India’s Ministry of Health and Family Welfare has recently released the first-phase data of the National Family Health Survey-5 (NFHS-5) for 2019-20. The survey provides a wealth of information on issues related to women in India, from fertility rates to domestic violence. The NFHS is a large-scale, multi-round survey that gives a representative sample of households throughout the nation. Phase-I offers data for 22 states/UTs, with ongoing fieldwork for the remaining 14 states/UTs.
Total Fertility Rate (TFR)
The TFR, indicating the average number of children a woman is expected to have during her reproductive years, has generally declined across most Indian states, especially among urban women, over the past five years. Sikkim recorded the lowest TFR while Bihar recorded the highest. In 19 out of the 22 surveyed states, TFRs fell ‘below-replacement level,’ suggesting that India’s population is stabilizing.
Anaemia Prevalence among Women and Children
In 13 out of the 22 states/UTs surveyed, more than half of children and women are anaemic. Anaemia rates among pregnant women have increased in half of these states/UTs compared to the previous survey, NFHS-4.
Contraception and its Prevalence
Female sterilization remains the dominant method of contraception in several states. Overall, the Contraceptive Prevalence Rate (CPR) has substantially increased in most states/UTs.
Child Marriages and Teenage Pregnancies
There has been an alarming increase in child marriages in certain states such as Tripura, Manipur, and Assam, alongside an uptick in teenage pregnancies in several other states, including Andhra Pradesh, Himachal Pradesh, and Nagaland.
Domestic and Spousal Violence
Despite a general decline in most of the states and UTs, domestic and spousal violence rates have increased in five states, namely Sikkim, Maharashtra, Himachal Pradesh, Assam, and Karnataka, with the highest increase observed in Karnataka.
Institutional Births and Caesarean Deliveries
The number of institutional births and caesarean (C-section) deliveries has increased, with over four-fifth of the women delivering in institutions in 19 states and UTs. However, some states, particularly Telangana and West Bengal, have seen a sharp rise in C-section deliveries at private healthcare facilities.
Sex Ratio at Birth (SRB)
The SRB has remained stable or increased in most states/UTs, with the majority maintaining a normal sex ratio of 952 or above. However, the SRB is below 900 in a few states including Telangana, Himachal Pradesh, and Goa.
Child Nutrition
Child nutrition indicators show mixed results across states, with improvements in some areas and minor declines in others.
Financial Inclusion, Sanitation and Clean Air
Progress has been recorded between NFHS-4 and NFHS-5 in regard to women operating bank accounts. Additionally, there has been an increase in households with improved sanitation facilities and clean fuel for cooking in almost all the 22 states/UTs over the last four years. This is largely due to the Government of India’s efforts through the Swachh Bharat Mission and Pradhan Mantri Ujjwala Yojana.
Way Forward
The data from NFHS-5 serves as a crucial input for strengthening existing programmes and developing new strategic policy interventions. It highlights the need for integrated and coordinated efforts from all health institutions, academia, and partners associated with health care services to make these services accessible, affordable, and acceptable to all. Further steps must be taken by the government and authorities to continue improving the condition of women in India.
