Lok Sabha Question No. 1053 (UNSTARRED), answered on 2023-12-08
Subject: National Family Health Survey-5
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Behanan Benny

## GOVERNMENTOFINDIA

## MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA

## UNSTARRED QUESTION NO. 1053 TO BE ANSWERED ON 08.12.2023

## NATIONALFAMILY HEALTH SURVEY-5

## 1053. SHRI BENNY BEHANAN:

Will the Minister of Health and Family Welfare be pleased to state :

(a) the details of the performance metrics for Scheduled Tribes (STs) under various health indicators in National Family Health Survey-5 (NFHS-5) such as mortality rates, maternal and child care, disease treatment, vaccinations, since 2019, State/UT-wise;

(b) the measures taken/proposed to take by the Government to enhance the health condition of the poor and marginalized tribes, State/UT-wise; and

(c) the steps taken/proposed to be taken by the Government to identify the impact on healthcare outcomes among women and children in tribal families due to wealth inequality, State/UT-wise?

## ANSWER

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

(a) to (c): The State-wise figures of NFHS-5 (2019-21) for various health indicators such as infant and child mortality, maternal and child care, disease treatment and child vaccination for Scheduled Tribes are placed at Annexure .

The National Health Policy 2017 under Ministry of Health & Family Welfare envisages to provide universal access to good quality health care services through increasing access, increasing affordability by lowering the cost of healthcare delivery and equity. The goal of the policy is to attain the highest possible level of health and well-being for all through a preventive and promotive health care orientation in all developmental policies and universal access to good quality health care services without anyone having to face financial hardship as a consequence. The policy is centered on the key principles of Equity, Affordability, Universality, Patient Centered & Quality of care, accountability, Inclusive partnerships, Pluralism and Decentralization. One of the key policy principles is Universality i.e. prevention of exclusions on social, economic or on grounds of current health status.

Under National Health Mission (NHM), many important steps have been taken towards universal health coverage by supporting the State Governments in providing accessible, affordable and quality healthcare to people, especially to the poor and vulnerable sections of the population. NHM support is also provided for provision of a range of free services related to maternal health, child health, adolescent health, family planning, universal immunisation programme, and for major diseases such as Tuberculosis, vector borne diseases like Malaria, Dengue and Kala Azar, Leprosy etc.

The major interventions taken by M/o Health and Family Welfare are Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Surakshit Matratva Ashwasan (SUMAN), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), Midwifery programme, LaQshya, Setting up of Maternal and Child Health (MCH) Wings, National Ambulances Services, Obstetric HDU&ICU, Delivery Points, Reproductive and child health portal, Comprehensive Abortion Care services, Maternal Death Surveillance Review (MDSR), Facility Based New-born Care, Community Based care of New-born and Young Children, Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS), Rashtriya Bal Swasthya Karyakaram (RBSK), Intensified Diarrhoea Control Fortnight / Defeat Diarrhoea (D2), Mothers' Absolute Affection (MAA), Nutrition Rehabilitation Centres (NRCs), Anemia Mukt Bharat (AMB), National Deworming Day (NDD), Rashtriya Kishor Swasthya Karyakram (RKSK), Adolescent Health and Wellness Day (AH&WD), Adolescent Friendly Health Clinics (AFHC) act, Weekly Iron Folic Acid Supplementation (WIFS) programme, Scheme for Promotion of Menstrual Hygiene among Adolescent Girls, National Tuberculosis Elimination Programme (NTEP), Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), PM National Dialysis Programme and Implementation of National Quality Assurance Framework, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY), Anamaya- Tribal health collaborative, Sickle Cell Mission-eRaktKosh, POSHAN Abhiyan, National Strategic Plan (NSP) for Malaria Elimination, Ayushman Arogya Mandir (erstwhile Health & Wellness Centres), National Free Drug and Diagnostic Service Initiative, National Programme for Health Care of the Elderly (NPHCE).

The Ministry of Health & Family Welfare (MoHFW) and Ministry of Tribal Affairs (MoTA) are complementing each other in achieving objectives for developing tribal communities. MoTA has established a dedicated Health Cell and also developed a Swasthya Portal. A Tribal health collaborative has been launched in April 2021 to build a sustainable, highperforming health eco-system to address the key health challenges faced by the tribal population of the country. A Tribal TB initiative under the National Tuberculosis Elimination Plan (NTEP) has been implemented since March 2021. A joint action plan for Malaria Elimination in Tribal areas has also been issued. Secondary and Tertiary Training modules for treatment/management of sickle cell disease, and awareness & counselling modules for the disease have been prepared in collaboration with MoHFW.

