UP_PSMS2Report_Complete_June200600014 by keralaguest

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									                                                                                                                                                        Health



  Figure 4.5: Percentage of Reporting Fever                      by income or social group. Table 4.12 reports the
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                                                                 breakdown of self-reported symptoms for
                                                                 consulting a doctor/quack or any health service.
 50
                                                                 More than half of the persons visiting a health
 40                                                              facility reported doing so because of fever. Clearly,
                                                                 fever could be indicative of a variety of ailments,
 30
                                                                 ranging from a minor infection to major health
 20                                                              problems. Other reasons reported for seeking health
                                                                 care included stomachache, diarrhea, cough and
 10
                                                                 injury. There appeared to be no marked differences
  0
        UP         Rural    Urban   Poor     Middle       Rich
                                                                 among rural and urban areas in most regards, except
      overall                                                    that the share of the population reporting a
                Residence                  Income level
                                                                 consultation for the reasons of delivery, antenatal/
                                                                 postnatal services and health check-up in urban areas
Considering all institutional deliveries as safe along with      was twice that in rural areas. The propensity to report
deliveries at home by trained personnel, the extent of           a fever or diarrhea fell with the respondents’ income
safe deliveries was analyzed (Table 4.8). In UP, the             level.
prevalence of safe deliveries was estimated to be 78.7
                                                                 Those who reported seeking health care for their
percent (90 percent urban, 77 percent rural). The gap
                                                                 illness were also asked about whom they consulted
between the rich and poor was found to be about 8
                                                                 (i.e., the type of consultation) for treatment. Their
percent. Similarly, SC/ST women reported a lower
                                                                 responses have been regrouped as: government,
incidence of safe deliveries (66.7 percent) as compared
                                                                 private, risky (private informal) and others (Table
to the OBC and general population (80.3 percent and
                                                                 4.13). The government and private consultation
88.5 percent respectively).
                                                                 type include trained doctors in the health facilities
The use of family planning in UP is generally low.               run by public and private sectors respectively. The
Only a third of all eligible couples in rural UP use             risky group of consultation type includes faith
any family planning method, and the poor are even                healers and untrained practitioners/quacks.
less likely to utilize a method than the wealthy (Table          Government type consultation was taken by 10.3
4.9). Among couples who do use family planning,                  percent (9.6 rural, 13.5 percent urban). About 40
female sterilization is still the most common method.
Other modern methods such as the oral pill and                            Figure 4.6: Proportion Consulting
condom/nirodh are used by only 14 percent of the                        Government Health Facility/Doctor by
family planning users in the poorest 20 percent of                                  Income Level
the population, and by 25 percent of all users among              16
the wealthiest 20 percent (Table 4.10). The most
                                                                  14
common non-modern method is periodic
                                                                  12
abstinence.
                                                                  10

4.4 Morbidity                                                       8

                                                                    6
A question on morbidity was asked in the PSMS-II
                                                                    4
with reference to the last 15 days preceding the
                                                                    2
interview. Overall, about 10.6 percent of the
                                                                    0
population reported experiencing some illness during
                                                                         UP overall

                                                                                       Rural area

                                                                                                    Urban area



                                                                                                                 Poor

                                                                                                                          Middle

                                                                                                                                   Rich




                                                                                                                                          SC/ST

                                                                                                                                                  OBC

                                                                                                                                                          General




this period (Table 4.11). The incidence of self-
reported illness in UP did not appear to vary much                                    UP overall                        Rural areas        Urban areas




