Neonatal Mortality (NN) Rates in Assam in comparison to some selected states of India – A study of NFHS Data Gobinda Pathak Research Investigator 2006 Population Research Centre Department of Statistics Gauhati University 1 PREFACE Neonatal mortality rate indicate the dying of children in the first month of life. Like infant mortality rates it also reflect the country’s level of socioeconomic development, quality of life. The Present study entitled “Neonatal Mortality (NN) Rate in Assam in comparison to some selected states of India – A study of NFHS Data” is one of the series of annual action plan studies to be under taken by the Population Research Centre, Gauhati University. The aim of the study is to find out the level, trend, socio-economic and demographic different in neonatal mortality rates in Assam in comparison to some selected state and Assam and the country as a whole. The present report has been prepared by Mr. Gobinda Pathak, Research Investigator of PRC, Gauhati University under the guidance of Mr. D.C. Choudhury, Dy. Director of the centre. It is hoped that the analysed information and conclusion will help the Government, policy maker and researcher in their needs. Hemanta K. Baruah Hony. Director Population Research Centre Gauhati University 2 INTRODUCTION Neonatal Mortality Rate shows the number of death of children under 4th week of month of age per thousand live births occurring in a year. Like infant and child mortality rates it also reflect a country’s level of socio-economic development and quality of life and is used for monitoring and evaluating population and health Programmes and Policies. National Family Health Survey 1 and 2 asked all ever married women age 15-49 to provide a complete history of their births- including, for each life birth, the sex, month and year of births, survival status, and age at the time of survey or age at death. Age at death is recorded in days for children dying in first month of life. The study on Neonatal Mortality in India including Assam is not more. In this study an attempt has been made to see the differences of Neonatal Mortality in Assam in comparison with India and some other selected states of India. It is hopped that the study will help the health personnel, demographers and policymakers in policy making. Objectives : The main objectives of the study are as follows : (i) to see the level and differences of Neonatal mortality among selected states of India in comparison with Assam. (ii) to see the socio-economic differences in Neonatal mortality in selected states of India and (iii) demographic differences in neonatal mortality in the selected state of India and in India as a whole. Source of data : The data used in the study have been taken from the National Family Health Survey 1 and 2. 3 Methodology : The study is a comparison of Neonatal mortality rates of Assam with selected states of India. The selected states are taken porposily from different parts of India. From the south eastern part Andra Pradesh has been taken, from the middle part Madhya Pradesh, from the western part Gujarat, from the northern part Jammu and Kashmir and the southern part of the country Tamilnadu has been taken for the study. The comparison of the states of Assam has also been considered along with the country as a whole. 