The Crude Birth Rate (CBR) is defined as the number of live births per 1,000 mid-year population per year. Which of the following is the MAIN limitation of CBR as a measure of fertility?

• A It excludes stillbirths from the numerator
• B It does not account for multiple births
• C It cannot be calculated without census data
• D It is influenced by the age and sex composition of the population ✓

Explanation

CBR uses the entire population as the denominator, not just women of reproductive age. Therefore, it is affected by the proportion of women in the reproductive age group and the sex ratio of the population. This makes it a crude and less sensitive measure of fertility compared to the General Fertility Rate or Age-Specific Fertility Rate, which use more specific denominators.

Reference: Park's Textbook of Preventive and Social Medicine, 26th ed.

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