding of open-ended questions, was conducted by the Field Agencies, and IIPS checked the secondary edits before the data set was finalized. Field-check tables were produced by IIPS and the Field Agencies on a regular basis to identify certain types of errors that might have occurred in eliciting information and recording question responses. Information from the field-check tables on the performance of each fieldwork team was promptly fed back to the Field Agencies during the fieldwork so that the performance of the teams could be improved, if required. Introduction Ȉ 7Introduction z�7 1.10 RESPONSE RATES Table 1.1 shows response rates for the 2015-16 National Family Health Survey. A total of 628,900 households were selected for the sample, of which 616,346 were occupied. Of the occupied households, 601,509 were successfully interviewed, for a response rate of 98 percent. In the interviewed households, 723,875 eligible women age 15-49 were identified for individual women’s interviews. Interviews were completed with 699,686 women, for a response rate of 97 percent. In all, there were 122,051 eligible men age 15-54 in households selected for the state module. Interviews were completed with 112,122 men, for a response rate of 92 percent. Table 1.2 shows response rates for each state and union territory. Overall, response rates are quite high. Household response rates were over 90 percent in every state and union territory. The response rate for women was also higher than 90 percent in every state and union territory except in Delhi (where it was 82%) and Chandigarh (where it was 87%). As expected, the response rate for men was lower than the response rate for women in every state and union territory. The response rate for men was particularly low in Delhi (53%) and Chandigarh (78%). 8 Ȉ Introduction8 z Introduction LIST OF TABLES For more information on response rate, see the following tables: Tables Table 1.1 Results of the household and individual interviews Table 1.2 Number of households, women, and men interviewed by state/union territory Introduction Ȉ 9Introduction z�9 Table 1.1 Results of the household and individual interviews Number of households, number of interviews with women and men, and response rates, according to residence, India, 2015-16 Result Residence Total Urban Rural Household interviews Households selected 187,095 441,805 628,900 Households occupied 182,415 433,931 616,346 Households interviewed 175,946 425,563 601,509 Household response rate1 96.5 98.1 97.6 Interviews with women age 15-49 Number of eligible women 213,759 510,116 723,875 Number of eligible women interviewed 204,735 494,951 699,686 Eligible women response rate2 95.8 97.0 96.7 Interviews with men age 15-54 Number of eligible men 39,624 82,427 122,051 Number of eligible men interviewed 35,526 76,596 112,122 Eligible men response rate2 89.7 92.9 91.9 Note: Eligible women and men are women age 15-49 and men age 15-54 who stayed in the household the night before the household interview (including both usual residents and visitors). This table is based on the unweighted sample. 1 Households interviewed/households occupied 2 Respondents interviewed/eligible respondents 10 z Introduction Table 1.2 Number of households, women, and men interviewed by state/union territory Month and year of fieldwork, number of households, women and men interviewed, and response rates by state/union territory, India, 2015-16 State/union territory Month and year of fieldwork Households interviewed Women interviewed Men interviewed From To Number Response rate Number Response rate Number Response rate India 1/15 12/16 601,509 97.6 699,686 96.7 112,122 91.9 North Chandigarh* 5/16 6/16 751 91.0 746 86.8 127 78.4 Delhi* 2/16 9/16 6,050 90.1 5,914 82.2 710 52.9 Haryana 2/15 6/15 17,332 99.2 21,654 98.9 3,584 97.0 Himachal Pradesh* 2/16 8/16 9,225 95.3 9,929 95.4 2,417 84.4 Jammu & Kashmir* 1/16 11/16 17,894 98.2 23,800 97.4 6,013 92.2 Punjab* 1/16 6/16 16,449 98.6 19,484 97.8 3,250 93.4 Rajasthan* 1/16 7/16 34,915 98.4 41,965 97.9 6,309 95.2 Uttarakhand 1/15 7/15 15,171 97.2 17,300 96.1 2,174 86.9 Central Chhattisgarh* 1/16 6/16 20,275 98.0 25,172 97.5 3,827 94.1 Madhya Pradesh 1/15 7/15 52,042 98.9 62,803 97.7 10,268 95.6 Uttar Pradesh* 1/15 9/16 76,233 97.5 97,661 97.2 13,835 92.4 East Bihar 3/15 8/15 36,772 99.6 45,812 98.4 5,872 96.3 Jharkhand* 4/16 12/16 25,723 95.6 29,046 95.4 4,069 90.1 Odisha* 1/16 7/16 30,242 98.1 33,721 96.8 4,634 91.2 West Bengal 2/15 7/15 15,327 97.6 17,668 97.1 2,645 93.0 Northeast Arunachal Pradesh* 4/16 12/16 14,617 95.4 14,294 93.3 2,140 88.6 Assam 11/15 3/16 24,542 97.6 28,447 96.1 4,191 90.1 Manipur 2/15 12/15 11,724 98.8 13,593 97.1 1,886 94.1 Meghalaya 4/15 9/15 7,327 98.2 9,202 96.9 1,236 91.1 Mizoram* 2/16 10/16 11,397 97.9 12,279 98.3 1,749 95.7 Nagaland* 3/16 10/16 11,213 97.6 10,790 95.8 1,596 92.3 Sikkim 1/15 7/15 4,662 99.6 5,293 98.1 879 97.3 Tripura 2/15 8/15 4,510 96.8 4,804 96.4 878 89.2 West Dadra & Nagar Haveli* 4/16 6/16 751 93.5 796 94.2 221 85.3 Daman & Diu* 4/16 6/16 1,523 94.1 1,393 94.6 451 90.9 Goa 1/15 4/15 1,588 98.5 1,696 98.8 848 97.4 Gujarat* 1/16 6/16 20,524 96.4 22,932 94.9 6,018 88.3 Maharashtra 4/15 9/15 26,890 95.5 29,460 94.3 4,811 89.2 South Andaman & Nicobar Islands 4/15 7/15 2,413 97.9 2,811 97.6 446 93.5 Andhra Pradesh 5/15 8/15 10,265 95.6 10,428 93.8 1,541 85.6 Karnataka 2/15 7/15 23,842 96.7 26,291 94.5 4,106 89.7 Kerala* 3/16 10/16 11,555 99.6 11,033 98.3 2,086 95.1 Lakshadweep* 7/16 9/16 741 99.1 1,070 97.6 173 96.6 Puducherry 6/15 7/15 3,205 98.0 4,012 99.4 682 96.5 Tamil Nadu 2/15 6/15 26,033 98.6 28,820 98.5 5,317 96.1 Telangana 2/15 5/15 7,786 94.6 7,567 91.8 1,133 82.6 Note: This table is based on the unweighted sample; all subsequent tables are based on the weighted sample unless otherwise specified. The number of women and men is based on the de facto population. The household response rate is defined as the number of households interviewed divided by the number of occupied households. The response rates for women and men are the percentages of eligible women and men with completed interviews. States/union territories with an asterisk were included in the second phase of fieldwork. All other states/union territories were included in the first phase of fieldwork, except for Uttar Pradesh, in which the Eastern Region was included in the first phase (with fieldwork from 1/15 to 7/15) and the rest of the state was included in the second phase. Introduction z�11 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS 2 Key Findings x Drinking water: Ninety percent of households use an improved source of drinking water. x Sanitation: Forty-eight percent of households use an improved sanitation facility that is not shared with other households and 9 percent use a facility that would be considered improved if it were not shared. Thirty-nine percent of households have no facility, which means that the household members practice open defecation. x Electricity: Eighty-eight percent of households have electricity (83% of rural households and 98% of urban households). x Cooking fuel: Only 44 percent of households use clean fuel for cooking. x Age distribution: Twenty nine percent of the population of India is under age 15 and 10 percent of the population is age 60 years and above. x Aadhaar card: Sixty-nine percent of the household population have an Aadhaar card. x Bank or post office account: Nine out of 10 households have a bank or post office account. x Birth registration: Eighty percent of children under age five had their birth registered. x Orphans: Among children under age 18, 5 percent are orphans (one or both parents are dead) and 3 percent are not living with a biological parent. x School attendance: The net attendance ratio falls from 78 percent in primary school to 68 percent in middle, secondary, and higher secondary school. The main reason given for children not attending school was that the child was not interested in studies (44% for male children and 25% for female children). nformation on the socioeconomic characteristics of the household population in the 2015-16 National Family Health Survey (NFHS-4) provides a context for interpreting demographic and health indicators and an approximate indication of the representativeness of the survey. In addition, this information describes the living conditions of the population.I Household Population and Housing Characteristics Ȉ 13Household Population and Housing Characteristics z�13 This chapter presents information on the sources of drinking water, sanitation, exposure to smoke inside the home, wealth, hand washing, composition of the household population, educational attainment, school attendance, birth registration, children’s living arrangements, and parental survivorship. 2.1 DRINKING WATER SOURCES AND TREATMENT In India, almost all urban households (91%) and rural households (89%) have access to an improved source of drinking water (Table 2.1). Improved sources of water protect against outside contamination so that the water is more likely to be safe to drink. Urban and rural households rely on different sources of drinking water. The main sources of drinking water for urban households are water piped into their dwelling, yard, or plot (52%), public taps or standpipes (17%), and tube wells or boreholes (17%) (Table 2.1 and Figure 2.1). In contrast, rural households rely most on tube wells or boreholes (51%), followed by water piped into their dwelling, yard, or plot (18%). In rural areas, 58 percent of households have water on their premises or delivered to their dwelling, compared with 82 percent in urban areas. In households in which water is not on the premises or delivered, women age 15 years and above are most likely to collect drinking water (80%). Clean water is a basic need for human life. However, more than 6 in 10 households (62%) report that they do no treat their water prior to drinking. Treatment is less common in rural areas than urban areas; 71 percent of rural households do not treat their water, compared with 47 percent of urban households. Boiling water and straining the water through a cloth before drinking are the most common types of water treatment prior to drinking (10% and 14% of households, respectively). Improved sources of drinking water Include piped water, public taps, standpipes, tube wells, boreholes, protected dug wells and springs, rainwater, and community reverse osmosis (RO) plants. Sample: Households 14 Ȉ Household Population and Housing Characteristics 52 18 30 17 15 16 17 51 39 3.9 4.0 4.0 0.1 0.2 0.2 0.7 0.5 0.5 8.7 11 10 Urban Rural Total Unimproved source Community RO Plant Rain water Protected dug well or spring Tube well or borehole Public tap/standpipe Piped into dwelling/yard/plot Figure 2.1 Household Drinking Water by Residence Percent distribution of households by source of drinking water 14 z Household Population and Housing Characteristics 2.2 SANITATION Improved toilet facilities Include any non-shared toilet of the following types: flush/pour flush toilets to piped sewer systems, septic tanks, and pit latrines; ventilated improved pit (VIP)/biogas latrines; pit latrines with slabs; and twin pit/composting toilets Sample: Households About half of Indian households (48%) use improved toilet facilities, which are non-shared facilities that prevent people from coming into contact with human waste and can reduce the transmission of cholera, typhoid, and other diseases. Shared toilet facilities of an otherwise acceptable type are also common, especially in urban areas; 15 percent of urban households use a shared facility, compared with 6 percent of rural households (Table 2.2 and Figure 2.2). Thirty-nine percent of households do not use any toilet facility, meaning that they practice open defecation. \Trends: The percentage of households practicing open defecation decreased from 55 percent in 2005-06 to 39 percent in 2015-16. 2.3 EXPOSURE TO SMOKE INSIDE THE HOME AND OTHER HOUSING CHARACTERISTICS 2.3.1 Exposure to Smoke inside the Home Exposure to smoke inside the home, either from cooking with solid fuels or smoking tobacco, has potentially harmful health effects. Fifty-five percent of households in India use some type of solid fuel for cooking, with virtually all being wood or dung cakes (Table 2.3). Exposure to cooking smoke is greater when cooking takes place inside the house rather than in a separate building or outdoors. In 29 percent of households, someone smokes inside the house on daily basis. 2.3.2 Other Housing Characteristics The survey collected data on access to electricity, on flooring materials, and on the number of rooms used for sleeping. Ninety-eight percent of urban households and 83 percent of rural households have electricity. Overall, 88 percent of households in India have electricity. Fifty-six percent of households have pucca houses (houses made with high quality materials throughout, including the floor, roof, and exterior walls) and 35 percent have semi-pucca houses. 70 37 48 15 6.0 9.1 3.7 3.1 3.3 0.5 0.1 0.2 11 54 39 Urban Rural Total No facility/uses open space/field Other source Unimproved Shared facility Improved, not shared facility Figure 2.2 Household Toilet Facilities by Residence Percent distribution of households by type of toilet facilities Household Population and Housing Characteristics z�15 2.4 HOUSEHOLD WEALTH Wealth index Households are given scores based on the number and kinds of consumer goods they own, ranging from a television to a bicycle or car, and housing characteristics such as source of drinking water, toilet facilities, and flooring materials. These scores are derived using principal component analysis. National wealth quintiles are compiled by assigning the household score to each usual (de jure) household member, ranking each person in the household population by their score, and then dividing the distribution into five equal categories, each with 20 percent of the population. Sample: Households Table 2.5 presents wealth quintiles according to urban-rural residence and state. In India, the wealthiest households are concentrated in urban areas. Seventy-four percent of the urban population is in the two highest wealth quintiles. By contrast, more than half of the rural population (55%) falls in the two lowest wealth quintiles (Figure 2.3). Chandigarh (81%), followed by Delhi (63%) and Punjab (62%) have the highest percentage of the population in the highest wealth quintile. The states with the highest percentages of popula- tion in the lowest wealth quintile are Bihar (51%) and Jharkhand (46%). Fifty percent of the population in scheduled caste households and 71 percent of the population in scheduled tribe households are in the two lowest wealth quintiles (Table 2.6). The survey also collected information on household effects, means of transportation, agricultural land, and farm animals (Table 2.8 and Table 2.9). Urban households are somewhat more likely than rural households to have a bank account or a post office account (92% versus 88%) and a mobile telephone (96% versus 87%). Rural households are more likely than urban households to own agricultural land (52% versus 13%) or farm animals (60% versus 11%). 2.5 HAND WASHING To obtain hand washing information, interviewers asked to see the place where members of the household most often wash their hands. A place for washing hands was observed in 97 percent of households. Soap and water were observed in 60 percent of the hand washing locations, while 16 percent had water only (Table 2.10). In households in which the place for hand washing was observed, 9 percent did not have water, soap, or another cleansing agent. 16 Ȉ Household Population and Housing Characteristics Figure 2.3 Household Wealth by Residence Percent distribution of de jure population by wealth quintiles 3.1 28 7.0 27 16 22 30 15 44 7.9 Urban Rural Highest Fourth Middle Second Lowest 16 z Household Population and Housing Characteristics 2.6 HOUSEHOLD POPULATION AND COMPOSITION Household A person or group of related or unrelated persons who live together in the same dwelling unit(s), who acknowledge one adult male or female as the head of the household, who share the same housekeeping arrangements, and who are considered a single unit. De facto population All persons who stayed in the selected households the night before the interview (whether usual residents or visitors). De jure population All persons who are usual residents of the selected households, whether or not they stayed in the household the night before the interview. How data are calculated All tables are based on the de facto population, unless specified otherwise. A total of 2,724,122 individuals stayed overnight in the 601,509 sample households in the NFHS-4 survey. The population pyramid in Figure 2.4 illustrates the distribution by five- year age groups and sex. The pyramid shows that India’s population is young, which is typical of developing countries with low life expectancy. The pyramid also shows that fertility has decreased considerably in the last 10 years. Children under age 15 represent 29 percent of the household population, while individuals age 60 and older represent only 10 percent of the household population (Table 2.12). Table 2.11 shows that 15 percent of house- holds have female heads. Urban households are somewhat smaller, on average, than rural households (4.3 and 4.7 persons, respectively). Overall, 15 percent of housholds have one or more foster or orphan children under age 18. Trends: The percentage of children under age 15 declined from 35 percent in NFHS-3 (2005-06) to 29 percent in NFHS-4 (2015-16). In contrast, the population 60 years and older increased slightly, from 9 percent in NFHS-3 to 10 percent in NFHS-4. The average household size decreased slightly between 2005-06 and 2015-16 (from 4.8 versus 4.6 persons), and the percentage of female-headed households was almost the same in NFHS-3 and NFHS-4. Household Population and Housing Characteristics Ȉ 17 2 6 10 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+ Percent Age in years Male Female 2 6 10 Figure 2.4 Population Pyramid Percent distribution of the household population Household Population and Housing Characteristics z�17 2.7 BIRTH REGISTRATION Registered birth Child has a birth certificate or child does not have a birth certificate, but his/her birth is registered with the civil authorities. Sample: De jure children under age five years Table 2.13 presents information on birth registration of children under age five years. At the time of the survey, 80 percent of children under age five years had births registered with the civil authority; this includes 62 percent of children with birth certificates. Female and male children are equally likely to have their birth registered. Children in urban areas (89%) are more likely than children in rural areas (76%) to have their birth registered. Birth registration is lowest in Uttar Pradesh (60%) and Bihar (61%) (Table 2.14 and Figure 2.5). 60 61 63 65 65 67 69 77 77 80 80 82 82 83 83 86 88 92 92 94 94 94 95 95 95 95 96 97 98 98 98 98 98 99 99 99 99 Uttar Pradesh Bihar Arunachal Pradesh Manipur Jharkhand Rajasthan Nagaland Uttarakhand Jammu & Kashmir INDIA Meghalaya Madhya Pradesh Odisha Andhra Pradesh Telangana Chhattisgarh Delhi Daman & Diu Tripura Dadra & Nagar Haveli Assam Haryana Karnataka Chandigarh Maharashtra Himachal Pradesh Gujarat West Bengal Kerala Andaman & Nicobar Islands Mizoram Tamil Nadu Punjab Sikkim Goa Lakshadweep Puducherry Figure 2.5 Birth Registration by State/UT Percentage of de jure children under age five whose births are registered with the civil authorities Trends: Birth registration among children under age five years doubled between NFHS-3 and NFHS-4 (from 41% to 80%). The percentage of births that were registered increased by more than 50 percentage points between 2005-06 and 2015-16 in Jharkhand, Bihar, Uttar Pradesh, Madhya Pradesh, and Rajasthan. 18 z Household Population and Housing Characteristics 2.8 CHILDREN’S LIVING ARRANGEMENTS AND PARENTAL SURVIVAL Orphan A child with one or both parents who are dead. Sample: De jure children under age 18 years Only 3 percent of children under age 18 years are not living with a biological parent (Table 2.15). Five percent of children under age 18 years are orphans with one or both parents who have died. The percentage of children who are orphans rises rapidly with age, from less than 1 percent among children under age 2 to 9 percent among children age 15-17 (Figure 2.6). The Northeast region has the highest percentage of children who are orphans (6% or more in every state except Tripura) (Table 2.16). Trends: The percentage of children under age 18 who do not live with a biological parent decreased only slightly between NFHS-3 and NFHS-4 (from 4% to 3%). The percentage of children under age 18 who are orphans (5%) did not change between 2005-06 and 2015-16. 2.9 SCHOOLING 2.9.1 Educational Attainment Median educational attainment Half the population has completed less than the median number of years of schooling and half the population has completed more than the median number of years of schooling. Sample: De facto household population age six and over Overall, 69 percent of females and 85 percent of males age six and over have ever attended school. One-third of females completed 7 years of schooling or less; 13 percent completed 8-9 years of schooling. Among males, 35 percent completed 7 years of schooling or less; 16 percent completed 8-9 years of schooling. Only 10 percent of females and 13 percent of males completed 10-11 years of schooling. Thirty-one percent of females and 15 percent of males have never attended school. Fourteen percent of females and 20 percent of males completed 12 or more years of schooling. The median number of years of schooling completed is higher for males (6.9 years) than for females (4.4 years) (Tables 2.17). Trends: Educational attainment at the household level increased substantially between 2005-06 and 2015-16. Among females, the median number of years of schooling increased from 1.9 years in NHFS-3 (2005-06) to 4.4 years in NHFS-4 (2015-16). The median number of years of schooling completed by males increased from 4.9 years in NHFS-3 to 6.9 years in NHFS-4. Over the same period, the percentage of females and males with no schooling decreased from 42 percent of females and 22 percent of males to 31 percent of females and 15 percent of males. Household Population and Housing Characteristics Ȉ 19 Figure 2.6 Orphanhood by Child's Age Percentage of de jure children under age 18 with one or both parents dead 0.6 1.5 3.3 6.3 9.2 <2 2-4 5-9 10-14 15-17 Household Population and Housing Characteristics z�19 20 Ȉ Household Population and Housing Characteristics Patterns by background characteristics x Among both females and males, the median number of years of schooling is higher in urban areas than in rural areas (7.0 years versus 3.1 years among females and 8.5 versus 5.8 years among males). x Educational attainment increases with household wealth. Females in the lowest wealth quintile have completed a median of 0 years of schooling, compared with a median of 9.1 years for females in the highest wealth quintile. The median number of years of schooling was 2.9 years among males in the lowest wealth quintile and 9.9 years among those in the highest quintile. x The median number of years of schooling is highest among those who do not belong to scheduled castes, scheduled tribes, and other backward classes (6.4 years for females and 8.2 years for males). The median number of years of schooling is lowest among Muslims than for other specific religious groups (3.7 years for females and 4.8 years for males). x The percentage of the household population with no schooling is higher in rural areas than urban areas (37% versus 19% for females and 18% versus 9% for males). 2.9.2 School Attendance Net attendance ratio (NAR) Percentage of the school-age population that attends primary or secondary school. Sample: Children age 6-10 for primary school NAR and children age 11-17 for secondary school NAR Gross attendance ratio (GAR) The total number of children attending primary school divided by the official primary school age population and the total number of children attending secondary school divided by the official secondary school age population. Sample: Children at the official primary school age for primary school GAR and children at the official secondary school age for secondary school GAR Eighty-five percent of children age 6-17 attend school, including pre-primary school (86% of males and 84% of females) (Table 2.19). Almost all (95%) males and females age 6-10 attend school, including pre-primary school. This percentage decreases to 88 percent for children age 11-14 and then drops further to 63 percent for children age 15-17. There is almost no difference in school attendance by males and females at age 6-14, but males are more likely than females to attend school at age 15-17 (67% versus 60%). Urban-rural differentials in school attendance are minimal at age 6-10, but widen at older ages (Figure 2.7). Seventy-seven percent of girls and 78 percent of boys age 6-10 attend primary school (Table 2.20). The net attendance ratio (NAR) drops in secondary school: only 66 percent of girls and 69 percent of boys age 11-17 attend secondary school. The gross attendance ratio (GAR) is 85 percent at the primary school level and 80 percent at the secondary school level. These figures indicate that a number of children outside the official school age population for that level are attending primary school, and not all those who should be are attending secondary school (Table 2.20). 20 z Household Population and Housing Characteristics Gender parity index (GPI) The ratio of female to male children attending primary school and the ratio of female to male children attending secondary school. The index reflects the magnitude of the gender gap. Sample: Children attending primary school and children attending secondary school A gender parity index (GPI) of 1 indicates parity or equality between the school participation ratios for males and females. A GPI lower than 1 indicates a gender disparity in favour of males, with a higher proportion of males than females attending that level of schooling. A GPI higher than 1 indicates a gender disparity in favour of females. The GPI for the NAR is 0.98 at the primary school level and 0.96 at the secondary school level. This indicates that there is relatively little difference in overall school attendance by school-age girls and boys at either the primary or secondary school level. The GPI for the GAR is also slightly less than 1, which indicates that male children outside of the official school age population are only slightly more likely to attend school than their female counterparts; the GPIs for the GAR are the same 0.97 at the primary school level and at the secondary school level. Patterns by background characteristics x At the primary school level, there is no difference in the NAR between urban and rural areas (78% each). However, at the secondary school level, the NAR is much higher in urban areas than in rural areas (72% versus 66%). Household Population and Housing Characteristics Ȉ 21 96 97 95 94 91 91 88 86 70 70 65 55 AGE 6-10, URBAN Male Female AGE 6-10, RURAL Male Female AGE 11-14, URBAN Male Female AGE 11-14, RURAL Male Female AGE 15-17, URBAN Male Female AGE 15-17, RURAL Male Female Figure 2.7 School Attendance by Age, Sex, and Residence Percentage of children age 6-17 years attending school Household Population and Housing Characteristics z�21 x The NARs increase with household wealth at the secondary school level. Attendance in the lowest wealth quintile is 52 percent for girls and 55 percent for boys, compared with 80 percent for girls and 81 percent for boys in the highest wealth quintile. x At the primary school level, there is slight difference in the GAR between urban and rural (83% and 86%, respectively). However, at the secondary school level, the GAR is much higher in urban areas than in rural areas (85% versus 78%). x The GARs increase with household wealth at the secondary school level. Attendance in the lowest wealth quintile is 63 percent for girls and 66 percent for boys, compared with 94 percent for girls and 95 percent for boys in the highest wealth quintile. x There is not much difference by caste/tribe in the NAR and GAR at of the primary school level, but at the secondary school level, children belonging to scheduled tribes have the lowest NARs and GARs. 22 Ȉ Household Population and Housing Characteristics22 z Household Population and Housing Characteristics LIST OF TABLES For more information on the household population and housing characteristics, see the following tables: Tables Table 2.1 Household drinking water Table 2.2 Household sanitation facilities Table 2.3 Housing characteristics Table 2.4 Housing characteristics by state/union territory Table 2.5 Wealth quintiles by state/union territory Table 2.6 Religion and caste/tribe by wealth quintiles Table 2.7 Religion and caste/tribe of household head by state/union territory Table 2.8 Household possessions Table 2.9 Household ownership of agricultural land, house, and farm animals Table 2.10 Hand washing Table 2.11 Household composition Table 2.12 Household population by age, residence, sex, and possession of an Aadhaar card Table 2.13 Birth registration of children Table 2.14 Birth registration of children by state/union territory Table 2.15 Children's living arrangements and orphanhood Table 2.16 Children's living arrangements and orphanhood by state/union territory Table 2.17 Educational attainment of household population Table 2.18 Educational attainment of household population by state/union territory Table 2.19 School attendance by state/union territory Table 2.20 School attendance ratios Table 2.21 Reasons for children currently not attending school Household Population and Housing Characteristics Ȉ 23Household Population and Housing Characteristics z�23 24 Ȉ Household Population and Housing Characteristics Table 2.1 Household drinking water Percent distribution of urban, rural, and total households and de jure population by source of drinking water, time to collect drinking water, and person who usually collects drinking water, and percentage of urban, rural, and total households and de jure population by treatment of drinking water, India, 2015-16 Drinking water characteristics Urban Rural Total De jure population Source of drinking water Improved source 91.1 89.3 89.9 90.2 Piped into dwelling/yard/plot 52.1 18.4 30.1 29.2 Public tap/standpipe 16.9 15.3 15.9 14.6 Tube well or borehole 17.4 50.9 39.2 42.0 Protected dug well 3.7 3.6 3.7 3.4 Protected spring 0.2 0.4 0.3 0.3 Rainwater 0.1 0.2 0.2 0.2 Community RO Plant 0.7 0.5 0.5 0.5 Unimproved source 8.7 10.6 9.9 9.7 Unprotected dug well 1.0 6.0 4.2 4.4 Unprotected spring 0.1 0.6 0.4 0.4 Tanker truck/cart with small tank 2.1 1.1 1.5 1.5 Surface water 0.4 0.8 0.7 0.7 Bottled water1 5.1 2.1 3.1 2.7 Other source 0.2 0.1 0.2 0.1 Total 100.0 100.0 100.0 100.0 Time to collect drinking water (round trip) Water on premises/delivered to dwelling 81.6 58.1 66.3 67.2 Less than 30 minutes 15.3 33.6 27.2 26.2 Thirty minutes or longer 2.9 8.3 6.4 6.6 Don't know 0.1 0.1 0.1 0.1 Total 100.0 100.0 100.0 100.0 Number 209,807 391,702 601,509 2,748,553 Person who usually collects drinking water2 Adult female 15+ years 71.2 82.3 80.2 81.4 Adult male 15+ years 24.4 13.8 15.8 14.1 Female child under age 15 years 2.2 2.8 2.7 3.2 Male child under age 15 years 1.1 0.7 0.8 0.8 Other 1.1 0.5 0.6 0.5 Total 100.0 100.0 100.0 100.0 Number 38,509 164,318 202,827 901,956 Water treatment prior to drinking3 Boil 14.3 7.5 9.9 9.0 Use alum 1.7 1.0 1.2 1.2 Add bleach/chlorine 3.3 3.1 3.2 3.1 Strain through cloth 14.8 14.2 14.4 14.7 Use ceramic, sand, or other water filter 12.5 3.5 6.6 6.2 Use electric purifier 11.0 1.5 4.8 4.6 Allow water to stand and settle 1.2 0.8 1.0 0.9 Other 2.7 2.4 2.5 2.6 No treatment 47.1 70.5 62.3 63.4 Number 209,807 391,702 601,509 2,748,553 1 Because the quality of bottled water is not known, households using bottled water are classified as using an unimproved source in accordance with the practice of the WHO-UNICEF Joint Monitoring Programme for Water Supply and Sanitation 2 Excludes those who have source of water on premises or who have water delivered to the dwelling 3 Total percentages may add to more than 100.0 because multiple answers are allowed 24 z Household Population and Housing Characteristics Table 2.2 Household sanitation facilities Percent distribution of urban, rural, and total households and de jure population by type of toilet facility, India, 2015-16 Type of toilet facility Urban Rural Total De jure population Improved, not shared facility 70.3 36.7 48.4 48.4 Flush/pour flush to piped sewer system 19.8 1.4 7.8 7.5 Flush/pour flush to septic tank 41.1 22.1 28.7 28.7 Flush/pour flush to pit latrine 6.3 7.7 7.2 7.4 Ventilated improved pit (VIP) latrine/ biogas latrine 0.4 0.7 0.6 0.6 Pit latrine with slab 2.7 4.6 3.9 4.1 Twin pit, composting toilet 0.1 0.1 0.1 0.1 Shared facility1 14.9 6.0 9.1 8.2 Flush/pour flush to piped sewer system 3.1 0.2 1.2 1.0 Flush/pour flush to septic tank 9.3 3.4 5.4 4.9 Flush/pour flush to pit latrine 1.5 1.4 1.4 1.3 Ventilated improved pit (VIP) latrine/ biogas latrine 0.1 0.2 0.1 0.1 Pit latrine with slab 0.9 1.0 0.9 0.8 Twin pit, composting toilet 0.1 0.0 0.0 0.0 Unimproved 3.7 3.1 3.3 3.4 Flush/pour flush not to sewer/septic tank/pit latrine 2.9 0.6 1.4 1.4 Pit latrine without slab/open pit 0.5 1.9 1.4 1.5 Dry toilet 0.3 0.6 0.5 0.5 Other 0.5 0.1 0.2 0.2 No facility/uses open space/field 10.5 54.1 38.9 39.8 Total 100.0 100.0 100.0 100.0 Number 209,807 391,702 601,509 2,748,553 1 Facilities that would be considered improved if they were not shared by two or more households Household Population and Housing Characteristics z�25 Table 2.3 Housing characteristics Percent distribution of urban, rural, and total households and de jure population by housing characteristics, India, 2015-16 Housing characteristic Urban Rural Total De jure population Electricity Yes 97.5 83.2 88.2 88.0 No 2.5 16.8 11.8 12.0 Total 100.0 100.0 100.0 100.0 Type of house1 Kachha 0.9 8.1 5.6 5.5 Semi-pucca 12.6 46.9 34.9 36.4 Pucca 84.5 41.2 56.3 54.8 Missing 2.0 3.8 3.2 3.3 Total 100.0 100.0 100.0 100.0 Persons per room used for sleeping <3 57.4 50.0 52.6 44.0 3-4 30.0 32.2 31.4 34.7 5-6 9.8 13.2 12.0 15.2 7+ 2.7 4.6 3.9 6.2 Missing 0.1 0.1 0.1 0.0 Total 100.0 100.0 100.0 100.0 Cooking fuel Electricity 1.0 0.4 0.6 0.6 LPG/natural gas 78.3 23.0 42.3 39.9 Biogas 1.3 0.6 0.8 0.8 Kerosene 2.5 0.6 1.2 1.0 Coal/lignite 1.3 0.7 0.9 1.0 Charcoal 0.6 0.6 0.6 0.6 Wood 12.0 55.7 40.5 41.9 Straw/shrubs/grass 0.5 3.6 2.5 2.5 Agricultural crop waste 0.4 4.4 3.0 3.2 Dung cakes 1.5 10.2 7.2 8.5 Other 0.5 0.2 0.3 0.1 Total 100.0 100.0 100.0 100.0 Percentage using clean fuel for cooking2 80.6 24.0 43.8 41.2 Percentage using solid fuel for cooking3 16.4 75.2 54.7 57.7 Continued. 26 z Household Population and Housing Characteristics Table 2.3 Housing characteristics³Continued Percent distribution of urban, rural, and total households and de jure population by housing characteristics, India, 2015-16 Housing characteristic Urban Rural Total De jure population Place for cooking In the house, separate room 64.3 40.9 49.0 49.3 In the house, no separate room 26.0 35.9 32.4 32.1 In a separate building 5.9 11.6 9.6 9.9 Outdoors 3.4 11.5 8.7 8.6 Other 0.5 0.2 0.3 0.1 Total 100.0 100.0 100.0 100.0 Number 209,807 391,702 601,509 2,748,553 Type of fire/stove among households using solid fuels Stove 3.3 0.8 1.1 1.0 Open fire/chullah 96.2 99.1 98.8 98.9 Other 0.5 0.0 0.1 0.1 Total 100.0 100.0 100.0 100.0 Number using solid fuel 34,433 294,596 329,029 1,584,909 Frequency of smoking in the home4 Daily 22.6 32.3 28.9 31.4 Weekly 7.5 8.7 8.3 8.3 Monthly 2.1 2.9 2.6 2.7 Less than monthly 2.6 3.0 2.8 2.9 Never 65.3 53.1 57.4 54.7 Total 100.0 100.0 100.0 100.0 Number 209,807 391,702 601,509 2,748,553 1 Houses made from mud, thatch, or other low-quality materials are called kachha houses, houses that use partly low-quality and partly high-quality materials are called semi-pucca houses, and houses made with high quality materials throughout, including the floor, roof, and exterior walls, are called pucca houses. 2 Electricity, LPG/natural gas, biogas 3 Includes coal/lignite, charcoal, wood, straw/shrubs/grass, agricultural crop waste, and dung cakes 4 Frequency of smoking by anyone inside the home Household Population and Housing Characteristics z�27 Table 2.4 Housing characteristics by state/union territory Percentage of households with selected housing characteristics by state/union territory, India, 2015-16 State/union territory Percentage of households: Mean number of persons per room used for sleeping With electricity With improved source of drinking water1 With toilet facility Using solid fuel for cooking2 In which anyone smokes at home Living in a SXFFD3 house ,QGLD� 88.2 89.9 61.1 54.7 42.6 56.3 2.9 1RUWK Chandigarh 99.6 99.5 97.8 4.1 27.5 94.2 2.7 Delhi 99.8 80.0 96.0 1.6 36.9 90.3 2.9 Haryana 98.8 91.6 89.8 47.4 64.3 76.3 2.7 Himachal Pradesh 99.5 94.9 85.7 62.5 56.2 70.2 2.1 Jammu & Kashmir 97.4 89.2 79.3 41.5 66.1 70.9 2.5 Punjab 99.6 99.1 92.9 33.5 21.7 80.8 2.7 Rajasthan 91.0 85.5 54.0 67.8 54.2 64.2 3.0 Uttarakhand 97.5 92.9 82.9 48.1 49.4 64.5 2.7 &HQWUDO Chhattisgarh 95.6 91.1 41.3 76.7 37.9 35.9 2.8 Madhya Pradesh 89.9 84.7 42.8 69.7 52.5 35.7 3.1 Uttar Pradesh 70.9 96.4 45.8 66.7 54.2 33.1 3.4 (DVW Bihar 58.6 98.2 33.5 81.9 51.6 25.9 3.3 Jharkhand 80.1 77.7 30.0 80.6 23.8 37.9 2.7 Odisha 85.5 88.8 35.0 79.6 31.1 44.5 2.8 West Bengal 93.7 94.6 74.9 69.6 59.4 46.5 2.7 1RUWKHDVW Arunachal Pradesh 88.7 87.5 90.8 54.2 50.9 23.9 2.1 Assam 78.2 83.8 88.9 74.2 50.3 25.2 2.3 Manipur 92.4 41.6 98.7 57.6 65.9 17.7 2.4 Meghalaya 91.4 67.9 92.4 74.7 73.6 43.0 2.3 Mizoram 95.9 91.4 99.1 31.2 83.2 54.7 3.0 Nagaland 96.9 80.6 98.3 66.6 51.9 28.4 2.1 Sikkim 99.4 97.6 99.7 39.1 40.0 71.6 1.9 Tripura 92.7 87.3 97.9 62.1 65.2 26.6 2.4 :HVW Dadra & Nagar Haveli 97.4 77.5 60.6 37.4 27.7 50.6 3.2 Daman & Diu 100.0 89.4 93.6 7.3 45.2 92.9 2.7 Goa 99.8 96.3 89.1 13.7 21.3 84.2 2.4 Gujarat 96.0 90.9 71.0 44.2 38.0 77.1 3.2 Maharashtra 92.5 91.5 71.2 36.0 26.6 72.9 3.2 &RQWLQXHG���� 28 z Household Population and Housing Characteristics Table 2.4 Housing characteristics by state/union territory³Continued Percentage of households with selected housing characteristics by state/union territory, India, 2015-16 State/union territory Percentage of households: Mean number of persons per room used for sleeping With electricity With improved source of drinking water1 With toilet facility Using solid fuel for cooking2 In which anyone smokes at home Living in a pucca3 house South Andaman & Nicobar Islands 97.0 94.3 84.7 22.7 17.5 66.0 2.3 Andhra Pradesh 98.8 72.7 61.3 37.1 34.6 81.5 2.9 Karnataka 97.8 89.3 65.8 43.4 29.2 62.9 2.7 Kerala 99.2 94.3 99.2 42.3 28.9 89.0 1.8 Lakshadweep 99.9 91.5 100.0 53.8 38.8 97.5 2.1 Puducherry 99.6 95.4 69.1 14.0 25.0 81.9 2.4 Tamil Nadu 98.8 90.6 61.7 24.3 33.6 78.9 2.4 Telangana 98.3 77.9 69.0 30.8 33.6 75.0 3.0 1 See Table 2.1 for list of improved sources. 2 Includes coal/lignite, charcoal, wood, straw/shrubs/grass, agricultural crop waste, and dung cakes 3 Refer to Table 2.3 for definition of pucca Household Population and Housing Characteristics z�29 Table 2.5 Wealth quintiles by state/union territory Percent distribution of the de jure population by wealth quintiles, according to residence and state/union territory, India, 2015-16 Residence/state/ union territory Wealth quintile Total Lowest Second Middle Fourth Highest India 20.0 20.0 20.0 20.0 20.0 100.0 Urban 3.1 7.0 15.6 30.0 44.4 100.0 Rural 28.4 26.5 22.2 15.0 7.9 100.0 North Chandigarh 0.7 2.4 4.9 11.2 80.8 100.0 Delhi 0.1 1.9 13.4 21.8 62.8 100.0 Haryana 1.7 7.3 17.4 26.5 47.1 100.0 Himachal Pradesh 1.7 9.5 23.2 33.3 32.3 100.0 Jammu & Kashmir 7.3 19.6 24.5 23.5 25.2 100.0 Punjab 0.6 3.7 11.8 21.9 62.0 100.0 Rajasthan 17.2 23.1 21.2 18.6 19.8 100.0 Uttarakhand 4.8 17.6 25.0 22.9 29.8 100.0 Central Chhattisgarh 31.0 25.3 16.7 12.7 14.3 100.0 Madhya Pradesh 31.0 22.4 16.0 14.4 16.2 100.0 Uttar Pradesh 29.4 22.9 17.3 14.9 15.5 100.0 East Bihar 51.2 23.2 13.4 8.9 3.3 100.0 Jharkhand 46.1 21.1 14.0 9.9 8.8 100.0 Odisha 37.0 26.2 18.4 11.0 7.3 100.0 West Bengal 22.8 29.7 21.2 17.2 9.1 100.0 Northeast Arunachal Pradesh 19.4 25.2 25.6 20.6 9.2 100.0 Assam 24.4 38.7 18.6 12.2 6.1 100.0 Manipur 8.8 30.9 30.3 19.5 10.4 100.0 Meghalaya 11.4 35.5 31.5 15.3 6.3 100.0 Mizoram 6.0 10.0 20.3 29.0 34.7 100.0 Nagaland 11.8 31.5 26.1 19.3 11.3 100.0 Sikkim 0.6 7.0 42.8 38.0 11.7 100.0 Tripura 13.0 43.4 22.7 14.7 6.2 100.0 West Dadra & Nagar Haveli 21.4 24.0 16.1 20.5 18.0 100.0 Daman & Diu 0.3 12.6 19.5 34.6 33.1 100.0 Goa 0.3 4.5 11.1 28.1 55.9 100.0 Gujarat 8.7 16.8 21.1 24.1 29.4 100.0 Maharashtra 9.2 16.0 22.5 26.4 25.9 100.0 South Andaman & Nicobar Islands 4.4 10.4 21.5 32.7 31.0 100.0 Andhra Pradesh 4.6 15.3 32.5 29.9 17.7 100.0 Karnataka 6.3 19.9 26.7 26.7 20.5 100.0 Kerala 0.3 2.2 13.3 35.8 48.5 100.0 Lakshadweep 0.1 0.4 9.1 52.8 37.6 100.0 Puducherry 2.4 9.3 21.2 30.5 36.6 100.0 Tamil Nadu 3.5 14.7 27.5 31.6 22.7 100.0 Telangana 6.3 17.2 25.9 27.4 23.2 100.0 30 z Household Population and Housing Characteristics Table 2.6 Religion and caste/tribe by wealth quintiles Percent distribution of the de jure population by wealth quintiles, according to religion and caste/tribe of household head, India, 2015-16 Wealth quintile Total De jure population Lowest Second Middle Fourth Highest Religion of household head Hindu 21.0 20.4 20.2 19.3 19.1 100.0 2,203,861 Muslim 18.0 20.3 20.0 22.9 18.8 100.0 388,606 Christian 11.4 15.9 21.2 23.3 28.1 100.0 64,722 Sikh 0.9 4.5 12.1 22.2 60.2 100.0 46,401 Buddhist/Neo-Buddhist 9.8 18.9 23.8 26.9 20.6 100.0 24,734 Jain 0.2 1.1 7.2 16.6 74.9 100.0 5,448 Other 46.3 28.5 13.2 9.1 2.9 100.0 14,781 Caste/tribe of household head Scheduled caste 25.9 24.2 21.9 16.7 11.3 100.0 566,399 Scheduled tribe 45.2 25.5 14.9 9.1 5.4 100.0 257,178 Other backward class 18.2 19.6 21.1 22.3 18.8 100.0 1,175,204 Other 9.4 15.4 18.4 22.8 34.0 100.0 729,971 Don't know 25.0 21.5 22.0 18.6 12.9 100.0 19,801 Total 20.0 20.0 20.0 20.0 20.0 100.0 2,748,553 Household Population and Housing Characteristics z�31 Ta bl e 2. 7 Re lig io n an d ca st e/ tri be o f h ou se ho ld h ea d by s ta te /u ni on te rr ito ry Pe rc en t d ist rib ut io n of h ou se ho ld s b y re lig io n an d ca st e/ tri be o f t he h ou se ho ld h ea d, a cc or di ng to re sid en ce a nd s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry Re lig io n of h ou se ho ld h ea d C as te /tr ib e of h ou se ho ld h ea d H in du M us lim C hr ist ia n Si kh Bu dd hi st / N eo -B ud dh ist Ja in O th er 1 To ta l Sc he du le d ca st e Sc he du le d tri be O th er ba ck w ar d cl as s O th er D on 't kn ow To ta l In di a 81 .4 12 .5 2. 7 1. 6 1. 0 0. 2 0. 5 10 0. 0 20 .6 9. 2 42 .2 27 .2 0. 8 10 0. 0 U rb an 77 .2 16 .2 3. 1 1. 5 1. 3 0. 5 0. 3 10 0. 0 16 .8 3. 9 42 .2 36 .0 1. 0 10 0. 0 Ru ra l 83 .7 10 .6 2. 5 1. 7 0. 8 0. 1 0. 7 10 0. 0 22 .6 12 .0 42 .2 22 .5 0. 6 10 0. 0 N or th C ha nd ig ar h 81 .1 4. 2 0. 7 13 .9 0. 0 0. 0 0. 1 10 0. 0 23 .9 0. 2 21 .5 54 .4 0. 0 10 0. 0 D el hi 83 .5 13 .4 0. 5 2. 1 0. 1 0. 4 0. 1 10 0. 0 26 .7 1. 5 24 .5 43 .9 3. 3 10 0. 0 H ar ya na 89 .3 6. 7 0. 1 3. 8 0. 0 0. 1 0. 0 10 0. 0 27 .8 0. 3 44 .0 27 .6 0. 3 10 0. 0 H im ac ha l P ra de sh 95 .5 1. 6 0. 1 1. 2 1. 6 0. 0 0. 1 10 0. 0 23 .3 4. 8 14 .3 57 .0 0. 6 10 0. 0 Ja m m u & K as hm ir 29 .1 67 .8 0. 1 2. 1 1. 0 0. 0 0. 0 10 0. 0 9. 5 8. 8 4. 6 76 .8 0. 3 10 0. 0 Pu nj ab 36 .8 1. 5 1. 3 60 .3 0. 0 0. 1 0. 0 10 0. 0 37 .5 0. 1 19 .5 42 .8 0. 0 10 0. 0 Ra ja st ha n 89 .6 8. 0 0. 1 1. 7 0. 0 0. 6 0. 0 10 0. 0 19 .1 14 .3 45 .5 20 .4 0. 7 10 0. 0 U tta ra kh an d 85 .7 12 .2 0. 2 1. 7 0. 1 0. 1 0. 0 10 0. 0 21 .8 4. 1 21 .2 52 .3 0. 6 10 0. 0 C en tr al C hh at tis ga rh 95 .2 2. 4 1. 8 0. 2 0. 2 0. 1 0. 1 10 0. 0 14 .2 31 .1 46 .1 8. 4 0. 2 10 0. 0 M ad hy a Pr ad es h 92 .6 6. 1 0. 2 0. 2 0. 2 0. 6 0. 1 10 0. 0 18 .0 19 .7 43 .9 18 .0 0. 4 10 0. 0 U tta r P ra de sh 82 .0 17 .5 0. 1 0. 3 0. 0 0. 1 0. 0 10 0. 0 24 .3 1. 3 51 .8 22 .4 0. 3 10 0. 0 Ea st Bi ha r 83 .8 16 .1 0. 1 0. 0 0. 0 0. 0 0. 1 10 0. 0 20 .5 3. 4 57 .5 18 .1 0. 5 10 0. 0 Jh ar kh an d 74 .0 13 .0 3. 7 0. 2 0. 0 0. 0 9. 1 10 0. 0 14 .1 27 .7 46 .1 11 .7 0. 4 10 0. 0 O di sh a 95 .0 1. 9 2. 8 0. 0 0. 0 0. 0 0. 2 10 0. 0 20 .0 23 .2 34 .9 21 .1 0. 8 10 0. 0 W es t B en ga l 73 .0 23 .9 0. 5 0. 0 0. 2 0. 0 2. 3 10 0. 0 28 .4 6. 3 11 .8 51 .8 1. 7 10 0. 0 N or th ea st A ru na ch al P ra de sh 26 .3 2. 3 41 .0 0. 1 12 .1 0. 0 18 .2 10 0. 0 7. 0 72 .5 4. 9 14 .7 0. 8 10 0. 0 A ss am 63 .8 32 .5 3. 3 0. 0 0. 2 0. 0 0. 0 10 0. 0 11 .0 12 .6 27 .0 48 .4 0. 9 10 0. 0 M an ip ur 46 .0 10 .1 31 .2 0. 0 0. 0 0. 0 12 .6 10 0. 0 6. 0 30 .4 18 .1 43 .7 1. 8 10 0. 0 M eg ha la ya 11 .1 5. 1 77 .0 0. 0 0. 1 0. 1 6. 6 10 0. 0 3. 4 88 .0 0. 8 7. 4 0. 3 10 0. 0 M iz or am 0. 9 0. 7 91 .8 0. 0 6. 4 0. 0 0. 1 10 0. 0 1. 1 96 .0 2. 0 0. 5 0. 4 10 0. 0 N ag al an d 7. 3 3. 4 89 .0 0. 0 0. 1 0. 0 0. 1 10 0. 0 5. 2 89 .3 0. 8 4. 3 0. 4 10 0. 0 Si kk im 58 .5 1. 4 9. 1 0. 0 30 .8 0. 0 0. 1 10 0. 0 5. 6 36 .9 32 .0 25 .3 0. 1 10 0. 0 Tr ip ur a 84 .4 7. 3 4. 6 0. 0 3. 7 0. 0 0. 0 10 0. 0 21 .2 30 .5 17 .8 30 .4 0. 1 10 0. 0 C on tin ue d. . 32 z Household Population and Housing Characteristics Ta bl e 2. 7 Re lig io n an d ca st e/ tr ib e of h ou se ho ld h ea d by s ta te /u ni on te rr ito ry — C on tin ue d Pe rc en t d ist rib ut io n of h ou se ho ld s b y re lig io n an d ca st e/ tri be o f t he h ou se ho ld h ea d, a cc or di ng to re sid en ce a nd s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry Re lig io n of h ou se ho ld h ea d C as te /tr ib e of h ou se ho ld h ea d H in du M us lim C hr ist ia n Si kh Bu dd hi st / N eo -B ud dh ist Ja in O th er 1 To ta l Sc he du le d ca st e Sc he du le d tri be O th er ba ck w ar d cl as s O th er D on 't kn ow To ta l W es t D ad ra & N ag ar H av el i 92 .3 2. 6 3. 4 0. 0 0. 4 0. 3 1. 1 10 0. 0 5. 5 53 .7 13 .4 24 .7 2. 7 10 0. 0 D am an & D iu 91 .5 6. 7 0. 7 0. 0 0. 0 0. 2 0. 9 10 0. 0 10 .9 8. 6 40 .1 33 .3 7. 0 10 0. 0 G oa 67 .6 7. 8 24 .2 0. 0 0. 2 0. 2 0. 1 10 0. 0 6. 1 7. 1 24 .0 62 .6 0. 2 10 0. 0 G uj ar at 91 .9 7. 0 0. 5 0. 0 0. 0 0. 4 0. 0 10 0. 0 11 .1 14 .7 40 .8 31 .3 2. 0 10 0. 0 M ah ar as ht ra 78 .6 10 .7 0. 8 0. 2 8. 6 0. 8 0. 2 10 0. 0 17 .3 10 .9 27 .3 43 .6 0. 9 10 0. 0 So ut h A nd am an & N ic ob ar Is la nd s 73 .5 7. 4 18 .5 0. 4 0. 1 0. 0 0. 1 10 0. 0 8. 8 5. 3 21 .6 64 .0 0. 3 10 0. 0 A nd hr a Pr ad es h 84 .8 7. 6 7. 6 0. 0 0. 0 0. 0 0. 0 10 0. 0 19 .9 5. 3 49 .6 24 .5 0. 6 10 0. 0 Ka rn at ak a 84 .2 12 .4 2. 9 0. 0 0. 0 0. 3 0. 1 10 0. 0 21 .0 9. 2 46 .4 22 .4 1. 0 10 0. 0 Ke ra la 58 .8 22 .9 18 .2 0. 0 0. 0 0. 0 0. 1 10 0. 0 9. 9 1. 2 49 .4 38 .2 1. 2 10 0. 0 La ks ha dw ee p 1. 7 97 .9 0. 4 0. 0 0. 0 0. 0 0. 0 10 0. 0 1. 4 95 .4 2. 3 1. 0 0. 0 10 0. 0 Pu du ch er ry 92 .5 2. 9 4. 6 0. 0 0. 0 0. 0 0. 0 10 0. 0 21 .8 0. 6 77 .0 0. 6 0. 0 10 0. 0 Ta m il N ad u 90 .1 4. 5 5. 3 0. 0 0. 0 0. 0 0. 0 10 0. 0 26 .8 1. 9 69 .4 1. 8 0. 1 10 0. 0 Te la ng an a 87 .0 9. 6 3. 2 0. 1 0. 0 0. 0 0. 0 10 0. 0 18 .8 7. 8 56 .4 16 .2 0. 8 10 0. 0 1 I nc lu de s Je w s, P ar sis /Z or oa st ria ns , t ho se fo llo w in g “o th er ” re lig io ns , a nd th os e w ith n o re lig io n Household Population and Housing Characteristics z�33 Table 2.8 Household possessions Percentage of urban, rural, and total households and de jure population possessing various household goods and means of transport, and percentage with a bank/post office account, health scheme/health insurance, or a BPL card, India, 2015-16 Household possessions Urban Rural Total De jure population Household goods Mattress 82.3 58.4 66.7 67.7 Pressure cooker 83.6 42.2 56.6 57.4 Chair 86.5 70.7 76.2 76.9 Cot or bed 88.5 88.3 88.4 89.6 Table 72.1 46.5 55.4 56.3 Electric fan 95.1 69.1 78.2 78.2 Radio or transistor 10.3 7.0 8.1 8.4 Television (black and white) 3.1 3.5 3.3 3.7 Television (colour) 86.0 51.5 63.5 64.1 Any television 87.0 53.5 65.2 65.9 Sewing machine 33.5 19.0 24.0 26.9 Mobile telephone 96.1 87.3 90.4 92.9 Landline telephone 7.8 1.9 3.9 3.7 Internet 20.4 5.7 10.9 11.2 Computer 19.2 3.6 9.0 9.0 Refrigerator 54.2 16.4 29.6 30.1 Air conditioner/cooler 32.9 9.9 17.9 18.9 Washing machine 28.8 5.5 13.6 13.7 Watch or clock 90.8 71.4 78.1 79.3 Water pump 21.5 14.9 17.2 18.3 Thresher 0.6 1.9 1.5 1.8 Tractor 0.7 3.4 2.5 3.3 None of the above 0.2 1.2 0.8 0.6 Means of transport Bicycle 45.0 55.9 52.1 56.4 Motorcycle or scooter 51.4 30.3 37.7 40.6 Animal-drawn cart 0.9 5.1 3.6 4.4 Car 11.4 3.2 6.0 6.3 None of the above 26.7 30.2 29.0 24.9 Percentage having a bank/post office account1 92.0 88.0 89.4 90.3 Percentage covered by a health scheme/health insurance1 28.2 28.9 28.7 27.3 Percentage having a BPL card 25.2 45.8 38.6 39.2 Number 209,807 391,702 601,509 2,748,553 BPL = Below poverty line 1 Any usual household member 34 z Household Population and Housing Characteristics Table 2.9 Household ownership of agricultural land, house, and farm animals Percent distribution of urban, rural, and total households and de jure population owning agricultural land by type of land and percentage owning a house and farm animals, India, 2015-16 Household possessions Urban Rural Total De jure population Ownership of agricultural land No agricultural land 86.6 47.4 61.1 57.9 Irrigated land only 7.5 28.6 21.3 23.6 Non-irrigated land only 3.8 16.3 11.9 12.1 Both irrigated and non-irrigated land 1.2 6.7 4.8 5.5 Missing 0.9 1.0 1.0 1.0 Total 100.0 100.0 100.0 100.0 Percentage owning a house 71.2 84.5 79.8 81.7 Percentage owning farm animals1 10.9 59.7 42.7 48.1 Number 209,807 391,702 601,509 2,748,553 1 Cows, bulls, buffaloes, camels, horses, donkeys, mules, goats, sheep, chickens, or ducks Household Population and Housing Characteristics z�35 Table 2.10 Hand washing Percentage of households in which the place most often used for washing hands was observed, and among households in which the place for hand washing was observed, percent distribution by availability of water, soap, and other cleansing agents, according to background characteristics, India, 2015-16 Background characteristic Percentage of households in which place for washing hands was observed Number of households Among households in which place for hand washing was observed, percentage with: Total Number of households with place for hand washing observed Soap and water1 Water and cleansing agent2 other than soap only Water only Soap but no water3 Cleansing agent other than soap only2 No water, no soap, no other cleansing agent Residence Urban 97.6 209,807 80.3 2.6 10.8 2.3 0.6 3.4 100.0 204,807 Rural 96.3 391,702 49.4 13.2 19.4 2.9 3.6 11.5 100.0 377,257 Education of the household head No schooling 95.8 183,354 42.8 14.8 21.5 2.8 4.4 13.7 100.0 175,628 <5 years complete 96.4 60,952 50.8 10.1 21.3 3.1 3.1 11.7 100.0 58,731 5-7 years complete 96.8 96,060 58.5 9.1 18.0 2.9 2.6 8.8 100.0 93,000 8-9 years complete 97.1 83,487 64.0 8.7 14.9 3.1 2.1 7.2 100.0 81,035 10-11 years complete 97.5 75,216 75.0 5.5 12.1 2.2 1.0 4.2 100.0 73,315 12 or more years complete 98.0 99,950 84.6 3.5 7.2 1.9 0.6 2.2 100.0 97,947 Don't know/missing 96.7 2,490 57.5 10.1 14.2 4.1 2.9 11.2 100.0 2,408 Religion of household head Hindu 96.8 489,726 58.7 10.0 16.5 2.8 2.8 9.1 100.0 474,026 Muslim 96.2 75,426 65.2 8.3 16.6 2.3 1.6 6.0 100.0 72,566 Christian 97.3 16,251 64.3 3.8 19.6 2.8 1.5 8.2 100.0 15,811 Sikh 98.3 9,858 88.4 3.6 6.0 0.4 0.3 1.3 100.0 9,686 Buddhist/Neo-Buddhist 97.8 5,762 75.2 5.0 11.3 2.9 1.4 4.2 100.0 5,635 Jain 97.9 1,261 95.4 1.3 2.0 0.8 0.0 0.5 100.0 1,235 Other 96.3 3,226 28.2 9.3 20.2 2.4 4.2 35.8 100.0 3,106 Caste/tribe of household head Scheduled caste 96.2 123,837 51.9 10.8 19.5 3.2 3.3 11.3 100.0 119,140 Scheduled tribe 95.4 55,438 38.4 13.6 18.4 3.5 6.7 19.5 100.0 52,894 Other backward class 97.1 253,993 60.6 10.4 16.8 2.5 2.2 7.5 100.0 246,669 Other 97.2 163,677 73.3 5.7 12.6 2.3 1.3 4.7 100.0 159,061 Don't know 94.2 4,564 54.3 8.0 19.4 4.4 3.3 10.7 100.0 4,300 Wealth index Lowest 94.2 122,002 24.3 23.2 20.4 3.2 7.7 21.2 100.0 114,961 Second 96.0 118,447 43.2 14.1 23.1 3.5 3.5 12.6 100.0 113,760 Middle 97.1 119,284 60.3 7.0 20.8 3.5 1.4 7.0 100.0 115,822 Fourth 97.9 120,839 78.1 2.8 13.6 2.4 0.4 2.6 100.0 118,330 Highest 98.6 120,937 93.3 0.9 4.5 0.8 0.0 0.5 100.0 119,192 Total 96.8 601,509 60.2 9.5 16.4 2.7 2.6 8.7 100.0 582,064 1 Soap includes soap or detergent in bar, liquid, powder, or paste form. This column includes households with soap and water only, as well as those that had soap and water and another cleansing agent. 2 Cleansing agents other than soap include ash, mud, or sand 3 Includes households with soap only, as well as those with soap and another cleansing agent 36 z Household Population and Housing Characteristics Table 2.11 Household composition Percent distribution of households by sex of head of household, household size, and household structure, and percentage of households with orphans and foster children under age 18, according to residence, India, 2015-16 Characteristic Urban Rural Total Household headship Male 85.9 85.1 85.4 Female 14.1 14.9 14.6 Total 100.0 100.0 100.0 Number of usual members 0 0.1 0.1 0.1 1 4.4 3.9 4.1 2 12.0 11.2 11.5 3 18.0 14.6 15.8 4 26.0 21.9 23.3 5 17.4 18.7 18.3 6 10.4 13.0 12.1 7 4.9 7.3 6.4 8 2.7 3.9 3.5 9+ 4.0 5.4 4.9 Total 100.0 100.0 100.0 Mean household size 4.3 4.7 4.6 Household structure1 Nuclear 61.0 56.2 57.9 Non-nuclear 39.0 43.8 42.1 Total 100.0 100.0 100.0 Percentage of households with orphans and foster children under age 18 Double orphans2 0.3 0.3 0.3 Single orphans2 3.2 4.3 4.0 Foster children3 2.9 4.0 3.6 Orphans and/or foster children 5.9 8.0 7.2 Number of households 209,807 391,702 601,509 Note: Table is based on de jure members, i.e., usual residents. 1 Nuclear households are households comprised of a married couple or a man or a woman living alone or with unmarried children (biological, adopted, or fostered) with or without unrelated individuals. 2 Double orphans are children both of whose parents are dead. Single orphans are children with one dead parent and an unknown survival status of the other parent 3 Foster children are those under age 18 living in households with neither their mother nor their father present, and the mother and/or the father are alive. Household Population and Housing Characteristics z�37 Table 2.12 Household population by age, residence, sex, and possession of an Aadhaar card Percent distribution of the de facto household population by age and percentage of individuals who have an Aadhaar card, according to residence and sex, India, 2015-16 Characteristic Urban Rural Total Male Female Total Male Female Total Male Female Total Age 0-4 8.0 7.5 7.8 10.1 9.3 9.7 9.4 8.7 9.1 5-9 8.3 7.9 8.1 10.6 9.7 10.1 9.8 9.1 9.5 10-14 9.1 8.8 9.0 11.0 10.2 10.6 10.4 9.8 10.1 15-19 9.4 8.6 9.0 9.7 9.5 9.6 9.6 9.2 9.4 20-24 9.4 9.7 9.5 8.2 9.2 8.7 8.6 9.3 9.0 25-29 9.1 9.5 9.3 7.7 8.3 8.0 8.1 8.7 8.4 30-34 7.9 8.0 8.0 6.5 6.9 6.7 7.0 7.3 7.1 35-39 7.4 7.6 7.5 6.2 6.5 6.4 6.6 6.9 6.7 40-44 6.3 6.6 6.5 5.4 5.5 5.4 5.7 5.8 5.8 45-49 6.1 6.1 6.1 5.3 5.3 5.3 5.6 5.6 5.6 50-54 4.8 5.5 5.1 4.1 4.8 4.4 4.3 5.0 4.7 55-59 4.6 4.4 4.5 4.2 4.3 4.2 4.3 4.3 4.3 60-64 3.6 3.5 3.6 4.0 3.8 3.9 3.8 3.7 3.8 65-69 2.5 2.6 2.5 3.0 2.8 2.9 2.8 2.7 2.8 70-74 1.6 1.6 1.6 2.0 1.8 1.9 1.9 1.7 1.8 75-79 0.9 0.9 0.9 1.0 1.0 1.0 1.0 0.9 0.9 80 + 0.8 1.1 0.9 1.1 1.2 1.2 1.0 1.2 1.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Dependency age groups 0-14 25.5 24.3 24.9 31.7 29.2 30.5 29.6 27.6 28.6 15-64 68.7 69.6 69.2 61.1 64.0 62.6 63.7 65.8 64.8 65+ 5.8 6.1 5.9 7.2 6.7 6.9 6.7 6.5 6.6 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Sex ratio, all ages1 na na 956 na na 1,009 na na 991 Sex ratio, age 0-61 na na 899 na na 923 na na 916 Aadhaar card Percentage with an Aadhaar card 77.5 75.9 76.7 66.2 64.4 65.3 70.0 68.2 69.1 Number of persons 461,853 441,509 903,362 906,506 914,489 1,820,995 1,368,359 1,355,998 2,724,357 na = Not applicable 1 Females per 1,000 males 38 z Household Population and Housing Characteristics Table 2.13 Birth registration of children Percentage of de jure children under age five years whose birth was registered with the civil authorities, according to background characteristics, India, 2015-16 Background characteristic Percentage of children whose birth was registered De jure children Registered, has a birth certificate Registered, does not have a birth certificate Total registered Age <2 years 60.4 20.1 80.4 93,746 2-4 years 63.5 15.8 79.3 150,121 Sex Male 61.8 17.7 79.4 127,046 Female 62.9 17.2 80.1 116,820 Residence Urban 77.0 11.8 88.8 69,557 Rural 56.4 19.7 76.1 174,310 Mother's schooling No schooling 41.4 22.4 63.8 68,431 <5 years complete 59.9 19.0 78.9 16,255 5-7 years complete 65.9 17.5 83.4 39,411 8-9 years complete 68.6 16.5 85.2 39,058 10-11 years complete 75.6 13.7 89.3 29,569 12 or more years complete 77.6 13.0 90.6 46,273 Don't know/missing 61.4 15.7 77.1 623 Mother not listed in the household 57.0 15.1 72.1 4,247 Father's schooling No schooling 45.2 20.9 66.1 34,705 <5 years complete 63.1 17.2 80.3 16,684 5-7 years complete 62.8 17.2 80.0 37,537 8-9 years complete 63.0 18.0 81.0 42,950 10-11 years complete 70.8 15.8 86.6 30,352 12 or more years complete 73.8 14.3 88.1 49,847 Don't know/missing 53.6 16.1 69.6 846 Father not listed in the household 52.6 20.1 72.6 30,946 Religion of household head Hindu 62.0 17.7 79.7 190,813 Muslim 60.2 17.2 77.4 41,226 Christian 68.8 16.6 85.4 5,074 Sikh 91.9 5.1 97.0 3,027 Buddhist/Neo-Buddhist 77.5 19.4 96.8 1,898 Jain 88.1 7.9 96.0 290 Other 52.9 22.6 75.5 1,538 Caste/tribe of household head Scheduled caste 60.2 18.5 78.7 53,072 Scheduled tribe 55.6 20.1 75.7 25,798 Other backward class 59.7 17.7 77.4 105,732 Other 71.9 14.9 86.8 57,313 Don't know 66.0 11.0 77.0 1,951 Wealth index Lowest 40.7 23.0 63.8 60,776 Second 57.8 19.5 77.3 52,979 Middle 67.5 16.6 84.1 48,105 Fourth 74.6 14.0 88.6 44,729 Highest 82.3 10.5 92.9 37,277 Total 62.3 17.4 79.7 243,867 Household Population and Housing Characteristics z�39 Table 2.14 Birth registration of children by state/union territory Percentage of de jure children under age five years whose birth was registered with the civil authorities, according to residence and state/union territory, India, 2015-16 State/union territory Urban Rural Total India 88.8 76.1 79.7 North Chandigarh 94.9 * 95.1 Delhi 88.0 (89.5) 88.0 Haryana 94.0 94.3 94.2 Himachal Pradesh 97.7 95.1 95.3 Jammu & Kashmir 90.5 73.3 77.4 Punjab 97.3 99.0 98.3 Rajasthan 81.5 62.5 66.6 Uttarakhand 81.8 74.2 76.7 Central Chhattisgarh 92.6 84.4 86.1 Madhya Pradesh 92.2 78.4 81.9 Uttar Pradesh 67.9 58.1 60.2 East Bihar 64.5 60.3 60.7 Jharkhand 77.7 61.9 65.0 Odisha 90.0 80.7 82.1 West Bengal 97.3 96.7 96.9 Northeast Arunachal Pradesh 80.0 58.3 62.9 Assam 97.4 93.8 94.2 Manipur 74.8 59.7 64.8 Meghalaya 89.2 78.4 79.8 Mizoram 97.8 98.0 97.9 Nagaland 80.2 64.2 68.5 Sikkim 98.6 98.4 98.5 Tripura 96.8 89.9 91.6 West Dadra & Nagar Haveli 94.0 93.3 93.6 Daman & Diu 88.3 98.4 91.5 Goa 98.9 99.0 98.9 Gujarat 97.2 94.8 95.8 Maharashtra 95.8 94.6 95.1 South Andaman & Nicobar Islands 97.2 98.4 97.9 Andhra Pradesh 90.1 79.9 82.7 Karnataka 95.0 94.9 94.9 Kerala 97.2 98.1 97.7 Lakshadweep 98.9 (100.0) 99.1 Puducherry 99.2 98.7 99.0 Tamil Nadu 98.5 98.2 98.3 Telangana 90.1 76.5 83.1 ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases 40 z Household Population and Housing Characteristics Ta bl e 2. 15 C hi ld re n' s liv in g ar ra ng em en ts a nd o rp ha nh oo d Pe rc en t d ist rib ut io n of d e ju re c hi ld re n un de r a ge 1 8 ye ar s b y th ei r l iv in g ar ra ng em en ts a nd su rv iv al st at us o f t he ir pa re nt s, p er ce nt ag e of c hi ld re n no t l iv in g w ith a b io lo gi ca l p ar en t, an d pe rc en ta ge of c hi ld re n w ith o ne o r b ot h pa re nt s de ad , a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Li vi ng w ith bo th pa re nt s Li vi ng w ith m ot he r bu t n ot w ith fa th er Li vi ng w ith fa th er bu t n ot w ith m ot he r N ot li vi ng w ith e ith er p ar en t To ta l Pe rc en ta ge n ot liv in g w ith a bi ol og ic al p ar en t Pe rc en ta ge w ith on e or b ot h pa re nt s de ad 1 N um be r of c hi ld re n Fa th er al iv e Fa th er de ad M ot he r al iv e M ot he r de ad Bo th al iv e O nl y m ot he r al iv e O nl y fa th er al iv e Bo th de ad Ag e < 2 86 .8 12 .1 0. 4 0. 1 0. 2 0. 4 0. 0 0. 0 0. 0 10 0. 0 0. 5 0. 6 93 ,7 46 2- 4 86 .7 10 .0 0. 9 0. 4 0. 4 1. 3 0. 1 0. 1 0. 1 10 0. 0 1. 6 1. 5 15 0, 12 1 5- 9 85 .3 8. 4 1. 9 0. 6 0. 9 2. 4 0. 1 0. 2 0. 2 10 0. 0 2. 9 3. 3 25 8, 68 9 10 -1 4 83 .2 6. 8 3. 9 0. 7 1. 5 2. 9 0. 3 0. 3 0. 4 10 0. 0 3. 9 6. 3 27 6, 43 6 15 -1 7 79 .8 5. 7 5. 8 0. 9 2. 0 4. 4 0. 4 0. 4 0. 6 10 0. 0 5. 8 9. 2 15 6, 22 4 Re si de nc e U rb an 87 .5 5. 0 2. 9 0. 7 0. 8 2. 4 0. 2 0. 2 0. 3 10 0. 0 3. 1 4. 4 27 4, 08 6 Ru ra l 82 .7 9. 4 2. 8 0. 6 1. 2 2. 6 0. 2 0. 3 0. 3 10 0. 0 3. 3 4. 7 66 1, 13 0 Se x M al e 84 .6 8. 0 2. 9 0. 6 1. 1 2. 1 0. 2 0. 2 0. 3 10 0. 0 2. 7 4. 6 48 5, 89 6 Fe m al e 83 .6 8. 2 2. 8 0. 6 1. 1 3. 0 0. 2 0. 3 0. 3 10 0. 0 3. 8 4. 6 44 9, 31 9 W ea lth in de x Lo w es t 80 .4 10 .9 3. 5 0. 6 1. 6 2. 3 0. 2 0. 3 0. 3 10 0. 0 3. 1 5. 9 23 8, 07 1 Se co nd 82 .5 9. 0 3. 1 0. 6 1. 3 2. 7 0. 2 0. 3 0. 3 10 0. 0 3. 6 5. 2 20 5, 17 8 M id dl e 85 .0 7. 0 2. 9 0. 6 1. 0 2. 8 0. 2 0. 3 0. 3 10 0. 0 3. 6 4. 6 18 2, 88 1 Fo ur th 86 .5 6. 3 2. 6 0. 7 0. 8 2. 6 0. 2 0. 2 0. 3 10 0. 0 3. 2 3. 9 16 6, 66 4 H ig he st 88 .8 5. 8 1. 7 0. 6 0. 6 2. 1 0. 2 0. 1 0. 2 10 0. 0 2. 6 2. 7 14 2, 42 1 To ta l a ge < 15 85 .0 8. 6 2. 2 0. 5 0. 9 2. 1 0. 2 0. 2 0. 2 10 0. 0 2. 7 3. 7 77 8, 99 2 To ta l a ge < 18 84 .1 8. 1 2. 8 0. 6 1. 1 2. 5 0. 2 0. 2 0. 3 10 0. 0 3. 2 4. 6 93 5, 21 6 1 I nc lu de s ch ild re n w ith fa th er d ea d, m ot he r d ea d, b ot h pa re nt s d ea d, a nd o ne p ar en t d ea d bu t m iss in g in fo rm at io n on su rv iv al s ta tu s of th e ot he r p ar en t Household Population and Housing Characteristics z�41 Table 2.16 Children's living arrangements and orphanhood by state/union territory Percent distribution of de jure children under age 18 by children's living arrangements and survival status of parents, percentage of children not living with a biological parent, and percentage of children with one or both parents dead, according to state/union territory, India, 2015-16 State/union territory Living with both parents Living with mother but not with father Living with father but not with mother Not living with either parent Total Percentage not living with a biological parent Percentage with one or both parents dead1 Father alive Father dead Mother alive Mother dead Both alive Only mother alive Only father alive Both dead India 84.1 8.1 2.8 0.6 1.1 2.5 0.2 0.2 0.3 100.0 3.2 4.6 North Chandigarh 91.1 3.3 2.2 0.9 0.6 1.8 0.0 0.1 0.0 100.0 2.0 2.9 Delhi 93.3 1.6 1.8 0.5 0.6 1.7 0.1 0.1 0.2 100.0 2.2 2.9 Haryana 92.1 1.7 2.7 0.3 1.2 1.4 0.1 0.1 0.4 100.0 2.0 4.5 Himachal Pradesh 76.9 16.3 2.5 0.7 0.6 2.5 0.2 0.2 0.1 100.0 3.0 3.5 Jammu & Kashmir 87.7 6.0 2.5 1.2 1.0 1.1 0.1 0.1 0.2 100.0 1.5 3.9 Punjab 89.0 4.4 2.8 0.9 0.8 1.5 0.2 0.1 0.3 100.0 2.1 4.2 Rajasthan 85.0 7.8 2.5 0.4 1.1 2.7 0.2 0.2 0.2 100.0 3.2 4.1 Uttarakhand 81.5 10.7 3.4 0.4 1.1 2.1 0.2 0.3 0.3 100.0 2.9 5.2 Central Chhattisgarh 87.4 2.3 3.0 0.6 1.5 4.3 0.3 0.3 0.4 100.0 5.2 5.3 Madhya Pradesh 88.9 2.8 2.5 0.7 1.3 3.0 0.3 0.3 0.3 100.0 3.8 4.6 Uttar Pradesh 81.0 11.1 2.8 0.4 1.7 2.1 0.2 0.4 0.3 100.0 2.9 5.3 East Bihar 70.7 21.7 2.3 0.6 1.1 2.9 0.1 0.3 0.2 100.0 3.5 4.0 Jharkhand 82.7 8.6 3.3 0.5 1.2 2.9 0.3 0.3 0.3 100.0 3.8 5.4 Odisha 85.5 6.2 3.3 0.4 1.3 2.5 0.2 0.2 0.3 100.0 3.3 5.4 West Bengal 87.7 4.8 2.3 0.6 1.0 2.8 0.2 0.2 0.3 100.0 3.5 4.0 Northeast Arunachal Pradesh 83.9 2.5 3.2 1.1 1.3 5.9 0.8 0.4 0.9 100.0 8.0 6.5 Assam 87.9 3.4 3.8 0.4 1.4 1.9 0.3 0.3 0.5 100.0 3.1 6.3 Manipur 85.2 3.5 3.7 1.4 1.1 3.9 0.5 0.2 0.4 100.0 5.1 6.0 Meghalaya 83.2 6.4 5.0 0.4 0.9 2.0 0.2 0.4 1.3 100.0 3.9 7.6 Mizoram 76.0 7.9 3.5 3.5 1.1 6.3 1.0 0.2 0.5 100.0 8.0 6.2 Nagaland 78.0 4.6 3.3 1.6 1.2 8.4 1.2 0.5 1.1 100.0 11.3 7.3 Sikkim 80.4 3.7 2.6 2.7 1.7 6.4 0.8 0.6 1.1 100.0 8.9 6.7 Tripura 89.5 3.8 2.5 0.2 1.1 2.3 0.3 0.2 0.1 100.0 2.9 4.1 West Dadra & Nagar Haveli 92.7 1.7 2.0 0.9 0.8 1.6 0.1 0.1 0.2 100.0 2.0 3.2 Daman & Diu 85.5 3.7 3.8 0.3 0.4 5.7 0.5 0.0 0.1 100.0 6.3 4.8 Goa 86.1 6.6 4.2 0.5 0.3 1.6 0.5 0.2 0.0 100.0 2.3 5.1 Gujarat 88.4 3.4 2.2 1.1 1.0 3.2 0.2 0.2 0.2 100.0 3.9 3.9 Maharashtra 89.7 2.7 3.3 0.5 0.7 2.5 0.2 0.1 0.3 100.0 3.1 4.6 South Andaman & Nicobar Islands 88.9 3.9 2.5 0.7 0.5 2.9 0.1 0.1 0.3 100.0 3.5 3.5 Andhra Pradesh 88.2 2.7 3.8 0.7 1.0 2.7 0.3 0.3 0.4 100.0 3.6 5.7 Karnataka 86.7 4.6 3.6 0.8 0.5 3.0 0.3 0.2 0.3 100.0 3.8 4.8 Kerala 79.1 16.7 1.5 0.7 0.2 1.4 0.1 0.1 0.1 100.0 1.8 2.0 Lakshadweep 70.3 25.5 2.0 0.6 0.1 1.2 0.0 0.2 0.0 100.0 1.4 2.3 Puducherry 85.1 8.1 4.6 0.5 0.4 1.1 0.1 0.1 0.2 100.0 1.4 5.1 Tamil Nadu 85.3 8.3 2.8 0.7 0.4 2.1 0.1 0.1 0.2 100.0 2.5 3.6 Telangana 88.8 2.8 4.3 0.5 0.8 1.8 0.4 0.1 0.4 100.0 2.8 6.1 1 Includes children with father dead, mother dead, both parents dead, and one parent dead but missing information on survival status of the other parent 42 z Household Population and Housing Characteristics Table 2.17 Educational attainment of household population Percent distribution of the GH�IDFWR female and male household populations age six and over by highest number of years of schooling completed and median number of years of schooling completed, according to selected background characteristics, India, 2015-16, and NFHS-3 Background characteristic Level of schooling Total Median number of years of schooling completed No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Don't know/ missing FEMALE Age 6-9 7.3 91.5 1.1 0.0 0.0 0.0 0.0 100.0 0.9 10-14 3.6 25.7 51.7 18.1 0.7 0.0 0.1 100.0 5.1 15-19 6.6 3.4 11.6 30.1 28.9 19.3 0.1 100.0 8.9 20-24 13.0 4.8 13.7 16.3 13.5 38.5 0.2 100.0 9.2 25-29 21.7 6.5 16.2 15.6 12.5 27.3 0.2 100.0 7.7 30-34 29.7 7.5 16.2 15.1 11.8 19.5 0.2 100.0 6.4 35-39 37.5 8.4 15.7 12.7 10.6 14.9 0.2 100.0 4.5 40-44 44.6 8.7 14.4 10.9 9.2 12.0 0.2 100.0 3.1 45-49 51.8 8.9 13.6 9.0 7.8 8.6 0.2 100.0 0.0 50-54 56.6 9.0 12.7 7.3 6.8 7.3 0.3 100.0 0.0 55-59 62.1 8.6 12.1 6.0 5.6 5.4 0.2 100.0 0.0 60-64 67.6 8.5 10.3 4.6 4.7 4.1 0.2 100.0 0.0 65+ 75.7 8.5 8.0 2.5 2.8 2.2 0.2 100.0 0.0 Residence Urban 19.2 14.0 16.5 13.3 13.0 23.8 0.2 100.0 7.0 Rural 36.8 17.3 16.6 12.6 7.9 8.7 0.2 100.0 3.1 Religion of household head Hindu 31.4 15.7 16.2 12.9 9.6 14.0 0.2 100.0 4.4 Muslim 32.3 19.5 18.3 12.3 8.3 9.2 0.2 100.0 3.7 Christian 18.8 16.2 16.2 13.9 12.9 21.9 0.2 100.0 6.8 Sikh 24.9 10.2 18.2 11.8 13.8 21.0 0.1 100.0 6.2 Buddhist/Neo-Buddhist 23.5 16.2 16.6 18.1 10.3 15.1 0.1 100.0 6.1 Jain 5.8 10.8 15.4 9.6 19.7 38.4 0.4 100.0 9.6 Other 36.8 21.6 15.1 12.3 7.1 6.9 0.2 100.0 2.4 Caste/tribe of household head Scheduled caste 36.2 16.7 16.5 12.9 7.9 9.6 0.1 100.0 3.3 Scheduled tribe 42.5 18.2 15.2 11.7 5.9 6.4 0.2 100.0 1.5 Other backward class 31.9 16.0 16.6 12.5 9.6 13.2 0.2 100.0 4.3 Other 21.5 15.2 16.9 13.8 12.1 20.4 0.2 100.0 6.4 Don't know 36.2 21.4 17.4 11.4 7.4 5.8 0.3 100.0 2.7 Wealth index Lowest 51.6 20.6 14.4 8.6 2.9 1.8 0.1 100.0 0.0 Second 39.6 18.8 17.4 13.2 6.1 4.7 0.2 100.0 2.2 Middle 31.2 16.7 18.6 14.7 9.7 8.9 0.2 100.0 4.2 Fourth 21.7 14.5 18.3 15.3 13.3 16.7 0.2 100.0 6.3 Highest 11.7 10.5 14.0 12.3 15.6 35.7 0.2 100.0 9.1 Total 31.0 16.2 16.5 12.8 9.6 13.7 0.2 100.0 4.4 NFHS-3 (2005-06) 41.5 18.1 15.7 10.2 6.7 7.6 0.2 100.0 1.9 &RQWLQXHG���� Household Population and Housing Characteristics z�43 Table 2.17 Educational attainment of household population³&RQWLQXHG Percent distribution of the GH�IDFWR female and male household populations age six and over by highest number of years of schooling completed and median number of years of schooling completed, according to selected background characteristics, India, 2015-16, and NFHS-3 Background characteristic Level of schooling Total Median number of years of schooling completed No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Don't know/ missing MALE Age 6-9 6.9 92.1 1.0 0.0 0.0 0.0 0.0 100.0 0.8 10-14 3.2 29.2 50.3 16.7 0.5 0.0 0.1 100.0 4.9 15-19 4.3 3.6 11.9 31.8 29.8 18.5 0.2 100.0 8.9 20-24 5.9 4.6 12.3 16.9 14.1 46.0 0.2 100.0 10.0 25-29 8.9 5.5 15.0 18.8 14.7 36.7 0.3 100.0 9.1 30-34 12.3 6.9 15.9 19.4 15.8 29.3 0.4 100.0 8.6 35-39 16.5 7.6 15.7 19.0 15.7 25.2 0.4 100.0 8.1 40-44 19.3 8.3 15.2 17.0 15.6 24.3 0.3 100.0 7.9 45-49 23.7 9.7 15.1 15.7 14.7 20.7 0.4 100.0 7.2 50-54 27.4 10.6 15.4 13.3 14.0 18.7 0.5 100.0 6.2 55-59 29.6 11.1 16.3 12.8 13.6 16.2 0.5 100.0 5.3 60-64 34.9 11.0 16.2 11.1 12.3 14.0 0.5 100.0 4.4 65+ 41.0 13.6 15.0 8.1 10.9 10.8 0.6 100.0 3.1 Residence Urban 8.9 14.2 15.5 15.1 15.6 30.3 0.3 100.0 8.5 Rural 18.4 19.8 18.6 16.7 11.7 14.6 0.3 100.0 5.8 Religion of household head Hindu 14.5 17.2 17.3 16.4 13.3 21.0 0.3 100.0 7.1 Muslim 19.8 22.5 19.6 14.8 10.3 12.7 0.3 100.0 4.8 Christian 11.9 16.1 17.0 15.7 15.7 23.4 0.2 100.0 7.7 Sikh 15.8 11.5 16.7 13.8 18.1 24.0 0.1 100.0 7.7 Buddhist/Neo-Buddhist 8.8 20.1 13.6 19.3 14.9 23.2 0.2 100.0 8.1 Jain 1.6 10.0 10.3 10.6 18.8 48.3 0.3 100.0 10.7 Other 22.4 25.4 17.0 15.7 8.8 10.3 0.4 100.0 4.3 Caste/tribe of household head Scheduled caste 18.8 18.9 18.7 16.9 11.4 15.0 0.3 100.0 5.9 Scheduled tribe 24.0 21.6 18.8 15.7 8.6 11.0 0.4 100.0 4.5 Other backward class 14.8 17.7 18.2 16.2 13.4 19.3 0.3 100.0 6.8 Other 9.8 15.9 15.1 15.6 15.1 28.3 0.3 100.0 8.2 Don't know 20.7 23.4 22.7 13.8 10.1 8.4 1.0 100.0 4.6 Wealth index Lowest 31.3 25.6 19.7 13.8 5.3 4.0 0.4 100.0 2.9 Second 19.7 21.9 20.8 18.3 9.8 9.1 0.3 100.0 4.9 Middle 14.3 17.8 19.8 18.8 13.9 15.1 0.3 100.0 6.7 Fourth 8.7 14.7 17.1 17.6 17.5 24.0 0.3 100.0 8.1 Highest 3.6 10.2 10.9 12.2 17.7 45.2 0.2 100.0 9.9 Total 15.1 17.9 17.6 16.1 13.0 20.0 0.3 100.0 6.9 NFHS-3 (2005-06) 21.9 20.9 18.4 14.8 10.6 13.2 0.2 100.0 4.9 44 z Household Population and Housing Characteristics Table 2.18 Educational attainment of household population by state/union territory Percent distribution of the de facto female and male household populations age six and over by highest number of years of schooling completed and median number of years of schooling completed, according to state/union territory, India, 2015-16 State/union territory Level of schooling Total Median number of years of schooling completed No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Don't know/ missing FEMALE India 31.0 16.2 16.5 12.8 9.6 13.7 0.2 100.0 4.4 North Chandigarh 16.3 8.6 14.0 12.3 12.9 35.8 0.0 100.0 8.7 Delhi 18.8 11.9 15.7 12.6 13.6 27.1 0.3 100.0 7.4 Haryana 29.5 12.6 16.2 11.6 11.6 18.3 0.2 100.0 4.9 Himachal Pradesh 20.8 12.0 18.6 11.6 14.4 22.3 0.2 100.0 6.7 Jammu & Kashmir 34.2 12.9 11.5 17.0 10.1 14.2 0.1 100.0 4.6 Punjab 24.0 10.4 17.5 11.2 14.5 22.4 0.0 100.0 6.5 Rajasthan 42.6 14.8 16.0 11.0 5.7 9.8 0.1 100.0 1.7 Uttarakhand 27.1 13.4 15.3 15.0 9.3 19.6 0.2 100.0 4.9 Central Chhattisgarh 32.2 16.0 17.6 16.7 6.4 10.9 0.2 100.0 4.2 Madhya Pradesh 35.7 16.1 17.8 15.2 6.0 8.9 0.3 100.0 3.6 Uttar Pradesh 36.8 16.1 14.4 12.0 6.6 13.9 0.2 100.0 3.0 East Bihar 43.0 20.1 14.1 9.6 6.3 6.8 0.1 100.0 0.9 Jharkhand 38.7 17.5 14.4 12.0 7.9 9.3 0.2 100.0 2.3 Odisha 32.1 17.7 18.0 15.1 8.8 8.2 0.2 100.0 4.0 West Bengal 25.8 20.7 18.1 16.4 9.0 9.7 0.2 100.0 4.5 Northeast Arunachal Pradesh 32.7 19.4 15.3 12.9 8.7 10.9 0.2 100.0 3.5 Assam 24.9 22.3 15.5 19.8 7.4 10.0 0.1 100.0 4.6 Manipur 18.0 18.9 13.5 18.9 11.8 18.6 0.3 100.0 6.8 Meghalaya 16.9 29.9 17.3 13.7 9.7 12.5 0.1 100.0 4.5 Mizoram 8.3 25.2 19.5 20.7 11.4 14.4 0.5 100.0 6.5 Nagaland 18.8 22.3 18.8 18.8 9.5 11.6 0.2 100.0 5.4 Sikkim 20.2 16.8 19.9 15.8 11.4 16.0 0.1 100.0 5.8 Tripura 18.0 21.2 19.8 23.7 8.3 8.9 0.1 100.0 5.4 West Dadra & Nagar Haveli 30.8 15.4 14.5 15.0 9.0 15.0 0.3 100.0 4.6 Daman & Diu 18.4 16.9 17.8 14.7 14.1 17.5 0.5 100.0 6.6 Goa 14.8 17.4 14.7 13.3 17.3 22.4 0.1 100.0 7.5 Gujarat 27.8 16.6 20.5 12.5 8.9 13.4 0.2 100.0 4.9 Maharashtra 22.5 17.2 18.0 14.3 11.8 16.1 0.1 100.0 6.1 South Andaman & Nicobar Islands 15.2 14.4 16.7 18.7 12.3 22.5 0.1 100.0 7.5 Andhra Pradesh 37.9 12.4 19.1 7.8 11.2 11.5 0.1 100.0 3.9 Karnataka 29.1 15.1 17.1 8.6 15.0 15.0 0.2 100.0 5.1 Kerala 4.2 15.4 15.8 17.5 17.9 28.7 0.3 100.0 8.7 Lakshadweep 8.8 17.4 20.9 16.6 16.6 19.4 0.1 100.0 7.5 Puducherry 18.5 10.2 16.8 12.7 15.7 25.9 0.1 100.0 7.6 Tamil Nadu 22.6 11.6 16.9 13.8 13.9 21.0 0.2 100.0 6.7 Telangana 37.3 12.9 14.5 6.7 12.5 16.0 0.1 100.0 3.9 Continued. Household Population and Housing Characteristics Ȉ 45Household Population and Housing Characteristics z�45 Table 2.18 Educational attainment of household population by state/union territory—Continued Percent distribution of the de facto female and male household populations age six and over by highest number of years of schooling completed and median number of years of schooling completed, according to state/union territory, India, 2015-16 State/union territory Level of schooling Total Median number of years of schooling completed No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Don't know/ missing MALE India 15.1 17.9 17.6 16.1 13.0 20.0 0.3 100.0 6.9 North Chandigarh 6.5 10.0 12.2 13.8 16.2 41.2 0.0 100.0 9.6 Delhi 8.3 12.9 15.0 14.0 16.1 33.2 0.5 100.0 8.9 Haryana 11.6 13.7 16.2 13.7 17.4 27.1 0.2 100.0 8.0 Himachal Pradesh 6.8 12.6 16.9 15.1 21.8 26.4 0.3 100.0 8.8 Jammu & Kashmir 15.9 13.9 12.9 21.4 15.2 20.3 0.3 100.0 7.8 Punjab 14.4 11.4 16.7 13.7 19.3 24.5 0.1 100.0 7.8 Rajasthan 18.1 16.9 18.6 17.0 10.7 18.4 0.3 100.0 6.3 Uttarakhand 9.8 15.3 16.9 18.5 14.3 24.8 0.4 100.0 7.7 Central Chhattisgarh 14.3 18.8 20.0 20.6 9.2 16.7 0.3 100.0 6.4 Madhya Pradesh 16.4 18.1 21.1 19.1 9.4 15.4 0.5 100.0 6.0 Uttar Pradesh 17.5 19.2 16.6 17.3 9.8 19.1 0.4 100.0 6.1 East Bihar 22.5 23.4 16.5 13.2 10.8 13.6 0.2 100.0 4.6 Jharkhand 18.8 20.0 17.3 16.3 11.3 15.9 0.4 100.0 5.8 Odisha 16.3 19.8 20.4 18.8 11.0 13.3 0.4 100.0 6.1 West Bengal 15.4 22.8 18.8 17.5 9.6 15.6 0.3 100.0 5.8 Northeast Arunachal Pradesh 20.1 20.1 15.7 15.0 11.3 17.5 0.3 100.0 5.7 Assam 15.6 24.4 17.0 19.6 9.0 14.3 0.2 100.0 5.8 Manipur 5.2 18.9 13.8 21.1 14.5 26.3 0.3 100.0 8.2 Meghalaya 15.6 31.2 15.9 12.4 10.4 14.3 0.1 100.0 4.5 Mizoram 5.3 23.9 20.3 20.6 11.8 17.5 0.6 100.0 7.0 Nagaland 11.3 22.8 19.1 19.0 12.2 15.3 0.3 100.0 6.5 Sikkim 11.4 18.8 21.2 16.4 12.7 19.2 0.3 100.0 6.7 Tripura 8.9 21.8 19.3 24.9 10.9 14.1 0.2 100.0 7.0 West Dadra & Nagar Haveli 12.6 14.9 15.2 18.7 14.0 23.5 1.0 100.0 7.8 Daman & Diu 7.6 12.6 16.3 18.0 22.2 22.6 0.7 100.0 8.4 Goa 5.5 17.6 13.6 14.3 22.5 26.3 0.2 100.0 8.8 Gujarat 11.2 16.9 19.8 18.0 14.0 19.7 0.3 100.0 7.3 Maharashtra 9.0 17.8 15.8 17.8 15.2 24.2 0.2 100.0 8.1 South Andaman & Nicobar Islands 8.2 14.0 18.4 20.8 15.7 22.7 0.2 100.0 8.1 Andhra Pradesh 22.5 13.6 19.2 9.3 15.1 20.2 0.1 100.0 6.2 Karnataka 15.1 16.0 17.2 10.5 18.0 22.9 0.3 100.0 7.3 Kerala 1.9 13.9 15.7 18.7 20.1 29.3 0.3 100.0 9.0 Lakshadweep 2.8 14.0 17.2 16.3 25.0 23.9 0.8 100.0 8.9 Puducherry 7.0 11.7 16.0 14.5 19.7 31.0 0.1 100.0 9.0 Tamil Nadu 11.9 11.9 17.7 15.4 17.6 25.2 0.2 100.0 7.9 Telangana 20.3 14.9 15.4 8.5 15.9 24.9 0.2 100.0 6.9 46 Ȉ Household Population and Housing Characteristics46 z Household Population and Housing Characteristics Table 2.19 School attendance by state/union territory Percentage of GH�IDFWR household population age 6-17 years attending school (including pre-primary school) in the 2014-15 school year for the first phase and 2015-16 school year for the second phase by sex and residence, according to age and state/union territory, India, 2015-16 Age and state/ union territory Male Female Total Urban Rural Total Urban Rural Total Urban Rural Total India 87.5 85.6 86.2 88.2 81.8 83.7 87.8 83.8 85.0 Age 6-10 years (Primary) 96.3 94.7 95.2 96.8 94.2 95.0 96.6 94.5 95.1 6-13 years (Elementary) 94.7 93.1 93.6 95.4 92.0 93.0 95.0 92.6 93.3 11-13 years (Upper primary) 92.1 90.6 91.0 93.2 88.5 89.9 92.6 89.6 90.5 14-15 years (Secondary) 83.5 78.6 80.2 83.1 73.3 76.2 83.3 76.0 78.3 16-17 years (Higher secondary) 65.5 59.6 61.6 65.1 48.9 53.8 65.3 54.2 57.8 11-14 years 90.5 88.4 89.0 91.4 85.8 87.5 90.9 87.1 88.3 15-17 years 70.2 64.7 66.5 70.0 55.4 59.8 70.1 60.0 63.2 6-14 years 93.7 91.9 92.4 94.3 90.4 91.6 94.0 91.2 92.0 6-17 years 87.5 85.6 86.2 88.2 81.8 83.7 87.8 83.8 85.0 North Chandigarh 94.2 * 93.9 92.7 * 91.8 93.5 (83.8) 93.0 Delhi 88.5 94.0 88.5 92.5 (100.0) 92.5 90.3 95.9 90.3 Haryana 91.9 91.9 91.9 90.1 87.0 88.2 91.1 89.8 90.3 Himachal Pradesh 92.6 95.1 94.9 97.4 94.2 94.5 94.7 94.7 94.7 Jammu & Kashmir 90.0 91.1 90.8 92.2 86.2 87.7 91.0 88.8 89.4 Punjab 91.7 90.6 91.0 92.2 90.0 90.8 91.9 90.3 90.9 Rajasthan 88.9 87.7 88.0 85.2 77.3 79.0 87.2 82.7 83.7 Uttarakhand 87.8 90.9 89.8 85.7 88.6 87.7 86.9 89.8 88.8 Central Chhattisgarh 88.3 85.5 86.1 92.0 85.6 86.9 90.1 85.5 86.5 Madhya Pradesh 85.6 82.4 83.3 86.8 77.4 79.9 86.2 80.0 81.6 Uttar Pradesh 78.5 83.2 82.1 79.8 78.1 78.5 79.1 80.7 80.4 East Bihar 85.9 85.2 85.3 86.6 81.7 82.3 86.2 83.5 83.8 Jharkhand 86.5 83.7 84.4 88.1 81.1 82.8 87.3 82.5 83.6 Odisha 85.9 84.1 84.4 85.2 80.4 81.1 85.6 82.2 82.8 West Bengal 83.8 83.7 83.7 89.2 84.7 85.9 86.4 84.2 84.8 Northeast Arunachal Pradesh 91.9 88.3 89.1 88.5 86.6 87.1 90.1 87.5 88.1 Assam 84.2 77.5 78.2 85.7 79.4 80.1 85.0 78.4 79.1 Manipur 94.4 92.3 93.0 93.2 90.8 91.7 93.8 91.5 92.4 Meghalaya 93.6 85.2 86.7 93.9 89.3 90.2 93.8 87.2 88.4 Mizoram 95.1 86.2 91.1 93.2 87.5 90.7 94.2 86.8 91.9 Nagaland 92.1 86.5 88.5 93.2 88.1 90.1 92.6 87.3 89.3 Sikkim 96.3 95.2 95.5 94.2 95.9 95.4 95.3 95.5 95.5 Tripura 95.6 90.1 91.4 92.5 86.4 87.8 94.1 88.3 89.7 &RQWLQXHG���� Household Population and Housing Characteristics z�47 Table 2.19 School attendance by state/union territory³&RQWLQXHG Percentage of GH�IDFWR household population age 6-17 years attending school (including pre-primary school) in the 2014-15 school year for the first phase and 2015-16 school year for the second phase by sex and residence, according to age and state/union territory, India, 2015-16 Age and state/ union territory Male Female Total Urban Rural Total Urban Rural Total Urban Rural Total West Dadra & Nagar Haveli 89.6 80.4 84.0 89.5 83.0 85.5 89.6 81.6 84.7 Daman & Diu 72.5 75.0 73.2 88.2 85.6 87.3 79.0 80.3 79.4 Goa 95.8 96.7 96.1 96.5 96.5 96.5 96.1 96.6 96.3 Gujarat 86.7 82.2 84.0 83.7 74.2 77.9 85.3 78.4 81.2 Maharashtra 89.2 88.3 88.7 87.8 85.4 86.5 88.5 86.9 87.7 South Andaman & Nicobar Islands 93.0 92.0 92.4 92.5 89.9 90.9 92.8 90.9 91.7 Andhra Pradesh 89.9 88.1 88.7 88.6 83.9 85.4 89.3 86.1 87.1 Karnataka 89.8 87.3 88.3 90.9 85.2 87.5 90.3 86.3 87.9 Kerala 97.2 97.1 97.1 98.0 97.5 97.8 97.6 97.3 97.4 Lakshadweep 93.8 95.5 94.3 96.1 100.0 97.1 95.0 97.5 95.7 Puducherry 93.4 92.1 93.0 95.0 93.6 94.6 94.2 92.9 93.8 Tamil Nadu 93.3 91.1 92.2 94.1 92.2 93.1 93.7 91.7 92.6 Telangana 90.6 90.9 90.7 92.4 85.6 88.6 91.4 88.3 89.7 Note: In this table, children's age refers to their age at the start of the 2014-15 school year (assumed here to be April 2014) for the first phase and at the start of the 2015-16 school year (assumed here to be April 2015) for the second phase. ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases 48 z Household Population and Housing Characteristics Table 2.20 School attendance ratios Net attendance ratio (NAR), gross attendance ratio (GAR), and gender parity index (GPI) for the de facto household population by level of schooling and sex, according to selected background characteristics, India, 2015-16 Background characteristic Net attendance ratio1 Gender parity index2 Gross attendance ratio3 Gender parity index2 Male Female Total Male Female Total PRIMARY SCHOOL Residence Urban 78.2 77.0 77.6 0.98 84.3 82.2 83.3 0.97 Rural 78.5 77.0 77.8 0.98 87.4 84.8 86.1 0.97 Religion of household head Hindu 78.5 77.0 77.8 0.98 85.9 83.4 84.7 0.97 Muslim 78.0 76.3 77.1 0.98 89.5 86.5 88.1 0.97 Christian 80.7 81.6 81.1 1.01 87.5 87.7 87.6 1.00 Sikh 78.5 75.7 77.2 0.97 83.5 79.3 81.6 0.95 Buddhist/Neo-Buddhist 76.3 80.3 78.1 1.05 79.6 84.5 81.8 1.06 Jain 84.8 74.9 80.0 0.88 88.5 76.3 82.6 0.86 Other 79.1 78.1 78.6 0.99 91.4 84.9 88.1 0.93 Caste/tribe of household head Scheduled caste 77.6 76.5 77.1 0.99 85.9 84.3 85.1 0.98 Scheduled tribe 76.9 75.3 76.1 0.98 84.9 82.2 83.6 0.97 Other backward class 78.9 77.9 78.4 0.99 87.9 85.3 86.6 0.97 Other 79.1 76.6 77.9 0.97 85.0 82.0 83.6 0.96 Don't know 78.8 78.5 78.6 1.00 91.1 89.4 90.3 0.98 Wealth index Lowest 76.9 76.4 76.7 0.99 89.3 87.6 88.5 0.98 Second 79.2 77.6 78.4 0.98 88.2 85.5 86.9 0.97 Middle 78.4 77.7 78.1 0.99 85.5 83.3 84.4 0.97 Fourth 79.1 76.3 77.8 0.97 84.4 80.6 82.6 0.95 Highest 79.4 77.3 78.4 0.97 82.8 80.0 81.5 0.97 Total 78.4 77.0 77.8 0.98 86.5 84.0 85.3 0.97 MIDDLE, SECONDARY, AND HIGHER SECONDARY SCHOOL Residence Urban 71.5 72.0 71.7 1.01 83.8 85.4 84.6 1.02 Rural 68.3 63.8 66.1 0.93 80.6 76.1 78.4 0.94 Religion of household head Hindu 71.4 68.0 69.8 0.95 84.1 81.1 82.7 0.96 Muslim 56.9 55.5 56.2 0.97 66.9 66.2 66.6 0.99 Christian 75.0 76.3 75.6 1.02 87.2 88.3 87.7 1.01 Sikh 77.5 77.9 77.7 1.00 91.1 93.6 92.2 1.03 Buddhist/Neo-Buddhist 79.1 78.9 79.0 1.00 93.9 89.0 91.5 0.95 Jain 83.7 78.9 81.7 0.94 93.9 101.4 97.0 1.08 Other 55.1 58.1 56.7 1.05 64.8 69.6 67.3 1.07 Continued. Household Population and Housing Characteristics z�49 Table 2.20 School attendance ratios—Continued Net attendance ratio (NAR), gross attendance ratio (GAR), and gender parity index (GPI) for the de facto household population by level of schooling and sex, according to selected background characteristics, India, 2015-16 Background characteristic Net attendance ratio1 Gender parity index2 Gross attendance ratio3 Gender parity index2 Male Female Total Male Female Total Caste/tribe of household head Scheduled caste 67.9 64.5 66.2 0.95 80.4 77.1 78.8 0.96 Scheduled tribe 63.6 60.0 61.8 0.94 75.5 72.1 73.8 0.95 Other backward class 69.5 66.1 67.8 0.95 81.7 78.3 80.0 0.96 Other 72.9 70.9 71.9 0.97 85.4 84.7 85.1 0.99 Don't know 53.8 58.0 55.9 1.08 64.3 68.7 66.5 1.07 Wealth index Lowest 55.4 52.4 53.9 0.95 66.2 62.6 64.4 0.95 Second 66.7 63.9 65.3 0.96 78.5 76.2 77.4 0.97 Middle 70.9 68.4 69.6 0.96 83.9 81.1 82.5 0.97 Fourth 76.5 73.3 74.9 0.96 89.6 88.1 88.9 0.98 Highest 81.4 79.7 80.6 0.98 94.6 93.9 94.3 0.99 Total 69.3 66.2 67.8 0.96 81.6 78.9 80.3 0.97 Note: In this table, children's age refers to their age at the start of the 2014-15 school year (assumed here to be April 2014) for the first phase and their age at the start of the 2015-16 school year (assumed here to be April 2015) for the second phase. 1 The NAR for primary school (standards 1-5) is the percentage of the primary-school age population (6-10 years) that is attending primary school. The NAR for middle, secondary, and higher secondary school (standards 6-12) is the percentage of the population in the appropriate age group for those school levels (11-17 years) that is attending those school levels. By definition, the NAR cannot exceed 100.0 percent. 2 The GPI for primary school is the ratio of the primary school NAR (GAR) for females to the NAR (GAR) for males. The gender parity index for middle, secondary, and higher secondary school is the ratio of the NAR (GAR) for females to the NAR (GAR) for males at those levels of school. 3 The GAR for primary school (standards 1-5) is the total number of primary school students, expressed as a percentage of the official primary- school-age population (6-10 years). The GAR for middle, secondary, and higher secondary school (standards 6-12) is the total number of students in those school levels, expressed as a percentage of the official population that is the appropriate age to be attending those school levels. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100.0. 50 z Household Population and Housing Characteristics � 7DEOH������5HDVRQV�IRU�FKLOGUHQ�FXUUHQWO\�QRW�DWWHQGLQJ�VFKRRO� 3HUFHQW�GLVWULEXWLRQ�RI�GH�IDFWR�FKLOGUHQ�DJH������\HDUV�ZKR�GURSSHG�RXW�RI�VFKRRO�EHIRUH�WKH���������VFKRRO�\HDU�IRU�WKH�ILUVW�SKDVH� DQG�EHIRUH�WKH���������VFKRRO�\HDU�IRU�WKH�VHFRQG�SKDVH�E\�WKH�PDLQ�UHDVRQ�IRU�QRW�DWWHQGLQJ�VFKRRO�LQ�WKDW�VFKRRO�\HDU��DFFRUGLQJ�WR� UHVLGHQFH�DQG�VH[��,QGLD����������� 0DLQ�UHDVRQ� 8UEDQ� � ��5XUDO� � 7RWDO� 0DOH� )HPDOH� 0DOH� )HPDOH� 0DOH� )HPDOH� � � � � � � � 6FKRRO�WRR�IDU�DZD\� ���� ���� ���� ���� ���� ���� 7UDQVSRUW�QRW�DYDLODEOH� ���� ���� ���� ���� ���� ���� )XUWKHU�HGXFDWLRQ�QRW�FRQVLGHUHG�QHFHVVDU\� ���� ���� ���� ���� ���� ���� 5HTXLUHG�IRU�KRXVHKROG�ZRUN� ���� ����� ����� ����� ����� ����� 5HTXLUHG�IRU�ZRUN�RQ�IDUP�IDPLO\�EXVLQHVV� ���� ���� ���� ���� ���� ���� 5HTXLUHG�IRU�RXWVLGH�ZRUN�IRU�SD\PHQW�LQ�FDVK�RU�NLQG� ���� ���� ���� ���� ���� ���� &RVWV�WRR�PXFK� ����� ����� ����� ����� ����� ����� 1R�SURSHU�VFKRRO�IDFLOLWLHV�IRU�JLUOV� ���� ���� ���� ���� ���� ���� 1RW�VDIH�WR�VHQG�JLUOV� ���� ���� ���� ���� ���� ���� 1R�IHPDOH�WHDFKHU� ���� ���� ���� ���� ���� ���� 5HTXLUHG�IRU�FDUH�RI�VLEOLQJV� ���� ���� ���� ���� ���� ���� 1RW�LQWHUHVWHG�LQ�VWXGLHV� ����� ����� ����� ����� ����� ����� 5HSHDWHG�IDLOXUHV� ���� ���� ���� ���� ���� ���� *RW�PDUULHG� ���� ���� ���� ���� ���� ���� 'LG�QRW�JHW�DGPLVVLRQ� ���� ���� ���� ���� ���� ���� 2WKHU� ���� ���� ���� ���� ���� ���� 'RQ W�NQRZ� ���� ���� ���� ���� ���� ���� � � � � � � � 7RWDO� ������ ������ ������ ������ ������ ������ � � � � � � � 1XPEHU�RI�FKLOGUHQ� ������ ������ ������� ������� ������� ������� Household Population and Housing Characteristics z�51 CHARACTERISTICS OF RESPONDENTS 3 Key Findings x Literacy: Sixty-eight percent of women and 86 percent of men are literate. x Schooling: More than one in three women (36%) and 47 percent of men have 10 or more years of schooling. x Exposure to mass media: Twenty-five percent of women and 14 percent of men are not regularly exposed to mass media (newspapers, magazines, television, radio, or cinema). x Employment: Men are more likely to be employed than women; 24 percent of women are currently employed, compared with 75 percent of men. Eighty-one percent of employed women earn cash for their work. his chapter presents information on the demographic and socioeconomic characteristics of the survey respondents, such as age, schooling, place of residence, marital status, employment, and wealth status. This information is useful for understanding the factors that affect use of reproductive health services, contraceptive use, and other health behaviours. 3.1 BASIC CHARACTERISTICS OF SURVEY RESPONDENTS A total of 699,686 women age 15-49 and 112,122 men age 15-54 were interviewed in the 2015-16 National Family Health Survey. Thirty-five percent of women and 34 percent of men are in the 15-24 age group, while 30 percent of both women and men are in the 25-34 age group (Table 3.1). Among respondents age 15-49, women are more likely than men to be currently married (73% versus 60%) or widowed (3% versus 0.6%). The distribution of respondents by religion shows that a large majority of the respondents are Hindus (81%), while 14 percent are Muslims, 2 percent each are Christians and Sikhs, and 1 percent are Buddhists/Neo-Buddhists. Forty-three percent of women and 44 percent of men belong to other backward classes (OBC), while 20 percent each of women and men belong to scheduled castes, 9 percent each of women and men belong to scheduled tribes, and 26 percent of women and 27 percent of men do not belong to scheduled castes, scheduled tribes, or other backward classes. Eighteen percent of women and 15 percent of men are in households in the lowest wealth quintile, while 21 percent of women and 23 percent of men are in households in the highest wealth quintile. T Characteristics of Respondents Ȉ 53Characteristics of Respondents z�53 3.2 SCHOOLING AND LITERACY Literacy Respondents who have completed standard six or higher are assumed to be literate. All other respondents were given a sentence to read, and they were considered to be literate if they could read all or part of the sentence. Sample: Women and men age 15-49 Twenty-eight percent of women and 12 percent of men have no schooling, and women (22%) are less likely than men (30%) to have completed 12 or more years of schooling (Table 3.2.1, Table 3.2.2, and Figure 3.1). Eighty-six percent of men and 68 percent of women are literate (Table 3.3.1 and Table 3.3.2). Trends: Since 2005-06, there has been a substantial increase in the percentage of women and men age 15-49 attending school and completing higher levels of education, and the gap between women and men has narrowed. The percentage of women with no schooling has decreased by 13 percentage points and the percentage of men with no schooling has decreased by 6 percentage points. The percentage of women and men completing 12 or more years of schooling has increased by nearly 10 percent points. Patterns by background characteristics x Younger respondents are more likely to have attended school and to have reached higher levels of education than older respondents. Only 7 percent of women age 15-19 and 14 percent of women age 20-24 have no schooling, while more than half of women age 45-49 (54%) and 46 percent of women age 40-44 have no schooling (Table 3.2.1). x Urban women are more educated than their rural counterparts. One-third of rural women (34%) have never attended school, compared with 16 percent of urban women. In rural areas, 15 percent of women have completed 12 or more years of schooling, compared with 34 percent in urban areas (Table 3.2.1 and Figure 3.2). 54 ‡ Characteristics of Respondents 28 12 5.8 6.0 14 14 17 21 14 17 22 30 Women Men No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete 36 52 27 47 58 40 Total Urban Rural Women Men Figure 3.1 Education of Survey Respondents Percent distribution of women and men age 15-49 Figure 3.2 Secondary or Higher Education by Residence Percentage of women and men age 15-49 54 z Characteristics of Respondents x The percentage of women and men who have completed secondary school or higher increases by wealth quintile; 3 percent of women and 7 percent of men in the lowest wealth quintile completed 12 or more years of schooling, compared with more than half of women (51%) and men (58%) in the highest wealth quintile. x Literacy in each group is lowest among men and women in rural areas; women and men age 40-49; those who are widowed, divorced, separated, or deserted; those in the lowest wealth quintile; and those belonging to a scheduled tribe (Table 3.3.1 and Table 3.3.2). x Bihar and Kerala represent two contrasting profiles of literacy. Bihar has the lowest literacy of 50 percent among women and 78 percent of men, while literacy is almost universal among women and men in Kerala (Table 3.4.1 and Table 3.4.2). 3.3 MASS MEDIA EXPOSURE Exposure to mass media Respondents were asked how often they read a newspaper or magazine, listened to the radio, watched television, or went to the cinema. Those who responded at least once a week are considered to be regularly exposed to that form of media. Sample: Women and men age 15-49 Information on the exposure of women and men to mass media is especially important for the development of educational programmes and the dissemination of all types of information, particularly information about family planning, HIV/AIDS, and other important health topics. Men are more likely than women to be exposed to any and all forms of media, including newspapers, television, radio, and the cinema (Figure 3.3). Television is the most common form of media exposure for both women and men across all subgroups, followed by newspapers or magazines. Some women and men do not access to any of the four media at least on a weekly basis (25% of women and 14% of men) (Table 3.5.1 and Table 3.5.2). Trends: Exposure to each of the four types of mass media increased for both women and men between 2005-06 and 2015-16, except for radio, which decreased substantially. The percentage of women who did not access any of the media types at least once a week decreased from 35 percent in 2005-06 to 25 percent in 2015-16. Eighteen percent of men did not access any of the media types at least once a week in 2005-06, compared with 14 percent in 2015-16. Patterns by background characteristics x Rural women are more likely to have no regular exposure to any form of mass media than their urban counterparts (34% versus 8%). The same pattern holds true for men (20% versus 6%) (Table 3.5.1 and Table 3.5.2). x Only 6 percent of women and 3 percent of men with 12 or more years of schooling lack regular exposure to any mass media, compared with 51 percent of women and 42 percent of men with no schooling. Characteristics of Respondents Ȉ 55 27 71 11 8.5 25 55 78 21 22 14 Reads a newspaper or magazine at least once a week Watches television at least once a week Listens to the radio at least once a week Visits the cinema/theatre at least once a month Not regularly exposed to any media Women Men Figure 3.3 Exposure to Mass Media Percentage of women and men age 15-49 Figure 3.3 Exposure to Mass Media Percentage of women and men age 15-49 Characteristics of Respondents z�55 3.4 EMPLOYMENT Currently employed Respondents who were employed in the seven days before the survey. Includes respondents who did not work in the past seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reasons. Sample: Women and men age 15-49 Men are three times as likely to be currently employed as women; 24 percent of women age 15-49 are currently employed, compared with 75 percent of men age 15-49 (Table 3.6.1 and Table 3.6.2). Seventy percent of women and 19 percent of men reported that they were not employed in the 12 months preceding the survey. A lower percentage of women than men are currently employed in every state (Table 3.7). Trends: Since 2005-06, current employment levels have decreased for both women and men. Thirty-six percent of women were currently employed in 2005-06, compared with 24 percent in 2015-16. Among men, the percentage currently employed decreased from 85 percent to 75 percent in the past decade. Patterns by background characteristics x Women and men with 8 or more years of schooling, never married women and men, women and men with no children, and women and men belonging to the highest wealth quintile are less likely to be employed than others. x Jammu & Kashmir (14%), and Bihar and Assam (15% each) have the lowest percentage of women currently employed. More than one-third of women were cur- rently employed in Manipur (41%), Telangana (39%), Meghalaya and Mizoram (35% each), and Andhra Pradesh (34%) (Table 3.7). 