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SUMMARY
OF KEY FINDINGS
INDIA
FACT SHEET, NFHS-3, 2005-06
About NFHS
The 2005-06 National Family
Health Survey (NFHS-3) is the third in a series of national
surveys; earlier NFHS surveys were carried out in 1992-93
(NFHS-1) and 1998-99 (NFHS-2). All three surveys were
conducted under the stewardship of the Ministry of Health
and Family Welfare, Government of India, with the
International Institute for Population Sciences, Mumbai,
serving as the nodal agency. Macro International, Calverton,
Maryland, USA, provided technical assistance for all three
NFHS surveys. NFHS-3 funding was provided by the United
States Agency for International Development, the Department
for International Development (United Kingdom), the Bill and
Melinda Gates Foundation, UNICEF, the United Nations
Population Fund, and the Government of India. Assistance for
the HIV component of the NFHS-3 survey was provided by the
National AIDS Control Organization and the National AIDS
Research Institute. In NFHS-3, 18 research organizations
conducted interviews with about 199,000 women age 15-49 and
men age 15-54 throughout India. NFHS-3 also tested more than
100,000 women and men for HIV and 215,000 adults and young
children for anaemia. Fieldwork for NFHS-3 was conducted
from December 2005 to August 2006.
Key
findings from the NFHS-3 India Fact sheet are highlighted
below:
Family Planning Use Up, Fertility Down
Smaller families are
slowly becoming the norm in India. Fertility has continued
to decline since NFHS-2, dropping to 2.7 children from 2.9
children. Ten states have reached replacement level or below
replacement level fertility. While son preference remains a
barrier to more rapid decline in fertility, an increasing
number of women who have only daughters say that they want
no more children. In NFHS-3, 62% of women with two daughters
and no sons say they want no more children, compared with
47% in NFHS-2.
Declining fertility is due in large part to women's
increased use of contraception. More than half of currently
married women use contraception, and their use of modern
methods increased from 43% to 49% between NFHS-2 and NFHS-3.
A rise in the average age at marriage is also contributing
to the drop in fertility. Forty-five percent of women ages
20-24 were married before the legal age of marriage of 18
years, compared with 50% seven years earlier. This shift in
age at marriage also influences the median age at first
birth, which increased by six months to 19.8 years.
Half of Women Lack Proper Care during
Pregnancy and Delivery
More than three-quarters of pregnant women in India receive
at least some antenatal care (ANC), but only half of
pregnant women make at least three visits to health
practitioners during their pregnancy, as recommended. The
disparity between urban and rural women is especially
pronounced, with 74% of urban women having at least three
ANC visits compared with 43% of rural women. Births assisted
by a health professional increased to 48% from 42%, with 75%
of urban women but only 39% of rural women in NFHS-3
receiving professional assistance. Institutional births
increased from 34% to 41%, but most women still deliver
their children at home. It is recommended that women receive
postnatal care within two days of delivery, but only about a
third reported receiving care during that critical period.
Infant Mortality Drops, but Full Immunization Coverage Shows
Little Progress
Infant mortality continues to decline, dropping from 68 to
57 per thousand births. There were particularly notable
drops in the infant mortality rate in Bihar, Goa, Haryana,
Jammu and Kashmir, Meghalaya, Orissa, Punjab, Rajasthan,
Tamil Nadu, and Uttar Pradesh. The situation regarding child
immunization rates, however, is not as clear cut. By the
time they are one year old, children are supposed to receive
a BCG vaccination against tuberculosis, a measles
vaccination, and three doses each of polio and DPT vaccine.
Overall, there was only a small improvement in full
vaccination coverage, with 44% of children ages 12-23 months
receiving all recommended vaccinations, up from 42% seven
years earlier. Substantial improvements in coverage have
been made in all vaccinations except DPT, which did not
change at all between NFHS 2 and NFHS-3. Gains are
particularly evident for polio immunization coverage, but
nearly one-quarter of children age 12-23 months have still
not received the recommended number of polio doses.
Progress
in vaccination coverage varies markedly among the states. In
11 states, there has been a substantial deterioration in
full immunization coverage in the last seven years, due to a
decline in vaccination coverage for both DPT and polio. On
the other hand, there was major improvement in full
immunization coverage in Bihar, Chhattisgarh, Jharkhand,
Sikkim, and West Bengal. Other states with marked
improvements in full immunization coverage were Assam, Jammu
and Kashmir, Madhya Pradesh, Meghalaya, and Uttaranchal.
Diarrhoea
continues to be a major health problem for many children.
Although knowledge about Oral Rehydration Salts (ORS) for
the treatment of diarrhoea is widespread among mothers, only
26% of children who had diarrhoea received a solution made
from ORS packets, virtually unchanged from 27% in NFHS-2.
Further, only 58% of children with diarrhoea were taken to a
health facility, down from 65% seven years earlier.
Domestic Violence Widespread
A substantial proportion of married women report that they
have been physically or sexually abused by their husbands at
some time in their lives. Overall, 37% of women report
abuse, with large variations among the states. Abuse ranges
from a low of 6% in Himachal Pradesh to a high of 59% in
Bihar. Women with no education were much more likely (at
47%) than other women to have suffered spousal violence.
However, spousal abuse also extends to women who have
secondary or higher education, with 16% reporting abuse.
Malnutrition Persists; Anaemia
Widespread
Malnutrition continues to be a significant problem
for children and adults in India. While there have been some
improvements in the nutritional status of young children in
several states, nutritional deficiencies are still
widespread. Most striking has been the increase in wasting,
or weight for height, among children. NFHS-3 found 19% of
children wasted, up from 16% seven years earlier. At the
same time, there has been virtually no change in the
percentage of children who are underweight (47% in NFHS-2
and 46% in NFHS-3).
NFHS-3 also found a remarkably high prevalence of anaemia -
79% - in children age 6-35 months. The prevalence of anaemia
is even worse than it was in NFHS-2 (74%). Anaemia in India
is primarily linked to poor nutrition.
Women and men suffer a dual burden of overnutrition and
undernutrition. One third of married women are too thin,
while 15% are overweight or obese. In all, nearly half of
married women are either underweight or overweight. For
married men, 28% are too thin and 12% are overweight. The
states with the largest percentage of overweight women and
men are Delhi, Kerala, and Punjab, especially among the more
educated.
Anaemia is also disturbingly common among adults, and among
women its prevalence has actually increased over the past
seven years. As with children, anaemia increased among
women, from 52% to 56% among married women and from 50% to
58% among pregnant women. Even though men are much less
likely than women to be anaemic, anaemia levels in men are
still unacceptably high (24%).
Two-thirds of Married Women Don't Know Condoms Prevent HIV
Given the large number of people living with HIV in India,
new findings from NFHS-3 on the extent and sex differentials
in knowledge of HIV/AIDS are of concern. Only 80% of men and
57% of women have ever heard of AIDS. Further, only 68% of
men and 35% of women know that consistent condom use can
reduce the chances of getting HIV. The results underscore
the pressing need to educate women and men about the virus,
how it is transmitted, and how it can be prevented.
Increasing HIV/AIDS education will be a critical step to
curbing the number of new HIV cases in India.
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