Himachal Pradesh District Level Household and Facility Survey 2012-13

CONTRIBUTORS
B. Paswan
H. Lhungdim
Rati Parihar
Ashish Pardhi
[AdSense-B]

CONTENT S PAGE
1. INTRODUCTION AND HOUSEHOLD CHARACTERISTICS ………………… .. 1
2. SURVEY DESIGN ………… 2
3. 4
4. DEMOGRAPHIC BACKGROUND OF HIMACHAL PRADESH 6
5. CHARACTERISTICS OF WOMEN AND FERTILITY …………………………… .. g
6. MATERNAL HEALTH CARE ………………………………………………………………. .. 12
7. CHILD HEALTH AND IMMUNIZATION …………………………………………….. .. 16
8. FAMILY PLANNING AND CONTRACEPTIVE USE …………………………….. .. 13
9. REPRODUCTIVE 22
10. PERSONAL HABITS………….. 24
11. MORBIDITY STATUS…………. 23
12. NUTRITION AND HEALTH ………………………………………………………………… .. 32
13. HEALTH FACILITIES …………………………………………………………………………. .. 33
TABLES ……………………………………………………………………………………………………. .. 43_16()
APPENDIX ……………………………………………………………………. .. 161-165
vii

LIST OF TABLES PAGE
Table 1.1
Table 1.2
Table 1.3
Table 1.4(a)
Table l.4(b)
Table 1.5
Table l.6(a)
Table 1.6(b)
Table 1.7
Table 1.8
Table 1.9
Table 1.10
Table 1.11
Table 1.12
Table 1.13
Table 1.14
Table 1.15
Table 1.16
Table 1.17
Table 2.1
Table 2.2
Table 2.3
Table 2.4
Table 2.5
Table 2.6
Table 2.7
Table 2.8
Table 3.1
Table 3.2
Table 3.3
Table 3.4
Table 3.5(a)
Table 3.5(b)
Table 3.6
Table 3.7
Table 3.8
Table 3.9
Table 3.10
Table 3.11
Table 3.12
Table 3.13
Table 3.14
Table 3.15
Table 3.16
Table 4.1
Table 4.2
Table 4.3
Table 4.4
Table 4.5
Table 4.6
Table 4.7
Table 4.8
Basic demographic indicators ……………………………………………………………. ..
Number ofhouseholds, ever-married women
Distance from the nearest educational facility……..
Distance from the nearest health facility
Programmes beneﬁciaries ……………….
Reasons for dropping out of school …………
Housing characteristics and household assets
Housing characteristics by district………………
Household characteristics ………
Household population by age and sex
Marital status of the household population………
Age at marriage ……………………………………
Educational level of the household population…….
Educational level of the household population…….
Educational level of the household population…….
Currently attending school ……………………………..
Availability of facility and health personnel by district
Birth registration
Birth registration
Background characteristics of ever married women
Level of education of ever married women ……….
Birth
Birth order by districts………
Children ever bom…………
Outcomes of pregnancy…….
Outcomes ofpregnancy………..
Fertility preferences………………..
Place 0fAntenatal Check-Up
Antenatal Care by district…………………….
Components of Antenatal Check-Up ……….
Women received advice during Antenatal care
Antenatal care: ANC visits and time of ﬁrst ANC
Antenatal care: TT, IFA and ANC …………….
Antenatal care indicators and pregnancy complications……………………………
Place ofdelivery and assistance …………………………
Mode of transportation used for delivery and arrangement of transportation
Place of delivery and assistance characteristics by district …………………….
Reasons for not going to health institutions for delivery………
Delivery complications …………………………………………
Post-delivery complications
Any check-up after
Complications during pregnancy, delivery and post~delivery period…….
Complications during pregnancy, delivery and post-delivery period…….
Awareness ofthe danger signs ofnew
Timing and childhood check-ups
Initiation of breastfeeding
Breastfeeding and weaning status
Exclusive breastfeeding………………
Breastfeeding by districts
Vaccination ofchildren
Status of childhood vaccination by districts
Place ofchildhood vaccination………………………
[AdSense-B]

LIST OF TABLES PAGE
Table 4.9
Table 4.10
Table 4.1 1
Table 4.12
Table 4.13
Table 5.1
Table 5.2
Table 5.3
Table 5.4
Table 5.5(a)
Table 5.5(b)
Table 5.6
Table 5.7
Table 5.8
Table 5.9
Table 5.10
Table 5.11
Table 5.12
Table 5.13
Table 5.14
Table 5.15
Table 5.16
Table 6.1
Table 6.2
Table 6.3
Table 6.4
Table 6.5
Table 6.6
Table 6.7
Table 6.8
Table 6.9
Table 6.10
Table 6.11
Table 6.12
Table 6.13
Table 7.1
Table 7.2
Table 7.3
Table 7.4
Table 7.5
Table 7.6
Table 7.7
Table 7.8
Table 7.9
Table 7.10
Table 7.11
Table 7.12
Table 7.13
Table 7.14
Table 7.15
Vitamin-A and Hepatitis-B supplementation for children…..,.
Awareness regarding diarrhoea management…………………..
Treatment ofdiarrhoea ………………………
Awareness and treatment of Acute Respiratory Infection (ARI)…………..
Awareness of ors and Acute Respiratory Infection (ARI) by districts
Awareness ofcontraceptive methods
Awareness of contraceptive methods
Awareness of contraceptive methods by district
Ever use ofcontraceptive method
Current use of contraceptive methods
Duration ofuse of spacing methods
Age at the time of sterilization
Contraceptive prevalence rate by district
Sources of modern contraceptive methods………
Cash beneﬁts received after sterilization ………………………………………
Health problems with current use of contraception and treatment received…….
Reasons for discontinuation ofcontraception
Future intention to use contraception ………
Advice on contraceptive use ………………………………………………………………………………………. ..
Reasons for not using modem contraceptive methods among rhythm and withdrawal method
users …………………………..
Unmet need for family planning services………………….
Unmet need for family planning services by district…………………….
Menstruation related problems by background characteristics…………..
Source of knowledge about RTI/STI by background characteristics …..
Knowledge ofmode oftransmission ofRT1/ST1 by background characteristics
Symptoms of RTI/STI by background characteristics ……………………………………………………. ..
Discussed about RTI/STI problems with husband and sought treatment by background

RTI/STI indicators by districts…….
Knowledge
Knowledge about mode oftransmission ofH1V/AIDS by background characteristics
Knowledge of HIV prevention methods by background characteristics …….
Misconception about transmission of HIV/AIDS by background characteristics
Knowledge about the place where HIV/AIDS test can be done ………………..
Undergone HIV/AIDS
HIV/AIDS indicators by districts
Personal
Personal habits-men
Personal habits-women……..
Personal habits ………
Personal habits tobacco
Personal habits smoke
Personal habits drink alcohol
Morbidity details …………
Morbidity details
Morbidity details
Morbidity details
Morbidity details
Morbidity details
Morbidity details
Morbidity details ……………………………………………………………………………………………………… ..
ix

LIST OF TABLES PAGE
Table 7.16
Table 8.1
Table 8.2
Table 8.3
Table 8.4
Table 8.5
Table 8.6
Table 8.7
Table 8.8
Table 8.9
Table 8.10
Table 8.11
Table 8.12
Table 8.13
Table 8.14
Table 8.15
Table 8.16
Table 8.17
Table 8.18
Table 8.19
Table 9.1
Table 9.2
Table 9.3
Table 9.4
Table 9.5
Table 9.6
Table 9.7
Table 9.8
Table 9.9
Table 9.10
Table 9.11
Table 9.12
Tuberculosis ……………….
Nutritional status ofehildren……………………
Nutritional status of children by districts
BMI (Body Mass Index) ofwomen……………..
BMI (Body Mass Index) ofwomen (new)
Prevalence ofanemia among children………………………
Anaemia among school going/adolescent population
Anaemia among population aged 20 years and
Anaemia among population children, adolescents aged 20 years and above
Anaemia among pregnant Women ………………………………………………….
Prevalence ofdiabeties……………….
Prevalence ofdiabeties……..
Prevalence of diabeties……..
Prevalence of diabeties……..
Blood pressure……………
Blood pressure……..
Blood pressure……………………………..
Blood pressure…………………………………
Presence ofiodized salt in household……………………………..
Presence of iodized salt in household………………………………..
Average population covered by health facility by districts …………………… ………..
Status of infrastructure at Sub-Health Centre ﬁlnctioning in govemment building by districts
Percentage of Sub-Health Centres having different activities by district
Available human resources at Sub Health Centres by districts ………..
Available human resources at Primary Health Centres by districts…………..
Available infrastructure at Primary Health Centres by districts
Speciﬁc health facilities available at Primary Health Centres by districts
Number of Primary Health Centres having different activities by districts……..
Human resources available at Community Health Centres by districts ……..
Speciﬁc health care facilities available at Community Health Centres by districts……
Number of Community Health Centres having different activities by districts
Human resources & other services available at District Hospitals by districts
X

LIST OF FIGURES PAGE
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Figure 8
Figure 9
Figure 10
Figure ll
Figure 12
Figure 13
LIST OF MAPS PAGE
Map 1
Map 2
Map 3
Map 4
Source of drinking water…..
Toilet facilities ………
Age-sex composition ……………..
School attendance by age and sex
Mean children ever born by districts…………………
Desire for the additional child/next
Any ANC by selected background characteristics
Progress in institutional delivery
Change in full immunization coverage ofchildren ……………..
Percent of currently married Women using contraceptive methodsm,
Change in contraceptive prevalence rate rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Change in unmet need for contraception ………………
Contraceptive prevalence rate and unmet need by districts……..
Full ante-natal checkup by districts rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr 44
Institutional delivery by districts tttttttttttttttttttt ttttttttttttttttttt
Full immunization coverage of children aged 12-23 months by districts….W
Contraceptive prevalence rate for any method by districts ttttttttttttttttt
xi
~Doo\1\1\1
ll
12
14
16
18
19
21
22
13
14
l7
21

AFMC
AHS
AIDS
ANC
ANM
ARI
ASHA
AWW
AYUSH
BCG
BP
BPL
CAB
CAPI
CHC
CPR
DBS
DH
DLHS
DPT
EAG
ECG
ECP
ELISA
EPI
FA
FBS
FHW
FRU
FOD
FP
FS
FSU
GPS
Gol
HH
HIV
ICDS
ICTC
IEC
IFA
IIPS
IMNCI
IMR
IPHS
IUD
JSY
LMO
LPG
MCEB
MDG
MMR
MO
MoHFW
MoU
ACRONYM
Administrative and Financial Management Committee
Annual Health Survey
Acquired lmmuno Deficiency Syndrome
Antenatal Care
Auxiliary Nurse Midwife
Acute Respiratory Infection
Accredited Social Health Activist
Anganwadi Worker
Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy
Bacillus Calmette Guerin
Blood Pressure
Below Poverty Line
Clinical Anthropometric Biochemical (Test)
Computer Assisted Personnel Interviewing
Community Health Centre
Contraceptive Prevalence Rate
Dried Blood Spot
District Hospital
District Level Household and Facility Survey
Diphtheria, Pertussis and Tetanus
Empowered Action Group
Electrocardiogram
Emergency Contraceptive Pill
Enzyme-linked Immunosorbent Assay
Expanded Programme on Immunization
Field Agency
Fasting Blood Sugar
Female Health Worker
First Referral Unit
Field Operation Division
Family Planning
Female Sterilization
First Stage Unit
Global Positioning System
Government of India
Household
Human lmmuno Deﬁciency Virus
Integrated Child Development Scheme
Integrated Counseling and Testing Centre
Information, Education and Communication
Iron and Folic Acid
International Institute for Population Sciences
Integrated Management of Neonatal and Childhood Illnesses
Infant Mortality Rate
Indian Public Health Standards
Intra-uterine Device
Janani Suraksha Yojana
Lady Medical Officer
Liquefied Petroleum Gas
Mean Children Ever Born
Millennium Development Goal
Maternal Mortality Ratio
Medical Officer
Ministry of Health and Family Welfare
Memorandum of Understanding
xii

MOA
MTP
NC
NIC
NIHFW
NGO
NPP
NRHM
NSSO
NSV
OBC
OPD
ORS
ORT
OT
PHC
Pl
PNC
PRC
PPS
PSU
RCH
RKS
RTI
SDH
SDRD
SC
SHC
ST
STI
TBA
TAC
TOT
TT
TV
UFS
UFWC
UHP
UIP
UNFPA
UNICEF
USU
UT
VCTC
VHSNC
WHO
ACRONYM
Memorandum of Agreement
Medical Termination of Pregnancy
Natal Care
National Informatics Centre
National Institute of Health and Family Welfare
Non-Governmental Organisation
National Population Policy
National Rural Health Mission
National Sample Survey Organization
Non-scalpel Vasectomy
Other Backward Class
Out~Patient Department
Oral Re-hydration Salt
Oral Re-hydration Therapy
Operation Theatre
Primary Health Centre
Partner Institute
Post Natal Care
Population Research Centre
Probability Proportional to Size
Primary Sampling Unit
Reproductive and Child Health
Rogi Kalyan Samiti
Reproductive Tract Infection
Sub-Divisional Hospital
Survey Design and Research Division
Scheduled Caste
Sub-Health Centre
Scheduled Tribe
Sexually Transmitted Infection
Trained Birth Attendant
Technical Advisory Committee
Training of Trainers
Tetanus Toxoid
Television
Urban Frame Survey
Urban Family Welfare Centre
Urban Health Post
Universal Immunization Programme
United Nations Population Fund
United Nation Children’s Fund
Ultimate Stage Sampling Unit
Union Territory
Voluntary Counseling and Testing Centre
Village Health Sanitation and Nutrition Committee
World Health Organisation
xm

xiv

Preface and Acknowledgements
The District Level Household and Facility Survey-4 (DLHS-4) is a nationwide survey
covering 640 districts from 36 States and Union Territories of India. This is the fourth round
of the district level household survey which was conducted during 2012-13. The Survey was
funded by the Ministry of Health and Family Welfare, Government of India.
At the outset, We acknowledge our sincere gratitude to the Ministry of Health & Family
Welfare, Government of India for designating the Intemational Institute for Population
Sciences (IIPS) as the nodal agency for conducting District Level Household and Facility
Survey-4 (DLHS-4) in India. We would also like to take this opportunity to acknowledge
Shri Bhanu Pratap Sharma, Secretary-Ministry of Health and Family Welfare (MoHFW),
Govemment of India for his advice, suggestions and support. Our special thanks are due to
Shri Lov Verrna and Shri Keshav Desiraju former Secretaries, Ministry of Health and Family
Welfare (MoHFW), Government of India, for providing overall guidance and support
extended to the project. We gratefully acknowledge the active involvement, assistance, help,
co-operation and suggestions received time to time from Shri C.R.K. Nair, Additional
Director General, Dr. Rattan Chand, the Chief Director and Shri Biswajit Das, Director-
Statistics Division, Ministry of Health and Family Welfare, Government of India. We also
extend our thanks to Smt. Madhu Bala, former Additional Director General and Shri Rajesh
Bhatia, former Director-Statistics Division, Ministry of Health and Family Welfare,
Government of India for their support from time to time.
We gratefully acknowledge the NIHFW, New Delhi, especially Dr. M. M. Misro, Dr. T. G.
Srivastava and Dr. Kalpna, for their immense help, assistance, support and coordination with
all Partner Institutes to bring out quality DBS results/data. We also acknowledge our sincere
gratitude to all Partner Institutes for providing training and support of CAB components and
bringing out the quality DBS results.
We sincerely extend our appreciation to HLL Life Care Ltd., New Delhi, for procuring CAB
equipments and consumables also supply chain to different states across the country.
Our special thanks are to all the members of Technical Advisory Committee of DLHS-4,
particularly Dr. N. S. Shastry, Chairman, Former DG & CEO (NSSO) for their constant
involvement and technical inputs and support at various stages of the survey.
We also gratefully acknowledge all members of Sub-Committee on Sampling especially Shri
G. C. Manna, Chairman, DDG, CSO, MoSPI for their technical support received from time to
time.
Thanks are also due to Dr. Rajiv Mehta and Shri A. K. Mehra former Additional Director
Generals at the National Sample Survey Organisations, Kolkata for providing UF S blocks.
We thank Dr. T. K. Roy, Former Director, IIPS, for reviewing the model report and his useful
suggestions.
This acknowledgement cannot be concluded without expressing appreciation for the efforts
and hard work put in by the ﬁeld investigators, supervisors, health investigators in collecting
data and timely transferring data to IIPS.
Last but not the least, we are grateful and appreciate the efforts of all the respondents who
participated and spared their valuable time with us by providing the required infonrration.
DLHS-4 Coordinators
International Institute for Population Sciences

1. INTRODUCTION AND HOUSEHOLD CHARACTERISTICS
This state report of Himachal Pradesh pertains to the fourth round of District Level
Household and Facility Survey (DLHS-4) 2012-13, following the preceding three rounds
undertaken by the Ministry of Health and Family Welfare (MoHFW), Government of India
(Gol). In the past (Round-I in 1998-99, Round-II in 2002-04, and Round-III in 2007-08) with
the main objective to provide reproductive and child health related database at district level in
India. The data from these surveys have been useful in setting the benchmarks and examining
the progress of the country after the implementation of RCH programme. In addition, the
evidences generated by these surveys have been useful for the purpose of monitoring and
evaluation of the ongoing programmes and the aspect of planning of suitable strategies by the
central and state governments. In view of the completion of eight years of National Rural
Health Mission (2005-12), that it was felt there was a need to focus on the achievements and
improvements. The Ministry of Health and Family Welfare, Government of India, therefore
initiated the process of conducting DLHS-4 and designated the International Institute for
Population Sciences (IIPS) as the nodal agency to carry out the survey. The MoHFW,
provided funds for implementation of DLHS-4, guided by a duly constituted Technical
Advisory Committee (TAC).
The main objective of District Level Household and Facility Survey-4 (DLHS-4) is to
provide matemal and child care (MCH) indicators and prevalence of morbidity for a wide
range of common, communicable, non-communicable and lifestyle diseases for the year
2012-13 covering the following aspects:
0 Household basic amenities
0 Prevalence of morbidity
0 Coverage of ante-natal services and immunization services.
0 Proportion of institutional/safe deliveries
0 J SY Beneﬁciaries
0 Economic burden of delivery
0 Contraceptive prevalence rate
0 ASHA’s involvement
0 Unmet need for family planning
0 Awareness about RTI/ STI and HIV / AIDS
0 Infrastructure, manpower, equipments, drugs, services of public health facilities
0 Linkage between health facility and MCH indicators
Bilingual questionnaires prepared in Hindi and English language pertaining to Household,
Clinical, Anthropometric and Bio-Chemical tests (CAB) and Ever Married Women (age 15-
49) were used and canvassed using Computer Assisted Personal Interviewing (CAPI). It was
for the ﬁrst time in the country that large scale demographic and health survey at the district
level was successfully carried out by using Computer Assisted Personal Interviewing (CAPI)
in DLHS-4. The CAPI software was developed by using MMIC (Multi-Mode Interviewing
Capability) tool. Mini laptops were also loaded with CAPI software and bilingual
questionnaires and provided to the Field Agencies authorized to carry out the survey with the
I

designated states. Each team was provided four CAPIs/Mini laptops, one for each
investigator. Supervisors were responsible for directly uploading the completed PSU’s data to
the IIPS, FTP server located in Mumbai on day-to-day basis. The use of CAPI optimized
resources were required for transferring the ﬁlled questionnaires from ﬁeld to state ofﬁce,
data entry and received at IIPS. For the ﬁrst time biomarkers were also used in DLHS-4. The
village and health facility questionnaires were canvassed by using paper & pen method in
DLHS-4. In the household questionnaire, information on all members of the household and
socio-economic characteristics of the household, possessed assets, number of marriages.
morbidities and deaths in the household since January 2008, and also drinking water, toilet,
drainage and kitchen facilities were collected. The ever-married women questionnaire
contained information on women’s characteristics, maternal care, immunization and
childcare, contraception and fertility preferences, reproductive health including knowledge
about HIV/AIDS. The village questionnaire contained information on availability of health,
education and other facilities in the village, and whether the facilities are accessible
throughout the year. The health facility questionnaire contained information on human
resources, infrastructure, equipments, drugs and services. For the ﬁrst time, a population-
linked facility survey has been conducted in DLHS-4. At the district level, all Community
Health Centres, Sub-Divisional Hospitals and District Hospitals were covered. Further, all
Sub Health Centres and Primary Health Centres which cater to the needs of the population of
the selected PSUs were also covered. Fieldwork in Himachal Pradesh for all the 12 districts
was conducted during January to July 2013, gathering information from 11,874 households
and 9,100 ever married women (15 to 49 years). Table 1.2 provides breakup of PSUs and
households by district and rural urban residence.
Z. SURVEY DESIGN
DLHS-4 is a district level survey and a multi-stage stratiﬁed designed is adopted for selection
of representative sample of each district in Himachal Pradesh. Rural and urban areas of a
district are considered as natural strata. Wherever applicable, urban in a district is further
stratified into million class cities and non-million class cities. For sampling of urban samples,
two-stage sampling is used where the primary sampling unit (PSU) is the NSSO urban frame
survey (UPS) blocks and second stage sampling unit (SSU) is the household. Urban PSUs are
selected by equal probability without replacement and USU selected by circular systematic
sampling. Allocation of PSUs to million and non-million class cities is proportional to
relative sizes. Distribution of PSUs of a district is proportional to projected urban population
of the district. For districts with less than projected 30 % urban population urban, PSUs are
oversampled. The sampling frame used for urban sampling is the town and city wise list of
NSSO UPS blocks for 2007-08 provided by the SRD Unit of National Sample Survey
Organisation (N SSO), Kolkata.
In rural area of each district, sampling design is two-stage sampling with census villages as
PSU and household as the second stage sampling unit (SSU). The PSUs are selected by PPS
with replacement and SSU are selected by circular systematic sampling. Large selected PSU
with more than 300 households are divided into at least three segments in such a way that
each segment has by and large the same number of households and two segments are then
2

selected by SRS. List of villages in a district in Census 2001 are updated by removing
villages of 2001 which have been designated as urban in 2007-08 NSSO UFS block list and
this serves as the sampling frame for sampling of rural PSUs from a district.
Selection of rural health facilities in DLHS-4 is linked with the sampled rural PSUs. Primary
Health Centres (PHC) and Sub Health Centres (SHC) catered to the health care needs of the
sampled rural PSUs were included in the Facility Survey (FS) of DLHS-4. All Community
Health Centres (CHC), Sub-Divisional Hospitals and District Hospitals are covered under the
Facility Survey of DLHS-4.
2.1. Sampling Weight
In generating district level demographic indicators, sample weight for household, Women and
children will be used. The Weights for a particular district are based on three selection
probabilities
fl‘, fl‘ and f3‘ pertaining to i’h PSU of the district. These probabilities are deﬁned as
fl‘ = Probability of selection of 1″“ PSU in a district
= (n ,* Hi)/H,
Where n, is the number of rural PSU to be selected in a district, Hi refers to the number of
household in the id‘ PSU and H I Z Hi , total number of household in a district.
ff = Probability of selecting segment (s) from segmented PSU (in case the id‘ selected PSU
is segmented) = (Number of segments selected after segmentation of PSU)/(number of
segment created a PSU)
The value of fgi is to be equal to one for un-segmented PSUs.
f3‘ = probability of selecting a household from the total listed households of a PSU or in
segment(s) of a PSU
: HLi
Where HRi is the household response rate of the ith sampled PSU and HLi is the number of
households listed in id‘ PSU in a district.
For urban PSU, ft‘ is computed either as the ratio of number of UF S blocks included in the
sample to the total number of UFS blocks of the district.
The probability of selecting a household from the district works out to be
fl : fl! * fzl * f3!
The non-nonnalized weight for the im PSU of the district is, wi = l/f ‘ while the normalized
weight used in the generation of district indicators for the it“ district would be
Z”,
= ‘e*w’
Z n,*w’
,
3

Where ni is the number of households interviewed in the im PSU. The weight for women and
children are computed in the similar manner considering corresponding response rate.
3. SURVEY INSTRUMENTS
The main instrument for collection of data in DLHS-4 was a set of structured questionnaires,
namely. household, ever married woman, and village questionnaires as components of
household survey. In the facility, separate questionnaires are used for Sub-Health Centre
(SHC), Primary Health Centre (PHC), Community Health Centre (CHC), Sub-Divisional
Hospital (SDH) and District Hospital (DH). Household and ever married women
questionnaires are bilingual, with questions in both Hindi and English languages.
3.1 Household Questionnaire: – The household questionnaire starts with listing of all usual
residents in each sample household including visitors who had stayed the night before the
interview. The listing of usual resident members is used for identiﬁcation of eligible
respondents for ever married women and CAB (Clinical, Anthropometric and Biochemical)
tests. For individual household member information on age, sex and marital status,
relationship to the head of the household and education were collected. Marriages and deaths
to members of household were also recorded. Efforts were made to get infonnation about
matemal deaths. lnfonnation were also collected on the main source of drinking water, type
of toilet facility, source of lighting, type of cooking ﬁlﬂl, religion and caste of household head
and ownership of durable goods in the household.
An added feature of household questionnaire of DLHS-4 is the collection of data on disability
status, injury, acute and chronic illness for all members of the household.
Clinical, Anthropometric and Biochemical (CAB) tests: An important component of
household questionnaire is the collection of biomarkers of eligible household members for
the ﬁrst time on a large scale demographic and health survey in the country at district level.
This includes weight and height for all household members of age one month and above,
Haemoglobin level for all household members aged 6 months and older, random blood sugar
test and blood pressure measurements for all household members aged 18 years and above.
3.2 Ever Married Woman’s Questionnaire:- The respondents for the ever married woman’s
questionnaire are ever married women in 15-49 years of age living in the sampled
households. Details on age, age at marriage, place of birth, educational attainment, number of
biological children ever born and surviving by sex were collected. Accounts of ante-natal
checks, experience of pregnancy related complications, place of delivery, delivery attendant
and post-partum care, together with history of contraceptive use, sex preference of children
and fertility intentions were recorded. For the recent births, immunizations status of children
was collected either from the immunization card or asking the mother about the status of
immunization of the child. The other infonnation collected includes knowledge and
awareness about RTI/STI and HIV/AIDS by source and treatment seeking behavior of
RTI/STI.
3.3 Village Questionnaire:- This questionnaire was designed to collect information on
availability and accessibility of education, health, transport and communication facilities at
4

village level. Functioning of village committees and utilization of fund were additionally
collected from the sampled villages. Information relating to implementation and beneﬁciaries
of various govemment programmes on girl child, maternal care, sanitation, food security,
employment generation, and women’s empowerment are also gathered as part of village
information.
3.4 Facility Questionnaire:- In the facility survey, the information collected at the SHC
level were availability of human resources, physical infrastnicture, equipments and essential
drugs and MCH service provided in one month preceding the survey. From the PHC, status
of availability for 24×7 facility and services for delivery and new born care were collected.
Additional information collected at PHC level were availability of Lady Medical Ofﬁcer,
functional Labour Room, Operation Theater, number of beds, drug storage facilities, waiting
room for OPD, availability of RCH related equipments, essential drugs and essential
laboratory testing facilities. Information that were collected for Community Health Centre
(CHC) includes availability of 24X7 services for delivery and new born care, status of in-
position clinical, supporting and Para-medical staff, availability of specialists trained for NSV
(Non-Scalpel Vasectomy), emergency obstetric, MTP, new born care, treatment of RTI / STI,
IMNCI, ECG etc. Physical infrastructure of CHC such as water supply, electricity,
communication, waste disposal facilities, OT, Labour Room and availability of residential
quarters for medical doctors were also collected in the facility survey. From the Sub-
Divisional and District Hospitals status of availability of essential laboratory and ambulance
services, emergency obstetric care service, availability of specialists, nurses, paramedics and
technicians either on regular or contractual basis were collected in addition to infrastructure,
provision for bio-medical and waste disposal and availability of residential quarters for
doctors, nurses and staff. The mode of collection of infonnation for health facilities is directly
asking to the concerned ofﬁcials, physical inspection and recording from relevant registers.
3.5 Sample Implementation
The ﬁeld implementation starts with the preparation of location and layout maps of sampled
PSUs in rural areas and obtaining map of sampled NSSO UF S blocks in urban areas. This is
followed by preparation of list of households which served as the sampling frame for
selection of representative households and it involved mapping and listing of structures and
households for each sampled primary sampling unit (PSU) following the preparation of
location and layout maps. The 1-napping and listing was carried out for each PSU by a team
comprising of a mapper, a lister and a supervisor. A PSU in rural area is a village or part of a
village or a group of small villages and it is NSSO UFS block in an urban area.
From the sampling frame of households prepared by mapping and listing, a sample of 28
households were selected by circular systematic sampling. Household and ever married
women’s questionnaires were canvassed by a team of 3 female and one male investigators,
one supervisor and two health investigators were assigned for collection of CAB information.
For quality assurance, ﬁeld teams were monitored constantly by Project Ofﬁcers, Ofﬁcials of
PRC, MoHFW, and Partner Institutes who facilitates DBS testing. Time to time DLHS-4
Project Coordinators of IIPS also made ﬁeld visits to check and provide support to ﬁeld
teams.
5

4. DEMOGRAPHIC BACKGROUND OF HIMACHAL PRADESH
Basic demographic indicators of Himachal Pradesh and its districts as of Census 2011 are
shown in Table 1.1. The population of the state in Census 2011 is enumerated as 68 million
and population of the state is concentrated mainly in the districts of Kangra, Mandi, Shimla,
Solan and Sirmaur. The decadal growth rate of the state during 2001-2011 Census is 12.9
percent. Decadal growth rate during this period is 16.2 percent in Una, it is the highest in the
state and nearly 15.9 percent in Solan district. The sex ratio of the state is 972 females per
1000 males, it is lowest (819) in Kinnaur and highest (1095) in Hamirpur. The overall
literacy rate is 82.8 percent and literacy rate is 89.5percent for males and 75.9 percent for
females.
4.1 Sample Coverage
DLHS-4 surveyed a total of 465 primary sampling units (PSUs) covering 11,874 households
with 88.3 percent response rate and 9,100 ever married women in reproductive age 15-49
years with 93.7 percent response rate. Table 1.2 shows the number of PSUs, households and
ever married women interviewed and corresponding response rates by districts. Household
response rate in the district varies from 57.7 to 96.6 percents while that for the ever married
women it is from 75.7 to 99.6 percents.
4.2 Village Facilities
Number of villages sun/eyed in Himachal Pradesh is 421 and 35 villages are surveyed from
most of the districts. Most villages (90%) have a primary school within the village (Table
1.3). In 51.9 percent of the villages, there is Sub-Health Centre (SHC) (Table 1.4a). Out of
total 421 villages 77.7 percent (327 villages) have beneﬁciaries of ICDS, while 92.6 percent
have JSY beneﬁciaries, but 84.8 percent (390 villages) have beneﬁciaries of JSSK (Table
1.4b). As can be seen from Table 1.15 almost all sampled villages (99%) have Anganwadi
centre, 63.7 percent have access to any government health facility but about 19.8 percent of
the sampled villages have Primary Health Centre (PHC) and 68.3 percent of the villages have
Village Health Nutrition and Sanitation Committee (VHNSC).
4.3 Household Amenities and Characteristics
As regards housing condition can be noted from table 1.6 (a), 57 percent of the surveyed
households live in pucca house, 12 percent in kachha house and 30 percent in semi-pucca
house. As many as 99.7 percent of households have electricity connection, 63 percents of
households use woods for cooking while 36 percent use LPG, 89 percent of households have
mobile, 91 percent owned television, 6.5 percent owned bicycle while 19 percent owned
motor cycle/ scooter and 8.2 percent owned car/jeep/van.
The sources of drinking water are shown in ﬁgure 1 and it is noted that 11.4 percent of
households are using tube well or borehole water for drinking and 83 percent of households
are using piped water into dwelling/yard/plot and public tap/stand pipe for drinking. As can
be seen from ﬁgure 2 households which do not have access to improved clean toilet
constitute 13 percent of the total surveyed households and 77 percent of the households have
access to improved ﬂush/septic/pit toilets.
6

Table 1.6 (b) provides household access to electricity, drinking Water, toilet and cooking gas
and type of house by districts. The mean household size of the state is 4.1 While it is 4.2 in
rural and 3.5 in urban areas (Table 1.7). One member households constitute 6.2 percent of all
surveyed households, 86.2 percent household heads are males, median age of the head of the
households is 50 years. Hindu are majority among households (92.5%) and signiﬁcant shares
(22.8%) of the household heads are scheduled castes (SC) and 50.7 percent of household
heads are from the general castes.
Figure 1: Sources of drinking water Figure 21 T°i|el Fa¢i|i”@5
_ _ Pit
pub|ic S::J”‘1’g‘2 ventilated
taplstand other ’ ‘“‘
improved,
improved,
/_ 0.2
No” \ Other, 0.0
Improved
source,
improved,
Piped
into
dwelling!
yardl plot,
35.6
The age-sex composition of the population ofHimachal Pradesh is depicted in the population
pyramid shown in ﬁgure 3. The pyramid is characterize by a shrinking base indicating
declining trend in fertility, more females than males in 15-49 years and at older ages.
Figure 3: Age- sex composition of Himachal Pradesh, 2012-13
80+
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
Ma”? Female
Table 1.8 provides differential in age-sex structures of rural and urban population of the state.
As evident from table 1.9 there is sizeable proportion of unmarried males and females in 20-
7

29 years and another distinctive feature is that are more widowed/divorced/separated among
females than among males. The mean age at marriage for girls is 22.3 years while it is 26.2
years among boys. Mean age marriage for girls and boys by districts are shown in table 1.10.
Only 3.5 percent marriage among girls is below the legal age of 18 years and 3 percent of the
boys got married below the legal age of 21 years. Tables 1.11 through 1.13 provide details
about years of schooling of sampled household members by age, sex, caste and religion by
rural-urban residence. Among females 7 years and older 0.9 percent are non-literate and
corresponding ﬁgure among males is 0.4 percent. More among females, 43.1 percent have 1 1
or more years of schooling as compared to 40.1 percent among males. Regardless of sex
individuals about 31.5 percent of the literate population has less than ﬁve years of schooling.
The non-literate persons are less in urban than in rural and more persons have 11 or more
years of schooling than among rural residents. Table 1.14 provides rate of current school
attendance by age, residence, religion and castes.
Figure 4 shows the school attendance by age, 6-11 years and 12-17 years, the stage of
primary and secondary education respectively and sex. The state achieved 99.8 percent
school attendance among 6-11 years children and 99.1 percent among 12-17 years suggesting
the existence of dropout at the secondary level. There is no evidence of sex differential in
school attendance among 6-11 years but for 12-17 years school attendance among females is
98.9 percent as compared 99.3 percent among males.
Figure 4: School attendance by age and sex
99.8 99.1 99.8 99.3 99.9 93_9
a eve ale 4.
Total Male Female
I6-11 years I12-17 years
5. CHARACTERISTICS OF WOMEN AND FERTILITY
The distribution by age of women surveyed remains almost constant above age 25 years and
above in both rural and urban settings. Age at consummation of marriage is below 18 years is
found to be low only 12.4 percent of ever-married sampled women between 15-49 years
irrespective of residence background. In rural, 12.7 percent of surveyed women reported their
age at consummation of marriage below 18 years. In urban area, 9.2 percent of surveyed
women reported that they had started living with husband before reaching at age 18 years
(Table 2.1). There are more non-literate women in rural (14%) than in urban areas (7.6%).
Non-literate husbands are less by 6.3 percentage points compared to non-literate
wives/women in rural areas. Around 13 percent of women are non-literate whereas 52 percent
of women are educated at least for 10 years. The proportion of husbands with 10 years or
more schooling is 65.6 percent in rural, 84.7 percent in urban and 67.6 percent as combined.
8

Nearly half of the ever-married women
(48.5%) were married for 15 years or
more with a marginal difference between
rural and urban settings. In case of less
than 15 years of marital duration, the
distribution of ever-married women in the
categories of less than 5 years, 5-9 years
and 10-14 years marital duration are
almost uniform, with around 18 percent in
each category. The proportion of women
Figure 5
Mean children ever born by districts
Sirmaur
Una
Solan
Chamba
Kangra
Himachal Pradesh
Kullu
1.9
1.9
1.9
1-B
1.a
2.0
belonging to Hindi has been highest and .
found to be 94.4 percent followed by 3.5 B”==P“’ 1-8
percent Buddhist/Neo Buddhist. The Mandi 1_7
proportion of Hindu women is slightly Lahul aspm ‘ 1-7
higher in urban area (95.9%) as compared
to rural (94.3%). The percent distribution
of women by castes/tribes is skewed Hamirpur 1.7
towards ‘Others‘ (51.6%) followed by Kinnaur i 15
women belonging to scheduled castes –
(22.7%) and Other Backward Classes (14.6%). The percent of women who belong to ‘Others‘
group is higher (68.6%) in urban than in the nlral (49.7%). It is to be noted that 23.6 percent
of surveyed women in rural area and 15 percent in urban area belong to scheduled castes.
Shimla 1.7
Table 2.2 shows the distribution of years of schooling among surveyed women by
background characteristics. The percentage of non-literate women (5.9%) is found to be
lowest in the age group 20-24. Nearly 14 percent rural women and 7.8 percent urban women
reported as non-literate in the survey. Relatively higher proportion of Muslim (36.5%) and
scheduled tribe women (19.3%) are found to be non-literate than other religion or cast groups
respectively. Slightly above one-fourth of surveyed women (27.3%) had ll or more years of
schooling in Himachal Pradesh comprising 25 percent in rural and 48.4 percent in urban. In
contrast, 16 percent of Muslim and 18 percent of scheduled caste women have 11 or more
years of schooling. It is to be noted that at least 14.3 percent of women with 0-5 years of
schooling and 6.7 percent of 6-8 years of schooling reported that their husband is non-literate.
Other than scheduled castes and Muslim women, the distribution is skewed towards 9 and
above years of schooling in Himachal Pradesh. The percentage is as high as 33 percent of
women from ‘other’ castes had ll or more years of schooling.
5.1 Birth Order
Out of the total births since Jan 1, 2008 to ever-married women, around 91 percent births
comes from rural area and the rest 9 percent from urban area. Almost 48 percent of them
belong to women in the age group 25-29 followed by 28.7 percent from women in the age
group 20-24 (Table 2.3). The distribution of these births by religion shows that 96.3 percent
births belong to Hindu and only 1.7 percent to Muslim and rest belong to other than these two
religions. The distribution of births by castes/tribes indicates that births from the ‘Others’
9

castes contribute maximum 49 percent followed by scheduled castes (24.7%) and Other
Backward Classes (18%). Out of the total births since Jan 1, 2008 to ever-married women,
45.5 percent were of second or higher order births and the corresponding ﬁgures are 57.8
percent and 83.5 percent respectively for non-literate and women with less than 5 years of
schooling (Table 2.3).
The births of second and higher order are more in proportion among ever-married women
aged 15-49 who are from rural area (46.1%), belonging to Muslim (69.5%), belonging to
scheduled caste (48.8%), and as, compared to ever-married women educated at least up to 10
years (41.2%), and those belonging (44.1%) to other castes (Table 2.3). Table 2.4 shows that
the proportion of second and higher order births is the highest in Una district (53.3%) and the
lowest in Kinnaur district (26%). The proportion of ﬁrst order birth has crossed the mark of
65 percent in Mandi, Shimla and Kinnaur districts.
5.2 Mean Children Ever Born
Mean children ever born (CEB) to ever-married women aged 15-49 years is 1.8 with
marginal differential by residence, while it is 2.2 for non-literate and 1.5 to women with at
least 10 years of education. The completed fertility measured in terms of average children
ever born to ever-married women aged 40-49 years is nearly 2.3. The differential by
castes/tribes has not seen clearly. Similarly, differential by religion are not wide and ranges
between 2.2 children for Muslim to 1.8 for Hindu. The state level estimates for mean children
ever bom by sex of children are also shown. It indicates that on an average an excess of 0.21
male children to per female children ever bom to ever-married women aged 15-49 years in
the state as a whole. The sex differentials in mean children ever born to ever-married women
aged 15-49 years is found to be higher than state average in the above age 45 years, Rural,
less than 5 years educated and scheduled castes women. In case of women 40-49 years, the
sex differential in mean children ever born is marginal or in the range of state level for almost
across all socioeconomic background characteristics (Table 2.5).
The mean children ever born to ever-married women by district of Himachal Pradesh is
shown in ﬁgure 5, it varies from 2.2 children in Sirmaur district to 1.5 children in Kinnaur
district, while the state average is 1.8 children.
In Himachal Pradesh, most of the outcomes (97.6%) of pregnancies which occurred since Jan
1, 2008 to currently married women aged 15-49 years turned to be live birth. Only 1.4
percent of the pregnancies outcomes are reported as spontaneous abortion. Percentage of
pregnancies that resulted in induced abortion is 0.4 percent for the state as a whole.
Interestingly, age, education and castes/tribes of women depict a large variation in the
percentage of pregnancies resulted as spontaneous abortion. For example, women in the age
group below 25 years show large percentage of spontaneous abortion (1.8%). The highest
rate of spontaneous abortion is estimated for women educated 5-9 years across all educational
background of women. Women belong to Scheduled castes (1.2%), Scheduled tribe (1.2%),
and ‘Others‘ castes (1.7%) tend to have higher rate of spontaneous abortion than the state
average. Similarly, percentage of induce abortions among the outcomes of pregnancies in the
survey reference period is found to be very negligible or nearly zero percent for almost across
10

the all socioeconomic background characteristics (Table 2.6). Percentage of pregnancies
resulted into spontaneous abortions varies from 0.0 percent in district Chamba to 4.2 percent
in district Kinnuar. The other districts also show not seen much rate of spontaneous abortion
Kullu (3.6%), 1.2 percent each in Srimaur , Shimla (1.1%) followed by Una district (2.8%).
The induced abortion rate is Zero in almost all districts except Una district of Himachal
Pradesh. District Una tends to have the lowest level of outcomes (93.9%) as live birth from
pregnancies since January 1, 2008 which should draw attention of reproductive and child
health programme managers (Table 2.7).
5.3 Fertility Intention and Sex Preferences for Additional Child
Fertility preferences of currently married women in terms of desire for an additional child,
timing to have and preferred sex of desired additional child by number of living children are
given in Table 2.8. Among those with no living children, about one-fourth of women (24.1%)
wanted a child soon (within the next two years) and 7 percent want a child two or more years
later. Among the currently married women aged 15-49 with one living child, 7.1 percent of
wanted an additional child soon i.e. within two years. Most of the currently married women
with two living children are either sterilized (60.2 %) or want no more children (31.9 %). In
addition, not more than l percent of women desired another child once they attain two or
more surviving children.
Figure 6 depicts the fertility preference of all currently married women regardless of number
of living children. Twenty eight percent of currently married women want no more children,
ﬁve percent want additional child soon, thirteen percent are undecided about having and
additional child and 46 percent have undergone sterilization. Among the currently married
women with no living children but want an additional child, 59 percent reported that sex of
Figure 6: Desire for the additional child/Next child
Sterilized {-
46% d in fecund
%ons|stent
response
2%
Want another soon
,’/’/”_ 5%
Want another later
2%
mwant another,
undecided when
2%
Want no more 4
28% \ 13%
the child does not matter, 36.9 percent say it is up to God while 2.5 and 1.6 percent want to
have an additional child as a boy and a girl respectively. Among those who had at least one
living child and wanted to have another child, the percentage of women who were able to tell
about preferred sex of additional child is quite high (19.3% wanting boy and 12.5% wanting
girl). With increasing number of living children, longing for an additional male child
ll

becomes more and more magniﬁed from 19.3 percent among currently married women with
one child to 62.5 percent among currently married women with three living children (Table
2.8).
6. MATERNAL HEALTH CARE
Matemal Health Care package of RCH components focused more on ANC is the main
programme under NRHM/NHM programme. The Maternal health care activities are
implemented to strengthen and fulﬁll the RCH goals. ANC services provided by medical and
paramedical professionals are comprises of regular physical checks with weight, height and
blood pressure measure, Haemoglobin level test, consumption of IFA, Tetanus (TT) injection
and growth status and position of foetus. These primary services are made compulsory to be
provided during the ANC check up from health facility. At least four checkups are made
compulsory to complete the ﬁall ANC course in order to prevent and protect women from
pregnancy related complication faced during the pregnancy and till the delivery. Janani
Suraksha Yojna (JSY) is a scheme which is implemented in health facilities under
NRHM/Nl—lM to promote the institutional delivery and post natal care to prevent from
maternal deaths.
6.1 ANC by Selected Background Characteristics
In Himachal Pradesh 92.3 percent of the women had received at least one antenatal care
(ANC) service during the pregnancy of their last birth in the three years period preceding the
survey. Utilisation of govemment health facility for ANC care is more than 89.4 percent
compare to 10.9 percent of private health
facility and 5.3 percent of community based
services (Table 3.1).
Any ANC coverage by selected background
characteristics are illustrated in Figure 7. Any
ANC received among the non-literate are 81.7
percent as against 93.6 percent among the
women educated for 10 or more years. There
is marginal rural-urban gap of (2.2%) in
availing any ANC. Women who had received
ANC with one living children is 92.5 percent
whereas women with 4 and above living
children is 86.5 percent.
The coverage of any ANC is highest in
Hamirpur district (98.7%), nearly universal
coverage in solan, kullu and una (96 to 98.7)
and lowest in Chamba district (76%). Majority
of Women from Lahul & Spiti, Mandi,
Hamirpur, Kinnaur and Chamba district are
availed ANC care from government health
facilities (93.3 to 97.2%) which is the highest in the state. The lowest ANC coverage in
l2
Figure 7
Any ANC by backgraound characteristics
Age group
15-19
20-24
25-29
30-34
35+
No. of Living Children
0
b
+w~_\
Residence
Rural
Urban
Education
Non literate
Less than 5 years
9-10
years
10 or more years
Religion
Hindu
Muslim
Sikh
BuddhistINeo Buddhist
Castes/tribes
Scheduled castes
Scheduled tribes
Other backward classes
Others
1
t_t_
_l
l
.l
il
84.6
92.6
92.8
92.8
88.1
92.5
93.4
88.8
86.5
92.1
94.3
81.7
78.6
90.8
93.6
92.4
92.8
90.9
86.2
94.1
90.5
94.1
91.2

government health facilities was in Una District (79%). The DLHS-4 data reveals that more
women availed from government health facilities for ANC as compare to private health
facilities (Table 3.2).
The speciﬁc components of ANC checkup which are supposed to be received by the Women
during the pregnancy were asked to response. The proportion of Women Who received
weight, height and blood pressure measurement, blood and urine tested, abdomen examined
and sonography/ ultrasound test done are 84.3, 63.3, 70.3, 70.7, 71, 60.2 & 72.2 percent
respectively, (Table no. 3.3). One important features of ANC check up in Himachal Pradesh
in case of ultrasound test done is high among women who are having two children than four
or more living children (74.2% and 62.5% respectively), having ten years of education
(75.7%), rural-urban residence (70.6% and 87.7% respectively), and Muslim and
Buddhist/Neo Buddhist religion (80% and 75%). The women from scheduled tribe caste are
the highest (77%) as compare to all others castes. The detail is shown in Table.3.3.
The proportion of Women Who had received at least three ANC (58.3 %) and the Women who
had received ﬁrst ANC in the ﬁrst trimester of the pregnancy (58.5%) (Table 3.5 A). The
proportion of women who had three ANC are highest among women who have two living
children (60%), having l0 years and above education (61%), Rural residence (58.4%), other
caste (61.5%). There is no much difference by religion and age group between l5 – 35 years.
The women who had full ANC (i.e. at least 3 ANC visits with 100+ IFA tabletsl Syrups
consumed at least l TT) in Himachal Pradesh is 41.1 percent. But 66.7 percent of women had
2 TT+ injections against 58.6 percent who had consumed 100+ IFA tablets/Syrups. The
proportion of women who had received full ANC is highest in Lahul & Spiti district (63.2%)
and lowest is 20 percent in Sinnaur district (Table 3.6). District wise variation in coverage of
full ANC is shown in the Map 1. The proportions of women Who consumed 100 IFA
tablets/syrup and received at least one TT injections are 58.6 percent and 89.7 percent
respectively in Himachal Pradesh during DLHS-4 (Table 3.6).
MAP l
FULL ANTE-NATAL CHECK UP BY DISTRICTS
onmnbu
KIWI?!
Kullll
Mandi Klnflallf
Shlmla
Pe rce nl
III 40 and less
|:| 40.1 – 45.0
slrmuur III 45-1 – 50-v
I More than 50
\\)_ Mag not to Scale
l3

