Progress from NFHS-4 (2015-16) to NFHS-5 (2019-21)

• 07 May 2022

On 5th May 2022, Union Health Minister Mansukh Mandaviya released the National Report of the fifth round of National Family Health Survey (NFHS-5) at Gujarat's Vadodara.

• The NFHS-5 National Report lists progress from NFHS-4 (2015-16) to NFHS-5 (2019-21).
• 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.

Major Findings/ Progress in Specific Sectors

• NFHS-5 shows an overall improvement in SDG indicators in all States/UTs, including fertility rates, institutional births, vaccination coverage among children and sanitation facilities, etc.

Total Fertility Rate (TFR)

• 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.

Institutional Births

• Institutional Births have increased substantially from 79 per cent to 89 per cent in India.
• In rural areas, around 87 per cent births are delivered in Institutions while it is 94 percent in urban areas.

Immunization

• In NFHS-5, more than three-fourths (77 per cent) children aged 12-23 months were fully immunized, compared with 62 per cent in NFHS-4.

Participation of Women in Decision Making

• The participation of women in decision making is high, ranging from 80 per cent in Ladakh to 99 per cent in Nagaland and Mizoram.

Teenage Pregnancies

• The Survey reports, it is down from 7.9% to 6.8%.

Financial Inclusion of Women

• The prevalence of women having a bank or savings account that they use has increased from 53 to 79 per cent in the last 4 years.

Domestic Violence

• Domestic violence is down from 31.2% in 2015-16 to 29.3% in 2019-21.

Clean Cooking Fuel and Improved Sanitation Facilities

• Between NFHS-4 and NFHS-5, the use of clean cooking fuel and improved sanitation facilities, including a hand-washing facility with soap and water have improved considerably.
• There has been a substantial increase in the proportion of households using improved sanitation facilities, which could be attributed to the Swatch Bharat Mission programme.

Underage Marriages

• National Average: While the national average of underage marriages has come down, the rate has increased in Punjab, West Bengal, Manipur, Tripura and Assam, according to the fifth round of National Family Health Survey (NFHS), conducted between 2019 and 2021. According to NFHS-5, 23.3% women surveyed got married before attaining the legal age of 18 years, down from 26.8% reported in NFHS-4. The figure for underage marriage among men is 17.7% (NFHS-5) and 20.3% (NFHS-4).
• State with Largest Jump in Underage Marriage:Tripura has seen the largest jump in marriages under the legal age of 18 years for women from 33.1% (NHFS-4, conducted 2015-1) to 40.1%, and from 16.2% to 20.4% among men.
• State with Highest Rate of Underage Marriage: West Bengal, along with Bihar, remains one of the states with highest rate of underage marriages. In Bihar, while it has come down, that reduction is marginal: from 42.5% (NFHS-4) to 40.8% (NFHS-5) for women, and 35.3% to 30.5%, respectively, for men.
• State/UT with big Improvement: Some of the biggest gains in improving legal marriage have been seen in Chhattisgarh, where underage marriages have come down from 21.3% to 12.1% among women and from 26.9% to 16.2% among men; Haryana (19.4% to 12.5% for women, and 23.9% to 16% for men); Madhya Pradesh (32.4% to 23.1% for women), Rajasthan (35.5% to 25.5% among women, 35.7% to 28.2% for men).
• State/UT with low Underage Marriages: The lowest such incidents are in J&K, Lakshadweep, Ladakh, Himachal Pradesh, Goa, Nagaland, Kerala, Puducherry and Tamil Nadu, according to NHFS-5.

Overweight or Obesity: A Concern

• 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.