Gains deepen but gaps persist for UP in NFHS-6

Lucknow: The latest round of NFHS-6 has highlighted gains for Uttar Pradesh across several social and health indicators, pointing to the impact of sustained efforts.A deeper dive also brings to fore the gaps and areas for improvement.Mission director, National Health Mission, Dr Pinky Jowel said, “The survey, in effect, offers both reassurance and a reminder of the work still ahead. And we are ready for fine tuning.”While key parameters of quality of life in a household such as availability of electricity connection, water supply and banking service also inched closer to saturation, social security through health insurance cover remains an area of improvement.Data showed that health insurance coverage in state doubled from 15.9% to 37.2% reflecting a jump of 21.3 percentage points. However, it remains far behind the national average of 60.2%.Rise in the number of internet users in state – particularly among women (up from 30.6% to 79%) – speaks for the fact that the state has caught up with digital age.NFHS-6 has several good updates on women’s condition but there is still ground to cover. Spousal violence has gone down from 34.9 to 28.5% but one in four women are being subjected to this ill-treatment.A jump of five percentage points in women getting paid in cash for work (from 15.5% to 21.1%) is good news. Eight out of 10 women having bank account; five out of 10 owning a house or land and one in two women using mobile phone are also reassuring.But a marginal decline in number of women having a say in household decision-making and use of hygienic menstrual protection call for a fine-tuning in strategy.The number of women aged 20-24 admitting that they got married before legal age came down from 15.8% to 13.7%, which is below national average.What dampens this happiness is the rise in teenage pregnancies from 2.9% to 3.5%, with higher prevalence in rural areas.The contradiction raises concerns over access to reproductive healthcare, contraception and continued education for girls. Delaying marriage has not necessarily translated into delayed motherhood.The numbers suggest UP has made progress on one social indicator while still struggling with the health and educational risks linked to early pregnancy. Underage marriages among men also came down from 23% to 19.5%Many indictors of child health are heartening. The percentage of fully vaccinated children has gone up from 69% to 81% which reflects across individual vaccination heads too.Intake of Vitamin A dose among toddlers has reduced. Severe malnutrition and stunting (height for age) have also come down.Proportion of overweight kids came to 0.5% from 3.1%. Breastfeeding within the first hour of birth increased significantly from 23.9% to 43.1% but exclusive breastfeeding for six months came down from about 60% to 34.6%.Toddlers getting adequate diet increased from 5.9% to 17.1% but the fact that four out of five babies were not getting their due nutrition is worrying.The survey underlines a growing nutrition dichotomy. The share of adults with BMI below normal has increased from 19% to 22.2% in women and 18% to 23.5% in men. The proportion of adults who are overweight or obese has also gone up – from 21.4% to 26.7% in women and 18.5% to 21.8% in men.What adds to this concern is rise in blood sugar in the working population – from 10% to 15.5% in women and 11.6% to 19.5% in men. Consumption of tobacco among men and women and that of alcohol in women furthers the worry.Caesarean deliveries have increased in UP but the rise has come largely from private hospitals (from 39.4% to 47.3%). Govt facilities continue to remain below the WHO benchmark of 10-15%, despite a slight increase (6.2% to 6.5%).The trend points to unequal access to emergency obstetric care. Families using private hospitals appear more likely to access surgical intervention when needed, while poorer women dependent on public facilities may still be missing out on timely procedures. Institutional deliveries in state also went up from 83.4% to 85.9% but 14% babies being born within the community is worrying.Meanwhile, anaemia continues to remain central to the nutrition and maternal health challenge. Despite wider healthcare access, it remains stubborn across women and children.One indicator of this from NFHS came from iron folic acid tablets consumption during pregnancy. Though the state record gains, the gaps behind are a dampener.One in three women in state consume IFA tablets for 100 or more days. The denominator increased to five when taking a look at the number of women who consumed IFA for 180 or more days.