The total fertility rate fell to 2.0, indicating only the replacement level.
Births in institutional settings, such as a hospital, improved by almost eight percentage points, but children who were stunted or showed signs of wasting fell by only three percentage points in maximum, shows a comparison of National Family Health Survey-5 (NFHS-5) and NFHS-4.
Full NFHS-5 results were released Wednesday. The NFHS-4 was released in 2014-2015 and the latest, which captured population health indicators in 2017-2019, was delayed due to the pandemic.
Growth under control
India has also officially achieved a total fertility rate (TSF) of 2.0, indicating a decrease from the 2.2 in the NFHS-4. According to the United Nations Population Division, a TFR of about 2.1 children per woman is called replacement fertility. If replacement level fertility is maintained over a long enough period, each generation will replace itself exactly. The urban TFR is 1.6 and the rural TFR is 2.1
“This is a significant achievement for the country’s family planning program, which does not include coercive policies. These findings shatter the myth of population explosion and show that India needs to move away from coercive population control measures. While the increase in the use of modern contraceptive methods is encouraging, an increase in female sterilization coupled with a continued stagnation in the uptake of male sterilization shows that the responsibility for family planning still rests with women,” said said the Population Foundation of India, a non-governmental organization. in a report.
A global survey of key differences between the NFHS-5 and NFHS-4 suggests that contraceptive use improved from 53.5% to 66.7% in the latest NFHS-5 and that institutional births went from 78.9% to 88.6%.
The proportion of children (12-23 months) fully immunized improved from 62% to 76% and children under 6 months who were exclusively breastfed also showed a marked improvement from 54.9 to 63.7 %.
There were, however, mixed signals when it came to nutrition. Although the gains in child nutrition were minimal, women and men (15-49 years) who had a lower than normal body mass index (BMI) each lost about four percentage points. People who were overweight (or with a higher than ideal BMI) increased by about 4 percentage points. Abnormal BMIs are linked to an increase in obesity and other non-communicable diseases (NCDs).
India’s battle against anemia also appears to have failed. The proportion of anemic children (5-59 months) increased from 58% to 67%. Women aged 15 to 49 who were anemic increased from 53% to 57% and men of the same age increased from 29% to 31% between the two editions of the NFHS.
A nutritionally deficient diet likely explains the rise in obesity, one expert said.
“What is gobsmacking is the increase in overweight people, the very heavy burden of non-communicable diseases and the very difficult results on the waist-hip ratio. 56.7% women and 47.7% of men have a high risk waist to hip ratio. What we’re going to see is that a lot of these diseases are diet-related, specifically the quality of people’s diets and what people can afford to eat,” said Purnima Menon, senior researcher at the International Food Policy Research Institute.
“Slow and steady progress [is seen] on stunting, which seems to stem from the changes that are happening in big states like Uttar Pradesh and others. These are outcomes that depend on multiple interventions and take longer to achieve,” she said.
NFHS-5 findings from 22 States and UTs covered by Phase I were released in December 2020 and the others including Arunachal Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, Delhi NCT, Odisha, Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand were made public on Wednesday.
NFHS-5 survey work was conducted in approximately 6.1 million households in 707 districts (as of March 2017) across the country; covering 7,24,115 women and 1,01,839 men to provide disaggregated estimates down to district level.
NFHS-5 includes new focus areas, such as death registration, preschool education, expanded areas of childhood immunization, components of micronutrients for children, menstrual hygiene, frequency of alcohol and tobacco consumption, additional components of non-communicable diseases (NCDs), expanded age ranges to measure hypertension and diabetes in all people aged 15 and over, which will provide the necessary information to strengthen existing programs and develop new strategies for policy intervention.