Monitoring Visit Report –Andhra Pradesh Quarter 4, 2012- 2013

Public Health Planning (PHP) Unit, NHSRC

Contents

Maps of Districts

Executive Summary of Report

Monitoring Visit Report

Annexures

- Monitoring Visit - Tour Schedule

- Photographs of Facilities

Andhra Pradesh Integrated Monitoring Report

Executive Summary

The integrated program monitoring visit for the first quarter of 2013 has covered the high focus districts of Visakhapatnam (Vizag) and Vizianagaram in 3 days.

Visit Findings and Critical Issues in facilities needing interventions:

Caseload of the facilities is varied. The caseloads in both the district hospitals of Anakapalle and Ghosha is very high, particularly the maternity OPD and IPD. Women from far flung interior areas visit these hospitals. Additional manpower to match the caseload, systems for OPD management, creating space for waiting areas with some minimum amenities are the need of the hour in the DHs. Caseloads in CHC Kotapadu and 24x7 PHC Devarapalli are relatively less.

Grievance redressal mechanism, privacy in maternal wards, biomedical waste management need attention. In the JSSK component, information availability / dissemination to the community in regard to the complete entitlements and transportation facilities to & from the Facility need to be streamlined. Diet provision services need to be reviewed and revamped for optimum utilization of services by the beneficiaries in both districts.

Some of the issues related to these facilities are non-availability of documentation (registers/ books) in an orderly and systematic manner (particularly those related to JSSK), lack of orientation to the concerned staff on the same, virtually non-functional laboratories at the Facilities e.g., the 24X7 PHC Pusapati Rega, absence of line-listing of JSSK beneficiaries in all the facilities, etc.

NBSUs and SNCUs are not properly put in place with a number of functional bottlenecks and some of them being only partially operational. The air-conditioners are not working in SNCUs (e.g.: DH Anakapalle & CHC Kotapadu, where there were two new-borns at the time of the visit); the staff is not oriented with regard to the requirement of proper ventilation and ideal temperature to be maintained for the infants in NBSU.

In the DHs, though scanners and other diagnostic equipment are available, they are underutilized due to non-availability of operating manpower on a consistent basis e.g., DH Anakapalle. Washrooms in maternity wards are available but dysfunctional in many cases such as 24x 7 PHC Pusapati Rega and PHC Devarapalli. Similarly, referral transport is not available in some facilities such as the 24x7 PHC Pusapati Rega and PHC Devarapalli.

IPHS formats are not filled in at any of the facilities. Laboratory systems need to be streamlined in terms of hygiene maintenance; records, addition of service components (such as blood grouping in some facilities) and bio-medical waste management should get strengthened.

Andhra Pradesh - Detailed Report on Monitoring Visit

Purpose

 Monitoring & Technical Assistance to high focus districts for planning and implementation of NRHM activities

 To assess the status of implementation of free and cashless services for delivery and referral transport for pregnant women and children under JSSK

Profile of the Districts - Geographical and Health

The integrated program monitoring visit for the first quarter of 2013 has covered the high focus districts of Visakhapatnam (Vizag) and Vizianagaram for three days. Details of Monitoring Program schedule is given in Annexure 1. Exit interview tools, facility checklists, interviews, and district level data are used to analyse the present status.

Vizianagaram

Vizianagaram District is bounded on the North by Chhattisgarh, on the South partly by Visakhapatnam District and partly by the Bay of Bengal, on the West partly by Odisha State (north- west) and on the East by Srikakulam District. The Sex Ratio is 1016 Females per 1000 Males. Scheduled Tribes account for 18% of the population in the district.

Visakhapatnam

Visakhapatnam (Vizag) District is one of the North Eastern Coastal districts of Andhra Pradesh. It is bounded on the North partly by the state of Odisha and partly by Vizianagaram District, on the South by East Godavari District, on the West by Odisha State and on the East by the Bay of Bengal. The Sex Ratio is 1003 Females per 1000 Males. The District has a Population Density of 384 per sq. km. Agency area shows lesser population density and plain area, higher density. 39.9%of the population resides in the 10 Hierarchic urban settlements while the rest of the population is distributed in 302 villages. Scheduled Castes constitute 7.6% of the population while Scheduled Tribes account for 14.55% of the population in the district.

Demographic and Health Indicators

Major demographic data and key Maternal & Child Health parameters are presented in Tables 1 and 2 below.

Table 1 - Demographic Fact Sheet for Visakhapatnam & Vizianagaram Districts

Visakhapatnam Vizianagaram Particulars / Parameters District District Persons 4,288,113 2,342,868 Population - Census - 2011 Male 2,140,872 1,161,913 Female 2,147,241 1,180,955 Population in the Persons 429,234 231,021 Age Group 0-6 - Male 218,923 118,149 Census - 2011 Female 210,311 112,872 Sex Ratio ( No. of Females per 1000 Males) 1,003 1,016 Sex Ratio 0 - 6 years 961 955 IMR (per thousand live births) 43 12.31 MMR( per one lakh population) 131 84.07 TFR 1.98 1.7 Persons 67.70 59.49 Literacy Rate (%) Male 75.47 69.04 - Census - 2011 Female 60.00 50.16 Population Density per sq. km 384 358

Table2 - Indicators in Maternal & Child Health

Visakhapatnam Vizianagaram Indicators (DLHS III) District District ANC ANC Check-up in First Trimester 59.7 57.8 3 or More ANC Check-up 76.4 82.6 Deliveries Institutional Delivery 59.8 56.9 Home Delivery 39.4 42

Home Delivery by SBA 1.3 7.4 New Born & Post Natal Care PNC within 48 Hours of Delivery 58.4 70.8 Immunisation Full Immunisation 60 55.4

Health Care Infrastructure:

Major infrastructure facilities / amenities available in the two districts is shown in Table 3. Table 4 shows the position vis-à-vis filled posts of ASHAs in the two districts.

Table 3 - Health Sector Infrastructure in Visakhapatnam and Vizianagaram Districts

Sl. No. Facility Visakhapatnam Vizianagaram

1 District Hospital 1 1 2 Area Hospital 1 1

3 No. of CHNCs 15 12

4 No. of CHC s 13 11 5 No. of PHCs 85 68

6 No. of Sub-centres 584 -

7 No. of 24 Hrs. PHCs 34 32

8 No. of Blood Banks 1 5 9 No. of BSUs 4 3

10 No. of ARSHs 59 31

11 No. of Ayush doctors 12 8 Source: DMHO/ DPMO Office, Visakhapatnam, Vizianagaram

Table 4 – ASHAs Visakhapatnam District Vizianagaram District Description Sanctioned In Position Vacant Sanctioned In Position Vacant Non-Tribal 3082 2628 - - - - Tribal 3106 3106 - - - - Total 6188 5734 454 2596 2450 146 Source: DMHO office Vizianagaram, Visakhapatnam

It is clear that more number of positions of ASHAs are vacant in Visakhapatnam.

Blood Banks & BSUs Two Blood Banks are available in Visakhapatnam district (DHs Anakapalle & KGH) and 4 BSUs in Araku, Paderu, Narsipatnam and Chintapalli Mandals.

In Vizianagaram district, Blood Banks are available in MR DH, Indian Red Cross Society facilities (at Vizianagaram and Parvathipuram), MIMs, and a Private facility. BSUs are available at CHCS of Saluru, Chipurupalli and S. Kota.

Key Observations

Facilities visited in Vizianagaram district are CHC Bhagapuram, PHC Pusapati Rega, SC village Tallapeta and DH Ghosha Hospital in Vizianagaram town. In Visakhapatnam district, the facilities visited are CHC Kotapadu, 24x7 PHC Devarapalli, sub-centre Chinna Gangavaram village, District Hospital in Anakapalle town and a normal PHC in Tallapalli Mandal. All facilities are in Government buildings.

Caseload of the facilities is varying. The caseloads in both the District Hospitals of Anakapalle and Ghosha is very high, particularly for the maternity OPD and IPD. Women from far flung, interior areas visit the hospital because specialist doctors and SNCU are available in these facilities. In the DH Anakapalle, gynaecology caseload is around 500 to 550 per day with about 10 deliveries and 3 C sections being conducted per day. During April 2012 - March 2013, a total of 2,085 normal deliveries, 1004 LSCs, and 434 sterilizations were conducted in the DH Anakapalle. The situation is more or less same in the DH Vizianagaram. The physical infrastructure such as waiting rooms, washrooms, basic equipment, etc.as well as the Human resources are not adequate to meet the caseload in both the District hospitals.

