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


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 Sikkim presents the important findings of the survey’s fourth round, conducted in all of the state’s 13 districts between January 30 and July 17, 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 Sikkim, data was gathered from 4,662 households; 5,293 women (aged 15-49) and 879 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 also gathered information on reproductive health, sexual behaviour, marriage, domestic violence, and attitudes towards gender roles. And it included information on the prevalence of HIV/AIDS, nutrition, water and sanitation, health services and insurance.


  1. Around 33 per cent of the surveyed households in Sikkim were in urban areas. Nearly three-fourths of all surveyed households (72 per cent) lived in a pucca (permanent) structure, 0.3 per cent defecated in the open, and 92 per cent had piped water in their dwellings.

  2. Among women in the 25-49 age bracket, the median age at their first marriage was 21.1 years. 15 per cent of women in the 20-24 age group got married before the legal minimum age of 18 and 11 per cent of men in the 25-29 age group got married before the legal minimum age of 21.

  3. The total fertility rate was 1.17 children per woman, nearly one child below replacement-level fertility (a steady population replacement rate over time).

  4. There was a  preference for sons – 7 per cent of all women and 8 per cent of all men wanted more sons than daughters. But 67 per cent of women and 70 per cent of men wanted at least one daughter.

  5. Knowledge of contraception among women (aged 15-49) was almost totall (98 per cent). Contraceptive use was lower in urban areas (37 per cent) than in rural areas (51 per cent). The contraceptive prevalence rate (use by a woman or her partner) was highest among women with less than five years of schooling (59.3 per cent) and lowest among those with 12 or more years of schooling (30.2 per cent).

  6. The infant mortality rate was estimated at 30 deaths before the age of 1 per 1,000 live births. 

  7. Around 94 per cent of mothers, who gave birth in the five years preceding the survey, received antenatal care for their last birth from a health professional (a doctor, an auxiliary nurse midwife, a ‘lady health visitor’, a nurse or a midwife).

  8. Around 83 per cent of 12-23-month-old children received all the basic vaccinations against six major childhood illnesses (tuberculosis, diphtheria, pertussis, tetanus, polio, and measles). Only 1 per cent had not received any vaccinations at all.

  9. Although breastfeeding was nearly universal, only 55 per cent of children under 6 months were exclusively breastfed, as recommended by the World Health Organization, and 95 per cent were breastfed on the first day of life. 

  10. 30 per cent of children under 5 were stunted (indicating that they had been undernourished for some time), 14 per cent were wasted (too thin for their height), and 6 per cent were severely wasted. Among babies under 6 months, most of whom were breastfed, 17 per cent were stunted, 6 per cent were underweight, and 20 per cent were wasted.

  11. Based on reports from household respondents, 475 persons in every 100,000 were estimated to have medically treated tuberculosis. According to self-reports, 1,580 women and 1,249 men  (both in the age group 15-49) per 100,000 had diabetes. Overall, 1,025 women and 928 men in every 100,000 suffered from asthma.

  12. Only 30 per cent of households had any kind of health insurance that covered at least one member of the family.

  13. Among the women surveyed, 91 per cent had heard of HIV/AIDS and 63 per cent knew that it could probably be prevented with consistent condom use. Among the men, the figures were 96 per cent and 73 per cent, respectively.

  14. Around 8 per cent of women believed that it was justifiable for a husband to beat his wife under some circumstances. Among women in the 15-49 age group, 5 per cent had experienced physical violence and 1 per cent sexual violence. 

    Focus and Factoids by Anupam Krishnamurthy.

    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: S.K. Singh, H. Lhungdim, Manoj Alagarajan and Alex Izmukhambetov


Ministry of Health and Family Welfare, Government of India, New Delhi


01 Sep, 2017