CSO-M-POPU.

2-2010

MANUAL
ON
VITAL STATISTICS July, 2010

Government of India
Ministry of Statistics and Programme Implementation
Central Statistics Office
Sansad Marg, New Delhi
www.mospi.gov.in
 TABLE OF CONTENTS

SL.NO. TOPIC PAGE

I VITAL STATISTICS 1-7
II CIVIL REGISTRATION SYSTEM AND HISTORY 8-12
OF CIVIL REGISTRATION IN INDIA
III LEGAL FRAMEWORK FOR CIVIL 13-25
REGISTRATION
IV SAMPLE REGISTRATION SYSTEM 26-36
V VITAL STATISTICS FROM NATIONAL FAMILY 37-53
HEALTH SURVEYS
ANNEXURE 1-9 54-87
1 THE REGISTRATION OF BIRTHS AND DEATHS ACT, 1969 55
2 MODEL REGISTRATION ON BIRTHS AND DEATHS RULES, 63
1999
3 DATES OF ENFORCEMENT OF THE RBD ACT, 1969 67
4 CIVIL REGISTRATION HIERARCHY IN STATES AND UNION 68
TERRITORIES
5 LEVEL OF REGISTRATION OF BIRTHS AND DEATHS,:2001- 75
2007
6 TABLES AND STATEMENTS PRESENTED IN SRS REPORTS 78
7 KEY INDICATORS-NATIONAL FAMILY HEALTH SURVEY 80
8 KEY INDICATORS BROUGHT OUT BY DISTRICT LEVEL 82
HOUSEHOLD SURVEY UNDER RCH PROGRAMME
 I - VITAL STATISTICS

Definition of a Vital statistics System and Sources of data

1.1 A vital statistics system is defined as the total process of 1

(a) collecting information by civil registration or enumeration on the frequency of occurrence of

specified and defined vital events, as well as relevant characteristics of the events themselves and
of the person or persons concerned, and

(b) Compiling, processing, analyzing, evaluating, presenting and disseminating these data in
statistical form. The vital events of interest are: live births, adoptions, legitimations, recognitions;
deaths and foetal deaths; and marriages, divorces, separations and annulments of marriage

1.2 The main source of vital statistics is records of vital events from civil registration, which
involves the continuous gathering of information on all relevant vital events occurring within the
boundaries of a country. For the calculation of vital rates, civil registration data are usually
complemented by census information, which also has national coverage. However, when civil
registration data either do not exist or are deficient, countries have taken recourse to data
sources other than civil registration to estimate the necessary vital statistics. The use of
complementary data sources has also been made to enrich and evaluate civil registration data or
to gather information on demographic or epidemiological processes in a way that enriches the
information obtained through civil registration.

1.3 Additional sources in a vital statistics system include specific questions on fertility and
mortality added to population censuses, household sample surveys, vital records from sample
registration and health records. For some countries, the uses of these sources of data together
with the application of indirect techniques of demographic estimation have been supplying some
of the statistical indicators needed for planning purposes, mainly at the national level. But there is
no substitute for the availability of continuous information on vital events as obtained from
registration of vital events in civil registration Accuracy, timeliness and completeness are essential
elements that countries should strive to attain in their systems. Allowance is made, as
appropriate, for the use of other sources of complementary or alternative data.

1.4 The important sources of vital statistics in India are (1) Population Census (2) Civil
Registration System;(3) Demographic Sample Surveys such as those conducted by the National
Sample Surveys Organization(NSSO); (4)Sample Registration System (SRS) and (5) Health Surveys,
such as National Family Health Surveys, (NFHS) and District Level Household Surveys (DLHS-RCH )
conducted for assessing progress under the Reproductive and Child Health programme. A
separate manual on Population Census is uploaded in MOSPI website. This manual deals with
Vital Statistics from other sources.

1
U.N., Department of Economic and Social Affairs, Statistics Division- “Principles and Recommendations
for a Vital statistics system, revision 2” ST/ESA/STAT/Series. M/19 /Rev 2
1
Civil Registration System

1.5 According to the United Nations, civil registration is defined as the continuous permanent
and compulsory recording of the occurrence of vital events, like, live births, deaths, foetal deaths,
marriages, divorces as well as annulments, judicial separation, adoptions, legitimations and
recognitions. Civil registration is performed under a law, decree or regulation so as to provide a
legal basis to the records and certificates made from the system, which has got several civil uses
in the personal life of individual citizens. Moreover, the information collected through the
registration process provides very useful and important vital statistics also on a continuous basis
at the national level starting from the smallest administrative unit. In fact, obtaining detailed vital
statistics on a regular basis is one of the major functions of the Civil Registration System (CRS) in
several countries of the world. Vital records obtained under CRS have got administrative uses in
designing and implementing public health programmes and carrying out social, demographic and
historical research. For an individual, the birth registration records provide legal proof of identity
and civil status, age, nationality, dependency status etc., on which depend a wide variety of
rights.

1.6 The office of the Registrar General of India was created in 1951 and the vital statistics
department was transferred to this office from the Director of Health Services in 1960. On the
deliberations and recommendations of various committees, the Registration of Births and Deaths
Act (1969) was enacted by Parliament to enforce uniform civil registration throughout the
country.

National Sample Survey

1.7 Data on fertility and mortality from the census are not very reliable and they are also
available only once in ten years. In the absence of reliable data from the civil registration system
(CRS), the need for reliable vital statistics at national and state levels is being met through sample
surveys launched from time to time. In the 1950’s and 1960’s, the National Sample Survey
attempted to provide reliable estimates of birth and death rates through its regular rounds.
However, the release of 1961 census data indicated that the birth rates and death rates and
consequently, the growth rates were often not estimated correctly. Many analysts, at that point
of time, felt that the one time retrospective recall surveys such as National Sample survey may
not be able to estimate the vital rates correctly. This resulted in a search for alternative
mechanism estimate vital rates. The sample registration system (SRS) was one such attempt.

Sample Registration System (SRS)

1.8 The Government of India, in the late 1960s, initiated the Sample Registration System that
is based on a Dual Recording System. In the Sample Registration System, there is a continuous
enumeration of births and deaths in a sample of villages/urban blocks by a resident part-time
enumerator and then, an independent six monthly retrospective survey by a full time supervisor.
The data obtained through these two sources are matched. The unmatched and partially matched
events are re-verified in the field to get the correct number of events. At present, the Sample
Registration System (SRS) provides reliable annual data on fertility and mortality at the state and
national levels for rural and urban areas separately. In this survey, the sample units, villages in
rural areas and urban blocks in urban areas are replaced once in ten years.

2
Health Surveys (NFHS, DLHS and AHS)

1.9 In the past about a decade or so, a few important sources for demographic data have
emerged. These are the National Family Health Surveys (NFHS) and the District Level Household
Surveys (DLHS) conducted for the evaluation of reproductive and child Health programmes. Three
rounds of NFHS surveys have since been completed. These provide estimates inter-alia of fertility,
child mortality and a number of health parameters relating to infants and children at state level.
They also provide information on the availability of health and family planning services to
pregnant mothers and other women in reproductive ages. The DLHS provide information at the
district level on a number of indicators relating to child health, reproductive health problems and
the quality of services available to them. Three rounds of DLHS surveys have been conducted so
far. In each of the first two rounds, the survey was conducted in two phases spread over two
years, wherein, under each phase of the survey, half of the districts in a state had been covered.
However, in the third round of the DLHS survey (2007-08), all the districts were covered in one
phase.

1.10 The concept of the Annual Health Survey (AHS) arose during a meeting of the National
Commission of Population held on 23rd July, 2005 under the Chairmanship of the Prime Minister,
wherein it was decided that “there should be an Annual Health Survey (AHS) of all districts, which
could be published/monitored and compared against bench marks”. This was followed up by
meetings with the Planning Commission and it was decided that Ministry of Health & Family
Welfare (MOHFW) would initiate follow up action for implementation of this decision. The Annual
Health Survey (AHS) aims to prepare District Health Profile of the 284 districts in the erstwhile
EAG States and Assam on an annual basis. The survey will be done through the Registrar General
of India Ministry of Home Affairs. The survey has since been launched in April 2010.

Use of Vital Records

1.11 Some common uses of vital records in vital statistics are:

(i) Preparing population estimates and projections;

(ii) In Cohort and period studies;
(iii) Construction of life tables;
(iv) Preparing health indicators, such as infant mortality rates, neonatal mortality rates,
post-neonatal mortality rates, maternal mortality rates, etc.;
(v) Starting points in retrospective epidemiological studies;
(vi) Public health programmes in the absence of morbidity data, or for health
education;
(vii) Maternal and child health services for planning and evaluation;
Fertility data in family planning.

Definition of Vital Events

1.12 Not all countries publish statistics on all 10 vital events recommended by the United
Nations. Some countries do not have the need to register all 10 events, and some do not have the
capacity to register or to publish them. As a country develops a civil registration system to
support the vital statistics system, it may follow a recommended priority of vital events in
3
organizing the registration system. In India, the civil registration system mandates registration of
births, deaths and still births. The standard international definition of these as events and the
definitions followed in India are given below.

Live Birth:

1.13 Live Birth is the complete expulsion or extraction from its mother of a product of
conception, irrespective of the duration of pregnancy, which after such separation, breathes or
shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or
definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the
placenta is attached; each product of such a birth is considered live-born (all live born infants
should be registered and counted as such, irrespective of gestational age or whether alive or dead
at time of registration, and if they die at any time following birth they should also be registered
and counted as deaths).

Death:

1.14 Death is the permanent disappearance of all evidence of life at any time after live birth
has taken place (post-natal cessation of vital functions without capability of resuscitation) (this
definition excludes foetal deaths, which are separately defined below).

Foetal Death

1.15 Foetal Death is death prior to the complete expulsion or extraction from its mother of a
product of conception, irrespective of the duration of pregnancy; the death is indicated by the
fact that after such separation, the foetus does not breathe or show any other evidence of life,
such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary
muscles (note that this definition broadly includes all terminations of pregnancy other than live
births, as defined above)

Evolution of Vital Registration System in India

1.16 A number of commissions and committees had stressed the importance of Vital Statistics.
The importance of vital statistics in the study of manpower and health conditions was
recognized in the reports of the Royal Commission on Agriculture (1924) and Royal Commission
on Labour (1938). The royal commission on agriculture observed

(i) that the problems involved in securing uniformity in the returns from the
different provinces were serious;

(ii) that the information though existed in numerous reports, is not collected in
a systematic form,

1.17 The Royal Commission on Labour went in to the statistics of cause of death for industrial
workers and found that the data supplied were inadequate. It recommended appointment of
medical registrars in large industrial towns.

4
 “It is essential, however, that municipal council and local bodies, who are primarily
responsible for registration should devote much more attention to the matter. In larger towns and
more important industrial areas, at least, the appointment of Medical Registrars should be
compulsory since only then will it be possible to improve the classification of causes of death. This
has already been done in certain areas and, as a result, special investigations which were
previously impossible have been successfully carried out".

1.18 In 1939, the Central Advisory Board of Health, which met in Madras (currently Chennai)
strongly recommended the compulsory registration of vital events, with provisions for strict
enforcement, establishment of Bureau of Vital Statistics for each province, appointment of
Medical Registrar for medical certification of cause of death, training of Registrars and several
other measures for improvement of vital statistics. But no significant development in the
registration system took place until about the middle of this century.

1.19 The Health Survey and Development Committee or Bhore Committee, as it was called
after its Chairman, was constituted in 1946. This Committee made an extensive survey of the
problem of public health in India and put forward several useful and noteworthy
recommendations: An important recommendation of this committee is reproduced below.
"In the areas in which our scheme will be introduced, registration of vital statistics should be
made compulsory along with the introduction of the scheme, wherever such provision does not
already exist'. In other areas compulsion should be introduced gradually. The enforcement of the
law through the prosecution of offenders is essential if definite improvement is to be secured”

“We recommend the appointment of an officer with the title of Registrar General of Vital
and Population Statistics. He will be attached to the Central Ministry of Health and will be
responsible for collection, compilation, study and publication of vital statistics from all parts of the
country, for carrying out of the census at periodical intervals and for continuous population
studies. He will work independently of the Central Health Department but in close co-operation
with it. He should publish an annual report on the population of India incorporating such
information as is available regarding existing conditions and possible tendencies for the future".

1.20 In 1948, the second Health Ministers’ Conference appointed a vital statistics committee.
This committee endorsed Bhore committee‘s recommendation.

"It is essential that there should be provision for enforcing uniformity throughout India in
the collection and compilation of the main items of information included in the vital statistics of
the country. Such enforcement will become possible only if the Centre has the power to prescribe
for regulating the registration and compilation of vital statistics in the component units of the
federation of India. It is recommended that such provision as may be necessary to achieve this end
should be incorporated in Constitution of the country. Individual Governments will be at liberty to
prescribe for the territories the collection of such other information as may be deemed necessary
to suit their purposes. The enactment of an Indian Vital Statistics Act as a piece of Central
Legislation should be undertaken as soon as circumstances permit’'.

1.21 Based on the recommendation of these two committees, the office of the Registrar
General India was created in 1951. Further, vital statistics, including civil registration was
included in the concurrent list.

5
1.22 In the 1950’s, 3 committees made recommendations which affected the civil registration
in India. These were the Central Expert Committee of the Indian Council of Medical Research and
Expert Committees of the States on Cholera and Small Pox and Manickavelu Committee of the
Central Council of Health (1960). The former recommended

(i) Legislation for compulsory registration of vital events,

(ii) appointment of the secretaries of gram Panchayat as Registrars and
(iii) Production of birth certificates for admission in schools and various other measures for
improvement in registration

The latter added the following recommendations

(i) The setting up of statistical units in state headquarters and in large municipalities and
municipal corporations and
(ii) Provision of statistical staff at the district level and in the primary health centers for the
work relating to health and vital statistics and
(iii) Centralized mechanical tabulation and provision of training facilities for statistical
personnel on a uniform basis.

1.23 In 1960, Vital statistics was transferred to the office of the Registrar General, India from
the Director General of Health services. Thus, population census and vital statistics, including civil
registration, came under one office, the office of the Registrar Central and Census Commissioner
of India.

1.24 A conference of State representatives, called “Conference on Improvement of Vital

Statistics” was convened in April 1961 to take stock of the registration system prevalent in various
parts of the country. This conference made specific recommendations over a wide range of topics
for the reorganization and strengthening of the vital statistics system in the country. The
conference recommended an early enactment of a Central law on compulsory registration of
births and deaths and spelt out in detail the scope and content of the proposed legislation. It
recommended adoption of a minimum tabulation plan, centralized tabulation, strengthening of
the vital and health statistical units at the state headquarters, appointment of Registrars and staff
at the district level, strengthening of statistical units in municipalities, imparting training to
Registrars and other officials concerned with registration and compilation of vital statistics,
educational programme for sensitizing the public on the importance of vital statistics and various
other matters.

1.25 Based on the recommendations of these conferences, the office of the Registrar General,
India (RGI) initiated a number of steps to improve vital statistics in India. As a first step a team of
experts in vital statistics, Dr. Forest E. Linder and Dr. Conrad Tuber of the National Centre of
Health Statistics, U.S. Government and U.S. Bureau of Census visited India and recommended
short term and long term measures to improve vital statistics. Their recommendations, with
suitable modifications, were submitted as plan proposals to the planning commission. These were
sanctioned as “Plan scheme for improvement of vital statistics” in the middle of third five year
plan. The main operational components of the scheme were as per the recommendations of the
Manickavelu committee referred to above. These were

(i) Strengthening of the Vital Statistics Organisation at the office of Registrar General, India

6
 (ii) Strengthening of statistical units in municipalities with full-time office staff for purposes
of supervision and compilation of registration data of the municipal area
(iii) Setting up of mechanical tabulation units at state headquarters for centralized
tabulation of data to cut down the intermediate levels for compilation of registration
data and thereby, minimize the deficiencies resulting from transcription errors and
delays in transmission of returns. The scheme envisaged supply of mechanical data
processing equipment such as 40 column range mechanical punches, verifiers,
reproducers, and sorters with full counting arrangement and tabulators, by the
Registrar General, India
(iv) Training in registration promotion, methods and research , and
(v) Organising training programmes for officers employed all along the line, from the
periphery to the headquarters

1.26 During Third, Fourth, Tenth and Eleventh Five Year Plans, some staff was provided at State
Headquarters, districts and large municipalities for work connected with the improvement of
registration of births and deaths and vital statistics.

7
II. CIVIL REGISTRATION SYSTEM AND HISTORY OF CIVIL REGISTRATION IN INDIA

International Resolutions on recording live birth

2.1 The United Nations, in a number of ways, has officially endorsed the protective value of
live birth records. The Universal Declaration of Human Rights (General Assembly resolution 217 A
(III)), adopted in 1948, proclaimed in article 15 that (a) everyone has the right to a nationality, and
(b) no one shall be arbitrarily deprived of his nationality or denied the right to change it. The basic
right to a nationality provided by the Declaration depends on having one’s birth legally recorded.
This was reinforced by the adoption in November 1959 of the Declaration of the Rights of the
Child (General Assembly resolution 1386 (XIV)), in which the Assembly affirmed, in principle that
“The child shall be entitled from his birth to a name and a nationality”. The International
Covenant on Civil and Political Rights, in article 24, states that “Every child shall be registered
immediately after birth and shall have a name”. (see General Assembly resolution 2200 A (XXI),
annex I, December 1996). This principle was further reinforced and emphasized, especially in
reference to the need for greater attention to the accurate and timely registration of female
infants and the dissemination of statistics, in the recommendations of the World Summit on
Children, the International Conference on Population and Development and the Fourth
Conference on Women.

2.2 Civil registration is a major foundation for a legal system for establishing the rights and
privileges of individuals in the country. Where it is comprehensively maintained, it is the main
source of vital statistics and the focus is on the collection, compilation and dissemination of vital
statistics.

2.3 Civil registration is the continuous, permanent, compulsory and universal recording of the
occurrence and characteristics of events, including vital events, pertaining to the population, as
provided by decree or regulation, in accordance with the legal requirements of a country. Civil
Registration is carried out primarily for the purpose of establishing the legal documents provided
for by law. These records are also the best source of vital statistics.

2.4 Even though civil registration includes all vital events (live birth, deaths, foetal death,
marriage, divorce, annulment, judicial separation of marriage, adoption, legitimation and
recognition), the vital events which comprise a vital statistics system are live births, deaths, foetal
deaths, marriages and divorces. In establishing or improving a vital statistics system, first priority
should be given to setting up procedures for the registration of (a) live births and (b) deaths,
followed closely by (c) foetal deaths, because it is these events that are basic to the measurement
of population growth rates and directly related to the measurement of key health indicators, such
as infant and childhood mortality and life expectancy. The increasing importance given to the
registration of foetal deaths is in recognition of their importance in measuring perinatal mortality
and pregnancy outcomes. In addition, it is recognized that, due to specific family patterns and
cultural values, it may not be feasible, in some countries, to give a very high priority to the
collection of data on marriage and divorce.

8
2.5 A system2 of civil registration includes all institutional, legal and technical settings needed
to perform the civil registration functions in a technically sound, coordinated and standardized
manner throughout the country, taking into account cultural and social circumstances particular
to the country.

2.6 The civil registration method is the procedure employed to gather the basic observations
on the incidence of vital events and their characteristics which occur to the population of a
country within a specified time period and upon which vital records with legal value are prepared
and vital statistics are based. This method should be distinguished from other methods that
gather data about the population. The civil registration method is distinguished from the
enumeration method and the administrative method by the fact that it is continuous and
permanent. It records data on every vital event as it occurs and it does so with no lapses in the
time period of collection. The enumeration method is the procedure used to gather information
through population or other census or survey statistics. Enumeration employs a snapshot
approach that gathers data on the population at a particular moment in time. It is often periodic,
such as a decennial census. The administrative method produces population data as a by-product
of various management controls. For example, automobile accident statistics may be produced as
a by-product of Department of Transportation data. The tax system may produce income data as
a byproduct of its control system.

Uses of civil registration

2.7 Civil registration has a dual purpose − legal on the one hand, and statistical, demographic
and epidemiological on the other. In the first purpose, the records generated have importance as
legal records documenting the facts surrounding each registered vital event. In that sense, each
vital record has an intrinsic importance of its own. For the second purpose , the records may be
aggregated to form a body of vital statistics which, collectively, convey important information
about the persons described in the statistics in summary form Those two purposes reinforce each
other in a number of ways, but it is important to maintain their distinctiveness in discussing the
uses and operation of civil registration.

Uses of civil registration records for administrative purposes

2.8 Live birth records are the basis for many public health programmes for post-natal care of
mother and child, and may be used, when needed, for programmes of vaccination and
immunization, premature-baby care, assistance to disabled persons. Death records are used to
provide legal permission for burial or disposal of deceased individuals. They can also provide
information of epidemiological importance, and indicate the need for preventive control
measures. Death records are also necessary to clear a number of administrative files, such as
disease-case registers, population registers, social security files, military service files, electoral
rolls, identity files and tax registers.

2
U.N., Department of Economic and Social Affairs, Statistics Division- “Handbook on training in Civil
Registration and Vital Statistics Systems” ST/ESA/STAT/Series. F/84

9
Uses of civil registration records for Individuals

2.9 For the individual, the birth registration records provide legal proof of identity and civil
status, age, nationality, dependency status etc., on which depend a wide variety of rights. The
birth registration record may be required for establishing:

(i) Identity and family relationships for settling inheritance or insurance claims and
arranging transfer of property.

(ii) Proof of age for admission in schools, entry into services and professions, obtaining a
driving license, exercising voting rights, entering into legal contracts, inheritance claims,
marriage etc.

(iii) Nationality or citizenship by birth, to obtain passport for foreign travel, qualify for
voting privileges, own property

(iv) Because of the increased national and international mobility of the population, vital
records have taken on additional importance. For the migrant, it has become essential to
have access to documents that can prove his or her civil status and nationality. To
facilitate the process of identification, those documents should conform to internationally
accepted standards. This is another reason to establish in each country a civil registration
process capable of registering vital events on a current basis, including efficient
procedures for providing documentation in cases where timely registration has not taken
place.

(v) Marriage and divorce records provide documentation for the establishment of the civil
status of individuals for such purposes as receipt of alimony allowances, claims for tax
benefits, provision and allocation of housing or other benefits related to the marital status
of a couple, and changing nationality on the basis of marriage. In addition, records of
divorce are important for establishing the right of an individual to remarry and to be
released from financial and other obligations incurred by the other party.

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 History of Civil Registration in India

2.10 Civil Registration in India dates back to 19th century. The first legislation at national level to
register births, deaths and marriages was made in 1886. Registration under this act was
voluntary. Foreigners mostly British were the ones to register the vital events under the act. It
was virtually inoperative as far as the general population was concerned. Registration was carried
on under various legal provisions in different parts of the country. In the urban areas the
registration was carried on under municipal by-laws and in the rural areas according to
administrative orders issued from time to time to village officials under the revenue codes and
police manuals.

2.11 Before the Central Act, some of the States had their own laws to register vital events. The
erstwhile Central Province of Berar introduced a system of registration as early as 1866. Punjab
and United Provinces followed a little later. In 1873, the Bengal Births and Deaths Registration Act
was passed and it was later adopted by the neighbouring states of Bihar and Orissa. Like Bengal
,the erstwhile composite Madras had its own Act. (Madras Registration of Births and Deaths Act
1899).Some other States had enabling provisions in this behalf in the Municipal Act, Panchayat
Act, Chowkidar Manual or Land Revenue Manual and registration was governed by executive
orders or by-laws setting out local registration procedures.

