NATIONAL POPULATION POLICY (EXTRA COPIES)
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- Title
- NATIONAL POPULATION POLICY (EXTRA COPIES)
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RF_HP_3_A_PART _ 1_SUDHA
PEOPLE ORIENTED
WHY CENSUS ?
To know the socio-economic
and demographic health
of the Nation
Census is a great national task. We owe
it to the Nation to make the Census a success
Please co-operate during the Population
Enumeration being conducted from
9 to 28th February, 2001
Provide accurate and complete
information to the census enumerator
information collected from you
will be kept confidential
Director of Census Operations, Karnataka. Bangalore and
Principal Census Officer (Deputy Commissioner,
or Commissioner of City Municipal Corporation
and Bangalore Development Authority
and Officers of Local Bodies)
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Census 2001
DISABILITY STATUS OF PEOPLE OF INDIA
The Census exercise of 2001 is scheduled from 9 to 28 February. In India, the census forms a large exercise and data
derived therein will form the basis of planning for all development programmes. The National Sample Survey Organization
(NSSO) conducted sample surveys of people with disabilities across the country as part of census in 1991; and the
Governments of Karnataka and Madhya Pradesh have conducted statewide surveys. Needless to say that these and
other surveys conducted by research and academic institutions, surveys done as part of ICDS activity; polio lameness
surveys - form the only data available in India today regarding disability.
The Census Directorate, Government of India and various groups working for People with Disabilities need to be
congratulated for their efforts to include the enumeration of disabled people of our country. The National Council for
Promotion of Employment of People with Disabilities, Disability Rights Group (DRG) and other disabled persons
organisations have been instrumental in bringing the focus of the Government to this area, negotiating and ensuring its
incorporation as part of the census activity in 2001.
The disability census taking place in February 2001 not without a challenge. The challenge being:
•
People must be informed that disability status is part of Census 2001.
•
Enumerators must be alert and record the disability status of people.
•
People with disability, their kith and kin, their family members need to be informed that disability status is being
recorded and that they should give accurate information to the enumerators when they visit the homes.
Let us take proactive measures . . .
Since disability census is part of the national census for the first time, the Enumerators will also be recording disability
status for the first time. Hence the training is extremely important both for the Enumerators and their Supervisors, and
has to be effective at all levels - District, sub-divisional and block. To facilitate this, we have to:
•
ensure that a minimum of one day’s training is conducted at the Mandal level;
•
develop effective educational material like posters, handbills, flip charts, messages for AIR and Doordarshan, etc.
•
ensure that government circulars reach all officers of the machinery involved in the Census - specially the revenue,
and educational departments - all over the country it well in advance.
•
ensure that the educational material used for training - be it messages telecast, broadcast or published in the print
media - is uniform.
•
ensure that all NGOs, disabled persons’ organisations and people with disabilities are aware of the Census well in advance.
Role of NGOs, Disabled Persons’ Organisations:
With two months left for the Census, it is a essential that all NGOs and disabled persons’ organisations take up a
campaign, use the data gathered and develop community based rehabilitation strategies.
It is essential that we:
•
interact with the all departments like the Census Directorate, Department of Disabled Welfare, etc. handling disability,
as well as the officials concerned such as the Commissioner for Disabilities, thereby ensuring that a collective plan is
arrived at jointly by Government and NGOs.
•
focus specifically on development and production of training and educational material in local languages and ensure its
optimal use.
•
•
ensure that NGOs and disabled persons’ organisations participate in the training.
ensure that local groups - youth groups, raitha sanghas, womens’ groups, milk cooperatives and all community
groups - are informed, well in advance and that they join in the campaign to assist the enumerators, the community
and persons with disability.
Role of the Census Directorate and the Government Machinery:
*
To ensure training of enumerators and inform the community about enumeration of disabled people in the
forthcoming census.
•
Develop uniform messages for telecasting and broadcasting before and after the News and before the farmer’s
programme on AIR, every day during December, January and early February.
•
Ensure that NGOs and disabled persons’ organisations are involved in the design and production of training and
educational material; development of materials for nationwide telecast and broadcast; training of enumerators, education
of communities and persons with disabilities and their families.
•
Contact corporate agencies and enlist their support for production of Information, Educational and Communication
material on a large scale in local languages.
•
Allocate additional budget for training of
enumerators, personnel from publicity units like the print and
electronic media.
•
Ensure that revenue officers develop a communication and training strategy, well in advance for campaign activity
over the next two months.
•
Ensure that all state and central government machinery are iinformed
'
• and• alerted
•
through circulars and meetings that
disability is part of census enumeration. This would involve all representatives, including panchayat representatives
Hold meetings in all Panchayats all over the country regarding community education for total participation in enumeration
of disability status during the first week of December to mark the International Day of Disabled Persons.
•
Request the postal department to print messages about disability census on postcards, inland letters that will be
distributed in January 2001 and early February.
Census 2001 is a great opportunity for people with disabilities. The exercise can
stakeholders make it accurate.
ACTIONAID INDIA
Disability Unit
No. 3, Rest House Road
Bangalore 560 001. INDIA
Fax: 080-5586284
e-mail: disability@actionaidindia.org
be fruitful only if all the
itions - are involved and
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STATEMENT SHO WIND THE ACHJUEVEMEN’IS OF INDIA IN CERTAIN KEY AREAS
1
1951
Age 5+ years
only
1981
Age 5-f- years
only
1991
Age 7+ years
only
LITERACY
1901
Literates
Persons
5.40
18.33
41.42
52.71
Males
9.83
27.16
53.45
63.86
Females
0.60
8.86
28.46
39.42
94.6
81.67
58.58
47.89
Males
90.17
72.84
46.55
36.14
Fernales
99.40
91.14
Illiterates
Persons
'
2 LIFE EXPJ0CTANCT
at Hurra
60.58
1901-1911
1951-1961
1981-1985
1987-1991
22.59
23.31
41.89
40.55
55.40 .
55.70
-58.10-58.60
MORTAITXY W
f Decade
RATE PER 1000
1901-11
POPULATION_____
Males
_____ 290,0
Females
284.6
(ESlIMATEDtGo^o)
BUTPH RAI’E
t
49.2
PER 1000
'~%
POPULATION
DEATH RATE fjL
PER 1000 MbsL
42.6
1951
(Specific)
1981
(Specific)
235
218
___ 86___
82
41.7
22.8
Males
_______
Females •5bw<35^6’J P
2001
(Expected)
62.36
63.39
3 Infant
4
5
1991
(Ibtal)
t>t5yr
80 ”
2001
(Expected)
33.9
29.5
24.10
12.5
9.8
8.99
4.5
3.6 .
3.05
63
64
fofulatton^Ua® r
6
FTTrniJITRATE
PER 1000
POPULATION
E
AGE Al’
MARRIAGE
3sr; Mean ago at
marriage of
•3b£pS*?-’ Ibnialcs
•fosoyi).
Married upto
ago 35______
Mean ago at
marriage of
males
married
upto age 50
18911901
19011911
19111921
19211931
1931-'
1941
19411951
19511961
1971
1981
12.77
13.04
13.52
12.50
14.03
15.38
15.43
17.1*
18.3*
21.01
20.44
20.74
18.45
20.34
19.93
21.76
22.3*
23.3*
<■4
‘fiXKN'oSUS
33
Q
■
MOnTAUlY OF riLEGNANT
WOMAN (PER THOUSAND
1994
rOFULATION IN RURAL AREAS)
Child birth & pregnancy
ffiP*
J^OTOnlnRo to Uto
I
12.1
Soiwoa: Census Publications of India.
1995 •
353
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(
SIGNIFICANCE AND NEW FEATURES
OF CENSUS 2001
dedi
HShashidhar, IAS
Director ofCensus
Operations, Karnataka
Once again after 10 years die one hundred and thirty years bld, gigantic and great
tn
.
Indian Census Organisation is mobilisipg all its men (and women), material and money to
undertake the biggest administrative exercise in the World Le., die Census of India 2001
during February 9th to 28th, 2001. The rignificance of Census 2001 lies in the feci that it
is the first Census of the twenty-first century and third miUeanium. Giving complete
account of the socio-economic, development and demog.’qdric health of die ever
burgeoning population of India, the Census 2001 will servi as a historic bench mark for
ths coming decades. It will be the 14th decennial Census of India since 1871 and sixth
since Independence.
The Census 2001 has many firsts to its credit. For the first time an unprecedented
strength of over two million people will be appointed and trained to rsach and capture
information from an anticipated 1000 million or 100 crore or one billion phis people
living in India as on 1st March, 2001. This whopping population living in 26 States, 6
Union Territories, 593 Districts, around 5,500 Taluks,
5,100 Cities & Towns and
6,83,000 Villages will have to be counted. Every child, woman, nan eunuch and
hermaphrodite regardless of age, sex and nationality will have to be enumerated without
omission or duplication. Indeed, it is a stupendous task. The Indian Census Organisation
has the expertise, experience and competence to undertake this task
2
The Indian Census has two phases. First or preliminary phase referred as t$k
Houschsting Operation during which information on housing and household amenirigs is
captured was held throughout the Country during April to June, 2000. Second or theJ*’
mam phase known as the Population Enumeration will be held (except Jammu and
Kashmir) between 9th and 28th February, 2001. The houseless households will fee
enumerated on the night of 28th February, 2001.
;■
.
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One of dm main features of the ensuing Census is die reduction m the number of
questionnaires or schedules used. In the previous Census, three schedules, namely the
houselist schedule, household schedule and individual slip were used to gather
■ >
**
; miormatron. But in this Census, since the individual slip has been done away with, only
two schedules le., the hotirelist schedule and the household schedule are going to be
used. The individual particulars will be collected in the household schedule itself.
'
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Another prominent feature of the Census 2001 is the dropping of the Economic
Census which used to be held alongwith the houschsting operation in the previous
Census. Similarly, the preparation of PGDHIP cards (Post Graduate and Degree Holders
and Technical Personnel), for which information used to be collected rftiring die
Population Enumeration has also been dropped fiom this Census.
•
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Yet another important feature of this Census is die introduction of certain new and
relevant questions both for the Houselisting Operation and the Population Enumeration.
The new questions in addition to the modifications of old ones, enhance the utility of
Census 2001 and takes it beyond a head count of population.
*
3
The Houselisting Operation included questions for the first time on (1) condition
of the house, (2) number of married couples living in the household, (3) number of
married couples having independent rooms, (4) drainage facilities, (5) bathroom within
the house, (6) kitchen within the house, (7) possession of Radio/Transistor/
Television/Telephone by the household,
(8) possession of transport vehicle such as
Bicycle/Scooter/Motor Cycle/Moped/Car/Jeep by the household and (9) Banking services
availed by the household.
Similarly, the Population Enumeration between 9th and 28th Feb., 2001 will have
questions for the time on (1) name of respondent and the relationship to head, (2) age of
marriage for males also, (3) disabilities, (4) travel to work place, distance and mode of
travel, (5) household engaged in cultivation and plantation and (6) dated signature or
thump impression of the respondent.
Census 2001 is expected to bring in a sort of technological revolution for in die
history of Indian Census. The questions in the schedules are self coded to make them
processor friendly. Latest image-based scanning technology will be tried for the first
time by the Census Organisation which should substantially speed up processing,
tabulation and publication of data.
Census of India 2001, a new road map to India's future is nothing but history in
the making. Glorious tradition is its' main strength.
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<
CENSUS OF INDIA 2001 - ENUMERATION OF THE DISABLED
OIRECTORATe OF WELFARE FOR DISABLED
GOVERNMENT OF KARNATAKA ON 1.12.M00
INTRODUCTION
***"* °ro' ounces Io,
r”0
fellow citizens « ,» C°n
enWle<i '0*“ 8a™,undamen,al rl9Ws just like the,
'
of the disabled have
aoycosk The practical redressal of the problems
reasonable opportunities'a^8686'1 3 ^h96 t0 Govemments and organisations. If
people and Z
T
Up the disa^
be as productive as normal
,nt0 main 8tream of
society. By this the disabled will
be rehabHitated and thereby the
.
' society would be fulfilling a great obligation.
-
0'’0'
T
«*»««. ^InnXr
0M^”'
™ >»•
mauaea a question on disability,
-nd
of disability prMrXmes9^^^ Plannln9‘imp,ernentatior1' monitoring and evaluation
tate Po,ici«s and programmes for the welfare of the
disabled.
.
*
'
■
-
•
•
•
•
, •*- 5 •
2
PURPOSE OF THE SEMINAR
This seminar alms to bring awareness amongst the Organisations working
for the welfare of the disabled on one hand and the people on the other. The office
.-.A-*’
’
■”
bearers of . about 250 Organisations spread over the State of Karnataka have been
invited to participate in the Seminar, it is envisaged that these office bearers would get
back to their districts and spread the message of Census in general and the
enumeration of the disabled in particular in Census of India 2001 so that all the disabled
are covered.
Disability is one of the challenging and prominent social problems. Questions on
disability are always sensitive. If questions are not asked carefully and delicately, the
respondent or any member of the household will get offended. Therefore the
Enumerator who seeks information on the type of disability has to be doubly
cautions, sensitive and full of empathy witli a lot of patience. The Enumerator
should try to explain the actual purpose of the question of disability by emphasizing that
the information collected would help the governments and voluntary organisations in
planning for the welfare of the disabled.
Voluntary organisations working for the welfare of the disabled can help the
Enumerator in identifying and providing the addresses particularly the children and
woman among the disabled, in their area of operation They can also motivate the
members in the household of the disabled to provide correct information without any
hesitation and reservation
These organisations with their network of grassroot level
workers should be in a position to reach out to the people and help in making the
Census a success.
Help of other voluntary organisations working for the rehabilitation in areas
such as child abuse and child labour, prostitutes, violence against women,
juvenile delinquency, beggary, family welfare, crime and criminals, AIDS, drug
abuse, bonded labour and other social problems will also be sought by this
Directorate.
3
Media's role can hardly be over-emphasized. They have the ability to bring the
theme and spirit of Census to the centre stage. This helps the people to actively and
willingly participate in the Census Operations and thereby help the Census Organisation
in their endeavour.
The Seminar thus envisages to achieve all these and to launch publicity
measures to bring awareness among the public about the Census of the disabled in
particular and the Census in general.
■»
QUESTION ON PHYSICALLY HANDICAPPED IN CENSUS 1981
Since Independence, question on disability was canvassed only in 1981
Census. As part of the 1981 Census for the first time in addition to the listing of
houses, some essential data on the Physically Handicapped which were badly wanted
for planning for this' disadvantage group was collected through Houselist.
The
information so collected was about the number of those who are totally blind / crippled/
dumb.
The term Totally Crippled was referred to such persons who had lost their arms
or limbs. The loss of either of the arms or legs was sufficient for classification was totally
crippled. However, the loss of only one arm and / or one leg was not classified as
totally crippled. The paralytic who will have lost the use of both the legs and both the
arms was also treated as totally crippled
Though the legs or arms were physically
present in case of persons who have more than one of the disabilities mentioned
above, the greater disability was considered for the purpose A person who was blind
or crippled due to old age was also treated as disable person.
QUESTION ON DISABILITY IN CENSUS 2001
The question on disability is very sensitive. The Enumerators will be repeatedly
instructed to be very polite and careful in eliciting the information to answer this question.
4
oo^ auCXX e
0-sta «
tnst^Z "
-he tnsttuetane thereunder tbt ^g
,h™* '-**’ »»
- -
K “='and ■"
" -he
:
"Q.15 :
If -he person S phyeioej), /
Number from the list below
may have to obtain
',Sked
.
give appropriate Code
a" P*"0"8 *n
househ<>,d- ^ou
from the main respondent whoTap0
-sitlve qu.stion^
9
respondent or any other memhT
actua, purpose oX^ZT
Pr01* <W,Cate,y S0 as not to offend the
<•*
°f the
-U that tNs Js a
and type of disability would hein T^*8*8111"9 that the ,nfom»«on on the number
the disabled You mavtha n
P "* 9°Vernm*nts 'n Pfenning for the welfare of
any l-ZtTXXX
disability, put a dash
‘
°r persons wh0 do not suffer from any
d-^threferenJLrX~
. 75.1
below
-
The «ve types ot
3,1 (h3S n° P®^'00 of W or
has blurred vision eve^withTT
—
-code.^zx^xxras
eye will also be treated as visually disabled Y
Pe-n may have barred ZldX
would improve by using spectacles
disabled.
,
.
'
he IS dumb SmZ'’
s h
uch
H6"30"
‘n 0"e
Pr0Per '^h
^S'00
her/h'S eye’sight
Persons would be treated as visually
* PerS0" "" 06 “““ 35 te™5 speech dtsaMy, l( sne ,
cornprehension and hX^T
“ “nde'5,°tXi * ’
a
code '2' will be entered Thi ’
6 '’V1"
COnSldefed t0 hav,n9 sPeech disability and
be entered This qUeSt(on win not be canvassed for chridren upto
years of age. Persons who stammer but whose speech is comprehensible will not be
classified as disabled by speech.
75.4 In Hearing : A person who cannot hear at all (deaf) or can hear only loud
sounds will be considered as having hearing disability and in such cases code '3‘ be
entered. A person who is able to hear, using hearing-aid will not be considered as
disabled under this category. If a person cannot hear through one ear but her / his other
ear is functioning normally, should be considered having hearing disability.
75.5 In Movement : A person who lacks limbs or is unable to use the limbs
normally, will be considered having movement disability and code '4' will be entered
here.
Absence of a part of a limb like a finger or a toe will not be considered as
disability. However, absence of all the fingers or toes ur a thumb will make a person
disabled by movement. If any part of the body is deformed, the person will also be
treated as disabled and covered under this category A person who cannot move
herself / himself or without the aid of another person or without the aid of stick, etc., will
be treated as disabled under this category. Similarly, a person would be treated as
disabled in movement if she / he is unable to move or lift or pick up any small article
placed near her/him. A person may not be able to move normally because of problems
of joints like arthritis and has to invariably limp while moving, will also be considered to
have movement disability.
75.6 Mental : A person who lacks comprehension appropriate to her / his age
will be considered as mentally disabled. This would not meant that if a person is not
able to comprehend her / his studies appropriate to her / his examination is mentally
disabled. Mentally retarded and insane persons would be treated as mentally disabled.
A mentally disabled person may generally depend on her / his family members for
performing daily routine. It should be left to the respondent to report whether the
member of the household Is mentally disabled and no tests are required to be
applied by you to judge the member's disability.
1
/
6
75.7
If a person is disabled, enter only one of the five disability for that person,
in codes, as given below :
T ’•
In Seeing
1
in Speech
2
In Hearing
3
In Movement
4
Mental
5
75 8 Please note that a person may have two or more types of disability
but only one of these is to be recorded. In such cases you will have to leave It to
the respondent to decide as to the type of disability she I he wants the member of
her / his household to be classified into. The disability of a person will be decided
with reference to the date of enumeration. Persons with temporaiy disability on the
date of enumeration will not be considered as disabled. For example, a pereon's
movement may have been restricted because of the some temporary injury and she / he
is likely to return to his normal state after sometime, such a person will not be treated as
disabled",
vyanana
■
h
A BRIEF NOTE ON
CENSUS AND CENSUS OF INDIA 2001
- Director of Census Operations,
Karnataka
ABOUT CENSUS . .
CENSUS IS NEITHER A MERE GIGANTIC HEADCOUNT NOR A
STATISTICAL EXERCISE. IT IS NOT EVEN A NUMBER GAME.
IT IS MUCH MORE THAN THAT. IT IS A MULTI-DIMENSIONAL
MOVE FROM NUMBERS TO POPULATION TO PEOPLE.
“ A CENSUS OF POPULATION MAY BE. DEFINED AS THE
TOTAL PROCESS
OF
COLLECTING,
COMPILING AND
PUBLISHING DEMOGRAPHIC, ECONOMIC AND SOCIAL DATA
ON A SPECIFIED TIME OR TIMES TO ALL PERSONS IN A
COUNTRY OR DELIMITED TERRITORY ”
- UNITED NATIONS
“ IN FACT IN THESE DAYS YOU CANNOT TAKE UP ANY
SERIOUS ADMINISTRATIVE, ECONOMIC OR SOCIAL WORK
WITHOUT REFERRING TO THE CENSUS REPORT WHICH IS
AN ESSENTIAL PART OF EVERY ENQUIRY, OF EVERY
STUDY.
EVEN FOR SOLUTION OF MINOR PROBLEMS YOU
HAVE OFTEN TO CONSULT THE CENSUS REPORTS ”
- SRI G.B. PANT
4
" THE INDIAN CENSUS IS ONE OF THE COUNTRY’S MOST
REMARKABLE EVENTS AND UNIVERSALLY ACKNOWLEDGED
AS THE MOST AUTHENTIC AND COMPREHENSIVE SOURCE
OF INFORMATION ABOUT OUR LAND AND PEOPLE ”
- PROF. S. CHANDRASHEKHAR
“ THE
INDIAN
CENSUS
DATABASE
HIGHLY MULTI
IS
DIMENSIONAL IN ITS RANGE AND SCOPE ENCOMPASSING
DEMOGRAPHIC,
ECONOMIC,
CHARACTERISTICS,
SOCIAL
SCHEDULED
RELIGION,
MIGRATION,
CULTURAL
AND
mortality;
TRIBE,
LANGUAGE,
EDUCATION,
HEALTH,
FERTILITY
NUPTIALITY,
AND
CASTE,
COMMUNICATION, CHILD LABOUR, EMPLOYMENT, AGING,
HOUSING,
HOUSEHOLD
AMENITIES,
URBANISATION
INFRASTRUCTURE AND MANY MORE ISSUES'. ”.
“ YOU NAME IT, CENSUS HAS IT ”
- RGI AND CO, 1999
2
i
*
“ APART FROM BEING A MAJOR ADMINISTRATIVE FEAT, IN A
COUNTRY OF INDIA’S SIZE AND DIVERSITY, THE CENSUS
POSSESSES AN INTELLECTUAL VALIDITY TO PLANNERS,
POLICY
MAKERS,
RESEARCHERS,
ADDRESS
ECONOMISTS,
ADMINISTRATORS
THEMSELVES
TO
AND
STATISTICIANS,
OTHERS
EVERY
TO
CHANGE,
DEMOGRAPHIC, DEVELOPMENT, SOCIAL AND ECONOMIC
QUESTIONS OF OUR COUNTRY ”
“IT IS A MONUMENTAL AFFAIR”
-ASHISH BOSE
3
M’ b; .
