The Total Fertility Rate (TFR), the average number of children per woman, has further declined from 2.2 to 2.0 at the national level between National Family Health Survey (NFHS) 4 and 5.

What is NFHS?

• The NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
• The IIPS is the nodal agency, responsible for providing coordination and technical guidance for the NFHS.
• NFHS was funded by the United States Agency for International Development (USAID) with supplementary support from United Nations Children’s Fund (UNICEF).
• The First National Family Health Survey (NFHS-1) was conducted in 1992-93.

Objectives of the NFHS

The survey provides state and national information for India on:

• Fertility
• Infant and child mortality
• The practice of family planning
• Maternal and child health
• Reproductive health
• Nutrition
• Anaemia
• Utilization and quality of health and family planning services

Modifications in NFHS 5

NFHS-5 includes new focal areas that will give requisite input for strengthening existing programmes and evolving new strategies for policy intervention. The areas are:

• Expanded domains of child immunization
• Components of micro-nutrients to children
• Menstrual hygiene
• Frequency of alcohol and tobacco use
• Additional components of non-communicable diseases (NCDs)
• Expanded age ranges for measuring hypertension and diabetes among all aged 15 years and above.

Highlights of the NFHS 5 Part-II

(a) Fertility Rate

• There are only five States — Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26) Manipur (2.17) —which are above replacement level of fertility of 2.1.

(b) Institutional Births

• The institutional births increased from 79% to 89% across India and in rural areas around 87% births being delivered in institutions and the same is 94% in urban areas.
• As per results of the NFHS-5, more than three-fourths (77%) children aged between 12 and 23 months were fully immunised, compared with 62% in NFHS-4.
• The level of stunting among children under five years has marginally declined from 38% to 36% in the country since the last four years.
• Stunting is higher among children in rural areas (37%) than urban areas (30%) in 2019-21.

(c) Decision making

• The extent to which married women usually participate in three household decisions (about health care for herself; making major household purchases; visit to her family or relatives) indicates that their participation in decision-making is high, ranging from 80% in Ladakh to 99% in Nagaland and Mizoram.
• Rural (77%) and urban (81%) differences are found to be marginal.
• The prevalence of women having a bank or savings account has increased from 53% to 79% in the last four years.

(d) Rise in obesity

• Compared with NFHS-4, the prevalence of overweight or obesity has increased in most States/UTs in NFHS-5.
• At the national level, it increased from 21% to 24% among women and 19% to 23% among men.
• More than a third of women in Kerala, Andaman and Nicobar Islands, AP, Goa, Sikkim, Manipur, Delhi, Tamil Nadu, Puducherry, Punjab, Chandigarh and Lakshadweep (34-46 %) are overweight or obese.

Also read

National Family Health Survey- 5 Part: I

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