NFHS-3 Key Findings

2005-06 National Family Health Survey (NFHS-3)

Key Findings

NFHS-3, India, 2005-06

Contents1. About NFHS-3

2. Household and individual haracteristics

3. Fertility, marriage and family planning

4. Maternal health

5. Immunization and child health care

6. Nutritional status

7. HIV knowledge, behaviour and prevalence


Overview

NFHS-3 is the third in the NFHS series of NFHS-3 is the third in the NFHS series of

surveys, preceded by NFHS-1 in 1992-93 surveys, preceded by NFHS-1 in 1992-93

and NFHS-2 in 1998-99and NFHS-2 in 1998-99

NFHS surveys are conducted under the NFHS surveys are conducted under the

stewardship of MoHFWstewardship of MoHFW

IIPS is the nodal agency for the National IIPS is the nodal agency for the National

Family Health SurveysFamily Health Surveys


Contd.…Contd.…

NFHS-3 is funded by USAID, DFID, the Bill and NFHS-3 is funded by USAID, DFID, the Bill and

Melinda Gates Foundation, UNICEF, and UNFPA Melinda Gates Foundation, UNICEF, and UNFPA

Macro International provided technical assistance to Macro International provided technical assistance to

NFHS-3NFHS-3

NACO and NARI provided assistance for the HIV NACO and NARI provided assistance for the HIV

componentcomponent

NFHS-3 fieldwork was carried out by 18 Research NFHS-3 fieldwork was carried out by 18 Research

Organizations including some Population Research Organizations including some Population Research

CentresCentres


Scope of NFHS-3 All 29 states are covered Slum and non-slum areas of eight

cities, i.e. Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai, Nagpur

Interviews were conducted with

Women age 15-49

Men age 15-54


Biomarkers Measured in NFHS-3

Height and weight Haemoglobin content in the blood

to measure anaemia Collection of blood samples for

HIV testing


NFHS-3 Sample for 29 states

Number Number InterviewedInterviewed

Response Response RateRate

HouseholdsHouseholds 109,041109,041 97.797.7

Women (age 15-49)Women (age 15-49) 124,385124,385 94.594.5

Men (age 15-54)Men (age 15-54) 74,36974,369 87.187.1



2. Household and Individual Characteristics

3. Fertility, Marriage and Family Planning

4. Maternal Health

5. Immunization and Child Health

6. Nutritional Status of Children and Adults

7. HIV Knowledge, Behaviour and Prevalence


Selected Household Characteristics

93

51

83

56

12

26

25

68

45

Electricity

Piped water

Any toilet facility

Urban Rural Total

Percent of households


NFHS-3 finds some improvements in the household NFHS-3 finds some improvements in the household environment since NFHS-2environment since NFHS-2

68% of households have 68% of households have electricity, up from 60% electricity, up from 60% in NFHS-2in NFHS-2

88% of households use 88% of households use an improved source of an improved source of drinking waterdrinking water

Only 29% of households Only 29% of households have improved toilet have improved toilet facilitiesfacilities


Media Exposure

Percent with exposure to TV, radio, or newspaper at least once a week

6555

87 9382

75

Urban Rural Total

Women age 15-49 Men age 15-49

73% of urban households and 30% of 73% of urban households and 30% of rural households possess a TVrural households possess a TV


EducationPercent distribution of men and women age 15-49 by

highest level of education

41

18

23

27

14

20 35

22Women

Men

No education

< 8 yearscomplete

8-9 yearscomplete

10 yearscomplete andabove

NFHS-3 shows that even among NFHS-3 shows that even among those in the age group 15-19, only 89% those in the age group 15-19, only 89% of men and 74% of women are literateof men and 74% of women are literate


Measuring Health InequitiesMeasuring Health Inequities

NFHS-3 provides information on key NFHS-3 provides information on key population, health, and nutrition indicators population, health, and nutrition indicators for socially and economically vulnerable for socially and economically vulnerable groups to examine health inequitiesgroups to examine health inequities

– Caste/tribe statusCaste/tribe status– Wealth statusWealth status– Slum/non-slum population in eight citiesSlum/non-slum population in eight cities


What is the wealth index?What is the wealth index?