CHC Bhagapuram in Vizianagaram district has considerably high case load, with a general OPD of 250 to 300 per day, gynaecology caseload of minimum 30 per day, 45 to 50 deliveries per month and at least 3 to 5 C Sections per month. One fulltime Gynaecologist is available, with 2 other doctors on contract basis. The caseload in 24X & PHC Pupapati Rega is 80-100 general OPD, and 15-18 deliveries per month. At the time of visit there are no inpatients in the maternity wards. The NBSU is newly renovated and yet to be made operational.

Sub-Centres: Sub-centre, Tallapalli village under CHC Bhogapuram was visited and interviews with delivered women revealed that complete information about JSSK is lacking and post-delivery local dietary practices are different from the diet provided in the Facility.

CHC Kotapadu and CHNC Kotapadu in Visakhapatnam reported caseload of 30-40 deliveries per month and a general OPD caseload of 100 per day, which is relatively less. One of the In-patients wards is mixed for men and women. The caseload due to GE outbreak (at the time of visit) was quite high and as there was no separate ward available. Corridors of the facility were used for treating the patients. It calls for facility strengthening for management of emergency situations such as this.

24 x 7 PHC Devarapalli (in the same CHNC cluster) has a caseload of 15 - 20 deliveries on average per month. The facility had no doctor for some time and a gynaecologist on contract has been on rolls since two months. There was one pregnant woman at the time of the visit. The laboratory was not well maintained and there is no blood grouping facility available and hence pregnant women are referred to get this particular test done outside, during the ANCs. The NBSU is a newly opened one.

PHC Tallapalem (in Yelamanchili CHNC) has a caseload of 1 or 2 deliveries a month, gynaecology OP load of 30 cases on an average per day and an average load of 70 -75 general cases, equipped with a female gynaecologist , male doctor and two staff nurses.

Sub-centre, Chinna Gangavam, Devarapalli Mandalam: This is in an interior area on the foothills of tribal belt, with a number of widely spread hamlets, without adequate transport services. The ANM lives in a house combined with the sub-centre services. It is very small in size and is without

adequate room for providing the sub-centre’s services, particularly the services required to be provided to women folk.

Required Intervention: Intervention by the Authorities is a must in order to initiate steps towards ensuring adequate sub-centre services - covering as many provisions as possible.

Critical Issues in Facilities Requiring Interventions:

Some of the critical issues related to these facilities are:

 Available documentation of registers / books is not systematic (particularly those related to JSSK)

 No separate line-listing of JSSK beneficiaries exists in any of the facilities

 Respective staff need orientation to improve the above two aspect

 Laboratory is virtually not functional as in the case of 24 x 7 PHC Pusapati Rega

 NBSUs and SNCUs are not properly put in place in the sense that they are partially operational in some cases and there are also a few functional bottlenecks: the air-conditioner are not functional e.g., DH Anakapalle and CHC Kotapadu where there were two new-borns (at the time of the visit). The staff is not oriented with regard to the requirement of proper ventilation and ideal temperature to be maintained for the infants in NBSU.

 In the DHs, though scanners and other diagnostic equipment are available, they are underutilized because operating manpower is not consistently available e.g., DH Anakapalle; Washrooms in maternity wards are available but dysfunctional in many cases such as 24x 7 PHC Pusapati Rega and PHC Devarapalli. Similarly, referral transport is not available in some facilities such as the 24x7 PHC Devarapalli.

 IPHS formats are not filled in at any of the facilities.

 Laboratory systems need to be streamlined in terms of hygiene maintenance, records, addition of service components (such as blood grouping in some facilities) and bio-medical waste management should get strengthened

Interventions Required: Infrastructure in the DHs in both districts need to be strengthened based on a detailed situational analysis of the various facilities.

Common Issues Requiring Interventions

Privacy in Maternity Wards:

Privacy in maternity wards is absolutely lacking in all the facilities visited. In one facility, the In- patient ward is shared between male and female patients, without even screens (Kotapadu CHC) being used to segregate female beds. In both the District Hospitals, even with a high load of patients in maternity wards, there was no provision of any privacy, and male attendants as well as others like journalists are allowed without restrictions.

Display of Information Critical and adequate Information display about Citizens Rights, essential stock updating, HDS, etc. is not seen in any facility. It is totally lacking in some facilities like the CHC Kotapadu and 24x7 PHC Devarapalli. Citizen charts and drug lists are displayed only in some facilities such as Bhogapuram CHC and DH Ghosha Hospital in Vizianagaram.

Mechanisms for Grievance Redressal Grievance redressal mechanism is totally absent in all the facilities. Awareness about the need for grievance redressal mechanism is lacking among even the key functionaries of all the facilities visited. The system is not institutionalized nor is the procedure to be followed for registering complaints and rederessal mechanism displayed at the facilities. There is no documentation of complaints received.

Bio Medical Waste Management Only in the case of DH Anakapalle, there is a provision and an arrangement with a NGO named MARIDI, for Bio-medical waste management and there is none in the other facilities. It is noticed that awareness about the significance of biomedical waste management is invariably lacking among the lower rungs / para-medical staff such as staff nurses, OT staff as well as some laboratory staff. Protocols on the use of colour-coded bins for disposal of different medical wastes in critical areas such as OTs, Injection rooms are not properly observed even in the District Hospitals at Vizianagaram and Anakapalle.

Basic Amenities / Facilities Basic equipment are available in all facilities. Critical basic facilities/equipment required for C Section maternal cases such as tilting beds, western toilets, wheel chair-fitted commodes, and adequate bed pans are lacking in the facilities. Availability of these must be ensured on a priority basis.

Maternal Death Review: A total of 78 maternal deaths are reported in Visakhapatnam district during April 2012 - March 2013 out of which, 4 are from private hospitals. Thenumber of maternal deaths reported is 31 in Vizianagaram district (data from DMHO, Visakhapatnam & Vizianagaram). Among the known causes of maternal deaths in Visakhapatnam district in the period April 2011 – March 2012, bleeding and hypertension / fits constituted 33.3% while obstructed / prolonged labour constituted 22.2%. In the case of Vizianagaram district, among the known causes of maternal deaths during the same period (Apr 11 Mar 12), 66.7% constituted bleeding and severe hypertension while fits and high fever comprised 16.7% each (source: HMIS Analysis, NHSRC 2011-2012)

Maternal death review process is being carried out in both the districts with the help of a prescribed verbal autopsy format and identifying the causes of death is in process. 10

Causes of Infant Deaths: In Visakhapatnam district, the cause of 69% of the total reported infant and child deaths (during April 2011 to March 2012) is recorded under the ‘OTHERS’ thus showing just 31% of the reported infant & child deaths across the different known causes. Out of these known causes, 29% are attributed to Low Birth Weight (LBW) while Sepsis, Asphyxia and Fever related causes comprised 21% each, with Measles and Pneumonia shown to constitute 6% and 2%, respectively (HMIS Data Analysis, NHSRC).

The ‘OTHERS’ category of the known causes of infant and child deaths in Vizianagaram district during the same period (i.e., Apr 11 to Mar 12) is even higher at 79% thus showing data for only 21% across different known causes. Of the known causes identified, 51% are due to LBW and 23% are due to Asphyxia. Pneumonia and Fever related causes re the next major ones constituting 12% and 8% respectively, while the causes of Measles, Diarrhoea and Sepsis caused the infant & child deaths to the extent of only 3%, 2% and 1% respectively (HMIS Data Analysis, NHSRC).

Required Intervention: knowing the exact cause of death is important for the channelizing focus on remedial programmatic action. District level authorities should focus their efforts to strengthen the documentation of the infant mortality causes by the outreach staff. Community sensitization and mobilization is also an important segment in this course.

Performance of Facilities-JSSK Service Delivery

In Patient and Out Patient Services: The facility at CHC Bhagapuram has a considerable load of general cases with a 250-300 OPs per day, delivery case-load of 45-50 per month, C section case-load of 3-5 per month and Gynaecology related case-load of minimum 30 per day. In all the facilities visited, case-loads are considerably high. The DH, Ghosha Hospital at Vizianagaram and DH Anakapalle are found to have very high caseloads, but without adequate HR to meet the requirements.

Both OPD and IPD services are free of cost in all facilities visited, as revealed the exit interviews by cent per cent respondents as well as the through the checklist of ‘Facility level Monitoring of User Fees at Health Facilities’.