6.2 Institutional Delivery
In Himachal Pradesh, the institutional delivery Progress in Hal delivery
increased from 32 percent in DLHS-1 (1998- 78
99) to 45 percent in DLHS-2 (2002-04) to 48
percent in DLHS-3 (2007-08) and further 32 45 48
substantially increased to 78 percent in
DLHS-4 (2012-13). The institutional delivery _ ‘ _ _ _
in Himachal Pradesh is presented in the Figure DLHS-1 DLSH-2 DLHS-3 DLH8-4
8.
Eighty eight percent of deliveries in the three years period preceding the survey which
results either in still or live births were in both government and private health facilities,
(Table 3.7). The proportion of Women having background of ten years or more education
(81.5%) and having one living child (82.3%) are going for institutional delivery. The
percentage of institutional delivery ranges from 92.8 percent in Hamirpur and 57.4 percent in
Chamba districts (Table 3.9). Around 93.4 percent of Skilled Birth Attendant (SBA) delivery
shows that safe delivery is practiced in Himachal Pradesh. The home delivery cases (21.4%)
who are assisted by skilled persons is only 15.6 percent. The mean delivery cost in Himachal
Pradesh ranges with a maximum of Rs.1 1, 097 in Mandi district and minimum is Rs.3, 483 in
Kinnaur district. In Himachal Pradesh, out of the 12 districts, nearly half districts are having
the institutional delivery 80 percent and above and in remaining 6 districts the percentage is
varies from 57.4-78.7 percent of Institutional delivery which are not low. District wise
variation in Institutional delivery is presented in the Map 2.
MAP 2
INSTITUTIONAL DELIVERY BY DISTRICTS
Llhlll Ind Splﬂ
nu
59’!” Perce nt
– 70 and less
|:| 10.1 -no.0
– no.1 -90.0
|:| More than 90
Mag not to Scale
14

The two districts having the lowest institutional delivery are Chamba (57%) and Srimaur
(67%).
In Himachal Pradesh, 20.8 percent of institutional delivery used ambulance and 50 percent
jeep or car for transportation of delivery with an average cost of Rs.1,074. The used of
ambulance for transportation for institutional delivery was low among women with
background of having 4 and above living children (9.8%), 10 or more years of education
(20.3%), Buddhist (17.4%) and scheduled tribe caste (16.6%). The mean delivery cost is
Rs.5,585 in government health facilities and Rs.13,373 in private health facilities. There is a
large variation of institutional delivery cost compare to government and private health
facilities.
The JSY ﬁnancial assistance for institutional delivery had beneﬁtted to 22.7 percent and
Home delivery 7.4 percent (Table 3.8). The highest beneﬁtted women for institutional
delivery in rural residence (23.7%), having two living children (23.8%), Hindu (22.8%) and
scheduled castes (36.7%).
6.3 Complications during Pregnancy, Delivery and Post-delivery Period
Women who either do not take ANC or take an incomplete course of ANC are exposed to the
risk of matemal death. In Himachal Pradesh as much as 39.8 percent women who had
still/live births in the three years preceding the survey had some complications during
pregnancy (Table 3.6). Out of 12 districts, in 9 districts women faced high pregnancy
complication percentage ranges from 68.9 percent in Hamirpur to 32.7 percent in Kangra.
The remaining 3 districts‘ women faced pregnancy complication ranges from 16.8 percent in
Shimla to 27.5 percent in Lahul & Spilit. Fourty percent of women who had reported
complication during pregnancy had sought treatment (62%) for the problem in Himachal
Pradesh (Table 3.15).
Around 46 percent of women in Himachal Pradesh had faced at least one delivery
complication. The main type of delivery complications experienced by women who had still
or live births in the three years period preceding the survey are mainly obstructed labour
(38.9%), premature labour (64.9 %), prolonged labour (32.3%), excessive bleeding (30%)
and convulsion or high Blood pressure (17.1%). Delivery complication is higher among who
undergone by caesarean (62.7%) compared to normal delivery (43.6%) (Table 3.11). In all
the districts of Himachal Pradesh, Hamirpur district is highest proportion of women had a
delivery complication (81.6%) and is lowest in Chamba (22.5%) (Table 3.15).
Women in Himachal Pradesh have low post-delivery complications (21%) as compared to
pregnancy and delivery complication. The major problem during post delivery period is high
fever (54.7%), lower abdominal pain (46.6%) and followed by excessive bleeding 21.8
percent (Table 3.12). Among the women who had post-delivery complications 66.6 percent
had sought treatment (Table 3.15). In all the districts, women sought treatment for post
delivery complication with highest in Shimla and Lahul & Spiti (100%) and in Chamba
district none of the women sought treatment for post delivery complication.
15

7. CHILD HEALTH AND IMMUNIZATION
To promote child survival and prevent infant mortality, NHM/NRHM envisages new bom
care, breastfeeding initiation, infant food supplementation at the right time and a complete
package of routine immunization for children. Sixty ﬁve percent of newboms were examined
within 24 hours of birth (Table 4.1). In Himachal Pradesh, women who availed newborn care
from Government health facility constitute 84.3 percent as compared to 15 percent from
Private, at home (0.4%) and others (0.2 %). It is a substantial increased from DLHS-3
(75.2%). There is variation in rural areas in utilization of government health facilities (84%)
and private health facilities (15.3%). Majority of women from Scheduled tribe and
Scheduled caste communities check-up in govemment health facilities (94 and 91%) than in
the private health facilities (12 and 21%).
Majority (90.6%) of children under 3 years of age,(bom after January 1, 2008) were fed with
colostrums and there is not much variation across selected background characteristics of
women (Table 4.2). Highest proportion of children being fed with colostrums (96.7%) in
Hamiipur district and the lowest in Bilaspur district (78.3%) (Table 4.5).
In Himachal Pradesh, 69 percent of women had initiated breastfeeding within one hour of the
birth of the child. However, 90 percent of women in Himachal Pradesh initiated breastfeeding
within 24 hours of birth of their children, ranging from 77.5 percent in Kinnaur district to
96.3 percent in Lahul & Spiti (Table 4.5). The proportion of women who initiated
breastfeeding within one hour, within 24 hours and after 24 hours of birth are 68.7, 90 and
5.6 percent respectively.
Duration of exclusive breast feeding practiced is high (among infant under 2 to 5 months old)
and is ranged from 66 to 56 percent. The introduction of food supplementation with semi-
solid and solid food started between the age 4 to 5 months along with breastfeeding. As the
age increases the percentage of the breast feeding declines and 17 percent of children under
18 to 23 months were breast fed along with other ﬂuids, semi solid and solid foods (Table
4.3).
7.1 Immunization Coverage ofChildren (aged 12-23 Months)
The immunization coverage of children (aged 12-23 months) has been recorded either from
vaccination card or by asking the mother in case the card was not available. Twenty one
percent of children’s immunization was recorded from the cards (Table 4.6). The full
immunization coverage was 62.9 percent among children (aged 12-23 months). The full
immunization comprises of BCG, three doses Progress mm” iﬁgﬂlrsisation coverage of
of DPT & Polio and measles (Table 4.6). In chime”
Himachal Pradesh, the coverage of BCG and 14 79 82
measles are 94.9 percent and 87 percent 63
respectively. Only less than one percent of
children have not received any immunization.
The coverage of full immunization was 74 . . .
percent in from DLHS-1 to DLHS-2 (79%) to “”5″ “”8″ °L”s’“ “”3″
16

nuts-3 (82%) and declined in mus-4 (63%) (Figure 9).
In the districts of Himachal Pradesh, the highest coverage of full immunization was in Shimla
with 83.3 percent and lowest in Kangra with 40.4 percent. Out of 12 districts of Himachal
Pradesh, 4 districts recorded full immunization coverage more than 70 percent whereas the
remaining 8 districts had less than 70 percent coverage (Table 4.7). While the coverage of
BCG is high in all the districts similarly for DPT-3 and Polio-3, except in Kangra district
(58.5% & 64.4%). In case of measles the coverage ﬂuctuates from 77 to 94.4 percent in the
districts. The key to improvement in full immunization coverage is to monitor drop out at any
stage of vaccination before completion of full course of immunization. Higher proportion of
children (67.5%) of women educated up to 10 years and above received full immunization.
Non-literate women’s children received full immunization 50 percent (Table 4.6). In
Himachal Pradesh full immunization coverage of children (aged 12-23 months) in urban
areas (72.2%) is higher than in rural areas (62%).
With regard to the place of vaccination of children, it was reported that Sub-Health Centre
(21.6%) and other government health facility (61%) (Table 4.8). District-wise variation in the
coverage of full Immunization is depicted spatially in Map 3.
Children aged 9-35 months who received at least one dose of Vitamin-A is 87.5 percent in
the State (Table 4.9). In Shimla district 95.3 percent of children received at least one dose of
Vitamin-A, remaining all other districts where coverage of Vitamin-A is above 80 percent
respectively.
Majority (88%) of children in Himachal Pradesh had received Hepatitis-B vaccination. There
is marginal gap between children living in urban and rural areas.
MAP 3
FULL IMMUNIZATION COVERAGE OF CHILDREN (AGED 12-23 MONTHS) BY
DISTRICTS
N
um! Mandi
gm“ I 55 and less
😐 55.1 -65.0
|:| 65.1 -15.0
– 75.1 -a5.o
– More than as
Mag not to Scale
l7

7.2 Management of Diarrhoea and Acute Respiratory Infection (ARI)
The information on knowledge of diarrhoea and ARI management was collected from Women
respondents as part of assessment of child care knowledge. Majority (94.8%) of women have
knowledge of diarrhoea management (Table 4.10) and more than 85.4 percent of the women
are aware of danger signs of ARI (Table 4.12).
The common practice followed by women for treatment of children who had diarrhoea was to
give ORS (83.2%), salt and sugar solution (69.4%), plenty of fluids (28.7%), continue normal
food (23.7%) and continue breastfeeding (23.2%) (Table 4.10). In Himachal Pradesh, 75.3
percent children given ORS who suffered from diarrhoea, while 67.5 percent of them were
given some treatment or the other (Table 4.11). Majority (82.6%) of children who had
suffered from diarrhoea are treated in a govemment health facility and 14.8 percent in a
private health facility (Table 4.1 1).
In Himachal Pradesh, 85.4 percent of women are aware of danger signs of ARI. Among
them, 47.4 percent of women knew that difficulty in breathing, 45.1 percent knew pain in
chest and productive cough, 32.8 percent knew wheezing/whistling, 27.8 percent consider
rapid breathing and 43.5 percent having knowledge of others signs of ARI (Table 4.12).
Five percent children had suffered from ARI in the last two weeks prior to the survey. Out of
total children suffered from ARI, 93.2 percent had sought advice/treatment. Majority (67.6%)
of children had treatment at govemment health facility and only 31.1 percent (Table 4.12)
went to private health facility.
The prevalence of ARI among children varies from 0.9 percent in Mandi district to 7.7
percent in Una district. The treatment seeking for ARI or fever is 100 percent and more in the
districts of Mandi, Kangra, Hamirpur, Bilaspur, Shimla and Srimaur (Table 4.13).
8. FAMILY PLANNING AND CONTRACEPTIVE USE
Family planning program in India has undergone sea changes in tenns of strategies, focus and
objectives. Post ICPD 1996 program oriented has evolved itself in to a human right
framework keeping in mind the central point to reduce unmet need for family planning.
Strategies under NRHM were to create demand for family planning through enhancing child
survival and improving matemal health.
Figue 10:
Percent of currently married women using contraceptive methods
59 58
42
9.9
4 1 1
Any method Any modern Female Male Pill IUD Condom
method sterilization sterilization
18

There is awareness to the extent of 78 percent about female sterilization but male sterilization
and Condom/Nirodh is known to only 46 and 41 percent of women respectively. Nearly 27
percent of the women know about IUD, but knowledge of Condom/Nirodh is as high as 41
percent. The knowledge of traditional method is only 12 percent among women in Himachal
Pradesh. However new methods on menu of Indian program/or in market like female condom
is known only 5 percent among women. Female sterilization is the predominant limiting
method being used by 42 percent of currently married women in 15-49 years and popular
male oriented spacing or temporary method is Condom/Nirodh having being used by 16
percent of husbands of currently married women. IUD and Oral pills are being ever used by
1.6 and 5.7 percents of women respectively. Among the currently married women the
proportion ever using any modem method is 62.4 percent, while 64.4 percent of women ever
used either modern or traditional methods. There is no substantial rural-urban difference in
the ever use of any modern contraceptive use. However, female sterilization among rural
women is 42 percent which comparatively more than among urban women with
corresponding ﬁgures is 37 percent.
Figure 11
The status of current contraceptive use among °”a”9° ‘” °°””a°°P””° P’°”°’a”°° “”9
currently married women or their husband 64 7° 71
shows that 58 percent of them were using one 59
or other modern method mostly female
sterilization (42%) at the time of survey.
Condom/Nirodh is in use by 10 percent of
currently married women’s husbands same as “ DLHs_1 ‘ DLHs_2 ‘ DLHs_3 ‘ DLHs_4 ‘
in DLHS-3. The female sterilizations are more (1998-99) (2002-04) (2001-os) (2012-13)
among rural women (42%) and non-literate
(50%) women compared to that among urban women (38%) and women educated for at least
10 years (33%).
Female sterilization regardless of family size is more among currently married women who
have one or more living sons compared to those with no living son. Nearly 10 percent of
women in 25-29 years and about 40 percent of women in 30-34 years have been found to
have undergone female sterilization at the time of survey. The mean age at the time
sterilization is 31 years. Among the currently married women, proportion continuing IUD use
for less than 2, 2-3 and more than 3 years are respectively ll, 6 and 54.6 percents
respectively. Oral pill users continuing for more than 6 months constitute 69 percent of the
total pill users and 64 percent of condom users are continuing for longer than 6 months. It
must be noted that the use of traditional methods has declined in Himachal Pradesh probably
being replaced by more effective method of contraception.
Contraceptive prevalence rate (CPR) for any modem method is below 70 percent in all the
districts of Himachal Pradesh. Highest CPR for any modern method is 68.4 percent in
Hamirpur district and lowest is 43.3 percent in Kinnaur district. The prevalence of female
sterilization in half of the total number of districts are above the state average of 42 percent.
The contrast in the source of terminal and temporary methods of contraceptive is that 95
percent of sterilization has been done in government health facility and 46 percent have
19

availed government health facility service for spacing methods. The high and low utilization
rate of government health facility for limiting and spacing methods is true for all the districts
of Himachal Pradesh. Nearly 64 percent of sterilized women and wives of sterilized men got
monetary compensation for sterilization, With variation of 50 percent in Kinnaur and 75
percent in Chamba district. As many as in 72 percent of sterilization cases monetary
compensation is given at the time of discharge.
Nearly 17 percent of sterilized women, 25 percent IUD and 28 percent Pills users were
informed about the side effects before the adoption and 4, 4 and 3 percents of women using
the aforesaid methods have experienced side effect or health problem. Among the currently
married women who have discontinued contraception the main reason cited is related to other
method (45%) while 30 percent mentioned fertility related problems and 25 percent
mentioned side effects. For the younger women in 15-29 years reasons for discontinuation of
contraception are mostly fertility related and it is also true for women with no or one living
children.
About 5 percent of currently married women aged 15-49 years, not using any contraception
intend to adopt limiting method and 4 percent spacing method in future. Those who intend to
adopt either limiting or spacing methods in future within 12 months, after 12 months and still
undecided about the timing constitute 24, 30 and 46 percents respectively.
Unmet need for spacing includes the proportion of currently married women who are neither
in menopause nor had hysterectomy nor are currently pregnant and who want more children
after two years or later and are currently not using any family planning method. The women
who are not sure about whether and when to have next child are also included in unmet need
for spacing. In Himachal Pradesh 11 percent of currently married women have unmet need
for spacing. Unmet need for spacing is 24 percent for women with one living child and 42,
32, 22 percents for women aged 15-19, 20-24 and 25-29. On the other hand, currently
married women who are still have physiologically potential for conceiving and want no more
children are categorized as having unmet need for limiting. The unmet need of contraceptive
for limiting is about 9.7 percent in the state.
20

MAP 4
CONTRACEPTIVE PREVALENCE RATE FOR ANY METHOD BY DISTRICTS
N
~‘ A
Bllaspu,
Percent
|:| 50 and less
|:| 50.1 – 55.0
|:| 55.1 – 60.0
1:1 60.1 – 65.0
|:| More than 65
Mag not to Scale
ai
*2
Currently married women with unmet need for spacing is highest in Lahul & Spiti district
(15%) and lowest is in Una disrtict (7%). On the other hand unmet need for limiting is also
highest in Kinnaur (14%) and lowest is in Hamirpur (4.8%)
The total unmet need of contraceptive has Fig[|fel2
been increased in DLHS-2 to DLHS-3. It was cha”9° i” “””‘°‘ “eed f°’ °°””a°°’°“°”
10 percent in 2002-O4, l4 percent in 2007- Z1
08. In 2012-13 it seems unmet need has
marginally increased to 21 percent. This is
basically due to higher unmet need for
spacing among the younger cohort, a sign of
decline in the desire for large family size. _ ‘ ‘ _
District wise contraceptive prevalence rate (gs-oféi) (gt;-Jlfég) (Z:-1″E1″;)
and unmet need are presented in ﬁgure 13.
14
12
21

Figure 13:
Contraceptive prevalance rate and unmet need by districts
Kinnaur 11
Shimla 13
Sirmaur 12
Solan 10
Bilaspur 9
lHlMACHAL PRADESH 11
Una 7
Hamirpur 7
Mandi 2 15
Kullu 11
Lahul & Spiti 2 15
Kangra – 14
Chamba – 9
30 2.5 21) 115 10 0 10 15 2.0 25 30 315 41) 415 50 55 60 65 70
Unmet Need for spacing I Unmet Need for limiting IContraceptive Prevelance Rate
9. REPRODUCTIVE HEALTH
Reproductive health addresses the issues of reproductive processes, encompassing the
functions and system at all stages of life. The reproductive health, is the ability for the people
to have a responsible, satisfying and safe sex life and have the capability to reproduce and the
freedom to decide if, when and how often to do so. This means that the right of men and
women alike to be informed of and to have access to safe, effective, affordable and
acceptable methods of fertility regulation of their choice, and the right of access to
appropriate health care services that will enable women to go safely through pregnancy and
childbirth and provide couples with the best chance of having a healthy infant. The burden of
diseases among women is due to reproductive function and system. The ﬁve main causes of
the disease burden among women in developing countries are maternal, Sexually transmitted
disease, tuberculosis, HIV infection, Depressive disorders. DLHS-4 has obtained information
on awareness and prevalence of RTI/STI, HIV/AIDS, information and ways to avoid AIDS.
9.1 Menstruation Related Problems
The women reported to have menstruation related problems and have speciﬁc symptoms
during three months preceding the survey by background characteristics is given in Table 6.1.
Menstrual problems are experienced by 8 percent of women in Himachal Pradesh. The
problems of painful periods (54%) and irregular period (39%) are the main menstrual
problems experienced by women. The other problems reported are frequent or short periods
(12%), prolonged (15%) and scanty bleeding (11%), absences of periods and blood
clots/excessive bleeding (5%). The differentials in menstruation related problems are found
by age, place of residences and education of both husband and the women. Women who had
consummated their marriage below 18 years of age have had more menstruation related
problems (9%). The menstrual related problems also increased with duration of marriage.
22

More than 8 percent of women had reported to have menstrual problems whose marital
duration was 10-14 years and was more than 15 years. The menstrual related problems did
not differ by caste and religion.
9.2 Awareness of RTI/STI
The awareness of RTI/STI was obtained from ever married women. The women who are
aware about RTI/STI were further asked on the modes of transmission and symptoms of the
disease. Table 6.2 shows the percentage of women who have heard of RTI/ST1 by
background characteristics. More than one-fourth of women in Himachal Pradesh had heard
of RTI/ST1. The proportion of women who were aware of RTI/STI was comparatively higher
in urban areas (36%) than in rural areas (29%). Awareness of RTI/STI was lower among
young women, women with low age at consummation of marriage, non-literate and women
from Other Backward Castes and Muslim Women. Awareness of RTI/STI increases with
education of women. Thirty nine percent of women who had completed ten or more years of
schooling were aware about RTI/STI.
Television is an important source of knowledge about RTI/STI, more than 90 percent women
reported they had heard about RTI/STI from TV. Another major important sources of
information about RTI/STI are from print media (54%), cinema (41%), community leaders‘
meeting (33%). The sources of knowledge about RT1/ST1 differ by education of women and
husband.
9.3 Knowledge Regarding Mode of Transmission of RTI/STI
The knowledge regarding mode of transmission of RTI/STI was asked to women who had
heard of RTI/STI (Table 6.3). Almost more than ﬁfty percent of women reported unsafe
delivery, unsafe abortion and unsafe sex with persons who have many partners as a mode of
transmission of RTI/STI. Around 38 percent women reported unsafe sex with sex workers as
a mode of transmission of RTI/ST1. More than one third women reported unsafe IUD
insertion and unsafe sex with homosexuals were also reported by women as mode of the
transmission of RTI/STI. The knowledge varies by residence, age at consummation,
education of women and education of the husband.
Table 6.4 shows the common symptoms of reproductive tract infections/sexually transmitted
infections among women. About 14 percent of ever married women have reported having
symptoms related RTIs/STls and 6 percent experienced abnormal vaginal discharge. The
women reported itching or irritation over vulva (4%), pain in lower abdomen not related to
menses (5%). About 58 percent of women discussed the RTI/STI related problems with their
husband or partner (Table 6.5). The women mostly sought treatment for RT]/ST1 (73%) from
government health facility.
The Women who have heard about RTI/STI varies from 17 percent in Solan district to 63
percent in Lahul & Spiti district. Women reporting any abnonnal vaginal discharge varied
from 2.2 percent in Shimla district to 10.1 percent in Kullu district. More than half of the
women in three districts (Kullu, Solan and Kinnaur) except all other district had Sought
treatment for any RTI/STI including abnormal discharge.
23

9.4 Awareness of HIV/AIDS
The awareness on HIV/AIDS was asked to ever-married women age 15-49 years. Nearly two
third of the women had heard about HIV/AIDS. Television is the one of the major source of
knowledge on HIV/AIDS. Ninety two percent of Women reported that TV is the main source
of knowledge on HIV/AIDS, cinema (46%), followed by Community‘s leaders meetings
(39%), print media (48%), school adult education programs (35%), health personal (34%),
husband (10%) and radio (23%) (Table 6.7). More than (65%) percent of the women reported
unsafe sex with person having many partners, transfusion of infected blood (52%), infected
mother to child (52%) and sharing of injection/needle as mode of transmission of HIV/AIDS
(46%) (Table 6.8). The reported modes of transmission of HIV/AIDS differ by residence,
education of women and husband.
Table 6.9 shows knowledge of methods of preventing HIV. About two third percent of
women were of the view that HIV/AIDS can be prevented by avoiding risks of getting
infected through blood. More than one-third of women were of the opinion that by using
condom correctly during each sexual intercourse and having sex with one uninfected partner
can prevent HIV/AIDS. The differences in the preventing HIV/AIDs were found by
residence, age at consummation of marriage, education of women and husband. The
misconception about transmission of HIV/AIDS from mosquito, ﬂea or bedbug was reported
by 4 percent of women. The other misconception was sharing food (1.5%), stepping on
someone’s urine/stool (2%), sharing clothes (1%), hugging (1%) and shaking hand (1.5%)
respectively.
The women who had heard about HIV/AIDS were asked the place to test the HIV/AIDS
(Table 6.11). More than half of the women know the place where the HIV/AIDS could be
tested. The differences in the place of test were found by residence, age at consummation of
marriage, education of women and husband. Forty seven percent of women reported
government hospital/dispensary and 12 percent reported private hospital/clinic as a place
where people can go to test HIV/AIDS. The women who have heard about HIV/AIDS were
asked if they had gone for the test. Thirty six percent of women had undergone for the test of
HIV/AIDS. The women who had undergone a test 18 percent had undergone test before a
year (Table 6.12). Comparison with district ﬁgures Lahul & Spiti highest (54%) and Mandi
(20%) has lowest number of women has been tested for HIV/AIDS.
10. PERSONAL HABITS
Personal habits of adults (age 15 and above) such as consumption or abuse of tobacco and
alcohol, and eating unhealthy foods are usually viewed from the lens of risk-taking behaviour
due to their adverse health outcomes. The emerging morbidity pattern from the personal
habits is a crucial predictor of current as well as future health status of a population. It has
become increasingly important to understand and examine the impact, these habits have on
overall health status in India in the context of the epidemiologic and demographic transitions.
Besides, the treatment seeking behaviours for these illnesses reﬂects the availability,
accessibility, as well as quality of health care services. Studies have shown evidences of
correlation between the shift towards non-communicable diseases (NCD) and increasing risk-
24

taking behaviours among adult individuals. For instance, excessive drinking is linked to acute
and chronic physical health problems, particularly those related to the heart, blood
circulation, respiratory, diabetes, mental health, cancer, crime and disorder, domestic
violence, unprotected sex, unintended pregnancy, etc., (Room, Baboor, and Rehm, (2005).
Alcohol consumption contributes to many diseases and is now the ﬁfth leading risk-factor for
the global disease (Lim, Vos, Flaxman, et al, 2012). Also, the economic burden of these NCD
is equally serious – i.e., a 10 percent rise in NCDs is found associated with l percent lower
rates of annual economic growth. However, programmes to combat NCDs were
tremendously underfunded, and a low priority policy, as it is not part of the millennium
development goals (MDG).
The WHO has recently stated that NCD such as cancer, diabetes, and hypertension are largest
causes of death, and by 2020 cardiovascular diseases will be the largest cause of death and
disability, including developing countries like India (WHO 2010). In 2012, the UN
conference on sustainable development (Rio+20), referred to non-communicable diseases as
“one of the major challenges for sustainable development in the 21“ century”, emphasising
the fundamental link between health and development. In the same year, the World Health
Assembly endorsed an important new health goal: to reduce avoidable mortality from non-
communicable diseases (NCDs) by 25% by 2025 (the 25 by 25 goal). The future threat to
health is from NCDs, as the world also urbanizes faster than before.
Since 1990s 1ndia’s overall health status has shown tremendous improvement, which signals
a change and shift in pattern of morbidity and causes of death to non-communicable diseases
(NCD), despite still substantial contribution of communicable diseases. The NCD accounted
for 42 percent of all deaths in India (56% in urban areas and 40% in rural areas), as compared
to communicable diseases with 38 percent (RG1, 2003). Estimated prevalence of diabetes,
hypertension, ischemic heart diseases (IHD) and stroke is 62.5, 159.5, 37.0 and 1.54 per 1000
respectively. In the National Health Policy (NHP), the Government of India (G01) has
committed to eradicating infectious illnesses and reducing the mortality associated with such
illness (MOHFW, 2002). One of the goals of the NHP 2002 is a 50 percent reduction of
deaths from TB, malaria, and other vector and water borne diseases by the year 2010.
This chapter presents ﬁndings on the personal risk-taking habits, acute and chronic
(infectious and non-communicable) diseases, and their treatment-seeking behaviours.
10.1 Tobacco and Alcohol Use in India
Tobacco and alcohol use have been associated with a wide range of major diseases, including
several types of cancers and heart and lung diseases. Studies have shown that in addition to
sharing the same health risks as men, women who use tobacco or alcohol also experience
difﬁculty in becoming pregnant, are at an increased risk of infertility, pregnancy
complications, premature births, low-birth-weight infants, stillbirths, and infant deaths
(USDHHS, 2004).
In India, information about tobacco and alcohol use among adults has been collected by
various household surveys such as the National Sample Survey (NSSO) (50th round, 1998),
NFHS (1992-93, 1998-99, and 2005-06), DLHS (2007-08), the Global Adult Tobacco
25

Survey-India (GATS-India, 2009-10), etc., each survey with speciﬁc objectives and
methodology. According to GATS India, 35 percent of adults in India age 15 and over use
tobacco in some fonn or the other, with higher use among adults in most North eastern region
(39-67%), east (36-50%), and central (40-53%) (IIPS & MoH&FW, 2010).
In India, there are varieties of tobacco products and its use is also very diverse. The most
common ways of tobacco use are the smoking and oral (smokeless) variety. Dominant among
the smoking form include cigarettes and bidis, while in case of the oral use of smokeless
tobacco, chewing or applying to the teeth or gums (scented/unscented, with paan) are the
popular forms, which has also become very popular in most parts of the country. The DLHS-
4 also collects information related to tobacco and alcohol usage directly from among the
eligible adults (women age 15-49 and men age 15-54).
In case of alcohol consumption, household surveys in India show that alcohol use among
adults, both men and women, is not uncommon, but the use is found much lesser than
tobacco use. Alcohol consumption is higher among men than females. Study in India
indicated the prevalence of current use of alcohol ranged from about 7 percent in Gujarat
(state officially under prohibition) to a very high 75 percent in Arunachal Pradesh, and its
consumption among women exceeded 5 percent only in the Northeastern region. DLHS-4
information on alcohol use by adult men and women comes from a substantial number of
respondents (9,935 men and 13,013 women).
10.2 Tobacco Use in Himachal Pradesh
As shown in Table 7.1, overall 18 percent of adults in Himachal Pradesh use any kind of
tobacco in one way or the other. However, tobacco use varies across the state by age,
residence, education, region, etc. The survey clearly indicates that tobacco use is highest and
more likely among men (36%), people with less than 5 years of education (20%), rural
residents (18%), and among schedule tribe (20%), etc.
In Himachal Pradesh, among adults, smoking is more prevalent (17%) as compared to the
oral fonn (smokeless variety) of tobacco (4%). Use of smoke tobacco is higher among men
(34%) as compared with females (2%) and also more likely to be higher among the older
adults age 40 and above (over 20%), and among schedule tribe (19%).
In general, it is observed that in Himachal Pradesh use of tobacco among adults increases
with age. The pattem of using tobacco among adults also shows an interesting scenario across
the districts in Himachal Pradesh. Of the 12 districts in the state, two districts, namely
Chamba and Shimla stand out as lower use of tobacco in the state (Table 7.4). Reporting of
use of oral or smokeless form is highest in Kullu (12%), followed by Bilaspur (6%) &
Srimaur (5%). In most of the districts, the proportion of adults using oral form of tobacco is
around 0.9 to 12 percent. In case of smoking fonn of tobacco the use among adults ranges
from 13 percent in Bilaspur to 26 percent in Kullu. Other districts in which around 14 to 19
percent of adults are likely to smoke.
The use of tobacco (all forms) among men is on the lower side in Himachal Pradesh — 8% for
oral or smokeless and 34% for smoking. It is interesting to note that both forms of tobacco
26

use is the lowest among teenagers (less than 1%), but increases from age 20 onwards (among
the youth) to older ages. Smokeless tobacco use is slightly higher among men in rural areas
(9%) than urban males (8%). Interestingly, smoking in men shows a same scenario in
Himachal Pradesh. Smoking is found to be higher among men in rural areas (35%) than in
urban areas (27%). Among men also, age and education emerge as important factors. The
older males say age 30 and above (8-11%) are much more likely to use tobacco products than
those aged less than 20 (below 1%). Similarly, as education level increases use of tobacco in
any form is more likely to diminish among men. The more educated males are less likely to
use tobacco than their counterparts who are illiterate (Table 7.2).
In Himachal Pradesh, strictly speaking, both forms of tobacco are widely used by men (8-
34%). About one percent of adult men use tobacco with paan, and below one percent with
guthka/paan masala. Use of paan with tobaaco among men is slightly higher in rural areas,
while use of guthka/paan masala with tobacco is higher in urban areas (Table 7.5). In the case
of smokers, more of rural men use this form (35%), higher by about 8 percent, than those in
urban areas (27%). About 15 percent of men are usual smokers (smoke at least once a day) in
Himachal Pradesh. The proportion of usual smokers is 16 percent in rural areas as compared
with 10 percent in urban areas (Table 7.6).
Generally, use of tobacco is found to be very less among women, more so when compared
with men. In Himachal Pradesh (Table 7.1), a small proportion of adult women reported
using any kind of tobacco (2%). Among the women tobacco users, while only about 2 percent
smoke, a very small proportion of them (about 1%) use the oral form or chew tobacco (Table
7.3).
The pattern of tobacco use observed among women is found to be very interesting. For
instance, it shows a constant pattem (below 1%) over different ages for both type of tobacco
for women in Himachal Pradesh. Only about 2 percent of women in rural areas smoke,
compared with about below 1 percent in urban areas. Among those women who use non-
smoke form/chew tobacco, about 0.1 percent used it with betel nut or paan (Table 7.5).
Among women who smoke, just about 0.7 percent are usual smokers (smoke at least once a
day) (Table 7.6).
10.3 Use ofAlcohol in Himachal Pradesh
Household surveys in India show that alcohol use among adults, both men and women, is not
uncommon, but the use is found much lesser than tobacco use. Alcohol consumption is higher
among men than women. Study in India indicated the prevalence of current use of alcohol
ranged from about 7 percent in Gujarat (state ofﬁcially under prohibition) to a very high 75
percent in Arunachal Pradesh, and its consumption among women exceeded 5 percent only in
the Northeastem region. DLHS-4 information on alcohol use by adult men and women comes
from a substantial number of respondents (9,935 men and 13,013 women).
As presented in Table 7.1, in Himachal Pradesh 18 percent of adults consume alcohol. In the
state, the level of consumption is found much higher among adults age above 30 (19-26%)
and highest among scheduled tribe (22%). Like use of tobacco, education does not make
much impact as an important factor. Highest alcohol consumption is observed for people with
27

more years education (19-20%). The level of alcohol consumption by religious afﬁliation
shows that the least consumption is among Muslims (15%) and highest among Others (25%).
In Himachal Pradesh, alcohol consumption across the districts shows that of the 12 districts,
only in 4 districts the level is less than 15 percent (Table 7.4). The prevalence of alcohol use
across the state ranges from l2 percent in Bilaspur to about 25 percent in Lahul & Spiti.
Consumption of alcohol is found high in districts such as Kullu (25%), Mandi (21%), and
Shimla (20%). Districts with l9 percent of adults consuming alcohol are Kinnaur, Srimaur
and Kangra.
In Himachal Pradesh, consumption of alcohol is found more concentrated among males
(37%) as compared with (2%) among females (Table 7.1). Men who are more likely to
consume alcohol are those in their 30’s and 40’s (above 40%), non-literates and less than 5
years of education (44-46%), for other religions (above 47%) and other backward clases
(40%). The reporting of consumption of alcohol is seen among the teenagers (2%). Alcohol
consumption among men is higher in rural areas (38%) as compared with urban areas (30%).
Only about 2 percent of adult females reported consuming alcohol in Himachal Pradesh
(Table 7.3). The consumption of alcohol increases by age, with higher intake among older
females age 35 and above (about l-3%). Women who reported consumption of alcohol are
non-literate (about 3%). A very small proportion (0.5%) of females in Himachal Pradesh
reported as being a usual drinker.
ll. MORBIDITY STATUS
In DLHS-4, for the ﬁrst time, information on morbidity status of the household members was
collected from the household respondent. The main objective is to get a somewhat fair idea
about the prevalence of both acute illnesses (suffered for a week) and chronic illnesses (for a
month or more), including disability (current) and injury (in last one year), suffered by any
household member prior to the survey. Respondents were asked about occurrences of such
illnesses among the household members, and to name the illness, including those diagnosed.
Further, in case of occurrence of any disability, injury or illness, respondents were also asked
about the nature of care sought, the type and place of health facility where treatment was
done.
Depending on the nature and duration, all the illnesses or diseases are classiﬁed as (a) acute,
and (b) chronic. Acute illness refers to those that occur suddenly with severe symptoms for
short period during the last l5 days prior to the survey. Example includes diarrhoea,
dysentery, acute respiratory tract infection (ARI), jaundice with fever, fever with
chill/rigors/malaria, fever with rash, reproductive tract infections (RTI), etc. In case of
chronic illness, those symptoms that persist for longer than one month in the past one year
prior to the survey. The list provided includes both symptoms and associated diseases
categories.
ll.l Disability and Injury
From each of the selected household, DLHS-4 collected information from the head of the
household or adult respondent on any injury and on ﬁve speciﬁc disabilities that household
28

members may have suffered from such as mental, visual, hearing, speech, and locomotor. As
it is difﬁcult to capture the type of injury and its severity from lay reporting, assessment is
made indirectly from the type and duration of hospitalization required for the injury.
As presented in Table 7.8, in Himachal Pradesh about 4 percent of the sample population
reported suffering from any injury. The prevalence of any injury is a little higher in the rural
areas (4.1%) compared to urban areas (3.7%). The prevalence of any injury shows not much
variation between males and females in the state.
About 10 percent of the injuries reported were treated in intensive care. However, 15 percent
of injuries were treated as in-patient with stay for less than a week, and 14 percent reported
they treated as in-patient with stay for more than 2 weeks. Interestingly, in Himachal Pradesh,
about 47 percent of injuries were treated using other fonn of treatments, i.e. other than
intensive care or staying/in-patient, such as out-patient, traditional healers, or home remedies.
More of females go for treatments for 1-2 week stay in-patient(l5%) as compared with
males (13%), while men are more likely to be treated in intensive care or as in-patient with
stay more than 2 week. There is variation in terms of treatment of any injury by residence in
Himachal Pradesh.
In Himachal Pradesh, among the ﬁve disabilities, the prevalence of hearing visual disability
is a little higher (1%) as compared to other disabilities. Reporting of visual disability is equal
for female and male (0.8%). Mental and hearing disabilities are the other two disabilities
reported in Himachal Pradesh (0.2% and 0.2% respectively). The prevalence of visual
disabilities is higher in urban area than rural area (Table 7.9).
11.2 Reported Illnesses: Acute and Chronic
In order to assess the prevalence of illnesses from the selected household level in DLHS-4,
the household respondents were ﬁrst asked if any member of their households had suffered
from any illness in the past one month or year. If reported that someone had suffered, more
detail of the illness recorded, including main source of treatment. As mentioned earlier, all
the illnesses are classiﬁed into (a) acute and (b) chronic, based on the nature and duration,
and the infonnation is collected from head or any adult member of the household.
Acute Illnesses
The prevalence of acute illness at the household level in Himachal Pradesh is 2 percent. The
differential in the prevalence of acute illness by residence shows not much variation (around
2.3% in rural & 1.5% in urban).
About 2 percent of household members reported suffering from any acute illness in Himachal
Pradesh, and equal proportion of men and women (2.2%) reported to have suffered from any
acute illness. Among the prevailing acute illnesses, fever (other than those with rash or
jaundice) is reported by nearly 22 percent, followed by acute respiratory tract infection
(ARTI) (7%), malaria (10%), fever with rash (1 1%), diarrhea/dysentery (19%), and Jaundice
with fever (15%). Acute respiratory tract infection (ARTI) and diarrhea/dysentery are found
to be higher in rural areas than in urban areas. The prevalence of other acute illnesses is
observed to be around 15%. Interestingly, for most of the acute illnesses reported, more men
29

suffered from most acute illnesses than women. Prevalence of acute illnesses is also found
higher in rural areas, barring ARI and fever (other type of fever).
Nearly everyone who had suffered from any acute illness sought treatment. Among those
who had sought treatment, 79 percent preferred treatment at govemment facility, mainly in
Hospitals (33%). About 12% of those Who had acute illnesses got treated in a private facility,
mainly in a hospital, followed by Dispensary/clinic (5%). About 1 percent with any acute
illnesses were treated at DOTS centre or at home. In Himachal Pradesh, use of government
health facility for treatment of acute illness is quite common even in rural areas (79%), and
equally accessed by both males and females.
Chronic Illnesses
Survey results of chronic illnesses described pertain to prevalence, type, and source of
treatment by sex and residence. In Himachal Pradesh about 3 percent of the households
reported a member suffering from chronic illnesses that lasted for over a month in the past
one year prior to the survey (Table 7.8). As shown in Table 7.13, reporting by symptoms of
chronic illnesses suffered by household members is highest for diseases of the respiratory
system (11%), followed by diseases of central nervous system (10%), musculoskeletal system
(8%), followed by diseases of skin and eye (7%). Diseases related to respiratory system,
musculoskeletal system and central nervous system account for about 8-ll percent
respectively. Interestingly, reporting of symptoms of chronic diseases other than the twelve
identiﬁed diseases account for 33 percent.
In Himachal Pradesh, not much differences observed in the repoﬁing of symptoms of chronic
diseases between males and females, except in case of some diseases. For instance, more
males reported symptoms related to respiratory system (13% as compared with 9% among
females), cardiovascular system (7% against 5% among females), and for central nervous
system (13% against 8% among females). In contrast, females reported more of symptoms
related to disease of musculoskeletal system (10% compared to 6% among males).
By and large, most chronic illnesses show more or less similar prevalence in both rural and
urban areas. However, some of these chronic illnesses show slightly higher prevalence either
in rural or urban areas. For instance, urban residents reported more of diseases of central
nervous system (19%), genitourinary system (6%), eye problem (10%) and skin diseases
(8%) than rural residents. In case of rural areas, much higher reporting related to diseases of
respiratory system (11%), cardiovascular system (6%) musculoskeletal system (8%) and
‘other‘ (34%).
Household respondents were also asked about the nature and source of treatment for chronic
illnesses suffered by any of their household member. In Himachal Pradesh, 75 percent of
those who suffered from chronic illnesses have details of diagnosis or treatment. About
(13%) has no details of diagnosis or treatment, and about 13 percent do not sought treatment
at all. The proportion with no details of treatment (13%) is more in the rural areas as
compared to urban areas (3% respectively). Overall, 74 percent of rural residents and 84
percent of urban residents have details of diagnosis or treatment for the chronic illnesses. It is
30

also observed that both males and females have more or less equal accessibility to health care
services for chronic diseases (Table 7.13).
Interestingly, in Himachal Pradesh most people who suffered from chronic illnesses sought
treatment at govemment facility (72%), even among rural residents (73%), and the proportion
is 66 percent among urban residents. About 27 percent were treated at private facility (26% in
rural areas and 34% in urban areas), while 1 percent reported being treated at home, and
about 1 percent sought other form of treatment.
Persons who sought treatment for chronic illnesses were also asked about the details of the
diagnoses at the facility. In Himachal Pradesh, hypertension (18%) and diabetes (14%) are
the most commonly diagnosed chronic illnesses, followed by diseases related to heart (8%)
and asthma or chronic respiratory failure (6%). Goitre accounts for about 2 percent of the
diagnosed chronic illnesses, and about 1 percent with tuberculosis (TB). As expected, the
proportion diagnosed With these chronic illnesses is much higher in urban areas, particularly
hypertension and diabetes. The results show that more males suffered from heart diseases
(10% against 6% among females) and asthma and chronic respiratory failure (9% against 3%
among female) (Table 7.14).
Contrast to situation in the general population, among the older persons age 60 and above the
prevalence of most chronic illnesses is much higher. For instance, about 15 percent of older
persons were diagnosed with diabetes and 11 percent with asthma and chronic respiratory
failure (Table 7.15). The prevalence of some of these chronic illnesses indicates that higher
proportion of older persons in urban areas suffered from hypertension (18% as compared
with 17% in rural areas) and diabetes (29% against 14% in rural areas). Similar to the
situation in the general population, among the older persons also it is found that more females
are diagnosed with hypertension (18% as compared with 17% among males) and diabetes
(19% as compared with 11% among males). More of male older persons are diagnosed with
diseases related to heart, asthma or chronic respiratory failure and TB, which is found to be
similar in both urban and rural areas.
11.3 Tuberculosis (TB)
Tuberculosis has re-emerged as a major public health problem in many parts of the world,
often as a concomitant illness to HIV/AIDS. Tuberculosis, once known as the ‘White
Plague’, is contagious and spreads through droplets that can travel through the air when a
person with the infection coughs, talks, or sneezes. Today, TB is a leading cause of death
among people who are HIV-positive. Worldwide, an estimated one-third of the nearly 40
million people living with HIV/AIDS are co-infected with TB. In most developing countries,
TB would continue to be a serious health threat even in the absence of HIV/AIDS due to the
public health challenges posed by poverty, high illiteracy, and poor sanitation. The G01 has
stated that ‘In 2005, a total of 97 percent population was covered under the Revised National
Tuberculosis Programme.’ The government allocated Rs. 680 crores for the National
Tuberculosis Control Programme (NTCP) in the 10th Plan (DGHS and WHO, 2005).
In Himachal Pradesh, about 1 percent of the household population diagnosed with TB, which
is found to be higher in urban areas.
31

