India has recorded an impressive performance in public health indicators in the sixth round of the National Family Health Survey (NFHS-6), released last week. The gains are significant compared with findings from recent surveys. Increased social health spending has helped the country achieve remarkable outcomes in reproductive health and childcare. Institutional deliveries are at 90% now. Compared with the NFHS-5 findings, child stunting dropped from 35.5% to 29.3%, and severe wasting dropped from 7.7% to 5.2%. Vaccination levels for children are above 96%. The survey reflects the positive impact of Ayushman Bharat-PMJAY and other health protection initiatives. Outside the health sector, it reveals commendable progress in women’s digital inclusion and financial empowerment.

While these are positive signals, some of the survey’s findings should also cause serious concern. Child nutrition is one such area: 85% of India’s children in the 6-23 months age group are not receiving an adequate diet. A decline in exclusive breastfeeding during the first six months has been reported. More than 31% of children have been found underweight. The survey also reports an increasing incidence of non-communicable diseases such as diabetes, hypertension, and obesity. One in six Indians is reportedly diabetic, and close to 30% are obese. The obesity level is about 27% for men and more than 30% for women. As most children do not receive essential nutrition, childhood obesity is a growing trend in the country. In the survey, there are pointers to a paradox related to nutrition: the coexistence of undernutrition, which leads to stunting and wasting in children, and worrying levels of obesity. The survey shows that nutritional diversity, which is critical to all segments of the population, needs to be promoted and accorded special attention in the case of children.

NFHS-6 is also important for what it does not say. It entails only 101 key indicators as against 131 in NFHS-5. The survey has left out markers such as anaemia prevalence, sex ratio at birth, infant and child mortality rates, and household use of clean cooking gas. Although the reason for these omissions is not explained, some parameters are reportedly shifted to specialised surveys. The survey does not reveal an ideal picture of the country’s health, with concerns marked across sections of the population. Its findings present a case for greater momentum in public health investment and targeted programmes tailored for optimal impact. India cannot afford a growing population that is grappling with falling health. (Source: DH)