The Watch (English language creative writing)

A while back I bought a gun from a man who stole a mustang. He sold it cheaply: hundred bucks for A Browning 9x19mm Grande Puissance. Hard black plastic handle – cold to touch, black metallic covers the barrel and the heaviness weighs my hand down as I hold it under my coat, carry it to my car and place it on the passenger seat. A criminal – cold, alone it stays still. I drive fast, imagining the scenarios where my trusty weapon would be used. Trapping a burglar, stopping a murderer. I take it to my house, hide it under the bathroom sink – and never speak of it to my two angels. My abode: so secure and sheltered, it is often one which is of difficulty to find. One of which is so protected it is under my own lock and key twenty four hours a day. My family, like my pride of lions -spellbound by my fantasy boundary. My imaginary line of the strictest limit to the edge of our fence, unless otherwise approved. Strict guidelines set: to be followed accordingly. Blinds open at zero six hundred hours every morning, pulled up to the third stopper on the wiry string: all seventeen in the house except one. This, followed swiftly by waking the children up at the exact precise time as of when the blinds are raised, so they are able to carry out their chores in austere time spans of fifteen minute bursts. Following this: the children head to school, and I take my place on the antique grey aged rocking chair in front of the porch window, draw the blind down at exactly zero eight hundred hours and watch as the slender young girls and broad young men outside cross the only way to the secondary school placed two hundred and fifty six meters down the avenue. Although it may seem a disgusting habit, if you truly took the time to understand the utter belief I have in this art, then you surely would understand the necessity of it. For I do not spy on the children. I do not seek to harm their innocent bodies, or to even make an attempt to frighten or threaten them. All I seek for them is their safety, and for that one obligation to stay out of harm's way. I spy only upon a small yellow house, a mere nineteen meters from my very residence. Inside this small house, gleaming with fake satisfaction and false contentment. Hiding behind the sunshine beaming from the walls of the bunkers' exterior lives a man. This man, I have observed for many months now, and have found that his main priority is to stay hidden in the gloom of the shadows, behind his window. This window, like a mirror reflects myself. he follows the same routine as me by staring out of his window when my children step out of the door, but for different reasons these glares are seen . He, for different reasons from my speculation lusts for the young. Like a cheetah, he prays on weak, girls, only just becoming of age. The intensity has grown, focusing upon him daily. His routine has changed; he starts to water his grass at zero seven hundred hours every morning, and stays there on his lawn for approximately eighty minutes, so he can catch the paper girls attention each morning. The children grow suspicious: I tell them its for their safety. My main concern my daughter: Jenny, a simple thirteen year old. Dark chocolate brown long hair with innocent mossy eyes. Slim and tall, his favourite. He spies on her: I can see it. in the evening when she is allowed out for an hour to visit the park, or to visit her dear acquaintance Jona who lives in the next avenue. I watch him watch her as she skips nightly to her play date – strict instructions to be home for bed at twenty hundred hours. Months pass. The necessity for him to prey increases and an itch begins to develop. To be scratched, there is only one way. It cannot be let to get that far. Soon the time will come and the itch will be gone: the sunshine will dim and the moon will shine clear upon our avenue. I saw him again like a ghost to the window: he stood white against the moonlight. I saw my opportunity. For months he had invaded my privacy, tried to separate my intact stable home and ruin he only thing I have left that I can say is real. My daughter not his. I ran to the bathroom. Staring into my mirror I saw sweat dripping from my forehead. I reach under the pipe in the cupboard and find the cold metal press against my fingertips. I rip it away from the tape and cock the gun, It clicks and the barrel is loaded. Before I realise – I'm out of the door and in his back garden, feet imprinted on his perfectly trimmed grass. I shout. No reply – and again, a clumsy rattle comes from his kitchen as he fondles to find the back door knob. I lift my hand – pointing the shaft directly at his heart, he steps out. ‘Whos the-‘ cut off mid sentence by a bang. Disbelief is the only emotion I feel. I stand next to my neighbour in cold blood shaking – frozen. Minutes pass – a siren bellows down the surrounding avenues. I try to move, but I cant, cement is weighing me down. Four officers around me – surrounded I drop to the floor, weapon down. I smile. A cold room – alone, grey. All that remains is a tape recorder, a table and two chairs – one which I, the hero sit on, and another opposite. The blind is down on the window, third click on the wiry string. And officer walks in. standing tall, staring with intention. He doesn't have a chance to speak before I tell my tale. ‘A while back I bought a gun from a man who stole a mustang.' I whispered to the tape recorder.

Leadership: do traits matter? Essay

Managers need skillful and talented leaders to make an organization successful. The reason is that talented leaders can drive their subordinates to achieve goals and objectives of an organization. That will enable organizations to stay competitive in the market. To be a successful leader there should be several qualities. Such as effective communication skills, effective decision making, effective planning, effective coaching skills, effective people management skills and effective motivating skills. These qualities of a competent leader are needed to plan to meet the requirements of an organization. Sailan also should have leaders who have above-mentioned qualities while facing a turbulent situation. As mentioned above Sailan has been failing to produce good advanced level and ordinary level results. Because of that, it has been difficult to achieve the competitive advantage for them as well. (ukessays, 2017) The following methods can be used to review current leadership requirements of Sailan international school. 360-degree feedback – according to Linda (2014) through this 360 feedback employees or managers can get feedbacks regarding their strengths and weaknesses or competencies from peers, supervisors, direct reports and customers. According to (Neil, 2017)this method can be used to evaluate the performance of the whole organization. Especially weaknesses of employees can be identified. This method is so important for Sailan. The reason is that while facing a turbulent situation identifying weaknesses of teachers and the principal is very important. If there is any weakness in teaching the principal/ leader can arrange training programs to improve teaching skills. If there is any weakness in controlling teachers of the principal, director of education can send him for some leadership programs. When this happens Sailan will be able to produce good results and achieve the vision. Even teachers can get a clear picture of their performance by this method. Blake and Mouton managerial grid – according to Peiris (2016) the managerial grid includes various techniques to evaluate leadership requirements. This grid is an important tool for managers to analyze their own leadership styles. According to Patty (2013), this grid has 81 leadership styles. Some of them are impoverished management, country club, task management, middle of the road, team management and team management. With the problem that Sailan faces at the moment team management is appropriate for Sailan. According to this leaders encourage and motivate their employees. Even leaders get a lot of respect from their employees. The principal can appoint sectional heads who can get respect from teachers. Then Sectional heads/ leaders of Sailan can motivate teachers to produce good results and achieve the vision. When teachers become loyal to the sectional heads those teachers will give their best to Sailan. That will enable Sailan to provide high-quality teaching for students . SWOT analysis – SOFT analysis can be used to recognize strengths, weaknesses, opportunities, and threats of an organization. Internal and external factors can be identified by this analysis. (Mike, 2016)Â   When considering the strengths of Sailan, which has got a lot of facilities in comparison to other international schools in that particular area. For example, they have their own ground, an auditorium that more than 1500 people can be seated. Even an indoor stadium (almost finished) and a swimming pool have been under construction. The discipline of Sailan has been really good when compared with other international schools. That is one of the main reasons that most of the parents are willing to send their children to Sailan. The main opportunity of Sailan is that this is mainly a Muslim community-based school. So easily they can get the attraction of Muslims who are living in that particular area rather than other international schools. The main weakness of this is lack of results. In last few years A/L and O/L results have been low compared to other schools. When talking about threats, there are a lot of competitive international schools situated around Sailan. Such as gateway, ST’Thomes, ST’ Nicholas, Lyceum, Leeds, Negombo south etc. Especially Leaders of Sailan should consider the weaknesses and threats. Leaders of Sailan such as Director of education, principal, and sectional heads need to correct if there is an error in the education system of Sailan. Principal or sectional heads can supervise teaching.Sectional heads can get feedbacks about the teaching of teachers from students. Even teachers can be asked to write lesson plans. Training programs can be provided for teachers. By moni toring teachers and providing training programs quality of teaching can be improved. It will lead to producing good O/L and A/L results. Then weaknesses of Sailan can be avoided. When producing good results Sailan can face threats easily. Even leader of Sailan should be able to exploit strengths and opportunities as well. 3.2 plan for the development of future situations requiring leadership. The leadership plays a major role in achieving competitive advantage in the industry. The leaders usually create strategies to drive employees to attain vision and mission of an organization. (research papers, 2013) As mentioned above Sailan has threats from its rivals. Even when the school develops more teachers will be recruited in the future. Then leadership will be required to control them. Controlling a large number of teachers will not be an easy task. Leaders of Sailan will need more skills to control those teachers. And also recruitment and selection process has to be considered by leaders at Sailan when it develops. Especially Proper recruitment method and recruiting cost is very crucial for Sailan. Some suggestions are mentioned in the following which can use to identify how to plan for the development of future s

Urban Enterprise Zones

Some policies that could promote economic growth are tax rebates, lowering interest rates and developing Urban Enterprise Zones (UEZs). Providing rebates on home purchases, appliances and home upgrades encourages people to spend money. Lower interest rates work to stimulate home sales, credit card loans and investment in the stock market. UEZs offer lower tax rates, encouraging people to shop and spend money.2) Schumpeter's creative destruction describes how long-term economic growth is sustained by innovative entrepreneurs even when established companies are destroyed. This is less likely to occur in less developed countries because there are less entrepreneurs with less available funds than developed countries. This allows older companies, sometimes even monopolies, to maintain their position in the market.3) With reductions in government spending on higher education, the rate of growth in the United States will surely drop. Less government funding means many students will no longe r be able to afford the cost of tuition.This leads to an unskilled workforce and a downturn in economic growth. Less funding could also translate to lower quality in public colleges and universities. Many people rely on these institutions for respected degrees at a lower cost than private schools. This too would lead to less college graduates and again, an unskilled workforce.

The Cask of Amontillado Research Paper Example | Topics and Well Written Essays - 1500 words

The Cask of Amontillado - Research Paper Example The story is about a love – hate relationship. In the story, the narrator is trying to portray the psychological complexities of these opposite emotion, emphasizing the way they enigmatically blend into each other. The story is about revenge, insult and death. Montresor loves himself and he cannot stand the insult by Fortunado; the self-love led Montresor to attempt murder. The death is ironic in the story as it is brought about by much desirable wine â€Å"Amontillado†. The wine enabled Montreso to entice Fortunado into death. Montreso persuades Fortunado into the dark recesses of the family catacombs and promises to offer a delicate wine. Here, the desire of wine led to the death of Fortunado.The title â€Å"The Cask of the Amontillado† of the story by Edgar Allan Poe has foreshadowing metaphor. The title of this grim story has an unusual ring to it. This is a strange title which we have not heard before. What does â€Å"Amontillado† literally mean? Actu ally, Amantillado is an alcoholic beverage something similar to Sherry. Only when people read the story they realize that it is a Spanish wine. Cask, by the way, is barrels in which wines are stored traditionally. Cask comes in many sizes. In the story, Montreso tells Fortunato, he has a â€Å"pipe of what passes for Amontillado†. In this context, â€Å"cask† also means â€Å"casket†. In the story, the Fortunado seeking a â€Å"cask of Amontillado† finds a â€Å"casket of death†.

Ethics in Contemporary organizations Essay Example | Topics and Well Written Essays - 500 words

Ethics in Contemporary organizations - Essay Example Ethnic leaders should have strong moral values and principles and are able to control their feelings. As such, they should be able to handle stressful situations through self-control and tolerance. Such leaders should always strive for success and be able to balance their personal and professional lives. Additionally, good leaders should learn new strategies to handle issues through scholarly means, advance their learning skills and seeking feedback from the rest of the crew ethical leaders should always be energetic at their work to set a good example to the workers and increase the effectiveness of the organization (Dhar & Indian Society for Training & Development, 2009 ). As such, organizational leaders ought to have high ethical standards as it encourages the employees in organization to meet the same level of ethnicity. An ethical leader enhances the reputation of the company and this increases the effectiveness of the organization. An ethical organization attracts customers and this helps in the boosting of the sales and profits of the company. As such, the investors of the business are always at peace that their money is being used in the right way. Ethical employees adhere to the rules and regulations of the organization and ensure that they offer quality services to the company (Dhar & Indian Society for Training & Development, 2009).With this; these principles ensure that employees stay and meet the goals hence increasing the productivity. An organization with high moral principles strives to keep its customers by making sure that they provide insurance covers to them. Increasing the employees’ retention reduces the cost of replacing more employees. The principles ensure that the organization keeps the talented work and this increases the organizations productivity. A principled company ensures that there is a good relationship between the management and the vendors. Through this, the leaders make certain that vendors are paid on

Research Question Paper Example | Topics and Well Written Essays - 500 words

Question - Research Paper Example The user can make the computer more fault tolerant by a way of thinking how the computer or the devices of the network may seems to fail as well as, taking the required steps so that the faults can be prevented whenever they occur (Qian, 2008 p 101). For this case, the steps to be followed when improving the network’s fault tolerance include. The user should by all the time have his or her computer or the networks running on the Uninterruptible Power Supply (UPS). UPS provides the backup power source when there is a power outage (blackout), or a power surge. UPS provides additional time for the computer to shut down by providing the power to the computer from where it was stored. However, the user should also have the system messages that are sent to every network so as to let the administrators know when the power goes off or when computer shut down because of the failure of the power. If there is no UPS which is connected on the computer or the UPS fails to provide the surge fortification, the surge protector may be connected to the network devices or the computer so as to help prevent those devices from failing during the power surge (Briggs, 2009, p 13). The user should all the time run backups on the computer. Running of the backups may be done daily or at least every month if only the relevant information is stored in them. The user should make sure that he/she creates a mirror of data on the alternate location. When the computer devices are connected to the network, the user should make sure that the firewall are set up. A firewall is normally the software utility that can limit the accessing of the network on the computer by blocking or restricting the ports. Firewalls are extremely significant since it helps preventing un-authorized members from accessing to the company network or a network which is at home.