4 CHAPTER-I LEVELS, TRENDS AND DIFFERENTIALS IN NEONATAL MORTALITY Table-1.1 depicts the neonatal mortality (NN) for the five years periods preceding the survey by residence in selected states of India, for NFHS-1 & NFHS-2. In urban areas, according to NFHS-1, in 0-4 years periods preceding the survey, the Neonatal mortality rates have been found highest in Assam (48.5) and lowest in Madhya Pradesh (35.0). In country as a whole this present has been found lowest (34.1) in comparison with the selected states. But in NFHS-2 this rates comes down to 36.0 in Assam. In Tamilnadu this rate comes down to lowest level 28.5 percent among the selected states. But in NFHS-2 this rate comes down to 36.0 in Assam. In Tamilnadu this rate comes down to lowest 28.5 among the selected states. In India as whole it comes down to 31.7, according to NFHS-1, for the years period 5-9 proceeding the survey this rate has also been found highest in Assam (59.6). The lowest has been found in Tamilnadu (30.4). In the country as a whole the rate has been found 36.8. In NFHS-2, this rate has been found much lower (29.5) than NFHS-1. Among the states the lowest rate has been found 25.5 in Tamilnadu and the highest has been found in Jammu & Kashmir (49.1). In the country as a whole this rate has been found slight lower than NFHS1. In NFHS-1, proceeding the survey period 10-14 years the rate of Assam has been found higher (49.5). In this period, the neonatal mortality rates has been found the highest in Madhya Pradesh (65.0) and the lowest in Tamilnadu (29.2%). In the country as a whole it is found 42.5. In NFHS-2 the neonatal mortality rate has been found the lowest in Assam (18.1) and the highest in Madhya Pradesh (71.4). In Tamilnadu also this rate of neonatal mortality has been found lower (20.7). 5 Table-1.1 Neonatal Mortality (NN) for five years period preceding the survey by Residence in selected states in India, NFHS-I & II. India/State India Assam Andhra Pradesh Madhya Pradesh Gujarat Tamilnadu Jammu & Kashmir India Assam Andhra Pradesh Madhya Pradesh Gujarat Tamilnadu Jammu & Kashmir India Assam Andhra Pradesh Madhya Pradesh Gujarat Tamilnadu Jammu & Kashmir Year Preceding the Survey 0-4 5-9 10-14 NFHS-I NFHS-II NFHS-I NFHS-II NFHS-I NFHS-II URBAN 34.1 31.7 36.8 35.1 42.5 42.1 48.5 36.0 59.6 29.5 49.5 18.1 39.7 36.6 33.9 29.7 37.0 47.9 35.0 44.0 34.6 40.0 65.0 71.4 39.3 41.6 28.6 28.5 39.0 30.4 38.2 25.5 40.7 29.2 45.5 20.7 NA 41.6 NA 49.1 NA 42.6 57.9 51.1 46.7 45.2 RURAL 62.2 59.8 56.3 30.4 65.1 66.0 58.4 38.0 47.2 46.1 54.9 56.9 63.7 60.3 57.7 57.8 66.5 70.8 66.7 74.9 43.6 48.9 46.0 38.1 55.1 54.2 47.7 42.8 59.2 59.9 65.9 44.6 NA 40.0 NA 32.8 NA 41.2 48.6 50.9 45.3 43.4 44.6 43.8 TOTAL 56.4 59.8 49.7 51.7 30.3 50.6 59.5 64.3 56.5 54.5 36.5 57.5 53.2 54.9 59.7 64.1 66.4 71.1 42.3 46.2 NA 39.6 34.8 40.3 49.9 46.5 NA 44.2 37.1 35.5 52.9 50.2 NA 58.1 36.8 41.4 In rural areas both in NFHS-1 & 2 the rate of neonatal mortality have been found higher in all selected states and India. In the years 0-4 proceeding the survey, in Assam the rate of neonatal mortality has been found 51.1. In Gujarat 6 the rate has been found lowest (43.6) and highest in Madhya Pradesh (57.7). About 58.0 have been found in India as a whole. In NFHS-2 this rate has been decreased to 45.2 in Assam. In NFHS-2 also the rates of neonatal mortality have been found highest in Madhya Pradesh (57.8) and lowest in Tamilnadu (38.1). In country as a whole this rate has come down to 11.0 in NFHS-2. In Jammu and Kashmir also this rate has been found lower. In the years 5-9 Preceding the survey, the rate of neonatal mortality in Assam is in second position (59.8) after Madhya Pradesh (66.5). In Tamilnadu and Gujarat the rate of neonatal mortality have found lower. In India as a whole the rate has also been found higher (62.2). In NFHS-2, among the selected states the rate of neonatal mortality have