3.5 OCCUPATION Occupation Categorized as professional/technical/administrative/managerial, clerical, sales and services, skilled manual, unskilled manual, agriculture Sample: Women and men age 15-49 who were currently employed or had worked in the 12 months before the survey Women and men are most commonly employed as agricultural workers (48% of women and 32% of men), followed by production workers (21% and 32%, respectively) (Tables 3.8). A slightly higher percentage of employed women (10%) than employed men (8%) are employed in professional, technical, administrative, or managerial occupations. Figure 3.4 Employment Status by Schooling Percentage of women and men age 15-49 who are currently employed 32 32 26 19 16 20 88 90 87 74 66 68 No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Women Men 56 z Characteristics of Respondents A large majority of women who worked in the past year and did agricultural work are employed by family members (83%) and earn cash for their work (70%). Ninety-two percent of women who did non-agricultural work earned cash for their work. Eleven percent of women who worked in past year were self employed (Table 3.9). Patterns by background characteristics x Urban women are most likely to be employed as production workers (30%) and service workers (21%), while urban men are most likely to be production workers (39%) and sales workers (19%). In rural areas, however, women and men are most likely to be agricultural workers (64% and 47%, respectively). x A large majority of employed women (81%) and men (90%) earned cash for their work, but 15 percent of women and 8 percent of men did not receive any payment. Characteristics of Respondents Ȉ 57Characteristics of Respondents z�57 LIST OF TABLES For more information on the characteristics of survey respondents, see the following tables: Tables Table 3.1 Background characteristics of respondents Table 3.2.1 Respondent's level of schooling: Women Table 3.2.2 Respondent's level of schooling: Men Table 3.3.1 Literacy: Women Table 3.3.2 Literacy: Men Table 3.4.1 Respondent's level of schooling and literacy by state/union territory: Women Table 3.4.2 Respondent's level of schooling and literacy by state/union territory: Men Table 3.5.1 Exposure to mass media: Women Table 3.5.2 Exposure to mass media: Men Table 3.6.1 Employment status: Women Table 3.6.2 Employment status: Men Table 3.7 Employment status of women and men by state/union territory Table 3.8 Occupation Table 3.9 Type of employment 58 ‡ Characteristics of Respondents58 z Characteristics of Respondents Table 3.1 Background characteristics of respondents Percent distribution of women and men age 15-49 by selected background characteristics, India, 2015-16 Background characteristic Weighted percent Number of women Number of men Women Men Weighted Unweighted Weighted Unweighted Age 15-19 17.4 18.1 121,552 124,878 18,740 19,082 20-24 17.6 16.1 122,966 122,955 16,624 16,630 25-29 16.4 15.6 115,043 115,076 16,171 16,151 30-34 13.8 14.1 96,769 97,048 14,604 14,640 35-39 13.0 13.3 90,890 90,433 13,771 13,897 40-44 11.1 11.7 77,969 76,627 12,050 11,954 45-49 10.6 11.1 74,497 72,669 11,451 11,171 Residence Urban 34.6 38.2 242,225 204,735 39,546 32,771 Rural 65.4 61.8 457,461 494,951 63,864 70,754 Schooling No schooling 27.6 12.0 193,078 197,568 12,422 12,777 <5 years complete 5.8 6.0 40,503 39,926 6,171 6,109 5-7 years complete 14.2 14.2 99,687 97,912 14,730 14,910 8-9 years complete 16.7 20.7 116,681 127,404 21,422 23,135 10-11 years complete 14.2 17.4 99,576 95,886 18,030 17,820 12 or more years complete 21.5 29.6 150,160 140,990 30,636 28,774 Marital status Never married 22.5 38.1 157,136 169,814 39,370 39,869 Currently married 73.1 60.4 511,373 499,627 62,499 62,091 Married, gauna not performed 0.3 0.3 1,898 1,983 262 267 Widowed 3.1 0.6 21,657 20,408 583 591 Divorced 0.3 0.3 2,384 3,112 272 316 Separated 0.6 0.3 4,146 3,769 340 308 Deserted 0.2 0.1 1,091 973 85 83 Religion Hindu 80.6 81.4 563,739 519,281 84,211 77,115 Muslim 13.8 13.3 96,461 94,591 13,793 14,437 Christian 2.4 2.2 16,620 52,113 2,277 7,026 Sikh 1.7 1.6 11,618 15,300 1,622 2,210 Buddhist/Neo-Buddhist 0.9 0.9 6,469 8,981 958 1,474 Jain 0.2 0.2 1,264 1,028 163 165 Zoroastrian/Parsi 0.0 0.0 18 7 0 0 Jewish 0.0 0.0 7 7 4 5 Other religion 0.5 0.3 3,374 7,979 351 1,032 No religion 0.0 0.0 116 399 31 61 Caste/tribe Scheduled caste 20.4 19.8 142,619 124,813 20,499 18,479 Scheduled tribe 9.2 8.8 64,144 127,133 9,132 18,404 Other backward class 43.4 43.6 303,837 273,700 45,110 40,181 Other 26.4 27.4 184,594 170,730 28,299 26,179 Don't know 0.6 0.4 4,492 3,310 371 282 Continued… Characteristics of Respondents z�59 Table 3.1 Background characteristics of respondents—Continued Percent distribution of women and men age 15-49 by selected background characteristics, India, 2015-16 Background characteristic Weighted percent Number of women Number of men Women Men Weighted Unweighted Weighted Unweighted Wealth index Lowest 17.7 14.7 124,054 133,249 15,205 17,035 Second 19.6 18.8 136,900 149,466 19,402 21,584 Middle 20.6 21.3 143,814 147,168 22,047 22,604 Fourth 21.1 22.2 147,978 138,502 22,930 21,516 Highest 21.0 23.0 146,939 131,301 23,827 20,786 Total age 15-49 100.0 100.0 699,686 699,686 103,411 103,525 Age 50-54 na 7.8 na na 8,711 8,597 Total age 15-54 na 100.0 na na 112,122 112,122 na = Not applicable 60 z Characteristics of Respondents Table 3.2.1 Respondent's level of schooling: Women Percent distribution of women age 15-49 by number of years of schooling completed, according to background characteristics, India, 2015-16 Background characteristic Respondent's level of schooling Total Number of women No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Age 15-24 10.4 3.6 12.5 23.3 21.1 29.2 100.0 244,518 15-19 6.9 2.9 11.3 30.0 29.0 19.9 100.0 121,552 20-24 13.8 4.2 13.7 16.6 13.3 38.4 100.0 122,966 25-29 22.8 5.9 16.0 15.8 12.4 27.1 100.0 115,043 30-34 31.1 6.6 16.2 15.1 11.7 19.3 100.0 96,769 35-39 39.1 7.6 15.4 12.8 10.5 14.7 100.0 90,890 40-44 46.1 7.7 14.2 11.0 9.2 11.8 100.0 77,969 45-49 53.7 7.8 13.3 9.0 7.7 8.5 100.0 74,497 Residence Urban 15.7 4.4 12.9 15.5 17.2 34.3 100.0 242,225 Rural 33.9 6.5 15.0 17.3 12.7 14.7 100.0 457,461 Marital status Never married 5.9 2.4 8.9 23.4 23.2 36.2 100.0 159,035 Currently married 33.2 6.7 15.8 14.9 11.8 17.7 100.0 511,373 Widowed/divorced/ separated/deserted 48.2 9.0 16.2 11.1 7.6 7.9 100.0 29,279 Religion Hindu 27.6 5.6 13.8 16.7 14.3 22.0 100.0 563,739 Muslim 31.4 7.3 17.1 16.5 12.8 14.8 100.0 96,461 Christian 16.8 5.5 13.1 15.4 16.6 32.6 100.0 16,620 Sikh 17.2 1.8 14.3 14.4 20.2 32.1 100.0 11,618 Buddhist/Neo-Buddhist 14.5 8.0 14.2 24.4 16.0 22.9 100.0 6,469 Jain 2.0 1.0 6.7 10.8 23.7 55.8 100.0 1,264 Other 34.4 10.9 14.0 18.9 10.9 10.9 100.0 3,515 Caste/tribe Scheduled caste 33.0 6.3 15.0 17.5 12.5 15.7 100.0 142,619 Scheduled tribe 42.1 7.7 13.6 16.5 9.6 10.6 100.0 64,144 Other backward class 28.5 5.2 14.3 16.1 14.5 21.2 100.0 303,837 Other 16.6 5.5 13.6 17.1 16.8 30.4 100.0 184,594 Don't know 38.6 11.3 20.6 14.9 8.8 5.7 100.0 4,492 Wealth index Lowest 56.9 7.9 13.3 13.2 5.3 3.3 100.0 124,054 Second 37.9 8.5 16.8 18.6 10.2 8.1 100.0 136,900 Middle 26.4 6.7 17.5 19.5 15.2 14.6 100.0 143,814 Fourth 15.9 4.5 15.2 19.0 19.3 26.1 100.0 147,978 Highest 6.2 1.9 8.5 12.8 19.4 51.2 100.0 146,939 Total 27.6 5.8 14.2 16.7 14.2 21.5 100.0 699,686 Characteristics of Respondents z�61 Table 3.2.2 Respondent's level of schooling: Men Percent distribution of men age 15-49 by number of years of schooling completed, according to background characteristics, India, 2015-16 Background characteristic Respondent's level of schooling Total Number of men No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Age 15-24 5.2 3.2 11.2 24.6 22.6 33.2 100.0 35,364 15-19 4.4 2.5 10.1 31.3 30.9 20.8 100.0 18,740 20-24 6.1 4.0 12.4 17.1 13.3 47.1 100.0 16,624 25-29 9.4 5.0 14.7 19.9 14.6 36.4 100.0 16,171 30-34 12.5 6.7 16.5 20.2 15.1 29.0 100.0 14,604 35-39 15.9 8.5 16.0 19.4 14.8 25.4 100.0 13,771 40-44 19.2 8.3 16.1 17.5 14.7 24.4 100.0 12,050 45-49 23.9 9.5 16.1 15.5 14.5 20.5 100.0 11,451 Residence Urban 7.6 4.4 12.0 18.1 18.6 39.3 100.0 39,546 Rural 14.7 7.0 15.6 22.3 16.7 23.6 100.0 63,864 Marital status Never married 5.1 2.7 10.0 22.7 22.0 37.5 100.0 39,631 Currently married 16.1 7.9 16.8 19.5 14.7 24.9 100.0 62,499 Widowed/divorced/ separated/deserted 25.3 12.9 21.0 17.3 9.6 13.9 100.0 1,280 Religion Hindu 11.3 5.6 13.8 20.8 17.7 30.7 100.0 84,211 Muslim 17.6 8.7 17.3 20.5 14.7 21.2 100.0 13,793 Christian 9.6 5.7 11.7 18.5 20.1 34.4 100.0 2,277 Sikh 9.6 2.3 13.7 14.8 24.2 35.4 100.0 1,622 Buddhist/Neo-Buddhist 4.5 6.9 13.5 27.1 16.6 31.4 100.0 958 Jain 1.7 0.0 8.3 14.9 17.5 57.6 100.0 163 Other 20.4 12.1 14.3 24.4 11.1 17.9 100.0 386 Caste/tribe Scheduled caste 14.5 6.8 16.3 22.9 16.3 23.2 100.0 20,499 Scheduled tribe 21.9 9.3 16.7 22.1 12.7 17.5 100.0 9,132 Other backward class 11.7 5.2 15.0 20.8 17.9 29.4 100.0 45,110 Other 7.4 5.5 10.7 18.5 19.1 38.7 100.0 28,299 Don't know 14.5 11.3 19.8 26.7 10.7 17.1 100.0 371 Wealth index Lowest 31.9 11.1 20.2 21.5 8.2 7.1 100.0 15,205 Second 17.3 9.2 18.8 25.4 14.5 14.9 100.0 19,402 Middle 10.6 6.3 17.1 24.1 19.1 22.8 100.0 22,047 Fourth 6.1 4.2 12.5 20.8 22.1 34.3 100.0 22,930 Highest 2.1 1.3 5.9 13.1 19.7 57.8 100.0 23,827 Total age 15-49 12.0 6.0 14.2 20.7 17.4 29.6 100.0 103,411 Age 50-54 22.7 4.5 11.9 16.8 15.9 28.2 100.0 8,711 Total age 15-54 12.8 5.9 14.1 20.4 17.3 29.5 100.0 112,122 62 z Characteristics of Respondents Ta bl e 3. 3. 1 Li te ra cy : W om en Pe rc en t d ist rib ut io n of w om en a ge 1 5- 49 b y lit er ac y, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic C om pl et ed st an da rd 6 or h ig he r N o sc ho ol in g or c om pl et ed le ss th an s ta nd ar d 6 To ta l N um be r of w om en Pe rc en ta ge lit er at e1 C an re ad a w ho le se nt en ce C an re ad pa rt o f a se nt en ce C an no t re ad at a ll N o ca rd w ith re qu ire d la ng ua ge Bl in d/ vi su al ly im pa ire d Ag e 15 -2 4 80 .9 1. 9 3. 6 13 .2 0. 1 0. 2 10 0. 0 24 4, 51 8 86 .4 1 5- 19 86 .2 1. 5 2. 8 9. 3 0. 1 0. 2 10 0. 0 12 1, 55 2 90 .4 2 0- 24 75 .8 2. 3 4. 4 17 .1 0. 2 0. 3 10 0. 0 12 2, 96 6 82 .4 25 -2 9 63 .9 3. 1 5. 8 26 .4 0. 2 0. 5 10 0. 0 11 5, 04 3 72 .8 30 -3 4 54 .9 3. 3 6. 4 34 .6 0. 2 0. 6 10 0. 0 96 ,7 69 64 .6 35 -3 9 45 .8 3. 6 6. 8 42 .6 0. 2 0. 9 10 0. 0 90 ,8 90 56 .2 40 -4 4 39 .2 3. 5 6. 5 49 .5 0. 2 1. 1 10 0. 0 77 ,9 69 49 .2 45 -4 9 31 .5 3. 6 7. 0 56 .6 0. 2 1. 0 10 0. 0 74 ,4 97 42 .1 Re si de nc e U rb an 74 .4 2. 5 4. 5 18 .1 0. 2 0. 4 10 0. 0 24 2, 22 5 81 .4 Ru ra l 52 .5 3. 1 6. 0 37 .6 0. 2 0. 7 10 0. 0 45 7, 46 1 61 .5 M ar ita l s ta tu s N ev er m ar rie d 88 .4 1. 3 2. 3 7. 7 0. 1 0. 2 10 0. 0 15 9, 03 5 92 .1 C ur re nt ly m ar rie d 52 .7 3. 3 6. 3 36 .8 0. 2 0. 7 10 0. 0 51 1, 37 3 62 .3 W id ow ed /d iv or ce d/ se pa ra te d/ de se rt ed 35 .0 4. 2 7. 4 52 .5 0. 1 0. 9 10 0. 0 29 ,2 79 46 .5 Re lig io n H in du 60 .4 2. 6 5. 2 31 .0 0. 1 0. 6 10 0. 0 56 3, 73 9 68 .3 M us lim 53 .7 4. 0 6. 6 34 .6 0. 5 0. 6 10 0. 0 96 ,4 61 64 .2 C hr ist ia n 72 .5 3. 1 5. 2 18 .7 0. 1 0. 4 10 0. 0 16 ,6 20 80 .8 Si kh 71 .8 3. 6 5. 7 18 .8 0. 1 0. 0 10 0. 0 11 ,6 18 81 .1 Bu dd hi st /N eo -B ud dh ist 72 .8 3. 0 5. 3 18 .1 0. 0 0. 8 10 0. 0 6, 46 9 81 .1 Ja in 95 .4 1. 1 1. 0 2. 3 0. 1 0. 1 10 0. 0 1, 26 4 97 .5 O th er 48 .8 3. 1 8. 2 39 .2 0. 2 0. 6 10 0. 0 3, 51 5 60 .0 C as te /tr ib e Sc he du le d ca st e 53 .3 2. 9 6. 1 36 .8 0. 1 0. 7 10 0. 0 14 2, 61 9 62 .3 Sc he du le d tri be 44 .4 2. 7 5. 9 45 .9 0. 2 0. 9 10 0. 0 64 ,1 44 53 .0 O th er b ac kw ar d cl as s 59 .4 2. 9 5. 4 31 .6 0. 2 0. 5 10 0. 0 30 3, 83 7 67 .7 O th er 72 .4 2. 8 4. 6 19 .4 0. 2 0. 5 10 0. 0 18 4, 59 4 79 .8 D on 't kn ow 40 .3 5. 0 8. 6 44 .1 0. 7 1. 3 10 0. 0 4, 49 2 53 .9 C on tin ue d. . Characteristics of Respondents z�63 Ta bl e 3. 3. 1 Li te ra cy : W om en — C on tin ue d Pe rc en t d ist rib ut io n of w om en a ge 1 5- 49 b y lit er ac y, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic C om pl et ed st an da rd 6 or h ig he r N o sc ho ol in g or c om pl et ed le ss th an s ta nd ar d 6 To ta l N um be r of w om en Pe rc en ta ge lit er at e1 C an re ad a w ho le se nt en ce C an re ad pa rt o f a se nt en ce C an no t re ad at a ll N o ca rd w ith re qu ire d la ng ua ge Bl in d/ vi su al ly im pa ire d W ea lth in de x Lo w es t 28 .3 2. 8 6. 3 61 .1 0. 4 1. 2 10 0. 0 12 4, 05 4 37 .4 Se co nd 45 .6 3. 6 7. 1 42 .6 0. 2 0. 8 10 0. 0 13 6, 90 0 56 .3 M id dl e 59 .0 3. 5 6. 5 30 .3 0. 2 0. 6 10 0. 0 14 3, 81 4 68 .9 Fo ur th 73 .2 2. 8 5. 0 18 .5 0. 1 0. 3 10 0. 0 14 7, 97 8 81 .0 H ig he st 88 .2 1. 7 2. 6 7. 3 0. 1 0. 1 10 0. 0 14 6, 93 9 92 .5 To ta l 60 .1 2. 9 5. 4 30 .8 0. 2 0. 6 10 0. 0 69 9, 68 6 68 .4 1 R ef er s to w om en w ho c an re ad a w ho le s en te nc e or p ar t o f a s en te nc e an d w om en w ho c om pl et ed s ta nd ar d 6 or h ig he r ( w ho a re a ss um ed to b e lit er at e) 64 z Characteristics of Respondents Ta bl e 3. 3. 2 Li te ra cy : M en Pe rc en t d ist rib ut io n of m en a ge 1 5- 49 b y lit er ac y, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic C om pl et ed st an da rd 6 or h ig he r N o sc ho ol in g or c om pl et ed le ss th an s ta nd ar d 6 To ta l N um be r of m en Pe rc en ta ge lit er at e1 C an re ad a w ho le se nt en ce C an re ad pa rt o f a se nt en ce C an no t re ad at a ll N o ca rd w ith re qu ire d la ng ua ge Bl in d/ vi su al ly im pa ire d Ag e 15 -2 4 87 .7 2. 3 3. 3 6. 5 0. 1 0. 2 10 0. 0 35 ,3 64 93 .2 1 5- 19 90 .0 1. 9 2. 6 5. 2 0. 1 0. 1 10 0. 0 18 ,7 40 94 .6 2 0- 24 85 .1 2. 6 4. 0 7. 9 0. 1 0. 3 10 0. 0 16 ,6 24 91 .7 25 -2 9 80 .0 3. 1 5. 1 11 .4 0. 1 0. 2 10 0. 0 16 ,1 71 88 .3 30 -3 4 73 .9 4. 4 6. 6 14 .8 0. 1 0. 3 10 0. 0 14 ,6 04 84 .8 35 -3 9 68 .5 4. 9 6. 9 19 .1 0. 2 0. 5 10 0. 0 13 ,7 71 80 .2 40 -4 4 65 .1 6. 1 7. 6 20 .5 0. 2 0. 5 10 0. 0 12 ,0 50 78 .8 45 -4 9 59 .0 6. 4 8. 5 25 .3 0. 3 0. 5 10 0. 0 11 ,4 51 73 .9 Re si de nc e U rb an 83 .3 3. 2 4. 2 9. 0 0. 0 0. 1 10 0. 0 39 ,5 46 90 .8 Ru ra l 71 .8 4. 4 6. 4 16 .8 0. 2 0. 4 10 0. 0 63 ,8 64 82 .6 M ar ita l s ta tu s N ev er m ar rie d 88 .8 2. 0 2. 8 6. 2 0. 1 0. 2 10 0. 0 39 ,6 31 93 .6 C ur re nt ly m ar rie d 68 .7 5. 1 7. 3 18 .3 0. 2 0. 4 10 0. 0 62 ,4 99 81 .1 W id ow ed /d iv or ce d/ se pa ra te d/ de se rt ed 52 .6 6. 0 7. 4 33 .0 0. 5 0. 5 10 0. 0 1, 28 0 66 .0 Re lig io n H in du 77 .6 3. 6 5. 2 13 .2 0. 1 0. 3 10 0. 0 84 ,2 11 86 .4 M us lim 66 .1 6. 2 8. 0 19 .1 0. 3 0. 4 10 0. 0 13 ,7 93 80 .3 C hr ist ia n 80 .8 3. 8 4. 8 10 .2 0. 0 0. 4 10 0. 0 2, 27 7 89 .4 Si kh 81 .5 2. 4 4. 4 11 .7 0. 0 0. 0 10 0. 0 1, 62 2 88 .3 Bu dd hi st /N eo -B ud dh ist 82 .2 5. 5 6. 5 5. 3 0. 0 0. 5 10 0. 0 95 8 94 .2 Ja in 94 .5 1. 5 1. 2 2. 9 0. 0 0. 0 10 0. 0 16 3 97 .1 O th er 62 .2 3. 7 9. 3 21 .4 0. 7 2. 7 10 0. 0 38 6 75 .1 C as te /tr ib e Sc he du le d ca st e 71 .6 4. 2 6. 8 16 .9 0. 1 0. 3 10 0. 0 20 ,4 99 82 .7 Sc he du le d tri be 62 .1 5. 2 8. 4 23 .6 0. 2 0. 6 10 0. 0 9, 13 2 75 .6 O th er b ac kw ar d cl as s 76 .7 4. 1 5. 2 13 .4 0. 2 0. 3 10 0. 0 45 ,1 10 86 .1 O th er 83 .2 3. 1 4. 3 9. 1 0. 1 0. 2 10 0. 0 28 ,2 99 90 .6 D on 't kn ow 68 .8 3. 8 11 .6 14 .3 0. 2 1. 3 10 0. 0 37 1 84 .2 C on tin ue d. . Characteristics of Respondents z�65 Ta bl e 3. 3. 2 Li te ra cy : M en — C on tin ue d Pe rc en t d ist rib ut io n of m en a ge 1 5- 49 b y lit er ac y, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic C om pl et ed st an da rd 6 or h ig he r N o sc ho ol in g or c om pl et ed le ss th an s ta nd ar d 6 To ta l N um be r of m en Pe rc en ta ge lit er at e1 C an re ad a w ho le se nt en ce C an re ad pa rt o f a se nt en ce C an no t re ad at a ll N o ca rd w ith re qu ire d la ng ua ge Bl in d/ vi su al ly im pa ire d W ea lth in de x Lo w es t 47 .0 6. 6 10 .9 34 .1 0. 5 0. 9 10 0. 0 15 ,2 05 64 .5 Se co nd 65 .8 5. 4 7. 8 20 .3 0. 1 0. 5 10 0. 0 19 ,4 02 79 .0 M id dl e 76 .7 4. 2 5. 9 12 .8 0. 1 0. 3 10 0. 0 22 ,0 47 86 .8 Fo ur th 85 .0 3. 1 4. 0 7. 8 0. 1 0. 1 10 0. 0 22 ,9 30 92 .1 H ig he st 94 .3 1. 6 1. 6 2. 4 0. 0 0. 0 10 0. 0 23 ,8 27 97 .6 To ta l a ge 1 5- 49 76 .2 3. 9 5. 6 13 .8 0. 1 0. 3 10 0. 0 10 3, 41 1 85 .7 Ag e 50 -5 4 53 .5 6. 8 8. 8 29 .9 0. 3 0. 7 10 0. 0 8, 71 1 69 .1 To ta l a ge 1 5- 54 74 .4 4. 2 5. 8 15 .1 0. 1 0. 4 10 0. 0 11 2, 12 2 84 .4 1 R ef er s to m en w ho c an re ad a w ho le s en te nc e or p ar t o f a s en te nc e an d m en w ho c om pl et ed s ta nd ar d 6 or h ig he r ( w ho a re a ss um ed to b e lit er at e) 66 z Characteristics of Respondents Table 3.4.1 Respondent's level of schooling and literacy by state/union territory: Women Percent distribution of women age 15-49 by number of years of schooling completed and percentage literate, by state/union territory, India, 2015-16 State/union territory Respondent's level of schooling Total Percentage literate1 No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete India 27.6 5.8 14.2 16.7 14.2 21.5 100.0 68.4 North Chandigarh 13.7 1.7 10.1 15.3 15.4 43.8 100.0 83.2 Delhi 16.8 2.2 12.1 14.8 18.3 35.9 100.0 80.9 Haryana 23.0 2.8 13.9 14.5 17.2 28.7 100.0 75.4 Himachal Pradesh 9.8 3.5 14.4 12.9 22.7 36.7 100.0 88.2 Jammu & Kashmir 29.2 1.9 8.0 23.7 15.2 22.1 100.0 69.0 Punjab 16.8 1.6 13.3 13.1 20.5 34.6 100.0 81.4 Rajasthan 40.6 4.1 14.9 15.3 9.1 16.0 100.0 56.5 Uttarakhand 21.3 3.0 11.7 19.3 14.1 30.5 100.0 76.5 Central Chhattisgarh 28.0 6.9 15.5 23.1 9.7 16.9 100.0 66.3 Madhya Pradesh 34.1 5.7 15.8 21.2 9.2 13.9 100.0 59.4 Uttar Pradesh 35.7 3.0 11.9 16.5 10.2 22.7 100.0 61.0 East Bihar 47.8 5.3 11.1 13.0 10.7 12.1 100.0 49.5 Jharkhand 37.5 5.7 11.5 16.6 13.1 15.5 100.0 59.0 Odisha 28.0 8.6 16.1 20.7 13.8 12.9 100.0 67.4 West Bengal 22.1 12.8 17.2 21.5 12.9 13.6 100.0 70.9 Northeast Arunachal Pradesh 31.3 6.8 13.0 18.0 13.7 17.3 100.0 65.6 Assam 23.0 10.4 12.9 27.5 11.2 15.0 100.0 71.8 Manipur 10.8 6.4 10.0 26.9 17.9 28.1 100.0 85.0 Meghalaya 16.0 14.6 16.8 19.1 14.7 19.0 100.0 82.8 Mizoram 6.2 8.3 17.2 28.4 16.9 22.9 100.0 93.4 Nagaland 14.9 7.9 17.0 26.9 14.4 18.9 100.0 80.9 Sikkim 12.1 8.8 17.7 20.7 16.9 23.8 100.0 86.6 Tripura 12.3 12.1 19.2 33.0 11.9 11.5 100.0 80.4 West Dadra & Nagar Haveli 30.8 6.2 11.1 16.0 13.6 22.3 100.0 62.5 Daman & Diu 15.0 4.5 12.6 18.7 21.0 28.2 100.0 83.1 Goa 8.9 5.0 10.0 17.8 23.7 34.5 100.0 89.0 Gujarat 22.9 7.4 20.4 16.3 12.5 20.5 100.0 72.9 Maharashtra 14.8 8.1 15.8 19.2 17.0 25.0 100.0 80.3 South Andaman & Nicobar Islands 9.5 5.3 13.6 22.5 16.5 32.6 100.0 84.1 Andhra Pradesh 33.4 5.3 18.7 8.2 16.8 17.5 100.0 62.9 Karnataka 23.9 6.0 15.2 9.5 22.0 23.4 100.0 71.7 Kerala 1.0 2.2 6.7 17.9 24.4 47.8 100.0 97.9 Lakshadweep 1.4 5.6 17.6 18.6 25.3 31.4 100.0 95.6 Puducherry 11.1 2.9 11.6 14.2 21.5 38.8 100.0 85.0 Tamil Nadu 16.0 3.8 13.8 15.5 18.9 32.0 100.0 79.4 Telangana 32.2 4.5 12.7 7.1 19.0 24.6 100.0 65.5 1 Refers to women who can read a whole sentence or part of a sentence and women who completed standard 6 or higher (who are assumed to be literate) Characteristics of Respondents z�67 Table 3.4.2 Respondent's level of schooling and literacy by state/union territory: Men Percent distribution of men age 15-49 by number of years of schooling completed and percentage literate, by state/union territory, India, 2015-16 State/union territory Respondent's level of schooling Total Percentage literate1 No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete India 12.0 6.0 14.2 20.7 17.4 29.6 100.0 85.7 North Chandigarh 8.8 0.5 13.0 11.8 13.0 52.9 100.0 87.7 Delhi 7.0 2.7 13.3 22.2 18.3 36.5 100.0 89.3 Haryana 7.5 2.8 13.5 15.3 22.0 39.1 100.0 90.6 Himachal Pradesh 2.3 2.5 10.0 14.0 28.2 43.0 100.0 96.2 Jammu & Kashmir 11.6 2.2 8.6 28.5 19.8 29.3 100.0 87.0 Punjab 10.5 2.3 13.6 13.8 24.2 35.6 100.0 87.5 Rajasthan 13.2 3.9 15.5 23.6 14.8 29.0 100.0 85.4 Uttarakhand 7.7 2.3 12.3 24.1 19.4 34.2 100.0 90.7 Central Chhattisgarh 11.2 7.4 18.0 27.4 12.2 23.7 100.0 85.7 Madhya Pradesh 14.1 6.8 18.3 26.5 12.1 22.2 100.0 81.8 Uttar Pradesh 16.1 3.8 13.8 24.1 14.2 28.1 100.0 82.4 East Bihar 20.8 6.3 13.2 17.2 16.7 25.8 100.0 77.8 Jharkhand 18.0 5.7 13.3 22.8 15.2 25.0 100.0 79.7 Odisha 12.5 8.7 16.5 25.2 16.3 20.7 100.0 84.3 West Bengal 14.3 13.4 17.2 21.3 11.9 21.9 100.0 81.1 Northeast Arunachal Pradesh 16.2 7.5 11.3 20.2 17.8 26.9 100.0 84.5 Assam 14.2 11.6 14.1 26.9 12.7 20.5 100.0 82.8 Manipur 3.1 4.2 9.7 28.2 19.7 35.2 100.0 96.0 Meghalaya 16.4 17.2 15.1 16.8 12.8 21.7 100.0 84.0 Mizoram 2.7 5.5 19.1 29.5 17.5 25.7 100.0 98.1 Nagaland 11.1 7.3 17.5 26.3 15.9 21.8 100.0 85.6 Sikkim 6.0 10.6 18.2 20.1 16.6 28.5 100.0 91.5 Tripura 4.8 10.7 16.7 32.4 16.1 19.4 100.0 89.5 West Dadra & Nagar Haveli 13.5 9.8 5.6 18.6 15.6 36.8 100.0 82.6 Daman & Diu 8.0 2.4 16.2 20.6 28.4 24.4 100.0 89.7 Goa 4.4 2.3 9.5 20.3 28.0 35.6 100.0 94.7 Gujarat 7.9 7.3 16.7 25.0 16.4 26.6 100.0 89.6 Maharashtra 6.3 6.1 11.0 23.0 19.1 34.4 100.0 92.8 South Andaman & Nicobar Islands 6.0 6.9 15.3 19.2 19.5 33.1 100.0 88.5 Andhra Pradesh 17.1 6.4 16.8 8.4 20.0 31.3 100.0 79.4 Karnataka 11.8 7.8 13.4 11.8 23.5 31.7 100.0 85.1 Kerala 0.6 2.9 7.4 18.6 25.9 44.6 100.0 98.7 Lakshadweep 0.6 1.8 12.9 8.3 42.2 34.1 100.0 98.8 Puducherry 5.1 1.4 11.2 16.3 29.3 36.8 100.0 91.9 Tamil Nadu 8.4 3.3 13.8 16.2 20.6 37.7 100.0 89.1 Telangana 16.8 4.1 13.8 10.8 23.2 31.3 100.0 83.4 1 Refers to men who can read a whole sentence or part of a sentence and men who completed standard 6 or higher (who are assumed to be literate) 68 z Characteristics of Respondents Table 3.5.1 Exposure to mass media: Women Percentage of women age 15-49 who usually read a newspaper or magazine, watch television, or listen to the radio at least once a week, who usually visit the cinema or theatre at least once a month, and who are not regularly exposed to any of these media by background characteristics, India, 2015-16 Background characteristic Exposure to mass media Number of women Reads a newspaper or magazine at least once a week Watches television at least once a week Listens to the radio at least once a week Visits the cinema/ theatre at least once a month Not regularly exposed to any media Age 15-19 32.5 70.8 11.5 9.0 23.5 121,552 20-24 30.3 73.6 11.2 11.5 22.3 122,966 25-29 27.3 72.4 10.4 10.3 24.2 115,043 30-34 25.5 70.9 10.1 8.3 25.9 96,769 35-39 23.3 69.9 10.1 7.0 27.0 90,890 40-44 21.8 69.2 10.2 5.6 27.8 77,969 45-49 19.1 68.7 9.7 4.9 28.4 74,497 Residence Urban 43.4 89.0 14.2 15.8 8.2 242,225 Rural 17.5 61.5 8.6 4.7 34.2 457,461 Schooling No schooling 0.5 46.8 6.5 2.2 50.5 193,078 <5 years complete 4.5 64.5 7.4 3.3 32.4 40,503 5-7 years complete 14.9 72.3 8.2 4.6 24.1 99,687 8-9 years complete 26.2 75.8 10.0 6.3 19.4 116,681 10-11 years complete 42.6 85.2 12.9 11.1 10.5 99,576 12 or more years complete 63.1 90.1 17.0 20.5 5.8 150,160 Marital status Never married 40.6 76.2 13.6 11.9 18.4 159,035 Currently married 22.7 69.7 9.7 7.7 27.0 511,373 Widowed/divorced/ separated/deserted 15.9 67.2 8.9 4.3 29.7 29,279 Religion Hindu 26.4 71.9 10.7 9.0 24.6 563,739 Muslim 22.0 61.5 10.2 4.8 33.1 96,461 Christian 42.3 81.1 11.8 11.2 15.2 16,620 Sikh 38.9 93.0 5.2 7.0 5.8 11,618 Buddhist/Neo-Buddhist 34.3 83.3 12.1 13.1 12.9 6,469 Jain 64.2 94.5 17.9 27.2 4.3 1,264 Other 12.3 47.1 6.6 2.0 49.4 3,515 Caste/tribe Scheduled caste 19.9 69.8 9.7 7.1 26.6 142,619 Scheduled tribe 14.3 55.3 8.2 4.5 40.8 64,144 Other backward class 26.0 70.3 10.1 8.4 25.9 303,837 Other 36.9 78.9 12.8 11.2 17.3 184,594 Don't know 9.7 64.3 9.5 4.8 32.3 4,492 Wealth index Lowest 4.5 23.8 6.4 1.8 70.6 124,054 Second 9.6 56.4 7.9 3.4 38.4 136,900 Middle 18.5 80.4 9.8 5.8 15.9 143,814 Fourth 34.1 90.8 11.8 10.0 6.6 147,978 Highest 60.7 95.5 16.0 20.0 2.4 146,939 Total 26.5 71.1 10.5 8.5 25.2 699,686 Characteristics of Respondents z�69 Table 3.5.2 Exposure to mass media: Men Percentage of men age 15-49 who usually read a newspaper or magazine, watch television, or listen to the radio at least once a week, who usually visit the cinema or theatre at least once a month, and who are not regularly exposed to any of these media by background characteristics, India, 2015-16 Background characteristic Exposure to mass media Number of men Reads a newspaper or magazine at least once a week Watches television at least once a week Listens to the radio at least once a week Visits the cinema/ theatre at least once a month Not regularly exposed to any media Age 15-19 54.8 78.5 20.5 29.3 12.8 18,740 20-24 58.5 79.2 20.7 34.0 11.6 16,624 25-29 57.4 79.9 20.6 29.0 12.4 16,171 30-34 55.3 78.4 20.8 19.0 14.1 14,604 35-39 51.7 76.1 20.8 14.2 16.2 13,771 40-44 52.0 75.4 21.2 10.9 17.2 12,050 45-49 48.8 74.1 20.2 9.1 18.7 11,451 Residence Urban 66.8 89.4 24.8 32.0 5.6 39,546 Rural 46.9 70.4 18.1 16.1 19.7 63,864 Schooling No schooling 4.5 51.6 16.1 8.5 41.7 12,422 <5 years complete 14.6 65.6 15.7 11.2 27.4 6,171 5-7 years complete 34.9 72.3 17.3 14.8 19.6 14,730 8-9 years complete 52.4 76.6 19.2 16.2 13.8 21,422 10-11 years complete 69.6 85.5 22.4 26.2 6.5 18,030 12 or more years complete 84.8 89.3 25.1 35.3 3.1 30,636 Marital status Never married 60.6 81.5 21.9 33.8 10.2 39,631 Currently married 51.0 75.5 20.0 15.1 16.7 62,499 Widowed/divorced/ separated/deserted 37.0 61.6 16.8 9.1 29.1 1,280 Religion Hindu 55.1 77.8 20.4 22.5 14.4 84,211 Muslim 48.4 73.4 22.7 20.2 16.1 13,793 Christian 64.7 85.2 23.2 25.9 9.3 2,277 Sikh 54.0 90.6 6.9 17.2 6.8 1,622 Buddhist/Neo-Buddhist 61.4 84.4 29.6 29.1 9.1 958 Jain 84.7 97.5 24.1 27.0 0.2 163 Other 39.5 62.2 18.3 11.2 26.1 386 Caste/tribe Scheduled caste 48.8 76.6 20.4 20.8 15.6 20,499 Scheduled tribe 35.4 63.7 17.6 14.0 27.8 9,132 Other backward class 56.3 76.6 20.6 23.5 14.4 45,110 Other 62.1 84.6 21.8 23.6 9.0 28,299 Don't know 38.4 73.6 23.4 29.2 16.4 371 &RQWLQXHG����� 70 z Characteristics of Respondents Table 3.5.2 Exposure to mass media: Men³&RQWLQXHG Percentage of men age 15-49 who usually read a newspaper or magazine, watch television, or listen to the radio at least once a week, who usually visit the cinema or theatre at least once a month, and who are not regularly exposed to any of these media by background characteristics, India, 2015-16 Background characteristic Exposure to mass media Number of men Reads a newspaper or magazine at least once a week Watches television at least once a week Listens to the radio at least once a week Visits the cinema/ theatre at least once a month Not regularly exposed to any media Wealth index Lowest 21.3 36.2 15.6 8.4 47.8 15,205 Second 37.8 64.9 18.2 13.3 22.5 19,402 Middle 51.5 84.0 20.0 20.6 8.7 22,047 Fourth 66.1 91.4 23.1 27.0 3.8 22,930 Highest 80.8 95.3 24.2 35.0 1.8 23,827 Total age 15-49 54.5 77.6 20.7 22.2 14.3 103,411 Age 50-54 46.2 72.4 21.7 6.4 19.9 8,711 Total age 15-54 53.8 77.2 20.7 20.9 14.8 112,122 Characteristics of Respondents z�71 Table 3.6.1 Employment status: Women Percent distribution of women age 15-49 by employment status, according to background characteristics, India, 2015-16 Background characteristic Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of women Currently employed1 Not currently employed Age 15-19 13.6 4.9 81.5 100.0 21,059 20-24 16.2 5.1 78.7 100.0 21,154 25-29 22.7 6.2 71.1 100.0 19,769 30-34 28.1 6.9 64.9 100.0 17,037 35-39 32.6 7.5 59.9 100.0 15,510 40-44 32.8 7.6 59.6 100.0 13,599 45-49 30.7 7.1 62.3 100.0 12,992 Residence Urban 21.3 3.6 75.1 100.0 43,510 Rural 25.5 7.8 66.7 100.0 77,610 Schooling No schooling 32.4 9.6 58.1 100.0 31,877 <5 years complete 32.4 8.7 58.9 100.0 6,902 5-7 years complete 25.7 7.0 67.3 100.0 17,550 8-9 years complete 18.5 5.3 76.2 100.0 20,268 10-11 years complete 16.1 3.8 80.0 100.0 17,502 12 or more years complete 20.0 3.7 76.2 100.0 27,022 Marital status Never married 18.9 4.9 76.2 100.0 27,821 Currently married 24.0 6.6 69.4 100.0 88,021 Widowed/divorced/ separated/deserted 50.6 8.2 41.2 100.0 5,277 Number of living children 0 18.6 5.2 76.1 100.0 37,432 1-2 24.1 6.0 69.9 100.0 51,093 3-4 30.0 7.8 62.2 100.0 26,539 5+ 29.8 8.7 61.5 100.0 6,055 Wealth index Lowest 28.7 10.7 60.6 100.0 19,430 Second 27.2 8.5 64.3 100.0 22,843 Middle 26.9 6.5 66.7 100.0 25,232 Fourth 22.2 4.4 73.5 100.0 26,358 Highest 17.1 3.1 79.9 100.0 27,256 Total 24.0 6.3 69.7 100.0 121,120 1 "Currently employed" is defined as having done work in the past seven days. Includes women who did not work in the past seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reasons. 72 z Characteristics of Respondents Table 3.6.2 Employment status: Men Percent distribution of men age 15-49 by employment status, according to background characteristics, India, 2015-16 Background characteristic Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of men Currently employed1 Not currently employed Age 15-19 29.4 4.5 66.2 100.0 18,740 20-24 63.9 6.5 29.6 100.0 16,624 25-29 85.8 6.0 8.2 100.0 16,171 30-34 91.6 5.4 3.0 100.0 14,604 35-39 93.0 5.1 1.9 100.0 13,771 40-44 92.8 5.1 2.1 100.0 12,050 45-49 91.9 5.5 2.6 100.0 11,451 Residence Urban 76.0 3.0 21.1 100.0 39,546 Rural 74.9 7.0 18.1 100.0 63,864 Schooling No schooling 87.6 7.5 4.9 100.0 12,422 <5 years complete 90.3 6.5 3.2 100.0 6,171 5-7 years complete 87.0 6.1 6.9 100.0 14,730 8-9 years complete 74.2 5.8 20.0 100.0 21,422 10-11 years complete 66.4 4.5 29.1 100.0 18,030 12 or more years complete 67.8 4.3 27.9 100.0 30,636 Marital status Never married 48.7 5.2 46.1 100.0 39,631 Currently married 92.0 5.6 2.5 100.0 62,499 Widowed/divorced/ separated/deserted 87.6 5.7 6.6 100.0 1,280 Number of living children 0 55.9 5.4 38.7 100.0 48,608 1-2 93.2 4.7 2.1 100.0 34,618 3-4 91.8 6.5 1.7 100.0 16,586 5+ 89.6 8.1 2.4 100.0 3,599 Wealth index Lowest 76.0 11.0 13.1 100.0 15,205 Second 76.7 6.9 16.4 100.0 19,402 Middle 76.9 5.1 18.0 100.0 22,047 Fourth 75.6 3.9 20.5 100.0 22,930 Highest 72.1 2.6 25.4 100.0 23,827 Total age 15-49 75.3 5.4 19.2 100.0 103,411 Age 50-54 89.5 5.5 4.9 100.0 8,711 Total age 15-54 76.4 5.4 18.1 100.0 112,122 1 "Currently employed" is defined as having done work in the past seven days. Includes men who did not work in the past seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reasons. Characteristics of Respondents z�73 Table 3.7 Employment status of women and men by state/union territory Percent distribution of women and men age 15-49 by employment status, according to state/union territory, India, 2015-16 State/union territory Women Men Currently employed1 Not currently employed Not employed in the 12 months preceding the survey Total Currently employed1 Not currently employed Not employed in the 12 months preceding the survey Total India 24.0 6.3 69.7 100.0 75.3 5.4 19.2 100.0 North Chandigarh 30.9 2.4 66.7 100.0 75.6 0.0 24.4 100.0 Delhi 18.6 2.9 78.5 100.0 69.2 0.8 30.0 100.0 Haryana 18.1 3.7 78.2 100.0 73.8 3.2 23.0 100.0 Himachal Pradesh 24.4 5.5 70.1 100.0 70.9 3.9 25.2 100.0 Jammu & Kashmir 13.7 4.1 82.2 100.0 69.9 5.0 25.1 100.0 Punjab 16.6 2.6 80.8 100.0 78.4 1.8 19.8 100.0 Rajasthan 19.7 9.2 71.2 100.0 67.4 7.6 25.0 100.0 Uttarakhand 17.2 3.4 79.4 100.0 67.7 4.2 28.1 100.0 Central Chhattisgarh 29.1 15.5 55.4 100.0 72.9 9.1 18.0 100.0 Madhya Pradesh 30.1 10.2 59.8 100.0 76.0 7.7 16.3 100.0 Uttar Pradesh 19.2 6.0 74.8 100.0 72.0 7.3 20.8 100.0 East Bihar 14.9 5.1 80.0 100.0 63.6 12.8 23.6 100.0 Jharkhand 22.8 9.1 68.1 100.0 71.2 11.0 17.8 100.0 Odisha 19.7 7.7 72.5 100.0 75.0 8.6 16.4 100.0 West Bengal 19.2 5.0 75.9 100.0 80.8 5.4 13.8 100.0 Northeast Arunachal Pradesh 24.2 9.8 66.0 100.0 67.0 7.3 25.7 100.0 Assam 14.8 3.8 81.4 100.0 80.5 4.4 15.0 100.0 Manipur 41.3 9.9 48.8 100.0 74.4 3.8 21.8 100.0 Meghalaya 35.2 8.8 56.1 100.0 74.6 2.2 23.2 100.0 Mizoram 34.5 11.6 53.9 100.0 81.3 7.8 10.9 100.0 Nagaland 28.1 5.9 66.0 100.0 72.0 5.7 22.3 100.0 Sikkim 19.8 4.1 76.1 100.0 71.3 6.5 22.2 100.0 Tripura 17.6 14.6 67.7 100.0 78.6 2.5 18.9 100.0 West Dadra & Nagar Haveli 24.3 6.3 69.4 100.0 76.0 6.3 17.7 100.0 Daman & Diu 17.4 10.3 72.4 100.0 83.5 4.8 11.7 100.0 Goa 23.7 2.2 74.1 100.0 79.1 1.2 19.7 100.0 Gujarat 31.7 5.2 63.1 100.0 81.8 2.3 15.9 100.0 Maharashtra 30.2 5.7 64.1 100.0 79.2 3.3 17.5 100.0 Continued. 74 z Characteristics of Respondents Table 3.7 Employment status of women and men by state/union territory—Continued Percent distribution of women and men age 15-49 by employment status, according to state/union territory, India, 2015-16 State/union territory Women Men Currently employed1 Not currently employed Not employed in the 12 months preceding the survey Total Currently employed1 Not currently employed Not employed in the 12 months preceding the survey Total South Andaman & Nicobar Islands 17.7 3.5 78.8 100.0 81.2 4.0 14.8 100.0 Andhra Pradesh 33.5 11.4 55.0 100.0 79.6 3.9 16.4 100.0 Karnataka 29.3 5.4 65.3 100.0 80.0 3.6 16.3 100.0 Kerala 17.3 3.8 78.9 100.0 71.6 2.9 25.4 100.0 Lakshadweep 16.9 4.1 79.1 100.0 69.1 0.0 30.9 100.0 Puducherry 20.0 3.2 76.8 100.0 82.8 1.6 15.5 100.0 Tamil Nadu 28.2 4.3 67.6 100.0 77.4 2.3 20.3 100.0 Telangana 38.8 8.1 53.1 100.0 75.3 6.1 18.6 100.0 1 "Currently employed" is defined as having done work in the past seven days. Includes persons who did not work in the past seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reasons. Characteristics of Respondents z�75 Table 3.8 Occupation Percent distribution of women and men age 15-49 employed in the 12 months preceding the survey by occupation, according to residence, India, 2015-16 Occupation Urban Rural Total Women Professional1 19.7 5.3 9.6 Clerical 2.8 0.8 1.4 Sales worker 8.9 3.1 4.8 Agricultural worker 11.7 63.6 48.3 Service worker 20.6 7.3 11.3 Production worker2 30.1 16.8 20.7 Don't know 6.2 3.1 4.0 Total 100.0 100.0 100.0 Number of women 10,824 25,868 36,692 Men Professional1 13.1 4.9 7.9 Clerical 3.7 1.7 2.5 Sales worker 19.0 7.3 11.7 Agricultural worker 6.6 47.2 32.0 Service worker 12.6 6.3 8.6 Production worker2 39.1 28.2 32.3 Don't know 6.0 4.4 5.0 Total 100.0 100.0 100.0 Number of men 31,216 52,298 83,514 1 Includes technical, administrative, and managerial occupations 2 Includes skilled and unskilled manual occupations 76 z Characteristics of Respondents Table 3.9 Type of employment Percent distribution of women age 15-49 employed in the 12 months preceding the survey by type of employer and continuity of employment, and percent distributions of women and men age 15-49 employed in the 12 months preceding the survey by type of earnings, according to the type of occupation (agricultural or non-agricultural), India, 2015-16 Employment characteristic Type of occupation Total Agricultural sector Non-agricultural sector Type of employer Employed by family member 82.9 74.4 78.5 Employed by non-family member 10.2 11.7 11.0 Self employed 6.9 13.9 10.5 Total 100.0 100.0 100.0 Continuity of employment All year 41.2 74.9 58.6 Seasonal 53.7 19.4 35.9 Occasional 5.1 5.7 5.4 Total 100.0 100.0 100.0 Type of earnings Cash only 59.4 88.0 74.2 Cash and in-kind 10.4 3.9 7.0 In-kind only 5.4 1.7 3.5 Not paid 24.7 6.4 15.2 Total 100.0 100.0 100.0 Number of employed women 17,717 18,975 36,692 Type of earnings Cash only 63.7 92.3 83.2 Cash and in-kind 17.3 2.4 7.2 In-kind only 4.4 0.4 1.7 Not paid 14.6 4.8 8.0 Total 100.0 100.0 100.0 Number of employed men 26,754 56,760 83,514 Characteristics of Respondents z�77 FERTILITY AND FERTILITY PREFERENCES 4 Key Findings x Total fertility rate: The total fertility rate is 2.2 children per woman, which declined from 2.7 children in 2005-06 and is currently just above the replacement level of fertility of 2.1 children per woman. x Birth intervals: The median birth interval is 32.0 months since the preceding birth. x Age at first birth: The median age at first birth among women age 25-49 is 21.0 years. x Teenage childbearing: Eight percent of women age 15-49 have begun childbearing, which is half the level in 2005-06. x Desire for another child: Only about one-fourth (24%) of currently married women age 15-49 want to have another child. x Wanted fertility rate: The wanted fertility rate is 1.8 children per woman and ranges from 0.9 children in Sikkim to 2.8 children in Meghalaya. he number of children that a woman bears depends on many factors, including the age she begins childbearing, how long she waits between births, and her fecundity. Postponing first births and extending the interval between births have played a role in reducing fertility levels in many countries. These factors also have positive health consequences. In contrast, short birth intervals (of less than 24 months) can lead to harmful outcomes for both newborns and their mothers, such as preterm birth, low birth weight, and death. Childbearing at a very young age is associated with an increased risk of complications during pregnancy and childbirth and higher rates of neonatal mortality. This chapter describes the current level of fertility in India and some of its proximate determinants. It presents information on the total fertility rate, birth intervals, insusceptibility to pregnancy (due to postpartum amenorrhoea, postpartum abstinence, or menopause), age at first birth, and teenage childbearing. 4.1 CURRENT FERTILITY Total fertility rate (TFR) The average number of children a woman would have by the end of her childbearing years if she bore children at the current age-VSHFL¿F�IHUWLOLW\�UDWHV�� Age-specific fertility rates are calculated for the three years before the survey, based on detailed birth histories provided by women. Sample: Women age 15-49 T Fertility and Fertility Preferences z�79 The total fertility rate (TFR) in India is 2.2 children per woman (Table 4.1), slightly higher than the replacement level of fertility of 2.1 children per woman. Women in rural areas have higher fertility, on average, than women in urban areas (TFR of 2.4 versus 1.8 children). Trends: The TFR has declined noticeably in India over time. Between 1992-93 and 2015-16, the TFR has declined by 1.2 children (from a TFR of 3.4 children in 1992-93 to 2.2 children in 2015-16) (Figure 4.1). The TFR among women in rural areas has declined from 3.7 children in 1992-93 to 2.4 children in 2015-16. The corresponding decline among women in urban areas was from 2.7 children in 1992-93 to 1.8 children in 2015-16. In all NFHS surveys, irrespective of place of residence, the fertility rate peaks at age 20-24, after which it declines steadily. Patterns by background characteristics x The number of children per woman declines with women’s level of schooling. Women with no schooling have an average 3.1 children, compared with 1.7 children for women with 12 or more years of schooling (Table 4.2). x Women in the lowest wealth quintile have an average of 1.6 more children than women in the highest wealth quintile (TFR of 3.2 children versus 1.5 children) (Figure 4.2). x The TFR varies from a low of 1.2 children per woman among Jains to a high of 2.6 children per woman among Muslims. The TFR ranges from 1.2 children per woman in Sikkim to 3.4 children per woman in Bihar (Table 4.3). x Twenty-three states and union territories, including all the states in the south region, have fertility below the replacement level of 2.1 children per woman. 2.7 3.7 3.4 2.3 3.1 2.9 2.1 3.0 2.7 1.8 2.4 2.2 Urban Rural Total NFHS-1 NFHS-2 NFHS-3 NFHS-4 Figure 4.1 Trends in Fertility by Residence Total fertility rate for the three years before the survey 3.2 2.5 2.1 1.8 1.5 Lowest Second Middle Fourth Highest Poorest Wealthiest 0 50 100 150 200 250 15-19 20-24 25-29 30-34 35-39 40-44 45-49 NFHS-1 NFHS-2 NFHS-3 NFHS-4 Age Figure 4.2 Fertility by Household Wealth Total fertility rate for the three years before the survey Figure 4.3 Trends in Age-specific Fertility Rates Births per 1,000 women 80 z Fertility and Fertility Preferences x Age-specific fertility rates in the five-year period before the survey increased from 56 births per 1,000 women age 15-19 to 187 births per 1,000 women age 20-24 and decline thereafter to 2 births per 1,000 women age 45-49 (Table 4.4 and Figure 4.3). 4.2 CHILDREN EVER BORN AND LIVING NFHS-4 collected data on the number of children ever born to women age 15-49 and those still living. On average, women age 45-49 have given birth to 3.3 children over their lives. Of these, 3.0 children survived to the time of the survey. Currently married women age 45-49 had an average 3.4 children, and 3.1 of these were alive at the time of the survey (Table 4.5). 4.3 BIRTH ORDER Among the births in the three years preceding the survey, 39 percent were of birth order one, 33 percent were second-order births, 15 percent were third-order births, and the rest were of birth order four or higher (Table 4.6). Trends: Among births in the 3 years preceding the survey, 14 percent were of birth order four or higher, compared with 25 percent in 2005-06. Patterns by background characteristics x The percentage of births of order four or more declines steadily for higher wealth quintiles (from 27% of the births to women from lowest wealth quintile to 3% of the births to women from highest wealth quintile). x Twice as many births were fourth-order births or higher in rural areas as in urban areas (16% compared with 8%). x Thirty-one percent of births to women with no schooling were of birth order four or higher, compared with 2 percent of the births to women with 12 or more years of schooling. 4.4 BIRTH INTERVALS Median birth interval Number of months since the preceding birth by which half of children are born. Sample: Non-first births in the five years before the survey Short birth intervals (<24 months) are associated with increased health risks for both mothers and newborns. The median birth interval in India is 32.0 months (Table 4.7). Twenty-seven percent of births occurred less than 24 months since the preceding birth (Figure 4.4). Patterns by background characteristics x Births to older women occurred after longer intervals than births to younger women. The median birth interval among women age 40-49 is 21 months longer than the median among women age 15-19 (43.6 months versus 22.6 months). x Births to women in wealthier households occurred after longer birth intervals. The median birth interval in the highest wealth quintile is 8 months longer than Figure 4.4 Birth Intervals Percent distribution of non-first order births by number of months since the preceding birth 7-17 11% 18-23 16% 24-35 32% 36-47 18% 48-59 9.8% 60+ 14% Fertility and Fertility Preferences z�81 in the lowest quintile (39.1 months versus 30.9 months). x The median birth interval is 9 months longer if the preceding birth is living than if the preceding birth has died. x Among the religious groups, the median birth interval is the lowest among Buddhists/Neo-Buddhists (30.7 months) and the highest among Jains (45.7 months). x Birth intervals are longer for births to women with 12 or more years of schooling than women with no schooling (35.7 months versus 31.3 months) 4.5 AGE AT FIRST BIRTH Median age at first birth Age by which half of women have had their first child. Sample: Women age 25-49 The median age at first birth among women age 25-49 in India is 21.0 years (Table 4.8). Patterns by background characteristics x Women age 25-49 in urban areas have their first birth, on average, more than 1 year later than women in rural areas (21.9 years versus 20.6 years) (Table 4.9). x The median age at first birth increases from 20 years or less among women age 25-49 with no schooling or less than 5 years of schooling to 24.7 years among women with 12 or more years of schooling (Figure 4.5). x The median age at first birth to women in the highest wealth quintile is 2.4 months longer than for women in the lowest wealth quintile (22.8 months versus 20.4 months). 4.6 MENSTRUAL PROTECTION Hygienic methods of protection during the menstrual period Women who use locally prepared napkins, sanitary napkins, or tampons during their menstrual period. Sample: Women age 15-24 Using a hygienic method of menstrual protection is important for women’s health and personal hygiene. In NFHS-4, women age 15-24 were asked what method or methods they use for menstrual protection, if anything. In India, 42 percent use sanitary napkins, 62 percent use cloth, and 16 percent use locally prepared napkins. Overall, 58 percent of women in this age group use a hygienic method of menstrual protection (Table 4.10). Figure 4.5 Median Age at First Birth by Schooling Among women age 25-49 20.0 19.8 20.2 21.0 21.7 24.7 No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete 82 z Fertility and Fertility Preferences Patterns by background characteristics x Women with 12 or more years of schooling are more than four times as likely to be using a hygienic method as women with no schooling (81% versus 20%). x Women from the highest wealth quintile are more than four times as likely to use a hygienic method as women from the lowest wealth quintile (89% versus 21%). x Forty-eight percent of rural women use a hygienic method of menstrual protection, compared with 78 percent of urban women. 4.7 TEENAGE CHILDBEARING Teenage childbearing Women who have given birth or are pregnant with their first child. Sample: Women age 15-19 In India, 8 percent of women age 15-19 have begun childbearing; 5 percent of women have had a live birth and 3 of women percent are pregnant with their first child (Table 4.11). Trends: The level of teenage childbearing declined between 2005-06 (16%) and 2015-16 (8%). The decline is higher for women who have had a live birth (from 12% to 5%) than for women who were pregnant with their first child (from 4% to 3%) between 2005-06 and 2015-16. Patterns by background characteristics x Teenage pregnancy is relatively high in rural areas. Nearly 1 in every 10 women in rural areas in the age group 15-19 have begun childbearing (Table 4.11). x The level of teenage pregnancy decreases with an increasing level of schooling. Twenty percent of women age 15-19 with no schooling have already begun childbearing, compared with only 4 percent of women who had 12 or more years of schooling. x Childbearing among women age 15-19 decreases with the level of wealth. Only 3 percent of teenage women in the highest wealth quintile have begun childbearing, compared with 11 percent of teenage women in the lowest two wealth quintiles. x Teenage childbearing is higher among scheduled tribe women age 15-19 years (11%) than the other three caste/tribe groups. x More than half (52%) of currently married women age 15-19 have already begun childbearing. x Tripura (19%); West Bengal (18%); Assam (14%); and Bihar, Jharkhand, and Andhra Pradesh (12% each) have higher levels of teenage pregnancy than other states and union territories (Table 4.12 and Figure 4.6). Information on fertility preferences can help family planning programme planners assess the desire for children, the extent of mistimed and unwanted pregnancies, and the demand for contraception to space or limit births. This information may suggest the direction that fertility patterns will take in the future. This section presents information on whether and when married women and men want more children, ideal family size, whether the last birth was wanted at that time, and the theoretical fertility rate if all unwanted births were prevented. Fertility and Fertility Preferences z�83 4.8 DESIRE FOR ANOTHER CHILD Desire for another child Women and men were asked whether they wanted more children and, if so, how long they would prefer to wait before the next child. Women and men who are sterilized are assumed not to want any more children. Sample: Currently married women and men age 15-49 Nearly one in four (24%) currently married women age 15-49 want to have another child. Twelve percent of women want to have a child soon and 11 percent want to wait at least two years before having another child. Most other women want to limit childbearing: 32 percent want no more child and 36 percent are sterilized. Similar to women, a little over one in four (27%) currently married men age 15-49 want to have another child. Thirteen percent of men want to have another child soon and 12 percent want to wait at least two years before having another child, 64 percent want no more children, and 7 percent are sterilized (Table 4.13). Eighty-four percent of women with two living children (including those who are sterilized) do not want any more children (Table 4.14). 0.0 2.1 2.1 2.6 2.6 2.8 2.8 2.9 2.9 3.0 3.5 3.8 4.5 4.7 4.8 5.0 5.7 5.8 6.3 6.5 7.2 7.3 7.4 7.6 7.8 7.9 8.3 8.6 10 11 11 12 12 12 14 18 19 Lakshadweep Chandigarh Delhi Himachal Pradesh Punjab Uttarakhand Sikkim Jammu & Kashmir Goa Kerala Puducherry Uttar Pradesh Daman & Diu Andaman & Nicobar Islands Chhattisgarh Tamil Nadu Nagaland Haryana Rajasthan Gujarat Mizoram Madhya Pradesh Manipur Odisha Karnataka INDIA Maharashtra Meghalaya Dadra & Nagar Haveli Arunachal Pradesh Telangana Andhra Pradesh Jharkhand Bihar Assam West Bengal Tripura Figure 4.6 Teenage Childbearing by State/UT Percentage of women age 15-19 who have begun childbearing 84 z Fertility and Fertility Preferences Trends: The percentage of currently married women age 15-49 who want no more children (including women who were sterilized) was slightly higher in 2005-06 (71%) as in 2015-16 (68%). Patterns by background characteristics x The proportion of currently married women who want no more children increases with age. Only 26 percent of currently married women age 15-24 want no more children, compared with 68 percent in the age group 25-34 years and 87 percent age 35-49. x Seventy-six percent of Buddhist/Neo-Buddhist currently married women age 15-49 want no more children, compared with 62 percent of Muslim currently married women. x Sixty-three percent of currently married women age 15-49 with two living daugh- ters and no sons want no more children, compared with 89 percent with two sons and no daughters and the pattern is similar for men, indicating that son preference is still an important factor in overall fertility preferences in India (Figure 4.7). x The desire of women not to have any more children is relatively low in all the northeast states except Sikkim and Tripura, in Bihar (58%) in the East, Goa (61%) in the West, Jammu & Kashmir (62%) in the North, and Kerala (63%) in the South. Among the union territories, Lakshadweep has the lowest percentage of women (29%) desiring no more children (Table 4.15). 4.9 IDEAL FAMILY SIZE Ideal family size 5HVSRQGHQWV� ZLWK� QR� FKLOGUHQ�ZHUH� DVNHG�� ³,I� \RX� FRXOG� FKRRVH� H[DFWO\� WKH� QXPEHU� RI� FKLOGUHQ� WR� KDYH� LQ� \RXU� ZKROH� OLIH�� KRZ� PDQ\� ZRXOG� WKDW� EH"´� 5HVSRQGHQWV�ZKR�KDG�FKLOGUHQ�ZHUH�DVNHG��³,I�\RX�FRXOG�JR�EDFN�WR�WKH�WLPH� when you did not have any children and could choose exactly the number of FKLOGUHQ�WR�KDYH�LQ�\RXU�ZKROH�OLIH��KRZ�PDQ\�ZRXOG�WKDW�EH"´ Sample: Women and men age 15-49 If both men and women age 15-49 were given a chance to choose their family size, they would both want to have an average of 2.2 children (Table 4.16.1 and Table 4.16.2). The composition of the ideal family among women age 15-49 comprises an average of 1.1 ideal number of sons, 0.9 daughters, and 0.2 children of either of sex, which is the same as the current total fertility rate. About four-fifths (82%) of women age 15-49 want at least one son and a similar proportion (79%) want at least one daughter. Only 4 percent of women want to have more daughters than sons, whereas 19 percent want to have more sons than daughters. The mean ideal number of sons and daughters among men age 15-49 is almost the same as the mean ideal number of sons and daughters among women. Figure 4.7 Currently Married Women and Men Age 15-49 with Two Children Who Want No More Children by Number of Living Sons 89 92 87 89 63 64 Women Men 2 sons 1 son No son Percentage Fertility and Fertility Preferences z�85 Trends: The average ideal family size among women age 15-49 has declined only marginally, from 2.3 in 2005-06 to 2.2 in 2015-16. Patterns by background characteristics x Older women want somewhat larger families than younger women. The average ideal family size increases from 1.9 children among women age 15-19 to 2.4 children among women age 40-49. x Ideal family size declines with an increasing level of education among women. Women with no schooling consider 2.6 children to be their ideal number of children, compared with 1.8 children for women with 12 or more years of schooling. x The average ideal size of the family decreases with increasing wealth status. The mean ideal family size is 2.5 children among women in the lowest wealth quintile, compared with 2.0 children among women in the highest quintile. A similar pattern is observed among men 15-49. x Women in Mizoram (3.8); Meghalaya (3.4); Nagaland (3.1); Manipur (2.7); and Bihar, Lakshadweep, and Arunachal Pradesh (2.6 each) have the highest ideal number of children. Bihar (37%) and Uttar Pradesh (31%) have the highest proportion of women who want more sons than daughters in their ideal family size, and the lowest proportion (5%) is in Himachal Pradesh, Goa, and the Andaman & Nicobar Islands (Table 4.17). 4.10 FERTILITY PLANNING STATUS Planning status of birth Women reported whether their most recent birth was wanted at the time (planned birth), at a later time (mistimed birth), or not at all (unwanted birth). Sample: Current pregnancies and births in the five years before the survey to women age 15-49 Mothers reported that 91 percent of births in the five years preceding the survey (including current pregnancies were wanted at the time of conception, 5 percent were unwanted at the time of conception, and only 4 percent were mistimed or wanted at a later date (Table 4.18). Trends: The percentage of births that were wanted at the time increased from 79 percent in 2005-06 to 91 percent in 2015-16. Patterns by background characteristics x The more children a woman has, the more likely it is that her birth was unwanted. Only 1 percent of first-order births were unwanted, compared with 7 percent of third-order births and 17 percent of fourth or higher-order births. x The percentage of unwanted births increases with the mother’s age, ranging from 1 percent of births to women less than 20 years of age to 33 percent of births to women age 45-49. 86 z Fertility and Fertility Preferences 4.11 WANTED FERTILITY RATES Unwanted birth Any birth in excess of the number of children a woman reported as her ideal number. Wanted birth Any birth less than or equal to the number of children a woman reported as her ideal number. Wanted fertility rate The average number of children a woman would have by the end of her childbearing years if she bore children at the current age-VSHFL¿F�IHUWLOLW\�UDWHV�� excluding unwanted births. Sample: Women age 15-49 The total wanted fertility rate indicates the level of fertility that would result if all unwanted births were prevented. The total wanted fertility rate in India is 1.8 children per woman, compared with the actual fertility rate of 2.2 children (Table 4.19). Trends: The total wanted fertility rate in India was almost the same in 2005-06 (1.9 children) and 2015-16 (1.8 children). The gap between the actual and wanted fertility rates, however, has declined by half (from 0.8 in 2005-06 to 0.4 in 2015-16) (Figure 4.8). Patterns by background characteristics x The gap between the actual and wanted fertility rate is 0.5 children among women age 15-49 in rural areas, compared with 0.3 children among women in urban areas. x The total wanted fertility rate of women with no schooling is 2.3 children, compared with only 1.5 children for women with 12 or more years of schooling. The gap between the actual and wanted fertility rates is much higher among women with no schooling (0.8) than women with 12 or more years of schooling (0.2). x Household wealth status not only affects wanted fertility but also affects the gap between the actual and wanted fertility rates. The level of wanted fertility declines with rising levels of wealth, as does the gap between actual and wanted fertility. The wanted fertility rate is 2.3 children among women in the lowest wealth quintile and 1.4 children among women in the highest quintile. The gap between actual and wanted fertility 0.9 children for women in the lowest wealth quintile, but only 0.1 children for women in the highest quintile. x In India, only five states have a wanted fertility rate above the replacement level of fertility—Meghalaya (2.8), Bihar (2.5), Manipur and Nagaland (2.3 each), and Mizoram (2.2) (Table 4.20). x The gap between the actual and wanted fertility rate is more than 0.5 children only in Bihar (0.9) and in Rajasthan and Uttar Pradesh (0.6% each). 1.9 1.8 0.8 0.4 2.7 2.2 NFHS-3 NFHS-4 Total fertility rate Difference Total wanted fertility rate Figure 4.8 Trends in Wanted and Actual Fertility Fertility and Fertility Preferences z�87 LIST OF TABLES For more information on fertility levels and fertility preferences, see the following tables: Tables Table 4.1 Current fertility Table 4.2 Fertility by background characteristics Table 4.3 Fertility by state/union territory Table 4.4 Age-specific fertility rates Table 4.5 Children ever born and living Table 4.6 Birth order Table 4.7 Birth intervals Table 4.8 Age at first birth Table 4.9 Median age at first birth Table 4.10 Menstrual protection Table 4.11 Teenage pregnancy and motherhood Table 4.12 Teenage pregnancy and motherhood by state/union territory Table 4.13 Fertility preferences by number of living children Table 4.14 Desire to limit childbearing Table 4.15 Desire to limit childbearing by state/union territory Table 4.16.1 Indicators of sex preference: Women Table 4.16.2 Indicators of sex preference: Men Table 4.17 Indicators of sex preference by state/union territory Table 4.18 Fertility planning status Table 4.19 Wanted fertility rates Table 4.20 Wanted fertility rates by state/union territory 88 z Fertility and Fertility Preferences Table 4.1 Current fertility Age-specific and total fertility rates and crude birth rates from NFHS-4, NFHS-3, NFHS-2, and NFHS-1 by residence, India Age NFHS-4 NFHS-3 NFHS-2 NFHS-1 Urban Rural Total Urban Rural Total Urban Rural Total Urban Rural Total 15-19 0.035 0.059 0.051 0.057 0.105 0.090 0.068 0.121 0.107 0.075 0.131 0.116 20-24 0.142 0.205 0.184 0.166 0.231 0.209 0.179 0.222 0.210 0.203 0.243 0.231 25-29 0.114 0.135 0.128 0.123 0.146 0.139 0.127 0.150 0.143 0.154 0.177 0.170 30-34 0.044 0.055 0.051 0.048 0.069 0.062 0.057 0.075 0.069 0.071 0.108 0.097 35-39 0.012 0.020 0.017 0.013 0.031 0.025 0.018 0.033 0.028 0.027 0.051 0.044 40-44 0.002 0.005 0.004 0.004 0.009 0.007 0.003 0.011 0.008 0.006 0.019 0.015 45-49 0.000 0.002 0.001 0.001 0.004 0.003 0.001 0.004 0.003 0.004 0.006 0.005 TFR (15-49) 1.75 2.41 2.18 2.06 2.98 2.68 2.27 3.07 2.85 2.70 3.67 3.39 CBR 15.8 20.7 19.0 18.8 25.0 23.1 20.9 26.2 24.8 24.1 30.4 28.7 Note: Rates are for the period 1-36 months preceding the survey (approximately 1990-92 for NFHS-1, 1996-98 for NFHS-2, 2003-05 for NFHS-3, and 2013-15 for NFHS-4). Age-specific fertility rates are expressed per woman. Rates for the age group 45-49 might be slightly biased due to truncation. TFR = Total fertility rate, expressed per woman CBR = Crude birth rate, expressed per 1,000 population Fertility and Fertility Preferences z�89 Table 4.2 Fertility by background characteristics Total fertility rate for the three years preceding the survey, percentage of women age 15-49 currently pregnant, and mean number of children ever born to women age 40-49 by background characteristics, India, 2015-16 Background characteristic Total fertility rate Percentage currently pregnant Mean number of children ever born to women age 40-49 Residence Urban 1.75 3.7 2.74 Rural 2.41 4.9 3.50 Schooling No schooling 3.07 4.0 3.82 <5 years complete 2.43 3.8 3.16 5-7 years complete 2.38 4.8 2.97 8-9 years complete 2.19 4.8 2.65 10-11 years complete 1.99 4.0 2.33 12 or more years complete 1.71 5.0 2.01 Religion Hindu 2.13 4.3 3.13 Muslim 2.62 5.6 4.15 Christian 1.99 3.9 2.65 Sikh 1.58 3.8 2.62 Buddhist/Neo-Buddhist 1.74 3.8 2.93 Jain 1.20 1.9 2.24 Other 2.57 6.0 3.79 Caste/tribe Scheduled caste 2.26 4.7 3.48 Scheduled tribe 2.48 4.6 3.52 Other backward class 2.22 4.6 3.28 Other 1.93 3.9 2.87 Don't know 2.81 5.3 3.31 Wealth index Lowest 3.17 5.8 4.28 Second 2.45 4.9 3.68 Middle 2.07 4.4 3.22 Fourth 1.84 3.8 2.84 Highest 1.54 3.5 2.49 Total 2.18 4.4 3.22 Note: Total fertility rates are for the period 1-36 months preceding the interview. 90 z Fertility and Fertility Preferences Table 4.3 Fertility by state/union territory Age-specific and total fertility rates (TFRs), and crude birth rates for NFHS-4, and TFRs for NFHS-3 and NFHS-2, for the three-year period preceding the survey, according to state/union territory, India, 2015-16 State/union territory NFHS-4 age-specific fertility rates Total fertility rate 15-49 NFHS-4 crude birth rate 15-19 20-24 25-29 30-34 35-39 40-44 45-49 NFHS-4 NFHS-3 NFHS-2 ,QGLD� 0.051 0.184 0.128 0.051 0.017 0.004 0.001 2.18 2.68 2.85 19.0 1RUWK Chandigarh 0.020 0.106 0.118 0.044 0.027 0.000 (0.000) 1.57 na na 14.0 Delhi 0.021 0.125 0.132 0.051 0.023 0.003 0.000 1.78 2.13 2.40 16.4 Haryana 0.041 0.189 0.123 0.040 0.012 0.005 0.002 2.05 2.69 2.88 18.7 Himachal Pradesh 0.025 0.154 0.130 0.050 0.011 0.004 0.001 1.88 1.94 2.14 15.3 Jammu & Kashmir 0.019 0.113 0.142 0.090 0.028 0.007 0.003 2.01 2.38 2.71 17.7 Punjab 0.020 0.123 0.120 0.045 0.014 0.002 0.000 1.62 1.99 2.21 13.8 Rajasthan 0.046 0.211 0.140 0.055 0.018 0.007 0.003 2.40 3.21 3.78 20.8 Uttarakhand 0.023 0.175 0.137 0.058 0.016 0.003 0.003 2.07 2.55 2.61 19.0 &HQWUDO Chhattisgarh 0.036 0.196 0.133 0.058 0.018 0.004 0.001 2.23 2.62 2.79 20.7 Madhya Pradesh 0.053 0.220 0.126 0.046 0.014 0.004 0.001 2.32 3.12 3.43 20.2 Uttar Pradesh 0.028 0.198 0.186 0.087 0.036 0.009 0.003 2.74 3.82 4.06 22.6 (DVW Bihar 0.077 0.273 0.185 0.091 0.038 0.012 0.005 3.41 4.00 3.70 27.0 Jharkhand 0.077 0.214 0.131 0.058 0.019 0.007 0.002 2.55 3.31 2.76 21.7 Odisha 0.046 0.156 0.128 0.055 0.018 0.005 0.002 2.05 2.37 2.46 18.1 West Bengal 0.090 0.147 0.077 0.031 0.007 0.001 0.000 1.77 2.27 2.29 16.6 1RUWKHDVW Arunachal Pradesh 0.056 0.130 0.116 0.067 0.032 0.016 0.004 2.10 3.03 2.52 17.8 Assam 0.072 0.151 0.120 0.065 0.025 0.007 0.002 2.21 2.42 2.31 19.5 Manipur 0.043 0.144 0.146 0.117 0.056 0.015 0.001 2.61 2.83 3.04 21.2 Meghalaya 0.048 0.151 0.165 0.123 0.083 0.030 0.009 3.04 3.80 4.57 24.6 Mizoram 0.038 0.124 0.129 0.095 0.049 0.016 0.002 2.27 2.86 2.89 18.8 Nagaland 0.042 0.150 0.154 0.110 0.063 0.021 0.008 2.74 3.74 3.77 21.4 Sikkim 0.022 0.079 0.070 0.046 0.017 0.001 0.000 1.17 2.02 2.75 11.4 Tripura 0.082 0.118 0.083 0.036 0.015 0.001 0.000 1.68 2.22 1.87 15.3 :HVW Dadra & Nagar Haveli 0.066 0.181 0.113 0.066 0.022 (0.007) * 2.32 na na 20.7 Daman & Diu 0.028 0.134 0.100 0.061 0.009 0.004 (0.000) 1.68 na na 13.3 Goa 0.016 0.074 0.122 0.074 0.036 0.006 0.004 1.66 1.79 1.77 12.8 Gujarat 0.041 0.170 0.131 0.045 0.014 0.002 0.001 2.03 2.42 2.72 16.7 Maharashtra 0.059 0.179 0.096 0.030 0.009 0.001 0.000 1.87 2.11 2.52 16.6 6RXWK Andaman & Nicobar Islands 0.028 0.124 0.086 0.033 0.017 0.000 0.000 1.44 na na 13.3 Andhra Pradesh 0.083 0.184 0.075 0.019 0.004 0.000 0.000 1.83 na na 16.1 Karnataka 0.051 0.167 0.102 0.031 0.008 0.001 0.000 1.80 2.07 2.13 15.9 Kerala 0.021 0.110 0.117 0.048 0.013 0.001 0.001 1.56 1.93 1.96 11.2 Lakshadweep 0.008 0.065 0.146 0.083 0.051 0.010 (0.000) 1.82 na na 16.3 Puducherry 0.023 0.150 0.114 0.042 0.006 0.003 0.000 1.70 na na 15.9 Tamil Nadu 0.039 0.152 0.113 0.031 0.005 0.001 0.000 1.70 1.80 2.19 15.5 Telangana 0.067 0.176 0.089 0.017 0.005 0.001 0.002 1.78 na na 17.1 Note: Rates are for the period 1-36 months preceding the survey (approximately 1990-92 for NFHS-1, 1996-98 for NFHS-2, 2003-05 for NFHS-3, and 2013-15 for NFHS-4). na = Not available ( ) Based on 125-249 unweighted woman-years of exposure * Not shown; based on fewer than 125 unweighted woman-years of exposure Fertility and Fertility Preferences z�91 Table 4.4 Age-specific fertility rates Age-specific fertility rates for five-year periods preceding the survey by mother's age at the time of the birth, according to residence, India, 2015-16 Age Number of years preceding survey 0-4 5-9 10-14 15-19 URBAN 15-19 0.040 0.057 0.078 0.091 20-24 0.147 0.166 0.186 0.201 25-29 0.115 0.122 0.134 0.154 30-34 0.046 0.048 0.063 [0.083] 35-39 0.013 0.015 [0.026] na 40-44 0.002 [0.005] na na 45-49 [0.000] na na na RURAL 15-19 0.063 0.087 0.114 0.122 20-24 0.207 0.220 0.233 0.243 25-29 0.138 0.152 0.169 0.189 30-34 0.058 0.072 0.097 [0.127] 35-39 0.021 0.034 [0.057] na 40-44 0.007 [0.016] na na 45-49 [0.002] na na na TOTAL 15-19 0.055 0.077 0.101 0.111 20-24 0.187 0.200 0.216 0.227 25-29 0.130 0.141 0.156 0.176 30-34 0.053 0.063 0.084 [0.111] 35-39 0.018 0.027 [0.045] na 40-44 0.005 [0.012] na na 45-49 [0.002] na na na Note: Age-specific fertility rates are expressed per woman. Estimates in brackets are truncated. Rates exclude the month of interview. na = Not available 92 z Fertility and Fertility Preferences Ta bl e 4. 5 C hi ld re n ev er b or n an d liv in g Pe rc en t d ist rib ut io n of a ll w om en a nd c ur re nt ly m ar rie d w om en b y nu m be r o f c hi ld re n ev er b or n (C EB ), an d m ea n nu m be r o f c hi ld re n ev er b or n an d liv in g, a cc or di ng to a ge , I nd ia , 20 15 -1 6 Ag e N um be r o f c hi ld re n ev er b or n To ta l N um be r of w om en M ea n nu m be r o f C EB M ea n nu m be r of li vi ng ch ild re n 0 1 2 3 4 5 6 7 8 9 10 + AL L W O M EN 15 -1 9 94 .8 4. 5 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 12 1, 55 2 0. 06 0. 06 20 -2 4 50 .8 27 .0 17 .4 4. 0 0. 6 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 12 2, 96 6 0. 77 0. 73 25 -2 9 17 .0 22 .4 36 .4 16 .7 5. 6 1. 5 0. 3 0. 1 0. 0 0. 0 0. 0 10 0. 0 11 5, 04 3 1. 78 1. 69 30 -3 4 6. 5 13 .6 38 .1 23 .4 11 .0 4. 7 1. 9 0. 6 0. 1 0. 1 0. 0 10 0. 0 96 ,7 69 2. 45 2. 30 35 -3 9 4. 3 9. 6 35 .4 24 .6 13 .4 6. 9 3. 4 1. 5 0. 6 0. 3 0. 1 10 0. 0 90 ,8 90 2. 81 2. 62 40 -4 4 3. 6 8. 3 30 .2 24 .7 15 .1 8. 6 4. 9 2. 5 1. 2 0. 6 0. 3 10 0. 0 77 ,9 69 3. 11 2. 86 45 -4 9 3. 6 8. 5 25 .1 24 .4 16 .0 9. 6 5. 9 3. 4 1. 9 0. 9 0. 7 10 0. 0 74 ,4 97 3. 34 3. 02 To ta l 30 .5 14 .2 25 .1 15 .2 7. 7 3. 8 1. 9 0. 9 0. 4 0. 2 0. 1 10 0. 0 69 9, 68 6 1. 84 1. 72 C U RR EN TL Y M AR RI ED W O M EN 15 -1 9 66 .3 29 .1 4. 3 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 18 ,4 93 0. 39 0. 36 20 -2 4 25 .7 40 .7 26 .4 6. 1 1. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 80 ,2 74 1. 16 1. 11 25 -2 9 9. 0 24 .2 40 .1 18 .4 6. 2 1. 6 0. 4 0. 1 0. 0 0. 0 0. 0 10 0. 0 10 2, 70 4 1. 95 1. 86 30 -3 4 3. 8 13 .5 39 .3 24 .2 11 .5 4. 9 2. 0 0. 6 0. 1 0. 1 0. 0 10 0. 0 90 ,9 01 2. 53 2. 38 35 -3 9 2. 7 9. 1 36 .0 25 .1 13 .8 7. 2 3. 5 1. 6 0. 6 0. 3 0. 1 10 0. 0 84 ,1 85 2. 88 2. 69 40 -4 4 2. 1 7. 7 30 .7 25 .2 15 .5 9. 0 5. 0 2. 6 1. 3 0. 6 0. 4 10 0. 0 70 ,1 98 3. 19 2. 94 45 -4 9 2. 3 7. 7 25 .4 24 .8 16 .4 10 .0 6. 2 3. 6 2. 0 1. 0 0. 7 10 0. 0 64 ,6 19 3. 43 3. 11 To ta l 9. 9 18 .2 32 .7 19 .7 9. 9 4. 9 2. 5 1. 2 0. 6 0. 3 0. 2 10 0. 0 51 1, 37 3 2. 39 2. 22 Fertility and Fertility Preferences z�93 Table 4.6 Birth order Percent distribution of births to all women during the three years preceding the survey by birth order, according to background characteristics, India, 2015-16, and percent distribution of births to women by birth order, NFHS-3 Background characteristic Birth order Total Number of births 1 2 3 4+ Mother's current age 15-19 87.7 11.5 0.7 0.1 100.0 6,539 20-29 43.2 35.7 14.5 6.5 100.0 110,771 30-39 13.2 26.6 20.7 39.4 100.0 28,165 40-49 6.0 9.8 10.6 73.7 100.0 2,122 Residence Urban 43.5 35.7 12.6 8.2 100.0 40,792 Rural 37.2 31.3 16.0 15.5 100.0 106,805 Mother's schooling No schooling 21.8 25.8 21.2 31.3 100.0 41,628 <5 years complete 28.9 32.4 20.7 18.0 100.0 8,391 5-7 years complete 35.0 36.6 17.4 11.1 100.0 23,708 8-9 years complete 44.2 34.9 14.4 6.5 100.0 24,974 10-11 years complete 48.2 37.7 10.6 3.5 100.0 18,536 12 or more years complete 58.5 33.6 6.4 1.5 100.0 30,361 Religion Hindu 39.8 33.4 14.7 12.1 100.0 115,966 Muslim 33.3 28.5 16.9 21.3 100.0 24,587 Christian 40.5 34.8 13.1 11.6 100.0 3,019 Sikh 51.0 32.8 11.2 5.0 100.0 1,822 Buddhist/Neo-Buddhist 46.2 37.6 13.6 2.6 100.0 1,098 Jain 53.4 30.3 14.4 1.9 100.0 135 Other 39.0 26.8 16.9 17.3 100.0 970 Caste/tribe Scheduled caste 37.3 31.9 15.9 14.9 100.0 31,850 Scheduled tribe 36.2 30.5 16.7 16.5 100.0 15,625 Other backward class 38.4 32.9 15.1 13.6 100.0 65,007 Other 43.0 33.3 13.4 10.4 100.0 33,798 Don't know 35.3 34.4 14.1 16.2 100.0 1,318 Wealth index Lowest 27.4 26.3 19.4 26.9 100.0 36,649 Second 35.9 31.6 17.3 15.2 100.0 32,494 Middle 41.2 34.7 14.7 9.4 100.0 29,711 Fourth 45.5 37.0 11.5 6.0 100.0 26,956 Highest 51.8 36.1 8.9 3.2 100.0 21,788 Total 39.0 32.6 15.0 13.5 100.0 147,598 NFHS-3 (2005-06) 31.2 27.7 16.0 25.1 100.0 33,104 94 z Fertility and Fertility Preferences � � 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����� �� � � � � � � � � � 6H[�RI�SUHFHGLQJ�ELUWK� � � � � � � � � � 0DOH�� ����� ����� ����� ����� ���� ����� ������ ������� ����� )HPDOH�� ����� ����� ����� ����� ���� ����� ������ ������� ����� �� � � � � � � � � � 6XUYLYDO�RI�SUHFHGLQJ�ELUWK� � � � � � � � � � /LYLQJ�� ���� ����� ����� ����� ����� ����� ������ �������� ����� 'HDG�� ����� ����� ����� ����� ���� ���� ������ ������� ����� �� � � � � � � � � � 7RWDO� ����� ����� ����� ����� ���� ����� ������ �������� ����� 1RWH��)LUVW�RUGHU�ELUWKV�DUH�H[FOXGHG�IURP�WKH�WDEOH��7KH�LQWHUYDO�IRU�PXOWLSOH�ELUWKV�LV�WKH�QXPEHU�RI�PRQWKV�VLQFH�WKH�SUHFHGLQJ�SUHJQDQF\�WKDW�HQGHG�LQ�D�OLYH� ELUWK��� Fertility and Fertility Preferences z�95 Table 4.8 Age at first birth Percentage of women who gave birth by specific exact ages and who have never given birth and median age at first birth by current age, India, 2015-16 Current age Percentage who gave birth by exact age: Percentage who have never given birth Number of women Median age at first birth 15 18 20 22 25 15-19 0.2 na na na na 94.8 121,552 a 20-24 1.0 9.3 26.1 na na 50.8 122,966 a 25-29 2.6 15.5 33.9 53.6 74.7 17.0 115,043 21.6 30-34 3.8 20.1 40.5 59.6 78.7 6.5 96,769 20.9 35-39 4.6 21.6 42.0 62.0 80.6 4.3 90,890 20.7 40-44 5.0 22.9 43.2 63.0 81.8 3.6 77,969 20.6 45-49 4.2 20.3 39.4 59.3 79.5 3.6 74,497 21.0 15-49 2.8 15.0 31.1 46.8 60.8 30.5 699,686 a 20-49 3.3 17.5 36.6 na na 16.9 578,134 a 25-49 3.9 19.7 39.4 59.1 78.7 7.8 455,168 21.0 na = Not applicable a = Not calculated because less than 50 percent of women had a birth before reaching the beginning of the age group 96 z Fertility and Fertility Preferences Table 4.9 Median age at first birth Median age at first birth among women age 25-49 years by current age according to background characteristics, India, 2015-16 Background characteristic Current age 25-49 25-29 30-34 35-39 40-44 45-49 Residence Urban 23.0 22.0 21.4 21.2 21.5 21.9 Rural 21.0 20.5 20.4 20.3 20.7 20.6 Schooling No schooling 20.1 19.7 19.8 19.8 20.4 20.0 <5 years complete 19.8 19.6 19.7 19.8 20.1 19.8 5-7 years complete 20.4 20.0 20.0 20.1 20.6 20.2 8-9 years complete 21.1 20.9 21.0 20.9 21.4 21.0 10-11 years complete 21.7 21.5 21.6 21.8 22.4 21.7 12 or more years complete a 24.6 24.5 24.3 24.8 24.7 Religion Hindu 21.6 20.9 20.7 20.6 20.9 21.0 Muslim 21.3 20.5 20.4 20.2 20.5 20.6 Christian 23.7 22.9 22.4 22.8 22.8 22.9 Sikh 23.8 22.7 22.2 22.3 22.5 22.7 Buddhist/Neo-Buddhist 22.5 22.0 20.3 20.2 21.3 21.2 Jain 23.2 23.7 24.1 22.6 22.7 23.3 Other 20.2 19.8 21.0 20.8 20.6 20.4 Caste/tribe Scheduled caste 21.3 20.5 20.2 20.1 20.6 20.6 Scheduled tribe 21.0 20.5 20.5 20.4 21.0 20.7 Other backward class 21.5 20.8 20.7 20.6 20.9 20.9 Other 22.3 21.7 21.4 21.1 21.4 21.6 Don't know 20.4 20.3 20.2 20.1 20.7 20.3 Wealth index Lowest 20.3 20.0 20.4 20.6 21.3 20.4 Second 20.6 20.0 20.0 20.1 20.7 20.3 Middle 21.0 20.3 20.2 20.1 20.5 20.5 Fourth 22.1 21.2 20.7 20.6 20.7 21.1 Highest 24.4 23.1 22.4 21.8 21.8 22.8 Total 21.6 20.9 20.7 20.6 21.0 21.0 a = Not calculated because less than 50 percent of women had a birth before reaching the beginning of the age group Fertility and Fertility Preferences z�97 Table 4.10 Menstrual protection Percentage of women age 15-24 who have ever menstruated by type of protection used during their menstrual period, according to background characteristics, India, 2015-16 Background characteristic Type of menstrual protection1 Percentage using a hygienic method2 Number of women Cloth Locally prepared napkins Sanitary napkins Tampons Other Nothing Age 15-19 61.9 16.4 41.8 2.4 0.1 0.4 57.7 121,552 20-24 62.4 16.1 41.8 2.4 0.1 0.5 57.4 122,966 Residence Urban 42.6 19.5 59.2 3.4 0.1 0.3 77.5 78,417 Rural 71.4 14.8 33.6 1.9 0.1 0.6 48.2 166,100 Schooling No schooling 88.8 6.8 13.0 1.0 0.1 1.1 19.9 25,324 <5 years complete 83.8 8.8 18.0 1.6 0.1 1.0 27.5 8,728 5-7 years complete 77.7 12.3 25.1 1.4 0.1 0.6 37.6 30,573 8-9 years complete 69.7 14.8 35.1 2.0 0.1 0.4 49.9 56,890 10-11 years complete 54.2 18.9 51.0 2.6 0.1 0.3 69.2 51,587 12 or more years complete 43.1 21.5 60.7 3.5 0.0 0.3 80.9 71,415 Religion Hindu 61.7 16.5 41.3 2.4 0.1 0.5 57.3 193,486 Muslim 67.7 14.8 39.1 2.3 0.1 0.7 53.9 38,738 Christian 47.4 15.5 60.9 2.9 0.1 0.2 74.9 4,926 Sikh 50.8 17.9 68.5 0.7 0.0 0.0 83.0 3,556 Buddhist/Neo-Buddhist 46.0 19.6 52.4 2.6 0.6 0.1 69.1 2,136 Jain 37.6 30.4 64.4 6.5 0.0 0.0 88.7 318 Other 76.5 11.7 28.7 10.4 0.6 0.1 48.3 1,358 Caste/tribe Scheduled caste 64.7 15.4 39.4 2.2 0.1 0.4 54.5 51,700 Scheduled tribe 75.4 12.3 28.0 1.7 0.1 0.7 40.3 23,286 Other backward class 63.0 16.7 41.1 2.4 0.1 0.5 57.3 107,138 Other 53.4 18.0 50.4 2.9 0.1 0.4 67.6 60,760 Don't know 61.7 10.6 37.8 2.7 0.3 1.8 47.5 1,634 Wealth index Lowest 88.4 7.6 13.2 0.9 0.1 0.7 21.1 44,923 Second 78.1 13.5 27.2 1.7 0.1 0.6 41.3 51,863 Middle 63.1 18.4 42.3 2.5 0.1 0.4 60.4 52,521 Fourth 48.5 21.3 55.9 3.2 0.0 0.3 76.2 50,556 Highest 31.5 20.1 70.8 3.8 0.1 0.2 88.8 44,654 Total 62.1 16.3 41.8 2.4 0.1 0.5 57.6 244,518 Note: Table is based on women age 15-24 who have ever menstruated. 1 Respondents may report multiple methods so the sum may exceed 100 percent 2 Locally prepared napkins, sanitary napkins, and tampons are considered to be hygienic methods of protection 98 z Fertility and Fertility Preferences Table 4.11 Teenage pregnancy and motherhood Percentage of women age 15-19 who have had a live birth or who are pregnant with their first child, and percentage who have begun childbearing, by background characteristics, India, 2015-16 Background characteristic Percentage of women age 15-19 who: Percentage of women age 15-19 who have begun childbearing Number of women Have had a live birth Are pregnant with first child Residence Urban 3.3 1.7 5.0 36,932 Rural 6.0 3.2 9.2 84,620 Schooling No schooling 14.0 6.2 20.2 8,398 <5 years complete 10.6 4.9 15.5 3,513 5-7 years complete 8.8 4.4 13.2 13,733 8-9 years complete 4.8 2.5 7.2 36,519 10-11 years complete 3.4 1.9 5.3 35,230 12 or more years complete 2.5 1.9 4.4 24,159 Marital status Never married 0.0 0.0 0.0 102,840 Currently married 33.7 17.8 51.5 18,493 Widowed/divorced/ separated/deserted 30.3 3.3 33.6 219 Religion Hindu 5.1 2.7 7.8 95,862 Muslim 5.9 3.1 9.0 19,918 Christian 4.6 1.8 6.4 2,391 Sikh 1.8 0.9 2.6 1,575 Buddhist/Neo-Buddhist 6.0 1.4 7.4 978 Jain 1.2 0.0 1.2 150 Other 11.8 5.4 17.3 678 Caste/tribe Scheduled caste 5.7 3.0 8.8 25,911 Scheduled tribe 7.6 3.0 10.5 11,609 Other backward class 4.4 2.6 7.0 54,029 Other 5.0 2.5 7.5 29,237 Don't know 12.3 5.1 17.5 766 Wealth index Lowest 7.0 3.6 10.6 25,257 Second 7.1 3.5 10.6 27,378 Middle 5.6 2.8 8.3 25,999 Fourth 3.6 2.2 5.9 23,379 Highest 1.5 1.1 2.5 19,540 Total 5.2 2.7 7.9 121,552 Fertility and Fertility Preferences z�99 Table 4.12 Teenage pregnancy and motherhood by state/union territory Percentage of women age 15-19 who have had a live birth or who are pregnant with their first child, and percentage who have begun childbearing, by state/union territory, India, 2015-16 State/union territory Percentage of women age 15-19 who: Percentage of women age 15-19 who have begun childbearing Have had a live birth Are pregnant with first child India 5.2 2.7 7.9 North Chandigarh 0.9 1.1 2.1 Delhi 1.1 1.0 2.1 Haryana 3.4 2.5 5.8 Himachal Pradesh 1.8 0.7 2.6 Jammu & Kashmir 2.1 0.8 2.9 Punjab 1.8 0.8 2.6 Rajasthan 3.9 2.5 6.3 Uttarakhand 1.4 1.4 2.8 Central Chhattisgarh 3.1 1.7 4.8 Madhya Pradesh 4.5 2.8 7.3 Uttar Pradesh 2.0 1.8 3.8 East Bihar 7.4 4.8 12.2 Jharkhand 8.6 3.3 11.9 Odisha 5.4 2.2 7.6 West Bengal 12.8 5.5 18.3 Northeast Arunachal Pradesh 8.1 2.4 10.5 Assam 10.1 3.5 13.6 Manipur 4.7 2.7 7.4 Meghalaya 5.8 2.8 8.6 Mizoram 5.1 2.0 7.2 Nagaland 4.1 1.7 5.7 Sikkim 2.2 0.6 2.8 Tripura 13.4 5.4 18.8 West Dadra & Nagar Haveli 6.8 3.5 10.2 Daman & Diu 3.0 1.5 4.5 Goa 2.0 0.9 2.9 Gujarat 4.5 2.0 6.5 Maharashtra 5.9 2.5 8.3 South Andaman & Nicobar Islands 2.6 2.1 4.7 Andhra Pradesh 8.6 3.2 11.8 Karnataka 4.8 2.9 7.8 Kerala 1.7 1.3 3.0 Lakshadweep 0.0 0.0 0.0 Puducherry 2.0 1.5 3.5 Tamil Nadu 3.2 1.8 5.0 Telangana 7.7 2.9 10.5 100 z Fertility and Fertility Preferences Table 4.13 Fertility preferences by number of living children Percent distribution of currently married women and men age 15-49 by desire for children, according to number of living children, India, 2015-16 Desire for children Number of living children Total 0 1 2 3 4 5 6+ WOMEN1 Want another soon2 66.8 22.5 4.6 2.5 1.8 1.6 1.4 12.2 Want another later3 13.4 36.7 4.8 2.2 1.3 0.8 0.5 10.7 Want another, undecided when 2.7 2.3 0.4 0.2 0.3 0.2 0.3 0.9 Undecided 2.9 5.2 2.3 1.7 1.6 1.8 1.9 2.7 Want no more 4.8 21.8 36.0 34.7 40.4 47.3 59.0 31.9 Sterilized4 0.8 7.6 47.6 53.4 48.4 40.7 28.1 36.3 Declared infecund 8.5 3.9 4.3 5.3 6.3 7.5 8.7 5.2 Missing 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of respondents 40,256 102,792 181,933 104,043 46,869 20,584 14,896 511,373 MEN5 Want another soon2 46.4 24.8 5.4 3.4 2.6 2.3 2.6 13.0 Want another later3 17.8 36.3 6.1 3.0 2.8 1.7 1.8 12.4 Want another, undecided when 2.7 2.4 0.5 0.4 0.5 0.2 0.8 1.1 Undecided 4.2 4.4 2.0 1.5 1.5 1.6 2.0 2.6 Want no more 22.7 29.8 77.6 82.7 84.6 86.1 87.0 63.9 Sterilized4 6.3 2.4 8.4 9.0 7.7 8.0 5.8 6.9 Declared infecund 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Missing 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of respondents 6,848 12,745 22,373 11,640 5,234 2,132 1,527 62,499 1 Includes current pregnancy of woman 2 Want next birth within 2 years 3 Want to delay next birth for 2 or more years 4 For women: Includes both female and male sterilization and women who have had a hysterectomy For men: Includes male sterilization and men who mention in response to the question about desire for children that their wife has been is sterilized 5 The number of living children includes one additional child if the respondent's wife is pregnant (or if any wife is pregnant for men with more than one current wife). Fertility and Fertility Preferences z�101 Table 4.14 Desire to limit childbearing Percentage of currently married women and men age 15-49 who want no more children by number of living children, according to background characteristics, India, 2015-16 , and by number of living children, NFHS-3 Background characteristic Women: Number of living children1 Total Men: Number of living children1 Total 0 1 2 3 4+ 0 1 2 3 4+ Age 15-24 2.2 10.3 65.4 73.9 79.0 26.4 7.8 11.8 55.3 70.4 (74.6) 19.1 25-34 4.8 27.2 82.7 85.2 84.8 68.1 16.7 18.7 76.3 82.3 82.9 52.7 35-49 21.3 73.0 90.8 91.4 89.6 87.1 50.0 61.0 92.5 94.9 94.1 87.1 Residence Urban 5.8 36.4 86.8 90.5 90.6 69.5 25.4 36.7 86.2 92.4 92.4 68.7 Rural 5.4 24.8 81.6 87.0 87.6 67.5 24.6 27.8 84.9 90.5 92.1 70.4 Schooling No schooling 9.8 34.2 79.1 86.9 88.2 76.3 37.1 36.4 82.8 90.3 92.0 78.0 <5 years complete 8.3 33.2 84.8 89.2 88.6 75.5 38.3 31.2 84.7 91.7 91.0 76.6 5-7 years complete 5.2 29.1 84.2 89.3 88.4 71.1 28.5 28.0 84.7 90.9 92.2 72.2 8-9 years complete 4.5 26.5 84.2 88.9 88.3 64.3 21.9 27.1 84.3 90.2 93.0 68.3 10-11 years complete 4.1 29.3 86.0 87.8 88.9 63.8 22.5 31.9 87.3 92.3 93.3 69.1 12 or more years complete 3.9 28.0 85.4 89.4 88.0 53.7 19.0 34.0 86.6 92.2 91.3 62.3 Religion Hindu 5.7 31.0 85.0 88.9 89.1 69.2 25.6 33.4 86.9 92.4 93.6 70.9 Muslim 4.4 16.5 69.5 82.3 86.0 61.9 18.3 17.6 70.7 83.3 88.9 63.0 Christian 7.7 27.3 82.3 83.8 77.5 64.9 41.6 29.1 82.1 86.1 73.8 67.0 Sikh 4.0 40.6 90.1 94.0 92.9 74.2 12.2 45.3 93.3 94.4 88.1 74.1 Buddhist/Neo-Buddhist 4.7 36.9 90.7 96.3 95.3 75.7 22.4 23.8 87.1 97.6 94.0 70.1 Jain 7.4 49.0 90.4 93.6 (83.6) 75.2 * * (94.1) * * 75.2 Other 8.5 14.9 71.3 82.1 84.3 57.6 22.2 9.8 84.3 89.3 82.9 57.7 Caste/tribe Scheduled caste 5.3 25.3 83.3 89.1 90.0 68.8 28.4 30.0 84.3 92.4 94.7 70.4 Scheduled tribe 5.7 22.2 77.2 86.1 86.8 64.6 26.3 21.0 80.7 89.0 90.4 66.7 Other backward class 5.7 26.6 82.9 87.3 87.5 67.8 24.5 30.7 84.9 90.7 92.3 70.2 Other 5.6 37.7 86.6 89.2 89.1 69.7 21.8 36.9 88.1 91.9 90.1 69.9 Don't know 5.2 26.0 81.5 87.4 85.3 65.4 * (24.0) (72.2) (75.0) (82.2) 58.4 Wealth index Lowest 5.7 18.2 71.1 83.1 86.4 65.6 28.2 21.8 75.6 86.5 91.1 70.2 Second 5.8 23.2 80.2 87.3 88.4 67.8 24.1 27.1 81.6 90.7 93.4 70.2 Middle 5.6 27.9 84.4 89.1 89.4 69.1 27.7 28.5 85.5 92.1 92.4 70.7 Fourth 5.0 32.1 86.2 90.2 90.2 69.2 24.9 32.7 88.1 92.7 92.1 70.3 Highest 5.7 37.6 88.6 91.5 90.2 68.9 20.8 38.5 89.0 93.6 92.2 67.8 Number of living sons2 0 5.6 20.7 62.6 65.2 64.9 29.6 24.9 22.1 63.8 65.9 62.6 35.0 1 na 38.1 86.7 88.6 88.3 75.4 na 41.1 88.5 91.2 92.1 77.5 2 na na 89.2 91.5 90.8 90.4 na na 92.2 95.0 94.7 93.7 3 na na na 90.6 89.7 90.1 na na na 94.5 95.0 94.8 4+ na na na na 87.4 87.4 na na na na 93.1 93.1 Total 5.6 29.4 83.6 88.0 88.3 68.2 24.9 31.6 85.4 91.1 92.2 69.8 NFHS-3 (2005-06) 2.8 27.7 83.2 90.4 91.2 70.5 4.2 26.9 83.6 90.6 94.4 70.6 Note: Women who have been sterilized or whose husband has been sterilized are considered to want no more children. Men who have been sterilized or who mention in response to the question about desire for children that their wife has been sterilized are considered to want no more children. na = Not applicable 1 Includes current pregnancy of woman/wife 2 Excludes pregnant women ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases 102 z Fertility and Fertility Preferences Table 4.15 Desire to limit childbearing by state/union territory Percentage of currently married women and men age 15-49 who want no more children by number of living children, according to state/union territory, India, 2015-16 State/union territory Women: Number of living children1 Total Men: Number of living children1 Total 0 1 2 3 4+ 0 1 2 3 4+ India 5.6 29.4 83.6 88.0 88.3 68.2 24.9 31.6 85.4 91.1 92.2 69.8 North Chandigarh (4.3) 45.7 88.5 93.9 96.7 77.4 * * (92.5) * * 74.7 Delhi 5.0 39.8 94.0 95.1 96.0 76.8 (16.8) 41.5 79.0 96.7 (97.7) 69.3 Haryana 4.6 29.5 87.4 90.6 88.0 71.1 14.7 30.3 90.6 93.4 87.6 71.4 Himachal Pradesh 4.5 42.2 92.5 93.2 93.4 77.4 11.4 49.1 93.0 96.9 97.6 78.8 Jammu & Kashmir 2.6 11.3 68.7 85.4 86.1 61.8 34.3 8.4 64.9 82.1 87.9 57.0 Punjab 3.8 40.4 90.7 93.8 95.1 74.9 7.0 43.6 92.8 96.2 89.6 73.9 Rajasthan 2.6 20.4 83.5 90.9 91.5 69.3 8.5 22.4 83.5 91.9 92.5 69.7 Uttarakhand 2.8 24.5 82.6 87.3 88.7 69.7 3.7 21.2 80.8 90.0 92.9 69.8 Central Chhattisgarh 5.3 19.1 82.8 92.4 93.0 69.8 6.6 17.5 80.8 91.4 94.3 68.7 Madhya Pradesh 5.4 22.9 82.5 88.1 89.2 69.7 23.6 27.0 84.9 92.7 94.2 73.8 Uttar Pradesh 3.5 17.8 72.7 86.1 90.5 66.8 13.4 20.4 72.8 88.3 94.2 68.1 East Bihar 5.7 12.4 58.8 74.8 78.5 57.6 28.9 20.7 69.9 85.1 90.8 68.2 Jharkhand 3.2 16.5 74.2 84.4 88.5 63.4 14.9 21.1 79.0 88.3 90.5 66.7 Odisha 5.4 33.7 85.0 90.5 91.7 68.1 16.4 33.0 83.4 92.7 89.3 65.3 West Bengal 6.6 43.3 92.5 94.9 92.9 71.7 32.7 42.5 90.2 95.2 89.2 68.9 Northeast Arunachal Pradesh 12.6 17.0 53.9 66.9 70.9 49.5 37.4 14.4 61.4 76.0 75.2 54.1 Assam 4.6 23.9 78.5 84.8 87.6 60.9 9.7 18.3 78.6 91.5 91.2 58.4 Manipur 3.8 14.5 58.3 71.0 75.1 50.2 35.8 9.5 59.3 73.8 73.3 49.7 Meghalaya 4.1 12.7 31.8 41.3 53.4 35.7 (0.0) 11.1 38.7 37.5 48.4 33.5 Mizoram 5.5 7.8 32.8 59.7 69.8 44.5 18.9 10.1 39.4 63.2 81.2 50.3 Nagaland 4.2 18.3 52.5 64.4 70.7 52.1 31.3 15.9 54.8 72.6 80.3 54.7 Sikkim 3.6 36.3 86.8 92.3 91.0 65.6 49.0 28.2 81.0 83.4 (88.6) 59.3 Tripura 5.6 46.9 90.1 92.3 92.8 69.6 (8.1) 46.1 88.7 87.7 (94.6) 66.7 West Dadra & Nagar Haveli (3.1) 24.1 71.8 79.8 83.7 59.4 * * (87.8) * * 74.7 Daman & Diu 6.4 22.9 72.7 86.8 92.3 57.1 (54.3) 66.2 87.6 (96.4) * 77.5 Goa 3.4 32.8 84.1 84.3 84.4 60.7 (5.2) 26.0 98.0 100.0 * 64.7 Gujarat 8.6 35.8 85.0 88.4 89.0 69.4 19.4 33.3 90.0 94.0 95.9 72.2 Maharashtra 3.6 34.1 89.5 94.2 93.9 72.9 13.7 36.4 90.4 94.9 92.4 73.0 South Andaman & Nicobar Islands 1.1 40.6 91.5 94.4 96.5 71.5 (2.1) (33.5) 94.4 (100.0) * 74.1 Andhra Pradesh 5.7 31.6 91.9 95.0 92.6 75.9 30.8 36.8 94.4 93.8 (98.5) 78.8 Karnataka 10.1 34.6 80.8 86.5 88.6 65.3 36.0 36.4 78.1 87.1 83.7 64.0 Kerala 3.0 25.1 83.2 83.6 84.9 63.1 18.0 34.5 86.8 80.8 (93.4) 66.4 Lakshadweep 0.0 5.5 34.9 52.1 60.6 28.7 * (5.9) (40.4) * * 25.2 Puducherry 4.6 31.1 88.7 95.7 91.1 71.2 (5.2) 36.1 93.4 (97.3) * 75.3 Tamil Nadu 12.3 35.4 87.4 90.0 89.1 70.3 48.6 37.7 87.7 92.9 90.9 71.7 Telangana 4.8 24.2 84.2 85.9 84.5 67.9 41.1 30.1 90.3 91.5 89.0 72.1 Note: Women who have been sterilized or whose husband has been sterilized are considered to want no more children. Men who have been sterilized or who mention in response to the question about desire for children that their wife has been sterilized are considered to want no more children. 1 Includes current pregnancy of woman/wife ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases Fertility and Fertility Preferences z�103 Table 4.16.1 Indicators of sex preference: Women Mean ideal number of sons, daughters, and children of either sex for women age 15-49, percentage who want more sons than daughters, percentage who want more daughters than sons, percentage who want at least one son, and percentage who want at least one daughter by background characteristics, India, 2015-16, and total for NFHS-3 Background characteristic Mean ideal number of Percentage who want more sons than daughters Percentage who want more daughters than sons Percentage who want at least one son Percentage who want at least one daughter Number of women Sons Daughters Either sex Mother's current age 15-19 0.9 0.8 0.2 11.9 2.8 76.9 74.4 119,765 20-29 1.0 0.8 0.2 16.1 3.2 82.3 78.9 236,809 30-39 1.1 0.9 0.2 21.5 3.8 84.2 80.5 186,738 40-49 1.2 1.0 0.2 25.2 4.1 84.3 80.6 151,292 Residence Urban 0.9 0.8 0.3 14.2 4.3 78.0 74.9 240,853 Rural 1.1 0.9 0.2 21.3 3.0 84.6 81.1 453,751 Schooling No schooling 1.4 1.0 0.2 30.9 3.1 88.0 84.6 191,327 <5 years complete 1.1 0.9 0.2 21.0 3.2 85.8 81.9 40,166 5-7 years complete 1.1 0.9 0.2 18.7 3.3 84.7 81.2 99,026 8-9 years complete 1.0 0.8 0.2 15.0 3.3 82.6 79.2 115,742 10-11 years complete 0.9 0.8 0.2 12.1 3.7 78.9 75.4 98,954 12 or more years complete 0.8 0.7 0.3 10.3 4.1 74.5 71.6 149,389 Marital status Never married 0.8 0.7 0.3 10.7 3.2 73.1 70.8 156,727 Currently married 1.1 0.9 0.2 21.3 3.5 85.3 81.6 508,856 Widowed/divorced/ separated/deserted 1.0 0.9 0.2 20.0 4.2 79.8 75.6 29,022 Religion Hindu 1.0 0.9 0.2 18.6 3.3 82.3 78.7 560,155 Muslim 1.2 1.0 0.3 22.5 3.8 83.1 81.0 95,198 Christian 1.0 0.9 0.3 14.3 7.1 78.0 75.6 16,449 Sikh 0.9 0.8 0.3 12.2 2.2 81.1 74.7 11,603 Buddhist/Neo-Buddhist 0.9 0.8 0.2 9.2 4.9 80.1 79.3 6,455 Jain 0.8 0.8 0.3 7.5 6.2 74.6 74.9 1,253 Other 1.2 1.0 0.1 19.5 2.5 89.8 87.5 3,490 Caste/tribe Scheduled caste 1.1 0.9 0.2 20.0 3.4 83.8 80.6 141,914 Scheduled tribe 1.2 1.0 0.2 20.1 3.8 85.2 81.8 63,581 Other backward class 1.1 0.9 0.2 20.3 3.4 82.7 79.5 301,422 Other 1.0 0.8 0.3 15.0 3.6 79.5 75.8 183,278 Don't know 1.0 0.9 0.2 18.4 2.8 80.2 76.5 4,408 Wealth index Lowest 1.4 1.0 0.1 30.3 2.4 88.9 85.7 122,645 Second 1.2 0.9 0.2 22.0 3.0 85.6 82.3 135,820 Middle 1.0 0.9 0.2 17.2 3.6 82.2 78.7 142,758 Fourth 1.0 0.8 0.2 14.8 4.0 80.4 76.9 147,112 Highest 0.9 0.8 0.3 11.9 4.1 75.6 72.5 146,269 Total 1.1 0.9 0.2 18.8 3.5 82.3 78.9 694,604 NFHS-3 (2005-06) 1.1 0.8 0.4 22.4 2.6 77.4 74.0 121,143 Note: Table excludes women who gave non-numeric responses to the questions on ideal number of children or ideal number of sons or daughters. 104 z Fertility and Fertility Preferences Table 4.16.2 Indicators of sex preference: Men Mean ideal number of sons, daughters, and children of either sex for men age 15-49, percentage who want more sons than daughters, percentage who want more daughters than sons, percentage who want at least one son, and percentage who want at least one daughter by background characteristics, India, 2015-16, and total for NFHS-3 Background characteristic Mean ideal number of Percentage who want more sons than daughters Percentage who want more daughters than sons Percentage who want at least one son Percentage who want at least one daughter Number of men Sons Daughters Either sex Mother's current age 15-19 1.0 0.8 0.2 16.9 2.2 81.9 75.9 18,124 20-29 1.0 0.8 0.3 15.7 3.0 81.5 77.2 32,261 30-39 1.1 0.9 0.3 19.4 4.0 83.8 79.4 28,034 40-49 1.2 0.9 0.3 23.5 4.7 84.5 79.4 23,155 Residence Urban 1.0 0.8 0.3 16.4 3.6 80.5 75.4 38,858 Rural 1.1 0.9 0.3 20.1 3.4 84.4 79.8 62,716 Schooling No schooling 1.3 1.0 0.2 28.2 4.1 87.8 83.3 12,152 <5 years complete 1.2 1.0 0.2 23.7 4.7 87.0 82.8 6,073 5-7 years complete 1.1 0.9 0.2 21.8 4.0 86.0 81.1 14,493 8-9 years complete 1.1 0.9 0.2 19.1 3.0 84.6 79.5 21,014 10-11 years complete 1.0 0.8 0.3 16.1 3.2 81.3 76.1 17,702 12 or more years complete 0.9 0.8 0.3 13.6 3.4 78.3 73.8 30,139 Marital status Never married 0.9 0.8 0.3 15.3 2.6 79.2 74.0 38,545 Currently married 1.1 0.9 0.3 20.8 4.1 85.2 80.7 61,764 Widowed/divorced/ separated/deserted 1.0 0.9 0.3 19.3 4.4 81.0 75.5 1,264 Religion Hindu 1.0 0.8 0.3 17.9 3.4 82.8 77.8 82,858 Muslim 1.3 1.0 0.3 24.2 4.0 84.0 80.5 13,403 Christian 1.1 0.9 0.3 19.4 5.9 80.9 75.0 2,204 Sikh 0.9 0.7 0.3 13.8 0.9 82.2 72.8 1,615 Buddhist/Neo-Buddhist 1.0 0.8 0.2 17.5 5.0 82.2 77.4 949 Jain 0.9 0.8 0.2 9.7 2.2 82.0 77.8 162 Other 1.2 1.1 0.2 21.0 7.1 89.8 90.7 381 Caste/tribe Scheduled caste 1.1 0.9 0.2 20.7 3.7 83.9 79.0 20,148 Scheduled tribe 1.2 1.0 0.2 21.0 4.0 87.8 83.5 8,921 Other backward class 1.1 0.9 0.3 19.0 3.6 83.4 78.8 44,343 Other 1.0 0.8 0.3 16.1 3.2 79.9 74.5 27,811 Don't know 1.0 0.9 0.2 14.9 3.8 82.8 77.7 350 Wealth index Lowest 1.3 1.0 0.2 28.1 3.7 88.6 84.7 14,855 Second 1.1 0.9 0.2 21.6 3.4 85.9 81.3 19,013 Middle 1.0 0.9 0.3 17.5 3.8 83.8 79.2 21,669 Fourth 1.0 0.8 0.3 16.4 3.8 81.3 76.0 22,577 Highest 0.9 0.8 0.3 13.6 3.0 77.5 72.3 23,460 Total age 15-49 1.0 0.9 0.3 18.7 3.5 82.9 78.1 101,574 Age 50-54 1.2 1.0 0.3 24.8 5.8 84.6 80.1 8,505 Total age 15-54 1.1 0.9 0.3 19.2 3.7 83.0 78.2 110,078 Age 15-49 NFHS-3 (2005-06) 1.0 0.7 0.6 20.0 2.0 69.9 65.2 68,490 Note: Table excludes men who gave non-numeric responses to the questions on ideal number of children or ideal number of sons or daughters. Fertility and Fertility Preferences z�105 Table 4.17 Indicators of sex preference by state/union territory Mean ideal number of sons, daughters, and children of either sex, percentage who want more sons than daughters, and percentage who want more daughters than sons for women and men age 15-49, by state/union territory, India, 2015-16 State/union territory Women Percentage who want more sons than daughters Percentage who want more daughters than sons Men Percentage who want more sons than daughters Percentage who want more daughters than sons Sons Daughters Either sex Sons Daughters Either sex India 1.1 0.9 0.2 18.8 3.5 1.0 0.9 0.3 18.7 3.5 North Chandigarh 0.7 0.7 0.5 6.2 3.2 0.6 0.5 0.8 9.6 3.3 Delhi 0.8 0.7 0.4 11.5 2.8 1.0 0.8 0.4 16.0 2.5 Haryana 1.0 0.9 0.2 15.4 1.3 1.1 0.9 0.2 19.6 1.5 Himachal Pradesh 0.7 0.6 0.5 5.1 3.5 0.6 0.6 0.7 6.3 2.2 Jammu & Kashmir 1.1 0.9 0.3 20.2 4.8 1.2 0.9 0.4 26.4 5.2 Punjab 0.9 0.8 0.3 12.1 1.9 0.9 0.7 0.4 13.7 0.6 Rajasthan 1.1 0.9 0.2 18.5 1.2 1.2 1.0 0.1 19.0 1.4 Uttarakhand 1.0 0.9 0.3 15.2 2.3 1.1 0.9 0.1 16.9 2.5 Central Chhattisgarh 1.1 0.9 0.4 19.5 3.8 1.0 0.9 0.4 17.9 3.7 Madhya Pradesh 1.1 0.9 0.1 19.0 1.9 1.1 0.9 0.2 17.5 2.8 Uttar Pradesh 1.3 1.0 0.2 31.3 1.4 1.2 0.9 0.3 27.9 2.3 East Bihar 1.5 1.0 0.1 37.1 1.9 1.4 1.0 0.1 30.4 3.9 Jharkhand 1.3 1.0 0.2 27.1 2.0 1.2 1.0 0.2 22.5 5.9 Odisha 1.0 0.8 0.2 15.9 2.9 1.0 0.8 0.2 17.3 3.6 West Bengal 0.9 0.8 0.2 13.3 4.0 1.0 0.8 0.1 19.4 2.8 Northeast Arunachal Pradesh 1.4 1.1 0.1 27.2 4.5 1.4 1.1 0.2 24.3 4.9 Assam 1.0 0.9 0.2 18.0 3.5 1.1 0.9 0.3 17.9 2.9 Manipur 1.4 1.2 0.1 24.6 4.7 1.6 1.3 0.2 36.6 3.6 Meghalaya 1.5 1.6 0.3 14.1 21.1 1.6 1.6 0.2 21.3 17.7 Mizoram 1.9 1.8 0.1 28.2 21.4 2.0 1.7 0.1 39.0 15.7 Nagaland 1.5 1.4 0.2 20.1 10.4 1.6 1.4 0.1 31.3 8.6 Sikkim 0.7 0.7 0.2 6.8 4.0 0.8 0.7 0.2 7.7 3.5 Tripura 0.6 0.5 0.8 11.2 3.9 0.7 0.6 0.6 15.9 4.4 West Dadra & Nagar Haveli 0.7 0.6 0.7 17.3 2.2 0.7 0.6 0.8 10.4 3.5 Daman & Diu 0.6 0.5 0.6 10.2 1.3 1.1 0.9 0.1 27.2 6.9 Goa 0.5 0.5 0.9 4.7 3.8 0.6 0.5 0.8 9.6 3.2 Gujarat 0.8 0.7 0.4 12.2 2.6 0.9 0.8 0.4 15.0 2.3 Maharashtra 0.9 0.9 0.2 11.1 4.9 1.0 0.9 0.2 14.5 4.3 South Andaman & Nicobar Islands 0.5 0.5 0.9 5.1 3.7 0.6 0.5 0.7 7.8 3.5 Andhra Pradesh 0.9 0.8 0.3 9.5 3.0 1.0 0.9 0.3 11.0 3.5 Karnataka 0.8 0.7 0.3 10.9 5.6 0.9 0.8 0.3 13.2 4.7 Kerala 0.9 0.8 0.5 11.2 6.5 0.9 0.7 0.6 15.0 4.6 Lakshadweep 1.0 0.9 0.7 12.8 8.8 1.1 1.0 0.5 18.9 10.8 Puducherry 0.9 0.8 0.2 16.0 8.0 1.0 0.9 0.2 15.8 6.7 Tamil Nadu 0.9 0.8 0.1 16.4 8.9 0.9 0.8 0.2 15.9 6.9 Telangana 0.9 0.9 0.2 10.6 4.1 1.0 0.9 0.1 14.0 4.1 Note: Table excludes women and men who gave non-numeric responses to the questions on ideal number of children or ideal number of sons or daughters. 106 z Fertility and Fertility Preferences Table 4.18 Fertility planning status Percent distribution of births in the five years preceding the survey (including current pregnancies) by planning status of the birth, according to birth order and mother's age at birth, India, 2015-16 Birth order and mother's age at birth Planning status of birth Total Number of births Wanted then Wanted later Wanted no more Missing Birth order 1 96.0 3.1 0.8 0.0 100.0 109,133 2 92.0 5.7 2.3 0.0 100.0 89,829 3 88.4 4.5 7.1 0.1 100.0 42,778 4+ 79.9 3.2 16.7 0.2 100.0 39,350 Mother's age at birth1 <20 94.0 4.8 1.2 0.1 100.0 37,270 20-24 92.8 4.7 2.5 0.0 100.0 126,393 25-29 90.7 3.9 5.3 0.0 100.0 78,609 30-34 87.4 2.4 10.0 0.1 100.0 27,943 35-39 82.0 2.0 15.7 0.3 100.0 8,479 40-44 73.2 1.4 24.4 1.0 100.0 2,067 45-49 60.5 0.7 33.3 5.5 100.0 317 Total 91.3 4.2 4.5 0.1 100.0 281,090 1 For current pregnancy, estimated maternal age at birth. Fertility and Fertility Preferences z�107 Table 4.19 Wanted fertility rates Total wanted fertility rates and total fertility rates for the three years preceding the survey, by background characteristics, India, 2015-16 Background characteristic Total wanted fertility rate Total fertility rate Residence Urban 1.5 1.8 Rural 1.9 2.4 Schooling No schooling 2.3 3.1 <5 years complete 1.9 2.4 5-7 years complete 1.9 2.4 8-9 years complete 1.8 2.2 10-11 years complete 1.7 2.0 12 or more years complete 1.5 1.7 Marital status Never married 0.0 0.0 Currently married 2.6 3.1 Widowed/divorced/ separated/deserted 1.2 1.4 Religion Hindu 1.7 2.1 Muslim 2.0 2.6 Christian 1.7 2.0 Sikh 1.4 1.6 Buddhist/Neo-Buddhist 1.5 1.7 Jain 1.0 1.2 Other 2.0 2.6 Caste/tribe Scheduled caste 1.8 2.3 Scheduled tribe 2.0 2.5 Other backward class 1.8 2.2 Other 1.6 1.9 Don't know 2.1 2.8 Wealth index Lowest 2.3 3.2 Second 1.9 2.5 Middle 1.7 2.1 Fourth 1.6 1.8 Highest 1.4 1.5 Total 1.8 2.2 Note: Rates are calculated based on births to women age 15-49 in the period 1-36 months preceding the survey. The total fertility rates are the same as those presented in Table 4.2. 108 z Fertility and Fertility Preferences Table 4.20 Wanted fertility rates by state/union territory Total wanted fertility rates and total fertility rates for the three years preceding the survey, by state/union territory, India, 2015-16 State/union territory Total wanted fertility rate Total fertility rate India 1.8 2.2 North Chandigarh 1.2 1.6 Delhi 1.4 1.8 Haryana 1.6 2.1 Himachal Pradesh 1.5 1.9 Jammu & Kashmir 1.7 2.0 Punjab 1.4 1.6 Rajasthan 1.8 2.4 Uttarakhand 1.6 2.1 Central Chhattisgarh 1.9 2.2 Madhya Pradesh 1.8 2.3 Uttar Pradesh 2.1 2.7 East Bihar 2.5 3.4 Jharkhand 2.1 2.5 Odisha 1.7 2.0 West Bengal 1.5 1.8 Northeast Arunachal Pradesh 1.6 2.1 Assam 1.8 2.2 Manipur 2.3 2.6 Meghalaya 2.8 3.0 Mizoram 2.2 2.3 Nagaland 2.3 2.7 Sikkim 0.9 1.2 Tripura 1.5 1.7 West Dadra & Nagar Haveli 1.8 2.3 Daman & Diu 1.3 1.7 Goa 1.4 1.7 Gujarat 1.5 2.0 Maharashtra 1.6 1.9 South Andaman & Nicobar Islands 1.3 1.4 Andhra Pradesh 1.6 1.8 Karnataka 1.4 1.8 Kerala 1.5 1.6 Lakshadweep 1.6 1.8 Puducherry 1.6 1.7 Tamil Nadu 1.5 1.7 Telangana 1.6 1.8 Note: Rates are calculated based on births to women age 15-49 in the period 1-36 months preceding the survey. The total fertility rates are the same as those presented in Table 4.3. Fertility and Fertility Preferences z�109 FAMILY PLANNING 5 Key Findings x Modern contraceptive use: Modern contraceptive use by currently married women has remained unchanged, at just under 50 percent, between 2005-06 and 2015-16. Female sterilization is still the most popular contraceptive method, used by 36 percent of currently married women. x Source of modern contraceptive methods: Sixty-nine percent of modern contraceptive method users obtained the method from the public health sector. x Contraceptive discontinuation: In the five years preceding the survey, 33 percent of the women who started using a contraceptive method discontinued the method in less than 12 months. The leading reason for discontinuation is a desire to become pregnant (9%). x Unmet need for family planning: Thirteen percent of currently married women have an unmet need for family planning, almost the same as the estimate in 2005-06 (14%). x Hysterectomy: Three percent of women had a hysterectomy. More than two-thirds (67%) of hysterectomies were performed in the private sector. ouples can use contraceptive methods to limit or space the number of children they have. This chapter presents information on the knowledge and use of contraceptive methods, sources of contraceptive methods, informed choice of methods, and rates and reasons for discontinuing contraceptives. The chapter also provides information on how men perceive contraception and women using contraceptives. It also examines the unmet need for family planning and exposure to family planning messages. 