Why NFHS Matters?
The National Family Health Survey (NFHS) is India’s most comprehensive health and demographic survey. Conducted periodically by the Ministry of Health and Family Welfare, it serves as the backbone of evidence-based policymaking in areas such as nutrition, maternal and child health, population, gender, and public health.
1. India is Moving Towards Population Stabilisation
India has achieved a major demographic milestone with fertility levels remaining below the replacement rate.
Key Data
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- Total Fertility Rate (TFR): 1.9 children per woman (NFHS-6), down from 2.0 in NFHS-5.
- Replacement-level fertility is 2.1 children per woman.
- Women aged 20-24 years married before 18 years declined from 23.3% (NFHS-5) to 16.7% (NFHS-6).
- Teenage motherhood has continued to decline across most states.
- Modern contraceptive use has expanded significantly, contributing to lower fertility rates.
Significance
India is now experiencing a demographic transition characterized by:
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- Smaller families
- Slower population growth
- Rising working-age population
- Greater female participation in education and employment
This demographic shift can generate a demographic dividend, provided sufficient investments are made in education, skills, and employment.
2. Maternal and Child Healthcare Has Improved Dramatically
NFHS-6 shows that access to maternal and child healthcare services has expanded substantially across the country.
Maternal Health Indicators
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- 95%+ women received antenatal care during pregnancy.
- Institutional deliveries exceed 95%, indicating that most births now take place in health facilities.
- Skilled health personnel attend the overwhelming majority of deliveries.
- Iron and Folic Acid (IFA) consumption during pregnancy has improved, though compliance remains a concern.
Child Health Indicators
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- Full immunization coverage has reached around 93%, one of the highest levels recorded in India.
- Coverage of key vaccines such as BCG, Polio, Pentavalent, and Measles has improved significantly.
- Early breastfeeding practices and postnatal care coverage have also expanded.
Significance
These improvements reflect the impact of initiatives such as:
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- Janani Suraksha Yojana (JSY)
- Janani Shishu Suraksha Karyakram (JSSK)
- POSHAN Abhiyaan
- Mission Indradhanush
- Ayushman Bharat
As a result, India has witnessed sustained reductions in maternal mortality and child mortality over the last decade.
3. Child Malnutrition is Improving but Remains a Concern
Despite steady progress, child malnutrition continues to affect millions of Indian children.
Key Data
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- Stunting (low height-for-age): 32.8% (down from 35.5%)
- Underweight children: 29.2% (down from 32.1%)
- Wasting (low weight-for-height): 16.1% (almost unchanged)
- Severely wasted children: 5.7% (down from 7.7%)
Significance
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- Nearly 1 in every 3 children still suffers from chronic undernutrition.
- Malnutrition remains a major cause of poor learning outcomes, low productivity, and disease vulnerability.
- Regional disparities continue to persist despite improvements at the national level.
4. India Faces a New Challenge: Rising Obesity
While undernutrition is declining, obesity is emerging as a major public health concern.
Key Data
Women (15-49 years)
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- Overweight/Obese: 30.7%
- NFHS-5: 24.0%
Men (15-49 years)
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- Overweight/Obese: 27.3%
- NFHS-5: 22.9%
Significance
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- Nearly 1 in 3 Indian women is now overweight or obese.
- Urban areas show significantly higher obesity levels.
- Obesity is driving increases in diabetes, hypertension, heart disease, and stroke.
Key Insight
India now faces a double burden of malnutrition—persistent undernutrition among children and rising obesity among adults.
5. Lifestyle Diseases are Rising Rapidly
NFHS-6 highlights a sharp increase in non-communicable diseases (NCDs), which are becoming India’s biggest health challenge.
Diabetes / High Blood Sugar
Women
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- High blood sugar or on medication: 17.8%
- NFHS-5: 13.5%
Men
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- High blood sugar or on medication: 20.9%
- NFHS-5: 15.6%
Hypertension
Women
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- Elevated blood pressure: 19.4%
Men
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- Elevated blood pressure: 22.1%
Significance
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- More Indians are now at risk from lifestyle diseases than from many infectious diseases.
- The burden on healthcare systems is likely to increase substantially in the coming decades.
6. Women’s Empowerment Indicators Show Significant Progress
NFHS-6 records notable gains in financial inclusion, digital access, and decision-making among women.
Key Data
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- Women participating in major household decisions: 89%
- Women with their own bank account: 89%
- Women owning and using a mobile phone: 63.6% (up from 53.9%)
- Young women using hygienic menstrual products: 79.2% (up from 77.6%)
Significance
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- Financial independence among women is increasing rapidly.
- Digital access is improving women’s participation in education, banking, and governance.
- Better menstrual hygiene contributes to improved health and school attendance.
7. Gender-Based Violence Remains a Serious Concern
While women are becoming more empowered economically and socially, domestic violence remains widespread.
Key Data
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- Ever-married women experiencing spousal violence: 22.3%
- NFHS-5: 29.2%
- Women experiencing violence during pregnancy: 2.7%
- Young women facing sexual violence before age 18: 0.7%
Significance
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- Although spousal violence has declined, more than one in five women still experiences domestic violence.
- Violence remains a major barrier to gender equality and women’s well-being.
Key Insight
Economic empowerment alone is insufficient; deeper social and behavioural changes are needed.
8. Tobacco and Alcohol Consumption Show a Gradual Decline
NFHS-6 records encouraging progress in reducing substance use.
Tobacco Use
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- Women using tobacco: 8.4%
- Men using tobacco: 36.3%
- NFHS-5 (Men): 38.0%
Alcohol Consumption
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- Women consuming alcohol: 1.1%
- Men consuming alcohol: 18.9%
Significance
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- Tobacco continues to be a major risk factor for cancer, heart disease, and respiratory illnesses.
- Declining consumption suggests positive outcomes from awareness campaigns, taxation measures, and tobacco-control policies.
Key Message of NFHS-6
India’s health story is increasingly defined by a transition from high fertility, infectious diseases, and poor healthcare access towards lower fertility, better healthcare coverage, and growing challenges from obesity, diabetes, hypertension, and lifestyle-related disorders. This transition will shape India’s public health priorities over the next decade.
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