Context: Recently, the fifth round of the National Family and Health Survey (NFHS) was released by the Union Health Ministry.
Key Findings 
Marriage

• The share of women aged 20-24 who married before turning 18 has declined from 27% to 23% in the last five years.

Gender Equality

• India now has 1,020 women for every 1000 men.

Decreasing fertility rate

• As per the latest National Family Health Survey, India’s total fertility rate has slipped below the replacement level for the first time. As per the NFHS 5, India has hit a Total Fertility Rate (TFR) of 2.0. This marks a decrease from the 2.2 TFR in the NFHS-4. The urban TFR is 1.6 and rural 2.1.
• A TFR of about 2.1 children per woman is called replacement-level fertility. The replacement-level fertility is the fertility rate that keeps a population stable over time by balancing births with deaths.
• If replacement level fertility is sustained over a sufficiently long period, each generation will exactly replace itself. The replacement-level fertility rate is considered essential to keep population growth in check, and has been linked to better education of women, less unmet need for family planning and reduced child mortality.
• This also marks a significant success for India’s family-planning programme based on non-coercive measures of population control like the adoption of modern contraceptive methods.

Institutional deliveries

• The NFHS-5 notes an increase in the proportion of institutional births – increased from 78.9% in NFHS-4 to the current level of 88.6%.
• This development augurs well for efforts to decrease the maternal mortality rate.

Limited improvements in child nutrition

• Despite some degree of improvement in childhood nutrition parameters, the gains are limited as compared to National Family Health Survey (NFHS) 4.
• Stunting and wasting in children have only dropped by a maximum of three percentage points, as compared to NFHS 4.

Increasing anaemia incidence

• The proportion of anaemic children (6-59 months) has increased. Also, anaemia incidence in women and men has also increased as compared to the previous survey.

Financial Inclusion of women

• The share of women who had a bank account they themselves use went up from 53% in NFHS-4 to 78.6% in NFHS-5.
• Similarly, health insurance coverage has increased from 28.7% to 41%.

Other important observations

• The proportion of children (12-23 months) who were fully vaccinated and children under six months who were exclusively breastfed also showed a sharp improvement.
• Overweight (higher Body Mass Index than ideal) women and men (15-49) increased by around 4 percentage points. Abnormal BMIs are linked to an increase in obesity and other non-communicable diseases.

Basic Necessities

• All states, except Manipur, Meghalaya, Assam and Jharkhand, had over 90% population with access to improved drinking water sources.
• Only Uttar Pradesh, Meghalaya, Assam, Jharkhand and Arunachal Pradesh had less than 95% population living in households with access to electricity.