5.1 CONTRACEPTIVE KNOWLEDGE AND USE Knowledge of contraceptive methods is almost universal in India, with 99 percent of currently married women and men age 15-49 knowing at least one method of contraception. Forty-two percent of currently married women and 48 percent of currently married men know about emergency contraception. Only one in seven currently married women and one in eight currently married men know about the lactational amenorrhoea method (LAM) (Table 5.1). Contraceptive prevalence rate (CPR) Percentage of women who use any contraceptive method Sample: All women, currently married women, and sexually active unmarried women age 15-49 C Family Planning z�111 Overall, the contraceptive prevalence rate (CPR) is 54 percent of currently married women age 15-49. Almost half (48%) of currently married women use a modern method. Only 15 percent of currently married women age 15-19 use a contraceptive method and 10 percent use a modern contraceptive method. Among sexually active, unmarried women age 15-49, about one-third (34%) use a contraceptive method and almost all of them (32%) use a modern contraceptive method (Table 5.5). Modern methods Include male and female sterilization, injectables, intrauterine devices (IUDs/ PPIUDs), contraceptive pills, implants, female and male condoms, diaphragm, foam/jelly, the standard days method, the lactational amenorrhoea method, and emergency contraception Female sterilization remains the most popular modern contraceptive method. Among currently married women age 15-49, 36 percent use female sterilization, followed by male condoms (6%) and pills (4%). Six percent use a traditional method, mostly the rhythm method (Figure 5.1). Among sexually active unmarried women, female sterilization is the most commonly used method (19%), followed by male condoms (12%). Trends: The contraceptive prevalence rate among currently married women age 15-49 decreased slightly, from 56 percent in 2005-06 to 54 percent in 2015-16 (Table 5.2). Among sexually active unmarried women age 15-49, the use of condoms/Nirodhs increased from 2 percent in 2005-06 to 12 percent in 2015-16. Patterns by background characteristics y Contraceptive use among currently married women rises with an increasing number of living children; from 8 percent of women with no living children to 36 percent of women with one child and 68 percent of women with three children (Table 5.3.1). y By employment status, 44 percent of women who are not employed use a modern contraceptive method, compared with 60 percent of women who are employed for cash (Table 5.3.1). y Modern contraceptive use increases with wealth, from 36 percent of women in the lowest wealth quintile to 53 percent of women in the highest quintile (Table 5.3.1 and Figure 5.2). y Almost two-thirds (65%) of Sikh women and Buddhist/Neo-Buddhist women use modern con- traception, compared with 38 percent of Muslim women (Table 5.3.1). 36 46 50 52 53 Lowest Second Middle Fourth Highest Figure 5.2 Use of Modern Contraceptive Methods by Household Wealth Percentage of currently married women age 15-49 Poorest Wealthiest Female sterilization 36% Male sterilization 0.3% Pill 4.1% IUD/PPIUD 1.5% Injectables 0.2% Condom/ Nirodh 5.6% Female condom <0.1% LAM 0.1% Rhythm 3.5% Withdrawal 2.3% Not using any method 47% Figure 5.1 What Contraceptive Methods do Women Use? Currently married women age 15-49 Currently married women age 15-49 112 z Family Planning y Half of the women who undergo sterilization have the operation by the age of 25.7 years (Table 5.7), almost the same as in NFHS-3. y Use of contraceptive methods is the lowest in Manipur, Bihar, and Meghalaya (24% each) and the highest in Punjab (76%). Among the states, a relatively low proportion of currently married women use contraceptive methods in all of the smaller states in the northeast region except for Sikkim and Tripura, as well as Goa. Among the union territories, the use of contraceptive methods is the lowest in Lakshadweep (30%) and the highest in Chandigarh (74%) (Table 5.2 and Figure 5.3). 5.2 SOURCE OF MODERN CONTRACEPTIVE METHODS Source of modern contraceptives The place where the modern method currently being used was obtained the last time it was acquired Sample: Women age 15-49 currently using a modern contraceptive method 24 24 24 26 27 30 32 32 35 38 40 46 47 47 51 51 52 52 53 53 53 54 55 57 57 57 57 58 60 62 64 64 65 70 71 74 76 Manipur Bihar Meghalaya Goa Nagaland Lakshadweep Arunachal Pradesh Daman & Diu Mizoram Dadra & Nagar Haveli Jharkhand Uttar Pradesh Sikkim Gujarat Andaman & Nicobar Islands Madhya Pradesh Karnataka Assam Kerala Tamil Nadu Uttarakhand INDIA Delhi Himachal Pradesh Jammu & Kashmir Telangana Odisha Chhattisgarh Rajasthan Puducherry Haryana Tripura Maharashtra Andhra Pradesh West Bengal Chandigarh Punjab Figure 5.3 Use of Contraceptive Methods by State/UT Percentage of currently married women age 15-49 Family Planning z�113 Almost seven in 10 (69%) modern method contraceptive users obtained their method from the public health sector. The rest of the users of modern methods obtained their method from the private health sector including NGO or trust hospitals/clinics (24%) and other sources (6%), including shops, their husband, friends, and relatives. A lower proportion of urban users (58%) than rural users (76%) obtained their method from the public health sector (Table 5.8 and Figure 5.4). The public health sector is the major source of female and male sterilization and IUDs/PPIUDs, whereas the private health sector is the major source of pills, injectables, and condoms/Nirodhs (Table 5.8). y Female sterilization: More than eight in 10 (82%) women who got sterilized underwent the proce- dure in a public health sector facility, mostly a government/municipal hospital or a CHC/rural hospital/Block PHC. y Pill: More than half (54%) of pill users received their supply from the private health sector, and 27 percent received their supply from the public health sector. y Male condoms and IUDs/PPIUDs: About two-fifths of users of male condoms (43%) and IUDs/PPIUDs (40%) obtained the method from the private health sector. The lowest use of the public health sector as a source for modern contraceptives was in Tripura (40%), followed by Assam (41%). In contrast, among the states, 86 percent of modern contraceptive method users in Madhya Pradesh obtained their method from the public health sector, followed by 85 percent in Chhattisgarh and 84 percent in Karnataka. Use of the public health sector for modern contraceptive methods is also very high in Puducherry (90%) and the Andaman & Nicobar Islands (88%). More than half of male condom users (57%) obtained their method from the public health sector in Karnataka, compared with only 7 percent in Uttar Pradesh (Table 5.9). Less than one percent of women have ever used emergency contraceptive pills. The major source of emergency contraceptive pills is the private health sector, primarily pharmacies or drugstores (Table 5.10). 5.3 INFORMED CHOICE Informed choice Informed choice refers to women being informed at the time they started the current episode of method use about the method’s side effects, what to do if they experience side effects, and other methods they could use. Sample: Women age 15-49 who are currently using selected modern contraceptive methods and who started the last episode of use within the five years before the survey Forty-seven percent of women currently using selected modern contraceptives were informed about the possible side effects or problems associated with the method they used, and 39 percent were informed about what to do if they experienced side effects. A higher proportion of women (54%) were informed about other available methods that they could use (Table 5.11). Figure 5.4 Source of Modern Contraceptive Methods Percent distribution of women age 15-49 who are current users of modern methods by most recent source of method Public health sector 69% Private health sector/NGO or trust hospital/clinic 24% Other source 6.2% 114 z Family Planning The percentage of women who were informed about possible side effects or problems with their method ranged from 25 percent in Telangana and Andhra Pradesh to 79 percent in Punjab. The percentage given information about what to do if they experienced side effects was lower in every state than the percentage who were told about side effects. Seven in 10 women in Tamil Nadu and Punjab were informed about what to do if they experienced side effects with the method. About four-fifths of women in Punjab (81%) and Tamil Nadu (79%) were informed by a health or family planning worker about other methods they could use (Table 5.12). 5.4 DISCONTINUATION OF CONTRACEPTIVES Contraceptive discontinuation rate Percentage of contraceptive use episodes discontinued within 12 months. Sample: Episodes of contraceptive use in the five years before the survey for women who are currently age 15-49 Thirty-three percent of episodes of contra- ceptive use in the five years before the survey were discontinued within 12 months. Contra- ceptive discontinuation rates were higher for “other methods” (77%), injectables (51%), withdrawal (50%), condoms/Nirodhs (47%), rhythm (44%), and pills (42%) than for IUDs/PPIUDs (26%) (Table 5.13 and Figure 5.5). The most common reason for discon- tinuing use of the method was that the woman wanted to become pregnant. Only 5 percent of episodes of contraceptive use were discon- tinued because the woman switched to another method (Table 5.13). Contraceptive discontinuation rates for any method are as low as 4 percent in Andhra Pradesh (where almost all contraceptive users were sterilized) and as high as 47 percent in Punjab and Jammu & Kashmir. The discontinuation rate for any spacing method is highest (60-64%) in Goa, Karnataka, Andhra Pradesh, Tamil Nadu, and Kerala (Table 5.14). 5.5 EXPOSURE TO FAMILY PLANNING MESSAGES About three-fourths (72%) of women heard or saw a family planning message in the past few months (59% on television, 53% on a wall painting or hoarding, and only 18% on radio) (Table 5.15.1). Older women, women in rural areas, women with little or no schooling, Muslim women, scheduled tribe women, and women in the two lowest wealth quintiles have less exposure to family planning messages. Exposure to family planning messages is slightly higher for men (76%) than women (72%). About three-fifths of men age 15-49 heard or saw a family planning message in the past few months on television (61%) or a wall painting or hoarding (59%). Men living in rural areas, having little or no schooling, Muslim and Christian men, men from scheduled tribes, and men in the two lowest wealth quintiles have more exposure to family planning (Table 5.15.2). Three in eight men believe that contraception is women’s business and that man should not have to worry about it. 42 26 51 47 44 Pill IUD/PPIUD Injectables Condom/ All modern spacing methods Figure 5.5 Contraceptive Discontinuation Rates for Modern Spacing Methods Percentage of contraceptive episodes discontinued within 12 months among women age 15-49 Nirodh Family Planning z�115 Twenty percent of men believe that a woman who uses contraception may become promiscuous. About three-fifths (61%) of men reported that if a male condom is used correctly, it protects against pregnancy most of the time. An additional one-fourth of men said that a condom sometime protects against pregnancy if it is used correctly (Table 5.16). 5.6 DEMAND FOR FAMILY PLANNING Unmet need for family planning Proportion of women who (1) are not pregnant and not postpartum amenorrhoeic, are considered fecund, and want to postpone their next birth for 2 or more years or stop childbearing altogether, but are not using a contraceptive method, or (2) have a mistimed or unwanted current pregnancy, or (3) are postpartum amenorrhoeic and their last birth in the last two years was mistimed or unwanted. Sample: All women, currently married women, and sexually active unmarried women age 15-49 Demand for family planning: Unmet need for family planning + current contraceptive use (any method) Proportion of demand satisfied: Current contraceptive use (any method) Unmet need + current contraceptive use (any method) Proportion of demand satisfied by modern methods: Current contraceptive use (any modern method) Unmet need + current contraceptive use (any method) Two-thirds of currently married women age 15-49 have a demand for family planning; 11 percent want to space births, and 55 percent want to limit births. Fifty-four percent of currently married women are already using a contraceptive method either to space or to limit births, and therefore have their need met. However, 13 percent of currently married women have an unmet need for family planning, including 6 percent who have an unmet need for spacing births and 7 percent who have an unmet need for limiting births (Table 5.18 and Figure 5.6). If all currently married women who want to space or limit their children were to use a family planning method, the contraceptive prevalence rate would increase from 54 percent to 66 percent. Trends: The total demand for family planning among currently married women age 15-49 in India decreased slightly from 70 percent in 2005-06 to 66 percent in 2015-16 (Table 5.19). The unmet need for family planning was almost the same in NFHS-3 and NFHS-4. Unmet need for spacing 5.6% Unmet need for limiting 7.2% Met need for spacing 5.5% Met need for limiting 48% No demand for family planning 34% Figure 5.6 Demand for Family Planning Percent distribution of currently married women age 15-49 by need for family planning 116 z Family Planning Patterns by background characteristics x Unmet need for family planning among currently married women ranges from a low of 3 percent among women age 45-49 to a high of 22 percent among women age 15-24 (Table 5.18). x Unmet need for family planning generally increases with increasing years of schooling, from 11 percent among currently married women with no schooling to 17 percent among those who have completed 12 or more years of schooling. x Unmet need for family planning is 20 percent or more in Manipur, Nagaland, Sikkim, Arunachal Pradesh, Meghalaya, Bihar, Mizoram, and Daman & Diu. Unmet need is less than 10 percent in Andhra Pradesh, Punjab, Chandigarh, Telangana, West Bengal, Puducherry, and Haryana (Table 5.19 and Figure 5.7). 4.6 6.2 6.3 7.4 7.5 8.3 9.3 10 10 10 11 11 12 12 12 13 14 14 14 15 16 16 16 17 17 18 18 18 19 20 20 21 21 22 22 22 30 Andhra Pradesh Punjab Chandigarh Telangana West Bengal Puducherry Haryana Maharashtra Tamil Nadu Karnataka Tripura Chhattisgarh Madhya Pradesh Jammu & Kashmir Rajasthan INDIA Odisha Kerala Assam Delhi Uttarakhand Andaman & Nicobar Islands Himachal Pradesh Lakshadweep Gujarat Goa Uttar Pradesh Jharkhand Dadra & Nagar Haveli Daman & Diu Mizoram Bihar Meghalaya Arunachal Pradesh Sikkim Nagaland Manipur Figure 5.7 Unmet Need for Family Planning by State/UT Percentage of currently married women age 15-49 Family Planning z�117 List of Tables For more information on family planning, see the following tables: Tables Table 5.1 Knowledge of contraceptive methods Table 5.2 Current use of contraception by state/union territory Table 5.3.1 Current use of contraception Table 5.3.2 Contraceptive use by men with last sexual partner Table 5.4 Knowledge of contraceptive methods among adolescents Table 5.5 Current use of contraception by age Table 5.6 Number of living children at first use of contraception Table 5.7 Timing of sterilization Table 5.8 Source of modern contraceptive methods Table 5.9 Public sector as source of modern contraceptive method by state/union territory Table 5.10 Use and source of emergency contraceptive pills Table 5.11 Informed choice Table 5.12 Informed choice by state/union territory Table 5.13 Twelve-month contraceptive discontinuation rates Table 5.14 Twelve-month contraceptive discontinuation rates by state/union territory Table 5.15.1 Exposure to family planning messages: Women Table 5.15.2 Exposure to family planning messages: Men Table 5.16 0HQ¶V�FRQWUDFHSWLRQ-related perceptions and knowledge Table 5.17 0HQ¶V�FRQWUDFHSWLRQ-related perceptions and knowledge by state/union territory Table 5.18 Need and demand for family planning Table 5.19 Need and demand for family planning by state/union territory and over time Table 5.20 Hysterectomy Table 5.21 Hysterectomy by state/union territory 118 z Family Planning Table 5.1 Knowledge of contraceptive methods Percentage of all women and men, currently married women and men, sexually active unmarried women and men, and never married women and men who know any contraceptive method by specific method and residence, India, 2015-16 Method Women Men All women Currently married women Sexually active unmarried women1 Never married women All men Currently married men Sexually active unmarried men1 Never married men URBAN Any method 98.6 99.6 100.0 95.6 98.6 99.5 99.9 97.3 Any modern method 98.5 99.5 100.0 95.6 98.6 99.5 99.9 97.3 Female sterilization 96.8 98.6 97.9 91.7 91.2 95.8 94.7 84.7 Male sterilization 83.8 88.6 90.6 69.9 86.5 91.4 92.7 79.5 Pill 89.3 92.4 89.7 81.0 85.5 89.8 92.6 79.4 IUD/PPIUD 79.0 85.5 85.1 60.7 50.6 59.4 48.8 38.4 Injectables 75.6 80.0 77.5 64.0 69.0 74.8 73.5 61.1 Condom/Nirodh 86.5 89.5 92.1 79.6 96.4 97.4 99.2 95.1 Female condom 27.4 29.1 32.8 23.1 41.8 44.5 48.5 38.0 Emergency contraception 47.7 52.3 49.5 35.8 50.7 55.0 61.2 44.6 Lactational amenorrhoea method (LAM) 15.5 18.3 17.3 7.5 13.3 16.5 9.9 9.0 Other modern method 0.2 0.3 0.1 0.0 0.2 0.2 2.3 0.2 Pill, IUD/PPIUD, and condom/ Nirodh2 72.6 79.4 79.5 54.2 48.6 57.4 47.4 36.4 Any traditional method 59.7 69.3 63.3 32.6 63.6 71.8 74.1 52.0 Rhythm 51.0 59.5 53.4 27.3 48.0 57.3 54.4 34.8 Withdrawal 47.5 57.4 50.7 19.9 56.4 63.4 63.6 46.4 Other traditional method 2.6 3.1 3.0 1.2 2.9 3.2 5.9 2.6 Mean number of methods known by respondents age15-49 7.0 7.5 7.4 5.6 6.9 7.5 7.5 6.1 Number of respondents age 15-49 242,225 170,815 255 60,580 39,546 22,700 1,596 16,402 Mean number of methods known by respondents age15-54 na na na na 6.9 7.5 7.5 6.1 Number of respondents age 15-54 na na na na 42,953 25,963 1,614 16,454 Continued… Family Planning z�119 Table 5.1 Knowledge of contraceptive methods—Continued Percentage of all women and men, currently married women and men, sexually active unmarried women and men, and never married women and men who know any contraceptive method by specific method and residence, India, 2015-16 Method Women Men All women Currently married women Sexually active unmarried women1 Never married women All men Currently married men Sexually active unmarried men1 Never married men RURAL Any method 97.4 98.7 99.1 92.9 97.5 98.5 98.5 95.8 Any modern method 97.4 98.7 98.8 92.8 97.4 98.4 98.4 95.7 Female sterilization 95.5 97.3 97.1 89.2 89.3 93.5 89.2 82.2 Male sterilization 78.1 82.7 76.1 62.4 81.4 86.0 84.2 73.4 Pill 83.2 86.2 84.4 73.7 78.5 82.1 84.3 72.5 IUD/PPIUD 66.6 72.3 68.8 47.5 39.8 45.6 41.8 30.1 Injectables 66.1 70.0 63.7 53.5 58.0 61.9 64.8 51.5 Condom/Nirodh 75.2 78.1 80.6 67.2 92.7 93.0 97.0 92.2 Female condom 16.7 17.7 12.5 13.7 28.6 29.7 31.0 27.1 Emergency contraception 33.6 36.6 39.0 24.4 40.7 43.5 54.4 36.0 Lactational amenorrhoea method (LAM) 11.2 12.9 7.6 5.1 8.6 10.2 7.9 6.1 Other modern method 0.3 0.3 0.2 0.0 0.2 0.2 0.6 0.1 Pill, IUD/PPIUD, and condom/ Nirodh2 57.8 63.3 60.6 39.9 37.5 43.0 40.0 28.2 Any traditional method 55.2 63.5 57.4 26.9 56.8 64.0 64.8 44.4 Rhythm 45.9 52.9 46.3 22.1 41.3 49.0 46.7 28.2 Withdrawal 42.8 50.8 45.4 15.4 48.2 54.1 56.0 38.0 Other traditional method 2.2 2.5 2.7 1.2 2.9 3.2 4.5 2.5 Mean number of methods known by respondents age15-49 6.2 6.6 6.2 4.8 6.1 6.5 6.6 5.4 Number of respondents age 15-49 457,461 340,557 567 98,455 63,864 39,799 2,103 23,229 Mean number of methods known by respondents age15-54 na na na na 6.1 6.5 6.6 5.4 Number of respondents age 15-54 na na na na 69,169 44,818 2,131 23,309 Continued… 120 z Family Planning Table 5.1 Knowledge of contraceptive methods—Continued Percentage of all women and men, currently married women and men, sexually active unmarried women and men, and never married women and men who know any contraceptive method by specific method and residence, India, 2015-16 Method Women Men All women Currently married women Sexually active unmarried women1 Never married women All men Currently married men Sexually active unmarried men1 Never married men TOTAL Any method 97.8 99.0 99.4 93.9 97.9 98.9 99.1 96.4 Any modern method 97.8 99.0 99.2 93.8 97.8 98.8 99.1 96.3 Female sterilization 96.0 97.7 97.4 90.1 90.0 94.3 91.6 83.2 Male sterilization 80.1 84.6 80.6 65.3 83.3 87.9 87.8 76.0 Pill 85.3 88.3 86.1 76.5 81.2 84.9 87.9 75.4 IUD/PPIUD 70.9 76.7 73.8 52.5 44.0 50.6 44.8 33.5 Injectables 69.4 73.4 68.0 57.5 62.2 66.6 68.5 55.5 Condom/Nirodh 79.1 81.9 84.2 71.9 94.1 94.6 97.9 93.4 Female condom 20.4 21.5 18.8 17.3 33.6 35.1 38.6 31.6 Emergency contraception 38.5 41.8 42.3 28.8 44.5 47.7 57.4 39.5 Lactational amenorrhoea method (LAM) 12.7 14.7 10.6 6.0 10.4 12.5 8.8 7.3 Other modern method 0.3 0.3 0.1 0.0 0.2 0.2 1.4 0.1 Pill, IUD/PPIUD, and condom/ Nirodh2 62.9 68.7 66.5 45.3 41.7 48.2 43.2 31.6 Any traditional method 56.8 65.5 59.3 29.1 59.4 66.8 68.8 47.5 Rhythm 47.6 55.1 48.5 24.1 43.9 52.0 50.0 30.9 Withdrawal 44.4 53.0 47.1 17.1 51.4 57.5 59.3 41.5 Other traditional method 2.4 2.7 2.8 1.2 2.9 3.2 5.1 2.5 Mean number of methods known by respondents age15-49 6.5 6.9 6.6 5.1 6.4 6.9 7.0 5.7 Number of respondents age 15-49 699,686 511,373 822 159,035 103,411 62,499 3,700 39,631 Mean number of methods known by respondents age15-54 na na na na 6.4 6.8 7.0 5.7 Number of respondents age 15-54 na na na na 112,122 70,781 3,745 39,762 na = Not applicable IUD = Intrauterine device; PPIUD = Postpartum intrauterine device 1 Had sexual intercourse in the 30 days preceding the survey 2 All three methods Family Planning z�121 Ta bl e 5. 2 C ur re nt u se o f c on tra ce pt io n by s ta te /u ni on te rr ito ry Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to re sid en ce a nd s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 , a nd b y re sid en ce , N FH S- 3 St at e/ un io n te rr ito ry An y m et ho d An y m od er n m et ho d M od er n m et ho d An y tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d Rh yt hm W ith - dr aw al O th er tra di - tio na l m et ho d U RB AN In di a 57 .2 51 .2 35 .7 0. 3 3. 6 2. 3 0. 2 9. 1 0. 0 0. 1 0. 0 5. 9 3. 5 2. 4 0. 0 42 .8 10 0. 0 N FH S- 3 (2 00 5- 06 ) 64 .0 55 .8 37 .8 1. 1 3. 8 3. 2 0. 1 9. 8 0. 0 na 0. 1 8. 1 5. 0 2. 9 0. 2 36 .0 10 0. 0 N or th C ha nd ig ar h 73 .4 57 .5 19 .9 1. 3 3. 6 5. 4 0. 0 27 .3 0. 0 0. 0 0. 0 15 .9 9. 6 6. 3 0. 0 26 .6 10 0. 0 D el hi 54 .8 48 .5 19 .8 0. 2 2. 9 5. 4 0. 1 20 .1 0. 0 0. 0 0. 0 6. 3 2. 3 4. 0 0. 0 45 .2 10 0. 0 H ar ya na 60 .0 55 .1 31 .0 0. 5 3. 2 6. 0 0. 3 13 .9 0. 0 0. 1 0. 0 4. 9 2. 1 2. 8 0. 0 40 .0 10 0. 0 H im ac ha l P ra de sh 57 .3 50 .0 27 .7 1. 1 1. 7 1. 7 0. 0 17 .6 0. 3 0. 0 0. 0 7. 3 0. 1 7. 2 0. 0 42 .7 10 0. 0 Ja m m u & K as hm ir 65 .0 55 .9 30 .4 0. 5 5. 7 3. 8 0. 9 14 .6 0. 0 0. 0 0. 0 9. 0 1. 2 7. 8 0. 0 35 .0 10 0. 0 Pu nj ab 76 .4 65 .3 32 .0 0. 4 2. 6 7. 7 0. 2 22 .4 0. 0 0. 0 0. 0 11 .2 7. 2 4. 0 0. 0 23 .6 10 0. 0 Ra ja st ha n 64 .1 57 .9 35 .3 0. 2 3. 5 2. 1 0. 4 16 .5 0. 0 0. 0 0. 0 6. 2 4. 1 2. 1 0. 0 35 .9 10 0. 0 U tta ra kh an d 53 .9 48 .4 18 .7 0. 4 4. 2 2. 2 0. 2 22 .7 0. 0 0. 1 0. 0 5. 5 2. 0 3. 4 0. 0 46 .1 10 0. 0 C en tr al C hh at tis ga rh 61 .7 57 .3 43 .6 0. 6 2. 3 2. 2 0. 0 8. 2 0. 0 0. 3 0. 0 4. 4 2. 7 1. 7 0. 0 38 .3 10 0. 0 M ad hy a Pr ad es h 51 .6 48 .9 35 .0 0. 4 2. 2 0. 9 0. 1 10 .3 0. 0 0. 0 0. 0 2. 6 1. 9 0. 8 0. 0 48 .4 10 0. 0 U tta r P ra de sh 55 .6 39 .8 15 .0 0. 1 2. 6 2. 0 0. 5 19 .5 0. 0 0. 0 0. 0 15 .8 12 .8 3. 0 0. 0 44 .4 10 0. 0 Ea st Bi ha r 34 .5 32 .1 26 .7 0. 1 1. 1 1. 3 0. 5 2. 3 0. 0 0. 1 0. 0 2. 4 0. 8 1. 6 0. 0 65 .5 10 0. 0 Jh ar kh an d 46 .7 42 .5 32 .7 0. 2 3. 3 1. 2 0. 2 4. 5 0. 1 0. 3 0. 0 4. 1 3. 0 1. 1 0. 0 53 .3 10 0. 0 O di sh a 61 .3 48 .2 25 .9 0. 1 12 .6 1. 3 0. 2 7. 9 0. 1 0. 1 0. 1 13 .0 3. 7 9. 3 0. 0 38 .7 10 0. 0 W es t B en ga l 69 .0 53 .0 22 .7 0. 0 17 .0 1. 9 0. 3 10 .8 0. 0 0. 2 0. 1 16 .0 7. 7 8. 2 0. 0 31 .0 10 0. 0 N or th ea st Ar un ac ha l P ra de sh 26 .5 23 .5 8. 3 0. 0 9. 9 2. 9 0. 0 2. 3 0. 0 0. 1 0. 0 3. 0 1. 8 1. 3 0. 0 73 .5 10 0. 0 As sa m 54 .9 38 .4 10 .0 0. 1 18 .7 2. 6 0. 0 6. 4 0. 2 0. 4 0. 0 16 .5 9. 8 6. 7 0. 0 45 .1 10 0. 0 M an ip ur 25 .0 12 .9 3. 6 0. 2 4. 0 3. 3 0. 1 1. 6 0. 1 0. 0 0. 0 12 .1 2. 7 9. 4 0. 0 75 .0 10 0. 0 M eg ha la ya 32 .8 27 .6 12 .4 0. 0 7. 8 3. 7 0. 5 3. 1 0. 1 0. 0 0. 0 5. 2 1. 0 4. 2 0. 0 67 .2 10 0. 0 M iz or am 38 .5 38 .4 19 .4 0. 0 13 .6 3. 9 0. 0 1. 5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 61 .5 10 0. 0 N ag al an d 31 .3 25 .5 10 .3 0. 0 5. 6 7. 3 0. 1 2. 0 0. 0 0. 2 0. 0 5. 8 3. 6 2. 3 0. 0 68 .7 10 0. 0 Si kk im 36 .9 35 .6 13 .1 1. 6 8. 9 4. 5 2. 1 5. 4 0. 0 0. 0 0. 0 1. 2 0. 2 1. 1 0. 0 63 .1 10 0. 0 Tr ip ur a 66 .8 43 .1 17 .5 0. 1 21 .1 1. 0 0. 1 3. 4 0. 0 0. 0 0. 0 23 .7 9. 2 14 .5 0. 0 33 .2 10 0. 0 C on tin ue d. . 122 z Family Planning Ta bl e 5. 2 C ur re nt u se o f c on tra ce pt io n by s ta te /u ni on te rr ito ry ³ C on tin ue d Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to re sid en ce a nd s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 , a nd b y re sid en ce , N FH S- 3 St at e/ un io n te rr ito ry An y m et ho d An y m od er n m et ho d M od er n m et ho d An y tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d Rh yt hm W ith - dr aw al O th er tra di - tio na l m et ho d W es t D ad ra & N ag ar H av el i 32 .0 31 .6 22 .0 0. 0 2. 1 1. 8 0. 0 5. 6 0. 0 0. 0 0. 0 0. 4 0. 0 0. 4 0. 0 68 .0 10 0. 0 D am an & D iu 30 .4 30 .2 23 .4 0. 0 1. 3 3. 2 0. 0 2. 1 0. 0 0. 0 0. 2 0. 2 0. 0 0. 2 0. 0 69 .6 10 0. 0 G oa 33 .2 31 .6 21 .6 0. 0 0. 4 0. 9 0. 2 8. 5 0. 0 0. 0 0. 0 1. 6 0. 7 0. 9 0. 0 66 .8 10 0. 0 G uj ar at 47 .1 41 .2 27 .5 0. 0 1. 6 4. 5 0. 0 7. 5 0. 0 0. 0 0. 0 5. 9 4. 5 1. 4 0. 0 52 .9 10 0. 0 M ah ar as ht ra 63 .9 60 .7 44 .8 0. 2 3. 3 2. 2 0. 2 9. 9 0. 0 0. 1 0. 0 3. 2 1. 6 1. 6 0. 0 36 .1 10 0. 0 So ut h An da m an & N ic ob ar Is la nd s 42 .2 40 .6 34 .7 0. 0 1. 7 1. 5 0. 0 2. 7 0. 0 0. 0 0. 0 1. 6 0. 3 1. 2 0. 0 57 .8 10 0. 0 An dh ra P ra de sh 68 .4 68 .1 65 .6 1. 2 0. 4 0. 5 0. 0 0. 5 0. 0 0. 0 0. 0 0. 3 0. 2 0. 1 0. 0 31 .6 10 0. 0 Ka rn at ak a 48 .0 47 .1 42 .8 0. 1 0. 7 1. 2 0. 0 2. 2 0. 0 0. 0 0. 0 0. 9 0. 5 0. 3 0. 0 52 .0 10 0. 0 Ke ra la 53 .3 50 .6 45 .7 0. 0 0. 3 1. 5 0. 0 3. 0 0. 0 0. 0 0. 0 2. 8 0. 9 1. 9 0. 0 46 .7 10 0. 0 La ks ha dw ee p 30 .0 14 .7 9. 9 0. 0 0. 0 0. 7 0. 2 4. 0 0. 0 0. 0 0. 0 15 .3 3. 0 12 .2 0. 0 70 .0 10 0. 0 Pu du ch er ry 62 .4 61 .5 58 .5 0. 0 0. 3 2. 1 0. 0 0. 6 0. 0 0. 0 0. 0 0. 8 0. 3 0. 5 0. 0 37 .6 10 0. 0 Ta m il N ad u 54 .1 53 .5 49 .4 0. 0 0. 4 2. 3 0. 1 1. 2 0. 1 0. 0 0. 0 0. 6 0. 1 0. 5 0. 0 45 .9 10 0. 0 Te la ng an a 58 .9 58 .3 54 .9 1. 4 0. 6 0. 7 0. 0 0. 8 0. 0 0. 0 0. 0 0. 5 0. 5 0. 0 0. 0 41 .1 10 0. 0 RU RA L In di a 51 .7 46 .0 36 .1 0. 3 4. 3 1. 1 0. 2 3. 9 0. 0 0. 1 0. 0 5. 7 3. 5 2. 2 0. 0 48 .3 10 0. 0 N FH S- 3 (2 00 5- 06 ) 53 .0 45 .3 37 .1 1. 0 2. 8 1. 1 0. 1 3. 2 0. 0 na 0. 0 7. 6 4. 9 2. 3 0. 4 47 .0 10 0. 0 N or th C ha nd ig ar h 89 .5 78 .9 42 .1 0. 0 5. 3 5. 3 0. 0 26 .3 0. 0 0. 0 0. 0 10 .5 10 .5 0. 0 0. 0 10 .5 10 0. 0 D el hi 56 .5 51 .0 22 .3 2. 5 5. 4 6. 8 0. 0 13 .9 0. 0 0. 0 0. 0 5. 6 2. 5 3. 0 0. 0 43 .5 10 0. 0 H ar ya na 66 .2 62 .2 42 .7 0. 6 2. 4 5. 3 0. 1 10 .7 0. 0 0. 2 0. 0 4. 0 2. 2 1. 8 0. 0 33 .8 10 0. 0 H im ac ha l P ra de sh 56 .8 52 .2 35 .1 2. 6 1. 5 0. 8 0. 1 12 .1 0. 0 0. 0 0. 0 4. 6 0. 9 3. 7 0. 0 43 .2 10 0. 0 Ja m m u & K as hm ir 53 .9 41 .9 21 .8 0. 3 6. 6 2. 4 0. 8 9. 9 0. 1 0. 1 0. 0 12 .0 1. 4 10 .6 0. 0 46 .1 10 0. 0 Pu nj ab 75 .4 67 .1 41 .2 0. 6 2. 8 5. 8 0. 1 16 .5 0. 0 0. 0 0. 0 8. 3 5. 5 2. 8 0. 0 24 .6 10 0. 0 Ra ja st ha n 58 .3 52 .1 42 .5 0. 2 2. 0 1. 0 0. 2 6. 1 0. 0 0. 1 0. 0 6. 2 4. 2 2. 0 0. 0 41 .7 10 0. 0 U tta ra kh an d 53 .1 49 .8 32 .2 0. 8 2. 7 1. 3 0. 2 12 .4 0. 0 0. 1 0. 0 3. 3 1. 4 1. 9 0. 0 46 .9 10 0. 0 C on tin ue d. . Family Planning z�123 Ta bl e 5. 2 C ur re nt u se o f c on tra ce pt io n by s ta te /u ni on te rr ito ry — C on tin ue d Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to re sid en ce a nd s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 , a nd b y re sid en ce , N FH S- 3 St at e/ un io n te rr ito ry An y m et ho d An y m od er n m et ho d M od er n m et ho d An y tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d Rh yt hm W ith - dr aw al O th er tra di - tio na l m et ho d C en tr al C hh at tis ga rh 56 .4 53 .6 47 .0 0. 7 1. 5 1. 4 0. 0 2. 6 0. 0 0. 5 0. 0 2. 8 1. 5 1. 2 0. 0 43 .6 10 0. 0 M ad hy a Pr ad es h 51 .2 49 .8 45 .1 0. 5 0. 9 0. 4 0. 1 2. 6 0. 0 0. 1 0. 0 1. 5 1. 1 0. 4 0. 0 48 .8 10 0. 0 U tta r P ra de sh 42 .1 29 .0 18 .1 0. 0 1. 7 0. 9 0. 3 7. 9 0. 0 0. 1 0. 0 13 .1 11 .1 2. 0 0. 0 57 .9 10 0. 0 Ea st Bi ha r 22 .5 22 .0 19 .8 0. 0 0. 7 0. 4 0. 2 0. 8 0. 0 0. 0 0. 0 0. 6 0. 1 0. 5 0. 0 77 .5 10 0. 0 Jh ar kh an d 38 .3 35 .7 30 .5 0. 2 2. 4 0. 9 0. 2 1. 4 0. 0 0. 2 0. 0 2. 5 1. 7 0. 8 0. 0 61 .7 10 0. 0 O di sh a 56 .5 44 .8 28 .7 0. 2 12 .0 1. 0 0. 2 2. 5 0. 0 0. 2 0. 0 11 .7 3. 4 8. 2 0. 0 43 .5 10 0. 0 W es t B en ga l 71 .7 58 .7 32 .1 0. 1 21 .4 0. 8 0. 2 3. 8 0. 0 0. 3 0. 0 13 .0 6. 8 6. 2 0. 0 28 .3 10 0. 0 N or th ea st Ar un ac ha l P ra de sh 33 .2 27 .6 12 .1 0. 1 10 .7 3. 3 0. 2 1. 2 0. 0 0. 1 0. 0 5. 7 3. 9 1. 8 0. 0 66 .8 10 0. 0 As sa m 52 .0 36 .8 9. 5 0. 1 22 .6 2. 1 0. 1 2. 1 0. 1 0. 2 0. 0 15 .2 7. 1 8. 2 0. 0 48 .0 10 0. 0 M an ip ur 22 .7 12 .5 2. 8 0. 0 4. 3 4. 0 0. 2 1. 2 0. 0 0. 0 0. 0 10 .1 1. 0 9. 2 0. 0 77 .3 10 0. 0 M eg ha la ya 22 .4 20 .6 4. 8 0. 0 12 .7 1. 6 0. 6 0. 9 0. 0 0. 0 0. 0 1. 7 0. 6 1. 1 0. 0 77 .6 10 0. 0 M iz or am 31 .6 31 .5 15 .1 0. 0 12 .7 2. 7 0. 1 1. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 68 .4 10 0. 0 N ag al an d 24 .0 19 .1 8. 4 0. 0 3. 2 6. 3 0. 1 1. 0 0. 0 0. 0 0. 0 5. 0 2. 5 2. 5 0. 0 76 .0 10 0. 0 Si kk im 51 .4 50 .9 19 .7 4. 3 12 .9 7. 1 1. 7 5. 1 0. 0 0. 0 0. 0 0. 6 0. 2 0. 4 0. 0 48 .6 10 0. 0 Tr ip ur a 63 .0 42 .7 12 .4 0. 0 28 .5 0. 4 0. 2 1. 2 0. 0 0. 0 0. 0 20 .3 7. 0 13 .2 0. 0 37 .0 10 0. 0 W es t D ad ra & N ag ar H av el i 43 .4 43 .4 40 .1 0. 0 0. 3 1. 0 0. 0 2. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 56 .6 10 0. 0 D am an & D iu 37 .5 35 .5 31 .7 0. 0 1. 2 0. 2 0. 0 2. 4 0. 0 0. 0 0. 0 2. 0 1. 6 0. 4 0. 0 62 .5 10 0. 0 G oa 13 .5 12 .0 6. 3 0. 0 0. 3 0. 9 0. 0 4. 4 0. 1 0. 0 0. 0 1. 5 0. 0 1. 5 0. 0 86 .5 10 0. 0 G uj ar at 46 .7 44 .6 38 .5 0. 2 1. 2 1. 9 0. 0 2. 8 0. 0 0. 0 0. 0 2. 1 1. 0 1. 2 0. 0 53 .3 10 0. 0 M ah ar as ht ra 65 .4 64 .1 55 .8 0. 7 1. 7 1. 1 0. 1 4. 6 0. 0 0. 0 0. 0 1. 3 0. 6 0. 7 0. 0 34 .6 10 0. 0 So ut h An da m an & N ic ob ar Is la nd s 56 .6 53 .5 43 .3 0. 0 2. 4 2. 5 0. 0 5. 3 0. 0 0. 0 0. 0 3. 1 0. 3 2. 8 0. 0 43 .4 10 0. 0 An dh ra P ra de sh 70 .0 70 .0 69 .5 0. 3 0. 1 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 30 .0 10 0. 0 Ka rn at ak a 54 .5 54 .3 52 .8 0. 0 0. 3 0. 6 0. 0 0. 6 0. 0 0. 0 0. 0 0. 2 0. 1 0. 1 0. 0 45 .5 10 0. 0 Ke ra la 52 .9 50 .0 45 .8 0. 1 0. 1 1. 7 0. 0 2. 2 0. 1 0. 0 0. 0 2. 8 1. 0 1. 9 0. 0 47 .1 10 0. 0 La ks ha dw ee p 28 .7 19 .3 13 .8 0. 0 0. 0 0. 7 0. 0 4. 8 0. 0 0. 0 0. 0 9. 5 0. 0 9. 5 0. 0 71 .3 10 0. 0 Pu du ch er ry 60 .9 60 .5 54 .8 0. 0 0. 4 3. 7 0. 0 1. 2 0. 2 0. 0 0. 0 0. 5 0. 2 0. 3 0. 0 39 .1 10 0. 0 Ta m il N ad u 52 .3 51 .6 49 .4 0. 0 0. 1 1. 4 0. 1 0. 5 0. 1 0. 0 0. 0 0. 6 0. 3 0. 4 0. 0 47 .7 10 0. 0 Te la ng an a 55 .7 55 .7 53 .5 1. 7 0. 1 0. 1 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 44 .3 10 0. 0 C on tin ue d. . 124 z Family Planning Ta bl e 5. 2 C ur re nt u se o f c on tra ce pt io n by s ta te /u ni on te rr ito ry — C on tin ue d Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to re sid en ce a nd s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 , a nd b y re sid en ce , N FH S- 3 St at e/ un io n te rr ito r y An y m et ho d An y m od er n m et ho d M od er n m et ho d An y tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d Rh yt hm W ith - dr aw al O th er tra di - tio na l m et ho d TO TA L In di a 53 .5 47 .7 36 .0 0. 3 4. 1 1. 5 0. 2 5. 6 0. 0 0. 1 0. 0 5. 8 3. 5 2. 3 0. 0 46 .5 10 0. 0 N FH S- 3 (2 00 5- 06 ) 56 .3 48 .5 37 .3 1. 0 3. 1 1. 7 0. 1 5. 2 0. 0 na 0. 0 7. 8 4. 9 2. 5 0. 3 43 .7 10 0. 0 N or th C ha nd ig ar h 74 .0 58 .2 20 .6 1. 3 3. 6 5. 4 0. 0 27 .3 0. 0 0. 0 0. 0 15 .8 9. 6 6. 1 0. 0 26 .0 10 0. 0 D el hi 54 .8 48 .6 19 .8 0. 2 2. 9 5. 4 0. 1 20 .0 0. 0 0. 0 0. 0 6. 3 2. 3 4. 0 0. 0 45 .2 10 0. 0 H ar ya na 63 .7 59 .4 38 .1 0. 6 2. 8 5. 6 0. 2 12 .0 0. 0 0. 2 0. 0 4. 3 2. 2 2. 2 0. 0 36 .3 10 0. 0 H im ac ha l P ra de sh 56 .8 52 .0 34 .4 2. 4 1. 5 0. 9 0. 1 12 .6 0. 1 0. 0 0. 0 4. 9 0. 8 4. 0 0. 0 43 .2 10 0. 0 Ja m m u & K as hm ir 57 .1 46 .0 24 .3 0. 4 6. 4 2. 8 0. 8 11 .2 0. 0 0. 1 0. 0 11 .1 1. 3 9. 8 0. 0 42 .9 10 0. 0 Pu nj ab 75 .8 66 .3 37 .5 0. 6 2. 7 6. 6 0. 1 18 .9 0. 0 0. 0 0. 0 9. 5 6. 2 3. 3 0. 0 24 .2 10 0. 0 Ra ja st ha n 59 .7 53 .5 40 .7 0. 2 2. 4 1. 2 0. 2 8. 7 0. 0 0. 0 0. 0 6. 2 4. 2 2. 0 0. 0 40 .3 10 0. 0 U tta ra kh an d 53 .4 49 .3 27 .4 0. 7 3. 3 1. 6 0. 2 16 .1 0. 0 0. 1 0. 0 4. 1 1. 6 2. 5 0. 0 46 .6 10 0. 0 C en tr al C hh at tis ga rh 57 .7 54 .5 46 .2 0. 7 1. 7 1. 6 0. 0 3. 9 0. 0 0. 4 0. 0 3. 2 1. 8 1. 3 0. 0 42 .3 10 0. 0 M ad hy a Pr ad es h 51 .3 49 .5 42 .2 0. 5 1. 3 0. 5 0. 1 4. 9 0. 0 0. 1 0. 0 1. 8 1. 3 0. 5 0. 0 48 .7 10 0. 0 U tta r P ra de sh 45 .5 31 .7 17 .3 0. 1 1. 9 1. 2 0. 4 10 .8 0. 0 0. 1 0. 0 13 .8 11 .5 2. 2 0. 0 54 .5 10 0. 0 Ea st Bi ha r 24 .0 23 .2 20 .7 0. 0 0. 8 0. 5 0. 3 1. 0 0. 0 0. 0 0. 0 0. 8 0. 2 0. 6 0. 0 76 .0 10 0. 0 Jh ar kh an d 40 .3 37 .4 31 .0 0. 2 2. 6 1. 0 0. 2 2. 2 0. 0 0. 2 0. 0 2. 9 2. 0 0. 9 0. 0 59 .7 10 0. 0 O di sh a 57 .3 45 .4 28 .2 0. 2 12 .1 1. 1 0. 2 3. 4 0. 0 0. 2 0. 0 11 .9 3. 5 8. 4 0. 0 42 .7 10 0. 0 W es t B en ga l 70 .9 57 .0 29 .2 0. 1 20 .0 1. 2 0. 2 5. 9 0. 0 0. 2 0. 0 13 .9 7. 1 6. 8 0. 0 29 .1 10 0. 0 N or th ea st Ar un ac ha l P ra de sh 31 .6 26 .6 11 .2 0. 0 10 .5 3. 2 0. 2 1. 4 0. 0 0. 1 0. 0 5. 0 3. 4 1. 6 0. 0 68 .4 10 0. 0 As sa m 52 .4 37 .0 9. 5 0. 1 22 .1 2. 2 0. 1 2. 7 0. 1 0. 3 0. 0 15 .4 7. 4 8. 0 0. 0 47 .6 10 0. 0 M an ip ur 23 .6 12 .7 3. 1 0. 1 4. 2 3. 7 0. 1 1. 3 0. 0 0. 0 0. 0 10 .9 1. 6 9. 3 0. 0 76 .4 10 0. 0 M eg ha la ya 24 .3 21 .9 6. 2 0. 0 11 .8 1. 9 0. 6 1. 3 0. 0 0. 0 0. 0 2. 4 0. 7 1. 7 0. 0 75 .7 10 0. 0 M iz or am 35 .3 35 .2 17 .4 0. 0 13 .2 3. 3 0. 0 1. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 64 .7 10 0. 0 N ag al an d 26 .5 21 .2 9. 1 0. 0 4. 0 6. 7 0. 1 1. 3 0. 0 0. 1 0. 0 5. 3 2. 9 2. 4 0. 0 73 .5 10 0. 0 Si kk im 46 .7 45 .9 17 .6 3. 4 11 .6 6. 3 1. 8 5. 2 0. 0 0. 0 0. 0 0. 8 0. 2 0. 6 0. 0 53 .3 10 0. 0 Tr ip ur a 64 .1 42 .8 13 .9 0. 0 26 .3 0. 6 0. 1 1. 9 0. 0 0. 0 0. 0 21 .3 7. 7 13 .6 0. 0 35 .9 10 0. 0 C on tin ue d. . Family Planning z�125 Ta bl e 5. 2 C ur re nt u se o f c on tra ce pt io n by s ta te /u ni on te rr ito ry ³ C on tin ue d Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to re sid en ce a nd s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 , a nd b y re sid en ce , N FH S- 3 St at e/ un io n te rr ito ry An y m et ho d An y m od er n m et ho d M od er n m et ho d Tr ad iti on al m et ho d Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d An y tra di - tio na l m et ho d Rh yt hm W ith - dr aw al O th er tra di - tio na l m et ho d N ot cu rr en tly us in g To ta l W es t D ad ra & N ag ar H av el i 38 .0 37 .9 31 .7 0. 0 1. 2 1. 4 0. 0 3. 7 0. 0 0. 0 0. 0 0. 2 0. 0 0. 2 0. 0 62 .0 10 0. 0 D am an & D iu 32 .3 31 .6 25 .6 0. 0 1. 3 2. 4 0. 0 2. 2 0. 0 0. 0 0. 1 0. 7 0. 4 0. 3 0. 0 67 .7 10 0. 0 G oa 26 .3 24 .8 16 .3 0. 0 0. 3 0. 9 0. 1 7. 1 0. 1 0. 0 0. 0 1. 6 0. 4 1. 1 0. 0 73 .7 10 0. 0 G uj ar at 46 .9 43 .1 33 .6 0. 1 1. 4 3. 0 0. 0 4. 9 0. 0 0. 0 0. 0 3. 8 2. 5 1. 3 0. 0 53 .1 10 0. 0 M ah ar as ht ra 64 .7 62 .5 50 .6 0. 4 2. 5 1. 6 0. 2 7. 1 0. 0 0. 1 0. 0 2. 2 1. 1 1. 1 0. 0 35 .3 10 0. 0 So ut h An da m an & N ic ob ar Is la nd s 50 .5 48 .0 39 .6 0. 0 2. 1 2. 1 0. 0 4. 2 0. 0 0. 0 0. 0 2. 4 0. 3 2. 1 0. 0 49 .5 10 0. 0 An dh ra P ra de sh 69 .5 69 .4 68 .3 0. 6 0. 2 0. 2 0. 0 0. 2 0. 0 0. 0 0. 0 0. 1 0. 1 0. 0 0. 0 30 .5 10 0. 0 Ka rn at ak a 51 .8 51 .3 48 .6 0. 1 0. 4 0. 8 0. 0 1. 3 0. 0 0. 0 0. 0 0. 5 0. 3 0. 2 0. 0 48 .2 10 0. 0 Ke ra la 53 .1 50 .3 45 .8 0. 1 0. 2 1. 6 0. 0 2. 6 0. 0 0. 0 0. 0 2. 8 0. 9 1. 9 0. 0 46 .9 10 0. 0 La ks ha dw ee p 29 .7 15 .7 10 .7 0. 0 0. 0 0. 7 0. 1 4. 1 0. 0 0. 0 0. 0 14 .0 2. 4 11 .7 0. 0 70 .3 10 0. 0 Pu du ch er ry 61 .9 61 .2 57 .4 0. 0 0. 4 2. 6 0. 0 0. 8 0. 1 0. 0 0. 0 0. 7 0. 3 0. 4 0. 0 38 .1 10 0. 0 Ta m il N ad u 53 .2 52 .6 49 .4 0. 0 0. 2 1. 9 0. 1 0. 8 0. 1 0. 0 0. 0 0. 6 0. 2 0. 4 0. 0 46 .8 10 0. 0 Te la ng an a 57 .2 56 .9 54 .2 1. 6 0. 3 0. 4 0. 0 0. 5 0. 0 0. 0 0. 0 0. 3 0. 2 0. 0 0. 0 42 .8 10 0. 0 N ot e: If m or e th an o ne m et ho d is us ed , o nl y th e m os t e ffe ct iv e m et ho d is co ns id er ed in th is ta bl e. na = N ot a va ila bl e IU D = In tra ut er in e de vi ce ; P PI U D = P os tp ar tu m in tra ut er in e de vi ce ; L AM = L ac ta tio na l a m en or rh oe a m et ho d 126 z Family Planning Ta bl e 5. 3. 1 C ur re nt u se o f c on tra ce pt io n Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic An y m et ho d An y m od er n m et ho d M od er n m et ho d An y tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l N um be r of w om en Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D or PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d Rh yt hm W ith - dr aw al Sc ho ol in g N o sc ho ol in g 54 .0 49 .0 42 .7 0. 3 2. 6 0. 6 0. 1 2. 5 0. 0 0. 1 0. 0 5. 1 3. 6 1. 5 46 .0 10 0. 0 16 9, 59 0 < 5 ye ar s co m pl et e 60 .5 55 .3 44 .6 0. 3 6. 8 0. 9 0. 1 2. 4 0. 0 0 .1 0. 0 5. 2 2. 8 2. 5 39 .5 10 0. 0 34 ,0 39 5- 7 ye ar s co m pl et e 57 .3 51 .9 41 .1 0. 2 5. 0 1. 3 0. 1 4. 0 0. 0 0. 1 0. 0 5. 4 3. 2 2. 2 42 .7 10 0. 0 80 ,7 85 8- 9 ye ar s co m pl et e 53 .1 46 .0 31 .6 0. 3 6. 0 1. 7 0. 2 6. 1 0. 0 0. 1 0. 0 7. 1 4. 1 3. 0 46 .9 10 0. 0 76 ,2 54 10 -1 1 ye ar s co m pl et e 53 .0 47 .3 33 .1 0. 3 4. 2 2. 0 0. 2 7. 4 0. 0 0. 1 0. 0 5. 8 3. 1 2. 7 47 .0 10 0. 0 60 ,3 86 12 o r m or e ye ar s co m pl et e 47 .2 40 .7 21 .2 0. 2 3. 3 3. 2 0. 3 12 .4 0. 1 0. 1 0. 0 6. 5 3. 8 2. 8 52 .8 10 0. 0 90 ,3 20 Em pl oy m en t (p as t 1 2 m on th s) N ot e m pl oy ed 50 .8 44 .3 31 .1 0. 2 4. 5 1. 6 0. 2 6. 6 0. 0 0. 1 0. 0 6. 5 3. 7 2. 8 49 .2 10 0. 0 61 ,0 54 Em pl oy ed fo r c as h 65 .0 60 .0 50 .4 0. 5 3. 2 1. 5 0. 1 4. 2 0. 0 0. 0 0. 0 5. 0 3. 0 2. 0 35 .0 10 0. 0 21 ,5 67 Em pl oy ed n ot fo r c as h 58 .0 52 .4 44 .7 0. 4 2. 2 0. 9 0. 5 3. 5 0. 1 0. 1 0. 0 5. 5 3. 7 1. 8 42 .0 10 0. 0 5, 40 0 Re lig io n H in du 54 .4 48 .8 38 .2 0. 3 3. 4 1. 4 0. 2 5. 2 0. 0 0. 1 0. 0 5. 6 3. 5 2. 1 45 .6 10 0. 0 41 6, 44 6 M us lim 45 .3 37 .9 20 .8 0. 1 8. 1 1. 4 0. 3 7. 2 0. 0 0. 1 0. 0 7. 3 4. 1 3. 3 54 .7 10 0. 0 67 ,3 17 C hr ist ia n 51 .2 47 .9 40 .2 0. 2 3. 2 1. 7 0. 2 2. 4 0. 0 0. 0 0. 0 3. 3 1. 5 1. 8 48 .8 10 0. 0 11 ,3 68 Si kh 73 .9 65 .4 38 .2 0. 7 2. 6 6. 5 0. 2 17 .3 0. 0 0. 0 0. 0 8. 5 5. 6 2. 9 26 .1 10 0. 0 8, 20 1 Bu dd hi st /N eo -B ud dh ist 67 .7 65 .4 52 .0 0. 6 3. 4 1. 5 0. 3 7. 5 0. 0 0. 1 0. 0 2. 3 0. 8 1. 5 32 .3 10 0. 0 4, 50 9 Ja in 62 .0 57 .6 38 .1 1. 3 1. 5 3. 1 0. 1 13 .5 0. 0 0. 0 0. 0 4. 4 2. 0 2. 3 38 .0 10 0. 0 94 3 O th er 42 .0 36 .6 14 .9 0. 2 16 .8 1. 6 0. 2 2. 8 0. 0 0. 0 0. 0 5. 4 4. 2 1. 2 58 .0 10 0. 0 2, 58 9 C as te /tr ib e Sc he du le d ca st e 54 .9 49 .2 38 .5 0. 3 3. 9 1. 2 0. 1 5. 0 0. 0 0. 1 0. 0 5. 7 3. 6 2. 1 45 .1 10 0. 0 10 3, 61 1 Sc he du le d tri be 49 .4 45 .0 36 .5 0. 5 4. 2 1. 2 0. 1 2. 3 0. 0 0. 2 0. 0 4. 3 2. 3 2. 1 50 .6 10 0. 0 46 ,7 06 O th er b ac kw ar d cl as s 51 .5 46 .5 37 .3 0. 2 2. 4 1. 4 0. 2 4. 9 0. 0 0. 1 0. 0 5. 0 3. 4 1. 7 48 .5 10 0. 0 22 3, 16 7 O th er 57 .5 49 .9 32 .0 0. 2 6. 9 2. 0 0. 2 8. 4 0. 0 0. 1 0. 0 7. 6 4. 1 3. 4 42 .5 10 0. 0 13 4, 37 5 D on 't kn ow 44 .7 39 .5 25 .4 0. 1 7. 5 1. 7 0. 1 4. 3 0. 0 0. 2 0. 0 5. 2 2. 2 3. 0 55 .3 10 0. 0 3, 51 4 C on tin ue d… Family Planning z�127 Ta bl e 5. 3. 1 C ur re nt u se o f c on tra ce pt io n— C on tin ue d Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic An y m et ho d An y m od er n m et ho d M od er n m et ho d An y tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l N um be r of w om en Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D or PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d Rh yt hm W ith - dr aw al W ea lth in de x Lo w es t 42 .0 36 .3 29 .1 0. 2 4. 4 0. 5 0. 1 1. 8 0. 0 0. 1 0. 0 5. 7 3. 9 1. 9 58 .0 10 0. 0 92 ,9 19 Se co nd 51 .9 45 .8 35 .3 0. 3 5. 9 0. 9 0. 2 3. 1 0. 0 0. 1 0. 0 6. 1 3. 8 2. 4 48 .1 10 0. 0 10 0, 91 0 M id dl e 55 .8 50 .2 40 .2 0. 2 4. 2 1. 0 0. 1 4. 3 0. 0 0. 1 0. 0 5. 6 3. 3 2. 3 44 .2 10 0. 0 10 4, 66 5 Fo ur th 57 .2 51 .8 39 .7 0. 3 3. 5 1. 8 0. 2 6. 3 0. 0 0. 1 0. 0 5. 4 3. 2 2. 2 42 .8 10 0. 0 10 7, 45 4 H ig he st 59 .2 53 .1 34 .7 0. 3 2. 6 3. 1 0. 2 12 .0 0. 0 0. 0 0. 0 6. 1 3. 5 2. 5 40 .8 10 0. 0 10 5, 42 5 N um be r of li vi ng c hi ld re n N o ch ild re n 8. 1 5. 6 0. 5 0. 0 1. 0 0. 1 0. 0 3. 9 0. 0 0. 0 0. 0 2. 5 1. 2 1. 4 91 .9 10 0. 0 53 ,4 81 1 c hi ld 35 .5 27 .2 7. 6 0. 1 7. 1 2. 7 0. 2 9. 2 0. 1 0. 2 0. 0 8. 3 4. 5 3. 8 64 .5 10 0. 0 99 ,6 72 1 so n 38 .4 29 .7 9. 1 0. 1 7. 4 3. 0 0. 2 9. 7 0. 1 0. 1 0. 0 8. 6 4. 7 4. 0 61 .6 10 0. 0 56 ,4 15 N o so ns 31 .8 23 .9 5. 8 0. 1 6. 7 2. 2 0. 2 8. 6 0. 1 0. 2 0. 0 7. 8 4. 2 3. 6 68 .2 10 0. 0 43 ,2 58 2 c hi ld re n 66 .9 61 .5 48 .7 0. 4 4. 2 1. 9 0. 2 6. 1 0. 0 0. 1 0. 0 5. 4 3. 1 2. 2 33 .1 10 0. 0 17 6, 37 7 2 so ns 71 .0 66 .4 55 .6 0. 4 3. 6 1. 5 0. 1 5. 1 0. 0 0. 0 0. 0 4. 6 2. 8 1. 8 29 .0 10 0. 0 54 ,3 23 1 so n 68 .3 62 .6 49 .0 0. 4 4. 2 2. 1 0. 2 6. 5 0. 0 0. 1 0. 0 5. 7 3. 3 2. 4 31 .7 10 0. 0 95 ,9 77 N o so ns 53 .0 47 .3 33 .4 0. 2 5. 1 1. 7 0. 2 6. 6 0. 0 0. 1 0. 0 5. 7 3. 2 2. 5 47 .0 10 0. 0 26 ,0 78 3 c hi ld re n 68 .2 63 .3 54 .5 0. 3 3. 3 1. 1 0. 2 3. 8 0. 0 0. 1 0. 0 4. 9 3. 3 1. 7 31 .8 10 0. 0 10 1, 21 7 3 so ns 71 .3 67 .0 60 .6 0. 3 2. 6 0. 8 0. 1 2. 6 0. 0 0. 1 0. 0 4. 2 2. 9 1. 4 28 .7 10 0. 0 11 ,8 27 2 so ns 72 .1 67 .7 60 .4 0. 3 2. 6 0. 8 0. 2 3. 3 0. 0 0. 0 0. 0 4. 4 3. 0 1. 3 27 .9 10 0. 0 43 ,8 00 1 so n 66 .7 61 .1 50 .1 0. 4 4. 0 1. 5 0. 2 4. 7 0. 0 0. 1 0. 0 5. 6 3. 6 2. 0 33 .3 10 0. 0 37 ,7 14 N o so ns 50 .0 44 .2 33 .5 0. 2 4. 8 1. 2 0. 1 4. 3 0. 0 0. 1 0. 0 5. 8 3. 3 2. 5 50 .0 10 0. 0 7, 87 5 4+ c hi ld re n 58 .2 51 .4 43 .4 0. 3 3. 2 0. 8 0. 2 3. 4 0. 0 0. 1 0. 0 6. 8 5. 1 1. 7 41 .8 10 0. 0 80 ,5 98 2+ s on s 58 .8 52 .0 44 .5 0. 3 3. 0 0. 7 0. 2 3. 2 0. 0 0. 0 0. 0 6. 8 5. 2 1. 7 41 .2 10 0. 0 56 ,9 97 1 so n 59 .4 52 .6 43 .5 0. 3 3. 7 0. 9 0. 2 3. 8 0. 0 0. 0 0. 0 6. 8 4. 9 1. 9 40 .6 10 0. 0 20 ,1 21 N o so ns 40 .8 34 .7 24 .2 0. 3 4. 1 1. 2 0. 1 4. 3 0. 0 0. 4 0. 1 6. 2 4. 1 2. 0 59 .2 10 0. 0 3, 48 0 To ta l 53 .5 47 .7 36 .0 0. 3 4. 1 1. 5 0. 2 5. 6 0. 0 0. 1 0. 0 5. 8 3. 5 2. 3 46 .5 10 0. 0 51 1, 37 3 N ot e: If m or e th an o ne m et ho d is us ed , o nl y th e m os t e ffe ct iv e m et ho d is co ns id er ed in th is ta bl e. IU D = In tra ut er in e de vi ce ; P PI U D = P os tp ar tu m in tra ut er in e de vi ce ; L AM = L ac ta tio na l a m en or rh oe a m et ho d 128 z Family Planning T ab le 5 .3 .2 C on tra ce pt iv e us e by m en w ith la st s ex ua l p ar tn er Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d m en a nd s ex ua lly a ct iv e un m ar rie d m en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d us ed th e la st ti m e th ey h ad s ex , a cc or di ng to ty pe o f s ex ua l p ar tn er a nd b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic An y m et ho d An y m od er n m et ho d M od er n m et ho d An y tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l N um be r of m en Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / 1 LUR GK Fe m al e co nd om O th er m od er n m et ho d Rh yt hm W ith - dr aw al Ty pe o f s ex ua l p ar tn er C ur re nt ly m ar rie d 24 .6 20 .2 10 .6 0. 4 3. 8 0. 7 0. 1 4. 4 0. 1 0. 2 4. 4 2. 3 2. 1 75 .4 10 0. 0 62 ,4 99 W ife 26 .7 21 .9 11 .5 0. 4 4. 1 0. 7 0. 1 4. 8 0. 1 0. 2 4. 8 2. 6 2. 2 73 .3 10 0. 0 55 ,8 10 L iv e- in p ar tn er /g irl fri en d 30 .6 26 .4 6. 7 0. 0 1. 5 0. 0 0. 0 18 .1 0. 0 0. 0 4. 2 1. 3 2. 9 69 .4 10 0. 0 13 9 O th er 6. 5 5. 6 3. 0 0. 7 1. 1 0. 3 0. 0 0. 3 0. 0 0. 1 0. 9 0. 3 0. 5 93 .5 10 0. 0 6, 55 0 N ot c ur re nt ly m ar rie d 47 .1 43 .8 1. 1 0. 0 3. 1 0. 0 0. 0 38 .5 0. 6 0. 3 3. 4 0. 9 2. 4 52 .9 10 0. 0 3, 70 0 L iv e- in p ar tn er 53 .8 50 .7 0. 3 0. 0 2. 0 0. 0 0. 0 48 .4 0. 0 0. 0 3. 1 0. 4 2. 7 46 .2 10 0. 0 44 2 G irl fri en d 48 .8 45 .1 0. 0 0. 0 3. 6 0. 0 0. 1 39 .9 1. 0 0. 5 3. 7 1. 0 2. 7 51 .2 10 0. 0 2, 30 0 O th er 40 .2 37 .4 4. 2 0. 0 2. 6 0. 0 0. 0 30 .5 0. 1 0. 0 2. 7 1. 1 1. 7 59 .8 10 0. 0 95 8 Ag e 15 -1 9 29 .7 27 .1 0. 0 0. 0 2. 9 0. 0 0. 0 24 .0 0. 1 0. 1 2. 6 0. 7 1. 8 70 .3 10 0. 0 1, 10 0 20 -2 4 22 .4 18 .7 0. 9 0. 0 3. 4 0. 1 0. 1 13 .5 0. 6 0. 2 3. 8 1. 7 2. 1 77 .6 10 0. 0 5, 52 9 25 -2 9 20 .8 16 .3 3. 3 0. 1 3. 7 0. 6 0. 2 8. 1 0. 1 0. 2 4. 5 2. 4 2. 1 79 .2 10 0. 0 11 ,0 17 30 -3 4 24 .8 20 .2 7. 9 0. 3 4. 5 0. 8 0. 2 6. 2 0. 1 0. 3 4. 7 2. 2 2. 5 75 .2 10 0. 0 12 ,8 96 35 -3 9 28 .9 24 .1 12 .7 0. 5 4. 5 0. 8 0. 1 5. 3 0. 1 0. 1 4. 8 2. 5 2. 3 71 .1 10 0. 0 13 ,1 11 40 -4 4 28 .6 24 .4 15 .5 0. 4 3. 4 0. 8 0. 1 3. 9 0. 1 0. 2 4. 2 2. 3 1. 9 71 .4 10 0. 0 11 ,5 97 45 -4 9 26 .8 22 .8 16 .1 0. 8 2. 6 0. 3 0. 0 2. 8 0. 0 0. 1 4. 0 2. 2 1. 7 73 .2 10 0. 0 10 ,9 49 Re si de nc e U rb an 26 .6 22 .4 8. 4 0. 3 3. 2 0. 9 0. 1 9. 2 0. 2 0. 2 4. 3 2. 3 2. 0 73 .4 10 0. 0 24 ,2 96 Ru ra l 25 .4 20 .9 11 .0 0. 4 4. 1 0. 5 0. 1 4. 6 0. 1 0. 2 4. 4 2. 2 2. 2 74 .6 10 0. 0 41 ,9 03 Sc ho ol in g N o sc ho ol in g 23 .1 19 .0 12 .4 0. 5 3. 2 0. 3 0. 1 2. 4 0. 0 0. 1 4. 1 2. 4 1. 7 76 .9 10 0. 0 10 ,3 45 < 5 ye ar s co m pl et e 28 .3 23 .8 15 .0 0. 2 5. 9 0. 2 0. 1 2. 2 0. 2 0. 1 4. 4 2. 3 2. 1 71 .7 10 0. 0 5, 07 6 5- 7 ye ar s co m pl et e 25 .2 21 .3 12 .0 0. 4 4. 4 0. 3 0. 1 3. 9 0. 1 0. 1 4. 0 2. 1 1. 8 74 .8 10 0. 0 10 ,9 71 8- 9 ye ar s co m pl et e 25 .1 20 .4 9. 8 0. 3 3. 7 0. 4 0. 2 5. 8 0. 0 0. 2 4. 7 2. 6 2. 1 74 .9 10 0. 0 12 ,9 05 10 -1 1 ye ar s co m pl et e 24 .8 20 .9 9. 5 0. 5 3. 0 0. 9 0. 1 6. 7 0. 1 0. 2 3. 9 1. 9 2. 0 75 .2 10 0. 0 9, 74 8 12 o r m or e ye ar s co m pl et e 28 .2 23 .5 6. 5 0. 4 3. 5 1. 1 0. 1 11 .5 0. 3 0. 3 4. 7 2. 2 2. 5 71 .8 10 0. 0 17 ,1 55 M ar ita l s ta tu s N ev er m ar rie d 48 .1 44 .7 0. 3 0. 0 3. 3 0. 0 0. 0 40 .1 0. 7 0. 3 3. 4 0. 9 2. 6 51 .9 10 0. 0 3, 45 1 C ur re nt ly m ar rie d 24 .6 20 .2 10 .6 0. 4 3. 8 0. 7 0. 1 4. 4 0. 1 0. 2 4. 4 2. 3 2. 1 75 .4 10 0. 0 62 ,4 99 W id ow ed /d iv or ce d/ s ep ar at ed /d es er te d 33 .4 30 .5 12 .7 0. 0 1. 2 0. 0 0. 0 16 .2 0. 0 0. 5 2. 8 2. 2 0. 6 66 .6 10 0. 0 24 8 &R QW LQ XH G« Family Planning z�129 Ta bl e 5. 3. 2 C on tra ce pt iv e us e by m en w ith la st s ex ua l p ar tn er ³ &R QW LQ XH G Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d m en a nd s ex ua lly a ct iv e un m ar rie d m en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d us ed th e la st ti m e th ey h ad s ex , a cc or di ng to t yp e of s ex ua l p ar tn er a nd b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic An y m et ho d An y m od er n m et ho d M od er n m et ho d An y tr ad i- tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l N um be r of m en Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / 1 LUR GK Fe m al e co nd om O th er m od er n m et ho d Rh yt hm W ith - dr aw al Re lig io n H in du 25 .0 21 .0 10 .5 0. 4 3. 2 0. 6 0. 1 5. 9 0. 1 0. 2 4. 0 2. 1 2. 0 75 .0 10 0. 0 54 ,4 81 M us lim 27 .6 21 .9 6. 5 0. 1 7. 2 0. 5 0. 1 7. 1 0. 2 0. 2 5. 6 2. 9 2. 7 72 .4 10 0. 0 8, 28 2 C hr ist ia n 22 .7 19 .0 8. 7 0. 1 3. 3 1. 9 0. 0 4. 9 0. 0 0. 0 3. 7 1. 4 2. 3 77 .3 10 0. 0 1, 38 6 Si kh 52 .7 40 .0 18 .6 0. 3 5. 5 3. 6 0. 0 12 .0 0. 1 0. 0 12 .6 8. 0 4. 6 47 .3 10 0. 0 1, 05 9 Bu dd hi st /N eo -B ud dh ist 32 .6 30 .9 8. 7 1. 0 1. 7 0. 5 0. 1 18 .9 0. 0 0. 0 1. 7 0. 7 0. 9 67 .4 10 0. 0 61 2 Ja in 35 .2 31 .0 15 .3 0. 6 1. 5 0. 0 0. 0 13 .6 0. 0 0. 0 4. 2 4. 1 0. 1 64 .8 10 0. 0 10 5 O th er 26 .0 22 .1 6. 0 0. 2 12 .7 0. 5 0. 8 1. 8 0. 0 0. 1 3. 9 2. 9 1. 0 74 .0 10 0. 0 27 3 C as te /tr ib e Sc he du le d ca st e 27 .3 22 .5 11 .3 0. 4 3. 5 0. 4 0. 1 6. 5 0. 1 0. 3 4. 8 2. 7 2. 1 72 .7 10 0. 0 13 ,2 17 Sc he du le d tri be 22 .6 18 .2 10 .0 0. 5 3. 9 0. 4 0. 0 3. 2 0. 1 0. 1 4. 4 1. 9 2. 5 77 .4 10 0. 0 6, 19 2 O th er b ac kw ar d cl as s 22 .4 19 .1 9. 6 0. 4 2. 5 0. 6 0. 1 5. 7 0. 1 0. 2 3. 4 1. 7 1. 7 77 .6 10 0. 0 28 ,9 91 O th er 31 .6 26 .0 10 .0 0. 3 6. 0 0. 9 0. 2 8. 2 0. 2 0. 1 5. 6 3. 0 2. 6 68 .4 10 0. 0 17 ,6 11 D on 't kn ow 13 .2 10 .6 4. 0 0. 0 2. 4 0. 1 0. 0 4. 1 0. 0 0. 0 2. 6 0. 6 2. 0 86 .8 10 0. 0 18 8 W ea lth in de x Lo w es t 20 .5 16 .1 8. 9 0. 3 3. 8 0. 2 0. 1 2. 7 0. 0 0. 1 4. 4 2. 4 1. 9 79 .5 10 0. 0 10 ,3 28 Se co nd 25 .6 20 .6 10 .5 0. 3 5. 2 0. 3 0. 2 3. 8 0. 1 0. 2 5. 1 2. 9 2. 2 74 .4 10 0. 0 12 ,6 36 M id dl e 25 .3 21 .7 11 .7 0. 5 3. 8 0. 4 0. 1 5. 0 0. 1 0. 1 3. 6 1. 9 1. 7 74 .7 10 0. 0 13 ,9 81 Fo ur th 26 .0 22 .2 10 .0 0. 4 3. 3 0. 7 0. 1 7. 1 0. 3 0. 2 3. 7 1. 7 2. 0 74 .0 10 0. 0 14 ,2 90 H ig he st 30 .0 25 .1 8. 9 0. 3 3. 0 1. 3 0. 1 11 .2 0. 1 0. 2 5. 0 2. 5 2. 5 70 .0 10 0. 0 14 ,9 63 To ta l a ge 1 5- 49 25 .8 21 .5 10 .1 0. 4 3. 8 0. 6 0. 1 6. 3 0. 1 0. 2 4. 4 2. 3 2. 1 74 .2 10 0. 0 66 ,1 99 Ag e 50 -5 4 25 .3 21 .9 16 .7 0. 6 1. 9 0. 3 0. 1 1. 9 0. 1 0. 3 3. 4 2. 0 1. 5 74 .7 10 0. 0 8, 32 7 To ta l a ge 1 5- 54 25 .8 21 .5 10 .8 0. 4 3. 5 0. 6 0. 1 5. 8 0. 1 0. 2 4. 2 2. 2 2. 0 74 .2 10 0. 0 74 ,5 26 IU D = In tra ut er in e de vi ce ; P PI U D = P os tp ar tu m in tra ut er in e de vi ce 130 z Family Planning Table 5.4 Knowledge of contraceptive methods among adolescents Percentage of women and men age 15-24 who know at least one contraceptive method, who know at least one modern contraceptive method, and who know any modern temporary contraceptive method by background characteristics, India, 2015-16 Background characteristic Women Men Know any method Know any modern method1 Know any modern temporary method2 Number of women Know any method Know any modern method1 Know any modern temporary method2 Number of men Age 15-19 93.2 93.1 83.1 121,552 94.4 94.3 92.1 18,740 20-24 98.1 98.0 93.5 122,966 98.3 98.2 97.3 16,624 Residence Urban 96.6 96.5 91.1 78,417 96.9 96.9 95.7 13,237 Rural 95.2 95.1 87.1 166,100 95.8 95.7 93.8 22,126 Schooling No schooling 93.4 93.3 80.6 25,324 89.0 89.0 86.1 1,850 <5 years complete 93.9 93.8 85.0 8,728 93.9 93.9 91.6 1,120 5-7 years complete 94.4 94.3 84.3 30,573 94.5 94.3 92.0 3,950 8-9 years complete 94.4 94.3 86.0 56,890 94.7 94.7 92.4 8,716 10-11 years complete 95.6 95.6 88.5 51,587 96.6 96.6 94.6 7,991 12 or more years complete 98.2 98.2 95.0 71,415 99.0 99.0 98.5 11,737 Marital status Never married 93.7 93.6 84.8 144,171 95.9 95.8 94.1 30,951 Currently married 98.5 98.4 93.6 98,767 98.7 98.7 97.5 4,361 Widowed/divorced/ separated/deserted 97.0 96.8 89.6 1,580 95.0 95.0 95.0 53 Religion Hindu 95.8 95.7 88.4 193,486 96.2 96.2 94.4 28,352 Muslim 94.7 94.6 87.4 38,738 96.0 95.9 94.7 5,272 Christian 94.6 94.6 87.0 4,926 95.2 95.2 93.5 726 Sikh 98.9 98.8 96.6 3,556 99.4 99.4 99.1 534 Buddhist/Neo-Buddhist 95.7 95.7 90.1 2,136 99.4 99.4 99.4 309 Jain 97.4 97.4 93.1 318 (100.0) (100.0) (100.0) 43 Other 93.9 93.9 86.4 1,358 96.6 96.5 95.7 127 Caste/tribe Scheduled caste 96.0 95.9 88.3 51,700 96.6 96.5 94.9 7,333 Scheduled tribe 94.1 94.0 84.9 23,286 95.3 95.2 92.8 3,148 Other backward class 95.6 95.6 87.4 107,138 95.7 95.7 94.0 15,583 Other 96.1 96.1 91.6 60,760 97.2 97.1 95.8 9,149 Don't know 90.6 90.4 81.8 1,634 93.3 93.3 91.9 152 Wealth index Lowest 92.5 92.4 79.9 44,923 93.1 92.9 89.3 5,391 Second 95.3 95.2 87.6 51,863 94.9 94.9 93.1 7,120 Middle 96.0 96.0 88.8 52,521 97.1 97.1 95.7 7,676 Fourth 96.7 96.7 91.0 50,556 97.0 97.0 95.8 7,664 Highest 97.6 97.6 94.2 44,654 98.0 98.0 97.2 7,513 Total 95.6 95.6 88.4 244,518 96.2 96.2 94.5 35,364 IUD = Intrauterine device; PPIUD = Postpartum intrauterine device 1 Female sterilization, male sterilization, pill, IUD/PPIUD, injectables, male condom, female condom, emergency contraception, lactational amenorrhoea method (LAM), and other modern methods 2 Pill, IUD/PPIUD, injectables, male condom, female condom, emergency contraception, lactational amenorrhoea method (LAM), and other modern methods ( ) Based on 25-49 unweighted cases Family Planning z�131 Ta bl e 5. 5 C ur re nt u se o f c on tr ac ep tio n by a ge Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a nd s ex ua lly a ct iv e un m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to re sid en ce a nd a ge , I nd ia , 2 01 5- 16 A ge A ny m et ho d A ny m od er n m et ho d M od er n m et ho d A ny tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l N um be r of w om en Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d Rh yt hm W ith - dr aw al C U RR EN TL Y M AR RI ED W O M EN ² U RB AN 15 -1 9 16 .8 12 .1 1. 3 0. 1 3. 8 0. 8 0. 1 5. 6 0. 0 0. 4 0. 0 4. 7 2. 4 2. 3 83 .2 10 0. 0 3, 56 5 20 -2 4 31 .2 26 .1 7. 9 0. 0 4. 6 2. 6 0. 2 10 .5 0. 0 0. 2 0. 0 5. 1 2. 7 2. 4 68 .8 10 0. 0 22 ,0 26 25 -2 9 49 .0 42 .6 21 .7 0. 1 4. 4 3. 0 0. 3 12 .9 0. 0 0. 1 0. 0 6. 4 3. 8 2. 7 51 .0 10 0. 0 34 ,3 84 30 -3 4 63 .7 56 .9 36 .4 0. 2 4. 6 3. 3 0. 3 12 .0 0. 0 0. 0 0. 0 6. 9 4. 0 2. 9 36 .3 10 0. 0 32 ,1 33 35 -3 9 69 .4 62 .0 46 .7 0. 3 3. 6 2. 5 0. 2 8. 7 0. 0 0. 0 0. 0 7. 4 4. 3 3. 1 30 .6 10 0. 0 30 ,2 75 40 -4 4 68 .8 63 .4 52 .8 0. 4 2. 4 1. 6 0. 1 6. 1 0. 0 0. 0 0. 1 5. 4 3. 4 2. 0 31 .2 10 0. 0 25 ,6 33 45 -4 9 62 .2 58 .7 54 .2 0. 5 1. 0 0. 7 0. 0 2. 2 0. 0 0. 0 0. 0 3. 5 2. 6 0. 9 37 .8 10 0. 0 22 ,8 00 To ta l 57 .2 51 .2 35 .7 0. 3 3. 6 2. 3 0. 2 9. 1 0. 0 0. 1 0. 0 5. 9 3. 5 2. 4 42 .8 10 0. 0 17 0, 81 5 C U RR EN TL Y M AR RI ED W O M EN ² R U RA L 15 -1 9 14 .4 9. 5 0. 7 0. 0 4. 0 0. 4 0. 1 4. 1 0. 0 0. 1 0. 0 4. 9 2. 3 2. 6 85 .6 10 0. 0 14 ,9 28 20 -2 4 28 .0 22 .6 9. 6 0. 0 5. 8 1. 3 0. 1 5. 4 0. 0 0. 2 0. 0 5. 4 3. 2 2. 3 72 .0 10 0. 0 58 ,2 48 25 -2 9 47 .4 41 .4 27 .7 0. 2 5. 9 1. 7 0. 2 5. 6 0. 0 0. 1 0. 0 6. 0 3. 5 2. 5 52 .6 10 0. 0 68 ,3 20 30 -3 4 61 .4 55 .0 42 .8 0. 4 5. 3 1. 4 0. 3 4. 7 0. 0 0. 1 0. 0 6. 4 3. 9 2. 4 38 .6 10 0. 0 58 ,7 68 35 -3 9 66 .0 59 .5 50 .7 0. 4 4. 0 1. 0 0. 1 3. 3 0. 0 0. 0 0. 0 6. 5 4. 2 2. 3 34 .0 10 0. 0 53 ,9 09 40 -4 4 64 .3 58 .5 53 .1 0. 4 2. 4 0. 6 0. 1 1. 9 0. 0 0. 0 0. 0 5. 8 3. 9 1. 9 35 .7 10 0. 0 44 ,5 65 45 -4 9 59 .5 55 .7 53 .2 0. 4 1. 1 0. 3 0. 1 0. 7 0. 0 0. 0 0. 0 3. 8 2. 6 1. 2 40 .5 10 0. 0 41 ,8 18 To ta l 51 .7 46 .0 36 .1 0. 3 4. 3 1. 1 0. 2 3. 9 0. 0 0. 1 0. 0 5. 7 3. 5 2. 2 48 .3 10 0. 0 34 0, 55 7 C U RR EN TL Y M AR RI ED W O M EN ² T O TA L 15 -1 9 14 .9 10 .0 0. 9 0. 0 3. 9 0. 5 0. 1 4. 4 0. 0 0. 2 0. 0 4. 9 2. 4 2. 5 85 .1 10 0. 0 18 ,4 93 20 -2 4 28 .9 23 .5 9. 1 0. 0 5. 5 1. 6 0. 2 6. 8 0. 0 0. 2 0. 0 5. 4 3. 0 2. 3 71 .1 10 0. 0 80 ,2 74 25 -2 9 47 .9 41 .8 25 .7 0. 2 5. 4 2. 1 0. 2 8. 0 0. 0 0. 1 0. 0 6. 1 3. 6 2. 6 52 .1 10 0. 0 10 2, 70 4 30 -3 4 62 .2 55 .7 40 .5 0. 4 5. 1 2. 1 0. 3 7. 3 0. 0 0. 1 0. 0 6. 5 3. 9 2. 6 37 .8 10 0. 0 90 ,9 01 35 -3 9 67 .2 60 .4 49 .2 0. 3 3. 9 1. 5 0. 2 5. 2 0. 0 0. 0 0. 0 6. 8 4. 3 2. 6 32 .8 10 0. 0 84 ,1 85 40 -4 4 65 .9 60 .3 53 .0 0. 4 2. 4 0. 9 0. 1 3. 4 0. 0 0. 0 0. 0 5. 7 3. 7 1. 9 34 .1 10 0. 0 70 ,1 98 45 -4 9 60 .5 56 .8 53 .6 0. 4 1. 1 0. 4 0. 1 1. 3 0. 0 0. 0 0. 0 3. 7 2. 6 1. 1 39 .5 10 0. 0 64 ,6 19 To ta l 53 .5 47 .7 36 .0 0. 3 4. 1 1. 5 0. 2 5. 6 0. 0 0. 1 0. 0 5. 8 3. 5 2. 3 46 .5 10 0. 0 51 1, 37 3 C on tin ue d« 132 z Family Planning Ta bl e 5. 5 C ur re nt u se o f c on tra ce pt io n by a ge — C on tin ue d Pe rc en t d ist rib ut io n of c ur re nt ly m ar rie d w om en a nd s ex ua lly a ct iv e un m ar rie d w om en a ge 1 5- 49 b y co nt ra ce pt iv e m et ho d cu rr en tly u se d, a cc or di ng to re sid en ce a nd a ge , I nd ia , 2 01 5- 16 A ge A ny m et ho d A ny m od er n m et ho d M od er n m et ho d A ny tra di - tio na l m et ho d Tr ad iti on al m et ho d N ot cu rr en tly us in g To ta l N um be r of w om en Fe m al e st er ili - za tio n M al e st er ili - za tio n Pi ll IU D o r PP IU D In je ct - ab le s C on do m / N iro dh Fe m al e co nd om LA M O th er m od er n m et ho d Rh yt hm W ith - dr aw al SE XU AL LY A C TI VE U N M AR RI ED W O M EN 1 – U RB A N 15 -1 9 (4 0. 5) (4 0. 5) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (4 0. 5) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (5 9. 5) 10 0. 0 38 20 -2 4 42 .0 37 .7 1. 0 0. 0 0. 5 2. 8 0. 0 33 .4 0. 0 0. 0 0. 0 4. 3 0. 7 3. 6 58 .0 10 0. 0 54 25 -4 9 53 .1 51 .8 36 .0 0. 0 4. 3 0. 0 0. 0 11 .5 0. 0 0. 0 0. 0 1. 3 0. 7 0. 7 46 .9 10 0. 0 16 3 To ta l 48 .9 47 .1 23 .2 0. 0 2. 9 0. 6 0. 0 20 .5 0. 0 0. 0 0. 0 1. 8 0. 6 1. 2 51 .1 10 0. 0 25 5 SE XU AL LY A C TI VE U N M AR RI ED W O M EN 1 – R U RA L 15 -1 9 11 .9 10 .4 1. 6 0. 0 0. 0 0. 0 0. 0 8. 8 0. 0 0. 0 0. 0 1. 4 0. 7 0. 7 88 .1 10 0. 0 15 4 20 -2 4 17 .4 14 .6 0. 0 0. 0 0. 0 0. 0 0. 0 14 .5 0. 0 0. 0 0. 0 2. 9 2. 6 0. 2 82 .6 10 0. 0 14 2 25 -4 9 40 .6 40 .2 34 .7 0. 0 1. 8 0. 3 0. 0 3. 4 0. 0 0. 0 0. 0 0. 4 0. 2 0. 2 59 .4 10 0. 0 27 2 To ta l 27 .0 25 .7 17 .0 0. 0 0. 9 0. 1 0. 0 7. 7 0. 0 0. 0 0. 0 1. 3 1. 0 0. 3 73 .0 10 0. 0 56 7 SE XU AL LY A C TI VE U N M AR RI ED W O M EN 1 – T O TA L 15 -1 9 17 .6 16 .4 1. 3 0. 0 0. 0 0. 0 0. 0 15 .1 0. 0 0. 0 0. 0 1. 2 0. 6 0. 6 82 .4 10 0. 0 19 2 20 -2 4 24 .2 20 .9 0. 3 0. 0 0. 1 0. 8 0. 0 19 .7 0. 0 0. 0 0. 0 3. 3 2. 1 1. 2 75 .8 10 0. 0 19 6 25 -4 9 45 .3 44 .5 35 .2 0. 0 2. 8 0. 2 0. 0 6. 5 0. 0 0. 0 0. 0 0. 7 0. 4 0. 3 54 .7 10 0. 0 43 4 To ta l 33 .8 32 .3 18 .9 0. 0 1. 5 0. 3 0. 0 11 .6 0. 0 0. 0 0. 0 1. 4 0. 8 0. 6 66 .2 10 0. 0 82 2 N ot e: If m or e th an o ne m et ho d is us ed , o nl y th e m os t e ffe ct iv e m et ho d is co ns id er ed in th is ta bu la tio n. IU D = In tra ut er in e de vi ce ; P PI U D = P os tp ar tu m in tra ut er in e de vi ce ; L AM = L ac ta tio na l a m en or rh oe a m et ho d 1 U nm ar rie d w om en w ho h ad s ex ua l i nt er co ur se in th e 30 d ay s pr ec ed in g th e su rv ey ( ) B as ed o n 25 -4 9 un w ei gh te d ca se s Family Planning z�133 Table 5.6 Number of living children at first use of contraception Percent distribution of ever-married women by number of living children at time of first use of contraception, according to residence and age, India, 2015-16 Current age Never used Number of living children Total Number of women 0 1 2 3 4+ URBAN 15-19 87.9 2.8 7.6 1.7 0.0 0.0 100.0 3,603 20-24 63.8 6.3 17.6 10.5 1.5 0.2 100.0 22,484 25-29 42.9 6.8 21.4 21.3 6.0 1.6 100.0 35,224 30-34 29.3 6.7 19.6 28.7 11.1 4.6 100.0 33,442 35-39 24.7 6.0 17.6 29.8 13.8 7.9 100.0 32,363 40-44 24.8 5.6 15.5 26.9 15.6 11.6 100.0 28,326 45-49 28.2 5.0 13.7 23.5 16.4 13.2 100.0 26,203 Total 35.7 6.1 17.6 23.6 10.7 6.3 100.0 181,645 RURAL 15-19 89.0 3.6 6.3 1.1 0.0 0.0 100.0 15,109 20-24 65.4 6.3 15.9 10.1 2.1 0.2 100.0 59,151 25-29 43.7 5.5 16.5 22.2 9.3 2.7 100.0 70,018 30-34 32.3 5.2 13.6 24.4 15.7 8.8 100.0 60,957 35-39 29.3 4.5 11.2 23.0 17.2 14.7 100.0 57,314 40-44 30.5 4.2 9.7 19.0 17.5 19.1 100.0 48,815 45-49 34.1 3.9 8.6 15.3 17.2 20.8 100.0 47,643 Total 41.9 4.9 12.7 18.5 12.2 9.8 100.0 359,006 TOTAL 15-19 88.8 3.4 6.6 1.2 0.0 0.0 100.0 18,712 20-24 64.9 6.3 16.4 10.2 1.9 0.2 100.0 81,635 25-29 43.5 5.9 18.2 21.9 8.2 2.3 100.0 105,243 30-34 31.2 5.7 15.7 25.9 14.1 7.4 100.0 94,399 35-39 27.7 5.1 13.5 25.5 16.0 12.2 100.0 89,676 40-44 28.4 4.7 11.9 21.9 16.8 16.4 100.0 77,141 45-49 32.0 4.3 10.4 18.2 16.9 18.1 100.0 73,846 Total 39.8 5.3 14.3 20.2 11.7 8.6 100.0 540,651 134 z Family Planning Table 5.7 Timing of sterilization Percent distribution of sterilized women, wives of sterilized men, and sterilized men by age at the time of sterilization (for NFHS-4), and median age at the time of sterilization (for NFHS-4 and NFHS-3), according to the number of years since the sterilization, India, 2015-16 Years since sterilization Age at time of sterilization Total Number Median age1 <20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 NFHS-4 (2015-16) NFHS-3 (2005-06) STERILIZED WOMEN <2 2.4 33.1 37.2 17.3 6.5 2.5 1.1 na 100.0 17,293 26.5 25.8 2-3 3.2 33.4 36.1 17.5 6.6 2.5 0.6 na 100.0 18,057 26.4 25.9 4-5 3.7 31.1 34.1 18.6 8.8 3.7 0.0 na 100.0 20,084 26.6 25.8 6-7 4.8 33.2 34.4 18.0 7.5 2.0 a na 100.0 19,938 26.5 25.8 8-9 5.9 30.9 35.4 19.2 7.9 0.7 a na 100.0 18,031 26.6 26.0 10+ 10.4 39.2 35.0 13.3 2.1 a a na 100.0 101,423 a a Total 7.3 35.9 35.2 15.6 4.7 1.1 0.2 na 100.0 194,826 25.7 25.5 WIVES OF STERILIZED MEN <10 2.6 26.1 37.7 21.1 9.9 2.5 a na 100.0 745 27.3 27.1 10+ 10.3 37.5 36.4 14.2 1.6 a a na 100.0 673 a a Total 6.3 31.5 37.1 17.8 6.0 1.3 0.1 na 100.0 1,418 26.5 25.3 STERILIZED MEN <10 0.0 5.3 20.1 20.0 18.4 8.3 a 0.5 100.0 172 31.4 31.4 10+ 1.9 10.1 31.7 36.0 19.7 a a 0.0 100.0 126 a a Total 0.8 7.3 25.0 26.8 18.9 5.1 0.6 0.3 100.0 298 30.9 30.6 a = Not calculated due to censoring na = Not applicable 1 To avoid censoring, median age is calculated only for sterilizations that took place when the respondent was less than 40 years old. Family Planning z�135 Table 5.8 Source of modern contraceptive methods Percent distribution of women age 15-49 who are current users of modern contraceptive methods by most recent source of the method, according to residence, India, 2015-16 Most recent source of method Female sterilization Male sterilization Pill IUD or PPIUD Injectables Condom/ Nirodh All modern methods1 URBAN 3XEOLF�KHDOWK�VHFWRU� 72.6 82.3 19.8 49.7 23.8 13.5 57.9 Government/municipal hospital 49.7 49.3 7.4 33.2 17.0 6.1 38.6 Vaidya/hakim/homeopath (AYUSH) 0.0 0.0 0.2 0.2 0.5 0.0 0.0 Government dispensary 2.6 6.0 2.1 3.6 1.1 2.4 2.6 UHC/UHP/UFWC 3.0 1.9 0.3 1.5 0.4 0.3 2.3 CHC/rural hospital/Block PHC 8.8 9.7 1.2 4.3 1.7 0.8 6.7 PHC/Additional PHC 4.4 6.8 0.8 3.9 1.3 0.8 3.5 Sub-centre/ANM 0.2 0.3 3.2 2.0 0.5 0.5 0.5 Government mobile clinic 0.2 0.0 0.4 0.0 0.0 0.3 0.2 Camp 3.5 6.7 0.1 0.2 0.0 0.1 2.6 Anganwadi/ICDS centre 0.0 0.0 1.4 0.3 0.2 1.3 0.3 ASHA 0.0 0.0 2.1 0.1 0.2 0.6 0.2 Other community-based worker 0.0 0.0 0.2 0.1 0.2 0.1 0.0 Other public health sector 0.2 1.7 0.5 0.2 0.7 0.2 0.3 NGO or trust hospital/clinic 0.8 0.2 0.3 0.6 1.0 0.2 0.6 3ULYDWH�KHDOWK�VHFWRU� 26.4 16.2 59.7 48.7 72.7 48.4 33.5 Private hospital 24.0 14.0 6.9 37.2 36.7 3.3 19.9 Private doctor/clinic 2.1 1.6 13.3 10.1 32.1 8.5 4.4 Private mobile clinic 0.2 0.0 2.6 0.1 0.3 1.4 0.5 Vaidya/hakim/homeopath (AYUSH) 0.0 0.0 0.3 0.1 0.1 0.2 0.1 Traditional healer 0.0 0.0 0.3 0.2 0.0 0.2 0.1 Pharmacy/drugstore 0.0 0.0 36.1 0.8 3.6 34.6 8.3 Dai (TBA) 0.0 0.0 0.1 0.1 0.0 0.1 0.0 Other private medical sector 0.1 0.6 0.1 0.1 0.0 0.2 0.1 2WKHU�VRXUFH� 0.2 0.7 20.2 0.9 2.4 37.9 8.0 Shop 0.0 0.0 12.0 0.3 1.5 9.8 2.5 Husband 0.0 0.0 8.0 0.3 0.5 27.7 5.3 Friend/relative 0.0 0.0 0.0 0.0 0.0 0.4 0.1 Other 0.2 0.7 0.1 0.3 0.3 0.1 0.2 Don't know 0.0 0.6 0.0 0.0 0.0 0.0 0.0 Missing 0.0 0.0 0.0 0.0 0.1 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of users 65,238 432 6,046 4,087 384 15,652 91,918 Continued« 136 z Family Planning Table 5.8 Source of modern contraceptive methods³Continued Percent distribution of women age 15-49 who are current users of modern contraceptive methods by most recent source of the method, according to residence, India, 2015-16 Most recent source of method Female sterilization Male sterilization Pill IUD or PPIUD Injectables Condom/ Nirodh All modern methods1 RURAL Public health sector 87.1 94.1 30.5 68.3 30.3 21.6 76.0 Government/municipal hospital 35.2 32.1 3.2 29.7 13.4 4.5 29.6 Vaidya/hakim/homeopath (AYUSH) 0.0 0.0 0.1 0.3 0.5 0.0 0.0 Government dispensary 2.2 2.5 1.3 2.0 0.7 1.8 2.1 UHC/UHP/UFWC 2.2 0.8 0.2 0.6 0.5 0.2 1.8 CHC/rural hospital/Block PHC 25.2 25.6 2.1 18.1 8.6 1.7 20.9 PHC/Additional PHC 12.4 17.1 2.0 9.6 3.7 2.2 10.6 Sub-centre/ANM 0.5 0.6 8.3 5.6 0.9 2.4 1.5 Government mobile clinic 0.1 0.0 0.3 0.1 0.3 0.2 0.1 Camp 9.2 15.4 0.3 0.2 0.4 0.2 7.4 Anganwadi/ICDS centre 0.0 0.0 3.7 1.0 0.3 3.3 0.6 ASHA 0.0 0.0 8.5 1.1 0.5 4.6 1.2 Other community-based worker 0.0 0.0 0.2 0.1 0.3 0.1 0.0 Other public health sector 0.1 0.1 0.3 0.1 0.2 0.3 0.1 NGO or trust hospital/clinic 0.3 0.0 0.2 0.7 0.5 0.2 0.3 Private health sector 12.4 4.9 51.2 30.3 66.1 36.2 18.5 Private hospital 10.9 4.5 2.3 22.4 29.6 2.3 9.7 Private doctor/clinic 1.3 0.4 13.4 6.6 29.9 7.9 3.2 Private mobile clinic 0.0 0.0 2.3 0.1 0.6 1.3 0.4 Vaidya/hakim/homeopath (AYUSH) 0.0 0.0 0.3 0.0 0.4 0.2 0.0 Traditional healer 0.0 0.0 0.3 0.0 0.0 0.1 0.0 Pharmacy/drugstore 0.0 0.0 32.3 0.8 4.8 24.0 4.9 Dai (TBA) 0.0 0.0 0.0 0.1 0.0 0.1 0.0 Other private medical sector 0.2 0.0 0.2 0.2 0.8 0.4 0.2 Other source 0.1 0.0 18.1 0.6 3.0 41.9 5.2 Shop 0.0 0.0 10.7 0.1 0.6 9.0 1.7 Husband 0.0 0.0 6.8 0.3 1.0 32.2 3.3 Friend/relative 0.0 0.0 0.1 0.0 0.0 0.5 0.1 Other 0.1 0.0 0.4 0.1 1.5 0.3 0.2 Don't know 0.0 0.9 0.0 0.0 0.0 0.0 0.0 Missing 0.1 0.2 0.0 0.1 0.1 0.1 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of users 129,587 986 14,773 3,812 560 13,457 163,256 Continued« Family Planning z�137 Table 5.8 Source of modern contraceptive methods³Continued Percent distribution of women age 15-49 who are current users of modern contraceptive methods by most recent source of the method, according to residence, India, 2015-16 Most recent source of method Female sterilization Male sterilization Pill IUD or PPIUD Injectables Condom/ Nirodh All modern methods1 TOTAL Public health sector 82.2 90.5 27.4 58.7 27.7 17.2 69.4 Government/municipal hospital 40.1 37.3 4.4 31.5 14.8 5.4 32.8 Vaidya/hakim/homeopath (AYUSH) 0.0 0.0 0.1 0.3 0.5 0.0 0.0 Government dispensary 2.3 3.6 1.6 2.8 0.9 2.1 2.3 UHC/UHP/UFWC 2.5 1.1 0.2 1.1 0.5 0.3 2.0 CHC/rural hospital/Block PHC 19.7 20.7 1.8 11.0 5.8 1.2 15.8 PHC/Additional PHC 9.7 13.9 1.6 6.6 2.7 1.4 8.0 Sub-centre/ANM 0.4 0.5 6.8 3.7 0.7 1.3 1.1 Government mobile clinic 0.1 0.0 0.3 0.1 0.2 0.2 0.2 Camp 7.3 12.7 0.2 0.2 0.3 0.2 5.7 Anganwadi/ICDS centre 0.0 0.0 3.0 0.6 0.3 2.2 0.5 ASHA 0.0 0.0 6.7 0.6 0.4 2.5 0.8 Other community-based worker 0.0 0.0 0.2 0.1 0.3 0.1 0.0 Other public health sector 0.1 0.6 0.4 0.2 0.4 0.2 0.2 NGO or trust hospital/clinic 0.4 0.1 0.3 0.7 0.7 0.2 0.4 Private health sector 17.1 8.3 53.7 39.8 68.8 42.8 23.9 Private hospital 15.3 7.4 3.6 30.1 32.5 2.8 13.4 Private doctor/clinic 1.6 0.8 13.3 8.4 30.8 8.2 3.6 Private mobile clinic 0.1 0.0 2.4 0.1 0.5 1.3 0.4 Vaidya/hakim/homeopath (AYUSH) 0.0 0.0 0.3 0.1 0.3 0.2 0.0 Traditional healer 0.0 0.0 0.3 0.1 0.0 0.2 0.1 Pharmacy/drugstore 0.0 0.0 33.4 0.8 4.3 29.7 6.2 Dai (TBA) 0.0 0.0 0.0 0.1 0.0 0.1 0.0 Other private medical sector 0.2 0.2 0.2 0.2 0.5 0.3 0.2 Other source 0.2 0.2 18.7 0.8 2.8 39.8 6.2 Shop 0.0 0.0 11.1 0.2 1.0 9.4 2.0 Husband 0.0 0.0 7.1 0.3 0.8 29.8 4.0 Friend/relative 0.0 0.0 0.1 0.0 0.0 0.4 0.1 Other 0.2 0.2 0.3 0.2 1.0 0.2 0.2 Don't know 0.0 0.8 0.0 0.0 0.0 0.0 0.0 Missing 0.0 0.1 0.0 0.0 0.1 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of users 194,826 1,418 20,820 7,899 944 29,109 255,173 Note: All information in this table is based on women's reports. Table includes all users of modern contraceptive methods regardless of their marital status. IUD = Intrauterine device; PPIUD = Postpartum intrauterine device AYUSH = Ayurveda, yoga and naturopathy, unani, siddha, and homeopathy; UHC = Urban health centre; UHP = Urban health post; UFWC = Urban family welfare centre; CHC = Community health centre; PHC = Primary health centre; ANM = Auxiliary nurse midwife; ICDS = Integrated Child Development Services; ASHA = Accredited Social Health Activist; NGO = Nongovernmental organization; TBA = Traditional birth attendant 1 Excludes standard days method, lactational amenorrhoea method (LAM), and "other" modern methods 138 z Family Planning Table 5.9 Public sector as source of modern contraceptive methods by state/union territory Percentage of women age 15-49 who are current users of modern contraceptive methods for whom the most recent source of contraceptives was the public sector, by specific method and residence, according to state/union territory, India, 2015-16 State/union territory Female sterilization Male sterilization Pill IUD or PPIUD Injectables Condom/ Nirodh All modern methods Urban Rural Total India 82.2 90.5 27.4 58.7 27.7 17.2 57.9 76.0 69.4 North Chandigarh 98.2 * * (83.5) * 20.8 54.1 * 55.6 Delhi 80.9 * 26.9 73.3 * 20.6 52.1 (64.2) 52.2 Haryana 85.5 97.4 43.2 60.7 (16.0) 27.2 58.9 75.9 69.6 Himachal Pradesh 97.4 99.5 49.6 80.3 * 36.0 65.8 82.7 81.3 Jammu & Kashmir 85.6 77.2 44.5 83.3 60.2 30.1 60.7 68.6 65.9 Punjab 88.0 96.9 40.5 55.0 * 20.9 52.8 71.7 64.2 Rajasthan 92.9 95.1 37.8 72.9 32.7 14.2 60.2 83.5 77.3 Uttarakhand 93.7 96.5 27.0 67.2 * 18.1 46.9 73.5 64.3 Central Chhattisgarh 92.6 93.5 39.3 79.1 * 21.2 68.6 90.7 85.0 Madhya Pradesh 94.9 95.5 29.8 74.1 (40.7) 21.0 68.8 92.7 85.8 Uttar Pradesh 88.2 (86.4) 15.2 51.7 23.7 6.6 34.3 63.0 54.1 East Bihar 68.3 * 14.1 47.4 14.4 14.0 52.0 65.6 63.3 Jharkhand 73.6 (78.9) 20.4 72.3 (14.5) 9.4 51.7 71.5 65.9 Odisha 94.5 (92.5) 44.5 91.5 (54.7) 30.4 59.1 80.5 76.5 West Bengal 88.0 * 24.7 73.5 (14.5) 16.6 45.5 63.3 58.2 Northeast Arunachal Pradesh 88.0 * 23.8 89.8 (53.7) 25.8 52.4 62.1 60.1 Assam 75.7 * 23.1 80.1 * 25.4 31.5 42.7 41.1 Manipur 73.5 * 15.4 74.8 * 15.3 43.6 50.9 48.0 Meghalaya 68.0 * 26.2 75.4 (25.4) 31.6 45.6 42.8 43.5 Mizoram 87.7 * 44.8 71.0 * 39.2 62.3 79.5 69.2 Nagaland 73.7 * 11.7 80.0 * 12.5 53.3 64.6 60.0 Sikkim 93.0 95.1 54.1 86.2 48.3 42.5 55.3 81.7 75.0 Tripura 93.0 * 11.3 * * 14.4 41.6 39.5 40.1 West Dadra & Nagar Haveli 87.4 * * * * * 60.1 94.6 81.3 Daman & Diu 59.0 * * * * (16.5) 52.6 50.9 52.1 Goa 70.0 * * * * 10.1 52.6 49.7 52.1 Gujarat 81.8 97.9 39.6 35.9 * 20.2 54.6 82.3 70.5 Maharashtra 80.3 88.9 23.6 33.9 (30.5) 21.0 56.8 82.3 70.6 South Andaman & Nicobar Islands 95.2 * (66.6) (100.0) * 26.3 86.0 89.8 88.4 Andhra Pradesh 75.8 (76.7) * * * * 65.8 79.4 75.3 Karnataka 85.5 * 66.2 60.5 * 57.4 75.2 90.0 84.1 Kerala 60.1 * * 71.4 * 18.6 55.1 61.3 58.4 Lakshadweep 50.7 * * * * (36.7) 51.1 * 48.8 Puducherry 90.1 * * (90.1) * (46.0) 87.2 95.1 89.6 Tamil Nadu 79.4 * (38.6) 61.7 * 24.9 71.5 84.4 77.7 Telangana 67.2 88.8 * * * (15.4) 57.9 74.9 66.6 Note: All information in this table is based on women's reports. Table includes all users of contraception regardless of their marital status. IUD = Intrauterine device; PPIUD = Postpartum intrauterine device ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases Family Planning z�139 Table 5.10 Use and source of emergency contraceptive pills Percentage of women who have ever used emergency contraceptive pills and percentage who have used emergency contraceptive pills in the past 12 months, and among those who used emergency contraceptive pills in the past 12 months, the percent distribution by the number of times the pills were used and the percentage of users by source from which the method was obtained, according to residence, India, 2015-16 Source Urban Rural Total Percentage who have ever used emergency contraceptive pills 0.6 0.3 0.4 Percentage who have used emergency contraceptive pills in the past 12 months 0.3 0.2 0.2 Among women who have used emergency contraceptive pills in the past 12 months, number of times used emergency contraceptive pills in the past 12 months 1 36.0 54.1 44.5 2 24.9 19.7 22.4 3+ 39.1 26.2 33.0 Total 100.0 100.0 100.0 Source of emergency contraceptive pills Public health sector 5.8 10.8 8.2 Government/municipal hospital 3.3 1.8 2.6 Government dispensary 0.3 0.3 0.3 UHC/UHP/UFWC 0.0 0.7 0.3 CHC/rural hospital/Block PHC 0.5 2.7 1.6 PHC/Additional PHC 0.3 0.5 0.4 Sub-centre/ANM 1.2 1.0 1.1 Anganwadi/ICDS centre 0.0 1.7 0.8 ASHA 0.2 2.1 1.1 NGO or trust hospital/clinic 0.0 0.9 0.4 Private health sector 82.1 69.3 76.1 Private hospital 8.5 3.9 6.3 Private doctor/clinic 10.9 17.3 13.9 Private mobile clinic 3.7 0.7 2.3 Vaidya/hakim/homeopath (AYUSH) 0.0 0.4 0.2 Traditional healer 0.0 0.1 0.0 Pharmacy/drugstore 58.4 46.3 52.7 Dai (TBA) 0.5 0.7 0.6 Other private medical sector 0.1 0.0 0.0 Other source 14.5 21.8 17.9 Shop 8.6 14.1 11.2 Friend/relative 5.0 5.7 5.3 Other 0.9 2.0 1.4 Number of users in the past 12 months 330 293 624 Note: All information in this table is based on women's reports. Table includes all users of emergency contraceptive pills regardless of their marital status. AYUSH = Ayurveda, yoga and naturopathy, unani, siddha, and homeopathy; UHC = Urban health centre; UHP = Urban health post; UFWC = Urban family welfare centre; CHC = Community health centre; PHC = Primary health centre; ANM = Auxiliary nurse midwife; ICDS = Integrated Child Development Services; ASHA = Accredited Social Health Activist; NGO = Nongovernmental organization; TBA = Traditional birth attendant 140 z Family Planning Table 5.11 Informed choice Among women who are current users of selected modern contraceptive methods who started the last episode of use within the five years preceding the survey, the percentage who were informed about possible side effects or problems of that method, the percentage who were informed about what to do if they experienced side effects, and the percentage who were ever told by a health or family planning worker about other methods of family planning they could use, by method, according to residence, India, 2015-16 Method Percentage who were informed about possible side effects or problems of method used Percentage who were informed about what to do if they experienced side effects Percentage who were ever told by a health or family planning worker of other methods that could be used Number of women URBAN Female sterilization1 46.4 39.5 53.0 13,033 Pill 53.1 45.9 66.8 3,711 IUD or PPIUD 64.7 56.7 68.6 2,765 Total 50.3 43.2 57.8 19,509 RURAL Female sterilization1 40.3 33.2 46.2 31,641 Pill 52.4 44.8 65.2 9,767 IUD or PPIUD 69.3 61.2 74.4 2,898 Total 44.9 37.6 52.3 44,306 TOTAL Female sterilization1 42.1 35.0 48.2 44,674 Pill 52.6 45.1 65.6 13,477 IUD or PPIUD 67.1 59.0 71.6 5,663 Total 46.5 39.3 54.0 63,815 Note: Table includes only the contraceptive methods separately shown in the table and excludes users who obtained their method from friends/relatives or husband. IUD = Intrauterine device; PPIUD = Postpartum intrauterine device 1 Among women who were sterilized in the five years preceding the survey Family Planning z�141 Table 5.12 Informed choice by state/union territory Among women who are current users of modern contraceptive methods who started the last episode of use within the five years preceding the survey, the percentage who were informed about possible side effects or problems of that method, the percentage who were informed about what to do if they experienced side effects, and the percentage who were ever told by a health or family planning worker about other methods of family planning they could use, by state /union territory, India, 2015-16 State/union territory Percentage who were informed about possible side effects or problems of method used Percentage who were informed about what to do if they experienced side effects Percentage who were ever told by a health or family planning worker of other methods that could be used India 46.5 39.3 54.0 North Chandigarh 63.3 56.4 64.9 Delhi 41.5 35.7 48.9 Haryana 63.5 54.3 69.3 Himachal Pradesh 39.7 27.3 55.5 Jammu & Kashmir 38.0 26.1 51.8 Punjab 79.1 70.7 80.5 Rajasthan 43.7 33.8 50.7 Uttarakhand 46.1 34.6 54.8 Central Chhattisgarh 54.6 47.3 65.8 Madhya Pradesh 39.1 31.6 47.7 Uttar Pradesh 47.2 36.2 52.4 East Bihar 34.2 26.5 40.2 Jharkhand 39.3 29.9 45.7 Odisha 61.9 54.9 69.1 West Bengal 49.6 43.9 61.1 Northeast Arunachal Pradesh 51.1 41.7 59.7 Assam 55.6 48.9 67.1 Manipur 47.2 30.1 52.4 Meghalaya 60.4 49.9 72.1 Mizoram 52.9 43.0 58.2 Nagaland 32.1 18.2 29.8 Sikkim 58.4 42.5 70.8 Tripura 39.6 35.6 49.2 West Dadra & Nagar Haveli 45.2 34.0 34.3 Daman & Diu 38.6 32.8 66.0 Goa (75.3) (61.4) (82.6) Gujarat 46.9 37.9 49.3 Maharashtra 36.5 30.2 45.5 South Andaman & Nicobar Islands 66.4 47.1 76.2 Andhra Pradesh 25.0 21.9 34.6 Karnataka 41.5 33.5 50.0 Kerala 55.6 47.8 54.5 Lakshadweep * * * Puducherry 70.5 63.7 69.6 Tamil Nadu 76.6 71.0 79.2 Telangana 25.0 19.7 30.3 Note: Table includes only users of female sterilization who were sterilized in the five years preceding the survey, pill, and IUD/PPIUD and excludes users who obtained their method from friends/relatives or husband. ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases 142 z Family Planning Table 5.13 Twelve-month contraceptive discontinuation rates Among women age 15-49 who experienced an episode of contraceptive use within the five years preceding the survey, the percentage of episodes discontinued within 12 months, by reason for discontinuation and specific method, India, 2015-16 Method Reason for discontinuation Switched to another method4 Number of episodes of use5 Method failure Desire to become pregnant Other fertility related reason1 Side effects/health concerns Wanted more effective method Other method related reason2 Other reason Any reason3 Pill 1.9 11.3 5.1 11.2 2.0 4.6 5.8 41.9 5.1 29,501 IUD or PPIUD 1.2 5.5 2.4 8.6 1.2 3.6 3.9 26.4 3.3 8,980 Injectables 2.1 8.1 3.1 14.5 6.7 7.8 8.3 50.6 8.2 1,402 Condom/Nirodh 2.9 14.9 6.9 3.0 2.2 6.5 10.8 47.2 5.4 42,469 Rhythm 4.9 13.4 6.8 1.2 3.8 5.3 8.1 43.5 7.1 22,164 Withdrawal 4.6 13.6 9.4 1.6 4.1 6.1 10.3 49.8 9.7 17,483 Other6 12.3 10.7 3.0 8.8 17.6 6.1 18.9 77.3 37.5 1,520 All modern spacing methods7 2.5 12.4 5.7 6.8 2.3 5.5 8.3 43.6 5.7 83,788 All spacing methods8 3.3 12.8 6.4 5.0 2.9 5.6 8.6 44.5 6.5 123,518 All methods 2.4 9.3 4.7 3.7 2.1 4.1 6.3 32.6 4.8 167,973 Note: Table is based on life table calculations using information on episodes of contraceptive use that began 3-62 months preceding the survey. All methods includes female and male sterilizations, which are not shown separately. IUD = Intrauterine device; PPIUD = Postpartum intrauterine device 1 Includes infrequent sex/husband away, difficult to get pregnant/menopausal, and marital dissolution/separation 2 Includes lack of access/too far, costs too much, and inconvenient to use 3 Reasons for discontinuation are mutually exclusive and add to the total given in this column 4 The episodes of use included in this column are a subset of the discontinued episodes included in the discontinuation rate. A woman is considered to have switched to another method if she used a different method in the month following discontinuation or if she gave "wanted a more effective method" as the reason for discontinuation and started another method within two months of discontinuation. 5 Number of episodes of use includes both episodes of use that were discontinued during the period of observation and episodes of use that were not discontinued during the period of observation 6 Includes female condom, diaphragm, foam/jelly, standard days method, lactational amenorrhoea method (LAM), and other modern and traditional methods that are not shown separately 7 Includes pill, IUD/PPIUD, injectables, male condom, female condom, lactational amenorrhoea method (LAM), diaphragm, foam/jelly, and other modern spacing methods that are not shown separately 8 Includes pill, IUD/PPIUD, injectables, male condom, female condom, lactational amenorrhoea method (LAM), diaphragm, foam/jelly, rhythm, withdrawal, and other modern spacing and traditional methods that are not shown separately Family Planning z�143 Table 5.14 Twelve-month contraceptive discontinuation rates by state/union territory Among women age 15-49 who experienced an episode of contraceptive use within the five years preceding the survey, the percentage of episodes discontinued within 12 months, by specific method and state/union territory, India, 2015-16 State/union territory Modern method Traditional method All methods Any modern method Any spacing method Pill IUD or PPIUD Condom/ Nirodh Rhythm With- drawal India 41.9 26.4 47.2 43.5 49.8 32.6 28.3 44.5 North Chandigarh * * (29.0) * * 33.1 (26.7) 35.4 Delhi (48.0) (13.2) 36.4 * * 27.8 30.7 30.9 Haryana 54.4 16.3 44.2 41.7 47.1 32.8 30.9 41.3 Himachal Pradesh (66.5) * 46.1 * 43.8 37.5 36.5 46.2 Jammu & Kashmir 53.1 28.0 55.1 61.9 49.1 47.3 45.8 51.8 Punjab 61.8 11.2 45.6 63.3 65.4 46.7 38.8 50.3 Rajasthan 51.9 21.1 42.3 40.1 52.3 31.8 27.3 43.7 Uttarakhand 56.6 (16.7) 48.4 (37.7) 40.8 40.0 40.0 47.0 Central Chhattisgarh 58.7 19.9 53.5 29.9 51.8 31.6 29.7 49.5 Madhya Pradesh 53.7 34.4 45.2 41.8 44.5 22.0 20.1 45.9 Uttar Pradesh 55.2 21.8 44.0 38.9 43.4 37.1 35.5 42.4 East Bihar 63.4 (33.3) 63.0 * 42.5 21.0 19.3 55.5 Jharkhand 43.7 (21.3) 44.9 15.2 (42.9) 18.8 17.4 37.0 Odisha 42.3 28.1 58.0 57.4 57.9 46.2 39.0 52.4 West Bengal 31.8 (17.5) 49.7 49.9 49.4 37.2 31.7 41.6 Northeast Arunachal Pradesh 37.8 18.3 63.8 47.4 63.5 40.6 35.5 43.9 Assam 31.1 15.7 55.8 35.4 42.3 34.4 31.9 36.6 Manipur 49.3 22.0 64.1 (35.5) 40.9 41.4 42.4 42.9 Meghalaya 27.2 * (60.7) * (52.4) 36.2 31.9 39.0 Mizoram 44.0 44.0 * * * 40.0 40.0 47.0 Nagaland 45.7 15.1 (60.7) (31.8) 43.2 33.5 31.4 39.2 Sikkim 20.6 * (31.6) * * 19.4 19.1 22.2 Tripura 16.4 * * (23.7) 30.0 22.2 19.3 24.0 West Dadra & Nagar Haveli * * * * * * * 29.2 Daman & Diu * * * * * (22.2) (21.5) 36.1 Goa * * * * * (47.7) (45.4) 59.5 Gujarat 62.0 28.6 46.7 42.8 55.1 34.9 30.6 46.9 Maharashtra 41.3 26.9 39.6 26.1 30.1 23.6 23.2 37.0 South Andaman & Nicobar Islands * * * * * 28.6 26.5 46.3 Andhra Pradesh * * * * * 3.6 3.3 60.6 Karnataka (58.3) (38.7) 73.0 * * 19.4 19.2 60.2 Kerala * (34.6) 68.2 (59.6) 64.9 42.9 35.6 63.5 Lakshadweep * * * * (48.8) (45.4) * 48.6 Puducherry * * * * * 17.3 16.4 46.3 Tamil Nadu (84.7) 47.8 71.2 * (65.4) 26.0 23.5 63.0 Telangana * * * * * 7.0 6.8 50.5 Note: All methods and any modern method includes female and male sterilizations, which are not shown separately. IUD = Intrauterine device; PPIUD = Postpartum intrauterine device ( ) Based on 25-49 unweighted cases * Based on fewer than 25 unweighted cases 144 z Family Planning Table 5.15.1 Exposure to family planning messages: Women Percentage of women age 15-49 who heard or saw a family planning message on radio, television, in a newspaper or magazine, or on a wall painting or hoarding in the past few months, according to background characteristics, India, 2015-16 Background characteristic Radio Television Newspaper/ magazine Wall painting or hoarding None of these media sources Number of women Age 15-19 16.4 55.8 40.0 54.7 28.8 121,552 20-24 18.5 62.4 42.5 57.9 24.4 122,966 25-29 18.9 61.7 40.0 56.5 25.9 115,043 30-34 18.7 60.4 36.9 54.3 27.3 96,769 35-39 18.4 58.1 33.2 50.9 29.6 90,890 40-44 17.8 55.9 30.2 48.3 31.7 77,969 45-49 16.9 53.5 26.6 45.8 34.1 74,497 Residence Urban 22.6 74.7 53.1 64.7 16.4 242,225 Rural 15.5 50.1 27.9 47.3 34.6 457,461 Schooling No schooling 10.9 36.4 6.8 30.4 49.1 193,078 <5 years complete 13.3 48.7 14.6 40.4 37.7 40,503 5-7 years complete 15.8 57.2 27.4 51.0 29.0 99,687 8-9 years complete 18.1 62.6 39.9 58.5 23.3 116,681 10-11 years complete 22.3 70.9 55.8 66.1 16.8 99,576 12 or more years complete 26.9 79.6 71.6 75.3 10.2 150,160 Religion Hindu 18.5 59.5 37.1 54.0 27.7 563,739 Muslim 15.9 50.8 30.5 46.9 34.4 96,461 Christian 19.2 58.1 45.1 60.1 25.3 16,620 Sikh 5.5 81.2 48.3 60.6 12.4 11,618 Buddhist/Neo-Buddhist 22.6 69.9 44.7 60.8 20.2 6,469 Jain 29.7 84.3 73.0 73.9 10.9 1,264 Other 11.0 33.2 16.8 44.2 45.6 3,515 Caste/tribe Scheduled caste 16.9 56.4 30.8 50.7 30.0 142,619 Scheduled tribe 14.2 44.4 22.6 43.9 39.3 64,144 Other backward class 18.7 58.5 37.0 54.4 28.0 303,837 Other 19.1 65.9 45.8 57.4 23.2 184,594 Don't know 9.9 42.1 18.6 33.6 47.0 4,492 Wealth index Lowest 11.8 23.0 10.1 32.2 55.5 124,054 Second 14.3 45.7 20.1 43.7 37.5 136,900 Middle 17.9 62.7 32.9 53.1 25.1 143,814 Fourth 20.9 73.1 47.5 61.8 17.7 147,978 Highest 23.6 82.1 67.0 72.0 10.7 146,939 Total 18.0 58.6 36.6 53.3 28.3 699,686 Family Planning z�145 Table 5.15.2 Exposure to family planning messages: Men Percentage of men age 15-49 who heard or saw a family planning message on radio, television, in a newspaper or magazine, or on a wall painting or hoarding in the past few months, according to background characteristics, India, 2015-16 Background characteristic Radio Television Newspaper/ magazine Wall painting or hoarding None of these media sources Number of men Age 15-19 16.9 54.3 46.3 54.1 28.9 18,740 20-24 21.1 62.5 55.2 60.7 21.8 16,624 25-29 22.5 65.0 55.5 62.0 20.5 16,171 30-34 23.6 64.3 53.1 61.2 21.6 14,604 35-39 24.6 62.6 51.4 59.0 22.9 13,771 40-44 24.8 60.7 50.4 57.1 24.3 12,050 45-49 23.7 59.7 47.6 56.2 25.2 11,451 Residence Urban 24.7 70.3 60.0 63.4 18.5 39,546 Rural 20.5 55.5 46.1 55.7 26.8 63,864 Schooling No schooling 15.2 38.5 12.0 33.1 45.5 12,422 <5 years complete 16.8 47.4 21.8 43.9 36.1 6,171 5-7 years complete 18.9 54.5 38.1 52.8 28.2 14,730 8-9 years complete 19.7 58.4 49.7 58.2 24.4 21,422 10-11 years complete 23.8 66.7 62.2 63.7 18.3 18,030 12 or more years complete 28.1 74.9 74.7 72.2 12.7 30,636 Religion Hindu 22.5 62.0 52.8 59.8 23.0 84,211 Muslim 20.4 53.7 42.2 51.1 28.5 13,793 Christian 25.7 57.2 50.4 55.1 26.7 2,277 Sikh 7.2 77.9 57.1 66.1 12.1 1,622 Buddhist/Neo-Buddhist 27.7 69.2 56.2 57.0 19.3 958 Jain 24.4 78.2 65.5 59.1 16.6 163 Other 23.4 55.7 39.9 65.3 24.3 386 Caste/tribe Scheduled caste 22.3 60.3 48.2 57.0 24.2 20,499 Scheduled tribe 18.1 48.6 36.9 50.0 33.1 9,132 Other backward class 23.5 61.6 53.7 60.3 22.7 45,110 Other 21.1 65.3 55.2 60.3 21.4 28,299 Don't know 12.6 43.2 28.7 34.1 39.2 371 Wealth index Lowest 17.7 32.0 24.8 42.6 42.8 15,205 Second 19.5 50.8 39.0 51.9 30.1 19,402 Middle 22.1 64.0 50.7 58.9 21.7 22,047 Fourth 24.5 70.8 60.3 63.2 17.3 22,930 Highest 24.7 76.2 70.7 69.6 14.1 23,827 Total age 15-49 22.1 61.1 51.4 58.6 23.6 103,411 Age 50-54 24.1 57.5 45.5 52.8 27.3 8,711 Total age 15-54 22.2 60.9 51.0 58.2 23.9 112,122 146 z Family Planning Table 5.16 Men's contraception-related perceptions and knowledge Percentage of men age 15-49 who agree with two specific statements about women and contraception, and percent distribution of men according to their belief about the efficacy of condoms in preventing pregnancy, by background characteristics, India, 2015-16 Background characteristic Percentage of men who agree Percentage of men who say that if a male condom is used correctly, it protects against pregnancy: Number of men Contraception is women's business and a man should not have to worry about it Women who use contraception may become promiscuous Most of the time Some- times Not at all Don't know/ unsure1 Total Age 15-19 31.5 18.0 52.1 23.8 2.2 21.9 100.0 18,740 20-24 37.3 20.7 63.2 25.8 2.1 9.0 100.0 16,624 25-29 38.4 20.8 64.9 25.4 2.3 7.4 100.0 16,171 30-34 39.6 20.2 64.1 26.4 2.3 7.1 100.0 14,604 35-39 38.7 19.9 63.1 26.4 2.3 8.2 100.0 13,771 40-44 38.4 21.5 60.8 26.5 2.0 10.6 100.0 12,050 45-49 39.3 21.4 59.5 23.8 1.9 14.8 100.0 11,451 Residence Urban 35.2 19.3 64.0 25.7 1.7 8.5 100.0 39,546 Rural 38.6 20.8 58.9 25.2 2.4 13.4 100.0 63,864 Schooling No schooling 37.8 22.7 50.0 24.6 2.5 22.8 100.0 12,422 <5 years complete 38.4 21.2 54.1 26.4 2.4 17.1 100.0 6,171 5-7 years complete 38.4 21.3 58.0 25.6 2.4 14.0 100.0 14,730 8-9 years complete 36.4 18.4 60.7 24.8 2.2 12.2 100.0 21,422 10-11 years complete 36.4 20.2 60.8 26.3 2.4 10.5 100.0 18,030 12 or more years complete 37.4 19.8 68.2 25.3 1.7 4.8 100.0 30,636 Religion Hindu 38.2 20.4 60.8 25.3 2.2 11.7 100.0 84,211 Muslim 32.4 20.6 61.1 25.5 2.0 11.4 100.0 13,793 Christian 27.7 20.5 54.7 28.5 1.9 14.8 100.0 2,277 Sikh 40.6 13.0 72.6 22.4 0.6 4.4 100.0 1,622 Buddhist/Neo-Buddhist 27.8 13.7 54.1 37.7 2.2 6.0 100.0 958 Jain 29.4 8.9 72.9 23.2 0.0 4.0 100.0 163 Other 69.6 25.0 64.9 21.1 2.5 11.4 100.0 386 Caste/tribe Scheduled caste 39.2 20.7 59.3 26.1 2.6 11.9 100.0 20,499 Scheduled tribe 36.0 22.6 53.4 25.9 2.5 18.2 100.0 9,132 Other backward class 37.7 21.0 60.6 25.1 2.3 12.0 100.0 45,110 Other 35.7 18.1 65.0 25.2 1.6 8.2 100.0 28,299 Don't know 21.4 12.8 50.6 25.1 1.3 23.0 100.0 371 Wealth index Lowest 39.3 20.7 52.1 25.3 2.6 20.1 100.0 15,205 Second 39.0 20.6 57.8 24.8 2.7 14.7 100.0 19,402 Middle 37.0 21.5 59.9 26.0 2.6 11.5 100.0 22,047 Fourth 36.5 21.0 63.1 25.5 2.2 9.2 100.0 22,930 Highest 35.5 17.7 67.8 25.3 1.0 5.8 100.0 23,827 Total age 15-49 37.3 20.2 60.9 25.4 2.2 11.5 100.0 103,411 Age 50-54 37.9 21.5 56.1 24.1 2.4 17.4 100.0 8,711 Total age 15-54 37.3 20.3 60.5 25.3 2.2 12.0 100.0 112,122 1 Includes missing values and those who have never heard of male condom Family Planning z�147 Table 5.17 Men's contraception-related perceptions and knowledge by state/union territory Percentage of men age 15-49 who agree with two specific statements about women and contraception and say that a woman who is breastfeeding cannot become pregnant, and percent distribution of men according to their belief about the efficacy of condoms in preventing pregnancy, by state/union territory, India, 2015-16 State/union territory Percentage of men who agree Percentage of men who say that if a male condom is used correctly, it protects against pregnancy most of the time Contraception is women's business and a man should not have to worry about it Women who use contraception may become promiscuous India 37.3 20.2 60.9 North Chandigarh 51.7 23.0 74.9 Delhi 36.2 21.3 68.7 Haryana 45.2 15.5 74.5 Himachal Pradesh 20.6 12.1 69.7 Jammu & Kashmir 25.6 28.9 59.2 Punjab 42.6 11.2 74.2 Rajasthan 45.3 17.4 64.8 Uttarakhand 54.9 12.7 68.9 Central Chhattisgarh 33.6 21.8 60.2 Madhya Pradesh 41.3 18.2 60.0 Uttar Pradesh 38.3 19.4 68.3 East Bihar 41.7 16.4 54.6 Jharkhand 55.5 28.5 51.3 Odisha 30.4 20.5 61.2 West Bengal 38.5 10.1 67.4 Northeast Arunachal Pradesh 23.3 18.0 57.7 Assam 23.7 12.7 55.1 Manipur 15.3 20.9 77.6 Meghalaya 15.0 12.8 42.6 Mizoram 18.7 9.8 87.8 Nagaland 20.9 28.4 64.1 Sikkim 35.2 16.3 39.1 Tripura 37.4 20.5 73.6 West Dadra & Nagar Haveli 56.5 47.0 55.1 Daman & Diu 24.4 6.4 30.1 Goa 37.4 3.3 49.9 Gujarat 44.6 21.5 66.3 Maharashtra 23.1 11.2 57.9 South Andaman & Nicobar Islands 32.0 9.5 70.3 Andhra Pradesh 45.9 47.2 51.0 Karnataka 42.2 44.7 50.4 Kerala 14.6 15.6 69.9 Lakshadweep 4.8 4.2 36.9 Puducherry 48.9 34.2 55.0 Tamil Nadu 33.4 15.8 49.3 Telangana 46.9 40.5 52.9 148 z Family Planning Ta bl e 5. 18 N ee d an d de m an d fo r f am ily p la nn in g Pe rc en ta ge o f c ur re nt ly m ar rie d w om en a ge 1 5- 49 w ith u nm et n ee d fo r f am ily p la nn in g, p er ce nt ag e w ith m et n ee d fo r f am ily p la nn in g, to ta l d em an d fo r f am ily p la nn in g, an d pe rc en ta ge o f t he d em an d fo r f am ily p la nn in g th at is s at isf ie d, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic U nm et n ee d fo r fa m ily p la nn in g M et n ee d fo r f am ily p la nn in g (c ur re nt ly u sin g) To ta l d em an d fo r fa m ily p la nn in g1 Pe rc en ta ge of d em an d sa tis fie d2 Pe rc en ta ge of d em an d sa tis fie d by m od er n m et ho ds 3 N um be r of w om en Fo r sp ac in g Fo r lim iti ng To ta l Fo r sp ac in g Fo r lim iti ng To ta l Fo r sp ac in g Fo r lim iti ng To ta l Ag e 15 -1 9 19 .9 2. 3 22 .2 12 .3 2. 6 14 .9 32 .2 4. 8 37 .0 40 .1 26 .9 18 ,4 93 20 -2 4 15 .7 6. 5 22 .3 13 .7 15 .2 28 .9 29 .4 21 .8 51 .2 56 .5 46 .0 80 ,2 74 25 -2 9 8. 4 10 .3 18 .7 9. 4 38 .6 48 .0 17 .7 48 .9 66 .6 72 .0 62 .8 10 2, 70 4 30 -3 4 3. 1 9. 4 12 .5 4. 1 58 .2 62 .2 7. 2 67 .5 74 .7 83 .3 74 .6 90 ,9 01 35 -3 9 1. 0 7. 3 8. 3 1. 2 66 .0 67 .2 2. 2 73 .3 75 .5 89 .0 80 .0 84 ,1 85 40 -4 4 0. 3 5. 5 5. 8 0. 3 65 .6 65 .9 0. 6 71 .1 71 .8 91 .9 84 .0 70 ,1 98 45 -4 9 0. 1 3. 3 3. 4 0. 1 60 .4 60 .5 0. 2 63 .7 63 .9 94 .7 88 .9 64 ,6 19 Re si de nc e U rb an 5. 1 7. 0 12 .1 6. 3 50 .8 57 .2 11 .4 57 .9 69 .3 82 .5 73 .9 17 0, 81 5 Ru ra l 5. 9 7. 3 13 .2 5. 0 46 .7 51 .7 10 .9 54 .0 64 .9 79 .6 70 .9 34 0, 55 7 Sc ho ol in g N o sc ho ol in g 3. 4 7. 6 11 .0 2. 0 52 .0 54 .0 5. 4 59 .6 65 .0 83 .1 75 .4 16 9, 59 0 < 5 ye ar s co m pl et e 3. 8 6. 3 10 .1 3. 9 56 .6 60 .5 7. 7 62 .9 70 .6 85 .7 78 .3 34 ,0 39 5- 7 ye ar s co m pl et e 5. 0 6. 6 11 .7 4. 7 52 .6 57 .3 9. 7 59 .3 69 .0 83 .1 75 .3 80 ,7 85 8- 9 ye ar s co m pl et e 6. 7 7. 4 14 .1 7. 4 45 .8 53 .2 14 .1 53 .2 67 .2 79 .0 68 .5 76 ,2 54 10 -1 1 ye ar s co m pl et e 6. 8 6. 9 13 .6 6. 8 46 .2 53 .1 13 .6 53 .1 66 .7 79 .5 70 .9 60 ,3 86 12 o r m or e ye ar s co m pl et e 9. 5 7. 5 17 .0 10 .6 36 .6 47 .3 20 .1 44 .1 64 .2 73 .6 63 .4 90 ,3 20 Re lig io n H in du 5. 4 7. 0 12 .4 5. 0 49 .4 54 .4 10 .4 56 .4 66 .8 81 .5 73 .1 41 6, 44 6 M us lim 7. 1 9. 4 16 .4 7. 5 37 .8 45 .3 14 .6 47 .1 61 .7 73 .4 61 .5 67 ,3 17 C hr ist ia n 6. 9 6. 0 12 .9 4. 6 46 .6 51 .2 11 .6 52 .6 64 .1 79 .9 74 .7 11 ,3 68 Si kh 2. 4 4. 0 6. 4 10 .2 63 .7 73 .9 12 .6 67 .7 80 .3 92 .0 81 .5 8, 20 1 Bu dd hi st /N eo -B ud dh ist 4. 9 6. 2 11 .1 6. 3 61 .4 67 .7 11 .2 67 .6 78 .8 85 .9 83 .0 4, 50 9 Ja in 4. 0 8. 0 12 .1 5. 3 56 .6 62 .0 9. 4 64 .6 74 .0 83 .7 77 .8 94 3 O th er 8. 8 9. 5 18 .3 9. 5 32 .4 42 .0 18 .3 41 .9 60 .2 69 .7 60 .7 2, 58 9 &R QW LQ XH G« Family Planning z�149 Ta bl e 5. 18 N ee d an d de m an d fo r f am ily p la nn in g³ C on tin ue d Pe rc en ta ge o f c ur re nt ly m ar rie d w om en a ge 1 5- 49 w ith u nm et n ee d fo r f am ily p la nn in g, p er ce nt ag e w ith m et n ee d fo r f am ily p la nn in g, to ta l d em an d fo r f am ily p la nn in g, an d pe rc en ta ge o f t he d em an d fo r f am ily p la nn in g th at is s at isf ie d, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic U nm et n ee d fo r fa m ily p la nn in g M et n ee d fo r f am ily p la nn in g (c ur re nt ly u sin g) To ta l d em an d fo r fa m ily p la nn in g1 Pe rc en ta ge of d em an d sa tis fie d2 Pe rc en ta ge of d em an d sa tis fie d by m od er n m et ho ds 3 N um be r of w om en Fo r sp ac in g Fo r lim iti ng To ta l Fo r sp ac in g Fo r lim iti ng To ta l Fo r sp ac in g Fo r lim iti ng To ta l C as te /tr ib e Sc he du le d ca st e 5. 4 6. 7 12 .1 5. 3 49 .6 54 .9 10 .7 56 .3 67 .0 82 .0 73 .5 10 3, 61 1 Sc he du le d tri be 6. 2 6. 8 13 .0 5. 1 44 .3 49 .4 11 .3 51 .1 62 .4 79 .2 72 .2 46 ,7 06 O th er b ac kw ar d cl as s 6. 0 7. 3 13 .4 4. 3 47 .2 51 .5 10 .4 54 .6 64 .9 79 .4 71 .6 22 3, 16 7 O th er 5. 0 7. 4 12 .4 7. 5 50 .0 57 .5 12 .5 57 .4 69 .8 82 .3 71 .5 13 4, 37 5 D on 't kn ow 7. 8 11 .7 19 .4 6. 1 38 .6 44 .7 13 .9 50 .2 64 .1 69 .7 61 .6 3, 51 4 W ea lth in de x Lo w es t 6. 7 10 .1 16 .7 3. 6 38 .4 42 .1 10 .3 48 .5 58 .8 71 .5 61 .8 92 ,9 19 Se co nd 5. 8 7. 2 13 .1 5. 2 46 .7 51 .9 11 .1 53 .9 65 .0 79 .9 70 .5 10 0, 91 0 M id dl e 5. 3 6. 2 11 .5 5. 0 50 .8 55 .8 10 .3 57 .0 67 .3 82 .9 74 .7 10 4, 66 5 Fo ur th 5. 4 6. 4 11 .8 5. 7 51 .5 57 .2 11 .1 57 .9 69 .1 82 .9 75 .1 10 7, 45 4 H ig he st 5. 1 6. 5 11 .6 7. 5 51 .7 59 .2 12 .6 58 .2 70 .8 83 .6 75 .0 10 5, 42 5 To ta l 5. 6 7. 2 12 .9 5. 5 48 .1 53 .5 11 .1 55 .3 66 .4 80 .6 71 .9 51 1, 37 3 N ot e: N um be rs in th is ta bl e co rr es po nd to th e re vi se d de fin iti on o f u nm et n ee d de sc rib ed in B ra dl ey e t a l., 2 01 2, R ev isi ng U nm et N ee d fo r F am ily P la nn in g, D H S An al yt ic al S tu di es N o. 2 5, IC F In te rn at io na l, C al ve rto n, M ar yl an d, U SA . 1 To ta l d em an d is th e su m o f u nm et n ee d an d m et n ee d. 2 Pe rc en ta ge o f d em an d sa tis fie d is m et n ee d di vi de d by to ta l d em an d. 3 M od er n m et ho ds in cl ud e fe m al e st er ili za tio n, m al e st er ili za tio n, p ill , I U D /P PI U D , i nj ec ta bl es , m al e co nd om , f em al e co nd om , s ta nd ar d da ys m et ho d (S D M ), di ap hr ag m , f oa m /je lly , la ct at io na l am en or rh oe a m et ho d (L AM ), an d ot he r m od er n m et ho ds 150 z Family Planning Ta bl e 5. 19 N ee d an d de m an d fo r f am ily p la nn in g by s ta te /u ni on te rr ito ry Pe rc en ta ge o f c ur re nt ly m ar rie d w om en a ge 1 5- 49 w ith u nm et n ee d fo r f am ily p la nn in g, p er ce nt ag e w ith m et n ee d fo r f am ily p la nn in g, to ta l d em an d fo r f am ily p la nn in g, an d pe rc en ta ge o f t he d em an d fo r f am ily p la nn in g th at is s at isf ie d, b y st at e/ un io n te rr ito ry , I nd ia , 2 01 5- 16 , a nd N FH S- 3 St at e/ un io n te rr ito ry U nm et n ee d fo r fa m ily p la nn in g M et n ee d fo r f am ily p la nn in g (c ur re nt ly u sin g) To ta l d em an d fo r fa m ily p la nn in g1 Pe rc en ta ge of d em an d sa tis fie d2 Pe rc en ta ge o f de m an d sa tis fie d by m od er n m et ho ds 3 Fo r s pa ci ng Fo r li m iti ng To ta l Fo r sp ac in g Fo r li m iti ng To ta l Fo r sp ac in g Fo r li m iti ng To ta l In di a 5. 