The Relationship between Poverty, Governance and Development and an Essay

The Relationship between Poverty, Governance and Development and an Analysis of the Strategies used by Key Actors in Dealing with these Three Variables - Essay Example Globalisation has taken the centre-stage in national affairs around the world in the past twenty years.This has been characterised by the fast growth in cross-border communication and travels, harmonisation of standards, stronger international treaties and the growth in the number of multinational organisations and entities.Globalisation has been supported by global partnerships and improved systems of cooperation amongst nations. It is obvious that governance in nations have changed and there are communities affected by global governance and standardisation now than ever. In spite of this, there are huge disparities between nations in different parts of the world. The aim of the research is to identify the relationship between poverty, governance and development and an analysis of the efficiency of methods used to deal with these three variables by governments and other key actors. In attaining this end, the following objectives would be explored by the researcher in order to draw a conclusion on the dominant trends in the relationship under review: 1. A critical examination of the key concepts: poverty, governance and development. 2. An evaluation of the key stakeholders and approaches used to deal with poverty and the metrics in examining them. 3. An assessment of the results of the strategies and approaches used to deal with poverty and its effectiveness. 2.0 Critical Examination of Key Concepts: Poverty, Governance and Development This section of the research would examine the key concepts under discussion in the paper. It would involve the definition of the three main concepts of poverty, governance and development. This review of literature will assess important trends that describe these three ideas in the international and global context. The popular definition of global poverty was set by the United Nations in 1995 (Segal-Horn and Faulkner, 2009). The definition include the people who live on â€Å"less than one dollar a day† (Segal-Horn and Fa ulkner, 2009). This classification provides a standardised view of who are poor and cannot afford the basic necessities of life. Generally, the world is divided into nations where there are few people who live below the poverty line and those who have most of their citizens living above it (Held and McGrew, 2007). The classification on the basis of the majority of nations provides a categorisation of richer nations and poorer nations. The classification provides an idea of the quality of life of nations and how much is available to people and how wealth is distributed in each of the nations. Another approach of viewing poverty on the global scale is to view the infrastructural development of the nation (McNeill and StClair, 2009). To this end, McNeill and StClair identify that some nations have better developed infrastructure whilst others have less developed systems and structures (2009). The classification on the basis of infrastructure puts nations into classes of developed, emer ging and underdeveloped nations (Thomas, 2000). Developed nations are those that have the best and most advanced structures and amenities which provides a good life for their citizens. Underdeveloped nations are those that have limited infrastructure whilst emerging nations are those in the transition between developing and developed nations. Most developed nations are in the northern continents like Europe and North America whilst the underdeveloped states are in the southern hemisphere. The criticism of the model of classifying nations according to their infrastructural base is that, they do not give a clear picture of how well wealth is distributed in these nations. A typical example is the case of large federal nations in the developing world like India, Mexico and Brazil who have huge national funds which can afford to fund the largest projects. Yet, these

Atomic Bombing Essay Example | Topics and Well Written Essays - 1000 words

Atomic Bombing - Essay Example The consequences of nuclear warfare were already foreseen, and as a matter of fact, at the top of its official voice that was publicly aired, in the midst of the heated issue of race for nuclear armaments the US abhorred potential destructions that may be brought by nuclear bombing to people, country and the entire world. Despite this, the US still remained to secretly initiate scientific researchers that would potentially pave the way for better understanding of the atomic bombs. Its actual bombing using this nuclear weapon in Japan had eventually proven to help it win its war with this country. However, it is evident that it simply orchestrated a move that was a bit contradictory to its personal public statement in line with its stand on nuclear warfare and even on the rudimentary issue on the race for nuclear armaments with the Soviet Union and other parts of the world. At this point, it is important to assess such secrecy involved associated with the creation of atomic bombs prio r to the actual consecutive bombing in Hiroshima and Nagasaki. Secrets laboratory studies pertaining to atomic bombs in one way or another could be a form of betrayal of public trust on the part of the US. Thus, it could be remarkably observed that the desire of the US to reach its competitive edge over the other seems bred in the bone. The point of keeping the whole thing about atomic bomb exploration secret from the world connotes there must be something the US devised to achieve in the future. In fact, this plan was eventually disclosed when Japan was taken by surprise and shuddered at the possibility that the US eventually created nuclear armaments, enough to destroy the entire world. The whole point is now clear, and there were two possible things that the US simply wanted to share

The irrepressible conflict chapter 7 in the imperiled union, by Essay

The irrepressible conflict chapter 7 in the imperiled union, by kenneth stampp(pages 191 to 245) - Essay Example In the social science, historical theories and concepts are criticized by current scholars in search of new knowledge. If new evidence is discovered, scholars critically analyze it in consideration to the past evidence provided. The reason for revisionism is history relies on past distant events, and very little evidence is used in postulating of theories, therefore, when more evidence is found, it call for revision of the earlier theories or critic their explanation to the past event. This essay focuses on the civil war and the views of the revisionist via a Vis Stampp disapproval of them. How and why do revisionists argue that the civil war was a needless or repressible war? The proponent of revisionism argued that the case for a civil was a moral judgment of whether slavery was right or wrong. In addition, the agitators for antislavery had questionable attitudes towards the issues of slavery as political issues. As Steven Douglas argued, slavery was an issue of the southern people , and it did not affect people in the north. Therefore, the issues of slavery were better left to the white in the south to deal with and not engage in an unnecessary war. Moreover, revisionist says that the moral indifference of slavery was not a big issue to fight over it. Men and women are created sane and would solve their differences in a sane manner and avoid unnecessary bloodshed. According to Ulrich Philips, the black people had no problem being slaves because, in their nature, they were submissive, amiable, and light-hearted, imitative, ingratiating, and they were not progressive by the fact that they were Negroes. Philips also argues that the case for the plantation system among the slave was nothing ethical but nostalgia. Therefore, slavery was not a cause for the alarm, to instigate civil war because it had nothing to excite (Stampp 191-245). Another revisionist, Frank L, Owsley says that slavery was a moral issue and was not economic determinism of civilization in the s outh. He says that the issue of slavery has been dragged in the wrong case of the causes of a civil war. Furthermore, Randall believed that the black slave in the south had adapted to bondage without much resistance, and performing their tasks cheerfully. Randall also argues that, the southern slaves were abused, and this amounted to mistreatment, but it was a lenient way of treating slave by their slave owners. Randall says that, in reality the slave’s owners were more enslaved than the black by the set out institutions (Stampp 191-245). Craven brought his assertion that the different between the West and East were much greater than that of the North and South. Craven argues that abolition of slavery hindered the understanding of the effect of slavery to the modern employee –employer relationship. According to Craven, the life American worker today is much like that of the slave. Craven note that, even during the debate of the relevancy of slavery in the south, the pa tient blacks continued with their tasks unconsciously never minding the merits of the system he was working. David Potter in his analysis of revisionism says that, the facts that slave were left to live and even to grow and expand in a new world, was better off than engaging in a war. David concedes that emancipation of four million slaves was of great value, but he says it came at a greater cost. According to David, for every

Political science Essay Example | Topics and Well Written Essays - 1000 words

Political science - Essay Example It showed scenarios about how the television network gathered information and broadcasted the war, which serves its main purpose - to provide a balance and fair view to their 40 million Arab worldwide audiences (Bacha and Noujaims, film). The film casted Hassan Ibrahim, the Sudanese Al-Jazeera journalist, Samir Khader, Al- Jazeera senior producer, Deema Khatib, Al- Jazeera producer, Tom Mintier, CNN Correspondents, Lieutenant Josh Rushing, US Central Command Press Officer, and David Shuster, NBC Correspondents. The film showed the events that transpired during the Iraq war of which media centers and their journalists or camera men were killed, wounded, or became casualties of war despite providing the Pentagon their GPRS locations prior to encounters (Bacha and Noujaims, film). Al-Jazeera became one of the most controversial news channels in the Arab world after documenting the Iraq war. It has been criticized both by the Arab Government and US President George Bush’s administ ration. The former accused that the network was the promoter of â€Å"American propaganda† while the latter accused the network as pro-Iraqi. The perceived bias even had them branded as â€Å"the mouthpiece of Osama bin Laden,† due to their fearless broadcasting of images of American tanks, bombing scenes, and the bloodied, wounded Iraqi casualties. The film also showed American soldiers shouting at Iraqi prisoners and harassing Iraqis, and interviews of Iraqis who have lost homes and family members during the war. The US government pointed out that the Arab media is exaggerated for reporting those war events. However, the network has defended their stand that the film only showed the real cost of war and counteracted that the US government were criticizing the film because they do not want the world to see their harshness and faults to Iraqi people and even to the members of the media in invading the country (Bacha and Noujaims, film). The movie’s real theme wa s about the war between the US and the Iraq. However, the scenes were mostly focused on the differences between Al-Jazeera network and the American news networks’ process of reporting the war. The network, though received tremendous attacks because of showing the facts of war still continued to provide fair and balanced information report because they believed that people deserve to know the truth. As Deema Khatib, the Al-Jazeera producer of the film said their main purpose of filming the war is to show all sides of the war claiming that the US networks camouflage the real cost of war (BBC News, P 3-11). 1. Do you think that the documentary has delivered the message of its theme? I believe that the film was able to deliver the message of its theme: the Iraq war as mindless. In fact, it was very obvious since even during the reign of Saddam Hussein, it was already found that the United States supplied many weapon materials to Saddam’s administration, and this has not be en sanctioned. In addition, all the US soldiers’ prowling of Iraq never yielded any form of weapon of mass destruction or WMD, which the Bush administration has declared and made the US citizens believe (Fisk, P 4). It is therefore true that many atrocities committed by the US are for reasons other than what it claimed. The US government claimed that the invasion of Iraq to defeat Saddam Hussein was aimed at freeing the Iraq people from a brutal dictator leader. This,

IT Professional Responsibilities toward the Society Essay

IT Professional Responsibilities toward the Society - Essay Example Nevertheless, metadata can be dangerous if the document gets passed on to others electronically. This can happen, for instance, during the submission of an electronic document into a court, distribution of the documents among the adverse groups, or during the document’s circulation to the opposing counsel during negotiations. â€Å"The document’s metadata may contain hidden information that the sender would not want to share with the recipients, such as comments on revisions or the time and by whom the comments were made† (Day et al., 2008, p. 12). Computing professionals assume this responsibility to be very careful in their handling of the metadata for their own safety, safety of their coworkers, and of the whole society. The responsibilities of the computing professionals extend beyond compliance with the policies and goals of their company to include the interests of the society at large. â€Å"Lack of security awareness and training, operating system design and security, open source issues, design complexity and multiple layer approach are some of the current issues with ICT† (Beqiri, n.d.). Computing professionals need to have a firm hold over all these areas to secure the information whose leakage may put the future of the society in the hands of the enemies. The responsibility of computing professionals toward members of their profession and the society translates into the broader area of business ethics. Over the passage of time, organizations have become quite experienced and informed about the delicate nature of information technology issues. This has brought a change in the employers’ attitude toward what skills they want in the information technology professionals. â€Å"When employers of newly qualified information systems professionals are asked what it is they would most like them to know, the answer is very rarely

The Perfect Copy (Unraveling the Cloning Debate) by Nicholas Agar Essay Example for Free

The Perfect Copy (Unraveling the Cloning Debate) by Nicholas Agar Essay Nicholas Agar is a professor of ethics and a senior lecturer at Victoria University of Wellington (VUW). Agar has an MA from VUW and a PhD from the Australian National University. He has been teaching at VUW since 1996. He has been known as an expert writer particularly in the field of genetics and ethics. In his book The Perfect Copy: Unraveling The Cloning Debate, he attempts to unravels the science and the ethics of cloning and proposes ideas on how we should face this highly controversial topic.   To clone or not to clone, that is the question that is in the center of one of the most controversial debates within the scientific community today. The present technology today has given our imagination an opportunity to deal with the perils and possibilities of cloning. Even Hollywood has ridden the cloning bandwagon and has turned out many films which exploit the topic.   Although these films are a departure to what is possible, they still manage to pique our imagination and implant in us false notions and promises. These past few years, with the advances made in regards to cloning, the ethics of this act has become a great issue. Both sides present valid reasons to defend their claim. The debate over the morality of cloning human beings becomes a debate over contrasting images of cloning. The method of moral consistency may not give us a simple permitted or not permitted answer. The reason is that no single familiar practice will resemble cloning in every morally interesting respect. In all likelihood, we will end up constructing a moral image of cloning out of a variety of familiar activities and practices. It is often pointed out that cloning differs from the natural sexual way of having children. Some say that this unnaturalness alone suffices to make cloning wrong. A solid rebuttal to this is that things deemed unnatural but have received no objection like insulin shots, airplanes, and life saving medicine are a integral part of mainstream society. If you would follow the unnatural proposal, these things must also be unallowed. The main concern in ethics is the unease which people have regarding cloning. This instinctive revulsion is said to be due to ingrained wisdom or to an upset stomache. Agar argues that if this was the basis to oppose cloning, then it is very unscientific and flimsy. Moral progress is all about subjecting sub-rational moral urges and aversions to rational scrutiny. The word clone obtains it etymological origin from the greek word klon meaning branch. Clones are copies of organisms currently or previously existing with the exact same nuclear DNA. They do not result from a sexually beginning and thus are not genetically different from their parent organism. In our world, clones are the rule rather than the exception. Most low level organisms like algae, bacteria, lower vertebrates, and plants use cloning as a means to ensure their reproductive survival. The case of twins is a clear example of cloning which occurs in nature, even among human beings. Twins come from one egg that divides into two. There is cloning from the moment when multiplication begins to produce two genetically identical children. Cloning ensures that the exact genetic code of the parent is passed on as opposed to sex where only half of each parent is transmitted. This makes cloning more efficient in ensuring the survival of a genetically fit species. One technology that has been used to create clones is reproductive cloning. An example of this is Dolly, the first ever cloned sheep. Dolly was cloned using the process called somatic cell nuclear transfer (SCNT).   A reconstructed egg which derives its genetic material from an adult donor is electrified or treated chemically. The resulting cloned embryo is then implanted unto the uterus of a female host. It is relevant to point out that clones produced by using nuclear transfer technology are not a truly identical clone of the parent animal. This is because nuclear DNA composes only 99.7% of the actual heritable data. The rest are found in genes located in the mitochondria. There are numerous barriers in cloning humans. Aside from the legal and social issues still currently being debated, cloning with today’s technology is also very inefficient and dangerous. Cloning technology today is highly expensive. Also the success rate is dismal with only less than 10% of cloning attempts achieving success. Also, clones have relatively poor health, and are susceptible to diseases, tumors and other illnesses. And clones like the first cloned sheep of Australia have been known to die without known cause. Scientist theorize that these defects are due to errors in the reprogramming process. However there has been several claims by Clonaid and Italian scientists led by Antinori that they are either capable or on the verge of creating human clones. A problem arises in a cloned embryo due to imprinting. It is the marking of the genetic material for the mother and the father so that only one can be utilized. An error in the genetic imprint from a single donor cell may cause some of the developmental abnormalities of cloned embryos. Also it is postulated that clones are unhealthy due to the fact that they have short telomeres. Telomeres act as clocks, directly affecting the cell structure of an organism before they pass away. Due to the process clones have short telomeres, making them sickly and frail. Cloning is deemed wrong for many reasons. First the process results in the death of many embryos, which may constitute murder.   Also cloning is seen as unnatural when they are view in concepts that are taboo to society, like having clones of the dead, the unborn and the dying. This problem comes from an individual’s sense of uniqueness. This can be repudiated by the cases of identical twins. Twins may have identical genetic components but they turn out to be different individuals. Moralists have also a problem that cloning gives us a concept of playing God. Bringing back a dead person or ensuring that a baby will be born as well as extending the life of a dying person is seen to be in the realm of the Almighty. The promise of being able to create an exact replica of a given genetic code has given many opportunities for those incapable of having children. Of primary concern are those who are infertile. Cloning as with artificial insemination and other in vitro techniques provide a way for their aim of having children to come true. Another is the families of those with deceased or dying children. They view cloning as a means to once more experience the love of their child. Also, lesbian couples who wish to have a child look on cloning to fulfill their dream. But it must be noted that were the technology realizable and actual human clones producible, cloning can only go so far. The debate of whether a cloned person still has the same trait and behavior as the original leans in favor of no.   It is vital to note that it is not only the genetic code that forms the person’s identity but that person’s experiences, teachers and influences. The issue regarding human clones is that they are born with a genetic bias of who they are, denying them the open future that is a right to every human being. They may be treated as objects rather than as persons. This underlies the discussion o whether the act is that of making rather that begetting. The problem is will being cloned from the somatic cell of an existing person result in the child being regarded as less of a person whose humanity and dignity would not be fully respected. This points us to the dilemma as to the humanity of clones. And the question is clones less human than we? Are clones of us us in every way, or are they new individuals? One reason to clone humans is for research. The process of therapeutic cloning uses cloned human embryos for research. cloned human beings are not the target of this process but the production of stem cells for research. Any specialized cell in the human body can be derived from stem cells. Stem cells come from five day old eggs..   This act destroys the embryo, raising ethical concerns. Therapeutic cloning has been touted as being able to produce human organs for transplants. Scientists say that for this to be possible, DNA would be obtained from the transplant recipient and injected into a enucleated egg. Stem cells can then be gathered from the egg. These can then be used as a template to produce the specific tissue or organ needed which would be an exact genetic match to the transplant recipient. Because of this fact, it is postulated that the organ will not be rejected by the body during transplant. Another use of therapeutic cloning is the creation of genetically modified pigs which can also be utilized as a source of human organs. The process of xenotranspalntation or the transplanting of animal organs into humans is seen as a medically viable way to accommodate the increasing demand for organs. Pigs are used due to their high rate of reproduction and their being able to be cloned with relative ease. Primates, who are of a much closer genetic match to humans, are more complex and thus much harder to clone. In comparison to other animals, the tissues and organs of pigs are the ones more similar to humans. To be able to achieve this, scientists deactivate the gene in individual pig cells that when detected by the human body, leads to organ rejection. Harvesting of the organs of the resulting clones is then done. Cloning has been seen as an advance in eugenics. Eugenics is the act of manipulating a population to promote one race or type as superior to others with the end goal of ultimately taking over the population. The idea is that people who are exceptional, who are deemed superior to others in one or many fields, must be cloned since they represent the best of the human race. This idea has many ambiguities particularly on the concept of superior and inferior. Although there were some unlikely ideas in the book, like trading gene samples as a commodity, Agar fails to fully express the debate in this topic. What he does show is that eugenics, by using positive methods would be beneficial to the race. And he also shows the impact of being a clone born under a eugenic driven ideal. There are different cases and different problems with cloning as a reproductive tool. Striking the right balance between procreative freedom and childrens welfare in the age of reproductive cloning is likely to require a case-by-case approach. Nevertheless, the transcendental advantage of cloning will be brought about not for simple transplants in mans body to replace his sick organs, but for the complete cloning of the human being to eventually achieve the immortality of the individual. Man will no longer change the parts of a body damaged to a greater or less degree, but he will leave the old body and change to a new one, which will be also improved by genetic engineering. Thus, the long-sought-after immortality, which man has always desired with all his being, will be achieved. It has been repeated insistently that the human being has a right to life. To ban cloning, then, would be to deny him the right to continue living. If clones were to be feasible, they would probably suffer. This can be brought upon by errors in their production leading to medical illnesses or to the preconceived notions that surround them. It is stipulated by Agar that the human race may not be ready to incorporate the idea of clones living among us. We simply have too many fears and false notions that inevitably we would end up stigmatizing them. Agar proposes that we get rid of these notions and keep an open and intelligent mind as to what cloning can offer us. We must learn as a society to separate fact from fiction and to rationalize our views about cloning.    References: Alan Man Humanity and the Cloning Question: Comparing and Contrasting Arguments http://www.amsa.org/bio/clone.cfm searched October 21 at using google.com What Are Some Issues In Cloning? http://learn.genetics.utah.edu/units/cloning/clissues/ searched at Yahoo.com CloningFactSheethttp://www.ornl.gov/sci/techresources/Human_Genome/elsi/cloning.shtml searched October 22 using google.com