                                                                                                                                                            39
  Directorate of Economics and Statistics, Uttar Pradesh and World Bank



percent reported consulting private health                                  reasons were cough (13.2 percent) and stomachache
services for treatment in the last 15 days. In urban                        (11.3 percent), for which no consultation was sought
areas about 61 percent relied on private health                             (Table 4.15).
services compared to 35 percent in rural areas.
The risky type consultation was more prevalent                              To get an indication of loss of man-days due to
in rural areas (50.2 percent) though a sizeable                             reported illness, the PSMS-II included a question
percentage (20.2 percent) was also found in urban                           on the number of days a person was unable to
areas. When looking at the income levels and                                function normally. One-third reported that despite
consultation type it was found that in both rural                           the illness there was not a single day when they
and urban areas, poor were less likely to go to a                           abstained from normal working, while an equal
government-type consultation compared to other                              proportion reported a loss of 3 to 7 days during the
income classes. In this regard, the gap between                             prior 15 days (Table 4.16). About one-sixth of the
rich and poor was almost double in rural areas                              persons reported a loss of 8 to 15 days, while 19
(4.8 percent) compared to urban areas (2.5                                  percent reported a loss of up to 2 days. About 7
percent). The private type consultation had                                 percent more persons in urban areas reported ‘no
increasing trends with the income levels for                                loss’ as compared to their rural counterparts. The
overall UP, rural areas and urban areas. The risky                          propensity to report 7 to 15 days grew with the
consultation remained more or less static for the                           increase in income level.
poor and middle income levels, but then declined
among the rich.                                                             4.5 Anganwadi Attendance
                                                                            Anganwadi centers have been established across
About 1 percent of the persons who reported some
                                                                            India for the welfare of children aged 0–6 years, in
illness or other but did not consult for their illness
                                                                            particular to improve nutritional status, for regular
were asked to describe the reasons why they did not
                                                                            health check-ups, immunization awareness and
consult (Table 4.14) and the symptoms of the illness.
                                                                            preschool education. The two PSMS rounds
About 79 percent reported three main reasons,
                                                                            included questions on awareness and current
namely: ‘problem not serious’, ‘resorted to home
                                                                            attendance of these centers. The specific question
remedy’ and ‘repeated old prescription’, reported by
                                                                            ‘does an Anganwadi exist within your village/block’
73, 77 and 85 percent, respectively, by poor, middle
                                                                            was asked to those households who had at least one
and rich income levels. Going by symptoms, about
                                                                            child of age 0–6. About 18 percent of households
one-third reported fever with decreasing propensity
                                                                            had no idea about the existence of an Anganwadi in
by income levels. About 30 percent reported other
                                                                            their village/block (Table 4.17). Among the rest, an
symptoms of the illness. Among other prominent
                                                                            equal proportion of households reported having and
                                                                            not having an Anganwadi in their village/bock.
       Figure 4.7: Proportion of Persons by                                 Awareness levels were found to be higher in rural
       Number of Days Unable to Function                                    areas, and among relatively better-off households
                     Normally
                                                                            as well as in the SC/ST group.
               14.6%                                                        The two PSMS rounds corroborate great success in
                                                                    33.2%
                                                                            improving Anganwadi attendance: whilst almost
                                                                            negligible in Round I, attendance rose to 9.8 percent
                                                                            in Round II. Moreover, the program appeared to be
 33.1%
                                                                            well-targeted towards the state’s poor and socially
                                                                  4.9%      disadvantaged groups [attendance of 11.4 percent
                                              14.1%
                                                                            for the poor vs. 7.4 percent for the rich; 3 percent
   None     One        Two   Three to seven           Eight to fifteen
                                                                            more SC/ST children attended the Anganwadi

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                                                                                                              Health



          Figure 4.8: Prevalence of Disability by District of Uttar Pradesh (Census 2001)

                                                                                        Rural Female
                                Rural Male
                                   Legend                                                  Legend
                                   under 2.00 %                                            under 2.00 %
                                   2.00 to 2.49 %                                          2.00 to 2.49 %
                                   2.50 or more                                            2.50 or more




                               Urban Male                                                Urban Female
                                   Legend                                                    Legend
                                   under 2.00 %                                              under 2.00 %
                                   2.00 to 2.49 %                                            2.00 to 2.49 %
                                   2.50 or more                                              2.50 or more




compared to other social groups (Table 4.18)]. The        there appears to be fairly close agreement between
survey also gathered specific information on              these two estimates of prevalence for ‘speech and
nutritional supplements received by children. More        hearing’ and ‘mental’ disability types, while the
than three-quarters of the children attending the         variation in visual and locomotor disabilities may be
Anganwadi reported receiving the food supplement          due to definitional and operational differences. The
‘always’, followed by 17.8 percent who got it             prevalence of disability was found to be 20.8 and
‘sometimes’, whilst only 4.9 percent reported ‘never’     13.2 per thousand, as per census 2001 and the NSS
receiving it (Table 4.19).                                58 round respectively. In both cases males had higher
                                                          prevalence compared to females. Table 4.22 presents
4.6 Disability                                            number of districts by prevalence categories. More
The persistence and prevalence of disability is an        than half the districts had prevalence levels below 2
important factor affecting the overall health status      percent, followed by 18 and 16 districts with
of the population. In the 2001 Population Census,         prevalence 2–2.49 percent and 2.5 percent and above.
questions on disability status were asked of              About three quarters of the districts reported a male
respondents, and the results of these are available at    prevalence of disability of 2 percent and above.
the district level (see figure 4.8). The NSS 58th round
also inquired about purpose schedule during July–
December 2002. Table 4.21 presents prevalence of
disability per 1000 population by disability type for
Census 2001 and the NSS 58th round. In general

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