12. NUTRITION AND HEALTH
The DLHS-4 collected data on the nutritional status of children by measuring the height and
weight of all children under age ﬁve in the selected households. The nutritional status
assessment helps to identify sub groups of child population that face increase risk of faltered
growth and potential health risks and vulnerabilities. The nutritional status of children in the
survey population is compared with WHO child growth standards , which are based on an
international sample of ethnically, culturally and genetically diverse healthy children living
under optimum condition that are conducive to achieving a Child’s full genetic growth
potential (WHO, 2006)]. These standards can therefore be used to assess nutritional status of
children all over the world, regardless of ethnicity, social and economic inﬂuence and child
feeding practices. Accordingly, three standard indices of physical growth that describes the
nutritional status of children are height-for-age (stunting), weight-for-height (wasting) and
weight-for-age (underweight). Each of these indices provides different infonnation about
growth and body composition that can be used to assess nutritional status.
In DLHS-4, all children listed in the household, who were born in year 2008 or later were
eligible for measurement of their height and weight. Thus, height and weight measurements
were collected even from those children whose mothers may not have been interviewed in the
survey. For this purpose, all the survey team carried with them two scales and two height
boards, which were standardized in all aspects and calibrated for accuracy. Recumbent length
was recorded for children under age two years. Standing height was measured for all other
children. Table 8.1 represents percentage of children below age ﬁve classiﬁed as
malnourished according to three anthropometric indices of nutritional status (height for age,
weight for height and weight for age) by some selected background characteristics. The
analysis is based on information collected from 1957 children from Himachal Pradesh for
whom complete and erodible anthropometric and age data are available.
12.1 Height-for-Age (Stunting)
Height-for-age measures linear growth. A child who is more than two standard deviations
below the median (-2SD) of the WHO reference population in tenns of height-for-age is
considered short for his or her age are stunted. This condition reﬂects the cumulative effect of
chronic malnutrition. If a child is below three standard deviations (-3SD) from the reference
median, he or she is considered to be severely stunted. In Himachal Pradesh 33 percent
children under age ﬁve are stunted and 18 percent are severely stunted. Variation in the
prevalence of stunting by age group shows that stunting is highest (55%) in children age 19-
24 months, followed by those in age 36 months and above(37%) and the lowest (12%) in
children below age 6 months. Prevalence of sever stunting shows a similar pattern, with the
height proportion of sever stunting in children age 19-24 months (39%), followed by among
those age 25-35 months (23%). Sex differential in the prevalence of stunting is not much
pronounced as male children are relatively more likely to be stunted (34%) than female
1 World Health Organization (WHO) Multicentre Growth Reference Study Group. 2006. WHO Child
Growth Standards: Length/Height-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Indexfor-
Age: Methods and Development. Geneva, Switzerland: WHO.
32

children (32%). The sex differential remains by and large the same even in ease of severe
stunting. There is different in children under age ﬁve belong to Muslim family and other
backward castes family are more to be stunted than all ‘others’.
The prevalence of stunting is not uniform across different districts in Himachal Pradesh.
Stunting is the lowest in Una district (19%) and followed by Kinnaur (25%). While, the
prevalence of stunting is the highest in lChamba (48%) followed by Mandi and Solan (46%
and 45% each). Severe stunting is the lowest in Shimla and Kinnaur (8%), Una (11%) and
Kangra (15%). On the other hand, Mandi portrays (38% each) the highest prevalence of sever
stunting.
12.2 Weight-for -Height (Wasting)
Weight-for-height describes the current nutritional status. A child who is more than two
standard deviations below (-2SD) the reference median for weight-for-height is considered to
be too thin for his or her height, or wasted. This condition reﬂects acute or recent nutritional
deﬁcit. As with stunting, wasting is considered sever if the child is more than three standard
deviations below the reference median. Overall 22 percent children in Himachal Pradesh are
wasted and 10 percent are severely wasted. Analysis by age group shows that wasting rages
from a minimum 15 percent in children age 19-24 months to the maximum 34 percentage in
children in age 0-6 months. Children from residing in rural areas are more likely to be wasted
(22%) than children living in urban areas (21%). There is much different of weight-for-
height/wasted in children from scheduled castes (24%), tribes (18%), others (24%) and other
backward classes (1 1%). Variations by district portray that wasting in children ranges from O
to 4 percent in each of Lahul & Spiti and Srimaur to 42 percent in Bilaspur.
12.3 Weight-for-Age (Underweight)
Weight-for-age is a composite index of weight-for-height and height-for-age. Thus, it is does
not distinguish between acute malnutrition (wasting) and chronic malnutrition (stunting). A
child can be underweight for his age because he or she is stunted, because he or she is wasted,
or both.
Table 8.1 reveals that 29 percent of children under age 5 are underweight and 10 percent are
severely underweight. The proportion of underweight children is the highest (38%) among
children age 19-24 months and the lowest (25%) among children age 13-18 months. The sex
differential in the proportion of underweight children is not pronounced. There is much
different of underweight in rural (29%) and urban (23%) children. Even children from
scheduled tribes, scheduled castes, other backward classes and other are relatively more or
less similar in underweight. By districts, underweight in children ranges from 50 percent in
Chamba to ll percent in Kinnaur.
12.4 Body Mass Index ofWomen
In many countries, chronic energy deﬁciency characterized by BMI of less than 18.5 among
adults remains the predominant problem, leading to low productivity and reduced resistance
to illness. Prevalence of overweight among women is also growing problem in developing
countries. Overweight individuals are predisposed to a wide range of health problem
33

including diabetes and heart diseases and also poor birth outcomes for pregnant women. The
BMI is used to measure thinness or obesity. It is deﬁned as weight in kilograms divided by
height in meters squared (Kg/m2). A BMI of less than 18.5 is used to deﬁne thinness or acute
under nutrition. A BMI of 25 or above usually indicates overweight and a BMI of 30 or
above indicates obesity.
In DLHS -4, height and weight measurements in Himachal Pradesh were obtained for 6042
women age 15-49 years who were present in the sample households at the time of survey.
Table 8.3 presents percentage of women age 15-49 by their BMI. The mean BMI is 24.8,
which falls in the normal BMI classiﬁcation. About two third (65%) of the women age 15-49
have a normal BMI , l6 percent are undemourished or thin (BMI less than 18.5) and 20
percent are overweight or obese ( BMI 25 or higher ). It is evident from the table that there is
profound variation in BMI by some selected background characteristics of women. Women
age 15-19 are more likely to be thin are or undernourished (40%) than women in other age
cohorts. Rural women are more likely to be thin or undernourished (16%) than their urban
counterpart (13%), where as urban women are 1.5 times as likely to be overweight or obese
as compared to rural women (19 and 28% respectively). Educational attainment has seen
same with (14%) minimum and (17%) maximum in case of underweight or thin and (19%)
minimum and (20%) maximum in case of overweight/obese. Among women who are non
literate, nearly (14%) are thin or underweight. There is not clear pattem seen in case of
proportion of women who are overweight or obese. Women from Other Backward caste
households, having larger potential to have food insecurity, are comparatively more likely to
be thin in comparison to those households from other caste-groups. Proportion of ever
married women who are thin or underweight is not uniform across districts of Himachal
Pradesh. It ranges from the minimum of 7 percent in Lahul & Spiti to 23 percent in Chamba
and Srimaur. On the other hand, proportion of women who are overweight or obese is the
highest in Solan (32%) and lowest in Chamba and Mandi (9%).
12.5 Prevalence ofAnemia
Anemia, characterized by a low level of hemoglobin in the blood, is major health problem in
developing countries, especially among young children and pregnant women. Anemia among
pregnant women may be an underlying cause of maternal mortality, spontaneous abortion,
premature births, and low birth weight. The most common cause of anemia is inadequate
dietary intake of nutrients necessary for synthesis of hemoglobin, such as iron, folic acid, and
vitamin B12. Anemia also results from sickle cell disease, malaria, and parasitic infections
(Benoist et al. 2OO8)2. It is against this background, a number of interventions have been put
in place to address anemia in children in developing countries. These include expanded
distribution of iron supplements and deworming medication to children age l-5 every six
months.
2 Benoist, B. D., E. McLean, I. Egli, l., and M. Cogswell (eds.). 2008. Worldwide Prevalence ofAnaemla
1993-2005: WHO Global Database on Anaemia. Geneva, Switzerland: World Health Organization
34

In DLHS-4, all the usual residents of the selected households including children age 6-59
months were included in the anemia testing, where blood drops were collected using dried
blood spot (DBS) method and tested in designated laboratories. The process of blood
collection consists of obtaining blood droplets by pricking in the middle or ring ﬁnger with a
retractable and non-reusable lancet. Before pricking, the ﬁnger was cleaned with a swab
containing 70 percent isopropyl alcohol and allowed to dry. In case of those children Where
blood droplets were not possible from middle or ring ﬁnger, heel pricking was practiced and
DBS were prepared.
Table 8.5 shows the anemia status of children age 6-59 months by some selected background
characteristics. Almost three-ﬁfth (59%) of children age 6-59 months suffer from some level
of anemia (Hb = 140 or DBP>=90) also portrays the same pattern with the lowest
proportion of women in Bilaspur and Kullu (25% and 26% each) and the highest proportion
in Kangra (40%), Una (37%) and Hamirpur (36%).
12.8 Use oflodized Salt
Salt used in the household is the most common vehicle for iodine fortiﬁcation to prevent the
public health concems of iodine deﬁciency disorders. The compound used for fortiﬁcation of
salt is potassium iodide (KIO3).According to the World Health Organization, a country’s salt
iodization program is considered to be on a good track to eliminate iodine deﬁciency when
90 percent of households use iodized salt. The DLHS-4 made an effort to assess household
iodized salt consumption by testing iodine contents in the salt being used by the household.
Table 8.18 shows the proportion of households using iodized salt according to some selected
background characteristics.
Over all, salt was tested for iodine contain in 87 percent of household in Himachal Pradesh
and 55 percent households were found to use salt with adequate iodine contain. Another 30
percent households were found to use salt with iodine but the proportion of iodine contain
was not adequate. Urban and Rural household are equally likely to use iodized salts.
Analyzing the variation in proportion of household using iodized salt by districts, it is evident
from Table 8.19 that it ranges from a maximum in Solan (34%) to the minimum in Srimaur
(5%).
13. HEALTH FACILITIES
The basic objective of the population linked facility survey conducted in DLHS-4 is to collect
data on health personnel, availability of drugs/medicines, equipments, basic RCH care
amenities, communication means and infrastructure at the level of, PHC and CHC, in order to
assess the adequacy of RCH services in rural areas.
In DLHS-4 facility survey, at the district level, all Community Health Centres (CHCS), Sub-
Divisional Hospital (SDH) and the District Hospitals (DH) were covered. All Sub Health
Centres and Primary Health Centres (PHCs) which were expected to serve the sampled
population of selected PSU were also covered.
38

In Himachal Pradesh, the average sampled rural population served per Sub Health Centre,
PHC and CHC are 3, 464, 16, 648 and 44, 794 respectively (Table 9.1). In total, villages were
surveyed in DLHS-4 and the RCH services of these sampled villages were catered by 280
Sub Health Centres, 153 PHCs and 70 CHCs.
Out of the 280 Sub Health Centres 208 SHCs are functioning in government building, 88
percent have regular electricity (Table 9.2). In three district namely Hamirpur, Una and Solan
were having labor room available at SHCs (4%) and rest of the districts SHCs were not
having labor room out of this 33.3 percent SHCs where labor room are currently in use.
Toilet facility is available in 86 percent of the sampled Sub Health Centre. Around 84 percent
of these Sub Health Centres running in government buildings have provision for water
supply.
Citizen’s charters are displayed in 71 percent of the sampled 280 Sub Health Centres (Table
9.3). The proportion of sampled Sub Health Centre facilitated by Village Health & Sanitation
Committee (VHSC) and those that received untied funds is 97 percent and 95 percent
respectively.
In Himachal Pradesh 93 percent of total 280 Sub Health Centers have Auxiliary-Nurse-Mid-
Wife (ANM) in position. State as whole only 3 percent of SHCs have Additional ANM. Fifty
two percent of the Sub-Health Centres have male health worker in position. It is lowest in
Srimaur district (30%) of Sub-Health Centres have male health worker in position (Table
9.4).
Out of 153 sampled PHCs of the state the number of PHCs are having of Medical Officers,
Lady Medical Ofﬁcers, AYUSH Doctors and Pharmacists in position are 82 percent, 12
percent, 18 percent and 43 percent of the sampled PHCs respectively.
Only 31 percent of the 153 sampled PHCs have residential quarters available for MO. About
16 percent of the sampled PHCs are functioning on a 24 hour basis. About 64 percent of the
sampled PHCs catering to the sample villages have at least four beds. Eighty six percent of
the PHCs have regular power supply and only 22 percent have functional vehicles (Table
9.6).
Newborn care services are available in 77 percent of the sampled PHCs, 16 percent provide
referral services for delivery care, and 24 percent of the PHCs have conducted at least 10
deliveries during last one month prior to the survey (Table 9.7).
Ninety six percent of sampled PHCs have received ‘Untied Fund‘ and almost all the sampled
PHCs (100%) have utilized the funds (Table 9.8). Rogi Kalyan Samiti (RKS) has been
constituted in 97 percent and the Citizen’s Charter displayed in 81 percent of sampled PHCs.
Out of 77 sun/eyed CHCs, 5 CHCs are having an Obstetric Gynecologist, 6 CHCs having
Pediatrician, 7 CHCs having Anesthetist and 6 CHCs having Public Health Manager in
position respectively (Table 9.9).
For the state as a whole out of 77 CHCs only 21 have blood storage facility and 27 CHCs
have designated as First Referral Units (FRUs). Out of the 77 CHCs around 40 and 53 CHCs
39

are having functional Operation Theaters (OTs) and newborn care services respectively
(Table 9.10).
Out of total 77 CHCs 66 have utilized untied funds, 75 CHCs have constituted RKS and
monitored regularly and displayed citizen‘s charter in 72 CHCs (Table 9.11).
In Himachal Pradesh total l2 Districts Hospitals have surveyed out of this ll districts
hospitals having pediatricians in position and 9 District Hospitals are having radiographers.
Nine District Hospitals are having 2D echo facility and 10 District Hospitals are having ultra
sound facilities. Three phase connection is available in all districts, critical care area is
available only in 6 District Hospitals and suggestions and complaint box are available in all
Districts Hospitals.
40

BACKGROUND CHARACTERISTICS
41

TABLE 1.1 BASIC DEMOGRAPHIC INDICATORS
Basic demographic indicators of Himachal Pradesh and its districts, Census 2011, India.
Percentage
Population Percentage decadal growth
Siale/Districi
(in thousands) urban
rate“
Sex ratioz
Male Femate
Percentage literate 7+
T0181
Chamba
Kangra
Lahul & Spiti
Kuliu
Mandi
Hamirpur
Una
Bilaspur
Sotan
Sirmaur
Shimla
Kinnaur
519.1
1,510.1
31.6
437.9
999.8
454.8
521.2
382.0
580.3
529.9
814.0
84.1
Himachal Pradesh 6,864.6
7.0
5.7
0.0
9.4
6.3
6.9
8.6
6.6
17.7
10.8
24.8
0.0
10.0
+12.es
+1211
-5.0
+1476
+10.92
+10.19
+1626
+12.05
+1593
+15.54
+12.67
+7.39
+12.94
986
1,012
903
942
1 .007
1 ,095
976
981
880
918
915
819
972
82.6
91.5
85.7
87.4
89.6
94.4
91.9
91.2
89.6
85.6
89.6
87.3
89.5
61.7
80.0
66.8
70.9
73.7
82.6
81.1
78.0
77.0
71.4
77.1
71.0
75.9
72.2
85.7
76.8
79.4
81.5
88.2
86.5
84.6
83.7
78.8
83.6
80.0
82.8
Source: Primary Census Abstract, Series 20, Census of India, 2011.
12001-2011. 2 Female per 1.000 males.
43

TABLE 1.2 NUMBER OF HOUSEHOLDS. EVER-MARRIED WOMEN
Number of households and ever-married women interviewed by district, Himachal Pradesh, 2012-13.
No of PSU Number of households interviewed
Number of ever-married women interviewed
Stale/Districts Rural
Urban
Total
HH response
Rural Urban rate Total
Rural
Urban EW response rate
Chamba 37
Kangra 38
Lahul & Spiti 25
Kullu 36
Mandi 37
Hamirpur 37
Una 37
Bilaspur 37
Solan 33
Sirmaur 36
Shimla 30
Kinnaur 40
Himachal Pradesh 423
03
02
00
04
03
03
03
03
07
04
10
00
42
1,024
1,030
646
1,082
1,045
990
1,044
1,011
993
1,059
1,001
949
11,874
941
981
646
976
990
920
966
946
823
961
790
949
10,889
91.4
92.0
57.7
96.6
93.3
88.4
93.2
90.3
88.7
94.6
89.4
84.7
88.3
817
868
494
1,101
853
734
828
685
706
B66
725
424
9,100
741
831
494
1,007
812
679
772
636
602
810
573
424
8,380
76 94.0
37 95.9
NA 90.8
94 99.6
41 98.4
55 95.4
56 89.4
49 90.7
104 91.2
56 97.0
152 97.1
NA 75.7
720 93.7
Note: Table based on unweight
ed cases. NA:
Not Applicable.

TABLE 1.3 DISTANCE FROM THE NEAREST EDUCATIONAL FACILITY
Percent distribution of sampled villages by distance from the nearest educational facility, Himachal Pradesh, 2012-13.
Distance from the village 1-O;a| percent
Educational facility Within village < 5 km 5»9 km 10+ km (100%) Primary school Middle school Secondary school Higher secondary school College Madarsa 90.0 72.4 49.2 33.7 7.1 3.9 8.8 18.8 27.1 27.1 10.9 25.5 1.2 6.4 16.2 22.1 16.9 15.7 0.0 2.4 7.6 17.1 65.1 54.9 100.0 100.0 100.0 100.0 100.0 100.0 Note: Distance from the village is calculated for only those villages which do not have the facility within the village.Table is based on unweighted cases. TABLE 1.4(g) DISTANCE FROM THE NEAREST HEALTH FACILITY Percent distribution of sampled villages by distance from the nearest health facility, Himachal Pradesh, 2012-13. Health facility Distance from the village' Within Within Within More than Within village 3km 5km 10km 10km Sub Health Centre Primary Health Centre Community Health Centre DistrictlGovt. Hospital Government Dispensary Private Clinic Private Hospital AYUSH Health Facility2 51.9 19.8 3.3 1.4 12.6 20.3 4.3 6.7 81.7 35.6 13.5 7.8 40.6 48.8 35.6 54.6 89.8 50.1 18.5 11.9 64.4 69.3 58.0 75.3 88.6 77.9 31.8 18.3 86.0 86.4 77.9 90.7 2.9 22.8 68.6 81.9 14.7 14.5 22.3 9.3 Note: I Including facilities within village. 2 AYUSH-Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy TABLE 1.4]B| PROGRAMMES BENEFICIARIES Percentage villages having any beneficiaries from selected programs , Himachal Pradesh, 2012-13. Programmes Percentage of villages Number of villages Janani Suraksha Yojana (JSY) 92.6 Janani Shishu Suraksha Karyakram (JSSK) 84.8 Integrated Child Development Scheme (ICDS) 77.7 390 357 327 Total number of villages 421 TABLE 1.5 REASONS FOR DROPPING OUT OF SCHOOL Percentage of household population aged 6 to 17 years who dropped out of school by main reasons, Himachal Pradesh, 2012-13. Total Rural Urban Reason Male Female Total Male Female Total Male Female Total School too far Further education not necessary Required for work in household activitiesl farm family/business Required for outside work Not interested in studies Cost too much Repeated failures Got married Others Total percent Number of persons“ 3.8 3.5 3.5 3.8 30.0 5.7 7.9 0.0 41.8 100.0 25 0.0 1.7 0.0 1.6 3.1 3.3 0.0 1.7 41.6 36.3 6.6 6.2 0.0 3.6 7.1 3.8 41.7 41.8 100.0 100.0 30 55 3.8 3.5 3.5 3.8 30.0 5.7 7.9 0.0 41.8 100.0 25 0.0 1 9 0.0 1 7 3.6 3 5 0.0 1 9 36.6 33.4 7.6 6 6 0.0 3 9 8.1 4 1 44.1 43.0 66.7 73.7 26.3 26.3 100.0 100.0 -- 100.0 100.0 27 52 03 03 -- no cases. " Unweighted cases. 45 TABLE 1.6(§) HOUSING CHARACTERISTICS AND HOUSEHOLD ASSETS Percent of households by housing characteristics and household assets goods, by residence, Himachal Pradesh, 2012 13 Housing characteristics Residence Total Rural Urban Electricity Having electricity Source of drinking water Improved sourcel Sanitation facility Improved sanitationz Fuel used for cooking Liquefied Petroleum Gas (LPG) Electricity Kerosene Wood Others Type of house Kachha Semi - pucca Pucca Number of rooms 1 2 3+ Household assets Radio/transistor Television Computer! laptops without internet Computerl laptops with internet Telephone only Mobile only Washing Machine Refrigerator Sewing machine Watch! clock Bicycle Motor cyclel scooter Car / Jeep/van Tractor Water pump/tube well Cart driven by animal Cart driven by Machine Other cart Cooler/AC Number of households“ 11 99.7 96.5 87.0 35.5 0.3 0.4 63.3 0.0 11.8 30.3 57.2 5.7 19.7 74.6 22.8 90.5 3.3 5.1 14.6 89.3 29.7 52.4 77.9 88.3 6.5 18.9 8.2 1.0 1.9 0.1 0.1 0.2 2.9 .874 10 99.7 96.1 85.6 29.8 0.2 0.3 69.1 0.0 13.1 32.4 53.8 5.1 18.7 76.2 23.6 90.0 2.8 3.7 14.3 88.8 26.1 49.2 78.0 88.2 6.2 17.5 6.9 1.1 2.1 0.1 0.1 0.2 2.3 .889 100.0 99.7 98.3 80.6 0.4 0.9 17.6 0.1 2.2 13.6 83.7 10.5 28.1 61.4 16.2 94.5 7.7 16.4 16.5 93.9 58.3 78.1 76.4 89.4 8.5 30.7 18.4 0.4 0.5 0.0 0.1 0.3 7.8 985 1 other. “unweighted cases. Includes piped into dwelling piped to yard/plot, public tap/stand pipe/hand pump,/tube welll bore well/well covered/spring tanker, can with small tank and bottled water. 2 includes ﬂush to sewer/septic/twin pit, pit with slab. pit ventilated improved TABLE 1.6(Q) HOUSING CHARACTERISTICS BY DISTRICT Percentage of households with selected characteristics by districts, Himachal Pradesh, 2012-13. Improved source Improved of drinking access to Using Liquefied Living in pucca Having District With electricity water‘ Sanitationz Petroleum Gas house BPL card Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur DLHS-4 DLHS-3 99.3 100.0 99.2 99.8 99.7 99.7 100.0 100.0 99.1 99.8 99.9 99.8 99.7 98.2 97.5 98.5 62.1 99.2 99.7 98.8 97.8 98.1 98.5 98.0 99.2 96.2 96.5 90.3 86.1 72.7 89.2 89.6 92.3 97.1 81.9 93.6 92.5 78.6 85.1 82.6 87.0 55.9 43.4 31.3 36.5 29.4 39.7 28.1 20.6 27.6 44.5 34.3 51.3 22.2 35.5 24.6 42.0 56.6 42.9 42.7 52.0 57.1 74.6 74.2 84.2 59.4 46.2 38.9 57.2 45.5 14.8 14.7 21.8 12.8 25.7 21.7 22.8 18.9 13.1 21.6 15.5 17.7 17.9 30.6 1 Note: Includes piped into dwelling piped to yard/plot, public tap/stand pipe/hand pump,/tube welll bore well/well covered/spring tanker, cart with small tank and bottled water. 2 Household having access to toilet facility = improved source of sanitation + ﬂush not to sewer/septic/pit/twin pit + pit without slab + dry toilet. TABLE 1.7 HOUSEHOLD CHARACTERISTICS Percentage of the households by selected characteristics of the household head, household size and residence, Himachal Pradesh, 2012-13. Characteristics Total Rural Urban Residence Sex Male Female Age < 30 30-44 45-59 60+ Median age Religion Hindu Muslim Sikh Buddhist Others CasteITribe Scheduled castes Scheduled tribes Other backward classes Others Number of usual members 1 c£0o\|®01J=~<.~>|u
86.2
13.8
3.9
27.6
38.3
30.1
50.0
92.5
1.1
0.8
5.4
0.2
22.8
13.0
13.5
50.7
6.2
12.8
16.8
28.6
18.7
9.8
3.5
1.7
2.1
Total percent 100.0
Mean household size
Number of households“ 11,874
4.1
86.6
13.4
3.4
27.2
38.7
30.8
52.0
92.2
1.0
0.8
5.9
0.2
23.7
14.2
13.5
48.6
5.4
12.3
16.5
28.6
19.3
10.2
3.6
1.8
2.3
100.0
4.2
10,889
82.9
17.0
8.6
31.0
35.3
25.1
48.0
no
53.‘.-‘.-‘.”‘
<.\>®-K=~\i—\
15.8
2.9
13.2
68.1
12.3
16.6
19.3
28.3
13.5
6.1
2.1
1.0
0.9
100.0
3.5
985
Note:Tota| ﬁgure may not add to 100 percent due to ‘do not know‘ or ‘missing cases. Note: ”Unweigl’|ted cases
47

TABLE 1.8HOUSEHOLD POPULATION BY AGE AND SEX
Percent distribution of the household population by age, residence and sex, Himaohal Pradesh, 2012-13
Total
Rural
Urban
Age group Total Male Female
Total Male Female Total
Male Female
<1 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+ Total percent Number of Persons" Sex ratio at b1irth’ Sex ratio 0-4 104,9 na .-‘.-‘!\’!\’.‘*$".“S7’.“.“?°$°$°9°.“.“$'°.° >mmmAA»@mmoAommmwm
.“.“Y‘>Y‘>.“$”.<”@.“.“.“9°9°9°9°9°Y*’.o amsmmmwmmémwmmmowm 100,0 100.0 49,168 25,252 106,4 na ??NN?¥@@N@@@@@NNW9 Aaowwmmwbowmmbméwm 100.0 23,874 na na ?fNN?@ﬁ@ﬁFF9@WﬁF@9 ANNmmNAwAA©O—m®mA® 100.0 45,683 106.9 103.4 .“.“Y°!°1“F"$7’9".“.“."9°9°9°9°9°Y"’.° hmhmmmmhhéwwmmméum 100.0 23,460 na na ??NPPW@@#F@@P¢FFP? A»omwow4Amoawa~4Ao 100.0 22,182 I13 I13 9?NN??N@@@@@PPNN@9 mm>mo»mwo>mMm>woom
100.0
3,485
97.4
129.9
.o.“!°Y‘>:”:”.”.”9°.\‘$°9°9°9°9°.”f”’.o
mmmmommmmmmammawwm
.o.“Y‘>!‘>.“.*‘.”.°”.”$°$°.89°9°.“F-”!”.o
mmomooamhwmmawmmww
100.0 100.0
1,792 1,692
na na
na na
Table is based on the de facto population,
both usual residents and visitors). na = Not applicable. 1
i,e. persons who stayed in the household the night before the interview (including
Females per 100 males. ** Unweighted oases.
TABLE 1.9 MARITAL STATUS OF THE HOUSEHOLD POPULATION
Percent distribution of the household population (agelO years and above) by marital status, age and sex, Himaehal Pradesh,
2012-13
Marital status
Age Never Married, gauna not – Widowed! divorcedl T018| Number of
. performed Currently Marned separated percem R9:
QTOUP
ITI
arrled
PGTSOTIS
Total
10-14
15-19
20-24
25-29
30-44
45-49
50-54
55-59
60+
Total
99.0
97.5
75.4
35.4
.oI”._‘I”:>
omomm
31.1
.o.°.°.°.°.°.°.°.o
NNONAANAO
0.1
mmmmomm
WWPPPPPN?
mwommmwao
62.1
83w+N@P@@
b@©m»mNOO
6.6
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
3,862
4,170
4,440
4,433
11,238
3,088
3,617
2,487
5,851
43,186
Male
10-14
15-19
20-24
25-29
30-44
45-49
50-54
55-59
60+
Total
99.0
98.7
89.8
5
Am»mmA
Ammomm
35.9
.o.°.°.°.°.°.°.°.o
m»AmmAwAA
0.2
mmmmmb
f@?@%WPfP
wéoowwwmo
60.1
Q
9’.“.“.-‘.-29.0.9.9
wmmmm»Aoo
3.8
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
2,133
2,162
2,230
2,181
5,645
1,624
1,669
1,317
3,123
22,084
Female
1 0-1 4
1 5-1 9
20-24
25-29
30-44
45-49
50-54
55-59
60+
Total
Ammo
PPPPNWPWW
mmoommwmm
26.2
.°.°.°.°.°.o.oF>F7
Aoomoéooo
0.1
oomw
?@?@@f
wowom»
84.8
81.2
53.9
64.2
bad
.U”.°°7’*.”!‘-1.0.09.0
wawmwmmoo
9.6
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
1,727
2,008
2,208
2,248
5,590
1,464
1,944
1,169
2,726
21,084
“Unweighted cases
48

TABLE 1.10 AGE AT MARRIAGE
Mean age at marriage and percentage of marriages below legally prescribed minimum age at marriage by sex, residence and
districts Himachal Pradesh, 2012-13
Percentage of marriages below legal Currently married women
Mean age at marriage age at marriage aged 20-24 who were
Place of residence/ married before age 18
Boys Girls Boys (<21 years) Girls (<18 years) years district Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Rural Urban DLHS-4 DLHS-3 26.7 27.4 25.5 24.8 26.4 27.3 27.0 26.7 24.9 24.2 26.6 25.6 26.1 27.1 26.2 26.0 22.7 22.1 23.1 21.2 20.3 21.3 22.7 23.2 23.1 23.3 22.8 22.0 22.2 24.4 22.3 21.9 0.0 0.0 0.0 3.7 0.0 0.0 0.0 0.0 0.0 0.0 2.8 0.0 0.5 0.0 .-‘$3 mow 21.8 1.5 21.4 19.6 17.5 9.3 7.7 9.7 10.7 18.2 12.1 7.1 12.9 13.8 13.0 9.1 Reference period: January 15‘, 2008 to survey date. TABLE 1.11 EDUCATIONAL LEVEL OF THE HOUSEHOLD POPULATION Percent distribution of household population age 7 years and above by literacy levels, years of schooling and background characteristics Himachal Pradesh, 2012-13 Years of schooling among those who are literate Background Non- characteristics literate Less than 5 6 ~ 8 9 - 10 11 or more Missing Total Percent Number of persons" Total Age 7-9 10-14 15-19 20-29 30-39 40-49 50+ 0.0 0.1 0.1 0.1 0.3 0.9 1.8 97.5 47.0 2.0 4.9 10.9 18.8 21.9 2.2 43.6 14.9 6.9 16.4 20.2 12.6 0.1 8.6 39.9 20.3 28.9 27.7 16.0 0.0 0.4 42.9 65.8 43.6 32.5 47.7 0.1 0,3 0.3 0,0 0.0 0.0 0.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 2,179 3,862 4,170 8,873 7,591 6,735 11,955 Sex Male Female 0.4 0.9 18.5 22.0 16.2 15.7 24.7 18.2 40.1 43.1 0.1 0.1 100.0 100.0 23,269 22,077 Religion Hindu Muslim Sikh Buddhist Others 0.7 0.7 0.7 0.5 4.7 20.3 25.1 18.6 17.4 26.2 16.1 18.2 13.5 13.7 20.4 21.7 18.8 27.7 19.0 15.9 41.2 37.1 39.4 49.4 31.3 0.1 0.0 0.0 0,0 1.6 100.0 100.0 100.0 100.0 100.0 42,086 529 347 2,285 118 Caste Scheduled Castes Scheduled Tribes Other Backward Classes Others 0.8 0.9 0.8 0.5 22.8 20.1 19.9 19.1 18.4 16.4 17.2 14.4 20.5 19.4 22.6 22.3 37.3 43,2 39.4 43,7 0.1 0.1 0.1 0.1 100.0 100.0 100.0 100.0 10,439 5,890 6,297 22,739 Total 0.7 31.5 20.2 16.0 21.5 41.5 0.1 45,365 ** Unweighted cases. 49 TABLE 1.12 EDUCATIONAL LEVEL OF THE HOUSEHOLD POPULATION Percent distribution of household population age 7 years and above by literacy levels, years of schooling and background characteristics Himachal Pradesh, 2012-13 Non- literate Years of schooling among those who are literate Number Less Total than 5 6 - 8 9 - 10 11 or more Missing Percent persons“ of Rural Age 7-9 10-14 15-19 20-29 30-39 40-49 50+ 0.0 0.1 0.1 0.1 0.3 0.9 1.9 97.6 47.1 2.1 5.2 11.6 19.9 22.7 2.0 43.7 15.4 9.3 17.2 20.8 12.6 0.2 8.5 40.0 21.0 29.4 27.5 15.0 0.0 0.4 42.1 64.4 41.5 30.9 47.8 0.1 0.3 0.3 0.0 0.0 0.0 0.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 2,040 3,597 3,878 8,251 6,966 6,215 11,170 Sex Male Female 0.5 1.0 19.1 22.8 16.7 16.0 24.8 17.9 39.0 42.4 0.1 0.1 100.0 100,0 21,601 20,498 Religion Hindu Muslim Sikh Buddhist Others” 0.7 0.9 0.9 0.5 3.3 21.0 27.0 19.0 17.5 28.9 16.5 18.7 14.7 13.4 21.1 21.6 17.8 26.9 18.9 12.7 40.2 35.6 38.5 49.7 32.3 0.1 0.0 0.0 0.0 1.8 100,0 100.0 100.0 100.0 100.0 39,002 466 289 2,255 105 Caste Scheduled Castes Scheduled Tribes Other Backward Classes Others 0.8 1.0 0.9 0.6 23.3 20.1 20.4 20.0 18.5 16.4 17.4 14.9 20.3 19.3 22.4 22.3 37.0 43.2 38.9 42,2 53.05353 100.0 100.0 100.0 100,0 9,917 5,812 5,831 20,557 Total 0.7 20.9 16.3 21.4 40.6 0.1 42,117 *" Unweighted cases. 50 TABLE 1.13 EDUCATIONAL LEVEL OF THE HOUSEHOLD POPULATION Percent distribution of household population age 7 years and above by literacy levels, years of schooling and background characteristics Himachal Pradesh, 2012-13 Background Non- characteristics literate Less than 5 6 - 8 9 - 10 11 or Years of schooling among those who are literate more Total Missing Percent Number of persons“ Urban Age 7-9 10-14 15-19 20-29 30-39 40-49 50+ 0.0 0.0 0.0 0.0 0.1 0.2 1.2 95.7 45.7 0.3 1.9 4.6 9.0 12.7 4.3 42.7 10.0 4.3 9.4 14.6 12.2 0.0 10.1 38.3 13.4 25.1 29.3 27.2 0,0 0.8 51.1 80.3 60.8 46.9 46.8 0.0 0.7 0.4 0.0 0.0 0.0 0.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 139 265 292 622 625 520 785 Sex* Male Female 0.2 0.5 12.6 14.7 11.6 13.4 24.4 21.5 51.2 49,7 0.0 0.2 100.0 100.0 1,668 1,579 Religion Hindu Muslim Sikh Buddhist Others 0.3 0.0 0,0 0.0 13,7 13.6 13.7 16.9 6.7 8.9 12.3 14.7 9.0 36.9 15.9 22.7 25.4 31,0 23.5 36.6 51.0 46.2 43,1 32.8 24,9 0.1 0.0 0.0 0.0 0.0 100.0 100.0 100.0 100.0 100.0 3,084 63 58 30 13 Caste Scheduled Castes Scheduled Tribes Other Backward Classes Others 0.6 0.0 0.6 0.2 16.0 17.8 15.6 12.5 16.5 19.9 15.3 10.7 24.8 20.9 24.5 22.3 42.1 41.4 43,5 54.3 0.0 0.0 0.5 0.0 100.0 100.0 100.0 100.0 522 78 466 2,182 Total 0.3 13.6 12.5 23.0 50.5 0.1 100.0 3,248 *Does not add up to N due to other category. ** Unweighted cases. TABLE 1.14 CURRENTLY ATTENDING SCHOOL Percentage of household population (aged 6 to 17 years) attending sch ool/college , Himachal Pradesh, 2012-13 Total Male Female Background characteristics Rural Urban Total Ru ral Urban Total Rural Urban Total Age 6-10 11-13 14-17 6-11 12-17 Total 90.6 90.4 90.1 90.6 90.2 90.4 100.0 99.5 99.1 99,7 99.4 99.5 99.8 99.6 98.9 99.8 99.1 99.4 99.7 99.8 99.0 99.8 99.2 99.4 100.0 100.0 100.0 100,0 100.0 100.0 99.7 99.8 99.1 99.8 99.3 99.5 100.0 99.4 98.7 99.9 98.9 99.3 100.0 98.9 98.0 99.3 98.6 98.9 100.0 99.3 98.6 99.9 98.9 99.3 Religion Hindu Muslim Sikh Buddhist Others Total 99.3 100.0 100.0 100.0 100.0 99.4 99,5 100.0 100.0 100.0 100.0 99.5 99.4 100.0 100.0 100.0 100.0 99.4 99.4 100.0 100.0 100.0 100.0 99.4 100,0 100.0 100,0 100.0 100,0 100.0 99.5 100.0 100.0 100.0 100.0 99.5 99.3 100.0 100.0 100.0 100.0 99.3 98.9 100.0 100.0 100.0 99.0 99.2 100.0 100,0 100.0 100,0 99.3 Caste/Tribe Scheduled Castes Scheduled Tribes Other Backward Classes Others Total 99.2 99.5 99.4 99.4 99.4 100.0 100.0 97.5 99.8 99.5 99.2 99.5 99.2 99.5 99.4 99.3 99.8 99.1 99.5 99.4 100.0 100.0 100.0 100.0 100.0 99.4 99.8 99.2 99.6 99.5 99.0 99.1 99.7 99.4 99.3 100.0 100.0 94.5 99.6 99.0 99.1 99.1 99.2 99.4 99.3 51 TABLE 1.15 AVAILABILITY OF FACILITY AND HEALTH PERSONNEL BY DISTRICT Percentage of villages with facility and health personnel by district, Himachal Pradesh, 2012-13 Number of villages having facility‘ Primary or Sub-Health government Anganwadi Number of health facility‘ Centre VHNSC villages Districts middle school centre PI-{Cs Any Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 97.3 97.4 100.0 91.7 78.4 91.9 97.3 91.9 100.0 97.2 96.7 100.0 94.8 45.9 57.9 43.5 51.4 43.2 56.8 70.3 62.2 57.6 63.9 36.7 30.0 51.9 21.6 10.5 17.4 20.0 10.8 13.5 13.5 24.3 15.2 16.7 36.7 37.5 19.8 59.5 60.5 52.2 55.6 48.6 56.8 78.4 75.7 60.6 69.4 70.0 72.5 63.7 97.3 100.0 100.0 97.1 100.0 94.6 100.0 100.0 100.0 100.0 100.0 100.0 99.0 78.4 60.5 87.0 74.3 43.2 64.9 89.2 75.7 33.3 58.3 80.0 80.0 68.3 _Note : table is based on unweighted cases. Facilities as reported by village pradhan/up pradhan/any other panchayat member/teacher/gram sevakl aganwadi worker Village Secretary/officer or any other ofﬁcial at village level. 1 Includes Sub- Health Centre, Primaw Health Centre (including Block PHC), Community Health Centre or referral hospital, government hospital, and government dispensary within the village. VHNSC = Village Health Nutrition and Sanitation Committee. TABLE 1.16 BIRTH REGISTRATION Proportion of children below age 5 years who have registered the birth with civil authority and received birth certificate, by background characteristics, Himachal Pradesh, 2012-13. Number of children below Background characteristics Birth Registered Having birth certificate‘ 5 years" Age of the children Below 1 year 1 to 2 years 3-4 years Sex of the children Male Female Place of residence Rural Urban Religion Hindu Muslim Sikh Buddhist Others CastesITribes Scheduled castes Scheduled tribes Other backward classes Others Total 81.9 88.4 89.2 86.8 86.8 86.5 89.8 86.8 87.8 86.7 85.0 100.0 84.1 84.8 86.8 88.4 86.8 87.5 89.0 91.9 90.6 91.1 90.2 97.3 91.1 84.0 74.7 94.5 100.0 88.8 91.5 90.2 91.8 90.9 421 446 784 1,014 966 1,858 123 1.889 36 16 39 01 460 185 333 1,003 1,981 Note:Total number will not match because of missing cases. ‘Out of those registered. ** Unweighted cases TABLE 1.17 BIRTH REGISTRATION Proportion of children below age 5 years whose birth have been registered with civil authority and received birth certiﬁcate, Himachal Pradesh, 2012-13. District Rural Urban Total children Birth Registered Received birth certificate Number of below Rural Urban Total 5 years“ Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 80.8 81.4 92.4 89.7 88.2 85.1 91.7 88.4 92.0 84.9 70.9 90.5 89.5 100.0 100.0 100.0 85.5 95.5 84.1 100.0 55.5 94.4 89.4 79.1 81.9 92.4 90.2 89.2 85.1 92.0 88.3 92.5 83.5 76.5 90.5 86.8 87.9 87.8 100.0 95.7 87.4 93.5 90.2 93.2 90.5 83.1 90.6 94.8 90.2 100.0 100.0 100.0 100.0 95.3 100.0 93.1 82.2 100.0 97.4 87.9 88.3 100.0 96.0 88.7 93.9 90.6 93.4 90.7 83.0 93.4 94.8 90.9 1 103 262 57 114 108 218 333 152 222 230 119 63 .981 “ Out of those who registered -- No cases available. *" Unweighted cases. CHARACTERISTICS OF WOMEN AND FERTILITY 55 TABLE 2.1 BACKGROUND CHARACTERISTICS OF EVERMARRIED WOMEN Percentage of ever married women age 15-49 years according to selected background characteristics, and place of residence, Himachal Pradesh, 2012-13 Background characteristics Place of residence Total Rural Urban Age Group 15-19 20-24 25-29 30-34 85-39 40-44 45-49 Consummation of marriage Below 18 years 18 years & above Marital Duration Less than 5 years 5-9 years 10-14 years 15 or more years Woman‘s education Non-literatea Less than 5 years 5-9 years 10 or more years Husband's education Non-literate’ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist/Neo-buddhist Others Castesltribes Scheduled castes Scheduled tribes Other backward classes Others (DLHS-4)" 0.8 8.7 18.8 19.3 19.2 18.0 15.1 12.4 87.6 15.5 18.0 18.0 48.5 13.4 2.2 32.4 52.0 7.5 1.7 23.2 67.6 94.4 1.1 0.9 3.5 0.1 22.7 11.0 14.6 51.6 9100 (DLHS-3)“ 10,016 0.8 9.0 18.9 19.1 18.9 18.2 15.1 12.7 87.3 15.5 17.9 17.9 48.7 14.0 2.4 33.9 49.6 7.7 1.8 24.9 65.6 94.3 1.0 0.8 3.8 0.1 23.6 12.0 14.6 49.7 8380 9,242 0.7 6.2 17.6 21.6 21.5 16.8 15.7 9.2 90.8 15.2 18.4 19.3 47.1 7.6 0.2 18.7 73.5 6.0 .8 8.4 84.7 no $39.-‘.-‘5~" -~|o
10.8
0.0
5.7
22.2
16.0
11.2
6.1
13.1
6.6
10.9
11.1
6.7
1.9
21.9
20.9
3.5
2.8
.‘**9°$°
\|o>w
5.7
4.4
0.0
6.6
NA
81
204
37
103
94
148
239
92
146
185
94
37
1460
2571
“‘ Women who had their last live/still birth since 01-01-2008. “ Total ﬁgure may not add to 100 percent due to ‘do not know‘ and ‘missing cases.
1 Includes sub-centre, primary health centre, community health centre or rural h0Spt\a|, urban health centrel urban health posll urban family
welfare centre, government hospital or dispensary. zlncludes Private hospital/clinic. 3 Includes own home, parents home, other home and others.
NAI Not available. ““ Unweighted cases.
TABLE 3.3 COMPONENTS OF ANTENATAL CHECK-UP
Percentage of women (aged 15-49)” who received specific components of antenatal check-up according to selected
background characteristics, Himachal Pradesh, 2012-13.
Background Weight Height pressure
characteristics measured measured checked
Blood
Blood
tested
(Hb)
Urine
tested
Number
Abdomen Sonography of
examined /ultrasound
Women
Age group
15-19
20-24
25-29
30-34
35+
No. of Living Children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non- literate’
Less than five years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Castesltribes
Scheduled Castes
Scheduled Tribes
Backward Classes
Others
DLHS-4
DLHS-3
(84.6)
86.2
84.6
82.9
80.1
85.0
85.7
76.1
78.9
84.6
80.9
73.0
(71.4)
84.0
85.2
84.4
79.6
(72.7)
86.2
86.7
83.1
84.7
83.2
84.3
70.7
(69.2)
67.0
63.8
60.6
56.0
64.6
64.5
52.6
60.3
64.2
55.0
58.2
(57.1)
59.6
64.9
63.0
58.1
972.7)
21.5
66.1
74.3
61.0
60.9
63.3
29.6
(61.5)
72.7
69.0
71.0
70.5
69.6
72.2
67.8
65.4
70.4
69.3
57.3
(42.9)
68.4
72.0
70.3
63.8
(54.5)
86.2
74.1
76.4
70.2
67.5
70.3
62.6
(53.8)
70.3
72.7
67.8
69.5
70.7
72.5
63.0
70.3
70.9
69.0
47.0
(35.7)
68.1
73.3
70.6
65.4
(63.6)
86.2
73.5
78.2
72.8
67.4
70.7
73.0
(53.2)
71.3
71.5
70.6
70.4
70.3
75.0
61.8
60.5
70.5
76.0
42.8
(28.6)
66.1
74.8
71.1
63.6
(54.5)
86.2
70.7
77.6
73.9
69.0
71.0
76.1
(53.8)
60.9
59.8
60.6
60.1
60.0
61.6
59.1
50.9
59.3
68.1
45.2
(35.7)
54.4
63.1
60.4
50.8
(36.4)
71.3
62.5
68.2
59.4
58.0
60.2
69.3
(61.5)
71.9
72.9
71.4
72.9
72.5
74.2
66.8
62.5
70.6
87.7
55.5
(42.9)
65.2
75.7
72.2
80.0
(63.6)
75.0
73.2
77.0
69.1
72.1
72.2
46.9
13
332
698
315
102
1
694
581
131
53
1354
106
66
14
320
1060
1404
20
11
25
334
140
253
733
1460
2571
Note: Percentage may not add to 100.0 due to multiple responses.“ Women who had their last live/still birth since 01-01-2008. 5 Literate but did
not attended school, are also included. . () Based on 10-Z0 unweighted cases. — Percentage not shown for less than 10 cases.
*’ Unweighted cases
65
1-9:

