The Ministry of Health and Family Welfare released the results from the first phase of the National Family Health Survey (NFHS-4), 2015-16. These are available on Ministry’s website, www.mohfw.gov.in. Findings for the 13 States of Andhra Pradesh, Bihar, Goa, Haryana, Karnataka, Madhya Pradesh, Meghalaya, Sikkim, Tamil Nadu, Telangana, Tripura, Uttarakhand, West Bengal and two Union Territories of Andaman and Nicobar Islands and Puducherry show promising improvements in maternal and child health and nutrition. Data collection for the second phase States and Union Territories is currently ongoing.
The results from NFHS-4 in 15 States/Union Territories indicate that fewer children are dying in infancy and early childhood. After the last round of National Family Health Survey in 2005-06, infant mortality has declined in all first phase States/Union Territories for which trend data are available. All 15 States/Union Territories have rates below 51 deaths per 1,000 live births, although there is considerable variation among the States/Union Territories. Infant mortality rates range from a low of 10 in Andaman and Nicobar Islands to a high of 51 deaths per 1000 live births in Madhya Pradesh.
Better care for women during pregnancy and childbirth contributes to reduction of maternal deaths and improved child survival. Almost all mothers have received antenatal care for their most recent pregnancy and increasing numbers of women are receiving the recommended four or more visits by the service providers. More and more women now give birth in health care facilities and rates have more than doubled in some States in the last decade. More than nine in ten recent births took place in health care facilities in Andaman and Nicobar Islands, Andhra Pradesh, Goa, Karnataka, Puducherry, Sikkim, Tamil Nadu, and Telangana, providing safer environments for mothers and new-borns.
Overall, women in the First Phase States/Union Territories are having fewer children. The total fertility rates, or the average number of children per woman, range from 1.2 in Sikkim to 3.4 in Bihar. All First Phase States/Union Territories except Bihar, Madhya Pradesh and Meghalaya have either achieved or maintained replacement level of fertility– a major achievement in the past decade.
Full immunization coverage among children age 12-23 months varies widely in the First Phase States/Union Territories. At least 6 out of 10 children have received full immunization in 12 of the 15 States / Union Territories. In Goa, West Bengal, Sikkim, and Puducherry more than four-fifths of the children have been fully immunised. Since the last round of National Family Health Survey, the coverage of full immunization among children has increased substantially in the States of Bihar, Madhya Pradesh, Goa, Sikkim, West Bengal and Meghalaya.
Married women are less likely to be using modern family planning in eight of the First Phase States/Union Territories. There has been any increase in the use of modern family planning methods only in the States of Meghalaya, Haryana, and West Bengal. The decline is highest in Goa followed by Karnataka and Tamil Nadu. Despite the decline, about half or more married women are using modern family planning in eight of the 15 States/Union Territories.
Poor nutrition is less common than reported in the last round of National Family Health Survey. Fewer children under five years of age are now found to be stunted, showing intake of improved nutrition. In nine States/Union Territories, less than one-third of children are found too short for their age. While this reveals a distinct improvement since the previous survey, it is found that in Bihar, Madhya Pradesh and Meghalaya more than 40% of children are stunted. Wasting is still very high by international standards in all of the States/Union Territories. Anaemia has also declined, but still remains widespread. More than half of children are anaemic in ten of the 15 States/Union Territories. Similarly, more than half of women are anaemic in eleven States/Union Territories. Over-nutrition continues to be a health issue for adults. At least 3 in 10 women are overweight or obese in Andaman and Nicobar Islands, Andhra Pradesh, Goa, Puducherry, and Tamil Nadu.
Indian families in the First Phase households are now more inclined to use improved water and sanitation facilities. Over two-thirds of households in every State/Union Territory have access to an improved source of drinking water, and more than 90% of households have access to an improved source of drinking water in nine of the 15 States/Union Territories. More than 50% of households have access to improved sanitation facilities in all First Phase States/Union Territories except Bihar and Madhya Pradesh. Use of clean cooking fuel, which reduces the risk of respiratory illness and pollution, varies widely among the First Phase States/Union Territories, ranging from only about 18% of households in Bihar to more than 70% of households in Tamil Nadu and more than 80% of households in Puducherry and Goa.
The 2015-16 National Family Health Survey (NFHS-4) is the fourth in a series of national surveys; earlier National Family Health Surveys were carried out in 1992-93 (NFHS-1), 1998-99 (NFHS-2) and 2005-06 (NFHS-3). NFHS-4 is the first of the NFHS series that collects data in each of India’s 29 States and all 7 Union Territories. Also, NFHS-4, for the first time, will provide estimates of most indicators at the district level for all 640 districts of the country included in the 2011 Census. In NFHS-4, women aged 15-49 years and men aged 15-54 years are interviewed. When the survey is completed throughout the country, approximately 570,000 households would be covered for information.
All National Family Health Surveys have been conducted under the stewardship of the Ministry of Health and Family Welfare, Government of India, with the International Institute for Population Sciences, Mumbai, serving as the nodal agency. ICF International (formerly Macro International), Maryland, USA, provided technical assistance for all four surveys. NFHS-4 funding was provided by the Government of India, the United States Agency for International Development (USAID), the Department for International Development (DFID), the Bill and Melinda Gates Foundation, UNICEF, the United Nations Population Fund (UNFPA), and the MacArthur Foundation. Technical assistance for the HIV component of the survey was provided by the National AIDS Control Organization and the National AIDS Research Institute.