India’s total fertility rate declines from 2.2 to 2.0: National Family Health Survey

NEW DELHI: The report of the fifth round of the National Family Health Survey (NFHS-5) revealed that the total fertility rate of India has declined from 2.2 to 2.0 indicating the significant progress of population control measures.

The Total Fertility Rate (TFR) which is measured as the average number of children per woman, has come down from 2.2 to 2.0 at the national level between NFHS-4 and 5.

There are only five states in India, which are above the replacement level of fertility of 2.1. including Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), and Jharkhand (2.26) Manipur (2.17).

The NFHS-5 survey work was conducted in around 6.37 lakh sample households from 707 districts (as on March, 2017) of the country from 28 States and 8 UTs, covering 7,24,115 women and 1,01,839 men to provide disaggregated estimates up to district level.

The Overall Contraceptive Prevalence Rate (CPR) has increased substantially from 54 per cent to 67 per cent in the country.

“Use of modern methods of contraceptives has also increased in almost all States/UTs. Unmet needs for family planning have witnessed a significant decline from 13 per cent to 9 per cent. The unmet need for spacing, which remained a major issue in India in the past has come down to less than 10 per cent,” said an official statement.

The NHFS-5 also mentioned that institutional births have increased substantially from 79 per cent to 89 per cent in India. Even in rural areas around 87 per cent births are delivered in institutions and the same is 94 per cent in urban areas.

Institutional births increased by a maximum of 27 percentage points in Arunachal Pradesh, followed by over 10 percentage points in Assam, Bihar, Meghalaya, Chhattisgarh, Nagaland, Manipur, Uttar Pradesh, and West Bengal. Over 91 per cent of districts have more than 70 per cent of births in the last 5 years that took place in health facilities.

As per the survey, the level of stunting among children under 5 years has marginally declined from 38 to 36 per cent for India in the last four years.

Stunting is higher among children in rural areas (37 per cent) than in urban areas (30 per cent) in 2019-21. Variation in stunting ranges from the lowest in Puducherry (20 per cent) and highest in Meghalaya (47 per cent).

A notable decrease in stunting was observed in Haryana, Uttarakhand, Rajasthan, Uttar Pradesh and Sikkim (7 percentage points each), Jharkhand, and Madhya Pradesh and Manipur (6 percentage points each), and Chandigarh and Bihar (5 percentage points each).

Compared with NFHS-4, the prevalence of overweight or obesity has increased in most States/UTs in NFHS-5. At the national level, it increases from 21 per cent to 24 per cent among women and 19 per cent to 23 per cent among men. More than a third of women in Kerala, A&N Islands, Andhra Pradesh, Goa, Sikkim, Manipur, Delhi, Tamil Nadu, Puducherry, Punjab, Chandigarh and Lakshadweep (34-46 per cent) are overweight or obese.

In NFHS-5, more than three-fourths (77 per cent) of children aged 12-23 months were fully immunized, compared with 62 per cent in NFHS-4 as the full vaccination coverage among children ranges from 57 per cent in Nagaland to 95 per cent in DNH and DD. Odisha (91 per cent), Tamil Nadu (89 per cent), and West Bengal (88 per cent) also have shown relatively higher immunization coverage.

Interestingly, NFHS-5 data showed an overall improvement in SDG indicators in all States/UTs. The extent to which married women usually participate in three household decisions (about health care for themselves; making major household purchases; visiting their family or relatives) indicates that their participation in decision making is high, ranging from 80 per cent in Ladakh to 99 per cent in Nagaland and Mizoram. Rural (77 per cent) and urban (81 per cent) differences are found to be marginal.

The prevalence of women having bank or savings accounts that they use has increased from 53 to 79 per cent in the last 4 years.

NFHS-5 also mentions an increase in usage of clean cooking fuel (44 per cent to 59 per cent) and improved sanitation facilities (49 per cent to 70 per cent), including a hand-washing facility with soap and water (60 per cent to 78 per cent) have improved considerably.

There has been a substantial increase in the proportion of households using improved sanitation facilities, which could be attributed to the Swatch Bharat Mission programme.