NFHS-6 records a sharp and accelerating rise in non-communicable disease risk factors among working-age adults  | Photo Credit: JDawnInk

The National Family Health Survey-6 is the most comprehensive picture of India’s health in four years. And if you read only the government’s press release, you would conclude that India’s health story is largely one of progress. That reading is not wrong. It is incomplete.

The gains are genuine and significant. Institutional deliveries have risen to 90.6 per cent. Antenatal care coverage is at 95.9 per cent. Stunting in children under five has declined substantially from 35.5 per cent to 29.3 per cent. Breastfeeding within one hour of birth has improved by more than eight percentage points. Hypertension has declined nationally among both women and men. These reflect years of sustained investment in maternal and child health — and they are working. The question NFHS-6 forces is what happens to that woman after she safely delivers and turns 35.

NFHS-6 records a sharp and accelerating rise in NCD (non-communicable disease) risk factors among working-age adults. Nearly one in three women aged 15-49 is now overweight or obese — up from one in four in NFHS-5. In urban areas, the figure reaches 42.8 per cent. Among men, the rise is from 22.9 per cent to 27.3 per cent. High blood sugar in men has risen from 15.6 per cent to 20.9 per cent in four years. In women, from 13.5 per cent to 17.8 per cent.

These are not marginal increases — they represent millions moving into metabolic risk for cardiovascular disease, diabetes, kidney disease, and cancer, in a health system still primarily organised around maternal care. The NSO’s health survey, published in April, showed cardiovascular disease nearly tripling over seven years — NFHS-6 shows the conditions producing that outcome. India also carries both ends of the nutrition burden simultaneously. While obesity climbs, 19.7 per cent of women aged 15-49 remain underweight.

The rural surprise

NFHS-6 demolishes the assumption that NCDs are an urban, middle-class problem. Rural women’s obesity stands at 25.5 per cent. Rural men’s high blood sugar is at 19.7 per cent — barely below the urban figure of 23.9 per cent. The convergence is happening fast, in primary health centres without NCD protocols, districts without dietitians, communities without the financial cushion to absorb a chronic illness diagnosis.

Buried in the delivery data is a figure that demands attention: caesarean sections have risen from 21.5 per cent to 27.2 per cent nationally — and to 40.5 per cent in urban areas. More than half of all births in private facilities are now delivered by C-section. India is not just medicalising birth; it is over-medicalising it, at cost to families and without evidence of commensurate health gains.

NFHS-6’s most significant omission is anaemia. In NFHS-5, 57 per cent of women aged 15-49 were anaemic. So were 67 per cent of children. The government launched the Anaemia Mukt Bharat programme in 2018. By NFHS-5, anaemia had risen — from 53 per cent in NFHS-4 to 57 per cent — despite the programme’s existence.

NFHS-6 does not measure anaemia. The official reason is methodological: reliability concerns about the haemoglobinometer used in previous rounds. A survey that functions as a government accountability tool has removed the indicator on which the government was most visibly failing. We do not know whether 57 per cent has become 60 per cent or fallen to 50 per cent. However, a robust ICMR survey has been promised.

India built its health system around two priorities: infectious disease and maternal and child health. What NFHS-6 also confirms — in its NCD data, in its C-section surge, in its anaemia silence, in what it measures and what it does not — is that the architecture has not kept pace with the disease burden shifting beneath it.

The gains are real. The system NFHS-6 reveals as inadequate for what comes next is just as real. A survey that celebrates the former without honestly reckoning with the latter is not a health report. It is a press release.

The writer is Senior Fellow, Pahlé India Foundation and Ex-Director NITI Aayog

Published on June 10, 2026