question: What is the national change where crude birth rate is less than 11.4, crude death rate is more than 12.1 and deaths are 4 376?
answer: SELECT natural_change FROM table_name_96 WHERE crude_birth_rate__per_1000_ < 11.4 AND crude_death_rate__per_1000_ > 12.1 AND deaths = "4 376"
context: CREATE TABLE table_name_96 (natural_change VARCHAR, deaths VARCHAR, crude_birth_rate__per_1000_ VARCHAR, crude_death_rate__per_1000_ VARCHAR)