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THE SECRETARIAT OF NATIONAL COALITION OF CIVIL SOCIETY ORGANIZAT IONS
DEVELOPED BY:
BIHARFACTSHEET
2020
In India the civil society organizations have been experimenting and developing various communityparticipation models but mostly its spread has been limited and operations remained in silosbecause of lack of platforms and alliances to highlight their works. Therefore, Oxfam India has set anational coalition for civil society organizations from 15 states in the country to bring certain macro-level changes that can help to achieve the envisaged health, nutrition and women’s economicempowerment outcomes through a common platform. It is believed that this platform will give acollective voice to the people and has the capacity to negotiate and influence the state for thenecessary integration of health, nutrition and gender under the government flagship programmeslike NRLM, NHM, ICDS and others. Oxfam India acts as an interim Secretariat for this coalition at thenational level to provide necessary support for its effective functioning. As the thematic areas ofwork of this coalition are being looked through the lens of gender discrimination and socialinclusion, emphasis is being given on Dalits, Adivasis and Muslims communities.
As evidence generation is one of the key strategies for functioning of this coalition, Oxfam Indiaintended to develop a state factsheet for each of the target states to highlight health, nutrition andwomen empowerment related issues of the state.
Only the important indicators related to health, nutrition and women empowerment have beenincluded in this factsheet and presentation of segregated data is limited to only locations (rural &urban), caste categories (SC, ST, OBC & Others) and religious groups (Hindus & Muslims). As data forother religious categories are not available for all indicators for all sources, only two religious groupshave been considered for the present analysis.
BACKDROP
.
STATE AT A GLANCE
47.952.1
104,099,452
OF INDIA POPULATION
STATE
INDIA 1,210,854,977
STATE POPULATION BY SEX (%)
Source: Census 2011
OVERALL POPULATION
88.7
11.3
Rural Urban
STATE POPULATION BY LOCATION (%)
Source: Census 2011 Source: Census 2011
(8.6%)
18.422.5
46.3
5.8
0-6 yr (Children) 10-19 yr (Adolescent) 15-49 yr (Reproductive) Above 60 yr (Old age)
STATE POPULATION BY AGE GROUP (%)
Source: Census 2011
*DECADAL POPULATION GROWTH RATE (%)
25.4
Source: Census 2011
* Total population growth between 2001-2011
17.7
STATEINDIA
SEX RATIO (FEMALES PER 1000 MALES)
Sex Ratio Sex Ratio (0-6 years)
918
921
895
935
938
912
State Total
Rural
Urban
Source: Census 2011
HEALTH INDEX (RANK)
20
Source: Economic Survey 2019
2 0 1 7 - 2 0 1 8
A M O N G 2 1 S T A T E S
O V ER AL L L I T ER ACY R A T E ( % )
Source: Census
43.9
71.9
33.1
59.759.8
76.9
51.5
71.2
Rural Urban Female Male
2001
2011STATE
INDIA 73.064.8
61.847.0
2 0 0 1 2 0 1 1
B Y S E X
943 918India Total
• Nearly 90% of Bihar’s population lives in rural areas.• Bihar’s decadal population growth rate is 8% more than India• Sex ratio in urban areas is a matter of concern - both overall and for children• Bihar fares well in comparison to national total in child sex ratio by 17 points• The state stands second from bottom in health index rank.
B Y L O C AT I ON
Name of the Districts Composite
Rank
Health
Rank
Education
Rank
Agriculture
Rank
Financial
Inclusion
Rank
Skill
Development
Rank
Basic Infrastructure
Rank
91 76 90 48 65 85 85
52 63 48 27 30 68 91
82 77 79 39 71 95 92
43 48 46 10 11 84 95
54 80 78 18 44 37 46
72 46 71 11 62 55 100
89 71 95 33 59 34 87
80 35 85 51 38 90 98
46 86 41 19 26 41 74
63 70 62 38 36 75 83
85 58 93 44 35 53 57
58 67 76 28 58 10 66
78 73 84 46 83 72 5113. Sitamarhi
7. Katihar
8. Khagaria
9. Muzaffarpur
10. Nawada
11. Purnia
12. Sheikhpura
6. Jamui
1. Araria
2. Aurangabad
3. Banka
4. Begusarai
5. Gaya
ASPIRATIONAL DISTRICTS OF STATE WITH THEIR RANKS AS PER BASELINE* CONDUCTED IN 2018
*Total 115 districts have been identified as Aspirational Districts in India. But the ranks given in the table are based on the baseline conducted by NITI Aayog in 2018 for 101 Aspirational Districts only.
T O P 2 0 I N I N D I ASource: Niti Aayog
M A I N W O R KER S ( % ) M A R GI NAL W O R KER S ( % )
87.7
12.3
Rural Urban
61.5S T A T E
I N D I A 75.2
Source: Census 2011 Source: Census 2011
94.5
5.5
Rural Urban
38.5S T A T E
I N D I A 24.8
O U T O F S T A T E ' S T O T A L M A R G I N A L W O R K E R S
O U T O F S T A T E ' S T O T A L M A I N W O R K E R S
B O T TOM 2 0 I N I N D I A
• Bihar has less main workers and more marginal workers in comparison to India, reflective of poor employment opportunities in the state.• Five districts in Bihar fall in the bottom 20 aspirational districts of India, when scored for composite ranking. On segregat ion, it is found that the state
fares somewhat well in agriculture.
