National Family Health Survey-6 2023-24

National Family Health Survey-6 2023-24

Why in News?

Recently, the Ministry of Health and Family Welfare (MoHFW) released the National Family Health Survey (NFHS-6) 2023-24, showcasing substantial progress in India’s maternal health indicators alongside a concerning lifestyle shift.

What is National Family Health Survey (NFHS)?

• About: The National Family Health Survey (NFHS) is India’s largest nationwide household health survey, conducted under the Ministry of Health and Family Welfare. 
  • It collects scientifically representative data on population, fertility, mortality, family planning, maternal health, child health, nutrition, anaemia, non-communicable diseases, and health service utilization across all States and Union Territories. 
  • NFHS is considered India’s most authoritative health database because it reveals long-term social and demographic transitions.
• Institutional Framework: NFHS is implemented by the Ministry of Health and Family Welfare (MoHFW).
  • The International Institute for Population Sciences (IIPS), Mumbai serves as the nodal agency responsible for survey design, coordination, technical guidance, data processing, and analysis.
• Historical Evolution: India launched the first NFHS in 1992–93. 
  • Subsequent rounds were conducted in 1998–99 (NFHS-2), 2005–06 (NFHS-3), 2015–16 (NFHS-4), 2019–21 (NFHS-5), and 2023–24 (NFHS-6). This continuous series provides more than three decades of demographic and health trends.
• Key Indicators Measured: The survey tracks:
  • Total Fertility Rate (TFR)
  • Child mortality
  • Immunization
  • Antenatal care
  • Institutional delivery
  • Nutrition
  • Stunting
  • Wasting
  • Obesity
  • Diabetes
  • Hypertension
  • Tobacco use
  • Alcohol consumption
  • Women’s empowerment
  • Financial inclusion
  • Gender-based violence
• Policy Importance: NFHS serves as the principal evidence base for major government programmes such as Ayushman Bharat, Poshan Abhiyaan, National Health Mission, immunization initiatives, maternal health programmes, and population stabilization strategies. 

Highlights of National Family Health Survey-6 (2023-24)

