Government of India Ministry of Health and Family Welfare ...

1 IndiaNational Family Health survey (NFHS-4)2015-16 International institute for Population SciencesDeonar, Mumbai 400 088 Ministry of Health and Family WelfareGovernment of IndiaNATIONAL Family Health survey (NFHS-4)2015-16 India DECEMBER 2017 Suggested citation: International institute for Population sciences (IIPS) and ICF. 2017. national Family Health survey (NFHS-4), 2015-16: India . Mumbai: IIPS. For additional information about the 2015-16 national Family Health survey (NFHS-4), please contact: International institute for Population sciences , Govandi Station Road, Deonar, Mumbai-400 088 Telephone: 022-4237 2442 Fax: 022-2556 3257 Email: For related information, visit or CONTRIBUTORSB alram SinghHemkhothang LhungdimChander ShekharFred ArnoldSunita KishorAbhishek SinghDhananjay W.

2 BansodManoj AlagarajanLaxmi Kant DwivediSarang PedgaonkarManas R. Pradhan Contents v CONTENTS TABLES AND FIGURES .. xi KEY MESSAGE FROM SECRETARY OF Ministry OF Health AND Family Welfare .. xxi FOREWORD .. xxiii PREFACE ..xxv )520 ',5(&725 6 '(6.. xxvii ACKNOWLEDGEMENTS .. xxix CHAPTER 1 INTRODUCTION .. 1 survey Objectives .. 1 Sample Design .. 1 Questionnaires .. 2 Biomarker Measurements and Tests .. 3 Pretest .. 6 Training of Field Staff .. 6 Fieldwork .. 6 Strategy to Ensure Data Quality .. 6 Data Processing .. 7 Response Rates .. 8 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS .. 13 Drinking Water Sources and Treatment.)

3 14 Sanitation .. 15 Exposure to Smoke inside the Home and Other Housing Characteristics .. 15 Exposure to Smoke inside the 15 Other Housing Characteristics .. 15 Household Wealth .. 16 Hand Washing .. 16 Household Population and Composition .. 17 Birth Registration .. 18 Children s Living Arrangements and Parental Survival .. 19 Schooling .. 19 Educational Attainment .. 19 School 20 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS .. 53 Basic Characteristics of survey Respondents .. 53 Schooling and Literacy .. 54 Mass Media Exposure .. 55 Employment .. 56 Occupation .. 56 Contents z v Contents vi CHAPTER 4 FERTILITY AND FERTILITY PREFERENCES.

4 79 Current Fertility .. 79 Children Ever Born and Living .. 81 Birth Order .. 81 Birth Intervals .. 81 Age at First Birth .. 82 Menstrual Protection .. 82 Teenage Childbearing .. 83 Desire for Another Child .. 84 Ideal Family Size .. 85 Fertility Planning Status .. 86 Wanted Fertility Rates .. 87 CHAPTER 5 Family Contraceptive Knowledge and Use ..111 Source of Modern Contraceptive Methods ..113 Informed Discontinuation of Contraceptives ..115 Exposure to Family Planning Messages ..115 Demand for Family Planning ..116 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY.

5 155 Marital Status ..155 Age at First Marriage ..156 Consanguineous Marriages ..157 Age at First Sexual Intercourse ..158 Recent Sexual Activity ..159 Insusceptibility to Pregnancy ..159 Pregnancy Outcomes ..160 Characteristics of Abortions ..161 CHAPTER 7 INFANT AND CHILD MORTALITY ..185 Infant and Child Biodemographic Risk Factors ..187 Perinatal Mortality ..188 CHAPTER 8 MATERNAL Health ..201 Pregnancy Registration ..202 Registration of Pregnancies ..202 Mother and Child Protection Card (MCP Card) ..202 Antenatal Care Coverage and Content ..202 Skilled Providers ..202 Timing and Number of ANC Visits.