been found the lowest in Assam (30.4) and the highest in Madhya Pradesh (70.8). Neonatal mortality in the period has been found the lowest in Jammu & Kashmir (32.8). In Tamilnadu (42.8) and Gujarat (47.7) have also been found lower neonatal mortality. In the country as a whole the, rate comes down to about 8 in NFHS-2. In NFHS-1 during 10-14 years period preceding the survey, neonatal mortality has found second highest in Assam (66.0) just after Madhya Pradesh (66.7). In Gujarat and Tamilnadu the rates of neonatal mortality are lower than the other selected states. In India as a whole this rate is much higher (65.1). In the same period in rural areas the rate of neonatal mortality have been found lower in the NFHS-2. In NFHS-2 in the concerned period neonatal mortality rate comes down in Assam to near about fifty from NFHS-I. Highest rate has been found in Madhya Pradesh (74.9) followed by Gujarat (65.9) and Andhra Pradesh (60.3). In Jammu & Kashmir and Tamilnadu the rate have been found some extent lower. In India as a whole the rate has come down to 58.4 in NFHS-2 from 65.1 in NFHS-1. In total (NFHS-1) in the years 0-4 preceding the survey Neonatal mortality rate in Assam has been found about 51 while in Madhya Pradesh it has been found highest (53.2) and lowest in Gujarat (42.3). In India it is found 48.6. In NFHS-2 the rate of neonatal mortality in Assam has comes down to 44.6. In this period in Tamilnadu it has been found lowest 34.8 and in India as a whole it has found 43.4. In the years 5-9 preceding the survey (NFHS-1) in Assam neonatal mortality rate have been found highest (59.8) just before Madhya Pradesh (59.7). 7 In Tamilnadu Neonatal mortality rate has been found lowest (46.5) followed by Andhra Pradesh (49.7) and Gujarat (49.9). In India also neonatal mortality rate has been found higher (56.4). According to NFHS-2 in the period 5-9 years preceding the survey, neonatal mortality has been found lowest 30.3 in Assam among the selected states and highest have been found in Madhya Pradesh (64.1). In Jammu and Kashmir the rate has been found 35.5 of neonatal mortality followed Tamilnadu (37.1). In the country as whole this rate has been found 51.7. In the preceding period of survey 10-14 years (NFHS-1) Neonatal mortality rate in Assam has been found 64.3 just after highest rate of Madhya Pradesh (66.4). Tamilnadu has the lowest neonatal mortality rate (50.2) followed by Gujarat (52.9). In India as a whole neonatal mortality rate has been found much lower than Assam. In NFHS-2 the neonatal mortality rate comes down to 36.5 in Assam which is lowest rate among the selected states. Madhya Pradesh has been found highest 71.1 of neonatal mortality rate while in India as a whole it has been found 54.5. 8 CHAPTER-II SOCIO-ECONOMIC DIFFERENTIALS IN NEONATAL MORTALITY Neonatal Mortality rates for the 10 years period preceding the survey by residence have been shown in table-2.1. In urban areas (NFHS-1) Neonatal mortality rate have been found highest in Assam (54.5) and lowest in Madhya Pradesh (34.8). On the other hand in NFHS-2 the rates have been found lowest in Tamilnadu (27.0) and highest in Madhya Pradesh (41.9). In Assam the rate is 32.5 and in India as a whole it has been found 35.6. In rural areas both in NFHS-1 and NFHS-2, the Neonatal mortality rates have been found higher than urban areas. In rural areas of Assam (NFHS-1) the rate has been found 55.8. Among the selected states the rate has been found highest in Madhya Pradesh and lowest in Gujarat (49.5). In the country as a whole the rate has been found 57.7. In NFHS-2, in Assam the