Development in transition: What NFHS-6 tells us about India
India has committed itself to achieving the Sustainable Development Goals (SDGs), which seek to improve the quality of life through progress across economic, social, demographic, environmental, and institutional dimensions. Achieving these goals requires more than economic expansion alone; it demands that growth be translated into improvements in health, education, nutrition, gender equality, and other indicators of human well-being. The National Family Health Survey (NFHS), while not capturing the entire spectrum of development, provides an important window into the extent to which economic growth has been accompanied by social and demographic progress.
The four rounds of the NFHS, spanning the period from 2005-06 to 2023-24, allow an assessment of India’s progress in select demographic and social indicators. The latest round, released this week, suggests that the country has undoubtedly moved forward. However, the pace of improvement has been uneven across sectors and regions, and in several dimensions remains slower than might be expected after nearly three decades of economic growth of over 6% annually. The experience of East and Southeast Asian countries provides a useful benchmark, as many of them combined economic growth with rapid gains in human development within a relatively short period.
The data points to important achievements. Health insurance coverage expanded dramatically from about 5% to nearly 60% of the population. Female educational attainment also improved substantially, with nearly half of women now having completed ten or more years of schooling. Fertility has declined to replacement level on aggregate and below replacement in large parts of the country, marking an important demographic transition. However, there is an underbelly: The southern states, much of the Northeast, and parts of northern India report substantially better outcomes than the large states of the Indo-Gangetic plains. Moreover, the survey provides little information on the quality of health or educational services, limiting conclusions about the effectiveness of these achievements.
Progress in reducing child marriage has also been noteworthy. The proportion of women aged 20-24 who were married before the age of 18 declined from 47.4 per cent to 20.1 per cent. Yet, the prevalence remains high by international standards. Countries such as China and Thailand have reduced child marriage to negligible levels, suggesting that considerable progress remains possible. Once again, regional differences are striking. Bihar and Jharkhand continue to report rates exceeding 30%, whereas Kerala, Tamil Nadu, and Mizoram have reduced the incidence to around 10% or lower.
The most serious concern emerges from nutrition-related indicators. Child stunting declined from about 48 per cent to 29.3 per cent, a substantial improvement but still one of the highest levels among major economies. The proportion of underweight children fell more modestly, from 42.5 per cent to 31.8 per cent. Similarly, the share of women with below-normal body mass index declined until 2019-21 but has since shown a slight reversal. These trends suggest that nutritional deprivation remains deeply entrenched despite sustained economic growth. Here too, regional disparities persist, with states such as Bihar and Jharkhand continuing to perform poorly while much of southern and northeastern India fares considerably better.
A recent article in the Indian Express (dt. June 2, 2026) finds that a number of indicators have been dropped in NFHS-6 compared to NFHS-5. This might not be a very serious issue as some of these variables do not change at short intervals. However, India’s development record has been otherwise mixed. The country has made some progress in education, health insurance coverage, decline of child marriage, and TFR in some states, etc. Improvements in nutrition and other measures of human well-being, however, have been slower than expected, and large regional inequalities remain. Compared with the experience of East- and Southeast Asian economies during their periods of rapid growth, India’s progress appears gradual rather than transformational.
Evidence from NFHS-6 suggests that while economic growth might have contributed to some social advancement, it has not consistently translated into equally rapid improvements in human development.
The challenge for the coming decades is therefore not merely to sustain growth, but to ensure that its benefits are converted more effectively into better health, nutrition, education, and quality of life for all sections of the population.
Dr. Ankita Goyal is an Assistant Professor at the Council for Social Development (CSD), New Delhi and Managing Editor, Social Change, Sage Publishing; Professor Sarthi Acharya is a Visiting Professor at the Council for Social Development (CSD), New Delhi and Managing Editor, Indian Journal of Labour Economics, Springer Publishing; Views presented are personal.