.
..
SIGNIFICANCE OF CENSUS OF INDIA 2001
“ THE 2001 CENSUS WILL BE THE 14TH DECENNIAL CENSUS,
SINCE 1871 AND THE 6TH CENSUS SINCE INDEPENDENCE/
ITS SIGNIFICANCE LIES IN THE FACT THAT IT COMES AT THE
COMMENCEMENT OF NOT ONLY THE NEXT CENTURY BUT
ALSO THE NEXT MILLENNIUM. AS IT PROVIDES A TURNING
POINT IN HISTORY, THE 2001 CENSUS MAY BE DESCRIBED
AS THE MILLENNIUM CENSUS.
IT WILL SERVE AS A
HISTORIC BENCHMARK ON THE STATE OF THE NATION’S
SOCIETY, DEMOGRAPHY AND ECONOMY. ”
- RGI AND CO
■
CHANGE IN SCHEDULES
Earlier there used -to be three Census Schedules namely the
Houselist, the Household Schedule and the, Individual Slip.
Individual Slip - one of the important schedules being used
hitherto to collect particulars of individuals is done away with.
For the 2001 Census, the only two schedules being canvassed
are the ‘HOUSELIST SCHEDULE’ during the first phase that is the
Houselisting Operation and the ‘HOUSEHOLD SCHEDULE’
through which both the details of the households and the
individuals are going to be collected during the second phase.
4
. \v.
HOUSELIST SCHEDULE (will be used during the Houselisting
Operations between 8th May and 6th June, 2000 in Karnataka) '
In the Houselist Schedule information on the following additional
NEW ITEMS in addition to 1991 is proposed to be collected such
as,
1.
Condition of house
2.
Number of married couples
3.
Number of married couples having independent bedroom
4.
Drainage facilities
5.
Bath room within the house
6.
Kitchen within the house
7.
Possession of radio/transistor/television/teiephone by the
household
8.
Possession of transport equipment such as bicycle/
scooter/motor cycle/moped/car/jeep/van by the household
9.
Banking service availed by the household
5
%
HOUSEHOLD SCHEDULE (will be used at the time of
Population Enumeration during 9th to 28th February 2001)
In the Household Schedule information on the following new items
is proposed to be collected.
1.
Name of the respondent & relationship to Head
2.
Composition of the household
3.
4.
, Number of persons in the age-group 0-6
Number of persons in the household covered under any Life
Insurance Scheme
5.
Food Habits of the household - number of members taking
1
non-vegetarian food
6.
Members in the household aged 60+ requiring physical
support, giving financial support, financially depending and
those help in the household work
7.
I
Number of persons attending school in the age group
(5-14)
8.
Travel to work place - distance, mode of travel and time
taken
9.
Age at marriage for males
10.
Land Tenure
6
I
SLUM ENUMERATION BLOCKS
It is proposed to identify in each State slum areas in all Municipal
Towns having a population of 50,000 or more as per the 1991
Census. Slum Enumeration Blocks with a population size of 650750 each would be formed separately to generate data on slums.
SIZE OF ENUMERATION BLOCKS
During 1991 Census, for the Houselisting Operations the
population size of Rural Blocks was kept between 750 to 1000 in
rural areas and 600 to 800 in urban areas depending on the
operational convenience. For enumeration, it was approximately
around 800 and 700 respectively. For Census of India 2001, the
population size per block would be between 650 and 750 per
Enumerator.
VILLAGE PERMANENT LOCATON CODE NUMBERS
For the first time, village Permanent Location Code Numbers are
being allotted. Location Code is a simple device by which every
area comprised in any administrative unit can’be identified by
assigning specific code numbers for different levels of
administrative units -Permanent location code numbers have been
given to all the 29,454 villages in Karnataka.
Encl : Draft Houselist Schedule, Household Schedule &
Instruction Manual for House numbering and Houselisting
7
1
Prepared by :
H.SHASHIDHAR
Director
Directorate of Census Operations,
Karnataka
1
CENSUS
IS
NEITHER
A
GIGANTIC
MERE
HEADCOUNT NOR A STATISTICAL EXERCISE.
IT IS NOT EVEN A NUMBER GAME.
IT IS MUCH
MORE THAN THAT.
IT IS A MULTI-DIMENSIONAL MOVE FROM NUMBERS
TO POPULATION TO PEOPLE.
CL)
HISTORY OF CENSUS
THE WORD 'CENSUS’ IS DERIVED FROM LATIN WORD ‘CENSERE’ MEANING
‘TO ASSESS’ OR ‘TO RATE’.
* IN THE 3RD CENTURY B.C. - KAUTILYA - COLLECTION OF POPULATION
STATISTICS.
IN THE FIRST/ SECOND CENTURY B.C. - MAGISTRATES IN ROME - TAXES
AND ADULT MALES FOR MILITARY SERVICE.
* IN THE 12/13TH CENTURY, CHENGIS KHAN - PEOPLE OF HIS CONCURRED
TERRITORY.
* AKBAR THE GREAT, IN THE ADMINISTRATION REPORT ANH-AKBARI
INCLUDED COMPREHENSIVE DATA ON POPULATION WEALTH AND OTHER
CHARACTERISTICS.
* IN/H >76^
AMEI UCA
IIVI
tHRSfv efNSUS^ OF NQRTH
IN 1872, THE BRITISH GOVERNMENT - FIRST SYNCHRONOUS CENSUS IN
INDIA. SINCE W, THERE HAS BEEN A CONTINUOUS AND UNBROKEN
CHAIN OF DECENNIAL CENSUSES.
1
SUPERINTENDENTS/
CENSUS
DIRECTORS OF
COMMISSIONERS
CENSUS OPERATIONS OF
OF INDIA_______
KARNATAKA
1871
1881
1891
1901
1911
1921
1931
1941
1951
1961
1971
1981
1991
NO SPECIFIC APPOINTMENT
W.W. PLOWDEN
J.A. BAINS
H.H. RISLEY
EA. GAIT
E.A. GAIT
J.T. MARTEN
J.H. HUTTON
M.W.M. YEATTS
M.W.M. YEATTS
RA GOPALASWAMY
A. MITRA
A. CHANDRASEKHAR
P. PADMANABHA
A.R. NANDA
JAYANT KUMAR BANTHIA
MAJOR. A.W.C. LINDSAY^
LEWIS RICE
V.N. NARASIMIENGAR
T. ANANDA RAO
V.R. THYAGARAJA AIYAR
V.R. THYAGARAJA AIYAR
M. VENKATESHA IYENGAR
P.H. KRISHNA RAO
J.B. MALLARADHYA
SUPERIN
TENDENTS
K. BALASUBRAMANYAMJ
P. PADMANABHA
B.K. DAS
SOBHA NAMBISAN
H. SHASHIDHAR
DIRECTORS
ABOUT CENSUS
“ A CENSUS OF POPULATION MAY BE DEFINED
AS THE TOTAL PROCESS OF COLLECTING,
COMPILING AND PUBLISHING DEMOGRAPHIC,
ECONOMIC AND SOCIAL DATA ON A SPECIFIED
TIME OR TIMES TO ALL PERSONS
IN A
COUNTRY OR DELIMITED TERRITORY ”
- UNITED NATIONS
a
2
ABOUT CENSUS
“ IN FACT IN THESE DAYS YOU CANNOT TAKE
UP ANY SERIOUS ADMINISTRATIVE, ECONOMIC
OR SOCIAL WORK WITHOUT REFERRING TO
THE CENSUS REPORT WHICH IS AN ESSENTIAL
PART OF EVERY ENQUIRY, OF EVERY STUDY.
EVEN FOR SOLUTION OF MINOR PROBLEMS
YOU HAVE OFTEN TO CONSULT THE CENSUS
REPORTS ”
- SRI G.B. PANT
ABOUT CENSUS
“ THE INDIAN CENSUS IS ONE OF THE
COUNTRY’S MOST REMARKABLE EVENTS AND
UNIVERSALLY ACKNOWLEDGED AS THE MOST
AUTHENTIC AND COMPREHENSIVE SOURCE OF
INFORMATION
ABOUT
OUR
LAND
AND
PEOPLE ”
- PROF. S. CHANDRASHEKHAR
3
INDIAN CENSUS DATABASE
“ THE INDIAN CENSUS DATABASE IS HIGHLY MULTI-DIMENSIONAL IN ITS
RANGE AND SCOPE ENCOMPASSING DEMOGRAPHIC, ECONOMIC,
SOCIAL AND CULTURAL CHARACTERISTICS, FERTILITY AND MORTALITY,
NUPTIALITY,
SCHEDULED
CASTE,
TRIBE,
RELIGION,
LANGUAGE,
MIGRATION, EDUCATION, HEALTH, COMMUNICATION, CHILD LABOUR,
HOUSING,
EMPLOYMENT,
AGING,
URBANISATION
INFRASTRUCTURE AND MANY
HOUSEHOLD
AMENITIES,
MORE ISSUES.
M
“ YOU NAME IT, CENSUS HAS IT. ”
-RGIAND CCI,1999
10
UTILITY OF CENSUS
*
IN ADMINISTRATION AND POLICY
FOR RESEARCH PURPOSES
IN BUSINESS AND INDUSTRY
AS FRAME FOR SAMPLE SURVEYS
IN PLANNING
BASIS FOR REPRESENTATION IN PARLIAMENT/
ASSEMBLIES/ URBAN LOCAL BODIES/ PANCHAYAT
RAJ SYSTEM
TO OTHER TYPES OF CENSUSES
4-
TO CIVIL REGISTRATION AND VITAL STATISTICS
E
4
a
f
1
I
Li
IE
1
GROWTH OF WORLD POPULATION, STONE AGE - 2001
■
•
SL. PERIOD
NO.
WORLD POPULATION
IN MILLION (APROX.)
1.
STONE AGE
15
2.
BEGINNING OF
CHRISTIAN ERA
250
3.
1830 AD
1000
4.
1925
2000
5.
1960
3014
6.
1970
3683
7.
1990
4453
8.
2000
6000
9.
2001 (PROJECTED)
6140
GROWTH RATE
IN YEARS
J— IN ABOUT 8000 YEARS - INCREASE BY 18 TIMES
~’ IN 1800 YEARS - INCREASE BY 4 TIMES
— IN 95 YEARS - INCREASE BY 100 PERCENT
— IN 35 YEARS - INCREASE BY 50.2 PERCENT
— IN 10 YEARS - INCREASE BY 22.2 PERCENT
—- IN 20 YEARS - INCREASE BY 21 PERCENT
— IN 10 YEARS - INCREASE BY 34.74 PERCENT
— IN 1 YEARS - INCREASE BY NEARLY 2.5 PERCENT
POPULATION & SURFACE AREA OF
SELECTED COUNTRIES OF THE WORLD (1991)
SL.
NO.
COUNTRY
1.
2.
SURFACE AREA IN MILLION
SQ. KMS. AND PERCENTAGE
TO TOTAL AREA (APROX.)
CHINA
INDIA
3.
USA.
4.
INDONESIA
5.
BRAZIL
6. JAPAN
7.
BANGLADESH
8.
PAKISTAN
9.
GERMANY
10. FRANCE
11. IRAN
12. UNITED KINGDOM
13. IRAQ
14. REMAINING ABOUT
143 COUNTRIES
TOTAL
9.60 (7.00)
3.28
9.37
1.90
8.51
0.38
0.14
0.79
0.35
0.54
1.64
0.24
0.43
98.62
(2.40)
(6.90)
(1.39)
(6.26)
(0.28)
(0.10)
(0.58)
(0.25)
(0.39)
(1.20)
(0.17)
(0.31)
(72)
135.79 (100)
POPULATION IN MILLIONS &
PERCENTAGE
TO POPULATION (APROX.)
1160 (26.00) '
MORE
843 (18.00)
THAN
251 (5.63)
50%
179(4.00) ,
146 (3.27)
123 (2.76)
109 (2.44)
108 (2.42)
80(1.79)
57(1.28)
58(1.30)
57 (1.28)
17(0.38)
1270 (30.00)
4455 (100)
1
■
PERCENTAGE OF SURFACE AREA AND POPULATION
AMONG MAJOR STATES AND UNION TERRITORIES, 1991
STATE/UNION TERRITORY
INDIA
MADHYA PRADESH
RAJASTHAN
AREA IN
SO. KMS.
POPULATION (RANK)
32,87,263(100.00)
4,43,446 (13.48)
8.46 (100)
7.82 (6)
5.20 (9)
9.93 (3)
16.44 (1)
3,42,239 (10.41)
3,07,713 (9.36)
2,94,411 (8.95)
2,75,045 (8.36)
MAHARASHTRA
UTTAR PRADESH
ANDHRA PRADESH
JAMMU & KASHMIR
GUJARAT
1,96,024
(5.96)
7.96 (5)
0.91 (17)
4.88 (10)
KARNATAKA
BIHAR
ORISSA
1,91,791
1,73,877
1,55,707
(5.83)
5.31 (8)
(5.28)
(4.73)
TAMILNADU
1,30,058 (3.95)
88,752 (2.69)
4,65,964 (14.23)
10.21 (2)
3.74 (11)
6.60 (7)
8.04 (4)
2,22,236
WEST BENGAL
REMAINING 14 STATES AND 6 UNION
TERRITORIES
f
(6.76)
13.06
POPULATION GROWTH IN INDIA AND KARNATAKA, 1901 - 2001
CENSUS
YEAR
1901
1911
1921
1931
INDIA
KARNATAKA
TOTAL
PERCENTAGE
POPULATION TO DECENNIAL
(IN MILLION) GROWTH RATE
TOTAL
PERCENTAGE
POPULATION TO DECENNIAL
(IN MILLION) GROWTH RATE
238
252
251
278
1941
318
1951
361
1961
439
548
1971
1981
683
1991
846
2001 (PROJ.)1012
♦ 5.75
- 0.31
+ 11.00
+14.21
+13.31
+ 21.51
+ 24.80
+ 24.66
+ 23.85
+19.62
13.00
13.52
13.37
14.63
16.25
19.40
23.50
29.29
37.13
44.97
52.72
+ 3.60
- 1.09
+ 9.38
+ 11.09
+19.36
+ 21.57
+ 24.22
+ 26.75
♦ 21.12
+17.23
2
DENSITY OF POPULATION PER SQ. K.M.,
IN INDIA AND KARNATAKA, 1901 - 2001
IN OTHER COUNTRIES, 1991
CENSUS YEAR
1901
1911
1921
1931
1941
1951
1961
1971
1981
1991
2001
(PROJ.)
DELHI
CHANDIGARH (UT)
INDIA
KARNATAKA
77
82
67
81
90
103
117
142
177
69
76
85
101
216
267
305
70
126
153
193
235
275
SL
NO.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
COUNTRY
DENSITY
AUSTRALIA
CANADA
BRAZIL
USA.
AUSTRIA
INDONESIA
FRANCE
CHINA
PAKISTAN
GERMANY
U.K.
SRILANKA
JAPAN
BANGALDESH
2
3
7
27
93
94
104
121
137
223
236
261
327
745
6352 HIGHEST
5632
BROAD AGE COMPOSITION IN
INDIA AND KARNATAKA, 1991
(PERCENTAGE TO TOTAL POPULATION)
INDIA
KARNATAKA
37.25
9.43
36.02
9.80
9.08
AGE GROUP
0-14
15-19
20-24
25-29
30-39
40-49
50-59
60+
AGE NOT STATED
TOTAL
8.88
8.26
8.45
13.21
6.27
6.76
0.56
13.37
9.54
6.21
6.99
0.54
100.00
100.00
9.38
a
3
POPULATION BY SEX IN INDIA AND KARNATAKA, 1991-2001
INDIA
KARNATAKA
YEAR
MALE
FEMALE
MALE
FEMALE
1991
51.8
48.2
51
49
2001
(PROJ)
51.6
48.4
51
49
ARE THE NUMBER OF MEN AND WOMEN BALANCED?
SEX RATIO IN INDIA AND KARNATAKA, 1901 -1991
SEX RATIO IN A FEW DEVELOPED COUNTRIES
CENSUS YEAR
INDIA
1901
1911
1921
1931
1941
1951
1961
1971
1981
1991
972
964
955
950
945
946
941
930
935
927
KARNATAKA
983
981
969
965
960
966
959
957
963
960
REASONS FOR LOW SEX RATIO IN INDIA
♦ PREFERENCE TO MALE BABIES
♦ LOWER EXPECTATION OF LIFE AT BIRTH FOR GIRLS
♦ HIGH MORTALITY RATES
♦ BIOLOGICALLY SEX SELECTIVE
♦ FEMALE INFANTICIDE
♦ MIGRATION OF MALE MEMBERS
♦ STATUS OF WOMEN
SL.NO. COUNTRY
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
U.S.A.
RUSSIA
JAPAN
AUSTRIA
GERMANY
ITALY
U.K.
MEXICO
CANADA
GREECE
AUSTRALIA
FRANCE
INDIA
DENSITY
1031
1135
1037
1077
1073
1059
1047
1037
1017
1029
1003
1054
927
4
PROPORTION OF RURAL/ URBAN POPULATION
IN INDIA AND KARNATAKA (IN PERCENT), 1981 - 91
INDIA
KARNATAKA
YEAR
RURAL
URBAN
RURAL
URBAN
1981
76.66
23.34
71.11
28.89
1991
74.29
25.71
69.08
30.92
I®.
NUMBER OF VILLAGES AND TOWNS
IN INDIA AND KARNATAKA, 1901-1991
INDIA
KARNATAKA
NO. OF
%
YEAR VILLAGES GROWTH
RATE
1901
1911
1921
1931
1941
1951
1961
1971
1981
1991
29,349
29,533
29,390
(- 0.48)
29,193
(- 0.67)
NO. OF
TOWNS
219
183
197
215
212
289
231
245
281
306
%
GROWTH
RATE
(+ 14.69)
(+ 8.89)
NO. OF
%
NO. OF
VILLAGES GROWTH TOWNS
RATE RATE
6,05,224
6,27,616
1916
1908
2048
2220
2427
3060
2700
3126
4029
(+ 3.69) 4689
%
GROWTH
(+ 28.88)
(+ 16.38)
5
■%
(
5
•J
•i
!
£■ : •
<s>
1
CENSUS OF INDIA 2001
“ THE 2001 CENSUS WILL BE THE 14TH DECENNIAL CENSUS,
SINCE 1871 AND THE 6TH CENSUS SINCE INDEPENDENCE. ITS
SIGNIFICANCE LIES IN THE FACT THAT IT COMES AT THE
COMMENCEMENT OF NOT ONLY THE NEXT CENTURY BUT ALSO
THE NEXT MILLENNIUM. AS IT PROVIDES A TURNING POINT IN
HISTORY, THE 2001 CENSUS MAY BE DESCRIBED AS THE
MILLENNIUM CENSUS.
IT WILL SERVE AS A HISTORIC
BENCHMARK ON THE STATE OF THE NATION’S SOCIETY,
DEMOGRAPHY AND ECONOMY. “
- RGI AND CCI
IMPORTANT PHASES - 2001 CENSUS
I.
PRELIMINARY PHASE OR
HOUSE LISTING OPERATION
8TH MAY TO 6TH JUNE, 2000
IN KARNATAKA
a. HOUSE NUMBERING
b. HOUSE LISTING
II.
MAIN PHASE OR ENUMERATION IN THE COUNTRY
a. ACTUAL ENUMERATION
STH TO 28TH FEBRUARY, 2001
b. ENUMERATION FOR
HOUSELESS HOLDS
NIGHT OF 28TH FEBRUARY, 2001
c. REVISIONAL ROUND
1ST TO STH MARCH, 2001
d. REFERENCE DATE
1ST MARCH, 2001
to
1
PREPARATIONS FOR THE PRELIMINARY PHASE OR
HOUSELISTING OPERATION, CENSUS 2001
I.
CENSUS CALENDAR FOR KARNATAKA
II.
FINALISATION OF RURAL AND URBAN FRAME
29,193 (1991)
TO
29,454 (2001)
1. STATUTORY
179 (1991)
TO
226 (2001)
2. NON STATUTORY
OR
CENSUS TOWNS
127 (1991)
TO
44 (2001)
a. VILLAGES
b. TOWNS
306
270
PREPARATIONS FOR THE PRELIMINARY PHASE OR
HOUSELISTING OPERATION, CENSUS 2001
III.
PRETEST WAS CONDUCTED IN JULY/AUGUST, 1999
IV.
APPOINTMENT OF CENSUS OFFICERS/ OFFICIALS
A. OFFICERS
B. OFFICIALS - BELOW CHARGE OFFICERS
C. CENSUS HIERARCHY
V.
TRANSLATION INTO KANNADA AND OTHER LANGUAGES
A. INSTRUCTIONS MANUAL
B. HOUSEUST SCHEDULE
C. HOUSELIST ABSTRACT
2
CHANGE IN THE SIZE OF
ENUMERATION BLOCKS, 2001 CENSUS
1991
RURAL AREAS - 750 T01000 POPULATION/BLOCK/
ENUMERATOR
URBAN AREAS - 600 TO 800 POPULATION/BLOCK/
ENUMERATOR
2001
RURAL OR URBAN - 600 TO 650 POPULATION/BLOCK/
ENUMERATOR
CREATION OF SLUM ENUMERATION BLOCK, 2001 CENSUS
A.
IDENTIFICATION OF SLUMS IN ALL MUNICIPAL TOWNS
HAVING A POPULATION OF 50,000 OR MORE AS PER 1991
CENSUS
B.
CREATION OF ENUMERATION BLOCKS EXCLUSIVELY
FOR SLUMS
C.
600 TO 650 POPULATION/ BLOCK/ ENUMERATOR
24
3
ADOPTION OF PERMANENT LOCATION CODE NUMBERS TO
STATES/ DISTRICTS/ VILLAGES, 2001 CENSUS
1.
PLCN FOR 26 STATES AND 6 UTs PLCN FOR KARNATAKA
2.