Solid Lipid Nanoparticles for Enhancement of Curcumin

Solid Lipid Nanoparticles for Enhancement of Curcumin Development and Evaluation of Solid Lipid Nanoparticles for Bioavailability Enhancement of Curcumin CHAPTER 2 LITERATURE REVIEW 2.2 LITERATURE REVIEWED ON DRUG Chirio, et.al (2011) formulated Curcumin-loaded solid lipid nanoparticles of fatty acids (FA) via coacervation technique based on FA precipitation from their sodium salt micelles in the presence of polymeric non-ionic surfactants and found higher entrapment efficiency and lowest possible cytotoxicity. Prashar, et.al (2011) studied the various biological effects and other aspects of the Curcumin, herbal remedy and dietary spice. According to them Curcumin is a lipophilic molecule and rapidly permeate cell membranes and act by inhibiting tumor cell proliferation, induction of analysis, inhibition of transformation of normal cells to tumor cells and inhibition of invasion of metastasis. A number of animal studies have shown that Curcumin has a dose-dependent chemopreventive effect in colon, duodenal, stomach, esophageal and oral carcinogenesis. Curcumin possess various other activities like anti-inflammatory, anti-cancer, anti-coagulant, anti-fibrotic, anti-mutagenic, anti-fertility, anti-bacterial, anti-diabetic, anti-protozoan, anti-viral etc and concluded that Curcumin is an effective bioactive agent. The low water solubility and poor bioavailability of Curcumin can be overcome by various structural modifications. Stability aspect shows better effect and less toxicity offering bet ter pharmacodynamic characteristics. Choudhary, et.al (2012) studied the various potential therapeutic effects of Curcumin and reported that the research towards nanoparticles encapsulated Curcumin should be strengthened to improve bioavailability and therapeutic efficacy in treatment of various disorders. Wang, et.al (2012) formulated Curcumin loaded solid lipid nanoparticles via solvent injection method using stearic acid and lecithin as lipid, tween 80 as surfactant and chloroform as cosolvent. The prepared SLNs were evaluated for various parameters like entrapment efficiency, drug loading, zeta potential, particle size, x-ray diffraction, in-vitro(via dialysis bag method) and in-vivo(in Balb/c mice) drug release and it was found that average size of C-SLNs was found to be 190 nm with zeta potential value of -20.7 mV and 75% drug entrapment efficiency. X-ray diffraction analysis revealed the amorphous nature of the encapsulated Curcumin. The release profile of C-SLLNs was an initial burst followed by sustained release and the Curcumin concentration in plasma suspension were significantly higher than those obtained with Curcumin alone, following C-SLNs, all the tissue concentrations of Curcumin increased, especially in lung and liver and it was found that in animal model of asthma, C -SLNs effectively suppressed airway hyperresponsiveness and inflammatory cell infiltration and also significantly inhibited the expression of T-helper-2-type cytokines, such as interleukin-4 and interleukin-13, in bronchoalveolar lavage fluid compared to the asthma group and Curcumin-treated group. These observations implied that C-SLNs could be a promising candidate for asthma therapy. Zheng, et.al (2013) formulated solid lipid nanoparticles to encapsulate Curcumin, by blending liquid lipids (Sefsol-218Â ®) with various solid lipids (Dynasan 114Â ®, Dynasan 118Â ®, Compritol ATO 888, Precirol 5ATO, Glyceryl monostearate, stearic acid and Hexadecanoid acid, Pluronic F68) via high pressure homogenization technique and found that the particle size decreased during the high shear process, and high pressure homogenization ensured the homogeneity of the nanoparticles. They also found that the Poloxamer 188 played a large role in the small and stable lipid nanoparticle system and contributed to the improved incorporation efficiency of Curcumin and concluded that suitable amount of liquid lipid when blended reduced the particle size of solid lipid nanoparticles and stabilized the system with improved dispensability and chemical stability in aqueous systems and exhibited sustained release and prolonged cell growth inhibition and cellular uptake in cancer cells as compare d to unformulated free Curcumin and the relative bioavailability significantly increase after intravenous administration in rats. Kakkar, et.al (2013) prepared and evaluated Curcumin loaded solid lipid nanoparticles in the experimental paradigm of cerebral ischemia (BCCAO model) in rats and found that there was an improvement of 90% in cognition and 52% inhibition of acetylcholinesterase versus cerebral ischemic group. Neurological scoring improved by 79%. Hence, study indicates protective role of Curcumin against cerebral ischemic insult; provided it is packaged suitably for improved brain delivery. Sun, et.al (2013) prepared Curcumin loaded solid lipid nanoparticles (C-SLNs) by high-pressure homogenization by blending liquid lipid Sefsol-218Â ® with the solid lipids and found that the high shear process, and high pressure homogenization ensured the homogeneity of the nanoparticles thereby improving the dispersibility and chemical stability of Curcumin, prolonging its antitumor activity and cellular uptake and enhancing its bioavailability. The morphology, sbability and release of Curcumin in the optimized formulation were investigated. The anti-cancer activity of the formulation was evaluated in MCF-7 cells. Fluorescence spectrophotometry was used to quantify cellular uptake of the drug. Blending sefsol-218Â ® into a lipid matrix reduced the particle size without improving drug loading, mean size was found to be 152.8Â ±4.7 nm and a 90% entrapment efficiency. Curcumin displayed a two-phase sustained release profile from C-SLNs with improved chemical stability, compared to th e soubilized solution, C-SLNSs exhibited prolonged inhibitory activity in cancer cells, as well as time-dependent increases in intra-cellular uptake. After inravenous administration to rats, the bioavailability of Curcumin was increased by 1.25 fold and it was concluded that C-SLNs with improved dispersibility and chemical stability in an aqueous system have been successfully developed. C-SLNs may represent a potentially useful cancer therapeutic Curcumin delivery system. Chen, et.al (2014) fabricated Curcumin loaded solid lipid nanoparticles via emulsion-evaporated technique and low temperature-solidification technique using monostearin as lipid, tween 80 as surfactant and methanol as cosolvent. C-SLNs were formed by lipid recrystallisation and the blank SLNs were prepared by the same procedure without adding Curcumin. Prepared C-SLNs were evaluated for various parameters like particle size, zeta potential, differential scanning calorimetry, x-ray diffraction, and in-vitro release and it was found that the particle size is 99.99 nm, polydispersity index of 0.158, zeta potential of -19.9 mV, and entrapment efficiency of 97.86 % and drug loading capacity of 4.35 %. The release kinetics in-vitro demonstrated Curcumin-loaded solid lipid nanoparticles can control drug-release and it was concluded that the Curcumin-loaded solid lipid nanoparticles could be prepared successfully with high drug entrapment efficiency and loading capacity and hence may be a pr omising drug delivery system to control drug release and improve bioavailability.

