Sample Registration System in India – An Overview. Prince Mahidol Award Conference, Bangkok, 27-30 Jan, 2010 Sample Registration System in India – An Overview. Prasanta Mahapatra, Institute of Health Systems, Hyderabad, India

Sources of vital statistics in India and their usability. Source & Periodicity Estimated Parameters Small area estimates Usability SRS Annual, Since 1970 Fertility & Mortality Indicators State level est. for big states, recently, intra state regions . Representative sample, Regular reports, Reliable. Census 10 Years Pop. count by age sex, area, IMR & Child Mortality Population count down to village level, Mortality: District level. Reliable & valid pop. Data in ab. 2 years. Ab 8 yr lag for indirect est. of Fert. & Mort. CRS An, 1958 District level and large cities with 10000 pop. Death reg <50%, Wide interstate variation. Av time to publication 45 months until 1994, no reports since then. NFHS 6 Years I:92-93, II:98-99, III:05-06 Fertility & IMR (Indirect Estimates) State level estimates Indirect estimates. Quick est available within a year. Small sample size. GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

P. Mahapatra: SRS in India An Overview SRS Sample Units Replacement Period Rural Urban Total 1969-70 2432 1290 3722 1977-78 3684 1738 5422 1983-85 4176 1846 6022 1993-95 4436 2235 6671 2004 4433 3164 7597 GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

Statistics available from SRS Information Statistics Availability & Location Population Distribution Pop by 5Y age sex groups, 0-4 to 70+ until 1994 and to 85+ since 1995 Table-1 in all annual reports from 1970. Fertility Population by marital status From 1992 as Table-2 Age sp. & marital fertility rates Table-3 since 93. Earlier T2-4 Age sp. fertility rates by education From 1996 as Table-4 Birth-order & birth-interval wise distribution of births From 1990, Tables 4,5&6 until 95. Later Tables 5,6&7 Mortality Age Sp. Death Rates by 0, 1-4, and 5Y age groups from 5-9 upto 70+ 0r 85+ Table-8 since 1996. Earlier Table 4, 5 or 7 Mortality indicators: Crude Death Rate, Child Mortality, IMR etc. Table-9 since 1996. Earlier 3, 4, 5, 8 or 9. % distribution of deaths by age. Since 1997, Table-10 Access to Medical Care Medical attention at birth Statements (St) 25, 30, 31, 34, 35, 38, 39 or 40. Medical attention at death St 42,44,47,48,51,53, or 55-57. GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

Evaluations of SRS in India Dates Study Design Findings Ref. 1970- 1975 Indirect estimate (Brass 1975) 6% under reporting of adult deaths RGI, 1982 1971- 1976 Indirect est. (Brass 1975; Preston & Coale 1980) 10% under reporting of deaths. Insignificant interstate variations. Excluded Bihar & West bengal for poor data quality. Bhat et al. 1984 1978 Indirect est. (P/F ratios, UN 1983, Ch-II) 6% under reporting of births. State underestimates in 1978 ranged from <1% (Guj) to >17% (KA) RGI 1984, Swamy et al. 1992 1980- 1981 Intensive inquiry of 10% subsample 3% under estimation of birth and death rates. State underestimates around 1% (Guj, Har, MP) to 11% (KA) Grover 1988; Swamy et al. 1992. 1985- 1986 State underestimates, <1% (AP, BI, Guj, KE, MP,, MH, OR, TN) to >3% (AS, WB) Swamy et al. 1992. … 1978- 1992 Comparison of SRS with NFHS fertility est. At least 10% under registration of births. Narasimhan et al. 1997 GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

Completeness of death registration by the Indian SRS from 1990-2007. Year AP MH OR UP India 1990 0.67 0.68 0.83 0.79 0.77 1992 0.71 0.82 0.88 0.90 0.99 1994 0.87 0.93 0.96 0.91 1996 0.80 0.85 0.89 1998 0.97 2000 0.94 0.78 2002 0.76 0.84 0.81 2004 2006 0.70 0.75 0.92 2007 0.58 0.72 1.05 =>90% : 5 (1992, 94,95,98,03) out of 18 years <80%: 6 (1990, 91, 99, 00,05, 06) out of 18 years Interstate variations: <80% for 13 yrs in AP & 11 yrs in MH GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

Overall quality and usefulness of the Indian SRS Accuracy Relevance Comparability Timeliness Accessibility GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

Overall Accuracy of SRS Data Coverage: Covers about 0.6% of India’s population. However, its representative character allows for estimation of vital statistics for the country and major states. Completeness: Around 90% registration of events upto 1980s. Interstate differences narrowed down by mid 1980s. Completeness appears to have worsened during the 1990s and after. Interstate differences in completeness appears to have widened also. Missing data: Generally believed to be low, but no information about missing data. Annual report should include a table showing the number of births and deaths for which age or sex information was not available and how those events were treated through the tabulation process. Also a table regarding timeliness of monthly returns from the state level offices. GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

Timeliness of SRS Annual Reports Production Time: Median production time: 2 ½ Years 1970s: 6 ½ Years 1980s: 2½ Years 1990s: 2 Years 2000-07: 1 Year 10 Months Regularity: SD of Production Time: 32 Months 05 Months 02 Months 07 Months Lumping of annual reports in a publication year: Publication Year 2000: 1997, 1998 Publication Year 2004: 2001, 2002 Publication Year 2006: 2004, 2005 GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

Accessibility of SRS Publications & Data Media: Annual reports in print form only. Half yearly bulletins in print; and pdf files through internet since April 1999 Metadata: Annual report gives details of sampling, system of data collection and definition of terms. But population figures in statement A or 1 are not available by sex. From 1993, the population figures are rounded to nearest 000, reducing scope for consistency checks and indirect estimation of accuracy of SRS statistics. User Service: Sale counter at RGI’s head office delivers reports across the counter and responds to requests over post. Regional sale counters in state capital do not usually stock all publications. RGI library in Delhi does not have a reference set of all SRS publications. GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

P. Mahapatra: SRS in India An Overview Summary Overall the Indian SRS has been a reliable and trusted source of fertility and mortality statistics for India and its bigger states. But no evaluation of SRS after the 1980s. Some evidence to suggest deterioration in completeness of registration, in some states. Need for in-house and indep. evaluations Scope to improve metadata and user services GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview

P. Mahapatra: SRS in India An Overview Comments, Questions…? and Thank You. GHIF 2010, Ssn1.4 P. Mahapatra: SRS in India An Overview