01 TO 32
- 26
PLCN FOR 27 DISTRICTS IN KARNATAKA - 01 TO 27
BELGAUM - 01,
BANGALORE - 20,
CHAMARAJANAGAR - 27
3.
PLCN FOR TALUKS IN EACH DISTRICT IN KARNATAKA
ADOPTION OF PERMANENT LOCATION CODE NUMBERS TO
STATES/ DISTRICTS/VILLAGES, 2001 CENSUS
4.
PLCN FOR 29,454 VILLAGES IN KARNATAKA EIGHT DIGITS - 0000-0000
PLCN FOR FIRST VILLAGE - 00000100 - 26/01/01/100 (EB)
PLCN FOR LAST VILLAGE - 02945400 - 26/ 27/ 04/ 02945400 (EB)
5.
HOW TO GIVE PLCN FOR TOWNS & CITIES?
/
STATE
26
/
DISTRICT
20
/ CITY OR TOWN /
/
IX
KARNATAKA / BANGALORE / BANGALORE /
I
DN. OR WARD
1 TO 100 (EB)
DN. OR WARD
MC
3.
4
CHANGES IN CENSUS SCHEDULES, 2001 CENSUS
1.
HOUSELIST SCHEDULE
2.
HOUSEHOLD SCHEDULE
1
AND
3.
INDIVIDUAL SLIP
X
DELETED
27
NEW ITEMS IN THE
HOUSELIST SCHEDULE, 2001 CENSUS
1.
CONDITION OF HOUSE
2.
NUMBER OF MARRIED COUPLES
3.
NUMBER OF BED ROOMS
4.
DRAINAGE FACILITIES
5.
BATH ROOMS WITHIN THE HOUSE
6.
KITCHEN WITHIN THE HOUSE
7.
SOURCE OF LIGHTING
8.
hSuXholdN °F rad,o/trans,stor/ T.V./ TELEPHONE BY THE
9.
10.
BANKING SERVICE AVAILED BY THE HOUSEHOLD
FIRST TIME IN THE
5
NEW ITEMS IN THE
HOUSEHOLD SCHEDULE, 2001 CENSUS
1.
COMPOSITION OF HOUSEHOLD
2.
NUMBER OF PERSONS IN THE HOUSEHOLD COVERED UNDER ANY LIFE
INSURANCE SCHEME
3.
FOOD HABITS OF THE HOUSEHOLD - NUMBER OF MEMBERS TAKING NON
VEGETARIAN FOOD BY SEX
4.
MEMBERS IN THE HOUSEHOLD AGED 60+ REQUIRING PHYSICAL
SUPPORT, GIVING FINANCIAL SUPPORT, FINANCIALLY DEPENDING AND
THOSE HELP IN HOUSEHOLD WORK
5.
NUMBER OF PERSONS ATTENDING SCHOOL IN THE AGE GROUP (5-14)
6.
TRAVEL TO WORK PLACE - DISTANCE, MODE OF TRAVEL AND TIME TAKEN
7.
AGE AT MARRIAGE FOR MALES
DATA ON THE ABOVE ITEMS ARE BEING COLLECTED FOR THE FIRST TIME IN THE
^HISTORY OF CENSUS, INDIA
ABOUT CENSUS
“ APART FROM BEING A MAJOR ADMINISTRATIVE FEAT, IN
A COUNTRY OF INDIA’S SIZE AND DIVERSITY, THE CENSUS
POSSESSES AN INTELLECTUAL VALIDITY TO PLANNERS,
POLICY
MAKERS,
RESEARCHERS,
ADDRESS
ECONOMISTS,
ADMINISTRATORS
THEMSELVES
TO
STATISTICIANS,
AND
EVERY
OTHERS
TO
CHANGE,
DEMOGRAPHIC, DEVELOPMENT, SOCIAL AND ECONOMIC
QUESTIONS OF OUR COUNTRY ”
“ IT IS A MONUMENTAL AFFAIR
n
- ASHISH BOSE
30] —
6
1
CENSUS HOUSES AND THE USES TO WHICH
THEY ARE PUT IN KARNATAKA, 1981-1991
SL.
NO.
NO. OF CENSUS
HOUSES USED AS
1.
2.
\
CENSUS HOUSES VACANT
RESIDENCE
SHOP CUM RESIDENCE
WORKSHOP, FACTORY
CUM RESIDENCE +
HOUSEHOLD INDUSTRIES ETC
HOTELS, DHARMASALAS
TOURIST HOUSES, IB ETC.
SHOPS (EXCLUDING
EATING PLACES
BUSINESS HOUSES, OFFICES
FACTORIES, WORKSHOPS
WORKSHEDS ETC.
RESTAURANTS, SWEET MEAT
SHOPS, EATING PLACES
PLACES OF ENTERTAINMENT &
COMMUNITY GATHERINGS
OTHER PLACES
28.55
30.22
16.61
- 13.00
TOTAL NO. OF CENSUS HOUSES
28.55
3.
4.
5.
6.
7.
8.
9.
10.
11.
31
PERCENTAGE OF
VARIATION (1981-91)
0.01
49.19
48.42
63.93
49.20
0.01
14.63
PUCCA AND KUTCHA HOUSES IN KARNATAKA, 1991
(IN PERCENT)
STATE/
TOTAL
KUTCHA
PUCCA
DISTRICT
CENSUS
HOUSES
HOUSES
56,88,935
49,25,915
14.91
85.09
71.23
59.71
HOUSES
KARNATAKA
BANGALORE
BIDAR
KOLAR
1,06,14,850
28.77
40.29
HIGHEST % PUCCA
HOUSES
REMAINING 14 DISTRICTS FALL HERE
RAICHUR
78.21
BIJAPUR
HASSAN
76.70
21.79
23.30
76.17
23.83
LEAST % PUCCA
HOUSES
32)
1
HOUSEHOLDS BY TENURE STATUS IN KARNATAKA; 1991
(PER THOUSAND)
OWNED
RANK
DISTRICT
RENTED
NO.
DISTRICT
NO.
1
BIDAR
912
BANGALORE
525
2
MANDYA
880
KODAGU
372
3
TUMKUR
874
CHIKMAGALORE
222
KARNATAKA
202
REMAINING 14 DISTRICTS FALL HERE
18
SHIMOGA
806
HASSAN
138
628
BANGALORE (R)
126
475
BIDAR
88
KARNATAKA
798
19
KODAGU
20
BANGALORE
33
HOUSEHOLD BY NUMBER OF ROOMS
IN KARNATAKA, 1971 -1991
(PER THOUSAND)
NO. OF
1971
1981
1991
1
490
398
357
2
315
324
348
3
112
115
145
4
83
117
121
32
41
ROOMS
UNSPECIFIED
3
2
1
HOUSEHOLDS BY NUMBER OF ROOMS IN KARNATAKA, 1991
(PER THOUSAND)
RANK
ONE ROOM
TWO ROOMS
THREE ROOMS
FOUR ROOMS & ABOVE
1
RAICHUR
495
U.K.
395
SHIMOGA
243
KODAGU
408
2
BIDAR
464
DHARWAD
391
U.K.
217
D.K.
286
3
BELLARY
429
BIJAPUR
389
KODAGU
211
RAICHUR
245
KARNATAKA
357
18
U.K.
158
D.K.
297
BIDAR &
BELLARY
100
MANDYA
71
19
SHIMOGA
127
KODAGU
285
MYSORE
102
BELLARY
64
20
KODAGU
94
KOLAR
275
RAICHUR
92
MYSORE
56
348
137
117
7
REMAINING 14 DISTRICTS FALL BETWEEN SL. NO. 3 AND 18
SIZE OF HOUSEHOLDS BY THE
NUMBER OF MEMBERS - KARNATAKA, 1981-91
(PER THOUSAND)
NUMBER OF
MEMBERS IN
A HOUSEHOLD
1981
1991
1-2
124
111
3-5
399
459
6+
477
310
9+
i
120
36.
3
I
SIZE OF HOUSEHOLDS BY THE NUMBER OF
MEMBERS - KARNATAKA, 1991
(PER THOUSAND)
RANK
1 TO 2 MEMBERS
1
KODAGU
2
U.K.
3
RAICHUR
KARNATAKA
3 TO 5 MEMBERS
6 TO 8 MEMBERS
9 AND ABOVE
159
KODAGU
573
BIDAR
378
BIJAPUR
168
133
BANGALORE
541
GULBARGA
350
BIDAR
167
123
CHIKMAGALUR 511
BiJAPUR
335
DK
163
111
459
310
120
18
SHIMOGA
98
GULBARGA
393
CHIKMAGALUR 290
CHIKMAGALUR 87
19
HASSAN
97
BIJAPUR
381
BANGALORE
261
BANGALORE
79
BIDAR
83
BIDAR
372
KODAGU
220
KODAGU
48
20
REMAINING 14 DISTRICTS FALL BETWEEN SL. NO. 3 AND 18
37
“c^Cs“
THESE THREE FACILITIES, 1991
RANK
ELECTRICITY
SAFE DRINKING WATER
TOILET
NONE OF THESE THREE
FOR INDIA & KARNATAKA
1
BANGALORE 79.40
KOLAR
2
BELGAUM
59.37
CHITRADURGA 88 10
D.K.
34.06
RURAL
URBAN
3
KOLAR
57.96
BLR (R)
KODAGU
32.12
31.32
5.41
KARNATAKA
52.47
INDIA
24.13
23.55
KARNATAKA
89.78
86.51
BANGALORE 72.86
71.68
18
KODAGU
36.28
BELGAUM
64.23
BIDAR
10.28
19
GULBARGA
35.91
GULBARGA
62.98
RAICHUR
7.32
20
RAICHUR
32.51
BIDAR
60.46
BIJAPUR
6.95
INDIA
30.54
- INDIA
RURAL
URBAN
19.93
4.13
55.54
REMAINING 14 DISTRICTS FALL BETWEEN SL. NO. 3 ANdTb
4
«
PERCENTAGE DISTRIBUTION OF HOUSEHOLDS
BY TYPE OF FUEL USED FOR COOKING IN
KARNATAKA AND INDIA, 1991
KARNATAKA
INDIA
TYPE OF FUELS
TOTAL
RURAL
URBAN
TOTAL
RURAL
URBAN
WOOD
78.58
94.43
43.36
61.50
71.69
32.74
KEROSENE
9.78
1.23
28.78
7.16
1.34
23.62
COOKING GAS
6.35
0.73
18.84
7.94
1.22
26.93
ELECTRICITY
1.86
0.35
5.22
0.31
0.16
0.72
BIOGAS
1.17
0.76
2.07
0.49
0.43
0.68
COWDUNG CAKE
1.16
1.44
0.54
15.39
19.60
3.51
CHARCOAL
0.08
0.04
0.17
0.77
0.41
1.77
COAL/COKE/LIGNITE
0.04
0.02
0.09
3.47
1.54
8.95
OTHERS
0.99
1.01
0.93
2.91
3.59
1.00
PERCENTAGE OF HOUSELESS POPULATION AND
HOUSELESS HOUSEHOLDS IN KARNATAKA, 1991
STATE/
DISTRICT
TOTAL
RURAL
URBAN
KARNATAKA
TOTAL
RURAL
URBAN
30,433
15,870
14,563
(100.00)
(52.00)
(48.00)
1
BANGALORE
TOTAL
5,175
(17.00)
12,158
(11.36)
2
BELGAUM
TOTAL
2,511
(8.25)
10,148
(9.48)
3
DAKSHIN KANNADA TOTAL
2,830
(9.29)
9,592
(8.96)
RANK
NO. OF HOUSELESS
HOUSEHOLDS
HOUSELESS
POPULATION
1,06,935 (100.00)
64,207 (60.00)
42,728 (40.00)
REMAINING 14 DISTRICTS FALL HERE
18
HASSAN
TOTAL
703
(1.30)
3,190
(2.98)
19
BANGALORE (R)
TOTAL -
729
(2.39)
2,493
(2.33)
20
KODAGU
TOTAL
402
(132)
1,576
(149)
40]
5
r
WORK, PARTICIPATION
I
MIGRATION
>
FERTILITY, MORTALITY, INFANT MORTALITY,
EXPECTANCY AT BIRTH, MEAN AGE AT
MARRIAGE BY EDUCATION AND BY RELIGION
>
SCHEDULED CASTES AND TRIBES
>
LITERACY
>
LANGUAGE
>
RELIGION
/
i
/
1
!
1
PERCENTAGE OF MAIN WORKERS, MARGINAL WORKERS
AND NON-WORKERS IN INDIA AND KARNATAKA, 1991
^CATEGORY
INDIA
KARNATAKA
MAIN WORKERS
I
CULTIVATORS
13.13
13.15
II
AGRICULTURAL LABOURERS
9.04
11.12
III
LIVESTOCK, FORESTRY etc.
0.65
1.37
IV
MINING QUARRYING
0.21
0.26
0.83
V (b) OTHER THAN HOUSEHOLD INDUSTRY 2.65
0.72
Vi
0.66
0.95
V(a) HOUSEHOLD INDUSTRY
CONSTRUCTION
3.40
VII
TRADE & COMMERCE
2.55
3.07
VIII
TRANSPORT, STORAGE &
COMMUNICATIONS
0.96
1.01
IX
OTHER SERVICES
3.50
3.40
MARGINAL WORKERS
3.32
3.54
NON-WORKERS
62.50
58.01
41
REASONS FOR MIGRATION
TO URBAN AREAS IN KARNATAKA, 1991
(IN PERCENT)
SL.NO.
REASONS
MALES
FEMALES
1,
EMPLOYMENT
37.91
5.04
2.
BUSINESS
5.37
0.63
3.
EDUCATION
9.42
2.82
4.
FAMILY MOVED
24.71
28.11
5.
MARRIAGE
1.46
47.82
6.
NATURAL CALAMITIES
0.63
0.28
7.
OTHERS
20.50
15.30
100.00
100.00
TOTAL
/
J
x>
r
PERCENTAGE OF MIGRANTS TO TOTAL POPULATION IN THE
STATE OF KARNATAKA ACCORDING TO PLACE OF BIRTH, 1991
TOTAL
MIGRANTS AT
THE PLACE OF
ENUMERATION
RANK
MIGRANTS
FROM
WITHIN
THE STATE
MIGRANTS
FROM
OTHER
STATES
MIGRANTS
FROM
OUTSIDE
INDIA
1.
KODAGU
44.66
KODAGU
36.14
BLR
11.50
U.K.
0.30
2.
DHARWAD
36 13
DHARWAD
34.89
KODAGU
8.05
KODAGU
0.25
3.
CHIKMGLR
35.65
CHIKMGLR
33.26
BELLARY
5.77
BLR
0.21
KARNATAKA
29.57
18.
GULBRG
24.42
RAICHUR
18.97
DHARWAD
1.15
HASSAN
0.03
19.
RAICHUR
22.29
BLR
17.96
BLR (R)
1.00
SHIMOGA
0.02
20.
BLR (R)
17.54
BLR (R)
16.34
HASSAN
0.93
BIDAR
0.01
25.71
0.09
3.68
REMAINING 14 DISTRICTS FALL BETWEEN SL. NO. 3 AND 18
FERTILITY INDICATORS - INDIA
(LIVE BIRTHS PER THOUSAND WOMEN)
CENSUS DATA ON BIRTHS
1901-2001
SRS DATA ON BIRTHS (1989)
STATE/UNION TERRITORY
RATE
UTTAR PRADESH
MADHYA PRADESH
BIHAR
RAJASTHAN
37.0
35.1
34.4
33.9
CENSUS YEAR
RATE
1901
49.2
1951
42.7
1991
29 5
D & HAVELI (UT), ARUNACHAL PRADESH, HARYANA. SIKKIM,
MEGHALAYA, J & K, ORISSA
2001
(PROJ.)
24.0
INDIA
29.5
ASSAM, L. DWEEP (UT), GUJARAT, PUNJAB & MAHARASHTRA
KARNATAKA
27.9
DAMAN AND DIU (UT), HIMACHAL PRADESH, DELHI, W.B.,
TRIPURA, A R., TAMILNADU, CHANDIGARH (UT), MANIPUR,
PONDICHERRY (UT), A & N ISLANDS (UT), NAGALAND
KERALA
GOA
19.8
15.5
-
2
MORTALITY INDICATORS - INDIA
(PER THOUSAND POPULATION)
CENSUS DATA ON DEATHS
1901-2001
SRS DATA QN DEATHS (1989)
STATE/UNION TERRITORY
RATE
12.8
12.6
12.6
12.1
CENSUS YEAR
RATE
1901
49.20
MADHYA PRADESH
ORISSA
UTTAR PRADESH
BIHAR
1951
22.80
MEGHALAYA. RAJASTHAN, ARUNACHAL PRADESH, ASSAM
1991
9.80
2001
(PROJ)
8.99
10.2
INDIA
GUJARAT, A.P., SIKKIM, H P.
8.7
KARNATAKA
W.B., TAMILNADU, D & N, HAVELI (UT). HARYANA, PUNJAB,
DAMAN & DIU (UT), J & K, MAHARASHTRA, GOA, TRIPURA,
PONDICHERRY (UT), TRIPURA, MANIPUR, DELHI, L. DWEEP
KERALA
ANDAMAN ISLANDS, NAGALAND
CHANDIGARH (UT)
S-
5.9
3.8
INFANT MORTALITY IN INDIA
(PER THOUSAND LIVE BIRTHS)
CENSUS DATA ON INFANT MORTALITY
1901-2001
MAJOR STATES
RATE
218
ORISSA
UTTAR PRADESH
MADHYA PRADESH
RAJASTHAN
122
118
117
96
INDIA, ASSAM, BIHAR
91
CENSUS YEAR
MALES
FEMALES
1901
290
284
1951
235
1991
85
82
2001
63
64
(PROJ.)
SRS DATA ON INFANT MORTALITY (1989)
GUJARAT, HARYANA, A.P.
KARNATAKA
80
W.B., HIMACHAL PRADESH, J & K
TAMILNADU, PUNJAB, MAHARASHTRA
KERALA
22
46]
3.
■ ?.
EXPECTANCY OF LIFE AT BIRTH, INDIA
CENSUS DATA ON
EXPECTANCY OF LIFE AT BIRTH
1901-2001
CENSUS YEAR
MALES
1901
22.59
23.31
1951
41.89
40.55
1991
59.00
59.40
2001
62.36
63.99
FEMALES
FOR MAJOR STATES -1993
KERALA
PUNJAB
MAHARASHTRA
TOTAL
MALES
FEMALES
72.0
66.4
64.2
68.8
65.2
63.0
74.7
67.6
65.4
HIMACHAL PRADESH, HARYANA, TAMILNADU
KARNATAKA
61.9
60.2
63.5
WEST BENGAL, ANDHRA PRADESH, GUJARAT
(PROJ.)
INDIA
59.4
59.0
59.7
BIHAR, RAJASTHAN, U P., ORISSA, ASSAM
MADHYA PRADESH 54.0
54.1
53.8
MEAN AGE AT MARRIAGE OF WOMEN BY
RELIGION IN INDIA AND KARNATAKA, 1991
20.5 j20.0 —
---- ------------------ !
V
O)
19.5
E
19.0 —
2
w
&co
1
18 5
-
18.0 -
17.0 165 ■ —
16.0 —
Hindus
Muslims Christians
j E INDIA
Sikhs
Buddhists
Jains
Others
KARNATAKA ]
4
>
5
MEAN AGE AT MARRIAGE OF WOMEN BY
EDUCATIONAL LEVEL IN INDIA AND KARNATAKA, 1991
25.0 f-------
? *
20.0
15.0
15
8. 10.0 —
CO
c
i 5.0
0.0
All women
Illiterate
MM
LM
LM Literate but below middle. MM MkMfe but below mstric,
and below
GA
MG
MG. MkMIe but below graduate, GA: Graduate
INDIA ■ KARNATAKA]
SCHEDULED CASTES AND SCHEDULED TRIBES
IN INDIA AND KARNATAKA (PERCENT), 1991
GENERAL CATEGORY
SL.
NO. PARAMETERS
SCHEDULED CASTE
SCHEDULED TRIBE
INDIA
KARNATAKA
INDIA
KARNATAKA
75.44
79.36
16.48
16.38
8.08
4.26
28.12
71.88
30.92
69.08
11.99
18.04
23.40
76.60
2.32
10.08
14.94
85.06
1981
1991
43.67
52.21
46.21
56.04
21.38
37.41
20.59
38.06
16.35
29.60
20.14
36.01
4. SEX RATIO
927
960
922
962
972
961
1.
PERCENTAGE
TO TOTAL
POPULATION
INDIA
KARNATAKA
2. POPULATION
DISTRIBUTION BY
URBAN/ RURAL
AREAS
A : URBAN
B: RURAL
3.
LITERACY RATES
50)
5
«
HOW MANY OF US CAN READ AND WRITE?
LITERACY RATE IN INDIA, 1951 - 1991
(IN PERCENT)
CENSUS
TOTAL
YEAR
PERSONS
MALES
FEMALES
1951
18.33
27.16
8.86
IN 1991
1961
28.31
40.40
15.34
♦ KERALA (89.8) HAS
RECORDED HIGHEST
1971
34.45
45.95
21.97
♦ KARNATAKA (56.04) IS ABOVE
THE NATIONAL AVERAGE
1981
41.42
53.45
28.46
1991
52.11
63.86
39.42
I
* BIMARU STATE - BIHAR
(38.46), MP. (44.20),
RAJASTHAN (38.55) AND UP.
(41.60) HAVE LOWEST
LITERACY RATES
51
LITERACY RATES IN KARNATAKA (IN PERCENT)
SL.
NO.
1.
2.
3.
STATE/tt.
LITERACY RATES X.
19d1
DISTRICT
RATE OF GROWTH
F OF LITERACY, (1^81-91)
----- w—
—r<---#—
J
26.13
BANGALORE
DAKSHIN KANNADA
KODAGU
76.27 (1)
75.86 (2)
68.35 (3)
20.20
15.83
UTTARA KANNADA, SHIMOGA, CHIKMAGALUR. DHARWAD.HASSAN
r
KARNATAKA
21.27
56.04
CHITRADURGA, BIJAPUR, TUMKUR, BELGAUM,
.........................
INDIA
.................................................................................................................................................... .............
