State HMIS Data Analysis Apr10 Mar11

Andhra Pradesh

NHSRC
This analysis is based on data downloaded from National Web portal on 28/4/11

Data Management & Analysis

4/28/2011

Data Management & Analysis- NHSRC

Note for Information Users

This data analysis is primarily presented to facilitate the use of this information by District level Programme Managers. They are in a better position to interpret this information in context and act on it. Even what are apparently data of poor quality or errors can be useful if the nature of error is understood. However those not sensitised to the data quality issues and those trying to use this for policy or journalistic purposes will find serious limitations especially due to incomplete reporting of private sector data and poor quality of death reporting. Also please note that interpretation of information will differ with choice of denominator. We should be familiar with choice of denominator in use. Do consult HMIS Training Manual 2 for further understanding of these issues. Data is also analysed and presented so as to help districts, find data errors and correct them. Only when data is converted into information and used, do many errors become apparent. Some states are likely to notice data entry errors & change their data- for which reason also, care should be taken when quoting from this source. We would advise you to check with state government and take permission before quoting from this.

Executive Director National Health Systems Resource Centre May 2011

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Data Management & Analysis- NHSRC

Andhra Pradesh- Summary -Apr'10 to Mar'11

ANC ANC Registration against Expected Pregnancies 3 ANC Check ups against ANC Registrations 103% TT2/ Booster given to Pregnant women against ANC Registration 100 IFA Tablets given to Pregnant women against ANC Registration Deliveries Reported Deliveries against Expected Deliveries Institutional Deliveries against Estimated Deliveries Institutional Deliveries against Reported Deliveries Home Deliveries( SBA& Non SBA) against Estimated Deliveries 93%

86%

93%

95.9%

5.4%

90.5%

Home Deliveries( SBA& Non SBA) against Reported Deliveries

5.6%

94.4%

C Section Deliveries against Institutional Deliveries( Pvt & Pub) Births & Neonates Care

18%

Live Births Reported against Estimated Live Births Still Births against reported 1000 live Births

98%

Newborns weighed against Reported Live Births

95%

Newborns weighed less than 2.5 kgs against newborns weighed Newborns breastfed within one hr of Birth against Reported live Births Child Immunisation( 0 to 11 mnths)

7%

Sex Ratio at Birth

938

82%

Measles given against Reported Live Births Fully Immunised Children against Reported Live Births Required numbers of VHNDs per thousand population in 12 mnths

96%

Measles given against Expected Live Births

94%

97%

Fully Immunised Children against Expected Live Births

94%

1,015,986

Immunisation Sessions held as percentage of required VHNDs

76%

Family Planning & Abortions Family Planning Methods Users ( Sterilisations(Male &Female)+IUD+ Condom pieces/72 + OCP Cycles/13) MTP up to 12 weeks MTP more than 12 weeks

2,084,975

Total Sterilisations ( Male & Female)

753,954

2,616

Abortion (spontaneous/induced)

16,662 1.2%

1,323

Abortion Rate against Expected pregnancies

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Data Management & Analysis- NHSRC

Demographic Denominators - Andhra Pradesh

IMR of the state Andhra Pradesh CBR - Andhra Pradesh Total Population Expected Pregnancies Expected Deliveries Eligible Couple ( 17% of total population)

Source

SRS - 2011

SRS - 2011

Census 2011

Derived

Derived

Derived

49

18.3

84,665,533

1,704,317

1,587,339

14,393,141

Andhra Pradesh Deliveries Apr'10 to Mar'11 Pradesh-

Total Population Apr'10 to Mar'11

84,665,533

Expected Deliveries Apr'10 to Mar'11

1,587,339 Unreported Deliveries

Home SBA

Home Non SBA

Institutional

Total Deliveries Reported

59,374 Home SBA %

25,858 Home Non SBA%

1,436,989 Institutional %

1,522,221 Total Deliveries Reported % 96%

65,118 Unreported Deliveries % 4%

4%

2%

91%

Andhra Pradesh- Home ( SBA & Non SBA) & Institutional Deliveries against Expected Deliveries - Apr'10 to Mar'11

Unreported Deliveries % 4%

Home SBA % 4% Home Non SBA% 2%

Institutional % 91%

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Data Management & Analysis- NHSRC

Andhra Pradesh- Home ( SBA & Non SBA) & Institutional Deliveries against Reported Deliveries - Apr'10 to Mar'11
Home SBA % 4% Home Non SBA% 2%

Institutional % 94%

Andhra Pradesh- C sections & Complicated Deliveries Apr'10 to Mar'11

Institutional Deliveries (Public)

