Family health

India’s total fertility rate drops from 2.2 to 2.0: National Family Health Survey

The report of the fifth round of the National Family Health Survey (NFHS-5) found that India’s total fertility rate declined from 2.2 to 2.0, indicating the significant progress in control measures Population.

Total fertility rate (TFR), measured as the average number of children per woman, fell from 2.2 to 2.0 nationally between NFHS-4 and 5.

There are only five states in India that are above the fertility replacement level of 2.1. This includes Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26) and Manipur (2.17).

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The NFHS-5 survey work was conducted in approximately 6.37 lakh households in 707 districts (as of March 2017) across the country in 28 states and 8 UTs, covering 7,24,115 women and 1,01,839 men to provide disaggregated estimates down to the district level.

The overall contraceptive prevalence rate (CPR) has increased significantly from 54% to 67% in the country.

“Use of modern methods of contraception has also increased in nearly every state/UT. Unmet need for family planning has dropped significantly from 13% to 9%. Unmet need for spacing , which has remained a major problem in India in the past has come down to less than 10%,” an official statement said.

The NHFS-5 also mentioned that institutional births increased significantly from 79% to 89% in India. Even in rural areas, about 87% of births take place in institutions and the same is true for 94% in urban areas.

Institutional births increased by a maximum of 27 percentage points in Arunachal Pradesh, followed by more than 10 percentage points in Assam, Bihar, Meghalaya, Chhattisgarh, Nagaland, Manipur, India. Uttar Pradesh and West Bengal. More than 91% of districts have more than 70% of births in the last 5 years that took place in health facilities.

According to the survey, the level of stunting among children under 5 has slightly decreased from 38 to 36 percent for India over the past four years.

Stunting is higher among children in rural areas (37%) than in urban areas (30%) in 2019-21. The variation in stunting varies from lowest in Pondicherry (20%) to highest in Meghalaya (47%).

A notable decrease in stunting was observed in Haryana, Uttarakhand, Rajasthan, Uttar Pradesh and Sikkim (7 percentage points each), Jharkhand, Madhya Pradesh and Manipur (6 percentage each), as well as Chandigarh and Bihar (5 percentage points each).

Compared to NFHS-4, the prevalence of overweight or obesity increased in most NFHS-5 states/UTs. At the national level, it goes from 21% to 24% among women and from 19% to 23% among men. Over a third of women in Kerala, A&N Islands, Andhra Pradesh, Goa, Sikkim, Manipur, Delhi, Tamil Nadu, Puducherry, Punjab, Chandigarh and Lakshadweep (34 to 46%) are overweight or obese.

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In NFHS-5, more than three quarters (77%) of children aged 12-23 months were fully immunized, compared to 62% in NFHS-4, with full immunization coverage among children ranging from 57% in Nagaland to 95 % in DNH and DD. Odisha (91%), Tamil Nadu (89%) and West Bengal (88%) also showed relatively higher vaccination coverage.

Interestingly, NFHS-5 data showed overall improvement in SDG indicators across all states/UTs. The extent to which married women typically participate in three household decisions (concerning health care for themselves; making major household purchases; visiting family or relatives) indicates that their participation in household decision is high, ranging from 80 percent in Ladakh to 99 percent in Nagaland and Mizoram. The rural (77%) and urban (81%) differences turn out to be marginal.

The prevalence of women with bank or savings accounts that they use has increased from 53% to 79% over the past 4 years.

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NFHS-5 also mentions an increase in the use of clean cooking fuels (44% to 59%) and improved sanitation facilities (49% to 70%), including a hand washing facility with water and soap (60% to 78%) improved considerably.

There has been a substantial increase in the proportion of households using improved sanitation facilities, which could be attributed to the Swatch Bharat Mission program.