rate has been found 37.5 just after the lowest rates 36.1. In Jammu & Kashmir. Highest rate has been found in Madhya Pradesh (64.6) and in India as a whole the rate has been found 51.7. Table-2.1 Neonatal Mortality Rates for the 10 years period preceding the survey by residence in selected states of India, NFHS-I & NFHS-2. Residence India/States Urban Rural NFHS-I NFHS-II NFHS-I NFHS-II India 35.5 33.6 57.7 51.7 Assam 54.5 32.5 55.8 37.3 Andhra Pradesh 36.6 33.1 51.4 52.0 Madhya Pradesh 34.8 41.9 62.3 64.6 Gujarat 39.1 35.5 49.5 46.9 Tamilnadu 36.1 27.0 51.7 40.6 Jammu & Kashmir NA 45.7 NA 36.1 Table-2.2 shows the neonatal mortality rates for the 10 years period preceding the survey by mother’s education in selected states of India in NFHS-1 9 and NFHS-2. Among illiterate women (NFHS-1) neonatal mortality rate has been found 60.5 in Assam. Lowest rate has been found in Andhra Pradesh (51.6) and highest in Madhya Pradesh (63.7). In India the rate has been found 60.6. Table-2.2 Neonatal Mortality Rates for the 10 years period preceding the survey by residence in selected states of India, NFHS-I & NFHS-2. Mothers Education Illiterate Literate<Middle Middle School High School Country/ School and above and above States NFHS- NFHS- NFHS- NFHS- NFHS- NFHS- NFHS- NFHSI II I II I II I II India 60.6 44.1 38.8 38.8 37.6 29.5 25.3 22.2 Assam 60.5 37.1 50.5 30.0 40.9 43.9 33.5 47.7 Andhra 51.6 54.3 40.2 NA 45.9 32.9 24.9 40.5 Pradesh Madhya 63.7 65.3 38.5 52.1 24.7 42.7 17.5 28.5 Pradesh Gujarat 57.1 48.5 35.0 38.4 27.3 27.1 18.1 30.5 Tamilnadu 59.6 44.9 38.4 41.7 42.0 19.7 15.9 15.6 Jammu & NA 39.3 NA 44.3 NA 28.3 NA 26.9 Kashmir Among the illiterate women in selected states in NFHS-2, Neonatal mortality rate has been found lowest (37.1) in Assam, while highest in Madhya Pradesh (65.3). In the country as a whole the rate is moderate (44.1). In NFHS-1, it is found that among the literates women below middle school completed the neonatal mortality rate has been found highest in Assam (50.5) and lowest in Gujarat (35.0). In all India also the rate has been found lower (38.8) than Assam. In the same education level in NFHS-2 the neonatal mortality rate comes down to the lowest in Assam (30.0) among the selected states and highest in Madhya Pradesh (52.1). In all India the rate is found 38.8. Among the Middle school completed women in NFHS-1, neonatal mortality rate has been found lowest in Madhya Pradesh (24.7) followed by Gujarat (27.3). In Assam this rate is 40.9 and India it is 37.6. Highest neonatal mortality rate has been found in Andhra Pradesh (45.9). In NFHS-2, in Assam the rate has been found highest (43.9). The lowest rate has been found in Tamilnadu (19.7) and in India as a whole it has been found 29.5. Among the High school completed women in NFHS-1, the neonatal 10 mortality rate has been found highest in Assam (33.5) in comparison with the selected states of India. Lowest rate has been found in Tamilnadu (15.9). In NFHS-2 also the rate is found highest in Assam (47.7) and lowest in Tamilnadu (15.6). Table-2.3 Neonatal Mortality Rates for the 10 years period preceding the survey by religion in selected states of India, NFHS-I & NFHS-2. Religion India/States Hindu Muslim NFHS-I NFHS-II NFHS-I NFHS-II India 55.0 36.6 47.1 25.9 Assam 52.8 35.2 66.6 39.1 Andhra Pradesh 50.3 50.6 15.4 24.2 Madhya Pradesh 58.3 61.1 39.4 42.4 Gujarat 48.3 43.9 32.9 26.9 Tamilnadu NA 35.7 NA 32.2 Jammu & Kashmir NA 37.8 NA 37.8 Table-2.3 shows neonatal mortality rates for the 10 years period preceding the survey by religion in the selected states of India, NFHS-1 & NFHS-2. Among