National Family Health Survey (NFHS-5) 2019-21: Himachal Pradesh


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, Government of India. The NFHS report for 2019-21 is the fifth in this series. It provides information on population, health and nutrition in 28 states, eight union territories, and 707 districts of India.

NFHS-5 presents district-level data on indicators such as population, fertility, family planning, infant and child mortality, maternal and child health, domestic violence and disability. This report on Himachal Pradesh – published in April 2021 – presents information covering 12 districts. The Population Research Centre, Himachal Pradesh University, Shimla, conducted the fieldwork for this report between July 16 to November 5, 2019, covering 10,698 households, 10,368 women (aged 15-49 years) and 1,477 men (aged 15-54 years).

This 205-page document is divided into 14 sections: Introduction (Section 1); Household Characteristics (Section 2); Education (Section 3); Fertility (Section 4); Family Planning (Section 5); Infant and Child Mortality (Section 6); Maternal Health (Section 7); Child Health (Section 8); Breastfeeding, Nutrition, and Anaemia (Section 9); Adult Health and Health Care (Section 10); HIV/AIDS (Section 11); Sexual Behaviour (Section 12); Women’s Empowerment (Section 13); and Domestic Violence (Section 14).


  1. Of all the households surveyed in Himachal Pradesh, 86 per cent were located in rural areas. Around 76 per cent of households lived in pucca dwellings and almost all households (99 per cent) had electricity.

  2. The survey found that 23 per cent of households were headed by women, with 20 per cent of the population in the state living in households headed by women.

  3. Among all households surveyed (96.4 per cent) had access to an ‘improved source’ of drinking water – piped water, public tap, standpipe, tube well or borehole. However, only 85 per cent had water in the house or delivered to the household premises.

  4. A total of 81 per cent of households had access to ‘improved sanitation facilities’ that were not shared with other households. Access to such facilities was higher in urban areas (84.8 per cent) than in rural areas (80.4 per cent). Around 6.5 per cent of households did not have any toilet facility.

  5. In Himachal Pradesh, around 51.7 per cent of the surveyed households used ‘clean fuel’ – electricity, liquefied petroleum gas, natural gas or biogas – for cooking.

  6. Of all the people surveyed, only 45 per cent of women and 48 per cent of men aged 15-49 years had finished 12 or more years of school education. Around seven per cent of women and four per cent of men in the same age group had never been to school.

  7. Overall, 95 per cent for children aged 6-17 years attended school in Himachal Pradesh. The attendance in school was noted to drop from 98.9 per cent at the elementary level (ages 6-13 years), and 94.3 per cent at the secondary level (ages 14-15 years) to 80.4 per cent at the higher secondary level (ages 16-17 years).

  8. Around five per cent of women surveyed between the ages of 20-24 years had married before attaining the legal minimum age of 18 years. This was a decrease from the nine per cent recorded in NFHS-4.

  9. The total fertility rate in the state was 1.7 children per woman, a drop from 1.9 children per woman recorded in NFHS-4. The survey also noted that three per cent of girls and women aged 15-19 years had already been or were pregnant at the time of the survey.

  10. About 90 per cent of pregnancies in the five years prior to the survey resulted in live births. Miscarriage accounted for 6.8 per cent, abortions made up three per cent and stillbirths accounted for 0.3 per cent of all pregnancies noted.

  11. Unplanned pregnancy (51 per cent) and complications during pregnancy (24 per cent) were the most common reasons reported by women seeking abortions. The contraceptive prevalence rate (CPR) among currently married women (aged 15-49 years) was 74 per cent. This was a significant rise from the 57 per cent CPR during NFHS-4.

  12. The infant mortality rate in Himachal Pradesh fell from 34 deaths (before the age of one year) per 1,000 live births during NFHS-4 to 26 deaths per 1,000 live births. The under-five mortality rate – probability of death between birth and the fifth birthday – also declined from 38 deaths per 1,000 live births to 29 deaths per 1,000 live births.

  13. Of the women surveyed who had given birth in the five years prior to the survey, 70 per cent received antenatal care from a doctor and 16 per cent received antenatal care from a nurse, a midwife, an auxiliary nurse midwife or a lady health visitor. Around 11 per cent of the women reported not receiving any antenatal care.

  14. Among children aged 12-23 months, 89 per cent had received all basic vaccinations against tuberculosis, diphtheria, pertussis, tetanus, polio and measles. This was a considerable increase from the NFHS-4 estimates of 69.5 per cent. Moreover, the survey found that 98 per cent of the children had been at least partially vaccinated.

  15. Among children less than five years of age, the percentage of children who were stunted (too short for their age) increased from 26 per cent to 31 per cent in the years between NFHS-4 and NFHS-5. The percentage of children who were wasted (too thin for their height) also increased from 14 per cent during NFHS-4 to 17 per cent in NFHS-5.

  16. In Himachal Pradesh, around 10 per cent of the women surveyed (aged 18-49 years) reported having experienced physical violence and two per cent reported experiencing sexual violence. Of the women facing such violence, as high as 59 per cent neither sought help nor informed anyone about the incidents.

    Focus and Factoids by Arunima Singh.


    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 for Population Sciences (IIPS), Mumbai

Contributors: Sarang Pedgaonkar, S. K. Singh, Chander Shekhar, Priyanka V. Janbandhu


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


Apr, 2021