National Family Health Survey and Total Fertility Rate

Contact Counsellor

National Family Health Survey and Total Fertility Rate

  • According to the latest National Family Health Survey (NFHS) released by the Union Health Ministry , the Total Fertility Rate (TFR), or the average number of children per woman, has decreased further from 2.2 reported in 2015-16 to 2.0 at the all-India level, owing to a decades-long family planning programme.
  • According to the UN's Population Division, countries with below-replacement fertility — less than 2.1 children per woman — imply that a generation is not producing enough children to replace itself, eventually leading to population decline.
  • A TFR of 2 is a ""definitive indication"" of long-term population stability in a country.

What is NFHS

  • NFHS is a multi-round, large-scale survey that is undertaken in a representative sample of Indian homes.
  • It serves as a monitoring indicator for the country's 30 Sustainable Development Goals (SDGs), which it wants to accomplish by 2030.
  • Preschool education, handicap, access to a toilet facility, death registration, bathing habits during menstruation, and techniques and reasons for abortion are all included in NFHS-5.


  • To supply the Ministry of Health and Family Welfare, as well as other agencies, with vital statistics on health and family welfare for policy and programme objectives.
  • To inform people about critical new health and family welfare concerns.


  • USAID, the Bill and Melinda Gates Foundation, UNICEF, UNFPA, and the Ministry of Health and Family Welfare have all contributed to different rounds of the NFHS (Government of India).

New Target Areas under NFHS-5

  • Hygiene during menstruation
  • Alcohol and tobacco usage frequency
  • Noncommunicable illnesses include additional components (NCDs)
  • Immunization domains for children have been expanded.
  • Micronutrient components for youngsters
  • Age ranges for assessing hypertension and diabetes have been expanded to include everyone aged 15 and above.

Key Findings of NFHS-5:

  • There has been a large rise in the current usage of any modern contraceptive technique, with 56.5 percent in 2019-21 compared to 47.8% in 2015-16.
  • Female sterilisation has increased to 38% of the population, up from 36% in 2015-16. Injectable contraceptives, which were launched in 2017, had a 0.6 percent adoption rate.
  • The rise in female sterilisation demonstrates that women bear the burden of family planning, with males refusing to participate and ""shrugging responsibility.""

NFHS and Total fertility Rate

  • The fifth survey in the series, NFHS 2019-21, reveals a fertility rate of 1.6 % in urban regions and 2.1 % in India.
  • A TFR of 2 is a ""definitive indication"" of long-term population stability in a country.
  • ""The number denotes that two parents are taking the place of two children.
  • We will have a potential growth rate of zero in the long run, which is a major development due to improvements in mother and child health.""

TFR Data

  • TFR above 2: Bihar (3),Meghalaya (2.9), Uttar Pradesh (2.4), Jharkhand (2.3) and Manipur (2.2).
  • TFR at the national average: Madhya Pradesh and Rajasthan. Two states have a TFR of 1.6: West Bengal and Maharashtra.
  • States with TFR of 1.7: Maharashtra, Karnataka, Andhra Pradesh, Himachal Pradesh, Nagaland and Tripura.
  • States With TFR of 1.8: Kerala, Tamil Nadu, Telangana, Arunachal Pradesh, Chhattisgarh and Odisha.
  • States with TFR of 1.9: Haryana, Assam, Gujarat, Uttarakhand and Mizoram.

Significance of TFR Decline

  • A diminished challenge to development,
  • The importance of investing in public health and education with skills,
  • The need to focus on environmental protection.

Goal of Population Stabilization

  • The country has been aiming for a TFR of 2.1.
  • A fall to 2 means we have achieved our goal of population stabilisation.
  • This means we will possibly still become the most populous country in the world but it will now be delayed.
  • Meaning we need not worry about a very large population being a challenge to our development.

Future Aspects

  • For the next 2-3 decades, the younger demographic profile will give a chance for faster economic growth.
  • However, maintaining a young population for another 2-3 decades, along with demographic stabilisation, should offer us a fantastic chance for rapid progress – if we invest in public health and skill-based education.