Lok Sabha Question No. 4965 (UNSTARRED), answered on 2022-04-01
Subject: Objective of National Family Health Survey
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Mahesh Sahoo

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 4965 TO BE ANSWERED ON 01.04.2022

## OBJECTIVE OF NATIONAL FAMILY HEALTH SURVEY

## 4965: SHRI MAHESH SAHOO:

Will the Minister of HEALTH & FAMILY WELFARE be pleased to state:

- (a) the objectives and importance of conducting National Family Health Survey (NFHS);
- (b)  the finding of the NFHSs conducted so far, State/UT-wise particularly in Odisha;
- (c) whether there has been any positive growth marked in the latest survey as compared to the previous surveys; and
- (d) if so, the details thereof?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH & FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

- (a)  &  (b):    The  Ministry  of  Health  &  Family  Welfare  conducts  one  integrated  survey  namely National Family Health Survey (NFHS) at an interval of about 3 years. The broad objectives of NFHS are to provide high  quality  data  on  population  and  health  indicators  as  well  as  data  on emerging issues in health and family welfare and to provide essential information that may assist policymakers and programme managers in setting benchmarks.

Five rounds of NFHS have been completed during the period 1992-93, 1998-99, 2005-06, 201516 and 2019-21. Keeping in view the content, coverage, sample size, design and methodology, the fourth round of NFHS has been considered as the benchmark for all future rounds of the survey. The State/UT wise details of performance of key health and family welfare indicators in NFHS-4 (2015-16) and NFHS-5 (2019-21) including the State of Odisha are given at Annexure-I.

- (c) & (d): It is evident from the recent round of NFHS that there are significant improvements in the key health, family welfare and associated indicators as compared to the previous rounds. The performance of key indicators emerged in NFHS-4 and NFHS-5 are given at Annexure-II.

