The total fertility rate has "further declined" from 2.2 to 2.0 nationally while more than half of the children and women, including pregnant ones, were found anaemic, the government said on Wednesday releasing the second phase of the National Family Health Survey (NFHS-5).
Releasing the factsheets of key indicators on population, reproductive and child health, family welfare, nutrition and others for India and 14 states and UTs, clubbed under phase two of the 2019-21 NFHS-5, it also said overall Contraceptive Prevalence Rate (CPR) has increased substantially from 54% to 67% at an all-India level and in almost all Phase-II States/UTswith an exception of Punjab.
The use of modern methods of contraceptives has also increased in almost all States/UTs.
The states and UTs which were surveyed in the second phase were Arunachal Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, NCT of Delhi, Odisha, Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand. The findings of the first phase of NFHS-5 for 22 states and UTs were covered in phase one survey, which was released in December last year.
Nationally, the Total Fertility Rates (TFR) or the average number of children per woman has declined from 2.2 in 2015-16 to 2.0 in 2019-21. The TFR for urban areas is 1.6 while it is 2.1 for rural areas.
For the 14 states and UTs, which were surveyed in the second phase, it ranged from 1.4 in Chandigarh to 2.4 in Uttar Pradesh. All phase-II states have achieved replacement level of fertility (2.1) except Madhya Pradesh, Rajasthan, Jharkhand and Uttar Pradesh.
Except for Bihar, Manipur and Meghalaya, all 22 states and UTs surveyed in the first phase of NFHS-5 have a TFR of 2.1 or less.
When it comes to gender violence, there was a slight decline from 31.2% to 29.3% for ever-married women age 18-49 years who have ever experienced spousal violence, which is defined as physical and/or sexual violence. The survey said 3.1% married women (18-49 years) have experienced physical violence during pregnancy.
According to the survey, 1.5% young women in the age group 18-29 years experienced sexual violence by age 18.
According to the survey, the child nutrition indicators have shown a "slight" improvement at an all-India level as stunting has declined from 38% to 36%, wasting from 21% to 19% and underweight from 36% to 32% at an all-India level.
In all phase-II states and UTs, the situation has improved in respect of child nutrition but the change is not significant as drastic changes in respect of these indicators are unlikely in a short span period.
"Anaemia among children and women continues to be a cause of concern. More than half of the children and women (including pregnant women) are anaemic in all the phase-II States/UTs and an all-India level compared to NFHS4, in spite of substantial increase in the composition of iron folic acid (IFA) tablets by pregnant women for 180 days or more," it said.
On exclusive breastfeeding to children under age six months, the survey said it has shown an improvement at an all-India level from 55% in 2015-16 to 64% in 2019-21. All the phase-II states and UTs also showed "considerable progress".
On women's empowerment indicators, the survey said there was considerable improvement at an all-India level and across all the phase-II states and UTs -- significant progress has been recorded between NFHS-4 and NFHS-5 in regard to women operating bank accounts from 53% to 79% at an all-India level. For instance, in the case of Madhya Pradesh, the increase was to the tune of 37% percentage point from 37% to 75% per cent. More than 70% of women in every state and UTs in the second phase have operational bank accounts.
There is a substantial improvement in full immunization drive among children aged 12-23 months -- from 62% to 76% at an all-India level. Eleven out of 14 states and UTs have more than three-fourth of children aged 12-23 months with fully immunisation and it is highest (90%) for Odisha.
On comparing NFHS-4 and NFHS-5 data, an official statement said, the increase in full immunization coverage is observed to be expeditious in many states and UTs. More than half of the phase-II states and UTs are sharing over 10% points during the short span of four years. This can be attributed to the flagship initiative of Mission Indradhanush launched by the government since 2015, it said.
The survey also showed that institutional births have increased substantially from 79% to 89% at an all-India level. Institutional delivery is 100% in Puducherry and Tamil Nadu and more than 90% per cent in seven states and UTs out of 12 phase-II states and UTs.
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