The Coverage Evaluation Survey 2009 (CES-2009), a nationwide survey covering all States and Union Territories of India, commissioned by UNICEF was conducted during November 2009 to January 2010.
The CES shows significant increase in major indicators for maternal and child health including immunization and reaffirms the positive results of the strategies adopted by the Ministry of Health and Family Welfare under the National Rural Health Mission (NRHM) for the Reproductive and Child Health Programme.
Janani Suraksha Yojana has changed the scenario of institutional delivery in the country. The CES results show that when compared to data of NFHS-III, which provides the figures for 2005-06, beginning of NRHM, certain important parameters of maternal health have shown impressive increases:
Institutional delivery has increased from 40.7 % to 72.9 %
Safe delivery by skilled birth attendants has increased from 48.2% to 76 %
Mothers who had 3 or more Ante Natal Check-ups has also increased from 50.7 % to 68.7%.
In the so called backward states such as Madhya Pradesh institutional delivery has increased from 29.7 % to 81%, in Orissa where institutional delivery has increased from 38.8 % to 75.5%, in Rajasthan from 32.2 % to 70.4 %, in Bihar from 22.0 % to 48.3%, in Chhattisgarh from 15.7% to 44.9% and in Uttar Pradesh this has increased from 22.0 % to 62.1 %.
There has been a considerable improvement in Child Health indicators as compared to NFHS III (2005 -06)
• The proportion of children with diarrhoea in the last two weeks who received ORS has increased from 26 % in NFHS III to 53.6 in CES 2009
• The proportion of children with Acute Respiratory Infection in the last two weeks who were given advise or treatment has increased from 69% in NFHS III (2005-06) to 82.6% in CES 2009
• The number of children breast fed within one hour has increased from 24.5 % in NFHS III (2005 -06) to 33.5 % in CES 2009
Additionally the CES findings in some of the high focus states show substantial change in two critical child health indicators:
Oral Rehydration Solution Use/Oral Rehydration Therapy (increased fluids for diarrhoea)
• Orissa (54.8 % in NFHS III to 69.0 % in CES)
• Chhattisgarh (46.4 % in NFHS III to 68.3 % in CES)
• Jammu & Kashmir (46.6 % in NFHS III to 79.8 % in CES)
Acute Respiratory Infections (ARI) care seeking in any health facility
• Madhya Pradesh (51.5 % in NFHS III to 75.9 % in CES)
• Jharkhand (67.0 % in NFHS III to 70.9 % in CES)
• Bihar (70.2 % in NFHS III to 82.9 % in CES)
• Orissa (76.5 % in NFHS III to 79.4 % in CES)
• Chhattisgarh (66.8 % in NFHS III to 85.0 % in CES)
• Jammu & Kashmir (71.6 % in NFHS III to 83.7 % in CES)
The Coverage Evaluation Survey shows a significant change in newborn care practices which are important in preventing infections and hypothermia and absence of these practises contribute substantially to Infant Mortality Rate. For instance:
• 86.0% of the newborn had their cord cut with a sterilized/new blade
• 43.6% of newborn were not given bath immediately.
• 74.3% of children were wiped dry and wrapped
• The Proportion of newborn checked within 24 hours is 65.6%
The full immunization coverage at the national level has also increased to 61.0% as per CES (Coverage Evaluation Survey) 2009 from 43.5 % in NFHS-3 (2005-06). Of the 23 states that have shown improvement in full immunization coverage when compared to NFHS -3 (2005-06), 9 states have shown improvement in full immunization coverage of 20 -30 %; and similarly in 6 states the improvement has been between 10-20%. The large states like Uttar Pradesh, Rajasthan, Jharkhand, Bihar, Assam, Karnataka, Maharashtra has shown improvement of full immunization coverage of more than 15 % as compared to NFHS-3. These improvements have been due to the various NRHM initiatives including strengthening of the immunization programme.
The findings of the survey are a testimony to the positive results of the RCH -II Programme and the efforts being made under National Rural Health Mission.