****

## Performance of Key Health and Family Welfare Indicators by States/UTs, NFHS-4 & NFHS-5

| India/States/UTs         | Total Fertility Rate (Children per Woman)   | Total Fertility Rate (Children per Woman)   | Under-Five Mortality rate (U5MR)   | Under-Five Mortality rate (U5MR)   | Current users of family planning- Any method (%)   | Current users of family planning- Any method (%)   | Total Unmet Need (%)   | Total Unmet Need (%)   | Mothers who had at least 4 Antenatal care visits (%)   | Mothers who had at least 4 Antenatal care visits (%)   |
|--------------------------|---------------------------------------------|---------------------------------------------|------------------------------------|------------------------------------|----------------------------------------------------|----------------------------------------------------|------------------------|------------------------|--------------------------------------------------------|--------------------------------------------------------|
| India/States/UTs         | NFHS-4                                      | NFHS-5                                      | NFHS-4                             | NFHS-5                             | NFHS-4                                             | NFHS-5                                             | NFHS-4                 | NFHS-5                 | NFHS-4                                                 | NFHS-5                                                 |
| INDIA                    | 2.0                                         | 2.2                                         | 49.7                               | 41.9                               | 53.5                                               | 66.7                                               | 12.9                   | 9.4                    | 51.2                                                   | 58.1                                                   |
| Andaman &Nicobar Islands | 1.4                                         | 1.3                                         | 13.0                               | (24.5)                             | 50.8                                               | 65.8                                               | 15.5                   | 13.5                   | 92.1                                                   | 83.4                                                   |
| Andhra Pradesh           | 1.8                                         | 1.7                                         | 40.8                               | 35.2                               | 69.5                                               | 71.1                                               | 4.7                    | 4.7                    | 76.3                                                   | 67.5                                                   |
| Arunachal Pradesh        | 2.1                                         | 1.8                                         | 32.9                               | 18.8                               | 31.7                                               | 59.1                                               | 21.5                   | 12.5                   | 26.7                                                   | 36.5                                                   |
| Assam                    | 2.2                                         | 1.9                                         | 56.5                               | 39.1                               | 52.4                                               | 60.8                                               | 14.2                   | 11.0                   | 46.4                                                   | 50.7                                                   |
| Bihar                    | 3.4                                         | 3.0                                         | 58.1                               | 56.4                               | 24.1                                               | 55.8                                               | 21.2                   | 13.6                   | 14.4                                                   | 25.2                                                   |
| Chandigarh               | 1.6                                         | 1.4                                         | *                                  | *                                  | 74.0                                               | 77.4                                               | 6.3                    | 6.9                    | 64.5                                                   | 78.7                                                   |
| Chhattisgarh             | 2.2                                         | 1.8                                         | 64.3                               | 50.4                               | 57.7                                               | 67.8                                               | 11.1                   | 8.3                    | 59.1                                                   | 60.1                                                   |
| DNH&DD                   | 2.1                                         | 1.8                                         | 39.9                               | 37.0                               | 36.2                                               | 68.0                                               | 19.5                   | 11.9                   | 71.9                                                   | 86.2                                                   |
| Goa                      | 1.7                                         | 1.3                                         | (12.9)                             | (10.6)                             | 26.3                                               | 67.9                                               | 17.5                   | 8.4                    | 89.0                                                   | 93.0                                                   |
| Gujarat                  | 2.0                                         | 1.9                                         | 43.5                               | 37.6                               | 46.9                                               | 65.3                                               | 17.0                   | 10.3                   | 70.5                                                   | 76.9                                                   |
| Haryana                  | 2.1                                         | 1.9                                         | 41.1                               | 38.7                               | 63.7                                               | 73.1                                               | 9.3                    | 7.6                    | 45.1                                                   | 60.4                                                   |
| Himachal Pradesh         | 1.9                                         | 1.7                                         | 37.6                               | 28.9                               | 57.0                                               | 74.2                                               | 15.7                   | 7.9                    | 69.1                                                   | 70.3                                                   |
| Jammu &Kashmir           | 2.0                                         | 1.4                                         | 37.6                               | 18.5                               | 57.1                                               | 59.8                                               | 12.4                   | 7.8                    | 81.2                                                   | 80.9                                                   |
| Jharkhand                | 2.6                                         | 2.3                                         | 54.3                               | 45.4                               | 40.4                                               | 61.7                                               | 18.4                   | 11.5                   | 30.3                                                   | 38.6                                                   |
| Karnataka                | 1.8                                         | 1.7                                         | 31.5                               | 29.5                               | 51.8                                               | 68.7                                               | 10.4                   | 6.5                    | 70.1                                                   | 70.9                                                   |
| Kerala                   | 1.6                                         | 1.8                                         | 7.1                                | 5.2                                | 53.1                                               | 60.7                                               | 13.7                   | 12.5                   | 90.1                                                   | 78.6                                                   |
