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DrTanveer Rehman
Senior Resident
Dept of Community Medicine & Family Medicine
Overview
11/06/2021 2
DRTANVEER REHMAN, CMFM, AIIMS-K
Overview
• Governments need to know how many inhabitants currently live in the
country and how many there will be in the future.
• From this they can plan and make better decisions regarding the
construction of schools, hospitals, roads etc.
• Governments also need to know how old the population is and will be in the
coming years in order to plan for pensions, health care etc.
11/06/2021 3
DRTANVEER REHMAN, CMFM, AIIMS-K
Overview
• Crude – unrefined/ grossly, not accounting age & gender, like CBR 15 means
1000 population gives 15 births, but those 1000 aren’t giving birth, maybe
500 women
• Population India: 439 million (1961) – 30 years doubled to 846 m (1991)
11/06/2021 4
DRTANVEER REHMAN, CMFM, AIIMS-K
POPULATION
• Denominator: grandpa smokes daily yet 90
years old – unimportant: check the proportion
surviving
• India – 1.39 billion ~ 20% of world
• By 2050 ~ 1.53 billion
• “Big divide” – 1921
11/06/2021 5
DRTANVEER REHMAN, CMFM, AIIMS-K
CRUDE BIRTH RATE
• The ratio of births in a year (other specified period) to the average population
in the same year/period (mid-year population), expressed per 1000:
• India – 20.0, Bihar - 26.2,West Bengal – 15.0
11/06/2021 6
DRTANVEER REHMAN, CMFM, AIIMS-K
CRUDE DEATH RATE
• The ratio of deaths in a year (other specified period) to the average
population in the same year/period (mid-year population), expressed per
1000
• India – 6.7, Chhattisgarh 8.0, West Bengal – 5.6
11/06/2021 7
DRTANVEER REHMAN, CMFM, AIIMS-K
POPULATION GROWTH RATE
• Current annual growth rate = (Crude birth rate – crude death rate)/
10
• Excusive of migration
• Population doubling time for 1% to 1.5% annual growth rate – 70
to 47 years
11/06/2021 8
DRTANVEER REHMAN, CMFM, AIIMS-K
LIFE EXPECTANCY
• Average number of years a person of that age may expect to live
according to mortality pattern prevalent
• In 1950 ~ 47 years in India
• Highest in Switzerland (Males 82 years, females 85 years)
• India: Males 68 years, females 70 years
11/06/2021 9
DRTANVEER REHMAN, CMFM, AIIMS-K
Sex Ratio
11/06/2021 10
1. Usually denoted by number of girls for every 1000 boys
2. Primary sex ratio: conception stage
3. Secondary sex ratio: birth stage
• Skewed towards boys – biological bias & female deficit syndrome
4. Tertiary sex ratio: adult stage
• Skewed towards boys – Female deficit syndrome
5. Quaternary sex ratio: post reproductive organs
• Skewed towards women
DRTANVEER REHMAN, CMFM, AIIMS-K
LITERACY RATE
• Can read, write & understand at least one language
• India – 73%, Bihar 62%,West Bengal – 76.3%
11/06/2021 11
DRTANVEER REHMAN, CMFM, AIIMS-K
11/06/2021 12
DRTANVEER REHMAN, CMFM, AIIMS-K
SEX RATIO
11/06/2021 13
1. Usually denoted by number of girls for every 1000 boys
2. Primary sex ratio: conception stage
3. Secondary sex ratio: birth stage
• Skewed towards boys – biological bias & female deficit syndrome (due to feticide,abortion)
4. Tertiary sex ratio: adult stage
• Skewed towards boys – Female deficit syndrome
5. Quaternary sex ratio: post reproductive organs
• Skewed towards women
DRTANVEER REHMAN, CMFM, AIIMS-K
Dependency ratio
• Current annual growth rate = (Crude birth rate – crude death rate)/ 10
• Excusive of migration
• Population doubling time for 1.5% to 2.0% annual growth rate – 47 to 35
years
11/06/2021 14
DRTANVEER REHMAN, CMFM, AIIMS-K
Dependency ratio (DR)
• Demographic bonus: with early development, fertility decreases more than
old population increases, so DR decreases – push for education & health care
• Demographic burden: Eventually with fertility decreasing & life expectancy
increasing – child DR shifts to old age DR
