National Family Health Survey–6 (NFHS–6)

Context

The Government of India released the National Family Health Survey–6 (NFHS–6), India's flagship nationwide health and demographic survey.

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What is NFHS–6?

The National Family Health Survey (NFHS) is a large-scale, multi-round survey that provides district-level data on:

• Population dynamics
• Health and nutrition
• Maternal and child health
• Family welfare
• Gender indicators

It is coordinated by the International Institute for Population Sciences (IIPS), Mumbai.

NFHS–6 at a Glance

Indicator	Details
Nodal Agency	IIPS, Mumbai
Households Surveyed	~6.79 lakh
Coverage	National, State and District Level
Purpose	Evidence-based policymaking and SDG monitoring
Significance	India's most comprehensive health and demographic database

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Key Findings of NFHS–6

1. Maternal & Child Health Improvements

Indicator	NFHS-5	NFHS-6
Institutional Deliveries	88.6%	90.6%
ANC Registration	—	95.9%
First Trimester ANC	70%	76.2%
4+ ANC Checkups	—	65.2%

Significance

• Reflects improved access to maternal healthcare.
• Indicates progress toward reducing maternal and neonatal mortality.
• Demonstrates growing utilization of public health facilities.

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2. Fertility Stabilisation Achieved

Indicator	NFHS-6
Total Fertility Rate (TFR)	2.0

Significance

• Below replacement level fertility (2.1).
• Indicates demographic transition and population stabilisation.
• Supports long-term human development outcomes.

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3. Significant Reduction in Malnutrition

Indicator	NFHS-5	NFHS-6
Stunting	35.5%	29.3%
Severe Wasting	7.7%	5.2%

Significance

• Reflects impact of nutrition interventions.
• Indicates progress under POSHAN-related initiatives.
• Improves child survival and cognitive development outcomes.

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4. Expansion of Immunisation Coverage

Indicator	NFHS-5	NFHS-6
Fully Vaccinated Children (12–23 months)	83.8%	87.1%
Rotavirus Vaccine Coverage	36.4%	85.4%

Significance

• Strong progress under the Universal Immunisation Programme.
• Better protection against vaccine-preventable diseases.
• Demonstrates effective public health outreach.

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5. Public Healthcare Remains the Backbone

Indicator	NFHS-6
Childhood Immunisations through Public Facilities	95.6%

Significance

• Reflects high dependence on government health infrastructure.
• Demonstrates increasing trust in public healthcare delivery systems.

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6. Improved Financial Risk Protection

Indicator	NFHS-5	NFHS-6
Health Insurance Coverage	41.0%	60.2%

Significance

• Reduces catastrophic out-of-pocket expenditure.
• Strengthens healthcare affordability.
• Reflects expansion of schemes such as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY).

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7. Closing the Gender Digital Divide

Indicator	NFHS-5	NFHS-6
Women Ever Using Internet	33.3%	64.3%

Significance

• Major improvement in digital inclusion.
• Supports financial empowerment and access to welfare services.
• Enhances participation in the digital economy.

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8. Rising Caesarean Deliveries

Indicator	NFHS-5	NFHS-6
C-Section Births	21.5%	27.2%

Concern

• Significantly above the WHO's recommended range.
• Raises concerns regarding unnecessary medicalisation of childbirth.

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Major Positives Emerging from NFHS–6

Strengthened Public Health System

• 95.6% of child vaccinations delivered through public facilities.
• Demonstrates improved state capacity and public confidence.

Progress Against Chronic Child Undernutrition

• Stunting reduced from 35.5% to 29.3%.
• Indicates effectiveness of nutrition-focused interventions.

Improved Financial Protection

• Health insurance coverage expanded to 60.2%.
• Greater protection from health-related poverty.

Women's Economic Empowerment

• Women's ownership and operation of bank accounts reached 89%.
• Increased digital connectivity and financial inclusion.

Successful Rollout of New Vaccines

• Rotavirus vaccine coverage more than doubled to 85.4%.
• Reflects improved last-mile delivery and cold-chain infrastructure.

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Key Challenges Identified

1. Poor Complementary Feeding Practices

Concern

Children aged 6–8 months require both breastmilk and complementary foods.

NFHS–6 Finding

• 40.5% of children aged 6–8 months do not receive adequate solid or semi-solid foods.

Implication

• Risk of stunting, wasting and developmental delays.

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2. Remaining Immunisation Gaps

Finding

• 12.9% of children remain partially or fully unvaccinated.

Implication

• Continued vulnerability to vaccine-preventable diseases.

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3. Rising Burden of Non-Communicable Diseases (NCDs)

Concerns

• Hypertension
• Diabetes
• Obesity
• Cardiovascular diseases

Implication

• Increased pressure on the healthcare system.
• Higher long-term treatment costs.

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4. Double Burden of Malnutrition

Emerging Challenge

India simultaneously faces:

Undernutrition

• Stunting
• Wasting
• Micronutrient deficiencies

Overnutrition

• Obesity
• Overweight adults

Implication

• Complex public health management challenge.

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5. Low Compliance with Iron-Folic Acid Supplementation

Finding

• Only 37.8% of pregnant women consumed Iron-Folic Acid tablets for the recommended 180 days.

Implication

• Persistent maternal anaemia.
• Increased pregnancy-related complications.

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Way Forward

Strengthen Data-Driven Immunisation through U-WIN

• Use real-time tracking to identify missed children.
• Improve last-mile vaccination coverage.

Scale Up POSHAN 2.0 and Saksham Anganwadi

• Focus on complementary feeding practices.
• Strengthen nutrition counselling for mothers.

Universal NCD Screening

• Expand screening through Health & Wellness Centres.
• Promote preventive healthcare and early diagnosis.

Improve Maternal Nutrition Compliance

• Behavioural change campaigns for Iron-Folic Acid consumption.
• Community-based monitoring through ASHAs and Anganwadi workers.

Universalise Health Insurance Coverage

• Integrate beneficiary databases.
• Ensure coverage of remaining uninsured households.

Regulate Rising Caesarean Deliveries

• Strengthen clinical audits.
• Promote evidence-based obstetric practices.

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Conclusion

NFHS–6 presents a picture of a healthier and more resilient India, marked by significant gains in maternal healthcare, immunisation, nutrition, digital inclusion and financial protection. However, persistent gaps in child feeding practices, maternal nutrition, rising Caesarean births and the growing burden of non-communicable diseases highlight the need for a shift from an access-centric approach to a quality- and outcomes-oriented health strategy. The next phase of health reforms must focus on preventive care, behavioural change, nutritional security and universal health coverage to realise the vision of a Healthy India and achieve the Sustainable Development Goals by 2030.