Data with Intent: A Summary of Insights Investigating Progress in Maternal and Child Health & Healthcare (Part 1)

Published on :- February 24th, 2022

The National Family Health Survey (NFHS) is a large-scale state and district-level survey that collects data on indicators related to health, nutrition, and overall well-being, giving a credible idea of the overall healthcare infrastructure in India. Launched in 1992-93, the study is conducted in various rounds for a representative sample of households throughout India. Over the last three decades, five national level surveys have been published, with NFHS-V (2019-20) being the latest.

Data from sources such as the NFHS are essential for planning effective interventions in areas that need urgent attention. Recognizing this, Sattva’s Data with Intent series offers sharp and meaningful data insights that can enable stakeholders to strategise and act in the impact ecosystem. Our first area of focus was maternal and child health and access to healthcare across different regions in India, for which NFHS provides data on nearly thirty key indicators.

The survey has shown some encouraging trends in several aspects since NFHS-IV (2015-16). One of these has been the access to pre and postnatal care, especially in underserved regions. Initiatives to push for institutional deliveries and consultation with skilled health workers such as ASHA and ANMs appear to be effective, with an overall increase of 47% percentage points in births attended by skilled health personnel between 1998 and 2021. Regular counseling by trained personnel is correlated with lower maternal and infant mortality rates. The presence of these health workers ensures timely availability of care, detection and management of pregnancy and childbirth-related complications, thereby improving chances of neonatal and infant survival, and maternal health.

However, greater efforts are required to promote institutional deliveries. This is true especially for states like Bihar and Chhattisgarh, where the improvement, while substantial, still lags in comparison to states such as Kerala.

According to The first 1,000 days of life: The brain’s window of opportunity, the first 1000 days of a child’s life are crucial to ensure its growth, lifelong health and well-being. Timely vaccination is an important requirement during this period. Vaccination rates for children have increased from 80% to 84% between 2015-16 and 2019-20. Most states reflect this positive trend. However, state-wise comparisons show considerable disparities. Vaccination rates in Arunachal Pradesh stand at 76% against a near-universal 96% in Himachal Pradesh.

An area that calls for attention is the proportion of newborn children across different states who receive postnatal care within two days of delivery. While less than 60% of newborns in Bihar and Arunachal Pradesh receive care from a doctor/nurse/ANM or other health personnel, states such as Kerala and Maharashtra fare better (~90%).

While the trends for overall access to pre and postnatal care are encouraging, the quality of health and nutrition available to newborns and mothers raises concern. Between NFHS-IV and NFHS-V, the number of anemic pregnant women and children in India has grown by 1.8 and 8.5 percentage points respectively. This is true even for states such as Kerala which perform relatively well on other SDG indicators. Of special note are Himachal Pradesh and Arunachal Pradesh, both of which have shown a decrease in the proportion of anemic women by nearly 10 percentage points.

Anemia among children aged 6-59 months is at a rise, with over 65% of Indian children in this age group suffering from the deficiency. It is linked with poor cognitive and motor development among children. Compounded with adult anemia that severely affects work capacity and productivity, it can affect long-term individual health and economic growth of the country.

Another worrying trend is seen in the occurrence of stunting, that is, poor nutrition, repeated infections and inadequate psycho-social stimulation in the formative years of a child’s life. 13 states have reported an increase in the number of stunted children since NFHS-IV. Similar patterns are visible across regions – northern states show relative improvement, while north-eastern, western and southern states have increasing rates of stunting. These trends indicate considerable scope for region-specific interventions to improve infant and child health.

Good maternal and child health significantly influences quality of life as well as the growth of a nation’s economy. It is a crucial focus area that demands systematic, targeted interventions guided by rich, credible data. In the second part of this series, we will cover how Data with Intent explored the evolution of the financial dynamics that have impacted maternal and child healthcare over the years in India.

For more data insights, please refer to the Data with Intent Series: Maternal and Child Health & Healthcare deck.

For more insights on other health related indicators from NFHS, please explore our interactive dashboard Health Indicators (NFHS)

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