Out of 20 respondents, 19 had normal delivery and one underwent C. section in a CHC.

Awareness about the JSSK entitlements: Complete awareness about all entitlements of JSSK is lacking among most respondents. While only 40 per cent (8 out of 20 respondents) mentioned they are ‘aware’, 45 per cent (9) of them have mentioned that they are aware only partly/ partially, not details of entitlements and two of them said “aware only about JSY, but not specific entitlements in this program”. One of them mentioned she is not aware at all.

Source of Information: While only 50 per cent have mentioned that the source of information is ANM and ASHA in all, others mentioned that they came to know after reaching the facility providers such as nurse/ doctor, media and few of them through peers/ local neighbours who delivered in the recent past. This calls 11

for a systematic strategy imposition for implementation by field level outreach staff or change agents to ensure that community is aware of the entitlements.

Required Intervention: Information about entitlements therefore needs to be percolated down to the community.

Display of Entitlements: Display of entitlements needs strengthening by all facilities. A maximum of one or two poster/s are displayed in some facilities. However adequate number of these, in critical locations like maternal wards and labour room are lacking and need to be displayed in all facilities at all levels.

To Facility & Drop Back Transportation: Out of the 20 respondents, 55 % have used their own transport such as ‘auto’ as the common mode of transport to reach the Facility, and the rest have mentioned about the 108 Services. Awareness about the 108 Service as a free service to the health facility provided by the Government is wide spread among the community. However the special entitlement to pregnant women is not known.

Expenditure on Transportation: To reach the Facility, the mentioned out of pocket expense figures ranges between Rs. 25 to Rs. 300. Varied range in expenses can be due to the nature of the geographical terrain in both these districts, particularly in Visakhapatnam, with the presence of tribal populations in the up-hills and interior, difficult forest ranges, from where the travel takes time. The district hospitals in both Anakapalle and Vizianagaram (Ghosha Maternity Hospital) have many coming from far off hilly Mandal areas. Since the 108 Services are not adequate to meet the requirements, some of them explained that ‘when they call for 108, they respond saying it may take time to reach, and since they cannot wait till it reaches their point, they resort to autos/ tempo autos or similar such transport to reach the Facility. Some of them mentioned they were accompanied by a relative or / and ASHA worker and the cost of auto charge is high.

Drop Back from Facility: Awareness about the entitlement of free drop back from the Facility is totally lacking among 80 per cent of respondents in the exit interviews. Majority of them mentioned they intend to return home on their own using ‘autos’. Only about 30 per cent (6 out of 20) stated that they “intend to go by 108 Service, if available in time”. Possible expenses on account of own transport back to their houses is indicated in the range of Rs. 20 to Rs.250.

Required Interventions: Awareness about onward and free drop back entitlement needs to be spread. Again, though awareness about 108 Service as a free service is present among them, its availability and timely availability in particular, is a question mark and so they opt to go on their own. Policy intervention is imminent for ensuring adequate services for free drop back facility either through 108 Service or other means, particularly for communities living in difficult geographical terrains.

Drugs: Drugs are totally given free of cost in all the facilities visited as mentioned by majority of the respondents. Only one respondent mentioned that she paid for the provision of oxygen at the district hospital.

Diagnostics: Diagnostics are provided as free of cost as mentioned by most of the respondents in all facilities. Only two respondents mentioned they were referred to a designated private diagnostic centre for X- Ray services, but this was provided free of cost (in Kotapadu CHC). Only in one facility (24x7 PHC at Devarapalli), it is mentioned that blood group test service is not available at present and therefore cases are referred to get it done outside.

Required Interventions: Overall laboratories services need to strengthen in some facilities with sensitization on records & hygiene maintenance, adequate trainings and sensitization of lab staff on critical issues and performance.

Blood: Blood provision is provided free of cost in District level and CHC level facilities.

Diet Provision: Diet is outsourced by engaging either an internal staff or external agency (depending on the load of the requirement at the facility) and provided in all the facilities, with a variation in the menu. Most respondents mentioned that 3 meals- breakfast, lunch and dinner – are provided. Guideline on menu to be followed is provided by the District/ State Administration.

However, invariably, the diet provided is not consumed by the delivered patient, as reiterated by almost all the respondents. Patient’s diet is used by the accompanying attendants in many cases. Majority mentioned that they follow ‘cultural diet practices’ during this time and cannot eat anything on the first day and in some cases the first three days, and this is so even in the C sections cases as ‘bathing prior to taking regular/ routine diet is a must’. Therefore they buy items like tea/coffee, milk and bread on their own as their food instead of the meal provided at the Facility.

At the same time, it is equally important within this context, to assess the possible effects of not consuming any diet for first three after delivery/ c section on health and breast feeding part,.

Out of Pocket Expenses for Food: Most of them incur out of pocket expenses for patient food and in a few cases for them together with their attendant’s food. 55% mentioned they spend approximately in the range of Rs.20 to Rs. 60 per day, while three respondents said they spend a per day expenditure of Rs.100 to Rs. 150. Four of them mentioned they bought food, but not sure of the amount since their ‘spouses paid for it’.

Required Intervention: A baseline study at the district level, to highlight the local cultural practices to arrive at existing dietary practices after delivery and post natal period is necessary. Accordingly diet provision needs to be tuned. Alternatively facility level rapid surveys are to be conducted to understand the dietary preferences to be followed with provision. Such an intervention would pave the way for optimum utilization of existing budget for diet provision by mothers.

Annexure 1

Monitoring Visit to Andhra Pradesh – Vizianagaram & Visakhapatnam April 2013 Tour Schedule

Day Activity Visiting Persons

Day 1 Journey from Visakhapatnam to Vizianagaram Dr. Shashikala, NHSRC 24.04.2013 District Ramanuja Naidu, Bhogapuram CHNC, Bhogapuram CHC DPM, Vizianagaram district

From Bhogapuram to Poosapati Rega 24x7PHC (P. Rega Mandal / Block) Journey from Poosapati Rega PHC to Sub-centre Village

Tallapeta Village Vizianagaram DH Ghosha Hospital

Vizianagaram DMHO Office ( feedback) to Dr. Shashikala DMHO, Dr. Swarajya Lakshmi DPM, Vizianagaram District

Day 2 Visakhapatnam to Dr. Shashikala & Kotapadu Mandal /CHNC & CHC Kotapadu 25.04.2013 Mr. Jagdish, DPM Vizag Kotapadu Mandal to Devarapalli Mandal 24 x 7 PHC Devarapalli Devarapalli PHC to Chinna Gangavaram Sub centre Chinna Gangavaram to Visakhapatnam

Day 3 Visakhapatnam to DH Anakapalle , Dr. Shashikala& 26.04.2013 (Anakapalle CHNC) Mr. Jagdish, DPM Vizag Anakapalle to PHC at Tallapalem

Visakhapatnam DMHO , to Meet & brief Dr. Shashikala& Dr. Mrs. Reddy Shyamala Mr. Jagdish, DPM Vizag Day 4 Technical Brief to MD, NRHM & JSSK Nodal Officer Dr. Shashikala Dr. Govardhan Reddy

Annexure 2

Photographs of Facilities Visited

Gynaecology OPD in DH Anakapalle (only a partial view of the OPD) lacking Adequate Facilities

Sub Centre with ANM in China Gangavaram Village, Visakhapatnam (near the foothills of tribal area)

DH Ghosha Hospital, Vizianagaram - Maternity In-Patient Ward without Privacy for Patients

Dysfunctional Laboratory in a 24x7 PHC, Pusapati Rega, Vizianagaram District

Andhra Pradesh

April 12 - Jan 13

Comparison with Last Year Performance using HMIS data from National Web portal 18 National Health Systems Resource Centre

Andhra Pradesh - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) 8,46,65,533 ANC Pregnancies 17,05,407 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 15,50,370 67.3 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 69714 15,15,513 Births 3 or more ANC Check-up 89.4 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 1,43,93,141 15% of 2,55,811 Atleast 1 TT received 92.4 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 45.7 Jan'13 2012 - 13 12 3ANC Check up against 64% 77% 86% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 57% 69% 95% Institutional Delivery 71.8 estimated deliveries

