Abstract

The 2015-16 National Family Health Survey (NFHS-4), the fourth in the NFHS series, provides information on population, health, and nutrition for India and each state and union territory. For the first time, NFHS-4 provides district-level estimates for many important indicators. All four NFHS surveys have been conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW), Government of India. MoHFW designated the International Institute for Population Sciences (IIPS), Mumbai, as the nodal agency for the surveys. Funding for NFHS-4 was provided by the United States Agency for International Development (USAID), the United Kingdom Department for International Development (DFID), the Bill and Melinda Gates Foundation (BMGF), UNICEF, UNFPA, the MacArthur Foundation, and the Government of India. Technical assistance for NFHS-4 was provided by ICF, Maryland, USA. Assistance for the HIV component of the survey was provided by the National AIDS Control Organization (NACO) and the National AIDS Research Institute (NARI), Pune.

Geographic coverage

National coverage

Analysis unit

• Household
• Individual
• Children age 0-5
• Woman age 15-49
• Man age 15-54

Kind of data

Sample survey data [ssd]

Sampling procedure

The NFHS-4 sample was designed to provide estimates of all key indicators at the national and state levels, as well as estimates for most key indicators at the district level (for all 640 districts in India, as of the 2011 Census). The total sample size of approximately 572,000 households for India was based on the size needed to produce reliable indicator estimates for each district and for urban and rural areas in districts in which the urban population accounted for 30-70 percent of the total district population. The rural sample was selected through a two-stage sample design with villages as the Primary Sampling Units (PSUs) at the first stage (selected with probability proportional to size), followed by a random selection of 22 households in each PSU at the second stage. In urban areas, there was also a two-stage sample design with Census Enumeration Blocks (CEB) selected at the first stage and a random selection of 22 households in each CEB at the second stage. At the second stage in both urban and rural areas, households were selected after conducting a complete mapping and household listing operation in the selected first-stage units.

The figures of NFHS-4 and that of earlier rounds may not be strictly comparable due to differences in sample size and NFHS-4 will be a benchmark for future surveys. NFHS-4 fieldwork for Bihar was conducted in all 38 districts of the state from 16 March to 8 August 2015 by the Academic Management Studies (AMS) and collected information from 36,772 households, 45,812 women age 15-49 (including 7,464 women interviewed in PSUs in the state module), and 5,872 men age 15-54.

Mode of data collection

Computer Assisted Personal Interview [capi]

Research instrument

Four questionnaires - household, woman's, man's, and biomarker, were used to collect information in 19 languages using Computer Assisted Personal Interviewing (CAPI).

Abstract

The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India. Four rounds of the survey have been conducted in 1992-93, 1998-99, 2005-06, and 2015-16. The fifth round of the survey (2019-2020) is currently in the field. All of the surveys are part of the Demographic and Health Surveys (DHS) Program. The surveys provide information on population, health, and nutrition at the national and state level. Since 2015-16, the surveys have also provided information at the district level. Some of the major topics included in NFHS-4 (2015-16) are fertility, infant and child mortality, family planning, maternal and reproductive health, child vaccinations, prevalence and treatment of childhood diseases, nutrition, women’s empowerment, domestic violence, marriage, sexual activity, employment, anemia, anthropometry, HIV/AIDS knowledge and testing, tobacco and alcohol use, biomarker tests (anthropometry, anemia, HIV, blood pressure, and blood glucose), and water, sanitation, and hygiene. The primary objective of the NFHS surveys is to provide essential data on health and family welfare, as well as emerging issues in these areas. The information collected through the NFHS surveys is intended to assist policymakers and program managers in setting benchmarks and examining progress over time in India’s health sector. The Ministry of Health and Family Welfare (MOHFW), Government of India, designated the International Institute for Population Sciences (IIPS), Mumbai, as the agency responsible for providing coordination and technical guidance for all of the surveys. IIPS has collaborated with a large number of field agencies for survey implementation. The Demographic and Health Surveys Program has provided technical assistance for all of the surveys.

Documentation

You can access the data through the DHS website. Data files are available in the following five formats:

• Hierarchical CSPro file
• Flat files: ASCII data with syntax, Stata, SPSS, SAS

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All datasets are distributed in archived ZIP files that include the data file and its associated documentation. The DHS Program is authorized to distribute, at no cost, unrestricted survey data files for legitimate academic research. Registration is required to access the data.

Additional information about the surveys is available on the India page on the DHS Program website. This page provides a list of surveys and reports, plus Country Quickstats for India, and it is the gateway to accessing more information about the India surveys and datasets.

Methodology

2015-16 National Family Health Survey (NFHS-4): Fieldwork for NFHS-4 was conducted in two phases, from January 2015 to December 2016. The fieldwork was conducted by 14 field agencies, including three Population Research Centers. Laboratory testing for HIV was done by seven laboratories throughout India. NFHS-4 collected information from a nationally representative sample of 601,509 households, 699,686 women age 15-49, and 112,122 men age 15-54. The survey covered all 29 states, 7 Union Territories, and 640 districts in India.

Funding for the survey was provided by the Ministry of Health and Family Welfare, Government of India; the United States Agency for International Development (USAID); UKAID/DFID; the Bill & Melinda Gates Foundation; UNICEF; the United Nations Population Fund (UNFPA); and the MacArthur Foundation. Technical Assistance for NFHS-4 was provided by Macro International, Maryland, USA.