2.12 The need for registration of births and deaths had been felt by the Administration much
earlier. In the middle of nineteenth century, deaths were registered by sanitary commissioners.
With a view to introducing sanitary reforms for control of pests and disease, registration of
deaths was started. The Provincial Sanitary Commissioners obtained statistics on deaths from the
local health officers and passed them on to the Sanitary Commissioner of the Government of
India. However, the quality of registration was highly deficient and inadequate.

2.13 The Indian Famine Commission in 1880 pointed out the need for registration of vital
events such as births and deaths. It made a recommendation that the registration of births and
deaths should be made legally obligatory in villages as well as in towns and the regular monthly
publication of the main vital statistics should be enforced. The Commission also fixed the
responsibility on the Sanitary Commissioner to warn the Government of any unusual rise in the
death rate in order that the Government might enquire into the cause of such a rise and take
remedial action. This recommendation was a land-mark one in the history of development of vital
statistics in India. The 1886 Act was a consequence of this recommendation.

Lack of uniformity
2.14 In the absence of uniform legal provisions, different systems were adopted in different
States for registration of vital events. Even in the same State, different procedures were followed
in urban and rural areas. The responsibility for reporting an event rested with the heads of
households in some States, while in some other States, village chowkidars were made responsible
for reporting all events occurring in their respective villages. The time period prescribed for
reporting an event, penalties for non-reporting as well as failure on the part of the Registrar to
register an event also varied from State to State and also within a State. Similarly, there existed
great diversity in all other matters connected with registration and compilation of vital statistics,
such as maintenance of records, inspection arrangements, issue of certificates, the channel of
transmission of returns from the primary Registrar to the State headquarters and the time
schedule prescribed for such transmission of returns, etc.
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2.15 In 1930, Bengal was the only province in which registration was compulsory both in rural
and urban areas. In Madras, registration was compulsory in all municipal towns and was later
extended to all villages with a population of 2,000 and more. In Bihar and Orissa, registration was
compulsory only in some municipalities whereas in Punjab and the Central Provinces, it was
compulsory in all municipal towns. In Bombay, it was compulsory in nearly all municipalities while
in Assam, it covered all municipal towns, small towns, tea gardens and a few towns of hill
districts.

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III LEGAL FRAMEWORK FOR CIVIL REGISTRATION

International Recommendations on Legal Framework

3.1 The foundation for a sound civil registration system in a country or area is a well designed
registration law that gives clear guidelines concerning how the civil registration system will work.
The existence of a civil registration system as such should spring from and be supported by a
comprehensive organic law that is not over-regulated. Comprehensive means that the law should
contain, as a minimum, provisions concerning the structural base of the system; definitions of its
objectives, functions and linkages; the principal features of its organization and method of
operation, its financing or financial set-up, and, if an earlier agency is being replaced, the
transitional arrangements. Not being over-regulated means taking careful decisions as to how
much freedom of action is to be given to system management. The basis for any civil registration
and vital statistics system should, therefore, be custom-designed legislation that maps out the
systems, establishes their organization and defines the classes of vital events to be registered, the
basic information to be gathered, and the registration requirements, as well as by whom, when
and how the events are to be registered. In addition, the registration legislation should clearly
define: the powers and resources of the agencies responsible for registration functions; the
mechanics of preparing the registration and statistical documents; quality controls on the
information obtained using the civil registration method, to ensure its effectiveness at law as the
preferred means of proof that the vital events registered actually occurred; and its subsequent
compilation for statistical purposes in order to prepare and comply with state programmes in
such areas of demographic studies, fertility and mortality studies, education, public housing, etc.3

3.2 The civil registration law should clearly define the objectives of the system. It must clearly
state the compulsory nature of the system and specify sanctions for noncompliance. The law
needs to designate the functions included under the civil registration method, and should also
specify the administrative, institutional, organizational and inter-agency participation necessary
for the operation of the civil registration system. Another key element to be included in the legal
framework that the law establishes is the method of funding the civil registration system.

3.3 The civil registration law should include, for example:

(i) General provisions: covers definitions of vital events, the compulsoriness of

registration, the collection of statistical items, confidentiality, privacy, access and the
safekeeping, storage and preservation of records.
(ii) Civil registration infrastructure: specifies the Ministry or Government agency in which
the central or national authority for civil registration will be located; establishes a Director
General or Registrar General, duties and responsibilities and the appointment of local
Registrars, their status and duties; at the local level, defines registration units, notifiers,
informants etc., as well as the authority to redefine them as the need arises.
(iii) Sphere of competence of the civil or register: specifies responsibility of the register for
completeness and place of registration of all registrable events.

3
U.N., Department of Economic and Social Affairs, Statistics Division, “Handbook on Civil Registration and
Vital Statistics Systems: Preparation of a Legal Framework”, ST/ESA/STAT/Series. F/71E

13
 (iv) Making of entries in registers: indicates in general what must be entered in registers,
time periods for entries, and where entries are to be made.
(v) Specific registers: indicates, in particular, as to how, when and where specific items
must be registered for births, deaths, marriages, divorces etc., and designates informants
for each type of vital event. Specifies incentives for registration and sanctions for non-
compliance with timely reporting.
(vi) Amendment of registration records: outlines who is authorized to amend registration
records and how it is to be accomplished.
(vii) Proof of registration: authorizes certain officials to issue documents certifying the
facts of registration.
(viii) Statistical reports: specifies the agency to which the local registrar will send statistical
reports, and delineates cooperation between civil registration and the national statistics
agency.
(ix) Inspection and penalties: outlines the Director General’s Registrar General’s
responsibility for oversight of the civil registration system and penalties for failures in
compliance.
(x) Funding arrangements: delineates how the civil registration system will be funded and
authorizes the method of funding.

3.4 The legal frame work for civil registration system in India is reviewed in the light of the
above recommendations. The write up in the following paragraphs is mostly as per the Census
Centenary Monograph4 on Civil Registration System in India brought out by the office of the
Registrar general in 1971 and its revision from time to time.

Need for Central Legislation

3.5 There was a great diversity in the legal provisions for registration of births and deaths in
different parts of the country. Different Acts were enforced in different parts of the country at
different points of time and even in a single state, there were many Acts in force in different
areas. A few states had their own Acts which were adopted by a few other states, while others
had only enabling provisions in this behalf in the Municipal Act, Panchayat Act, Chowkidar
Manual, Land Revenue Manual and the registration was governed by executive orders or by-laws
setting out local registration procedure. The details and provisions of the enactments were as
varied as the Acts themselves. The position was made more complex by the re-organization of the
states in 1956, which resulted in the prevalence of different Acts and rules in different parts of
the same state. Apart from this, generally speaking, the provisions themselves were not adequate
and did not take into account new possibilities and developments. They were based on outdated
circumstances and concepts and did not make much use of the recent notable advances in the
general administrative set up and the rapid expansion of developmental activities in various
directions.

The Registration of Births & Deaths (RBD) Act 1969

3.6 Against this background of multiplicity of Acts and rules governing civil registration in
various parts of the country, a Central legislation on the subject was considered absolutely
necessary to bring about improvement in the system. The recommendations of the 1961
4
Census of India, 1971, “Civil Registration System in India-a perspective ”-Census Centenary Monograph No 4 ,
Office of the Registrar General ,India, Ministry of home affairs , New Delhi
14
conference of State representatives convened in April 1961 provided a blue print for action and
the Government of India took a decision, in consultation with the State Governments, for
enactment of a Central law relating to registration of births and deaths. Accordingly, the
Registration of Births and Deaths Bill was introduced in the Rajya Sabha in 1964, which was
passed in the Budget Session of 1964-65 but lapsed on the dissolution of the Lok Sabha. The Rajya
Sabha again passed the Bill on February 27, 1968. The Lok Sabha passed the Bill on May 27, 1969,
with certain amendments. The Rajya Sabha approved those amendments on May 16, 1969. The
Bill, as passed by both Houses of Parliament, received the assent of the President on May 31,
1969. It was notified in the Gazette of India extraordinary, Part-II Section I on June 2, 1969
(Annex-1). Annex-2 contains details regarding the Model Registration of Births and Deaths Rules,
1999.

Provisions of the Act

3.7 The RBD act 1969 has 5 chapters and different sections. The significance of these in
establishing a legal basis of the civil registration system is discussed below.

3.8 Chapter 1 of the Act , has two sections. The first section enables different enforcement
dates in different states . Section 2 defines the vital events to be registered and their definition.

3.9 The notification regarding enforcement was to be issued by the Central Government. The
states had to be consulted about the suitable date for enforcement in the states. Section 1 of the
Act, provides for different dates of enforcement in different parts of a state. The enforcement of
the Act called for preparatory steps to be taken by the State Governments, such as the
appointment of registration functionaries, framing of the state rules, registration procedures and
registration forms for implementing the various provisions of the Act.

3.10 To discuss various issues connected with the early enforcement of the Act, in February
1970, the Registrar General, India, convened a conference of officers to be designated as Chief
Registrars of Births by the states under the Act. This Conference, which is now known as the first
Conference of Chief Registrars, favoured the enforcement of the Act in most of the states from
April 1, 1970, excluding certain areas to be intimated by the individual states to the Registrar
General, India. The conference also discussed in detail the model rules prepared in connection
with the framing of state rules. It recommended the continuation of the old forms and registers,
pending the notification of the state rules and appointment of additional officers to assist the
registration functionaries. The Act has been enforced at present in all the States and Union
territories. Annex-3 gives the dates of enforcement of the Act and notification of state Rules in
various States and Union Territories.

3.11 Section 2 specifies that birth would mean live birth or still birth. The definitions of live
birth, death and foetal death and still birth are the same as international definitions. Birth, where
definition in the Indian Act includes still birth and death are to be registered. The Act defines that
“foetal death” means absence of all evidence of life prior to the complete expulsion or extraction
from its mother of a product of conception irrespective of the duration of pregnancy and “still-
birth” means foetal death, where a product of conception has attained at least the prescribed
period of gestation. The model rules framed under the Act define period of gestation as 28

15
weeks. In effect, the Act read in conjunction with model Rules framed there under, would imply
that the still birth would mean foetal death of conception of at least 28 weeks or more.

3.12 Chapter II of the Act enables to set up the registration establishment at national and
state level and has 5 sections. These sections deal with the appointment of registration
machinery at the national, state, district and below district level. It also specifies their duties.

3.13 Section 1 deals with the appointment of Registrar General India. Section 2 enables him to
appoint such other officers to discharge his functions .Section 3 defines his responsibilities and
duties. Sections 4 & 5 deal with the establishment of machinery at state level and sections 6 and 7
below state level. These sections have sub sections that deal with the duties and responsibilities
of each of the functionaries.

National Level Machinery

3.14 The Registrar General, India is appointed by the Central Government under section 3(1) of
the Act and is the central authority to coordinate and unify the activities of the Chief Registrars of
Births & Deaths in States and Union Territories and to provide general directions and guidance in
the matter of registration of births and deaths and working of the Act. He has to submit to the
Central Government an annual report on the working of the Act in the various states as stipulated
in section 3(3) of the Act.

3.15 At the national level, all matters relating to vital registration and vital statistics are
handled by the Vital Statistics (Civil Registration) Division. The Division assists the Registrar
General, India in (i) coordinating and unifying the work of registration and compilation of vital
statistics in the states, (ii) providing direction and guidance to the state authorities, (iii)
standardization of forms and procedures for registration and compilation of vital statistics for
promoting uniformity and comparability, (iv) providing clarifications on various provisions of the
Act and ensuring uniform interpretations of the law, (v) organizing training programmes, (vi)
initiating publicity and other promotional measures, (vii) preparation of annual report on the
working of the Act in different states for submission to the Central Government, (viii) preparation
of annual statistical report for the country entitled 'Vital Statistics of India' and (ix) various other
matters for securing a uniform and efficient system of registration throughout the country.

3.16 The Vital Statistics Division also deals with all other vital statistics activities of the
organization, i.e., those relating to Sample Registration System (SRS) and Medical Certification of
Cause of Deaths (MCCD). SRS is described in detailed later.

3.17 The Directors of Census Operations of the States/UTs, the Joint Directors/Deputy Directors
posted in respective Directorate of Census Operations have been appointed by the Central Govt.
under Section 3(2) as Joint Registrar General. They are required to discharge various provisions of
the Act in their respective States/UTs, under the supervision and direction of the Registrar
General, India.

State Level Machinery

3.18 The Chief Registrar is appointed by the State Government under section 4(1) of the Act.
The Chief Registrar is the Chief Executive Authority in the State/Union Territory for implementing

16
the provisions of the Act and the rules made there under in his State/Union Territory. He has to
submit a report annually on the working of the Act to the State Government on July 31 of the
following year.
3.19 The State Governments under the provision of section 4(2) of the Act is empowered to
appoint officers such as Additional Chief Registrar/Deputy Chief Registrar. They are required to
discharge, under the supervision of the Chief Registrar, such of the functions of the Chief
Registrar as he may authorise them to do from time to time. Almost all the States/UTs have
appointed one or more officers with the designations of Additional/Deputy Chief Registrar for the
entire State/UT or a part there of.

District Level Machinery

3.20 State Government also appoints District Registrar and Additional District Registrars under
the powers conferred in section 6(1) of the Act. The Registrar is also appointed under section 7(1)
of the Act. The Registrar may, with the prior approval of the Chief Registrar, appoint Sub-
Registrars and assign to them any or all of his powers and duties in relation to specified areas
within his jurisdiction.

District Registrar

3.21 He is to assist the Chief Registrar in his functions. The Handbook of Civil Registration5 lists
the following as his responsibilities.
(i) Arranging inspection of registration offices and examination of the registers kept
therein.
(ii) Issuing timely instructions and guidance to the Registrars.
(iii) Organising periodical training courses for the Registrars.
(iv) Ensuring regular and timely flow of returns from the Registrars to the state
headquarters.
(v) Organising studies to identify good and bad registration areas.
(vi) Informing the public of the necessity, procedures and requirements of registration.
(vii) Authorising delayed registration prescribed in the rules.
(viii) Ensuring permanent recording and storage of registration documents.
(ix) Periodic monitoring of the system, with a view to improving the efficiency of the
system.

Registrar/Sub Registrar

3.22 The Registrar is appointed by the State Government, under section 7(1) of the Act, for any
local area comprising the area within the jurisdiction of a municipality, Panchayati or other local
authority or any other area or a combination of any two or more of them. The Registrar may, with
the prior approval of the Chief Registrar, appoint Sub-Registrars and assign to them any or all of
his powers and duties, in relation to specified areas within his jurisdiction. Section 7(2) stipulates
the duties of the Registrar as follows:

5
, Office of the Registrar General ,India, “Handbook on civil Registration -Third Edition” , Ministry of Home affairs ,
Government of India, New Delhi, 1993

17
(i) Every Registrar shall, without fee or reward, enter in the register maintained for the
purpose all information given to him under section 8 or section 9 and shall also take steps to
inform himself carefully of every birth and of every death which takes place in his jurisdiction and
to ascertain and register the particulars required to be registered.

(ii) The Registrar is responsible for recording the specified information regarding the vital
events which take place in his jurisdiction; ensuring compliance with the registration law;
ensuring the completeness and accuracy of each record; informing the public of the necessity,
procedures and requirements for effecting registration and the value of vital statistics; taking
custody of the records; and recording and reporting of data for statistical purposes.

Registration of Births and Deaths

3.23 Chapter III of the Act is the crucial chapter that defines the responsibilities of different
categories of persons for registration and has eight sections (8 to 15), lays down the registration
procedures, and provides for late registration.

3.24 Section 8 fixes responsibility on different categories of persons required to report

occurrence of births and deaths to the Registrar Births and deaths. The information required to
be given to the Registrar under section 8 or section 9, as the case may be, shall be in Form Nos. 1,
2 and 3 for the Registration of a birth, death and still birth respectively. Prior to that, these forms
were called form 2, form 3 and form 4 respectively. Some states still retain the numbers.
Earlier, these forms were same for registration and statistical reporting. But, under model rules
1999, this has been amended. Now, these forms have two parts; one contains the legal
information and other contains statistical information.

3.25 Originally, it was prescribed in the Model Rules that the required information should be
furnished within 7 or 3 days respectively in respect of a birth or a death in a municipality or
cantonment and within 14 or 7 days in respect of a birth or a death in any other area.
Subsequently, because of the difficulties expressed by some of the States with regard to the
reporting period in the urban areas, uniform reporting periods of 14 days in the case of births and
7 days in the case of deaths had been prescribed for all areas, whether rural or urban. Now this
period has been made 21 days uniformly for birth and death for all areas, whether rural or urban.

3.26 Section 9 is a special provision regarding births and deaths occurring in a plantation.
3.27 Statement 1 shows the persons responsible for reporting of vital events occurring under
different circumstances.
3.28 Section10 lays down that midwife or any other medical or health attendant at a birth or
death, keeper of owner of a place set apart for the disposal of dead bodies responsible to notify
births and deaths and provides for medical certification of cause of death. Medical certification
is required only in places where such facilities exist. Form No. 4 is prescribed for medical
certification of cause of death for hospital in patients. Form No. 4A is prescribed for medical
certification of cause of death for non-institutional deaths. These forms shall not be filled up for
the still births. The filled up forms are required to be sent to the Registrar, along with the death
report form No. 2 of the respective death.
3.29 Sections 11 and 12 lay down the registration procedures. Section 11 stipulates that
Informant has to sign the Register and section 12 directs the registrar to provide an extract of the
18
prescribed particulars to the informant under his hand from the register relating to such birth or
death. Soon after the registration is complete, the registrar is required to issue, under Section 12
of the Act, an extract (certificate) in the prescribed form free of cost to the informant. Form No.
5 has been prescribed for birth certificate and Form No. 6 for death certificate.

19
 Statement 1; Persons responsible for reporting of births and deaths under sections 8
& 9 of the RBD act, 1969
Informant Place of occurrence of events
1 2
(a) Head of the Household and in his absence, his Events occurring in a house.
nearest relative and in his absence, oldest adult
male person.
(b) Medical Officer in- charge or Any person Events occurring in Hospital, Health
authorised by him. Centre, Nursing home or other like
institutions.

(c) Jailor in charge Events occurring in Jail

(d) Person in charge Events occurring in choultry,

chhattram hostel, dharamshala,
boarding house, lodging house,
tavern, barrack, toddy shop or place
of public resort.
(e) Headman or other corresponding officer of the Newborn child or dead body found
village in the case of a village and officer in charge deserted in a public place.
of local police station elsewhere.

(f) Officer, who conducts an inquest Deaths not covered under clauses (1)-
(e) of section 8(1) of the Act.

(g) Superintendent of the Plantation specified by the Events in Plantation.

rules (The informants mentioned in clause (a) to (f)
above have to furnish the necessary particulars to
the superintendent of the plantation).
(h) Person in charge of the moving vehicle Events in moving vehicle on land air
and water.

Source: Handbook on RBD act- - 2004

3.30 Section 13 provides for registration of events reported after the prescribed period and
prescribes the late fee. Registration of an event, of which information is given to the Registrar
after the expiry of the prescribed period but within 30 days of its occurrence, is done on payment
of a prescribed late fee. Registration of an event, of which information is given to the Registrar
after 30 days but within one year of its occurrence, is done on payment of a prescribed fee and
on production of an affidavit made before a notary public or any other officer authorized in this
behalf and with the written permission of the District Registrar or any other officer authorized. If
an event has not been registered within one year, then the registration of such an event can be
done only on an order of the Executive Magistrate and on payment of the prescribed fee.

3.31 Section 14, allows inclusion of name of child at a later date but within one year. The name
of the child can also be entered even after one year on payment of a prescribed late fee, subject
to the provisions of rules made for the purpose.
20
3.32 If it is proved to the satisfaction of the registrar that an entry in his register is erroneous,
the entry can be corrected or cancelled by him under section 15 of the act.

Maintenance of Civil Registration Records

3.33 Chapter IV of the act deals with the maintenance of the record and has 4 sections, 16 to
19. Sections 16-17, provide for maintenance of records and issuance of certified extracts by the
Registrar.

3.34 The part of the reporting Forms No. 1, 2 and 3 containing the legal information will be
kept in the form of bound registers. These will form the pages of the Birth Register, Death
Register and the Still Birth Register respectively, after the process of registration of an event is
completed. Additional items like birth weight of the child in the birth register and cause of death
in the death register have also been included in the bound registers and the reporting forms. The
bound registers so maintained will also be used for day-to-day activities. These registers are
permanent records. All the information, inclusive of orders given for delayed registration under
Section 13, are the integral part of the registers and shall be kept by the Registrar, along with the
register. The Registrars keep these registers with them for a period prescribed in the State Rules,
after the end of the calendar year to which the records relate. Thereafter, these registers shall be
transferred to the officer specified under the state rules in this behalf for safe custody and
preservation.

3.35 Under section 17 of the Act, a person can obtain certified extract from the register relating
to a birth or death, on payment of the fee prescribed in the Rules. Such extracts (certificate) are
to be issued in Form No. 5 in the case of births and Form No. 6 in the case of deaths as prescribed
in the Rules. In the case of an extract relating to a death, the particulars regarding the cause of
death shall not be disclosed. All extracts given under this section are required to be certified by
the Registrar or any officer specified under the Rules and such extracts are admissible as evidence
for the purpose or for proving the birth or death to which the entry relates.

3.36 Section 18 deals with inspection of registration registers and offices. These can be
inspected only by officers authorized by the chief Registrar.

3.37 Section 19 prescribes the regular flow of returns from the Registrar and statistical report
to be submitted by the Chief Registrar. Following forms have been prescribed for submission of
monthly statistical reports:
Form No.11 Summary Monthly Report of Births
Form No.12 Summary Monthly Report of Deaths
Form No.13 Summary Monthly Report of Still Births

3.38 The part of the reporting forms 1, 2 and 3 containing the statistical information of the
events registered during the month shall be enclosed along with the respective summary. The
summary has to be submitted every month on the first working day. Form 12 will also contain
certain information relating to infant and maternal deaths. These forms will be prepared in

21
triplicate. One copy with the reporting forms will be sent to the Chief Registrar. One copy will be
sent to the district Registrar and one copy retained by the Registrar for his reference.

3.39 Chief Registrar is required to submit an annual report on the working of the Act, along
with an annual statistical report, to the State Government by the 31 st July of the following year to
which the report relates. He is also required to send to the Registrar General, India (i) monthly
return, within two months after the expiry of the month to which the return relates and (ii) the
annual reports, within nine months after the end of the calendar year.

3.40 The monthly return provides summary data on the number of births, deaths, and infant
deaths for the district for rural and urban areas separately, along with the information on the
total number of registration units and the number of units from which the returns were received.

3.41 The Annual Statistical Report in the prescribed format is also to be sent to the Registrar
General, India every year by the Chief Registrars.

3.42 The data relating to births are processed according to the place of usual residence of the
mother and those of death are processed according to the place of usual residence of the
deceased. For processing the above data, computerized data processing has been introduced, in
which records of individual events are entered into the computer. Prior to 2000, these were
processed on the basis of place of occurrence of the events. This created a difficulty in using the
tables prepared, as large number of institutions are located in urban areas and these events get
registered there.