| Ladakh                   | 2.3                                         | 1.3                                         | 40.6                               | 29.5                               | 66.6                                               | 51.3                                               | 9.6                    | 7.9                    | 87.5                                                   | 78.4                                                   |
| Lakshadweep              | 1.8                                         | 1.4                                         | (30.2)                             | (0.0)                              | 29.7                                               | 52.6                                               | 16.9                   | 12.3                   | 82.3                                                   | 88.3                                                   |
| Madhya Pradesh           | 2.3                                         | 2.0                                         | 64.6                               | 49.2                               | 51.4                                               | 71.7                                               | 12.1                   | 7.7                    | 35.7                                                   | 57.5                                                   |
| Maharashtra              | 1.9                                         | 1.7                                         | 28.7                               | 28.0                               | 64.8                                               | 66.2                                               | 9.7                    | 9.6                    | 72.2                                                   | 70.3                                                   |
| Manipur                  | 2.6                                         | 2.2                                         | 25.9                               | 30.0                               | 23.6                                               | 61.3                                               | 30.1                   | 12.2                   | 69.0                                                   | 79.4                                                   |
| Meghalaya                | 3.0                                         | 2.9                                         | 39.6                               | 40.0                               | 24.3                                               | 27.4                                               | 21.2                   | 26.9                   | 50.0                                                   | 52.2                                                   |
| Mizoram                  | 2.3                                         | 1.9                                         | 46.0                               | 24.0                               | 35.3                                               | 31.2                                               | 20.0                   | 18.9                   | 61.4                                                   | 58.0                                                   |
| Nagaland                 | 2.7                                         | 1.7                                         | 37.5                               | 33.0                               | 26.5                                               | 57.4                                               | 22.3                   | 9.1                    | 15.0                                                   | 20.7                                                   |
| NCT of Delhi             | 1.8                                         | 1.6                                         | 42.2                               | 30.6                               | 54.9                                               | 76.4                                               | 15.0                   | 6.1                    | 67.9                                                   | 77.2                                                   |
| Odisha                   | 2.1                                         | 1.8                                         | 48.1                               | 41.1                               | 57.3                                               | 74.1                                               | 13.6                   | 7.2                    | 61.9                                                   | 78.1                                                   |
| Puducherry               | 1.7                                         | 1.5                                         | 16.2                               | 3.9                                | 61.9                                               | 66.0                                               | 8.3                    | 10.5                   | 87.7                                                   | 86.9                                                   |
| Punjab                   | 1.6                                         | 1.6                                         | 33.2                               | 32.7                               | 75.8                                               | 66.6                                               | 6.2                    | 9.9                    | 68.5                                                   | 59.3                                                   |
| Rajasthan                | 2.4                                         | 2.0                                         | 50.7                               | 37.6                               | 59.7                                               | 72.3                                               | 12.3                   | 7.6                    | 38.5                                                   | 55.3                                                   |
| Sikkim                   | 1.2                                         | 1.1                                         | 32.2                               | 11.2                               | 46.7                                               | 69.1                                               | 21.7                   | 11.9                   | 74.7                                                   | 58.4                                                   |
| Tamil Nadu               | 1.7                                         | 1.8                                         | 26.8                               | 22.3                               | 53.2                                               | 68.6                                               | 10.1                   | 7.5                    | 81.1                                                   | 89.9                                                   |
| Telangana                | 1.8                                         | 1.8                                         | 31.7                               | 29.4                               | 57.2                                               | 68.1                                               | 7.4                    | 6.4                    | 74.9                                                   | 70.4                                                   |
| Tripura                  | 1.7                                         | 1.7                                         | 32.7                               | 43.3                               | 64.1                                               | 71.2                                               | 10.7                   | 8.2                    | 64.3                                                   | 52.7                                                   |
| Uttar Pradesh            | 2.7                                         | 2.4                                         | 78.1                               | 59.8                               | 45.5                                               | 62.4                                               | 18.1                   | 12.9                   | 26.4                                                   | 42.4                                                   |
| Uttarakhand              | 2.1                                         | 1.9                                         | 46.5                               | 45.6                               | 53.4                                               | 70.8                                               | 15.5                   | 8.8                    | 30.9                                                   | 61.8                                                   |
| West Bengal              | 1.8                                         | 1.6                                         | 31.8                               | 25.4                               | 70.9                                               | 74.4                                               | 7.5                    | 7.0                    | 76.4                                                   | 75.8                                                   |

