National Family Health Survey

Also called: NFHS · Topic: Population of India: Distribution, Density, Growth and Composition · NCERT: Beyond NCERT

Meaning

The National Family Health Survey (NFHS) is a large survey of a sample of households across India. It collects data on population, health and nutrition. The Ministry of Health and Family Welfare runs it, and IIPS (International Institute for Population Sciences), Mumbai is the nodal agency (the lead body that runs the survey).

It matters because India's census comes only once in 10 years. NFHS gives newer figures on fertility, nutrition and family planning in between. It showed that India's fertility has fallen below replacement level, which is a turning point in India's population story.

Explanation

How it works

• It is a sample survey, not a full count.
• It does not visit every person, as the census does.

• It visits a large, chosen set of households and uses them to estimate figures for the whole country.

• It is held about every 3–5 years. That makes it more frequent than the census (every 10 years) but less frequent than the SRS (every year).

• Its scale is large. NFHS-6 (2023-24) covered about 6.79 lakh households in 715 districts [4].

What it measures

• Fertility: TFR (Total Fertility Rate: the average number of children a woman would have in her lifetime).
• Nutrition: for example, stunting (children too short for their age) and anaemia (too little iron or haemoglobin in the blood).
• Contraception: CPR (Contraceptive Prevalence Rate: the share of couples who use a family-planning method).
• Household sex ratio: the number of women per 1,000 men in the households surveyed.

Key findings: NFHS-5 and NFHS-6

Round	Years	TFR	Other key finding
NFHS-5	2019-21	2.0	Sex ratio of 1,020 women per 1,000 men. This was the first NFHS with more women than men.
NFHS-6	2023-24	2.0 [4]	CPR rose from 66.7% to 69.1% [4]

• Replacement level = 2.1. This is the number of children each woman needs to have to keep the population size stable over the long run.
• A TFR of 2.0 is below replacement level.
• Each new generation of parents is having slightly fewer children than needed to replace themselves.

• Over time, this leads to slower growth and later to a fall in population.

• NFHS-6 confirmed the trend. TFR stayed at 2.0, so fertility is still below replacement level [4].

Why the population still grows

• Low TFR does not mean the population is falling yet.
• A large number of young people are now entering child-bearing age.
• Even with fewer children per woman, the total number of births stays high.

• This is called population momentum.

• So the UN's World Population Prospects (WPP) 2024 expects India to keep growing until it peaks around 2064, at about 1.7 billion [2].

Where it occurs

• Coverage: all of India. NFHS-6 covered 715 districts [4].
• Who runs it: the Ministry of Health and Family Welfare, with IIPS, Mumbai as the nodal agency.
• Latest round: NFHS-6 (2023-24), released by the Union Health Ministry [4].
• Where it fits among India's data sources:

Source	Run by	How often	Main use
Census	Registrar General and Census Commissioner, Ministry of Home Affairs	Every 10 years	Total population, density, literacy, language, religion, SC/ST, migration
SRS	Registrar General of India	Every year	Birth rate, death rate, IMR, TFR, MMR (state-wise)
NFHS	Health Ministry + IIPS Mumbai	About every 3–5 years	Nutrition, contraception, household sex ratio, TFR
PLFS	NSO, MoSPI	Every year	Employment and unemployment

Don't confuse with

• Census of India: The census is a full count of every person, held every 10 years under the Ministry of Home Affairs. NFHS is a sample survey run by the Health Ministry. Census 2027 is the 16th census [1].
• Sample Registration System (SRS): SRS is run by the Registrar General of India. It gives yearly birth rate, death rate, IMR (Infant Mortality Rate) and MMR (Maternal Mortality Ratio). For example, it put IMR at 25 in 2023 [3]. NFHS is the main source for nutrition and contraception data.
• Periodic Labour Force Survey (PLFS): PLFS is run by NSO, MoSPI. It measures jobs and unemployment, not health or fertility.
• NFHS sex ratio vs census sex ratio: The NFHS figure of 1,020 is a household sex ratio taken from a sample. It is not the census sex ratio, which comes from counting everyone.

Prelims Hooks

• NFHS is run by the Ministry of Health and Family Welfare, with IIPS Mumbai as the nodal agency. A common trap is to name the Registrar General or MoSPI instead.
• NFHS-5 (2019-21): TFR was 2.0, below the replacement level of 2.1.
• NFHS-5: sex ratio of 1,020 women per 1,000 men. This was the first NFHS with more women than men.
• NFHS-6 (2023-24): about 6.79 lakh households in 715 districts. TFR stayed at 2.0 [4].
• NFHS-6: CPR rose from 66.7% to 69.1% [4].
• Source–indicator match: stunting, anaemia and contraception come from NFHS. Yearly IMR and MMR come from SRS. Unemployment comes from PLFS. Language and religion come from the Census.

Mains Points

• Filling the census gap: The last census was in 2011, and the next is in 2027. In the meantime, policy has been running on figures that are 15 years old. NFHS gives newer data on fertility, nutrition and family planning. This helps target health and nutrition schemes. Still, as a sample survey, it can only partly replace a full count.
• India at a demographic turning point: NFHS shows TFR at 2.0, which is below replacement level.
• The population will still grow until about 2064 because of population momentum [2].
• India must use its demographic dividend (the extra economic growth possible when a large share of people are of working age) before the population ages.

• Southern states have low fertility and northern states have high fertility, so they need different policies.

• Family planning and women's health: CPR rose from 66.7% to 69.1% [4], which shows that more couples are choosing family planning. The NFHS data on nutrition, such as stunting and anaemia, helps the government see which regions need help most.

Related concepts

• Census of India
• Census 2027
• Sample Registration System
• India as the most populous country

Read more

• India's population and its data sources