PROPORTION OF VULNERABLE POPULATION
(8.2%)
O V ER AL L S C H EDUL E C A S T E ( S C ) P O P ULATI O N
16,567,325 48.1
51.9
Out of India's SC population
92.6
7.4
Rural Urban
• Scheduled castes, Scheduled Tribes and Muslims contribute to 15.9%, 1.3%, 16.8% respectively of the total state population, reflecting the major contribution of SC and Muslim groups.
S T AT E
I N D I A 201,378,372
Source: Census 2011
Source: Census 2011
Source: Census 2011
S C P O P U L A T I O N B Y L O C A T I O N ( % ) S C P O P U L A T I O N B Y S E X ( % )
(1.3%)
O V ER AL L S C H EDUL E T R I B E ( S T ) P O P ULATI O N
1,336,573
Out of India's ST population
95.1
4.9
Rural Urban
S T AT E
I N D I A 104,545,716
S T P O P U L A T I O N B Y L O C A T I O N ( % ) S T P O P U L A T I O N B Y S E X ( % )
48.9 51.1
(10.2%)
O V E R A L L M U S L I M P O P U L A T I ON
17,557,809
Out of India's Muslim population
86.6
13.4
Rural Urban
S T AT E
I N D I A 172,245,158
M U S L I M P O P U L A T I O N B Y L O C A T I O N ( % ) M U S L I M P O P U L A T I O N B Y S E X ( % )
48.551.5
H O USELESS P O P UL ATI O N ( N o . )
P E R S O NS W I T H D I S ABI L I T I ES I N A L L A G E G R O UP
P O P ULATI O N L I V I NG B E L O W P O VER TY L I N E ( % )
Source: Planning Commission (As Per Tendulkar Estimation)
54.4 53.5
33.737.229.8
21.9
2004-05 2009-10 2011-12
State India
H O USELESS P O P UL ATI O N ( N o . )
45,584
Source: Census 2011
I N D I A S T A T E
1,773,040
257,288285,716
523,545
370,638
10,873 21,619
1961 1971 1981 1991 2001 2011
N U M B ER O F P A R TI C ULAR LY V U LNER AB LE T R I B AL G R O UP S ( N o . )
Source: Statistical Profile Of Scheduled Tribes In India 2013
A G E - WI SE D I ST R I BUT I ON O F S I N GLE W O MEN ( N o . )
• There is a reduction of more than 20 percentile points in the state's BPL population between 2004-05 and 2011-12.• In the last three decades, there has been a severe depletion in the state's PVTG population, coming down from 5 lakhs to as l ow as 20 thousand in 2011.• Nearly 14 lakh women aged 60 years and above are single in the state which depicts their vulnerability in terms of both age a nd social security.
Source: Census 2011
20-24Years
25-29Years
30-34Years
35-39Years
40-44Years
45-49Years
50-54Years
55-59Years
60-64Years
65-69Years
70-74Years
75-79Years
80+Years
WIDOWED 19,624 36,535 63,047 96,289 129,390 149,006 192,275 179,371 382,485 330,246 322,659 126,737 186,929
DIVORCED 1,620 2,130 2,188 1,947 1,618 1,097 782 529 662 420 302 116 189
SEPARATED 4,715 5,855 6,323 5,625 4,763 3,400 2,576 1,556 1,903 1,019 577 201 263
NEVER MARRIED 622,475 125,214 41,374 20,437 11,428 7,134 6,510 6,336 23,383 21,226 9,964 4,139 20,519
NEVER MARRIED SEPARATED DIVORCED WIDOWED
A G E G R O U P
TOTAL
Below never married Total Single women
648,434 169,734 112,932 124,298 147,199 160,637 202,143 187,792 408,433 352,911 333,502 131,193 207,900
Source: Census 2011
P E R SO NS W I T H D I S ABI L I T I ES I N A L L A G E G R O UP
26,814,994
2,116,698
O U T O F W H I C H
R E P O R T E D M U L T I P L E D I S A B I L I T I E S
I N D I A ' S T O T A L P E R S O N W I T H D I S A B I L I T I E S
42.4
57.6
P E R S O N S W I T H M U L T I P L E D I S A B I L I T I E S O U T O F S T A T E ' S
M U L T I P L E D I S A B L I T I E S ( % )
38.8
61.2
S T A T E ' S T O T A L P E R S O N W I T H D I S A B I L I T I E S
Source: Census 2011
C H I LD R EN ( 0 - 4 Y E A R S) WI TH D I S AB I L I T I ESP E S O N S W I T H D I S A B L I T I E S O U T O F
S T A T E ' S D I S A B L I T I E S ( % )
P E R S O N S W I T H M U L T I P L E D I S A B I L I T I E S O U T O F S T A T E ' S
M U L T I P L E D I S A B L I T I E S ( % )
47.552.5
40.9
59.1
Source: Census 2011
C H I LD R EN ( 5 - 9 Y E A R S) W I T H D I S ABI L I T I ESP E S O N S W I T H D I S A B L I T I E S O U T O F
S T A T E ' S D I S A B L I T I E S ( % )
P E R S O N S W I T H M U L T I P L E D I S A B I L I T I E S O U T O F S T A T E ' S
M U L T I P L E D I S A B L I T I E S ( % )
45.9
54.1
38.4
61.6
• Out of total disabilities, 16% of the children aged 0-9 years are living with disabilities in Bihar.• Across age-groups, more males are found to be living with disabilities than their female counterparts.