the Hindu (NFHS-1) the highest neonatal mortality rate has been found in Madhya Pradesh (58.3) and lowest in Gujarat (48.3). In Assam the rate has been found 52.8 but in NFHS-2 the rate comes down to the lowest 35.2 among the selected states. In NFHS-2 the rates has been found highest in Madhya Pradesh (61.1). In all India rates also sharp decline has been found in neonatal mortality rate in NFHS-2. Among the Muslims in NFHS-1 highest (66.6) neonatal mortality rate has been found in Assam which comes down from 66.6 in NFHS-1 to 39.1 in NFHS-2. In NFHS-2 also the rate of neonatal mortality rate has been found highest in Assam and lowest in Andhra Pradesh (24.2). In India this rate has come down to 25.9 (NFHS-2) from 47.1 in NFHS-1. Table-2.4 shows the neonatal mortality rates for the 10 years period preceding the survey by caste/Tribe in selected states in India. According to NFHS-1 among the schedule castes highest neonatal mortality rate (69.7) has been found in Andhra Pradesh and lowest has been found in Gujarat (37.0). In Assam it 11 is found 47.6 and in India as a whole it has been found 63.1 . In NFHS-2 the rates comes down in Assam to 32.7. But in NFHS-2 the lowest neonatal mortality rates has been found in Jammu and Kashmir (21.8). In India it comes down to 40.1 in NFHS-2. Table-2.4 Neonatal Mortality Rates for the 10 years period preceding the survey by caste/Tribe in selected states of India, NFHS-I & NFHS-2. Caste/Tribe India/ Schedule Caste Schedule Tribe OBC Others States NFHS- NFHS- NFHS- NFHS- NFHS- NFHS- NFHS- NFHSI II I II I II I II India 63.1 40.1 54.6 35.3 --50.6 29.6 Assam 47.6 32.7 58.2 32.8 ----Andhra 69.7 69.4 56.4 57.7 42.5 42.9 -35.7 Pradesh Madhya 64.0 68.2 60.2 69.4 54.0 58.0 -42.2 Pradesh Gujarat 37.0 49.1 60.7 31.1 -51.7 43.8 39.2 Tamilnadu 59.1 29.2 42.1 -NA 37.1 NA NA Jammu & -21.8 -43.3 ---39.9 Kashmir In Andhra Pradesh, among schedule castes neonatal mortality rate has been found almost same both in NFHS-1 and NFHS-2. According to NFHS-1 among the schedule tribe neonatal mortality rate has been found 58.2 in Assam while highest neonatal mortality has been found in Gujrat (60.7) and lowest in Tamilnadu (42.1) In India as a whole the rate has been found lower (54.6) than Assam. In NFHS-2, among the Tribals neonatal mortality rate has been found 32.8 in Assam while in Madhya Pradesh the rates is highest 69.4 and lowest in Gujarat (31.1). 12 CHAPTER-III DEMOGRAPHIC DIFFERENCE IN NEONATAL MORTALITY Table-3.1 shows neonatal mortality rates for the 10 years period precding the survey by sex of child in the selected states of India, NFHS-1 and NFHS-2. According to NFHS-1 male neonatal mortality rate in Assam has been found 63.0 next to highest in Madhya Pradesh (63.1). In Gujarat male neonatal mortality rate has been found lowest (47.8). Interestingly in the country as a whole this rate is 39.7 only. In NFHS-2 the rate is lowest (35.3) in Tamilnadu. In Assam this rate has been found 41.1. Highest male neonatal mortality rate has been found in Madhya Pradesh (67.3). In the country as a whole the rate has also been found higher (50.7). According to NFHS-2 in Assam female neonatal mortality rate has been found 47.9 while highest rate has been found in Madhya Pradesh (49.5) and lowest in Tamilnadu (38.9). In the country as a whole this rate is very low (31.1) in comparision with the selected states. NFHS-2 reveals that the female neonatal mortality rate in Assam is lowest (31.5) and highest in Madhya Pradesh (51.7). In India this rate has been found 44.6. Table-3.1 Neonatal Mortality Rates for the 10 years period preceding the