India’s population is stabilising, as the total fertility rate (TFR) has decreased across majority of the states. Of 17 states analysed in the fifth round of National Family Health Survey (NFHS), except for Bihar, Manipur and Meghalaya, all other states have a TFR of 2.1 or less, which implies that most states have attained replacement level fertility, an analysis by the Population Foundation of India (PFI) has said.
The first set of findings from the fifth NFHS, conducted in 2019-20, was released by the Ministry of Health and Family Welfare on Saturday, December 12, four years after the last survey (NFHS-4, 2015-16).
NFHS 5 merits urgent attention, as this is the most comprehensive and robust data at scale on health and family welfare and emerging issues in this area, stated PFI.
All 17 states have witnessed an increase in the use of modern contraceptives of family planning. The proportion of women with unmet need for family planning, who want to stop or delay child-bearing but are not using any method of contraception, has declined in all states, except Meghalaya and Andhra Pradesh. Except for Manipur, all states have reported an increase in users getting information on side effects of current contraceptive methods, said Poonam Muttreja, executive director of PFI.
Health concerns must receive higher priority in terms of resources allocated towards public health, she said, adding that frontline health workers, who bear the burden of health issues on the ground, must be compensated fairly.
Anaemia among women remains a major cause of concern. In all the states, anaemia is much higher among women compared to men. Female sterilisation continues to dominate as the modern method of contraception in states like Andhra Pradesh (98 per cent), Telangana (93 per cent), Kerala (88 per cent), Karnataka (84 per cent), Bihar (78 per cent) and Maharashtra (77 per cent).
Male engagement in family planning continues to be limited and disappointing as seen by the low uptake of condoms and male sterilisation across states.
Despite the efforts being made, it is alarming to see the increase in child marriages in a number of states, reveals the data.
There has been an increase in child marriages in Tripura (40.1 per cent from 33.1 per cent in 2015-16), Manipur (16.3 per cent from 13.7 per cent in 2015-16) and Assam (31.8 per cent from 30.8 per cent in 2015-16), while states like West Bengal (41.6 per cent) and Bihar (40.8 per cent) still have high prevalence of child marriages. States such as Manipur, Andhra Pradesh, Himachal Pradesh and Nagaland have also shown increase in teenage pregnancies. Along with increase in child marriages, Tripura has also shown an increase in teenage pregnancies, from 18.8 per cent in 2015-16 to 21.9 per cent in 2019-20.
While spousal violence has generally declined in most of the states and UTs, it has witnessed an increase in five states, namely Sikkim, Maharashtra, Himachal Pradesh, Assam and Karnataka. Karnataka witnessed the largest increase in spousal violence, from 20.6 per cent in NFHS 4 to 44.4 per cent in NFHS-5.
Sexual violence has increased in five states (Assam, Karnataka, Maharashtra, Meghalaya and West Bengal), as per the data.