2005-06 National Family Health Survey (NFHS-3): Fieldwork for NFHS-3 was conducted in two phases, from November 2005 to August 2006. The fieldwork was conducted by 18 field agencies, including six Population Research Centers. Laboratory testing for HIV was done by the SRL Ranbaxy laboratory in Mumbai. NFHS-3 collected information from a nationally representative sample of 109,041 households, 124,385 women age 15-49, and 74,369 men age 15-54. The survey covered all 29 states. Only the Union Territories were not included.

Funding for the survey was provided by the United States Agency for International Development (USAID); United Kingdom Department for International Development (DFID); the Bill & Melinda Gates Foundation; UNICEF; the United Nations Population Fund (UNFPA); and the Government of India. Technical assistance for NFHS-3 was provided by Macro International, Maryland, USA.

1998-99 National Family Health Survey (NFHS-2): Fieldwork for NFHS-2 was conducted in two phases, from November 1998 to December 1999. The fieldwork was conducted by 13 field agencies, including five Population Research Centers. NFHS-2 collected information from a nationally representative sample of 91,196 households and 89,188 ever-married women age 15-49. Male interviews were not included in the survey. The survey cover

Analysis unit

Woman, Birth, Child, Man, Member

Universe

Women age 15-49, Births, Children age 0-4, Men age 15-54, All persons

Kind of data

Demographic and Household Survey [hh/dhs]

Sampling procedure

MICRODATA SOURCE: International Institute for Population Sciences (IIPS) and ICF.

SAMPLE UNIT: Woman SAMPLE SIZE: 699686

SAMPLE UNIT: Birth SAMPLE SIZE: 1315617

SAMPLE UNIT: Child SAMPLE SIZE: 259627

SAMPLE UNIT: Man SAMPLE SIZE: 112122

SAMPLE UNIT: Member SAMPLE SIZE: 2869043

Mode of data collection

Face-to-face [f2f]

The National Family Health Survey 2019-2021, the fifth in the NFHS series, provides information on the population, health, and nutrition of India and each state and union territory. Like NFHS-4, NFHS-5 also provides district-level estimates for many important indicators. The contents of NFHS-5 are similar to NFHS-4 to allow comparisons over time. However, NFHS-5 includes some new topics, such as 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 testing has also been expanded to include the measurement of waist and hip circumferences, and the age range for the measurement of blood pressure and blood glucose has been expanded. However, HIV testing has been dropped. The NFHS-5 sample has been designed to provide national, state and union territory, and district level estimates of various indicators covered in the survey. However, estimates of indicators of sexual behaviour, husband's background and woman's work, HIV and AIDS knowledge, attitudes and behaviour, and domestic violence are available only at the state and union territory and national level.

The dataset contains state-wise National Family Health Survey (NFHS) compiled data on various family planning, childbirth, population, medical, health and other parameters which provide statistical indicators data on family profile and health status in India. There are 100+ indicators covered in the survey which broadly fall in the following categories: Health and Wellness, Maternal and Child Health, Family Planning and Reproductive Health, Disease Screening and Prevention, Social and Economic Factors, General Healthcare and Treatment

The different types of health data contained in the dataset include Anaemia among women and children, blood sugar levels and hypertension among men and women, tobacco and alcohol consumption among adults, delivery care and child feeding practices of women, quality of family planning services, screening of cancer among women, marriage and family, maternity care, nutritional status of women, child vaccinations and vitamin A supplementation, treatment of childhood diseases, etc.

Within these categories of health data, the dataset contains indicators data such as births attended by skilled health care professionals and caesarean section, number of children with under and heavy weight, stunted growth, their different vaccations status, male and female sterilization, consumption of iron folic acid among mothers, mother who had antenatal, postnatal, neonatal services, women who are obese and at the risk of weight to hip ratio, educational status among women and children, sanitation, birth and sex ratio, etc.

All of the data is compiled from the NFHS 4th and 5th survey reports. The The NFHS is a collaborative project of the International Institute for Population Sciences(IIPS), aimed at providing health data to strengthen India's health policies and programmes.

There are 100+ indicators covered in the survey which broadly fall in the following categories: Health and Wellness, Maternal and Child Health, Family Planning and Reproductive Health, Disease Screening and Prevention, Social and Economic Factors, General Healthcare and Treatment

Abstract

The National Family Health Survey 2019-21 (NFHS-5), the fifth in the NFHS series, provides information on population, health, and nutrition for India, each state/union territory (UT), and for 707 districts.

The primary objective of the 2019-21 round of National Family Health Surveys is to provide essential data on health and family welfare, as well as data on emerging issues in these areas, such as levels of fertility, infant and child mortality, maternal and child health, and other health and family welfare indicators by background characteristics at the national and state levels. Similar to NFHS-4, NFHS-5 also provides information on several emerging issues including perinatal mortality, high-risk sexual behaviour, safe injections, tuberculosis, noncommunicable diseases, and the use of emergency contraception.

The information collected through NFHS-5 is intended to assist policymakers and programme managers in setting benchmarks and examining progress over time in India’s health sector. Besides providing evidence on the effectiveness of ongoing programmes, NFHS-5 data will help to identify the need for new programmes in specific health areas.

The clinical, anthropometric, and biochemical (CAB) component of NFHS-5 is designed to provide vital estimates of the prevalence of malnutrition, anaemia, hypertension, high blood glucose levels, and waist and hip circumference, Vitamin D3, HbA1c, and malaria parasites through a series of biomarker tests and measurements.

