National Family Health Survey (NFHS-5) 2019-21: 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, 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 Sikkim – published in March 2021 – presents information covering four districts. Karvy Data Management Services Ltd. conducted the fieldwork for the report between August 1, and December 28, 2019, covering 3,516 households, 3,271 women (aged 15-49 years) and 469 men (aged 15-54 years). 

This 186-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. As per this NFHS-5 report, 58 per cent of households in Sikkim were located in rural areas. In the state, 76 per cent households lived in a pucca house and 99 per cent had electricity.

  2. Of the households surveyed, over 50 per cent of household heads belonged to Other Backward Classes, 35 per cent were part of a Scheduled Tribe, and almost six per cent belonged to a Scheduled Caste.

  3. Around 94 per cent households had basic drinking water services and 78.4 per cent used clean fuel – electricity, liquefied petroleum gas, natural gas or biogas – for cooking. In Sikkim, 85.3 per cent of all surveyed households had access to basic sanitation facilities. Only 0.4 per cent of households did not have any sanitation facilities, the report notes.

  4. Pre-school attendance in Sikkim, for children between the ages of 2-4 years was marked at 60 per cent for boys and 71 per cent for girls. School attendance among children aged 6-14 years was 97.7 per cent. It dropped to 87.6 per cent among children between the ages of 15 and 17 years.

  5. The median age at first marriage for women between the ages of 25-49 years was 21.5 years.

  6. In the five years preceding the survey, 92 per cent of last pregnancies resulted in a live birth and the remaining eight per cent resulted in foetal wastage (abortion, miscarriage and childbirth as per the report).

  7. The contraceptive prevalence rate (CPR) among married women significantly increased between NFHS-4 (46.7 per cent) and NFHS-5 (69 per cent). The use of contraceptive methods was higher in rural areas (77 per cent) compared to urban areas (56 per cent), the report notes.

  8. As recorded in NFHS-5, the infant mortality rate in Sikkim was estimated to be at 11.2 deaths (before the age of one year) per 1,000 live births, a considerable decrease from the 29.5 deaths recorded in NFHS-4. The under-five mortality rate also decreased from 32.2 deaths (before the age of five years) per 1,000 live births in NFHS-4 to 11.2 deaths in NFHS-5.

  9. In the five years preceding the survey, 94.7 per cent of births in Sikkim took place in health facilities while the remaining 5.3 per cent took place at home. Of the total births, 96.5 per cent of the births were assisted by a skilled provider (a doctor, an auxiliary nurse midwife or a lady health visitor) and around two per cent were delivered by a traditional birth attendant.

  10. According to the survey conducted, 80.6 per cent of the children aged 12 to 23 months had received all basic vaccinations against major diseases which include tuberculosis, diphtheria, pertussis, tetanus, polio and measles. Only around three per cent of children in this age group had not received any vaccinations at all.

  11. Among children under five years of age, the percentage of those who were stunted (too short for their age) reduced from 30 per cent to 22 per cent between NFHS-4 and NFHS-5. Further, 56 per cent of children (aged 6-59 months) were also recorded to be suffering from anaemia.

  12. The report notes that 41 per cent of women and men in Sikkim were either too thin or overweight or obese. Anaemia was recorded as a major health problem in the state with about 42 per cent of women and 19 per cent of men in the state recorded as anaemic.

  13. Overall, 25.7 per cent of households in Sikkim had some kind of health insurance or financing scheme that covered at least one member of the household. Insurance coverage was higher in urban areas (22 per cent) than in rural areas (21.6 per cent).

  14. A significant percentage of women (95.9 per cent) and men (97.7 per cent) had heard of HIV/AIDS. However, only 23.9 per cent women and 18.5 per cent men (aged 15-49 years) had comprehensive knowledge of HIV/AIDS.

  15. In Sikkim, 86.3 per cent of women aged 15 to 24 years used hygienic methods of menstrual protection. Roughly 81 per cent using sanitary napkins, 24 per cent using cloth, and 0.9 per cent using tampons.

  16. In the 12 months preceding the survey, 72.6 per cent of men and 38.9 per cent women (aged 15-49 years) were employed. Also, as per the report, around 76.4 per cent of the women in Sikkim have their own bank and savings accounts which they themselves use.

  17. In the state, around 14 per cent of women (aged 18-49 years) reported having experienced either physical or sexual violence and four per cent had experienced both. Of the women who had experienced such violence, only 11 percent sought help.

    Focus and Factoids by Anushka Mukherjee.


    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: Laxmi Kant Dwivedi, Sarang Pedgaonkar, Hemkhothang Lhungdim and Akash N. Wankhede


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


Mar, 2021