The findings of the fifth cycle of the National Family Health Survey (NFHS), conducted over two years from 2019, are a mix of highs and lows. While child malnutrition remains a concern, women’s literacy has improved and fewer women are marrying before they turn 18. The NFHS is one of the most definitive snapshots of Indian well-being, covering key indicators such as population, child and maternal health, nutrition, adult health and family planning. NFHS-5 has provided vital data for policy makers to consider when planning the course of India’s development for the next decade.
Fieldwork for NFHS-5 was conducted in two phases, from June 17, 2019 to January 30, 2020 and then from January 2, 2020 to April 30, 2021. Seventeen field agencies collected information from 636,699 households, 724,115 women and 101,839 men.
The results of the NFHS-5 show that India is far from being a country characterized by the shortage of basic foodstuffs. A rising trend is obesity among adults. The proportion of overweight women and men in the 15-49 age group has increased in all states since the last such survey in 2015-2016. In states like Andhra Pradesh, Goa, Karnataka, Telangana, Kerala and Himachal Pradesh, nearly a third of women and men between the ages of 15 and 49 are obese.
The sex ratio at birth showed a decline in seven states, according to an analysis by PRS Legislative Research. The sex ratio is the number of girls born per 1,000 boys. In Goa, Himachal Pradesh and Telangana, the ratio is below 900. The most notable drop in sex ratio since NFHS-4 (2015-16) was recorded in Goa and Kerala. Tripura emerges as the only state with a sex ratio at birth above 1,000.
Teenage pregnancies fell to 43% from 51% in 2015-2016. Also, fewer women marry before the age of 18 — 23.3% compared to 26.8% in the last survey. The number of institutional births increased: 88.6% of deliveries were reported in nursing homes, hospitals and other medical institutions, compared to 78.9% in 2015-2016. Cesarean births in private hospitals were much higher than in public hospitals – 47.4% of births in private hospitals were cesarean sections compared to 14.3% in public hospitals.
The nutritional status of young children remains a concern. The decline in the number of stunted children (height for age) has been marginal: 35.5% in the last survey compared to 38.4% in 2015-16. There is an increase in the number of women making decisions within the household. More women own a home (individually or jointly)—from 38.4% in the NFHS-4 to 43.3% in the NFHS-5. There was an increase in the percentage of households using clean fuels for cooking (such as LPG) – 58.6% compared to 43.8% in 2015-2016.
As the latest NFHS findings show, one of India’s biggest challenges is to improve the health of its children. The rise in obesity is another red flag. Stricter regulations regarding access to junk food and transparency in food labeling should be on the government’s priority list. What is encouraging is the improved access to maternal care, as well as to vaccines, mobile phones and bank accounts, especially for women.