Thread by @anshgupta64

We celebrate stories like UPI, IT sector or even big companies. But we miss: are things becoming better for the average Indian?

I tried to compare the past few National Family Health Surveys to see if things have genuinely improved and was not disappointed.

On a broad level, most things have improved. Let’s see each parameter 1 by 1.

NFHS 3 - 2005-06
NFHS 4 - 2015-16
NFHS 5 - 2019-21

1) Household changes

One of the biggest changes since NFHS - 3 (2005-06) to NFHS - 5 (2019-21) is access to electricity. 96.8% of households now have access to electricity up from just 68%.

Households which have access to sanitation facilities (toilets) have increased from 45% to 70.2%. Swachh Bharat Mission has been instrumental in this push in rural as well as urban areas.

Iodine deficiencies lead to goitre, miscarriages and mental retardation. To counter this, iodised salt should be used.

Households that use iodised salt for cooking increased from 51% to 58.6%. There was a drop in NFHS 4 (43.8%) but we bounced back.

70% of Indians are 1 accident away from poverty! That makes insurance very important for financial well being.

Households with any member covered by health insurance/ financing increased from 5% to 41%.

Significant credit goes to the Ayushman Bharat- National Health Mission.

Households which use clean fuel for cooking - 43.8% -> 58.6%. PM Ujjwala Yojana was targeted to help 5 crore households. Data for NFHS 3 was not available.

2) Population stats

Fertility rate has been steadily dropping over the past surveys. There are multiple reasons for this such as…

… increased awareness and implementation of family planning

Sex ratio of the total population (females per 100 males) has increased from 991 to 1020. However for children born in the last five years, the change has been from 919 to 929. This means change is mainly due to women living longer than men.

3) Literacy Rate for both males and females is steadily improving but it might plateau unless reforms are made.

Two very interesting indicators that stood out to me -

% of women who have 10 or more years of education has increased from 35.7% to 41.0%

% of the female population aged 6 years and over that has ever attended school has increased from 68.8% to 71.8%.

Children’s Health

Institutional births (Births that took place in a medical facility) has increased from 39% to 88.6%! Number of hospitals and access to healthcare has greatly improved.

Infant mortality rate (deaths per 1000) has also greatly reduced.

And this holds true even for births that may not take place at hospitals. % of births attended by a health professional increased from 47% to 89.4%.

Vaccination coverage has improved. Children age 12-23 months fully vaccinated increased from 44% to 76.4%

Prevalence of diarrhoea has reduced. In the 2 weeks preceding the survey, 9 out of 10 children nationally had diarrhoea. This has been reduced to 7.3%!

Nutrition

There has been steady progress in removing nutritional deficiency. BMI of less than 18.5 is used to define acute malnutrition.

Women with Body Mass Index below normal: 36% -> 18.7%
Men with Body Mass Index below normal : 34% ->16.2%

On the other hand, obesity (another kind of poor nutrition) has been steadily rising over the years.
Women who are overweight or obese: 11%(NFHS -2) -> 24%
Men who are overweight or obese: 18.9% (NFHS 4) -> 22.9%

At a systemic level, it might be time to adopt millets which are richer in micronutrients compared to rice and wheat.

https://twitter.com/Nithin0dha/status/1625496196419846144

And finally, some indicators on women empowerment
Women having a mobile phone that they themselves use: 45.9% -> 54%

Women owning a house or land (alone or jointly): 38.4% -> 43.3%
This might not be as reliable an indicator since many families purchase land in the name of females in the family, but this is a good trend.

Women having a bank or savings account that they themselves use: 15% -> 53% -> 78.6%

The Jan Dhan push has led to a lot of financial inclusion and integration with the banking sector.

When we look at the economy, it's easy to get lost in the GDP growth, GDP per capita growth, but ultimately it's the life of the people we are trying to improve. There have been some misses but the outcomes of good policies are always visible.