Periodic assessment of health and social development indicators is crucial for any country still striving to achieve the ideal standards of the Human Development Index. While NFHS results are generally mixed and improvements in some areas accompany stagnation and deterioration in others, this year there have been dramatic improvements in maternal and child health, sex ratio and population control. A greater proportion of births than ever before are occurring in institutions, more children in the 12-23 month age group have been vaccinated and, most interestingly, India has achieved a total fertility rate of 2.0, dropping even further from the 2.2 figure during NFHS-4, indicating that India has contained the population explosion. Policies, some even coercive, as in the case of the family planning sector, seem to have borne fruit, years after their implementation. While the gender ratio has, for the first time, recorded more women per 1,000 men, the gender ratio at birth over the past five years still points to the persistence of a deep-rooted preference for sons, which must be countered by policy and law. There are also other areas, particularly in the case of child nutrition, where marginal gains in terms of wasting and severe wasting are deemed insufficient and require further remedial efforts. The impact of the pandemic can also be noted, the disruption it has caused to services such as balanced nutrition for children must be acknowledged, as this set of circumstances underscores the need to build resilient and strengthened systems. able to function in the most difficult circumstances. After measuring blood sugar and hypertension in the population for the first time, NFHS-5 highlighted the looming threat of lifestyle-related diseases.
This massive exercise, which this year covered more than six million households across the country, aims to provide data that will help shape policies to correct gaps and ensure equitable access to services, especially those that have an impact on the social determinants that improve the quality of life. State-level indices are also published, to provide comparisons, but also to allow states to initiate course correction, or to learn from successes in other regions. Data on marriage and fertility, family planning, access to education and health services are provided by the NFHS, arguably second only to the comprehensive data that the decennial population census generates. States must treat it as such, and even if they may dispute certain assessments, the most important idea is to recognize it as a matrix on which to work, to further improve development indicators. In the meantime, the Center should also not treat it as a simple inventory exercise, but exploit the opportunities that the NFHS offers to initiate reforms or reassess certain policies without using it as a political tool in a federal configuration.