NFHS 6 Report 2023-24: Key Findings and Data for UPSC ISS

There is a particular kind of answer that examiners remember. A student writes about women’s empowerment and, instead of the usual sentences about awareness and education, states that the proportion of women who have ever used the internet nearly doubled from 33.3 percent to 64.3 percent. One number, and the answer stops sounding like an essay and starts sounding like evidence. The sixth National Family Health Survey is full of numbers exactly like that.

Short answer. The sixth National Family Health Survey, covering 2023-24, was released by the Ministry of Health and Family Welfare. Conducted by the International Institute for Population Sciences across 6.79 lakh households in 715 districts, it shows the Total Fertility Rate steady at 2.0, stunting down from 35.5 to 29.3 percent and health insurance coverage up from 41 to 60.2 percent. It also records rising obesity and caesarean deliveries, and a reduction in the number of published indicators from 131 to 101.

What is the National Family Health Survey?

The National Family Health Survey is India’s largest multi round household survey on health, nutrition, fertility, family welfare and population dynamics. It provides estimates that are representative at both the national and the district level, which is why it is used so heavily for policy design and programme monitoring.

For a statistics candidate, note the survey design point behind that table. District level representativeness is what forces such a large sample. A national estimate alone would need a far smaller one. This is a standard sampling argument and it is worth being able to state in one line.

What are the main improvements recorded?

Maternal health

• Institutional deliveries rose from 88.6 percent to 90.6 percent.
• Births attended by skilled health personnel rose from 89.4 percent to 91.3 percent.
• Antenatal care registration reached 95.9 percent, and registration in the crucial first trimester improved from 70 percent to 76.2 percent.
• Postnatal care for newborns within two days of delivery rose from 79.1 percent to 85.3 percent.
• Consumption of iron and folic acid tablets for more than 100 days during pregnancy rose from 44.1 percent to 54.9 percent.

Child nutrition

• Stunting, meaning low height for age among children under five, declined from 35.5 percent to 29.3 percent.
• Severe wasting, meaning low weight for height, fell from 7.7 percent to 5.2 percent.
• Underweight children declined only marginally, from 32.1 percent to 31.8 percent.
• Children aged six to eight months receiving complementary food alongside breastmilk rose from 45.9 percent to 59.5 percent.

Immunisation

• Full vaccination among children aged twelve to twenty three months rose from 83.8 percent to 87.1 percent, with 95.6 percent of vaccinations delivered through public facilities.
• Rotavirus vaccination coverage jumped from 36.4 percent to 85.4 percent.
• Coverage of the second dose of measles vaccine rose from 58.6 percent to 71.8 percent.

Population and women’s empowerment

• The Total Fertility Rate remains at 2.0, below the replacement level of 2.1, indicating that India has largely entered population stabilisation.
• The contraceptive prevalence rate rose from 66.7 percent to 69.1 percent.
• Women who have ever used the internet nearly doubled, from 33.3 percent to 64.3 percent.
• Women operating their own bank or savings account rose from 78.6 percent to 89 percent.
• Women reporting spousal violence declined from 29.3 percent to 22.3 percent.
• Household health insurance coverage rose from 41 percent to 60.2 percent.

What are the concerns?

The rise in caesarean deliveries

Caesarean section deliveries increased sharply from 21.5 percent to 27.2 percent, well above the range of 10 to 15 percent generally regarded as appropriate by the World Health Organization. The split is the striking part: 54.1 percent in private hospitals against 16.9 percent in public hospitals. That gap is difficult to explain by medical need alone and has raised concerns about the commercialisation of maternal healthcare.

The double burden of malnutrition

Nearly a third of children remain stunted while adult obesity has climbed sharply, from 24 percent to 30.7 percent among women and from 22.9 percent to 27.3 percent among men. India is now dealing with undernutrition and overnutrition at the same time, in the same country and sometimes in the same household.