ICT In The Hospitality Industry

ICT In The Hospitality Industry Information and Communication Technology (ICT) is supposed to be one of the basic building blocks of the modern society and it is a necessary component of business culture. Information and Communication Technology plays a vital role in the hospitality industry and its importance has dramatically increased over the years. In todays world, each and every business uses ICTs and it is no more a distinct characteristic or a unique quality of any business, but using ICTs in a more effective and efficient way will help in obtaining a competitive advantage. Hospitality industry belongs to the service industry and consists of number of fields such as restaurants, lodging, theme parks, transportation, event planning and various other fields within the tourism industry. The hospitality industry always depend upon two main factors: one is the availability of leisure time and the other is the disposable income. Hospitality industries is one of the worlds largest and most permeant industries, the industry has exposed itself to the forces of change, especially by the ongoing developments in ICTs. E-commerce has been negatively influenced by few factors such as the current political developments and the slowing economy, but it is still booming in the hospitality industry. In the hospitality industry, the internet is not only used for gathering information, but it is also being used for acceptance of ordering services over the internet. Information and communication technology and hospitality are two of the most dynamic drivers of our global economy. In the case of hospitality industry, many authors have claimed that tourism must be treated as an information-intensive industry (Poon 1993; Sheldon 1997; Inkpen 1998), whereas, travel and tourism can be defined as an information business. Hospitality industry is a business that is related to information in all the ways, because information is one of the most important quality parameters to support actions for the tourism area as a service industry. Information is also used in various means in the hospitality industry, mainly they are observed in areas where gathering of information, generation, application, processing, application and communication of information is as important for day-to-day operation. Hospitality industry is also considered as a hybrid industry because more than any other services, they are more dominated by information. In the whole tourism sector, hospitality industry is considered as the forefront and it is always sensitive to the competitive pressure which keeps increasing constantly. The industry is also sensitive to the operational needs that are effective and control tools which are always the growing need. In order to overcome all the competitive pressure and to be effective, the use of ICTs will be the only solution as it is capable of bringing in new business opportunities as well as help in the overall business development. NEW INFORMATION AND COMMUNICATION TECHNOLOGIES Innovation is a process that mediates between two streams of human activity. Market and technology develop in parallel and independently, save for a linkage through innovation. Innovation, therefore, is a response to changes in one or both of these streams. As the market changes, firms have to innovate with new products and services, frequently having to seek out new technology in order to accomplish this. On the other side, rapidly changing technology creates new opportunities and sometimes even creates changes in market structure. As a consequence, the more rapidly that stream changes, the greater the pressure will be for firms to be innovative. (Morton 1991) ICT always has a significant impact on all the industries and the growing importance of ICT in the daily business started causing threats and opportunities for the business. The current markets are changing, becoming bigger, faster, getting more standardised, it is always being segmented properly and all these makes it completely competitive. ICT has created a all new information infrastructure which resulted in a new way of accessing information between the buyer, seller and the middleman. Over the past few years, there has been a transformation from an industrial economy to an information economy in the industrialized world (Parker, 1998). ICT has been completely changing the business world and will also be changing the forms, processes as well as the substance of the firms and organisations. One of the most important scenes in the current world is that ICT has been driving the productivity as well as the profitability of any business. The scenario is not just about the decrease in computing costs or the increase in computing speeds and capacities, it is all about the new ways of using the computers and technology which would influence the existing business processes as well as the value chain in the hospitality industry (Thompson 1990; King 1998). Porter and Millar (Porter and Millar 1985) contend that ICT is also affecting the competition in major ways: ICT can change the structure of an industry, and alter rules of competition. ICT can be used to create sustainable competitive advantage and provide companies with new competitive weapons. ICT enables new business which can be developed from a companys existing activities. Porter (Porter 1985; Porter and Millar 1985; Porter 1995; Porter 2001) recognizes that ICT is reshaping industries and organizations competitiveness by changing the nature or conduct of business. ICT enhances the ability of organizations to manage their resources, increases their productivity, to communicate their policies and market their offerings, and to develop partnerships with all their stakeholders, namely consumers, suppliers, public sector, etc. We can state that ICT supports the development and maintenance of organizational competitiveness and competitive advantage. ICTs ADOPTION IN HOSPITALITY INDUSTRY In the hospitality industry, technology is considered as an important of sustainable competitive advantage and a strategic weapon (Poon, 1993; Sheldon, 1997; Connolly and Olsen, 2000; Rao, Metts and Monge, 2003). Various studies (Buhalis and Main, 1998; Evans and Peacock, 1999; Vich-i-Martorell, G.A., 2004; Tang and Louvieris, 2004) have found that the hospitality industry have been always keen in adopting information technology. The reason for the adoption of ICTs in hospitality industry is that they require a diverse range of information which basically made them encouraged to adopt the technology, as well as because of the widespread use of e-mail and the development of an on-line presence amongst the vast majority of organisations. Buhalis (2003) proposed that internet has been an ideal way of selling inventories on-line because of the broke up nature of the hospitality industry. Further investigation revealed that the level of ICTs adoption varies between various enterprises (Sigala, 2003). In most of the small and medium organisation, these services are available rarely because of the inadequate on-line booking services (Fux et al. (2007). Most of the earlier studies have cited the issue about the problems in answering to e-mails and defensive adoption of e-mail marketing in the small organisations. (Frey et al., 2003; Murphy et al. 2003; Schegg et al. 2006; Schegg et al. 2007). The following indicates the ICT index in the hospitality industry for various activities. Activities and ICT Index 4. ICT IN USE 4.1 Electronic Data Processing (EDP) Electronic Data Processing is usually referred to the use of automated methods to process data. The technology adoption increased before many years but it was basically limited to only the operational and administrative areas. Most of the organisation does not utilize the information that is available in the information system in order to use them in their strategic planning and decision making processes. 4.2 Property Management System (PMS) In the hospitality industry, ICTs are mainly used in booking systems which is considered as an internal technology. Property Management System acts as a central point that coordinates both the technology and hospitality operations. The main purpose of property management system is to manage room inventory, produce billing information and also to record the details of the guests or the customers. In order to integrate the billing and management reports, it often creates a interface with various other systems such as telephone system and food and beverages point of sales terminal. 4.3 Central Reservation System (CRS) Central Reservation System is a computerised system that helps to store and distribute information. When an organisation has a chain or belongs to any franchise group, Central Reservation System always helps in various ways. The system helps to book between all the organisations in the chain and would also accept direct booking from the central reservation office. The systems always have a direct access into property management system which would automatically update information to the front office. 4.4 Global Distribution System (GDS) Global Distribution System is also a computerised system which will include hotels, airlines, car rental and also other travel resources and they are most commonly used by travel agents. Global Distribution System is actually an operation in the computer reservation system and helps to book and sell tickets to multiple airlines. The system is not always connected to the main system and information will not be updated automatically, which means the information has to be updated manually. 4.5 Yield Management (YM) Yield Management which is also known as revenue management is a process in which the consumer behaviour is understood, anticipated and also influenced. It will result in maximizing the revenue as well as the profit from the resources. In the hospitality industry, yield management is used widely and largely in the same way. Using yield management, the rates, rooms and restrictions on sales are calculated in order to maximize the return of the business. The revenue managers in the hospitality industry have acquired over the last few years and in such a global economy the right distribution channel, correct controlling costs and the right marketing mix plays a vital role in yield management. The services are sold to the right people, at the right time and at the right place. Model of ICT INTERNET AND ITS USAGE IN HOSPITALITY INDUSTRY The Internet is a worldwide network and a global system that is interconnected to computer networks which use TCP/IP protocols to serve billions of users. The Internet plays a vital role in the hospitality industry and is being used in various forms. It also supports a wide range of services and tools that would enable communication and also data sharing. Some of the most important usage and activities on the internet are: (Cockburn and Wilson 1996) 5.1 Communication The Internet helps a lot in communication especially in the hospitality industry. It represents the largest part of the traffic that crosses the Internet. eMail is one way to communicate and it is also better for many companies and a way to go online. The main reason eMail is efficient is because it is cheap (eMail costs less than long-distance charges for fax machines or the phone), fast (most Internet mail arrives at its destination only minutes after dispatch), easy to use, and links many companies. The other advantage of eMails is that the message that is being delivered to the destination will already be in the electronic form. It reduces the time to scan and re-enter the data into the computer. eMail is the most used communication medium today for internal as well as for external communication. 5.2 Collaboration Collaboration is one other way the Internet can be used and most of the companies use the Internet to link themselves to the outside world. Usually, the connections are very easy to set up and also are very fast. In the hospitality industry, most of the companies are some way or the other linked with each other, so establishing a connection is very important and the Internet helps a lot. Staples, which is an American office that supplies store chain uses the Internet in a effective way and helps the customer to order various office supplies. Staples have also created their own customized supply catalogs which can run even in the intranet of the customers. All these catalogues will contain various items and their prices which are negotiated in the contract with each company. Using some of the eProcurement technologies, the customers are able to reduce cost of purchase order processing dramatically and also helps them to search and order items electronically (Ghosh 1998). 5.3 Information gathering The Internet can also be used to gather information easily and faster. Many companies use the Internet to gather data and information which can be used as an additional resource, especially companies that are involved in research and development. Almost most of the information and data are available over the Internet free of charge which helps the company to reduce their overall operating costs. One such example is Magna International, which is a leading global supplier of automotive components, systems and also complete modules. The company has created a database of their own which stores all the information about several of their competitors, rivals and partners. Information about their activities, development and future plans are stored in the Internet, most of which are extracted from the Internet. 5.4 Direct marketing and advertising The Internet and worldwide web is a useful resource which most of the companies use to improve their overall performance and profitability of the company. The Internet is an ideal medium in the business world that helps to promote the company as well as their services and products. The Internet marketing is one way of promoting the hospitality industry to the entire world which is also flexible and interactive. It helps to deliver all the required information to the consumers or the customers. Most of the companies in the hospitality industry have created their own homepages on the web which helps to get in contact with millions of people all over the world. It is helpful in one way or the other for the small companies to compete with larger ones. 5.5 Direct online selling Nowadays people are not required to go to some shopping centres or malls to do their shopping. They can do all that at the convenience from their house, companies have got their virtual experience into the web, where the customers can browse through the entire range of catalogs, and also examine their products more in detail. Whereas in the hospitality industry, customers are able to order food, book air tickets, rail tickets, browse through the events, and books the hotels with all the customized options. One good example of online selling will be the companies like Dell and Amazon. Dell sells their computers online, where the customers can choose their required configuration and they sell computers online at the rate of about $1 million a day. The travel platform Tiscover has almost initiated about 500,000 reservations and bookings in the year 2008. Different Forms of eCommerce CHALLENGES FOR THE FUTURE OF HOSPITALITY The hospitality industry has started realizing gradually that the revolution of ICT has changed all the operational practices and various paradigms; it has also altered the competitiveness of all the major hospitality actors in the market. In order to take advantage of the capabilities of the Internet, the hospitality industry has integrated the front office as well as the back office in a framework. Greater speed, connectivity, information-sharing and transparency is achieved by the convergence of all the technological devices. Because of which, all the organisation in the hospitality industry are focusing more on knowledge-based competition and are in the need for continuous innovation. The management are also under pressure and are forced to stay abreast on all the developments that occur in the market (Connolly et al., 2000). The organisations in the hospitality industry are focussed on increasing their online booking and online services by promoting their presence in the web more aggressively. The organisations have also capitalised on various collaboration and partnership marketing. In order to help the organisations connect to the wide range of distributors in the market, a multi-channel strategies are used. Some of the reports say that there are almost 35,000 websites where the consumers are able to book rooms in various hotels. All these developments have given way to wide range of challenges, integrity of rates, perception of brand, customer value and also segmentation. Because of the advancement in technology, the consumers are able to contact various organisations constantly which in return increase the transparency. The increase in transparency has made the entire organisation in the hospitality industry to rethink about their pricing strategies. The Internet has come up with many new tools for communicating with partners and consumers, which has implication on the distribution of the industry. The personalisation of products, information and processes has resulted in the emergence of high-tech and high-touch opportunities which the industry itself has to appreciate. The industry now has the opportunity to create a relationship with the customers and basically makes it to adopt the customer-centred approach. The organisations are able to add value at each and every stage of consumer interaction just because all the departments in the organisation are coordinated using ICT-enabled processes. In order to demonstrate the benefits and to illustrate the innovation of small properties, the ICTs are utilised strategically. The organisations are also enhancing their virtual size and compete with larger players by developing links with other properties. Whereas, all larger organisations are benefitted from the multi-channel distribution strategies, economies of scale and also from streamlining their operations through e-procurement. Globalised agenda are developed and are ensured that their operations and strategies are coordinated throughout the world by all the larger chain of organisation. In any case, ICTs and the Internet will be critical for the competitiveness of both large and small hospitality organizations. CONCLUSION The aim of the research is to explain the various uses of Information and Communication Technology (ICT) in the hospitality industry. ICT has been already used by all the key players in the industry which gives them the required competitive advantage, whereas small organisations are at a lower level. However, the Internet can be used as a powerful instrument to overcome all the disadvantages and helps to establish a competitive advantage in the market. Using ICT will not offer a competitive advantage, because the entire world is well aware about the technology and its usage. So the organisation should focus on using the right technology more effectively and efficiently. Basically, there are three objectives which the industry as well as the organisations in the industry has to focus on: Define a framework with which competitive advantage can be gained, and make the process systematised and evaluated from eCommerce solution Consolidating the business values of the Internet Explore the ways in which the competitive advantage can be enhanced and improved The advantages of the internet can be classified into two main categories: one as a primary tool for distribution, reducing the overall costs and by increasing the occupancy rate, and secondly it can be considered as a tool to increase the direct contact with the consumers or the customers. To extend the success factor in the hospitality industry, the internet can be used in product development, online surveys, online booking and also for various personalisations.

Hamlet as the Complete Man :: Shakespeare Hamlet

Hamlet as the Complete Man Tragedy, Shakespeare had come to see when he was writing Hamlet, is a kind of consecration of the common elements of man's moral life. Shakespeare introduces the common man in Hamlet not for what we are apt to think of as his "commonness" but for this strange power however you care to name it that he possesses-we have used art, or virtue, or we might have borrowed from Henry James "the individual vision of decency." In Tragedy there is no longer a Chorus moving round the altar of a god; but if Proust is right the spectators are still participants in a supernatural ceremony. Perhaps I may put the aspect of Tragedy I wish to keep before you more clearly by drawing on Professor Harbage's study of Shakespeare's ideal man. Collecting the approving references he finds that this ideal man is soldierly, scholarly, and honest. If these men seem to lack the larger idealism that is so common and abundant in our own generation, there is no suspicion that Shakespeare's men will fail to back with their own skin their apparently modest programs. As Professor Harbage says: "All soldierly, scholarly, honest men are potential martyrs -you can substitute for "martyrs" tragic figures. Of that Shakespearean type Hamlet is the ideal. Shakespeare had before him in Saxo and Belleforest what was presented as an ideal type. This type Shakespeare transformed. To what may be called the instinctive wisdom of antiquity and her heroic passions, represented so impressively by Hamlet's father, Shakespeare has united the meditative wisdom of later ages in Hamlet himself. The re is no surrender of the old pieties, and the idea of the drama comes from the impact of new circum1stances upon the old forms of feeling and estimation; there is a conflict between new exigencies and old pieties, that have somehow to be reconciled. The play dramatizes the perpetual struggle to which all civilization that is genuine is doomed. To live up to its own ideals it has to place itself at a disadvantage with the cunning and treacherous. The problem Mr. Chandler (1) sets his hero is infinitely complicated in Hamlet-to be humane without loss of toughness. The hero must touch both extremes: without one he is just brutal, lacking the other he is merely wet.

Essay on The Crucible: The Concept of Conscience :: Essay on The Crucible

The Crucible:   The Concept of Conscience Conscience is the awareness of right and wrong. In The Crucible, the idea of conscience in strongly emphasized. Miller himself said, "No critic seemed to sense what I was after [which was] the conflict between a man’s raw deeds and his conception of himself; the question of whether conscience is in fact an organic part of the human being, and what happens when it is handed over not merely to the state or the mores of the time but to one’s friend or wife." The idea of conscience in the play The Crucible is based very much on Christian concepts, firstly the idea of morality, or conscience of right and wrong, secondly the idea of the confession of sin, and finally the idea of guilt and penance for sins. Conscience, then, as an issue of morality, is defined very clearly at the start of the play. "†¦a minister is the Lord’s man in the parish; a minister is not to be so lightly crossed and contradicted" says Parris in Act One. Here it is established that theologically the minister, in this case, Parris, is supposed to be the ultimate decider of morality in Salem. The Church, in theocratic Massachusetts, defines conscience. Right and wrong is decided by authority, and the authority here is the Church. Law is based on the doctrines of the Church, and Salem is a theocracy.   "For good purposes, even high purposes, the people of Salem developed a theocracy, a combine of state and religious power whose function was to keep the community together, and to prevent any kind of disunity†¦but all organization is and must be grounded on the idea of exclusion and prohibition, just as two objects cannot occupy the same space. Evidently the time came in New England when the repressions of order were heavier than seemed warranted by the dangers against which the order was organized." So firstly Salem was a place where the conscience of the people was strictly governed by the theocracy, and socially Salem was repressive. However, at the start of the book, we see that the people of Salem have already begun to strain under this strict idea of conscience, this repression. Abigail says to John, "I look for John Proctor that took me from my sleep and put knowledge in my heart! I never knew what pretence Salem was, I never knew the lying lessons I was taught by all these Christian women and their covenanted men! And now you bid me tear the light out of my eyes?

Sex as a Means of Agency Essay -- Aristophanes Female Women Essays

Sex as a Means of Agency â€Å"A woman’s harder to conquer than any beast, than fire, and no panther is quite so ferocious.† (Aristophanes 1058) Life for an Athenian woman was marked by her daily occupation to the household and its occupants. This was the sphere of life where she was able to exert the most power and maintain a certain degree of agency. Her domestic duties included attendance to her husband, and his sexual needs. In the comic portrayal of women in Lysistrata, Aristophanes exploits this domestic power to create a scenario where â€Å"the harsh and intractable realities of life, politics and international aggression are transformed so that wives manage to overcome husbands, love conquers war, insignificant citizens manage to discredit powerful ones† (Henderson 36). Aristophanes manipulates the Athenian reality by operating on common stereotypes of women, adding to the comic element but also highlighting the gaping gender division that existed in everyday life. In this comic utopian ideal, women are able to overcome their lack of agency in the public sphere by juxtaposing their domestic (primarily sex ual) power with the general polis. It is important to note that in ancient literary portrayals of women, men depict women according to their perceptions and the common social stereotypes. Although this may, in some cases, create a certain amount of discrepancy between the depiction of women and their actual life, it can still be a beneficial tool to understand their attitudes and struggles. As Henderson writes, â€Å"†¦even by itself the male view is interesting: it enables us to study the rules and roles that men created for women and to glimpse the desires and fears that prompted their enforcement† (20). In Atheni... ...ikely that one of women’s foremost complaints would be their invisibility in the public sphere. Therefore, although this comedic piece is clearly an exaggeration of reality, it is a useful tool in understanding the lives of women in the Athenian period. Aristophanes mirrors and manipulates Athenian reality as he portrays women and men through the comedic lens. In the case of Lysistrata, he incorporates common stereotypes and current institutions of power into a plot that not only puts women in a position of power, but also delineates them as the protagonists in forming a well-functioning polis. As this reflects the women’s role in maintaining a respectable household, he manifests their domestic agency on a higher level as a collective â€Å"mothering† of Athenian society where the entire polis is analogous to a household managed by competent and sensible women.

