1.2. Socio-Economic Indicator:
The Socio-Economic status of the population has direct impact on health seeking behavior of the population. These are very important for planning and implementation of various Health programmes and has significant role in the health outcomes of the community. Some of the important indicator which has direct impact on health has been selected for analysis in this chapter.

District Code	State/District	Literacy rate(India-73.0 in 2011)
		Literacy rate(India-73.0 in 2011)
		Persons		Males		Females
		2001	2011	2001	2011	2001	2011
1	2	3	4	5	6	7	8
	SIKKIM	68.81	82.20	76.04	87.30	60.41	76.43
01	North District	67.21	77.39	75.69	83.03	55.39	69.92
02	West District	58.81	78.69	66.82	84.86	50.10	72.12
03	South District	67.31	82.07	74.29	87.06	59.73	76.58
04	East District	74.68	84.67	81.20	89.22	66.81	79.41

1.2.1. Literacy Rate.

Source: Census India. 2011.

Table 1.2.1. The literacy rate of Sikkim stands at 76.43% among females and 87.30% among males in 2011. This is marked increase from 60.41% among females and 76.04% males in 2001. Average literacy improved from 68.81% in 2001 to 82.20% in 2011. The literacy is found to be highest in the East districts 84.67% and lowest in the North 77.39%. We expect further improvement in present day literacy since already it is past five years since last census in year 2011.

1.2.2. PER CAPITA NET STATE DOMESTIC PRODUCT AT CURRENT PRICES; BASE YEAR 2011-12.

State Domestic Product of Sikkim at Current Prices

YEAR	GSDP	GROWTH	PCI (GROSS)	GROWTH	NSDP	GROWTH	PCI(NET)	GROWTH
2011-12	1116510		181842		974218		158667
2012-13	1233842	10.51	1081675	9.26	1081675	11.03	174183	9.78
2013-14	1386190	12.35	1220293	11.27	1220293	12.82	194624	11.74
2014-15	1540672	11.14	1355554	10.09	1355554	11.08	214148	10.03
2015-16	1803394	17.05	1574320	15.77	1574320	16.14	245987	14.87
2016-17	2002046	11.02	1750602	9.81	1750602	11.2	270572	9.99
2017-18	2224791	11.13	1944404	10.1	1944404	11.07	297765	10.05

Source: DESME.
Table 1.2.2. Per capita Net SDP is also important indicator for health outcome. Improved State Domestic Product empowers state for undertaking various social and developmental schemes, which can have positive impact on health of the community. The Per Capita Net Income of the Sikkim has improved significantly. It was Rs 158667 in the year 2011-12 and was Rs. 245987 in 2015-16 and has increased to 297765 in the year 2017-18.

1. 1. Distribution of Household by Predominant Material of Roof.

Sl No	Type of roofing	Sikkim	India
1.	Grass, Thatch, Bamboo, Wood, Mud etc	5.7 %	15%
2.	Plastic, Polythene	1 %	0.6 %
3.	G.I, Metal, Asbestos Sheets	68.2 %	15.9 %
4.	Concrete	23.1%	29 %
5.	Any other material (Machine/hand made tiles, Bricks, Stone Slabs, etc)	2%	39.5 %

NB: Number of Household – 128131. Source: Census India. 2011.

Table 1.2.3 Type of house a family has is also an important indicator which affects health outcome. In the State 68.2% families have GI/Metal/Asbestos sheets roofing. 23.1% have concrete roof. 5.7% have Grass/ Bamboo/ wood/mud roofs. 1% have Plastic/polythene roof and 2% have roof of any other material. This figure of 2011 census is bound to improve significantly by now. Hundreds of families have been benefitted by free housing schemes launched by Government for poor and underprivileged families every year.
1.2.4. Household having safe drinking water in the State.

Sl.no	Indicators	Sikkim	India
1.	From Treated source	29.2 %	32.0 %
2.	From Untreated Source	56.1 %	11.6 %
3.	spring	11.1%	0.5 %
4.	River, canal, tank, pond, lake, Covered/uncovered well, Hand pump and Tube well.	1 %	55.4 %
5.	Any other source	2.6%	1.5 %

NB: Number of households 128131. Source Census India. 2011.

Table.1.2.4. Households having drinking water from treated source in Sikkim is 29.2% which is lower than national average of 32%. Drinking from untreated source in the state is 56.1% significantly higher than national average of 11.6%. Drinking from springs is 11.1% which is higher than national average of 0.5%. 2.6% of household in the State and 1.5% in the country is drinking from any other source not listed above.
1.2.5. Household by availability of toilet.

Sl no	Indicators	Sikkim	India
1.	Toilet within the premises	87.2 %	46.9 %
2.	Public Latrine	1.5 %	3.2 %
3.	Open	11.3 %	49.8 %

Source: Census 2011
Table1.2.5. Availability of Toilet within household is also an important indicator of personal hygiene and health outcome in the community. In the state 87.2% household has been shown to have toilet within household premises. This figure is nearly double of national average of 46.9 %. 11.3% household has been shown to do it in open compared to 49.8 % in India. 1.5 % household in the State is shown to be using public latrines against national average of 3.2 %.
Sikkim became the first Nirmal Rajya in the country for 100% sanitation.
1.2.6. Women Empowerment and Gender Based Violence (15-49 yrs).

Sl.No	Indicators	NFHS 4 2015-16.	NFHS 5 2019-20.
1.	Married women in decision making	95.3 %	89.7 %
2.	Women ever experienced spouse violence	2.6 %	12.1 %
3.	Women having saving account they themselves use	63.5 %	76.4 %

Table 1.2.6. In Sikkimese society historically women have been always involved in household decision making. The data too shows that 95.3 % women were involved in decision making during NFHS 4, which however has decreased to 89.7 % in NFHS 5. Spouse violence has shown marked increase in the State. It was 2.6 % during 2015-16, increased significantly to 12.1% in 2019-20. The women having their own bank account and using them themselves have improved more than three fold in Sikkim since NFHS 3. It was 20.9% during 2005-06, 63.5% during 2015-16 and is currently 76.4% in 2019-20.

1.2.7. Tobacco use and Alcohol consumption among Adults (age 15-49 yrs).

Sl.no	Indicators	NFHS 4	NFHS 5
1.	Women who use any kind of tobacco	7.3 %	11.7%
2.	Men who use any kind of tobacco	40.3 %	41.3 %
3.	Women who consume alcohol	23 %	16.2 %
4.	Men who consume alcohol	51.2 %	39.8 %

Table 1.2.7. The findings shows that Women using tobacco has gone up from 7.3 % in NFHS 4 to 11.7% NFHS 5. The men using tobacco has also gone up from 40.3 % during NFHS 4 to 41.3 % in NFHS 5.
The alcohol use is ingrained in majority of Sikkimese culture and society. However, the survey also shows decrease in consumption amongst both women and men. Amongst women it has gone down from 23 % to 16.2 % and amongst men it has gone down from 51.2% to 39.8% from NFHS 4 to NFHS 5.

Socio Economic Indicators