The nine lives of India’s National Family Health Survey

News: The NFHS data evolved much from the Demographic and Health Survey and became a well-structured one.

Must readNFHS-5 and its findings – Explained, pointwise
About the Demographic and Health Survey (DHS)

The declassified Kissinger report of 1974 had feared that an ‘explosion’ in the Third World population would create masses of discontented youth, who would fall prey to communism and undermine US commercial interests globally.

So, the US Agency for International Development (USAID) first started its Demographic and Health Survey (DHS) programme in the 1980s to study fertility behaviour in the developing world.

But, despite criticism from Left activists and India, the first DHS survey was conducted in 1992-93.

About the evolution of NFHS

The Health Ministry in India demanded a sample reverification by an independent team. But, the USAID refused to fund. Finally, the ministry used its own funds for the exercise and decided to publish the results as NFHS.

About the NFHS

Read here: What is National Family Health Survey (NFHS)?

What are the key reasons behind the success of NFHS?

1. The surveys draw on the experience of experts from national and international organisations, besides that of the Government of India, 2. Technical innovation in data collection — NFHS relies on high-end organisational machinery and technically trained personnel to conduct the survey work. NFHS uses a bio-marker questionnaire in which entries are recorded after actual clinical, anthropometric and biochemical testing. 3. Provides a vast range of critical information on the demographic, health, nutrition and socio-economic status of people, including the SDGs and data for the country’s development at the global level.

What are the challenges associated with NFHS data?

1. Sampling error margins, as the survey is not designed to estimate a key population characteristic like sex ratio or even the total population, 2. No clear norms for the selection of households. For instance, the NFHS excludes those living in hostels, workers’ camps or places that predominantly house men, resulting in a high sex ratio.

Note: In the National Sample Survey, the definition of a household includes single members living in institutions, and theoretically it excludes only a section of armed forces personnel and jail inmates.
What lessons did India learn from NFHS?

First, the importance of transparency: NFHS data is available to everyone. This helped to establish NFHS credibility and improved transparency in government. For instance, the NSS unit-level data was opened up only after the NFHS.

Second, Indigenisation of data sets: Nutrition was not the primary focus area of the original DHS programme, but it was the nutritional component of the NFHS that grabbed attention in India.

Note: Nutrition received more attention in India because 1. Data on fertility and mortality trends were available from other sources, 2. The ‘real time’ data generated through Integrated Child Development Services (ICDS) was biased and varied greatly in quality and coverage across regions, 3. More acceptability of NFHS resulted in more and more states beginning to rely on it for nutritional planning.

There is no alternative to an independent, well-designed survey like NFHS. The growing demand for credible data in the world’s largest democracy ensured NFHS survival. Now, India must continue to track its data ecosystem closely on the lines of NFHS.

Source: This post is based on the following articles

“The nine lives of India’s National Family Health Survey” published in Live Mint on 7th December 2021.

“Thanks to data gaps, NFHS provides a limited picture” published in Indian Express on 7th December 2021.

Print Friendly and PDF