• Survey Scale: NFHS-6 was conducted in two phases between May 2023 and December 2024. 
  • The survey covered 679,238 households, 716,397 women, and 100,977 men, making it one of India’s largest health and demographic surveys.
• Survey Methodology: The survey adopted Computer Assisted Personal Interviewing (CAPI), real-time monitoring, standardized training, and secondary data editing.
  • It adopted international-standard Clinical, Anthropometric and Biochemical protocols to improve data quality.
• Shrinking Child Population: Children below age five constitute 8.0% of India’s population, slightly lower than 8.2% in NFHS-5. This reflects continuing demographic transition.
  • The population below age fifteen declined from 26.5% to 25.5%, indicating lower fertility and slower population growth.
• Growing Elderly Population: People aged sixty years and above increased from 11.8% to 12.9%, highlighting India’s gradual ageing trend.
• Universal Electrification: Households with electricity reached 98.3%, up from 96.8%, demonstrating significant infrastructure expansion.
• Drinking Water Access: Population using improved drinking-water sources increased from 95.9% to 96.5%, showing continued improvement in basic amenities.
• Health Insurance Expansion: Coverage under health insurance or financing schemes surged from 41.0% to 60.2%, representing one of the largest gains recorded in NFHS-6.
• Rising Female Education: Females aged six years and above who ever attended school increased from 71.8% to 73.7%.
• School Participation: Children aged 2–4 years attending preschool increased from 40.1% to 47.0%, indicating stronger early childhood education access.
  • Women with ten or more years of schooling increased sharply from 41.0% to 46.4%. Men improved from 50.2% to 54.6%.
• Digital Transformation: Women who ever used the internet nearly doubled from 33.3% to 64.3%. Men increased from 51.2% to 80.5%, showing rapid digital adoption.
• Financial Inclusion: Households with a bank or post-office account increased from 95.7% to 98.2%, reflecting deeper financial inclusion.
• Child Marriage Decline: Women aged 20–24 married before eighteen declined from 23.3% to 20.1%, marking continued progress against child marriage.
  • Men aged 25–29 married before twenty-one declined from 17.7% to 15.9%.
  • Kerala is the safest state for child marriage with a rate of 2.9%, well below the national average. Conversely, West Bengal and Bihar report the highest incidences in India at 36.4% and 34.6%, respectively. 
• Fertility Rate: India’s Total Fertility Rate (TFR) holding steady at 2.0 reflects a historic demographic shift. 
  • Falling just below the standard global replacement threshold of 2.1, it signals that the country’s population is moving firmly toward long-term stabilization.
• Motherhood & Planning Teenage motherhood or pregnancy among girls aged 15–19 slightly decreased from 6.8% to 6.7%.
  • Current use of any family planning method increased from 66.7% to 69.1%, indicating greater contraceptive acceptance.
  • Total unmet need for family planning declined from 9.4% to 8.5%, suggesting improved reproductive health services.
• Antenatal Care: Women receiving antenatal care in the first trimester rose from 70.0% to 76.2%. Mothers with at least four antenatal visits increased from 58.5% to 65.2%.
  • Pregnant women consuming Iron-Folic Acid tablets for at least 100 days increased from 44.1% to 54.9%. Consumption for 180 days rose from 26.0% to 37.8%.
  • Institutional births increased from 88.6% to 90.6%, reflecting stronger healthcare utilization.
  • Births attended by skilled health personnel increased from 89.4% to 91.3%, improving maternal and newborn safety.
  • Caesarean births increased significantly from 21.5% to 27.2% nationally. Private facilities recorded 54.1%, while public facilities reported 16.9%.
  • Mothers receiving postnatal care within two days of delivery increased from 78.0% to 82.8%. Child postnatal care rose from 79.1% to 85.3%.
  • Young women aged 15–24 using hygienic menstrual protection increased from 77.6% to 79.2%.
• Vaccination Coverage: Fully vaccinated children aged 12–23 months increased from 76.6% to 82.6%, showing substantial immunization gains.
  • Second-dose measles vaccination among children aged 24–35 months jumped from 58.6% to 71.8%, one of the strongest improvements in child immunization.
  • Coverage for three doses of rotavirus vaccine rose dramatically from 36.4% to 85.4%, reflecting successful program expansion.
• Childhood Disease & Wasting: Acute Respiratory Infection prevalence fell from 2.8% to 1.9%. Severe diarrhoea prevalence also declined from 0.7% to 0.5%.
  • Stunting among children under five fell significantly from 35.5% to 29.3%, indicating notable nutritional improvement.
  • Child wasting reduced slightly from 19.3% to 19.0%, remaining a persistent challenge.
  • Severe wasting dropped from 7.7% to 5.2%, reflecting better nutrition interventions.
• Breastfeeding: Exclusive breastfeeding among infants under six months declined from 63.7% to 55.8%, suggesting an area requiring policy attention.
  • Children aged 6–8 months receiving solid or semi-solid food and breastmilk increased from 45.9% to 59.5%.
• Health Challenges: Nearly 19.7% of both women and men remain underweight, indicating continuing nutritional vulnerabilities.
  • Underweight prevalence among children declined marginally from 32.1% to 31.8%.
  • Overweight or obesity increased from 24.0% to 30.7% among women and from 22.9% to 27.3% among men, showing rapid lifestyle-related health risks.
  • Women’s obesity peaks in Andhra Pradesh, Sikkim, and Kerala at over 46%, while Meghalaya and Jharkhand report the lowest rates at under 17%.
  • Women with high or very high blood sugar, or taking diabetes medication, increased from 13.5% to 17.8%. Men rose from 15.6% to 20.9%.
  • Elevated blood pressure or treatment prevalence stands at 19.4% among women and 22.1% among men, indicating a substantial non-communicable disease burden.
• Women’s Decision-Making & Participation: Currently married women participating in all three major household decisions increased from 88.7% to 89.0%.
  • Women with self-operated bank accounts increased from 78.6% to 89.0%, demonstrating growing economic autonomy.
  • Women owning and using a mobile phone increased from 53.9% to 63.6%, narrowing the gender digital gap.
  • 18.8% of families in India have women owning a house or land. This includes 18.2% in urban areas and 19.1% in rural areas. 
• Violence Declines: Ever-married women experiencing spousal violence decreased substantially from 29.2% to 22.3%, a significant social improvement.
  • Physical violence during pregnancy fell from 3.1% to 2.7%.
  • Himachal Pradesh (4.3%) is the safest state in terms of marital violence, whereas Bihar is the worst-affected state at 36.1% of women facing such violence.
• Tobacco & Alcohol Use: Tobacco consumption decreased from 8.9% to 8.4% among women and from 38.0% to 36.3% among men.
  • Alcohol use remained low among women (1.1%) and relatively stable among men (18.9%).