Child health improves in NFHS-6 as surge in C-section births draws focus

The National Family Health Survey-6 (NFHS-6) points to a mixed picture in India’s public health landscape, with stronger maternal and child health indicators on one side and a steady climb in surgical deliveries on the other.

According to the survey, institutional deliveries rose to 90.6% in 2023-24 from 88.6% in 2019-21, bringing the country closer to near-universal coverage.

At the same time, caesarean section births increased from 21.5% to 27.2%, highlighting a trend that health officials and observers have repeatedly flagged in recent years.

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Rise in surgical births

The rise in surgical births was sharper in urban India than in rural areas.

NFHS-6 data show that 40.5% of deliveries in urban areas were through C-section, compared with 22.8% in rural areas. The gap was even wider across hospital types: private facilities reported C-sections in 54.1% of births, while public facilities recorded 16.9%.

The survey also showed that public health facilities saw their C-section rate rise from 14.3% earlier to 16.9% in the latest round, underlining that the increase was not limited to the private sector.

Child health indicators improve

Child-health indicators also improved in the survey.

Severe diarrhoea among children under five declined from 0.7% in NFHS-5 to 0.5% in NFHS-6.

Over the same period, full coverage of all three doses of the rotavirus vaccine among children aged 12 to 23 months rose sharply from 36.4% to 85.4%.

Rotavirus remains one of the leading causes of severe diarrhoea and dehydration in young children, making the vaccination increase a notable public-health gain.

Many hands behind the progress

The Ministry of Health attributed the improvement to coordinated work under the National Health Mission, including the Universal Immunisation Programme and the STOP Diarrhoea Campaign.

Frontline workers such as ASHAs, ANMs and Anganwadi Workers have been promoting ORS, zinc supplementation, breastfeeding, handwashing, nutrition awareness and early treatment-seeking behaviour.

“These sustained awareness and outreach activities have strengthened community-level management of diarrhoea, particularly in rural and underserved regions,” the ministry said.

It also linked the trend to improved access to safe drinking water under the Jal Jeevan Mission, with rural tap-water coverage rising from 17% in 2019 to 81%, reaching 15.85 crore households and more than 5.91 lakh villages.

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Encouraging gains, unfinished business

The combined effect of vaccination, sanitation, hygiene promotion, nutrition and safe drinking water was helping bring down under-five mortality, which had fallen from 45 per 1,000 live births in 2014 to 28 per 1,000 in 2024.

The NFHS-6 findings show measurable gains in child health even as the rise in C-sections leaves a separate policy challenge for the health system.