India’s Evolving Public Health Landscape: Comparative Insights from the National Family Health Survey-6 (2023–24) and NFHS-5
Ajit Kumar Lenka
Abstract
Over the course of more than three decades, the National Family Health Survey (NFHS) has been India’s most comprehensive source of data that is nationally representative on population health, nutrition, reproductive health, and healthcare utilization. The recently released fact sheet for NFHS-6 (2023–24) reviews progress since the NFHS-5 (2019–21) and presents the first post-COVID-19 assessment of India’s health indicators. When the two rounds of the survey are compared, it is clear that there have been encouraging advances in areas such as demographic transition, utilization of maternal healthcare, institutional deliveries, children’s immunization, women’s education, digital inclusion, and health insurance coverage. At the national level, the total fertility rate has reached a level that is equivalent to replacement, while the rates of child marriage and adolescent pregnancy have continued to decrease. Concurrently, the survey sheds light on new concerns, such as the growing prevalence of diabetes, the stubbornly high rates of caesarean sections, the coexistence of undernutrition and non-communicable diseases, and the increasing prevalence of overweight and obesity. The data presented here are indicative of the ongoing epidemiological and demographic transformation that is taking place in India. This transition necessitates a re-evaluation of health priorities outside of the traditional mother and child health programs and toward integrated life-course approaches. In this article, important changes that occurred between the National Family Health Survey (NFHS) 5 and the NFHS 6 are analysed critically, their implications for the achievement of the Sustainable Development Goals (SDGs) are discussed, and policy objectives for improving equitable health systems are highlighted.
