Home/People/Evescorner/Article

Indian Women - Development Challenges

• In India, almost twice as many girls die before the age of five than boys 
• 40 percent of India's women are literate compared to 64 percent of males 
• 43 percent of Indian girls attend primary school compared to 62 percent of boys 
• There are only 93 women for every 100 men in India

Women are the most disadvantaged members of the Indian population and comprise the largest portion living in absolute poverty. This status is reflected in indicators such as low literacy rate, a significant gender gap in primary education, high prevalence of a number of forms of violence against women, and lack of access to financial resources. India's most recent census (1991) indicate that there are 927 females for every 1000 males, and a 1992-93 study of literacy identifies literacy rates as 43 percent for females and 69 percent for males. Worsening environmental conditions and the absence of basic services, also deprive women access to healthy and productive lives. 


National Survey Provides "Progress Report" on Population and Health 

NEW DELHI, November 16, 2000: How is India faring in population and health? In a major initiative to provide much-needed information to decision makers and program managers, the second National Family Health Survey (NFHS-2) report was formally released during a seminar today in Delhi. "The survey results reveal what progress has been made as well as what challenges remain ahead," noted Dr. T.K. Roy, Director of the International Institute for Population Sciences, which coordinated the survey. Mr. K.C. Pant, Deputy Chairman of the Planning Commission opened the seminar, and Dr. C.P. Thakur, Union Minister of Health and Family Welfare, chaired the inaugural session. Walter North, Director of the U.S. Agency for International Development (USAID), which funded the survey with supplementary support from UNICEF, and Mr. A.R. Nanda, Secretary of Health and Family Welfare, also shared the dias.

Nearly Half of Young Children are Malnourished

Malnutrition continues to be widespread in India, with 47 percent of young children underweight, according to the results of NFHS-2. The level of child undernutrition has decreased only slightly since the early 1990s, from 52 to 47 percent. 
"Improving child nutrition is necessary to safeguard the well-being of future generations," noted Dr. Roy. "Some improvements could be realized by promoting better infant feeding practices. The NFHS-2 shows that two out of three infants are not given solid or mushy food - which should be introduced at six months - until they are much older. By this time, many infants are already malnourished."

One in Six Women has an Unmet Need for Family Planning

NFHS-2 also reports that one in six women has a need for family planning that has not been met by current programmes. By satisfying this demand, the rate of contraception use in India would rise from 48 percent to 64 percent, a level found in countries with low fertility rates. 
"Although contraceptive use is rising, many couples are still in need of family planning," said Dr. Roy. "The survey results show that efforts to provide family planning need to be intensified so that couples can have the number of children they desire."

A Comprehensive Health and Demographic Database 

NFHS-2 is the second in a series of comprehensive surveys on population, health and nutrition among women and children in India. The first survey (NFHS-1), conducted in 1992-93, was a landmark in the development of a comprehensive demographic and health database for India. NFHS-2, based on interviews with a nationally representative selection of 90,000 women, further expands the database, including additional information on postpartum care, the quality of health and family planning services, reproductive health problems, and domestic violence. The survey also tested haemoglobin levels in the blood of women and young children and tested household cooking salt to see if the salt was iodized. 

The International Institute for Population Sciences (IIPS) in Mumbai served as the nodal agency for both the NFHS-1 and NFHS-2. ORC Macro and the East-West Center provided technical guidance. Five Population Research Centres and eight survey research companies collected data for the NFHS-2 from November 1998 to December 1999. Interviews were conducted with household members and women age 15 to 49 who are or have been married. Extensively trained personnel conducted the interviews in 17 different languages. 

Other Key Findings

Nutrition

The level of child undernutrition ranges from 21 percent in Sikkim to 55 percent in Madhya Pradesh. More than one-third of women are undernourished and, at the same time, obesity in women is becoming a substantial problem, particularly in cities.

Anaemia

Anaemia is also common in India. Overall, 74 percent of Indian children are anaemic, with even higher rates in major states such as Haryana (84 percent), Rajasthan (82 percent), and Bihar (81 percent). Half of women are anaemic.

Contraceptive use

Nearly half - 48 percent - of women use contraception, up from 41 percent at the time of NFHS-1. Three out of four users rely on sterilization, overwhelmingly female sterilization. Despite women's expressed desire to space their children, only 3 percent of women use the condom and 2 percent each use the pill or IUD. Contraceptive use is lowest in Meghalaya (20 percent), Bihar (25 percent), and Uttar Pradesh (28 percent). It is highest in Himachal Pradesh (68 percent), Punjab (67 percent), and West Bengal (67 percent).

Safe motherhood

Only 44 percent of mothers receive three or more antenatal check-ups as recommended, almost unchanged from NFHS-1. Among those not receiving check-ups, most believe they are not necessary. But there has been an increase in the proportion receiving two or more doses of tetanus toxoid vaccine (55 to 67 percent) and iron and folic acid supplementation (52 to 58 percent) during pregnancy.

Childhood immunization

While strides have been made in programmes to immunize children, only 42 percent of children ages 12-23 months have received all recommended childhood vaccinations. This is up from 36 percent at the time of NFHS-1. Only 14 percent of children have not received any vaccinations at all, a notable improvement over 30 percent in NFHS-1. The largest increases in immunization coverage have been for polio vaccinations, undoubtedly due to the success of the Pulse Polio Immunization Campaigns, but 37 percent of young children had still not received the recommended three doses by the time of the survey.

Childhood mortality

One in every 11 children in India dies before reaching age 5. Childhood mortality is particularly high for children born less than two years after a previous birth, indicating that children would have a much better chance of surviving if births were spaced further apart. Continuing discrimination against girls in health care and other areas is evidenced by the fact that at ages 1-4, girls have almost a 50 percent higher chance of dying than do boys.

AIDS awareness

Awareness of AIDS among women has increased since NFHS-1, but it is still quite low--40 percent nationwide. One-third of women who have heard of AIDS do not know any way to avoid it. Awareness is lowest in Bihar (12 percent), Uttar Pradesh (20 percent), Rajasthan (21 percent), and Madhya Pradesh (24 percent). It is estimated that at least 3.5 million people in India now suffer from AIDS.

Education

School attendance for children age 6-14 is up sharply from 68 percent in NFHS-1 to 79 percent in NFHS-2. Girls are less likely than boys to go to school, but the gap has been closing over time.