Table-1: State-wise Health Indicators for Scheduled Tribes (STs), NFHS-5 (2019-21)

| State             | Infant mortality Rate (per 1,000 live births)   | Child mortality Rate (per 1,000 live births)   | Mothers who had four or more ANC visits (%)   | Births with a health check in the first two days after birth (%)   | Births delivered in a health facility (%)   |   Current use of any family planning method by currently married women age 15-49 years (%) | Percentage of children under age five with fever for whom treatment was sought from a health facility or provider 1   | Percentage of children with diarrhoea for whom advice or treatment was sought from a health facility or provider 1   | Percentage of children (age 12-23 months) fully vaccinated (all basic vaccinations) 2   |
|-------------------|-------------------------------------------------|------------------------------------------------|-----------------------------------------------|--------------------------------------------------------------------|---------------------------------------------|--------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------|
| INDIA             | 41.6                                            | 9.0                                            | 57.6                                          | 79.0                                                               | 82.3                                        |                                                                                       64.4 | 74.7                                                                                                                  | 73.8                                                                                                                 | 76.5                                                                                    |
| Andhra Pradesh    | NA                                              | NA                                             | 59.8                                          | 85.6                                                               | 89.3                                        |                                                                                       56.7 | (80.8)                                                                                                                | *                                                                                                                    | (70.0)                                                                                  |
| Arunachal Pradesh | (1.9)                                           | (0.0)                                          | 35.9                                          | 57.3                                                               | 80.3                                        |                                                                                       57.2 | 53.1                                                                                                                  | 53.9                                                                                                                 | 63.7                                                                                    |
| Assam             | 33.9                                            | 7.7                                            | 59.9                                          | 75.4                                                               | 89.8                                        |                                                                                       63.2 | 46.8                                                                                                                  | 54.2                                                                                                                 | 67.5                                                                                    |
| Bihar             | 57.0                                            | 12.2                                           | 17.5                                          | 53.5                                                               | 67.7                                        |                                                                                       52.1 | 68.5                                                                                                                  | 73.5                                                                                                                 | 71.8                                                                                    |
| Chhattisgarh      | 58.0                                            | 9.6                                            | 55.9                                          | 81.1                                                               | 77.4                                        |                                                                                       58.7 | 59.4                                                                                                                  | 63.3                                                                                                                 | 79.0                                                                                    |
| Goa               | NA                                              | NA                                             | (87.8)                                        | (90.7)                                                             | (100.0)                                     |                                                                                       58.7 | *                                                                                                                     | NA                                                                                                                   | NA                                                                                      |
| Gujarat           | 31.9                                            | 10.0                                           | 77.6                                          | 90.9                                                               | 89.3                                        |                                                                                       71.6 | 78.8                                                                                                                  | 72.3                                                                                                                 | 80.2                                                                                    |
| Haryana           | NA                                              | NA                                             | (36.3)                                        | (93.4)                                                             | 95.4                                        |                                                                                       66   | *                                                                                                                     | *                                                                                                                    | NA                                                                                      |
| Himachal Pradesh  | (20.8)                                          | (6.0)                                          | 71.5                                          | 84.3                                                               | 82.1                                        |                                                                                       68.2 | (77.1)                                                                                                                | *                                                                                                                    | 87.3                                                                                    |
| Jammu& Kashmir    | 30.1                                            | 3.2                                            | 66.8                                          | 71.5                                                               | 77.5                                        |                                                                                       55.8 | (69.0)                                                                                                                | (69.8)                                                                                                               | 82.5                                                                                    |
| Jharkhand         | 44.4                                            | 12.0                                           | 32.7                                          | 66.3                                                               | 66.4                                        |                                                                                       55.9 | 57.7                                                                                                                  | 58.7                                                                                                                 | 76.0                                                                                    |
| Karnataka         | 28.7                                            | 7.2                                            | 70.6                                          | 85.1                                                               | 95.7                                        |                                                                                       65   | 67.9                                                                                                                  | (73.2)                                                                                                               | 82.0                                                                                    |
| Kerala            | NA                                              | NA                                             | 86.0                                          | 100.0                                                              | 100.0                                       |                                                                                       59.7 | *                                                                                                                     | *                                                                                                                    | NA                                                                                      |
| Madhya Pradesh    | 41.3                                            | 13.9                                           | 55.5                                          | 83.8                                                               | 82.0                                        |                                                                                       72.1 | 70.1                                                                                                                  | 64.5                                                                                                                 | 76.4                                                                                    |
