The report of the fifth round of the National Family Health Survey (NFHS-5) revealed that the total fertility rate of India has declined from 2.2 to 2.0 indicating the significant progress of population control measures.
The Total Fertility Rate (TFR) which is measured as the average number of children per woman, has come down from 2.2 to 2.0 at the national level between NFHS-4 and 5.
There are only five states in India, which are above the replacement level of fertility of 2.1. including Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26) Manipur (2.17). The NFHS-5 survey work was conducted in around 6.37 lakh sample households from 707 districts (as of March 2017) of the country from 28 States and 8 UTs, covering 7,24,115 women and 1,01,839 men to provide disaggregated estimates up to district level.
The Overall Contraceptive Prevalence Rate (CPR) has increased substantially from 54 percent to 67 percent in the country. “Use of modern methods of contraceptives has also increased in almost all States/UTs. Unmet needs for family planning have witnessed a significant decline from 13 percent to 9 percent. The unmet need for spacing, which remained a major issue in India in the past has come down to less than 10 percent,” said an official statement.
The NHFS-5 also mentioned that institutional births have increased substantially from 79 percent to 89 percent in India. Even in rural areas around 87 percent of births are delivered in institutions and the same is 94 percent in urban areas. Institutional births increased by a maximum of 27 percentage points in Arunachal Pradesh, followed by over 10 percentage points in Assam, Bihar, Meghalaya, Chhattisgarh, Nagaland, Manipur, Uttar Pradesh, and West Bengal. Over 91 percent of districts have more than 70 percent of births in the last 5 years that took place in health facilities.
As per the survey, the level of stunting among children under 5 years has marginally declined from 38 to 36 percent in India in the last four years. Stunting is higher among children in rural areas (37 percent) than in urban areas (30 percent) in 2019-21. Variation in stunting ranges from the lowest in Puducherry (20 percent) to and highest in Meghalaya (47 percent).
A notable decrease in stunting was observed in Haryana, Uttarakhand, Rajasthan, Uttar Pradesh, and Sikkim (7 percentage points each), Jharkhand, Madhya Pradesh, and Manipur (6 percentage points each), and Chandigarh and Bihar (5 percentage points each). Compared with NFHS-4, the prevalence of overweight or obesity has increased in most States/UTs in NFHS-5. At the national level, it increases from 21 percent to 24 percent among women and 19 percent to 23 percent among men. More than a third of women in Kerala, A&N Islands, Andhra Pradesh, Goa, Sikkim, Manipur, Delhi, Tamil Nadu, Puducherry, Punjab, Chandigarh, and Lakshadweep (34-46 percent) are overweight or obese.
In NFHS-5, more than three-fourths (77 percent) of children aged 12-23 months were fully immunized, compared with 62 percent in NFHS-4 as the full vaccination coverage among children ranges from 57 percent in Nagaland to 95 percent in DNH and DD. Odisha (91 percent), Tamil Nadu (89 percent), and West Bengal (88 percent) also have shown relatively higher immunization coverage. Interestingly, NFHS-5 data showed an overall improvement in SDG indicators in all States/UTs. The extent to which married women usually participate in three household decisions (about health care for themselves; making major household purchases; visiting their family or relatives) indicates that their participation in decision making is high, ranging from 80 percent in Ladakh to 99 percent in Nagaland and Mizoram. Rural (77 percent) and urban (81 percent) differences are found to be marginal.
The prevalence of women having bank or savings accounts that they use has increased from 53 to 79 percent in the last 4 years. NFHS-5 also mentions an increase in usage of clean cooking fuel (44 percent to 59 percent) and improved sanitation facilities (49 percent to 70 percent), including a hand-washing facility with soap and water (60 percent to 78 percent) 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 program.