National Family Health Survey-6 (2023–24): Progress, Persistent Gaps and Emerging Public Health Challenges in India-Implications for Sustainable Development Goals and the One Health Framework

Abstract

Background: The National Family Health Survey (NFHS) is India’s largest source of population, health, and nutrition data. NFHS-6 (2023–24) provides an opportunity to assess progress since NFHS-5 (2019–21) and evaluate India’s trajectory toward Sustainable Development Goals (SDGs).Objective: To review key findings of NFHS-6, compare them with NFHS-5, and examine their public health implications through a One Health perspective. Methods: A narrative review of India Fact Sheet data from NFHS-5 and NFHS-6 was conducted. Major indicators related to demographic transition, reproductive health, maternal and child health, immunization, and non-communicable diseases (NCDs) were analyzed.Results: NFHS-6 showed improvements in maternal and child health indicators, including first-trimester antenatal registration (70.0% to 76.2%), four or more antenatal visits (58.5% to 65.2%), institutional deliveries (88.6% to 90.6%), and full immunization coverage (76.6% to 82.6%). Child marriage declined from 23.3% to 20.1%. However, overweight, obesity, diabetes, and hypertension increased substantially. Conclusion: NFHS-6 reflects notable public health gains but highlights persistent nutritional challenges and a growing NCD burden, underscoring the need for integrated multisectoral strategies aligned with the One Health framework.