Partial results of the fourth National Family Health Survey, for the 13 states and two union territories that comprise its first phase, have been released. Data for the second phase are currently being collected. The numbers are useful as far as individual states are concerned and they are distributed in a way that, when taken together, are fairly representative of the whole country. But the overall picture is still incomplete. It is now 10 years since the third survey and the gap between surveys has been increasing. (The gap between the first and second surveys was six years.) According to one report, the ministry of health and family welfare was not entirely in the picture when the department of statistics took the initiative to make the data available. There may have been some hurry to show results. Certainly, the gap between surveys has been commented upon by domestic and international researchers, and does not indicate a happy state of affairs. It is urgently necessary to select a set of important indicators, which impact national health and have data on them collected and released every two or three years. Unless this is done, it will be difficult most of the time to get recent data that are historically comparable - and without that discipline policymaking may suffer.
The official statement on the survey results released says that infant mortality rates for all the states and territories have gone down - but the national figure had also gone down between the first, second and third surveys. What is important to know is whether the rate of decline has gone up or down. It is also not very helpful to know that Madhya Pradesh is a laggard and Goa is a front-runner. This is true to a well-established pattern. What is significant is that both Madhya Pradesh and Bihar, which are laggards, have shown a significant improvement between the third and the fourth surveys - but West Bengal, which was not a laggard, has done even better in terms of the rate of improvement.
The statement also notes that the total fertility rate (the number of children a woman is likely to have in her entire reproductive life) has gone down in all states. This is in keeping with the changes between the first three surveys - and it is again not surprising that Bihar and Madhya Pradesh are laggards. What appears significant is that 10 of the 13 states covered have either achieved or maintained the replacement rate (have enough children so as to maintain the population at the save level, neither falling nor rising). As the statement says, this is a major achievement. It is also apparent from the survey results that women are receiving better ante-natal care overall, and larger proportions are going through assisted or institutional deliveries. What is disappointing is that the sex ratio (number of women to men) has worsened in virtually all the states covered. As this is a reflection of social attitudes, indicating that there is no end to the preference for boys and adverse sex selection, the aim of achieving gender equality remains distant.
