The fifth edition of the National Family Health Survey (NFHS) provides a valuable insight into changes underway in Indian society. It throws light on traditional parameters, for instance immunisation among children, births in registered hospital facilities, and nutritional levels. While there is a general improvement in these parameters, there were mixed signals in nutrition. Gains in childhood nutrition were minimal as were improvements in obesity levels. The prevalence of anaemia has actually worsened since the last survey in 2015-16. But the survey’s major contribution is its insight into behavioural and sociological churn. When highlights were made public last year, the focus was on India’s declining total fertility rate that had, for the first time in the country’s history, dipped to below the replacement level, or a TFR (Total Fertility Rate) of 2.1. If the trend were to persist, India’s population was on the decline in line with what has been observed in developed countries, and theoretically means improved living standards per capita and greater gender equity. Because this TFR had been achieved across most States, two notable exceptions being most populous Uttar Pradesh and Bihar, it was also evidence that population decline could be achieved without coercive state policies and family planning has struck deep roots. The more detailed findings, made public last week, suggest that this decline is agnostic to religion.
The fertility rate among Muslims dipped to 2.3 in 2019-2021 from 2.6 in 2015-16, the sharpest among all religious communities when compared to the 4.4 in NFHS 1 in 1992-93. Another set of subjective questions that the NFHS attempts to answer using hard data is gender equity. Less than a third of married women are working and nearly 44% do not have the freedom to go to the market alone. However, a little over 80% have said that they can refuse demands for sex from their husband. This has implications for legal questions surrounding marital rape. Only 72% of Indian men think it is not right to coerce, threaten or use force on a woman if denied sex, which again points to the vast territory that needs to be covered in educating men about equality, choice and freedom in marriage. This question made it for the first time in the family health survey as did another question, about the number of registered births and deaths, in the family survey. Multiple surveys such as the NFHS, Sample Registration Surveys, the Census, labour, economic surveys and ways of interrogation are necessary for insights about a country as vast and complex as India; the Centre should invest more substantially in improving their reliability.
