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8 - Data-Quality Indicators from the National Family Health Survey
- Edited by K. S. James, International Institute for Population Sciences, Mumbai, T. V. Sekher, International Institute for Population Sciences, Mumbai
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- Book:
- India Population Report
- Published online:
- 15 August 2023
- Print publication:
- 27 June 2024, pp 270-310
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Summary
Introduction
The National Family Health Survey (NFHS) was initiated under the stewardship of the Ministry of Health and Family Welfare (MoHFW), Government of India, in the year 1992 when its first round was conducted. Four more rounds since then have been conducted. All rounds of the NFHS have persistently made a sincere effort to provide valuable nationally representative maternal and child-health indicators. The sample size and structure of the questionnaire, along with the pertinent health-related questions, have increased with the passing time. In NFHS-1 (1992–93), 88,562 households were surveyed in 24 states and the National Capital Territory of Delhi. A total of 89,777 ever-married women aged 13–49 years were interviewed to obtain the maternal and child-health indicators. In NFHS-2 (1998–99), the sample size of ever-married women increased to 91,000 aged 15–54 years from 26 states. A few additional health indicators, such as the nutritional status of women and children by running blood tests, were introduced in this round. In NFHS-3 (2005–06), the sample size for ever-married women was increased to 131,596 aged 15–49 years from 29 states of India. For the first time, information on men aged 15–54 years was collected in this round. Human immunodeficiency virus (HIV) and anaemia testing among women and children was also initiated.
After NFHS-3, the MoHFW wanted to integrate the different existing health surveys into one full-fledged survey providing district-level estimates. The NFHS had been designed as per the standard Demographic and Health Surveys (DHS), which have global coverage, whereas some of the previous district-level surveys like the Annual Health Survey (AHS) and the District-Level Household Survey (DLHS) had been planned to cover limited demographic and health issues and were subsequently subsumed to avoid duplication of efforts. In lieu of this, the periodicity of the NFHS was fixed at three years, and the NFHS was proposed to be turned into a government-funded survey (Shrinivasan, 2012). NFHS-4 (2015–16) was partially funded, and the most recent round, NFHS-5 (2019–21), is completely funded by the MoHFW. NFHS-4 was evidently different from its successors in two ways: (a) it provided an array of maternal- and child-health estimates at the district level, and (b) there was more than a five-fold increase in its sample size (Table 8.1). In addition to the 29 states that were surveyed in NFHS-3, six union territories were also included in the NFHS-4 sample.
Linkage in stunting status of siblings: a new perspective on childhood undernutrition in India
- Kajori Banerjee, Laxmi Kant Dwivedi
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- Journal:
- Journal of Biosocial Science / Volume 52 / Issue 5 / September 2020
- Published online by Cambridge University Press:
- 11 November 2019, pp. 681-695
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Almost 30% of the world’s stunted children reside in India. This study examined sibling linkage in childhood stunting by assessing the extent of clustering of stunted children born to the same mother. Data were taken from 225,002 children under the age of five from the Indian National Family and Health Survey (NFHS)-4 conducted in 2015–16. States with high fertility and lower socioeconomic development displayed higher clustering of childhood stunting among siblings. Simulating removal of this clustered burden showed an almost 10 percentage point reduction in stunting in India. Multinomial regression analysis highlighted that the propensity to have multiple stunted births was higher among less-educated women, scheduled caste/tribes and poor households. The multilevel model results indicated that the odds of stunting for the index child increased by 1.93 if the older sibling was stunted. The odds of the index child being stunted if the previous child was stunted were high, irrespective of the differences in state-level public health performances and political commitments. Although socioeconomic correlates play a crucial role in determining child stunting status, they also act as proxies for poor-quality intra-generational health. Clustering of stunting among siblings is an indicator of both genetic and environmental association with the height-for-age (HAZ) of children. Mothers with repeated stunted births should be prioritized and monitored over a substantial part of their lives. Inclusion of multiple child beneficiaries in nutrition policies and revisiting the ‘one size fits all’ concept at the micro level, owing to the substantial village/ward-level variation, might be an effective policy measure.