Geographic coverage

National coverage

Analysis unit

• Household
• Individual
• Children age 0-5
• Woman age 15-49
• Man age 15 to 54

Universe

The survey covered all de jure household members (usual residents), all women aged 15-49, all men age 15-54, and all children aged 0-5 resident in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

A uniform sample design, which is representative at the national, state/union territory, and district level, was adopted in each round of the survey. Each district is stratified into urban and rural areas. Each rural stratum is sub-stratified into smaller substrata which are created considering the village population and the percentage of the population belonging to scheduled castes and scheduled tribes (SC/ST). Within each explicit rural sampling stratum, a sample of villages was selected as Primary Sampling Units (PSUs); before the PSU selection, PSUs were sorted according to the literacy rate of women age 6+ years. Within each urban sampling stratum, a sample of Census Enumeration Blocks (CEBs) was selected as PSUs. Before the PSU selection, PSUs were sorted according to the percentage of SC/ST population. In the second stage of selection, a fixed number of 22 households per cluster was selected with an equal probability systematic selection from a newly created list of households in the selected PSUs. The list of households was created as a result of the mapping and household listing operation conducted in each selected PSU before the household selection in the second stage. In all, 30,456 Primary Sampling Units (PSUs) were selected across the country in NFHS-5 drawn from 707 districts as on March 31st 2017, of which fieldwork was completed in 30,198 PSUs.

For further details on sample design, see Section 1.2 of the final report.

Mode of data collection

Computer Assisted Personal Interview [capi]

Research instrument

Four survey schedules/questionnaires: Household, Woman, Man, and Biomarker were canvassed in 18 local languages using Computer Assisted Personal Interviewing (CAPI).

Cleaning operations

Electronic data collected in the 2019-21 National Family Health Survey were received on a daily basis via the SyncCloud system at the International Institute for Population Sciences, where the data were stored on a password-protected computer. Secondary editing of the data, which required resolution of computer-identified inconsistencies and coding of open-ended questions, was conducted in the field by the Field Agencies and at the Field Agencies central office, and IIPS checked the secondary edits before the dataset was finalized.

Field-check tables were produced by IIPS and the Field Agencies on a regular basis to identify certain types of errors that might have occurred in eliciting information and recording question responses. Information from the field-check tables on the performance of each fieldwork team and individual investigator was promptly shared with the Field Agencies during the fieldwork so that the performance of the teams could be improved, if required.

Response rate

A total of 664,972 households were selected for the sample, of which 653,144 were occupied. Among the occupied households, 636,699 were successfully interviewed, for a response rate of 98 percent.

In the interviewed households, 747,176 eligible women age 15-49 were identified for individual women’s interviews. Interviews were completed with 724,115 women, for a response rate of 97 percent. In all, there were 111,179 eligible men age 15-54 in households selected for the state module. Interviews were completed with 101,839 men, for a response rate of 92 percent.

Data in table tells us about the year-wise National Family Health Survey- Main Findings.

Indicators used are: Population and Household Profile, Characteristics of Adults (age 15-49), Marriage and fertility, Infant and Child Mortality Rates (per 1,000 live births), Current Use of Family Planning Methods (currently married women age 15-49 years), Unmet Need for Family Planning (currently married women age 15-49 years), Quality of Family Planning Services, Maternal and Child Health includes- Maternity Care (for last birth in the 5 years before the survey), Delivery Care (for births in the 5 years before the survey), Treatment of Childhood Diseases (children under age 5 years), Child Feeding Practices and Nutritional Status of Children, Nutritional Status of Adults (age 15-49 years) includes- Anaemia among Children and Adults 15, Blood Sugar Level among Adults (age 15-49 years)16, Women Age 15-49 Years Who Have Ever Undergone Examinations of: Cervix, breast and oral cavity, Knowledge of HIV/AIDS among Adults (age 15-49 years), Women's Empowerment and Gender Based Violence (age 15-49 years) and Tobacco Use and Alcohol Consumption among Adults (age 15-49 years). NFHS-3 was calculated for 2005-2006 and NFHS-4 for 2015-16 for urban areas, rural areas and total separately.

We utilized nationally representative sample survey data from round 4 (2015-16) and round 5 (2019-21) of the National Family Health Survey (NFHS). NFHS data from various rounds was accessed from the 7th phase of Demographic Health Surveys (DHS). The surveys were conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW) and the designated nodal agency- the International Institute for Population Science (IIPS). We considered household data sets from various rounds of NFHS.

The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India. The survey is conducted by the Ministry of Health and Family Welfare, in collaboration with the International Institute for Population Sciences (IIPS) and other partner organizations. The NFHS is conducted periodically and provides important information on a wide range of health and social indicators, such as fertility, infant and child mortality, maternal and child health, nutrition, family planning, HIV/AIDS, and other health-related issues. The survey is designed to provide reliable data at the national, state, and district levels, and the results are widely used by policymakers, researchers, and program managers to inform policy and programs related to health and development.