The epidemiological transition

Rising obesity travels with rising diabetes, hypertension and other lifestyle related conditions. This shift from infectious disease to chronic non communicable disease as the main health burden is called the epidemiological transition, and naming it correctly is worth a mark by itself.

The indicator controversy

The preliminary fact sheet carries 101 indicators against 131 in the previous round. Forty three indicators were removed and only thirteen added. The removals include anaemia, the neonatal mortality rate, the infant mortality rate, the under five mortality rate, the sex ratio at birth, the overall sex ratio, sanitation coverage, clean cooking fuel usage, cancer screening and several indicators on awareness of the human immunodeficiency virus.

This is the part of the topic that belongs specifically to a statistics candidate. Removing indicators is not a small administrative decision. It breaks the comparability of a time series that has run since 1992-93, and several of the removed indicators are used to monitor Sustainable Development Goal targets. The stated reason in the case of anaemia is a debate over measurement method, since the survey has traditionally used a finger prick blood sample, which some experts argue overestimates prevalence compared with venous blood testing. Whatever the merits, a discontinued series cannot be repaired retrospectively.

How is this asked in the UPSC ISS paper?

Two entry points exist. The Economy question regularly covers demography, including the demographic dividend, which has been asked four times, female workforce participation, asked three times, and fertility. Separately, the paper repeatedly references statistical reports and bodies, which is where a survey of this scale naturally sits.

A likely framing is: highlight the major findings of the sixth National Family Health Survey and discuss what they reveal about India’s demographic and health transition.

Model answer skeleton, about 200 words

1. Opening line. Name the survey, the period, the conducting agency and the scale of 6.79 lakh households across 715 districts.
2. Demographic transition. Fertility at 2.0 below replacement level, contraceptive prevalence at 69.1 percent, indicating population stabilisation.
3. Access gains. Institutional deliveries at 90.6 percent, full immunisation at 87.1 percent, insurance coverage at 60.2 percent, stunting down to 29.3 percent.
4. Empowerment gains. Internet use, bank account ownership and the decline in reported spousal violence.
5. The new challenge. Obesity, non communicable disease and the caesarean rate, framed as the epidemiological transition.
6. Closing line. India’s health story has moved from a problem of access to a double burden of undernutrition and lifestyle disease.

Facts you must remember

• Total Fertility Rate 2.0, below the replacement level of 2.1; contraceptive prevalence 69.1 percent.
• Institutional deliveries 90.6 percent; stunting 29.3 percent; health insurance coverage 60.2 percent of households.
• Obesity 30.7 percent among women and 27.3 percent among men; caesarean deliveries 27.2 percent overall and 54.1 percent in private hospitals.
• Conducted by the International Institute for Population Sciences for the Ministry of Health and Family Welfare, 6.79 lakh households, 715 districts.
• Indicators reduced from 131 to 101, with anaemia and the infant mortality rate among those removed.

Where else this data pays you back

This is not only a General Studies topic. Official Statistics in Statistics Paper II covers the national statistical system and its major surveys, and this survey is one of the largest of them. Demography and Vital Statistics is also one of the seven optional sub sections in Statistics Paper IV, where fertility measures such as the Total Fertility Rate, the Gross Reproduction Rate and the Net Reproduction Rate are core syllabus.

If you have chosen Demography as one of your two sub sections, read this survey as a data source rather than as news. Work it alongside the Official Statistics complete guide, and check the exact scope of your chosen sub sections on the syllabus page.

Frequently asked questions

What comes next in this series

A survey samples the population. The next article is about the exercise that counts every single person in it, and for a future official statistician it is the biggest topic of the year.

Next: Census 2027 explained for UPSC ISS

Practice. Improve. Repeat.

Sources

Ministry of Health and Family Welfare (mohfw.gov.in), International Institute for Population Sciences (iipsindia.ac.in), Press Information Bureau (pib.gov.in), World Health Organization (who.int).