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National Family Health Survey (NFHS)-5

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The findings of the National Family Health Survey-5 have been released in two phases. The
first phase was released in December 2020 and the second phase was released recently in
May 2022. The present document deals with the second phase of NFHS-5.

1. Introduction
● The National Family Health Survey (NFHS) is a large, multi-round survey that, inter
alia, provides information on fertility, infant and child mortality, the practice of family
planning, reproductive health, nutrition, anaemia, quality and utilisation of health and
family planning services. The latest data of the second phase of NFHS-5 — were
released by Union Health Minister Mansukh Mandaviya in Vadodara, Gujarat. Along
with this, Rural Health Statistics Publication for the year 2020-21 were also released.
● NFHS was funded by the United States Agency for International Development
(USAID) with supplementary support from United Nations Children's Fund
(UNICEF).
● The survey was started in the year 1992-93 and culminated in its fifth round in 2019-
21. The data was released in May 2022.
● The NFHS-4 was released in 2014-15. The findings of NFHS-5 have been released in
two phases. The first phase was released in December 2020 and the second phase in
May 2022.
● The surveys provide essential data needed by the Ministry of Health and Family
Welfare and other agencies for policy and programme purposes. The Ministry
assigned the nodal responsibility for the task to the International Institute for
Population Sciences (IIPS), Mumbai.
● The surveys provide essential data needed by the Ministry of Health and Family
Welfare and other agencies for policy and programme purposes. The Ministry
assigned the nodal responsibility for the task to the International Institute for
Population Sciences (IIPS), Mumbai.
● IIPS collaborates with a number of field Organisations to conduct the survey in
different states. Several international agencies are involved in providing technical and
financial assistance, mainly USAID, DFID, UNICEF, and UNFPA.

2. Previous year NFHS

● First Survey- The first NFHS survey was conducted in the year 1992-93.
● Second Surey- The NFHS- 2 was conducted in the year 1998-1999 in 26 states of
India
● Third Survey- The NFHS-3 was carried out in 2005-2006 for all 28 states of India
● Fourth Survey- The NFHS-4 was conducted in 2014-15. It was the first NFhS that
was carried out in all 29 states and 7 Union Territories.
● Further, it was also for the first time that indicators for all 640 districts were included
in the 2011 census. (773 districts in NFHS-5).

3. New indicators Included in NFHS-5

● NFHS-5 includes many new indicators such as death registration, cancer incidence,
pre-school education, expanded domains of child immunisation, menstrual hygiene,
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frequency of alcohol and tobacco, expanded age ranges for measuring hypertension
and diabetes among all aged above 15 years

4. NFHS- 5 on Underage Marriages Total Fertility Rate (TFR)

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● The underage marriage both in men and women has seen a decline from NFHS-4.
According to NFHS-5, 23.3% of 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).
● As per the NFHS-5 national average of underage marriages has come down but
some of the states show an increase in the rate.
● Tripura has seen the largest jump in marriages under the legal age of 18 years for
women from 33.1% (NFHS-4) to 40.1%, and from 16.2% to 20.4% among men.
● West Bengal, along with Bihar, remains one of the states with the highest rate of
underage marriages.
● Underage marriages are lowest in J&K, Lakshadweep, Ladakh, Himachal Pradesh,
Goa, Nagaland, Kerala, Puducherry, and Tamil Nadu.

5. NFHS-5 on Total Fertility Rate (TFR)

● Total Fertility Rates, an average number of children per woman, have declined from
2.2 (NFHS-4) to 2.0 at the national level.
● The Survey says only five states are above the replacement level of fertility of 2.1:
Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26) Manipur
(2.17).
● Institutional births have increased substantially from 79% to 89%. (87 % in rural
areas and 94 % in urban areas)

6. NFHS-5 on use of modern contraception

● According to the survey, the knowledge of contraceptive methods is almost universal
in India — more than 99% of married women and men aged between 15 and 49
know at least one modern method.
● But the use of modern contraceptives for family planning is only 56.4%.

7. NFHS-5 on stunting and obesity

● The proportion of stunted children below the age of 5 has marginally declined from
38.4 per cent to 35.4 per cent during this period.
● Stunting is higher among children in rural areas (37%) as compared to children in
urban areas (30%).
● Nearly 25 % of all women and men are overweight or obese (BMI = 25.0 kg/m2)
and this proportion is increasing over the years.
● The infant mortality rate declined from 41 deaths per 1,000 live births to 35 deaths
per 1,000 live births during the same period.

