CENTRE OF EXCELLENCE IN

NUTRITION

COMPARATIVE ANALYSIS OF KEY INDICATORS

OF NFHS DATA FOR I.C.D.S. REGION - SURAT

S O U R C E - N H F S 4 & 5 D ATA

Vijay Rajput
Regional Coordinator
Centre of excellence in
Nutrition,
Surat Region.
LIST OF INDICATORS
A. Maternal and Child Health
1. Mothers who had antenatal check-up in the first trimester (%).
2. Mothers who had at least 4 antenatal care visits (%)
3. Mothers whose last birth was protected against neonatal tetanus (%)
4. Mothers who consumed iron folic acid for 100 days or more when they were
pregnant (%)
5. Mothers who consumed iron folic acid for 180 days or more when they were
pregnant (%)

B. Child Vaccinations and Vitamin A Supplementation

6. Children age 12-23 months fully vaccinated based on information from either
vaccination card or mother's recall (%)
• Source – NHFS 4 & 5 Data
LIST OF INDICATORS
C. Child Feeding Practices and Nutritional Status of Children
7. Children under age 3 years breastfed within one hour of birth (%)
8. Children under age 6 months exclusively breastfed (%)
9. Children age 6-8 months receiving solid or semi-solid food and breastmilk (%)
10. Breastfeeding children age 6-23 months receiving an adequate diet (%)
11. Non-breastfeeding children age 6-23 months receiving an adequate diet (%)
12. Total children age 6-23 months receiving an adequate diet (%)
13. Children under 5 years who are stunted (height-for-age) (%)
14. Children under 5 years who are wasted (weight-for-height) (%)
15. Children under 5 years who are severely wasted (weight-for-height) (%)
16. Children under 5 years who are underweight (weight-for-age) (%)
• Source – NHFS 4 & 5 Data
LIST OF INDICATORS
D. Nutritional Status of Adults (age 15-49 years)
17. Women whose Body Mass Index (BMI) is below normal (BMI < 18.5 kg/m2 ) (%)

E. Anaemia among Children and Adults

18. Children age 6-59 months who are anaemic (<11.0 g/dl) (%)
19. Non-pregnant women age 15-49 years who are anaemic (<12.0 g/dl) (%)
20. Pregnant women age 15-49 years who are anaemic (<11.0 g/dl) (%)
21. All women age 15-49 years who are anaemic (%)
22. All women age 15-19 years who are anaemic (%)

• Source – NHFS 4 & 5 Data

PART A

MATERNAL AND CHILD HEALTH

1. Mothers who had antenatal check-up in the first trimester (%).

2. Mothers who had at least 4 antenatal care visits (%)
3. Mothers whose last birth was protected against neonatal tetanus (%)
4. Mothers who consumed iron folic acid for 100 days or more when they were
pregnant (%)
5. Mothers who consumed iron folic acid for 180 days or more when they were
pregnant (%)
 1. MOTHERS WHO HAD ANTENATAL
CHECK-UP IN THE FIRST TRIMESTER (%)
70
India
58.6