The National Family Health Surveys (NFHS) programme, initiated in the early 1990s, has emerged as a nationally important source of data on population, health, and nutrition for India and its states. The 2005-06 National Family Health Survey (NFHS-3), the third in the series of these national surveys, was preceded by NFHS-1 in 1992-93 and NFHS-2 in 1998-99. Like NFHS-1 and NFHS-2, NFHS-3 was designed to provide estimates of important indicators on family welfare, maternal and child health, and nutrition. In addition, NFHS-3 provides information on several new and emerging issues, including family life education, safe injections, perinatal mortality, adolescent reproductive health, high-risk sexual behaviour, tuberculosis, and malaria. Further, unlike the earlier surveys in which only ever-married women age 15-49 were eligible for individual interviews, NFHS-3 interviewed all women age 15-49 and all men age 15-54. Information on nutritional status, including the prevalence of anaemia, is provided in NFHS3 for women age 15-49, men age 15-54, and young children. A special feature of NFHS-3 is the inclusion of testing of the adult population for HIV. NFHS-3 is the first nationwide community-based survey in India to provide an estimate of HIV prevalence in the general population. Specifically, NFHS-3 provides estimates of HIV prevalence among women age 15-49 and men age 15-54 for all of India, and separately for Uttar Pradesh and for Andhra Pradesh, Karnataka, Maharashtra, Manipur, and Tamil Nadu, five out of the six states classified by the National AIDS Control Organization (NACO) as high HIV prevalence states. No estimate of HIV prevalence is being provided for Nagaland, the sixth high HIV prevalence state, due to strong local opposition to the collection of blood samples. NFHS-3 covered all 29 states in India, which comprise more than 99 percent of India's population. NFHS-3 is designed to provide estimates of key indicators for India as a whole and, with the exception of HIV prevalence, for all 29 states by urban-rural residence. Additionally, NFHS-3 provides estimates for the slum and non-slum populations of eight cities, namely Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai, and Nagpur. NFHS-3 was conducted under the stewardship of the Ministry of Health and Family Welfare (MOHFW), Government of India, and is the result of the collaborative efforts of a large number of organizations. The International Institute for Population Sciences (IIPS), Mumbai, was designated by MOHFW as the nodal agency for the project. Funding for NFHS-3 was provided by the United States Agency for International Development (USAID), DFID, the Bill and Melinda Gates Foundation, UNICEF, UNFPA, and MOHFW. Macro International, USA, provided technical assistance at all stages of the NFHS-3 project. NACO and the National AIDS Research Institute (NARI) provided technical assistance for the HIV component of NFHS-3. Eighteen Research Organizations, including six Population Research Centres, shouldered the responsibility of conducting the survey in the different states of India and producing electronic data files. The survey used a uniform sample design, questionnaires (translated into 18 Indian languages), field procedures, and procedures for biomarker measurements throughout the country to facilitate comparability across the states and to ensure the highest possible data quality. The contents of the questionnaires were decided through an extensive collaborative process in early 2005. Based on provisional data, two national-level fact sheets and 29 state fact sheets that provide estimates of more than 50 key indicators of population, health, family welfare, and nutrition have already been released. The basic objective of releasing fact sheets within a very short period after the completion of data collection was to provide immediate feedback to planners and programme managers on key process indicators.

