Karnataka records gains in maternal and child health, but nutrition remains a concern: NFHS-6

Karnataka has registered improvements across several key maternal and child health indicators over the past five years, with higher antenatal care coverage, institutional deliveries, skilled birth attendance and immunisation rates, according to the National Family Health Survey-6 (NFHS-6), 2023-24.

At the same time, the survey indicates that child malnutrition continues to pose a challenge, even though some nutrition indicators have improved compared with that of the NFHS-5 (2019-21).

The State recorded near-universal institutional deliveries, with 98.7% of births taking place in health facilities, up from 97% in NFHS-5. Deliveries attended by skilled health personnel increased to 96.6% from 93.8%.

Gains in maternal health

Maternal healthcare coverage also showed improvement. The proportion of women receiving antenatal care during the first trimester rose from 71% to 82.4%, while the proportion of mothers receiving at least four antenatal check-ups increased from 70.9% to 84.5%.

Maternal nutrition indicators registered substantial gains. The percentage of pregnant women who consumed iron and folic acid tablets for at least 100 days nearly doubled from 44.7% in NFHS-5 to 78.0% in NFHS-6. Similarly, the proportion consuming supplements for at least 180 days increased from 26.7% to 66.4%.

The survey also showed high coverage of maternal health services, with 97.6% of registered pregnancies receiving a mother and child protection card and 95.9% of mothers protected against neonatal tetanus.

C-sections rise

One of the notable findings of the survey is the considerable rise in caesarean section deliveries. Overall, 45.7% of births in Karnataka were delivered through caesarean section, up from 31.5% in NFHS-5.

The rate was considerably higher in urban areas, where 52.6% of births were delivered through C-section, compared with 40.2% in rural areas. Caesarean deliveries accounted for 63.8% of births in private hospitals, against 34% in public health facilities.

Exclusive breastfeeding among infants below six months improved marginally from 61% in NFHS-5 to 61.6% in NFHS-6.

Immunisation coverage

Child health indicators showed encouraging progress. Full immunisation coverage among children aged 12-23 months increased from 84.3% in NFHS-5 to 90.2% in NFHS-6. Coverage of individual vaccines also remained high, with 95.6% of children receiving a measles-containing vaccine and 79.4% receiving the second dose of the vaccine.

Rajani B.N., State Project Director, Reproductive and Child Health (RCH), said regular reviews and close monitoring are crucial to improving immunisation coverage. “We have been consistently reviewing data through the Health Management Information System (HMIS) and following up on cases that require attention. Every child must be tracked to ensure completion of the vaccination schedule, including follow-up doses after birth and at subsequent stages,” she said.

Pointing out that monitoring mechanisms at the micro level is particularly important, especially in reaching children in hard-to-reach and vulnerable areas, Dr. Rajani said sustained follow-up by health staff has helped improve coverage over time. “Even when vaccinations are delayed, it is better that children receive them late rather than miss them altogether. The focus should be on ensuring that no eligible child is left out of the immunisation programme,” she said. 

Nutrition concerns

Nutrition indicators presented a mixed picture. The prevalence of stunting — low height for age — among children under five years declined significantly from 35.4% in NFHS-5 to 26.5% in NFHS-6, indicating a reduction in chronic undernutrition. The proportion of underweight children also fell from 32.9% to 27.8%.

Wasting among children under five, an indicator of acute undernutrition, declined only marginally from 19.5% to 18.7%, suggesting that acute malnutrition continues to remain a public health concern.

Feeding practices among young children continued to require attention. Only 14.2% of children aged six to 23 months received an adequate diet, although this was an improvement from 10.6% recorded in NFHS-5. The proportion receiving a minimum acceptable diet increased from 12.4% to 18.3%.