What NFHS-5 results reveal
The country is undergoing a surprising demographic transition. But it also faces several serious developmental challenges
The findings of the fifth National Family and Health Survey (NFHS) — it was conducted between 2019 and 2021 — ought to be treated as an important turning point for policy-making in India. Sure, NFHS is a sample survey and we should wait for the (delayed) 2021 Census numbers to authenticate some of the findings. But policy reckoning and recalibration need not be delayed.
First, the firsts — India’s total fertility rate falling below replacement levels and women exceeding men in the population. When read with the fact that the share of the under-15 population has fallen in the last decade-and-a-half, the biggest policy challenge is not improving literacy or controlling the population. It has to be generation of sustainable remunerative employment, including for women.
To be sure, the headline gender ratio should not blind us to the problems of entrenched patriarchy, which promotes son-preference through various illegal means. This is reflected in the fact that the gender ratio for children under five years is still 929 girls per 1,000 boys. This is as much a case for social intervention as an economic or health-based one.
Then there is the question of India’s food security challenge. Under-nutrition, broadly speaking, continues to decline. But complacency can be costly here. One, the progress of decline in under-nutrition has slowed. This must be read with the fact that economic growth slowed between NFHS-4 (2015-16) and NFHS-5 (2019-20). That the government has repeatedly extended the post-pandemic provision of free ration to 800 million people — even if for political considerations — underlines the precarity of the food security situation in India. The other important insight to be drawn is the ability of limited financial help to achieve behavioural change, which entails an economic cost. Both the Swachh Bharat Mission and the Ujjwala Yojna seem to have achieved remarkable progress in their goals, namely, healthy sanitation and use of clean fuel for cooking. But the data shows that actual achievements are significantly lower than the claims made by the government. This has an important policy lesson. In certain things, there is no substitute for the fruits of a high GDP growth rate.
Last but not least is the growing regional divide in India. The southern states have much better socio-economic and health indicators than their counterparts in north and central India. The former will also see an increasingly falling share in the population. If and when the delimitation happens, this can reduce their political representation in the legislature. It will hardly be a smooth transition.