Met need for EmOC * 91.51% 110% 141.27% Home Delivery 27.8 Reported Live Births against estimated Live 74% 88% 101% Home Delivery by SBA 3.8 Births BCG to Measles dropout 3% 3% 3% New born & post natal care rate Fully Immunised against 75% 91% 94% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 80% 80% 81% Still Birth 0.9 as % of required VHNDs Childhood Disease 183 219.6 102 Live Birth 94 Diphtheria Childhood Disease Breastfed within 1 hour of 51 61.2 50 47.5 Pertussis birth Childhood Disease 2745 3294 551 Measles PNC within 48 hrs of delivery Childhood Disease 6201 7441.2 1973 Malaria Immunisation Sterilization - Female per BCG 97.3 1000 eligible couple 23.39 28.07 36.68 Sterilization - Male per DPT3 78.7 1000 eligible couple 0.53 0.63 0.94 Reported Abortion Rate per 1000 Estimated live 15.2 19.9 18.3 Measeles 88.4 births OPD All (per 1000 483.5 557.6 Full immunisation 66.7 population) 580.2

IPD (per 1000 population) 19.4 21.9 23.3 Unmet need for Family Planning Operation Major (per 428.3 111.546 Lakh population) 514.0 Spacing 4.1 Reported Infant and Child 10177 14343 Deaths 12,212.4 Limiting 4 Reported Maternal 911 95 Deaths 1,093.2 Total 8.1 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Adilabad - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 27,37,738 Pregnancies 55,146 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 50,133 56.7 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2254 49,006 Births 3 or more ANC Check-up 79.2 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 4,65,415 15% of 8,272 Atleast 1 TT received 82.7 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 35 Jan'13 2012 - 13 12 3ANC Check up against 96% 115% 112% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 66% 80% 93% Institutional Delivery 43.2 estimated deliveries Met need for EmOC * 100.76% 121% 104.32% Home Delivery 55 Reported Live Births against estimated Live 99% 119% 110% Home Delivery by SBA 2.9 Births BCG to Measles dropout 6% 6% 8% New born & post natal care rate Fully Immunised against 118% 141% 101% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held as % of required 90% 90% 108% Still Birth 0 VHNDs Childhood Disease 2 2.4 0 Diphtheria Live Birth 97.4 Childhood Disease Breastfed within 1 hour of 0 0 0 35.6 Pertussis birth Childhood Disease 96 115.2 15 Measles PNC within 48 hrs of delivery 36 Childhood Disease 110 132 0 Malaria Immunisation Sterilization - Female per BCG 92.9 1000 eligible couple 12.27 14.72 26.88 Sterilization - Male per DPT3 70.9 1000 eligible couple 0.43 0.52 1.74 Reported Abortion Rate per 1000 Estimated live 20.0 8.7 23.9 Measeles 73.6 births OPD All (per 1000 716.2 584.5 population) 859.5 Full immunisation 55.8

IPD (per 1000 population) 64.1 94.7 77.0 Unmet need for Family Planning Operation Major (per 0.0 0.000 Lakh population) - Spacing 4.2 Reported Infant and Child 334 496 Deaths 400.8 Limiting 7.6 Reported Maternal 12 0 Deaths 14.4 Total 11.8 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Anantpur - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) 40,83,315 ANC Pregnancies 82,250 Estimated CBR (SRS-2011) 74,772 17.9 Deliveries ANC Check-up in first trimester 64.8 Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 3362 73,091 Births 3 or more ANC Check-up 86.1 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples ( Complications( 6,94,164 17% of population) 15% of 12,337 Atleast 1 TT received 95.7 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 41 Jan'13 2012 - 13 12 3ANC Check up against 73% 87% 100% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 47% 56% 104% Institutional Delivery 66.7 estimated deliveries Met need for EmOC * 29.41% 35% 65.91% Home Delivery 31.7 Reported Live Births against estimated Live 64% 77% 108% Home Delivery by SBA 4.7 Births BCG to Measles dropout 0% 0% 4% New born & post natal care rate Fully Immunised against 83% 99% 102% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 70% 70% 78% Still Birth 2 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 91.3 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 54 Pertussis birth Childhood Disease Measles 119 142.8 0 PNC within 48 hrs of delivery 69.6 Childhood Disease Malaria 326 391.2 0 Immunisation Sterilization - Female per BCG 97.9 1000 eligible couple 21.92 26.31 40.86 Sterilization - Male per DPT3 92.8 1000 eligible couple 0.01 0.01 0.05 Reported Abortion Rate per 1000 Estimated live 8.1 14.7 9.7 Measeles 94.7 births OPD All (per 1000 882.0 1,058.4 1171.9 population) Full immunisation 71.2

IPD (per 1000 population) 27.6 45.9 33.2 Unmet need for Family Planning Operation Major (per Lakh 45.4 0.000 population) 54.5 Spacing 4.5 Reported Infant and Child 210 431 Deaths 252.0 Limiting 4

Reported Maternal Deaths 30 4 36.0 Total 8.5 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Chittoor - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) 41,70,468 ANC Pregnancies 84,005 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 76,368 64.3 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 3434 74,651 Births 3 or more ANC Check-up 90.5 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 7,08,980 15% of 12,601 Atleast 1 TT received 94.6 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 39.6 Jan'13 2012 - 13 12 3ANC Check up against 58% 70% 91% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 44% 53% 97% Institutional Delivery 74.1 estimated deliveries Met need for EmOC * 34.72% 42% 67.65% Home Delivery 25 Reported Live Births against estimated Live 49% 59% 100% Home Delivery by SBA 6.1 Births BCG to Measles dropout 5% 5% 2% New born & post natal care rate Fully Immunised against 73% 87% 97% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 116% 116% 116% Still Birth 0 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 92.6 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 62.8 Pertussis birth Childhood Disease 255 306 0 Measles PNC within 48 hrs of delivery 76.6 Childhood Disease 43 51.6 0 Malaria Immunisation Sterilization - Female per BCG 99.4 1000 eligible couple 20.39 24.46 38.69 Sterilization - Male per DPT3 70.7 1000 eligible couple 0.01 0.02 0.03 Reported Abortion Rate per 1000 Estimated live 18.2 26.0 21.9 Measeles 88.5 births OPD All (per 1000 626.5 640.4 population) 751.8 Full immunisation 62

IPD (per 1000 population) 25.6 22.8 30.7 Unmet need for Family Planning Operation Major (per 6537.9 36.399 Lakh population) 7,845.5 Spacing 3.2 Reported Infant and Child 495 639 Deaths 594.0 Limiting 5.1 Reported Maternal 52 3 Deaths 62.4 Total 8.3 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

East Godavari - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) 51,51,549 ANC Pregnancies 1,03,767 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 94,334 53.8 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 4242 92,213 Births 3 or more ANC Check-up 89.8 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 8,75,763 15% of 15,565 Atleast 1 TT received 94.9 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 30.2 Jan'13 2012 - 13 12 3ANC Check up against 57% 69% 71% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 69% 83% 92% Institutional Delivery 86.6 estimated deliveries

Met need for EmOC * 87.06% 104% 175.62% Home Delivery 13.4 Reported Live Births against estimated Live 76% 91% 95% Home Delivery by SBA 5.6 Births BCG to Measles dropout 6% 6% 6% New born & post natal care rate Fully Immunised against 70% 84% 82% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 63% 63% 59% Still Birth 0.1 as % of required VHNDs Childhood Disease 73 87.6 40 Live Birth 96.6 Diphtheria Childhood Disease Breastfed within 1 hour of 10 12 18 65.2 Pertussis birth Childhood Disease Measles 7 8.4 134 PNC within 48 hrs of delivery 93.1 Childhood Disease Malaria 12 14.4 80 Immunisation Sterilization - Female per BCG 99.8 1000 eligible couple 24.81 29.78 32.43 Sterilization - Male per DPT3 72.1 1000 eligible couple 0.58 0.69 0.68 Reported Abortion Rate per 1000 Estimated live 16.3 15.4 19.6 Measeles 90 births OPD All (per 1000 376.6 371.8 population) 452.0 Full immunisation 65.4

IPD (per 1000 population) 27.6 31.3 33.1 Unmet need for Family Planning Operation Major (per 253.8 309.829 Lakh population) 304.5 Spacing 3.8 Reported Infant and Child 248 456 Deaths 297.6 Limiting 1.6

Reported Maternal Deaths 23 1 27.6 Total 5.4 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication 23

Guntur - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 48,89,230 Pregnancies 98,483 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 89,530 68.1 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 4026 87,517 Births 3 or more ANC Check-up 88 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples ( Complications( 17% of population) 8,31,169 14,772 Atleast 1 TT received 97 15% of Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 43.8 Jan'13 2012 - 13 12 3ANC Check up against 60% 72% 90% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 73% 88% 98% Institutional Delivery 77.8 estimated deliveries

