bihar factsheet 2020

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 ( % )



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 ( % )



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


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


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


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)


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


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


* 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


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


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




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



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


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


63.9

52.0

Hindu Muslim

61.2

49.5

63.759.7

SC ST OBC Others


• 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



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


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)



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



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



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



22.4 23.8 20.8 17.8

SC ST OBC Others

20.7 21.1

Hindu Muslim


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


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



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



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



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



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


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



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 ( % )


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



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


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 ( % )


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.



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



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.


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


* Three Decisions Own health careMaking major household purchasesVisits to her family or relatives


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


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


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


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.

bihar factsheet 2020

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