TABLE3.4 WOMEN RECEIVED ADVICE DURING ANTENATAL CARE
Percentage of women (aged 15-49)“ who received advice on different components, according to selected background
characteristics, Himachal Pradesh, 2012-13
Background
characteristics
Nutrition Cleanliness
formother atthe time Institutional Keep baby
and child of delivery delivery warm
Breast
feeding
Advice for family
P|a””i”9 Number of
Spacing Limiting Women”
Age group
15-19
20-24
25-29
30-34
35+
No. of living children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non-literatea
Less than 5 years
5-9 years
10 or more year
Religion
Hindu
Muslim
Sikh
Buddhist
Castesltribes
Scheduled castes
Scheduled Tribes
Other backward classes
Others
DLHS-4
DLHS-3
(36.4)
44.7
44.6
47.4
48.9
46.8
45.4
41.1
39.4
45.8
43.3
34.9
(9-1)
41.8
47.5
45.3
54.2
(30.0)
62.1
48.8
47.9
42.2
44.8
45.5
66.2
(54.5)
60.6
59.3
60.8
62.6
60.5
60.2
58.9
56.5
59.8
62.8
56.2
(18.2)
55.5
62.0
60.2
73.9
(50.0)
43.9
65.1
57.7
54.7
60.2
60.1
70.8
(18.2)
27.0
2s.s
27.2
31.6
28.0
27.8
28.0
36.9
28.7
23.4
23.4
(27.3)
26.2
29.0
27.9
34.7
(30.0)
39.5
29.3
36.7
26.6
26.7
28.2
58.2
(36.4)
60.8
61.4
62.0
59.7
60.1
63.6
58.6
51.1
60.9
62.2
53.1
(36.4)
59.2
62.3
61.0
53.0
(50.0)
74.2
62.9
68.2
60.5
59.2
61.1
68.4
(54.5)
58.7
60.1
55.6
53.4
59.6
59.8
52.4
37.8
58.4
57.7
55.2
(54.5)
58.0
58.7
58.4
55.7
(30.0)
77.5
59.2
64.7
56.5
57.5
58.4
75.8
(45.5)
52.8
53.8
57.5
59.3
54.4
56.6
47.9
52.1
55.5
46.9
53.9
(36.4)
51.2
55.9
54.8
67.4
(40.0)
39.1
55.9
58.6
50.5
55.0
54.7
63.2
(27.3)
40.2
41.9
44.3
43.1
40.1
44.5
44.8
32.7
43.5
28.9
44.7
(9-1)
33.2
43.2
42.1
49.2
(20.0)
39.4
46.0
44.0
33.5
42.9
42.0
60.1
13
332
698
315
102
1
694
581
131
53
1354
106
66
14
320
1060
1404
20
11
25
334
140
253
733
1460
2571
. F” Women who had their last live/slill birth since 01-01-2008. Q Literate but did not attended school. are also included.
unweighted cases. — Percentage not shown for less than 10 cases. “‘ Unweighted cases
. ()Ba
sed on 10-20
66

TABLE 3.5 (A) ANTENATAL CARE: ANC VISITS AND TIME OF FIRST ANC
Percent distribution of women (aged 15-49)” by the number of antenatal check-up and the stage of pregnancy at the time of
first check-up during pregnancy according to selected background characteristics, Himachal Pradesh, 2012-13.
Stage of pregnancy at the time of
Number of ANC Check up the first antenatal check-up
No
First Second Third Number
Background characteristics Checkup 1 2 3+ trimester trimester trimester ofWomen
Age group
15-19
20-24
25-29
30-34
35+
No. of living children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non-literate‘
Less than 5 years
5-9 years
10 or more year
Religion
Hindu
Muslim
Sikh
Buddhist
Castes/tribes
Scheduled castes
Scheduled Tribes
Other backward classes
Others
DLHS-4
DLHS-3
(15.4)
26.2
29.0
26.2
33.0
28.2
26.0
31.3
37.5
27.6
31.5
49.4
(42.9)
34.1
24.6
28.0
31.1
(45.5)
13.8
28.1
32.3
31.0
26.1
28.0
15.5
(0.0)
3.1
1.9
2.3
2.3
2.4
2.0
2.8
3.6
2.5
0.8
-§e
“””;‘-‘
2.3
4.1
(Om
0.0
2.9
2.0
2.6
1.9
2.3
4.9
(15.4)
12.6
11.0
10.3
13.2
10.5
12.1
14.5
9.0
11.6
10.0
10.0
(14.3)
9.2
12.2
11.3
4.4
(9.1)
25.1
12.6
7.2
14.8
10.5
11.4
20.2
(69.2)
58.0
58.0
61.2
51.5
58.9
60.0
51.3
49.9
58.4
57.7
39.4
(35.7)
54.1
61.0
58.3
60.4
(45.5)
61.1
56.4
58.5
51.6
61.5
58.3
59.4
(61.5)
60.8
57.7
58.9
55.6
58.7
59.6
53.4
56.8
58.9
54.7
40.7
(57.1)
53.1
61.2
58.3
55.8
(54.5)
73.9
60.5
56.8
52.6
60.0
58.5
62.1
(15.4)
10.5
10.4
15.8
12.8
10.7
12.3
17.5
7.8
12.2
8.7
8.7
(0.0)
14.5
11.4
12.0
8.2
(0.0)
12.3
11.1
12.8
13.2
11.5
11.8
21.7
(7-7)
M
u
u
M
3.5
4.3
0.9
2.0
3.5
3.6
2.0
(0.0)
2.7
3.9
3.6
7.9
(0.0)
0.0
3.1
1.8
5.9
3.2
3.5
1.1
13
332
698
315
102
1
694
581
131
53
1354
106
66
14
320
1060
1404
20
1 1
25
334
140
253
733
1460
2571
Note: Percentage may not add to 100.0 due to multiple responses, do not know or missing cases.
W‘ Women who had their last live/still birth since 01-01-2008. 3 Literate but did not attend school are also included.
() Based on 10-20 unweighted cases. — Percentage not shown for less than 10 cases. ” Unweighted cases.
Q

TABLE 3.5 (§) ANTENATAL CARE: TT. IFA AND ANC
Percent distribution of women (aged 15 49)“ by the number of tetanus toxoid (TT) injections and iron
olic acid (IFA)
– r
tablets/syrup received during pregnancy, and the percentage who received full antenatal check-up (ANC) according to selected
background characteristics, Himachal Pradesh, 2012-13.
Women who received IFA
Women who received TT tablets/syrup equivalent
Background characteristics
N0 TT
1 2+
No lFA/ 100+ IFA
syrup tablets Full ANCI’
Number
of W0men**
Age group
15-19
20-24
25-29
30-34
35+
No. of Living Children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non literate“
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Castes/tribes
Scheduled castes
Scheduled tribes
Other backward classes
Others
DLHS-4
DLHS-3
$6995
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U1@\|LD
P3
mm
@388
wngn
5955
003/wo
jwjﬂ
bqmggm
10.0
14.4
(15.4)
23.6
23.1
23.9
22.1
17.3
28.1
29.3
35.2
23.0
25.7
29.6
(21.4)
29.4
21.0
@E£8
“*2.-abok
27.7
21.6
23.5
21.4
23.2
10.3
(69.2)
67.0
67.4
65.8
63.8
72.8
63.2
56.1
51.3
66.8
65.8
50.2
(50.0)
59.4
70.2
66.9
44.9
(63.6)
76.9
65.1
67.0
67.6
67.1
66.7
74.9
eeeeﬁ
Aewag
N???
I\)U’lI\)O’1
!\‘.°
–<0 9+3? ®®9Q 03¢? O8@© .“.o.°.* moooo 1.0 5.2 (61.5) 59.3 58.3 59.0 56.9 58.5 60.7 51.5 55.4 58.3 62.1 33.5 (21.4) 54.3 61.9 58.5 76.8 (27.3) 69.3 62.2 54.5 44.9 62.6 58.6 51.1 (53.8) 43.1 40.3 42.1 35.7 41.5 42.8 35.0 34.4 41.7 36.0 19.7 (21.4) 37.0 43.9 41.2 52.1 (18.2) 44.2 39.8 41.3 29.2 46.0 41.1 31.4 13 332 698 315 102 1 694 581 131 53 1354 106 66 14 320 1060 1404 20 11 25 334 140 253 733 1460 2571 Note: Percentage may not add to 100.0 due to multiple responses, do not know or missing cases. ”" Women who had their last live/still birth since 01-01-2008. “ Literate but did not attended school are also inciu “At least three visits for antenatal check-up, at least one TT injection received and 100+ IFA tablets/ syrup consumed. () Based on 10-20 unweighted cases. -- Percentage not shown based on less than 10 cases. ** Unweighted cases. ded. TABLE 3.6 ANTENATAL CARE INDICATORS AND PREGNACY COMPLICATIONS Percentage of women (aged 15-49)” who received different types of antenatal care (ANC) by districts, Himachal Pradesh. 2012-13 antenatal check-up three or more at least one 100+lFA in the ﬁrst trimester antenatal tetanus toxoid tabletsl DistrictJState of pregnancy check-up injection syrup‘ Full antenatal Any check-upz complicati Number of ons Women" Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur DLHS-4 DLHS-3 48.8 56.1 59.4 68.5 63.6 57.3 54.1 62.9 62.1 56.0 55.1 83.0 58.5 62.1 45.2 48.1 67.0 63.5 51.2 62.1 72.1 66.8 64.9 44.0 53.7 73.1 58.3 59.4 73.7 85.5 85.5 93.0 84.8 95.9 96.0 92.8 94.3 85.1 87.5 90.8 89.7 85.3 40.0 37.5 81.7 73.3 59.8 66.4 71.5 71.4 68.3 36.0 65.8 57.7 58.6 55.0 29.0 25.6 63.2 49.6 41.8 40.2 56.7 54.6 51.4 20.0 43.5 42.2 41.1 31.4 18.7 32.7 27.5 33.1 34.3 68.9 41.2 51.7 49.4 33.9 16.8 66.6 39.8 54.8 81 204 37 103 94 148 239 92 146 185 94 37 1460 2571 W Women who had their last live/still birth since 01-01-2008. ‘100 or more iron folic acid tablets including visits for antenatal check-up, at least one TT injection received and 100+ IFA tablets/ syrup consumed. syrup. ‘ Al least three ** Unwei ghted cases. 68 TABLE 3.7 PLACE OF DELIVERY AND ASSISTANCE Percent distribution of women (aged 15-49)” according to place of delivew, assistance during home deliveries, and safe deliveries according to background characteristics, Himachal Pradesh, 2012-13. Institutional delivery Home delivery assisted by Percentage Background characteristics Government Private Total skilled of SBA Number of Delivery at home persons‘ deliveriesz women" Age group 15-19 20-24 25-29 30-34 35+ No. of Living Children 0 1 2 3 4+ Residence Rural Urban Education Non literatea Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist Castesltribes Scheduled castes Scheduled tribes Other backward classes Others DLHS-4 DLHS-3 (53.8) 64.5 57.2 ass 52.5 70.5 64.4 57.0 48.5 64.8 77.6 67.9 (42.9) 63.2 67.2 66.0 55.4 (72.7) 76.0 66.2 67.9 68.4 64.9 66.0 NA (7.7) 7.3 12.8 12.1 20.0 11.8 13.4 8.9 3.6 11.6 14.5 1.9 (21.4) 5.3 14.3 11.7 7.2 (27.3) 15.6 10.9 9.5 15.4 11.5 11.9 NA (61.5) 71.8 80.0 78.9 82.8 82.3 77.8 65.8 52.0 76.4 92.1 69.8 (64.3) 68.5 81.5 77.7 52.5 (100.0) 92.5 77.1 77.3 83.8 76.4 77.8 48.3 (38.5) 27.6 19.6 19.6 17.2 17.2 21.9 32.7 44.4 22.9 7.9 28.5 (35.7) 30.2 18.1 21.6 37.4 (0.0) 7.4 22.3 21.9 15.9 22.9 21.4 51.2 (15.4) 19.4 14.7 15.0 11.7 13.0 15.2 25.6 31.4 16.5 7.9 19.2 (21.4) 19.3 14.2 15.s 25.4 (0-0) 7.4 15.8 14.5 13.7 16.5 15.6 2.6 (75.9) 91.3 94.6 93.5 94.5 95.3 93.0 90.5 83.4 92.8 100.0 89.0 (85.7) 87.8 95.6 93.4 85.0 (100.0) 1oo.o 92.9 91.9 97.0 92.8 93.4 50.9 13 332 698 315 102 1 694 581 131 53 1354 106 66 14 320 1060 1404 20 1 1 25 334 140 253 723 1460 2571 Note: Percentage of women who had institutional and home delivery may not add to 100.0. as some deliveries took place on the way to the institute, working place, other place etc. “Women who had their last live/still birth since 01-01-2008. E Literate but did not attended school are also included. 1 Includes Doctor/ANM/Nurse. 2 Skilled Birth Attendant. () Based on 10-20 unweighted cases. -- Percentage not shown for less than 10 cases. Na: not available. *" Unweighted cases. 69 TABLE 3.8 MODE OF TRANSPORTATION USED FOR DELIVERY AND ARRANGEMENT OF TRANSPORTATION Percent distribution of women (aged 15-49)” who had institutional delivery, according to the transportation used to reach the health facility for delivery and transportation arrangement made according to selected background characteristics, Himachal Pradesh, 2012- 13. Background characteristics Mode of transportation used to Govt. ﬁnancial reach the health facility for assistance for delivery delivery care (JSY)" Mean Ambulance Jeep! car Motor Number Transport cycl el scooter Others‘ Institutional Home of C women" (Ru ost pees) Mean Delivery cost (Rupees) Govt. Number of Private women” Age group 15-19 20-24 25-29 30-34 35+ No. of Living Children 0 1 2 3 4+ Residence Rural Urban Education Non literate“ Less than 5 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist Castes/tribes Scheduled Castes Scheduled Tribes Other backward classes Others DLHS-4 DLHS-3 (23.1) 23.2 20.2 20.4 16.8 @888 woe» 19.6 31.9 30.5 (28.6) 20.3 20.3 20.7 30.1 (18.2) 17.4 21.0 16.6 31.0 17.8 20.8 2.1 (23.1 ) 44.0 53.0 49.4 60.5 53.2 51.8 38.0 29.8 49.7 57.5 31.9 (28.6) 39.2 55.2 50.0 39.7 (81.8) 66.5 48.5 49.4 45.6 53.2 50.4 69.1 w>P@§
01$->\i\j
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mmom
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1.6
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oewm
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mim
w@§w
<.DLD:l\) @39@ QSOW NP@P wmmﬂ 3.3 26.8 (37.5) 27.9 21.5 21.9 15.4 23.3 23.8 12.1 21.1 23.7 14.4 24.1 (22.2) 28.2 21.2 N/\_n\>
w@w~
wimm
25.6
36.7
23.6
18.3
22.7
8.7
ease?
4:-ui<»-O3 9¢@@ omww 53>‘
O\i
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8830
@339
sea»
kOmw
7.4
1.4
13
332
698
315
102
1
694
581
131
53
1354
106
66
14
320
1060
1404
20
11
25
334
140
253
723
1460
2571
911
1184
914
1233
1176
1028
650
1000
1074
000
1200
1000
1076
1076
0
0
944
1100
925
1195
1074
793
5166
5622
5965
5421
5743
4688
8606
7618
5599
5394
4982
4020
6044
5618
4125
3470
5164
4948
4389
6314
5585
3371
12561
13921
12293
14469
12720
14587
9640
000
12552
20286
22000
9329
13859
13232
25000
10000
12357
1 1 150
13265
14292
13373
10431 1
2
120
305
129
49
2%
me
M
w
xv
m
w
4
1%
M7
mo
5
s
n
1%
w
113
298
605
255
Total figure may not add to 100 percent due to cion’t know or missing cases. ” Women who had their last live/still birth since 01-01-2008. ‘ includes
bus/train. tempo/auto/tractor. animal drawn cart. foot march. a Literate but did not attended school are also included. I’ Percentage women who got JSY
assistance. . () Based on 10-20 unweighted cases. — Percentage not shown for less than 10 cases. “ Unweighted cases.
TABLE 3.9 PLACE OF DELIVERY AND ASSISTANCE CHARACTERISTICS BY DISTRICT
Percent distribution of women (aged 15-49)'”‘ according to place of delivery, assistance during home deliveries, and safe deliveries
by districts. Himachal Pradesh, 2012-13.
DistrictJState
Percentage of
women who had Percentage of Home delivery Percentage Mean
institutional women who had assisted by 1 of SBA Delivery
delivery delivery at home skilled persons Delivery’
cost
Number
of Women*
Q
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
DLHS-4
DLHS-3
57.4
81.1
78.7
66.6
84.4
92.8
75.4
81.4
78.0
66.6
83.9
88.0
77.8
48.3
38.7
16.5
21.3
Ab)
ﬁww
N07-J>
24.6
17.2
22.0
32.3
16.1
12.0
21.4
51.2
wiﬁ
u’i“o“_
19.1
14.8
6.4
– to
eﬁw
mono
ewﬁ
15.6
2.6
79.4
95.7
84.2
85.7
99.3
99.2
98.2
89.0
92.2
91.0
93.2
94.3
93.4
50.9
5553
6643
6965
6112
11097
4224
9056
4796
7307
7583
9792
3483
7284
NA
81
204
37
103
94
148
239
92
146
185
94
37
1460
2571
“’ Unweighted cases.
Note: Percentage of women wha had institutional and home delivery may not add to 100.0, as some deliveries took place on the way to the institute,
working place, other place etc. Women who had their last live/still birth since 01-01-2008. I Includes Doctor/ANM/Nurse. Skilled Birth Attendants.
70

TABLE 3.10 REASONS FOR NOT GOING TO HEALTH INSTITUTIONS FOR DELIVERY
Percent distribution of women (aged 15-49)“ according to main reasons for not going to health institution for delivery, according to
selected background characteristics, Himachal Pradesh, 2012-13
Background
characteristics
Reasons
Cost Poor Too farl
too quality
much service transport
N0
No
time
to go
Not Not
Necessary Customary
Better
care
at
home
not know
allow ledge Other women”
Family Lack
did of
Number
of
Age group
15-19
20-24
25-29
30-34
35+
No. of Living Children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non literatea
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Castesltribes
Scheduled castes
Scheduled tribes
Other backward classes
Others
DLHS-4
DLHS-3
2.8
5.9
4.9
0.0
2.9
4.5
9.2
3.4
4.6
(11.1)
4.7
2.9
4.3
2.4
2.7
9.6
4.3
4.4
13.1
1.6
0.6
0.0
0.0
1.0
1.8
0.0
0.0
1.1
(0.0)
‘-\’u|
0.7
0.0
0.0
0.0
2.0
1.1
2.9
10.6
6.7
7.6
4.7
7.3
7.9
10.5
4.5
8.1
(5.6)
9.4
7.5
8.0
1.2
32.5
0.0
8.3
7.8
10.7
21.7
30.3
38.1
30.1
28.8
31.2
26.7
24.0
28.3
(27.8)
26.0
31.9
29.8
26.0
24.2
38.9
29.0
29.1
31.6
26.8
26.8
19.5
45.1
29.3
24.8
24.5
22.2
25.5
(22.2)
27.9
26.9
25.6
29.2
5.4
20.1
30.1
26.3
28.3
0.9
0.8
0.0
0.0
0.9
0.7
0.0
0.0
0.6
(0.0)
0.0
1.0
0.6
1.1
0.0
0.0
0.6
0.6
3.9
24.6
16.2
16.8
15.0
20.1
16.6
13.3
28.4
19.1
(11.1)
18.3
17.7
18.4
28.4
19.9
15.8
14.5
18.4
24.8
7.1
9.2
8.1
0.0
7.3
7.0
12.9
8.2
8.3
(11.1)
8.8
7.5
8.2
8.0
9.0
9.5
7.5
8.0
3.7
3.9
3.6
1.9
5.1
2.4
5.1
2.8
3.9
3.8
(11.1)
2.1
3.2
3.8
3.8
4.0
6.0
3.0
3.7
2.0
0.0
0.0
3.1
0.0
0.0
0.5
0.0
5.3
0.6
(0-0)
1.3
0.4
0.6
0.0
2.4
0.0
0.7
0.6
1.7
5
93
143
62
20
125
132
43
23
314
9
18
5
99
201
314
7
0
2
76
32
39
176
323
1326
Total ﬁgure may not add to 100 percent due to multiple responses, don’t know or ‘missing cases. Women who had their last live/still
birth since 01-01-2008. a Literate but did not attend school, are also included () Based on 10-20 unweighted cases. — Percentage
not shown for less than 10 cases. “* Unweighted cases.
ma
71

TABLE 3.11 DELIVERY COMPLICATIONS
Percentage of women (aged 15-49) who had complication during delivery and type of complications during delivery, according to
selected background characteristics, Himachal Pradesh, 2012-13
Any Type of delivery complications Number
delivery Premature Excessive Prolonged obstructed Breech Convulsionl
Background characteristics complication labour bleeding labour labour presentation high BP
of
Women
Age group
15-19
20-24
25-29
30-34
35+
No. of Living Children
0
1
2
3
4+
Residence
Rural
Urban
Number of ANC Visits
0
1
2
3+
Delivery
Normal
Caesarean
By Instrument or Assisted
Place of Delivery
Government facility
Private facility
Home
Other
DLHS-4
DLHS-3
(23.1 )
49.1
44.4
45.6
46.9
45.4
47.4
43.6
35.8
44.8
53.3
29.6
54.1
48.9
52.4
43.6
62.7
45.5
52.0
43.2
45.6
74.0
(66.7)
64.9
64.9
66.1
61.8
66.4
64.4
62.3
56.7
66.0
56.8
73.4
83.5
66.8
61.6
65.8
60.7
66.7
55.2
65.8
64.9
63.8
(0.0)
35.4
29.2
28.0
24.3
32.8
28.3
22.7
27.0
30.7
24.1
31.6
24.8
21.6
31.3
30.4
27.7
31.2
28.3
26.3
30.0
.5
(33.3)
39.0
30.6
28.4
32.0
31.4
33.0
33.6
33.1
32.9
27.5
24.2
9.4
43.0
33.4
31.8
34.3
32.8
31.8
31.5
32.3
36.0
(0-0)
43.7
37.4
41.7
25.5
39.5
41.0
24.3
39.0
37.7
48.1
37.6
26.0
38.9
39.7
39.1
37.8
40.1
30.4
41.2
38.9
7 .6
(0.0)
17.9
14.2
15.5
20.3
14.0
18.9
10.8
14.5
16.2
12.6
9.8
8.4
19.4
17.0
15.7
15.4
16.4
7.9
19.1
15.8
4.4
(0-0)
18.4
16.4
17.6
16.5
17.0
16.8
18.1
19.2
18.1
9.0
7.8
0.0
14.3
20.8
17.8
13.5
17.6
14.9
17.3
17.1
12.1
13
332
698
315
102
1
694
581
131
53
1354
106
406
37
160
856
1299
156
4
955
171
323
7
1460
2569
18 1 1
Note: Total figure may not add to 100 percent due to ‘multiple responses, don’t know or missing cases.
W Women who had their last live/still birth since 01-01-2008 () Based on 10-20 unweighted cases. — g
than 10 cases. ” Unweighted cases.
Percenta e not shown for less

TABLE 3.12 POST-DELIVERY COMPLICATIONS
Percentage of women (aged 15-49) who had post delivery complication and type of complications, according to selected
background characteristics, Himachal Pradesh, 2012 -13
Any post
delivery
complication
Background characteristics
Type of post delivery complication
High
fever
Lower Foul smelling
abdominal vaginal Number of
pain discharge Excessive bleeding women*
Age group
15-19
20-24
25-29
30-34
35+
No. of Living Children
0
1
2
3
4+
Residence
Rural
Urban
Delivery
Normal
Caesarean
By Instrument or Assisted
Place of Delivery
Government facility
Private facility
Home
Others
Who Conducted the Last Delivery
Doctor
ANM/Nurse/Midwife/LHV
Dai
Relatives/Friends
None
DLHS-4
DLHS-3
(23.1)
19.8
22.1
19.8
21.0
20.2
22.3
21.6
15.1
21.0
21.1
19.7
31.1
24.3
20.9
11.6
(16.7)
3.7
11.4
11.8
21.0
32.9
(33.3)
55.1
60.7
51.1
23.6
59.9
51.7
44.0
45.1
54.6
54.8
55.3
52.4
54.9
66.3
41.6
(50.0)
100.0
40.6
39.6
54.7
42.1
(33.3)
43.8
46.8
50.2
44.6
42.1
50.5
52.2
44.3
46.9
43.7
43.6
60.8
46.4
58.9
35.8
(50.0)
0.0
39.8
0.0
46.6
64.4
(0-0)
18.3
19.0
18.6
13.2
22.8
14.5
17.5
0.0
18.4
16.9
18.4
17.6
21.2
7.7
9.6
(0-0)
0.0
9.1
20.4
18.2
28.7
(33.3)
24.7
23.8
19.5
4.8
23.5
21.6
17.5
10.6
23.7
4.4
23.8
12.5
23.0
20.4
15.9
(0.0)
0.0
19.8
0.0
21.8
30.4
13
332
698
315
102
1
694
581
131
53
1354
106
1299
156
4
955
171
323
7
12
22
262
39
3
1460
2571
we
Women who had their last live/still birth since 01-01-2008. () Based on 10-20 unweighted cases. — Percentage not shown for
less than 10 cases. ” Unweighted cases.
73

TABLE 3.13 ANY CHECK-UP AFTER DELIVERY
Percentage of women (aged 15-49) whether received any check-up after delivery according to background characteristics,
Himachal Pradesh, 2012-13.
Background
characteristics
Check up within Check up within Check up within Check up within Number
48 hours after 48 hours after 2 weeks after 14 to 42 days
delivery delivery at Home delivery after delivery
of
Women
Age group
15-19
20-24
25-29
30-34
35+
No. of Living Children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non literatea
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Castes/tribes
Scheduled castes
Scheduled tribes
Other backward classes
Others
DLHS-4
DLHS-3
(53.8)
68.2
73.9
78.1
70.7
76.3
73.2
63.1
55.0
71.9
84.4
55.3
(54.3)
54.5
11.0
72.5
40.0
(90.9)
88.0
66.0
75.9
76.9
74.5
73.1
47.8
(20.0)
25.0
25.2
30.5
28.2
23.1
30.7
27.6
18.5
25.7
45.5
27.9
(0.0)
21.7
29.4
26.4
14.3
(0.0)
100.0
17.7
40.7
24.2
28.3
26.4
NA
(61.5)
72.5
76.3
81.2
77.0
80.1
76.2
66.7
56.3
75.5
85.3
51.9
(54.3)
59.2
80.0
76.1
45.0
(90.9)
92.0
69.6
79.7
80.4
77.6
76.5
50.5
(69.2)
74.4
77.2
83.1
79.0
81.2
77.6
70.5
56.3
77.0
86.1
59.1
(54.3)
11.s
51.1
77.5
50.0
(90.9)
92.0
71.4
81.2
80.7
79.2
77.9
NA
13
332
698
315
102
1
694
581
131
53
1354
106
66
14
320
1060
1404
20
11
25
334
140
253
733
1460
2571
w Women who had their last live/still birth since 01-01-2008. E Literate but did not attended school are also included. () Based
on 10-20 unweighted cases. — Percentage not shown for less than 10 cases. NA: Not available. *‘ Unweighted cases.
74

TABLE 3.14 COMPLICATIONS DURING PREGNANCY. DELIVERY AND POST-DELIVERY PERIOD
Percentage of women (aged 15-49)“ who had extent of pregnancy, delivery and post-delivery complications and sought
treatment for the problem according to background characteristics, Himachal Pradesh, 2012-13.
Who had Sought Sought
complication treatment for Who had Who had treatment for
during pregnancy delivery post- delivery post-delivery
Background characteristics pregnancy complication‘ complication complication complication?
Number
of
women“
Age group
15-19
20-24
25-29
30-34
35+
No. of living Children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non literatea
Less than five years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Castesltribes
Scheduled castes
Scheduled tribes
Other backward classes
Others
DLHS-4
DLHS-3
(23.1 )
40.4
39.6
40.3
41.2
38.6
42.4
37.1
35.2
39.7
40.8
27.2
(28.6)
37.2
41.6
39.5
39.7
(63.6)
48.3
39.3
39.8
41.8
39.4
39.8
54.8
67.6
63.4
58.7
66.0
68.5
64.2
59.0
68.6
56.0
62.4
60.1
55.4
(25.0)
50.5
65.7
61.5
38.9
(85.7)
94.3
59.2
68.5
56.9
64.3
62.1
47.8
(23.1)
49.1
44.4
45.6
46.9
45.4
47.4
43.6
35.8
44.8
53.3
28.3
(28.6)
39.8
48.6
45.2
54.7
(54.5)
63.1
44.6
44.9
44.5
46.6
45.6
74.0
(23.1)
19.8
22.1
19.8
21.0
20.2
22.3
21.6
15.1
21.0
21.1
roro/–\
ee*~
-:>or:3¢o
20.7
28.8
(27.3)
30.6
22.8
22.4
20.0
20.3
21.0
32.9
49.7
66.0
61.8
78.4
66.6
68.3
63.4
72.3
73.2
68.4
51.8
71.5
(100.0)
50.0
71.5
65.3
57.1
(100.0)
100.0
65.6
75.7
57.0
69.1
66.6
45.4
13
332
698
315
102
1
694
581
131
53
1354
106
66
14
320
1060
1404
20
11
25
334
140
253
733
1460
2571
W Women who had their last live/still birth since 01-01-2008. E Literate but did not attended school are also included. ‘ Women
who reported at least one complication of pregnancy. 2 Women who reported at least one post delivery complication. () Based
on 10-20 unweighted cases. — Percentage not shown based on less than 10 cases. ” Unweighted cases.
TABLE 3.15 COMPLICATIONS DURING PREGNANCY. DELIVERY AND POST-DELIVERY PERIOD
Percentage of women (aged 15-49)“ who had extent of pregnancy, delivery and post-delivery complications and sought
treatment for the problem according to by districts, Himachal Pradesh. 2012-13.
Who had Sought
complication treatmentfor
during pregnancy
Districts pregnancy complication‘
Who had Who had
delivery post- delivery
complication complication
Sought
treatment for
post-delivery
complicationz
Number
of
women
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
DLHS-4
DLHS-3
18.7
32.7
27.5
33.1
34.3
68.9
41.2
51.7
49.4
33.9
16.8
66.6
39.8
54.8
29.2
56.9
100.0
61.7
53.6
61.5
67.9
59.2
65.7
59.6
51.7
83.1
62.1
47.8
22.5
35.5
36.9
25.6
28.3
81.6
57.1
58.0
60.4
27.9
34.1
65.9
45.6
74.0
12.9
15.6
16.0
16.9
12.8
42.6
27.7
35.2
16.8
11.3
4.4
50.7
21.0
32.9
30»
99.0
oroo
61.6
39.0
65.1
71.0
58.0
71.8
70.5
100.0
94.9
66.6
45.4
81
204
37
103
94
148
239
92
146
185
94
37
1460
2571
W Women who had their last live/still birth since 01-01-2008. ‘Women who reported at least one complication of pregnancy.
Women who reported at least one post delivew complication. ” Unweighted cases.
*9:

TABLE 3.16 AWARENESS OF THE DANGER SIGNS OF NEW BORN
Percentage of women (aged 15-49)“ who had awareness of the danger signs of new born. according to selected background
characteristics, Himachal Pradesh, 2012-13.
Background
characteristic
Difficulty in Coldl hot staining on palm tongue & Abnormal sucking of did not
breathing to touch and soles
Develop yellow Blue Poor Baby Number
Lips
Of
movement breast cw Women“
Age group
15-19
20-24
25-29
30-34
35+
Children ever born
0
1
2
3
4+
Residence
Rural
Urban
Education
Non literate“
Less than 5 years
9-10 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Castesltribes
Scheduled castes
Scheduled tribes
Other backward classes
Others
DLHS-4
DLHS-3
(7-7)
12.6
14.2
15.6
15.0
15.7
13.7
9.8
9.0
14.8
7.8
7.3
(0.0)
10.7
15.8
14.2
3.1
(18.2)
18.7
13.2
19.5
16.9
12.7
14.2
37.5
(15.4)
18.4
23.1
28.2
26.6
23.3
24.0
20.9
22.3
23.6
21.3
11.4
(0.0)
19.6
25.5
23.4
13.4
(27.3)
26.2
21.6
25.6
26.2
22.7
23.3
36.2
(0-0)
3.7
3.7
4.4
3.9
3.6
3.8
4.8
6.1
4.3
0.0
0.0
(0.0)
2.5
4.5
4.0
0.0
(0.0)
2.9
:’>$-“.-‘P’
»—=ao
3.8
16.1
(0-0)
6.2
7.7
9.4
s.s
8.0
7.0
9.9
7.7
7.8
7.4
3.0
(0.0)
6.2
8.6
7.5
7.2
(0.0)
29.7
6.3
8.4
9.6
7.6
7.8
27.0
(0.0)
8.4
8.2
8.7
13.3
7.7
10.4
8.1
3.8
9.0
6.0
3.4
(7.1)
7.6
9.3
8.7
4.7
(0.0)
16.8
8.2
8.3
7.1
9.5
8.7
22.7
(0.0)
21.0
24.7
26.7
27.9
24.0
26.2
21.1
14.8
24.8
19.1
16.3
(7-1)
19.9
26.3
24.0
27.0
(9-1)
40.5
21.0
28.7
30.4
22.8
24.3
37.8
(0-0)
7.9
10.0
12.8
21.7
9.4
12.8
6.1
21.7
11.4
6.3
6.8
(0.0)
8.5
12.0
11.0
4.7
(9.1)
13.0
8.7
6.7
14.2
11.5
10.9
29.0
13
332
698
315
102
1
694
581
131
53
1354
106
66
14
320
1060
1404
20
11
25
334
140
253
733
1460
2571
W Women who had their last live/still birth since 01-01-2008. E Literate but did not attended school are also included. () Based on
10-20 unweighted cases. — Percentage not shown for less than 10 cases. “‘ Unweighted cases.