Institutional Deliveries (Pvt)

Total Institutional deliveries

557,004 C Section

879,985

1,436,989

66,296 12%

195,105 22%

261,401 18.2%

C Section%

Complicated Pregnancies attended Complicated Pregnancies attended %

43,792

28,700

72,492

8%

3%

5.0%

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Data Management & Analysis- NHSRC

Andhra Pradesh- Facility wise %ge of C sections & Complicated Deliveries Apr'10 to Mar'11

PHC

CHC

SDH/DH

Other State owned institution

Private Facilities

Total

Complicated deliveries managed ( Reported) Complicated deliveries managed as %ge of total reported

6,378

9,669

21,183

6,562

28,700

72,492

8.8%

13.3%

29.2%

9.1%

39.6%

C Section (Reported)

364

10,492

42,492

12,948

195,105

261,401

C Section as percentage of total reported

0.1%

4.0%

16.3%

5.0%

74.6%

Andhra Pradesh- C-Section, Complicated & Normal Deliveries against Reported -Section, Institutional Deliveries ( Pvt. & Public) Apr'10 to Mar'11

C- section % 18.2%

Complicated Pregnancies attended % 5.0%

Normal deliveries % 76.8%

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Data Management & Analysis- NHSRC

Andhra Pradesh- Complicated Pregnancies & Deliveries Treated - Apr'10 to Mar'11

Reported Deliveries

1,522,221

Complicated Pregnancies attended Complicated Pregnancies Rate C - Section Deliveries PNC Maternal Complications Abortions Still Births

72,492

4.3%

261,401

13,992

16,662

11,627

Complicated Deliveries Treated with No Of Eclampsia cases Treated IV Oxytocis Blood Transfusion No Of severe anemia cases treated

IV Antibiotics

IV antihypertensive/Magsulph injection

39,861

3,428

32,934

1,243

7,249

52,471

Andhra Pradesh- Stay duration as percentage of Reported Institutional Deliveries - Apr'10 to Mar'11

Stay for more than 48 hrs after delivery 26%

Stay for less than 48 hrs after delivery 74%

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Data Management & Analysis- NHSRC

Andhra Pradesh -JSY Paid to Mothers as % of reported deliveries - Apr'10 to Mar'11

25% 20% 20% 15% 10% 5% 1% 0% Home Institutional (Public) Institutional (Pvt) 0%

Andhra Pradesh-ANC Services - Apr'10 to Mar'11

2,000,000 1,800,000 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 1,704,317 1,762,254 1,512,224 1,197,455 1,570,254 1,642,508 1,630,485

535,566

Expected Total ANC ANC Pregnancies - Registration Registration Apr'10 to within first Mar'11 trimester

ANC registration for JSY

3 ANC check ups

TT1

TT2 or Booster

100 IFA tablets given

Andhra Pradesh- Management of Complications (Reflecting Quality of ANC )against Reported ANC Registration- Apr'10 to Mar'11
Reported %age against reported ANC Registration

Hypertensive cases detected at institution Eclampsia cases managed during delivery ANC women having Hb level<11 ANC women having severe anaemia (Hb<7) treated at institution

71081

4.0%

7249

0.4%

489614

27.8%

52471

3.0%

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Data Management & Analysis- NHSRC

Andhra Pradesh- Management of Complications (Reflecting Quality of ANC )against Reported ANC Registration- Apr'10 to Mar'11
30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Hypertensive cases detected at institution Eclampsia cases managed during delivery ANC women having Hb level<11 ANC women having severe anaemia (Hb<7) treated at institution 4.0% 0.4% 3.0% 27.8%

Andhra Pradesh- Post Natal Check up against Reported deliveries -Apr'10 to Mar'11
120% 100% 80% 60% 40% 20% 0% PNC within 48 hours after deliveries PNC between 48 hours and 14 days of Deliveries 6% 96%

Andhra Pradesh-Births - Apr'10 to Mar'11

1,800,000 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 1,549,379 1,511,373 1,435,347 1,245,964

98,295

Estimated Live Births - Reported Live Birth - Newborns weighed at Number of Newborns Newborns breast fed Apr'10 to Mar'11 Apr'10 to Mar'11 birth having weight less within 1 hour than 2.5 kg

Andhra Pradesh - Births - Apr'10 to Mar'11

Still Birth per 1000 live births ( reported)

Live Birth - Males

Live Birth - females

Live Birth - Total

Sex Ratio at birth

780,018

731,355

1,511,373

938

7.7

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Data Management & Analysis- NHSRC

