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NFHS-5: Women don’t outnumber men in India


There are 1,020 women per 1,000 men in India according to the recently released Fifth Edition of the National Family Health Survey (NFHS-5). Such a sex ratio has not been recorded in any of the previous four editions of the NFHS.

But demography experts say it is not the time to rejoice yet as the figures do not give an accurate picture of India’s sex ratio.


GS-I: Indian Society (Population and Associated Issues), GS-II: Polity and Governance (Government Policies and Interventions, Issues arising out of the design and implementation of policies)

Dimensions of the Article:

  1. What is National Family Health Survey-5 (NFHS-5)?
  2. Details and Highlights of the NFHS-5
  3. About the survey on NFHS-5 on women outnumbering men

What is National Family Health Survey-5 (NFHS-5)?

  • The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
  • The NFHS is a collaborative project of the International Institute for Population Sciences (IIPS), Mumbai, India; ORC Macro, Calverton, Maryland, USA and the East-West Center, Honolulu, Hawaii, USA.
  • NFHS was funded by the United States Agency for International Development (USAID) with supplementary support from United Nations Children’s Fund (UNICEF).
  • The Ministry of Health and Family Welfare (MOHFW), Government of India, designated IIPS as the nodal agency, responsible for providing coordination and technical guidance for the NFHS.

How often is the NFHS conducted?

  • National Family Health Survey (NFHS) has been conducted five times so far with the latest survey being the fifth NFHS.
  • NFHS-1 was conducted in 1992-93 – which collected extensive information on population, health, and nutrition, with an emphasis on women and young children.
  • The Second National Family Health Survey (NFHS-2) was conducted in 1998-99 in all 26 states of India with added features on the quality of health and family planning services, domestic violence, reproductive health, anemia, the nutrition of women, and the status of women.
  • The Third National Family Health Survey (NFHS-3) was carried out in 2005-2006 in 29 states of India funded by – USAID, DFID, the Bill and Melinda Gates Foundation, UNICEF, UNFPA, and MOHFW, GOI.
  • The fourth National Family Health Survey (NFHS-4) was conducted in 2015 under the stewardship of the Ministry of Health and Family Welfare, and the survey included all 6 Union territories at that time.

Details and Highlights of the NFHS-5

The new survey shows that several states have either witnessed meagre improvements or sustained reversals on child (under 5 years of age) malnutrition parameters such as child stunting; child wasting; share of children underweight and child mortality rate.

Child Wasting

  • Child Wasting reflects acute undernutrition and refers to children having low weight for their height.
  • States such as Telangana, Kerala, Bihar, and Assam as well as the UT of J&K have witnessed an increase in Child wasting.
  • Other states like Maharashtra and West Bengal have been stagnant on Child Wasting status.

Child Mortality

  • Infant Mortality Rate (the number of deaths per 1000 live births for children under the age of 1) and Under 5 Mortality Rate data is mostly stagnant.
  • Several big states, Gujarat, Maharashtra, West Bengal, Telangana, Assam and Kerala, have seen an increase in Underweight Children issue.
  • Under 5 mortality was observed to have a decline of about 33% over 10 years.
  • NFHS-5 and NFHS-4 are about five years apart, but we are seeing very little progress in many states.
  • In Maharashtra, the under-5 mortality rate is basically the same in NFHS-4 and 5, and in Bihar, it reduced by just 3% over five years
  • Over 60% of child mortality is explained by child malnutrition, which is the central problem and needs to be addressed.

Population Control

  • India’s population is stabilizing, as the total fertility rate (TFR) has decreased across majority of the states.
  • Of 17 states analyzed 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.
  • All 17 states have witnessed an increase in the use of modern contraceptives of family planning.
  • Male engagement in family planning continues to be limited and disappointing as seen by the low uptake of condoms and male sterilisation across states.

Child Marriages

  • 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.


  • 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).

Spousal Violence

  • 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.

Urban-rural Gender Gaps in Internet Use

  • There is an urban-rural gap as well as gender divide with respect to the use of the Internet in several states and union territories.
  • On average, less than 3 out of 10 women in rural India and 4 out of 10 women in urban India ever used the Internet.
  • An average 42.6% of women ever used the Internet as against an average of 62.16% among the men.
  • The percentage of women, who ever used the Internet, significantly dropped in rural India.

About the survey on NFHS-5 on women outnumbering men

  • For the first time since the NFHS began in 1992, the proportion of women exceeded men: there were 1,020 women for 1,000 men. In the last edition of the survey in 2015-16, there were 991 women for every 1,000 men.
  • However, sex ratio at birth for children born in the last five years only improved from 919 per 1,000 males in 2015-16 to 929 per 1,000, underscoring that boys, on average, continued to have better odds of survival than girls.
  • All of these States and UTs, however, showed improvements in the population increase of women. Most States and Union Territories (UTs) had more women than men, the NFHS-5 shows.
  • States that had fewer women than men included Gujarat, Maharashtra, Arunachal Pradesh, Haryana, Madhya Pradesh, Punjab and Union territories such as Jammu & Kashmir, Chandigarh, Delhi, Andaman and Nicobar islands, Dadra and Nagar Haveli, and Ladakh.
  • A State-wise breakup of the NFHS data also shows that India is on its way to stabilising its population, with most States and UTs having a Total Fertility Rate (TFR) of less than two.
  • A TFR of less than 2.1, or a woman on average bearing two children over a lifetime, suggests that an existing generation of a people will be exactly replaced. Anything less than two suggests an eventual decline in population over time.
  • Only six States: Bihar, Meghalaya, Manipur, Jharkhand and Uttar Pradesh have a TFR above two.
  • Bihar has a TFR of three which, however, is an improvement from the 3.4 of the NFHS-4. Again, much like the broader trend towards feminisation, the TFR in all States has improved in the last five years.
  • India is still poised to be the most populous country in the world with the current projection by the United Nations population division forecasting that India’s population will peak around 1.6 to 1.8 billion from 2040-2050.

-Source: The Hindu, Down to Earth Magazine

December 2023