CHILD HEALTH CARE AND IMMUNIZATION
77

TABLE 4.1 TIMING AND CHILDHOOD CHECK-UPS
Percentage of children aged under 3 years received check up and place of check-up according to selected background
characteristics, Himachal Pradesh, 2012-13.
Children Place of check-up “
received
Background
characteristics
Check-up within Number of
24 hours of birth children“
Government‘ Privatez Home: Others
Total
Number
of
children
4″
Age group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Mother’s education
Non-literate’
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
(35.1)
64.7
64.0
68.0
12.6
63.0
85.7
59.0
(72.7)
52.4
69.0
64.8
(43.8)
(100.0)
65.3
53.0
71.5
64.7
65.0
48.9
14
282
480
174
41
5
2
931
67
38
11
217
732
960
16
8
14
238
96
173
491
998
2268
87.5
81.5
86.6
82.8
84.0
86.4
100.0
95.8
82.0
85.0
(84.6)
91.4
93.5
80.1
81.3
84.3
75.2
12.5
18.2
11.2
17.2
15.3
13.6
0.0
4.2
17.2
14.5
(7-7)
8.6
6.5
19.9
17.5
15.0
17.4
0.0
0.4
1.2
0.0
0.5
0.0
0.0
0.0
0.5
0.2
(7.7)
0.0
0.0
0.0
0.8
0.4
4.2
0.0
0.0
1.1
0.0
0.2
0.0
0.0
0.0
0.3
0.2
(0-0)
0.0
0.0
0.0
0.4
0.2
3.2
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
(100.0)
100.0
100.0
100.0
100.0
100.0
100.0
5
179
305
116
29
3
2
582
57
22
8
113
496
611
7
7
14
154
50
124
311
639
1103
Note: Table based on youngest living child born since 01.01.2008. “Literate but did not attend school are also included.
1 Includes government hospital or dispensary, urban health centrel urban health post] urban family welfare centre, community
health centre or rural hospital, primary health centre, sub-centre, ICDS and Govt. AYUSH hospital /clinic. 2 Includes non-
governmental hospitall trust hospital or clinic, private hospital/clinic and private AYUSH hospital /clinic.
Includes Doctor ASHA and ANM/Nurse. Among those Children who received check-up within 24 hours of birth.
— Percentage not shown for less than 10 cases. ** Unweighted cases.
79

TABLE 4.2 INITIATION OF BREASTFEEDING
Percentage of youngest living child born since 01.01.2008 aged under 3 years whose mother started breastfeeding within one
hour of birth, within 24 hours of birth and after 24 hours of birth according to selected background characteristics, Himachal
Pradesh, 2012-13.
Ch]|d|-en Initiation of breastfeeding Number
received Within one Within 24 hours After 24 hours
of
Background characteristics Colostrum/Kheesb hour of birth of birth‘ of birth children“
Age group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Mother’s education
Non-literate“
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
CastesITrihes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
(92.9)
90.6
89.6
94.0
91.7
90.4
92.0
88.7
(63.6)
89.0
91.6
90.9
(87.5)
(78.6)
87.2
93.8
93.3
90.6
90.6
92.3
(78.6)
69.6
67.4
70.5
69.0
69.0
64.1
73.5
(63.6)
63.9
69.9
69.3
(43.8)
(s5.7)
69.3
65.8
78.3
65.1
68.6
56.5
(100.0)
90.9
89.0
92.4
89.7
89.7
92.3
87.8
(72.7)
87.6
91.0
89.9
(93.8)
(85.7)
91.9
85.5
95.0
88.0
90.0
89.8
(0-0)
5.3
6.7
4.0
1.9
6.0
1.0
5.0
(18.2)
as
5.1
5.5
(0-0)
(14.3)
3.7
8.5
3.0
6.9
5.6
10.2
14
287
491
180
42
6
2
954
68
39
1 1
225
747
984
16
8
14
244
96
179
503
1022
2268
E Literate but did not attended school are also included. ” Yellowish thick milk secretion during the first few days after child birth
1 Includes children whose mother started breastfeeding within one hour of birth. –Percentage not shown for less than 10 cases
“Unweighled cases.
TABLE 4.3 BREASTFEEDING AND WEANING STATUS
Percentage of children aged under 3 years who had exclusive breastfeeding and weaning status, Himachal Pradesh, 2012-13
1
Weaning status Number
Exclusive Other Semisolid Solid/semi-solid of
Age in months breastfeeding ﬂuids food Solid food food children“
<2 2-3 4-5 6-8 9-1 1 12-17 18-23 24-35 e-9 6-352 63.4 66.4 55.7 41.0 30.9 26.6 17.2 20.2 37.1 24.5 0.0 0.0 0.0 4.3 18.7 23.9 24.2 22.2 8.9 20.6 0.0 0.0 0.0 6.9 21.1 25.5 30.9 28.2 11.8 25.0 0.0 0.0 1.3 3.1 10.0 22.0 20.3 18.7 5.2 17.2 0.0 0.0 1.3 8.2 21.1 27.1 32.9 31.0 12.8 26.9 42 47 82 98 80 204 178 291 128 851 Note: Table based on youngest living child born since 01.01.2008. ‘ Based on those children who had breastfeeding with other fluids, semi solid food and solid food. 2 Children aged 6-35 months breastfed for at least 6 months. ** Unweighted cases. 80 TABLE 4.4 EXCLUSIVE BREASTFEEDING Percentage of youngest living child born since 01.01.2008 aged 0-5 months who received exclusive breastfeeding according to selected background characteristics, Himachal Pradesh, 2012-13. Exclusive breastfeeding Background characteristics 0-5 months Number of children“ Age group 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Rural Urban Mother's education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others DLHS-4 DLHS-3 61.6 58.8 (73.3) 61.0 59.4 63.3 61.5 58.5 (84.6) 60.3 61.3 62.0 58.2 E Literate but did not attend school are also included. () based on 10-20 unweighted cases. -- Percentage not shown for less than 10 cases.“ Unweighted cases. TABLE 4.5 BREASTFEEDING BY DISTRICTS Percentage of children aged under 3 years whose mother started breastfeeding within one hour of birth, within 24 hours of birth, and after 24 hours of birth by districts, Himanchal Pradesh, 2012-13. District Initiation of breastfeeding Children received Within one hour Within 24 hours of After 24 hours of Colostrum/Kheesa of birth birth‘ birth Number of children" Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur DLHS-4 DLHS-3 96.0 94.7 96.2 89.9 90.2 96.7 85.2 78.3 92.8 91.8 90.3 83.6 90.6 92.3 76.3 78.7 91.3 65.1 88.4 84.2 54.6 44.9 66.5 68.5 58.4 74.2 68.7 56.5 95.3 95.8 96.3 90.0 94.2 95.7 83.6 81.9 90.9 88.8 88.6 77.5 90.0 89.8 1.4 2.0 3.7 4.4 1.2 2.3 7.4 15.0 6.2 7.8 6.0 13.2 5.6 10.2 59 143 21 62 63 106 174 66 101 142 62 23 1022 2268 Note: Table based on youngest living child born since 01.01.2008. 6 Yellowish thick milk secretion during the ﬁrst few days after child birth. 1lncludes children whose mother started breastfeeding within one hour of birth. *" Unweighted cases. TABLE 4.6 VACCINATION OF CHILDREN Percentage of children aged 12-23 months who received speciﬁc vaccination according to selected background characteristics Himachal Pradesh, 2012-13 Background characteristics BCG DPT Polio Number Full No Vaccination 1 2 3 0 1 2 3 Measles vaccination‘ vaccination card seen of children“ Residence Rural Urban Sex of child Male Female Birth order 1 2 3 4+ Mother's education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others DLHS-4 DLHS-3 95.1 92.5 94.1 95.9 94.5 94.2 100.0 (37.5) 94.3 95.7 94.7 93.0 97.8 96.3 94.7 94.9 98.5 95.4 87.8 93.8 95.9 95.4 93.0 96.8 (37.5) 93.7 95.3 94.5 91.6 97.8 95.0 95.5 94.7 98.0 89.9 88.6 88.8 91.0 90.6 87.4 92.5 (31.3) 35.9 91.4 89.9 83.6 94.2 89.4 92.0 89.8 96.5 76.2 76.2 76.9 75.3 74.3 76.7 80.5 (33.3) 34.2 30.2 76.2 70.6 78.9 69.0 80.8 76.2 18.4 16.4 14.9 22.4 14.9 23.3 17.6 (31.3) 20.9 16.6 18.3 14.6 28.9 16.5 18.8 18.2 94.4 92.5 93.5 95.3 94.6 92.9 96.8 (31.3) 93.7 95.3 94.0 89.9 97.8 95.0 95.4 94.3 91.3 88.6 89.8 92.7 92.6 88.8 88.6 (31.3) 39.5 92.2 91.0 88.9 97.8 84.6 93.2 91.1 82.5 84.7 82.1 83.6 82.7 82.7 77.4 (75.0) 33.0 32.7 82.3 78.7 94.2 71.7 86.8 82.7 87.2 84.6 86.5 87.6 86.9 86.0 96.8 (32.5) 32.9 9o.o 86.5 84.7 90.0 80.4 89.7 87.0 62.0 72.2 64.9 60.3 60.6 65.3 64.6 (50.0) 51.9 37.5 62.4 59.1 71.0 48.4 68.5 62.9 0.8 0.0 1.3 0.0 0.9 0.8 0.0 0.0 0.0 1.0 0.8 1.0 0.0 1.7 0.5 0.8 20.1 38.8 23.8 19.2 21.2 22.1 17.2 (18.8) 20.5 22.4 22.2 25.8 11.9 20.7 22.2 21.8 90.9 11.7 99.0 97.4 87.4 94.2 82.2 0.9 56.1 348 25 208 165 200 140 25 8 16 5 80 272 359 6 4 4 91 36 63 183 373 778 Note: Table based on youngest living child born since 01.01.2008. “Literate but did not attend school are also included. 'BCG, three injections of DPT, three doses of Polio (excluding Polio 0) and measles. () based on 10-20 unweighted cases. -- percentage not shown for less than 10 cases. ‘* Unweighted cases. 82 TABLE 4.1 STATUS OF CHILDHOOD VACCINATION BY DISTRICTS Percentage of children aged 12-23 months received specific vaccination and Vitamin-A supplementation by districts, Himachal Pradesh, 2012-13. Vaccination Status District Vaccination card seen BCG DPT 3 Polio 3 Measles Full‘ Percentage received any dose of None Vitamin-A2 Number of children" Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shlmla Kinnaur DLHS-4 DLHS-3 10.8 28.2 28.6 8.7 8.5 29.7 10.1 34.7 15.3 (33.3) 21.4 56.1 100.0 89.2 96.4 88.5 100.0 97.6 96.2 100.0 88.1 (100.0) 94.9 98.5 86.7 58.5 85.4 86.0 82.0 84.2 73.4 71.6 64.5 (88.9) 76.2 90.0 100.0 64.4 91.5 77.2 81.9 81.9 72.3 89.6 87.9 84.8 88.2 93.7 93.4 86.9 ss.5 75.7 7a.s (100.0) (94.4) 91.0 82.7 87.0 87.4 94.2 78.2 40.4 77.1 57.4 65.4 70.9 60.8 59.8 53.1 (83.3) 62.7 82.2 0.0 3.7 0.0 0.0 0.0 0.0 0.0 0.0 1.6 (0.0) 0.8 0.9 91.1 92.6 91.0 81.3 79.1 93.0 93.6 91.0 82.9 (95.3) 89.1“ ss.s 31 58 8 25 23 33 50 26 38 56 18 7 373 778 Note. Table based on last two survived child born since 01.01.2008. ‘BCG, three injections of DPT, three doses of Polio (excluding Polio O) and measles. 2Children aged 12-35 months. “Children aged 9-35 months. () based on 10 -20 unweighted cases. -- percentage not shown for less than 10 cases. “ percentage in fact sheet age group of children is 9-35 months. ‘*’Unweighted cases. 83 TABLE 4.8 PLACE OF CHILDHOOD VACCINATION Percentage of children aged 3 years received vaccination by place of vaccination, according to selected background characteristics, Himachal Pradesh, 2012-13. Background characteristics Place of vaccination Government health sector other Private . . t Aganwadi Sub-Health Primary hge0;?$:j|Hy health‘ Centre Centre Health Centre sector Othe rs Number of children" Residence Rural Urban Sex of the child Male Female Birth order 1 2 3 4+ Mother's education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist CastesITrihes Scheduled Castes Scheduled Tribes Other Backward Classes Others DLHS-4 DLHS-3 12.1 0.0 10.0 12.1 10.6 11.4 11.5 10.8 24.3 (20.0) 11.0 10.3 11.0 (26.7) (0-0) 8.6 14.7 15.7 9.5 11.0 NA 22.5 12.8 22.7 20.5 20.6 23.0 24.8 15.1 26.9 (40.0) 24.1 20.5 22.3 (6.7) (7.1) 20.5 31.3 19.9 21.0 21.6 20.7 11.8 5.5 10.6 11.9 12.8 9.6 9.0 10.2 12.0 (20.0) 11.3 11.1 11.0 (0-0) (50.0) 11.6 18.2 5.1 12.1 11.2 33.2 59.3 78.3 61.1 60.9 60.6 61.0 61.3 67.6 47.9 (30.0) 57.0 63.1 60.8 (66.7) (50.0) 66.7 44.9 64.4 60.0 61.0 48.0 3.0 13.4 4.2 3.7 4.1 4.2 3.6 0.0 0.0 (0-0) 1.5 4.8 3.3 (6-7) (7.1) 3.0 3.9 4.2 4.4 3.9 2.7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 (0-0) 0.0 0.0 0.0 (0-0) (0-0) 0.0 0.0 0.0 0.0 0.0 0.4 870 63 488 445 483 343 78 29 33 10 193 697 896 15 8 14 218 90 165 453 933 2161 Note: Table based on youngest living child born since 01.01.2008. . aLiterate but did not attend school are also included. ‘ Includes non-governmental hospital/trust hospital or clinic, private hospital and private doctor/clinic () based on 10 -20 unweighted cases. -- percentage not shown for less than 10 cases. Na: Not available.“ Unweighted cases. 84 TABLE 4.9 VITAMIN-A AND HEPATITIS-B SUPPLEMENTATION FOR CHILDREN Percentage of children aged 12-35 months received at least one dose of Vitamin-A, 3-5 doses of Vitamin-A and Hepatitis-B injection, according to selected background characteristics, Himachal Pradesh, 2012-13. Children who received at least one dose of Vitamin- Children who received Children who received Number of Background characteristics A” 3-5 doses of Vitamin-A Hepatitis-B injection children Age of the child 12-23 months 24-35 months Residence Rural Urban Sex of the child Male Female Birth order 1 2 3 4+ Mother's education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist Others CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others DLHS-4 DLHS-3 87.7 87.3 86.8 93.3 87.4 87.7 88.6 85.5 93.7 77.6 83.2 91.6 85.7 88.2 87.3 (85.7) (100.0) H3 82.0 84.2 85.5 91.8 87.5 88.8 29.2 39.9 34.8 22.7 34.2 32.5 29.5 36.0 48.4 28.7 39.2 23.7 34.9 32.9 33.7 (33.3) (25.0) Na 30.4 27.1 29.0 36.8 33.4 16.2 89.3 85.9 87.7 90.0 86.4 89.8 89.0 84.9 94.9 89.3 80.0 92.1 81.6 90.1 87.9 (71.4) (100.0) H3 87.0 94.9 83.6 88.4 88.0 47.9 448 287 677 58 397 338 378 274 61 22 30 10 159 536 703 14 6 12 0 175 76 121 357 735 1534 Note: Table based on youngest living child born since 01.01.2008. 5 Literate but not attend school are also included. ’“‘ Children aged 9-35 months. -- Percentage not shown for less than 10 cases. ** Unweighted cases. TABLE 4.10 AWARENESS REGARDING DIARRHOEA MANAGEMENT Percentage of women who are aware of diarrhoea management according to selected background characteristics, Himachal Pradesh, 2012-13 Background characteristics Knowledge of diarrhoea management Type of practices followed if child gets diarrhoea‘ Give ORS Salt and Continue Continue Give Number sugar normal breast- plenty of solution food feeding fluids of Others women“ Age group 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Rural Urban Mother’s education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist others CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others DLHS-4 DLHS-3 74.9 89.7 95.2 95.7 95.2 95.9 95.1 94.3 99.1 89.4 91.1 94.1 96.6 94.7 87.3 94.2 92.6 (91.7) 93.7 95.5 92.6 95.7 94.8 86.5 67.0 81.8 85.2 85.3 83.4 82.2 80.2 82.1 92.3 73.0 68.0 79.9 88.3 83.2 71.9 77.4 87.1 (83.3) 80.5 83.9 81.1 84.8 83.2 76.8 55.7 65.5 67.6 69.8 71.3 72.0 68.9 68.8 75.1 53.9 54.5 69.1 74.1 69.7 57.1 68.5 67.3 (50.0) 68.1 69.9 65.5 71.0 69.4 77.2 18.7 19.7 25.2 25.2 24.4 22.9 22.3 23.5 25.6 18.3 13.8 21.3 26.9 23.9 14.1 12.4 22.4 (33.3) 22.3 27.7 18.5 25.0 23.7 12.3 19.3 20.8 24.8 25.7 21.5 22.0 23.1 23.9 16.6 14.8 19.5 22.3 26.0 23.7 14.4 6.5 16.8 (25.0) 19.8 30.4 19.4 24.3 23.2 8.7 13.4 23.9 30.5 29.6 30.1 28.6 27.0 28.7 28.3 21.5 23.5 26.7 31.9 28.9 27.4 14.6 27.0 (33.3) 27.4 33.8 23.0 29.8 28.7 16.1 1.4 3.1 3.9 4.5 5.3 4.6 7.9 4.9 5.2 4.4 14.5 5.9 4.1 5.0 4.5 3.1 4.1 (8-3) 5.6 5.9 2.7 4.9 4.9 23.6 70 771 1672 1713 1668 1543 1284 8033 688 1167 195 2824 4535 8255 96 62 296 12 1985 1013 1239 4484 8721 10016 Note: Table based on women with youngest living children born since 01.01.2008. Literate but did not attend school are also included. ’ Among women aware of diarrhoea management. () based on 10-20 unweighted cases. ** Unweighted cases. 86 TABLE 4.11 TREATMENT OF DIARRHOEA Percentage of children suffered from diarrhoea and sought advice/ treatment according to selected background Characteristics, Himachal Pradesh, 2012-13. Background characteristics suffered from diarrhoea‘ c of hildre fl Given ORS Source of treatment Children Number Government Children sought health advice/treatment facilityz Private Health facilityg Other Number of children“ Age group Less than 25 25-29 30-34 35-39 40-49 Residence Rural Urban Mother’s education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist CastesITribes Scheduled Castes Schedule Tribes Other Backward Classes Others DLHS-4 DLHS-3 4.4 4.8 4.6 2.9 0.0 4.6 3.3 2.2 (6.3) 2.7 5.2 4.3 2.9 (14.3) 15.6 2.2 7.0 4.4 5.0 4.5 9.0 400 827 352 94 11 1573 111 73 16 385 1210 1615 28 14 27 401 156 294 821 1684 3250 (88.9) 67.4 (75.0) na 75.2 (81.8) 73.8 74.4 (90.0) (70.0) (71.4) 76.1 75.3 60.7 (55.6) es] (75.0) na 65.3 (54.5) 68.5 65.9 (80.0) (70.0) (78.6) 61.0 67.5 62.8 (50.0) 02.4 (83.3) na 86.0 (100.0) 79.3 82.7 (87.5) (05.1) (s1.s) 82.0 82.6 75.9 (20.0) 12.7 (16.7) na 14.0 (<5-11>
17.6
14.4
(12.5)
(14.3)
(18.2)
12.7
14.8
24.7
(0)0)
0.0
(0-0)
na
0.0
(O-._0)
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.7
18
41
16
3
0
74
4
2
1
11
64
\|
4:-to-\-\
10
10
14
42
78
182
Note: Table based on women with youngest living children born since 01.01.2008. 3 Literate but did not attended school are
also included. ‘ Last two weeks prior to survey. 2 Includes government hospital or dispensary, urban health centre! urban health
post] urban family welfare centre, community health centre or rural hospital, primary health centre, sub-centre, ICDS and Govt.
AYUSH hospital /clinic. 3 Includes non-governmental hospital! trust hospital or clinic, private hospital/clinic and private AYUSH
hospital /clinic. () based on 10-20 unweighted cases. — percentage not shown for less than 10 cases. na: not applicable.“
Unweighted cases.
87

Table 4.12 AWARENESS AND TREATMENT OF ACUTE RESPIRATORY INFECTION (ARI)
Percentage of women who are aware of danger signs of AR1 and whose children suffer from ARI and sought advice/treatment according to selected background characteristics, Himachal Pradesh,
2012-13.
Danger signs of Acute Respiratory Infection (ARl)I Source of treatment”
Women Pain in chest Children Children
aware of Number and suffered sought Government
Private
dangersigns of Difficulty in productive Wheezing! Rapid Othezr
Background characteristics of ARI women breathing cough whistling breathing Signs
from
mP
advicel health
treatment“ facilitye
heahh
hwy
Others
Number of
children”
Age group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Mother’s education
Non-literate’
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Other
Castes/Tribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
69.9
77.4
85.5
85.8
86.9
85.9
87.6
84.4
93.9
79.9
74.7
82.6
88.8
85.5
67.1
80.1
89.5
(83.3)
82.7
83.9
84.1
87.5
85.4
67.6
70
771
1672
1713
1668
1543
1284
8033
688
1167
195
2824
4535
8255
96
62
296
12
1985
1013
1239
4484
8721
10016
40.6
43.2
49.7
48.0
47.1
48.1
45.7
46.5
54.7
35.8
27.2
43.4
53.5
47.6
33.2
36.4
48.5
(41.7)
45.3
52.1
41.7
49.0
47.4
58.5
36.8
39.1
44.1
43.8
47.7
46.4
47.3
44.2
52.8
36.7
38.5
41.2
49.8
45.2
37.9
49.7
42.7
(58.3)
41.5
43.9
42.1
47.8
45.1
63.8
27.1
30.2
34.7
33.5
32.4
31.4
33.3
32.2
37.5
18.1
23.8
31.0
37.9
32.9
21.7
20.4
34.1
(33.3)
33.3
41.6
21.0
33.9
32.8
45.3
14.3
25.6
28.5
30.2
28.5
26.0
27.3
27.4
31.9
20.4
19.1
25.8
31.3
28.1
20.5
32.0
21.9
(41.7)
28.2
26.8
22.0
29.5
27.8
36.4
36.4
34.4
43.7
43.7
47.1
44.9
42.8
42.7
51.3
28.8
30.8
41.8
48.9
43.2
38.3
51.1
54.3
(41.7)
39.2
47.0
41.6
45.3
43.5
61.5
WW
M
m
41
M
M
00
4.7
3.6
++3+
cowguw
4.2
11.1
(21.4)
9.6
na
4.1
1.0
5.4
5.2
4.6
5.1
(03.3)
92.7
(100.0)
I13
I13
92.8
I13
93.2
93.2
97.4
I13
(94.1)
0.0
(94.1)
94.7
93.3
83.9
(mm
nn
(Mn
I13
I13
73.1
I13
89.3
63.0
73.1
I13
77.2
na
(68.8)
65.6
67.6
63.6
(70.0)
24.7
(35.3)
I13
I13
25.6
I13
10.7
35.4
26.9
I13
17.0
na
(31.3)
34.4
31.1
34.3
(0-0)
0.0
(0.0)
na
na
0.0
na
0.0
0.0
0.0
I13
0.0
na
(0.0)
0.0
0.0
2.2
13
387
827
352
94
8
3
1573
111
73
16
385
1210
1615
28
14
27
0
401
156
294
821
1684
3250
Note: Table based on women with youngest living children born since 01.01.2008.” Literate but did not attend school are also included.
I Among women who are aware of any danger signs of ARI. 2 Includes not able to drink or take a feed, excessive drowsy and difﬂculty to keep awake, running nose and others? Last two weeks prior
to survey. A Among children with ARI or fever in last two weeks who sought advice! treatment 5 Among children who sought advice/treatment. 6 Includes government hospital or dispensary, urban
health centre/urban health postlurban family welfare centre, community health centre or rural hospital, primary health centre, sub-centre, ICDS and Govt. AYUSH hospital/clinic. Includes non-
governmental hospital/trust hospital or clinic, private hospital/clinic and private AYUSH hospital/clinic. () based on 10-20 unweighted cases. –Percentage not shown for less than 10 cases. **
Unweighted cases.
%

Table 4.13 AWARENESS OF ORS AND ACUTE RESPIRATORY INFECTION (ARI) BY DISTRICTS
Percentage of women by awareness of ORS and percentage of children suffered from diarrhoea and ARI and sought
advice/treatment by districts, Himachal Pradesh, 2012-13
District
Oral Rehydration Therapy/Solution (ORS) Acute Respiratory lnfection(ARl)
Women aware Children suffered Children sought Children suffered Children sought Number of
of ORS from diarrhoea‘ advice/treatment from ARI‘ advice/treatment2 children”
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
DLHS-4
DLHS-3
85.6
77.4
88.1
87.5
90.2
82.8
78.3
82.4
80.6
70.2
83.6
82.0
82.3
76.8
0.8
3.9
0.0
1.7
6.9
6.7
5.8
6.2
3.8
2.8
1.5
22.4
4.5
9.0
100.0
67.9
50.1
72.0
83.4
68.1
82.1
38.6
53.1
55.0
60.0
67.0
62.8
na
100.0
0.0
79.1
100.0
100.0
94.9
100.0
92.8
100.0
100.0
0.0
93.2
83.9
90
244
41
112
99
176
289
106
170
224
97
36
1684
3250
Note: Table based on women with last two surviving children born since 01.01.2008.
‘ Last two weeks prior to survey. 2 Among children with ARI or fever in last two weeks sought advice /treatment. na: not
applicable. ** Unweighted cases.
89

FAMILY PLANNING
91

TABLE 5.1 AWARENESS OF CONTRACEPTIVE METHODS
Percentage of ever married and currently married women aged 15-49 years who are aware of specific contraceptive method by
place of residence, Himachal Pradesh, 2012-13.
Contraceptive methods
Total
Rural
Urban
Total
Ever married women Currently married women
I
Rura
Urban
Any method
Any modern methodl
Female sterilization
Male sterilization
lntra Uterine Device
Pill
Emergency contraceptive pill
lnjectables
Condom/nirodh
Female condom
Rhythm method
Withdrawal method
Contraceptive herbs
Lactational Amenorrhoea Method(LAM)
Others
Number of women”
95.0
92.8
77.6
45.7
26.4
32.7
10.0
6.8
41.1
5.1
5.2
6.2
0.6
1.2
0.4
9100
95.4
93.0
77.9
46.2
27.0
32.9
10.3
7.0
41.0
5.2
5.5
6.6
0.6
1.2
0.4
8381
91.9
90.6
75.3
41.7
21.9
30.5
6.8
4.9
42.4
3.9
2.6
2.6
0.5
0.8
0.3
720
95.5
93.6
78.4
46.2
26.8
33.2
9.9
6.9
41.8
5.2
5.3
6.1
0.6
1.1
0.4
8721
95.8
93.8
78.7
46.7
27.4
33.4
10.3
7.2
41.6
5.3
5.6
6.5
0.6
1.2
0.4
8033
92.8
91.6
75.7
41.5
22.0
31.1
6.8
4.9
43.8
4.1
2.6
2.7
0.5
0.9
0.3
688
1|ncludes female sterilization, male sterilization, lntra-Uterine Device, pill, condom, female condom, emergency Contraceptive
Pill and lnjectables. ** Unweighted cases.
93

TABLE 5.2 AWARENESS OF CONTRACEPTIVE METHODS
Percentage of currently married women aged 15-49 years who are aware of specific contraceptive method according to selected background characteristics, Himachal Pradesh. 2012-13
Background
characteristics
Any modern
method method
Any
Male
sterili-
zaﬂon
Female
sterili-
zation
IUD
Pill
ECP
With-
Female Rhythm drawal Contraceptive
lnjectables Condom/Nirodh condom method method herbs LAM Other
Number
of
s women“
Age group
15-24
25-29
30-34
35-39
40-49
No. of living children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non-literate“
Less than five years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist/Neo-Buddhist
Others
CastesITribes
Scheduled castes
Scheduled tribes
Other Backward Caste
Others
DLHS-4
DLHS-3
90.1
94.2
95.2
96.9
97.4
87.6
93.7
97.5
98.6
98.0
95.8
92.8
97.7
96.7
96.0
94.5
95.6
97.8
95.2
93.7
(91.7)
96.3
96.1
94.3
95.4
95.5
99.8
85.6
90.6
93.6
95.6
96.5
84.3
91.1
95.7
98.0
96.9
93.8
91.6
96.2
95.4
95.0
91.8
93.5
97.1
95.2
93.1
(91.7)
94.7
94.7
91.8
93.3
93.6
99.8
41.7
46.5
45.2
45.3
48.4
37.4
45.8
46.8
50.2
52.0
46.7
41.5
42.9
49.4
49.7
44.8
45.6
46.8
49.0
60.0
(58.3)
45.6
60.3
42.0
44.5
46.2
93.8
63.8
72.2
77.6
81.2
85.3
58.7
69.9
84.2
87.3
91.0
78.7
75.7
80.9
84.7
82.2
74.5
78.7
79.7
79.9
70.6
(58.3)
79.3
75.1
78.7
78.6
78.4
99.1
27.7
30.5
26.4
24.8
25.8
23.6
26.8
27.5
27.2
27.7
27.4
22.0
16.2
26.9
27.0
29.4
27.1
12.9
18.7
25.6
(8.3)
27.6
33.3
19.1
27.2
26.8
80.8
41.2
40.1
33.7
31.1
27.6
35.1
34.2
32.9
31.7
30.3
33.4
31.1
19.9
30.7
31.4
37.9
33.3
28.9
33.4
31.8
(16.7)
33.4
39.6
28.1
33.1
33.2
92.4
12.2
12.4
10.7
10.6
6.9
13.8
10.9
9.7
7.3
6.4
10.3
6.8
7.8
7.3
8.2
11.9
9.9
11.9
1.3
14.1
(0-0)
9.1
15.7
8.7
9.4
9.9
43.6
8.0
8.8
7.4
7.0
5.2
8.6
7.9
7.4
3.8
4.1
7.2
4.9
4.0
4.6
5.9
8.7
6.9
5.5
2.4
9.1
(0.0)
5.8
9.9
5.9
7.1
6.9
46.9
49.6
50.4
42.5
39.5
35.4
53.4
46.1
38.8
37.1
33.1
41.6
43.8
28.3
36.6
37.4
48.4
41.2
31.3
27.4
67.0
(16.7)
41.1
55.0
34.4
41.4
41.8
87.4
5.7
5.9
5.8
5.5
4.1
8.2
5.0
5.4
3.1
3.0
5.3
4.1
3.8
3.7
3.6
6.5
4.9
3.2
1.3
13.8
(16.7)
5.1
7.6
3.9
5.1
5.2
20.8
5.4
6.2
5.4
5.4
4.6
6.6
5.3
4.8
5.9
5.0
5.6
2.6
4.0
4.7
4.4
6.1
5.0
2.0
1.3
14.2
(0.0)
5.1
13.0
3.1
4.3
5.3
43.3
6.9
7.2
6.6
6.1
5.0
7.6
6.9
5.3
5.7
6.7
6.5
2.7
5.1
5.9
4.7
7.0
5.9
0.7
0.0
16.7
(0.0)
5.7
14.4
3.8
5.2
6.1
31.4
0.8
0.7
0.6
0.8
0.4
0.4
0.6
0.8
0.5
0.3
0.6
0.5
0.4
0.3
0.6
0.8
0.6
2.1
0.0
0.0
(0.0)
0.5
0.8
0.3
0.7
0.6
NA
3.3
2.0
0.9
0.6
0.5
.o.O._‘._‘._‘
mwoww
1.2
0.9
0.4
0.8
0.7
1.6
1.2
2.1
0.0
0.0
(0.0)
0.8
1.4
0.6
1.4
1.1
NA
0.6
0.6
0.3
0.3
0.2
0.7
0.4
0.3
0.3
0.0
0.4
0.3
0.3
0.2
0.4
0.5
0.4
0.0
1.6
0.0
(0.0)
0.4
0.3
0.5
0.3
0.4
0.8
841
1672
1713
1668
2827
1086
2020
3807
1325
483
8033
688
1167
1467
1552
4535
8255
96
62
296
12
1985
1013
1239
4484
8721
9622
Note: IUD = lntra-Uterine Device; ECP = Emergency Contraceptive Pill; LAM =Lactationa| Amenorrhoea Method.
‘ Lilerates but did not attend school, are also included. Not available. () Based on 10-20 unweighted cases. *’ Unweighled cases.
94

TABLE 5.3 AWARENESS OF CONTRACEPTIVE METHODS BY DISTRICT
Percentage of currently married women age 15-49 years who are aware of specific contraceptive method by district. , Himachal Pradesh. 2012-13
Di strict
Any modern
method method
Any
Male
sterili-
zation
Female
sterili-
zation
IUD
Pill
ECP
ables
With-
lnject- Condom! Female Rhythm drawal Contraceptive
Nirodh condom method method herbs
LAM
Number
of
Other women“
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
DLHS-4
DLHS-3
93.6
96.1
99.5
98.6
93.4
91.1
95.2
97.3
95.8
97.0
93.9
95.6
95.6
99.8
89.9
90.7
99.5
97.8
92.5
88.2
94.6
95.0
94.0
95.1
93.2
92.7
93.6
99.8
50.9
38.1
61.6
52.0
40.3
29.0
45.2
44.2
46.3
48.5
51.8
53.7
46.3
93.8
72.6
77.4
72.1
90.9
80.9
66.4
81.2
73.5
78.2
85.7
79.9
67.5
78.5
99.1
25.8
16.4
35.2
43.7
24.8
13.0
41.8
26.2
28.5
15.8
26.4
18.0
26.9
80.8
23.5
26.1
37.7
46.3
25.0
38.3
51.2
31.3
40.1
19.2
28.6
28.5
33.2
92.4
12.9
4.8
9.1
9.3
9.6
10.7
9.9
10.5
11.2
5.7
8.2
27.4
10.0
43.6
9.8
3.4
9.4
10.2
7.6
9.8
10.4
3.9
1.8
3.8
4.0
10.2
7.0
46.9
32.5
21.6
85.0
54.3
26.9
40.8
56.4
50.0
38.9
22.8
38.0
56.7
41.8
87.4
7.4
2.2
9.0
5.4
5.2
8.4
4.6
4.3
2.7
3.3
2.0
13.5
5.2
20.8
5.9
2.3
16.8
5.8
3.4
6.9
2.4
4.0
1.7
1.6
3.0
23.1
5.4
43.3
6.7
3.2
19.5
7.9
2.4
2.0
2.2
9.3
2.0
1.5
3.2
31.0
6.2
31.4
1.9
1.0
0.0
0.8
1.0
2.0
0.4
1.1
Mgr?
01-_,~|a>
1.1
NA
0.6 775
0.4 820
0.0 482
0.0 1064
0.2 832
1.7 687
0.0 797
0.4 660
0.8 665
0.3 842
0.2 696
0.0 401
0.4 8721
0.8 9622
Note: IUD = lntra-Uterine Device; ECP = Emergency Contraceptive Pill; LAM =Lactationa| Amenorrhoea Method.
NA: Not available. *‘ Unweighted cases.
%

TABLE 5.4 EVER USE OF CONTRACEPTIVE METHOD
Percentage of currently married women age 1549 years who ever used specific contraceptive method according to selected background characteristics, Himachal Pradesh. 2012-13
Background
characteristics
Any Any modern Male Female Condoml Female Rhythm Withdrawal Numberof
method method sterilization sterilization IUD Pill ECP lnjectables Nirodh condom method method Others women
Age group
15 – 19
20 – 24
25 – 29
30 – 34
35 ~ 39
40 – 44
45 — 49
No. of living children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non-literate’
Less than five years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist/Neo-Buddhist
Others
Castes/Tribes
Scheduled castes
Scheduled tribes
Other Backward Caste
Others
DLHS-4
DLHS-3
21.8
36.0
53.3
65.4
73.5
74.8
73.0
27.8
51.7
75.6
78.4
77.5
64.8
61.4
66.0
72.6
68.5
60.1
65.0
62.9
68.0
49.2
(62.6)
65.9
65.0
63.1
64.0
64.4
76.4
20.7
32.7
50.1
63.3
71.7
73.5
71.9
25.6
48.9
73.7
77.6
75.3
62.7
59.9
64.6
70.4
67.5
57.6
62.9
60.9
66.4
48.3
(62.6)
64.4
62.8
60.8
61.8
62.4
73.8
0.0
0.8
1.9
3.1
4.0
5.8
6.1
0.2
2.2
4.4
6.0
6.7
3.8
2.7
5.5
4.8
4.3
2.8
3.6
2.1
2.8
6.7
(33.3)
4.0
8.1
1.6
3.3
3.9
7.7
1.5
9.1
19.7
39.8
52.4
58.9
58.9
5.4
19.5
54.6
61.2
62.0
42.0
37.2
49.5
55.1
49.5
32.5
42.1
44.2
50.1
22.3
(25.0)
43.9
32.1
44.1
41.7
41.8
47.5
.-‘.-‘.-‘.-‘.’°.-‘P
<.nu:w:>o4>o
0.7
2.6
1.7
0.8
0.7
bob:
.-‘.-‘.-‘.9
0000-10
1.6
0.9
1.6
3.0
(1-3)
bv%.~>bo’\:
1.6
3.3
3.7
6.8
7.4
6.8
6.1
4.0
2.8
4.3
7.2
5.8
4.6
4.1
5.7
5.4
3.1
4.4
5.3
6.9
5.6
6.1
11.8
5.0
(10.2)
7.2
5.2
6.0
5.0
5.7
8.9
._‘._‘._‘.“‘._‘.“‘.o
->-\:o<.»:\|-no .07‘.-‘.—‘.-‘ \i<.nwoion 1.5 0.3 i.n'ul'-\l>
1.4
0.0
0.0
1.6
(0-0)
._‘._‘!‘-1?‘
0\|<.-am 1.4 0.6 0.0 0.2 0.3 0.1 0.2 0.2 0.4 0.1 0.4 0.2 0.3 0.3 0.3 0.0 0.3 0.3 0.3 0.2 0.3 0.0 0.0 0.0 (0.0) 0.6 0.1 0.1 0.1 0.2 0.5 16.8 20.5 25.0 19.1 15.5 10.4 7.4 19.8 22.0 15.5 11.1 5.6 16.2 18.4 8.2 11.7 14.6 20.5 16.4 13.2 6.5 20.9 (6.6) 15.9 20.7 13.9 16.4 16.4 18.1 0.0 0.4 0.6 0.4 0.3 0.5 0.4 0.8 0.6 0.4 0.2 0.0 0.4 0.3 0.0 0.3 0.4 0.6 0.4 1.2 0.0 1.0 (0-0) 0.5 0.5 0.3 0.4 0.4 0.2 0.0 0.9 1.7 1.5 0.9 0.9 0.5 ?9.“"I-‘.-“.0 nouzouioa 1.1 0.9 ._‘.".“‘.o <.-acme: 1.2 0.0 0.0 0.0 (0-0) 1.1 2.2 0.9 0.9 1.1 8.3 1.1 2.2 2.4 2.0 1.9 1.5 0.9 !°.“"._‘._‘._‘ -\¢.ooa<0\|LnaoJ>
0.6
2.2
2.0
0.9
2.0
0.6
6.4
1.2
0.0
ii
mm
0.6
1.0
0.8
1.6
.“‘.“!\‘.o.“‘
coo:-\<.o|\>
12.3
12.0
17.2
12.3
9.0
4.9
2.8
9.7
14.9
15.3
9.1
16.4
NS”
2.0
5.6
9.3
15.3
3.1
5.7
8.7
13.3
9.9
8.6
5.7
12.7
4.9
70
771
1672
1713
1668
1543
1284
1086
1360
660
3449
358
1241
84
450
33
8033
688
1167
1467
1552
4535
8255
96
62
296
74
Contd
97

1 TABLE 5.5 (A) CURRENT USE OF CONTRACEPTIVE METHODS —C0ntinued
Background
characteristics
Any
modern Male Female
Any method method sterilization sterilization
Pill
Condoml Rhythm Withdrawal Number of
Niroclh method method Other women*
CasteslTribes
Scheduled castes
Scheduled tribes
Other Backward Caste
Others
DLHS-4
DLHS-3
60.5
54.9
58.6
59.0
58.8
71.4
59.6
53.5
57.2
57.9
57.7
69.5
44.4
32.4
44.4
42.0
41.8
47.2
.“”.‘“.oT‘
I\)(.\JkO-J>
1.2
2.8
8.9
11.1
8.9
10.3
9.9
10.0
0.3
0.0
0.2
0.3
.-‘P
4:-<» 1985 1013 1239 4484 8721 9622 Note: IUD = lntra-Uterine Device; ECP = Emergency Contraceptive Pill; LAM =Lactationa| Arnenorrhoea Method E Literates but did not attend school, are also included. "' Unweighted cases. 98 TABLE 5.5 (Q) DURATION OF USE OF SPACING METHODS Percentage of currently married women age 15-49 years who are currently using spacing method by duration of use according to selected background characteristics, Himachal Pradesh, 2012-13 Background characteristics IUD Pill Condom/Nirodh < 6 months 6 months to 2 years 2-3 years 3 or more years Number of IUD users" > 6
months
Number of
Number condom!
of Pill > 6 nirodh
users” months users
Age group
15 – 19
20 – 24
25 – 29
30 – 34
35 – 39
40 – 44
45 – 49
No. of living children
0
1
2
3
4+
Residence
Rural
Urban
Education
Non-literate“
Less than five years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist/Neo-Buddhist
Others
CastesITribes
Scheduled castes
Scheduled tribes
Other Backward Caste
Others
DLHS-4
DLHS-3
(1611)
(15.0)
(0.0)
4.8
8.7
8.3
9.5
8.0
(0.0)
9.9
7.1
NA
(J5)
(10.0)
(U9)
5.8
0.0
4.1
4.7
4.0
(7-7)
2.0
3.5
NA
(J6)
(11.1)
(8.3)
3.1
10.6
3.1
8.1
6.8
(0-0)
10.1
6.0
NA
(33.3)
(44.4)
(66.7)
70.6
42.4
56.8
55.5
51.4
(53.8)
58.2
54.6
NA
06
20
18
08
12
04
03
28
31
04
02
60
08
04
04
09
51
60
01
01
06
13
06
08
41
68
121
(53.3)
77.0
76.5
63.0
65}
64.6
(69.2)
68.6
(70.0)
(64.6)
(46.2)
(67.1)
70.1
77.2
(58.8)
68.6
69.0
71.5
02
15
22
29
25
O8
05
06
42
40
13
05
96
10
07
13
13
73
99
01
O1
05
26
O9
17
54
106
299
46.9
57.8
68.4
76.3
69.9
73.1
33.7
62.5
14.1
69.2
(40.0)
65.3
57.8
61.5
64.5
64.9
64.0
63.3
76.9
60.1
66.8
60.2
65.9
64.1
78.1
07
95
289
208
151
75
36
103
304
373
71
10
756
105
36
B4
133
608
808
08
03
42
181
114
110
456
861
964
Note: IUD = lntra-Uterine Device. ‘ Literates but did not attend school. are also included. () Based on 10-20 unweighted cases.
— Percentage not shown for less than 10 cases. NA: Not available. *‘ Unweighted cases.
99