Andhra Pradesh-Immunisation ( 0 to 11mnths) Against Estimated Live BirthsApr'10 to Mar'11

120% 100% 80% 60% 40% 20% 0% BCG % DPT3% OPV3% Measles % Fully Immunised % 96% 95% 95% 94% 94%

Andhra Pradesh-Immunisation ( 0 to 11mnths) Against Reported Live BirthsApr'10 to Mar'11

120% 100% 80% 60% 40% 20% 0%

99%

98%

97%

96%

97%

BCG %

DPT3%

OPV3%

Measles %

Fully Immunised %

Andhra Pradesh-Immunisation Sessions- Apr'10 to Mar'11

900,000 800,000 700,000 600,000 500,000 400,000 300,000 200,000 100,000 Immunisation sessions planned Immunisation sessions Held Sessions where ASHAs were present 795,829 775,278 734,293

Andhra Pradesh - Abortions - Apr'10 to Mar'11

MTP Less than 12 weeks MTP More than 12 weeks Abortions (spontaneous/Induced) Abortion Rate against expected pregnancies 1.2%

2,616

1,323

16,662

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Data Management & Analysis- NHSRC

Andhra Pradesh-Abortions - Apr'10 to Mar'11

MTP less than 12 weeks 12.70% MTP more than 12 weeks 6.42%

Abortion (spontaneous/induce d) 80.88%

Andhra Pradesh- RTI Cases Apr'10 to Mar'11 CasesTotal OPD Total RTI/STI cases RTI/STI cases as %ge of Total OPD 1.49%

45,302,552

672,853

Andhra Pradesh RTI Cases -Apr'10 to Mar'11 Pradesh-

Male 42%

Female 58%

Andhra Pradesh-Sterilisations - Apr'10 to Mar'11 Sterilisations

Reported Total Sterilisation NSV Laparoscopic MiniLap Post Partum Male Sterilisation Female Sterilisation 753,954 13,763 71,316 270,334 398,541 13,763 %age of Reported Sterilisation 2% 9% 36% 53% 2%

740,191

98%

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Data Management & Analysis- NHSRC

Andhra Pradesh-FP Methods - Apr'10 to Mar'11

Reported Total Reported FP Method (All types) Users Sterilisations IUD Condom Users OCP Users %age of All Reported FP Methods 36% 17% 33% 14%

2,084,975 753,954 358,583 682,203 290,235

Limiting Methods

753,954

36%

Spacing Methods

1,331,021

64%

Andhra Pradesh- Facility wise % of Sterilisations & IUDs - Apr'10 to Mar'11

Subcenter PHC CHC SDH/DH Other State owned institution 3.3% Private Facilities

NSV as % of total reported

49.3%

14.3%

29.0%

4.0%

Laparoscopic as % of total reported

25.5%

30.0%

35.1%

2.1%

7.3%

MiniLap as % of total reported

26.0%

6.2%

18.2%

2.3%

47.4%

Post Partum as % of total reported

24.8%

10.1%

20.4%

2.5%

42.1%

IUD inserted as % of total reported

13%

62%

6%

8%

2%

9%

Andhra Pradesh- Unmet need (DLHSIII) met by reported FP Methods - Apr'10 to Mar'11 Eligible Couples for unmet need- Calculated Using DLHSIII Unmet need - Andhra Pradesh Total reported FP Users - HMIS - Apr'10 to Mar'11 Unmet need met by Reported Family Planning Methods Apr'10 to Mar'11 179%

Estimated total Eligible Couples ( 17% of population) Total Unmet Needs

1,43,93,141

8.1

11,65,844

20,84,975

Limiting

5,75,726

7,53,954

131%

Spacing

4.1

5,90,119

13,31,021

226%

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Data Management & Analysis- NHSRC

Andhra Pradesh- Service Delivery - Apr'10 to Mar'11

Operation major (General and spinal anaesthesia) Adolescent counselling services

Total OPD

Total IPD

Operation minor (No or local anaesthesia)