3.43 Chapter V is titled miscellaneous and includes 13 sections-20 to 32. Section 20 deals with
registration of births and deaths of Indian citizens abroad. Section 21 empowers a Registrar to
obtain information regarding birth or death from a local resident. Section 22 Confers powers on
the Central Government to give directions to the State Governments. Sections 23-25 prescribe
penalties for the various offences. Sections 26-28 declare Registrars as public servants and
provide protection. Section 29 saves the Births, Deaths and Marriages Registration Act, 1886.
Sections 30 and 32 empower the State Governments to make rules and remove difficulties. With
the approval of the Central Government, section 31 repeals the earlier state laws on registration.

Coordination Mechanism

3.44 Civil Registration is the joint effort of the Centre and State Governments. There is a need
for co ordination of their activities and to exchange views on implementation of civil Registration.
This is achieved through the conference of Chief Registrars. The first conference was held in 1970
to discuss the preparatory steps required and decide about the date of implementation of the
Act. The second conference held in 1974 discussed the enforcement of the Act in the remaining
States, where it had not been enforced till then and various other steps needed in connection
with the implementation of the Act. This conference recommended that a training centre should
be set up at the centre to train senior officers. It emphasized the need for a full time training at
the state level to train the civil registration officials. The third conference was held in New Delhi
during 26-29 November 1980 to undertake a thorough review of the working of the system. The
fourth conference was held during August 15-19, 1985. Two rounds of Regional Conferences
were held during 1981 and 1987. So far, there have been 12 Conferences of the Chief Registrars
of Births and Deaths. Meetings of the State Secretaries and Chief Registrars of Births & Deaths

22
were held in 1996 and 1997 in which issues relating to various aspects of Civil Registration System
and strategies for its improvement were discussed. In the meetings of the State Secretaries and
Chief Registrars of Births & Deaths held in 1998 and 1999, the forms, procedures and statistical
systems based on Civil Registration were reviewed with a view to meeting the requirement of
vital statistics in the changed scenario and new system of registration evolving new forms and
procedure of registration has been developed. Need of vital statistics based on usual place of
residence of the mother and the deceased was felt for planning and implementation of various
programmes. A new set of tables for preparation of Annual Statistical Reports based on place of
usual residence have been recommended. All the states agreed to implement the new system of
registration from 1.1.2000. The National Conference of Chief Registrars of Births and Deaths,
2003 felt the need of strengthening the reporting of the events for registration by strict
monitoring of the work.

Statistical reports

3.45 The office of the Registrar General, India brings out annually a comprehensive statistical
report entitled 'Vital Statistics of India'. The series of reports have been brought out starting with
1958. The report is divided into two parts. The detailed statistical data based on the registration
records are presented in the main tables included in Part-II of the report. Part-I contains analytical
notes on important features and analysis of the data, along with a brief review of the progress
made towards enforcement of the Act and measures initiated for improvement of the registration
system. Part I also contains brief notes on the sample registration system, along with the latest
data available from this source.

3.46 The registration data at present suffer from both under registration and incomplete
coverage. Information in respect of certain registration areas is not available in time. A set of
control charts has been prescribed to monitor the reporting. These charts provide for monitoring
the receipt of forms from each registration unit month wise, separately for births, deaths and still
births. These are to be maintained at the sub district, district and state levels.

List of tables generated

3.47 The following tables are generated on priority based on the data collected in the civil
registration system.

1. Vital Statistics by districts

2. Vital Statistics by sex
3. Vital Rates by district
4. Vital Statistics for towns with population 30000 and above
5. Number of live births by type of medical attention at delivery
6. Deaths by type of medical attention received
7. Deaths by age and sex
8. Deaths by cause(medically certified or otherwise)
9. Deaths by cause, age and sex for medically certified cases

3.48 The following tables are generated as priority table

1. Vital Statistics by religion

23
 2. Vital Statistics by month and sex
3. Live births by birth order and age of mother (rural, urban. and individual cities with
population 100000 and above)
4. Live births by birth order and literacy of mother (rural and urban areas)
5. Live births by birth order and literacy of father (rural and urban areas)
6. Live births by birth order and occupation of father (rural and urban areas)
7. Live births by birth order and religion of father (rural and urban areas)
8. Deaths by occupation and sex
9. Infant deaths by sex and age
10. Time gap in registration of live births and deaths

CRS performance levels compared to SRS

3.49 The registration of births and deaths varies from state to state and between births and
deaths. One way to assess the performance of CRS is to compare the rates derived at state level
from CRS with those derived from SRS, which collects these information for the usually resident
population and provides reliable estimates of birth and death rates at state level. Annex 6 shows
such a comparison for the years 1990-1999, separately for births and deaths.

3.50 At the national level, only about 71 per cent of the births and 64 per cent of the deaths
are being covered by the registration machinery at present. It has to be kept in mind that the
figures shown for CRS are based on events registered at the place of occurrence and not at the
place of usual residence of the mother, in the case of birth and of the person who died in the case
of death. In those States and Union Territories, where a large number of people come from
outside its boundaries due to availability of medical facilities, the birth rates and death rates are
likely to be significantly higher in the civil registration system.

3.51 Some of the States such as Goa, Gujarat, Haryana, Himachal Pradesh, Karnataka, Kerala,
Maharashtra, Meghalaya, Mizoram, Nagaland, Punjab, Sikkim and Tamil Nadu and the Union
Territories of Chandigarh, Daman & Diu, Delhi and Puducherry have achieved above 90%
registration of births while some of the States such as Andhra Pradesh, Arunachal Pradesh,
Assam, Chhatisgarh, Jammu & Kashmir, Madhya Pradesh, Manipur, Orissa, Rajasthan, Tripura
and Uttarakhand and the Union Territories of A&N Islands, Dadra & Nagar Haveli and
Lakshadweep are able to register between 50 and 90 per cent of the births. Jharkhand, Uttar
Pradesh and Bihar are below 50 per cent level.

3.52 Goa, Karnataka, Kerala and Mizoram and Union Territories of A & N Islands, Chandigarh,
Delhi and Puducherry registered more than 90 per cent of the deaths. The States of Andhra
Pradesh, Chhatisgarh, Gujarat, Haryana, Himachal Pradesh, Madhya Pradesh, Maharashtra,
Meghalaya, Nagaland, Orissa, Punjab, Rajasthan, Tripura and West Bengal and Union Territories
of Dadra & Nagar Haveli, Daman & Diu and Lakshadweep fall in the 50-90 per cent range. Levels
of death registration in Arunachal Pradesh, Assam, Jammu & Kashmir, Jharkhand, Manipur,
Uttarakhand and Uttar are below the 50 per cent mark,

Medical Certification of Cause of Death

3.53 One important aspect of vital statistics is the certification of cause of death. This
information is very important for public health planners. A provision has been made in the RBD

24
Act for certification by a medical practitioner who attends death. In the case of hospital deaths,
report of death and cause of death are to be sent by the authorities to the registrar. Separate
forms have been prescribed for reporting by hospitals and individuals. These are form 4 and 4A.
Form 4 is to be filled up in the case of hospital deaths and form 4A is to be used in all other cases.
Form 4 uses international classification evolved by World Health Organization. This form has two
parts, Part-I provides for entering the diseases in a specific sequence of events leading to death so
that the immediate cause is shown first and the underlying cause is shown last. The underlying
cause is that morbid condition which initiated the chain of events leading to death. The World
Health Organisation has recommended that the underlying cause of death is to be taken into
account for tabulating cause-specific mortality. In cases of violent deaths and other medico-legal
cases usually brought to the notice of a medical examiner at the postmortem stage, the
certificate may be filled in by the medical examiner on the basis of evidence noticed by him.
Considering the present state of medical infrastructure, it may not be possible to fully implement
the international recommendations.

3.54 The medical certification of cause of death was in operation in all major medical teaching
institutions and other hospitals in many states by the beginning of the seventies. It envisages that
the certificate of cause of death is to be filled in by the attending medical practitioner and given
to the informant for onward transmission to the Registrar for registering the death. Classification
of causes of deaths is to be done according to WHO's International Classification of Diseases (ICD)
by trained persons. At present, the data mainly relate to hospitals and similar institutions, which
are compiled at the municipal headquarters, along with the other registration data.

3.55 The certificate of cause of death is the basic document for generating cause of death
statistics. Filling this accurately needs training. Central Bureau of Health Intelligence, Directorate
General of Health Services, Ministry of Health and Family Welfare, Government of India through
its training centres provides such trainings to non medical personnel. The National Workshop on
Civil Registration and Causes of Death held at New Delhi during 24 - 26 May 2001 reviewed the
status and functioning of the Medical Certification of Cause of Death in the States/UTs. It has
made a number of useful suggestions such as involving medical record unit of medical institutions
in coding of causes of death, training of doctors for writing the proper cause of death in Form
4/4A medical certificate of cause of death; (ii) training of staff entrusted with coding of cause of
death according to ICD; and (iii) printing of forms used in the registration of births & deaths,
including form 4/4A in the implementation of the MCCD scheme. Indian Medical Association may
be involved in giving wider publicity among doctors regarding the statutory requirement and
protection available to them. Newsletters brought out by the IMA should be made available to all
private practitioners to sensitize them about the importance of the medical certification.

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 IV-Sample Registration System

Brief History of Sample Registration System (SRS)

4.1 In India, the registration of births and deaths is governed by the Registration of Births and
Deaths Act, 1969. The Rules under the Act have been notified in all the States. The civil
registration system functions at different levels of efficiency in different states and it has not yet
reached a stage where the data generated can be directly used for calculating vital rates. This
necessitated the initiation of sample surveys for getting vital rates and its continuance till date.

4.2 The conference on improvement of vital statistics 1961 recommended that a scheme of
sample registration areas be set up to get reliable estimates of birth and death rates at the state
and national levels. In pursuance of the above recommendation, the Office of the Registrar
General India (ORGI) formulated a plan scheme titled “Plan for improvement of Vital Events”
during the third five year plan, as a centrally sponsored scheme. The planning commission,
recognizing the importance of the data on vital events approved the scheme in 1963 for inclusion
in the middle of third five-year plan. A pilot study was initiated during 1964-65 and on full scale
from 1969-70.This was called the Sample Registration Scheme (SRS). Later on, the name changed
to Sample Registration System (SRS).

Objective of SRS

4.3 The main objective of SRS is to provide reliable estimates of birth rate, death rate and infant
mortality rate at the natural division level for the rural areas and at the state level for the urban
areas. Natural divisions are National Sample Survey (NSS) classified group of contiguous
administrative districts with distinct geographical and other natural characteristics. It also
provides data for other measures of fertility and mortality including total fertility, infant and child
mortality rate at higher geographical levels. In order to facilitate effective tracking of Millennium
Development Goals (MDGs) on under-five mortality, the estimates of Under-5 mortality rate for
India and bigger states separately for rural & urban and also by sex have been made a regular
feature of SRS - Annual Statistical Report starting from the year 2008. Similarly, the estimates of
maternal mortality generated under the domain of SRS starting from 1997 provide important
inputs for tracking of MDGs on maternal mortality.

Dual Record System

4.4 The field investigation under Sample Registration System consists of continuous enumeration
of births and deaths in a sample of villages/urban blocks by a resident part-time enumerator, and an
independent six monthly retrospective survey by a full-time supervisor. The data obtained through
these two sources are matched. The unmatched and partially matched events are re-verified in the
field to get an unduplicated count of correct events. The advantage of this procedure, in addition to
elimination of errors of duplication, is that it leads to a quantitative assessment of the sources of
distortion in the two sets of records making it a self-evaluating technique.
Structure of the Sample Registration System
4.5 The main components of SRS are:

26
(i) Base-line survey of the sample units to obtain demographic details of the usual resident
population of the sample areas;
(ii) Continuous (longitudinal) enumeration of vital events pertaining to usual resident population
by the enumerator;
(iii) Independent retrospective half-yearly surveys for recording births and deaths which
occurred during the half-year under reference and up-dating the House-list, Household
schedule and the list of women in the reproductive age group along with their pregnancy
status by the Supervisor;

(iv) Matching of events recorded during continuous enumeration and those listed in course of
half- yearly survey;
(v) Field verification of unmatched and partially matched events; and
(vi) Filling of Verbal Autopsy Forms for finalized deaths.

Baseline Survey:

4.6 The base-line survey is carried out prior to the start of continuous enumeration. This
involves preparation of a notional map of the area to be surveyed, house numbering and house
listing and filling-in of a household schedule. Wherever a sound system of house numbering exists
the same is adopted. Otherwise, the house numbering is done by the enumerator/supervisor with
the help of chalk and tar, etc. at a conspicuous place near the entrance of the house. The
supervisor prepares a notional map, with the help of the local Part-time enumerator, showing
important landmarks and location of the houses covered by the sample unit. Thereafter, a list of
houses/households covered by the sample is prepared in the House List (Form 1) and the details
relating to the residential status and demographic particulars of each individual residing in the
household viz. name, sex, age, marital status and relation to head of household, etc. are recorded
in the Household Schedule (Form 2). The inmates of public institutions like hotels, inns, schools
and hospitals are excluded, but households living permanently within the compound of such
institutions are covered. A list of all women in the reproductive age group 15-49 years along with
their pregnancy status is also prepared in the Pregnancy Status of women (Form 3)

Continuous Enumeration

4.7 An enumerator is appointed in each sample unit to record birth and death, as and when
they occur in a sample unit. The enumerator maintains a Birth Record (Form 4) and a Death
Record (Form 5) in respect of his area. The enumerator is expected to record all births and deaths
occurring within the sample unit, as well as those of the usual residents occurring outside the
sample unit. The events to visitors occurring within the sample unit are also listed, but these are
not taken into account while calculating rates. Thus the events to be enumerated by the
enumerator are those pertaining to: (i) Usual residents inside the sample unit; (ii) Usual residents
outside the sample unit; (iii) In-migrants present; (iv) in-migrants absent; (v) Visitors inside the
sample unit.

4.8 For ensuring complete netting, the enumerator uses different sources to get information of
the occurrence of vital events in the sample unit. These include the help of the village priest, barber,
village headman, midwife and such other functionaries. The enumerators maintain contact with
these informants at frequent intervals and collects information about the occurrence of births and
27
deaths. On being informed about the occurrence of an event, the enumerator visits the concerned
household and records the prescribed particulars. The enumerator also keeps in touch with other
socially important persons and visits local or nearby hospitals, nursing homes, cremation or burial
grounds, at frequent intervals to keep updated about the occurrence of events. The enumerator
maintains and updates a list of all women in the reproductive span along with their pregnancy
status, which helps in netting of all the births. Despite all these efforts, the enumerators may miss
information about some of the events, therefore, they are required to visit all the households once a
month so as to ensure that all the events have been recorded.

Half-Yearly Survey

4.9 Half-yearly survey is carried out independently in each sample unit by a full-time supervisor.
The supervisor belonging to the statistical cadre of the State Census Directorates (either a Compiler
or a Sr. Compiler or Statistical Investigator or any suitable official) visits each household in the
sample unit and records the particulars of births and deaths in Forms 9 & 10 respectively in respect
of all the usual residents and visitors (only those occurring within the sample unit) which had
occurred during the half-yearly period (January-June or July-December) under reference.
Simultaneously, updating of the house-list, the household schedule and the pregnancy status of
women is also done by making entries of changes, if any. While carrying out this survey, supervisors
do not have access to the birth and death records of the enumerator for the same periods which are
withdrawn from the field before the supervisor’s visit for the half yearly survey.

Matching

4.10 On completion of the half-yearly survey, the Forms 9 & 10 filled-in by the supervisors are
compared with those in the Forms 4 & 5 (filled-in by the enumerators). This is done at the office of
Directorate of Census Operations for all states except for rural areas of Kerala and Maharashtra,
where it is done at the Directorate of Economics and Statistics of the respective states. Selected
important entries in the enumerator's and supervisor's record are matched item by item and events
are classified as fully matched, partially matched and unmatched. The items generally considered
for matching for birth events are: Identification code of the head of Household and mother,
Relationship of the mother to head, date of live birth, month in case of still birth/abortion, sex in
case of live birth /still birth (for birth) and the item considered for death events are: identification
code of the head of household and mother in infant death, relationship of the deceased to head,
date of death and sex of the deceased.

Field verification of unmatched and partially matched events

4.11 Every unmatched or partially matched event is verified by a visit to the concerned household.
This is done either by a third person or jointly by the supervisor and the enumerator, depending
upon the availability of staff.

Sample Design

Background

4.12 The Sample design adopted for SRS is a uni-stage stratified simple random sample without
replacement in rural areas except in larger villages of rural areas, where two stage stratification has

28
been applied. In urban areas, the sample design was a stratified two stage simple random sample,
with towns as first stage unit and census enumeration blocks as second stage units. While the basic
design of the survey has remained the same since 1969 when it was initiated the survey design has
undergone few changes during the course of time in the way the sampling units are selected.

Sample design during 1993-94 replacement

4.13 The Sample design adopted for SRS is a uni-stage stratified simple random sample without
replacement. In rural areas, each district within a state has been divided into two stratas viz. Strata 1
- Villages with population less than 1500 and Strata 2 - Villages with population 1500 or more. In
order to cover the village by one part-time enumerator, villages belonging to the second strata
(having population of more than 1,500) were segmented into two or more segments of equal size. A
simple random sample of villages and segments has been selected, from each of the two strata,
without replacement in each State/Union Territory. In urban areas stratification has been done on
the basis of size class of the towns/cities. The towns/cities were grouped into five classes,
viz.:- towns with population below 20,000 (b) towns with population of 20,000 and more but less
than 50,000 (c) towns with population of 50,000 and more but less than 100,000 (d) towns with
population of 100,000 and more but less than 500,000, (e) cities with population of 500,000 and
more but less than 1,000,000 and (f) each city with population 1,000,000 or more, treated as a
separate stratum. The sampling unit in urban area is a census enumeration block. A simple random
sample of these enumeration blocks has been selected without replacement from each of the size
classes of towns/cities in each State/Union Territory.

Sample design during 2004 replacement

4.14 The Sample design adopted for SRS is a uni-stage stratified simple random sample without
replacement, except in stratum II (larger villages) of rural areas, where two stage stratification has
been applied. In rural areas of bigger states (population with ten million or more as per Census
2001), the NSS natural division is the first level of geographical stratification. The overall
stratification in rural areas has been done on size of villages with villages having population less
than 2,000 forming Stratum I and villages with population 2,000 or more forming Stratum II.
Smaller villages with population less than 200 were excluded from the sampling frame in such a
manner that the total population of villages so excluded did not exceed 2 per cent of the total
population of the state. The number of sample villages in each state was allocated to the
substrata proportionally to their size (population). The villages within each size stratum were
ordered by the female literacy rate based on the Census 2001 data, and three equal size substrata
were established. The sample villages within each substratum were selected at random with
equal probability. In the case of villages of Stratum II, each sample village with a population of
2,000 or more was sub-divided into two or more segments in a way that none of the segments
cut across the Census Enumeration Blocks (CEBs) and the population of each segment formed by
grouping the contiguous CEBs was approximately equal and did not exceed 2000. A frame of
segments was prepared and the selection of segments was done at random at the second
sampling stage for the SRS enumeration.

4.15 In urban areas, the categories of towns/cities have been divided into four strata based on
the size classes in contrast to the six strata in the earlier sampling frame. Towns with population
less than one lakh have been placed under stratum I, towns/cities with population one lakh or
more but less than 5 lakhs under stratum II, towns/cities with population 5 lakh or more under
stratum III and four metro cities of Delhi, Mumbai, Chennai and Kolkata as separate strata viz.
stratum IV. The sampling unit in urban area is a Census Enumeration Block. The Census

29
Enumeration Blocks within each size stratum were ordered by the female literacy rate based on
the Census 2001 data, and three equal size substrata were established. The sample Census
Enumeration Block within each substratum was selected at random with equal probability. A
simple random sample of these enumeration blocks have been selected within each sub-strata
without replacement from each of the size classes of towns/cities in each State/Union Territory.

Sample Size

4.16 At the initial stage, 3412 rural units and 584 urban units were selected. The total number
of units was 3696. In Jammu & Kashmir, Ladakh was not included. Subsequently, 20 rural and 6
urban units were added. In the fifth plan, an additional 1700 units were sanctioned to strengthen
the existing sample. The total number of units increased to 5422, out of which 3684 were rural
units. The entire 5422 units were re allocated among different states and union territories.
During the 6th plan, another 600 units were added. The new 600 units were distributed to the
state of Uttar Pradesh, Bihar, West Bengal, Karnataka, Manipur, Meghalaya and Sikkim.

4.17 By the 1980s, there was demand for collecting data on age at marriage, live birth order
and interval between previous and current births from SRS on a continuing basis for evaluation of
family planning programme. A Technical Advisory Committee set up for this purpose
recommended that it would be possible to estimate the birth rates in some cases at Natural
Division level in rural areas by marginally augmenting the sample size. It recommended 825
additional units, of which 508 units were in rural areas. As per the recommendations, forms were
revised and from 1990, additional data were collected.

Sample Size

4.18 The Infant Mortality is the decisive indicator for estimation of sample size at Natural
Division, the ultimate level for estimation and dissemination of indicators for rural areas.
The permissible level of error has been taken as 10 PRSE (Percentage Relative Standard
Error) at Natural Division level for rural areas and 10 PRSE at state level for urban areas, in
respect of major states having population more than 10 million as per Census 2001. For
minor states, 15 PRSE has been fixed at the total state level. By and large, the above
criteria have been followed. However, there have been a few exceptions, on account of
operational constraints. Based on the above criteria, the number of units has been
increased from 6671 to 7597 (4433 in rural and 3164 in urban areas). Statement 1 shows
the number of sample units and population covered in 2008, separately for rural and urban
areas of all the states and union territories.

30
 Statement: 1
Number of sample units and population covered India, States and Union territories, 2008

India/States/Union territories Number of sample units Population covered (in'000)

Total Rural Urban Total Rural Urban
1 2 3 4 5 6 7
India 7,597 4,433 3,164 7,103 5,198 1,904
Bigger States
1. Andhra Pradesh 375 235 140 404 317 88
2. Assam 300 90 210 206 91 116
3. Bihar 330 200 130 353 286 67
4. Chhattisgarh 130 40 90 106 44 62
5. Delhi 200 10 190 157 20 137
6. Gujarat 365 215 150 359 279 80
7. Haryana 210 100 110 211 134 77
8. Jammu & Kashmir 260 150 110 220 170 50
9. Jharkhand 170 60 110 116 61 55
10. Karnataka 480 330 150 437 355 82
11. Kerala 250 150 100 343 280 63
12. Madhya Pradesh 340 220 120 315 242 73
13. Maharashtra 485 250 235 407 276 131
14. Orissa 405 290 115 335 269 67
15. Punjab 250 150 100 243 175 67
16. Rajasthan 350 250 100 331 280 51
17. Tamil Nadu 465 250 215 464 327 137
18. Uttar Pradesh 500 350 150 559 460 99
19. West Bengal 555 310 245 583 423 161
Smaller States
1. Arunachal Pradesh 60 45 15 32 21 11
2. Goa 85 43 42 79 56 23
3. Himachal Pradesh 190 140 50 95 69 27
4. Manipur 150 110 40 134 110 24
5. Meghalaya 120 90 30 66 49 17
6. Mizoram 40 20 20 30 17 13
7. Nagaland 45 33 12 37 29 8
8. Sikkim 60 45 15 63 52 11
9. Tripura 80 60 20 109 97 12
10. Uttaranchal 150 100 50 111 82 30
Union Territories
1. Andaman & Nicobar Islands 50 34 16 35 25 10
2. Chandigarh 35 5 30 33 10 23
3. Dadra & Nagar Haveli 30 22 8 40 34 5
4. Daman & Diu 20 13 7 28 23 5
5. Lakshadweep 12 6 6 15 10 5
6. Pondicherry 50 17 33 46 25 21
Note: Rural-Urban population may not add up to total due to rounding

31
Revision of Sampling Frame

4.19 The revision of SRS sampling frame is undertaken once in every ten years, based on the
results of the latest census. While changing the sample, modifications in the sampling design;
wider representation of population; overcoming the limitations in the existing scheme; meeting
the additional requirements are taken into account. The first replacement was carried out in
1977-78, with the last being in 2004. Whereas the replacement of samples in earlier years was
undertaken in phases spread over 2-3 years, the replacement in 2004 was done in one go, within
a year. The following table viz. Statement-2 provides the details of the sample size in different
replacement periods.