.J ■
-----------------------------------------------------------
■
52.21
52.11
KOLAR, BANGALORE RURAL, MANDYA, MYSORE, BELLARY
18.
19.
20.
BIDAR
GULBARGA
RAICHUR
45.11 (18)
38.54 (19)
35.96. (20)
.
40.22
26.86
19.35 ,
I
52
I.
6
I
DISTRIBUTION OF LANGUAGES IN KARNATAKA, 1991
(inclusive of other Mother tongues grouped under each)
specified in Schedule VIII to the Constitution of India
53
SL.
NO.
NAME OF THE
LANGUAGE
NUMBER OF
SPEAKERS
PERCENTAGE
1.
2.
3.
4.
5.
6.
7
8.
9
10.
11.
12.
13.
14.
15.
16.
17.
18.
KANNADA
URDU
TELUGU
TAMIL
MARATHI
HINDI
MALAYALAM
KONKANI
GUJARATHI
BENGALI
SINDHI
PUNJABI
ORIYA
NEPALI
KASHMIRI
ASSAMESE
SANSKRIT
MANIPURI
29,785,004
4,480,038
3,325,062
1,728,361
1.640,020
885,251
757,030
706,397
53,785
20,926
13,930
13,824
5,474
4,702
1,140
829
695
272
66.22
9,96
7.39
3.84
3.65
1.97
1.68
1.57
0.12
0.05
0.03
0.03
0.01
0.01
N
N
N
N
DISTRIBUTION OF LANGUAGES IN KARNATAKA, 1991
(inclusive of other Mother tongues grouped under each)
other than those specified in Schedule VIII to the Constitution of India
ADI, ANGAMI, AO, ARABIC/ ARBI, BHILI/ BHILODI,
BHOTIA, BODO/BORO, COORGI/KODAGU.DOGRI,
ENGLISH, GANGTE, GARO, GONDI, HALABI, HO,
JATAPU, KARBI/ MIKRI, KHANDESHI, KHARIA,
KHASI, KISAN, KODA/ KORA, KONAYAK, KOM,
KORWA, KOYA, KUI, KUKI, KURUKH/ ORAON,
15,54,461
= 3.47%
LAHNDA, LIMBU, LOTHA, LUSHAI/ MIZO, MISHMI,
MONPA, MUNDA, MUNDARI, NICOBARES, POITE,
SANTALI, SHERPA, SEMA, TANGKHUL, THADO,
TIBETAN, TRIPURI, TULU, OTHERS.
7
i
PROPORTION OF POPULATION
BY MAJOR RELIGIONS OF
KARNATAKA AT SELECTED CENSUS YEARS
RELIGIONS
1991
1981
1971
1961
1951
1931
1911
HINDUS
85.45
85.77
86.46
87.26
87.03
87.70
88.60
MUSLIMS
11.64
11.21
10.63
9.87
10.05
9.36
8.64
CHRISTIANS
1.91
2.08
2.09
2.07
2.16
1.63
1.31
JAINS
0.73
0.77
0.75
0.74
0 72
0.76
0.69
BUDDHISTS
0.16
0.11
0.05
0.04
0.01
0.02
0.01
SIKHS
0.02
0.02
0.02
0.02
0.02
N
N
[55)
PERCENTAGE DISTRIBUTION OF POPULATION
BY RELIGIONS IN INDIA & KARNATAKA -1991
INDIA
KARNATAKA
PERCENTAGE TO
TOTAL POPULATION
PERCENTAGE TO
TOTAL POPULATION
HINDUS
82.00
85.45
2.
MUSLIMS
12.12
11.64
3.
CHRISTIANS
2.34
1.91
4.
SIKHS
1.94
0.02
5.
BUDDHISTS
0.76
0.16
6.
JAINS
0.40
0.73
7.
OTHER RELIGIONS &
PERSUATIONS
0.39
0.01
8.
RELIGIONS NOT STATED
0.05
0 08
SL.
NO.
RELIGIOUS
COMMUNITIES
1.
56
8
\
PROCSBDINGS
OP
GeVERNMBNC -GF
•s*
Census of India, 2001 - Coustimdou of
Census Co-ordinadon Ccmnduee
■y~\
D :
•I-LARNATAKA
D.O.letter No.TCH 9 CPO. 99-Cvol.il) dated ...-r“
of the Director cf Census Operations m naiaauu-.a,
Bamtrdorc. Government cf India. Ministry c- nc^c mxaus
addressed to the Chief Secretary to Govermricui.
of Karnsraita, Bmgaican.
PREAMBLE
. .T-'n- Hov^listinq Operations which, is me rest phase Oi me ^va
cr
chmts of India 2001 is scheduled to be conducted between Sth Km
^mh'bune, 2000 mrouglmut the State. ' The orgamsnmnm worn
.
'
connected with Houselisting Operations involves amir, mages mmjis --•• be completed according to the schedule as pm -me
m=.-.-m ....
‘ . .
- f.
q-.’c operations--------- - ------ - ------- - ------------------
.
.
.
n CG~mi:
In the first n.e -mg cf me State In
held cn 5.1.2CCJ at Fjcm^mois it ■•-•tgs i
co-civiutadon cornea dees at 'die district levels ?_so u
of Deputy Commission rs -Principal Census Officers:.
cons Lino.
1 CQLisif er^h
The Government cf Kamataha, umreioie,
this nropesai hereby orders as follows :
• DATmD .G-p^v.m.y-yco-'
horise/empower me Depur*
Crevenii~en- oi
is ; easec. to a:
hnsus Cc-crdmamm
bee Districts
Ccm-nis sinners of
ot tne
Disnncts to co-sl rhe gTiidehues am.',
. ■Committees at. the District level with a J:e7
horns, Kamamka. from
instructions issued•' bv
by the D
Dirsctcr c-t Tenses
ier
mid rare b-’- ail the
time to tune are impiementen vnth uimosL yrcm
departments concerned.
The Cc-^ — htee may comprise of the loilov.m
1. Depum Com issioner & Pi"ci 1 Census
Officer
. . .
2. Chief Executive Officer Additional Rrmc-pal
Census Officer
3. District Superintendent of Police
4. District Forest Officer
T3
Ch sAOjHT-
Vice- Chain nan
I
5. District HcMlh Ofbeer
'
rn,,:.
6. Joint Dirceiur/Deputy Director ot mun.
Member
7 JSWCW/IWW Di-ciorofCoiDgmtc
8-. Cohd^k-lcdbcpuly Director bMgncurmk
'' Member
Me: liber
.. Member
i Member
Men.’!j ci'
Members
Convenor
9. District InlbimaLion &, Publicity OL!1C<7
10. Dcpn'v Director ol Vvoinm atid Cbi... wum...
11. All Assis(;.!:il CimnnissMsicrs M DistnM
•2. Secretary Mass Ednc.Mion
13. District Statistical. Olkccr
"4-. Ofilcials of dvr d in ere a i N<iOs
13. ilcadqumlem Assisinai to Deputy
Co in mission er
Tbc Commit ice ;
• :i:« c
; it ’ i i ‘J bl. I c / rev ;:J
?. work
' * -- ‘ * cG-ordinnle i'-
M i -1
or nn
— (talc
ucmbm.sboll be allotted a rural charge
Each
CM.cc
’
.
M’^inS
C-5
Local bedy] Mf supcivising, moni-o ng anc
large ; .bar.
for kinooth conduce .01 Census
bi
rhat
Charge
c ns cis autiioriucs
oroncr tiarmng
train mg is ijm-s.-Meu *■•.•
mdons. ! -c/shc s i in i 1 niso see t’uuT. Ciimgc O
< j Ulcers encl Tiainicii
lL:e
Serjervisors mid i: nijiieiu Mrs bv
rvisors al he on; enrci le vc 1:
. ...... oncrations 1.0. bmweyn c a—.-,
jo ihc
ecriod
ot
.During
me
yermu
particular Charge
• - w; - -,.h Im’- 2000, the..ous^mM
officer
caees^
u
—
1the work of.. Uu:
..
20Q0
and 6 “ dime, /COCO,
-------------,1
,>^0
-for
suneivising
i
—
shall freaucntly- visit the
-o^ area.
8 u lie iv iso r/ E: u i me n i»o
c-r tlicrommiltcc sbffii altorid the irffiffing ckisscs Ail the members V
’elves with, the instivcl^us issued irothe district to acqurdut ibemse
the diilcient aspects of Census talcing s<?
""
dHIcrcnt
to liiue rcgaidiiig t!ic
asci U. x.c.Lu...
yarding
HouseUsting Operahons ano
s uoeivis ion work
EnuraeratMn becomes easy;
Pollpffiatioo
. ..
.
thf Additional Priiicmal
(5) In die absence of Princina. Census
\
Census Officers shall discharge tire ffinebons of Jk- C-au
(Oi s'KdmsuuU.bl-clly iluuuKl. varfeus
G-.'.C".UO:1S to bri::g mr;mer.ess umoiig public
i*
.,3.
Ce,.M
.
(
j-npaiiaiice.
oi
(7) Census Operapons be ii 12, C'i
nmu oniA ^o »—i
Honoraiium/ Renunei'P.e.ou., etc.-, shall' be q not to otilers.
authorities designated iukLi the insus Act ?n
n\
■(ShThe-Go.tmoirtee.may.ifdr.so rtesires,
■ additional member/ s.
ffikea by the Comwittee snail be mtmaad m the Director
■The action
Karnataka from tinae to paaeof Census Operations
-BY ORDEB AND K'i THE NAME Dijipp
GOVERNOR OF KARN-tAi'--.
oTT
■ ‘ '
To
■
Tj “V
■■■
“i
.
• (K<RXC?-:U rCMt-'OHANDAr.s ,•
r-pT.r.n-3 Bangalore, icr
The Comouer, nn.sa-.-.^.c.
s
.
_ ■. f- ,____ -_-n. ;s
remestea to
••-■
issae 01 tre Bare —• —------------ i _
same to tins oixi.ee•
1-'? R£
■
cones oi ne
CGpy to •
- ~ -ch-__ T’'-'0" Minister
- The PhnciGUi ^ecre^? .o
~
~^veruuieut ol
-•
. A .
w. .--...-orq^e^c-7 aud DevelounieuL
3. The Aumnonai
o--..
r’
r-r
is-augsioie
.
:
ld- Resident Commissioner,
4. The Acaiuonai un—tio—n<5T7>i'a Bnavan, Nev. Dclni.
_
_
K~—■ o- rur^c^re^H'a-M Prmcmm Seo.-— ?
—, 5 The Additional obn — -----J
Fomst- Ecologv and Eiivmonmenv nept.
& Transport Depai meat
,
’nai ^cretarv to Govt., Home
:e Departmet
7. The Principal Secretary to-Govt., tmanc
to Govt-., Revenue Departme:
5. The Principal Secretary
Development Depm -unent
9. The Principal Secrcitaiy
—, to Govt., Urban I
Pluuuiiig DcpS-irtiucii'*.
” 10. The Secretary to Govu,\ Rural Development & Panchayat Raj uept.
11. The Secretary to Gove,
Education Department
12. The Secretary to Govt., .
13. The Secretary to Gov^, DP-AR
Supply and
i anan, Karnataka Urban. Water
’
14. Sri B.K.Das, !AS,^Ch?m
mpegowda.
Road,
KHB Complex, Ke.
Drainage Beam, / tn Floor,
i.
Kamaiaka, Eangalc
Bangalore (Ex-vu'ec.Ox Oi Census Operations, t
maiaka Siam
15. Smr.rSobha Nambism IAS, Ftanagu•g' Director
nd, Bonrriore
no ration Ltd.
Handicrafts Ecvciopn
(Ex-Director ci Census ^pc. dons, Knmat
<>■
-I t
%
CENSUS OF INDIA 2001 : A STUPENDOUS
NATIONAL TASK
- AN OVERVIEW
oil
i
PEOPLE ORIENTED
H.Shashidhar, ias
Director of Census
Operations, Karnataka
INTRODUCTION
The countdown has begun for the next Census in 2001. The 2001 Census,
coming at the commencement of the twenty-first century and the third millennium, will
quietly register the^ Indian Population crossing the one billion mark. This Indian
population drama will soon unfold in the guise of Census figures and statistics once
again after ten years and remind us to review the successes and failures of India's
people, policies and programmes. It is likely to evoke world-wide interest in reassessing
India's position among the developing countries. Therefore, reaching or counting one
billion = 1000 million = 100 crore is not about numbers. It is beyond that It is
about a multidimensional move from numbers to population to people.
HISTORY OF INDIAN CENSUS
Census has a long history behind it, being primarily used for purpose of taxation.
Kautilya's Arthasastra written around 321-296 B.C. laid stress on Census taking as a
measure of State Policy for purpose of taxation. Originally, thus, Census and taxation
were virtually inseparable. In India the year 1872 marked the beginning of Census
2
taking. From 1881 onwards, however, a complete and synchronous Census has been
held once in ten years without break. India is proud of long and uninterrupted record of
decennial Censuses since 1871. The Census of India 2001 will be the 14lh decennial
Census since 1871 and the 6th Census since Independence.
MODERN CONCEPTS OF A POPULATION CENSUS
«>-
The modem concepts of a Population census has been very well defined by the
United Nations. It states, "a census of population may be defined as the total process of
collecting, compiling and publishing demographic, economic and social data pertaining
at a specified time or times, to all persons in a country or delimited territory". The Indian
Census has been adopting this in letter and spirit There is hardly any country in
the world today which does not take Census.
AUTHORITY TO CONDUCT CENSUS AND THE CENSUS ACT, 1948
<»-
The authority to conduct Census in India comes from Article 246 of the
Constitution of India. This article empowers the Parliament to make laws with respect
to any of the matters enumerated in the List-1 in the Seventh Schedule referred to as
'Union List’ and the subject 'Census', figures at Serial No.69 in the List. Accordingly, the
Indian Parliament made 'The Census Act, 1948* (Act No.37 of 1948) which provides "for
the taking of Census in India or any part thereof whenever necessary or desirable and to
promote for certain matters for taking such Census"
3
tr
The Census Act of 1948 makes it obligatory for a person assigned with Census
duty to perform the same faithfully and diligently. It also makes it obligatory for the
person to answer all the questions correctly and fully. While giving any information to the
Census Enumerators, the public need not have any hesitation or reservation as the
Census Act guarantees the confidentiality of the information and total non
identification of the individual.
ROLE OF STATE AND CENTRAL GOVERNMENTS
<3-
Coming under the Ministry of Home Affairs, Government of India, at the National
level, the Census Organisation is headed by the Registrar General and Census
Commissioner of India. There is a separate Directorate in each State and Union Territory
to carry out the Census Operation. The Directorate of Census Operations in Karnataka
with the active help and support of the State Government is making all necessary
arrangements for the 2001 Census.
APART FROM BEING A MAJOR ADMINISTRATIVE FEAT
Perhaps no other account about the Indian Census is as complete and
comprehensive as the one given by renowned economist Ashish Bose. To quote him
. apart from being a major administrative feat in a country of India's size and diversity;
the Census possess an intellectual validity to planners, policy makers, administrators,
economists, statisticians,, researchers and others to address themselves to the ever
changing demographic, development, social and economic questions of our country
Further, " the Indian Census is a monumental affair" he said.
4
WEALTH OF INFORMATION
o-
Apart from being the biggest administrative exercise in the world, the Indian
Census is "one of country's most remarkable events and universally acknowledged as
the most authentic and comprehensive source of information about our land and
people",
•9-
Information on the Indian Census, considered to be a treasure house of
multidimensional data is known for "its range and scope encompassing demographic,
economic, social and cultural characteristics, fertility and mortality, nuptiality, scheduled
caste, tribe, language, religion, migration, education, health, communication, child
labour, employment, ageing, housing, household amenities, organisation infrastructure
and many more issues. You name it, Census has it". This huge database is a veritable
mine of information, the value of which has not been fully realised, let alone
utilised. It is a case of poverty amidst plenty.
•9-
The source on Indian Census is in plenty and is available in the form of
published reports, CD-Roms, internet, floppy, e-mail, etc., at:
1.
O/o the Registrar General & Census Commissioner, India, Data
Processing Division, II Floor, E Wing, Pushpa Bhavan, Madangir Road,
New Delhi-110 062, Phone : (91 -11) 698 1558, Fax: : (91 -11) 698 0295,
E-mail . rgdpd@rqi.satyam. net, in, Internet: http://www.censusindia.net
2.
O/o the Director of Census Operations, Karnataka, 7th Floor, F Wing,
Kendriya Sadan, Koramangala, Bangalore-560 034, Phone & Fax :
5538973, E-mail: dcokar@rqi.satyam.net. in.
UTILITY OF CENSUS DATA
•9-
The utility of the Indian Census data can hardly be over emphasized. They are
used in administration and policy; for research purposes; in business and industries; as
frame for sample surveys; in planning; basis for representation in parliament /
assemblies / urban local bodies / Panchayat Raj Systems and for other democratic
5
purposes; to other types of census; to Civil Registration and Vital Statistics and in many
others.
HOW CENSUS IS TAKEN
«-
Before the commencement of the enumeration, a tremendous amount of spade
work has to be done. This includes listing of all villages along with hamlets, if any, towns
in every taluk and district and identifying them in suitble maps indicating the boundaries
of all the administrative units. This frames the basic task and facilitates the operation, to
conduct the census in a systematic manner without any overlapping or omission. This
frame with reference to 1991 Census, has to be continuously updated by taking into
account the changes that occurred and occurring in the jurisdiction of State / District /
Taluk / Town / Village from time to time upto a certain date. It is a massive administrative
operation involving a network of intricate steps which have been carefully planned and
worked out to a definite time schedule on a war footing. Therefore, demands on time are
numerous and exact.
SIGNIFICANCE OF CENSUS OF INDIA 2001
«»-
Once again after 10 years the 130 years old, gigantic and great Indian Census
Organisation is mobilising all its women and men, material and money to undertake the
biggest administrative exercise in the World i.e.,
the Census of India 2001 during
February Sth to 28th, 2001. The significance of Census 2001 lies in the fact that it
is the first Census of the twenty-first century and the third millennium. Giving
complete
account of the socio-economic, development and demographic health
of the ever burgeoning population of India, the Census 2001 will serve as a
6
historic bench mark for the coming decades. It will be the 14th decennial Census
of India since 1871 and sixth since Independence.
PHASES OF CENSUS 2001
qp’
The Indian Census has two phases
First or preliminary phase referred as
the Houselisting Operation during which information on housing and household
amenities is captured was held throughout the Country during April to June, 2000.
Second
or the main phase known as the Population Enumeration will be held
(except Jammu and Kashmir) between 9th and 28th February, 2001.
The houseless
households will be enumerated on the night of 28th February, 2001. The Population
Enumeration in Jammu & Kashmir and snow bound areas of Himachal Pradesh and
Uttar Pradesh has already been completed.
MAIN FEATURES - THE SCHEDULES USED IN CENSUS 2001
<9-
One of the main features of the ensuing Census is the reduction in the number of
questionnaires or schedules used. In the previous Census, three schedules, namely the
houselist schedule, household schedule and individual slip were used to gather
information. But in this Census, since the individual slip has been done away with, only
two schedules i.e., the houselist schedule and the household schedule are going to be
used. The individual particulars will be collected in the household schedule itself
<9-
Another prominent feature of the Census 2001 is the dropping of the Economic
Census which used to be held alongwith the houselisting operation in the previous
Censuses.
Similarly, the preparation of PGDHTP cards (Post Graduate and Degree
Holders and Technical Personnel), for which information used to be collected during the
Population Enumeration has also been dropped from this Census.
Yet another important feature of this Census is the introduction of certain new
and relevant questions both for the Hodselisting Operation and the Population
Enumeration. The new questions in addition to the modifications of old ones, enhance
the utility of Census 2001 and takes it beyond a head count of population.
NEW ITEMS IN HOUSELISTING OPERATION OF CENSUS 2001
The Houselisting Operation included questions for the first time on (1) condition
of the house, (2) number of married couples living in the household, (3) number of
married couples having independent rooms, (4) drainage facilities, (5) bathroom within
the house,
(6) kitchen within the house,
Television/Telephone by the household,
(7) possession
of Radio/Transistor/
(8) possession of transport vehicle such as
Bicycle/Scooter/Motor Cycle/Moped/Car/Jeep by the household and (9) Banking
services availed by the household.
NEW ITEMS IN POPULATION ENUMERATION OF CENSUS 2001
car
Similarly, the Population Enumeration scheduled to be held between 9th and
28th Feb., 2001 will have questions for the first time on (1) name of respondent and the
relationship to head, (2) age of marriage for males also, (3) disabilities, (4) travel to
work place, distance and mode of travel, (5) household engaged in cultivation and
plantation and (6) dated signature or thumb impression of the respondent.
8
THE TASK AHEAD
The Census 2001 has many firsts to its credit.
For the first time an
unprecedented strength of over two million people are being appointed and
trained to capture information from an anticipated 1000 million or 100 crore or one
billion plus people living in India as on 1st March, 2001. Every child, woman and
man regardless of age, sex and nationality will have to be enumerated without omission
or duplication. Indeed, it is a stupendous task. The Indian Census Organisation has the
expertise, experience and competence to undertake this task.
In the Census of India 2001. the Indian Census Organisation has been given the
following stupendous task.
1.
Cover every nook and corner of all the 27 States, 6 Union Territories,
593 Districts, around 5500 Taluks, 5100 Cities and Towns and 6,38,000
Villages in the country.
2
In the projected One billion plus population of India,
count every
individual i.e., every child, woman and man (even those who don't want to
be counted) regardless of age or sex or nationality without omission or
duplication.
3.
Identify and appoint more than two million Census staff and train them to
undertake this huge administrative operation during 9th to 28th February,
2001.
Enumerate all the Houseless households on the night of 28th
February, 2001. The reference time and date being 00.00 hrs (midnight)
of 1st March 2001.
4
Maintain confidentiality of the information and total non-identification of
the individual or the household who provides information to the
enumerator.
9
5.
Data so collected to be compiled and tabulated for preparing and
publishing written reports including statements, tables and maps.
6.
Provide the general public and data users with published reports, CD
ROMs, floppies, internet and through other media with summary data at
the Country / State / Union Territory / District / City /Taluk / Town / Village
level.