AYUSH

Dental Procedures

45,302,552

2,097,598

74,131

319,378

1,960,568

211,805

104,661

OPD Visit Per Capita Population

IPD as percentage of OPD

Operation major (General and spinal anaesthesia) as %ge of IPD

Operation minor (No or local anaesthesia)as %ge of OPD

AYUSH as %ge of OPD

Dental Procedures as %ge of OPD

Adolescent counselling services as %ge of OPD

0.5

4.6%

3.5%

0.7%

4.3%

0.47%

0.2%

Andhra Pradesh- Lab Services - Apr'10 to Mar'11

Total Widal Test Conducted

Total Population

Total HB tested

Total HIV tested

Total VDRL Tested

Blood Smear Examined

84,665,533

1,405,629 HB test conducted as %age of OPD

1,651,545 HIV test conducted as %age of OPD

120,393

90,147 Widal test conducted as %age of OPD

8,704,698 Blood Smear Examined as % of Population

Total OPD

HB<7gm as %age of HB tested

HIV positive as %age of HIV tested

VDRL test conducted as %age of OPD

45,302,552

3.1%

8.1%

3.6%

3.6%

0.3%

0.2%

10.3%

Andhra Pradesh- Childhood Disease - Vaccine Preventable -Apr'10 to Mar'11

Tetanus Neonatorum 153

Diphtheria

Pertussis

Tetanus others

Polio

Measles

41

633

Andhra Pradesh-Childhood Disease - Others - Apr'10 to Mar'11

Diarrhoea and dehydration

Malaria

Number admitted with Respiratory Infections

99,864

1,552

32,589

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Data Management & Analysis- NHSRC

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Data Management & Analysis- NHSRC

ANDRA PRADESH NDRA

MORTALITY INFORMATION as reported in HMIS
Apr10 - Mar11

NATIONAL HEALTH SYSTEMS RESOURCE CENTRE, SYSTEMS NEW DELHI

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Data Management & Analysis- NHSRC

Note for Information Users

Information user must understand that the data given below are not to be used as a measure of mortality but as a measure of completion of reporting on mortality. We are at the stage, where we are working to improve routine mortality recording and reporting. However we also reiterate that without conversion to rate, we will not be able to estimate the adequacy of reporting. This information is for district level managers to use for improving mortality reporting.

Executive Director National Health Systems Resource Centre May 2011

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Data Management & Analysis- NHSRC

Mortality in- Andhra Pradesh- Apr'10-Mar'11

Death Groups

Cause-wise deaths included in the group wise

Reported deaths

Communicable Disease

Maternal, Child under 5, Diarrhoea, Tuberculosis, Respiratory (excluding TB), Malaria, Other Fever related, HIV/AIDS, Other known acute diseases

37,842

Non communicable disease

Heart Disease/ Hypertension, Neurological including Stroke, Other known chronic diseases

34,986

Injuries

Trauma, Accidents, Burns, Suicide, Animal Bites

13,469

Others

Other diseases (Causes not known)

128,868

Mortality- Disease Category-Andhra Pradesh-Apr'10-Mar'11 -by

Communicable Diseases 18%

Others 60% Injuries 6%

Non communicable diseases 16%

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Data Management & Analysis- NHSRC

Andhra Pradesh- Still Births, Neonatal & Infant Deaths - Apr'10 to Mar'11
Live Births Reported Live Births Estimated Early Neonatal deaths Late Neonatal Deaths

Still Births

Infant Death

1,511,373

1,549,379

11,627

5,671

3,344

12,045

Andhra Pradesh- Still Birth Rate, Perinatal,Neonatal & Infant Mortality Rates - Apr'10 to Mar'11 Against Reported Live Births ( 1000) Reported Still Birth 7.69 Reported Perinatal Mortality Reported Neonatal Mortality Reported Infant Mortality 7.50 Against Estimated Live Births ( 1000)

11.45

11

5.96

5.82

7.97

7.77

Infant Mortality Indicators Andhra Pradesh-"Apr'10-Mar'11

Total Deaths Neonatal Mortality Rate (per 1000 live births) Perinatal Mortality Rate (per 1000 live births) Infant Mortality Rate (per 1000 live births) Under 5 Mortality Rate (per 1000 live births) Maternal Mortality Ratio (per one lakh live births) Reported Death Rate 6.0

9,015

17,298

11.4

12,045

8.0

13,981 724

9.3 47.9

Infant & Child Deaths -Andhra Pradesh-Apr'10-Mar'11

Infant Deaths within 24 hrs of birth Infant Deaths between 24hrs & under 1 week Infant Deaths between 1 week & under 1 month Child Deaths between 1 month & under 1 year Total Infant Deaths Child Deaths between 1yr under 5years Total Deaths 921 4,750 3,344 3,030 12,045 1,936 13,981

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Data Management & Analysis- NHSRC

Infant & Child Deaths against reported Infnat & Child deaths - Andhra Pradesh Pradesh-Apr'10Mar'11

Child Deaths between 1yr under 5years 14% Child Deaths between 1 month & under 1 year 22%