## Annexure -I (Continued)

## Performance of Key Health and Family Welfare Indicators by States/UTs, NFHS-4 & NFHS-5

| India/States/UTs         | Institutional Births (%)   | Institutional Births (%)   | Children under 5 years who are stunted (height-for-age) (%)   | Children under 5 years who are stunted (height-for-age) (%)   | Children under 5 years who are wasted (weight-for-height) (%)   | Children under 5 years who are wasted (weight-for-height) (%)   | Children under 5 years who are underweight (weight- for-age) (%)   | Children under 5 years who are underweight (weight- for-age) (%)   |
|--------------------------|----------------------------|----------------------------|---------------------------------------------------------------|---------------------------------------------------------------|-----------------------------------------------------------------|-----------------------------------------------------------------|--------------------------------------------------------------------|--------------------------------------------------------------------|
| India/States/UTs         | NFHS-4                     | NFHS-5                     | NFHS-4                                                        | NFHS-5                                                        | NFHS-4                                                          | NFHS-5                                                          | NFHS-4                                                             | NFHS-5                                                             |
| INDIA                    | 78.9                       | 88.6                       | 38.4                                                          | 35.5                                                          | 21                                                              | 19.3                                                            | 35.8                                                               | 32.1                                                               |
| Andaman &Nicobar Islands | 96.4                       | 99.0                       | 23.3                                                          | 22.5                                                          | 18.9                                                            | 16.0                                                            | 21.6                                                               | 23.7                                                               |
| Andhra Pradesh           | 91.5                       | 96.5                       | 31.4                                                          | 31.2                                                          | 17.2                                                            | 16.1                                                            | 31.9                                                               | 29.6                                                               |
| Arunachal Pradesh        | 52.2                       | 79.2                       | 29.4                                                          | 28.0                                                          | 17.3                                                            | 13.1                                                            | 19.4                                                               | 15.4                                                               |
| Assam                    | 70.6                       | 84.1                       | 36.4                                                          | 35.3                                                          | 17.0                                                            | 21.7                                                            | 29.8                                                               | 32.8                                                               |
| Bihar                    | 63.8                       | 76.2                       | 48.3                                                          | 42.9                                                          | 20.8                                                            | 22.9                                                            | 43.9                                                               | 41.0                                                               |
| Chandigarh               | 91.6                       | 96.9                       | 28.7                                                          | 25.3                                                          | 10.9                                                            | 8.4                                                             | 24.5                                                               | 20.6                                                               |
| Chhattisgarh             | 70.2                       | 85.7                       | 37.6                                                          | 34.6                                                          | 23.1                                                            | 18.9                                                            | 37.7                                                               | 31.3                                                               |
| DNH&DD                   | 88.5                       | 96.5                       | 37.2                                                          | 39.4                                                          | 26.7                                                            | 21.6                                                            | 35.8                                                               | 38.7                                                               |
| Goa                      | 96.9                       | 99.7                       | 20.1                                                          | 25.8                                                          | 21.9                                                            | 19.1                                                            | 23.8                                                               | 24.0                                                               |
| Gujarat                  | 88.5                       | 94.3                       | 38.5                                                          | 39.0                                                          | 26.4                                                            | 25.1                                                            | 39.3                                                               | 39.7                                                               |
| Haryana                  | 80.4                       | 94.9                       | 34.0                                                          | 27.5                                                          | 21.2                                                            | 11.5                                                            | 29.4                                                               | 21.5                                                               |
| Himachal Pradesh         | 76.4                       | 88.2                       | 26.3                                                          | 30.8                                                          | 13.7                                                            | 17.4                                                            | 21.2                                                               | 25.5                                                               |
| Jammu &Kashmir           | 85.5                       | 92.4                       | 27.4                                                          | 26.9                                                          | 12.2                                                            | 19.0                                                            | 16.6                                                               | 21.0                                                               |
| Jharkhand                | 61.9                       | 75.8                       | 45.3                                                          | 39.6                                                          | 29.0                                                            | 22.4                                                            | 47.8                                                               | 39.4                                                               |
| Karnataka                | 94.0                       | 97.0                       | 36.2                                                          | 35.4                                                          | 26.1                                                            | 19.5                                                            | 35.2                                                               | 32.9                                                               |
| Kerala                   | 99.8                       | 99.8                       | 19.7                                                          | 23.4                                                          | 15.7                                                            | 15.8                                                            | 16.1                                                               | 19.7                                                               |
