The fifth edition of the National Family Health Survey, or NFHS, was released _recently_. This piece discusses some of the key findings from this survey and provides some historical context

to survey data. Specifically, we look at how things have changed in the various human development metrics measured by the NFHS under the current Modi regime and the previous UPA regime. But

first, some background. The Indian republic has always strived to be a welfare state, where the government plays an active, deliberate role in providing economic and social support to all

its citizens. Since independence, every regional and national political party has adhered to this vision, espousing intents to improve the lives of the millions that remain mired in poverty.

public welfare initiative is a key challenge. It is easy to monitor the inputs allocated to any effort. But there are no easy feedback mechanisms to gauge the outputs especially in welfare

domains such as food security, health, education, etc. The only way to close this loop is to undertake the arduous task of conducting extensive surveys and statistical analysis. In India,

one such effort of collecting systematic data from households across the country is the National Family Health Survey. The NFHS is a large-scale, multi-round survey conducted throughout

India. It measures a wide array of indicators related to health, nutrition, social issues, literacy, and access to public utilities – all measures of public wellbeing . The survey, which is

commissioned by the ministry of health and family welfare, MOHFW, was first conducted in 1992-93 and has since been administered four more times. As per the NFHS _website_, “each successive

round of the NFHS has had two specific goals: a) to provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and

programme purposes, and b) to provide information on important emerging health and family welfare issues.” To this end, the survey collects detailed information across a wide spectrum of

issues spanning health, education, and living conditions, providing a detailed dataset at a very granular level. To illustrate, the latest survey collected information on 131 key indicators

from 6,36,699 households, 7,24,115 women, and 1,01,839 men and provides district level data granularity. The last two surveys were conducted in 2004-05 and 2015-16. providing a rich dataset

to infer trends across and policy efficacy across various socio-economic dimensions – both at the state level and the national level. Either by coincidence or by design, the last three

survey timelines neatly align with regime changes at the national level. Changes in data between NFHS-3 (2004-05) and NFHS-4 (2014-15) can be broadly attributed to the United Progressive

Alliance government which was in power from 2004 to 2014. Similarly, changes in data between NFHS-4 (2014-15) and NFHS-5 (2019-21) can be attributed to policies instituted by the Modi-led

NDA government. Of course, all such sweeping inferences are prone to over simplification. But some broad observations and inferences can be drawn which are rooted in data, rather than pure

narrative. Keep in mind that although the timelines align with the UPA and NDA years, health and education, which are the primary realms being discussed, are state subjects. While the

central government often influences policy in these areas, both through the budgetary outlays and various central schemes, state governments and policies are more influential in determining

the final outcomes in each state. As such, the purpose of the comparisons between the UPA and NDA years is not to pin responsibility on either regime, but to get a broad sense of how things

have changed across these periods. Plus, comparing trends over time provides context to the latest data. As mentioned earlier, NFHS-5 collects information on 131 indicators. To keep this

analysis palatable, we track trends across 20 key indicators within the larger pool that can be grouped into five distinct dimensions: (1) standard of living (2) child nutrition (3) adult

nutrition (4) maternal and child health (5) basic literacy Note that most indicators chosen for this analysis are attributable to direct government intervention, unlike others on the survey

that may also be influenced by individual choices and societal attitudes (such as sex ratio, under-age marriage, family planning, etc). QUALITY OF LIFE NFHS collects information on basic

amenities available to a household which include access to clean drinking water, sanitation, electricity, and clean cooking fuel, all of which significantly affect one’s quality of life.

Figure 1 shows how we have fared on these metrics over the last three NFHS exercises. An additional indicator of access to health insurance is also included in this list.