Family Welfare Statistics 2011

FAMILY  WELFARE  STATISTICS  Ã‚   IN  Ã‚   INDIA 2011 Statistics  Division   Ministry  of  Health  and  Family  Welfare   Government  of  IndiaAbbreviations AIDS AHS ANC ANM ANC APL ARI ASHA AWW AYUSH BCG BE BMS BPL CBR CDR CES CHC CNAA CPR CPR DLHS DPT DT EAG ECR EmOC FP FRUs HIV HMIS ICDS IDSP IDDCP IIPS IPHS IEC IFA Acquired Immunodeficiency Syndrome Annual Health Survey Antenatal Care Auxiliary Nurse Mid-wife Ante Natal Care Above Poverty Line Acute Respiratory Infection Accredited Social Health Activist Anganwadi Worker Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy Bacillus Calmette Guerin Budget Estimates Basic Minimum Services Programme Below Poverty Line Crude Birth Rate Crude Death Rate Coverage Evaluation Survey Community Health Centre Community Needs Assessment Approach Contraceptive Prevalence Rate Couples Protection Rate District Level Household Survey Diphtheria, Pertussis and Tetanus Diphtheria and Tetanus Empower ed Action Group Eligible Couple Register Emergency Obstetric Care Family Planning First Referral Units Human Immunodeficiency Virus Health Management Information Systems Integrated Child Development Services Integrated Disease Surveillance Programme Iodine Deficience Disorder Control Programme International Institute for Population Sciences Indian Public Health Standards Information, Education and Communication Iron and Folic Acid IMR IPHS IUCD IUD JSK JSY LHV MCTS M&E MIES MIS MMR MNP MoH&FW MPW-F/M MTP NACP NACO NCP NFHS NGO NLEP NIHFW NNMR NPCB NPP NPSF NRHM NSV NVBDCP NUHM Obs/gyn OP OPV ORS PC&PNDT PHC PHN PIP PMG PMUInfant Mortality Rate Indian Public Health Standards Intra Uterine Contraceptive Device Intra Uterine Device Jansankhya Sthirtha Kosh Janani Suraksha Yojana Lady Health Visitor Mother and Child Tracking System Monitoring and Evaluation Monitoring, Information & Evaluation System Management Information System Maternal Mortality Ratio Minimum Needs Programme Ministry of Health and Family Welfare Multi Purpose Worker – Female / Male Medical Termination of Pregnancy National AIDS Control Program National AIDS Control Organisation National Commission on Population National Family Health Survey Non-Governmental Organization National Leprosy Eradication Programme National Institute of Health and Family Welfare Neonatal Mortality Rate National Programme for Control of Blindness National Population Policy National Population Stabilisation Fund National Rural Health Mission No Scalpel Vasectomy National Vector Borne Disease Control Programme National Urban Health Mission Obstetrics and Gynecology Oral Pills Oral Polio Vaccine Oral Rehydration Solution Pre-conception & Pre-natal Diagnostic Techniques Primary Health Centre Public Health Nurse Programme Implementation Plan Programme Management Group Programme Management Unit PNC PPP PRCs RCH RHS RKS RGI RNTCP RTI SBA SC SC/ST SRS STDs STI TBAs TFR TT UIPPost Natal Care Public Private Partnership Po pulation Research Centres Reproductive and Child Health Rapid Household Survey Rogi Kalyan Samiti, Registrar General of India Revised National Tuberculosis Control Programme Reproductive Tract Infection Skilled Birth Attendants Sub Centre Scheduled- Caste / Scheduled- Tribe Sample Registration System Sexually Transmitted Diseases Sexually Transmitted Infections Traditional Birth Attendants Total Fertility Rate Tetanus Toxoid Universal Immunization Program CONTENTS Page No. Preface †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Abbreviations Executive Summary and overview of Family Welfare Programme in India (Hindi & English version)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. LIST OF TABLES SECTION – A Population & Vital Statistics TABLE NO. A. 1 TITLEPopulation Growth, Crude Birth Rate, Death Rate & Sex Ratio India 1901-2001 Distribution of Population, Sex Ratio, Density and Growth Rate of Population Census 2001 Rural and Urban Composition of Population, Census 1991 Total Population, Population of Scheduled Castes and Scheduled Tribes and their proportions to the total population Total Urban Population, Population of Cities/Towns Reporting Slums and Slum Population in Slum Areas – India, States, Union Territories Child Population in the age-group 0-6 by sex – Census 2001 & 2011 Population Aged 7 years and above 2011 (Provisional) Literates and Literacy Rates by sex, 2001 and 2011(Provisional) census Sex-ratio of total population and child population in the age-group 0-6 and 7+ years 2001 & 2011 Distribution of Population by Age Groups 2001(Census) Percentage Distribution of Population by Age and Sex, India, 1951-2001 census Projected Population Characteristics 2001-2012 Proportion of Population in Age Groups 0-4 and 5-9 a A. 2 A. 3 A. 3. 1 A. 3. 2 A. 3. 3 A. 3. 4 A. 3. 5 A. 3. 6 A. 4 A. 5 A. 6 A. 7 Child-Woman Ratio, and Dependency Ratio, 2001 A 8. Number of Married Couples (With Wife Aged Between 15-44 Years), All India 2001 Percentage Distribution of Married Couples (With Wife Aged Between 15-44 years) by Age Group, Censuses 1961, 1971 , 1981, 1991 & 2001 Number of Married Females in Rural Areas by Age,2001 Number of Married Females in Urban Areas by Age,2001. A. 9 A. 10 A. 11 A11. 1 Estimated eligible couples per 1000 population – 1991 & 2001 Census A. 12 A. 3 Expectation of Life at Birth 1901-2016 Projected Levels of the Expectation of Life at Birth By Sex ,1996-2016 A13. 1 Expectancy of life at birth by sex and residence, India and bigger States, 2002-06 A. 14 A. 15 A. 16 A. 17 A. 18 Fertility Indicators 1996-2009 – All India Time Series Data on CBR, CDR, IMR and TFR – India Crude Birth and Death Rates in Rural and Urban Areas 1981-2009 Estimated Birth and Death Rates in Different States/UTs – à ¢â‚¬ ¦1981,1991,2001-2009 Estimated Age-specific Death Rates by Sex, 2005-2009- India A. 18. 1 Estimated Age-specific Death Rates by Sex, 2005-2009- Rural A. 18. 2 Estimated Age-specific Death Rates by Sex, 2005-2009- Urban A. 19 A. 20 A. 21 A22 A. 2 A23 A24 Infant Mortality Rates by Sex, 1980 to 2009 – All India Infant Mortality Rates by Sex, 2001 to 2009 – India and Major States Mortality Indicators by Residence: All India 1980-2009 Infant Mortality Rate by Residence – All states/UTs Child Mortality Rate by Residence Mortality Indicators, India and Major States 2005 to 2009 Age Specific Fertility Rates (ASFR*) and Age Specific Marital Fertility Rates (ASMFR*): India, 2005-2009 Fertility Indicators for Major States -2005-2009 Estimated Age Specific Fertility Rates by Major States, 2005-2009 b A. 25 A. 26 A. 27 Age Specific Fertility Rates by Educational Level of the Woman, 2005 to 2009(All India) Mean Age at Effective Marriage (Female), India and Major States, 2005 to 2009 Mean age at effective marriage of females , by residence India and Major States ,2005 to 2009 Percentage of Females by Age at Effective Marriage by Residence, India and Major States, 2005 to 2009 Percent Distribution of Live Births by Order of Birth , India and Major States, 2005-2009 Percentage Distribution of Births By Order of Births By Residence, 2005 to 2009 Average Number of Children Born per Woman by Age – 2001 A. 28 A. 29 A. 30 A. 31 A. 32 A. 33 A. 34Proportion of Ever-married Womwn of parity (i+1) and above to 1000 Ever-married women of parity (i) and above 2001 Percentage of Ever-Married Women (Aged 50 and Above) With No Live Birth 2001 Percent distribution of live Births by Type of Medical Attention Received by the Mother at Delivery by Residence –All India Percentage of Deaths by Causes Related to Child Birth & Pregnancy (Maternal) – All India (Rural) – 1985, 1990 , 1995,1997 & 1998 Percentage Distribution of Deaths due to Specifi c Causes under the Major Group â€Å"Causes Peculiar to Infancy† for selected States 1996-98 Maternal Mortality Ratio, 1997-98 to 2007-09 Under-five Mortality Rates(U5MR) by sex and residence, 2008 & 2009 Sex-ratio of child (age group 0-4) 2004-06 to 2007-09 – SRS A. 35 A. 36 A. 37 A. 38 A. 39 A. 40 A. 41 SECTION – B Family Welfare Programme Statistics i) Immunisation Coverage & MTP Services B. 1 Year-Wise Achievement of Targets of MCH Activities – All India c B. 2 B. 3 B. 4State-wise Targets and Achievements of M. C. H. Activities, 2004-05 to 2007-08 Year-Wise Medical Termination of Pregnancy Performed – All India State-Wise Medical Termination of Pregnancy Performed (ii) Family Planning Acceptance & Impact of the programme B. 5 B. 6 B. 7 B. 8 B. 9 B. 10 B. 11 B. 12 Family Planning Acceptors by Methods – All India Sex-wise Break up of Sterilisation Performed Year-Wise Achievement of Family Planning Methods-All India State-Wise Achievements in respect of Sterilisations State-Wise Achievements in respect of IUD Insertions State-Wise Achievements in respect of Condom Users State-Wise Achievements in respect of O. P.Users State-Wise Vasectomies, Tubectomies and % share of Tubectomy to total Sterilisations State-Wise Number of Laparoscopic Tubectomies Along with Total Number Tubectomy Operations Performed State-wise Number of NSV & Total Number of Vasectomy Operations Performed State-Wise Distribution of Condom Pieces State-Wise Number of Oral Pill Centres Functioning and Distribution of Oral Pill Cycles of B. 13 B. 14 B. 15 B. 16 B. 17 B. 18 B. 19 Number of Condom pieces and Oral Pill Cycles Distributed – All India Information Relating to Maternal Health, 2007 to 2011 Couples Currently and Effectively Protected in India By Various Methods of Family Planning Percentage effective CPR due to all Methods Couples Currently and Effectively Protected Number of Births Averted dB. 20 B. 21 B. 22 SECTION – C HMIS- New Key Indicators C. 1 C. 2 C. 3 C. 4 C. 5 C. 6 C. 7 C. 8 C. 9 C. 10 Number of pregnant women received 3 ANC Checkups Number of women given TT2/Booster Number of women having Hb level < 11 (tested cases) Number of newborn visited within 24 hrs of home delivery Number of women discharged under 48 hrs of delivery from public facility Number of Still Births Number of newborns weighed at Birth Number of newborns having weight less than 2. 5 Kgs Number of Newborns breastfed within 1 hour Number of women receiving post partum check-up within 48 hours after delivery SECTION – D Survey Findings D. 1 D. 2 D. 3 D. Key Indicators NHFS-III Comparative Key Indicators – NFHS-III, NFHS-II and NFHS-I Comparative Key Indicators- DLHS-1, DLHS-2 and DLHS-3 Comparison of Key Indicators – NFHS(2005-06), DLHS (2007-08) and Converage Evaluation Survey(CES) 2009 conducted by UNICEF Concurrent Evaluation NRHM – India Facts (2009) Results of Annual Health Survey, 2010-11 D. 5 D. 6 S ECTION –E Infrastructure facilities E. 1 E. 2 Number of Sub-Centres, PHCs & CHCs functioning as on March, 2010 Facility Survey, DLHS ,2007-2008 e E. 3 E. 4 E. 5 E. 6 E. 7 Health Worker (Female)/ANM at Sub-Centre Health Worker (Female) Sub-Centre and PHCs Number of sub-centres without ANMs or and Health Workers(M) Doctors+ at Primary Health Centres Number of PHCs with Doctors and without Doctors/Lab Technician/Pharmacist SECTION –F Outlay and Expenditure on Family Welfare F. Year Wise BE, RE and Actual Expenditure relating to Department of Family Welfare Plan Outlay on Health Family Welfare in Different Plan Periods Centre, States and Union Territories Scheme-wise breakup of actual expenditure during 2007-08 and outlay for 2008-09 Details of External Assistance fro RCH Programme and Immunization Strengthening Project External Funding Assistance for Polio Programme F. 2 F. 3 F. 4 F. 5 Annexures Annex1 Annex 2 Annex 3 Demographic Indicators Demographic Estimates for Selec ted Countries, 2008 Definitions f SUMMARY  OF  FAMILY  WELFARE   PROGRAMME  IN  INDIA Executive Summary The Ministry of Health and Family Welfare brings out a statistical publication titled â€Å"Family Welfare Statistics in India†. The publication presets the most up-to-date data on the performance of various family welfare programmes and various demographic indicators. The 2011 edition contains six sections. Section â€Å"A† (Tables: A. 1 to A. 1) of the report covers Vital Statistics and captures data on population, sex ratio, rural & urban composition, child population, percentage distribution of population by age and sex, number of married couples, life expectancy at birth, fertility indicators, age specific fertility rates by educational levels, age specific death rates by sex, infant mortality rate by sex, child mortality rate, Maternal Mortality Ratio, etc. Analysis of some of the important indicators, is given in the â€Å"Over View† (Para 1 . 0 to 5. 0). Performance of immunization activities, family planning programmes, MTP services, etc. are covered in Section-B (Tables-B. 1 to B. 22). Para 6. 0 to 6. 9 discusses some of these important parameters in the â€Å"Overview†. The â€Å"Section-C† (Tables C. 1 to C. 0) of the Report covers State-wise data on some of the indicators like; Number of pregnant women received 3 ANC checkups, Number of women given TT2/Booster, Number of women having Hb level < 11 (tested cases), Number of newborn visited within 24 hrs of home delivery, Number of women discharged within 48 hrs of delivery from public facility, Number of Still Births, Number of newborns weighed at Birth, Number of newborns having weight less than 2. 5 Kgs. , Number of Newborns breastfed within 1 hour, Number of women receiving post partum check-up within 48 hours after delivery, etc. This data is an aggregation of district level data which is uploaded on Health Management Information System (HMIS) por tal of the Ministry by States/UTs.A number of large scale surveys are being carried out by the Ministry from time to time to assess the performance of various health and family welfare programmes. These surveys inter-alia include, National Family Health Survey (NFHS), District Level Household and Facility Survey (DLHS), Annual Health Survey (AHS), Facility Survey, Concurrent Evaluation Survey (CES) of NRHM, etc. Section-D focuses on the indicators covered in these large surveys. Data on key indicators (State-wise) covered in NFHS-III (2005-06) as compared with NFHS-II (1998-99) and NFHS-I (1992-93) are given in Tables D. 1 and D. 2. Tables D-3 captures data on key indicators covered in DLHS-III (2007-08) as compared with DLHS-II(2002-04) and DLHS-I (1998-99). Concurrent Evaluation of NRHM was carried out in 2009.The indicators covered include (a) health infrastructure facilities (b) Communitisation of services (c) Functioning of ANM (d) Availability of Human Resources (e) Service Ou tcomes. The results of the evaluation survey i are presented in Table D-5. A comparative data on common indicators covered in NFHS-III, DLHS-III and CES-2009 are brought out in Table D-4. The Ministry of Health & Family Welfare, in collaboration with the Registrar General of India (RGI), had launched an Annual Health Survey (AHS) in the erstwhile Empowered Action Group States (Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa and Rajasthan) and Assam.The aim of the survey was to provide feedback on the impact of the schemes under NRHM in reduction of Total Fertility Rate (TFR), Infant Mortality Rate (IMR) at the district level and the Maternal Mortality Ratio (MMR) at the regional level by estimating these rates on an annual basis for around 284 districts in these States. The results of the first round of AHS for some of the indicators viz. Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under F ive Mortality Rate, Maternal Mortality Ratio (MMR), Sex Ratio, etc. have since become available and are given in Section-D (Tables D. 6. 1 to D. 6. 