The second National Family Health Survey (NFHS-2), conducted in 1998-99, provides information on fertility, mortality, family planning, and important aspects of nutrition, health, and health care. The International Institute for Population Sciences (IIPS) coordinated the survey, which collected information from a nationally representative sample of more than 90,000 ever-married women age 15-49. The NFHS-2 sample covers 99 percent of India's population living in all 26 states. This report is based on the survey data for 25 of the 26 states, however, since data collection in Tripura was delayed due to local problems in the state. IIPS also coordinated the first National Family Health Survey (NFHS-1) in 1992-93. Most of the types of information collected in NFHS-2 were also collected in the earlier survey, making it possible to identify trends over the intervening period of six and one-half years. In addition, the NFHS-2 questionnaire covered a number of new or expanded topics with important policy implications, such as reproductive health, women's autonomy, domestic violence, women's nutrition, anaemia, and salt iodization. The NFHS-2 survey was carried out in two phases. Ten states were surveyed in the first phase which began in November 1998 and the remaining states (except Tripura) were surveyed in the second phase which began in March 1999. The field staff collected information from 91,196 households in these 25 states and interviewed 89,199 eligible women in these households. In addition, the survey collected information on 32,393 children born in the three years preceding the survey. One health investigator on each survey team measured the height and weight of eligible women and children and took blood samples to assess the prevalence of anaemia. SUMMARY OF FINDINGS POPULATION CHARACTERISTICS Three-quarters (73 percent) of the population lives in rural areas. The age distribution is typical of populations that have recently experienced a fertility decline, with relatively low proportions in the younger and older age groups. Thirty-six percent of the population is below age 15, and 5 percent is age 65 and above. The sex ratio is 957 females for every 1,000 males in rural areas but only 928 females for every 1,000 males in urban areas, suggesting that more men than women have migrated to urban areas. The survey provides a variety of demographic and socioeconomic background information. In the country as a whole, 82 percent of household heads are Hindu, 12 percent are Muslim, 3 percent are Christian, and 2 percent are Sikh. Muslims live disproportionately in urban areas, where they comprise 15 percent of household heads. Nineteen percent of household heads belong to scheduled castes, 9 percent belong to scheduled tribes, and 32 percent belong to other backward classes (OBCs). Two-fifths of household heads do not belong to any of these groups. Questions about housing conditions and the standard of living of households indicate some improvements since the time of NFHS-1. Sixty percent of households in India now have electricity and 39 percent have piped drinking water compared with 51 percent and 33 percent, respectively, at the time of NFHS-1. Sixty-four percent of households have no toilet facility compared with 70 percent at the time of NFHS-1. About three-fourths (75 percent) of males and half (51 percent) of females age six and above are literate, an increase of 6-8 percentage points from literacy rates at the time of NFHS-1. The percentage of illiterate males varies from 6-7 percent in Mizoram and Kerala to 37 percent in Bihar and the percentage of illiterate females varies from 11 percent in Mizoram and 15 percent in Kerala to 65 percent in Bihar. Seventy-nine percent of children age 6-14 are attending school, up from 68 percent in NFHS-1. The proportion of children attending school has increased for all ages, particularly for girls, but girls continue to lag behind boys in school attendance. Moreover, the disparity in school attendance by sex grows with increasing age of children. At age 6-10, 85 percent of boys attend school compared with 78 percent of girls. By age 15-17, 58 percent of boys attend school compared with 40 percent of girls. The percentage of girls 6-17 attending school varies from 51 percent in Bihar and 56 percent in Rajasthan to over 90 percent in Himachal Pradesh and Kerala. Women in India tend to marry at an early age. Thirty-four percent of women age 15-19 are already married including 4 percent who are married but gauna has yet to be performed. These proportions are even higher in the rural areas. Older women are more likely than younger women to have married at an early age: 39 percent of women currently age 45-49 married before age 15 compared with 14 percent of women currently age 15-19. Although this indicates that the proportion of women who marry young is declining rapidly, half the women even in the age group 20-24 have married before reaching the legal minimum age of 18 years. On average, women are five years younger than the men they marry. The median age at marriage varies from about 15 years in Madhya Pradesh, Bihar, Uttar Pradesh, Rajasthan, and Andhra Pradesh to 23 years in Goa. As part of an increasing emphasis on gender issues, NFHS-2 asked women about their participation in household decisionmaking. In India, 91 percent of women are involved in decision-making on at least one of four selected topics. A much lower proportion (52 percent), however, are involved in making decisions about their own health care. There are large variations among states in India with regard to women's involvement in household decisionmaking. More than three out of four women are involved in decisions about their own health care in Himachal Pradesh, Meghalaya, and Punjab compared with about two out of five or less in Madhya Pradesh, Orissa, and Rajasthan. Thirty-nine percent of women do work other than housework, and more than two-thirds of these women work for cash. Only 41 percent of women who earn cash can decide independently how to spend the money that they earn. Forty-three percent of working women report that their earnings constitute at least half of total family earnings, including 18 percent who report that the family is entirely dependent on their earnings. Women's work-participation rates vary from 9 percent in Punjab and 13 percent in Haryana to 60-70 percent in Manipur, Nagaland, and Arunachal Pradesh. FERTILITY AND FAMILY PLANNING Fertility continues to decline in India. At current fertility levels, women will have an average of 2.9 children each throughout their childbearing years. The total fertility rate (TFR) is down from 3.4 children per woman at the time of NFHS-1, but is still well above the replacement level of just over two children per woman. There are large variations in fertility among the states in India. Goa and Kerala have attained below replacement level fertility and Karnataka, Himachal Pradesh, Tamil Nadu, and Punjab are at or close to replacement level fertility. By contrast, fertility is 3.3 or more children per woman in Meghalaya, Uttar Pradesh, Rajasthan, Nagaland, Bihar, and Madhya Pradesh. More than one-third to less than half of all births in these latter states are fourth or higher-order births compared with 7-9 percent of births in Kerala, Goa, and Tamil Nadu. Efforts to encourage the trend towards lower fertility might usefully focus on groups within the population that have higher fertility than average. In India, rural women and women from scheduled tribes and scheduled castes have somewhat higher fertility than other women, but fertility is particularly high for illiterate women, poor women, and Muslim women. Another striking feature is the high level of childbearing among young women. More than half of women age 20-49 had their first birth before reaching age 20, and women age 15-19 account for almost one-fifth of total fertility. Studies in India and elsewhere have shown that health and mortality risks increase when women give birth at such young ages?both for the women themselves and for their children. Family planning programmes focusing on women in this age group could make a significant impact on maternal and child health and help to reduce fertility. INFANT AND CHILD MORTALITY NFHS-2 provides estimates of infant and child mortality and examines factors associated with the survival of young children. During the five years preceding the survey, the infant mortality rate was 68 deaths at age 0-11 months per 1,000 live births, substantially lower than 79 per 1,000 in the five years preceding the NFHS-1 survey. The child mortality rate, 29 deaths at age 1-4 years per 1,000 children reaching age one, also declined from the corresponding rate of 33 per 1,000 in NFHS-1. Ninety-five children out of 1,000 born do not live to age five years. Expressed differently, 1 in 15 children die in the first year of life, and 1 in 11 die before reaching age five. Child-survival programmes might usefully focus on specific groups of children with particularly high infant and child mortality rates, such as children who live in rural areas, children whose mothers are illiterate, children belonging to scheduled castes or scheduled tribes, and children from poor households. Infant mortality rates are more than two and one-half times as high for women who did not receive any of the recommended types of maternity related medical care than for mothers who did receive all recommended types of care. HEALTH, HEALTH CARE, AND NUTRITION Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. One goal is for each pregnant woman to receive at least three antenatal check-ups plus two tetanus toxoid injections and a full course of iron and folic acid supplementation. In India, mothers of 65 percent of the children born in the three years preceding NFHS-2 received at least one antenatal

Using the district factsheets from the National Family Health Surveys (NFHS-4 and NFHS-5), we present an interactive dashboard to visualize health, nutrition, and population indicators across India. Through this dashboard, users can visualize and analyze NFHS-5 (2019-21) and change between NFHS-4 (2015-16) and NFHS-5 for the districts of India. Users can further filter visualization and analysis by: - Aspirational Districts - Survey Phases of NFHS-5 - States/Districts The aim of this interactive data resource is to inform design of policies and enable prioritization of districts for intervention in the domains of health, nutrition and population. This dashboard was created in collaboration with National Institution for Transforming India (NITI) Aayog and the International Institute for Population Sciences (IIPS).

