Policy Expert Push for State-Specific Customization in National Health Surveys

The Case for Regionalized Data Modules

Prominent demographers and public health researchers are urging a fundamental shift in how India’s National Family Health Survey (NFHS) collects data. During a recent workshop hosted by the Madras Institute of Development Studies and SRMIST, experts argued that the current 101-variable framework often fails to capture the most pressing policy needs of individual states. S. Irudaya Rajan, chairman of the International Institute for Migration and Development, noted that only 10% of the metrics in the latest NFHS-6 round provide actionable insights for a state like Tamil Nadu.

A primary criticism involves the redundancy of tracking the Total Fertility Rate (TFR) in regions where it has already stabilized at 1.7. Researchers suggest shifting the focus from fertility to infertility and the challenges of an aging demographic, which the current NFHS framework largely ignores. Dr. K. Srinivasan, former director of the International Institute for Population Sciences, recommended streamlining the national questionnaire to its core objectives while allowing states to append bespoke modules that address local socioeconomic realities.

Critical Gaps in Tamil Nadu’s Health Indicators

Despite being a leader in healthcare, Tamil Nadu shows concerning trends in specific maternal and child health segments. Data presented at the workshop highlighted a surge in surgical deliveries and nutritional deficits. Key concerns include:

• C-Section Explosion: Surgical births have more than doubled over two decades. In private facilities, 60.3% of deliveries are by caesarean section, while public hospitals have seen an increase to 39.6%.
• Nutritional Deficits: Nearly one-fourth of children (23.2%) are underweight, with 20.7% stunted and 17.4% wasted. Only 20.6% of children aged 6-23 months receive a diet deemed adequate.
• Breastfeeding Lags: At 55.6%, exclusive breastfeeding for infants under six months is the lowest among South Indian states.
• Double Burden of Health: While malnutrition persists, 44.2% of women and 38.8% of men are now classified as overweight or obese, signaling a rise in non-communicable diseases.

Addressing Migration and Labor Lifelines

The expert panel also emphasized the invisibility of internal migrants within the current survey structure. Identifying migrants as the economic lifeline of the state, S. Irudaya Rajan called for research into their wages, language barriers, and the social cost of family separation. M. Suresh Babu, director of MIDS, proposed the implementation of state-level longitudinal surveys to better track these shifting demographic phenomena over time, rather than relying on the general snapshots provided by the periodic NFHS rounds.

Source: The Hindu — Cities