2,331,009
110,844
1,291,637
78,662
O U T O F W H I C H
R E P O R T E D M U L T I P L E D I S A B I L I T I E S
I N D I A ' S T O T A L C H I L D R E N ( 0 -4 Y E A R S ) W I T H D I S A B I L I T I E S
S T A T E ' S T O T A L C H I L D R E N ( 0 - 4 Y E A R S ) W I T H
D I S A B I L I T I E S
186,314
6,843
1,955,926
187,492
O U T O F W H I C H
R E P O R T E D M U L T I P L E D I S A B I L I T I E S
I N D I A ' S T O T A L C H I L D R E N ( 5 - 9 Y E A R S ) W I T H D I S A B I L I T I E S
S T A T E ' S T O T A L C H I L D R E N ( 5 - 9 Y E A R S ) W I T H
D I S A B I L I T I E S
257,526
13,161
(8.7%)
(5.2%)
(14.4%)
(8.7%)
(13.2%)
(7%)
P E S O N S W I T H D I S A B L I T I E S O U T O F S T A T E ' S D I S A B L I T I E S ( % )
44.5
29.1
Rural UrbanSource: NFHS 2015-2016
W O M EN 2 0 - 2 4 Y E A R S M A R R I ED B E F O R E 1 8 Y E A R S ( % )
HEALTH AND NUTRITION
M A R R I AGE A N D F E R T I L I T Y
42.5S T A T E
26.8I N D I A
T O T AL F E R T I L I T Y R A T E ( % )
3.6 2.4
Rural UrbanSource: NFHS 2015-2016
3.4S T A T E
I N D I A 2.2
3.9 3.8 3.4 2.8
SC ST OBC Others
3.3 4.1
Hindu Muslim
B Y L O C A T I O N B Y C A S T E ( % ) B Y R E L I G I O N
12.88.3
Rural Urban
W O M EN 1 5 - 1 9 Y E A R S W H O W E R E A L R EADY M O T H ERS O R P R EG NANT ( %)
12.2S T A T E
I N D I A 7.9
14.7 12.4 12.57.7
SC ST OBC Others
12.5 10.7
Hindu Muslim
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
• More than 40% girls living in rural Bihar get married before they turn 18. • High rate (15%) of teenage pregnancies among SCs • The state records a higher rate of TFR in comparison to the national total with Muslims recording the maximum (4.1%).
M O R T AL I TY
M O R T ALI TY R A T ES ( D EAT HS P E R 1 0 0 0 L I V E B I R TH S)
Source: NFHS 2015-2016
S T A T EI N D I A
49.7 58.1
40.7 48.2
29.5 36.7
46.5
40.6
35.0
27.7
60.2
47.1 46.8
35.4
73.0
52.5
56.1
44.6
SC ST OBC Others
60.1
40.4
49.7
34.337.7
28.0
Rural Urban
Under-fiveMortality
InfantMortality
NeonatalMortality
37.7
31.9
49.1
43.4
58.2 57.2
Hindu Muslim
B Y R E L I G I O NB Y C A S T EB Y L O C A T I O N
178167
130 122
219208
165 165
2010-2012 2011-2013 2014-2016 2015-2017
India State
M A T ERNAL M O R T AL I TY R A T E ( M MR ) ( D EAT HS P E R 1 0 0 , 00 0 L I V E B I R TH S )
Source: SRS
C U R R ENT LY M A R R I ED W O MEN A G E D 1 5 - 4 9 W I T H U N M E T N E E D * F O R F A M I L Y P L A NNI N G ( % )
21.4 19.1
Rural UrbanSource: NFHS 2015-2016
21.2S T A T E
12.9I N D I A
• High Child mortality rates (neonatal, infant and under-5) in rural areas and among scheduled caste population in Bihar • Mortality rates (both maternal and child) in Bihar are much higher in comparison to country figures.• While the country has not witnessed any change in its maternal mortality rate since 2014, Bihar recorded a change of 8 points between 2014 to 2017, signifying
improvement.• Prevalence of high unmet need among Muslim women signifying poor access to contraceptive measures. Also need to remember that TFR is also high among Muslims
in the state.
21.2 23.5 20.7 22.4
SC ST OBC Others
19.928.0
Hindu Muslim
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
* Unmet need for family planning is defined as the percentage of currently married women who either want to space their next birth or stop childbearing entirely, but are not using contraception.
M A T ERNAL C A R E
Source: NFHS 2015-2016
13.0
26.3
Rural Urban
M O T H ERS W H O H A D A T L E A ST 4 A N T ENAT AL C A R E V I S I T S ( % )
14.4S T A T E
I N D I A 51.2
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
8.6 11.214.2
24.4
SC ST OBC Others
14.6 13.4
Hindu Muslim
M O T HERS W H O C O N SUMED I F A F O R 1 0 0 D A Y S O R M O R E W H E N T H EY W E R E P R E G NANT ( % )
9.4 12.3
Rural Urban
9.7S T A T E
I N D I A 30.3
7.6 7.1 9.614.0
SC ST OBC Others
10.0 8.2
Hindu Muslim
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
M O T HE RS W H O R E C E I V E D P O S T NA T AL C A R E F R O M A N Y S K I L L E D H E A L TH P E R S O NN E L W I T HI N 2 D A Y S O F D E L I V E RY ( % )
44.9
54.8
Rural Urban
45.9S T A T E
I N D I A 65.1
47.339.9
Hindu Muslim
43.2
29.4
46.951.0
SC ST OBC OthersSource: NFHS 2015-2016
• The state shows low utilization of antenatal care services among all women and postnatal care services especially among ST's.• Extreme low consumption rate of IFA tablets during pregnancy, with the state recording a meagre 9% in comparison to a national total of 30%.