The National Family Health Survey (NFHS) was carried out as the principal activity of a collaborative project to strengthen the research capabilities of the Population Reasearch Centres (PRCs) in India, initiated by the Ministry of Health and Family Welfare (MOHFW), Government of India, and coordinated by the International Institute for Population Sciences (IIPS), Bombay. Interviews were conducted with a nationally representative sample of 89,777 ever-married women in the age group 13-49, from 24 states and the National Capital Territoty of Delhi. The main objective of the survey was to collect reliable and up-to-date information on fertility, family planning, mortality, and maternal and child health. Data collection was carried out in three phases from April 1992 to September 1993. THe NFHS is one of the most complete surveys of its kind ever conducted in India. The households covered in the survey included 500,492 residents. The young age structure of the population highlights the momentum of the future population growth of the country; 38 percent of household residents are under age 15, with their reproductive years still in the future. Persons age 60 or older constitute 8 percent of the population. The population sex ratio of the de jure residents is 944 females per 1,000 males, which is slightly higher than sex ratio of 927 observed in the 1991 Census. The primary objective of the NFHS is to provide national-level and state-level data on fertility, nuptiality, family size preferences, knowledge and practice of family planning, the potentiel demand for contraception, the level of unwanted fertility, utilization of antenatal services, breastfeeding and food supplemation practises, child nutrition and health, immunizations, and infant and child mortality. The NFHS is also designed to explore the demographic and socioeconomic determinants of fertility, family planning, and maternal and child health. This information is intended to assist policymakers, adminitrators and researchers in assessing and evaluating population and family welfare programmes and strategies. The NFHS used uniform questionnaires and uniform methods of sampling, data collection and analysis with the primary objective of providing a source of demographic and health data for interstate comparisons. The data collected in the NFHS are also comparable with those of the Demographic and Health Surveys (DHS) conducted in many other countries.

Respondent’s characteristics and birth weight of children by explanatory variables, NFHS-4 (n = 147,762).

