The first NFHS was conducted in 1992-93 and covered all states except Sikkim. NFHS-2 was conducted in 1998-99 in all states with similar content and methods to those in NFHS-1. In addition, NFHS-2 provided information on reproductive health, women’s autonomy, and domestic violence, women’s and children’s nutrition, anaemia, and salt iodization. NFHS-3 built on the strengths and successes of NFHS-1 and NFHS-2 by maintaining continuity in content and methods with an additional component of community-based HIV testing in the country. It also included a men’s interview for the first time. With additional components of CAB (clinical, anthropometric, and biochemical testing), NFHS-4 has contents similar to NFHS-3, maintaining the continuity and comparability in information. However, NFHS-4 provided information at the district level through increasing the sample size by nearly fivefold as compared with NFHS 3. NFHS-4 used a modular approach, where the last four sections of woman’s questionnaire, interviews with men, and HIV testing were done only for the households included in the state module, and the information is provided only at the state level for those indicators.
Like NFHS-4, NFHS-5 also provides district-level estimates for many important indicators. The contents of NFHS-5 are similar to NFHS-4 to allow comparisons over time. However, NFHS-5 includes some new topics, such as preschool education, disability, access to a toilet facility, death registration, bathing practices during menstruation, and methods and reasons for abortion. The scope of clinical, anthropometric, and biochemical testing (CAB) has also been expanded to include measurement of waist and hip circumferences, and the age range for the measurement of blood pressure and blood glucose has been expanded. However, HIV testing was not included in NFHS-5. The NFHS-5 sample was designed to provide national, state/union territory (UT), and district level estimates of various indicators covered in the survey. However, estimates of indicators of sexual behaviour; husband’s background and woman’s work; HIV/AIDS knowledge, attitudes, and behaviour; and domestic violence are available only at the state/union territory (UT) and national level.
The National Family Health Survey 2019-21 (NFHS-5), the fifth in the NFHS series, provides information on population, health, and nutrition for India, each state/union territory (UT), and for 707 districts.
The primary objective of the 2019-21 round of National Family Health Surveys is to provide essential data on health and family welfare, as well as data on emerging issues in these areas, such as levels of fertility, infant and child mortality, maternal and child health, and other health and family welfare indicators by background characteristics at the national and state levels. Similar to NFHS-4, NFHS-5 also provides information on several emerging issues including perinatal mortality, high-risk sexual behaviour, safe injections, tuberculosis, noncommunicable diseases, and the use of emergency contraception.
The information collected through NFHS-5 is intended to assist policymakers and programme managers in setting benchmarks and examining progress over time in India’s health sector. Besides providing evidence on the effectiveness of ongoing programmes, NFHS-5 data will help to identify the need for new programmes in specific health areas.
The clinical, anthropometric, and biochemical (CAB) component of NFHS-5 is designed to provide vital estimates of the prevalence of malnutrition, anaemia, hypertension, high blood glucose levels, and waist and hip circumference, Vitamin D3, HbA1c, and malaria parasites through a series of biomarker tests and measurements.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
- Children age 0-5
- Woman age 15-49
- Man age 15 to 54
The data dictionary was generated from hierarchical data that was downloaded from the The DHS Program website (http://dhsprogram.com).
The 2019-21 India National Family Survey covered the following topics:
- Household: socioeconomic characteristics; water, sanitation, and hygiene; water treatment; type of toilet facilities; type of cooking fuel; materials used for the floor, roof, and walls of the dwelling unit; ownership of various durable goods; health insurance coverage; land ownership; number of deaths in the household in the two years preceding the survey; and the ownership and use of mosquito nets.
- Woman: age, literacy, schooling, religion, caste/tribe, media exposure; children ever born, birth history, current pregnancy, pregnancy terminations; prevalence of hysterectomy; menstrual hygiene (for women age 15-24 years); knowledge and use of contraception, sources of contraceptive methods, information on family planning; contacts with community health workers; maternal and child health, breastfeeding, and nutrition; marriage and sexual activity; fertility preferences; husband’s background and woman’s work; women’s empowerment; HIV/AIDS; other health issues; and domestic violence.