79.3
Gujarat
73.8

63.4
Bharuch
83.4

81.7
Narmada
75.4

83.2
Tapi
67.1

92.2
Surat
68.9

93.4
Navsari
87.2

86.4
Dang
58

88.3
Valsad
68.9
0 10 20 30 40 50 60 70 80 90 100

NFHS 5 NFHS 4 NFHS 5

 2. MOTHERS WHO HAD AT LEAST 4
ANTENATAL CARE VISITS (%)
58.1
India
51.2

76.9
Gujarat
70.5

65.7
Bharuch
86.4

83.4
Narmada
70.3

91
Tapi
74.5

93.4
Surat
71.6

94.7
Navsari
91.9

90.2
Dang
47.6

92.5
Valsad
55
0 10 20 30 40 50 60 70 80 90 100

NFHS 5 NFHS 4
 3. MOTHERS WHOSE LAST BIRTH WAS PROTECTED
AGAINST NEONATAL TETANUS (%)
92
India
89

89.1
Gujarat
86.6

84.5
Bharuch
84.4

94.3
Narmada
80.2

94.2
Tapi
94.8

95.3
Surat
89

97.6
Navsari
89.5

96.8
Dang
89

97.5
Valsad
78.3
0 20 40 60 80 100 120

NFHS 5 NFHS 4
 4. MOTHERS WHO CONSUMED IRON FOLIC ACID FOR
100 DAYS OR MORE WHEN THEY WERE PREGNANT (%)
44.1
India
30.3

60
Gujarat
36.8

38.4
Bharuch
51.3

65.1
Narmada
45.2

73.6
Tapi
42.8

73.1
Surat
35.5

79.1
Navsari
58.5

78.9
Dang
38.8

76.5
Valsad
39.9
0 10 20 30 40 50 60 70 80 90

NFHS 5 NFHS 4
 5. MOTHERS WHO CONSUMED IRON FOLIC ACID FOR
180 DAYS OR MORE WHEN THEY WERE PREGNANT (%)

26
India
14.4

43.2
Gujarat
18.5

21
Bharuch
27.9

48.4
Narmada
28.3

51.6
Tapi
18.9

52.7
Surat
14.3

67
Navsari
40.1

56.6
Dang
13.5

59.1
Valsad
23.3
0 10 20 30 40 50 60 70 80

NFHS 5 NFHS 4
PART B

Child Vaccinations and Vitamin A

Supplementation

6. Children age 12-23 months fully vaccinated based on information from either
vaccination card or mother's recall (%)
 6. CHILDREN AGE 12-23 MONTHS FULLY VACCINATED
BASED ON INFORMATION FROM EITHER VACCINATION
CARD OR MOTHER'S RECALL (%)
76.4
India
62

76.3
Gujarat
50.4

80
Bharuch
56.9

82.8
Narmada
69.3

97.5
Tapi
72.9

92.8
Surat
48

95
Navsari
78.5

91.3
Dang
44.3

91.1
Valsad
52.9
0 20 40 60 80 100 120

NFHS 5 NFHS 4
PART C
Child Feeding Practices and Nutritional Status of
Children
7. Children under age 3 years breastfed within one hour of birth (%)
8. Children under age 6 months exclusively breastfed (%)
9. Children age 6-8 months receiving solid or semi-solid food and breastmilk (%)
10. Breastfeeding children age 6-23 months receiving an adequate diet (%)
11. Non-breastfeeding children age 6-23 months receiving an adequate diet (%)
12. Total children age 6-23 months receiving an adequate diet (%)
13. Children under 5 years who are stunted (height-for-age) (%)
14. Children under 5 years who are wasted (weight-for-height) (%)
15. Children under 5 years who are severely wasted (weight-for-height) (%)
16. Children under 5 years who are underweight (weight-for-age) (%)
 7. CHILDREN UNDER AGE 3 YEARS
BREASTFED WITHIN ONE HOUR OF BIRTH (%)
41.8
India
41.6