6 7. 2 12 .9 5. 5 48 .1 53 .5 11 .1 55 .3 66 .4 80 .6 71 .9 N FH S- 3 (2 00 5- 06 ) 6. 1 7. 8 13 .9 4. 8 51 .5 56 .3 10 .9 59 .3 70 .2 80 .2 69 .6 N or th C ha nd ig ar h 1. 8 4. 5 6. 3 9. 4 64 .6 74 .0 11 .2 69 .1 80 .3 92 .2 72 .5 D el hi 4. 5 10 .5 15 .0 6. 2 48 .6 54 .8 10 .7 59 .1 69 .9 78 .5 69 .5 H ar ya na 3. 8 5. 5 9. 3 8. 0 55 .8 63 .7 11 .8 61 .3 73 .1 87 .3 81 .3 H im ac ha l P ra de sh 4. 8 10 .9 15 .7 4. 8 52 .1 57 .0 9. 6 63 .0 72 .7 78 .4 71 .7 Ja m m u & K as hm ir 5. 8 6. 6 12 .3 11 .4 45 .9 57 .3 17 .2 52 .4 69 .6 82 .3 66 .3 Pu nj ab 2. 3 3. 9 6. 2 10 .4 65 .4 75 .8 12 .7 69 .3 82 .0 92 .4 80 .9 Ra ja st ha n 5. 7 6. 6 12 .3 6. 2 53 .5 59 .7 11 .8 60 .2 72 .0 82 .9 74 .3 U tta ra kh an d 5. 2 10 .3 15 .5 6. 1 47 .3 53 .4 11 .4 57 .6 69 .0 77 .5 71 .6 C en tr al C hh at tis ga rh 5. 3 5. 8 11 .1 4. 6 53 .1 57 .7 9. 9 58 .9 68 .8 83 .8 79 .3 M ad hy a Pr ad es h 5. 7 6. 4 12 .1 3. 5 47 .9 51 .4 9. 2 54 .3 63 .5 80 .9 78 .0 U tta r P ra de sh 6. 8 11 .2 18 .0 6. 0 39 .5 45 .5 12 .8 50 .7 63 .5 71 .6 49 .9 Ea st Bi ha r 9. 4 11 .7 21 .1 0. 8 23 .2 24 .1 10 .3 34 .9 45 .2 53 .2 51 .4 Jh ar kh an d 9. 0 9. 4 18 .4 2. 9 37 .5 40 .4 11 .9 46 .8 58 .7 68 .7 63 .8 O di sh a 4. 7 8. 9 13 .6 9. 7 47 .6 57 .3 14 .4 56 .5 70 .9 80 .8 64 .0 W es t B en ga l 3. 0 4. 4 7. 5 14 .5 56 .4 70 .9 17 .5 60 .8 78 .4 90 .5 72 .7 N or th ea st Ar un ac ha l P ra de sh 12 .7 8. 8 21 .5 8. 8 22 .8 31 .7 21 .5 31 .7 53 .2 59 .5 50 .0 As sa m 5. 8 8. 4 14 .1 16 .1 36 .2 52 .4 21 .9 44 .6 66 .5 78 .7 55 .6 M an ip ur 12 .7 17 .4 30 .1 7. 4 16 .1 23 .6 20 .2 33 .5 53 .6 43 .9 23 .6 M eg ha la ya 15 .3 6. 0 21 .2 9. 5 14 .8 24 .3 24 .8 20 .7 45 .5 53 .4 48 .1 M iz or am 12 .4 7. 6 20 .0 11 .6 23 .7 35 .3 24 .0 31 .3 55 .2 63 .8 63 .8 N ag al an d 11 .3 10 .9 22 .3 4. 0 22 .5 26 .5 15 .4 33 .4 48 .8 54 .4 43 .5 Si kk im 8. 9 12 .8 21 .7 8. 6 38 .1 46 .7 17 .5 50 .9 68 .4 68 .3 67 .1 Tr ip ur a 4. 1 6. 6 10 .7 13 .3 50 .8 64 .1 17 .5 57 .3 74 .8 85 .7 57 .2 &R QW LQ XH G« Family Planning z�151 Ta bl e 5. 19 N ee d an d de m an d fo r f am ily p la nn in g by s ta te /u ni on te rr ito ry ³ C on tin ue d Pe rc en ta ge o f c ur re nt ly m ar rie d w om en a ge 1 5- 49 w ith u nm et n ee d fo r f am ily p la nn in g, p er ce nt ag e w ith m et n ee d fo r f am ily p la nn in g, to ta l d em an d fo r f am ily p la nn in g, an d pe rc en ta ge o f t he d em an d fo r f am ily p la nn in g th at is s at isf ie d, b y st at e/ un io n te rr ito ry , I nd ia , 2 01 5- 16 , a nd N FH S- 3 St at e/ un io n te rr ito ry U nm et n ee d fo r fa m ily p la nn in g M et n ee d fo r f am ily p la nn in g (c ur re nt ly u sin g) To ta l d em an d fo r fa m ily p la nn in g1 Pe rc en ta ge of d em an d sa tis fie d2 Pe rc en ta ge o f de m an d sa tis fie d by m od er n m et ho ds 3 Fo r s pa ci ng Fo r lim iti ng To ta l Fo r sp ac in g Fo r li m iti ng To ta l Fo r S pa ci ng Fo r lim iti ng To ta l W es t D ad ra & N ag ar H av el i 10 .6 8. 8 19 .3 2. 2 35 .8 38 .0 12 .8 44 .6 57 .4 66 .3 66 .0 D am an & D iu 11 .0 8. 7 19 .7 3. 8 28 .5 32 .3 14 .8 37 .2 52 .0 62 .1 60 .8 G oa 8. 3 9. 2 17 .5 3. 4 22 .9 26 .3 11 .7 32 .1 43 .8 60 .0 56 .5 G uj ar at 6. 6 10 .3 17 .0 4. 4 42 .5 46 .9 11 .1 52 .8 63 .9 73 .4 67 .4 M ah ar as ht ra 4. 3 5. 4 9. 7 5. 2 59 .5 64 .7 9. 5 64 .9 74 .4 87 .0 84 .0 So ut h An da m an & N ic ob ar Is la nd s 8. 1 7. 4 15 .5 5. 0 45 .7 50 .8 13 .1 53 .1 66 .2 76 .7 73 .0 An dh ra P ra de sh 3. 1 1. 5 4. 6 0. 2 69 .3 69 .5 3. 3 70 .8 74 .2 93 .7 93 .6 Ka rn at ak a 6. 0 4. 4 10 .4 1. 3 50 .5 51 .8 7. 3 54 .8 62 .2 83 .3 82 .5 Ke ra la 8. 3 5. 4 13 .7 4. 5 48 .6 53 .1 12 .8 54 .0 66 .8 79 .5 75 .3 La ks ha dw ee p 12 .7 4. 3 16 .9 13 .5 16 .2 29 .7 26 .2 20 .5 46 .6 63 .7 33 .6 Pu du ch er ry 4. 8 3. 5 8. 3 2. 8 59 .1 61 .9 7. 6 62 .7 70 .3 88 .1 87 .1 Ta m il N ad u 4. 8 5. 3 10 .1 1. 9 51 .3 53 .2 6. 8 56 .6 63 .3 84 .0 83 .0 Te la ng an a 3. 8 3. 6 7. 4 0. 7 56 .5 57 .2 4. 6 60 .1 64 .6 88 .6 88 .2 N ot e: N um be rs in th is ta bl e co rr es po nd to th e re vi se d de fin iti on o f u nm et n ee d de sc rib ed in B ra dl ey e t a l., 2 01 2, R ev isi ng U nm et N ee d fo r F am ily P la nn in g, D H S An al yt ic al S tu di es N o. 2 5, IC F In te rn at io na l, C al ve rto n, M ar yl an d, U SA . 1 To ta l d em an d is th e su m o f u nm et n ee d an d m et n ee d. 2 Pe rc en ta ge o f d em an d sa tis fie d is m et n ee d di vi de d by to ta l d em an d. 3 M od er n m et ho ds in cl ud e fe m al e st er ili za tio n, m al e st er ili za tio n, p ill , I U D /P PI U D , i nj ec ta bl es , m al e co nd om , f em al e co nd om , s ta nd ar d da ys m et ho d (S D M ), di ap hr ag m , f oa m /je lly , l ac ta tio na l am en or rh oe a m et ho d (L AM ), an d ot he r m od er n m et ho ds 152 z Family Planning Table 5.20 Hysterectomy Percentage of women age 15-49 who have had a hysterectomy, and among women with a hysterectomy, percent distribution by place the hysterectomy was performed, according to background characteristics, India, 2015-16 Background characteristic Percentage of women who have had a hysterectomy Median age at time of hysterectomy Number of women Place of hysterectomy (%) Total Number of women with a hysterectomy Public health sector Private health sector1 Elsewhere or don't know place Age 15-29 0.4 a 359,560 33.9 64.9 1.2 100.0 1,292 30-39 3.6 a 187,659 28.6 71.2 0.2 100.0 6,740 40-49 9.2 37.8 152,467 33.9 65.7 0.3 100.0 14,021 Residence Urban 2.7 35.4 242,225 33.5 66.2 0.2 100.0 6,594 Rural 3.4 33.5 457,461 31.8 67.8 0.4 100.0 15,459 Schooling No schooling 5.7 34.0 193,078 33.7 66.0 0.3 100.0 11,039 <5 years complete 4.7 33.7 40,503 35.9 63.5 0.6 100.0 1,902 5-7 years complete 3.7 33.2 99,687 31.6 68.1 0.3 100.0 3,665 8-9 years complete 1.9 33.5 116,681 31.5 68.0 0.5 100.0 2,169 10-11 years complete 1.7 33.9 99,576 30.6 69.1 0.3 100.0 1,656 12 or more years complete 1.1 36.9 150,160 22.9 76.7 0.3 100.0 1,622 Religion Hindu 3.4 33.8 563,739 32.6 67.1 0.3 100.0 18,891 Muslim 2.2 35.2 96,461 29.9 69.5 0.6 100.0 2,092 Christian 3.3 32.9 16,620 30.7 68.8 0.5 100.0 556 Sikh 2.7 37.1 11,618 35.5 64.1 0.4 100.0 319 Buddhist/Neo-Buddhist 1.5 38.0 6,469 35.7 64.2 0.0 100.0 99 Jain 4.0 34.8 1,264 (15.5) (84.5) (0.0) 100.0 51 Other 1.3 36.7 3,515 35.8 56.3 7.9 100.0 46 Caste/tribe Scheduled caste 2.9 33.5 142,619 40.3 59.2 0.5 100.0 4,069 Scheduled tribe 2.3 33.3 64,144 45.1 54.0 0.9 100.0 1,468 Other backward class 3.6 33.4 303,837 29.0 70.7 0.3 100.0 10,847 Other 3.0 35.7 184,594 29.2 70.5 0.3 100.0 5,505 Don't know 3.6 33.6 4,492 39.1 60.9 0.0 100.0 164 Wealth index Lowest 2.4 33.2 124,054 35.7 63.3 1.0 100.0 3,007 Second 3.1 33.3 136,900 37.3 62.3 0.4 100.0 4,226 Middle 3.6 32.8 143,814 33.7 66.2 0.2 100.0 5,177 Fourth 3.5 33.8 147,978 31.9 67.8 0.3 100.0 5,149 Highest 3.1 36.9 146,939 24.3 75.6 0.2 100.0 4,494 Total 3.2 34.0 699,686 32.3 67.3 0.3 100.0 22,053 a = Omitted because less than 50 percent of women had a hysterectomy by the beginning of this age group 1 Includes nongovernmental organizations or trust hospitals/clinics ( ) Based on 25-49 unweighted cases Family Planning z�153 Table 5.21 Hysterectomy by state/union territory Percentage of women age 15-49 who have had a hysterectomy, by state/union territory, India, 2015-16 State/union territory Percentage of women who have had a hysterectomy India 3.2 North Chandigarh 1.5 Delhi 1.1 Haryana 1.9 Himachal Pradesh 2.2 Jammu & Kashmir 2.6 Punjab 2.6 Rajasthan 2.3 Uttarakhand 2.0 Central Chhattisgarh 1.9 Madhya Pradesh 3.0 Uttar Pradesh 2.2 East Bihar 5.4 Jharkhand 2.3 Odisha 2.1 West Bengal 2.0 Northeast Arunachal Pradesh 1.8 Assam 0.9 Manipur 1.6 Meghalaya 1.1 Mizoram 1.0 Nagaland 1.6 Sikkim 1.3 Tripura 1.3 West Dadra & Nagar Haveli 3.6 Daman & Diu 3.0 Goa 2.6 Gujarat 4.2 Maharashtra 2.6 South Andaman & Nicobar Islands 1.8 Andhra Pradesh 8.9 Karnataka 3.0 Kerala 1.8 Lakshadweep 0.9 Puducherry 1.7 Tamil Nadu 3.4 Telangana 7.7 154 z Family Planning OTHER PROXIMATE DETERMINANTS OF FERTILITY 6 Key Findings y Age at first marriage: The median age at first marriage is 18.6 years for women and 24.5 years for men age 25-49. y Consanguineous marriages: Fourteen percent of marriages are consanguineous marriages, which are more common in all of the southern states except Kerala. y Sexual initiation: The median age at first sexual intercourse is 0.4 years later than the median age at first marriage for women. y Abortion: Three percent of pregnancies in the five years preceding the survey resulted in an abortion and 6 percent resulted in a miscarriage. y Complications from abortions: Almost one in five women with an abortion had complications from the abortion. y Widowhood: One in nine women age 45-49 are widowed. arriage and sexual activity help to determine the extent to which women are exposed to the risk of pregnancy. Thus they are important determinants of fertility levels. However, the timing and circumstances of marriage and sexual activity also have profound consequences for women’s and men’s lives. 6.1 MARITAL STATUS Marriage is nearly universal in India. By age 45-49, only 1 percent of women and 2 percent of men have never been married (Table 6.1). Seventy-three percent of women and 60 percent of men age 15-49 are currently married (Figure 6.1). Only a small proportion of women and men (0.3% each) are married, but the gauna ceremony associated with the consummation of marriage has not been performed. The same percentage of women and men age 15-49 are divorced. One in nine women age 45-49 are widowed, compared with one in 48 men. Trends: The percentage of women who are currently married has declined slightly, from 75 percent in 2005-06 to 73 percent in 2015-16. The percentage of men who are currently married also decreased slightly, from 62 percent in 2005-06 to 60 percent in 2015-16. M Other Proximate Determinants of Fertility z�155 6.2 AGE AT FIRST MARRIAGE Median age at first marriage Age by which half of respondents have been married. Sample: Women and men age 25-49 Men tend to marry considerably later than women in India. The median age at first marriage is 19 years among women age 20-49 and 24.5 years among men age 25-49 (Table 6.2). Forty percent of women age 20-49 marry before the legal minimum age of marriage of 18 years, and 26 percent of men age 25-49 marry before the minimum legal age of marriage of 21 years. Trends: Early marriage has been declining over time. Marriage before the legal age of 18 is 27 percent for women age 20-24, compared with 46 percent for women age 45-49. Similarly, for men, marriage before the legal age of 21 years has dropped from 29 percent for men age 45-49 to 20 percent for men age 25-29. The median age at first marriage for women age 20-49 increased from 17.2 years in 2005-06 to 19.0 years in 2015-16. For men age 25-49, the median age at first marriage increased by almost two years between 2005-06 and 2015-16 (22.6 and 24.5 years, respectively). Patterns by background characteristics y Urban women marry later than rural women. For women age 25-49, the median age at first marriage is 1.7 years more among urban women than rural women (19.8 versus 18.1 years) (Table 6.3.1). y Women having 12 or more years of schooling marry much later than other women. The median age at first marriage for women age 25-49 increases from 17.2 years for women with no schooling to 22.7 years for women with 12 or more years of schooling (Figure 6.2). y The median age at first marriage for women age 25-49 is higher among Christian women (21.6 years), Jain women (21.2 years), and Sikh women (20.9 years) than women from all other specific religions (18.0-19.2 years). Figure 6.1 Marital Status Percent distribution of women and men age 15-49 Never married 23% Currently married 73% Married, gauna not performed 0.3% Divorced/ separated/ deserted 1.1% Widowed 3.1% Women Never married 38% Currently married 60% Married, gauna not performed 0.3% Divorced/ separated/ deserted 0.7% Widowed 0.6% Men 156 z Other Proximate Determinants of Fertility y Women in the highest wealth quintile marry much later (20.8 years) than women in other wealth quintiles (17.4-19.0 years). y Twenty-eight percent of women age 18-29 and 17 percent of men age 21-29 marry before reaching the legal minimum age at marriage. About two-fifths of women marry before reaching the legal minimum age at marriage in West Bengal (44%), Bihar (42%), Jharkhand (39%), and Andhra Pradesh (36%). About one-third of women in Rajasthan, Assam, Madhya Pradesh, and Tripura (33% each), as well as Dadra & Nagar Haveli (32%) and Telangana (31%) marry before reaching the legal minimum age at marriage. The percentage of women marrying before reaching the legal minimum age of 18 is lowest in Lakshadweep (5%), Jammu & Kashmir and Kerala (9% each), and Himachal Pradesh and Punjab (10% each) (Table 6.4). y About one-fourth of men age 21-29 in Rajasthan and Madhya Pradesh (28% each), Bihar and Jharkhand (27% each), Dadra & Nagar Haveli and Gujarat (26% each), and Arunachal Pradesh (24%) marry before the minimum legal age at 21 years. The lowest proportions of men marrying below the legal age at marriage are in Kerala (2%), Chandigarh (4%), Puducherry and Goa (5% each), Himachal Pradesh (6%), and Tamil Nadu and Andaman & Nicobar Islands (7% each). 6.3 CONSANGUINEOUS MARRIAGES Consanguineous marriage Women who report that their husband was related to them by blood before their marriage. Sample: Ever-married women age 15-49 Fourteen percent of ever-married women were related to their husband before their marriage, and 12 percent of these marriages were consanguineous marriages (Table 6.5). The most common type of consanguineous marriages were marriages to first cousins (9% of all marriages). Patterns by background characteristics y Young women are much more likely than older women to be related to their husbands. y Women in urban areas are slightly more likely to be in consanguineous marriages than are women in rural areas. y Muslim and Buddhist/Neo-Buddhist women are the most likely to be in consanguineous marriages. y Women in all the Southern states except Kerala are much more likely to be in consanguineous marriages than women in other states. About one-third of women in Tamil Nadu, Lakshadweep, Andhra Pradesh, and Telangana reported being in consanguineous marriages (Table 6.6 and Figure 6.3). 17.2 17.5 18.0 18.9 19.7 22.7 No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Figure 6.2 Women's Median Age at First Marriage by Schooling Among women age 25-49 Other Proximate Determinants of Fertility z�157 6.4 AGE AT FIRST SEXUAL INTERCOURSE Median age at first sexual intercourse Age by which half of respondents have had sexual intercourse. Sample: Women and men age 25-49 In India, the median age at first sexual intercourse is 19.0 years for women age 25-49 (Table 6.7). Eleven percent of women age 25-49 had sex before age 15, and 39 percent before age 18. By age 20, 59 percent of women age 25-49 have had sexual intercourse (Table 6.7). On average, men age 25-49 in India initiate sexual intercourse at age 24.3, five years older than women. One percent of men age 25-49 first had sexual intercourse before age 15 and 7 percent had sexual intercourse before age 18. By age 25, 55 percent of men have had sexual intercourse. Age at first marriage is widely considered a proxy indicator for the age at which women begin to be exposed to the risks inherent in sexual activity. A comparison of the median age at first intercourse with the median age at first marriage can be used as a measure of whether respondents engage in sex before marriage. The median age at first marriage for women age 25-49 in India (19.0 years) is the same as the median age at first sexual intercourse (19.0 years). The same pattern is 1.4 1.9 2.7 3.7 3.7 4.3 4.4 4.5 4.8 6.0 6.1 6.2 6.2 6.8 7.3 7.3 7.5 9.2 9.7 9.7 9.8 9.8 10 12 12 13 14 16 18 20 22 26 27 30 32 33 33 Dadra & Nagar Haveli Mizoram Chandigarh Punjab Meghalaya Daman & Diu Himachal Pradesh Manipur Rajasthan Kerala Jharkhand Haryana Uttarakhand Bihar Chhattisgarh Arunachal Pradesh Assam Nagaland Delhi Madhya Pradesh West Bengal Gujarat Goa Tripura Uttar Pradesh Odisha INDIA Sikkim Maharashtra Jammu & Kashmir Puducherry Karnataka Andaman & Nicobar Islands Telangana Andhra Pradesh Lakshadweep Tamil Nadu Figure 6.3 Consanguineous Marriages by State/UT Percent of ever-married women age 15-49 158 z Other Proximate Determinants of Fertility observed for men age 25-49, with a median age at first intercourse of 24.3 years and a median age at first marriage of 24.5 years. Trends: The median age at first sexual intercourse among women age 25-49 increased from 17.6 years in 2005-06 to 19.0 years in 2015-16. The median age at first sexual intercourse for men age 25-49 also increased, from 22.6 years in 2005-06 to 24.3 years in 2015-16. Patterns by background characteristics y Urban women age 25-49 begin having sex almost two years later than rural women. The median age at first sex is 20.2 years for women in urban areas, compared with 18.5 years for women in rural areas (Table 6.8.1). y The median age at first intercourse increases with schooling for both women and men. Among women age 25-49, there is a gap of 5.2 years in the median age of first sex between those with no schooling and those with 12 or more years of schooling. 6.5 RECENT SEXUAL ACTIVITY NFHS-4 also collected data on recent sexual activity. Thirty-one percent of both women and men age 15-49 reported having sexual intercourse within the last week. Twenty-two percent of women and one-third of men age 15-49 have never had sexual intercourse. For more information on recent sexual activity, see Table 6.9.1 and Table 6.9.2. 6.6 INSUSCEPTIBILITY TO PREGNANCY Median duration of postpartum amenorrhoea Number of months after childbirth by which time half of women have begun menstruating. Sample: Women who gave birth in the three years before the survey Median duration of postpartum insusceptibility Number of months after childbirth by which time half of women are no longer protected against pregnancy either by postpartum amenorrhoea or abstinence from sex. Sample: Women who gave birth in the three years before the survey Postpartum amenorrhoea refers to the interval between childbirth and the return of menstruation. The length and intensity of breastfeeding influence the duration of amenorrhoea, which offers protection from conception. Postpartum abstinence is the period between childbirth and the time when a woman resumes sexual activity. Eighty-four percent of women are insusceptible to pregnancy two months after a birth. Continued postpartum amenorrhoea and abstinence from sexual intercourse may protect women from pregnancy for longer periods. Among births in the three years before the survey, the median duration of postpartum amenorrhoea is 4.9 months, while the median duration of abstinence from sexual intercourse after giving birth is 3.4 months. Women are insusceptible to pregnancy after childbirth for a median of 6.6 months (Table 6.10). Trends: The median duration of postpartum amenorrhoea and insusceptibility has declined since 2005-06. However, the median duration of abstinence has increased marginally. From 2005-06 to 2015-16, the median duration of postpartum amenorrhoea declined from 7.0 months to 4.9 months. The median duration of abstinence increased from 2.3 months in 2005-06 to 3.4 months in 2015-16. During this same period, the median duration of postpartum insusceptibility fell from 8.1 months to 6.6 months. Other Proximate Determinants of Fertility z�159 Patterns by background characteristics y The duration of postpartum amenorrhoea is slightly longer among women in rural areas than women in urban areas (5.3 months and 4.1 months, respectively). y Scheduled tribe women remain amenorrhoeic longer (7.0 months) than scheduled caste women (4.9 months), women from other backward classes (4.6 months), and women who are not from scheduled caste, scheduled tribe, or other backward class (4.3 months). y The median duration of amenorrhoea declines steadily with increasing wealth quintiles of households, from 6.6 months in the lowest wealth quintile to 3.6 months in the highest wealth quintile (Table 6.11). Menopause Women are considered to have reached menopause if they are neither pregnant nor postpartum amenorrhoeic and have not had a menstrual period in the six months before the survey, or if they report being menopausal or having had a hysterectomy or never having menstruated. Sample: Women age 30-49 Women who have reached menopause are no longer able to become pregnant. Eighteen percent of women age 30-49 are menopausal. The percentage of menopausal women increases with age, rising from 4 percent among women age 30-34 to 56 percent among women age 48-49 (Table 6.12). 6.7 PREGNANCY OUTCOMES Non-live births Percentage of women whose pregnancies ended in a non-live birth (abortion, miscarriage, or stillbirth) in the five years preceding the survey Sample: Women age 15-49 Ninety percent of all pregnancies in the five years preceding the survey ended in a live birth, and the remaining 10 percent terminated in abortion, miscarriage, or stillbirth. Miscarriage is the most common type of non-live birth, accounting for 6 percent of all pregnancies, and abortions account for 3 percent (Table 6.15). Trends: In 2015-16, 12 percent of women age 15-49 have experienced a stillbirth, miscarriage, or abortion in their lifetime, compared with 14 percent in 2005-06. Four percent of women age 15-49 had a non-live birth in the five years preceding the survey, down from 6 percent in NFHS-3. Patterns by background characteristics y The percentage of women who ever had a non-live birth increases with age until age 30-34 (peaking at 18%) and then declines with age to 14 percent among women age 45-49 years (Table 6.13). y The percentage of pregnancies in the past five years that ended in a non-live birth varies from 8 percent to 15 percent by age, with the highest percentage of non-live births in the older ages (age 35-49) and among teenagers (age 15-19). y The percentage of all pregnancies in the past five years that ended in a non-live birth was particularly high in Manipur (13%) and Uttar Pradesh and Tripura (12% each). 160 z Other Proximate Determinants of Fertility y Three percent of last pregnancies in the past five years resulted in an abortion, with a slightly higher percentage among women in urban areas, women age 30-49, and women in the highest wealth quintile. y Miscarriages are particularly high (10%) for women age 15-19 years (Table 6.15). 6.7.1 CHARACTERISTICS OF ABORTIONS A majority of the abortions were performed in the private health sector (52%) and 20 percent were performed in the public health sector. More than one-quarter (26%) of the abortions were reportedly performed by the woman herself at home. Nineteen percent of women reporting an abortion said that they had complications from the abortion (Table 6.17). Other Proximate Determinants of Fertility z�161 LIST OF TABLES For more information on the proximate determinants of fertility, see the following tables: Tables Table 6.1 Current marital status Table 6.2 Age at first marriage Table 6.3.1 Median age at first marriage: Women Table 6.3.2 Median age at first marriage: Men Table 6.4 Age at first marriage by state/union territory Table 6.5 Consanguineous marriages Table 6.6 Consanguineous marriages by state/union territory Table 6.7 Age at first sexual intercourse Table 6.8.1 Median age at first sexual intercourse: Women Table 6.8.2 Median age at first sexual intercourse: Men Table 6.9.1 Most recent sexual activity: Women Table 6.9.2 Most recent sexual activity: Men Table 6.10 Postpartum amenorrhoea, abstinence, and insusceptibility Table 6.11 Median duration of postpartum amenorrhoea, postpartum abstinence, and postpartum insusceptibility Table 6.12 Menopause Table 6.13 Non-live births Table 6.14 Non-live births by state/union territory Table 6.15 Pregnancy outcome Table 6.16 Pregnancy outcome by state/union territory Table 6.17 Characteristics of abortions 162 z Other Proximate Determinants of Fertility Table 6.1 Current marital status Percent distribution of women age 15-49 and men age 15-54 by current marital status, according to age and residence, India, 2015-16 Age Marital status Total Number of respondents Never married Currently married Married, gauna not performed Widowed Divorced Separated Deserted URBAN WOMEN 15-19 89.9 9.7 0.3 0.0 0.0 0.0 0.0 100.0 36,932 20-24 45.6 53.1 0.2 0.3 0.3 0.4 0.1 100.0 41,486 25-29 13.7 84.2 0.1 1.0 0.4 0.6 0.1 100.0 40,857 30-34 3.7 92.5 0.0 2.2 0.6 0.8 0.2 100.0 34,748 35-39 1.8 91.9 0.0 4.6 0.6 1.0 0.2 100.0 32,943 40-44 1.4 89.2 0.0 7.5 0.5 1.1 0.3 100.0 28,728 45-49 1.2 85.9 0.1 11.2 0.5 1.0 0.2 100.0 26,531 Total 24.9 70.5 0.1 3.3 0.4 0.7 0.1 100.0 242,225 URBAN MEN 15-19 98.8 0.9 0.3 0.0 0.0 0.0 0.0 100.0 6,859 20-24 83.1 16.4 0.4 0.0 0.0 0.0 0.0 100.0 6,378 25-29 45.1 53.9 0.1 0.1 0.3 0.3 0.2 100.0 6,341 30-34 15.2 83.1 0.0 0.2 0.9 0.7 0.0 100.0 5,689 35-39 5.8 93.0 0.1 0.5 0.3 0.3 0.1 100.0 5,283 40-44 2.6 95.5 0.0 0.6 0.4 0.7 0.2 100.0 4,707 45-49 2.6 94.2 0.0 2.1 0.4 0.6 0.0 100.0 4,290 50-54 1.4 95.8 0.1 2.0 0.3 0.3 0.0 100.0 3,406 Total age 15-49 41.3 57.4 0.2 0.4 0.3 0.3 0.1 100.0 39,546 Total age 15-54 38.2 60.4 0.2 0.5 0.3 0.3 0.1 100.0 42,953 RURAL WOMEN 15-19 80.8 17.6 1.3 0.0 0.1 0.1 0.0 100.0 84,620 20-24 26.9 71.5 0.5 0.4 0.2 0.4 0.1 100.0 81,480 25-29 5.5 92.1 0.1 1.1 0.4 0.6 0.2 100.0 74,185 30-34 1.7 94.8 0.0 2.2 0.4 0.7 0.2 100.0 62,021 35-39 1.1 93.0 0.0 4.4 0.4 0.8 0.2 100.0 57,947 40-44 0.8 90.5 0.0 7.1 0.4 0.9 0.3 100.0 49,242 45-49 0.6 87.2 0.0 10.8 0.4 0.7 0.3 100.0 47,967 Total 21.2 74.4 0.4 3.0 0.3 0.6 0.2 100.0 457,461 RURAL MEN 15-19 97.2 2.0 0.8 0.0 0.0 0.0 0.0 100.0 11,881 20-24 69.4 29.4 0.8 0.1 0.2 0.1 0.1 100.0 10,245 25-29 30.1 68.7 0.2 0.2 0.3 0.4 0.1 100.0 9,831 30-34 9.8 88.7 0.1 0.6 0.4 0.3 0.1 100.0 8,915 35-39 3.2 95.1 0.0 0.7 0.4 0.4 0.1 100.0 8,488 40-44 2.0 95.3 0.0 1.6 0.3 0.6 0.1 100.0 7,343 45-49 1.7 95.2 0.0 2.2 0.2 0.6 0.1 100.0 7,161 50-54 1.5 94.6 0.0 2.9 0.3 0.5 0.1 100.0 5,305 Total age 15-49 36.1 62.3 0.3 0.7 0.2 0.3 0.1 100.0 63,864 Total age 15-54 33.4 64.8 0.3 0.8 0.2 0.3 0.1 100.0 69,169 Continued… Other Proximate Determinants of Fertility z�163 Table 6.1 Current marital status—Continued Percent distribution of women age 15-49 and men age 15-54 by current marital status, according to age and residence, India, 2015-16 Age Marital status Total Number of respondents Never married Currently married Married, gauna not performed Widowed Divorced Separated Deserted TOTAL WOMEN 15-19 83.6 15.2 1.0 0.0 0.1 0.1 0.0 100.0 121,552 20-24 33.2 65.3 0.4 0.3 0.3 0.4 0.1 100.0 122,966 25-29 8.4 89.3 0.1 1.1 0.4 0.6 0.1 100.0 115,043 30-34 2.4 93.9 0.0 2.2 0.5 0.8 0.2 100.0 96,769 35-39 1.3 92.6 0.0 4.5 0.5 0.9 0.2 100.0 90,890 40-44 1.0 90.0 0.0 7.3 0.4 0.9 0.3 100.0 77,969 45-49 0.8 86.7 0.1 10.9 0.4 0.8 0.2 100.0 74,497 Total 22.5 73.1 0.3 3.1 0.3 0.6 0.2 100.0 699,686 TOTAL MEN 15-19 97.8 1.6 0.6 0.0 0.0 0.0 0.0 100.0 18,740 20-24 74.6 24.4 0.6 0.1 0.1 0.1 0.0 100.0 16,624 25-29 36.0 62.9 0.2 0.2 0.3 0.4 0.2 100.0 16,171 30-34 11.9 86.5 0.1 0.4 0.5 0.5 0.1 100.0 14,604 35-39 4.2 94.3 0.1 0.6 0.4 0.4 0.1 100.0 13,771 40-44 2.2 95.4 0.0 1.2 0.3 0.7 0.2 100.0 12,050 45-49 2.0 94.8 0.0 2.1 0.3 0.6 0.1 100.0 11,451 50-54 1.4 95.1 0.1 2.6 0.3 0.4 0.1 100.0 8,711 Total age 15-49 38.1 60.4 0.3 0.6 0.3 0.3 0.1 100.0 103,411 Total age 15-54 35.2 63.1 0.2 0.7 0.3 0.3 0.1 100.0 112,122 164 z Other Proximate Determinants of Fertility Table 6.2 Age at first marriage Percentage of women age 15-49 and men age 15-54 who were first married by specific exact ages, percentage never married, and median age at first marriage and first cohabitation with spouse, according to current age, India, 2015-16 Current age Percentage first married by exact age: Percentage never married Number of respondents Median age at first marriage Median age at first cohabitation 15 18 20 21 25 WOMEN 15-19 2.6 na na na na 84.6 121,552 a a 20-24 6.6 26.8 48.0 na na 33.6 122,966 a a 25-29 12.3 36.3 55.1 63.4 84.6 8.5 115,043 19.4 19.6 30-34 16.8 44.4 62.5 69.7 87.0 2.4 96,769 18.6 18.8 35-39 18.4 46.4 64.5 71.5 87.6 1.3 90,890 18.4 18.7 40-44 20.3 48.6 65.7 72.6 87.5 1.1 77,969 18.2 18.7 45-49 19.0 46.0 63.6 70.3 85.9 0.9 74,497 18.4 19.2 20-49 14.7 40.1 58.8 na na 9.7 578,134 19.0 19.3 25-49 16.9 43.7 61.8 69.1 86.4 3.3 455,168 18.7 19.0 MEN 15-19 0.4 na na na na 98.4 18,740 a a 20-24 0.8 4.1 10.3 na na 75.3 16,624 a a 25-29 1.8 6.8 14.8 20.3 48.2 36.1 16,171 a a 30-34 2.9 9.9 19.1 25.2 52.0 11.9 14,604 24.7 24.7 35-39 3.9 11.1 20.7 27.7 54.8 4.3 13,771 24.3 24.3 40-44 3.9 12.6 23.8 31.0 57.1 2.3 12,050 23.9 23.9 45-49 3.8 11.8 22.0 29.4 57.0 2.0 11,451 24.0 23.9 50-54 3.7 10.5 20.1 26.6 53.9 1.5 8,711 24.5 24.5 20-49 2.7 9.0 17.9 na na 25.0 84,671 a a 25-49 3.2 10.2 19.7 26.3 53.4 12.8 68,047 24.5 24.5 na = Not applicable due to censoring a = Omitted because less than 50 percent of the women or men were married or began living with their spouse before reaching the beginning of the age group Other Proximate Determinants of Fertility z�165 Table 6.3.1 Median age at first marriage: Women Median age at first marriage among women age 20-49, by current age, according to background characteristics, India, 2015-16 Background characteristic Age Women age 20-49 Women age 25-49 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban a 21.0 19.9 19.4 19.1 19.3 a 19.8 Rural 19.6 18.7 17.9 17.8 17.6 17.9 18.4 18.1 Schooling No schooling 18.1 17.4 16.8 17.0 17.0 17.5 17.3 17.2 <5 years complete 18.0 17.6 17.3 17.4 17.5 17.8 17.6 17.5 5-7 years complete 18.5 18.2 17.7 17.8 17.8 18.3 18.1 18.0 8-9 years complete 19.2 18.9 18.7 18.8 18.7 19.3 19.0 18.9 10-11 years complete 19.7 19.8 19.5 19.6 19.8 20.1 19.7 19.7 12 or more years complete a 23.0 22.6 22.4 22.3 22.6 a 22.7 Religion Hindu a 19.3 18.5 18.2 18.0 18.3 18.9 18.5 Muslim a 19.4 18.5 18.3 18.1 18.2 19.0 18.6 Christian a 22.0 21.4 21.2 21.5 21.3 a 21.6 Sikh a 22.1 20.9 20.6 20.5 20.7 a 20.9 Buddhist/Neo-Buddhist a 20.2 19.6 18.5 18.3 19.0 19.6 19.2 Jain a 21.6 21.9 22.2 20.5 20.7 a 21.2 Other 19.2 18.1 17.6 18.5 17.9 17.9 18.3 18.0 Caste/tribe Scheduled caste 19.9 19.0 18.1 17.7 17.5 17.9 18.6 18.1 Scheduled tribe 19.5 18.9 18.2 18.3 18.2 18.5 18.7 18.4 Other backward class a 19.2 18.3 18.2 18.0 18.2 18.9 18.5 Other a 20.4 19.5 19.2 18.8 19.1 19.8 19.5 Don't know 18.2 18.2 17.8 18.1 18.3 18.9 18.2 18.2 Wealth index Lowest 18.4 17.6 17.1 17.3 17.2 17.7 17.6 17.4 Second 19.1 18.2 17.5 17.5 17.4 17.7 18.0 17.7 Middle 19.9 18.9 18.1 18.0 17.7 18.1 18.6 18.2 Fourth a 20.2 19.1 18.6 18.4 18.5 19.5 19.0 Highest a 22.3 21.1 20.4 19.7 19.7 a 20.8 Total a 19.4 18.6 18.4 18.2 18.4 19.0 18.7 a = Omitted because less than 50 percent of the women were married before reaching the beginning of the age group 166 z Other Proximate Determinants of Fertility Table 6.3.2 Median age at first marriage: Men Median age at first marriage among men age 25-54, by current age, according to background characteristics, India, 2015-16 Background characteristic Age Men age 25-49 25-29 30-34 35-39 40-44 45-49 50-54 Residence Urban a 26.1 25.7 25.2 25.1 25.5 a Rural 24.4 23.8 23.3 22.9 23.2 23.7 23.6 Schooling No schooling 22.2 21.9 21.9 21.6 22.4 23.5 22.0 <5 years complete 22.7 22.5 22.7 22.0 22.8 23.6 22.6 5-7 years complete 23.2 23.3 23.1 22.7 23.4 23.6 23.1 8-9 years complete 24.0 23.7 23.3 23.8 23.7 24.1 23.7 10-11 years complete a 25.5 25.2 24.7 24.7 25.5 a 12 or more years complete a 27.4 27.2 26.6 26.8 26.6 a Religion Hindu a 24.6 24.1 23.7 23.9 24.4 24.3 Muslim a 24.3 24.8 24.0 23.8 24.6 24.6 Christian a 27.7 27.7 27.0 27.6 26.7 a Sikh a 25.1 24.2 24.6 23.7 24.5 a Buddhist/Neo-Buddhist a 26.8 26.2 23.9 25.1 24.6 a Jain a 28.3 28.7 29.3 25.0 26.3 a Other 24.4 21.7 24.2 24.7 23.7 21.0 24.1 Caste/tribe Scheduled caste 24.7 24.0 23.5 22.9 23.0 23.8 23.7 Scheduled tribe 23.5 23.3 22.9 22.8 23.0 24.0 23.2 Other backward class 24.9 24.4 24.0 23.5 23.8 24.0 24.2 Other a 25.9 25.5 25.2 25.1 25.6 a Don't know 25.0 24.0 25.2 a 23.3 28.0 24.7 Wealth index Lowest 21.8 21.6 21.8 21.7 21.9 22.8 21.7 Second 23.5 23.1 22.6 22.0 22.8 23.4 22.9 Middle 25.0 24.2 24.0 23.8 23.5 24.2 24.2 Fourth a 25.6 25.1 24.8 24.4 24.5 a Highest a 27.1 26.6 25.7 25.6 25.8 a Total a 24.7 24.3 23.9 24.0 24.5 24.5 a = Omitted because less than 50 percent of the men were married before reaching the beginning of the age group Other Proximate Determinants of Fertility z�167 Table 6.4 Age at first marriage by state/union territory Percentage of women age 18-29 who were first married by exact age 18 and percentage of men age 21-29 who were first married by exact age 21, by residence and state/union territory, India, 2015-16 State/union territory Women Men Urban Rural Total Urban Rural Total ,QGLD� 19.2 32.4 27.9 11.4 21.3 17.4 1RUWK Chandigarh 12.7 * 12.7 (4.6) * (4.4) Delhi 17.2 (10.6) 17.2 18.8 * 18.7 Haryana 21.9 21.9 21.9 17.9 22.4 20.4 Himachal Pradesh 6.2 9.8 9.5 1.4 7.1 6.1 Jammu & Kashmir 4.2 11.1 9.2 6.8 10.8 9.5 Punjab 10.4 9.5 9.8 7.0 10.3 9.0 Rajasthan 21.8 36.6 32.9 13.5 33.9 27.5 Uttarakhand 14.1 17.8 16.4 9.8 14.1 12.3 &HQWUDO Chhattisgarh 16.6 26.7 24.2 10.3 23.4 20.0 Madhya Pradesh 20.3 38.5 33.0 14.9 33.7 27.7 Uttar Pradesh 13.1 26.0 22.5 13.5 25.6 21.9 (DVW Bihar 31.0 43.6 41.9 16.9 29.6 27.2 Jharkhand 24.9 44.5 39.2 13.8 32.0 26.9 Odisha 18.9 23.6 22.8 4.5 12.3 10.7 West Bengal 29.6 50.0 43.6 13.2 20.9 18.3 1RUWKHDVW Arunachal Pradesh 22.8 32.3 29.5 11.8 29.3 24.2 Assam 22.0 34.3 32.6 16.0 17.9 17.6 Manipur 9.8 13.8 12.3 8.1 16.0 12.9 Meghalaya 9.9 21.4 18.6 7.3 19.2 16.5 Mizoram 6.3 17.2 10.7 5.4 22.3 12.2 Nagaland 10.2 16.0 13.6 2.9 13.2 9.4 Sikkim 16.5 16.3 16.4 8.8 9.3 9.0 Tripura 27.3 35.0 32.9 6.3 22.1 17.8 :HVW Dadra & Nagar Haveli 29.9 32.7 31.5 (20.7) (33.7) 26.1 Daman & Diu 24.2 15.7 21.7 17.1 (12.0) 15.9 Goa 19.8 4.2 13.9 7.8 0.0 5.0 Gujarat 18.2 29.4 24.5 18.6 33.2 26.1 Maharashtra 19.6 32.1 26.0 7.8 10.5 9.1 6RXWK Andaman & Nicobar Islands 16.5 19.8 18.4 * 10.4 7.0 Andhra Pradesh 30.4 38.9 36.2 10.9 18.9 16.1 Karnataka 19.3 29.3 25.0 7.0 8.1 7.6 Kerala 8.6 9.9 9.3 1.1 3.5 2.4 Lakshadweep 2.7 11.2 4.5 (0.0) * (0.0) Puducherry 15.1 13.8 14.7 5.3 (4.5) 5.0 Tamil Nadu 15.3 20.1 17.7 7.8 6.6 7.2 Telangana 21.2 40.1 30.8 7.9 18.8 13.4 ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases 168 z Other Proximate Determinants of Fertility Table 6.5 Consanguineous marriages Percent distribution of ever-married women age 15-49 by relationship to current (last) husband before their marriage, according to selected background characteristics, India, 2015-16 Background characteristic First cousin Second cousin Uncle Other blood relative Brother- in-law Other non-blood relative Not related Total Number of women Father's side Mother's side Age 15-19 5.7 5.0 0.7 0.5 3.4 1.0 3.2 80.4 100.0 18,712 20-24 4.7 4.8 0.7 0.5 2.7 0.9 2.3 83.6 100.0 81,635 25-29 4.2 4.2 0.7 0.6 2.2 0.7 1.9 85.6 100.0 105,243 30-34 4.1 4.3 0.6 0.5 2.1 0.6 1.6 86.2 100.0 94,399 35-39 4.2 4.5 0.6 0.6 1.9 0.6 1.4 86.1 100.0 89,676 40-44 4.1 3.9 0.6 0.6 1.7 0.6 1.2 87.4 100.0 77,141 45-49 4.1 4.2 0.7 0.6 1.7 0.7 1.1 87.0 100.0 73,846 Residence Urban 4.8 4.9 0.8 0.6 2.3 0.6 1.8 84.1 100.0 181,645 Rural 4.0 4.0 0.6 0.5 2.0 0.7 1.6 86.5 100.0 359,006 Schooling No schooling 4.2 4.0 0.6 0.5 1.8 0.8 1.1 87.0 100.0 183,705 <5 years complete 4.3 4.3 0.7 0.5 2.3 0.7 2.0 85.4 100.0 36,679 5-7 years complete 4.9 4.9 0.7 0.6 2.3 0.7 1.8 84.1 100.0 85,523 8-9 years complete 3.9 4.2 0.7 0.6 2.4 0.6 2.1 85.6 100.0 79,491 10-11 years complete 5.2 5.4 0.8 0.6 2.3 0.8 2.0 83.1 100.0 62,608 12 or more years complete 3.7 3.8 0.7 0.6 2.2 0.5 1.9 86.7 100.0 92,646 Religion Hindu 4.0 4.0 0.6 0.6 2.0 0.7 1.6 86.5 100.0 440,115 Muslim 6.5 6.8 1.1 0.4 2.6 0.7 1.7 80.3 100.0 70,904 Christian 5.2 5.1 0.5 0.8 1.9 0.8 2.3 83.4 100.0 12,350 Sikh 0.8 0.8 0.4 0.1 0.7 0.4 1.2 95.5 100.0 8,630 Buddhist/Neo-Buddhist 7.3 4.2 0.9 0.1 3.2 0.1 3.5 80.7 100.0 4,920 Jain 3.1 1.3 0.3 0.4 2.9 0.4 0.6 91.1 100.0 971 Other 1.7 2.4 0.1 0.0 4.0 0.3 2.9 88.6 100.0 2,761 Caste/tribe Scheduled caste 4.4 4.4 0.6 0.7 2.0 0.7 1.8 85.5 100.0 110,110 Scheduled tribe 3.6 3.8 0.5 0.3 2.2 0.7 2.4 86.5 100.0 49,970 Other backward class 4.8 4.8 0.7 0.7 2.1 0.7 1.3 84.9 100.0 235,184 Other 3.6 3.7 0.6 0.3 2.2 0.6 1.8 87.1 100.0 141,609 Don't know 4.1 4.3 0.4 0.4 1.8 1.1 1.7 86.3 100.0 3,779 Wealth index Lowest 2.6 2.5 0.4 0.3 1.9 0.6 1.5 90.2 100.0 98,860 Second 4.1 4.2 0.5 0.5 2.1 0.7 1.8 86.1 100.0 107,170 Middle 5.4 5.5 0.7 0.7 2.2 0.8 1.7 83.0 100.0 111,516 Fourth 5.1 5.3 0.8 0.7 2.3 0.7 1.6 83.4 100.0 113,496 Highest 4.0 3.9 0.8 0.6 2.0 0.6 1.7 86.6 100.0 109,609 Total 4.3 4.3 0.7 0.6 2.1 0.7 1.7 85.7 100.0 540,651 Other Proximate Determinants of Fertility z�169 Table 6.6 Consanguineous marriages by state/union territory Percent distribution of ever-married women age 15-49 by relationship to current (last) husband before their marriage, according to state/union territory, India, 2015-16 State/union territory First cousin Second cousin Uncle Other blood relative Brother- in-law Other non-blood relative Not related Total Father's side Mother's side India 4.3 4.3 0.7 0.6 2.1 0.7 1.7 85.7 100.0 North Chandigarh 0.8 0.2 0.0 0.0 0.2 0.0 1.5 97.3 100.0 Delhi 2.1 2.2 0.5 0.2 1.9 1.1 1.6 90.3 100.0 Haryana 1.2 1.1 0.7 0.5 0.7 0.9 1.0 93.8 100.0 Himachal Pradesh 0.2 0.2 0.0 0.1 1.0 0.3 2.6 95.6 100.0 Jammu & Kashmir 6.9 7.0 2.4 0.1 2.5 0.1 1.4 79.6 100.0 Punjab 0.6 0.7 0.3 0.1 0.5 0.3 1.2 96.3 100.0 Rajasthan 1.3 1.1 0.3 0.1 0.7 0.5 0.8 95.2 100.0 Uttarakhand 1.9 1.9 0.3 0.2 0.7 0.4 0.8 93.8 100.0 Central Chhattisgarh 1.3 1.6 0.5 0.1 1.9 0.2 1.8 92.7 100.0 Madhya Pradesh 2.4 2.5 0.7 0.5 2.0 0.4 1.1 90.3 100.0 Uttar Pradesh 4.1 2.8 0.6 0.1 2.2 0.6 1.7 87.9 100.0 East Bihar 1.2 1.7 0.3 0.3 1.8 0.8 0.7 93.2 100.0 Jharkhand 0.9 1.1 0.3 0.1 1.7 0.3 1.7 93.9 100.0 Odisha 2.2 2.1 0.3 0.4 3.3 0.6 4.2 87.1 100.0 West Bengal 1.3 1.5 0.3 0.1 2.8 0.4 3.5 90.2 100.0 Northeast Arunachal Pradesh 0.6 1.5 0.3 0.4 1.0 0.4 3.1 92.7 100.0 Assam 0.4 0.4 0.1 0.0 0.9 0.1 5.6 92.5 100.0 Manipur 0.6 0.7 0.1 0.0 1.6 0.0 1.5 95.5 100.0 Meghalaya 0.8 1.1 0.1 0.1 0.6 0.0 1.1 96.3 100.0 Mizoram 0.4 0.2 0.6 0.1 0.6 0.0 0.1 98.1 100.0 Nagaland 0.4 0.9 0.4 0.0 1.1 0.1 6.2 90.8 100.0 Sikkim 0.4 0.1 0.3 0.1 0.3 0.5 14.7 83.6 100.0 Tripura 0.1 0.1 0.0 0.0 0.2 0.1 11.4 88.0 100.0 West Dadra & Nagar Haveli 0.0 0.2 0.2 0.0 0.8 0.0 0.3 98.6 100.0 Daman & Diu 0.8 0.7 0.7 0.4 0.7 0.0 1.0 95.7 100.0 Goa 3.4 2.9 0.5 0.0 2.0 0.0 1.4 89.8 100.0 Gujarat 2.4 2.7 0.5 0.5 1.9 0.4 1.4 90.2 100.0 Maharashtra 6.4 4.9 0.7 0.1 3.1 0.2 2.1 82.5 100.0 South Andaman & Nicobar Islands 3.8 7.2 0.6 0.0 2.1 0.0 13.5 72.7 100.0 Andhra Pradesh 11.6 12.1 0.5 1.8 2.4 3.4 0.3 67.7 100.0 Karnataka 9.1 13.1 1.2 0.3 1.7 0.3 0.3 73.9 100.0 Kerala 1.7 1.5 0.5 0.1 1.2 0.0 1.2 94.0 100.0 Lakshadweep 10.6 6.9 2.9 0.1 6.1 0.0 6.1 67.3 100.0 Puducherry 8.0 8.2 0.7 2.9 2.3 0.0 0.2 77.8 100.0 Tamil Nadu 10.5 13.2 2.2 3.5 2.7 0.1 0.8 66.9 100.0 Telangana 12.7 8.2 0.5 0.5 2.9 4.2 1.1 69.8 100.0 170 z Other Proximate Determinants of Fertility Table 6.7 Age at first sexual intercourse Percentage of women age 15-49 and men age 15-54 who had first sexual intercourse by specific exact ages, percentage who never had sexual intercourse, and median age at first sexual intercourse, according to current age, India, 2015-16 Current age Percentage who had first sexual intercourse by exact age: Percentage who never had sexual intercourse Number of respondents Median age at first sexual intercourse 15 18 20 21 22 25 WOMEN 15-19 1.6 na na na na na 82.3 121,552 a 20-24 3.9 23.2 46.6 na na na 32.1 122,966 a 25-29 7.8 31.5 52.9 61.6 68.4 82.1 8.2 115,043 19.7 30-34 10.3 39.0 59.6 67.3 72.6 83.6 2.4 96,769 18.9 35-39 11.3 41.4 61.9 69.5 74.4 83.9 1.4 90,890 18.7 40-44 12.6 42.7 62.6 70.2 74.8 83.6 1.2 77,969 18.6 45-49 12.2 41.8 61.2 68.6 73.3 82.6 1.1 74,497 18.7 20-49 9.2 35.4 56.5 na na na 9.4 578,134 19.3 25-49 10.6 38.7 59.1 67.0 72.4 83.1 3.2 455,168 19.0 MEN 15-19 1.1 na na na na na 91.8 18,740 a 20-24 0.7 5.9 16.9 na na na 61.7 16,624 a 25-29 0.9 5.7 15.6 23.7 31.2 53.9 28.1 16,171 24.4 30-34 1.5 7.8 17.7 25.6 32.2 52.4 9.2 14,604 24.6 35-39 1.8 7.9 18.8 27.2 33.6 55.0 3.3 13,771 24.2 40-44 1.5 8.3 20.1 29.6 36.9 56.8 1.5 12,050 23.9 45-49 1.1 7.0 18.3 27.7 34.6 57.0 1.8 11,451 24.0 50-54 0.8 6.4 16.3 24.6 31.3 53.1 1.1 8,711 24.5 20-49 1.2 7.0 17.8 na na na 20.0 84,671 a 25-49 1.3 7.3 18.0 26.5 33.5 54.8 9.9 68,047 24.3 na = Not applicable due to censoring a = Omitted because less than 50 percent of the women or men had sexual intercourse before reaching the beginning of the age group Other Proximate Determinants of Fertility z�171 7DEOH�������0HGLDQ�DJH�DW�ILUVW�VH[XDO�LQWHUFRXUVH��:RPHQ� 0HGLDQ�DJH�DW�ILUVW�VH[XDO�LQWHUFRXUVH�DPRQJ�ZRPHQ�DJH��������E\�FXUUHQW�DJH��DFFRUGLQJ�WR�EDFNJURXQG�FKDUDFWHULVWLFV��,QGLD�� ��������� %DFNJURXQG�� FKDUDFWHULVWLF� &XUUHQW�DJH� :RPHQ�� DJH������� :RPHQ�� DJH������������� ������ ������ ������ ������ ������ � � � � � � � � � 5HVLGHQFH� � � � � � � � � 8UEDQ�� D� ����� ����� ����� ����� ����� D� ����� 5XUDO�� ����� ����� ����� ����� ����� ����� ����� ����� � � � � � � � � � 6FKRROLQJ� � � � � � � � � 1R�VFKRROLQJ�� ����� ����� ����� ����� ����� ����� ����� ����� ���\HDUV�FRPSOHWH�� ����� ����� ����� ����� ����� ����� ����� ����� ����\HDUV�FRPSOHWH�� ����� ����� ����� ����� ����� ����� ����� ����� ����\HDUV�FRPSOHWH�� ����� ����� ����� ����� ����� ����� ����� ����� ������\HDUV�FRPSOHWH�� ����� ����� ����� ����� ����� ����� ����� ����� ���RU�PRUH�\HDUV�FRPSOHWH�� D� ����� ����� ����� ����� ����� D� ����� � � � � � � � � � 5HOLJLRQ� � � � � � � � � +LQGX�� D� ����� ����� ����� ����� ����� ����� ����� 0XVOLP�� D� ����� ����� ����� ����� ����� ����� ����� &KULVWLDQ�� D� ����� ����� ����� ����� ����� D� ����� 6LNK�� D� ����� ����� ����� ����� ����� D� ����� %XGGKLVW�1HR�%XGGKLVW�� D� ����� ����� ����� ����� ����� ����� ����� -DLQ�� D� ����� ����� ����� ����� ����� D� ����� 2WKHU�� ����� ����� ����� ����� ����� ����� ����� ����� � � � � � � � � � &DVWH�WULEH� � � � � � � � � 6FKHGXOHG�FDVWH�� ����� ����� ����� ����� ����� ����� ����� ����� 6FKHGXOHG�WULEH�� ����� ����� ����� ����� ����� ����� ����� ����� 2WKHU�EDFNZDUG�FODVV�� D� ����� ����� ����� ����� ����� ����� ����� 2WKHU�� D� ����� ����� ����� ����� ����� D� ����� 'RQ W�NQRZ�� ����� ����� ����� ����� ����� ����� ����� ����� � � � � � � � � � :HDOWK�LQGH[� � � � � � � � � /RZHVW�� ����� ����� ����� ����� ����� ����� ����� ����� 6HFRQG�� ����� ����� ����� ����� ����� ����� ����� ����� 0LGGOH�� D� ����� ����� ����� ����� ����� ����� ����� )RXUWK�� D� ����� ����� ����� ����� ����� ����� ����� +LJKHVW�� D� ����� ����� ����� ����� ����� D� ����� � � � � � � � � � 7RWDO� D� ����� ����� ����� ����� ����� ����� ����� D� �2PLWWHG�EHFDXVH�OHVV�WKDQ����SHUFHQW�RI�WKH�ZRPHQ�KDG�VH[XDO�LQWHUFRXUVH�EHIRUH�UHDFKLQJ�WKH�EHJLQQLQJ�RI�WKH�DJH�JURXS�� � � � 172 z Other Proximate Determinants of Fertility Table 6.8.2 Median age at first sexual intercourse: Men Median age at first sexual intercourse among men age 25-54, by current age, according to background characteristics, India, 2015-16 Background characteristic Current age Men age 25-49 25-29 30-34 35-39 40-44 45-49 50-54 Residence Urban a 25.7 25.5 25.3 25.3 25.5 a Rural 23.8 23.8 23.3 22.9 23.1 23.7 23.4 Schooling No schooling 22.0 21.9 22.1 22.0 22.3 23.5 22.1 <5 years complete 22.3 22.7 22.7 22.2 23.0 23.3 22.6 5-7 years complete 22.8 23.3 23.2 23.1 23.3 23.6 23.1 8-9 years complete 23.6 23.6 23.5 23.6 23.9 23.9 23.6 10-11 years complete 24.9 25.3 25.1 24.5 24.9 25.8 25.0 12 or more years complete a 27.2 26.8 26.4 26.8 26.8 a Religion Hindu 24.4 24.6 24.1 23.8 23.9 24.3 24.2 Muslim 24.6 24.4 24.4 23.8 23.5 24.9 24.2 Christian a 26.6 26.8 26.8 26.9 26.7 a Sikh 24.5 24.6 24.1 24.4 23.8 24.6 24.3 Buddhist/Neo-Buddhist a 26.0 26.9 23.7 26.4 23.8 a Jain a 27.0 27.6 29.0 25.2 29.8 a Other 23.5 22.6 24.3 25.4 23.3 21.0 23.7 Caste/tribe Scheduled caste 23.8 23.8 23.7 23.3 23.3 23.6 23.6 Scheduled tribe 22.8 22.7 22.5 22.7 22.8 24.1 22.7 Other backward class 24.2 24.5 24.0 23.6 23.8 24.2 24.1 Other a 25.6 25.3 24.9 25.0 25.5 a Don't know 24.4 24.3 23.7 25.2 23.0 28.4 23.9 Wealth index Lowest 21.7 21.7 22.1 22.2 22.3 23.1 22.0 Second 23.0 23.0 22.7 22.2 22.8 23.3 22.8 Middle 24.3 24.2 23.9 23.6 23.4 24.1 24.0 Fourth a 25.4 25.2 24.9 24.4 24.6 a Highest a 26.9 26.4 25.7 25.6 25.9 a Total 24.4 24.6 24.2 23.9 24.0 24.5 24.3 a = Omitted because less than 50 percent of the men had sexual intercourse before reaching the beginning of the age group Other Proximate Determinants of Fertility z�173 Table 6.9.1 Most recent sexual activity: Women Percent distribution of women age 15-49 by timing of last sexual intercourse, according to background characteristics, India, 2015-16 Background characteristic Timing of last sexual intercourse Never had sexual intercourse Total Median number of days since last sexual intercourse3 Number of women Within the last week Within the last four weeks1 Within one year2 One or more years Missing Age 15-19 7.3 2.3 4.6 0.6 2.2 83.1 100.0 7.3 21,059 20-24 30.9 11.3 15.8 2.0 7.0 33.0 100.0 7.1 21,154 25-29 45.5 18.3 16.6 3.8 7.5 8.3 100.0 5.8 19,769 30-34 46.3 23.4 16.1 5.4 6.2 2.5 100.0 6.6 17,037 35-39 40.4 24.7 18.1 8.4 7.0 1.4 100.0 7.4 15,510 40-44 29.8 26.1 21.0 13.6 8.5 1.0 100.0 10.6 13,599 45-49 20.6 23.3 25.5 18.9 10.8 0.8 100.0 21.2 12,992 Marital status Never married 0.2 0.4 1.3 0.6 1.0 96.6 100.0 a 27,821 Currently married 43.0 23.6 20.9 5.0 7.4 0.1 100.0 7.3 88,021 Widowed/divorced/ separated/deserted 1.2 0.9 10.4 61.5 25.0 1.0 100.0 a 5,277 Residence Urban 30.5 17.3 14.1 7.4 6.2 24.6 100.0 7.5 43,510 Rural 31.8 17.2 17.0 6.0 7.0 21.0 100.0 7.6 77,610 Schooling No schooling 34.6 21.0 20.3 10.1 9.2 4.8 100.0 8.1 31,877 <5 years complete 35.2 20.3 18.8 9.5 7.6 8.7 100.0 7.7 6,902 5-7 years complete 35.8 19.6 16.9 7.3 6.7 13.8 100.0 7.4 17,550 8-9 years complete 30.2 15.2 13.5 4.4 5.5 31.2 100.0 7.2 20,268 10-11 years complete 26.9 14.4 12.8 4.5 5.5 35.9 100.0 7.3 17,502 12 or more years complete 27.3 13.8 13.4 3.6 5.3 36.5 100.0 7.3 27,022 Religion Hindu 31.7 17.5 16.1 6.5 6.7 21.4 100.0 7.6 97,299 Muslim 29.8 15.8 14.9 5.9 6.7 26.9 100.0 7.5 17,295 Christian 23.3 15.2 18.4 9.9 9.0 24.2 100.0 14.0 3,064 Sikh 40.0 18.3 11.4 4.1 2.1 24.2 100.0 5.6 1,702 Buddhist/Neo-Buddhist 29.8 18.5 17.0 6.2 4.7 23.7 100.0 7.9 1,052 Jain 38.5 19.9 6.7 3.1 6.2 25.6 100.0 5.3 177 Other 38.0 12.2 18.3 5.2 6.4 19.8 100.0 5.9 530 Caste/tribe Scheduled caste 30.8 17.5 16.2 6.3 6.5 22.7 100.0 7.6 23,524 Scheduled tribe 33.3 16.1 14.9 6.8 8.3 20.7 100.0 7.3 11,010 Other backward class 30.0 17.6 16.8 6.6 7.0 22.0 100.0 7.7 53,500 Other 33.2 16.9 14.8 6.1 5.7 23.3 100.0 7.3 32,509 Don't know 37.9 13.8 16.0 8.7 12.0 11.6 100.0 7.1 578 Wealth index Lowest 32.8 15.7 18.6 5.7 7.7 19.4 100.0 7.8 19,430 Second 32.1 16.5 16.6 6.1 7.3 21.4 100.0 7.6 22,843 Middle 30.1 17.6 15.6 7.7 7.1 21.9 100.0 7.7 25,232 Fourth 29.6 17.9 15.5 6.9 6.7 23.5 100.0 7.6 26,358 Highest 32.6 18.0 14.3 5.7 5.2 24.3 100.0 7.3 27,256 Total 31.3 17.2 16.0 6.5 6.7 22.3 100.0 7.6 121,120 a = Omitted because less than 50 percent of women ever had sexual intercourse 1 Excludes women who had sexual intercourse within the last 1 week 2 Excludes women who had sexual intercourse within the last 1 and 4 weeks 3 Among those who have ever had sexual intercourse 174 z Other Proximate Determinants of Fertility Table 6.9.2 Most recent sexual activity: Men Percent distribution of men age 15-49 by timing of last sexual intercourse, according to background characteristics, India, 2015-16 Background characteristic Timing of last sexual intercourse Never had sexual intercourse Total Median number of days since last sexual intercourse3 Number of men Within the last week Within the last four weeks1 Within one year2 One or more years Missing Age 15-19 1.6 1.0 4.2 1.1 0.4 91.8 100.0 a 18,740 20-24 15.7 5.9 12.3 3.4 0.9 61.7 100.0 10.5 16,624 25-29 37.5 12.7 14.7 4.8 2.2 28.1 100.0 5.3 16,171 30-34 49.8 19.3 13.4 5.1 3.2 9.2 100.0 4.9 14,604 35-39 51.0 24.6 11.5 6.2 3.5 3.3 100.0 5.2 13,771 40-44 43.8 27.9 14.3 7.9 4.6 1.5 100.0 7.1 12,050 45-49 34.5 29.0 17.7 10.4 6.6 1.8 100.0 7.9 11,451 Marital status Never married 1.2 1.9 7.4 3.0 0.5 86.0 100.0 a 39,631 Currently married 51.2 24.5 14.9 5.3 4.0 0.1 100.0 5.4 62,499 Widowed/divorced/ separated/deserted 3.8 4.3 21.3 58.2 11.7 0.7 100.0 a 1,280 Residence Urban 28.8 14.9 12.3 5.2 3.1 35.7 100.0 7.3 39,546 Rural 33.1 16.0 12.0 5.0 2.5 31.4 100.0 7.1 63,864 Schooling No schooling 38.8 21.1 14.7 7.5 4.4 13.4 100.0 7.0 12,422 <5 years complete 41.6 20.6 13.4 6.3 3.5 14.6 100.0 5.8 6,171 5-7 years complete 36.8 18.5 13.5 5.7 3.0 22.5 100.0 6.1 14,730 8-9 years complete 30.0 14.9 11.6 4.2 2.3 37.0 100.0 6.5 21,422 10-11 years complete 26.6 13.0 9.9 4.5 2.3 43.7 100.0 6.0 18,030 12 or more years complete 27.6 12.9 11.8 4.5 2.4 40.7 100.0 6.7 30,636 Religion Hindu 31.7 15.7 12.4 5.1 2.8 32.3 100.0 6.5 84,211 Muslim 30.6 14.8 10.3 4.6 2.3 37.5 100.0 5.8 13,793 Christian 24.5 16.1 10.6 9.0 4.5 35.3 100.0 7.4 2,277 Sikh 35.9 17.6 12.4 2.9 0.1 31.1 100.0 5.9 1,622 Buddhist/Neo-Buddhist 26.2 15.6 16.5 5.4 4.1 32.1 100.0 8.2 958 Jain 31.7 19.1 9.8 3.4 2.7 33.3 100.0 6.6 163 Other 43.5 9.8 14.5 3.6 2.6 26.0 100.0 3.6 386 Caste/tribe Scheduled caste 31.8 16.2 12.0 5.3 2.5 32.1 100.0 6.7 20,499 Scheduled tribe 33.2 15.3 13.0 5.2 4.7 28.6 100.0 6.0 9,132 Other backward class 31.1 15.6 12.4 5.2 2.7 33.0 100.0 6.8 45,110 Other 31.2 15.4 11.4 4.6 2.4 35.1 100.0 6.0 28,299 Don't know 23.4 7.0 8.3 8.7 9.5 43.0 100.0 5.6 371 Wealth index Lowest 35.1 16.3 12.7 5.0 2.6 28.3 100.0 7.1 15,205 Second 31.8 15.7 12.8 5.0 2.7 31.9 100.0 7.2 19,402 Middle 30.3 15.4 12.5 5.6 2.7 33.5 100.0 7.3 22,047 Fourth 29.4 15.7 11.8 5.2 2.7 35.2 100.0 7.3 22,930 Highest 31.6 15.1 11.0 4.6 3.0 34.6 100.0 7.0 23,827 Total age 15-49 31.4 15.6 12.1 5.1 2.8 33.0 100.0 6.4 103,411 Age 50-54 22.6 29.0 23.8 16.1 7.4 1.1 100.0 7.2 8,711 Total age 15-54 30.7 16.6 13.0 5.9 3.1 30.6 100.0 7.2 112,122 a = Omitted because less than 50 percent of men ever had sexual intercourse 1 Excludes men who had sexual intercourse within the last 1 week 2 Excludes men who had sexual intercourse within the last 1 and 4 weeks 3 Among those who have ever had sexual intercourse Other Proximate Determinants of Fertility z�175 Table 6.10 Postpartum amenorrhoea, abstinence, and insusceptibility Percentage of births in the three years preceding the survey for which mothers are postpartum amenorrhoeic, abstaining, and insusceptible by number of months since birth, and median and mean durations, India, 2015-16 Months since birth Percentage of births for which the mother is: Number of births Amenorrhoeic Abstaining Insusceptible1 0 80.1 94.7 97.8 1,617 1 81.0 87.7 95.2 3,621 2 69.2 66.1 83.9 3,910 3 60.6 51.3 75.6 4,090 4 54.3 39.8 67.2 4,366 5 47.3 31.0 58.1 4,428 6 42.1 24.8 52.4 4,452 7 36.8 21.2 45.8 4,380 8 33.2 19.6 42.0 4,567 9 29.8 17.4 38.7 4,260 10 27.2 16.2 35.3 4,063 11 21.7 15.7 30.4 3,868 12 19.0 12.8 26.3 4,167 13 17.2 12.4 24.5 4,198 14 12.4 11.6 19.5 4,049 15 12.9 13.4 21.5 4,021 16 10.4 11.9 18.5 4,220 17 8.2 8.8 14.6 4,120 18 8.3 10.2 15.4 4,443 19 8.7 9.3 14.3 4,160 20 6.6 10.0 14.1 4,155 21 6.0 8.4 12.0 4,228 22 6.1 8.3 12.1 3,969 23 6.4 8.8 12.5 3,750 24 5.4 8.6 11.5 4,062 25 5.2 8.1 10.4 4,204 26 5.0 7.7 10.1 4,101 27 4.5 7.0 9.7 4,257 28 4.3 7.4 9.6 4,104 29 5.8 7.5 10.2 4,098 30 4.5 7.7 10.3 4,201 31 4.1 7.0 9.4 4,211 32 4.9 7.3 9.4 4,094 33 3.8 6.6 8.6 3,990 34 4.0 6.4 8.7 3,939 35 3.5 6.0 8.0 3,937 Median 4.9 3.4 6.6 na Mean 8.2 7.5 10.9 na Note: Estimates are based on status at the time of the survey. na = Not applicable 1 Includes births for which mothers are still amenorrhoeic or still abstaining (or both) following birth 176 z Other Proximate Determinants of Fertility Table 6.11 Median duration of postpartum amenorrhoea, postpartum abstinence, and postpartum insusceptibility Median number of months of postpartum amenorrhoea, postpartum abstinence, and postpartum insusceptibility following births in the three years preceding the survey, by background characteristics, India, 2015-16 Background characteristic Postpartum amenorrhoea Postpartum abstinence Postpartum insusceptibility1 Mother's age 15-29 4.8 3.4 6.6 30-49 5.4 3.5 7.0 Residence Urban 4.1 3.5 5.9 Rural 5.3 3.4 6.9 Mother's schooling No schooling 6.0 2.8 7.6 <5 years complete 5.9 3.3 6.7 5-7 years complete 5.3 3.2 6.8 8-9 years complete 4.9 3.4 6.9 10-11 years complete 4.8 4.1 6.1 12 or more years complete 3.9 4.0 5.8 Religion Hindu 5.0 3.5 6.8 Muslim 4.4 3.0 6.1 Christian 5.7 4.2 8.8 Sikh 2.5 2.6 3.7 Buddhist/Neo-Buddhist 4.0 4.3 7.1 Other 6.3 2.8 6.6 Caste/tribe Scheduled caste 4.9 3.1 6.9 Scheduled tribe 7.0 3.7 8.1 Other backward class 4.6 3.5 6.5 Other 4.3 3.4 5.8 Don't know 5.0 3.3 9.3 Wealth index Lowest 6.6 3.0 8.2 Second 5.6 3.3 7.2 Middle 4.9 3.6 6.7 Fourth 4.2 3.9 6.3 Highest 3.6 3.6 5.1 Total 4.9 3.4 6.6 Note: Medians are based on status at the time of the survey. 1 Includes births for which mothers are still amenorrhoeic or still abstaining (or both) following birth Other Proximate Determinants of Fertility z�177 Table 6.12 Menopause Percentage of women age 30-49 who are menopausal, by age, India, 2015-16 Age Percentage menopausal1 Number of women 30-34 3.7 96,769 35-39 7.9 90,890 40-41 16.0 37,851 42-43 21.7 28,640 44-45 33.1 36,765 46-47 43.1 23,585 48-49 55.8 25,626 Total 17.5 340,126 1 Women age 30-49 who are neither pregnant nor post-partum amenorrhoeic and who have not had a menstrual period in the six months before the survey, or who report being menopausal or having had a hysterectomy or never having menstruated. 178 z Other Proximate Determinants of Fertility Table 6.13 Non-live births Percentage of women age 15-49 who have ever had a non-live birth and have had a non-live birth in the five years preceding the survey, and percentage of pregnancies (not including current pregnancies) that ended in a non-live birth in the five years preceding the survey by current age of mother, India, 2015-16 Mother's current age Women age 15-49 Number of women Pregnancies in the past five years Number of pregnancies Percentage who have ever had a non-live birth Percentage who have had a non-live birth in the past five years Percentage that ended in a non- live birth 15-19 1.1 1.1 121,552 10.0 12,236 20-24 8.3 7.3 122,966 8.2 101,078 25-29 14.5 8.5 115,043 7.6 112,554 30-34 17.7 5.6 96,769 9.3 50,026 35-39 17.2 2.6 90,890 11.2 18,084 40-44 15.8 1.0 77,969 14.5 4,864 45-49 14.1 0.3 74,497 12.2 1,366 Total 12.0 4.1 699,686 8.5 300,209 20-49 14.3 4.8 578,134 8.5 287,973 25-49 15.9 4.1 455,168 8.6 186,895 Note: Non-live births include stillbirths, abortions, and miscarriages. Other Proximate Determinants of Fertility z�179 Table 6.14 Non-live births by state/union territory Percentage of women age 15-49 who have ever had a non-live birth and have had a non-live birth in the five years preceding the survey and percentage of pregnancies (not including current pregnancies) that ended in a non-live birth in the five years preceding the survey by state/union territory, India, 2015-16 State/union territory Women age 15-49 Pregnancies in the past five years Percentage who have ever had a non-live birth Percentage who have had a non-live birth in the past five years Percentage that ended in a non-live birth India 12.0 4.1 8.5 North Chandigarh 15.9 4.6 10.4 Delhi 16.5 5.9 10.1 Haryana 12.2 4.1 8.3 Himachal Pradesh 13.5 4.0 10.3 Jammu & Kashmir 12.2 4.3 10.0 Punjab 11.1 3.4 9.2 Rajasthan 12.0 4.4 8.3 Uttarakhand 13.9 4.6 9.0 Central Chhattisgarh 11.5 3.8 8.2 Madhya Pradesh 8.5 2.9 6.0 Uttar Pradesh 16.9 7.0 11.6 East Bihar 10.5 4.1 5.8 Jharkhand 11.2 4.4 8.0 Odisha 14.1 5.0 11.1 West Bengal 13.8 4.1 9.8 Northeast Arunachal Pradesh 7.4 3.1 6.0 Assam 11.9 4.5 8.9 Manipur 23.7 10.6 13.3 Meghalaya 5.8 2.5 4.2 Mizoram 8.2 3.0 5.8 Nagaland 8.0 2.7 4.7 Sikkim 4.9 1.6 5.9 Tripura 14.6 4.5 11.5 West Dadra & Nagar Haveli 5.7 2.9 5.5 Daman & Diu 8.9 3.5 8.8 Goa 9.2 2.8 8.1 Gujarat 10.5 3.2 7.5 Maharashtra 9.9 3.3 7.9 South Andaman & Nicobar Islands 7.4 2.0 6.3 Andhra Pradesh 10.0 2.8 8.0 Karnataka 6.1 2.0 5.5 Kerala 11.5 3.0 8.3 Lakshadweep 9.8 3.1 7.6 Puducherry 9.7 2.8 8.6 Tamil Nadu 12.1 2.8 7.8 Telangana 11.7 3.6 9.8 Note: Non-live births include stillbirths, abortions, and miscarriages. 180 z Other Proximate Determinants of Fertility Table 6.15 Pregnancy outcome Percent distribution of last pregnancies among women age 15-49 during the five years preceding the survey by pregnancy outcome, according to background characteristics, India, 2015-16 Background characteristic Pregnancy outcome Total Number of pregnancies Live birth Abortion Miscarriage Stillbirth Mother's current age 15-19 86.0 2.7 10.1 1.2 100.0 7,124 20-29 91.4 2.7 5.2 0.6 100.0 132,660 30-39 88.2 5.1 5.9 0.9 100.0 50,500 40-49 83.3 6.9 8.4 1.3 100.0 5,187 Residence Urban 88.3 4.7 6.4 0.6 100.0 58,981 Rural 91.0 2.9 5.3 0.8 100.0 136,489 Mother's schooling No schooling 91.3 2.6 5.0 1.0 100.0 53,766 <5 years complete 89.8 3.8 5.5 1.0 100.0 11,396 5-7 years complete 90.5 3.2 5.6 0.8 100.0 31,016 8-9 years complete 89.1 3.9 6.3 0.8 100.0 33,039 10-11 years complete 90.2 3.8 5.4 0.5 100.0 24,534 12 or more years complete 89.5 3.9 6.3 0.4 100.0 41,719 Religion Hindu 90.2 3.4 5.6 0.7 100.0 154,130 Muslim 89.6 3.5 6.0 0.9 100.0 31,521 Christian 91.6 3.6 4.2 0.6 100.0 4,111 Sikh 90.3 2.8 6.3 0.6 100.0 2,593 Buddhist/Neo-Buddhist 90.3 3.0 6.2 0.5 100.0 1,601 Jain 93.1 3.2 3.4 0.3 100.0 250 Other 92.5 2.5 4.0 1.0 100.0 1,264 Caste/tribe Scheduled caste 90.1 3.4 5.7 0.9 100.0 41,272 Scheduled tribe 92.8 2.1 4.5 0.7 100.0 19,848 Other backward class 90.3 3.3 5.6 0.8 100.0 85,005 Other 89.0 4.3 6.2 0.6 100.0 47,677 Don't know 90.4 3.5 4.8 1.3 100.0 1,667 Wealth index Lowest 92.2 2.1 4.7 1.0 100.0 44,949 Second 90.5 3.1 5.6 0.9 100.0 41,222 Middle 89.9 3.7 5.7 0.7 100.0 38,886 Fourth 89.3 4.2 6.0 0.6 100.0 37,374 Highest 88.3 4.6 6.7 0.4 100.0 33,039 Total 90.2 3.4 5.7 0.7 100.0 195,470 Other Proximate Determinants of Fertility z�181 Table 6.16 Pregnancy outcome by state/union territory Percent distribution of last pregnancies during the five years preceding the survey among women age 15-49 by pregnancy outcome, according to state/union territory, India, 2015-16 State/union territory Pregnancy outcome Total Live birth Abortion Miscarriage Stillbirth India 90.2 3.4 5.7 0.7 100.0 North Chandigarh 84.8 7.3 6.4 1.4 100.0 Delhi 81.8 7.1 10.5 0.5 100.0 Haryana 90.8 1.9 6.6 0.8 100.0 Himachal Pradesh 90.2 2.5 7.2 0.1 100.0 Jammu & Kashmir 89.3 3.5 6.3 0.8 100.0 Punjab 90.5 2.7 6.1 0.7 100.0 Rajasthan 90.8 2.0 6.6 0.6 100.0 Uttarakhand 88.7 3.3 7.2 0.9 100.0 Central Chhattisgarh 91.1 2.4 5.4 1.0 100.0 Madhya Pradesh 93.5 1.6 4.4 0.6 100.0 Uttar Pradesh 84.9 5.1 8.6 1.4 100.0 East Bihar 93.2 1.3 4.6 0.9 100.0 Jharkhand 90.7 2.6 5.6 1.0 100.0 Odisha 87.7 4.7 7.0 0.7 100.0 West Bengal 89.2 5.4 4.9 0.5 100.0 Northeast Arunachal Pradesh 91.0 4.0 4.4 0.6 100.0 Assam 89.6 5.5 4.4 0.5 100.0 Manipur 78.9 10.8 10.0 0.4 100.0 Meghalaya 94.7 1.2 3.6 0.5 100.0 Mizoram 93.9 0.2 5.3 0.5 100.0 Nagaland 93.4 2.0 4.1 0.5 100.0 Sikkim 93.3 1.1 4.8 0.8 100.0 Tripura 86.6 5.1 7.7 0.5 100.0 West Dadra & Nagar Haveli 94.6 1.6 3.8 0.0 100.0 Daman & Diu 90.4 1.5 8.2 0.0 100.0 Goa 91.2 3.3 5.5 0.0 100.0 Gujarat 92.0 2.2 5.3 0.5 100.0 Maharashtra 90.9 3.8 4.9 0.4 100.0 South Andaman & Nicobar Islands 94.3 2.9 2.1 0.7 100.0 Andhra Pradesh 93.1 2.9 3.4 0.7 100.0 Karnataka 94.5 1.8 3.2 0.5 100.0 Kerala 90.4 4.6 4.7 0.3 100.0 Lakshadweep 93.6 1.7 3.3 1.4 100.0 Puducherry 93.0 3.6 3.4 0.0 100.0 Tamil Nadu 92.2 3.6 3.8 0.3 100.0 Telangana 92.2 3.3 4.1 0.4 100.0 182 z Other Proximate Determinants of Fertility Table 6.17 Characteristics of abortions Among women age 15-49 whose last pregnancy in the five years preceding the survey ended in an abortion, percent distribution by place of abortion and person who performed the abortion, percentage who had complications from the abortion; among women who had complications, percentage who sought treatment for the complications; and among women who sought treatment for the complications, percent distribution by the place of treatment, according to residence, India, 2015-16 Characteristics of abortion Urban Rural Total 3ODFH�RI�DERUWLRQ Public health sector 16.9 22.5 20.2 Private health sector1 60.1 47.0 52.4 At home 22.7 30.1 27.0 Other 0.3 0.4 0.4 Total 100.0 100.0 100.0 3HUVRQ�ZKR�SHUIRUPHG�WKH�DERUWLRQ Doctor 60.2 48.6 53.4 Nurse/ANM/LHV 14.5 18.6 16.9 'DL (TBA) 0.2 0.6 0.4 Family member/relative/friend 1.9 3.6 2.9 Self 22.9 27.7 25.7 Other 0.4 0.8 0.6 Total 100.0 100.0 100.0 &RPSOLFDWLRQV�IURP�WKH�DERUWLRQ Percentage of women who had complications from the abortion 17.8 19.0 18.5 Number of women with abortions 2,759 3,936 6,695 7UHDWPHQW�IRU�WKH�FRPSOLFDWLRQV Percentage of women with complications from an abortion who sought treatment for the complications 84.0 82.8 83.3 Number of women with complications 490 747 1,237 3ODFH�RI�WUHDWPHQW Public health sector 21.2 26.0 24.1 Private health sector1 77.3 71.2 73.6 At home 1.4 2.4 2.0 Other 0.1 0.5 0.3 Total 100.0 100.0 100.0 Number of women who sought treatment 411 619 1,030 ANM = Auxiliary nurse midwife; LHV = Lady health visitor; TBA = Traditional birth attendant 1 Includes nongovernmental organizations or trust hospitals/clinics Other Proximate Determinants of Fertility z�183 INFANT AND CHILD MORTALITY 7 Key Findings x Mortality levels: For the five years preceding the survey, the under-five mortality rate was 50 deaths per 1,000 live births, and the infant mortality rate was 41 deaths per 1,000 live births. The neonatal mortality rate was 30 deaths per 1,000 live births. x Trends: The under-five mortality rate declined from 109 deaths per 1,000 live births in the five years before the 1992-93 survey to 50 deaths per 1,000 live births in the five years before the 2015-16 survey. The infant mortality rate declined from 79 deaths per 1,000 live births to 41 deaths per 1,000 live births during the same period. x Patterns: The under-five mortality rate and infant mortality rate are highest in Uttar Pradesh and lowest in Kerala. The under-five mortality rate and infant mortality rate are considerably higher in rural areas than in urban areas. x Perinatal mortality: The perinatal mortality rate is 36 deaths per 1,000 pregnancies. nformation on infant and child mortality is relevant to a demographic assessment of the population, and is an important indicator of the country’s socioeconomic development and quality of life. These estimates can also help identify children who may be at higher risk of death and lead to strategies to reduce this risk, such as promoting birth spacing. This chapter presents information on levels, trends, and differentials in perinatal, neonatal, infant, and under-five mortality rates. It also examines biodemographic factors and fertility behaviours that increase mortality risks for infants and young children. The information is collected as part of a retrospective birth history, in which female respondents list all of the children they have borne, along with each child’s date of birth, survivorship status, and current age or age at death. The quality of mortality estimates calculated from birth histories depends on the mother’s ability to recall all of the children she has given birth to, as well as their birth dates and ages at death. Potential data quality problems include: y The selective omission from the birth histories of those births that did not survive, which can result in underestimation of childhood mortality. y The displacement of birth dates, which may distort mortality trends. This can occur if an interviewer knowingly records a birth as occurring in a different year than the one in which it occurred. This may happen if an interviewer is trying to cut down on her overall work load, because live births occurring during the five years before the interview are the subject of a lengthy set of additional questions. I Infant and Child Mortality ‡ 185Infant and Child Mortality z�185 y The quality of reporting of age at death. Misreporting the child’s age at death may distort the age pattern of mortality, especially if the net effect of the age misreporting is to transfer deaths from one age bracket to another. y Any method of measuring childhood mortality that relies on the mothers’ reports (e.g., birth histories) assumes that female adult mortality is not high, or if it is high, that there is little or no correlation between the mortality risks of the mothers and those of their children. Selected indicators of the quality of the mortality data on which the estimates of mortality given in this chapter are based are presented in Appendix E (Tables E.4-E.6). 7.1 INFANT AND CHILD MORTALITY Neonatal mortality: The probability of dying within the first month of life. Postneonatal mortality: The probability of dying between the first month of life and the first birthday (computed as the difference between infant and neonatal mortality). Infant mortality: The probability of dying between birth and the first birthday. Child mortality: The probability of dying between the first and fifth birthdays. Under-five mortality: The probability of dying between birth and the fifth birthday. For the five-year period before the 2015-16 NFHS, the neonatal mortality rate was 30 deaths per 1,000 live births. This means that one in 33 live births died during the neonatal period. The infant mortality rate was 41 deaths per 1,000 live births. The under-five mortality rate was 50 deaths per 1,000 live births (Table 7.1 and Figure 7.1). This indicates that one in 20 children in India die before their fifth birthday. More than four-fifths (82%) of these deaths occur during infancy. Trends: The neonatal mortality rate declined from 49 deaths per 1,000 live births in the five years before the 1992-93 NFHS survey to 30 deaths per 1,000 live births in the five years before the 2015-16 NFHS survey. The neonatal mortality rates in the five years before the 1998-99 survey and the 2005-06 survey were 43 and 39 deaths per 1,000 live births, respectively. The infant mortality rate declined from 79 deaths per 1,000 live births in the five years before the 1992-93 NFHS survey to 41 deaths per 1,000 live births in the five years before the 2015-16 NFHS survey. During the same period, the under-five mortality rate declined from 109 deaths per 1,000 live births to 50 deaths per 1,000 live births. The infant mortality rate decreased by 48 percent over a period of 23 years. The decline in the under-five mortality rate is slightly higher than the decline in the infant mortality rate during this period (a decrease of 54 percent). Patterns by background characteristics y The under-five mortality rate is higher in rural areas than in urban areas (56 deaths per 1,000 live births versus 34 deaths per 1,000 live births). y The under-five mortality rate is highest in Uttar Pradesh (78 deaths per 1,000 live births) and lowest in Kerala (7 deaths per 1,000 live births) (Figure 7.2). 186 ‡ Infant and Child Mortality 109 95 74 50 79 68 57 41 49 43 39 30 NFHS-1 NFHS-2 NFHS-3 NFHS-4 Under-five mortality Infant mortality Neonatal mortality Figure 7.1 Trends in Early Childhood Mortality Rates Deaths per 1,000 live births in the five-year period before the survey 186 z Infant and Child Mortality y The under-five mortality rate declines with an increase in mother’s schooling (Table 7.2). y The under-five mortality rate for scheduled castes (56 deaths per 1,000 live births), scheduled tribes (57 deaths per 1,000 live births), and other backward classes (51 deaths per 1,000 live births) are considerably higher than for those who are not from scheduled castes, scheduled tribes, or other backward classes (39 deaths per 1,000 live births). y The under-five mortality rate also declines with increasing household wealth. The under-five mortality rate declined from 72 deaths per 1,000 live births in the lowest wealth quintile to 23 deaths per 1,000 live births in the highest wealth quintile. 7.2 BIODEMOGRAPHIC RISK FACTORS Researchers have identified multiple risk factors for infant and child mortality based on the characteristics of the mother and child and the circumstances of the birth. Table 7.3 and Figure 7.3 illustrate the relationship between these risk factors and neonatal, infant, and under-five mortality. y Boys are slightly more likely to die before their fifth birthday than girls. The gender gap is most pronounced in the neonatal period (within one month after birth). y Shorter birth intervals are associated with higher under-five mortality. The under-five mortality rate for children born less than 2 years after the preceding birth is more than twice as high as that for children born 3 years after their preceding sibling. y Children reported to be very small are 4-1/2 times as likely to die during the first month of life as children reported to be average size or larger (108 deaths per 1,000 live births versus 24 deaths per 1,000 live births). 7.1 13 13 16 26 27 29 30 32 32 32 32 33 33 33 34 37 38 38 38 40 41 41 42 42 44 46 47 48 50 51 54 57 58 64 65 78 Kerala Goa Andaman & Nicobar Islands Puducherry Manipur Tamil Nadu Maharashtra Lakshadweep Karnataka Telangana West Bengal Sikkim Tripura Arunachal Pradesh Punjab Daman & Diu Nagaland Himachal Pradesh Jammu & Kashmir Chandigarh Meghalaya Andhra Pradesh Haryana Delhi Dadra & Nagar Haveli Gujarat Mizoram Uttarakhand Odisha INDIA Rajasthan Jharkhand Assam Bihar Chhattisgarh Madhya Pradesh Uttar Pradesh Figure 7.2 Under-five Mortality Rate by State/UT Deaths per 1,000 live births for the five-year period before the survey Infant and Child Mortality ‡ 187 7.1 13 13 16 26 27 29 30 32 32 32 32 33 33 33 34 37 38 38 38 40 41 41 42 42 44 46 47 48 50 51 54 57 58 64 65 78 Kerala Goa Andaman & Nicobar Islands Puducherry Manipur Tamil Nadu Maharashtra Lakshadweep Karnataka Telangana West Bengal Sikkim Tripura Arunachal Pradesh Punjab Daman & Diu Nagaland Himachal Pradesh Jammu & Kashmir Chandigarh Meghalaya Andhra Pradesh Haryana Delhi Dadra & Nagar Haveli Gujarat Mizoram Uttarakhand Odisha INDIA Rajasthan Jharkhand Assam Bihar Chhattisgarh Madhya Pradesh Uttar Pradesh Deaths per 1,000 live births for the five-year period before the survey Figure 7.2 Under-five Mortality Rate by State/UT Infant and Child Mortality z�187 7.3 PERINATAL MORTALITY Perinatal mortality rate Perinatal deaths comprise stillbirths (pregnancy loss that occurs after seven months of gestation) and early neonatal deaths (deaths of live births within the first seven days of life). The perinatal mortality rate is calculated as the number of perinatal deaths per 1,000 pregnancies of seven or more months’ duration. Sample: Number of pregnancies of seven or more months’ duration to women age 15-49 in the five years before the survey. The causes of stillbirths and early neonatal deaths are closely linked, and it can be difficult to determine whether a death is one or the other. The perinatal mortality rate encompasses both stillbirths and early neonatal deaths, and offers a better measure of the level of mortality and quality of service around delivery. During the five years before the survey, the perinatal mortality rate was 36 deaths per 1,000 pregnancies (Table 7.5). Patterns by background characteristics y The perinatal mortality rate is higher in rural areas than in urban areas (40 deaths per 1,000 pregnancies versus 26 deaths per 1,000 pregnancies). y The perinatal mortality rate is highest in Uttar Pradesh (56 deaths per 1,000 pregnancies) and lowest in Kerala (8 deaths per 1,000 pregnancies). y The perinatal mortality rate is twice as high among pregnancies to women in which the previous pregnancy interval was less than 15 months (56 deaths per 1,000 pregnancies) than those with an interval of 27 or more months. y The perinatal mortality rate declines with an increase in the mother’s schooling. y The perinatal mortality rate also declines with higher household wealth. The perinatal mortality rate is 48 deaths per 1,000 pregnancies in the lowest wealth quintiles and 21 deaths per 1,000 pregnancies in the highest wealth quintile. For additional information on high-risk fertility behaviour, see Table 7.7. 188 ‡ Infant and Child Mortality 52 48 59 46 59 104 75 44 36 40 CHILD'S SEX Male Female MOTHER'S AGE AT BIRTH <20 20-29 30-39 40-49 PREVIOUS BIRTH INTERVAL <2 years 2 years 3 years 4 years or more Figure 7.3 High-risk Births Have Higher Mortality Rates Deaths in the first five years of life per 1,000 live births 188 z Infant and Child Mortality LIST OF TABLES For more information on infant and child mortality, see the following tables: Tables Table 7.1 Early childhood mortality rates Table 7.2 Early childhood mortality rates by background characteristics Table 7.3 Early childhood mortality rates by demographic characteristics Table 7.4 Early childhood mortality rates by state/union territory Table 7.5 Perinatal mortality Table 7.6 Perinatal mortality by state/union territory Table 7.7 High-risk fertility behaviour Infant and Child Mortality ‡ 189Infant and Child Mortality z�189 Table 7.1 Early childhood mortality rates Neonatal, postneonatal, infant, child, and under-five mortality rates for five-year periods preceding the survey, by residence, India, 2015-16 Years preceding the survey Neonatal mortality (NN) Postneonatal mortality1 (PNN) Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) URBAN 0-4 20.1 8.4 28.5 6.0 34.4 5-9 21.6 9.4 31.0 7.0 37.8 10-14 24.8 10.1 34.9 7.3 41.9 RURAL 0-4 33.1 12.4 45.5 10.7 55.8 5-9 35.5 13.4 48.8 13.1 61.3 10-14 36.5 14.9 51.4 15.4 66.0 TOTAL 0-4 29.5 11.3 40.7 9.4 49.7 5-9 31.5 12.2 43.7 11.3 54.6 10-14 33.0 13.5 46.5 12.9 58.8 1 Computed as the difference between the infant and neonatal mortality rates 190 z Infant and Child Mortality Table 7.2 Early childhood mortality rates by background characteristics Neonatal, postneonatal, infant, child, and under-five mortality rates for the five-year period preceding the survey, by background characteristics and residence, India, 2015-16, and for 0-4 years before NFHS-3, NFHS-2, and NFHS-1 Background characteristic Neonatal mortality (NN) Postneonatal mortality1 (PNN) Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) URBAN Schooling No schooling 28.2 13.3 41.5 12.8 53.8 <5 years complete 31.8 17.6 49.5 6.8 56.0 5-7 years complete 25.5 7.1 32.6 6.5 38.9 8-9 years complete 22.2 10.7 32.9 4.4 37.1 10-11 years complete 13.4 8.4 21.8 5.1 26.8 12 or more years complete 14.4 4.2 18.6 2.5 21.0 Religion Hindu 20.3 7.9 28.2 5.9 33.9 Muslim 21.8 10.3 32.1 7.4 39.3 Christian 6.7 5.6 12.3 2.1 14.4 Sikh 14.0 3.5 17.5 2.2 19.6 Buddhist/Neo-Buddhist 11.7 16.7 28.4 1.0 29.3 Other 25.3 0.1 25.4 0.0 25.4 Caste/tribe Scheduled caste 20.7 10.4 31.1 8.0 38.9 Scheduled tribe 16.5 7.1 23.5 4.4 27.8 Other backward class 23.1 9.0 32.1 5.8 37.7 Other 16.2 6.5 22.7 5.2 27.8 Don't know (21.0) (12.1) (33.1) (13.7) (46.3) Wealth index Lowest 33.4 13.3 46.7 13.2 59.3 Second 27.2 11.8 39.0 12.7 51.2 Middle 26.0 13.9 40.0 10.2 49.7 Fourth 20.2 7.6 27.8 4.9 32.6 Highest 13.7 5.0 18.7 2.5 21.1 Total 20.1 8.4 28.5 6.0 34.4 NFHS-3 28.5 13.0 41.5 10.6 51.7 NFHS-2 31.7 15.4 47.0 16.9 63.1 NFHS-1 34.1 22.0 56.1 19.6 74.6 Continued… Infant and Child Mortality z�191 Table 7.2 Early childhood mortality rates by background characteristics—Continued Neonatal, postneonatal, infant, child, and under-five mortality rates for the five-year period preceding the survey, by background characteristics and residence, India, 2015-16, and for 0-4 years before NFHS-3, NFHS-2, and NFHS-1 Background characteristic Neonatal mortality (NN) Postneonatal mortality1 (PNN) Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) RURAL Schooling No schooling 38.8 16.5 55.3 15.5 69.9 <5 years complete 39.1 12.5 51.6 12.2 63.2 5-7 years complete 35.6 11.4 47.0 9.7 56.3 8-9 years complete 31.4 11.0 42.4 6.8 48.9 10-11 years complete 23.5 7.8 31.3 3.4 34.6 12 or more years complete 21.4 7.1 28.4 3.8 32.1 Religion Hindu 33.9 12.2 46.2 10.5 56.2 Muslim 31.8 13.5 45.2 12.2 56.9 Christian 19.0 12.0 31.0 9.9 40.6 Sikh 23.6 10.9 34.5 6.7 40.9 Buddhist/Neo-Buddhist 22.1 9.2 31.3 7.1 38.2 Other 30.1 13.7 43.8 19.6 62.5 Caste/tribe Scheduled caste 36.8 12.7 49.6 12.1 61.1 Scheduled tribe 33.4 13.9 47.3 14.7 61.3 Other backward class 33.4 12.6 46.1 10.4 56.0 Other 27.7 10.5 38.2 7.4 45.4 Don't know 36.5 9.7 46.2 10.4 56.1 Wealth index Lowest 41.1 15.7 56.8 16.4 72.3 Second 35.1 13.1 48.3 10.4 58.2 Middle 28.7 10.2 38.9 6.2 44.8 Fourth 22.8 8.5 31.3 6.0 37.1 Highest 16.8 5.8 22.6 3.6 26.1 Total 33.1 12.4 45.5 10.7 55.8 NFHS-3 42.5 19.7 62.2 21.0 82.0 NFHS-2 46.7 26.6 73.3 32.8 103.7 NFHS-1 52.9 32.2 85.0 37.6 119.4 Continued… 192 z Infant and Child Mortality Table 7.2 Early childhood mortality rates by background characteristics³Continued Neonatal, postneonatal, infant, child, and under-five mortality rates for the five-year period preceding the survey, by background characteristics and residence, India, 2015-16, and for 0-4 years before NFHS-3, NFHS-2, and NFHS-1 Background characteristic Neonatal mortality (NN) Postneonatal mortality1 (PNN) Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) TOTAL Schooling No schooling 37.2 16.0 53.2 15.1 67.5 <5 years complete 37.6 13.6 51.2 11.0 61.7 5-7 years complete 33.0 10.3 43.3 8.9 51.8 8-9 years complete 28.9 10.9 39.8 6.1 45.6 10-11 years complete 19.8 8.0 27.9 4.1 31.8 12 or more years complete 17.9 5.6 23.5 3.0 26.5 Religion Hindu 30.5 11.1 41.6 9.3 50.5 Muslim 27.8 12.2 40.0 10.3 49.9 Christian 15.1 9.9 25.0 7.4 32.2 Sikh 20.9 8.8 29.7 5.4 34.9 Buddhist/Neo-Buddhist 17.7 12.4 30.0 4.5 34.4 Other 29.4 11.6 41.0 16.8 57.1 Caste/tribe Scheduled caste 33.0 12.2 45.2 11.1 55.9 Scheduled tribe 31.3 13.1 44.4 13.4 57.2 Other backward class 30.5 11.6 42.1 9.0 50.8 Other 23.2 8.9 32.1 6.6 38.5 Don't know 30.4 10.6 41.0 11.8 52.3 Wealth index Lowest 40.7 15.6 56.3 16.3 71.7 Second 34.2 13.0 47.2 10.6 57.3 Middle 28.0 11.1 39.2 7.3 46.2 Fourth 21.6 8.1 29.6 5.4 34.9 Highest 14.6 5.2 19.8 2.8 22.6 Total 29.5 11.3 40.7 9.4 49.7 NFHS-3 39.0 18.0 57.0 18.4 74.3 NFHS-2 43.4 24.2 67.6 29.3 94.9 NFHS-1 48.6 29.9 78.5 33.4 109.3 Note: All estimates are for the five years preceding the survey (approximately 1988-1992 for NFHS-1, 1994-1998 for NFHS-2, 2001-2005 for NFHS-3, and 2011-2015 for NFHS-4). 1 Computed as the difference between the infant and neonatal mortality rates ( ) Based on 250-499 unweighted person-years of exposure to the risk of death Infant and Child Mortality z�193 Table 7.3 Early childhood mortality rates by demographic characteristics Neonatal, postneonatal, infant, child, and under-five mortality rates for the five-year period preceding the survey, by demographic characteristics and residence, India, 2015-16 Demographic characteristic Neonatal mortality (NN) Postneonatal mortality1 (PNN) Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) URBAN Child's sex Male 22.1 7.2 29.3 5.8 34.9 Female 18.0 9.8 27.7 6.3 33.9 Mother's age at birth <20 23.8 11.9 35.7 6.3 41.7 20-29 19.3 7.8 27.1 5.7 32.6 30-39 21.2 8.7 29.9 7.7 37.4 40-49 (31.0) (9.8) (40.8) (9.8) (50.2) Birth order 1 20.4 7.3 27.8 5.3 32.9 2-3 17.7 7.9 25.6 5.3 30.8 4-6 29.9 14.0 43.9 11.6 55.0 7 or more 48.6 43.6 92.2 17.4 108.0 Previous birth interval2 <2 years 28.5 16.0 44.5 9.0 53.1 2 years 16.0 7.8 23.8 6.6 30.2 3 years 13.9 9.0 22.9 6.1 28.8 4 years or more 19.8 5.3 25.1 4.6 29.6 Birth size Very small 107.9 38.3 146.2 (12.0) * Small 31.0 9.6 40.5 12.5 (52.5) Average or larger 15.5 6.9 22.4 8.7 30.9 Total 20.1 8.4 28.5 6.0 34.4 Continued… 194 z Infant and Child Mortality Table 7.3 Early childhood mortality rates by demographic characteristics—Continued Neonatal, postneonatal, infant, child, and under-five mortality rates for the five-year period preceding the survey, by demographic characteristics and residence, India, 2015-16 Demographic characteristic Neonatal mortality (NN) Postneonatal mortality1 (PNN) Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) RURAL Child's sex Male 37.1 11.8 48.9 9.6 58.1 Female 28.8 13.0 41.8 12.0 53.3 Mother's age at birth <20 43.1 13.9 57.0 7.8 64.4 20-29 30.0 11.1 41.1 10.2 50.9 30-39 36.5 17.0 53.5 15.9 68.5 40-49 64.2 24.5 88.7 28.1 114.3 Birth order 1 38.9 11.0 49.9 7.3 56.8 2-3 26.8 10.9 37.7 9.9 47.3 4-6 34.7 17.9 52.6 17.8 69.5 7 or more 62.2 31.8 94.0 27.7 119.2 Previous birth interval2 <2 years 45.3 19.0 64.3 18.1 81.2 2 years 24.7 11.8 36.5 11.7 47.8 3 years 20.4 8.9 29.3 9.1 38.1 4 years or more 24.7 11.1 35.8 8.9 44.4 Birth size Very small 107.9 28.5 136.5 21.9 (155.4) Small 42.6 15.7 58.3 14.4 71.8 Average or larger 26.8 10.9 37.7 11.1 48.4 Total 33.1 12.4 45.5 10.7 55.8 Continued… Infant and Child Mortality z�195 Table 7.3 Early childhood mortality rates by demographic characteristics—Continued Neonatal, postneonatal, infant, child, and under-five mortality rates for the five-year period preceding the survey, by demographic characteristics and residence, India, 2015-16 Demographic characteristic Neonatal mortality (NN) Postneonatal mortality1 (PNN) Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) TOTAL Child's sex Male 32.8 10.5 43.3 8.5 51.5 Female 25.8 12.1 37.9 10.4 47.8 Mother's age at birth <20 38.7 13.4 52.1 7.4 59.2 20-29 26.9 10.1 37.1 8.8 45.6 30-39 31.9 14.6 46.5 13.5 59.4 40-49 58.9 22.2 81.1 25.2 104.2 Birth order 1 33.0 9.8 42.8 6.6 49.1 2-3 24.3 10.0 34.3 8.6 42.6 4-6 33.8 17.2 51.1 16.7 67.0 7 or more 60.3 33.4 93.8 26.2 117.5 Previous birth interval2 <2 years 41.4 18.3 59.7 16.0 74.7 2 years 22.7 10.9 33.6 10.5 43.8 3 years 18.8 8.9 27.7 8.3 35.8 4 years or more 23.1 9.1 32.3 7.5 39.6 Birth size Very small 107.9 30.8 138.7 19.7 155.7 Small 39.7 14.1 53.8 13.9 67.0 Average or larger 23.5 9.8 33.3 10.4 43.3 Total 29.5 11.3 40.7 9.4 49.7 1 Computed as the difference between the infant and neonatal mortality rates 2 Excludes first-order births ( ) Based on 250-499 unweighted person-years of exposure to the risk of death * Rate not shown; based on fewer than 250 unweighted person-years of exposure to the risk of death 196 z Infant and Child Mortality Table 7.4 Early childhood mortality rates by state/union territory Neonatal, postneonatal, infant, child, and under-five mortality rates for the five-year period preceding the survey, by state/union territory, India, 2015-16 State/union territory Neonatal mortality (NN) Postneonatal mortality1 (PNN) Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) India 29.5 11.3 40.7 9.4 49.7 North Chandigarh 30.3 8.1 38.3 0.0 38.3 Delhi 17.8 13.4 31.2 11.3 42.2 Haryana 22.1 10.7 32.8 8.6 41.1 Himachal Pradesh 25.5 8.8 34.3 3.5 37.6 Jammu & Kashmir 23.2 9.3 32.4 5.4 37.6 Punjab 21.2 8.0 29.2 4.1 33.2 Rajasthan 29.8 11.5 41.3 9.7 50.7 Uttarakhand 27.9 11.8 39.7 7.1 46.5 Central Chhattisgarh 42.1 11.9 54.0 10.9 64.3 Madhya Pradesh 36.9 14.3 51.2 14.2 64.6 Uttar Pradesh 45.1 18.4 63.5 15.6 78.1 East Bihar 36.7 11.4 48.1 10.5 58.1 Jharkhand 33.0 10.8 43.8 11.1 54.3 Odisha 28.2 11.5 39.6 8.8 48.1 West Bengal 22.0 5.5 27.5 4.4 31.8 Northeast Arunachal Pradesh 11.8 11.1 22.9 10.2 32.9 Assam 32.8 14.8 47.6 9.3 56.5 Manipur 15.6 6.2 21.7 4.3 25.9 Meghalaya 18.3 11.6 29.9 10.1 39.6 Mizoram 11.2 28.9 40.1 6.1 46.0 Nagaland 16.5 13.1 29.5 8.2 37.4 Sikkim 20.8 8.7 29.5 2.8 32.2 Tripura 13.2 13.4 26.7 6.1 32.7 West Dadra & Nagar Haveli 9.2 23.9 33.0 9.5 42.2 Daman & Diu 26.3 8.2 34.4 0.0 34.4 Goa 12.9 0.0 12.9 0.0 12.9 Gujarat 26.8 7.4 34.2 9.6 43.5 Maharashtra 16.2 7.5 23.7 5.2 28.7 South Andaman & Nicobar Islands 7.3 2.5 9.8 3.2 13.0 Andhra Pradesh 23.6 11.3 34.9 6.1 40.8 Karnataka 18.5 8.4 26.9 4.7 31.5 Kerala 4.4 1.2 5.6 1.5 7.1 Lakshadweep 23.3 3.7 26.9 3.3 30.2 Puducherry 5.8 9.9 15.7 0.5 16.2 Tamil Nadu 14.0 6.2 20.2 6.7 26.8 Telangana 20.0 7.7 27.7 4.2 31.7 1 Computed as the difference between the infant and neonatal mortality rates Infant and Child Mortality z�197 Table 7.5 Perinatal mortality Number of stillbirths and early neonatal deaths, and perinatal mortality rates for the five-year period preceding the survey, by background characteristics, India, 2015-16 Background characteristic Number of stillbirths1 Number of early neonatal deaths2 Perinatal mortality rate3 Number of pregnancies of 7 or more months' duration Mother's age at birth <20 461 1,086 45.0 34,341 20-29 2,116 4,027 33.4 183,688 30-39 484 795 39.2 32,575 40-49 44 90 62.4 2,143 Previous pregnancy interval in months4 First pregnancy 1,346 2,531 42.4 91,417 <15 254 683 56.1 16,706 15-26 533 1,232 32.7 53,927 27-38 387 722 27.3 40,698 39 or more 584 828 28.2 49,999 Residence Urban 738 1,127 26.3 70,810 Rural 2,367 4,870 39.8 181,936 Schooling No schooling 1,159 2,277 44.9 76,516 <5 years complete 214 461 44.3 15,251 5-7 years complete 529 1,128 40.2 41,260 8-9 years complete 525 944 35.2 41,702 10-11 years complete 277 486 25.3 30,126 12 or more years complete 400 699 23.0 47,891 Religion Hindu 2,412 4,850 36.5 198,768 Muslim 567 962 36.5 41,905 Christian 51 60 21.6 5,155 Sikh 35 49 27.2 3,095 Buddhist/Neo-Buddhist 16 32 25.0 1,944 Jain 1 2 12.8 266 Other 22 40 38.5 1,614 Caste/tribe Scheduled caste 751 1,451 40.4 54,552 Scheduled tribe 296 665 36.1 26,590 Other backward class 1,362 2,758 36.9 111,610 Other 663 1,075 30.1 57,783 Don't know 32 48 36.0 2,212 Wealth index Lowest 956 2,098 47.6 64,215 Second 774 1,531 41.4 55,629 Middle 608 1,143 34.9 50,130 Fourth 439 791 26.9 45,703 Highest 327 433 20.5 37,069 Total 3,104 5,997 36.0 252,746 1 Stillbirths are foetal deaths in pregnancies lasting seven or more months 2 Early neonatal deaths are deaths at age 0-6 days among live-born children 3 The sum of the number of stillbirths and early neonatal deaths divided by the number of pregnancies of seven or more months' duration, expressed per 1,000 4 Categories correspond to birth intervals of <24 months, 24-35 months, 36-47 months, and 48+ months 198 z Infant and Child Mortality Table 7.6 Perinatal mortality by state/union territory Perinatal mortality rates for the five-year period preceding the survey, by state/union territory, India, 2015-16 State/union territory Perinatal mortality rate ,QGLD� 36.0 1RUWK Chandigarh 48.7 Delhi 18.6 Haryana 26.0 Himachal Pradesh 25.8 Jammu & Kashmir 30.4 Punjab 29.5 Rajasthan 35.7 Uttarakhand 35.5 � &HQWUDO Chhattisgarh 48.2 Madhya Pradesh 37.9 Uttar Pradesh 56.4 � (DVW Bihar 43.3 Jharkhand 42.5 Odisha 34.9 West Bengal 30.9 � 1RUWKHDVW Arunachal Pradesh 17.5 Assam 34.6 Manipur 19.9 Meghalaya 26.7 Mizoram 12.7 Nagaland 21.7 Sikkim 26.2 Tripura 22.3 � :HVW Dadra & Nagar Haveli 8.8 Daman & Diu 20.5 Goa 13.4 Gujarat 30.3 Maharashtra 20.7 � 6RXWK Andaman & Nicobar Islands 21.5 Andhra Pradesh 32.3 Karnataka 21.9 Kerala 8.4 Lakshadweep 35.2 Puducherry 16.9 Tamil Nadu 17.6 Telangana 28.6 Note: The perinatal mortality rate is the sum of the number of stillbirths and early neonatal deaths divided by the number of pregnancies of seven or more months' duration, expressed per 1,000. Infant and Child Mortality z�199 Table 7.7 High-risk fertility behaviour Percent distribution of children born in the five years preceding the survey by category of elevated risk of mortality and the risk ratio, and percent distribution of currently married women by category of risk if they were to conceive a child at the time of the survey, India, 2015-16 Risk category Births in the five years preceding the survey Percentage of currently married women1 Percentage of births Risk ratio Not in any high-risk category 32.9 1.00 53.9a Unavoidable risk category First order births between ages 18 and 34 years 35.8 1.41 8.5 Single high-risk category Mother's age <18 3.0 2.26 0.4 Mother's age >34 1.2 1.49 9.7 Birth interval <24 months 12.7 1.74 7.5 Birth order >3 8.3 1.49 5.6 Subtotal 25.2 1.71 23.1 Multiple high-risk category Mother's age <18 and birth interval <24 months2 0.2 3.49 0.1 Mother's age >34 and birth interval <24 months 0.1 1.59 0.1 Mother's age >34 and birth order >3 2.1 2.29 11.4 Mother's age >34 and birth interval <24 months and birth order >3 0.4 5.38 0.4 Birth interval <24 months and birth order >3 3.2 3.13 2.4 Subtotal 6.1 2.99 14.5 In any avoidable high-risk category 31.3 1.96 37.6 Total 100.0 na 100.0 Number of births 249,967 na 511,373 Note: Risk ratio is the ratio of the proportion dead among births in a specific high-risk category to the proportion dead among births not in any high-risk category. na = Not applicable 1 Women are assigned to risk categories according to the status they would have at the birth of a child if they were to conceive at the time of the survey: current age less than 17 years and 3 months or greater than 34 years and 2 months, latest birth less than 15 months ago, or latest birth of order 3 or higher. 2 Includes the category mother’s age <18 and birth order >3 a Includes sterilized women 200 z Infant and Child Mortality MATERNAL HEALTH 8 Key Findings x Antenatal care (ANC): The proportion of women age 15-49 in India who received ANC has risen from 77 percent in NFHS-3 (2005-06) to 84 percent in NFHS-4 (2015-16), and in NFHS-4 79 percent received ANC from a skilled provider in NFHS-4. Fifty-nine percent of women had their first ANC visit during the first trimester of pregnancy, an increase from 44 percent in 2005-06, and 51 percent had four or more ANC visits, an increase from 37 percent in 2005-06. x Components of antenatal care: Pregnant women are more likely to have their weight measured (91%), their blood pressure measured (89%), and a blood sample taken (87%), than to take iron and folic acid (IFA) tablets for at least 100 days (30%) or to take an intestinal parasite drug (18%). A urine sample was taken for 88 percent of women and 89 percent of women had their abdomen examined. x Protection against neonatal tetanus: Eighty-nine percent RI�ZRPHQ¶V�ODVW�OLYH�ELUWKV�ZHUH�SURWHFWHG�DJDLQVW�QHRQDWDO� tetanus. x Delivery: Institutional deliveries have increased markedly from 39 percent in 2005-06 to 79 percent in 2015-16. x Postnatal checks: Thirty-six percent of newborns had a postnatal check, and 27 percent of newborns received a postnatal check within 2 days of birth. x C-sections: The rate of C-section deliveries almost doubled from 9 percent in 2005-06 to 17 percent in 2015-16. C-sections are particularly common in private sector health facilities (41% of deliveries). ealth care services during pregnancy and childbirth and after delivery are important for the survival and well-being of both the mother and the infant. Antenatal care (ANC) can reduce the health risks for mothers and their babies by monitoring pregnancies and screening for complications. Delivery at a health facility, with skilled medical attention and hygienic conditions, reduces the risk of complications and infections during labour and delivery. To improve the availability of and access to quality health care, especially for those residing in rural areas, the poor, women, and children, the government launched the National Rural Health Mission for the 2005-2012 period. One of the important goals of the National Rural Health Mission (NRHM) is to provide access to improved health care at the household level through female Accredited Social Health Activists (ASHAs), who act as an interface between the community and the public health system. The National Urban Health Mission (NUHM) was established as a Sub-mission of the over-arching National Health Mission (NHM) in 2013, with NRHM being the other Sub-mission of the National Health Mission. H Maternal Health z�201 At the same time, the RMNCH+A (reproductive, maternal, newborn, child, and adolescent health) approach was launched to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care and services. The RMNCH+A strategic approach was developed to provide an understanding of the ‘continuum of care’ to ensure an equal focus on various life stages. This chapter presents information on ANC providers, the number and timing of ANC visits, and various components of maternal care. The chapter examines childbirth and postnatal care and presents information on the place of delivery, assistance during delivery, caesarean delivery, cost of delivery, and postnatal health checks for mothers and newborns. 8.1 PREGNANCY REGISTRATION 8.1.1 Registration of Pregnancies Eighty-five percent of women age 15-49 who had a live birth in the five years before the survey registered the pregnancy for their most recent birth. Birth registration exceeds 80 percent for all groups except women age 35-49, women with no schooling, and births of order four or more (Table 8.1). 8.1.2 Mother and Child Protection Card (MCP Card) The Mother and Child Protection Card (MCP Card) is a tool for informing and educating mothers and families on different aspects of maternal and child care and linking maternal and childcare into a continuum of care through the Integrated Child Development Services (ICDS) scheme of the Ministry of Women and Child Development and the National Rural Health Mission (NRHM) of the Ministry of Health & Family Welfare. The card also captures some of key services delivered to mothers and babies during antenatal, delivery, and postnatal care for ensuring that the minimum package of services are delivered to the beneficiary. The card also serves as a tool for providing complete immunization to infants and children, early and exclusive breastfeeding, complementary feeding, and growth monitoring. Eighty-nine percent of women age 15-49 who had a live birth in the five years before the survey and registered their last pregnancy received an MCP Card for that birth (Table 8.1). Differentials by background characteristics are generally quite small. 8.2 ANTENATAL CARE COVERAGE AND CONTENT 8.2.1 Skilled Providers Antenatal care (ANC) from a skilled provider Pregnancy care received from skilled providers, that is, doctors, auxiliary nurse midwives, nurses, midwives, and lady health visitors. Sample: Women age 15-49 who had a live birth in the five years before the survey Seventy-nine percent of women age 15-49 who had a live birth in the five years before the survey received antenatal care from a skilled provider at least once for their last birth (Table 8.3). The majority of women received antenatal care from doctors (59%), followed by auxiliary nurse midwives (ANMs), nurses, midwives, and lady health visitors (LHVs) (20%). Table 8.4 shows that use of a skilled provider for ANC is low in Nagaland (44%) and Bihar (49%), and high in Kerala and Lakshadweep (more than 99%). 202 z Maternal Health Patterns by background characteristics y Use of a skilled provider for ANC services is higher in urban areas than rural areas (89% and 75%, respectively). y Use of a skilled provider for ANC services increases with rising education. Sixty-one percent of women with no schooling obtained ANC services from a skilled provider, compared with 93 percent of women with 12 or more years of schooling. y Women in the highest wealth quintile are much more likely to receive ANC from a skilled provider (94%) than those in the lowest quintile (57%). y Women in the younger ages (below 20 years) are more likely to receive ANC from a skilled provider than women in the older age group 35-49 years (81% versus 62%). y Similarly, women with a first birth are more likely to receive ANC from a skilled provider than women with a birth of order 6 and above (87% versus 49%). 