The release of the National Family Health Survey-6 (NFHS-6) fact sheets has been accompanied by considerable attention from policymakers, researchers, and the media. As India's most important source of information on health, nutrition, fertility, and family welfare, the NFHS occupies a central place in the country's development discourse. Its findings influence public policy, shape welfare interventions, guide academic research, and provide citizens with a means of assessing the state's developmental claims.
For more than three decades, the NFHS has functioned as far more than a statistical exercise; it has served as a crucial instrument for understanding the changing social realities of India. Successive rounds of the survey have documented improvements in maternal health, child survival, sanitation, and healthcare access, while simultaneously exposing persistent challenges such as malnutrition, anaemia, gender disparities, and unequal access to public services.
The NFHS-6 fact sheets indicate improvements in several indicators relating to maternal healthcare, immunisation, child nutrition, institutional deliveries, and digital access. These findings have been widely interpreted as evidence of developmental progress and expanding access to welfare services. However, development is not simply a matter of aggregate improvement. National averages often conceal significant disparities across regions, social groups, and economic categories. A decline in child malnutrition at the national level, for example, does not necessarily mean that all communities have benefited equally. Likewise, improvements in healthcare utilisation do not automatically reveal who continues to face barriers in accessing quality healthcare. This is particularly important in a society marked by deep inequalities. The question, therefore, is not simply whether certain indicators have improved, but whether the available data allow us to understand who is benefiting and who remains excluded.
One of the defining strengths of the NFHS has always been its ability to facilitate comparison across time. Researchers have relied upon successive rounds to track changes over several decades. In this sense, the NFHS performs a democratic function by providing a common empirical framework through which developmental claims can be assessed and debated. Any change that affects the comparability of the survey, therefore, deserves scrutiny.
The most significant aspect surrounding NFHS-6 concerns the reduction in the number of indicators reported in the currently released fact sheets. The number of indicators has declined from 131 in NFHS-5 to 101 in NFHS-6, prompting concerns among researchers and public health experts. Among the indicators absent from the current fact sheets are data relating to anaemia prevalence, sex ratio at birth, infant and child mortality, sanitation access, clean cooking fuel usage, HIV awareness, cancer screening, and several reproductive and adolescent health measures. These are not marginal indicators; historically, they have been among the most important measures used to assess health outcomes, nutritional deprivation, gender inequality, and access to basic services. Government officials have clarified that the fact sheets do not constitute the final national report and that some indicators may be released through subsequent reports or specialised databases.
The debate surrounding NFHS-6 ultimately raises broader questions about the relationship between data and accountability. Statistics play a powerful role in shaping public discourse, influencing what governments prioritise, what researchers study, and what citizens discuss. Issues measured consistently tend to remain visible within policy debates. Conversely, issues that become less visible within official statistics often receive less sustained attention. Earlier rounds of the NFHS revealed alarmingly high levels of anaemia among women and children, triggering widespread concern. The absence of comparable anaemia estimates from the current fact sheets makes it more difficult to evaluate whether interventions aimed at addressing nutritional deficiencies have produced meaningful improvements. Similar concerns arise with respect to infant and child mortality indicators, sanitation measures, and access to clean cooking fuel. The concern is not that these issues have disappeared, but that the ability to monitor them through one of the country's most important surveys has become more limited.
The implications of missing indicators are particularly significant for communities that have historically experienced social and economic marginalisation. Previous rounds of the NFHS consistently demonstrated that malnutrition, anaemia, inadequate sanitation, and limited access to healthcare were disproportionately concentrated among poorer households, Dalits, Adivasis, and other socially disadvantaged groups. Such findings were important because they challenged the assumption that national progress benefits all sections of society equally. They highlighted the uneven distribution of development and drew attention to the structural inequalities that continue to shape life chances in contemporary India.
National averages, by their very nature, tend to flatten social differences. Detailed indicators are therefore essential for understanding how caste, class, gender, and geography continue to shape well-being. For historically marginalised communities, visibility within official statistics is not merely symbolic; it is a prerequisite for policy recognition. Data provides evidence of deprivation, justifies targeted interventions, and enables inequalities to be tracked over time. When indicators associated with deprivation become less visible, assessing whether developmental gains have reached those at the margins also becomes more difficult.
(Akhilesh is a PhD Research Scholar at Jamia Millia Islamia, New Delhi, and an Ambedkarite activist)