National Family Health Survey (NFHS-4) 2015-16: Bihar


Since 1992, the International Institute for Population Sciences, Mumbai, has conducted the National Family Health Survey (NFHS) for the Ministry of Health and Family Welfare. The survey provides detailed information on population, health and nutrition in each state and union territory of India.  

This state report on Bihar presents the important findings of the survey’s fourth round, conducted in 38 districts between March 16 and August 8, 2015. Previous NFHS surveys were conducted in 1992-93, 1998-99 and 2005-06.

NFHS-4 surveyed 572,000 households in 640 districts of India (as per the 2011 Census). In Bihar, data was gathered from 36,772 households; 7,464 women (aged 15-49) and  5,872 men (aged 15-54) were interviewed.   

The survey collected information on the socio-economic characteristics of households, education, fertility, family planning, infant and child mortality, and maternal and child health. It further gathered information on reproductive health, sexual behaviour, marriage, domestic violence, and attitudes towards gender roles. It also put together information on HIV/AIDS status, nutrition, water and sanitation, health services and insurance.


  1. More than 1 in 10 of Bihar's households (13 per cent) were in urban areas. On average, households in Bihar comprised of 5 members and 24 per cent were headed by women.

  2. Over two-thirds or 67 per cent of all households did not use a sanitation facility, which meant that their members practised open defecation – a small improvement from 75 per cent at the time of NFHS-3 (2005-06). Open defecation was more common among rural households (73 per cent) than urban households (22 per cent).

  3. More urban households (15 per cent) than rural households (3 per cent) got piped water in their dwellings, yards or plots.

  4. School attendance was 84 per cent among children in the 6-17 age group in Bihar. In the 6-14 age group, it was 89 per cent but it dropped to 70 per cent for children between 15 and 17 years. In urban areas, 86 per cent of all children went to school, while the figure was 84 per cent in rural areas. 

  5. Around 50 per cent of women and 78 per cent of men (both in the age groups 15-49) were literate, that is, they had either completed Class 6  or passed a simple literacy test conducted as part of NFHS-4.

  6. The total fertility rate (TFR) in Bihar was 3.4 children per woman, one of the highest for any state in India. The fertility rate in urban areas was 2.4 children per woman and in rural areas, it was 3.6 children per woman.

  7. There was a strong preference for sons in the state – 37 per cent of women and 30 per cent of men wanted more sons than daughters. Only 2-4 per cent of women and men wanted more daughters than sons. However, most men and women would like to have at least one son and one daughter.

  8. Contraceptive use was higher in urban areas (35 per cent) than in rural areas (23 per cent). Also, 42 per cent of men aged 15-49 thought that contraception was ‘women’s business’. More than three-fourths of married women knew about the birth control pill and 64 per cent about condoms (nirodhs), but only 16 per cent knew about female condoms.

  9. The infant mortality rate was 68 per 1,000 live births for teenage mothers as compared to 44 per 1,000 live births for mothers aged 20-29 and 46 per 1,000 live births for mothers aged 30-39.    

  10. Less than two-thirds (62 per cent) of children aged 12-23 months received all the basic vaccinations against six major childhood illnesses. That is: tuberculosis, diphtheria, pertussis, tetanus, polio, and measles. Most children were at least partially vaccinated and only 7 per cent had not received any vaccinations at all. 

  11. As many as 48 per cent of children under the age of five were stunted (too short for their age); 21 per cent were wasted (too thin for their height); and 7 per cent were severely wasted.

  12. More than two-fifths of women (42 per cent) and 38 per cent of men were either too thin, or overweight or obese. More men and women were thin than overweight or obese, which was also the case in NFHS-3. Undernutrition was common in younger age groups in rural areas and among Scheduled Caste women. Being overweight or obese was most prevalent in older adults, among those in urban areas, and those who were well-educated.

  13. About 12 per cent of all households had health insurance that covered at least one member of the family. Health insurance coverage was somewhat more common in rural areas (13 per cent) than in urban areas (10 per cent).

    Focus and Factoids by Vedika Inamdar.

    PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.


International Institute of Population Sciences (IIPS), Mumbai

Contributors: B. Paswan, S.K. Singh, Abhishek Singh and Fred Arnold


Ministry of Health and Family Welfare, Government of India


01 Sep, 2017