In NFHS-5 report card the good the sober the future


  • NFHS-5 has encouraging news but addressing discriminatory social norms must remain top priority.

Positive Signs in NFHS-5 Edition

  • Population growth is stabilising
    • The Total Fertility Rate — the average number of children born per woman — has declined from 2.2 to 2.0 at the national level.
  • Family planning services have improved
    • Increase in adoption of modern family planning methods (from 47.8% in 2015-16 to 56.5% in 2019-21) and a reduction in unmet need for family planning by 4% points over the same period.

      Credit: The Hindu
    • Increased reach of the health system to more non-user couples with information about family planning (from 18% in 2015-16 to 24% in 2019-21).
  • Health systems are delivering better.
    • Maternal health services are steadily improving. 
    • Institutional births were accessed by 88.6% of women in 2019-21, marking an increase of 9.8% points from 2015-16. There has also been an increase in institutional deliveries in public health facilities (52.1% to 61.9%), demonstrating an improvement in quality of services.
  • Significant improvements in female literacy, with 41% women having received 10 or more years of schooling (compared to 36% in 2015-16).
  • Significant progress where women have the right to bodily autonomy and integrity, and the ability to take decisions about their lives.
  • Proportion of women (aged 15-24 years) who use menstrual hygiene products has increased by almost 20% points between 2015-16 and 2019-21 and currently stands at 77.3%.
  • Women who have their own bank accounts has gone up by 25.6% points over the same time period to reach 78.6%.
  • Around 54% of women have their own mobile phones and about one in three women have used the Internet.
  • Prevalence of child marriage has gone down marginally from 26.8% in 2015-16 to 23.3% in 2019-21. Similarly, sex ratio at birth has shown slight improvement (from 919 to 929 over the same time period).

Associated Challenges

  • Gender-based violence and harmful practices against women and girls, such as child marriage and gender-biased sex selection
  • The survey indicates a worrisome figure of 11% of pregnant women who were still either unreached by a skilled birth attendant or not accessing institutional facilities. 
  • Teenage pregnancy has declined marginally by 1% point, and 7.9% of women in the age group of 15-19 years who were already mothers or pregnant at the time of the survey.
  • One in three women continue to face violence from their spouse.
  • Women’s participation in the economy continues to remain low (only 25.6% women engaged in paid work, a meagre increase of 0.8% point).
  • Women still bear a disproportionate burden of unpaid domestic and care work, hindering their ability to access gainful employment.

Way Forward

  • Five States (Nagaland, Bihar, Meghalaya, Jharkhand and Uttar Pradesh), indicating the need for an area-specific approach to improving maternal health services.
  • Need to invest in comprehensive sexuality education as a key component of life-skills education for both in school and out-of-school adolescents, and ensuring access to quality sexual and reproductive health services for them.
  • It is imperative to address harmful practices, such as child marriage and gender-biased sex selection. 
  • Need to enhance the value of women and girls by working on transforming unequal power relations, structural inequalities and discriminatory norms, attitudes and behaviours.
  • The pace of progress between one NFHS and the next should be accelerated by devising targeted strategies based on specific indicators and regions that are currently lagging.
  • We must challenge discriminatory social norms that drive gender-based violence and harmful practices, and empower women to exercise agency and autonomy in all spheres of life. 


  • Women and girls having agency and bodily autonomy is not only the foundation for a better future; it is a fundamental human right.

Source: TH

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