NFHS-6 reveals contraceptives concern despite women’s broad progress in other fields

India’s women are healthier, more connected and more financially empowered than ever before, according to the sixth National Family Health Survey (NFHS-6), which was released by the Ministry of Health and Family Welfare in New Delhi on Friday (May 29). However, a shift away from modern contraception toward traditional methods has raised concerns among public health experts.

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According to the findings of the survey, which was carried out by the ministry in 2023-24 to encompass 6.79 lakh households across 715 districts of the country, internet use among women nearly doubled, bank account ownership rose to 89 per cent, and maternal health indicators improved significantly. The International Institute for Population Sciences, Mumbai, acted as the survey’s nodal agency.

Women’s digital, financial empowerment

Recording the progress in women’s digital inclusion and financial empowerment, the survey said that women who had used the internet at least once nearly doubled from 33.3 per cent during NFHS-5 (2019-21) to 64.3 per cent during the NFHS-6 period. Women having a personal mobile phone rose from less than 54 per cent in 2019-21 to 63.6 per cent in 2023-24, as per the national survey.

Modern contraceptive use among currently married women has declined from 56.4 per cent to 52.7 per cent, while traditional method use has risen sharply from 10.3 per cent to 16.4 per cent. This is not just a service-delivery issue; it is about women’s agency

The NHFS-6 findings also indicated that women’s financial empowerment was getting better. Their banking or savings accounts went up from 78.6 per cent in the NHFS-5 period to 89 per cent in the NHFS-6 coverage period.

The NFHS-6 records continued advancement in women’s digital inclusion and financial empowerment, the Union health ministry said.

Increased use of hygienic methods

The adoption of hygienic menstrual protection methods among women aged 15 to 24 has risen from 77.6 per cent to 79.2 per cent, as per the latest survey. This increase is bolstered by programmes such as the Menstrual Hygiene Scheme (MHS) under the Rashtriya Kishor Swasthya Karyakram (RKSK) and the provision of affordable sanitary products through the Pradhan Mantri Bhartiya Janaushadhi Pariyojana.

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Such initiatives have significantly improved awareness, accessibility, and the uptake of safe menstrual hygiene practices across the country, the Union ministry said.

Institutional deliveries exceed 90 pc

Institutional deliveries in India rose from 88.6 per cent to 90.6 per cent between 2019-21 and 2023-24, inching closer to the universal coverage, according to NFHS-6.

Institutional deliveries refer to the process of giving birth in a licensed healthcare facility under the supervision of professionals. It drastically reduces maternal and neonatal mortality chances by providing access to emergency, specialised and hygienic care.

Antenatal care coverage in the national survey period reached 95.9 per cent, with first-trimester visits increasing from 70 per cent to 76.2 per cent. Mothers receiving at least four ANC visits also increased from 58.5 per cent to 65.2 per cent.

Caesarean deliveries climbed from 21.5 per cent to 27.2 per cent, predominantly at private facilities (54.1 per cent as against 16.9 per cent in public ones although both saw a rise). Postnatal care within two days of birth improved from 79.1 per cent to 85.3 per cent. Mothers consuming iron and folic acid supplements for 100-plus days rose from 44.1 per cent to 54.9 per cent. Government schemes, including Janani Suraksha Yojana and PMMVY 2.0, have been instrumental in driving these improvements.

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These gains reflect strengthened public health infrastructure and improved access to maternal and child healthcare services across the country, driven by focused implementation of initiatives such as Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan, Surakshit Matritva Aashwasan (SUMAN), Facility-Based Newborn Care, Home-Based Newborn Care, and Pradhan Mantri Matru Vandana Yojana. (PMMVY 2.0),” the health ministry said.

Less use of modern contraceptives

However, one of the concerning findings of the survey said use of modern contraceptives among married Indian women declined, even as overall family planning adoption has gone up. The proportion of married women aged 15-49 using modern methods fell from 56.4 per cent in 2019-21 to 52.7 per cent in 2023-24, while reliance on traditional methods such as rhythm and withdrawal rose sharply from 10.3 per cent to 16.4 per cent.

Overall contraceptive use — modern and traditional combined — increased from 66.7 per cent to 69.1 per cent, suggesting more couples are planning families, but increasingly on their own terms. Female sterilisation, the most common method, dipped marginally from 37.9 per cent to 36.5 per cent, while male sterilisation remained negligible at 0.5 per cent.

Poonam Muttreja, Executive Director of Population Foundation of India, said the shift reflects gaps in counselling, fears around side effects, limited access to spacing methods and social norms that continue to place the burden of contraception on women.

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“The NFHS-6 should be read as a warning that access alone is not enough. Modern contraceptive use among currently married women has declined from 56.4 per cent to 52.7 per cent, while traditional method use has risen sharply from 10.3 per cent to 16.4 per cent. This is not just a service-delivery issue; it is about women’s agency,” she said, according to news agency PTI.

India’s total fertility rate remained stable at 2.0 children per woman, the same level recorded in NFHS-5, indicating that the country continues to remain below replacement-level fertility.

(With agency inputs)