When the 2014 global Human Development Report is released later this month, it will include for the fourth time statistics from the new Multi-dimensional Poverty Index. For India, however, these numbers will be almost meaningless as a widening gap in its official health statistics undermines both domestic and global health monitoring efforts.
India’s main source for detailed health statistics is the National Family Health Survey (NFHS), a large-scale household sample survey. It produces internationally accepted estimates of fertility and mortality, reproductive health, contraceptive use and violence against women among other indicators. Crucially, it is also the only source for malnutrition data (extent of those stunted and underweight in the population).
The NFHS is commissioned by the Ministry of Health and Family Welfare and carried out by the Mumbai-based International Institute for Population Sciences (IIPS). It is funded by the United States Agency for International Development (USAID) and the government. The first round of NFHS surveying took place in 1992-93, the second round in 1998-99 and the third round in 2005-6.
Fieldwork on the next round should have begun in 2010. However some in the ministry were of the view that the NFHS should be continued and instead, the District Level Health Survey conducted by the Census office should be expanded to cover nutrition data, official sources told The Hindu. Following protest from many quarters, the decision was taken to stick with the NFHS.
“Training of the fieldworkers has begun and fieldwork will be conducted over 2014-15. The results will be out in the end of 2015,” Dr Ratan Chand, chief director of statistics at the ministry of health, said on Tuesday. “There has been a delay of around two years. However the new round will have all the information including on nutrition, and also some additional information on non-communicable diseases,” Dr. Faujdar Ram, director of the IIPS, said.
The NFHS is not just relevant for India; it is part of the globally standardised Demographic and Health Surveys (DHS) led by USAID. For instance, since 2010, UNDP’s Human Development Reports have included a new index, the Multi-dimensional Poverty Index (MPI), created by Oxford University. For India, however, the numbers have remained unchanged since 2010; as India has not updated its numbers, the researchers could not either, they told The Hindu in connection with their 2014 findings.
“Essentially the situation we have is that between 2004-5 and 2014-15, a period in which India has probably experienced more change than ever before as consumption data seems to indicate, we have no idea what happened with malnutrition,” a senior official at the India office of an international aid agency told The Hindu, asking that the organisation not be named as it works with the government.