D E L I VER Y C A R E
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
I N S T I TUT I ONAL B I R T H S ( % )
62.7
74.3
Rural Urban
63.8S T A T E
78.9I N D I A
58.654.7
65.5 67.8
SC ST OBC Others
66.7
51.1
Hindu Muslim
Source: NFHS 2015-2016
5.4
13.9
Rural Urban
B I R T HS D E L I VER ED B Y C A E S AR EAN S E C T I ON ( % )
6.2
S T A T EI N D I A
17.2
C H I LD R EN A G E D 1 2 - 23 M O N T HS F U L LY I M M UNI Z ED ( % )
61.9 59.7
Rural Urban
61.7S T A T E
62.0I N I D A
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
63.9
52.0
Hindu Muslim
61.2
49.5
63.759.7
SC ST OBC Others
Source: NFHS 2015-2016
• Both institutional delivery and immunization is a concern among Scheduled Tribe population.
C H I LD F E ED I NG P R AC TI C ES A N D N U T R I T I ONAL S T AT US
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
34.543.5
Rural Urban
C H I LD R E N U N D E R A G E O F 2 Y E A R S B R E AST F E D W I T H I N O N E H O UR O F B I R T H ( % )
35.4S T A T E
41.5I N D I A
35.8 33.5
Hindu Muslim
34.6 33.0 36.3 33.2
SC ST OBC Others
Source: NFHS 2015-2016
C H I LD R EN A G E D 6 - 8 M O N T HS R E C E I V I NG S O L I D O R S E M I - SOL I D F O O D A N D B R EAST MI LK ( %)
30.8S T A T E
42.7I N D I A
29.5
41.2
Rural Urban
P R EVAL ENC E O F L O W B I R T HWEI GH T ( % )
Source: Lancet Global Burden of Disease 2019 Source: NFHS 2015-2016
C H I L DR E N U N DE R A G E 6 M O N TH S E X C L U S I V E LY B R E A S TF E D ( % )
23.42 0 1 7
STATEINDIA
21.4
54.9 53.4
INDIA STATE
• The country and Bihar shows low rate in early initiation of breastfeeding, with only 35% of the mothers in the state, breast-feeding their babies within one hour of birth• While half of the state’s children are exclusively breastfed yet data for median duration of exclusive breastfeeding comes to only around 3 months for each child
instead of the stipulated 6 months of compulsory exclusive feeding.
M E D I AN D U R AT I ON O F E X C LUS I VE B R EAST FEED I NG A M O NG L A S T - B OR N C H I LD REN B O R N I N T H E L A S T T H R EE Y E A R S ( M O NT HS)
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
2.8 1.2
Rural Urban
2.7
2.9
3.4 2.6 2.4 2.5
SC ST OBC Others
2.7 3.1
Hindu Muslim
S T A T E
I N D I A
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
C H I LD R EN U N D ER 5 Y E A R S W H O A R E U N D ER WEI GH T ( %)
44.637.5
Rural Urban
43.9S T A T E
35.7I N D I A
51.046.8 43.6
33.3
SC ST OBC Others
43.8 44.0
Hindu Muslim
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
C H I LD R EN U N D ER 5 Y E A R S W H O A R E S T U NT ED ( %)
49.3
39.8
Rural Urban
48.3
38.4
55.848.2 48.1
37.8
SC ST OBC Others
48.2 48.7
Hindu Muslim
20.8 21.3
Rural Urban
C H I LD R EN U N D ER 5 Y E A R S W H O A R E W A S T ED ( % )
20.8
21.0
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
22.4 23.8 20.8 17.8
SC ST OBC Others
20.7 21.1
Hindu Muslim
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
C H I LD R EN A G E 6 - 5 9 M O NT H S W H O A R E A N A E MI C ( < 1 1 . 0 G / D L) ( %)
64.058.8
Rural Urban
63.5
58.5
Source: NFHS 2015-2016
67.3 68.062.3 60.9
SC ST OBC Others
63.4 63.7
Hindu Muslim
• While the state fares very badly in child stunting and underweight figures (48.3% & 43.9% respectively), the prevalence of this is further high among the Scheduled caste community.
S T A T E
I N D I A
S T A T E
I N D I A
S T A T E
I N D I A
D I E T AR Y D I VE R S I TY P A T T E R N
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
18.1 19.6
Rural Urban
6 - 2 3 M O NT H S C H I L D RE N F E D 4 + F O O D G R O U P S I N P A S T 2 4 H O U R S ( % )
18.2
22.0
16.820.6 18.1 20.3
SC ST OBC Others
17.023.9
Hindu Muslim
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
6 - 2 3 M O NT H S C H I LD REN F E D M I N I MUM M E A L F R EQ UENC Y I N P A S T 2 4 H O UR S ( % )
29.3
37.0
Rural Urban
30.0
35.9
29.9 29.7 29.8 31.5
SC ST OBC Others
29.433.1
Hindu Muslim
• Only 18% of Bihar’s children consume meals having 4 or more food groups. This can also be linked with the appalling level of malnutrition prevalent among the children in the state. Similar concern is with minimum meal frequency.