Met need for EmOC * 91.73% 110% 147.42% Home Delivery 20.1 Reported Live Births against estimated Live 80% 96% 99% Home Delivery by SBA 5.1 Births BCG to Measles dropout 6% 6% 6% New born & post natal care rate Fully Immunised against 74% 89% 92% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 66% 66% 60% Still Birth 2.1 as % of required VHNDs Childhood Disease 73 87.6 8 Live Birth 90.6 Diphtheria Childhood Disease Breastfed within 1 hour of 10 12 0 51.6 Pertussis birth Childhood Disease Measles 7 8.4 22 PNC within 48 hrs of delivery 81.2 Childhood Disease Malaria 12 14.4 23 Immunisation Sterilization - Female per 31.37 BCG 97.3 1000 eligible couple 26.14 46.62 Sterilization - Male per 0.73 DPT3 77.9 1000 eligible couple 0.61 0.38 Reported Abortion Rate per 1000 Estimated live 17.2 20.6 26.4 Measeles 92.8 births OPD All (per 1000 396.9 476.2 594.8 Full immunisation 59.4 population) IPD (per 1000 population) 29.0 34.8 19.2 Unmet need for Family Planning Operation Major (per Lakh 267.4 320.9 91.896 population) Spacing 4 Reported Infant and Child 248 297.6 1070 Deaths Limiting 3.2 Reported Maternal Deaths 23 27.6 2 Total 7.2 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Hyderabad - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 40,10,238 Pregnancies 80,778 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 73,434 86.2 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 3302 71,783 Births 3 or more ANC Check-up 98 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 6,81,740 15% of 12,117 Atleast 1 TT received 100 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 55.8 Jan'13 2012 - 13 12 3ANC Check up against 68% 82% 104% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 78% 93% 115% Institutional Delivery 95.6 estimated deliveries Met need for EmOC * 156.36% 188% 209.32% Home Delivery 4.5 Reported Live Births against estimated Live 79% 94% 118% Home Delivery by SBA 1.4 Births BCG to Measles dropout 3% 3% -1% New born & post natal care rate Fully Immunised against 75% 90% 112% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held as % of required 32% 32% 34% Still Birth 0 VHNDs Childhood Disease 0 0 0 Live Birth 96.4 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 40.7 Pertussis birth Childhood Disease 0 0 0 Measles PNC within 48 hrs of delivery 80.6 Childhood Disease 1 1.2 0 Malaria Immunisation Sterilization - Female per BCG 98.4 1000 eligible couple 27.53 33.03 42.06 Sterilization - Male per DPT3 80.7 1000 eligible couple 0.41 0.49 0.56 Reported Abortion Rate per 1000 Estimated live 25.2 71.3 30.3 Measeles 90.6 births OPD All (per 1000 233.7 212.1 population) 280.4 Full immunisation 68.4

IPD (per 1000 population) 6.8 17.1 8.2 Unmet need for Family Planning Operation Major (per 209.6 116.801 Lakh population) 251.5 Spacing 4.4 Reported Infant and Child 86 92 Deaths 103.2 Limiting 4.7 Reported Maternal 35 3 Deaths 42.0 Total 9.1 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Karimnagar - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 38,11,738 Pregnancies 76,779 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 69,799 85.1 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 3139 68,230 Births 3 or more ANC Check-up 97.3 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 6,47,995 15% of 11,517 Atleast 1 TT received 97.7 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 57.5 Jan'13 2012 - 13 12 3ANC Check up against 68% 82% 91% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 46% 55% 106% Institutional Delivery 89.2 estimated deliveries Met need for EmOC * 171.67% 206% 361.22% Home Delivery 9.6 Reported Live Births against estimated Live 72% 87% 113% Home Delivery by SBA 2.9 Births BCG to Measles dropout 0% 0% 3% New born & post natal care rate Fully Immunised against 102% 123% 105% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held as % of required 69% 69% 58% Still Birth 1.1 VHNDs Childhood Disease 45 54 0 Live Birth 95.3 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 28 Pertussis birth Childhood Disease 140 168 0 Measles PNC within 48 hrs of delivery 93.2 Childhood Disease 1645 1974 0 Malaria Immunisation Sterilization - Female per BCG 94.8 1000 eligible couple 12.23 14.68 30.83 Sterilization - Male per DPT3 92.5 1000 eligible couple 3.37 4.04 7.21 Reported Abortion Rate per 1000 Estimated live 14.2 7.0 17.1 Measeles 94.8 births OPD All (per 1000 388.7 384.8 population) 466.4 Full immunisation 82.5 IPD (per 1000 19.3 19.0 population) 23.2 Unmet need for Family Planning Operation Major (per 103.1 35.233 Lakh population) 123.7 Spacing 5.7 Reported Infant and Child 272 779 Deaths 326.4 Limiting 4.3 Reported Maternal 140 0 Deaths 168.0 Total 10 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Khammam - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 27,98,214 Pregnancies 56,364 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 51,240 63.9 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2304 50,088 Births 3 or more ANC Check-up 89.8 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 4,75,696 15% of 8,455 Atleast 1 TT received 95.2 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 46.3 Jan'13 2012 - 13 12 3ANC Check up against 49% 59% 70% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 76% 91% 97% Institutional Delivery 69.2 estimated deliveries Met need for EmOC * 241.92% 290% 233.64% Home Delivery 30.3 Reported Live Births against estimated Live 80% 96% 100% Home Delivery by SBA 1.3 Births BCG to Measles dropout 6% 6% 7% New born & post natal care rate Fully Immunised against 57% 69% 93% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 105% 105% 94% Still Birth 0.5 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 97.7 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 58 Pertussis birth Childhood Disease 0 0 0 Measles PNC within 48 hrs of delivery 75.0 Childhood Disease 0 0 623 Malaria Immunisation Sterilization - Female per BCG 100 1000 eligible couple 28.23 33.88 34.32 Sterilization - Male per DPT3 74.5 1000 eligible couple 0.26 0.31 0.45 Reported Abortion Rate per 1000 Estimated live 0.5 5.9 0.6 Measeles 96.4 births OPD All (per 1000 1019.8 1431.2 population) 1,223.8 Full immunisation 66.7

IPD (per 1000 population) 43.3 68.7 52.0 Unmet need for Family Planning Operation Major (per 164.6 164.855 Lakh population) 197.5 Spacing 1.7 Reported Infant and Child 401 624 Deaths 481.2 Limiting 1.9 Reported Maternal 20 0 Deaths 24.0 Total 3.5 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Krishna - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) 45,29,009 ANC Pregnancies 91,227 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 82,934 76.6 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 3729 81,069 Births 3 or more ANC Check-up 98.3 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 7,69,932 15% of 13,684 Atleast 1 TT received 98.2 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 42.2 Jan'13 2012 - 13 12 3ANC Check up against 57% 68% 80% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 59% 71% 89% Institutional Delivery 84 estimated deliveries Met need for EmOC * 101.18% 121% 122.73% Home Delivery 16.2 Reported Live Births against estimated Live 65% 78% 91% Home Delivery by SBA 3.9 Births BCG to Measles dropout 6% 6% 1% New born & post natal care rate Fully Immunised against 63% 76% 89% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 52% 52% 59% Still Birth 0.6 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 96 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 52.5 Pertussis birth Childhood Disease Measles 0 0 2 PNC within 48 hrs of delivery 92.5 Childhood Disease Malaria 66 79.2 0 Immunisation Sterilization - Female per BCG 98.6 1000 eligible couple 24.96 29.95 33.87 Sterilization - Male per DPT3 93.2 1000 eligible couple 0.28 0.34 0.50 Reported Abortion Rate per 1000 Estimated live 10.2 11.9 12.2 Measeles 96.9 births OPD All (per 1000 190.8 331.7 population) 229.0 Full immunisation 82.9

IPD (per 1000 population) 8.3 7.8 10.0 Unmet need for Family Planning Operation Major (per 75.9 471.759 Lakh population) 91.1 Spacing 4.7 Reported Infant and Child 344 388 Deaths 412.8 Limiting 2.1

Reported Maternal Deaths 22 0 26.4 Total 6.8 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Kurnool - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) 40,46,601 ANC Pregnancies 81,510 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 74,100 53.3 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 3332 72,434 Births 3 or more ANC Check-up 81.8 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 6,87,922 15% of 12,227 Atleast 1 TT received 86.6 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 39.8 Jan'13 2012 - 13 12 3ANC Check up against 73% 87% 105% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 53% 64% 89% Institutional Delivery 61.5 estimated deliveries