TECHNOLOGICAL REVOLUTION
«>-
Census 2001 is expected to bring in a sort of technological revolution in the
history of Indian Census. The questions in the schedules are self coded to make them
processor friendly. Latest image-based scanning technology will be tried for the first
time by the Census Organisation which should substantially speed up processing,
tabulation and publication of data.
CENSUS 2001 IN KARNATAKA
<>■
The Houselisting Operation in Karnataka was undertaken in May-June 2000 and
the preparations for the Population Enumeration to be held from 9lh February to 28,h
February 2001 are under way.
The preparations for taking the Population Enumeration in Karnataka are under
way. In our State, this gigantic task would have an army of more than a lakh
Enumerators and Supervisors, who would move from house to house covering six City
Municipal Corporations, nearly 300 urban local bodies over 29,480 villages and 28,300
hamlets spread over the entire length and breadth of Karnataka. Every child, woman and
man regardless of sex, age and citizenship status in an anticipated population of 535
million in Karnataka will be counted without omission and duplication.
10
Karnataka has an excellent record of Census taking. It Js needless to emphasise
the fact that the success of the 2001 Census largely depends on the willing and
enthusiastic co-operation of the people, media, government and non-governmental
agencies associated in this stupendous national task.
<>-
Therefore, every citizen should extend fullest co-operation and support for
performing in what has been considered as a largest administrative operation in the
world.
HISTORY IN THE MAKING
<>-
Census will help to grasp the gravity of socio-economic and demographic
problems of our society. The unchecked and rapid growth of population in India carries
along with it multi-dimensional problems such as disability, unemployment, lack of
education, sub-standard health services and sanitation, inadequate welfare measures,
child labour, the poor status of women in general,
inadequate housing and
transportation, urban ward migration and its effects and so on. The Census 2001 throws
light on all these problems directly or indirectly. No section of the society remains
untouched by the Census statistics, which is the ultimate aim and utility of Census
<&-
Thus, Census of India 2001, a new road map to India’s future is nothing but
history in the making. Glorious tradition is its' main strength.
Wr-MrMr*
V
'UT H IT
*
CENSUS - URGENT
H. Shashidhar i a s
Director
chwin^/Main Office
^rn/ter/Tel/Fax: 080-5538973
^r>W(WTel [Gen]: 080-5520352
^-na/e-mail: dcokar@rgi.satyam.net.in
Wcl <Rchl<
GOVERNMENT OF INDIA
MINISTRY OF HOME AFFAIRS
•3T^r chi<41^ /Other Offices
'WNbll
chT "chI<4Id<4, chHidcfr
OFFICE OF THE DIRECTOR OF
CENSUS OPERATIONS, KARNATAKA
'Straps yfafe M^iiril
TT^T, ’ ks’ eft HH,
fan,
Kendriya Sadan, 7th Floor, T Wing,
chUn'Id,
- 560 034
Koramangala, BANGALORE - 560 034
' ^o. TCH 5g cpo 2QQQ
Direct Data Entry System
^pWTel: 080-2223306
cblOq
Central Record Section
^WTel: 080-2261716
PEOPLE ORIENTED
IMPORTANT
fedico/Date:
30.11.2000
POPULATION ENUMERATION CIRCULAR NO.13
SUB : CENSUS OF INDIA 2001 - PUBLICITY PLAN FOR POPULATION ENUMERATION
INTRODUCTION
This is yet another important Population Enumeration
Circular which requires your
personal attention for compliance.
2
The countdown has begun for the Population Enumeration for Census of India 2001. By
now it is hoped, you must have intensified the preparations for the actual operation. Nevertheless,
a very' important factor i.e. publicity needs to be intensified now so as to draw interest of the
people at large who are the respondents in this massive task The publicity campaign should
be such that it reaches people of even the farthest villages.
3
Since there are a few new features to be adopted in this Millennium Census, it is rather more
important that publicity of these features of the Population Enumeration schedule is taken up in
its right spirit for capturing accurate data.
The following publicity materials are sent herewith. Please make use of these materials.
1. Census message for printing hand bills.
2. Census message for banners.
3. Census slogans for telecasting through cable operators.
Please acknowledge receipt of this circular.
F
z^n.SHASHlDHAR)
Director of Census
Operations^ Karnataka
<■
9
To
All Commissioners of City Corporations & Principal Census Officers
The Commissioner, Bangalore Development Authority & Principal Census Officer
All the Deputy Commissioners of Districts & Principal Census Officers
All the Zonal Deputy Commissioners, Bangalore City Corporation & Zonal Census
Officer
The Secretary, BDA & Additional Principal Census Officer
The Addl. Joint Commissioner, Bangalore City Corporation & Additional Principal
Census Officer
The Chief Executive Officers of Zilla Panchayats & Additional Principal Census Officers
All the Headquarters Assistant to Deputy Commissioners & District Census Officers
All the District Statistical Officers & Additional District Census Officers
All the Assistant Commissioners of Sub-Divisions & Sub-Divisional Census Officers
All the Commissioners of City Municipalities & City Census Officers
All the City Census Officers of Bangalore City Corporation
All Chief Officers of Town Municipalities/Town Panchayats/Notified Area Committees/
Cantonment Boards, etc., & Census Charge Officers (Urban)
All Tahsildars of the Taluks & Census Charge Officers (Rural)
All the Deputy Tahsildars of Taluks & Additional Census Charge Officers (Rural)
All the Additional Census Charge Officers (Urban), Bangalore City Corporation.
Copy to
The Registrar General & Census Commissioner, India, New Delhi
The Secretary to Governor, Government of Karnataka
The Secretary to Speaker, Legislative Assembly
The Secretary to Chairman, Legislative Council
All Ministers, Government of Karnataka
The Nodal Officer of State Government & Additional Secretary to Revenue Department
All Divisional Commissioners of Divisions
The Chief Secretary to Government of Karnataka, Bangalore/Additional Chief/Principal
Secretaries and Secretaries to Government of Karnataka
The Director of Economics & Statistics, Government of Karnataka
All Members of the State Level Census Co-ordination Committee
All Officers/lnvestigators & District Team Leaders of this Directorate
PA to Director
>rf.SHASHIDHAR)
Director of Census
Operations, Karnataka
'ut n
CENSUS - URGENT
H^|cb
H. Shashidhar i as
Director
cbMH^/Main Office
^Wter/Tel/Fax: 080-5538973
^nw(WTel [Gen]: 080-5520352
^-HcT/e-mail: dcokar@rgi.satyam.net.in
,lTR?r
GOVERNMENT OF INDIA
Tfi? HHIdH
MINISTRY OF HOME AFFAIRS
cfj chiqiciq,
OFFICE OF THE DIRECTOR OF
CENSUS OPERATIONS, KARNATAKA
ch$5)4 7KH, ’ eft
f^T,
Kendriya Sadan, 7th Floor, F Wing,
4’lei/ - 560 034
Koramangala, BANGALORE - 560 034
' ^o-
TCH 59 CPO 2000
3PT cfTOOT/Other Offices
Trhn
Direct Data Entry System
^T^r/Tel: 080-2223306
i'-sOn
31^1*1
Central Record Section
^WTel: 080-2261716
PEOPLE ORIENTED
IMPORTANT
kHi<^7Date :
30.11.2000
POPULATION ENUMERATION CIRCULAR NO.13
SUB : CENSUS OF INDIA 2001 - PUBLICITY PLAN FOR POPULATION ENUMERATION
INTRODUCTION
This is yet another important Population Enumeration
Circular which requires your
personal attention for compliance.
2
The countdown has begun for the Population Enumeration for Census of India 2001. By
now it is hoped, you must have intensified the preparations for the actual operation. Nevertheless,
a very important factor i.e. publicity needs to be intensified now so as to draw interest of the
people at large who are the respondents in this massive task. The publicity campaign should
be such that it reaches people of even the farthest villages.
i
7
NEED OF THE HOUR
3
The Census Co-ordination Committee formed in the District/ Taluk are to be activated
and various other departments in the district should be made to actively associate in the publicity
programme by exhibiting Census messages in their offices and other public places to bring
awareness among public about Population Enumeration.
4.
Frequent meetings regarding organisational set up should be conducted to review the
progress achieved on various items of work regarding Population Enumeration and reported to
this Directorate.
5.
For
vigorous
publicity
messages of Census through
campaign in the
rural
and
urban charges
announcing
Public Address System by authorised persons near important
public places like Railway Station, Bus Stand, Market place, places of worship etc., using easy
mode of available transport should be resorted to.
6.
Apart from those referred above, there may also be other effective conventional media
through which you feel can carry the Census message down to the villager.
You may do so.
The main purpose is to bring awareness among public about the importance of Census and
make them realise their responsibility and co-operate in this gigantic task by furnishing correct
information.
7.
To achieve this all out effort at all levels is the need of the hour.
3
PUBLICITY PLAN THROUGH DIFFERENT MEDIA
8.
Cloth Banners / Hoardings / Posters / Pamphlets and handouts ; Cloth Banners with
T
•
Census messages and slogans are required to be displayed in prominent junctions in the city viz.,
Railway Stations, Bus Stands, important road junctions etc.
Visual publicity through posters
conveying Census theme is an important tool of communication.
It is less expensive but very
effective. Hence the Principal Census Officers may find out sources for getting maximum
number of posters printed and get displayed at important places in the Districts, Taluks and
Villages.
Financial commitments have to be met indigenously. Efforts need to be made to get
pamphlets and handouts printed locally and distributed to the people. This approach of publicity is
very economical and most effective in the rural side.
For all these, local organisations may be requested to sponsor.
9.
Participation in Fairs and Exhibitions :
Participation
in fairs
and exhibitions and
displaying Census posters/ materials give magical returns both at rural and urban areas. The
period from November to February basically being festival season in our country, many fairs and
exhibitions take place in the towns and villages across the countryside. The Principal Census
Officers are requested to avail these opportunities and exert efforts for spreading the message
regarding importance of Census and peoples' participation in the national task.
10.
Beating of Drum : The Village Panchayat may be requested to spread the message of
Census through the cross section of the village. This needs to be done for a continuous period
from January 2001 till the end of February 2001
i
4
11.
Local Cable TV : Census slogans and messages are to be telecast through local
cable TV. This is one of the most effective media. The Principal Census Officers are required to
impress upon the Cable TV owners regarding their participation in this national task and utilize
their services for spreading the message of Census taking.
12.
Cinema Slides : Cinema Slides with Census theme will
Karnataka.
be
provided
by
DCO,
These slides need to be properly distributed to different Cinema Halls in the
Districts/Taluks with instructions to project the slides before the start of film shows and during
‘intermission’of the film shows from 1 st December, 2000 to 5th March, 2001.
13.
State Level Essay Competition : The Director of Census Operations has already
issued a Circular regarding Taluk and District Level Essay Competition in both Kannada and
English. The modalities for the event have been detailed in the Circular. Wide publicity for Essay
Competition needs to be given so that maximum number of entries are received.
Procedural
details have been circulated separately.
14.
District and State Level Elocution Competitions : The Director of Census Operations
has already issued a Circular regarding Taluk and District level elocution competitions.
The
Principal Census Officers are required to make this competition a great success. The procedure
for conducting this competition has already been circulated separately.
15.
Seminars : With the help of District Information and Publicity Officers, District level and
Taluk Level seminars are required to be organised on Census 2001 to bring awareness among
people so that they are motivated to actively and willingly participate in this national task.
Necessary literature is being supplied.
5
16.
Press Meetings : Press meetings at regular intervals at District and Charge level may be
arranged and information be given regarding' organisational and other arrangements made for
conducting Census 2001. It needs to be emphasized that Census is people oriented and hence
to reap the fruit of Census,
people need
to
participate and co-operate with the
Census
authorities whenever they are called upon.
17.
Press Notes : Series of Press Notes will be prepared by the Directorate of Census
Operations, Karnataka on different aspects and features of Census of India 2001. Copies will be
sent to all the Principal Census Officers, District Information and Publicity Officers etc. These
Press notes may be got released in prominent District Newspapers.
QUIZ ON "KNOW YOUR FAMILY”
18.
Students tn all schools in different classes should be first asked to get the details about
their family by questioning each of the family members as under:
(1)
Who are the members in your household ?
(2)
What is your relationship to the head of household ?
(3)
What is your age & religion ?
(4)
Do you belong to Scheduled Castes /Scheduled Tribes ?
(5)
Can you read and write ?
(6)
Do you have any type of disability ?
(7)
During last year what work you have done ?
(8)
How many days you have worked during last year ?
O)
Whether you are cultivator / Agricultural Labourer / Household Industry worker or
any other worker ?
(10)
Since when do you five in the village ?
i
6
(11)
Where were you born ?
(12)
If married female, how many children were born to you ?
(13)
Whether your family is engaged in Cultivation / Plantation ?
(14)
How much land do you have ?
19.
This should also be taken up by the officers of the Education department at the taluk and
district level. These should be then discussed with them by the teachers in a specific period to
make the students acquainted with the questions. This procedure helps the students to know
about themselves and their families and would help increase their confidence and develop their
personality.
20.
To assess the knowledge of the students towards their family members it is felt necessary
that a Quiz Competition is to be conducted in the schools. For this purpose groups by age
category may be formed. To the qualifying students token awards may also be given
21. Newspaper Articles : This Directorate will be releasing Press Notes and Articles in leading
Newspapers from December 2000 and continue till the end of Population Enumeration.
22.
Newspaper Advertisement : Messages both in English and vernacular language
regarding conduct of Population Enumeration will be published just before commencement of
Population Enumeration.
This advertisement will include the questions that are going to be
canvassed during Population Enumeration.
23.
Publishing Messages by VIPs in Newspapers : On the first day of
Enumeration, Messages from Hon’ble
Governor
Population
and Hon’ble Chief Minister of Karnataka
requesting people at large to extend full co-operation will be published in leading newspapers.
7
24.
Publicity Through AIR : Apart from regular radio talk by experts on Census subject
messages from celebrities from different walks of life will be broadcast in prime chunks of AIR
programmes. Small skits of 15 minute duration and Census jingles are proposed to be broadcast.
It is also proposed to compose a thematic music (signature tune) and broadcast each time a
>-
Census message is in the air. During the operation of Population Enumeration, the AIR news
will carry out Census news at frequent intervals. Details are being worked out.
25.
Publicity Through TV : Messages from Hon'ble Governor and Hon'ble Chief Minister
will be beamed through TV. Also, Census messages from popular celebrities informing the
importance of Census in Nation's Development and people's participation will be telecast before
and during the operation of Population Enumeration. Audio Video Spots on Census theme are
also proposed to be beamed through TV. A signature tune is proposed to be composed and
played during the telecast of Census messages over TV. Details are being worked out.
YOUR ROLE
26.
Various methods through which publicity could be undertaken are detailed in this circular.
Some of these measures will betaken care of by the Registrar General, India and some by this
Directorate.
However, publicity through Press Notes, Press Meetings, Elocution Competition,
Newspaper Articles, Banners / Hoardings, utilising the services of Charge Officers, Beating of
Drums, participation in Fairs and Exhibitions and printing and distribution of Pamphlets and
Handouts are the areas where the Commissioners and Principal Census Officers of Municipal
Corporations, the Deputy Commissioners and Principal Census Officers of the District / Chief
Executive Officers and Additional.
Principal Census Officers of Zilla Panchayats, can play an
effective role in sensitising the people about the concept, utility and purpose of the Census
8
Since there are a few new features to be adopted in this Millennium Census, it is rather more
important that publicity of these features of the Population Enumeration schedule is taken up in
its right spirit for capturing accurate data.
The following publicity materials are sent herewith. Please make use of these materials
1. Census message for printing hand bills.
2. Census message for banners.
3. Census slogans for telecasting through cable operators.
Please acknowledge receipt of this circular.
Xf^SHASHIDHAR)
Director of Census
Operations^ Karnataka
.•Af’
9
To
All Commissioners of City Corporations & Principal Census Officers
The Commissioner, Bangalore Development Authority & Principal Census Officer
All the Deputy Commissioners of Districts & Principal Census Officers
All the Zonal Deputy Commissioners, Bangalore City Corporation & Zonal Census
Officer
The Secretary, BDA & Additional Principal Census Officer
The Addl. Joint Commissioner, Bangalore City Corporation & Additional Principal
Census Officer
The Chief Executive Officers of Zilla Panchayats & Additional Principal Census Officers
All the Headquarters Assistant to Deputy Commissioners & District Census Officers
All the District Statistical Officers & Additional District Census Officers
All the Assistant Commissioners of Sub-Divisions & Sub-Divisional Census Officers
All the Commissioners of City Municipalities & City Census Officers
All the City Census Officers of Bangalore City Corporation
All Chief Officers of Town Municipalities/Town Panchayats/Notified Area Committees/
Cantonment Boards, etc., & Census Charge Officers (Urban)
All Tahsildars of the Taluks & Census Charge Officers (Rural)
All the Deputy Tahsildars of Taluks & Additional Census Charge Officers (Rural)
All the Additional Census Charge Officers (Urban), Bangalore City Corporation.
Copy to
The Registrar General & Census Commissioner, India, New Delhi
The Secretary to Governor, Government of Karnataka
The Secretary to Speaker, Legislative Assembly
The Secretary to Chairman, Legislative Council
All Ministers, Government of Karnataka
The Nodal Officer of State Government & Additional Secretary to Revenue Department
All Divisional Commissioners of Divisions
The Chief Secretary to Government of Karnataka, Bangalore/Additional Chief/Principal
Secretaries and Secretaries to Government of Karnataka
The Director of Economics & Statistics, Government of Karnataka
All Members of the State Level Census Co-ordination Committee
All Officers/lnvestigators & District Team Leaders of this Directorate
PA to Director
>14SHASHIDHAR)
Director of Census
w Operations, Karnataka
TEXT FOR HAND BULLS
£
PEOPLE ORIENTED
WHY CENSUS ?
To know the socio-economic
and demographic health
of the Nation
Census is a great national task. We owe
it to the Nation to make the Census a success
Please co-operate during the Population
Enumeration being conducted from
9th to 28th February, 2001
Provide accurate and complete
information to the census enumerator
Information collected from you
will be kept confidential
Director of Census Operations, Karnataka, Bangalore and
Principal Census Officer (Deputy Commissioner,
or Commissioner of City Municipal Corporation
and Bangalore Development Authority
and Officers of Local Bodies)
final text for hand bills
/
PEOPLE ORIENTED
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BANGALORE MAHANAGARA PALIKE, BANGALORE
CENSUS DIRECTORATE, KARNATAKA
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^D^eDd^cD
WORKSHOP ON
CENSUS 2001 - ENUMERATION OF PERSONS WITH DISABILITY - CAMPAIGN
Venue : Shruthi Auditorium, Kendriya Sadan, Koramangala, Bangalore
WORKSHOP SCHEDULE
s
Registration of participants
Core group volunteers
9.30
10-15
10-15
10-30
10-30
10-40
Welcoming the participants
Mr.Basavaraj, BGVS
10-40
11-15
About Census 2001
Mr.H.Shashidhan IAS
Director of Census
11-15
11-45
Enumeration of Persons with Disability (PWD) in
Census 2001 - its importance
Dr.Pruthvish,
ACTION AID INDIA
11-45
12-00
Efforts of Dept of Welfare for Disabled, GOK in
Census 2001
Mr.Veda Murthy,
Director, Dept, of Welfare
for Disabled, GOK
12-00
1-00
Gender perspective in Census 2001
Ms. Vinutha, BGVS
Census 2001 - view from an education perspective
M r. ^tea^eva- Reddy
BGVS
Woman & Children - from work perspective, reflection
in Census 2001
Ms. Tasqeen,
ACTION AID INDIA
Tea
1-00
1-45
LUNCH BREAK
1-45
2-10
A Brief presentation on mass education strategies by
some NGOs on the issue
D.K.Venu & B.C.Patil
NGOs; ARD & SPEED
2-10
3-00
Group exercise by NGOs on strategies to spread the
message of enumeration of PWD in Census 2001
Exercise in groups
3-00
3-20
Brief presentation of group exercise by two groups
3-20
3-40
Summing up of the workshop
Mr. Rajendra,
LEONARD
CHESHIRE
INTERNATIONAL
3-40
4-00
Vote of thanks
Ms. Jayashri Ramesh
NGO - ASHA
4-00
4-30
Distribution of materials to NGOs
4-30
Tea & Workshop Concludes
Hp-’1
DEALING WITH THE TRANSFERABILITY
PROBLEM IN COMPARATIVE APPLIED POLICY
RESEARCH AND ADVICE
Guest Lecture Faculty of Health Sciences
Monday 18 March 1996
February 1996
Dr J.G.A. van Mierlo
Associate Professor of Public Economics
Faculty of Economics and Business Administration
University of Limburg, Maastricht
1. Introduction
1. The Problem in International Policy Analysis:
CAN SOLUTIONS FOR POLICY PROBLEMS,
PROVEN TO BE SUCCESSFUL IN SOME COUNTRIES,
BE APPLIED TO SOLVE THE SAME POLICY PROBLEMS
IN OTHER COUNTRIES?
2. What can we learn from the methodology of comparative
(social or policy research to answer this central question?
3. Types of (comparative) policy research
a. descriptive analysis (establishing statistical relations between
different variables).
b. explanatory analysis (explaining dependent variables by
independent variables by the logic of theory: causal modelling,
and by empirical testing of these causal models).
c. prescriptive analysis (translating causal models in final
models, translating cause-effect relations in instrument-goal
relations).
2
2. Causal modelling
a. Descriptive analysis:
variable A<
> variable B
b. Explanatory analysis:
independent
variable A
CAUSE
> dependent
variable B
EFFECT
c. Prescriptive analysis:
instrument
> target
variable B
variable A
POLICY
POLICY
INSTRUMENTS OBJECTIVES
3
3. Conclusion 1
1. Empirical research (testing hypotheses derived from theory:
the concept of the empirical cycle of Karl Popper!) is the only
scientific basis for the formulation of policy proposals to solve
policy problems!
t
2. Problem is: can causal models be translated into final
models, how, under what conditions, to which extent, etc.
