NATIONAL FAMILY HEALTH SURVEY (NFHS-4)

The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India. It was conducted by Ministry of Health & Family Welfare, Government of India and coordinated by the International Institute for Population Sciences, Mumbai. Technical assistance for NFHS-4 will again be provided by ICF International, USA with the major financial support from the United States Agency for International Development and Ministry of Health and Family Welfare, Government of India. Further other institutions like Department for International Development (DFID), The Bill and Milinda Gates Foundation,United Nations Children's Emergency Fund (UNICEF), United Nations Population Fund (UNFPA) and MacArthur Foundation also contributed in terms of funding for this robust survey.

Findings for the 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 show promising improvements in maternal and child health and nutrition in this first phase survey report. Data collection for the second phase States and Union Territories is currently ongoing.

The salient findings are as follows...

1. Fewer children are dying in infancy and early childhood - 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.
2. Better health care facilities for pregnant women and new born babies - 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 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. 
   
3. Replacement level fertility rate- 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. 
4. Full immunization coverage among children age 12-23 months - It 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 immunized.
5. 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. 
6. Poor nutrition is less common than reported in the last round of National Family Health Survey - In nine States/Union Territories, less than one-third of children are found too short for their age. While this reveals a distinct improvement since the previous survey, it is found that in Bihar, Madhya Pradesh and Meghalaya more than 40% of children are stunted.
   
7. 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.
8. Use of clean cooking fuel - It 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.
9. Lack of HIV awareness in Indian adults -  Nearly 82 % women and nearly 70 % men in the 13 States lacked comprehensive knowledge of HIV/AIDS and safe sex practices.
10. Use of tobacco - Tobacco use among men has fallen from 50 per cent in 2005-06 to 47 per cent in 2015. Similarly, alcohol consumption among men has fallen from 38 per cent to 34 per cent. Over the last decade, consumption of alcohol among men has fallen in Madhya Pradesh, Bihar, Uttarakhand, Haryana, West Bengal and Meghalaya.

KEY-NOTES:-

1. NFHS-4 is 4th in this series of survey..
• NFHS-1 (1992-93)
• NFHS-2 (1998-99)
• NFHS-3 (2005-06)
• NFHS-4 (2014-15)
2. NFHS-4 is the first of the NFHS series that collects data in each of India’s 29 States and all 7 Union Territories. 
3. NFHS-4, for the first time, will provide estimates of most indicators at the district level for all 640 districts of the country included in the 2011 Census. 
4. In NFHS-4, women aged 15-49 years and men aged 15-54 years are interviewed.

References:-

1. http://pib.nic.in/newsite/PrintRelease.aspx?relid=134608
2. http://www.indiaenvironmentportal.org.in/content/424110/national-family-health-survey-2015-16-nfhs-4-states-fact-sheets/
3. http://www.thehindu.com/news/national/national-family-health-survey4-child-stunting-declines-but-still-high-data-show/article8131301.ece
4. http://www.thehindu.com/sci-tech/health/policy-and-issues/national-family-health-survey-fewer-children-dying-in-infancy/article8126073.ece?utm_source=InternalRef&utm_medium=relatedNews&utm_campaign=RelatedNews