8.2.2 Timing and Number of ANC Visits About half (51%) of the women had at least four ANC visits during their last pregnancy, as recommended by WHO (Table 8.5). Seventeen percent of women had no ANC visits. Urban women are more likely to have had four or more ANC visits than rural women (66% and 45%, respectively). Fifty-nine percent of women had their first ANC visit during the first trimester. Another 18 percent of women had their first ANC visit during the fourth and fifth month of pregnancy, and 7 percent first received ANC in the sixth month or later. The median number of months pregnant at the time of the first visit for all women with at least one ANC visit is 3.5 months. The proportion of women who had at least four ANC visits during their last pregnancy is lowest in Bihar (14%) and highest in Kerala (90%) and Andaman & Nicobar Islands (92%) (Table 8.11). Trends: The proportion of women that received the recommended four or more ANC visits increased from 37 percent in 2005-06 to 51 percent in 2015-16 (Figure 8.1). Over the same time period, the proportion of women who received ANC in the first trimester increased from 44 percent to 59 percent. Maternal Health ‡ 203 37 44 51 59 Four or more ANC visits ANC visit during first trimester NFHS-3 NFHS-4 Figure 8.1 Trends in Antenatal Coverage Percentage of women age 15-49 Maternal Health z�203 204 ‡ Maternal Health 8.3 COMPONENTS OF ANC VISITS In India, 87-91 percent of women who received ANC for their most recent live birth in the past five years had their weight measured, a blood sample taken, a urine sample taken, their abdomen examined, and their blood pressure measured (Figure 8.2). About half of women received information on specific pregnancy complications, namely prolonged labour (50%), severe abdominal pain, and high blood pressure (52% each). About two-thirds (67%) were told where they could go if they experienced pregnancy complications. Seventy-eight percent of all women with a birth in the past five years were given or purchased iron and folic acid (IFA) tablets during the pregnancy for their most recent birth, but only 30 percent took the tablets for at least 100 days. Only 18 percent took an intestinal parasite drug during the pregnancy (Table 8.7 and Table 8.8). 8.4 PROTECTION AGAINST NEONATAL TETANUS Protection against neonatal tetanus The number of tetanus toxoid injections needed to protect a baby from neonatal tetanus depends on the mother’s vaccinations. A birth is protected against neonatal tetanus if the mother has received any of the following: x Two tetanus toxoid injections during that pregnancy x Two or more injections, the last one within three years of the birth x Three or more injections, the last one within five years of the birth x Four or more injections, the last one within ten years of the birth x Five or more injections at any time prior to the birth Sample: Last live births in the five years before the survey to women age 15-49 Neonatal tetanus, a major cause of early infant death in many developing countries, is often due to failure to observe hygienic procedures during delivery. Table 8.7 VKRZV� WKDW� ��� SHUFHQW� RI� ZRPHQ¶V� ODVW� ELUWKV� ZHUH� SURWHFWHG� DJDLQVW� neonatal tetanus. Patterns by background characteristics y About 9 in 10 women less than age 35 had their last birth protected against neonatal tetanus, compared with 81 percent of older women age 35-49. y The percentage of women whose last birth was protected against neonatal tetanus increases with education, from 84 percent among women with no schooling to 92 percent among those with 12 or more years of schooling. y Similarly, the percentage of women whose last birth was protected against neonatal tetanus increases with the wealth quintile, from 85 percent among women in households in the lowest wealth quintile to 93 percent among those in the highest wealth quintile. 87 88 89 89 91 Blood sample taken Urine sample taken Blood pressure measured Abdomen examined Weighed Figure 8.2 Components of Antenatal Care (ANC) Among women who received ANC for their most recent birth, percentage who received selected services 204 z Maternal Health 8.5 ULTRASOUND TESTING DURING PREGNANCY Mothers had an ultrasound test for 61 percent of their pregnancies in the past five years (Table 8.12) Trends: Between 2005-06 and 2015-16, the proportion of pregnancies with an ultrasound test increased from 24 percent to 61 percent. Patterns by background characteristics y Ultrasound tests are particularly common in urban areas, among women with 12 or more years of schooling, for Jain and Sikh women, and for women in households in the two highest wealth quintiles. y Women with no sons are more likely than women with one or more sons to have an ultrasound test. y Women with no sons who have an ultrasound test are much more likely to have the pregnancy end in the birth of a son than the birth of a daughter. For example, for women with no sons and three daughters who had an ultrasound test, 53 percent of their pregnancies resulted in the birth of a son and 34 percent resulted in the birth of a daughter. The results provide clear evidence of the existence and impact of son preference in India. 8.6 DELIVERY SERVICES 8.6.1 Institutional Deliveries Institutional deliveries Deliveries that occur in a health facility. Sample: All live births in the five years before the survey Increasing institutional deliveries is an important factor in reducing maternal and neonatal mortality. Seventy-nine percent of live births in the five years before the survey were delivered in a health facility (Table 8.13). The most common reason for not delivering in a health facility was that the woman did not think it was necessary (40%), but 18 percent of women said that it was too far or there was no transportation, 18 percent said that the husband or family did not allow them to have the delivery in a health facility, and 16 percent said it costs too much (Table 8.14). Trends: Institutional deliveries doubled between 2005-06 and 2015-16, from 39 percent to 79 percent (Figure 8.3). 39 68 29 79 89 75 Total Urban Rural NFHS-3 NFHS-4 Figure 8.3 Trends in Health Facility Births Percentage of births in the five years before the survey Maternal Health ‡ 205 Figure 8.3 Trends in Health Facility Births Percentage of births in the five years before the survey 39 68 29 79 89 75 Total Urban Rural NFHS-3 NFHS-4 Maternal Health z�205 Patterns by background characteristics y Higher-order births are much less likely to be institutional deliveries; only 48 percent of sixth or higher order births occurred at a health facility, compared with 88 percent of first births. y Antenatal care increases the likelihood of an institutional delivery. Ninety-one percent of births to mothers who had four or more ANC visits were delivered in a health facility, compared with 57 percent of births to mothers who had no ANC visits. y Eighty-nine percent of births to urban women were delivered in a health facility, compared with 75 percent of births to rural women. y The mother’s educational status is highly correlated with the place of delivery. Ninety-five percent of births to mothers with 12 or more year of schooling were delivered in a health facility, compared with 62 percent of births to mothers with no schooling (Figure 8.4). y Similarly, 95 percent of births to mothers in households in the highest wealth quintile were delivered in a health facility, compared with 60 percent of births to mothers in households in the lowest wealth quintile. y Almost 100 percent of births in Puducherry, Kerala, Lakshadweep, and Tamil Nadu were delivered in a health facility. Ninety percent of births or more were delivered in health facilities in 14 states and union territories. At the other end of the spectrum, only one-third of births in Nagaland and just over half of births in Meghalaya and Arunachal Pradesh were delivered in health facilities (Figure 8.5). 206 ‡ Maternal Health 62 70 80 85 92 95 No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Figure 8.4 Health Facility Births by Schooling Percentage of births in the five years before the survey 62 70 80 85 92 95 No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Figure 8.4 Health Facility Births by Schooling Percentage of births in the five years before the survey 206 z Maternal Health Maternal Health ‡��207 8.6.2 Skilled Assistance during Delivery Skilled assistance during delivery Births delivered with the assistance of doctors, auxiliary nurse midwives, nurses, midwives, and lady health visitors. Sample: All live births in the five years before the survey Assistance during childbirth can influence the birth outcome and the health of the mother and the newborn. A skilled attendant can manage complications of pregnancy and delivery or refer the mother and/or the baby to the next level of care. In the five years before the survey, 8 in 10 live births (81%) were delivered by a skilled provider (Table 8.19). The majority of births were attended by doctors (56%), followed by ANMs, nurses, midwives, LHVs (25%), and dais (TBAs) (11%) (Figure 8.6). Trends: Skilled assistance during deliveries in India has increased substantially; the proportion of births assisted by a skilled provider increased from 47 percent in 2005-06 to 81 percent in 2015-16. 33 51 52 62 64 68 69 69 70 71 75 76 79 80 80 80 81 84 84 85 86 88 89 90 90 91 92 92 92 94 95 96 97 99 99 100 100 Nagaland Meghalaya Arunachal Pradesh Jharkhand Bihar Uttar Pradesh Uttarakhand Manipur Chhattisgarh Assam West Bengal Himachal Pradesh INDIA Mizoram Tripura Haryana Madhya Pradesh Rajasthan Delhi Odisha Jammu & Kashmir Dadra & Nagar Haveli Gujarat Daman & Diu Maharashtra Punjab Andhra Pradesh Telangana Chandigarh Karnataka Sikkim Andaman & Nicobar Islands Goa Tamil Nadu Lakshadweep Kerala Puducherry Figure 8.5 Health Facility Births by State/UT Percentage of live births in the five years before the survey Maternal Health z�207 Patterns by background characteristics y Ninety-three percent of births to mothers who had four or more ANC visits were delivered by a skilled attendant, compared with 60 percent of births to mothers with no ANC visits. y Only 19 percent of births that took place at the ZRPDQ¶V� RZQ� KRPH� ZHUH� GHOLYHUHG� E\� D� VNLOOHG� provider. y Births to women in urban areas (90%) are more likely to be delivered by a skilled provider than births to women in rural areas (78%). y 7KH� PRWKHUV¶� HGXFDWLRQDO� VWDWXV� LV� KLJKO\� FRUUH- lated with skilled delivery. Ninety-five percent of births to mothers with 12 or more years of school- ing were delivered by a skilled attendant, compared with 66 percent of births to mothers with no schooling. y Skilled birth attendance increases from 64 percent of women in the lowest wealth quintile to 96 percent of women in the highest wealth quintile (Figure 8.7). 8.6.3 Delivery by Caesarean Section Access to caesarean section (C-section) can reduce maternal and neonatal mortality and complications such as obstetric fistula. However, a caesarean section without a medical need can put a woman at risk of short and long-term health problems. WHO advises that caesarean sections should only be done when medically necessary, and does not recommend a target rate for countries to achieve at the population level. Doctor 56% ANM/nurse/ midwife/LHV 25% Other health personnel 0.7% Dai (TBA) 11% Friends/relatives 6.4% Other 0.9% No one 0.3% Don't know/ missing 0.1% Figure 8.6 Assistance during Delivery Percent distribution of births in the five years before the survey 64 78 87 92 96 Lowest Second Middle Fourth Highest WealthiestPoorest the survey Figure 8.7 Skilled Assistance at Delivery by Household Wealth 92 Percentage of live births in the five years preceding the survey WealthiestPoorest 208 z Maternal Health The 2015-16 NFHS found that 17 percent of live births in the five years before the survey were delivered by caesarean section. Forty-five percent of the C-sections were decided on after the onset of labour pains, compared with 55 percent that were decided on before the onset of labour pains (Table 8.19). Trends: Since 2005-06, the rate of C-sections has doubled, from 9 percent to 17 percent in 2015-16. Patterns by background characteristics y Caesarean deliveries are more common among first births (24%) than higher-order births (ranging from 2% to 16%). y C-sections are particularly common in private sector health facilities (41% of deliveries), an increase from 28 percent in 2005-06. y The caesarean delivery rate is higher in urban than rural areas (28% against 13%). y More educated women are much more likely to undergo caesarean deliveries. The caesarean rate for deliveries for women with 12 or more years of schooling is 34 percent, compared with 26 percent for women with 10-11 years of schooling, 15 percent for women with 5-7 years of schooling, and 6 percent for women with no schooling. There is strong positive relationship between wealth quintiles and delivery by C-section. Mothers in households in the highest wealth quintile are much more likely to deliver through C-section (36%) than mothers in households in the lowest wealth quintile (4%) (Table 8.19). 8.7 DELIVERY COSTS The average out-of-pocket cost paid for delivery for the most recent live birth among women age 15-49 who had a live birth in the five years preceding the survey that was delivered in a health facility was Rs. 7,938 (Table 8.20). The average cost was five times as high in private health facilities (Rs. 16,522) as in public health facilities (Rs. 3,198). 8.8 POSTNATAL CARE 8.8.1 Postnatal Health Check for Mothers A large proportion of maternal and neonatal deaths occur during the first 24 hours after delivery. For both the mother and the infant, prompt postnatal care is important to treat complications that arise from delivery and to provide the mother with important information on caring for herself and her baby. The Ministry of Health and Family Welfare (MoHFW) recommends that all women who deliver in a health facility receive a postnatal health check within the first 24 hours after delivery and that women giving birth outside of a health facility should be referred to a health facility for a postnatal check within 12 hours after giving birth. The 2015-16 NFHS found that among women age 15-49 giving birth in the five years before the survey, 65 percent had a postnatal check during the first two days after birth. Thirty percent of mothers did not receive any postnatal checks (Table 8.21). Trends: The proportion of mothers who received a postnatal check in the first two days after birth increased from 37 percent to 65 percent between 2005-06 and 2015-16. Maternal Health ‡ 209Maternal Health z�209 Patterns by background characteristics y Women who delivered in a health facility were more than three times as likely to receive a postnatal health check within two days of delivery as are those who delivered elsewhere (Figure 8.8). y Seventy-three percent of urban women received a postnatal check within two days, compared with 62 percent of rural women. y Women with 12 or more years of schooling (78%) are more likely than women with no schooling (51%) to have a postnatal check within two days. y Women from the wealthiest households (80%) are more likely to receive a postnatal check within two days than women from the lowest wealth quintile (48%). y Scheduled tribe women (59%) are less likely to receive a postnatal check within two days than women from any other caste/tribe group (64-69%). y Mothers were most likely to receive a postnatal check within two days of delivery in Goa and Lakshadweep (93%), Chandigarh (91%), and Kerala and Punjab (89% each), and least likely to receive a postnatal check within two days in Nagaland (23%), Arunachal Pradesh (30%), and Bihar (46%). The skills of the provider are an important factor in determining the provider’s ability to diagnose problems and recommend appropriate treatment or referral. In India, less than half (43%) of women received their first postnatal check from a doctor; 22 percent received a postnatal check from an ANM, nurse, midwife, or LHV, and 2 percent from an ASHA. Only 2 percent of women received a check from a dai (TBA) (Table 8.22). 8.8.2 Postnatal Health Checks for Newborns The first 48 hours of life is a critical phase in the lives of newborn babies and a period in which many neonatal deaths occur. Lack of postnatal health checks during this period can delay the identification of newborn complications and the initiation of appropriate care and treatment. In India, only 27 percent of newborns had a first postnatal check within the first 2 days after birth (Table 8.23). Sixty-four percent of newborns did not receive any postnatal health check. 75 29 23 17 65 27 Women Newborns Health facility Elsewhere Total Figure 8.8 Postnatal Care by Place of Delivery Percentage of last births in the five years before the survey for which women and newborns received a postnatal check during the first two days after birth 210 ‡ Maternal Health 75 29 23 17 65 27 Women Newborns Health facility Elsewhere Total Figure 8.8 Postnatal Care by Place of Delivery Percentage of last births in the five years before the survey for which women and newborns received a postnatal check during the first two days after birth 210 z Maternal Health Patterns by background characteristics y Newborns delivered in a health facility were much more likely to receive a postnatal health check within two days of birth than those delivered elsewhere, particularly at their own home/parent’s home. y There is a positive relationship between the mother’s level of education and a postnatal check in the first two days after birth. Thirty-one percent of babies born to mothers with 12 or more years of schooling received a postnatal check within two days, compared with 22 percent of babies born to mothers with no schooling. Eighteen percent of newborns received a first postnatal check from a doctor, while 12 percent received a first postnatal check from an ANM, nurse, midwife, or LHV (Table 8.24). A summary of symptoms of postpartum complications for all pregnancies in the five years before the survey is presented in Table 8.25. Maternal Health ‡ 211Maternal Health z�211 212 ‡ Maternal Health LIST OF TABLES For more information on maternal health, see the following tables: Tables Table 8.1 Pregnancy registration and Mother and Child Protection Card Table 8.2 Health problems during pregnancy Table 8.3 Antenatal care Table 8.4 Antenatal care by state/union territory Table 8.5 Number of antenatal care visits and timing of first visit Table 8.6 Number of antenatal care visits and timing of first visit by source Table 8.7 Components of antenatal care Table 8.8 Antenatal care services and information received Table 8.9 Male involvement in antenatal care Table 8.10 Reasons why child’s mother did not receive antenatal care: Men Table 8.11 Antenatal care indicators by state/union territory Table 8.12 Pregnancies for which an ultrasound test was done Table 8.13 Place of delivery Table 8.14 Reasons for not delivering in a health facility Table 8.15 Institutional delivery of youngest child: Men Table 8.16 Delivery and other related information given to men: Men’s reports Table 8.17 Delivery and other related information given to men by state/union territory: Men’s reports Table 8.18 Adherence to delivery protocol for home delivery Table 8.19 Assistance during delivery Table 8.20 Delivery costs Table 8.21 Timing of first postnatal check for the mother Table 8.22 Type of provider of first postnatal check for the mother Table 8.23 Timing of first postnatal check for the newborn Table 8.24 Type of provider of first postnatal check for the newborn Table 8.25 Symptoms of postpartum complications Table 8.26 Maternal care indicators by state/union territory Table 8.27 Trends in maternal care indicators Table 8.28 Advice received during pregnancy Table 8.29 Delivery and postnatal care by state/union territory Table 8.30 Birth order and delivery characteristics by state/union territory 212 z Maternal Health Table 8.1 Pregnancy registration and Mother and Child Protection Card Percentage of women age 15-49 who had a live birth in the five years preceding the survey who registered the pregnancy for the most recent live birth; and among registered pregnancies, the percent distribution by the timing of the registration and the percentage who received a Mother and Child Protection Card (MCP Card), by background characteristics, India, 2015-16 Background characteristic Percentage of pregnancies that were registered Number of pregnancies Timing of pregnancy registration Total Percentage of mother's given an MCP Card Number of registered pregnancies First trimester Later Don't know Mother's age at birth <20 87.6 20,506 78.4 21.2 0.4 100.0 92.1 17,955 20-34 85.7 155,757 78.4 21.2 0.4 100.0 89.1 133,464 35-49 72.9 8,378 68.2 31.4 0.5 100.0 83.9 6,110 Birth order 1 88.9 62,584 81.7 17.9 0.3 100.0 91.0 55,615 2-3 86.3 94,026 78.4 21.2 0.4 100.0 89.6 81,163 4+ 74.0 28,030 66.2 33.3 0.5 100.0 83.4 20,751 Residence Urban 87.0 54,847 82.3 17.4 0.3 100.0 87.7 47,706 Rural 84.6 129,794 76.1 23.5 0.4 100.0 90.0 109,824 Schooling No schooling 75.7 51,290 69.1 30.4 0.5 100.0 85.1 38,836 <5 years complete 86.2 10,753 75.4 24.2 0.4 100.0 90.9 9,268 5-7 years complete 88.4 29,402 78.1 21.5 0.5 100.0 90.5 25,989 8-9 years complete 89.8 30,990 79.3 20.4 0.3 100.0 91.9 27,833 10-11 years complete 90.5 23,134 83.5 16.2 0.3 100.0 92.0 20,925 12 or more years complete 88.8 39,071 84.2 15.5 0.3 100.0 88.8 34,679 Religion Hindu 85.8 145,617 77.8 21.8 0.4 100.0 89.8 124,935 Muslim 81.8 29,734 77.8 21.8 0.4 100.0 85.7 24,334 Christian 86.0 3,900 81.2 18.5 0.4 100.0 90.0 3,354 Sikh 91.6 2,437 86.4 13.5 0.1 100.0 94.8 2,233 Buddhist/Neo-Buddhist 93.9 1,502 85.3 14.7 0.0 100.0 93.9 1,410 Jain 91.3 239 82.1 17.5 0.4 100.0 86.2 218 Other 86.3 1,210 67.1 32.7 0.2 100.0 92.4 1,044 Caste/tribe Scheduled caste 86.7 39,059 76.1 23.6 0.3 100.0 91.1 33,846 Scheduled tribe 83.8 19,002 77.8 21.7 0.5 100.0 90.2 15,915 Other backward class 84.4 80,461 77.6 22.0 0.4 100.0 88.1 67,928 Other 86.6 44,560 80.5 19.2 0.3 100.0 89.5 38,582 Don't know 80.8 1,558 76.3 21.2 2.5 100.0 84.6 1,259 Total 85.3 184,641 78.0 21.6 0.4 100.0 89.3 157,530 Maternal Health z�213 Table 8.2 Health problems during pregnancy Among women age 15-49 who had a live birth in the five years preceding the survey, percentage who experienced specific health problems during pregnancy for the most recent live birth, by residence, India, 2015-16 Problem during pregnancy Urban Rural Total Difficulty with vision during daylight 8.7 11.9 10.9 Convulsions not from fever 13.2 17.9 16.5 Swelling of the legs, body, or face 34.5 30.7 31.8 Number of women 54,847 129,794 184,641 214 z Maternal Health Table 8.3 Antenatal care Percent distribution of women age 15-49 who had a live birth in the five years preceding the survey by antenatal care (ANC) provider during pregnancy for the most recent live birth and percentage receiving ANC from a skilled provider, according to background characteristics, India, 2015-16 Background characteristic Doctor ANM/ nurse/ midwife/ LHV Dai/ TBA Anganwadi/ ICDS worker Community/ village health worker ASHA Other No ANC Missing Total Percentage receiving ANC from a skilled provider1 Number of women 0RWKHU·V�DJH�DW�ELUWK <20 62.7 18.8 0.3 2.5 0.1 1.4 0.1 14.2 0.0 100.0 81.4 20,506 20-34 59.3 20.6 0.3 2.5 0.1 1.1 0.1 15.9 0.0 100.0 79.9 155,757 35-49 40.8 21.4 0.6 2.9 0.2 1.6 0.1 31.8 0.6 100.0 62.2 8,378 %LUWK�RUGHU 1 69.7 17.3 0.2 1.8 0.1 0.9 0.1 9.8 0.0 100.0 87.0 62,584 2-3 59.7 20.4 0.3 2.7 0.1 1.2 0.1 15.6 0.1 100.0 80.1 94,026 4-5 35.1 27.5 0.6 3.8 0.2 1.7 0.1 30.8 0.1 100.0 62.6 20,939 6+ 22.1 26.9 0.6 3.7 0.3 2.0 0.2 43.9 0.3 100.0 49.0 7,091 5HVLGHQFH Urban 76.1 13.0 0.2 1.0 0.1 0.3 0.1 9.2 0.0 100.0 89.0 54,847 Rural 51.5 23.6 0.3 3.2 0.2 1.5 0.1 19.5 0.1 100.0 75.1 129,794 6FKRROLQJ No schooling 34.6 26.1 0.6 4.3 0.2 1.9 0.1 32.2 0.1 100.0 60.7 51,290 <5 years complete 54.3 21.8 0.4 3.4 0.2 1.8 0.1 17.9 0.1 100.0 76.2 10,753 5-7 years complete 59.5 22.4 0.3 2.9 0.1 1.3 0.1 13.4 0.0 100.0 81.9 29,402 8-9 years complete 63.0 21.3 0.2 2.3 0.1 1.2 0.1 11.8 0.0 100.0 84.4 30,990 10-11 years complete 74.7 14.8 0.1 1.2 0.1 0.6 0.1 8.4 0.0 100.0 89.5 23,134 12 or more years complete 78.7 13.8 0.1 0.8 0.1 0.4 0.1 6.1 0.0 100.0 92.5 39,071 5HOLJLRQ Hindu 58.3 20.9 0.3 2.8 0.1 1.1 0.1 16.3 0.1 100.0 79.3 145,617 Muslim 58.6 18.4 0.4 1.6 0.2 1.6 0.1 19.1 0.0 100.0 77.0 29,734 Christian 72.4 11.8 0.3 1.4 0.2 1.0 0.2 12.5 0.1 100.0 84.2 3,900 Sikh 58.2 35.4 0.2 1.3 0.1 1.0 0.0 3.7 0.0 100.0 93.6 2,437 Buddhist/Neo-Buddhist 78.1 15.1 0.0 0.9 0.0 0.6 0.0 5.4 0.0 100.0 93.2 1,502 Jain 81.2 12.5 0.0 0.0 0.9 0.0 0.0 5.4 0.0 100.0 93.7 239 Other 51.4 17.1 0.4 8.2 0.1 0.5 0.0 22.4 0.0 100.0 68.5 1,210 &DVWH�WULEH Scheduled caste 54.6 23.0 0.3 2.7 0.1 1.4 0.0 17.8 0.1 100.0 77.5 39,059 Scheduled tribe 47.9 24.9 0.6 5.1 0.2 1.5 0.1 19.6 0.1 100.0 72.9 19,002 Other backward class 57.2 21.1 0.2 2.6 0.1 1.0 0.1 17.7 0.0 100.0 78.2 80,461 Other 70.3 15.4 0.2 1.3 0.1 1.2 0.0 11.4 0.0 100.0 85.6 44,560 Don't know 57.8 15.6 0.2 1.3 0.1 1.2 0.0 23.5 0.4 100.0 73.4 1,558 :HDOWK�LQGH[ Lowest 30.2 26.9 0.5 5.1 0.3 2.2 0.1 34.7 0.1 100.0 57.1 43,155 Second 51.9 24.3 0.4 3.2 0.2 1.9 0.1 18.0 0.1 100.0 76.2 39,070 Middle 65.6 20.0 0.2 1.9 0.1 0.8 0.1 11.2 0.1 100.0 85.6 36,722 Fourth 74.8 15.6 0.1 1.1 0.1 0.4 0.1 7.8 0.0 100.0 90.4 35,066 Highest 81.6 12.5 0.0 0.5 0.0 0.2 0.1 5.0 0.0 100.0 94.1 30,627 Total 58.8 20.4 0.3 2.5 0.1 1.2 0.1 16.4 0.1 100.0 79.3 184,641 Note: If more than one source of ANC was mentioned, only the provider with the highest qualification is considered in this table. ANM = Auxiliary nurse midwife; LHV = Lady health visitor; TBA = Traditional birth attendant; ICDS = Integrated Child Development Services; ASHA = Accredited Social Health Activist 1 Skilled provider includes doctor, auxiliary nurse midwife, nurse, midwife, and lady health visitor Maternal Health z�215 Table 8.4 Antenatal care by state/union territory Percent distribution of women age 15-49 who had a live birth in the five years preceding the survey by antenatal care (ANC) provider during pregnancy for the most recent live birth and percentage receiving ANC from a skilled provider, according to state/union territory, India, 2015-16 State/union territory Doctor ANM/ nurse/ midwife/ LHV Dai/ TBA Anganwadi/ ICDS worker Community/ village health worker ASHA Other No ANC Missing Total Percentage receiving ANC from a skilled provider1 India 58.8 20.4 0.3 2.5 0.1 1.2 0.1 16.4 0.1 100.0 79.3 North Chandigarh 61.1 35.9 0.6 0.0 0.0 0.0 0.0 2.4 0.0 100.0 97.0 Delhi 76.7 12.3 0.5 0.5 0.0 0.1 0.0 9.8 0.1 100.0 89.1 Haryana 48.3 30.9 0.7 2.3 0.1 0.6 0.1 17.1 0.0 100.0 79.2 Himachal Pradesh 77.7 12.9 0.5 0.5 0.2 0.1 0.1 7.9 0.0 100.0 90.6 Jammu & Kashmir 81.8 8.6 0.6 0.2 0.1 1.1 0.0 7.6 0.1 100.0 90.4 Punjab 59.3 35.4 0.3 0.9 0.0 1.1 0.0 2.9 0.0 100.0 94.6 Rajasthan 54.9 27.8 0.2 2.5 0.0 0.5 0.0 14.1 0.0 100.0 82.7 Uttarakhand 52.2 22.7 0.6 1.4 0.1 1.2 0.1 21.8 0.0 100.0 74.8 Central Chhattisgarh 44.0 47.2 0.2 4.2 0.1 0.4 0.1 3.8 0.0 100.0 91.2 Madhya Pradesh 31.3 37.6 0.5 6.9 0.1 1.0 0.1 22.4 0.1 100.0 68.9 Uttar Pradesh 36.8 35.5 0.4 1.6 0.1 1.7 0.2 23.7 0.0 100.0 72.3 East Bihar 30.4 18.6 0.4 4.4 0.3 1.7 0.1 43.9 0.0 100.0 49.0 Jharkhand 39.0 30.7 0.3 5.9 0.2 0.4 0.1 23.4 0.1 100.0 69.6 Odisha 75.9 7.0 0.4 7.8 0.2 2.8 0.1 5.7 0.1 100.0 82.9 West Bengal 78.9 9.0 0.2 1.2 0.2 1.9 0.0 8.6 0.0 100.0 87.9 Northeast Arunachal Pradesh 45.4 12.5 0.1 0.1 0.1 0.7 0.2 40.8 0.1 100.0 57.9 Assam 58.8 23.6 0.3 1.4 0.5 4.7 0.0 10.5 0.1 100.0 82.5 Manipur 86.6 1.9 0.5 0.1 0.1 0.6 0.1 10.1 0.0 100.0 88.6 Meghalaya 62.3 18.0 0.6 0.4 0.2 1.5 1.6 15.3 0.1 100.0 80.4 Mizoram 67.5 19.3 0.2 0.2 1.2 0.6 0.2 10.9 0.1 100.0 86.8 Nagaland 35.5 8.5 0.8 0.2 0.2 1.0 0.0 53.7 0.1 100.0 44.0 Sikkim 70.8 22.8 0.0 0.0 0.0 1.3 0.0 5.1 0.0 100.0 93.6 Tripura 92.2 0.8 0.0 0.2 0.0 0.4 0.0 6.3 0.0 100.0 93.1 West Dadra & Nagar Haveli 56.5 29.3 0.0 2.1 0.0 0.4 0.0 11.7 0.0 100.0 85.8 Daman & Diu 66.7 12.7 0.7 4.2 0.0 0.0 0.0 15.8 0.0 100.0 79.4 Goa 87.4 7.0 0.0 2.7 0.0 0.0 0.0 2.9 0.0 100.0 94.4 Gujarat 71.0 9.4 0.4 3.3 0.1 2.0 0.0 13.7 0.1 100.0 80.4 Maharashtra 77.5 13.5 0.2 0.9 0.1 0.2 0.1 7.5 0.0 100.0 91.0 South Andaman & Nicobar Islands 31.6 65.8 0.0 0.0 0.0 0.0 0.0 2.5 0.0 100.0 97.5 Andhra Pradesh 90.7 6.6 0.0 1.3 0.0 0.3 0.0 1.0 0.1 100.0 97.3 Karnataka 82.3 5.1 0.0 1.1 0.0 0.2 0.0 11.0 0.2 100.0 87.5 Kerala 98.9 0.3 0.0 0.1 0.0 0.0 0.0 0.6 0.1 100.0 99.2 Lakshadweep 99.3 0.4 0.0 0.0 0.0 0.0 0.0 0.4 0.0 100.0 99.6 Puducherry 87.9 9.1 0.0 0.1 0.0 0.2 0.0 2.6 0.0 100.0 97.0 Tamil Nadu 83.1 8.6 0.0 0.4 0.1 0.1 0.0 7.6 0.0 100.0 91.7 Telangana 85.8 8.6 0.0 2.0 0.1 0.2 0.2 2.7 0.3 100.0 94.5 Note: If more than one source of ANC was mentioned, only the provider with the highest qualification is considered. ANM = Auxiliary nurse midwife; LHV = Lady health visitor; TBA = Traditional birth attendant; ICDS = Integrated Child Development Services; ASHA = Accredited Social Health Activist 1 Skilled provider includes doctor, auxiliary nurse midwife, nurse, midwife, and lady health visitor 216 z Maternal Health Table 8.5 Number of antenatal care visits and timing of first visit Percent distribution of women age 15-49 who had a live birth in the five years preceding the survey by number of antenatal care (ANC) visits for the most recent live birth, and by the timing of the first visit, and among women with ANC, median months pregnant at first visit, according to residence, India, 2015-16 Number and timing of ANC visits Urban Rural Total Number of ANC visits None 9.3 19.6 16.5 1 4.2 6.3 5.7 2 8.5 14.0 12.4 3 10.7 14.6 13.4 4+ 66.4 44.8 51.2 Don't know/missing 1.1 0.7 0.8 Total 100.0 100.0 100.0 Number of months pregnant at time of first ANC visit No antenatal care 9.3 19.6 16.5 <4 69.1 54.2 58.6 4-5 14.7 19.4 18.0 6-7 2.9 3.9 3.6 8+ 3.9 2.8 3.1 Don't know/missing 0.1 0.2 0.2 Total 100.0 100.0 100.0 Number of women 54,847 129,794 184,641 Median months pregnant at first visit (for those with ANC) 3.3 3.6 3.5 Number of women with ANC 49,771 104,404 154,175 Maternal Health z�217 Table 8.6 Number of antenatal care visits and timing of first visit by source Among women age 15-49 who had antenatal care (ANC) for their most recent live birth in the five years preceding the survey, percent distribution by number of ANC visits and by the timing of the first visit, and median months pregnant at first visit, according to the source of antenatal care, India, 2015-16 Number and timing of ANC visits Source Total Public sector only Private/NGO sector only Both public and private/ NGO sector ANC received only at home Number of ANC visits 1 7.1 7.0 1.5 10.5 6.8 2 18.0 11.0 6.2 17.0 14.8 3 18.1 13.1 13.9 15.9 16.1 4+ 56.0 68.0 77.8 53.9 61.3 Don't know/missing 0.8 0.9 0.6 2.8 1.0 Total 100.0 100.0 100.0 100.0 100.0 Number of months pregnant at time of first ANC visit <4 67.0 76.5 77.9 60.1 70.2 4-5 24.5 16.0 17.8 25.8 21.6 6-7 4.5 3.8 2.8 7.0 4.3 8+ 3.8 3.6 1.5 6.3 3.7 Don't know/missing 0.2 0.1 0.0 0.8 0.2 Total 100.0 100.0 100.0 100.0 100.0 Median months pregnant at first visit (for those with ANC) 3.6 3.3 3.4 3.7 3.5 Number of women with ANC 82,502 43,819 14,761 13,093 154,175 NGO = Nongovernmental organization 218 z Maternal Health Table 8.7 Components of antenatal care Among women age 15-49 with a live birth in the five years preceding the survey, percentages who were given or purchased iron and folic acid (IFA) tablets or syrup, took IFA for 100 days or more, received two or more tetanus toxoid (TT) injections during the pregnancy, whose birth was protected against neonatal tetanus, and who took a drug for intestinal parasites during the pregnancy for their most recent live birth, by background characteristics, India, 2015-16 Background characteristic Among women with a live birth in the past five years, percentage who during the pregnancy of their last birth: Number of women Were given or purchased IFA Took IFA for 100 days or more Received two or more TT injections Had birth protected against neonatal tetanus1 Took an intestinal parasite drug 0RWKHU·V�DJH�DW�ELUWK <20 79.3 28.1 84.7 89.8 17.8 20,506 20-34 78.2 31.0 83.1 89.3 18.3 155,757 35-49 63.7 22.1 75.1 81.0 13.4 8,378 Birth order 1 83.5 36.0 86.6 90.7 20.1 62,584 2-3 78.7 31.2 82.6 89.6 18.7 94,026 4-5 64.4 15.9 77.8 85.1 12.0 20,939 6+ 52.4 10.1 70.2 77.2 7.8 7,091 Residence Urban 83.9 40.8 84.4 89.9 21.4 54,847 Rural 75.1 25.9 82.4 88.6 16.6 129,794 Schooling No schooling 62.2 15.7 77.6 84.4 12.0 51,290 <5 years complete 75.9 23.8 82.6 89.0 15.8 10,753 5-7 years complete 78.7 28.0 84.0 90.3 17.8 29,402 8-9 years complete 82.3 30.4 85.4 91.2 19.1 30,990 10-11 years complete 85.9 40.8 84.0 90.3 22.6 23,134 12 or more years complete 89.2 46.7 86.7 91.6 23.1 39,071 Religion Hindu 78.5 30.7 83.1 89.2 18.4 145,617 Muslim 71.2 24.6 82.1 88.1 14.5 29,734 Christian 85.7 46.7 79.6 84.8 20.0 3,900 Sikh 87.8 42.7 90.0 93.9 21.3 2,437 Buddhist/Neo-Buddhist 87.8 43.2 81.8 90.8 28.8 1,502 Jain 84.3 47.2 91.4 95.0 22.7 239 Other 80.5 18.0 83.7 89.0 25.2 1,210 Caste/tribe Scheduled caste 78.0 28.6 82.4 88.8 18.5 39,059 Scheduled tribe 78.4 26.8 79.0 85.9 19.3 19,002 Other backward class 75.5 30.2 82.8 88.6 17.8 80,461 Other 81.3 33.6 85.5 91.3 17.5 44,560 Don't know 73.7 25.6 78.5 86.1 15.6 1,558 Wealth index Lowest 63.8 14.4 78.2 84.9 12.2 43,155 Second 74.9 23.2 82.3 88.9 16.4 39,070 Middle 81.1 32.8 83.8 89.5 20.0 36,722 Fourth 84.9 39.6 84.6 90.4 21.6 35,066 Highest 88.4 48.2 87.6 92.6 21.8 30,627 Total 77.7 30.3 83.0 89.0 18.0 184,641 1 Includes mothers with two injections during the pregnancy of her last birth, or two or more injections (the last within 3 years of the last live birth), or three or more injections (the last within 5 years of the last birth), or four or more injections (the last within 10 years of the last live birth), or five or more injections at any time prior to the last birth Maternal Health z�219 T ab le 8 .8 A nt en at al c ar e se rv ic es a nd in fo rm at io n re ce iv ed A m on g w om en a ge 1 5- 49 w ith a li ve b irt h in th e fiv e ye ar s p re ce di ng th e su rv ey w ho re ce iv ed a nt en at al c ar e fo r t he m os t r ec en t l iv e bi rth , p er ce nt ag e re ce iv in g sp ec ifi c se rv ic es a nd in fo rm at io n on s pe ci fic s ig ns o f p re gn an cy c om pl ic at io ns a nd w he re to g o if th er e w as a p re gn an cy c om pl ic at io n, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic Pe rc en ta ge re ce iv in g se le ct ed s er vi ce s du rin g an te na ta l c ar e Pe rc en ta ge re ce iv in g in fo rm at io n on s pe ci fic s ig ns o f p re gn an cy c om pl ic at io ns N um be r of w om en W ei gh ed Bl oo d pr es su re m ea su re d U rin e sa m pl e ta ke n Bl oo d sa m pl e ta ke n A bd om en ex am in ed Va gi na l bl ee di ng C on vu lsi on s Pr ol on ge d la bo ur Se ve re ab do m in al pa in H ig h bl oo d pr es su re W he re to g o if ex pe rie nc ed pr eg na nc y co m pl ic at io ns Ag e at b ir th < 20 92 .5 91 .3 89 .7 89 .2 88 .1 47 .0 45 .3 51 .1 53 .2 51 .5 66 .0 17 ,6 00 20 -3 4 90 .5 89 .6 88 .1 87 .5 88 .9 46 .1 44 .0 50 .2 51 .8 51 .9 67 .5 13 0, 91 4 35 -4 9 82 .9 80 .3 78 .1 76 .7 82 .6 40 .0 39 .3 44 .8 46 .7 46 .7 63 .8 5, 66 1 Bi rt h or de r 1 93 .7 93 .5 92 .5 92 .4 92 .1 49 .8 47 .5 53 .8 55 .5 55 .8 69 .8 56 ,4 19 2- 3 91 .2 90 .0 88 .6 87 .9 89 .0 45 .9 43 .7 50 .0 51 .7 51 .5 67 .4 79 ,3 41 4- 5 80 .0 77 .2 74 .3 72 .3 77 .7 36 .3 36 .1 40 .9 42 .6 41 .2 59 .6 14 ,4 62 6+ 68 .6 63 .5 59 .8 58 .0 70 .2 27 .8 28 .4 32 .5 34 .1 32 .1 54 .3 3, 95 3 Re si de nc e U rb an 95 .0 95 .4 94 .4 94 .6 94 .1 50 .3 47 .0 53 .5 54 .8 56 .7 69 .7 49 ,7 71 Ru ra l 88 .3 86 .5 84 .9 83 .8 86 .0 43 .9 42 .6 48 .4 50 .3 49 .2 66 .0 10 4, 40 4 Sc ho ol in g N o sc ho ol in g 80 .2 76 .8 74 .4 72 .2 77 .7 37 .0 36 .3 41 .1 43 .2 41 .4 59 .0 34 ,7 32 < 5 ye ar s co m pl et e 90 .3 88 .7 86 .3 84 .7 84 .3 46 .1 44 .6 50 .0 52 .8 50 .7 64 .9 8, 81 7 5- 7 ye ar s co m pl et e 91 .0 90 .0 88 .5 88 .3 87 .8 46 .0 43 .8 50 .1 52 .1 51 .0 66 .4 25 ,4 39 8- 9 ye ar s co m pl et e 92 .0 91 .4 90 .1 89 .9 90 .3 47 .7 45 .6 52 .2 53 .5 53 .2 69 .1 27 ,3 33 10 -1 1 ye ar s co m pl et e 95 .8 95 .6 94 .6 94 .6 94 .4 49 .7 47 .3 54 .4 55 .6 56 .1 69 .9 21 ,1 78 12 o r m or e ye ar s co m pl et e 95 .7 96 .0 95 .3 95 .3 95 .9 51 .0 48 .2 54 .5 55 .9 58 .2 73 .0 36 ,6 76 Re lig io n H in du 90 .6 89 .1 87 .9 87 .4 88 .7 46 .4 44 .7 50 .7 52 .2 52 .1 67 .5 12 1, 78 0 M us lim 87 .3 88 .2 85 .8 84 .6 86 .4 41 .1 39 .7 44 .2 46 .7 46 .6 63 .4 24 ,0 51 C hr ist ia n 97 .5 97 .1 92 .7 93 .4 94 .1 45 .6 41 .0 50 .4 50 .4 51 .8 71 .1 3, 40 9 Si kh 97 .4 97 .6 96 .4 97 .2 95 .0 65 .7 52 .2 70 .8 74 .4 76 .7 83 .4 2, 34 7 Bu dd hi st /N eo -B ud dh ist 98 .2 98 .0 98 .3 97 .7 96 .7 48 .6 41 .9 52 .4 58 .0 52 .6 62 .3 1, 42 2 Ja in 97 .2 98 .0 96 .8 97 .9 98 .3 67 .5 55 .7 67 .9 70 .4 59 .7 74 .4 22 6 O th er 96 .7 93 .0 86 .7 83 .1 85 .6 62 .8 58 .1 61 .8 59 .4 53 .2 74 .2 93 9 C on tin ue d. . 220 z Maternal Health Ta bl e 8. 8 A nt en at al c ar e se rv ic es a nd in fo rm at io n re ce iv ed — C on tin ue d A m on g w om en a ge 1 5- 49 w ith a li ve b irt h in th e fiv e ye ar s p re ce di ng th e su rv ey w ho re ce iv ed a nt en at al c ar e fo r t he m os t r ec en t l iv e bi rth , p er ce nt ag e re ce iv in g sp ec ifi c se rv ic es a nd in fo rm at io n on s pe ci fic s ig ns o f p re gn an cy c om pl ic at io ns a nd w he re to g o if th er e w as a p re gn an cy c om pl ic at io n, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic Pe rc en ta ge re ce iv in g se le ct ed s er vi ce s du rin g an te na ta l c ar e Pe rc en ta ge re ce iv in g in fo rm at io n on s pe ci fic s ig ns o f p re gn an cy c om pl ic at io ns N um be r of w om en W ei gh ed Bl oo d pr es su re m ea su re d U rin e sa m pl e ta ke n Bl oo d sa m pl e ta ke n A bd om en ex am in ed Va gi na l bl ee di ng C on vu lsi on s Pr ol on ge d la bo ur Se ve re ab do m in al pa in H ig h bl oo d pr es su re W he re to g o if ex pe rie nc ed pr eg na nc y co m pl ic at io ns C as te /tr ib e Sc he du le d ca st e 89 .1 87 .0 86 .5 85 .6 87 .2 47 .0 45 .4 51 .6 53 .0 51 .9 68 .3 32 ,0 67 Sc he du le d tri be 93 .8 90 .9 86 .3 87 .0 85 .6 46 .4 44 .7 51 .3 53 .5 51 .3 65 .2 15 ,2 51 O th er b ac kw ar d cl as s 88 .4 87 .5 86 .2 85 .3 88 .3 43 .8 42 .2 48 .0 49 .3 49 .4 66 .8 66 ,2 10 O th er 93 .6 94 .0 92 .6 92 .0 91 .4 48 .8 45 .8 52 .1 54 .3 55 .3 68 .0 39 ,4 60 D on 't kn ow 91 .8 91 .2 89 .4 89 .9 83 .5 40 .5 39 .5 43 .2 48 .3 46 .9 60 .5 1, 18 7 W ea lth in de x Lo w es t 80 .6 75 .6 72 .8 70 .0 74 .1 36 .4 37 .2 41 .7 43 .7 40 .4 59 .8 28 ,1 72 Se co nd 87 .4 85 .9 84 .5 83 .4 85 .2 43 .8 42 .6 48 .2 50 .2 48 .6 65 .1 32 ,0 11 M id dl e 91 .8 91 .4 90 .4 90 .1 91 .4 47 .3 44 .9 51 .4 52 .8 52 .3 67 .6 32 ,5 83 Fo ur th 94 .8 95 .3 94 .2 94 .6 94 .4 48 .7 45 .8 52 .5 53 .7 55 .2 69 .5 32 ,3 15 H ig he st 97 .1 97 .8 96 .7 97 .2 96 .8 53 .1 49 .1 56 .2 58 .0 61 .2 73 .7 29 ,0 94 To ta l 90 .5 89 .4 87 .9 87 .3 88 .6 46 .0 44 .0 50 .1 51 .8 51 .6 67 .2 15 4, 17 5 Maternal Health z�221 Ta bl e 8. 9 M al e in vo lv em en t i n an te na ta l c ar e Am on g m en a ge 1 5- 49 w ho se y ou ng es t l iv in g ch ild w as a ge 0 -3 5 m on th s, p er ce nt ag e fo r w ho m th e m ot he r o f t he c hi ld re ce iv ed a nt en at al c ar e (A N C ) a nd th e fa th er w as p re se nt o r n ot pr es en t a t t he ti m e of a ny A N C v isi t, pe rc en ta ge w ho w er e to ld b y a he al th p ro vi de r or w or ke r at a ny ti m e du rin g th e pr eg na nc y ab ou t s pe ci fic s ig ns o f p re gn an cy c om pl ic at io ns , a nd pe rc en ta ge w ho w er e to ld w ha t t o do if th e ch ild ’s m ot he r h ad a ny p re gn an cy c om pl ic at io n, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Pe rc en ta ge fo r w ho m th e ch ild 's m ot he r r ec ei ve d AN C an d th e fa th er w as : Pe rc en ta ge w ho w er e to ld b y a he al th p ro vi de r o r w or ke r a bo ut sp ec ifi c sig ns o f p re gn an cy c om pl ic at io ns Pe rc en ta ge e ve r to ld w ha t t o do if c hi ld ’s m ot he r h ad an y pr eg na nc y co m pl ic at io n N um be r of m en Pr es en t f or an y AN C N ot p re se nt fo r a ny A N C To ta l V ag in al bl ee di ng C on vu lsi on s Pr ol on ge d la bo ur Se ve re ab do m in al pa in H ig h bl oo d pr es su re Fa th er 's ag e at b ir th < 20 72 .1 13 .9 86 .0 35 .6 41 .3 40 .8 46 .8 44 .3 41 .9 14 3 20 -3 4 68 .9 18 .1 87 .0 36 .9 38 .3 45 .3 51 .3 44 .9 47 .4 13 ,1 29 35 -4 9 64 .7 16 .7 81 .5 37 .8 39 .9 45 .0 50 .2 44 .6 46 .3 2, 88 0 Fa th er 's nu m be r of c hi ld re n e ve r bo rn 1 75 .3 16 .9 92 .2 41 .8 42 .5 49 .3 55 .6 48 .7 51 .4 6, 03 0 2- 3 68 .6 17 .5 86 .1 36 .4 38 .2 45 .1 51 .0 45 .3 48 .1 7, 81 0 4+ 48 .1 21 .1 69 .1 27 .0 30 .0 34 .7 39 .4 33 .4 32 .5 2, 31 1 Re si de nc e U rb an 76 .9 14 .6 91 .5 40 .5 40 .5 48 .4 54 .2 48 .8 52 .7 5, 32 2 Ru ra l 63 .9 19 .4 83 .3 35 .4 37 .7 43 .6 49 .5 42 .9 44 .4 10 ,8 29 Fa th er 's sc ho ol in g N o sc ho ol in g 50 .1 21 .6 71 .6 29 .2 31 .4 36 .0 42 .5 34 .3 36 .2 2, 44 5 < 5 ye ar s co m pl et e 54 .4 25 .3 79 .6 34 .7 36 .4 45 .0 49 .4 41 .7 42 .4 1, 16 8 5- 7 ye ar s co m pl et e 61 .7 21 .8 83 .5 33 .5 35 .4 42 .4 47 .8 41 .4 43 .4 2, 72 5 8- 9 ye ar s co m pl et e 69 .1 17 .6 86 .7 36 .7 39 .8 46 .1 51 .4 46 .0 47 .3 3, 41 1 10 -1 1 ye ar s co m pl et e 76 .3 15 .7 91 .9 39 .6 42 .1 47 .2 54 .0 47 .1 50 .3 2, 18 0 12 o r m or e ye ar s co m pl et e 81 .7 12 .2 94 .0 43 .6 42 .8 50 .6 56 .9 51 .9 55 .4 4, 22 2 Re lig io n H in du 68 .4 18 .0 86 .4 36 .3 38 .3 44 .7 50 .8 44 .3 47 .0 12 ,8 29 M us lim 64 .1 18 .0 82 .1 36 .9 37 .6 44 .3 49 .1 43 .9 44 .7 2, 56 8 C hr ist ia n 72 .7 16 .8 89 .5 42 .6 41 .7 47 .3 57 .9 48 .8 56 .2 31 6 Si kh 85 .7 12 .7 98 .4 70 .0 66 .0 72 .1 76 .0 74 .0 70 .5 21 2 Bu dd hi st /N eo -B ud dh ist 83 .0 9. 4 92 .3 55 .2 43 .4 65 .9 64 .7 65 .8 58 .0 12 3 O th er 1 65 .9 12 .6 78 .4 27 .6 28 .5 39 .6 47 .2 27 .9 36 .0 87 C on tin ue d. . 222 z Maternal Health Ta bl e 8. 9 M al e in vo lv em en t i n an te na ta l c ar e— C on tin ue d Am on g m en a ge 1 5- 49 w ho se y ou ng es t l iv in g ch ild w as a ge 0 -3 5 m on th s, p er ce nt ag e fo r w ho m th e m ot he r o f t he c hi ld re ce iv ed a nt en at al c ar e (A N C ) a nd th e fa th er w as p re se nt o r n ot pr es en t a t t he ti m e of a ny A N C v isi t, pe rc en ta ge w ho w er e to ld b y a he al th p ro vi de r or w or ke r at a ny ti m e du rin g th e pr eg na nc y ab ou t s pe ci fic s ig ns o f p re gn an cy c om pl ic at io ns , a nd pe rc en ta ge w ho w er e to ld w ha t t o do if th e ch ild ’s m ot he r h ad a ny p re gn an cy c om pl ic at io n, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Pe rc en ta ge fo r w ho m th e ch ild 's m ot he r r ec ei ve d AN C an d th e fa th er w as : Pe rc en ta ge w ho w er e to ld b y a he al th p ro vi de r o r w or ke r a bo ut sp ec ifi c sig ns o f p re gn an cy c om pl ic at io ns Pe rc en ta ge e ve r to ld w ha t t o do if c hi ld ’s m ot he r h ad an y pr eg na nc y co m pl ic at io n N um be r of m en Pr es en t f or an y AN C N ot p re se nt fo r a ny A N C To ta l V ag in al bl ee di ng C on vu lsi on s Pr ol on ge d la bo ur Se ve re ab do m in al pa in H ig h bl oo d pr es su re C as te /tr ib e Sc he du le d ca st e 66 .6 18 .1 84 .8 37 .0 38 .6 44 .9 50 .9 43 .9 47 .3 3, 28 1 Sc he du le d tri be 61 .9 20 .3 82 .2 34 .1 35 .3 41 .5 48 .3 39 .3 43 .5 1, 72 5 O th er b ac kw ar d cl as s 67 .1 17 .9 85 .0 33 .6 36 .3 42 .2 48 .9 42 .3 44 .1 6, 98 1 O th er 74 .0 16 .3 90 .4 44 .5 44 .2 52 .2 55 .9 52 .5 53 .6 4, 09 5 D on 't kn ow (6 2. 0) (1 7. 9) (7 9. 9) (2 4. 6) (2 9. 5) (4 0. 9) (5 3. 4) (3 5. 4) (5 2. 9) 69 W ea lth in de x Lo w es t 47 .5 20 .8 68 .3 29 .7 33 .2 37 .1 42 .8 33 .9 34 .3 3, 31 1 Se co nd 61 .2 21 .5 82 .7 34 .7 37 .6 42 .6 47 .8 42 .1 43 .6 3, 37 3 M id dl e 71 .0 18 .9 89 .9 35 .7 37 .2 45 .0 50 .7 44 .8 49 .2 3, 40 6 Fo ur th 79 .5 14 .6 94 .2 40 .7 41 .9 48 .9 56 .4 49 .8 52 .2 3, 07 4 H ig he st 83 .9 12 .4 96 .3 45 .7 44 .1 53 .5 59 .0 55 .0 57 .8 2, 98 8 To ta l 68 .2 17 .8 86 .0 37 .1 38 .6 45 .2 51 .1 44 .9 47 .1 16 ,1 51 N ot e: T ot al in cl ud es Ja in m en , w ho a re n ot s ho w n se pa ra te ly . 1 N ot a H in du , M us lim , C hr ist ia n, S ik h, B ud dh ist /N eo -B ud dh ist , o r J ai n ( ) B as ed o n 25 -4 9 un w ei gh te d ca se s Maternal Health z�223 7DEOH������5HDVRQV�ZK\�FKLOG V�PRWKHU�GLG�QRW�UHFHLYH�DQWHQDWDO�FDUH��0HQ� 3HUFHQW�GLVWULEXWLRQ�RI�PHQ�DJH�������ZKRVH�\RXQJHVW� OLYLQJ�FKLOG�ZDV�DJH������PRQWKV�DQG�WKH� FKLOG V�PRWKHU�GLG�QRW�UHFHLYH�DQWHQDWDO�FDUH�ZKHQ�SUHJQDQW�ZLWK�WKH�FKLOG�E\�WKH�PDLQ�UHDVRQ�IRU�QRW� UHFHLYLQJ�DQWHQDWDO�FDUH��DFFRUGLQJ�WR�UHVLGHQFH��,QGLD����������� 5HDVRQ�ZK\�WKH�FKLOG·V�PRWKHU�GLG�QRW�� UHFHLYH�DQWHQDWDO�FDUH� 8UEDQ� 5XUDO� 7RWDO� � � � � +H�GLG�QRW�WKLQN�LW�ZDV�QHFHVVDU\�GLG�QRW�DOORZ� ����� ����� ����� )DPLO\�GLG�QRW�WKLQN�LW�ZDV�QHFHVVDU\�GLG�QRW�DOORZ� ����� ����� ����� &KLOG V�PRWKHU�GLG�QRW�ZDQW�FKHFN�XS� ���� ����� ���� +DV�KDG�FKLOGUHQ�EHIRUH� ���� ���� ���� &RVWV�WRR�PXFK� ����� ����� ����� 7RR�IDU�QR�WUDQVSRUWDWLRQ� ���� ���� ���� 1R�IHPDOH�KHDOWK�ZRUNHU�DYDLODEOH� ���� ���� ���� 2WKHU� ���� ���� ���� 'RQ W�NQRZ�PLVVLQJ� ���� ���� ���� � � � � 7RWDO� ������ ������ ������ 1XPEHU�RI�PHQ� ���� ������ ������ � � � � 224 z Maternal Health Table 8.11 Antenatal care indicators by state/union territory Among women age 15-49 with a live birth in the five years preceding the survey, percentage who received different types of antenatal care (ANC) during the pregnancy for their most recent live birth by state/union territory, India, 2015-16 State/union territory Percentage who had at least one ANC visit Percentage who had four or more ANC visits Percentage with an ANC visit in the first trimester of pregnancy Percentage who received information from a health provider or worker about pregnancy complications1 Percentage who received two or more TT injections during the pregnancy Percentage whose last birth was protected against neonatal tetanus2 Percentage who were given or bought IFA Percentage who took IFA for at least 100 days Percentage who took an intestinal parasite drug India 82.7 51.2 58.6 64.8 83.0 89.0 77.7 30.3 18.0 North Chandigarh 96.9 64.5 67.4 87.7 89.1 95.1 88.8 44.9 15.9 Delhi 89.2 67.9 63.0 67.9 83.3 90.6 89.8 53.8 13.1 Haryana 82.3 45.1 63.2 73.8 86.3 92.3 83.3 32.5 17.0 Himachal Pradesh 90.4 69.1 70.5 73.8 69.7 86.2 92.7 49.4 10.5 Jammu & Kashmir 90.9 81.3 76.7 64.1 81.6 87.4 74.6 30.2 9.5 Punjab 97.1 68.4 75.6 90.9 89.0 92.9 88.9 42.6 20.8 Rajasthan 85.5 38.5 63.0 61.1 81.9 89.7 64.6 17.3 7.2 Uttarakhand 77.0 30.9 53.5 53.3 85.7 91.4 78.3 24.9 7.3 Central Chhattisgarh 95.7 59.1 70.8 83.9 89.7 94.3 91.3 30.3 23.4 Madhya Pradesh 75.6 35.7 53.0 62.0 83.3 89.8 83.0 23.5 18.2 Uttar Pradesh 76.1 26.4 45.9 49.4 81.4 86.5 62.7 12.9 7.9 East Bihar 55.7 14.4 34.6 37.0 81.5 89.6 55.8 9.7 9.0 Jharkhand 76.3 30.3 52.0 49.3 85.9 91.7 69.3 15.3 12.4 Odisha 92.9 61.9 64.0 81.2 89.3 94.3 90.4 36.5 31.1 West Bengal 90.3 76.4 54.9 79.0 91.4 95.4 91.1 28.0 18.7 Northeast Arunachal Pradesh 56.1 26.7 36.9 43.7 56.5 63.9 63.9 8.3 11.7 Assam 87.8 46.4 55.1 74.5 83.6 89.8 85.2 32.0 9.4 Manipur 89.5 69.0 77.0 49.9 84.5 88.8 83.6 39.2 2.3 Meghalaya 81.1 50.0 53.3 67.2 67.8 79.2 80.5 36.2 3.7 Mizoram 87.9 61.4 65.6 70.4 74.2 82.5 83.7 53.6 5.5 Nagaland 45.8 15.0 24.7 21.8 59.4 63.7 42.0 4.4 1.8 Sikkim 91.0 74.7 76.2 91.8 95.9 97.2 97.1 52.8 8.7 Tripura 88.9 64.3 66.4 73.5 91.9 93.0 86.4 13.4 9.5 West Dadra & Nagar Haveli 84.9 75.6 63.5 79.3 81.1 86.8 82.6 43.9 10.4 Daman & Diu 80.7 62.7 75.1 76.2 61.1 71.1 71.1 38.3 20.9 Goa 96.7 89.0 84.4 88.9 89.3 96.2 93.9 67.4 58.1 Gujarat 85.1 70.5 73.8 71.0 81.4 86.6 75.5 36.8 19.1 Maharashtra 91.9 72.2 67.6 70.5 81.4 90.4 85.0 40.6 26.7 South Andaman & Nicobar Islands 96.8 92.1 68.4 93.2 89.9 91.8 92.4 58.4 5.2 Andhra Pradesh 98.8 76.3 82.3 79.4 91.7 94.9 91.3 56.1 20.0 Karnataka 88.0 70.1 65.9 70.6 80.1 88.1 84.1 45.2 31.6 Kerala 92.6 90.1 95.1 86.7 94.8 96.4 96.1 67.1 21.0 Lakshadweep 87.4 82.3 90.6 93.1 90.0 93.6 95.5 81.7 14.8 Puducherry 97.2 87.7 80.6 91.7 75.0 82.1 95.4 66.3 47.7 Tamil Nadu 91.4 81.1 64.0 87.5 65.4 71.0 94.4 64.0 46.8 Telangana 96.6 74.9 83.1 69.4 85.4 88.8 90.7 52.7 22.7 TT = Tetanus toxoid; IFA = Iron and folic acid 1 Vaginal bleeding, convulsions, prolonged labour, severe abdominal pain, high blood pressure, or where to go if she had pregnancy complications 2 Includes mothers with two injections during the pregnancy of her last birth, or two or more injections (the last within 3 years of the last live birth), or three or more injections (the last within 5 years of the last birth), or four or more injections (the last within 10 years of the last live birth), or five or more injections at any time prior to the last birth Maternal Health z�225 Ta bl e 8. 12 P re gn an ci es fo r w hi ch a n ul tr as ou nd te st w as d on e Pe rc en ta ge o f al l p re gn an ci es t o w om en a ge 1 5- 49 in t he f iv e ye ar s pr ec ed in g th e su rv ey f or w hi ch a n ul tr as ou nd t es t w as d on e an d pe rc en t di st rib ut io n of p re gn an ci es w ith a n ul tr as ou nd te st b y pr eg na nc y ou tc om e, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic Pe rc en ta ge o f pr eg na nc ie s w ith an u ltr as ou nd te st N um be r o f pr eg na nc ie s Pr eg na nc y ou tc om e1 To ta l N um be r o f pr eg na nc ie s w ith an u ltr as ou nd te st So n D au gh te r Te rm in at io n St ill p re gn an t M ot he r's a ge a t p re gn an cy < 20 61 .0 55 ,4 50 44 .6 41 .7 5. 4 8. 3 10 0. 0 33 ,8 37 20 -3 4 62 .2 24 3, 47 5 45 .3 40 .2 6. 4 8. 0 10 0. 0 15 1, 44 3 35 -4 9 43 .3 10 ,1 02 45 .1 38 .9 8. 3 7. 8 10 0. 0 4, 37 8 Re si de nc e U rb an 78 .4 89 ,0 28 44 .5 39 .7 7. 4 8. 4 10 0. 0 69 ,8 09 Ru ra l 54 .5 22 0, 00 0 45 .6 40 .9 5. 6 7. 9 10 0. 0 11 9, 84 9 An te na ta l c ar e vi si ts 2 N on e 28 .2 36 ,6 62 45 .9 37 .7 6. 9 9. 5 10 0. 0 10 ,3 26 1- 3 55 .7 72 ,3 79 48 .2 38 .5 5. 7 7. 6 10 0. 0 40 ,2 92 4+ 79 .6 11 9, 75 8 46 .2 39 .3 6. 8 7. 8 10 0. 0 95 ,2 96 D on 't kn ow /m iss in g 75 .9 1, 92 8 46 .1 40 .2 5. 2 8. 6 10 0. 0 1, 46 4 M ot he r's s ch oo lin g N o sc ho ol in g 36 .9 89 ,6 74 46 .0 42 .3 5. 4 6. 3 10 0. 0 33 ,0 50 < 5 ye ar s co m pl et e 50 .0 18 ,2 36 47 .1 41 .5 5. 6 5. 8 10 0. 0 9, 12 7 5- 7 ye ar s co m pl et e 62 .2 49 ,9 72 46 .8 40 .9 5. 4 7. 0 10 0. 0 31 ,0 69 8- 9 ye ar s co m pl et e 66 .5 52 ,1 56 45 .7 39 .9 6. 4 8. 0 10 0. 0 34 ,6 77 10 -1 1 ye ar s co m pl et e 79 .5 37 ,4 14 44 .5 41 .1 6. 2 8. 2 10 0. 0 29 ,7 53 12 o r m or e ye ar s co m pl et e 84 .4 61 ,5 75 43 .5 38 .7 7. 5 10 .3 10 0. 0 51 ,9 83 Re lig io n H in du 61 .3 24 2, 66 0 45 .4 40 .4 6. 2 8. 0 10 0. 0 14 8, 80 5 M us lim 58 .5 51 ,5 72 44 .5 40 .5 6. 7 8. 3 10 0. 0 30 ,1 54 C hr ist ia n 68 .8 6, 24 7 42 .8 41 .5 7. 0 8. 6 10 0. 0 4, 30 1 Si kh 89 .1 3, 87 5 44 .1 39 .6 6. 9 9. 4 10 0. 0 3, 45 3 Bu dd hi st /N eo -B ud dh ist 78 .7 2, 40 6 45 .2 41 .1 6. 5 7. 2 10 0. 0 1, 89 4 Ja in 93 .2 31 5 54 .9 31 .9 5. 9 7. 3 10 0. 0 29 3 O th er 38 .8 1, 95 4 48 .3 40 .8 2. 5 8. 4 10 0. 0 75 9 C as te /tr ib e Sc he du le d ca st e 58 .0 66 ,5 77 45 .0 41 .1 6. 0 7. 9 10 0. 0 38 ,6 44 Sc he du le d tr ib e 46 .1 31 ,1 88 45 .5 42 .6 4. 7 7. 3 10 0. 0 14 ,3 70 O th er b ac kw ar d cl as s 61 .5 13 6, 53 9 45 .4 40 .1 6. 2 8. 3 10 0. 0 83 ,9 72 O th er 71 .0 71 ,9 97 44 .9 40 .0 7. 1 8. 0 10 0. 0 51 ,1 47 D on 't kn ow 55 .9 2, 72 7 50 .3 36 .1 7. 0 6. 6 10 0. 0 1, 52 5 C on tin ue d. . 226 z Maternal Health Ta bl e 8. 12 P re gn an ci es fo r w hi ch a n ul tr as ou nd te st w as d on e— C on tin ue d Pe rc en ta ge o f al l p re gn an ci es t o w om en a ge 1 5- 49 in t he f iv e ye ar s pr ec ed in g th e su rv ey f or w hi ch a n ul tr as ou nd t es t w as d on e an d pe rc en t di st rib ut io n of p re gn an ci es w ith a n ul tr as ou nd te st b y pr eg na nc y ou tc om e, a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic Pe rc en ta ge o f pr eg na nc ie s w ith an u ltr as ou nd te st N um be r o f pr eg na nc ie s Pr eg na nc y ou tc om e1 To ta l N um be r o f pr eg na nc ie s w ith an u ltr as ou nd te st So n D au gh te r Te rm in at io n St ill p re gn an t W ea lth in de x Lo w es t 28 .3 75 ,4 83 46 .6 41 .6 5. 0 6. 9 10 0. 0 21 ,3 86 Se co nd 52 .5 67 ,3 66 45 .4 42 .4 5. 0 7. 2 10 0. 0 35 ,3 42 M id dl e 71 .3 61 ,6 90 46 .0 40 .5 5. 7 7. 8 10 0. 0 43 ,9 92 Fo ur th 82 .1 56 ,8 63 44 .5 40 .8 6. 5 8. 2 10 0. 0 46 ,6 65 H ig he st 88 .8 47 ,6 27 44 .4 37 .7 8. 3 9. 6 10 0. 0 42 ,2 73 M ot he r's n um be r o f l iv in g ch ild re n a t t im e of p re gn an cy N o ch ild re n 73 .3 12 5, 04 5 44 .7 40 .8 6. 1 8. 4 10 0. 0 91 ,6 08 1 ch ild 64 .3 10 0, 57 9 44 .9 41 .3 5. 7 8. 1 10 0. 0 64 ,6 55 0 so ns 65 .0 50 ,7 48 46 .7 40 .2 5. 4 7. 7 10 0. 0 33 ,0 02 1 so n 63 .5 49 ,8 31 43 .0 42 .6 5. 9 8. 5 10 0. 0 31 ,6 53 2 ch ild re n 47 .2 46 ,6 43 46 .8 38 .0 7. 7 7. 5 10 0. 0 22 ,0 19 0 so ns 55 .5 16 ,5 83 50 .4 35 .4 6. 3 7. 9 10 0. 0 9, 20 3 1 so n 42 .9 21 ,1 15 45 .1 39 .0 8. 7 7. 3 10 0. 0 9, 06 1 2 so ns 42 .0 8, 94 5 42 .4 41 .8 8. 7 7. 0 10 0. 0 3, 75 5 3 ch ild re n 35 .6 20 ,0 48 48 .4 37 .5 7. 6 6. 5 10 0. 0 7, 13 6 0 so ns 46 .9 5, 09 8 52 .7 34 .1 5. 3 7. 8 10 0. 0 2, 38 8 1 so n 33 .7 8, 58 1 48 .3 38 .8 6. 8 6. 1 10 0. 0 2, 89 2 2- 3 so ns 29 .1 6, 36 9 43 .2 39 .8 11 .6 5. 4 10 0. 0 1, 85 6 4+ c hi ld re n 25 .4 16 ,7 11 46 .9 36 .7 10 .1 6. 3 10 0. 0 4, 23 9 0 so ns 41 .1 2, 52 9 52 .8 34 .9 5. 7 6. 6 10 0. 0 1, 04 1 1 so n 27 .4 5, 06 5 48 .5 36 .3 7. 9 7. 3 10 0. 0 1, 39 0 2+ s on s 19 .8 9, 11 7 42 .4 38 .0 14 .2 5. 4 10 0. 0 1, 80 8 To ta l 61 .4 30 9, 02 7 45 .2 40 .4 6. 3 8. 1 10 0. 0 18 9, 65 8 1 Fo r m ul tip le b irt hs , s ex o f p re gn an cy o ut co m e is th e se x of th e fir st li st ed b irt h 2 F or th e m os t r ec en t p re gn an cy in th e fiv e ye ar s pr ec ed in g th e su rv ey Maternal Health z�227 Table 8.13 Place of delivery Percent distribution of live births to women age 15-49 in the five years preceding the survey by place of delivery, and percentage delivered in a health facility, according to background characteristics, India, 2015-16 Background characteristic Health facility Home Other1 Total Percentage delivered in a health facility Number of births Public sector NGO/ trust Private sector Own home Parent's home Other home Mother's age at birth <20 57.9 0.6 23.0 14.3 3.8 0.2 0.3 100.0 81.4 33,928 20-34 51.7 0.5 27.0 17.7 2.6 0.2 0.3 100.0 79.3 206,369 35-49 39.9 0.4 21.5 35.5 1.4 0.3 1.0 100.0 61.8 9,670 Birth order 1 53.7 0.7 33.8 9.3 2.2 0.1 0.2 100.0 88.2 97,213 2-3 52.8 0.5 24.4 18.7 3.1 0.2 0.3 100.0 77.7 117,595 4-5 47.4 0.2 12.7 35.7 3.1 0.3 0.5 100.0 60.3 26,273 6+ 38.9 0.3 8.8 49.0 2.0 0.3 0.7 100.0 48.0 8,885 Residence Urban 46.2 0.9 41.6 9.4 1.5 0.2 0.2 100.0 88.7 70,118 Rural 54.4 0.4 20.3 21.2 3.2 0.2 0.4 100.0 75.1 179,849 Antenatal care visits2 None 43.4 0.2 13.1 37.6 4.8 0.4 0.6 100.0 56.7 30,466 1-3 56.5 0.3 20.5 19.6 2.5 0.2 0.3 100.0 77.4 58,096 4+ 53.2 0.8 37.2 6.9 1.6 0.1 0.2 100.0 91.2 94,541 Don't know/missing 55.4 0.8 30.2 10.4 2.4 0.0 0.8 100.0 86.4 1,537 Mother's schooling No schooling 49.5 0.3 11.8 33.4 4.3 0.3 0.4 100.0 61.6 75,535 <5 years complete 54.4 0.4 15.2 24.6 4.8 0.3 0.4 100.0 69.9 15,079 5-7 years complete 58.4 0.5 21.2 16.4 2.8 0.3 0.4 100.0 80.2 40,773 8-9 years complete 60.9 0.7 23.7 12.2 2.1 0.1 0.2 100.0 85.3 41,205 10-11 years complete 53.8 0.7 37.0 6.8 1.5 0.1 0.2 100.0 91.5 29,868 12 or more years complete 41.2 0.7 52.8 4.3 0.7 0.1 0.2 100.0 94.7 47,506 Religion Hindu 54.0 0.5 26.2 16.3 2.4 0.2 0.3 100.0 80.8 196,629 Muslim 43.9 0.4 24.9 25.8 4.4 0.3 0.3 100.0 69.2 41,379 Christian 43.2 0.6 34.8 18.9 2.0 0.1 0.4 100.0 78.5 5,111 Sikh 53.1 0.3 39.1 6.2 1.0 0.2 0.1 100.0 92.5 3,060 Buddhist/Neo-Buddhist 63.5 1.1 27.6 5.4 2.2 0.1 0.1 100.0 92.2 1,930 Jain 31.7 1.1 65.3 1.7 0.2 0.0 0.0 100.0 98.1 265 Other 41.6 0.1 9.3 43.1 5.6 0.1 0.2 100.0 51.0 1,592 Caste/tribe Scheduled caste 59.9 0.4 18.1 18.5 2.6 0.2 0.3 100.0 78.3 53,851 Scheduled tribe 55.9 0.4 11.6 27.9 3.6 0.2 0.4 100.0 68.0 26,350 Other backward class 50.4 0.5 28.9 17.1 2.6 0.2 0.3 100.0 79.8 110,399 Other 46.1 0.7 36.1 14.1 2.6 0.2 0.3 100.0 82.9 57,172 Don't know 54.7 0.4 18.5 21.2 3.8 0.5 0.9 100.0 73.6 2,194 Wealth index Lowest 51.7 0.1 7.8 35.1 4.6 0.3 0.4 100.0 59.6 63,394 Second 60.4 0.3 14.4 20.7 3.6 0.2 0.4 100.0 75.1 54,939 Middle 58.8 0.6 25.5 12.2 2.3 0.2 0.3 100.0 85.0 49,577 Fourth 49.8 0.7 40.0 8.0 1.2 0.1 0.2 100.0 90.5 45,305 Highest 34.1 1.0 60.1 4.0 0.5 0.1 0.2 100.0 95.3 36,752 Total 52.1 0.5 26.3 17.9 2.7 0.2 0.3 100.0 78.9 249,967 NGO = Nongovernmental organization 1 Includes missing 2 For the most recent birth in the five years preceding the survey 228 z Maternal Health Table 8.14 Reasons for not delivering in a health facility Percentage of women age 15-49 who had a live birth in the five years preceding the survey by reasons for not delivering the most recent live birth in a health facility, according to residence, India, 2015-16 Reason for not delivering in a health facility Urban Rural Total Costs too much 14.5 16.2 15.9 Facility not open 7.9 9.9 9.6 Too far/no transportation 11.0 19.3 18.1 Don't trust facility/poor quality service 6.9 5.7 5.9 No female provider at facility 3.0 3.7 3.6 Husband/family did not allow 16.8 18.2 18.0 Not necessary 43.8 38.8 39.6 Not customary 3.6 4.0 3.9 Other 9.3 8.1 8.3 Number of women 5,230 29,095 34,324 Note: Percentages do not add to 100.0 because multiple responses were permitted. Maternal Health z�229 Table 8.15 Institutional delivery of youngest child: Men Percent distribution of men age 15-49 whose youngest living child was age 0-35 months by whether the child was delivered in a health facility, and percent distribution of men whose youngest living child age 0-35 months was not delivered in a health facility by the main reason for not delivering in a health facility, according to residence, India, 2015-16 Place of delivery/ reason for not delivering in a health facility Urban Rural Total Youngest child delivered at a health facility Yes 89.5 80.4 83.4 No 10.5 19.6 16.6 Total 100.0 100.0 100.0 Number of men 5,322 10,829 16,151 Main reason for not delivering in health facility Cost too much 18.7 17.7 17.9 Facility not open 10.2 9.0 9.3 Too far/no transportation 9.5 19.1 17.1 Don't trust facility/poor quality service 5.8 4.2 4.5 No female provider at facility 2.8 2.2 2.4 Not the first child 3.5 4.6 4.3 Child's mother did not think it was necessary 12.1 11.1 11.3 He did not think it was necessary/did not allow 12.4 6.5 7.7 Family did not think it necessary/did not allow 13.1 13.1 13.1 Other 7.7 9.7 9.2 Don't know 4.4 2.8 3.1 Total 100.0 100.0 100.0 Number of men 559 2,119 2,678 230 z Maternal Health Table 8.16 Delivery and other related information given to men: Men's reports Among men age 15-49 whose youngest living child was age 0-35 months, percentage who were given specific types of pregnancy, delivery, and family planning information by a health provider or health worker during the mother's pregnancy, and among men whose youngest living child age 0-35 months was not delivered in a health facility, percentage who were given specific types of information needed to make home deliveries safer, according to background characteristics, India, 2015-16 Background characteristic Percentage of fathers who said that at some time during the pregnancy, a health provider or worker spoke to them about: Number of men Percentage of fathers who said that during the pregnancy, someone explained to them the importance of 1: Number of men The importance of delivering in a health facility The importance of proper nutrition for the mother during pregnancy Family planning or delaying his next child Cord care Breastfeeding the baby immediately after birth Keeping the baby warm immediately after birth Father's age at birth <20 68.5 69.2 60.3 143 (48.9) (45.2) (34.9) 20 20-34 64.5 70.8 58.8 13,129 32.8 44.0 40.0 2,074 35-49 61.8 68.3 56.0 2,880 33.5 41.2 37.8 584 Father's number of children ever born 1 70.1 76.2 63.6 6,030 29.8 43.5 39.4 561 2-3 63.7 70.8 59.2 7,810 35.0 44.8 41.8 1,354 4+ 49.4 53.4 41.7 2,311 32.0 40.8 35.3 764 Residence Urban 69.0 76.0 65.4 5,322 33.6 42.4 36.8 559 Rural 61.6 67.5 54.8 10,829 32.9 43.6 40.1 2,119 Father's schooling No schooling 50.6 54.6 41.7 2,445 29.1 37.7 33.3 780 <5 years complete 64.9 68.6 51.7 1,168 35.6 44.2 43.1 266 5-7 years complete 60.8 67.4 55.6 2,725 31.6 46.3 39.4 547 8-9 years complete 64.5 69.6 57.9 3,411 35.7 45.2 41.2 570 10-11 years complete 65.7 74.5 63.7 2,180 35.1 46.5 44.6 242 12 or more years complete 72.4 80.2 69.1 4,222 37.3 46.4 45.1 275 Religion Hindu 64.0 70.7 59.1 12,829 32.7 42.1 38.2 1,961 Muslim 61.4 66.3 52.6 2,568 31.8 45.2 41.4 609 Christian 71.6 77.7 59.3 316 45.6 59.4 59.7 56 Sikh 83.4 84.0 76.0 212 * * * 11 Buddhist/Neo-Buddhist 81.0 83.7 76.1 123 (88.1) (76.2) (68.7) 9 Other2 49.9 56.0 35.2 87 33.1 48.4 33.2 31 Caste/tribe Scheduled caste 64.7 69.7 57.1 3,281 35.2 42.9 37.6 551 Scheduled tribe 65.0 68.4 55.2 1,725 35.0 43.0 42.2 441 Other backward class 60.9 67.7 56.6 6,981 29.5 41.0 36.6 1,198 Other 68.3 76.0 63.8 4,095 37.1 50.1 45.8 482 Don't know (71.1) (69.4) (51.1) 69 * * * 7 Wealth index Lowest 49.3 53.3 41.4 3,311 29.1 41.1 37.4 1,149 Second 61.5 66.9 54.6 3,373 34.2 43.9 39.6 690 Middle 66.4 73.0 59.2 3,406 39.2 47.2 43.6 444 Fourth 70.8 79.4 67.4 3,074 35.4 45.7 41.2 229 Highest 73.4 80.6 70.9 2,988 35.9 44.2 39.2 168 Total 64.0 70.3 58.3 16,151 33.0 43.4 39.4 2,678 Note: Total includes Jain men, who are not shown separately. 1 Men whose youngest living child age 0-35 months was not delivered in a health facility 2 Not a Hindu, Muslim, Christian, Sikh, Buddhist/Neo-Buddhist, or Jain ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases Maternal Health z�231 Table 8.17 Delivery and other related information given to men by state/union territory: Men's reports Among men age 15-49 whose youngest living child was age 0-35 months, percentage who were given specific types of pregnancy, delivery, and family planning information by a health provider or health worker during the mother's pregnancy, and among men whose youngest living child age 0-35 months was not delivered in a health facility, percentage who were given specific types of information needed to make home deliveries safer, by state/union territory, India, 2015-16 State/union territory Percentage of fathers who said that at some time during the pregnancy, a health provider or worker spoke to them about: Percentage of fathers who said that during the pregnancy, someone explained to them the importance of 1: The importance of delivering in a health facility The importance of proper nutrition for the mother during pregnancy Family planning or delaying his next child Cord care Breastfeeding the baby immediately after birth Keeping the baby warm immediately after birth India 64.0 70.3 58.3 33.0 43.4 39.4 North Chandigarh * * * * * * Delhi 51.3 69.2 57.5 * * * Haryana 64.6 73.2 64.4 49.4 51.4 48.1 Himachal Pradesh 64.5 70.4 61.2 54.6 59.6 63.8 Jammu & Kashmir 69.8 75.1 46.5 49.8 65.7 58.5 Punjab 86.6 87.7 82.2 * * * Rajasthan 55.9 60.0 56.6 22.1 29.3 28.4 Uttarakhand 63.0 69.9 60.0 58.4 51.1 62.0 Central Chhattisgarh 77.3 81.2 71.5 50.8 64.3 56.0 Madhya Pradesh 51.7 56.7 49.7 21.6 27.5 27.5 Uttar Pradesh 42.6 46.4 34.8 22.7 31.2 27.0 East Bihar 44.7 53.5 41.6 30.8 42.0 36.7 Jharkhand 54.9 61.3 53.4 38.3 42.0 41.9 Odisha 86.8 87.8 77.8 52.1 65.8 65.0 West Bengal 74.5 74.0 59.2 40.7 57.6 50.4 Northeast Arunachal Pradesh 61.1 64.4 57.7 39.1 40.6 51.4 Assam 80.6 83.8 77.0 47.1 65.0 58.4 Manipur 58.7 61.3 32.4 41.1 52.3 53.5 Meghalaya 66.1 69.0 43.1 40.5 62.1 57.8 Mizoram 73.7 74.9 47.4 14.8 34.5 40.7 Nagaland 39.2 48.8 18.1 41.2 42.7 45.6 Sikkim 89.2 92.6 79.0 * * * Tripura 78.5 71.7 63.9 * * * West Dadra & Nagar Haveli (47.0) (67.8) (57.7) * * * Daman & Diu 32.7 35.0 26.8 * * * Goa 94.6 97.6 96.6 * * * Gujarat 74.2 79.2 68.4 25.6 40.8 41.1 Maharashtra 73.6 83.8 70.7 36.1 43.7 38.1 South Andaman & Nicobar Islands (91.5) (93.7) (93.6) * * * Andhra Pradesh 67.2 85.5 59.2 * * * Karnataka 75.5 80.4 72.1 36.7 52.0 51.8 Kerala 79.9 84.6 61.4 * * * Lakshadweep * * * * * * Puducherry 94.3 94.5 88.5 * * * Tamil Nadu 86.2 92.8 81.7 * * * Telangana 53.6 80.4 52.7 * * * 1 Men whose youngest living child age 0-35 months was not delivered in a health facility ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases 232 z Maternal Health Table 8.18 Adherence to delivery protocol for home delivery Percentage of women age 15-49 who had a live birth delivered at home in the five years preceding the survey by whether the recommended protocol was followed at the time of delivery for the most recent live birth delivered at home, according to residence, India, 2015-16 Protocol at delivery Urban Rural Total Disposable delivery kit (DDK) used 51.4 44.5 45.6 Clean blade used to cut the cord 96.3 95.6 95.7 Either of the above 96.7 96.1 96.2 Baby was immediately wiped dry and then wrapped without being bathed 79.4 81.4 81.1 Number of women 5,230 29,095 34,324 Maternal Health z�233 Ta bl e 8. 19 A ss ist an ce d ur in g de liv er y Pe rc en t d ist rib ut io n of li ve b irt hs to w om en a ge 1 5- 49 in th e fiv e ye ar s pr ec ed in g th e su rv ey b y pe rs on p ro vi di ng a ss ist an ce d ur in g de liv er y, p er ce nt ag e de liv er ed b y ca es ar ea n se ct io n (C -s ec tio n) , pe rc en ta ge d el iv er ed b y C -s ec tio n th at w as p la nn ed b ef or e th e on se t of la bo ur p ai ns , an d pe rc en ta ge d el iv er ed b y C -s ec tio n th at w as d ec id ed o n af te r th e on se t of la bo ur p ai ns , ac co rd in g to ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic Pe rs on p ro vi di ng a ss ist an ce d ur in g de liv er y To ta l Pe rc en ta ge de liv er ed b y a sk ill ed pr ov id er 1 Pe rc en ta ge de liv er ed b y ca es ar ea n se ct io n Ti m in g of d ec isi on to co nd uc t a C -s ec tio n N um be r of b irt hs D oc to r AN M / nu rs e/ m id w ife / LH V O th er he al th pe rs on ne l D ai (T BA ) Fr ie nd s/ re la tiv es O th er N o on e D on 't kn ow / m iss in g Be fo re on se t o f la bo ur pa in s Af te r on se t o f la bo ur pa in s M ot he r's a ge a t b ir th < 20 58 .3 24 .8 0. 6 9. 4 5. 8 0. 7 0. 3 0. 1 10 0. 0 83 .7 15 .2 7. 8 7. 3 33 ,9 28 20 -3 4 56 .3 24 .7 0. 7 10 .8 6. 3 0. 9 0. 3 0. 0 10 0. 0 81 .7 17 .6 9. 7 7. 7 20 6, 36 9 35 -4 9 41 .7 23 .0 0. 9 19 .5 11 .6 1. 7 0. 9 0. 6 10 0. 0 65 .6 14 .5 8. 6 5. 7 9, 67 0 Bi rt h or de r 1 66 .1 22 .7 0. 5 6. 0 4. 0 0. 5 0. 2 0. 0 10 0. 0 89 .3 24 .0 12 .3 11 .5 97 ,2 13 2- 3 55 .0 24 .9 0. 7 11 .5 6. 6 0. 9 0. 3 0. 1 10 0. 0 80 .6 15 .6 9. 4 6. 1 11 7, 59 5 4- 5 34 .5 29 .4 1. 0 21 .0 11 .6 1. 8 0. 6 0. 1 10 0. 0 65 .0 3. 9 2. 0 1. 9 26 ,2 73 6+ 22 .9 28 .5 1. 1 28 .1 15 .5 2. 6 1. 0 0. 3 10 0. 0 52 .5 2. 1 0. 8 1. 3 8, 88 5 Re si de nc e U rb an 72 .7 17 .0 0. 2 5. 9 3. 4 0. 5 0. 1 0. 0 10 0. 0 90 .0 28 .2 16 .0 12 .1 70 ,1 18 Ru ra l 49 .5 27 .7 0. 9 12 .9 7. 6 1. 0 0. 4 0. 1 10 0. 0 78 .0 12 .8 6. 9 5. 9 17 9, 84 9 M ot he r's s ch oo lin g N o sc ho ol in g 35 .9 28 .9 1. 1 20 .4 11 .1 1. 8 0. 6 0. 1 10 0. 0 66 .0 6. 0 2. 9 3. 0 75 ,5 35 < 5 ye ar s co m pl et e 48 .8 24 .3 1. 0 15 .6 8. 8 0. 9 0. 4 0. 2 10 0. 0 74 .1 10 .6 5. 7 4. 7 15 ,0 79 5- 7 ye ar s co m pl et e 56 .1 26 .0 0. 6 10 .3 5. 9 0. 6 0. 3 0. 0 10 0. 0 82 .8 14 .7 8. 1 6. 4 40 ,7 73 8- 9 ye ar s co m pl et e 59 .7 27 .0 0. 6 7. 5 4. 5 0. 4 0. 2 0. 0 10 0. 0 87 .3 17 .4 9. 6 7. 7 41 ,2 05 10 -1 1 ye ar s co m pl et e 72 .2 19 .7 0. 4 3. 8 3. 2 0. 4 0. 2 0. 0 10 0. 0 92 .3 25 .7 14 .4 11 .1 29 ,8 68 12 o r m or e ye ar s co m pl et e 76 .6 18 .0 0. 3 2. 4 2. 3 0. 3 0. 1 0. 0 10 0. 0 94 .9 33 .6 18 .8 14 .6 47 ,5 06 Re lig io n H in du 56 .3 25 .9 0. 6 9. 8 6. 1 0. 9 0. 3 0. 1 10 0. 0 82 .8 17 .3 9. 5 7. 6 19 6, 62 9 M us lim 52 .7 19 .9 0. 9 16 .8 8. 2 1. 0 0. 4 0. 0 10 0. 0 73 .6 15 .1 8. 2 6. 8 41 ,3 79 C hr ist ia n 64 .4 15 .7 0. 7 8. 7 9. 1 1. 0 0. 4 0. 1 10 0. 0 80 .8 24 .8 14 .6 10 .0 5, 11 1 Si kh 63 .1 32 .1 0. 2 3. 7 0. 8 0. 0 0. 1 0. 0 10 0. 0 95 .4 25 .7 13 .5 12 .1 3, 06 0 Bu dd hi st /N eo -B ud dh ist 74 .4 18 .0 1. 1 3. 2 2. 8 0. 1 0. 5 0. 0 10 0. 0 93 .4 17 .7 8. 5 9. 2 1, 93 0 Ja in 83 .9 13 .9 0. 1 1. 3 0. 5 0. 0 0. 3 0. 0 10 0. 0 97 .8 37 .2 21 .5 15 .7 26 5 O th er 40 .5 18 .7 1. 8 29 .3 8. 3 1. 1 0. 3 0. 0 10 0. 0 61 .0 11 .0 4. 3 6. 7 1, 59 2 C on tin ue d. . 234 z Maternal Health Ta bl e 8. 19 A ss ist an ce d ur in g de liv er y— C on tin ue d Pe rc en t d ist rib ut io n of li ve b irt hs to w om en a ge 1 5- 49 in th e fiv e ye ar s pr ec ed in g th e su rv ey b y pe rs on p ro vi di ng a ss ist an ce d ur in g de liv er y, p er ce nt ag e de liv er ed b y ca es ar ea n se ct io n (C -s ec tio n) , pe rc en ta ge d el iv er ed b y C -s ec tio n th at w as p la nn ed b ef or e th e on se t of la bo ur p ai ns , an d pe rc en ta ge d el iv er ed b y C -s ec tio n th at w as d ec id ed o n af te r th e on se t of la bo ur p ai ns , ac co rd in g to ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic Pe rs on p ro vi di ng a ss ist an ce d ur in g de liv er y To ta l Pe rc en ta ge de liv er ed b y a sk ill ed pr ov id er 1 Pe rc en ta ge de liv er ed b y ca es ar ea n se ct io n Ti m in g of d ec isi on to co nd uc t a C -s ec tio n N um be r of b irt hs D oc to r AN M / nu rs e/ m id w ife / LH V O th er he al th pe rs on ne l D ai (T BA ) Fr ie nd s/ re la tiv es O th er N o on e D on 't kn ow / m iss in g Be fo re on se t o f la bo ur pa in s A fte r on se t o f la bo ur pa in s C as te /tr ib e Sc he du le d ca st e 52 .2 27 .8 0. 6 11 .2 6. 8 1. 0 0. 3 0. 0 10 0. 0 80 .7 14 .5 8. 0 6. 3 53 ,8 51 Sc he du le d tr ib e 44 .8 25 .8 1. 0 17 .4 9. 3 1. 1 0. 6 0. 1 10 0. 0 71 .5 8. 3 4. 3 3. 9 26 ,3 50 O th er b ac kw ar d cl as s 54 .9 26 .4 0. 7 10 .6 6. 1 0. 9 0. 3 0. 1 10 0. 0 82 .0 17 .2 9. 3 7. 8 11 0, 39 9 O th er 66 .8 18 .0 0. 6 8. 4 5. 3 0. 6 0. 3 0. 0 10 0. 0 85 .3 23 .7 13 .2 10 .3 57 ,1 72 D on 't kn ow 57 .3 19 .8 1. 1 11 .9 8. 1 0. 7 0. 7 0. 4 10 0. 0 78 .2 15 .9 11 .1 4. 1 2, 19 4 W ea lth in de x Lo w es t 32 .4 30 .5 1. 2 21 .0 12 .3 1. 8 0. 7 0. 1 10 0. 0 64 .1 4. 4 1. 9 2. 5 63 ,3 94 Se co nd 48 .3 29 .0 0. 9 13 .0 7. 3 1. 0 0. 4 0. 1 10 0. 0 78 .3 9. 7 4. 9 4. 8 54 ,9 39 M id dl e 61 .5 24 .8 0. 5 7. 9 4. 4 0. 5 0. 2 0. 1 10 0. 0 86 .8 19 .0 10 .6 8. 3 49 ,5 77 Fo ur th 72 .2 19 .2 0. 3 4. 9 2. 9 0. 3 0. 1 0. 0 10 0. 0 91 .8 26 .8 15 .1 11 .5 45 ,3 05 H ig he st 80 .7 14 .6 0. 1 2. 4 2. 0 0. 2 0. 1 0. 0 10 0. 0 95 .5 35 .9 20 .7 15 .0 36 ,7 52 An te na ta l c ar e vi si ts 2 N on e 32 .9 25 .9 1. 3 22 .1 14 .4 2. 1 0. 9 0. 3 10 0. 0 60 .2 6. 4 3. 5 2. 7 30 ,4 66 1- 3 46 .6 32 .9 0. 8 12 .0 6. 5 1. 0 0. 3 0. 0 10 0. 0 80 .3 12 .1 6. 2 5. 8 58 ,0 96 4+ 74 .1 18 .2 0. 4 4. 3 2. 7 0. 3 0. 1 0. 0 10 0. 0 92 .7 27 .7 15 .6 12 .0 94 ,5 41 D on 't kn ow /m iss in g 69 .0 15 .5 0. 8 6. 6 6. 7 0. 5 0. 9 0. 0 10 0. 0 85 .3 22 .2 13 .7 7. 8 1, 53 7 Pl ac e of d el iv er y Pu bl ic s ec to r h ea lth fa ci lit y 60 .2 36 .9 0. 4 0. 7 1. 6 0. 2 0. 1 0. 0 10 0. 0 97 .4 11 .9 6. 5 5. 3 13 0, 20 0 N G O o r t ru st h os pi ta l/c lin ic 79 .4 16 .8 0. 1 0. 5 3. 2 0. 0 0. 0 0. 0 10 0. 0 96 .3 35 .8 20 .5 15 .0 1, 29 5 Pr iv at e se ct or h ea lth fa ci lit y 83 .6 13 .8 0. 1 0. 2 2. 0 0. 1 0. 1 0. 0 10 0. 0 97 .6 41 .0 22 .6 18 .1 65 ,6 93 O w n ho m e 9. 5 7. 7 2. 2 51 .3 24 .6 3. 4 1. 2 0. 0 10 0. 0 19 .4 0. 0 0. 0 0. 0 44 ,7 28 Pa re nt 's ho m e 16 .8 9. 9 2. 0 46 .5 20 .2 3. 8 0. 8 0. 0 10 0. 0 28 .7 0. 0 0. 0 0. 0 6, 76 9 O th er h om e 12 .6 18 .9 5. 4 37 .8 21 .2 1. 6 2. 5 0. 0 10 0. 0 36 .9 0. 0 0. 0 0. 0 51 4 O th er 3 28 .1 12 .8 0. 8 8. 6 18 .9 5. 5 4. 7 20 .5 10 0. 0 41 .7 0. 0 0. 0 0. 0 76 9 To ta l 56 .0 24 .7 0. 7 11 .0 6. 4 0. 9 0. 3 0. 1 10 0. 0 81 .4 17 .2 9. 4 7. 6 24 9, 96 7 N ot e: If th e re sp on de nt m en tio ne d m or e th an o ne p er so n at te nd in g du rin g de liv er y, o nl y th e m os t q ua lif ie d pe rs on is c on sid er ed in th is ta bu la tio n. AN M = A ux ili ar y nu rs e m id w ife ; L H V = L ad y he al th v isi to r; T BA = T ra di tio na l b irt h at te nd an t; N G O = N on go ve rn m en ta l o rg an iz at io n 1 Sk ill ed p ro vi de r i nc lu de s d oc to r, au xi lia ry n ur se m id w ife , n ur se , m id w ife , l ad y he al th v isi to r, an d ot he r h ea lth p er so nn el 2 Fo r t he m os t r ec en t b irt h in th e fiv e ye ar s pr ec ed in g th e su rv ey 3 In cl ud es m iss in g Maternal Health z�235 Table 8.20 Delivery costs The average out-of-pocket cost paid for delivery for the most recent live birth among women age 15-49 who had a live birth in the five years preceding the survey that was delivered in a health facility, according to background characteristics, India, 2015-16 Background characteristic Average cost (Rs.)1 Number of births in a health facility Public health facility Private health facility Any health facility Mother's age at birth <20 3,878 14,945 7,114 17,256 20-34 3,089 16,489 7,963 127,168 35-49 3,333 21,346 9,921 5,345 Birth order 1 3,877 18,441 9,951 56,965 2-3 3,072 15,439 7,281 76,164 4+ 1,968 11,824 4,115 16,638 Residence Urban 3,913 18,287 10,998 49,515 Rural 2,946 15,034 6,427 100,253 Schooling No schooling 2,193 12,228 4,235 32,556 <5 years complete 3,804 13,776 6,035 7,755 5-7 years complete 3,523 13,706 6,275 23,998 8-9 years complete 3,338 15,060 6,783 26,813 10-11 years complete 3,612 16,183 8,876 21,355 12 or more years complete 3,771 19,589 12,956 37,292 Religion Hindu 2,991 16,429 7,679 120,682 Muslim 4,277 16,257 8,764 21,380 Christian 3,996 20,864 11,603 3,163 Sikh 2,392 17,039 8,958 2,280 Buddhist/Neo-Buddhist 4,582 15,518 7,901 1,379 Jain 2,682 18,789 13,812 234 Other 3,752 12,739 5,499 650 Caste/tribe Scheduled caste 3,389 15,285 6,282 31,370 Scheduled tribe 2,474 14,273 4,671 13,293 Other backward class 2,635 16,542 7,974 66,093 Other 4,503 17,432 10,473 37,813 Don't know 2,594 12,134 5,140 1,198 Total 3,197 16,522 7,935 149,768 Note: Out-of-pocket 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�� � �� �� 2 WK HU � �� �� �� � �� �� �� �� �� �� �� �� � �� �� � �� �� �� �� �� � �� �� �� � � � � � � � � � 7R WD O� �� �� � �� �� �� �� �� �� �� �� �� �� � �� �� �� �� �� � �� �� �� �� 1 RW H� �3 RV WQ DW DO �F KH FN V�D UH �F KH FN V�R Q� WK H� QH Z ER UQ V� KH DO WK �Z LWK LQ �� �� GD \V �R I�W KH �E LUW K� �� �� ,Q FO XG HV �P LVV LQ J� � � � � 242 z Maternal Health Table 8.24 Type of provider of first postnatal check for the newborn Percent distribution of last births in the five years preceding the survey by type of provider for the newborn's first postnatal check during the two months after the birth, according to background characteristics, India, 2015-16 Background characteristic Type of health provider of newborn's first postnatal check No postnatal check Total Number of births Doctor ANM/nurse/ midwife/LHV Other health personnel Dai (TBA) ASHA Other Don't know/ missing Mother's age at birth <20 18.8 11.4 0.2 0.9 5.6 0.1 0.4 62.7 100.0 20,506 20-34 18.2 11.7 0.2 1.2 4.5 0.1 0.3 63.8 100.0 155,757 35-49 13.9 10.5 0.3 2.2 4.7 0.2 0.9 67.3 100.0 8,378 Birth order 1 21.8 10.7 0.2 0.7 4.5 0.1 0.3 61.7 100.0 62,584 2-3 18.3 11.8 0.2 1.2 4.5 0.1 0.3 63.5 100.0 94,026 4-5 10.0 12.8 0.3 2.1 5.4 0.2 0.4 68.7 100.0 20,939 6+ 6.9 12.0 0.4 3.3 4.9 0.5 0.5 71.6 100.0 7,091 Residence Urban 23.5 9.1 0.2 0.8 2.1 0.1 0.2 64.0 100.0 54,847 Rural 15.8 12.6 0.2 1.4 5.7 0.1 0.4 63.7 100.0 129,794 Mother's schooling No schooling 9.7 11.9 0.3 2.2 5.1 0.2 0.4 70.2 100.0 51,290 <5 years complete 15.5 13.2 0.3 1.7 6.3 0.2 0.4 62.5 100.0 10,753 5-7 years complete 17.2 12.7 0.2 1.3 5.3 0.1 0.3 62.8 100.0 29,402 8-9 years complete 19.4 12.8 0.2 0.9 5.3 0.1 0.3 61.0 100.0 30,990 10-11 years complete 23.9 10.9 0.1 0.6 3.6 0.1 0.4 60.4 100.0 23,134 12 or more years complete 26.0 9.3 0.1 0.5 3.0 0.0 0.3 60.9 100.0 39,071 Mother's religion Hindu 18.0 11.8 0.2 1.1 4.7 0.1 0.3 63.7 100.0 145,617 Muslim 17.1 9.7 0.2 1.8 3.9 0.3 0.3 66.7 100.0 29,734 Christian 21.7 10.2 0.4 1.0 4.6 0.1 0.8 61.1 100.0 3,900 Sikh 25.9 21.1 0.1 2.3 3.3 0.0 0.2 47.2 100.0 2,437 Buddhist/Neo-Buddhist 25.0 11.8 0.0 0.7 2.6 0.0 0.8 59.2 100.0 1,502 Jain 21.1 6.9 0.0 0.6 0.6 0.0 0.4 70.4 100.0 239 Other 14.7 14.4 1.3 2.4 14.0 0.0 0.1 53.0 100.0 1,210 Mother's caste/tribe Scheduled caste 17.7 13.0 0.3 1.2 5.2 0.1 0.3 62.1 100.0 39,059 Scheduled tribe 13.3 14.0 0.2 2.0 6.7 0.1 0.6 63.2 100.0 19,002 Other backward class 18.0 11.8 0.2 1.2 4.0 0.2 0.3 64.4 100.0 80,461 Other 20.9 9.0 0.1 1.0 4.4 0.1 0.3 64.1 100.0 44,560 Don't know 13.1 8.7 0.2 0.6 5.2 0.1 1.1 71.1 100.0 1,558 Wealth index Lowest 8.6 12.0 0.3 1.8 6.3 0.2 0.3 70.5 100.0 43,155 Second 14.3 13.2 0.2 1.5 6.1 0.2 0.4 64.1 100.0 39,070 Middle 19.8 12.9 0.2 1.2 4.4 0.1 0.4 61.0 100.0 36,722 Fourth 24.4 10.7 0.2 0.9 3.1 0.1 0.4 60.4 100.0 35,066 Highest 27.1 8.4 0.1 0.6 2.3 0.1 0.2 61.2 100.0 30,627 Place of delivery Public sector health facility 17.9 14.7 0.1 0.2 5.2 0.0 0.3 61.6 100.0 97,201 NGO or trust hospital/clinic 22.0 9.2 0.4 0.1 3.0 0.0 0.2 65.2 100.0 987 Private sector health facility 26.7 7.9 0.1 0.2 2.2 0.0 0.3 62.6 100.0 51,579 Own home 5.6 8.2 0.6 5.7 7.0 0.6 0.2 72.1 100.0 29,541 Parent's home 7.2 9.9 0.3 5.0 5.6 0.3 0.3 71.4 100.0 4,444 Other home 6.2 11.5 1.1 7.2 2.7 1.1 0.0 70.1 100.0 339 Other1 7.4 10.7 0.8 2.0 3.4 0.9 19.7 55.0 100.0 548 Total 18.1 11.6 0.2 1.2 4.6 0.1 0.3 63.8 100.0 184,641 ANM = Auxiliary nurse midwife; LHV = Lady health visitor; TBA = Traditional birth attendant; ASHA = Accredited Social Health Activist; NGO = Nongovernmental organization 1 Includes missing Maternal Health z�243 Table 8.25 Symptoms of postpartum complications Among women age 15-49 giving birth in the five years preceding the survey, percentage who had massive vaginal bleeding or very high fever within two months after the most recent delivery by background characteristics, India, 2015-16 Background characteristic Massive vaginal bleeding Very high fever Number of births Residence Urban 19.0 12.6 54,847 Rural 20.0 16.3 129,794 Mother's age at birth <20 21.2 14.7 20,506 20-34 19.5 15.1 155,757 35-49 18.4 17.9 8,378 Birth order 1 20.8 14.5 62,584 2-3 19.5 14.5 94,026 4-5 18.0 18.6 20,939 6+ 17.8 21.2 7,091 Place of delivery Public sector health facility 19.9 15.2 97,201 NGO or trust hospital/clinic 18.2 14.8 987 Private sector health facility 20.0 13.3 51,579 Own home 18.2 18.1 29,541 Parent's home 21.1 18.1 4,444 Other home 20.7 14.3 339 Other1 16.1 12.3 548 Assistance during delivery Doctor 20.4 13.6 108,192 ANM/nurse/midwife/LHV 18.8 17.0 44,474 Other health personnel 19.2 18.0 1,206 Dai (TBA) 17.8 17.4 17,821 Other1 19.5 18.9 12,378 No one 19.2 16.5 570 Total 19.7 15.2 184,641 NGO = Nongovernmental organization; ANM = Auxiliary nurse midwife; LHV = Lady health visitor; TBA = Traditional birth attendant 1 Includes missing 244 z Maternal Health Table 8.26 Maternal care indicators by state/union territory Maternal care indicators for births to mothers age 15-49 during the five years preceding the survey by state/union territory, India, 2015-16 State/union territory Percentage who received all recommended types of antenatal care1 Percentage of deliveries with a postnatal check2 for the mother Percentage of deliveries with a postnatal check for the mother in the first two days of birth2 India 20.9 69.0 65.1 North Chandigarh 34.7 91.2 90.6 Delhi 39.0 67.6 65.6 Haryana 19.5 73.4 70.8 Himachal Pradesh 36.8 80.4 76.4 Jammu & Kashmir 26.8 78.4 76.0 Punjab 30.7 90.9 89.3 Rajasthan 9.7 66.5 64.9 Uttarakhand 11.5 61.8 58.4 Central Chhattisgarh 21.7 74.1 69.0 Madhya Pradesh 11.4 59.4 56.9 Uttar Pradesh 5.9 61.6 58.8 East Bihar 3.3 48.6 45.9 Jharkhand 8.0 52.3 48.5 Odisha 23.0 82.3 78.5 West Bengal 21.8 71.4 63.7 Northeast Arunachal Pradesh 3.5 35.3 30.2 Assam 18.1 62.4 57.6 Manipur 33.9 69.2 65.9 Meghalaya 23.5 67.0 55.7 Mizoram 38.3 68.7 65.8 Nagaland 2.4 25.2 23.4 Sikkim 39.0 80.4 74.8 Tripura 7.6 65.3 63.0 West Dadra & Nagar Haveli 33.1 78.8 67.4 Daman & Diu 29.9 65.5 61.5 Goa 63.4 92.6 92.6 Gujarat 30.7 70.7 66.0 Maharashtra 32.4 82.1 79.7 South Andaman & Nicobar Islands 53.6 77.8 75.6 Andhra Pradesh 43.9 85.5 80.5 Karnataka 32.8 67.8 65.8 Kerala 61.2 89.3 88.8 Lakshadweep 65.9 92.7 92.7 Puducherry 55.6 92.9 84.9 Tamil Nadu 45.0 87.1 74.2 Telangana 42.1 86.3 82.6 1 For the last live birth in the five years preceding the survey, mother received four or more antenatal checks, received at least one tetanus toxoid injection, and took iron and folic acid tablets or syrup for 100 days or more 2 Based on the last live birth in the five years preceding the survey. Postnatal checks are checks on the woman's health within 42 days of the birth Maternal Health z�245 Table 8.27 Trends in maternal care indicators Maternal care indicators for births to women age 15-49 during the five years preceding the survey by residence, NFHS-4 and NFHS-3, India Indicator NFHS-4 (2015-16) NFHS-3 (2005-06) URBAN Percentage who received antenatal care1 90.7 90.7 Percentage who had at least three antenatal care visits1 77.0 74.7 Percentage who received antenatal care within the first trimester of pregnancy1 69.1 63.6 Percentage of births delivered in a health facility2 88.7 67.5 Percentage of deliveries assisted by a skilled provider2,3 90.0 73.5 RURAL Percentage who received antenatal care1 80.4 72.2 Percentage who had at least three antenatal care visits1 59.4 43.7 Percentage who received antenatal care within the first trimester of pregnancy1 54.2 36.7 Percentage of births delivered in a health facility2 75.1 28.9 Percentage of deliveries assisted by a skilled provider2,3 78.0 37.5 TOTAL Percentage who received antenatal care1 83.5 77.2 Percentage who had at least three antenatal care visits1 64.6 52.0 Percentage who received antenatal care within the first trimester of pregnancy1 58.6 43.9 Percentage of births delivered in a health facility2 78.9 38.7 Percentage of deliveries assisted by a skilled provider2,3 81.4 46.6 1 Based on the last birth to women in the five years preceding the survey 2 Based on all births to women in the five years preceding the survey 3 Doctor, auxiliary nurse midwife, nurse, midwife, lady health visitor, or other health personnel 246 z Maternal Health Table 8.28 Advice received during pregnancy Among women age 15-49 with a live birth in the five years preceding the survey who met with a community health worker in the last three months of pregnancy for their most recent live birth, percentage who received different types of advice, by background characteristics, India, 2015-16 Background characteristic Percentage who received advice on: Number of women who met with a community health worker in the last three months of pregnancy1 Importance of institutional delivery Cord care Breast- feeding Keeping the baby warm Family planning 0RWKHU·V�DJH�DW�ELUWK <20 79.5 72.2 81.9 77.3 68.5 11,005 20-34 78.9 71.7 80.5 75.8 69.9 77,411 35-49 72.4 64.8 72.1 68.0 61.6 3,406 Birth order 1 80.4 73.8 82.8 78.4 70.5 32,060 2-3 79.4 72.5 81.5 76.9 71.0 47,724 4+ 71.6 61.5 69.5 63.5 60.1 12,038 Residence Urban 81.2 75.7 83.9 80.1 75.6 21,633 Rural 77.9 70.3 79.3 74.3 67.5 70,189 Schooling No schooling 73.6 64.2 72.9 66.6 59.7 22,606 <5 years complete 78.3 69.9 79.0 74.6 68.9 5,887 5-7 years complete 79.5 72.9 81.0 76.2 70.0 15,959 8-9 years complete 79.5 72.8 81.7 77.4 71.5 17,374 10-11 years complete 82.7 76.7 86.2 82.9 75.8 12,497 12 or more years complete 81.0 75.4 84.5 80.4 74.9 17,500 Religion Hindu 79.1 71.9 80.7 75.8 69.7 73,947 Muslim 74.6 67.0 75.5 71.6 65.2 12,915 Christian 82.6 72.0 87.7 85.8 72.6 1,972 Sikh 88.6 84.8 90.7 85.4 77.1 1,528 Buddhist/Neo-Buddhist 74.5 83.1 86.1 81.3 81.6 685 Jain 75.2 71.7 76.0 69.8 70.4 68 Other 84.6 78.9 83.9 82.0 80.1 707 Caste/tribe Scheduled caste 80.0 72.7 81.1 76.0 69.9 21,340 Scheduled tribe 80.0 73.8 82.7 78.2 71.5 10,610 Other backward class 78.2 69.8 79.1 74.1 67.6 39,093 Other 77.7 72.7 81.1 77.3 71.3 20,068 Don't know 75.9 63.6 77.5 68.5 66.5 711 Total 78.7 71.5 80.4 75.7 69.4 91,822 1 Community health worker includes auxiliary nurse midwife (ANM), lady health visitor (LHV), Accredited Social Health Activist (ASHA), anganwadi worker, and other community health worker. Maternal Health z�247 Table 8.29 Delivery and postnatal care by state/union territory Percentage of live births in the five years preceding the survey delivered in a health facility, percentage delivered with assistance from a skilled provider, percentage delivered by caesarean section (C-section), percentage delivered by a C-section that was planned before the onset of labour pains, and percentage delivered by a C-section that was decided on after the onset of labour pains, and percentage of last-born children in the five years preceding the survey who received a postnatal check in the first two days of birth, by state/union territory, India, 2015-16 State/union territory Percent- age of births delivered in a public health facility Percent- age of births delivered in a private health facility Percent- age of births delivered in a health facility Percent- age of deliveries assisted by a skilled provider1 Percent- age of births delivered by caesarean section Timing of decision to conduct a C-section Percentage of children who received postnatal care from a skilled provider in the first two days of birth1 Before onset of labour pains After onset of labour pains India 52.1 26.8 78.9 81.4 17.2 9.4 7.6 24.2 North Chandigarh 72.4 19.3 91.6 93.3 22.6 13.8 8.7 50.5 Delhi 55.5 28.8 84.4 86.6 26.7 15.2 10.5 21.1 Haryana 52.0 28.4 80.4 84.6 11.7 5.8 5.8 21.4 Himachal Pradesh 61.6 14.8 76.4 78.9 16.7 8.9 7.3 29.0 Jammu & Kashmir 78.1 7.5 85.6 87.5 33.1 21.9 10.8 20.3 Punjab 51.6 38.8 90.5 94.1 24.6 13.5 11.1 47.2 Rajasthan 63.5 20.5 84.0 86.5 8.6 4.5 4.0 22.6 Uttarakhand 43.8 24.9 68.6 71.2 13.1 6.7 5.9 19.2 Central Chhattisgarh 55.9 14.4 70.2 78.0 9.9 4.5 5.4 34.2 Madhya Pradesh 69.4 11.4 80.8 78.0 8.6 4.7 3.8 17.5 Uttar Pradesh 44.5 23.3 67.8 70.4 9.4 4.1 5.2 24.4 East Bihar 47.6 16.2 63.8 69.9 6.2 2.5 3.7 10.8 Jharkhand 41.8 20.1 61.9 69.6 9.9 4.4 5.5 21.7 Odisha 75.8 9.5 85.3 86.5 13.8 6.4 7.3 29.5 West Bengal 56.6 18.6 75.2 81.6 23.8 13.2 10.5 26.7 Northeast Arunachal Pradesh 42.7 9.6 52.2 53.7 8.9 4.5 3.3 8.0 Assam 59.9 10.6 70.6 74.3 13.4 6.9 6.3 22.9 Manipur 45.7 23.4 69.1 77.2 21.1 13.1 8.0 10.7 Meghalaya 39.5 11.9 51.4 53.8 7.6 5.0 2.3 9.0 Mizoram 63.7 16.0 79.7 83.6 12.7 9.6 3.1 11.0 Nagaland 25.1 7.7 32.8 41.3 5.8 2.9 2.9 1.6 Sikkim 82.7 12.0 94.7 97.1 20.9 15.2 5.6 12.7 Tripura 69.1 10.8 79.9 80.9 20.5 12.0 8.5 8.4 West Dadra & Nagar Haveli 66.4 21.6 88.0 89.5 16.2 11.3 4.9 20.7 Daman & Diu 43.0 47.1 90.1 77.0 15.7 6.5 7.0 19.4 Goa 58.2 38.7 96.9 97.5 31.4 16.4 15.0 49.5 Gujarat 32.6 55.9 88.5 87.1 18.4 9.4 8.9 15.7 Maharashtra 48.9 41.4 90.3 91.1 20.1 11.9 8.2 30.5 South Andaman & Nicobar Islands 92.0 4.3 96.4 97.2 19.3 10.6 8.6 23.1 Andhra Pradesh 38.3 53.2 91.5 92.1 40.1 25.4 14.4 28.5 Karnataka 61.2 32.8 94.0 93.7 23.6 13.0 10.4 22.3 Kerala 38.3 61.5 99.8 99.9 35.8 22.7 12.8 49.1 Lakshadweep 64.3 35.0 99.3 100.0 38.4 26.5 11.8 56.9 Puducherry 82.0 17.9 99.9 100.0 33.6 21.5 12.1 36.0 Tamil Nadu 66.6 32.3 98.9 99.2 34.1 20.6 13.2 35.4 Telangana 30.5 60.9 91.5 91.3 57.7 34.1 23.4 25.2 1 A skilled provider includes a doctor, auxiliary nurse midwife, nurse, midwife, lady health visitor, and other health personnel. For birth attendance, if the woman mentioned more than one person attending the delivery, only the most qualified person is considered in this table. 248 z Maternal Health Table 8.30 Birth order and delivery characteristics by state/union territory Percentage of births to women age 15-49 during the three years preceding the survey of birth order 3 or more, percentage of women who had a live birth in the five years preceding the survey by antenatal care (ANC) provider during pregnancy for the most recent live birth, by state/union territory, India, 2015-16 State/union territory Percentage of births of order 3 or more Percentage of births receiving antenatal care from a doctor Percentage of births receiving antenatal care from an ANM/nurse/ midwife/LHV India 28.5 58.8 23.1 North Chandigarh 23.4 61.1 41.3 Delhi 25.2 76.7 15.6 Haryana 25.6 48.3 34.8 Himachal Pradesh 16.6 77.7 16.0 Jammu & Kashmir 29.0 81.8 10.8 Punjab 17.6 59.3 42.3 Rajasthan 32.8 54.9 31.2 Uttarakhand 28.5 52.2 26.2 Central Chhattisgarh 28.8 44.0 51.8 Madhya Pradesh 28.6 31.3 40.5 Uttar Pradesh 41.6 36.8 38.2 East Bihar 43.5 30.4 19.7 Jharkhand 34.7 39.0 33.9 Odisha 23.3 75.9 8.6 West Bengal 16.9 78.9 11.6 Northeast Arunachal Pradesh 39.4 45.4 14.9 Assam 28.4 58.8 27.7 Manipur 29.0 86.6 2.4 Meghalaya 50.2 62.3 20.3 Mizoram 41.5 67.5 22.5 Nagaland 42.1 35.5 9.4 Sikkim 14.4 70.8 29.3 Tripura 10.9 92.2 1.5 West Dadra & Nagar Haveli 24.5 56.5 33.5 Daman & Diu 18.4 66.7 14.0 Goa 21.3 87.4 8.9 Gujarat 24.5 71.0 11.6 Maharashtra 20.0 77.5 16.3 South Andaman & Nicobar Islands 13.6 31.6 71.9 Andhra Pradesh 13.8 90.7 8.3 Karnataka 17.0 82.3 6.4 Kerala 12.9 98.9 0.5 Lakshadweep 23.6 99.3 1.1 Puducherry 8.9 87.9 11.0 Tamil Nadu 11.3 83.1 12.2 Telangana 15.6 85.8 11.4 ANM = Auxiliary nurse midwife; LHV = Lady health visitor Maternal Health z�249 CHILD HEALTH 9 Key Findings x Birth weight: Seventy-eight percent of live births in the five years preceding the survey had a written record of the child’s weight at the time of birth or the mother was able to recall the child’s weight. Eighteen percent of these births had a low birth weight (less than 2.5 kg), down from 22 percent in 2005-06. x Vaccination coverage: Sixty-two percent of children age 12-23 months received all basic vaccinations, up from 44 percent in 2005-06. Almost two-thirds of children (63%) received three doses of hepatitis B vaccine. x Symptoms of acute respiratory infection (ARI): Three percent of children under five years had symptoms of ARI in the two weeks before the survey, and advice or treatment was sought from a health facility or provider for 78 percent of those children. x Diarrhoea: Nine percent of children under age five years had diarrhoea in the two weeks before the survey, and advice or treatment was sought from a health facility or provider for 68 percent of those children. Thirty-eight percent of children with diarrhoea received continued feeding and oral rehydration therapy (ORT), as recommended. x Disposal of children’s stools: Only 36 percent of young children’s stools are disposed of safely. x Integrated Child Development Services (ICDS) for children under age six years: Fifty-four percent of children received any service from an anganwadi centre. Forty-eight percent received food supplements. x Services from ICDS during pregnancy and while breastfeeding: Fifty-four percent of pregnant women and 49 percent of breastfeeding women received any service from an anganwadi centre. nformation on child health and survival can help policymakers and programme managers assess the efficacy of current strategies, formulate appropriate interventions to prevent deaths from childhood illnesses, and improve the health of children in India. This chapter presents information on birth weight and vaccination status for young children. It also looks at the prevalence of, and treatment practices for, three common childhood illnesses: symptoms of acute respiratory infection (ARI), fever, and I Child Health ‡ 251Child Health z�251 diarrhoea. Because appropriate sanitary practices can help prevent and reduce the severity of diarrhoeal disease, information is also provided on the disposal of children’s stools. 9.1 BIRTH WEIGHT Low birth weight Births with a reported birth weight less than 2.5 kg regardless of gestational age Sample: Live births in the five years before the survey that have a reported birth weight, either from a written record or mother’s report Birth weight is an important indicator when assessing a child’s health for early exposure to childhood morbidity and mortality. Children who weigh less than 2.5 kilograms (kg) at birth are considered to have a higher-than-average risk of early childhood death. In the 2015-16 National Family Health Survey, birth weight was recorded from either a written record or the mother’s report. The mother’s estimate of the infant’s size at birth was also obtained because the birth weight is unknown for many infants. For 78 percent of births, a written record of birth weight was available or the mother was able to recall the birth weight (Table 9.1). Eighteen percent of these infants had a low birth weight of less than 2.5 kg. Low birth weight decreases with an increase in the mother’s schooling and household wealth status. Only 15 percent of births to mothers having 12 or more years of schooling have a low birth weight, compared with 20 percent of births to mothers having no schooling. Similarly, 15 percent of births to mothers in households in the highest wealth quintile have a low birth weight, compared with 20 percent of births to mothers in the lowest wealth quintile households. The pattern of birth weight by background characteristics may be affected by the availability of birth weight records or the mother’s recall and should be interpreted with caution. Table 9.1 also includes information on the mother’s estimate of her infant’s size at birth. The mother’s estimate of size is subjective, but can be a useful proxy for the child’s weight. Three percent of births are reported as very small, 9 percent as smaller than average, and 86 percent as average or larger than average. 9.2 VACCINATION OF CHILDREN Immunizing children against vaccine preventable diseases can greatly reduce childhood morbidity and mortality. Information on vaccination coverage was collected from the child’s health card and direct reporting from the mother. Coverage of all basic vaccinations Children age 12-23 months who received specific vaccines at any time before the survey (according to a vaccination card or the mother's report). To have received all basic vaccinations, a child must receive at least: x one dose of BCG vaccine, which protects against tuberculosis x three doses of DPT vaccine, which protects against diphtheria, pertussis (whooping cough), and tetanus x three doses of polio vaccine x one dose of measles vaccine Sample: Living children age 12-23 months In India, 62 percent of children age 12-23 months received all basic vaccinations at any time before the survey, and 54 percent received all basic vaccinations by age 12 months (Table 9.3). 252 ‡ Child Health252 z Child Health Figure 9.1 shows the coverage for each of the basic vaccinations among children age 12-23 months. Coverage was highest for the BCG vaccine (92%) and lowest for the third dose of polio vaccine (73%). Although more children received the first doses of the DPT and polio vaccines than the second or third doses, the dropout rates are higher for polio than for DPT (Table 9.4). Ninety percent of children age 12-23 months received the first DPT dose and 78 percent received the last dose. These percentages were 91 percent and 73 percent for the polio vaccine. Six percent of children age 12-23 months received no vaccinations. Sixty-three percent of children received three doses of hepatitis B vaccine. Trends: The percentage of children age 12-23 months who have received all basic vaccinations increased from 44 percent in 2005-06 to 62 percent in 2015-16 (Figure 9.2). Between 2005-06 and 2015-16, this percentage increased more in rural areas (from 39% to 61%) than in urban areas (from 58% to 64%). The proportion of children who received no vaccinations remained low in both surveys (5-6%). Patterns by background characteristics x Children age 12-23 months of first birth order are much more likely to receive all basic vaccinations than children of birth order 6 or more (67% versus 43%) (Table 9.4). x Vaccination coveUDJH�LQFUHDVHV�ZLWK�LQFUHDVLQJ�PRWKHU¶V�VFKRROLQJ�����SHUFHQW�RI�FKLOGUHQ�DJH���-23 months whose mothers have 12 or more years of schooling have received all basic vaccinations, compared with 52 percent of children whose mothers have no schooling (Figure 9.3). 92 90 86 78 91 86 73 81 62 6.0 BCG 1 2 3 1 2 3 All basic None Measles Polio DPT 44 62 5.1 6.0 NFHS-3 NFHS-4 All basic vaccinations No vaccinations Figure 9.2 Trends in Childhood Vaccinations Percentage of children age 12-23 months Figure 9.1 Childhood Vaccinations Percentage of children age 12-23 months Child Health z�253 x Sikh children are more likely to have received all basic vaccinations than Muslim or Buddhist/Neo-Buddhist children (89% versus 55-56%). x Vaccination coverage increases with increasing wealth status; 70 percent of children age 12-23 months from households in the highest wealth quintile received all basic vaccinations, compared with 53 percent of children from households in the lowest wealth quintile. x Coverage of all basic vaccinations varies considerably by state and union territory. The coverage is highest in Puducherry, Punjab, Lakshadweep, and Goa (88-91%) and lowest in Nagaland (35%) and Arunachal Pradesh (38%) (Table 9.5 and Figure 9.4). Vaccination cards are a critical tool in ensuring that a child receives all recommended vaccinations on schedule. All mothers were not able to produce a vaccination card for their child at the time of the interview; vaccination cards were available for only 63 percent of children age 12-23 months (Table 9.4). 