5).Data on key indicators covered in â€Å"Facility Survey-2007-08† conducted as part of DLHS-III are given in â€Å"Section E†. Latest data received from States /UTs regarding availability of Human resource & infrastructure facilities at Sub Centre, Primary Health Centre (PHC) and Community Health Centre (CHC) are also given in â€Å"Section-E† (Tables E. 1 to E. 7). Section-F covers â€Å"Outlay and Expenditure on Family Welfare† 2010-11 programmes for the year ii Overview Family Welfare Programme in India, 2011 DEMOGRAPHIC PROFILE OF INDIA 1. 0 Vital Statistics 1. 1 As on 1st March, 2011 India's population stood at 1. 21 billion comprising of 623. 72 million (51. 54%) males and 586. 47 million (48. 46%) females. India, which accounts for world's 17. percent population, is the second most populous country in the world next only to China (19. 4%). One of the important features of the present decade is that, 2001-2011 is the first decade (with the exception of 1911-21) which has actually added lesser population compared to the previous decade. In absolute terms, the population of India has increased by about 181. 46 million during the decade 2001-2011. Of the 121 crore Indians, 83. 3 crore (68. 84%) live in rural areas while 37. 7 crore (31. 16%) live in urban areas, as per the Census of India's 2011. Highlights of Census 2011 The average annual exponential growth declined to 1. 64% per annum during 2001-2011 from 1. 97% per annum during 1991-2001.Decadal growth during 2001-2011 declined to 17. 64% from 21. 54% during 1991-2001. The decade is the first, with the exception of 1911-21, which has actually added fewer people compared to the previous decade. The rural population (83. 31 crore) and urban Population (37. 71 crore) constitutes 68. 84% and 31. 16% respectively to the total popula tion of the country. During 2001-2011, for the first time, the growth momentum of population for the EAG States declined by about four percentage points. This, together with a similar reduction in the non-EAG States and Union Territories, has brought down the rate of growth of population for the country by 3. 9 percent as compared to 1991-2001. iiiThough the child-sex ratio [0 to 6 years] has declined from 927 female per 1000 males in 1991-2001 to 914 females per 1000 males, increasing trend in the child sex ratio was seen in Punjab, Haryana, Himachal Pradesh, Gujarat, Tamil Nadu, Mizoram and Andaman and Nicobar Island. Literacy rate increased from 64. 83% in 2001 to 74. 04% in 2011; 82. 14% male literacy, 65. 46% female literacy. Among the States and Union Territories, Uttar Pradesh is the most populous State with 199. 6 million people and Lakshadweep the least populated with 64,429 people. The contribution of Uttar Pradesh (UP) to the total population of the country is 16. 5% foll owed by Maharashtra (9. 3%), Bihar (8. 6%), West Bengal (7. 6%), Andhra Pradesh (7. 0%) and Madhya Pradesh (6. ). The combined contribution of these six most populous States in the country accounts for 55% to the country’s population 1. 2 The country's headcount is almost equal to the combined population of the United States of America (USA), Indonesia, Brazil, Pakistan, Bangladesh and Japan — all put together. The combined population of UP and Maharashtra is bigger than that of the USA. Population of many Indian States is comparable with countries like United Kingdom (UK), Germany, Italy, Japan, Mexico, etc. States in India vs Countries in the World (In Millions) State in India Population- Country @ [email  protected] 2011 Uttar Pradesh 199. 6 Brazil 195. Maharashtra 112. 4 Japan 127. 0 Bihar 103. 8 Mexico 110. 5 iv West Bengal Andhra Pradesh Madhya Pradesh Tamil Nadu Rajasthan Karnataka 91. 3 84. 7 72. 6 72. 1 68. 6 61. 1 Philippines Germany Turkey 93. 6 82. 1 72. 7 Thailand 68. 1 France 62. 8 United 61. 9 Kingdom Gujarat 60. 4 Italy 60. 1 Orissa 41. 9 Argentina 40. 7 Kerala 33. 4 Canada 33. 9 Jharkhand 33. 0 Morocco 32. 4 Assam 31. 2 Iraq 31. 5 Punjab 27. 7 Malaysia 27. 9 Chhattisgarh 25. 5 Saudi 26. 2 Arabia Haryana 25. 4 Australia 21. 5 @Source: State of World Population 2010 1. 3 The Average Annual Exponential Growth Rate (AAEGR) for 2001-2011 dipped sharply to 1. 64 percent per annum from 2. 6 percent during 1981-1991 and 1. 97 percent per annum during 1991-2001. Among the major States, Bihar, J&K, Chattisgarh, Jharkhand, Rajasthan, NCT of Delhi, Madhya Pradesh, Uttar Pradesh, Haryana, Uttarakhand and Gujarat recorded higher annual exponential growth rate as compared to the national average during 2001-2011. The State of Bihar registered the highest (2. 26%) AAEGR and Kerala (0. 48) registered the lowest. v 1. 4 The decadal rate of growth of population has slowed down to 17. 64% in 2001-2011 as compared to 21. 54% in 1991-2001. At the St ate level, growth rates varied widely. Nagaland with (-) 0. 47% had the lowest decadal growth rate.The phenomenon of low growth has started to spread beyond the boundaries of the Southern States during 2001-11, where in addition to Andhra Pradesh, Tamil Nadu and Karnataka in the South, Himachal Pradesh and Punjab in the North, West Bengal and Orissa in the East, and Maharashtra in the West have registered a growth rate between eleven to sixteen percent in 2001-2011 over the previous decade. Among the larger States, Bihar registered the highest decadal growth rate of 25% and Kerala the lowest (4. 86%). It is significant that the percentage decadal growth during 2001-2011 has registered the sharpest decline since independence. It declined from 23. 87 percent for 1981-1991 to 21. 54 percent for the period 1991-2001, a decrease of 2. 33 percentage point. During 20012011, this decadal growth has become 17. 64 percent, a further decrease of 3. 90 percentage points (Table A-1). 1. Traditio nally, for historical reasons, some States depicted a tendency of higher growth in population. Recognizing this phenomenon, and in order to facilitate the creation of area-specific programmes, with special emphasis on eight States that have been lagging behind in containing population growth to manageable limits, the Government of India constituted an Empowered Action Group (EAG) in the Ministry of Health and Family Welfare in March 2001. These eight States were Rajasthan, Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh and Orissa, which came to be known as ‘the EAG States'. During 2001-11, the rate of growth of population in the EAG States except Chhattisgarh has slowed down (Table-A-2).For the first time, the growth momentum of population in the EAG States has given the signal of slowing down, falling by about four percentage points. This, together with a similar reduction in the non-EAG States and Union Territories, has brought down the rate of gr owth for the country by 3. 9 percentage points during 2001-11 as compared to 1991-2001. vi 1. 6 Natural Growth Rate: The natural growth rate, which is the difference between the birth rate and death rate, was estimated as 1. 52% in 2009 against 1. 97 % in 1991. 1. 7 Sex Ratio: According to Census of India 2011, the sex ratio has shown some improvement in the last 10 years. It has gone up from 933 in 2001 census to 940 in 2011 census. Kerala with 1084 has the highest sex ratio followed by Pondicherry with 1038.Daman and Diu has the lowest sex ratio of 618. The Sex Ratio in Arunachal Pradesh (920), Bihar (916), Gujarat (918), Haryana (877), J(883), Madhya Pradesh(930), Maharashtra (925), Nagaland(931), Punjab(893), Rajasthan(926),Sikkim (889) and Uttar Pradesh (908) is lower than the national average. All UTs except Puducherry and Lakshadweep also have lower Sex Ratio as compared to national average (Table A-2). 1. 8 Child Sex Ratio: The child sex ratio (0-6 years), has declined to 91 4 in 2011 Census as compared to 927 in 2001. It showed a continuing preference for male children over females in the last decade. Increasing trend in the child sex ratio was seen in States/UTs viz.Punjab, Haryana, Himachal Pradesh, Gujarat, Tamil Nadu, Mizoram, Chandigarh and Andaman & Nicobar Islands but in all the remaining States / Union Territories, the child sex ratio showed decline over Census 2001 (Table-A-3. 6). Literacy level: According to the provisional data of the 2011 census, the literacy rate 1. 9 went up from 64. 83 per cent in 2001 to 74. 04 per cent in 2011 — showing an increase of 9. 21 percentage points. Significantly, the female literacy level saw a significant jump as compared to males. The female literacy in 2001 was 53 per cent and it has gone up to 65. 46 per cent in 2011. The male literacy, in comparison, rose from 75. 3 to 82. 14 per cent (Table A-3. 5). Kerala, with 93. 1 per cent, continues to occupy the top position among States as far as literacy is concerned while Bihar remained at the bottom of the ladder at 63. 82 per cent. vii Ten States and Union Territories, including Kerala, Lakshadweep, Mizoram, Tripura, Goa, Daman and Diu, Puducherry, Chandigarh, NCT of Delhi and Andaman and Nicobar Islands have achieved a literacy rate of above 85 per cent. 2. 0 POPULATION PROJECTIONS 2. 1 Population Projections: The projections for the country, individual States and Union Territories up to the year 2026 made by the Technical Group constituted by the National Commission on Population (NCP) under the Chairmanship of Registrar General, India, reveals that the country’s population would reach 1. 4 billion by 2026. Projected Population of India (In Millions)The projected population and proportion (percent) of population by broad age-group as on 1st March, 2001-2026 as per â€Å"Report of the Technical Group on Population Projections – Ministry of Health & Family Welfare (May 2006)† are given in the Table below: Ye ar Population (in millions) Proportion (percent) 15-59 15-49 (years) (years) (Female Population) 35. 4 57. 7 51. 1 32. 1 60. 4 53. 1 29. 1 62. 6 54. 5 0-14 (years) 60+ (years) 6. 9 7. 5 8. 3 2001 2006 2011 1029 1112 1193 (1210 )* 1269 1340 1400 2016 2021 2026 26. 8 25. 1 23. 4 63. 9 64. 2 64. 3 54. 8 54. 1 53. 3 9. 3 10. 7 12. 4 *As per provisional figures of Census 2011. viii 2. 2 National Population Policy (NPP), 2000: Government has adopted a National Population Policy in February, 2000. The main objective is to provide or undertake activities aimed to achieve population stabilisation, at a level consistent with the needs of sustainable economic growth, social development and environment protection, by 2045.The other objectives are: †¢ †¢ †¢ To promote and support schemes, programmes, projects and initiatives for meeting the unmet needs for contraception and reproductive and child health care. To promote and support innovative ideas in the Government, private and v oluntary sector with a view to achieve the objectives of the National Population Policy 2000. To facilitate the development of a vigorous people’s movement in favour of the national effort for population stabilisation. 2. 3 National Commission on Population (NCP): With a view to monitor and direct the implementation of the National Population Policy, the NCP was constituted in 2000 and it was re-constituted in 2005.The Chairman of the re-constituted Commission continued to be Hon’ble Prime Minister of India, whereas Deputy Chairman of the Planning Commission and the Minister of Health & FW are the two Vice-Chairmen and Secretary, H, is the Member-Secretary of the Commission. State Population Commissions: State Population Commissions have been 2. 4 constituted in 20 States/UTs. viz. Andhra Pradesh, Arunachal Pradesh, Assam, Haryana, Himachal Pradesh, J, Kerala, Madhya Pradesh, Gujarat, Uttar Pradesh, Maharashtra, West Bengal, Meghalaya, Mizoram, Punjab, Rajasthan, Sikki m, Tamil Nadu, Andaman & Nicobar Island and Lakshadweep. Janasankhya Sthirata Kosh (JSK): The Jansankhya Sthirata Kosh (JSK) has been set 2. 5 up as an autonomous body in the Ministry of Health and Family Welfare, duly registered as a Society under the Societies Registration Act, 1860.The objective of JSK is to facilitate the attainment of the goals of National Population Policy 2000 and support projects, schemes, initiatives and innovative ideas designed to help population stabilization both in the Government and Voluntary sectors and provide a window for canalizing resources through voluntary contributions from individuals, industry, trade organizations and other legal entities in furtherance of the national cause of population stabilization. 3. 0 DEMOGRAPHIC and HEALTH STATUS INDICATORS 3. 1 The demographic and health status indicators have shown significant improvements. The Table below captures data on Crude Birth Rate, Crude Death Rate, and Life Expectancy etc. ix Sl. No. 1 2 3 4Parameters Crude Birth Rate (per 1000 population Crude Death Rate (per 1000 population) Total Fertility Rate Maternal Mortality Ratio (per 100,000 live births) Infant Mortality Rate (per 1000 live births) Child Mortality Rate (0-4 yrs. ) per 1000 children Couple Protection Rate (%) Expectation of life at birth (in years) -Male -Female 1951 40. 8 25. 1 6. 0 NA 1981 33. 9 12. 5 4. 5 NA 1991 29. 5 9. 8 3. 6 398 SRS (199798) 80 26. 5 2001 25. 4 8. 4 3. 1 301 (2001-03) Current Levels 22. 5 (2009) 7. 3 (2009) 2. 6(2009) 212 SRS (2007-09) 50(2009) 14. 1(2009) 5 6 146 (1951-61) 57. 3 (1972) 10. 4 (1971) 110 41. 2 66 19. 3 7 8 22. 8 44. 1 45. 6 40. 4(2011) 37. 1 36. 1 (1951) 54. 1 54. 7 60. 6 61. 7 (199196) 61. 8 63. 5 (1999-03) 62. 6 64. 2 (2002-06)Source: Office of Registrar General of India, except 7 above which is based on estimation done by statistics Division of Ministry of Health and Family Welfare. NA – Not available 3. 2 Crude Birth Rate (CBR): The Crude Birth Rate decline d from 29. 5 in the 1991 to 22. 5 in 2009. The CBR is higher (24. 1) in rural areas as compared to urban areas (18. 3). Uttar Pradesh recorded the highest CBR (28. 7) and Goa the lowest (13. 5). Assam (23. 6), Bihar (28. 5), Chhattisgarh (25. 7), Jharkhand (25. 6), Madhya Pradesh (27. 7), Rajasthan (27. 2), Uttar Pradesh (28. 7) recorded higher CBR as compared to the national average. Among the Smaller States / UTs, D Haveli (27. 0) and Meghalaya (24. ) recorded higher CBR as compared to the national average while Tripura (14. 8) recorded the lowest CBR during 2009-Table A-15, A16 & A17. x 3. 3 Life Expectancy: The life expectancy at birth for male was 62. 6 years as compared to females, 64. 2 years according to 2002-06 estimates. Urban Male (67. 1 years) and Urban Female (70 years) have longer life span as compared to their rural counter parts. The life expectancy in Kerala is the highest (74 years) and the lowest in Madhya Pradesh (58 years) Table A-13. 1. xi 4. 0 MORTALITY INDICA TORS 4. 1 Crude Death Rate (CDR): The CDR, which was stagnant during 2007 and 2008 at 7. 4, came down to 7. 3 in 2009. The CDR is higher in rural areas (7. ) as compared to urban areas (5. 8). The death rate is highest (8. 8) in Orissa and lowest in Nagaland (3. 6) – (Table A-17). Age-specific Death Rates: The ASDR for the year 2009 was 14. 1 per 1000 in the age-group 0-4; it drastically declined in the next age-group (5-9) to 1 per 1000. The ASDR gradually increased in each age-group to reach to the level 20. 4 per 1000 in the age-group 60-64 and continued to increase to reach finally to the level 173. 9 per 1000 in the last age-group, 85+. ) The Age-specific Mortality rates are declining over the years; the rural-urban and Male – Female differentials are still high (Table A-18 to A-18. 