TABLE 5.6 AGE AT THE TIME OF STERILIZATION
Percent distribution of women age. 15-49 years by age at the time of sterilization, according to selected background
characteristics, Himachal Pradesh, 2012-13.
Background Age at the time of sterilization
characteristics <20 20 -24 25 -29 30 -34 35 -39 40+ Total‘ Mean age of Number of sterilization women Years since sterilization <2 2-3 4-5 6-7 8-9 10+ No. of living children 0 1 2 3 4+ Residence Rural Urban Education Non-literate’ Less than five years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist/Neo-Buddhist Others Castes/Tribes Scheduled castes Scheduled tribes Other Backward Caste Others DLHS-4 DLHS-3 0.6 0.7 1.4 2.3 1.4 4.2 8.3 2.4 2.0 1.9 1.7 fl“ §D@ 4.2 2.4 2.2 1.0 2.0 6.7 0.0 1.8 1.9 2.5 2.6 1.9 2.1 2.2 11.4 12.0 17.5 20.1 19.3 26.9 17.6 15.6 19.8 14.6 9.3 17.5 15.3 16.3 21.6 15.4 16.4 17.3 21.2 8.1 14.7 21.4 13.3 13.2 17.3 17.3 28.7 25.8 28.2 37.2 43.0 39.6 43.4 31.6 22.6 33.1 34.8 33.2 32.6 28.0 31.3 28.8 29.9 35.6 32.2 35.4 42.0 27.8 29.9 36.0 31.6 32.8 32.2 44.0 21.8 26.3 28.4 19.0 30.4 21.4 5.9 16.7 20.7 25.6 32.3 21.6 26.2 16.9 21.2 21.8 24.6 22.1 16.1 31.8 21.2 23.2 23.1 21.5 21.4 22.0 19.9 16.7 18.5 11.3 13.7 6.4 4.2 7.9 15.7 12.2 9.7 10.2 11.8 11.7 9.8 10.7 14.5 11.8 11.9 10.6 7.7 10.1 11.6 11.3 15.4 11.0 11.8 4.5 23.6 14.4 4.2 1.9 2.9 0.0 28.6 26.9 12.3 13.4 13.4 14.3 17.0 21.5 15.3 16.2 10.7 14.4 10.0 10.4 24.5 12.1 13.7 15.7 15.6 14.6 0.8 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 32.70 31.84 28.94 28.31 28.35 26.62 30.98 33.05 30.12 30.52 31.37 30.59 31.49 31.49 30.42 31.08 30.22 30.62 28.73 30.97 32.65 30.10 30.68 31.33 30.72 30.65 26.8 175 405 381 275 266 1555 61 459 2291 901 339 3764 287 666 886 857 1 642 3869 45 35 95 07 978 421 593 2059 4051 5289 1 Total figure may not add to 100 percent due to ‘don't know‘ or ‘missing cases. E Literates but did not attend school, are also included. ’* Unweighted cases. 100 TABLE 5.7 CONTRACEPTIVE PREVALENCE RATE BY DISTRICT Percentage of currently married women age 1549 years who are currently using any contraceptive method, by districts, Himachal Pradesh, 2012-13. Di strict Any Any modern Male Female method method sterilization sterilization Pill Condoml Rhythm Withdrawal Number Of Nirodh method method Other Women‘ Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur DLHS-4 DLHS-3 59.4 57.6 50.1 57.2 64.3 69.8 56.5 55.3 62.0 67.1 50.6 46.3 58.8 71.4 57.1 56.5 49.0 56.7 63.9 68.4 54.8 54.7 61.3 66.7 48.8 43.3 57.7 69.5 1.6 4.2 10.0 7.7 1.8 2.9 3.0 3.1 2.1 4.1 0.7 7.8 3.9 7.8 46.6 43.4 24.6 38.3 51.6 50.2 29.4 40.9 48.5 54.7 37.3 23.7 41.8 47.2 0.2 1.6 0.3 1.0 0.9 3.3 1.4 1.4 .-‘.-‘P.-‘ r\=oo~|m 1.2 2.8 8.3 6.7 13.5 9.4 8.6 10.9 20.4 7.0 8.2 6.6 8.9 9.5 9.9 10.0 775 820 482 1064 832 687 797 660 665 842 696 401 8721 9622 Note: IUD = lntra Uterine Device . *’ Unweighted oases. TABLE 5.8 SOURCES OF MODERN CONTRACEPTIVE METHODS Percent distribution of currently married women age 15-49 years who are currently using modern contraceptive methods by source according to selected background characteristics Himachal Pradesh, 2012-13 Background Characteristics Spacing Method Number Limiting method Govern- mentz Private3 Other“ Tota I1 of G women“ ments Privates Other7 overn- Total‘ Number of women“ Age group 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 — 49 No. of living children 0 1 2 3 4+ Residence Rural Urban Education Non-literatea Less than ﬁve years 5-9 years 10 or more years Religion Hindu Muslim Sikh BuddhistJNeo-Buddhist Others CastesITribes Scheduled castes Scheduled tribes Other Backward Caste Others DLHS-4 DLHS-3 39.8 41.8 51.6 48.3 47.1 48.9 32.3 45.5 46.9 57.0 (46.2) 46.2 41.8 44.0 55.2 53.9 42.7 45.1 (44.4) 59.6 48.2 46.1 52.3 42.7 45.5 49.2 14.1 18.5 15.7 9.9 9.0 4.2 8.2 17.3 14.8 10.7 (7.7) 14.7 13.6 12.1 7.6 8.7 16.7 14.9 (11.1) 5.8 15.1 9.7 9.6 16.6 14.5 17.1 46.1 39.7 32.7 41.8 43.9 47.0 59.5 37.2 38.3 32.3 (46.2) 39.1 44.6 43.9 37.2 37.3 40.6 40.0 (44.4) 34.6 36.7 44.2 38.1 40.7 39.9 33.7 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 09 116 333 255 184 95 45 112 376 444 88 17 914 123 47 101 155 734 969 10 05 53 220 129 136 552 1037 1276 97.6 96.5 95.7 94.4 95.4 95.6 87.9 95.3 95.2 95.9 97.2 95.9 90.1 98.2 96.0 94.9 94.2 95.5 97.3 87.0 94.1 95.7 97.6 94.5 95.1 95.4 98.0 0.0 3.2 4.2 5.5 4.5 4.1 6.9 4.7 4.7 4.0 2.8 3.9 9.9 1.8 3.9 4.9 5.5 4.3 2.7 13.0 4.0 4.1 2.2 5.5 4.6 4.4 1.6 2.4 0.2 0.1 0.1 0.1 0.3 5.2 0.0 0.2 0.2 0.0 0.2 0.0 0.0 0.2 0.2 0.3 0.2 0.0 0.0 1.9 0.2 0.2 0.0 0.2 0.2 0.5 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 01 80 374 758 966 1012 840 58 457 2277 900 339 3749 282 665 885 852 1629 3852 45 35 92 07 976 419 588 2048 4051 5289 Note: Spacing method includes — pill (Daily/Weekly), condom (Male/Female), and lnjectables and limiting method includes male sterilization and female sterilization. E Literates but did not attend school, are also included. ‘Total figure may not add to 100 percent due to ‘missing cases’. Z Hospital, dispensary, UHC/UHP/UFWC, CHC/ Rural Hospital, PHC, Sub Health Centre/ANM, Mobile clinic, Anganwadi / ICDS centre, ASHA, Other Community Based Worker, AYUSH Hospital/Clinic and Other Public Health Sector. 3 Hospital, Doctor/Clinic, Mobile Clinic, AYUSH Hospital/Clinic, Traditional Healer, Pharmacy/Drugstore and Other Private Medical Sector. A NGO or Trust Hospital/clinic Private, Shop, Vending Machine, Husband. Relatives/Friends, Others and Don‘t Know. 5Hospital, Dispensary, CHC/Rural Hospital, PHC, Mobile Clinic, Camp and Other Public Sector Health Facility. 6 Hospital, Doctor/Clinic, Mobile Clinic and Other Private Health Facility. 7 NGO or Trust Hospital/Clinic, Other and Don't Know. -- percentage not shown for less than 10 cases." Unweighted cases. 102 TABLE 5.9 CASH BENEFITS RECEIVED AFTER STERILIZATION Percent distribution of currently married women and wives of sterilized men who received cash benefits after sterilization, by districts, Himachal Pradesh, 2012»13 Received cash At the time of At the time of After benefits discharge ﬁrst follow-up several visits District Cash benefits received Total (100%) Number of women“ Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur DLHS-4 DLHS-3 75.4 58.5 58.3 64.3 68.0 66.4 74.5 62.4 51.1 62.0 60.0 50 0 63.5 76.9 82.7 83.4 57.7 51.4 51.2 74.1 86.7 76.2 85.6 77.0 70.9 74.2 71.7 93.6 13.4 13.5 34.0 36.7 25.9 16.5 10.1 19.9 7.5 19.1 27.2 11.3 20.2 5.0 4.0 3.1 8.2 11.9 22.9 9.5 3.2 3.9 6.9 3.9 1.9 14.5 .-‘.°° ;,;_t 100.0 100,0 100.0 100.0 100.0 100.0 100.0 100.0 100,0 100.0 100.0 100.0 100.0 100.0 387 395 172 490 446 369 256 291 330 501 266 128 4051 5289 Total number may not add up to N due to missing cases. ** Unweighted cases. TABLE 5.10 HEALTH PROBLEMS WITH CURRENT USE OF CONTRACEPTION AND TREATMENT RECEIVED Percentage of currently married women age 15-49 years who are currently using contraceptive method and who were informed about side effects, had side effects with the method, treatment taken for side effect with the method, Himachal Pradesh, 2012- 13 Health problems/side effect Female sterilization Type of method IUD Pill Women who were informed about the side effects before 17.1 adoption of the method Women who had side-effect/health problem due to use of contraceptive method Number of current users“ 3630 Type of health problems/side effects’ 4.3 Weakness/inability to work 22.3 Body ache! backache 31.2 Abdominal pain 15.4 Weight gain 19.2 Dizziness Nausea/vomiting 4.5 5.0 Fever 32.1 Breast tenderness 4.1 Irregular periods 11.7 Excessive bleeding Spotting Amenorrhoea Cramps Decreased libido Rashes/allergy Infection Others Number of users with side ef'fects** Percentage of women received treatment Source of treatment Government health facility Private health facility Other Number of women with treatment taken” 4.6 1.7 3.8 1.6 1.3 2.6 5.4 2.2 161 65.8 61.5 3.6 0.0 106 25.4 4.0 68 03 02 28.3 2.9 106 O3 01 1 Percentages may add to more than 100 because of multiple responses. -- percentage not shown for less than 10 cases. ** Unweighted cases. TABLE 5.11 REASONS FOR DISCONTINUATION OF CONTRACEPTION Percent distribution of currently married women age 15-49 years who are past users (currently non-users) by reason for discontinuation of the contraceptive method according to selected background characteristics, Himachal Pradesh . 2012-13 Reasons for discontinuation Background characteristics Fertility related‘ Side effect related Others“ Number of women Age group 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 No. of living children 0 1 2 3 4+ Residence Rural Urban Education Non-literate“ Less than ﬁve years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist/Neo-Buddhist Others Castesffribes Scheduled castes Scheduled tribes Other Backward Caste Others DLHS-4 DLHS-3 48.0 40.7 29.1 (20.0) 45.5 41.7 12.5 28.7 (51.6) (16.5) (21.4) (23.2) 36.7 30.1 35.9 20.8 (24.7) 32.7 30.3 66.6 20.3 17.6 28.9 (30.5) 16.5 22.2 28.5 24.7 (29.0) (25.3) (2a.e) (32.9) 22.1 25.6 25.4 25.6 (25.9) 23.9 25.0 14.5 31.7 41.7 41.9 (49.5) 38.0 36.2 59.0 46.5 (19.4) (58.2) (50.0) (43.9) 41.1 44.3 38.7 53.6 (49.4) 43.4 44.7 18.9 03 41 80 36 19 05 01 56 93 24 06 06 169 16 13 15 19 138 1 76 04 01 04 49 23 20 93 185 496 1 4 - 2 Wanted child, method failed/became pregnant. Others include supply not available, difficult to get method, lack of pleasure method was inconvenient, cost too much, family/husband opposed, not having sex. infrequent sex, husband away and others “ Literates but did not attend school, are also included. () based on 10-20 unweighted cases. -- percentage not shown for less than 10 cases. ** Unweighted cases. TABLE 5.12 FUTURE INTENTION TO USE CONTRACEPTION Percent distribution of currently married women aged 15-49 years who are not using contraceptive method but having intention to use contraception in future by background characteristics, Himachal Pradesh, 2012-13 Future intention to use‘ Want to use any family planning method Spacing Limiting Within 12 12 months Number of Background Characteristics Method Method months and more Undecided non-users Age group 15 - 19 3.4 20 - 24 5.0 25 - 29 5.9 30 - 34 4.4 35 - 39 3.0 40 - 44 4.3 45 - 49 1.5 No. of living children 0 3.4 1 5.4 2 3.5 3 5.6 4+ 2.9 Residence Rural 4.3 Urban 4.3 Education Non-literate“ 2.3 Less than five years 2.7 5-9 years 4.4 10 or more years 5.1 Religion Hindu 4.1 Muslim 5.2 Sikh 11.5 Buddhist/Neo-Buddhist 5.5 Others CastesITribes Scheduled castes 3.6 Scheduled tribes 4.1 Other Backward Caste 6.9 Others 3.8 DLHS-4 4.3 DLHS-3 1.7 0.0 7.8 5.9 5.9 2.8 3.1 2.0 2.1 6.3 5.1 5.3 4.1 5.0 3.1 2.2 3.8 5.7 5.4 4.9 0.0 0.0 5.2 5.8 3.5 4.4 4.8 4.8 14.8 20.1 17.0 25.7 24.9 31.9 15.5 41.0 18.3 16.0 35.7 35.0 15.4 24.4 22.6 2.9 30.8 24.7 25.3 24.4 42.6 50.0 15.5 20.4 29.4 25.5 24.5 24.3 29.2 30.3 28.9 31.0 32.3 25.9 33.9 23.8 26.2 32.4 26.5 38.1 29.7 30.7 26.0 24.5 29.4 28.6 31.4 29.7 25.0 50.0 38.0 38.5 29.4 33.2 25.5 30.2 19.6 49.6 54.1 43.3 42.7 42.2 50.6 35.2 55.5 51.6 37.8 26.9 54.9 44.9 51.4 72.6 39.8 46.8 43.3 45.9 32.5 0.0 46.4 41.0 41.3 41.3 50.0 45.5 51.2 50 475 850 677 519 446 408 747 1124 1080 343 131 3148 277 459 465 545 1956 3205 42 21 152 05 739 440 484 1762 3425 2750 Note: Spacing method includes IUD, pills, condom (Male/Female) and lnjectables. Limiting method includes male sterilization and female sterilization. ). E Literates but did not attend school, are also included. ' Total ﬁgure may not add to 100 percent due to exclusion of other methods (Rhythm! Periodic abstinence, Withdrawal, Undecided and Others. -- percentage not shown for less than 10 cases. ** Unweighted cases. TABLE 5.13 ADVICE ON CONTRACEPTIVE USE Percentage of currently married women age 15-49 years who are currently not using any contraceptive and were advised by the ANM/health worker to use modern contraception by suggested method and place of residence, Himachal Pradesh, 20012- 13 Residence Advice Total Rural Urban Percent Non-users advised to use modern contraceptive method‘ Number of Non-users"* Percent of Traditional method users advised to use modern method Number of traditional method users“ Percent of non-users or traditional method users who were advised to use Female sterilization Male sterilization IUD Pill(Daily/weekly) lnjectables Condom/Nimrod Female condom Rhythmic /periodic abstinence Withdrawal Others 39.6 3425 21.1 68 27.5 10.6 11.3 10.2 3.0 35.0 3.2 1.9 5.3 0.9 39.9 3148 24.6 61 26.6 10.4 11.4 10.1 3.0 34.7 3.2 1.9 5.3 0.9 36.9 277 07 Note: Exclude women in menopause or those who have undergone hysterectomy. 1 Includes Doctor, ANM, Health Worker, anganwadi Worker and ASHA. -- percentage not shown for less than 10 cases Unweighted cases. 106 TABLE 5.14 REASONS FOR NOT USING MODERN CONTRACEPTIVE METHODS AMONG RHYTHM AND WITHDRAWAL METHOD USERS Percent distribution of currently married women age reasons for not using modern contraceptive method 2012-13 15-49 years who are currently using rhythm or withdrawal method by . according to selected background characteristics, Himachal Pradesh Background characteristics Fertility related Reason for not using modern contraceptive method Opposition to use/lack of Number of knowledge Method related women Age group 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 No. of living children 0 1 2 3 4+ Residence Rural Urban Education Non-literate“ Less than five years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist/Neo-Buddhist Others Castesffribes Scheduled castes Scheduled tribes Other Backward Caste Others DLHS-4 DLHS-3 (5115) (42.9) (44.4) 60.5 40.2 47.6 51.5 47.7 (53.8) 52.8 49.0 22.4 (£2) (14.3) (11.1) 7.9 10.6 12,5 12.4 10.9 (15.4) 14,9 10.6 36.3 (21-73) (42.9) (44.4) 31.7 49.2 39.9 36.1 41.4 (30.8) 32.3 40.4 41.3 13 15 20 07 06 07 O7 22 32 06 O1 61 07 05 09 07 47 66 O2 13 O8 09 38 68 190 E Literates but did not attend school, are also included. than 10 cases.“ Unweighted cases. ():based on 10-20 unweighted cases. -- percentage not shown for less 107 TABLE 5.15 UNMET NEED FOR FAMILY PLANNING SERVICES Percentage of currently married women age 15-49 years by unmet need for family planning services according to selected background characteristics, Himachal Pradesh, 2012-13. Background characteristics Unmet need for FP Spacing‘ Limiting’ Total Number of women" Age group 15 -19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 Number of living children 0 1 2 3 4+ Residence Rural Urban Education Non-literate“ Less than five years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist/Neo-Buddhist Others CastesITribes Scheduled Castes Scheduled Tribes Other Backward Caste Others DLHS-4 DLHS-3 41.9 31.6 22.1 11.1 5.4 2.7 2.5 29.7 23.6 3.8 2.8 2.9 11.1 11.0 8.0 6.3 7.6 14.6 10.9 11.0 13.6 15.2 (16.7) 9.4 11.7 11.8 11.5 10.9 4.9 3.8 5.7 9.4 10.6 10.8 11.4 8.1 7.5 9.5 10.8 9.0 8.6 9.9 8.5 11.5 10.7 10.3 8.8 9.5 13.9 14.0 13.9 (8.3) 10.3 11.0 10.5 9.0 9.7 9.1 45.8 37.3 31.5 21.7 16.2 14.2 10.6 37.3 33.1 14.6 11.8 11.5 21.0 19.5 19.5 17.0 17.9 23.4 20.4 25.0 27.6 29.1 (25.0) 19.7 22.6 22.4 20.5 20.6 14.0 70 771 1672 1713 1668 1543 1284 1086 2020 3807 1325 483 8033 688 1167 1467 1552 4535 8255 96 62 296 12 1985 1013 1239 4484 8721 9622 Note: Total unmet need refers to unmet for limiting and spacing. E Literates but did not attend school. are also included. . ' Unmet need for spacing includes the proportion of currently married women who are neither in menopause or had hysterectomy nor are currently pregnant and who want more children after two years nor later and are currently not using any family planning method. The women who are not sure about whether and when to have next child are also included in unmet need for spacing. 2 Unmet need for limiting includes the proportion of currently married women who are neither in menopause nor had hysterectomy nor are currently pregnant and do not want any more children but are currently not using any family planning method. Total unmet need refers to unmet for limiting and spacing. ** Unweighted cases 108 TABLE 5.16 UNMET NEED FOR FAMILY PLANNING SERVICES BY DISTRICT Percentage of currently married women age 15-49 years by unmet need for family planning services by districts, Himachal Pradesh, 2012-13. District Unmet need for FP Number Spacing‘ Limiti ngz Total of women“ Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur DLHS-4 DLHS-3 9.2 14.2 14.8 11.3 15.1 7.1 7.0 8.7 10.6 11.5 12.8 10.8 10.9 4.9 13.1 13.4 10.0 5.8 8.5 4.8 11.9 10.4 6.4 9.4 11.9 13.9 9.7 9.1 22.3 27.6 24.8 17.2 23.6 11.9 18.8 19.1 16.9 20.9 24.7 24.7 20.6 14.0 775 820 482 1064 832 687 797 660 665 842 696 401 8721 9622 Note: Total unmet need refers to unmet for limiting and spacing. 1 Unmet need for spacing includes the proportion of currently married women who are neither in menopause nor had hysterectomy nor are currently pregnant and who want more children after two years or later and are currently not using any family planning method. The women who are not sure about whether and when to have next child are also included in unmet need for spacing. 2 Unmet need for limiting includes the proportion of currently married women who are neither in menopause nor had hysterectomy nor are currently pregnant and do not want any more children but are currently not using any family planning method. ** Unweighted cases. 109 REPRODUCTIVE HEALTH PROBLEMS AND AWARENESS 111 TABLE 6.1 MENSTRUATION RELATED PROBLEMS BY BACKGROUND CHARACTERISTICS Percentage of ever married women aged 15-49 years who had any menstruation related problem during three months prior to survey and among them, reported specific symptoms according to selected background characteristics, Himachal Pradesh, 2012-13 Reported Symptoms among who had any menstruation problem Number of Who had any women menstruation Total Frequent or Blood who had related problem number of No Painful short Irregular Prolonged Scanty Inter-menstrual clots/excessive menstruation Background characteristics (%) women‘ periods periods periods periods bleeding bleeding bleeding bleeding problem" Age g rou p 1 5-1 9 20-24 2 5-29 30-34 35-39 40-44 45-49 Place of residence Rural Urban Age at consummation of marriage Below18 years 18 years & above Marital duration 0-4 5-9 10-14 15+ Education Non-literate’ Less than 5 yrs 5-9 years 10 or more years Husband's education Non-literate“ Less than 5 yrs 5-9 years 10 or more years 6.8 7.7 8.2 7.5 8.7 7.2 8.1 5.9 8.7 7.8 7.8 6.4 8.2 8.4 4.9 9.8 8.2 7.8 4.6 10.0 8.8 7.6 63 688 1596 1722 1706 1568 1145 7796 692 1027 7132 1173 1510 1565 3986 1126 1440 1522 4400 627 867 1269 5725 19.3 13.9 9.2 7.8 8.0 21.2 12.7 1.7 6.4 12.7 19.7 15.7 7.4 10.8 14.9 14.1 11.2 10.8 30.5 16.5 12.0 9.7 67.0 64.6 54.6 50.1 47.6 45.8 54.2 54.6 49.4 55.5 64.0 70.2 48.2 49.9 46.7 47.8 56.8 57.0 47.7 42.3 53.7 57.1 20.8 9.0 5.7 13.5 10.4 23.6 12.5 7.3 17.5 10.8 16.8 3.0 10.7 13.1 12.6 10.8 15.7 11.2 7.7 9.2 12.8 12.7 35.2 31.7 43.9 41.5 35.2 44.3 39.5 35.5 35.8 39.6 35.4 38.9 42.6 38.5 28.8 39.1 41.5 40.0 34.1 34.5 42.6 39.6 14.6 11.4 16.7 16.3 19.9 11.4 15.8 9.7 17.9 15.0 8.3 19.7 16.0 15.9 10.0 14.2 11.1 18.1 6.4 14.5 15.0 16.1 4.6 10.2 9.5 10.4 14.6 11.9 10.4 17.3 11.7 10.9 9.9 5.6 12.8 12.1 14.2 13.3 9.6 9.9 6.1 14.0 12.7 10.2 7 48 125 145 130 139 84 637 41 90 569 92 101 131 339 59 137 131 351 31 87 114 446 Contd I TABLE 6.1 MENSTRUATION RELATED PROBLEMSBY BACKGROUND CHARACTERISTICS — Continued Who had any Total menstruation number of Background characteristics related problem women‘ Reported Symptoms Number of No peﬂods Painful penods Frequent or short Irregular periods periods Prolonged bleeding Scanty bleeding Blood ‘”°me" . who had Inter-menstrual clot;/eX3?55'Ve menstruation bleeding ee mg problem“ Religion Hindu 7.8 Muslim (11.5 Sikh ~- Buddhist 8.3 Other » CastesITribes Scheduled Castes 8.3 Scheduled Tribes 7.0 Other Backward Classes 6.4 Others 8.2 DLHS-4 7.8 DLHS-3 16.7 8026 ) 96 61 290 14 1922 969 1255 4342 8488 8227 10.6 (27.3) 43.1 13.6 23.9 15.0 8.2 11.9 7.3 53.3 (36.4) 79.8 56.0 57.7 59.3 51.6 54.2 69.3 12.2 (9-1) 12.8 7.2 17.0 12.6 13.2 12.1 12.2 40.0 (27.3) 23.6 39.4 41.0 30.1 40.8 39.2 18.6 15.3 (9-1) 11.6 10.3 13.4 23.2 16.1 15.3 11.4 '93:.‘ :,‘i\: 6.6 12.7 6.0 9.8 11.3 10.9 11.6 4.3 5.6 ass (0.0) (0.0) 1 1 -- -- 4 0.0 2.6 23 -- -- 2 2.7 4.5 163 6.5 3.2 69 2.4 7.3 81 4.6 6.2 365 4.1 5.5 678 4.7 9.9 1377 Note: Total ﬁgure may not add to 100 percent due to multiple responses. “Literate but did not attend school, are also included. ‘ Excludes pregnant, in amenorrhea, in menopause, had hysterectomy and ever menstruated women. () based on 10-20 unweighted cases. -- percentage not shown for less than 10 cases. *" Unweighted cases. TABLE 6.2 SOURCE OF KNOWLEDGE ABOUT RTI/STIBY BACKGROUND CHARACTERISTICS Percentage of ever married women aged 15- 49 years who have heard about RTI/STI, among them, who received information from speciﬁc sources according to selected background characteristics, Himachal Pradesh, 2012-13 Background characteristics Who have number of heard RTI/STI women“ Total Source of Knowledge Radio T.V. Print Cinema medial Health education community Relative! heard of personnelz programs: meeting‘ Husband friends Other RTI/STl** School! Number of adult Leadersl women Age group 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Rural Urban Age at consummation of marriage Below 18 years 18 years & above Marital duration 0-4 5-9 10-14 15+ Education Non-literate“ Less than 5 yrs 5-9 years 10 or more years Husband's education Non-literate’ Less than 5 years 5-9 years 10 or more years 25.9 33.9 34.4 32.3 27.9 26.6 23.2 28.8 35.6 23.3 30.3 36.0 35.1 30.5 25.6 16.1 21.1 21.0 38.6 20.9 19.7 20.8 33.9 75 785 1704 1764 1736 1647 1390 8381 720 1117 7633 1344 1572 1596 4315 1222 1572 1631 4676 671 943 1377 6110 9.0 28.6 26.2 26.3 23.1 24.3 21.0 25.8 17.9 17.8 24.2 31.1 24.9 26.1 21.6 12.3 19.8 30.0 26.1 15.0 23.6 23.4 25.8 87.0 94.0 91.0 92.5 91.9 90.0 93.4 91.9 91.8 88.3 92.7 94.2 91.1 91.5 91.8 89.8 92.4 89.0 92.5 96.1 86.7 89.3 92.4 27.2 46.7 44.0 40.8 45.4 32.2 35.2 39.3 51.4 38.7 41.0 50.1 37.2 41.8 38.3 13.7 31.2 36.9 46.1 19.1 23.6 33.1 44.8 36.8 56.3 56.3 56.5 52.7 52.7 48.4 53.9 55.1 55.4 54.4 62.3 52.3 57.6 50.4 27.9 50.6 49.1 58.3 26.9 45.5 47.8 57.4 36.0 41.7 43.4 45.2 42.0 41.0 34.7 41.6 43.7 44.4 42.6 47.1 40.6 44.5 39.7 18.8 37.9 45.3 44.4 12.9 36.5 42.8 44.2 13.6 26.3 27.4 26.6 26.2 22.7 23.5 25.3 27.5 29.1 26.1 28.5 26.8 27.6 23.7 11.8 22.4 24.2 27.9 11.7 15.4 21.9 27.9 44.3 37.5 33.6 32.0 33.9 30.4 31.7 34.2 25.0 36.0 33.1 36.2 33.1 30.8 32.7 24.6 32.1 30.0 34.7 21.3 24.4 28.2 35.3 4.3 5.3 9.4 10.9 12.5 10.3 12.5 9.5 16.6 12.0 10.4 6.7 11.5 11.0 11.2 3.0 10.3 10.3 11.2 3.1 6.1 9.1 11.4 13.9 8.3 11.4 7.5 8.3 8.1 10.7 9.4 7.3 7.2 9.5 10.9 9.4 7.8 8.7 1.7 8.8 6.1 10.5 1.7 8.1 6.6 10.0 .o.o.-‘.-‘.-‘- .9 000$-J>(.~JI\>®<3 1.1 0.4 0.7 1.1 0.7 1.7 1.5 0.6 0.3 0.7 1.0 1.2 0.0 0.5 0.9 1.2 21 273 589 571 481 435 311 2434 247 257 2310 492 555 491 1084 196 335 343 1807 137 191 289 2064 Contd 115 I TABLE 6.2 SOURCE OF KNOWLEDGE ABOUT RTI/STIBY BACKGROUND CHARACTERlSTlCS—Continued Background characteristics Who have number of heard RTI/STI women“ Total Source of Knowledge Number of Radio T.V. Cinema Print media‘ School/adult Leadersl Health education community Relativel personnel’ programsa meeting‘ Husband friends Other women heard of RTI/STl** Religion Hindu Muslim Sikh Buddhist Other CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others DLHS-4 DLHS-3 28.9 (16.3) (23.0) 53.5 26.5 40.1 19.7 31.4 29.4 44.8 8604 100 68 314 14 2069 1051 1317 4664 9100 10016 25.2 (16.7) (21.4) 20.5 23.9 23.0 26.0 25.5 24.8 26.0 01.8 (77.0) (100.0) 94.0 92.7 95.1 89.8 91.1 91.9 59.6 40.5 (10.7) (57.1) 44.4 38.3 48.7 49.3 38.0 40.8 8.0 53.6 (55.6) (42.9) 61.6 51.3 65.3 51.5 52.4 54.0 23.3 42.4 (44.4) (42.9) 35.2 41.8 45.2 36.4 42.0 41.9 32.3 25.5 (11.1) (14.3) 30.4 25.3 32.4 21.4 24.6 25.6 3.5 32.1 (33.3) (7.1) 50.3 34.7 48.0 23.4 30.1 33.1 3.5 10.4 (15.7) (14.3) 10.1 10.1 11.2 4.9 11.2 10.4 12.8 9.2 (0-0) (7.1) 9.1 8.9 16.8 2.4 8.2 9.1 51.8 1.1 (0-0) (0.0) 1.1 1.7 1.7 0.0 0.8 1.1 3.8 2476 18 14 168 5 546 437 254 1 444 2681 4488 Note: Total ﬁgure may not add to 100 percent due to multiple responses. “Literate but did not attend school, are also included. ' Includes News papers/books/magazines/slogans/pamphlets and posters. 2 Includes Doctor/ASHA/health workers. 3 Includes school/teacher, adult education programs.“ Includes religiousl political leaders, community meetings and exhibitionl Mela. () based on 10-20 unweighted cases. -- percentage not shown for less than 10 cases. "‘ Unweighted cases. 116 TABLE 6.3 KNOWLEDGE OF MODE OF TRANSMISSION OF RTI/STIBY BACKGROUND CHARACTERISTICS Percentage of ever married women aged 15-49 years who have heard of RTI/STI and among them, who have knowledge of transmission of RTI/STI, according to selected background characteristics, Himachal Pradesh, 2012-13 Background characteristics of knowledge of transmission of RTI/STI Unsafe sex with Unsafe persons Unsafe Number of Heard Unsafe sex with who have sex with women Unsafe Unsafe IUD homosex many sex heard of RTI/STI delivery abortion insertion uals partners workers Other RTI/STI Age group 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Rural Urban Age at consummation of marriage Below 18 years 18 years & above Marital duration 0-4 5-9 10-14 15+ Education Non-literate’ Less than 5 yrs 5-9 years 10 or more years Husband's education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist Other CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others DLHS-4 DLHS-3 25.9 33.9 34.4 32.3 27.9 26.6 23.2 28.8 35.6 23.3 30.3 36.0 35.1 30.5 25.6 16.1 21.1 21.0 38.6 20.9 19.7 20.8 33.9 28.9 (18.0) (20.6) 53.5 26.5 40.1 19.7 31.4 29.4 44.8 53.5 69.3 65.3 62.7 58.9 57.9 62.4 63.6 53.5 57.6 62.8 70.0 63.6 61.7 58.8 61.7 56.5 55.4 64.7 70.1 54.4 56.8 63.3 62.7 (55.6) (50.0) 59.0 60.2 65.0 61.5 62.6 62.3 41.3 48.1 62.8 60.4 59.7 53.7 50.8 55.5 57.8 51.6 54.9 57.4 62.9 58.9 57.5 53.4 44.6 50.1 53.8 60.2 46.9 50.6 50.2 59.2 56.6 (66.7) (64.3) 60.5 54.0 59.3 63.8 56.3 57.0 30.6 42.1 37.9 36.5 40.9 39.4 33.6 30.0 36.3 40.8 31.2 37.8 41.7 35.7 39.5 34.2 23.9 32.6 33.3 39.7 19.5 31.0 30.5 39.4 36.6 (55.6) (50.0) 38.0 32.7 40.0 50.7 35.1 36.9 26.6 46.5 46.8 50.7 47.6 47.8 42.0 43.2 46.2 51.4 44.2 47.9 49.2 49.0 46.8 45.4 28.1 42.2 39.8 50.9 27.1 40.2 42.7 49.3 46.6 (44.4) (57.1) 48.4 43.2 55.1 41.1 46.9 46.8 27.2 55.7 57.0 62.1 60.5 58.2 54.5 54.3 57.8 62.4 62.4 58.4 59.8 59.7 60.1 56.4 38.4 56.8 52.0 61.9 25.5 58.6 50.8 61.5 58.2 (38.9) (57.1) 61.5 58.3 65.6 43.3 59.0 58.3 67.1 27.3 41.2 41.9 41.7 36.7 35.0 30.2 38.0 39.5 38.7 38.9 45.1 40.1 39.3 33.8 25.2 32.5 31.9 41.7 14.6 34.9 30.9 41 .1 39.1 (44.4) (14.3) 26.4 34.9 43.7 30.5 39.3 38.2 30.0 0.0 0.5 1.0 0.2 0.0 0.8 0.9 0.6 0.0 0.0 0.6 0.6 0.6 0.4 0.6 0.0 0.6 1.5 0.4 0.0 0.4 0.8 0.5 0.6 (0-0) (0-0) 0.0 0.8 0.4 0.4 0.5 0.5 7.3 21 273 589 571 481 435 311 2434 247 257 2310 492 555 491 1084 196 335 343 1807 137 191 289 2064 2476 18 14 168 5 546 437 254 1444 2681 4488 Note: Total figure may not add to 100 percent due to multiple responses. " Literate but did not attend school, are also included. () based on 10-20 10 cases. "* Unweighted cases. unweighted cases. -- percentage not shown for les s than 117 TABLE 6.4 SYMPTOMS OF RTIISTIBY BACKGROUND CHARACTERISTICS Percentage of ever married women aged 15-49 years who had reported abnormal vaginal discharge, other RTI/STI symptoms during three months prior to survey according to selected background characteristics, Himachal Pradesh 2012-13 Background characteristics reported Women Women Percentage reported speciﬁc symptom of RTI/STI‘ abnormal reported Itching or Boils/U|cers/ Pain in lower Painful Pain during Spotting after Total vaginal other RTI/S;l'l irritation Warts around abdomen not Swelling in blister like sexual 2 sexual 2 number of discharge symptoms over vulva vulva related menses the groin lesions intercourse intercourse women" Age group 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Rural Urban Age at consummation of marriage Below 18 years 18 years & above Marital duration 0-4 5-9 10-14 15+ Education Non-literate“ Less than 5 yrs 5-9 years 10 or more years Husband's education Non-literatea Less than 5 years 5-9 years 10 or more years Rﬁyw Hindu Muslim Sikh Buddhist Other ¢@@@@@@ Awowmua @@ mo-Au
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TTABLE 6.4 SYMPTOMS OF RTIISTIBY BACKGROUND CHARACTERISTlCS— Continued
Background characteristics
Women Percentage reported speciﬁc symptom of RT]/STI‘
reported Women
abnormal reported Itching or Boils/Ulcers/ Pain in lower Painful Pain during Spotting after Total
vaginal other RTI/STI irritation Warts around abdomen not Swelling in blister like sexual 2 sexual 2 number of
discharge symptoms over vulva vulva related menses the groin lesions intercourse intercourse w
omen”
Castes/Tribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
6.3 15.2
8.2 15.0
5.4 13.0
6.1 14.5
6.3 14.8
8.2 18.3
.-‘.NF*’!\*
mocow
2.0
:’>.°’9″:’>
~|oo-\o~|
4.6
.-‘.-‘.-‘.0
<.~>o:=-no
1.2
9.-‘PP
~44>oooo
0.9
!\’.-“N.”
o\|m\|
1.9
. —\—\@
wade
0.9
2075
1052
1323
4688
9138
10016
4 9 1 5 6 4 0 8 0 6 2 4 0 5
Note: Total ﬁgure may not add to 100 percent due to ‘do not know’ or ‘missing cases’.
E Literate but did not attend school, are also included. ‘ Excluding women having abnormal vaginal discharge problem.
2 Only for currently married women. () based on 10-20 unweighted cases. “‘ Unweighted cases.

TABLE 6.5 DISCUSSED ABOUT RTI/STI PROBLEMS WITH HUSBAND AND SOUGHT TREATMENTBY BACKGROUND
CHARACTERISTICS
Percentage of ever married women aged 15-49 years discussed RTI /STI problem with husband/partner and sought treatment
among who reported any RTI/STI‘ problem and source of treatment according to selected background characteristics, Himachal
Pradesh, 2012-13.
Background
characteristics
Women Number of Source of treatment
Women discussed sought women
RTI/STI problems treatment for having
with husband! RTI/STI any
partner problems‘ RTI/STl
2
Number of
women who
sought
Government Private Other treatment”
Age group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Age at consummation
of marriage
Below 18 years
18 years & above
Marital duration
0-4
5-9
10-14
15+
Education
Non-literatea
Less than 5 yrs
5-9 years
10 or more years
Husband’s education
Non-literate“
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Other
Castesffribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
(80.4)
66.3
66.1
58.4
54.2
49.5
58.4
59.0
51.3
58.2
58.7
66.9
64.8
56.6
54.8
55.2
58.1
46.9
63.9
52.6
59.5
53.3
59.8
57.8
65.5
58.1
55.6
43.1
62.7
58.2
74.6
(28.5)
47.4
44.9
41.6
41.4
35.6
42.0
41.7
37.8
40.1
41.5
42.4
44.7
40.2
40.8
31.1
44.3
33.7
45.7
31.4
45.2
37.7
42.4
40.8
46.4
40.6
40.3
36.8
43.0
41.3
43.3
14
118
244
257
267
281
176
1257
100
182
1128
209
207
255
660
151
32
508
666
86
31
350
890
1296
13
06
40
02
322
159
178
698
1357
2130
84.6
73.8
70.4
67.5
78.7
65.5
75.2
48.9
66.8
73.5
84.0
75.1
68.9
70.0
81.7
72.4
73.8
71.5
77.8
68.3
78.7
72.1
72.5
73.5
69.1
82.8
74.8
72.1
72.9
70.3
12.3
20.3
27.9
24.7
17.8
25.3
19.7
45.6
24.2
21.9
15.0
19.3
25.7
23.9
11.9
22.8
19.2
24.0
12.8
25.3
19.1
22.5
22.4
13.1
24.3
7.7
25.2
23.1
21.9
26.5
3.1
5.9
1.7
7.9
3.5
9.2
5.2
5.5
9.0
4.6
1.0
5.6
5.4
6.1
6.4
4.8
7.0
4.6
9.4
6.4
2.2
5.4
5.0
13.4
6.6
9.6
0.0
4.8
5.2
3.2
04
56
111
109
110
100
73
526
37
71
473
90
93
104
269
45
112
100
306
25
73
85
380
530
8
04
20
01
129
65
67
302
563
923
a
Note: Total figure may not add to 100 percent due to ‘do not know’ or ‘missing cases’. Literate but did not attend school, are
also included. 1 Any RTI/STI (Including abnormal vaginal discharge or other RTI/STI problem). ( ) Based on 10-20 unweighted
cases. — percentage not shown for less than 10 cases. *” Unweighted cases.

TABLE 6.6 RTIISTI INDICATORS BY DISTRICTS
Percentage of ever married women aged 15-49 years who reported RTI/STI problem during three months prior to the survey
and among them percentage sought treatment for the problem by districts, Himachal Pradesh, 2012-13
District
Who heard Who reported any Who have any Total Who sought Number of
about abnormal vaginal other symptoms number of treatment for women having
RTI/STI discharge of RTI/STI’ women“ any RTI/STIZ any RTI/ST]?
Chamba
Kangra
Lahul & Spill
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
DLHS-4
DLHS-3
26.9
20.5
63.3
52.8
23.3
22.8
30.3
23.0
17.0
18.7
20.4
41.4
29.4
44.8
4.7
5.4
7.6
10.1
5.7
4.2
6.4
7.7
4.6
7.9
2.2
9.3
6.3
8.2
13.9
12.0
10.8
11.0
12.6
24.0
17.4
16.9
15.7
17.0
5.5
19.8
14.8
18.3
817
868
494
1101
853
734
828
685
706
866
725
424
9101
10016
15.0
41.9
39.2
52.7
28.8
43.1
42.0
40.2
52.8
44.3
33.7
57.2
41.4
43.3
119
111
50
130
109
179
145
118
125
144
42
85
1357
2130
1 Excluding w
omen having abnormal vaginal discharge. Z Any RTI/STI (Including abnormal vaginal discharge problem or other
RTIISTI problem). *“ Unweighted cases.

TABLE 6.7 KNOWLEDGE OF HIV/AIDS
Percentage of ever married women aged 15-49 years who have heard of HIV/AIDS and among them, who received information from specific sources according to selected background
characteristics, Himachal Pradesh, 2012-13
Background
characteristics
Who have Total
heard of women*
HIV/AIDS
Sources of knowledge for HIV/AIDS
Radio
T.V.
Print
Cinema media‘
Health education munity Relativesl women heard of
Schoo|/
adult Leaders/com Number of
personnelz programsa meetings‘ Husband friends Other HIV/AIDS”
Age group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Age at consummation
of marriage
Below 18 years
18 years & above
Marital duration
0-4
5-9
10-14
15+
Education
Non-literatea
Less than 5 yrs
5-9 years
10 or more years
Husband’s education
Non-literate
Less than 5 years
5-9 years
10 or more years
73.3
80.2
80.6
77.6
73.4
70.7
65.6
72.9
88.3
67.4
75.6
81.8
80.5
77.0
69.5
43.8
63.7
74.3
85.9
46.9
60.3
67.5
81.1
75
785
1704
1764
1736
1647
1390
8381
720
1117
7633
1344
1572
1596
4315
1231
210
2984
4676
686
161
2144
6110
16.1
23.8
23.2
23.6
23.1
24.9
18.2
23.5
16.7
19.6
22.9
26.0
22.8
23.3
21.9
17.2
19.0
26.1
23.6
17.3
18.8
22.5
23.8
91.1
92.4
91.7
91.5
91.4
92.0
91.6
91.8
90.7
91.3
91.8
92.8
91.1
91.5
91.6
89.2
90.1
89.7
93.0
90.3
87.8
90.6
92.5
53.6
49.1
47.1
45.8
47.1
40.5
44.7
44.6
55.7
47.5
45.7
50.4
46.4
45.6
44.1
25.4
36.3
41.4
52.0
29.2
33.4
38.1
49.5
48.2
52.4
49.9
47.3
48.3
44.3
48.1
48.6
43.2
51.7
48.1
54.4
48.3
47.8
46.6
39.4
48.3
45.4
50.0
28.6
48.0
48.8
49.2
33.9
35.9
36.4
33.1
34.5
30.2
31.3
33.5
33.9
32.9
34.1
37.6
34.5
33.2
32.3
24.3
29.0
33.1
36.1
21.4
26.8
32.3
35.4
25.0
37.5
36.7
37.6
35.3
32.2
33.3
35.6
33.6
37.6
36.0
38.0
37.4
36.0
34.5
31.5
30.3
30.2
38.7
23.6
25.7
32.6
37.8
50.0
41.6
38.6
38.3
39.2
34.9
43.5
40.1
29.0
42.8
38.8
41.3
38.2
38.9
38.6
35.1
36.8
34.2
41.6
35.2
37.0
33.4
40.6
5.4
8.8
9.3
11.2
10.9
8.8
11.4
10.0
11.2
10.3
10.2
8.8
11.4
10.5
9.9
9.0
9.9
7.6
11.0
7.5
9.9
8.7
10.5
10.7
9.0
9.3
8.7
8.7
9.5
14.3
10.0
7.7
12.4
9.5
9.7
8.9
8.6
10.6
6.3
12.7
8.5
9.8
6.3
11.8
10.0
9.7
56
635
1372
1370
1278
1167
912
6156
634
750
5784
1108
1265
1230
3003
536
1015
1216
4023
318
575
938
4959
Contd
122

l TABLE 6.7 KNOWLEDGE OF HlVIAlDS— Continued
Who have
heard of
Background HIV/AIDS
Total
characteristics AIDS women“
Sources of knowledge for HIV/AIDS
Radio
T.V.
Print
Cinema media‘
Schooll
adult Leadersl
Health education community Relativesl
personnelz programsa meetings Husband Friends Other
Number of
women heard of
HIV/AIDS“
Religion
Hindu 74.5
Muslim 54.3
Sikh 66.4
Buddhist 84.1
Other —
Castes/Tribes
Scheduled Castes 72.6
Scheduled Tribes 73.7
Other Backward Classes
Others 69.3
76.9
DLHS-4
DLHS-3 74.5
81.9
8604
100
68
314
15
2069
1051
1317
4664
9100
10016
23.1
21.8
20.0
17.2
21.8
20.5
26.8
22.8
22.9
39.1
91.7
85.5
93.3
92.9
90.0
93.3
89.3
92.7
91.7
89.0
45.6
34.5
62.2
45.7
43.1
49.5
45.5
45.8
45.6
10.7
47.5
43.6
35.6
64.0
48.0
61.2
38.4
47.7
48.1
31.3
33.5
25.5
26.7
39.0
33.6
39.2
29.4
33.4
33.6
34.1
34.9
20.0
44.4
48.7
32.8
45.1
29.8
35.7
35.4
4.7
38.8
23.6
31.1
49.1
39.2
51.4
27.3
39.3
39.0
4.9
9.7
10.9
4.4
20.6
8.4
14.9
4.5
11.2
10.1
16.9
9.9
3.6
6.7
9.4
12.3
16.0
2.7
9.1
9.7
30.9
2.6
0.0
2.2
6.7
2.5
8.9
0.2
2.0
2.7
4.5
6413
55
45
267
10
1502
794
917
3577
6790
8205
Note: Total ﬁgure may not add to 100 percent due to multiple responses
‘ Literate but did not attend school, are also included. 1 includes News paperslbookslmagazinesl slogans/pamphlets and posters. 2 Includes Doctor/ASHA/health workers.
adult education programs. A Includes religiousl political leaders. community meetings and exhibitionl Mela. — percentage not shown for less than 10 cases. ** Unweighted
3
Includes school/teacher,
cases.
123

TABLE 6.8 KNOWLEDGE ABOUT MODE OF TRANSMISSION OF HIV/AIDSBY BACKGROUND CHARACTERISTICS
Percentage of ever married women aged 15-49 years having knowledge of mode of transmission of HIV/AIDS among who have
heard about HIV/AIDS according to selected background characteristics, Himachal Pradesh, 2012-13
Percentage of women who reported mode of transmission as
Unsafe
sex with Unprotected
person Unsafe sex with Sharing Number of
Unsafe sex having sex with HIV/AIDS Infected Transfusion of women who
Background with homo- many sex infected mother of infected injectionl heard of
characteristics sexuals partners workers person to child blood Needles HIV/AIDS“
Age group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Age at consummation of
marriage
Below 18 years
18 years & above
Marital duration
0-4
5-9
10-14
15+
Education
Non-literate“
Less than 5 yrs
5-9 years
10 or more years
Husband’s Education
Non-literate’
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Other
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
56.7
41.0
39.6
40.7
34.4
35.7
36.8
38.5
34.4
32.7
38.8
43.1
41.5
36.5
36.0
36.0
31.5
32.8
41.4
46.9
31.8
33.3
39.0
38.1
23.2
47.1
36.9
36.2
45.1
35.1
38.1
38.0
26.0
69.5
70.0
70.5
67.5
67.4
63.6
63.3
66.8
69.3
69.4
66.9
69.2
69.5
66.7
65.8
53.6
64.9
62.5
70.7
54.1
62.3
61.5
69.4
67.0
65.3
82.9
64.6
63.8
68.1
63.6
69.1
67.1
65.1
47.8
49.1
48.8
49.6
48.9
40.4
42.3
46.4
48.3
42.9
47.4
51.7
47.2
49.0
44.1
36.1
38.5
43.3
51.0
35.3
35.3
42.9
49.3
47.0
52.3
58.7
35.7
41.7
47.0
49.0
48.1
46.7
31.8
45.0
45.3
47.3
47.1
46.5
42.0
44.7
45.2
49.0
45.5
46.1
49.4
45.8
47.6
43.6
37.3
39.3
40.0
49.9
31.9
40.8
36.9
48.7
45.6
41.1
41.1
48.0
43.2
52.6
36.7
47.5
45.6
47.2
38.8
54.2
56.2
52.7
52.6
47.2
49.2
52.4
49.1
53.7
52.4
55.9
54.5
54.5
48.8
36.9
43.8
49.4
56.7
31.5
41.4
47.7
55.3
52.3
45.6
57.4
45.5
50.9
56.5
48.9
52.4
52.0
43.9
47.5
51.2
53.4
50.2
52.5
51.5
50.0
51.6
51.1
51.0
52.5
55.0
50.4
52.0
51.2
39.5
44.3
51.2
55.0
31.5
42.6
47.1
54.6
51.5
39.9
48.8
56.9
52.1
60.3
47.8
50.5
51.6
63.8
41.1
45.2
47.4
45.4
46.2
42.5
48.7
46.5
41.2
47.4
46.4
47.7
45.7
47.0
45.2
38.5
40.2
42.9
49.0
28.6
40.4
41.5
48.4
45.2
34.9
37.1
65.9
43.8
58.6
39.3
45.7
45.9
9.4
56
635
1372
1370
1278
1167
912
6156
634
750
5784
1108
1265
1230
3003
536
1015
1216
4023
318
575
938
4959
6413
55
45
267
10
1502
794
917
3577
6790
8205
Note: Total figure may not add to 100 percent due to multiple responses. “Literate but did not attend school, are also included
— percentage not shown for less than 10 cases . ” Unweighted cases.

