National Family Health Survey

The National Family Health Survey collects data on landownership by gender through a woman’s questionnaire and a household questionnaire. The WQ figures were found to be highly inflated and showing contrary regional patterns and serious inconsistencies. In contrast, the HHQ figures appear reliable but need extraction and are not published. The NFHS should extract and publish
these for analysis.

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This study investigates the quality of the National Family Health Survey-4 data on contraceptive use by estimating investigator-induced bias. An outlier-bound approach was used to detect investigator bias, and contraceptive use was re-estimated adjusting for the bias in six study states. The findings suggest investigator bias at two levels: over-reporting of women as “never users” of contraception and a tendency to report sterilised women as current non-users and as cases of hysterectomy. Re-estimation of contraceptive use confirmed a declining trend in contraceptive prevalence in four study states. While the effect of the bias was moderate at the state level, it can potentially distort district-level estimates to a great extent.

Despite the efforts of the Indian government to make available and promote clean fuels, the use of cow dung cakes and other traditional fuels continues unabated. A survey conducted in two districts of Punjab reveals that both poor and well-off sections of society use solid biomass for various reasons, and women suffer from various health problems due to the inhalation of smoke released from the burning of these fuels. Policies need to be put in place to ensure the affordability of clean fuels, and people should be made aware of the adverse effects of this practice on health and the environment.

In the context of India where public expenditure on healthcare is low, the private sector plays an important role in delivering healthcare during childbirth. An analysis of the latest round of National Family Health Survey data to estimate the differential probability of caesarean sections in private medical facilities relative to government facilities, and focusing on unplanned C-sections, reveals that the probability of an unplanned C-section is 13.5–14 percentage points higher in the private sector. These results call for a critical assessment of the role of private sector in healthcare in the context of inadequate public provision, expanding private provision and weak governance structures.