37.8
Gujarat
49.9

30.7
Bharuch
67.6

30.6
Narmada
51.5

46.8
Tapi
35.9

44.1
Surat
46

17
Navsari
58.2

37.5
Dang
42.3

29.1
Valsad
68.9
0 10 20 30 40 50 60 70 80

NFHS 5 NFHS 4
 8. CHILDREN UNDER AGE 6 MONTHS
EXCLUSIVELY BREASTFED (%)
63.7
India
54.9

65
Gujarat
55.8

Bharuch

74.2
Narmada
62.2

Tapi

Surat

Navsari

76.2
Dang
80.5

49.9
Valsad

0 10 20 30 40 50 60 70 80 90

NFHS 5 NFHS 4
 9. CHILDREN AGE 6-8 MONTHS RECEIVING SOLID
OR SEMI-SOLID FOOD AND BREASTMILK (%)
45.9
India
42.7

42
Gujarat
49.4

Bharuch

Narmada
29.6

Tapi

Surat

Navsari

Dang

Valsad

0 10 20 30 40 50 60

NFHS 5 NFHS 4
 10. BREASTFEEDING CHILDREN AGE 6-23
MONTHS RECEIVING AN ADEQUATE DIET (%)
11.1
India
8.7

5.9
Gujarat
5.8

8.8
Bharuch
8.3

4.3
Narmada
4.3

4
Tapi
7.4

1.9
Surat
0

0
Navsari
4.2

14.7
Dang
2

14.5
Valsad
5
0 2 4 6 8 10 12 14 16

NFHS 5 NFHS 4
 11. NON-BREASTFEEDING CHILDREN AGE 6-23
MONTHS RECEIVING AN ADEQUATE DIET (%)
12.7
India
14.3

6
Gujarat
2.8

Bharuch

Narmada

Tapi

Surat

Navsari

Dang

Valsad

0 2 4 6 8 10 12 14 16

NFHS 5 NFHS 4
 12. TOTAL CHILDREN AGE 6-23 MONTHS
RECEIVING AN ADEQUATE DIET (%)
11.3
India
9.6

5.9
Gujarat
5.2

7.7
Bharuch
11.5

4.1
Narmada
4.9

6.7
Tapi
9.4

3.2
Surat
0

0
Navsari
3.4

16.5
Dang
1.9

16
Valsad
8.3
0 2 4 6 8 10 12 14 16 18

NFHS 5 NFHS 4
 13. CHILDREN UNDER 5 YEARS WHO
ARE STUNTED (HEIGHT-FOR-AGE) (%)
35.5
India
38.4

39
Gujarat
38.5

40.9
Bharuch
41.5

47.2
Narmada
47.4

41.7
Tapi
35.9

36.1
Surat
30

36.8
Navsari
38.9

37.6
Dang
48.1

37.8
Valsad
43.3
0 10 20 30 40 50 60

NFHS 5 NFHS 4
 14. CHILDREN UNDER 5 YEARS WHO
ARE WASTED (WEIGHT-FOR-HEIGHT) (%)
19.3
India
21

25.1
Gujarat
26.4

24.5
Bharuch
29.4

23
Narmada
35.8

36.6
Tapi
35.8

26
Surat
26.2

29
Navsari
26.8

40.9
Dang
43

23.2
Valsad
30.3
0 5 10 15 20 25 30 35 40 45 50

NFHS 5 NFHS 4
 15. CHILDREN UNDER 5 YEARS WHO ARE
SEVERELY WASTED (WEIGHT-FOR-HEIGHT) (%)

7.7
India
7.5

10.6
Gujarat
9.5

8
Bharuch
7.6

9.9
Narmada
12.7

17.1
Tapi
9.6

14.7
Surat
8.1

9.3
Navsari
5.7

22.2
Dang
18.9

9.1
Valsad
11.9
0 5 10 15 20 25

NFHS 5 NFHS 4
 16. CHILDREN UNDER 5 YEARS WHO ARE
UNDERWEIGHT (WEIGHT-FOR-AGE) (%)
32.1
India
35.8

39.7
Gujarat
39.3

45.5
Bharuch
44.2

52.8
Narmada
53.6

51.8
Tapi
42.4

32.5
Surat
36.1

43.6
Navsari
37.4

53.1
Dang
60

34.8
Valsad
41.9
0 10 20 30 40 50 60 70

NFHS 5 NFHS 4
PART D

Nutritional Status of Adults (age 15-49 years)

17. Women whose Body Mass Index (BMI) is below normal (BMI < 18.5 kg/m2 ) (%)
 17. WOMEN WHOSE BODY MASS INDEX (BMI)
IS BELOW NORMAL (BMI < 18.5 KG/M2 ) (%)
18.7
India
22.9

25.2
Gujarat
27.2

30.3
Bharuch
31.3

30.7
Narmada
44.1

35.4
Tapi
43.4

21
Surat
18.4

21.8
Navsari
29.5

33.7
Dang
44

23.8
Valsad
22.9
0 5 10 15 20 25 30 35 40 45 50

NFHS 5 NFHS 4
PART E

Anaemia among Children and Adults

18. Children age 6-59 months who are anaemic (<11.0 g/dl) (%)
19. Non-pregnant women age 15-49 years who are anaemic (<12.0 g/dl) (%)
20. Pregnant women age 15-49 years who are anaemic (<11.0 g/dl) (%)
21. All women age 15-49 years who are anaemic (%)
22. All women age 15-19 years who are anaemic (%)
 18. CHILDREN AGE 6-59 MONTHS WHO
ARE ANAEMIC (<11.0 G/DL) (%)
67.1
India
58.6