52 63 61 66 68 70 No schooling <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete 12 or more years complete Figure 9.3 Coverage with All Basic Vaccinations by Mother's Schooling Percentage of children age 12-23 months 254 z Child Health 9.3 SYMPTOMS OF ACUTE RESPIRATORY INFECTION Mothers reported that 3 percent of children under age five years had symptoms of acute respiratory infection (ARI) in the two weeks before the survey. The prevalence of symptoms of ARI is highest among children age 6-11 months and Sikhs (4% each) (Table 9.7). Treatment of acute respiratory infection (ARI) symptoms Children with ARI symptoms for whom advice or treatment was sought. ARI symptoms consist of cough accompanied by (1) short, rapid breathing that is chest related, and/or (2) difficult breathing that is chest related. Sample: Children under age five years with symptoms of ARI in the two weeks before the survey Advice or treatment was sought for 78 percent of children under age five years with ARI symptoms in the two weeks before the survey (Table 9.7); advice or treatment was sought the same or the next day for 58 percent of children (Table 9.8). Seeking advice or treatment increases with increasing PRWKHU¶V schooling and household wealth status. Seeking advice or 35 38 43 47 50 51 51 54 55 55 56 58 61 62 62 62 62 63 65 66 66 68 69 70 70 73 75 76 79 80 82 83 84 88 89 89 91 Nagaland Arunachal Pradesh Dadra & Nagar Haveli Assam Gujarat Mizoram Uttar Pradesh Madhya Pradesh Tripura Rajasthan Maharashtra Uttarakhand Meghalaya Bihar Jharkhand INDIA Haryana Karnataka Andhra Pradesh Manipur Daman & Diu Telangana Delhi Himachal Pradesh Tamil Nadu Andaman & Nicobar Islands Jammu & Kashmir Chhattisgarh Odisha Chandigarh Kerala Sikkim West Bengal Goa Lakshadweep Punjab Puducherry Figure 9.4 Coverage with All Basic Vaccinations by State/UT Percentage of children age 12-23 months by State/UT Percentage of children age 12-23 months Child Health z�255 treatment ranges between 32 percent in Nagaland to 96 percent in Kerala. Seeking advice or treatment the same day or the next day ranges between 17 percent in Arunachal Pradesh to 100 percent in the Andaman & Nicobar Islands. 9.4 FEVER Fever is a symptom of malaria, but it is also associated with other childhood illnesses that may contribute to high levels of malnutrition, morbidity, and mortality in young children. Treatment of fever Children with fever for whom advice or treatment was sought. Sample: Children under age five years with fever in the two weeks before the survey Among children under age five years, 13 percent had fever in the two weeks before the survey. The prevalence of fever peaks at 18 percent among children age 6-11 months (Table 9.9). Seventy-three percent of children with fever were taken to a health facility or provider for advice or treatment, and advice or treatment was sought the same day or the next day for 58 percent of children. Twenty-one percent of children under age five years with fever were given antibiotic drugs. 9.5 DIARRHOEAL DISEASE 9.5.1 Prevalence of Diarrhoea Mothers reported that 9 percent of children under age five years had diarrhoea in the two weeks before the survey (Table 9.10). Advice or treatment was sought for 68 percent of children under age five years who had diarrhoea in the two weeks before the survey (Table 9.11). Patterns by background characteristics x The prevalence of diarrhoea rises from 11 percent among children under age six months to 16 percent among those age 6-11 months, when complementary foods and other liquids are introduced. Prevalence remains high (13%) at age 12-23 months, which is the time when children begin to walk and are at increased risk of contamination from the environment (Figure 9.5). x Differences by other characteristics are generally quite small. Figure 9.5 Prevalence of Diarrhoea by Age Percentage of children under age five years 11 16 13 8.5 5.8 4.6 9.2 <6 6-11 12-23 24-35 36-47 48-59 <60 Age in months 256 z Child Health 9.5.2 Treatment of Diarrhoea Oral rehydration therapy Children with diarrhoea are given increased fluids or a fluid made from a special packet of oral rehydration salt (ORS) or gruel. Sample: Children under age five years with diarrhoea in the two weeks before the survey Oral rehydration therapy (ORT) is a simple and effective way to reduce dehydration caused by diarrhoea. Sixty percent of children with diarrhoea received some form of ORT—ORS packets (51%) or gruel (28%) or increased fluids (7%) (Figure 9.6). While 19 percent of children received antibiotics, 15 percent were given both zinc and ORS, which can reduce the duration and severity of diarrhoea. Thirty-eight percent received continued feeding and ORT, as recommended. Eighteen percent of children with diarrhoea did not receive any treatment. Trends: The proportion of children with diarrhoea who received fluid from ORS packets increased from 26 percent in 2005-06 to 51 percent in 2015-16. The percentage of children who did not receive any treatment decreased from 26 percent in 2005-06 to 18 percent in 2015-16. Patterns by background characteristics x Urban children with diarrhoea are more likely than rural children to receive fluid from an ORS packet (59% versus 48%) (Table 9.11). x The use of ORS packets for the treatment of diarrhoea among the states ranges from 38 percent in Uttar Pradesh to 77 percent in Meghalaya. 18 12 0.3 12 5.5 38 19 15 20 60 6.7 57 28 51 68 No treatment Home remedy/herbal/other Intravenous solution Other drug Antimotility drug Continued feeding and ORT Antibiotic drug ORS and zinc Zinc Any ORT Increased fluids Either ORS or gruel Gruel Fluid from ORS packet Sought advice or treatment Figure 9.6 Treatment of Diarrhoea Percentage of children under age five years with diarrhoea in the two weeks before the survey Child Health z�257 x Children in households in the lowest wealth quintile (34%) are less likely to receive continued feeding and ORT than children in households in the highest wealth quintile (45%). 9.5.3 Feeding Practices Appropriate feeding practices Children with diarrhoea are given more liquids than usual, and as much food or more than usual. Sample: Children under age five years with diarrhoea in the two weeks before the survey To reduce dehydration and minimise the effects of diarrhoea on nutritional status, mothers are encouraged to continue normal feeding of children with diarrhoea and to increase the amount of fluids. Only 7 percent of children under five years with diarrhoea in the two weeks before the survey were given more liquids than usual, as recommended. Thirty-one percent received the same amount of liquids. Of greater concern, 57 percent of children with diarrhoea were given less to drink and 5 percent were not given anything to drink (Figure 9.8). Only 31 percent of children with diarrhoea were fed according to the recommended practice of giving the same or more food to the sick child. Fifty-six percent of children were given less food than usual, while 3 percent who had previously been given food received no food during the diarrhoea. For additional information on feeding practices during diarrhoea, see Table 9.13 and Table 9.14. 258 ‡ Child Health Figure 9.7 Prevalence and Treatment of Childhood Illness Percentage of children under age five years with symptoms of illness in the two weeks before the survey and percentage with an illness for whom advice or treatment was sought from a health facility or provider 2.7 13 9.2 78 73 68 ARI Fever Diarrhoea ARI Fever Diarrhoea 78 With symptoms of illness With illness for whom advice or treatment was sought 258 z Child Health 9.5.4 Knowledge of ORS Packets Eighty-six percent of women in India know about ORS packets for the treatment of diarrhoea (Table 9.15). Knowledge of ORS packets is highest among women living in urban areas (92%), women with 12 or more years of schooling (95%), women in the wealthiest households (95%), and Sikh women (97%). 9.6 DISPOSAL OF CHILDREN’S STOOLS Safe disposal of children’s stools The child’s last stools were put or rinsed into a toilet or latrine, buried, or the child used a toilet or latrine. Sample: Youngest child under age five years living with the mother Proper disposal of children’s faeces is important to prevent the spread of disease. Only 36 percent of youngest children under age five years living with their mother had their last stools disposed of safely (Table 9.16). Patterns by background characteristics x Children’s stools are more likely to be disposed of safely in households with an improved toilet facility that is not shared (59%) or a shared toilet (51%) than in households with an unimproved facility or no facility (12%). x Children’s stools are much more likely to be disposed of safely in urban households (61%) than in rural households (26%). x Stools are disposed of safely for 59 percent of children of mothers with 12 or more years of schooling, compared with only 18 percent of children of mothers with no schooling. x Stools are safely disposed of for 75 percent of children in households belonging to the highest wealth quintile, compared with only 10 percent of children in households in the lowest wealth quintile. x The proportion of children whose stools are disposed of safely varies from 13 percent in Odisha and 17 percent in Bihar to 92 percent in Kerala and 98 percent in Sikkim. Child Health ‡ 259 0 5 Figure 9.8 Feeding Practices during Diarrhoea Percentage of children under age five years with diarrhoea in the two weeks before the survey 4.1 6.7 27 31 35 36 20 21 2.6 5.2 0.7 0.5 11Food given Liquids given More Same as usual Somewhat less Much less None Don't know Never gave food (compared to usual) (compared to usual) in the two weeks before the survey Child Health z�259 9.7 UTILIZATION OF INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) Established in 1975 under India’s largest ICDS programme, anganwadi centres (AWCs) provide health, nutrition, and education services for children from birth to six years of age, as well as nutritional and health services for pregnant and breastfeeding mothers. The programme is implemented through a network of community-level anganwadi centres. Fifty-four percent of children under age six years receive one or more services from an AWC (Table 9.18). The provision of food supplements is the service most likely to be used (48%), but 38-43 percent receive growth monitoring, immunizations, health check-ups, and early childhood care or preschool services. Patterns by background characteristics x Rural children are more likely to receive any service from an AWC (59%) than urban children (40%). x The proportion of children receiving supplementary food from an anganwadi centre ranges from 14 percent in Delhi to 75 percent in Odisha. 9.7.1 Utilization of ICDS by Pregnant and Lactating Mothers Pregnant and lactating mothers can receive supplementary food from an anganwadi centre. Anganwadi centres also monitor the health status of mothers during pregnancy and breastfeeding and provide them with health and nutritional education. Forty-six percent of mothers did not receive any AWC services during pregnancy for their children under six years, and 51 percent did not receive any service from an AWC while breastfeeding children born in the six years preceding the survey. Pregnant and breastfeeding mothers were more likely to have received supplementary food than health check-ups or health and nutrition education. Patterns by background characteristics x Services during pregnancy and while breastfeeding are utilized more for births to women in rural areas than urban areas. x The percentage of women receiving supplementary food during pregnancy and while breastfeeding is higher in almost all states than the percentage receiving health check-ups or health and nutrition education. 260 ‡ Child Health260 z Child Health LIST OF TABLES For more information on low birth weight, vaccinations, childhood illness, the disposal of children’s stools, and the utilization of ICDS services, see the following tables: Tables Table 9.1 Child's weight and size at birth Table 9.2 Child's weight and size at birth by state/union territory Table 9.3 Vaccinations by source of information Table 9.4 Vaccinations by background characteristics Table 9.5 Vaccinations by state/union territory Table 9.6 Trends over time in vaccinations Table 9.7 Prevalence and treatment of symptoms of ARI Table 9.8 Prevalence and treatment of symptoms of ARI by state/union territory Table 9.9 Prevalence and treatment of fever Table 9.10 Prevalence of diarrhoea Table 9.11 Diarrhoea treatment Table 9.12 Diarrhoea treatment by state/union territory Table 9.13 Feeding practices during diarrhoea Table 9.14 Feeding practices during diarrhoea by state/union territory Table 9.15 Knowledge of ORS packets Table 9.16 Disposal of children's stools Table 9.17 Disposal of children's stools by state/union territory Table 9.18 Indicators of utilization of ICDS services by background characteristics Table 9.19 Indicators of utilization of ICDS services by state/union territory Table 9.20 Utilization of ICDS services during pregnancy and while breastfeeding Table 9.21 Indicators of women’s utilization of ICDS services during pregnancy and while breastfeeding by state/union territory Child Health z�261 Table 9.1 Child's weight and size at birth Percent distribution of live births in the five years preceding the survey with a reported birth weight by birth weight, percentage of live births with a reported birth weight, and percent distribution of alO�OLYH�ELUWKV�LQ�WKH�ILYH�\HDUV�SUHFHGLQJ�WKH�VXUYH\�E\�PRWKHU·V�HVWLPDWH�RI� child's size at birth, according to background characteristics, India, 2015-16 Background characteristic Percent distribution of live births with a reported birth weight1 Total Number of births Percentage of all live births whose birth weight was reported1 Percent distribution of all live births by size of child at birth Total Number of births Less than 2.5 kg 2.5 kg or more Very small Smaller than average Average or larger Don't know/ missing Mother's age at birth <20 20.6 79.4 100.0 27,758 81.8 3.5 9.9 84.9 1.7 100.0 33,928 20-34 17.8 82.2 100.0 161,383 78.2 3.0 8.8 86.6 1.6 100.0 206,369 35-49 18.2 81.8 100.0 5,677 58.7 4.1 9.5 82.9 3.5 100.0 9,670 Birth order 1 19.5 80.5 100.0 84,135 86.5 3.2 9.3 86.3 1.1 100.0 97,213 2-3 17.0 83.0 100.0 91,662 77.9 2.8 8.5 87.0 1.7 100.0 117,595 4-5 18.5 81.5 100.0 15,298 58.2 3.5 9.8 83.8 2.9 100.0 26,273 6+ 18.4 81.6 100.0 3,723 41.9 4.4 10.0 81.7 3.9 100.0 8,885 Residence Urban 17.6 82.4 100.0 62,079 88.5 2.5 8.0 88.5 1.0 100.0 70,118 Rural 18.5 81.5 100.0 132,739 73.8 3.3 9.4 85.3 2.0 100.0 179,849 Mother's schooling No schooling 20.1 79.9 100.0 43,808 58.0 3.8 9.8 83.5 2.9 100.0 75,535 <5 years complete 20.4 79.6 100.0 11,133 73.8 3.7 9.9 83.5 2.9 100.0 15,079 5-7 years complete 19.6 80.4 100.0 33,137 81.3 3.1 9.4 86.0 1.5 100.0 40,773 8-9 years complete 18.8 81.2 100.0 34,943 84.8 2.9 9.1 86.7 1.3 100.0 41,205 10-11 years complete 17.0 83.0 100.0 27,360 91.6 2.3 8.2 88.8 0.7 100.0 29,868 12 or more years complete 15.1 84.9 100.0 44,437 93.5 2.4 7.5 89.6 0.5 100.0 47,506 Religion Hindu 18.5 81.5 100.0 156,052 79.4 3.1 9.1 86.2 1.6 100.0 196,629 Muslim 17.3 82.7 100.0 28,536 69.0 3.2 9.0 85.6 2.1 100.0 41,379 Christian 17.1 82.9 100.0 4,269 83.5 2.1 8.1 86.3 3.5 100.0 5,111 Sikh 17.7 82.3 100.0 2,906 95.0 2.7 8.9 88.0 0.4 100.0 3,060 Buddhist/Neo-Buddhist 15.9 84.1 100.0 1,844 95.5 1.6 8.6 88.8 1.0 100.0 1,930 Jain 20.9 79.1 100.0 254 95.7 4.2 2.8 92.5 0.5 100.0 265 Other 12.2 87.8 100.0 957 60.1 1.9 6.6 90.1 1.5 100.0 1,592 Caste/tribe Scheduled caste 19.1 80.9 100.0 41,128 76.4 3.2 9.3 85.9 1.6 100.0 53,851 Scheduled tribe 20.5 79.5 100.0 19,458 73.8 2.9 9.8 83.9 3.4 100.0 26,350 Other backward class 17.7 82.3 100.0 84,750 76.8 3.3 8.9 86.4 1.4 100.0 110,399 Other 17.2 82.8 100.0 47,832 83.7 2.6 8.6 87.3 1.5 100.0 57,172 Don't know 25.0 75.0 100.0 1,650 75.2 4.0 8.5 83.5 4.0 100.0 2,194 Continued. 262 z Child Health Table 9.1 Child's weight and size at birth³Continued Percent distribution of live births in the five years preceding the survey with a reported birth weight by birth weight, percentage of live births with a reported birth weight, and percent distribution of all live births in the five years preceding the survey by moWKHU·V�HVWLPDWH�RI� child's size at birth, according to background characteristics, India, 2015-16 Background characteristic Percent distribution of live births with a reported birth weight1 Total Number of births Percentage of all live births whose birth weight was reported1 Percent distribution of all live births by size of child at birth Total Number of births Less than 2.5 kg 2.5 kg or more Very small Smaller than average Average or larger Don't know/ missing Wealth index Lowest 19.7 80.3 100.0 36,595 57.7 4.0 10.2 82.9 2.9 100.0 63,394 Second 19.1 80.9 100.0 40,899 74.4 3.4 9.4 84.9 2.2 100.0 54,939 Middle 18.7 81.3 100.0 41,719 84.1 2.8 9.0 87.0 1.3 100.0 49,577 Fourth 18.1 81.9 100.0 40,863 90.2 2.6 8.5 88.1 0.7 100.0 45,305 Highest 15.1 84.9 100.0 34,742 94.5 2.1 6.9 90.5 0.5 100.0 36,752 Mother's current tobacco use Uses tobacco 20.8 79.2 100.0 9,644 64.6 4.3 10.4 81.4 4.0 100.0 14,932 Does not use tobacco 18.1 81.9 100.0 185,174 78.8 3.0 8.9 86.5 1.5 100.0 235,035 Total 18.2 81.8 100.0 194,818 77.9 3.1 9.0 86.2 1.7 100.0 249,967 1 Based on either a written record or the mother's recall Child Health z�263 Table 9.2 Child's weight and size at birth by state/union territory Among live births in the five years preceding the survey with a reported birth weight, the percent distribution by birth weight and the percentage whose weight was reported, and the percent distribution of all live births in the five years preceding the survey by mother's estimate of child's size at birth, according to state/union territory, India, 2015-16 State/union territory Percent distribution of live births with a reported birth weight1 Total Percentage of live births whose birth weight was reported1 Percent distribution of all live births by size of child at birth Total Less than 2.5 kg 2.5 kg or more Very small Smaller than average Average or larger Don't know/ missing India 18.2 81.8 100.0 77.9 3.1 9.0 86.2 1.7 100.0 North Chandigarh 22.2 77.8 100.0 94.9 3.1 7.8 88.7 0.5 100.0 Delhi 26.6 73.4 100.0 84.0 2.3 6.7 88.6 2.4 100.0 Haryana 20.4 79.6 100.0 86.0 1.9 7.5 90.2 0.4 100.0 Himachal Pradesh 19.6 80.4 100.0 81.5 2.9 10.7 84.9 1.6 100.0 Jammu & Kashmir 14.0 86.0 100.0 70.6 3.3 7.0 85.4 4.2 100.0 Punjab 17.2 82.8 100.0 94.0 2.7 10.0 87.0 0.4 100.0 Rajasthan 21.4 78.6 100.0 78.7 2.5 7.9 87.7 1.9 100.0 Uttarakhand 24.7 75.3 100.0 64.1 5.9 8.7 84.7 0.7 100.0 Central Chhattisgarh 12.6 87.4 100.0 84.8 1.9 8.1 88.2 1.8 100.0 Madhya Pradesh 21.9 78.1 100.0 80.8 4.2 8.7 85.1 2.0 100.0 Uttar Pradesh 20.7 79.3 100.0 53.0 4.7 10.7 83.3 1.3 100.0 East Bihar 14.4 85.6 100.0 58.7 4.2 9.6 84.2 2.1 100.0 Jharkhand 14.5 85.5 100.0 69.2 2.2 7.5 89.5 0.9 100.0 Odisha 20.8 79.2 100.0 92.1 2.9 10.5 83.9 2.7 100.0 West Bengal 16.7 83.3 100.0 86.6 2.3 10.2 85.9 1.6 100.0 Northeast Arunachal Pradesh 10.7 89.3 100.0 51.3 2.6 9.0 76.0 12.5 100.0 Assam 15.8 84.2 100.0 75.5 2.3 12.8 77.5 7.5 100.0 Manipur 9.1 90.9 100.0 71.8 2.2 11.2 84.1 2.5 100.0 Meghalaya 12.2 87.8 100.0 63.3 1.2 6.8 80.4 11.6 100.0 Mizoram 6.0 94.0 100.0 88.8 0.6 7.4 89.9 2.1 100.0 Nagaland 7.8 92.2 100.0 37.8 1.4 9.3 83.4 5.9 100.0 Sikkim 8.4 91.6 100.0 98.2 1.0 3.3 95.2 0.5 100.0 Tripura 17.5 82.5 100.0 82.2 1.4 10.9 73.6 14.1 100.0 West Dadra & Nagar Haveli 23.1 76.9 100.0 87.5 0.7 6.0 93.0 0.3 100.0 Daman & Diu 17.8 82.2 100.0 84.2 0.8 4.5 87.8 6.9 100.0 Goa 22.3 77.7 100.0 97.4 2.1 7.2 89.6 1.1 100.0 Gujarat 19.0 81.0 100.0 91.4 2.7 10.8 84.9 1.6 100.0 Maharashtra 19.5 80.5 100.0 95.3 2.2 8.5 88.7 0.6 100.0 South Andaman & Nicobar Islands 16.2 83.8 100.0 98.2 1.5 4.1 93.6 0.7 100.0 Andhra Pradesh 17.6 82.4 100.0 95.9 1.8 6.9 89.7 1.7 100.0 Karnataka 17.2 82.8 100.0 94.8 2.8 5.7 90.0 1.5 100.0 Kerala 15.5 84.5 100.0 99.5 1.2 6.4 92.3 0.1 100.0 Lakshadweep 18.4 81.6 100.0 97.4 2.7 12.9 82.7 1.6 100.0 Puducherry 15.9 84.1 100.0 99.2 1.0 5.5 93.6 0.0 100.0 Tamil Nadu 16.4 83.6 100.0 98.7 1.7 8.4 89.6 0.3 100.0 Telangana 15.9 84.1 100.0 96.8 2.4 5.0 91.3 1.2 100.0 1 Based on either a written record or the mother's recall 264 z Child Health Ta bl e 9. 3 Va cc in at io ns b y so ur ce o f i nf or m at io n Pe rc en ta ge o f c hi ld re n ag e 12 -2 3 m on th s w ho re ce iv ed sp ec ifi c va cc in es a t a ny ti m e be fo re th e su rv ey , b y so ur ce o f i nf or m at io n (v ac ci na tio n ca rd o r m ot he r's re po rt ), an d pe rc en ta ge v ac ci na te d by 1 2 m on th s of a ge , I nd ia , 2 01 5- 16 So ur ce o f i nf or m at io n BC G H ep at iti s B1 D PT Po lio 2 M ea sle s Al l ba sic va cc in at io ns 3 Al l a ge ap pr op ria te va cc in at io ns 4 N o va cc in at io ns N um be r of ch ild re n 0 1 2 3 1 2 3 0 1 2 3 Va cc in at ed a t a ny ti m e b ef or e su rv ey Va cc in at io n ca rd 98 .4 74 .3 92 .6 90 .5 86 .2 97 .4 95 .3 92 .2 88 .6 98 .3 96 .5 92 .6 87 .9 82 .9 62 .7 0. 4 30 ,2 40 M ot he r's re po rt 80 .7 50 .5 65 .0 54 .2 22 .5 75 .9 69 .1 54 .6 62 .7 77 .9 67 .8 38 .8 69 .4 26 .0 8. 9 15 .7 17 ,5 99 Ei th er s ou rc e 91 .9 65 .6 82 .5 77 .1 62 .7 89 .5 85 .7 78 .4 79 .1 90 .8 86 .0 72 .8 81 .1 62 .0 42 .9 6. 0 47 ,8 39 Va cc in at ed b y 12 m on th s of a ge 5 91 .4 64 .6 81 .8 76 .0 60 .7 88 .6 84 .4 75 .9 78 .7 90 .2 84 .9 70 .7 71 .3 53 .9 37 .4 6. 0 47 ,8 39 1 H ep at iti s B 0 is th e he pa tit is va cc in at io n gi ve n at b irt h 2 P ol io 0 is th e po lio v ac ci na tio n gi ve n at b irt h 3 B C G , m ea sle s, a nd th re e do se s ea ch o f D PT a nd p ol io v ac ci ne (e xc lu di ng p ol io v ac ci ne g iv en a t b irt h) 4 B C G , m ea sle s, fo ur d os es o f h ep at iti s B, a nd th re e do se s ea ch o f D PT a nd p ol io v ac ci ne (e xc lu di ng p ol io v ac ci ne g iv en a t b irt h) 5 F or c hi ld re n w ho se in fo rm at io n w as b as ed o n th e m ot he r's re po rt, th e pr op or tio n of v ac ci na tio ns g iv en d ur in g th e fir st y ea r o f l ife w as a ss um ed to b e th e sa m e as fo r c hi ld re n w ith a w rit te n re co rd o f v ac ci na tio n. Child Health z�265 Ta bl e 9. 4 V ac ci na tio ns b y ba ck gr ou nd c ha ra ct er ist ic s Pe rc en ta ge o f c hi ld re n ag e 12 -2 3 m on th s w ho re ce iv ed s pe ci fic v ac ci ne s at a ny ti m e be fo re th e su rv ey (a cc or di ng to a v ac ci na tio n ca rd o r t he m ot he r's re po rt ), an d pe rc en ta ge w ith a v ac ci na tio n ca rd s ee n, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic B C G H ep at iti s B1 D PT Po lio 2 M ea sle s Al l b as ic va cc i- na tio ns 3 A ll ag e ap pr o- pr ia te va cc i- na tio ns 4 N o va cc i- na tio ns Pe rc en ta ge w ith a va cc in at io n ca rd s ee n N um be r of ch ild re n 0 1 2 3 1 2 3 0 1 2 3 Se x M al e 92 .1 65 .9 82 .5 77 .1 62 .5 89 .7 85 .9 78 .3 79 .4 91 .0 86 .0 72 .4 81 .7 62 .1 43 .1 5. 9 62 .8 24 ,7 50 Fe m al e 91 .7 65 .2 82 .4 77 .1 63 .0 89 .3 85 .4 78 .5 78 .7 90 .6 85 .9 73 .3 80 .4 61 .9 42 .8 6. 2 63 .6 23 ,0 89 Bi rt h or de r 1 93 .8 69 .8 85 .2 80 .5 66 .9 91 .9 88 .7 82 .5 82 .4 92 .4 88 .4 76 .4 84 .8 67 .3 47 .8 4. 7 67 .9 18 ,2 97 2- 3 92 .3 66 .0 82 .9 77 .3 62 .6 89 .7 85 .9 78 .4 79 .6 91 .1 86 .2 72 .5 81 .3 61 .4 42 .7 5. 7 62 .9 23 ,1 37 4- 5 87 .0 54 .4 75 .8 69 .0 53 .1 84 .1 78 .3 69 .0 70 .7 86 .8 79 .7 64 .9 72 .9 51 .0 31 .0 9. 5 52 .8 4, 94 7 6+ 78 .1 44 .0 64 .8 59 .6 45 .3 74 .0 68 .1 58 .7 57 .9 79 .1 73 .1 61 .0 59 .9 43 .3 25 .2 16 .6 44 .5 1, 45 8 Re si de nc e U rb an 93 .2 70 .7 84 .1 78 .5 63 .3 90 .3 86 .7 80 .2 83 .8 91 .9 87 .1 73 .4 83 .2 63 .8 46 .0 5. 1 65 .3 13 ,6 02 Ru ra l 91 .4 63 .6 81 .8 76 .6 62 .5 89 .2 85 .2 77 .7 77 .2 90 .4 85 .5 72 .6 80 .3 61 .3 41 .7 6. 4 62 .4 34 ,2 37 M ot he r's s ch oo lin g N o sc ho ol in g 86 .4 55 .2 74 .4 68 .3 53 .5 82 .9 77 .8 68 .3 69 .3 85 .7 79 .2 64 .7 71 .5 51 .5 33 .3 10 .2 52 .1 13 ,2 48 < 5 ye ar s co m pl et e 92 .0 61 .4 83 .6 77 .8 64 .8 90 .1 86 .2 78 .8 77 .6 91 .6 85 .9 73 .0 80 .5 63 .2 41 .3 5. 8 63 .9 2, 82 0 5- 7 ye ar s co m pl et e 92 .5 65 .1 82 .7 77 .4 62 .1 89 .9 85 .6 78 .4 79 .3 91 .5 86 .6 72 .8 81 .4 61 .2 41 .2 5. 2 63 .3 7, 59 5 8- 9 ye ar s co m pl et e 93 .8 67 .6 84 .6 79 .6 65 .3 92 .1 88 .7 82 .0 81 .2 92 .7 88 .9 75 .9 84 .8 65 .9 45 .1 4. 6 66 .9 8, 15 5 10 -1 1 ye ar s co m pl et e 94 .5 73 .5 87 .2 81 .4 68 .4 92 .4 89 .2 82 .8 85 .5 92 .8 88 .8 77 .4 85 .6 67 .6 50 .1 4. 2 70 .3 6, 08 4 12 o r m or e ye ar s co m pl et e 95 .5 74 .5 88 .1 83 .7 69 .5 94 .0 91 .4 86 .1 86 .6 94 .1 90 .4 78 .3 88 .1 69 .7 51 .3 3. 5 70 .3 9, 93 7 Re li g io n H in du 92 .9 67 .4 83 .6 78 .2 63 .6 90 .7 87 .0 79 .7 80 .5 91 .7 86 .9 73 .6 82 .7 63 .0 44 .2 5. 3 63 .8 37 ,4 74 M us lim 87 .1 56 .3 76 .8 71 .5 56 .6 84 .0 78 .9 71 .2 71 .9 86 .3 80 .8 67 .5 73 .2 55 .4 34 .8 9. 8 57 .8 8, 08 8 C hr ist ia n 90 .2 64 .1 80 .8 73 .5 61 .4 87 .9 84 .7 78 .0 76 .4 90 .6 85 .8 72 .7 76 .6 61 .7 40 .9 7. 0 66 .9 1, 00 0 Si kh 98 .6 92 .3 95 .1 92 .6 89 .7 98 .1 96 .6 94 .4 96 .5 97 .6 96 .1 93 .4 93 .8 88 .9 81 .6 1. 2 89 .9 59 8 Bu dd hi st /N eo -B ud dh ist 86 .7 58 .2 82 .3 79 .8 69 .6 83 .7 78 .0 70 .2 76 .3 87 .3 86 .1 73 .6 78 .7 55 .9 34 .8 9. 7 68 .4 33 5 Ja in (9 5. 9) (7 3. 5) (8 6. 4) (8 2. 2) (5 9. 3) (9 0. 8) (9 0. 8) (8 8. 4) (7 8. 7) (9 3. 6) (8 5. 7) (6 7. 6) (9 2. 0) (6 3. 7) (4 0. 3) (4 .1 ) (5 0. 0) 42 O th er 96 .5 55 .7 77 .7 74 .5 63 .5 91 .1 87 .0 79 .9 73 .6 94 .5 88 .0 77 .2 85 .8 69 .1 39 .5 2. 5 63 .2 30 2 C on tin ue d. . 266 z Child Health Ta bl e 9. 4 V ac ci na tio ns b y ba ck gr ou nd c ha ra ct er ist ic s— C on tin ue d Pe rc en ta ge o f c hi ld re n ag e 12 -2 3 m on th s w ho re ce iv ed s pe ci fic v ac ci ne s at a ny ti m e be fo re th e su rv ey (a cc or di ng to a v ac ci na tio n ca rd o r t he m ot he r's re po rt ), an d pe rc en ta ge w ith a v ac ci na tio n ca rd s ee n, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic B C G H ep at iti s B1 D PT Po lio 2 M ea sle s A ll ba sic va cc i- na tio ns 3 A ll ag e ap pr o- pr ia te va cc i- na tio ns 4 N o va cc i- na tio ns Pe rc en ta ge w ith a va cc in at io n ca rd s ee n N um be r of ch ild re n 0 1 2 3 1 2 3 0 1 2 3 C as te /tr ib e Sc he du le d ca st e 92 .5 65 .9 83 .4 78 .5 64 .3 90 .2 86 .7 79 .3 79 .5 91 .5 86 .9 74 .2 81 .5 63 .2 43 .8 5. 4 65 .0 10 ,2 07 Sc he du le d tri be 88 .7 62 .8 78 .0 72 .2 56 .9 86 .4 82 .0 73 .5 74 .5 87 .7 82 .1 66 .3 77 .4 55 .8 38 .4 9. 2 56 .2 4, 95 6 O th er b ac kw ar d cl as s 92 .3 66 .8 82 .5 76 .7 62 .4 89 .9 86 .0 78 .2 79 .7 91 .1 86 .2 73 .4 81 .1 61 .9 43 .9 5. 5 62 .9 21 ,1 04 O th er 92 .2 64 .8 83 .9 79 .3 65 .1 89 .7 86 .0 80 .5 79 .7 91 .0 86 .7 73 .9 82 .8 64 .5 42 .9 6. 1 65 .6 11 ,1 49 D on 't kn ow 84 .2 49 .9 71 .2 66 .2 48 .8 83 .7 77 .9 67 .1 71 .0 86 .3 80 .2 62 .3 71 .6 46 .0 24 .7 11 .2 52 .8 42 3 W ea lth in de x Lo w es t 87 .0 55 .0 75 .8 70 .2 55 .2 84 .2 79 .5 70 .0 68 .9 86 .2 80 .4 65 .9 73 .2 52 .8 33 .5 10 .0 52 .9 11 ,7 42 Se co nd 91 .2 62 .2 81 .3 76 .0 62 .1 88 .6 84 .4 76 .8 76 .7 90 .2 84 .9 71 .8 78 .9 60 .6 40 .4 6. 3 62 .9 10 ,3 08 M id dl e 93 .2 68 .1 84 .5 79 .1 64 .9 91 .2 87 .4 80 .5 81 .2 92 .5 87 .9 75 .0 83 .1 64 .2 44 .9 4. 8 65 .4 9, 68 3 Fo ur th 94 .8 71 .9 86 .1 80 .7 66 .4 93 .0 89 .2 83 .4 85 .6 93 .5 89 .4 76 .6 85 .7 66 .9 48 .1 3. 7 69 .0 8, 93 9 H ig he st 95 .4 76 .3 87 .8 82 .9 68 .6 92 .9 90 .9 85 .3 88 .1 93 .5 89 .9 78 .0 88 .8 70 .0 52 .9 3. 7 70 .3 7, 16 7 To ta l 91 .9 65 .6 82 .5 77 .1 62 .7 89 .5 85 .7 78 .4 79 .1 90 .8 86 .0 72 .8 81 .1 62 .0 42 .9 6. 0 63 .2 47 ,8 39 1 H ep at iti s B 0 is th e he pa tit is va cc in at io n gi ve n at b irt h 2 P ol io 0 is th e po lio v ac ci na tio n gi ve n at b irt h 3 B C G , m ea sle s, a nd th re e do se s ea ch o f D PT a nd p ol io v ac ci ne (e xc lu di ng p ol io v ac ci ne g iv en a t b irt h) 4 B C G , m ea sle s, fo ur d os es o f h ep at iti s B , a nd th re e do se s ea ch o f D PT a nd p ol io v ac ci ne (e xc lu di ng p ol io v ac ci ne g iv en a t b irt h) ( ) B as ed o n 25 -4 9 un w ei gh te d ca se s Child Health z�267 Ta bl e 9. 5 V ac ci na tio ns b y st at e/ un io n te rr ito ry Pe rc en ta ge o f c hi ld re n ag e 12 -2 3 m on th s w ho re ce iv ed sp ec ifi c va cc in es a t a ny ti m e be fo re th e su rv ey (a cc or di ng to a v ac ci na tio n ca rd o r t he m ot he r's re po rt) , a nd p er ce nt ag e w ith a va cc in at io n ca rd s ee n, b y st at e/ un io n te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry BC G H ep at iti s B1 D PT Po lio 2 M ea sle s Al l b as ic va cc i- na tio ns 3 Al l a ge ap pr o- pr ia te va cc i- na tio ns 4 N o va cc i- na tio ns Pe rc en ta ge w ith a va cc in at io n ca rd s ee n 0 1 2 3 1 2 3 0 1 2 3 In di a 91 .9 65 .6 82 .5 77 .1 62 .7 89 .5 85 .7 78 .4 79 .1 90 .8 86 .0 72 .8 81 .1 62 .0 42 .9 6. 0 63 .2 N or th C ha nd ig ar h (9 5. 9) (8 9. 4) (9 5. 9) (9 3. 2) (8 2. 6) (9 5. 9) (9 5. 9) (9 5. 9) (9 3. 2) (9 2. 7) (9 0. 1) (7 9. 5) (9 5. 9) (7 9. 5) (7 3. 0) (4 .1 ) (7 8. 0) D el hi 95 .0 75 .6 85 .2 79 .3 62 .7 93 .3 89 .5 84 .8 83 .8 94 .2 90 .1 79 .0 91 .1 68 .8 46 .3 2. 9 71 .0 H ar ya na 92 .8 67 .7 68 .4 62 .9 54 .3 87 .6 83 .6 76 .5 83 .8 90 .2 84 .7 75 .3 79 .0 62 .2 45 .4 6. 3 70 .6 H im ac ha l P ra de sh 94 .8 71 .6 92 .4 87 .1 74 .1 95 .2 91 .8 85 .0 75 .8 94 .6 91 .7 82 .4 87 .5 69 .5 50 .2 2. 7 70 .8 Ja m m u & K as hm ir 95 .6 85 .5 82 .1 78 .1 70 .3 94 .1 91 .6 88 .1 92 .7 94 .3 91 .6 83 .8 86 .2 75 .1 61 .7 3. 5 80 .4 Pu nj ab 98 .2 94 .2 95 .8 94 .3 91 .0 96 .7 96 .3 94 .5 96 .8 97 .5 96 .5 93 .7 93 .1 89 .0 84 .7 1. 7 90 .9 Ra ja st ha n 88 .8 67 .4 76 .9 69 .8 53 .0 86 .1 81 .0 71 .6 76 .3 87 .9 81 .1 65 .4 78 .1 54 .8 39 .1 7. 4 50 .3 U tta ra kh an d 92 .8 59 .6 83 .2 76 .9 59 .4 90 .7 86 .1 79 .9 73 .8 90 .4 83 .5 67 .9 80 .4 57 .6 33 .5 5. 2 57 .8 C en tr al C hh at tis ga rh 98 .4 80 .4 92 .2 90 .1 76 .4 97 .9 96 .2 91 .4 90 .6 97 .9 94 .7 81 .7 93 .9 76 .4 61 .2 0. 8 71 .5 M ad hy a Pr ad es h 91 .6 74 .6 81 .6 74 .4 56 .3 89 .7 84 .4 73 .4 82 .6 88 .9 81 .2 63 .6 79 .6 53 .6 44 .4 6. 1 52 .8 U tta r P ra de sh 87 .6 45 .2 76 .8 69 .7 52 .8 83 .7 77 .7 66 .5 64 .1 86 .8 80 .6 68 .3 70 .8 51 .1 25 .6 8. 7 52 .5 Ea st Bi ha r 91 .6 65 .0 83 .6 79 .9 65 .5 90 .2 87 .2 80 .1 76 .3 89 .9 85 .1 72 .9 79 .4 61 .7 43 .5 6. 5 58 .9 Jh ar kh an d 95 .8 55 .0 75 .3 70 .6 56 .3 93 .5 89 .1 82 .3 70 .1 92 .8 87 .9 73 .8 82 .6 61 .9 29 .6 2. 9 64 .1 O di sh a 94 .1 81 .2 92 .2 90 .1 83 .2 93 .1 92 .4 89 .2 89 .0 93 .3 91 .4 82 .8 87 .9 78 .6 69 .1 5. 8 81 .1 W es t B en ga l 97 .5 55 .7 95 .3 93 .8 86 .4 96 .6 95 .3 92 .7 81 .9 96 .7 95 .0 87 .9 92 .8 84 .4 46 .7 2. 0 84 .2 N or th ea st A ru na ch al P ra de sh 70 .9 30 .1 61 .3 53 .3 40 .9 68 .4 60 .3 52 .3 45 .1 75 .2 65 .8 53 .7 54 .6 38 .2 17 .2 19 .7 47 .1 A ss am 82 .3 45 .4 74 .9 68 .2 52 .0 81 .4 76 .9 66 .5 56 .6 83 .0 75 .0 56 .0 71 .4 47 .1 25 .3 13 .8 55 .3 M an ip ur 91 .2 25 .9 84 .5 80 .1 69 .8 90 .4 86 .0 77 .8 38 .5 93 .3 88 .7 76 .6 74 .2 65 .8 19 .5 5. 2 69 .5 M eg ha la ya 85 .9 33 .9 77 .1 73 .0 62 .8 83 .0 80 .0 73 .9 53 .1 86 .2 80 .9 70 .9 71 .8 61 .4 23 .2 11 .6 67 .1 M iz or am 75 .3 40 .5 72 .3 66 .3 57 .0 75 .5 71 .9 61 .9 47 .4 76 .5 72 .2 61 .8 61 .3 50 .7 25 .1 22 .1 63 .2 N ag al an d 68 .1 29 .4 61 .1 53 .5 45 .3 67 .8 60 .5 51 .6 45 .9 76 .2 67 .0 52 .1 50 .1 35 .4 17 .4 19 .1 52 .1 Si kk im 98 .9 84 .6 94 .7 90 .8 84 .1 98 .9 97 .5 93 .0 94 .8 98 .9 94 .9 87 .7 93 .3 83 .0 71 .7 1. 1 79 .6 Tr ip ur a 82 .4 32 .3 65 .2 60 .1 54 .4 80 .4 78 .0 71 .1 49 .3 85 .8 78 .8 70 .1 69 .7 54 .5 19 .6 13 .0 66 .5 C on tin ue d. . 268 z Child Health Ta bl e 9. 5 V ac ci na tio ns b y st at e/ un io n te rr ito ry — C on tin ue d Pe rc en ta ge o f c hi ld re n ag e 12 -2 3 m on th s w ho re ce iv ed sp ec ifi c va cc in es a t a ny ti m e be fo re th e su rv ey (a cc or di ng to a v ac ci na tio n ca rd o r t he m ot he r's re po rt) , a nd p er ce nt ag e w ith a va cc in at io n ca rd s ee n, b y st at e/ un io n te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry BC G H ep at iti s B1 D PT Po lio 2 M ea sle s Al l b as ic va cc i- na tio ns 3 Al l a ge ap pr o- pr ia te va cc i- na tio ns 4 N o va cc i- na tio ns Pe rc en ta ge w ith a va cc in at io n ca rd s ee n 0 1 2 3 1 2 3 0 1 2 3 W es t D ad ra & N ag ar H av el i 88 .9 55 .0 77 .5 72 .6 52 .1 92 .9 90 .8 73 .3 69 .6 93 .2 85 .9 58 .1 81 .7 43 .2 27 .5 3. 4 63 .3 D am an & D iu 84 .3 69 .8 74 .7 65 .5 60 .6 77 .9 76 .3 74 .0 79 .7 84 .3 80 .7 74 .4 79 .1 66 .3 52 .6 15 .7 67 .6 G oa 10 0. 0 91 .5 91 .8 90 .0 85 .2 95 .9 95 .4 94 .2 97 .6 10 0. 0 98 .7 92 .9 96 .5 88 .4 82 .7 0. 0 90 .3 G uj ar at 87 .9 55 .6 62 .4 54 .7 38 .6 85 .3 80 .8 72 .7 77 .2 88 .4 83 .9 62 .3 75 .0 50 .4 26 .6 8. 7 50 .3 M ah ar as ht ra 90 .0 69 .5 84 .6 80 .0 60 .8 85 .8 80 .9 74 .8 82 .8 89 .0 84 .3 67 .0 82 .8 56 .2 41 .2 8. 2 60 .7 So ut h A nd am an & N ic ob ar Is la nd s 87 .4 75 .9 87 .0 86 .6 83 .1 87 .4 87 .4 83 .5 85 .5 87 .4 87 .4 83 .8 76 .4 73 .2 62 .3 12 .6 86 .3 A nd hr a Pr ad es h 97 .2 84 .4 93 .4 88 .0 68 .8 96 .5 94 .5 89 .0 93 .1 94 .8 89 .3 72 .3 89 .4 65 .2 55 .5 2. 3 62 .2 Ka rn at ak a 92 .5 80 .9 81 .5 74 .1 58 .9 90 .3 86 .0 77 .9 87 .9 91 .8 88 .0 74 .6 82 .4 62 .6 50 .2 6. 2 63 .2 Ke ra la 98 .1 76 .4 92 .6 90 .0 82 .4 95 .4 93 .8 90 .4 95 .1 96 .7 94 .5 88 .5 89 .4 82 .1 61 .0 1. 7 86 .1 La ks ha dw ee p 10 0. 0 85 .8 96 .8 96 .8 88 .9 96 .8 96 .8 95 .1 98 .4 98 .5 98 .5 92 .1 93 .7 89 .0 74 .9 0. 0 92 .1 Pu du ch er ry 99 .9 93 .8 96 .6 93 .4 89 .4 99 .5 98 .5 96 .0 97 .3 99 .9 98 .8 95 .4 95 .4 91 .2 82 .7 0. 1 93 .2 Ta m il N ad u 94 .9 82 .1 83 .7 76 .9 68 .2 92 .4 89 .0 84 .5 92 .9 94 .9 92 .2 82 .3 85 .1 69 .7 57 .4 3. 4 80 .3 Te la ng an a 97 .4 88 .2 93 .8 87 .1 70 .5 95 .6 93 .9 87 .9 95 .3 95 .9 90 .9 75 .2 90 .1 67 .5 59 .1 1. 1 68 .3 1 H ep at iti s B 0 is th e he pa tit is va cc in at io n gi ve n at b irt h 2 P ol io 0 is th e po lio v ac ci na tio n gi ve n at b irt h 3 B C G , m ea sle s, a nd th re e do se s ea ch o f D PT a nd p ol io v ac ci ne (e xc lu di ng p ol io v ac ci ne g iv en a t b irt h) 4 B C G , m ea sle s, fo ur d os es o f h ep at iti s B , a nd th re e do se s ea ch o f D PT a nd p ol io v ac ci ne (e xc lu di ng p ol io v ac ci ne g iv en a t b irt h) ( ) B as ed o n 25 -4 9 un w ei gh te d ca se s Child Health z�269 Table 9.6 Trends over time in vaccinations Percentage of children age 12-23 months who received specific vaccines at any time before the survey (according to a vaccination card or the mother's report), and percentage with a vaccination card seen, by residence, India Vaccinations given any time before the survey Urban Rural Total NFHS-4 (2015-16) NFHS-3 (2005-06) NFHS-4 (2015-16) NFHS-3 (2005-06) NFHS-4 (2015-16) NFHS-3 (2005-06) BCG 93.2 86.9 91.4 75.1 91.9 78.1 DPT 1 90.3 84.4 89.2 73.0 89.5 76.0 DPT 2 86.7 78.1 85.2 62.6 85.7 66.7 DPT 3 80.2 69.1 77.7 50.4 78.4 55.3 Polio 01 83.8 68.5 77.2 41.3 79.1 48.4 Polio 1 91.9 94.8 90.4 92.5 90.8 93.1 Polio 2 87.1 91.1 85.5 88.0 86.0 88.8 Polio 3 73.4 83.1 72.6 76.5 72.8 78.2 Measles 83.2 71.8 80.3 54.2 81.1 58.8 All basic vaccinations2 63.8 57.6 61.3 38.6 62.0 43.5 No vaccinations 5.1 3.3 6.4 5.7 6.0 5.1 Percentage with a vaccination card seen 65.3 46.2 62.4 34.5 63.2 37.5 Number of children 13,602 2,723 34,237 7,696 47,839 10,419 1 Polio 0 is the polio vaccination given at birth 2 BCG, measles, and three doses each of DPT and polio vaccine (excluding polio vaccine given at birth) 270 z Child Health Table 9.7 Prevalence and treatment of symptoms of ARI Among children under age five, the percentage who had symptoms of acute respiratory infection (ARI) in the two weeks preceding the survey and the percentage with symptoms of ARI for whom treatment was sought from a health facility or provider, India, 2015-16 Background characteristic Children under age five Children under age five with symptoms of ARI Percentage with symptoms of ARI1 Number of children Percentage for whom advice or treatment was sought from a health facility or provider2 Number of children Age in months <6 2.6 21,368 76.7 565 6-11 4.0 24,740 79.5 980 12-23 3.3 47,839 79.7 1,578 24-35 2.6 47,398 78.6 1,233 36-47 2.4 49,829 77.5 1,216 48-59 2.0 47,771 75.0 957 Sex Male 2.9 124,493 80.4 3,671 Female 2.5 114,452 75.2 2,858 Residence Urban 2.3 67,958 86.2 1,567 Rural 2.9 170,987 75.5 4,962 Mother's schooling No schooling 2.7 71,004 72.6 1,909 <5 years complete 2.8 14,240 70.7 399 5-7 years complete 3.0 38,852 78.2 1,182 8-9 years complete 2.9 39,507 79.2 1,152 10-11 years complete 2.5 28,999 83.6 734 12 or more years complete 2.5 46,343 85.1 1,153 Religion Hindu 2.6 187,795 77.9 4,965 Muslim 3.2 39,564 78.5 1,277 Christian 2.1 4,969 72.2 106 Sikh 4.0 2,963 92.1 120 Buddhist/Neo-Buddhist 1.8 1,878 (82.8) 34 Jain 1.9 262 * 5 Other 1.5 1,514 32.9 22 Caste/tribe Scheduled caste 3.0 51,209 78.6 1,559 Scheduled tribe 2.2 25,051 70.5 556 Other backward class 2.7 105,385 78.5 2,859 Other 2.7 55,206 80.2 1,493 Don't know 3.0 2,094 67.8 63 Mother's current tobacco use Uses tobacco 3.3 13,862 68.2 454 Does not use tobacco 2.7 225,084 78.8 6,075 Continued. Child Health z�271 Table 9.7 Prevalence and treatment of symptoms of ARI—Continued Among children under age five, the percentage who had symptoms of acute respiratory infection (ARI) in the two weeks preceding the survey and the percentage with symptoms of ARI for whom treatment was sought from a health facility or provider, India, 2015-16 Background characteristic Children under age five Children under age five with symptoms of ARI Percentage with symptoms of ARI1 Number of children Percentage for whom advice or treatment was sought from a health facility or provider2 Number of children Cooking fuel Electricity or gas3 2.4 82,996 84.7 1,979 Kerosene 1.8 2,376 88.1 43 Coal/lignite 3.7 2,325 82.0 87 Charcoal 3.3 1,483 (69.9) 49 Wood/straw4 2.8 125,005 75.0 3,494 Animal dung 3.5 24,655 75.1 873 Other 4.6 106 * 5 Wealth index Lowest 3.1 59,416 69.3 1,825 Second 2.9 52,153 75.1 1,495 Middle 2.7 47,494 80.5 1,275 Fourth 2.6 43,896 85.0 1,123 Highest 2.3 35,986 90.0 811 Total 2.7 238,945 78.1 6,529 1 Symptoms of ARI include cough accompanied by short, rapid breathing which is chest related and/or difficult breathing which is chest related 2 Excludes pharmacy, shop, and traditional healer 3 Includes LPG, natural gas, and biogas 4 Includes grass, shrubs, and crop waste ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases 272 z Child Health Table 9.8 Prevalence and treatment of symptoms of ARI by state/union territory Among children under age five, the percentage who had symptoms of acute respiratory infection (ARI) in the two weeks preceding the survey and the percentage with symptoms of ARI for whom advice or treatment was sought from a health facility or provider, according to state/union territory, India, 2015-16 State/union territory Children under age five Children under age five with symptoms of ARI Percentage with symptoms of ARI1 Percentage for whom advice or treatment was sought from a health facility or provider2 Percentage for whom advice or treatment was sought the same day or the next day India 2.7 78.1 58.0 North Chandigarh 2.8 * * Delhi 2.4 (71.9) (63.0) Haryana 3.2 80.6 67.0 Himachal Pradesh 1.6 89.0 37.9 Jammu & Kashmir 5.4 81.9 51.0 Punjab 4.1 92.3 87.9 Rajasthan 2.1 87.8 56.0 Uttarakhand 4.6 80.1 41.2 Central Chhattisgarh 2.2 77.9 45.3 Madhya Pradesh 2.1 72.3 38.3 Uttar Pradesh 4.7 76.5 64.3 East Bihar 2.5 68.0 47.6 Jharkhand 3.2 68.8 38.5 Odisha 2.4 70.7 43.9 West Bengal 3.3 76.8 65.9 Northeast Arunachal Pradesh 2.1 51.3 16.8 Assam 1.0 62.7 32.3 Manipur 1.7 45.8 21.3 Meghalaya 5.8 76.3 72.7 Mizoram 2.2 63.6 47.4 Nagaland 1.4 32.3 26.2 Sikkim 0.3 * * Tripura 2.6 (55.2) (40.8) West Dadra & Nagar Haveli 1.9 * * Daman & Diu 0.6 * * Goa 1.4 * * Gujarat 1.4 79.1 48.3 Maharashtra 2.4 89.3 62.1 South Andaman & Nicobar Islands 1.5 * * Andhra Pradesh 0.5 * * Karnataka 1.2 91.5 57.5 Kerala 0.8 * * Lakshadweep 0.9 * * Puducherry 3.0 (76.7) (58.0) Tamil Nadu 2.8 88.6 65.7 Telangana 2.0 (87.9) (64.2) 1 Symptoms of ARI include cough accompanied by short, rapid breathing which is chest related and/or difficult breathing which is chest related 2 Excludes pharmacy, shop, and traditional healer ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases Child Health z�273 Table 9.9 Prevalence and treatment of fever Among children under age five, the percentage who had a fever in the two weeks preceding the survey and the percentage of children with fever for whom advice or treatment was sought from a health facility or provider and who took antibiotic drugs, by background characteristics, India, 2015-16 Background characteristic Children under age five Children under age five with fever Percentage with fever Number of children Percentage for whom advice or treatment was sought from a health facility or provider1 Percentage for whom advice or treatment was sought the same day or next day Percentage who took antibiotic drugs Number of children Age in months <6 12.2 21,368 70.8 56.6 16.2 2,612 6-11 17.6 24,740 77.2 61.9 20.1 4,358 12-23 16.9 47,839 74.4 59.3 20.6 8,105 24-35 12.8 47,398 72.4 58.5 20.3 6,056 36-47 10.8 49,829 71.6 56.4 22.4 5,358 48-59 9.3 47,771 71.7 56.4 21.6 4,422 Sex Male 13.4 124,493 74.2 58.9 20.3 16,715 Female 12.4 114,452 72.1 57.7 20.9 14,195 Residence Urban 12.0 67,958 79.5 66.7 23.5 8,127 Rural 13.3 170,987 71.0 55.4 19.5 22,783 Mother's schooling No schooling 12.4 71,004 66.7 53.1 17.1 8,822 <5 years complete 14.5 14,240 69.6 54.1 19.1 2,069 5-7 years complete 13.4 38,852 74.1 56.6 20.0 5,205 8-9 years complete 13.5 39,507 75.6 59.7 20.5 5,329 10-11 years complete 12.4 28,999 76.3 62.5 23.1 3,606 12 or more years complete 12.7 46,343 79.5 65.4 25.2 5,879 Religion Hindu 12.6 187,795 73.4 57.5 19.7 23,674 Muslim 14.9 39,564 71.1 59.8 20.8 5,881 Christian 12.2 4,969 78.2 59.5 32.9 606 Sikh 12.2 2,963 90.7 82.2 49.4 361 Buddhist/Neo-Buddhist 10.5 1,878 80.7 65.5 23.7 198 Jain 11.9 262 (79.8) (71.3) (15.4) 31 Other 10.5 1,514 63.8 57.8 21.2 159 Caste/tribe Scheduled caste 13.0 51,209 74.6 60.2 21.4 6,649 Scheduled tribe 10.6 25,051 67.0 43.6 16.8 2,651 Other backward class 13.4 105,385 73.4 59.3 19.8 14,115 Other 13.1 55,206 74.1 60.5 22.8 7,238 Don't know 12.3 2,094 69.4 49.2 14.7 257 Wealth index Lowest 13.0 59,416 63.7 48.0 17.1 7,732 Second 13.5 52,153 70.3 55.4 19.2 7,039 Middle 13.4 47,494 75.7 60.7 19.9 6,359 Fourth 12.9 43,896 80.4 65.0 23.6 5,673 Highest 11.4 35,986 82.6 70.0 26.2 4,108 Total 12.9 238,945 73.2 58.4 20.6 30,910 1 Excludes pharmacy, shop, and traditional healer ( ) Based on 25-49 unweighted cases 274 z Child Health Table 9.10 Prevalence of diarrhoea Percentage of children under age five who had diarrhoea in the two weeks preceding the survey, by background characteristics, India, 2015-16 Background characteristic Percentage of children with diarrhoea Number of children Age in months <6 11.1 21,368 6-11 16.4 24,740 12-23 13.3 47,839 24-35 8.5 47,398 36-47 5.8 49,829 48-59 4.6 47,771 Sex Male 9.5 124,493 Female 8.9 114,452 Residence Urban 8.2 67,958 Rural 9.5 170,987 Mother's schooling No schooling 9.5 71,004 <5 years complete 10.2 14,240 5-7 years complete 9.1 38,852 8-9 years complete 9.7 39,507 10-11 years complete 8.5 28,999 12 or more years complete 8.4 46,343 Religion Hindu 9.1 187,795 Muslim 9.9 39,564 Christian 6.7 4,969 Sikh 7.0 2,963 Buddhist/Neo-Buddhist 11.1 1,878 Jain 6.6 262 Other 5.5 1,514 Caste/tribe Scheduled caste 9.6 51,209 Scheduled tribe 8.1 25,051 Other backward class 9.6 105,385 Other 8.4 55,206 Don't know 9.6 2,094 Wealth index Lowest 10.2 59,416 Second 9.5 52,153 Middle 9.3 47,494 Fourth 8.5 43,896 Highest 7.8 35,986 Source of drinking water1 Improved 9.3 214,824 Not improved 8.1 23,781 Other 12.7 340 Toilet facility2 Improved, not shared 8.2 97,505 Shared3 9.9 21,981 Unimproved4 9.8 119,459 Total 9.2 238,945 1 See Table 2.1 for definition of categories 2 See Table 2.2 for definition of categories 3 Facilities that would be considered improved if they were not shared by two or more households 4 Includes no facility Child Health z�275 Ta bl e 9. 11 D ia rr ho ea tr ea tm en t A m on g ch ild re n un de r a ge fi ve w ho h ad d ia rr ho ea in th e tw o w ee ks p re ce di ng th e su rv ey , t he p er ce nt ag e fo r w ho m a dv ic e or tr ea tm en t w as so ug ht fr om a h ea lth fa ci lit y or p ro vi de r, th e pe rc en ta ge w ho re ce iv ed o ra l r eh yd ra tio n th er ap y (O RT ), th e pe rc en ta ge w ho w er e gi ve n ot he r t re at m en ts , a nd th e pe rc en ta ge g iv en n o tre at m en t, by b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Pe rc en ta ge fo r w ho m ad vi ce o r tre at m en t w as so ug ht fro m a h ea lth fa ci lit y or pr ov id er 1 Pe rc en ta ge o f c hi ld re n w ho w er e gi ve n: Pe rc en ta ge w ho w er e gi ve n ot he r t re at m en ts N o tre at m en t N um be r o f ch ild re n w ith di ar rh oe a A flu id m ad e fro m an O RS pa ck et G ru el Ei th er O RS or gr ue l In cr ea se d flu id s A ny O RT Zi nc O RS an d zi nc O RS o r in cr ea se d flu id s C on tin ue d fe ed in g an d O RT 2 A nt i- bi ot ic dr ug A nt i- m ot ili ty dr ug O th er dr ug In tr a- ve no us so lu tio n H om e re m ed y/ he rb al / ot he r Ag e in m on th s < 6 65 .1 30 .7 10 .0 32 .9 4. 7 36 .4 13 .9 7. 1 34 .3 16 .2 15 .6 5. 2 10 .1 0. 2 16 .0 30 .5 2, 37 7 6- 11 72 .0 47 .8 22 .9 53 .0 6. 3 55 .5 19 .7 13 .9 50 .9 32 .7 19 .2 5. 8 12 .9 0. 3 14 .5 18 .6 4, 05 1 12 -2 3 69 .9 54 .1 29 .9 61 .8 7. 0 64 .3 21 .2 15 .7 57 .1 42 .0 20 .3 5. 2 12 .3 0. 3 13 .7 15 .3 6, 38 2 24 -3 5 68 .3 52 .8 31 .0 60 .8 6. 7 63 .0 20 .1 15 .5 55 .4 41 .1 18 .9 5. 3 12 .5 0. 4 10 .0 16 .5 4, 02 6 36 -4 7 64 .5 54 .7 31 .8 63 .1 7. 5 65 .8 24 .3 19 .0 58 .1 45 .8 21 .6 6. 2 11 .6 0. 2 8. 5 14 .9 2, 90 0 48 -5 9 61 .6 57 .5 36 .3 65 .1 8. 0 67 .1 20 .4 16 .1 59 .9 47 .1 18 .3 5. 4 11 .3 0. 1 8. 7 16 .2 2, 18 5 Se x M al e 69 .4 51 .4 28 .3 58 .4 7. 0 61 .1 20 .7 15 .0 54 .6 38 .6 19 .6 5. 4 12 .2 0. 2 12 .4 16 .5 11 ,7 73 Fe m al e 66 .2 49 .6 26 .6 56 .1 6. 5 58 .4 19 .8 14 .7 52 .4 38 .0 19 .0 5. 6 11 .8 0. 3 12 .1 19 .2 10 ,1 47 Re si de nc e U rb an 74 .1 58 .5 32 .4 65 .9 8. 0 68 .2 23 .7 18 .5 61 .3 42 .9 20 .1 4. 9 12 .0 0. 3 11 .0 14 .5 5, 59 1 Ru ra l 65 .8 47 .9 25 .9 54 .4 6. 3 57 .0 19 .1 13 .6 50 .9 36 .7 19 .1 5. 7 12 .0 0. 3 12 .7 18 .9 16 ,3 28 M ot he r's s ch oo lin g N o sc ho ol in g 61 .7 43 .5 23 .5 50 .4 5. 0 52 .6 16 .6 11 .4 46 .1 33 .3 19 .1 6. 3 13 .3 0. 3 11 .4 21 .4 6, 72 6 < 5 ye ar s co m pl et e 64 .3 49 .3 23 .2 55 .7 6. 3 58 .3 20 .6 15 .7 52 .1 36 .8 20 .3 3. 6 11 .4 0. 5 12 .6 18 .4 1, 45 1 5- 7 ye ar s co m pl et e 68 .1 51 .2 26 .3 57 .0 7. 7 59 .6 19 .6 14 .5 54 .4 39 .2 19 .1 4. 7 12 .1 0. 3 11 .6 18 .5 3, 53 4 8- 9 ye ar s co m pl et e 71 .4 52 .0 27 .9 59 .3 7. 7 62 .0 21 .0 15 .3 55 .6 39 .5 19 .3 5. 7 11 .5 0. 1 12 .7 16 .3 3, 84 2 10 -1 1 ye ar s co m pl et e 71 .3 56 .6 31 .7 63 .7 8. 3 66 .7 23 .4 18 .4 60 .1 40 .5 19 .7 5. 7 11 .5 0. 1 12 .7 15 .1 2, 47 8 12 o r m or e ye ar s co m pl et e 74 .4 57 .4 34 .2 64 .4 7. 0 66 .8 24 .4 18 .3 60 .2 44 .2 19 .3 5. 2 10 .7 0. 3 13 .5 13 .9 3, 88 9 Re lig io n H in du 67 .7 50 .4 27 .3 57 .2 6. 5 59 .6 20 .4 14 .9 53 .3 38 .0 19 .0 5. 5 11 .7 0. 3 12 .0 18 .2 17 ,1 55 M us lim 67 .7 48 .2 26 .0 55 .4 6. 8 58 .2 18 .1 13 .0 51 .6 37 .6 20 .3 5. 9 13 .2 0. 3 13 .0 16 .8 3, 91 5 C hr ist ia n 66 .0 59 .0 31 .4 64 .3 10 .6 67 .1 29 .6 23 .9 62 .3 42 .9 16 .5 3. 3 11 .8 0. 2 15 .8 19 .6 33 1 Si kh 87 .7 64 .4 26 .1 68 .1 11 .1 73 .1 26 .6 22 .3 69 .7 44 .1 26 .5 3. 3 18 .5 0. 0 10 .3 6. 7 20 8 Bu dd hi st /N eo -B ud dh ist 76 .6 76 .3 71 .6 84 .1 9. 9 85 .6 26 .4 24 .4 80 .3 56 .8 22 .2 3. 0 14 .3 0. 3 13 .2 6. 9 20 9 O th er 3 69 .3 58 .8 13 .5 59 .6 8. 1 62 .0 22 .1 16 .8 61 .3 50 .5 19 .6 5. 2 10 .4 0. 2 8. 5 24 .4 83 C on tin ue d. . 276 z Child Health Ta bl e 9. 11 D ia rr ho ea tr ea tm en t— C on tin ue d A m on g ch ild re n un de r a ge fi ve w ho h ad d ia rr ho ea in th e tw o w ee ks p re ce di ng th e su rv ey , t he p er ce nt ag e fo r w ho m a dv ic e or tr ea tm en t w as so ug ht fr om a h ea lth fa ci lit y or p ro vi de r, th e pe rc en ta ge w ho re ce iv ed o ra l r eh yd ra tio n th er ap y (O RT ), th e pe rc en ta ge w ho w er e gi ve n ot he r t re at m en ts , a nd th e pe rc en ta ge g iv en n o tre at m en t, by b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Pe rc en ta ge fo r w ho m ad vi ce o r tre at m en t w as so ug ht fro m a h ea lth fa ci lit y or pr ov id er 1 Pe rc en ta ge o f c hi ld re n w ho w er e gi ve n: Pe rc en ta ge w ho w er e gi ve n ot he r t re at m en ts N o tre at m en t N um be r o f ch ild re n w ith di ar rh oe a A flu id m ad e fro m an O RS pa ck et G ru el Ei th er O RS or gr ue l In cr ea se d flu id s A ny O RT Zi nc O RS an d zi nc O RS o r in cr ea se d flu id s C on tin ue d fe ed in g an d O RT 2 A nt i- bi ot ic dr ug A nt i- m ot ili ty dr ug O th er dr ug In tr a- ve no us so lu tio n H om e re m ed y/ he rb al / ot he r C as te /tr ib e Sc he du le d ca st e 68 .6 51 .1 28 .7 57 .5 6. 7 60 .1 20 .7 15 .4 54 .1 38 .5 20 .7 6. 0 13 .2 0. 2 13 .8 16 .4 4, 92 2 Sc he du le d tri be 64 .6 55 .3 29 .0 61 .7 7. 2 64 .1 21 .4 17 .0 58 .5 43 .5 16 .1 4. 4 8. 3 0. 4 9. 2 22 .3 2, 01 8 O th er b ac kw ar d cl as s 67 .4 48 .1 26 .2 55 .1 5. 9 57 .4 20 .3 14 .4 50 .9 35 .8 19 .2 5. 8 13 .0 0. 3 12 .6 17 .9 10 ,1 15 O th er 70 .3 53 .8 28 .9 60 .4 8. 1 63 .3 19 .7 14 .5 57 .1 41 .4 19 .6 4. 9 10 .3 0. 2 11 .2 16 .8 4, 66 3 D on 't kn ow 59 .2 42 .7 21 .1 51 .1 8. 8 55 .8 13 .5 11 .8 47 .3 35 .7 14 .7 0. 4 7. 3 0. 0 10 .9 23 .9 20 1 W ea lth in de x Lo w es t 59 .5 43 .9 24 .2 50 .7 5. 6 53 .2 17 .2 12 .3 46 .9 33 .9 19 .5 6. 4 11 .9 0. 2 10 .6 22 .1 6, 06 1 Se co nd 65 .0 47 .8 25 .4 54 .4 6. 0 56 .9 19 .0 13 .6 50 .8 36 .5 19 .6 5. 5 11 .8 0. 3 13 .7 18 .0 4, 93 2 M id dl e 71 .1 50 .9 26 .9 57 .7 7. 3 60 .3 21 .3 15 .2 53 .9 37 .9 17 .6 4. 3 12 .6 0. 2 12 .7 17 .3 4, 39 4 Fo ur th 73 .4 56 .8 30 .1 63 .4 7. 7 66 .0 22 .1 16 .6 59 .9 43 .0 19 .9 5. 4 12 .5 0. 2 13 .0 15 .2 3, 73 0 H ig he st 79 .1 61 .1 36 .1 68 .3 8. 1 70 .7 25 .1 19 .8 64 .1 45 .4 20 .4 5. 4 11 .0 0. 5 11 .4 12 .3 2, 80 3 To ta l 67 .9 50 .6 27 .5 57 .3 6. 7 59 .9 20 .3 14 .9 53 .6 38 .3 19 .3 5. 5 12 .0 0. 3 12 .2 17 .8 21 ,9 19 N ot e: T ot al in cl ud es Ja in c hi ld re n, w ho a re n ot s ho w n se pa ra te ly . O RT in cl ud es a s ol ut io n pr ep ar ed fr om a n or al re hy dr at io n sa lt (O RS ) p ac ke t a nd /o r g ru el a nd /o r i nc re as ed fl ui ds . 1 E xc lu de s ph ar m ac y, s ho p, a nd tr ad iti on al h ea le r 2 C on tin ue d fe ed in g in cl ud es c hi ld re n w ho w er e gi ve n m or e, s am e as u su al , o r s om ew ha t l es s fo od d ur in g th e di ar rh oe a ep iso de 3 N ot a H in du , M us lim , C hr ist ia n, S ik h, B ud dh ist /N eo -B ud dh ist , o r J ai n Child Health z�277 Ta bl e 9. 12 D ia rr ho ea tr ea tm en t b y st at e/ un io n te rr ito ry A m on g ch ild re n un de r a ge fi ve w ho h ad d ia rr ho ea in th e tw o w ee ks p re ce di ng th e su rv ey , t he p er ce nt ag e fo r w ho m a dv ic e or tr ea tm en t w as so ug ht fr om a h ea lth fa ci lit y or p ro vi de r, th e pe rc en ta ge w ho re ce iv ed o ra l r eh yd ra tio n th er ap y (O RT ), th e pe rc en ta ge w ho w er e gi ve n ot he r t re at m en ts , a nd th e pe rc en ta ge g iv en n o tre at m en t, by s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry Pe rc en ta ge fo r w ho m ad vi ce o r tre at m en t w as so ug ht fro m a he al th fa ci lit y or pr ov id er 1 Pe rc en ta ge o f c hi ld re n w ho w er e gi ve n: Pe rc en ta ge w ho w er e gi ve n ot he r t re at m en ts N o tre at m en t A flu id m ad e fro m an O RS pa ck et G ru el Ei th er O RS o r gr ue l In cr ea se d flu id s A ny O RT Zi nc O RS an d zi nc O RS o r in cr ea se d flu id s C on tin ue d fe ed in g an d O RT 2 A nt i- bi ot ic dr ug A nt i- m ot ili ty dr ug O th er dr ug In tr a- ve no us so lu tio n H om e re m ed y/ he rb al / ot he r In di a 67 .9 50 .6 27 .5 57 .3 6. 7 59 .9 20 .3 14 .9 53 .6 38 .3 19 .3 5. 5 12 .0 0. 3 12 .2 17 .8 N or th C ha nd ig ar h * * * * * * * * * * * * * * * * D el hi 80 .6 62 .1 37 .1 68 .2 9. 1 69 .5 25 .3 20 .7 64 .6 37 .8 13 .0 4. 8 15 .1 0. 0 9. 9 10 .4 H ar ya na 77 .3 60 .6 35 .4 67 .7 7. 6 70 .8 21 .9 17 .7 64 .1 44 .5 17 .8 5. 9 14 .0 0. 2 11 .8 12 .7 H im ac ha l P ra de sh 67 .7 62 .7 25 .8 66 .7 19 .5 72 .6 15 .0 13 .2 69 .2 48 .6 6. 6 1. 5 4. 8 0. 0 15 .9 16 .0 Ja m m u & K as hm ir 74 .1 69 .1 30 .6 71 .2 6. 3 72 .1 39 .1 31 .3 70 .0 43 .7 32 .6 2. 3 7. 0 0. 0 2. 2 13 .6 Pu nj ab 87 .2 66 .2 27 .7 69 .3 8. 0 73 .4 26 .7 23 .3 70 .2 42 .9 28 .2 3. 8 15 .2 0. 0 7. 1 8. 7 Ra ja st ha n 73 .9 56 .2 27 .6 59 .9 5. 4 62 .6 17 .5 13 .0 59 .0 40 .2 27 .3 8. 0 11 .8 0. 1 8. 0 15 .7 U tta ra kh an d 73 .7 56 .0 34 .7 64 .3 4. 9 66 .3 30 .3 21 .4 58 .3 43 .3 23 .0 8. 4 11 .7 0. 7 4. 6 15 .1 C en tr al C hh at tis ga rh 71 .3 67 .9 40 .9 73 .8 4. 1 74 .3 28 .9 24 .7 68 .8 53 .6 17 .6 6. 2 17 .0 0. 3 10 .5 12 .3 M ad hy a Pr ad es h 68 .2 55 .2 30 .8 60 .9 4. 3 61 .8 26 .6 20 .5 56 .3 40 .7 15 .4 5. 6 12 .3 0. 2 7. 5 20 .2 U tta r P ra de sh 66 .6 37 .9 19 .5 43 .9 5. 4 46 .8 12 .6 7. 7 41 .1 27 .7 20 .9 6. 9 17 .5 0. 3 21 .1 18 .0 Ea st Bi ha r 54 .9 45 .2 28 .8 54 .2 4. 4 56 .0 20 .1 14 .2 47 .6 34 .9 20 .9 6. 3 10 .2 0. 2 8. 9 22 .2 Jh ar kh an d 56 .7 44 .8 26 .9 49 .0 11 .5 54 .1 19 .1 14 .3 50 .3 30 .9 16 .3 5. 4 10 .3 0. 2 11 .3 23 .7 O di sh a 68 .5 68 .6 18 .9 71 .4 13 .2 74 .6 17 .0 14 .7 72 .6 48 .0 16 .2 3. 2 7. 9 0. 2 6. 7 16 .8 W es t B en ga l 74 .7 64 .7 18 .8 69 .4 9. 0 73 .3 20 .8 16 .5 69 .3 54 .2 26 .2 2. 8 7. 0 0. 0 9. 3 10 .3 N or th ea st A ru na ch al P ra de sh 44 .9 66 .1 40 .1 72 .1 10 .7 74 .3 35 .8 30 .5 69 .2 39 .5 22 .1 1. 4 7. 3 0. 0 6. 6 16 .7 A ss am 50 .8 51 .9 24 .0 58 .1 4. 8 58 .6 21 .9 17 .7 52 .7 45 .8 15 .2 1. 4 8. 2 0. 3 7. 6 28 .6 M an ip ur 31 .2 60 .2 9. 1 63 .5 14 .8 68 .3 14 .1 9. 4 65 .3 52 .6 14 .9 0. 9 5. 6 0. 8 28 .1 12 .8 M eg ha la ya 69 .9 77 .4 54 .0 81 .4 14 .8 83 .0 57 .8 51 .9 79 .1 60 .2 29 .1 12 .5 8. 8 0. 8 33 .9 6. 3 M iz or am 42 .0 70 .0 28 .0 73 .7 9. 9 77 .2 29 .0 23 .6 74 .5 46 .9 8. 8 4. 2 5. 4 0. 0 9. 9 11 .3 N ag al an d 21 .8 40 .3 23 .8 49 .7 20 .7 53 .7 16 .0 8. 8 46 .8 39 .9 17 .4 2. 4 5. 2 0. 0 10 .8 32 .9 Si kk im * * * * * * * * * * * * * * * * Tr ip ur a 65 .7 46 .3 17 .7 48 .5 6. 9 48 .5 19 .0 13 .3 46 .3 38 .4 23 .2 3. 4 6. 7 0. 0 18 .7 17 .9 C on tin ue d. . 278 z Child Health Ta bl e 9. 12 D ia rr ho ea tr ea tm en t b y st at e/ un io n te rr ito ry — C on tin ue d A m on g ch ild re n un de r a ge fi ve w ho h ad d ia rr ho ea in th e tw o w ee ks p re ce di ng th e su rv ey , t he p er ce nt ag e fo r w ho m a dv ic e or tr ea tm en t w as so ug ht fr om a h ea lth fa ci lit y or p ro vi de r, th e pe rc en ta ge w ho re ce iv ed o ra l r eh yd ra tio n th er ap y (O RT ), th e pe rc en ta ge w ho w er e gi ve n ot he r t re at m en ts , a nd th e pe rc en ta ge g iv en n o tre at m en t, by s ta te /u ni on te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry Pe rc en ta ge fo r w ho m ad vi ce o r tre at m en t w as so ug ht fro m a he al th fa ci lit y or pr ov id er 1 Pe rc en ta ge o f c hi ld re n w ho w er e gi ve n: Pe rc en ta ge w ho w er e gi ve n ot he r t re at m en ts N o tre at m en t A flu id m ad e fro m an O RS pa ck et G ru el Ei th er O RS o r gr ue l In cr ea se d flu id s A ny O RT Zi nc O RS an d zi nc O RS o r in cr ea se d flu id s C on tin ue d fe ed in g an d O RT 2 A nt i- bi ot ic dr ug A nt i- m ot ili ty dr ug O th er dr ug In tr a- ve no us so lu tio n H om e re m ed y/ he rb al / ot he r W es t D ad ra & N ag ar H av el i * * * * * * * * * * * * * * * * D am an & D iu * * * * * * * * * * * * * * * * G oa * * * * * * * * * * * * * * * * G uj ar at 65 .4 46 .1 15 .6 51 .9 7. 2 54 .5 17 .4 13 .4 48 .9 36 .7 10 .6 2. 4 6. 7 0. 0 13 .7 26 .9 M ah ar as ht ra 77 .6 60 .5 52 .9 72 .9 13 .4 76 .8 13 .0 10 .2 65 .8 51 .0 16 .9 5. 0 8. 6 0. 6 10 .0 12 .3 So ut h A nd am an & N ic ob ar Is la nd s (5 3. 5) (6 5. 0) (4 3. 6) (8 5. 3) (1 0. 3) (8 5. 3) (8 .3 ) (8 .3 ) (6 5. 0) (6 2. 0) (4 .6 ) (0 .0 ) (0 .0 ) (0 .0 ) (7 .4 ) (1 4. 7) A nd hr a Pr ad es h 72 .7 47 .6 15 .3 51 .5 5. 5 54 .4 30 .1 15 .9 50 .8 36 .5 10 .2 3. 7 14 .1 0. 0 10 .5 20 .7 Ka rn at ak a 69 .7 52 .8 44 .4 64 .2 1. 2 64 .5 34 .3 26 .7 53 .5 31 .9 16 .9 6. 5 2. 4 0. 0 1. 8 26 .7 Ke ra la 76 .3 49 .4 75 .3 82 .6 20 .9 87 .1 14 .0 12 .3 58 .8 55 .1 13 .5 0. 0 2. 2 0. 0 4. 0 9. 7 La ks ha dw ee p * * * * * * * * * * * * * * * * Pu du ch er ry 73 .6 71 .2 54 .9 81 .3 0. 0 81 .3 69 .6 59 .7 71 .2 53 .3 21 .4 3. 6 0. 0 0. 0 3. 7 13 .0 Ta m il N ad u 73 .2 61 .8 30 .5 67 .2 7. 2 68 .9 41 .3 33 .0 63 .7 49 .2 22 .5 2. 9 7. 2 0. 5 6. 8 15 .2 Te la ng an a 74 .1 56 .8 17 .8 63 .0 4. 8 65 .1 31 .6 22 .0 59 .2 42 .2 9. 7 1. 9 10 .1 0. 4 5. 0 16 .2 N ot e: O RT in cl ud es a s ol ut io n pr ep ar ed fr om a n or al re hy dr at io n sa lt (O RS ) p ac ke t a nd /o r g ru el a nd /o r i nc re as ed fl ui ds . 1 E xc lu de s ph ar m ac y, s ho p, a nd tr ad iti on al h ea le r 2 C on tin ue d fe ed in g in cl ud es c hi ld re n w ho w er e gi ve n m or e, s am e as u su al , o r s om ew ha t l es s fo od d ur in g th e di ar rh oe a ep iso de ( ) B as ed o n 25 -4 9 un w ei gh te d ca se s * Pe rc en ta ge n ot s ho w n; b as ed o n fe w er th an 2 5 un w ei gh te d ca se s Child Health z�279 Ta bl e 9. 13 F ee di ng p ra ct ic es d ur in g di ar rh oe a Pe rc en t di st rib ut io n of c hi ld re n un de r ag e fiv e ye ar s w ho h ad d ia rr ho ea in t he t w o w ee ks p re ce di ng t he s ur ve y by a m ou nt o f l iq ui ds a nd fo od g iv en c om pa re d w ith n or m al p ra ct ic e, ac co rd in g to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Am ou nt o f l iq ui ds g iv en To ta l Am ou nt o f f oo d gi ve n To ta l N um be r o f ch ild re n w ith di ar rh oe a M or e Sa m e as u su al So m e- w ha t le ss M uc h le ss N on e D on 't kn ow M or e Sa m e as us ua l So m e- w ha t le ss M uc h le ss N on e N ev er ga ve fo od D on 't kn ow Ag e in m on th s < 6 4. 7 33 .9 30 .9 19 .0 10 .9 0. 6 10 0. 0 3. 6 21 .2 23 .3 14 .1 2. 3 33 .9 1. 5 10 0. 0 2, 37 7 6- 11 6. 3 31 .8 34 .2 21 .7 5. 7 0. 3 10 0. 0 3. 4 25 .1 31 .1 18 .8 2. 8 18 .1 0. 7 10 0. 0 4, 05 1 12 -2 3 7. 0 30 .1 37 .6 21 .0 3. 8 0. 6 10 0. 0 4. 1 25 .8 37 .7 21 .2 2. 7 7. 9 0. 6 10 0. 0 6, 38 2 24 -3 5 6. 7 31 .1 35 .9 21 .2 4. 6 0. 5 10 0. 0 4. 3 28 .3 38 .4 22 .5 2. 6 3. 5 0. 5 10 0. 0 4, 02 6 36 -4 7 7. 5 30 .2 37 .6 20 .1 4. 0 0. 6 10 0. 0 4. 3 29 .3 40 .5 20 .4 2. 7 2. 2 0. 6 10 0. 0 2, 90 0 48 -5 9 8. 0 29 .1 36 .8 20 .9 4. 4 0. 7 10 0. 0 5. 4 30 .3 37 .8 21 .8 2. 1 2. 0 0. 5 10 0. 0 2, 18 5 Se x M al e 7. 0 30 .5 36 .0 21 .0 5. 0 0. 5 10 0. 0 4. 3 25 .8 35 .1 20 .5 2. 5 10 .9 0. 8 10 0. 0 11 ,7 73 Fe m al e 6. 5 31 .4 35 .7 20 .5 5. 4 0. 5 10 0. 0 3. 9 27 .3 35 .8 19 .8 2. 7 10 .0 0. 6 10 0. 0 10 ,1 47 Re si de nc e U rb an 8. 0 29 .3 35 .6 23 .1 3. 9 0. 2 10 0. 0 3. 7 25 .5 36 .3 22 .6 2. 4 9. 0 0. 3 10 0. 0 5, 59 1 Ru ra l 6. 3 31 .5 36 .0 20 .0 5. 6 0. 6 10 0. 0 4. 2 26 .9 35 .1 19 .3 2. 7 11 .0 0. 8 10 0. 0 16 ,3 28 M ot he r's s ch oo lin g N o sc ho ol in g 5. 0 32 .4 36 .1 19 .9 5. 7 0. 8 10 0. 0 4. 1 27 .4 34 .4 19 .1 2. 5 11 .6 0. 8 10 0. 0 6, 72 6 < 5 ye ar s co m pl et e 6. 3 29 .1 37 .0 21 .7 5. 3 0. 7 10 0. 0 3. 8 24 .9 37 .9 20 .1 2. 4 10 .1 0. 7 10 0. 0 1, 45 1 5- 7 ye ar s co m pl et e 7. 7 31 .9 36 .3 18 .5 4. 9 0. 8 10 0. 0 4. 8 27 .0 36 .7 18 .8 2. 9 9. 0 0. 9 10 0. 0 3, 53 4 8- 9 ye ar s co m pl et e 7. 7 30 .3 34 .9 21 .3 5. 4 0. 4 10 0. 0 4. 2 27 .4 33 .7 20 .4 2. 6 10 .9 0. 7 10 0. 0 3, 84 2 10 -1 1 ye ar s co m pl et e 8. 3 30 .1 33 .1 24 .3 4. 0 0. 1 10 0. 0 3. 6 25 .0 35 .2 23 .8 3. 2 8. 7 0. 4 10 0. 0 2, 47 8 12 o r m or e ye ar s co m pl et e 7. 0 29 .4 37 .3 21 .3 4. 8 0. 3 10 0. 0 3. 8 25 .4 36 .9 20 .7 2. 3 10 .5 0. 4 10 0. 0 3, 88 9 Re lig io n H in du 6. 5 30 .8 35 .8 21 .0 5. 3 0. 6 10 0. 0 4. 0 26 .2 35 .3 20 .4 2. 7 10 .7 0. 7 10 0. 0 17 ,1 55 M us lim 6. 8 32 .2 36 .2 19 .5 4. 9 0. 4 10 0. 0 4. 3 27 .4 36 .0 19 .1 2. 3 10 .4 0. 5 10 0. 0 3, 91 5 C hr ist ia n 10 .6 32 .7 34 .0 16 .7 5. 3 0. 6 10 0. 0 3. 1 32 .9 33 .4 21 .1 2. 8 6. 0 0. 7 10 0. 0 33 1 Si kh 11 .1 25 .7 36 .2 22 .2 4. 7 0. 0 10 0. 0 5. 7 24 .4 34 .2 20 .7 5. 4 9. 0 0. 5 10 0. 0 20 8 Bu dd hi st /N eo -B ud dh ist 9. 9 17 .7 32 .9 36 .5 3. 0 0. 0 10 0. 0 8. 9 23 .9 32 .5 28 .0 0. 8 5. 8 0. 0 10 0. 0 20 9 O th er 1 8. 1 33 .6 46 .4 9. 0 2. 7 0. 2 10 0. 0 1. 8 35 .0 45 .2 11 .1 0. 5 6. 2 0. 4 10 0. 0 83 C on tin ue d. . 280 z Child Health Ta bl e 9. 13 F ee di ng p ra ct ic es d ur in g di ar rh oe a— C on tin ue d Pe rc en t di st rib ut io n of c hi ld re n un de r ag e fiv e ye ar s w ho h ad d ia rr ho ea in t he t w o w ee ks p re ce di ng t he s ur ve y by a m ou nt o f l iq ui ds a nd f oo d gi ve n co m pa re d w ith n or m al p ra ct ic e, ac co rd in g to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Am ou nt o f l iq ui ds g iv en To ta l Am ou nt o f f oo d gi ve n To ta l N um be r o f ch ild re n w ith di ar rh oe a M or e Sa m e as u su al So m e- w ha t le ss M uc h le ss N on e D on 't kn ow M or e Sa m e as us ua l So m e- w ha t le ss M uc h le ss N on e N ev er ga ve fo od D on 't kn ow C as te /tr ib e Sc he du le d ca st e 6. 7 31 .1 34 .5 22 .0 5. 1 0. 6 10 0. 0 4. 2 27 .6 34 .1 20 .0 2. 6 10 .9 0. 5 10 0. 0 4, 92 2 Sc he du le d tri be 7. 2 29 .6 39 .3 18 .6 4. 5 0. 9 10 0. 0 4. 8 26 .6 38 .2 19 .0 1. 9 8. 9 0. 6 10 0. 0 2, 01 8 O th er b ac kw ar d cl as s 5. 9 30 .7 35 .9 21 .1 5. 9 0. 5 10 0. 0 3. 4 26 .0 35 .3 20 .2 2. 9 11 .3 0. 9 10 0. 0 10 ,1 15 O th er 8. 1 31 .6 35 .8 20 .1 4. 0 0. 3 10 0. 0 5. 1 26 .3 36 .1 20 .6 2. 4 8. 9 0. 6 10 0. 0 4, 66 3 D on 't kn ow 8. 8 34 .8 32 .5 18 .6 4. 6 0. 6 10 0. 0 7. 1 31 .6 29 .3 24 .1 0. 6 6. 9 0. 4 10 0. 0 20 1 W ea lth in de x Lo w es t 5. 6 32 .0 35 .8 19 .5 6. 2 0. 9 10 0. 0 4. 7 26 .0 34 .9 18 .8 2. 8 11 .9 1. 0 10 0. 0 6, 06 1 Se co nd 6. 0 30 .2 36 .5 21 .5 5. 3 0. 6 10 0. 0 4. 1 26 .5 35 .6 20 .4 2. 4 10 .2 0. 8 10 0. 0 4, 93 2 M id dl e 7. 3 30 .1 36 .3 20 .6 5. 4 0. 3 10 0. 0 3. 7 26 .7 35 .4 19 .9 2. 7 11 .1 0. 6 10 0. 0 4, 39 4 Fo ur th 7. 7 31 .1 36 .0 20 .7 4. 0 0. 4 10 0. 0 3. 9 26 .9 36 .3 20 .9 2. 7 8. 8 0. 4 10 0. 0 3, 73 0 H ig he st 8. 1 31 .0 34 .0 22 .9 3. 8 0. 2 10 0. 0 3. 8 26 .9 35 .3 22 .4 2. 2 8. 9 0. 3 10 0. 0 2, 80 3 To ta l 6. 7 30 .9 35 .9 20 .8 5. 2 0. 5 10 0. 0 4. 1 26 .5 35 .4 20 .2 2. 6 10 .5 0. 7 10 0. 0 21 ,9 19 N ot e: T ot al in cl ud es Ja in c hi ld re n, w ho a re n ot s ho w n se pa ra te ly . 1 N ot a H in du , M us lim , C hr ist ia n, S ik h, B ud dh ist /N eo -B ud dh ist , o r J ai n Child Health z�281 Ta bl e 9. 14 F ee di ng p ra ct ic es d ur in g di ar rh oe a by s ta te /u ni on te rr ito ry Pe rc en t d ist rib ut io n of c hi ld re n un de r a ge fi ve w ho h ad d ia rr ho ea in th e tw o w ee ks p re ce di ng th e su rv ey b y am ou nt o f l iq ui ds a nd fo od g iv en c om pa re d w ith n or m al p ra ct ic e, a nd p er ce nt ag e of w om en w ho k no w a bo ut o ra l r eh yd ra tio n sa lt (O RS ) p ac ke ts fo r t he tr ea tm en t o f d ia rr ho ea b y st at e/ un io n te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry A m ou nt o f l iq ui ds g iv en To ta l A m ou nt o f f oo d gi ve n To ta l Pe rc en ta ge of w om en w ho k no w ab ou t O RS pa ck et s M or e Sa m e as us ua l So m e- w ha t le ss M uc h le ss N on e D on 't kn ow M or e Sa m e as us ua l So m e- w ha t le ss M uc h le ss N on e N ev er ga ve fo od D on 't kn ow In di a 6. 7 30 .9 35 .9 20 .8 5. 2 0. 5 10 0. 0 4. 1 26 .5 35 .4 20 .2 2. 6 10 .5 0. 7 10 0. 0 83 .7 N or th C ha nd ig ar h 0. 0 63 .9 36 .1 0. 0 0. 0 0. 0 10 0. 0 0. 0 40 .8 36 .6 0. 0 0. 0 22 .6 0. 0 10 0. 0 96 .0 D el hi 9. 1 41 .9 18 .8 26 .0 3. 8 0. 4 10 0. 0 4. 1 38 .3 17 .2 21 .7 1. 7 15 .9 1. 1 10 0. 0 96 .0 H ar ya na 7. 6 27 .2 31 .9 27 .9 5. 3 0. 0 10 0. 0 5. 3 24 .3 32 .2 25 .4 1. 4 10 .9 0. 5 10 0. 0 86 .7 H im ac ha l P ra de sh 19 .5 41 .6 21 .7 10 .9 5. 4 0. 9 10 0. 0 7. 2 36 .2 30 .3 15 .2 0. 7 9. 9 0. 5 10 0. 0 92 .9 Ja m m u & K as hm ir 6. 3 42 .6 23 .1 25 .8 1. 9 0. 3 10 0. 0 2. 4 36 .5 22 .9 27 .3 3. 0 7. 4 0. 4 10 0. 0 89 .1 Pu nj ab 8. 0 27 .1 36 .9 24 .2 3. 8 0. 0 10 0. 0 1. 6 24 .2 33 .0 22 .4 7. 7 11 .0 0. 0 10 0. 0 93 .4 Ra ja st ha n 5. 4 35 .0 34 .5 22 .0 1. 9 1. 2 10 0. 0 4. 4 29 .2 32 .2 20 .0 1. 1 12 .0 1. 1 10 0. 0 89 .8 U tta ra kh an d 4. 9 27 .3 36 .4 27 .3 3. 4 0. 7 10 0. 0 2. 2 24 .9 39 .7 23 .8 1. 6 7. 2 0. 6 10 0. 0 90 .7 C en tr al C hh at tis ga rh 4. 1 37 .7 39 .2 15 .8 3. 2 0. 1 10 0. 0 1. 2 30 .7 39 .6 15 .9 0. 8 11 .6 0. 1 10 0. 0 93 .0 M ad hy a Pr ad es h 4. 3 24 .0 43 .4 21 .9 5. 6 0. 8 10 0. 0 3. 3 20 .3 40 .9 20 .3 2. 0 11 .8 1. 4 10 0. 0 87 .0 U tta r P ra de sh 5. 4 33 .2 35 .1 20 .3 5. 5 0. 5 10 0. 0 4. 0 27 .0 32 .6 19 .4 2. 5 13 .8 0. 7 10 0. 0 78 .6 Ea st Bi ha r 4. 4 32 .0 34 .2 21 .0 7. 7 0. 7 10 0. 0 5. 5 25 .0 32 .6 19 .3 3. 8 13 .0 0. 9 10 0. 0 70 .9 Jh ar kh an d 11 .5 30 .2 33 .9 19 .3 4. 5 0. 6 10 0. 0 7. 2 23 .5 32 .5 20 .3 2. 9 13 .2 0. 4 10 0. 0 79 .3 O di sh a 13 .2 36 .6 26 .3 18 .0 5. 4 0. 4 10 0. 0 3. 0 32 .9 31 .6 23 .1 3. 8 5. 4 0. 3 10 0. 0 96 .4 W es t B en ga l 9. 0 21 .6 44 .6 21 .3 3. 4 0. 0 10 0. 0 6. 1 24 .4 46 .0 19 .1 0. 8 3. 6 0. 0 10 0. 0 93 .6 N or th ea st A ru na ch al P ra de sh 10 .7 26 .4 21 .1 32 .9 2. 9 6. 0 10 0. 0 8. 8 27 .3 22 .5 29 .8 2. 7 1. 9 7. 1 10 0. 0 81 .3 A ss am 4. 8 30 .9 37 .1 22 .6 4. 2 0. 3 10 0. 0 3. 2 33 .0 38 .8 19 .7 1. 4 3. 2 0. 8 10 0. 0 89 .4 M an ip ur 14 .8 47 .4 30 .7 6. 0 0. 8 0. 3 10 0. 0 3. 4 41 .6 37 .8 12 .5 0. 9 3. 8 0. 1 10 0. 0 96 .2 M eg ha la ya 14 .8 32 .3 28 .2 20 .8 3. 6 0. 3 10 0. 0 6. 3 34 .5 34 .0 20 .7 2. 1 1. 9 0. 5 10 0. 0 91 .9 M iz or am 9. 9 45 .5 22 .4 17 .4 4. 8 0. 0 10 0. 0 2. 0 39 .9 26 .9 25 .2 2. 2 3. 8 0. 0 10 0. 0 97 .2 N ag al an d 20 .7 45 .8 19 .3 11 .6 2. 0 0. 6 10 0. 0 6. 0 45 .4 24 .7 16 .4 1. 5 6. 1 0. 0 10 0. 0 66 .1 Si kk im 52 .6 37 .8 1. 8 7. 8 0. 0 0. 0 10 0. 0 18 .8 47 .5 0. 8 32 .9 0. 0 0. 0 0. 0 10 0. 0 97 .0 Tr ip ur a 6. 9 32 .0 17 .5 41 .3 2. 2 0. 0 10 0. 0 0. 0 20 .3 34 .0 42 .1 0. 0 3. 6 0. 0 10 0. 0 96 .6 C on tin ue d. . 282 z Child Health Ta bl e 9. 14 F ee di ng p ra ct ic es d ur in g di ar rh oe a by s ta te /u ni on te rr ito ry — C on tin ue d Pe rc en t d ist rib ut io n of c hi ld re n un de r a ge fi ve w ho h ad d ia rr ho ea in th e tw o w ee ks p re ce di ng th e su rv ey b y am ou nt o f l iq ui ds a nd fo od g iv en c om pa re d w ith n or m al p ra ct ic e, a nd p er ce nt ag e of w om en a ge 1 5- 49 w ho k no w a bo ut O RS p ac ke ts fo r t re at m en t o f d ia rr ho ea b y st at e/ un io n te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry A m ou nt o f l iq ui ds g iv en To ta l A m ou nt o f f oo d gi ve n To ta l Pe rc en ta ge of w om en w ho k no w ab ou t O RS pa ck et s M or e Sa m e as us ua l So m e- w ha t le ss M uc h le ss N on e D on 't kn ow M or e Sa m e as us ua l So m e- w ha t le ss M uc h le ss N on e N ev er ga ve fo od D on 't kn ow W es t D ad ra & N ag ar H av el i 6. 6 21 .9 26 .4 28 .5 8. 6 8. 0 10 0. 0 0. 0 23 .3 40 .9 19 .2 0. 0 16 .6 0. 0 10 0. 0 82 .1 D am an & D iu 8. 4 5. 1 47 .9 14 .5 0. 0 24 .1 10 0. 0 0. 0 0. 0 44 .3 16 .5 0. 0 15 .2 24 .1 10 0. 0 67 .0 G oa 3. 2 30 .6 46 .1 20 .1 0. 0 0. 0 10 0. 0 0. 0 30 .6 40 .3 26 .0 0. 0 3. 2 0. 0 10 0. 0 95 .7 G uj ar at 7. 2 32 .5 39 .5 16 .6 3. 2 1. 0 10 0. 0 3. 0 28 .8 41 .1 16 .2 1. 4 8. 3 1. 1 10 0. 0 74 .5 M ah ar as ht ra 13 .4 26 .3 36 .4 19 .3 4. 1 0. 5 10 0. 0 7. 2 26 .2 38 .1 20 .2 2. 0 6. 0 0. 2 10 0. 0 82 .8 So ut h A nd am an & N ic ob ar Is la nd s 10 .3 51 .5 3. 8 18 .7 15 .7 0. 0 10 0. 0 6. 2 41 .0 14 .8 18 .7 0. 0 19 .3 0. 0 10 0. 0 95 .7 A nd hr a Pr ad es h 5. 5 39 .0 36 .2 14 .3 5. 0 0. 0 10 0. 0 1. 2 35 .3 34 .7 16 .7 3. 6 8. 1 0. 3 10 0. 0 88 .4 Ka rn at ak a 1. 2 18 .9 28 .5 44 .8 5. 7 0. 9 10 0. 0 0. 8 23 .6 26 .3 41 .0 3. 3 4. 8 0. 3 10 0. 0 72 .9 Ke ra la 20 .9 33 .0 24 .9 21 .2 0. 0 0. 0 10 0. 0 3. 3 30 .3 29 .1 32 .3 3. 6 1. 5 0. 0 10 0. 0 93 .6 La ks ha dw ee p 0. 0 45 .2 43 .6 11 .2 0. 0 0. 0 10 0. 0 0. 0 49 .2 39 .6 11 .2 0. 0 0. 0 0. 0 10 0. 0 90 .7 Pu du ch er ry 0. 0 10 .5 63 .0 21 .8 4. 7 0. 0 10 0. 0 1. 7 6. 9 61 .3 25 .2 0. 6 4. 2 0. 0 10 0. 0 87 .8 Ta m il N ad u 7. 2 24 .7 44 .5 18 .1 5. 2 0. 3 10 0. 0 1. 5 23 .7 47 .6 18 .6 3. 7 3. 9 1. 0 10 0. 0 79 .3 Te la ng an a 4. 8 34 .0 34 .7 18 .3 8. 2 0. 0 10 0. 0 2. 2 21 .5 41 .5 18 .4 5. 0 11 .3 0. 0 10 0. 0 81 .4 Child Health z�283 Table 9.15 Knowledge of ORS packets Percentage of women age 15-49 who had a live birth in the five years preceding the survey who know about ORS packets for treatment of diarrhoea, by background characteristics, India, 2015-16 Background characteristic Percentage of women who know about ORS packets Number of women Age 15-19 81.9 6,285 20-24 86.7 57,840 25-34 87.0 103,204 35-49 80.2 17,312 Residence Urban 91.6 54,847 Rural 83.8 129,794 Schooling No schooling 73.8 51,290 <5 years complete 85.3 10,753 5-7 years complete 86.9 29,402 8-9 years complete 90.8 30,990 10-11 years complete 92.0 23,134 12 or more years complete 94.6 39,071 Religion Hindu 85.9 145,617 Muslim 85.7 29,734 Christian 89.4 3,900 Sikh 96.6 2,437 Buddhist/Neo-Buddhist 90.7 1,502 Jain 85.8 239 Other 82.2 1,210 Caste/tribe Scheduled caste 85.1 39,059 Scheduled tribe 83.7 19,002 Other backward class 84.9 80,461 Other 90.5 44,560 Don't know 76.6 1,558 Wealth index Lowest 73.5 43,155 Second 84.6 39,070 Middle 88.9 36,722 Fourth 92.3 35,066 Highest 95.3 30,627 Total 86.1 184,641 ORS = Oral rehydration salt 284 z Child Health Table 9.16 Disposal of children's stools Percent distribution of mothers with a child under age five living with her by the manner of disposing of the youngest child's last stools and percentage of mothers with children whose stools that were disposed of safely, according to background characteristics, India, 2015-16 Background characteristic Manner of disposal of children's stools Total Percentage of mothers with children whose stools were disposed of safely1 Number of mothers Child used toilet or latrine Put/rinsed into toilet or latrine Put/rinsed into drain or ditch Thrown in garbage Buried Left in the open Other Don't know/ missing &KLOG·V�Dge in months <6 8.6 13.1 10.3 20.4 2.3 43.5 1.5 0.4 100.0 24.0 21,151 6-11 11.1 13.3 8.4 19.8 1.9 44.6 0.7 0.3 100.0 26.3 24,485 12-23 15.8 13.0 5.6 17.0 1.6 46.4 0.3 0.3 100.0 30.4 45,206 24-35 25.3 12.5 4.0 11.8 1.3 44.6 0.3 0.3 100.0 39.0 35,539 36-47 33.2 12.2 3.0 9.0 0.9 41.1 0.4 0.3 100.0 46.3 29,478 48-59 37.3 12.1 2.2 7.6 1.0 38.7 0.5 0.5 100.0 50.5 24,586 Residence Urban 38.8 21.4 5.5 10.4 0.8 22.6 0.2 0.1 100.0 61.0 53,915 Rural 14.8 9.0 5.2 15.8 1.7 52.5 0.6 0.4 100.0 25.5 126,530 Mother's schooling No schooling 10.7 5.6 4.8 16.0 2.1 59.6 0.7 0.4 100.0 18.4 49,731 <5 years complete 14.6 9.5 6.3 17.0 1.4 50.0 0.8 0.4 100.0 25.5 10,454 5-7 years complete 19.2 11.2 6.4 15.3 1.2 45.8 0.4 0.5 100.0 31.7 28,708 8-9 years complete 22.2 13.2 5.5 14.8 1.4 42.2 0.5 0.3 100.0 36.8 30,318 10-11 years complete 28.6 16.8 5.5 12.3 1.3 34.9 0.5 0.2 100.0 46.6 22,762 12 or more years complete 36.5 21.0 4.5 10.8 1.0 25.6 0.4 0.2 100.0 58.5 38,471 Religion Hindu 20.6 11.4 5.2 14.2 1.5 46.2 0.5 0.3 100.0 33.5 142,236 Muslim 25.4 16.0 5.1 14.9 1.4 36.5 0.4 0.3 100.0 42.8 29,094 Christian 25.8 20.6 9.1 13.4 1.2 28.6 1.1 0.3 100.0 47.6 3,833 Sikh 47.1 31.1 4.9 7.4 0.3 9.0 0.1 0.1 100.0 78.6 2,390 Buddhist/Neo-Buddhist 34.7 9.7 4.0 11.9 0.8 38.6 0.0 0.2 100.0 45.2 1,477 Jain 61.3 20.7 3.7 3.2 0.8 10.4 0.0 0.0 100.0 82.7 235 Other 14.1 25.5 10.7 12.7 1.3 35.3 0.1 0.2 100.0 40.9 1,180 Caste/tribe Scheduled caste 18.0 10.1 5.6 15.8 1.4 48.2 0.6 0.2 100.0 29.6 38,083 Scheduled tribe 10.8 7.5 6.0 15.7 2.0 57.0 0.5 0.4 100.0 20.4 18,500 Other backward class 21.3 12.1 5.2 13.1 1.6 45.9 0.6 0.3 100.0 34.9 78,645 Other 31.5 18.3 4.8 13.9 1.0 29.8 0.4 0.3 100.0 50.7 43,692 Don't know 20.1 15.3 8.4 15.2 1.2 37.6 0.4 1.9 100.0 36.5 1,524 Toilet facility2 Improved, not shared 37.1 21.0 5.1 10.8 1.0 24.5 0.3 0.2 100.0 59.1 77,940 Shared3 30.9 19.4 6.6 15.5 1.0 26.0 0.4 0.2 100.0 51.3 16,678 Unimproved4 6.5 3.8 5.3 17.0 2.0 64.2 0.8 0.4 100.0 12.3 85,826 Wealth index Lowest 4.6 3.0 4.4 17.6 2.4 66.6 0.9 0.5 100.0 10.0 41,804 Second 10.6 6.7 5.9 17.8 1.7 56.3 0.7 0.4 100.0 19.0 38,050 Middle 19.6 12.1 6.5 15.1 1.3 44.8 0.5 0.3 100.0 32.9 35,858 Fourth 34.4 20.6 5.7 10.6 1.0 27.2 0.3 0.2 100.0 56.0 34,511 Highest 48.9 25.4 4.0 7.9 0.7 12.8 0.2 0.2 100.0 75.0 30,221 Total 22.0 12.7 5.3 14.2 1.5 43.6 0.5 0.3 100.0 36.1 180,444 1 Children's stools are considered to be disposed of safely if the child used a toilet or latrine, if the fecal matter was put/rinsed into a toilet or latrine, or if it was buried 2 See Table 2.2 for definition of categories 3 Facilities that would be considered improved if they were not shared by two or more households 4 Includes no facility Child Health z�285 Table 9.17 Disposal of children's stools by state/union territory Percent distribution of mothers with a child under age five living with her by the manner of disposing of the youngest child's last stools and percentage of mothers with children whose stools that were disposed of safely, according to state/union territory, India, 2015-16 State/union territory Manner of disposal of children's stools Total Percentage of mothers with children whose stools were disposed of safely1 Child used toilet or latrine Put/rinsed into toilet or latrine Put/rinsed into drain or ditch Thrown in garbage Buried Left in the open Other Don't know/ missing India 22.0 12.7 5.3 14.2 1.5 43.6 0.5 0.3 100.0 36.1 North Chandigarh 53.5 31.1 2.0 10.0 0.0 3.5 0.0 0.0 100.0 84.6 Delhi 51.1 23.2 7.2 10.1 0.5 7.8 0.1 0.1 100.0 74.8 Haryana 48.0 16.1 5.3 9.9 1.2 19.2 0.1 0.4 100.0 65.2 Himachal Pradesh 42.0 36.5 3.3 4.6 0.2 12.5 0.4 0.5 100.0 78.7 Jammu & Kashmir 37.1 15.6 2.6 14.6 1.5 28.1 0.1 0.3 100.0 54.2 Punjab 49.1 31.3 4.5 8.8 0.0 6.1 0.0 0.1 100.0 80.5 Rajasthan 20.0 11.9 6.8 12.3 1.2 47.5 0.2 0.2 100.0 33.1 Uttarakhand 35.6 29.1 2.6 3.6 0.5 27.6 0.1 0.8 100.0 65.3 Central Chhattisgarh 12.7 7.6 6.5 18.7 1.7 51.9 0.8 0.1 100.0 21.9 Madhya Pradesh 16.3 9.1 4.0 11.5 1.2 55.7 0.6 1.5 100.0 26.6 Uttar Pradesh 17.8 7.4 5.4 18.8 1.7 48.0 1.0 0.1 100.0 26.9 East Bihar 8.5 5.2 3.1 11.7 3.4 66.6 1.0 0.6 100.0 17.1 Jharkhand 10.8 6.4 6.9 9.3 3.3 62.9 0.2 0.1 100.0 20.5 Odisha 7.0 2.9 3.8 19.9 2.6 61.2 1.7 0.9 100.0 12.5 West Bengal 18.6 21.9 6.4 26.2 0.9 25.6 0.3 0.1 100.0 41.4 Northeast Arunachal Pradesh 22.1 12.4 7.9 22.3 1.3 28.3 0.3 5.5 100.0 35.8 Assam 10.9 7.0 5.2 22.9 1.6 51.5 0.4 0.5 100.0 19.5 Manipur 17.4 34.1 16.6 15.8 0.9 14.0 0.4 0.7 100.0 52.5 Meghalaya 19.8 15.3 23.7 20.6 1.2 16.0 3.3 0.2 100.0 36.3 Mizoram 41.3 34.0 7.7 14.4 0.0 2.4 0.1 0.0 100.0 75.3 Nagaland 22.5 31.8 13.4 18.7 1.6 10.9 0.4 0.7 100.0 55.9 Sikkim 47.9 49.8 0.6 1.7 0.0 0.0 0.0 0.0 100.0 97.7 Tripura 13.2 41.4 27.1 7.8 0.0 9.7 0.5 0.2 100.0 54.7 West Dadra & Nagar Haveli 22.2 21.5 7.7 16.3 0.0 32.3 0.0 0.0 100.0 43.7 Daman & Diu 59.9 14.7 4.1 3.9 0.0 16.9 0.4 0.0 100.0 74.6 Goa 48.2 30.5 1.2 9.2 0.0 10.6 0.4 0.0 100.0 78.7 Gujarat 35.2 22.9 3.7 6.0 0.9 31.0 0.1 0.1 100.0 59.1 Maharashtra 36.8 12.9 4.9 10.7 0.4 34.1 0.1 0.1 100.0 50.1 South Andaman & Nicobar Islands 45.5 17.9 3.0 8.1 0.2 24.5 0.8 0.0 100.0 63.6 Andhra Pradesh 17.5 10.8 10.5 16.9 0.5 43.2 0.5 0.0 100.0 28.9 Karnataka 27.0 14.3 4.0 14.6 0.9 38.9 0.2 0.3 100.0 42.1 Kerala 37.3 54.4 1.4 2.3 0.3 4.3 0.0 0.0 100.0 92.0 Lakshadweep 43.9 40.9 5.2 2.6 1.1 6.4 0.0 0.0 100.0 85.9 Puducherry 31.0 5.3 0.8 9.3 4.3 49.3 0.0 0.0 100.0 40.6 Tamil Nadu 23.3 9.6 4.5 9.1 1.4 51.9 0.2 0.1 100.0 34.2 Telangana 28.4 11.5 10.9 11.0 0.4 36.8 0.5 0.5 100.0 40.3 1 Children's stools are considered to be disposed of safely if the child used a toilet or latrine, if the fecal matter was put/rinsed into a toilet or latrine, or if it was buried 286 z Child Health Table 9.18 Indicators of utilization of ICDS services Percentage of living children under age six years who received any service from an anganwadi centre (AWC) in the 12 months preceding the survey, percentage who received specific services from an AWC in the 12 months preceding the survey, and among children age 0-59 months who were weighed at an AWC in the 12 months preceding the survey, the percentage whose mothers received counselling from an AWC after the child was weighed by background characteristics, India, 2015-16 Background characteristic Percentage of children age 0-71 months who received any service Percentage of children under age six years who: Number of children under age six years Percentage whose mothers received counselling from an AWC after child was weighed Number of children who were weighed3 Received food supplements1 Received immuni- zations Received health check- ups Went for early childhood care/ preschool2 Were weighed3 Residence Urban 39.8 35.6 28.6 30.9 28.1 33.9 67,958 66.2 23,007 Rural 59.1 53.0 44.2 43.2 42.3 47.0 170,987 63.5 80,426 Mother's schooling No schooling 51.0 44.0 38.5 34.2 35.0 36.8 71,004 59.3 26,162 <5 years complete 62.3 57.3 44.5 47.6 49.1 51.6 14,240 63.3 7,346 5-7 years complete 60.0 55.0 45.3 46.5 45.4 50.6 38,852 65.9 19,663 8-9 years complete 58.5 53.2 43.2 45.0 41.7 49.0 39,507 65.6 19,361 10-11 years complete 55.6 51.3 41.7 44.3 40.1 48.5 28,999 66.9 14,051 12 or more years complete 43.9 39.1 31.3 32.9 28.5 36.4 46,343 65.7 16,849 Religion Hindu 55.0 49.3 41.7 41.0 39.2 44.8 187,795 64.6 84,054 Muslim 45.7 40.4 31.5 32.6 32.1 34.9 39,564 61.6 13,817 Christian 55.1 53.2 34.0 41.0 39.9 45.8 4,969 62.4 2,277 Sikh 60.0 56.9 39.4 44.3 43.0 46.5 2,963 59.2 1,377 Buddhist/Neo-Buddhist 55.8 53.0 43.3 50.4 52.2 51.8 1,878 57.8 972 Jain 22.8 21.7 12.7 19.9 8.5 27.4 262 (62.7) 72 Other 65.4 63.7 38.4 45.9 48.3 57.0 1,514 79.5 863 Caste/tribe Scheduled caste 59.1 53.2 44.2 43.9 43.5 47.6 51,209 65.0 24,392 Scheduled tribe 63.8 60.4 47.7 51.0 48.9 55.7 25,051 63.3 13,957 Other backward class 52.1 45.6 40.0 37.3 35.3 40.7 105,385 63.7 42,934 Other 47.0 42.7 32.2 35.6 34.1 38.7 55,206 64.3 21,360 Don't know 46.6 43.3 29.4 33.8 35.6 37.7 2,094 63.8 789 Wealth index Lowest 55.1 47.8 41.4 36.7 38.6 39.5 59,416 59.2 23,446 Second 60.6 54.8 45.2 45.1 45.2 48.7 52,153 64.4 25,389 Middle 59.5 54.6 44.2 46.2 43.8 50.7 47,494 66.3 24,068 Fourth 51.8 47.4 38.3 41.0 36.5 45.1 43,896 66.2 19,791 Highest 35.3 31.1 25.1 26.9 22.1 29.8 35,986 65.0 10,739 Total 53.6 48.1 39.8 39.7 38.2 43.3 238,945 64.1 103,433 ICDS = Integrated Child Development Services 1 Supplementary food includes both food cooked and served at an AWC on a daily basis or given in the form of take home rations 2 Children age 36-71 months 3 Children age 0-59 months ( ) Based on 25-49 unweighted cases Child Health z�287 Table 9.19 Indicators of utilization of ICDS services by state/union territory Percentage of living children under age six years who received any service from an anganwadi centre (AWC) in the 12 months preceding the survey, percentage who received specific services from an AWC in the 12 months preceding the survey, and among children age 0-59 months who were weighed at an AWC in the 12 months preceding the survey, the percentage whose mothers received counselling from an AWC after the child was weighed by state/union territory, India, 2015-16 State/union territory Percentage of children age 0-71 months who received any service Percentage of children under age six years who: Percentage whose mothers received counselling from an AWC after child was weighed2 Received food supple- ments1 Received immuni- zations Received health check-ups Went for early childhood care/ preschool2 Were weighed3 India 53.6 48.1 39.8 39.7 38.2 43.3 64.1 North Chandigarh 52.7 47.1 28.5 33.4 39.7 38.6 74.9 Delhi 18.4 14.3 13.4 12.6 11.8 13.8 46.8 Haryana 44.4 37.7 39.0 36.8 32.3 40.1 68.5 Himachal Pradesh 69.0 68.0 17.7 37.2 36.4 48.8 55.5 Jammu & Kashmir 33.2 32.1 13.6 22.1 21.9 22.3 54.4 Punjab 59.4 56.7 38.1 42.9 43.0 44.8 60.0 Rajasthan 38.6 32.4 30.8 25.7 20.1 28.3 60.3 Uttarakhand 55.6 54.0 26.0 32.8 24.7 47.4 50.4 Central Chhattisgarh 77.2 71.7 62.5 67.9 55.1 77.4 72.9 Madhya Pradesh 63.4 60.2 49.8 51.8 42.3 57.8 61.7 Uttar Pradesh 38.8 29.7 29.0 19.4 18.5 22.6 48.8 East Bihar 48.7 34.3 41.1 23.5 32.8 23.0 50.0 Jharkhand 55.0 50.8 42.5 33.2 30.1 41.5 60.8 Odisha 78.2 74.9 61.3 66.2 60.5 74.6 71.5 West Bengal 74.4 72.7 42.1 64.9 66.8 69.5 73.4 Northeast Arunachal Pradesh 20.0 19.2 6.2 9.4 14.4 10.0 43.2 Assam 55.5 53.9 29.4 42.8 44.1 38.7 61.2 Manipur 28.5 27.9 4.2 2.7 9.2 2.3 14.2 Meghalaya 56.1 55.7 19.9 35.7 37.6 42.5 52.1 Mizoram 64.9 64.2 22.4 44.7 58.1 58.7 39.8 Nagaland 35.1 34.8 5.6 3.4 5.9 4.0 8.4 Sikkim 49.8 49.1 32.9 43.4 42.6 45.1 76.5 Tripura 60.6 58.6 28.9 40.3 55.1 47.8 48.8 West Dadra & Nagar Haveli 47.9 46.5 35.2 44.9 46.5 44.4 76.6 Daman & Diu 29.5 24.7 23.0 24.9 21.6 25.6 59.2 Goa 58.0 55.9 35.1 46.5 38.0 55.3 77.0 Gujarat 60.7 56.5 51.2 54.2 51.6 57.7 71.2 Maharashtra 49.4 47.7 38.1 44.4 45.9 46.1 58.4 South Andaman & Nicobar Islands 47.3 47.0 16.6 34.8 37.8 49.1 78.9 Andhra Pradesh 70.5 69.3 55.7 59.9 50.8 66.1 72.7 Karnataka 60.3 57.2 50.4 51.8 45.8 54.1 63.3 Kerala 48.8 45.9 19.4 34.6 35.5 44.0 41.2 Lakshadweep 57.8 56.9 5.0 26.0 30.7 33.0 20.2 Puducherry 59.5 58.1 44.7 57.7 50.4 58.1 80.5 Tamil Nadu 61.2 58.5 46.0 56.4 50.4 58.5 82.6 Telangana 56.8 55.3 42.9 43.4 39.3 50.3 64.5 ICDS = Integrated Child Development Services 1 Supplementary food includes both food cooked and served at an AWC on a daily basis or given in the form of take home rations 2 Children age 36-71 months 3 Children age 0-59 months 288 z Child Health Ta bl e 9. 20 U til iz at io n of IC D S se rv ic es d ur in g pr eg na nc y an d w hi le b re as tfe ed in g Am on g ch ild re n un de r a ge si x ye ar s, p er ce nt ag e w ho se m ot he rs re ce iv ed sp ec ifi c se rv ic es fr om a n an ga nw ad i c en tre (A W C ) d ur in g pr eg na nc y an d w hi le b re as tfe ed in g, ac co rd in g to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic M ot he r r ec ei ve d fro m a n AW C d ur in g pr eg na nc y M ot he r r ec ei ve d fro m a n AW C w hi le b re as tfe ed in g2 N o se rv ic es Su pp le - m en ta ry fo od 1 H ea lth ch ec k- up s H ea lth a nd nu tri tio n ed uc at io n N um be r o f ch ild re n N o se rv ic es Su pp le - m en ta ry fo od 1 H ea lth ch ec k- up s H ea lth a nd nu tri tio n ed uc at io n N um be r o f ch ild re n br ea st fe d Re si de nc e U rb an 61 .7 36 .3 31 .6 29 .8 81 ,2 30 65 .1 33 .7 28 .4 27 .6 81 ,1 38 Ru ra l 40 .1 57 .5 47 .4 41 .9 20 4, 05 6 45 .7 53 .1 40 .5 38 .0 20 3, 80 9 M ot he r's s ch oo lin g N o sc ho ol in g 49 .0 48 .2 38 .2 32 .0 87 ,6 94 54 .4 44 .3 31 .6 28 .7 87 ,5 73 < 5 ye ar s co m pl et e 37 .5 60 .4 50 .6 45 .8 17 ,3 40 42 .8 56 .0 43 .3 41 .4 17 ,3 23 5- 7 ye ar s co m pl et e 38 .8 58 .9 50 .2 45 .7 46 ,6 93 44 .2 54 .7 43 .8 41 .8 46 ,6 40 8- 9 ye ar s co m pl et e 40 .2 57 .7 48 .7 44 .1 46 ,2 86 45 .4 53 .5 42 .6 40 .2 46 ,2 43 10 -1 1 ye ar s co m pl et e 43 .7 54 .5 46 .9 44 .2 34 ,0 80 47 .9 51 .1 42 .5 41 .5 34 ,0 39 12 o r m or e ye ar s co m pl et e 58 .0 40 .0 34 .0 31 .8 53 ,1 93 62 .2 36 .5 29 .9 28 .9 53 ,1 29 Re lig io n H in du 44 .1 53 .5 45 .0 40 .3 22 4, 30 4 49 .2 49 .6 39 .0 36 .7 22 4, 05 8 M us lim 57 .5 40 .0 32 .4 28 .5 47 ,1 37 61 .8 36 .9 27 .7 26 .0 47 ,0 61 C hr ist ia n 45 .2 53 .7 42 .9 42 .9 5, 89 1 47 .6 51 .7 39 .6 40 .7 5, 88 7 Si kh 39 .2 59 .4 44 .2 39 .3 3, 58 1 47 .7 51 .6 37 .0 34 .5 3, 57 2 Bu dd hi st /N eo -B ud dh ist 50 .0 49 .0 45 .1 41 .5 2, 20 1 54 .6 45 .0 41 .8 39 .5 2, 20 0 Ja in 64 .7 33 .6 25 .4 25 .2 38 9 73 .8 25 .9 20 .9 18 .8 38 9 O th er 24 .3 75 .3 51 .6 54 .3 1, 78 3 38 .5 61 .4 35 .5 40 .6 1, 78 0 C as te /tr ib e Sc he du le d ca st e 39 .7 58 .2 47 .8 42 .6 61 ,0 88 45 .1 53 .7 41 .5 39 .0 61 ,0 13 Sc he du le d tri be 33 .7 65 .1 55 .0 49 .6 29 ,8 75 38 .7 60 .6 48 .2 45 .3 29 ,8 49 O th er b ac kw ar d cl as s 47 .6 49 .7 41 .7 37 .0 12 5, 85 2 52 .7 45 .8 35 .5 33 .5 12 5, 71 3 O th er 55 .4 42 .6 35 .3 32 .6 66 ,0 27 59 .5 39 .4 31 .2 29 .8 65 ,9 33 D on 't kn ow 51 .6 47 .1 37 .4 34 .6 2, 44 3 58 .2 41 .6 31 .6 31 .3 2, 43 9 W ea lth in de x Lo w es t 45 .2 52 .3 40 .9 34 .2 71 ,7 59 50 .1 48 .7 34 .1 30 .7 71 ,6 53 Se co nd 38 .2 59 .3 49 .4 44 .0 61 ,9 98 44 .2 54 .6 42 .2 39 .8 61 ,9 27 M id dl e 39 .3 58 .5 50 .1 46 .2 56 ,7 03 44 .4 54 .4 44 .3 42 .6 56 ,6 53 Fo ur th 48 .3 49 .5 42 .7 40 .1 51 ,9 41 53 .1 45 .7 38 .2 37 .0 51 ,8 89 H ig he st 66 .3 31 .7 27 .3 25 .4 42 ,8 85 70 .0 28 .6 23 .8 23 .1 42 ,8 25 To ta l 46 .3 51 .4 42 .9 38 .5 28 5, 28 6 51 .2 47 .5 37 .1 35 .0 28 4, 94 7 IC D S = In te gr at ed C hi ld D ev el op m en t S er vi ce s 1 S up pl em en ta ry fo od in cl ud es b ot h fo od c oo ke d an d se rv ed a t t he A W C o n a da ily b as is or g iv en in th e fo rm o f t ak e ho m e ra tio ns 2 E xc lu de s ch ild re n w ho w er e no t b re as tfe d. S er vi ce s ar e us ua lly p ro vi de d to b re as tfe ed in g m ot he rs d ur in g th e fir st s ix m on th s of b re as tfe ed in g Child Health z�289 Table 9.21 Indicators of women’s utilization of ICDS services during pregnancy and while breastfeeding by state/union territory Among children under age six years, percentage whose mothers received specific services from an anganwadi centre (AWC) during pregnancy and while breastfeeding by state/union territory, India, 2015-16 State/union territory Mother received from an AWC during pregnancy Mother received from an AWC while breastfeeding2 No services Supple- mentary food1 Health check-ups Health and nutrition education No services Supple- mentary food1 Health check-ups Health and nutrition education India 46.3 51.4 42.9 38.5 51.2 47.5 37.1 35.0 North Chandigarh 53.1 45.2 30.4 25.0 59.6 39.3 25.4 23.0 Delhi 85.8 11.8 10.7 10.9 90.4 9.1 6.8 7.8 Haryana 62.6 32.4 34.1 28.3 68.3 29.3 29.2 25.8 Himachal Pradesh 22.4 77.6 37.4 41.9 33.8 66.1 30.8 36.6 Jammu & Kashmir 73.4 26.1 13.7 13.7 80.2 19.5 11.0 11.2 Punjab 40.6 58.6 42.7 38.5 48.5 51.1 36.0 34.2 Rajasthan 52.3 43.7 38.5 28.1 61.8 36.7 27.4 22.6 Uttarakhand 49.3 50.2 25.0 24.2 47.3 52.5 25.5 24.1 Central Chhattisgarh 11.5 87.8 80.5 78.4 12.7 86.8 72.5 73.0 Madhya Pradesh 29.1 69.8 61.6 53.8 34.2 65.3 53.5 48.4 Uttar Pradesh 61.1 34.5 24.3 16.5 68.7 29.1 16.0 12.9 East Bihar 62.8 33.2 24.3 18.4 65.0 32.8 20.0 16.4 Jharkhand 29.9 68.4 48.9 39.7 35.5 63.6 39.1 35.5 Odisha 12.2 87.5 82.7 79.6 15.2 84.6 78.8 76.8 West Bengal 26.3 72.6 62.3 61.0 29.6 69.6 56.9 56.7 Northeast Arunachal Pradesh 86.7 12.9 6.5 6.2 85.3 14.3 6.3 6.1 Assam 42.5 56.0 39.0 33.7 49.0 50.3 33.6 30.2 Manipur 76.0 23.8 0.7 2.3 80.4 19.4 0.6 1.5 Meghalaya 45.5 53.7 28.2 31.0 48.8 50.3 27.4 29.5 Mizoram 33.4 66.3 33.1 38.7 39.0 60.8 31.1 36.1 Nagaland 90.8 9.1 1.0 0.9 91.9 8.1 0.7 0.9 Sikkim 50.9 48.7 38.8 40.5 53.7 46.1 36.4 37.7 Tripura 46.2 53.7 24.0 26.9 50.7 49.3 22.7 25.4 West Dadra & Nagar Haveli 61.5 37.6 35.8 32.5 77.7 22.0 21.1 18.7 Daman & Diu 76.2 18.9 22.5 18.3 83.9 13.6 15.0 14.6 Goa 31.3 68.0 54.5 56.8 33.2 66.7 54.8 55.6 Gujarat 43.1 55.0 51.2 47.0 50.3 48.7 44.1 41.6 Maharashtra 56.0 43.0 40.2 36.3 60.0 39.4 36.8 33.7 South Andaman & Nicobar Islands 52.9 46.9 25.7 35.9 64.1 35.9 22.8 30.0 Andhra Pradesh 18.6 80.9 68.7 76.0 18.2 81.1 67.6 76.3 Karnataka 37.2 62.0 54.8 49.4 45.2 53.9 49.4 45.8 Kerala 68.3 30.2 19.2 21.9 75.9 23.1 14.5 16.0 Lakshadweep 35.9 64.1 21.8 26.4 44.4 54.7 18.6 24.0 Puducherry 37.9 60.8 60.5 59.4 37.5 61.8 60.6 60.1 Tamil Nadu 36.7 61.5 60.8 58.4 38.9 60.0 58.5 56.9 Telangana 38.7 61.0 47.0 53.1 42.0 57.5 43.4 49.4 ICDS = Integrated Child Development Services 1 Supplementary food includes both food cooked and served at the AWC on a daily basis or given in the form of take home rations 2 Excludes children who were not breastfed. Services are usually provided to breastfeeding mothers during the first six months of breastfeeding. 290 z Child Health NUTRITION AND ANAEMIA 10 his chapter focuses on the nutritional status of children and adults, examining the types of food consumed and the consequences of inadequate nutrition and poor infant and child feeding practices. The chapter also addresses the diversity of food consumed by women and men age 15-49 years, as well as the prevalence of anaemia and malnutrition. Key Findings x Nutritional status of children: Thirty-eight percent of children under age five years are stunted (short for their age); 21 percent are wasted (thin for their height); 36 percent are underweight (thin for their age); and 2 percent are overweight (heavy for their height). Children born to mothers with no schooling and children in the lowest wealth quintile are most likely to be undernourished. x Initial breastfeeding: About two-fifths (42%) of children born in the last 5 years were breastfed within 1 hour of birth, as recommended. Timely initiation of breastfeeding is particularly low for women with no schooling, for home deliveries, and for births delivered by a dai. x Exclusive breastfeeding: Fifty-five percent of children under age six months are exclusively breastfed. x Anaemia among children: Fifty-eight percent of children age 6-59 months have anaemia (haemoglobin levels below 11.0 g/dl), an improvement from the NFHS-3 estimate of 70 percent. x Micronutrient intake: Sixty percent of children age 6-59 months were given vitamin A supplements in the six months preceding the survey. Forty-four percent of children age 6-23 months consumed foods rich in vitamin A in the day or night before the interview and 18 percent consumed iron-rich foods. x Deworming: Thirty-one percent of children age 6-59 months received deworming medication in the past six months. x Nutritional status of adults: Twenty-three percent of women and 20 percent of men age 15-49 are thin. Almost the same percentage are overweight or obese (21% of women and 19% of men). x Anaemia among adults: Fifty-three percent of women and 23 percent of men age 15-49 have anaemia. T Nutrition and Anaemia ‡ 291Nutrition and Anaemia z�291 10.1 NUTRITIONAL STATUS OF CHILDREN The anthropometric data on height and weight collected in the 2015-16 NFHS permit the measurement and evaluation of the nutritional status of young children in India. This evaluation allows identification of subgroups of the child population that are at increased risk of faltered growth, disease, impaired mental development, and death. 10.1.1 Nutritional Status among Young Children The 2015-16 NFHS measured the weight and height of children under age five years regardless of whether their mothers were interviewed in the survey. Weight was measured with an electronic SECA 874 flat scale designed for mobile use. For the weighing of very young children, the mother or caretaker was weighed first. The mother or caretaker was weighed again while holding the child. An automatic two-in-RQH�DGMXVWPHQW�EXWWRQ�DOORZHG�WKH�PRWKHU¶V�VWRUHG�ZHLJKW�WR�EH�GHGXFWHG�DQG� WKH�EDE\¶V�ZHLJKW�WR�EH�GLVSOD\HG�RQ�WKH�VFDOH��+eight was measured with a Seca 213 infantometer. Children younger than age 24 months were measured lying down (recumbent length using a Seca 417 infantometer), while standing height was measured for the older children. &KLOGUHQ¶V�KHLJKW�OHQJWK��ZHLJKW��DQG age data were used to calculate three indices: height-for-age, weight-for-height, and weight-for-age. Each of these indices provides different information about growth and body composition for assessing nutritional status, as indicated in the box below. Stunting, or low height-for-age, is a sign of chronic undernutrition that reflects failure to receive adequate nutrition over a long period. Stunting can also be affected by recurrent and chronic illness. Wasting, or low weight-for-height, is a measure of acute undernutrition and represents the failure to receive adequate nutrition in the period immediately before the survey. Wasting may result from inadequate food intake or from a recent episode of illness causing weight loss. The opposite of wasting is overweight (high weight-for-height), a measure of overnutrition. Weight-for-age is a composite index that takes into account both acute and chronic undernutrition. Stunting (assessed via height-for-age) Height-for-age is a measure of linear growth retardation and cumulative growth deficits. Children whose height-for-age Z-score is below minus two standard deviations (-2 SD) from the median of the reference population are considered short for their age (stunted), or chronically undernourished. Children who are below minus three standard deviations (-3 SD) are considered severely stunted. Sample: Children under age five years Wasting (assessed via weight-for-height) Weight-for-height index measures body mass in relation to body height or length and describes current nutritional status. Children whose Z-score is below minus two standard deviations (-2 SD) from the median of the reference population are considered thin (wasted), or acutely undernourished. Children whose weight-for-height Z-score is below minus three standard deviations (-3 SD) from the median of the reference population are considered severely wasted. Sample: Children under age five years Underweight (assessed via weight-for-age) Weight-for-age is a composite index of height-for-age and weight-for-height. It takes into account both acute and chronic undernutrition. Children whose weight-for-age Z-score is below minus two standard deviations (-2 SD) from the median of the reference population are classified as underweight. Children whose weight-for-age Z-score is below minus three standard deviations (-3 SD) from the median are considered severely underweight. Sample: Children under age five years 292 z Nutrition and Anaemia Overweight children Children whose weight-for-height Z-score is more than 2 standard deviations (+2 SD) above the median of the reference population are considered overweight. Sample: Children under age five years The means of the z-scores for height-for-age, weight-for-height, and weight-for-age are also calculated as summary statistics representing the nutritional status of children in a population. These mean scores describe the nutritional status of the entire population of children without the use of a cut-off point. A mean Z-score of less than zero (i.e., a negative mean value for stunting, wasting, or underweight) suggests a downward shift in the entire sample population’s nutritional status relative to the reference population. The farther away the mean z-scores are from zero, the higher is the prevalence of undernutrition. 10.1.2 Levels of Child Malnutrition In India, 38 percent of children under age five years are stunted (too short for their age). This is a sign of chronic undernutrition. Twenty-one percent of children under age five years are wasted (too thin for their height), which is a sign of acute undernu- trition, while 36 percent of children under age five years are underweight. Two percent of children are overweight (Table 10.1). Trends: The prevalence of stunting and under- weight has decreased since 2005-06, especially for stunting, which declined from 48 percent in 2005-06 to 38 percent in 2015-16. Over this same time period, the prevalence of wasting has remained about the same (Figure 10.1). Patterns by background characteristics x The prevalence of undernutrition is almost the same among girls and boys (Table 10.1). x The prevalence of stunting increases with a child’s age through 18-23 months and decreases slightly thereafter. x Over half (53%) of children who were reported to be very small at birth are stunted, compared with 37 percent of children who were of average size or larger. x Children born to thin mothers (BMI less than 18.5 kg/m2) are more likely to be stunted, wasted, and underweight than children born to mothers with a normal BMI or children whose mothers are overweight/obese. x Stunting is higher among children in rural areas (41%) than urban areas (31%). x Fifty-one percent of children born to mothers with no schooling are stunted, compared with 24 percent of children born to mothers with 12 or more years of schooling. The corresponding proportions of underweight children are 47 and 22 percent, respectively. x The prevalence of stunting decreases steadily with an increase in wealth quintiles, from 51 percent of children in households in the lowest wealth quintile to 22 percent of children in households in the highest wealth quintile. 