S T A T E
I N D I A
S T A T E
I N D I A
62.9 64.459.7 58.2
32.0 35.0 32.3 32.2
SC ST OBC Others
60.9 57.1
32.7 29.6
Hindu Muslim
60.5 58.7
34.124.2
Rural Urban
N U T R I T I ONAL S T AT US O F W O MEN A N D M E N
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
31.822.2
Rural Urban
W O M EN W H O SE B O D Y M A S S I N D EX I S B E L O W N O R MAL ( B MI < 1 8 . 5 K G / M 2 ) ( %)
30.4
22.9
30.2 31.4
Hindu Muslim
35.329.2 30.6
25.3
SC ST OBC Others
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
7.8 10.1 11.217.4
SC ST OBC Others
W O M EN W H O A R E O V ER WEI GH T O R O B ESE ( B M I ≥ 2 5 . 0 K G / M 2 ) ( %)
11.7
20.7
9.7
23.5
Rural Urban
11.6 11.8
Hindu Muslim
Source: NFHS 2015-2016
50.4
P R E GNA NT W O ME N A G E D 1 5 - 4 9 Y E A R S W H O A R E A N A EMI C ( < 1 1. 0 G / D L) ( %)
58.3
INDIA STATE
B Y L O C A T I O N
B Y C A S T E B Y R E L I G I O N
Source: NHS 2015-2016
W O M EN A N D M E N A G E D 1 5 - 49 Y E A R S W H O A R E A N A EMI C ( % )
53.1
I N D I A
22.7
60.3
S T A T E
32.3
• There is a higher proportion of women with below normal Body Mass Index (BMI) in rural areas and among scheduled caste commun ities. • Anaemia is a major concern both across the nation and state with around 60% of the women (pregnant and non-pregnant) with low haemoglobin count. In the
previous section, it was found that anaemia is also prevalent among the children.
S T A T E
I N D I A
S T A T E
I N D I A
M E N ST RUAL H Y G I ENE
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
27.3
55.6
Rural Urban
W O M EN A G E D 1 5 - 24 W H O U S ED H Y G I ENI C M E T HOD O F P R O T EC TI O N D U R I NG M E N STR UATI O N ( %)
31.0S T A T E
57.6I N D I A
31.6 28.2
Hindu Muslim
21.3 19.6
29.9
47.8
SC ST OBC Others
O T H ER H E ALT H I S S UES
P E R SO NS S U F F ERI NG F R O M T U B ERC ULO SI S
Source: India TB Report 2019
4.9%
2018
O U T O F T B P A T I E N T S N O T I F I E D I N I N D I A
64.435.6
S T A T E
I N D I A 2,155,894
104,930
O U T O F T B P A T I E N T S N O T I F I E D I N S T A T E ( % )
• Prevalence of unsafe menstrual practices is a major concern in the state with around 70% having poor menstrual hygiene. This difference is particularly high among the rural and urban agglomerations and also across the social groups (SC, ST, OBCs fare lower than the others).
• High prevalence of Tuberculosis among men is another concern.
W O M EN & M E N A G E D 1 5 - 4 9 Y E A R S W H O R E P O RT ED S E X UALL Y T R A NS MI TT ED I N F ECT I ON ( S T I ) I N T H E P A S T 1 2
M O NT H S ( % )
Source: NFHS 2015-2016
2.5 1.20.27 0.26 0.26 0.25 0.16
0.28 0.27 0.27 0.260.22
2012 2013 2014 2015 2017
STATE INDIA
P E O P LE ( 1 5 - 49 Y E A R S) L I V I NG W I T H H I V / A I DS ( % )
Source: India NACO-Report
INDIA
STATE 1.8 1.5
H E A LTH E X P END I TUR ES
G O V E R N M E N T H E A L T H E X P E N D I T U R E ( % O F T O T A L H E A L T H E X P E N D I T U R E )
O U T O F P O C K E T H E A L T H E X P E N D I T U R E( % O F T O T A L H E A L T H E X P E N D I T U R E )
Source: National Health Accounts Estimates for India 2015-16
30.6 60.6I N D I A
S T A T E 19.1 79.9
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NFHS 2015-2016
A V E R AGE O U T O F P O C KET E X P END I T URE P E R D E L I VER Y I N P U B L I C , P R I V AT E A N D A N Y H E A LTH F A C I L I T Y ( R UPEES)
1,778 1,835
12,303
10,638
4,305
5,774
Rural Urban
Public
Private
Any
1,588
2,984
1,708 2,153
10,797
12,322 11,735
13,072
3,199
4,677 4,286
6,862
SC ST OBC Others
1,786 1,757
12,186
10,709
4,531 4,245
Hindu Muslim
3,197 1,784
16,522 11,955
7,935 4,488
I N D I A S T A T E
• Government share in health expenditure is abysmal in both India and Bihar. However, Bihar fares lower with around 10% differe nce in comparison to the country. • With low government share in health expenditure, Bihar shows high out of pocket expense (80%). Moreover, while average expenditure for delivery in public health
facilities is around Rs. 1700/- in Bihar, it is approximately Rs. 3000/- for the scheduled tribes.