8. NFHS-5 on seeking government healthcare

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● The survey report shows that the percentage of households that did not generally

● The
report
survey
shows
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use a government health facility during 2019-21 was 49.9%, which is lower than the
55.1% recorded in the previous round of NFHS in 2015-16.

that the
percentage of
households that
did not generally
use a
government
health facility
during 2019-21
was 49.9%,
which is lower
than the 55.1%
recorded in the
previous round
of NFHS in
2015-16.
● The most
commonly reported reason for not using government health facilities at the national
level is the poor quality of care. (48%).

9. NFHS-6
● NFHS-6 is scheduled to be conducted in 2023-24 and is proposed to include new
domains such as COVID- 19 hospitalizations, COVID- 19 vaccinations, migration
data, digital literacy, etc.
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Practice Questions:
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The National Family Health Survey 2019-21 (NFHS-5), the [X] in the NFHS series, provides
information on population, health, and nutrition for India and each state/Union Territory
(UT). NFHS includes topics such as preschool education, disability, access to a toilet facility,
death registration, bathing practices during menstruation, and methods and reasons for
abortion. The scope of clinical, anthropometric, and biochemical testing (CAB) has also been
expanded to include measurement of waist and hip circumferences, and the age range for the
measurement of blood pressure and blood glucose has been expanded. However, HIV
testing has been dropped. The NFHS sample has been designed to provide national,
state/UT, and district level estimates of various indicators covered in the survey. However,
estimates of indicators of sexual behaviour; husband’s background and woman’s work;
HIV/AIDS knowledge, attitudes and behaviour; and domestic violence are available only at
the state/UT and national level.
As in the earlier rounds, the Ministry of Health and Family Welfare, Government of India,
designated the International Institute for Population Sciences, Mumbai, as the nodal agency to
conduct NFHS-5. The main objective of each successive round of the NFHS has been to
provide high-quality data on health and family welfare and emerging issues in this area. NFHS
data will be useful in setting benchmarks and examining the progress the health sector has
made over time. Besides providing evidence for the effectiveness of ongoing programmes,
the data from NFHS help in identifying the need for new programmes with an area specific
focus and identifying groups that are most in need of essential services. Four Survey
Schedules - Household, Woman’s, Man’s, and Biomarker - were canvassed in local languages
using Computer Assisted Personal Interviewing (CAPI). In the Household Schedule,
information was collected on all usual members of the household and visitors who stayed in
the household the previous night, as well as socio-economic characteristics of the household;
water, sanitation, and hygiene; health insurance coverage; disabilities; land ownership;
number of deaths in the household in the three years preceding the survey; and the
ownership and use of mosquito nets.
Readers should be cautious while interpreting and comparing the trends as some states/UTs
may have smaller sample size. Moreover, at the time of survey, Ayushman Bharat AB-PMJAY
and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) were not fully rolled out and
hence, their coverage may not have been factored in the results of indicator 12 (percentage
of households with any usual member covered under a health insurance/financing scheme)
and indicator 41 (percentage of mothers who received 4 or more antenatal care check-ups).
This factsheet provides information on key indicators and trends for NCT Delhi. Due to the
Covid-19 situation and the imposition of lockdown, NFHS fieldwork in phase 2 states/UTs
was conducted in two parts. NFHS fieldwork for NCT Delhi was conducted from January 4
2020 to March 25 2020 prior to the lockdown and from November 21 2020 to January 20
2021 post-lockdown by Population Research Centre (PRC), Institute of Economic Growth
(IEG). Information was gathered from 9,486 households, 11,159 women, and 1,700 men.
Factsheets for each district in NCT Delhi are also available separately.
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Source: Hindustan Times (https://www.hindustantimes.com/ht-insight/public-health/key-
indicators-from-the-national-family-health-survey-nfhs-5-2019-21-factsheet-
101652859945451.html).
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1. The National Family Health Survey 2019-21 was which in series? (Redacted by X in the
passage)
A. Fourth
B. Fifth
C. Sixth
D. Seventh
2. Consider the following statements:
1. The first NFHS survey was conducted in the year 1994-95
2. The latest NFHS includes many new indicators such as death registration, cancer
incidence, pre-school education.
3. The Ministry of Health and Family Welfare assigned the nodal responsibility for the
task to the International Institute for Population Sciences (IIPS)
A. All statements are true
B. Statements i and ii are true
C. Statements ii and iii are true
D. Only statement iii is true
3. What is the Total Fertility Rate (TFR) as per the latest NFHS?
A. 2.1
B. 2.2
C. 2.0
D. 2.3
4. Who among the following is the current union health minister?
A. Mansukh Mandaviya
B. Ashwani Vaishnaw
C. Kiren Rijiju
D. Ramesh Pokhriyal
5. Which state has seen the largest jump in marriages under the legal age of 18 years for
women from 33.1%?
A. Assam
B. Jharkhand
C. Tripura
D. Chhattisgarh

Answers:
1. B
2. C
3. C
4. A
5. C