48 20 43 38 21 36 Stunted (low height-for-age) Wasted (low weight-for-height) Underweight (low weight-for-age) NFHS-3 NFHS-4 Figure 10.1 Trends in Nutritional Status of Children Percentage of children age 0-59 months Note: Nutritional status estimates are based on the 2006 WHO International Reference Population Nutrition and Anaemia z�293 x The prevalence of stunting in children under age five is the highest in Bihar (48%), Uttar Pradesh (46%), Jharkhand (45%), and Meghalaya (44%), and lowest in Kerala and Goa (20% each). Jharkhand has the highest levels of underweight (48%) and wasting (29%) (Figure 10.2). 10.2 INFANT AND YOUNG CHILD FEEDING PRACTICES Appropriate infant and young child feeding (IYCF) practices include exclusive breastfeeding in the first six months of life, continued breastfeeding through age two years, introduction of solid and semi-solid foods at age six months, and gradual increases in the amount of food given and the frequency of feeding as the child gets older. It is also important for young children to receive a diverse diet, i.e., eating foods from different food groups to take care of the growing micronutrient needs. 10.2.1 Initiation of Breastfeeding Early initiation of breastfeeding is important for both the mother and the child. The first breastmilk contains colostrum, which is highly nutritious and has antibodies that protect the newborn from diseases. Early initiation of breastfeeding also encourages bonding between the mother and her newborn, facilitating the production of regular breastmilk. Thus, it is 20 20 23 23 24 24 26 26 27 27 27 28 28 29 29 29 29 30 31 32 33 34 34 34 34 36 36 38 38 39 39 42 42 44 45 46 48 Kerala Goa Andaman & Nicobar Islands Daman & Diu Puducherry Tripura Punjab Himachal Pradesh Lakshadweep Tamil Nadu Jammu & Kashmir Telangana Mizoram Nagaland Chandigarh Manipur Arunachal Pradesh Sikkim Andhra Pradesh Delhi West Bengal Uttarakhand Haryana Odisha Maharashtra Karnataka Assam Chhattisgarh INDIA Gujarat Rajasthan Dadra & Nagar Haveli Madhya Pradesh Meghalaya Jharkhand Uttar Pradesh Bihar Figure 10.2 Stunting in Children by State/UT Percentage of children age 0-59 months 294 z Nutrition and Anaemia recommended that children be put to the breast immediately or within one hour after birth and that prelacteal feeding (i.e., feeding newborns anything other than breastmilk before breastmilk is regularly given) be discouraged. Early breastfeeding Initiation of breastfeeding within one hour of birth Sample: Last-born children who were born in the two years before the survey Table 10.4 shows that 95 percent of children born in the two years before the survey were breastfed at some time. There are no major differences by background characteristics. More than two-fifths (42%) of last-born children in the two years before the survey who ever breastfed were breastfed within one hour of birth, and over four-fifths (81%) of children began breastfeeding within one day of birth. Twenty-one percent of children received a prelacteal feed. Early breastfeeding practices by background characteristics x Children whose delivery was assisted by health personnel (43%) or who were born at a health facility (43%) were more likely to start breastfeeding within one hour of birth than other children. x The percentage of children that are breastfed within one hour of birth is very low in Uttar Pradesh (25%); the only states in which more than two-thirds of children are breastfed within one hour of birth are Goa, Mizoram, Sikkim, and Odisha (Table 10.5). x Prelacteal feeding ranges from a minimum of 3 percent of children in Tripura to a maximum of 42 percent of children in Uttar Pradesh. 10.2.2 Exclusive Breastfeeding Breastmilk contains all of the nutrients needed by children in the first six months of life and is an uncontaminated nutritional source. It is recommended that children be exclusively breastfed in the first six months of their life; that is, they are given nothing but breastmilk. Complementing breastmilk before age six months is unnecessary and is discouraged because the likelihood of contami- nation and the resulting risk of diarrhoeal disease are high. Early initiation of complementary feeding also reduces breastmilk output because the produc- tion and release of breastmilk is modulated by the frequency and intensity of suckling. Table 10.6 and Figure 10.3 show breastfeeding practices by children’s age. Fifty-five percent of infants under age six months are exclusively breastfed. Contrary to the recommendation that children under age six months be exclusively breastfed, many children in that age group consume other liquids, such as plain water (18%), other milk (11%), or complementary foods (10%) in addition to breastmilk. Trends: Exclusive breastfeeding among children under six months increased from 46 percent in 2005-06 to 55 percent in 2015-16. Figure 10.3 Breastfeeding Practices by Age Percentage of children under age two years 0 20 40 60 80 100 <2 2-3 4-5 6-8 9-11 12-17 18-23 Age in months Breastfeeding and consuming complementary foods Not breastfeeding Exclusive breastfeeding Nutrition and Anaemia z�295 10.2.3 Median Duration of Breastfeeding The median duration of breastfeeding in India is 29.6 months. This means that half of children have stopped breastfeeding by age about 30 months (Table 10.7). The median duration of exclusive breastfeeding is 2.9 months, and the median duration of predominant breastfeeding (the period in which an infant receives only water or other non-milk liquids in addition to breastmilk) is 5.8 months. Trends: The median duration of exclusive breastfeeding increased from 2.0 months in 2005-06 to 2.9 months in 2015-16.The median duration of any breastfeeding has also increased, from 24.4 months to 29.6 months. Patterns by background characteristics x On average, children in rural areas are breastfed longer (median duration of 33.0 months) than their counterparts in urban areas (median duration of 24.4 months). x On average, children of scheduled caste and scheduled tribe mothers are breastfed longer (median duration of more than 33 months) than the children whose mothers belong to other backward classes (median duration of 27.5 months) and children not from scheduled castes, scheduled tribes or other backward classes (median duration of 28.1 months). x The median duration of breastfeeding is 36.0 months or longer in eight states (mostly in the East and Northeast) and is shortest in Tamil Nadu (17.4 months) (Table 10.8). 10.2.4 Complementary Feeding After the first six months, breastmilk is no longer enough to meet the nutritional needs of the infant; therefore, complementary foods should be added to the diet of the child. Appropriate complementary feeding should include a variety of foods to ensure that requirements for nutrients are met. Fruits and vegetables rich in vitamin A should be consumed daily. Eating a range of fruits and vegetables, in addition to those rich in vitamin A, is also important. Table 10.9 shows that the type of foods and liquids received by children during the day and night before the survey depends on the child’s age and breastfeeding status. Overall, foods made from grains are the most consumed complementary food items irrespective of breastfeeding status, followed by fruits and vegetables rich in vitamin A. Patterns by background characteristics x For children age 6-23 months, consumption of liquids other than milk is lower among breastfed children (32%) than among nonbreastfed children (44%). x Fewer breastfed (38%) children age 6-23 months eat fruits and vegetables rich in vitamin A than nonbreastfeeding children (51%). x Among children age 6-23 months, the least consumed food items are food made from beans, peas, lentils, and nuts for both breastfed (13%) and nonbreastfed children (19%). 10.2.5 Minimum Acceptable Diet Infants and young children should be fed a minimum acceptable diet (MAD) to ensure appropriate growth and development. Without adequate diversity and meal frequency, infants and young children are vulnerable to undernutrition, especially stunting and micronutrient deficiencies, and to increased morbidity and mortality. The WHO minimum acceptable diet recommendation, which is a combination of dietary diversity and minimum meal frequency, is different for breastfed and nonbreastfed children. The definition of the composite indicator of a minimum acceptable diet for all children 6-23 months is indicated in the box below. 296 z Nutrition and Anaemia Dietary diversity is a proxy for adequate micronutrient-density of foods. Minimum dietary diversity means feeding the child food from at least four food groups. The cut-off of four food groups is associated with better-quality diets for both breastfed and nonbreastfed children. The minimum meal frequency is a proxy for a child’s energy requirements. For infants and young children, the indicator is based on how much energy the child needs and, if the child is breastfed, the amount of energy needs not met by breastmilk. Breastfed children are considered to be consuming a minimum meal frequency if they receive solid, semi-solid, or soft foods at least twice a day for infants 6-8 months and at least three times a day for children 9-23 months. Nonbreastfed children ages 6-23 months are considered to be fed with a minimum meal frequency if they receive solid, semi-solid, or soft foods at least four times a day. Minimum acceptable diet Proportion of children age 6-23 months who receive a minimum acceptable diet. This indicator is a composite of the following two groups: Breastfed children age 6-23 months who had at least the minimum dietary diversity and the minimum meal frequency during the previous day Breastfed children age 6-23 months and Nonbreastfed children age 6-23 months who received at least two milk feedings, and had at least the minimum dietary diversity (not including milk feeds), and the minimum meal frequency during the previous day Nonbreastfed children age 6-23 months The 2015-16 NFHS indicates that 94 percent of Indian children age 6-23 months received breastmilk, milk, or milk products (2+ times) during the day or night before the interview (Table 10.10). Twenty percent of breastfed children had an adequately diverse diet since they had been given foods from the appropriate number of food groups, while 31 percent had been fed the minimum number of times appropriate for their age. The feeding practices of only 9 percent of breastfed children age 6-23 months meet the minimum standards for all IYCF feeding practices. Ten percent of all children age 6-23 months were fed the minimum acceptable diet. The IYCF indicators for minimum acceptable diet by breastfeeding status among children age 6-23 months are summarised in Figure 10.4. 20 31 8.7 34 61 14 22 36 9.6 Minimum dietary diversity (IYCF Indicator 5) Minimum meal frequency (IYCF Indicator 6) Minimum acceptable diet (IYCF Indicator 7) Breastfed children Nonbreastfed children All children Figure 10.4 IYCF Indicators on Minimum Acceptable Diet (MAD) Percentage of children age 6-23 months Nutrition and Anaemia z�297 Patterns by background characteristics x Breastfed children age 6-23 months are less likely than nonbreastfed children age 6-23 months to receive the minimum number of food groups (20% and 34%, respectively). x Children in urban areas (28%) are more likely than those in rural areas (20%) to have an adequately diverse diet. x Breastfed infants (9%) are less likely to meet the minimum acceptable diets than the nonbreastfed infants (14%). x The percentage of children age 6-23 months who receive a minimum acceptable diet increases with the mother’s schooling. For example, only 7 percent of children whose mothers have no schooling receive the minimum acceptable diet, compared with 12 percent of children whose mothers have 12 or more years of schooling. x The proportion of children age 6-23 months who receive a minimum acceptable diet is highest in Tamil Nadu and Puducherry (31% each) and the lowest in Rajasthan and Dadra & Nagar Haveli (3% or less). The pattern is the same among breastfed and nonbreastfed children (Table 10.11). 10.3 ANAEMIA PREVALENCE IN CHILDREN Anaemia in children Anaemia status Haemoglobin level in grams/decilitre* Anaemic <11.0 Mildly anaemic 10.0-10.9 Moderately anaemic 7.0-9.9 Severely anaemic <7.0 Not anaemic 11.0 or higher *Haemoglobin levels are adjusted for altitude in enumeration areas that are above 1,000 metres Sample: Children 6-59 months Anaemia is a condition that is marked by low levels of haemoglobin in the blood. Iron is a key component of haemoglobin, and iron deficiency is estimated to be responsible for half of all anaemia globally. Other causes of anaemia include malaria, hookworm and other helminths, other nutritional deficien- cies, chronic infections, and genetic conditions. Anaemia is a serious concern for children because it can impair cognitive development, stunt growth, and increase morbidity from infectious diseases. In 2015-16 NFHS, haemoglobin testing was performed on children age 6-59 months. The testing was successfully completed for 91 percent of the children eligible for testing. The methodology used to measure haemoglobin is described in Chapter 1. Overall, 59 percent of children had some degree of anaemia (haemoglobin levels below 11.0 g/dl). Twenty-eight percent of children had mild anaemia, 29 percent had moderate anaemia, and 2 percent had severe anaemia (Table 10.12). 26 28 40 29 2.9 1.6 NFHS-3 NFHS-4 Severe Moderate Mild Figure 10.5 Trends in Childhood Anaemia Percentage of children age 6-59 months 298 z Nutrition and Anaemia Trends: Between 2005-06 and 2015-16, the prevalence of anaemia among children age 6-59 months declined from 70 percent to 59 percent, but continued to be higher among rural children (Figure 10.5). Patterns by background characteristics x Anaemia is more prevalent among children under age 24 months than among older children, with a peak prevalence of 71 percent observed among children age 12-17 months (Table 10.12). x Anaemia prevalence increases with increasing birth order of children and is higher among the children of anaemic mothers than non-anaemic mothers. x The prevalence of anaemia declines as the mother’s schooling and household wealth increases. The prevalence of anaemia among children age 6-59 months is highest among children in Haryana (72%), followed by Jharkhand (70%) and Madhya Pradesh (69%). Several union territories have even higher prevalence of anaemia (Dadra and Nagar Haveli, Daman & Diu, and Chandigarh). The states with the lowest prevalence of anaemia among children are Mizoram (19%), Manipur (24%), and Nagaland (26%) (Table 10.13). 10.4 PRESENCE OF IODIZED SALT IN HOUSEHOLDS Iodine is an essential micronutrient, and iodized salt prevents goitre or any other thyroid-related health problems among children and adults. It is recommended that household salt should be fortified with iodine to at least 15 parts per million (ppm). The 2015-16 NFHS tested for the presence or absence of potassium iodate or potassium iodide in household salt. Salt was tested in almost all households (Table 10.15). Among the households in which salt was tested, 93 percent had iodized salt. This is much higher than in NFHS-3, when only 76 percent of households were using iodized salt. There is steady increase in the use of iodized salt by household wealth quintiles, from 90 percent in the lowest wealth quintile to 98 percent in the highest wealth quintile. Among the states, the use of iodized salt is lowest in Andhra Pradesh (82%), Tamil Nadu (83%), and Dadra & Nagar Haveli (71%) (Table 10.16). 10.5 MICRONUTRIENT INTAKE AND SUPPLEMENTATION AMONG CHILDREN Micronutrient deficiency is a major contributor to childhood morbidity and mortality. Micronutrients are available in foods and can also be provided through direct supplementation. Breastfeeding children benefit from supplements given to the mother. The information collected on food consumption among the youngest children under age two years is useful in assessing the extent to which children are consuming foods rich in two key micronutrients—vitamin A and iron—in their daily diet. Iron deficiency is one of the primary causes of anaemia, which has serious health consequences for both women and children. Vitamin A is an essential micronutrient for the immune system and plays an important role in maintaining the epithelial tissue in the body. Severe vitamin A deficiency (VAD) can cause eye damage and is the leading cause of childhood blindness. VAD also increases the severity of infections such as measles and diarrhoeal disease in children and slows recovery from illness. VAD is common in dry environments where fresh fruits and vegetables are not readily available. Forty-four percent of children age 6-23 months consumed foods rich in vitamin A in the day or night before the interview, and 18 percent consumed iron-rich foods (Table 10.17). The intake of both vitamin A-rich and iron-rich foods increases as children are weaned. Among children age 6-59 months, 26 percent were given iron supplements in the seven days prior to survey. In the six months before the survey, 60 percent of children age 6-59 months were given vitamin A supplements and 31 percent were given deworming medication. Ninety-three percent of children age 6-59 months are in households using iodized salt. Nutrition and Anaemia z�299 The percentage of children age 6-59 months given Vitamin A supplements in the last six months ranges from 29 percent in Nagaland and 31 percent in Manipur to 89 percent in Goa (Table 10.18). 10.6 NUTRITIONAL STATUS IN ADULTS The 2015-16 NFHS collected anthropometric data on the height and weight of women age 15-49 and men age 15-54 years. These data were used to calculate several measures of nutritional status such as ZRPHQ¶V height and body mass index (BMI). Information on BMI of women is provided in Table 10.19.1 and Figure 10.6. Twenty-three percent of women age 15-49 are thin, 21 percent are overweight or obese, and 56 percent have a BMI in the normal range. Eleven percent of women age 15-49 years have a height below 145 cm. Trends: The proportion of thin women age 15-49 declined from 36 percent in 2005-06 to 23 percent in 2015-16; at the same time the proportion of overweight or obese women increased from 13 percent to 21 percent. Overall, there has been an increase in the mean BMI from 20.5 in 2005-06 to 21.9 in 2015-16. The proportion of women whose height was below 145 cm was the same (11%) in 2005-06 and 2015-16 (Figure 10.7). Patterns by background characteristics x The percentage of women suffering from either undernutrition or over nutrition (overweight or obesity) is fairly constant across all groups. x The proportion of thin women decreases with age, from 42 percent for women age 15-19 to 14 percent for women age 40-49, whereas the proportion of overweight or obese women increases steadily, from 4 percent of women age 15-49 to 34 percent of women age 40-49. x The proportion of thin women is higher in rural areas (27%) than in urban areas (16%) and the reverse is observed for the prevalence of overweight or obesity (31% in urban areas and 15% in rural areas). Body mass index (BMI) BMI is calculated by dividing weight in kilograms by height in metres squared (kg/m2). Status BMI (kg/m2) Too thin for their height <18.5 Normal 18.5-24.9 Overweight 25.0-29.9 Obese •30.0 Sample: Women age 15-49 who are not pregnant and who have not had a birth in the two months before the survey and men age 15-49 23 20 56 61 16 16 5.1 3.0 Women Men Obese Overweight Normal weight Thin Figure 10.6 Nutritional Status of Women and Men Percent distribution of women and men age 15-49 300 z Nutrition and Anaemia x There is a steady decrease in the proportion of thin women as household wealth increases (from 36% in the lowest wealth quintile to 12% in the highest wealth quintile), which is accompanied by a steady increase in the proportion of overweight or obese women (from 6% in the lowest wealth quintile to 36% in the highest wealth quintile). x The highest proportion of thin women is observed in Jharkhand (32%), followed by Bihar (31%). The highest proportion of over- weight or obese women is found in Goa (34%), several southern states (33% in Andhra Pradesh, 32% in Kerala, and 31% in Tamil Nadu) and all of the union territories except Dadra & Nagar Haveli (Table 10.20.1). Twenty percent of men age 15-49 are thin, 19 percent are overweight or obese, and 61 percent have a BMI in the normal range. The mean body mass index for men (21.8) is similar to that of women (21.9) (Table 10.19.2). Patterns by background characteristics x The patterns of nutritional status by background characteristics among men are similar to those among women. x The proportion of thin men decreases with age, from 45 percent of men age 15-19 to 13 percent of men age 40-49, whereas the proportion of overweight or obese men increases from 5 percent of men age 15-19 to 28 percent of men age 40-49. x The proportion of thin men is higher in rural areas (23%) than in urban areas (16%), whereas 27 percent of men are overweight or obese in urban areas, compared with 14 percent in rural areas. x There is steady decrease in the proportion of thin men with increasing household wealth (from 32% in the lowest wealth quintile to 11% in the highest wealth quintile), and a steady increase in the proportion of overweight or obese men (from 5% in the lowest wealth quintile to 33% in the highest wealth quintile). x The proportion of thin men is highest in Madhya Pradesh (28%), followed by Uttar Pradesh and Bihar (26% each). The highest proportion of overweight or obese men is observed in Sikkim (35%), several southern states (34% in Andhra Pradesh, 28% in Tamil Nadu, and 29% in Kerala) and most of the union territories (Table 10.20.2). 10.7 ANAEMIA PREVALENCE IN ADULTS Haemoglobin levels below which women and men are considered anaemic Respondents Haemoglobin level in grams/decilitre* Non-pregnant women age 15-49 <12.0 Pregnant women age 15-49 <11.0 Men age 15-49 <13.0 *Haemoglobin levels are adjusted for smoking, and for altitude in enumeration areas that are above 1,000 metres 36 23 13 21 NFHS-3 NFHS-4 Women 34 20 9.3 19 NFHS-3 NFHS-4 Men Thin Overweight/obese Figure 10.7 Trends in Nutritional Status Percentage of women and men age 15-49 Men Nutrition and Anaemia z�301 The same equipment and procedures used to measure anaemia in children were used to measure anaemia in women and men, except that capillary blood was collected exclusively from a finger prick. Fifty-three percent of women and 23 percent of men age 15-49 in India are anaemic (Table 10.21.1 and Table 10.21.2). Forty percent of women are mildly anaemic, 12 percent are moderately anaemic, and 1 percent are severely anaemic. Twelve percent of men are classified as mildly anaemic, 10 percent as moderately anaemic, and 1 percent as severely anaemic. Trends: Anaemia prevalence has barely changed in the 10 years between NFHS-3 and NFHS-4, decreasing from 55 percent in 2005-06 to 53 percent in 2015-16 among women and from 24 percent in 2005-06 to 23 percent in 2015-16 among men (Figure 10.8). Patterns by background characteristics x The overall prevalence of anaemia is consistently high, at more than 50 percent, in almost all of the subgroups of women. For men, the prevalence is above 20 percent in most of the subgroups. x Anaemia varies by maternity status—58 percent of women who are breastfeeding are anaemic, compared with 50 percent of women who are pregnant and 52 percent of women who are neither pregnant nor breastfeeding. 39 40 15 12 1.8 1.0 NFHS-3 NFHS-4 Women Mild Moderate Severe 13 12 9.9 9.7 1.3 1.1 NFHS-3 NFHS-4 Men Mild Moderate Severe Figure 10.8 Trends in Anaemia Status Percentage of women and men age 15-49 Mild Moderate Severe Mild Moderate Severe Men x The prevalence of anaemia decreases with schooling, from 56 percent among women with no schooling to 49 percent among women with 12 or more years of schooling. Across the same schooling groups, the prevalence of anaemia among men decreases from 29 percent to 18 percent. x The proportion of anaemic women and men declines steadily as the wealth of the household increases (from 59% in the lowest wealth quintile to 48% in the highest wealth quintile among women and from 32% in the lowest wealth quintile to 17% in the highest wealth quintile among men). x Women in urban areas are slightly less likely to be anaemic (51%) than those in rural areas (54%). The difference is larger for the prevalence of anaemia in men (25% in rural areas versus 19% in urban areas). The prevalence of anaemia among women is more than 60 percent or more in Jharkhand, Haryana, West Bengal, Bihar, and Andhra Pradesh, and the prevalence is less than one-third in Mizoram (25%), Manipur (26%), Nagaland (28%), and Goa (31%). The prevalence of anaemia is also very high in the union territories of Dadra & Nagar Haveli (80%), Chandigarh (76%), and the Andaman & Nicobar Islands (66%). The statewise distribution pattern of anaemia prevalence in men is similar to that in women, except that the prevalence among men in Haryana and Chandigarh is slightly below the national average whereas it is well above the national average in the case of women. 302 z Nutrition and Anaemia 10.8 FOOD CONSUMPTION OF WOMEN AND MEN The consumption of a wide variety of nutritious foods is important for women’s and men’s health. A well-balanced diet is required for adequate amounts of protein, fat, carbohydrates, vitamins, and minerals. The 2015-16 NFHS asked women and men how often they consume various types of food (daily, weekly, occasionally, or never). Among these food groups, women consume dark green, leafy vegetables most often (Table 10.23). Almost half (47%) of women consume dark green, leafy vegetables daily and an additional 38 percent consume them weekly. Almost half (45%) of women consume pulses or beans daily and an equal percentage of women consume them weekly. Milk or curd is consumed daily by 45 percent of women and weekly by 23 percent of women, but 7 percent never consume milk or curd and 25 percent consume milk or curd only occasionally. Consumption of fruits is less common. Fifty-four percent of women do not consume fruits even once a week. Very few women consume chicken, meat, fish, or eggs on a daily basis, although about one-third of women consume these types of food weekly. Ten percent of women consume fried foods daily and 36 percent weekly. Aerated drinks are consumed daily by 5 percent of women and weekly by 20 percent of women. The pattern of food consumption by men is similar to that of women, but men are slightly more likely than women to consume milk or curd regularly, as well as fruits. Men are less likely than women to completely abstain from eating chicken, meat, fish, and eggs. Overall, 30 percent of women and 22 percent of men are vegetarians according to this measure. Trends: The pattern of daily food consumption has remained more or less the same since 2005-06 except there has been a decrease in the daily consumption of dark green, leafy vegetables among both women and men, and an increase in the daily consumption of milk or curd. Patterns by background characteristics x Deficiencies in the diet of both women and men are observed among those with little or no schooling, those in rural areas, those in poorer households, and those belonging to scheduled tribes and scheduled castes. The most prominent deficiency in their diet is in fruits and milk or curd (Table 10.24.1 and Table 10.24.2). x The regular consumption of pulses and beans, as well as dark green, leafy vegetables, is common in every state (Table 10.25.1 and Table 10.25.2). x At least three-quarters of women eat dark green, leafy vegetables at least once a week in every state except Rajasthan (61%), Kerala (63%), and Uttar Pradesh (73%). The consumption of dark green, leafy vegetables among women at least once a week is also relatively low in the union territories of Lakshadweep (52%) and Daman & Diu (67%). x The consumption of other types of food at least once a week among women varies widely across the states, particularly milk or curd (from 24% in Mizoram and 30% in Odisha to 91% in Haryana, 93% in Karnataka, and 96% in Sikkim) and fruits (from 19% in Odisha to 83% in Kerala). Nutrition and Anaemia ‡ 303Nutrition and Anaemia z�303 LIST OF TABLES For more information on nutrition and anaemia of children and adults, see the following tables: Tables Table 10.1 Nutritional status of children Table 10.2 Nutritional status of children by state/union territory Table 10.3 Trends in nutritional status of children Table 10.4 Initial breastfeeding Table 10.5 Initial breastfeeding by state/union territory Table 10.6 Breastfeeding status by age Table 10.7 Median duration of breastfeeding Table 10.8 Median duration of breastfeeding by state/union territory Table 10.9 Foods and liquids consumed by children in the day or night preceding the interview Table 10.10 Minimum acceptable diet Table 10.11 Minimum acceptable diet by state/union territory Table 10.12 Prevalence of anaemia in children Table 10.13 Prevalence of anaemia in children by state/union territory Table 10.14 Trends in prevalence of anaemia in children Table 10.15 Presence of iodized salt in household Table 10.16 Presence of iodized salt in household by state/union territory Table 10.17 Micronutrient intake among children Table 10.18 Micronutrient intake among children by state/union territory Table 10.19.1 Nutritional status of women Table 10.19.2 Nutritional status of men Table 10.20.1 Nutritional status of women by state/union territory Table 10.20.2 Nutritional status of men by state/union territory Table 10.21.1 Prevalence of anaemia in women Table 10.21.2 Prevalence of anaemia in men Table 10.22 Prevalence of anaemia in women and men by state/union territory Table 10.23 :RPHQ¶V�DQG�PHQ¶V�IRRG�FRQVXPSWLRn Table 10.24.1 :RPHQ¶V�IRRG�FRQVXPSWLRQ Table 10.24.2 0HQ¶V�IRRG�FRQVXPSWLRQ Table 10.25.1 :RPHQ¶V�IRRG�FRQVXPSWLRQ�E\�VWDWH�XQLRQ�WHUULWRU\ Table 10.25.2 0HQ¶V�IRRG�FRQVXPSWLRQ�E\�VWDWH�XQLRQ�WHUULWRU\ 304 z Nutrition and Anaemia Ta bl e 10 .1 N ut rit io na l s ta tu s of c hi ld re n Pe rc en ta ge o f ch ild re n un de r ag e fiv e ye ar s cl as sif ie d as m al no ur ish ed a cc or di ng t o th re e an th ro po m et ric i nd ic es o f nu tri tio na l st at us : he ig ht -fo r- ag e, w ei gh t- fo r- he ig ht , an d w ei gh t- fo r- ag e, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic H ei gh t- fo r- ag e1 W ei gh t- fo r- he ig ht W ei gh t- fo r- ag e N um be r of ch ild re n Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 M ea n Z- sc or e (S D ) Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 Pe rc en ta ge ab ov e + 2 SD M ea n Z- sc or e (S D ) Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 Pe rc en ta ge ab ov e + 2 SD M ea n Z- sc or e (S D ) Ag e in m on th s < 6 9. 5 20 .1 -0 .6 14 .9 31 .9 5. 3 -1 .2 9. 5 26 .7 0. 9 -1 .3 17 ,6 44 6- 8 9. 0 20 .2 -0 .6 11 .0 28 .0 3. 2 -1 .1 8. 2 26 .7 0. 6 -1 .3 11 ,5 29 9- 11 11 .9 25 .9 -0 .9 10 .4 27 .3 2. 8 -1 .1 9. 6 31 .0 0. 6 -1 .4 10 ,7 46 12 -1 7 16 .6 38 .2 -1 .4 8. 3 23 .7 2. 2 -1 .0 10 .5 32 .8 0. 7 -1 .5 21 ,9 41 18 -2 3 22 .0 46 .9 -1 .8 6. 8 20 .4 1. 6 -1 .0 12 .1 37 .3 0. 5 -1 .6 22 ,2 42 24 -3 5 18 .6 42 .7 -1 .7 6. 8 19 .1 1. 4 -1 .0 11 .8 37 .6 0. 5 -1 .6 44 ,0 60 36 -4 7 17 .1 43 .2 -1 .7 5. 7 17 .9 1. 5 -1 .0 11 .9 38 .2 0. 4 -1 .7 46 ,7 75 48 -5 9 15 .8 40 .0 -1 .7 5. 3 17 .7 1. 7 -1 .0 10 .7 39 .1 0. 3 -1 .7 44 ,8 59 Se x M al e 16 .9 38 .9 -1 .5 7. 9 21 .9 2. 1 -1 .0 11 .1 36 .1 0. 5 -1 .6 11 3, 80 4 Fe m al e 15 .6 37 .9 -1 .4 6. 9 20 .1 2. 1 -1 .0 10 .9 35 .3 0. 5 -1 .6 10 5, 99 2 Bi rt h in te rv al in m on th s3 Fi rs t b irt h4 13 .0 33 .4 -1 .3 7. 2 20 .5 2. 3 -1 .0 9. 0 31 .6 0. 6 -1 .4 81 ,3 87 < 24 21 .7 46 .9 -1 .8 7. 4 21 .1 1. 5 -1 .1 14 .5 42 .5 0. 3 -1 .8 34 ,8 60 24 -3 5 19 .4 43 .4 -1 .7 7. 9 22 .2 1. 7 -1 .1 12 .8 40 .5 0. 4 -1 .7 41 ,6 84 36 + 15 .3 36 .9 -1 .4 7. 5 20 .9 2. 3 -1 .0 10 .4 34 .1 0. 6 -1 .5 54 ,0 99 D on 't kn ow 17 .0 34 .8 -1 .5 8. 4 25 .5 0. 8 -1 .2 14 .2 39 .1 0. 6 -1 .7 55 9 Bi rt h or de r3 1 13 .0 33 .4 -1 .3 7. 2 20 .5 2. 3 -1 .0 9. 0 31 .6 0. 6 -1 .4 81 ,3 87 2- 3 16 .4 39 .0 -1 .5 7. 4 21 .1 2. 0 -1 .0 10 .9 36 .1 0. 5 -1 .6 10 1, 09 1 4- 5 23 .5 48 .9 -1 .8 8. 1 22 .4 1. 4 -1 .1 15 .9 44 .9 0. 3 -1 .8 22 ,7 44 6+ 28 .8 55 .0 -2 .1 8. 6 22 .6 1. 3 -1 .1 19 .4 49 .7 0. 2 -2 .0 7, 36 7 Re si de nc e U rb an 12 .0 31 .0 -1 .2 7. 5 20 .0 2. 8 -0 .9 8. 2 29 .1 0. 8 -1 .3 60 ,1 24 Ru ra l 17 .9 41 .2 -1 .6 7. 4 21 .4 1. 8 -1 .1 12 .1 38 .3 0. 4 -1 .7 15 9, 67 1 C on tin ue d… Nutrition and Anaemia z�305 T ab le 1 0. 1 N ut rit io na l s ta tu s of c hi ld re n— C on tin ue d Pe rc en ta ge o f ch ild re n un de r ag e fiv e ye ar s cl as sif ie d as m al no ur ish ed a cc or di ng t o th re e an th ro po m et ric i nd ic es o f nu tr iti on al s ta tu s: h ei gh t- fo r- ag e, w ei gh t- fo r- he ig ht , an d w ei gh t- fo r- ag e, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic H ei gh t- fo r- ag e1 W ei gh t- fo r- he ig ht W ei gh t- fo r- ag e N um be r of ch ild re n Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 M ea n Z- sc or e (S D ) Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 Pe rc en ta ge ab ov e + 2 SD M ea n Z- sc or e (S D ) Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 Pe rc en ta ge ab ov e + 2 SD M ea n Z- sc or e (S D ) Si ze a t b ir th 3 Ve ry s m al l 26 .9 52 .8 -2 .0 10 .0 28 .1 1. 4 -1 .3 23 .3 53 .5 0. 2 -2 .1 5, 85 4 Sm al l 20 .0 45 .1 -1 .7 8. 4 24 .5 1. 6 -1 .2 15 .9 44 .6 0. 3 -1 .8 19 ,0 89 Av er ag e or la rg er 15 .5 37 .1 -1 .4 7. 3 20 .5 2. 1 -1 .0 10 .0 34 .2 0. 5 -1 .5 18 4, 56 9 D on 't kn ow 23 .0 48 .5 -1 .8 7. 3 21 .8 1. 4 -1 .1 15 .3 45 .1 0. 2 -1 .8 3, 07 9 M ot he r's s ch oo lin g5 N o sc ho ol in g 24 .8 50 .7 -1 .9 8. 1 22 .7 1. 5 -1 .1 16 .7 46 .8 0. 3 -1 .9 64 ,8 78 < 5 ye ar s co m pl et e 18 .5 45 .3 -1 .7 7. 6 22 .2 1. 7 -1 .1 12 .6 41 .9 0. 4 -1 .8 13 ,0 01 5- 7 ye ar s co m pl et e 16 .0 39 .8 -1 .6 7. 5 21 .6 1. 7 -1 .1 11 .0 37 .6 0. 4 -1 .6 35 ,0 34 8- 9 ye ar s co m pl et e 13 .3 35 .5 -1 .4 7. 3 21 .0 1. 9 -1 .0 9. 3 33 .1 0. 5 -1 .5 36 ,0 16 10 -1 1 ye ar s co m pl et e 10 .5 29 .7 -1 .2 6. 9 19 .8 2. 2 -1 .0 7. 4 28 .5 0. 7 -1 .3 25 ,7 01 12 o r m or e ye ar s co m pl et e 8. 7 23 .8 -0 .9 6. 9 18 .5 3. 3 -0 .8 5. 5 21 .8 1. 0 -1 .1 40 ,9 70 Re lig io n H in du 16 .4 38 .5 -1 .5 7. 6 21 .5 2. 1 -1 .0 11 .3 36 .3 0. 5 -1 .6 17 2, 36 0 M us lim 17 .1 39 .8 -1 .5 6. 9 19 .4 1. 9 -1 .0 10 .6 34 .9 0. 5 -1 .6 36 ,8 47 C hr ist ia n 12 .4 29 .9 -1 .2 6. 4 18 .5 3. 3 -0 .8 7. 0 27 .2 1. 0 -1 .2 4, 48 8 Si kh 7. 2 23 .4 -1 .0 6. 1 16 .1 2. 4 -0 .7 5. 6 19 .9 0. 7 -1 .1 2, 82 6 Bu dd hi st /N eo -B ud dh ist 16 .4 43 .0 -1 .5 7. 8 20 .9 1. 9 -1 .1 10 .6 35 .8 0. 5 -1 .6 1, 65 9 Ja in 4. 9 19 .1 -1 .0 8. 2 17 .8 2. 6 -1 .0 5. 2 28 .8 0. 2 -1 .2 24 2 O th er 17 .5 42 .5 -1 .6 10 .5 29 .6 1. 6 -1 .3 15 .2 45 .9 0. 1 -1 .8 1, 37 4 C as te /tr ib e Sc he du le d ca st e 19 .0 42 .8 -1 .6 7. 5 21 .2 1. 8 -1 .1 12 .6 39 .1 0. 4 -1 .7 48 ,3 59 Sc he du le d tri be 19 .7 43 .8 -1 .7 10 .3 27 .4 2. 0 -1 .2 16 .1 45 .3 0. 5 -1 .8 22 ,7 48 O th er b ac kw ar d cl as s 16 .4 38 .7 -1 .5 7. 2 20 .5 2. 0 -1 .0 10 .7 35 .5 0. 5 -1 .6 96 ,5 64 O th er 11 .9 31 .2 -1 .2 6. 5 19 .0 2. 4 -0 .9 7. 8 28 .8 0. 7 -1 .3 50 ,4 51 D on 't kn ow 16 .2 38 .8 -1 .4 7. 3 19 .9 2. 1 -1 .0 10 .4 35 .2 0. 6 -1 .5 1, 67 4 &R QW LQ XH G« 306 z Nutrition and Anaemia T ab le 1 0. 1 N ut rit io na l s ta tu s of c hi ld re n— C on tin ue d Pe rc en ta ge o f ch ild re n un de r ag e fiv e ye ar s cl as sif ie d as m al no ur ish ed a cc or di ng t o th re e an th ro po m et ric i nd ic es o f nu tri tio na l st at us : he ig ht -fo r- ag e, w ei gh t- fo r- he ig ht , an d w ei gh t- fo r- ag e, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic H ei gh t- fo r- ag e1 W ei gh t- fo r- he ig ht W ei gh t- fo r- ag e N um be r of ch ild re n Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 M ea n Z- sc or e (S D ) Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 Pe rc en ta ge ab ov e + 2 SD M ea n Z- sc or e (S D ) Pe rc en ta ge be lo w -3 S D Pe rc en ta ge be lo w -2 S D 2 Pe rc en ta ge ab ov e + 2 SD M ea n Z- sc or e (S D ) M ot he r's in te rv ie w s ta tu s In te rv ie w ed 16 .3 38 .5 -1 .5 7. 4 21 .1 2. 1 -1 .0 11 .0 35 .8 0. 5 -1 .6 21 2, 58 9 N ot in te rv ie w ed b ut in h ou se ho ld 17 .7 37 .9 -1 .4 9. 0 22 .9 2. 6 -1 .0 12 .5 36 .1 0. 6 -1 .5 3, 02 9 N ot in te rv ie w ed , a nd n ot in th e ho us eh ol d6 15 .7 36 .2 -1 .4 6. 4 19 .1 2. 0 -0 .9 10 .8 33 .4 0. 9 -1 .5 4, 17 7 M ot he r's n ut ri tio na l s ta tu s7 U nd er w ei gh t ( BM I< 18 .5 k g/ m 2 ) 20 .5 45 .8 -1 .8 8. 9 26 .7 1. 1 -1 .3 16 .3 47 .8 0. 2 -1 .9 53 ,2 96 N or m al (B M I 1 8. 5- 24 .9 k g/ m 2 ) 16 .2 38 .2 -1 .5 7. 5 20 .4 2. 2 -1 .0 10 .3 34 .3 0. 5 -1 .5 12 8, 51 5 2 YH UZ HL JK W�� %0 ,�• 25 .0 k g/ m 2 ) 9. 4 27 .1 -1 .1 4. 8 14 .2 2. 8 -0 .7 5. 0 21 .7 1. 1 -1 .1 31 ,7 63 C hi ld 's liv in g ar ra ng em en ts Li vi ng w ith b ot h pa re nt s 16 .2 38 .4 -1 .5 7. 5 21 .3 2. 1 -1 .0 11 .1 36 .0 0. 5 -1 .6 18 0, 30 4 Li vi ng w ith m ot he r ( no t f at he r) 16 .8 38 .7 -1 .5 7. 1 20 .1 2. 0 -1 .0 10 .8 34 .9 0. 4 -1 .5 35 ,2 31 Li vi ng w ith fa th er (n ot m ot he r) 18 .7 40 .6 -1 .6 6. 7 17 .8 1. 7 -0 .9 11 .2 38 .2 0. 6 -1 .6 1, 13 3 Li vi ng w ith n ei th er p ar en t 14 .6 34 .5 -1 .3 6. 5 19 .6 2. 2 -0 .9 10 .7 31 .4 1. 0 -1 .4 3, 12 8 W ea lth in de x Lo w es t 25 .7 51 .4 -1 .9 8. 7 24 .2 1. 5 -1 .2 17 .8 48 .6 0. 3 -1 .9 55 ,5 78 Se co nd 18 .3 43 .5 -1 .7 7. 5 21 .7 1. 6 -1 .1 12 .5 40 .4 0. 4 -1 .7 48 ,7 58 M id dl e 13 .5 36 .5 -1 .4 7. 0 20 .2 2. 0 -1 .0 8. 9 33 .2 0. 4 -1 .5 43 ,6 42 Fo ur th 10 .6 29 .2 -1 .2 6. 8 19 .3 2. 5 -0 .9 6. 8 27 .4 0. 7 -1 .3 39 ,9 41 H ig he st 7. 9 22 .2 -0 .9 6. 6 17 .9 3. 3 -0 .8 5. 1 20 .1 1. 1 -1 .0 31 ,8 77 To ta l 16 .3 38 .4 -1 .5 7. 4 21 .0 2. 1 -1 .0 11 .0 35 .7 0. 5 -1 .6 21 9, 79 6 N ot e: T ab le is b as ed o n ch ild re n w ho s ta ye d in th e ho us eh ol d th e ni gh t b ef or e th e in te rv ie w . E ac h of th e in di ce s is ex pr es se d in s ta nd ar d de vi at io n (S D ) u ni ts fr om th e m ed ia n of th e 20 06 W H O C hi ld G ro w th S ta nd ar ds . T ab le is b as ed o n ch ild re n w ith v al id d at es o f b irt h (m on th a nd y ea r) an d va lid m ea su re m en t o f b ot h he ig ht a nd w ei gh t. To ta l i nc lu de s c hi ld re n w ho se m ot he rs ’ s ch oo lin g is no t k no w n, w ho a re n ot s ho w n se pa ra te ly . BM I = B od y m as s in de x 1 R ec um be nt le ng th is m ea su re d fo r c hi ld re n un de r a ge 2 , o r i n th e fe w c as es w he n th e ag e of th e ch ild is u nk no w n an d th e ch ild is le ss th an 8 5 cm ; s ta nd in g he ig ht is m ea su re d fo r a ll ot he r c hi ld re n 2 In cl ud es c hi ld re n w ho a re b el ow -3 s ta nd ar d de vi at io ns (S D ) f ro m th e W H O C hi ld G ro w th S ta nd ar ds p op ul at io n m ed ia n 3 Ex cl ud es c hi ld re n w ho se m ot he rs w er e no t i nt er vi ew ed 4 Fi rs t b or n tw in s (tr ip le ts , e tc .) ar e co un te d as fi rs t b irt hs b ec au se th ey d o no t h av e a pr ev io us b irt h in te rv al 5 Fo r w om en w ho a re n ot in te rv ie w ed , i nf or m at io n is ta ke n fro m th e H ou se ho ld Q ue st io nn ai re . E xc lu de s ch ild re n w ho se m ot he rs a re n ot li st ed in th e ho us eh ol d sc he du le . 6 In cl ud es c hi ld re n w ho se m ot he rs a re d ec ea se d 7 Ex cl ud es c hi ld re n w ho se m ot he rs w er e no t w ei gh ed a nd m ea su re d, c hi ld re n w ho se m ot he rs w er e no t i nt er vi ew ed , a nd c hi ld re n w ho se m ot he rs a re p re gn an t o r g av e bi rth w ith in th e pr ec ed in g 2 m on th s Nutrition and Anaemia z�307 Table 10.2 Nutritional status of children by state/union territory Percentage of children under age five years classified as malnourished according to three anthropometric indices of nutritional status: height-for-age, weight-for-height, and weight-for-age, according to state/union territory, India, 2015-16 State/union territory Height-for-age1 Weight-for-height Weight-for-age Percentage below -3 SD Percentage below -2 SD2 Mean Z-score (SD) Percentage below -3 SD Percentage below -2 SD2 Percentage above +2 SD Mean Z-score (SD) Percentage below -3 SD Percentage below -2 SD2 Percentage above +2 SD Mean Z-score (SD) India 16.3 38.4 -1.5 7.4 21.0 2.1 -1.0 11.0 35.7 0.5 -1.6 North Chandigarh 7.0 28.7 -1.2 3.9 10.9 1.1 -0.9 5.8 24.5 0.0 -1.3 Delhi 10.7 31.9 -1.2 4.6 15.9 1.2 -0.9 6.2 27.0 0.5 -1.3 Haryana 14.8 34.0 -1.3 9.0 21.2 3.1 -0.9 8.1 29.4 0.6 -1.4 Himachal Pradesh 7.8 26.3 -1.1 3.9 13.7 1.9 -0.7 4.3 21.2 0.5 -1.1 Jammu & Kashmir 11.9 27.4 -1.0 5.6 12.1 5.6 -0.3 4.9 16.6 1.9 -0.8 Punjab 8.3 25.7 -1.1 5.6 15.6 2.3 -0.7 5.8 21.6 0.8 -1.1 Rajasthan 17.3 39.1 -1.5 8.5 23.0 2.1 -1.1 12.2 36.7 0.3 -1.6 Uttarakhand 14.0 33.5 -1.2 9.0 19.5 3.5 -0.8 7.5 26.6 0.6 -1.3 Central Chhattisgarh 15.7 37.6 -1.6 8.4 23.1 2.9 -1.1 11.2 37.7 0.3 -1.7 Madhya Pradesh 18.6 42.0 -1.6 9.2 25.8 1.7 -1.2 14.3 42.8 0.3 -1.8 Uttar Pradesh 21.2 46.2 -1.8 6.0 17.9 1.5 -1.0 12.2 39.5 0.2 -1.7 East Bihar 23.1 48.3 -1.8 7.0 20.8 1.2 -1.1 15.2 43.9 0.3 -1.8 Jharkhand 20.2 45.3 -1.7 11.4 29.0 1.5 -1.4 17.4 47.8 0.3 -1.9 Odisha 12.3 34.1 -1.4 6.4 20.4 2.6 -1.0 9.4 34.4 0.8 -1.5 West Bengal 10.3 32.5 -1.4 6.5 20.3 2.1 -1.0 8.8 31.5 0.5 -1.5 Northeast Arunachal Pradesh 11.9 29.3 -1.1 8.0 17.3 4.9 -0.5 5.7 19.4 1.5 -1.0 Assam 14.3 36.4 -1.4 6.2 17.0 2.3 -0.8 8.1 29.8 0.6 -1.4 Manipur 8.8 28.9 -1.2 2.2 6.8 3.1 -0.3 2.4 13.8 0.7 -0.9 Meghalaya 18.9 43.8 -1.5 6.5 15.3 3.9 -0.7 6.8 28.9 0.9 -1.3 Mizoram 8.8 28.1 -1.2 2.3 6.1 4.2 -0.1 2.8 12.0 1.5 -0.8 Nagaland 10.3 28.6 -1.1 4.2 11.3 3.8 -0.4 4.3 16.7 1.2 -0.9 Sikkim 12.5 29.6 -0.9 5.9 14.2 8.6 -0.3 3.7 14.2 1.7 -0.7 Tripura 8.1 24.3 -1.0 6.3 16.8 3.0 -0.8 5.3 24.1 1.1 -1.2 West Dadra & Nagar Haveli 19.7 41.7 -1.5 11.4 27.6 4.5 -1.1 11.3 38.8 0.4 -1.6 Daman & Diu 8.0 23.4 -0.6 11.9 24.1 2.1 -1.2 4.8 26.7 2.0 -1.2 Goa 8.8 20.1 -0.8 9.5 21.9 3.7 -0.9 5.5 23.8 0.8 -1.1 Gujarat 16.5 38.5 -1.4 9.5 26.4 1.9 -1.2 12.4 39.3 0.4 -1.7 Maharashtra 12.9 34.4 -1.3 9.4 25.6 1.9 -1.2 10.5 36.0 0.6 -1.6 South Andaman & Nicobar Islands 6.9 23.3 -1.0 7.5 18.9 3.0 -0.8 4.4 21.5 1.1 -1.1 Andhra Pradesh 10.7 31.4 -1.3 4.5 17.2 1.2 -1.0 7.2 31.9 0.5 -1.5 Karnataka 16.6 36.2 -1.3 10.5 26.1 2.6 -1.1 11.6 35.2 0.6 -1.5 Kerala 6.8 19.7 -0.7 6.5 15.7 3.4 -0.7 3.6 16.1 1.3 -0.9 Lakshadweep 6.2 26.8 -1.4 2.9 13.7 1.6 -0.7 5.6 23.6 0.0 -1.2 Puducherry 11.0 23.7 -0.9 7.8 23.6 2.2 -0.9 7.0 22.0 0.5 -1.1 Tamil Nadu 10.8 27.1 -1.0 7.9 19.7 5.0 -0.8 6.5 23.8 1.5 -1.1 Telangana 9.1 28.0 -1.2 4.8 18.0 0.7 -1.0 7.8 28.3 0.9 -1.4 Note: Table is based on children who stayed in the household the night before the interview. Each of the indices is expressed in standard deviation (SD) units from the median of the 2006 WHO Child Growth Standards. Table is based on children with valid dates of birth (month and year) and valid measurements of both height and weight. 1 Recumbent length is measured for children under age 2, or in the few cases when the age of the child is unknown and the child is less than 85 cm; standing height is measured for all other children 2 Includes children who are below -3 standard deviations (SD) from the International Reference Population median 308 z Nutrition and Anaemia � 7DEOH������7UHQGV�LQ�QXWULWLRQDO�VWDWXV�RI�FKLOGUHQ� 3HUFHQWDJH�RI�FKLOGUHQ�XQGHU�DJH�ILYH�\HDUV�FODVVLILHG�DV�PDOQRXULVKHG�DFFRUGLQJ�WR�WKUHH�DQWKURSRPHWULF�LQGLFHV�RI� QXWULWLRQDO�VWDWXV��KHLJKW�IRU�DJH��ZHLJKW�IRU�KHLJKW��DQG�ZHLJKW�IRU�DJH��E\�UHVLGHQFH��,QGLD��1)+6���DQG�1)+6��� 0HDVXUH�RI�QXWULWLRQ� 1)+6������������� 1)+6������������� 8UEDQ� 5XUDO� 7RWDO� 8UEDQ� 5XUDO� 7RWDO� � � � � � � � +HLJKW�IRU�DJH�� � � � � � � 3HUFHQWDJH�EHORZ����6'�� ����� ����� ����� ����� ����� ����� 3HUFHQWDJH�EHORZ����6'�� ����� ����� ����� ����� ����� ����� � � � � � � � :HLJKW�IRU�KHLJKW� � � � � � � 3HUFHQWDJH�EHORZ����6'�� ���� ���� ���� ���� ���� ���� 3HUFHQWDJH�EHORZ����6'�� ����� ����� ����� ����� ����� ����� � � � � � � � :HLJKW�IRU�DJH� � � � � � � 3HUFHQWDJH�EHORZ����6'�� ���� ����� ����� ����� ����� ����� 3HUFHQWDJH�EHORZ����6'�� ����� ����� ����� ����� ����� ����� � � � � � � � 1XPEHU�RI�FKLOGUHQ� ������� �������� �������� ������� ������� ������� 1RWH��7DEOH�LV�EDVHG�RQ�FKLOGUHQ�ZKR�VWD\HG�LQ�WKH�KRXVHKROG�WKH�QLJKW�EHIRUH�WKH�LQWHUYLHZ��(DFK�RI�WKH�LQGLFHV�LV�H[SUHVVHG�LQ� VWDQGDUG�GHYLDWLRQ��6'��XQLWV�IURP�WKH�PHGLDQ�RI�WKH������:+2�&KLOG�*URZWK�6WDQGDUGV�DGRSWHG�LQ�������7KH�LQGLFHV�LQ�WKLV� WDEOH�DUH�QRW�FRPSDUDEOH�WR�WKRVH�EDVHG�RQ�WKH�SUHYLRXVO\�XVHG������1&+6�&'&�:+2�5HIHUHQFH��7DEOH�LV�EDVHG�RQ�FKLOGUHQ� ZLWK�YDOLG�GDWHV�RI�ELUWK��PRQWK�DQG�\HDU��DQG�YDOLG�PHDVXUHPHQWV�RI�ERWK�KHLJKW�DQG�ZHLJKW�� ��5HFXPEHQW�OHQJWK�LV�PHDVXUHG�IRU�FKLOGUHQ�XQGHU�DJH����RU�LQ�WKH�IHZ�FDVHV�ZKHQ�WKH�DJH�RI�WKH�FKLOG�LV�XQNQRZQ�DQG�WKH�FKLOG� LV�OHVV�WKDQ����FP��VWDQGLQJ�KHLJKW�LV�PHDVXUHG�IRU�DOO�RWKHU�FKLOGUHQ� ���,QFOXGHV�FKLOGUHQ�ZKR�DUH�EHORZ����VWDQGDUG�GHYLDWLRQV��6'��IURP�WKH�,QWHUQDWLRQDO�5HIHUHQFH�3RSXODWLRQ�PHGLDQ� � � � � � � � � � � � Nutrition and Anaemia z�309 Table 10.4 Initial breastfeeding Percentage of children born in the two years preceding the survey who were ever breastfed, and for last-born children born in the two years preceding the survey who were ever breastfed, percentage who started breastfeeding within one hour and one day of birth and percentage who received a prelacteal feed, by background characteristics, India, 2015-16 Background characteristic Percentage ever breastfed Number of children Among last-born children born in the past two years who were ever breastfed, percentage who started breastfeeding: Percentage who received a prelacteal feed3 Number of last-born ever breastfed children Within one hour of birth1 Within one day of birth2 Residence Urban 94.9 26,772 42.9 80.2 22.3 24,615 Rural 95.1 71,217 41.0 81.9 20.6 65,345 Sex Male 94.7 51,238 41.5 81.1 21.1 47,064 Female 95.4 46,750 41.5 81.8 21.0 42,895 Mother's schooling No schooling 94.4 27,040 36.4 79.0 22.8 24,524 <5 years complete 94.7 5,485 42.8 83.5 18.0 5,011 5-7 years complete 95.2 15,532 43.1 82.3 18.9 14,289 8-9 years complete 95.3 16,828 44.5 83.9 19.1 15,437 10-11 years complete 95.3 12,338 45.7 82.5 19.0 11,369 12 or more years complete 95.6 20,764 41.6 80.7 24.1 19,329 Religion Hindu 95.1 77,167 41.3 81.6 20.5 70,861 Muslim 94.8 16,147 40.5 79.7 24.4 14,772 Christian 95.7 2,001 54.0 87.6 14.7 1,844 Sikh 94.8 1,214 32.1 76.2 31.3 1,113 Buddhist/Neo-Buddhist 95.3 712 57.0 89.9 12.1 663 Jain 91.0 93 31.2 66.9 26.8 85 Other 96.7 655 49.9 88.1 14.3 622 Caste/tribe Scheduled caste 94.8 21,369 41.4 82.2 19.7 19,549 Scheduled tribe 95.6 10,482 45.3 86.3 12.4 9,701 Other backward class 95.2 43,080 39.9 80.0 23.5 39,522 Other 94.8 22,148 42.6 81.0 22.1 20,356 Don't know 95.1 910 46.9 85.5 16.3 832 Assistance at delivery Health personnel4 95.2 82,237 42.9 82.7 19.6 75,652 Dai (TBA) 94.7 8,931 33.7 75.9 29.1 8,118 Other/no one 94.1 6,821 35.2 73.1 28.4 6,190 Place of delivery Health facility 95.1 80,405 43.0 82.8 19.3 73,995 At home 94.5 17,315 34.6 75.0 29.3 15,729 Other 94.9 269 30.9 61.3 24.7 236 Wealth index Lowest 94.6 24,415 38.9 80.7 20.7 22,234 Second 95.0 21,615 42.2 83.0 19.5 19,772 Middle 95.2 19,835 43.2 82.0 19.5 18,242 Fourth 95.3 17,727 43.6 82.2 20.8 16,353 Highest 95.4 14,398 39.9 78.5 26.4 13,359 Total 95.0 97,989 41.5 81.4 21.1 89,960 Note: Table is based on births in the past two years whether the children are living or dead at the time of interview. TBA = Traditional birth attendant 1 Includes children who started breastfeeding immediately after birth 2 Includes children who started breastfeeding within one hour of birth 3 Children given something other than breastmilk during the first three days of life 4 Doctor, nurse, midwife, auxiliary nurse midwife, lady health visitor, or other health personnel 310 z Nutrition and Anaemia Table 10.5 Initial breastfeeding by state/union territory Percentage of children born in the two years preceding the survey who were ever breastfed, and for last-born children born in the two years preceding the survey who were ever breastfed, percentage who started breastfeeding within one hour and one day of birth and percentage who received a prelacteal feed, according to state/union territory, India, 2015-16 State/union territory Among children born in the past two years, percentage ever breastfed Among last-born children born in the past two years who were ever breastfed: Percentage who started breastfeeding within one hour of birth1 Percentage who started breastfeeding within one day of birth2 Percentage who received a prelacteal feed3 India 95.0 41.5 81.4 21.1 North Chandigarh 95.9 35.1 75.0 26.1 Delhi 94.0 29.9 82.0 17.1 Haryana 95.1 42.3 82.1 31.2 Himachal Pradesh 93.7 40.6 80.7 20.4 Jammu & Kashmir 93.0 47.1 84.7 16.8 Punjab 94.5 29.9 74.9 32.1 Rajasthan 96.1 28.4 85.0 16.8 Uttarakhand 94.1 28.8 72.2 39.1 Central Chhattisgarh 97.1 47.4 90.3 9.4 Madhya Pradesh 95.1 34.6 84.0 12.4 Uttar Pradesh 93.8 25.4 67.5 41.5 East Bihar 94.4 35.3 80.9 24.7 Jharkhand 96.7 33.0 83.4 19.3 Odisha 97.2 68.9 94.2 5.9 West Bengal 96.8 47.7 88.7 11.0 Northeast Arunachal Pradesh 92.0 61.0 82.9 19.0 Assam 94.0 65.4 91.5 6.0 Manipur 97.0 65.6 90.4 22.6 Meghalaya 96.7 60.8 92.5 15.5 Mizoram 95.4 73.4 91.9 16.3 Nagaland 95.5 52.9 85.9 30.7 Sikkim 97.0 69.7 94.6 5.0 Tripura 97.7 46.2 90.2 2.9 West Dadra & Nagar Haveli 95.3 46.0 81.5 5.7 Daman & Diu 96.6 53.8 84.8 11.5 Goa 96.8 75.4 93.1 8.8 Gujarat 95.6 49.7 81.0 18.6 Maharashtra 96.3 57.0 86.5 13.1 South Andaman & Nicobar Islands 96.9 43.4 83.8 13.2 Andhra Pradesh 96.4 39.2 79.0 23.4 Karnataka 89.2 57.6 82.1 8.7 Kerala 98.5 63.3 95.1 9.0 Lakshadweep 97.8 61.3 91.0 8.5 Puducherry 95.5 64.6 90.9 5.7 Tamil Nadu 94.5 55.4 88.1 13.5 Telangana 97.0 35.8 74.2 26.2 Note: Table is based on births in the past two years whether the children are living or dead at the time of interview. 1 Includes children who started breastfeeding immediately after birth 2 Includes children who started breastfeeding within one hour of birth 3 Children given something other than breastmilk during the first three days of life Nutrition and Anaemia z�311 Ta bl e 10 .6 B re as tfe ed in g st at us b y ag e Pe rc en t d ist rib ut io n of y ou ng es t c hi ld re n un de r a ge tw o ye ar s l iv in g w ith th e m ot he r b y br ea st fe ed in g st at us , p er ce nt ag e cu rr en tly b re as tfe ed in g, a nd p er ce nt ag e of c hi ld re n un de r ag e tw o ye ar s us in g a bo ttl e w ith a n ip pl e, a cc or di ng to a ge in m on th s, In di a, 2 01 5- 16 Ag e in m on th s N ot br ea st fe ed in g Ex cl us iv el y br ea st fe d Br ea st fe ed in g an d co ns um in g: To ta l Pe rc en ta ge cu rr en tly br ea st fe ed in g N um be r o f yo un ge st ch ild re n un de r ag e tw o ye ar s Pe rc en ta ge us in g a bo ttl e w ith a n ip pl e N um be r o f ch ild re n un de r a ge tw o ye ar s Pl ai n w at er o nl y N on -m ilk liq ui ds /ju ic e O th er m ilk C om pl em en ta ry fo od s < 2 3. 8 72 .5 9. 6 0. 6 5. 9 7. 7 10 0. 0 96 .2 5, 02 5 5. 8 5, 08 9 2- 3 4. 6 58 .4 17 .2 1. 1 10 .6 8. 1 10 0. 0 95 .4 7, 67 4 11 .3 7, 74 5 4- 5 4. 9 41 .5 23 .9 1. 6 14 .0 14 .1 10 0. 0 95 .1 8, 45 3 16 .2 8, 53 4 6- 8 6. 2 17 .0 20 .0 2. 4 12 .2 42 .2 10 0. 0 93 .8 12 ,8 01 20 .5 12 ,9 32 9- 11 8. 6 7. 2 12 .0 2. 1 7. 9 62 .3 10 0. 0 91 .4 11 ,6 84 23 .4 11 ,8 08 12 -1 7 15 .1 4. 2 5. 0 1. 6 4. 4 69 .8 10 0. 0 84 .9 23 ,3 06 23 .0 23 ,9 15 18 -2 3 26 .2 2. 3 2. 4 0. 9 2. 7 65 .6 10 0. 0 73 .8 21 ,9 00 22 .5 23 ,9 24 < 4 4. 3 64 .0 14 .2 0. 9 8. 7 7. 9 10 0. 0 95 .7 12 ,6 99 9. 1 12 ,8 33 < 6 4. 5 55 .0 18 .1 1. 2 10 .8 10 .4 10 0. 0 95 .5 21 ,1 51 12 .0 21 ,3 68 6- 9 6. 7 15 .0 18 .7 2. 3 11 .7 45 .7 10 0. 0 93 .3 16 ,8 88 21 .1 17 ,0 60 12 -2 3 20 .5 3. 3 3. 7 1. 2 3. 5 67 .8 10 0. 0 79 .5 45 ,2 06 22 .8 47 ,8 39 N ot e: B re as tfe ed in g st at us re fe rs to a "2 4- ho ur " p er io d (in th e da y or n ig ht p re ce di ng th e in te rv ie w ). C hi ld re n w ho a re c la ss ifi ed a s b re as tfe ed in g an d co ns um in g pl ai n w at er o nl y co ns um ed n o liq ui d or so lid su pp le m en ts . T he c at eg or ie s of n ot b re as tfe ed in g, e xc lu siv el y br ea st fe d, b re as tfe ed in g an d co ns um in g pl ai n w at er , n on -m ilk li qu id s/ ju ic e, o th er m ilk , a nd c om pl em en ta ry fo od s ( so lid s an d se m i- so lid s) a re h ie ra rc hi ca l a nd m ut ua lly e xc lu siv e, a nd th ei r p er ce nt ag es a dd to 1 00 p er ce nt . A ny c hi ld re n w ho g et c om pl em en ta ry fo od a re c la ss ifi ed in th at c at eg or y as lo ng a s th ey a re b re as tfe ed in g as w el l. C hi ld re n w ho re ce iv e br ea st m ilk a nd n on -m ilk li qu id s an d w ho d o no t r ec ei ve c om pl em en ta ry fo od s ar e cl as sif ie d in th e no n- m ilk li qu id c at eg or y ev en th ou gh th ey m ay a lso g et p la in w at er . 312 z Nutrition and Anaemia Table 10.7 Median duration of breastfeeding Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among last-born children born in the three years preceding the survey, by background characteristics, India, 2015-16 Background characteristic Median duration (months) of breastfeeding among last-born children born in the last three years1 Number of children Any breastfeeding Exclusive breastfeeding Predominant breastfeeding2 Sex Male 31.0 3.0 5.7 68,923 Female 27.6 2.8 5.8 61,228 Residence Urban 24.4 2.6 5.1 36,796 Rural 33.0 3.0 6.1 93,355 Mother's schooling No schooling •���� 2.7 6.4 35,700 <5 years complete •���� 2.9 5.7 7,322 5-7 years complete 29.6 2.6 6.0 20,693 8-9 years complete 29.9 3.0 5.7 22,072 10-11 years complete 26.2 3.2 5.5 16,551 12 or more years complete 24.7 3.1 5.3 27,812 Religion Hindu 31.0 3.0 5.9 102,337 Muslim 26.1 2.3 5.6 21,461 Christian 27.3 3.0 4.8 2,672 Sikh 25.4 3.0 5.9 1,658 Buddhist/Neo-Buddhist 27.7 4.5 5.7 1,002 Jain 22.2 4.9 5.5 132 Other •���� 2.2 5.7 887 Caste/tribe Scheduled caste 33.5 3.0 5.8 27,824 Scheduled tribe •���� 3.8 6.5 13,754 Other backward class 27.5 2.7 5.8 57,025 Other 28.1 2.6 5.2 30,404 Don't know 28.1 4.6 7.0 1,144 Total 29.6 2.9 5.8 130,150 1 Median durations are based on the distributions at the time of the survey of the proportion of births by months since birth. Includes children living and deceased at the time of the survey. It is assumed that non-last-born children and last-born children not currently living with the mother are not currently breastfeeding. 2 Either exclusively breastfed or received breastmilk and plain water, and/or non-milk liquids only Nutrition and Anaemia z�313 Table 10.8 Median duration of breastfeeding by state/union territory Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among last-born children born in the three years preceding the survey, percentage of children under three years using a bottle with a nipple, according to state/union territory, India, 2015-16 State/union territory Median duration (months) of breastfeeding among last-born children born in the last three years1 Percentage using a bottle with a nipple Any breastfeeding Exclusive breastfeeding Predominant breastfeeding2 India 29.6 2.9 5.8 20.1 North Chandigarh 33.2 0.7 4.3 31.8 Delhi 26.2 2.3 6.0 33.4 Haryana 31.5 2.4 6.0 20.5 Himachal Pradesh 22.1 4.1 5.1 32.4 Jammu & Kashmir 28.9 4.5 5.6 27.2 Punjab 25.3 2.6 5.5 32.0 Rajasthan 26.5 3.2 7.0 14.5 Uttarakhand 31.0 2.4 4.7 36.8 Central Chhattisgarh •���� 5.3 6.6 7.8 Madhya Pradesh 29.7 3.3 6.8 11.8 Uttar Pradesh 30.1 1.6 5.2 28.4 East Bihar •���� 2.7 6.7 16.6 Jharkhand •���� 4.0 6.6 10.1 Odisha •���� 4.0 5.6 12.0 West Bengal •���� 2.6 4.7 21.0 Northeast Arunachal Pradesh 31.1 3.7 5.3 18.7 Assam •���� 4.3 6.2 12.2 Manipur •���� 4.5 5.1 12.8 Meghalaya 29.3 0.9 4.4 29.1 Mizoram 25.8 3.9 5.2 15.1 Nagaland 18.5 1.6 4.5 30.0 Sikkim 32.0 3.1 4.9 35.8 Tripura •���� 7.1 7.9 21.5 West Dadra & Nagar Haveli 17.2 4.6 7.2 11.7 Daman & Diu 18.2 0.7 0.7 27.1 Goa (26.0) a (5.0) 33.0 Gujarat 23.6 2.9 6.5 13.2 Maharashtra 25.4 3.2 5.6 17.3 South Andaman & Nicobar Islands 28.8 4.2 5.0 35.2 Andhra Pradesh 22.9 4.4 6.0 23.9 Karnataka 20.9 2.8 5.5 17.7 Kerala 28.7 2.9 5.0 27.9 Lakshadweep 23.2 4.0 6.0 9.0 Puducherry 19.9 0.6 4.8 31.5 Tamil Nadu 17.4 2.2 3.9 28.5 Telangana 25.7 4.2 5.8 22.6 a = Omitted because the smoothed percentage is below 50% in the first age cell (<2 months) and therefore the median can not be calculated 1 Median durations are based on the distributions at the time of the survey of the proportion of births by months since birth. Includes children living and deceased at the time of the survey. It is assumed that non-last-born children and last-born children not currently living with the mother are not currently breastfeeding. 2 Either exclusively breastfed or received breastmilk and plain water, and/or non-milk liquids only ( ) Based on 25-49 unweighted cases 314 z Nutrition and Anaemia Ta bl e 10 .9 F oo ds a nd li qu id s co ns um ed b y ch ild re n in th e da y or n ig ht p re ce di ng th e in te rv ie w Pe rc en ta ge o f y ou ng es t c hi ld re n un de r ag e tw o ye ar s liv in g w ith th e m ot he r w ho c on su m ed s pe ci fic ty pe s of li qu id s an d fo od s in th e da y or n ig ht p re ce di ng th e in te rv ie w , b y br ea st fe ed in g st at us a nd a ge , I nd ia , 2 01 5- 16 Ag e (m on th s) Li qu id s So lid o r s em i-s ol id fo od s N um be r of ch ild re n In fa nt fo rm ul a O th er m ilk 1 O th er liq ui ds 2 Fo rt ifi ed ba by fo od s Fo od m ad e fro m g ra in s3 Fr ui ts a nd ve ge ta bl es ric h in vi ta m in A 4 O th er fr ui ts an d ve ge ta bl es Fo od m ad e fro m ro ot s Fo od m ad e fro m be an s, p ea s, le nt ils , n ut s M ea t, fis h, po ul tr y, an d eg gs C he es e, yo gu rt , ot he r m ilk pr od uc t An y so lid or s em i- so lid fo od BR EA ST FE ED IN G C H IL D RE N < 2 2. 3 8. 3 5. 3 1. 8 6. 3 4. 9 3. 1 2. 6 1. 7 2. 8 1. 9 8. 0 4, 83 3 2- 3 2. 9 13 .3 5. 3 2. 4 6. 3 4. 9 3. 2 2. 4 1. 8 2. 4 2. 3 8. 6 7, 32 0 4- 5 4. 5 17 .7 8. 0 4. 3 9. 8 6. 3 4. 1 3. 3 1. 9 2. 9 3. 1 15 .1 8, 04 2 6- 8 7. 8 27 .4 19 .1 13 .9 32 .5 14 .5 9. 3 7. 3 4. 7 5. 6 7. 2 45 .5 12 ,0 10 9- 11 9. 6 34 .7 28 .3 17 .0 56 .3 28 .3 16 .7 15 .1 9. 4 10 .5 12 .1 68 .7 10 ,6 84 12 -1 7 10 .6 39 .5 36 .1 15 .3 71 .6 44 .8 26 .3 24 .3 14 .4 19 .0 17 .3 83 .1 19 ,7 95 18 -2 3 9. 8 40 .8 38 .3 14 .4 79 .0 54 .3 31 .5 29 .4 18 .5 23 .9 20 .4 89 .3 16 ,1 61 6- 23 9. 6 36 .5 31 .8 15 .1 62 .8 38 .2 22 .5 20 .6 12 .6 16 .1 15 .1 74 .5 58 ,6 50 To ta l 8. 0 30 .7 25 .3 12 .0 48 .7 29 .8 17 .7 16 .0 9. 9 12 .6 11 .9 58 .2 78 ,8 46 N O N BR EA ST FE ED IN G C H IL D RE N < 2 9. 1 23 .1 11 .5 5. 3 8. 8 9. 5 6. 9 2. 9 5. 0 8. 8 9. 0 16 .5 19 2 2- 3 6. 7 36 .0 9. 9 5. 3 9. 8 7. 6 4. 2 3. 5 2. 8 3. 6 3. 8 14 .8 35 3 4- 5 13 .8 44 .0 19 .0 8. 2 11 .6 9. 6 5. 4 5. 6 3. 6 4. 5 6. 0 23 .2 41 0 6- 8 12 .9 50 .7 30 .0 20 .3 32 .2 21 .6 12 .2 8. 2 4. 6 8. 3 9. 0 50 .4 79 2 9- 11 18 .0 59 .9 34 .2 22 .7 56 .1 37 .8 24 .1 22 .5 11 .2 16 .5 15 .4 69 .7 99 9 12 -1 7 16 .9 62 .1 44 .7 21 .2 70 .6 51 .1 33 .6 26 .9 17 .8 25 .4 26 .8 84 .5 3, 51 1 18 -2 3 14 .9 62 .7 47 .3 20 .2 79 .3 56 .8 39 .4 32 .6 22 .1 29 .7 30 .0 90 .4 5, 73 9 6- 23 15 .7 61 .4 44 .0 20 .7 71 .1 50 .7 34 .2 28 .1 18 .5 25 .6 26 .2 83 .8 11 ,0 40 To ta l 15 .3 59 .4 41 .7 19 .6 66 .2 47 .4 31 .9 26 .2 17 .3 24 .0 24 .6 78 .6 11 ,9 96 N ot e: B re as tfe ed in g st at us a nd fo od c on su m ed re fe r t o a "2 4- ho ur " p er io d (in th e da y or n ig ht p re ce di ng th e in te rv ie w ). 1 O th er m ilk in cl ud es ti nn ed , p ow de re d, a nd fr es h an im al m ilk 2 D oe s no t i nc lu de p la in w at er 3 In cl ud es fo rti fie d ba by fo od 4 In cl ud es p um pk in , c ar ro ts , s qu as h, sw ee t p ot at oe s th at a re y el lo w o r o ra ng e in sid e, d ar k gr ee n le af y ve ge ta bl es , r ip e m an go es , p ap ay as , c an ta lo up e, o r j ac kf ru it Nutrition and Anaemia z�315 Ta bl e 10 .1 0 M in im um a cc ep ta bl e di et Pe rc en ta ge o f y ou ng es t c hi ld re n ag e 6- 23 m on th s liv in g w ith th ei r m ot he r w ho a re fe d a m in im um a cc ep ta bl e di et b as ed o n br ea st fe ed in g st at us , n um be r o f f oo d gr ou ps , a nd ti m es th ey w er e fe d du rin g th e da y or n ig ht p re ce di ng th e in te rv ie w , a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Am on g br ea st fe d ch ild re n 6- 23 m on th s, p er ce nt ag e fe d: N um be r o f br ea st fe d ch ild re n ag e 6- 23 m on th s Am on g no nb re as tfe d ch ild re n 6- 23 m on th s, p er ce nt ag e fe d: N um be r of no nb re as tfe d ch ild re n ag e 6- 23 m on th s Am on g al l c hi ld re n 6- 23 m on th s, p er ce nt ag e fe d: N um be r o f a ll ch ild re n ag e 6- 23 m on th s M in im um di et ar y di ve rs ity 1 M in im um m ea l fre qu en cy 2 M in im um ac ce pt ab le di et 3 M ilk o r m ilk pr od uc ts 4 M in im um di et ar y di ve rs ity 1 M in im um m ea l fre qu en cy 5 M in im um ac ce pt ab le di et 6 Br ea st - m ilk , m ilk , o r m ilk pr od uc ts 7 M in im um di et ar y di ve rs ity 1 M in im um m ea l fre qu en cy 8 M in im um ac ce pt ab le di et 9 Ag e (m on th s) 6- 8 6. 6 34 .1 4. 9 12 ,0 10 49 .8 10 .6 44 .0 2. 5 79 2 96 .9 6. 8 34 .7 4. 8 12 ,8 01 9- 11 13 .5 22 .5 5. 4 10 ,6 84 61 .2 23 .1 56 .5 7. 9 99 9 96 .7 14 .3 25 .4 5. 7 11 ,6 84 12 -1 7 23 .6 30 .8 9. 4 19 ,7 95 64 .6 33 .2 63 .1 14 .3 3, 51 1 94 .7 25 .0 35 .7 10 .1 23 ,3 06 18 -2 3 29 .2 35 .2 12 .6 16 ,1 61 62 .9 38 .8 63 .0 17 .1 5, 73 9 90 .3 31 .8 42 .5 13 .8 21 ,9 00 Se x M al e 19 .5 31 .7 8. 8 30 ,9 87 64 .6 33 .9 62 .8 14 .7 5, 67 8 94 .5 21 .7 36 .5 9. 7 36 ,6 65 Fe m al e 20 .2 30 .6 8. 5 27 ,6 63 60 .0 33 .3 59 .3 13 .9 5, 36 2 93 .5 22 .3 35 .3 9. 4 33 ,0 25 Re si de nc e U rb an 24 .5 32 .5 10 .1 15 ,3 79 66 .2 38 .8 64 .5 16 .9 4, 25 6 92 .7 27 .6 39 .5 11 .6 19 ,6 35 Ru ra l 18 .1 30 .7 8. 2 43 ,2 71 59 .9 30 .3 58 .9 12 .7 6, 78 5 94 .6 19 .8 34 .5 8. 8 50 ,0 56 M ot he r's s ch oo lin g N o sc ho ol in g 14 .9 28 .9 6. 6 16 ,7 18 53 .6 24 .1 53 .1 8. 1 2, 38 7 94 .2 16 .0 31 .9 6. 8 19 ,1 05 < 5 ye ar s co m pl et e 19 .3 31 .1 8. 5 3, 46 4 51 .0 26 .5 55 .5 9. 4 49 0 93 .9 20 .2 34 .2 8. 6 3, 95 4 5- 7 ye ar s co m pl et e 18 .9 30 .7 8. 2 9, 46 2 59 .0 29 .7 60 .0 12 .2 1, 55 2 94 .2 20 .4 34 .8 8. 8 11 ,0 13 8- 9 ye ar s co m pl et e 20 .7 33 .1 9. 6 10 ,0 56 62 .8 31 .6 61 .2 12 .9 1, 89 0 94 .1 22 .4 37 .5 10 .1 11 ,9 46 10 -1 1 ye ar s co m pl et e 22 .8 31 .6 9. 8 7, 18 7 66 .0 40 .9 63 .1 19 .0 1, 71 9 93 .4 26 .3 37 .7 11 .5 8, 90 6 12 o r m or e ye ar s co m pl et e 25 .2 33 .0 10 .6 11 ,7 64 70 .6 41 .4 67 .7 19 .3 3, 00 3 94 .0 28 .5 40 .1 12 .4 14 ,7 67 Re lig io n H in du 18 .9 31 .2 8. 1 46 ,3 19 62 .6 33 .6 61 .1 14 .0 8, 51 2 94 .2 21 .2 35 .8 9. 0 54 ,8 30 M us lim 22 .7 30 .3 10 .4 9, 54 0 61 .4 31 .9 61 .9 14 .5 1, 93 7 93 .5 24 .3 35 .6 11 .1 11 ,4 77 C hr ist ia n 29 .5 38 .6 14 .1 1, 15 5 55 .3 48 .5 55 .2 23 .6 29 8 90 .8 33 .4 42 .0 16 .1 1, 45 3 Si kh 15 .4 26 .9 6. 2 67 4 78 .5 24 .3 71 .2 5. 5 17 4 95 .6 17 .2 36 .0 6. 1 84 8 Bu dd hi st /N eo -B ud dh ist 25 .2 30 .8 11 .5 47 0 56 .4 44 .1 44 .6 29 .0 81 93 .6 28 .0 32 .9 14 .0 55 1 Ja in (2 5. 5) (2 8. 3) (5 .2 ) 42 * * * * 21 97 .8 19 .8 40 .8 4. 7 63 O th er 24 .9 42 .1 18 .3 45 0 26 .2 40 .7 31 .4 11 .0 17 97 .3 25 .5 41 .7 18 .0 46 7 C on tin ue d. . 316 z Nutrition and Anaemia Ta bl e 10 .1 0 M in im um a cc ep ta bl e di et ² C on tin ue d Pe rc en ta ge o f y ou ng es t c hi ld re n ag e 6- 23 m on th s liv in g w ith th ei r m ot he r w ho a re fe d a m in im um a cc ep ta bl e di et b as ed o n br ea st fe ed in g st at us , n um be r o f f oo d gr ou ps , a nd ti m es th ey w er e fe d du rin g th e da y or n ig ht p re ce di ng th e in te rv ie w , a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, In di a, 2 01 5- 16 Ba ck gr ou nd ch ar ac te ris tic Am on g br ea st fe d ch ild re n 6- 23 m on th s, p er ce nt ag e fe d: N um be r o f br ea st fe d ch ild re n ag e 6- 23 m on th s Am on g no nb re as tfe d ch ild re n 6- 23 m on th s, p er ce nt ag e fe d: N um be r of no nb re as tfe d ch ild re n ag e 6- 23 m on th s Am on g al l c hi ld re n 6- 23 m on th s, p er ce nt ag e fe d: N um be r o f a ll ch ild re n ag e 6- 23 m on th s M in im um di et ar y di ve rs ity 1 M in im um m ea l fre qu en cy 2 M in im um ac ce pt ab le di et 3 M ilk o r m ilk pr od uc ts 4 M in im um di et ar y di ve rs ity 1 M in im um m ea l fre qu en cy 5 M in im um ac ce pt ab le di et 6 Br ea st - m ilk , m ilk , o r m ilk pr od uc ts 7 M in im um di et ar y di ve rs ity 1 M in im um m ea l fre qu en cy 8 M in im um ac ce pt ab le di et 9 C as te /tr ib e Sc he du le d ca st e 19 .3 31 .7 8. 6 13 ,0 98 61 .6 34 .0 57 .9 14 .4 2, 03 7 94 .8 21 .3 35 .2 9. 4 15 ,1 35 Sc he du le d tri be 19 .5 33 .9 8. 8 6, 45 1 39 .1 28 .3 45 .4 8. 1 85 2 92 .9 20 .6 35 .2 8. 7 7, 30 3 O th er b ac kw ar d cl as s 18 .3 31 .0 7. 8 25 ,3 44 65 .2 36 .4 63 .9 16 .4 5, 29 1 94 .0 21 .4 36 .7 9. 3 30 ,6 35 O th er 23 .4 30 .0 10 .4 13 ,1 85 65 .0 29 .3 63 .3 12 .0 2, 79 4 93 .9 24 .5 35 .8 10 .7 15 ,9 79 D on 't kn ow 18 .2 25 .7 6. 7 57 2 49 .4 45 .4 49 .8 14 .0 67 94 .7 21 .1 28 .3 7. 4 63 9 To ta l 19 .8 31 .2 8. 7 58 ,6 50 62 .4 33 .6 61 .1 14 .3 11 ,0 40 94 .0 22 .0 35 .9 9. 6 69 ,6 90 1 C hi ld re n re ce iv e fo od s fro m fo ur o r m or e of th e fo llo w in g fo od g ro up s: a . i nf an t fo rm ul a, m ilk o th er th an b re as tm ilk , c he es e or y og ur t o r o th er m ilk p ro du ct s; b . f oo ds m ad e fro m g ra in s or ro ot s, in cl ud in g po rr id ge o r g ru el , f or tif ie d ba by fo od ; c . v ita m in A -r ic h fru its a nd v eg et ab le s; d . o th er fr ui ts a nd v eg et ab le s; e . e gg s; f. m ea t, po ul try , f ish , s he llf ish , o r o rg an m ea ts ; g . b ea ns , p ea s, le nt ils , o r n ut s; h . f oo ds m ad e w ith o il, fa t, gh ee , o r b ut te r 2 Fo r b re as tfe d ch ild re n, m in im um m ea l f re qu en cy is re ce iv in g so lid o r s em i-s ol id fo od a t l ea st tw ic e a da y fo r i nf an ts 6 -8 m on th s an d at le as t t hr ee ti m es a d ay fo r c hi ld re n 9- 23 m on th s 3 Br ea st fe d ch ild re n ag e 6- 23 m on th s a re c on sid er ed to b e fe d a m in im um a cc ep ta bl e di et if th ey a re fe d th e m in im um d ie ta ry d iv er sit y as d es cr ib ed in fo ot no te 1 a nd th e m in im um m ea l f re qu en cy a s d ef in ed in fo ot no te 2 4 In cl ud es tw o or m or e fe ed in gs o f c om m er ci al in fa nt fo rm ul a, fr es h, ti nn ed a nd p ow de re d an im al m ilk , a nd y og ur t 5 Fo r n on br ea st fe d ch ild re n ag e 6- 23 m on th s, m in im um m ea l f re qu en cy is re ce iv in g so lid o r s em i-s ol id fo od o r m ilk fe ed s at le as t f ou r t im es a d ay 6 N on br ea st fe d ch ild re n ag e 6- 23 m on th s a re c on sid er ed to b e fe d a m in im um a cc ep ta bl e di et if th ey re ce iv e ot he r m ilk o r m ilk p ro du ct s a t l ea st tw ic e a da y, re ce iv e th e m in im um m ea l f re qu en cy a s d es cr ib ed in fo ot no te 5 , a nd re ce iv e so lid o r s em i-s ol id fo od s fro m a t l ea st fo ur fo od g ro up s no t i nc lu di ng th e m ilk o r m ilk p ro du ct s fo od g ro up 7 Br ea st fe ed in g, o r n ot b re as tfe ed in g an d re ce iv in g tw o or m or e fe ed in gs o f c om m er ci al in fa nt fo rm ul a, fr es h, ti nn ed , a nd p ow de re d an im al m ilk , a nd y og ur t 8 C hi ld re n ar e fe d th e m in im um re co m m en de d nu m be r o f t im es p er d ay a cc or di ng to th ei r a ge a nd b re as tfe ed in g st at us a s d es cr ib ed in fo ot no te s 2 an d 5 9 C hi ld re n ag e 6- 23 m on th s ar e co ns id er ed to b e fe d a m in im um a cc ep ta bl e di et if th ey r ec ei ve b re as tm ilk , o th er m ilk o r m ilk p ro du ct s as d es cr ib ed in fo ot no te 7 , a re fe d th e m in im um d ie ta ry d iv er sit y as de sc rib ed in fo ot no te 1 , a nd a re fe d th e m in im um m ea l f re qu en cy a s d es cr ib ed in fo ot no te s 2 an d 5 ( ) B as ed o n 25 -4 9 un w ei gh te d ca se s * Pe rc en ta ge n ot s ho w n; b as ed o n fe w er th an 2 5 un w ei gh te d ca se s Nutrition and Anaemia z�317 Table 10.11 Minimum acceptable diet by state/union territory Percentage of youngest children age 6-23 months living with their mother who are fed a minimum acceptable diet based on breastfeeding status, number of food groups, and times they are fed during the day or night preceding the interview, according to state/union territory, India, 2015-16 State/ union territory Among breastfed children 6-23 months, percentage fed: Among nonbreastfed children 6-23 months, percentage fed: Among all children 6-23 months, percentage fed: Minimum dietary diversity1 Minimum meal frequency2 Minimum acceptable diet3 Milk or milk products4 Minimum dietary diversity1 Minimum meal frequency5 Minimum acceptable diet6 Breast- milk, milk, or milk products7 Minimum dietary diversity1 Minimum meal frequency8 Minimum acceptable diet9 India 19.8 31.2 8.7 62.4 33.6 61.1 14.3 94.0 22.0 35.9 9.6 North Chandigarh (7.5) (28.8) (0.0) * * * * 98.1 10.3 38.1 0.0 Delhi 24.1 30.3 4.3 74.0 32.5 70.5 9.4 95.2 25.7 37.7 5.2 Haryana 16.4 26.3 7.0 71.2 27.4 65.5 10.0 95.1 18.3 32.9 7.5 Himachal Pradesh 24.5 40.0 11.2 75.8 37.9 78.0 10.0 94.3 27.6 49.0 10.9 Jammu & Kashmir 43.7 37.4 21.8 66.3 53.8 69.2 32.1 94.4 45.4 42.6 23.5 Punjab 15.6 26.0 5.7 78.4 26.1 71.9 6.7 95.7 17.7 35.1 5.9 Rajasthan 8.5 26.7 3.4 74.7 16.0 70.7 3.7 96.0 9.7 33.6 3.4 Uttarakhand 19.8 35.8 8.6 76.6 29.0 74.9 7.8 96.4 21.2 41.9 8.5 Central Chhattisgarh 18.5 56.2 11.1 46.8 28.4 67.4 8.5 97.3 19.0 56.8 10.9 Madhya Pradesh 14.8 33.4 6.9 48.8 21.7 50.8 4.8 93.5 15.6 35.7 6.6 Uttar Pradesh 9.8 31.2 5.3 77.0 17.7 73.2 5.3 96.1 11.1 38.3 5.3 East Bihar 16.8 25.8 7.3 60.2 28.5 60.5 9.2 95.1 18.2 30.0 7.5 Jharkhand 13.8 39.5 7.2 40.6 26.2 49.1 7.1 96.2 14.6 40.2 7.2 Odisha 22.5 38.7 8.9 40.8 19.7 43.4 5.0 94.7 22.2 39.1 8.5 West Bengal 36.6 36.7 19.1 52.8 55.1 56.7 25.7 96.9 37.8 38.1 19.6 Northeast Arunachal Pradesh 33.3 27.8 12.3 39.0 55.6 41.4 26.0 92.6 36.0 29.5 14.0 Assam 27.8 26.2 8.7 29.5 27.6 31.1 10.8 95.4 27.8 26.6 8.9 Manipur 36.9 52.6 19.3 41.6 38.9 58.6 14.0 94.3 37.1 53.2 18.8 Meghalaya 45.4 48.6 24.2 39.3 66.9 54.8 19.5 90.5 48.8 49.6 23.5 Mizoram 41.2 35.1 14.6 28.7 53.8 30.8 13.3 91.1 42.8 34.6 14.5 Nagaland 33.2 48.8 17.5 48.2 53.9 50.5 21.9 85.3 39.1 49.3 18.8 Sikkim 49.9 41.8 23.0 * * * * 96.8 49.1 42.3 23.1 Tripura 15.1 21.4 5.3 * * * * 98.3 16.1 22.5 5.9 West Dadra & Nagar Haveli 0.0 16.1 0.0 * * * * 87.7 1.1 22.3 0.0 Daman & Diu 17.8 22.5 6.2 (56.7) (50.2) (44.8) (7.4) 87.8 27.0 28.9 6.5 Goa 17.2 24.3 9.1 (59.8) (55.8) (66.0) (15.1) 91.1 25.7 33.5 10.4 Gujarat 13.3 30.8 5.8 48.0 24.3 47.7 2.8 90.6 15.3 33.9 5.2 Maharashtra 20.1 24.9 5.2 49.6 28.4 45.2 12.2 90.8 21.6 28.7 6.5 Continued. 318 z Nutrition and Anaemia Table 10.11 Minimum acceptable diet by state/union territory³Continued Percentage of youngest children age 6-23 months living with their mother who are fed a minimum acceptable diet based on breastfeeding status, number of food groups, and times they are fed during the day or night preceding the interview, according to state/union territory, India, 2015-16 State/ union territory Among breastfed children 6-23 months, percentage fed: Among nonbreastfed children 6-23 months, percentage fed: Among all children 6-23 months, percentage fed: Minimum dietary diversity1 Minimum meal frequency2 Minimum acceptable diet3 Milk or milk products4 Minimum dietary diversity1 Minimum meal frequency5 Minimum acceptable diet6 Breast- milk, milk, or milk products7 Minimum dietary diversity1 Minimum meal frequency8 Minimum acceptable diet9 South Andaman & Nicobar Islands 31.5 37.2 13.5 (63.1) (70.2) (56.3) (17.6) 94.3 37.5 40.2 14.2 Andhra Pradesh 21.0 25.1 6.5 62.9 30.2 60.7 11.9 92.4 22.9 32.4 7.6 Karnataka 17.9 19.3 5.8 52.4 34.6 49.0 14.4 86.9 22.5 27.5 8.2 Kerala 37.9 43.1 21.3 53.4 44.3 54.7 22.3 96.6 38.4 44.0 21.4 Lakshadweep 28.3 43.5 16.8 * * * * 94.5 28.9 43.3 15.9 Puducherry 49.6 33.9 21.8 79.8 76.2 78.0 54.8 94.3 57.1 46.3 31.1 Tamil Nadu 46.6 41.2 21.4 70.9 76.2 71.7 47.1 89.5 57.3 52.3 30.7 Telangana 25.0 26.3 9.9 53.6 38.1 53.6 11.2 93.6 26.8 30.1 10.1 1 Children receive foods from four or more of the following food groups: a. infant formula, milk other than breastmilk, cheese or yogurt or other milk products; b. foods made from grains or roots, including porridge or gruel, fortified baby food; c. vitamin A-rich fruits and vegetables; d. other fruits and vegetables; e. eggs; f. meat, poultry, fish, shellfish, or organ meats; g. beans, peas, lentils, or nuts; h. foods made with oil, fat, ghee, or butter 2 For breastfed children, minimum meal frequency is receiving solid or semi-solid food at least twice a day for infants 6-8 months and at least three times a day for children 9-23 months 3 Breastfed children age 6-23 months are considered to be fed a minimum acceptable diet if they are fed the minimum dietary diversity as described in footnote 1 and the minimum meal frequency as defined in footnote 2 4 Includes two or more feedings of commercial infant formula, fresh, tinned and powdered animal milk, and yogurt 5 For nonbreastfed children age 6-23 months, minimum meal frequency is receiving solid or semi-solid food or milk feeds at least four times a day 6 Nonbreastfed children age 6-23 months are considered to be fed a minimum acceptable diet if they receive other milk or milk products at least twice a day, receive the minimum meal frequency as described in footnote 5, and receive solid or semi-solid foods from at least four food groups not including the milk or milk products food group 7 Breastfeeding, or not breastfeeding and receiving two or more feedings of commercial infant formula, fresh, tinned, and powdered animal milk, and yogurt 8 Children are fed the minimum recommended number of times per day according to their age and breastfeeding status as described in footnotes 2 and 5 9 Children age 6-23 months are considered to be fed a minimum acceptable diet if they receive breastmilk, other milk or milk products as described in footnote 7, are fed the minimum dietary diversity as described in footnote 1, and are fed the minimum meal frequency as described in footnotes 2 and 5 ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases Nutrition and Anaemia z�319 Table 10.12 Prevalence of anaemia in children Percentage of children age 6-59 months classified as having anaemia, by background characteristics, India, 2015-16 Background characteristic Anaemia status by haemoglobin level Any anaemia (<11.0 g/dl) Number of children Mild (10.0-10.9 g/dl) Moderate (7.0-9.9 g/dl) Severe (<7.0 g/dl) Age in months 6-8 30.1 37.0 1.4 68.4 10,271 9-11 28.1 38.4 2.1 68.6 10,980 12-17 27.7 41.0 2.4 71.2 22,607 18-23 27.4 39.7 2.8 69.9 22,842 24-35 28.6 31.9 1.8 62.3 45,188 36-47 28.1 23.2 1.1 52.3 47,601 48-59 26.4 17.6 0.7 44.7 45,547 Sex Male 27.3 29.5 1.6 58.4 106,802 Female 28.4 28.8 1.5 58.7 98,233 Birth order1 1 27.8 26.5 1.3 55.6 75,222 2-3 28.0 29.9 1.6 59.5 94,191 4-5 27.4 34.3 2.0 63.7 21,369 6+ 27.7 34.7 2.3 64.7 7,069 Residence Urban 26.8 27.5 1.6 56.0 56,237 Rural 28.2 29.8 1.5 59.5 148,798 Mother's schooling2 No schooling 28.7 34.3 1.9 64.9 61,867 <5 years complete 28.2 30.2 1.6 60.0 12,247 5-7 years complete 28.3 28.9 1.5 58.7 32,632 8-9 years complete 27.3 27.8 1.4 56.6 33,181 10-11 years complete 27.6 26.3 1.2 55.1 23,756 12 or more years complete 26.5 24.0 1.3 51.7 37,085 Religion Hindu 27.8 29.3 1.6 58.7 160,878 Muslim 27.9 29.9 1.7 59.5 34,233 Christian 25.3 18.6 0.9 44.8 4,149 Sikh 27.5 27.6 1.2 56.3 2,632 Buddhist/Neo-Buddhist 27.6 27.8 1.6 57.0 1,622 Jain 30.5 22.1 0.4 53.0 220 Other 35.3 32.6 0.4 68.4 1,302 Caste/tribe Scheduled caste 28.2 30.7 1.6 60.6 45,208 Scheduled tribe 28.5 33.3 1.5 63.3 21,411 Other backward class 27.8 29.2 1.6 58.6 90,237 Other 27.2 25.6 1.4 54.2 46,649 Don't know 27.7 32.4 1.8 61.9 1,530 &RQWLQXHG« 320 z Nutrition and Anaemia Table 10.12 Prevalence of anaemia in children²Continued Percentage of children age 6-59 months classified as having anaemia, by background characteristics, India, 2015-16 Background characteristic Anaemia status by haemoglobin level Any anaemia (<11.0 g/dl) Number of children Mild (10.0-10.9 g/dl) Moderate (7.0-9.9 g/dl) Severe (<7.0 g/dl) Mother's interview status Interviewed 27.9 29.2 1.6 58.6 197,851 Not interviewed but in household 26.0 28.8 1.7 56.5 2,931 Not interviewed, and not in the household3 27.8 26.0 1.4 55.3 4,253 Child's living arrangements Living with both parents 27.7 29.0 1.5 58.3 169,729 Living with mother (not father) 28.4 30.2 1.6 60.2 30,976 Living with father (not mother) 28.4 28.1 2.3 58.8 1,153 Living with neither parent 27.4 25.3 1.1 53.8 3,177 Mother's anaemia status4 Not anaemic 26.6 22.9 1.1 50.6 85,663 Mildly anaemic 29.3 31.4 1.5 62.3 83,309 Moderately anaemic 27.6 41.0 2.8 71.3 27,990 Severely anaemic 22.6 46.3 6.8 75.7 1,885 Wealth index Lowest 29.2 33.3 1.5 64.0 52,483 Second 28.5 29.7 1.6 59.7 45,355 Middle 27.8 29.3 1.8 58.9 40,598 Fourth 26.2 26.8 1.4 54.4 37,100 Highest 26.5 24.0 1.4 51.8 29,500 Total 27.8 29.2 1.6 58.5 205,035 Note: Table is based on children who stayed in the household the night before the interview. Prevalence of anaemia, based on haemoglobin levels, is adjusted for altitude using the CDC formulas (Centers for Disease Control (CDC). 1998. Recommendations to prevent and control iron deficiency in the United States. Morbidity and Mortality Weekly Report 47 (RR-3): 1-29). Haemoglobin levels are shown in grams per decilitre (g/dl). Total includes children whose mothers’ schooling is not known, who are not shown separately. 1 Excludes children whose mothers were not interviewed 2 For mothers who are not interviewed, information is taken from the Household Questionnaire. Excludes children whose mothers are not listed in the household schedule. 3 Includes children whose mothers are deceased 4 Mildly anaemic is classified as 10.0-11.9 g/dl for non-pregnant women and 10.0-10.9 g/dl for pregnant women. Moderately/ severely anaemic is <10.0 g/dl. Adjusted for altitude and for smoking status. Excludes children whose mother's anaemia status is not known. Nutrition and Anaemia z�321 Table 10.13 Prevalence of anaemia in children by state/union territory Percentage of children age 6-59 months classified as having anaemia, according to state/union territory, India, 2015-16 State/union territory Anaemia status by haemoglobin level Any anaemia (<11.0 g/dl) Mild (10.0-10.9 g/dl) Moderate (7.0-9.9 g/dl) Severe (<7.0 g/dl) India 27.8 29.2 1.6 58.5 North Chandigarh 27.5 41.6 4.0 73.1 Delhi 19.4 36.2 4.1 59.7 Haryana 28.2 40.5 3.0 71.7 Himachal Pradesh 23.1 28.0 2.6 53.7 Jammu & Kashmir 22.5 29.6 2.4 54.5 Punjab 27.3 27.9 1.4 56.6 Rajasthan 27.1 31.3 1.9 60.3 Uttarakhand 27.3 30.1 2.4 59.8 Central Chhattisgarh 24.0 17.0 0.6 41.6 Madhya Pradesh 29.4 37.6 2.0 68.9 Uttar Pradesh 26.4 34.4 2.4 63.2 East Bihar 30.2 31.8 1.4 63.5 Jharkhand 31.6 37.2 1.1 69.9 Odisha 24.8 19.0 0.8 44.6 West Bengal 30.9 22.8 0.5 54.2 Northeast Arunachal Pradesh 29.2 24.0 1.1 54.2 Assam 23.9 11.4 0.4 35.7 Manipur 16.5 7.2 0.2 23.9 Meghalaya 30.2 17.3 0.5 48.0 Mizoram 12.8 5.9 0.7 19.3 Nagaland 15.1 10.8 0.5 26.4 Sikkim 32.4 22.2 0.4 55.1 Tripura 30.5 17.6 0.2 48.3 West Dadra & Nagar Haveli 35.5 47.4 1.7 84.6 Daman & Diu 35.7 37.2 0.9 73.8 Goa 29.8 18.1 0.5 48.3 Gujarat 31.5 29.3 1.7 62.6 Maharashtra 27.7 25.0 1.1 53.8 South Andaman & Nicobar Islands 26.0 22.6 0.4 49.0 Andhra Pradesh 26.4 29.9 2.4 58.6 Karnataka 30.3 29.8 0.8 60.9 Kerala 22.8 12.5 0.4 35.7 Lakshadweep 27.8 25.5 0.4 53.6 Puducherry 29.0 15.6 0.2 44.9 Tamil Nadu 27.5 22.2 0.9 50.7 Telangana 24.7 33.5 2.5 60.7 Note: Table is based on children who stayed in the household the night before the interview. Prevalence of anaemia, based on haemoglobin levels, is adjusted for altitude using the CDC formulas (Centers for Disease Control (CDC). 1998. Recommendations to prevent and control iron deficiency in the United States. Morbidity and Mortality Weekly Report 47 (RR-3): 1-29). Haemoglobin levels are shown in grams per decilitre (g/dl). 322 z Nutrition and Anaemia Table 10.14 Trends in prevalence of anaemia in children Percentage of children age 6-59 months classified as having anaemia by residence, NFHS-4 and NFHS-3, India Anaemia status by haemoglobin level NFHS-4 (2015-16) NFHS-3 (2005-06) Urban Rural Total Urban Rural Total Mild (10.0-10.9 g/dl) 26.8 28.2 27.8 25.6 26.5 26.3 Moderate (7.0-9.9 g/dl) 27.5 29.8 29.2 34.2 42.1 40.2 Severe (<7.0 g/dl) 1.6 1.5 1.6 3.1 2.9 2.9 Any anaemia (<11.0 g/dl) 56.0 59.5 58.5 63.0 71.5 69.5 Number of children 56,237 148,798 205,035 10,133 32,255 42,388 Note: Table is based on children who stayed in the household the night before the interview. Prevalence of anaemia, based on haemoglobin levels, is adjusted for altitude using the CDC formulas (Centers for Disease Control (CDC). 1998. Recommendations to prevent and control iron deficiency in the United States. Morbidity and Mortality Weekly Report 47 (RR-3): 1-29). Haemoglobin levels are shown in grams per decilitre (g/dl). Nutrition and Anaemia z�323 Table 10.15 Presence of iodized salt in household Percentage of households with salt tested for iodine content, and among households with salt tested, percentage with iodized salt, according to background characteristics, India, 2015-16 Background characteristic Percentage of households with salt tested Number of households Among households with salt tested Percentage with iodized salt Number of households Residence Urban 99.4 209,133 96.5 207,893 Rural 99.6 391,269 91.4 389,658 Religion of household head Hindu 99.5 488,816 92.7 486,442 Muslim 99.6 75,351 94.9 75,022 Christian 99.5 16,155 93.3 16,077 Sikh 99.8 9,840 98.0 9,816 Buddhist/Neo-Buddhist 99.6 5,761 98.4 5,740 Jain 99.3 1,254 95.7 1,245 Other 99.5 3,225 95.7 3,210 Caste/tribe of household head Scheduled caste 99.5 123,739 91.6 123,069 Scheduled tribe 99.5 55,407 91.6 55,155 Other backward class 99.5 253,359 92.5 252,219 Other 99.5 163,347 95.7 162,584 Don't know 99.4 4,550 93.4 4,524 Wealth index Lowest 99.2 121,922 89.5 121,007 Second 99.4 118,290 90.5 117,634 Middle 99.5 119,102 91.9 118,530 Fourth 99.7 120,578 95.6 120,204 Highest 99.7 120,510 98.1 120,175 Total 99.5 600,402 93.1 597,551 324 z Nutrition and Anaemia Table 10.16 Presence of iodized salt in household by state/union territory Percentage of households with salt tested for iodine content, and among households with salt tested, percentage with iodized salt, according to background characteristics, India, 2015-16 State/union territory Percentage of households with salt tested Among households with salt tested Percentage with iodized salt India 99.5 93.1 North Chandigarh 99.0 99.0 Delhi 98.6 98.5 Haryana 99.6 92.8 Himachal Pradesh 99.6 99.1 Jammu & Kashmir 99.7 95.5 Punjab 99.7 98.4 Rajasthan 99.7 93.4 Uttarakhand 99.5 95.3 Central Chhattisgarh 99.7 99.1 Madhya Pradesh 99.5 93.2 Uttar Pradesh 99.4 93.7 East Bihar 99.7 93.6 Jharkhand 99.8 97.6 Odisha 99.8 92.9 West Bengal 99.8 94.6 Northeast Arunachal Pradesh 99.7 99.3 Assam 99.8 99.6 Manipur 99.8 99.5 Meghalaya 99.8 99.1 Mizoram 99.8 99.0 Nagaland 99.9 99.5 Sikkim 99.7 99.6 Tripura 100.0 99.1 West Dadra & Nagar Haveli 98.5 70.7 Daman & Diu 96.8 96.6 Goa 99.9 95.7 Gujarat 99.1 95.5 Maharashtra 99.4 96.4 South Andaman & Nicobar Islands 99.9 99.3 Andhra Pradesh 99.4 81.6 Karnataka 99.4 86.8 Kerala 99.8 98.4 Lakshadweep 98.8 96.3 Puducherry 99.7 92.7 Tamil Nadu 99.5 82.8 Telangana 99.1 95.8 Nutrition and Anaemia z�325 Ta bl e 10 .1 7 M ic ro nu tri en t i nt ak e am on g ch ild re n Pe rc en ta ge o f y ou ng es t c hi ld re n ag e 6- 23 m on th s l iv in g w ith th ei r m ot he r w ho c on su m ed v ita m in A -r ic h an d iro n- ric h fo od s i n th e da y or n ig ht p re ce di ng th e in te rv ie w , p er ce nt ag e of c hi ld re n ag e 12 -3 5 m on th s an d 6- 59 m on th s w ho w er e gi ve n vi ta m in A su pp le m en ts in th e six m on th s p re ce di ng th e su rv ey , p er ce nt ag e of c hi ld re n ag e 6- 59 m on th s w ho w er e gi ve n iro n su pp le m en ts in th e pa st se ve n da ys , w ho w er e gi ve n de w or m in g m ed ic at io n in th e six m on th s pr ec ed in g th e su rv ey , a nd w ho li ve in h ou se ho ld s us in g io di ze d sa lt, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic Yo un ge st c hi ld re n ag e 6- 23 m on th s l iv in g w ith th ei r m ot he r C hi ld re n ag e 12 -3 5 m on th s C hi ld re n ag e 6- 59 m on th s C hi ld re n ag e 6- 59 m on th s in ho us eh ol ds w ith s al t t es te d Pe rc en ta ge w ho co ns um ed fo od s ric h in v ita m in A in p as t 2 4 ho ur s1 Pe rc en ta ge w ho co ns um ed fo od s ric h in ir on in pa st 2 4 ho ur s2 N um be r of ch ild re n Pe rc en ta ge gi ve n vi ta m in A su pp le m en ts in pa st 6 m on th s N um be r of c hi ld re n Pe rc en ta ge g iv en vi ta m in A su pp le m en ts in pa st 6 m on th s Pe rc en ta ge gi ve n iro n su pp le m en ts in p a st 7 d ay s Pe rc en ta ge g iv en de w or m in g m ed ic at io n in p a st 6 m on th s N um be r of ch ild re n Pe rc en ta ge li vi ng in h ou se ho ld s us in g io di ze d sa lt3 N um be r of ch ild re n Ag e in m on th s 6- 8 16 .6 5. 9 12 ,8 01 na na 43 .7 22 .3 18 .3 12 ,9 32 92 .0 13 ,1 79 9- 11 32 .2 11 .2 11 ,6 84 na na 61 .3 25 .4 22 .6 11 ,8 08 93 .3 12 ,0 57 12 -1 7 50 .3 20 .4 23 ,3 06 71 .4 23 ,9 15 71 .4 27 .1 29 .0 23 ,9 15 93 .3 24 ,5 36 18 -2 3 59 .9 25 .9 21 ,9 00 68 .0 23 ,9 24 68 .0 26 .9 32 .5 23 ,9 24 93 .2 24 ,3 99 24 -3 5 na na na 61 .2 47 ,3 98 61 .2 27 .2 34 .0 47 ,3 98 93 .1 48 ,8 40 36 -4 7 na na na na na 57 .0 26 .1 33 .6 49 ,8 29 93 .0 51 ,4 58 48 -5 9 na na na na na 54 .1 25 .2 32 .9 47 ,7 71 93 .1 49 ,3 07 Se x M al e 43 .5 17 .3 36 ,6 53 65 .9 49 ,3 23 59 .5 26 .2 31 .7 11 3, 42 9 93 .0 11 6, 58 2 Fe m al e 44 .8 18 .6 33 ,0 37 65 .1 45 ,9 14 59 .5 25 .9 31 .1 10 4, 14 8 93 .1 10 7, 19 4 Bi rt h or de r 1 43 .4 17 .9 26 ,4 04 69 .1 36 ,9 99 62 .6 28 .2 33 .8 84 ,5 34 93 .0 12 0, 40 2 2- 3 45 .6 19 .1 34 ,0 25 66 .0 45 ,4 72 60 .2 26 .4 32 .0 10 2, 87 6 93 .2 79 ,3 28 4- 5 41 .3 14 .1 7, 15 5 56 .0 9, 73 2 51 .1 20 .7 24 .3 22 ,7 18 92 .8 18 ,1 15 6+ 37 .8 12 .1 2, 10 6 44 .5 3, 03 3 40 .5 13 .8 17 .7 7, 44 9 91 .3 5, 93 0 Br ea st fe ed in g st at us 4 Br ea st fe ed in g 41 .9 16 .4 58 ,6 50 67 .7 54 ,3 11 62 .4 25 .8 29 .6 88 ,5 27 93 .2 86 ,5 74 N ot b re as tfe ed in g 55 .5 25 .9 11 ,0 40 62 .5 40 ,9 26 57 .5 26 .3 32 .6 12 9, 05 1 93 .0 12 3, 52 4 Re si de nc e U rb an 47 .6 21 .7 19 ,6 35 68 .7 27 ,1 97 62 .4 29 .1 35 .3 62 ,3 48 96 .6 63 ,9 18 Ru ra l 42 .7 16 .4 50 ,0 56 64 .2 68 ,0 40 58 .3 24 .9 29 .8 15 5, 23 0 91 .6 15 9, 85 8 M ot he r's s ch oo lin g N o sc ho ol in g 39 .8 13 .8 19 ,1 05 55 .7 26 ,9 20 50 .5 20 .9 23 .2 65 ,4 61 90 .9 63 ,2 85 < 5 ye ar s co m pl et e 47 .2 20 .9 3, 95 4 64 .5 5, 56 3 58 .2 25 .7 32 .0 13 ,1 64 93 .4 13 ,2 90 5- 7 ye ar s co m pl et e 43 .8 17 .8 11 ,0 13 66 .2 15 ,3 86 60 .8 27 .5 32 .5 35 ,4 62 92 .5 35 ,6 43 8- 9 ye ar s co m pl et e 45 .0 17 .7 11 ,9 46 68 .0 15 ,9 64 61 .6 25 .7 33 .8 35 ,8 11 93 .2 38 ,9 60 10 -1 1 ye ar s co m pl et e 45 .4 22 .5 8, 90 6 72 .2 12 ,0 98 66 .8 30 .5 37 .4 26 ,3 09 93 .6 28 ,4 34 12 o r m or e ye ar s co m pl et e 47 .6 19 .9 14 ,7 67 72 .5 19 ,3 07 66 .6 30 .7 37 .4 41 ,3 70 95 .9 44 ,1 63 &R QW LQ XH G� ��� 326 z Nutrition and Anaemia Ta bl e 10 .1 7 M ic ro nu tri en t i nt ak e am on g ch ild re n² C on tin ue d Pe rc en ta ge o f y ou ng es t c hi ld re n ag e 6- 23 m on th s l iv in g w ith th ei r m ot he r w ho c on su m ed v ita m in A -r ic h an d iro n- ric h fo od s i n th e da y or n ig ht p re ce di ng th e in te rv ie w , p er ce nt ag e of c hi ld re n ag e 12 -3 5 m on th s an d 6- 59 m on th s w ho w er e gi ve n vi ta m in A su pp le m en ts in th e six m on th s p re ce di ng th e su rv ey , p er ce nt ag e of c hi ld re n ag e 6- 59 m on th s w ho w er e gi ve n iro n su pp le m en ts in th e pa st se ve n da ys , w ho w er e gi ve n de w or m in g m ed ic at io n in th e six m on th s pr ec ed in g th e su rv ey , a nd w ho li ve in h ou se ho ld s us in g io di ze d sa lt, b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic Yo un ge st c hi ld re n ag e 6- 23 m on th s l iv in g w ith th ei r m ot he r C hi ld re n ag e 12 -3 5 m on th s C hi ld re n ag e 6- 59 m on th s C hi ld re n ag e 6- 59 m on th s in ho us eh ol ds w ith s al t t es te d Pe rc en ta ge w ho co ns um ed fo od s ric h in v ita m in A in p as t 2 4 ho ur s1 Pe rc en ta ge w ho co ns um ed fo od s ric h in ir on in pa st 2 4 ho ur s2 N um be r o f c hi ld re n Pe rc en ta ge gi ve n vi ta m in A su pp le m en ts in pa st 6 m on th s N um be r of ch ild re n Pe rc en ta ge g iv en vi ta m in A su pp le m en ts in pa st 6 m on th s Pe rc en ta ge gi ve n iro n su pp le m en ts in pa st 7 d ay s Pe rc en ta ge g iv en de w or m in g m ed ic at io n in pa st 6 m on th s N um be r o f ch ild re n Pe rc en ta ge li vi ng in h ou se ho ld s us in g io di ze d sa lt3 N um be r of ch ild re n Re lig io n H in du 43 .5 15 .7 54 ,8 30 66 .4 74 ,5 18 60 .4 26 .4 31 .2 17 1, 01 3 92 .6 17 5, 21 9 M us lim 45 .3 26 .2 11 ,4 77 59 .5 16 ,1 39 53 .7 23 .2 31 .3 36 ,0 00 94 .2 37 ,6 69 C hr ist ia n 56 .6 37 .1 1, 45 3 69 .0 1, 98 7 64 .1 27 .5 36 .0 4, 53 1 93 .7 4, 71 8 Si kh 35 .7 7. 0 84 8 78 .7 1, 19 2 70 .2 32 .8 29 .1 2, 67 8 98 .6 2, 73 9 Bu dd hi st /N eo -B ud dh ist 46 .0 23 .6 55 1 72 .9 71 6 68 .5 42 .9 46 .8 1, 75 5 98 .6 1, 76 6 Ja in 36 .2 1. 3 63 65 .7 84 66 .5 27 .1 28 .0 23 6 93 .9 25 0 O th er 58 .9 29 .1 46 7 62 .7 60 1 55 .6 18 .8 33 .4 1, 36 5 95 .7 1, 41 5 C as te /tr ib e Sc he du le d ca st e 43 .0 18 .0 15 ,1 35 66 .3 20 ,1 94 60 .0 26 .2 31 .2 46 ,6 34 91 .9 48 ,6 21 Sc he du le d tri be 48 .2 18 .9 7, 30 3 65 .4 9, 83 8 59 .4 28 .1 31 .5 22 ,6 03 91 .3 23 ,3 15 O th er b ac kw ar d cl as s 43 .1 16 .6 30 ,6 35 64 .2 41 ,9 90 58 .5 24 .4 29 .2 96 ,0 38 92 .7 97 ,5 44 O th er 45 .3 19 .8 15 ,9 79 67 .4 22 ,4 15 61 .3 28 .4 35 .7 50 ,4 23 95 .4 52 ,4 93 D on 't kn ow 43 .1 18 .9 63 9 56 .4 79 9 52 .2 22 .2 32 .8 1, 88 0 92 .2 1, 80 2 W ea lth in de x Lo w es t 41 .7 14 .7 16 ,9 95 58 .2 23 ,1 84 52 .4 20 .9 24 .6 54 ,1 72 90 .3 55 ,7 71 Se co nd 43 .2 17 .4 15 ,0 47 63 .3 20 ,6 33 57 .7 24 .5 30 .3 47 ,2 67 91 .4 48 ,4 89 M id dl e 44 .0 19 .4 14 ,2 51 67 .0 19 ,1 54 61 .4 27 .4 32 .8 43 ,2 93 92 .2 44 ,2 27 Fo ur th 46 .3 21 .1 12 ,9 12 71 .5 17 ,8 63 65 .2 30 .1 36 .5 40 ,0 87 95 .5 41 ,2 77 H ig he st 46 .6 17 .8 10 ,4 86 70 .9 14 ,4 03 64 .4 30 .2 36 .1 32 ,7 59 98 .0 34 ,0 11 To ta l 44 .1 17 .9 69 ,6 90 65 .5 95 ,2 37 59 .5 26 .1 31 .4 21 7, 57 8 93 .0 22 3, 77 5 N ot e: In fo rm at io n on ir on s up pl em en ts a nd d ew or m in g m ed ic at io n is ba se d on th e m ot he r's re ca ll. In fo rm at io n on v ita m in A s up pl em en ta tio n is ba se d on th e va cc in at io n ca rd (i f a va ila bl e) a nd m ot he r's re ca ll. na = N ot a pp lic ab le 1 In cl ud es m ea t a nd o rg an m ea ts , f ish , p ou ltr y, e gg s, p um pk in , c ar ro ts , s qu as h, s w ee t p ot at oe s th at a re y el lo w o r o ra ng e in sid e, d ar k gr ee n le af y ve ge ta bl es , r ip e m an go , p ap ay a, c an ta lo up e, a nd ja ck fru it 2 In cl ud es m ea t a nd o rg an m ea ts , f ish , p ou ltr y, o r e gg s 3 Ex cl ud es c hi ld re n in h ou se ho ld s in w hi ch s al t w as n ot te st ed . I nc lu de s ch ild re n w ho se m ot he rs w er e no t i nt er vi ew ed e xc ep t f or b irt h or de r, br ea st fe ed in g st at us , a nd m ot he r’s s ch oo lin g. F or m ot he r's s ch oo lin g, e xc lu de s ch ild re n w ho se m ot he rs a re n ot li st ed in th e ho us eh ol d sc he du le . 4 To ta l i nc lu de s ch ild re n w ho se b re as tfe ed in g st at us is u nk no w n, w ho a re n ot s ho w n se pa ra te ly Nutrition and Anaemia z�327 Table 10.18 Micronutrient intake among children by state/union territory Percentage of youngest children age 6-23 months living with their mother who consumed vitamin A-rich and iron-rich foods in the day or night preceding the interview, percentage of children age 12-35 months and 6-59 months who were given vitamin A supplements in the six months preceding the survey, percentage of children age 6-59 months who were given iron supplements in the past seven days, who were given deworming medication in the six months preceding the survey, and who live in households using iodized salt, by state/union territory, India, 2015-16 State/union territory Youngest children age 6-23 months living with their mother Children age 12-35 months Children age 6-59 months Children age 6-59 months in households with salt tested Percentage who consumed foods rich in vitamin A in past 24 hours1 Percentage who consumed foods rich in iron in past 24 hours2 Percentage given vitamin A supplements in past 6 months Percentage given vitamin A supplements in past 6 months Percentage given iron supplements in past 7 days Percentage given deworming medication in past 6 months Percentage living in households using iodized salt3 India 44.1 17.9 65.5 59.5 26.1 31.4 93.0 North Chandigarh 22.0 5.9 62.0 56.3 12.9 16.3 100.0 Delhi 51.6 11.5 64.2 58.1 28.1 41.5 98.2 Haryana 36.7 8.0 70.9 66.0 40.7 35.0 91.0 Himachal Pradesh 51.8 5.1 73.7 63.1 19.7 39.7 99.0 Jammu & Kashmir 62.1 44.2 72.0 64.0 19.1 39.1 93.4 Punjab 34.0 6.6 77.9 70.4 32.5 29.0 98.5 Rajasthan 26.6 2.8 45.1 40.1 14.1 15.6 92.1 Uttarakhand 39.6 9.5 40.2 36.5 14.2 15.6 95.4 Central Chhattisgarh 62.7 13.7 78.2 69.2 35.7 39.7 99.3 Madhya Pradesh 39.6 7.6 66.3 59.6 25.9 29.5 92.1 Uttar Pradesh 32.6 5.3 45.0 39.2 13.1 17.0 93.3 East Bihar 39.2 13.8 64.8 60.7 21.9 25.0 93.1 Jharkhand 45.1 13.7 58.8 52.9 17.3 21.6 97.6 Odisha 62.5 16.5 76.8 68.5 27.9 27.5 92.7 West Bengal 61.9 42.6 76.5 66.4 27.9 54.1 94.1 Northeast Arunachal Pradesh 59.0 41.4 46.7 40.3 20.8 28.6 99.4 Assam 53.3 26.8 57.3 51.2 20.5 30.2 99.6 Manipur 68.9 52.9 39.0 31.4 4.5 9.2 99.4 Meghalaya 68.9 53.5 58.6 53.1 29.7 32.8 99.0 Mizoram 73.9 61.1 70.7 68.4 24.9 56.3 98.9 Nagaland 63.1 51.8 35.1 28.6 8.2 17.4 99.4 Sikkim 68.2 36.8 86.6 82.7 50.9 47.9 99.8 Tripura 38.5 19.6 67.3 62.3 7.9 55.2 99.1 Continued. 328 z Nutrition and Anaemia Table 10.18 Micronutrient intake among children by state/union territory—Continued Percentage of youngest children age 6-23 months living with their mother who consumed vitamin A-rich and iron-rich foods in the day or night preceding the interview, percentage of children age 12-35 months and 6-59 months who were given vitamin A supplements in the six months preceding the survey, percentage of children age 6-59 months who were given iron supplements in the past seven days, who were given deworming medication in the six months preceding the survey, and who live in households using iodized salt, by state/union territory, India, 2015-16 State/union territory Youngest children age 6-23 months living with their mother Children age 12-35 months Children age 6-59 months Children age 6-59 months in households with salt tested Percentage who consumed foods rich in vitamin A in past 24 hours1 Percentage who consumed foods rich in iron in past 24 hours2 Percentage given vitamin A supplements in past 6 months Percentage given vitamin A supplements in past 6 months Percentage given iron supplements in past 7 days Percentage given deworming medication in past 6 months Percentage living in households using iodized salt3 West Dadra & Nagar Haveli 24.1 1.1 63.2 58.9 15.3 13.9 62.1 Daman & Diu 46.3 19.6 77.5 68.2 25.1 22.8 96.5 Goa 36.0 20.9 91.1 88.6 55.5 65.6 97.9 Gujarat 43.8 5.1 75.9 70.3 32.0 28.2 95.8 Maharashtra 40.8 15.3 74.8 69.7 41.2 44.7 96.3 South Andaman & Nicobar Islands 67.1 51.3 75.2 66.7 25.3 46.2 98.9 Andhra Pradesh 38.5 24.3 78.8 71.6 27.3 20.7 81.4 Karnataka 43.1 21.9 82.8 78.2 50.2 51.2 86.6 Kerala 55.1 37.8 81.6 74.4 17.8 50.5 98.1 Lakshadweep 54.3 44.6 54.2 52.2 10.1 47.2 95.8 Puducherry 72.2 56.9 76.5 74.4 45.1 49.1 93.6 Tamil Nadu 72.5 58.5 72.8 68.1 34.0 52.9 84.0 Telangana 42.8 26.8 81.3 75.3 37.3 25.2 95.3 Note: Information on iron supplements and deworming medication is based on the mother's recall. Information on vitamin A supplementation is based on the vaccination card (if available) and mother's recall. 