On November 24th, the Ministry of Health and Family Welfare has released phase-11 of the National Family Health Survey (NFHS) -5 . NFHS is a large-scale, multi-round survey which provides information on fertility, maternal and child healthcare, family planning services, nutrition, etc. This round of NFHS was released in two phases (Phase-1 and Phase -11). The first phase was released in December 2020. The survey work was conducted in 6.1 lakh households in 707 districts. Total men and women who participated in the survey were 1,01,839 and 7,24,115, respectively. However, the limitation lies in the small sample sizes of some states and union territories.

14 States and UTs included in the second phase of the survey were Arunachal Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, NCT of Delhi, Odisha, Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand.

New focus areas of the survey

Some of the new focal areas and components added to survey were death registration, children receiving post natal care by health care staff, children immunization (rotavirus), literacy levels of women & men, internet usage, cancer screening, nutritional status, menstrual hygiene, tobacco and alcohol consumption of males and females.

Increase in the Sex ratio

One of the exciting highlights of this round of survey is significant increase in sex ratio (1020 females per 1000 male population). Compared to previous rounds, the ratio was 1000:1000 (NFHS-3, Year 2005–06) and 991:1000 (NFHS-4, year 2015–16). Such increase is attributable to improved sex ratio over the decades due to various schemes and programs, defacto number (number of men and women present during the time of the survey). However, sex ratio of the census can only give us the broader and just figures.

Let us talk about women’s health — Caesarean section deliveries are still on rise

The percentage of births delivered by caesarean section has increased substantially from 17.2% in 2015–16 to 21.5% in 2019–21 in public facilities. For private facilities, the percentage rose from 40.9% in 2015–16 to 47.4% in 2019–21. States like Tripura, Andhra Pradesh, Chattisgarh, Punjab, Madhya Pradesh, Himachal Pradesh have more than 50% of c-sec deliveries conducted in privately run health facilities. Like always the percentage is more tilted towards private facilities and not public facilities. Some studies suggest an increase in insurance coverage, better private health facilities, shortage of specialists in public facilities, and individual and family preferences could be the possible reasons for such a high percentage.

It is important to note that the rate of C-section deliveries in India is far above than WHO’s set ideal (between 10–15%). Unnecessary or avoidable c-sec deliveries puts high burden on OOPE and hampers women’s health.

Child’s health in India

Percentage of children in the age group (12–23 months) who are fully vaccinated has increased from 77.9% to 83.8%. Public private facilities distribution for vaccination is 94.5:4.2. However, child mortality rate is still significantly high as Neonatal Mortality Rate stood at 24.9 per 1000 live births), Infant mortality rate at 35.2 and Under-5 Mortality Rate at 41.9 respectively. When it comes to nutritional status of children, still 32.1% of children below 5 years of age are underweight, 35.5% are stunted (height-for-age), 19.3% are wasted (weight-for-height) and 7.7 are severely wasted. 67.1% of children below 5 years of age are found to be anaemic (58.6% in 2015–16).

Below are some other of the highlights from the survey:

  • The Total Fertility Rates (TFR), defined as the average number of children per woman, has further declined from 2.2 to 2.0 at the national level.
  • Overall Contraceptive Prevalence Rate (CPR) has increased from 54% to 67% at all-India level and in almost all Phase-II States/UTs with an exception of Punjab.
  • Unmet needs of family Planning have witnessed a decline from13 per cent to 9 per cent at all-India level.
  • Percentage of anaemic men and women aged 15–49 years are 25% and 57% respectively.

To be continued…