The 2019-20 National Family Health Survey (NFHS-5), the fifth in the NFHS series, provides information on population, health, and nutrition for India and each state and union territory. Like NFHS-4, NFHS-5 also provides district-level estimates for many important indicators. All five NFHS surveys have been conducted under the stewardship of the Ministry of Health and Family Welfare (MoHFW), Government of India. MoHFW designated the International Institute for Population Sciences (IIPS), Mumbai, as the nodal agency for the surveys. Funding for NFHS-5 was provided by the Government of India. Technical assistance and additional funding for NFHS-5 was provided by the USAID-supported Demographic and Health Surveys Program, ICF, USA. Assistance for some of the Clinical, Anthropometric, and Biochemical (CAB) tests was provided by the ICMR and the National AIDS Research Institute (NARI), Pune.

Four survey questionnaires—household, woman’s, man’s, and biomarker–were used to collect information in 19 languages using Computer Assisted Personal Interviewing (CAPI). All women age 15-49 and men age 15-54 in the selected sample households were eligible for interviewing. In the household questionnaire, basic information was collected on all usual members of the household and visitors who stayed in the household the previous night, as well as socioeconomic characteristics of the household, water and sanitation, health insurance, and number of deaths in the household in the three years preceding the survey. Two versions of the woman’s questionnaire were used in NFHS-5. The first version (district module), which collected information on women’s characteristics, marriage, fertility, contraception, reproductive health, children’s immunizations, treatment of childhood illnesses, and nutrition was fielded in the entire sample of NFHS-5 households. Information on these topics is available at the district, state, and national levels. In the second version of the questionnaire (state module), four additional topics, namely, sexual behaviour, HIV/AIDS, husband’s background and women’s work, and domestic violence, were also included. This version was fielded in a subsample of NFHS-5 households designed to provide information only at the state and national levels. The man’s questionnaire covered the man’s characteristics, marriage, number of children, contraception, fertility preferences, nutrition, sexual behaviour, attitudes towards gender roles, HIV/AIDS, and lifestyle. The biomarker questionnaire covered measurements of height, weight, and haemoglobin levels for children; height, weight, waist and hip circumference, haemoglobin levels, and finger-stick blood for additional CAB testing in a laboratory for women age 15-49 and men age 15-54; and blood pressure and random blood glucose for women and men age 15 years and over. Questionnaire information and biomarkers were collected only with informed consent from the respondents.

The NFHS-5 sample was designed to provide estimates of all key indicators at the national and state levels, as well as estimates for most key indicators at the district level (for all 707 districts in India, as on 31 March, 2017). The total sample size of approximately 610,000 households for India was based on the size needed to produce reliable indicator estimates for each district. The rural sample was selected through a two-stage sample design with villages as the Primary Sampling Units (PSUs) at the first stage (selected with probability proportional to size), followed by a random selection of 22 households in each PSU at the second stage. In urban areas, there 2 was also a two-stage sample design with Census Enumeration Blocks (CEB) selected at the first stage and a random selection of 22 households in each CEB at the second stage. At the second stage in both urban and rural areas, households were selected after conducting a complete mapping and household listing operation in the selected first-stage units.

The estimates presented in the NFHS-5 National Report may be considered as final.