79.7
Gujarat
62.6

81
Bharuch
56.8

93.2
Narmada
53.6

80.7
Tapi
49.5

83.6
Surat
42.3

75.3
Navsari
51.9

82.4
Dang
74.1

87.6
Valsad
50.4
0 10 20 30 40 50 60 70 80 90 100

NFHS 5 NFHS 4
 19. NON-PREGNANT WOMEN AGE 15-49
YEARS WHO ARE ANAEMIC (<12.0 G/DL) (%)
57.2
India
53.2

65.1
Gujarat
55.1

71.6
Bharuch
51.8

75.9
Narmada
55.5

77.6
Tapi
54.3

69.3
Surat
39.4

68.9
Navsari
51.9

77.6
Dang
72.6

75.8
Valsad
50.8
0 10 20 30 40 50 60 70 80 90

NFHS 5 NFHS 4
 20. PREGNANT WOMEN AGE 15-49 YEARS
WHO ARE ANAEMIC (<11.0 G/DL) (%)
52.2
India
50.4

62.6
Gujarat
51.3

77.2
Bharuch
55.6

75.6
Narmada
58.2

72
Tapi

58.7
Surat
29

Navsari

66.8
Dang
66.5

71
Valsad
53.6
0 10 20 30 40 50 60 70 80 90

NFHS 5 NFHS 4
 21. ALL WOMEN AGE 15-49 YEARS
WHO ARE ANAEMIC (%)
57
India
53.1

65
Gujarat
54.9

71.8
Bharuch
52

75.9
Narmada
55.6

77.4
Tapi
54.4

69
Surat
39

68.7
Navsari
52.1

77.2
Dang
72.2

75.7
Valsad
50.9
0 10 20 30 40 50 60 70 80 90

NFHS 5 NFHS 4
 22. ALL WOMEN AGE 15-19 YEARS
WHO ARE ANAEMIC (%)
59.1
India
54.1

69
Gujarat
56.5

69.8
Bharuch
59.9

83
Narmada
52.4

72.8
Tapi
57.8

76.2
Surat
39.9

72.6
Navsari
48.4

77.1
Dang
77.8

85.8
Valsad
57.7
0 10 20 30 40 50 60 70 80 90 100

NFHS 5 NFHS 4
 CONCLUSION
 As far as comparison between NFHS 4 we have achieved some improvements in
NFHS 5 however it is not good enough when compared it to the overall nutrition
status of India, despite leading in infrastructure development and per capita
income, we are struggling to achieve an average growth in health and nutrition
indicators.
 We have been successful in improving the provision of routine health check-ups
and other health services to pregnant women.
 We have achieved phenomenal progress as far as IFA intake during pregnancy and
vaccination in children is concerned.
 But we have not done very well in child feeding practices, whether it is early
initiation of breast feeding or exclusive breast feeding or complimentary feeding,
resulting in increase in stunting, severe wasting and poor weight gain among
children under 5 years compared to the average Indian child, however there is a
slight reduction in wasting in some districts.
 CONCLUSION
 We have improved BMI status among women in NFHS 5 as compared to
NFHS4, however when we compare with the average Indian woman we lag
far behind in this indicator.
 Compared to NFHS4 we have fared dismal when it comes to anemia status
among women and children in NHFS 5, the anemia status in Gujarat and
especially in the districts of Surat region is much worse and there is still a
long way to go to improve this index.
 Prevalence of Anaemia in children rose by 17% across state in five years
and 12% among young girls.
 WAY FORWARD
 A comprehensive action plan is needed to improve these indicators and for this
all departments including I.C.D.S, Health, Education, Panchayat Department,
Food-Civil Supplies & Consumer Affairs Department etc. will have to come
together to develop district and sub-district level action plans and targeted
strategies.
 Identifying high-priority districts and talukas.
 Increase the PPP model in such areas. 
 Focusing on non-iron deficiency anaemia.
 A strong supportive monitoring mechanism for service delivery and periodic
assessment.
 Periodic capacity building at each level of service delivery to introduce and
share best practices and
 WAY FORWARD
 We have to work on the following areas to improve health and nutrition
indicators in Surat region.
1. Pre pregnancy dietary advice to adolescents and balanced diet during
pregnancy to avoid micronutrient deficiency
2. Ensuring Institutional Deliveries.
3. Strengthening engagement with private hospitals/ maternity homes to
promote early initiation of Breastfeeding, Colostrum feeding and Exclusive
feeding.
4. Strengthening awareness activities to promote the use of post natal
consumption of IFA, THR from ICDS, and awareness on adequate
complimentary feeding from 6 months.
5. Micronutrient supplementation and continued breastfeeding.
THANK YOU