TABLE 6.9 KNOWLEDGE OF HIV PREVENTION METHODSBY BACKGROUND CHARACTERISTICS
Percentage of ever married women aged 15-49 years who heard about HIV/AIDS, percentage who reported HIV/AIDS can be
prevented in specific ways, according to selected background characteristics, Himachal Pradesh, 2012-13
Percentage who say that HIV/AIDS can be prevented by Number of
Using condom Avoid women
correctly during Avoid risks Pregnancy having
Background
characteristics
each sexual Sex with avoid getting infected when having knowledge of
intercourse one partner homosexual‘ through bloodsz HIV/AIDS HIV/AIDS
Age group
1 5-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Age at consummation of
marriage
Below 18 years
18 years & above
Marital duration
0-4
5-9
10-14
15+
Education
Non-literate“
Less than 5 yrs
5-9 years
10 or more years
Husband’s education
Non-literate“
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Other
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
39.4
42.5
39.0
43.0
39.0
36.3
34.5
38.6
42.8
32.6
39.8
42.4
40.8
41.1
36.6
27.9
32.5
34.5
43.5
35.2
30.6
32.8
41.4
38.3
47.5
47.0
53.9
32.7
48.0
44.0
38.6
39.1
26.7
30.7
41.9
40.4
41.4
39.8
34.5
33.6
38.5
39.4
37.8
38.9
41.6
40.4
41.7
36.0
30.6
33.7
35.8
41.7
25.8
34.3
34.1
40.7
38.6
39.6
63.0
32.9
33.8
37.7
42.2
39.9
38.6
62.8
22.5
26.5
26.4
25.2
25.0
23.4
27.6
26.3
19.7
26.1
25.8
28.0
26.3
23.7
25.2
21.2
22.0
21.0
28.3
21.5
21.1
21.1
27.1
25.7
10.6
28.2
23.5
25.8
35.3
17.6
25.4
25.5
69.9
57.0
64.7
67.6
65.7
66.1
67.1
64.8
66.7
61.9
67.1
66.8
66.3
65.2
67.5
66.2
53.4
63.4
64.7
68.9
42.2
59.9
63.2
68.9
66.2
49.2
60.3
69.8
65.3
75.6
61.3
65.7
66.1
62.6
12.1
13.5
16.5
15.0
14.8
13.6
15.2
15.1
13.2
15.3
15.0
15.9
15.2
15.2
14.3
7.0
11.7
14.5
16.8
7.9
9.6
10.4
16.7
14.9
12.7
7.1
15.7
12.1
24.4
12.1
14.8
14.9
23.0
56
635
1372
1370
1278
1 167
912
6156
634
750
5784
1 108
1265
1230
3003
536
1015
1216
4023
318
575
938
4959
6413
55
45
267
10
1502
794
917
3577
6790
8205
Note: Total figure may not add to 100 percent due to multiple respo
H565.
3 Literate but did not attend school, are also included. 1 Includes sex with one partner, Limit number of sexual partner, Avoid sex
with sex workers and avoids sex with homosexuals.’ Includes avoid sex with who inject drugs, use tested blood, use only newl
sterilized needles, avoid IV drip and avoid razors/blades. — percentage not shown for less than 10 cases. ** Unweighted cases.
125

TABLE 6.10 MISCONCEPTION ABOUT TRANSMISSION OF HIV/AIDSBY BACKGROUND CHARACTERISTICS
Percentage of ever married women aged 15-49 years having misconception about the transmission of HIV/AIDS among
who have heard of HIV/AIDS, according to selected background characteristics, Himachal Pradesh, 2012-13
Background characteristics
Misconception about the transmission of HIV/AIDS
hand Hugging clothes
food
Stepping on Get HIV/AIDS Number of
Shaking Sharing Sharing someone’s from mosquito, women heard
urine/stool ﬂea or bedbug of HIV/AIDS
Age group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Age at consummation of
marriage
Below 18 years
18 years 8. above
Marital duration
0-4
5-9
10-14
15+
Education
Non-literate’
Less than 5 yrs
5-9 years
10 or more years
Husband’s education
Non-literate“
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Other
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
.-‘.-‘.-‘.-‘.-‘.-‘.0
ooomcowwo
ink»
is-Lo
‘o’>’J=’4>%.n
.-‘.-‘.-‘N
wmmw
0.8
1.9
2.2
1.4
.°’!\’.-‘.-‘
_q;_<;1 .—‘.-‘.—‘!\>
oom-
1.5
1.9
0.0
1.1
0.5
0.7
1.2
1.3
1.6
1.0
0.7
1.2
0.8
0.4
0.5
1.0
1.3
2.5
2.2
1.1
.5
0.6
2.1
2.0
0.7
.9
2.8
2.8
1.6
.0?“ T‘
~:—“-‘oi
1.0
2.2
0.0
1.2
1.1
0.6
1.3
1.2
2.3
1,3
0.9
2.4
0.9
0.7
0.8
1.2
1.5
.Ao>m
u”o:‘-nbv
2.0
3.5
2.3
0.7
.”!\‘.’“.“
u:oo\|v\>
’02.-:b1E.n
1.2
4.3
0.0
1.0
1.0
0.7
1.9
1.3
3.3
Lobi
2.4
1.3
0.8
0.5
1.6
2.0
2.5
3.8
1.6
.7
1.9
3.5
3.0
0.9
1.5
3.3
0.0
0.9
iwknioin
1.5
4.4
b§I>’oa’J>
2.4
2.5
4.3
2.2
1.3
4.2
1.7
1.0
0.9
2.1
2.9
4.0
5.5
2.7
.8
3.8
5.4
3.6
1.3
2.1
3.8
0.0
1.1
2.8
2.6
1.5
1.8
2.1
4.9
1.4
1.7
3.0
2.5
4.1
4.3
6.3
3.6
3.8
6.7
3.2
1.7
2.3
3.4
5.0
5.7
8.4
4.7
1.9
5.7
8.2
6.6
2.4
3.7
3.3
2.1
3.2
4.5
5.3
2.4
3.2
3.6
8.8
56
635
1372
1370
1278
1167
912
6156
634
750
5784
1108
1265
1230
3003
536
1015
1216
4023
318
575
938
4959
6413
55
45
267
10
1502
794
917
3577
6790
8205
“Literate but did not attend school, are also included. — percentage not shown for less than 10 cases. ” Unweighted
C8585

TABLE 6.11 KNOWLEDGE ABOUT THE PLACE WHERE HIVIAIDS TEST CAN BE DONE
Percentage of ever married women aged 15-49 years having knowledge about place where HIV/AIDS test can be done according lo selected background characteristics, Himachal Pradesh 2012-
13
Places where people can go to get tested for HIV /AIDS
Government Private
Who know the Total women Other Other
place of heard of Hospita|/ CHC/PHC/ VCTC/lCTC/ public/NGO VCTC/lCTC/ Private
Background Characteristics HIV/AIDS test HIV/AIDS“ dispensary Sub-Centre RTI/STI Clinic hospital Hospital/Clinic RTI/STI Clinic centre
Number of
women who
know the place
for HIV/AIDS
test“
Age Group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Age at consummation of
marriage
Below 18 years
18 years S. above
Marital Duration
0-4
5-9
10-14
15+
Education
Non-literate’
Less than 5 yrs
5-9 years
10 or more years
Husband’s Education
Non-literate“
Less than 5 years
5-9 years
10 or more years
53.1
59.1
61.2
59.6
55.1
49.9
52.7
55.4
63.7
56.4
56.6
61.4
62.5
55.7
52.6
46.8
48.9
48.8
61.7
49.2
48.0
50.1
58.9
56
635
1372
1370
1278
1167
912
6156
634
750
5784
1108
1265
1230
3003
536
1015
1216
4023
318
575
938
4959
49.0
46.4
47.9
45.2
47.2
50.5
47.1
44.8
63.0
42.9
47.6
46.9
47.0
44.2
48.5
66.4
45.4
44.5
46.5
75.5
48.9
42.9
46.4
20.3
17.6
12.0
13.5
11.5
13.6
13.3
14.0
8.4
13.3
13.0
14.7
13.2
12.8
13.0
8.5
12.7
13.3
13.8
10.6
12.7
16.7
12.9
10.5
11.6
13.1
14.0
12.7
8.0
7.8
12.9
3.4
10.8
11.8
11.5
14.6
14.3
9.1
2.7
8.8
9.2
13.6
2.7
8.6
8.5
12.9
6.2
11.6
12.6
11.8
12.9
13.0
11.3
12.2
12.5
14.5
12.0
13.4
10.8
12.8
12.2
15.1
13.5
15.6
11.0
5.8
13.7
15.3
12.0
11.1
9.4
9.5
9.1
10.1
9.7
13.9
10.7
6.2
12.2
10.1
9.2
8.8
10.9
11.1
5.3
14.4
10.7
9.6
3.6
10.8
11.3
10.2
31
379
849
811
702
586
481
3439
400
423
3286
688
796
685
1577
250
502
597
2490
154
279
474
2932
Contd. ..

I TABLE 7.11 KNOWLEDGE ABOUT THE PLACE WHERE HIVIAIDS TEST CAN BE DONE— Continued
Background Characteristics
Places where people can go to get tested for HIV /AIDS
Government Private
Clinic
hospital
Clinic
RTI/STi Clinic centre
Who know the Total women VCTC/lCTC/ Other Other
place of heard of Hospital! CHC/PHC/Su RTI/ST] public/NGO Hospital! VCTCIICTCI Private
HIV/AIDS test HIV/AIDS“ dispensary b-Centre
Number of
women who
know the place
for HIV/AIDS
test“
Religion
Hindu
Muslim
Sikh
Buddhist
Other
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
DLHS-3
56.0
43.1
54.9
69.4
58.4
63.2
43.8
57.4
56.4
53.2
6413
55
45
267
10
1502
794
917
3577
6790
8205
46.9
61.0
57.9
52.3
46.9
36.7
49.3
49.5
47.3
57.0
13.3
2.6
9.8
13.0
12.3
15.8
14.9
12.7
13.2
27.3
11.7
9.7
10.9
11.0
9.0
15.5
11.7
11.9
11.6
0.2
4.0
2.6
2.9
4.1
1.8
2.6
4.6
3.9
1.2
12.4
9.6
12.2
10.3
14.9
13.9
12.5
10.7
12.2
12.9
10.1
14.5
6.1
10.1
11.6
14.7
7.1
9.1
10.1
0.8
0.1
00
0.0
0.0
0.0
0.0
0.3
0.0
0.0
0.5
3598
24
23
188
6
872
518
392
2057
3839
4366
Note: Total ﬁgure may not add to 100 percent due to ‘do not know‘ or ‘missing cases.
CHC= Community Health Centre; PHC= Primary Health Centre; VCTC/iCTC= voluntary/integrated counseling and testing centre, NGO= Non Governmental Organization. 3 Literate but did not attend
school, are also included. -— percentage not shown for less than 10 cases.“ Unweighted cases.

TABLE 6.12 UNDERGONE HIVIAIDS TEST
Percentage of ever married women aged 15-49 years undergone for HIV/AIDS test and time to be tested for HIV/AIDS
according to selected background characteristics, Himachal Pradesh, 2012-13
Percentage who have been tested for
Who have Number of H|V Number of
been tested women heard Less than 12 1 or more than 1 women went for
Background Characteristics for HIV HIV/AIDS” months ago years ago HIV/AIDS test”
Age group
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Residence
Rural
Urban
Age at consummation of
marriage
Below 18 years
18 years & above
Marital duration
O-4
5-9
10-14
15+
Education
Non-literate”
Less than 5 yrs
5-9 years
10 or more years
Husband’s education
Non-literatea
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Other
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
(20.0)
38.0
45.1
39.1
33.4
20.0
30.1
35.0
41.6
32.4
36.7
38.8
49.5
35.6
29.4
25.1
30.9
30.1
40.0
27.4
30.8
30.6
37.8
35.4
(30.9)
(31.1)
40.7
36.1
41.5
28.9
36.2
35.8
56
635
1372
1370
1278
1167
912
6156
634
750
5784
1108
1265
1230
3003
536
1015
1216
4023
318
575
938
4959
6413
55
45
267
10
1502
794
917
3577
6790
(80.0)
48.4
28.6
13.9
8.1
3.2
2.5
18.8
12.3
10.2
19.0
54.9
18.6
8.1
4.7
2.4
7.4
16.2
21.4
5.1
12.3
13.3
19.6
18.7
(21.4)
4.6
19.4
12.7
23.3
17.3
17.8
(20.0)
51.6
11.4
80.1
91.9
90.0
97.5
81.2
87.7
89.8
81.0
45.1
81.4
91.9
95.3
97.6
92.6
83.8
78.6
94.9
87.7
86.7
80.4
01.3
(100.0)
(1s.e)
95.4
80.6
87.3
76.7
82.7
82.2
DLHS-3 5.8 8205 36.7 63.3
14
240
626
532
427
309
272
2078
341
236
2117
430
628
435
876
133
302
361
1624
86
170
281
1883
2259
15
18
124
4
542
307
265
1305
2420
476
“ Literate but did not attend school, are also included. ( ) Based on 10-20 unweighted cases. — percentage not shown for less
than 10 cases. “* Unweighted cases.
129

TABLE 6.13 HIVIAIDS INDICATORS BY DISTRICTS
Percentage of ever married women aged 15-49 years who have heard of HIV/AIDS, know HIV/AIDS prevention, transmiss|on,
places where people can go to get tested for HIV /AIDS and who have been tested for HIV/AIDS in the past 12 months, by
districts, Himachal Pradesh, 2012-13.
District
baby
Who underwent
Who know that Who know the HIV/AIDS test |n
Who know that HIV/AIDS can be places where the past
Who have HIV/AIDS can be transmitted from people can go to Who ever been 12 months
heard of prevented by mother to her get tested for tested for among ever
HIV/AIDS using condom
HIV /AIDS H1\//AIDS (%) tested
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Soian
Sirmaur
Shimla
Kinnaur
DLHS-4
DLHS-3
71.6
69.3
89.4
80.6
71.1
77.5
86.4
75.4
68.2
56.1
77.7
69.1
74.5
81.9
55.4
38.8
55.0
22.5
44.3
40.0
36.6
32.2
28.8
42.5
31.9
61.1
39.1
62.8
47.3
44.0
60.2
55.7
52.5
58.6
55.3
48.0
60.6
42.3
51.5
44.4
52.0
43.9
40.8
31.6
75.6
64.1
46.8
58.2
68.4
66.5
58.6
40.6
62.7
60.1
56.4
53.2
23.3
23.3
54.0
35.4
19.9
31.5
53.7
42.8
40.5
28.6
37.0
42.8
35.8
5.8
27.6
33.5
4.0
14.0
28.0
22.5
25.4
10.3
13.2
32.4
10.5
10.1
17.8
36.7
130

PERSONAL HABITS AND MORBIDITY
131

Table 7.1 PERSONAL HABITS
Percentage of persons (age 15 years and above) who use any kind of tobacco, smoking and drinking habits by selected
background characteristics, Himachal Pradesh, 2012-13.
Personal habits
Percentage who use Percentage who use Percentage who
Background Characteristics any kind of tobacco‘ any kind of smoking Consume alcohol No. of persons
Age group
15-24
25-29
30-34
35-39
40-44
45-49
50+
Sex
Male
Female
Residence
Rural
Urban
Education
Non-literate”
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Others
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
4.1
11.3
17.2
18.6
21.7
24.0
22.8
36.0
2.3
18.0
14.9
16.1
19.6
19.6
17.2
17.8
16.2
7.7
17.8
22.5
18.3
19.8
15.9
17.5
17.7
3.7
10.3
16.1
17.7
20.6
22.9
21.6
34.1
2.0
17.0
13.7
15.2
18.5
18.1
16.3
16.8
15.4
7.7
17.2
22.5
16.8
18.7
15.0
16.6
16.7
3.8
12.2
18.8
20.0
21.8
25.5
21.9
37.0
1.8
18.1
15.2
14.1
20.2
19.0
18.5
17.9
14.6
14.7
19.1
25.1
16.5
21.5
17.3
17.8
17.9
3872
2358
2297
2374
2367
2175
7631
9935
13013
21375
1699
4141
737
6426
11770
21382
266
191
1189
37
5241
2854
3292
11687
23074*
“ Literate but did not attend the school are also included. ‘Missing cases are excluded. ‘Includes smoking. *” Unweighted
KISSES.

Table 7.2 PERSONAL HABITS
Percentage of Men (age 15 years and above) classified as having personal habits by selected background characteristics,
Himachal Pradesh, 2012-13.
Percentage of Men
Using Smokeless Total number of
Background characteristics Tobacco Smoking Consuming Alcohol Men covered
Age of the men
15-19
20-24
25-29
30-34
35-39
40-44
45 years and above
Residence
Rural
Urban
Education
Non-literate’
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Others
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
0.3
3.1
8.2
9.3
8.5
10.7
9.8
8.5
7.5
13.6
11.4
10.3
6.5
8.7
3.3
3.9
4.3
(10.5)
9.0
6.9
7.5
8.7
8.4
1.3
13.7
25.3
38.9
39.8
41.9
40.4
34.8
27.1
43.5
43.3
40.5
29.2
34.6
30.2
16.9
29.5
(42.1)
35.4
34.7
34.1
33.5
34.1
1.5
13.6
29.9
45.4
44.8
44.6
42.9
37.7
29.9
43.7
46.2
42.7
33.0
37.5
29.5
32.2
31.1
(47.4)
34.7
39.0
40.0
36.8
37.0
840
815
843
859
945
1020
4613
9196
739
1047
278
2497
61 13
9132
113
85
581
19
2229
1329
1365
5012
9935*
..
*’ Unweighled cases.
Literate but did not attend the school are also included. *Missing cases are excluded. ( ) based on 10-20 unweighted cases

Table 7.3 PERSONAL HABITS
Percentage of Women (age 15 years and above) classiﬁed as having personal habits by selected background characteristics,
Himachal Pradesh, 2012-13.
Percentage of women
Using Smokeless Total number of
Background characteristics Tobacco Smoking Consuming Alcohol women covered
Age of the women
15-19
20-24
25-29
30-34
35-39
40-44
45 years and above
Residence
Rural
Urban
Education
Non-literate’
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Others”
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
DLHS-4
0.2
0.2
0.3
0.5
0.6
1.0
1.5
0.9
0.7
1.9
1.0
0.8
0.3
0.9
0.0
0.0
0.6
(0.0)
0.9
1.0
0.6
1.0
0.9
0.3
0.9
0.8
0.9
1.1
1.7
3.5
2.1
0.7
4.3
2.2
1.8
0.8
2.0
2.2
0.0
3.1
(0-0)
1.5
2.7
1.2
2.3
2.0
0.5
0.9
1.1
1.0
1.4
1.6
2.7
1.9
0.7
2.7
3.1
1.7
1.1
1.6
1.1
0.0
5.4
(0.0)
1.4
4.1
0.9
1.7
1.8
948
1250
1505
1428
1412
1332
5138
12060
953
3073
456
3891
5593
12136
152
105
598
18
2980
1519
1908
6606
13013’
=1
cases.
Literate but did noi at’lend the school are also included. ’Missing cases are excluded. ( ) based on 10-20 unweighted cases. “Unweighted
Table 7.4 PERSONAL HABITS
Percentage of all persons (age 15 years and above) classiﬁed as having personal habits by districts, Himachal Pradesh, 2012-
13.
Percentage of all persons Tom number of a||
District Using Smokeless Tobacco Smoking Consuming Alcohol persons covered
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
DLHS-4
0.9
2.4
4.3
11.8
6.2
1.7
3.0
5.8
3.0
4.9
1.3
3.6
4.3
15.2
15.0
21.5
26.2
18.9
13.5
14.6
13.2
13.6
17.1
17.4
15.8
16.7
17.4
18.9
26.8
25.1
20.9
13.8
12.3
11.9
13.4
19.1
20.2
19.3
17.9
1357
2224
1235
2421
2025
2123
2125
1897
1948
2391
1838
1490
23074
” Unweighted cases
135

Table 7.5 PERSONAL HABITS TOBACCO
Percentage of men and women age 15 years having habits of chewing Tobacco, Himachal Pradesh, 2012-13.
Tobacco chewing
Women Men
Tobacco use Rural Urban Total Rural Urban Total
Total
Use of Tobacco
Pan with tobacco 0.1
Guthakal Pan masala with tobacco 0.0
Other forms of tobacco 0.8
Non-user 92.9
Not known 6.1
DLHS-4 0.9
0.3 0.1 1.0 0.5 1.0
0.0 0.0 0.6 1.2 0.7
0.5 0.7 6.8 5.7 6.7
88.5 92.6 86.4 85.6 86.3
6.5 5.2 6.9 5.3
10.7
0.7 0.9 8.5 7.5 8.4
0.5
0.3
3.5
89.7
6.0
4.3
Table 7.6 PERSONAL HABITS SMOKE
Percentage of men and women age 15 years having habits of smoking, Himanchal Pradesh, 2012-13.
Smoking
Women Men
Smoking habits Rural Urban Total Rural Urban Total
Total
Usual smoker‘ 0.8
Occasional smoker 1.3
Ex-smoker 0.5
Non smoker 91.8
Not known 5.6
DLHS-4 2.1
0.0 0.7 15.9
0.7 1.3 18.9
1.1 0.5 9.0 14.7 9.5
88.4 91.5 52.5 53.2 52.5
9.9 5.9 3.7 5.2 3.8
0.7 2.0 34.8
10.3 15.4
16.7 18.7
27.1 34.1
7.4
9.2
4.6
73.7
5.0
16.7
* At least once evew day
Table 7.7 PERSONAL HABITS DRINK ALCOHOL
Percentage of men and women age 15 years having habits of drinking alcohol, Himanchal Pradesh, 2012-13.
Drinking alcohol
Women
Men
Drinking habits Rural Urban Total Rural
U rban Total
Total
Usual drinker‘ 0.5
Occasional drinker 1.3
Ex-drinker 0.5
Non drinker 91.6
Not known 6.1
DLHS-4 1.9
0.0
0.7
1.2
88.0
10.1
0.7
0.5 9.8
1.3 27.9
0.5 7.8
91.3 50.5
6.4 4.0
1.8 37.7
5.3 9.4
24.7 27.6
13.6 8.3
51.3 50.6
5.2 4.1
30.0 37.0
4.6
13.3
4.1
72.7
5.3
17.9
” At least once every week
Table 7.8 MORBIDITY DETAILS
Prevalence of any injury, acute illness and chronic illness according to place of residence, Himanchal Pradesh, 2012-13.
Residence
Morbidity Total Rural Urban
Prevalence Rate of Any Injury‘
Male
Female
Total
Prevalence Rate of Acute Illness‘
Male
Female
Total
Prevalence Rate of Chronic Illness“
Male
Female
Total
4.2
4.1
4.1
2.2
2.3
2.3
2.7
3.3
3.0
3.9
3.5
3.7
1.8
1.1
1.5
1.8
2.9
2.3
I During last one year, ‘ During last ﬁfteen days
136

Table 7.9 MORBIDITY DETAILS
Percentage of household population having any form of disability as on the day of survey, Himanchal Pradesh, 2012-13.
Total
Rural
Urban
Type of Disability Male Female Total
Male
Female Total
Male Female Total
Mental Disability
Visual Disability
Hearing Disability
Speech Disability
0.3
0.8
1.1
0.2
0.2
1.0
0.9
0.2
0.2
0.8
1.0
0.2
0.3
0.7
1.2
0.2
0.2
0.9
0.9
0.2
0.2
0.8
1.0
0.2
Nun1berofpersons”’ 25252 23874 49126 23460 22182 45642
0.3
1.2
1.1
0.0
1792
0.1
1.0
0.8
0.1
1692
0.2
1.1
0.9
0.1
3484
** Unweighted cases & missing/others cases are excluded.
Table 7.10 MORBIDITY DETAILS
Percentage of household population having any injury and received treatment during last one year, Himanchal Pradesh, 2012-
13.
Type of treatment
Total
Rural
Urban
Male
Female
Total
Male
Female
Tota
Male
Female
Total
Treated in intensive care unit for any time
Treated as in-patient with stay <1 week Treated as in-patient with stay 1-2 week Treated as in-patient with stay >2 week
Other treatmer1t*
Number of persons“
9.0
17.5
12.6
14.2
46.6
368
10.5
12.4
15.4
13.5
48.
272
1
9.7
15.4
13.8
13.9
47.2
640
9.3
16.9
11.9
14.2
47.7
352
10.0
12.0
14.8
12.8
50.4
260
9.6
14.8
13.1
13.6
48.8
612
(6-3)
25.0
25.0
12.5
31.3
10
(16.7)
(16.7)
(25.0)
(25.0)
(16.7)
12
8.1
24.3
24.3
16.2
27.0
28
*Out patient /traditional healer/at home. “Unweighted cases & missing/others cases are excluded. ( )
unweighted cases.
based on
10-20
Table 7.11 MORBIDITY DETAILS
Percentage of household population having acute illness during last 15 days. Himanchal Pradesh, 2012-13.
Type of acute illness
Total
Rural
Urban
Male
Female
Total
Male
Female
Total
Male
Female
Total
Diarrhoea/ Dysenteiy
Acute respiratory tract infection
Jaundice with fever
Malaria
Fever of short duration with
rashes
Reproductive tract infection
Other type of fever
Other
Number of persons”
19.5
7.1
14.8
10.6
10.2
0.7
24.6
12.4
558
17.5
6.1
15.0
9.6
12.3
3.1
19.6
16.9
528
18.5
6.6
14.9
10.1
11.2
1.9
22.2
14.6
1086
18.0
7.3
15.0
11.3
10.5
0.8
23.6
13.5
525
16.9
6.5
14.7
9.3
12.7
3.2
20.2
16.5
510
17.5
6.9
14.9
10.3
11.6
2.0
21.9
15.0
1035
36.4
6.8
11.4
2.3
6.8
0.0
36.4
0.0
33
(27.8)
(0-0)
(10.7)
(10.7)
(5.0)
(11.1)
(22.2)
(27.8)
1s
32.9
4.3
14.3
7.1
5.7
0.0
27.1
8.6
51
” Unweiglnted cases & missing/others cases are excluded. ( ) based on 10-20 unweighted ca
58$.
Table 7.12 MORBIDITY DETAILS
Percentage of household population having acute illness during last 15 days and received treatment by type of health facilities,
Himachal Pradesh, 2012-13.
Total
Rural
Urban
Place of treatment Male Female
Total
Male
Female Total Male
Female
Total
Government health facility
Sub Health Centre
Primary Health Centre
Community Health Centre
UHC/UHP/UFWC
Dispensary/clinic
Hospital
AYUSH hospital/clinic
Private health facility
Dispensaryl clinic
Hospital
AYUSH hospital/clinic
NGOI trust hospital
Other‘
Number of persons“
9.1
24.2
9.5
0.2
3.8
30.9
2.5
5.0
10.9
1.3
0.0
1.3
536
7.8
20.5
9.0
0.0
4.0
34.9
2.0
4.6
12.9
1.0
0.2
1.4
506
8.5
22.4
9.3
0.1
3.9
32.8
2.2
4.8
11.8
1.2
0.1
1.4
1 042
9.9
25.2
8.2
0.2
3.5
30.9
2.7
4.7
10.5
1.4
0.0
1.4
505
8.2
21.4
9.0
0.0
4.2
33.8
2.1
4.4
12.6
1.0
0.2
1.5
491
9.0
23.3
8.6
0.1
3.8
32.3
2.4
4.6
11.5
1.2
0.1
1.5
996
0.0
12.2
24.4
0.0
7.3
29.3
0.0
7.3
17.1
0.0
0.0
0.0
31
(0.0)
(0.0)
(13.3)
(0-0)
(0-0)
(60.0)
(0.0)
(6-7)
(20.0)
(0.0)
(0.0)
(0.0)
15
0.0
8.1
21.0
0.0
4.8
40.3
0.0
6.5
17.7
0.0
0.0
0.0
46
* DOT centre and at home. *” Unweighted cases & missing/others cases are excluded. ( ) based on 10-20 unweighted cases.
137

Table 7.13 MORBIDITY DETAILS
Percentage of household population having main symptoms of chronic illness persisting for more than one month and sought
medical care and source of treatment, Hlmachal Pradesh, 2012-13.
Total
Rural
Urban
Place of treatment Male
Female Total
Male
Female Total
Male
Female Total
Prevalence Of Chronic Illness
Disease of respiratory system
Disease of cardiovascular system
Disease of central nervous system 13.0
Disease of musculoskeletal system 5.8
Disease of gastrointestinal system 7.5
Disease of genitourinary system 2.5
Skin disease 6.6
Goitre 0.9
Elephantiasis 0.5
Eye problem 6.9
ENT problem 3.4
Mouth and dental problem 3.1
Other 30.3
12.9
6.7
Sought Medical Care
Details of Diagnosis/Treatment available 72.7
Details of Diagnosis/Treatment not available 14.2
Not at all 13.1
Source of Treatment
At government health facility 70.7
At private health facility 28.4
At home 0.4
Other 0.4
8.6
4.6
8.1
9.9
7.7
3.0
7.2
1.7
1.2
6.9
3.1
2.6
35.3
76.0
11.2
12.7
73.0
25.9
0.7
0.4
10.6
5.6
10.4
8.0
7.6
2.8
6.9
1.3
0.8
6.9
3.2
2.8
33.0
74.5
12.6
12.9
72.0
27.1
0.6
0.4
12.7
6.9
12.7
5.9
7.4
2.5
6.4
1.0
0.5
6.5
3.6
3.1
30.9
71.4
15.2
13.5
71.7
27.4
0.4
0.4
9.2
5.0
6.9
10.0
7.7
2.6
7.3
1.7
1.1
6.9
3.3
2.6
35.8
75.9
11.9
12.2
73.2
25.6
0.8
0.4
10.8
5.9
9.6
8.1
7.6
2.5
6.9
1.4
0.8
6.7
3.4
2.8
33.5
73.8
13.4
12.8
72.5
26.4
0.6
0.4
14.3
4.8
16.7
2.4
9.5
2.4
11.9
0.0
0.0
14.3
0.0
2.4
21.4
92.3
0.0
7.7
58.3
41.7
0.0
0.0
3.0
0.0
21.2
9.1
6.1
7.6
6.1
1.5
1.5
7.6
1.5
3.0
31.8
7.4
1.9
19.4
6.5
7.4
5.6
8.3
0.9
0.9
10.2
0.9
2.8
27.8
78.8
4.5 2.9
16.7 13.3
83.8
71.2
28.8
0.0
0.0
65.9
34.1
0.0
0.0
Table 7.14 MORBIDITY DETAILS
Percentage of household population diagnosed with
chronic illness during last one year, Himanchal Pradesh,
2012-13.
Total Rural
Urban
Diagnosed chronic illness Male
Female Total Male Female Total
Male
Female Total
Diabetes 13.2
Hypertension 15.3
Disease related to heart‘ 10.3
Epilepsy 1.1
Asthma/chronic respiratory failure 8.7
Goitrel thyroid disorder 1.1
Tuberculosis 1.0
Leprosy 0.6
14.9
19.7
5.9
0.4
3.2
2.8
1.0
0.4
14.1
17.7
7.9
0.7
5.7
2.0
1.0
0.5
12.6
14.8
10.3
1.2
8.6
1.2
1.0
0.7
14.8
18.4
6.2
0.5
3.3
2.3
0.8
0.5
13.7
16.7
8.1
0.8
5.8
1.8
0.9
0.6
25.6
23.1
10.3
0.0
10.3
0.0
0.0
0.0
16.7
31.8
1.5
0.0
1.5
7.6
3.0
0.0
20.0
28.6
4.8
0.0
4.8
4.8
1.9
0.0
* Chronic heart diseases, Myocardial infection/heart attack, stroke cerebro vascular accident.
Table 7.15 MORBIDITY DETAILS
Percentage of household population aged 60 years and above diagnosed with chronic illness during last one
Pradesh, 2012-13.
year, Himanchal
Total
Rural
Urban
Diagnosed chronic illness Male Female
Total
Male
Female
Total
Male
Female Total
11.2
16.7
13.8
14.9
1.5
0.7
0.0
3.3
0.7
19.2
17.6
8.4
6.7
2.1
1.7
0.4
2.5
0.8
Diabetes
Hypertension
Disease related to heart‘
Asthma/chronic respiratory failure
Goitrel thyroid disorder
Tuberculosis
Leprosy
Cataract
Stroke
15.0
17.1
11.2
11.0
1.8
1.2
0.2
3.0
0.8
10.7
17.4
13.0
13.8
1.6
0.8
0.0
3.2
0.8
17.6
16.7
8.6
6.8
1.8
1.8
0.5
2.7
0.5
13.9
17.1
10.9
10.5
1.7
1.3
0.2
2.9
0.6
mm
WM
mm
mm
wm
mm
mm
mm
Wm
mm m4
@m>1m
m>1m
m)1m
BBEQAA
929:
F1199!“
KOOQKD
(7.7) 2.9
* Chronic heart diseases, Myocardial infection/heart attack, stroke cerebro vascular accident. ( ) based on 10-20 unweighted
C3595.
B8

Table 7.16 TUBERCULOSIS
Number of persons who have tuberculosis by background characteristics, Himachal Pradesh, 2012-13.
Number of persons suffering from tuberculosis
Background characteristics Rural Urban Total
Number of
persons“
Age
15-19 00 00 O0
20-34 02 00 O2
35-44 00 O0 O0
45-59 03 00 03
60 and above 06 00 06
Education
Non-literate’ 06 00 O6
Less than 5 years 01 00 O1
5-9 years 03 01 04
10 or more years 01 00 01
Religion
Hindu 08 01 O9
Muslim 00 00 00
Sikh 00 O0 00
Buddhist 03 O0 03
Others 00 00 00
CastesITribes
Scheduled Castes 05 O1 06
Scheduled Tribes 02 00 O2
Other Backward Classes 01 O0 01
Others 03 00 03
DLHS-4 11 O1 12
4170
12785
7326
9192
5851
10067
3418
13543
22140
45639
596
376
2387
88
1 1315
6263
6905
24685
49168
I 3 Literate but did not attend the school are also included. *” Unweighted cases. l
139

HEALTH AND NUTRITIONAL STATUS
141

Table 8.1 NUTRITIONAL STATUS OF CHILDREN
Percentage of children under age ﬁve years classified as malnourished according to three anthropometric indices of nutritional status: height-for-age. weight-for-height, and weight-for-age, by
background characteristics, Himachal Pradesh, 2012-13.
Background
Characteristics
Height for Age
Weight for Height
Weight for Age
Below Below
-3SD -2SD
Above
+2SD”
Mean Z- Below
score (SD) -3SD
Below Above
-2SD +2SD”
Mean Z- Below
score(SD) –
3SD
below
-2so
Above
+2SD‘
Number of
Mean Z- eligible
score(SD) children”
Age group (month)
0-6
7-12
13-18
19-24
25-35
36 and above
Sex of child
Male
Female
Place of residence
Rural
Urban
Religion
Hindu
Muslim
Sikh
Buddhist
Others
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
Himachal Pradesh
6.2
5.5
20.6
39.2
23.0
16.3
19.3
17.0
18.4
14.9
18.0
23.5
16.7
(21.4)
17.7
14.5
22.9
17.5
18.1
12.3
12.3
33.0
54.9
34.8
37.0
33.5
31.5
32.2
36.2
31.9
47.1
50.0
(35.1)
32.3
32.7
36.7
31.3
32.5
87.7
87.7
67.0
45.1
65.2
63.0
66.5
68.5
67.8
63.8
68.1
52.9
50.0
(64.3)
67.7
67.3
63.3
68.7
67.5
24.1
20.3
22.5
5.3
10.9
10.7
15.1
13.5
14.2
15.9
14.1
29.8
17.5
1.7
16.2
10.4
11.3
14.7
14.3
19.5
14.0
10.9
5.0
8.1
8.6
10.6
9.5
9.7
14.7
10.0
25.0
0.0
0.0
10.7
10.5
3.8
11.6
10.0
34.1
29.8
23.4
15.0
19.2
18.8
19.5
23.7
21.7
20.6
22.0
25.0
0.0
0.0
23.7
18.4
11.3
24.3
21.7
65.9
70.2
76.6
85.0
80.8
81.2
80.5
76.3
78.3
79.4
78.0
75.0
100.0
100.0
76.3
81.6
88.8
75.7
78.3
8.7
5.1
9.2
1.9
7.6
5.7
6.5
6.2
6.5
4.6
6.2
1.8
21.4
14.0
6.9
4.4
6.7
6.2
6.3
7.7
3.1
7.0
12.5
11.1
11.6
9.9
9.3
10.2
2.6
9.8
12.5
0.0
0.0
8.6
12.5
9.0
10.0
9.6
30.8
28.1
25.4
37.5
25.9
28.9
29.4
27.7
28.9
23.1
28.3
43.8
40.0
11.1
28.5
30.0
23.6
29.9
28.5
65.9
70.2
76.6
85.0
80.8
81.2
80.5
76.3
78.3
79.4
78.0
75.0
100.0
100.0
76.3
81.6
88.8
75.7.
78.3
16.5
9.2
9.8
1.6
4.4
4.3
6.5
7.2
6.1
7.0
1.8
6.5
13.6
1.6
2.0
5.5
4.1
7.1
7.3
247
205
239
135
363
735
1,023
934
1,838
119
1,870
40
13
32
2
462
157
333
1,005
1,957
Note: reference period: January 15‘, 2008 to survey date.
* +2SD includes Don’t know. — percentage not shown for less than 10 cases
unweighted cases
143

Table 8.2 NUTRITIONAL STATUS OF CHILDREN BY DISTRICTS
Percentage of children under age ﬁve years classified as malnourished according to three anthropometric indices of nutritional status: height-for-age. weight-for-height, and weight-for-age, by
districts, Himachal Pradesh 2012-13
Districts
Height-for-Age
Weight-for-Height
Weight-for- Age
below
-3SD
below
-2SD
above
+2SD*
Mean Z- below
score (SD) -3SD
below
-2SD
Above
+2SD“
Mean Z-
score (SD)
Below
-3SD
Below
-2SD
Mean Number of
Percentage Z- score eligible
above +2SD*
($9)
children“
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shirnla
Kinnaur
Himachal Pradesh
26.1
15.1
25.0
27.1
37.5
16.3
11.4
24.4
25.0
16.1
8.2
8.3
18.1
47.8
35.6
40.0
41.7
45.8
26.1
19.3
36.6
44.8
31.2
28.6
25.0
32.5
52.2
64.4
60.0
58.3
54.2
73.9
80.7
63.4
55.2
68.8
71.4
75.0
67.5
14.1
7.0
16.1
21.6
13.5
12.2
15.6
11.1
8.5
25.4
11.6
9.9
14.3
7.1
5.9
0.0
3.3
0.0
9.9
15.0
18.2
10.0
0.0
20.7
12.5
10.0
21.4
13.7
0.0
13.3
8.3
22.5
30.8
42.4
20.0
4.3
27.6
25.0
21.7
78.6
86.3
100.0
86.7
91.7
77.5
69.2
57.6
80.0
95.7
72.4
75.0
78.3
8.7
3.8
2.1
1.9
25.9
4.5
11.3
1.5
4.2
2.0
5.0
25.7
31.3
5.8
7.1
0.0
0.0
9.0
11.5
20.0
13.6
1.6
5.6
11.1
6.3 9.6
50.0
17.3
14.3
33.3
15.4
32.1
29.0
35.0
38.6
14.8
27.8
11.1
28.5
50.0
82.7
85.7
66.7
84.6
67.9
71.0
65.0
61.4
85.2
72.2
88.9
71.5
1.5
3.6
8.8
13.3
16.7
4.1
3.9
11.3
2.7
17.6
1.8
12.7
6.6
102
273
36
99
124
226
316
133
203
259
129
57
1957
Note: reference period: January 15‘, 2008 to survey date. ’ +2SD includes Don’t know. *“ unweighted oases
144