Infant Deaths within 24 hrs of birth 6%

Infant Deaths between 1 week & under 1 month 24%

Infant Deaths between 24hrs & under 1 week 34%

Causes of Neonatal Deaths Deaths-Andhra Pradesh-Apr'10-Mar'11

Sepsis Asphyxia LBW Others Total

Up to 1 Weeks of Birth Between 1 week & 4 weeks of birth

248

630

1,262

2,610

4,750

165

284

701

2,194

3,344

Total

413

914

1,963

4,804

8,094

Causes of Infant Child Deaths Deaths-Andhra Pradesh-Apr'10-Mar'11 Mar'11

Fever related

Pneumonia Between 1 month and 11 months Between 1 year & 5 years Total

Diarrhoea

Measles

Others

Total

246

77

206

2,495

3,030

84

102

247

1,498

1,936

330

179

453

11

3,993

4,966

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Data Management & Analysis- NHSRC

Causes of Infant Child Deaths against total reported infant & child deaths Andhra deaths-Andhra Pradesh-Apr'10-Mar'11 Asphyxia LBW 7% Sepsis 15% 3%

Pneumonia 3% Diarrhoea 1% Others 67% Fever related 4%

Known causes of Infant Child Deaths against total reported infant & child deaths (excluding causes not known) known)-Andhra Pradesh-Apr'10-Mar'11

Diarrhoea 4% Pneumonia 8%

Fever related 11%

Sepsis 10%

Asphyxia 21%

LBW 46%
Maternal Deaths & Causes-Andhra Pradesh Pradesh-Apr'10Mar'11
Total Abortion Obstructed/prolonged labour Severe hypertension/fits Bleeding High Fever Other Causes Total 6 24 91 105 22 476 724

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Data Management & Analysis- NHSRC

Maternal Deaths & Causes against total reported maternal deaths Andhra Pradesh deaths-Andhra PradeshApr'10-Mar'11

Abortion 1%

Obstructed/prolong ed labour 3%

Severe hypertension/fits 13%

Bleeding 14%

Other Causes 66%

High Fever 3%

Known Maternal Death causes against total reported maternal deaths (exclusing unknown causes)-Andhra Pradesh-Apr'10-Mar'11

Abortion 2% High Fever 9%

Obstructed/prolong ed labour 10%

Severe hypertension/fits 37% Bleeding 42%

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Data Management & Analysis- NHSRC

Cause of deaths above 6 yrs of age-Andhra Pradesh-Apr'10-Mar'11

6-14 yrs 15-55 yrs. Above 55yrs Total

Diarrhoeal Diseases

109

400

274

783

Tuberculosis Respiratory Diseases (Other than TB) Malaria

50

1,128

1,170

2,348

149

1,615

1,522

3,286

19

65

21

105

Other fever Related

461

2,018

2,609

5,088

HIV/AIDS Heart Disease/ Hypertension related Neurological Disease including strokes Trauma/Accidents/ Burn Cases

43

1,250

387

1,680

155

5,736

7,314

13,205

99

2,014

3,166

5,279

298

4,984

2,100

7,382

Suicide

97

2,855

931

3,883

Animal Bites & Stings

451

1,015

738

2,204

Known Acute Disease

433

4,263

5,151

9,847

Known Chronic Disease

196

5,970

10,336

16,502

Causes not known

2,026

43,072

83,770

128,868

Total Deaths

4,586

76,385

119,489

200,460

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Data Management & Analysis- NHSRC

Cause of deaths above 6 yrs against total reported deaths 6 yrs & above -Mortality in Mortality inAndhra Pradesh- Apr'10-Mar'11-

Tuberculosis 1%

Other fever Related Respiratory Diseases 2% (Other than TB) HIV/AIDS 2% 1%

Neurological Heart Disease/ Disease Hypertension including strokes related 3% 7% Trauma/Accidents/ Burn Cases 4% Suicide 2% Animal Bites & Stings 1% Known Acute Disease 5% Known Chronic Disease 8%

Causes not known 64%

Known cause of deaths above 6 yrs against total reported deaths 6 yrs & above (excluding unkown causes) causes)-Andhra Pradesh-Apr'10-Mar'11

Known Chronic Disease 23% Known Acute Disease 14%

Tuberculosis Diarrhoeal Diseases 3% 1%

Respiratory Diseases (Other than TB) 5% Other fever Related 7% HIV/AIDS 2%

Animal Bites & Stings 3% Suicide 6%

Trauma/Accidents/ Burn Cases 10%

Neurological Disease including strokes 7%

Heart Disease/ Hypertension related 19%

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Data Management & Analysis- NHSRC

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