Uses information on Uses information on 33 household assets and 33 household assets and housing characteristicshousing characteristics, such as ownership of , such as ownership of consumer items, type of dwelling, source of consumer items, type of dwelling, source of water, and availability of electricitywater, and availability of electricity

Combines this information into Combines this information into a single wealth a single wealth indexindex, using a scientific method of assigning , using a scientific method of assigning weights to individual componentsweights to individual components

The household population is divided into The household population is divided into five five equal groups of 20% each (quintiles)equal groups of 20% each (quintiles) at the at the national level from 1 (lowest, poorest) to 5 national level from 1 (lowest, poorest) to 5 (highest, wealthiest)(highest, wealthiest)


Caste/Tribe StatusCaste/Tribe Status

OTHER 32%

OBC 41%

ST 8%

SC 19%


Distribution of Households by Wealth Distribution of Households by Wealth Index and ResidenceIndex and Residence

28

3

20

26

6

20

23

14

20

16

29

20

7

48

20

Rural

Urban

National

Lowest Second Middle Fourth Highest


Distribution of Households by Wealth Distribution of Households by Wealth Index and CasteIndex and Caste

50

2818

10

24

25

22

14

13

21

23

17

8

17

21

24

5 1016

36

ST SC OBC Other

Lowest Second Middle Fourth Highest


Proportion of Households in the Proportion of Households in the Highest Two Wealth Quintiles by StateHighest Two Wealth Quintiles by State

8983

78 7772

66 6560 59 57 57 55

4944 43 43 41 40 40

3633 32 30

27 26 24 24 23 2319

0

10

20

30

40

50

60

70

80

90

100

DL KEGO PJ

MZ

HP SK GJHR

MH UT JK M

N TN KA AP NGM

GIn

dia RJAR

WB UP AS

MP BH JH OR TR CH



2. Household and Individual Characteristics


4. Maternal Health





Total Fertility RateTotal Fertility Rate

3.4

2.92.7

1.0

1.5

2.0

2.5

3.0

3.5

4.0

NFHS-1 NFHS-2 NFHS-3

2.1

3.0

2.7

1.0

1.5

2.0

2.5

3.0

3.5

NFHS-3

Urban Rural Total


4550

54

28

53

NFHS-1 NFHS-2 NFHS-3 Urban Rural

Marital StatusPercent of women age 20-24 married by age 18

NFHS-3


Current Contraceptive Use by Method

4937

1

56

532

Any method

Any modern method

Female sterilizatio

n

Male sterilization

IUD Pill

Condom

Percent of currently married women age 15-49


Trends in Contraceptive Use by Trends in Contraceptive Use by MethodMethod

4137

27

4 2 1 2

4843

34

2 2 3

56

49

37

15

22 3


Percent of currently married women age 15-49


Desire for No More Children among Women with 2 Children

908372

8876

66 61

4737


2 sons 1 son and 1 daughter 2 daughters



2. Household and individual characteristics


4. Maternal health care


6. Nutritional status of children and adults

7. HIV knowledge, behaviour and Prevalence


Trends in Antenatal Care Percent of women who had any ANC*

84

6559

86

6660

77

91

72

Urban Rural Total


* For last births in the past 3 years


35

61

75

29

19

44

23

37

52

3+ ANC IFA for 90+ days Postnatal carewithin 2 days

Urban Rural Total

Maternity Care(for most recent birth in the last 5 years)


Institutional Delivery



2. Household and Individual characteristics


4. Maternal Health





Infant Mortality Rate

7985

56

6873

47

5762

42

Urban Rural Total



Infant Mortality Rates

611

27

64

7965

5757

India

LDCM

DC

Bangla

desh

Pakis

tan

Nepal

Sri Lan

ka

China


Child Immunization Trends

62

54

52

42

35

72

63

55

51

42

78

78

55

59

44

BCG

Polio3

DPT3

Measles

All Vaccines


Percent of children age 12-23 months vaccinated



Trends in Treatment of Childhood Diarrhoea with ORS

3325 2733

24 26

Urban Rural Total

NFHS-2 NFHS-3

Percent of children under age 3 with diarrhoea in the past 2 weeks


Percentage Received Any ORT or Increased Fluids by State

25 26 26

33

39 4043 43 43

46 47 47 47 47 48 48 4953 53 54 55

5963

6567 68 69

7275

85




3. Fertility and its determinants




7. HIV knowledge, behaviour and Prevalence


Trends in Child Nutritional Status

40

23

45 43

20

51

UnderweightWastedStunted

NFHS-3 NFHS-2

Percent of children age under 3 years

(Low-height-for-age) (Low-weight-for-height) (Low-weight-for- age)



Anaemia among Children

7479 81

72

Total Urban Rural NFHS-2

Percent of children 6-35 months with anaemia


How Many Children Receive How Many Children Receive Services from an AWC?Services from an AWC?

