Demography India Vol. 29. Issue 2 (2000)

From the Chief Editor’s Desk

Major Findings of the National Family Health Survey (NFHS-2), 1998-99 THE first round of National Family Health Survey (NFHS), conducted in 1992-93, provided wealth of information on various aspects like fertility, the practice of family planning, infant and child mortality, and maternal and child health. The second round of NFHS, in addition to all these, also examines the quality of health and family planning services and care, indicators of status of women, women's reproductive health problems, and domestic violence.

Another feature of the second NFHS is to provide information on the prevalence of anaemia throughout the country. Ever-married women and their children below age three had their blood tested for the level of hemoglobin, using the Hemocue instrument. In addition, children in Delhi and Mumbai were also tested for lead content in their blood.

NFHS-2 interviewed more than 90,000 women in all 26 states in 1998-99. The survey provides estimates for all these states of India. For four of the larger states, UP, Bihar, MP and Rajasthan, the estimates are also available at the regional level. The survey also provides separate estimates for three metro cities, Calcutta, Chennai, and Mumbai, and also separate estimates for slum areas in Mumbai.

The all India report of NFHS-2 was released in November 2000 by the Hon'ble Union Minister of Health & Family Welfare, Dr. C. P. Thakur, at the National Seminar on NFHS-2 Results held at Delhi. The main findings of the survey are:

• Fertility in India is still high. At the present rate, a couple will have, on an average, around 3 children during the woman's reproductive life, which is about one child higher than what is being desired to be achieved in the recent National Population Policy by 2010.

• The fertility has declined by about 0.5 children since NFHS-1. Also, more than 70 percent of currently married women with 2 children say that they want no more children, compared with 60 percent in 1992- 93.

• There exists a strong preference for sons. Women who already have two or more children are much more likely to want another child if they have only daughters than if they have at least one son.

• The adolescent fertility is substantially high. Fertility at age less than 20 accounts for 19 percent of total fertility. Also. a large proportion of births occur within 24 months of a previous birth. Births at adolescent ages and births at short intervals can adversely affect mother's health and chances of survival of her children. It will be important for the programme to focus on reducing such high-risk births. Two specific issues are important in this context.

• The early marriage pattern in India. The survey shows that half of young women still marry below the legal minimum marriage age of l8years.

• The lack of use of spacing methods of contraception—the pill, condoms and lUDs. The survey shows that only 7 percent of couples are using any modern spacing method.

• Young women have the highest levels of unmet need for contraception, mostly for spacing their births. Despite demand, spacing methods, such as pills, lUDs and condoms are not being widely promoted and are not being widely used.

• Although mortality is declining, 1 in 15 children still die before age one. Infant mortality rates vary substantially among major states, ranging from 16 in Kerala to 86 or more in Uttar Pradesh and Madhya Pradesh.

• Infant mortality rate is 110 for closely spaced births (less than 24 months), compared with 39 for those births spaced, atleast, four years apart.

• Mothers of only one out of every five births received all the recommended components of antenatal care (that is, atleast 3 check-ups during pregnancy, 2 doses of tetanus toxide and iron folic supplementations for 3 or more months).

• Mothers and families still need to be better informed about the benefits of antenatal check-ups. Among those who did not receive check-ups, most said that they did not consider antenatal check-ups to be necessary.

• Only one among three deliveries are institutional deliveries and about 40 percent of deliveries are attended by a health professional. The goal set under the New Population Policy is to achieve 80 percent institutional deliveries and 100 percent deliveries attended by a health professional by the year 2010.

• Mothers of only 17 percent of non-institutional births received a postpartum check-up within two months after delivery.

• About half of women are not involved at all in decisions about seeking health care for themselves. The proportion of women involved in decision-making regarding their own health care ranges from 37 percent in Madhya Pradesh to 81 percent in Himachal Pradesh.

• Only 40 percent of women reported that a health or family planning worker discussed family planning with them. It appears that these workers are missing a good opportunity to discuss family planning with women even during antenatal check-ups because mothers of only 28 percent births reported having received such advice during any antenatal check-up.

• The survey also shows that 4 out of 10 mothers do not know about Oral Rehydration Salt (ORS) packets, the recommended treatment of diarrhoea.

• In the country as a whole, only 40 percent women have heard AIDS.

• Almost half of children in India are underweight—this is among the highest levels of undernutrition in tne world—there has been some improvement since the time NFHS-1 six years earlier, with the percent of children underweight declining from 52 percent to 47 percent. Malnutrition is also a problem for women— more than one-third of women are undernourished.

• A related nutritional problems is anaemia, which is very common in India as well as worldwide. Nearly three-fourths of Indian children and half of Indian women are anaemic. Anaemia is a serious problem because it can result in maternal deaths, premature delivery, low birth weight for babies, and child development problems [such as impaired motor development, coordination, language development and scholastic achievement]. The good news is that early detection and treatment of anaemia can prevent these problems and more than half of pregnant women do take iron and folic acid supplementation for the prevention of anaemia.

The findings NFHS-2 show that although India has made important strides to improve population and health conditions, still concerted efforts need to be made to achieve the goals set by the National Population Policy. The survey provides the policy makers and programme managers a comprehensive portrait of the existing demographic and health situations. This information can be a vital input in the implementation of various developmental programmes

T. K. Roy
Chief Editor, Demography India