Stunting among children marginally reduced, obesity rises in most states/UTs: NFHS-5

The level of stunting among children under five years has marginally declined from 38 to 36 per cent in the last four years while obesity has increased in most states and union territories, according to the fifth round of the National Family Health Survey (NFHS).

Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation.

The NFHS-5 (2019-21) report comprises detailed information on key domains of population, health and family welfare and associated domains like characteristics of the population, fertility, family planning, infant and child mortality, maternal and child health, nutrition and anaemia, morbidity and healthcare and women's empowerment.

The report said the level of stunting among children under five years has marginally declined from 38 to 36 per cent for India since the last four years.

"Stunting is higher among children in rural areas (37 per cent) than urban areas (30 per cent) in 2019-21. Variation in stunting ranges from the lowest in Puducherry (20 per cent) and highest in Meghalaya (47 per cent). A notable decrease in stunting was observed in Haryana, Uttarakhand, Rajasthan, Uttar Pradesh and Sikkim (7 percentage points each), Jharkhand, Madhya Pradesh and Manipur (6 percentage points each), and Chandigarh and Bihar (5 percentage points each)," it said.

Compared with NFHS-4 (2015-16) , the prevalence of overweight or obesity has increased in most states and UTs in NFHS-5.

"At national level, obesity increases from 21 per cent to 24 per cent among women and 19 per cent to 23 per cent among men. More than a third of women in Kerala, Andaman and Nicobar Islands, Andhra Pradesh, Goa, Sikkim, Manipur, Delhi, Tamil Nadu, Puducherry, Punjab, Chandigarh and Lakshadweep (34-46 per cent) are overweight or obese," the report said.

The main objective of successive NHFS rounds has been to provide reliable and comparable data relating to health and family welfare and other emerging areas in India.

The NFHS-5 survey work has been conducted in around 6.37 lakh sample households from 707 districts (as on March 2017) in 28 states and eight UTs, covering 7,24,115 women and 1,01,839 men to provide dis-aggregated estimates up to the district level, the report said.

It also provides data by socio-economic and other background characteristics, useful for policy formulation and effective programme implementation.

The NFHS-5 shows an overall improvement in Sustainable Development Goals indicators in all states and UTs.

"The extent to which married women usually participate in three household decisions (about health care for herself; making major household purchases; visit to her family or relatives) indicates that their participation in decision making is high, ranging from 80 per cent in Ladakh to 99 per cent in Nagaland and Mizoram. Rural (77 per cent ) and urban (81 per cent ) difference is found to be marginal. The prevalence of women having a bank or savings account that they use has increased from 53 to 79 per cent in the last four years," the report said.

The Total Fertility Rates (TFR), an average number of children per women, has further declined from 2.2 to 2 at the national level between NFHS-4 and 5. There are only five states, which are above replacement level of fertility of 2.1, it said.

These are Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26) Manipur (2.17).

Overall Contraceptive Prevalence Rate (CPR) has increased substantially from 54 per cent to 67 per cent in the country. Use of modern methods of contraceptives has also increased in almost states and UTs, the report said.

Unmet needs of family planning have witnessed a significant decline from 13 per cent to 9 per cent. The unmet need for spacing, which remained a major issue in the past has come down to less than 10 per cent, it said.

The proportion of pregnant women who had an ANC visit in the first trimester increased from 59 to 70 per cent between NFHS-4 and 5. The maximum increase of 25 percentage points was in Nagaland followed by Madhya Pradesh and Haryana, the survey said.

In contrast, Goa, Sikkim, Punjab and Chhattisgarh showed marginal decrease in first trimester ANC visits. A considerable progress is noticed in 4+ ANC at the national level from 51 per cent in 2015-16 to 58 per cent in 2019-21, it noted

Institutional births have increased substantially from 79 per cent to 89 per cent. Even in rural areas around 87 per cent births are delivered in institutions and same is 94 per cent in urban areas. Institutional births increased by a maximum of 27 percentage points in Arunachal Pradesh, followed by over 10 percentage points in Assam, Bihar, Meghalaya, Chhattisgarh, Nagaland, Manipur, Uttar Pradesh, and West Bengal, the report said.

"Over 91 per cent of districts have more than 70 per cent of births in the last five years that took place in health facilities," it said.

In NFHS-5, more than three-fourths (77 per cent) children age 12-23 months were fully immunized, compared with 62 per cent in NFHS-4.

"Full vaccination coverage among children ranges from 57 per cent in Nagaland to 95 per cent in DNH & DD. Odisha (91 per cent), Tamil Nadu (89 per cent), and West Bengal (88 per cent) also have shown relatively higher immunization coverage," the report said.

NFHS-5 shows an overall improvement in SDG indicators in all states and UTs.

Between NFHS-4 and 5, the use of clean cooking fuel (44 to 59 per cent) and improved sanitation facilities (49 to 70 per cent), including a hand-washing facility with soap and water (60 to 78 per cent) have improved considerably, it said.

Union Health Minister Mansukh Mandaviya released the NHFS-5 at the 'Swasthya Chintan Shivir' being held at Vadodara on Thursday.