survey by sex of child in selected states of India, NFHS-I & NFHS-2. Neonatal Mortality by Sex of child India/States Male Female NFHS-I NFHS-II NFHS-I NFHS-II India 39.7 50.7 31.1 44.6 Assam 63.0 41.1 47.9 31.2 Andhra Pradesh 54.4 45.0 40.9 50.2 Madhya Pradesh 63.1 67.3 49.5 51.7 Gujarat 47.8 46.6 44.6 37.0 Tamilnadu 53.5 35.5 38.9 36.6 Jammu & Kashmir NA 40.6 NA 34.6 13 Table-3.2 shows the neonatal mortality rate for 10 years period preceding the survey by Mothers age at birth in selected states of India, NFHS-1 and NFHS2. According to NFHS-1, at mother’s age at birth below 20 in Assam neonatal mortality rate has been found 70.5. This rate is highest in Gujarat 34.2) and lowest in Tamilnadu (50.6). In India this is lowest (48.0) than all the selected states. In NFHS-2 this rate comes down to 46.8 in Assam. In Madhya Pradesh this is highest (84.2) and lowest in Tamilnadu. In the country this rates has been found higher in NFHS-2 than NFHS-1, Mother’s age at birth in between 20-29 (NFHS1) neonatal mortality rate in Assam has been found highest (48.9) and lowest in Tamilnadu (37.3). In the country as a whole the rates is lower than the selected states. In the same age in NFHS-2 lowest neonatal mortality rate has been found in Assam (31.4) and highest in Madhya Pradesh (51.7). In the country this rate has been found medium (40.7). In the mother’s age at birth 30-29 in NFHS-1 the rate of neonatal mortality rate in Assam has been found 54.2. Highest rate has been found in Tamilnadu (66.0) and lowest rate in Gujarat (35.0), In the country the rate has been found lower (36.4). In the same age group, in NFHS-2 the neonatal mortality rate has been found 51.6 in Assam. Among the states highest rate have been found highest in Andhra Pradesh (52.3) and lowest in Gujarat (29.0). In the country the rate is 48.7. Table-3.2 Neonatal Mortality Rates for the 10 years period preceding the survey by mothers age at birth in selected states of India, NFHS-I & NFHS-2. Mother age at birth < 20 20-29 30-39 India/States NFHS-I NFHS- NFHS- NFHS-II NFHS-I NFHS-II II I India 48.0 63.1 31.4 40.7 36.4 48.7 Assam 70.5 46.8 48.4 31.4 54.2 51.6 Andhra Pradesh 63.4 52.1 34.8 42.9 55.1 52.3 Madhya Pradesh 79.1 84.2 48.2 51.7 44.6 38.0 Gujarat 84.2 62.2 37.3 37.0 35.0 29.0 Tamilnadu 50.6 43.2 41.1 33.8 66.0 35.5 Jammu & NA 49.4 NA 36.4 NA 33.3 Kashmir 14 Table-3.3 shows neonatal mortality rates for 10 years period preceding the survey by birth order in the selected states of India. According to NFHS-1 in Assam neonatal mortality rate is 71.1 in first birth order. This rates in highest in Madhya Pradesh (77.9) than the selected states. According to NFHS-2 neonatal mortality rate in 1st birth order has been found 39.4 in Assam. Highest rate has been found in Madhya Pradesh (80.4) and lowest in Tamilnadu (32.3). Neonatal Mortality rate in 2nd birth order (NFHS-1) has been found highest in Assam (53.7). In the country as a whole the rate is found much lower (31.0). Data for Gujarat, Tamilnadu and Jammu and Kashmir are not available. In the same birth order in NFHS-2 highest neonatal mortality rate has been found in Madhya Pradesh (64.4) and lowest in Jammu and Kashmir (35.6). In Assam the rate is comparatively lower (37.8). In third birth order neonatal mortality rate (NFHS-1) has been found highest in Madhya Pradesh (4.7). In Assam this rate is 44.0. In NFHS-2 this rate is found highest in Andhra Pradesh (40.8) and lowest in Tamilnadu (28.7). In Assam this rate is some extend lower (31.9). Table-3.3 Neonatal Mortality Rates for the 10 years period preceding the survey by Birth Order in