9
4
4. Problems in comparative research
1. The choice of the unit of analysis
> countries versus problems
2. Comparability and functional equivalence
> ’idiographic’ versus ’nomothetic research’
3. Substitution of country names by variables
> explanation of similarities/differences
between countries
4. Subjectivity and ethnocentrism
> absolutism versus relativism
5. Confusion of levels of analysis
> individual versus country characteristics
> ecological fallacy, reverse ecological fallacy
6. Translation
> the meaning of language
5
5. Transfer ability problems
1. The translation-problem of causal models into final model
2. The problem of elaboration and intervening variables
3. The problem of field-experiments versus laboratoryexperiments
4. The stability condition and the ceteris-paribus clause
5.
The seduction of thinking in blue-print models
6. The contingency problem
7. The determination of success and failure,
8. The determination of factors of success of failure
9. The manipulation of factors of success and failure
10. The problem of society s
culture and culture shocks
11. The problem of society’s structure
and structural change
12. The problem of conflicting policy priorities
13. Other problems?
6
*
6. Case: Public Management Reform in Western Europe
and Central and Eastern Europe
1. Research question
2. Research methods
3. The financier
4. Research problems
5. Research solutions
6. Further research
7
8. INTERVENTION STUDIES 183
182 II. TYPES OF EPIDEMIOLOGIC STUDIES
Reference population
Experimental population
Nonparticipants
Participants
(study population)
Treatment allocation
Treatment
group
Comparison
group(s)
Fig. 8-1. Population hierarchy for an intervention study.
results are obtained. These include the selection of the study population,
allocation of the treatment regimens, maintenance and assessment of
compliance, and achieving high and uniform rates of ascertainment of
outcomes.
Selection of a Study Population
The groups of individuals among whom an intervention study is con
ducted are derived from a number of interrelated populations, which
can be considered as a population hierarchy (Fig. 8-1). The reference
population is the general group to whom the investigators expect the
results of the particular trial to be applicable. The reference population
may include all human beings, if it seems likely that the study f indings
are universally applicable. Conversely, the reference population may be
restricted by geography, age, sex, or any other characteristic that is
thought to modify the existence or magnitude of the effects seen in the
trial. Thus, the reference population represents the scope of the public
health impact of the intervention. For example, the Physicians’ Health
Study [19] is a randomized trial of aspirin in the reduction of total car
diovascular mortality and beta-carotene in decreasing cancer incidence
that is being conducted among over 22,000 male physicians aged 40 to
84 years in the U.S. There seems to be no reason to believe that the
effects of either aspirin or beta-carotene would be inherently different
among male physicians in the U.S. than in a comparable group of males
who are not physicians or even among those who do not live in the U.S.
Therefore, the reference population of this trial may reasonably include
all men 40 years of age and older. While some may consider the refer
ence population to be as broad as all people over 40 years of age, others
might be unwilling to generalize the findings of this trial to women.
Thus, the reference population is related to the issue of generalizability,
which involves a judgment about an intervention based on considera
tions beyond the data from an individual trial.
The experimental population is the actual group in which the trial is
conducted. While, in general, it is preferable that this group not differ
from the reference population in such a way that generalizability to the
latter is not possible, the primary consideration in the design of the trial
should always be to obtain a valid result. The selection of the experi
mental population is crucial to achieving that aim and involves consid
eration of each of several important issues. First, it is essential to deter
mine whether the proposed experimental population is sufficiently large
to achieve the necessary sample size for the trial. For example, in consid
ering design features for a trial of intravenous streptokinase therapy in
acute myocardial infarction to decrease subsequent cardiovascular mor
tality, a single hospital would certainly not admit enough patients to per
mit enrollment of the requisite number of participants to test the hy
pothesis of a small to moderate benefit, even within a study period of
several years. It would therefore be necessary to design a mullicenter
trial, including a number of hospitals in the community, across the coun
try, or throughout the world. Such a study is currently underway in 15
countries and expects to enroll perhaps 20,000 patients over 2 years
[24].
Analogously, it is essential to choosv an experimental population that
will experience a sufficient number of the end points or outcomes of
interest to permit meaningful comparisons between various treatments
or procedures within a reasonable period of lime. For example, if a pri
mary prevention trial of regular aspirin consumption in reducing the
risk of total cardiovascular mortality were conducted among a group of
20,000 women under age 40, it would take several decades to accumu
late sufficient end points to test the hypothesis because of the relatively
low frequency of this disease in this population. In contrast, a similar
trial conducted among men aged 40 and over could provide sound evi
dence on this question after several years, since total cardiovascular dis
ease death rates are several-fold higher in men than women and increase
markedly in middle age. A third major concern is the likelihood of ob
taining complete and accurate follow-up information for the duration
of the trial. A long-term trial conducted among a highly mobile group
such as college students or a study requiring frequent clinic visits among
I
18^//. TYPES OF EPIDEMIOLOGIC STUDIES
a group of infirm elderly subjects might result in low follow-up rates,
which would render the findings uninterpretable.
In designing the Physicians’ Health Study [19], for example, the con
siderations described above contributed to the choice of doctors as the
experimental population. The number of willing and eligible physicians
in the age groups at risk of death from cardiovascular disease as well as
the development of cancer seemed sufficient for an adequate test of
each hypothesis. Moreover, because of their training, doctors would be
able to recognize any side effects of the agents promptly. They are also
well aware of their medical history and health status and would report
this information with a high degree of accuracy and detail. Finally, since
physicians are less mobile and easier to trace than members of the gen
eral population, a high rate of follow-up could be attained, even for an
extended duration of the trial. Pilot studies conducted among random
samples of this group also indicated a high degree of compliance with
the study regimen as well as adherence to the trial protocol, which in
cluded the completion of follow-up questionnaires. Thus, the trial could
be conducted entirely by mail at a small fraction of the usual cost for
previous intervention studies of primary prevention [18]. These general
considerations must all be addressed in the design phase of any trial, to
avoid the possibility of wasting valuable time and resources on studies
that cannot provide either a definitive positive finding or a null result
that is truly informative.
Once the experimental population has been defined, subjects must
then be invited to participate after being fully informed as to the pur
poses of the trial, the study procedures, and the possible risks and ben
efits. If appropriate, this information will include knowledge that they
may be allocated to a group receiving no active treatment and that they
may not know the treatment they received until the end of the trial.
Those willing to participate must then be screened for eligibility accord
ing to predetermined criteria. Reasons for exclusion from the trial may
include factors such as a previous history of any end points under study,
a definite need for the study treatments, as well as contraindications to
their use. Those who are eventually determined to be both willing and
eligible to enroll in the trial compose the actual study population and
are often a relatively small subgroup of the experimental population.
For example, as shown in Figure 8-2, in the Hypertension Detection and
Follow'-Up Program (HDFP) [23], a randomized trial testing a steppedcare approach compared with usual medical care to treat hypertension,
an initial enumeration of the populations of the 14 participating com
munities identified a total of 178,009 men and women in the eligible age
range, 30 to 69 years. Of these potentially eligible subjects, 158,906 com
pleted a first screen, and 22,978 were found to have diastolic blood pres
sures of at least 95 mm Hg. Subsequently, 17,176
these individuals
completed a second screen to establish the final i
.y population of
8. INTERVENTION STUDIES
Experimented population
178,009 potentially eligible
19,103 (10.7%)
Unwilling
158,906 (89.3%)
Completed first screening
135,928 (76.4%)
Ineligible
22,978 (12.9%)
Eligible
17,476 (9.8%)
Completed second screening
--------
185
5,502 (3.1%)
Unwilling
6,536 (3.7%)
Ineligible
Study population
10,940 willing and eligible
participants
Fifr. 8-2. Population hierarchy lor hypertension detection and follow-up
program. (From Hypertension Detection and Follow-up Program (A)opcrative
Group, Five-year Findings of the Hypertension Detection and Follow-up
Program: I. Reduction in mortality of per-.ons with high blood pressure,
including mild hypertension. J.A.M.A. 242:2562, 1979.)
10,940 persons with diastolic blood pressures greater than or equal to
90 mm Hg who were both willing and eligible to participate in the trial.
Thus, only 6.1 percent of the total experimental population formed the
study population for the HDFP.
The actual study population of a trial is often not only a relatively
small but also a select subgroup of the experimental population. It is
well recognized that those who participate in an intervention study are
very likely to differ from nonparticipants in many ways that may affect
the rate of development of the end points under investigation [16].
Among all who are eligible, those willing to participate in clinical trials
tend to experience lower morbidity and mortality rates than those w'ho
do not, regardless not only of the hypothesis under study, but of the
actual treatment to which they are assigned [44]. Volunteerism is likely
to be associated with age, sex, socioeconomic status, education and other,
less well-defined correlates of health consciousness that might signifi
cantly influence subsequent morbidity and mortality. Whether the
subgroup of participants is representative of the entire experimental
population will not af fect the validity of the results of a trial conducted
among that group, h
'y, however, af fect the ability to generalize those
results to either the experimental or the reference population.
186 II. TYPES OF EPIDEMIOLOGIC STUDIES
If it is possible to obtain baseline data and/or to ascertain outcomes
for subjects who are eligible but unwilling to participate, such informa
tion is extremely valuable to assess the presence and extent of differ
ences between participants and nonparticipants in a particular trial. This
will aid in the judgment of whether the results among trial participants
are generalizable to the reference population. For example, in the pre
viously discussed CASS trial [6], 780 patients at 11 participating institu
tions entered the trial and were randomized to either coronary artery
bypass surgery or medical management. An additional 1315 patients at
the same institutions met the randomization criteria but were unwilling
to participate. Of these 1315 eligible but unwilling patients, 435 started
with surgical therapy, and 880 received medical treatment. These 1315
eligible/unwilling patients were compared with the 780 eligible/willing
patients regarding a number of baseline characteristics such as demo
graphic factors, medical history, extent of disease, and life-style vari
ables, and all were followed for an average of 5 years. The investigators
found that the entry characteristics of randomized patients were gen
erally similar to those of eligible but unwilling patients. Moreover, mor
tality rates in both the randomized and nonrandomized groups of med
ically treated patients were similar, as were those for the two groups of
surgically treated subjects [7], These data indicate that those who were
willing to enter the CASS trial do not appear to have been a special
subset of those eligible for randomization but seemed representative of
all eligible patients. The availability of these data strengthen the belief
that the study results are generalizable beyond the trial population.
Allocation of Study Regimens
Since participants and nonparticipants may differ in important ways re
lated to the outcome under study, allocation into the various treatmem
groups should take place only after subjects have been determined to be
eligible and have expressed a willingness to participate (see fig. 8-1).
The effects of a treatment, procedure, or program can be compared
with those of one or more of a variety of groups, such as another dosage
of the same drug, another therapy or program, continuation of standard
medical practice, or a placebo. To maximize the probability that the
groups receiving these differing interventions will be comparable, as
signment to a study group should be at random. Random assignment
implies that each individual has the same chance of receiving each of the
possible treatments and that the probability that a given subject will re
ceive a particular allocation is independent of the probability that any
other subject will receive the same treatment assignment. The two meth
ods most commonly used to achieve this objective are the use of a table
of random numbers or the use of a computer-generated randomization
8. INTERVENTION STUDIES
187
list. In addition, when the outcome under study is anticipated to vary
appreciably in frequency among subgroups of the study population, for
instance, between men and women, or when response is likely to differ
markedly between subjects, such as those with different stages of disease,
the efficiency of the study might be increased by ensuring that treatment
groups are approximately equal or balanced with respect to such char
acteristics. This can be accomplished by a somewhat more complex form
of randomization, called blocking, in which every participant is classified
with respect to each such variable before allocation and then randomized
within the subgroup. Since randomization of large samples virtually
guarantees comparability of treatment groups, blocking has particular
relevance when the study size is limited [31, 32].
Randomization has many unique advantages when compared with
other methods of allocation. First, if randomization is properly done,
nobody either involved in deciding whether a patient is eligible to enter
into a trial or responsible for the allocation procedure will know the as
signed treatment group. Finis, the potential for bias in allocation to
study groups is removed, and investigators can be confident that ob
served differences are not due to the selection of particular patients to
receive a given therapy. Whenever a system can be predicted, as with the
use of any other procedure to allocate treatment, there is the potential
for manipulation. For example, alternate assignment to study and com
parison groups is often used but is always liable to potential bias. Specif
ically, if two willing and eligible subjects presented at the same lime with
different prognoses, a physician might, consciously or not, enter them
into the study in the order that would allow the more seriously ill patient
to receive the treatment the physician already believed to be more (or
perhaps even less) promising. If a large proportion of subjects were en
tered in this way, a serious imbalance in the treatment groups with re
spect to factors affecting the outcome under study would result. A truly
more promising treatment could in fact appear less effective than the
alternative simply because it was administered to a group less likely to
benefit f rom any form of therapy than the individuals who were system
atically assigned to the alternative being studied. Allocation on the basis
of day of the week is also subject to a systematic bias, especially for pa
tients presenting at or near midnight.
Another unique advantage of randomization is that on average, the
study groups will tend to be comparable with respect to all variables ex
cept for the interventions being studied. “On average” implies that the
larger the sample size, the more successful the randomization process
will be in distributing these factors equally among the groups. For ex
ample, the total population of 10,940 participants in the HDFP [23] con
sisted of 34.3 percent white males, 25.9 percent regular smokers, 26.0
percent current takers of antihypertensive medications, and 5.2 percent
8. INTER VENTION STUDIES
TYPES OF EPIDEMIOLOGIC STUDIES
Table 8-1. Selected baseline characteristics of the total study
population and the two treatment groups of the Hypertension
Detection and Follow-up Program (HDFP)
Baseline
characteristics
White male
Regular smoker
Currently taking
antihypertensive
medication
History of myocardial
infarction
Total
HDFP
(n= 10,940)
Stepped
care
(n = 5485)
Referred
care
(n = 5455)
34.3%
25.9%
26.0%
34.5%
25.6%
26.3%
34.1%
26.2 c/
25.7%
5.2%
5.1^
5.29f
Source: Hypertension Detection and Follow-up Program Cooperative Croup.
Five-year findings of the Hypertension Detection and Follow-up Program: 1.
Reduction in mortality of persons with high blood pressure, including mild
hypertension. J.A.M.A. 242:2562, 19/9.
with a history of myocardial infarction. Randomization resulted in two
study groups of 5485 (stepped care) and 5455 (referred care) with vir
tually identical proportions of each of these factors ( Fable 8-1).
This feature of randomization is important because all baseline char
acteristics that affect risk and differ between the treatment groups could
potentially confound the relationship between exposure and disease. An
even more crucial implication, however, is that on average not only will
all known confounding variables be equally distributed, but so will all
>r because
1
potential con founders that are unsuspected by the investigator
of limitations of biologic knowledge at the time the trial is initialed. Vari
ables that are not identifiable cannot be deah with by any direct proce
dures. Consequently, the only possible way to achieve control lor any
influence of unknown variables is through randomization. When the
sample size is sufficiently large, both known and unknown confounding
factors are distributed equally among treatment groups. Thus, random
ization can provide a degree of assurance about the coni pa i ability of the
study groups that is simply not possible in any observational study de
sign.
Finally, a significant advantage of randomization is the desei vedly fa
vorable impression that this design strategy may have on those reading
the published results of a trial. When exposure is assigned by a method
other than randomization, the burden of proof is on the investigatoi to
show that all possible biases in the allocation of patients to a study group
or confounding effects of known or unknown factors that may diffei
rved result. Thus,
between the study groups did not account for the <
189
there is an inherent confidence in the results of a well-designed and
conducted randomized trial that cannot be achieved with any alternative
allocation scheme [16].
A type of nonrandomized intervention study that is sometimes seen
in the literature is one in which the comparison group is historical. In
this instance, the experience of a group of hospitalized patients allocated
to a new agent or procedure is compared with that of other patients in
the same hospital who had been exposed to the preexisting standard
form of treatment. In general, such observational comparisons can pro
vide reliable evidence when there is a relatively large effect of the new
treatment compared with previous standard therapy. For example, the
efficacy of treatment of malignant hypertension was demonstrated by
observing a f ar lower mortality experience of newly treated patients with
those previously untreated [12]. However, in the more common circum
stance, where the effects are small to moderate, it is difficult to distin
guish reliably such differences between the study groups. Since data on
(he new treatment and the standard therapy are collected during two
dif ferent time periods, there may have been changes in the patient pop
ulation admitted to the hospital, other advances in diagnostic or treat
ment methods, or even general modifications of health behavior. Any or
all such factors may result in changes in the frequency of the disease that
arc totally unrelated to the intervention being tested.
Mainleiunice aiul Assessvteid of Compliance
By definition, an intervention study requires the active participation and
cooperation of the study subjects. After agreeing to participate, subjects
in a trial of medical therapy may deviate from the protocol for a variety
of reasons, including developing side effects, forgetting to take their
medication, or simply withdrawing their consent after randomization.
Analogously, in a trial of surgical therapy, those who were randomized
to one group may choose to obtain the alternative treatment on their
own initiative. In addition, there will be instances where participants can
not comply, such as when the condition of a randomized patient rapidly
worsens to the point where therapy becomes contraindicated. Conse
quently, the problem of achieving and maintaining high compliance is
an issue in the design and conduct of all clinical trials.
The extent of noncompliance in any trial is related to the length of
lime that participants are expected to adhere to the intervention, as well
as to the complexity of the study protocol, fhere are a number of pos
sible strategies that can be adopted to try to enhance compliance among
the participants in a trial. As discussed earlier, selection of a population
of individuals who are both interested and reliable can enhance compli
ance rates. For example, the CPPT [26] was conducted among men with
elevated blood chol
rol levels, who were consequently at increased
190 .Z-K. TYPES OF EPIDEMIOLOGIC STUDIES
risk of developing CHD. Such individuals in general have a much
stronger motivation to comply with a study regimen than those at usual
risk. Other ways of attempting to increase compliance include frequent
contact with participants by home or clinic visit, telephone, or mail, the
use of calendar packs of study medication, in which each pill is labelled
with the day it is to be taken; and the use of incentives such as detailed
medical information not ordinarily available from their usual source of
health care.
Monitoring compliance is important because noncompliance will de
crease the statistical power of a trial to detect any true effect of the study
treatment. Thus, the interpretation of any trial result must take into ac
count the extent to which there was adherence to the intervention regi
men. To the extent that participants in the alternative treatment group
receive the intervention under study or those in the intei venlion gtoup
do not actuallv adhere to their assigned regimen, the two groups will
become very similar in terms of exposure. Consequently, any true mag
nitude of effect of the intervention may be obscured. For example, in
the Multiple Risk Factor Intervention Trial (MRF1T) [27], 12,866
healthy men, aged 35 to 57 years, who were al high risk of developing
CHD on the basis of current cigarette smoking, elevated blood pressure,
and high blood cholesterol were randomized either to a special interven
tion program designed to promote the reduction of these three risk fac
tors or to their usual sources of health care in the community- Aftei 7
years of follow-up, there was a nonsignificant 7-percenl decrease m
deaths from CHD in the special intervention group compared with those
allocated to usual medical care. One factor that contributed to the in
ability of the study to detect a significant difference despite sizeable re
ductions in the levels of all three risk factors in the special intervention
group was that a large proportion of individuals in the usual caie gioup
also stopped smoking, received antihypertensive medication, and low
ered their serum cholesterol through weight loss or dietary changes. Al
though it is not possible to know for certain why these men assigned to
receiving usual care became “noncompliant” with their treatment iegimen, it seems likely that it was due to the increasing awareness of the
general public of the adverse effects of smoking, hypertension, and high
cholesterol and attempts to alter these risk factors.
The higher the degree of compliance with the offered program, the
greater the extent to which observed differences between those allocated
to alternative therapies reflect real differences in the effects of the treat
ments themselves. Thus, compliance levels must be measured, which is
generally not easy. All of the measures available to estimate compliance
have inherent limitations. The simplest measure is a self-report. In fact,
for some interventions, such as exercise programs or behavior modifi
cations, this may be the only practical way to assess compliance. In trials
of pharmacologic agents, pill counts have been used, where participants
8. INTERVENTION STUDIES
191
bring unused medication to each clinic visit or return it to the investi
gators at specified intervals. For example, participants in the CPPT
brought unused packets of cholestyramine or placebo to each follow-up
visit [26]. Although this method may eliminate inaccuracies due to poor
memory, it assumes that the subject has ingested all medication that has
not been returned to the clinic. A more objective means of assessing
compliance, which is also expensive and logistically difficult, is the use
of biochemical parameters to validate self-reports. Laboratory detei minations on either blood or urine can frequently detect the presence of
active drugs or metabolites. In cases where drugs or metabolites are dif
ficult to measure, or for subjects taking an inert placebo, a safe biochem
ical marker such as trace amounts of riboflavin can be added to the treat
ment. Laboratory determinations are limited, however, in that they
usually only reflect whether medication was taken in the preceding day
or two and thus cannot be used as a reliable measure for long-term com
pliance.
Inevitably, some proportion of participants in a trial will become noncompliant despite all reasonable efforts. In such instances, maintaining
any level of compliance is preferable to complete noncompliance. More
over, as will be discussed, every randomized subject should be included
in the primary analysis of any intervention study, so that it is essential to
obtain as complete follow-up information as possible on those who have
discontinued the treatment program. Investigators should pursue fol
low-up data on outcome for such individuals for the duration of the ti ial
in a manner identical to that for subjes is who continue to comply.
Uniform and High Rates of Ascertainment of Outcome
Another crucial issue to be considered in the design and conduct of an
intervention study is the ascertainment of the outcome(s) ol interest.
I he primary objective is to ensure that results are not biased by the col
lection of more complete or accurate information from one or anothei
of the study groups. In addition to the need for uniform ascertainment
of outcome is the requirement for complete follow-up of study partiti
pants over the duration of the trial. For some research questions, ascer
tainment of the outcome may require only a short follow-up period, as
in a study of in-hospital mortality after treatment for acute myocardial
infarction or in a trial assessing the acute toxicity following administra
tion of a new chemotherapeutic agent. In these circumstances, it is often
relatively easy to maintain contact with all participants during the entire
study period. Often, however, many years of follow-up will be needed,
especially for trials of treatments or other interventions that affect the
risk of developing or dying from chronic diseases. As the period of lime
over which subjects must be followed increases, maintaining complete
ascertainment of outcomes becomes more difficult. When outcomes for
192 //. TYPES OF EPIDEMIOLOGIC STUDIES
a proportion of study subjects are not identified but that proportion is
similar for all treatment groups, the smaller the losses, the greater the
likelihood that the magnitude of a bias will be small. On the other hand,
if the proportion of outcomes that are not ascertained is large or differs
among the study groups, the result could be an under- or overestimate
or even, by chance, reflect the true effect. To avoid this situation, where
it is not possible to know the magnitude or direction of the bias, it is
crucial to keep the number of individuals lost to follow-up to an absolute
minimum. For studies with mortality as an end point, the availability of
the U.S. National Death Index has enabled researchers, at the very least,
to assess the vital status on every individual entered into a trial [37].