- Man: man’s characteristics, media exposure, marriage, employment, presence at antenatal care visits, number of children, contraceptive knowledge and use, fertility preferences, nutrition, sexual behaviour, attitudes toward gender roles, HIV/AIDS, health issues, attitudes towards gender roles, tobacco and alcohol use, knowledge of tuberculosis, current morbidity (diabetes, asthma, goitre and other thyroid diseases, heart disease, cancer), and household decision making.
- Biomarker: measurements of height, weight, and haemoglobin levels for children; measurements of height, weight, waist and hip circumference, and haemoglobin levels for women age 15-49 years and men age 15-54 years; and blood pressure and random blood glucose levels for women and men age 15 years and over.
The survey covered all de jure household members (usual residents), all women aged 15-49, all men age 15-54, and all children aged 0-5 resident in the household.
Producers and sponsors
Ministry of Health and Family Welfare (MoHFW)
Government of India
International Institute for Population Sciences (IIPS)
Provided technical assistance through the Demographic and Health Surveys (DHS) Program
Indian Council of Medical Research
Provided assistance in collecting Dried Blood Sample (DBS)
National AIDS Research Institute
Provided assistance in collecting Dried Blood Sample (DBS)
Government of India
Funding the study
United States Agency for International Development
Funding the study
A uniform sample design, which is representative at the national, state/union territory, and district level, was adopted in each round of the survey. Each district is stratified into urban and rural areas. Each rural stratum is sub-stratified into smaller substrata which are created considering the village population and the percentage of the population belonging to scheduled castes and scheduled tribes (SC/ST). Within each explicit rural sampling stratum, a sample of villages was selected as Primary Sampling Units (PSUs); before the PSU selection, PSUs were sorted according to the literacy rate of women age 6+ years. Within each urban sampling stratum, a sample of Census Enumeration Blocks (CEBs) was selected as PSUs. Before the PSU selection, PSUs were sorted according to the percentage of SC/ST population. In the second stage of selection, a fixed number of 22 households per cluster was selected with an equal probability systematic selection from a newly created list of households in the selected PSUs. The list of households was created as a result of the mapping and household listing operation conducted in each selected PSU before the household selection in the second stage. In all, 30,456 Primary Sampling Units (PSUs) were selected across the country in NFHS-5 drawn from 707 districts as on March 31st 2017, of which fieldwork was completed in 30,198 PSUs.
For further details on sample design, see Section 1.2 of the final report.
A total of 664,972 households were selected for the sample, of which 653,144 were occupied. Among the occupied households, 636,699 were successfully interviewed, for a response rate of 98 percent.
In the interviewed households, 747,176 eligible women age 15-49 were identified for individual women’s interviews. Interviews were completed with 724,115 women, for a response rate of 97 percent. In all, there were 111,179 eligible men age 15-54 in households selected for the state module. Interviews were completed with 101,839 men, for a response rate of 92 percent.
Dates of Data Collection
Data Collection Mode
Computer Assisted Personal Interview [capi]
The field supervisor was responsible for the overall management of the field teams. In addition, the field supervisor conducted spot-checks to verify the accuracy of key information, particularly with respect to the eligibility of respondents. IIPS also appointed one or more project officers or senior project officers in each state for monitoring and supervision throughout the training and fieldwork period to ensure that correct survey procedures were followed and that data quality was maintained. Project directors and other senior staff from the Field Agencies, the Principal Investigators from IIPS, officials from MoHFW, and technical consultants from The DHS Program at ICF also visited the field sites to monitor data collection operations.
Data Collection Notes
Training was conducted in a tiered fashion. For each of the two fieldwork phases, a Training of Trainers (ToT) course was conducted by IIPS, Mumbai, and ICF. The ToT for the 19 states and union territories (UTs) included in the first phase was conducted in Goa from 22 April to 12 May, 2019. The ToT for the remaining 17 states and UTs was conducted from October 5-24, 2019 in Chandigarh. The trainees in both ToT workshops included project coordinators, health coordinators, statisticians/demographers, and information technology coordinators from the Field Agencies, and Project Officers/Senior Project Officers from IIPS. The coordinators from Field Agencies were responsible for training fieldworkers at the state/UT level.