1 Includes meat and organ meats, fish, poultry, eggs, pumpkin, carrots, squash, sweet potatoes that are yellow or orange inside, dark green leafy vegetables, ripe mango, papaya, cantaloupe, and jackfruit 2 Includes meat and organ meats, fish, poultry, or eggs 3 Excludes children in households in which salt was not tested. Includes children whose mothers were not interviewed. Nutrition and Anaemia z�329 Table 10.19.1 Nutritional status of women Percentage of women age 15-49 below 145 cm, mean body mass index (BMI), and percentage with specific BMI levels, by background characteristics, India, 2015-16 Background characteristic Height Number of women Body mass index1 Number of women Mean (BMI) 18.5- 24.9 (normal) Thin Overweight/obese Percentage below 145 cm <18.5 (total thin) 17.0-18.4 (mildly thin) <17.0 (moderately/ severely thin) •����� (overweight or obese) 25.0-29.9 (overweight) •����� (obese) Age 15-19 12.7 118,553 19.4 53.9 41.9 23.2 18.7 4.2 3.4 0.8 114,001 20-29 10.3 232,542 21.2 60.5 25.3 15.1 10.1 14.2 11.3 2.9 205,828 30-39 10.7 183,450 22.9 56.7 15.7 9.4 6.3 27.7 20.7 7.0 178,670 40-49 11.7 149,094 23.5 52.6 13.7 7.9 5.7 33.8 24.4 9.3 148,669 Marital status Never married 11.5 154,102 19.9 56.0 37.4 20.7 16.7 6.6 5.2 1.4 153,802 Currently married 10.9 500,956 22.5 56.6 18.4 11.1 7.3 25.0 18.8 6.3 464,904 Widowed 13.2 21,158 22.7 55.4 18.0 10.2 7.8 26.5 19.2 7.3 21,098 Divorced/separated/deserted 13.1 7,423 22.2 57.2 20.1 11.5 8.7 22.7 17.3 5.3 7,364 Residence Urban 9.3 232,816 23.3 53.1 15.5 8.9 6.6 31.4 22.2 9.1 222,802 Rural 12.1 450,823 21.1 58.2 26.8 15.6 11.1 15.1 12.0 3.1 424,366 Schooling No schooling 14.8 189,437 21.4 58.5 24.6 14.5 10.1 16.8 13.2 3.7 180,224 <5 years complete 14.2 39,942 21.8 56.2 23.1 13.3 9.7 20.8 16.3 4.5 38,081 5-7 years complete 12.2 97,762 22.2 55.0 21.9 12.7 9.2 23.1 17.0 6.1 92,062 8-9 years complete 11.5 114,569 21.6 54.6 26.2 14.9 11.3 19.2 14.3 4.9 107,956 10-11 years complete 8.5 97,036 22.0 53.9 23.9 13.7 10.2 22.2 16.2 6.0 92,483 12 or more years complete 6.3 144,893 22.5 57.9 17.9 10.6 7.2 24.2 18.0 6.2 136,362 Religion Hindu 11.5 550,907 21.8 56.7 23.6 13.7 9.9 19.8 15.0 4.8 522,551 Muslim 10.3 94,035 22.2 54.9 21.5 12.6 8.9 23.6 17.1 6.5 87,766 Christian 10.1 16,199 22.9 58.1 14.6 8.9 5.7 27.3 20.2 7.1 15,429 Sikh 2.6 11,457 23.5 55.8 12.3 7.2 5.0 31.9 22.4 9.6 10,946 Buddhist/Neo-Buddhist 13.1 6,356 21.8 56.5 23.7 11.9 11.7 19.8 14.8 5.0 6,071 Jain 5.4 1,220 23.9 49.7 11.7 7.7 4.0 38.6 26.8 11.8 1,189 Other 12.4 3,466 21.0 61.0 26.5 18.1 8.4 12.4 9.5 2.9 3,214 Caste/tribe Scheduled caste 14.1 139,778 21.4 57.5 25.3 14.4 10.8 17.2 13.4 3.8 131,830 Scheduled tribe 12.7 62,957 20.5 58.3 31.7 18.3 13.4 10.0 8.1 1.9 59,292 Other backward class 11.0 297,867 21.9 56.3 22.9 13.4 9.5 20.8 15.6 5.2 281,579 Other 8.4 178,774 22.7 55.3 17.8 10.5 7.4 26.9 19.6 7.3 170,479 Don't know 14.1 4,264 21.6 53.8 26.1 14.7 11.4 20.2 15.1 5.1 3,987 Wealth index Lowest 18.0 122,312 19.9 58.3 35.8 20.9 14.9 5.8 5.0 0.8 113,613 Second 13.7 135,017 20.7 59.1 29.5 17.1 12.4 11.4 9.5 1.8 126,973 Middle 11.0 141,175 21.7 58.2 23.1 13.4 9.7 18.7 14.9 3.8 133,730 Fourth 8.5 144,157 22.8 54.8 17.1 9.9 7.2 28.2 20.8 7.4 137,676 Highest 5.6 140,979 23.9 52.3 11.6 6.9 4.7 36.2 25.2 11.0 135,176 Total 11.1 683,639 21.9 56.4 22.9 13.3 9.6 20.7 15.5 5.1 647,168 Note: The body mass index (BMI) is expressed as the ratio of weight in kilograms to the square of height in metres (kg/m2). 1 Excludes pregnant women and women with a birth in the preceding 2 months 330 z Nutrition and Anaemia Table 10.19.2 Nutritional status of men Among men age 15-49, mean body mass index (BMI) and percentage with specific BMI levels by background characteristics, India, 2015-16 Background characteristic Body mass index Number of men Mean (BMI) 18.5-24.9 (normal) Thin Overweight/obese <18.5 (total thin) 17.0-18.4 (mildly thin) <17.0 (moderately/ severely thin) •25.0 (overweight or obese) 25.0-29.9 (over- weight) •30.0 (obese) Age 15-19 19.3 50.4 44.8 23.0 21.9 4.8 3.8 1.0 17,996 20-29 21.6 66.3 18.7 12.6 6.1 15.0 12.8 2.2 31,300 30-39 22.8 62.9 12.0 8.0 4.1 25.1 21.1 4.0 27,270 40-49 23.0 59.4 12.5 8.1 4.4 28.1 23.4 4.6 22,602 Marital status Never married 20.6 59.2 30.6 17.0 13.7 10.1 8.6 1.6 37,670 Currently married 22.7 61.9 13.6 9.2 4.4 24.5 20.5 3.9 60,249 Widowed 21.3 62.3 24.2 14.4 9.8 13.5 10.9 2.6 569 Divorced/separated/deserted 21.6 62.1 22.5 14.8 7.7 15.4 11.1 4.3 680 Residence Urban 22.8 58.0 15.5 9.0 6.5 26.6 21.9 4.7 37,104 Rural 21.3 62.7 23.0 14.1 8.9 14.3 12.3 2.0 62,064 Schooling No schooling 21.1 65.5 22.5 14.2 8.3 12.0 10.1 1.8 11,994 <5 years complete 21.5 62.0 22.3 14.8 7.5 15.7 13.8 1.9 5,944 5-7 years complete 21.6 60.8 22.2 13.6 8.7 16.9 14.3 2.6 14,173 8-9 years complete 21.2 58.6 26.3 14.6 11.7 15.1 12.8 2.3 20,615 10-11 years complete 21.9 58.9 21.1 12.2 8.8 20.0 16.2 3.8 17,286 12 or more years complete 22.8 61.6 13.0 8.4 4.5 25.4 21.4 4.0 29,155 Religion Hindu 21.8 60.9 20.7 12.5 8.2 18.4 15.5 2.9 81,046 Muslim 22.0 60.8 19.3 11.6 7.8 19.9 16.6 3.3 12,899 Christian 22.8 63.5 12.2 8.5 3.7 24.3 20.0 4.3 2,185 Sikh 23.3 60.9 10.5 6.8 3.7 28.6 22.6 6.0 1,584 Buddhist/Neo-Buddhist 22.0 59.3 19.7 12.9 6.8 21.0 16.6 4.3 919 Jain 23.1 53.4 12.9 3.7 9.2 33.7 29.0 4.7 158 Other 20.9 63.5 24.5 13.5 11.0 12.0 11.3 0.7 377 Caste/tribe Scheduled caste 21.4 62.2 22.9 14.0 8.9 15.0 12.5 2.4 19,785 Scheduled tribe 20.8 65.1 25.2 16.0 9.1 9.8 8.5 1.3 8,862 Other backward class 21.9 60.1 20.3 12.0 8.3 19.6 16.7 2.9 43,447 Other 22.5 60.0 16.3 10.0 6.3 23.7 19.4 4.3 26,720 Don't know 21.6 55.7 23.9 9.0 14.9 20.4 16.8 3.6 353 Wealth index Lowest 20.0 63.3 31.9 19.8 12.2 4.7 4.3 0.5 14,781 Second 20.7 63.7 26.6 16.3 10.3 9.8 8.8 1.0 18,873 Middle 21.6 62.9 20.5 12.5 8.0 16.6 14.2 2.4 21,198 Fourth 22.5 59.3 16.3 9.5 6.7 24.4 20.3 4.1 21,878 Highest 23.6 56.7 10.6 6.1 4.5 32.7 26.7 6.0 22,438 Total age 15-49 21.8 60.9 20.2 12.2 8.0 18.9 15.9 3.0 99,168 Age 50-54 22.9 58.2 14.3 9.4 4.9 27.5 22.3 5.1 8,362 Total age 15-54 21.9 60.7 19.7 12.0 7.8 19.6 16.4 3.2 107,529 Note: The body mass index (BMI) is expressed as the ratio of weight in kilograms to the square of height in metres (kg/m2). Nutrition and Anaemia z�331 Table 10.20.1 Nutritional status of women by state/union territory Percentage of women age 15-49 below 145 cm, mean body mass index (BMI), and percentage with specific BMI levels, by state/union territory, India, 2015-16 State/union territory Height Body mass index1 Mean (BMI) 18.5-24.9 (normal) Thin Overweight/obese Percentage below 145 cm <18.5 (total thin) 17.0-18.4 (mildly thin) <17.0 (moderately/ severely thin) •25.0 (overweight or obese) 25.0-29.9 (overweight) •30.0 (obese) India 11.1 21.9 56.4 22.9 13.3 9.6 20.7 15.5 5.1 North Chandigarh 7.7 24.3 45.2 13.3 6.6 6.7 41.4 26.5 14.9 Delhi 12.0 23.5 51.7 14.8 8.7 6.1 33.5 23.4 10.1 Haryana 4.5 22.3 63.2 15.8 9.5 6.3 21.0 16.1 4.9 Himachal Pradesh 5.0 22.8 55.2 16.2 9.8 6.3 28.7 21.7 7.0 Jammu & Kashmir 4.7 23.2 58.8 12.1 7.9 4.2 29.1 21.6 7.5 Punjab 2.9 23.5 57.0 11.7 6.9 4.8 31.3 22.2 9.2 Rajasthan 4.5 21.1 58.9 27.0 15.5 11.5 14.1 10.8 3.3 Uttarakhand 8.1 22.1 61.1 18.4 11.8 6.6 20.5 15.6 4.9 Central Chhattisgarh 10.5 20.9 61.4 26.7 16.6 10.1 11.9 9.5 2.4 Madhya Pradesh 8.8 21.0 58.0 28.4 16.8 11.5 13.6 10.5 3.1 Uttar Pradesh 14.8 21.4 58.2 25.3 15.3 10.0 16.5 12.6 3.9 East Bihar 18.1 20.6 57.8 30.5 18.5 12.1 11.7 9.5 2.2 Jharkhand 17.6 20.5 58.1 31.6 18.9 12.7 10.3 8.2 2.1 Odisha 14.4 21.3 57.0 26.5 15.6 10.9 16.5 13.0 3.5 West Bengal 13.9 21.8 58.9 21.3 12.4 8.9 19.9 16.1 3.8 Northeast Arunachal Pradesh 11.8 22.5 72.7 8.5 6.2 2.4 18.8 15.9 2.9 Assam 14.4 21.0 61.1 25.7 15.5 10.2 13.2 11.1 2.1 Manipur 7.5 23.0 65.2 8.8 6.7 2.1 26.0 20.8 5.2 Meghalaya 21.5 21.7 75.7 12.1 9.0 3.1 12.2 10.4 1.7 Mizoram 6.6 22.6 70.6 8.4 6.7 1.6 21.1 17.4 3.7 Nagaland 5.6 21.9 71.6 12.3 9.4 2.9 16.2 13.5 2.7 Sikkim 4.4 23.3 66.9 6.4 4.6 1.8 26.7 21.3 5.4 Tripura 20.7 21.7 65.0 19.0 12.2 6.8 16.0 13.7 2.4 West Dadra & Nagar Haveli 10.2 21.4 52.2 28.7 14.1 14.6 19.2 14.2 5.0 Daman & Diu 9.6 23.3 55.4 12.9 6.7 6.2 31.7 23.6 8.1 Goa 9.3 23.5 51.9 14.7 7.8 6.9 33.5 23.6 9.9 Gujarat 8.6 22.0 49.0 27.2 13.8 13.4 23.8 16.7 7.1 Maharashtra 9.6 22.1 53.1 23.5 12.9 10.6 23.4 17.3 6.1 South Andaman & Nicobar Islands 6.8 23.3 55.1 13.1 6.5 6.6 31.8 24.0 7.8 Andhra Pradesh 10.2 23.3 49.2 17.6 10.3 7.4 33.2 22.9 10.3 Karnataka 8.3 22.3 56.0 20.8 11.5 9.2 23.3 16.7 6.5 Kerala 4.8 23.5 57.9 9.7 5.8 3.8 32.4 26.0 6.4 Lakshadweep 6.3 24.2 45.9 13.5 6.2 7.2 40.6 26.0 14.6 Puducherry 6.3 23.9 52.0 11.3 6.2 5.1 36.7 26.5 10.2 Tamil Nadu 9.2 23.2 54.4 14.6 8.1 6.5 30.9 22.6 8.3 Telangana 11.1 22.6 48.4 22.9 12.1 10.7 28.7 20.0 8.6 Note: The body mass index (BMI) is expressed as the ratio of weight in kilograms to the square of height in metres (kg/m2). 1 Excludes pregnant women and women with a birth in the preceding 2 months 332 z Nutrition and Anaemia Table 10.20.2 Nutritional status of men by state/union territory Among men age 15-49, mean body mass index (BMI) and percentage with specific BMI levels, by state/union territory, India, 2015-16 State/union territory Body mass index Mean body mass index (BMI) 18.5-24.9 (normal) Thin Overweight/obese <18.5 (total thin) 17.0-18.4 (mildly thin) <17.0 (moderately/ severely thin) •25.0 (overweight or obese) 25.0-29.9 (overweight) •30.0 (obese) India 21.8 60.9 20.2 12.2 8.0 18.9 15.9 3.0 North Chandigarh 22.8 46.3 21.7 12.6 9.1 32.0 27.5 4.5 Delhi 22.4 57.7 17.7 10.6 7.1 24.6 21.0 3.6 Haryana 22.6 68.7 11.3 7.3 3.9 20.0 17.3 2.7 Himachal Pradesh 22.2 60.0 18.0 11.5 6.5 22.0 18.6 3.4 Jammu & Kashmir 22.4 68.0 11.5 8.1 3.4 20.5 17.2 3.3 Punjab 23.2 61.2 10.9 7.3 3.6 27.8 22.8 5.1 Rajasthan 21.3 64.1 22.7 12.9 9.9 13.2 11.1 2.1 Uttarakhand 22.0 66.2 16.1 10.4 5.8 17.7 15.2 2.5 Central Chhattisgarh 20.9 65.7 24.2 16.1 8.0 10.2 8.8 1.4 Madhya Pradesh 20.7 60.7 28.4 17.0 11.4 10.9 9.4 1.6 Uttar Pradesh 21.0 61.5 25.9 15.7 10.3 12.5 10.9 1.6 East Bihar 21.0 62.0 25.5 16.4 9.0 12.6 11.3 1.3 Jharkhand 21.0 65.1 23.8 14.8 9.0 11.1 10.0 1.2 Odisha 21.7 63.2 19.5 13.0 6.5 17.3 14.9 2.3 West Bengal 21.5 65.9 19.9 11.9 8.0 14.2 12.4 1.8 Northeast Arunachal Pradesh 22.7 71.1 8.3 6.5 1.8 20.6 18.3 2.3 Assam 21.3 66.4 20.7 14.4 6.3 12.9 11.2 1.7 Manipur 22.4 69.1 11.1 8.4 2.8 19.8 17.0 2.8 Meghalaya 21.5 78.4 11.6 8.4 3.2 10.0 8.7 1.4 Mizoram 22.7 71.9 7.3 5.8 1.5 20.9 16.1 4.8 Nagaland 21.8 74.7 11.4 9.9 1.6 13.9 12.6 1.3 Sikkim 24.1 62.9 2.4 1.6 0.8 34.8 28.9 5.9 Tripura 21.9 68.4 15.7 10.0 5.8 15.9 14.2 1.7 West Dadra & Nagar Haveli 22.4 57.3 19.7 13.1 6.7 22.9 18.1 4.8 Daman & Diu 23.2 57.4 12.0 6.6 5.3 30.7 25.9 4.8 Goa 23.7 56.5 10.8 7.7 3.1 32.7 25.0 7.7 Gujarat 21.8 55.5 24.7 13.2 11.5 19.7 16.0 3.8 Maharashtra 22.3 57.1 19.1 11.6 7.5 23.8 19.5 4.3 South Andaman & Nicobar Islands 24.0 53.0 8.8 5.5 3.2 38.2 30.1 8.1 Andhra Pradesh 23.3 51.7 14.8 9.1 5.6 33.5 25.8 7.7 Karnataka 22.4 61.3 16.5 10.0 6.6 22.1 17.5 4.6 Kerala 23.3 63.0 8.5 4.9 3.6 28.5 24.7 3.8 Lakshadweep 22.9 67.7 8.2 5.2 3.1 24.1 19.6 4.6 Puducherry 23.6 52.7 10.2 5.2 4.9 37.1 32.3 4.8 Tamil Nadu 23.0 59.3 12.4 7.0 5.4 28.2 24.4 3.9 Telangana 22.1 54.3 21.5 11.9 9.6 24.2 19.5 4.8 Note: The body mass index (BMI) is expressed as the ratio of weight in kilograms to the square of height in metres (kg/m2). Nutrition and Anaemia z�333 Table 10.21.1 Prevalence of anaemia in women Percentage of women age 15-49 with anaemia by background characteristics, India, 2015-16, and total for NFHS-3 Background characteristic Anaemia status by haemoglobin level Number of women Mild (10.0-11.9 g/dl)1 Moderate (7.0-9.9 g/dl) Severe (<7.0 g/dl) Any anaemia (<12.0 g/dl)2 Age 15-19 41.2 11.9 1.0 54.1 117,711 20-29 39.3 13.0 0.9 53.1 230,947 30-39 39.3 12.1 1.1 52.5 182,462 40-49 39.4 12.4 1.2 53.0 148,325 Marital status Never married 40.1 11.3 1.0 52.5 153,088 Currently married 39.5 12.6 1.0 53.1 497,926 Widowed 40.5 14.6 1.5 56.6 21,058 Divorced/separated/deserted 38.3 14.5 1.6 54.4 7,373 Maternity status Pregnant 24.5 24.6 1.3 50.4 30,326 Breastfeeding 44.5 12.6 0.9 58.0 101,598 Neither 39.6 11.7 1.1 52.3 547,522 Number of children ever born 0 38.9 11.8 1.1 51.7 205,294 1 39.1 12.4 0.8 52.3 96,004 2-3 39.9 12.7 1.0 53.7 274,601 4-5 40.6 13.0 1.2 54.8 78,629 6+ 41.7 12.5 1.3 55.5 24,918 Residence Urban 38.3 11.6 0.9 50.8 230,496 Rural 40.3 12.8 1.1 54.2 448,950 Schooling No schooling 40.9 14.2 1.4 56.4 188,619 <5 years complete 41.4 13.1 1.1 55.6 39,738 5-7 years complete 39.6 12.9 1.2 53.7 97,131 8-9 years complete 39.7 12.0 0.9 52.7 113,923 10-11 years complete 39.3 11.7 0.9 51.9 96,304 12 or more years complete 37.7 10.4 0.6 48.7 143,731 Religion Hindu 39.9 12.7 1.1 53.7 548,124 Muslim 38.5 11.2 0.9 50.6 92,850 Christian 34.6 12.1 0.9 47.5 16,053 Sikh 41.0 10.5 0.5 52.0 11,456 Buddhist/Neo-Buddhist 39.5 11.2 1.0 51.6 6,308 Jain 30.7 8.1 0.5 39.2 1,209 Other 49.0 14.0 1.0 64.0 3,445 Caste/tribe Scheduled caste 40.8 13.9 1.2 55.9 139,148 Scheduled tribe 43.7 14.9 1.3 59.9 62,695 Other backward class 38.9 12.2 1.1 52.2 296,292 Other 38.3 10.6 0.7 49.8 177,127 Don't know 38.4 15.6 1.0 55.0 4,184 Continued. 334 z Nutrition and Anaemia Table 10.21.1 Prevalence of anaemia in women—Continued Percentage of women age 15-49 with anaemia by background characteristics, India, 2015-16, and total for NFHS-3 Background characteristic Anaemia status by haemoglobin level Number of women Mild (10.0-11.9 g/dl)1 Moderate (7.0-9.9 g/dl) Severe (<7.0 g/dl) Any anaemia (<12.0 g/dl)2 Wealth index Lowest 43.3 14.2 1.2 58.7 121,886 Second 40.9 13.1 1.2 55.1 134,473 Middle 39.1 13.1 1.1 53.3 140,381 Fourth 38.0 11.9 1.0 51.0 143,066 Highest 37.4 10.0 0.7 48.2 139,639 Smoking status Smokes cigarettes/other tobacco 40.6 14.3 1.6 56.5 46,720 Does not smoke 39.6 12.3 1.0 52.8 632,725 Total 39.6 12.4 1.0 53.1 679,445 NFHS-3 (2005-06) 38.6 15.0 1.8 55.3 116,855 Note: Table is based on women who stayed in the household the night before the interview. Prevalence is adjusted for altitude and for smoking status, if known, using the CDC formulas (Centers for Disease Control (CDC). 1998. Recommendations to prevent and control iron deficiency in the United States. Morbidity and Mortality Weekly Report 47 (RR-3): 1-29). Haemoglobin levels are shown in grams per decilitre (g/dl). 1 For pregnant women, the value is 10.0-10.9 g/dl 2 For pregnant women, the value is <11.0 g/dl Nutrition and Anaemia z�335 Table 10.21.2 Prevalence of anaemia in men Percentage of men age 15-49 with anaemia by background characteristics, India, 2015-16 Background characteristic Anaemia status by haemoglobin level Number of men Mild (12.0-12.9 g/dl) Moderate (9.0-11.9 g/dl) Severe (<9.0 g/dl) Any anaemia (<13.0 g/dl) Age 15-19 15.5 12.5 1.2 29.2 17,912 20-29 10.1 8.0 0.9 19.0 31,090 30-39 11.3 8.6 1.1 21.0 27,203 40-49 12.6 11.0 1.4 24.9 22,517 Marital status Never married 12.3 10.0 1.0 23.4 37,437 Currently married 11.7 9.4 1.2 22.3 60,036 Widowed 15.3 13.2 1.3 29.8 570 Divorced/separated/deserted 14.5 9.8 1.1 25.4 678 Residence Urban 9.9 7.6 0.9 18.5 36,766 Rural 13.2 10.9 1.2 25.3 61,955 Schooling No schooling 14.5 13.0 1.6 29.0 11,956 <5 years complete 14.0 11.1 1.4 26.5 5,925 5-7 years complete 12.6 10.5 1.3 24.4 14,167 8-9 years complete 13.6 10.0 1.1 24.7 20,517 10-11 years complete 11.4 9.3 1.1 21.9 17,219 12 or more years complete 9.4 7.5 0.7 17.7 28,938 Religion Hindu 12.1 9.8 1.2 23.0 80,761 Muslim 11.4 8.7 0.8 20.9 12,784 Christian 11.3 8.3 0.7 20.3 2,179 Sikh 13.5 11.0 0.5 25.0 1,581 Buddhist/Neo-Buddhist 12.1 9.5 0.9 22.5 888 Jain 9.8 5.7 0.5 16.1 158 Other 15.2 12.8 0.5 28.5 370 Caste/tribe Scheduled caste 12.1 10.5 1.0 23.6 19,697 Scheduled tribe 17.3 13.3 1.3 32.0 8,823 Other backward class 11.5 9.3 1.2 22.0 43,345 Other 11.0 8.4 1.0 20.3 26,506 Don't know 12.1 7.3 0.4 19.7 350 Wealth index Lowest 16.2 14.3 1.6 32.0 14,780 Second 14.1 11.0 1.2 26.3 18,849 Middle 11.9 9.4 1.2 22.4 21,119 Fourth 10.4 8.1 1.1 19.5 21,728 Highest 9.1 7.2 0.7 17.0 22,245 Smoking status Smokes cigarettes/other tobacco 12.4 10.4 1.4 24.2 49,227 Does not smoke 12.0 9.6 1.0 22.6 57,812 Total age 15-49 12.0 9.7 1.1 22.7 98,721 Age 50-54 14.4 14.0 1.9 30.3 8,318 Total age 15-54 12.2 10.0 1.2 23.3 107,039 Note: Table is based on men who stayed in the household the night before the interview. Prevalence is adjusted for altitude and for smoking status, if known, using the CDC formulas (Centers for Disease Control (CDC). 1998. Recommendations to prevent and control iron deficiency in the United States. Morbidity and Mortality Weekly Report 47 (RR-3): 1-29). Haemoglobin levels are shown in grams per decilitre (g/dl). 336 z Nutrition and Anaemia Table 10.22 Prevalence of anaemia in women and men by state/union territory Percentage of women and men age 15-49 with anaemia by state/union territory, India, 2015-16 State/union territory Women Men Mild (10.0-11.9 g/dl)1 Moderate (7.0-9.9 g/dl) Severe (<7.0 g/dl) Any anaemia (<12.0 g/dl)2 Mild (12.0-12.9 g/dl) Moderate (9.0-11.9 g/dl) Severe (<9.0 g/dl) Any anaemia (<13.0 g/dl) India 39.6 12.4 1.0 53.1 12.0 9.7 1.1 22.7 North Chandigarh 53.8 20.6 1.6 75.9 11.2 8.2 0.0 19.3 Delhi 40.1 12.6 1.6 54.3 10.7 9.6 1.4 21.6 Haryana 42.9 18.4 1.4 62.7 11.0 9.4 0.5 20.9 Himachal Pradesh 39.8 13.0 0.7 53.5 12.1 7.6 0.3 20.1 Jammu & Kashmir 33.6 14.5 1.3 49.4 10.5 8.9 1.2 20.6 Punjab 42.3 10.8 0.5 53.5 16.1 9.5 0.4 25.9 Rajasthan 34.6 11.2 1.0 46.8 10.1 6.5 0.6 17.2 Uttarakhand 33.5 10.5 1.2 45.2 8.6 6.2 0.7 15.5 Central Chhattisgarh 37.8 8.4 0.8 47.0 12.7 8.5 1.0 22.2 Madhya Pradesh 39.3 12.2 1.1 52.5 14.3 10.1 1.1 25.5 Uttar Pradesh 38.8 12.5 1.1 52.4 12.0 10.2 1.5 23.7 East Bihar 45.7 13.9 0.7 60.3 17.2 13.8 1.3 32.3 Jharkhand 49.1 15.2 0.9 65.2 16.3 12.7 1.0 29.9 Odisha 40.5 9.8 0.7 51.0 15.6 11.8 0.9 28.4 West Bengal 48.9 12.8 0.8 62.5 15.6 13.6 1.1 30.3 Northeast Arunachal Pradesh 33.4 9.0 0.8 43.2 9.6 8.4 0.7 18.6 Assam 37.1 8.3 0.6 46.0 13.8 10.8 0.8 25.4 Manipur 22.1 4.0 0.3 26.4 5.7 3.2 0.6 9.5 Meghalaya 38.7 16.1 1.4 56.2 14.6 16.0 1.7 32.4 Mizoram 20.4 4.2 0.2 24.8 7.5 4.3 0.3 12.1 Nagaland 22.0 5.2 0.6 27.9 6.6 4.1 0.9 11.6 Sikkim 27.1 7.2 0.6 34.9 9.0 6.0 0.8 15.7 Tripura 42.3 11.5 0.7 54.5 14.1 10.1 0.5 24.7 West Dadra & Nagar Haveli 58.4 20.0 1.1 79.5 20.8 8.7 1.1 30.7 Daman & Diu 45.4 12.5 1.0 58.9 11.9 11.2 0.5 23.6 Goa 24.8 5.8 0.7 31.3 6.3 4.4 0.3 11.0 Gujarat 40.3 13.2 1.4 54.9 11.6 8.8 1.3 21.7 Maharashtra 36.9 10.3 0.7 48.0 9.3 7.7 0.7 17.6 South Andaman & Nicobar Islands 41.9 22.5 1.2 65.7 15.2 12.3 3.3 30.8 Andhra Pradesh 39.6 18.5 1.9 60.0 11.0 13.5 2.4 26.9 Karnataka 33.0 10.9 0.9 44.8 8.5 8.3 1.4 18.2 Kerala 29.6 4.4 0.3 34.3 8.3 2.9 0.5 11.7 Lakshadweep 35.7 9.9 0.4 46.0 7.6 2.0 1.9 11.4 Puducherry 41.5 10.4 0.5 52.4 8.9 6.7 0.3 15.9 Tamil Nadu 39.7 14.0 1.4 55.0 10.2 9.1 1.1 20.4 Telangana 36.8 17.3 2.5 56.6 7.7 6.4 1.2 15.3 Note: Table is based on women and men who stayed in the household the night before the interview. Prevalence is adjusted for altitude and for smoking status, if known, using the CDC formulas (Centers for Disease Control (CDC). 1998. Recommendations to prevent and control iron deficiency in the United States. Morbidity and Mortality Weekly Report 47 (RR-3): 1-29). Haemoglobin levels are shown in grams per decilitre (g/dl). 1 For pregnant women, the value is 10.0-10.9 g/dl 2 For pregnant women, the value is <11.0 g/dl Nutrition and Anaemia z�337 Table 10.23 Women's and men's food consumption Percent distribution of women and men age 15-49 by frequency of consumption of specific foods, India, 2015-16 Type of food Frequency of consumption Total Number Daily Weekly Occasionally Never WOMEN Milk or curd 45.0 22.9 24.7 7.3 100.0 699,686 Pulses or beans 44.8 45.1 9.5 0.6 100.0 699,686 Dark green, leafy vegetables 47.2 38.3 14.1 0.4 100.0 699,686 Fruits 12.4 33.2 51.8 2.6 100.0 699,686 Eggs 4.0 37.4 29.4 29.3 100.0 699,686 Fish 5.6 28.4 30.9 35.1 100.0 699,686 Chicken or meat 1.1 31.5 35.7 31.8 100.0 699,686 Fish or chicken or meat 6.1 36.6 27.3 29.9 100.0 699,686 Fried foods 9.8 35.7 49.7 4.7 100.0 699,686 Aerated drinks 4.5 19.5 59.5 16.5 100.0 699,686 MEN Milk or curd 46.2 28.8 20.0 5.0 100.0 103,411 Pulses or beans 46.5 44.1 9.0 0.4 100.0 103,411 Dark green, leafy vegetables 46.6 41.5 11.4 0.5 100.0 103,411 Fruits 10.9 39.6 47.6 1.9 100.0 103,411 Eggs 4.9 44.7 30.7 19.6 100.0 103,411 Fish 4.8 33.8 34.2 27.3 100.0 103,411 Chicken or meat 1.8 38.9 36.3 23.0 100.0 103,411 Fish or chicken or meat 5.7 43.2 29.5 21.6 100.0 103,411 Fried foods 9.8 35.6 47.1 7.5 100.0 103,411 Aerated drinks 6.5 25.6 56.2 11.6 100.0 103,411 338 z Nutrition and Anaemia Table 10.24.1 Women's food consumption Percentage of women age 15-49 consuming specific foods at least once a week by background characteristics, India, 2015-16 Background characteristic Type of food Number of women Milk or curd Pulses or beans Dark green, leafy vegetables Fruits Eggs Fish Chicken or meat Fish or chicken or meat Fried foods Aerated drinks Age 15-19 65.0 88.9 83.4 43.3 39.0 31.1 30.4 39.6 47.2 25.5 121,552 20-29 69.0 90.3 85.9 47.8 42.8 34.1 33.6 43.4 46.2 25.3 238,008 30-39 68.3 90.2 86.1 45.6 42.2 35.1 33.3 43.8 45.1 23.3 187,659 40-49 68.3 89.8 85.7 44.2 40.0 34.9 31.6 43.2 43.6 21.7 152,467 Marital status Never married 67.9 89.3 84.1 47.7 39.8 31.1 31.3 40.2 48.2 28.4 159,035 Currently married 68.3 90.2 85.9 45.4 41.7 35.0 32.9 43.5 44.9 22.8 511,373 Widowed 63.4 88.2 84.4 38.7 41.9 32.5 31.2 42.3 39.8 20.2 21,657 Divorced/separated/deserted 58.8 88.0 85.9 39.9 45.6 37.3 35.1 47.4 42.6 20.3 7,621 Maternity status Pregnant 70.8 90.1 85.1 50.7 38.6 31.7 31.0 40.1 43.3 23.2 31,123 Breastfeeding 63.2 90.1 85.8 39.8 41.6 34.9 31.5 42.5 45.7 20.2 103,932 Neither 68.7 89.9 85.4 46.5 41.4 34.0 32.8 43.0 45.6 24.7 564,630 Residence Urban 76.2 91.8 87.3 62.9 47.8 37.8 40.4 49.2 48.3 31.9 242,225 Rural 63.6 88.9 84.5 36.5 37.9 32.0 28.4 39.4 44.0 19.8 457,461 Schooling No schooling 58.7 87.5 81.7 28.2 35.7 28.4 28.7 37.4 39.4 17.9 193,078 <5 years complete 57.9 89.3 87.2 36.6 48.2 43.4 36.0 51.8 47.9 18.0 40,503 5-7 years complete 65.8 89.7 85.8 41.4 43.3 35.2 34.1 44.7 44.9 22.1 99,687 8-9 years complete 65.7 89.9 86.5 44.9 42.1 36.6 32.4 44.1 48.5 22.8 116,681 10-11 years complete 74.9 91.0 87.2 56.0 45.3 36.8 36.0 46.5 48.1 28.2 99,576 12 or more years complete 81.1 92.6 87.8 67.1 42.4 34.1 33.3 42.5 49.0 32.9 150,160 Religion Hindu 68.8 90.1 85.7 44.4 38.0 31.0 28.6 38.3 44.5 23.9 563,739 Muslim 62.3 89.6 84.0 49.9 59.7 50.6 54.9 67.3 53.2 24.1 96,461 Christian 65.8 84.6 82.4 56.5 64.7 60.1 54.2 74.3 47.6 22.3 16,620 Sikh 85.2 91.0 88.4 51.7 9.0 2.4 4.4 4.8 33.0 32.9 11,618 Buddhist/Neo-Buddhist 67.7 88.8 89.1 54.8 55.8 35.8 46.2 52.1 38.5 22.6 6,469 Jain 91.5 93.6 87.2 76.6 9.7 7.4 7.8 8.6 41.2 30.1 1,264 Other 29.6 85.9 89.7 34.2 53.6 56.3 32.2 60.1 34.9 9.9 3,515 Caste/tribe Scheduled caste 62.9 88.7 85.2 39.3 44.5 35.8 33.2 44.8 44.6 22.8 142,619 Scheduled tribe 50.1 86.0 85.5 32.2 42.4 34.3 33.2 43.1 40.0 17.7 64,144 Other backward class 71.2 90.0 84.0 44.9 38.3 30.3 30.9 39.3 42.7 24.1 303,837 Other 72.9 92.0 88.1 56.6 43.4 38.4 34.3 46.6 52.5 27.1 184,594 Don't know 61.9 89.1 87.5 45.7 49.2 43.7 38.4 51.6 51.8 19.8 4,492 Wealth index Lowest 45.6 85.7 82.9 19.0 32.5 30.0 22.7 34.2 42.5 13.6 124,054 Second 58.7 88.4 84.9 30.9 41.0 35.2 29.5 42.6 45.7 17.1 136,900 Middle 68.9 89.8 85.3 42.5 45.6 35.8 36.5 46.8 44.6 22.4 143,814 Fourth 77.0 91.3 86.3 56.7 46.6 37.1 38.9 48.6 46.2 27.8 147,978 Highest 85.5 93.6 87.6 74.0 39.7 31.4 33.2 40.4 48.1 36.9 146,939 Total 68.0 89.9 85.5 45.7 41.4 34.0 32.5 42.8 45.5 24.0 699,686 Nutrition and Anaemia z�339 Table 10.24.2 Men's food consumption Percentage of men age 15-49 consuming specific foods at least once a week by background characteristics, India, 2015-16 Background characteristic Type of food Number of men Milk or curd Pulses or beans Dark green, leafy vegetables Fruits Eggs Fish Chicken or meat Fish or chicken or meat Fried foods Aerated drinks Age 15-19 75.8 89.6 86.3 50.0 47.9 35.4 38.0 45.9 47.4 36.2 18,740 20-29 75.1 90.5 88.0 51.1 50.8 38.6 41.8 49.5 45.9 35.0 32,795 30-39 75.0 90.9 89.0 50.7 50.0 39.7 41.0 49.6 45.3 30.2 28,374 40-49 74.1 91.0 88.8 49.9 49.0 39.8 40.6 49.7 43.1 27.2 23,501 Marital status Never married 76.7 90.0 87.3 52.9 50.5 38.0 41.2 49.2 47.2 37.0 39,631 Currently married 74.1 91.0 88.8 49.2 49.3 39.1 40.3 48.9 44.3 29.2 62,499 Widowed 65.5 88.6 81.5 37.1 38.8 29.7 33.8 38.2 34.6 26.5 583 Divorced/separated/deserted 66.4 85.5 84.9 42.3 42.2 34.2 38.1 45.8 41.4 29.6 697 Residence Urban 80.4 91.3 88.5 62.6 53.8 40.1 46.0 52.8 47.5 38.7 39,546 Rural 71.6 90.2 87.9 43.0 47.1 37.6 37.3 46.5 44.0 28.1 63,864 Schooling No schooling 62.9 87.3 84.8 35.2 47.9 38.4 39.4 49.2 38.9 23.9 12,422 <5 years complete 62.8 90.7 89.0 38.1 54.2 46.5 44.8 57.6 45.5 22.3 6,171 5-7 years complete 70.1 88.8 86.9 42.1 50.0 39.9 41.3 50.9 43.9 28.8 14,730 8-9 years complete 71.1 90.0 87.6 46.2 47.5 37.3 38.8 46.7 45.5 29.7 21,422 10-11 years complete 80.7 91.8 88.6 55.4 50.7 38.5 41.1 49.0 46.0 35.8 18,030 12 or more years complete 83.9 92.4 90.1 63.4 50.1 37.3 40.9 47.6 48.2 38.7 30,636 Religion Hindu 75.7 90.9 88.3 49.7 46.7 36.1 36.9 44.8 44.6 31.5 84,211 Muslim 70.3 89.0 86.8 52.4 66.5 52.9 62.3 73.1 49.5 33.7 13,793 Christian 73.1 86.6 88.4 64.2 71.5 63.9 62.3 75.6 52.1 40.0 2,277 Sikh 94.2 95.0 90.2 59.8 19.3 5.0 10.0 10.8 44.6 50.6 1,622 Buddhist/Neo-Buddhist 62.8 91.5 92.3 53.1 63.5 38.3 57.5 61.3 39.1 19.4 958 Jain 89.3 96.0 94.7 66.5 4.4 2.6 2.7 3.5 41.6 45.5 163 Other 40.6 85.4 90.9 29.2 65.2 66.5 57.8 70.6 39.7 15.1 386 Caste/tribe Scheduled caste 71.1 89.8 88.3 46.3 52.6 40.4 42.4 50.6 44.7 31.3 20,499 Scheduled tribe 55.8 87.3 87.3 36.5 50.6 40.0 41.8 50.1 41.3 21.7 9,132 Other backward class 78.3 90.2 86.8 50.5 47.4 36.7 39.2 46.7 43.7 33.8 45,110 Other 78.6 92.8 90.6 58.1 50.7 39.6 41.2 50.7 49.7 33.5 28,299 Don't know 72.4 90.4 82.7 49.7 60.8 59.2 51.0 66.4 51.1 32.2 371 Wealth index Lowest 52.4 86.5 83.7 25.4 42.3 37.4 31.9 42.6 42.2 18.7 15,205 Second 66.3 90.3 88.4 37.1 49.1 39.9 38.4 48.9 44.6 24.4 19,402 Middle 76.7 90.8 88.8 48.4 53.1 40.2 43.4 52.3 43.4 30.8 22,047 Fourth 82.0 91.0 88.6 59.2 54.6 41.4 46.8 54.0 45.4 37.3 22,930 Highest 88.0 92.9 89.8 71.2 46.8 34.0 39.5 45.0 49.7 43.3 23,827 Total age 15-49 75.0 90.6 88.2 50.5 49.6 38.6 40.6 48.9 45.4 32.2 103,411 Age 50-54 75.4 91.8 89.6 49.6 49.1 41.3 41.0 50.8 42.4 25.0 8,711 Total age 15-54 75.0 90.7 88.3 50.5 49.6 38.8 40.7 49.1 45.1 31.6 112,122 340 z Nutrition and Anaemia Table 10.25.1 Women's food consumption by state/union territory Percentage of women age 15-49 consuming specific foods at least once a week by state/union territory, India, 2015-16 State/union territory Type of food Milk or curd Pulses or beans Dark green, leafy vegetables Fruits Eggs Fish Chicken or meat Fish or chicken or meat Fried foods Aerated drinks India 68.0 89.9 85.5 45.7 41.4 34.0 32.5 42.8 45.5 24.0 North Chandigarh 84.2 92.4 89.0 68.0 18.2 6.9 8.9 10.1 35.5 42.9 Delhi 82.3 95.4 88.6 72.0 35.3 16.8 28.3 30.2 47.9 44.4 Haryana 91.3 91.2 85.1 57.7 10.7 4.4 6.8 7.8 39.7 49.5 Himachal Pradesh 84.4 97.6 94.8 66.4 16.2 3.7 6.9 7.9 34.2 22.6 Jammu & Kashmir 74.1 75.4 92.1 60.6 37.4 10.5 48.3 50.0 34.4 19.8 Punjab 84.4 90.9 90.0 53.2 8.3 2.0 3.3 4.0 32.8 33.2 Rajasthan 80.3 79.4 60.7 29.4 7.1 2.9 5.5 6.0 22.9 17.2 Uttarakhand 71.9 93.2 84.1 49.9 27.4 11.4 13.1 16.3 44.6 28.8 Central Chhattisgarh 36.9 88.2 94.6 32.5 38.4 26.4 25.1 31.7 32.6 13.2 Madhya Pradesh 62.8 93.5 92.3 42.3 21.3 14.2 15.2 18.0 40.4 24.6 Uttar Pradesh 61.3 89.6 73.4 33.6 20.3 12.6 15.5 18.3 49.8 26.2 East Bihar 66.3 93.4 88.9 26.5 26.8 27.7 25.2 30.8 42.5 16.2 Jharkhand 34.7 84.5 81.5 20.1 31.3 26.0 26.0 31.3 25.2 7.0 Odisha 30.0 90.4 94.9 19.2 57.7 61.1 39.8 63.9 89.5 37.7 West Bengal 47.9 93.2 97.5 47.1 83.3 91.4 52.4 93.0 78.7 12.9 Northeast Arunachal Pradesh 38.7 74.5 93.3 39.5 52.2 56.5 55.0 67.7 54.0 34.1 Assam 52.2 93.4 94.5 43.7 67.5 76.6 50.5 80.4 79.5 15.7 Manipur 41.4 81.1 99.0 57.5 49.1 64.6 42.0 77.2 56.8 15.2 Meghalaya 50.1 83.6 93.6 64.5 72.3 64.2 58.6 75.3 69.6 16.1 Mizoram 23.9 55.5 93.4 47.3 57.3 26.1 54.1 60.3 94.9 8.3 Nagaland 70.3 64.0 89.9 39.1 47.8 41.9 53.3 61.4 45.8 16.4 Sikkim 95.6 98.6 98.4 55.6 61.9 51.2 64.4 67.5 36.3 35.6 Tripura 49.7 73.3 89.3 43.8 61.6 77.1 61.2 79.2 67.7 10.2 West Dadra & Nagar Haveli 61.1 96.3 79.8 54.1 32.1 18.2 21.5 25.1 21.4 20.8 Daman & Diu 87.9 88.8 67.4 69.6 57.7 55.9 41.0 66.8 32.4 43.5 Goa 72.5 89.1 93.2 82.4 62.5 82.9 32.9 85.7 66.3 46.6 Gujarat 80.9 94.2 89.8 52.3 14.8 10.3 12.2 14.8 32.1 23.7 Maharashtra 73.9 90.1 89.5 55.4 44.0 30.5 38.2 42.2 35.1 23.6 South Andaman & Nicobar Islands 39.2 96.1 97.1 56.3 86.6 92.3 77.1 94.3 33.8 32.0 Andhra Pradesh 81.0 93.6 76.2 47.1 73.9 39.9 64.8 71.2 33.3 27.2 Karnataka 93.2 97.7 96.8 77.0 62.2 39.8 50.7 57.2 48.2 44.5 Kerala 70.1 87.7 62.7 82.6 56.4 91.3 39.4 92.8 54.3 9.9 Lakshadweep 21.4 73.4 52.2 67.6 56.5 98.5 37.5 99.0 69.5 2.0 Puducherry 88.7 87.1 93.6 58.6 79.3 79.5 67.9 85.9 35.5 33.8 Tamil Nadu 86.1 80.1 92.9 59.9 71.2 58.9 61.3 73.8 37.8 28.1 Telangana 74.6 90.1 78.3 47.8 60.3 23.5 53.1 57.7 31.4 18.9 Nutrition and Anaemia z�341 Table 10.25.2 Men's food consumption by state/union territory Percent distribution of men age 15-49 consuming specific foods at least once a week by state/union territory, India, 2015-16 State/union territory Type of food Milk or curd Pulses or beans Dark green, leafy vegetables Fruits Eggs Fish Chicken or meat Fish or chicken or meat Fried foods Aerated drinks India 75.0 90.6 88.2 50.5 49.6 38.6 40.6 48.9 45.4 32.2 North Chandigarh 97.3 92.0 92.9 68.9 28.1 5.9 15.9 17.4 69.7 84.5 Delhi 80.3 87.1 83.9 65.9 50.1 27.9 33.1 40.4 41.3 42.5 Haryana 96.0 92.5 81.0 63.4 22.0 8.0 11.4 13.0 46.9 58.6 Himachal Pradesh 91.8 97.7 93.5 68.6 29.6 8.6 17.5 19.4 47.9 36.8 Jammu & Kashmir 81.4 78.7 92.2 63.5 47.3 13.4 53.6 55.8 33.9 22.4 Punjab 93.2 94.5 90.2 60.7 17.7 3.9 9.1 10.0 46.9 57.0 Rajasthan 87.7 87.0 73.3 41.3 13.4 6.2 9.0 10.2 28.8 24.0 Uttarakhand 87.2 94.2 90.9 67.2 38.3 18.8 24.5 29.5 69.7 50.8 Central Chhattisgarh 51.9 90.6 94.3 29.6 48.2 34.8 29.2 40.1 40.1 17.5 Madhya Pradesh 68.5 92.2 88.4 44.2 28.8 19.8 20.7 24.5 41.7 30.4 Uttar Pradesh 67.6 88.3 83.2 37.2 32.1 20.9 24.9 28.4 47.3 34.6 East Bihar 74.6 94.2 84.3 35.6 41.5 37.7 35.8 43.3 45.6 24.1 Jharkhand 47.5 83.1 80.2 26.3 45.4 39.7 37.4 44.5 31.9 12.3 Odisha 40.0 92.4 95.3 28.2 66.9 63.9 50.5 68.5 79.3 38.6 West Bengal 59.2 97.4 98.4 47.0 88.7 91.3 63.6 93.1 70.8 16.8 Northeast Arunachal Pradesh 57.1 80.7 94.0 54.5 72.4 74.9 70.6 80.9 48.9 28.6 Assam 57.5 97.0 93.8 46.7 73.2 80.2 55.7 82.3 72.0 18.7 Manipur 44.9 86.6 98.3 69.7 55.6 77.2 56.7 86.4 50.4 30.4 Meghalaya 55.9 80.5 88.4 70.0 69.0 66.8 59.0 76.3 64.4 17.0 Mizoram 20.7 57.9 94.4 36.6 65.4 36.1 81.7 83.8 97.5 12.3 Nagaland 60.9 60.4 83.8 43.9 56.5 49.2 57.7 63.1 40.9 19.3 Sikkim 90.3 92.7 92.9 38.4 49.4 38.6 47.2 49.1 40.2 17.6 Tripura 44.3 88.4 96.3 39.5 81.2 92.1 81.1 94.8 65.9 12.5 West Dadra & Nagar Haveli 69.6 94.5 93.4 61.2 62.2 49.7 53.3 58.6 61.2 60.3 Daman & Diu 87.7 96.8 57.2 48.1 49.4 49.2 46.0 55.7 54.6 42.0 Goa 89.1 98.3 99.7 88.9 66.6 86.8 57.8 88.0 65.2 69.8 Gujarat 82.4 88.6 89.5 44.6 20.4 12.0 16.8 19.3 30.8 28.2 Maharashtra 70.4 90.5 89.9 52.6 51.0 33.1 46.7 50.0 38.4 21.8 South Andaman & Nicobar Islands 64.0 86.6 89.5 78.5 87.0 86.6 59.2 87.0 39.8 27.5 Andhra Pradesh 90.2 93.9 88.5 61.3 80.0 50.3 72.4 78.2 38.6 45.4 Karnataka 87.7 91.5 92.5 71.2 65.7 45.1 57.6 61.7 46.0 40.8 Kerala 78.2 90.2 80.0 81.8 72.4 87.9 62.0 90.1 67.3 49.4 Lakshadweep 63.6 93.3 84.5 91.8 78.2 100.0 72.8 100.0 84.4 56.1 Puducherry 94.9 89.0 97.6 78.8 85.4 81.8 70.4 88.9 32.1 41.8 Tamil Nadu 94.1 86.9 93.1 70.6 75.5 61.1 66.5 76.8 36.6 41.4 Telangana 84.1 90.9 84.0 60.3 77.8 43.1 68.1 73.8 33.5 42.9 342 z Nutrition and Anaemia MORBIDITY AND HEALTH CARE 11 The health status of a population is reflected in the levels of morbidity and treatment seeking behaviour of its members. With the ongoing demographic and epidemiological transition in India, non-communicable diseases are now taking more of a toll on the health of the Indian population, while the problem of endemic and re-emerging infectious diseases still persists. This chapter presents data on some common infectious and important non-communicable diseases and their risk factors, health treatment seeking behaviour, tobacco and alcohol use, and coverage of health insurance. Prevalence estimates for tuberculosis (TB), diabetes, asthma, goitre or any other thyroid disorder, heart disease, and cancer are provided. 11.1 TUBERCULOSIS Tuberculosis has re-emerged as a major public health problem in many parts of the world, often as a concomitant illness to HIV/AIDS. TuberculosLV��RQFH�NQRZQ�DV�WKH�µ:KLWH�3ODJXH¶��LV�FRQWDJLRXV�DQG�VSUHDGV�WKURXJK�GURSOHWV�WKDW�FDQ�WUDYHO� through the air when a person with the infection coughs, talks, or sneezes. In most developing countries, TB would continue to be a serious health threat even in the absence of HIV/AIDS due to the public health challenges posed by poor sanitation, poverty, and high illiteracy. 11.1.1 Prevalence of Tuberculosis Based on reports from household respondents, 305 persons per 100,000 are estimated to have medically treated tuberculosis. The prevalence of tuberculosis is higher among men (389 per 100,000) than among women (220 per 100,000). Ninety-seven percent of reported tuberculosis cases are medically treated (Table 11.1). Trends: Between 2005-06 and 2015-16, the overall prevalence of medically treated tuberculosis decreased from 418 persons per 100,000 to 305 persons per 100,000, and the prevalence among men decreased from 526 persons per 100,000 to 389 persons per 100,000. The prevalence among women decreased from 309 persons per 100,000 to 220 persons per 100,000. The overall decrease in prevalence for men and women combined is evident in all age and residence groups. Key Findings x Prevalence of tuberculosis: Based on reports from household respondents, 305 persons per 100,000 have medically treated tuberculosis. The prevalence of tuberculosis is higher among men (389 per 100,000) than among women (220 per 100,000). x Prevalence of goitre or any other thyroid disorder: Based on self reports, 2 percent of women age 15-49 have goitre or any other thyroid disorder. x Use of Tobacco: Forty-five percent of men and 7 percent of women age 15-49 use any form of tobacco. x Use of alcohol: Twenty-nine percent of men and 1 percent of women age 15-49 drink alcohol. x Coverage of health insurance or scheme: At least one usual household member is covered under any health insurance or health scheme in less than one-third (29%) of households. T Morbidity and Health Care z�343 Patterns by background characteristics x Medically treated TB prevalence increases substantially with increasing age. The prevalence is more than twice as high among persons age 60 and above (855 persons per 100,000) as among persons age 15-59 (327 persons per 100,000) and 15 times as high as among children below age 15 (56 persons per 100,000). x Medically treated TB prevalence is somewhat higher in rural areas (332 persons per 100,000) than in urban areas (251 persons per 100,000). Both sex and age differentials are more pronounced in rural areas than they are in urban areas (Table 11.1). x Medically treated TB prevalence increases with levels of crowding, from 289 persons per 100,000 in households with fewer than three persons sleeping per room to 380 persons per 100,000 in households with seven or more persons sleeping per room (Table 11.2). x There is a great deal of variation in the prevalence of medically treated TB according to the type of cooking fuel the household uses, ranging from a low of 207 persons per 100,000 usual residents in households using electricity, liquid petroleum gas, natural gas, or biogas to a high of 566 persons per 100,000 in households using straw, shrubs, or grass for cooking. High TB prevalence is also seen among households using other fuels not specified in the table (655 persons per 100,000). x Medically treated TB prevalence is higher in households cooking in the house without having a separate room for cooking (383 persons per 100,000) than in households that cook in a separate room of the house (233 persons per 100,000) or in a separate building (306 persons per 100,000, but is highest of all in households cooking outdoors (425 persons per 100,000) or in other places not specified in the table (477 persons per 100,000). x Among the states, the number of persons suffering from medically treated TB ranges from a low of 74 persons per 100,000 in Goa to a high of 799 persons per 100,000 in Arunachal Pradesh, 715 persons per 100,000 in Manipur, 640 persons per 100,000 in Nagaland, and 637 persons per 100,000 in Bihar (Table 11.3). In addition to Goa, two union territories have prevalence below 100 persons per 100,000: Daman & Diu (51 persons per 100,000) and Chandigarh (89 persons per 100,000). x All the states in the North and the West have prevalence levels well below the national average. 11.1.2 Knowledge and Attitudes toward Tuberculosis Despite being a curable disease, TB can still be a stigmatizing illness, due mainly to people’s ignorance of its etiology and transmission. Eighty-seven percent of women age 15-49 and 88 percent of men age 15-49 have heard of TB (Table 11.4.1 and Table 11.4.2). In India, 69 percent of women and 72 percent of men who have heard of TB correctly mentioned coughing or sneezing as a mode of transmission for TB. However, more than half the population that has heard of TB has some misconceptions regarding its transmission. One in every six women and one in every five men report they would want the TB positive status of a family member to remain a secret. Eighty-nine percent of women and 91 percent of men who have heard of TB believe that it can be cured. Trends: There has been almost no change in the proportion of women who have heard of TB (85% in 2005-06 and 87% in 2015-16), whereas the proportion decreased slightly in men, from 92 percent to 88 percent. There has been a substantial increase in the proportion of both women and men who report that TB is spread through the air by coughing and sneezing (from 50% to 69% for women and from 55% to 72% for men in the decade between NFHS-3 and NFHS-4). In the same period, the knowledge that TB can be cured increased from 79 percent to 89 percent among women and from 86 percent to 91 percent in men. Patterns by background characteristics x The proportion of women who have heard of TB generally increases steadily with increases in schooling and the wealth index, from about four-fifths of women in the lowest schooling and wealth categories to well over 90 percent in the 344 z Morbidity and Health Care Morbidity and Health Care ‡��345 highest schooling and wealth categories. The same pattern by schooling and the wealth index exists for men (Table 11.4.1 and Table 11.4.2). x Knowledge of TB transmission and that TB can be cured among women and men generally increases with increases in schooling and the wealth index. x Almost half of women and men in almost all subgroups of background characteristics have misconception about the transmission of TB. 11.2 HEALTH PROBLEMS All interviewed women and men were asked whether they have diabetes, asthma, or goitre or any other thyroid disorder. NFHS 2015-16, for first time, asked about the presence of any heart disease or cancer. Table 11.5.1 and Table 11.5.2 show the number of women and men age 15-49 per 100,000 who have diabetes, asthma, goitre or any other thyroid disorder, any heart disease, and cancer by background characteristics. The prevalence of diabetes, as reported by respondents, is 2 percent among both men and women age 15-49 years. Prevalence of asthma is 2 percent among women and 1 percent among men age 15-49 years. Similarly, goitre or any other thyroid disorder is more prevalent among women (2%) than men (less than 1%). One percent of women and men age 15-49 have any heart disease and less than 1 percent have cancer. Trends: The prevalence of diabetes has almost doubled among both women and men since 2005-06 (1% in 2005-06 to 2% in 2015-16).The prevalence of goitre or any other thyroid disorder among women increased from 1 percent in 2005-06 to 2 percent in 2015-16, whereas the prevalence of asthma among both sexes and goitre or any other thyroid disorder among men remained almost unchanged. Patterns by background characteristics x Although the above-mentioned diseases affect all age groups and are present across all groups of background characteristics, their prevalence increases with age. x The prevalence of diabetes among women and men in the highest wealth quintile (3%) is higher than the prevalence among women and men in the lowest wealth quintile (1%). The prevalence of diabetes is also higher in urban areas than rural areas. x The prevalence of diabetes is highest in the southern states, whereas that of goitre or any other thyroid disorder is relatively high in most of the northern and southern states. 11.3 USE OF TOBACCO Tobacco use is associated with a widse range of diseases, including several types of cancers and heart and lung diseases, diabetes, eye disease, and rheumatoid arthritis. Studies have shown that in addition to sharing the same health risks as men, women who use tobacco experience difficulty in becoming pregnant and are at an increased risk of infertility, pregnancy complications, premature births, low birth-weight infants, stillbirths, miscarriages, and infant deaths 11.3.1 Consumption of Tobacco Forty-five percent of men and 7 percent of women age 15-49 use some form of tobacco. The most common form of tobacco consumption among men is chewing paan masala or gutkha (15%), followed closely by smoking cigarettes (14%) and bidis (13%). Among men who smoke cigarettes or bidis, 37 percent smoked 10 or more cigarettes or bidis in the past 24 hours. Among women, the most common form of tobacco used is chewing paan masala or gutkha, or chewing paan with tobacco (2% each) (Table 11.7). Morbidity and Health Care z�345 Trends: Use of any kind of tobacco decreased from 57 percent among men and 11 percent among women in 2005-06 to 45 percent and 7 percent among men and women, respectively, in 2015-16. Patterns by background characteristics x Among men as well as women, the use of any form of tobacco is higher in rural areas than in urban areas (Figure 11.1). Among men, in urban areas cigarettes are more popular than any other form of tobacco, but in rural areas paan masala or gutkha and bidis are more popular (Table 11.8). x More than two-thirds of men and one-eighth of women with no schooling or less than 5 years of schooling use some form of tobacco. Tobacco use shows a steady and substantial decrease with increasing levels of education among both men and women. However, almost 3 in 10 men with 12 or more years of schooling use tobacco. x There is an equally clear and continual decrease in tobacco use with increasing wealth quintiles. Almost three in 10 men in the highest wealth quintile use tobacco, in comparison with 63 percent of men in the lowest wealth quintile. Fourteen percent of women in the lowest wealth quintile use tobacco. x Women (17%) and men (57%) from scheduled tribes are more likely to use tobacco than those from any other caste/tribe group. 11.3.2 Quitting Tobacco The 2015-16 NFHS collected data on attempts to quit smoking or stop tobacco use in the 12 months preceding the survey by women and men age 15-49 who were using any kind of tobacco. Tobacco users who visited a doctor or other health care provider in the past 12 months were also asked whether they had received any advice to quit smoking or using tobacco in any form during the visits. All women and men age 15-49 were asked whether they were present when someone smoked in their home or elsewhere in the 30 days preceding the survey. About 3 in 10 men and women who are tobacco users said they tried to stop smoking or using tobacco in any form in the 12 months preceding the survey. Only about half of male and female tobacco users who visited a doctor or other health care provider in the 12 months preceding the survey were advised to stop smoking or using tobacco in any form. More than half of women and two-thirds of men were present when someone was smoking in their home or elsewhere in the 30 days preceding the survey (Table 11.9). 346 Ȉ Morbidity and Health Care 4.4 39 8.1 48 6.8 45 Women Men Urban Rural Total Figure 11.1 Tobacco Use by Sex and Residence Percentage of women and men age 15-49 346 z Morbidity and Health Care 11.4 ALCOHOL USE, HEALTH INSURANCE, AND SOURCES OF HEALTH CARE Information on alcohol use, health insurance coverage, and sources of health care among women and men are presented in this section. The reasons for not utilizing a government health facility, recent contacts with health personnel, matters discussed during contacts with health personnel, and problems in accessing health care are also discussed. 11.4.1 Use of Alcohol Only 1 percent of women drink alcohol, compared with 29 percent of men. Among women who drink alcohol, 18 percent drink alcohol almost every day and 35 percent drink alcohol about once a week (Table 11.11.1). Among men who drink alcohol, 12 percent drink almost every day, 41 percent drink alcohol about once a week, and 48 percent drink less than once a week (Table 11.11.2). The percentage of women age 15-49 who drink alcohol is by far the highest among women in Arunachal Pradesh (26%) and Sikkim (23%). Alcohol use among men is highest in Arunachal Pradesh (59%) and Tripura (58%) and is the lowest in Lakshadweep (5%). Trends: The proportion of men who drink alcohol decreased slightly, from 32 percent to 29 percent, between NFHS-3 in 2005-06 and NFHS-4 in 2015-16. During that period, the proportion of women who drink decreased from 2 percent to 1 percent. Patterns by background characteristics x Drinking alcohol is more common among women from scheduled tribes (7%) than from any other caste/tribe group. Drinking is most common among Christian men and men belonging to “other" religions (43% each), men with no schooling (40%), men from scheduled tribes (41%), and men age 35-49 (37%). 11.5 HEALTH INSURANCE COVERAGE Health insurance coverage in India is far from satisfactory. Less than one-third (29%) of households have at least one usual member covered under health insurance or health scheme (Table 11.13). Only 20 percent of women age 15-49 and 23 percent of men age 15-49 are covered by health insurance or a health scheme. Half of those with insurance are covered by a state health insurance scheme and more than one-third are covered by Rashtriya Swasthya Bima Yojana (RSBY). Four percent of women and 3-5 percent of men are covered by the Employee State Insurance Scheme (ESIS) or the Central Government Health Scheme (CGHS). The highest proportion of households covered under health insurance or a health scheme is found in Andhra Pradesh (75%) and the lowest coverage (less than 5%) is in Lakshadweep, Manipur, and Jammu & Kashmir (Figure 11.2). Trends: The percentage of households in which at least one usual member is covered by health insurance or a health scheme increased from 5 percent to 29 percent in the 10 years between NFHS-3 and NFHS-4. Patterns by background characteristics x The percentage of households in which at least one usual member is covered by health insurance or a health scheme is highest in households with a Christian head of household (45%). There is very little difference in coverage in urban and rural areas. Coverage is low among households whose head is a Buddhist/Neo-Buddhist and households in the lowest wealth quintile. Morbidity and Health Care ‡��347Morbidity and Health Care z�347 11.6 SOURCES OF HEALTH CARE When household members get sick, they are somewhat more likely to seek care in the private sector (51%) than the public sector (45%). Government and municipal hospitals are the most important source of health care in the public sector, providing services to 20 percent of households when household members get sick. In the private sector, private doctors and clinics are most frequently visited. Trend: The percentage of households that use the public sector for health care increased from 34 percent in 2005-06 to 45 percent in 2015-16. Patterns by background characteristics x The private health sector is the primary source of health care in urban areas (56%) and rural areas (49%). The public health sector is the main source of health care for 42 percent of households in urban areas and 46 percent of households in rural areas (Table 11.16). 2.9 3.6 4.2 5.7 6.1 6.1 10 12 12 13 15 16 16 17 18 19 20 21 21 23 26 28 29 30 31 33 33 35 46 48 48 58 58 64 66 69 75 Lakshadweep Manipur Jammu & Kashmir Andaman & Nicobar Islands Uttar Pradesh Nagaland Assam Bihar Haryana Jharkhand Maharashtra Goa Delhi Daman & Diu Madhya Pradesh Rajasthan Uttarakhand Punjab Chandigarh Gujarat Himachal Pradesh Karnataka INDIA Sikkim Dadra & Nagar Haveli West Bengal Puducherry Meghalaya Mizoram Odisha Kerala Arunachal Pradesh Tripura Tamil Nadu Telangana Chhattisgarh Andhra Pradesh Figure 11.2 Health Insurance Coverage of Households by State/UT Percentage of households with at least one member covered by a health scheme or health insurance 348 z Morbidity and Health Care 11.7 REASONS FOR NOT USING GOVERNMENT HEALTH CARE More than half (55%) of households in India do not generally seek health care from the public sector. The percentage of households that do not generally use government health facilities is highest in Uttar Pradesh (80%) and Bihar (78%), and lowest in Tripura (9%) (Table 11.17). The most commonly reported reason for not using government health facilities at the national level is the poor quality of care (reported by 48% of households that do not generally use government facilities). The second most commonly reported reason is that no government facility is nearby, reported by 45 percent of households, followed by the long waiting time at government facilities (41%). 11.8 RECENT CONTACT WITH HEALTH WORKERS Table 11.18 shows the percentage of women who had contact with a health worker in the three months preceding the survey by type of health worker. Women are more likely to have contacts with an auxiliary nurse midwife (ANM) or a lady health visitor (LHV) (14%), an anganwadi worker (AWW) (14%), or an ASHA (11%) than any other type of health worker. Among women who met with a health worker in the past three months, 63 percent met with a health worker at home, 60 percent met with a health worker at an anganwadi centre, and 41 percent met with a health worker at a health facility or camp. Among ever-married women who had at least one contact with a health worker in the past three months, the majority discussed immunizations. Other common topics were supplementary food, medical treatment for themselves, treatment for a sick child, and family planning. Never married women mostly discussed medical treatment for themselves, immunizations, and menstrual hygiene. Trend: The percentage of women who contacted an ANM/LHV increased slightly from 12 percent to 14 percent and the percentage who contacted an AWW increased from 10 percent to 14 percent in the 10 years from NFHS-3 to NFHS-4. Twenty-four percent of women contacted any health worker in NFHS-4, compared with only 17 percent in NFHS-3. Patterns by background characteristics x Recent contact with any health worker is more common for rural women (26%) than urban women (19%). Contact with any health worker is more common for currently married women (28%) than never married women (11%) and women who are widowed, divorced, separated, or deserted (14%). ����� PROBLEMS IN ACCESSING HEALTH CARE� NFHS-4 asked women age 15-49 about potential problems in obtaining medical treatment for themselves when they are sick. About two-thirds (67%) of women report at least one problem for themselves in obtaining medical care (Table 11.21). One-fourth of women cite money as a problem. Thirty percent of women cite the distance to a health facility and 27 percent cite having to take transport as a problem. Thirty-seven percent of women report concerns that no female health provider is available. Forty-five percent of women report concern that no provider is available and 46 percent that no drugs are available. Morbidity and Health Care z�349 LIST OF TABLES For more information on morbidity, use of tobacco and alcohol, and health care, see the following tables: Tables Table 11.1 Prevalence of tuberculosis Table 11.2 Prevalence of tuberculosis by persons per sleeping room and cooking fuel/cooking arrangements Table 11.3 Prevalence of tuberculosis by state/union territory Table 11.4.1 Knowledge and attitudes toward tuberculosis: Women Table 11.4.2 Knowledge and attitudes toward tuberculosis: Men Table 11.5.1 Self-reported health problems: Women Table 11.5.2 Self-reported health problems: Men Table 11.6 Self-reported health problems by state/union territory Table 11.7 Tobacco use by women and men Table 11.8 Use of tobacco by background characteristics Table 11.9 Quitting tobacco use and advice by a health care provider Table 11.10 Quitting tobacco use and advice by a health care provider by state/union territory Table 11.11.1 Use of alcohol: Women Table 11.11.2 Use of alcohol: Men Table 11.12 Use of alcohol by state/union territory Table 11.13 Health scheme/health insurance coverage Table 11.14.1 Health scheme/health insurance coverage: Women Table 11.14.2 Health scheme/health insurance coverage: Men Table 11.15 Health scheme/health insurance coverage among women and men by state/union territory Table 11.16 Source of health care Table 11.17 Reasons for not using a government health facility by state/union territory Table 11.18 Recent contacts with health workers Table 11.19 Matters discussed during contacts with a health worker Table 11.20 Contacts with health workers and visits to a health facility or camp by state/union territory Table 11.21 Problems in accessing health care 350 Ȉ Morbidity and Health Care350 z Morbidity and Health Care Table 11.1 Prevalence of tuberculosis Number of persons per 100,000 usual household residents suffering from any tuberculosis and medically treated tuberculosis by age and sex, according to residence, India, 2015-16 Age and sex Number of persons per 100,000 suffering from: Number of usual residents Tuberculosis1 Medically treated tuberculosis2 URBAN Age <15 56 56 225,565 15-59 271 263 598,885 60+ 708 674 86,524 Sex Women 198 191 443,455 Men 318 308 467,520 Total 259 251 910,974 RURAL Age <15 59 57 553,427 15-59 375 362 1,085,153 60+ 975 934 198,998 Sex Women 244 234 917,015 Men 445 431 920,564 Total 345 332 1,837,578 TOTAL Age <15 58 56 778,992 15-59 338 327 1,684,039 60+ 894 855 285,522 Sex Women 229 220 1,360,469 Men 402 389 1,388,083 Total 316 305 2,748,553 1 Includes medically treated tuberculosis 2 Suffering from tuberculosis and received medical treatment Morbidity and Health Care z�351 Table 11.2 Prevalence of tuberculosis by persons per sleeping room and cooking fuel/ cooking arrangements Number of persons per 100,000 usual household residents suffering from any tuberculosis and medically treated tuberculosis by persons per sleeping room and cooking fuel/cooking arrangements, India, 2015-16 Persons per sleeping room and cooking fuel/cooking arrangements Number of persons per 100,000 suffering from: Number of usual residents Tuberculosis1 Medically treated tuberculosis2 Persons per room used for sleeping <3 298 289 1,208,248 3-4 314 303 954,583 5-6 342 326 416,414 7 or more 400 380 169,308 Cooking fuel Electricity or gas3 212 207 1,132,964 Kerosene 482 447 27,086 Coal/lignite/charcoal 338 337 42,729 Wood 355 342 1,151,278 Straw/shrubs/grass 604 566 70,023 Agricultural crop residue 541 513 86,845 Dung cakes 433 420 234,033 Other 682 655 3,594 Place for cooking In the house, separate room 239 233 1,354,644 In the house, no separate room 401 383 883,135 In a separate building 315 306 270,832 Outdoors 440 425 236,629 Other 506 477 3,313 Type of fire/stove among households using solid fuels4 or kerosene Stove 408 391 38,748 Open fire/chullah 389 374 1,571,837 Other 169 169 1,409 Total 316 305 2,748,553 1 Includes medically treated tuberculosis 2 Suffering from tuberculosis and received medical treatment 3 Includes LPG, natural gas, and biogas 4 Includes coal, lignite, charcoal, wood, straw/shrubs/grass, agricultural crop waste, and dung cakes 352 z Morbidity and Health Care Table 11.3 Prevalence of tuberculosis by state/union territory Number of persons per 100,000 usual household residents suffering from any tuberculosis and medically treated tuberculosis by state/ union territory, India, 2015-16 State/union territory Number of persons per 100,000 suffering from: Tuberculosis1 Medically treated tuberculosis2 ,QGLD� 316 305 1RUWK Chandigarh 89 89 Delhi 211 208 Haryana 234 229 Himachal Pradesh 148 148 Jammu & Kashmir 165 165 Punjab 156 155 Rajasthan 222 215 Uttarakhand 257 244 &HQWUDO Chhattisgarh 167 157 Madhya Pradesh 224 217 Uttar Pradesh 346 337 (DVW Bihar 661 637 Jharkhand 328 312 Odisha 338 322 West Bengal 356 345 1RUWKHDVW Arunachal Pradesh 846 799 Assam 311 295 Manipur 717 715 Meghalaya 549 542 Mizoram 253 242 Nagaland 657 640 Sikkim 475 475 Tripura 256 238 :HVW Dadra & Nagar Haveli 156 156 Daman & Diu 51 51 Goa 74 74 Gujarat 181 169 Maharashtra 245 238 6RXWK Andaman & Nicobar Islands 615 571 Andhra Pradesh 320 296 Karnataka 180 172 Kerala 374 369 Lakshadweep 391 368 Puducherry 137 104 Tamil Nadu 360 348 Telangana 308 296 1 Includes medically treated tuberculosis 2 Suffering from tuberculosis and received medical treatment Morbidity and Health Care z�353 Table 11.4.1 Knowledge and attitudes toward tuberculosis: Women Percentage of women age 15-49 who have heard of tuberculosis (TB), and among women who have heard of TB, percentage with specific knowledge and beliefs, according to background characteristics, India, 2015-16 Background characteristic Percentage who have heard of TB Number of women Among women who have heard of TB, percentage who: Number of women who have heard of TB Report that TB is spread through the air by coughing or sneezing Have misconceptions about transmission of TB Believe that TB can be cured Would want a family member's TB kept secret Age 15-19 88.1 121,552 69.9 57.8 87.6 15.3 107,087 20-34 87.7 334,777 70.3 56.0 89.4 15.7 293,564 35-49 86.0 243,357 67.2 53.9 88.2 16.4 209,404 Residence Urban 90.4 242,225 77.5 56.2 91.3 17.6 218,861 Rural 85.5 457,461 64.5 55.2 87.2 14.9 391,195 Schooling No schooling 79.5 193,078 55.3 53.1 84.6 15.3 153,502 <5 years complete 83.5 40,503 56.9 49.5 85.3 13.7 33,810 5-7 years complete 86.1 99,687 64.5 52.8 87.1 16.1 85,865 8-9 years complete 90.5 116,681 69.6 55.4 88.8 14.0 105,545 10-11 years complete 90.4 99,576 77.0 56.4 90.3 17.9 90,051 12 or more years complete 94.1 150,160 84.7 61.1 93.7 17.0 141,283 Religion Hindu 86.9 563,739 69.2 55.6 88.4 16.2 489,742 Muslim 87.7 96,461 66.0 56.6 89.0 14.5 84,603 Christian 88.6 16,620 76.0 42.9 85.7 22.1 14,732 Sikh 96.9 11,618 80.6 75.7 95.9 5.9 11,259 Buddhist/Neo-Buddhist 85.4 6,469 82.8 34.6 92.6 17.6 5,526 Jain 90.4 1,264 80.9 53.9 94.4 16.9 1,142 Other 86.8 3,515 49.9 58.8 92.0 4.9 3,053 Caste/tribe Scheduled caste 87.0 142,619 68.0 57.1 88.1 16.4 124,143 Scheduled tribe 79.7 64,144 58.7 46.7 84.6 14.1 51,128 Other backward class 87.4 303,837 69.8 56.0 87.9 17.8 265,453 Other 89.8 184,594 72.8 56.9 91.7 12.9 165,749 Don't know 79.7 4,492 43.9 42.5 82.7 14.8 3,582 Wealth index Lowest 80.8 124,054 52.3 53.6 84.9 12.1 100,180 Second 84.9 136,900 60.4 55.3 86.2 13.7 116,168 Middle 86.1 143,814 68.5 54.4 87.3 17.1 123,888 Fourth 89.3 147,978 75.7 54.7 89.7 18.4 132,190 Highest 93.7 146,939 83.1 59.3 93.7 16.8 137,630 Total 87.2 699,686 69.2 55.6 88.7 15.9 610,056 354 z Morbidity and Health Care Table 11.4.2 Knowledge and attitudes toward tuberculosis: Men Percentage of men age 15-49 who have heard of tuberculosis (TB), and among men who have heard of TB, percentage with specific knowledge and beliefs, according to background characteristics, India, 2015-16 Background characteristic Percentage who have heard of TB Number of men Among men who have heard of TB, percentage who: Number of men who have heard of TB Report that TB is spread through the air by coughing or sneezing Have misconceptions about transmission of TB Believe that TB can be cured Would want a family member's TB kept secret Age 15-19 84.1 18,740 68.6 50.7 87.7 20.6 15,762 20-34 88.7 47,399 73.1 52.8 91.3 19.7 42,042 35-49 87.9 37,272 71.7 52.4 91.3 19.9 32,762 Residence Urban 89.3 39,546 77.5 51.4 91.5 21.3 35,310 Rural 86.5 63,864 68.2 52.9 90.1 19.1 55,256 Schooling No schooling 78.3 12,422 57.9 50.7 87.0 20.2 9,731 <5 years complete 84.4 6,171 59.2 47.9 86.8 18.4 5,208 5-7 years complete 85.5 14,730 66.2 50.1 87.9 21.9 12,590 8-9 years complete 88.3 21,422 69.3 51.6 89.9 18.3 18,907 10-11 years complete 88.7 18,030 74.8 51.8 90.7 21.8 15,997 12 or more years complete 91.8 30,636 81.5 55.4 94.3 19.3 28,132 Religion Hindu 87.6 84,211 71.8 52.2 90.6 20.7 73,747 Muslim 86.5 13,793 69.6 51.9 90.4 16.4 11,931 Christian 85.9 2,277 77.3 41.5 86.9 24.0 1,957 Sikh 96.0 1,622 81.1 77.3 96.3 9.1 1,557 Buddhist/Neo-Buddhist 92.7 958 79.4 38.2 92.7 14.0 888 Jain 89.5 163 76.0 52.4 96.4 21.7 146 Other 88.0 386 68.8 73.4 93.0 11.7 340 Caste/tribe Scheduled caste 87.8 20,499 69.8 55.5 90.4 20.8 17,995 Scheduled tribe 82.7 9,132 64.1 46.7 88.4 19.3 7,553 Other backward class 86.9 45,110 71.2 52.3 89.8 23.7 39,195 Other 90.1 28,299 76.6 51.8 92.9 13.8 25,511 Don't know 84.0 371 66.0 47.5 82.5 15.9 311 Wealth index Lowest 83.5 15,205 58.3 53.4 88.6 15.7 12,697 Second 85.8 19,402 65.9 52.2 89.8 18.1 16,640 Middle 86.3 22,047 71.0 50.8 89.5 22.5 19,036 Fourth 88.1 22,930 75.3 51.6 90.6 24.1 20,190 Highest 92.3 23,827 81.6 53.7 93.5 17.7 22,002 Total age 15-49 87.6 103,411 71.8 52.3 90.6 19.9 90,566 Age 50-54 87.4 8,711 69.9 51.7 90.2 21.0 7,614 Total age 15-54 87.6 112,122 71.7 52.3 90.6 20.0 98,180 Morbidity and Health Care z�355 T ab le 1 1. 5. 1 Se lf- re po rte d he al th p ro bl em s: W om en Pe rc en ta ge o f w om en a ge 1 5- 49 w ho re po rte d th at th ey h av e di ab et es , a st hm a, g oi tre o r a ny o th er th yr oi d di so rd er , a ny h ea rt di se as e, o r c an ce r a nd w he th er th ey h av e so ug ht tr ea tm en t f or e ac h re po rte d he al th p ro bl em , b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic D ia be te s As th m a G oi tre o r a ny o th er th yr oi d di so rd er An y he ar t d ise as e C an ce r N um be r of w om en Pe rc en ta ge w ith di ab et es Pe rc en ta ge w ith d ia be te s w ho h av e so ug ht tre at m en t Pe rc en ta ge w ith as th m a Pe rc en ta ge w ith a st hm a w ho h av e so ug ht tr ea tm en t Pe rc en ta ge w ith g oi tre o r an y ot he r th yr oi d di so rd er Pe rc en ta ge w ith g oi tre o r an y ot he r th yr oi d di so rd er w ho ha ve so ug ht tre at m en t Pe rc en ta ge w ith an y he ar t di se as e Pe rc en ta ge w ith a ny h ea rt di se as e w ho h av e so ug ht tr ea tm en t Pe rc en ta ge w ith ca nc er Pe rc en ta ge w ith c an ce r w ho h av e so ug ht tr ea tm en t Ag e 15 -1 9 0. 3 60 .8 1. 0 64 .2 0. 7 77 .7 0. 5 60 .9 0. 1 42 .0 12 1, 55 2 20 -3 4 0. 8 71 .7 1. 5 70 .2 1. 8 86 .3 1. 0 68 .9 0. 1 63 .2 33 4, 77 7 35 -4 9 3. 5 85 .3 3. 0 73 .3 3. 4 88 .1 2. 3 74 .8 0. 2 73 .8 24 3, 35 7 Re si de nc e U rb an 2. 6 85 .3 2. 1 73 .4 3. 5 90 .3 1. 2 74 .2 0. 2 70 .3 24 2, 22 5 Ru ra l 1. 2 76 .8 1. 9 70 .2 1. 5 82 .5 1. 4 70 .9 0. 2 63 .1 45 7, 46 1 Sc ho ol in g N o sc ho ol in g 1. 6 79 .3 2. 2 70 .7 1. 4 79 .7 1. 8 71 .2 0. 2 62 .9 19 3, 07 8 < 5 ye ar s co m pl et e 2. 2 81 .5 2. 6 68 .0 1. 9 82 .8 2. 1 73 .0 0. 1 79 .0 40 ,5 03 5- 7 ye ar s co m pl et e 2. 0 80 .1 2. 2 69 .2 2. 1 86 .6 1. 4 71 .1 0. 2 61 .7 99 ,6 87 8- 9 ye ar s co m pl et e 1. 4 81 .7 1. 9 70 .7 2. 1 83 .8 1. 2 69 .2 0. 2 66 .3 11 6, 68 1 10 -1 1 ye ar s co m pl et e 1. 8 83 .4 1. 7 71 .9 2. 6 87 .8 1. 0 74 .6 0. 2 64 .1 99 ,5 76 12 o r m or e ye ar s co m pl et e 1. 5 83 .1 1. 4 77 .0 3. 2 92 .7 0. 8 75 .3 0. 2 69 .8 15 0, 16 0 M ar ita l s ta tu s N ev er m ar rie d 0. 4 65 .4 1. 1 69 .2 0. 9 82 .9 0. 6 62 .5 0. 1 50 .8 15 9, 03 5 C ur re nt ly m ar rie d 2. 0 82 .3 2. 1 71 .6 2. 6 87 .6 1. 5 72 .9 0. 2 68 .5 51 1, 37 3 W id ow ed /d iv or ce d/ se pa ra te d/ de se rte d 2. 9 81 .8 3. 3 72 .3 2. 5 79 .9 2. 3 73 .1 0. 2 71 .4 29 ,2 79 Re lig io n H in du 1. 6 80 .6 2. 0 70 .8 2. 0 86 .5 1. 3 70 .8 0. 2 65 .5 56 3, 73 9 M us lim 2. 0 82 .2 1. 7 74 .8 2. 6 87 .1 1. 8 76 .7 0. 2 64 .6 96 ,4 61 C hr ist ia n 2. 7 88 .6 2. 9 70 .2 4. 2 86 .7 1. 6 65 .1 0. 2 75 .1 16 ,6 20 Si kh 1. 7 87 .3 1. 3 87 .3 2. 9 93 .1 1. 6 81 .1 0. 1 58 .3 11 ,6 18 Bu dd hi st /N eo -B ud dh ist 1. 9 82 .5 2. 3 62 .2 1. 7 96 .1 0. 6 72 .8 0. 0 20 .9 6, 46 9 Ja in 3. 2 83 .9 1. 1 75 .9 4. 4 99 .2 1. 1 93 .6 0. 2 10 0. 0 1, 26 4 O th er 0. 3 74 .6 2. 0 69 .3 2. 0 77 .3 0. 7 76 .8 0. 0 10 0. 0 3, 51 5 C on tin ue d. . 356 z Morbidity and Health Care T ab le 1 1. 5. 1 Se lf- re po rte d he al th p ro bl em s: W om en — C on tin ue d Pe rc en ta ge o f w om en a ge 1 5- 49 w ho re po rte d th at th ey h av e di ab et es , a st hm a, g oi tre o r a ny o th er th yr oi d di so rd er , a ny h ea rt di se as e, o r c an ce r a nd w he th er th ey h av e so ug ht tr ea tm en t f or e ac h re po rte d he al th p ro bl em , b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic D ia be te s As th m a G oi tre o r a ny o th er th yr oi d di so rd er An y he ar t d ise as e C an ce r N um be r of w om en Pe rc en ta ge w ith di ab et es Pe rc en ta ge w ith d ia be te s w ho h av e so ug ht tre at m en t Pe rc en ta ge w ith as th m a Pe rc en ta ge w ith a st hm a w ho h av e so ug ht tr ea tm en t Pe rc en ta ge w ith g oi tre o r an y ot he r th yr oi d di so rd er Pe rc en ta ge w ith g oi tre o r an y ot he r th yr oi d di so rd er w ho ha ve so ug ht tre at m en t Pe rc en ta ge w ith an y he ar t di se as e Pe rc en ta ge w ith a ny h ea rt di se as e w ho h av e so ug ht tr ea tm en t Pe rc en ta ge w ith ca nc er Pe rc en ta ge w ith c an ce r w ho h av e so ug ht tr ea tm en t C as te /tr ib e Sc he du le d ca st e 1. 5 78 .7 1. 8 67 .8 1. 8 84 .7 1. 4 71 .0 0. 2 63 .9 14 2, 61 9 Sc he du le d tri be 1. 1 79 .1 1. 8 63 .9 1. 1 77 .4 1. 1 68 .4 0. 2 60 .4 64 ,1 44 O th er b ac kw ar d cl as s 1. 7 80 .5 1. 9 71 .9 2. 0 86 .7 1. 3 71 .0 0. 2 61 .6 30 3, 83 7 O th er 2. 1 84 .3 2. 1 74 .9 3. 1 89 .2 1. 5 74 .9 0. 2 73 .8 18 4, 59 4 D on 't kn ow 1. 4 78 .7 2. 8 77 .4 2. 6 85 .6 1. 7 78 .7 0. 0 10 0. 0 4, 49 2 W ea lth in de x Lo w es t 0. 8 64 .6 1. 7 66 .0 0. 7 68 .8 1. 4 65 .3 0. 2 54 .7 12 4, 05 4 Se co nd 0. 9 71 .4 1. 9 66 .7 1. 1 75 .5 1. 4 69 .6 0. 2 61 .2 13 6, 90 0 M id dl e 1. 3 76 .2 2. 0 69 .5 1. 8 83 .5 1. 5 69 .3 0. 2 52 .0 14 3, 81 4 Fo ur th 2. 3 84 .1 2. 2 73 .3 2. 7 87 .5 1. 3 75 .6 0. 2 77 .2 14 7, 97 8 H ig he st 2. 9 88 .2 1. 9 79 .5 4. 3 93 .0 1. 1 81 .1 0. 2 83 .0 14 6, 93 9 To ta l 1. 7 81 .3 1. 9 71 .3 2. 2 86 .8 1. 3 72 .0 0. 2 65 .6 69 9, 68 6 Morbidity and Health Care z�357 T ab le 1 1. 5. 2 Se lf- re po rte d he al th p ro bl em s: M en Pe rc en ta ge o f m en a ge 1 5- 49 w ho re po rte d th at th ey h av e di ab et es , a st hm a, g oi tre o r a ny o th er th yr oi d di so rd er , a ny h ea rt di se as e, o r c an ce r a nd w he th er th ey h av e so ug ht tr ea tm en t f or e ac h re po rte d he al th pr ob le m , b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic D ia be te s As th m a G oi tre o r a ny o th er th yr oi d di so rd er An y he ar t d ise as e C an ce r N um be r of m en Pe rc en ta ge w ith di ab et es Pe rc en ta ge w ith d ia be te s w ho h av e so ug ht tre at m en t Pe rc en ta ge w ith as th m a Pe rc en ta ge w ith a st hm a w ho h av e so ug ht tre at m en t Pe rc en ta ge w ith g oi tre o r an y ot he r th yr oi d di so rd er Pe rc en ta ge w ith g oi tre o r an y ot he r th yr oi d di so rd er w ho h av e so ug ht tr ea tm en t Pe rc en ta ge w ith a ny he ar t di se as e Pe rc en ta ge w ith a ny h ea rt di se as e w ho h av e so ug ht tre at m en t Pe rc en ta ge w ith ca nc er Pe rc en ta ge w ith c an ce r w ho h av e so ug ht tre at m en t Ag e 15 -1 9 0. 4 36 .5 0. 7 55 .9 0. 4 50 .5 0. 4 32 .5 0. 2 14 .6 18 ,7 40 20 -3 4 0. 8 54 .1 1. 0 59 .1 0. 4 60 .3 0. 8 57 .7 0. 3 47 .4 47 ,3 99 35 -4 9 3. 6 79 .6 1. 9 63 .5 0. 7 54 .2 1. 7 65 .8 0. 3 26 .3 37 ,2 72 Re si de nc e U rb an 2. 1 75 .5 1. 1 58 .5 0. 5 50 .5 0. 9 57 .0 0. 3 20 .0 39 ,5 46 Ru ra l 1. 5 69 .8 1. 3 62 .5 0. 5 59 .5 1. 1 62 .3 0. 3 44 .1 63 ,8 64 Sc ho ol in g N o sc ho ol in g 1. 4 64 .0 1. 9 70 .4 0. 5 62 .0 1. 4 55 .0 0. 3 49 .2 12 ,4 22 < 5 ye ar s co m pl et e 1. 8 68 .9 2. 2 58 .2 0. 5 74 .1 1. 3 76 .4 0. 2 63 .1 6, 17 1 5- 7 ye ar s co m pl et e 1. 8 72 .5 1. 5 60 .1 0. 5 57 .9 1. 2 59 .2 0. 3 41 .7 14 ,7 30 8- 9 ye ar s co m pl et e 1. 4 78 .5 1. 0 59 .0 0. 4 60 .0 0. 9 66 .6 0. 2 47 .5 21 ,4 22 10 -1 1 ye ar s co m pl et e 1. 8 72 .6 1. 0 55 .1 0. 5 48 .9 0. 8 53 .6 0. 3 20 .0 18 ,0 30 12 o r m or e ye ar s co m pl et e 2. 0 72 .5 1. 0 61 .2 0. 6 51 .6 0. 9 59 .5 0. 3 26 .0 30 ,6 36 M ar ita l s ta tu s N ev er m ar rie d 0. 6 45 .4 0. 9 54 .9 0. 4 46 .9 0. 6 44 .5 0. 2 28 .9 39 ,6 31 C ur re nt ly m ar rie d 2. 4 76 .5 1. 5 63 .0 0. 6 61 .1 1. 3 64 .8 0. 3 37 .2 62 ,4 99 W id ow ed /d iv or ce d/ se pa ra te d/ de se rte d 3. 1 87 .3 2. 7 76 .1 0. 7 9. 0 2. 1 80 .0 0. 3 60 .2 1, 28 0 Re lig io n H in du 1. 7 72 .9 1. 3 61 .4 0. 5 52 .8 1. 0 58 .1 0. 3 33 .0 84 ,2 11 M us lim 1. 6 73 .3 1. 0 67 .9 0. 4 86 .7 0. 9 76 .3 0. 1 77 .4 13 ,7 93 C hr ist ia n 3. 6 58 .7 1. 8 30 .8 1. 3 20 .8 2. 4 58 .6 0. 9 11 .8 2, 27 7 Si kh 1. 7 79 .4 0. 2 68 .0 0. 4 97 .4 0. 5 72 .1 0. 0 10 0. 0 1, 62 2 Bu dd hi st /N eo -B ud dh ist 1. 2 67 .5 0. 8 57 .4 0. 5 81 .9 0. 7 46 .2 0. 0 nc 95 8 Ja in 2. 9 90 .5 0. 6 10 0. 0 0. 4 10 0. 0 0. 0 nc 0. 0 nc 16 3 O th er 1. 7 95 .5 0. 9 97 .9 0. 3 93 .1 1. 3 86 .9 0. 6 10 0. 0 38 6 C on tin ue d. . 358 z Morbidity and Health Care T ab le 1 1. 5. 2 Se lf- re po rte d he al th p ro bl em s: M en — C on tin ue d Pe rc en ta ge o f m en a ge 1 5- 49 w ho re po rte d th at th ey h av e di ab et es , a st hm a, g oi tre o r a ny o th er th yr oi d di so rd er , a ny h ea rt di se as e, o r c an ce r a nd w he th er th ey h av e so ug ht tr ea tm en t f or e ac h re po rte d he al th pr ob le m , b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic D ia be te s As th m a G oi tre o r a ny o th er th yr oi d di so rd er An y he ar t d ise as e C an ce r N um be r of m en Pe rc en ta ge w ith di ab et es Pe rc en ta ge w ith d ia be te s w ho h av e so ug ht tre at m en t Pe rc en ta ge w ith as th m a Pe rc en ta ge w ith a st hm a w ho h av e so ug ht tre at m en t Pe rc en ta ge w ith g oi tre o r an y ot he r th yr oi d di so rd er Pe rc en ta ge w ith g oi tre o r an y ot he r th yr oi d di so rd er w ho h av e so ug ht tr ea tm en t Pe rc en ta ge w ith a ny he ar t di se as e Pe rc en ta ge w ith a ny h ea rt di se as e w ho h av e so ug ht tre at m en t Pe rc en ta ge w ith ca nc er Pe rc en ta ge w ith c an ce r w ho h av e so ug ht tre at m en t C as te /tr ib e Sc he du le d ca st e 1. 6 64 .2 1. 3 57 .4 0. 5 58 .4 1. 1 56 .4 0. 3 35 .5 20 ,4 99 Sc he du le d tri be 1. 1 63 .3 1. 7 58 .6 0. 4 63 .5 1. 3 66 .6 0. 2 55 .7 9, 13 2 O th er b ac kw ar d cl as s 1. 8 70 .1 1. 3 57 .3 0. 6 44 .9 1. 0 52 .4 0. 3 23 .0 45 ,1 10 O th er 1. 9 82 .7 0. 9 76 .1 0. 5 72 .6 0. 9 75 .5 0. 1 73 .3 28 ,2 99 D on 't kn ow 1. 9 48 .4 1. 4 33 .0 0. 3 16 .3 0. 5 43 .2 0. 5 0. 0 37 1 W ea lth in de x Lo w es t 1. 0 57 .8 1. 7 65 .9 0. 5 71 .1 1. 4 62 .8 0. 3 71 .2 15 ,2 05 Se co nd 1. 1 63 .8 1. 5 60 .7 0. 3 63 .8 1. 1 65 .0 0. 2 49 .8 19 ,4 02 M id dl e 1. 4 65 .2 1. 1 48 .0 0. 6 40 .5 1. 0 52 .2 0. 3 19 .1 22 ,0 47 Fo ur th 2. 0 73 .6 1. 4 65 .2 0. 7 52 .3 1. 0 53 .1 0. 3 15 .7 22 ,9 30 H ig he st 2. 7 81 .6 0. 8 66 .2 0. 5 65 .1 0. 7 72 .5 0. 2 35 .0 23 ,8 27 To ta l a ge 1 5- 49 1. 7 72 .5 1. 2 61 .2 0. 5 55 .9 1. 0 60 .5 0. 3 34 .6 10 3, 41 1 Ag e 50 -5 4 7. 2 86 .7 3. 8 69 .3 0. 7 61 .7 3. 1 75 .3 0. 4 49 .9 8, 71 1 To ta l a ge 1 5- 54 2. 1 76 .2 1. 5 62 .8 0. 5 56 .5 1. 2 63 .5 0. 3 36 .5 11 2, 12 2 nc = N o ca se s Morbidity and Health Care z�359 Ta bl e 11 .6 S el f-r ep or te d he al th p ro bl em s by s ta te /u ni on te rr ito ry Pe rc en ta ge o f w om en a nd m en a ge 1 5- 49 w ho r ep or te d th at th ey h av e di ab et es , a st hm a, g oi tre o r an y ot he r th yr oi d di so rd er , a ny h ea rt d ise as e, o r ca nc er , b y st at e/ un io n te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry Pe rc en ta ge o f w om en w ho h av e: Pe rc en ta ge o f m en w ho h av e: D ia be te s As th m a G oi tr e or a ny ot he r t hy ro id di so rd er An y he ar t di se as e C an ce r D ia be te s As th m a G oi tr e or a ny ot he r t hy ro id di so rd er An y he ar t di se as e C an ce r ,Q GL D� 1. 7 1. 9 2. 2 1. 3 0. 2 1. 7 1. 2 0. 5 1. 0 0. 3 1 RU WK C ha nd ig ar h 2. 3 1. 4 6. 2 0. 6 0. 1 1. 6 0. 0 0. 8 1. 8 0. 0 D el hi 2. 3 1. 4 4. 5 1. 4 0. 0 1. 5 0. 2 0. 1 0. 4 0. 0 H ar ya na 1. 1 1. 4 2. 2 1. 1 0. 2 0. 5 0. 3 0. 5 0. 5 0. 1 H im ac ha l P ra de sh 1. 6 1. 0 2. 7 0. 9 0. 1 1. 1 0. 5 0. 4 0. 5 0. 3 Ja m m u & K as hm ir 1. 9 0. 9 7. 0 4. 5 0. 1 3. 0 1. 3 1. 7 2. 4 0. 0 Pu nj ab 1. 7 1. 3 2. 7 1. 5 0. 1 1. 4 0. 5 0. 2 0. 6 0. 0 Ra ja st ha n 0. 6 0. 9 1. 1 0. 6 0. 1 0. 9 0. 7 0. 3 0. 4 0. 0 U tta ra kh an d 1. 4 1. 0 1. 6 0. 9 0. 1 0. 6 0. 8 0. 1 1. 3 0. 0 & HQ WU DO C hh at tis ga rh 0. 5 0. 9 1. 3 0. 6 0. 1 0. 8 0. 4 0. 1 0. 5 0. 0 M ad hy a Pr ad es h 1. 2 1. 9 1. 5 1. 8 0. 2 0. 9 1. 1 0. 5 1. 1 0. 2 U tta r P ra de sh 1. 0 1. 2 1. 3 1. 4 0. 1 1. 1 1. 0 0. 3 0. 6 0. 1 (D VW Bi ha r 1. 6 1. 8 1. 2 2. 3 0. 6 1. 3 1. 4 0. 5 1. 5 0. 1 Jh ar kh an d 0. 7 0. 7 1. 1 0. 7 0. 0 2. 1 1. 4 0. 7 1. 7 1. 4 O di sh a 1. 5 2. 5 1. 2 1. 1 0. 1 2. 9 2. 2 0. 3 1. 0 0. 2 W es t B en ga l 1. 7 3. 3 3. 2 2. 0 0. 1 1. 6 1. 8 0. 5 1. 6 0. 1 1 RU WK HD VW Ar un ac ha l P ra de sh 1. 2 1. 2 0. 9 1. 4 0. 1 1. 2 0. 3 0. 3 0. 8 0. 2 As sa m 1. 0 0. 9 1. 7 1. 3 0. 1 1. 1 0. 7 0. 3 0. 8 0. 0 M an ip ur 0. 9 1. 6 4. 4 3. 1 0. 1 1. 3 0. 5 0. 6 1. 0 0. 1 M eg ha la ya 1. 1 3. 0 2. 3 3. 8 0. 4 4. 6 0. 7 1. 8 1. 9 0. 1 M iz or am 1. 2 1. 8 1. 8 3. 6 0. 3 1. 0 1. 2 0. 7 2. 5 0. 2 N ag al an d 0. 8 1. 3 1. 0 2. 5 0. 1 1. 0 2. 2 0. 0 0. 6 0. 0 Si kk im 1. 6 1. 0 1. 0 0. 6 0. 0 1. 2 0. 9 0. 3 0. 0 0. 0 Tr ip ur a 1. 4 3. 5 1. 8 3. 6 0. 1 1. 6 0. 4 0. 1 2. 9 0. 0 &R QW LQ XH G� ��� � 360 z Morbidity and Health Care Ta bl e 11 .6 S el f-r ep or te d he al th p ro bl em s by s ta te /u ni on te rr ito ry ³ &R QW LQ XH G Pe rc en ta ge o f w om en a nd m en a ge 1 5- 49 w ho r ep or te d th at th ey h av e di ab et es , a st hm a, g oi tr e or a ny o th er t hy ro id d iso rd er , a ny h ea rt d ise as e, o r ca nc er , b y st at e/ un io n te rr ito ry , I nd ia , 2 01 5- 16 St at e/ un io n te rr ito ry Pe rc en ta ge o f w om en w ho h av e: Pe rc en ta ge o f m en w ho h av e: D ia be te s As th m a G oi tr e or a ny ot he r t hy ro id di so rd er An y he ar t di se as e C an ce r D ia be te s As th m a G oi tr e or a ny ot he r t hy ro id di so rd er An y he ar t di se as e C an ce r � : HV W D ad ra & N ag ar H av el i 0. 8 1. 6 1. 0 0. 5 0. 0 1. 0 0. 5 0. 0 0. 0 0. 0 D am an & D iu 0. 5 0. 8 0. 2 0. 3 0. 1 0. 0 0. 1 0. 1 0. 0 0. 0 G oa 3. 8 1. 0 1. 8 0. 2 0. 0 3. 0 0. 5 0. 2 0. 3 0. 2 G uj ar at 1. 2 1. 3 1. 0 0. 3 0. 1 1. 1 0. 9 0. 2 0. 5 0. 1 M ah ar as ht ra 1. 4 1. 9 1. 8 0. 6 0. 1 1. 1 1. 2 0. 3 0. 5 0. 1 6R XW K An da m an & N ic ob ar Is la nd s 4. 6 4. 5 2. 8 0. 8 0. 0 3. 9 0. 9 0. 1 1. 3 1. 6 An dh ra P ra de sh 2. 4 3. 0 3. 8 1. 4 0. 1 3. 2 1. 6 0. 6 1. 4 0. 2 Ka rn at ak a 2. 6 1. 5 1. 8 0. 8 0. 3 2. 6 0. 7 0. 3 0. 7 0. 1 Ke ra la 4. 3 3. 1 8. 1 1. 3 0. 2 4. 3 1. 0 0. 5 1. 3 0. 1 La ks ha dw ee p 3. 8 3. 1 5. 7 0. 5 0. 1 1. 8 1. 2 0. 6 3. 0 0. 0 Pu du ch er ry 2. 9 2. 2 3. 3 0. 8 0. 1 2. 5 2. 8 0. 2 0. 2 0. 2 Ta m il N ad u 3. 7 3. 6 2. 8 1. 5 0. 4 3. 6 3. 0 2. 0 2. 2 1. 8 Te la ng an a 2. 2 3. 5 4. 6 1. 7 0. 1 2. 1 1. 5 0. 6 1. 5 0. 1 Morbidity and Health Care z�361 Table 11.7 Tobacco use by women and men Percentage of women and men age 15-49 and men age 15-54 by their use of tobacco, and percent distribution of those who smoke cigarettes or bidis by number of cigarettes/bidis smoked in the 24 hours preceding the survey, India, 2015-16 Tobacco use Women Men Urban Rural Total 15-49 Urban Rural Total 15-49 Total 15-54 Use of tobacco Smokes cigarettes 0.1 0.1 0.1 16.2 12.0 13.6 13.7 Smokes bidis 0.2 0.6 0.5 8.9 15.8 13.2 14.3 Smokes cigars 0.1 0.1 0.1 0.4 0.5 0.4 0.5 Smokes a pipe 0.0 0.0 0.0 0.1 0.2 0.2 0.2 Smokes a hookah 0.1 0.2 0.2 0.4 0.7 0.6 0.6 Chews paan masala or gutkha 1.7 2.5 2.2 13.6 16.3 15.3 14.9 Uses khaini 0.6 1.6 1.3 7.7 14.9 12.2 12.4 Chews paan with tobacco 1.2 2.2 1.8 4.1 6.3 5.4 5.6 Other chewing tobacco 0.5 0.8 0.7 1.7 2.7 2.3 2.3 Uses snuff 0.1 0.2 0.1 0.0 0.1 0.1 0.1 Other 0.3 0.8 0.6 0.2 0.6 0.4 0.5 Does not use tobacco 95.6 91.9 93.2 61.1 52.0 55.5 54.5 Number of respondents 242,225 457,461 699,686 39,546 63,864 103,411 112,122 Number of cigarettes smoked in the past 24 hours 0 2.8 1.9 2.4 7.9 15.9 12.3 12.1 1-4 75.2 71.0 73.1 55.4 59.0 57.4 56.6 5-9 8.5 18.3 13.4 21.0 14.0 17.2 17.5 10 or more 13.5 8.8 11.2 14.7 9.5 11.9 12.5 Missing 0.0 0.0 0.0 1.0 1.6 1.3 1.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of cigarette smokers 325 315 639 6,401 7,674 14,075 15,341 Number of bidis smoked in the past 24 hours 0 0.0 0.0 0.0 4.9 3.1 3.5 3.3 1-4 51.8 50.5 50.7 24.8 24.3 24.4 23.5 5-9 15.7 23.7 22.8 21.1 20.4 20.6 20.3 10 or more 32.6 25.7 26.5 48.6 51.6 50.9 52.4 Missing 0.0 0.0 0.0 0.6 0.5 0.6 0.6 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of bidi smokers 365 2,793 3,158 3,513 10,122 13,635 16,050 Number of cigarettes/bidis smoked in the past 24 hours 0 1.4 0.2 0.4 5.4 6.1 5.9 5.5 1-4 61.2 50.6 52.5 41.7 33.9 36.7 35.1 5-9 13.1 24.1 22.2 21.2 19.5 20.1 20.2 10 or more 24.1 25.1 24.9 31.0 39.7 36.5 38.5 Missing 0.1 0.0 0.0 0.7 0.8 0.8 0.8 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of cigarette/ bidi smokers 625 2,987 3,612 8,682 15,105 23,786 26,964 362 z Morbidity and Health Care Ta bl e 11 .8 U se o f t ob ac co b y ba ck gr ou nd c ha ra ct er ist ic s Pe rc en ta ge o f w om en a nd m en a ge 1 5- 49 w ho u se a ny k in d of to ba cc o an d pe rc en ta ge w ho sm ok e ci ga re tte s o r b id is, a nd a m on g th os e w ho sm ok e ci ga re tte s o r b id is, p er ce nt ag e w ho sm ok ed a t l ea st o ne c ig ar et te o r b id i i n th e 24 h ou rs p re ce di ng th e su rv ey b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic W om en M en N um be r of m en w ho s m ok e ci ga re tte s/ bi di s Pe rc en ta ge w ho u se an y ki nd of to ba cc o Pe rc en ta ge w ho sm ok e ci ga re tte s Pe rc en ta ge w ho s m ok e bi di s N um be r of w om en Pe rc en ta ge w ho s m ok ed at le as t o ne ci ga re tte /b id i in th e pa st 24 h ou rs N um be r of w om en w ho s m ok e ci ga re tte s/ bi di s Pe rc en ta ge w ho u se an y ki nd of to ba cc o Pe rc en ta ge w ho s m ok e ci ga re tte s Pe rc en ta ge w ho s m ok e bi di s N um be r of m en Pe rc en ta ge w ho s m ok ed at le as t o ne ci ga re tte /b id i in th e pa st 24 h ou rs Ag e 15 -1 9 1. 6 0. 0 0. 0 12 1, 55 2 93 .6 96 18 .5 6. 3 2. 8 18 ,7 40 86 .4 1, 46 1 20 -3 4 5. 0 0. 1 0. 2 33 4, 77 7 99 .4 79 1 45 .3 15 .6 10 .5 47 ,3 99 91 .5 10 ,6 40 35 -4 9 11 .8 0. 1 1. 0 24 3, 35 7 99 .9 2, 72 5 56 .6 14 .7 21 .8 37 ,2 72 96 .0 11 ,6 86 Re si de nc e U rb an 4. 4 0. 1 0. 2 24 2, 22 5 98 .6 62 5 38 .9 16 .2 8. 9 39 ,5 46 93 .9 8, 68 2 Ru ra l 8. 1 0. 1 0. 6 45 7, 46 1 99 .8 2, 98 7 48 .0 12 .0 15 .8 63 ,8 64 93 .1 15 ,1 05 M at er ni ty s ta tu s Pr eg na nt 4. 6 0. 0 0. 2 31 ,1 23 99 .9 76 na na na na na na Br ea st fe ed in g (n ot pr eg na nt ) 6. 0 0. 1 0. 3 10 3, 93 2 99 .6 40 2 na na na na na na N ei th er 7. 1 0. 1 0. 5 56 4, 63 0 99 .6 3, 13 4 na na na na na na Sc ho ol in g N o sc ho ol in g 14 .3 0. 1 1. 4 19 3, 07 8 99 .9 2, 86 1 68 .1 13 .0 30 .7 12 ,4 22 96 .7 4, 70 9 < 5 ye ar s co m pl et e 12 .3 0. 1 0. 3 40 ,5 03 10 0. 0 16 4 67 .5 16 .0 26 .7 6, 17 1 95 .1 2, 16 0 5- 7 ye ar s co m pl et e 6. 9 0. 1 0. 2 99 ,6 87 99 .6 21 7 58 .3 15 .2 20 .1 14 ,7 30 94 .4 4, 39 6 8- 9 ye ar s co m pl et e 4. 1 0. 1 0. 1 11 6, 68 1 99 .2 12 9 47 .2 13 .2 13 .2 21 ,4 22 93 .0 4, 75 5 10 -1 1 ye ar s co m pl et e 1. 7 0. 1 0. 0 99 ,5 76 97 .0 84 33 .2 12 .4 6. 8 18 ,0 30 90 .7 3, 02 9 12 o r m or e ye ar s co m pl et e 1. 0 0. 1 0. 0 15 0, 16 0 95 .0 15 7 28 .4 13 .5 3. 8 30 ,6 36 90 .4 4, 73 8 Re lig io n H in du 6. 8 0. 1 0. 5 56 3, 73 9 99 .7 2, 91 7 45 .0 13 .1 13 .3 84 ,2 11 93 .1 19 ,1 48 M us lim 7. 1 0. 1 0. 4 96 ,4 61 99 .8 49 3 45 .6 16 .5 13 .9 13 ,7 93 95 .4 3, 59 5 C hr ist ia n 9. 9 0. 7 0. 3 16 ,6 20 97 .9 15 8 38 .1 21 .3 10 .7 2, 27 7 91 .0 61 2 Si kh 0. 2 0. 0 0. 0 11 ,6 18 * 5 15 .9 5. 6 6. 4 1, 62 2 94 .9 16 6 Bu dd hi st /N eo -B ud dh ist 7. 2 0. 2 0. 2 6, 46 9 10 0. 0 24 41 .3 9. 6 5. 7 95 8 88 .3 13 3 Ja in 1. 4 0. 1 0. 0 1, 26 4 * 1 30 .8 11 .0 0. 7 16 3 * 19 O th er 12 .5 0. 1 0. 3 3, 51 5 96 .1 12 59 .5 17 .7 20 .7 38 6 88 .1 11 4 C on tin ue d. . Morbidity and Health Care z�363 Ta bl e 11 .8 U se o f t ob ac co b y ba ck gr ou nd c ha ra ct er ist ic s³ C on tin ue d Pe rc en ta ge o f w om en a nd m en a ge 1 5- 49 w ho u se a ny k in d of to ba cc o an d pe rc en ta ge w ho s m ok e ci ga re tte s or b id is, a nd a m on g th os e w ho s m ok e ci ga re tte s or b id is, p er ce nt ag e w ho sm ok ed a t l ea st o ne c ig ar et te o r b id i i n th e 24 h ou rs p re ce di ng th e su rv ey b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 2 01 5- 16 Ba ck gr ou nd c ha ra ct er ist ic W om en M en N um be r of m en w ho s m ok e ci ga re tte s/ bi di s Pe rc en ta ge w ho u se an y ki nd of to ba cc o Pe rc en ta ge w ho sm ok e ci ga re tte s Pe rc en ta ge w ho s m ok e bi di s N um be r of w om en Pe rc en ta ge w ho s m ok ed at le as t o ne ci ga re tte /b id i in th e pa st 24 h ou rs N um be r of w om en w ho s m ok e ci ga re tte s/ bi di s Pe rc en ta ge w ho u se an y ki nd of to ba cc o Pe rc en ta ge w ho s m ok e ci ga re tte s Pe rc en ta ge w ho sm ok e bi di s N um be r of m en Pe rc en ta ge w ho s m ok ed at le as t o ne ci ga re tte /b id i in th e pa st 24 h ou rs C as te /tr ib e Sc he du le d ca st e 7. 6 0. 1 0. 7 14 2, 61 9 99 .9 1, 01 7 48 .9 14 .4 18 .5 20 ,4 99 93 .8 5, 71 3 Sc he du le d tri be 16 .9 0. 3 0. 7 64 ,1 44 99 .4 57 5 56 .8 12 .6 16 .6 9, 13 2 91 .4 2, 22 5 O th er b ac kw ar d cl as s 5. 3 0. 1 0. 5 30 3, 83 7 99 .9 1, 51 9 42 .4 12 .3 11 .8 45 ,1 10 93 .2 9, 56 3 O th er 5. 1 0. 1 0. 2 18 4, 59 4 98 .4 46 9 40 .6 15 .4 10 .4 28 ,2 99 94 .0 6, 19 5 D on 't kn ow 11 .1 0. 1 0. 7 4, 49 2 (1 00 .0 ) 32 46 .7 15 .5 12 .9 37 1 89 .3 90 W ea lth in de x Lo w es t 13 .8 0. 1 1. 3 12 4, 05 4 99 .9 1, 63 5 62 .9 11 .1 23 .3 15 ,2 05 93 .3 4, 42 2 Se co nd 10 .0 0. 1 0. 6 13 6, 90 0 99 .9 90 6 54 .8 12 .6 19 .3 19 ,4 02 93 .6 5, 20 4 M id dl e 6. 1 0. 1 0. 3 14 3, 81 4 99 .7 44 3 45 .5 14 .0 13 .9 22 ,0 47 92 .6 5, 17 2 Fo ur th 3. 8 0. 1 0. 2 14 7, 97 8 99 .4 34 9 38 .5 15 .1 9. 3 22 ,9 30 93 .9 4, 82 1 H ig he st 1. 7 0. 1 0. 1 14 6, 93 9 96 .8 27 8 29 .1 14 .3 4. 8 23 ,8 27 93 .5 4, 16 7 To ta l a ge 1 5- 49 6. 8 0. 1 0. 5 69 9, 68 6 99 .6 3, 61 2 44 .5 13 .6 13 .2 10 3, 41 1 93 .4 23 ,7 86 Ag e 50 -5 4 na na na na na na 57 .7 14 .5 27 .7 8, 71 1 96 .8 3, 17 7 To ta l a ge 1 5- 54 na na na na na na 45 .5 13 .7 14 .3 11 2, 12 2 93 .8 26 ,9 64 na = N ot a pp lic ab le ( ) B as ed o n 25 -4 9 un w ei gh te d ca se s * Pe rc en ta ge n ot s ho w n; b as ed o n fe w er th an 2 5 un w ei gh te d ca se s 364 z Morbidity and Health Care T ab le 1 1. 9 Q ui tti ng to ba cc o us e an d ad vi ce b y a he al th c ar e pr ov id er Am on g w om en a nd m en a ge 1 5- 49 w ho c ur re nt ly u se a ny k in d of to ba cc o, p er ce nt ag e w ho h av e tri ed to st op sm ok in g or u sin g to ba cc o in a ny o th er fo rm in th e 12 m on th s p re ce di ng th e su rv ey , a nd a m on g cu rr en t u se rs o f t ob ac co w ho v isi te d a do ct or o r o th er h ea lth c ar e pr ov id er in th e 12 m on th s pr ec ed in g th e su rv ey , p er ce nt ag e w ho w er e ad vi se d to q ui t sm ok in g or u sin g to ba cc o in a ny o th er fo rm , a nd am on g al l w om en a nd m en a ge 1 5- 49 , p er ce nt ag e w ho w er e pr es en t w he n so m eo ne s m ok ed in th ei r ho m e or a ny w he re e lse in th e 30 d ay s pr ec ed in g th e su rv ey b y ba ck gr ou nd c ha ra ct er ist ic s, In di a, 20 15 -1 6 Ba ck gr ou nd ch ar ac te ris tic W om en M en N um be r of m en Pe rc en ta ge w ho tr ie d to s to p sm ok in g or u sin g to ba cc o in a ny ot he r f or m in th e pa st 12 m on th s N um be r o f c ur re nt us er s o f to ba cc o Pe rc en ta ge w ho w er e ad vi se d to qu it sm ok in g or u sin g to ba cc o in an y ot he r f or m am on g th os e w ho v isi te d a do ct or o r ot he r h ea lth ca re p ro vi de r in th e pa st 12 m on th s N um be r of c ur re nt us er s o f to ba cc o w ho v isi te d a do ct or or o th er h ea lth c ar e pr ov id er in th e pa st 12 m on th s Pe rc en ta ge w ho w er e pr es en t w he n so m eo ne w as sm ok in g in th ei r h om e or an yw he re e lse in th e pa st 30 d ay s N um be r of w om en Pe rc en ta ge w ho tr ie d to s to p sm ok in g or u sin g to ba cc o in a ny ot he r f or m in th e pa st 12 m on th s N um be r of c ur re nt us er s o f to ba cc o Pe rc en ta ge w ho w er e ad vi se d to qu it sm ok in g or u sin g to ba cc o in an y ot he r f or m am on g th os e w ho v isi te d a do ct or o r ot he r h ea lth ca re p ro vi de r in th e pa st 12 m on th s N um be r of c ur re nt us er s o f to ba cc o w ho v isi te d a do ct or or o th er he al th c ar e pr ov id er in th e pa st 12 m on th s Pe rc en ta ge w ho w er e pr es en t w he n so m eo ne w as sm ok in g in th ei r h om e or an yw he re e lse in th e pa st 30 d ay s Ag e 15 -1 9 27 .2 1, 95 6 42 .2 28 3 55 .7 12 1, 55 2 30 .7 3, 46 1 43 .8 48 2 64 .0 18 ,7 40 20 -3 4 29 .2 16 ,8 86 48 .2 3, 12 9 52 .4 33 4, 77 7 31 .7 21 ,4 64 49 .2 3, 56 2 69 .4 47 ,3 99 35 -4 9 29 .5 28 ,7 09 53 .8 5, 32 7 53 .6 24 3, 35 7 29 .6 21 ,0 84 54 .8 3, 70 4 70 .4 37 ,2 72 Re si de nc e U rb an 33 .0 10 ,6 88 55 .0 2, 03 6 49 .7 24 2, 22 5 29 .6 15 ,3 78 52 .5 2, 47 4 65 .0 39 ,5 46 Ru ra l 28 .2 36 ,8 63 50 .3 6, 70 4 55 .4 45 7, 46 1 31 .2 30 ,6 31 51 .0 5, 27 5 71 .1 63 ,8 64 Sc ho ol in g N o sc ho ol in g 28 .4 27 ,6 23 54 .2 4, 73 3 59 .1 19 3, 07 8 24 .4 8, 45 8 50 .9 1, 28 2 73 .5 12 ,4 22 < 5 ye ar s co m pl et e 29 .0 4, 96 8 49 .8 1, 02 1 55 .1 40 ,5 03 30 .3 4, 16 4 54 .9 79 7 71 .9 6, 17 1 5- 7 ye ar s co m pl et e 32 .4 6, 88 2 50 .1 1, 40 8 54 .3 99 ,6 87 31 .4 8, 58 9 53 .0 1, 47 8 72 .6 14 ,7 30 8- 9 ye ar s co m pl et e 30 .8 4, 84 2 44 .3 98 7 53 .2 11 6, 68 1 32 .8 10 ,1 17 50 .0 1, 72 2 70 .9 21 ,4 22 10 -1 1 ye ar s co m pl et e 30 .2 1, 73 5 49 .4 28 9 49 .3 99 ,5 76 31 .7 5, 99 0 55 .8 1, 01 8 64 .9 18 ,0 30 12 o r m or e ye ar s co m pl et e 26 .6 1, 50 1 43 .5 30 2 48 .0 15 0, 16 0 32 .8 8, 69 2 47 .4 1, 45 1 65 .2 30 ,6 36 C on tin ue d. . Morbidity and Health Care z�365 Ta bl e 11 .9 Q ui tti ng to ba cc o us e an d ad vi ce b y a he al th c ar e pr ov id er ³ C on tin ue d Am on g w om en a nd m en a ge 1 5- 49 w ho c ur re nt ly u se a ny k in d of to ba cc o, p er ce nt ag e w ho h av e tri ed to st op sm ok in g or u sin g to ba cc o in a ny o th er fo rm in th e 12 m on th s p re ce di ng th e su rv ey , a nd a m on g cu rr en t u se rs o f t ob ac co w ho v isi te d a do ct or o r o th er h ea lth c ar e pr ov id er in th e 12 m on th s pr ec ed in g th e su rv ey , p er ce nt ag e w ho w er e ad vi se d to q ui t s m ok in g or u sin g to ba cc o in a ny o th er fo rm , a nd am on g al l w om en a nd m en a ge 1 5- 49 , p er ce nt ag e w ho w er e pr es en t w he n so m eo ne s m ok ed in th ei r ho m e or a ny w he re e lse in th e 30 d ay s pr ec ed in g th e su rv ey b y ba ck gr o un d ch ar ac te ris tic s, In di a, 20 15 -1 6 Ba ck gr ou nd c ha ra ct er ist ic W om en M en N um be r of m en Pe rc en ta ge w ho tr ie d to s to p sm ok in g or u sin g to ba cc o in a ny ot he r f or m in th e pa st 12 m on th s N um be r o f c ur re nt us er s o f to ba cc o Pe rc en ta ge w ho w er e ad vi se d to qu it sm ok in g or u sin g to ba cc o in an y ot he r f or m am on g th os e w ho v isi te d a do ct or o r ot he r h ea lth ca re p ro vi de r in th e pa st 12 m on th s N um be r of c ur re nt us er s o f to ba cc o w ho v isi te d a do ct or or o th er h ea lth c ar e pr ov id er in th e pa st 12 m on th s Pe rc en ta ge w ho w er e pr es en t w he n so m eo ne w as sm ok in g in th ei r h om e or an yw he re e lse in th e pa st 30 d ay s N um be r of w om en Pe rc en ta ge w ho tr ie d to s to p sm ok in g or u sin g to ba cc o in a ny ot he r f or m in th e pa st 12 m on th s N um be r of c ur re nt us er s o f to ba cc o Pe rc en ta ge w ho w er e ad vi se d to qu it sm ok in g or u sin g to ba cc o in an y ot he r f or m am on g th os e w ho v isi te d a do ct or o r ot he r h ea lth ca re p ro vi de r in th e pa st 12 m on th s N um be r of c ur re nt us er s o f to ba cc o w ho v isi te d a do ct or or o th er he al th c ar e pr ov id er in th e pa st 12 m on th s Pe rc en ta ge w ho w er e pr es en t w he n so m eo ne w as sm ok in g in th ei r h om e or an yw he re e lse in th e pa st 30 d ay s Re lig io n H in du 29 .3 38 ,0 86 52 .4 6, 89 5 53 .6 56 3, 73 9 31 .1 37 ,9 25 52 .0 6, 38 4 68 .6 84 ,2 11 M us lim 29 .0 6, 87 9 50 .0 1, 31 5 53 .5 96 ,4 61 28 .1 6, 28 3 50 .4 1, 07 0 71 .8 13 ,7 93 C hr ist ia n 31 .7 1, 64 8 40 .7 37 8 54 .8 16 ,6 20 30 .7 86 7 46 .8 12 1 64 .2 2, 27 7 Si kh * 18 * 1 52 .3 11 ,6 18 24 .9 25 8 (7 1. 0) 35 66 .0 1, 62 2 Bu dd hi st /N eo -B ud dh ist 33 .9 46 3 55 .2 86 38 .0 6, 46 9 27 .3 39 5 55 .8 46 53 .9 95 8 Ja in * 18 * 1 36 .3 1, 26 4 (3 9. 1) 50 * 12 68 .7 16 3 O th er 20 .9 43 8 28 .9 63 61 .3 3, 51 5 30 .1 23 0 25 .4 81 75 .5 38 6 C as te /tr ib e Sc he du le d ca st e 31 .2 10 ,8 61 54 .1 2, 15 0 57 .5 14 2, 61 9 31 .0 10 ,0 19 52 .3 1, 66 2 70 .5 20 ,4 99 Sc he du le d tri be 24 .4 10 ,8 39 44 .3 1, 90 9 53 .7 64 ,1 44 27 .6 5, 18 2 43 .1 84 2 69 .5 9, 13 2 O th er b ac kw ar d cl as s 32 .4 16 ,0 18 57 .2 2, 92 0 53 .6 30 3, 83 7 32 .1 19 ,1 47 52 .6 2, 99 7 68 .8 45 ,1 10 O th er 27 .4 9, 33 3 45 .8 1, 64 5 49 .9 18 4, 59 4 29 .2 11 ,4 88 52 .7 2, 20 6 67 .3 28 ,2 99 D on 't kn ow 30 .8 50 0 51 .5 11 5 49 .5 4, 49 2 36 .2 17 3 (4 9. 4) 41 66 .7 37 1 W ea lth in de x Lo w es t 25 .9 17 ,1 07 46 .0 2, 75 5 57 .4 12 4, 05 4 28 .5 9, 56 1 46 .9 1, 55 1 73 .4 15 ,2 05 Se co nd 29 .1 13 ,6 38 47 .7 2, 63 0 57 .2 13 6, 90 0 31 .2 10 ,6 27 50 .8 1, 89 7 71 .8 19 ,4 02 M id dl e 32 .8 8, 72 1 59 .0 1, 79 5 54 .5 14 3, 81 4 31 .6 10 ,0 42 51 .3 1, 71 7 69 .6 22 ,0 47 Fo ur th 33 .0 5, 56 2 59 .3 1, 10 8 51 .1 14 7, 97 8 31 .1 8, 83 5 56 .0 1, 40 5 66 .0 22 ,9 30 H ig he st 33 .6 2, 52 3 56 .4 45 1 47 .8 14 6, 93 9 30 .8 6, 94 4 53 .6 1, 17 9 65 .4 23 ,8 27 To ta l a ge 1 5- 49 29 .3 47 ,5 51 51 .4 8, 73 9 53 .4 69 9, 68 6 30 .6 46 ,0 09 51 .5 7, 74 9 68 .8 10 3, 41 1 Ag e 50 -5 4 na na na na na na 27 .3 5, 03 0 59 .9 95 9 68 .8 8, 71 1 To ta l a ge 1 5- 54 na na na na na na 30 .3 51 ,0 39 52 .4 8, 70 7 68 .8 11 2, 12 2 na = N ot a pp lic ab le ( ) B as ed o n 25 -4 9 un w ei gh te d ca se s * Pe rc en ta ge n ot s ho w n; b as ed o n fe w er th an 2 5 un w ei gh te d ca se s 366 z Morbidity and Health Care Table 11.10 Quitting tobacco use and advice by a health care provider by state/union territory Among women and men age 15-49 who currently use any kind of tobacco, percentage who have tried to stop smoking or using tobacco in any other form in the 12 months preceding the survey, and among current users of tobacco who visited a doctor or other health care provider in the 12 months preceding the survey, percentage who were advised to quit smoking or using tobacco in any other form, and among all women and men age 15-49, percentage who were present when someone smoked in their home or anywhere else in the 30 days preceding the survey by state/union territory, India, 2015-16 State/union territory Women Men Percentage who tried to stop smoking or using tobacco in any other form in the past 12 months Percentage who were advised to quit smoking or using tobacco in any other form among those who visited a doctor or other health care provider in the past 12 months Percentage who were present when someone was smoking in their home or anywhere else in the past 30 days Percentage who tried to stop smoking or using tobacco in any other form in the past 12 months Percentage who were advised to quit smoking or using tobacco in any other form among those who visited a doctor or other health care provider in the past 12 months Percentage who were present when someone was smoking in their home or anywhere else in the past 30 days India 29.3 51.4 53.4 30.6 51.5 68.8 North Chandigarh * * 60.9 (21.7) * 60.6 Delhi 31.5 * 62.0 31.7 * 52.6 Haryana 34.2 (72.8) 68.6 17.2 54.7 78.0 Himachal Pradesh 47.2 * 68.8 40.0 59.8 89.5 Jammu & Kashmir 40.5 47.8 71.0 37.2 55.3 81.7 Punjab (16.0) * 54.9 24.4 71.1 67.7 Rajasthan 37.0 68.9 68.0 25.8 38.1 86.7 Uttarakhand 49.3 63.9 67.6 33.7 57.0 87.7 Central Chhattisgarh 28.8 46.1 55.0 31.6 50.9 86.6 Madhya Pradesh 38.5 62.3 61.4 37.2 52.1 79.8 Uttar Pradesh 36.6 52.0 67.1 38.7 48.7 84.4 East Bihar 25.8 54.2 49.4 32.3 52.4 65.5 Jharkhand 18.7 41.4 35.5 27.2 43.8 62.5 Odisha 17.5 35.8 42.9 35.0 31.5 60.2 West Bengal 26.1 40.5 61.1 14.2 41.3 85.5 Northeast Arunachal Pradesh 18.6 43.0 56.5 24.9 26.5 64.9 Assam 9.2 19.5 43.6 14.1 35.1 69.5 Manipur 30.7 27.2 80.8 34.2 34.6 89.5 Meghalaya 29.4 44.5 78.0 17.8 42.9 85.7 Mizoram 40.9 30.5 97.0 41.5 31.5 99.1 Nagaland 45.4 33.8 65.9 41.7 41.1 83.1 Sikkim 20.0 * 49.3 13.5 (9.4) 61.9 Tripura 18.7 42.6 77.5 10.7 45.4 91.0 West Dadra & Nagar Haveli * * 56.1 12.9 * 25.9 Daman & Diu * nc 40.9 13.5 (63.4) 52.2 Goa (21.9) * 60.2 6.6 * 75.6 Gujarat 36.9 71.1 46.3 40.4 64.9 67.1 Maharashtra 28.0 70.0 33.5 31.1 59.5 45.2 &RQWLQXHG« Morbidity and Health Care z�367 Table 11.10 Quitting tobacco use and advice by a health care provider by state/union territory³Continued Among women and men age 15-49 who currently use any kind of tobacco, percentage who have tried to stop smoking or using tobacco in any other form in the 12 months preceding the survey, and among current users of tobacco who visited a doctor or other health care provider in the 12 months preceding the survey, percentage who were advised to quit smoking or using tobacco in any other form, and among all women and men age 15-49, percentage who were present when someone smoked in their home or anywhere else in the 30 days preceding the survey by state/union territory, India, 2015-16 State/union territory Women Men Percentage who tried to stop smoking or using tobacco in any other form in the past 12 months Percentage who were advised to quit smoking or using tobacco in any other form among those who visited a doctor or other health care provider in the past 12 months Percentage who were present when someone was smoking in their home or anywhere else in the past 30 days Percentage who tried to stop smoking or using tobacco in any other form in the past 12 months Percentage who were advised to quit smoking or using tobacco in any other form among those who visited a doctor or other health care provider in the past 12 months Percentage who were present when someone was smoking in their home or anywhere else in the past 30 days South Andaman & Nicobar Islands 19.9 53.7 60.1 33.4 53.4 73.3 Andhra Pradesh 37.8 78.4 63.6 33.1 71.2 76.3 Karnataka 25.5 74.7 26.2 29.6 79.6 37.3 Kerala 44.6 (64.2) 44.3 22.6 42.3 71.4 Lakshadweep 39.5 59.0 42.2 (21.9) nc 34.5 Puducherry (42.0) * 46.8 11.7 * 49.7 Tamil Nadu 40.4 82.2 49.1 23.3 55.1 50.3 Telangana 34.7 75.2 54.1 42.1 55.1 67.2 nc = No cases ( ) Based on 25-49 unweighted cases * Percentage not shown; based on fewer than 25 unweighted cases 368 z Morbidity and Health Care Table 11.11.1 Use of alcohol: Women Percentage of women age 15-49 who drink alcohol and percent distribution of alcohol drinkers by frequency of drinking, according to background characteristics, India, 2015-16 Background characteristic Percentage of women who drink alcohol Number of women Among w