What is lost and gained in NFHS-6

Published 8 June 2026 · health

India’s latest Family Health Survey (NFHS-6) records gains in child nutrition, maternal care, institutional births and women’s internet use. But its preliminary fact sheet is

India’s latest Family Health Survey (NFHS-6) records gains in child nutrition, maternal care, institutional births and women’s internet use. But its preliminary fact sheet is also thinner than the last round, with 101 indicators compared with 131 in NFHS-5. Which indicators were removed from NFHS-6? Key indicators such as anaemia, mortality, sex ratio at birth, sanitation, and clean cooking fuel have been removed from the survey. The Union Health Ministry released the fact sheets of NFHS-6 on May 29, covering 2023-24. The survey recorded data from nearly 6.8 lakh households across every State and Union Territory except Manipur. Preliminary findings report clear gains on several measures, including mothers getting at least four antenatal check-ups, up about seven percentage points from NFHS-5, an increase in institutional births and women’s internet usage. It also points to declines in several metrics, such as exclusive breastfeeding of infants under six months, down nearly eight percentage points, and the use of modern contraception, down to 52.7% from 56.4%. The NFHS is commissioned by the Ministry of Health and Family Welfare, which designates the International Institute for Population Sciences (IIPS) to conduct the survey. Over the years, the scope of the survey has been additive by design, retaining the previous questionnaire and adding to it. NFHS-4 in 2015-16 introduced district-level estimates and tablet-based digital interviewing for survey collection. NFHS-5 pushed the indicators further, including new topics, such as preschool education, disability, access to a toilet facility, death registration, bathing practices during menstruation and methods and reasons for abortion. It also extended blood pressure and blood sugar measurements from adults aged between 15 and 49 to all adults aged 15 and above. The survey measured 131 key indicators, up from 114 in NFHS-4. While the HIV testing component was dropped from NFHS-5, it retained questions on HIV/AIDS knowledge, attitudes, prior testing, sexually transmitted infections, and sexual behaviour.

In NFHS-6, biological HIV testing has been brought back as part of the clinical, anthropometric and biochemical testing schedule. The NFHS-6 fact sheet does not separately spell out whether all HIV/AIDS knowledge and attitude questions were retained. NFHS-6 also added new questions on direct benefit transfers, self-help group memberships, digital literacy and financial transactions. It also includes testing for Hepatitis-B and Hepatitis-C among women and men, as well as dried blood spot collection from children aged 4-5 for Hepatitis-B testing. But for the first time, the survey has also subtracted overall, showing a net reduction of 30 indicators in the preliminary results. Among the dropped indicators, the most notable ones, such as anaemia, infant and child mortality, sex ratio at birth, clean cooking fuel use, and sanitation, have all appeared since at least NFHS-4. Why was anaemia dropped? The case for removing anaemia is related to how it was measured. The indicator had long shown a worsening picture. Between NFHS-4 in 2015-16 and NFHS-5 in 2019-21, anaemia rose across the board. Among children, anaemia prevalence went up from 58.6% to 67.1%, among women aged 15-49, it rose from 53.1% to 57%, and among pregnant women, anaemia rose from 50.4% to 52.2%. The rise in anaemia was near-universal across the country, with child anaemia increasing in 28 States and Union Territories, and in some cases by big leaps, from 35.7% to 68.4% in Assam and 19.3% to 46.4% in Mizoram. Such deterioration was reported despite the government launching the Anaemia Mukt Bharat campaign in 2018, aimed at tackling anaemia. The reason for dropping it as an indicator then boiled down to how the data were being collected. NFHS measured haemoglobin from a finger-prick blood sample read on a portable analyser, which several nutrition researchers contend overstated anaemia compared to the venous blood drawn by other surveys.