The National Family Health Survey (NFHS) in India was initiated in the early 1990s, with the first NFHS being conducted in 1992-93. Since then, India has successfully completed five rounds: NFHS-1 in 1992-93, NFHS-2 in 1998-99, NFHS-3 in 2005-06, NFHS-4 in 2015-16, and NFHS-5 in 2019-21. All five rounds of the survey were conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW), Government of India, with the International Institute for Population Sciences (IIPS), Mumbai, as the nodal agency and technical assistance provided by the United States Agency for International Development (USAID) through ICF.
The main objectives of the NFHS programme have been to strengthen India’s demographic and health database by providing information that is both reliable and widely used; to strengthen the survey research capabilities of Indian institutions to provide, analyse, and disseminate high-quality data; and to anticipate and meet the country’s needs for data on emerging health and family welfare issues.
The First National Family Health Survey (NFHS-1) was conducted in 1992-93. The survey collected extensive information on population, health, and nutrition, with an emphasis on women and young children. Eighteen Population Research Centres (PRCs), located in universities and institutes of national repute, assisted IIPS in all stages of conducting NFHS-1. All the state-level and national-level reports for the survey have been published (48 reports in all).
The Second National Family Health Survey (NFHS-2) was conducted in 1998-99 in all 26 states of India, with added features on the quality of health and family planning services, domestic violence, reproductive health, anaemia, the nutrition of women, and the status of women. The survey results have been published.
The Third National Family Health Survey (NFHS-3) was carried out in 2005-06. Eighteen research organizations, including five Population Research Centres, carried out the survey in 29 states of India. Funding for NFHS-3 was provided by USAID, DFID, the Bill and Melinda Gates Foundation, UNICEF, UNFPA, and the Ministry of Health and Family Welfare (MoHFW), Government of India. ICF provided technical assistance for NFHS-3, while the National AIDS Control Organization (NACO) and the National AIDS Research Institute (NARI) provided technical assistance for the HIV component.
The 2015-16 National Family Health Survey (NFHS-4), the fourth in the NFHS series, provided information on population, health, and nutrition for India and each state and union territory. All four NFHS surveys had been conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW), Government of India. MoHFW designated the International Institute for Population Sciences (IIPS), Mumbai, as the nodal agency for all the surveys. Funding for NFHS-4 was provided by the United States Agency for International Development (USAID), the United Kingdom Department for International Development (DFID), the Bill and Melinda Gates Foundation (BMGF), UNICEF, UNFPA, the MacArthur Foundation, and the Government of India.
ICF provided technical assistance through The DHS Program, which is funded by USAID. Assistance for the HIV component of the survey was provided by the National AIDS Control Organization (NACO) and the National AIDS Research Institute (NARI), Pune. NFHS-4 fieldwork was conducted by 14 field agencies, and seven laboratories conducted the HIV testing. Data collection took place in two phases from 1 January 2015 to 31 December 2016.
NFHS-4 was designed to provide information on sexual behaviour; HIV/AIDS knowledge, attitudes, and behaviour; and domestic violence only at the state level (in the state module), while most indicators in the district module were reported at the district level. The primary objective of the 2015-16 National Family Health Survey was to provide essential data on health and family welfare, as well as data on emerging issues in these areas. The clinical, anthropometric, and biochemical (CAB) component of NFHS-4 was designed to provide vital estimates of the prevalence of malnutrition, anaemia, hypertension, HIV, and high blood glucose levels through a series of biomarker tests and measurements.
The National Family Health Survey 2019-21 (NFHS-5), the fifth in the NFHS series, provides information on population, health, and nutrition for India, each state/union territory (UT), and 707 districts as of 31 March 2017. All five NFHS surveys were conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW), Government of India. MoHFW designated the International Institute for Population Sciences (IIPS), Mumbai, as the nodal agency for all rounds of NFHS. Funding for NFHS-5 was provided by the MoHFW, Government of India. ICF provided technical assistance through the Demographic and Health Surveys (DHS) Program, which is funded by USAID. Assistance for the Dried Blood Sample (DBS) component of the survey was provided by the Indian Council of Medical Research (ICMR) and the National AIDS Research Institute (NARI), Pune.
NFHS-5 fieldwork for India was conducted in two phases: Phase I, from 17 June 2019 to 30 January 2020, covering 17 states and 5 UTs; and Phase II, from 2 January 2020 to 30 April 2021, covering 11 states and 3 UTs. The fieldwork was conducted by 17 field agencies and gathered information from 636,699 households, 724,115 women, and 101,839 men. Like NFHS-4, NFHS-5 also provides district-level estimates for many important indicators.
The contents of NFHS-5 are similar to those of NFHS-4 to allow comparisons over time. However, NFHS-5 includes some new topics, such as preschool education, disability, access to a toilet facility, death registration, bathing practices during menstruation, and methods and reasons for abortion. The scope of clinical, anthropometric, and biochemical (CAB) testing was also expanded to include measurements of waist and hip circumferences, and the age range for the measurement of blood pressure and blood glucose was expanded. However, HIV testing was not included in NFHS-5.
The NFHS-5 sample was designed to provide national, state/union territory (UT), and district-level estimates of various indicators covered in the survey. However, estimates of indicators of sexual behaviour; husband’s background and woman’s work; HIV/AIDS knowledge, attitudes, and behaviour; and domestic violence are available only at the state/union territory (UT) and national levels.
In 2023–2024, India has conducted the sixth round of the National Family Health Survey (NFHS-6). Like its predecessors, NFHS-6 has been conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW). Funding for NFHS-6 has been provided by the MoHFW, Government of India. For the first time, all aspects of the survey have been coordinated solely by the International Institute for Population Sciences, Mumbai.
The survey has been implemented by a group of survey organizations and Population Research Centres, selected through a rigorous selection procedure. NFHS-6 has provided estimates of fertility levels, infant and child mortality, and other family welfare and health indicators by background characteristics at the national and district levels. It has also measured trends in family welfare and health indicators over time at the national and district levels.
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