GOVERNMENT FLAGSHIP PROGRAMMES FOR HEALTH AND NUTRITION
N A T I ONAL H E A LT H M I S S I ON I N T EGRAT ED C H I LD D E V ELO PMENT P O SH AN A B H I YAAN
The National Health Mission (NHM)encompasses its two Sub-Missions, theNational Rural Health Mission (NRHM) and theNational Urban Health Mission (NUHM). Themain programmatic components includeHealth System Strengthening, Reproductive-Maternal- Neonatal-Child and AdolescentHealth (RMNCH+A), and Communicable andNon-Communicable Diseases. The NHMenvisages achievement of universal access toequitable, affordable & quality health careservices that are accountable and responsive topeople’s needs.
NHM has six financing components:
(i) NRHM-RCH Flexipool,(ii) NUHM Flexipool,(iii) Flexible pool for Communicable disease,(iv) Flexible pool for Non communicabledisease including Injury and Trauma,(v) Infrastructure Maintenance and(vi) Family Welfare Central Sector component.
Integrated Child Development Services (ICDS)Scheme is one of the flagship programmes ofthe Government of India and represents one ofthe world’s largest and unique programmes forearly childhood care and development.
The beneficiaries under the Scheme arechildren in the age group of 0-6 years, pregnantwomen and lactating mothers. Objectives of theScheme are:1. To improve the nutritional and health statusof children in the age-group 0-6 years;2. To lay the foundation for properpsychological, physical and social developmentof the child;3. To reduce the incidence of mortality,morbidity, malnutrition and school dropout;4. To achieve effective co-ordination of policyand implementation amongst the variousdepartments to promote child development;5. To enhance the capability of the mother tolook after the normal health and nutritionalneeds of the child through proper nutrition andhealth education.
The Prime Minister’s Overarching Scheme forHolistic Nutrition (POSHAN) Abhiyaan orNational Nutrition Mission is one of the India’sflagship programmes to improve nutritionaloutcomes for children, adolescents, pregnantwomen and lactating mothers by leveragingtechnology, a targeted approach andconvergence. It aims to build a people’smovement (Jan Andolan) around malnutrition.
Key Strategies
For implementation of POSHAN Abhiyaan themission adopts a four point strategy:1. Inter-sectoral convergence for better servicedelivery2. Use of technology (ICT) for real time growthmonitoring and tracking of women and children3. Intensified health and nutrition services forthe first 1000 daysJan Andolan
India
Bihar
PHCs and HWC-PHCs
S H O R T F A LL I N H E A L TH F A C I L I T I E S I N R U R A L A R E A S ( % )
53.4
46.5
83.1
(as on 1st July 2019)
S H O R T F A LL I N H U M A N R E S O URC E I N R U R A L A R E A S ( % )
Anganwadi Workers
ASHA 14.2
ANM at Sub Centres Surplus
(as on 1st July 2019)
Surplus
Doctors+ at PHCs Surplus
Specialists at CHCs 86.3
ANM at PHCs
Source: Status report of ICDS as on 31st March 2015
Source: Rural Health Statistics 2019 Source: Rural Health Statistics 2019
StateIndia
Sub Centres and HWC-SCs
CHCs
23.0
28.2
36.9
StateIndia
Surplus
2.8
26.1
6.0
81.8
6.94.7
115,009
91,677
60,838
Sanctioned Operational Providing Services
N U M B ER O F A W C s
Source: Status report of ICDS as on 31st March 2015
1,400,000 I N D I A 1,346,186 1,258,166
S T A T E
38 38 38
2012-2013 2013-2014 2014-2015
N U M B ER O F N U T R I T I O NAL R E H AB I L I TAT I O N C E N T RES
Source: PIB 2012-13 , 2013-14 & 2014-15
688I N D I A 875 896
S T A T E
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
49.839.1
Rural Urban
C H I LD R EN A G E D 0 - 7 1 M O NT H S W H O R E C E I VED S E R VI C ES F R O M A N A W C ( % )
Source: NFHS 2015-16
48.7S T A T E
53.6I N D I A54.4
43.948.9
42.2
SC ST OBC Others
49.744.4
Hindu Muslim
• The state has a tremendous shortfall of primary health-care facilities, with a shortfall of more than 80% of CHCs which is the first point of contact for the people with any health specialist. Consequently, there is also a shortfall of more than 85% specialists at the CHC level.
• While more than 20% of the sanctioned AWCs are not operational in the state, out of those operational more than 30% of the centres are not providing services. • More than half of the state’s children and nearly two-third of its pregnant women do not receive their entitled services like nutritious food etc. from AWC.
38.029.9
Rural Urban
M O T H ERS R E C E I VED S E R VI C ES F R O M A N A W C D U R I NG P R EGNANC Y ( % )
37.2S T A T E
NO DATAI N D I A
Note: For India 'No Service 'is available.