3) xii 4. Infant Mortality Rate (IMR): According to SRS 2009, the IMR at national level was 50 per 1000 live births in 2009 as compared to 53 in 2008. The IMR is higher in respect of F emale (52) as compared to Male (49). The highest infant mortality rate has been reported from Madhya Pradesh (67) and lowest from Kerala (12). Assam (61), Bihar (52), Chhattisgarh (54), Haryana (51), Madhya Pradesh (67), Orissa (65), Rajasthan (59) and Uttar Pradesh (63) recorded higher IMR as compared to the national average (Table-A-20) Infant Mortality Rates – Rural/Urban (All India) xiii The IMR is very high in rural areas (55 per 1000 live births) as compared to urban areas (34). Rural areas of Madhya Pradesh registered the highest IMR (72) followed by Orissa (68), Uttar Pradesh (66).Rural areas of Kerala State recorded the Lowest IMR (12) in the country. Uttar Pradesh and Chhattisgarh recorded highest IMR in urban areas. Kerala had the lowest IMR (11) in urban areas. Amongst the smaller states, Rural and Urban areas of Goa recorded lowest IMR during 2009 (Table-A-22). The increase in medical attention to the pregnant women at the time of live births may have resulted in decline in IMR over the period. But in the rural areas, the medical attention is still on the lower side (Table-A36) Distribution of Live Births by Type of Medical Attention Received by the Mother-2009 (%) Neo-natal Mortality Rate: Neo-natal mortality refers to number of infants dying within one month.Neo-natal health care is concerned with the condition of the newborn from birth to 4 weeks (28 days) of age. Neo-natal survival is a very sensitive indicator of population growth and socio-economic development. The survival rate of female infants correlates to subsequent population replacement. The neo-natal mortality rate which was stagnant at 37 per 1000 live births during 2003 to 2006 marginally came down to 36 in 2007, 35 in 2008 and stood at 34 during 2009. The neo-natal mortality rate is very high in rural areas (38 per 1000 live births) as compared to 21 in urban areas in 2009. The neonatal mortality rate also xiv varies considerably among Indian States.Madhya Pradesh (47), Utt ar Pradesh (45), Orissa (43), Rajasthan (41), J (37), Himachal Pradesh (36), Haryana(35), Gujarat(34), Chhattisgarh(38) recorded higher neo-natal mortality rate as compared to national average. The Neo-natal mortality rate is lowest in the Kerala State (7). The significant feature is that, the Neo-natal Mortality Rate came down or remained stagnant in 2009 as compared to 2008 except in the case of Haryana, Himachal Pradesh, Jharkhand and Karnataka (Table A23) Post-Neo-Natal Mortality Rate: Refers to number of infant deaths at 28 days to one year of age per 1000 live births. The Post Neo natal Mortality Rate came down to 16 in 2009 from 24 in 2002.The Post Neo Natal Mortality Rate is high in rural areas (17) as compared to urban areas (13) (Table A-21) Peri–natal Mortality Rate: Refers to number of still birth and deaths within 1st week of delivery per 1000 live births. The Peri-natal Mortality Rate varies in the range of 37 to 35 since 2001 and stood at 35 in 2009. It is high in rural areas (39) as compared to urban areas (23) during 2009. The Peri-natal Mortality Rate significantly varied across the States. Kerala with 13 is the best performing State, Madhya Pradesh and Chhattisgarh (45) are least performing States during 2009. Still Birth Rate (SBR): The SBR came down to 8 in 2008 from 9 in 2007. However, it remained stagnant at 8 in 2009 also.The number of Still Births varied across the States between 1 (Bihar) and 17 (Karnataka) in 2009 (TableA-23). 4. 3 Child Mortality Rate (0-4): Child Mortality Rate is measured in terms of death of number of children (0-4 years) taking place per 1000 children (0-4 year’s age). As per SRS estimates, the Child Mortality Rate (CMR) has come down from 57. 3 in 1972 to 26. 5 in 1991 and 14. 1 in 2009. The CMR is very high in rural areas (15. 7) as compared to urban areas (8. 7) in 2009 and this observation is relevant for almost all States uniformly. The highest Child Mortality Rate was recorded in Madhya Prade sh (21. 4) closely followed by Uttar Pradesh (20. 1) and Assam (19. 0). Kerala with 2. 6 CMR is the best Performing State (Table A22. 1) 5. 0FERTILITY INDICATORS The three common measures of fertility are; (a) Crude Birth Rate (CBR), (b) Age-Specific Fertility Rates (ASFR), and (c) Total Fertility Rate (TFR). CBR has already been discussed in para 3 . 2 above. 5. 1 Age Specific Fertility Rates (ASFR) & Age Specific Marital Fertility Rates (ASMFR): ASFR is defined as the number of children born to women in the said age group per 1000 women in the same age group and ASMFR as the number of children born to married women in the said age group per 1000 women in the same age group. Table A-24 presents ASFR and ASMFR data separately for rural and urban areas, for the years 2004 to 2009. It is xv bserved that ASMFRs are higher than ASFRs in respect of all age groups as ASMFR covers only married women. Throughout the period 2004-2009, the age group 20-24 continued to have peak fertility rate s in rural and urban areas, but both these indicators are lower in urban areas as compared to rural areas. The ASMFR increased to 326 in 2009 from 303 in 2008 and the ASFR increased to 227. 8 in 2009 from 218. 6 in 2008 for the age group 20-24. Data on Age Specific Fertility Rate (ASFR) reveals that the fertility rate in 15 to 19 years age group has moderately declined in 2009 (38. 5) as compared to 2008 (41. 6). Lower fertility rates are observed in U. P. Bihar only after attaining the age 40 years while in Kerala, Tamil Nadu, Andhra Pradesh, Maharashtra, Karnataka, Himachal Pradesh and Punjab, this stage is reached in the earlier age groups namely 30-34 and 35-39 (Table A-26). ASFR is showing a decreasing trend as the literacy level increases in the age group of 20-24 (the peak fertility age group)-Tables A-27. 5. 2 Age at Effective Marriage (AEM): The Mean age at effective marriage is the age at consummation of marriage, is almost stagnant and hovering around 20 years between 200 5 and 2009. The State level data show variations in the AEM. It is the highest in J (23. 6) followed by Kerala (22. 7), Delhi & Tamil Nadu (22. 4), Himachal Pradesh (22. 2), and Punjab (22. 1) in 2009. Rajasthan (19. ) has the lowest AEM. The AEM in urban areas is higher than the rural one but the difference is just two years. The rural- urban difference is highest (3. 1 years) in Assam and least in Kerala (0. 1 years). The AEM in respect of more than 50% female in rural areas is 18-20 years whereas in urban areas, the AEM in respect of more than 60% female is 21+ (Tables A-28 to A-30) xvi 5. 3 Total Fertility Rate (TFR): The TFR for the country remained constant at 2. 6 during 2008 and 2009 with Bihar reporting the highest TFR at 3. 9 while Kerala and Tamil Nadu continued its outstanding performance with the lowest TFR of 1. 7. Among the major States, the TFR level of 2. has been attained by Andhra Pradesh (1. 9), Karnataka (2. 0), Kerala (1. 7), Maharashtra (1. 9), Punjab (1. 9), Tamil Nadu (1. 7) and West Bengal (1. 9). The rural woman is having higher TFR (2. 9) as compared to urban (2. 0) women (TableA-25). 6. 0 FAMILY PLANNING PROGRAMME: In 1952, the Indian Government was one of the first in the world to launch a national family planning programme, which was later expanded to encompass maternal and child health, family welfare and nutrition. The figures given in the publication are based on the data reported by the State/UTs at district level and then consolidated at State and National level on HMIS portal.Percentage of districts reported in 2009-10 and 2010-11 was 98%. 6. 1 Maternal Health: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Antenatal care (ANC) is the systemic medical supervision of women during pregnancy. Its aim is to preserve the physiological aspect of pregnancy and labour and to prevent or detect, as early as possible, all pathological disorders. Early diagnosis during pregnancy ca n prevent maternal ill-health, injury, maternal mortality, foetal death, infant mortality and morbidity. During 2010-11, 28. 30 million women got registered for ANC checkup and more than 20 million underwent 3 check-ups during the pregnancy period. vii The institutional deliveries to total deliveries (Institutional +home) increased from 56. 7% in 2006-07 to 78. 5% in 2010-11. Kerala and Tamil Nadu (99. 8%) are the best performing States in the country during 2010-11 (Table B-18). 6. 2 Medical Termination of Pregnancy: To avoid the misuse of induced abortions, most countries have enacted laws whereby only qualified Gynecologists under conditions laid down and done in clinics/hospitals that have been approved, can do abortions. The Medical Termination of Pregnancy Act was enacted by the Indian Parliament in 1971 and came into force from 01 April, 1972. The MTP Act was again revised in 1975.The MTP Act lays down the condition under which a pregnancy can be terminated, especially the pe rsons and the place to perform it. During 2010-11, 620472 MTPs were performed by 12510 approved institutions in the country. Uttar Pradesh with 576 approved institutions performed maximum number (81420) MTPs in the country followed by Maharashtra (78047) during 2010-11. xviii About 60% MTPs in the country were performed in 6 States viz. Assam, Maharashtra, West Bengal, Tamil Nadu, Uttar Pradesh and Haryana in 2010-11(Table B4). 6. 3 Child Health Immunization programmes aim to reduce mortality and morbidity due to Vaccine Preventable Diseases (VPDs), particularly for children.India's immunization programme is one of the largest in the world in terms of quantities of vaccines used, numbers of beneficiaries, number of immunization sessions organized and the geographical area covered. Under the immunization program, vaccines are used to protect children and pregnant mothers against six diseases. They are: †¢ †¢ †¢ †¢ †¢ †¢ Tuberculosis Diphtheria Pertussis Polio Measles Tetanus In India, under Universal Immunization Programme (UIP) vaccines for six vaccinepreventable diseases (tuberculosis, diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, and measles) are provided free of cost to all. Tetanus Immunization for expectant Mother: During 2010-11, 78. 14% of the estimated need for vaccinating 29. 68 million expectant mothers was achieved. As compared to 200910 the achievement is on lower side (83. 82%).The achievement varied widely across the States, the highest percentage of achievement is observed in Lakshadweep (112. 1%) followed by the Mizoram (106. 8%). Among major States, Tamil Nadu immunized 98. 5% of the targeted numbers and Bihar recorded the lowest immunization (58%). The achievement xix of Bihar is the lowest among the major States consecutively for the third year (TableB1&B2). DPT Immunization for Children: The DPT is an immunization or vaccine to protect against the diseases of Diphtheria (D), Pertussis (P), and Tetanus (T). The III dose of DPT vaccination was to be administered to 25. 54 Million children (Target) and achieved 89. 20% during 201011 as against the achievement of 99. 0% in 2009-10. Andhra Pradesh (100. 3%), Tamil Nadu (102. %), Himachal Pradesh (105. 7%), J&K (105. 3%), Manipur (118. 8%), Meghalaya (108. 5%) and Mizoram (134. 2%) achieved more than 100% targeted numbers (Table- B1&B2). Polio: More than 89 percent children received the third dose of Polio vaccine in 2010-11 but the percentage dropped from 98. 6% in 2009-10. The percentage of children who received third dose of polio ranges from 31. 4% in A&N Islands to 133. 8% in Mizoram. Eight States viz. Andhra Pradesh, Orissa, Tamil Nadu, Himachal Pradesh, J&K, Manipur, Meghalaya and Mizoram achieved more than 100% targeted numbers during 2010-11. Achievement of Bihar State is the lowest (69. 1%) among the major States (Table- B1&B2).BCG: BCG vaccine is given for protection against tuberculosis, mainly severe forms of chil dhood tuberculosis. 23. 88 million Children of below one year were targeted for administering BCG vaccine during 2010-11 as against 25. 19 million in 2009-10. The achievement in 2010-11 was 93. 5% as against 101. 7 % in 2009-10. 14 States / UTs achieved more than 100% immunization during 2010-11 as against 20 States/UTs in 2009-10. Pondicherry achieved the highest percentage immunization (179. 8%) in 2010-11. Measles: 22. 10 million Children of below one year age received measles vaccine during 2010-11 as against 25. 54 million children accounting for an achievement of 86. 6% as against 95. 0% in 2009-10.Himachal Pradesh, J&K, Manipur, Meghalaya and Mizoram achieved more than 100% vaccination in 2010-11 (Table- B1&B2). Tetanus: Vaccination against Tetanus was administered to 9. 7 million (Target: 25. 1 Million) children of 5 years age (DT), 14. 30 million children of 10 years age (Target: 25. 66 million) and 13. 0 million children of 16 years age (Target: 26. 01 Million) during 2010 -11. The achievement as against the set target works out to 38. 6%, 54. 8% and 50. 0% respectively in respect of the above age group of children. Bihar State is lagging behind in achievement as compared to all other major States. The achievement is only 5. 6% (of the target) in the case of children 5 years of age, 14. 8% for children of 10 Years and 20. % for children of 16 years during 2010-11. Except Sikkim (for the age group children 10 years), no other State vaccinated the children to the extent of 100% of the target during 2010-11(Table- B1&B2). 6. 4 Family Planning: Birth control pills, condoms, sterilization, IUD (Intrauterine device) etc. are most commonly practiced Family Planning methods in the country. The efforts of the Government in implementing the Family Planning Programme in the country have significant impact. However, Social factors like reluctance, traditions and socio-cultural beliefs towards large family emerge as the major constraints towards adopting Family Pl anning methods. Female xx iteracy, age at marriage of girls, status of women, strong son preference, and lack of male involvement in family planning, are also significant factors associated with adoption of small family norm. IMPACT OF FAMILY WELFARE ACTIVITIES †¢ †¢ Knowledge of contraception is nearly universal: 98 percent of women and 99 percent of men age 15-49 know one or more methods of contraception. Among the permanent modern Family Planning methods, female sterilization was the most popular Over 97 percent of women and 95 percent men know about female sterilization. Male sterilization, by contrast, is known only by 79 percent of women and 87 percent of men. Ninety-three percent of men know about condoms, compared with 74 percent of women. More than 80 percent women and men know about contraceptive pills.Knowledge of contraception is widespread even among adolescents: 94 percent of young women and 96 percent of young men have heard of a modern method of contracepti on Source: NFHS-3 †¢ †¢ †¢ 6. 5 Family Planning Performance The year 2010-11 ended with 34. 9 million total family planning acceptors at national level comprising of 5. 0 million Sterilizations, 5. 6 million IUD insertions, 16. 0 million condom users and 8. 3 million O. P. users as against 35. 6 million total family planning acceptors in 2009-10 (Table B. 5) xxi Total FP Acceptors 60000 50000 40000 30000 20000 10000 0 6. 6 A total of 50. 09 Lakh sterilizations were performed in the country during 2010-11 as against 49. 98 Lakh in 2009-10. States/UTs viz.Assam, Bihar, Gujarat, Jharkhand, Madhya Pradesh, Orissa, Punjab. Arunachal, Manipur, Meghalaya, Nagaland, Tripura, Uttarakhand, Daman & Diu, Lakshadweep and Puducherry have shown improved performance in 2010-11 as compared to 2009-10. (Nos. 000†²) Sterilisations 6,000 5,000 (Nos. 000†²) 4,000 3,000 2,000 1,000 0 The proportion of tubectomy operations to total sterilizations was 95. 6 percent in 2010-11 as ag ainst 94. 6 percent in 2009-10 (Table B-6). xxii Though the share of vasectomy operations to total sterilizations is increasing, it is quite insignificant. 