NFHS-6 reveals progress amid nutrition challenges

The sixth round of the National Family Health Survey (NFHS-6), covering 2023–24, has been released and reveals a mixed picture: measurable progress on most c...

What Happened

The sixth round of the National Family Health Survey (NFHS-6), covering 2023–24, has been released and reveals a mixed picture: measurable progress on most child health and maternal care indicators, but stubborn challenges in wasting, underweight, and anaemia persist.
Stunting among children under five declined from 35.5% (NFHS-5, 2019–21) to 29.3% (NFHS-6, 2023–24) — a reduction of over 6 percentage points — reflecting cumulative gains from nutrition programmes, sanitation improvements, and better antenatal care.
Wasting remains high at 19.0%, while underweight has barely moved (32.1% → 31.8%), signalling that acute malnutrition and chronic food insecurity are not responding to the same interventions that reduced stunting.
A notable reversal: exclusive breastfeeding rates fell from 63.7% (NFHS-5) to 55.8% (NFHS-6), a decline that nutritionists view as a warning sign, since exclusive breastfeeding is the single most cost-effective intervention for infant nutrition in the first six months.
The survey also shows sharp improvements in maternal health infrastructure: institutional deliveries rose to 90.6% (from 88.6%), first trimester antenatal care registration improved to 76.2% (from 70%), and fully vaccinated children increased to 87.1% (from 83.8%).

Static Topic Bridges

National Family Health Survey (NFHS) — Methodology and Significance

The NFHS is India's flagship household-level survey on population, health, and nutrition, conducted by the International Institute for Population Sciences (IIPS), Mumbai, under the Ministry of Health and Family Welfare. Surveys are conducted approximately every four to five years and cover nationally representative samples of hundreds of thousands of households. NFHS data is the primary evidence base for health policy in India and is used by WHO, UNICEF, and NITI Aayog for planning and accountability purposes.

NFHS-6 (2023–24) surveyed over 6.7 lakh households across 715 districts, making it the most comprehensive round.
The survey measures fertility, infant and child mortality, maternal and child health, nutrition, anaemia, domestic violence, and health service utilisation.
NFHS-6 differs from NFHS-5 in expanded coverage of digital access and health insurance indicators.

Connection to this news: NFHS-6 is the primary source of India's child nutrition data; its release has triggered renewed policy debate on whether programme design and resource allocation are sufficiently targeting the stubborn persistence of wasting and underweight.

Child Malnutrition Indicators — WHO/UNICEF Definitions

Malnutrition in children is measured along three axes using WHO child growth standards. Stunting (height-for-age below -2 SD) reflects chronic, long-term undernutrition beginning in utero and through early childhood — often driven by food insecurity, repeated infections, and poor maternal nutrition. Wasting (weight-for-height below -2 SD) indicates acute, recent undernutrition and is a marker of immediate risk of mortality. Underweight (weight-for-age below -2 SD) is a composite indicator capturing both. Anaemia (haemoglobin below WHO thresholds) is tracked separately for children under 5 and women of reproductive age.

India accounts for a disproportionately large share of the global stunted and wasted child burden.
Stunting declines with long-run improvements in sanitation, maternal nutrition (POSHAN Abhiyaan), and breastfeeding; wasting responds faster to acute intervention (therapeutic foods, ORT).
Exclusive breastfeeding for the first six months is universally recognised as the most powerful intervention for infant nutrition — its decline in India is a regression on a key indicator.

Connection to this news: The NFHS-6 data shows Indian policy has been more effective at reducing stunting (long-term) than wasting (acute) — a pattern consistent with infrastructure improvements but insufficient acute nutrition response. The breastfeeding decline is an independent regression.

POSHAN Abhiyaan and India's Nutrition Policy Architecture

POSHAN Abhiyaan (National Nutrition Mission), launched in 2018, is the Government of India's flagship convergence programme targeting stunting, undernutrition, anaemia, and low birth weight through the Integrated Child Development Services (ICDS), Anganwadi system, health and sanitation convergence, and community-level mobilisation. The Mission set targets for 2022: a 2% annual reduction in stunting, 2% in undernutrition, 3% in anaemia, and 2% in low birth weight.

POSHAN 2.0 (2021) merged ICDS, POSHAN Abhiyaan, and the Scheme for Adolescent Girls into a unified nutrition framework.
Progress against POSHAN targets is tracked via the NFHS and the Rapid Reporting System.
The persistent high wasting rate suggests that interventions effective in reducing stunting may not be adequately addressing acute malnutrition, which requires different supply chains and protocols.

Connection to this news: NFHS-6 data serves as a mid-course assessment of POSHAN 2.0 — it shows the programme is producing results on stunting but falling short on wasting and reversing on breastfeeding, pointing to implementation gaps that require course correction.

Key Facts & Data

Stunting (children under 5): NFHS-5 — 35.5%; NFHS-6 — 29.3% (decline of 6.2 pp).
Severe wasting: NFHS-5 — 7.7%; NFHS-6 — 5.2%.
Wasting (overall): NFHS-6 — 19.0% (remains high).
Underweight: NFHS-5 — 32.1%; NFHS-6 — 31.8% (virtually unchanged).
Exclusive breastfeeding (0–6 months): NFHS-5 — 63.7%; NFHS-6 — 55.8% (concerning decline).
Institutional deliveries: NFHS-5 — 88.6%; NFHS-6 — 90.6%.
First trimester ANC registration: NFHS-5 — 70%; NFHS-6 — 76.2%.
Fully vaccinated children: NFHS-5 — 83.8%; NFHS-6 — 87.1%.
Rotavirus vaccine coverage: NFHS-5 — 36.4%; NFHS-6 — 85.4%.
Women with health insurance: NFHS-5 — 41%; NFHS-6 — 60.2%.
Women with internet access: NFHS-5 — 33.3%; NFHS-6 — 64.3%.
NFHS-6 covered: 6.7 lakh+ households, 715 districts, 2023–24.
Conducted by: IIPS Mumbai, under the Ministry of Health and Family Welfare.