There are now only five states that have a TFR above the replacement level of fertility of 2.1 children per woman: Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26), and Manipur (2.17).
The NFHS-5 survey work was conducted in around 6.37 lakh sample households from 707 districts (as on March, 2017) across 28 States and 8 UTs, covering 7,24,115 women and 1,01,839 men to provide disaggregated estimates up to district level.
Key findings of the report regarding fertility:
* Total fertility rate: The total fertility rate is 2 children per woman, which declined from 2.2 children in 2015- 16 and is currently below the replacement level of fertility of 2.1 children per woman. Women in rural areas have higher fertility, on average, than women in urban areas (TFR of 2.1 versus 1.6 children).
* The TFR has declined noticeably in India over time. Between 1992-93 and 2019-21, the TFR declined from 3.4 children to 2.0 children (a decrease of 1.4 children). The TFR among women in rural areas has declined from 3.7 children in 1992-93 to 2.1 children in 2019-21. The corresponding decline among women in urban areas was from 2.7 children in 1992-93 to 1.6 children in 2019-21.
* The report further found that the number of children per woman declines with women’s level of schooling. Women with no schooling have an average of 2.8 children, compared with 1.8 children for women with 12 or more years of schooling.
* Women in the lowest wealth quintile have an average of 1.0 more children than women in the highest wealth quintile (TFR of 2.6 children versus 1.6 children).
* The TFR varies from a low of 1.4 children per woman among Buddhists/Neo-Buddhists to a high of 2.4 children per woman among Muslims.
* The TFR ranges from 1.1 children per woman in Sikkim to 3.0 children per woman in Bihar.
* Age-specific fertility rates in the five-year period before the survey show that fertility has declined in all age groups from NFHS-3 to NFHS-5. Among women age 15-19 years, fertility has declined from 90 to 43; for women age 20-24 years, it has declined from 209 to 165, and for women age 25-29 years, it has declined from 139 to 122.
* Birth intervals: The median birth interval is 33 months since the preceding birth.
* Age at first birth: The median age at first birth among women age 25-49 is 21.2 years.
* Teenage childbearing: 7% of women age 15-19 have begun childbearing, which is just a 1% decline from 2015-16.
* Desire for another child: About one-fourth (23%) of currently married women age 15-49 want to have another child.
* Wanted fertility rate: The wanted fertility rate is 1.6 children per woman and ranges from 0.9 children in Sikkim to 2.7 children in Meghalaya.
The NFHS-5 report also revealed that the Overall Contraceptive Prevalence Rate has increased substantially from 54% to 67%.
“Use of modern methods of contraceptives has increased in almost all States/UTs. Unmet needs for family planning have witnessed a significant decline from 13% to 9%. The unmet need for spacing, which remained a major issue in India in the past has come down to less than 10%,” said an official statement.
The NHFS-5 also mentioned that institutional births have increased substantially from 79% to 89%. Even in rural areas, around 87% births are delivered in institutions and the same is 94% in urban areas.
Institutional births increased by a maximum of 27 percentage points in Arunachal Pradesh, followed by over 10 percentage points in Assam, Bihar, Meghalaya, Chhattisgarh, Nagaland, Manipur, Uttar Pradesh, and West Bengal. Over 91% of districts have more than 70% of births in the last 5 years that took place in health facilities.
As per the survey, the level of stunting among children under 5 years has marginally declined from 38% to 36% in the last four years.
Obesity rate rising
Compared with NFHS-4, the prevalence of overweight or obesity has increased in most States/UTs in NFHS-5.
At the national level, it increased from 21% to 24% among women and 19% to 23% among men. More than a third of women in Kerala, A&N Islands, Andhra Pradesh, Goa, Sikkim, Manipur, Delhi, Tamil Nadu, Puducherry, Punjab, Chandigarh and Lakshadweep (34-46%) are overweight or obese.
In NFHS-5, more than three-fourths (77%) of children aged 12-23 months were fully immunised, compared with 62% in NFHS-4.
(With inputs from agencies)