Source: NFHS 2015-16
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
45.4
31.737.3
27.1
SC ST OBC Others
38.432.1
Hindu Muslim
Activity type State Value (%) India Value (%)
Home Visits 64.6 14.4
Anemia Camp 2.0 1.5
CBE-Community Based Events (ICDS) 1.9 22.3
Community Radio Activities 0.4 0.3
Cooperative/Federation 0.4 0.2
Cycle Rally 0.7 0.3
DAY-NRLM SHG Meet 3.6 1.9
Defeat Diarrhoea Campaign (D2) 0.2 No Data
Farmer Club Meeting 0.5 0.2
Haat Bazaar Activities 0.4 0.4
Harvest Festival 0.1 0.2
Local Leader Meeting 0.5 0.5
Nukkad natak/Folk Shows 0.2 0.4
Other Activities 7.7 34.7
Panchayat Meeting 1.1 1.0
Poshan Mela 1.9 8.2
Poshan Rally 2.1 2.6
Poshan Walk 1.4 1.5
Poshan Workshop/Seminar 0.7 4.1
Prabhat Faree 1.5 1.1
Providing Water to the Toilets 0.3 0.3
Safe Drinking Water in Anganwadi Centres 1.0 0.7
Safe Drinking Water in Schools 0.5 0.2
School Based Activities 3.0 2.9
VHSND 2.6 No Data
Youth Group Meeting 0.7 No Data
4.7
11.4
6.0
11.0
7.7
8.03.5
6.0
7.4
9.8
6.0
18.5
Adolescent Ed, Diet, Age of Marriage
Anemia
Antenatal Checkup
Breastfeeding
Compl. Feeding
Diarrhoea
ECCE
Food Fortification & Micronutrients
Growth Monitoring
Hygiene, Water, Sanitation
Immunisation
Poshan (Overall Nutrition)
T H EMES - WI SE A C T I VI T I ES I N P O SHAN M A A H ( S EP T EMB ER 2 0 1 9)
Source: http://dashboard.poshanabhiyaan.gov.in/janandolan/#/
C O NT R IB UT I ON O F A C T I VI T I ES I N P O SHAN M A A H ( S EP TEMB ER 2 0 1 9 )
Source: http://dashboard.poshanabhiyaan.gov.in/janandolan/#/
Total
F E M A L E W O R K E R S ( 1 5 - 5 9 Y E A R S ) P O P U L A T I O N R A T I O ( % )
Source: Annual Report PLFS 2017-18 Source: Annual Report PLFS 2017-18
F E M A L E ( 1 5 - 5 9 Y E A R S ) L A B O U R F O R C E P A R T I C I P A T I O N R A T E ( % )
F E M A L E ( 1 5 - 5 9 Y E A R S ) U N E M P L O Y M E NT R A T E ( % )
Source: Annual Report PLFS 2017-18
WOMEN EMPOWERMENT
4.3S T A T E
23.8I N D I A
4.4S T A T E
25.3I N D I A
2.6S T A T E
6.0I N D I A
W O M EN H E AD ED E S T AB L I S H MENT S
Source: All India Report of Sixth Economics Census 2016
6.43.0
36.5
54.1
SC ST OBC Others
40.7
11.8
Hindu Muslim
B Y C A S T E B Y R E L I G I O N
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
Source: NHS 2015-2016
M E N A N D W O M EN A G E D 1 5 - 49 Y E A R S W H O W A N T M O R E S O N S T H AN D A U GHTER S ( % )
31.6 24.9
38.3
29.4
Rural Urban
MALE
FEMALE
35.4 29.2 30.2 26.0
40.940.1 38.0
29.6
SC ST OBC Others
29.237.4
37.037.8
Hindu Muslim
18.7
18.8
I N D I A
30.4
37.1
S T A T E
8,050,819
I N D I A
153,610
S T A T E
1 . 9 % 0 u t o f I n d i a ’ s W o m e n H e a d e d E s t a b l i s h m e n t s
9 . 0 % 0 u t o f S t a t e ’ s T o t a l E s t a b l i s h m e n t s -A g r i c u l t u r e & N o n - A g r i c u l t u r e
4.0 6.5
Rural Urban
4.1 6.9
Rural Urban
2.0 6.4
Rural Urban
• The state has less than 5% of women in its labour force. And this consists of both currently employed and unemployed women signifying the proportion of active employed women to be further less.
• Bihar has only 1.9% of women headed establishments in the country, with SC, ST and Muslims contributing the least in this.
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
50.758.8
Rural Urban
53.342.9
52.4 49.5
SC ST OBC Others
52.1 50.5
Hindu Muslim
C U R R ENT LY M A R R I ED W O MEN W H O P A R TI C I P ATE I N T H R EE D E C I S I ONS* ( % )
63.0I N D I A
51.8S T A T E
Source: NFHS 2015-16
* Three Decisions Own health careMaking major household purchasesVisits to her family or relatives
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
W O M E N W H O H A V E E V E R E X P E R I E N C E D E M O T I O N A L , P H Y S I C A L O R S E X U A L V I O L E N C E C O M MI T T E D B Y T H E I R H U S B A N D ( % )
45.5S T A T E
Source: NFHS 2015-16
33.3I N D I A
Source: NCRB 2016
S T AT E R A NK B A S ED O N C R I ME R A T E A G A I NS T W O M EN ( R ANK)
2215,393
13,904 13,400 14,711
16,920
2014 2015 2016 2017 2018Source: NCRB
C R I MES A G A I NS T W O M EN ( I P C + S L L ) ( N o . )
O U T O F 36 S T A T ES & U T s
I N D I A ( 2 0 1 8 )
378,277
S T A T E ( 2 0 1 8 )
16,920
(4.5%)O U T O F I N D I A
D O WR Y D E AT HS R E P OR T ED ( N O . )
1,154
987 1,081 1,107
2015 2016 2017 2018
7,166
W O M EN T R AF F I CK I NG C A S ES R E P OR T ED
( No.)