Met need for EmOC * 56.54% 68% 79.43% Home Delivery 38.3 Reported Live Births against estimated Live 86% 103% 111% Home Delivery by SBA 3.7 Births BCG to Measles dropout 3% 3% 4% New born & post natal care rate Fully Immunised against 83% 100% 101% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 74% 74% 68% Still Birth 0.7 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 93.8 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 52.2 Pertussis birth Childhood Disease Measles 200 240 54 PNC within 48 hrs of delivery 65.5 Childhood Disease Malaria 59 70.8 6 Immunisation Sterilization - Female per BCG 97.7 1000 eligible couple 23.23 27.88 37.13 Sterilization - Male per DPT3 68.3 1000 eligible couple 0.00 0.00 0.01 Reported Abortion Rate per 1000 Estimated live 24.1 22.2 28.9 Measeles 84.9 births OPD All (per 1000 417.4 470.3 Full immunisation 54.7 population) 500.8

IPD (per 1000 population) 21.2 22.8 25.5 Unmet need for Family Planning Operation Major (per 85.8 102.209 Lakh population) 103.0 Spacing 5.1 Reported Infant and Child 799 1277 Deaths 958.8 Limiting 3.5

Reported Maternal Deaths 52 12 62.4 Total 8.6 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Mahbubnagar - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 40,42,191 Pregnancies 81,421 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 74,019 62 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 3328 72,355 Births 3 or more ANC Check-up 87.3 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 6,87,172 15% of 12,213 Atleast 1 TT received 92.8 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 45.2 Jan'13 2012 - 13 12 3ANC Check up against 63% 76% 85% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 63% 75% 88% Institutional Delivery 66.6 estimated deliveries Met need for EmOC * 106.10% 127% 119.85% Home Delivery 32.8 Reported Live Births against estimated Live 71% 85% 98% Home Delivery by SBA 4.5 Births BCG to Measles dropout -5% -5% 3% New born & post natal care rate Fully Immunised against 75% 90% 93% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 101% 101% 108% Still Birth 2.6 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 89.9 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 40.2 Pertussis birth Childhood Disease 289 346.8 264 Measles PNC within 48 hrs of delivery 72.6 Childhood Disease 30 36 25 Malaria Immunisation Sterilization - Female per BCG 100 1000 eligible couple 22.35 26.82 35.49 Sterilization - Male per DPT3 85.7 1000 eligible couple 0.01 0.01 0.05 Reported Abortion Rate per 1000 Estimated live 14.4 13.0 17.2 Measeles 89.8 births OPD All (per 1000 401.8 523.9 population) 482.2 Full immunisation 68.3

IPD (per 1000 population) 10.1 8.2 12.1 Unmet need for Family Planning Operation Major (per 0.4 2.746 Lakh population) 0.5 Spacing 4.3 Reported Infant and Child 902 896 Deaths 1,082.4 Limiting 4.2 Reported Maternal 49 10 Deaths 58.8 Total 8.5 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Medak - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 30,31,877 Pregnancies 61,071 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 55,519 80.3 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2496 54,271 Births 3 or more ANC Check-up 93.2 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 5,15,419 15% of 9,161 Atleast 1 TT received 96.3 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 42.4 Jan'13 2012 - 13 12 3ANC Check up against 65% 79% 91% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 62% 75% 91% Institutional Delivery 75 estimated deliveries

Met need for EmOC * 101.89% 122% 189.75% Home Delivery 24.8 Reported Live Births against estimated Live 72% 87% 97% Home Delivery by SBA 2.3 Births BCG to Measles dropout 1% 1% 2% New born & post natal care rate Fully Immunised against 71% 85% 90% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 81% 81% 79% Still Birth 2.4 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 94.8 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 46.1 Pertussis birth Childhood Disease 2 2.4 1 Measles PNC within 48 hrs of delivery 73.9 Childhood Disease Malaria 5 6 0 Immunisation Sterilization - Female per BCG 98.9 1000 eligible couple 33.70 40.44 36.65 Sterilization - Male per DPT3 88.4 1000 eligible couple 0.06 0.07 0.23 Reported Abortion Rate per 1000 Estimated live 15.5 72.9 18.6 Measeles 97.3 births OPD All (per 1000 564.9 860.1 population) 677.9 Full immunisation 82.8

IPD (per 1000 population) 26.0 30.8 31.2 Unmet need for Family Planning Operation Major (per 174.1 141.068 Lakh population) 208.9 Spacing 5.1 Reported Infant and Child 806 925 Deaths 967.2 Limiting 4.1

Reported Maternal Deaths 41 15 49.2 Total 9.2 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Nalgonda - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) 34,83,648 ANC Pregnancies 70,171 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 63,792 70.5 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2868 62,357 Births 3 or more ANC Check-up 95.7 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 5,92,220 15% of 10,526 Atleast 1 TT received 98.5 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 42.2 Jan'13 2012 - 13 12 3ANC Check up against 71% 85% 77% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 42% 51% 86% Institutional Delivery 75 estimated deliveries

Met need for EmOC * 132.49% 159% 200.12% Home Delivery 25.1 Reported Live Births against estimated Live 77% 93% 93% Home Delivery by SBA 1.7 Births BCG to Measles dropout 4% 4% -11% New born & post natal care rate Fully Immunised against 88% 105% 99% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 107% 107% 99% Still Birth 0.2 as % of required VHNDs Childhood Disease 1 1.2 0 Live Birth 92.1 Diphtheria Childhood Disease Breastfed within 1 hour of 1 1.2 0 32.1 Pertussis birth Childhood Disease 457 548.4 0 Measles PNC within 48 hrs of delivery 84.5 Childhood Disease Malaria 360 432 2 Immunisation Sterilization - Female per BCG 100 1000 eligible couple 16.05 19.27 32.13 Sterilization - Male per DPT3 80.1 1000 eligible couple 0.19 0.22 0.08 Reported Abortion Rate per 1000 Estimated live 28.7 18.3 34.4 Measeles 99.4 births OPD All (per 1000 530.9 432.6 population) 637.0 Full immunisation 73.2

IPD (per 1000 population) 25.7 19.1 30.8 Unmet need for Family Planning Operation Major (per 97.5 187.017 Lakh population) 117.0 Spacing 3.4 Reported Infant and Child 377 612 Deaths 452.4 Limiting 4.9

Reported Maternal Deaths 27 4 32.4 Total 8.2 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Nellore - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 29,66,082 Pregnancies 59,745 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 54,314 71.8 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2442 53,093 Births 3 or more ANC Check-up 92.3 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 5,04,234 15% of 8,962 Atleast 1 TT received 92.5 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 46 Jan'13 2012 - 13 12 3ANC Check up against 47% 57% 82% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 34% 41% 89% Institutional Delivery 88.4 estimated deliveries Met need for EmOC * 29.93% 36% 100.02% Home Delivery 11.3 Reported Live Births against estimated Live 53% 64% 94% Home Delivery by SBA 1.6 Births BCG to Measles dropout -2% -2% 3% New born & post natal care rate Fully Immunised against 57% 69% 88% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 111% 111% 136% as % of required VHNDs Still Birth 0 Childhood Disease 0 0 0 Diphtheria Live Birth 93.7 Childhood Disease Breastfed within 1 hour of 0 0 0 53.5 Pertussis birth Childhood Disease Measles 82 98.4 0 PNC within 48 hrs of delivery 83.7 Childhood Disease Malaria 331 397.2 0 Immunisation Sterilization - Female per BCG 96.5 1000 eligible couple 24.00 28.80 42.31 Sterilization - Male per DPT3 78.3 1000 eligible couple 0.05 0.06 0.20 Reported Abortion Rate per 1000 Estimated live 7.1 10.1 8.5 Measeles 87.6 births OPD All (per 1000 440.8 1018.0 population) 529.0 Full immunisation 55.6

IPD (per 1000 population) 5.2 7.2 6.3 Unmet need for Family Planning Operation Major (per 104.1 61.158 Lakh population) 124.9 Spacing 2.3 Reported Infant and Child 257 540 Deaths 308.4 Limiting 5