• Child DR: 26, Old age DR: 6.6,Total DR: 48.7%
11/06/2021 15
DRTANVEER REHMAN, CMFM, AIIMS-K
Sex Ratio
11/06/2021 16
1. Usually denoted by number of girls for every 1000 boys
2. Primary sex ratio: conception stage
3. Secondary sex ratio: birth stage
• Skewed towards boys – biological bias & female deficit syndrome
4. Tertiary sex ratio: adult stage
• Skewed towards boys – Female deficit syndrome
5. Quaternary sex ratio: post reproductive organs
• Skewed towards women
DRTANVEER REHMAN, CMFM, AIIMS-K
FERTILITY
• Fertility or family size in this context: total number of children a woman
borne at a point of time
• Completed family size: total borne in her reproductive age period 15-45/49
years
11/06/2021 17
DRTANVEER REHMAN, CMFM, AIIMS-K
CRUDE BIRTH RATE
• The ratio of births in a year (other specified period) to the average population
in the same year/period (mid-year population), expressed per 1000:
• India – 20.0, Bihar - 26.2,West Bengal – 15.0
11/06/2021 18
DRTANVEER REHMAN, CMFM, AIIMS-K
GENERAL FERTILITY RATE
• Births to women aged 15–44/49 in a year/period per 1000 women aged 15–
44/49 in the same period
• Not all women are at risk of childbirth – General Marital Fertility Rate
11/06/2021 19
DRTANVEER REHMAN, CMFM, AIIMS-K
AGE-SPECIFIC FERTILITY RATE (ASFR)
• Average number of children a woman would have if she were to pass through
reproductive years bearing children at same rate as women now in each age
group
• ASFRs are frequently calculated for 5-year age groups from 15–19 to 40–44 or
45–49
11/06/2021 20
DRTANVEER REHMAN, CMFM, AIIMS-K
TOTAL FERTILITY RATE (TFR)
• The sum of the ASFR for all reproductive age groups for a particular period
(usually a year), conventionally expressed per woman
• Indicates how many children a woman would have if throughout her
reproductive life, she had children at the ASFR
If x=49
11/06/2021 21
DRTANVEER REHMAN, CMFM, AIIMS-K
TFR continuing…
• ‘ fx’ is the ASFR at age x
• If rates for age groups, rather than single years, are used then the sum of the
ASFR must be multiplied by the number of single ages included in the group
(usually five).
If x = 45–49:
11/06/2021 22
DRTANVEER REHMAN, CMFM, AIIMS-K
GROSS REPRODUCTION RATE (GRR)
• Sum of the age-specific female fertility rates (births of daughters), for all
reproductive age groups for a particular period (usually a year) conventionally
expressed per woman
• The GRR indicates how many daughters a woman would have if, throughout
her reproductive life, she had children at the ASFR prevalent in the specified
year of period
11/06/2021 23
DRTANVEER REHMAN, CMFM, AIIMS-K
NET REPRODUCTION RATE (NRR)
• Average number of daughters that would be borne, according to specified
rates of mortality and ASFR, by a new-born female
• The NRR employs the same fertility data as the GRR, but also takes into
account the effects of mortality.
• An NRR of 1.0 indicates that a population’s fertility and mortality levels would
result in exact replacement of mothers by daughters – 2 child norm
11/06/2021 24
DRTANVEER REHMAN, CMFM, AIIMS-K
TOTAL FERTILITY RATE (TFR)
11/06/2021 25
GROSS REPRODUCTION RATE (GRR)
NET REPRODUCTION RATE (NRR)
Total number of children born (males and females)
Total number of females born
Total number of females born who survived till
age 15-45/49 years
DRTANVEER REHMAN, CMFM, AIIMS-K
Exercises
11/06/2021 26
DRTANVEER REHMAN, CMFM, AIIMS-K
Reference
1. Detels R, editor. Oxford textbook of global public health. Oxford
Textbook; 2015
2. National Health Profile 2020. Central Bureau of Health Intelligence,
Directorate General of Health Services, Ministry of Health & Family
Welfare. Government of India, New Delhi 2020.
3. Park K. Park's textbook of preventive and social medicine. Jabalpur.
Banarasidas Bhanot. 2020.