6. 7 IUD Insertions: During the year 2010-11, 5. 6 million IUD insertions were reported as against 5. 7 million in 2009-10.Assam, Bihar, Gujarat, Jharkhand, Uttar Pradesh, Arunachal Pr, Delhi, Goa, Meghalaya, Mizoram, Sikkim, D&N Haveli reported better performance in 2010-11 than in 2009-10 (Table B-9). 6. 8 Condom Users and O. P. Users: Based on the distribution figures reported, there were 16. 0 million equivalent users of Condoms and 83. 07 million equivalent users of Oral Pills during 2010-11 (Table B-10, B-11). 6. 9 Number of Births Averted: Implementation of various Family Planning measures averted 16. 335 million births in the country during 2010-11 as compared to 16. 605 million in 2009-10. The cumulative total of births avoided in the country up to 2010-11 was 442. 75 million (Table B-22). 7. 0 PROGRAMMES and SCHEMES 7. The National Rural Health Mission (NRHM): NRHM launched by the Hon’ble Prime Minister on 12th April 2005 throughout the country with special focus on 18 States, including eight Empowered Action Group (EAG) States, the North-Eastern States, Jammu & Kashmir and Himachal Pradesh, seeks to provide accessible, affordable and quality health care xxiii services to rural population, especially the vulnerable sections. The NRHM operates as an omnibus broadband programme by integrating all vertical health programmes of the Departments of Health and Family Welfare including Reproductive & Child Health Programme and various diseases control Programmes.The NRHM has emerged as a major financing and health sector reform strategy to strengthen States Health systems. The NRHM has been successful in putting in place large number of voluntary community health workers in the programme, which has contributed in a major way to improved utilisation of health facilities and increased health awarenes s. NRHM has also contributed by increasing the human resources in the public health sector, by up-gradation of health facilities and their flexible financing, and by professionalization of health management. The current policy shift is towards addressing inequities, through a special focus on inaccessible and difficult areas and poor performing districts.This requires also improving the Health Management Information System, an expansion of NGO participation, a greater engagement with the private sector to harness their resources for public health goals, and a greater emphasis on the role of the public sector in the social protection for the poor. †¢ †¢ †¢ †¢ †¢ †¢ †¢ 7. 2 NRHM GOALS Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR) Universal access to public health services such as Women’s health, child health, water, sanitation & hygiene, immunization, and Nutrition. Prevention and control of communicable and nonco mmunicable diseases, including locally endemic diseases Access to integrated comprehensive primary healthcare Population stabilization, gender and demographic balance. Revitalize local health traditions and mainstream AYUSH. Promotion of healthy life styles.Primary Health Care services Health Services are provided to the community through a network of Sub-centres, Primary Health Centres (PHCs) and Community Health Centres (CHCs) in the rural areas and Hospitals and Dispensaries etc. in the urban areas. The Primary Health Care infrastructure in rural areas has been developed as a three-tier system. The norms for establishing Sub centres, PHCs and CHCs are as under: xxiv Centre Plain Area Sub Centre PHC CHC 5000 30000 120000 Population Norms Hilly/Tribal Area 3000 20000 80000 7. 3 Sub-Centres (SCs): The Sub-Centre is the most peripheral and first contact point between the primary health care system and the community.Each Sub-Centre is manned by one Auxiliary Nurse Midwife (ANM) and on e Male Health Worker MPW (M). One Lady Health Worker (LHV) is entrusted with the task of supervision of six Sub-Centres. SubCentres are assigned tasks relating to interpersonal communication in order to bring about behavioural change and provide services in relation to maternal and child health, family welfare, nutrition, immunization, diarrhoea control and control of communicable diseases programmes. The Sub-Centres are provided with basic drugs for minor ailments needed for taking care of essential health needs of men, women and children. There were 147069 Sub Centres functioning in the country as on March 2010. An Auxiliary Nurse Midwife (ANM), a female aramedical worker posted at the Sub-Centre and supported by a Male Multipurpose Worker MPW (M) is the front line worker in providing the Family Welfare services to the community. ANM is supervised by the Lady Health Visitor (LHV) posted at PHC. 7. 4 Primary Health Centres (PHCs): PHC is the first contact point between village comm unity and the Medical Officer. The PHCs were envisaged to provide an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care. The PHCs are established and maintained by the State Governments under the Minimum Needs Programme (MNP)/Basic Minimum Services Programme (BMS).There were 23673 PHCs functioning as on March 2010 in the country. A PHC is manned by a Medical Officer supported by 14 paramedical and other staff. It acts as a referral unit for 6 Sub Centres. It has 4-6 beds for patients. The activities of PHC involve curative, preventive, primitive and Family Welfare Services. 7. 5 Community Health Centres (CHCs): CHCs are being established and maintained by the State Government under MNP/BMS programme . It is manned by four medical specialists i. e. Surgeon, Physician, Gynaecologist and Paediatrician supported by 21 paramedical and other staff. It has 30 in-door beds with one OT, X-ray, Labour Room an d Laboratory facilities.It serves as a referral centre for 4 PHCs and also provides facilities for obstetric care and specialist consultations. As on March, 2010, there were 4535 CHCs functioning in the country. 7. 6 Reproductive Child Health (RCH) Programme: Reproductive and Child Health Programme is a major component of NRHM and aims at reduction of Infant Mortality Rate, Maternal Mortality Ratio and Total Fertility Rate xxv 7. 7 Janani Suraksha Yojana: The Jannani Suraksha Yojana (JSY) is a 100% centrally sponsored scheme and it integrates cash assistance with delivery and post delivery care. The scheme was launched with focus on demand promotion for institutional deliveries in States and regions where these are low.It targeted lowering of MMR by ensuring that deliveries were conducted by Skilled Birth Attendants at every birth. The Yojana has identified the Accredited Social Health Activist (ASHA), as an effective link between the Government and the poor pregnant women in 18 low performing States, namely the 8 EAG States and Assam and J&K and the remaining NE States. In other States and UTs, wherever, AWW and TBAs or ASHA like activist has been engaged for this purpose, they can be associated with this Yojana for providing the services. The JSY scheme has shown phenomenal growth in the last three years. Starting with a modest number of 7. 39 Lakhs beneficiaries in 2006-07, the total number reached 113. 89 lakh during 2010-11. 7. Family Welfare Linked Health Insurance Scheme: Family Planning Linked Insurance Scheme was introduced w. e. f. 29th November, 2005 to take care of the cases of failure of Sterilisation, medical complications for death resulting from Sterilisation, and also provide indemnity cover to the doctor / health facility performing Sterilisation procedure. The scheme is in operation for the last 5 years and is renewed with ICICI Lombard Insurance Company for the sixth year w. e. f. 01-01-2011 based on 50 lakh sterilization acceptors. The tot al liability of the company is limited to Rs. 25 crore under Section-I and Rs. 1 crore under Section-II. Benefits of the Scheme w. e. f. 1. 1. 011( 6th Year) Section Coverage Financial compensation I following IA Death sterilization (inclusive of Rs. 2 Lakhs death during process of sterilization operation) within 7 days from the date of discharge from the hospital. IB Death following Rs. 50,000 sterilization within 8 – 30 days from the date of discharge from the hospital IC Failure of Sterilization Rs. 30,000 ID Cost of treatment upto Actual not exceeding 60 days arising out of Rs. 25,000 complication following the sterilization operation (inclusive of xxvi II complication during process of sterilization operation) from the date of discharge. Indemnity Insurance per Upto Rs. 2 Lakh per Doctor/facility but not claim more than 4 cases in a year. 7. Compensation for Acceptors of Sterilisation: As a measure to encourage people to adopt permanent method of Family Planning, this Mi nistry has been implementing a Centrally Sponsored Scheme since 1981 to compensate the acceptors of sterilization for the loss of wages for the day on which he/she attended the medical facility for undergoing sterilization. Compensation for Acceptors of Sterilisation Public facilities Vasectomy Tubectomy Focus 1500 1000 1500 (Rs. ) Accredited Private/NGO facilities Vasectomy Tubectomy 1500 1500 1500 (BPL/SC/ST) High States Non-high Focus States 1000 (BPL/SC/ST) 1500 650 (APL) 8. 0 MONITORING AND EVALUATION SYSTEMThe Information System to measure the process and impact of the NRHM including Family Welfare Programme is as below: a) Service Statistics through HMIS and Routine Monitoring b) Sample Registration System & Population Census, Office of Registrar General India c) Large scale surveys- National Family Health Surveys, District Level Household and Facility Surveys. Annual Health Survey d) Area specific surveys by Population Research Centres e) Other specific surveys by National & International agencies f) Field Evaluation through Regional Evaluation Teams xxvii 8. 1 Service Statistics/Routine Monitoring The Statistics Division in the Ministry of Health & Family Welfare is responsible for Monitoring & Evaluation activities. 8. 2 Health Management Information System (HMIS) Health services are provided through the network of health centers spread throughout rural and urban areas of the country. Each centre maintains record of its activities in one or more of the primary registers.The performance data collected and compiled primarily at peripheral levels (Rural/Urban) such as Sub-centre, Primary Health Centres, Urban Family Welfare Centres / Post Partum Centres / Hospitals / Dispensaries are presented in Tables C-1 to C-10. For capturing information on the service statistics from the peripheral institutions, an exercise was undertaken to rationalize the facility level data capturing format by removing redundant information, reducing the number of forms and focu sed on facility based reporting. The revised forms were finalized in September 2008 and disseminated to the States. A web based Health MIS (HMIS) portal was also launched in October, 2008 http://nrhm-mis. nic. n to facilitate data capturing at District level. The HMIS portal has led to faster flow of information from the district level and about 98% of the districts are reporting monthly data since 2009-10. The HMIS portal is now being rolled out to capture information at the facility level. Some of indicators for which data has been captured through HMIS portal (district level) are included for the first time in the publication (Detailed tables are given in Section–C (Tables C1 to C-10). Data for these indicators are provisional and may only be compared with DLHS-III indicators keeping in view the methodological differences. 8. 3 Tracking of Mothers and ChildrenIt has been decided to have a name-based tracking whereby pregnant women and children can be tracked for their ANCs and immunisation along with a feedback system for the ANM, ASHA etc to ensure that all pregnant women receive their Ante-Natal Care (ANCs) and postnatal care (PNCs) Checkups; and the children receive their full immunisation. All new pregnancies detected/being registered from 1st April, 2010 at the first point of contact of the pregnant mother are being captured as also all births occurring from 1st December, 2009. A number of States have established the system and other are putting in place systems to capture such information on a regular basis. Mother and Child Tracking System require intense capacity building at various levels primarily at the Block and Sub-Centre levels. The National Informatics Centre (NIC) has developed software application. The rollout is being monitored centrally. xxviii 8. 4 Large Scale/Demographic SurveysA number of large scale surveys are being conducted by the Ministry of Health & Family Welfare as enumerated below: National Family Health Survey (NFHS): The 2005-06, National Family Health Survey (NFHS-3) was the third in a series of national surveys preceded by earlier NFHS surveys carried out in 1992-93 (NFHS-1) and 1998-99 (NFHS-2) with the objective to provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes, and to provide information on important emerging health and family welfare issues. Annual Health Survey (AHS): The Ministry of Health & Family Welfare, in collaboration with the Registrar General of India (RGI), had launched an Annual Health Survey (AHS) in the erstwhile Empowered Action Group States (Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa and Rajasthan) and Assam. AHS will provide District-wise data on Total Fertility Rate (TFR), Infant Mortality Rate (IMR) and the Maternal Mortality Ratio (MMR) at the regional level. Other RCH indicators like Ante-natal care, Institutional delive ry, immunisation, use of contraceptives will also be available.The aim of the survey was to provide feedback on the impact of the schemes under NRHM in reduction of Total Fertility Rate (TFR), Infant Mortality Rate (IMR) at the district level and the Maternal Mortality Ratio (MMR) at the regional level by estimating these rates on an annual basis for around 284 districts in these States. The results of the first round of AHS for some of the indicators viz. Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under Five Mortality Rate, Maternal Mortality Ratio (MMR), Sex Ratio at Birth (SRB), Sex Ratio (0-4 years) and Total Sex Ratio have been released by the Registrar General of India (RGI).The District-wise data in respect of the above indicators for the nine States viz. Bihar, Jharkhand, Madhya Pradesh, Chhattishgarh, Uttarakhand, Uttar Pradesh, Orissa, Rajasthan and Assam are given in Table D. 6. 0 (Section D). Comparison of State -wise AHS results and SRS: 2009, in respect of five indicators namely Crude Birth Rate (CBR), Crude Death Rate (CDR), Infant Mortality Rate (IMR), Neo-natal Mortality Rate and Maternal Mortality Ratio (MMR), Sex Ratio at Birth (SRB) reveals that they are broadly comparable (Table D. 6. 1). All 284 districts covered in the AHS (first round) have been ranked by arranging them in ascending order based on the rank of the individual indicators viz.Infant Mortality Rate (IMR), Neo-natal Mortality Rate, Under 5 Mortality Rate and Maternal Mortality Ratio (MMR) and presented in Table D. 6. 2. Tables D. 6. 3 and D. 6. 4 give details of bottom 100 districts as per the rankings and also covered under High Focus Districts identified under National Rural Health Mission, xxix The second Round of AHS (2011-12) would also cover additional parameters viz. height & weight measurement, blood test for anemia and sugar, blood pressure measurement and testing of iodine in the salt used by households thro ugh a separate questionnaire on Clinical, Anthropometric and Biochemical (CAB) test and measurements in addition to the indictors covered in AHS first round.District Level Household and Facility Survey (DLHS): The District Level Household and Facility S