National Report of the 2nd phase of fifth round of National Family Health Survey (NFHS-5)
was released recently.
Key findings and sociological analysis:
The Total Fertility Rates (TFR) has further declined since NFHS-4 in almost all the
Phase-1 States and UTs.
Overall Contraceptive Prevalence Rate (CPR) has increased substantially in most
States/UTs and it is the highest in HP and WB (74%). Use of modern methods of
contraception has also increased in almost all States/UTs.
Bhat and Ghosh write that studies have found that women’s education has a significant
net negative effect on fertility even after controlling for the effects of other potentially
Studies have also observed the “indirect” role of education through channels like
diffusion of fertility norms from the educated to uneducated through social learning and
Institutional births have increased substantially with over four-fifth of the women
delivering in institutions in 19 States and UTs.
Charu C Garg in earlier studies writes that the findings reveal that the utilization of
public facilities for childbirth increased three times in rural areas and almost one and a
half times in urban areas between 2004 and 2014.Also, the average medical expenditure
on childbirth in government health facilities declined by 36% in rural areas and by 5%
in urban areas. Considerable interstate variations in regard to out of pocket expenditure
on drugs, diagnostics and transportation were also witnessed. Thus, more needs to be
done for the benefits to reach the vulnerable sections, especially in urban areas.
Sex ratio at birth has remained unchanged or increased in most States/UTs. Majority of
the states are in normal sex ratio of 952 or above. SRB is below 900 in Telangana,
Himachal Pradesh, Goa, DNH & DD.
Debolina Kundu,Rakesh Mishra believe that the exploration of the trends and
patterns of sex ratio at birth in urban India and the processes behind son preference
suggests a systematic worsening of SRB with increasing urban district size classes. The
interrelationship between SRB and educational attainment shows an inverted U-
shape. A balanced SRB among poor women corroborates their unbiased gender preference. In contrast, wealthier women and those with exposure to mass media exhibit
poor SRB, although they report a neutral preference.
Child nutrition indicators show a mixed pattern across states. While the situation
improved in many States/UTs, there has been minor deterioration in others. Drastic
changes in respect of stunting and wasting are unlikely in a short period.
Anemia among women and children continues to be a cause of concern. More than half
of the children and women are anemic in 13 of the 22 States/UTs.
Biplab Dhak writes that while there has been a saturation of persistent government
interventions for immunization, antenatal care, and institutional delivery; education and
economic status have become stronger predictors. They ensure better childcare
practices, sanitation, proper diet, and access to healthcare. Therefore, the future of child
nutrition lies largely in the improvement of quality education and inclusive economic
Women’s empowerment indicators portray considerable improvement across all the
States/UTs included in Phase 1. More than 60 per cent of women in every state and
UTs in the first phase have operational bank accounts.
Kumud Sharma argues that gender inequalities are particularly visible in resource-
based entitlements (land titles, property rights, credit, etc). Hence the rationale, that
access to credit and functional bank accounts will generate income and livelihood
options, give women more bargaining power within the household and contribute to