India’s fertility rate slips below replacement level, says govt survey

Anaemia among children and women continues to be a cause of concern, with more than half of them being found anaemic in 14 states and UTs, according to the findings of phase two of the National Family Health Survey (NFHS-5).

The government on Wednesday released the factsheets of key indicators on population, reproductive and child health, family welfare, nutrition and others for India as well as 14 states and UTs, clubbed under phase two, of the 2019-21 NFHS-5 here.

The states and UTs which were surveyed in this phase were Arunachal Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, NCT of Delhi, Odisha, Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand, a Health Ministry statement said.

At the national level, the occurrence of anaemia among women and children was found to be the same as that in 14 states and UTs. The findings for national level were calculated by using data from phase one and phase two of the NHFS-5.

The findings of phase one of the NFHS-5 for 22 states and UTs were released in December, 2020.

According to the findings, child nutrition indicators showed a slight improvement at all-India level as stunting declined from 38 per cent to 36 per cent, wasting from 21 per cent to 19 per cent and underweight from 36 per cent to 32 percent.

In all phase two states and UTs, the situation improved in respect of child nutrition but the change was not significant as drastic changes in respect of these indicators are unlikely in a short span, the statement said.

“Anaemia among children and women continues to be a cause of concern. More than half of the children and women (including pregnant women) are anaemic in all the phase two states and UTs and all-India level compared to NFHS-4, in spite of substantial increase in the composition of iron folic acid (IFA) tablets by pregnant women for 180 days or more,” it said.

Exclusive breastfeeding to children under six months of age has shown an improvement in all-India level from 55 per cent in 2015-16 to 64 per cent in 2019-21. All the phase two states and UTs are also showing a considerable progress, it said.

There is an increase from 51 per cent to 58 per cent of women receiving the recommended four or more ANC visits by health providers at all-India level, the findings stated.

Also, all the phase two states and UTs have shown improvement, except Punjab, between 2015-16 to 2019-20.

Institutional births have increased substantially from 79 per cent to 89 per cent at all-India level. Institutional delivery is 100 per cent in Puducherry and Tamil Nadu and more than 90 per cent in seven states and UTs out of 12 phase two states and UTs, the statement said.

Along with an increase in institutional births, there has also been a substantial increase in C-section deliveries in many states and UTs, especially in private health facilities, it said.

According to the findings, unmet needs of family planning have witnessed a significant decline from 13 per cent to 9 per cent at all-India level and in most of the phase two states and UTs.

The unmet need for spacing, which remained a major issue in India in the past, has come down to less than 10 per cent in all the states, except Jharkhand (12 pc), Arunachal Pradesh (13 pc) and Uttar Pradesh (13 pc).

Full immunisation drive among children aged 12-23 months has recorded substantial improvement from 62 per cent to 76 per cent at all-India level.

Also, 11 out of 14 states and UTs have more than three-fourth of children aged 12-23 months with full immunisation and it is the highest for Odisha at 90 per cent, the statement said.

On comparing NFHS-4 and NFHS-5 data, the increase in full immunisation coverage is observed to be expeditious in many states and UTs. More than 50 per cent of phase two states and UTs are sharing over 10 percentage points during the short span of four years. This can be attributed to the flagship initiative of Mission Indradhanush launched by the government in 2015.

The Total Fertility Rate (TFR), the average number of children per woman, has further declined from 2.2 to 2.0 at the national level and in all 14 states and UTs. All phase two states have achieved replacement level of fertility (2.1), except Madhya Pradesh, Rajasthan, Jharkhand and Uttar Pradesh, it said.

Overall Contraceptive Prevalence Rate (CPR) has increased substantially from 54 per cent to 67 per cent at all-India level and in almost all phase two states and UTs, with the exception of Punjab. Use of modern methods of contraceptives has also increased in almost all states and UTs, according to the statement.

Women’s empowerment indicators portray considerable improvement at all-India level and across all 14 states and UTs. Significant progress has been recorded between NFHS-4 and NFHS-5 with respect to women operating bank accounts from 53 per cent to 79 per cent at all-India level, it said.

For instance, in the case of Madhya Pradesh, the increase was from 37 per cent to 75 per cent. More than 70 per cent of women in every state and UT in the second phase have operational bank accounts.

The main objective of successive rounds of the NFHS is to provide reliable and comparable data relating to health and family welfare and other emerging issues, the ministry said in the statement.

The NFHS-5 survey work has been conducted in around 6.1 lakh sample households from 707 districts (as on March, 2017) of the country.