(January 2001) The results of India’s second National Family Health Survey (NFHS-2) are out. They show that progress is being made on many fronts but that, in general, the improvement is painfully slow.

NFHS-2 collected data in 1998 and 1999 on population, health, and nutrition topics in interviews with about 90,000 ever-married Indian women ages 15 to 49. The International Institute for Population Sciences in Mumbai (Bombay) directed the survey, which was conducted with technical assistance from ORC Macro, based in Calverton, Md., and the East-West Center in Honolulu. ORC Macro has helped conduct such surveys as a part of the U.S. Agency for International Development’s Demographic and Health Surveys program in more than 70 countries.

As in all DHS surveys, NFHS-2 interviewers asked women questions about contraceptive use, fertility intentions, immunization of children, and maternal care before and after a birth. But in NFHS-2, interviewers also collected data on women’s autonomy, domestic violence, women’s nutrition, and the use of iodized salt. They even measured anemia levels among women and children.

The proportion of married women using contraception was 48 percent, up from 41 percent in the first NFHS (conducted in 1992 and 1993). Most (91 percent) of this increase, however, came from an increase in female sterilization (see accompanying figures). The use of modern temporary methods, such as the pill, condoms, and IUDs, rose only slightly, from 6 percent of married women in NFHS-1 to 7 percent in NFHS-2.

Progress has been made toward universal immunization of children. Whereas 30 percent of children had received no immunizations in NFHS-1, that proportion declined to 14 percent in NFHS-2. Nonetheless, one-third of children have not been fully immunized against polio and about half have not been immunized against measles. Child undernutrition remains a very serious problem. Almost one-half (47 percent) of Indian children under age 3 are underweight. Children born to mothers with a large number of children are most likely to be underweight.

NFHS-2 also measured anemia among women and children. The survey found that 74 percent of children and just over half (52 percent) of women were anemic. Anemia is a particular problem during pregnancy, as it increases the likelihood of maternal and infant death, premature delivery, and low birth weight.

AIDS has quickly become a major national concern, and NFHS-2 questioned women on their knowledge of HIV/AIDS. Six out of 10 women in India have never heard of AIDS, and the proportion varies widely by state. In Bihar, 88 percent of women had never heard of AIDS.

During 2000, the Indian government adopted a new National Population Policy, setting a goal of a two-child family norm for the year 2010 and “zero” population growth by the year 2045 (see Population Today, April 2000). When asked in the survey, almost three-fourths of women with two living children said they would prefer to stop childbearing at that point. This result indicates a significant shift in attitudes toward family size in the country. The NFHS-2 results also show that, if all unmet need for family planning were met, contraceptive prevalence would rise from 48 percent to 64 percent, a level observed in many developed countries.

The stage may be set for India to make more dramatic progress, but stepped-up effort at both the national and local levels is critical.

Contraceptive Use in India, by Method*

Latest Data

Cross-Survey Comparison

Source:*Contraceptive use is measured for married women ages 15 to 49.
Source: NFHS-2.

Carl Haub holds the Conrad Taeuber Chair of Population Information at PRB.

For More Information

For more on the survey, visit the ORC Macro website: www.measuredhs.com. Three wallcharts are available from PRB: Health and Family Welfare; Women and Reproductive Health; and Welfare of Children and Youth. Contact PRB’s Customer Service Department: 800/877-9881; fax 202/328-3937; e-mail: popref@prb.org; or order online.