Explanation:

 National Family Health Survey (NFHS- 4)
? The Fourth National Family Health Survey (NFHS-4) is a nationally representative household survey that measures a wide range of indicators relating to fertility, family planning, and maternal and child health, as well as knowledge, attitudes and behavior around HIV/AIDS and the prevalence of HIV infection among Indian adults.
? This is the fourth NFHS conducted in India and include for the first time blood glucose and hypertension measurements.
? NFHS-4 produces population-based estimates of anemia, HIV prevalence, blood glucose, blood pressure, and height and weight measurements among women age 15 -49 and men age 15-54. Among young children age 6-7 months, anemia, height and weight will be measured.
? This survey includes findings of only 13 States of Andhra Pradesh, Bihar, Goa, Haryana, Karnataka, Madhya Pradesh, Meghalaya, Sikkim, Tamil Nadu, Telangana, Tripura, Uttarakhand, West Bengal and two Union Territories of Andaman and Nicobar Islands and Puducherry.
Highlights:
Infant mortality rate:
? This survey indicate that fewer children are dying in infancy and early childhood. After the last round of National Family Health Survey in 2005-06, infant mortality has declined in all first phase States/Union Territories for which trend data are available.
? All 15 States/Union Territories have rates below 51 deaths per 1,000 live births, although there is considerable variation among the States/Union Territories.
? 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.
Fertility Rate:
? 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 and increasing numbers of women are receiving the recommended four or more visits by the service providers. More and more women now give birth in health care facilities and rates have more than doubled in some States in the last decade. More than nine in ten recent births took place in health care facilities in Andaman and Nicobar Islands, Andhra Pradesh, Goa, Karnataka, Puducherry, Sikkim, Tamil Nadu, and Telangana, providing safer environments for mothers and new-borns.
? Overall, women in the First Phase States/Union Territories are having fewer children. The total fertility rates, or the average number of children per woman, range from 1.2 in Sikkim to 3.4 in Bihar. All First Phase States/Union Territories except Bihar, Madhya Pradesh and Meghalaya have either achieved or maintained replacement level of fertility– a major achievement in the past decade.
Immunization Programme:
? Full immunization coverage among children age 12-23 months varies widely in the First Phase States/Union Territories.
? At least 6 out of 10 children have received full immunization in 12 of the 15 States / Union Territories.
? In Goa, West Bengal, Sikkim, and Puducherry more than four-fifths of the children have been fully immunised.
Family planning:
? Married women are less likely to be using modern family planning in eight of the First Phase States/Union Territories.
? There has been any 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.
? Despite the decline, about half or more married women are using modern family planning in eight of the 15 States/Union Territories.
Water and sanitation facilities
? Indian families in the First Phase households are now more inclined to use improved water and sanitation facilities.
? 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 in nine of the 15 States/Union Territories.
? More than 50% of households have access to improved sanitation facilities in all First Phase States/Union Territories except Bihar and Madhya Pradesh.
? Use of clean cooking fuel, which reduces the risk of respiratory illness and pollution, varies widely among the First Phase States/Union Territories, ranging from only about 18% of households in Bihar to more than 70% of households in Tamil Nadu and more than 80% of households in Puducherry and Goa.
Obesity:
? Even as India battles malnutrition, the country has developed another nutritional problem—obesity. In past 10 years, the number of obese people has doubled in the country. People having Body Mass Index (BMI) more than 25 kilogram per meter square have been considered as obese.
? Andhra Pradesh, Andaman and Nicobar, Puducherry and Sikkim have more than 30 per cent of their populations falling under the “obese” category.
? The survey highlights that urban population is more prone to obesity as compared to their rural counterparts
HIV:
? There is widespread ignorance about HIV/AIDS among adults in India. Nearly 82 per cent women and nearly 70 per cent men lacked comprehensive knowledge of HIV/AIDS and safe sex practices.
? This is seen as a direct result of budget cuts, with IEC (information, education and communication) measures and targeted intervention activities coming to a screeching halt.
Anaemia
? Anaemia has declined in the country. However, it still remains widespread as more than half the women in eleven States/Union Territories are anaemic.
Child stunting
? Indian States have seen some improvements in child nutrition over the last decade, but over one in three children is still stunted, andover one in five underweight.
? As of 2005-06, India had 62 million stunted children, accounting for a third of the world’s burden of stunting.
Child sex ratio
? In the past 10 years, the sex ratio has significantly decreased in nine out of 11 states of India.
? Institutional deliveries - children delivered in a medical institution under supervision - increased by 32.8 per cent in the past 10 years. Madhya Pradesh, Karnataka and Bihar saw a huge rise of 54.6 per cent, 44.8 per cent and 43.9 per cent, respectively in institutional deliveries.
? The only state where the sex ratio rose was Uttarakhand - from 996 to 1,015 females per 1,000 males.
? In first phase , on an average, there are 985 females per 1,000 males in 2015-16 compared to 1,000 females per 1,000 males in 2005-06.
Tobacco
? Number of tobacco consumers — men as well as women— has decreased marginally in the past 10 years. However, alcohol consumption has remained almost static in the same period.
? The number of male and female tobacco consumers has fallen by 10 per cent and 4.4 per cent, respectively, compared to the previous survey done in 2005- 06. However, male alcohol consumers increased by 0.16 per cent, whereas it was a fall of 0.24 per cent for females.
? Male tobacco consumption dropped in every state.
? Among females, alcohol consumption dropped by 3.8 per cent, 0.3 per cent and 2.1 per cent in Sikkim, Tamil Nadu and Goa, respectively. Apart from Meghalaya, every other state saw a decline in female tobacco consumption.
Demographic dividend:
? A part of India’s touted demographic dividend — the population below age 15 years — has decreased in the past 10 years.
? Sikkim topped the list of states showing a decrease of population aged below 15 years, to 23.1 per cent in 2015-16 from 30.7 per cent in 2005-06. Madhya Pradesh was next, with a decrease of seven percentage points in the period.
? Uttarakhand was the only state which showed significant improvement in all five parameters of living standards. These being households with improved sanitation facilities, a clean cooking fuel source, electricity connection, clean drinking water source and using iodised salt. It increased the household numbers by 20 per cent, 15 per cent, 17.5 per cent, 5.5 per cent and 24.3 per cent, respectively.
? Demographic dividend down, standard of living up Haryana was number one in increasing the number of households with improved sanitation, from 40 per cent in 2005-06 to 79.2 per cent in 2015-16.