Context

The National Family Health Survey (NFHS) 5 report that was awaited for nearly six months is finally out. And it provides a heartening outlook.

About NHFS

• Started in 1992-93, it has culminated in the fifth round 2019-21.
• The NFHS is a large, multi-round survey that, inter alia, provides information on fertility, infant and child mortality, the practice of family planning, reproductive health, nutrition, anaemia, quality and utilisation of health and family planning services.
• The surveys provide essential data needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes.
• The Ministry assigned the nodal responsibility for the task to the International Institute for Population Sciences(IIPS), Mumbai.
• Several international agencies are involved in providing technical and financial assistance, mainly USAID, DFID, UNICEF, and UNFPA.

Replacement rate achieved

• Replacement rate achieved: The report shows that India has finally achieved the replacement rate of 2.1TFR (Total Fertility Rate is the total number of children a woman will bear in her lifetime).
• In fact, it has gone below the mark to 2.0.
• There are, of course, large interstate variations.
• The lagging states are UP, Bihar, Jharkhand, Manipur and Meghalaya.
• Significantly, there were four states which were keeping the figures poor, namely, Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh.
• Two states, Rajasthan and MP, have struggled to get out of this group, while Jharkhand and the two northeastern states have replaced them.
• UP and Bihar because of their sheer size are pulling down the national average.
• Rajasthan and MP have reached the TFR of 2, which shows the success of their efforts.

Influencing factors

• It is not religion as commonly propounded but literacy, especially of girls, income and delivery of family planning, and health services.
• 1] Delivery of services: The figures would have been even better if all those who have been made aware of the benefits of family planning had received the services they desire.
• Making people informed of the need and methods of family planning and motivating them to adopt family planning is difficult enough.
•  Having achieved the difficult task, we are not able to provide the services communities need — the “unmet need” — which is still very high at 9.4 per cent.
• If we focus on this issue in a mission mode, the family planning performance will dramatically improve.
• 2] Male attitude towards family planning: They tend to put the onus for birth control on women.
• As many as 35 per cent men believe that using contraceptives is a woman’s responsibility. They ignore the fact that male vasectomy is a much simpler procedure than female tubectomy.
• 3] Acceptance of family planning:  Muslim acceptance of family planning has continued through the five surveys spread over three decades at a rate faster than all other communities.
• Though birth control practice among Muslims is still the least – 47.4 per cent (up from 45 per cent in NFHS-4).
• Other communities — for example, Hindus — are not far behind with 58 per cent (up from 56 per cent).
• This means that 42 per cent of the 80 per cent of the population are not practising family planning.
• Education:  Women who have not attended school have 2.8 TFR as against 1.8 for those who have completed class XII.
• Poverty: Similar gap of figure one is visible in the context of poverty with the poorest segment having higher TFR than the richest.

Conclusion

The time has come to leave politics behind and work together for achieving the goals set by National Population Policy 2000. Instead of misleading narratives, we need to address the real determinants of fertility behaviour – literacy, income generation and improvement of health and family planning services.

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