Statement 2
Number of sample units at different replacement period
Residence 1969-70 1977-78 1983-85 1993-95 2004 2008
Rural 2432 3684 4176 4436 4433 4433
Urban 1290 1738 1846 2235 3164 3164
Total 3722 5422 6022 6671 7597 7597

Information Collected in SRS

SRS Forms and their flow

4.20 For collecting information on population and vital events various forms/schedules have
been prescribed under the SRS. Depending upon various operations under the system, the
following 17 types of forms are in use:

Baseline Survey Forms

Form 1: House List
Form 2: Household Schedule
Form 3: Pregnancy Status of women
Continuous Enumeration Forms
Form 4: Outcome of Pregnancy recorded by Enumerator (January-June/July-December)
Form 5: Deaths recorded by Enumerator (January-June/July-December)
Form 6: Monthly report of Outcome of Pregnancy
Form 7: Monthly report of Deaths

Half yearly Survey Forms

Form 9: Outcome of Pregnancy recorded by Supervisor (January-June/July-December)
Form 10: Deaths recorded by Supervisor (January-June/July-December)
Form 15: Distribution of usual resident population by age, sex and marital status
(as on 1st July/1st January)
Form 16: Distribution of Female population by broad age groups and levels of
education (as on 1st July/1st January)
Form 17: Number of females who got married
by age at effective marriage (January-June/July-December)

32
Compilation/Tabulation Forms
Form 8: Consolidated monthly report on births and deaths
Form 11: Finalised list of Outcome of Pregnancy (January-June/July-December)
Form 12: Finalised list of Deaths (January-June/July-December)
Form 13: Results of the HYS for Outcome of Pregnancy (January-June/July-December)
Form 14: Results of the HYS for Deaths (January-June/July-December)

4.21 Every enumerator records all births and deaths events (Forms 4 and 5) on a continuous
basis and the same is retained for six months prior to initiation of the next half yearly surveys. The
enumerator is required to send to the state headquarters in the first week of the following month,
a monthly report on births and deaths (Forms 6 and 7). The relevant entries of birth and death
records are copied in monthly report from six monthly records and sent to the state headquarter.
On the basis of the monthly reports received from the sample units, the state headquarters are
required to prepare a consolidated monthly report (Form 8) and forward the same to the Office of
the Registrar General, India by the end of the following month. The monthly reports for the
individual units remain at the state headquarters. The supervisor records details of each birth and
death event occurring during the six-month reference period in Forms 9 and 10 respectively. After
matching of each birth and death event recorded in Forms 4 and 5 with those in Forms 9 and 10
and verification of partially and unmatched events in the field, finalized forms 11 and 12 are pre-
pared, after necessary corrections and inclusion of additional events recorded during the survey.
These forms are sent to the Office of the Registrar General, India, along with the half-yearly survey
results in Forms 13, 14, 15, 16 and 17.

Evaluation of Sample Registration System

4.22 The SRS is a dual registration system designed to net all the vital events. This provides built
in checks on the work of the enumerators and as well as the supervisors. Despite this, omission of
events cannot be ruled out. Attempts have therefore been made from time to time to assess the
extent of omission. These evaluations are based on survey and analytical methods (Indirect
estimation techniques using P/F ratio method). These have been discussed in brief in the following
paragraphs.

Evaluation based on survey methods

4.23 An intensive check undertaken in rural Kerala during 1965-66 indicated that 8 per cent of
births and 5 per cent of deaths were omitted. An intensive enquiry undertaken in Assam during
1972-73 indicated that the in rural areas, birth and deaths were omitted to the extent of 2.4 per
cent and 3 per cent respectively. In urban areas, the corresponding figures were 5.8 and 5.2 per
cent respectively. In 1973-74, the extent of under enumeration in urban areas of Andhra Pradesh
was 7.7 per cent of births and 9.2 per cent of deaths.

4.24 An intensive enquiry in a ten per cent of sub sample of SRS units was undertaken during
1980-81 by the Office of the Registrar General, India. This survey provided correction factors at
national and state level. At national level, the correction factors were 3.2 per cent of birth and 3.4
per cent of deaths. Another comprehensive enquired a correction factor of 1.018 of birth and
1.025 of deaths.

Evaluation based on analytical methods

4.25 Panel on India of the committee on Population and Demography, National Academy of
Sciences, U.S.A. estimated that SRS births were under reported to the extent of 7.3 per cent in
1970-73. These estimates were based on the data on children ever born collected in the fertility
33
survey, 1972 undertaken in a sub sample of SRS units. Using brass growth balance method on the
SRS data for the period 1970-75, it was estimated that the births were under estimated to the
extent of 6 per cent. A survey on infant and child mortality was conducted in all units of SRS
during 1979. In this survey, questions on the number of children ever born and the number
surviving were canvassed. Based on this data and applying Brass P/F ratio method, it was
estimated that the births in SRS were under estimated to the extent of 2.5 per cent at the
national level. The survey also estimated under enumeration at state level. The child mortality
estimates derived from the survey were close to SRS estimates. Another study done in 1992,
using indirect regression estimates, revealed that both SRS fertility and mortality estimates were
remarkably good.

Data brought out by SRS and Publications

4.26 A number of fertility and mortality indicators based on SRS are published regularly. The
most important fertility indicators are Crude Birth Rate, General Fertility Rate, Age Specific
Fertility Rates, Total Fertility Rates, Gross Reproduction Rate, General Marital Fertility Rate, Total
Marital Fertility Rate, Mean age at effective marriage for females, per cent distribution of life
births and birth order, percent distribution of life births by birth interval (in months). The
mortality indicators available are Crude Death Rate, Infant Mortality Rate, Neo-natal Mortality
Rate, early Neo natal Mortality Rate, late Neo Natal Mortality Rate post Neo Natal Mortality Rate,
Peri-natal Mortality Rate and still birth rate. Apart from these indicators, per cent distribution of
births by type of medical attention at delivery and also before death - institutional (Govt. hospital
and private hospital), qualified professionals and untrained functionary and others are also
published. The SRS data on birth rate, death rate and infant mortality rates and their confidence
intervals are brought in the Sample Registration Bulletin published regularly. This is followed by
an annual publication titled “Sample Registration System-A Statistical Report”. This report
presents a number of demographic indicators for each state and union territory and includes
analysis focusing on population composition by broad age group, sex and marital status for India
and bigger states. The given information was on mean age at effective marriage for females,
interval between current and previous live birth, and distribution of live births by birth order is
also published. The tables published in the report are mentioned in Annex-7.
Based on the tables, a number of derived indicators are presented in the form of
statements. Apart from the statistical reports mentioned above, during the last about ten years
or so, the office of the Registrar General India has been regularly bringing our “SRS based
abridged life tables”. The publication SRS based abridged life table for 2002-06 has been brought
out recently viz. in 2008. The SRS Bulletin for 2009 and SRS Statistical Report -2008 were also
published in 2009.

SRS based life tables

4.27 In the absence of reliable estimates of mortality rates from the civil registration system, in
India, it had been the practice to estimate expectation of life at birth from the life tables
constructed using the age distribution of population in two censuses which are ten years apart.
With the introduction of the SRS system, an alternative and more reliable source of age specific
death rates has become available. Based on the age specific death rates, life tables have been
constructed for the period 1970-75, 1976-80, 1981-85 and 1986-90. After this, life tables have
been brought out every year regularly. These are constructed separately for males and females,
in rural and urban areas. From these life tables, expectation of life is available at every age for

34
males and females and for rural and urban areas. To reduce sampling fluctuations, the mortality
rates are based on the last five years’ data and relate to the mid point of the period.

Special Surveys

4.28 A number of special surveys have been carried our from time to time using SRS
infrastructure. These are:
 A fertility survey during 1972 in a 25 per cent sub sample of SRS households in each unit
with a view to study the socio economic differentials in fertility
 Survey on infant and child mortality in 1979 to study the pattern of differential of fertility
and child mortality, health and care of children.
 Survey of fertility, 1984 to provide fertility and mortality differentials by socio economic
group.
 Special fertility and mortality survey, conducted around February 1998, in 6434 and the
6671 SRS sample units. Apart from collection of data on birth and death events, data on
fertility history of each married women, total by number of children ever born and
surviving, gender of the previous births, personal habits i.e., alcohol, smoking and visual
and physical impairments were also collected.
 To make available bench mark data on cause specific mortality by age and sex, a special
survey of death was completed in all the states and union territories by pooling deaths in
SRS sample for the period 2001-03 during 2004-05. Based on this study, two landmarks
reports namely ‘Maternal Mortality in India-1997-2003’ and ‘Causes of Death in India-
2001-03’ were published in 2006 and 2009 respectively. A Special Bulletin on Maternal
Mortality in India, 2004-06 has been published in 2009.

New initiatives:

4.29 To enhance the utility of SRS data, the following two initiatives have been taken
recently:
 Collection of additional data in SRS: Special schedules have been canvassed during
July-December, 2001 to collect additional data on ‘Proof of age, registration of births
and determining the residential status of the mother during pre and post natal
period’.
 Integration of Survey of Causes of Deaths (Rural) in SRS: In the absence of dependable
statistics on cause of death based on medical certificate of death, Office of the
Registrar General, India initiated in the 1960s a scheme called “Model Registration
Scheme” in selected Primary Health Centers. In 1982 this scheme was renamed as
“The Survey of Causes of Deaths (Rural)”. This has been merged with the Sample
Registration System from 1st January, 1999 to give more impetus to collect reliable
data on cause of death, covering both rural and urban areas. In the SRS blocks, deaths
are classified by causes of death based on Verbal Autopsy (VA). For this, instruments
based on existing experience of WHO, Chinese Surveillance System and other national
and international studies, VA instruments have been developed. Since then causes of
death data under the domain of SRS are being collected regularly and the results are
published in the form of special reports/bulletins.
 Unlike in past, the entire SRS sample units were replaced in a single year during the
latest revision done in 2004 based on 2001 census frame.

35
 Introduction of Unique Identification Code: One of the significant initiative during
the latest revision is introduction of unique identification code. This will result in :
o easy storage and retrieval of data
o aggregation at different levels
o Cross-classification of various determinants with fertility and mortality
indicators
o Cohort studies.

36
 V VITAL STATISTICS FROM NATIONAL FAMILY HEALTH SURVEYS

Background of the Survey

5.1 India’s first National Family Health Survey 1(NFHS-1) was conducted in 1992–93. The
primary objective of survey was to provide national and state level data on fertility, nuptiality,
family size preferences, knowledge and practice of family planning, the potential demand for
family planning services, the level of unwanted fertility , utilization of ante natal care services ,
breast feeding and food supplementation practices , child nutrition and health immunization and
infant and child mortality. Financial assistance for NFHS was provided by the United States
Agency for International Development (US AID).The Ministry of Health and Family Welfare
(MOHFW), Government of India, subsequently designated the International Institute for
Population Sciences (IIPS), Mumbai, as the nodal agency to conduct the survey.

5.2 The second survey (NFHS-2) which was conducted in 1998-99 collected most of the
information covered in NFHS 1 and in addition expanded to a number of new topics such as
reproductive health, women’s autonomy, domestic violence, women’s nutrition, anaemia and salt
iodization. The survey also provided estimates at the regional level for four states (Bihar, Madhya
Pradesh, Rajasthan, and Uttar Pradesh) and estimates for three metro cities (Calcutta, Chennai,
and Mumbai), as well as slum areas in Mumbai.

5.3 The third Survey (NFHS-3) was conducted in the year 2005-06. This survey, as in the past,
collected information on Mortality, Marriage, Family Planning, Maternal and Child Health,
Immunization of children, treatment of infection, child feeding practices, Obesity among men and
women, knowledge, attitude and behavior with regard to HIV/AIDS and its prevalence. Questions
on several emerging issues such as perinatal mortality, male involvement in maternal health care,
adolescent reproductive health, higher risk sexual behavior, family life education, safe injections,
domestic violence and knowledge and treatment seeking behavior about tuberculosis and malaria
were also asked.

5.4 NFHS is a household survey with an overall target sample size of approx. 90,000 ever
married women in the age group of 15-49. NFHS-1 and NFHS-2 covered more than 99% of India’s
population living in all 25 states. While the state of Sikkim was not covered in NFHS-1, it was
covered in NFHS-2. Both the surveys did not cover Union Territories. NFHS-3 covered 29 states.
Some more additional features of NFHS-3 were:

(i) Unlike the earlier surveys in which only ever-married women (age 15-49) were
interviewed, NFHS-3 covered samples from all ever married, unmarried and
widowed women in the age group of 15-49 years and men in the age group of 15-
54 years.
(ii) NFHS-3 provided estimates of key indicators for India as a whole and, with the
exception of HIV prevalence, for all 29 states by urban-rural residence.
(iii) NFHS-3 was the first nation-wide community based survey to provide an estimate
of HIV prevalence in the general population. It also provided estimates of HIV
prevalence among women in the age-group of 15-49 yrs and men in the age group
of 15-54 years at the national level.

37
 (iv) NFHS-3 provided estimates for the slum and non-slum population of eight selected
cities viz; Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai and
Nagpur.

Organisation of Survey

5.5 NFHS-2 was conducted with major financial support from the United States Agency for
International Development (USAID), with additional funding from UNICEF, ORC Macro, Calverton,
Maryland, USA, and the East-West Center, Honolulu, Hawaii, USA provided technical assistance.
Thirteen field organizations were selected to collect the data. Eight of the field organizations are
private sector organizations and five are Population Research Centres (PRCs) established by the
Government of India in various states. Each field organization had responsibility for collecting the
data in one or more states.

5.6 NFHS-3 was conducted under the stewardship of the Ministry of Health and Family
Welfare (MOHFW), Government of India, with support from a number of organizations. The
International Institute for Population Sciences (IIPS), Mumbai, was designated as the nodal
agency. Funding was provided by United States Agency for International Development (US AID),
DFID, the Bill and Melinda Gates Foundation, UNICEF, UNFP and MOHFW. Macro International,
USA, provided technical assistance whereas the National Aids Control Organization (NACO) and
the National Aids Research Institute (NARI) provided technical guidance for the HIV component of
NFHS-3, including testing. Eighteen Research Organizations were involved in conducting the field
work in the different states of India.

5.7 Decisions about policies and procedures, including design, methodology, questionnaire,
contents etc for NFHS-3 were reviewed by three project committees, namely: (a) A Steering
Committee under the chairmanship of the Secretary, MOHFW; (b) An Administrative and Finance
Management Committee under the Chairmanship of the Additional Secretary and Financial
Advisor to the MOHFW and ( c) A Technical Advisory Committee under the Chairmanship of Dr.
Arvind Pandey, the then Director, National Institute For Medical Statistics, Indian Council of
Medical Research (ICMR). These Committees included representatives of MOHFW, other
Government of India Ministries and Organizations such as Statistics and Programme
Implementation, Women and Child Development, Planning Commission, ICMR, NACO etc.

Sample Design

5.8 The survey used a uniform sample design, questionnaires (translated into 18 Indian
languages), field procedures, and procedures for biomarker measurements throughout the
country to facilitate comparability across the states and to ensure the highest possible data
quality. In each state, the rural sample was selected in two stages; the selection of Primary
Sampling Units (PSUs), which are villages, with probability proportional to population size (PPS) at
the first stage, followed by the random selection of an equal number of households within each
PSU in the second stage. In urban areas, a three-stage procedure was followed. In the first stage,
wards were selected with PPS sampling. In the next stage, one Census Enumeration Block (CEB)
was randomly selected from each sample ward. In the final stage, an equal number of
households were randomly selected within each sample CEB. Information was collected from a
nationally representative sample of 109,041 households, 124,385 women (age group 15-49 years)
and 74,369 men (age group 15-54 years).

38
5.9 The sample size for each state was specified in terms of a target number of completed
interviews with eligible women. The target sample size was set considering the size of the state,
the resources available for the survey, and the aggregate level (urban/rural, region, metropolitan
cities) at which separate estimates were needed.

5.10 In NFHS 1, the initial target sample size was 4,000 completed interviews with eligible
women in states with a 1991 population of more than 25 million, 3,000 completed interviews
with eligible women in states with a 1991 population between 2 and 25 million, and 1,000
completed interviews with eligible women in states with a population of less than 2 million.
However, there were some exceptions. In Uttar Pradesh the interviews to be completed were
fixed at 8000. For Uttar Pradesh, Bihar, Madhya Pradesh, and Rajasthan, the samples were
designed to provide estimates for backward districts of the states. The sample size in these states
was fixed at 8000 interviews.

5.11 In NFHS 2, for states with population less than 2 million the sample size was fixed at 1500
completed interviews. The target sample size was set at 10,000 completed interviews with
eligible women in Uttar Pradesh and 7,000 completed interviews with eligible women in Madhya
Pradesh, Bihar, and Rajasthan. For other states, the sample size remained three thousand
completed interviews. For Maharashtra, West Bengal, and Tamil Nadu, the initial target samples
were increased to allow separate estimates to be made for the metropolitan cities of Mumbai,
Calcutta, and Chennai. The target sample size was 5,500 in Maharashtra, 4,750 in West Bengal,
and 4,750 in Tamil Nadu. For Mumbai, the target sample was large enough to allow separate
estimates for its slum and non-slum populations.

Sample Selection in Rural Areas

5.12 Prior to NFHS-3, in rural areas, the 1991 Census list of villages served as the sampling
frame. The list was stratified by a number of variables. Except in Delhi, the first level of
stratification was geographic, with districts being subdivided into contiguous regions. Within each
of these regions, villages were further stratified using selected variables from the following list:
sub regions, village size, percentage of males working in the nonagricultural sector, percentage of
the population belonging to scheduled castes or scheduled tribes, and female literacy. However,
not all variables were used in every state. Each state was examined individually and a subset of
variables was selected for stratification with the aim of creating not more than 6 strata for small
states, not more than 12 strata for medium size states, and not more than 15 strata for large
states. Female literacy was used for implicit stratification (i.e., the villages were ordered prior to
selection according to the proportion of females who were literate) in every state except Kerala
and Orissa, where female literacy was an explicit stratification variable. From the list of villages
arranged in this way, villages were selected systematically with probability proportional to the
1991 Census population of the village. Small villages with 5–49 households were linked with an
adjoining village to form PSUs with a minimum of 50 households. Villages with fewer than five
households were excluded from the sampling frame.

5.13 In every state, a mapping and household listing operation was carried out in each sample
area. The listing provided the necessary frame for selecting households at the second stage. The
household listing operation involved preparing up-to-date notional and layout sketch maps of
each selected PSU, assigning numbers to structures, recording addresses of these structures,

39
identifying residential structures, and listing the names of heads of all the households in
residential structures in the selected PSUs. Large sample villages (with more than a specified
number of households, usually 500) were segmented, and two segments were selected randomly
using the PPS method. Household listing in the segmented PSUs was carried out only in the
selected segments. Each household listing team comprised one lister and one mapper. Senior
field staff of the concerned field organization supervised the listing operation.

5.14 The households to be interviewed were selected with equal probability from the
household list in each area using systematic sampling. The interval applied for the selection was
determined to obtain a self-weighting sample of households. On an average, 30 households were
initially targeted for selection in each selected enumeration area. To avoid extreme variations in
the workload, minimum and maximum limits were put on the number of households that could
be selected from any area, at 15 and 60, respectively. Each survey team supervisor was provided
with the original household listing, layout sketch map, and the list of selected households for each
PSU. All the households which were selected were contacted during the main survey, and no
replacement was made if a selected household was absent during data collection. However, if a
PSU was inaccessible, a replacement PSU with similar characteristics was selected by IIPS and
provided to the field organization.

5.15 In NFHS-3, in rural areas, the 2001 Census list of villages served as the sampling frame.
The list was stratified by a number of variables. The first level of stratification was geographic,
with districts being subdivided into contiguous regions. Within each of these regions, villages
were further stratified using selected variables from a list containing the village sizes, percentage
of males working in the non-agricultural sector, percentage of the population belonging to
scheduled castes or scheduled tribes and female literacy. In addition to these variables, an
external estimate of HIV prevalence viz. “High”, “Medium”, or “Low”, as estimated for all the
districts in high HIV prevalence states, was used for stratification in high HIV prevalence states.
Female literacy was used for implicit stratification (i.e., villages were ordered prior to selection
according to the proportion of females who were literate) in most states although literacy was an
explicit stratification variable in a few states.

5.16 The households to be interviewed were selected with equal probability from the
household list in each area using systematic sampling. The interval applied for the selection was
determined to obtain a self-weighting sample of households within each domain. On an average,
30 households were initially targeted for selection in each selected enumeration area. All the
households which were selected were contacted during the main survey and no replacement was
made, if a selected household was absent during data collection. However, if a PSU was
inaccessible, a replacement PSU with similar characteristics was selected.

Sample Selection in Urban Areas

5.17 Prior to NFHS-3, the procedure adopted for the first stage of the sample design in urban
areas was similar to the one followed in rural areas. The 1991 Census list of wards was arranged
according to districts and within districts by the level of female literacy, and a sample of wards
was selected systematically with probability proportional to size. Next, one census enumeration
block, consisting of approximately 150–200 households, was selected from each selected ward
using the PPS method. In Jammu and Kashmir, two census enumeration blocks were selected in
each selected ward. As in rural areas, a household listing operation was carried out in each

40
selected census enumeration block, which provided the necessary frame for selecting households
in the third stage of sample selection. On an average, 30 households per block were targeted for
selection (except in Jammu and Kashmir and in Mumbai, where the target was 20 households per
block).

5.18 In NFHS-3, the procedure adopted for the first stage of the sample design in urban areas
was similar to the one followed in rural areas. The 2001 Census list of wards was arranged
according to districts and within districts, by the level of female literacy and a sample of wards
was selected systematically, with probability proportional to size. Next, one Census Enumeration
Block, consisting of approximately 150-200 households, was selected from each selected ward
using the PPS method. As in rural areas, a household listing operation was carried out in each
CEB, which provided the necessary frame for selecting households in the third stage of sample
selection. On an average, 30 households were targeted for selection from each CEB, with
minimum and maximum limits from any area of 15 and 60 households.

Questionnaires Canvassed

5.19 NFHS- 1& 2 used three types of questionnaires: the Village Questionnaire, Household
Questionnaire and the Woman’s Questionnaire.

5.20 For each village selected in the sample, the Village Questionnaire collected information on
the availability of various facilities in the village (especially health and education facilities) and
amenities such as electricity and telephone connections.

5.21 In NFHS 1, a set of state specific questions were added in most of the states. The set of
questions included were: dowry in Bihar, age at marriage in Rajasthan, sex preference in Uttar
Pradesh, international migration in Kerala, and Green card for family planning in Madhya Pradesh,
benefits received from anti poverty measures in Karnataka and international migration in Punjab.
In all other states, a set of questions relating to knowledge of AIDS was canvassed.

