Background:

• The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
• International Institute for Population Sciences (IIPS) is nodal agency.
• Funded by the United States Agency for International Development (USAID) {United Nations Children’s Fund (UNICEF) support}

First  National Family Health Survey (NFHS-1):

• Conducted in 1992-93.
• Survey collected extensive information on population, health, and nutrition, with an emphasis on women and young children.

The Second National Family Health Survey (NFHS-2)

• Conducted in 1998-99
• added features on the quality of health and family planning services, domestic violence, reproductive health, anemia, the nutrition of women, and the status of women.

The Third National Family Health Survey (NFHS-3)

• carried out in 2005-2006.
• The National AIDS Control Organization (NACO) and the National AIDS Research Institute (NARI) are providing technical assistance for the HIV component.

The Fourth National Family Health Survey (NFHS-4)

• was carried out in 2014-2015.
• The first of the NFHS series that collects data in each of India’s 29 States and all 7 Union Territories.
• Also, NFHS-4, for the first time, will provide estimates of most indicators at the district level

Salient findings of NFHS-4:

• Fewer children are dying in infancy and early childhood – (51 deaths per 1,000 live births)
• Infant mortality rates range from a low of 10 in Andaman and Nicobar Islands to a high of 51 deaths per 1000 live births in Madhya Pradesh. (variability)
• Better care for women during pregnancy and childbirth contributes to reduction of maternal deaths and improved child survival
• Almost all mothers have received antenatal care for their most recent pregnancy
• More and more women now give birth in health care facilities and rates have more than doubled in some States in the last decade. (9 in 10 in some states)
• The total fertility rates, or the average number of children per woman, range from 1.2 in Sikkim to 3.4 in Bihar.
• Full immunization coverage among children age 12-23 months varies widely (At least 6 out of 10 children have received full immunization in 12 of the 15 States / Union Territories).
• There has been an increase in the use of modern family planning methods only in the States of Meghalaya, Haryana, and West Bengal. The decline is highest in Goa followed by Karnataka and Tamil Nadu.
• Fewer children under five years of age are now found to be stunted(previous survey, it is found that in Bihar, Madhya Pradesh and Meghalaya more than 40% of children are stunted)
• Wasting is still very high by international standards in all of the States/Union Territories.
• Anaemia has also declined, but still remains widespread.
• Over-nutrition continues to be a health issue for adults.
• Over two-thirds of households in every State/Union Territory have access to an improved source of drinking water, and more than 90% of households have access to an improved source of drinking water
• More than 50% of households have access to improved sanitation facilities
• Use of clean cooking fuel, which reduces the risk of respiratory illness and pollution, varies widely among (18% of households in Bihar to more than 70% of households in Tamil Nadu and more than 80% of households in Puducherry and Goa)
• Lack of HIV awareness in Indian adults – Nearly 82 % women and nearly 70 % men in the 13 States lacked comprehensive knowledge of HIV/AIDS and safe sex practices.
• Tobacco use among men has fallen from 50 per cent in 2005-06 to 47 per cent in 2015.
• Alcohol consumption among men has fallen from 38 per cent to 34 per cent.

Concern:

• Difficulties in obtaining reliable, high quality data

Solution:

• Set realistic goals and use creative strategies.
• Adapt to changing institutional and technological environment for data collection.

Conclusion:

• This is the data that guides the policies affecting millions of Indians and must be faithfully collected.
• Unless we pay systematic attention to the data infrastructure, we are likely to have the national discourse hijacked by poor quality data as has happened in the past with a measurement of poverty or inconsistent data on GDP.