Estimation of district level TFR of eight EAG states and Assam from NFHS-4, 2015-16

TFR estimates the average number of children a woman will have during her reproductive lifespan. The TFR for selected districts and states in India was estimated based on age-specific fertility rates 36 months prior to the survey and birth histories of married women (aged 15-49) from the National Family Health Survey-4 (NFHS-4) conducted in 2015-16. The NFHS-4 data was used to calculate TFRs for the eight Empowered Action Group (EAG) states and Assam. The EAG states are a group of eight states in India that have been identified as having high fertility rates and are a priority for family planning interventions. The TFR estimates were calculated using a method that takes into account the age-specific fertility rates and birth histories of married women. The results of the TFR estimates showed a significant range in fertility rates within states. In Uttar Pradesh, for example, the TFR ranged from 1.58 in Lucknow to 4.4 in Shrawasti. In contrast, the smallest range in TFR variations was seen in Uttarakhand, where the TFR ranged from 1.49 in Dehradun to 2.78 in Haridwar. Many districts in the nine states have a TFR below replacement level, with the exception of Bihar, where the lowest district-level TFR was in Gopalganj, with a rate of 2.55. The use of NFHS-4 data to estimate district-level TFRs has several implications for family planning programs. The estimates can inform government flagship programs, such as Mission Parivar Vikas, which aims to improve contraceptive use in the EAG states. The TFR estimates can also be used to inform the Aspirational Districts Program, which aims to reduce disparities in Human Development Indices among 115 districts. The results of the TFR estimates highlight the need for targeted family planning interventions in districts with high fertility rates and low contraceptive use. The use of NFHS-4 data to estimate district-level TFRs also has implications for the decentralization of data access and action around family planning. Publishing district-level estimates of TFR in future NFHS rounds can facilitate decentralized data access and action around family planning. This can help to ensure that family planning programs are tailored to the specific needs of each district and can be more effective in reducing unintended pregnancies and improving reproductive health outcomes.