Reported Maternal Deaths 20 4 24.0 Total 7.4 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Nizamabad - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) 25,52,073 ANC Pregnancies 51,406 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 46,733 83.4 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2101 45,682 Births 3 or more ANC Check-up 95.3 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 4,33,852 15% of 7,711 Atleast 1 TT received 96 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 46.9 Jan'13 2012 - 13 12 3ANC Check up against 72% 87% 89% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 77% 93% 101% Institutional Delivery 83.4 estimated deliveries

Met need for EmOC * 151.58% 182% 195.39% Home Delivery 16 Reported Live Births against estimated Live 80% 96% 104% Home Delivery by SBA 3.4 Births BCG to Measles dropout -2% -2% 0% New born & post natal care rate Fully Immunised against 73% 87% 98% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 65% 65% 74% Still Birth 1.3 as % of required VHNDs Childhood Disease 0 0 32 Live Birth 96.8 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 32 27.2 Pertussis birth Childhood Disease 0 0 0 Measles PNC within 48 hrs of delivery 79.8 Childhood Disease 0 0 0 Malaria Immunisation Sterilization - Female per BCG 98.7 1000 eligible couple 42.27 50.73 51.41 Sterilization - Male per DPT3 90.1 1000 eligible couple 0.65 0.78 0.33 Reported Abortion Rate per 1000 Estimated live 19.2 18.9 23.0 Measeles 92.3 births OPD All (per 1000 254.8 451.0 Full immunisation 78.1 population) 305.8

IPD (per 1000 population) 3.4 7.5 4.0 Unmet need for Family Planning Operation Major (per 3.8 0.313 Lakh population) 4.6 Spacing 6.4 Reported Infant and Child 351 409 Deaths 421.2 Limiting 4.1 Reported Maternal 22 4 Deaths 26.4 Total 10.6 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Prakasam - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 33,92,764 Pregnancies 68,340 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 62,127 62.9 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2794 60,730 Births 3 or more ANC Check-up 84.6 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 5,76,770 15% of 10,251 Atleast 1 TT received 95.1 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 43.4 Jan'13 2012 - 13 12 3ANC Check up against 59% 70% 78% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 53% 63% 87% Institutional Delivery 76.1 estimated deliveries

Met need for EmOC * 80.52% 97% 93.22% Home Delivery 23.7 Reported Live Births against estimated Live 72% 87% 99% Home Delivery by SBA 3.5 Births BCG to Measles dropout 2% 2% 8% New born & post natal care rate Fully Immunised against 69% 83% 88% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 123% 123% 134% Still Birth 0.1 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 93.6 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 40.6 Pertussis birth Childhood Disease 87 104.4 6 Measles PNC within 48 hrs of delivery 78.1 Childhood Disease Malaria 304 364.8 1 Immunisation Sterilization - Female per BCG 100 1000 eligible couple 24.82 29.78 37.28 Sterilization - Male per DPT3 62 1000 eligible couple 0.03 0.04 0.07 Reported Abortion Rate per 1000 Estimated live 16.4 17.8 19.7 Measeles 94.1 births OPD All (per 1000 356.0 267.4 Full immunisation 58.5 population) 427.2

IPD (per 1000 population) 13.3 13.5 16.0 Unmet need for Family Planning Operation Major (per 104.3 79.581 Lakh population) 125.1 Spacing 3.4 Reported Infant and Child 476 710 Deaths 571.2 Limiting 3.7

Reported Maternal Deaths 32 8 38.4 Total 7 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Rangareddy - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 52,96,396 Pregnancies 1,06,685 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 96,986 74.7 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 4361 94,805 Births 3 or more ANC Check-up 97 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 9,00,387 15% of 16,003 Atleast 1 TT received 98.6 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 51.9 Jan'13 2012 - 13 12 3ANC Check up against 63% 76% 96% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 53% 64% 104% Institutional Delivery 87.1 estimated deliveries Met need for EmOC * 78.02% 94% 118.85% Home Delivery 12.3 Reported Live Births against estimated Live 67% 81% 108% Home Delivery by SBA 1.7 Births BCG to Measles dropout -6% -6% -4% New born & post natal care rate Fully Immunised against 69% 83% 107% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 47% 47% 53% Still Birth 1 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 95 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 40.8 Pertussis birth Childhood Disease 330 396 2 Measles PNC within 48 hrs of delivery 90.6 Childhood Disease 168 201.6 0 Malaria Immunisation Sterilization - Female per BCG 98 1000 eligible couple 17.27 20.72 35.06 Sterilization - Male per DPT3 92.4 1000 eligible couple 0.06 0.08 0.32 Reported Abortion Rate per 1000 Estimated live 0.5 0.3 0.6 Measeles 90.2 births OPD All (per 1000 227.5 294.2 population) 273.0 Full immunisation 77.5

IPD (per 1000 population) 5.0 3.0 6.0 Unmet need for Family Planning Operation Major (per 30.5 41.726 Lakh population) 36.6 Spacing 3.6 Reported Infant and Child 331 696 Deaths 397.2 Limiting 4.3 Reported Maternal 22 0 Deaths 26.4 Total 7.9 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Srikakulum - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 26,99,471 Pregnancies 54,375 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 49,432 66.6 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2223 48,321 Births 3 or more ANC Check-up 92.6 from SRS - 2011 ) Estimated Maternal Estimated Eligible Complications( couples ( 17% of 4,58,910 15% of 8,156 Atleast 1 TT received 92.9 population) Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 52.8 Jan'13 2012 - 13 12 3ANC Check up against 54% 64% 82% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 50% 60% 82% Institutional Delivery 56.6 estimated deliveries Met need for EmOC * 36.27% 44% 113.59% Home Delivery 42 Reported Live Births against estimated Live 63% 76% 97% Home Delivery by SBA 13.6 Births BCG to Measles dropout 0% 0% -1% New born & post natal care rate Fully Immunised against 65% 79% 93% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held as % of required 75% 75% 93% Still Birth 0.6 VHNDs Childhood Disease 0 0 12 Diphtheria Live Birth 92.8 Childhood Disease Breastfed within 1 hour of 0 0 0 55 Pertussis birth Childhood Disease 13 15.6 1 Measles PNC within 48 hrs of delivery 75.0 Childhood Disease 32 38.4 91 Malaria Immunisation Sterilization - Female per BCG 97.6 1000 eligible couple 22.90 27.49 39.56 Sterilization - Male per DPT3 67.7 1000 eligible couple 0.41 0.49 0.59 Reported Abortion Rate per 1000 Estimated live 11.7 34.1 14.0 Measeles 90.1 births OPD All (per 1000 388.7 648.5 population) 466.4 Full immunisation 62.3 IPD (per 1000 2.9 5.3 population) 3.5 Unmet need for Family Planning Operation Major (per 5.3 259.014 Lakh population) 6.3 Spacing 3.3 Reported Infant and Child 393 617 Deaths 471.6 Limiting 2.6 Reported Maternal 30 0 Deaths 36.0 Total 5.9 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication 37

Vishakhapatnam - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 42,88,113 Pregnancies 86,375 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 78,523 59.7 Deliveries trimester Apprehended Infant Deaths Estimated Live ( IMR = 46 taken from SRS - 3531 76,757 Births 3 or more ANC Check-up 76.4 2011 ) Estimated Maternal Estimated Eligible couples ( Complications( 17% of population) 7,28,979 15% of 12,956 Atleast 1 TT received 85.4 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 Indicator 100 IFA Tablets 50.8 Jan'13 2012 - 13 - 12 3ANC Check up against 48% 58% 69% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 60% 72% 83% Institutional Delivery 59.8 estimated deliveries Met need for EmOC * 49.37% 59% 60.25% Home Delivery 39.4

Reported Live Births against 68% 82% 94% Home Delivery by SBA 1.3 estimated Live Births BCG to Measles dropout 2% 2% 6% New born & post natal care rate Fully Immunised against 66% 79% 86% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 50% 50% 56% Still Birth 0.7 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 91.6 Diphtheria Breastfed within 1 hour of Childhood Disease Pertussis 0 0 0 54.2 birth PNC within 48 hrs of Childhood Disease Measles 0 0 26 58.4 delivery Childhood Disease Malaria 376 451.2 185 Immunisation Sterilization - Female per BCG 86.9 1000 eligible couple 17.96 21.55 26.20 Sterilization - Male per DPT3 67.6 1000 eligible couple 0.93 1.12 2.27 Reported Abortion Rate per 3.1 8.8 Measeles 73.9 1000 Estimated live births 3.7 OPD All (per 1000 578.7 358.2 population) 694.4 Full immunisation 60

