NFHS & SDGs – THE HEALTH STATUS – Today Current Affairs

The main objective of the National Family Health Survey (NFHS) has been to provide high-quality data on health and family welfare and other emerging issues. Five rounds of the NFHS (1992–93, 1998–99, 2005–06, 2015–16, an­­­­­­­d 2019–20) have been successfully completed in India. The NFHS-5, implemented during 2019–21, was successfully completed despite two waves of COVID-19 by temporarily halting the survey in the second-phase states and union territories (IIPS and Macro International 2021).

Today Current Affairs

The NFHS-5 sample is designed to provide national, state/union territory, and district-level estimates of various indicators that are critical to monitor the Sustainable Development Goals (SDGs) on population, health, nutrition, and gender equality, among others. How­ever, some indicators like sexual behaviour, women’s work, HIV/AIDS knowledge, attitudes, pra­ctices, domestic violence, and men’s health are provided only at the state/union territory and national levels. The content and definitions are similar to other rounds to allow for comparisons over time. However, the NFHS-5 has been expanded to include new issues such as the extent of preschool education, disability, access to a toilet facility, death registration, bathing practices during menstruation, and methods and reasons for abortion. The scope of clinical, anthropometric, and bio­chemical (CAB) testing has been exp­an­ded to include measurement of waist and hip circumferences and malaria testing.

Household Environment, Water, and Sanitation : The Hindu Analysis

Concerns for healthy living free from diseases entail keeping the household environment clean, including proper sani­tation, hygiene, and adequate access to clean water as envisaged in the SDGs 6 and 7—water, sanitation, and hygiene (WASH).

Use of clean fuel for cooking: An ess­ential indicator of the improved household environment is the type of fuel used for cooking. India has made efforts to improve the household environment and health status of its members through the Ujjwala Yojana.

Use of improved sanitation and toilet facilities: There has been a remarkable improvement in the proportion of households using improved sanitation facilities in India (from 49% to 70%) and in each of the 36 states/union territories, which may be attributed to the Swachh Bharat Mission. India has a number of programmes to improve maternal and child health, like Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakaram (JSSK), and Pradhan Mantri Surakshit Matritva Vandana Abhiyan (PSMVA).

Marriage, fertility, and family planning: Fertility is best summarised by the total fertility rate (TFR). Replacement-level fertility of 2.1 children per woman or less has been achieved in 31 of the 36 states/union territories (Figure 1). MP (2.0), and Raj­asthan (2.0), Assam (1.9), Mizoram (1.9), Chhattisgarh (1.8), and Nagaland (1.7) attained the replacement level between NFHS-4 and NFHS-5. However, despite the decline in TFR, Bihar (3.0), Meghalaya (2.9), UP (2.4), Jharkhand (2.3), and Manipur (2.2) have higher than the rep­lacement level of fertility.

All 36 states/union territories, except Punjab, sho­wed an improvement in the use of any modern method of family planning over the previous round of the survey (Figure 2). The maximum increase between NFHS-4 and NFHS-5 was observed in Goa (from 25% to 60%), followed by Karnataka (51% to 68%), Bihar (23% to 44%), Jharkhand (40% to 62%), and Arunachal Pradesh (27% to 47%). 

Immunisation coverage: Immunisation helps in the development of the imm­une system and improves the overall nutritional status of the child and helps in the decline of infant mortality. Since 1985 when the first universal immunisation programme was launched, the government focused on achieving full coverage of essential vaccines for all children and has been successful in deli­vering the targets. In NFHS-5, full vaccination coverage among children has increased from 62% to 76%, which increases further to 84% if restricted to information from the mother–child protection (MCP) card. Today Current Aff.airs

Nutritional status of children under five years: Despite implementation of the Poshan Abhiyan in the country since March 2018, the NFHS-5 findings portray no remarkable improvements in nutritional status of under-five children that might have resulted due to COVID-19-induced interruptions in micronutrient supplementation.

Stunting is one of the three standard indices used globally to track physical growth and development of children, and it is the preferred indicator used for long-term planning of policies and intervention programmes like Poshan Abhiyan.

Children aged under three breastfed within one hour of birth: Breastfeeding within an hour of birth, or colostrum feeding, has been a significant contributor to preventing avoidable mortality in early childhood as it provides protection from various types of infections. The level of breastfeeding within one hour after birth in the NFHS-5 is the highest in Meghalaya (79%) and the lowest in Jharkhand (22%). 

Non-communicable Diseases : The Hindu Analysis

Non-communicable diseases (NCDs) are a leading cause of mortality, a major public health problem, and an obs­tacle to achieving the SDGs for India. The NFHS-5, through an objective assessment by CAB investigations and supporting biomarker questions, provides valuable information on the situation of NCDs and their risk factors in India.

Gender Equality – Today Current Affairs

Two important aspects of gender equality highlighted here pertain to women’s empowerment and domestic (spousal) violence. The NFHS-5 shows an overall improvement in these SDG indicators in all the states/union territories.

Women’s empowerment: The indicators of women’s empowerment presen­ted are (a) participation in three key household decisions and (b) having a bank or savings account women themselves use. The three key household deci­sions are (i) decisions about healthcare for herself, (ii) making major household purchases, and (iii) visits to her family or relatives. 

Gender-based violence: The two im­por­tant dimensions of violence against women (ever-experience of spousal violence and experience of sexual violence by age of 18 years) are highlighted in this section. There has been a substantial dec­line in the ever-experience of spousal violence by ever-married women and in the experience of sexual violence by age of 18 years among younger women (aged 18–29 years) in the last four years. In 27 states/union territories, the extent of spousal violence has decre­ased, but it has increased in the remaining states/union territories. 

The NFHS-5 results from all 36 states/union territories provides an opportunity to assess the progress of several important programmes in the country that have been launched to improve the performance of SDG indicators. Undoubtedly, considerable improvements in the critical SDG indi­cators on population and health in India are visible over the last four years. At the same time, there are several areas of concern that need focused attention.


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