A periodic assessment of health and social development indicators is crucial for any country that is still clawing its way towards achieving ideal standards in the Human Development Index. While the results of the NFHS are usually mixed, and improvements in certain sectors ride along with stagnation and deterioration in other sectors, this year, there have been radical improvements in maternal and child health, sex ratio and population control. A greater proportion of births than ever before is now happening in institutions, more children in the 12-23 months age group have received their vaccinations, and, most interestingly, India has achieved a total fertility rate of 2.0, dropping further from the figure of 2.2 during NFHS-4, indicating that India has contained the population explosion. Policies, some even coercive, as in the case of the family planning sector, seem to have borne fruit, years after they were implemented. While gender ratio has, for the first time, recorded more women per 1,000 men, gender ratio at birth in the last five years still underlines the persistence of a deep-rooted son preference, one that has to be countered, through policy and law. There are other areas too, specially in the case of childhood nutrition where marginal gains in say, wasting and severe wasting, are deemed insufficient, and require renewed corrective efforts. The impact of the pandemic may also be noted, the disruption it caused to services such as balanced nutrition for children must be acknowledged, while this set of circumstances underscores the need for building resilient and fortified systems capable of delivering in the most trying circumstances. Having measured blood sugar and hypertension in the population for the first time, NFHS-5 highlighted the looming threat from lifestyle diseases.
This massive exercise that covered, this year, over six lakh households across the country, aims at providing data that will help shape the policies in a manner that will correct deficiencies, and ensure equitable access to services, particularly those with impact on social determinants that improve the quality of life. State-level indices are also released, to provide comparisons, but also to allow States to launch course correction, or to be inspired by success stories in other regions. Inputs on marriage and fertility, family planning, access to education and health services are provided by the NFHS, arguably second only to the exhaustive data that the decennial population census throws up. States need to treat it as such, and while they might dispute some assessments, the greater idea is to recognise it as a matrix to work on, to improve the development indicators further. Meanwhile, the Centre too must not treat it as a mere stocktaking exercise, but harness the opportunities the NFHS provides for launching reform or re-assessing certain policies without using it as a political tool in a federal set up.