The Total Fertility Rate (TFR), an 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. There are only five States in India which are above replacement level of fertility of 2.1 — Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26) Manipur (2.17) — as per the national report of the NFHS-5, released by the Health Ministry.
The main objective of successive rounds of the NFHS has been to provide reliable and comparable data relating to health and family welfare and other emerging areas in India. The NFHS-5 National Report lists progress from NFHS-4 (2015-16) to NFHS-5 (2019-21).
The other key highlights of the survey include _ institutional births having increased from 79% to 89% in 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 age 12-23 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.
Sustainable Development Goals
Additionally, NFHS-5 shows an overall improvement in Sustainable Development Goals indicators in all States/Union Territories (UTs). 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 that they use has increased from 53% to 79% in the last four years.
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, Andhra Pradesh, Goa, Sikkim, Manipur, Delhi, Tamil Nadu, Puducherry, Punjab, Chandigarh and Lakshadweep (34-46 %) are overweight or obese.
The NFHS-5 survey work has been conducted in around 6.37 lakh sample households from 707 districts (as on March, 2017) of the country from 28 States and eight UTs, covering 7,24,115 women and 1,01,839 men to provide dis-aggregated estimates up to district level.
The national report also provides data by socio-economic and other background characteristics; useful for policy formulation and effective programme implementation.
The scope of NFHS-5 is expanded in respect of earlier round of the survey (NFHS-4) by adding new dimensions such as death registration, pre-school education, expanded domains of child immunisation, components of micro-nutrients to children, menstrual hygiene, frequency of alcohol and tobacco use, additional components of non-communicable diseases, expanded age range for measuring hypertension and diabetes among all aged 15 years and above, which will give requisite inputs for monitoring and strengthening existing programmes and evolving new strategies for policy intervention.
“NFHS-5 provides information on important indicators which are helpful in tracking the progress of Sustainable Development Goals (SDGs) in the country. NFHS-4 (2015-16) estimates were used as baseline values for a large number of SDG indicators and NFHS- 5 will provide data for around 34 SDG indicators at various levels,’’ said the release. It added that NFHS-6 is scheduled to be conducted during 2023-24.