| Ladakh                   | 90.8                       | 95.1                       | 30.9                                                          | 30.5                                                          | 9.3                                                             | 17.5                                                            | 18.7                                                               | 20.4                                                               |
| Lakshadweep              | 99.3                       | 99.6                       | 26.8                                                          | 32.0                                                          | 13.7                                                            | 17.4                                                            | 23.6                                                               | 25.8                                                               |
| Madhya Pradesh           | 80.8                       | 90.7                       | 42.0                                                          | 35.7                                                          | 25.8                                                            | 19.0                                                            | 42.8                                                               | 33.0                                                               |
| Maharashtra              | 90.3                       | 94.7                       | 34.4                                                          | 35.2                                                          | 25.6                                                            | 25.6                                                            | 36.0                                                               | 36.1                                                               |
| Manipur                  | 69.1                       | 79.9                       | 28.9                                                          | 23.4                                                          | 6.8                                                             | 9.9                                                             | 13.8                                                               | 13.3                                                               |
| Meghalaya                | 51.4                       | 58.1                       | 43.8                                                          | 46.5                                                          | 15.3                                                            | 12.1                                                            | 28.9                                                               | 26.6                                                               |
| Mizoram                  | 79.7                       | 85.8                       | 28.1                                                          | 28.9                                                          | 6.1                                                             | 9.8                                                             | 12.0                                                               | 12.7                                                               |
| Nagaland                 | 32.8                       | 45.7                       | 28.6                                                          | 32.7                                                          | 11.3                                                            | 19.1                                                            | 16.7                                                               | 26.9                                                               |
| NCT of Delhi             | 84.4                       | 91.8                       | 31.9                                                          | 30.9                                                          | 15.9                                                            | 11.2                                                            | 27.0                                                               | 21.8                                                               |
| Odisha                   | 85.3                       | 92.2                       | 34.1                                                          | 31.0                                                          | 20.4                                                            | 18.1                                                            | 34.4                                                               | 29.7                                                               |
| Puducherry               | 99.9                       | 99.6                       | 23.7                                                          | 20.0                                                          | 23.6                                                            | 12.4                                                            | 22.0                                                               | 15.3                                                               |
| Punjab                   | 90.5                       | 94.3                       | 25.7                                                          | 24.5                                                          | 15.6                                                            | 10.6                                                            | 21.6                                                               | 16.9                                                               |
| Rajasthan                | 84.0                       | 94.9                       | 39.1                                                          | 31.8                                                          | 23.0                                                            | 16.8                                                            | 36.7                                                               | 27.6                                                               |
| Sikkim                   | 94.7                       | 94.7                       | 29.6                                                          | 22.3                                                          | 14.2 19.7                                                       | 13.7                                                            | 14.2                                                               | 13.1                                                               |
| Tamil Nadu               | 98.9                       | 99.6                       | 27.1                                                          | 25.0                                                          |                                                                 | 14.6                                                            | 23.8                                                               | 22.0                                                               |
| Telangana                | 91.5                       | 97.0                       | 28.0                                                          | 33.1                                                          | 18.1                                                            | 21.7                                                            | 28.4                                                               | 31.8                                                               |
| Tripura                  | 79.9                       | 89.2                       | 24.3                                                          | 32.3                                                          | 16.8                                                            | 18.2                                                            | 24.1                                                               | 25.6                                                               |
| Uttar Pradesh            | 67.8                       | 83.4                       | 46.3                                                          | 39.7                                                          | 17.9                                                            | 17.3                                                            | 39.5                                                               | 32.1                                                               |
| Uttarakhand              | 68.6                       | 83.2                       | 33.5                                                          | 27.0                                                          | 19.5                                                            | 13.2                                                            | 26.6                                                               | 21.0                                                               |
| West Bengal              | 75.2                       | 91.7                       | 32.5                                                          | 33.8                                                          | 20.3                                                            | 20.3                                                            | 31.6                                                               | 32.2                                                               |

