Sample Registration System

in India

 State Institute of Health & Family Welfare, Jaipur

Sample Registration System (SRS)

ØInitiated 1964-65
ØOperational -1969-70
ØOne of the largest continuous
demographic household
sample survey in the world

SIHFW: An ISO:9001:2008 certified Institution 2

SRS is-
Ø Dual reporting system
Ø Provides annual estimates of -
Ø Birth and death rate
Ø Infant Mortality Rate (IMR)
Ø Total Fertility Rate (TFR)
Ø Maternal Mortality Rate
Ø Other measures of fertility and mortality

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 Objective of SRS

Ø The main objective is to provide reliable

estimate of
ØBirth rate
ØDeath rate
ØInfant mortality rate
Ø Also provides data for other measures of
ØFertility rate
ØMortality rate(infant & child) at higher
geographic level
Ø
Ø SIHFW: An ISO:9001:2008 certified Institution 4
 Sample Design
Ø
Ø A uni-stage stratified simple random sample
without replacement.
Ø A simple random sample of enumeration block is
selected without replacement from each of the
size classes of towns/cities in each State/UT
Ø The sample unit in
Ø rural areas -village or a segmented village
Ø Urban area- census enumeration block

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 Estimation Procedure

Ø The estimates of population, live births,

deaths and infant deaths are obtained
using unbiased method of estimation.
Ø
Ø The annual estimates of births, deaths and
infant mortality rates are based on reported
number of sample births, deaths and infant
deaths respectively at the national level.
Ø

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 Infant mortality
ØMost sensitive index of the level of socio-
economic development and quality of life.
ØUsed for monitoring and evaluating population
and health programmers and policies.
ØIMR -
ØIndia- 53 (2009 SRS Bulletin)
ØRajasthan- (63)
ØLowest- 12 (Kerala )
ØHighest -70 (MP)

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 Maternal Mortality

ØSRS (1997) : 408

ØSRS (1998) : 407
ØSRS(2003) : 301
ØSRS(2006) : 254
ØMMR of Rajasthan is 388 (2006)


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SRS Bulletin (Oct. 2009)
Ø Birth Rate: 22.8(per 1000 population)
Ø Death Rate: 7.4(per 1000 population)
Ø Natural Growth Rate:15.4 (per 1000
population)


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Revision of SRS sampling frame
10-yearly based on recent results of Census

ØTo make necessary modification in the

sampling design
ØTo give wider representation of population
ØTo overcome the difficulties/limitations in
the existing scheme
ØTo meet the additional requirements
Ø Enhancing the scope of SRS
Ø Rationalization of SRS forms
Ø Better netting of events
Ø User friendly
Ø Easy for scanning
Ø Streamlining the system

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Enhancing the Scope of Data

 Data on:
ØMorbidity
ØFamily planning practices
ØAbortion
ØBirth history of all currently married
women in reproductive span
ØReasons of migration
ØSchool attendance (up to 16 years)
ØDisability
Ø
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Introduction of Unique Identification


Code


ØOne of the significant modification proposed

is introduction of unique identification code.
This will result in :
Øeasy storage and retrieval of data
Øaggregation at different levels
ØCross-classification of various
determinants with fertility and mortality
indicators
ØCohort studies

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  Causes of Death in SRS
ØData on causes of death are useful for health
planners, administrators, and medical
professionals
ØTo identify the public health importance of different
diseases
ØTo evaluate trends in causes of mortality over time
in order to assess the impact of national health
programs
ØTo analyze the socio-economic, demographic and
life style factors that are associated with the
deaths due to various diseases

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 Verbal Autopsy Activities
Part Time Enumerator

Continuous recording of birth/death events

Inform households about

Supervisors the conduct of VA

Half yearly retrospective survey

Cause of Death
Assignment by
Collection of the circumstances, Health Professional
symptoms and signs of illness and
Narrative in VA forms

Quality Check
10% Re-sample in the field
by independent Re-Sample Teams

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 Initiatives in SRS

Ø To improve the data on causes of death in SRS:

ØDevelopment of VA Forms
ØForms based on the existing
experience of WHO, Chinese
Surveillance System and other
international and national studies.
ØType of Forms : incl. Structured & Narrative
ØNeo-Natal Form
ØChildhood Form
ØAdult Form
ØMaternal Death Form
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ØConduct of pre-tests of VA Forms in
various regions
ØReview of the results of pre-test by
eminent epidemiologist/researchers
ØRefinements in VA Forms based on
the feed-back
ØPreparation of VA Instruction
Manuals

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Ø Premier Institutes like CGHR (University of
Toronto), NIMHANS(Bangalore), PGI
(Chandigarh), ICMR, TIFR (Mumbai),
Medical colleges of India, ERC (Chennai),
have been identified in all the major States
as long term technical partners with SRS
for :
ØTraining/Refresher Training to
RGI Staff on verbal Autopsy
ØConducting VA in 10 percent
resample units
ØAssignment of causes of
deaths
ØQuality Control
ØEpidemiological analyses
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Ø Re-sampling
ØObjective- 10% of VAs for each
SRS Supervisor will be checked
by collaborating institutions for
training feedback
ØIdentification of operational
problems and possible remedial
measures:
Ø Physician coding
Ø100% double coding,
ØReconciliation with another
physician
ØAdjudication of disagreements

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 Present Scenario & Future Plans
Ø All the SRS Surveyors have been trained and re-
trained in the art of canvassing VA
Ø The VA has been introduced in all the states/uts.
as an integral component of SRS
Ø The preliminary results for two Half Yearly
Surveys (2nd HYS, 2002 & 1st HYS, 2003)
were presented in Trivandrum Workshop
Ø The results suggest that VA would result in
generating cause specific mortality by age,
sex and other risk factors on a continuous
basis.
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To see the SRS bulletin follow few
steps:
ØGo to the Census site
(www.censusindia.gov.in)
ØIn the web page See below in Vital
Statistics
ØClick on SRS bulletins
Ø
Ø

Ø
Ø SIHFW: An ISO:9001:2008 certified Institution 20
THANK YOU