The 1996 Nepal Family Health Survey (NFHS) is a nationally representative survey of 8,429 ever- married women age 15-49. The survey is the fifth in a series of demographic and health surveys conducted in Nepal since 1976. The main purpose of the NFHS was to provide detailed information on fertility, family planning, infant and child mortality, and matemal and child health and nutrition. In addition, the NFHS included a series of questions on knowledge of AIDS. The primary objective of the Nepal Family Health Survey (NFHS) is to provide national level estimates of fertility and child mortality. The survey also provides information on nuptiality, contraceptive knowledge and behaviour, the potential demand for contraception, other proximate determinants of fertility, family size preferences, utilization of antenatal services, breastfeeding and food supplementation practices, child nutrition and health, immunizations, and knowledge about Acquired Immune Deficiency Syndrome (AIDS). This information will assist policy-makers, administrators and researchers to assess and evaluate population and health programmes and strategies. The NFHS is comparable to Demographic and Health Surveys (DHS) conducted in other developing countries. MAIN RESULTS FERTILITY Survey results indicate that fertility in Nepal has declined steadily from over 6 births per woman in the mid-1970s to 4.6 births per woman during the period of 1994-1996. Differentials in fertility by place of residence are marked, with the total fertility rate (TFR) for urban Nepal (2.9 births per woman) about two children less than for rural Nepal (4.8 births per woman). The TFR in the Mountains (5.6 births per woman) is about one child higher than the TFR in the Hills and Terai (4.5 and 4.6 births per woman, respectively). By development region, the highest TFR is observed in the Mid-western region (5.5 births per woman) and the lowest TFR in the Eastern region (4.1 births per woman). Fertility decline in Nepal has been influenced in part by a steady increase in age at marriage over the past 25 years. The median age at first marriage has risen from 15.5 years among women age 45-49 to 17.1 years among women age 20-24. This trend towards later marriage is supported by the fact that the proportion of women married by age 15 has declined from 41 percent among women age 45-49 to 14 percent among women age 15-19. There is a strong relationship between female education and age at marriage. The median age at first marriage for women with no formal education is 16 years, compared with 19.8 years for women with some secondary education. Despite the trend towards later age at marriage, childbearing begins early for many Nepalese women. One in four women age 15-19 is already a mother or pregnant with her first child, with teenage childbearing more common among rural women (24 percent) than urban women (20 percent). Nearly one in three adolescent women residing in the Terai has begun childbearing, compared with one in five living in the Mountains and 17 percent living in the Hills. Regionally, the highest level of adolescent childbearing is observed in the Central development region while the lowest is found in the Western region. Short birth intervals are also common in Nepal, with one in four births occurring within 24 months of a previous birth. This is partly due to the relatively short period of insusceptibility, which averages 14 months, during which women are not exposed to the risk of pregnancy either because they are amenorrhoeic or abstaining. By 12-13 months after a birth, mothers of the majority of births (57 percent) are susceptible to the risk of pregnancy. Early childbearing and short birth intervals remain a challenge to policy-makers. NFHS data show that children born to young mothers and those born after short birth intervals suffer higher rates of morbidity and mortality. Despite the decline in fertility, Nepalese women continue to have more children than they consider ideal. At current fertility levels, the average woman in Nepal is having almost 60 percent more births than she wantsthe total wanted fertility rate is 2.9 births per woman, compared with the actual total fertility rate of 4.6 births per woman. Unplanned and unwanted births are often associated with increased mortality risks. More than half(56 percent) of all births in the five-year period before the survey had an increased risk of dying because the mother was too young (under 18 years) or too old (more than 34 years), or the birth was of order 3 or higher, or the birth occurred within 24 months of a previous birth. Nevertheless, the percentage of women who want to stop childbearing in Nepal has increased substantially, from 40 percent in 1981 to 52 percent in 1991 and to 59 percent in 1996. According to the NFHS, 41 percent of currently married women age 15-49 say they do not want any more children, and an additional 18 percent have been sterilized. Furthermore, 21 percent of married women want to wait at least two years for their next child and only 13 percent want to have a child soon, that is, within two years. FAMILY PLANNING Knowledge of family planning is virtually universal in Nepal, with 98 percent of currently married women having heard of at least one method of family planning. This is a five-fold increase over the last two decades (1976-1996). Much of this knowledge comes from media exposure. Fifty-three percent of ever-married women had been exposed to family planning messages on the radio and/or the television and 23 percent have been exposed to messages through the print media. In addition, about one in four women has heard at least one of three specific family planning programmes on the radio. There has been a steady increase in the level of ever use of modern contraceptive method over the past 20 years, from 4 percent of currently married women in 1976, to 27 percent in 1991 and 35 percent in 1996. Among ever-users, female sterilization and male sterilization are the most popular methods (37 percent), indicating that contraceptive methods have been used more for limiting than for spacing births. The contraceptive prevalence rate among currently married women is 29 percent, with the majority of women using modern methods (26 percent). Again, the most widely used method is sterilization (18 percent, male and female combined), followed by injectables (5 percent). Although current use of modern contraceptive methods has risen steadily over the last two decades, the pace of change has been slowest in the most recent years (1991-1996). Current use among currently married non-pregnant women increased from 3 percent in 1976 to 15 percent in 1986 to 24 percent in 1991 and to 29 percent in 1996. While female sterilization increased by only 3 percent from 45 percent of modern methods in 1986 to 46 percent in 1996, male sterilization declined by almost 50 percent from 41 percent to 21 percent over the same period. The level of current use is nearly twice as high in the urban areas (50 percent) as in rural areas (27 percent). Only 18 percent of currently married women residing in the Mountains are currently using contraception, compared with 30 percent and 29 percent living in the Hills and Terai regions, respectively. There is a notable difference in current contraceptive use between the Far-western region (21 percent) and all the other regions, especially the Central and Eastern regions (31 percent each). Educational differences in current use are large, with 26 percent of women with no education currently using contraception, compared with 52 percent of women who have completed their School Leaving Certificate (SLC). In general, as women's level of education rises, they are more likely to use modem spacing methods. The public sector figures prominently as a source of modem contraceptives. Seventy-nine percent of modem method users obtained their methods from a public source, especially hospitals and district clinics (32 percent) and mobile camps (28 percent). The public sector is the predominant source of sterilizations, 1UDs, injectables, and Norplant, and both the public and private sectors are equally important sources of the pill and condoms. Nevertheless, the public sector's share of the market has fallen over the last five years from 93 percent of current users in 1991 to 79 percent in 1996. There is considerable potential for increased family planning use in Nepal. Overall, one in three women has an unmet need for family planning14 percent for spacing and 17 percent for limiting. The total demand for family planning, including those women who are currently using contraception, is 60 percent. Currently, the family planning needs of only one in two women is being met. While the increase in unmet need between 1991 (28 percent) and 1996 (31 percent) was small, there was a 14 percent increase in the percentage of women using any method of family planning and, over the same period, a corresponding increase of 18 percent in the demand for family planning. MATERNAL AND CHILD HEALTH At current mortality levels, one of every 8 children born in Nepal will die before the fifth birthday, with two of three deaths occurring during the first year of life. Nevertheless, NFHS data show that mortality levels have been declining rapidly in Nepal since the eighties. Under-five mortality in the period 0-4 years before the survey is 40 percent lower than it was 10-14 years before the survey, with child mortality declining faster (45 percent) than infant mortality (38 percent). Mortality is consistently lower in urban than in rural areas, with children in the Mountains faring much worse than children living in the Hills and Terai. Mortality is also far worse in the Far-western and Mid-western development regions than in the other regions. Maternal education is strongly related to mortality, and children of highly educated mothers are least likely to die young. For example, infant mortality is nearly

