National Family Health Survey (NFHS) 2020: Observations, significance and way ahead

The Union Minister of Health and Family Welfare, Dr Harsh Vardhan recently released the National Family Health Survey 2019-20, NFHS-5. It includes the factsheets of key indicators on population, reproductive and child health, family welfare, nutrition for 22 States/UTs of India. It was released on Universal Health Coverage Day, that is December 12, 2020. 

What is the National Family Health Survey, NFHS?

The National Family Health Survey, NFHS is a large-scale, multi-round survey that is conducted in a representative sample of households across India. Three rounds of the survey are being conducted since the first survey in 1992-93.

NFHS provides reliable and comparable datasets on health, family welfare and other emerging issues. Four rounds of NFHS conducted in 1992–93, 1998–99, 2005–06 and 2015–16, have been successfully completed in India. 

International Institute for Population Sciences, IIPS, Mumbai is the nodal agency that conducts NFHS. Earlier Ministry of Health itself conducted District Level Health Survey, DLHS and Annual Health Survey, AHS. 

States under the survey: These 22 Phase-I States/UTs are Andhra Pradesh, Assam, Bihar, Goa, Gujarat, Himachal Pradesh, Karnataka, Kerala, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Telangana, Tripura, West Bengal, Andaman Nicobar Island, Dadra and Nagar Haveli and Daman and Diu, Jammu and Kashmir, Ladakh and Lakshadweep. 

Remaining states: The fieldwork in the remaining 14 (Phase-II) States/UTs is under progress.

Significance of NFHS:

The survey provides state and national information for India on fertility, infant and child mortality, the practice of family planning, maternal and child health, reproductive health, nutrition, anaemia, utilization and quality of health and family planning services. 

Goals of NFHS:

a) to provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes

b) to provide information on important emerging health and family welfare issues

National Family Health Survey 2019-20: Findings

1. The NFHS-5 was conducted in around 6.1 lakh sample households to provide disaggregated data up to district levels. It is still going on in some states
2. Total Fertility Rate (TFR) has declined since NFHS-4 in almost every Phase-1 State and UT. The replacement level of fertility was 2.1 in 19 out of the 22 States/UTs. Only 3 states exceeded the mark, namely Manipur at 2.2, Meghalaya at 2.9, and Bihar at 3.0. 
3. Overall Contraceptive Prevalence Rate, CPR saw a substantial increment in most States/UTs and it has been the highest in Himachal Pradesh and West Bengal at 74%. 
4. Unmet needs of family planning's trend declined in most of the Phase-1 States/UTs.
5. Full immunization drive among children between ages 12-23 months, recorded a substantial improvement. In 75% of the districts surveyed, 70% of children between 12-23 months are fully immunized against childhood diseases.
6. 11 out of the 22 states and UTs saw an increment of over 10 per cent in immunisation and in another 4 states/UT, the range was between 5 to 9 per cent over a short span of 4 years. This can be attributed to the flagship initiative of Mission Indradhanush launched by the government since 2015.
7. An increase in the per cent of women receiving the recommended four or more ANC visits by health providers in many States/UTs has also been observed. 
8. Institutional births have increased in a good amount with more than four-fifths of the women delivering in institutions in 19 States and UTs. 

Keeping in view of the prevailing COVID-19 situation, a lot of planning and preparations have been carried out in terms of the necessary revisions in the survey protocols and protective measures to resume fieldwork in Phase II States/UTs. 

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