India has made progress in child and maternal health over the past few years. But new challenges are emerging in the form of caesarean deliveries, according to the latest National Family Health Survey (NFHS-6).
The survey, conducted in 2023-24 by the Union Health Ministry and the International Institute for Population Sciences (IIPS), covered all states and Union Territories except Manipur.
The findings show that while child marriage has declined over the years, it still affects about one in five girls. The survey also highlights improvements in immunisation, maternal healthcare and child nutrition, even as lifestyle diseases continue to rise.
CHILD CARE INDICATORS SHOW IMPROVEMENT
The survey recorded encouraging gains in child health and nutrition.
Stunting among children under five years declined from 35.5% in NFHS-5 to 29.3% in NFHS-6.
Severe wasting dropped from 7.7% to 5.2%, while the proportion of underweight children fell slightly from 32.1% to 31.8%.
There was also progress in disease prevention. Symptoms of acute respiratory infection among children decreased from 2.8% to 1.9%, while severe diarrhoea prevalence fell to 0.5%.
Vaccination coverage improved significantly. Full immunisation among children aged 12-23 months increased from 83.8% to 87.1%. The survey found that 95.6% of children received most of their vaccines through public health facilities.
Coverage of key vaccines also increased sharply. Rotavirus vaccination rose from 36.4% to 85.4%, while the second dose of measles vaccine increased from 58.6% to 71.8%.
MATERNAL CARE IMPROVES, BUT C-SECTIONS RAISE CONCERNS
Maternal healthcare indicators showed steady improvement across the country.
Nearly 96% of pregnant women received antenatal care (care during pregnancy), while first-trimester registration increased from 70% to 76.2%.
Women receiving at least four antenatal care (ANC) visits increased from 58.5% to 65.2%.
Institutional births also rose from 88.6% to 90.6%, indicating that more women are delivering in healthcare facilities.
Maternal nutrition improved as well. The proportion of women consuming iron-folic acid supplements for at least 100 days during pregnancy increased from 44.1% to 54.9%.
However, the sharp rise in caesarean deliveries has emerged as a major concern. C-section births increased from 21.5% to 27.2% nationally. This can lead to delayed breastfeeding practices among many women.
“Post C-section, the postoperative pain makes it uncomfortable for mothers to hold the neonate. In women who have had C-sections in them there is delayed onset of lactation and sometimes low milk supply in the first few days,” says Dr. Anita Gupta, Additional Director Obstetrics, Gynaecology, Fortis La Femme.
In urban India, the rate reached 40%, far above the World Health Organisation’s recommended range of 10-15%.
The increase is being largely driven by private hospitals, where C-section rates rose from 47% to 54%.
At the national level, caesarean deliveries were 37 percentage points higher in private facilities than in public hospitals.
While India’s total fertility rate remained stable at 2.0, below the replacement level of 2.1, the survey makes it clear that the country’s next major health challenge is tackling lifestyle-related diseases while continuing to improve maternal and child health.