Source: NFHS Reports and Factsheets available on website: http://rchiips.org/NFHS/index.shtml

NA: Not Available

For under-five mortality rate, figures in ( ) are based on 250-499 unweighted person-years of exposure to the risk of death; and * denotes  figures  not  given  based  on  fewer  than  250  unweighted  person-years  of  exposure  to  the  risk  of  death.  For  all  other indicators, figures in  (  )  are  based  on  25-49  unweighted cases;  and * denotes percentage not shown based on fewer than 25 unweighted cases.

## Annexure-II

## Performance of Key Indicators, NFHS-4 & NFHS-5

| Sl. No.   | Indicator                                                                                                                    | NFHS-4 (2015-16)   | NFHS-5 (2019-21)   |
|-----------|------------------------------------------------------------------------------------------------------------------------------|--------------------|--------------------|
|           | Population and Household Profile                                                                                             |                    |                    |
| 1         | Children under age 5 years whose birth was registered with the civil authority (%)                                           | 79.7               | 89.1               |
| 2         | Population living in households with electricity (%)                                                                         | 88                 | 96.8               |
| 3         | Population living in households with an improved drinking-water source (%)                                                   | 94.4               | 95.9               |
| 4         | Population living in households that use an improved sanitation facility (%)                                                 | 48.5               | 70.2               |
| 5         | Households using clean fuel for cooking (%)                                                                                  | 43.8               | 58.6               |
| 6         | Households with any usual member covered under a health insurance/financing scheme (%)                                       | 28.7               | 41                 |
|           | Marriage and Fertility                                                                                                       |                    |                    |
| 7         | Women age 20-24 years married before age 18 years (%)                                                                        | 26.8               | 23.3               |
| 8         | Women age 15-19 years who were already mothers or pregnant at the time of the survey (%)                                     | 7.9                | 6.8                |
| 9         | Total fertility rate (children per woman)                                                                                    | 2.2                | 2.0                |
|           | Family Planning                                                                                                              |                    |                    |
| 10        | Current Use of Family Planning Methods- Any method (%)                                                                       | 53.5               | 66.7               |
| 11        | Current Use of Family Planning Methods- Any modern method (%)                                                                | 47.8               | 56.5               |
| 12        | Total unmet need for Family Planning (%)                                                                                     | 12.9               | 9.4                |
|           | Maternity and Delivery Care                                                                                                  |                    |                    |
| 13        | Mothers who had an antenatal check-up in the first trimester (%)                                                             | 58.6               | 70                 |
| 14        | Mothers who had at least 4 antenatal care visits (%)                                                                         | 51.2               | 58.1               |
| 15        | Mothers who received postnatal care from a doctor/nurse/LHV/ANM/midwife/other health personnel within 2 days of delivery (%) | 62.4               | 78                 |
| 16        | Institutional births (%)                                                                                                     | 78.9               | 88.6               |
|           | Child Vaccination and Child Feeding Practices                                                                                |                    |                    |
| 17        | Children age 12-23 months fully vaccinated based on information from either vaccination card or mother's recall (%)          | 62                 | 76.4               |
| 18        | Children under age 3 years breastfed within one hour of birth (%)                                                            | 41.6               | 41.8               |
| 19        | Children under age 6 months exclusively breastfed (%)                                                                        | 54.9               | 63.7               |
|           | Nutritional Status of Children                                                                                               |                    |                    |
| 20        | Children under 5 years who are stunted (height-for-age) (%)                                                                  | 38.4               | 35.5               |
| 21        | Children under 5 years who are wasted (weight-for-height) (%)                                                                | 21                 | 19.3               |
| 22        | Children under 5 years who are underweight (weight-for-age) (%)                                                              | 35.8               | 32.1               |
|           | Women's Empowerment                                                                                                          |                    |                    |
| 23        | Women having a bank or savings account that they themselves use (%)                                                          | 53                 | 78.6               |
| 24        | Women age 15-24 years who use hygienic methods of protection during their menstrual period (%)                               | 57.6               | 77.3               |

Source: NFHS Reports and Factsheets