5.22 In NFHS 2 respondents to the Village Questionnaire were also asked about development
and welfare programmes operating in the village. The village survey included a short, open-ended
questionnaire that was administered to the village head, with questions on major problems in the
village and actions that could be taken to alleviate the problems.

5.23 The Household Questionnaire listed all usual residents in each sample household plus any
visitors who stayed in the household the night before the interview. For each listed person, the
survey collected basic information on age, sex, marital status, relationship to the head of the
household, education, and occupation. Information was also collected on the main source of
drinking water, type of toilet facility, material used in the construction of the house, source of
lighting, type of cooking fuel, religion of the household head, caste/tribe of the household head,
ownership of a house, ownership of agricultural land, ownership of livestock, and ownership of
other selected consumer durable goods items. In NFHS 1, the Household Questionnaire also
collected information on the prevalence of blindness, tuberculosis, leprosy, physical impairment
of limbs and malaria during last three months. In NFHS 2, the Household Questionnaire also
collected information on the usual place where household members go for treatment when they
get sick, the prevalence of asthma, tuberculosis, malaria, and jaundice, as well as three risk
behaviors—chewing paan masala or tobacco, drinking alcohol, and smoking. In addition, a test
41
was conducted to assess whether the household uses cooking salt that has been fortified with
iodine. In NFHS 1, Household Questionnaire included question about births in the last two years
(since 1990) and in NFHS 2 there were questions on deaths occurring to household members in
the two years before the survey, with particular attention to maternal mortality. The information
on the age, sex, and marital status of household members was used to identify eligible
respondents for the Woman’s Questionnaire.

5.24 In NFHS 1, height/length and weight of children under age 4 were recorded in most of the
states. However due to non availability of measuring instruments during first phase of data
collection height/length was not measured in a few states.

5.25 In NFHS 2 ,the health investigator on each survey team measured the height and weight of
each woman and each of her children born since January 1995 (in states where fieldwork started
in 1998) or January 1996 (in states where fieldwork started in 1999) This height and weight
information is useful for assessing levels of nutrition prevailing in the population. The health
investigators also took blood samples from each woman and each of her children born since
January 1995/1996 to assess hemoglobin levels. This information is useful for assessing
prevalence rates of anemia among women and children. Haemoglobin levels were measured in
the field at the end of each interview using portable equipment (the HemoCue) that provides test
results in less than one minute. Severely anaemic women and children were referred to local
medical authorities for treatment. In Delhi and Mumbai, the blood samples of young children
were also used to test levels of lead using the portable Lead Care instrument.

5.26 The Woman’s Questionnaire collected information from all ever-married women age 15–
49 who were usual residents of the sample household or visitors who stayed in the sample
household the night before the interview. The questionnaire covered the following topics:

Background characteristics: Questions on age, marital status, education, employment

status, and place of residence provided information on characteristics likely to influence
demographic and health behaviour. Questions were also asked about a woman’s husband and
work status of the woman herself. NFHS 2 added questions on gender roles, and the treatment
of women in the household.

Reproductive behaviour and intentions: Questions covered dates and survival status of all
births, current pregnancy status, and future childbearing intentions of each woman.

Knowledge and use of contraception: Questions covered knowledge and use of specific
family planning methods and source of family planning i.e; where the user obtained her family
planning method. For women not using family planning, questions on reasons for nonuse and
intentions about future use were included.

Antenatal, delivery, and postpartum care: The questionnaire collected information on

whether women received antenatal and postpartum care, who attended the delivery and the
nature of complications during pregnancy for recent births.

Breastfeeding and health: Questions covered feeding practices, the length of

breastfeeding, immunization coverage, and recent occurrences of diarrhoea, fever, and cough for
young children.

42
5.27 In 1996, the then existing family welfare programme was transformed to Reproductive
and Child Health (RCH) programme. Therefore, NFHS 2 included several questions on the quality
of health and family welfare services provided in the public and private sector. These were
covered in the following sections.

Reproductive health: Questions assessed various aspects of women’s reproductive health and
the type of care sought for health problems.

Status of Women: The questionnaire included questions about women’s autonomy and violence
against women. The questions canvassed focused on woman’s role in respect of household
decision making, decision on use of earnings (for women who earn cash), freedom of movement,
and control over money.

Quality of care: Questions assessed the quality of family planning and health services.

Knowledge of AIDS: Questions assessed women’s knowledge of AIDS and the sources of their
knowledge, as well as knowledge about ways to avoid getting AIDS.

5.28 Like NFHS-1 and NFHS-2, NFHS-3 was designed to provide estimates of important
indicators on family welfare, maternal and child health and nutrition. Besides, it included
questions on several new and emerging issues. Information on nutritional status including the
prevalence of anaemia was provided in NFHS-3 for women (age 15-49), men (age 15-54) and
young children. A special feature of NFHS-3 is the inclusion of testing of the adult population for
HIV. It was the first nationwide community based survey in India to provide an estimate of HIV
prevalence in the general population. Specifically, NFHS-3 provided estimates of HIV prevalence
among women (15-49 years), and men (age 15-54 years) for all of India and also, separately for
Uttar Pradesh, Andhra Pradesh, Karnataka, Maharashtra, Manipur and Tamil Nadu, five of the six
states classified by NACO as high HIV prevalence states. No estimate of HIV prevalence had been
provided for Nagaland, the sixth high HIV prevalence state, due to strong local opposition to the
collection of blood samples.

Sample Implementation

5.29 In order to achieve better coordination and supervision, the NFHS-2 survey operation was
carried out in two phases. The first phase included the states of Andhra Pradesh, Bihar, Gujarat,
Haryana, Madhya Pradesh, Punjab, Rajasthan, Sikkim, Uttar Pradesh, and West Bengal. The
second phase states were Arunachal Pradesh, Assam, Delhi, Goa, Himachal Pradesh, Jammu and
Kashmir, Karnataka, Kerala, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Orissa, and
Tamil Nadu. Tripura fieldwork was delayed due to local problems.

5.30 A total of 91,196 households were interviewed, two-thirds of which were rural. The
overall household response rate—the number of households interviewed per 100 occupied
households—was 98 percent. The household response rate was more than 94 percent in every
state except Meghalaya and Delhi where it was 89 percent and 91 percent, respectively. The
household response rate was almost 100 percent in Tamil Nadu.

43
5.31 In the interviewed households, interviews were completed with 89,199 eligible women
who stayed in the household the night before the household interview. The individual response
rate—the number of completed interviews per 100 identified eligible women in the households
with completed interviews—was 96 percent for the country as a whole. The variation in the
women’s response rate by state was similar to that observed for the household response rate.

5.32 The NFHS-3 field work was carried out in two phases, in order to achieve better
coordination and supervision in the implementation of the survey. Twelve States were canvassed
in the first phase and the remaining 17 states were canvassed in the second phase. First phase
data collection was carried out from November, 2005 to May, 2006 while the second phase data
collection was carried out from April to August, 2006.

Field Work

5.33 Prior to NFHS-3, the fieldwork in each state was carried out by a number of interviewing
teams, each team consisting of one field supervisor, one female field editor, four female
interviewers, and one health investigator. The number of interviewing teams in each state varied
according to the sample size. In each state, interviewers were hired specifically for NFHS-2, taking
into consideration their educational background, experience, and other relevant qualifications. All
interviewers were female, a stipulation that was necessary to ensure that women who were
survey respondents would feel comfortable talking about topics that they may find somewhat
sensitive.

5.34 In NFHS-3, the field work in each state was carried out by a number of interviewing
teams, each team consisting of one field supervisor, one female field editor, four interviewers and
two health investigators. In the states in which all sample households were eligible for men’s
interviews, two of the interviewers were males and the other two were females. In the remaining
states, each team included three female interviewers and one male interviewer. The number of
interviewing teams in each state varied according to the sample size. Assignment of PSUs to the
teams and various logistical decisions were made by the survey coordinators from the concerned
research organizations which were hired for NFHS-3. Each interviewer was required to make a
minimum of three call backs, if no suitable informant was available for the household interview or
if an eligible woman or man in the household was not present at the time of the interviewer’s
visit.

Training of field staff

5.35 Prior to NFHS-3, training of the field staff lasted for a minimum of three weeks in each
state. The training course consisted of instruction in interviewing techniques and survey field
procedures, a detailed review of each item in the questionnaires, instruction and practice in
weighing and measuring children, mock interviews between participants in the classroom, and
practice interviews in the field. In addition, at least two special lectures were arranged in each
state: one on the topic of family planning at the beginning of training on the section on
contraception in the Woman’s Questionnaire, and one on maternal and child health practices,
including immunization, at the beginning of training on the section on the health of children. In
addition to the main training, two days’ training was arranged for field editors and supervisors,
which focused on the organization of fieldwork as well as methods of detecting errors in field
procedures and in the filled-in questionnaires. Health investigators attached to interviewing

44
teams were given additional specialized training on measuring height and weight and testing for
anaemia in a centralized training programme conducted by IIPS in collaboration with the All India
Institute of Medical Sciences (AIIMS), New Delhi. This specialized training included classroom
training and extensive field practice in schools, anganwadis, and communities.

5.36 Assignment of Primary Sampling Units (PSUs) to the teams and various logistical decisions
were made by the survey coordinators from each field organization. Each interviewer was
instructed not to conduct more than three individual interviews a day and was required to make a
minimum of three callbacks if no suitable informant was available for the household interview or
if the eligible woman identified in the selected household was not present at the time of the
household interview.

5.37 The main duty of the field editor was to examine the completed questionnaires in the field
for completeness, consistency, and legibility of the information collected, and to ensure that all
necessary corrections were made. Special attention was paid to missing information, skip
instructions, filter questions, age information, and completeness of the birth history and the
health section. If major problems were detected, such as discrepancies between the birth history
and the health section, the interviewers were required to revisit the respondent to correct the
errors. An additional duty of the field editor was to observe ongoing interviews and verify the
accuracy of the method of asking questions, recording answers, and following skip instructions.

5.38 The field supervisor was responsible for the overall operation of the field team and
collection of information on villages using the Village Questionnaire. In addition, the field
supervisor conducted spot-checks to verify the accuracy of information collected on the eligibility
of respondents. IIPS also appointed one or more research officers in each state to help with
monitoring throughout the training and fieldwork period in order to ensure that correct survey
procedures were followed and data quality was maintained. Survey directors and other senior
staff from the field organizations, project coordinators, other faculty members from IIPS, senior
research officers, and staff members from ORC Macro and the East-West Center also visited the
field sites to monitor the data collection operation. Medical health coordinators appointed by IIPS
monitored the nutritional component of the survey. Field data were quickly entered into
microcomputers, and field-check tables were produced to identify certain types of errors that
might have occurred in eliciting information and filling out questionnaires. Information from the
field-check tables was fed back to the interviewing teams and their supervisors so that their
performance could be improved.

Data Processing

5.39 All completed questionnaires were sent to the office of the concerned field organization
(FO) for editing and data processing (including office editing, coding, data entry, and machine
editing). Although field editors examined every completed questionnaire in the field, the
questionnaires were re-edited at the FO headquarters by specially trained office editors. The
office editors checked all skip sequences, response codes that were circled, and information
recorded in filter questions. Special attention was paid to the consistency of responses to age
questions and the accurate completion of the birth history. In the second stage of office editing,
appropriate codes were assigned for open-ended responses on occupation and cause of death,
and commonly mentioned “other” responses were added to the coding scheme. For each state,
the data were processed with microcomputers using the data entry and editing software known

45
as the Integrated System for Survey Analysis (ISSA). The data were entered directly from the pre-
coded questionnaires, usually starting within one week of the receipt of the first set of completed
questionnaires. Data entry and editing operations were usually completed a few days after the
end of fieldwork in each state. Computer-based checks were used to clean the data and remove
inconsistencies. Age imputation was also completed at this stage. Age variables such as the
woman’s current age and the year and month of birth of all of her children were imputed for
those cases in which information was missing or incorrect entries were detected.

5.40 Preliminary reports with selected results were prepared for each state within a few
months of data collection and presented to policymakers and programme administrators
responsible for improving health and family welfare programmes. Detailed NFHS-2 state reports
were prepared by IIPS, in collaboration with the Population Research Centres, other local
organizations, ORC Macro, and the East-West Center. The state reports contained detailed
information on such topics as the state’s survey design and implementation, household and
respondent background characteristics, fertility and fertility preferences, family planning,
mortality, morbidity, child immunization, lifestyle indicators, domestic violence, knowledge of
HIV/AIDS, nutritional status of women and children, infant feeding practices, anaemia among
women and children, maternal care and reproductive health, and the quality of care of health and
family welfare services. Annex 8 presents a list of indicators available for each state in NFHS 2.

5.41 In NHFS-3, which involved many organizations and a large number of individuals who
required various skills to successfully implement all stages of the survey, centralized training
workshops were held to train the representatives of each of the 18 field organizations, as well as
the personnel at IIPS (which assisted with the supervision and monitoring of all NFHS-3 activities).
Persons who were trained in each workshop subsequently trained the staff in each state,
according to the standard procedures discussed in the training workshops. The purpose of these
workshops was to ensure uniformity in data collection procedures in different states. Five types
of training workshops were held for the personnel involved in the NFHS-3 project
implementation, namely, (a) Health Coordinator Training, (b) Household Listing and Mapping
Workshops, (c) Training of Trainers (TOT) Workshops, (d) Health Investigator Training and (e) Data
Processing Training.

5.42 NFHS-3 Data Processing involved office editing, data entry using CSPro software,
verification of data entry and secondary editing by the concerned research organizations which
participated in NHFS-3. Final data cleaning and recording of the data into a standard structure
and variable naming conventions was done at IIPS.

5.43 All completed questionnaires were sent to the office of the concerned research
organization for editing and data processing (including office editing, data entry and machine
editing). Although field editors examined every completed questionnaire in the field, the
questionnaires were re-edited at the research organization headquarter by specially trained office
editors. In the second stage of office editing, appropriate codes were assigned for open-ended
responses on occupation. For each state, the data were processed with micro computers, using
the CSPro data entry and editing software. The data were entered directly from the pre-coded
questionnaires, usually starting within one week of the receipt of the first set of completed
questionnaires. Data entry and editing operations were usually completed a few days after the
end of field work in each state. Computer-based checks were used to clean the data and the
inconsistencies were resolved on the basis of the information recorded in the questionnaires. All

46
the completed data sets were sent to IIPS for final processing. At this stage, secondary editing
programs were run again to detect any remaining errors and inconsistencies.

NHFS-3 Publications

5.44 Fact sheets presenting key indicators were prepared for each state and for India, as a
whole within three months of the end of data collection in the last state. These fact sheets have
been widely distributed to policy makers and programme administrators responsible for
appropriate interventions in health and family welfare programmes and to other key stake-
holders.

5.45 The first volume of the NFHS-3 national report was prepared by IIPS in collaboration with
Macro International. The second volume of the national report provided additional information
on sampling and on standard errors of key indicators, as well as the questionnaires used in NFHS-
3. An additional report on key findings from NFHS-3 had also been prepared as a companion
volume to the comprehensive national report. Short state reports were also proposed to be
produced, with a summary discussion on major population, health and nutrition indicators and
selected state level tables. Several specialized subject reports on key topics were also proposed
to be published.

RAPID HOUSEHOLD SURVEYS (RHS) UNDER REPRODUCTIVE AND CHILD HEALTH (RCH)
INTERVENTIONS

5.46 The Reproductive and Child Health (RCH) interventions that are being implemented by the
Government of India (GOI) are expected to provide quality services and achieve multiple
objectives. The new approach requires decentralization of planning, monitoring and
evaluation of the services. Under such objectives, district is the basic nucleus of administration.
GOI has been entrusted to generate district level data, other then service statistics, on utilisation
of the services provided by government health facilities. Since covering all the households would
be very expensive, it was decided to conduct a sample survey in each district to assess the extent
of delivery of services and to assess the people’s perceptions on quality of services. Therefore, it
was decided to undertake District Level Household Survey (DLHS) under RCH Project in the
country. In phase I of second round of DLHS–RCH, 297 districts were covered and the remaining
districts covered in phase II of the DLHS–RCH.

5.47 The first round of RCH survey (RHS-RCH) in India was conducted during the year 1998–99 in
two phases (each phase covered half of the districts from all states/union territory) for which
International Institute for Population Sciences (IIPS), Mumbai was designated as the nodal
agency. The second round of RCH survey was conducted during 2002-04.

5.48 In DLHS-RCH, more detailed data on RCH were collected. Some new dimensions were
added to RHS-RCH such as testing of cooking salt to assess fortified with iodine, testing of blood
of children, adolescents and pregnant women to assess level of anaemia and weighing children
to assess the nutritional status.

5.49 The main focus of the District Level Household Survey is on the following aspects:

1) Coverage of Ante Natal Care(ANC) & immunisation Services

47
 2) Proportion of safe deliveries
3) Contraceptive Prevalence Rates
4) Unmet need for Family Planning
5) Awareness about RTI/ STI and HIV/AIDS and
6) Utilization of government health services and the users’ satisfaction

5.50 For the purpose of conducting DLHS-RCH, all the States and the Union territories were
grouped into 16 regions. A total of twelve research organizations, including Population Research
Centres (PRCs) were involved in conducting the survey and IIPS, Mumbai was designated as the
nodal agency .

Survey Design and Sample Size

5.51 A multi-stage stratified sampling design was adopted in District Level Household Survey
under Reproductive and Child Health Survey (DLHS-RCH). In each state/union-territory, at first
stage half of the districts were selected alternatively with random start for first phase and
remaining were taken up in second phase of DLHS-RCH (the selection of districts was based on
the total number of districts according to 2001 Census). In each selected district, 40 Primary
Sampling Units (PSUs – Villages/UFS) were selected with probability proportional to size (pps) at
second stage using 1991 Census data. The distribution of number of rural and urban PSUs was
made in proportion to percent of urbanization in the district. The target sample size in each
district was set at 1000 complete residential households from 40 selected PSUs. In third stage,
within each PSU, 28 residential households were selected with Circular Systematic Random
Sampling (CSRS) procedure, in order to take care of anticipated 10 percent non-response due to
various reasons.

5.52 The National Sample Survey Organization (NSSO) provided the list of selected urban frame
survey (UFS) blocks on the basis of percent of urbanization in the district. The UFS were made
available separately for each district for urban areas. The maps of selected blocks were obtained
from the NSSO field office located in each state/union-territory.

5.53 However, in the case of two old districts, one with highest proportion of safe delivery and
another with lowest proportion of safe delivery were surveyed during first round of RHS-RCH in
each state. The same districts were surveyed during DLHS-RCH on the bases of sample procedure
adopted in first round of RHS-RCH, 1998–99.

House Listing

5.54 A household listing operation was carried out in each of the selected PSU prior to the data
collection. This provided the necessary frame for selecting the households for DLHS-RCH. The
household listing involved

(a) preparation of location map of each selected PSU

(b) preparation of layout sketch map of the structures and
(c) recording details of the households in these structures.

48
5.55 This exercise was carried out by independent teams each comprising one lister, one mapper
and one supervisor under the overall supervision and monitoring of the research staff of regional
agencies.

5.56 A complete listing was carried out in the villages with number of households up to 300. In
case of villages with more than 300 households but less than or equal to 600 households, two
segments of more or less same equal size were formed and one segment was selected at random
and completely listed. In case of villages with more than 600 households, segments each of about
300 households were formed and two segments were selected. In case of small villages with less
than 50 households, village was linked with the nearest village available. After combining it with the
nearest village the same sampling procedure was adopted as mentioned above. As the urban PSUs
were of almost equal size and contained less than 300 households, as provided by NSSO, there
was no need of segmentation.

5.57 No replacement was made if a selected household was absent during data collection.
However, if a PSU was inaccessible, a replacement PSU with similar characteristics was selected
by Nodal agency IIPS and provided to regional agency.

Questionnaires

5.58 The details of questionnaires canvassed are as follows:

Household Questionnaire: The household questionnaire listed all usual residents in each
sample household including visitors who stayed in the household the night before the interview.
For each listed household member, the survey collected basic information on age, sex, marital
status, relationship to the head of the household, education and the prevalence /incidence of
tuberculosis, blindness and malaria. Information was also collected on the main source of
drinking water, type of toilet facility, source of lighting, type of cooking fuel, religion and caste of
household head and ownership of other durable goods in the household. In addition, a test was
conducted to assess whether the household used cooking salt that has been fortified with iodine.
Besides, details of marriages and deaths which happened with usual residents within reference
period were collected A specific enquiry was made on for maternal death and detailed
information about maternal death, if any, was collected..

5.59 Women Questionnaire: Women questionnaire was designed to collected information

from currently married women age 15 – 44 years who are usual residents of the sample
household or visitors who stayed in the sample household the night before the interview. The
women questionnaire covered the following sections

Section I: Background Characteristics: In this section the information was collected on age,
educational status and birth and death history of biological children including still birth, induced
and spontaneous abortions.

Section II: Antenatal, Natal and Post natal Care This section was canvassed only for women who
had live birth, still birth, spontaneous or induced abortion during last three years preceding the
survey date. Information on whether the women received antenatal and postpartum care, type
of attention at delivery, , and the nature of complications during pregnancy for recent births was
collected.
49
Section III: Immunization and childcare: This section was to collect data on breast feeding
practices, the length of breastfeeding, immunization coverage and recent occurrence of diarrhoea
and pneumonia fever and cough for young children.

Section IV: Contraception: This section provided information on knowledge and use of specific
family planning methods. Questions were also asked about women who were not using any
contraception, reasons for non use, intentions about future use, desire for additional child, sex
preference for next child etc.

Section V: Assessment of quality of Government health services and client satisfaction. In this
section the questions were designed to the quality of family planning and health services
provided by Government health facilities. Information was also collected about the rate of
Government health facilities and reasons for not visiting to government health facilities by eligible
woman.

Section VI: Awareness about RTI/STI and HIV/AIDS: In this section the data were collected about
women’s knowledge of RTI/STI, source of such knowledge, mode of transmission, curability,
symptoms and treatment seeking behavior. The data on awareness, source of knowledge, mode
of transmission and prevention of HIV/AIDS were also collected.

5.60 Husband Questionnaire: In DLHS-RCH, husband questionnaire was used to collect

information from eligible women’s husbands about age, educational status, knowledge and
source of knowledge of RTI/STI and HIV/AIDS reported symptoms of RTI/STI and male
participation of family planning. Apart from these, data pertaining to desire for children, reasons
for not using family planning methods, future intention to use F.P. methods and knowledge about
no scalpel vasectomy (NSV) were also collected.

5.61 Health Questionnaire: For the first time in RCH survey, a health questionnaire was
included in the second round of DLHS-RCH. The information collected were on weight of children
of age 0–71 months old and the blood sample to assess the haemoglobin levels of children of age
0–71 months old, adolescents of 10–19 years old and pregnant eligible women. These were
useful for assessing the levels of nutrition prevailing in the population and prevalence of anaemia
among women, adolescent girls and children.

5.62 Village Questionnaire: A village questionnaire was also added in this round of RCH survey.
This questionnaire collected information on the availability and accessibility of various facilities in
the village, especially educational and health facilities.

