India - Third Population Project

Document of The World Bank FOR OFFICIAL USE ONLY Report No. 4691-IN INDIA STAFF APPRAISAL OF A THIRD POPULATION PROJ November 9, 1983 Population, Health and Nutrition Department This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization.  CURRENCY EQUIVALENT US $1.00 = Rupees (Rs) 9.75 GOVERNMENT OF INDIA FISCAL YEAR : April 1 - March 31 MEASURE (METRIC SYSTEM) 1 meter (m) = 3.28 feet (ft) 1 kilometer (kim) = 0.62 miles (mi)  FOR OFFICIAL USE ONLY ABBREVIATIONS ADHEO Assistant District Health Education Officer AIR All-India Radio A.p. Andhra Pradesh State BEE Block Extension Educator CHC Community Health Center CHO Community Health Officer DHEO District Health Education Officer DPEC District Population Education Center FEC Family Education Center GOI Government of India RAF Health Assistant (Female) HAM Health Assistant (Male) HEO Health Education Officer HFWTC Health Family Welfare Training Center IEC Information, Education and Communication IUD Intra-Uterine Device KANFED Kerala Association for Non-Formal Education and Development KHRWS Kerala Health Research and Welfare Society MCH Maternal and Child Health MIES Management Information and Evaluation System MOH Ministry of Health MOHFP Ministry of Health and Family Planning MOHFW Ministry of Health and Family Welfare MPWF Multipurpose Worker Female MPWM Multipurpose Worker Male MTP Medical Termination of Pregnancy NSS National Social Service OTC Orientation Training Camps PHC Primary Health Center PWD Public Works Department RHFWTC Regional Health and Family Welfare Training Center RPEC Regional Population Education Center SHC Subsidiary Health Center SPEC State Population Education Center SRS Sample Registration Survey TFR Total Fertility Rate U.P. Uttar Pradesh VHG Village Health Guides This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization.  DEFINITIONS Crmde Birth Rate Number of live births per year per 1,000 population. Crude Death Rate Number of deaths per year per 1,000 population. Rate of Natural Differience between crude birth ard crude death rates; Increase usually expressed as a percentage. Rate of Population Rate of natural increase adjusted for (net) migration, Growth expressed as a percentage of the total population in a given year. Age Specific Number of live births to women in a given age group Fertility Rate per 1,000 women in the same age group, in a given year. It is usually calculated for five-year age groups. Total Fertility The average number of live children that would be born Rate per woiln if she were to live to the end of her diild- bearing years, and bear children according to a given set of age-specific fertility rates. The Total Fer- tility Rate often serves as an estimate of the aver- age numnber of children per family. Net Reproduction The nuimber of live-born daughters a cohort of females Rate would bear under a given fertility schedule and a given set of survival probabilities, from birth to the erd of the child-bearing years. Infant Mortality Annual number of deaths of infants under one year per Rate 1,000 Live births during the same year. Maternal Mortality Number of maternal deaths per 1,000 births attribut- Rate able to pregnancy, childbirth, or puerperal ccnplica- tions (i.e., within six weeks fillowing childbirth). Life Expectancy Average number of years expected to be lived by childrean born in a given year if mDrtality rates for each age/sex group renain the same in the future. Age Dependency Ratio of population 14 years and under plus population Ratio 65 years and over to population aged 15 to 64 years. Tehsil/Taluk SubdivLsions of districts. Equivalent An index of overall family planning performance cal- Sterilizations culated by adding the number of sterilizations per- formed over a period of time, one-third the number of IIJDs inserted, one-eighteenth the number of equivalent convenl:-ional contraceptive users (condoms, diaphragms, etc.), and one-ninth the number of equivalent oral contraceptive users. These weights are derived from an assessuent of numbers of births averted by dif fer- ent conitraceptive nEmtDds in India. Dai Traditional Birth Atterdant. Panchayat A local government body usually covering a large village or several smaller villages  INDIA STAFF APPRAISAL OF A THIRD POPULATION PROJECT BASIC DATA Total Area 3,287,263 km2 Total Population (March 1981) 685.2 million Density per km2 (March 1981) 216 Rate of Natural Increase of the Population (1971-81) 2.25%/annum Crude Birth Rate (1981) 34/1OOOa/ Crude Death Rate (1981) 13/1000T/ Life Expectancy at Birth (1977) 51.0a/ Infant Mortality Rate (1978) 1279t Maternal Mortality Rate (1972) 50/10,000 Urban Population as Percent of Total Population (1981) 23.3% Adult Literacy Rate (1981) Males 47% Females 25% Primary School Enrollment (1980) Males 90% Females 61% Age Structure (est. 1981) 0-14 39% 15-60 55% 60 and over 6% Population per Physician (1977) 3,135 Population per Nurse (1976) 6,320 Percentage of Eligible Couples Currently Protected Against Pregnancy (1982-83) 29%a/ Per Caput Gross National Product (1981) US$260 a/ Latest Official GOI estimates.   INDIA THIRD POPULATION PROJECT CREDIT AND PROJECT SUMMARY Borrower: India, acting by its President. Beneficiaries: The States of Karnataka and Kerala. Amount: US$70 million. Terms: Standard. Relending As part of Central assistance by the Government of Terms: India (GOI) to the States for development projects on terms and conditions applicable at the time. At present, Central assistance for health and family welfare activities is provided on a grant basis. GOI will bear the exchange risk. Project The project would assist the GOI in accelerating the Description: development of its family welfare program in the back- ward districts of the two States. It would have the following major components: (a) service delivery; (b) demand generation, including information, educa- tion, and communication activities and population edu- cation; (c) research and evaluation; and (d) project management. The proposed project would cover six dis- tricts in northern Karnataka and four districts in Kerala, with a total population of 18.2 million. The project would have as its major objectives a reduction of fertility and a lowering of infant, child and maternal mortality. The risks under the proposed project are attendant on the difficulties of persuading some 2.8 million couples to change their attitudes towards the accep- tance of family planning and MCH practices which will improve the health of their children and curtail the size of their families. The project has been designed to minimize the risks to an acceptable level.  Estimated Costs: Local Foreign Total --(US$ Millions)