IPD (per 1000 population) 10.2 8.6 12.2 Unmet need for Family Planning Operation Major (per Lakh 3.8 8.442 population) 4.6 Spacing 5.4 Reported Infant and Child 868 691 Deaths 1,041.6 Limiting 4.8

Reported Maternal Deaths 62 10 74.4 Total 10.2 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

Vizianagram - Apr'12 - Jan'13 DLHSIII Population (Census- Estimated ANC 2011) 23,42,868 Pregnancies 47,192 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 42,902 57.8 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 1929 41,937 Births 3 or more ANC Check-up 82.6 from SRS - 2011 ) Estimated Maternal Estimated Eligible Complications( couples ( 17% of 3,98,288 15% of 7,079 Atleast 1 TT received 86.5 population) Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 44.8 Jan'13 2012 - 13 12 3ANC Check up against 94% 113% 87% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 54% 65% 93% Institutional Delivery 56.9 estimated deliveries Met need for EmOC * 91.95% 110% 157.06% Home Delivery 42 Reported Live Births against estimated Live 94% 113% 101% Home Delivery by SBA 7.4 Births BCG to Measles dropout 2% 2% 0% New born & post natal care rate Fully Immunised against 110% 132% 100% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held as % of required 190% 190% 112% Still Birth 2.2 VHNDs Childhood Disease 12 14.4 0 Live Birth 89.9 Diphtheria Childhood Disease Breastfed within 1 hour of 21 25.2 0 59.7 Pertussis birth Childhood Disease PNC within 48 hrs of 247 296.4 24 70.8 Measles delivery Childhood Disease 1290 1548 922 Malaria Immunisation Sterilization - Female BCG 97.2 per 1000 eligible couple 29.61 35.53 43.48 Sterilization - Male per DPT3 65.5 1000 eligible couple 0.78 0.93 1.13 Reported Abortion Rate per 1000 Estimated live 31.1 30.6 37.3 Measeles 82.2 births OPD All (per 1000 809.7 726.1 population) 971.7 Full immunisation 55.4 IPD (per 1000 35.3 39.5 population) 42.3 Unmet need for Family Planning Operation Major (per 272.8 157.414 Lakh population) 327.4 Spacing 4.4 Reported Infant and 265 617 Child Deaths 318.0 Limiting 2.5 Reported Maternal 24 2 Deaths 28.8 Total 6.9 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal 39

complication

Warangal - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 35,22,644 Pregnancies 70,956 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 64,506 82.6 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2901 63,055 Births 3 or more ANC Check-up 96.8 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 5,98,849 15% of 10,643 Atleast 1 TT received 94.6 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 51.9 Jan'13 2012 - 13 12 3ANC Check up against 56% 68% 64% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 56% 67% 100% Institutional Delivery 84.3 estimated deliveries Met need for EmOC * 116.79% 140% 243.83% Home Delivery 13.6 Reported Live Births against estimated Live 71% 85% 102% Home Delivery by SBA 4.8 Births BCG to Measles dropout 4% 4% 20% New born & post natal care rate Fully Immunised against 63% 76% 75% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 107% 107% 124% Still Birth 0 as % of required VHNDs Childhood Disease 1 1.2 0 Live Birth 95.9 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 29.4 Pertussis birth Childhood Disease 322 386.4 0 Measles PNC within 48 hrs of delivery 81.4 Childhood Disease 367 440.4 2 Malaria Immunisation Sterilization - Female per BCG 100 1000 eligible couple 15.15 18.17 25.90 Sterilization - Male per DPT3 87.8 1000 eligible couple 3.24 3.89 4.17 Reported Abortion Rate per 1000 Estimated live 17.7 12.8 21.2 Measeles 78.2 births OPD All (per 1000 482.6 237.9 population) 579.1 Full immunisation 68.3

IPD (per 1000 population) 56.5 23.8 67.8 Unmet need for Family Planning Operation Major (per 480.9 0.284 Lakh population) 577.1 Spacing 3.6 Reported Infant and Child 325 295 Deaths 390.0 Limiting 2.8 Reported Maternal 24 0 Deaths 28.8 Total 6.4 40

* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

West Godavari - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 39,34,782 Pregnancies 79,258 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 72,053 64.8 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 3240 70,433 Births 3 or more ANC Check-up 95.2 from SRS - 2011 ) Estimated Maternal Estimated Eligible Complications( couples ( 17% of 6,68,913 15% of 11,889 Atleast 1 TT received 98.1 population) Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 39.6 Jan'13 2012 - 13 12 3ANC Check up against 62% 74% 81% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 60% 72% 92% Institutional Delivery 81.5 estimated deliveries Met need for EmOC * 39.68% 48% 45.34% Home Delivery 18.2 Reported Live Births against estimated Live 70% 84% 94% Home Delivery by SBA 4.4 Births BCG to Measles dropout 5% 5% 3% New born & post natal care rate Fully Immunised against 65% 77% 83% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held as % of required 55% 55% 65% Still Birth 0.8 VHNDs Childhood Disease 0 0 10 Live Birth 96 Diphtheria Childhood Disease Breastfed within 1 hour of 19 22.8 0 53.3 Pertussis birth Childhood Disease 24 28.8 0 Measles PNC within 48 hrs of delivery 88.6 Childhood Disease 385 462 0 Malaria Immunisation Sterilization - Female per BCG 100 1000 eligible couple 38.01 45.61 37.73 Sterilization - Male per DPT3 79.1 1000 eligible couple 0.48 0.58 0.76 Reported Abortion Rate per 1000 Estimated live 5.8 0.5 7.0 Measeles 97.8 births OPD All (per 1000 430.1 536.7 population) 516.1 Full immunisation 72 IPD (per 1000 6.2 3.8 population) 7.4 Unmet need for Family Planning Operation Major (per 107.4 77.183 Lakh population) 128.9 Spacing 2.3 Reported Infant and Child 326 356 Deaths 391.2 Limiting 1.8 Reported Maternal 28 1 Total 4.1 41

Deaths 33.6 * Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication

YSR - Apr'12 - Jan'13 DLHSIII Estimated Population (Census-2011) ANC 28,84,524 Pregnancies 58,103 Estimated ANC Check-up in first CBR (SRS-2011) 17.9 52,821 72.1 Deliveries trimester Apprehended Infant Estimated Live Deaths ( IMR = 46 taken 2375 51,633 Births 3 or more ANC Check-up 82.7 from SRS - 2011 ) Estimated Maternal Estimated Eligible couples Complications( ( 17% of population) 4,90,369 15% of 8,715 Atleast 1 TT received 98.1 Estimated pregnancies) Apr'12 - Projected for Last Year 2011 - Indicator 100 IFA Tablets 40.4 Jan'13 2012 - 13 12 3ANC Check up against 68% 81% 89% Deliveries estimated pregnancies Institutional Deliveries (Public+Private) against 74% 89% 99% Institutional Delivery 78.6 estimated deliveries Met need for EmOC * 101.77% 122% 98.17% Home Delivery 21.6 Reported Live Births against estimated Live 79% 95% 106% Home Delivery by SBA 2.9 Births BCG to Measles dropout 10% 10% 2% New born & post natal care rate Fully Immunised against 80% 96% 102% Abortion (Induced + Spontaneous) estimated Live Births Immunisation session held 71% 71% 80% Still Birth 1.3 as % of required VHNDs Childhood Disease 0 0 0 Live Birth 90.1 Diphtheria Childhood Disease Breastfed within 1 hour of 0 0 0 45.3 Pertussis birth Childhood Disease 0 0 0 Measles PNC within 48 hrs of delivery 83.2 Childhood Disease 0 0 13 Malaria Immunisation Sterilization - Female per BCG 98.2 1000 eligible couple 28.34 34.01 44.07 Sterilization - Male per DPT3 85 1000 eligible couple 0.05 0.06 0.03 Reported Abortion Rate per 1000 Estimated live 25.8 30.5 30.9 Measeles 82 births OPD All (per 1000 727.4 970.0 population) 872.8 Full immunisation 64.1

IPD (per 1000 population) 10.0 21.0 12.0 Unmet need for Family Planning Operation Major (per 103.6 159.576 Lakh population) 124.3 Spacing 6.4 Reported Infant and Child 683 727 Deaths 819.6 Limiting 6.5 Reported Maternal 52 12 Deaths 62.4 Total 12.9 42

* Total Maternal complications ( C-section deliveries + Eclampsia cases )treated against estimated maternal complication