Data Processing

5.63 The completed questionnaires were brought to the headquarter of regional agencies and
data were processed using microcomputers. The process consisted of office editing of
questionnaires, data entry, data cleaning and tabulation. Data cleaning included validation, range
and consistency checks. For both data entry and tabulation of the data, IIPS developed the
software package. Annex-9 shows key indicators available based on this survey (DLHS-RCH-2)
for each district of the country.

50
District Level Household and Facility Survey (DLHS-3)

5.64 The District Level Household and Facility Survey (DLHS-3) is one of the largest ever
demographic and health surveys carried out in India, with a sample size of about 7 lakh
households covering all the districts of the country. DLHSs were initiated in 1997, with a view to
assess the utilization of services provided by the Government health care facilities and people’s
perceptions about the quality of services. DLHS-3 is the third in the series of such district surveys,
preceded by DLHS-1 in 1998-99 and DLHS-2 in 2002-04. As in DLHS-1 and DLHS-2, in DLHS-3 also,
the IIPS was the nodal agency to conduct the survey. Like the other two earlier rounds of DLHS,
DLHS-3 was designed to provide estimates on important indicators on maternal and child health,
family planning and other reproductive health services. In addition, DLHS-3 provided information
on important interventions of the National Rural Health Mission (NRHM). However, unlike the
previous two rounds, in which only currently married women (age 15-44 years) were interviewed,
DLHS-3 interviewed ever-married women (age 15-49 years) and never-married women (age 15-24
years). DLHS-3 adopted a multistage stratified sample design and sampled households
representing a district varied from 1000 to 1500.

5.65 The uniform bilingual questionnaires, both in English and in local language, were used in
DLHS-3 viz. Household, Ever Married Women (age 15-49), Un-married Women (age 15-24), Village
and Health Facility Questionnaires. In the household questionnaire, information on all members
of the household and the socio-economic characteristics of the household, assets possessed,
number of marriages and deaths in the household since January 2004, etc. was collected. In the
case of female deaths, attempts were made to assess maternal death. The household
questionnaire also collected information on respondent’s knowledge about messages related to
Government Health Programme being spread through media and other sources. The ever
married women’s questionnaire consisted of sections on women’s characteristics, maternal care,
immunization and child care, contraception and fertility preferences, reproductive health
including knowledge about HIV/AIDS. The unmarried women’s questionnaire contained
information on her characteristics, family life education and age at marriage, reproductive health-
knowledge and awareness about contraception, HIV/ AIDS, etc. The village questionnaire
contained information on availability of health, education and other facilities in the village and
whether the health facilities are accessible throughout the year. For the first time, population-
linked facility survey was conducted as part of DLHS-3. In a district, all the Community Health
Centres (CHCs) and District Hospitals were covered. Further, all the Sub-Centres(SCs) and Primary
Health Centres(PHCs) which were expected to serve the population of the selected PSU were also
covered. There were separate questions for SCs, PHCs, CHCs and District Hospitals. They broadly
included questions on infrastructure, human resources, supply of drugs and instruments and
performance.

5.66 DLHS-3 provided the latest statistics for examining the performance of programme
implementation in the health sector. The information available on health and family welfare
indicators can help the programme managers at the district level to monitor the implementation
and to take necessary corrective measures, whenever called for. For each district, a fact sheet is
prepared stating the performance levels. The IIPS, as the Nodal Agency for DLHS-3, involved 16
regional agencies and six monitoring agencies in carrying out the survey, which was sponsored by
the Ministry of Health and Family Welfare, Government of India.

51
Annual Health Survey (AHS)

5.67 The National Rural Health Mission (NRHM) proposes an intensive accountability
framework through a three pronged process of community based monitoring, external surveys
and stringent internal monitoring. The concept of the Annual Health Survey (AHS) arose during a
meeting of the National Commission of Population held on 23rd July, 2005 under the
Chairmanship of the Prime Minister, wherein it was decided that “there should be an Annual
Health Survey (AHS) of all districts, which could be published/monitored and compared against
bench marks”. This was followed up by meetings with the Planning Commission and it was
decided that Ministry of Health & Family Welfare (MOHFW) would initiate follow up action for
implementation of this decision.

5.68 The Annual Health Survey (AHS) aims to prepare District Health Profile of the 284 districts
in the erstwhile EAG States and Assam on an annual basis. The Mission Steering Group (MSG) has
been delegated powers of the Cabinet to sanction suitable initiatives within the approved NRHM
Framework. The MSG, in its meeting held on 17.07.2007, approved conduct of the Annual Health
Survey through the Registrar General of India (RGI), Ministry of Home Affairs. The AHS is a hybrid
model where the field work will be outsourced to external agencies and supervision done by the
additional staff provided by RGI.

5.69 The Annual Health Survey aims to provide feedback on the impact of the schemes under
NRHM in reduction of Total Fertility Rate (TFR), Infant Mortality Rate (IMR) at the district level
and the Maternal Mortality Ratio (MMR) at the regional level. These are important indicators of
health which are currently being estimated at the national/state level through the Sample
Registration System (SRS) by Registrar General of India.

The following tables gives the coverage of AHS:

State No. of District Sample No. of Households* Sample

Units Total Population Total
Assam 23 1,784 327,593 1,637,967
Bihar 37 2,356 439,268 2,196,340
Jharkhand 18 2,109 377,504 1,887,520
Madhya Pradesh 45 2,557 440,432 2,202,161
Chhatisgarh 16 1,255 225,188 1,125,940
Orissa 30 2,364 428,264 2,141,319
Rajasthan 32 1,841 324,342 1,621,710
Uttar Pradesh 70 3,927 693,893 3,469,464
Uttaranchal 13 2,059 368,934 1,844,670
Total 284 20,252 3,625,418 18,127,089

*' : No. of households estimated using 5.0 as average household size

The survey design has been prepared after elaborate discussions on the subject with concerned Ministries,
Institutions and experts in the field. The sample design, size, periodicity, reliability of estimates at the level of
aggregation etc has been vetted by the Technical Group constituted by the MOHFW. The Technical Advisory Group
(TAG) constituted for the purpose shall continue to oversee and refine the methodology adopted for the AHS as
necessary. A proposal for inclusion of Bio-marker tests in AHS to measure the levels of anaemia, sugar, nutritional
status in terms of height and weight measurements, Blood Pressure measurement and measurement of level of iodine
in salt consumed by households is under consideration.. The survey has been launched in April, 2010.

52
Concurrent Evaluation of NRHM
5.70 The objective of the Concurrent Evaluation is to assess the reach of NRHM activities to the
rural communities. The aim is to get various indicators about implementation of health care
programmes which will be helpful to policy makers and programme managers in effective
implementation of NRHM. The concurrent evaluation was carried out in all States and UTs
covering 197 selected districts.

5.71 As per the sampling strategy, from each district, along with District Hospital, 2 CHCs, 4
PHCs, 12 Sub-Centres, 24 villages, 12 Gram Panchayat, 24 ASHAs, 1200 heads of the household
and 1200 currently married women (15-49) were to be covered. In-patients and out-patients
were also interviewed to know their opinion about the health services through exit interview
schedules from different facilities such as District Hospital, selected CHCs and PHCs in each
district. The field work was conducted during 2009 in the selected districts.

5.72 Bilingual interview schedules, both in English and in regional language, were used to
collect information from households, currently married women (age 15-49), Gram Panchayat and
Accredited Social Health Activist(ASHA). In the household schedule, information on socio-
economic characteristics, assets of the household and knowledge about the health related issues
and health programmes, and awareness of Rogi Kalyan Samiti were included. Further, health
related practices, treatment seeking behavior and utilization of government health facilities were
also covered in the household survey. Eligible woman’s schedule contained information on
women’s characteristics, awareness about ASHA, Janani Suraksha Yojana (JSY), Nishchay
Pregnancy Test Kit (NPTK), breastfeeding and immunization of children, family planning and
HIV/AIDS. The Gram Panchayat schedule contained information on availability of health
functionaries and facilities available in the villages, type of improvements brought by NRHM at
the village level, and the difficulties faced in its implementation.

5.73 Districts and State Fact sheets are being prepared which will provide key indicators related
to the core strategies of NRHM such as infrastructure and management practices,
communitisation of services and innovations at community level, human resources, response to
NRHM at the grass root level and JSY. Detailed State-wise reports and National Report shall also
be brought out.

53
ANNEXURES 1-9

54
Annex-1

The Registration of Births and Deaths Act, 1969

(Act No. 18 of 1969)
[31st May 1969]

An Act to provide for the regulation of registration of births and deaths

and for matters connected therewith .

Be it enacted by Parliament in the Twentieth Year of the Republic of India as follows:

CHAPTER I
PRELIMINARY

1. Short title, extent and commencement—(1) This Act may be called the Registration of Births and Deaths
Act, 1969.

(2) It extends to the whole of India.

(3) It shall come into force in a State on such date as the Central Government may, by notification in the Official
Gazette, appoint:

Provided that different dates may be appointed for difference parts of a State.

1. Definitions and interpretation—(1)

In this Act, unless the context otherwise requires,

(a) “birth” means live-birth or still-birth ;

(b) “death” means the permanent disappearance of all evidence of life at any time after live-birth has taken place ;

(c) “foetal death” means absence of all evidence of life prior to the complete expulsion or extraction from its
mother of a product of conception irrespective of the duration of pregnancy ;

(d) “live-birth” means the complete expulsion of extraction from its mother of a product of conception, irrespective
of the duration of pregnancy, which, after such expulsion or extraction, breathes or shows any other evidence
of life, and each product of such birth is considered live-born ;

(e) “prescribed” means prescribed by rules made under this Act;

(f) “State Government”, in relation to a Union territory, means the Administrator thereof;

(g) “still-birth” means foetal death where a product of conception has attained at least the prescribed period of
gestation.

(2) Any reference in this Act to any law which is not in force in any area shall, in relation to that area, be
construed as a reference to the corresponding law, if any, in force in that area.

55
 CHAPTER II

REGISTRATION ESTABLISHMENT

3. Registrar General, India—(1) The Central Government may, by notification in the Official Gazette, appoint a
person to be known as the Registrar-General, India.

(2) The Central Government may also appoint such other officers with such designations as it thinks fit for the
purpose of discharging, under the superintendence and direction of the Registrar-General, such functions of the
Registrar-General under this Act as he may, from time to time, authorize them to discharge.

(3) The Registrar-General may issue general directions regarding registration of births and deaths in the
territories to which this Act extends, and shall take steps to co-ordinate and unify the activities of Chief Registrars in
the matter of registration of births and deaths and submit to the Central Government an annual report on the
working of this Act in the said territories.

4. Chief Registrar—(1) The State Government may, by notification in the Official Gazette, appoint a Chief
Registrar for the State.

(2) The State Government may also appoint such other officers with such designations as it thinks fit for the
purpose of discharging, under the superintendence and direction of the Chief Registrar, such of his functions as he
may, from time to time, authorize them to discharge.

(3) The Chief Registrar shall be the chief executive authority in the State for carrying into execution the
provisions of this Act and the rules and orders made thereunder subject to the directions, if any, given by the State
Government.
(4) The Chief Registrar shall take steps by the issue of suitable instructions or otherwise, to co-ordinate, unify
and supervise the work of registration in the State for securing an efficient system of registration and shall prepare
and submit to the State Government, in such manner and at such intervals as may be prescribed, a report on the
working of this Act in the State alongwith the statistical report referred to in sub-section (2) of section 19.

5. Registration divisions—The State Government may, by notification in the Official Gazette, divide the
territory within the State into such registration divisions as it may think fit and prescribe different rules for different
registration divisions.

6. District Registrar—(1) The State Government may appoint a District Registrar for each revenue district and
such number of Additional District Registrars as it thinks fit who shall, subject to the general control and direction of
the District Registrar, discharge such functions of the district Registrar as the District Registrar may, from time to
time, authorize them to discharge.

7. Registrars—(1) The State Government may appoint a Registrar for each local area comprising the area
within the jurisdiction of a municipality, Panchayat or other local authority or any other area or a combination of any
two or more of them :

Provided that the State Government may appoint in the case of a municipality, Panchayat or other local
authority, any officer or other employee thereof as a Registrar.

(2) Every Registrar shall, without fee or reward, enter in the register maintained for the purpose all information
given to him under section 8 or section 9 and shall also take steps to inform himself carefully of every birth and of
every death which takes place in his jurisdiction and to ascertain and register the particulars required to be
registered.

(3) Every Registrar shall have an office in the local area for which he is appointed.

(4) Every Registrar shall attend his office for the purpose of registering births and deaths on such days and at
such hours as the Chief Registrar may direct and shall cause to be placed in some conspicuous place on or near the

56
outer door of the office of the Registrar a board bearing, in the local language, his name with the addition of
Registrar of Births and Deaths for the local area for which he is appointed, and the days and hours of his attendance.

(5) The Registrar may, with the prior approval of the Chief Registrar, appoint Sub-Registrars and assign to them
any or all of his powers and duties in relation to specified areas within his jurisdiction.

CHAPTER III

REGISTRATION OF BIRTHS AND DEATHS

8. Persons required to register births and deaths—(1) It shall be the duty of the persons specified below to
give or cause to be given, either orally or in writing, according to the best of their knowledge and belief, within such
time as may be prescribed, information to the Registrar of the several particulars required to be entered in the forms
prescribed by the State Government under sub-section (1) of section 16,--
(a) in respect of births and deaths in a house, whether residential or non-residential, not being any place referred
to in clauses (b) to (e), the head of the house or, in case more than one household live in the house, the head
of the household, the head being the person, who is so recognized by the house or the household, and if he is
not present in the house at any time during the period within which the birth or death has to be reported, the
nearest relative of the head present in the house, and in the absence of any such person, the oldest adult male
person present therein during the said period;
(b) in respect of births and deaths in a hospital, health center, maternity or nursing home or other like institution,
the medical officer in charge or any person authorized by him in this behalf;
(c) in respect of births and deaths in a jail, the jailor in -charge;
(d) in respect of births and deaths in a choultry, chattram, hostel, dharmasala, boarding house, lodging house,
tavern, barrack, toddy shop or place of public resort, the person in charge thereof ;
(e) in respect of any new-born child or dead body found deserted in a public place, the headman or other
corresponding officer of the village in the case of a village and officer in charge of the local police station
elsewhere :
Provided that any person who finds such child or dead body, or in whose charge such child or dead body may
be placed, shall notify such fact to the headman or officer aforesaid ;
(f) in any other place, such person as may be prescribed.

(2) Notwithstanding anything contained in sub-section (1), the State Government, having regard to the
conditions obtaining in a registration division, may be order require that for such period as may be specified in the
order, any person specified by the State Government by designation in this behalf, shall give or cause to be given
information regarding births and deaths in a house referred to in clause (a) of sub-) section (1) instead of the persons
specified in that clause.

9. Special provision regarding births and deaths in a plantation—In the case of births and deaths in a
plantation, the superintendent of the plantation shall give or cause to be given to the Registrar the information
referred to in section 8:

Provided that the persons referred to in clauses (a) to (f) of sub-section (i) of section 8 shall furnish the necessary
particulars to the superintendent of the plantation.

Explanation – In this section, the expression “plantation” means any land not less than four hectares in extent
which is being prepared for the production of, or actually produces, tea, coffee, pepper, rubber, cardamom, cinchona
or such other products as the State Government may, by notification in the Official Gazette, specify and the
expression “superintendent of the plantation” means the person having the charge or supervision of the labourers
and work in the plantation whether called a manager, superintendent or by any other name.

10. Duty of certain persons to notify births and deaths and to certify cause of death—(1) It shall be the duty
of—

(i) the midwife or any other medical or health attendant at a birth or death,

57
 (ii) the keeper or the owner of a place set apart for the disposal of dead bodies or any person required by a local
authority to be present at such place, or

(iii) any other person whom the State Government may specify in this behalf by his designation, to notify every
birth or death or both at which he or she attended or was present, or which occurred in such areas as may be
prescribed, to the Registrar within such time and in such manner as may be prescribed.

(2) In any area, the State Government, having regard to the facilities available therein in this behalf, may
require that a certificate as to the cause of death shall be obtained by the Registrar from such person and in such
form as may be prescribed.

(3) Where the State Government has required under sub-section (2) that a certificate as to the cause of
death shall be obtained, in the event of the death of any person who, during his last illness was attended by a
medical practitioner, the medical practitioner shall, after the death of that person, forthwith, issue without charging
any fee, to the person required under this Act to give information concerning the death, a certificate in the
prescribed form stating to the best of his knowledge and belief the cause of death; and the certificate shall be
received and delivered by such person to the Registrar at the time of giving information concerning the death as
required by this Act.

11. Informant to sign the register – Every person who has orally given to the Registrar may information
required under this Act shall write in the register maintained in this behalf, his name, description and place of abode,
and, if he cannot write, shall put his thumb mark in the register against his name, description and place of abode, the
particulars being in such a case entered by the Registrar.

12. Extracts of registration entries to be given to informant.—The Registrar shall, as soon as the
registration of a birth or death has been completed, give, free of charge, to the person who gives information under
section 8 or section 9 an extract of the prescribed particulars under his hand from the register relating to such birth
or death.

13. Delayed registration of births and deaths. – (1) Any birth or death of which information is given to the
Registrar after the expiry of the period specified therefore, but within thirty days of its occurrence, shall be registered
on payment of such late fee as may be prescribed.

(2) Any birth or death of which delayed information is given to the Registrar after thirty days but within one
year of its occurrence shall be registered only with the written permission of the prescribed authority and on
payment of the prescribed fee and the production of an affidavit made before a notary public or any other office
authorized in this behalf by the State Government.

(3) Any birth or death which has not been registered within one year of its occurrence, shall be registered
only on an order made by a magistrate of the first class or a Presidency Magistrate after verifying the correctness of
the birth or death and on payment of the prescribed fee.

(4) The provisions of this section shall be without prejudice to any action that may be taken against a person
for failure on his part to register any birth or death within the time specified therefore and any such birth or death
may be registered during the pendency of any such action.

14. Registration of name of child.—Where the birth of any child has been registered without a name, the
parent or guardian of such child shall within the prescribed period give information regarding the name of the child
to the Registrar either orally or in writing and thereupon the Registrar shall enter such name in the register and initial
and date of the entry.

15. Correction or cancellation of entry in the register of births and deaths.—If it is proved to the satisfaction of
the Registrar that any entry of a birth or death in any register kept by him under this Act is erroneous in form or
substance, or has been fraudulently or improperly made, he may, subject to such rules as may be made by the State
Government with respect to the conditions on which and the circumstances in which such entries may be corrected
or cancelled, correct the error or cancel the entry by suitable entry in the margin, without any alteration of the
original entry, and shall sign the marginal entry and add thereto the date of the correction or cancellation.

58
 CHAPTER IV

MAINTENANCE OF RECORDS AND STATISTICS

16. Registrars to keep registers in the prescribed form – (1) Every Registrar shall keep in the prescribed
form a register of births and deaths for the registration area or any part thereof in relation to which he exercises
jurisdiction.

(2) The Chief Registrar shall cause to be printed and supplied a sufficient number of register books for
making entries of births and deaths according to such forms and instructions as may, from time to time, be
prescribed; and a copy of such forms in the local language shall be posted in some conspicuous place on or near the
outer door of the office of every Registrar.

17. Search of births and deaths register—(1) Subject to any rules made in this behalf by the State
Government, including rules relating to the payment of fees and postal charges, any person may--

(a) cause a search to be made by the Registrar for any entry in a register of births and deaths; and

(b) obtain an extract from such register relating to any birth or death :

Provided that no extract relating to any death, issued to any person, shall disclose the particulars regarding
the cause of death as entered in the register.

(2) All extracts given under this section shall be certified by the Registrar or any other officer authorised by
the State Government to give such extracts as provided in section 76 of the Indian Evidence Act, 1872 (1 of 1872),
and shall be admissible in evidence for the purpose of proving the birth or death to which the entry relates.

18. Inspection of registration offices – The registration offices shall be inspected and the registers kept
therein shall be examined in such manner and by such authority as may be specified by the District Registrar.

19. Registrars to send periodical returns to the Chief Registrar for compilation—(1) Every Registrar shall
send to the Chief Registrar or ot any officer specified by him, at such intervals and in such form as may be prescribed,
a return regarding the entries of births and deaths in the register kept by such Registrar.

(2) The Chief Registrar shall cause the information in the returns furnished by the Registrars to be compiled
and shall publish for the information of the public a statistical report on the registered births and deaths during the
year at such intervals and in such form as may be prescribed.

CHAPTER V

MISCELLANEOUS

20. Special provision as to registration of births and deaths of citizens outside India—(1) The Registrar
General shall, subject to such rules as may be made by the Central Government in this behalf, cause to be registered
information as to births and deaths of citizens of India outside India received by him under the rules relating to the
registration of such citizens at Indian Consulates made under the Citizenship Act, 1955 (57 of 1955), and every such
registration shall also be deemed to have been duly made under this Act.

(2) In the case of any child born outside India in respect of whom information has not been received as
provided in sub-section (1), if the parents of the child returns to India with a view to settling therein, they may, at any
time within sixty days from the date of the arrival of the child in India, get the birth of the child registered under this
Act in the same manner as if the child was born in India and the provisions of section 13 shall apply to the birth of
such child after the expiry of the period of sixty days aforesaid.

59
 21. Power of Registrar to obtain information regarding birth or death—The Registrar may either orally or in
writing require any person to furnish any information within his knowledge in connection with a birth or death in the
locality within which such person resides and that person shall be bound to comply with such requisition.

22. Power to give directions—The Central Government may give such directions to any State Government
as may appear to be necessary for carrying into execution in the State any of the provisions of this Act or of any rule
or order made thereunder.

23. Penalties—(1) Any person who—

(a) fails without reasonable cause to give any information which it is his duty to give under any of the
provisions of sections 8 and 9; or

(b) gives or causes to be given, for the purpose of being inserted in any register of births and deaths, any
information which he knows or believes to be false regarding any of the particulars required to be
known and registered; or

(c) refuses to write his name, description and place of abode or to put his thumb mark in the register as
required by section 11, shall be punishable with fine which may extend to fifty rupees.

(2) Any Registrar or Sub-Registrar who neglects or refuses, without reasonable cause, to register any birth or
death occuring in his jurisdiction or to submit any returns as required by sub-section (1) of section 19 shall be
punishable with fine which may extend to fifty rupees.

(3) Any medical practitioner who neglects or refuses to issue a certificate under sub-section (3) of section 10
and any person who neglects or refuses to deliver such certificate shall be punishable with fine which may extend to
fifty rupees.

(4) Any person who, without reasonable cause, contrvenes any provision of this Act for the contravention of
which no penalty is provided for in this section shall be punishable with fine which may extend to ten rupees.

(5) Notwithstanding anything contained in the Code of Criminal Procedure, 1898 (5 of 1898), an offence
under this section shall be tried summarily by a Magistrate.

24. Power to compound offices—(1) Subject to such conditions as may be prescribed, any officer authorised
by the Chief Registrar by a general or special order in this behalf may, either before or after the institution of criminal
proceedings under this Act, accept from the person who has committed or is reasonably suspected of having
committed an offence under this Act, by way of composition of such offence a sum of money not exceeding fifty
rupees.

(2) On the payment of such sum of money, such person shall be discharged and no further proceedings shall
be taken against him in respect of such offence.

25. Sanction for prosecution—No prosecution for an offence punishable under this Act shall be instituted
except by an officer authorised by the Chief Registrar by general or special order in this behalf.

26. Registrars and Sub-Registrars to be deemed public servants—All Registrars and Sub-Registrars shall,
while acting or purporting to act in pursuance of the provisions of this Act or any rule or order made thereunder be
deemed to be public servants within the meaning of section 21 of the Indian Penal Code (45 of 1860).

