February 2022

Smile Foundation

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Learning from NFHS 5: Renewed focus on nutrition and women

The National Family Health Survey (NFHS) presents a bird’s eye view of the state of India’s health development. The large-scale, multi-round survey is conducted in a representative sample of households throughout India. It is second only to the Census in India. The NFHS data gives insights into the various aspects of the country’s development. Much of this data is significant for the work that civil society organizations are doing. While carrying out our work in marginalized communities, this data proves to be a benchmark to base our activities on and plan the further course of action.

It is significant to note that the improvements seen in the data is a result of the collective efforts of government institutions and civil society organizations.

Malnutrition in India

Malnutrition is among India’s most serious development challenges. It contributes significantly to the country’s disease burden. Stunting and under-nutrition continue to be the big challenges.

As per NFHS-5 Phase II (for 14 states and UTs), 35.5% of children below five years were stunted and 32.1 per cent were underweight in 2019-21.

Among the stunted children, 37.3% are in the rural areas as compared to 30.1% in urban areas. If we look at state-wise data, Meghalaya (46.5 per cent), Bihar (42.9%), Uttar Pradesh (39.7%), and Jharkhand (39.6%) have the highest rates of stunting while Sikkim (22.3%) and Puducherry (20%) have the lowest.

Two states that had the lowest stunting rates in children in NFHS-4 (2015-16) but showed a substantial rise as per the NFHS-5 are Goa (from 20.1% to 25.8%) and Kerala (from 19.7% to 23.4%).

Moreover, the proportion of overweight children, women, and men also increased. This also reflects malnutrition which can lead to serious health consequences.

As part of our work with women and children, we have actively been working on reducing malnutrition. At our Mission Education centres, we ensure that children get healthy and nutritious meals. We also educate their parents on the same. Through our Swabhiman programme, which works for and with women in particular, we are constantly educating and empowering women to take charge of their own lives and health. For this, we conduct various informative workshops with them to teach them how they can take care of themselves as well as their newborns through the means of good food. Nutrition is a vital aspect of our work towards the improvement of society. After knowing what NFHS-5 has revealed about malnutrition in India, it is more important than ever to intervene on this aspect of development.

Talking about how civil society organizations have an important role to play here, Santanu Mishra, co-founder of Smile Foundation, says, “Our country has had a history of stakeholders collaborating and working closely to drive positive outcomes in nutrition for all. With their strong on-ground connect, reach, and understanding of the peculiarities of the Indian landscape, civil society organisations can design and implement high-impact programs to improve nutrition of people at the grassroots.”

NFHS and women

Among other things, the NFHS focuses specifically on the condition of women in the country. This is in tune with India’s aim to achieve United Nations-mandated Sustainable Development Goal-5, which focuses on women empowerment and gender equality.

On the state of women, the survey has six key indicators.

• The percentage of currently married women who usually participate in household decisions;
• Women who worked in the last 12 months and were paid in cash;
• Those owning a house and/or land (alone or jointly with others);
• Women having a mobile phone that they themselves use;
• Those who have a bank or savings account that they use; and
• Women aged 15-24 years who use hygienic methods of protection during their menstrual period.

Apart from these, the survey also highlights the need for further improvement on various fronts. This includes gender-based violence and harmful practices against women.

In 2015-16, the percentage of married women involved in household decisions was 73.8%. This number increased significantly in 2019-21 to 92%. This is possibly a reflection of the growing number of women who have their own bank accounts, and thus some level of financial independence.

The number of employed women increased from 21.1% to 24.9%. Land/house ownership among women went up in all the states except five–MP, Odisha, Uttarakhand, Delhi NCT, and Puducherry.

Low tariffs since 2016 saw a rise in mobile phone use among women across many states. However, Haryana and Chandigarh saw a drop in the share of women owning a mobile phone. The all-India figure, however, went up from 45.9% in 2015-16 to 54% in 2019-2021.

There is a significant jump in the number of women using bank accounts. The figures show that close to 80% women now have their own bank account. The number went up from 53 per cent in 2015-16 to 78.6 per cent in 2019-21.

The proportion of women aged 15-24 years who use menstruation-related products improved. Seventeen states and union territories had 90% or more women using period products. The number is even better in Puducherry and the Andaman and Nicobar Islands–99%. Using period products can improve overall health outcomes. It could also lead to prevention of reproductive and urinary tract infections.

The pandemic has impacted all spheres of life, including nutrition and women’s health and empowerment. It is time all stakeholders came together and supported each other to design, implement and fund programs that ensure improved access to nutrition for a large section of our population.

We must work closer-than-ever to solve this problem with urgency so that India can truly realize its demographic dividend. Access to nutritious food, alongside health and education, is an area that is fundamental or core to human development. Progress made here would enable India to dramatically improve human development and meet its sustainable development goals too.

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