National Family Health Survey- 5 (NFHS-5)

Q. Why is this in news?

• Recently, the first-phase data of the National Family Health Survey-5 (NFHS-5) 2019-20 has been released by the Ministry of Health and Family Welfare.

Q. What is the National Family Health Survey?

• The NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
• Three rounds of the survey have been conducted since the first survey in 1992-93.
• 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, etc.
• NFHSs have been conducted under the stewardship of the Ministry of Health and Family Welfare, Government of India, with the International Institute for Population Sciences (IIPS) Mumbai, serving as the nodal agency.

Coverage of Survey 

• The latest data pertains to 17 states — including Maharashtra, Bihar, and West Bengal — and five UTs (including J&K) and, crucially, captures the state of health in these states before the Covid pandemic.
• Phase 2 of the survey, which will cover other states such as Uttar Pradesh, Punjab and Madhya Pradesh, was delayed due to the covid and its results are expected to be made available in May 2021.

Q. What are the findings of NHFS-5? 

• The NFHS-5 contains detailed information on population, health, and nutrition for India and its States and Union Territories.
• This is a globally important data source as it is comparable to Demographic Health Surveys (DHS) Programme of 90 other countries on several key indicators.
• It can be used for cross country comparisons and development indices.
• NFHS-5 includes some new topics, such as preschool education, disability, access to a toilet facility, death registration, bathing practices during menstruation, and methods and reasons for abortion.
• In 2019, for the first time, the NFHS-5 sought details on the percentage of women and men who have ever used the Internet.

Findings : 

• Several of the 22 states and UTs, for which findings have been released, showed an increase in childhood immunisation.
• There has been a drop in neonatal mortality in 15 states, a decline in infant mortality rates in 18 states and an increase in the female population (per 1,000 males) in 17 states.
• Fertility rate decline and increase in contraceptive use were registered in almost all the states surveyed showing trends of population stabilization.
• There has been an increase in stunting and wasting among children in several states, a rise in obesity in women and children, and an increase in spousal violence.
• In several other development indicators, the needle has hardly moved since the last NFHS-4.

(1) Hunger Alarm

• The proportion of stunted children has risen in several of the 17 states and five UTs surveyed, putting India at risk of reversing previous gains in child nutrition made over previous decades.
• Worryingly, that includes richer states like Kerala, Gujarat, Maharashtra, Goa and Himachal Pradesh.
• The share of underweight and wasted children has also gone up in the majority of the states.

(2) Fertility Rate

The total fertility rate (TFR) is defined as the average number of children that would be born to a woman by the time she ends childbearing.

• The TFR across most Indian states declined in the past half-a-decade, more so among urban women, according to the latest NFHS-5.
• Sikkim recorded the lowest TFR, with one woman bearing 1.1 children on average; Bihar recorded the highest TFR of three children per woman.
• In 19 of the 22 surveyed states, TFRs were found to be ‘below-replacement’ — a woman bore less than two children on average through her reproductive life.
• India’s population is stabilizing, as the total fertility rate (TFR) has decreased across majority of the states.

(3) Under-5 and infant mortality rate (IMR)

• The Under 5 and infant mortality rate (IMR) has come down but in parallel recorded an increase in underweight and severely wasted under 5 children among 22 states that were surveyed.
• These states are Goa, Gujarat, Himachal Pradesh, Kerala, Maharashtra, Meghalaya, Mizoram, Nagaland, Telangana, Tripura, West Bengal, Lakshadweep and Dadra & Nagar Haveli and Daman and Diu.

Urban-rural Gender Gaps in Internet Use:

• In 2019, for the first time, the NFHS-5, which collects data on key indicators on population health, family planning and nutrition, sought details on two specific indicators: Percentage of women and men who have ever used the Internet.
• On average, less than 3 out of 10 women in rural India and 4 out of 10 women in urban India ever used the Internet, according to the survey.

1. First, only an average of 42.6 per cent of women ever used the Internet as against an average of 62.16 per cent among the men.
2. Second, in urban India, average 56.81 per cent women ever used the Internet compared to an average of 73.76 per cent among the men.
3. Third, dismal 33.94 per cent women in rural India ever used the Internet as against 55.6 per cent among men.

• In urban India, 10 states and three union territories reported more than 50 per cent women who had ever used the Internet: Goa (78.1%), Himachal Pradesh (78.9%), Kerala (64.9%), and Maharashtra (54.3%).
• The five states reporting the lowest percentage of women, whoever used the Internet in urban India were Andhra Pradesh (33.9%), Bihar (38.4%), Tripura (36.6%), Telangana (43.9%) and Gujarat (48.9%).