NFHS-6: Women Empowerment Is Rising—But Their Health Data Tell a Different Story

Almost 30.7% of women aged 15-49 are now overweight or obese—up from 24% in the last survey.

Empowerment, as NFHS measures it, has not translated into the dietary, physical activity, or healthcare environments that protect metabolic health, writes Urvashi Prasad.

(Photo: iStock/Altered by The Quint)

The picture of Indian women that emerges from National Family Health Survey-6 (NFHS-6) is, in several ways, genuinely remarkable. Nearly two in three women aged 15-49 have used the internet—a figure that has nearly doubled from 33.3 percent to 64.3 percent since the fifth edition of the survey.

In Bihar, where internet use among women stood at just 20.6 percent four years ago, it has risen to 58.4 percent—nearly tripling in a single survey cycle. Bank account ownership among women is at 89 percent. Spousal violence has declined from 29.2 percent to 22.3 percent nationally. Child marriage is down from 23.3 percent to 20.1 percent.

These are not marginal improvements. They represent shifts in access, agency, and institutional protection that compound across generations. They deserve acknowledgement—and they are getting it, prominently, in the government's communication around NFHS-6.

What is getting less attention is the health data for the same women.

Behind the Empowerment Numbers

Almost 30.7 percent of women aged 15-49 are now overweight or obese—up from 24 percent in NFHS-5. In urban areas, the figure is 42.8 percent. Women's obesity has overtaken men's, which stands at 27.3 percent. High blood sugar has risen from 13.5 percent to 17.8 percent.

These are women in the same age bracket as the empowerment gains. More connected, better educated, less exposed to violence—and metabolically more at risk than their predecessors. Empowerment, as NFHS measures it, has not translated into the dietary, physical activity, or healthcare environments that protect metabolic health.

The state-level data reveals a paradox that the national figures obscure. Kerala, which leads India on nearly every social and health indicator, now has 46.7 percent of its women aged 15-49 overweight or obese, among the highest rates in the country alongside Andhra Pradesh at 47.9 percent and Tamil Nadu at 44.2 percent. The same urbanisation, education, and economic development that produced these states' social progress has produced their NCD (non-communicable diseases) crisis.

A woman with a postgraduate degree in Thiruvananthapuram and a woman with no schooling in rural Bihar face the same epidemic—just at different rates and through different pathways. The national policy response has not caught up with either.

The Persistence of Violence

Nationally, spousal violence has fallen. In Bihar, it remains at 36.1 percent—over one in three married women—down from 40.1 percent but still among the highest in the country. In Uttar Pradesh, 28.5 percent of ever-married women have experienced spousal violence.

Kerala presents a counterintuitive finding: spousal violence appears to have risen from 9.8 percent to 17.7 percent. This finding requires careful interpretation. One possibility is better disclosure—more empowered, more educated women may be more willing to name and report abuse rather than normalise it, producing a higher measured rate without a genuine increase in violence. Another possibility is that the figure reflects a real change in household dynamics as economic and social pressures have intensified.

NFHS-6 cannot tell us which explanation holds. What it does tell us is that a declining national average and a rising figure in a leading state should not be read as simple evidence of uniform progress. The violence that gets counted is not the same as the violence that exists—and both the counting and the existence deserve scrutiny.

Nationally, Bihar's child marriage rate—34.6 percent, meaning over 1 in 3 women aged 20-24 were married before 18—is the starkest marker of the distance between progress and persistence. The national figure of 20.1 percent is encouraging. The Bihar figure makes clear that national averages conceal states where a girl's childhood is still, routinely, cut short.

The Breastfeeding Decline

NFHS-6 shows that 19.7 percent of women aged 15-49 remain underweight—a figure that has edged upward since NFHS-5. India's women carry both ends of the nutrition crisis simultaneously.

Nearly one in three is overweight or obese; one in five is underweight. These are not the same women, but they share a health system that has no systematic protocol for either group beyond the reproductive years. A woman is carefully tracked through her pregnancy. Once she leaves the maternity ward, she largely disappears from systematic health contact.

The government's press release celebrated breastfeeding within one hour of birth, up from 41.8 percent to 50.1 percent. What it did not mention: exclusive breastfeeding among children under six months has declined nationally from 63.7 percent to 55.8 percent—nearly eight percentage points in four years. In Uttar Pradesh, the figure has fallen to 34.6 percent. In India's most populous state, just over one in three infants under six months is being exclusively breastfed—well below the national average, and well below what the evidence says they need.

This matters for women as much as for children. Exclusive breastfeeding is protective against breast and ovarian cancer, and supports better postpartum metabolic outcomes for mothers. Its national decline, and the depth of that decline in India's largest state, is a signal that the postnatal support environment is failing.

NFHS-5 showed 57 percent of women aged 15-49 were anaemic—a figure that had risen from 53 percent in NFHS-4 despite the existence of the Anaemia Mukt Bharat programme since 2018. NFHS-6 does not measure anaemia. The official reason is methodological. The effect is that the indicator most disproportionately affecting women—the one on which the government's flagship nutrition programme was most visibly failing—has no report card in the survey designed to track women's health.

What NFHS-6 Reveals

NFHS-6 shows Indian women making genuine, measurable gains in access and agency. But the same survey shows women's metabolic health deteriorating, breastfeeding declining, anaemia unmeasured, and within-state disparities that reduce national averages to political consolation. A health policy that celebrates the empowerment gains without building infrastructure for the health crisis that accompanies them is not a women's health policy. It is half of one.

(Urvashi Prasad is Former Director, NITI Aayog and Senior Fellow at Pahle India Foundation. She can be reached at @urvashi01. This is an opinion piece. The views expressed above are the author’s own. The Quint neither endorses nor is responsible for them.)