NFHS-5 fieldwork for India was conducted in two phases (phase one from 17 June 2019 to 30 January 2020 and phase two from 2 January 2020 to 30 April 2021) by 17 Field Agencies. NFHS-5 gathered information from 636,699 households, 724,115 women, and 101,839 men. Data collection was conducted by using 1,061 field teams. Each team consisted of one field supervisor, three female interviewers, one male interviewer, two health investigators, and a driver. The number of interviewing teams in each state varied according to the sample size. In each state, interviewers were hired by the selected Field Agencies, taking into consideration their educational background, experience, and other relevant qualifications. Female and male interviewers were assigned to interview respondents of the same sex. The assignment of Primary Sampling Units (PSUs) to the teams and various logistical decisions were made by the survey coordinators from each Field Agency. Each interviewer was required to make a minimum of three callbacks if no suitable informant was available for the household interview or if an eligible woman or man in the household was not present at the time of the interviewer’s visit.
International Institute for Population Sciences
Four survey schedules/questionnaires: Household, Woman, Man, and Biomarker were canvassed in 18 local languages using Computer Assisted Personal Interviewing (CAPI).
Electronic data collected in the 2019-21 National Family Health Survey were received on a daily basis via the SyncCloud system at the International Institute for Population Sciences, where the data were stored on a password-protected computer. Secondary editing of the data, which required resolution of computer-identified inconsistencies and coding of open-ended questions, was conducted in the field by the Field Agencies and at the Field Agencies central office, and IIPS checked the secondary edits before the dataset was finalized.
Field-check tables were produced by IIPS and the Field Agencies on a regular basis to identify certain types of errors that might have occurred in eliciting information and recording question responses. Information from the field-check tables on the performance of each fieldwork team and individual investigator was promptly shared with the Field Agencies during the fieldwork so that the performance of the teams could be improved, if required.
Information about The DHS Program
The DHS Program
The DHS Program
Data and Data Related Resources
The DHS Program
Request Dataset Access
The following applies to DHS, MIS, AIS and SPA survey datasets (Surveys, GPS, and HIV).
To request dataset access, you must first be a registered user of the website. You must then create a new research project request. The request must include a project title and a description of the analysis you propose to perform with the data.
The requested data should only be used for the purpose of the research or study. To request the same or different data for another purpose, a new research project request should be submitted. The DHS Program will normally review all data requests within 24 hours (Monday - Friday) and provide notification if access has been granted or additional project information is needed before access can be granted.
DATASET ACCESS APPROVAL PROCESS
Access to DHS, MIS, AIS and SPA survey datasets (Surveys, HIV, and GPS) is requested and granted by country. This means that when approved, full access is granted to all unrestricted survey datasets for that country. Access to HIV and GIS datasets requires an online acknowledgment of the conditions of use.
A dataset request must include contact information, a research project title, and a description of the analysis you propose to perform with the data.
A few datasets are restricted and these are noted. Access to restricted datasets is requested online as with other datasets. An additional consent form is required for some datasets, and the form will be emailed to you upon authorization of your account. For other restricted surveys, permission must be granted by the appropriate implementing organizations, before The DHS Program can grant access. You will be emailed the information for contacting the implementing organizations. A few restricted surveys are authorized directly within The DHS Program, upon receipt of an email request.
When The DHS Program receives authorization from the appropriate organizations, the user will be contacted, and the datasets made available by secure FTP.
GPS/HIV Datasets/Other Biomarkers
Once downloaded, the datasets must not be passed on to other researchers without the written consent of The DHS Program. All reports and publications based on the requested data must be sent to The DHS Program Data Archive in a Portable Document Format (pdf) or a printed hard copy.
Datasets are made available for download by survey. You will be presented with a list of surveys for which you have been granted dataset access. After selecting a survey, a list of all available datasets for that survey will be displayed, including all survey, GPS, and HIV data files. However, only data types for which you have been granted access will be accessible. To download, simply click on the files that you wish to download and a "File Download" prompt will guide you through the remaining steps.
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
DDI Document ID
Development Economics Data Group
The World Bank
Documentation of the DDI
Date of Metadata Production
DDI Document version
Version 01 (May 2022). Metadata is excerpted from "India National Family Survey 2019-21" Report.