selected states of India, NFHS-I & NFHS-2. Birth Order India/ 1 2 3 4 States NFHS- NFHS- NFHS- NFHS- NFHS- NFHS- NFHS- NFHSI II I II I II I II India 40.9 52.4 31.0 43.8 29.1 38.5 36.9 44.7 Assam 71.1 39.4 53.7 37.8 44.0 31.9 64.2 37.3 Andhra 66.2 48.7 40.8 35.2 31.6 40.8 -64.7 Pradesh Madhya 77.9 80.4 48.5 64.4 47.0 46.2 63.7 50.5 Pradesh Gujarat 61.5 45.0 -49.6 -37.1 41.3 33.4 Tamilnadu 47.4 32.3 -41.8 -28.7 58.8 42.2 Jammu & -42.8 -35.6 -35.3 -36.9 Kashmir 15 Table-3.4 shows the neonatal mortality rates for the 10 years preceding the survey by previous birth interval in the selected state of India. Below 24 month of birth interval (NFHS-1) neonatal mortality rate has been found highest in Madhya Pradesh (84.0) and lowest in Andhra Pradesh (52.4). In Assam this rate age has been found much higher (69.8) and in the country as whole this rate has been found much lower (45.5) in comparision with the selected states. In NFHS-2 in the same birth interval lowest neonatal mortality rate has been found in Assam (48.7) and highest in Madhya Pradesh (81.1). In between 24-47 months birth interval (NFHS-1) neonatal mortality rate has been found lowest in Gujarat (30.4) and highest in Assam (38.8). In NFHS-2 the rate has been found lowest in Gujarat (30.6) and highest in Madhya Pradesh (39.0). The rate of Assam has been found 38.8. In NFHS-2 lowest rate has found in Gujarat (30.6) and highest in Madhya Pradesh (39.0). The rate of Assam is reasonable (31.5) in comparision with the other states. Neonatal mortality rate in 48 or above 48 months birth interval (NFHS-2) has been found lowest in Jammu and Kashmir (15.7) and highest in Madhya Pradesh (37.0. In Assam the rate has been found 19.3. Table-3.4 Neonatal Mortality Rates for the 10 years period preceding the survey by previous birth internal in selected states of India, NFHS-I & NFHS-2. Previous birth internal < 24 months 24-47 months 48+ months India/States NFHS-I NFHS- NFHS- NFHS-II NFHS-I NFHS-II II I India 45.5 71.7 27.4 35.5 23.0 24.1 Assam 69.8 48.7 38.8 31.5 49.5 19.3 Andhra Pradesh 52.4 77.6 35.4 35.0 29.3 20.3 Madhya Pradesh 84.0 81.1 37.3 39.0 18.3 37.0 Gujarat 59.5 62.0 30.4 30.6 18.6 20.2 Tamilnadu 61.3 53.8 38.6 35.4 33.1 18.8 Jammu & NA 49.5 NA 34.6 NA 15.7 Kashmir Table-3.5 shows neonatal mortality rate for the 10 years preceding the survey by Medical care in selected states of India. In spite of no medical care (NFHS-2) neonatal mortality rate has been found lowest in Tamilnadu (24.0). The 16 highest rate has been found in Madhya Pradesh (72.3). In Assam also the rate is some extent lower (44.0). According to NFHS-1 neonatal mortality rate which got medical care has been found lowest in Gujarat (29.1) and highest in Madhya Pradesh (35.8). In Assam this rate is 34.3. On the other hand, in NFHS-2 highest neonatal mortality rate has been found in Assam (44.1) and lowest in Andhra Pradesh (14.1). Table-3.5 Neonatal Mortality Rates for the 10 years period preceding the survey by medical care in selected states of India, NFHS-I & NFHS-2. Medical Care India/States No care One or two types of care NFHS-I NFHS-II NFHS-I NFHS-II India 57.5 53.6 29.8 35.8 Assam 63.4 44.0 34.3 44.1 Andhra Pradesh 59.3 49.0 32.6 14.1 Madhya Pradesh 60.9 72.3 35.8 42.5 Gujarat 51.3 41.9 29.1 21.9 Tamilnadu 98.6 24.0 35.6 30.7 Jammu & Kashmir NA NA NA NA 17 CHAPTER-IV CONCLUSION Chapter IV gives the conclusion on the result of the analysis. The chapter shows that the difference of neonatal mortality level are not inform. There vast differences are found among the selected stated in comparision with Assam. In 0-4 years preceding