6 203 Components of ANC Visits ..204 Protection against Neonatal Tetanus ..204 Ultrasound Testing during Pregnancy ..205 Delivery Services ..205 Institutional Deliveries ..205 Skilled Assistance during Delivery ..207 Delivery by Caesarean Section ..208 vi z Contents Contents vii Delivery Costs ..209 Postnatal Care ..209 Postnatal Health Check for Postnatal Health Checks for Newborns ..210 CHAPTER 9 CHILD Health ..251 Birth Weight ..252 Vaccination of Children ..252 Symptoms of Acute Respiratory Infection ..255 Fever ..256 Diarrhoeal Disease ..256 Prevalence of Diarrhoea ..256 Treatment of Diarrhoea ..257 Feeding Practices.

7 258 Knowledge of ORS Packets ..259 Disposal of Children s Stools ..259 Utilization of Integrated Child Development Services (ICDS) ..260 Utilization of ICDS by Pregnant and Lactating Mothers ..260 CHAPTER 10 NUTRITION AND ANAEMIA ..291 Nutritional Status of Children ..292 Nutritional Status among Young Children ..292 Levels of Child Malnutrition ..293 Infant and Young Child Feeding Practices ..294 Initiation of Breastfeeding ..294 Exclusive Breastfeeding ..295 Median Duration of Breastfeeding ..296 Complementary Feeding ..296 Minimum Acceptable Diet ..296 Anaemia Prevalence in Children ..298 Presence of Iodised Salt in Households ..299 Micronutrient Intake and Supplementation among Children ..299 Nutritional Status in Adults ..300 Anaemia Prevalence in Adults.

8 301 Food Consumption of Women and Men ..303 CHAPTER 11 MORBIDITY AND Health CARE ..343 Tuberculosis ..343 Prevalence of Tuberculosis ..343 Knowledge and Attitudes toward Tuberculosis ..344 Health Problems ..345 Use of Tobacco ..345 Consumption of Tobacco ..345 Quitting Tobacco ..346 Alcohol Use, Health Insurance, and Sources of Health Care ..347 Use of Alcohol ..347 Health Insurance Coverage ..347 Sources of Health Care ..348 Reasons for Not Using Government Health Care ..349 Recent Contact with Health Workers ..349 Problems in Accessing Health Care ..349 Contents z vii CHAPTER 12 OTHER ADULT Health ISSUES ..385 Coverage of Testing for Blood Pressure and Random Blood Glucose Measurements.

9 386 Blood Pressure ..386 Self Reports of Blood Pressure Measurement and Medication ..386 Blood Pressure Levels and Treatment Status ..386 Random Blood Glucose ..387 Health Examinations ..388 Age-Specific Death Rates and Crude Death Rates ..389 Adult CHAPTER 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR ..411 HIV/AIDS Knowledge, Transmission, and Prevention Methods ..412 Comprehensive Knowledge ..413 Knowledge about Mother-to-Child Transmission ..415 Accepting Attitudes toward People Living with HIV ..415 Attitudes toward Negotiating Sex with Husband ..416 Multiple Sexual Partners ..417 Paid Coverage of HIV Testing Services ..418 Awareness of HIV Testing Services and Experience with HIV Testing.

10 418 HIV Testing of Pregnant Women ..419 Self-Reporting of Sexually Transmitted Infections ..420 HIV/AIDS-related Knowledge and Behaviour among Young People ..421 Knowledge of HIV/AIDS ..421 First Sex ..421 Premarital Sex ..422 Multiple Sexual Partners ..422 Coverage of HIV Testing Services ..423 CHAPTER 14 HIV PREVALENCE ..473 Coverage Rates for HIV Testing ..474 HIV Prevalence ..475 HIV Prevalence by Age and Sex ..475 HIV Prevalence by Sexual Risk Behaviour and Prior HIV Testing ..477 HIV Prevalence among Couples ..478 HIV Prevalence among Young People ..478 CHAPTER 15 :20(1 6 (032:(50(17 ..507 Currently Married Women s and Men s Employment ..508 Control over Women s Earnings ..509 Control over Men s Earnings ..510 Participation in Household Decision Making.))))