3
O U T O F 854I N I N D I A
Source: NCRB 2018Source: NCRB
1,107
(15.4%)O U T O F I N D I A
I N D I A ( 2 0 1 8 )
S T A T E ( 2 0 1 8 )
46.141.9
Rural Urban
53.8 56.1
46.2
32.6
SC ST OBC Others
45.6 45.4
Hindu Muslim
B Y L O C A T I O N B Y C A S T E B Y R E L I G I O N
4.5 6.8
Rural Urban
7.31.5 4.9 2.4
SC ST OBC Others
4.8 4.9
Hindu Muslim
W O M EN W H O H A V E E X P ERI ENC ED V I O LENC E D U R I NG A N Y P R EGNANC Y ( % )
3.9I N D I A
4.8S T A T E
Source: NHS 2015-2016
F E M ALE S U I C I D E C A S ES ( No.)
Source: Accidental Deaths & Suicides in India 2018
F O ET I CI D ES & I N F ANT I C I D ES R E P O RT ED ( No.)
Source: NCRB 2018
1F O ET I C I D ES
0I N F A N T I C I D E S
S T A T EI N D I A
128
56185
42,391
S T A T E
I N D I A
• Bihar has a high incidence of violence against women with around every second woman woman in the state having an abusive hist ory. Further, proportion of Bihar’s women experiencing violence is 12% more than the overall national figure.
• There has been an increase of 26% in crime against women since 2016.
GOVERNMENT FLAGSHIP PROGRAMMES FOR WOMEN EMPOWERMENT
N A T I ONAL R U R AL L I V E L I HO OD M I S S I ON B E T I B A C H AO B E T I P A D H AO
What is NRLMGovt. of India established National Rural Livelihoods Mission (NRLM) inJune 2010 to implement the new strategy of poverty alleviation wovenaround community based institutions.
Mission’s primary objective is to reduce poverty by promoting diversifiedand gainful self-employment and wage employment opportunities forsustainable increase in incomes.
To achieve the desired goal of the mission, NRLM provides a combinationof financial resource and technical assistance to states such that theycould use the comprehensive livelihoods approach encompassing fourinter-related tasks. These tasks are:
1. Mobilizing all rural, poor households into effective self-help groups(SHGs) and their federations;2. Enhancing access of the rural poor to credit and other financial,technical and marketing services;3. Building capacities and skills of the poor for gainful and sustainablelivelihoods; and4. Improving the delivery of social and economic support services to thepoor.
Beti Bachao, Beti Padhao is a campaign of the Government of India thataims to generate awareness and improve the efficiency of welfare servicesintended for girls in India.
The Overall Goal of the Beti Bachao Beti Padhao (BBBP) Scheme is tocelebrate the girl child and enable her education. The objectives of theScheme are as under:
i. To prevent gender biased sex selective eliminationii. To ensure survival and protection of the girl childiii. To ensure education and participation of the girl child
Strategies employed to successfully carry out the scheme are:
1. Implement a sustained social mobilization and communicationcampaign to create equal value for the girl child and promote hereducation.
2. Place the issue of decline in child sex ratio/sex ratio at birth in publicdiscourse, improvement of which would be an indicator for goodgovernance.
3. Focus on gender critical districts and cities.
T O T AL S H G s F O R MED
918,091 77.2
S H G s H A V I NG B A N K A C C O UNT ( % )
61.6
S H G s H A V I NG C R ED I T L I N K ED ( %)
T O T A L V I L L A GE O R G A NI Z A T I ON S
F O R M ED
59,846
T O T AL C L U ST ER L E V EL F E D ER ATI O NS
F O R ME D
1,027Source: Jeevika dashboard accessed on 6th Mar 2020
Source: U-Dise
S C H O OL S H A V I NG G I R L ’ S T O I LET I N E L E MENT ARY E D UC AT I ON ( % )
Source: U-Dise
49.1 49.3 49.651.0 53.1 55.1
2014-2015 2015-2016 2016-2017
INDIA STATE
G I R LS E N R O LMENT I N S E C O ND AR Y E D U C ATI O N ( % )
Source: U-Dise
S C H O OL S H A V I NG G I R L ’ S T O I LET I N S E C O ND ARY E D UC AT I ON ( % )
Source: U-Dise
90.395.2
91.8
83.4
91.996.7
2014-2015 2015-2016 2016-2017
INDIA STATE
46.1 48.4 48.349.8 49.8 50.0
2014-2015 2015-2016 2016-2017
INDIA STATE
87.1
97.6 96.5
71.2
89.9 87.3
2014-2015 2015-2016 2016-2017
INDIA STATE
G I R LS E N R O LMENT I N E L E MENT ARY E D U C ATI O N ( % )
• There has been almost no improvement in girls’ enrolment in both elementary and secondary level for Bihar as well as for the entire country since 2014 to 2017. However, toilets being one of the major contributors for improving girl’s enrolment has shown an improvement for both Bihar a nd India.