3326 23

20 18 16

0

10

20

30

40

50

60

70

80

Any se

rvice

Supp

lem

entary

food

Pre-sc

hool

Imm

unizations

Gro

wth m

onito

ring

Health

chec

k-up

s

Percent of age-eligible children in areas with an AWC


Nutritional Status of Adults

34

9

24

13

55

36

BMI below normal Overweight/Obese Anaemic

Women Men

Percent of women and men age 15-49


Malnutrition of Women by Malnutrition of Women by Residence and EducationResidence and Education

36

25

41 4235 35

25

36

1324

7 713 14

21

11

0

10

20

30

40

50

60

Underweight Overweight

Percent of women age 15-49


Malnutrition of Men by Malnutrition of Men by Residence and EducationResidence and Education

34

8

27

14

38

5

40

3

38

5

40

6

25

14

0

5

10

15

20

25

30

35

40

45

50

Total

Urban

Rural

No educa

tion

<8 ye

ars

8-9

year

s

10+ y

ears

Overweight

Underweight

Percent of men age 15-49








7. HIV knowledge, behaviour and prevalence


AIDS Awareness

9473

81

46

57

80

Urban Rural Total

Percent of women and men age 15-49 who have heard of AIDS

Women

Men


Most Adults Support Family Life Most Adults Support Family Life Education in SchoolsEducation in Schools

63% women and 81% men think that information about 63% women and 81% men think that information about HIV/AIDS should be taught in schools to both boys and HIV/AIDS should be taught in schools to both boys and girlsgirls

More than 40% of women and 60% of men are in favour More than 40% of women and 60% of men are in favour of teaching both boys and girls about sexual behaviour of teaching both boys and girls about sexual behaviour and condom use to avoid sexually transmitted diseasesand condom use to avoid sexually transmitted diseases

Adults are less likely to favour teaching about Adults are less likely to favour teaching about contraception than about HIV/AIDS contraception than about HIV/AIDS


Coverage of HIV Testing in NFHS-3

• Percent of eligible women age 15-49 Percent of eligible women age 15-49 and men age 15-54 whose blood was and men age 15-54 whose blood was tested for HIVtested for HIV• Women: 85 percentWomen: 85 percent• Men: 78 percentMen: 78 percent

• Response rates are comparable to Response rates are comparable to HIV test response rates on national HIV test response rates on national household surveys worldwidehousehold surveys worldwide


HIV Prevalence

HIV prevalence estimates are based on HIV HIV prevalence estimates are based on HIV tests of 102,946 blood samples:tests of 102,946 blood samples:

52,853 from de facto women age 15-49 52,853 from de facto women age 15-49

++

50,093 from de facto men age 15-5450,093 from de facto men age 15-54


SexSex

Women Women (%)(%)

Men Men (%)(%)

Total Total (%)(%)

UrbanUrban

RuralRural

0.290.29

0.180.18

0.410.41

0.320.32

0.350.35

0.250.25

IndiaIndia 0.220.22 0.360.36 0.280.28

HIV Prevalence by Residence and Sex, India

HIV prevalence rate is 60% higher among males than females and 40%

higher in urban areas than rural areas


Summary and HighlightsSummary and Highlights

Substantial improvements have been seen in Substantial improvements have been seen in child survivalchild survival

Fertility continues to declineFertility continues to decline– Urban women have already reached replacement Urban women have already reached replacement

level fertility, but rural women even now have an level fertility, but rural women even now have an average of three childrenaverage of three children

For the first time more than half of currently For the first time more than half of currently married women are using a contraceptive married women are using a contraceptive method method


Summary and Highlights (contd.)Summary and Highlights (contd.)

There is steady decline in the proportion of There is steady decline in the proportion of women age 20-24 marrying before the legal women age 20-24 marrying before the legal minimum age of marriageminimum age of marriage

There have been improvements in antenatal There have been improvements in antenatal care, institutional deliveries, and assistance care, institutional deliveries, and assistance at delivery by a health professional, but the at delivery by a health professional, but the changes over time have been slowchanges over time have been slow

Immunization coverage for children has Immunization coverage for children has improved for all vaccines except DPTimproved for all vaccines except DPT



Full immunization coverage has not Full immunization coverage has not changed much in the last 7 yearschanged much in the last 7 years

Undernutrition and anaemia among Undernutrition and anaemia among children remain major challengeschildren remain major challenges

Adults suffer a dual burden of Adults suffer a dual burden of undernutrition and overnutrition undernutrition and overnutrition



HIV prevalence among the NFHS-3 HIV prevalence among the NFHS-3 household population of men and household population of men and women age 15-49 is 0.28 percent. women age 15-49 is 0.28 percent. Based on this estimate and other Based on this estimate and other data, the Government of India has data, the Government of India has reduced its official HIV estimate for reduced its official HIV estimate for the adult population. However, strong the adult population. However, strong programmes are still required to programmes are still required to prevent the further spread of HIV.prevent the further spread of HIV.


Thank you…

And now, on to the rest of the NFHS-3 NationalDissemination Seminar!

Documents

NFHS-3 Key Findings