| Maharashtra       | 31.1                                            | 6.4                                            | 65.5                                          | 83.8                                                               | 84.8                                        |                                                                                       63.7 | 82.7                                                                                                                  | 74.5                                                                                                                 | 74.7                                                                                    |
| Manipur           | 23.2                                            | 3.1                                            | 59.5                                          | 52.9                                                               | 59.2                                        |                                                                                       61.3 | 38.3                                                                                                                  | 48.5                                                                                                                 | 59.6                                                                                    |
| Meghalaya         | 32.6                                            | 7.9                                            | 52.5                                          | 52.5                                                               | 57.6                                        |                                                                                       28   | 77.8                                                                                                                  | 71.5                                                                                                                 | 64.1                                                                                    |
| Mizoram           | NA                                              | NA                                             | 59.5                                          | 37.2                                                               | 87.4                                        |                                                                                       30.9 | 55.6                                                                                                                  | 44.5                                                                                                                 | NA                                                                                      |
| Nagaland          | NA                                              | NA                                             | 17.8                                          | 41.7                                                               | 43.5                                        |                                                                                       57.3 | 28.3                                                                                                                  | 30.0                                                                                                                 | NA                                                                                      |
| NCT of Delhi      | NA                                              | NA                                             | (83.6)                                        | (89.3)                                                             | (92.6)                                      |                                                                                       75.7 | *                                                                                                                     | *                                                                                                                    | NA                                                                                      |
| Odisha            | 55.9                                            | 10.9                                           | 69.8                                          | 85.9                                                               | 82.8                                        |                                                                                       71.4 | 60.7                                                                                                                  | 46.5                                                                                                                 | 88.6                                                                                    |
| Punjab            | NA                                              | NA                                             | NA                                            | NA                                                                 | (86.2)                                      |                                                                                       61.1 | *                                                                                                                     | *                                                                                                                    | NA                                                                                      |
| Rajasthan         | 43.2                                            | 8.8                                            | 55.9                                          | 88.7                                                               | 94.0                                        |                                                                                       71   | 83.6                                                                                                                  | 74.9                                                                                                                 | 79.2                                                                                    |
| Sikkim            | NA                                              | NA                                             | 55.7                                          | 68.9                                                               | 97.1                                        |                                                                                       68.5 | (62.6)                                                                                                                | NA                                                                                                                   | 92.2                                                                                    |
| Tamil Nadu        | NA                                              | NA                                             | 85.3                                          | 91.7                                                               | 100.0                                       |                                                                                       67.3 | *                                                                                                                     | *                                                                                                                    | NA                                                                                      |
| Telangana         | 39.6                                            | 2.1                                            | 67.3                                          | 85.6                                                               | 94.0                                        |                                                                                       65.2 | 71.5                                                                                                                  | 77.3                                                                                                                 | 69.5                                                                                    |
| Tripura           | 50.8                                            | 11.7                                           | 42.7                                          | 68.6                                                               | 85.9                                        |                                                                                       71   | 62.7                                                                                                                  | 61.3                                                                                                                 | 57.9                                                                                    |
| Uttar Pradesh     | 57.6                                            | 6.9                                            | 28.7                                          | 65.2                                                               | 74.7                                        |                                                                                       57.1 | (69.1)                                                                                                                | (68.1)                                                                                                               | 53.1                                                                                    |
| Uttarakhand       | NA                                              | NA                                             | 67.1                                          | 91.6                                                               | 84.8                                        |                                                                                       77.9 | *                                                                                                                     | *                                                                                                                    | NA                                                                                      |
| West Bengal       | (26.7)                                          | 0.0                                            | 70.9                                          | 78.6                                                               | 90.8                                        |                                                                                       65.4 | 81.3                                                                                                                  | *                                                                                                                    | 90.4                                                                                    |

Source:

NFHS-5 national and State reports; http://rchiips.org/nfhs/index.shtml

Note: - () Figures in parentheses are based on 250-499 unweighted cases for mortality indicators and 25-49 unweighted cases for other indicators.

NA-Data Not Available

* figure is based on fewer than 25 unweighted cases and has been suppressed

1 Includes advice or treatment from the public health sector, the private health sector, or shop. Excludes advice or treatment from a traditional healer or friend/relative.

2 BCG, MCV/Measles/MMR/MR, and three doses each of DPT/Penta and polio vaccine (excluding polio vaccine given at birth)

## Annexure