11/06/2021 27
DRTANVEER REHMAN, CMFM, AIIMS-K

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Indicators_demographic & fertility_practical class

  • 1. DrTanveer Rehman Senior Resident Dept of Community Medicine & Family Medicine
  • 3. Overview • Governments need to know how many inhabitants currently live in the country and how many there will be in the future. • From this they can plan and make better decisions regarding the construction of schools, hospitals, roads etc. • Governments also need to know how old the population is and will be in the coming years in order to plan for pensions, health care etc. 11/06/2021 3 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 4. Overview • Crude – unrefined/ grossly, not accounting age & gender, like CBR 15 means 1000 population gives 15 births, but those 1000 aren’t giving birth, maybe 500 women • Population India: 439 million (1961) – 30 years doubled to 846 m (1991) 11/06/2021 4 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 5. POPULATION • Denominator: grandpa smokes daily yet 90 years old – unimportant: check the proportion surviving • India – 1.39 billion ~ 20% of world • By 2050 ~ 1.53 billion • “Big divide” – 1921 11/06/2021 5 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 6. CRUDE BIRTH RATE • The ratio of births in a year (other specified period) to the average population in the same year/period (mid-year population), expressed per 1000: • India – 20.0, Bihar - 26.2,West Bengal – 15.0 11/06/2021 6 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 7. CRUDE DEATH RATE • The ratio of deaths in a year (other specified period) to the average population in the same year/period (mid-year population), expressed per 1000 • India – 6.7, Chhattisgarh 8.0, West Bengal – 5.6 11/06/2021 7 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 8. POPULATION GROWTH RATE • Current annual growth rate = (Crude birth rate – crude death rate)/ 10 • Excusive of migration • Population doubling time for 1% to 1.5% annual growth rate – 70 to 47 years 11/06/2021 8 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 9. LIFE EXPECTANCY • Average number of years a person of that age may expect to live according to mortality pattern prevalent • In 1950 ~ 47 years in India • Highest in Switzerland (Males 82 years, females 85 years) • India: Males 68 years, females 70 years 11/06/2021 9 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 10. Sex Ratio 11/06/2021 10 1. Usually denoted by number of girls for every 1000 boys 2. Primary sex ratio: conception stage 3. Secondary sex ratio: birth stage • Skewed towards boys – biological bias & female deficit syndrome 4. Tertiary sex ratio: adult stage • Skewed towards boys – Female deficit syndrome 5. Quaternary sex ratio: post reproductive organs • Skewed towards women DRTANVEER REHMAN, CMFM, AIIMS-K
  • 11. LITERACY RATE • Can read, write & understand at least one language • India – 73%, Bihar 62%,West Bengal – 76.3% 11/06/2021 11 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 13. SEX RATIO 11/06/2021 13 1. Usually denoted by number of girls for every 1000 boys 2. Primary sex ratio: conception stage 3. Secondary sex ratio: birth stage • Skewed towards boys – biological bias & female deficit syndrome (due to feticide,abortion) 4. Tertiary sex ratio: adult stage • Skewed towards boys – Female deficit syndrome 5. Quaternary sex ratio: post reproductive organs • Skewed towards women DRTANVEER REHMAN, CMFM, AIIMS-K
  • 14. Dependency ratio • Current annual growth rate = (Crude birth rate – crude death rate)/ 10 • Excusive of migration • Population doubling time for 1.5% to 2.0% annual growth rate – 47 to 35 years 11/06/2021 14 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 15. Dependency ratio (DR) • Demographic bonus: with early development, fertility decreases more than old population increases, so DR decreases – push for education & health care • Demographic burden: Eventually with fertility decreasing & life expectancy increasing – child DR shifts to old age DR • Child DR: 26, Old age DR: 6.6,Total DR: 48.7% 11/06/2021 15 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 16. Sex Ratio 11/06/2021 16 1. Usually denoted by number of girls for every 1000 boys 2. Primary sex ratio: conception stage 3. Secondary sex ratio: birth stage • Skewed towards boys – biological bias & female deficit syndrome 4. Tertiary sex ratio: adult stage • Skewed towards boys – Female deficit syndrome 5. Quaternary sex ratio: post reproductive organs • Skewed towards women DRTANVEER REHMAN, CMFM, AIIMS-K