27. Delegation of powers—The State Government may, by notification in the Official Gazette, direct that
any power exercisable by it under this Act (except the power to make rules under section 30) or the rules made
thereunder shall, subject to such conditions, if any, as may be specified in the direction be exercisable also by such
officer or authority subordinate to the State Government as may be specified in the direction.

60
 28. Protection of action taken in good faith—(1) No suit, prosecution or other legal proceeding shall lie
against the Government, the Registrar General, any Registrar, or any person exercising any power or performing any
duty under this Act for anything which is in good faith done or intended to be done in pursuance of this Act or any
rule or order made thereunder.

(2) No suit or other legal proceeding shall lie against the government for any damage caused or likely to be
caused by anything which is in good faith done or intended to be done in pursuance of this act or any rule or order
made thereunder.

29. Act not to be in derogation of Act 6 of 1886—Nothing in this Act shall be construed to be in derogation
of the provisions of the Births, Deaths and Marriages Registration Act, 1886.

30. Power to make rules—(1) The State Government may with the approval of the Central Government, by
notification in the Official Gazette, make rules to carry out the purposes of this Act.

(2) In particular, and without prejudice to the generality of the foregoing provision, such rules may provide
for—

(a) the forms of registers of births and deaths required to be kept under this Act;

(b) the period within which and the form and the manner in which information should be given to the Registrar
under section 8;

(c) the period within which and the manner in which births and deaths shall be notified under sub-section (1) of
section 10;

(d) the person from whom and the form in which a certificate as to cause of death shall be obtained;

(e) the particulars of which extract may be given under section 12

(f) the authority which may grant permission for registration of a birth or death under sub-section (2) of section
13;

(g) the fees payable for registration made under section 13;

(h) the submission of reports by the Chief Registrar under sub-section (4) of section 4;

(i) the search of birth and death registers and the fees payable for such search and for the grant of extracts
from the register;

(j) the forms in which and the intervals at which the returns and the statistical report under section 19 shall be
furnished and published;

(k) the custody, production and transfer of the registers and other records kept by Registrars;

(l) the correction of errors and the cancellation of entries in the register of births and deaths;

(m) any other matter which has to be, or may

be, prescribed.
1
[(3) Every rule made under this Act shall be laid, as soon as may be after it is made, before the State
Legislature].

31. Repeal and saving—(1) Subject to the provisions of section 29, as from the coming into force of this Act in any
State or part thereof, so much of any law in force therein as relates to the matters covered by this Act shall stand
repealed in such State or part, as the case may be.

61
 (2) Notwithstanding such repeals, anything done or any action taken (including any instruction or direction
issued, any regulation or rule or order made) under any such law shall, in so far as such thing or action is not
inconsistent with the provisions of this Act, be deemed to have been done or taken under the provisions aforesaid, as
if they were in force when such thing was done or such action was taken, and shall continue in force accordingly until
superseded by anything done or any action taken under this Act.

32. Power to remove difficulty—If any difficulty arises in giving effect in a State to the provisions of this Act
in their application to any areas, the State Government may, with the approval of the Central Government, by order
make such provisions or give such directions not inconsistent with the provisions of this Act as appears to the State
Government to be necessary or expedient for removing the difficulty :

Provided that no order shall be made under this section in relation to any area in a State after the expiration
of two years from the date on which this Act comes into force in that area.

1. Ins. by Act 4 of 1986, s.2 and Schedule (w.e.f.15.5.1986).

62
 ANNEX 2
MODEL REGISTRATION OF BIRTHS AND DEATHS RULES, 1999

In exercise of the powers conferred by section 30 of the Registration of Births and Deaths Act, 1969, (18 of 1969) the State
Government/Governor/Administrator of.……... with the approval of the Central Government, hereby makes the following rules,
namely;

1. Short title--(1) These rules may be called the Registration of Births and Deaths Rules, 1999.

(2) They shall come into force with effect from 1.1.2000 through notification in the Official Gazette.

(3) These rules will replace the………… Registration of Births and Deaths Rules,---------and all its subsequent amendments
notified from time to time.

2. Definitions--In these rules, unless the context otherwise requires :

(a) "Act" means the Registration of Births & Deaths Act, 1969;

(b) "Form" means a Form appended to these rules; and

(c) "Section" means a section of the Act.

3. Period of gestation--The period of gestation for the purposes of clause (g) of sub-section (I) of section 2 shall be twenty-eight
weeks.

4. Submission of report under section 4(4)--The report under sub-section (4) shall be prepared in the prescribed format
appended to these Rules and shall be submitted alongwith the statistical report referred to in sub-section (2) of section 19, to the
st
State Government by the Chief Registrar for every year by the 31 July of the year following the year to which the report relates.

5. Form, etc. for giving information of births and deaths--(1) The information required to be given to the Registrar under section
8 or section 9, as the case may be, shall be in Form Nos. 1, 2 and 3 for the Registration of a birth, death and still birth respectively,
hereinafter to be collectively called the reporting forms. Information if given orally, shall be entered by the Registrar in the
appropriate reporting forms and the signature/thumb impression of the informant obtained.

(2) The part of the reporting forms containing legal information shall be called the 'Legal Part'
and the part containing statistical information shall be called the 'Statistical Part'.
(3) The information referred to in sub-rule (1) shall be given within twenty one days from the date of birth, death and still birth.

6. Birth or death in a vehicle--(1) In respect of a birth or death in a moving vehicle, the person in-charge of the vehicle shall give
or cause to be given the information under sub-section (1) of section 8 at the first place of halt.

Explanation--For the purpose of this rule the term "Vehicle" means conveyance of any kind used on land, air or water and includes
an aircraft, a boat, a ship, a railway carriage, a motor-car, a motor-cycle, a cart, a tonga and a rickshaw.

(2) In the case of deaths (not falling under clauses (a) to (e) of sub-section (1) of section (8) in which an inquest is held, the officer
who conducts the inquest shall give or cause to be given the information under sub-section (1) of section 8.

7. Form of certificate under section 10(3)--The certificate as to the cause of death required under sub-section (3) of section 10
shall be issued in Form No.4 or 4A and the Registrar shall, after making necessary entries in the register of deaths, forward all such
th
certificates to the Chief Registrar or the officer specified by him in this behalf by the 10 of the month immediately following the
month to which the certificates relate.

8. Extracts of registration entries to be given under section 12-(1) The extracts of particulars from the register relating to births
or deaths to be given to an informant under section 12 shall be in Form No.5 or Form No.6, as the case may be.
(2) In the case of domiciliary events of births and deaths referred to in clause (a) of sub-section (1) of Section 8 which are
reported direct to the Registrar of Births and Deaths, the head of the house or household as the case may be, or, in his absence,
the nearest relative of the head present in the house may collect the extracts of birth or death from the Registrar within thirty
days of its reporting.

(3) In the case of domiciliary events of births and deaths referred to in clause (a) of sub-section (1) of section 8 which are
reported by persons specified by the State Government under sub-section (2) of the said section, the person so specified shall
63
transmit the extracts received from the Registrar of Births and Deaths to the concerned head of the house or household as the
case may be, or, in his absence, the nearest relative of the head present in the house within thirty days of its issue by the
Registrar.

(4) In the case of institutional events of births and deaths referred to in clauses (b) to (e) of sub-section (1) of section 8, the
nearest relative of the new born or deceased may collect the extract from the officer or person in charge of the institution
concerned within thirty days of the occurrence of the event of birth or death.

(5) If the extract of birth or death is not collected by the concerned person as referred to in sub-rules (2) to (4) within the period
stipulated therein, the Registrar or the officer or person in charge of the concerned institution as referred to in sub-rule (4) shall
transmit the same to the concerned family by post within fifteen days of the expiry of the aforesaid period.

9. Authority for delayed registration and fee payable therefor--(1) Any birth or death of which information is given to the
Registrar after the expiry of the period specified in rule 5, but within thirty days of its occurrence, shall be registered on payment
of a late fee of rupee two.

(2) Any birth or death of which information is given to the registrar after thirty days but within one year of its occurrence, shall
be registered only with the written permission of the officer prescribed in this behalf and on payment of a late fee of rupees five.

(3) Any birth or death which has not been registered within one year of its occurrence, shall be registered only on an order of a
Magistrate of the first class or a Presidency Magistrate and on payment of a late fee of rupees ten.

10. Period for the purpose of section 14-- (1) Where the birth of any child had been registered without a name, the parent or
guardian of such child shall, within 12 months from the date of registration of the birth of child, give information regarding the
name of the child to the Registrar either orally or in writing :

Provided that if the information is given after the aforesaid period of 12 months but within a period of 15 years, which shall be
reckoned

(i) in case where the registration had been made prior to the date of commencement of the Registration of Births & Deaths
(Amendment) Rules, 19…, from such date, or

(ii) in case where the registration is made after the date of commencement of the Registration of Births & Deaths (Amendment)
Rules 19…, from the date of such registration, subject to the provisions of sub section (4) of section 23,

the Registrar shall

(a) if the register is in his possession forthwith enter the name in the relevant column of the concerned form in the birth
register on payment of a late fee of rupees five,

(b) if the register is not in his possession and if the information is given orally, make a report giving necessary particulars,
and, if the information is given in writing, forward the same to the officer specified by the State Government in this
behalf for making the necessary entry on payment of a late fee of rupees five.

(2) The parent or the guardian, as the case may be, shall also present to the Registrar the copy of the extract given to him
under section 12 or a certified extract issued to him under section 17 and on such presentation the Registrar shall make the
necessary endorsement relating to the name of the child or take action as laid down in clause (b) of the proviso to sub-rule
(1).
11. Correction or cancellation of entry in the register of births and deaths--(1) If it is reported to the Registrar that a clerical or
formal error has been made in the register or if such error is otherwise noticed by him and if the register is in his possession, the
Registrar shall enquire into the matter and if he is satisfied that any such error has been made, he shall correct the error (by
correcting or cancelling the entry) as provided in section 15 and shall send an extract of the entry showing the error and how it
has been corrected to the State Government or the officer specified by it in this behalf.

(2) In the case referred to in sub rule (1) if the register is not in his possession, the Registrar shall make a report to the State
Government or the office specified by it in this behalf and call for the relevant register and after enquiring into the matter, if he is
satisfied that any such error has been made, make the necessary correction.

(3) Any such correction as mentioned in sub-rule (2) shall be countersigned by the State Government or the officer specified by it
in this behalf when the register is received from the Registrar.

(4) If any person asserts that any entry in the register of births and deaths is erroneous in substance, the Registrar may correct
the entry in the manner prescribed under section 15 upon production by that person a declaration setting forth the nature of the
error and true facts of the case made by two credible persons having knowledge of the facts of the case.

64
 (5) Notwithstanding anything contained in sub-rule (I) and sub-rule (4) the Registrar shall make report of any correction of the
kind referred to therein giving necessary details to the State Government or the officer specified in this behalf.

(6) If it is proved to the satisfaction of the Registrar that any entry in the register of births and deaths has been fraudulently or
improperly made, he shall make a report giving necessary details to the officer authorised by the Chief Registrar by general or
special order in this behalf under section 25 and on hearing from him take necessary action in the matter.

(7) In every case in which an entry is corrected or cancelled under this rule, intimation thereof should be sent to the permanent
address of the person who has given information under section 8 or section 9.

12. Form of register under Section 16 - The legal part of the Forms No. 1, 2 and 3 shall constitute the birth register, death
register and still birth register (Form Nos. 7,8 and 9) respectively.

13. Fees and postal charges payable under section 17--(1) The fees payable for a search to be made, an extract or a non-
availability certificate to be issued under section 17, shall be as follow :
Rs

(a) Search for a single entry in the 2.00

first year for which the search is made

(b) for every additional year for which the 2.00 search is continued

(c) for granting extract relating to each 5.00

birth or death

(d) for granting non-availability certificate 2.00

of birth or death

(2) Any such extract in regard to a birth or death shall be issued by the Registrar or the officer authorised by the State Govt. in
this behalf in Form No. 5 or, as the case may be, in Form No. 6 and shall be certified in the manner provided for in section 76 of
the Indian Evidence Act, 1872 (1 of 1872).

(3) If any particular event of birth or death is not found registered the Registrar shall issue a non-availability certificate in Form
No. 10.

(4) Any such extracts or non-availability certificate may be furnished to the person asking for it or sent to him by post on
payment of the postal charges therefor.

14. Interval and forms of periodical returns under section 19(1) - (1) Every Registrar shall after completing the process of
registration send all the Statistical Parts of the reporting forms relating to each month along with a Summary Monthly Report in
Form No. 11 for births, Form No. 12 for deaths and Form No. 13 for still births to the Chief Registrar or the officer specified by him
th
on or before the 5 of the following month.
(2) The officer so specified shall forward all such statistical parts of the reporting forms received by him to the Chief Registrar not
th
later than the 10 of the month.

15. Statistical report under section 19(2)--The statistical report under sub-section (2) of section 19 shall contain the tables in the
st
prescribed formats appended to these rules and shall be compiled for each year before the 31 July of the year immediately
following and shall be published as soon as may be thereafter but in any case not later than five months from that date.

16. Conditions for compounding offences—

(1) Any offence punishable under section 23

may, either before or after the institution of
criminal proceedings under this Act, be compounded by an officer authorised by the Chief Registrar by a general or special order in
this behalf, if the officer so authorised is satisfied that the offence was committed through inadvertence or oversight or for the
first time.

(2) Any such offence may be compounded on payment of such sum, not exceeding rupees fifty for offences under sub-sections
(1), (2) and (3) and rupees ten for offences under sub-section (4) of section 23 as the said officer may think fit.
17. Registers and other records under section 30(2)(k)--(1)The birth register, death register and still birth register shall be
records of permanent importance and shall not be destroyed.

65
 (2) The court orders and orders of the specified authorities granting permission for delayed registration received under section
13 by the Registrar, shall form an integral part of the birth register, death register and still birth register and shall not be
destroyed.

(3) The certificate as to the cause of death furnished under sub-section (3) of the section 10 shall be retained for a period of at
least 5 years by the Chief Registrar or the officer specified by him in this behalf.

(4) Every birth register, death register and still birth register shall be retained by the Registrar in his office for a period of twelve
months after the end of the calendar year to which it relates and such register shall thereafter be transferred for safe custody to
such officer as may be specified by the State Government in this behalf.

66
 ANNEX 3
Dates of Enforcement of the RBD Act, 1969

State/Union Territory Date of Date of approval Date of

Enforcement of of State Rules by notification of
the Act Central Rules in State
Government Gazette
1 2 3 4
1 Andhra Pradesh 1-4-1972 23-7-1976 29-12-1977
2 Arunachal Pradesh 1-7-1972 24-2-1973 6-10-1973
3 Assam 1-4-1970 22-4-1970 28-6-1978
4 Bihar 1-4-1970 13-4-1970 8-7-1970
5 Chatisgarh 1-4-1970 24-10-1970 2-5-1975
6 Goa 1-7-1971 20-11-1970 31-12-1970
7 Gujarat 1-4-1970 10-4-1970 18-4-1973
8 Haryana 1-4-1970 11-11-1970 15-2-1972
9 Himachal Pradesh 1-4-1970 21-7-1978 29-8-1979
10 Jammu & Kashmir 1-10-1970 19-6-1972 26-11-1975
11 Jharkhand 1-4-1970 13-4-1970 8-7-1970
12 Karnataka 1-4-1970 6-10-1970 15-12-1970
13 Kerala 1-4-1970 13-4-1970 1-7-1970
14 Madhya Pradesh 1-4-1970 24-10-1970 2-5-1975
15 Maharashtra 1-4-1970 7-4-1975 7-2-1976
16 Manipur 1-1-1971 2-12-1970 14-12-1971
17 Mehghalaya 1-11-1971 8-3-1973 13-4-1974
18 Mizoram 1-5-1974 25-3-1975 15-4-1980
19 Nagaland 1-10-1971 28-12-1971 24-6-1972
20 Orissa 1-4-1970 13-4-1970 11-8-1970
21 Punjab 1-4-1970 26-4-1972 22-9-1972
22 Rajasthan 1-4-1970 2-12-1970 7-7-1972
23 Sikkim 30-9-1976 7-4-1979 27-9-1979
24 Tamil Nadu 1-4-1970 3-1-1976 15-3-1977
25 Tripura 1-4-1972 20-6-1972 13-2-1976
26 Uttar Pradesh 1-4-1970 20-3-1972 8-1-1977
27 Uttranchal 1-4-1970 20-3-1972 8-1-1977
28 West Bengal 1-4-1970 18-8-1970 15-1-1977

67
 ANNEX 4
Civil Registration hierarchy in states and union territories
Sl. State level District level / Below Local area level (rural)
No district level
1 2 3 4 5

1. Andhra Pradesh

Chief Registrar Addl. Chief Registrar District Registrar: District Registrar: Panchayati Secretary
Director of Health Addl. Director of Medical and Health Officer
Medical & Health
Services (CD) Addl. District. Registrar:
Dy. District. Medical & Health
Commissioner & Director Officer in-charge of Medical
Municipal Administration & Health Work other than
Family Welfare
Dy. Commissioner
Panchayat Raj District Revenue Officer &
District Panchayati Officer
Dy. Chief Registrar: Dy.
Director of Medical & Addl. District. Medical &
Health Services (Stat.) Health Officer (FW)
2. Arunachal Pradesh

Chief Registrar District Registrar: Dy. Registrar: Extra-Assistant

Director of Commissioner Commissioner/Circle Officer
Economics &
Statistics Addl. District. Registrar: Sub-Registrar: Teacher/Village
District Statistical Officer level worker

3. Assam
Addl. Chief Registrar
Chief Registrar Director, Rural District Registrar: Registrar: Medical Officer In
Director of Health Development District. Magistrates charge of CHC / PHC / MPHC/
Services SHC / State Dispensary, etc.
Director Municipal Addl. District. Registrar:
Administration
Joint Director of Health
Services

CEO of Zola Parish ads

4. Chhatisgarh

Chief Registrar Addl. Chief Registrar: District Registrar: Registrar:

Commissioner-cum- District Collectors District Planning & Statistics Chief Executive Officer, Janpad
Director of Officer Panchayati
Economics & Dy.Chief Registrar:
Statistics Dy.Director (VS) Sub Registrar :
Economics & Statistics Panchayati Secretary / Karmi
5. Bihar

Chief Registrar District Registrar: Registrar: Panchayati Sevak

Director of Statistics District Magistrate
& Evaluation
Addl. District. Registrar:
Joint Chief Registrar: District. Statistical Officer
Joint Director (VS)
Addl. District. Registrar:
Block Development Officer
Dy. Chief Registrar:

Dy. Director (VS)

6. Goa

Chief Registrar Addl.Chief Registrar: District Registrar: Registrar: Secretary of Village

Director of Planning, Joint Director, Planning, Additional Collector Panchayati

68
Statistics & Statistics & Evaluation
Evaluation Addl. District. Registrar:
Block Development Officer

69
Sl. State Level District level / Below District Local Area Level (Rural)
No Level
1 2 3 4 5
7. Gujarat

Chief Registrar Dy. Chief Registrar: District Registrar: Registrar:

Commissioner of Addl. Director (Stats.) District Health Officer/Chief Galati-cum-Mantra/Mantra
Health, Medical District Health Officer
Services & Medical Addl.Dy.Chief Registrar:
Education Dy. Director (Stats.) Taluka Registrar: Taluka Sub-Registrar: Clerk of
Development Officer Village Panchayati

8. Haryana

Chief Registrar Addl.Chief Registrar: District Registrar: Civil Registrar:

Director General of Dy. Director Health Surgeon In charge Medical Officer
Health Services Services (ME) P.H.C
Addl.Distt.Registrar:
Asstt. Director, Urban District. Health Officer
Development Deptt.

9. Himachal Pradesh

Chief Registrar Dy. Chief Registrar: District Registrar: Registrar: Panchayati

Director of Health Dy. Director (CR) Chief Medical Officer Secretary and Panchayati
Services Sahayak of Gram
Specified Officer Panchayati
Block Development Officer

10. Jammu & Kashmir

Chief Registrar Addl. Chief Registrar: District Registrar: Chief Registrar:

Director of Health Director of Economics & Medical Officer In-charge of Police Station
and Family Welfare Statistics
Addl. District. Registrar:
District. Statistics & Evaluation
Officer
11. Jharkhand

Chief Registrar District Registrar: Registrar: Panchayati

Principal Secretary, Dy. Commissioner / Collector Sevak
Statistics &
Evaluation Addl. District. Registrar:
Joint Chief Registrar: District. Statistical Officer
Joint Director (VS)
Addl. District. Registrar: Block
Development Officer
Dy. Chief Registrar:

Dy. Director (VS)

12. Karnataka

Chief Registrar Joint Chief Registrar: District Registrar: Dy. Registrar:

Director, Bureau of Joint Director, Economics Commissioner Village Accountant
Economics & & Statistics
Statistics Addl.Distt.Registrar: District
Dy. Chief Registrar: Statistical Office
Dy. Director Economics &
Statistics

70
Sl. State Level District Level /Below District Local Area Level (Rural)
No Level
1 2 3 4 5
13. Kerala

Chief Registrar Addl.Chief Registrar: District Registrar: Deputy. Registrar:

Director of Addl. Director of Director of Panchayats Secretary of Gram
Panchayats Economics & Statistics Panchayati

Dy. Chief Registrar: Addl. District. Registrar:

Dy. Director of Economics Deputy Director of District
& Statistics Statistical Office

14. Madhya Pradesh

Chief Registrar Addl.Chief Registrar District Registrar: Registrar:

Commissioner, District Collectors District Planning Officer Chief Executive Officer,
Economics & Janpad Panchayati
Statistics Dy.Chief Registrar:
Dy.Director (VS) MO In charge of
PHC/CHC/Civil and District
Asstt. Chief Registrar Hospitals
Assistant Director (VS)
Sub Registrar
Panchayati Secretary /
Karmi

15. Maharashtra

Chief Registrar Dy. Chief Registrar: Dy. District Registrar: District Registrar: Gram
Director Health Director of Health Services Health Officer Sevak/Asstt. Gram Sevak
Services (SBHI & VS)
Addl. District. Registrar:
Dy. Chief Executive Officer
(Village Panchayati) of Zola
Panchayati

BDO (Panchayati Samiti)

16. Manipur

Chief Registrar Addl. Chief Registrar: District Registrar: Chief Registrar:

Director of Medical Director Economics & Medical Officer Block Development Officer
& Health Services Statistics for CD Block areas

Addl. Director Health Sub Divisional

Services Officers/Medical Officer in-
charge of PHCs of hilly
Dy. Chief Registrar: areas
Dy. Director (VS)
Sub-Registrar:
Panchayati Secretary CD
Block areas
17. Meghalaya

Chief Registrar Dy. Chief Registrar: Joint District Registrar: Registrar:

Director of Health Director of Health Services District. Medical & Health Medical and Health Officer
Services services in-charge of PHC
18. Mizoram
Addl. Chief Registrar: District Registrar: Registrar:
Chief Registrar Director of Economics & Deputy Commissioner Primary School Teacher
Secretary/ Statistics
Commissioner Addl. District. Registrar:
Planning Dy. Chief Registrar: District Education Officer
Dy. Director of Economics
& Statistics Asstt. District. Registrar:
Research Officer Economics
& Statistics