Methods to maintain high follow-up rates in intervention studies are
identical to those used in prospective cohort studies, which have been
described in Chapter 7.
The potential for observation bias in ascertainment of outcome can
exist in an intervention study in that knowledge of a participant’s treat
ment status might, consciously or not, influence the identification or re
porting of relevant events. The likelihood of such bias is directly related
to the subjectivity of the outcomes under study. If the end point being
considered is total mortality, observation bias is unlikely, since the fact
of death is objective and indisputable and cannot be affected by knowl
edge of a patient’s treatment regimen. In contrast, ascertainment of a
specific cause of death may lx? less clear-cut and thus may be influenced
by a clinician’s knowledge of treatment assignment. Moreover, there are
trials in which the end points of interest may include subjective outcomes
such as severity of illness, frequency of side effects, increased mobility,
or decreased pain. In all these circumstances, it is especially important
to utilize methods to minimize the likelihood of any systematic dif fer
ence in the ascertainment of outcomes between study groups.
One such approach is to keep the study participants and/or the inves
tigators blinded so far as possible to the identity of the interventions
until data collection has been completed. In a double-blind design, nei
ther the participants nor the investigators responsible for assessment of
outcomes know to which treatment group an individual has been as
signed. The ability to conduct a double-blind trial is dependent on hav
ing treatment and comparison programs that are as nearly identical as
possible. Consequently, in many trials, especially of drug therapies, the
comparison group is assigned to receiving a placebo, which is an inert
agent indistinguishable from the active treatment. By making it ex
tremely difficult, if not impossible, to differentiate between the treat
ment and comparison groups, the use of a placebo will minimize bias in
the ascertainment of both subjective disease outcomes and side effects.
One problem in the evaluation of such end points is the well-docu
mented tendency for individuals to report a favorable response to any
therapy regardless of the physiologic efficacy of wl
hey receive. This
8. INTERVENTION STUDIES
193
phenomenon is referred to as the placebo effect. If a study does not use
placebo control, it is impossible to tell whether subjective outcomes are
due to the actual trial treatments, to the extra attention participants re
ceive, or merely to their belief that the treatment will help. For example,
in 1962, Wangensteen and colleagues [43] introduced a new technique
for the treatment of duodenal ulcer, gastric “freezing,” in which a cool
ant was administered by nasogastric tube to suppress secretions. In their
case series of 31 patients, all reported marked or complete relief of pain
following this procedure. Despite the fact that the data were descriptive
and therefore could not test the hypothesis, gastric freezing began to be
used in many clinical centers. Subsequently, concern about its efficacy
and safety led to the initiation of a randomized trial [36]. Specifically, of
137 patients with duodenal ulcer, 69 were assigned at random to gastric
freezing and 68 received a placebo, in that the nasogastric tube was in
serted but coolant applied only as far as the upper esophagus. Using
these procedures, all patients were aware of the presence of the coolant,
but in the placebo group, no direct effect on gastric secretions was pos
sible. The trial showed similar proportions of marked or complete relief
of pain, suppression of secretions, as well as f requency and severity of
recurrence between those who received the actual freezing procedure
and those who did not. These statistically nonsignificant results sug
gested that the relief of symptoms reported by all subjects in the case
series may have been due to the psychological effect of the procedure
rather than any true physiologic benefits.
On the other hand, persons taking a drug or undergoing a medical
procedure may be sensitized to their physical condition and lend to as
cribe every symptom or unusual occurrence to their treatment. For ex
ample, in the Veterans Administration Cooperative Study of Antihyper
tensive Agents [42], 186 men were randomized to a combination of
hydrochlorothiazide, reserpine, and hydralazine, and 194 were assigned
to placebo. One of the anticipated side effects of these agents is impo
tence. Nevertheless, the proportions of subjects reporting this outcome
at any time during the study period were virtually identical in the treat
ment and placebo groups (29% and 28%, respectively). Similarly, in the
Aspirin Myocardial Infarction Study [3], 23.7 percent of subjects ran
domized to receiving 1 gm of aspirin per day reported symptoms
suggestive of peptic ulcer, gastritis, or erosion of gastric mucosa, whereas
14.9 percent of those receiving placebo reported similar symptoms. If
the trial had not used placebo control, an erroneously high rate of gas
trointestinal side effects would have been attributed to aspirin, whereas
in actuality the rate was 23.7 percent minus 14.9 percent, or 8.8 percent.
The use of a placebo will ensure that all aspects of the program of fered
to participants are identical except for the actual experimental treat
ment. (Consequently by comparing the proportions of individuals in the
active treatment ar.
lacebo groups who report a particular symptom
8. INTERVENTION STUDIES
TYPES OF EPIDEMIOLOGIC STUDIES
or outcome, the true incidence of subjective treatment-related effects
can be determined.
-t
Thus, the primary strength of a double-blind design is to eliminate
the potential for observation bias. Of course, a concomitant limitation is
that such trials are usually more complex and difficult to conduct. Pro
cedures must be established for immediate “unblinding” of a partici
pant’s physician in the event of serious side effects or other clinical emer
gencies in which this information seems essential. Moreover, in some
circumstances, it is not possible to “blind” both the participants and the
investigators to the allocated treatment regimen. It is very difficult to
design a double-blind trial for the evaluation of programs involving sub
stantial changes in life-style, such as exercise, cigarette smoking or diet,
surgical procedures, or drugs with characteristic side effects. In these
circumstances, a single-blind or unblinded trial may be necessary. In a
single-blind design, the investigator alone is aware of which intervention
a subject is receiving, while in an unblinded or open trial, both the sub
ject and the investigator know to which study group (he individual has
been assigned.
Single-blind or unblinded trials are simpler to execute than double
blind studies and may be more acceptable both to physicians randomiz
ing (heir patients and to participants. Of course, these designs also have
special problems. For example, subjects aware that (hey are not on the
new or experimental program may become dissatisfied and drop out of
the trial, thus resulting in dif ferential compliance or loss to follow-up.
Moreover, as discussed earlier, knowledge of the intervention to which
the participant has been assigned again raises the potential for observa
tion bias in the reporting of side effects or assessment of outcomes.
Thus, when a double-blind design is not possible, it is imperative that
special precautions be taken to reduce the potential for observation bias.
For measurement of both side effects and end points, objective criteria
should be used, and the study groups should be followed with equal
intensity by independent examiners who are unaware of the subjects’
treatment status.
Use of a Factorial Design
In this chapter, we have thus far considered issues in the design of in
tervention trials of a single factor, where one treatment or regimen is
compared with one or more alternatives or placebo. Given the cost and
feasibility issues in designing clinical trials, one technique to improve
efficiency is to test two or more hypotheses simultaneously in a factorial
design. A clinical trial of two hypotheses can utilize a two-by-two factorial
design, in which subjects are first randomized to treatments a or p to
address one hypothesis, and then within each treatment group there is
further randomization to treatments A or B to evaluate a second ques
195
22,071 Randomized
5,517
Beta-carotene
5,520
Beta-carotene
placebo
5,520
Beta-carotene
5,514
Beta-carotene
placebo
Fig. 8-3. Randomization scheme for a two-by-two factorial design: Physicians’
Health Study.
tion. Similarly, in a two-by-two-by-iwo factorial design, each of these
subgroups would be f urther randomized into two additional interven
tion groups to address a third hypothesis, and so on.
fhe Physicians’ Health Study [19, 38] utilizes a two-by-two factorial
design to evaluate the two hypotheses that consumption of low-dose as
pirin reduces cardiovascular mortality and that beta-carotene consump
tion decreases cancer incidence. As shown in Figure 8-3, the more than
22,000 willing and eligible physicians were first randomized into two
groups, one receiving aspirin and the other aspirin placebo. Each of
these treatment groups was further randomized to receiving either beta
carotene or its placebo. Thus, physicians in the trial were allocated to
one of four possible regimens: aspirin alone, beta-carotene alone, both
active agents, or both placebos.
'Fhe principal advantage of the f actorial design is its ability to answer
two or more questions in a single trial for only a marginal increase in
cost. Moreover, as in the Physicians’ Health Study, the use of a factorial
design can allow testing a less mature hypothesis together with a more
mature question having reliable evidence available to justify its evalua
tion. The Physicians’ Health Study sought primarily to test the hypoth
esis that a single 325-mg aspirin tablet taken every other day could re
duce total cardiovascular mortality among men with no history of a prior
myocardial infarction. Since there was a large body of laboratory and
observational epidemiologic data, as well as information from trials of
aspirin among those with a history of myocardial infarction or unstable
TYPES OF EPIDEMIOLOGIC STUDIES
angina [2, 25], a primary prevention trial of aspirin seemed warranted.
Whether beta-carotene could decrease cancer incidence, however, was a
promising but as yet immature hypothesis [20, 21, 33]. Nevertheless, as
discussed earlier, because of the continuing widespread use of multivi
tamin supplements in the U.S., for reasons of feasibility it seemed im
portant that a trial of beta-carotene be conducted as soon as possible. By
using a two-by-two factorial design, the carotene hypothesis could also
be tested in the Physicians’ Health Study without materially af fecting the
sensitivity or the cost of the aspirin component.
Ideally, of course, the additional treatments in a factorial design
should not complicate trial operations, materially affect eligibility re
quirements, or cause side effects that could lead to pool compliance oi
losses to follow-up. In addition, the possibility of an interaction between
treatment regimens must be considered. Fortunately, such inleiactions
tend to affect the magnitude of observed treatment effects rather than
changing their direction from benefit to harm or vice versa. Moreover,
while the effects of interactions could be viewed as a potential limitation
of a factorial trial, this design in fact facilitates the identification of their
existence [38]. For example, in the Second International Study of In
farct Survival [24], the two major questions of interest arc the efficacy
of intravenous streptokinase and of low-dose oral aspirin in the i;educ
tion of cardiovascular mortality after an acute myocardial infarction. It
may well be that any benefit of the thrombolytic agent intravenous strep
tokinase would be greater in the presence of the antiplatelet drug aspirin
than in its absence, fhe use of a two-by-two factorial design allows foi
the assessment of such an interaction, which could not be done in a sin
gle-factor study.
STOPPING RULES: DECISION FOR
EARLY TERMINATION OF A TRIAL
In the design phase of a trial, there is a need to develop guidelines for
deciding whether a trial should be modified or terminated before orig
inally scheduled. In addition, in some trials of preventive and therapeu
tic regimens, individuals enter the study over an extended period of
time, and the experience of the early participants becomes available
while later individuals are still being enrolled. To assure that the welfare
of the participants is protected, interim results should be monitored by
a group that is independent of the investigators conducting the tiial. If
the data indicate a clear and extreme benefit on the primary end point
due to the intervention, or if one treatment is clearly harmful, then eai ly
termination of the trial must be considered. For example, the Beta
Blocker Heart Attack Trial [10] was a randomize'* double-blind study
comparing propranolol with placebo in 3837 patie. with a recent mvo-
1
8. INTERVENTION STUDIES
197
cardial infarction. The trial was terminated 9 months before the sched
uled closing date on the recommendation of an external data monitor
ing board. At that time, the propranolol group had a highly statistically
significant (P = 0.005) 26-percent reduction in the primary end point,
total mortality, when compared with the placebo group. The emergence
of such an extreme result raised the question of whether it would be
ethical to continue withholding propranolol from the placebo group.
Of at least equal importance, it would also seem unethical to stop a
trial prematurely based solely on emerging trends from a small number
of patients. Such findings might well be only transient and disappear or
even reverse after data have accumulated from a larger sample. For ex
ample, on three occasions during the first 30 months of the Coronary
Drug Project (('DP) trial [9], the mortality of the group receiving clofibrate was significantly lower, at the conventional P = 0.05 level, than
that of the placebo group. However, the finding did not achieve the ex
treme level of significance recommended f or consideration of early ter
mination [31, 32]. fhe study group therefore decided not to slop the
trial but to continue to monitor the results closely. On this basis, the
scheduled follow-up period was completed, and when the final results
were analyzed, the mortality of the dofibrate group was. in fact, identical
to that of the placebo group (25.5% versus 25.4%).
finis, a decision to terminate a study early is based on a number of
complex issues and must be made with a great deal of caution. There
are a variety of sophisticated statistical methods that are currently avail
able for monitoring the accumulating data f rom a clinical trial. As a gen
eral rule, the first requirement for even considering modification or
early termination of an ongoing trial is the observation of a sustained
statistical association that is so extreme, and, therefore, so highly signif
icant, that it is virtually impossible to arise by chance alone [1, 16, 31,
34]. While a statistical test should not normally be used as the sole basis
for the decision to slop or continue a trial, it serves an important func
tion to alert those responsible for monitoring interim data to the possi
bility that there may be cause for concern. The observed association
must then be considered in the context of the totality of evidence, in
cluding known or postulated biologic mechanisms that might explain
such an effect, if it was unanticipated; results f rom other randomized
trials and, to a lesser extent, those from observational studies; and an
assessment of how the observed association would affect the overall riskto-benefii ratio of the intervention. Similarly, the specific statistical cri
terion used to alert investigators to the need to consider these issues
cannot be specified exactly for all trials. In fact, there are many different
views of what constitutes sufficient proof that an observed association in
interim data does not represent a temporary, random fluctuation. More
over, some inveslig
rs feel that this criterion should not be equally
stringent for beneficial and harmful effects, or with respect to antici-
II. TYPES OF EPIDEMIOLOGIC STUDIES
)
paled and unanticipated findings. Whatever the specific guideline, how
ever, the aim is to achieve an equitable balance between, on the one
hand, protection of randomized participants against real harm and, on
the other, minimizing the risk of mistakenly modifying or stopping the
trial prematurely. Detailed discussions of the issues involved in such de
cisions can be found elsewhere [1,9, 10, 16, 31, 34].
SAMPLE SIZE CONSIDERATIONS:
STATISTICAL POWER
Although sample size must be addressed early in the planning stage of
any analytic epidemiologic investigation, it has particular importance in
an intervention study. Observational analytic study designs can most teliably study large effects, so that the sample may be moderate in size. In
contrast, a trial must have a sufficient sample size to have adequate sta
tistical power or ability to detect reliably the small to moderate but clin
ically important differences between treatment groups that are most
likely to occur [47]. Veto [29] has stated that most of the roughly 2000
randomized clinical trials currently underway worldwide are of “little or
no scientific value,” based primarily on the fact that these studies aie of
inadequate sample size to detect such effects reliably. We believe that
such trials actually have the potential for great scientific harm, especially
if their results are misinterpreted as demonstrating that an intervention
has no effect when in fact the sample size was not sufficient to provide
an informative null result. Even if an investigator feels confident that a
new intervention will have a large benefit (i.e., a 50% or greater reduc
tion in the primary end point), it is far preferable to design a trial to test
the more likely small to moderate benefit (i.e., 10—20%) and stop the
trial early than to anticipate a larger effect and have no ability to detect
smaller but nonetheless clinically important differences.
In designing a clinical trial, investigators often devote much time and
effort to increasing the total number of participants enrolled. However,
the statistical power of a trial to detect a postulated dif f erence between
treatment groups, if one truly exists, is dependent not simply on the
sample size, but more specifically on two factors: (1) the total number of
end points experienced by the study population and (2) the difference
in compliance between the treatment groups [29].
Accumulation Of Adequate End Points
To accumulate sufficient numbers of end points, two major strategies
may be considered: first, selecting a high-risk population for study and,
second, ensuring an adequate duration of follow-up.
8. INTERVENTION STUDIES
199
Selection of a High-Risk Population
A primary strategy to ensure the accumulation of an adequate number
of end points is to select individuals at increased risk of developing the
outcomes of interest. With respect to the general population, a simple
but important criterion for this selection is age. Since the frequency of
most outcomes rises with increasing age, the impact of this factor can be
dramatic. For example, in a study of mortality from CHD, 10,000 men
aged 45 and 54 would be expected to experience only about 27 coronary
deaths during a 1-year follow-up period, while a comparable group of
men aged 65 to 74 followed for 1 year would yield about 167 such fa
talities [40]. Other risk factors on which selection of a study population
might be based include sex, occupation, geographic area, or one or more
medical or life-style variables. As mentioned earlier, the CPPT [26] was
conducted among middle-aged men at increased risk of CHD due to
elevated blood cholesterol levels (above 265 mg/dl). Similarly, MRFIT
[27] selected men aged 35 to 57 years who were in the upper 15 percent
of a risk score distribution based on combined levels of cigarette smok
ing, blood cholesterol, and/or blood pressure.
Fhe collection of baseline data can be planned to allow the identifi
cation of particular subgroups who might experience different effects
of an intervention. For example, in the Physicians’ Health Study, if the
true reduction in cancer incidence due to beta-carotene is 30 percent or
greater, there is excellent power to detect that difference among the total
of more than 22,000 randomiz.ed physicians. On the other hand, if the
overall reduction in risk is only 10 percent, it would not be possible to
detect such an ef fect with great assurance. However, a 10-percent overall
reduction could result from a much larger effect confined exclusively to
a particular subgroup, in this case, those with the lowest levels of beta
carotene or vitamin A at baseline [30]. This f inding could easily be de
tected if participants were stratified by baseline levels of these parame
ters. For this reason, prerandomization blood specimens were collected
by mail from 14,916 of the participating physicians, to be analyzed for
baseline levels of retinol, carotene, retinol-binding protein, as well as
other relevant parameters. The availability of these prerandomization
blood specimens will increase the sensitivity of the trial to identify which
particular subgroup of doctors, if any, stands to benefit most from beta
carotene. If there is a benefit confined to those having low baseline lev
els, then f uture public health interventions could be aimed at that target
population. Conversely, if there is no true effect of beta-carotene sup
plementation on cancer incidence, this strategy would in fact produce a
more convincing and truly informative null result, for then it could be
stated that not only was there nd significant overall effect observed, but
in addition, no effect of supplementation with this agent was apparent
regardless of initial blood levels. Despite the fact that such hypotheses
0 II. TYPES OF EPIDEMIOLOGIC STUDIES
are formulated before data collection, it remains important to keep in
mind that such comparisons are not strictly randomized.
Length of the Follow-Up Period
The length of any planned follow-up period should always consider that
the actual rate of accrual of end points will be less than projected. This
situation is not unusual in clinical trials and may occur for reasons be
yond the control of the investigators. First, as discussed previously, those
who volunteer to participate in intervention studies are a self-selected
group who also tend to experience generally lower morbidity and mor
tality rates than those who do not take part, regardless of the hypothesis
under study or the treatment allocated at random. For example, in plan
ning the Physicians’ Health Study, we considered the likelihood that the
relatively small proportion of all potential participants who were actually
both willing and eligible to enroll would have substantially lower rates of
cardiovascular mortality and cancer than the general population, due to
the generally better health and habits of U.S. doctors as a whole, to the
impact of our exclusion criteria, and to the “healthy volunteer effect.”
We therefore postulated that the rates of these end points in the trial
would be about half those that might be expected. In fact, mortality rates
during the first year were less than 20 percent of what would have been
expected among a general population with the same age distribution, or
about 40 percent of our projection for the initially planned duration of
the study (3.5 years). The only way to compensate for this deficit in ex
pected end points would be to extend the length of the follow-up period.
In fact, with the continued cooperation and permission of participating
doctors, we have doubled the length of follow-up and expect to accrue
about four times the number of end points.
Moreover, there may be secular changes in disease rates during the
course of the trial, sometimes as great as that due to the intervention
studied. For example, as discussed previously, MRFIT [27] was designed
to evaluate whether the combined effects of cessation of smoking, con
trol of hypertension, and reduction of cholesterol would decrease the
mortality rate from CHD. During the decade in which this trial was con
ducted, the entire U.S. population, including all MRFIT participants,
experienced a marked 25- to 30-percent decline in CHD mortality [17].
In part due to this secular trend, the observed numbers of deaths in the
trial were less than two-thirds the numbers expected for the 6-year fol
low-up period. Extending the length of follow-up would have increased
the number of end points, thereby increasing the power of the trial.
The choice of duration of the follow-up period must also take into
consideration the postulated mechanism by which the study agent exerts
its effects. In the Physicians’ Health Study, for example, any benefit
from aspirin in reducing cardiovascular mortal’ 'S likely to be acute,
since the postulated mechanism relates to imme< .<.e effects on platelet
8. INTERVENTION STUDIES 201
aggregability. On the other hand, if the beneficial effect of beta-carotene
supplementation is analogous to the effect of cessation of cigarette
smoking on reduction of lung cancer risk, where it may take 2 years
before any decrease begins to become apparent and 6 to 9 before the
effect becomes maximal [11], then a much longer period of follow-up is
required.
While every effort should be made to incorporate an adequate length
of follow-up during the planning phase of a trial, the emergence of new
evidence on mechanisms, changes in rales of disease within the general
population, and even, on occasion, the failure to achieve a sufficient
sample size or enough end points within the trial itself may all, for the
reasons discussed above, raise the question of increasing the duration
beyond the planned period of follow-up. Any such decision should be
made as early in the trial as possible to maintain the scientific credibility
ol the study and avoid the implication that the change in study design
was based on last-minute efforts to achieve statistical significance [16].
For this reason, with the consent of the participating doctors, the Phy
sicians’ Health Study research group was able, at an early stage of the
study, to secure funding to extend the duration of the trial, based pri
marily on far lower than expected mortality rates among trial partici
pants. Additional issues that should be considered in making a decision
regarding extensions of a trial can be found elsewhere [16].
The Effect of Compliance
In addition to the number of end points accrued, the second major f ac
tor influencing the power of the study to detect a true difference be
tween treatment groups is compliance. It is important to remember that
the assessment of whether compliance is adequate must include all (he
study participants, regardless of their particular treatment assignment.
