Hyderabad: Telangana has made measurable progress in child nutrition, maternal health and financial protection over the past five years, but the state’s latest health data paints a more complicated picture.
Caesarean deliveries now account for nearly two-thirds of all births, more than double the national average, diabetes prevalence has jumped sharply and obesity among adults is rising faster than in most other states.
These are among the key findings from the sixth National Family Health Survey (NFHS-6, 2023-24), released on Friday, May 29. The survey covers a wide range of health, nutrition and demographic indicators for the country and all states and Union Territories (UT).
The NFHS-6 data was collected between 2023 and 2024. The Telangana survey was conducted in early 2024.
Maternal health: near-universal coverage, but C-section question looms
The state’s maternal health numbers are, by most measures, good. Almost all deliveries – 98.8 per cent – take place in institutions, against a national figure of 90.6 per cent. Antenatal care has improved considerably, with 89.6 per cent of mothers having their first check-up in the first trimester, compared to 76.2 per cent nationally.
The share of mothers who took iron-folic acid tablets for at least 100 days during pregnancy rose from 57.9 per cent in NFHS-5 to 81 per cent. This is a gain of more than 23 percentage points and well above the national average of 54.9 per cent.
What stands out, however, is the caesarean section rate. At 62.2 per cent overall, and 70.1 per cent in urban Telangana, the state’s C-section rate is more than twice the national average of 27.2 per cent. In private facilities, the rate climbs to 83.9 per cent, and even public hospitals record a figure of 48.1 per cent.
The World Health Organization (WHO) considers rates above 10-15 per cent as having no additional benefit for mothers or newborns. The figures in Telangana are not new, with NFHS-5 already recording 60.7 per cent, but the upward trend has continued.
Child health: stunting falls, but diet quality a problem
On child malnutrition, Telangana has improved. The proportion of children under five who are stunted – an indicator of chronic undernutrition – fell from 33.1 per cent in NFHS-5 to 27 per cent in NFHS-6, a six-point improvement that compares favourably with the national average of 29.3 per cent.
The share of severely wasted children also fell steeply, from 8.5 per cent to 3.9 per cent.
Vaccination coverage has broadly held up. The full vaccination rate (based on card or recall) stands at 80.9 per cent, slightly below the national average of 82.6 per cent. Rotavirus vaccine coverage, almost absent in NFHS-5 at 5.3 per cent, is now at 63.8 per cent, though still short of the national average of 85.4 per cent.
Where the state struggles is with dietary adequacy. Only 15.3 per cent of children aged six to 23 months receive an adequate diet. This is in line with the national average, but reflects how poorly both the state and the country are doing on this front. The pace of early breastfeeding initiation has improved by a significant margin, from 37.1 per cent in NFHS-5 to 57.1 per cent in NFHS-6 – now above the national figure of 50.1 per cent.
However, exclusive breastfeeding under six months has slipped from 68.2 per cent to 64.8 per cent, though Telangana still remains above the national average of 55.8 per cent.
Diabetes and obesity problem
The most striking set of findings in the NFHS-6 Telangana data relates to non-communicable diseases. Among women aged 15 and above, 19.6 per cent have high blood sugar or are on medication to control it, against a national figure of 17.8 per cent and up sharply from 14.7 per cent recorded in NFHS-5.
For men, the figure is more alarming. As many as 24.5 per cent of men have high blood sugar, against 20.9 per cent nationally and 18.1 per cent in the previous survey.
This comes against a backdrop of rising obesity. More than a third of adult women (36.3 per cent) in Telangana are overweight or obese, against 30.7 per cent nationally and 30.1 per cent in NFHS-5 for the state. Among men, the figure is 35.5 per cent, against 27.3 per cent nationally.
Hypertension, too, remains significant. Among men, 28.2 per cent have elevated blood pressure or are on medication, above the national figure of 22.1 per cent.
Child marriage down, but adolescent pregnancy a concern
Child marriage, historically a persistent problem in the state, has continued to decline. The share of women aged 20-24 who were married before 18 fell from 23.5 per cent in NFHS-5 to 17.9 per cent, below the national average of 20.1 per cent. The gap between urban Telangana (12.9 per cent) and rural Telangana (19.6 per cent) points to where the problem remains concentrated.
Against this, the adolescent pregnancy rate – women aged 15 to 19 who were already mothers or pregnant at the time of the survey – increased marginally from 5.8 per cent to 6 per cent, in line with the national average of 6.7 per cent.
Health insurance coverage expands significantly
One of the more striking improvements in the state is the expansion of health insurance. The share of households with at least one member covered under a health insurance or financing scheme rose from 69.2 per cent in NFHS-5 to 82.2 per cent in NFHS-6.
This was well above the national average of 60.2 per cent, reflecting the reach of Aarogyasri and other state-level schemes.
Women’s safety, empowerment
Spousal violence has declined, from 37.2 per cent of ever-married women in NFHS-5 to 30.8 per cent in NFHS-6, but the figure remains higher than the national average of 22.3 per cent. The rural figure of 33 per cent is significantly above the urban 24.8 per cent.
On more positive indicators, 92.3 per cent of women now have a bank account they use themselves, up from 84.4 per cent in the previous round and above the national average of 89 per cent. Internet usage among women has more than doubled since NFHS-5, from 26.5 per cent to 64.8 per cent, now marginally above the national average of 64.3 per cent.
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