National Family Health Survey
Imagine you’re trying to understand the health of a country, not from guesswork or headlines, but from actual, ground-level data collected door-to-door from Indian households. That’s exactly what the National Family Health Survey (NFHS) does.
Definition:
NFHS is a large-scale, multi-round survey that collects reliable data on population, health, and nutrition across India. Think of it as India’s detailed “health report card” done every few years.
✅ Objective:
To gather up-to-date and representative data on:
- Fertility
- Family Planning
- Mortality
- Maternal and Child Health
All this is essential for evidence-based policymaking.
🔷 Institutional Framework: Who Conducts It?
🏢 Conducted under:
The stewardship of the Ministry of Health and Family Welfare (MoHFW), Government of India.
🎓 Nodal Agency:
International Institute for Population Sciences (IIPS), Mumbai – an autonomous research and training institute in population studies.
💵 Funding Agencies:
- USAID (United States Agency for International Development)
- UNICEF (provided supplementary support)
So, this is an India-led but globally-supported survey mechanism.
🔷 Evolution of NFHS: From NFHS-1 to NFHS-6
Let’s understand each round like different volumes of a research encyclopedia—each adding more layers of depth.
| NFHS Round | Year | Key Features |
|---|---|---|
| NFHS-1 | 1992-93 | First baseline data on health, nutrition, fertility—focused on women and children. |
| NFHS-2 | 1998-99 | Added: domestic violence, reproductive health, anaemia, women’s status. |
| NFHS-3 | 2005-06 | Added: HIV/AIDS data (with help from NACO & NARI) |
| NFHS-4 | 2015-16 | First time data collected for all States and UTs |
| NFHS-5 | 2019–21 | Added C-Section data, child malnutrition parameters like stunting, wasting, anaemia. |
| NFHS-6 | 2023–24 | Latest (released May 2026). Covered about 6.79 lakh households in 715 districts; offers district-level estimates for major indicators. |
So from basic health indicators, NFHS has grown into a multidimensional demographic tool.
🔷 Key Findings: NFHS-6 (2023–24) and NFHS-5 (2019–21)
Let’s now decode the key indicators — their meaning, significance and India’s current status. NFHS-6 values are given wherever the Government’s NFHS-6 findings report them; otherwise the latest NFHS-5 or other official figure is shown.
🔹 NFHS-6 at a Glance
| Indicator | NFHS-5 (2019–21) | NFHS-6 (2023–24) |
|---|---|---|
| Total Fertility Rate | 2.0 | 2.0 |
| Women (20–24) married before 18 | 23.3% | 20.1% |
| Institutional births | 88.6% | 90.6% |
| Caesarean births | 21.5% | 27.2% |
| Fully immunised children (12–23 months) | 83.8% | 87.1% |
| Contraceptive prevalence (any method) | 66.7% | 69.1% |
| Households with health insurance/financing | 41.0% | 60.2% |
| Women who have used the internet | 33.3% | 64.3% |
| Overweight/obese women (15–49) | 24.0% | 30.7% |
| Overweight/obese men (15–49) | 22.9% | 27.3% |
| High blood sugar — women | 13.5% | 17.8% |
| High blood sugar — men | 15.6% | 20.9% |
Takeaway: clear gains in maternal care, immunisation, insurance cover and women’s digital inclusion, alongside an emerging dual burden — rising adult overweight, obesity and high blood sugar. Sources: MoHFW release on NFHS-6; NFHS-6 key findings note, Government of India.
🔹 Total Fertility Rate (TFR):
- Meaning: Average number of children a woman is expected to have in her reproductive years.
- Replacement level: 2.1 (to keep population stable)
- India (NFHS-6): 2.0 (unchanged from NFHS-5) – ✅ Below replacement level → India’s population is stabilizing.
🔹 Infant Mortality Rate (IMR):
- Definition: Deaths of infants (under 1 year) per 1,000 live births.
- Significance: Lower IMR = better neonatal care & maternal health.
- NFHS-5 IMR: 35.2 (was 40.7 in NFHS-4) → 📉 Positive decline.
- Latest (SRS 2024): 24 per 1,000 live births — NFHS-6’s findings use the Sample Registration System (SRS) for child mortality.
🔹 Under-5 Mortality Rate (U5MR):
- Definition: Deaths of children under 5 years per 1,000 live births.
- NFHS-5 U5MR: 41.9 (down from 49.7)
- Latest (SRS 2024): 28 per 1,000 live births.
- Tells us how well India is doing in sanitation, immunization, and child nutrition.
🔹 Sex Ratio:
- Definition: Number of females per 1,000 males.
- NFHS-5:1020 females per 1000 males
🟢 Highest since NFHS started!- Rural India: 1037
- Urban India: 985
- NFHS-6: the sex ratio is not reported in the NFHS-6 findings released so far — NFHS-5 remains the latest NFHS figure.
Compare with 2011 Census figure: 943 → So, considerable improvement.
🔹 Child Sex Ratio (0–6 years):
- NFHS-5: 920 girls per 1000 boys
(Better than 914 in 2011 Census)
Still a concern → shows societal bias hasn’t fully gone.
🔹 Life Expectancy at Birth:
- Definition: Average number of years a newborn is expected to live if current mortality rates persist.
- India (SRS 2011–16): 68.3 years
- Influenced by healthcare access, nutrition, and hygiene.
🔹 Literacy Rate:
- Definition: People above 15 years who can read & write.
- India (2011 Census):74.04%
- Gender and regional disparities still exist.
🔷 Child Nutrition Indicators: The Triple Burden
Think of this as India’s “malnutrition report card”:
| Indicator | Meaning | NFHS-5 % (under 5 years) | NFHS-6 % (under 5 years) |
|---|---|---|---|
| Stunting | Low height-for-age → Chronic malnutrition | 35.5% | 29.3% |
| Wasting | Low weight-for-height → Acute malnutrition | 19.3% | 19.0% |
| Severe wasting | Very low weight-for-height → High-risk acute malnutrition | 7.7% | 5.2% |
| Underweight | Low weight-for-age → Cumulative nutrition failure | 32.1% | 31.8% |
NFHS-6 shows the sharpest falls in stunting and severe wasting, while underweight has barely moved (MoHFW, May 2026).
🧠 Remember this order (Severity of root causes):
Stunting > Underweight > Wasting
- Stunting affects cognition and physical growth → long-term impact.
- Wasting signals urgent medical attention.