The effect of noncompliance in any participant is to make the interven
tion and comparison groups more alike, which has the result of decreas
ing the ability of the trial to delect any true differences between the
groups. For example, in MRFIT, while the compliance among partici
pants in the special intervention program was generally higher than ex
pected, individuals in the usual care group also stopped smoking, re
duced their blood pressure, and lowered their cholesterol to an extent
unanticipated by the investigators. As a result, the small differences in
risk factors between the groups could only result in a 22-perccnt reduc
tion in CHD mortality. When coupled with secular decreases in mortality
from CHD in the general population, this study did not have adequate
power to detect this small effect [27],
The impact of noncompliance is illustrated in Figure 8-4, which shows
power curves calcu
d for various postulated reductions in risk of mor
tality from CHI) due to aspirin in the Physicians’ Health Study. The top
202 //. TYPES OF EPIDEMIOLOGIC STUDIES
8. INTERVENTION STUDIES 203
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£
0.7 -
B/
0.6-
C
0.5 0.4 -
0.3 0.2-
0.1
0.0L1.00
0.95
0.90
0.85
0.80
0.75
0.70
Relative risk of mortality
Curve A Sample size = 33,000; compliance = 100% in both groups
Cune B Sample size = 22,000; compliance = 100% in both groups
Curve C Sample size = 33,000; compliance = 67% in treated group
95% in placebo group
Fig. 8-4. Power curves for various postulated reductions in risk of mortality,
total sample sizes, and levels of compliance in those receiving active treatment
and placebo.
curve (A) represents the power for a total sample size of 33,000 and 100percent compliance in the active aspirin and placebo groups. The bot
tom curve (C) shows the decrease in power that results when the same
number of subjects are randomized, but the compliance rates are only
67 percent among those in the active aspirin group and 95 percent for
those taking placebo. The shapes of both curves are approximately lhe
same, but with noncompliance there is less power for lhe detection of an
effect of any size. Moreover, lhe greatest reduction in power is for the
most plausible relative risks, which are on lhe order of 0.8 to 0.9.
One strategy to maximize compliance that has been used infrequently
to date in intervention studies but could have wide applicability in clini
cal trials is the implementation of a run-in or “wash-out period prior to
actual randomization. All participants receive either the active treatment
or placebo for a number of weeks or months before formal randomiza
tion to a treatment group. This permits potentially eligible participants
who have difficulty adhering to the intervention program or those per
ceiving adverse effects to withdraw before randomization without af
fecting the validity of the study [5, 18]. Such a strategy seems particularly
attractive in trials where it is not necessary for an intervention to begin
during or immediately following an acute event. The effects on power
of reducing the sample size in this way is illustrated in Figure 8-4. The
middle curve (B) represents the power associated with a sample size that
is one-third smaller than the 33,000 enrollees in the Physicians’ Health
Study, or 22,000 subjects, but again with compliance rates of 100 percent
in both groups. This results in an intermediate power curve, with less
power than if a larger number of good compilers had been randomized,
but considerably more than if a larger, mixed group of compilers and
noncompliers were randomized. Consequently, the use of techniques to
maintain high compliance, such as the use of a run-in period, will max
imize the power of a clinical trial to delect small to moderate effects
between treatment groups [5].
The actual formal of lhe run-in period will depend on the particular
hypotheses being tested. For example, in the Veterans Administration
(Cooperative Group Study on Antihypertensive Agents [41], male pa
tients whose diastolic blood pressures averaged 90 to 129 mm Hg were
considered for admission to a randomized trial of active drug (hydro
chlorothiazide plus reserpine plus hydralazine hydrochloride) versus
placebo treatment. Following discharge from the hospital, the patients
entered a prerandomization phase, where for 2 to 4 months they look
daily tablets of a placebo containing a fluorescent biochemical marker
(rilx)flavin) and were seen in the clinic at monthly intervals. Failure to
appear for a clinic appointment, failure of the urine to exhibit fluores
cence, or a count of returned tablets outside a specific range excluded a
potential participant from randomization into the actual trial. Using this
procedure, nearly 50 percent of the patients initially eligible for this trial
were excluded before randomization for one of these reasons. While
decreasing the actual sample size, this technique resulted in a study of
greater power due to the exclusion of noncompliers before randomiza
tion.
Both the postulated mechanisms of action and frequency of side ef
fects should be considered in determining the specific agents for a runin period. In the Physicians’ Health Study, the postulated beneficial ef
fects of aspirin are acute and side effects common [35], so that it was
desirable to expose all willing and eligible subjects to active aspirin dur
ing a run-in prior to randomization. On the other hand, as the possible
beneficial effects of beta-carotene are cumulative and side effects mini
mal [21, 33], a placebo rather than active agent was given. Thus, during
the 18-week run-in period, all 33,211 physicians who were initially will
ing and eligible to enroll in the trial took a daily pill from calendar packs
containing active aspirin alternating with beta-carotene placebo. At the
end of that lime, each physician was sent a questionnaire to identify doc
tors reporting side effects or a desire to discontinue participation, those
2^4
II. TYPES OF EPIDEMIOLOGIC STUDIES
who wished to continue but whose self-reported compliance was consid
ered inadequate by the investigators, and those who developed a cardio
vascular or cancer end point during this period. Using these criteria,
about 35 percent of enrolled physicians were deemed ineligible to be
randomized and were excluded from the trial. The remaining 22,071
willing and eligible physicians who were proven good compliers were
then randomized into one of the four treatment groups.
One possible limitation of a run-in is that by restricting a trial to a
group of proven good compliers, the study subjects may differ from the
genera] population with respect to factors that might affect the devel
opment of the outcomes of interest. Of course, to the extent that the
noncompliers who were eliminated can be followed, this question can be
evaluated directly. From a more theoretic perspective, however, this is
sue relates solely to the generalizability of study findings> io the total
experimental or reference populations. In that regard, as 1has been discussed previously, the primary goal in the design of a trial is to ensure
that the results obtained are valid. Consequently, any procedure that
maximizes compliance, thus increasing the chances of obtaining a valid
result, will positively affect the ability to generalize that finding to other
populations. The proven good compliers resulting from a run-in period
who contribute to a valid result are a far greater asset to the generahzabilitv of the trial results than would be a more representative study pop
ulation who were unable to maintain adequate compliance lor the du
ration of the study. Such an investigation would lead to an invalid result
and, therefore, one that has no potential for generalizability despite hav
ing been conducted among a representative population.
ISSUES IN ANALYSIS AND INTERPRETATION
The basic approach to the analysis of intervention studies is similar to
that discussed for cohort studies (see Chap. 7), where the fundamental
comparison is between the rates of the outcome of interest in the treated
group(s) and the corresponding rates in the comparison group(s). As for
any analytic epidemiologic study, the roles of chance, bias, and con
founding must be evaluated as possible alternative explanations for the
findings. Clinical trials, however, have unique design features with spe
cial implications for their analysis and inlet pretation.
Ar regards chance, a sufficient sample size addresses this issue in a
manner analogous to other analytic designs. Moreover, randomization
minimizes the potential for bias in the allocation ol participants to treat
ment group, and bias in the observation of outcomes ol interest can be
minimized by using blind or double-blind procedures. With respect to
8. INTERVENTION STUDIES 205
confounding, randomization tends to distribute both known and un
known confounders evenly among the treatment groups. If the sample
size is large, this comparability is virtually guaranteed. However, as dis
cussed previously, with a small sample size or even, in the rare instance,
as a result of the play of chance in a large sample, randomization may
not always result in groups that are alike with respect to every factor
except the treatment under study. Consequently, one important early
step in the analysis of any clinical trial is to compare the relevant char
acteristics of the randomized treatment and comparison groups to as
sure that balance was achieved. This comparison should always be pre
sented as one of the first tables in the report of the study findings.
For example, Table 8-2 shows the baseline distribution of subjects in
the CASS trial [6] for a number of potentially important risk factors for
subsequent mortality and the development of CHI). Additional compar
isons were made of electrocardiographic, arteriographic, and ventricu
lographic characteristics. There were no imbalances between patients as
signed to receive surgical and those allocated to medical therapy with
respect to any of these baseline characteristics. Thus, randomization was
effective in establishing two study groups that were similar with respect
to other factors that could independently affect the outcome under
study. If such a comparison had indicated that randomization was not
ef fective and that there were imbalances between the study groups with
respect to known confounding factors, such discrepancies could be con
trolled in the analysis using statistical techniques analogous to those em
ployed in observational cohort studies (see Chap. 12).
A second important issue that often arises in clinical trials is the ques
tion of which subjects to include in the analysis. Some investigators re
move from the analysis subjects who were determined to be ineligible
after randomization or who did not comply with the study protocol. We
believe, however, that the exclusion of any randomized patients f rom the
analysis can lead to biased results. It may be particularly appealing, in
tuitively, to eliminate those who become noncompliant. However, it is
unwarranted and incorrect to perform a f undamental analysis that com
pares the outcome rates of only those individuals who actually received
that treatment with only those who did not.
First, in most trials, perfect compilers represent only a f raction of the
total study population. As with losses to follow-up, noncompliance may
be related to factors that also affect the risk of the outcome under study,
and failure to analyze data on all randomized participants could intro
duce bias. For example, as mentioned earlier, when all randomized sub
jects in the Coronary Drug Project trial of clofibrate in the reduction of
mortality following myocardial infarction were included in the major
analysis, the 5-year total mortality rates in the two groups were very sim
ilar (18.0% versus 1° t>%) [9]. To explore the effect of compliance on
8. INTERVENTION STUDIES 207
II. TYPES OF EPIDEMIOLOGIC STUDIES
Table 8-2. Baseline characteristics of participants in the
Coronary Artery Surgery Study, by treatment group
Variable
Sex
Male
Female
Race: White
Work status
Full-time
Part-time
Retired or quit
Other
Angina
None
Class I
Class HI-IV
Nonexertional
Cigarette use
Present smoker
Former smoker
Never smoked
Medical history
Prior MI
Hypertension
Congestive failure
Diabetes mellitus
Stroke
Peripheral artery disease
Use of medications
Nitroglycerin
Long-acting nitrates
Beta-blockers
Antiarrhythmics
Medical
group
(n = 390)
Surgical
group
(n = 390)
90.0%
7.5
98.7
90.5%
7.3
98.0
64.1
71.0
4.6
22.8
8.5
19.5
21.5
12.1
0.0
22.1
16.9
0.0
4.1
5.4
40.8
43.6
38.7
44.4
15.6
16.9
62.6
29.4
57.2
32.7
3.9
9.3
2.1
7.3
2.3
8.1
2.1
9.3
54.9
44.6
42.6
9.0
4.6
4.9
56.2
47.3
44.1
9.7
Source: Coronary Artery Surgery Study (CASS), A randomized trial of
coronary artery bypass surgery: Comparability of entry characteristics and
survival in randomized patients and nonrandomized patients meeting
randomization criteria. J.A.C.C. 3:114, 1984.
this outcome, the investigators then analyzed the mortality experience
within the clofibrate group and found that those whose compliance was
at least 80 percent had a mortality rate of 15.0 percent, compared with
24.6 percent among those who were poor compilers. Such a finding
might be erroneously interpreted to indicate that clofibrate reduces
mortality. Indeed, a similar analysis within the placebo group found a
comparable disparity in mortality among compilers and noncompliers,
with rates of 15.1 and 28.2 percent, respectively [8]. These data do in
dicate that in both the active and placebo groups, compliers are different
from noncompliers in ways that affect their prognosis. Even after con
trolling for 40 known possible confounders, there was still a difference
in the mortality rates in the placebo group between good (16.4%) and
poor (25.8%) compliers. Thus, there must be additional but unknown
variables associated with both compliance and mortality in this trial.
These data clearly show that subgroup comparisons of compliers did not
provide valid results.
A second limitation in evaluating data on only those subjects who com
ply with the study regimen is that such an analysis does not address the
actual research question being posed in an intervention study—whether
the offering of a treatment program is of Ixiiiefit. While we wish to study
the actual effect of the treatment, we are in fact randomizing only on
the basis of the offering of treatment, so that we must analyze the data
on this basis to preserve the power of randomization, ft is only the entire
groups allocated by randomization that are truly comparable. Once par
ticipants are randomized to a treatment group, their subsequent health
experience must be assessed and analyzed along with all others in that
group, regardless of whether they comply with their assigned regimen.
This methodologic issue emphasizes the need to maintain high compli
ance with their assigned regimen among all study participants. It is also
important to keep in mind that if a particular regimen is so difficult and
uncomfortable that it is likely to be accepted and used by only a small
proportion of the reference population, it may not be practical to rec
ommend its use, no matter how effective the actual treatment may be.
Thus, in all circumstances, the comparison that is optimal to estimate
the true benefit to be obtained f rom the intervention program is to ana
lyze by intention to treat—in other words, “once randomized, always
analyzed.’’ For this reason, it is imperative to maintain high levels of
compliance, keep losses to follow-up at a minimum, and to collect com
plete information on all randomized subjects. 1 hose who are no longer
complying with the study regimen should continue to provide all follow
up information whenever possible, or at the very least, their vital status
should be ascertained. Subsequent analyses can certainly be performed
based on that subgroup of participants who actually received their as
signed treatment. However, if this is done, while it is possible to perform
8. INTERVENTION STUDIES
2^ II. TYPES OF EPIDEMIOLOGIC STUDIES
analyses that achieve balance in the distribution of known confounders,
it is impossible to regain the control of unknown confounders that had
been achieved originally through randomization.
The need to perform randomized comparisons in the analyses of data
from a trial is equally important when subgroups are identified on the
basis of other characteristics besides compliance. Investigators are often
tempted to examine differences in treatment effects among those with
various baseline characteristics, such as age, prognostic factors, or pre
vious medical history. For example, in MRFIT [28], a subgroup analysis
by presence or absence of resting electrocardiogram abnormalities sug
gested that among men with such abnormalities at baseline, those i e
ceiving the special intervention program actually had an increased risx
of death from CHD relative to those in the group allocated to usual
medical care. This finding led to a further exploration of the effects of
the intervention among those with various levels of hypertension. I he
investigators wisely concluded that “subgroup analyses must be inter
preted with caution, particularly those that go beyond the randomized
clinical trial design by the MRFIT” and added that “these findings pose
hypotheses for investigation by other researchers in systemic hypei ten
sion” [28].
In general, the caveats needed to compare subgroups defined a prion
by baseline characteristics are far less than those required when com
parisons are made on the basis of variables chosen after randomization
such as compliance. As regards the former, a minor concern involves a
loss of statistical power oecause only subgroups of the total number of
randomized subjects are being compared. A greater concern, however,
is to ensure adequate control of variables that may no longer be distrib
uted at random among the subgroups. With respect to analyses of
subgroups defined a posteriori on the basis of information accumulated
after randomization, they can only raise data-derived hypotheses, not
test particular research questions.
CONCLUSION
The ultimate goal of any intervention study is to provide either a definitive positive result on which public policy can be based or a reliable and
informative null finding that can then safely permit the redistribution
of resources to other important areas of research. Intervention studies
certainly can be more difficult to design and conduct than observational
epidemiologic studies, due to their unique problems of ethics, feasibility,
and costs. However, trials that are sufficiently large, randomized, and
carefully designed, conducted, and analyzed can provide the strongest
and most direct epidemiologic evidence on which to make a judgment
about the existence of a cause-effect relationship
209
STUDY QUESTIONS
1. In the Physicians’ Health Study [19], 22,071 male physicians were ran
domized and mortality was postulated to be 70 percent that of white
males in the general population. During the first 2 years, mortality
was less than 25 percent rather than the anticipated 70 percent.
a. How do you explain these findings?
b. What could be done at that stage of the trial to increase the power
of the study to maximize the chances of observing the small to
moderate effects anticipated, which include a 20-percent reduction
in total cardiovascular mortality, a 10-percent reduction in mortal
ity from all causes, and a 30-percent reduction in cancer rates?
2. During the planning phase of the Physicians’ Health Study, which re
stricted admission to male physicians between the ages of 40 and 84,
it was suggested that female physicians be included to study the effect
of aspirin in women and to see if there was a different effect in women
as compared with men. Discuss the advantages and disadvantages of
including female physicians in the trial.
3. As discussed earlier, in the MRFIT trial [27], 480 end points were
anticipated, and only 260 were observed. Consequently, at the end of
the trial, the reduction in cardiovascular deaths was statistically non
significant.
a. What factors contributed to these findings?
b. What changes in the study design might have enabled MRFIT to
report a more definitive result?
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'»- r; ■
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.<fr-
Original Contributions
(
16.
The Efficacy of Influenza Vaccination
in Elderly Individuals
A Randomized Double-blind Placebo-Controlled Trial
Th. M. E. Govaert. MD. PhD; C. T. M. C. N. Thijs, MD, PhD; N. Masurel, MD, PhD;
c
M. J. W. Sprenger. MD. PhD; G. J. Dinant, MD, PhD; J. A. Knottnerus, MD, PhD
Objective.—To determine the efficacy of influenza vaccination in elderly people.
Design.—Randomized double-blind placebo-controlled trial.
Setting.—Fifteen family practices in the Netherlands during influenza season
1991-1992.
Participants.—A total of 1838 subjects aged 60 years or older, not known as
belonging to those high-risk groups in which vaccination was previously given.
Intervention.—Purified split-virion vaccine containing A/Singapore/6/86(H1 N1),
A/Beijing/353/89(H3N2), B/Beijing/1/87, and B/Panama/45/90 (0=927) or intra
muscular placebo containing physiological saline solution (n=911).
Main Outcome Measures.—Patients presenting with influenzalike illness up to
5 months after vaccination; self-reported influenza in postal questionnaires 10
weeks and 5 months after vaccination; serological influenza (fourfold increase of
antibody titer between 3 weeks and 5 months after vaccination).
Results.—The incidence of serological influenza was 4% in the vaccine group
and 9% in the placebo group (relative risk [RR], 0.50; 95% confidence interval [Cl],
0.35 to 0.61). The incidences of clinical influenza were 2% and 3%, respectively
(RR, 0.53; 95% Cl, 0.39 to 0.73). The effect was strongest for the combination of
serological and clinical influenza (RR, 0.42; 95% Cl, 0.23 to 0.74). The effect was
less pronounced for self-reported influenza.
Conclusion.—In the elderly, influenza vaccination may halve the incidence of
‘--serological and clinical influenza (in periods of antigenic drift).
(JAMA. 1994;272:1661-1665)
BASED on studies among young healthy
volunteers, influenza vaccination ap
pears to have a protective effect of 40%
to 70%.1-3 Since 95% of the deaths due to
influenza occur among people aged 60
years and older, it is important to know
the efficacy of vaccination among the
From the Departments of General Practice (Drs Go
vaert. Dinant, and Knottnerus) and Epidemiology (Dr
Thijs). University of Limburg. Maastricht, the Nether
lands; Department of Virology and WHO Influenza
Centre. Erasmus University, Rotterdam, the Nether
lands (Drs Masurel and Sprenger); and Department of
Infectious Diseases Epidemiology. National Institute of
Public Health and Environmental Protection. Bilthoven,
the Netherlands (Dr Sprenger).
Reprint requests to Mauritsweg 3. NL-6171 RM
Stein, the Netherlands (Dr Govaert).
elderly.4 Several studies have suggested
that vaccination of elderly people re
sults in a decrease in complication rate
(up to 72%) and mortality (up to 87%).^®
However, these studies were primarily
retrospective. Only a few prospective
studies have been performed among the
elderly912; none were randomized and
blinded.
For editorial comment see p 1700.
We conducted a randomized double
blind placebo-controlled trial of the ef
ficacy of influenza vaccination in elderly
individuals, using both clinical and se
rological outcome parameters.
METHODS
Patients
The study was conducted in the win
ter of 1991-1992 and involved 34 family
physicians in 15 practices in the south
ern region of the Netherlands. All per
sons aged 60 years or older (n=9907),
not known as belonging to those highrisk groups in which vaccination had
previously been given, were invited to
enter the trial.
According to the Dutch Health Coun
cil,13 high-risk groups are patients with
heart or lung conditions, diabetes mellitus, chronic renal insufficiency, and
chronic staphylococcal infections. Of the
people invited to enroll in the trial, 1838
(19%) agreed. The following reasons were
given for nonparticipation: not under
standing the letter of invitation; hesita
tion about participating in an investiga
tion; fear of receiving an injection and
having blood samples taken; and being
pressed for time. Of those who enrolled,
238 indicated that they had been vacci
nated against influenza in 1989 and/or in
1990. A history of cardiological, pulmo
nary, or metabolic problems were re
ported in 490 participants. (The family
physicians appear to have had different
interpretations of what it means to be at
high risk for influenza.) To assess the in
fluence of risk status on the effect of vac
cination, the participants were divided
into the following categories: cardiac dis
ease, pulmonary disease, diabetes mellitus, and other conditions or healthy.
Intervention
The vaccine used was the purified
split-virus vaccine produced by Evans
Medical Ltd (Langhurst, Horsham, En
gland). This vaccine was composed in
('-JAMA. December 7. 1994—Vol 272, No. 21
Influenza Vaccination in Elderly Individuals—Govaert et al
1661
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Census of India 2001
Why Census?
Kutumbada Anusuchi (Household Schedule)
Census of India 2001: Household Schedule.
Brocure
Deshada habagabateyalli angavikala vyaktigala samiksheya serpade.
Disability status of people ofIndia.
vandu bilion anikeyindachege by S Shashidhar.
janaganati 2001ra mahaihwa mathu hosa lakshanagalu.
Significance and new features of Cenus 2001.
sadarbhadalli pracharakkagi upayoogisabaliudaada dhyeyamanthra
Bharatadajanaganati 2001.
Rasthrada Pragaiiya dikshuti.
Enumeration of the disabled.
A Brief note on census and census of India 2001
Census and its history by H Shashidhar.
Proceedings of Govemement ofkarnataka
Census of India 2001: A Stupendous National Task - An Overview.
Population Enumeration Circular No. 13: Census of India 2001 >
Publicity plan for population enumeration.
Workshop schedule "Cenus 2001 - Enumeration of Persons with
disability - campaign.
- Media
RF_HP_3_A_SUDHA.pdf
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