Table 8.3 BMI (BODY MASS INDEX) OF WOMEN
Percentage of women age 15-49 average body mass index (BMI), and percentage with specific BMI levels, by background characteristics, Hirnachal Pradesh, 2012-13
Background
characteristics
Mean Height
Mean
BMI
(normal)
Body Mass Index (BMI) in kg/m2
Thin Overweight/Obese
thin)
<17.0 225.0 18.5-24.9 <18.5 (total 17.0-18.4 (moderateiyl (overweight 25.0-29.9 230.0 (mildly thin) severely thin) or obese) (overweight) (obese) Total number of Women" Age 15-19 20-29 30-39 40-49 Place of residence Rural Urban Education Non-literatea Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist Others Castes/Tribes Scheduled Castes Scheduled Tribes Other Backward Classes Others Himachal Pradesh 152.9 155.6 156.3 156.1 155.6 156.6 155.5 156.7 155.7 155.7 155.6 157.0 156.1 156.9 153.6 155.4 156.9 154.3 156.0 155.7 24.2 24.5 24.5 25.7 24.7 25.9 29.1 23.0 22.8 25.1 24.9 23.6 28.3 22.7 21.8 25.4 22.7 28.4 23.9 24.8 54.7 67.6 64.4 65.1 65.1 59.8 66.0 62.3 64.0 64.7 64.4 65.1 56.8 70.7 47.0 64.5 69.1 60.8 64.8 64.6 39.6 19.5 11.7 7.6 16.1 12.7 14.4 17.4 15.3 16.1 16.1 18.8 14.0 7.8 19.9 18.1 13.6 17.3 14.6 15.7 22.1 10.3 6.9 4.1 9.0 6.0 6.7 11.1 8.9 8.8 8.9 10.8 9.6 4.5 10.0 9.4 8.7 9.6 8.1 8.7 17.2 8.6 4.5 3.2 6.7 6.0 7.2 5.5 6.2 6.9 6.8 6.5 4.4 3.3 10.0 8.4 4.6 7.3 6.1 6.7 5.7 12.9 23.9 27.3 18.9 27.5 19.6 20.3 20.7 19.2 19.6 16.1 29.2 21.5 33.1 17.4 17.3 21.9 20.6 19.7 3.8 10.0 19.1 20.5 14.6 21.1 15.5 12.9 16.2 14.7 15.0 10.6 23.6 17.7 33.1 14.0 12.9 16.3 15.9 15.2 614 1,811 1,915 1,702 5,584 458 641 148 1,836 3,417 5,632 80 52 265 11 1,405 662 915 3,060 6,042 Note: reference period: January 1*‘, 2008 to survey date. 3 Literate but did not attend school, are also included. *’ unweighted cases 145 Table 8.4 BMI (BODY MASS INDEX] OF WOMEN Percentage of women age 15-49 average body mass index (BMI), and percentage with specific BMI levels by districts, Hirnachal Pradesh, 2012-13 Di strict 18.5-24.9 Mean Height Mean BMI (normal) Body Mass Index (BMI) in kg/m2 Thin Ovenueight/Obese <18.5 (total 17.0-18.4 (moderatelyl (overweight 25.0-29.9 230.0 Total number <17.0 225.0 thin) (mildly thin) severely thin) or obese) (oveniveight) (obese) of Women" Charnba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 156.0 153.1 156.9 156.3 157.2 154.1 156.0 155.4 154.2 154.5 158.8 157.1 155.7 20.6 34.8 23.9 23.0 21.9 24.1 22.2 22.4 23.8 31.3 23.1 21.5 24.8 68.7 54.1 71.4 73.9 75.5 56.5 54.3 72.2 56.1 62.3 63.3 73.8 64.6 22.5 19.4 7.3 10.9 15.1 14.6 21.3 11.0 12.2 22.9 16.8 13.8 15.7 13.7 9.5 5.2 7.1 9.0 5.6 10.2 5.9 6.8 14.2 8.0 9.6 8.7 8.2 9.3 2.1 3.5 5.2 8.8 10.5 5.1 5.2 8.5 8.8 3.9 6.7 8.8 26.5 21.3 15.2 9.4 28.9 24.3 16.8 31.7 14.8 20.0 12.4 19.7 6.0 17.7 17.6 12.8 7.6 21.7 19.8 14.1 22.5 10.6 16.7 10.9 15.2 323 573 332 788 540 484 617 446 506 661 432 340 6042 ** unweighted cases 146 Table 8.5 PREVELANCE OF ANEMIA AMONG CHILDREN Percentage of children age ( 6-59 months) classified as having iron-deficiency (anaemia) by selected background characteristics, Himachal Pradesh, 2012-13 Anaemia status by haemoglobin level ‘|'Q¢a| number of Mild anemia Moderate anemia Severe anemia Any anaemia children <5 Background characteristics (10.0-10.9 g/dl) (7.0-9-9 g/dl) (< 7g/dl) <11.0 gldl years“ Sex of Child Male Female Place of residence Rural Urban Religion Hindu Muslim Sikh Buddhist Others CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others Himachal Pradesh 11.8 10.2 9.9 18.7 10.5 12.1 18.2 7.9 10.6 11.0 38.6 28.1 34.8 24.3 34.0 34.8 36.6 35.6 31.5 33.5 12.3 16.0 15.7 3.3 13.8 18.6 9.0 9.1 14.7 14.1 62.8 54.3 60.4 46.4 58.3 65.6 63.9 52.7 56.7 58.6 154 141 265 30 284 08 01 O2 71 23 55 146 295 st Note: reference period: January 1 , 2008 to survey date. -- percentage not shown due to below 10 cases! no cases." Unweighted cases TABLE 8.6 ANAEMIA AMONG SCHOOL GOING/ADOLESCENT POPULATION Percentage of school going population (age 6-19 years) classified as having iron-deficiency (anaemia) by degree of anaemia and by selected background characteristics, Himachal Pradesh, 2012-13. Background characteristics Mild anemia Moderate anemia Severe anemia Any anaemia population (age 6- Anaemia status by haemoglobin level Total number of school going (10.0-10.9 g/dl) (7.0-9-9 g/dl) (< 7g/dl) <11.o g/dl 19 years)“ Age 6 yrs - 10 yrs 11 yrs - 14 yrs 15yrs—16 yrs 17yrs~19 yrs Sex Male Female Residence Rural Urban Education Non-literate’ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist Others CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others Himachal Pradesh 9.0 10.2 8.7 8.8 9.0 9.4 9.4 8.1 8.0 9.4 9.7 8.9 9.0 8.4 16.1 12.7 7.2 11.4 8.0 10.3 9.2 27.6 28.3 25.0 28.6 27.6 27.6 28.4 20.9 24.8 27.8 28.8 26.7 28.0 33.4 28.7 13.2 28.3 24.4 33.2 26.0 27.6 7.6 7.6 8.1 8.6 6.8 9.2 8.0 7.9 10.7 8.2 7.4 8.2 8.1 18.2 2.6 0.0 9.5 4.5 9.0 7.6 8.0 44.2 46.1 41.7 46.0 43.9 45.9 45.8 36.8 43.5 45.4 45.9 43.8 45.2 60.0 47.3 25.9 44.9 40.4 50.2 43.9 44.8 639 749 499 853 1,336 1,404 2,514 226 115 406 1,088 1,131 2,553 57 42 86 2 722 284 444 1,290 2 740 5 Literate but did not attend school, are also included. "un weighted cases 147 TABLE 8.7 ANAEMIA AMONG POPULATION AGED 20 YEARS AND ABOVE Percentage of population (age 20 years and above) classiﬁed as having iron-deficiency (anaemia) by degree of anaemia and selected background characteristics, Himachal Pradesh, 2012-13. Background characteristics Male Female Total Mild anemia (7.0-9-9 anemia anemia (10.0-10.9 (7.0-9-9 anemia anaemia (10.0-10.9 (7.0-9-9 anemia anaemia (< 7g/dl) <11.0 gldl (10.0-10.9 gldl) Moderate Mild Moderate Mild Moderate anemia Severe Any anemia anemia Severe Any anemia anemia Severe Any gldl) (< 7g/dl) <11.0 gldl gldl) gldl) (< 7g/dl) <11.o g/dl gldl) gldl) Age 20yrs - 29 yrs 30 yrs - 39 yrs 40 yrs — 49 yrs 50 yrs and above Residence Rural Urban Education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist Others CastesITribes Scheduled Castes Scheduled Tribes Other Backward Classes Others Himachal Pradesh 10.8 9.9 11.9 10.3 10.9 8.5 11.0 10.1 10.2 10.8 10.6 7.8 15.4 12.0 0.0 10.7 12.3 11.5 10.0 10.7 19.7 18.4 19.8 22.1 21.0 15.7 21.4 20.1 21.9 19.8 21.0 24.4 16.9 12.9 16.7 22.4 18.4 29.7 17.8 20.5 3.8 34.4 3.0 31.4 3.5 35.2 5.4 37.8 4.0 35.9 6.4 30.6 3.3 35.6 6.0 36.2 4.0 36.1 4.4 35.0 4.6 36.2 4.6 36.8 2.6 34.9 0.2 25.1 0.0 16.7 3.8 36.9 1.9 32.6 7.7 48.8 4.2 32.1 4.2 35.4 10.6 10.0 11.0 9.4 10.3 8.9 9.6 12.4 10.3 10.3 10.2 8.7 7.2 10.9 12.9 9.9 10.7 8.3 10.7 10.2 26.3 27.0 24.5 26.8 26.7 22.0 23.1 25.6 28.9 26.2 26.8 32.7 28.1 14.7 25.7 25.6 22.1 37.2 24.4 26.2 7.2 7.6 7.0 8.4 7.6 8.0 6.9 7.2 7.9 7.9 5-"- 5-“.\'9° Q-|°_\m_t 9.1 2.4 15.1 6.1 7.7 44.1 44.6 42.6 44.6 44.7 38.9 39.6 45.2 47.2 44.4 45.0 48.9 40.4 25.6 44.1 44.6 35.2 60.6 41.2 44.1 10.7 10.0 11.4 9.9 10.6 8.8 10.0 11.6 10.2 10.6 10.4 8.3 10.7 11.4 6.1 10.3 11.4 9.6 10.4 10.4 23.9 23.8 22.5 24.6 24.3 19.4 22.6 23.5 26.3 22.9 24.4 29.2 23.3 13.8 21.0 24.3 20.4 34.2 21.6 23.8 6.0 5.9 5.5 6.9 6.1 7.3 6.0 6.8 6.5 6.1 6.6 6.3 4.0 0.1 2.7 6.9 2.2 12.1 5.3 6.2 40.6 39.7 39.5 41.4 41.0 35.5 38.6 41.9 43.1 39.6 41.4 43.8 38.0 25.4 29.8 41.4 34.0 55.9 37.4 40.4 E Literate but did not attend school, are also included. TABLE 8.8 ANAEMIA AMONG POPULATION CHILDREN. ADOLESECENTS AGED 20 YEARS AND ABOVE Percentage of children aged 6-59 months, adolescents aged 6-19 year and population aged 20 years and above having any and severe anaemia by districts, Himachal Pradesh, 2012-13. Children Adolescents Aged 20 years and above District <11 .0 g/dl Severe Any anemia anemia (< 7g/dl) Any Severe anemia anemia Any anemia Severe anemia <11.0 g/dl (< 7g/dl) <11.0 g/dl (< 7g/dl) Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 54.8 85.1 66.5 23.3 32.7 79.9 91.1 17.7 31.4 51.5 58.0 49.8 58.6 0.0 30.7 0.0 0.0 0.0 29.5 39.5 0.0 0.0 10.9 0.0 0.0 14.1 46.5 88.1 27.4 18.4 39.0 65.0 82.3 20.8 16.5 49.6 30.4 14.5 44.8 4.0 22.3 0.0 0.4 3.6 17.8 26.2 0.0 1.0 4.5 2.6 0.0 8.0 45.6 83.4 28.4 23.5 34.6 66.3 77.6 20.2 15.2 43.0 26.6 21.0 40.4 2.9 21.3 0.0 0.4 1.0 16.5 22.0 0.5 $3.-‘.9153 _;s_.(>
6.2
TABLE 8.9 ANAEMIA AMONG PREGNANT WOMEN
Percentage of pregnant women (age 15-49 years) classified as having iron-deﬁciency (anaemia) by degree of anaemia and by
selected background characteristics, Himachal Pradesh, 2012-13.
Background
characteristics
Anaemia status by haemoglobin level
Mild anemia anemia Severe anemia Any anaemia Total number of
Moderate
(10.0-10.9 g/dl) (7.0-9-9 g/dl) (< 7g/dl) <11.0 g/dl Pregnant Women Age group (years) 15-19 20-29 30-39 40-49 Residence Rural Urban Woman's Education Non-literate“ Less than 5 years 5-9 years 10 or more years Religion Hindu Muslim Sikh Buddhist Others CastesITrihes Scheduled Castes Scheduled Tribes Other Backward Classes Others Himachal Pradesh (20.0) 10.5 10.3 (16.0) 11.0 (13.0) (8.3) 11.4 11.2 10.0 0.0 (25.0) 14.9 13.2 5.0 9.8 11.1 (10.0) 26.5 26.7 (20.0) 26.4 (17.4) (33.3) 29.6 24.2 26.5 (6.3) 27.2 17.7 38.5 25.5 25.7 (0-0) 1.3 5.0 0.0 6.0 (8-7) (0.0) 5.1 6.8 6.5 (0.0) 9.2 1.1 20.8 3.7 6.2 (30.0) 44.3 42.0 (36.0) 43.5 (39.1) (41.7) 46.1 42.2 43.8 (31.3) 51.3 32.0 64.2 39.0 43.0 12 284 76 26 375 23 12 2 85 299 375 02 03 18 88 85 42 183 398 E Literate but did not attend school, are also included. () based on 10-20 unewighted cases. -- percentage not shown due to below 10 cases! no cases ** Unweighted cases 149 Table 8.10 PREVALENCE OF DIABETIES Percentage of men (age 18 years and above) classified as having Sugar by selected background characteristics, Himachal Pradesh, 2012-13. Background characteristics Below (< 140) Mild (140-160) Moderate/High (>160) Tested“
Any type of blood sugar level -|-Ota| number of men
Age group
18 – 29
30 – 39
40 — 49
50 – 59
60 +
Residence
Rural
Urban
Education
Non-literate“
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Others
Castesffribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
Himachal Pradesh
91.5
86.4
82.1
77.9
74.0
82.5
80.1
79.1
78.0
80.8
83.6
82.2
85.1
76.8
82.6
(86.8)
82.4
81.2
81.0
82.8
82.2
5.8
9.0
11.3
13.0
14.9
10.9
10.1
14.1
14.9
11.5
9.8
10.8
11.5
13.7
11.9
(7.7)
10.7
11.3
11.8
10.6
10.9
2.8 1,625
4.6 1,553
6.6 1,724
9.1 1,534
11.2 1,738
6.6 7,580
9.8 594
6.8 935
7.1 242
7.7 2,054
6.6 4,943
7.0 7,458
3.4 91
9.4 67
5.5 537
(5.5) 18
6.9 1,785
7.5 1,091
7.3 1,103
6.6 4,195
6.9 8,174
” Literate but did not attend school, are also included. () based on 10-20 unewighted cases. ’* Unweighted cases.
Table 8.11 PREVALENCE OF DIABETIES
Percentage of men aged 18 years and above classiﬁed with level of any type of blood Sugar by districts, Himachal Pradesh
2012-13.
District
Any type of blood sugar level
Below Mild Moderate/High Total number of men
140 “*
(140-160) (>160) Tested
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
Himachal Pradesh
83.7
81.5
84.4
83.3
85.5
78.4
75.2
79.4
81.7
83.4
87.6
82.8
82.2
10.8
10.2
8.4
10.1
9.7
9.4
17.7
11.9
11.3
10.6
8.0
13.0
10.9
5.4 457
8.3 582
7.2 507
6.5 953
4.8 764
12.3 663
7.1 601
8.7 723
7.0 714
6.0 878
4.5 685
4.3 647
6.9 8,174
” Unweighted cases
150

Table 8.12 PREVALENCE OF DIABETIES
Percentage of Women (age 18 years and above) classiﬁed as having Sugar by selected background characteristics, Himachal
Pradesh, 2012-13.
Background characteristics Below 140 Mild (140-160) Moderate/High (>160)
Any type of blood sugar level
Total number of
women Tested“
Age group
18 – 29
30 – 39
40 — 49
50 – 59
60 +
Residence
Rural
Urban
Education
Non-literate“
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Others
Castesffribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
Himachal Pradesh
93.0
87.6
83.6
76.7
71.6
84.3
80.3
78.1
82.0
82.4
88.6
83.8
86.4
81.4
86.2
(83.0)
84.6
84.6
82.6
83.9
83.9
(1
4.5
7.7
10.2
13.0
14.3
9.3
9.1
11.9
9.6
10.6
6.8
9.3
10.5
7.9
9.5
2.6)
9.4
8.8
9.7
9.3
9,3
2.5
4.7
6.2
10.3
14.1
6.4
10.5
10.0
8.4
7.0
4.6
6.9
3.2
10.7
4.4
(4-2)
6.0
6.6
7.7
6.9
6.8
2,753
2,589
2,362
1,900
1,630
10,402
832
2,763
409
3,420
4,642
10,436
130
91
558
16
2,533
1,316
1,622
5,763
11,234
” Literate but did not attend school, are also included. () Based on unweighted cases. ** Unweighted cases
Table 8.13 PREVALENCE OF DIABETIES
Percentage of women aged 18 years and above classified with level of any type of blood Sugar by districts, Himachal Pradesh,
2012-13.
District
Any type of blood sugar level
Below 140 Mild (140-160) Moderate/High (>160)
Total number of
women Tested“
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
Himachal Pradesh
88.8
85.0
83.3
86.3
90.8
81.8
74.4
81.6
79.8
85.3
88.8
85.1
83.9
7.2
7.7
9.8
6.9
5.3
9.6
17.1
10.5
12.2
9.1
5.2
9.8
9.3
4.0
7.3
6.9
6.8
3.8
8.6
8.5
7.9
8.0
5.6
6.1
5.1
6.8
715
1,011
603
1,129
986
1,152
1,058
958
990
1,125
792
715
11,234
* *Unweighted cases
151

Table 8.14 BLOOD PRESSURE
Percentage of men (age 18 years and above) classified as having Blood Pressure by selected background characteristics,
Himachal Pradesh, 2012-13.
Background characteristics 1 2 3 4 5 6 pressure measured“ Covered“
Status 97 B|°°d PT955U’e Number of men blood Number of men
Age group
18 – 29
30 – 39
40 — 49
50 – 59
60 +
Residence
Rural
Urban
Education
Non-literate’
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Others
Castesffribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
Himachal Pradesh
51.5
44.0
38.6
34.6
33.2
41.0
34.9
38.0
37.0
40.0
41.2
40.5
44.9
27.6
41.0
11.1
39.7
44.9
40.0
39.7
40.4
20.5
21.8
21.2
19.5
17.1
20.0
20.1
20.2
16.8
19.8
20.2
20.1
20.6
19.3
17.6
50.1
22.2
19.9
17.7
19.7
20.0
20.0
23.6
28.5
28.5
28.3
25.7
26.5
26.3
24.6
26.7
25.3
25.8
24.1
22.6
25.3
33.4
26.1
22.9
26.6
26.1
25.8
4.7
5.6
7.1
9.4
10.7
7.5
7.1
7.7
11.2
7.8
7.1
7.5
3.6
15.9
7.5
5.5
6.5
7.2
7.8
7.9
7.5
1.5
2.9
2.2
4.2
6.3
3.2
5.7
4.8
5.0
3.3
3.2
3.3
4.4
5.8
4.7
0.0
2.8
2.9
4.5
3.5
3.4
1.8
2.1
2.5
3.8
4.4
2.6
5.7
2.9
5.5
2.4
3.0
2.8
2.4
8.8
3.9
0.0
2.7
2.2
3.3
3.1
2.9
1,803
1,678
1,839
1,626
1,858
8,149
655
997
263
2,190
5,354
8,060
99
67
556
19
1,935
1,156
1,189
4,524
8,804
1,969
1,804
1,965
1,724
1,944
8,710
696
1,045
274
2,341
5,746
8,640
106
75
561
19
2,074
1,257
1,291
4,784
9,406
” Literate but did not attend school, are also included.“ unweighted cases
Table 8.15 BLOOD PRESSURE
Percentage of rnen (age 18 years and above) classiﬁed as having Blood Pressure by districts, Himachal Pradesh, 2012-13.
District
Status of Blood Pressure Number of men Number of men
1
2
3
4
blood pressure aged 18 years &
measured“ above“
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
Himachal Pradesh
46.4
34.2
43.8
45.8
44.2
30.5
29.2
44.0
38.8
48.4
37.0
42.3
40.4
15.7
18.1
20.1
22.1
17.5
17.7
26.8
22.5
20.3
17.0
21.1
18.1
20.0
23.8
29.2
22.3
25.3
29.4
32.1
26.9
19.4
28.9
22.3
26.8
22.4
25.8
5.1
10.6
8.3
3.9
5.9
10.7
8.9
6.8
7.2
7.3
8.0
8.8
7.5
461
680
533
1,043
772
700
701
788
773
929
750
674
8,804
503
835
538
1,049
871
755
739
796
777
1,026
830
687
9,406
“ unweighted cases
Average Systolic | Average Diastolic
0
S129
1
ru
w
A
Ul
|s84 | as-39 | 90-99 l 100-109 l 110-119 212
l 6
130-139
2
M
co
5
0|
6
140-159
co
or
co
Ii
or
ca
160-179
-b
#-
-b
A
Ur
0:
180-209
01
01
01
01
U1
0″:
2 210
ov
0
ov
ov
ca
0:
152

Table 8.16 BLOOD PRESSURE
Percentage of women (age 18 years and above) classiﬁed as having Blood Pressure by selected background characteristics,
Himachal Pradesh, 2012-13.
Background
characteristics
Status of Blood Pressure Number of women Number of
1
2
3
4
5
6
blood pressure women aged 18
measured“ year & above“
Age group
18 – 29
30 – 39
40 – 49
50 – 59
60 +
Residence
Rural
Urban
Education
Non-literate”
Less than 5 years
5-9 years
10 or more years
Religion
Hindu
Muslim
Sikh
Buddhist
Others
CastesITribes
Scheduled Castes
Scheduled Tribes
Other Backward Classes
Others
Himachal Pradesh
66.6
54.4
47.8
40.3
32.3
51.1
46.2
42.6
41.0
49.1
57.0
50.9
44.9
55.7
43.9
66,0
50.5
50.6
52.3
50.1
50.6
16.3
19.2
19.7
16.9
16.2
17.3
21.4
16.5
20,6
18.2
18,0
17.8
19.9
19.0
16.6
19.0
18.1
17.9
14.4
18.5
17.8
12.3
18.9
22.1
25.4
26.7
20.1
20.1
23.1
25.6
21.0
17.2
20.0
22.0
10.4
22.7
22.3
20.3
20.2
20.2
19.9
20.1
2.5
4.3
6.0
9.3
2.5
6.2
6.2
9.4
6.2
6.5
4,1
6.1
6.6
9.7
7.6
0.0
6.0
5.8
7.3
6.1
6.2
.°‘.‘>!°.-‘f
ooaomoam
3.0
2.5
4.6
3.6
3.0
2.0
2.9
4.4
3.8
3.7
0.0
2.6
2.5
4.3
2.9
3.0
1.1
1.7
2.0
3.2
5.4
2.3
3.5
3.8
2.9
2.1
1.7
2.2
2.3
1.4
5.5
8.2
2.4
2.9
1.6
2.5
2.4
3,022
2,772
2,509
2,026
1,787
11,226
890
2,985
441
3,660
5,030
11,285
138
94
578
18
2,744
1,407
1,756
6,209
12,116
3,139
2,840
2,549
2,085
1,836
11,540
909
3,068
452
3,737
5,192
11,611
140
98
578
18
2,829
1,457
1,826
6,337
12,449
a Literate but did not attend school, are also included.” unweighted cases
Table 8.17 BLOOD PRESSURE
Percentage of women (age 18 years and above) classiﬁed as having Blood Pressure by districts, Himachal Pradesh, 2012-13.
Status of Blood Pressure Number of women Number of
District
1
2 3 4 5 6
blood pressure
measure“
women aged 18
years & above“
Chamba
Kangra
Lahul & Spill
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
Himachal Pradesh
62.0
47.2
48.6
53.6
57.6
47.4
39.3
53.9
52.0
58.5
42.9
48.9
50.6
10.4
13.0
17.2
20.6
15.8
16.2
23.3
20.7
17.7
14.8
23.3
15.5
17.8
14.6
22.5
20.6
19.5
19.0
22.7
22.2
16.5
21.6
17.9
22.1
20.2
20.1
6.2
9.8
6.3
3.1
4.9
7.7
8.1
3.7
5.2
5.8
6.5
7.1
6.2
2.8
5.3
2.2
1.6
1.4
3.9
4.8
3.0
2.3
1.8
2.5
3.7
3.0
,“.”‘!°:’>
~|–o
1.4
2.1
2.3
2.2
1.2
1.2
2.8
4.5
2.4
722
1,179
643
1,246
996
1,210
1,247
1,026
1,053
1,179
878
737
12,116
741
1,272
645
1,250
1,057
1,254
1,261
1,029
1,059
1,221
919
741
12,449
‘* unweighted cases
Average Systolic
Average Diastolic
|v
A
I\J
0
$129
I
|sa4 | as-89 | 90-99 I 100-109 I 110-119
I 1 I I I I
M
co
A
0|
cw
130-139
2
r\>
co
A
0|
ca
140-159
no
1.0
no
-In
<11 av 160-179 -h dQ
mm-\\|
‘-\Z»
0.0
0.6
1.3
1.5
9.0.‘.-‘.*
U’lI\)U’lU1J>
1.4
0.5
2.2
1.2
1.3
26.6
31.6
30.8
30.5
31.3
23.7
43.6
30.3
32.8
29.5
31.9
23.8
21.0
15.9
8.6
29.9
24.6
41.7
29.2
30.4
57.8
56.7
54.9
55.4
54.1
63.0
38.8
54.3
53.5
57.4
54.2
58.2
64.0
78.3
74.0
56.4
64.5
43.3
55.1
55.1
14.9
10.6
12.6
12.9
13.3
12.3
17.6
14.7
12.4
11.6
12.5
16.4
13.5
5.6
12.0
12.3
10.4
12.7
14.4
13.2
458
3,267
4,550
3,599
10,889
985
2,363
482
3,480
5,549
10,969
128
90
664
23
2,712
1,570
1,606
5,986
11,874
Note; PPM: parts per million. ’ Literate but did not attended school, are also included. “ includes salt not
irﬁ
tested, refused and missing cases. unweighted cases..
at home, salt not
Table 8.19 PRESENCE OF IODIZED SALT IN HOUSEHOLD
Percent distribution of household with salt tested for iodine content, by level of iodine in salt ( Parts Per Million ) by districts,
Himachal Pradesh, 2012-13
Iodine content of salt
District
None Inadequate Adequate Not
0 ppm (< 15 ppm) ( 15 + ppm ) Tested/Missing* Number of Households“ Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 0.6 1.6 0.2 0.6 .-‘.-‘P’.-‘ ~|wroco .9.-‘.-‘.-‘ saloon 1.3 40.9 52.9 23.4 34.7 48.9 28.4 19.0 18.7 17.2 44.8 21.1 16.5 30.4 39.5 35.4 71.1 55.6 38.8 57.7 62.4 71.0 46.7 49.1 70.4 75.6 55.1 19.1 10.1 5.3 9.1 10.4 10.7 17.3 8.6 34.3 4.9 7.3 7.4 13.2 1,024 1,030 646 1,082 1,045 990 1,044 1,011 993 1,059 1,001 949 11 874 Note; PPM: parts per million. ‘includes salt not at home, salt not tested, refused and missing cases. *“ unweighted cases | 154 HEALTH FACILITY 155 TABLE 9.1: AVERAGE POPULATION COVERED BY HEALTH FACILITY BY DISTRICTS, HIMACHAL PRADESH, 2012- 13,DLHS-4 District Average population covered by Sub-Centre PHC CHC Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 2238 4213 505 4279 3445 3372 4952 3376 3841 3482 2236 1042 3464 101 14 45654 3042 18276 14799 15175 23429 12099 19720 11713 12153 1714 16648 38374 731 12 3950 40564 57887 40737 32881 351 18 61233 43187 38712 4989 44794 PHC= Primary Health Centre; CHC= Community Health Centre. TABLE 9.2: STATUS OF INFRASTRUCTURE AT SUB-CENTRE FUNCTIONING IN GOVERNMENT BUILDING BY DISTRICTS, HIMACHAL PRADESH, 2012-13, DLHS-4 District Regular Electricity Water" Toilet Labor room Number of Sub-Centres Number of Labor room Sub-Centres Total in current with govt. number of use‘ Building Sub-Centres Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 68.4 94.7 80.0 100.0 95.8 88.9 100.0 100.0 88.9 78.6 61.5 55.6 88.0 73.7 79.0 60.0 100.0 91.7 94.4 100.0 90.5 72.2 50.0 61.5 88.9 83.7 84.2 57.9 80.0 82.6 83.3 88.9 96.0 100.0 94.4 78.6 92.3 88.9 86.1 0.0 0.0 0.0 0.0 0.0 5.6 24.0 0.0 5.6 0.0 0.0 0.0 3.9 NA NA NA NA NA 0.0 25.0 NA 100.0 NA NA NA 33.3 19 22 19 36 05 O5 23 25 24 26 18 32 25 28 21 22 18 27 14 26 13 19 09 12 208 280 # Includes piped, bore well, well hand pump and other source of water. ‘ Percentage calculated from number of labor room available. NA : Not applicable TABLE 9.3: PERCENTAGE OF SUB-CENTRES HAVING DIFFERENT ACTIVITIES BY DISTRICTS, HIMACHAL PRADESH, 2012-13, DLHS-4 District Citizen's Charter \/HSC Total number of Sub- Facilitated’ Untied Fund Received Centres displayed Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 72.7 94.3 100.0 60.0 76.9 56.3 64.3 59.1 51.9 73.9 89.5 83.3 71.0 100.0 100.0 100.0 100.0 95.8 100.0 95.5 100.0 83.3 85.7 100.0 100.0 96.5 86.4 97.1 100.0 100.0 92.3 100.0 92.9 86.4 96.3 95.7 89.5 100.0 94.6 22 36 05 25 26 32 28 22 27 26 19 12 280 \/HSC= Village Health and Sanitation Committee. ‘Based on availability of VHSC. 157 201 2-1 3, DLHS-4 TABLE 9.4: AVAILABLE HUMAN RESOURCES AT SUB HEALTH CENTRES BY DISTRICTS, HIMACHAL PRADESH, District Human resources Status of Sub Health Centre '|'O1a| numbe; of ANM MHW Additional ANM SHCS Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 72.7 94.3 80.0 92.0 96.2 96.9 92.9 100.0 100.0 95.7 94.7 75.0 92.8 45.5 51.4 40.0 64.0 80.8 65.6 57.1 50.0 33.3 30.4 31.6 50.0 51.8 0.0 2.9 20.0 0.0 3.9 0.0 3.6 0.0 0.0 8.7 0.0 8.3 2.5 | ANM= Auxiliary Nurse Midwife. MHW= Male health Worker. 201 2-1 3, DLHS-4 TABLE 9.5: AVAILABLE HUMAN RESOURCES AT PRIMARY HEALTH CENTRES BY DISTRICTS, HIMACHAL PRADESH, District Human resources Status of PHC Tom number of Medical ofﬁcer Lady Medical Officer“ AYUSH Doctor“ Pharmacist PHCs Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 55.6 94.7 100.0 60.0 85.7 84.6 90.0 44.4 93.3 72.7 100.0 81.3 81.7 0.0 27.8 0.0 0.0 25.0 27.3 11.1 0.0 7.1 0.0 13.3 0.0 12.0 38.9 15.8 0.0 20.0 28.6 15.4 10.0 11.1 13.3 18.2 33.3 0.0 18.3 33.3 52.6 37.5 60.0 64.3 61.5 40.0 66.7 53.3 9.1 20.0 25.0 42.5 *“ Out of total medical officer 2012-13 TABLE 9.6: AVAILABLE INFRASTRUCTURE AT PRIMARY HEALTH CENTRES BY DISTRICTS, HIMACHAL PRADESH, District Percentage of PHCs having Residential Having Functioning Regular power functional Total number PHC 24 hours At least 4 beds supply vehicle of PHCs Quarter for MO Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 22.2 31.6 62.5 40.0 35.7 46.2 10.0 44.4 20.0 27.3 26.7 25.0 30.7 16.7 26.3 50.0 0.0 7.1 7.7 0.0 33.3 6.7 18.2 26.7 6.3 16.3 35.3 75.0 50.0 100.0 88.9 100.0 80.0 75.0 64.3 37.5 72.7 33.3 63.5 72.2 89.5 50.0 100.0 100.0 100.0 100.0 100.0 93.3 90.9 86.7 56.3 85.6 44.4 5.3 50.0 40.0 14.3 0.0 30.0 44.4 6.7 9.1 26.7 18.8 21.6 | MO= Medical Officer. 158 TABLE 9.7 SPECIFIC HEALTH FACILITIES AVAILABLE AT PRIMARY HEALTH CENTRES BY DISTRICTS, HIMACHAL PRADESH, 2012-13 District Number of PHCs having New born care Referral services for Conducted at least 10 Total number of services* delivery" deliveries PHCs Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 100.0 75.0 100.0 0.0 0.0 100.0 0.0 100.0 0.0 100.0 66.7 0.0 76.9 66.7 20.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 50.0 0.0 0.0 16.0 33.3 33.3 0.0 0.0 0.0 100.0 0.0 0.0 0.0 100.0 0.0 0.0 23.5 * Services based on during last one month. ** Based on PHC functioning on 24 hours basis. TABLE 9.8: NUMBER OF PRIMARY HEALTH CENTRES HAVING DIFFERENT ACTIVITIES BY DISTRICTS, HIMACHAL PRADESH, 2012-13 District Number of PHCs Citizens Charter Received untied Utilized untied Total number of RKS constituted fund“ fund“ PHCs displayed Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 83.3 89.5 87.5 80.0 50.0 76.9 90.0 66.7 93.3 90.9 86.7 75.0 81.1 94.4 94.7 100.0 100.0 92.9 100.0 90.0 100.0 100.0 90.9 100.0 100.0 96.7 100.0 94.7 87.5 100.0 100.0 92.3 100.0 88.9 93.3 100.0 93.3 100.0 96.1 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 RKS = Rogi Kalyan Samiti.* Untied fund for previous financial year ’* it includes full and partial utilization of fund TABLE 9.9: HUMAN RESOURCES AVAILABLE AT COMMUNITY HEALTH CENTRES BY DISTRICTS, HIMACHAL PRADESH, 2012-13 District Number of CHCs having: Obstetric Public Health Total number of Gynecologist Pediatrician Anesthetist Manager CHCs Chamba Kangra Lahul & Spiti Kullu Mandi Hamirpur Una Bilaspur Solan Sirmaur Shimla Kinnaur Himachal Pradesh 00 00 00 00 01 00 01 00 01 00 02 00 05 00 00 00 00 oooo _>_\_d
01
00
01
00
06
00
01
01
00
01
01
00
00
01
00
01
01
07
00
01
00
00
00
02
01
00
00
00
02
00
06
159

TABLE 9.10: SPECIFIC HEALTH CARE FACILITIES AVAILABLE AT COMMUNITY HEALTH CENTRES BY DISTRICTS,
HIMACHAL PRADESH, 2012-13
District
Number of CHCs having:
Designated as New born care Blood storage Total nurnber of
Functional OT FRU services‘ facility CHCs
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
Himachal Pradesh
04
O6
O2
O4
07
04
O2
O2
01
01
05
02
40
O2
02
01
04
03
O2
02
O4
01
03
02
01
27
05 04
10 04
01 NA
O5 02
07 03
06 01
02 01
05 NA
O2 NA
03 01
06 04
01 01
53 21
08
11
O2
06
10
06
04
07
05
04
10
04
77
OT= Operation Theatre; FRU= First Referral Unit. — No cases. ‘ Based on last one month services.
TABLE 9.11: NUMBER OF COMMUNITY HEALTH CENTRES HAVING DIFFERENT ACTIVITIES BY DISTRICTS,
HIMACHAL PRADESH, 2012-13
District
Number of CHCs having:
Citizen’s charter RKS Monitored Utilized untied Total number
RKS constituted reguiarly* fund” of CHCs
displayed
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
Himachal Pradesh
07
11
O2
O6
09
O6
04
06
05
03
09
O4
72
08
10
O2
06
09
O6
04
07
O5
O4
10
O4
75
08 07
09 09
O2 02
06 04
09 08
O6 O6
04 O4
07 06
O5 05
O4 03
10 08
O4 04
74 66
08
1 1
O2
O6
10
06
04
O7
05
O4
1 0
O4
77
*RKS monitored regularly is from number of RKS constituted.“ Including full and partial utilization.
TABLE 9.12: HUMAN RESOURCES 8. OTHER SERVICES AVAILABLE AT DISTRICT HOSPITALS BY DISTRICTS,
HIMACHAL PRADESH, 2012-13
District
Number of DHs having:
2DEcho Ultrasound Threephase Critical andcomplaint number
Pediatrician Radiographer facility
fac
ility
Suggestion Total
connection care area bo
X
of DHs
Chamba
Kangra
Lahul & Spiti
Kullu
Mandi
Hamirpur
Una
Bilaspur
Solan
Sirmaur
Shimla
Kinnaur
Himachal Pradesh
O1
O1
O0
01
S323
2323
11
01
O1
00
01
01
O1
O0
O1
0000
o_._\_\
09
O1
O0
O0
01
2323
0000
_\_._\Q
O9
O1
01
O0
01
01
01
O0
01
01
O1
00
01
10
0000
_»_\_>_\
O1
00
O1
00
0000
_~_t_\_t
00
00
O1
00
0000
_.\_»_\._~
01
O0
01
01
12 6
3232
2223
S323
12
0000
0000
0000
12
160

APPENDIX – A
LIST OF CONTRIBUTORS
Dr. B. Paswan, Professor and Head, Department of Population Policy and Programme,
Intemational Institute for Population Sciences, Govandi Station Road, Deonar,
Murnbai-400088,
Dr, H. Lhungdim, Professor, Department of Public Health and Mortality studies,
International Institute for Population Sciences, Govandi Station Road, Deonar,
Murnbai-400088.
Miss. RatiParihar, Project Coordinator, DLHS-4, International Institute for Population Sciences,
Govandi Station Road, Deonar, Mumbai-400088.
Mr.Ashish Pardhi, Project Ofﬁcer, DLHS»4, Intemational Institute for Population Sciences,
Govandi Station Road, Deonar, Mumbai-400088.
APPENDIX – B
FIELD AGENCY INVOLVED IN DATA COLLECTION OF DLHS-4 IN HIMACHAL PRADESH
DMG Consulting Pvt. Ltd. A-81, Sector-65, Noida- 201301, Uttar Pradesh, India
APPENDIX ~ C
EXTERNAL MONITORING AGENCY FOR DLHS-4 IN HIMACHAL PRADESH
Population Research Centre (PRC) Himachal Pradesh University, Summer Hill, Shimla- 171005
Himachal Pradesh, India
APPENDIX – D
AGENCY DEVELOPED CAPI SOFTWARE
Tech Mahindra Limited Satyam Infocity, Unit-12, Plot 35/36, Hi-Tech City Layout, Survey No 64,
Madhapur, Hyderabad-500081, Andhra Pradesh (Now Telangana) India
APPENDIX – E
MEMBERS OF ADMINISTRATIVE AND FINANCIAL MANAGEMENT COMMITTEE OF DLHS-4
Shri P. K. Pradhan, Spl. Secretary & Mission Director, NRHM, GOI, New Delhi, Chainnan
Smt. Madhu Bala, Former ADG (Stats), MQHFW, Govt. of India, New Delhi
Dr. Rattan Chand, Chief Director (Stats.), MoHFW, Govt. of India, New Delhi
Prof. F. Ram, Director & Senior Professor, IIPS, Mumbai
Prof. M. M. Misro, Professor, NIHFW, New Delhi
Shri Bhaskar Mishra, Deputy RGI, Ofﬁce of RGI, Govt. of India, New Delhi
Shri Rajesh Bhatia, Former Director (Stats.), MQHFW, Govt. of India, New Delhi
Shri Shailesh, Consultant EPW, MoHFW, Govt. of India, New Delhi
Dr. S. C. Agrawal, AD, MoHFW, Govt. of India, New Delhi
161

Shri K. Chandramouli,
Shri Naved Masood,
Shri P. K. Pradhan,
Smt. Madhu Bala,
Shri R. C. Sethi,
Dr. Shiv Lal,
Shri Ambrish Kumar,
Dr. Rattan Chand,
Prof. F. Ram,
Prof. Arvind Pandey,
Prof. Deoki Nandan,
Shri Bhaskar Mishra,
Shri Pravin Srivastava,
Shri V. Parameswaran,
Dr. Pavitra Mohan,
Shri Shantanu Gupta,
Shri K. D. Maiti,
Prof. M. M. Misro,
Prof. K. Kalaivani,
Shri Rajesh Bhatia,
Shri Aditya Prakash,
Dr. A. K. Harit,
Smt. K.mkum Marwah,
Dr. Paul Fancis,
Smt. Anagha Khot,
Dr. Subodh S. Gupta,
Shri Ramesh Babu,
Shri Sathyanaraynan,
Dr. S. C. Agrawal,
APPENDIX—F
MEMBER OF STEERING COMMITTEE OF DLHS-4
Fonner Secretary (H&FW), Govt. of India, New Delhi, Chairman
SS & FA, MoHFW, Govt. of India, New Delhi
S & MD, (NRHM), MoHFW, Govt. oflndia, New Delhi
Fonner ADG (Stats.), MoHFW, Govt. of India, New Delhi
Addl. RGI, Ofﬁce of RGI, Govt. oflndia, New Delhi
Former Spl. DG & Advisor (PH), DGHS, MoHFW, Govt. of India, New Delhi
Advisor (Health), Planning Commission, Govt. of India, New Delhi
Chief Director (Stats), MoHFW, Govt. oflndia, New Delhi
Director & Senior Professor, IIPS, Mumbai
Director, NIMS, ICMR, New Delhi
Director, NIHFW, New Delhi
Deputy RGI, Ofﬁce of RGI, Govt. of India, New Delhi
DDG, MoHFW, Govt. of India, New Delhi
DDG, CSO, MoS&PI, Govt. of India, New Delhi
Health Specialist, UNICEF, New Delhi
M & E Ofﬁcer, UNICEF, New Delhi
Planning, Monitoring & Evaluation Specialist, UNICEF, New Delhi
Professor, NIHFW, New Delhi
Professor, NIHFW, New Delhi
Director (Stats), MoHFW, Govt. of India, New Delhi
Statistical Advisor MoWCD, Govt. of India, New Delhi
CMO, DGHS, MoHFW, Govt. of India, New Delhi
Joint Technical Advisor, MoWCD, Govt. of India, New Delhi
WHO, New Delhi
NPO, WHO, New Delhi
NPO, WHO, New Delhi
Sr. Proframme Manager, USAID, New Delhi
Sr. NPO, UNFPA, New Delhi
AD, MoHFW, Govt. of India, New Delhi
APPENDIX – G
MEMBERS OF TECHNICAL ADVISORY COMMITTEE (TAC) OF DLHS-4
Dr. N. S. Shastry,
Smt. Madhu Bala,
Prof. F. Ram,
Prof. Arvind Pandey,
Dr. Himanshu Bhushan,
Mr. Dhananjay Gupta,
Dr. Sanjay Kumar,
Dr. Jyoti Shankar,
Ms. Sheena Chhabra,
Dr. U. C. Sud,
Shri G. C. Manna,
Prof. A. K. Sood,
Shri Bhaskar Mishra,
Ms. Pratima Gupta,
Shri Rajesh Bhatia,
Former DG & CEO, NSSO, Govt. of India, New Delhi, Chairman
Former ADG (Stats.), MoHFW, Govt. of India, New Delhi
Director Senior Professor, IIPS, Mumbai
Director, NIMS, ICMR, New Delhi
Asst Commissioner (MH), MoHFW, Govt. of India, New Delhi
UNICEF, New Delhi
National Programme Ofﬁcer (M&E) UNFPA, New Delhi
Health Advisor, DFID, New Delhi
Chief Health Systems Division, USAID, New Delhi
Director, IASRI, New Delhi
DDG (CSO), MoSPI, Govt. of India, New Delhi
Head D/O Ed. & Trg., NIHFW, New Delhi
Deputy RGI, Ofﬁce of RGI, New Delhi
Deputy Director, MoWCD, Govt. of India, New Delhi
Former Director (Stats.), MoHFW, Govt. of India, New Delhi
162

Dr. N. S. Shastry,
Smt. Madhu Bala,
Dr. Rattan Chand,
Prof. F. Ram,
Shri G. C. Manna,
Dr. U. C. Sud,
Prof. A. K. Sood,
Shri Bhaskar Mishra,
Shri Rajesh Bhatia,
Ms. P. A. Mini,
Shri C. K. Jha,
Shri Nitish Kumar,
Dr. S. C. Agrawal,
APPENDIX – H
MEMBERS OF SUB-COMMITTEE OF TAC OF DLHS—4
Former DG & CEO, NSSO, Govt. of India, New Delhi, Chainnan
Former ADG (Stats), MQHFW, Govt. oflndia, New Delhi
ChiefDirector (Stats.), MOHFW, Govt. of India, New Delhi
Director Senior Professor, IIPS, Mumbai
DDG (CSO), MOSPI, Govt. of India, New Delhi
Director, IASRI, New Delhi
Head D/O Ed. & Trg., NII-IFW, New Delhi
Deputy RGI, Ofﬁce of RG1, Govt. oflndia, New Delhi
Former Director (Stats.), MoHFW, Govt. of India, New Delhi
DRG, Ofﬁce of RGI, Govt. oflndia, New Delhi
DRG, Ofﬁce of RGI, Govt. of India, New Delhi
SRO, Ofﬁce of RGI, Govt. oflndia, New Delhi
Asst. Director, MoHFW, Govt. of India, New Delhi
APPENDIX – I
MEMBERS OF SUB-COMMITTEE ON SAMPLING OF DLHS—4
Shri G. C. Manna,
Dr. U. C. Sud,
Dr. I. P. Bhattacharjee,
Prof L. Ladu Singh,
Shri Bhaskar Mishra,
Dr. Rattan Chand,
Shri Rajesh Bhatia,
National Institute for Health & Family Welfare (NIHFW), Baba Gang Nath Marg, Mumika, New Delhi
DDG, CSO, MoSPI, New Delhi, Chairman
Director, IASRI, New Delhi
DDG, SDRD, NSSO, Kolkata
Professor & DLHS—4 Coordinator, IIPS, Mumbai
Deputy RGI, Ofﬁce of RGI, Govt. of India, New Delhi
Chief Director (Stats), MQHFW, Govt of India, New Delhi
Fonner Director (Stats), MQHFW, Govt. of India, New Delhi
APPENDIX – J
CAB COMPONENTS NODAL AGENCY OF DLHS—4
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APPENDIX-K
LIST OF THE PARTNER INSTITUTES FOR CAB COMPONENTS INVOLVED IN DLHS-4
Name ofthe Partner Institute
Sher-E Kashmir Institute of Medical Sciences
Dr. R.P. Govt. Medical College, Tanda, Himachal Pradesh
PGIMER, Chandigarh
NIHFW, New Delhi
NIOH, Ahmedabad
NIRRH, Mumbai
MGIMS, Sewagrarn
RMRC, Dibrugarh
RIMS, Imphal
NEIGRIHMS, Shillong
Government Medical College, Agartala
Gandhi Medical College, Hyderabad
NIE, Chennai
JN Medical Collage, Belgaum
Kasturba Medical College, Manglore
Thiruvananthapuram Medical College,
NICED, Kolkata
Kashmir and Ladakh Region
Jammu region and Himachal Pradesh
Punjab, Chandigarh and Haryana
Delhi
Gujarat, Daman & Diu and Dadra Nagar Haveli
Maharashtra (excluding Vidharbha) and Goa
Only Vidharbha, Maharashtra
Sikkim and Arunachal Pradesh
Manipur, Mizoram & Nagaland
Me ghalaya
Tripura
Andhra Pradesh & Telangana
Tamil Nadu, Puducherry and Andaman & Nicobar Island
Nonh Kamataka
South Kamataka
Kerala & Lakshadwcep
West Bengal
APPENDIX – L
PROCUREMENT OF CAB EQUIPMENTS FOR DLHS-4
HLL Life Care Limited, B-14, A, Sector-62, Noida
APPENDIX – M
STAFF INVOLVED IN DLHS-4
International Institute for Population Sciences, Mumbai
Coordinators
Prof. F. Ram
Prof. L. Ladu Singh
Prof. B. Paswan
Prof. S. K. Singh
Prof. H. Lhungdim
Prof. T. V. Sekher
Prof. P. K. Murthy
Prof. Chander Shekhar
Dr. Manoj Alagarajan
Project Coordinator
Dr. Gopal Singh Kshetrimayum
Dr. Akash N. Wankhede
Dr. G. P. Kumar
Health Coordinator
Dr. Mithilesh Velma
IT & Data Manager
Mr. Dnyaneshwar Kale
Mr. Prabhu Ponnusamy
Ms. Rojalin Behura
I64

Project Ofﬁcer (Ofﬁce)
Mr. L. Priyananda Singh (IT) Mr. Mahadev Digambar Bhise
Mr. Ashish Kumar Upadhya Mr. Ashish Pardhi
Mr. Imran Ahmad Mr. Junaid Khan
Mr. Mohd Usman Mr. N. Brahmanandam
Mr. Mukesh Ranj an Ms. Rati Parihar
Ms. Ragini Mishra Ms. Swati Srivastava
Mr. Santosh Bhagwanrao Phad Mr. Raj Kr. Verma
Mr: Shrikant D. Kuntla Ms. Shalini Meshram
Ms. Arpita Paul Mr. Manish Singh
Mr. P. R. A. Nair Mr. AnupamVerma
Mr. Satish Kumar Chauhan Mr. Rahul Koli
Ms. Renu Sisodia Ms. Preetam D. Gaikwad
Ms. Kakoli Brokotoky Mr. Ajil Kumar Yadav
Mr. Ankit Anand Mr. Prakash Chand D. Meher
Mr. Satish Kumar Chauhan Ms. Mamta Rajbhar
Project Ofﬁcer (Field)
Mr. Anupam Varma
ADMINISTRATIVE STAFF
Project Coordinator (Adm. & Finance)
C. A. Gurrudutt Belhekar
ACCOUNTANT CUM OFF. ASSISTANT OFFICE ASSISTANT
Ms. Sumita Bohra Ms. Namarta Thorat
Ms. Pratidnya Kasare Ms. Ranjita Nimbalkar
Mr. Jay Kavashik Davda Mrs. Remya Pradeep
Mr. Roshan D’s0uza
OFFICE ATTENDANTS
Mr. Prakash Kandera Mr. Nitin M. Dekhane
Mr. Vishal P. Patil Mr. Asif D. Kokane
Mr. Ravindra P. Gawade
165

HIMACHAL PRADE SH i

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