The National Family Health Survey-5 was conducted in 2019-21. The previous survey (NHFS-4) was conducted in 2015-16. Both were periods when the NDA government was in office; therefore, the changes between the two surveys reflect the effect of the policy pursued up to 2014-15 and the policy of Narendra Modi’s government.
As in the previous study, the key indicators for NFHS-5 are issues such as population and household profile, literacy, marriage and fertility, maternal and child health, vaccinations, quality of medical treatment, anemia, women’s autonomy and tobacco and alcohol use. The figures are statistical estimates based on the two surveys separated by four years. Because the methodology used in the surveys was the same, the change in the numbers – what statisticians call DELTA – conveys very useful lessons. Some changes will make us proud, some will depress us and some will raise doubts and questions.
The big, “breaking” news is that total fertility has dropped from 2.2 (children per woman) to 2.0. The ‘compensation rate’ is 2.1. The figure 2.0 has good as well as negative implications that require a separate essay. Therefore, we can currently take comfort in the fact that India’s population is not growing at an alarming rate and may stabilize sooner than expected.
First, the good news. 88.6 percent of the children were born in an institution (that is, during some form of medical care) – up from 78.9 percent. More girls are welcomed into families, especially in rural India. The gender ratio (women per 1,000 men) has climbed from 991 to 1,020. While 88.0 percent of the population lived in households with electricity in 2015-16, the Modi government has added 8.8 percent to make the proportion 96.8 percent (Rome ) was not built in a day, as claimed). Fewer women and men married before the legal age of 18 and 21, respectively, but with 23.3 per cent of women marrying before the age of 18, there is still a long way to go.
Not so good news
The big, breaking, bad news is that just over half of India’s population did not complete 10 years of schooling – 59 percent of women and 49.8 percent of men. This means that half of the population after 75 years of independence can not be engaged in the jobs and companies of the 21st century that require higher education, advanced technology and superior skills.
India’s population is still young (26.5 percent are under the age of 15), but the proportion is declining – meaning the proportion of older people is growing. The “demographic dividend” we boast will not last forever. A majority of the women were anemic: 57.0 percent in the age group 15-49 and, more worryingly, 59.1 percent in the age group 15-19. Both proportions have increased since NFHS-4. The other bitter news is that only 11.3 percent of children aged 6-23 months received an adequate diet. The result is that 32.1 percent of children under the age of 5 were underweight; 35.5 percent were inhibited; 19.3 percent was wasted; and 7.7 percent were seriously wasted. The infant mortality rate (IMR) of 35.2 per mille and the mortality rate over 5 years (U5MR) at 41.9 per mille live births are still too high and far above the lowest in the world.
News that raises questions
Some tasks raise more questions about the aspects they need to clarify. The data claim that 95.9 percent of the population lives in households with “an improved source of drinking water”. The footnote defines an “improved drinking water source” as including tap water, a public tap or a pipe well. These are fine, but when the definition includes “a protected well, a protected spring and rainwater”, it is clear that extensive efforts were made to include old, unprotected water sources to reach an impressive 95.9 per cent. I suspect that this will be the penultimate step before explaining that the goal of providing individual household faucets to all households has been achieved by the target year 2024!
Information on the use of an “improved sanitation facility” is also questionable. The improved sanitation system includes flushing to the pit latrine, flushing for not knowing where, pit latrine with plate and double pit / compost toilet – that is, everything except Open Defecation (OD) is an improved sanitation system!
Despite the hype about Ujjwala Yojana, only 58.6 percent of households (up from 43.8 percent) use clean fuel for cooking. The proportion actually refers to LPG or gas connections, not the actual number who regularly use LPG bottles.
Thanks to indifferent growth rates, many millions are poor and many may be living in absolute poverty. Let’s take just one indicator, namely food consumption. Food is the first tax on a household’s income. If a large proportion of women are anemic and a significant proportion of children are underweight or anemic in addition to many children who are crushed or ejaculated, it is due to lack of adequate nutrition. Lack of food is, in my opinion, a crucial indicator of poverty. These poor people – children of a lesser god – have been forgotten by the current government.