the survey of NFHS-1 neonatal mortality rate in urban areas of Assam has been found highest in comparison with the other selected states and India as whole. It has come down to 36 in NFHS-2. In the developed states like Tamilnadu and Gujarat the rates have been found much lower. In rural areas of Assam both in NFHS-1 and NFHS-2 the rates are also found much higher. In total also the rates are found higher in Assam In urban areas in Assam the rate has been found much higher in NFHS-1 than NFHS-2. The rate come down to 33 from 54.5 in NFHS-1. In rural area also the rate have been found higher in NFHS-1 than NFHS-2. Among the illiterate women in NFHS-1 the neonatal market rates have been found much higher than other selected states except Andhra Pradesh. In NFHS-2 the rate come down to in Assam 37.1, the lowest rate among the selected states and India as a whole. Among the literate<middle school, in NFHS-2 the neonatal mortality rates have been found lowest (30.0) In been middle school completed and high school and above, the rate of neonatal mortality rates have been found higher in NFHS-2 than NFHS-2. In Tamilnadu the rates in both NFHS-1 and NFHS-2 have found lower than other selected states of India. Among the Hindus in NFHS-1 the neonatal mortality rates has been found comparatively lower in Assam than others states and the rate is lowest in Assam in NFHS-2. Among the Muslims in the NFHS-1 the neonatal mortality rate has been found highest in Assam (66.6) and lowest has been found in Andhra Pradesh (15.0). In NFHS-2 in respect of Assam the rate has come down sharply to 39.1. But among the selected states the rate is highest in Madhya Pradesh (NFHS-2). 18 In respect of schedule castes neonatal mortality rate has been found some extent lower in Assam than other selected status. In NFHS-2 it rate has been found much lower in Assam (32.7). Among the schedule Tribes in Assam (NFHS1) the rate are has been found moderate than other states like Madhya Pradesh and Gujarat. Female neonatal mortality rates have been found lower than male both in NFHS-1 and NFHS-2. Male neonatal mortality rate has been found higher NFHS1 in Assam in comparison with the other slates, Of course the rate has come down to 41.1 in NFHS-2, In Assam female mortality rate has also been found higher. In NFHS-2, it come down to 31.8. Among the women’s age below 20 years and above 30 years the neonatal mortality rate have been found higher. Both in NFHS-1 and NFHS-2 neonatal mortality rate have been found lower in between 20-29 years of mother’s age at birth. Neonatal mortality in 1st birth order have been found higher while in 2nd birth order it has been found lower. In Assam (NFHS-1) as well as in Andhra Pradesh, Madhya Pradesh and Gujarat the neonatal mortality have been found much higher in 1st birth order. In NFHS-2 the rate has found some extent lower. Medical care has as important role in the neonatal mortality. In NFHS-1, in all the selected state the rates of neonatal mortality without medical care have been found higher. It has comes down in all the status in NFHS-2. In Assam neonatal mortality rate without medical care (NFHS-1) has been found highest (63.4) but comes down in NFHS-2 to 44.0. From the study it may come to conclusion that the neonatal mortality rate is moderate in Assam, lowest in Tamilnadu, Andhra Pradesh and Gujarat and highest in Madhya Pradesh Jammu and Kashmir. The variation among the states have been found depending the variation of socio economic development of the concerned selected states. ***** 19
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