Background and objectiveIndia contributes the highest global share of deaths among the under-fives. Continuous monitoring of the reduction in the under-five mortality rate (U5MR) at local level is thus essential to set priorities for policy-makers and health professionals. In this study, we aimed to provide an update on district-level disparities in the neonatal mortality rate (NMR) and the U5MR with special reference to Sustainable Development Goal 3 (SDG3) on preventable deaths among new-borns and children under five.Data and methodsWe used recently released population-based cross-sectional data from the National Family Health Survey (NFHS) conducted in 2015–2016. We used the synthetic cohort probability approach to analyze the full birth history information of women aged 15–49 to estimate the NMR and U5MR for the ten years preceding the survey.ResultsBoth the NMR and U5MR vary enormously across Indian districts. With respect to the SDG3 target for 2030 for the NMR and the U5MR, the estimated NMR for India for the period studied is about 2.4 times higher, while the estimated U5MR is about double. At district level, while 9% of the districts have already reached the NMR targeted in SDG3, nearly half (315 districts) are not likely to achieve the 2030 target even if they realize the NMR reductions achieved by their own states between the last two rounds of National Family Health Survey of India. Similarly, less than one-third of the districts (177) of India are unlikely to achieve the SDG3 target on the U5MR by 2030. While the majority of high-risk districts for the NMR and U5MR are located in the poorer states of north-central and eastern India, a few high-risk districts for NMR also fall in the rich and advanced states. About 97% of districts from Chhattisgarh and Uttar Pradesh, for example, are unlikely to meet the SDG3 target for preventable deaths among new-borns and children under age five, irrespective of gender.ConclusionsTo achieve the SDG3 target on preventable deaths by 2030, the majority of Indian districts clearly need to make a giant leap to reduce their NMR and U5MR.

This survey was conducted in India by the International Institute for Population Sciences (IIPS). 89,777 ever married women between the ages of 19 - 49 were interviewed from April 1992 - September 1993. Major topics covered:Abortion; Anthropometry; Causes of Death; HIV Knowledge; Maternal Mortality; Micronutrients; Service Availability; Tuberculosis Questions; Vitamin A Questions

Data access requires registration with USAID. USAID now makes this data available directly on their website, which can be accessed here: https://dhsprogram.com/methodology/survey/survey-display-50.cfm - along with additional years of data here: https://dhsprogram.com/data/available-datasets.cfm

We advise you use this location to access the data as they have updated formats, etc. This material remains in the archive for preservation and historical purposes.

Tribal or indigenous communities have unique health behaviors, challenges, and inequities that nationally representative surveys cannot document. Odisha has one of India’s largest and most diverse tribal populations, constituting more than a fifth of the state. State and tribe-specific health data generation is recommended in India’s national roadmap of tribal health. The Odisha tribal family health survey (OTFHS) aims to describe and compare the health status of tribal communities in the state of Odisha and to estimate the prevalence of key maternal-child health indicators and chronic diseases. This paper summarizes the methodology, protocols, and tools used in this survey. This is a population-based cross-sectional survey with a multistage random sampling design in 13 (tribal sub-plan areas) districts of Odisha, India. We will include participants of all age groups and gender who belong to tribal communities. The sample size was calculated for each tribe and aggregated to 40,921, which will be collected from 10,230 households spread over 341 clusters. The survey data will be collected electronically in modules consisting of Village, Household, and Individual level questionnaires. The age-group-specific questionnaires were adapted from other national family health surveys with added constructs related to specific health issues of tribal communities, including-critical indicators related to infectious and non-communicable diseases, multimorbidity, nutrition, healthcare-seeking behavior, self-rated health, psycho-social status, maternal and child health and geriatric health. A battery of laboratory investigations will be conducted at the household level and the central laboratory. The tests include liver function tests, kidney function tests, lipid profile, iron profile, and seroprevalence of scrub typhus and hepatitis infections. The datasets from household questionnaires, field measurements and tests and laboratory reports will be connected using a common unique ID in the database management system (DBMS) built for this survey. Robust quality control measures have been built into each step of the survey. The study examines the data focused on different aspects of family health, including reproductive health, adolescent and child health, gender issues in the family, ageing, mental health, and other social problems in a family. Multistage random sampling has been used in the study to enable comparison between tribes. The anthropometric measurements and biochemical tests would help to identify the indicators of chronic diseases among various age groups of the population.

Disruptions in food, health, and economic systems during the COVID-19 pandemic may have adversely affected child health. This is the code and data used to examine the short-term associations between the pandemic and anthropometric outcomes of under-5 children in India, for the paper: "COVID-19 pandemic and anthropometric outcomes in Indian children: Analysis of the 2019-2021 National Family Health Survey data".

Belize is one of the countries in Latin America that was not included in the World Fertility Survey, the Contraceptive Prevalence Survey project, or the Demographic and Health Survey program during the 1970's and 1980's. As a result, data on contraceptive prevalence and the use of maternal and child health services in Belize has been limited. The 1991 Family Health Survey was designed to provide health professionals and international donors with data to assess infant and child mortality, fertility, and the use of family planning and health services in Belize. The objectives of the 1991 Family Health Survey were to: obtain national fertility estimates; estimate levels of infant and child mortality; estimate the percentage of mothers who breastfed their last child and duration of breastfeeding; determine levels of knowledge and current use of contraceptives for a variety of social and demographic background variables and to determine the source where users obtain the methods they use; determine reasons for nonuse of contraception and estimate the percentage of women who are at risk of an unplanned pregnancy and, thus, in need of family planning services; and examine the use of maternal and child health services and immunization levels for children less than 5 years of age and to examine the prevalence and treatment of diarrhea and acute respiratory infections among these children.