71
Sl. State Level District Level / Below District Local Area Level (Rural)
No Level
1 2 3 4 5
19. Nagaland

Chief Registrar Joint Chief Registrar: District Registrar: Registrar:

Development Director of Economics & Dy. Commissioner Head Teacher
Commissioner Statistics District Statistical Officer Govt. Primary School

Dy. Chief Registrar Circle Registrar:

Dy. Director Economics Block Development Officer
Statistics
20. Orissa

Chief Registrar Addl. Chief Registrar: District Registrar: Registrar:

Director of Health Joint Director of Health Chief District Medical Officer Medical Officer in-charge of
Services Services (Public Health) PHC
Addl. District. Registrar:
Dy. Chief Registrar: Addl. District Medical Officer
Dy. Director (VS)

Asstt. Chief Registrar:

Asstt. Director (VS)

21. Punjab

Chief Registrar Dy. Chief Registrar: District Registrar: Registrar:

Director of Health & Sr. Research Officer Civil Surgeon Panchayati Secretary of
Family Welfare Gram Panchayati
Addl. District. Registrar:
District Health Officer
Assistant Civil Surgeon

22. Rajasthan

Chief Registrar Addl. Chief Registrar: Registrar:

Director of District Collectors Gram Sevak
Economics & Group Sachiv
Statistics Dy. Chief Registrar: Head Master of Primary,
Dy. Director (VS) District Registrar: Middle School
CEO of Zola Prishand
District Statistical Officer

Addl. District. Registrar:

Development Officer of
Panchayati Samiti
23. Sikkim

Chief Registrar District Registrar: Registrar:

Principal Director of Chief Medical Officer Medical Officer in-charge of
Health & Family PHC
Joint Chief Registrar:
Welfare
Director, Bureau of
Economics & Statistics

24. Tamil Nadu

Chief Registrar Dy. Chief Registrar: District Registrar: Registrar:

Director of Public Jt. Director, SBHI Collector/District Revenue Village Administrative
Health & Officer/Additional Collector Officer
Preventive
Medicine Addl. District. Registrar: Dy.
Director Health Services
Health Officer Corporation

72
Sl. State Level District Level / Below District Local Area Level (Rural)
No Level
1 3 4 5 6
25. Tripura

Chief Registrar District Registrar: Registrar:

Director of Health District. Magistrate/Collector Tehsildar (in TTAADC
Services rural area)
Addl. District. Registrar:
Sub-divisional Officer (in Panchayati Secretary (in
Tripura Tribal Area Non TTAADC rural area)
Autonomous District Council
(TTAADC) rural area)

Block Development Officer (in

Non TTAADC rural area)
26. Uttar Pradesh

Chief Registrar District Registrar: Registrar:

Director General District Collector Gram Panchayati Vikas
Director Local
Medical & Health Adhikari
Administration (Urban
Addl. District. Registrar:
area)
Chief Medical Officer
Director Panchayati Raj
Dy. District. Registrar
(Rural area)
Dy. Chief Medical Officer
(urban area)
Dy. Chief Registrar:
Assistant Director /
Addl. District. Registrar
Statistical Officer, Medical
District Panchayati Raj Officer
and Health
(Rural area)
27. Uttarkhand

Chief Registrar District Registrar: Registrar:

Principal Secretary/ District Collector Gram Panchayati Vikas
Secretary, Medical, Addl. Chief Registrar: Adhikari
Health and Family Director General of Addl. District. Registrar:
Welfare Medical, Health and Chief Medical Officer
Family Welfare
Addl. District. Registrar
Director Local Dy. Chief Medical Officer
Administration (Urban (urban area)
area)
Addl. District. Registrar
Director Panchayati Raj District Panchayati Raj Officer
(Rural area) (Rural area)

Dy. Chief Registrar:

Addl. Director,

Medical, Health and

Family Welfare
28. West Bengal
Dy. Chief Registrar: District Registrar: District
Chief Registrar Director (SBHI) Magistrate/Dy. Commissioner Registrar:
Director of Health Block Sanitary Inspector
Services Addl. District. Registrar:
Asstt. Chief Registrar: CMO of Health Sub Registrar:
Asstt. Director Health Pradhan, Gram
Services (VS) Addl. District Magistrate. Panchayati
(Gen.Admn.)

Dy. CMOH – II

73
Sl. State Level District Level / Below District Local Area Level (Rural)
No Level
1 3 4 5 6

Union territories

1. A&N Islands District Registrar: Registrar:

Medical Supdt. of G.B. Pant Medical Officer-in-Charge
Chief Registrar Hospital for Andaman and of Community Health
Director M.O. in-charge of Nicobar for Centres and Primary
Health Services Nicobar District Health Centre

2. Chandigarh

Chief Registrar District Registrar: Registrar:

Director of Health Medical Officer of Health Thana Officer
Services
Addl. District. Registrar:
Nosologist

3. Dadra & Nagar

Haveli

Chief Registrar District Registrar: Registrar:

Secretary to Mamlatdar-cum-Survey & Patel, Galati
Administration Settlement Officer

4. Daman & Diu

Chief Registrar Addl. Chief Registrar: Registrar:

Development Dy. Director, Planning & Panchayati Secretary
Commissioner / Statistics District Registrar: Collector
Secretary Planning
Addl. District. Registrar:
Block Development Officer

5. Delhi

Addl. Chief Registrar: Registrar:

Chief Registrar: Municipal H.O. of MCD Municipal Health Officer
Director Bureau of
Municipal H.O. of NDMC District Registrar: Officer In charge (Vital
Economics &
Executive Officer Stat.)
Statistics
Cantonment Area Asstt. Director (VS) Dy. Health Officer
Dte. Of Economics &
Statistics
6. Lakshadweep
Addl. Chief Registrar
Chief Registrar Addl. District Registrar: Registrar:
Secretary Director of Medical & Medical Officer in-Charge Health Inspector
Health Health Services

7.
Pondicherry
District Registrar: Registrar:
Dy. Director (Municipal Commissioner of
Chief Registrar Administration/Local Admn.) Commune Panchayati
Director of Local
Administration Addl. District. Registrar:
Dy. Director (Statistics)
Local Admn. Deptt

74
 Annex-5
Level of Registration of Births and Deaths, 2001 - 2007

India/ State/ Births Deaths

Union Territory 2001
Sl. No. 2002 2003 2004 2005 2006 2007 2001 2002 2003 2004 2005 2006 2007

India 58.0 59.5 57.7 60.4 62.5 69.0 71.0 52.2 52.1 53.5 55.2 55.0 63.2 64.4

States
1. Andhra Pradesh 55.3 61.5 57.1 63.2 61.0 73.4 77.4 57.8 58.9 59.8 67.7 60.5 68.3 70.6
2. Arunachal Pradesh 100.0 100.0 100.0 94.3 73.9 75.6 75.7 28.7 26.1 24.0 28.2 23.5 23.2 22.5
3. Assam 44.7 51.0 58.0 67.5 71.2 74.6 76.8 22.8 27.6 28.2 29.2 35.1 36.7 30.9
4. Bihar 3.9 4.6 5.9 11.5 16.9 20.3 26.2 11.0 12.0 13.5 18.1 21.7 24.6 25.3
5. Chhatisgarh 55.4 62.9 59.0 55.2 63.3 64.1 62.4 66.6 72.6 72.6 75.7 77.3 76.6 81.0
6. Goa 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 98.5 97.7 100.0 100.0 100.0 100.0
7. Gujarat 86.2 85.0 84.6 94.9 89.5 96.6 97.8 62.9 58.3 64.3 74.3 65.1 73.8 75.7
8. Haryana 73.2 73.7 74.6 83.0 84.3 90.8 91.6 70.6 75.5 81.1 83.0 72.9 81.0 84.7
9. Himachal Pradesh 100.0 100.0 100.0 100.0 100.0 100.0 100.0 80.7 77.1 84.3 84.5 85.2 91.6 85.8
10. Jammu & Kashmir 56.2 60.5 63.3 64.3 64.8 66.5 64.5 41.0 48.6 49.5 50.4 52.0 49.0 49.1
11. Jharkhand 18.9 19.9 24.3 28.8 32.9 37.0 36.6 23.8 29.4 32.6 36.8 41.3 44.7 45.2
12. Karnataka 86.5 81.9 84.3 85.8 87.6 92.2 92.0 90.7 91.8 91.7 90.3 91.9 96.7 91.6
13. Kerala 100.0 100.0 100.0 100.0 100.0 100.0 100.0 86.4 89.5 94.8 99.5 96.4 98.0 100.0
14. Madhya Pradesh 38.0 38.9 41.4 51.1 53.3 65.2 72.9 47.9 49.4 52.4 52.0 52.6 57.2 56.0
15. Maharashtra 90.6 92.8 93.1 86.6 85.9 88.1 91.5 72.4 78.1 83.2 78.8 78.1 80.6 85.5
16. Manipur 44.6 57.8 65.5 75.5 72.0 80.0 77.2 23.0 43.6 33.3 43.0 50.8 40.2 48.2
17. Meghalaya 52.2 53.4 73.8 64.0 100.0 100.0 100.0 38.7 39.9 41.4 63.6 53.3 64.2 67.7
18. Mizoram 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 96.7 97.9 89.9 98.1
19. Nagaland nc 100.0 100.0 100.0 100.0 100.0 100.0 nc 80.6 69.6 78.8 79.5 70.9 57.6
20. Orissa 79.3 82.5 80.2 80.2 85.3 88.3 88.7 61.6 67.1 67.6 64.1 69.1 68.7 71.9
21. Punjab 90.8 89.2 92.0 100.0 100.0 100.0 100.0 89.3 87.6 93.3 91.9 91.4 91.9 93.8
22. Rajasthan 39.5 55.6 46.2 56.9 65.3 81.5 83.2 55.1 62.4 59.1 70.4 65.9 72.9 74.6
23. Sikkim 80.6 84.3 90.6 100.0 95.8 97.5 93.9 54.9 74.5 92.1 97.2 90.8 83.9 87.6
24. Tamil Nadu 92.6 94.7 93.3 99.3 100.0 99.7 100.0 80.8 82.9 86.7 84.8 87.4 90.5 91.6
25. Tripura 100.0 78.6 80.6 100.0 100.0 100.0 89.1 75.1 43.4 58.5 77.4 73.7 65.9 60.9
26. Uttar Pradesh 39.0 41.1 34.9 29.4 35.3 45.3 45.4 28.7 20.5 18.9 19.1 21.2 45.4 45.1
75
27. Uttarakhand na 75.4 73.3 60.5 61.5 57.4 66.0 na 44.1 42.7 37.9 41.6 39.3 44.8
28. West Bengal 100.0 100.0 100.0 100.0 97.0 97.9 99.6 56.2 59.3 59.1 58.0 51.1 52.7 51.3

Union Territories
1. A & N Islands 100.0 100.0 95.6 94.6 86.9 91.7 87.0 73.3 71.2 72.3 100.0 84.7 90.3 95.8
2. Chandigarh 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
Dadra & Nagar
3. Haveli 80.1 88.9 96.8 78.9 79.4 82.6 79.1 60.3 56.9 77.5 82.1 76.4 86.3 81.7
4. Daman & Diu 100.0 100.0 100.0 100.0 98.3 99.6 99.3 83.0 79.9 76.6 80.5 71.7 79.0 81.1
5. Delhi 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
6. Lakshadweep 95.1 87.4 82.4 66.5 76.6 73.9 68.2 93.1 95.0 99.8 64.9 70.0 83.5 72.1
7. Puducherry 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

2007 data : Provisional

76
SAMPLE SURVEYS

ANNEXURES 6-8

77
 ANNEX 6

Tables & Statements presented in SRS reports

General
1: Number of sample units and population covered, India, states and union territories
Population Composition
2: Percentage distribution of population by broad age groups to total population by sex and residence, India
3: Percentage of population in the age group 0-4 years to total population by sex and residence, India and bigger states
4: Percentage of population in the age group 0-14 years to total population by sex and residence, India and bigger states
5: Percentage of population in the age group 15-59 years to total population by sex and residence, India and bigger states
6: Percentage of population in the age group 60 years and above to total population by sex and residence, India and bigger states
7: Percentage distribution of population by marital status and sex, India and bigger states
8: Percentage distribution of population age 10+ by marital status and sex, India and bigger states
9: Percentage distribution of female age 10+ by marital status and residence, India and bigger states
10: Percentage distribution of female age 15+ by marital status and residence, India and bigger states
11: Percentage of females by age at effective marriage and by residence, India and bigger states
12: Mean age at effective marriage of female by residence, India and bigger states,
Fertility Indicators
13: CBR (Crude birth rate) by residence, India and bigger states
14: Percent change in average birth rate in 10 years by residence, India and bigger states
15: Sex ratio at birth by residence, India and bigger states
16: GFR (General fertility rate) by residence, India and bigger states
17: Per cent change in average GFR (general fertility rate) in ten years, by residence, India and bigger states
18: ASFRs (Age specific fertility rates) by residence, India, 2001
19: Percent change in age specific fertility rates by residence in ten years , India
20: ASFRs (Age specific fertility rates), India and bigger states
21: Percentage distribution of cumulative fertility by age group, India and bigger states
22: Mean age of fertility and associated standard deviation, India and bigger states
23: TFR (Total fertility rate) by residence, India and bigger states
24: Percent change in average TFR (Total fertility rate) in ten years, by residence, India and bigger states
25: GRR (gross reproduction rate) by residence, India and bigger states
26: ASMFRs (age specific marital fertility rates) by residence, India
27: ASMFRs (Age specific marital fertility rates) India and bigger states
28: TMFRs (Total marital fertility rates) by residence, India and bigger states
29: Per cent change in average Total Marital Fertility rate (TMFR) in ten years, by residence, India and bigger states
30: Per cent female population in the age group 15-49 by level of education, India and bigger states
31: General fertility rate by level of education of women, India and bigger states,
32: Age specific fertility rates by level of education of women,
33: Total fertility rate by level of education of women, India and bigger states
34: Percentage distribution of current live births by birth order, India and bigger states
35: Percentage distribution of current live births by birth order and residence, India and bigger states
36: Percentage distribution of second and higher order live births by interval, India and bigger states
37: Percentage distribution of second and higher order live births by interval and residence, India and bigger states
38: Per cent distribution of live births by type of medical attention received by the mother at delivery by residence, India and
bigger states
Mortality Indicators
39: CDR (Crude Death Rates) by residence, India and bigger states
40: Percent change in average crude death rate between ten years, by residence, India and bigger states
41: Crude death rates by sex and residence, India
42: Crude death rates by sex, India and bigger states
43: Per cent distribution of deaths by broad age groups, India and bigger states
44: Percentage of infant deaths to total deaths by residence, India and bigger states,
45: Infant mortality rates by sex and residence, India and bigger states
46: Per cent change in average infant mortality rates between 10 years by residence, India and bigger states
47: Neo-natal mortality rates and percentage share of neo-natal deaths to infant deaths by residence, India and bigger states
48 Early neo-natal mortality rates and percentage share of early neo-natal deaths to infant deaths by residence, India and bigger
states

49 Peri-natal mortality rates and still birth rates by residence,

India and bigger states

78
50 Percentage of deaths in the age group 0-4 years to total deaths by residence, India and bigger states

51 Estimated death rates for children age 0-4 years by sex and residence, India and bigger states

52 Under-five Mortality Rate by sex and residence, India and bigger states

53 Death rates for children age 5-14 years by sex and residence, India and bigger states

54 Death rates for persons age 15-59 years by sex and residence, India and bigger states

55 Death rates for persons age 60 years and above by sex and residence, India and bigger states

56 Percentage distribution of deaths by type of medical attention received before death by residence, India and bigger states

79
 ANNEX 7

Key Indicators –National Family health Survey

Sample Size
Number of Households sampled
Ever-married women age 15–49 interviewed
Characteristics of Households
Percent with electricity
Percent within 15 minutes of safe water supply (
Water from taps, covered well, tanker, truck)
Percent with flush toilet
Percent with no toilet facility
Percent using govt. health facilities for sickness
Percent using iodized salt (at least 15 ppm)
Characteristics of Women (Ever-married women age 15–49)
Percent urban
Percent illiterate
Percent completed high school and above
Percent Hindu
Percent Muslim
Percent Christian
Percent regularly exposed to mass media
Percent working in the past 12 months
Status of Women2 (Ever-married women age 15–49)
Percent involved in decisions
Percent with control over some money
Marriage
Percent never married among women age 15–19
Median age at marriage among women age 20–49
Fertility and Fertility Preferences
Total fertility rate (for the past 3 years)
Mean number of children ever born to women 40–49
Median age at first birth among women age 20–49.(
Percent of births(For births in the past 3 years)
of order 3 and above
Mean ideal number of children (Excluding women giving non-numeric responses)
Percent of women with 2 living children wanting another child
Current Contraceptive Use (Among currently married women age 15–49)
Any method
Any modern method
Pill
IUD
Condom
Female sterilization
Male sterilization
Any traditional method
Rhythm/safe period
Withdrawal
Other traditional or modern method
Unmet Need for Family Planning5 (6For current users of modern methods )

Percent with unmet need for family planning

Percent with unmet need for spacing
Quality of Family Planning Services (For current users of modern methods)

Percent told about side effects of method

80
Percent who received follow-up services
Childhood Mortality
Infant mortality rate for 5 years preceding the survey (1994–98)
Under-five mortality rate (or the 5 years preceding the survey (1994–98))
Safe Motherhood and Women’s Reproductive Health
Maternal mortality ratio
6
Percent of births8 within 24 months of previous birth
Percent of births3 whose mothers received:
Antenatal check-up from a health professional
Antenatal check-up in first trimester
Two or more tetanus toxoid injections
Iron and folic acid tablets or syrup
Percent of births3 whose mothers were assisted at delivery by a:
Doctor
Nurse/midwife
Traditional birth attendant
Percent5 reporting at least one reproductive
health problem
Awareness of AIDS
Percent of women who have heard of AIDS
Child Health
Percent of children age 0–3 months exclusively
breastfed
Median duration of breastfeeding (months)
Percent of children9 who received vaccinations: (Children age 12–23 months)
BCG.
DPT (3 doses).
Polio (3 doses)
Measles
All vaccinations
Percent of children10 with diarrhea in the past
2 weeks who received oral rehydration salts (ORS?)
7
Percent of children with acute respiratory infection in
The past 2 weeks taken to a health facility or provider
Nutrition
8
Percent of women with anemia
Percent of women with moderate/severe anaemia11
Percent of children age 6–35 months with anaemia11
Percent of children age 6–35 months with moderate/
Severe anaemia11
Percent of children chronically undernourished (stunted.
9
Percent of children acutely undernourished (wasted) 12. )
Percent of children underweight

6
For births in the past 5 years (excluding first births
7
Children under 3 years

8
Anaemia–haemoglobin level < 11.0 grams/decilitre (g/dl) for children and pregnant women and < 12.0 g/dl for nonpregnant
women. Moderate/severe anaemia haemoglobin level < 10.0 g/dl

9
Stunting assessed by height-for-age, wasting assessed by weight-for-height, underweight assessed by weight-for-age

81
 Annex 8
Key indicators brought out by District Level Household survey under RCH programme

Variable Description
1 State Name
2 Phase
3 District Name
4 Mean age at marriage for boys
5 Mean age at marriage for girls
6 Boys married below legal age at marriage 21 years
7 Girls married below legal age at marriage 18 years
8 Knowledge of any modern family planning method
9 Knowledge of any modern spacing family planning method
10 Knowledge of all modern family planning methods
11 Knowledge of any traditional method
12 Current use of any family planning method
13 Current use of any modern family planning method
14 Current use - Female sterilization
15 Current use - Male sterilization
16 Current use – IUD
17 Current use – PILLS
18 Current use – CONDOM
19 Current use of any traditional family planning method
20 Unmet need for limiting-1
21 Unmet need for spacing-1
22 Unmet need -total-1
23 Unmet need for limiting-2
24 Unmet need for spacing-2
25 Unmet need -total-2
26 No antenatal check up
27 Any antenatal check up
28 3 or more antenatal check ups
29 Antenatal check up at home
30 Who had no TT injection during pregnancy
31 Who had one TT injection during pregnancy
32 Who had two or more TT injection during pregnancy
33 Who consumed one IFA tablet regularly
Variable Description
35 Who received 100 or more IFA tablets during pregnancy
36 Received adequate IFA tablets/syrup
37 Full ANC1 - (At least 3 visits for ANC + at least one TT injection + 100 or more IFA tablets)
38 Full ANC2 - (At least 3 visits for ANC + at least one TT injection + 100 or more IFA tablets/syrup)

82
39 Institutional deliveries
40 Institutional deliveries - government
41 Institutional deliveries - private
42 Safe Deliveries (Either institutional delivery or home delivery attendant by Doctor/Nurse/TBA)
43 Safe Deliveries (Either institutional delivery or home delivery attendant by Doctor/Nurse)
44 Breastfeeding within 2 hours (children age below 36 months)
45 Percentage whose mother squeezed out the first breast milk (children age below 36 months)
46 Exclusive breastfeeding at least 4 months (children age 4-12 months)
47 Percentage of children age 12-35 months received Polio 0
48 Percentage of children age 12-35 months received BCG
49 Percentage of children age 12-35 months received DPT 3
50 Percentage of children age 12-35 months received POLIO 3
51 Percentage of children age 12-35 months received Measles
52 Percentage of children age 12-35 months received Full Immunization
53 Percentage of children age 12-35 months not received any vaccination
54 Aware of diarrhea
55 Knowledge of ORS
56 who had diarrhea (two weeks prior to survey)
57 Given ORS to children during Diarrhea
58 Sought treatment for Diarrhea
59 Aware of danger signs of Pneumonia
60 who had Pneumonia (two weeks prior to survey)
61 Sought treatment for Pneumonia
62 Women aware of RTI/STI
63 Women aware of HIV/AIDS
64 Women who had pregnancy complications
65 Women who had delivery complications
66 Women who had post delivery complications
67 Women had side effects due to female sterilization
68 Women had side effects due to IUD
Variable Description
69 Women who had Menstruation related problems
70 Abnormal vaginal discharge
71 Women who had any symptom of RTI/STI
72 Sought treatment for Pregnancy complications
73 Sought treatment for Post delivery complications
74 Sought treatment abnormal vaginal discharge
75 Women visited by ANM/Health worker
76 Women who had said worker spent enough time with them
77 Women who satisfied with service/advice given by health worker
78 Women who utilized government health facility for antenatal care
79 Women who utilized government health facility for treatment of pregnancy complications
80 Women who utilized government health facility for treatment of post delivery complications
81 Women who utilized government health facility for treatment of RTI/STI (vaginal discharge) Unmet need for
contraception
83
82 Limiting 1-The proportion of currently married women who are neither in menopause or had hysterectomy nor are
currently pregnant and do not want any more children but are currently not using any family planning method.
83 Spacing 1: The proportion of currently married women who are neither in menopause nor had hysterectomy nor are
currently pregnant and who want more children but 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 not included in unmet
for spacing.

84 Total Unmet need for limiting-1 and spacing-1

85 Limiting 2: The proportion of currently married women who are neither in menopause or had hysterectomy nor are
currently pregnant and do not want any more children but are currently not using any family planning method.
86 Spacing 2: The proportion of currently married women who are neither in menopause not had hysterectomy nor are
currently pregnant and who want more children but after two years or later and are currently not using any currently
pregnant . The women who are not sure about whether and when to have next child are also included in unmet for
spacing.
87 Total 2: Unmet need for limiting-2 and spacing-2

84