  • 17. FERTILITY • Fertility or family size in this context: total number of children a woman borne at a point of time • Completed family size: total borne in her reproductive age period 15-45/49 years 11/06/2021 17 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 18. CRUDE BIRTH RATE • The ratio of births in a year (other specified period) to the average population in the same year/period (mid-year population), expressed per 1000: • India – 20.0, Bihar - 26.2,West Bengal – 15.0 11/06/2021 18 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 19. GENERAL FERTILITY RATE • Births to women aged 15–44/49 in a year/period per 1000 women aged 15– 44/49 in the same period • Not all women are at risk of childbirth – General Marital Fertility Rate 11/06/2021 19 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 20. AGE-SPECIFIC FERTILITY RATE (ASFR) • Average number of children a woman would have if she were to pass through reproductive years bearing children at same rate as women now in each age group • ASFRs are frequently calculated for 5-year age groups from 15–19 to 40–44 or 45–49 11/06/2021 20 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 21. TOTAL FERTILITY RATE (TFR) • The sum of the ASFR for all reproductive age groups for a particular period (usually a year), conventionally expressed per woman • Indicates how many children a woman would have if throughout her reproductive life, she had children at the ASFR If x=49 11/06/2021 21 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 22. TFR continuing… • ‘ fx’ is the ASFR at age x • If rates for age groups, rather than single years, are used then the sum of the ASFR must be multiplied by the number of single ages included in the group (usually five). If x = 45–49: 11/06/2021 22 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 23. GROSS REPRODUCTION RATE (GRR) • Sum of the age-specific female fertility rates (births of daughters), for all reproductive age groups for a particular period (usually a year) conventionally expressed per woman • The GRR indicates how many daughters a woman would have if, throughout her reproductive life, she had children at the ASFR prevalent in the specified year of period 11/06/2021 23 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 24. NET REPRODUCTION RATE (NRR) • Average number of daughters that would be borne, according to specified rates of mortality and ASFR, by a new-born female • The NRR employs the same fertility data as the GRR, but also takes into account the effects of mortality. • An NRR of 1.0 indicates that a population’s fertility and mortality levels would result in exact replacement of mothers by daughters – 2 child norm 11/06/2021 24 DRTANVEER REHMAN, CMFM, AIIMS-K
  • 25. TOTAL FERTILITY RATE (TFR) 11/06/2021 25 GROSS REPRODUCTION RATE (GRR) NET REPRODUCTION RATE (NRR) Total number of children born (males and females) Total number of females born Total number of females born who survived till age 15-45/49 years DRTANVEER REHMAN, CMFM, AIIMS-K
  • 27. Reference 1. Detels R, editor. Oxford textbook of global public health. Oxford Textbook; 2015 2. National Health Profile 2020. Central Bureau of Health Intelligence, Directorate General of Health Services, Ministry of Health & Family Welfare. Government of India, New Delhi 2020. 3. Park K. Park's textbook of preventive and social medicine. Jabalpur. Banarasidas Bhanot. 2020. 11/06/2021 27 DRTANVEER REHMAN, CMFM, AIIMS-K

Editor's Notes

  • #6: Solution for inequality is not equal treatment
  • #7: May 28th Menstrual Hygiene Day
  • #8: May 28th Menstrual Hygiene Day
  • #9: May 28th Menstrual Hygiene Day
  • #10: May 28th Menstrual Hygiene Day
  • #11: Multiple facets
  • #12: May 28th Menstrual Hygiene Day
  • #14: Multiple facets
  • #15: May 28th Menstrual Hygiene Day
  • #16: May 28th Menstrual Hygiene Day
  • #17: Multiple facets
  • #18: May 28th Menstrual Hygiene Day
  • #19: May 28th Menstrual Hygiene Day
  • #20: May 28th Menstrual Hygiene Day
  • #21: May 28th Menstrual Hygiene Day
  • #22: May 28th Menstrual Hygiene Day
  • #23: May 28th Menstrual Hygiene Day
  • #24: May 28th Menstrual Hygiene Day
  • #25: May 28th Menstrual Hygiene Day
  • #26: May 28th Menstrual Hygiene Day
  • #27: May 28th Menstrual Hygiene Day